code_type,code,description,gross_charge,discounted_cash,min_negotiated,max_negotiated,payer_entries
,,Administered intravenously,,,,,0
,,Administered subcutaneously,,,,,0
,,Colorectal cancer screening test; converted to diagnostic test or other procedure,,,,,0
,,Distinct Procedural Service,,,,,0
,,Drug amount discarded/not administered to any patient,,,,,0
,,Drug or biological acquired with 340b drug pricing program discount,,,,,0
,,Erythropoetic stimulating agent (esa) administered to treat anemia due to anti-cancer chemotherapy,,,,,0
,,Erythropoetic stimulating agent (esa) administered to treat anemia not due to anti-cancer radiotherapy or anti-cancer chemotherapy,,,,,0
,,Investigational clinical service provided in a clinical research study that is in an approved clinical research study,,,,,0
,,Item or service expected to be denied as not reasonable and necessary,,,,,0
,,Item or service furnished to an esrd patient that is not for the treatment of esrd,,,,,0
,,"Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit",,,,,0
,,Left side (used to identify procedures performed on the left side of the body),,,,,0
,,Medical supervision by a physician: more than four concurrent anesthesia procedures,,,,,0
,,Modifier description not available,,,,,0
,,Performance Measure Exclusion Modifier due to Medical Reasons,,,,,0
,,"Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery",,,,,0
,,Positron emission tomography (pet) or pet/computed tomography (ct) to inform the initial treatment strategy of tumors that are biopsy proven or strongly suspected of being cancerous based on other dia,,,,,0
,,Positron emission tomography (pet) or pet/computed tomography (ct) to inform the subsequent treatment strategy of cancerous tumors when the beneficiary's treating physician determines that the pet stu,,,,,0
,,Professional Component,,,,,0
,,Progressive addition lenses,,,,,0
,,Reduced Services,,,,,0
,,Requirements specified in the medical policy have been met,,,,,0
,,"Separate encounter, a service that is distinct because it occurred during a separate encounter",,,,,0
,,"Separate structure, a service that is distinct because it was performed on a separate organ/structure",,,,,0
,,"Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the same day of the Procedure or Other Service",,,,,0
,,Skin substitute used as a graft,,,,,0
,,"Technical Component; represents the costs of equipment, supplies, and technician personnel for a procedure, excluding the physician's interpretation. It is used when only the technical portion of a te",,,,,0
,,"Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service",,,,,0
,,"Waiver of liability statement issued as required by payer policy, individual case",,,,,0
,,Zero drug amount discarded/not administered to any patient,,,,,0
APC,1506,New Technology - Level 6 ($401 - $500),,,,,0
APC,2040,"Endo, single, urinary tract",,,,,0
APC,2044,"Ret dev, laser, ivc filter",,,,,0
APC,2050,Cath coronary drug-delivery,,,,,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,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,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,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,5212,Level 2 Electrophysiologic Procedures,,,,,0
APC,5213,Level 3 Electrophysiologic 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,5243,Level 3 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,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,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,5464,Level 4 Neurostimulator and Related Procedures,,,,,0
APC,5465,Level 5 Neurostimulator and Related Procedures,,,,,0
APC,5501,"Level 1 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,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,5743,Level 3 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,5871,Dental Procedures,,,,,0
APC,764,Ketorolac tromethamine inj,,,,,0
APC,792,"Inj, glycopyrrolate, 0.1 mg",,,,,0
APC,9282,"Inj, acetaminophen (hikma)",,,,,0
APC,9290,"Inj, bupivacaine, nos, 0.5mg",,,,,0
APC,9512,RBC leukocytes reduced,,,,,0
APC,9522,RBC leukoreduced irradiated,,,,,0
APC,9530,Plate pheres leukoredu irrad,,,,,0
APC,N800,Clinical Diagnostic Lab Services,,,,,0
APC,N801,Therapy 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
CDM,1,"DUMMY EAP FOR NSA - SUPPLIES  - $1,000 INCREMENT",1000.0,700.0,,,0
CDM,10528,DEXRAZOXANE 500 MG IV SOLR,1906.5,1334.55,,,0
CDM,10784,"DIPHTH,PERTUS(ACELL),TETANUS SYRG (INFANRIX) 25 LF UNIT-58MCG-10 LF/0.5ML IM SYRINGE",343.0,240.1,,,0
CDM,10879,GEMCITABINE 1 GRAM IV SOLR,259.0,181.3,,,0
CDM,10879,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) IV SOLN,196.5,137.55,,,0
CDM,10879,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) BLADDER INSTILLATION,314.0,219.8,,,0
CDM,10880,IRINOTECAN 100 MG/5 ML IV SOLN,202.0,141.4,,,0
CDM,11021,RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML IM SOLN,6262.0,4383.4,,,0
CDM,11029,"VARICELLA-ZOSTER GE VAC,2 OF 2 50 MCG IM SUSR",763.0,534.1,,,0
CDM,11031,FLU VACCINE TS 2024-25 65 YR UP (PF) 180 MCG/0.5 ML IM SYRG,373.0,261.1,,,0
CDM,11031,FLU VACCINE TS 2024-25 6MOS UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,121.0,84.7,,,0
CDM,11031,HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX (PF) 10 MCG IM,76.0,53.2,,,0
CDM,11031,"HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM SYRG",1089.0,762.3,,,0
CDM,11031,PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG,955.0,668.5,,,0
CDM,11031,PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML INJ SYRG,506.0,354.2,,,0
CDM,11032,HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX (PF) 10 MCG IM,76.0,53.2,,,0
CDM,11032,HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML IM SYRINGE,353.0,247.1,,,0
CDM,11032,POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML INJ SUSP,118.0,82.6,,,0
CDM,11039,HEPATITIS A VIRUS VACCINE (PF) 1440 ELISA UNIT/ML IM SYRG,396.5,277.54999999999995,,,0
CDM,11040,HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML IM MERGE (CAM USE ONLY),231.0,161.7,,,0
CDM,11040,HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML IM SYRG,228.0,159.6,,,0
CDM,11040,HEPATITIS A VIRUS VACCINE (PF) 720 EL UNIT/0.5 ML IM SYRG,229.0,160.3,,,0
CDM,11042,HEPATITIS A & B VIRUS VACCINE (PF) 720 ELISA UNIT-20 MCG/ML IM SYRINGE,558.5,390.95,,,0
CDM,11045,HAEMOPH B POLYSAC CONJ-MENING (PF) 7.5 MCG/0.5 ML IM,181.5,127.05000000000001,,,0
CDM,11046,HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX (PF) 10 MCG IM,76.0,53.2,,,0
CDM,11050,FLU VACC TV LIVE 2025(2-49YRS) 10EXP6.5-7.5 FF UNIT/0.2 ML NASL NSSY,153.0,107.1,,,0
CDM,11053,"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM KIT",1200.0,840.0,,,0
CDM,11053,"RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT IM",1281.5,897.05,,,0
CDM,11055,"ROTAVIRUS VACCINE LIVE, PENTA 2 ML ORAL SUSP",435.5,304.85,,,0
CDM,11057,TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML IM SYRG,649.5,454.65,,,0
CDM,11439,TRASTUZUMAB 150 MG IV SOLR,17205.0,12043.5,,,0
CDM,11467,DIPHENHYDRAMINE 50 MG CAP,7.0,4.9,,,0
CDM,11468,PROCHLORPERAZINE MALEATE 10 MG ORAL TAB,10.0,7.0,,,0
CDM,11481,HYDROXYZINE 25 MG TAB,7.0,4.9,,,0
CDM,11500001,HC ROOM&CARE HOSPICE,1163.0,814.1,,,0
CDM,11799,HEP B-DP(ACELL)T-POLIO VACC-PF 10MCG-25LF-25MCG-10LF-40-8-32 IM SYRING,433.0,303.1,,,0
CDM,12000001,HC ROOM&CARE ACUTE,1198.0,838.6,,,0
CDM,12000004,HC ROOM&CARE SNF SEMI,847.0,592.9,,,0
CDM,12000008,HC ROOM & CARE ACUTE HOSPITAL AT HOME,1198.0,838.6,,,0
CDM,12000009,HC ROOM & CARE ACUTE HOSPICE HOUSE,1163.0,814.1,,,0
CDM,12300001,HC ROOM&CARE ACUTE PEDS,1198.0,838.6,,,0
CDM,12400001,HC ROOM&CARE BEHAVIORAL,1961.0,1372.7,,,0
CDM,12612,IRON DEXTRAN 50 MG/ML INJ SOLN,209.0,146.3,,,0
CDM,12614,PIPERACILLIN-TAZOBACTAM  3.375 GRAM IV SOLR,37.0,25.9,,,0
CDM,12619,ALTEPLASE 2 MG INJ SOLR,781.0,546.7,,,0
CDM,12675,ONDANSETRON 8 MG ORAL TBDL,182.0,127.4,,,0
CDM,12675,ONDANSETRON HCL 4 MG/5 ML ORAL SOLN,75.0,52.5,,,0
CDM,15298,ADJUVANT AS01B (PF)VIAL 1 OF 2 IM SUSP,763.0,534.1,,,0
CDM,15298,"VARICELLA-ZOSTER GE VAC,2 OF 2 50 MCG IM SUSR",809.0,566.3,,,0
CDM,15298,VARICELLA-ZOSTER GE-AS01B (PF) 50 MCG/0.5 ML IM SUSR,763.0,534.1,,,0
CDM,15298,VARICELLA-ZOSTER GE-AS01B (PF) 50 MCG/0.5 ML IM SUSR (CAM USE ONLY),855.0,598.5,,,0
CDM,15541,"LIDOCAINE-EPINEPHRINE 2 %-1:200,000 INJ SOLN",19.0,13.3,,,0
CDM,15542,"LIDOCAINE-EPINEPHRINE 2 %-1:200,000 INJ SOLN",19.0,13.3,,,0
CDM,15921,INSULIN GLARGINE 100 UNIT/ML SUBQ SOLN (LANTUS/SEMGLEE) (MERGE),16.0,11.2,,,0
CDM,15921,INSULIN LISPRO 100 UNIT/ML SUBQ SOLN (HUMALOG/ADMELOG),16.0,11.2,,,0
CDM,15921,INSULIN REGULAR HUMAN 100 UNIT/ML INJ SOLN,16.0,11.2,,,0
CDM,16197,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,24.0,16.799999999999997,,,0
CDM,16206,"OCTREOTIDE,MICROSPHERES 10 MG IM SERR",9725.0,6807.5,,,0
CDM,16206,"OCTREOTIDE,MICROSPHERES 20 MG IM SERR",19112.0,13378.4,,,0
CDM,16206,"OCTREOTIDE,MICROSPHERES 30 MG IM SERR",12720.0,8904.0,,,0
CDM,16327,THIAMINE 100 MG/ML INJECTION,30.0,21.0,,,0
CDM,16544,"MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM KIT",680.0,476.0,,,0
CDM,16544,"MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM KIT (CAM USE ONLY)",680.0,476.0,,,0
CDM,16544,"MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM SOLN",700.0,490.0,,,0
CDM,16544,"MENINGOC VAC A,C,Y,W-135 DIP (PF) 4 MCG/0.5 ML IM",612.0,428.4,,,0
CDM,16900001,HC ROOM & CARE CHILD AWAIT PLACEMENT,2197.0,1537.9,,,0
CDM,17100001,HC ROOM & CARE NURSERY,1440.0,1008.0,,,0
CDM,17200001,HC ROOM&CARE EXT NURSERY,2551.0,1785.7,,,0
CDM,17300001,HC ROOM&CARE SAC NURSERY,3350.0,2345.0,,,0
CDM,17400001,HC ROOM&CARE NIC,4752.0,3326.4,,,0
CDM,19464,INSULIN REGULAR HUMAN 100 UNIT/ML INJ SOLN,16.0,11.2,,,0
CDM,19534,EPOETIN ALFA 20000 UNIT/ML INJ SOLN,587.0,410.9,,,0
CDM,19534,EPOETIN ALFA 40000 UNIT/ML INJ SOLN,2951.0,2065.7,,,0
CDM,19537,"DIPH,PERTUS(ACEL),TET,POLIO(PF)(KINRIX) 25 LF-58 MCG-10 LF/0.5 ML IM SYRINGE",318.0,222.6,,,0
CDM,19537,"DIPHTH,PERTUS(ACELL),TETANUS SYRG (INFANRIX) 25 LF UNIT-58MCG-10 LF/0.5ML IM SYRINGE",257.5,180.25,,,0
CDM,19537,"DIPHTH,PERTUS(ACELL),TETANUS SYRG(BOOSTRIX) 2.5-8-5 LF-MCG-LF/0.5ML IM SYRG",243.5,170.45,,,0
CDM,19537,"DIPHTH,PERTUS(ACELL),TETANUS VIAL (ADACEL) 2 LF-(5-3-5MCG)-5 LF/0.5 ML IM SUSP",249.0,174.3,,,0
CDM,19537,"DIPHTH,PERTUS(ACELL),TETANUS VIAL (BOOSTRIX*) 2.5-8-5 LF-MCG-LF/0.5ML IM SUSP",240.0,168.0,,,0
CDM,19694,DARBEPOETIN ALFA IN POLYSORBAT  40 MCG/0.4 ML INJ SYRG,1096.0,767.2,,,0
CDM,19694,DARBEPOETIN ALFA IN POLYSORBAT  60 MCG/0.3 ML INJ SYRG,1282.0,897.4,,,0
CDM,19694,DARBEPOETIN ALFA IN POLYSORBAT 100 MCG/0.5 ML INJ SYRG,669.5,468.65,,,0
CDM,19694,DARBEPOETIN ALFA IN POLYSORBAT 200 MCG/0.4 ML INJ SYRG,3205.0,2243.5,,,0
CDM,19694,DARBEPOETIN ALFA IN POLYSORBAT 25 MCG/0.42 ML INJ SYRG,2007.0,1404.9,,,0
CDM,19694,DARBEPOETIN ALFA IN POLYSORBAT 300 MCG/0.6 ML INJ SYRG,5500.5,3850.3500000000004,,,0
CDM,19694,DARBEPOETIN ALFA IN POLYSORBAT 500 MCG/ML INJ SYRG,8545.0,5981.5,,,0
CDM,19798,METHACHOLINE CHLORIDE STERILE INHALATION SOLUTION (PF) KIT,2145.5,1501.8500000000001,,,0
CDM,2,DUMMY EAP FOR NSA - SUPPLIES  - $500 INCREMENT,500.0,350.0,,,0
CDM,20000002,HC ROOM&CARE INTENSIVE,3953.0,2767.1,,,0
CDM,20300001,HC ROOM&CARE PEDS INTENSIVE,3953.0,2767.1,,,0
CDM,20600001,HC ROOM & CARE PROGRESSIVE,2786.0,1950.2,,,0
CDM,21000001,HC ROOM & CARE CORONARY CARE,3953.0,2767.1,,,0
CDM,21463,FLU VACCINE TS 2024-25 6MOS UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,116.0,81.2,,,0
CDM,21466,FLU VACCINE TS 2024-25 65 YR UP (PF) 180 MCG/0.5 ML IM SYRG,373.0,261.1,,,0
CDM,21466,FLU VACCINE TS 2024-25 6MOS UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,121.0,84.7,,,0
CDM,21466,FLU VACCINE TS 2025-26 6 MO UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,122.0,85.4,,,0
CDM,21630,SODIUM HYALURONATE (VISCOSUP) 10 MG/ML IATC SYRG,672.0,470.4,,,0
CDM,21632,SODIUM HYALURONATE 30 MG/2 ML IATC SYRG,1320.0,924.0,,,0
CDM,21732,DEXAMETHASONE 4 MG ORAL TAB,21.0,14.7,,,0
CDM,21814,LIDOCAINE HCL  2 % MM JELP,47.0,32.9,,,0
CDM,21899,"ROTAVIRUS VAC,LIVE ATT, 89-12 STRAIN G1P(8) 10EXP6 CCID50/ML ORAL SUSP",953.0,667.1,,,0
CDM,21899,"ROTAVIRUS VACCINE LIVE, PENTA 2 ML ORAL SUSP",427.0,298.9,,,0
CDM,21899,"ROTAVIRUS VACCINE, LIVE, 89-12 10EXP6 CCID50 /1.5 ML ORAL SUSP",511.5,358.05,,,0
CDM,22000001,HC HUMAN BREAST MILK PROCESSING STORAGE/DISTRIBUTION ONLY,22.0,15.4,,,0
CDM,22574,PALIPERIDONE PALMITATE 117 MG/0.75 ML IM SYRG,4926.0,3448.2,,,0
CDM,22574,PALIPERIDONE PALMITATE 156 MG/ML IM SYRG,6568.0,4597.6,,,0
CDM,22574,PALIPERIDONE PALMITATE 234 MG/1.5 ML IM SYRG,9851.0,6895.7,,,0
CDM,22574,PALIPERIDONE PALMITATE 39 MG/0.25 ML IM SYRG,1642.0,1149.4,,,0
CDM,22574,PALIPERIDONE PALMITATE 78 MG/0.5 ML IM SYRG,3284.0,2298.8,,,0
CDM,22614,ROMIPLOSTIM 125 MCG SUBQ SOLR,2155.0,1508.5,,,0
CDM,22614,ROMIPLOSTIM 250 MCG SUBQ SOLR,3512.0,2458.4,,,0
CDM,22614,ROMIPLOSTIM 500 MCG SUBQ SOLR,6146.0,4302.2,,,0
CDM,22666,BEVACIZUMAB 25 MG/ML IV SOLN,7009.0,4906.3,,,0
CDM,22762,IPILIMUMAB 200 MG/40 ML (5 MG/ML) IV SOLN,69955.5,48968.850000000006,,,0
CDM,22762,IPILIMUMAB 50 MG/10 ML (5 MG/ML) IV SOLN,18655.0,13058.5,,,0
CDM,22974,NALTREXONE MICROSPHERES 380 MG IM SERR,4666.0,3266.2,,,0
CDM,23523,DEGARELIX 120 MG SUBQ SOLR,3155.5,2208.85,,,0
CDM,23523,DEGARELIX 80 MG SUBQ SOLR,1348.5,943.95,,,0
CDM,23955,DOCETAXEL 160 MG/16 ML (10 MG/ML) IV SOLN,869.0,608.3,,,0
CDM,23955,DOCETAXEL 160 MG/16 ML (10 MG/ML) IV SOLN- NONSTANDARD DOSING,362.5,253.75,,,0
CDM,24760,DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBQ SOLN,9295.0,6506.5,,,0
CDM,24760,DENOSUMAB 60 MG/ML SUBQ SYRG,5053.5,3537.45,,,0
CDM,24951,"MENING VAC A,C,Y,W135,TET (PF) 10 MCG/0.5 ML IM SOLN",732.0,512.4,,,0
CDM,25000000,HC PROLACTA 4 CAL 10ML,284.0,198.8,,,0
CDM,25000005,HC PROLACTA 4 CAL 20ML,426.0,298.2,,,0
CDM,25000006,HC PROLACTA 6 CAL 30ML,638.0,446.6,,,0
CDM,25000007,HC PROLACTA 8 CAL 40 ML,851.0,595.7,,,0
CDM,25000008,HC PROLACTA CR 10 ML,205.0,143.5,,,0
CDM,25000009,HC NC OCREVUS (OCRELIZUMAB 300MG VIAL),0.01,0.007,,,0
CDM,25000010,HC PROLACT RTF 24 100ML,508.0,355.6,,,0
CDM,25000011,HC PROLACT RTF 26 100 ML,725.0,507.5,,,0
CDM,25000012,HC PROLACT RTF 28 100ML,943.0,660.1,,,0
CDM,25000013,HC NC DUPIXENT (DUPILUMAB),0.01,0.007,,,0
CDM,25050,"RITUXIMAB-HYALURONIDASE,HUMAN 1400 MG/11.7 ML (120 MG/ML) SUBQ SOLN",13985.0,9789.5,,,0
CDM,25073,DURVALUMAB 50 MG/ML IV SOLN,9602.0,6721.4,,,0
CDM,25138,PALONOSETRON 0.25 MG/5 ML IV INJECTION (MERGE),206.0,144.2,,,0
CDM,25148,FULVESTRANT 250 MG/5 ML IM SYRG,4591.0,3213.7,,,0
CDM,25167,FOSAPREPITANT 150 MG IV SOLR,1089.5,762.65,,,0
CDM,25339,EMICIZUMAB-KXWH 105 MG/0.7 ML SUBQ SOLN,45550.0,31885.0,,,0
CDM,25339,EMICIZUMAB-KXWH 150 MG/ML SUBQ SOLN,67574.0,47301.8,,,0
CDM,25339,EMICIZUMAB-KXWH 300 MG/2 ML (150 MG/ML) SUBQ SOLN,100109.0,70076.3,,,0
CDM,25538,LEVONORGESTREL 17.5 MCG/24 HR (5 YEARS) IU IUD,3763.5,2634.45,,,0
CDM,25730,LEVONORGESTREL 14 MCG/24 HOUR (3 YEARS) IU IUD,1973.0,1381.1,,,0
CDM,26000001,HC IV INFUSION HYDRAT 31-60 MIN,599.0,419.3,,,0
CDM,26000002,IV INFUSION HYDRAT EA ADDL HOUR,292.0,204.4,,,0
CDM,26000003,IV THER/PROPHY/DX INITIAL HOUR,599.0,419.3,,,0
CDM,26000004,IV THER/PROPHY/DX EA ADDL HOUR,214.0,149.8,,,0
CDM,26000005,IV THER/PROPHY/DX ADD NEW RX,600.0,420.0,,,0
CDM,26000006,IV CONCURR ADD-ON,599.0,419.3,,,0
CDM,26000007,INJ THER/PROPHY/DX IM SUBQ,107.0,74.9,,,0
CDM,26000008,INJ THER/PROPHY/DX IV PUSH 1ST,453.0,317.1,,,0
CDM,26000009,INJ THER/PRO/DX IV NEW DRUG,207.0,144.9,,,0
CDM,26000010,HC INJ THER/PRO/DX SAME DRUG 2ND,296.0,207.2,,,0
CDM,26000012,HC SUBQ INFUSION THERAPY/PROPHYLAXIS INITIAL  UP TO 1 HR,630.0,441.0,,,0
CDM,26000013,HC SUBQ INFUSION THERAPY/PROPHYLAXIS ADDTL PUMP SET-UP NEW SITE,208.0,145.6,,,0
CDM,26000014,HC SUBQ INFUSION THERAPY/PROPHYLAXIS EA ADDTL HOUR,172.0,120.4,,,0
CDM,27000001,HC PER DIEM SUPPLY ACUTE ROOM & CARE,16.0,11.2,,,0
CDM,27000002,HC PER DIEM SUPPLY SPECIAL ACUTE CARE,15.0,10.5,,,0
CDM,27000003,HC PER DIEM SUPPLY INTENSIVE CARE,58.0,40.6,,,0
CDM,27000004,HC PER DIEM SUPPLY CORONARY CARE,63.0,44.1,,,0
CDM,27000005,HC PER DIEM SUPPLY EXTENDED NURSERY,9.0,6.3,,,0
CDM,27000006,HC PER DIEM SUPPLY NURSERY,9.0,6.3,,,0
CDM,27000007,HC PER DIEM SUPPLY OBSERVATION,16.0,11.2,,,0
CDM,27000008,HC AVAMAX PLUS BONE CEMENT DELIVERY SYSTEM,2164.0,1514.8,,,0
CDM,27000009,HC AVAMAX VERTEBRAL BALLOON TRAY,4659.0,3261.3,,,0
CDM,27000010,HC AVAMAX VERTEBRAL AUGMENTATION DRILL,480.0,336.0,,,0
CDM,27000011,HC NEEDLE ASPIRATION,301.0,210.7,,,0
CDM,27000012,HC SET BLADE SHAPER SPINEOLOGY,1649.0,1154.3,,,0
CDM,27000013,HC SET DILATOR SPINEOLOGY,879.0,615.3,,,0
CDM,27000014,HC SET LIVER ACCESS ROSCH-UCHIDA,999.0,699.3,,,0
CDM,27000015,HC TUBE FEEDING LOW PROFILE MIC,999.0,699.3,,,0
CDM,27000016,HC ADAPTIC DRESSINGS ALL SIZES,7.0,4.9,,,0
CDM,27000498,HC FORTEX PTA BALLOON CATH 80MM,281.0,196.7,,,0
CDM,27000499,HC RAPIDCROSS PTA BALLOON CATH 90CM,305.0,213.5,,,0
CDM,27000557,HC SET EXT SM BORE 7IN BIFUSE,16.0,11.2,,,0
CDM,27000558,HC SET EXT SM BORE TRIFUSE 4IN,44.0,30.8,,,0
CDM,27000559,HC SET EXTENSION SMLLBOR QDFUSE,21.0,14.7,,,0
CDM,27000561,HC COOK ENDOBRONCHIAL BLOCKER SET,731.0,511.7,,,0
CDM,27000562,HC PLEURX-LOCKABLE DRAINAGE KIT,132.0,92.4,,,0
CDM,27000654,HC CATH SCEPTER C BLLN,4490.0,3143.0,,,0
CDM,27000655,HC CATH SCEPTER XC BLLN,5452.0,3816.4,,,0
CDM,27000658,HC DISPOSABLE MASK SM/MED/LG,44.0,30.8,,,0
CDM,27000659,HC PORTER DISPOSABLE BREATHING CIRCUIT (6FT),160.0,112.0,,,0
CDM,27000660,HC SENSOR FORE SIGHT,504.0,352.8,,,0
CDM,27000670,"HC EEF GRASS DISPOSABLE 10MM AG/AGCL DEEP-CUP ELECTRODE 39"" WIRE",126.0,88.2,,,0
CDM,27000672,HC ESOPHAGEAL BALLOON CATHETER,261.0,182.7,,,0
CDM,27000681,HC MARKER DELIVERY KIT,506.0,354.2,,,0
CDM,27000705,HC DRESSING ALLEVYN LIFE SACRUM (SMALL) 6.75X6.875,41.0,28.7,,,0
CDM,27000706,HC DRESSING ALLEVYN LIFE SACRUM (LARGE) 8.5X9,64.0,44.8,,,0
CDM,27000707,HC SNAP CARTRIDGE 75/100/125 MM HG,489.0,342.3,,,0
CDM,27000708,HC SNAP 10X10CM DRSNG KIT W/FOAM,261.0,182.7,,,0
CDM,27000709,HC SNAP 15X15CM DRSNG KIT W/FOAM,278.0,194.6,,,0
CDM,27000710,HC SNAP 20X20CM DRSNG KIT W/FOAM,277.0,193.9,,,0
CDM,27000711,HC SNAP 14X11CM BRG DRSG KT W/FM,308.0,215.6,,,0
CDM,27000712,HC SNAP 14X34CM LONG DRSNG KIT,388.0,271.6,,,0
CDM,27000713,HC SNAP SM/MED/LG STRAP,80.0,56.0,,,0
CDM,27000714,HC CERARING 2IN SLIM,13.0,9.1,,,0
CDM,27000740,HC CONTROL BOX ENPOWER,5539.0,3877.3,,,0
CDM,27000741,HC CABLE ENPOWER CONNECTING,479.0,335.3,,,0
CDM,27000774,HC SMART GUARD,148.0,103.6,,,0
CDM,27000796,HC AEROBIKA,213.0,149.1,,,0
CDM,27000797,HC RETRACTOR ABDOMINAL PANNICULUS,293.0,205.1,,,0
CDM,27000902,HC GLIDESCOPE SPECTRUM LOPRO SZ1/SZ2,272.0,190.4,,,0
CDM,27000903,HC GLIDESCOPE SPECTRUM LOPRO SZ3/SZ4,236.0,165.2,,,0
CDM,27000961,HC CANN CAPNOLINE NASAL ETCO2,95.0,66.5,,,0
CDM,27001020,HC FEMALE EXTERNAL PUREWICK CATHETER,58.0,40.6,,,0
CDM,27001133,HC BFLEX 3.8 BRONCHOSCOPE,4732.0,3312.4,,,0
CDM,27001134,HC BFLEX 5.0 BRONCHOSCOPE,4732.0,3312.4,,,0
CDM,27001135,HC BFLEX 5.8 BRONCHOSCOPE,5454.0,3817.8,,,0
CDM,27001136,HC THERAHONEY FLEX FOAM,71.0,49.7,,,0
CDM,27001137,HC ENLUXTRA 6X6,95.0,66.5,,,0
CDM,27001184,HC COMPRESSION WRAP COBAN 2 LITE,70.0,49.0,,,0
CDM,27001185,HC COMPRESSION WRAP COBAN 2,70.0,49.0,,,0
CDM,27001186,HC COMPRESSION WRAP COBAN 2XL,70.0,49.0,,,0
CDM,27001208,HC VASHE EACH BOTTLE,98.0,68.6,,,0
CDM,27001218,HC DISPOSABLE SUCTION CUPS FOR LUCUS CPR DEVICE,427.0,298.9,,,0
CDM,27001219,HC LIFESPARC PROTEKDUO 31 FR TANDEMLIFE PROCEDURE KIT,22990.0,16093.0,,,0
CDM,27001242,HC ELBOW RESTRAINT PEDI-WRAPS SMALL,172.0,120.4,,,0
CDM,27001243,HC ELBOW RESTRAINT PEDI-WRAPS LARGE,213.0,149.1,,,0
CDM,27001261,HC SET TLAB TRNSJUG LIVER BX,1862.0,1303.4,,,0
CDM,27001270,"HC HYPODERMIC EMG NEEDLES BIONEN 25MM (1"") X THIN 30 GAUGE ORANGE",84.0,58.8,,,0
CDM,27001318,HC KT EEG DISP NON-METAL MRI/CT LEADS 3A 26LD 1M,493.0,345.1,,,0
CDM,27001324,HC MICRO G JET BUTTON 14FR FEEDING TUBE,3369.0,2358.3,,,0
CDM,27001344,HC KIT TRANSFER SYS AIRTAP LC REPOSITION STANDARD 37IN X 65IN 600LB,884.0,618.8,,,0
CDM,27001345,HC KIT SYS PREVALON AIRTAP 2XLARGE 46IN X 51IN 800LB,1047.0,732.9,,,0
CDM,27001346,HC KIT CV SAFETY 7FRX16CM PU 3-LUM,300.0,210.0,,,0
CDM,27001349,HC STRYKER SAGE PRIMO FIT MALE EXTERNAL CATHETER,131.0,91.7,,,0
CDM,27001401,HC ORTHOSIS MULTI PODUS ALL SIZES,442.0,309.4,,,0
CDM,27001418,HC SNUGGLE UPS XSMALL SMALL MED LG,73.0,51.1,,,0
CDM,27001419,HC PHILIPS SQUISHON JELL PILLOW,53.0,37.1,,,0
CDM,27001451,HC FLOTRAC SENSOR,1143.0,800.1,,,0
CDM,27001485,HC AG CUFFILL CUFF PRESSURE MANOMETER 10CC,119.0,83.3,,,0
CDM,27001511,HC STRYKER MUL-T BLANKET PEDIATRIC/ADULT,66.0,46.2,,,0
CDM,27001535,HC KIT PREVALON AIRTAP XXL PATIENT REPOSITIONING SYSTEM 43IN X 81IN 1200LB,1015.0,710.5,,,0
CDM,27001561,HC BARD INTRA-ABDOMINAL PRESSURE MONITORING KIT,207.0,144.9,,,0
CDM,27001562,HC DRESSING ALLEVYN CLASSIC NON-ADHERENT 4IN X 4IN,16.0,11.2,,,0
CDM,27001582,HC CANISTER RENASYS WITH SOLIDIFIER 800ML,173.0,121.1,,,0
CDM,27001794,HC SURGICEL FIBRILLAR ABSORBABLE HEMOSTAT 2IN X 4IN,436.0,305.2,,,0
CDM,27001796,HC STATSEAL ADVANCED PLUS 2.2 CM 24 APPLICATIONS,182.0,127.4,,,0
CDM,27001926,HC PORT REMOVAL TRAY,344.0,240.8,,,0
CDM,27001943,HC MEFIX 2 IN 11 YD,23.0,16.1,,,0
CDM,27002001,HC KT MICINTRO CAPELLA COAX 4FR W/0.18IN X45CM GUIDEWIRE/ 21GA X 7CM NEEDLE,123.0,86.1,,,0
CDM,27002031,HC SET KENDALL ECG LEADWIRE 5LD 144IN,90.0,63.0,,,0
CDM,27002036,"HC PREVALON MOBILE AIR TRANSFER SYSTEM 39"" X 81""",282.0,197.4,,,0
CDM,27002068,HC SAGE CATHETER PRIMAFIT URETHRAL ADULT FEMALE,68.0,47.6,,,0
CDM,27002103,HC AFFERA LOCATION REFERENCE PATCH KIT,3713.0,2599.1,,,0
CDM,27002121,HC AIRVO AIRSPIRAL TUBE & CHAMBER KIT,424.0,296.8,,,0
CDM,27002139,HC ALRM POSEY MTRS PAD 13X32IN,78.0,54.6,,,0
CDM,27002140,HC ALRM POSEY CHR PAD 13X13IN,69.0,48.3,,,0
CDM,27100002,HC OXYGEN 24HR,477.0,333.9,,,0
CDM,27100003,HC OXYGEN SET UP,109.0,76.3,,,0
CDM,27100004,HC OXYGEN PER HOUR,22.0,15.4,,,0
CDM,27100005,HC NITRIC OXIDE HOURLY,288.0,201.6,,,0
CDM,27100006,HC NITRIC OXIDE SET UP,1093.0,765.1,,,0
CDM,27100007,HC H2O BELLOWS,447.0,312.9,,,0
CDM,27100008,HC OSCILLATOR CIRCUIT 3100A,490.0,343.0,,,0
CDM,27100009,HC AERO CHAMBER,169.0,118.3,,,0
CDM,27100011,HC TEDS KNEE HIGH,32.0,22.4,,,0
CDM,27100012,HC ADAPTER FLO-SWITCH,32.0,22.4,,,0
CDM,27100013,HC ADAPTER Y TUOY-BORST,69.0,48.3,,,0
CDM,27100014,HC ADHESIVE LIQ MASSITOL HAZ,176.0,123.2,,,0
CDM,27100015,HC AEROSOL THERAPY PER HOUR,94.0,65.8,,,0
CDM,27100016,HC APNEA MONITOR/DAY,90.0,63.0,,,0
CDM,27100017,HC BAG AMBU ADULT,55.0,38.5,,,0
CDM,27100018,HC BAG AMBU,81.0,56.7,,,0
CDM,27100019,HC BAG AMBU DISP,372.0,260.4,,,0
CDM,27100020,HC BAG DRAIN ABSCESS,59.0,41.3,,,0
CDM,27100021,HC BAG DRAIN LEG,75.0,52.5,,,0
CDM,27100022,HC BAG DRAIN SUCTION,169.0,118.3,,,0
CDM,27100023,HC BAG HYPERINFLATION 1/2 L,46.0,32.2,,,0
CDM,27100024,HC BAG RESUSCITATION PUL DISP,169.0,118.3,,,0
CDM,27100025,HC BAG URINARY,32.0,22.4,,,0
CDM,27100026,HC BAND HEMOSTASIS 14 INCH,112.0,78.4,,,0
CDM,27100029,HC DERMABOND / ETHICON,137.0,95.9,,,0
CDM,27100030,HC BELT ABDOMINAL OBESE,164.0,114.8,,,0
CDM,27100031,HC ELASTIC BANDAGE,16.0,11.2,,,0
CDM,27100032,HC BELT/BELLY BAND TRANSDUCER DISPOSABLE,21.0,14.7,,,0
CDM,27100033,HC BILI CHECK CALIBRATION TIPS,44.0,30.8,,,0
CDM,27100034,HC BILIARY BRUSH BIOPSY SET,427.0,298.9,,,0
CDM,27100035,HC BINDER ABDOMINAL,76.0,53.2,,,0
CDM,27100036,HC BINDER UNIVERSAL,76.0,53.2,,,0
CDM,27100037,HC BIOCLUSIVE 4X5,5.0,3.5,,,0
CDM,27100038,HC BIOPSY NEEDLE DEVICE,294.0,205.8,,,0
CDM,27100040,HC BREAST FEEDING UNIT,53.0,37.1,,,0
CDM,27100041,HC BUNNY BOOT,136.0,95.2,,,0
CDM,27100042,HC BURITROL,48.0,33.6,,,0
CDM,27100043,HC CAP SENSOR CO2 DETECTOR ADULT,58.0,40.6,,,0
CDM,27100044,HC CASKET INFANT 19 INCH,400.0,280.0,,,0
CDM,27100045,HC CATHETER SUCTION,5.0,3.5,,,0
CDM,27100046,HC CD MEDICAL GRADE,21.0,14.7,,,0
CDM,27100047,HC CHITO-SEAL,253.0,177.1,,,0
CDM,27100050,HC CONTAINER URINE 24 HR,9.0,6.3,,,0
CDM,27100051,HC DIAL A FLOW,29.0,20.3,,,0
CDM,27100052,HC ELECTRODE GROUNDING PAD,18.0,12.6,,,0
CDM,27100053,HC ELECTRODE PACING EXTERNAL,489.0,342.3,,,0
CDM,27100054,HC FEMSTOP,478.0,334.6,,,0
CDM,27100065,HC HEEL PROTECTOR SAGE,324.0,226.8,,,0
CDM,27100066,HC HIGHFLOW OXYGEN EA ADDT'L HOUR,22.0,15.4,,,0
CDM,27100067,HC HIGHFLOW OXYGEN INITIAL HOUR,141.0,98.7,,,0
CDM,27100068,HC INCENTIVE SPIROMETER,21.0,14.7,,,0
CDM,27100069,HC INT DELIVERY SET CLOSED,82.0,57.4,,,0
CDM,27100070,HC JET VENT CARTRIDGE,1017.0,711.9,,,0
CDM,27100071,HC J-LOOP IV W/INJ,15.0,10.5,,,0
CDM,27100073,HC KIT QUICKDRAW ABG 3CC 22G,9.0,6.3,,,0
CDM,27100074,HC KIT/TRAY TROCAR CATH,158.0,110.6,,,0
CDM,27100075,HC K-PAD DISPOSABLE,55.0,38.5,,,0
CDM,27100076,HC LEUR LOCK MALE/FEMALE,8.0,5.6,,,0
CDM,27100077,HC MASK ANES INFANT W/VALVE,16.0,11.2,,,0
CDM,27100078,HC MASK BILI DISP EA,24.0,16.8,,,0
CDM,27100079,HC MASK NEONATE W/VALVE,16.0,11.2,,,0
CDM,27100080,HC MONITOR BLOOD PRESSURE ARTERIAL,262.0,183.4,,,0
CDM,27100081,HC NELCOR OXISENSOR PEDIATRIC,105.0,73.5,,,0
CDM,27100083,HC OXYGEN PER HOUR,20.0,14.0,,,0
CDM,27100085,HC PAD 72,267.0,186.9,,,0
CDM,27100086,HC PAD COOLING ARCTIC DISPOSABLE SM/MED/LG,2863.0,2004.1,,,0
CDM,27100087,HC PAD COOLING ARCTIC DISPOSABLE UNIVERSAL,1140.0,798.0,,,0
CDM,27100088,HC PAD RADIATION PROTECTION,400.0,280.0,,,0
CDM,27100089,HC PAD W/TUBING,139.0,97.3,,,0
CDM,27100090,HC PAPER FETAL MONITOR,15.0,10.5,,,0
CDM,27100091,HC PELVIC EXAM COMPLETE ASST-SUPPLY,112.0,78.4,,,0
CDM,27100092,HC PILLOW ABDUCTION DISP,130.0,91.0,,,0
CDM,27100093,HC PILLOW ABDUCTION DISP LARGE,131.0,91.7,,,0
CDM,27100094,HC PRIMARY W/O CASSETTE 79C-0593,22.0,15.4,,,0
CDM,27100095,HC PROTECTION MANIFOLD STATION,249.0,174.3,,,0
CDM,27100096,HC PROTECTOR HEEL SAGE,324.0,226.8,,,0
CDM,27100098,HC SEAL RECTAL FECAL,1028.0,719.6,,,0
CDM,27100099,HC SEAL RECTALFECAL SPEC ORDER,1028.0,719.6,,,0
CDM,27100100,HC SET ADMIN CONTINUE FLOW,22.0,15.4,,,0
CDM,27100101,HC SET ANCHOR GI SCOPE,390.0,273.0,,,0
CDM,27100102,HC SET DRSSNG OPERICARDIAL PUHRA PLEURA,509.0,356.3,,,0
CDM,27100103,HC SET EZ,13.0,9.1,,,0
CDM,27100104,HC SET G-J TUBE,840.0,588.0,,,0
CDM,27100105,HC SET IV SECONDARY,9.0,6.3,,,0
CDM,27100106,HC SET POSSIS PUMP SUPPLY,1080.0,756.0,,,0
CDM,27100107,HC SET SECONDARY VENTED W/LL,9.0,6.3,,,0
CDM,27100108,HC SET TRANSDUCER MONITORING,149.0,104.3,,,0
CDM,27100109,HC SETUP AEROSOL /HUMIDITY,148.0,103.6,,,0
CDM,27100110,HC SETUP END TIDAL CARB DIOX,160.0,112.0,,,0
CDM,27100111,HC SETUP INITIAL BIPAP SUPPLIES,671.0,469.7,,,0
CDM,27100112,HC SHIELD BREAST,77.0,53.9,,,0
CDM,27100113,HC SHIELD BREAST 30,16.0,11.2,,,0
CDM,27100114,HC SHIELD BREAST PRSNL 36  NON STERILE,24.0,16.8,,,0
CDM,27100115,HC SHIELD NIPPLE,39.0,27.3,,,0
CDM,27100116,HC SLEEVE CMPR REG SCD EXP FT CUF,146.0,102.2,,,0
CDM,27100117,HC SLEEVE CMPR THIGH ALL SIZES,282.0,197.4,,,0
CDM,27100118,HC TUBE CHEST DRAINAGE THORAKLEX,238.0,166.6,,,0
CDM,27100119,HC SLEEVE ELECTRI COOL DISPOSABLE,236.0,165.2,,,0
CDM,27100120,HC SLEEVE SCD REPLACEMENT ONLY,214.0,149.8,,,0
CDM,27100121,HC SLING AND SWATHE DELUX UNIL BLUE,58.0,40.6,,,0
CDM,27100122,HC SOFT BAND KERLIX,13.0,9.1,,,0
CDM,27100123,HC SPIROMETER ADULT 4000ML,18.0,12.6,,,0
CDM,27100124,HC STRAINER CALCULI,13.0,9.1,,,0
CDM,27100125,HC SUCTION UNITS KIWI DISPOSABLE,148.0,103.6,,,0
CDM,27100126,HC SUPPORTER ATHLETIC ADULT SMALL,39.0,27.3,,,0
CDM,27100127,HC TEDS SCD LARGE,270.0,189.0,,,0
CDM,27100128,HC TEDS SEQUENTIAL,187.0,130.9,,,0
CDM,27100129,HC TEDS THIGH LENGTH,39.0,27.3,,,0
CDM,27100132,HC TRAP SPECIMEN,11.0,7.7,,,0
CDM,27100133,HC TRAY PERICARDIOCENTESIS,600.0,420.0,,,0
CDM,27100134,HC TRAY UROLOGY OBSTRUCTED URETHRA URO,959.0,671.3,,,0
CDM,27100135,HC TRAY UV CARGYLE NEO-SERT W/O CATH,277.0,193.9,,,0
CDM,27100136,HC TUBE BLAKEMORE,1190.0,833.0,,,0
CDM,27100137,HC TUBE CHEST DRAINAGE DOUBLE,242.0,169.4,,,0
CDM,27100138,HC TUBE FEEDING 5FR 15,5.0,3.5,,,0
CDM,27100139,HC TUBE GEL IODASORB 40G,203.0,142.1,,,0
CDM,27100140,HC TUBING BLOOD IV,40.0,28.0,,,0
CDM,27100141,HC TUBING BLOOD IV,40.0,28.0,,,0
CDM,27100142,HC TUBING BURITROL LINE 6.5,30.0,21.0,,,0
CDM,27100143,HC TUBING EPIDURAL NOT PORT,57.0,39.9,,,0
CDM,27100144,HC TUBING FOR HOT LINE,66.0,46.2,,,0
CDM,27100145,HC URINE COLLECTOR PED,10.0,7.0,,,0
CDM,27100146,HC VALVE DRAIN HEIMLICK,181.0,126.7,,,0
CDM,27100147,HC WIRE CUTTERS,72.0,50.4,,,0
CDM,27100148,HC WND FILLIODOSORB GEL OZ,41.0,28.7,,,0
CDM,27100149,HC WNDFILL MULTIDEX PWD IODOFLEX,31.0,21.7,,,0
CDM,27100150,HC HEMOVAC 1/4,52.0,36.4,,,0
CDM,27100151,HC ELASTIC STOCKINGS THIGH,32.0,22.4,,,0
CDM,27100154,HC LINER CANISTER SUCT BOTTLE,10.0,7.0,,,0
CDM,27100155,HC AMBU BAG,90.0,63.0,,,0
CDM,27100156,HC DRAIN SALEM SUMP,29.0,20.3,,,0
CDM,27100157,HC VALVE SALEM SUMP,31.0,21.7,,,0
CDM,27100158,HC IV SET NITRO W/LL,37.0,25.9,,,0
CDM,27100159,HC TRANSDUCER TRUWAVE PRESSURE CABLE,64.0,44.8,,,0
CDM,27100160,HC MANIFOLD 4-VALVE,151.0,105.7,,,0
CDM,27100161,HC SITZ BATH,16.0,11.2,,,0
CDM,27100168,HC BAG DRAINAGE BECKER 700L,214.0,149.8,,,0
CDM,27100169,HC BLANKET UPPER BODY SM W/ STRAPS,40.0,28.0,,,0
CDM,27100170,HC TRAY UVC ARGYLE NEO-SERT W/O CATH,277.0,193.9,,,0
CDM,27100171,HC 3M BLOOD SET,13.0,9.1,,,0
CDM,27100172,HC LEUR LOCK MALE/FEMALE,16.0,11.2,,,0
CDM,27100173,HC SET ADMIN CONTINUE FLOW,22.0,15.4,,,0
CDM,27100174,HC SET SECONDARY VENTED W/LL,11.0,7.7,,,0
CDM,27100175,HC TUBING BURITROL LINE 6.5,30.0,21.0,,,0
CDM,27100178,HC COMMODE CONTAINER HAT,4.0,2.8,,,0
CDM,27100179,HC CONTAINER URINE 24 HR,10.0,7.0,,,0
CDM,27100180,HC STRAINER CALCULI,13.0,9.1,,,0
CDM,27100181,HC PLEXIPULSE EACH,151.0,105.7,,,0
CDM,27100185,HC RETRIEVAL DEVICE INSERTABLE,1748.0,1223.6,,,0
CDM,27100228,HC CLEANSER SKN SPRAY 1OZ,5.0,3.5,,,0
CDM,27100230,HC SMITH & NEPHEW PICO NWPT SUPPLY (ALL SIZES),871.0,609.7,,,0
CDM,27100231,HC KIT PLEURAL SGL BOTTLE DRAIN,284.0,198.8,,,0
CDM,27100232,HC QUIK-CLOT 4X4 DRESSING,61.0,42.7,,,0
CDM,27100244,HC CATH INDIGO 3 STR TIP 150 CM,4144.0,2900.8,,,0
CDM,27100245,HC CATH INDIGO 6 STR TIP 135 CM,6490.0,4543.0,,,0
CDM,27100246,HC CATH INDIGO 8 STR TIP 85 CM,9818.0,6872.6,,,0
CDM,27100247,HC SEPARATOR INDIGO 3,2547.0,1782.9,,,0
CDM,27100248,HC SEPARATOR INDIGO 6,3845.0,2691.5,,,0
CDM,27100249,HC SEPARATOR INDIGO 8,6507.0,4554.9,,,0
CDM,27100250,HC TUBING ASPIRATION INDIGO,1778.0,1244.6,,,0
CDM,27100251,HC CANISTER PENUMBRA MAX,1414.0,989.8,,,0
CDM,27100288,HC PULMONARY AMBU BAG,55.0,38.5,,,0
CDM,27100289,HC DELIVERY SYS EVOLUT R 16FR,6768.0,4737.6,,,0
CDM,27100290,HC LOADING SYS EVOLUT R 34FR,1511.0,1057.7,,,0
CDM,27100299,HC POWER PULSE Y ADAPTER,201.0,140.7,,,0
CDM,27100313,HC CATH PROWLER MICRO 20CM,3429.0,2400.3,,,0
CDM,27100314,HC CATH PROWLER MICRO STRT,3349.0,2344.3,,,0
CDM,27100315,HC CATH ENVOY MPD,1771.0,1239.7,,,0
CDM,27100319,HC DANDLE ROO LITE BILI WRAP SM - LG,119.0,83.3,,,0
CDM,27100424,HC INFANT TRANSPORT MATTRESS,203.0,142.1,,,0
CDM,27100425,HC REPOSITIONING SYS QUICK CONNECT NON STERILE PREVALON AIRTRP SYSTEM,659.0,461.3,,,0
CDM,27100438,"HC COLOPLAST INTERDRY MOISTURE WICKING DRESSING 10"" X 36""",185.0,129.5,,,0
CDM,27100452,HC BRIDLE NG TUBE HOLDER,377.0,263.9,,,0
CDM,27100453,HC PATIENT MONITOR NOT RETURNED,200.0,140.0,,,0
CDM,27147,PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML IV SUSP,735.0,514.5,,,0
CDM,27200020,HC DUODERM 6X6 OR SACRAL,58.0,40.6,,,0
CDM,27200023,HC ELASTOMULL ELASTIC GAUZE 1 IN,44.0,30.8,,,0
CDM,27200026,HC CMPRLN STRCH COMPRSS 10CM X 5CM,64.0,44.8,,,0
CDM,27200030,CATH ATHEREC ROTA ADVNCR W/BURR,5597.0,3917.9,,,0
CDM,27200031,HC CATH ATHEREC ROTA PERIPH ROTAT,11162.0,7813.4,,,0
CDM,27200032,HC BALLOON PTA C,369.0,258.3,,,0
CDM,27200033,HC BALLOON EV3 .035,541.0,378.7,,,0
CDM,27200034,HC BALLOON ABBOTT .035,700.0,490.0,,,0
CDM,27200035,HC BALLOON PTA A,744.0,520.8,,,0
CDM,27200036,HC BALLOON PERIPHERAL,797.0,557.9,,,0
CDM,27200038,HC BALLOON ATLAS,999.0,699.3,,,0
CDM,27200039,HC BALLOON PTA B,1061.0,742.7,,,0
CDM,27200044,HC BALLOON PTCA,466.0,326.2,,,0
CDM,27200045,HC BALLOON EV3 LONG .018,1558.0,1090.6,,,0
CDM,27200048,HC BALLOON CUTTING SCIMED,2000.0,1400.0,,,0
CDM,27200049,HC BALLOON TYSHAK BRAUN,2033.0,1423.1,,,0
CDM,27200052,HC BALLOON CATH INFLAT UNIT POLAR,4061.0,2842.7,,,0
CDM,27200053,HC BALLOON CATH TAMPONADE BAKRI,816.0,571.2,,,0
CDM,27200054,HC BALLOON CATH DIL NON-VASC AMPLATZ,1061.0,742.7,,,0
CDM,27200056,HC DRAINAGE CATHETER G,121.0,84.7,,,0
CDM,27200057,HC DRAINAGE CATHETER H,301.0,210.7,,,0
CDM,27200058,HC CATH DRAIN PNEUMOTHORAX KIT A,426.0,298.2,,,0
CDM,27200059,HC CATH DRAIN PNEUMOTHORAX KIT,445.0,311.5,,,0
CDM,27200060,HC DRAINAGE CATHETER B,454.0,317.8,,,0
CDM,27200061,HC DRAINAGE CATHETER C,480.0,336.0,,,0
CDM,27200062,HC DRAINAGE CATHETER A,509.0,356.3,,,0
CDM,27200063,HC CATH DRAIN CHEST TUBE PLEURAGUIDE,511.0,357.7,,,0
CDM,27200064,HC CATH DRAIN PNEUM WYNE 14FR,609.0,426.3,,,0
CDM,27200065,HC CATH DRAIN PNEUMOTHORAX KIT B,850.0,595.0,,,0
CDM,27200066,HC DRAINAGE CATHETER F,1748.0,1223.6,,,0
CDM,27200067,HC PLEURX-PLEURAL CATH KIT,1892.0,1324.4,,,0
CDM,27200068,HC CATH EP DX QUAD NON DEFL < 19 ELE,2439.0,1707.3,,,0
CDM,27200069,HC DIAG ER CATH W/20 OR MORE ELECTRODES,2330.0,1631.0,,,0
CDM,27200070,HC EP CATHETER HALO 20 ELECTRODES,3759.0,2631.3,,,0
CDM,27200075,HC EZ STEER BI-DIRECTIONAL CARTO 4MM,6670.0,4669.0,,,0
CDM,27200076,HC THERMACOOL SF NAV CATHETER,8120.0,5684.0,,,0
CDM,27200079,HC ABLATION CATHETER-WEBSTER,2996.0,2097.2,,,0
CDM,27200080,HC EZ STEER BI DIRECTIONAL NON-CARTO 8MM,3495.0,2446.5,,,0
CDM,27200083,HC EZ STEER THERMOCOOL CARTO,6969.0,4878.3,,,0
CDM,27200084,HC BALLOON ARCTIC FRONT,15972.0,11180.4,,,0
CDM,27200088,HC CATH DX PERIPH,416.0,291.2,,,0
CDM,27200089,HC CATH PICC A,509.0,356.3,,,0
CDM,27200090,HC CATH PICC B,509.0,356.3,,,0
CDM,27200091,CATH PICC DUAL LUMEN 1.9FRX30CM,360.0,252.0,,,0
CDM,27200092,HC CATH INF UNIFUSE,668.0,467.6,,,0
CDM,27200093,HC CATH CV LINE POWERLINE,1080.0,756.0,,,0
CDM,27200094,HC TEMPORARY DIALYSIS CATHETER,341.0,238.7,,,0
CDM,27200095,HC TEMP DIALYSIS CATHETER B POWER-TRIALYSIS,660.0,462.0,,,0
CDM,27200096,HC CVIS ULTRACROSS CATH/SONICATH MDL 37-410,2613.0,1829.1,,,0
CDM,27200097,HC EMBOLIZATION PRODUCT D,509.0,356.3,,,0
CDM,27200098,HC EMBOLIZATION PRODUCT E,509.0,356.3,,,0
CDM,27200099,HC EMBOLIZATION PRODUCT C,999.0,699.3,,,0
CDM,27200100,HC EMBOLIZATION PRODUCT A,1300.0,910.0,,,0
CDM,27200102,HC ATRIUM XPRESSWAY CATH-ASPIRATION CATH,1261.0,882.7,,,0
CDM,27200104,HC AVX 50CM ULTRA,2086.0,1460.2,,,0
CDM,27200105,HC THROMBECTOMY DEVICE A,2497.0,1747.9,,,0
CDM,27200109,HC RHEOLYTIC CATHETER W/PUMP,5741.0,4018.7,,,0
CDM,27200113,HC SOUNDSTAR/RS,4792.0,3354.4,,,0
CDM,27200114,HC ACUNAV/SOUNDSTAR INTRACARDIAC ECHO CATH,9651.0,6755.7,,,0
CDM,27200116,HC VASCULAR SHEATH E,490.0,343.0,,,0
CDM,27200117,HC STEERABLE GROIN SHEATH,5758.0,4030.6,,,0
CDM,27200118,HC SPRING WIRE GUIDE,48.0,33.6,,,0
CDM,27200120,HC DIAGNOSTIC GUIDE WIRE,59.0,41.3,,,0
CDM,27200121,HC GUIDEWIRE TORQUE DEVICE,69.0,48.3,,,0
CDM,27200122,HC GUIDEWIRE B,143.0,100.1,,,0
CDM,27200123,GW VASC L80CM L2MM OD.018IN,184.0,128.8,,,0
CDM,27200124,HC GUIDE WIRE A,230.0,161.0,,,0
CDM,27200127,HC GUIDEWIRE C,253.0,177.1,,,0
CDM,27200128,HC GUIDEWIRE G,255.0,178.5,,,0
CDM,27200130,HC GUIDEWIRE H,321.0,224.7,,,0
CDM,27200131,HC GUIDEWIRE D,341.0,238.7,,,0
CDM,27200132,HC GLIDEWIRE,381.0,266.7,,,0
CDM,27200133,HC GUIDEWIRE E,396.0,277.2,,,0
CDM,27200134,HC GUIDEWIRE I,410.0,287.0,,,0
CDM,27200135,PTCA GUIDEWIRE,366.0,256.2,,,0
CDM,27200136,HC GUIDEWIRE THRUWAY 0.018 300CM,447.0,312.9,,,0
CDM,27200137,HC PULMONARY JAGWIRE,480.0,336.0,,,0
CDM,27200138,HC GUIDEWIRE L,509.0,356.3,,,0
CDM,27200139,HC GUIDEWIRE J,521.0,364.7,,,0
CDM,27200140,MALLINCKRODT TAD WIRE,576.0,403.2,,,0
CDM,27200141,HC V-14/18 300 CM CONTROLWIRE,761.0,532.7,,,0
CDM,27200142,HC GUIDEWIRE K,1198.0,838.6,,,0
CDM,27200143,HC DOPPLER PRESSURE WIRE,2081.0,1456.7,,,0
CDM,27200144,HC RETRIEVAL DEVICE SNARE A,1168.0,817.6,,,0
CDM,27200145,HC RETRIEVAL DEVICE SNARE B,1485.0,1039.5,,,0
CDM,27200146,HC RETRIEVAL DEVICE SNARE CATH,2277.0,1593.9,,,0
CDM,27200151,HC SYSEMBOLIC PROTECTION 190/300CM,5159.0,3611.3,,,0
CDM,27200152,HC GUIDE CATHETER,350.0,245.0,,,0
CDM,27200153,HC COOK CURVED SHEATH,528.0,369.6,,,0
CDM,27200155,HC GW MICROCATH CARAVEL 1.9FX150CM,1364.0,954.8,,,0
CDM,27200156,HC CS GUIDE CATHETER,2396.0,1677.2,,,0
CDM,27200157,HC ENB LOCATABLE GUIDE,3313.0,2319.1,,,0
CDM,27200158,HC VASCULAR SHEATH D,290.0,203.0,,,0
CDM,27200159,HC TRANSSEPTAL NEEDLE,1104.0,772.8,,,0
CDM,27200160,HC DIAGNOSTIC SHEATH/INTRODUCER,55.0,38.5,,,0
CDM,27200162,HC SHEATH INTRODUCER SUPER SHEATH BOSTON SC,145.0,101.5,,,0
CDM,27200163,HC VASCULAR SHEATH A,162.0,113.4,,,0
CDM,27200165,HC VASCULAR SHEATH B,225.0,157.5,,,0
CDM,27200166,HC AVANTI 23CM SHEATH 6FR,246.0,172.2,,,0
CDM,27200168,HC PERCUTANEOUS SHEATH INTRODUCER,285.0,199.5,,,0
CDM,27200169,HC CORDIS BRITE-TIP SHEATH,289.0,202.3,,,0
CDM,27200171,HC SHEATH INTRODUCER COOK 14X30,381.0,266.7,,,0
CDM,27200172,HC SHEATH INTRODUCER MULLINS 85CM,477.0,333.9,,,0
CDM,27200173,HC SHEATH INTRODUCER COOK 16X30,478.0,334.6,,,0
CDM,27200174,HC COOK BALKEN SHEATH,528.0,369.6,,,0
CDM,27200175,HC VASCULAR SHEATH C,720.0,504.0,,,0
CDM,27200176,HC DAIG SAFL SHEATH,864.0,604.8,,,0
CDM,27200178,HC RAPIDO CS GUIDING CATHETER,3594.0,2515.8,,,0
CDM,27200179,HC CRYOABLATION PROBE,4327.0,3028.9,,,0
CDM,27200180,HC DRAINAGE CATHETER E,554.0,387.8,,,0
CDM,27200181,HC SUPRAPUBIC CATHETER,509.0,356.3,,,0
CDM,27200182,HC BALLOON CATH SIZING AMPLATZER,868.0,607.6,,,0
CDM,27200183,HC OCCLUSION CATHETER,2647.0,1852.9,,,0
CDM,27200184,HC CARTO NAVISTAR CATHETER,7787.0,5450.9,,,0
CDM,27200185,HC NEEDLE CRV RF 18 GA 145 MM,150.0,105.0,,,0
CDM,27200186,HC PEAK PLASMA BLADE,1099.0,769.3,,,0
CDM,27200187,HC AVAMAX COAXIAL BONE BIOPSY SYSTEM,440.0,308.0,,,0
CDM,27200188,HC ON CONTROL BONE BIOPSY SYSTEM,520.0,364.0,,,0
CDM,27200189,HC MORPH ACCESSPRO SYSTEM,1916.0,1341.2,,,0
CDM,27200190,HC DEFLECTABLE GUIDE CATHETER,2913.0,2039.1,,,0
CDM,27200191,HC ONYX LIQUID EMBOLIC SYSTEM,8852.0,6196.4,,,0
CDM,27200192,HC CONCERTO EMBOLIZATION COIL,2497.0,1747.9,,,0
CDM,27200193,HC NEEDLE CERVICAL STRAIGHT 22 GA 100 MM,142.0,99.4,,,0
CDM,27200194,HC NEEDLE SPINAL 22 GA X 3.5,11.0,7.7,,,0
CDM,27200195,HC NEEDLE CHIBA 22 GA X 5.0,69.0,48.3,,,0
CDM,27200196,HC NEEDLE NERVE ROOT BLOCK 22 GA X 6.0,39.0,27.3,,,0
CDM,27200197,HC NEEDLE SPINAL 22 GA X 8.0,104.0,72.8,,,0
CDM,27200198,HC NEEDLE SPINAL 23 GA X 3.5,32.0,22.4,,,0
CDM,27200199,HC NEEDLE SPINAL 23 GA X 5.0,43.0,30.1,,,0
CDM,27200200,HC NEEDLE SPINAL 25 GA X 2.5,36.0,25.2,,,0
CDM,27200201,HC NEEDLE SPINAL 25 GA X 3.5,10.0,7.0,,,0
CDM,27200202,HC NEEDLE NERVE ROOT BLOCK 25 GA X 6.0,129.0,90.3,,,0
CDM,27200203,HC NEEDLE NERVE ROOT BLOCK 25 GA X 8.0,95.0,66.5,,,0
CDM,27200204,HC CANN RF OD20GA 145 MM STR,66.0,46.2,,,0
CDM,27200205,HC NEEDLE CATH STRAIGHT 16 GA X 3.5,290.0,203.0,,,0
CDM,27200206,HC NEEDLE CATH STRAIGHT 18 GA X 3.5,290.0,203.0,,,0
CDM,27200207,HC GROUNDING PADS,138.0,96.6,,,0
CDM,27200208,HC VERSA KATH 21 GA X 12.0,358.0,250.6,,,0
CDM,27200209,HC MANO METRIC DEVICE,504.0,352.8,,,0
CDM,27200210,HC REFILL KIT / IMPLANT INF PUMP,134.0,93.8,,,0
CDM,27200211,HC NEEDLE RF CURVED EXTRA LONG 145 MM,139.0,97.3,,,0
CDM,27200212,HC NEEDLE CANNULA RFK C15D,227.0,158.9,,,0
CDM,27200213,HC SET TUBING IV LL 110 IN,17.0,11.9,,,0
CDM,27200214,HC SYRINGE UNIVERSAL FLUID DISPENSING,504.0,352.8,,,0
CDM,27200215,HC TUN-L-KATH 19 GA X 12.0,323.0,226.1,,,0
CDM,27200216,HC BRONCHAVEOLAR LAVAGE CATH / SUPPLIES,396.0,277.2,,,0
CDM,27200217,HC DIAPHRAGM CAP,213.0,149.1,,,0
CDM,27200218,HC AIRWAY LARYNGEAL DIS INTUB,118.0,82.6,,,0
CDM,27200219,HC FORCEPS BIOPSY PULM,194.0,135.8,,,0
CDM,27200220,HC PASSEY MUIR SPEAKING VALVE,330.0,231.0,,,0
CDM,27200221,HC ANESTHESIA SUPPLY CHARGE,341.0,238.7,,,0
CDM,27200223,HC SWAN GANZ CATHETER,284.0,198.8,,,0
CDM,27200224,HC ACCUSTICK,465.0,325.5,,,0
CDM,27200225,HC ACTICOAT 7,92.0,64.4,,,0
CDM,27200227,HC ADAPTER MALE,16.0,11.2,,,0
CDM,27200228,HC ADVISER TRANSDUCER POLE MOUNT,454.0,317.8,,,0
CDM,27200229,HC AERO NEB SOLO SUPPLY,288.0,201.6,,,0
CDM,27200230,HC AMNIHOOK STERILE,13.0,9.1,,,0
CDM,27200232,HC BAG COLLECTION FLEXI-SEAL  F,283.0,198.1,,,0
CDM,27200233,HC BAG FOLEY PRECON,97.0,67.9,,,0
CDM,27200235,HC BALLOON CATH BIB,2497.0,1747.9,,,0
CDM,27200236,HC BALLOON INTRAAORTIC,2830.0,1981.0,,,0
CDM,27200237,HC BALLOON RIPENING CERVICAL COOK,350.0,245.0,,,0
CDM,27200238,HC BALLOON STINGRAY,3828.0,2679.6,,,0
CDM,27200239,HC BALLOON VENOGRAM MEDTRONIC,640.0,448.0,,,0
CDM,27200240,HC BANDAGE BULKY 4X4,6.0,4.2,,,0
CDM,27200241,HC BARRIER ADHESION INTERCEED,1041.0,728.7,,,0
CDM,27200242,HC BIO PATCH,44.0,30.8,,,0
CDM,27200243,HC BLAKE FLAT FULL FLUTED 10MM,163.0,114.1,,,0
CDM,27200245,HC BLANKET BILI COVER S DISP,70.0,49.0,,,0
CDM,27200246,HC BLANKET HYPO/HYPER ADULT/OR 25X64,83.0,58.1,,,0
CDM,27200247,HC BOTTLE CHEST ADULT,306.0,214.2,,,0
CDM,27200248,HC BOTTLE PERFUSION REPLACEMENT,470.0,329.0,,,0
CDM,27200250,HC CARTRIDGE STAPLE RELOAD TR45W,439.0,307.3,,,0
CDM,27200251,HC CATHETER AIRWAY EXCHANGE,275.0,192.5,,,0
CDM,27200252,HC CATHETER AIRWAY INTUB,2859.0,2001.3,,,0
CDM,27200253,HC CATHETER AORTIC DIAG RAD MEASURING,632.0,442.4,,,0
CDM,27200254,HC CATHETER ARTERIAL LINE 20G 55IN (12C,213.0,149.1,,,0
CDM,27200255,HC CATHETER COUDE,49.0,34.3,,,0
CDM,27200256,HC CATHETER CROSSER CTO RECANALIZATION,6655.0,4658.5,,,0
CDM,27200257,HC CATHETER CRYO 4MM,7650.0,5355.0,,,0
CDM,27200258,HC CATHETER DIAG PCG SWAN 5FR PED,336.0,235.2,,,0
CDM,27200259,HC CATHETER DIAG RAD W/MARKERS,200.0,140.0,,,0
CDM,27200260,HC CATHETER DIAGNOSTIC,77.0,53.9,,,0
CDM,27200261,HC CATHETER DIAGNOSTIC JKYRADIAL,281.0,196.7,,,0
CDM,27200262,HC CATHETER DIAGNOSTIC RADIOLOGIC,541.0,378.7,,,0
CDM,27200263,HC CATHETER EPIDURAL 18G,61.0,42.7,,,0
CDM,27200264,HC CATHETER FLEXCATH ARCTIC FRONT,3993.0,2795.1,,,0
CDM,27200265,HC CATHETER FLOW DIRECTED,567.0,396.9,,,0
CDM,27200266,HC CATHETER FOLEY,28.0,19.6,,,0
CDM,27200267,HC CATHETER FOLEY MEDIUM,66.0,46.2,,,0
CDM,27200268,HC CATHETER FOLEY SILA 30CC 16FR,35.0,24.5,,,0
CDM,27200269,HC CATHETER FOLEY SILA 30CC 18FR,59.0,41.3,,,0
CDM,27200270,HC CATHETER FOLEY SILA 30CC 20FR,25.0,17.5,,,0
CDM,27200271,HC TUBE FEEDING DOBBHOFF,28.0,19.6,,,0
CDM,27200273,HC CATHETER GUIDING PERIPHERAL,488.0,341.6,,,0
CDM,27200274,HC CATHETER INTRA-UTERINE PRESS,149.0,104.3,,,0
CDM,27200275,HC CATHETER INTRODUCER 1.9 FR NEONATAL,204.0,142.8,,,0
CDM,27200276,HC CATHETER IV,16.0,11.2,,,0
CDM,27200277,HC CATHETER IV 14 INCH,11.0,7.7,,,0
CDM,27200278,HC CATHETER IV 16 X 1 1/4,15.0,10.5,,,0
CDM,27200279,HC CATHETER IV 16 X 1 1/4,13.0,9.1,,,0
CDM,27200280,HC CATHETER IV 18 X 1 1/4 LATEX FREE,13.0,9.1,,,0
CDM,27200281,HC CATHETER IV 18 X 1 1/4 LATEX FREE,13.0,9.1,,,0
CDM,27200282,HC CATHETER IV 18 X 1 3/4 LATEX FREE,13.0,9.1,,,0
CDM,27200283,HC CATHETER IV 18 X 1 3/4 LATEX FREE,13.0,9.1,,,0
CDM,27200284,HC CATHETER IV 20 X 1 1/4 LATEX FREE,13.0,9.1,,,0
CDM,27200285,HC CATHETER IV 20 X 1 1/4 LATEX FREE,13.0,9.1,,,0
CDM,27200286,HC CATHETER IV 22 INCH,16.0,11.2,,,0
CDM,27200287,HC CATHETER J-TUBE REPLACEMENT,999.0,699.3,,,0
CDM,27200288,HC CATHETER LATEX FREE 30CC 16FR,39.0,27.3,,,0
CDM,27200289,HC CATHETER LEAD EXTRACTION LASER,6092.0,4264.4,,,0
CDM,27200290,HC CATHETER MULTI TRACK BRAUN,1534.0,1073.8,,,0
CDM,27200291,HC CATHETER OUTBACK RE ENTRY,7188.0,5031.6,,,0
CDM,27200292,HC CATHETER PICC 1.9 FR X 50 CM,271.0,189.7,,,0
CDM,27200293,HC CATHETER PICC ALL SIZES,599.0,419.3,,,0
CDM,27200294,HC CATHETER PIONEER PLUS,10617.0,7431.9,,,0
CDM,27200295,HC CATHETER POSSIS E-TRAIN 110,2402.0,1681.4,,,0
CDM,27200296,HC CATHETER PRO TRACK MICRO,720.0,504.0,,,0
CDM,27200297,HC CATHETER RE ENTRY CROSSBOSS,2913.0,2039.1,,,0
CDM,27200298,HC CATHETER RED ROBINSON 18FR,5.0,3.5,,,0
CDM,27200299,HC CATHETER RE-ENTRY OUTBACK LTD,6757.0,4729.9,,,0
CDM,27200300,HC CATHETER ROB NEL 14 FR,5.0,3.5,,,0
CDM,27200301,HC CATHETER SUCTION 10FR,6.0,4.2,,,0
CDM,27200302,HC CATHETER SUCTION 14FR,5.0,3.5,,,0
CDM,27200303,HC CATHETER SUCTION 5/6 FR,6.0,4.2,,,0
CDM,27200304,HC CATHETER SUCTION 8FR,5.0,3.5,,,0
CDM,27200305,HC CATHETER SUPPORT EV3,700.0,490.0,,,0
CDM,27200306,HC CATHETER SWAN GANZ CCO,823.0,576.1,,,0
CDM,27200307,HC CATHETER THORACIC,32.0,22.4,,,0
CDM,27200308,HC CATHETER TROCAR,32.0,22.4,,,0
CDM,27200309,HC CATHETER UMBILICAL ARTERY,488.0,341.6,,,0
CDM,27200310,HC CATHETER UMBILICAL VESSEL DUAL,189.0,132.3,,,0
CDM,27200311,HC CATHETERIZATION INTERMITTENT,39.0,27.3,,,0
CDM,27200312,HC CAUTERY HI-TEMP FINE TIP ACCUTEMP,71.0,49.7,,,0
CDM,27200313,HC CIRCUIT BREATHING NEONATAL,63.0,44.1,,,0
CDM,27200314,HC CIRCUIT BREATHNG FLXB HT WR L51IN,151.0,105.7,,,0
CDM,27200315,HC CIRCUMCISION SET DISPOSABLE,104.0,72.8,,,0
CDM,27200316,HC COAGULANT SRGICEL 1/2X2,104.0,72.8,,,0
CDM,27200317,HC COAGULANT SRGICEL 2X3,172.0,120.4,,,0
CDM,27200318,HC COLLECTOR NEWBORN URIN STER,10.0,7.0,,,0
CDM,27200319,HC COVER PROBE ULTRASOUND,53.0,37.1,,,0
CDM,27200320,HC CUP BREAST PROTECTIVE MEMBRANES,76.0,53.2,,,0
CDM,27200321,HC CUP VACUUM DISPOSAL STER,143.0,100.1,,,0
CDM,27200322,HC DEVICE EZ-PAP,302.0,211.4,,,0
CDM,27200323,HC DEVICE GUIDEWIRE TORQUE,24.0,16.8,,,0
CDM,27200324,HC DEVICE INFLATION GUARD DOG CO2,1738.0,1216.6,,,0
CDM,27200325,HC DEVICE SAFEGUARD PRESSURE ASSISTED,315.0,220.5,,,0
CDM,27200326,HC DEVICE SAFEGUARD PRESSURE ASSISTED,315.0,220.5,,,0
CDM,27200327,HC DEVICE VERIFYING OPTIMESH,999.0,699.3,,,0
CDM,27200328,HC DRAIN HEMOVAC 1/8,31.0,21.7,,,0
CDM,27200329,"HC DRESSING AQUACEL 3.5"" X 14""",224.0,156.8,,,0
CDM,27200330,HC DRESSING AQUACEL ALGINATE ROPE 6 INCH,25.0,17.5,,,0
CDM,27200332,HC DRESSING EXUDRY SPEC ABSORP 4X6,10.0,7.0,,,0
CDM,27200333,HC DRESSING EXUDRY SPEC ABSORP 6X9,13.0,9.1,,,0
CDM,27200334,HC DRESSING FOAM HYDRASORB 4X4,9.0,6.3,,,0
CDM,27200335,HC DRESSING FOAM HYDRASORB 4X8,79.0,55.3,,,0
CDM,27200336,HC DRESSING FOAM TIELLE 4X4,16.0,11.2,,,0
CDM,27200337,HC DRESSING FOAM TIELLE SACRAL 7X7,35.0,24.5,,,0
CDM,27200338,HC DRESSING GELFOAM,137.0,95.9,,,0
CDM,27200339,HC DRESSING HYDROCOLLOID  4X4 OR <CGF,46.0,32.2,,,0
CDM,27200340,HC DRESSING HYDROCOLLOID 4X4 OR <THIN,46.0,32.2,,,0
CDM,27200341,HC DRESSING HYDROGEL ELASTOGEL,24.0,16.8,,,0
CDM,27200343,HC DRESSING KALTOSTAT PAD,9.0,6.3,,,0
CDM,27200344,HC DRESSING POLYMEM SILVER,64.0,44.8,,,0
CDM,27200345,HC DRESSING POLYWIC PLAIN,30.0,21.0,,,0
CDM,27200346,HC DRESSING POLYWIC SILVER,53.0,37.1,,,0
CDM,27200347,HC DRESSING RELEASE SPEC ABSORP,8.0,5.6,,,0
CDM,27200348,HC DRESSING SORBAVIEW STABILIZATION,22.0,15.4,,,0
CDM,27200349,HC DRESSING WOUND PRISMA,55.0,38.5,,,0
CDM,27200350,HC DRILL HAND 10G,427.0,298.9,,,0
CDM,27200351,HC DRSG ADPTC TOUCH SILIC 3X2IN,13.0,9.1,,,0
CDM,27200352,HC DRSG ADPTC TOUCH SILIC 3X4.25IN,16.0,11.2,,,0
CDM,27200353,HC DRSG POLYMEM WOUND,24.0,16.8,,,0
CDM,27200354,HC DRSG TEGADERM SMALL (BIOCLUSIVE),5.0,3.5,,,0
CDM,27200355,HC DRSG VAC GRANUFOAM MEDIUM,266.0,186.2,,,0
CDM,27200356,HC DRSG VAC GRANUFOAM SMALL,212.0,148.4,,,0
CDM,27200357,HC DRSG VAC GRANUFOAM XLARGE,442.0,309.4,,,0
CDM,27200358,HC DRSG WND 4.24SQIN HX SVRFBRCL ALGNT CLGN,64.0,44.8,,,0
CDM,27200359,HC DRSG WOUND MEPITEL MESH 3X4,37.0,25.9,,,0
CDM,27200360,HC DRSG WOUND MEPITEL MESH 4X8,80.0,56.0,,,0
CDM,27200361,HC DUAL LUMEN PIG,516.0,361.2,,,0
CDM,27200362,HC ELECTRODE SCALP LIFE TRAC,22.0,15.4,,,0
CDM,27200363,HC EXT IV WITH FILTER,19.0,13.3,,,0
CDM,27200364,HC EXTRACTOR KIWI OMNI CUP W/TRACTION,547.0,382.9,,,0
CDM,27200365,HC FILM TRANSPARENT 2.5X3 IN,4.0,2.8,,,0
CDM,27200366,HC FILM TRANSPARENT 4X5 IN,9.0,6.3,,,0
CDM,27200367,HC FILM TRANSPARENT 6X8 IN,10.0,7.0,,,0
CDM,27200368,HC FILTER IV,8.0,5.6,,,0
CDM,27200369,HC FOLEY BAG PRECON,63.0,44.1,,,0
CDM,27200370,HC FOLEY METER PRECON,76.0,53.2,,,0
CDM,27200371,HC FUHRMAN PLEURAL&PNEUM ALL SIZES,509.0,356.3,,,0
CDM,27200372,HC GASTROSTOMY TUBE SET,212.0,148.4,,,0
CDM,27200373,HC GAUZE HYROGEL,25.0,17.5,,,0
CDM,27200374,HC GAUZE NON-ELASTIC STERILE YD,6.0,4.2,,,0
CDM,27200375,HC GAUZE NON-STERILE SURGINET,17.0,11.9,,,0
CDM,27200376,HC GAUZE SALINE/HYDR ADAPTIC 3X16,6.0,4.2,,,0
CDM,27200377,HC GAUZE SALINE/HYDR ADAPTIC 3X3,4.0,2.8,,,0
CDM,27200378,HC GAUZE SALINE/HYDR ADAPTIC 3X8,5.0,3.5,,,0
CDM,27200379,HC GAUZE VASELINE/XEROFORM,5.0,3.5,,,0
CDM,27200380,HC GENERAL/SPINAL/EPIDURAL SUPPLY,150.0,105.0,,,0
CDM,27200381,HC GLIDESCOPE RANGER 3 AND 4 DISPOSABLE,106.0,74.2,,,0
CDM,27200382,HC GLIDEWIRE EXCHANGE,269.0,188.3,,,0
CDM,27200383,HC GUIDE NEEDLE RADIO-FREQUENCY,1061.0,742.7,,,0
CDM,27200384,HC GUIDE WIRE STINGRAY,999.0,699.3,,,0
CDM,27200385,HC GUIDEWIRE NITREX,383.0,268.1,,,0
CDM,27200386,HC HYDROCOIL EMBOLIZATION,900.0,630.0,,,0
CDM,27200387,HC INTRODUCER RADIAL 6FR,275.0,192.5,,,0
CDM,27200389,HC IV PRIMARY INTERLINK AB,69.0,48.3,,,0
CDM,27200390,HC IV SECONDARY INTERLINK,11.0,7.7,,,0
CDM,27200391,HC IV SET NITRO W/LL,40.0,28.0,,,0
CDM,27200392,HC IVAS 10G 15MM (2/15),4327.0,3028.9,,,0
CDM,27200393,HC IVUS SLED,216.0,151.2,,,0
CDM,27200394,HC CUP EXTRACT W/ TRACTION KIWI OMNI,31.0,21.7,,,0
CDM,27200395,HC JACKSON PRATT RESERVOIR,43.0,30.1,,,0
CDM,27200396,HC CATHETER INTRAUTERINE PRESSURE ACCUTRACE,31.0,21.7,,,0
CDM,27200397,HC JACKSON PRATT ROUND/FLAT,118.0,82.6,,,0
CDM,27200398,HC KIT BREAST PUMP MEDELA,157.0,109.9,,,0
CDM,27200399,HC KIT CANNISTER VACUUM W/GEL,225.0,157.5,,,0
CDM,27200400,HC KIT CATH DRESSING,106.0,74.2,,,0
CDM,27200402,HC KIT CATHETER FOLEY W/BAG 16/18FR,59.0,41.3,,,0
CDM,27200403,HC KIT CENTRAL LINE FLUSH,76.0,53.2,,,0
CDM,27200404,HC KIT DRAINAGE BECKER EXTERNAL SYS,630.0,441.0,,,0
CDM,27200405,HC KIT DRESSING WOUND TRAC GRANUFOAM LG,285.0,199.5,,,0
CDM,27200406,HC KIT FEEDING ALL SIZES BUTTON RPLCT GAS,480.0,336.0,,,0
CDM,27200408,HC KIT INDEFLATOR,224.0,156.8,,,0
CDM,27200409,HC KIT MICRO PUNCTURE 3-5FR 21G,174.0,121.8,,,0
CDM,27200410,HC PHERESIS KIT NON-PHOTO,1291.0,903.7,,,0
CDM,27200411,HC KIT QCARE ORAL ANTISEPTIC W/SC,128.0,89.6,,,0
CDM,27200412,HC KIT RADIAL ACCESS,360.0,252.0,,,0
CDM,27200413,HC KIT TIPS ACCESS,1916.0,1341.2,,,0
CDM,27200414,HC KIT TRANSDUCER MONITORING SING LINE 84IN,65.0,45.5,,,0
CDM,27200415,HC KIT UMBILICAL DRAW,9.0,6.3,,,0
CDM,27200416,HC KIT VAS CATH/TESIO DRESSING,105.0,73.5,,,0
CDM,27200417,HC KPHYX ONE-STEP OSTEO INTRO SYSTEM SIZE 3,3212.0,2248.4,,,0
CDM,27200418,HC KYPHON INFLATION SYRINGE,720.0,504.0,,,0
CDM,27200419,HC KYPHOPAK EXPR TRAY 15/2 ADDT'L FX,7971.0,5579.7,,,0
CDM,27200420,HC KYPHOPAK EXPR TRAY 15/2 FIRST FRACTURE,11964.0,8374.8,,,0
CDM,27200421,HC KYPHX EXPR OSTEO INTRO DEV BEVEL/DIAMOND,3113.0,2179.1,,,0
CDM,27200422,HC KYPHX EXPRESS BONE BIOPSY DEVICE SIZE 2,520.0,364.0,,,0
CDM,27200423,HC KYPHX EXPRESS BONE BIOPSY DEVICE SIZE 3,520.0,364.0,,,0
CDM,27200424,HC KYPHX EXPRESS BONE FILLER DEVICE SIZE 2,460.0,322.0,,,0
CDM,27200425,HC KYPHX EXPRESS BONE FILLER DEVICE SIZE 3,495.0,346.5,,,0
CDM,27200426,HC KYPHX EXPRESS INFLATABLE BONE TAMP 15/2,3479.0,2435.3,,,0
CDM,27200427,HC KYPHX EXPRESS OSTEO INTRO DEVICE TROCAR,1598.0,1118.6,,,0
CDM,27200428,HC KYPHX HV-R BONE CEMENT/MIXER PACK,759.0,531.3,,,0
CDM,27200429,HC KYPHX ONE-STEP BEVEL DEVICE SIZE 3,600.0,420.0,,,0
CDM,27200430,HC LOCAL/MAC/BLOCK SUPPLY,66.0,46.2,,,0
CDM,27200431,HC LOCK LEVER INTERLINK,4.0,2.8,,,0
CDM,27200432,HC MANIFOLD 3-VALVE,132.0,92.4,,,0
CDM,27200433,HC MASK BI-PAP SM/MD/LG,139.0,97.3,,,0
CDM,27200434,HC MECONIUM SUCTION DEVICE,68.0,47.6,,,0
CDM,27200435,HC MEDITECH INTRO SHEATH NONLASER,291.0,203.7,,,0
CDM,27200436,HC MEDRAD SYRINGE,31.0,21.7,,,0
CDM,27200438,HC MEPILEX BORDER 4X4IN,21.0,14.7,,,0
CDM,27200439,HC MEPILEX BORDER 4X8IN,35.0,24.5,,,0
CDM,27200440,HC MICROPUNCTURE A,255.0,178.5,,,0
CDM,27200441,HC MICROWAVE ABLATION PROBE,5511.0,3857.7,,,0
CDM,27200443,HC MINI-CATH,284.0,198.8,,,0
CDM,27200444,HC MONITOR CATH FOLEY SIL 10FR TMP,130.0,91.0,,,0
CDM,27200445,HC MONITOR CATH FOLEY SIL 12FR TMP,132.0,92.4,,,0
CDM,27200446,HC MONITOR CATH FOLEY SIL 14FR TMP,112.0,78.4,,,0
CDM,27200447,HC MONITOR CATH FOLEY SIL 16FR TMP,76.0,53.2,,,0
CDM,27200448,HC MONITOR CATH FOLEY SIL 18FR TMP,76.0,53.2,,,0
CDM,27200449,HC MONITOR CATH FOLEY SIL 8FR TMP,132.0,92.4,,,0
CDM,27200450,HC MULLINS SHEATH,435.0,304.5,,,0
CDM,27200451,HC NEEDLE BX TRANSBRONCHIAL,294.0,205.8,,,0
CDM,27200452,HC NEEDLE CHIBA,106.0,74.2,,,0
CDM,27200453,HC NEEDLE HUBER,43.0,30.1,,,0
CDM,27200454,HC NEEDLE HUBER NON-CORING,128.0,89.6,,,0
CDM,27200455,HC NEEDLE HUBER NON-CORING,113.0,79.1,,,0
CDM,27200456,HC NEEDLE INTRODUCER OPTIMESH,427.0,298.9,,,0
CDM,27200457,HC NEEDLE LUMBAR CURVED 18 GAUGE 100MM,142.0,99.4,,,0
CDM,27200458,HC NEEDLE LUMBAR CURVED 20 GAUGE 100MM,142.0,99.4,,,0
CDM,27200459,HC NEEDLE SPINAL 22 X 3 1/2 WH,42.0,29.4,,,0
CDM,27200460,HC DERMABOND .5CC,40.0,28.0,,,0
CDM,27200461,HC NEEDLE SPINAL TUOHY 18 GAUGE X 5.0,57.0,39.9,,,0
CDM,27200462,HC NEEDLE SPINAL TUOHY 20 GAUGE X 3.5,54.0,37.8,,,0
CDM,27200463,HC NEEDLE SPINAL TUOHY 20 GUAGE X 6.0,82.0,57.4,,,0
CDM,27200464,HC NEEDLE TOUHY 18 GAUGE X 3 1/2 IN,39.0,27.3,,,0
CDM,27200465,HC NEPTUNE HEMOSTASIS PAD,148.0,103.6,,,0
CDM,27200466,HC NIPPLE BTL W DBL CLFT PAL,55.0,38.5,,,0
CDM,27200467,HC NIPPLE BTL XCUT LF INF PGN,24.0,16.8,,,0
CDM,27200468,HC NO PORT TUBING,18.0,12.6,,,0
CDM,27200469,HC OXISENSOR TRANSDUCER,82.0,57.4,,,0
CDM,27200470,HC PACK BASIC PROCEDURE,88.0,61.6,,,0
CDM,27200471,HC PACK PROCEDURE DISPOSABLE,238.0,166.6,,,0
CDM,27200472,HC PACKAGE INJECTOR,178.0,124.6,,,0
CDM,27200473,HC PACKING VAGINAL,6.0,4.2,,,0
CDM,27200474,HC PAD AQUACEL,19.0,13.3,,,0
CDM,27200475,HC PAD CHITO-SEAL TOPICAL HEMOSTASIS 4X4C,236.0,165.2,,,0
CDM,27200476,HC PAD HEMOSTASIS CLCM ALGNT 2X2,148.0,103.6,,,0
CDM,27200477,HC PATCH EXTERNAL REFERENCE,1997.0,1397.9,,,0
CDM,27200478,HC PATCH EXTERNAL REFERENCE CARTO 3D,1543.0,1080.1,,,0
CDM,27200479,HC PATCH REFERENCE ENSITE X,2996.0,2097.2,,,0
CDM,27200480,HC PBC PRECISION SYS VERTAPLEX HV CEMENT,1798.0,1258.6,,,0
CDM,27200481,HC PENCIL CAUTERY DISP,51.0,35.7,,,0
CDM,27200482,HC PERCU-STAY,83.0,58.1,,,0
CDM,27200483,HC PLUG VASCULAR AMPLATZER,2913.0,2039.1,,,0
CDM,27200484,HC PORTAL OPTIMESH,427.0,298.9,,,0
CDM,27200485,HC POUCH DRAINABLE/UROSTOMY,6.0,4.2,,,0
CDM,27200486,HC POUCH OSTOMY DRAINABLE EXTENDED,33.0,23.1,,,0
CDM,27200487,HC POUCH OSTOMY DRAINABLE STANDARD,9.0,6.3,,,0
CDM,27200488,HC POUCH OSTOMY URINARY,48.0,33.6,,,0
CDM,27200489,HC POUCH OSTOMY URINARY EXT WEAR,79.0,55.3,,,0
CDM,27200490,HC PROBE INJECTION 7/10 FR,990.0,693.0,,,0
CDM,27200491,HC PROBE RF ABLATION,4077.0,2853.9,,,0
CDM,27200492,HC PROTECTOR SKIN LOLLIPOP,9.0,6.3,,,0
CDM,27200493,HC PTI W/TRACH TUBE,1399.0,979.3,,,0
CDM,27200494,HC RED ROBIN INSERTION,44.0,30.8,,,0
CDM,27200495,HC RESPIRATORY CARE SYSTEM INFANT,226.0,158.2,,,0
CDM,27200496,HC RETRACTOR ALEXIS-O DISPOSABLE,360.0,252.0,,,0
CDM,27200497,HC RING OSTOMY ADAPT,13.0,9.1,,,0
CDM,27200498,HC SENSOR BIS QUATRO,240.0,168.0,,,0
CDM,27200499,HC SENSOR OXYGEN FOREHEAD ADULT,145.0,101.5,,,0
CDM,27200500,HC SENSOR OXYGEN INFANT SAT PROBE,51.0,35.7,,,0
CDM,27200501,HC SENSOR OXYPEDS DISP,88.0,61.6,,,0
CDM,27200502,HC SET BLOOD 3M,13.0,9.1,,,0
CDM,27200503,HC SET CATH FEM ARTERY 3 FR 8 C SNGL LUM,263.0,184.1,,,0
CDM,27200504,HC SET CATH RADIAL ARTERY 2.5FR 5C SGL LUM,179.0,125.3,,,0
CDM,27200505,HC SET EXTENSION,6.0,4.2,,,0
CDM,27200506,HC SET INFUSION BLD COMPONENT FIL 13 IN LON,35.0,24.5,,,0
CDM,27200507,HC SET IV EXTENSION INTERLINK Y TYPE 5IN,22.0,15.4,,,0
CDM,27200508,HC SET IV TUBING BLOOD INTERLINK Y-TYPE,40.0,28.0,,,0
CDM,27200509,HC SET TRANSJUGULAR LIVER BIOPSY,1773.0,1241.1,,,0
CDM,27200510,HC SET TUBING PUMP COOLFLOW,321.0,224.7,,,0
CDM,27200511,HC SHIELD BREAST,30.0,21.0,,,0
CDM,27200512,HC SHIELD BREAST ALL SIZES,30.0,21.0,,,0
CDM,27200513,HC SHIELD BREAST PERSONAL FIT 24,44.0,30.8,,,0
CDM,27200514,HC SHOE POST-OP,25.0,17.5,,,0
CDM,27200515,HC SHUNT TRACKER COOK,165.0,115.5,,,0
CDM,27200516,HC SLEEVE CMPR KNEE SCD EXP LRG,209.0,146.3,,,0
CDM,27200517,HC SLEEVE CMPR KNEE SCD EXP MED,130.0,91.0,,,0
CDM,27200518,HC SLEEVE CMPR KNEE SCD EXP XLG,318.0,222.6,,,0
CDM,27200519,HC SLING ARM,19.0,13.3,,,0
CDM,27200520,HC SOLN IV 0.9% NACL 1L VFLX LF,9.0,6.3,,,0
CDM,27200521,HC SPECULUM DISPOSABLE,16.0,11.2,,,0
CDM,27200522,HC STAPLER PREMIUM POLLY,1906.0,1334.2,,,0
CDM,27200523,HC STAPLER SKIN 35W,54.0,37.8,,,0
CDM,27200524,HC STOPCOCK 3 WAY,5.0,3.5,,,0
CDM,27200525,HC SUCT SYST ETT PED 10FR Y ADAPTER,108.0,75.6,,,0
CDM,27200526,HC SURGIFOAM ABSORBABLE GELATIN SPONGE SIZE 12-7 2CM X 6CM X 0.7CM,137.0,95.9,,,0
CDM,27200527,HC SURGIPAD ABD,3.0,2.1,,,0
CDM,27200528,HC SUTURE CATAGORY 7,41.0,28.7,,,0
CDM,27200529,HC SUTURE CATEGORY 8,24.0,16.8,,,0
CDM,27200530,HC SUTURE CATEGORY 8,24.0,16.8,,,0
CDM,27200531,HC SUTURE SKIN STAPLES TW-35,39.0,27.3,,,0
CDM,27200532,HC SYRINGE INFLATION,240.0,168.0,,,0
CDM,27200533,HC SYST FECAL FLEXI-SEAL FS,900.0,630.0,,,0
CDM,27200534,HC SYST FEM ARCH FEMOSTOP,512.0,358.4,,,0
CDM,27200535,HC SYSTEM AUTOPLEX W/VERTAPLEX HV CEMENT,2662.0,1863.4,,,0
CDM,27200536,HC SYSTEM SHEATH AMPLATZER,935.0,654.5,,,0
CDM,27200537,HC TAPE DRESSING 2IN X 10YD PER 18SQ INCHES,8.0,5.6,,,0
CDM,27200538,HC TAPER DILATOR COONS COOK,132.0,92.4,,,0
CDM,27200539,HC TIP BOVIE TEFLON,39.0,27.3,,,0
CDM,27200540,HC TIPSUCTION YANKUER CLEAR,5.0,3.5,,,0
CDM,27200541,HC TR BAND HEMOSTASIS COMPRESSION DEVICE,196.0,137.2,,,0
CDM,27200542,HC TRANSCATH DELIVERY SYSTEM ENSEMBLE,17303.0,12112.1,,,0
CDM,27200543,HC KT TRUWAVE TRANSDUCER,68.0,47.6,,,0
CDM,27200544,HC TRANSDUCER NEONATAL/PEDIACTRIC DISP,65.0,45.5,,,0
CDM,27200545,HC TRANSDUCER TRIPLE CUSTOM,228.0,159.6,,,0
CDM,27200546,HC TRAY AMNIOCENTESIS 20G X 3,72.0,50.4,,,0
CDM,27200547,HC TRAY BIOPSY BONE PROCEDURE 10G,373.0,261.1,,,0
CDM,27200548,HC TRAY CATHETER FOLEY,52.0,36.4,,,0
CDM,27200549,HC TRAY EPIDURAL,172.0,120.4,,,0
CDM,27200550,HC TRAY EPIDURAL 18 GAUGE,149.0,104.3,,,0
CDM,27200551,HC TRAY EPIDURAL CUSTOM,184.0,128.8,,,0
CDM,27200552,HC TRAY EXCHANGE TRANSFUSION,466.0,326.2,,,0
CDM,27200554,HC TRAY IRRIGATION,11.0,7.7,,,0
CDM,27200555,HC TRAY LUMBAR CATH L30CM OD1.9FR 2,528.0,369.6,,,0
CDM,27200556,HC TRAY LUMBAR PUNCTURE ADULT DIS,72.0,50.4,,,0
CDM,27200557,HC TRAY LUMBAR PUNCTURE PEDS DIS,64.0,44.8,,,0
CDM,27200558,HC TRAY PERICARDIALCENTESIS,520.0,364.0,,,0
CDM,27200559,HC TRAY PICC CATH DRESSING,101.0,70.7,,,0
CDM,27200560,HC TRAY PORT ACCESS LONG TERM,79.0,55.3,,,0
CDM,27200561,HC TRAY PROCEDURE NEO/PED,215.0,150.5,,,0
CDM,27200562,HC TRAY PUNDENDAL,84.0,58.8,,,0
CDM,27200563,HC TRAY SPINAL W/O LIDOCAINE,95.0,66.5,,,0
CDM,27200564,HC TRAY THORACENTESIS DISP,181.0,126.7,,,0
CDM,27200565,HC TRAY TRACH CARE DISPOSABLE,15.0,10.5,,,0
CDM,27200566,HC TRAY URETHRAL PRECONNEC 1,18.0,12.6,,,0
CDM,27200567,HC TRUEPATH CTO DEVICE,6389.0,4472.3,,,0
CDM,27200568,HC TUBE CHEST DRAINAGE SGL COLL DRY SUCTION,197.0,137.9,,,0
CDM,27200569,HC TUBE CHEST THAL QUICK ALL SIZES,468.0,327.6,,,0
CDM,27200570,HC TUBE ENDO TRACH,10.0,7.0,,,0
CDM,27200571,HC TUBE FEEDING KEOFEED,124.0,86.8,,,0
CDM,27200572,HC TUBE HYDROGEL,21.0,14.7,,,0
CDM,27200573,HC TUBE NASAL GASTRIC,52.0,36.4,,,0
CDM,27200574,HC TUBE TRACH ADULT,226.0,158.2,,,0
CDM,27200575,HC TUBE TRACH ADULT HYPERFLEX,424.0,296.8,,,0
CDM,27200576,HC TUBE TRACH COMPLEX,850.0,595.0,,,0
CDM,27200577,HC TUBE TRACH EXT CUFFED,348.0,243.6,,,0
CDM,27200578,HC TUBE TRACH HYPERFLEX ANY SIZE,737.0,515.9,,,0
CDM,27200579,HC TUBE TRACH INTERMEDIATE,341.0,238.7,,,0
CDM,27200580,HC TUBE TRACH NONFENESTRATED UNCUFFED,214.0,149.8,,,0
CDM,27200581,HC TUBE TRACH PEDS,239.0,167.3,,,0
CDM,27200582,HC TUBE TRACH SET BLUE RHINO,1399.0,979.3,,,0
CDM,27200583,HC TUBE TRACH SHILEY ANY SIZE,258.0,180.6,,,0
CDM,27200584,HC TUBE TRACH TTS 7.0,405.0,283.5,,,0
CDM,27200585,HC TUBE TRACH TTS 8.0,405.0,283.5,,,0
CDM,27200586,HC TUBE TRACH TTS SZ 6,405.0,283.5,,,0
CDM,27200587,HC TUBECONNECTINGSUCTION5MM X 6FT,5.0,3.5,,,0
CDM,27200588,HC TUBIGRIP SURG SUPPLY PER YARD,174.0,121.8,,,0
CDM,27200589,HC TUBING CONNECT 10 FT 5MM,6.0,4.2,,,0
CDM,27200590,HC TUBING CONNECT 6FT 5MM,5.0,3.5,,,0
CDM,27200591,HC TUBING EXTENSION HIGH PRESSURE,51.0,35.7,,,0
CDM,27200592,HC TUBING IV PRIMARY,22.0,15.4,,,0
CDM,27200593,HC TUCKER SLING VARIOUS SIZES,156.0,109.2,,,0
CDM,27200594,HC TUCKER SLING VARIOUS SIZES,156.0,109.2,,,0
CDM,27200595,HC URIMETER,55.0,38.5,,,0
CDM,27200596,HC VERTEPORT CEMENT CANNULA 10G,373.0,261.1,,,0
CDM,27200597,HC VERTEPORT SHORT STYLET ACCESS NEEDLE,294.0,205.8,,,0
CDM,27200598,HC VESSEL DILATOR,52.0,36.4,,,0
CDM,27200599,HC WAFER OSTOMY CONVEX,11.0,7.7,,,0
CDM,27200600,HC WAFER SKIN OSTOMY FLAT,8.0,5.6,,,0
CDM,27200601,HC WC SUPPLIES MINOR W/O SUTURES,79.0,55.3,,,0
CDM,27200602,HC WEDGE FOR TUCKER SLING,457.0,319.9,,,0
CDM,27200603,HC WEDGE FOR TUCKER SLING,457.0,319.9,,,0
CDM,27200604,HC WIPE BARRIER SKIN PROTEC/EMOLI BARD,4.0,2.8,,,0
CDM,27200605,HC WIRE PACING TEMPORARY,427.0,298.9,,,0
CDM,27200606,HC WIRE ROTO SCIMED,587.0,410.9,,,0
CDM,27200607,HC WIRE TIGER,480.0,336.0,,,0
CDM,27200608,HC WND FILLMULTIDEX GEL 1 OZ,21.0,14.7,,,0
CDM,27200609,HC WOUND CARE INTER W/O SUTURES,102.0,71.4,,,0
CDM,27200610,HC WOUND CARE MAJOR W/O SUTURES,168.0,117.6,,,0
CDM,27200611,HC WOUND CARE MINOR W/O SUTURES,68.0,47.6,,,0
CDM,27200612,HC SLV CMPR MR KNEE REG SCD EXP,93.0,65.1,,,0
CDM,27200613,HC CATHETER SUCTION 10FR 14FR 16FR,16.0,11.2,,,0
CDM,27200614,HC CONN SUCT ARG PLAS 5 IN 1 BRB,21.0,14.7,,,0
CDM,27200615,HC DRESSING TEGADERM BIOCLUSIVE,4.0,2.8,,,0
CDM,27200616,HC STOPCOCK 3-WAY STD BORE,6.0,4.2,,,0
CDM,27200617,HC CATHETER ROB NEL,5.0,3.5,,,0
CDM,27200619,HC BLOOD FILTER,46.0,32.2,,,0
CDM,27200620,HC BOTTLE CHEST ADULT,242.0,169.4,,,0
CDM,27200621,HC DRESSING TELFA NON-ADHER,3.0,2.1,,,0
CDM,27200622,HC DRESSING SOFT BAND KERLIX,6.0,4.2,,,0
CDM,27200623,HC BANDAGE ELASTIC,8.0,5.6,,,0
CDM,27200624,HC PREP URETHRAL BOAT,13.0,9.1,,,0
CDM,27200625,HC TOURNIQUET STERILE 24IN 30IN,202.0,141.4,,,0
CDM,27200626,HC DERMABOND,121.0,84.7,,,0
CDM,27200627,HC SLV MR CMPR REG KNEE SCD EXP,93.0,65.1,,,0
CDM,27200628,HC PRIMARY IV TUBING,22.0,15.4,,,0
CDM,27200629,HC IV EXTENSION TUBING,13.0,9.1,,,0
CDM,27200630,HC KIT CATH STERILE INFANT,17.0,11.9,,,0
CDM,27200631,HC FEMALE CATH KIT,15.0,10.5,,,0
CDM,27200633,HC SKIN STAPLE EXTRACTOR,16.0,11.2,,,0
CDM,27200634,HC WIRE MICRO-INFUSION,1177.0,823.9,,,0
CDM,27200635,HC CATHETER AXIS SUREFIRE,799.0,559.3,,,0
CDM,27200636,HC MICROCATHETER SUREFIRE,1346.0,942.2,,,0
CDM,27200637,HC NEEDLE AVAMAX 11G,358.0,250.6,,,0
CDM,27200638,HC PROBE ABLATION MICROWAVE PMTA,10449.0,7314.3,,,0
CDM,27200639,HC BIOPSY NEEDLE,54.0,37.8,,,0
CDM,27200640,HC RENTAL DIOMED LASER W/FIBER,605.0,423.5,,,0
CDM,27200641,HC RENTAL OMNI GUIDE LASER 2HRS,733.0,513.1,,,0
CDM,27200642,HC FEE OMNI GUIDE LASER ADDL HRS,134.0,93.8,,,0
CDM,27200645,HC CATH ANGIOPLASTY 5X40X130CML,2816.0,1971.2,,,0
CDM,27200685,HC LAMINARIA,90.0,63.0,,,0
CDM,27200686,HC NEEDLE SPINAL 27 X 4 11/16,40.0,28.0,,,0
CDM,27200687,HC NEEDLE DISCYPHOR DIRECT REG,799.0,559.3,,,0
CDM,27200690,HC AVAFLEX PLUS CURVED INJECTION NEEDLE,1916.0,1341.2,,,0
CDM,27200691,HC CATH INF PER/CENT/MIDLINE,460.0,322.0,,,0
CDM,27200692,HC CATHETER DUAL LUMEN UMBILICAL VESSEL,189.0,132.3,,,0
CDM,27200693,HC CATHETER UMBILICAL VESSEL,93.0,65.1,,,0
CDM,27200694,HC ICD ANTI-BACTERIAL POCKET,2980.0,2086.0,,,0
CDM,27200695,HC PTVP ANTI-BACTERIAL POCKET,2315.0,1620.5,,,0
CDM,27200696,HC WIRE RADIOFREQUENCY NYKANAN,2830.0,1981.0,,,0
CDM,27200697,HC ELECTRODE DISPERSIVE INFANT MACROLYTE,200.0,140.0,,,0
CDM,27200699,HC BALLOON CATH Z-MED II,1762.0,1233.4,,,0
CDM,27200700,HC CATHETER ULTRAFUSE SCIMED,1055.0,738.5,,,0
CDM,27200703,HC CATHETER MICRO CANTATA,1203.0,842.1,,,0
CDM,27200704,HC DRAINAGE CHEST PEDI/INFANT,253.0,177.1,,,0
CDM,27200705,HC CATH POLYURETHANE TRIPLE LUMEN 5FR,229.0,160.3,,,0
CDM,27200706,HC CATH IV INSYTE WNGD SAFETY 24G,13.0,9.1,,,0
CDM,27200707,HC GLIDESCOPE RANGER 0 1 AND 2 DISPOSABLE,143.0,100.1,,,0
CDM,27200708,HC POUCH URO ODOR PROOF W/ PLAIN BARR 9 IN,46.0,32.2,,,0
CDM,27200709,HC TUBE ET ANG TP ESCHANN 15FR,49.0,34.3,,,0
CDM,27200710,HC INTRODUCER AVANTI,47.0,32.9,,,0
CDM,27200711,HC SPECULUM DISPOSABLE,16.0,11.2,,,0
CDM,27200712,HC EXTENSION SET,9.0,6.3,,,0
CDM,27200713,HC CATH IV 16 X 1 1/4,15.0,10.5,,,0
CDM,27200714,HC CATH IV 18 X 1 3/4 LATEX FREE,39.0,27.3,,,0
CDM,27200715,HC CATH IV 20 X 1 1/4 LATEX FREE,39.0,27.3,,,0
CDM,27200716,HC OXISENSOR TRANSDUCER,91.0,63.7,,,0
CDM,27200717,HC MIDSTREAM VACUTAINER,8.0,5.6,,,0
CDM,27200719,HC URIMETER,59.0,41.3,,,0
CDM,27200726,HC CATH TRANSLUMINAL ANGIO LASER PERIPHERAL,6989.0,4892.3,,,0
CDM,27200727,HC HEAMONETIC CELL SAVER,2584.0,1808.8,,,0
CDM,27200728,HC DAVINCI SUPPLY,2929.0,2050.3,,,0
CDM,27200730,HC HEART PUMP PERFUSIONIST SUPPLY,8771.0,6139.7,,,0
CDM,27200731,HC CARTRIDGE BN CORTOSS 10CC,4792.0,3354.4,,,0
CDM,27200732,HC NOZZLE DLV MIX TIPS LUER 3PK,700.0,490.0,,,0
CDM,27200733,HC GUN CORTOSS MIX DELIVERY,1198.0,838.6,,,0
CDM,27200734,HC CARTRIDGE CORTOSS BN AUG 5CC,2330.0,1631.0,,,0
CDM,27200736,HC CORSAIR CATHETER 135,1832.0,1282.4,,,0
CDM,27200737,HC COCHLEAR PROCESSOR Z185554,16620.0,11634.0,,,0
CDM,27200738,HC COCHLEAR PROCESSOR DISCOUNTED Z185554,8310.0,5817.0,,,0
CDM,27200739,HC STRYKER CURETTE 10G,1806.0,1264.2,,,0
CDM,27200740,HC RETRIEVAL DEVICE AIRWAY,940.0,658.0,,,0
CDM,27200741,HC AXO TRACK ACCESS KIT,283.0,198.1,,,0
CDM,27200742,HC CATHETER CRYO 6MM,4427.0,3098.9,,,0
CDM,27200743,HC INTERLOCK COILS,1898.0,1328.6,,,0
CDM,27200744,HC SENSOR OXY RECYCLED NEONAT/ADULT DISP,36.0,25.2,,,0
CDM,27200751,HC SALEM SUMP TUBE,27.0,18.9,,,0
CDM,27200753,HC FOLEY CATHETER 2 WAY,77.0,53.9,,,0
CDM,27200757,HC FEEDING TUBE - 12 FRENCH,29.0,20.3,,,0
CDM,27200759,HC DRSG DUODERM EXT THIN (TEGASORB),22.0,15.4,,,0
CDM,27200763,HC AVATEX BONE CEMENT INJECTOR,1180.0,826.0,,,0
CDM,27200764,HC ANGIOVAC CANNULA,34606.0,24224.2,,,0
CDM,27200765,HC IV CATH ALL SIZES,15.0,10.5,,,0
CDM,27200766,HC CATH ANGIOPLASTY 4X120X130CML,3116.0,2181.2,,,0
CDM,27200767,HC CATH H1 ATHERECTMY STD,6490.0,4543.0,,,0
CDM,27200769,HC PACIFIC EXTREME PERIPHERAL ANGIOPLASTY BALLOON CATH 250.0X5.0 MILL,371.0,259.7,,,0
CDM,27200770,HC FORCEP BIOPSY DISP,1140.0,798.0,,,0
CDM,27200771,HC GUIDE EXTENDER,798.0,558.6,,,0
CDM,27200773,HC OUTBACK LTD RE-ENTRY CATHETER,6757.0,4729.9,,,0
CDM,27200774,HC MARKER CATHETER,560.0,392.0,,,0
CDM,27200775,HC PRONTO CATHETER,900.0,630.0,,,0
CDM,27200776,HC CATH EXTRAVASCULAR TISS ABLAT,830.0,581.0,,,0
CDM,27200777,HC  ATLAS GOLD BALLOON,1687.0,1180.9,,,0
CDM,27200778,HC CATH TRUE BALLOON,2830.0,1981.0,,,0
CDM,27200779,HC AVAFLEX VERTEBRAL BALLOON,9983.0,6988.1,,,0
CDM,27200783,HC CATH INQUE BALLN 28MM,7654.0,5357.8,,,0
CDM,27200784,HC HYDROFERA BLUE READY 4X5,47.0,32.9,,,0
CDM,27200785,HC HYDROFERA BLUE READY 8X8,84.0,58.8,,,0
CDM,27200786,HC LUTONIX DRUG COVERED BALLOON,5492.0,3844.4,,,0
CDM,27200787,HC MULTI-LUMEN CENTRAL VENOUS KIT,116.0,81.2,,,0
CDM,27200794,HC DRAGONFLY INTRAVASCULAR IMAGING,2662.0,1863.4,,,0
CDM,27200795,HC RES Q WEDGE,670.0,469.0,,,0
CDM,27200796,HC RES Q SLING,307.0,214.9,,,0
CDM,27200797,HC AMPLATZER TORQUE PDA DELIVERY SYSTEM,2450.0,1715.0,,,0
CDM,27200798,HC BRITE BLADE (ALL SIZES),207.0,144.9,,,0
CDM,27200802,HC DEVICE SUT DLV LARIAT,16473.0,11531.1,,,0
CDM,27200803,HC CUTTER SUT SURECUT LARIAT,1598.0,1118.6,,,0
CDM,27200804,HC CANNULA SOFTIP LNG 4.3MM,1198.0,838.6,,,0
CDM,27200805,HC PULLER SUT TENSURE LARIAT,799.0,559.3,,,0
CDM,27200807,HC STIFF ANGLED GLIDEWIRE 180CM .035,141.0,98.7,,,0
CDM,27200808,HC GLIDECATH STRAIGHT,299.0,209.3,,,0
CDM,27200813,HC KIT INTVN CLSR + .018IN L7CM,185.0,129.5,,,0
CDM,27200814,HC DEV MAX30 20ML SYR MNMTR INFL,252.0,176.4,,,0
CDM,27200816,HC GJ TUBE PEDS,1646.0,1152.2,,,0
CDM,27200817,HC RIGHT ANGLE BOLUS/Y G-J FEEDING SET,533.0,373.1,,,0
CDM,27200820,HC GENCUT CORE BIOPSY SYSTEM,1399.0,979.3,,,0
CDM,27200821,HC JETSTREAM SC ATHERECTOMY CATHETER ALL SIZES,9485.0,6639.5,,,0
CDM,27200826,HC BROVIAC REPAIR KIT 4.2FR,693.0,485.1,,,0
CDM,27200827,HC BARD ULTRAVERSE 035 PTA DILATATION CATHETER 4MM AND 6MM DIAMETER,460.0,322.0,,,0
CDM,27200829,HC CENTRAL LINE PLACEMENT SUPPLIES,1955.0,1368.5,,,0
CDM,27200830,HC ARTERIAL LINE SUPPLIES,1242.0,869.4,,,0
CDM,27200831,HC SWAN GANZ SUPPLIES,3850.0,2695.0,,,0
CDM,27200836,HC SITZMARKS,501.0,350.7,,,0
CDM,27200838,HC MULTILAYER COMPRESSION BANDAGE,80.0,56.0,,,0
CDM,27200839,HC TCC-EZ CAST SYSTEM W/2 REG BOOTS 3-4 INCH,435.0,304.5,,,0
CDM,27200840,HC TCC-EZ REGULAR BOOT MENS 6-10/WOMENS 5-11.5,362.0,253.4,,,0
CDM,27200841,HC TCC EZ-LARGE BOOT MENS 10.5-13/WOMENS 11.5+ WIDE,432.0,302.4,,,0
CDM,27200842,HC TCC-EZ XL BOOT 13.5-18 WIDE,454.0,317.8,,,0
CDM,27200843,HC TCC-EZ LARGE CHARCOT BOOT,495.0,346.5,,,0
CDM,27200844,HC TCC-EZ XL CHARCOT BOOT,523.0,366.1,,,0
CDM,27200845,HC PICC SHEATH INTRODUCER ONLY 1.4 FR,187.0,130.9,,,0
CDM,27200846,HC PLOY PICC COMPLETE KIT,476.0,333.2,,,0
CDM,27200847,HC LOCATOR PLUS,840.0,588.0,,,0
CDM,27200848,HC GELOCAST UNNA BOOT,409.0,286.3,,,0
CDM,27200849,HC MEDELA STARTER SNS,156.0,109.2,,,0
CDM,27200851,HC EYE EXAM KITS ROP,161.0,112.7,,,0
CDM,27200852,HC DRSG OPN PORE HYDPHB NEG PRSS,128.0,89.6,,,0
CDM,27200853,HC DRSG L15 X W 10CM LG S LF VAC,92.0,64.4,,,0
CDM,27200854,HC DRSG L60 X W 30CM OPN PORE,532.0,372.4,,,0
CDM,27200855,HC OSTOMY BELT LRG,10.0,7.0,,,0
CDM,27200857,HC CONNECTOR DRN Y-TYPE CA/10,15.0,10.5,,,0
CDM,27200858,HC DILATOR PLST TPRD 14F 70CM,264.0,184.8,,,0
CDM,27200859,HC ESOPHAGEAL TEMP PROBE,1997.0,1397.9,,,0
CDM,27200861,HC PROTACK PIGTAIL WIRE 0.025IN DIAMETER 230CM LENGTH,1978.0,1384.6,,,0
CDM,27200862,HC NRG RF TRANSSEPTAL NEEDLE 71CM,860.0,602.0,,,0
CDM,27200863,HC CATHETER BRACHYTHERAPY SEED ADMINISTRATION,8320.0,5824.0,,,0
CDM,27200865,HC HUMMI MICRO DRAW BLOOD TRANSFER DEVICE,39.0,27.3,,,0
CDM,27200866,HC HUMMINGBIRD T CONNECTOR,16.0,11.2,,,0
CDM,27200867,HC 1CC VNTD SYRINGE W/HEP NO NEEDLE,6.0,4.2,,,0
CDM,27200868,HC 3CC VNTD SYRINGE NO HEP NO NEEDLE,6.0,4.2,,,0
CDM,27200869,HC NEEDLE ANESTHESIA EPIDURAL 17GX5 WEISS THIN WALL,54.0,37.8,,,0
CDM,27200870,HC MONGOOSE PEDIATRIC ANGIOGRAPHY CATHETER 4F 60 CM,501.0,350.7,,,0
CDM,27200871,HC BOSTON SCIENTIFIC WATCHMAN ANTERIOR CURVE 14F,3328.0,2329.6,,,0
CDM,27200872,HC BOSTON SCIENTIFIC WATCHMAN LAA CLOSURE DEVICE 24 MM,45254.0,31677.8,,,0
CDM,27200873,HC INTRO/SHEATH FIXED NON-PEEL VISISHEATH,900.0,630.0,,,0
CDM,27200874,HC ECKOSONIC MACH 4 ENDOVASCULAR DEVICE 135CM,9605.0,6723.5,,,0
CDM,27200879,HC DEPLOYMENT CATH AND LOADER HUD,2497.0,1747.9,,,0
CDM,27200880,HC KIT AIRWAY SIZING HUD,960.0,672.0,,,0
CDM,27200883,HC VIATRAC BALLOON,855.0,598.5,,,0
CDM,27200884,HC VERSACORE GUIDE WIRE,536.0,375.2,,,0
CDM,27200890,HC TAD WIRE,506.0,354.2,,,0
CDM,27200891,HC ARMADA 35 CATH BALLOON,572.0,400.4,,,0
CDM,27200892,HC ARMADA 14 CATH BALLOON,1043.0,730.1,,,0
CDM,27200893,HC ARMADA 18 PTA BALLOON,911.0,637.7,,,0
CDM,27200917,HC INFLATION GUN,1678.0,1174.6,,,0
CDM,27200918,HC PULMONARY BALLOON DILATOR,1180.0,826.0,,,0
CDM,27200946,HC EMBOSHIELD PROTECTION SYSTEM,4161.0,2912.7,,,0
CDM,27200947,HC PULMONARY INFLATION SYRINGE,184.0,128.8,,,0
CDM,27201015,HC BRIDGE OCCLUSION BALLOON CATHETER,2727.0,1908.9,,,0
CDM,27201016,HC BRIDGE PREP KIT,1027.0,718.9,,,0
CDM,27201017,HC TIGHTRAIL ROTATING DILATOR SHEATH 11FR,6078.0,4254.6,,,0
CDM,27201018,HC TIGHTRAIL SUB-C ROTATING DILATOR SHEATH 9FR,5437.0,3805.9,,,0
CDM,27201043,HC BOSTON SCIENTIFIC PULM SNARE DEVICE,466.0,326.2,,,0
CDM,27201063,HC CENTRAL VENOUS 2 LUM CATHETER SET 5.0 FR / 8 CM / 0.18 DIAMETER,493.0,345.1,,,0
CDM,27201066,HC MEDIHONEY HCS NON-ADHESIVE DRESSING 2 X 2 (DERMASCIENCES),28.0,19.6,,,0
CDM,27201067,HC MEDIHONEY HCS NON-ADHESIVE DRESSING 4 X 4 (DERMASCIENCES),64.0,44.8,,,0
CDM,27201074,HC TOURGUIDE STEERABLE SHEETH,1845.0,1291.5,,,0
CDM,27201076,HC TURKEL PNEUMOTHORAX PROC TRAY,395.0,276.5,,,0
CDM,27201080,HC CATH GUIDEZILLA 6F LONG,1452.0,1016.4,,,0
CDM,27201083,HC GUIDE WIRE MAXXWIRE .035 X 180,484.0,338.8,,,0
CDM,27201084,HC MERIT MEDICAL ELATION BALLOON DILATOR,1065.0,745.5,,,0
CDM,27201085,HC PLEURX-CATH ACCESS KIT,205.0,143.5,,,0
CDM,27201086,HC THORACENTESIS KIT,176.0,123.2,,,0
CDM,27201096,HC DEBRISOFT,77.0,53.9,,,0
CDM,27201120,HC 5MAX REPERFUSION CATHETER 6FR,9092.0,6364.4,,,0
CDM,27201121,HC 3MAX REPERFUSION CATHETER 4.7FR,6527.0,4568.9,,,0
CDM,27201122,HC SHEATH NEURON MAX,1898.0,1328.6,,,0
CDM,27201123,HC BENCHMARK INTRACRANIAL ACCESS SYSTEM,3161.0,2212.7,,,0
CDM,27201124,HC CATH SELECT SIMV 6FR,484.0,338.8,,,0
CDM,27201148,HC INZONE 2.0 DETACHMENT SYSTEM,829.0,580.3,,,0
CDM,27201150,HC CATH EXCELSION SL10 MICRO J,3124.0,2186.8,,,0
CDM,27201152,HC GUIDE CATH MERCI BLLN 9F X 80CM,3947.0,2762.9,,,0
CDM,27201153,HC SHEATH AXS INFINITY LS LNG 70,1822.0,1275.4,,,0
CDM,27201154,HC RETRIEVER TERO XP PROVUE 4 X 20M,18819.0,13173.3,,,0
CDM,27201163,"HC MARKSMAN MICRO CATHETER 3.2 > 2.8F 0.027"" DIA 160CM",3513.0,2459.1,,,0
CDM,27201164,HC SOLITAIRE PLATINUM REVASC DEVICE 4 X 20MM / 4 X 40MM / 6 X 40MM,17039.0,11927.3,,,0
CDM,27201165,HC APOLLO ONYX DELIVERY MICRO CATHETER 2.7F,5629.0,3940.3,,,0
CDM,27201167,HC SET EPIX PROBE TUNING 5MM X 33CM,371.0,259.7,,,0
CDM,27201168,HC SET EPIX VLV W DUAL BAG TUBING,345.0,241.5,,,0
CDM,27201174,HC LUTONIX 035 DRUG COATED BALLOON PTA CATH 5F,1634.0,1143.8,,,0
CDM,27201184,HC OSSEOFLEX STEERABLE NEEDLE 10GA,4154.0,2907.8,,,0
CDM,27201185,HC OSSEOFLEX STEERABLE BALLOON 10GA,6078.0,4254.6,,,0
CDM,27201186,HC OSSEOFLEX VERTEBRAL ACCESS KIT 10GA,1918.0,1342.6,,,0
CDM,27201187,HC BASIXTOUCH INFLATION DEVICE,1531.0,1071.7,,,0
CDM,27201188,HC OSSEOFLEX CEMENT BONE POLYMER MEDIUM/HIGH VISCOSITY,3192.0,2234.4,,,0
CDM,27201189,HC OSSEOFLEX CEMENT MIXER,1143.0,800.1,,,0
CDM,27201190,HC OSSEOFLEX CD-H HYDRAULIC CEMENT DELIVERY SYSTEM,3192.0,2234.4,,,0
CDM,27201191,HC OSSEOFLEX HAND DRILL 10GA COMPATIBLE,1268.0,887.6,,,0
CDM,27201192,HC OSSEOFLEX BONE FILLER TUBE 10GA,1909.0,1336.3,,,0
CDM,27201194,HC SALIENT SURGICAL AQUAMANTYS,1627.0,1138.9,,,0
CDM,27201195,HC AVECURE PROBE MINI - LARGE,9620.0,6734.0,,,0
CDM,27201197,HC OSSEOFLEX BALLOON SB STRAIGHT 10GA 4ML,4795.0,3356.5,,,0
CDM,27201199,HC KIT STABILIT MX W/ PWRCRV 10GA,8002.0,5601.4,,,0
CDM,27201200,HC BAG DRAINAGE REPLACEMENT FOR DUET,259.0,181.3,,,0
CDM,27201201,HC CATH SET BACTISEAL EVD,2457.0,1719.9,,,0
CDM,27201210,HC COSEAL SURGICAL SEALANT 8ML,3072.0,2150.4,,,0
CDM,27201211,HC TREVO MICROCATHETER,2438.0,1706.6,,,0
CDM,27201227,HC CATH ENVOY DA MPD,2514.0,1759.8,,,0
CDM,27201233,HC DRSNG BIATAIN SILICONE 3X3IN-7X7IN,42.0,29.4,,,0
CDM,27201234,HC DRSNG BIATAIN SIL LITE 2X2IN-4X4IN,16.0,11.2,,,0
CDM,27201245,HC DEVICE SEALING 10MM OD 20CML STRAIGHT NON-ABSORB BLUNT JAW BILAT F/FORCETRIAD ENERGY PLATFORM LIG,1559.0,1091.3,,,0
CDM,27201247,HC CATH SAPPHIRE II PRO,775.0,542.5,,,0
CDM,27201259,HC CATH PHENOM + DIST ACCESS,5757.0,4029.9,,,0
CDM,27201281,HC CATALYST 6 132CM,6992.0,4894.4,,,0
CDM,27201282,HC TREVO FAST PACK,24128.0,16889.6,,,0
CDM,27201290,HC SENTINEL CEREBRAL PROTECTION SYSTEM,12826.0,8978.2,,,0
CDM,27201364,HC FIBER WAVEGUIDE FEE,968.0,677.6,,,0
CDM,27201374,HC PLEURX-PATIENT STARTER KIT,1408.0,985.6,,,0
CDM,27201375,HC DRSG RELIATECT W-CHG 8CMX15CM,125.0,87.5,,,0
CDM,27201376,HC DRSG RELIATECT W-CHG 10CMX25CM,197.0,137.9,,,0
CDM,27201396,HC SVC FEE HOLMIUM LASER,545.0,381.5,,,0
CDM,27201397,HC FIBER HOLMIUM SNGL USE 150-300,242.0,169.4,,,0
CDM,27201398,HC FIBER HOLMIUM SNGL USE 300-400,273.0,191.1,,,0
CDM,27201399,HC SVC FEE LITHROTRIPSY,1936.0,1355.2,,,0
CDM,27201400,HC SVC FEE LITHROTRIPSY XTRA SHOCK,495.0,346.5,,,0
CDM,27201401,HC EMERGENCY/AFTER HOURS,303.0,212.1,,,0
CDM,27201402,HC KIT IMPELLA RP INTRODUCER,2246.0,1572.2,,,0
CDM,27201403,HC INTRODUCER D VILL,888.0,621.6,,,0
CDM,27201488,HC CATH DIAMONDBACK360 1.25 135CM,13310.0,9317.0,,,0
CDM,27201489,HC CLAMP CIRC W/BELL 1.1/1.3/1.45 CM DISP,168.0,117.6,,,0
CDM,27201532,HC SVC FEE ULTRASOUND HLTHRONICS,2904.0,2032.8,,,0
CDM,27201559,HC SHOCKWAVE LITHOPLASTY CATHETER,15073.0,10551.1,,,0
CDM,27201572,HC PENUMBRA ENGINE CANISTER,1414.0,989.8,,,0
CDM,27201573,HC INDIGO 12 XTORQ TIP & LIGHTING ASPIRATION TUBING 12FR 100CM .014-.038 INCHES,17407.0,12184.9,,,0
CDM,27201574,HC SEPARATOR 12 .110IN X 150CM WIRE,6398.0,4478.6,,,0
CDM,27201600,HC CLOTTRIEVER CATHETER,16517.0,11561.9,,,0
CDM,27201601,HC CLOTTRIEVER SHEATH 13F,4811.0,3367.7,,,0
CDM,27201602,HC CLOTTRIEVER SHEATH 16F,4811.0,3367.7,,,0
CDM,27201625,HC CONQUEST BALLON 10 X2,719.0,503.3,,,0
CDM,27201634,HC INTRO DRYSEAL FLEX 33CM,1856.0,1299.2,,,0
CDM,27201635,HC SHEATH DRYSEAL FLEX,2420.0,1694.0,,,0
CDM,27201640,HC CATH SUPREME QUAD,1400.0,980.0,,,0
CDM,27201641,HC CATH CLEAN THRMB 15-7FRX135CM ARGON,4971.0,3479.7,,,0
CDM,27201655,HC CATH SOFTVU OMNI .035 5FX65CM,214.0,149.8,,,0
CDM,27201665,HC WIRE CATH PRFR RF NYKANEN,2727.0,1908.9,,,0
CDM,27201669,HC VOLCANO VISIONS PV DIGITAL IVUS CATHETER 0.035,3192.0,2234.4,,,0
CDM,27201670,HC ABRE STENT 60MM AND 100MM,5437.0,3805.9,,,0
CDM,27201671,HC ABRE STENT 150MM,6175.0,4322.5,,,0
CDM,27201672,HC STEERABLE BALLOON 10G 15MM,6767.0,4736.9,,,0
CDM,27201673,HC BS EXALT MODEL B BRONCHOSCOPE,1531.0,1071.7,,,0
CDM,27201685,HC CATH PICC 3FR 55CM 1L POWER INJECTION,734.0,513.8,,,0
CDM,27201700,HC SHEATH VIZIGO BI DIRECT GD SM CURVE,2781.0,1946.7,,,0
CDM,27201701,HC CATH DECANAV MAP,3067.0,2146.9,,,0
CDM,27201702,HC CASSETTE IMPELLA IABP PRG 2.5,3209.0,2246.3,,,0
CDM,27201706,HC SILICONE WATERPROOF TAPE PER 9 INCHES,4.0,2.8,,,0
CDM,27201712,HC CATHETER BALLON WEDGE PRESSURE,444.0,310.8,,,0
CDM,27201713,HC CATHETER ATLAS GOLD BALLON 20MMX2CM,2018.0,1412.6,,,0
CDM,27201714,HC CENTRAL VENOUS CATHETER SET 5.0FR/15 CM,213.0,149.1,,,0
CDM,27201715,HC BRACHYTHERAPY NEEDLE,455.0,318.5,,,0
CDM,27201726,HC SOUNDSTAR ECO DIAGNOSTIC ULTRASOUND CATHETER 8FR,7706.0,5394.2,,,0
CDM,27201727,HC PERIPHERAL IVL CATHETER,11064.0,7744.8,,,0
CDM,27201741,HC KIT INDIGO CATHETER ASPIRATION INCLUDING TUBING,6446.0,4512.2,,,0
CDM,27201742,HC INDIGO SYSTEM LIGHTNING 7,14358.0,10050.6,,,0
CDM,27201743,HC CATH OCTARAY D-CRV,7059.0,4941.3,,,0
CDM,27201744,HC MEPILEX BORDER 4X10IN,136.0,95.2,,,0
CDM,27201745,HC MEPILEX BORDER 4X12IN,140.0,98.0,,,0
CDM,27201748,HC CODMAN CRANIAL ACCESS KIT,1410.0,987.0,,,0
CDM,27201749,HC MEDTRONIC BARIUM IMPREGNATED VENTRICULAR CATHETER,674.0,471.8,,,0
CDM,27201751,HC CATHETER ANGIOJET ZELANTE DVT,12353.0,8647.1,,,0
CDM,27201752,HC CATHETER ANGIOJET SOLENT DISTA 4F,6409.0,4486.3,,,0
CDM,27201753,HC CATHETER ULTRASOUND OPTICROSS 0.018IN 4F X 135CM,2156.0,1509.2,,,0
CDM,27201754,HC CATHETER RANGER DCB 4X100MM 135CM,5452.0,3816.4,,,0
CDM,27201755,HC CATHETER RANGER DCB OTW 4/5 X 150MM X 150CM,5934.0,4153.8,,,0
CDM,27201756,HC CATHETER RANGER DCB OTW 5/6/7 X 150/200MM X 150CM,7055.0,4938.5,,,0
CDM,27201761,HC MICRO CATHETER 2.3FR X 150 CM,7055.0,4938.5,,,0
CDM,27201770,HC GW FIELDER FC STRT 300CM,339.0,237.3,,,0
CDM,27201771,HC GW PROWATERFLEX WH J-TIP 180CM,339.0,237.3,,,0
CDM,27201772,HC GW EXTENSION ASAHI GW 165CM,366.0,256.2,,,0
CDM,27201773,HC GW MINAMO STRT TIP 190CM,366.0,256.2,,,0
CDM,27201774,HC GW SION BLACK J-TIP 300CM,366.0,256.2,,,0
CDM,27201775,HC GW MINAMO J-TIP 190/300CM,366.0,256.2,,,0
CDM,27201776,HC GW SION BLUE STRT .014INX190CM,417.0,291.9,,,0
CDM,27201777,HC GW SION BLUE FL J-TIP 190CM,417.0,291.9,,,0
CDM,27201778,HC GW SION BLUE FL STRT 300CM,417.0,291.9,,,0
CDM,27201779,HC GW GRAND SLAM J-TIP .014X 180/300CM,444.0,310.8,,,0
CDM,27201780,HC GW SION BLACK STRT 190/300 CM,444.0,310.8,,,0
CDM,27201781,HC GW SION BLACK J-TIP 190CM,444.0,310.8,,,0
CDM,27201782,HC GW GRAND SLAM STRT .014X180CM,444.0,310.8,,,0
CDM,27201783,HC GW MICROCATH CORSAIR PRO XS 2.1F,1765.0,1235.5,,,0
CDM,27201784,HC GW MICROCATH CORSAIR PRO 2.6FX135,1765.0,1235.5,,,0
CDM,27201785,HC GW VASC .45MMDIA 300CM STRT,427.0,298.9,,,0
CDM,27201786,HC GW FIELDER XT-A 0.6G STRT 190,446.0,312.2,,,0
CDM,27201787,HC GW CONFIANZA PRO 12 STRT 180CM,446.0,312.2,,,0
CDM,27201788,HC GW GAIA NEXT 2 PRE-SHAPE 190CM,446.0,312.2,,,0
CDM,27201789,HC GW MIRACLEBROS 6 STRT 180CM/300CM,446.0,312.2,,,0
CDM,27201790,HC GW SION WH STRT 300CM,446.0,312.2,,,0
CDM,27201791,HC GW RG3 CTO STRAIGHT 330CM,446.0,312.2,,,0
CDM,27201792,HC GW GLADIUS MONGO STRT 190CM,446.0,312.2,,,0
CDM,27201793,HC GW GLADIUS MONGO ES PRE-SHAPE 300CM,446.0,312.2,,,0
CDM,27201794,HC GW GLADIUS MONGO ES STRT 300CM,446.0,312.2,,,0
CDM,27201795,HC GW CONFIANZA PRO STRT 180CM,446.0,312.2,,,0
CDM,27201796,HC GW FIELDER XT STRT 190CM/300CM,446.0,312.2,,,0
CDM,27201797,HC GW MIRACLEBROS 3/12 STRT 300CM,446.0,312.2,,,0
CDM,27201798,HC GW SUOH 03 STRAIGHT 190CM,446.0,312.2,,,0
CDM,27201799,HC GW VASC .014/.018DIA 180CML,581.0,406.7,,,0
CDM,27201800,HC GW ASTATO 30 STRT 180CM,581.0,406.7,,,0
CDM,27201801,HC GW ASTATO XS 20 STRT 300CM,581.0,406.7,,,0
CDM,27201802,HC GW MICROCATH CORSAIR PRO XS 150CM,2727.0,1908.9,,,0
CDM,27201803,HC GW GLADIUS STRT 0.014/0.018INX300CM,659.0,461.3,,,0
CDM,27201804,HC GW VASC .45MMDIA 300CM LGTH,698.0,488.6,,,0
CDM,27201805,HC GW HALBRED STRT 0.014INX300CM,698.0,488.6,,,0
CDM,27201807,HC GW CATH SASUKE GD TAPER TIP 145CM,1531.0,1071.7,,,0
CDM,27201808,HC GW THRUWAY .014 STRAIGHT,438.0,306.6,,,0
CDM,27201812,HC MICROCATHETER SNIPER OCCLUSION 150CM,4330.0,3031.0,,,0
CDM,27201813,HC SYSTEM INDIGO LIGHTNING,21966.0,15376.2,,,0
CDM,27201817,HC CATHETER COYOTE OTW 2.5MM X 220MM X 150CM,1085.0,759.5,,,0
CDM,27201818,HC CATHETER SOUNDSTAR ECO ICE,2336.0,1635.2,,,0
CDM,27201830,HC CATHETER SHOCKWAVE C2 INTRAVASCULAR LITHOTRIPSY,13702.0,9591.4,,,0
CDM,27201833,HC CATHETER LIGHTNING EMBOL 16FR X 115CM,22662.0,15863.4,,,0
CDM,27201837,HC KIT CATHETER THROMBECTOMY,10903.0,7632.1,,,0
CDM,27201838,HC CATHETER WEBSTER CS BI-DIRECT D-F 7FR X 115CM,634.0,443.8,,,0
CDM,27201842,HC PERIPHERAL ROTALINK PLUS BURR CATHETER 1.50MM X 5F,4956.0,3469.2,,,0
CDM,27201843,HC PERIPHERAL ROTALINK PLUS BURR CATHETER 1.75/2.00MM X 6/7F,3779.0,2645.3,,,0
CDM,27201844,HC SURPREME ELECTROPHYSIOLOGY CATHETER 5MM CRD2 6FR X 120CM,193.0,135.1,,,0
CDM,27201845,HC FLEXIBLE CRYOPROBE SINGLE USE 1.1 MM LENGTH 1150 MM W/OVERSHEATH LENGTH 817MM,1434.0,1003.8,,,0
CDM,27201846,HC FLEXIBLE CRYOPROBE SINGLE USE 1.7/2.4 MM LENGTH 1150,1071.0,749.7,,,0
CDM,27201851,HC SHEATH AGILIS NXT STEERABLE INTRODUCER MED CURVE,2859.0,2001.3,,,0
CDM,27201852,HC SHEATH AGILIS NXT STEERABLE INTRODUCER SM CURVE,1599.0,1119.3,,,0
CDM,27201853,HC CATHETER OCTAPOLAR D-CRV 6FR X 92CM,392.0,274.4,,,0
CDM,27201854,HC CATHETER DUO-DECAPOLAR 7F,986.0,690.2,,,0
CDM,27201855,HC CATHETER VIEWFLEX XTRA INTRACARDIAC ECHOCARDIOGRAPHY 9F,6825.0,4777.5,,,0
CDM,27201865,HC KIT DRESSING RENASYS-G GAUZE SMALL,148.0,103.6,,,0
CDM,27201866,HC KIT DRESSING RENASYS-G GAUZE MEDIUM,186.0,130.2,,,0
CDM,27201867,HC KIT DRESSING RENASYS-G GAUZE LARGE,264.0,184.8,,,0
CDM,27201868,HC PATCH RENASYS ADHESIVE GEL 7X10CM,33.0,23.1,,,0
CDM,27201869,HC KIT DRESSING RENASYS-F FOAM SMALL,148.0,103.6,,,0
CDM,27201870,HC KIT DRESSING RENASYS-F FOAM MEDIUM,186.0,130.2,,,0
CDM,27201871,HC KIT DRESSING RENASYS-F FOAM LARGE,264.0,184.8,,,0
CDM,27201872,HC KIT DRESSING RENASYS-F FOAM XLARGE,450.0,315.0,,,0
CDM,27201873,HC PORT SOFT RENASYS STAND ALONE,104.0,72.8,,,0
CDM,27201874,HC CONNECTOR Y SHAPED RENASYS,66.0,46.2,,,0
CDM,27201875,HC FOAM FILLER RENASYS NPWT 4X5X0.5IN,58.0,40.6,,,0
CDM,27201876,HC FILM TRANSPARENT RENASYS 20X30CM,58.0,40.6,,,0
CDM,27201877,HC FOAM RENASYS WHITE LARGE,77.0,53.9,,,0
CDM,27201880,HC AGNT ARISTA AH HEMOSTATIC COLL 5GM,2902.0,2031.4,,,0
CDM,27201881,HC MUSTANG 0.035 BALLOON DILATION CATHETER 6.0MM X 200MM  X 35CM,728.0,509.6,,,0
CDM,27201887,HC ACUNAV CATHETER ICE DIAG GE 8F X 90CM,2411.0,1687.7,,,0
CDM,27201888,HC BALLOON DILATATION CATHETER 3MM X 60MM X 150CM,912.0,638.4,,,0
CDM,27201889,HC SAFARI2 GUIDEWIRE XSMALL/SMALL/LARGE CURVE 0.035 IN X 275CM,967.0,676.9,,,0
CDM,27201893,HC CATH CROSSWALK,652.0,456.4,,,0
CDM,27201896,HC ARGENT SURGICAL CAUTERY TIPS,58.0,40.6,,,0
CDM,27201915,HC STERADIAN SHIELD RADIATION ATTENUATION PAD,257.0,179.9,,,0
CDM,27201921,HC OPTRELL MAPPING CATHETER SMALL LOOP,6934.0,4853.8,,,0
CDM,27201936,HC ATTAIN HYBRID GUIDE WIRE,522.0,365.4,,,0
CDM,27201939,HC MEDTRONIC STYLET KIT,160.0,112.0,,,0
CDM,27201940,HC MEDTRONIC KIT LEAD PACING SPRINT QUATTRO,160.0,112.0,,,0
CDM,27201946,HC INDIGO SYSTEM LIGHTNING BOLT 7,18619.0,13033.3,,,0
CDM,27201949,HC MICROCATHETER TRUSELECT 0.021IN X 175CM,2327.0,1628.9,,,0
CDM,27201950,HC KIT CATHETER EKOS PLUS ENDOVASCULAR SYSTEM 106CM X 8CM/16CM,9870.0,6909.0,,,0
CDM,27201953,HC STABILIT ER SATURATE MIXING SYSTEM,1947.0,1362.9,,,0
CDM,27201954,HC STABILIT MASTER SYRINGE ASSEMBLY,1015.0,710.5,,,0
CDM,27201962,HC ROTAGLIDE LUBRICANT MIXTURE 20 CC VIALS,406.0,284.2,,,0
CDM,27201963,HC INTRODUCER CATHETER MICROPUNCTURE ACCESS SET,141.0,98.7,,,0
CDM,27201967,HC PROBE COVER W/GUIDE,120.0,84.0,,,0
CDM,27201968,HC ARTHROGRAM TRAY,66.0,46.2,,,0
CDM,27201970,HC RENTAL GREENLIGHT LASER,500.0,350.0,,,0
CDM,27201974,HC CATHETER SHOCKWAVE M5 IVL (CVL),9592.0,6714.4,,,0
CDM,27201975,HC LEVEL 1 NORMOTHERMIC IV FLUID ADMINISTRATION SET,321.0,224.7,,,0
CDM,27201976,HC FLASH MINI OSTIAL CATHETER BALLOON 3.0/3.5/4.0/4.5 X 8MM,2781.0,1946.7,,,0
CDM,27201977,HC FLASH OSTIAL CATHETER BALLOON 5.0/6.0 X 12MM,2781.0,1946.7,,,0
CDM,27201978,HC FLASH OSTIAL OTW CATHETER BALLON 6.0/7.0 X 12MM,2781.0,1946.7,,,0
CDM,27201979,HC QDOT MICRO UNI-DIRECTIONAL CATHETER,4028.0,2819.6,,,0
CDM,27201980,HC QDOT MICRO BI-DIRECTIONAL CATHETER,4028.0,2819.6,,,0
CDM,27201981,HC VTE INARI SYSTEM,26281.0,18396.7,,,0
CDM,27201985,HC FLEXCATH CROSS AG/VZ 71 CM,1931.0,1351.7,,,0
CDM,27202001,HC SELECTSITE DEFLECTABLE CATHETER W/PRESHAPED DISTAL CURVE,1449.0,1014.3,,,0
CDM,27202002,HC THERMOCOOL SF BI-DIRECTIONAL CATHETER,4660.0,3262.0,,,0
CDM,27202003,HC HIGH DENSITY CATHETER FOCAL CATH TO GEN STERILE CBL,1456.0,1019.2,,,0
CDM,27202010,HC MERIT ASPIRA PERITONEAL DRAINAGE CATHETER INSERTION TRAY PERITONEAL 15.5FR,1708.0,1195.6,,,0
CDM,27202011,HC MERIT ASPIRA PERITONEAL DRAINAGE SYSTEM STARTER KIT 15.5FR 1L,1931.0,1351.7,,,0
CDM,27202012,HC MERIT ASPIRA UNIVERSAL TUBING ADAPTER,111.0,77.7,,,0
CDM,27202013,HC MERIT ASPIRA PLEURAL DRAINAGE CATHETER INSERTION TRAY 15.5FR,1708.0,1195.6,,,0
CDM,27202014,HC MERIT ASPIRA PLEURAL DRAINAGE STARTER KIT 15.5FR 1L,1931.0,1351.7,,,0
CDM,27202016,HC JADA POSTPARTUM BALLOON SYSTEM,4144.0,2900.8,,,0
CDM,27202017,HC DVT INARI SYSTEM,23100.0,16170.0,,,0
CDM,27202018,HC 365U LASER FIBER PL SINGLE USE,195.0,136.5,,,0
CDM,27202044,HC MESALT RIBBON 3/4 X 39 IN,10.0,7.0,,,0
CDM,27202045,HC ARCADIA CURVED DELIVERY CANNULA,2480.0,1736.0,,,0
CDM,27202053,HC SHEATH STEERABLE,2228.0,1559.6,,,0
CDM,27202054,HC SYSTEM LOADING NAVITOR TAVI SMALL,1810.0,1267.0,,,0
CDM,27202055,HC SYSTEM CATHETER DELIVERY FEXNAV 5.0 VES 15 FR,5955.0,4168.5,,,0
CDM,27202056,HC TOOL EPSILA EV  LEAD TRANSV/STERNAL TNL,3564.0,2494.8,,,0
CDM,27202058,HC CAVACLEAR LASER SHEATH 16 FR,9401.0,6580.7,,,0
CDM,27202059,HC INDIGO SYSTEM CAT7D KIT,8049.0,5634.3,,,0
CDM,27202060,HC SHTH AMP TREVISIO 45D,1958.0,1370.6,,,0
CDM,27202082,HC CATHETER ARROW THERMODILUTION 5FR X 10MM X 80CM,797.0,557.9,,,0
CDM,27202084,HC INDIGO CATHETER 12 100CM XTORQ INCLUDING LIGHTNING BOLT ASPIRATION TUBING,22546.0,15782.2,,,0
CDM,27202085,HC KT MINIONE LOW PROFILE BALLON BUTTON G-TUBE 14FR X 1.5 CM,388.0,271.6,,,0
CDM,27202091,HC CATH SOFT-VU COBRA1/MP 4FR/5FR X 100CM/65CM,162.0,113.4,,,0
CDM,27202092,HC SABER 0.018 PTA DILATATION CATHETER,780.0,546.0,,,0
CDM,27202096,HC GW NITINOL GLD,39.0,27.3,,,0
CDM,27202097,HC VASCULAR SPECIALTY GUIDEWIRE,65.0,45.5,,,0
CDM,27202100,HC CATH PERFORMA 4FR 70CM JL2,128.0,89.6,,,0
CDM,27202101,HC CATH PERFORM INF PGTL 4FR 65CM,168.0,117.6,,,0
CDM,27202102,HC CATH PERFORM INF PGTL 4FR 80CM,74.0,51.8,,,0
CDM,27202104,HC CATH SOFTVU COBRA1 4FR 65CM,162.0,113.4,,,0
CDM,27202105,HC CATH ROYAL FLUSH PIGTAIL 5FR 100CM,126.0,88.2,,,0
CDM,27202106,HC HAMILTON T1/C1/MRI EXPIRATORY VALVE SET SINGLE USE,151.0,105.7,,,0
CDM,27202121,HC STYLET INTUBATION GLIDERITE 6MM TUBE LARGE,75.0,52.5,,,0
CDM,27202123,HC CATH VARIPULSE BI-DIRECTIONAL 8.5FR,14547.0,10182.9,,,0
CDM,27202124,HC CABLE VARIPULSE INTERFACE,2296.0,1607.2,,,0
CDM,27202126,HC INTRODUCER CATHETER PINNACLE 4/7/8 FR X 10 CM .038,58.0,40.6,,,0
CDM,27202137,HC INTRODUCER CATHETER BRITE TIP 9/10 FR X 35/45 MM X 23 CM,118.0,82.6,,,0
CDM,27202145,HC PROC WATCHMAN TRUSTEER ACCESS SYSTEM,4455.0,3118.5,,,0
CDM,27202153,HC CABLE AFFERA EXTENSION CATHETER,5940.0,4158.0,,,0
CDM,27202154,HC SET TUBING AFFERA HEXAFLOW,905.0,633.5,,,0
CDM,27202155,HC CATHETER SPHERE-9 AFFERA MAPPING AND ABLATION,25410.0,17787.0,,,0
CDM,27202161,HC NANOKNIFE SINGLE ELECTRODE ACTIVATION PROBE 15 CM,9801.0,6860.7,,,0
CDM,27202162,HC IODOSORB GEL TUBE 10MG,101.0,70.7,,,0
CDM,27202168,HC CATHETER BALLOON DILATION AGENT PACLITAXEL 2.00/4.00 X 12MM/30MM,13052.0,9136.4,,,0
CDM,27202169,HC KIT STYLET LEAD J CURVED 53 CM,157.0,109.9,,,0
CDM,27202196,HC CATH GUIDELINER CRV 6/7 FR X .07X.078IN,1322.0,925.4,,,0
CDM,27202198,HC CATH TRUE DILATION 20MMX4.5CM,4901.0,3430.7,,,0
CDM,27202199,HC INTRO R2P SLNDR STR 6FR 149/119 CM,1264.0,884.8,,,0
CDM,27500009,HC LEADLESS PACEMAKER SINGLE CHAMBER,23080.0,16156.0,,,0
CDM,27500010,HC LEADLESS PACEMAKER AV MEDTRONIC DUAL CHAMBER,29391.0,20573.7,,,0
CDM,27800046,HC ALLOGRAFT BONE TUBE,409.0,286.3,,,0
CDM,27800047,HC TUNNELED DIALYSIS CATHETER,1399.0,979.3,,,0
CDM,27800048,HC CATH SINGLE LUMEN UVC 3.5 FR,81.0,56.7,,,0
CDM,27800050,HC CATH TRIPLE LUMEN CVC KIT W/SHRP,146.0,102.2,,,0
CDM,27800054,HC CATH SINGLE LUMEN CVC,358.0,250.6,,,0
CDM,27800056,HC CATH CVC SET,647.0,452.9,,,0
CDM,27800057,HC CATH INF CENTRAL,468.0,327.6,,,0
CDM,27800058,HC CATH DOUBLE LUMEN SET 4.0,528.0,369.6,,,0
CDM,27800060,HC CATH CVL TUNNELED A,1400.0,980.0,,,0
CDM,27800061,HC CATH CVL TUNNELED B,1694.0,1185.8,,,0
CDM,27800062,HC CATH MICRO-INFUSION,1894.0,1325.8,,,0
CDM,27800063,CLOSURE DEVICE,820.0,574.0,,,0
CDM,27800064,HC CLOSURE E ANGIO-SEAL,820.0,574.0,,,0
CDM,27800065,HC VASCULAR CLOSURE DEVICE,1061.0,742.7,,,0
CDM,27800067,HC LOOP RECORDER MEDTRONIC,11435.0,8004.5,,,0
CDM,27800071,HC IMPLANTABLE CV PORT C,1957.0,1369.9,,,0
CDM,27800072,HC BARD CATHETER/PORT,2035.0,1424.5,,,0
CDM,27800073,HC IMPLANTABLE CV PORT A,2055.0,1438.5,,,0
CDM,27800074,HC IMPLANTABLE CV PORT B,2648.0,1853.6,,,0
CDM,27800075,HC AMPLATZER DUCT OCCLUDER,3524.0,2466.8,,,0
CDM,27800076,CARDIAC SEPTAL DEFECT IMPLANT SYSTEM,8718.0,6102.6,,,0
CDM,27800077,HC INTEGRITY DRUG ELUTING STENT,2677.0,1873.9,,,0
CDM,27800078,HC INTRAVASC COATED W/DEL STENT C,7396.0,5177.2,,,0
CDM,27800079,WALLFLEX ESOPHAGEAL STENT W/ DEL SYSTEM,7821.0,5474.7,,,0
CDM,27800081,HC WALLFLEX BILIARY STENT,9419.0,6593.3,,,0
CDM,27800085,HC INTRAVASC COATED W/DEL STENT D,12978.0,9084.6,,,0
CDM,27800087,HC COVERED STENT,11237.0,7865.9,,,0
CDM,27800088,HC INTRAVASC NONCOATED W/DEL STENT A,3178.0,2224.6,,,0
CDM,27800089,HC INTRAVASC NONCOATED W/DEL STENT B,3178.0,2224.6,,,0
CDM,27800090,HC LIFESTENT VASC STENT < 100MM NON-COV,1947.0,1362.9,,,0
CDM,27800091,HC BARE METAL STENT,3980.0,2786.0,,,0
CDM,27800093,HC STENT WITH DELIVERY SYSTEM,4792.0,3354.4,,,0
CDM,27800095,HC VISION STENT,5550.0,3885.0,,,0
CDM,27800096,HC LIFESTENT VASC STENT 170MM NON-COV,8257.0,5779.9,,,0
CDM,27800097,TISSUE MARKER-IMPLANTABLE (EACH),179.0,125.3,,,0
CDM,27800098,HC GOLD ANCHOR FIDUCIAL MARKER,600.0,420.0,,,0
CDM,27800099,HC IVC FILTER,3328.0,2329.6,,,0
CDM,27800100,HC NEPHRO-URETERAL STENT TEMP W/ DEL SYS,509.0,356.3,,,0
CDM,27800101,CATHETER VASCULAR VSD OCCLUDER,22764.0,15934.8,,,0
CDM,27800102,HC INTERLOCK COILS 2D,1918.0,1342.6,,,0
CDM,27800103,HC EMBOLIZATION PRODUCT J COIL DETACH CONTR,799.0,559.3,,,0
CDM,27800104,HC VASCULAR PLUG,1985.0,1389.5,,,0
CDM,27800105,HC EMBOLIZATION PRODUCT I DETACH FRAM COIL,3993.0,2795.1,,,0
CDM,27800106,HC EMBOLIZATION PRODUCT H DETACH HELI COIL,4327.0,3028.9,,,0
CDM,27800107,HC EMBOLIZATION PRODUCT K DRUG ELUTING SPHERES EACH VIAL,6450.0,4515.0,,,0
CDM,27800108,HC MELODY VALVE PB1018,63888.0,44721.6,,,0
CDM,27800114,HC LOOP RECORDER ST JUDE,11647.0,8152.9,,,0
CDM,27800120,HC BRACHYTX SOURCE NON-STR HDR IR-192 PER SOURCE,746.0,522.2,,,0
CDM,27800123,HC PERIPHERAL STENT,4228.0,2959.6,,,0
CDM,27800124,HC PROPEL MINI,5559.0,3891.3,,,0
CDM,27800127,HC IMPELLA 25 ALC PUMP SET US,66550.0,46585.0,,,0
CDM,27800129,HC I-CAST BALLOON EXPANDABLE COVERED STENT,11314.0,7919.8,,,0
CDM,27800132,HC TRANSLUMINAL BILIARY BIOPSY FORCEPS,2271.0,1589.7,,,0
CDM,27800133,HC CAROTID WALLSTENT 8X29 5FR MR,6374.0,4461.8,,,0
CDM,27800134,HC IMPELLA 5.0 ALC PUMP SET,74536.0,52175.2,,,0
CDM,27800135,HC IMPELLA 3.4 ALC PUMP SET,66550.0,46585.0,,,0
CDM,27800137,HC AMPLATZER DUCT OCCLUDER PDA 4F 90 DEG CURVE,13644.0,9550.8,,,0
CDM,27800142,HC NIT-OCCLUD PDA CLOSURE SYSTEM W/FLEX SHEATH ALL SIZES,5649.0,3954.3,,,0
CDM,27800144,HC CARDIOFORM SEPTAL OCCLUDER,18233.0,12763.1,,,0
CDM,27800145,HC ALLOGRAFT BONE TUBE LARGE,1060.0,742.0,,,0
CDM,27800146,HC OPTIMESH MESH POUCH LARGE,15972.0,11180.4,,,0
CDM,27800149,HC MITRA CLIP SYSTEM KIT,79860.0,55902.0,,,0
CDM,27800152,HC STENT EPIC ILIAC,2330.0,1631.0,,,0
CDM,27800153,HC SYNERGY DRUG ELUTING STENT,2968.0,2077.6,,,0
CDM,27800158,HC SURESCAN PATIENT RECHARGING SYSTEM,2980.0,2086.0,,,0
CDM,27800166,HC VALVE IN CARTRIDGE HUD,8819.0,6173.3,,,0
CDM,27800167,HC BARE CP STENT SHORT,9152.0,6406.4,,,0
CDM,27800168,HC BARE CP STENT LONG,9818.0,6872.6,,,0
CDM,27800169,HC COVERED CP STENT SHORT,14242.0,9969.4,,,0
CDM,27800170,HC COVERED CP STENT LONG,14775.0,10342.5,,,0
CDM,27800171,HC MOUNTED COVERED CP STENT SHORT,17437.0,12205.9,,,0
CDM,27800172,HC MOUNTED COVERED CP STENT LONG,17969.0,12578.3,,,0
CDM,27800174,HC HERCULINK STENT NON-COATED/NON-COVERED W/DELIVERY SYSTEM,2647.0,1852.9,,,0
CDM,27800175,HC ABBOTT VASCULAR STENTS,5772.0,4040.4,,,0
CDM,27800176,HC ABSOLUTE STENT SYSTEM NON-COATED/NON-COVERED W/DELIVERY SYSTEM,2876.0,2013.2,,,0
CDM,27800177,HC OMNILINK STENT NON-COATED/NON-COVERED W/DELIVERY SYSTEM,2317.0,1621.9,,,0
CDM,27800178,HC CATH TRANSLUMINAL LASER TURBO ELITE .9MM,13295.0,9306.5,,,0
CDM,27800185,HC LD DBL STENT,2396.0,1677.2,,,0
CDM,27800186,HC MARIGEN MICRO 8 CM,1863.0,1304.1,,,0
CDM,27800187,HC RUBY COIL POD OCCLUSION J 60,3713.0,2599.1,,,0
CDM,27800188,HC RUBY COIL CMPLX SOFT 3MM X 5CM,2228.0,1559.6,,,0
CDM,27800189,HC HARMONY TRANSCATHETER PULM SYSTEM,19635.0,13744.5,,,0
CDM,27800190,HC HARMONY VALVE PULMONARY TRANSCATHETER,76230.0,53361.0,,,0
CDM,27800192,HC SMOOTH RESPONSIVE (SR),901.0,630.7,,,0
CDM,27800193,HC SMOOTH SOFT TOUCH (SS),1241.0,868.7,,,0
CDM,27800194,HC SMOOTH COHESIVE (SC),1241.0,868.7,,,0
CDM,27800196,HC MARIGEN MICRO 4 CM,1578.0,1104.6,,,0
CDM,27800197,HC STENT PERIPHERAL ESPRIT EVROL 3.0/3.75 X 18/38 MM,8317.0,5821.9,,,0
CDM,27800315,HC AMPLATZER PFO OCCLUDER,25398.0,17778.6,,,0
CDM,27800316,HC SENSATION PLUS 7.5FR 40CC FIBER-OPTIC BALLOON CATH,3288.0,2301.6,,,0
CDM,27800317,HC VALVE IN CARTRIDGE 9MM,11064.0,7744.8,,,0
CDM,27800318,HC VLV COREVALVE EVOLUT R 34MM,76230.0,53361.0,,,0
CDM,27800319,HC KIT VALVE SAPIEN 3 W COMMANDER 20MM,82583.0,57808.1,,,0
CDM,27800324,HC STNT MINI TB CVRD,8337.0,5835.9,,,0
CDM,27800325,HC STNT TB CVRD,8337.0,5835.9,,,0
CDM,27800326,HC AEROSIZER STENT SIZING DEVICE,968.0,677.6,,,0
CDM,27800327,HC MONITOR LINQ IMPLANT CARD,13456.0,9419.2,,,0
CDM,27800330,HC STENT RESOLUTE ONYX RX,4154.0,2907.8,,,0
CDM,27800331,HC ANGIOJET THROMBECTOMY CATHETER SOLENT OMNI 6FR 120CM,5196.0,3637.2,,,0
CDM,27800332,HC ANGIOJET THROMBECTOMY CATHETER SOLENT PROXI 6FR 90CM,4875.0,3412.5,,,0
CDM,27800333,HC ANGIOJET THROMBECTOMY CATHETER ZELANTE 8FR 105CM,9107.0,6374.9,,,0
CDM,27800334,HC COIL TARGET 360 ULTRA 2MM X 3CM,6687.0,4680.9,,,0
CDM,27800335,HC COIL TARGET HELLCAL ULTRA DETACHABLE 2MM X 1CM,4571.0,3199.7,,,0
CDM,27800336,HC COIL TARGET XL 360 STANDARD DETACHABLE 6MM X 20CM,8836.0,6185.2,,,0
CDM,27800337,HC COIL TARGET XL HELLCAL DETACHABLE 5MM X 15CM,6322.0,4425.4,,,0
CDM,27800338,HC COIL TARGET 3D DETACHABLE 3MM X 6CM,6703.0,4692.1,,,0
CDM,27800339,HC SYS NEUROFORM ATLAS STENT 3 X 15,8335.0,5834.5,,,0
CDM,27800340,HC SYS WINGSPAN STENT 2.5 X 9MM,17611.0,12327.7,,,0
CDM,27800341,HC CATH GATEWAY PTA BLLN 1.5 X 9,3657.0,2559.9,,,0
CDM,27800345,HC GLUE TRUFILL LIQ EMBOLIC 2GM,17844.0,12490.8,,,0
CDM,27800346,HC IMPL PULSRIDER Y ARCH,15125.0,10587.5,,,0
CDM,27800351,HC DEV PIPELINE FLX EMBOL,33607.0,23524.9,,,0
CDM,27800352,HC DEV PIPELINE FLX EMBOL LONG,36148.0,25303.6,,,0
CDM,27800355,HC COIL MICROFRAME,6065.0,4245.5,,,0
CDM,27800356,HC MICRUSFRAME,5729.0,4010.3,,,0
CDM,27800357,HC GALAXY G3,46945.0,32861.5,,,0
CDM,27800359,HC STENT PK PAPYRUS,9620.0,6734.0,,,0
CDM,27800363,HC STENT SYNERGY XD MR,3509.0,2456.3,,,0
CDM,27800365,HC RENAL BALLON EXPANDABLE STENT NON COATED/NON-COVERED W/DELIVERY SYSTEM,3369.0,2358.3,,,0
CDM,27800367,HC STENT VIABAHN VBX,11975.0,8382.5,,,0
CDM,27800368,HC ELUVIA STENT COVERED W/DELIVERY SYSTEM 6/7 X 100/120 X 130,9284.0,6498.8,,,0
CDM,27800369,HC SYSTEM LINQII INSERTABLE CARDIAC MONITOR,14896.0,10427.2,,,0
CDM,27800370,HC STENT VIABAHN ENDOPROSTHESIS W/HEPARIN 6/7 MM X 25CM X 120CM,18213.0,12749.1,,,0
CDM,27800371,HC STENT ENDOPROSTHESIS WITH HEPARIN 5/6MM / 2.5/5.0 CM / 120CM,11660.0,8162.0,,,0
CDM,27800372,HC SYSTEM INDIGO SEPARATOR,5064.0,3544.8,,,0
CDM,27800373,HC ABRE VENOUS SELF-EXPANDING STENT SYSTEM,5437.0,3805.9,,,0
CDM,27800374,HC ABRE VENOUS SELF-EXPANDING STENT SYSTEM 12/14/16/18 MM X 150MM,6175.0,4322.5,,,0
CDM,27800375,HC STENT VIABAHN ENDOPROSTHESIS W/HEPARIN 7MM X 15CM X 120CM,12865.0,9005.5,,,0
CDM,27800376,HC STENT VIABAHN ENDOPROSTHESIS W/HEPARIN 8MM X 10CM X 120CM,11550.0,8085.0,,,0
CDM,27800377,HC VALVE COREVALVE EVOLUT PRO 29MM,69300.0,48510.0,,,0
CDM,27800378,HC KIT VALVE SAPIEN 3 W COMMANDER 29MM,75075.0,52552.5,,,0
CDM,27800379,HC RUBY COIL POD OCCLUSION 4,4927.0,3448.9,,,0
CDM,27800380,HC COIL EMBOLIZATION OCCLUSION 2MM X 3MM X 2.3CM,1268.0,887.6,,,0
CDM,27800381,HC COIL EMBOLIZATION INTERLOCK 10MM X 50CM,2048.0,1433.6,,,0
CDM,27800382,HC INTERLOCK 35 COIL 2D 6/8 MM X 20CM,2133.0,1493.1,,,0
CDM,27800383,HC INTERLOCK 35 COIL 2D 10/12/15 MM X 40CM,2467.0,1726.9,,,0
CDM,27800384,HC EPSILA EV QUADRIPOLAR LEAD W/SHAPED PASSIVE FIXATION,12451.0,8715.7,,,0
CDM,27803834,HC TEMPERATURE MANAGEMENT DEVICE ESOPHAGEAL,2447.0,1712.9,,,0
CDM,27803839,HC KIT VALVE SAPIEN 3 RESILIA,82500.0,57750.0,,,0
CDM,27803843,HC MARIGEN 16 MM CIRCULAR,1441.0,1008.7,,,0
CDM,27803844,HC MARIGEN 1.75X1.75 CM,1530.0,1071.0,,,0
CDM,27803845,HC MARIGEN 3X3.5 CM,2108.0,1475.6,,,0
CDM,27803846,HC MARIGEN 3X7 CM,3359.0,2351.3,,,0
CDM,27803847,HC MARIGEN 5X7 CM,3998.0,2798.6,,,0
CDM,27803848,HC MARIGEN 3X3.5 CM FENESTRATED,2319.0,1623.3,,,0
CDM,27803849,HC MARIGEN 3X7 CM FENESTRATED,3695.0,2586.5,,,0
CDM,27803850,HC STENT EXPRESS NON-COATED/NON-COVERED W/DELIVERY SYSTEM,3615.0,2530.5,,,0
CDM,27803852,HC DETOUR SYSTEM CAP ANY NUMBER OF TORUS STENT GRAFTS/ENDOCROSS DEVICE,57751.0,40425.7,,,0
CDM,27803853,HC GORE VIABAHN ENDOPROSTHESIS W/HEPARIN 10MMX15CM 8FR 120CM CATH,12834.0,8983.8,,,0
CDM,27803854,HC GORE VIABAHN ENDOPROSTHESIS W/ HEPARIN 10MMX10CM 8FR 120CM CATH,11497.0,8047.9,,,0
CDM,27803855,HC GORE VIABAHN VBX BALLOON EXPANDABLE ENDOPROSTHESIS 6MM X 8MM X 19MM,8605.0,6023.5,,,0
CDM,27803856,HC NAVITOR TRANSCATHETER AORTIC VALVE IMPLANT VISION 23 MM,57750.0,40425.0,,,0
CDM,27803857,HC NAVITOR TRANSCATHETER AORTIC VALVE IMPLANT VISION 25 MM,57750.0,40425.0,,,0
CDM,27803860,HC TRICLIP G4,90090.0,63063.0,,,0
CDM,27803861,HC OCLR AMULET LA APPNDG 16MM/34 MM,28875.0,20212.5,,,0
CDM,28041,TESTOSTERONE CYPIONATE 100 MG/ML IM OIL,37.0,25.9,,,0
CDM,28041,TESTOSTERONE CYPIONATE 200 MG/ML IM OIL,80.0,56.0,,,0
CDM,29395,SODIUM HYALURONATE (VISCOSUP) 10 MG/ML(MW 2.4 -3.6 MILLION) IATC SYRG,1915.5,1340.85,,,0
CDM,3,"DUMMY EAP FOR NSA - IMPLANTS - $1,000 INCREMENT",1000.0,700.0,,,0
CDM,30000001,HC VENOUS BLOOD DRAW,40.0,28.0,,,0
CDM,30000002,HC CAPILLARY BLOOD DRAW,13.0,9.1,,,0
CDM,30000003,METABOLIC PANEL W/ TOTAL CA,89.0,62.3,,,0
CDM,30000004,HC COMPREHEN METABOLIC PANEL,92.0,64.4,,,0
CDM,30000007,URINALYSIS AUTO W/SCOPE,92.0,64.4,,,0
CDM,30000008,URINALYSIS AUTO W/O SCOPE,65.0,45.5,,,0
CDM,30000011,HC URINE PREGNANCY TEST,97.0,67.9,,,0
CDM,30000012,HC ASSAY SERUM CHOLINESTERASE,48.0,33.6,,,0
CDM,30000014,HC ASSAY OF CHROMIUM,85.0,59.5,,,0
CDM,30000015,HC CREATINE MB FRACTION,104.0,72.8,,,0
CDM,30000016,HC ENZYME CELL ACTIVITY,89.0,62.3,,,0
CDM,30000017,HC GASTRIC ANALY W/ PH EA SPEC,28.0,19.6,,,0
CDM,30000018,HC GLUC TOLER TEST (GTT) 3 SPECIM,193.0,135.1,,,0
CDM,30000021,HC EVAL AMNIOTIC FLUID PROTEIN,98.0,68.6,,,0
CDM,30000022,HC ASSAY OF PROTEIN SERUM,98.0,68.6,,,0
CDM,30000024,HC HEMATOCRIT,48.0,33.6,,,0
CDM,30000025,HEMOGLOBIN,49.0,34.3,,,0
CDM,30000026,HC COMPLETE CBC W/AUTO DIFF WBC,66.0,46.2,,,0
CDM,30000027,HC COMPLETE CBC AUTO W/O DIFF,40.0,28.0,,,0
CDM,30000029,MANUAL RETICULOCYTE COUNT,50.0,35.0,,,0
CDM,30000031,HC AUTOMATED LEUKOCYTE COUNT,8.0,5.6,,,0
CDM,30000032,HC AUTOMATED PLATELET COUNT,77.0,53.9,,,0
CDM,30000033,HC BLOOD CLOT FACTOR II TEST,442.0,309.4,,,0
CDM,30000034,HC BLOOD CLOT FACTOR V TEST,442.0,309.4,,,0
CDM,30000035,HC BLOOD CLOT FACTOR VII TEST,39.0,27.3,,,0
CDM,30000036,HC BLOOD CLOT FACTOR VIII TEST,442.0,309.4,,,0
CDM,30000037,HC BLOOD CLOT FACTOR VIII VW FACTOR,486.0,340.2,,,0
CDM,30000038,HC BLOOD CLOT FACTOR VIII VW ANTIGEN,180.0,126.0,,,0
CDM,30000039,HC BLOOD CLOT FACTOR IX TEST,442.0,309.4,,,0
CDM,30000040,HC BLOOD CLOT FACTOR X TEST,39.0,27.3,,,0
CDM,30000041,HC BLOOD CLOT FACTOR XI TEST,39.0,27.3,,,0
CDM,30000042,HC BLOOD CLOT FACTOR XII TEST,42.0,29.4,,,0
CDM,30000044,ANTITHROMBIN III TEST,261.0,182.7,,,0
CDM,30000046,BLOOD CLOT INHIBITOR C ACTIVITY,442.0,309.4,,,0
CDM,30000047,BLOOD CLOT INHIBITOR S FREE,180.0,126.0,,,0
CDM,30000048,HC ASSAY ACTIVATED PROTEIN C,24.0,16.8,,,0
CDM,30000049,HC FACTOR INHIBITOR TEST,118.0,82.6,,,0
CDM,30000050,HC POC COAGULATION TIME ACTIVATED,63.0,44.1,,,0
CDM,30000051,HC FIBRIN DEGRADATION QUANT,162.0,113.4,,,0
CDM,30000052,HC FIBRINOGEN,138.0,96.6,,,0
CDM,30000053,HC CLOTTING FUNCT ACTIVITY NOS,64.0,44.8,,,0
CDM,30000054,HC FIBRINOLYTIC ANTIPLASMIN,18.0,12.6,,,0
CDM,30000055,HC FIBRINOLYTIC PLASMINOGEN,89.0,62.3,,,0
CDM,30000056,HC FIBRINOLYTIC PLASMINOGEN,289.0,202.3,,,0
CDM,30000057,HC HEMOGLOBIN FETAL,227.0,158.9,,,0
CDM,30000058,HC HEMOGLOBIN FETAL ROSETTE,67.0,46.9,,,0
CDM,30000059,HC HEPARIN ASSAY,89.0,62.3,,,0
CDM,30000061,HC MURAMIDASE,218.0,152.6,,,0
CDM,30000062,HC RBC OSMOTIC FRAGILITY,46.0,32.2,,,0
CDM,30000063,HC BLOOD PLATELET AGGREGATION,496.0,347.2,,,0
CDM,30000065,HC PROTHROMBIN TIME,35.0,24.5,,,0
CDM,30000067,RUSSELL VIPER VENOM DILUTED,295.0,206.5,,,0
CDM,30000068,HC RBC SED RATE NONAUTOMATED,91.0,63.7,,,0
CDM,30000069,HC RBC SED RATE AUTOMATED,99.0,69.3,,,0
CDM,30000070,HC RBC SICKLE CELL TEST,77.0,53.9,,,0
CDM,30000071,HC THROMBIN TIME PLASMA,169.0,118.3,,,0
CDM,30000072,HC THROMBOPLASTIN TIME PARTIAL (PTT) PLASMA OR WHOLE BLOOD,84.0,58.8,,,0
CDM,30000073,HC BLOOD VISCOSITY EXAMINATION,136.0,95.2,,,0
CDM,30000074,HC AGGLUTININS FEBRILE,246.0,172.2,,,0
CDM,30000075,HC ALLERGEN SPECIFIC IGE QUANTITATIVE/SEMIQUANTITATIVE CRUDE ALLERGEN EXTRACT EACH,94.0,65.8,,,0
CDM,30000076,HC WBC ANTIBODY IDENTIFICATION,146.0,102.2,,,0
CDM,30000077,HC PLATELET ANTIBODIES,244.0,170.8,,,0
CDM,30000078,HC PLATELET IMMUNOGLOB ASSAY,104.0,72.8,,,0
CDM,30000079,HC ANTINUCLEAR ANTIBODIES (ANA),136.0,95.2,,,0
CDM,30000080,HC ANTINUCLEAR ANTIBODIES (ANA) TITER,213.0,149.1,,,0
CDM,30000081,HC ANTISTREPTOLYSIN O TITER,90.0,63.0,,,0
CDM,30000083,HC C-REACTIVE PROTEIN HIGH SENSIT,69.0,48.3,,,0
CDM,30000084,GLYCOPROTEIN ANTIBODY,138.0,96.6,,,0
CDM,30000085,CARDIOLIPIN ANTIBODY EA IG CLASS,618.0,432.6,,,0
CDM,30000087,COLD AGGLUTININ TITER,44.0,30.8,,,0
CDM,30000088,HC COMPLEMENT ANTIGEN EA COMP,279.0,195.3,,,0
CDM,30000089,HC COMPLEMENT/FUNCTION ACTIVITY,90.0,63.0,,,0
CDM,30000090,HC COMPLEMENT TOTAL (CH50),91.0,63.7,,,0
CDM,30000092,HC CCP ANTIBODY,87.0,60.9,,,0
CDM,30000093,HC DEOXYRIBONUCLEASE ANTIBODY,444.0,310.8,,,0
CDM,30000094,HC DNA ANTIBODY,181.0,126.7,,,0
CDM,30000095,HC NUCLEAR ANTIGEN ANTIBODY,279.0,195.3,,,0
CDM,30000096,FLUORES ANTIBODY SCREEN EA,361.0,252.7,,,0
CDM,30000097,HC FLUORES ANTIBODY TITER  EA ANTI,128.0,89.6,,,0
CDM,30000098,HC IMMUNOA TUMOR ANTIGENCA15-3,242.0,169.4,,,0
CDM,30000099,HC IMMUNOA TUMOR ANTIGENCA19-9,361.0,252.7,,,0
CDM,30000100,HC IMMUNOA TUMOR ANTIGENCA125,361.0,252.7,,,0
CDM,30000101,HC HETEROPHILE ANTIBODIES,144.0,100.8,,,0
CDM,30000102,HC IMMUNOA TUMOR ANTIGEN OTHER,229.0,160.3,,,0
CDM,30000103,HC IMMUNOASSAY INFECTIOUS AGENT,75.0,52.5,,,0
CDM,30000104,IMMUNODIFFUSION GEL DIFF EA,104.0,72.8,,,0
CDM,30000105,HC IMMUNE COMPLEX ASSAY,758.0,530.6,,,0
CDM,30000106,IMMUNOFIX E-PHORESIS SERUM,291.0,203.7,,,0
CDM,30000107,HC IMMUNFIX E-PHORSIS/URINE/CSF,87.0,60.9,,,0
CDM,30000108,HC INHIBIN A,108.0,75.6,,,0
CDM,30000109,HC INSULIN ANTIBODIES,359.0,251.3,,,0
CDM,30000110,HC INTRINSIC FACTOR ANTIBODY,55.0,38.5,,,0
CDM,30000111,HC ISLET CELL ANTIBODY,97.0,67.9,,,0
CDM,30000112,HC CELL FUNCTION ASSAY W/STIM,346.0,242.2,,,0
CDM,30000113,HC LYMPHOCYTE TRANSFORMATION,414.0,289.8,,,0
CDM,30000114,HC MONONUCLEAR CELL ANTIGEN,122.0,85.4,,,0
CDM,30000115,T CELL ABSOLUTE CD4 COUNT,398.0,278.6,,,0
CDM,30000116,HC MICROSOMAL ANTIBODY,106.0,74.2,,,0
CDM,30000117,HC NEUTRALIZATION TEST VIRAL,170.0,119.0,,,0
CDM,30000120,HC RHEUMATOID FACTOR QUANT,116.0,81.2,,,0
CDM,30000123,HC TB INTRADERMAL TEST,70.0,49.0,,,0
CDM,30000124,HC SYPHILIS TEST NON-TREP QUAL,115.0,80.5,,,0
CDM,30000125,HC SYPHILIS TEST NON-TREP QUANT,26.0,18.2,,,0
CDM,30000126,HC ASPERGILLUS ANTIBODY,175.0,122.5,,,0
CDM,30000127,HC BACTERIUM ANTIBODY NES,130.0,91.0,,,0
CDM,30000128,HC BARTONELLA ANTIBODY,100.0,70.0,,,0
CDM,30000129,HC BLASTOMYCES ANTIBODY,191.0,133.7,,,0
CDM,30000130,BORDETELLA ANTIBODY,135.0,94.5,,,0
CDM,30000131,HC LYME DISEASE ANTIBODY CONFIRMATORY,85.0,59.5,,,0
CDM,30000132,HC LYME DISEASE ANTIBODY,320.0,224.0,,,0
CDM,30000133,HC BRUCELLA ANTIBODY,106.0,74.2,,,0
CDM,30000134,HC CAMPYLOBACTER ANTIBODY,70.0,49.0,,,0
CDM,30000135,HC CANDIDA ANTIBODY,71.0,49.7,,,0
CDM,30000136,HC CHLAMYDIA ANTIBODY,113.0,79.1,,,0
CDM,30000137,HC CHLAMYDIA IGM ANTIBODY,94.0,65.8,,,0
CDM,30000138,HC COCCIDIOIDES ANTIBODY,443.0,310.1,,,0
CDM,30000139,HC Q FEVER ANTIBODY,22.0,15.4,,,0
CDM,30000140,HC CMV ANTIBODY,139.0,97.3,,,0
CDM,30000141,HC CMV ANTIBODY IGM,71.0,49.7,,,0
CDM,30000142,HC ENCEPHALITIS ANTIBODY CALIF,72.0,50.4,,,0
CDM,30000143,HC ENCEPHALITIS ANTIBODY EAST EQUIN,72.0,50.4,,,0
CDM,30000144,HC ENCEPHALITIS ANTIBODY ST LOUIS,72.0,50.4,,,0
CDM,30000145,HC ENCEPHALITIS ANTIBODY WESTERN,72.0,50.4,,,0
CDM,30000146,HC ENTEROVIRUS ANTIBODY,106.0,74.2,,,0
CDM,30000147,HC EPSTEIN-BARR EARLY ANTIGEN,128.0,89.6,,,0
CDM,30000148,HC EPSTEIN-BARR NUCLEAR ANTIGEN,128.0,89.6,,,0
CDM,30000149,HC EPSTEIN-BARR VIRAL CAPSID,128.0,89.6,,,0
CDM,30000150,HC EHRLICHIA ANTIBODY,68.0,47.6,,,0
CDM,30000151,HC FRANCISELLA TULARENSIS,246.0,172.2,,,0
CDM,30000152,HC FUNGUS ANTIBODY NES,260.0,182.0,,,0
CDM,30000153,HC GIARDIA LAMBLIA ANTIBODY,97.0,67.9,,,0
CDM,30000155,HC HELMINTH ANTIBODY,132.0,92.4,,,0
CDM,30000156,HTLV/HIV CONFIRMATORY TEST,606.0,424.2,,,0
CDM,30000157,HC HERPES SIMPLEX TEST NONSPECIFIC,401.0,280.7,,,0
CDM,30000158,HC HERPES SIMPLEX TYPE 1,85.0,59.5,,,0
CDM,30000159,HC HERPES SIMPLEX TYPE 2,104.0,72.8,,,0
CDM,30000160,HC HISTOPLASMA,63.0,44.1,,,0
CDM,30000162,HC HIV-1/HIV-2 SINGLE RESULT,63.0,44.1,,,0
CDM,30000163,HC HEP B CORE ANTIBODY TOTAL,58.0,40.6,,,0
CDM,30000164,HC HEP B CORE ANTIBODY IGM,187.0,130.9,,,0
CDM,30000165,HC HEP B SURFACE ANTIBODY,224.0,156.8,,,0
CDM,30000166,HC HEP B ANTIBODY,187.0,130.9,,,0
CDM,30000167,HC HEP A ANTIBODY TOTAL,70.0,49.0,,,0
CDM,30000168,HC HEP A ANTIBODY IGM,121.0,84.7,,,0
CDM,30000169,HC INFLUENZA VIRUS ANTIBODY,129.0,90.3,,,0
CDM,30000170,HC LEGIONELLA ANTIBODY,132.0,92.4,,,0
CDM,30000171,HC LEISHMANIA ANTIBODY,47.0,32.9,,,0
CDM,30000172,HC LEPTOSPIRA ANTIBODY,196.0,137.2,,,0
CDM,30000173,HC LYMPH CHORIOMENINGITIS,72.0,50.4,,,0
CDM,30000174,HC MUMPS ANTIBODY,240.0,168.0,,,0
CDM,30000175,HC MYCOPLASMA ANTIBODY,132.0,92.4,,,0
CDM,30000176,HC PARVOVIRUS ANTIBODY,143.0,100.1,,,0
CDM,30000178,HC PROTOZOA ANTIBODY NOS,83.0,58.1,,,0
CDM,30000179,HC RICKETTSIA ANTIBODY,128.0,89.6,,,0
CDM,30000180,HC RUBELLA ANTIBODY,121.0,84.7,,,0
CDM,30000181,HC RUBEOLA ANTIBODY,223.0,156.1,,,0
CDM,30000182,HC SALMONELLA ANTIBODY,87.0,60.9,,,0
CDM,30000183,HC TOXOPLASMA ANTIBODY,70.0,49.0,,,0
CDM,30000184,HC TOXOPLASMA ANTIBODY IGM,70.0,49.0,,,0
CDM,30000185,TREPONEMA PALLIDUM,224.0,156.8,,,0
CDM,30000186,VARICELLA-ZOSTER ANTIBODY,170.0,119.0,,,0
CDM,30000187,HC WEST NILE VIRUS ANTIBODY,90.0,63.0,,,0
CDM,30000188,HC VIRUS ANTIBODY NES,124.0,86.8,,,0
CDM,30000189,HC YERSINIA ANTIBODY,66.0,46.2,,,0
CDM,30000190,HC THYROGLOBULIN ANTIBODY,143.0,100.1,,,0
CDM,30000191,HC HEPATITIS C ANTIBODY,130.0,91.0,,,0
CDM,30000194,HC RBC ANTIBODY SCREEN EA TECHNIQ,212.0,148.4,,,0
CDM,30000195,HC RBC ANTIBO ID EA PANEL EA TECH,478.0,334.6,,,0
CDM,30000196,HC COOMBS TEST DIRECT EA ANTISERUM,257.0,179.9,,,0
CDM,30000198,HC COOMBS TST INDIRECT EA TITER,305.0,213.5,,,0
CDM,30000200,HC BLOOD TYPING ABO,98.0,68.6,,,0
CDM,30000201,HC BLOOD TYPING RH (D),81.0,56.7,,,0
CDM,30000202,HC BLOOD TYPE ANTIGEN DONOR EA,98.0,68.6,,,0
CDM,30000203,HC BLOOD TYPING RBC ANTIGENS,94.0,65.8,,,0
CDM,30000204,HC COMPATIBILITY TEST SPIN,160.0,112.0,,,0
CDM,30000206,HC COMPATIBILITY TEST ELECTRIC,160.0,112.0,,,0
CDM,30000207,HC PLASMA FRESH FROZEN THAWING EA,134.0,93.8,,,0
CDM,30000208,HC BLOOD PRODUCT/IRRADIATION EA UNIT,111.0,77.7,,,0
CDM,30000209,HC POOLING BLOOD PLATELETS,174.0,121.8,,,0
CDM,30000213,HC CONCENTRATION FOR INFECT AGENTS,87.0,60.9,,,0
CDM,30000214,HC BLOOD CULTURE FOR BACTERIA,205.0,143.5,,,0
CDM,30000216,HC FECES CULT OTHER PATHOGENS,64.0,44.8,,,0
CDM,30000217,HC CULTURE BACTERIA OTHER SOURCES,172.0,120.4,,,0
CDM,30000218,HC CULT BACT AEROBIC OTHER SOURCES,64.0,44.8,,,0
CDM,30000220,HC CULT BACT AEROBIC ISOLATE,104.0,72.8,,,0
CDM,30000221,HC CULTURE SCREEN ONLY,104.0,72.8,,,0
CDM,30000222,HC CULTURE BACT URINE,63.0,44.1,,,0
CDM,30000223,HC CULTURE BACT URINE IDENT EA,58.0,40.6,,,0
CDM,30000224,HC CULTURE FUNGI SKIN NAILS HAIR,57.0,39.9,,,0
CDM,30000225,HC CULTURE FUNGI SOURCE NOT BLOOD,243.0,170.1,,,0
CDM,30000227,HC CULTURE FUNGI DEF IDENT EA ORG MOLD,63.0,44.1,,,0
CDM,30000228,HC CULTURE MYCOPLASMA,174.0,121.8,,,0
CDM,30000229,HC CULTURE CHLAMYDIA,155.0,108.5,,,0
CDM,30000230,HC CULTURE ACID FACT BACILLI,242.0,169.4,,,0
CDM,30000231,HC CULT TYPE IMMUNOFLUORESC EA,32.0,22.4,,,0
CDM,30000232,HC CULTURE TYPE IMMUNOLOGIC,34.0,23.8,,,0
CDM,30000233,HC CULTURE IDENT DNA RNA PROBE,72.0,50.4,,,0
CDM,30000234,HC MACROSCOPIC EXAM PARASITE,9.0,6.3,,,0
CDM,30000235,HC PINWORM EXAM,18.0,12.6,,,0
CDM,30000236,HC TISSUE HOMOGENIZATION CULTR,52.0,36.4,,,0
CDM,30000237,HC OVA AND PARASITES SMEARS,190.0,133.0,,,0
CDM,30000238,HC MICROBE SUSCEPTIBLE DIFFUSE,40.0,28.0,,,0
CDM,30000239,HC MICROBE SUSCEPTIBLE DISK,99.0,69.3,,,0
CDM,30000240,HC MICROBE SUSCEPTIBLE ENZYME,58.0,40.6,,,0
CDM,30000241,MICROBE SUSCEPTIBLE MICRODIL,109.0,76.3,,,0
CDM,30000242,HC MICROBE SUSCEPT MACROBROTH,40.0,28.0,,,0
CDM,30000244,HC SMEAR GRAM STAIN,52.0,36.4,,,0
CDM,30000245,HC SMEAR FLUORESCENT/ACID STAI,124.0,86.8,,,0
CDM,30000246,HC SMEAR SPECIAL STAIN PARASITES,155.0,108.5,,,0
CDM,30000247,HC SMEAR COMPLEX STAIN OVA PARASIT,37.0,25.9,,,0
CDM,30000248,HC SMEAR WET MOUNT SALINE/INK,50.0,35.0,,,0
CDM,30000249,KOH PREP FUNGI OVA MITES,62.0,43.4,,,0
CDM,30000250,HC VIRUS INOCULATION TISSUE CULT,104.0,72.8,,,0
CDM,30000251,HC VIRUS INOCULATION SHELL VIAL,140.0,98.0,,,0
CDM,30000262,HC CLOSTRIDIUM AG EIA,218.0,152.6,,,0
CDM,30000263,HC CRYPTOCOCCUS NEOFORM AG EIA,47.0,32.9,,,0
CDM,30000264,HC CRYPTOSPORIDIUM AG EIA,85.0,59.5,,,0
CDM,30000265,HC GIARDIA AG EIA,87.0,60.9,,,0
CDM,30000266,HC HPYLORI STOOL EIA,47.0,32.9,,,0
CDM,30000267,HC HEPATITIS B SURFACE AG EIA,169.0,118.3,,,0
CDM,30000268,HC HEPATITIS B SURFACE AG EIA NEUTR,124.0,86.8,,,0
CDM,30000269,HC HEPATITIS BE AG EIA,169.0,118.3,,,0
CDM,30000270,HC HEPATITIS DELTA AG EIA,256.0,179.2,,,0
CDM,30000271,HC HISTOPLASMA CAPSUL AG EIA,65.0,45.5,,,0
CDM,30000276,HC AG DETECT EIA MULT NOS,49.0,34.3,,,0
CDM,30000277,HC LYME DIS DNA AMP PROBE,190.0,133.0,,,0
CDM,30000278,HC CHYLMD TRACH DNA AMP PROBE,209.0,146.3,,,0
CDM,30000279,HC CYTOMEG DNA QUANT,196.0,137.2,,,0
CDM,30000281,HC HEPATITIS B DNA QUANT,65.0,45.5,,,0
CDM,30000282,HC HEPATITIS C DNA QUANT,279.0,195.3,,,0
CDM,30000283,HC HSV DNA AMP PROBE,279.0,195.3,,,0
CDM,30000286,HC HIV-1 DNA AMP PROBE,194.0,135.8,,,0
CDM,30000287,HC HIV-1 DNA QUANT,614.0,429.8,,,0
CDM,30000288,M TUBERCULO DNA AMP PROBE,203.0,142.1,,,0
CDM,30000289,HC M PNEUMON DNA AMP PROBE,203.0,142.1,,,0
CDM,30000290,HC N GONORRHOEAE DNA AMP PROB,154.0,107.8,,,0
CDM,30000291,HC DETECT AGENT DNA AMP NOS,217.0,151.9,,,0
CDM,30000292,HC DETECT AGENT DNA QUANT NOS,433.0,303.1,,,0
CDM,30000293,HC DETECT AGNT MULT DNA AMPLI,242.0,169.4,,,0
CDM,30000297,HC AGENT ASSAY W/OPTIC NOS,64.0,44.8,,,0
CDM,30000298,HC GENOTYPE DNA HIV REVERSE T,1069.0,748.3,,,0
CDM,30000299,GENOTYPE DNA HEPATITIS C,1213.0,849.1,,,0
CDM,30000303,HC POC BILIRUBIN TOTAL TRANSCUT,25.0,17.5,,,0
CDM,30000304,BODY FLUID NOT BLD CELL COUNT,29.0,20.3,,,0
CDM,30000305,BODY FLUID NOT BLD W/ DIFF COUNT,98.0,68.6,,,0
CDM,30000307,HC COLLECT SWEAT FOR TEST,106.0,74.2,,,0
CDM,30000309,HC SEMEN ANALYS SPERM DETECTION,46.0,32.2,,,0
CDM,30000310,HC PROSTATE CANCER SCREEN PSA TEST,151.0,105.7,,,0
CDM,30000800,HC HPV HIGH-RISK TYPES POOLED RESULT,150.0,105.0,,,0
CDM,30000943,HC MUCOPOLYSACCHARIDES ACIDE QUANT,121.0,84.7,,,0
CDM,30000947,HC POC PROTHROMBIN TIME,35.0,24.5,,,0
CDM,30000948,HC STREP A ASSAY W/OPTIC,91.0,63.7,,,0
CDM,30000949,HC POC EVAL CERVICOVAGINAL FLUID AMNIOTIC FLUID PROTEIN QUALITATIVE EACH SPECIMAN,98.0,68.6,,,0
CDM,30000950,HC POC URINE PREGNANCY,97.0,67.9,,,0
CDM,30000989,HC FLT3 GENE ANALYSIS,801.0,560.7,,,0
CDM,30000992,HC FMR1 GENE ANALYSIS EVAL DETECT ABNORMAL ALLELES,899.0,629.3,,,0
CDM,30000993,HC CFTR GENE FULL SEQUENCE,1703.0,1192.1,,,0
CDM,30000994,HC CYTOGEN ANALYSIS CONSTITUT CHROMOSMAL ABNORM GENOMIC REGIONS CGH,2535.0,1774.5,,,0
CDM,30000995,HC MTHFR MUTATION,657.0,459.9,,,0
CDM,30000996,HC RETT SYNDROME MECP2,2118.0,1482.6,,,0
CDM,30000997,HC RETT SYNDROME MECP2,602.0,421.4,,,0
CDM,30000998,HC NPM1 GENE ANALYSIS,801.0,560.7,,,0
CDM,30000999,HC PRADER-WILLI OR ANGELMAN SYNDROME,450.0,315.0,,,0
CDM,30001020,HC POC TB INTRADERMAL TEST,70.0,49.0,,,0
CDM,30001022,HC POC SKIN TEST NOS ANTIGEN,17.0,11.9,,,0
CDM,30001023,HC POC MONONUCLEAR CELL ANTIGEN,114.0,79.8,,,0
CDM,30001024,HC POC RAPID STREP A,91.0,63.7,,,0
CDM,30001032,HC KEPRA/LEVETIRACTAM/ELEPSIA,34.0,23.8,,,0
CDM,30001033,HC ASSAY OF ALUMINUM,276.0,193.2,,,0
CDM,30001034,HC RBC ANTIBODY ELUTION,233.0,163.1,,,0
CDM,30001035,HC VW MULTIMERS,200.0,140.0,,,0
CDM,30001039,HC HIV-1 INTEGRASE SEQ.,546.0,382.2,,,0
CDM,30001045,HC MOPATH PROCEDURE LEVEL 9,2731.0,1911.7,,,0
CDM,30001046,HC DRDQDRP LOCI LOW RES,999.0,699.3,,,0
CDM,30001053,HC C DIFF AMPLIFIED PROBE,150.0,105.0,,,0
CDM,30001054,HC TRICHINELLA ANTIBODY,59.0,41.3,,,0
CDM,30001057,HC MATRIX METALLOPROTEINASE 9,56.0,39.2,,,0
CDM,30001058,HC ASSAY FOR PHENCYCLIDINE,249.0,174.3,,,0
CDM,30001063,HC ALLERGEN SPECIFIC IGG,20.0,14.0,,,0
CDM,30001065,HC OVA 1 FIVE PROTEINS (OVAR),1012.0,708.4,,,0
CDM,30001066,HC T CELLS TOTAL COUNT,145.0,101.5,,,0
CDM,30001079,HC ANTIEPILEPTICS NOT OTHERWISE SPECIFIED 1-3,206.0,144.2,,,0
CDM,30001080,HC CLOT FACTOR XIII FIBRIN STAB,35.0,24.5,,,0
CDM,30001081,HC CULTURE TYPING OTHER METHODS,23.0,16.1,,,0
CDM,30001087,HC B CELLS TOTAL COUNT,145.0,101.5,,,0
CDM,30001088,HC NK CELLS TOTAL COUNT,145.0,101.5,,,0
CDM,30001089,HC T CELL ABSOLUTE COUNT/RATIO,92.0,64.4,,,0
CDM,30001128,HC BLOOD COUNT AUTOMATED DIFFERENTIAL WBC COUNT,28.0,19.6,,,0
CDM,30001144,HC FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYSIS PANEL,2630.0,1841.0,,,0
CDM,30001151,HC INFECTIOUS AGENT PHENOTYPE ANALYSIS NUCLEIC ACID HIV 1 FIRST THROUGH 10 DRUGS TESTED,2073.0,1451.1,,,0
CDM,30001152,HC INFECTIOUS AGENT PHENOTYPE ANALYSIS NUCLEIC ACID HIV 1 EACH ADDITIONAL DRUG TESTED (LIST SEP IN ADDITION TO PRIMARY PROCEDURE),111.0,77.7,,,0
CDM,30001159,HC C-REACTIVE PROTEIN FOR DETECTION OF INFECTION/INFLAMMATION,20.0,14.0,,,0
CDM,30001174,HC INFECTIOUS AGENT DETECT NUCLEIC ACID (DNA/RNA) HEPATITIS B AMP PROBE TECH,151.0,105.7,,,0
CDM,30001175,HC INFECTIOUS AGENT DECT NUCLEIC ACID (DNA/RNA) HEPATITIS B AMP PROBE TECH INCL REVERSE TRANSCRIPTIO,151.0,105.7,,,0
CDM,30001176,HC HUMAN LEUKOCYTE ANTIGEN (HLA) CROSSMATCH NON-CYTOTOXIC FIRST SERUM SAMPLE OR DILUTION,463.0,324.1,,,0
CDM,30001180,HC INFECTIOUS AGENT DRUG SUSCEPTIBILITY PREDICTION USING REGULARLY UPDATED GENOTYPIC BIOINFORMATICS,558.0,390.6,,,0
CDM,30001185,HC HANDLING/CONVEYANCE OF SPECIMEN FOR TRANSFER FROM PATIENT TO A LABORATORY,62.0,43.4,,,0
CDM,30001209,HC ALLERGEN SPECIFIC IGE QUANTITATIVES/SEMIQUANTITATIVE RECOMBINAT/PURIFIED COMPONENT EACH,76.0,53.2,,,0
CDM,30001215,HC CLOTTING PREKALLIKREIN ASSAY,96.0,67.2,,,0
CDM,30001217,HC EXOME SEQUENCE ANALYSIS,20192.0,14134.4,,,0
CDM,30001219,HC POC HEMOGLOBIN,49.0,34.3,,,0
CDM,30001240,HC POC HEMATOCRIT ISTAT,48.0,33.6,,,0
CDM,30001241,HC POC D-DIMER TRIAGE,162.0,113.4,,,0
CDM,30001242,HC POC BMP,89.0,62.3,,,0
CDM,30001244,HC POC GRP A STREP LIAT,186.0,130.2,,,0
CDM,30001245,HC POC COMPLETE CBC W/AUTO DIFF WBC,66.0,46.2,,,0
CDM,30001246,HC POC URINE DIPSTICK,65.0,45.5,,,0
CDM,30001266,HC BLOOD COUNT RETICULOCYTES AUTO INCL 1 OR MORE CELLULAR PARAMETERS DIRECT MEASUREMENT,26.0,18.2,,,0
CDM,30001286,HC DRUG ASSAY LACOSAMIDE,33.0,23.1,,,0
CDM,30001288,HC DRUG ASSAY ADALIMUMAB,35.0,24.5,,,0
CDM,30001290,HC DRUG ASSAY INFLIXIMAB,35.0,24.5,,,0
CDM,30001292,HC DRUG ASSAY VORICONAZOLE,26.0,18.2,,,0
CDM,30001296,HC CHROMOGENIC SUBSTRATE ASSAY,27.0,18.9,,,0
CDM,30001297,HC COVID-19 MULTIPLE TYPES/SUBTYPES NON-CDC,134.0,93.8,,,0
CDM,30001299,HC RESPIRATORY  INFECT AGENT DETECT (DNA/RNA) TYPE & SUBTYPES 2 BACTERIAL TARGETS,802.0,561.4,,,0
CDM,30001300,HC ANTIBODY JC (JOHN CUNNINGHAM) VIRUS,30.0,21.0,,,0
CDM,30001303,HC INFECT AGENT DETECT DNA/RNA SARS-COV-2 AMPLIFIED PROB TECH,96.0,67.2,,,0
CDM,30001304,HC ANTIBODY SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2,122.0,85.4,,,0
CDM,30001305,HC CDC 2019-NCOV REAL-TIME RT-PCR DIAGNOSTIC PANEL,94.0,65.8,,,0
CDM,30001309,HC INFECT (DNA/RNA) TRICHOMONAS VAGINALIS AMPLIF PROBE TECH,169.0,118.3,,,0
CDM,30001325,HC NFCT DS DNA & RNA 21 TARGETS SARS-COV-2 AMP PROBE,620.0,434.0,,,0
CDM,30001332,HC IADNA SARSCOV2 & INF A&B MULT AMPLIFIED PROBE TQ,454.0,317.8,,,0
CDM,30001333,HC IADNA SARSCOV2 INF A&B & RSV  MULTI AMPLIFIED PROBE TQ,472.0,330.4,,,0
CDM,30001335,HC BLOOD BANK PHYS SERV INVEST TRANSFUSION REACT INCL INTERP & REPORT,91.0,63.7,,,0
CDM,30001336,HC POC LIAT SARS-COV-2/FLUA/FLUB,454.0,317.8,,,0
CDM,30001337,HC POC INFECT AGENT DETECT DNA/RNA SARS-COV-2 AMPLIFIED PROB TECH,96.0,67.2,,,0
CDM,30001338,HC POC IADNA DNA/RNA RSV AMPLIFIED PROBE TECHNIQUE,78.0,54.6,,,0
CDM,30001339,HC DRUG ASSAY ACETAMINOPHEN,33.0,23.1,,,0
CDM,30001340,HC DRUG ASSAY SALICYLATE,33.0,23.1,,,0
CDM,30001341,HC DRUG ASSAY METHOTREXATE,33.0,23.1,,,0
CDM,30001342,HC JAK2 TARGETED SEQUENCE ANALYSIS,407.0,284.9,,,0
CDM,30001343,HC MPL GENE COMMON VARIANTS,330.0,231.0,,,0
CDM,30001344,HC TP53 GENE FULL GENE SEQUENCE,1404.0,982.8,,,0
CDM,30001350,HC POC BASIC METABOLIC PANEL CALCIUM IONIZED,45.0,31.5,,,0
CDM,30001358,HC NEUROLOGY CSF DECT PRION PROTEIN QUALITATIVE,1124.0,786.8,,,0
CDM,30001361,HC HBA1/HBA2 GENE ANALYSIS DUP/DEL VARIANTS,456.0,319.2,,,0
CDM,30001362,HC MYCOBACTERIAL DEF ID 1,58.0,40.6,,,0
CDM,30001364,HC INFECTIOUS DISEASE BACTERIAL VAGINOSIS&VAGINITIS DNA VAG FLU ALG,562.0,393.4,,,0
CDM,30001369,HC NUDT15 GENE ANALYSIS COMMON VARIANTS,656.0,459.2,,,0
CDM,30001384,HC CYP2C9 GENE ANAKYSIS COMMON VARIANTS,394.0,275.8,,,0
CDM,30001389,HC IMMUNOGLOBULIN LIGHTS CHAINS FREE EACH,37.0,25.9,,,0
CDM,30001390,HC GLIADIN ANTIBODY EACH IMMUNOGLOBULIN CLASS,28.0,19.6,,,0
CDM,30001391,HC TISSUE TRANSGLTMNASE EA IMMUNOGLOBULIN CLASS,28.0,19.6,,,0
CDM,30001392,HC ACTIN SMOOTH MUSCLE ANTIBODY EACH,28.0,19.6,,,0
CDM,30001393,HC ANTINEUTROPHIL CYTOPLASMI ANTB SCREEN EA ANTIBODY,29.0,20.3,,,0
CDM,30001394,HC ANTINEUTROPHIL CYTOPLASMIC ANTB TITER EACH ANTIBODY,29.0,20.3,,,0
CDM,30001395,HC MITOCHONDRIAL ANTIBODY EACH,61.0,42.7,,,0
CDM,30001396,HC ELASTASE PANCREATIC FECAL QUANTITATIVE,49.0,34.3,,,0
CDM,30001397,HC ASSAY OF INTERLEUKIN-6,37.0,25.9,,,0
CDM,30001398,HC AQUAPORIN-4 ANTIBODY ELISA,28.0,19.6,,,0
CDM,30001399,HC QUAPORIN-4 ANITBODY FLOW CYTOMETRY EACH,29.0,20.3,,,0
CDM,30013400,HC MYELIN OLIGODENDROCYTE GLYCOPROTEIN ANTIBODY FLOW SYTOMETRY EACH,29.0,20.3,,,0
CDM,30013401,HC VOLTAGE-GATED CALCIUM CHANNEL ANTIBODY EACH,44.0,30.8,,,0
CDM,30013402,HC ENDOMYSIAL ANTIBODY EACH IMMUNOGLOBULIN CLASS,29.0,20.3,,,0
CDM,30013416,HC INFECTIOUS DISEASE BACTERIAL VAGINOSIS RNA VAGINAL-FLUID ALG,305.0,213.5,,,0
CDM,30013422,HC POC COMPLETE CBC AUTO W/O DIFF,40.0,28.0,,,0
CDM,30013423,HC COAGULATION/FIBRINOLYSIS ASSAY WHOLE BLOOD INCL INTERP/REPORT ADDITIVE/DAY,82.0,57.4,,,0
CDM,30013427,HC TRANSPLANTATION MED QUAN DONOR-DERIVED CELL FREE DNA PLASMA,5887.0,4120.9,,,0
CDM,30013434,HC INFECTIOUS AGENT (DNA OR RNA) ORTHPOXVIRUS AMPLIFIED PROBE TECHNIQUE EA,137.0,95.9,,,0
CDM,30013445,HC POC HEPARIN ASSAY,89.0,62.3,,,0
CDM,30013446,HC POC HEPARIN PROTAMINE TOLERANCE TEST,66.0,46.2,,,0
CDM,30013452,HC FMR1 GENE ANALYSIS CHARACTERIZATION OF ALLELES,330.0,231.0,,,0
CDM,30013455,HC STREPTOCOCCUS PNEUM ANTIBODY IGG SEROTYPES MLT IMMUNOASSAY QUAN,56.0,39.2,,,0
CDM,30013456,HC IADNA HPV SEP RPRT HI-RISK TYP&HI-RISK POOLED RESULTS,305.0,213.5,,,0
CDM,30013457,HC IADNA PNEUMOCYSTIS JIROVECII AMPLIFIED PROBE TECHNIQUE,153.0,107.1,,,0
CDM,30013458,HC IADNA MTB RIFAMPIN RESISTANCE AMPLIFIED PROBE TECHNIQUE,334.0,233.8,,,0
CDM,30013459,HC IADNA MYCOPLASMA GENITALIUM AMPLIFIED PROBE TECH,153.0,107.1,,,0
CDM,30013460,HC AQUAPORIN-4 ANTIBODY CELL-BASED IMFLUOR ASSAY EA,53.0,37.1,,,0
CDM,30100001,GENERAL HEALTH PANEL,434.0,303.8,,,0
CDM,30100002,HC ELECTROLYTE PANEL,104.0,72.8,,,0
CDM,30100003,LIPID PANEL,165.0,115.5,,,0
CDM,30100004,HC RENAL FUNCTION PANEL,99.0,69.3,,,0
CDM,30100005,ACUTE HEPATITIS PANEL,256.0,179.2,,,0
CDM,30100006,HC HEPATIC FUNCTION PANEL,142.0,99.4,,,0
CDM,30100011,HC ASSAY OF AMIKACIN,33.0,23.1,,,0
CDM,30100014,HC ASSAY CARBAMAZEPINE TOTAL,229.0,160.3,,,0
CDM,30100015,HC ASSAY OF CYCLOSPORINE,200.0,140.0,,,0
CDM,30100017,HC ASSAY OF DIGOXIN,103.0,72.1,,,0
CDM,30100020,HC ASSAY OF ETHOSUXIMIDE,85.0,59.5,,,0
CDM,30100021,HC ASSAY OF GENTAMICIN,223.0,156.1,,,0
CDM,30100022,HC ASSAY OF HALOPERIDOL,63.0,44.1,,,0
CDM,30100024,HC ASSAY OF LIDOCAINE,87.0,60.9,,,0
CDM,30100025,HC ASSAY OF LITHIUM,116.0,81.2,,,0
CDM,30100027,HC ASSAY OF PHENOBARBITAL,138.0,96.6,,,0
CDM,30100028,ASSAY OF PHENYTOIN TOTAL,187.0,130.9,,,0
CDM,30100029,HC ASSAY OF PHENYTOIN FREE,72.0,50.4,,,0
CDM,30100030,HC ASSAY OF PRIMIDONE,207.0,144.9,,,0
CDM,30100031,HC ASSAY OF SIROLIMUS,65.0,45.5,,,0
CDM,30100033,HC ASSAY OF TACROLIMUS,98.0,68.6,,,0
CDM,30100034,HC ASSAY OF THEOPHYLLINE,196.0,137.2,,,0
CDM,30100035,HC ASSAY OF TOBRAMYCIN,252.0,176.4,,,0
CDM,30100036,HC ASSAY OF TOPIRAMATE,72.0,50.4,,,0
CDM,30100037,HC ASSAY OF VANCOMYCIN,190.0,133.0,,,0
CDM,30100038,HC QUANTITATIVE ASSAY DRUG NES,241.0,168.7,,,0
CDM,30100039,HC ACTH STIMULATION PANEL,270.0,189.0,,,0
CDM,30100042,HC KETONE BODY QUANTITATIVE,54.0,37.8,,,0
CDM,30100044,HC ACYLCARNITINES QUANT,76.0,53.2,,,0
CDM,30100045,HC ASSAY OF ACTH,82.0,57.4,,,0
CDM,30100046,HC ASSAY OF SERUM ALBUMIN,141.0,98.7,,,0
CDM,30100047,HC ALBUMIN OTHER SOURCE QUANTITATIVE EACH SPECIMEN,44.0,30.8,,,0
CDM,30100048,HC ALBUMIN URINE (EG MICROALBUMIN) QUANTITATIVE,223.0,156.1,,,0
CDM,30100051,HC ASSAY OF ALDOLASE,275.0,192.5,,,0
CDM,30100052,HC ASSAY OF ALDOSTERONE,552.0,386.4,,,0
CDM,30100053,HC ALPHA-1-ANTITRYPSIN TOTAL,172.0,120.4,,,0
CDM,30100054,HC ALPHA-1-ANTITRYPSIN PHENO,270.0,189.0,,,0
CDM,30100055,ALPHA-FETOPROTEIN SERUM,242.0,169.4,,,0
CDM,30100058,HC AMINO ACIDS SINGLE QUANT,352.0,246.4,,,0
CDM,30100059,HC ASSAY AMINOLEVULINIC ACID,252.0,176.4,,,0
CDM,30100061,HC AMINO ACIDS QUAN 6 OR MORE,1100.0,770.0,,,0
CDM,30100062,HC ASSAY OF AMMONIA,124.0,86.8,,,0
CDM,30100064,HC ASSAY OF AMYLASE,137.0,95.9,,,0
CDM,30100065,HC ASSAY OF ANDROSTENEDIONE,44.0,30.8,,,0
CDM,30100066,HC ANGIOTENSIN I ENZYME TEST,229.0,160.3,,,0
CDM,30100067,HC ASSAY OF APOLIPOPROTEIN,154.0,107.8,,,0
CDM,30100068,HC ASSAY OF ARSENIC,184.0,128.8,,,0
CDM,30100069,HC ASSAY OF ASCORBIC ACID,296.0,207.2,,,0
CDM,30100070,HC ASSAY OF BETA-2 PROTEIN,147.0,102.9,,,0
CDM,30100071,HC BILE ACIDS TOTAL,75.0,52.5,,,0
CDM,30100072,HC BILIRUBIN TOTAL,124.0,86.8,,,0
CDM,30100073,HC BILIRUBIN DIRECT,104.0,72.8,,,0
CDM,30100074,OCCULT BLOOD FECES,41.0,28.7,,,0
CDM,30100076,HC ASSAY TEST FOR BLOOD FECAL,65.0,45.5,,,0
CDM,30100077,VITAMIN D 25 HYDROXY,118.0,82.6,,,0
CDM,30100078,HC ASSAY OF CALCITONIN,304.0,212.8,,,0
CDM,30100079,HC ASSAY OF CALCIUM TOTAL,88.0,61.6,,,0
CDM,30100080,HC POC ASSAY OF CALCIUM IONIZED,230.0,161.0,,,0
CDM,30100081,HC ASSAY OF CA IN URINE TIMED,138.0,96.6,,,0
CDM,30100082,HC CALCULUS INFRARED SPECTROSCOPY,172.0,120.4,,,0
CDM,30100083,HC ASSAY C-D TRANSFER MEASURE,69.0,48.3,,,0
CDM,30100084,HC ASSAY BLOOD CARBON DIOXIDE,90.0,63.0,,,0
CDM,30100085,HC ASSAY CARBOXYHB QUANT,164.0,114.8,,,0
CDM,30100086,HC CARCINOEMBRYONIC ANTIGEN,184.0,128.8,,,0
CDM,30100087,HC ASSAY OF CARNITINE,36.0,25.2,,,0
CDM,30100088,HC ASSAY OF CAROTENE,141.0,98.7,,,0
CDM,30100089,HC ASSAY CATECHOLAMINES FRACTION,60.0,42.0,,,0
CDM,30100090,HC ASSAY OF CERULOPLASMIN,158.0,110.6,,,0
CDM,30100091,CHEMILUMINESCENT ASSAY,84.0,58.8,,,0
CDM,30100092,ASSAY OF BLOOD CHLORIDE,94.0,65.8,,,0
CDM,30100093,HC ASSAY OF URINE CHLORIDE,94.0,65.8,,,0
CDM,30100094,HC ASSAY OTHER FLUID CHLORIDES,28.0,19.6,,,0
CDM,30100095,HC ASSAY BLD/SERUM CHOLESTEROL,34.0,23.8,,,0
CDM,30100098,HC ASSAY OF CITRATE,394.0,275.8,,,0
CDM,30100100,COLLAGEN CROSSLINKS,102.0,71.4,,,0
CDM,30100101,HC ASSAY OF COPPER,55.0,38.5,,,0
CDM,30100102,HC CORTISOL FREE,235.0,164.5,,,0
CDM,30100103,HC TOTAL CORTISOL,174.0,121.8,,,0
CDM,30100105,HC COLUMN CHROMATOGRAPHY INCL MASS SPECTROMETRY IF PERFORMED NON-DRUG ANALYTE(S) NOT ELSEWHERE SPECIFIED QUALITATIVE/QUANTITATIVE EACH SPECIMEN,105.0,73.5,,,0
CDM,30100107,HC ASSAY OF CK (CPK) TOTAL,65.0,45.5,,,0
CDM,30100108,HC ASSAY OF CPK IN BLOOD,130.0,91.0,,,0
CDM,30100109,HC ASSAY OF CREATININE,85.0,59.5,,,0
CDM,30100110,HC ASSAY OF CREATININE OTHER SOURCE,94.0,65.8,,,0
CDM,30100111,HC CREATININE CLEARANCE TEST,265.0,185.5,,,0
CDM,30100112,HC ASSAY OF CRYOFIBRINOGEN,116.0,81.2,,,0
CDM,30100113,HC ASSAY OF CRYOGLOBULIN,81.0,56.7,,,0
CDM,30100114,HC ASSAY OF CYANIDE,168.0,117.6,,,0
CDM,30100115,VITAMIN B-12,154.0,107.8,,,0
CDM,30100116,HC B-12 BINDING CAPACITY,23.0,16.1,,,0
CDM,30100117,HC CYSTATIN C,58.0,40.6,,,0
CDM,30100118,HC DHEA,494.0,345.8,,,0
CDM,30100119,HC DHEA SO4,369.0,258.3,,,0
CDM,30100120,HC DEOXYCORTISOL,124.0,86.8,,,0
CDM,30100122,VIT D 1 25-DIHYDROXY,617.0,431.9,,,0
CDM,30100123,HC ASSAY OF ERYTHROPOIETIN,161.0,112.7,,,0
CDM,30100124,HC ASSAY OF TOTAL ESTRADIOL,336.0,235.2,,,0
CDM,30100125,HC ASSAY OF ESTROGENS,563.0,394.1,,,0
CDM,30100128,HC ASSAY OF ETHYLENE GLYCOL,255.0,178.5,,,0
CDM,30100129,HC FATS/LIPIDS FECES QUAL,110.0,77.0,,,0
CDM,30100130,FATS/LIPIDS FECES QUANT,301.0,210.7,,,0
CDM,30100131,HC ASSAY OF BLOOD FATTY ACIDS,65.0,45.5,,,0
CDM,30100132,HC LONG CHAIN FATTY ACIDS,96.0,67.2,,,0
CDM,30100133,HC ASSAY OF FERRITIN,161.0,112.7,,,0
CDM,30100134,HC ASSAY OF FETAL FIBRONECTIN,456.0,319.2,,,0
CDM,30100135,HC BLOOD FOLIC ACID SERUM,243.0,170.1,,,0
CDM,30100136,HC ASSAY OF FOLIC ACID RBC,76.0,53.2,,,0
CDM,30100138,HC ASSAY IGA/IGD/IGG/IGM EACH,455.0,318.5,,,0
CDM,30100139,HC ASSAY OF IGE,177.0,123.9,,,0
CDM,30100140,HC IGG 1 2 3 OR 4 EACH,684.0,478.8,,,0
CDM,30100141,HC BLOOD GASES PH,124.0,86.8,,,0
CDM,30100142,BLOOD GASES ANY COMBINATION,212.0,148.4,,,0
CDM,30100143,BLOOD GASES W/ O2 SATURATION,212.0,148.4,,,0
CDM,30100144,HC BLOOD GASES O2 SAT ONLY,129.0,90.3,,,0
CDM,30100145,HC ASSAY OF GASTRIN,208.0,145.6,,,0
CDM,30100146,HC ASSAY OF GLUCAGON,283.0,198.1,,,0
CDM,30100147,HC GLUCOSE FLUID NOT BLOOD,104.0,72.8,,,0
CDM,30100148,ASSAY GLUCOSE BLOOD QUANT,89.0,62.3,,,0
CDM,30100149,HC ASSAY POCT GLUCOSE SCREEN,62.0,43.4,,,0
CDM,30100150,HC GTT-ADDED SAMPLES,47.0,32.9,,,0
CDM,30100151,HC ASSAY OF G6PD ENZYME,182.0,127.4,,,0
CDM,30100153,HC ASSAY OF GGT,123.0,86.1,,,0
CDM,30100154,HC GLYCATED PROTEIN,46.0,32.2,,,0
CDM,30100155,HC GONADOTROPIN (FSH),177.0,123.9,,,0
CDM,30100156,HC GONADOTROPIN (LH),206.0,144.2,,,0
CDM,30100157,HC ASSAY GROWTH HORMONE (HGH),304.0,212.8,,,0
CDM,30100158,HC ASSAY OF HAPTOGLOBIN QUANT,188.0,131.6,,,0
CDM,30100159,HC QUANTITATIVE SCREEN METALS,180.0,126.0,,,0
CDM,30100160,HC HEMOGLOBIN ELECTROPHORESIS,212.0,148.4,,,0
CDM,30100162,GLYCOSYLATED HEMOGLOBIN TEST,61.0,42.7,,,0
CDM,30100163,HC BLOOD METHEMOGLOBIN ASSAY,129.0,90.3,,,0
CDM,30100164,HC ASSAY OF PLASMA HEMOGLOBIN,180.0,126.0,,,0
CDM,30100166,HC ASSAY OF HEMOSIDERIN QUAL,15.0,10.5,,,0
CDM,30100167,HC ASSAY OF HISTAMINE,196.0,137.2,,,0
CDM,30100168,HC ASSAY OF HOMOCYSTINE,324.0,226.8,,,0
CDM,30100169,HC ASSAY OF FOR HVA,254.0,177.8,,,0
CDM,30100170,HC ASSAY OF 5-HIAA,21.0,14.7,,,0
CDM,30100171,HC ASSAY OF PROGESTERONE 17-D,301.0,210.7,,,0
CDM,30100172,HC IMMUNOASSAY NONANTIBODY,256.0,179.2,,,0
CDM,30100173,HC RIA NONANTIBODY,163.0,114.1,,,0
CDM,30100175,HC ASSAY OF INSULIN,194.0,135.8,,,0
CDM,30100176,HC ASSAY OF IRON,85.0,59.5,,,0
CDM,30100177,HC IRON BINDING TEST,171.0,119.7,,,0
CDM,30100178,HC ASSAY 17- KETOSTEROIDS TOTAL,169.0,118.3,,,0
CDM,30100179,ASSAY OF LACTIC ACID,188.0,131.6,,,0
CDM,30100180,HC LACTATE (LD) (LDH) ENZYME,123.0,86.1,,,0
CDM,30100181,HC ASSAY OF LDH ENZYMES,227.0,158.9,,,0
CDM,30100182,HC LACTOFERRIN FECAL (QUAL),56.0,39.2,,,0
CDM,30100183,HC ASSAY OF LEAD,137.0,95.9,,,0
CDM,30100184,HC LAMELLAR BODY DENSITY,58.0,40.6,,,0
CDM,30100185,HC ASSAY OF LIPASE,184.0,128.8,,,0
CDM,30100186,HC ASSAY OF LIPOPROTEIN(A),88.0,61.6,,,0
CDM,30100187,HC ASSAY LIPOPROTEIN PLA2,201.0,140.7,,,0
CDM,30100189,HC ASSAY OF LIPOPROTEIN,68.0,47.6,,,0
CDM,30100190,HC ASSAY OF BLOOD LIPOPRO LDL,118.0,82.6,,,0
CDM,30100191,HC ASSAY OF MAGNESIUM,81.0,56.7,,,0
CDM,30100192,HC ASSAY OF MANGANESE,87.0,60.9,,,0
CDM,30100193,HC MASS SPECTOMETRY AND TANDEM MASS SPECTROMETRY NON-DRUG ANALYTE(S) NOT ELSEWHERE SPECIFIED QUALITATIVE/QUANTITATIVE EACH SPECIMEN,90.0,63.0,,,0
CDM,30100194,HC ASSAY OF MERCURY,171.0,119.7,,,0
CDM,30100195,HC ASSAY OF METANEPHRINES,94.0,65.8,,,0
CDM,30100197,HC ASSAY OF CSF PROTEIN,291.0,203.7,,,0
CDM,30100198,HC ASSAY OF MYOGLOBIN,292.0,204.4,,,0
CDM,30100199,HC NATRIURETIC PEPTIDE,162.0,113.4,,,0
CDM,30100200,HC ASSAY NEPHELOMETRY NES,69.0,48.3,,,0
CDM,30100218,HC OLIGOCLONAL BANDS,154.0,107.8,,,0
CDM,30100219,HC ORGANIC ACIDS TOTAL QUANT EA,134.0,93.8,,,0
CDM,30100220,HC ORGANIC ACID SINGLE QUANT,209.0,146.3,,,0
CDM,30100222,HC ASSAY OF BLOOD OSMOLALITY,94.0,65.8,,,0
CDM,30100223,HC ASSAY OF URINE OSMOLALITY,94.0,65.8,,,0
CDM,30100225,HC ASSAY OF OXALATE,55.0,38.5,,,0
CDM,30100226,HC ASSAY OF PARATHORMONE,565.0,395.5,,,0
CDM,30100227,HC ASSAY PH BODY FLUID NOS,55.0,38.5,,,0
CDM,30100228,HC ASSAY FOR CALPROTECTIN FECAL,89.0,62.3,,,0
CDM,30100232,HC ASSAY ALK PHOS ISOENZYMES,123.0,86.1,,,0
CDM,30100233,HC ASSAY ALK PHOS ISOENZYMES,334.0,233.8,,,0
CDM,30100235,HC ASSAY OF PHOSPHORUS,96.0,67.2,,,0
CDM,30100236,HC ASSAY OF URINE PHOSPHORUS,10.0,7.0,,,0
CDM,30100237,HC ASSAY OF PORPHOBILINOGEN,184.0,128.8,,,0
CDM,30100238,HC ASSAY OF URINE PORPHYRINS,23.0,16.1,,,0
CDM,30100239,HC ASSAY OF FECES PORPHYRINS,292.0,204.4,,,0
CDM,30100240,HC POC POTASSIUM SERUM PLASMA/WHOLE BLOOD,82.0,57.4,,,0
CDM,30100241,HC ASSAY OF URINE POTASSIUM,98.0,68.6,,,0
CDM,30100242,HC ASSAY OF PREALBUMIN,45.0,31.5,,,0
CDM,30100244,HC ASSAY OF 17-HYDROXYPREG,109.0,76.3,,,0
CDM,30100245,HC ASSAY OF PROGESTERONE,213.0,149.1,,,0
CDM,30100246,HC ASSAY OF PROLACTIN,281.0,196.7,,,0
CDM,30100247,HC PSA SPECIFIC ANTIGEN TOTAL,199.0,139.3,,,0
CDM,30100248,HC ASSAY OF PSA FREE,86.0,60.2,,,0
CDM,30100249,HC ASSAY OF PROTEIN URINE,89.0,62.3,,,0
CDM,30100250,HC ASSAY OF PROTEIN OTHER SOURCE,118.0,82.6,,,0
CDM,30100251,HC PAPPA SERUM,73.0,51.1,,,0
CDM,30100252,HC PROTEIN E-PHORESIS SERUM,218.0,152.6,,,0
CDM,30100253,HC PROTEIN E-PHORESIS/URINE/CSF,86.0,60.2,,,0
CDM,30100255,HC WESTERN BLOT TEST IMMUN PROBE,94.0,65.8,,,0
CDM,30100256,HC ASSAY RBC PROTOPORPHYRIN,317.0,221.9,,,0
CDM,30100257,HC ASSAY OF PROINSULIN,242.0,169.4,,,0
CDM,30100258,HC ASSAY OF VITAMIN B-6,192.0,134.4,,,0
CDM,30100259,HC ASSAY OF PYRUVATE,77.0,53.9,,,0
CDM,30100260,HC ASSAY OF PYRUVATE KINASE,52.0,36.4,,,0
CDM,30100261,HC ASSAY NONENDOCRINE RECEPTOR,56.0,39.2,,,0
CDM,30100262,HC ASSAY OF RENIN,265.0,185.5,,,0
CDM,30100263,HC ASSAY OF VITAMIN B-2,63.0,44.1,,,0
CDM,30100264,HC ASSAY OF SELENIUM,127.0,88.9,,,0
CDM,30100265,HC ASSAY OF SEROTONIN,479.0,335.3,,,0
CDM,30100266,HC ASSAY OF SEX HORMONE GLOBUL,134.0,93.8,,,0
CDM,30100267,HC POC ASSAY OF SERUM SODIUM,82.0,57.4,,,0
CDM,30100268,HC ASSAY OF URINE SODIUM,98.0,68.6,,,0
CDM,30100269,HC ASSAY OF SODIUM OTHER SOURCE,26.0,18.2,,,0
CDM,30100270,HC ASSAY OF SOMATOMEDIN,302.0,211.4,,,0
CDM,30100271,HC ASSAY OF SOMATOSTATIN,78.0,54.6,,,0
CDM,30100272,SPECTROPHOTOMETRY NES,13.0,9.1,,,0
CDM,30100273,HC BODY FLUID SPECIF GRAV NOT URINE,13.0,9.1,,,0
CDM,30100274,HC SUGARS SINGLE QUAL EA,28.0,19.6,,,0
CDM,30100276,HC ASSAY OF TESTOSTERONE FREE,87.0,60.9,,,0
CDM,30100277,HC ASSAY OF TOTAL TESTOSTERONE,261.0,182.7,,,0
CDM,30100278,ASSAY OF VITAMIN B-1,68.0,47.6,,,0
CDM,30100279,HC ASSAY OF THIOCYANATE,283.0,198.1,,,0
CDM,30100280,HC ASSAY OF THYROGLOBULIN,301.0,210.7,,,0
CDM,30100281,HC ASSAY OF TOTAL THYROXINE,133.0,93.1,,,0
CDM,30100282,HC ASSAY OF FREE THYROXINE,62.0,43.4,,,0
CDM,30100283,HC ASSAY OF THYROID ACTIVITY,124.0,86.8,,,0
CDM,30100284,ASSAY THYROID STIM HORMONE,70.0,49.0,,,0
CDM,30100285,HC ASSAY THYROID STIM IMM GLOB,673.0,471.1,,,0
CDM,30100286,HC ASSAY OF VITAMIN E,90.0,63.0,,,0
CDM,30100287,HC ASSAY OF TRANSCORTIN,74.0,51.8,,,0
CDM,30100288,HC TRANSFERASE (AST) (SGOT),123.0,86.1,,,0
CDM,30100289,ALANINE AMINO (ALT) (SGPT),123.0,86.1,,,0
CDM,30100290,HC ASSAY OF TRANSFERRIN,142.0,99.4,,,0
CDM,30100291,HC ASSAY OF TRIGLYCERIDES,63.0,44.1,,,0
CDM,30100292,HC ASSAY OF THYROID (T3 OR T4),101.0,70.7,,,0
CDM,30100293,HC ASSAY TRIIODOTHYRONINE (T3) TOTAL,161.0,112.7,,,0
CDM,30100294,HC ASSAY T3 TOTAL,313.0,219.1,,,0
CDM,30100295,HC ASSAY T3 REVERSE,26.0,18.2,,,0
CDM,30100296,HC ASSAY OF TROPONIN QUANT,223.0,156.1,,,0
CDM,30100298,HC ASSAY OF UREA NITROGEN,89.0,62.3,,,0
CDM,30100299,HC ASSAY OF URINE/UREA-N,70.0,49.0,,,0
CDM,30100300,HC ASSAY OF BLOOD/URIC ACID,116.0,81.2,,,0
CDM,30100301,HC ASSAY OF URIC ACID OTHER SOURCE,21.0,14.7,,,0
CDM,30100302,HC ASSAY OF URINE VMA,242.0,169.4,,,0
CDM,30100303,HC ASSAY OF VIP,534.0,373.8,,,0
CDM,30100304,HC ASSAY OF VASOPRESSIN,254.0,177.8,,,0
CDM,30100305,HC ASSAY OF VITAMIN A,222.0,155.4,,,0
CDM,30100306,ASSAY VITAMIN NOS,70.0,49.0,,,0
CDM,30100307,HC ASSAY OF VITAMIN K,81.0,56.7,,,0
CDM,30100309,HC ASSAY OF ZINC,222.0,155.4,,,0
CDM,30100310,HC ASSAY OF C-PEPTIDE,238.0,166.6,,,0
CDM,30100311,CHORIONIC GONADOTROPIN QUANT,209.0,146.3,,,0
CDM,30100312,HC CHORIONIC GONADOTROPIN QUANL,111.0,77.7,,,0
CDM,30100314,HC SUGARS SINGLE QUANTITATIVE EA SPECIMEN,53.0,37.1,,,0
CDM,30100319,HC POC BLOOD GASES W/ O2 SATURATION,212.0,148.4,,,0
CDM,30100320,HC POC OCCULT BLOOD FECES,41.0,28.7,,,0
CDM,30100321,HC POC ASSAY PH BODY FLUID NOS,55.0,38.5,,,0
CDM,30100323,HC POC OCCULT BLOOD OTHER SOURCES,15.0,10.5,,,0
CDM,30100324,HC POC ASSAY OF BREATH ETHANOL,52.0,36.4,,,0
CDM,30100325,HC POC BLOOD GASES ANY COMBINATION,212.0,148.4,,,0
CDM,30100326,HC POC GLUC BLD TEST MONITORING DEVICE,45.0,31.5,,,0
CDM,30100328,HC UNLISTED CHEMISTRY PROCEDURE,3653.0,2557.1,,,0
CDM,30100330,HC 5 NUCLEOTIDASE,186.0,130.2,,,0
CDM,30100331,HC BIOTINIDASE,78.0,54.6,,,0
CDM,30100332,HC ANGIOTENSIN II,87.0,60.9,,,0
CDM,30100333,HC PROCALCITONIN (PCT),114.0,79.8,,,0
CDM,30100334,HC RBC CHOLINESTERASE,174.0,121.8,,,0
CDM,30100336,HC DRUG SCRN QUAN MYCOPHENOLATE,63.0,44.1,,,0
CDM,30100340,HC ANTIDEPRESSANTS TRICYCLIC AND OTHER CYCLICALS 3-5,122.0,85.4,,,0
CDM,30100341,HC ANTIDEPRESSANTS TRICYCLIC AND OTHER CYCLICALS 1-7 CLASSES,141.0,98.7,,,0
CDM,30100342,HC BENZODIAZAPINES 1-12,206.0,144.2,,,0
CDM,30100343,HC BENZODIAZAPINES 13 OR MORE,316.0,221.2,,,0
CDM,30100359,HC ANALGESICS NON-OPIOID (ACETAMINOPHEN) 1 OR 2,222.0,155.4,,,0
CDM,30100362,HC ALCOHOLS,141.0,98.7,,,0
CDM,30100363,HC ALCOHOLS BIOMARKERS 1OR 2,313.0,219.1,,,0
CDM,30100364,HC ALCOHOLS 3 OR MORE,128.0,89.6,,,0
CDM,30100365,HC AMPHETAMINES 1 OR 2,206.0,144.2,,,0
CDM,30100366,HC AMPHETAMINES 3 OR 4,206.0,144.2,,,0
CDM,30100367,HC AMPHETAMINES 5 OR MORE,206.0,144.2,,,0
CDM,30100368,HC COCAINE,206.0,144.2,,,0
CDM,30100371,HC SKELETAL MUSCLE RELAXANTS 1 OR 2,206.0,144.2,,,0
CDM,30100373,HC METHADONE,206.0,144.2,,,0
CDM,30100374,HC ALKALOIDS NOT OTHERWISE SPECIFIED,206.0,144.2,,,0
CDM,30100375,HC OPIATES 1 OR MORE,206.0,144.2,,,0
CDM,30100376,HC OPIOIDS AND OPIATE ANALOGS 1 OR 2,206.0,144.2,,,0
CDM,30100378,HC OPIOIDS AND OPIATE ANALOGS 5 OR MORE,302.0,211.4,,,0
CDM,30100379,HC ANTIPSYCHOTICS NOT OTHERWISE SPECIFIED 1-3,206.0,144.2,,,0
CDM,30100382,HC ASSAY CARBAMAZEPINE FREE,57.0,39.9,,,0
CDM,30100384,HC ASSAY OF BARBITURATES,206.0,144.2,,,0
CDM,30100385,HC DRUG SCREENING FENTANYL,206.0,144.2,,,0
CDM,30100386,HC DRUG SCREENING BUPRENORPHINE,206.0,144.2,,,0
CDM,30100387,HC DRUG SCREEN QUANT ZONISAMIDE,47.0,32.9,,,0
CDM,30100388,HC 1ST TRIMESTER SEQ SC,218.0,152.6,,,0
CDM,30100389,HC 2ND TRIMESTER SEQ SC,617.0,431.9,,,0
CDM,30100391,HC OCCULT BLOOD FECES 1-3 TESTS PERFORMED FOR OTHER THAN COLORECTRAL NEOPLASM SCREENING,14.0,9.8,,,0
CDM,30100394,HC ASSAY OF CREATINE,20.0,14.0,,,0
CDM,30100398,HC DRUG TEST(S) DEFINITIVE QUAL/QUANT ALL SOURCE(S) 1-7 CLASS(ES),302.0,211.4,,,0
CDM,30100399,HC CLOZAPINE,65.0,45.5,,,0
CDM,30100400,HC EVEROLIMUS,48.0,33.6,,,0
CDM,30100401,HC GABAPENTIN WHOLE BLOOD/SERUM/PLASMA,47.0,32.9,,,0
CDM,30100402,HC LAMOTRIGINE,47.0,32.9,,,0
CDM,30100403,HC OXCARBAZEPINE,47.0,32.9,,,0
CDM,30100410,HC ANTIDEPRESSANTS SEROTONERGIC CLASS 1 OR 2,206.0,144.2,,,0
CDM,30100411,HC ANTIDEPRESSANTS NOT OTHERWISE SPECIFIED,206.0,144.2,,,0
CDM,30100412,HC CANNABINOIDS NATURAL,206.0,144.2,,,0
CDM,30100414,HC OXYCODONE,206.0,144.2,,,0
CDM,30100415,HC PROPOXYPHENE,206.0,144.2,,,0
CDM,30100416,HC SEDATIVE HYPNOTICS (NON-BENZODIAZEPINES),206.0,144.2,,,0
CDM,30100417,HC STIMULANTS SYNTHETIC,206.0,144.2,,,0
CDM,30100418,HC TRAMADOL,206.0,144.2,,,0
CDM,30100419,HC DRUG(S)/SUBSTANCE(S) DEFINITIVE QUALITATIVE/QUANTITATIVE NOT OTHERWISE SPECIFIED 1-3,206.0,144.2,,,0
CDM,30100420,HC DRUG(S)/SUBSTANCE(S) DEFINITIVE QUALITATIVE/QUANTITATIVE NOT OTHERWISE SPECIFIED 7 OR MORE,206.0,144.2,,,0
CDM,30100422,HC ANTIDEPRESSANTS TRICYCLIC & OTHER CYCLICALS 1 OR 2,206.0,144.2,,,0
CDM,30100423,HC VALPROIC ACID (DIPROPYLACETIC ACID) TOTAL,58.0,40.6,,,0
CDM,30100424,HC VALPROIC ACID (DIPROPYLACETIC ACID) FREE,58.0,40.6,,,0
CDM,30100425,HC HEROIN METABOLITE,206.0,144.2,,,0
CDM,30100426,HC ANTIDEPRESSANT TRICYCLIC AND OTHER CYCLICALS 3-5,29.0,20.3,,,0
CDM,30100429,HC FIBRINOLYSINS OR COAGULOPATHY SCREEN INTERP AND REPORT,68.0,47.6,,,0
CDM,30100431,HC ELECTROPHORETIC TECHNIQUE NOT ELSEWHERE SPECIFIED,260.0,182.0,,,0
CDM,30100433,HC METHYLENEDIOXYAMPHETAMINES,206.0,144.2,,,0
CDM,30100434,HC DIBUCAINE NUMBER,53.0,37.1,,,0
CDM,30100435,HC DRUG TEST PRESUMP DIRECT OPTICAL OBS PER DATE OF SERVICE,168.0,117.6,,,0
CDM,30100436,HC DRUG TEST PRESUMP INSTRUMENT ASSISTED DIRECT OPTICAL OBS PER DATE OF SERVICE,177.0,123.9,,,0
CDM,30100437,HC DRUG TEST PRESUMP INSTRUMENT CHEMISTRY ANALYZER CHROMATOGRAPHY/MASS SPECTROMETRY  W/WO CHROMATOGRAPHY PER DATE OF SERVICE,168.0,117.6,,,0
CDM,30100439,HC POTASSIUM SERUM PLASMA/WHOLE BLOOD,82.0,57.4,,,0
CDM,30100440,HC ASSAY OF SERUM SODIUM,82.0,57.4,,,0
CDM,30100441,HC CRYSTAL ID FROM TISSUE OR BODY FLUID,30.0,21.0,,,0
CDM,30100442,HC DRUG SCREEN METHYLPHENIDATE,222.0,155.4,,,0
CDM,30100443,HC ASSAY OF CALCIUM IONIZED,230.0,161.0,,,0
CDM,30100444,HC LUTEINIZING RELEASING FACTOR (LRH),74.0,51.8,,,0
CDM,30100445,HC POC DRUG TEST PRESUMP DIRECT OPTICAL OBS PER DATE OF SERVICE,51.0,35.7,,,0
CDM,30100447,HC ASSAY OF CADMIUM,36.0,25.2,,,0
CDM,30100448,HC POC CREATININE ISTAT,85.0,59.5,,,0
CDM,30100450,HC POC B-HCG ISTAT,209.0,146.3,,,0
CDM,30100451,HC POC BNP,162.0,113.4,,,0
CDM,30100452,HC POC TROPONIN,223.0,156.1,,,0
CDM,30100453,HC POC LIVER PNL ISTAT,142.0,99.4,,,0
CDM,30100454,HC POC URINE PREGNANCY (HCG),111.0,77.7,,,0
CDM,30100455,HC POC ASSAY OF BLOOD CHLORIDE,94.0,65.8,,,0
CDM,30100456,HC POC ASSAY GLUCOSE BLOOD QUANT,89.0,62.3,,,0
CDM,30100457,HC POC ASSAY OF LACTIC ACID,188.0,131.6,,,0
CDM,30100459,HC POC ASSAY CARBOXYHB QUANT,164.0,114.8,,,0
CDM,30100460,HC POC DRUG TEST PRESUMP INSTRUMENT CHEM ANALYZER CHROMATOGRAPHY/MASS SPECTROMETRY  W/WO CHROMATOGRAPHY PER DOS,168.0,117.6,,,0
CDM,30100461,HC POC ASSAY OF UREA NITROGEN,89.0,62.3,,,0
CDM,30100463,HC ASSAY OF NICKEL,130.0,91.0,,,0
CDM,30100465,HC ALCOHOL SPECIMEN EXCEPT URINE & BREATH IA,37.0,25.9,,,0
CDM,30100466,HC DRUG ASSAY AMIODARONE,33.0,23.1,,,0
CDM,30100467,HC DRUG ASSAY FELBAMATE,33.0,23.1,,,0
CDM,30100468,HC DRUG ASSAY FLECAINIDE,33.0,23.1,,,0
CDM,30100469,HC DRUG ASSAY LEFLUNOMIDE,67.0,46.9,,,0
CDM,30100470,HC DRUG ASSAY ITRACONAZOLE,48.0,33.6,,,0
CDM,30100471,HC DRUG ASSAY CARBAMAZEPINE--10 11-EPOXIDE,33.0,23.1,,,0
CDM,30100476,HC POC KETONE BODY QUANTITATIVE,54.0,37.8,,,0
CDM,30100477,HC DRUG SCREENING PREGABALIN,206.0,144.2,,,0
CDM,30100478,HC DRUG TEST(S) DEFINITIVE QUAL/QUANT ALL SOURCES 8-14 CLASSES,486.0,340.2,,,0
CDM,30100479,HC DRUG TEST(S) DEFINITIVE QUAL/QUANT ALL SOURCES 15-21 CLASSES,610.0,427.0,,,0
CDM,30100480,HC DRUG TEST(S) DEFINITIVE QUAL/QUANT ALL SOURCES 22+ CLASSES,758.0,530.6,,,0
CDM,30100483,HC DRUG SCREENING GABAPENTIN NON BLOOD,302.0,211.4,,,0
CDM,30100484,HC POC BILIRUBIN TOTAL,124.0,86.8,,,0
CDM,30100485,HC ASSAY THIOPURINE S-METHYLTRANSFERASE,42.0,29.4,,,0
CDM,30100486,HC ANTI-MULLERIAN HORMONE,156.0,109.2,,,0
CDM,30100487,HC POC ASSAY BLOOD CARBON DIOXIDE,25.0,17.5,,,0
CDM,30100488,HC BETA-AMYLOID 1-42,177.0,123.9,,,0
CDM,30100489,HC TAU PHOSPHORYLATED EACH,177.0,123.9,,,0
CDM,30100490,HC TOTAL TAU,177.0,123.9,,,0
CDM,30100491,HC POC ASSAY OF MAGNESIUM,50.0,35.0,,,0
CDM,30100492,HC POC ASSAY OF LIPASE,116.0,81.2,,,0
CDM,30200001,HC TB TEST CELL IMMUN MEASURE,324.0,226.8,,,0
CDM,30200004,HC WEST NILE VIRUS AB IGM,102.0,71.4,,,0
CDM,30200006,HC HUMAN EPIDIDYMIS PROTEIN 4,98.0,68.6,,,0
CDM,30200010,HC ANTIBODY HEPATITIS DELTA AGENT,87.0,60.9,,,0
CDM,30200011,HC HIV-1 ANTIGEN(S) WITH HIV-1 AND HIV-2 ANTIBODIES SINGLE RESULT BY IMMUNOASSAY TECHNIQUE QUAL/SEMIQUAL MULTIPLE-STEP METHOD,103.0,72.1,,,0
CDM,30200012,HC INFECTIOUS AGENT DETECTION BY NUCLEIC ACID GASTROINTESTINAL PATHOGEN MULTIPLE TYPES/SUBTYPES 3-5 TARGETS,545.0,381.5,,,0
CDM,30200014,HC INFECTIOUS AGENT DETECT NUCLEIC ACID GI PTHGN INCL MULTIPLEX REVERSE TRANSCRIPT WHEN PERFORM/MULTIPLEX AMPLIFIED PROBE TECH MULTI TYPES/SUBTYPES 6-11 TARGETS,2541.0,1778.7,,,0
CDM,30200018,HC ACETYLCHOLINE RECEPTOR BINDING ANTIBODY,78.0,54.6,,,0
CDM,30200019,HC ACETYLCHOLINE RECEPTOR MODULATING ANTIBODY,51.0,35.7,,,0
CDM,30200020,HC MUSCLE-SPECIFIC KINASE ANTIBODY,78.0,54.6,,,0
CDM,30200021,HC ACETYLCHOLINE RECEPTOR BLOCKING ANTIBODY,78.0,54.6,,,0
CDM,30500001,HC RETICULATED PLATELET ASSAY,114.0,79.8,,,0
CDM,30600001,HC CULT BACT ANAEROBIC NOT BLOOD,348.0,243.6,,,0
CDM,30600003,HC ASPERGILLUS AG EIA,20.0,14.0,,,0
CDM,30600004,HC ENTAMOEB HIST GROUP AG EIA,48.0,33.6,,,0
CDM,30600005,HC CANDIDA DNA DIR PROBE,92.0,64.4,,,0
CDM,30600006,HC ENTEROVIRUS DNA AMP PROBE,167.0,116.9,,,0
CDM,30600009,HC GARDNER VAG DNA DIR PROBE,92.0,64.4,,,0
CDM,30600010,HHV-6 QUANTIFICATION,186.0,130.2,,,0
CDM,30600011,HC MRSA DNA AMP PROBE,167.0,116.9,,,0
CDM,30600012,STREP A DNA DIR PROBE,92.0,64.4,,,0
CDM,30600013,HC STREP B DNA AMP PROBE,154.0,107.8,,,0
CDM,30600014,HC TRICHOMONAS VAGIN DIR PROBE,92.0,64.4,,,0
CDM,30600015,HC ACID-FAST BACILLUS (AFB) ID,489.0,342.3,,,0
CDM,30600016,HC RESP VIRUS 3-5 TARGETS,566.0,396.2,,,0
CDM,30600018,HC CULTURE TYPING ID BY NUCLEIC ACID (DNA/RNA) PROBE PER CULTURE OR ISOLATE,150.0,105.0,,,0
CDM,30600020,HC INFECT AGENT DET BY NUCLEIC ACID MYCOBACT AMPL PROBE TECHNIQ,186.0,130.2,,,0
CDM,30600021,HC RESP VIRUS PANEL PCR,1830.0,1281.0,,,0
CDM,30600022,HC POC FLU A/B COMBO,194.0,135.8,,,0
CDM,30600023,HC POC FLU A/B RSV,566.0,396.2,,,0
CDM,30600024,HC INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA/RNA) CYTOMEGALOVIRUS AMPLIFIED PROBE,75.0,52.5,,,0
CDM,30600025,HC INFECTIOUS AGENT (DNA OR RNA) CANDIDA SPECIES AMPLIFIED PROBE TECHNIQUE,154.0,107.8,,,0
CDM,30600026,HC INFECT AGENT DETECT NUCLEIC ACID (DNA OR RNA) CHLAMYDIA PNEUMONIAE AMPLIFIED PROBE,154.0,107.8,,,0
CDM,30600027,HC UNLISTED MICROBIOLOGY PROCEDURE,154.0,107.8,,,0
CDM,30600029,HC CNS DNA/RNA AMP PROBE MULTIPLE SUBTYPES 12-25,2065.0,1445.5,,,0
CDM,30600030,HC IADNA STREPTOCOCCUS GROUP A AMPLIFIED PROBE TECH,186.0,130.2,,,0
CDM,30600031,HC IADNA ANAPLASMA PHAGOCYTOPHILUM AMPLIFIED PROBE TECHNIQUE,66.0,46.2,,,0
CDM,30600032,HC IADNA EHRLICHIA CHAFFEENSIS AMPLIFIED PROBE TECHNIQUE,66.0,46.2,,,0
CDM,30600033,HC IADNA HPV SEP HIGH-RISK TYPES  & HIGH-RISK POOLED RESULT(S),305.0,213.5,,,0
CDM,30653,PERTUZUMAB 420 MG/14 ML (30 MG/ML) IV SOLN,9375.0,6562.5,,,0
CDM,30700001,HC URINALYSIS NONAUTO W/O SCOPE,58.0,40.6,,,0
CDM,30700002,HC POC URINALYSIS NON-AUTO W/O SCOPE,58.0,40.6,,,0
CDM,30700003,HC URINALYSIS VOLUME MEASURE TIMED COLLECTION EACH,13.0,9.1,,,0
CDM,31000001,HC CYTOPATH FL NONGYN SMEARS,86.0,60.2,,,0
CDM,31000002,HC CYTOPATH CONCENTRATE TECH,103.0,72.1,,,0
CDM,31000003,HC TISSUE CULTURE LYMPHOCYTE,740.0,518.0,,,0
CDM,31000004,HC TISS CULT SKIN SOLID TISSUE BX,277.0,193.9,,,0
CDM,31000006,HC TISSUE CULTURE BONE MARROW,1037.0,725.9,,,0
CDM,31000007,HC TISSUE CULTURE SOLID TUMOR,709.0,496.3,,,0
CDM,31000008,HC CHROMO ANALYSIS BREAK 100 CELLS,1666.0,1166.2,,,0
CDM,31000010,HC CHROM ANALY SHORT 15-20 2K B,588.0,411.6,,,0
CDM,31000011,HC CHROM ANALYZE 20-25 CELLS,1037.0,725.9,,,0
CDM,31000013,HC CHROMOSOME STUDY ADDITIONAL,487.0,340.9,,,0
CDM,31000014,HC SURGICAL PATH GROSS,33.0,23.1,,,0
CDM,31000015,HC SURG PATH GROSS AND MICROSCOP II,69.0,48.3,,,0
CDM,31000016,HC SURG PATH GROSS AND MICROSC LII,79.0,55.3,,,0
CDM,31000017,SURG PATH GROSS AND MICROSC IV,375.0,262.5,,,0
CDM,31000018,HC SURG PATH GROSS AND MICROSC V,338.0,236.6,,,0
CDM,31000019,HC SURG PATH GROSS AND MICROSC VI,375.0,262.5,,,0
CDM,31000020,HC DECALCIFY TISSUE,39.0,27.3,,,0
CDM,31000021,HC SPECIAL STAINS GROUP 1,91.0,63.7,,,0
CDM,31000022,HC HISTOCH STAINS FZN TISS ADD-ON,199.0,139.3,,,0
CDM,31000025,HC PATH CONSULT INTRAOP 1 BLOC,235.0,164.5,,,0
CDM,31000026,HC PATH CONSULT INTRAOP ADDL,46.0,32.2,,,0
CDM,31000027,INTRAOP CYTO PATH CONSULT 1ST,375.0,262.5,,,0
CDM,31000028,HC IMMUNOFLUORESCENCE PER SPECIMEN INITIAL SINGLE ANTIBODY STAIN PROCEDURE,235.0,164.5,,,0
CDM,31000029,ELECTRON MICROSCOPY,1264.0,884.8,,,0
CDM,31000030,MICRODISSECTION LASER,203.0,142.1,,,0
CDM,31000032,HC BCR/ABL1 GENE MAJOR BP,971.0,679.7,,,0
CDM,31000033,HC BCR ABL1 GENE MINOR BP,796.0,557.2,,,0
CDM,31000034,HC BRAF GENE ANALYSIS V600 VARIANT(S),391.0,273.7,,,0
CDM,31000035,HC CFTR GENE COM VARIANTS,1703.0,1192.1,,,0
CDM,31000036,HC CFTR GENE KNOWN FAM VARIANTS,1703.0,1192.1,,,0
CDM,31000037,HC CFTR GENE DUP/DELET VARIANTS,1703.0,1192.1,,,0
CDM,31000038,HC EGFR GENE COM VARIANTS,1356.0,949.2,,,0
CDM,31000039,HC F2 GENE,883.0,618.1,,,0
CDM,31000040,HC F5 GENE,883.0,618.1,,,0
CDM,31000041,HC HFE GENE,1273.0,891.1,,,0
CDM,31000042,HC IGH GENE REARRANGE AMP METH,533.0,373.1,,,0
CDM,31000043,HC STR MARKERS SPECIMEN ANAL,1439.0,1007.3,,,0
CDM,31000044,HC ENGRAFTMENT POST TRANSPLANT,3809.0,2666.3,,,0
CDM,31000045,HC JAK2 GENE,371.0,259.7,,,0
CDM,31000046,HC KRAS GENE ANALYSIS VARIANTS IN EXON 2,573.0,401.1,,,0
CDM,31000047,HC MICROSATELLITE INSTABILITY,2179.0,1525.3,,,0
CDM,31000048,HC PML/RARALPHA COM BREAKPOINTS,1279.0,895.3,,,0
CDM,31000049,HC TRG GENE REARRANGEMENT ANAL,701.0,490.7,,,0
CDM,31000050,HC LOW RES HLA TYPE,2024.0,1416.8,,,0
CDM,31000052,HC A B C LOCI LOW RES,3430.0,2401.0,,,0
CDM,31000053,HC A B C OR HLA LOW RES LOCUS,4663.0,3264.1,,,0
CDM,31000054,HC HLA B5701 OR B27 TEST,960.0,672.0,,,0
CDM,31000055,HC DQ OR DR LOCUS LOW RES,1243.0,870.1,,,0
CDM,31000056,HC HLA I & II TYPING HR,4267.0,2986.9,,,0
CDM,31000058,HC HLA II TYPING 1 LOC HR,4399.0,3079.3,,,0
CDM,31000059,HC MOPATH PROCEDURE LEVEL 3,391.0,273.7,,,0
CDM,31000060,HC MOPATH PROCEDURE LEVEL 4,662.0,463.4,,,0
CDM,31000061,HC MOPATH PROCEDURE LEVEL 5,1338.0,936.6,,,0
CDM,31000063,HC HLA AB SCR L PST TXP,107.0,74.9,,,0
CDM,31000064,HC PRA SA CI ABS PTX-L,616.0,431.2,,,0
CDM,31000065,HC PRA SA CII ABS PTX-L,561.0,392.7,,,0
CDM,31000067,HC IGH VARI REGIONAL MUTATION,533.0,373.1,,,0
CDM,31000071,HC MOPATH PROCEDURE LEVEL 7,2185.0,1529.5,,,0
CDM,31000072,HC MOPATH PROCEDURE LEVEL 8,2588.0,1811.6,,,0
CDM,31000073,HC MOPATH PROCEDURE LEVEL 2,1361.0,952.7,,,0
CDM,31000074,HC MOPATH PROCEDURE LEVEL 6,4238.0,2966.6,,,0
CDM,31000078,HC IMMHISTO/CYTO PER SPEC EA MULTI ANTIBODY,338.0,236.6,,,0
CDM,31000079,HC IMMHISTO/CYTO PER SPEC EA ADDL SINGLE ANTIBODY,122.0,85.4,,,0
CDM,31000080,HC MORPHOMETRIC ANALYSIS IN SITU HYBRIDIZATION MANUAL PER SPECIMEN EACH ADDITIONAL SINGLE PROBE STAIN,222.0,155.4,,,0
CDM,31000082,HC CYTOGEN CONSTITUT CHROMOSMAL ABNORM GENOMIC REGIONS COPY NUMBER VARIANTS CGH,1092.0,764.4,,,0
CDM,31000083,HC SOLID ORGAN NEOPLASM GENOMIC SEQ ANALYSIS PANEL 5-50 GENES DNA ANALYSIS/COMBINED DNA & RNA ANALYSIS,1960.0,1372.0,,,0
CDM,31000084,HC HEMATOLYMPHOID NEOPLASM/DISORDER GENOMIC SEQ ANALYSIS PANEL 5-50 GENES DNA ANALYSIS/COMBINED DNA & RNA ANALYSIS,2140.0,1498.0,,,0
CDM,31000085,HC MORPHOMETRIC ANALYSIS IN SITU HYBRIDIZATION MANUAL PER SPECIMEN,235.0,164.5,,,0
CDM,31000086,HC UNLISTED MOLECULAR PATHOLOGY PROCEDURE,804.0,562.8,,,0
CDM,31000091,HC SPECIAL STAIN GROUP II INCL INTERP AND REPORT,69.0,48.3,,,0
CDM,31000092,HC SPECIAL STAIN GROUP III INCL INTERP AND REPORT,375.0,262.5,,,0
CDM,31000093,HC PATHOLOGY CONSULT DURING SURGERY CYTOLOGIC EXAM EA ADDTL SITE,235.0,164.5,,,0
CDM,31000097,HC SURG PATH GROSS/MIICROSCOPIC EXAM PROSTATE NEEDLE BIOPSY ANY METHOD,375.0,262.5,,,0
CDM,31000098,HC MGMT METHYLATION ANALYSIS,274.0,191.8,,,0
CDM,31000099,HC MLH1 GENE ANALYSIS PROMOTER METHYLATION ANALYSIS,9733.0,6813.1,,,0
CDM,31000101,HC IMMUNOFLUORESCENCE PER SPECIMEN EA ADDTL SINGLE ANTIBODY STAIN PROCEDURE,143.0,100.1,,,0
CDM,31000102,HC BRCA1 BRCA2 GENE ANALYSIS FULL SEQ ANALYSIS & FULL DUPLICATION/DELETION ANALYSIS,72001.0,50400.7,,,0
CDM,31000103,HC ABL1 GENE ANALYSIS VARIANTS IN KINASE DOMAIN,1205.0,843.5,,,0
CDM,31000105,HC CALR GENE ANALYSIS COMMON VARIANTS IN EXON 9,544.0,380.8,,,0
CDM,31000106,HC KIT GENE ANALYSIS TARGETED SEQ ANALYSIS,1080.0,756.0,,,0
CDM,31000107,HC KIT GENE ANALYSIS D816 VARIANT,409.0,286.3,,,0
CDM,31000108,HC KRAS GENE ANALYSIS VARIANT(S) ADDITIONAL VARIANT(S),647.0,452.9,,,0
CDM,31000109,HC NRAS GENE ANALYSIS VARIANTS IN EXON 2 AND EXON 3,970.0,679.0,,,0
CDM,31000110,HC PDGFRA GENE ANALYSIS TARGETED SEQ ANALYSIS,1088.0,761.6,,,0
CDM,31000112,HC HEREDITARY BRST CANCER-RELATED GEN SEQ ANALYSIS PANEL 5 OR MORE GENES INTERROGATION FOR SEQUENCE VARIANTS & COPY NUMBER VARIANTS,1529.0,1070.3,,,0
CDM,31000117,HC NOONAN SPECTRUM DISORDERS GENOMIC SEQ ANALYSIS PANEL INCL SEQ 12 GENES BRAF/CBL/HRAS/KRAS/MAP2K1/MAP2K2/NRAS/PTPN11/RAF1/RIT1/SHOC2/SOS1,8603.0,6022.1,,,0
CDM,31000125,HC ONCOLOGY (TUMOR UNKNOWN ORIGIN) MRNA GENE EXPRESS PROFIL REAL-TIME RT-PCR 92 GENES CLASSIFY MAIN CANCER TYPE/SUBTYPE USE FORMALIN-FIXED PARRIFIN-EMBEDDED TISSUE,14297.0,10007.9,,,0
CDM,31000127,HC ONCOLOGY (BREAST) MRNA GENE EXPRESS PROFILING REAL-TIME RT-PCR OF 21 GENES FORMALIN-FIXED PARRAFIN EMBEDDED TISSUE,10648.0,7453.6,,,0
CDM,31000128,HC CYP2D6 GENE ANALYSIS COMMON VARIANTS,1478.0,1034.6,,,0
CDM,31000130,HC HLA CLASS I TYPING HIGH RESOLUTION B5701,423.0,296.1,,,0
CDM,31000132,HC SOLID ORGAN/HEMATOLYMPHOID NEOPLASM/DISORDER 51 OR GREATER GENES GENOMIC SEQ ANALYSIS PANEL DNA ANALYSIS/COMBINED DNA & RNA ANALYSIS,2140.0,1498.0,,,0
CDM,31000133,HC IDH1 COMMON VARIANTS,264.0,184.8,,,0
CDM,31000134,HC IDH2 COMMON VARIANTS,405.0,283.5,,,0
CDM,31000135,HC TPMT GENE ANALYSIS COMMON VARIANTS,574.0,401.8,,,0
CDM,31000140,HC MOLECULAR PATHOLOGY PROCEDURE LEVEL 1,257.0,179.9,,,0
CDM,31000142,HC HEARING LOSS DUPLICATION/DELETION ANALYSIS PANE,1114.0,779.8,,,0
CDM,31000148,HC HTT GENE ANALYSIS EVAL TO DETECT ABNORMAL ALLELES,309.0,216.3,,,0
CDM,31000149,HC SMN1 GENE ANALYSIS DOSAGE/DELETION ANALYSIS INCL SMN2 ANALYSIS IF PERFORMED,150.0,105.0,,,0
CDM,31000150,HC PABPN1 GENE ANALYSIS EVAL TO DETECT ABNORMAL ALLELES,300.0,210.0,,,0
CDM,31000152,HC MLH1 GENE ANALYSIS FULL SEQUENCE ANALYSIS,2854.0,1997.8,,,0
CDM,31000153,HC MLH1 GENE ANALYSIS DUPLICATION/DELETION VARIANTS,1706.0,1194.2,,,0
CDM,31000155,HC CACNA1A GENE ANALYSIS FULL GENE SEQUENCE,925.0,647.5,,,0
CDM,31000156,HC GENETIC TESTING FOR SEVERE INHERITED CONDITIONS GENOMIC SEQUENCE ANALYSIS PANEL MUST INCLUDE SEQUENCING OF AT LEAST 15 GENES,2675.0,1872.5,,,0
CDM,31000158,HC INFECT DISEASE GRAM-NEG BACT ID AND DRUG RESIST DNA AMPLIFIED PROBE TECH EA TARGET,154.0,107.8,,,0
CDM,31000159,HC INFECT DISEASE GRAM-POSITIVE ORG ID AND DRUG RESIST DNA BLOOD CULTURE AMPLIFIED PROBE EA TARGET,154.0,107.8,,,0
CDM,31000160,HC INFECT DISEASE FUNGAL PATH ID DNA BLOOD CULTURE AMPLIFIED PROBE EA TARGET,88.0,61.6,,,0
CDM,31000161,HC MYD88 GENE ANALYSIS P.LEU265PRO VARIANT,385.0,269.5,,,0
CDM,31000162,HC EPILEPSY GEN SEQ ANALYSIS PANEL,5352.0,3746.4,,,0
CDM,31000163,HC SURG PATH GROSS/MICROSCOPIC EXAM PROSTATE NEEDLE BIOPSY ANY METHOD,1002.0,701.4,,,0
CDM,31000164,HC PATH CLINICAL CONSULT LIMITED 5-20 MINUTES,194.0,135.8,,,0
CDM,31000165,HC PATH CLINICAL CONSULT MODERATELY COMPLEX 21-40 MINUTES,580.0,406.0,,,0
CDM,31000166,HC PATH CLINICAL CONSULT HIGHLY COMPLEX 41-60 MINUTES,580.0,406.0,,,0
CDM,31000167,HC PATH CLINICAL CONSULT PROLONGED SERVICE EA ADDTL 30 MINUTES,291.0,203.7,,,0
CDM,31000168,HC PATHOLOGY CLIN CONSULATION SF MEDICAL DECSION MAKING 5-20 MIN,194.0,135.8,,,0
CDM,31000169,HC DPYD GENE ANALYSIS COMMON VARIANTS,394.0,275.8,,,0
CDM,31000170,HC MORPHOMETRIC ALYS ISH QUANT/SEM-QUANT COMPUTER ASSISTED TECH EA MULTI PROBE STAIN PROCEDURE,664.0,464.8,,,0
CDM,31000171,HC CONSULT COMPREHENSIVE W/ REVIEW OF RECORDS/SPECIMENS W/ REPRT ON REFER MATERIAL,299.0,209.3,,,0
CDM,31000172,HC AORTIC DYSFUNCTION/DILATION GENOMIC SEQ ANALYSIS PANEL INCL SEQ 9 GENES FBN1/TGFBR1/TGFBR2/COL3A1/MYH11/ACTA2/SLC2A10/SMAD3/MYLK,2024.0,1416.8,,,0
CDM,31000174,HC PALB2 GENE ANALYSIS FULL GENE SEQUENCE,2715.0,1900.5,,,0
CDM,31000175,HC PTEN GENE ANALYSIS FULL SEQUENCE ANALYSIS,2408.0,1685.6,,,0
CDM,31000176,HC PTEN GENE ANALYSIS DUPLICATION/DELETION VARIANT,1205.0,843.5,,,0
CDM,31000177,HC PMP22 GENE ANALYSIS FULL SEQUENCE ANALYSIS,3088.0,2161.6,,,0
CDM,31000178,HC HBA1/HBA2 GENE ANALYSIS FULL GENE SEQUENCE,2408.0,1685.6,,,0
CDM,31000179,HC TP53 GENE ANALYSIS TARGETED SEQUENCE ANALYSIS,1322.0,925.4,,,0
CDM,31000180,HC ONCOLOGY BREAST MRNA GENE EXPRESSION PROFILING REAL-TIME RT-PCR OF 11 GENE FORMALIN-FIXED PARAFFIN-EMBEDDED TISSUE,15543.0,10880.1,,,0
CDM,31000181,HC ATXN1 GENE ANALYSIS EVAL TO DETECT ABNORMAL ALLELES,579.0,405.3,,,0
CDM,31000182,HC ATXN2 GENE ANALYSIS EVAL TO DETECT ABNORMAL ALLELES,579.0,405.3,,,0
CDM,31000183,HC CACNA1A GENE ANALYSIS EVAL TO DETECT ABNORMAL ALLELES,579.0,405.3,,,0
CDM,31000184,HC ATXN7 GENE ANALYSIS EVAL TO DETECT ABNORMAL ALLELES,579.0,405.3,,,0
CDM,31000185,HC CHIMERSIM ANALYSIS POST TRANSPLANTATION SPECIMEN COMP TO BASELINE W/CELL SELECTION EACH CELL TYPE,1102.0,771.4,,,0
CDM,31000186,HC MSH2 GENE ANALYSIS FULL SEQUENCE ANALYSIS,2729.0,1910.3,,,0
CDM,31000187,HC MSH2 GENE ANALYSIS DUPLICATION/DELETION VARIANTS,1882.0,1317.4,,,0
CDM,31000188,HC MSH6 GENE ANALYSIS FULL SEQUENCE ANALYSIS,3366.0,2356.2,,,0
CDM,31000189,HC MSH6 GENE ANALYSIS DUPLICATION/DELETION VARIANTS,1751.0,1225.7,,,0
CDM,31000190,HC DMD DELETION ANALYSIS AND DUPLICATION ANALYSIS,1179.0,825.3,,,0
CDM,31000191,HC ATXN3 GENE ANALYSIS EVAL DETECT ABNORMAL ALLELES,579.0,405.3,,,0
CDM,31000192,HC HBB FULL GENE SEQUENCE,1408.0,985.6,,,0
CDM,31000193,HC G6PD GENE ANALYSIS FULL GENE SEQUENCE,2603.0,1822.1,,,0
CDM,31000195,HC AORTIC DYSFUNCTION OR DILATION DUPLICATION/DELETION ANALYSIS PANEL MUST INCLUDE ANALYSES FOR TGFBR1/TGFBR2/MYH11/COL3A1,5857.0,4099.9,,,0
CDM,31000196,HC LIVER DISEASE ANALYSIS OF 3 BIOMARKERS IA SRM PROGNOSTIC ALG RPT RISK SCORE/RISK LIVER FIBROSIS/LIVER RELATED CLIN EVENT W/I 5 YRS,765.0,535.5,,,0
CDM,31100002,CYTOPATH CELL ENHANCE TECH,132.0,92.4,,,0
CDM,31100003,CYTPTH CERV/VAG FLUID THIN AUTO,86.0,60.2,,,0
CDM,31100004,CYTOPATH SMEAR OTHER SOURCE,82.0,57.4,,,0
CDM,31100006,CYTP DX EVAL FNA 1ST EA SITE,84.0,58.8,,,0
CDM,31100007,CYTOPATH EVAL FNA REPORT,136.0,95.2,,,0
CDM,31100008,HC CYTOPATH CERV/VAG RESCREEN AUTO THIN LAYER PREP,144.0,100.8,,,0
CDM,31100009,HC FLOW CYTOMETRY CELL CYCLE OR DNA ANALYSIS,479.0,335.3,,,0
CDM,31100010,FLOWCYTOMETRY/ TC 1 MARKER,470.0,329.0,,,0
CDM,31100011,HC FLOWCYTOMETRY/TC ADD-ON,313.0,219.1,,,0
CDM,31100016,CYTOGENETICS DNA PROBE,207.0,144.9,,,0
CDM,31100021,HC CYTOGENETICS 10-30,207.0,144.9,,,0
CDM,31100022,HC CYTOGENETICS 25-99,184.0,128.8,,,0
CDM,31100026,HC CYTOPATH EVAL OF FNA EA ADDTL EVAL EPISODE,154.0,107.8,,,0
CDM,31100027,HC SCRN CYTO CERVICAL/ VAGINAL THIN LAYER W/SCRN AUTO SYSTEM & MANUAL RESCRN,110.0,77.0,,,0
CDM,31200001,CYTP URNE 3-5 PROBES EA SPEC,317.0,221.9,,,0
CDM,31200002,HC IMMUNOHISTOCHEMISTRY INITIAL SINGLE ANTIBODY,235.0,164.5,,,0
CDM,31200004,TUMOR IMMUNOHISTOCHEM/MAN,235.0,164.5,,,0
CDM,31200005,HC INSITU HYBRIDIZATION (FISH),203.0,142.1,,,0
CDM,31200007,HC INSITU HYBRIDIZATION MANUAL,334.0,233.8,,,0
CDM,31200011,HC TUMOR IMMUNOHISTOCHEM/COMPUT,330.0,231.0,,,0
CDM,31200015,HC INSITU HYBRIDIZATION (FISH) PER SPEC EA ADDTL SINGLE STAIN,69.0,48.3,,,0
CDM,31200016,HC INSITU HYBRIDIZATION PER SPECIMEN EACH MULTIPLEX PROBE STAIN,69.0,48.3,,,0
CDM,31544,DARATUMUMAB 20 MG/ML IV SOLN,1491.0,1043.7,,,0
CDM,31562,"DARATUMUMAB-HYALURONIDASE-FIHJ 1,800 MG-30,000 UNIT/15 ML SUBQ SOLN",20904.5,14633.15,,,0
CDM,31590,LURBINECTEDIN 4 MG IV SOLR,36615.0,25630.5,,,0
CDM,31664,EPOETIN ALFA-EPBX 40000 UNITS/ML INJ SOLN,1218.0,852.6,,,0
CDM,31724,DOXORUBICIN LIPOSOMAL 2 MG/ML IV INJ,3401.0,2380.7,,,0
CDM,31766,"ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) IV SOLN",23792.0,16654.4,,,0
CDM,31766,ATEZOLIZUMAB 840 MG/14 ML (60 MG/ML) IV SOLN,26644.5,18651.15,,,0
CDM,31881,BEVACIZUMAB-AWWB 25 MG/ML IV SOLN,5778.0,4044.6,,,0
CDM,32000001,HC INSERT VENA CAVA FILTER,8290.0,5803.0,,,0
CDM,32000004,HC XRAY OF JAW < 4 VIEWS,348.0,243.6,,,0
CDM,32000005,HC XRAY OF JAW 4 OR MORE VIEWS,383.0,268.1,,,0
CDM,32000007,XRAY MASTOIDS 3> VIEWS PER SIDE,180.0,126.0,,,0
CDM,32000008,XRAY FACIAL BONES < 3 VIEWS,356.0,249.2,,,0
CDM,32000009,HC XRAY FACIAL BONES  3> VIEWS,433.0,303.1,,,0
CDM,32000010,HC XRAY NASAL BONES 3> VIEWS,287.0,200.9,,,0
CDM,32000011,HC XRAY EYE SOCKETS 4> VIEWS,404.0,282.8,,,0
CDM,32000012,HC XRAY SINUSES < 3 VIEWS,218.0,152.6,,,0
CDM,32000013,HC XRAY SINUSES 3> VIEWS,370.0,259.0,,,0
CDM,32000014,HC XRAY SKULL < 4 VIEWS,316.0,221.2,,,0
CDM,32000015,HC XRAY SKULL 4> VIEWS,385.0,269.5,,,0
CDM,32000016,HC FULL MOUTH XRAY OF TEETH,169.0,118.3,,,0
CDM,32000017,HC XRAY TMJ OPEN AND CLD UNILAT,267.0,186.9,,,0
CDM,32000018,HC XRAY TMJ OPEN AND CLD BILAT,370.0,259.0,,,0
CDM,32000019,HC XRAY EXAM OF NECK SOFT TISSUE,342.0,239.4,,,0
CDM,32000021,HC XRAY RIBS 2 VIEWS UNILAT,279.0,195.3,,,0
CDM,32000022,HC XRAY RIBS 3 VIEWS UNILAT INCL PA,332.0,232.4,,,0
CDM,32000023,HC XRAY RIBS 3 VIEWS BILAT,385.0,269.5,,,0
CDM,32000024,HC XRAY RIBS 3 VIEWS BILAT INCL PA,442.0,309.4,,,0
CDM,32000025,HC XRAY STERNUM 2 VIEWS,295.0,206.5,,,0
CDM,32000026,HC XRAY STERNUM 3> VIEWS,290.0,203.0,,,0
CDM,32000028,HC XRAY SPINE 1 VIEW,168.0,117.6,,,0
CDM,32000029,HC XRAY CERVICAL SPINE 2 OR 3 VIEWS,232.0,162.4,,,0
CDM,32000030,HC XRAY CERVICAL SPINE 4> VIEWS,337.0,235.9,,,0
CDM,32000031,HC XRAY CERV SPINE COMPL W/FLEX EXT,427.0,298.9,,,0
CDM,32000033,HC XRAY THORACIC SPINE 2 VIEWS,305.0,213.5,,,0
CDM,32000034,HC XRAY THORACIC SPINE 3 VIEWS,378.0,264.6,,,0
CDM,32000035,HC XRAY THOR SPINE 4> VIEWS,478.0,334.6,,,0
CDM,32000036,HC XRAY THORACOLUMBAR JUNCTION MINIMUM OF 2 VIEWS,280.0,196.0,,,0
CDM,32000038,HC XRAY LUMB SPINE 2 OR 3 VIEWS,326.0,228.2,,,0
CDM,32000039,HC XRAY LUMB SPINE 4> VIEWS,455.0,318.5,,,0
CDM,32000040,HC XRAY LUMB SPINE COMPL W/ BEND,578.0,404.6,,,0
CDM,32000041,HC XRAY LUMB SPINE FLEX EXT 2/3 VIEWS,185.0,129.5,,,0
CDM,32000042,HC XRAY PELVIS 1 OR 2 VIEWS,203.0,142.1,,,0
CDM,32000043,HC XRAY PELVIS 3> VIEWS,370.0,259.0,,,0
CDM,32000044,HC XRAY SI JOINTS 1 OR 2 VIEWS,166.0,116.2,,,0
CDM,32000045,HC XRAY SI JOINTS 3> VIEWS,333.0,233.1,,,0
CDM,32000046,HC XRAY SACRUM/COCC 2> VIEWS,305.0,213.5,,,0
CDM,32000047,HC CONTRAST XRAY OF CERV SPINE SI,1303.0,912.1,,,0
CDM,32000048,HC CONTRAST XRAY L-S SPINE SI,1270.0,889.0,,,0
CDM,32000049,HC CONTR XRAY SPINE 2> REGIONS SI,1520.0,1064.0,,,0
CDM,32000053,HC XRAY COLLAR BONE,211.0,147.7,,,0
CDM,32000054,HC XRAY SHOULDER BLADE,245.0,171.5,,,0
CDM,32000055,HC XRAY SHOULDER 1 VIEW,197.0,137.9,,,0
CDM,32000056,XRAY SHOULDER 2> VIEWS,225.0,157.5,,,0
CDM,32000057,HC XRAY SHOULDERS W/WO WEIGHT,330.0,231.0,,,0
CDM,32000058,HC XRAY HUMERUS 2> VIEWS,278.0,194.6,,,0
CDM,32000059,HC XRAY ELBOW 2 VIEWS,209.0,146.3,,,0
CDM,32000060,HC XRAY ELBOW 3> VIEWS,286.0,200.2,,,0
CDM,32000061,HC XRAY FOREARM 2 VIEWS,246.0,172.2,,,0
CDM,32000062,HC XRAY ARM INFANT 2> VIEWS,218.0,152.6,,,0
CDM,32000063,HC XRAY WRIST 2 VIEWS,198.0,138.6,,,0
CDM,32000064,HC XRAY WRIST 3> VIEWS,263.0,184.1,,,0
CDM,32000065,HC XRAY HAND 2 VIEWS,232.0,162.4,,,0
CDM,32000066,HC XRAY HAND 3> VIEWS,265.0,185.5,,,0
CDM,32000067,HC XRAY FINGER(S) 2> VIEWS,180.0,126.0,,,0
CDM,32000069,HC XRAY KNEE 1 OR 2 VIEWS,170.0,119.0,,,0
CDM,32000070,HC XRAY KNEE 3 VIEWS,308.0,215.6,,,0
CDM,32000071,HC XRAY KNEE 4> VIEWS,308.0,215.6,,,0
CDM,32000072,HC XRAY KNEES STANDING AP,201.0,140.7,,,0
CDM,32000073,HC XRAY TIB-FIB 2 VIEWS,248.0,173.6,,,0
CDM,32000074,HC XRAY LEG INFANT 2> VIEWS,227.0,158.9,,,0
CDM,32000075,HC XRAY ANKLE 2 VIEWS,199.0,139.3,,,0
CDM,32000076,HC XRAY ANKLE 3 VIEWS,265.0,185.5,,,0
CDM,32000077,HC XRAY FOOT 2 VIEWS,200.0,140.0,,,0
CDM,32000078,HC XRAY FOOT 3> VIEWS,262.0,183.4,,,0
CDM,32000079,HC XRAY HEEL 2> VIEWS,242.0,169.4,,,0
CDM,32000080,HC XRAY TOE(S) 2> VIEWS,180.0,126.0,,,0
CDM,32000084,HC XRAY ABDOMEN ACUTE SERIES,480.0,336.0,,,0
CDM,32000086,HC XRAY ESOPHAGUS,554.0,387.8,,,0
CDM,32000087,HC SWALLOW W/ VIDEO,508.0,355.6,,,0
CDM,32000088,HC XRAY UPPER GI INCL SCOUT ABDOMINAL RADIOGRAPH/DELAYED IMAGE SINGLE CONTRAST,858.0,600.6,,,0
CDM,32000091,HC XRAY UPPER GI INCL SCOUNT ABDOMINAL RADIOGAPH & DELAYED IMAGE DOUBLE CONTRAST STUDY INCL GLUCAGON WHEN ADMIN,987.0,690.9,,,0
CDM,32000094,HC XRAY SMALL BOWEL,584.0,408.8,,,0
CDM,32000095,HC XRAY COLON BARIUM W/WO KUB,739.0,517.3,,,0
CDM,32000096,HC XRAY COLON BARIUM AIR CONTR,1046.0,732.2,,,0
CDM,32000097,HC BE REDUCE INTUSSUSCEPTION,659.0,461.3,,,0
CDM,32000098,HC XRAY BILE DUCTS/PANC DURING SURG,665.0,465.5,,,0
CDM,32000103,HC XRAY BILE DUCT ENDOS CATHETER,629.0,440.3,,,0
CDM,32000104,HC XRAY PANC DUCT ENDOS CATHETER,629.0,440.3,,,0
CDM,32000105,HC XRAY PANC/BILE ENDOS CATHETER,629.0,440.3,,,0
CDM,32000106,HC XRAY GUIDE GI DILATION,583.0,408.1,,,0
CDM,32000107,HC XRAY GUIDE BILE DUCT DILATION,1707.0,1194.9,,,0
CDM,32000110,HC XRAY U T  RETROGRADE W/WO KUB,677.0,473.9,,,0
CDM,32000111,HC XRAY UROGRAPHY ANTEGRADE RAD S&I,514.0,359.8,,,0
CDM,32000112,HC XRAY BLADDER 3> VIEWS,588.0,411.6,,,0
CDM,32000113,HC XRAY URETH/BLADD RETROGRADE,374.0,261.8,,,0
CDM,32000114,HC XRAY URETH/BLADD VOIDING,758.0,530.6,,,0
CDM,32000118,HC XRAY GUIDE GU DILATION,1513.0,1059.1,,,0
CDM,32000119,HC XRAY FEMALE GENITAL TRACT,627.0,438.9,,,0
CDM,32000121,HC XRAY VEIN EXTR BILAT SI,974.0,681.8,,,0
CDM,32000122,HC XRAY VEIN INFERIOR CAVAL SI,2279.0,1595.3,,,0
CDM,32000123,HC XRAY VEIN SUP CAVAL SERIALO SI,2279.0,1595.3,,,0
CDM,32000124,HC XRAY VEIN RENAL UNILAT SI,2535.0,1774.5,,,0
CDM,32000125,HC XRAY VEIN RENAL BILAT SI,13400.0,9380.0,,,0
CDM,32000126,HC XRAY VEIN ADRENAL BILAT SI,2975.0,2082.5,,,0
CDM,32000127,HC XRAY VEIN VENOUS SINUS/JUGULAR SI,2656.0,1859.2,,,0
CDM,32000128,HC XRAY VEIN LIVER W/O HEMOD PERQ SI,879.0,615.3,,,0
CDM,32000129,HC XRAY VEIN LIVER W/ HEMODYN SI,5849.0,4094.3,,,0
CDM,32000130,HC XRAY VEIN LIVER W/O HEMODYN SI,4628.0,3239.6,,,0
CDM,32000131,HC VENOUS SAMP W/WO ANGIO CATH SI,20692.0,14484.4,,,0
CDM,32000132,HC XRAY TRANSCATH THER EMBOLIZ ANY METH SI,5918.0,4142.6,,,0
CDM,32000139,HC VASCULAR BIOPSY TRANSCATH SI,2071.0,1449.7,,,0
CDM,32000143,HC XRAY CHANGE DRAIN TUBE CATH SI,929.0,650.3,,,0
CDM,32000144,HC XRAY PERQ DRAIN FOR ABSCESS SI,757.0,529.9,,,0
CDM,32000145,HC FLUOROSCOPY UP TO 1 HOUR,1042.0,729.4,,,0
CDM,32000147,HC XRAY NOSE TO RECTUM FOR FB,209.0,146.3,,,0
CDM,32000148,HC XRAY ABSCESS FISTULA SINUS TRACT,776.0,543.2,,,0
CDM,32000149,HC XRAY SURGICAL SPECIMEN,382.0,267.4,,,0
CDM,32000150,HC FLUORO GUIDE VEIN DEVICE SI,82.0,57.4,,,0
CDM,32000151,HC FLUORO GUIDE NEEDLE PLACEMENT,1003.0,702.1,,,0
CDM,32000152,HC FLUOR GUIDE NEEDLE CATH INJ SPI,485.0,339.5,,,0
CDM,32000155,HC XRAY FOR BONE AGE,200.0,140.0,,,0
CDM,32000156,HC XRAY FOR BONE LENGTH,501.0,350.7,,,0
CDM,32000158,HC XRAY FOR BONE SURVEY COMPLETE,632.0,442.4,,,0
CDM,32000159,HC XRAY BONE DENSITY AXIAL,453.0,317.1,,,0
CDM,32000165,HC THROMBLYTIC ART/VEN THERAPY,3800.0,2660.0,,,0
CDM,32000169,PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY W/HEMODYNAMIC EVAL,2535.0,1774.5,,,0
CDM,32000170,HC UROGRAPHY INFUSION DRIP TECH OR BOLUS,750.0,525.0,,,0
CDM,32000173,HC RADIOLOGIC EXAM EYE FOR DETECTION OF FOREIGN BODY,67.0,46.9,,,0
CDM,32000175,HC RADIOLOGIC EXAM SPINE ENTIRE THORACIC & LUMBAR INCL SKULL CERVICAL & SACRAL SPINE ONE VIEW,212.0,148.4,,,0
CDM,32000176,HC RADIOLOGIC EXAM SPINE ENTIRE THORACIC & LUMBAR INCL SKULL CERVICAL & SACRAL SPINE 2 OR 3 VIEWS,212.0,148.4,,,0
CDM,32000180,HC XRAY FEMUR MINIMUM 2 VIEWS,194.0,135.8,,,0
CDM,32000184,HC XRAY ABDOMEN 1 VIEW,237.0,165.9,,,0
CDM,32000185,HC XRAY ABDOMEN 2 VIEWS,307.0,214.9,,,0
CDM,32000186,HC XRAY ABDOMEN 3 OR MORE VIEWS,312.0,218.4,,,0
CDM,32000187,HC XRAY VEIN ADRENAL UNILATERAL SI,1488.0,1041.6,,,0
CDM,32000188,HC INTRO LONG GASTROINTESTINAL TUBE INCL MULTI FLUORO IMAGES RAD S&I,301.0,210.7,,,0
CDM,32000193,HC ORTHOPANTOGRAM,278.0,194.6,,,0
CDM,32000194,HC UNLISTED DIAGNOSTIC RADIOGRAPHIC PROCEDURE,375.0,262.5,,,0
CDM,32000196,HC EVASC REPAIR DESCND THORCIC AORTA CELIAC ORG RAD S&I,354.0,247.8,,,0
CDM,32000197,HC CISTERNOGRAPHY POSITIVE CONTRAST RS&I,3545.0,2481.5,,,0
CDM,32000199,HC MECHANICAL RMVL INTRALUMINAL OBSTRUCTIVE MATERIAL RAD SUPERVISION & INTERP,191.0,133.7,,,0
CDM,32000200,HC XRAY SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RAD S&I,707.0,494.9,,,0
CDM,32000201,HC TBS STRUCTURAL CONDITION BONE MICROARCHITECTURE TECH PREP & TRANSMISSION DATA ALYS PFRMD ELSEWHERE,415.0,290.5,,,0
CDM,32000202,HC SPLENOPORTOGRAPHY RADIOLOGICAL SUPERVISION & INTERPRETATION,12111.0,8477.7,,,0
CDM,32000203,HC LYMPHANGIOGRAPHY PELVIC/ABDOMINAL UNILATERAL RADIOLOGICAL SUPERVISION/INTERPRETATION,12111.0,8477.7,,,0
CDM,32000204,HC LYMPHANGIOGRAPHY PELVIC/ABDOMINAL BILATERAL RADIOLOGICAL SUPERVISION/INTERPRETATION,13928.0,9749.6,,,0
CDM,32000205,HC RADIOLOGIC SMALL INTESTINE FOLLOW-THROUGH STUDY INCLUDING MULTIPLE SERIAL IMAGES,121.0,84.7,,,0
CDM,32000206,HC CINERADIOGRAPHY/VIDEORADIOGRAPHY EXCEPT WHERE SPECIFICALLY INCLUDED,697.0,487.9,,,0
CDM,32000207,HC MECHANICAL RMVL PRICATH OBSTR  MATRL FROM CENTRAL VENOUS DEVICE VIA SEPARATE VENOUS ACCESS RS&I,233.0,163.1,,,0
CDM,32000208,HC MR SAFETY IMPLANT/FOREIGN BODY ASSESS BY CLINICAL STAFF INCL ID & VERIFICATION OF IMPLANT COMPONENTS INITIAL 15 MINUTES,105.0,73.5,,,0
CDM,32000209,HC MR SAFETY IMPLANT/FOREIGN BODY ASSESS BY CLINICAL STAFF INCL ID & VERIFICATION OF IMPLANT COMPONENTS EACH ADDTL 30 MINUTES,121.0,84.7,,,0
CDM,32000210,HC MR SAFETY DETERMINATION BY PHYSICIAN/QHP FOR SAFETY OF PROCEDURE  W/REPORT,375.0,262.5,,,0
CDM,32000211,HC MR SAFETY MEDICAL PHYSICS EXAM CUSTOMIZATION PLANNING/PERFORMANCE W/REPORT,1030.0,721.0,,,0
CDM,32000212,HC MR SAFETY IMPLANT ELECTRONICS PREP INCL MR-SPECIFIC PROGRAM PULSE GENERATOR/TRANSMITTER W/REPORT,391.0,273.7,,,0
CDM,32000213,HC MR SAFETY IMPLANT POSITIONING/IMMOBILIZATION W/REPORT,253.0,177.1,,,0
CDM,32073,IRINOTECAN LIPOSOMAL 4.3 MG/ML IV DISP,8489.5,5942.65,,,0
CDM,32100001,HC X-RAY ANGIO INTER MAMM SI,12111.0,8477.7,,,0
CDM,32200001,HC XRAY SHOULDER ARTHROGRAM SI,718.0,502.6,,,0
CDM,32200002,HC XRAY WRIST ARTHROGRAM,509.0,356.3,,,0
CDM,32200006,HC XRAY HIP ARTHROGRAM SI,742.0,519.4,,,0
CDM,32200009,HC XRAY KNEE ARTHROGRAM SI,542.0,379.4,,,0
CDM,32200010,HC XRAY HIP UNILATERAL W/PELVIS 1 VIEW,132.0,92.4,,,0
CDM,32200011,HC XRAY HIP UNILATERAL W/PELVIS 2-3 VIEWS,240.0,168.0,,,0
CDM,32200013,HC XRAY HIPS BILATERAL W/PELVIS 2 VIEWS,428.0,299.6,,,0
CDM,32200014,HC XRAY HIPS BILATERAL W/PELVIS 3-4 VIEWS,493.0,345.1,,,0
CDM,32200015,HC XRAY HIPS BILATERAL W/PELVIS MINIMUM 5 VIEWS,895.0,626.5,,,0
CDM,32200016,HC X-RAY ANKLE ARTHROGRAPHY RAD S & I,1319.0,923.3,,,0
CDM,32300001,HC XRAY THOR AORTA SERIALOGRAPHY,2374.0,1661.8,,,0
CDM,32300002,HC XRAY ABD AORTA SERIALOGRAPHY SI,3028.0,2119.6,,,0
CDM,32300003,HC XRAY ABD AORTA LWR EXTR BILAT,3557.0,2489.9,,,0
CDM,32300011,HC XRAY ANGIO SPINAL SI,5269.0,3688.3,,,0
CDM,32300012,HC XRAY ANGIO EXTREMITY UNILAT SI,2790.0,1953.0,,,0
CDM,32300013,HC XRAY ANGIO EXTREMEITY BILAT SI,3611.0,2527.7,,,0
CDM,32300015,HC XRAY ANGIO VISCERAL SI,5269.0,3688.3,,,0
CDM,32300016,HC XRAY ANGIO PELVIC SI,4411.0,3087.7,,,0
CDM,32300017,HC XRAY ANGIO PULMON SI,2721.0,1904.7,,,0
CDM,32300018,HC XRAY ANGIO EACH ADDL VESSEL SI,1287.0,900.9,,,0
CDM,32300019,HC XRAY VEIN EXTR UNILAT SI,766.0,536.2,,,0
CDM,32300020,HC XRAY ANGIO F/UP THRU CATHETER,2208.0,1545.6,,,0
CDM,32300022,HC TRNSLUM PERIPH ARTHRE ILIAC EA,22164.0,15514.8,,,0
CDM,32300023,HC SELECTIVE CATH PLACE CAROTID/INOM ART,2277.0,1593.9,,,0
CDM,32300024,HC SELECTIVE CATH PLACE CAROTID ART,5269.0,3688.3,,,0
CDM,32300025,HC SELECTIVE CATH PLACE VETEBRAL ART,5269.0,3688.3,,,0
CDM,32300027,HC ANGIOGRAPHY PULM UNILAT SELECT RAD S&I,3230.0,2261.0,,,0
CDM,32300028,HC PLACE CATH SUBCLAVIAN ART,2277.0,1593.9,,,0
CDM,32300030,HC ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I,4011.0,2807.7,,,0
CDM,32400002,HC XRAY CHEST 2 VIEWS,281.0,196.7,,,0
CDM,32400006,HC XRAY CHEST 4 OR MORE VIEWS,363.0,254.1,,,0
CDM,32400010,HC XRAY CHEST SINGLE VIEW,236.0,165.2,,,0
CDM,32400011,HC XRAY CHEST 3 VIEWS,323.0,226.1,,,0
CDM,32737,"HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM INJ MERGE (CAM USE ONLY)",1127.0,788.9,,,0
CDM,32737,"HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM SUSP",885.0,619.5,,,0
CDM,32737,"HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM SYRG",1127.0,788.9,,,0
CDM,32743,HC MCARE ADMIN HEPATITIS B VACC,262.0,183.4,,,0
CDM,32869,SODIUM CHLORIDE 0.9 % INJ SYRG,16.0,11.2,,,0
CDM,33000001,HC RADIOPHARM THERAPY BY INTRA-ART PARTICULATE ADMIN,1265.0,885.5,,,0
CDM,33000002,HC APPLY INTERSTIT RADIATION COMPLEX,4095.0,2866.5,,,0
CDM,33000003,HC CHEMO ADMIN INTRALESIONAL UP TO AND INCL 7 LESIONS,76.0,53.2,,,0
CDM,33038,"HYALURONATE SODIUM, STABILIZED 88 MG/4 ML IATC SYRG",3105.0,2173.5,,,0
CDM,33059,PEGFILGRASTIM-JMDB (FULPHILA) 6 MG/0.6 ML SUBQ SYRG,8642.5,6049.75,,,0
CDM,33100001,CHEMO ANTINEOPL IM SUBQ,267.0,186.9,,,0
CDM,33100002,CHEMO HORM ANTINEOPL IM SUBQ,171.0,119.7,,,0
CDM,33100003,HC CHEMO ADMIN INTO CNS REQ/INCLUDE SPINAL PUNCTURE,863.0,604.1,,,0
CDM,33100005,HC CHEMO ADMIN INTO PLEURAL CAVITY REQ/INCLUDE THORACENTESIS,1223.0,856.1,,,0
CDM,33100006,HC CHEMO ADMIN INTO PERITONEAL CAVITY IMPLANTED PORT/CATHETER,1223.0,856.1,,,0
CDM,33124,TESTOSTERONE ENANTHATE 200 MG/ML IM OIL,97.0,67.9,,,0
CDM,33152,TESTOSTERONE  75 MG IMPL PLLT,29210.0,20447.0,,,0
CDM,33259,HC ADMIN RESPIRATORY SYNCYTIAL VIRUS MONOCLONAL ANTIBODY SEASONAL DOSE INTRAMUSCULAR INJECTION,1485.0,1039.5,,,0
CDM,33300001,SET RAD THERAPY FIELD SIMPLE,1784.0,1248.8,,,0
CDM,33300002,SET RAD THERAPY FIELD INTERMED,1956.0,1369.2,,,0
CDM,33300003,SET RAD THERAPY FIELD COMPLEX,3824.0,2676.8,,,0
CDM,33300004,SET RAD THERAPY FIELD 3D,9493.0,6645.1,,,0
CDM,33300005,RADIATION THERAPY DOSE PLAN,662.0,463.4,,,0
CDM,33300006,RADIOTHERAPY DOSE PLAN IMRT,4262.0,2983.4,,,0
CDM,33300010,SPECIAL TELETX PORT PLAN,955.0,668.5,,,0
CDM,33300013,RAD TX AID(S)SIMPLE,634.0,443.8,,,0
CDM,33300014,RAD TX AID(S) INTERMED,723.0,506.1,,,0
CDM,33300015,HC FIELD BLOCK DESIGN,2014.0,1409.8,,,0
CDM,33300016,RADIATION PHYSICS CONSULT,571.0,399.7,,,0
CDM,33300017,DESIGN MLC DEVICE FOR IMRT,938.0,656.6,,,0
CDM,33300018,RAD PHYSICS CONSULT SPECIAL,698.0,488.6,,,0
CDM,33300019,LIN ACC STEREOTAC RADIOSURG,7770.0,5439.0,,,0
CDM,33300029,HC XRAY PORT FILMS - 4,364.0,254.8,,,0
CDM,33300030,HC XRAY PORT FILMS - 3,313.0,219.1,,,0
CDM,33300031,HC XRAY PORT FILMS - 2,257.0,179.9,,,0
CDM,33300032,HC XRAY PORT FILMS - 1,273.0,191.1,,,0
CDM,33300035,SBRT MANAGEMENT  UP TO 5 FRACT,434.0,303.8,,,0
CDM,33300036,SPECIAL RADIATION TREATMENT,2853.0,1997.1,,,0
CDM,33300041,HC RESPIRATORY MOTION MGMT SIMULATION,1174.0,821.8,,,0
CDM,33300042,HC GUIDE FOR LOCALIZATION OF TARGET VOLUME FOR RADIATION TREATMENT DELIVERY KV,540.0,378.0,,,0
CDM,33300043,HC TELETHERAPY ISODOSE PLAN SIMPLE INCLUDES BASIC DOSIMETRY CALCULATION(S),627.0,438.9,,,0
CDM,33300044,HC TELETHERAPY ISODOSE PLAN COMPLEX INCLUDES BASIC DOSIMETRY CALCULATION(S),2655.0,1858.5,,,0
CDM,33300045,HC BRACHYTHERAPY ISODOSE PLAN SIMPLE INCLUDES BASIC DOSIMETRY CALCULATION(S),502.0,351.4,,,0
CDM,33300046,HC BRACHYTHERAPY ISODOSE PLAN COMPLEX INCLUDES BASIC DOSIMETRY CALCULATION(S),771.0,539.7,,,0
CDM,33300047,HC RADIATION TX DELIVERY >= 1 MEV SIMPLE,507.0,354.9,,,0
CDM,33300048,HC RADIATION TX DELIVERY >= 1 MEV INTERMEDIATE,534.0,373.8,,,0
CDM,33300049,HC RADIATION TX DELIVERY >= 1 MEV COMPLEX,1196.0,837.2,,,0
CDM,33300050,HC IMRT INCLUDES GUIDANCE/TRACKING SIMPLE,3669.0,2568.3,,,0
CDM,33300051,HC IMRT INCLUDES GUIDANCE/TRACKING COMPLEX,3758.0,2630.6,,,0
CDM,33300052,HC GUIDE FOR LOCALIZATION OF TARGET VOLUME FOR RADIATION TREATMENT DELIVERY BAT,540.0,378.0,,,0
CDM,33300053,HC GUIDE FOR LOCALIZATION OF TARGET VOLUME FOR RADIATION TREATMENT DELIVERY CT,722.0,505.4,,,0
CDM,33300057,HC REMOTE AFTERLOADING HIGH DOSE RATE RADIONUCLIDE INTERSTITIAL/INTRACAVITARY BRACHYTHERAPY INCL BASIC DOSIMETRY 1 CHANNEL,1182.0,827.4,,,0
CDM,33300058,HC REMOTE AFTERLOADING HIGH DOSE RATE RADIONUCLIDE INTERSTITIAL/INTRACAVITARY BRACHYTHERAPY INCL BASIC DOSIMETRY 2-12 CHANNELS,1673.0,1171.1,,,0
CDM,33300059,HC REMOTE AFTERLOADING HIGH DOSE RATE RADIONUCLIDE INTERSTITIAL/INTRACAVITARY BRACHYTHERAPY INCL BASIC DOSIMETRY OVER 12 CHANNELS,4627.0,3238.9,,,0
CDM,33300061,HC SPECIAL DOSIMETRY ONLY WHEN PRESCRIBED BY TREATING PHYS,381.0,266.7,,,0
CDM,33500001,CHEMO IV PUSH SINGL DRUG,493.0,345.1,,,0
CDM,33500002,CHEMO IV PUSH ADDL DRUG,284.0,198.8,,,0
CDM,33500003,CHEMO INFUS SINGL DRUG 1 HOUR,713.0,499.1,,,0
CDM,33500004,CHEMO INFUS SINGL DRUG EA ADD HR,239.0,167.3,,,0
CDM,33500005,CHEMO INFUS W/PUMP >8 HRS,671.0,469.7,,,0
CDM,33500006,CHEMO INFUS DIFF DRUG SEQ 1 HR,602.0,421.4,,,0
CDM,33500007,HC CHEMO INTRA-ARTERIAL PUSH,334.0,233.8,,,0
CDM,33500008,HC CHEMO ADMIN INTRA-ARTERIAL INFUS TECH INITIATION PROLONGED INFUSION > 8HRS PRTBLE/IMPLTBL PUMP,1223.0,856.1,,,0
CDM,33500009,HC CHEMO ADMIN INTRA-ARTERIAL INFUSION TECH EA ADDT'L HOUR,314.0,219.8,,,0
CDM,33962,ROMIPLOSTIM 125 MCG SUBQ SOLR,1283.0,898.0999999999999,,,0
CDM,33962,ROMIPLOSTIM 250 MCG SUBQ SOLR,2678.0,1874.6,,,0
CDM,33962,ROMIPLOSTIM 500 MCG SUBQ SOLR,7375.0,5162.5,,,0
CDM,34000001,HC THYROID SINGLE UPTAKE,297.0,207.9,,,0
CDM,34000006,HC THYROID METS IMAGING BODY,2039.0,1427.3,,,0
CDM,34000008,HC ADRENAL IMAGING,1900.0,1330.0,,,0
CDM,34000009,HC LYMPH SYSTEM IMAGING,1581.0,1106.7,,,0
CDM,34000011,HC LIVER AND SPLEEN IMAGING STATIC,2071.0,1449.7,,,0
CDM,34000012,HC HEPATOBILIARY SYSTEM IMAGING,1202.0,841.4,,,0
CDM,34000013,HC HEPATOBIL SYST IMAGE W/DRUG,1941.0,1358.7,,,0
CDM,34000014,HC GASTROESOPHAGEAL REFLUX EXAM,839.0,587.3,,,0
CDM,34000015,HC GASTRIC EMPTYING IMAGING STUDY,1340.0,938.0,,,0
CDM,34000016,HC ACUTE GI BLOOD LOSS IMAGING,1770.0,1239.0,,,0
CDM,34000017,HC MECKELS DIVERTICULUM,970.0,679.0,,,0
CDM,34000018,HC BONE AND/OR JOINT IMAGING LIMITED AREA,1404.0,982.8,,,0
CDM,34000019,HC BONE AND/OR JOINT IMAGING MULTIPLE AREAS,1738.0,1216.6,,,0
CDM,34000020,HC BONE AND/OR JOINT IMAGING WHOLE BODY,1946.0,1362.2,,,0
CDM,34000021,HC BONE AND/OR JOINT IMAGING 3 PHASE STUDY,1986.0,1390.2,,,0
CDM,34000023,HC CARDIAC BLOOD POOL IMAGING,1695.0,1186.5,,,0
CDM,34000024,HC LUNG VENTILATION IMAGING,1568.0,1097.6,,,0
CDM,34000025,HC LUNG PERFUSION IMAGING,845.0,591.5,,,0
CDM,34000026,HC LUNG VENTILAT&PERFUS IMAG,1482.0,1037.4,,,0
CDM,34000027,HC LUNG VENTILAT&PERFUS DIFFERENTL,1326.0,928.2,,,0
CDM,34000028,HC BRAIN IMAGE W/FLOW 4 + VIEWS,1477.0,1033.9,,,0
CDM,34000030,HC CEREBROSPINAL FLUID SCAN,1523.0,1066.1,,,0
CDM,34000031,HC CSF SHUNT EVALUATION,877.0,613.9,,,0
CDM,34000034,HC K FLOW/FUNCT IMAGE W/O DRUG,1277.0,893.9,,,0
CDM,34000035,HC K FLOW/FUNCT IMAGE W/DRUG,1888.0,1321.6,,,0
CDM,34000037,HC URETERAL REFLUX STUDY,796.0,557.2,,,0
CDM,34000038,HC TUMOR IMAGING PLANAR WHOLE BODY SINGLE DAY IMAGING,2661.0,1862.7,,,0
CDM,34000039,HC TUMOR SPECT SINGLE AREA/ACQUISITION SINGLE DAY IMAGING,3804.0,2662.8,,,0
CDM,34000043,HC THYROID IMAGING W/ BLOOD FLOW,199.0,139.3,,,0
CDM,34000044,HC THYROID IMAGING W/ BLOOD FLOW W/ SNGL/MULT UPTAKE(S),308.0,215.6,,,0
CDM,34000047,HC SUPERVISION/HANDLING/LOADING OF RADIATION SOURCE,466.0,326.2,,,0
CDM,34000048,HC GASTRIC EMPTYING IMAGING STUDY W/SMALL BOWEL TRANSIT,1412.0,988.4,,,0
CDM,34000049,HC GASTRIC EMPTYING IMAGING STUDY W/SMALL BOWEL & COLON TRANSIT MULTI DAYS,1873.0,1311.1,,,0
CDM,34000050,HC PARATHYROID IMAGING W/ TOMOGRAPHIC (SPECT),1600.0,1120.0,,,0
CDM,34000051,HC PARATHYRD PLANAR IMAG INCL SUBTRACTION W/TOMOGRAHIC (SPECT) AND CT FOR ANATOMICAL LOCALIZATION,1807.0,1264.9,,,0
CDM,34000053,HC LIVER IMAGING WITH VASCULAR FLOW,4055.0,2838.5,,,0
CDM,34000055,HC TUMOR IMAGING PLANAR SINGLE AREA SINGLE DAY IMAGING,1357.0,949.9,,,0
CDM,34000057,HC TUMOR SPECT W/CT SINGLE AREA/ACQUISITION SINGLE DAY IMAGING,4529.0,3170.3,,,0
CDM,34000059,HC TUMOR SPECT W/CT MIN 2 AREAS SINGLE DAY IMAGING OR SINGLE AREA IMAGING OVER 2 OR MORE DAYS,5138.0,3596.6,,,0
CDM,34000060,HC UNLISTED RESPIRATORY PROCEDURE DX NUCLEAR MED,1322.0,925.4,,,0
CDM,34000061,HC RADIOPHARM QUANT MEASURE SINGLE AREA,77.0,53.9,,,0
CDM,34000062,HC ESOPHAGEAL MOTILITY,1340.0,938.0,,,0
CDM,34032,YTTRIUM-90 (SIR-SPHERES) MICROSPHERES,42831.0,29981.699999999997,,,0
CDM,34032,YTTRIUM-90 (Y-90 THERASPHERE) GLASS MICROSPHERES,44379.0,31065.3,,,0
CDM,34100001,HC THYROID METS IMAGING/STUDIES,417.0,291.9,,,0
CDM,34100002,HC BONE MARROW IMAGING LTD,1565.0,1095.5,,,0
CDM,34100003,HC RED CELL SEQUESTRATION,801.0,560.7,,,0
CDM,34100006,HC HEART MUSC IMAGE SPECT MULT,2202.0,1541.4,,,0
CDM,34100007,HC TUMOR IMAGING WHOLE BODY 2 DAYS,3951.0,2765.7,,,0
CDM,34100010,HC BRAIN IMAGING PET PERFUSION EVALUATION,4864.0,3404.8,,,0
CDM,34100011,HC BONE MARROW IMAGING MULTIPLE AREAS,1800.0,1260.0,,,0
CDM,34200002,HC THYROID THERAPY,1609.0,1126.3,,,0
CDM,34200004,HC BRACHYTHERAPY ISODOSE PLAN INTERMEDIATE INCLUDES BASIC DOSIMETRY CALCULATION(S),657.0,459.9,,,0
CDM,34300024,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,1.0,0.7,,,0
CDM,34542,LEVONORGESTREL 20 MCG/24 HR IU IUD,3553.5,2487.45,,,0
CDM,34546,PREDNISONE  5 MG ORAL TAB,5.5,3.85,,,0
CDM,34546,PREDNISONE 10 MG ORAL TAB,7.0,4.9,,,0
CDM,34546,PREDNISONE 20 MG ORAL TAB,8.0,5.6,,,0
CDM,34738,AVELUMAB 20 MG/ML IV SOLN,14907.0,10434.9,,,0
CDM,35000001,HC CT ANGIO ABD&PELV W/WO DYE,4674.0,3271.8,,,0
CDM,35000002,HC CT ANGIO ABDOM W/WO DYE,3330.0,2331.0,,,0
CDM,35000003,HC CT HEART W/3D IMAGE,1618.0,1132.6,,,0
CDM,35000004,HC CT HEART  W/CONTRAST EVAL CHD INCL 3D IMAGE LV RV EVAL VASCULAR STRUCTURES,1618.0,1132.6,,,0
CDM,35000005,HC CT ANGIO HEART W/3D IMAGE,1618.0,1132.6,,,0
CDM,35000006,HC CT ANGIO ABD AORTA LWR EXTR BILAT,3364.0,2354.8,,,0
CDM,35000007,HC 3D RENDER W/O POSTPROCESS,375.0,262.5,,,0
CDM,35000008,HC 3D RENDERING W/POSTPROCESS,401.0,280.7,,,0
CDM,35000009,HC CT LIMITED OR FOLLOW-UP STUDY,413.0,289.1,,,0
CDM,35000010,CT GUIDE FOR STEREO LOCALIZATION,843.0,590.1,,,0
CDM,35000011,HC CT GUIDE NDL ASPIRATE BX,1100.0,770.0,,,0
CDM,35000012,HC CT GUIDE TISSUE ABLATION,2027.0,1418.9,,,0
CDM,35000014,HC 3D CT GUIDE FOR PLACEMENT OF RADIATION THERAPY FIELDS,529.0,370.3,,,0
CDM,35000015,HC CT HEART W/O CONTRAST W/ QUAL EVAL CORONARY CALCIUM,298.0,208.6,,,0
CDM,35000016,HC 4D CT GUIDE FOR PLACEMENT OF RADIATION THERAPY FIELDS,529.0,370.3,,,0
CDM,35000019,HC NONINVASIVE EST CORONARY FFR DERIVED SOFTWARE ANALYSIS DATA SET FROM CTA W/INTERP/REPORT BY PHY/QHP,3973.0,2781.1,,,0
CDM,35100001,HC CT HEAD/BRAIN W/O DYE,1071.0,749.7,,,0
CDM,35100002,HC CT HEAD/BRAIN W/DYE,1986.0,1390.2,,,0
CDM,35100003,HC CT HEAD/BRAIN W/WO DYE,2111.0,1477.7,,,0
CDM,35100004,HC CT ORBIT/EAR/FOSSA W/O DYE,1322.0,925.4,,,0
CDM,35100005,HC CT ORBIT/EAR/FOSSA W/DYE,1605.0,1123.5,,,0
CDM,35100006,HC CT ORBIT/EAR/FOSSA W/WO DYE,2116.0,1481.2,,,0
CDM,35100007,HC CT MAXILLOFACIAL W/O DYE,1036.0,725.2,,,0
CDM,35100008,HC CT MAXILLOFACIAL W/DYE,1595.0,1116.5,,,0
CDM,35100009,HC CT MAXILLOFACIAL W/WO DYE,2109.0,1476.3,,,0
CDM,35100010,HC CT SOFT TISSUE NECK W/O DYE,1152.0,806.4,,,0
CDM,35100011,HC CT SOFT TISSUE NECK W/DYE,1790.0,1253.0,,,0
CDM,35100012,HC CT SFT TSUE NCK W/WO DYE,2362.0,1653.4,,,0
CDM,35100013,HC CT ANGIO HEAD W/WO DYE,3284.0,2298.8,,,0
CDM,35100014,HC CT ANGIO NECK W/WO DYE,3284.0,2298.8,,,0
CDM,35100015,HC CEREBRAL PERFUSION ANALYSIS USING CT W/ CONTRAST ADMIN INCL POST-PROCESSING OF PARAMETRIC MAPS,2660.0,1862.0,,,0
CDM,35200001,HC CT THORAX DIAGNOSTIC W/O DYE,1222.0,855.4,,,0
CDM,35200002,HC CT THORAX DIAGNOSTIC W/DYE,2047.0,1432.9,,,0
CDM,35200003,HC CT THORAX DIAGNOSTIC W/WO DYE,2471.0,1729.7,,,0
CDM,35200004,HC CT ANGIO CHEST W/CONTRAST INCL NONCONTRAST IMAGE,3337.0,2335.9,,,0
CDM,35200005,HC CT C-SPINE W/O DYE,2068.0,1447.6,,,0
CDM,35200006,HC CT C-SPINE W/DYE,2523.0,1766.1,,,0
CDM,35200007,HC CT C-SPINE W/WO DYE,2777.0,1943.9,,,0
CDM,35200008,HC THORACIC SPINE W/O DYE,722.0,505.4,,,0
CDM,35200009,HC THORACIC SPINE W/DYE,1102.0,771.4,,,0
CDM,35200010,HC THORACIC SPINE W/WO DYE,1235.0,864.5,,,0
CDM,35200011,HC CT LUMBAR SPINE W/O DYE,1609.0,1126.3,,,0
CDM,35200012,HC CT LUMBAR SPINE W/DYE,2349.0,1644.3,,,0
CDM,35200013,HC CT LUMBAR SPINE W/WO DYE,2586.0,1810.2,,,0
CDM,35200014,HC CT ANGIOGRAPH PELV W/WO DYE,3319.0,2323.3,,,0
CDM,35200015,HC CT PELVIS W/O DYE,1662.0,1163.4,,,0
CDM,35200016,HC CT PELVIS W/DYE,2121.0,1484.7,,,0
CDM,35200017,HC CT PELVIS W/WO DYE,2657.0,1859.9,,,0
CDM,35200019,HC CT UPPER EXTREMITY W/O DYE,1369.0,958.3,,,0
CDM,35200020,HC CT UPPER EXTREMITY W/DYE,1926.0,1348.2,,,0
CDM,35200021,HC CT UPPR EXTREMITY W/O&W/DYE,2265.0,1585.5,,,0
CDM,35200022,HC CT ANGIO UPR EXTRM W/WO DYE,3007.0,2104.9,,,0
CDM,35200023,HC CT LOWER EXT W/O DYE,1309.0,916.3,,,0
CDM,35200024,HC CT LOWER EXT W/DYE,1889.0,1322.3,,,0
CDM,35200025,HC CT LWR EXT W/WO DYE,2221.0,1554.7,,,0
CDM,35200026,HC CT ANGIO LWR EXT W/WO DYE,2983.0,2088.1,,,0
CDM,35200027,HC CT ABDOMEN W/O DYE,1409.0,986.3,,,0
CDM,35200028,HC CT ABDOMEN W/DYE,2163.0,1514.1,,,0
CDM,35200029,HC CT ABDOMEN W/WO DYE,2632.0,1842.4,,,0
CDM,35200030,HC CT ABD & PELVIS W/O DYE,3293.0,2305.1,,,0
CDM,35200031,CT ABD & PELV W/ DYE,4178.0,2924.6,,,0
CDM,35200032,HC CT ABD & PELV 1/> REGNS W/WO DYE,4674.0,3271.8,,,0
CDM,35200034,HC CT THORAX LUNG CANCER SCR C-,276.0,193.2,,,0
CDM,35333,BENRALIZUMAB 30 MG/ML SUBQ ATIN,14769.0,10338.3,,,0
CDM,35402,2-OCTYL CYANOACRYLATE TOPICAL LIQD,117.0,81.9,,,0
CDM,35402,ACETAMINOPHEN   80 MG ORAL CHEW,7.0,4.9,,,0
CDM,35402,ACETAMINOPHEN  120 MG RECT SUPP,7.0,4.9,,,0
CDM,35402,ACETAMINOPHEN  325 MG ORAL TAB,4.0,2.8,,,0
CDM,35402,ACETAMINOPHEN  325 MG RECT SUPP,6.0,4.2,,,0
CDM,35402,ACETAMINOPHEN  500 MG ORAL TAB,5.0,3.5,,,0
CDM,35402,ACETAMINOPHEN  650 MG RECT SUPP,5.0,3.5,,,0
CDM,35402,ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLN,9.0,6.3,,,0
CDM,35402,ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSP,10.0,7.0,,,0
CDM,35402,ACETAMINOPHEN 160 MG/5 ML ORAL (PHS ERX MERGE),20.5,14.35,,,0
CDM,35402,ACETAMINOPHEN 650 MG/20.3 ML ORAL SOLN,14.0,9.8,,,0
CDM,35402,ACETIC ACID (VINEGAR) 5% IRRIGATION 12 ML (REPACK),16.0,11.2,,,0
CDM,35402,ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSP,65.5,45.85,,,0
CDM,35402,ALBUTEROL SULFATE 1.25 MG/3 ML INHL NEBU,9.0,6.3,,,0
CDM,35402,ALBUTEROL SULFATE 2.5 MG/0.5 ML INHL NEBU,15.0,10.5,,,0
CDM,35402,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) NEB SOLUTION,11.5,8.05,,,0
CDM,35402,ALBUTEROL SULFATE 5 MG/ML INHL NEB CONTINUOUS,7.0,4.9,,,0
CDM,35402,ALBUTEROL SULFATE 90 MCG/ACTUATION INHL HFAA,8.0,5.6,,,0
CDM,35402,ALLOPURINOL 100 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,ALPRAZOLAM 0.5 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,ALUM-MAG HYDROXIDE-SIMETH 200 MG-200 MG-20 MG/5 ML ORAL SUSP,20.0,14.0,,,0
CDM,35402,ALUM-MAG HYDROXIDE-SIMETH 400 MG-400 MG-40 MG/5 ML ORAL SUSP,13.0,9.100000000000001,,,0
CDM,35402,ALUMINUM CHLORIDE 20 % TOP SOLN,52.0,36.4,,,0
CDM,35402,ALUMINUM-MAGNESIUM HYDROXIDE 200 MG-200 MG/5 ML ORAL SUSP,44.0,30.8,,,0
CDM,35402,AMIODARONE 200 MG ORAL TAB,45.0,31.5,,,0
CDM,35402,AMLODIPINE  5 MG ORAL TAB,14.5,10.15,,,0
CDM,35402,AMLODIPINE 10 MG ORAL TAB,13.5,9.45,,,0
CDM,35402,AMOXICILLIN 250 MG ORAL CAP,18.5,12.95,,,0
CDM,35402,AMOXICILLIN 250 MG/5 ML ORAL SUSR,9.5,6.65,,,0
CDM,35402,AMOXICILLIN 500 MG ORAL CAP,13.0,9.1,,,0
CDM,35402,AMOXICILLIN-POT CLAVULANATE 400 MG-57 MG/5 ML ORAL SUSP,25.0,17.5,,,0
CDM,35402,AMOXICILLIN-POT CLAVULANATE 500 MG-125 MG TAB,21.0,14.7,,,0
CDM,35402,AMOXICILLIN-POT CLAVULANATE 600 MG-42.9 MG/5 ML ORAL SUSP,21.5,15.05,,,0
CDM,35402,AMOXICILLIN-POT CLAVULANATE 875 MG-125 MG TAB,29.0,20.3,,,0
CDM,35402,APIXABAN 5 MG ORAL TAB,60.0,42.0,,,0
CDM,35402,ARIPIPRAZOLE 10 MG ORAL TAB,74.0,51.8,,,0
CDM,35402,ASPIRIN   81 MG ORAL TBEC,5.0,3.5,,,0
CDM,35402,ASPIRIN  325 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,ASPIRIN  325 MG ORAL TBEC,5.0,3.5,,,0
CDM,35402,ASPIRIN 81 MG ORAL CHEW,5.0,3.5,,,0
CDM,35402,AXATILIMAB-CSFR 50 MG/ML IV SOLN,25286.0,17700.2,,,0
CDM,35402,AZITHROMYCIN 1 GRAM ORAL PACK,143.0,100.1,,,0
CDM,35402,AZITHROMYCIN 200 MG/5 ML ORAL SUSR,38.0,26.6,,,0
CDM,35402,AZITHROMYCIN 250 MG ORAL TAB,33.0,23.1,,,0
CDM,35402,AZITHROMYCIN 500 MG ORAL TAB,77.0,53.9,,,0
CDM,35402,BACITRACIN 500 UNIT/G TOP PACK,7.0,4.9,,,0
CDM,35402,BACITRACIN 500 UNITS/1 GRAM PACKET (MERGE RECORD),8.0,5.6,,,0
CDM,35402,BACLOFEN 10 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,BACTERIOSTATIC SALINE 0.9 % INJ SOLN,17.0,11.899999999999999,,,0
CDM,35402,BALANCED SALT IRRIG SOLN COMB2 INTRAOCULAR,75.0,52.5,,,0
CDM,35402,BALANCED SALT SOLN NON-SURG #3 EYE,118.0,82.6,,,0
CDM,35402,BENZOCAINE 20 % MM SPRY,76.0,53.2,,,0
CDM,35402,BENZONATATE 100 MG ORAL CAP,8.0,5.6,,,0
CDM,35402,BISACODYL  5 MG ORAL TBEC,7.0,4.9,,,0
CDM,35402,BISACODYL 10 MG RECT SUPP,7.0,4.9,,,0
CDM,35402,BUDESONIDE 0.5 MG/2 ML INHL NBSP,55.0,38.5,,,0
CDM,35402,BUDESONIDE 1 MG/2 ML INHL NBSP,85.0,59.5,,,0
CDM,35402,BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION,23.0,16.1,,,0
CDM,35402,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN,29.0,20.3,,,0
CDM,35402,BUPIVACAINE 0.5 % (5 MG/ML) INJ SOLN,42.0,29.4,,,0
CDM,35402,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN",43.0,30.1,,,0
CDM,35402,"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN",157.0,109.9,,,0
CDM,35402,"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN",16.0,11.2,,,0
CDM,35402,BUSPIRONE 10 MG ORAL TAB,8.0,5.6,,,0
CDM,35402,BUSPIRONE 15 MG ORAL TAB,9.5,6.65,,,0
CDM,35402,CALCIUM CARBONATE 500 MG (200 MG ELEMENTAL) CHEW TAB,7.0,4.9,,,0
CDM,35402,CARBAMAZEPINE 200 MG ORAL TAB,8.0,5.6,,,0
CDM,35402,CARBAMIDE PEROXIDE 6.5 % OTIC DROP,43.5,30.450000000000003,,,0
CDM,35402,CARVEDILOL  3.125 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,CARVEDILOL  6.25 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,CARVEDILOL 25 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,CEFDINIR 250 MG/5 ML ORAL SUSR,32.0,22.4,,,0
CDM,35402,CEFDINIR 300 MG ORAL CAP,37.0,25.9,,,0
CDM,35402,CEPHALEXIN 250 MG ORAL CAP,9.0,6.3,,,0
CDM,35402,CEPHALEXIN 250 MG/5 ML ORAL SUSR,17.5,12.25,,,0
CDM,35402,CETIRIZINE 10 MG ORAL TAB,14.0,9.8,,,0
CDM,35402,CETIRIZINE 5 MG/5 ML ORAL SOLN,26.0,18.2,,,0
CDM,35402,CHLORDIAZEPOXIDE 25 MG CAP,8.0,5.6,,,0
CDM,35402,CIPROFLOXACIN 250 MG ORAL TAB,25.0,17.5,,,0
CDM,35402,CIPROFLOXACIN 500 MG ORAL TAB,23.0,16.1,,,0
CDM,35402,CLINDAMYCIN 150 MG CAP,9.0,6.3,,,0
CDM,35402,CLINDAMYCIN 150 MG/ML INJECTION,34.5,24.15,,,0
CDM,35402,CLONAZEPAM 1 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,CLONIDINE 0.1 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,CLONIDINE 0.2 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,COLCHICINE 0.6 MG ORAL TAB,68.5,47.95,,,0
CDM,35402,CONJUGATED ESTROGENS 0.625 MG/G VAGL CREA,1257.5,880.25,,,0
CDM,35402,CUPRIC CHLORIDE 0.4 MG/ML IV SOLN,87.0,60.9,,,0
CDM,35402,CYCLOBENZAPRINE 10 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,DEXAMETHASONE 0.75 MG ORAL TAB,9.0,6.3,,,0
CDM,35402,DEXAMETHASONE 10 MG/ML INJECTION,53.5,37.45,,,0
CDM,35402,DEXAMETHASONE 4 MG ORAL TAB,21.5,15.05,,,0
CDM,35402,DEXAMETHASONE 4 MG/ML INJECTION,19.0,13.3,,,0
CDM,35402,DEXAMETHASONE SODIUM PHOS (PF) 10MG/ML INJ SOLN,27.5,19.25,,,0
CDM,35402,DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML SYRUP,16.0,11.2,,,0
CDM,35402,DEXTROSE 40 % ORAL GEL,22.0,15.4,,,0
CDM,35402,DEXTROSE 5% IN NORMAL SALINE IV,39.0,27.3,,,0
CDM,35402,DIAZEPAM  5 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,DICLOFENAC 1 % TOPICAL GEL,77.0,53.9,,,0
CDM,35402,DICYCLOMINE 10 MG ORAL CAP,8.0,5.6,,,0
CDM,35402,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,17.0,11.9,,,0
CDM,35402,DIPHENHYDRAMINE 25 MG CAP,7.0,4.9,,,0
CDM,35402,DIPHENHYDRAMINE 50 MG CAP,7.0,4.9,,,0
CDM,35402,DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,23.0,16.1,,,0
CDM,35402,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TAB,24.0,16.8,,,0
CDM,35402,"DIPHTH,PERTUS(ACELL),TETANUS SYRG(BOOSTRIX) 2.5-8-5 LF-MCG-LF/0.5ML IM SYRG",247.0,172.9,,,0
CDM,35402,DIVALPROEX 125 MG ORAL CPSP,14.0,9.8,,,0
CDM,35402,DIVALPROEX 250 MG ORAL TBEC,7.0,4.9,,,0
CDM,35402,DOCUSATE SODIUM 100 MG ORAL CAP,7.0,4.9,,,0
CDM,35402,DORZOLAMIDE-TIMOLOL 2 %-0.5 % EYE DROPS,440.0,308.0,,,0
CDM,35402,DOXYCYCLINE 100 MG TAB,15.0,10.5,,,0
CDM,35402,DOXYCYCLINE HYCLATE 100 MG ORAL TAB,28.0,19.6,,,0
CDM,35402,DULOXETINE 30 MG ORAL CPDR,59.5,41.650000000000006,,,0
CDM,35402,DULOXETINE 60 MG ORAL CPDR,27.0,18.9,,,0
CDM,35402,DUPILUMAB 200 MG/1.14 ML SUBQ PNIJ,5511.0,3857.7,,,0
CDM,35402,DUPILUMAB 300 MG/2 ML SUBQ PNIJ,5511.0,3857.7,,,0
CDM,35402,EMTRICITABINE-TENOFOVIR 200 MG-300 MG TAB,297.0,207.9,,,0
CDM,35402,EPINEPHRINE 1 MG/ML (1ML) INJ SOLN (FOR IRRIGATION ONLY),80.0,56.0,,,0
CDM,35402,ERYTHROMYCIN 5 MG/G OPHT OINT,76.5,53.550000000000004,,,0
CDM,35402,ESCITALOPRAM 10 MG ORAL TAB,36.5,25.55,,,0
CDM,35402,ESKETAMINE 56 MG (28 MG X 2) NASL SPRY,1159.0,811.3,,,0
CDM,35402,ESKETAMINE 84 MG (28 MG X 3) NASL SPRY,5213.0,3649.1,,,0
CDM,35402,ETHYL CHLORIDE 100 % TOP SPRA,194.0,135.8,,,0
CDM,35402,FAMOTIDINE (PF) 20 MG/2 ML IV SOLN,16.0,11.2,,,0
CDM,35402,FAMOTIDINE 20 MG ORAL TAB,9.5,6.65,,,0
CDM,35402,FAMOTIDINE 40 MG/5 ML ORAL SUSP,40.0,28.0,,,0
CDM,35402,FENTANYL  12 MCG/HR TD PT72,100.0,70.0,,,0
CDM,35402,FENTANYL  25 MCG/HR TD PT72,104.0,72.8,,,0
CDM,35402,FENTANYL  50 MCG/HR TD PT72,191.0,133.7,,,0
CDM,35402,FENTANYL 100 MCG/HR TD PT72,227.0,158.9,,,0
CDM,35402,FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN,17.5,12.25,,,0
CDM,35402,FERRIC SUBSULFATE 0.2 TO 0.22 GRAM/ML MISC SOLA,53.0,37.1,,,0
CDM,35402,FLUCONAZOLE 100 MG ORAL TAB,95.0,66.5,,,0
CDM,35402,FLUMAZENIL 0.1 MG/ML IV SOLN,19.0,13.3,,,0
CDM,35402,FLUORESCEIN 1 MG OPHT STRP,7.0,4.9,,,0
CDM,35402,FLUOXETINE 20 MG ORAL CAP,10.5,7.3500000000000005,,,0
CDM,35402,FLUOXETINE 20 MG/5 ML ORAL SOLN,55.0,38.5,,,0
CDM,35402,FLUTICASONE  50 MCG/ACTUATION NASL SPSN,362.0,253.4,,,0
CDM,35402,FUROSEMIDE 20 MG ORAL TAB,9.5,6.65,,,0
CDM,35402,GABAPENTIN 100 MG ORAL CAP,7.0,4.9,,,0
CDM,35402,GABAPENTIN 300 MG ORAL CAP,12.0,8.399999999999999,,,0
CDM,35402,GENTIAN VIOLET 1 % TOP SOLN,47.0,32.9,,,0
CDM,35402,GLYCERIN (ADULT) RECTAL SUPPOSITORY,7.0,4.9,,,0
CDM,35402,GLYCERIN (CHILD) RECTAL SUPPOSITORY,7.0,4.9,,,0
CDM,35402,GUAIFENESIN 100 MG/5 ML ORAL LIQD,16.5,11.55,,,0
CDM,35402,GUAIFENESIN 600 MG ORAL TP12,9.5,6.65,,,0
CDM,35402,HALOPERIDOL  2 MG ORAL TAB,10.0,7.0,,,0
CDM,35402,HALOPERIDOL 2 MG/ML ORAL CONCENTRATE,10.0,7.0,,,0
CDM,35402,HONEY 100 % TOP PSTE,59.0,41.3,,,0
CDM,35402,HYDRALAZINE  25 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,HYDROCHLOROTHIAZIDE  25 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,HYDROCODONE-ACETAMINOPHEN 5 MG-325 MG TAB,7.0,4.9,,,0
CDM,35402,HYDROCODONE-ACETAMINOPHEN 7.5 MG-325 MG/15 ML ORAL SOLN (REPACK),7.0,4.9,,,0
CDM,35402,HYDROCORTISONE  1 % TOP CREA,29.5,20.65,,,0
CDM,35402,HYDROCORTISONE-ALOE VERA 1 % TOP CREA,22.0,15.4,,,0
CDM,35402,HYDROMORPHONE  2 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,HYDROXYZINE 25 MG TAB,9.0,6.300000000000001,,,0
CDM,35402,HYDROXYZINE PAMOATE  25 MG ORAL CAP,7.0,4.9,,,0
CDM,35402,"HYOSCYAMINE 0.125 MG TAB, RAPID DISSOLVE",7.0,4.9,,,0
CDM,35402,HYOSCYAMINE SULFATE 0.125 MG ORAL TAB,12.0,8.4,,,0
CDM,35402,IBUPROFEN 100 MG ORAL CHEW,7.0,4.9,,,0
CDM,35402,IBUPROFEN 100 MG/5 ML ORAL SUSP,17.0,11.9,,,0
CDM,35402,IBUPROFEN 200 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,IBUPROFEN 400 MG ORAL TAB,5.5,3.85,,,0
CDM,35402,IBUPROFEN 600 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,IBUPROFEN 800 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,IPRATROPIUM BROMIDE 0.02 % INHL SOLN,16.0,11.2,,,0
CDM,35402,IPRATROPIUM-ALBUTEROL 0.5 MG-2.5 MG/3 ML NEB SOLUTION,12.5,8.75,,,0
CDM,35402,IRBESARTAN 150 MG ORAL TAB,18.0,12.6,,,0
CDM,35402,KETAMINE 100 MG/ML INJ SOLN,79.0,55.3,,,0
CDM,35402,KETAMINE 50 MG/5ML (10 MG/ML) SYRINGE (PHS MERGE),19.0,13.3,,,0
CDM,35402,KETOROLAC TROMETHAMINE 15 MG/ML INJ SOLN,18.5,12.95,,,0
CDM,35402,LABETALOL 100 MG ORAL TAB,8.5,5.95,,,0
CDM,35402,LABETALOL 5 MG/ML IV SOLN,31.5,22.049999999999997,,,0
CDM,35402,LACTULOSE 10 GRAM/15 ML ORAL SOLN,11.0,7.7,,,0
CDM,35402,LACTULOSE 20 GRAM/30 ML ORAL SOLN,13.0,9.1,,,0
CDM,35402,LATANOPROST 0.005 % OPHT DROP,403.5,282.45000000000005,,,0
CDM,35402,LET TOP SOLN 5ML (COMPOUNDED),115.0,80.5,,,0
CDM,35402,LET TOPICAL GEL 3 ML,56.0,39.2,,,0
CDM,35402,LEVETIRACETAM  500 MG ORAL TAB,18.0,12.6,,,0
CDM,35402,LEVONORGESTREL 1.5 MG ORAL TAB,191.0,133.7,,,0
CDM,35402,LEVOTHYROXINE  50 MCG ORAL TAB,8.0,5.6,,,0
CDM,35402,LEVOTHYROXINE  75 MCG ORAL TAB,7.0,4.9,,,0
CDM,35402,LEVOTHYROXINE  88 MCG ORAL TAB,7.0,4.9,,,0
CDM,35402,LEVOTHYROXINE 100 MCG ORAL TAB,4.0,2.8,,,0
CDM,35402,LEVOTHYROXINE 112 MCG ORAL TAB,5.5,3.85,,,0
CDM,35402,LEVOTHYROXINE 25 MCG ORAL TAB,5.5,3.85,,,0
CDM,35402,"LIDO-EPI WITH 8.4% SOD BICARB 1 %- 1:100,000 (3 ML) INJ SYRG",72.0,50.400000000000006,,,0
CDM,35402,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,50.0,35.0,,,0
CDM,35402,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,29.0,20.3,,,0
CDM,35402,LIDOCAINE 1% 10MG/ML (1ML-UD) OR SYRINGE,14.5,10.15,,,0
CDM,35402,LIDOCAINE 1%/EPINEPHRINE 1:200K INJECTION (PF),16.0,11.2,,,0
CDM,35402,LIDOCAINE 10 MG/ML (1 %) INJECTION,35.5,24.85,,,0
CDM,35402,LIDOCAINE 2 % MUCOSAL GEL,463.0,324.1,,,0
CDM,35402,LIDOCAINE 2 % MUCOSAL SOLN (VISCOUS),28.0,19.6,,,0
CDM,35402,LIDOCAINE 2% 20MG/ML (5ML-UD) OR SYRINGE,19.5,13.65,,,0
CDM,35402,LIDOCAINE 20 MG/ML (2 %) INJECTION,27.0,18.9,,,0
CDM,35402,LIDOCAINE 4 % MUCOSAL TOPICAL SOLN,255.0,178.5,,,0
CDM,35402,LIDOCAINE 4 % TOP CREA,54.0,37.8,,,0
CDM,35402,LIDOCAINE 4% TOP PATCH,17.0,11.9,,,0
CDM,35402,LIDOCAINE 5 % TOP OINT,803.0,562.1,,,0
CDM,35402,LIDOCAINE HCL  2 % MM JELP,43.0,30.1,,,0
CDM,35402,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN",26.0,18.2,,,0
CDM,35402,"LIDOCAINE-EPINEPHRINE 1 %-1:200,000 INJ SOLN",80.0,56.0,,,0
CDM,35402,"LIDOCAINE-EPINEPHRINE 2 %-1:200,000 INJ SOLN",28.0,19.6,,,0
CDM,35402,LIOTHYRONINE  5 MCG ORAL TAB,12.5,8.75,,,0
CDM,35402,"LIPASE-PROTEASE-AMYLASE 24,000-76,000- 120,000 UNIT ORAL CAP, DELAY REL",50.0,35.0,,,0
CDM,35402,LISINOPRIL  5 MG ORAL TAB,9.0,6.300000000000001,,,0
CDM,35402,LISINOPRIL 10 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,LISINOPRIL 20 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,LOPERAMIDE 2 MG ORAL CAP,10.0,7.0,,,0
CDM,35402,LORATADINE 10 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,LORAZEPAM 0.5 MG ORAL TAB,15.0,10.5,,,0
CDM,35402,LORAZEPAM 1 MG ORAL TAB,8.5,5.95,,,0
CDM,35402,LOSARTAN  25 MG ORAL TAB,8.5,5.95,,,0
CDM,35402,MAGNESIUM CITRATE ORAL SOLN,11.5,8.05,,,0
CDM,35402,MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSP,13.5,9.45,,,0
CDM,35402,MAGNESIUM OXIDE 400 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,MECLIZINE 12.5 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,MECLIZINE 25 MG ORAL TAB,8.5,5.95,,,0
CDM,35402,MELATONIN  3 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,"MENING A,C,Y,W TT-N. MEN B(PF) 5-120 MCG/0.5 ML IM KIT",817.0,571.9,,,0
CDM,35402,"MENING A,C,Y,W TT-N. MEN B(PF) 5-120 MCG/0.5 ML IM KIT (CAM USE ONLY)",727.0,508.9,,,0
CDM,35402,METHADONE  5 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,METHADONE 10 MG ORAL TAB,10.0,7.0,,,0
CDM,35402,METHOCARBAMOL 500 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,METOCLOPRAMIDE  5 MG ORAL TAB,8.0,5.6,,,0
CDM,35402,METOCLOPRAMIDE 10 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,METOPROLOL SUCCINATE SR 25 MG 24 HR TAB,10.0,7.0,,,0
CDM,35402,METOPROLOL SUCCINATE SR 50 MG 24 HR TAB,7.0,4.9,,,0
CDM,35402,METOPROLOL TARTRATE 100 MG TAB,7.0,4.9,,,0
CDM,35402,METOPROLOL TARTRATE 25 MG TAB,7.0,4.9,,,0
CDM,35402,METOPROLOL TARTRATE 5 MG/5 ML IV,16.0,11.2,,,0
CDM,35402,METRONIDAZOLE 500 MG ORAL TAB,15.0,10.5,,,0
CDM,35402,MIDAZOLAM (PF) 1 MG/ML INJ SOLN,8.5,5.949999999999999,,,0
CDM,35402,MIDODRINE  5 MG ORAL TAB,16.0,11.2,,,0
CDM,35402,MIFEPRISTONE 200 MG ORAL TAB,285.0,199.5,,,0
CDM,35402,MIRTAZAPINE 15 MG ORAL TAB,24.0,16.799999999999997,,,0
CDM,35402,MISOPROSTOL 200 MCG ORAL TAB,54.0,37.8,,,0
CDM,35402,MISOPROSTOL 800 MCG (4 X 200 MCG TAB) PACKAGE,34.0,23.8,,,0
CDM,35402,MONTELUKAST 10 MG ORAL TAB,31.0,21.7,,,0
CDM,35402,MORPHINE CONCENTRATE 10 MG/ 0.5 ML ORAL SYRINGE (0.5ML UD MERGE),7.0,4.9,,,0
CDM,35402,MOXIFLOXACIN 0.5 % OPHT DROP,603.0,422.1,,,0
CDM,35402,MOXIFLOXACIN 400 MG ORAL TAB,133.0,93.1,,,0
CDM,35402,MUPIROCIN 2 % TOP OINT,210.0,147.0,,,0
CDM,35402,"N.MENINGITIDIS B,LIPID FHBP RC 120 MCG/0.5 ML IM SYRG",859.0,601.3,,,0
CDM,35402,NALOXONE 4 MG/ACTUATION NASL SPRY,286.5,200.55,,,0
CDM,35402,NEMOLIZUMAB-ILTO 30 MG SUBQ PNIJ,9752.0,6826.4,,,0
CDM,35402,NEOMYCIN-BACITRACIN ZN-POLYMYXIN 3.5 MG-400 UN*,25.0,17.5,,,0
CDM,35402,NEOMYCIN-BACITRACN ZN-POLYMYXIN 3.5 MG-400 U*,9.0,6.3,,,0
CDM,35402,"NEOMYCIN-POLYMYXIN-HC 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS, SUSP",370.5,259.35,,,0
CDM,35402,NICOTINE  7 MG/24 HR TD PT24,24.0,16.8,,,0
CDM,35402,NICOTINE 14 MG/24 HR TD PT24,12.0,8.4,,,0
CDM,35402,NICOTINE 21 MG/24 HR TD PT24,13.0,9.100000000000001,,,0
CDM,35402,NITROFURANTOIN (25% MACROCRYSTAL FORM) 100 MG CAP,18.0,12.6,,,0
CDM,35402,NITROGLYCERIN 0.4 MG SL SUBL,9.0,6.300000000000001,,,0
CDM,35402,NYSTATIN  100000 UNIT/G TOP POWD,135.0,94.5,,,0
CDM,35402,OLANZAPINE  2.5 MG ORAL TAB,165.0,115.5,,,0
CDM,35402,OLANZAPINE  5 MG ORAL TBDL,23.0,16.1,,,0
CDM,35402,ONDANSETRON 4 MG ORAL TBDL,97.0,67.9,,,0
CDM,35402,ONDANSETRON 8 MG ORAL TBDL,180.0,126.0,,,0
CDM,35402,ONDANSETRON HCL  4 MG ORAL TAB,119.0,83.3,,,0
CDM,35402,ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN,16.0,11.2,,,0
CDM,35402,ONDANSETRON HCL 4 MG/5 ML ORAL SOLN,57.0,39.9,,,0
CDM,35402,OSELTAMIVIR  6 MG/ML ORAL SUSR,100.5,70.35,,,0
CDM,35402,OSELTAMIVIR PHOSPHATE 30 MG ORAL CAP,104.5,73.15,,,0
CDM,35402,OSELTAMIVIR PHOSPHATE 75 MG ORAL CAP,83.0,58.1,,,0
CDM,35402,OXYBUTYNIN CHLORIDE  5 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,OXYCODONE  15 MG ORAL TAB,17.5,12.25,,,0
CDM,35402,OXYCODONE 5 MG ORAL TAB,10.0,7.0,,,0
CDM,35402,OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TAB,11.0,7.7,,,0
CDM,35402,OXYMETAZOLINE 0.05 % NASAL MERGE,12.5,8.75,,,0
CDM,35402,OXYMETAZOLINE 0.05 % NASL SPRA,20.0,14.0,,,0
CDM,35402,PANTOPRAZOLE 40 MG IV SOLR,41.0,28.700000000000003,,,0
CDM,35402,PANTOPRAZOLE 40 MG ORAL TBEC,23.0,16.1,,,0
CDM,35402,PEGINTERFERON ALFA-2A 180 MCG/ML SUBQ SOLN,1794.5,1256.15,,,0
CDM,35402,PENICILLIN G POTASSIUM  5000000 UNIT INJ SOLR,16.0,11.2,,,0
CDM,35402,PENICILLIN V POTASSIUM 250 MG ORAL TAB,10.0,7.0,,,0
CDM,35402,PHENAZOPYRIDINE 100 MG ORAL TAB,11.0,7.7,,,0
CDM,35402,PHENYLEPHRINE 1 % NASAL SPRAY AEROSOL,25.0,17.5,,,0
CDM,35402,PHENYLEPHRINE HCL  0.5 % NASL SPRY,24.0,16.8,,,0
CDM,35402,PHENYLEPHRINE IN 0.9% NS (PF) 1 MG/10 ML (100 MCG/ML) IV SYRG(PDS MERGE),20.0,14.0,,,0
CDM,35402,PHYTONADIONE 5 MG ORAL TAB,148.5,103.94999999999999,,,0
CDM,35402,PILOCARPINE 2 % EYE DROPS,363.0,254.1,,,0
CDM,35402,POLYETHYLENE GLYCOL 3350 17 GRAM (100 %) ORAL PWPK,8.0,5.6,,,0
CDM,35402,POTASSIUM BICARB-CITRIC ACID 20 MEQ ORAL TBEF,7.5,5.25,,,0
CDM,35402,POTASSIUM CHLORIDE  10 MEQ ORAL CPSR,17.0,11.9,,,0
CDM,35402,POTASSIUM CHLORIDE  20 MEQ ORAL PACK,106.0,74.2,,,0
CDM,35402,POTASSIUM CHLORIDE  20 MEQ ORAL TBTQ,7.0,4.9,,,0
CDM,35402,POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML IV SOLP,77.0,53.9,,,0
CDM,35402,PRAZOSIN 1 MG ORAL CAP,9.0,6.3,,,0
CDM,35402,PREDNISOLONE 15 MG/5 ML ORAL SOLN,16.0,11.2,,,0
CDM,35402,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (5 ML) ORAL SOLN,21.5,15.05,,,0
CDM,35402,PREDNISONE  1 MG ORAL TAB,62.0,43.4,,,0
CDM,35402,PREDNISONE  5 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,PREDNISONE 10 MG ORAL TAB,6.0,4.2,,,0
CDM,35402,PREDNISONE 20 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,PREDNISONE 50 MG ORAL TAB,18.0,12.6,,,0
CDM,35402,PREGABALIN  25 MG ORAL CAP,18.0,12.6,,,0
CDM,35402,PREGABALIN  50 MG ORAL CAP,196.0,137.2,,,0
CDM,35402,PREGABALIN  75 MG ORAL CAP,13.5,9.45,,,0
CDM,35402,PROCHLORPERAZINE MALEATE 10 MG ORAL TAB,10.0,7.0,,,0
CDM,35402,PROMETHAZINE  6.25 MG/5 ML ORAL SYRP,43.0,30.1,,,0
CDM,35402,PROMETHAZINE 25 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,PROMETHAZINE 25 MG RECT SUPP,87.0,60.9,,,0
CDM,35402,PROPARACAINE 0.5 % OPHT DROP,206.0,144.2,,,0
CDM,35402,PROPOFOL 10 MG/ML 20ML BOLUS IV EMUL,40.0,28.0,,,0
CDM,35402,PSEUDOEPHEDRINE 30 MG TAB,7.0,4.9,,,0
CDM,35402,QUETIAPINE  25 MG ORAL TAB,10.0,7.0,,,0
CDM,35402,RACEPINEPHRINE 2.25 % INHL NEBU,14.0,9.8,,,0
CDM,35402,RALTEGRAVIR 400 MG ORAL TAB,200.0,140.0,,,0
CDM,35402,RISPERIDONE 0.25 MG ORAL TAB,22.0,15.4,,,0
CDM,35402,RIVAROXABAN 10 MG ORAL TAB,234.0,163.8,,,0
CDM,35402,RIVAROXABAN 15 MG ORAL TAB,114.5,80.15,,,0
CDM,35402,ROPEGINTERFERON ALFA-2B-NJFT 500 MCG/ML SUBQ SYRG,23234.0,16263.8,,,0
CDM,35402,"ROTAVIRUS VAC,LIVE ATT, 89-12 STRAIN G1P(8) 10EXP6 CCID50/ML ORAL SUSP",913.0,639.1,,,0
CDM,35402,"ROTAVIRUS VACCINE LIVE, PENTA 2 ML ORAL SUSP",252.0,176.4,,,0
CDM,35402,"ROTAVIRUS VACCINE, LIVE, 89-12 10EXP6 CCID50 /1.5 ML ORAL SUSP",511.5,358.05,,,0
CDM,35402,SEMAGLUTIDE 1 MG/DOSE (4 MG/3 ML) SUBQ PNIJ,2754.0,1927.8,,,0
CDM,35402,SENNOSIDES  8.6 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,SENNOSIDES-DOCUSATE SODIUM 8.6 MG-50 MG TAB,5.5,3.85,,,0
CDM,35402,SERTRALINE  50 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,SERTRALINE 100 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,21.0,14.700000000000001,,,0
CDM,35402,SILVER SULFADIAZINE 1 % TOP CREA,96.5,67.55000000000001,,,0
CDM,35402,SIMETHICONE  80 MG ORAL CHEW,7.0,4.9,,,0
CDM,35402,SIMETHICONE 40 MG/0.6 ML ORAL DRPS,7.0,4.9,,,0
CDM,35402,SODIUM BICARBONATE 8.4 % IV (PHS ERX MERGE),53.0,37.099999999999994,,,0
CDM,35402,SODIUM BICARBONATE 8.4 % IV SOLN,58.0,40.6,,,0
CDM,35402,SODIUM CHLORIDE  0.65 % NASL SPRA,7.0,4.9,,,0
CDM,35402,SODIUM CHLORIDE  7 % INHL NEBU,7.0,4.9,,,0
CDM,35402,SODIUM CHLORIDE 0.45 % 0.45 % IV SOLP,32.0,22.4,,,0
CDM,35402,SODIUM CHLORIDE 0.9 % INHL NEBU,7.0,4.9,,,0
CDM,35402,SODIUM CHLORIDE 0.9 % INJ SOLN (VIAL),25.0,17.5,,,0
CDM,35402,SODIUM CHLORIDE 0.9 % INJ SYRG,18.5,12.95,,,0
CDM,35402,SODIUM CHLORIDE 0.9 % IV SOLP,51.0,35.7,,,0
CDM,35402,SODIUM POLYSTYRENE SULF-SORBTL 15-20 GRAM/60 ML ORAL SUSP,208.0,145.60000000000002,,,0
CDM,35402,SPIRONOLACTONE  25 MG ORAL TAB,8.0,5.6,,,0
CDM,35402,SPIRONOLACTONE 100 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,SUCRALFATE 100 MG/ML ORAL SUSP,59.0,41.3,,,0
CDM,35402,SUMATRIPTAN 25 MG TAB,230.0,161.0,,,0
CDM,35402,TAMSULOSIN 0.4 MG ORAL CP24,24.0,16.8,,,0
CDM,35402,TEMAZEPAM  7.5 MG ORAL CAP,53.0,37.1,,,0
CDM,35402,TESTOSTERONE  75 MG IMPL PLLT,10333.5,7233.45,,,0
CDM,35402,TETRACAINE 0.5 % EYE DROPS,159.0,111.3,,,0
CDM,35402,TETRACAINE HCL (PF) 0.5 % OPHT DROP (STANDARD STOCK),78.0,54.6,,,0
CDM,35402,THIAMINE 100 MG TAB,7.0,4.9,,,0
CDM,35402,TIMOLOL MALEATE 0.5 % OPHT DROP,84.0,58.8,,,0
CDM,35402,TOBRAMYCIN 0.3 % EYE DROPS,167.0,116.9,,,0
CDM,35402,TOBRAMYCIN 0.3 % EYE OINTMENT,947.0,662.9,,,0
CDM,35402,TRAMADOL  50 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,TRANEXAMIC ACID (FOR TOPICAL USE),42.0,29.4,,,0
CDM,35402,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN",118.0,82.6,,,0
CDM,35402,"TRANEXAMIC ACID IN NACL,ISO-OS 1,000 MG/100 ML (10 MG/ML) IV PGBK",124.0,86.8,,,0
CDM,35402,TRAZODONE  50 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,TRIAMCINOLONE ACETONIDE 0.025 % TOP OINT,34.0,23.8,,,0
CDM,35402,TRICHLOROACETIC ACID 80 % TOP SOLN,329.0,230.3,,,0
CDM,35402,TRIMETHOPRIM-SULFAMETHOXAZOLE 160 MG-800 MG TAB,7.0,4.9,,,0
CDM,35402,TROPICAMIDE 0.5 % OPHT DROP,127.0,88.9,,,0
CDM,35402,TROPICAMIDE 1 % OPHT DROP,69.0,48.3,,,0
CDM,35402,"TYPHOID VACCINE 2 BILLION UNIT CAP, DELAYED RELEASE",165.0,115.5,,,0
CDM,35402,VALACYCLOVIR 500 MG ORAL TAB,19.0,13.3,,,0
CDM,35402,VENLAFAXINE 150 MG ORAL CP24,26.0,18.2,,,0
CDM,35402,VERAPAMIL 120 MG ORAL TAB,7.0,4.9,,,0
CDM,35402,WARFARIN  5 MG ORAL TAB,8.0,5.6,,,0
CDM,35402,"WATER FOR INJECTION, STERILE INJECTION",30.0,21.0,,,0
CDM,35444,PEGFILGRASTIM-CBQV 6 MG/0.6 ML SUBQ SYRG,11523.0,8066.1,,,0
CDM,35526,"MENINGOCOCCAL B VACC,4-CMP(PF) 50-50-50-25 MCG/0.5 ML IM SYRG",792.0,554.4,,,0
CDM,35715,"DIP,PER(A)TET-HEPB-POL-HIB(PF) 15 UNIT-5 UNIT- 10 MCG/0.5 ML IM INJ MERGE (CAM USE ONLY)",652.5,456.75,,,0
CDM,35715,"DIP,PER(A)TET-HEPB-POL-HIB(PF) 15 UNIT-5 UNIT- 10 MCG/0.5 ML IM SYRG",421.0,294.7,,,0
CDM,35715,"DIPH,PERTUS(ACEL),TET,POLIO(PF)(KINRIX) 25 LF-58 MCG-10 LF/0.5 ML IM SYRINGE",318.0,222.6,,,0
CDM,35715,POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML INJ SUSP,124.0,86.8,,,0
CDM,35727,PEGFILGRASTIM (NEULASTA) 6 MG/0.6ML SUBQ SYRG,13749.0,9624.3,,,0
CDM,35727,PEGFILGRASTIM 6 MG/0.6 ML SUBQ W/ ON BODY INJECTOR,17714.0,12399.8,,,0
CDM,35776,FILGRASTIM-SNDZ 300 MCG/0.5 ML INJ SYRG,974.0,681.8,,,0
CDM,35776,FILGRASTIM-SNDZ 480 MCG/0.8 ML INJ SYRG,1212.0,848.4,,,0
CDM,35787,AMIVANTAMAB-VMJW 50 MG/ML IV SOLN,28823.5,20176.45,,,0
CDM,35799,IOHEXOL 240 MG/ML IV SOLN,108.0,75.6,,,0
CDM,35979,POLATUZUMAB VEDOTIN-PIIQ 20 MG/ML IV WET SOLR VIAL (RECON 140 MG VIAL),25834.0,18083.8,,,0
CDM,36000002,HC DRESSING CHANGE W/ ANESTHESIA,3030.0,2121.0,,,0
CDM,36000006,HC BRONCH FB REMOVAL,2833.0,1983.1,,,0
CDM,36000009,HC PERQ TRANSCATH STENT CERV CAROTID,7247.0,5072.9,,,0
CDM,36000010,HC EXC LINGUAL FRENUM,801.0,560.7,,,0
CDM,36000013,HC REP OF OMPHALOCELE,3632.0,2542.4,,,0
CDM,36000014,HC PDA LIGATION,6576.0,4603.2,,,0
CDM,36000015,US ENDOBRONCHIAL ADD-ON,2496.0,1747.2,,,0
CDM,36000016,DX BRONCHOSCOPE/BRUSH,3258.0,2280.6,,,0
CDM,36000017,HC DX BRONCHOSCOPE/LAVAGE,3748.0,2623.6,,,0
CDM,36000018,HC BRONCHOSCOPY RIGID/FLEX INCL FLUORO GUIDE W/TRANSBRONCHIAL LUNG BIOPSY(S) SINGLE LOBE,2979.0,2085.3,,,0
CDM,36000020,NAVIGATIONAL BRONCHOSCOPY,314.0,219.8,,,0
CDM,36000021,BRONCH NEEDLE ASP BX EACH,3427.0,2398.9,,,0
CDM,36000022,BRONCH DILATE W/STENT,6489.0,4542.3,,,0
CDM,36000023,BRONCH NEEDLE BX ADDL LOBE,753.0,527.1,,,0
CDM,36000024,HC ABLATION THER 1 OR MORE PULM TUMORS INCL PLEURA/CHEST WALL WHEN INVOL BY TUMOR EXT PERQ  INCL GUIDE WHEN PEF UNILATERAL CRYOABLATION,3210.0,2247.0,,,0
CDM,36000025,BRONCH W/BALLOON OCCLUSION,6489.0,4542.3,,,0
CDM,36000026,BRONCH W/PLMT BRONC STENT INIT,7463.0,5224.1,,,0
CDM,36000027,BRONCH W/PCMT BRONC STENT ADDI,794.0,555.8,,,0
CDM,36000028,HC BRONCH W/REVI TRAC/BRONC STENT,3878.0,2714.6,,,0
CDM,36000029,HC BRONCHOSCOPY W/THERAPEUTIC ASPIRATION OF TRACHBRNCL TREE INITIAL,4722.0,3305.4,,,0
CDM,36000035,HC OR ACUITY 1,4455.0,3118.5,,,0
CDM,36000036,HC OR ACUITY 2,8105.0,5673.5,,,0
CDM,36000037,HC OR ACUITY 3,12329.0,8630.3,,,0
CDM,36000038,HC OR ACUITY 4,18147.0,12702.9,,,0
CDM,36000039,HC OR ACUITY 5,27329.0,19130.3,,,0
CDM,36000044,HC C-SECTION FIRST HALF HOUR,8018.0,5612.6,,,0
CDM,36000045,HC ABDOMINAL HYSTERECTOMY FIRST HALF HOUR,9778.0,6844.6,,,0
CDM,36000046,HC D & C FIRST HALF HOUR,5902.0,4131.4,,,0
CDM,36000047,HC LAC REPAIR FIRST HALF HOUR,6811.0,4767.7,,,0
CDM,36000048,HC 4TH DEGREE LAC REP FIRST HALF HOUR,2651.0,1855.7,,,0
CDM,36000050,HC OR L&D STAFF 2 15 MIN,608.0,425.6,,,0
CDM,36000051,HC OR L&D STAFF 3 15 MIN,810.0,567.0,,,0
CDM,36000052,HC OR L&D STAFF > 3 15 MIN,1013.0,709.1,,,0
CDM,36000079,HC OR STAFF 1 15 MIN,440.0,308.0,,,0
CDM,36000080,HC OR STAFF 2 15 MIN,656.0,459.2,,,0
CDM,36000081,HC OR STAFF 3 15 MIN,876.0,613.2,,,0
CDM,36000082,HC OR STAFF > 3 15 MIN,1095.0,766.5,,,0
CDM,36000086,HC COSMETIC SURGERY 1 HR,1400.0,980.0,,,0
CDM,36000088,HC COSMETIC SURGERY 1.5 HRS,2100.0,1470.0,,,0
CDM,36000090,HC COSMETIC SURGERY 2 HRS,2800.0,1960.0,,,0
CDM,36000092,HC COSMETIC SURGERY 2.5 HRS,3500.0,2450.0,,,0
CDM,36000094,HC COSMETIC SURGERY 3 HRS,4200.0,2940.0,,,0
CDM,36000096,HC COSMETIC SURGERY 3.5 HRS,4900.0,3430.0,,,0
CDM,36000098,HC COSMETIC SURGERY 4 HRS,5600.0,3920.0,,,0
CDM,36000100,HC COSMETIC SURGERY 4.5 HRS,6300.0,4410.0,,,0
CDM,36000102,HC COSMETIC SURGERY 5 HRS,7000.0,4900.0,,,0
CDM,36000104,HC COSMETIC SURGERY 5.5 HRS,7700.0,5390.0,,,0
CDM,36000106,HC COSMETIC SURGERY 6 HRS,8400.0,5880.0,,,0
CDM,36000110,HC COSMETIC SECONDARY EA ADDTL 15 MIN,71.0,49.7,,,0
CDM,36000111,HC COSMETIC OVERNIGHT STAY,711.0,497.7,,,0
CDM,36000112,HC ESOPH ENDOSCOPY ABLA (HALO BARX),14105.0,9873.5,,,0
CDM,36000113,HC PERIURETHRAL LACERATION REPAIR,5605.0,3923.5,,,0
CDM,36000114,HC CIRCLAGE CERVIX INSERT/REMOVAL,2516.0,1761.2,,,0
CDM,36000116,HC UTERINE INVERSION,8714.0,6099.8,,,0
CDM,36000118,HC REMOVAL CERVICAL CERCLAGE,635.0,444.5,,,0
CDM,36000119,HC EVACUATION OF HEMATOMA,7355.0,5148.5,,,0
CDM,36000122,HC PERFUSIONIST,6680.0,4676.0,,,0
CDM,36000123,HC EXPLORATORY LAP/CELIOTOMY W/WO BIOPSY,10057.0,7039.9,,,0
CDM,36000124,HC BRONCHIAL VALVE INSERT INIT,5523.0,3866.1,,,0
CDM,36000125,HC BRONCHIAL VALVE INSERT ADDL,1073.0,751.1,,,0
CDM,36000126,HC BRONCHIAL VALVE REMOV INIT,4694.0,3285.8,,,0
CDM,36000127,HC BRONCHIAL VALVE REMOV ADDL,1224.0,856.8,,,0
CDM,36000132,HC BRONCHOSCOPY RIGID/FLEX INCL FLUORO DX W/ CELL WASHING,2833.0,1983.1,,,0
CDM,36000137,HC CLOSURE MEDIAN STERNOTOMY SEPARATION W/WO DEBRIDEMENT,2966.0,2076.2,,,0
CDM,36000140,HC BRONCHOSCOPY RIGID/FLEX INCL FLURO GUIDE W/TRACHEAL/BRONCHIAL DILATION OR CLSD REDUCTION OF FX,3942.0,2759.4,,,0
CDM,36000147,HC BRONCHOSCOPY RIGID/FLEXIBLE INCL FLUORO GUIDE W/EXCISION OF TUMOR,13532.0,9472.4,,,0
CDM,36000149,HC PLEURAL DRAINAGE PERCUTANEOUS W/INSERTION OF INDWELLING CATHETER W/O IMAGING GUIDE,2504.0,1752.8,,,0
CDM,36000157,HC DENTAL VERT BITEWINGS-SEV TO EIGHT,1879.0,1315.3,,,0
CDM,36000166,HC BRONCH RIGID/FLEX W/ EBUS SAMPLING 1 OR 2 NODE,8379.0,5865.3,,,0
CDM,36000167,HC BRONCH RIGID/FLEX INCL FLUORO W/ EBUS 3 OR MORE NODES STATNS/STRCT,9636.0,6745.2,,,0
CDM,36000168,HC BRONCHOSCOPY RIGID/FLEX INCL FLUORO GUIDE W/BRONCHIAL OR ENDOBRONC BIOPSY(S) SINGLE/MULTI SITES,4310.0,3017.0,,,0
CDM,36000169,HC THORACOSCOPY SURGICAL W/RESECTION-PLICATION EMPHYSEMA LUNG FOR LUNG VOL REDUCT UNILAT INCL PLEURAL PROCEDURE,4380.0,3066.0,,,0
CDM,36000170,HC REMOVAL OF LUNG OTH/THN PNEUMONEC W/RESECTION-PLICATION OF EMPHYSEMATOUS LUNG FOR LUNG VOL REDUCT STERNAL SPLIT /TRANSTHORACIC APPROACH,3141.0,2198.7,,,0
CDM,36000171,HC BRONCHOSCOPY W/THERAPEUTIC ASPIRATION OF TRACHBRNCL TREE SUBSEQUENT,2543.0,1780.1,,,0
CDM,36000175,HC BRONCHOSCOPY RIGID/FLEXIBLE INCLUDE FLUOROSCOPIC GUIDE WHEN PERFORMED W/TRANSBRONCHIAL LUNG BIOPSY EA ADDTL LOBE,3256.0,2279.2,,,0
CDM,36100002,I&D SKIN SUBQ ABSCESS SIMPLE,287.0,200.9,,,0
CDM,36100003,HC I&D HEMATOMA SEROMA,1369.0,958.3,,,0
CDM,36100004,HC PUNCTURE ASPIRATION ABSCESS/HEMATOMA/BULLA/CYST,336.0,235.2,,,0
CDM,36100005,HC DEBRID SKIN UP TO 10% BODY SURF,424.0,296.8,,,0
CDM,36100006,HC DEBRID MUSC/FASCIA FIRST 20 SQ CM OR LESS,424.0,296.8,,,0
CDM,36100007,HC DEBRID BONE 1ST 20 SQ CM,1233.0,863.1,,,0
CDM,36100012,HC TRIMMING NONDYSTROPHIC NAILS ANY NUMBER,223.0,156.1,,,0
CDM,36100013,HC SKIN ALLOGRAFT T/A/L 1ST 25 SQ CM,2390.0,1673.0,,,0
CDM,36100014,HC SKIN ALLOGRAFT T/A/L ADDL 25 SQ CM,394.0,275.8,,,0
CDM,36100015,HC CAUTERY TISSUE CHEMICAL,740.0,518.0,,,0
CDM,36100016,HC ASP PUNCTURE CYST BREA,2620.0,1834.0,,,0
CDM,36100018,HC OPEN BX BREAST WO IMAG,2692.0,1884.4,,,0
CDM,36100020,HC BIOPSY MUSCLE PERCUTANEOUS NEEDLE,1571.0,1099.7,,,0
CDM,36100021,HC BONE BX TROCAR/NEEDLE,1350.0,945.0,,,0
CDM,36100022,HC BONE BX TROCAR/NEEDLE DEEP,2109.0,1476.3,,,0
CDM,36100023,HC BONE BX EXCISIONAL SUPERFICIAL,10428.0,7299.6,,,0
CDM,36100024,HC INJ SINUS TRACT FOR X-RAY,272.0,190.4,,,0
CDM,36100025,HC INJ TENDON SHEATH/LIGAMENT,406.0,284.2,,,0
CDM,36100027,HC INJ TRIGGER POINT 1/2 MUSCL,276.0,193.2,,,0
CDM,36100028,HC INJ TRIGGER POINTS => 3,276.0,193.2,,,0
CDM,36100029,HC ARTHROCENTESIS ASPIRATION/INJ SMALL JOINT/BURSA W/O US GUIDE,540.0,378.0,,,0
CDM,36100030,HC ARTHROCENTESIS ASPIRATION/INJ INTERMEDIATE JOINT/BURSA W/O US GUIDE,620.0,434.0,,,0
CDM,36100031,HC ARTHROCENTESIS ASPIRATION/INJ MAJOR JOINT/BURSA W/O US GUIDE,714.0,499.8,,,0
CDM,36100032,HC ABLATE BONE TUMOR(S) PERQ,5618.0,3932.6,,,0
CDM,36100033,HC BX OF NECK/CHEST SFT TISSUE,2244.0,1570.8,,,0
CDM,36100040,HC INJ FOR SHOULDER X-RAY,275.0,192.5,,,0
CDM,36100041,HC INJ FOR WRIST ARTHROGRAPHY,369.0,258.3,,,0
CDM,36100042,HC TREAT FX RAD & ULNA SHAFT,440.0,308.0,,,0
CDM,36100044,HC INJECTION FOR HIP ARTHROGRAPHY W/O ANESTHESIA,753.0,527.1,,,0
CDM,36100045,HC INJ SACROILIAC ARTHRGRPHY/ANES/STEROID W/IMAGE GUIDE,791.0,553.7,,,0
CDM,36100047,HC APPLY MULTLAY COMPRS LWR LEG,552.0,386.4,,,0
CDM,36100048,NASAL/SINUS ENDOS W/ BX,1812.0,1268.4,,,0
CDM,36100049,HC INSERT EMERGENCY AIRWAY,773.0,541.1,,,0
CDM,36100050,HC LARYNGOSCOPY FLEXIBLE DIAGNOSTIC,786.0,550.2,,,0
CDM,36100051,HC CATH ASP NASOTRACHEAL,198.0,138.6,,,0
CDM,36100052,HC CATH ASP TRACHEOBRONCH W/ FIBERSCOPE BEDSIDE,446.0,312.2,,,0
CDM,36100053,HC INTRO WINDPIPE WIRE/TUBE,596.0,417.2,,,0
CDM,36100055,HC NEEDLE BX CHEST LINING,1568.0,1097.6,,,0
CDM,36100059,INSERT PLEURAL CATH,3250.0,2275.0,,,0
CDM,36100060,INSERTION CHEST TUBE,690.0,483.0,,,0
CDM,36100061,HC ABLATE THER REDUCT/ERAD 1+ PULM TUMOR(S) INCL PLEURA/CHEST WALL PERQ INCL IMAGE GUIDE UNILATL RF,7144.0,5000.8,,,0
CDM,36100064,HC INSERT HEART PM VENTRICULAR,12422.0,8695.4,,,0
CDM,36100065,HC INSRT HEART PM ATRIAL & VENT,18009.0,12606.3,,,0
CDM,36100066,HC INSERT ELECTRD/PM CATH SNGL,9309.0,6516.3,,,0
CDM,36100068,HC INSERT PULSE GEN DUAL LEADS,13809.0,9666.3,,,0
CDM,36100070,HC INSERT 1 ELECTRODE PM-DEFIB,7522.0,5265.4,,,0
CDM,36100071,HC INSERT 2 ELECTRODE PM-DEFIB,12318.0,8622.6,,,0
CDM,36100072,HC REPAIR LEAD PACE-DEFIB ONE,4851.0,3395.7,,,0
CDM,36100073,HC REVISE POCKET PACEMAKER,2222.0,1555.4,,,0
CDM,36100074,HC REVISE POCKET FOR DEFIB,2532.0,1772.4,,,0
CDM,36100075,HC REMV/REPLC PM GEN SINGL,16794.0,11755.8,,,0
CDM,36100076,HC REMV/REPLC PM GEN DUAL LEAD,18774.0,13141.8,,,0
CDM,36100077,HC INSRT PULSE GEN W/MULT LEADS,43822.0,30675.4,,,0
CDM,36100078,HC REMV PM GENERATOR,9309.0,6516.3,,,0
CDM,36100079,HC REMV PM SYSTEM,16857.0,11799.9,,,0
CDM,36100080,HC REMV PM ELECTRODE,12318.0,8622.6,,,0
CDM,36100082,HC REMOVAL OF IMPLANTABLE DEFIBRILLATOR PULSE GENERATOR ONLY,4965.0,3475.5,,,0
CDM,36100083,HC REMV ELTRD TRANSVEN,8108.0,5675.6,,,0
CDM,36100084,HC INSERT PACE-DEFIB W/LEAD,44794.0,31355.8,,,0
CDM,36100090,HC PERQ INSERT AORTA BALLOON DEVICE,6137.0,4295.9,,,0
CDM,36100091,HC CARDIAC SURG PROCEDURE UNLIS,558.0,390.6,,,0
CDM,36100096,HC INJ PSEUDOANEURYSM,506.0,354.2,,,0
CDM,36100097,HC INJ FOR EXT VENOGRAPHY,381.0,266.7,,,0
CDM,36100098,HC PLACE CATH SUP INF VENA CAVA,558.0,390.6,,,0
CDM,36100099,HC PLACE CATH VEIN 1ST ORDER,750.0,525.0,,,0
CDM,36100100,HC PLACE CATH IN VEIN 2ND>  ORDER,1060.0,742.0,,,0
CDM,36100101,HC PLACE CATH IN PULM ARTERY,1598.0,1118.6,,,0
CDM,36100102,HC INTRO OF NEEDLE/INTRACATHETER UPPER OR LOWER EXTREMITY ARTERY,267.0,186.9,,,0
CDM,36100105,HC PLACE CATHETER IN AORTA,665.0,465.5,,,0
CDM,36100106,HC PLACE CATH 1ST THOR BRACHIO,731.0,511.7,,,0
CDM,36100107,HC PLACE CATH 2ND THOR BRACHIO,2087.0,1460.9,,,0
CDM,36100108,HC PLACE CATH 3RD> THOR BRACHIO,1497.0,1047.9,,,0
CDM,36100109,HC PLACE CATH ADD 2ND 3RD THOR BRACH,749.0,524.3,,,0
CDM,36100110,HC PLACE CATH 1ST ABD PELVIC LWR EXT,1071.0,749.7,,,0
CDM,36100111,HC PLACE CATH 2ND ABD PELVIC LWR EXT,1885.0,1319.5,,,0
CDM,36100112,HC PLACE CATH 3D> ABD PELVIC LWR EXT,2358.0,1650.6,,,0
CDM,36100113,HC CATH ADD 2D 3D ABD PEL LWR EXT,317.0,221.9,,,0
CDM,36100114,HC PLACE CATH 1ST RENAL UNILAT SI,6468.0,4527.6,,,0
CDM,36100115,HC PLACE CATH 1ST RENAL BILAT SI,9703.0,6792.1,,,0
CDM,36100116,HC PLACE CATH 2D> RENAL UNILAT SI,6601.0,4620.7,,,0
CDM,36100117,HC VENIPUNCTURE YOUNGER THAN AGE 3 YEAR NECESSITATING SKILL OF A PHYSICIAN OTHER VEIN,306.0,214.2,,,0
CDM,36100118,HC PERCUTANEOUS PORTAL VEIN CATH ANY METHOD,5333.0,3733.1,,,0
CDM,36100119,HC INSERTION CATH VEIN,1275.0,892.5,,,0
CDM,36100120,HC INSERTION CATH VEIN,386.0,270.2,,,0
CDM,36100121,INSERT NON-TUNN CV CATH <5 YRS,1512.0,1058.4,,,0
CDM,36100122,HC INSERT NON-TUNN CV CATH >5 YRS,1308.0,915.6,,,0
CDM,36100123,HC INSERT TUNNEL CV CATH >5 YRS,3338.0,2336.6,,,0
CDM,36100124,HC INSERT TUNNEL CV DEVICE >5 YRS,7179.0,5025.3,,,0
CDM,36100125,INSERT PICC CATH <5 YRS,1309.0,916.3,,,0
CDM,36100126,HC INSERT PICC CATH >5 YRS,1217.0,851.9,,,0
CDM,36100128,HC REPAIR CV DEVICE,1344.0,940.8,,,0
CDM,36100129,HC REPLACE NON-TUNN CV CATH,1092.0,764.4,,,0
CDM,36100130,HC REPLACE TUNNEL CV CATH,2712.0,1898.4,,,0
CDM,36100131,HC REPLACE PICC CATH,2807.0,1964.9,,,0
CDM,36100132,HC REPLACE CV DEVICE,4353.0,3047.1,,,0
CDM,36100133,HC REMOV TUNNEL CV CATH,920.0,644.0,,,0
CDM,36100134,HC REMOV TUNNEL CV DEVICE,3020.0,2114.0,,,0
CDM,36100135,HC BLOOD COLLECT CV DEVICE,294.0,205.8,,,0
CDM,36100136,DECLOT VASCULAR CATH DEVICE,629.0,440.3,,,0
CDM,36100137,HC REPOSITION VENOUS CATH FLUORO,1123.0,786.1,,,0
CDM,36100138,HC X-RAY CV DEVICE FLUORO,262.0,183.4,,,0
CDM,36100139,HC INSERT CATH ARTERY,285.0,199.5,,,0
CDM,36100140,HC INSERT CATH UMBIL ARTERY,568.0,397.6,,,0
CDM,36100141,HC INSERT NEEDLE BONE CAVITY,300.0,210.0,,,0
CDM,36100143,HC INSERT HEPATIC SHUNT (TIPS),13661.0,9562.7,,,0
CDM,36100144,HC REVJ TRANSVNS INTRAHEPATIC PORTOSYSTEMIC SHUNT,12254.0,8577.8,,,0
CDM,36100145,HC PRIMARY PERCU TRANSLUM MECH THROMBECTOMY NONCORONARY/NONINTRACRANIAL ARTERIAL/ARTERIAL BYPASS GRAFT INCL FLUORO & INTRAPROCEDURAL PHARMACOLOGICAL THROMBOLYTIC INJECTION(S) INITIAL VESSEL,21596.0,15117.2,,,0
CDM,36100146,HC PRIMARY PERCU TRANSLUM MECH THROMBECTOMY NONCORONARY/NONINTRACRANIAL ARTERIAL/ARTERIAL BYPASS GRAFT INCL FLUORO & INTRAPROCEDURAL PHARMACOLOGICAL THROMBOLYTIC INJECTION(S) EACH ADDTL VE*,12777.0,8943.9,,,0
CDM,36100147,HC SECONDARY PERCU TRANSLUM THROMBECTOMY NONCORONARY/NONINTRACRANIAL ARTERIAL/ARTERIAL BYPASS GRAFT INCL FLUORO & INTRAPROCEDURAL PHARMACOLOGICAL THROMBOLYTIC INJECTION(S),12285.0,8599.5,,,0
CDM,36100148,HC PRIM PERQ MECH VEN THROMB,17677.0,12373.9,,,0
CDM,36100149,HC PRIM PERQ MECH VEN THROMB ADDL,15274.0,10691.8,,,0
CDM,36100150,HC TRANSCATHETER BX,4839.0,3387.3,,,0
CDM,36100157,HC ILIAC ARTERY REVASC,5498.0,3848.6,,,0
CDM,36100158,HC ILIAC ARTERY REVASC STENT,12763.0,8934.1,,,0
CDM,36100159,HC REVASCULARIZATION ENDOVASCULAR OPEN/PERCUTANEOUS ILIAC ARTERY EACH ADDTL IPSILATERAL ILIAC VESSEL W/TRANSLUMINAL ANGIOPLASTY,14351.0,10045.7,,,0
CDM,36100160,HC REVASCULARIZATION ENDOVASCULAR OPEN/PERCUTANEOUS ILIAC ARTERY EACH ADDTL IPSILATERAL ILIAC VESSEL W/TRANSLUMINAL STENT PLACEMENT(S) INCL ANGIOPLASTY WITHIN SAME VESSEL,16504.0,11552.8,,,0
CDM,36100161,HC FEM/POPL ART REVASC W/TLA,5498.0,3848.6,,,0
CDM,36100162,HC FEM/POPL ART REVASC ATHERECT,68415.0,47890.5,,,0
CDM,36100163,HC FEM/POPL ART REVASC STENT,42923.0,30046.1,,,0
CDM,36100164,HC FEM/POPL ART REVASC STENT ARTHR,20213.0,14149.1,,,0
CDM,36100165,HC TIB/PER ART REVASC W/TLA,17218.0,12052.6,,,0
CDM,36100166,HC TIB/PER ART REVASC W/ATHERECT,21111.0,14777.7,,,0
CDM,36100167,HC TIB/PER ART REVASC STENT,21111.0,14777.7,,,0
CDM,36100168,HC TIB/PER ARAT REVASC STENT ATHER,64135.0,44894.5,,,0
CDM,36100169,HC TIB/PER ART REVASC W/TLA ADDL,5498.0,3848.6,,,0
CDM,36100172,NEEDLE BIOPSY LYMPH NODES,1571.0,1099.7,,,0
CDM,36100173,HC RA TRACER ID OF SENTINL NODE,1561.0,1092.7,,,0
CDM,36100175,HC NASO/OROGASTRIC TUBE PLACE FLUORO GUIDE,234.0,163.8,,,0
CDM,36100176,HC PLACEMENT LONG GI TUBE,655.0,458.5,,,0
CDM,36100178,HC PERQ NEEDLE BX LIVER,1521.0,1064.7,,,0
CDM,36100181,HC PERQ RF ABLATION 1> LIVER TUMORS,6771.0,4739.7,,,0
CDM,36100182,HC PERQ CHOLECYSTOSTOMY SI,3394.0,2375.8,,,0
CDM,36100189,HC DILAT BILIARY DUCT ENDO W/ STENT,18937.0,13255.9,,,0
CDM,36100191,HC PERQ NEEDLE BX PANCREAS,1699.0,1189.3,,,0
CDM,36100196,HC ABDOMINAL PARACENTESIS DX/THERAPEUTIC W/IMAGING GUIDANCE,2047.0,1432.9,,,0
CDM,36100197,HC BIOPSY ABDOMINAL/RETROPERITONEAL MASS PERCUTANEOUS NEEDLE,1378.0,964.6,,,0
CDM,36100198,HC PERQ RAD DEVICE ABD PELVIC,1331.0,931.7,,,0
CDM,36100199,HC PERQ INSERT TUNN CATH ABD PELV,3262.0,2283.4,,,0
CDM,36100200,HC REMOVAL TUNN CATH ABD PELV,2673.0,1871.1,,,0
CDM,36100201,HC EXCHANGE DRAINAGE CATH,1920.0,1344.0,,,0
CDM,36100202,HC INJECT CONTRAST ASSESS CYST,474.0,331.8,,,0
CDM,36100203,HC PERQ PLACE GASTRO TUBE,3452.0,2416.4,,,0
CDM,36100204,HC PERQ PLACE DUOD JEJUN TUBE,1358.0,950.6,,,0
CDM,36100205,HC PERQ CHANGE G-TUBE TO G-J TUBE,1358.0,950.6,,,0
CDM,36100206,HC PERQ REPLACE G/C TUBE,2266.0,1586.2,,,0
CDM,36100207,HC PERQ REPLACE DOUD JEJUN TUBE,655.0,458.5,,,0
CDM,36100208,HC REPLACE GASTROJEJUNOSTOMY TUBE PERQ  UNDER FLUORO GUIDE INCL CONTRAST INJECTION(S) IMAGE DOC & REPORT,655.0,458.5,,,0
CDM,36100209,HC FLUORO EXAM OF G/COLON TUBE,220.0,154.0,,,0
CDM,36100210,HC REPAIR UMBILICAL LESION,11808.0,8265.6,,,0
CDM,36100212,HC RENAL BIOPSY PERCUTANEOUS BY TROCAR/NEEDLE,1697.0,1187.9,,,0
CDM,36100213,HC PERC URETER STENT CHANGE,7217.0,5051.9,,,0
CDM,36100214,HC REMOVE & REPLACE EXTERNALLY ACCESSIBLE NEPHROURETERAL CATHETER,3461.0,2422.7,,,0
CDM,36100215,HC REM RENAL TUBE W/ FLUORO,2759.0,1931.3,,,0
CDM,36100216,HC PERC NEEDLE ASP/INJ RENAL CYST,1571.0,1099.7,,,0
CDM,36100223,HC PERC ABLAT CRYO REN TUMOR UNILAT,5271.0,3689.7,,,0
CDM,36100224,HC CHANGE OF URETER TUBE/STENT,1583.0,1108.1,,,0
CDM,36100225,HC INJECTION FOR URETER X-RAY,136.0,95.2,,,0
CDM,36100226,DRAIN BL VIA SUPRAPUBIC CATH,2844.0,1990.8,,,0
CDM,36100228,HC INJECTION PX FOR RETROGRADE URETHROCYSTOGRAPHY,227.0,158.9,,,0
CDM,36100229,INSERT NON-INDWELLING BL CATH,256.0,179.2,,,0
CDM,36100230,HC INSERT TEMP INDWELLING BLADDER CATH SIMPLE,198.0,138.6,,,0
CDM,36100231,HC INSERT TEMP INDWELLING BLADDER CATH COMPLICATED,379.0,265.3,,,0
CDM,36100232,HC CHANGE BLADDER CATH SIMPLE,440.0,308.0,,,0
CDM,36100233,HC CHANGE OF CYSTOSTOMY TUBE COMPLICATED,1598.0,1118.6,,,0
CDM,36100235,HC US URINE CAPACITY MEASURE,230.0,161.0,,,0
CDM,36100236,HC BIOPSY PROSTATE,7739.0,5417.3,,,0
CDM,36100237,PLACE RAD THER DEVICE PROSTATE,1608.0,1125.6,,,0
CDM,36100239,INSERT VAG BRACHYTX DEVICE,825.0,577.5,,,0
CDM,36100240,HC CATHETERIZE FOR HYSTEROGRAPHY,227.0,158.9,,,0
CDM,36100243,HC AMNIOCENTESIS DIAGNOSTIC,2691.0,1883.7,,,0
CDM,36100245,HC PERQ ASPIR INTERDISCAL DX,1510.0,1057.0,,,0
CDM,36100246,HC PUNCTURE SPINAL LUMB DX,664.0,464.8,,,0
CDM,36100247,HC PUNCTURE DRAIN CSF,974.0,681.8,,,0
CDM,36100248,HC INJECT EPIDURAL BLOOD PATCH,1727.0,1208.9,,,0
CDM,36100249,HC MYLEGRAM NOT C1-C2,637.0,445.9,,,0
CDM,36100256,HC PUMP REFILL REPROGRAM,897.0,627.9,,,0
CDM,36100257,HC INJ NERVE BLOCK OCCIPITAL,1095.0,766.5,,,0
CDM,36100258,HC INJ NERVE BLOCK SUPRASCAP,884.0,618.8,,,0
CDM,36100259,HC INJ AA(S) / STEROID INTERCOSTAL NERVE SINGLE LEVEL,2464.0,1724.8,,,0
CDM,36100260,HC INJ NERVE BLOCK INTERCOST MULT,3259.0,2281.3,,,0
CDM,36100261,HC INJ NERVE BLOCK ILIOING HYPOGI,1423.0,996.1,,,0
CDM,36100262,HC INJ NERVE BLOCK OTHER PERIPH,921.0,644.7,,,0
CDM,36100263,HC INJ FORA EPIDU CERV THOR SINGL,2545.0,1781.5,,,0
CDM,36100264,HC INJ FORA EPIDU CERV THOR ADDL,1159.0,811.3,,,0
CDM,36100265,HC INJ FORA EPIDU LUMB SACR SINGL,1805.0,1263.5,,,0
CDM,36100266,HC INJ FORA EPIDU LUMB SACR ADDL,1214.0,849.8,,,0
CDM,36100267,HC INJ FACET CERV THOR FLUORO SINGL,1699.0,1189.3,,,0
CDM,36100268,HC INJ FACET CERV THOR FLUORO 2ND,860.0,602.0,,,0
CDM,36100269,HC INJECTION(S) PARAVERTEBRAL FACET JOINT W/ IMAGE GUIDE CERVICAL/THORACIC THIRD AND ANY ADDITIONAL LEVEL(S),881.0,616.7,,,0
CDM,36100270,HC INJ FACET LUMB SACR FLUORO SINGL,1278.0,894.6,,,0
CDM,36100271,HC INJ FACET LUMB SACR FLUORO 2ND,645.0,451.5,,,0
CDM,36100272,HC INJ FACET LUMB SACR FLUORO 3RD>,600.0,420.0,,,0
CDM,36100273,HC INJ N BLOCK SPHENOPAL GANG,1081.0,756.7,,,0
CDM,36100274,HC INJ N BLOCK STELLATE GANG,1484.0,1038.8,,,0
CDM,36100275,HC INJ N BLOCK LUMB THOR SYMPH,3294.0,2305.8,,,0
CDM,36100276,HC INJ N BLOCK CELIAC PLEXUS,3294.0,2305.8,,,0
CDM,36100277,HC DESTROY NERVE FACE MUSCLE,1112.0,778.4,,,0
CDM,36100280,HC DESTROY CERV/THOR FACET JNT SINGL,2981.0,2086.7,,,0
CDM,36100281,HC DESTROY CERV/THOR FACET JNT ADDL,1498.0,1048.6,,,0
CDM,36100282,HC DESTROY LUMB/SAC FACET JNT,2628.0,1839.6,,,0
CDM,36100283,HC DESTROY LUMB/SAC FACET JNT ADDL,1200.0,840.0,,,0
CDM,36100284,HC DESTROY PERIPHER NERVE,1121.0,784.7,,,0
CDM,36100285,HC NERV SYS SURG UNLISTED,2020.0,1414.0,,,0
CDM,36100288,HC ELECTRONIC ANALYSIS IMPLANTED NERUOSTIMULATOR PULSE GENERATOR/TRANSMITTER SIMPLE SPINAL CORD/PERIPHERAL NERVE PROGRAMMING,174.0,121.8,,,0
CDM,36100289,HC SACROPLASTY INJ BILAT 2> NEEDLES,3260.0,2282.0,,,0
CDM,36100291,HC PLACE OCC DEVICE POST PROCED,375.0,262.5,,,0
CDM,36100292,FNA W/O IMAGE,424.0,296.8,,,0
CDM,36100293,HC COMPLEX DRAINAGE WOUND,8925.0,6247.5,,,0
CDM,36100296,HC DEBRIDE SKIN/MUSCLE FX,2563.0,1794.1,,,0
CDM,36100299,HC REMOVAL OF SKIN TAGS,198.0,138.6,,,0
CDM,36100302,HC SHAVING EPIDERMAL/DERMAL LESION SINGLE LESION TRUNK/ARMS/LEGS 0.6-1.0 CM,724.0,506.8,,,0
CDM,36100313,HC EXC TR-EXT BEN MARG 0.5 <CM,4687.0,3280.9,,,0
CDM,36100326,EXC FACE-MM B9+MARG 0.6-1CM,6671.0,4669.7,,,0
CDM,36100327,EXC FACE-MM B9+MARG 1.1-2 CM,7671.0,5369.7,,,0
CDM,36100350,HC EXCISION OF NAIL FOLD TOE,163.0,114.1,,,0
CDM,36100352,HC INJECTION INTRALESIONAL MORE THAN 7 LESIONS,833.0,583.1,,,0
CDM,36100354,HC REMOVAL CONTRACEPTIVE CAP,335.0,234.5,,,0
CDM,36100355,HC INSERT DRUG IMPLANT DEVICE,501.0,350.7,,,0
CDM,36100358,RPR CMPLX TRNK 2.6-7.5CM,656.0,459.2,,,0
CDM,36100359,HC RPR CMPLX F/C/C/M/N/AX/G/H/F EA AD 5CM OR LESS,453.0,317.1,,,0
CDM,36100360,HC DRESSING/DEBRIDEMENT PARTIAL THICKNESS BURNS INITIAL/SUBSEQUENT MEDIUM,525.0,367.5,,,0
CDM,36100387,HC ASPIRATE/INJ GANGLION CYST(S),3485.0,2439.5,,,0
CDM,36100388,HC RMVL SUPPRT IMPLNT SPRFCL,5803.0,4062.1,,,0
CDM,36100392,HC CLOSED TX NASAL BONE FX W/MANIP W/O STABLIZATION,5591.0,3913.7,,,0
CDM,36100395,HC DRAINAGE OF ARM BURSA,5970.0,4179.0,,,0
CDM,36100398,HC REMOVAL FOREIGN BODY UPPER ARM/ELBOW AREA SUBCUTANEOUS,2004.0,1402.8,,,0
CDM,36100399,HC REMOVAL FOREIGN BODY UPPER ARM/ELBOW AREA DEEP (SUBFASCIAL/INTRAMUSCULAR),6053.0,4237.1,,,0
CDM,36100400,RX HUMERUS FX,852.0,596.4,,,0
CDM,36100401,HC CLOSED TX HUMERAL EPICONDYLAR FX MEDIAL/LATERAL W/O MANIPULATION,852.0,596.4,,,0
CDM,36100404,HC CLOSED TREATMENT RADIAL SHAFT FX W/O MANIPULATION,914.0,639.8,,,0
CDM,36100405,HC CLSD ULNAR W/O MANIP,852.0,596.4,,,0
CDM,36100406,HC CLOSED TX CARPAL BONE FX W/O MANIPULATION EACH BONE,852.0,596.4,,,0
CDM,36100408,HC CLOSED TX ULNAR STYLOID FX,852.0,596.4,,,0
CDM,36100409,HC CLSD TX DISTAL RADIO DISLOC,898.0,628.6,,,0
CDM,36100410,HC EXC HAND LES SC > 1.5 CM,6544.0,4580.8,,,0
CDM,36100411,HC CLOSED TX METACARPAL FX SINGLE W/O MANIPULATION EACH BONE,846.0,592.2,,,0
CDM,36100412,HC TREAT THUMB DISLOCATION,320.0,224.0,,,0
CDM,36100413,TREAT THUMB FRACTURE,5792.0,4054.4,,,0
CDM,36100414,HC CLOSED TX METACARPOPHALANGEAL DISLOCATION SINGLE W/ MANIP & ANES,6326.0,4428.2,,,0
CDM,36100416,HC CLSD TX ARTICULAR FX INCL METACARPOPHALANGEAL/INTERPHANLANGEAL JOINT W/MANIP EACH,5523.0,3866.1,,,0
CDM,36100419,HC CLOSED TX FEMORAL SHAFT FRACTURE W/MANIPULATION W/ OR W/O SKIN/SKELETAL TRACTION,3078.0,2154.6,,,0
CDM,36100420,HC CLOSED TX FEMORAL FRACTURE DISTAL END MEDIAL/LATERAL CONDYLE W/O MANIPULATION,852.0,596.4,,,0
CDM,36100424,HC CLOSED RX TIBIA,383.0,268.1,,,0
CDM,36100426,HC CLOSED TX DISTAL FIBULAR FX W/O MANIPULATION,716.0,501.2,,,0
CDM,36100431,HC METATARSAL FX W/O MANIP,792.0,554.4,,,0
CDM,36100432,HC METATARSAL FX W/MANIP,880.0,616.0,,,0
CDM,36100433,HC CLOSED TX OF FX GREAT TOE PHALANX/PHALANGES W/O MANIPULATION,836.0,585.2,,,0
CDM,36100434,HC CLOSED TX FX GREAT TOE PHALANX/PHALANGES W/MANIPULATION,961.0,672.7,,,0
CDM,36100436,HC CLSD FOOT DISLOC W/O ANEST,885.0,619.5,,,0
CDM,36100437,HC TARSOMETATRSL DIS W/O ANES,914.0,639.8,,,0
CDM,36100442,HC APPLY HAND/WRIST CAST,335.0,234.5,,,0
CDM,36100449,INTRANASAL BIOPSY,965.0,675.5,,,0
CDM,36100452,HC REPEAT CONTROL OF NOSEBLEED,195.0,136.5,,,0
CDM,36100453,FLEX LARYNGOSCOPY BX,1668.0,1167.6,,,0
CDM,36100457,HC NON-ROUTINE BL DRAW > 3 YRS,133.0,93.1,,,0
CDM,36100461,HC INJECT SCLEROSANT SINGLE INCOMPETENT VEIN,527.0,368.9,,,0
CDM,36100463,HC CUTDWN ARTERY CATH SMPLNG,2256.0,1579.2,,,0
CDM,36100464,REMOVAL FOREIGN BODY MOUTH,198.0,138.6,,,0
CDM,36100465,BIOPSY OF MOUTH LESION,543.0,380.1,,,0
CDM,36100470,NDLE BX SALIVARY GLAND,729.0,510.3,,,0
CDM,36100471,HC DRAINAGE OF SALIVARY CYST,10709.0,7496.3,,,0
CDM,36100473,HC DILATION OF ESOPHAGUS SINGLE/MULTIPLE PASSES,3628.0,2539.6,,,0
CDM,36100475,HC DRAINAGE OF RECTAL ABSCESS,4388.0,3071.6,,,0
CDM,36100479,HC DIAGNOSTIC SIGMOIDOSCOPY,3020.0,2114.0,,,0
CDM,36100493,HC DILT URETHRA STRCTR INIT,1133.0,793.1,,,0
CDM,36100495,HC DILATION URETHRAL STRICTURE BY PASSAGE OF FILLIFORM AND FOLLOWER MALE INITIAL,5120.0,3584.0,,,0
CDM,36100507,HC FORESKIN MANIPULATION INCL LYSIS PREPUTIAL ADHESIONS AND STRETCHING,320.0,224.0,,,0
CDM,36100510,I & D OF VULVA/PERINEUM,1146.0,802.2,,,0
CDM,36100514,HC BX VULVA/PERINEUM ONE,3290.0,2303.0,,,0
CDM,36100518,HC BX VAGINAL MUCOSA SIMPLE,922.0,645.4,,,0
CDM,36100524,REMV VAG FOREIGN BODY,12352.0,8646.4,,,0
CDM,36100534,HC ENDOMETRIAL BIOPSY W/ OR W/O ENDOCERVIX BIOPSY W/O CERVICAL DILATION ANY METHOD,590.0,413.0,,,0
CDM,36100535,HC DILATION AND CURETTAGE,9300.0,6510.0,,,0
CDM,36100543,HC INJECTION(S) ANESTHERIC AGENT(S)/STERIOD PLANTAR DIGITAL NERVE(S),4649.0,3254.3,,,0
CDM,36100544,HC CHEMODEN ECCRINE BOTH AXIL,2760.0,1932.0,,,0
CDM,36100558,HC DRAIN EXTRNL EAR LESN SMPL,243.0,170.1,,,0
CDM,36100559,BIOPSY OF EXTERNAL EAR,959.0,671.3,,,0
CDM,36100565,HC COLO CA SCRNG/SIGMOID,3020.0,2114.0,,,0
CDM,36100568,HC CYSTOSCOPY,4417.0,3091.9,,,0
CDM,36100573,HC INSTL CH TUBE/CATH FBRN 1ST DAY,460.0,322.0,,,0
CDM,36100574,HC INSTL CH TUBE/CATH FBRN SBSQ DAY,460.0,322.0,,,0
CDM,36100576,HC INSERT NEW/REPL PERM PMKR W/ TRNSVN ELECTRODE(S) ATRIAL,11462.0,8023.4,,,0
CDM,36100577,HC INSRT TUNNELED CENTRALLY INSRTD CV ACCESS DEVICE W/ SUBCU PORT < 5 YRS,10198.0,7138.6,,,0
CDM,36100579,HC INSERT TUN IP CATH PERC,3262.0,2283.4,,,0
CDM,36100580,HC THORACENTESIS NEEDLE/CATH W/O IMAGE GUIDE,586.0,410.2,,,0
CDM,36100581,HC THORACENTESIS NEEDLE/CATH W/ IMAGE GUIDE,1681.0,1176.7,,,0
CDM,36100583,HC REMOVAL INDWELLING TUNNELED PLEURAL CATH W/ CUFF,699.0,489.3,,,0
CDM,36100584,HC INSERT PICVAD CATH,4788.0,3351.6,,,0
CDM,36100585,HC TRANSCATH THERAPY ARTERIAL INFUSION FOR THROMBOLYSIS OTHER THAN CORONARY/INTRACRANIAL ANY METHOD INCL RAD S & I INTIAL TX DAY,2631.0,1841.7,,,0
CDM,36100586,HC THROMBOLYTIC VENOUS THERAPY,3770.0,2639.0,,,0
CDM,36100587,HC CESSJ THERAPY CATH REMOVAL,3090.0,2163.0,,,0
CDM,36100588,HC PERC RF ABLATE 1 OR MORE RENAL TUMOR(S),5271.0,3689.7,,,0
CDM,36100589,HC INJECTION FOR URETER X-RAY,107.0,74.9,,,0
CDM,36100590,HC DESTRUCTION BY NEUROLYTIC AGENT CELIAC PLEXUS,1112.0,778.4,,,0
CDM,36100591,HC TRANSCATH STENT CCA W/O EPS,40376.0,28263.2,,,0
CDM,36100593,HC TIBPER REVASC W/ ATHER ADD-ON,11673.0,8171.1,,,0
CDM,36100594,HC REVSC OPN/PRQ TIB/PERO STENT,5498.0,3848.6,,,0
CDM,36100595,HC TIB/PER REVASC STENT & ATHER,17231.0,12061.7,,,0
CDM,36100596,HC IVUS FIRST VESSEL ADD-ON,2540.0,1778.0,,,0
CDM,36100597,HC IVUS EA ADD VESSEL ADD -ON,2117.0,1481.9,,,0
CDM,36100598,HC INSERT PULSE GEN MULT LEADS,23331.0,16331.7,,,0
CDM,36100599,HC INSERT PULSE GEN W/ DUAL LEADS,34916.0,24441.2,,,0
CDM,36100600,HC REMOVE & REPLACE PERM PM GEN MULTI LEADS,18774.0,13141.8,,,0
CDM,36100601,HC DIAGNOSTIC BONE MARROW BIOPSY(IES),2952.0,2066.4,,,0
CDM,36100605,HC EGD W/BIOPSY SINGLE/MULTIPLE,3608.0,2525.6,,,0
CDM,36100608,HC THORACOSCOPY W/ PLEURODESIS,13655.0,9558.5,,,0
CDM,36100609,HC PLACE CATH RT HEART OR MAIN PULM ARTERY,1410.0,987.0,,,0
CDM,36100610,HC PLACE CATH LT OR RT PULM ARTERY,1357.0,949.9,,,0
CDM,36100611,HC EGD REMOVE FOREIGN BODY,3966.0,2776.2,,,0
CDM,36100612,HC FETAL FLUID DRAINAGE W/ US GUIDANCE,401.0,280.7,,,0
CDM,36100613,HC PLEURAL DRAIN PERCU W/ INDWELLING CATH W/ IMAGE GUIDE,2879.0,2015.3,,,0
CDM,36100617,HC IRRIGATION CORPORA CAVERNOSA FOR PRIAPRISM,320.0,224.0,,,0
CDM,36100618,HC EGD PLACE GASTROSTOMY TUBE,5474.0,3831.8,,,0
CDM,36100619,HC DRAIN BLADDER BY TROCAR/CATH,3973.0,2781.1,,,0
CDM,36100620,HC EGD CONTROL BLEEDING ANY METHOD,4199.0,2939.3,,,0
CDM,36100622,HC IMAGE GUIDED FLUID COLLECTION BY CATH PERCU SOFT TISSUE,1294.0,905.8,,,0
CDM,36100623,HC BREAST BX 1ST LES W/ PLACE LOCALIZATION DEVICE,4482.0,3137.4,,,0
CDM,36100635,HC TRNSCATH PLACE INTRAVASC STENT OPEN/PERCU INIT ARTERY,13132.0,9192.4,,,0
CDM,36100636,HC TRNSCATH PLACE INTRAVASC STENT OPEN/PERCU EA ADD ART,6351.0,4445.7,,,0
CDM,36100637,HC TRANSCATH PLACE INTRAVASC OPEN/PERCU INITIAL VEIN,13132.0,9192.4,,,0
CDM,36100638,HC TRNSCATH PLACE INTRAVASC STENT OPEN/PERCU EA ADD VEIN,6351.0,4445.7,,,0
CDM,36100639,HC VASC EMBOLIZE/OCCLUDE VENOUS,15212.0,10648.4,,,0
CDM,36100640,HC VASC EMBOLIZE/OCCLUDE ARTERY,15212.0,10648.4,,,0
CDM,36100641,HC VASC EMBOLIZE/OCCLUDE ORGAN,15212.0,10648.4,,,0
CDM,36100642,HC VASC EMBOLIZE/OCCLUDE ART/VENOUS HEMORRHAGE,15212.0,10648.4,,,0
CDM,36100643,HC IMAGE GUIDED FLUID CATH COLLECT PERCU VISCERAL,2104.0,1472.8,,,0
CDM,36100644,HC IMAGE GUIDED FLUID CATH COLLECT PERI/RETROPERI,2104.0,1472.8,,,0
CDM,36100645,HC IMAGE GUIDED FLUID CATH COLLECT TRNSVAG/TRNSRECT,1787.0,1250.9,,,0
CDM,36100646,HC CHEMODENERV MUSC NECK DYSTONIA,1542.0,1079.4,,,0
CDM,36100647,HC CHEMODENERV 1 EXTREMITY 1-4 MUSC,1096.0,767.2,,,0
CDM,36100648,HC CHEMODENERV 1 EXTREMITY 1-4 EA ADD MUSC,801.0,560.7,,,0
CDM,36100649,HC CHEMODENERV 1 EXTREMITY 5 OR MORE MUSC,1261.0,882.7,,,0
CDM,36100650,HC CHEMODENERV 1 EXTREMITY EA ADD EXTREMITY 5 OR MORE MUSC,697.0,487.9,,,0
CDM,36100651,HC CHEMODENERV TRUNK 1-5 MUSC,356.0,249.2,,,0
CDM,36100652,HC CHEMODENERV TRUNK 6 OR MORE MUSC,2702.0,1891.4,,,0
CDM,36100663,HC TRANSCATHETER RETRIVAL PERCUTANEOUS INTRAVASCULAR FOREIGN BODY,3924.0,2746.8,,,0
CDM,36100664,HC PERCUTANEOUS REMOVAL OF URETERAL STENT VIA SNARE/CAPTURE,6917.0,4841.9,,,0
CDM,36100665,HC TRANSURETHERAL REPLACEMENT OF INTERNAL URETERAL STENT B,7360.0,5152.0,,,0
CDM,36100666,HC REMOVAL DWELLING URETERAL STENT VIA TRANSURETHERAL W/CYSTOSCOPY,8159.0,5711.3,,,0
CDM,36100667,HC BIOPSY THYROID PERCUTANEOUS CORE NEEDLE,932.0,652.4,,,0
CDM,36100668,HC ASPIRATION AND/OR INJECTION THYRIOD CYST,751.0,525.7,,,0
CDM,36100669,HC NON-SELECT CATHETER PLACE W/ANGIOGRAPHY EXTRACRANIAL CAROTID VERTEBRAL/INTRACRANIAL VESSESLS UNILAT OR BILAT,10264.0,7184.8,,,0
CDM,36100670,HC COMMON CAROTID AND EXTERNAL CAROTID IMAGING W/CATHETER,2277.0,1593.9,,,0
CDM,36100672,HC REMOVAL OF IMPLANT DEEP,12185.0,8529.5,,,0
CDM,36100675,HC PELVIC EXAMINATION UNDER ANESTHESIA,2879.0,2015.3,,,0
CDM,36100681,HC CHEMODENERV MUSC MIGRAINE,1112.0,778.4,,,0
CDM,36100689,HC REM ENDOVAS VENA CAVA FILTER,11476.0,8033.2,,,0
CDM,36100694,HC SKIN SUBSTITUTE APPLICATION TO FOOT FIRST 25 SQ CM,7384.0,5168.8,,,0
CDM,36100697,HC INSERT/PLACE HEART CATH SWAN GANZ,2242.0,1569.4,,,0
CDM,36100698,HC I&D DEEP ABSCESS/HEMATOMA SOFT TISS NECK/THORAX,2442.0,1709.4,,,0
CDM,36100702,HC LARYNGOSCOPY FLEX FIBEROPTIC W/ REM,1919.0,1343.3,,,0
CDM,36100705,HC NASAL/SINUS ENDOSCOPY SURG W/ CONTROL NASAL HEMORRHAGE,1461.0,1022.7,,,0
CDM,36100706,HC TRACHEOBRONCH THROUGH ESTAB TRACH INCISION,750.0,525.0,,,0
CDM,36100710,HC INCISION LABIAL FRENUM,543.0,380.1,,,0
CDM,36100711,HC INJ INTRALESIONAL UP TO AND INCL 7 LESIONS,724.0,506.8,,,0
CDM,36100716,HC BIOPSY OROPHARYNX,965.0,675.5,,,0
CDM,36100717,HC BIOPSY/EXCISION LYMPH NODE(S) OPEN SUPERFICIAL,16303.0,11412.1,,,0
CDM,36100718,HC REPLACE TUNNELED CV CATH COMPLETE,3546.0,2482.2,,,0
CDM,36100719,HC TRACHEOSTOMY EMERGENCY PROCEDURE CRICOTHYROID MEMBRANE,2089.0,1462.3,,,0
CDM,36100720,HC TREAT PLEUROSESIS W/ AGENT,731.0,511.7,,,0
CDM,36100721,HC BIOPSY BONE OPEN DEEP,10428.0,7299.6,,,0
CDM,36100723,HC INSERT CECOSTOMY/COLONIC TUBE PERCU UNDER FLUORO INCL CONTRAST INJ,2147.0,1502.9,,,0
CDM,36100726,HC PERCU VERTEBROPLASTY 1 VERT BODY UNILAT/BILAT INJ LUMB INCLUDES ALL IMAGING GUIDANCE,4420.0,3094.0,,,0
CDM,36100727,HC PERCU KYPHOPLASTY 1 VERT BODY UNILAT/BILAT CANN THORACIC INCLUDES ALL IMAGING GUIDANCE,10737.0,7515.9,,,0
CDM,36100728,HC PERCU KYPHOPLASTY 1 VERT BODY UNILAT/BILAT CANN LUMBAR INCLUDES ALL IMAGING GUIDANCE,10737.0,7515.9,,,0
CDM,36100729,HC PERCU KYPHOPLASTY 1 VERT BODY UNILAT/BILAT CANN EA ADD THOR/LUMB VERT BODY,10737.0,7515.9,,,0
CDM,36100733,HC INSERT/REPLACE PERM SUBCU IMPLANTABLE DEFIB SYSTEM INCL PRO/REPROGRAMMING WHEN PERFORMED,43805.0,30663.5,,,0
CDM,36100735,HC INSERT PACING CARDIOVERTER-DEFIBRILLATOR PULSE GEN ONLY W/ EXISTING SINGLE LEAD,92369.0,64658.3,,,0
CDM,36100737,HC REMOVE AND REPLACE PACING CARDIOVERTER-DEFIBRILLATOR PULSE GEN SINGLE LEAD SYSTEM,32573.0,22801.1,,,0
CDM,36100738,HC REMOVE AND REPLACE PACING CARDIOVERTER-DEFIBRILLATOR PULSE GEN DUAL LEAD SYSTEM,32573.0,22801.1,,,0
CDM,36100739,HC REMOVE AND REPLACE PACING CARDIOVERTER-DEFIBRILLATOR PULSE GEN MULTIPLE LEAD SYSTEM,128359.0,89851.3,,,0
CDM,36100740,HC REMOVE SUBCU IMPLANTABLE DEFIBRILLATOR ELECTRODE,3336.0,2335.2,,,0
CDM,36100741,HC REPOSITION PREVIOUSLY IMPLANTED SUBCU IMPLANTABLE DEFIBRILLATOR ELECTRODE,10559.0,7391.3,,,0
CDM,36100742,HC NASAL ENDOSCOPY DX UNILATERAL/BILATERAL,176.0,123.2,,,0
CDM,36100745,HC DBRDMT SUB TIS EACH ADDL 20 SQ CM,68.0,47.6,,,0
CDM,36100746,HC DBRDMT MUSCLE AND/OR FASCIA EA ADDTL 20 SQ CM,171.0,119.7,,,0
CDM,36100747,HC DBRMT BONE EA ADDL 20 SQ CM,341.0,238.7,,,0
CDM,36100748,HC INSRT TUNNELED CENTRALLY INSRTD CV CATH W/O SUBCU PORT/PUMP < 5 YRS,3338.0,2336.6,,,0
CDM,36100749,HC REPLACE CATH ONLY CV DEVICE W/SUBCU PORT/PUMP CENTRAL/PERIPH INSERT SITE,12370.0,8659.0,,,0
CDM,36100751,HC TRANSCATH PLACE INTRAVASC STENT(S) INTRATHOR COMM CAROTID ART/INNOM ART OPEN/PERCUT ANTEGRADE APPROACH INCLUD ANGIO WHEN PEF RAD S & I,2873.0,2011.1,,,0
CDM,36100755,HC MYELOGRAPHY LUMBAR INJ INCL RADIOLOGICAL SUPRVSON/INTERP LOMBOSACRAL,960.0,672.0,,,0
CDM,36100756,HC INJECTION OF SINUS TRACT THERAPEUTIC,965.0,675.5,,,0
CDM,36100757,HC LARYNGOSCOPY INDIRECT DIAGNOSTIC (SEPARATE PROCEDURE),684.0,478.8,,,0
CDM,36100759,HC REP TWO TRANSVENOUS ELECTRODES FOR PERM PACEMAKER/IMPLANTABLE DEFIBRILLATOR,10559.0,7391.3,,,0
CDM,36100762,HC CANTHOTOMY,14518.0,10162.6,,,0
CDM,36100763,HC CLOSED TX INTERPHALANGEAL JOINT DISLOC SINGLE W/MANIP REQ ANESTH,1253.0,877.1,,,0
CDM,36100764,HC INCISION OF LINGUAL FRENUM (FRENOTOMY),965.0,675.5,,,0
CDM,36100765,HC REPAIR INTERMED WOUNDS NCK/HNDS/FT/EXTERNAL GENITALIA OVER 30.0,5963.0,4174.1,,,0
CDM,36100766,HC REPAIR COMPLEX TRUNK EACH ADDL 5 CM OR LESS,431.0,301.7,,,0
CDM,36100767,HC CLOSURE OF LACERATION VESTIBULE OF MOUTH OVER 2.5 CM OR COMPLEX,2393.0,1675.1,,,0
CDM,36100768,HC ARTHROCENTESIS ASPIRATION/INJECTION MAJOR JOINT/BURSA W/ ULTRASOUND GUIDANCE,1459.0,1021.3,,,0
CDM,36100771,HC BLEPHAROTOMY DRAINAGE OF ABSCESS EYELID,446.0,312.2,,,0
CDM,36100772,HC REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,198.0,138.6,,,0
CDM,36100774,HC PLACE URETERAL STENT PERCU INCL DX NEPHROSTOGRAM AND/OR URETEROGRAM IMAGE GUIDE ASSOC RAD S & I PRE-EXISTING NEPHROSTOMY TRACT,7874.0,5511.8,,,0
CDM,36100776,HC PLACE URETERAL STENT PERCU INCL DX NEPHROSTOGRAM AND/OR URETEROGRAM IMAGE GUIDE ASSOC RAD S & I NEW ACCESS W/SEP NEPHROSTOMY CATH,13191.0,9233.7,,,0
CDM,36100777,HC INJECT PX ANTEGRADE NEPHROSTOGRAM AND/OR URETEROGRAM COMPLETE DX PX INCL IMAGE GUIDE ASSOC RAD S & I NEW ACCESS,689.0,482.3,,,0
CDM,36100778,HC INJECT PX ANTEGRADE NEPHROSTOGRAM AND/OR URETEROGRAM COMPLETE DX PX INCL IMAGE GUIDE ASSOC RAD S & I EXISTING ACCESS,689.0,482.3,,,0
CDM,36100779,HC URETERAL EMBOLIZATION/OCCLUSION INCL IMAGE GUIDE ASSOC RAD S & I,771.0,539.7,,,0
CDM,36100780,HC BALLOON DILATION URETERAL STRICTURE INCL IMAGE GUIDE ASSOC RAD S & I,1754.0,1227.8,,,0
CDM,36100781,HC PARAVERTEBRAL BLOCK (PVB) THORACIC SINGLE INJECT SITE,2499.0,1749.3,,,0
CDM,36100782,HC PARAVERTEBRAL BLOCK (PVB) THORACIC SECOND & ADDL INJECT SITE(S),184.0,128.8,,,0
CDM,36100783,HC PARAVERTEBRAL BLOCK (PVB) THORACIC CONTINUOUS INFUSION BY CATHETER,2499.0,1749.3,,,0
CDM,36100784,HC INJ CHOLANGIO PERCU COMPLETE DX PX INCL IMAGE GUIDE ASSOC RAD S & I EXISTING ACCESS,652.0,456.4,,,0
CDM,36100785,HC INJ CHOLANGIO PERCU COMPLETE DX PX INCL IMAGE GUIDE ASSOC RAD S & I NEW ACCESS,2109.0,1476.3,,,0
CDM,36100786,HC PLACEMENT BILIARY DRAIN CATH PERCU INCL DX CHOLANGIO IMAGE GUIDE ASSOC RAD  S & I EXTERNAL,8004.0,5602.8,,,0
CDM,36100787,HC PLACEMENT BILIARY DRAIN CATH PERCU INCL DX CHOLANGIO IMAGE GUIDE ASSOC RAD  S & I INTERNAL/EXTERNAL,11276.0,7893.2,,,0
CDM,36100788,HC CONVERSION EXTERNAL BILIARY DRAIN CATH TO INTERNAL-EXTERNAL BILIARY DRAIN CATH PERCU INCL DX CHOLANGIO IMAGE GUIDE ASSOC RAD S & I,10538.0,7376.6,,,0
CDM,36100789,HC EXCHANGE BILIARY DRAIN CATH PERCU INCL DX CHOLANGIO IMAGE GUIDE ASSOC RAD S & I,3620.0,2534.0,,,0
CDM,36100790,HC REMOVAL BILIARY DRAIN CATH PERCU FLUORO GUIDE INCL DX CHOLANGIO IMAGE GUIDE ASSOC RAD S & I,1120.0,784.0,,,0
CDM,36100791,HC PLACE STENT(S) BILE DUCTS PERCU INCL DX CHOLANGIO IMAGE GUIDE BALLOON DILATION CATH EXCHANGE(S) & CATH REMOVAL(S) ASSOC RAD S & I EACH STENT EXISTING ACCESS,11304.0,7912.8,,,0
CDM,36100792,HC PLACE STENT(S) BILE DUCTS PERCU INCL DX CHOLANGIO IMAGE GUIDE BALLOON DILATION CATH EXCHANGE(S)  & CATH REMOVAL(S) ASSOC RAD S & I NEW ACCESS W/O SEP BILIARY DRAIN CATH,14164.0,9914.8,,,0
CDM,36100794,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNILATERAL,84.0,58.8,,,0
CDM,36100796,HC BALLOON DILATION BILIARY DUCT(S) OR AMPULLA PERCU INCL IMAGE GUIDE ASSOC RAD S & I EACH DUCT,7184.0,5028.8,,,0
CDM,36100797,HC ENDOLUMINAL BX(S) BILIARY TREE PERCU ANY METHOD(S) INCL IMAGE GUIDE ASSOC RAD S & I SINGLE/MULTI,2471.0,1729.7,,,0
CDM,36100799,HC SCLEROTHERAPY OF FLUID COLLECT PERCU INCL CONTRAST INJECT(S) SCLEROSANT INJECT(S) DX STUDY IMAGE GUIDE RAD S& I,1377.0,963.9,,,0
CDM,36100800,HC PLACE NEPHROSTOMY CATH PERCU INC DX NEPHROSTOGRAM URETOGRAM IMAGE GUIDE  ASSOC  RAD S & I,6976.0,4883.2,,,0
CDM,36100801,HC EXCHANGE NEPHROSTOMY CATH PERCU INCL DX NEPHROSTOGRAM URETEROGRAM IMAGE GUIDE  ASSOC RAD S & I,2817.0,1971.9,,,0
CDM,36100802,HC PLACE NEPHROURETERAL CATH PERCU INCL DX NEPHROSTOGRAM/URETEROGRAM IMAGE GUIDE ASSOC RAD S & I NEW ACCESS,9952.0,6966.4,,,0
CDM,36100803,HC CONVERT NEPHROSTOMY CATH TO NEPHROURETERAL CATH PERCU INCL DX NEPHROSTOGRAM/URETERGRAM IMAGE GUIDE ASSOC RAD S & I VIA PRE-EXISTING NEPHROSTOMY TRACT,8578.0,6004.6,,,0
CDM,36100804,HC ENDOLUMINAL BX URETER/RENAL PELVIS NON-ENDOSCOPIC INCL IMAGE GUIDE ASSOC RAD S & I,602.0,421.4,,,0
CDM,36100809,HC TRANSCATH PULM VALVE IMPLANT PERQ INCL PRE-STENTING VALVE DELIVERY SITE,20826.0,14578.2,,,0
CDM,36100810,HC BONE MARROW ASPIRATION W/BONE MARROW BIOPSY SAME INCISION SAME DOS,3259.0,2281.3,,,0
CDM,36100812,HC TRACHEOSTOMY PLANNED SEPARATE PROCEDURE,2689.0,1882.3,,,0
CDM,36100813,HC TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL,1148.0,803.6,,,0
CDM,36100850,HC DIAGNOSTIC BONE MARROW ASPIRATION(S),2867.0,2006.9,,,0
CDM,36100851,HC EGD FLEXIBLE/TRANSORAL W/BAND LIGATION ESOPHAGEAL/GASTRIC VARICES,5104.0,3572.8,,,0
CDM,36100852,HC PINCH GRAFT SINGLE/MULTIPLE COVER SMALL ULCER/TIP OF DIGIT/MINIMAL OPEN AREA UP TO 2CM DIAMETER,595.0,416.5,,,0
CDM,36100853,HC SPLIT-THICKNESS AUTOGRAFT TRUNK/ARMS/LEGS FIRST 100 SQ CM OR LESS OR 1% OF BODY AREA OF INFANTS/CHILDREN,2966.0,2076.2,,,0
CDM,36100855,HC PERCUT TRANSCATH CLOSURE LEFT ATRIAL APPENDAGE W/ENDOCARDIAL IMPLANT INCL FLUORO  RAD S&I,11522.0,8065.4,,,0
CDM,36100856,HC INTRO CATH DIALYSIS CIRCUIT W/DX ANGIO INCL DIRECT PUNCT/CATH PLACE/INJECT CONTRAST INCL INFERIOR/SUPERIOR VENA CAVA FLUORO GUIDE RAD S&I IMAGE DOC/REPORT,1704.0,1192.8,,,0
CDM,36100857,HC INTRO CATH DIALYSIS CIRCUIT W/TRANSLUMINAL BALLOON ANGIO PERIPHERAL DIALYSIS SEG INCL IMAGE  RAD S&I,15822.0,11075.4,,,0
CDM,36100859,HC PERCUT TRANSLUMINAL MECHANICAL THROMBECTOMY/INFUSION ANY METHOD INCL IMAGE/RAD S&I INTERP,19271.0,13489.7,,,0
CDM,36100860,HC THRMBC/NFS DIALYSIS CIRCUIT W/TRANSLUMINAL BALLOON ANGIO PERIPHERAL DIALYSIS SEG INCL IMAGE RAD S&I INTERP,37814.0,26469.8,,,0
CDM,36100861,HC THRMBC/NFS DIALYSIS CIRCUIT W/TRANSCATH PLACE INTRAVASCULAR STENT PERIPHERAL DIALYSIS SEG INCL IMAGE RAD S&I INTERP,21291.0,14903.7,,,0
CDM,36100862,HC TRANSLUMINAL BALLOON ANGIO CENTRAL DIALYSIS SEG DIALYSIS CIRCUIT INCL IMAGE RAD S&I  (LIST SEP IN ADDITION TO CODE FOR PRIMARY PX),15822.0,11075.4,,,0
CDM,36100863,HC TRANSLUMINAL BALLOON ANGIO OPEN/ PERCUT INCL IMAGE RAD S&I INITIAL ARTERY,14865.0,10405.5,,,0
CDM,36100864,HC TRANSLUMINAL BALLOON ANGIO OPEN/PERCUT INCL IMAGE RAD S&I EACH ADDL ARTERY (LIST SEP IN ADDITION TO CODE FOR PRIMARY PX),623.0,436.1,,,0
CDM,36100865,HC TRANSLUMINAL BALLOON ANGIO (EXCEPT DIALYSIS CIRCUIT) OPEN/PERCUT INCL IMAGE RAD S&I INITIAL VEIN,14118.0,9882.6,,,0
CDM,36100866,HC TRANSLUMINAL BALLOON ANGIO OPEN/PERCUT INCL IMAGE RAD S&I EACH ADDL VEIN (LIST SEP IN ADDITION TO CODE FOR PRIMARY PX),4096.0,2867.2,,,0
CDM,36100867,HC INJECT DX/THERPEUTIC SUBSTANCE INCL NEEDLE/CATH PLACE INTERLAMINAR EPIDURAL/SUBARACHNOID/CERVICAL/THORACIC W/O IMAGE GUIDE,2499.0,1749.3,,,0
CDM,36100868,HC INJECT DX/THERPEUTIC SUBSTANCE INCL NEEDLE/CATH PLACE INTERLAMINAR EPIDURAL/SUBARACHNOID/CERVICAL/THORACIC W/IMAGE GUIDE (IE FLUORO OR CT),1727.0,1208.9,,,0
CDM,36100869,HC INJECT DX/THERAPEUTIC SUBSTANCE INCL NEEDLE/CATH PLACE INTERLAMINAR EPIDURAL/SUBARACHNOID/ LUMBAR/SACRAL (CAUDAL) W/O IMAGE GUIDE,2945.0,2061.5,,,0
CDM,36100870,HC INJECT DX/THERAPEUTIC SUBSTANCE INCL NEEDLE/ CATH PLACE INTERLAMINAR EPIDURAL/SUBARACHNOID/LUMBAR/SACRAL (CAUDAL) W/IMAGE GUIDE (IE FLUORO OR CT),1504.0,1052.8,,,0
CDM,36100871,HC INJECT INCL INDWELLING CATH PLACE CONT INFUSION/INTERMIT BOLUS INTERLAMINAR EPIDURAL/SUBARACHNOID/CERVICAL/THORACIC W/O IMAGE GUIDE,3294.0,2305.8,,,0
CDM,36100872,HC INJECT INCL INDWELLING CATH PLACE CONT INFUSION/INTERMIT BOLUS INTERLAMINAR EPIDURAL/SUBARACHNOID/CERVICAL/THORACIC W/IMAGE GUIDE (IE FLUORO OR CT),3788.0,2651.6,,,0
CDM,36100873,HC INJECT INCL INDWELLING CATH PLACE CONT INFUSION/INTERMIT BOLUS INTERLAMINAR EPIDURAL/SUBARACHNOID/LUMBAR/SACRAL (CAUDAL) W/O IMAGE GUIDE,1323.0,926.1,,,0
CDM,36100874,HC INJECT INCL INDWELLING CATH PLACE CONT INFUSION/INTERMIT BOLUS INTERLAMINAR EPIDURAL/ SUBARACHNOID/LUMBAR/SACRAL (CAUDAL) W/IMAGE GUIDE (IE FLUORO OR CT),3294.0,2305.8,,,0
CDM,36100875,HC DECOMPRESSION FASCIOTOMY FOREARM/WRIST FLEXOR AND EXTENSOR COMPARTMENT W/O DEBRIDEMENT NONVIABLE MUSCLE/NERVE,9421.0,6594.7,,,0
CDM,36100876,HC MYELOGRAPHY VIA LUMBAR INJECT INCL RAD S&I 2 OR MORE REGIONS,1738.0,1216.6,,,0
CDM,36100877,HC MYELOGRAPHY VIA LUMBAR INJECTION INC RAD S&I CERVICAL,1738.0,1216.6,,,0
CDM,36100879,HC CYSTOURETHROSCOPY W/URETERAL CATH W/WO IRRIGATION/INSTILLATION/URETEROPYELOGRAPHY EXCLUSIVE OF RA,4726.0,3308.2,,,0
CDM,36100894,HC PERCU VRTBRPLSTY 1 VERT BODY UNI/BIL INJ INCL IMG GUID CERVICOTHORA,11791.0,8253.7,,,0
CDM,36100902,HC INJECTION ANESTHETIC AGENT SUPERIOR HYPOGASTRIC PLEXUS,3294.0,2305.8,,,0
CDM,36100913,HC TANGENTIAL BIOPSY OF SKIN SINGLE LESION,704.0,492.8,,,0
CDM,36100914,HC PUNCH BIOPSY OF SKIN INCL SIMPLE CLOSURE SINGLE LESION,740.0,518.0,,,0
CDM,36100915,HC INCISIONAL BIOPSY OF SKIN INCL SIMPLE CLOSURE SINGLE LESION,1251.0,875.7,,,0
CDM,36100916,HC TANGENTIAL BIOPSY OF SKIN EACH SEPARATE/ADDTL LESION,79.0,55.3,,,0
CDM,36100917,HC PUNCH BIOPSY OF SKIN INCL SIMPLE CLOSURE EACH SEPARATE/ADDTL LESION,352.0,246.4,,,0
CDM,36100918,HC INCISIONAL BIOPSY OF SKIN EACH SEPARATE/ADDT LESION,626.0,438.2,,,0
CDM,36100919,HC INSERTION SUBCUTANEOUS CARDIAC RHYTHM MONITOR INCL PROGRAMMING,26892.0,18824.4,,,0
CDM,36100920,HC REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR,2104.0,1472.8,,,0
CDM,36100921,HC DILATION OF EXISIT TRAC PERCUTANEOUS FOR ENDOURO PX INCL IMAGE GUID RAD S&I,7549.0,5284.3,,,0
CDM,36100922,HC DILATION OF EXIST TRACT ENDOURO PX INCL IMAGE GUIDE RAD S&I W/POST PX TUBE PLCMT,13563.0,9494.1,,,0
CDM,36100923,HC INJECTION PROCEDURE FOR CONTRAST KNEE ARTHROGRAPY/CONTRAST ENCHANCED CT/MRI KNEE ARTHROGRAPY,265.0,185.5,,,0
CDM,36100924,HC INSERT OF PICC W/O SUB PORT/PUMP INCLUD ALL IMAGE GUIDE IMAGE DOC/ASSOC RADIOLOGICAL < 5 YRS,2470.0,1729.0,,,0
CDM,36100925,HC INSERT OF PICC W/O SUB PORT/PUMP INCLUD ALL IMAGE GUIDE IMAGE DOC/ASSOC RADIOLOGICAL >5 YRS,4356.0,3049.2,,,0
CDM,36100927,HC EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS,3208.0,2245.6,,,0
CDM,36100928,HC ARTHOCENTISIS ASPIR/INJECT SM JOINT/BURSA W/ULTRA SOUND GUIDE W/PERM RECORDING & REPORTING,1103.0,772.1,,,0
CDM,36100930,HC ENDOVENOUS ABLATION THERAPY INCOMP VEIN EXTREMITY IMAGE GUIDE & MONITORING FIRST VEIN TX,11932.0,8352.4,,,0
CDM,36100931,HC ENDOVENOUS ABLATION THERAPY INCOM VEIN EXTREMITY IMAGE GUIDE & MONITOR SUBQ VEIN(S) TX IN SINGLE EXTREMITY EA SEP ACESS SITES,100.0,70.0,,,0
CDM,36100932,HC INJECTION PX FOR ANKLE ARTHROGRAPHY,958.0,670.6,,,0
CDM,36100940,HC PERICARDIOCENTESIS INCL IMAGE GUIDE WHEN PERFORMED,6288.0,4401.6,,,0
CDM,36100941,HC PERICARDIAL DRAINAGE W/INSERT INDWELLING CATH PERQ INCL FLURO AND/OR US GUIDE 6 YEARS AND OLDER W/O CONGENTIAL CARDIAC ANOMALY,6107.0,4274.9,,,0
CDM,36100942,HC PERICARDIAL DRAINAGE W/INSERT INDEWLLING CATH PERQ INCL FLURO AND/OR US GUIDE BIRTH THROUGH 5 YEARS OF AGE OR ANY AGE W/CONGENTIAL CARDIAC ANOMALY,6107.0,4274.9,,,0
CDM,36100944,HC INJECTION ANESTHETIC AGENT(S)/STEROID NERVES INNERVATING THE SACROILIAC JOINT W/IMAGE GUIDANCE,2566.0,1796.2,,,0
CDM,36100946,HC DESTRUCTION NEUROLYTIC AGT W/IMG,7058.0,4940.6,,,0
CDM,36100947,HC DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT,2802.0,1961.4,,,0
CDM,36100951,HC EGD ESOPHAGOGASTRC FUNDOPLASTY,3208.0,2245.6,,,0
CDM,36100952,HC CORE NEEDLE BIOPSY LUNG/MED PERQ INCL IMAGE GUIDE,3021.0,2114.7,,,0
CDM,36100953,HC BURR HOLE IMPLANT VENTRICULAR CATH/OTHER DEVICE,23290.0,16303.0,,,0
CDM,36100955,HC TAS CONGENTIAL CARDIAC ANOMALIES INCL IMAGING GUIDANCE ANY METHOD,5764.0,4034.8,,,0
CDM,36100956,HC INJECTION(S) ANESTHETIC AGENT(S) AND/OR STERIOD GENICULAR NERVE BRANCHES INCL IMAGE GUIDE WHEN PERFORMED,2800.0,1960.0,,,0
CDM,36100957,HC BIOPSY MUSCLE SUPERFICIAL,5815.0,4070.5,,,0
CDM,36100958,HC BIOPSY MUSCLE DEEP,9794.0,6855.8,,,0
CDM,36100959,HC SPINAL PUNCTURE THERAPEUTIC DRAINAGE OF CSF W/FLUORO OR CT GUIDE,2884.0,2018.8,,,0
CDM,36100960,HC EVASC TTA REPAIR W/O SUBCLAVIAN ARTERY ORIGIN TO LEVEL OF CELIAC ATETERY ORIGIN,18516.0,12961.2,,,0
CDM,36100961,HC AMPUTATION TOE METATARSOPHALANGEAL JOINT,12082.0,8457.4,,,0
CDM,36100962,HC OPEN AXILLARY/SUBCL ARTERY EXPOSE DELIVERY ENDOVASCULAR PROSTHESIS UNILATERAL,1201.0,840.7,,,0
CDM,36100963,HC EXTRAORAL INCISION & DRAINAGE ABSCESS/CYSTS/HEMATOMA OF MOUTH MASTICATOR SPACE,5758.0,4030.6,,,0
CDM,36100964,HC CHEMODENERV PAROTID&SUBMANDIBL SALIVARY GLNDS BILATERAL,1211.0,847.7,,,0
CDM,36100965,HC CHEMODENERV MUSCLE LARYNX UNILAT INCL GUIDE NEEDLE EMG WHEN PERFORMED,3675.0,2572.5,,,0
CDM,36100966,HC DESTRUCTION NEUROLYTIC AGENT INTERCOSTAL NERVE,3501.0,2450.7,,,0
CDM,36100967,HC RADIOFREQUENCY ABLTJ NERVE SI JOINT W/IMG GUIDANCE,8165.0,5715.5,,,0
CDM,36100968,HC DESTRUCTION NEUROLYTIC AGENT PUDENDAL NERVE,3501.0,2450.7,,,0
CDM,36100969,HC DESTRUCTION BY NEUROLYTIC AGENT PLANTAR COMMON DIGITAL NERVE,1112.0,778.4,,,0
CDM,36100970,HC INTRAORAL INCISION/DRAINAGE OF ABSCESS/CYST/HEMATOMA OF TONGUE OR FLOOR OF MOUTH SUBMENTAL SPACE,5758.0,4030.6,,,0
CDM,36100971,HC DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM,1926.0,1348.2,,,0
CDM,36100972,HC INJECT/INFUSION NEUROLYTIC SUBST W/WO THERAP SUBST EPIDURAL/CERVICAL/THORACIC,3558.0,2490.6,,,0
CDM,36100973,HC INJECT/INFUSION NEUROLYTIC SUBST W/WO THERAP SUBST EPIDURAL/LUMBAR/SACRAL,3876.0,2713.2,,,0
CDM,36100974,HC LARYNGOSCOPY FOREIGN BODY REMVL W/OPERATING MICROSCOPE OR TELESCOPE,9952.0,6966.4,,,0
CDM,36100975,HC PERCUTANEOUS/NEPHROLITHOTOMY/PYELOLITHOTOMY/LITHOTRIPSY STONE EXTRACTION INCL IMAGE GUIDE SIMPLE UP TO 2 CM KIDNEY/RENAL PELVIS,38852.0,27196.4,,,0
CDM,36100976,HC CISTERNAL/LATERAL C1-C2 PUNCTURE W/INJECTION OF MEDICATION/OTH SUBSTANCE DX/TREATMENT,2328.0,1629.6,,,0
CDM,36100977,HC PUNCTURE ASPIRATION HYDROCELE TUNICA VAGIS W/WO INJECTION OF MEDICATION,2689.0,1882.3,,,0
CDM,36100978,HC PLACEMENT OF NEEDLE PELVIC ORGAN RADIOELEMENT APPL,17148.0,12003.6,,,0
CDM,36100980,HC PLACEMENT SOFT TISS LOC DEVICE PLMT W/GUIDANCE 1ST LESION,2682.0,1877.4,,,0
CDM,36100981,HC PLACEMENT SOFT TISS LOC DEVICE PLMT W/GUIDANCE EACH ADDTL LESION,175.0,122.5,,,0
CDM,36100983,HC INJECTION ANESTHETIC AGENT(S)/STEROID AXILLARY NERVE INCL IMAGE GUIDE,3086.0,2160.2,,,0
CDM,36100984,HC UNLISTED PROCEDURE VASCULAR SURGERY,3849.0,2694.3,,,0
CDM,36100985,HC UNLISTED PROCEDURE SKIN MUCOUS MEMBRANE & SUBCUTANEOUS TISSUE,674.0,471.8,,,0
CDM,36100986,HC MECHANICAL RMVL INTRAL OBSTRUCTIVE CENTRAL VENOUS DEVICE LUMEN,5272.0,3690.4,,,0
CDM,36100987,HC EGD INTRALUMINAL TUBE/CATHETER INSERTION,3803.0,2662.1,,,0
CDM,36100988,HC TRANSCATHETER MITRAL VALVE IMPLANTATION/REPLACEMENT W/PROSTHETIC VALVE PERCUTANEOUS APPROACH,4795.0,3356.5,,,0
CDM,36100989,HC REVASCULAR ENDOVASC OPEN/PERCU LOW EXTREM ARTERY EXCEPT TIBI/PERONE W/INTRAVASC LITHO INCL ANGIO WITHIN SAME VESSEL,35180.0,24626.0,,,0
CDM,36100990,HC REVASCULAR ENDOVASC OPEN/PERCU LOW EXTREM ARTERY EXCEPT TIBI/PERONE W/INTRAVASC LITHO-STENT  INCL ANGIO WITHIN SAME VESSEL,56250.0,39375.0,,,0
CDM,36100991,HC REVASCULAR ENDOVASC OPEN/PERCU LOW EXTREM ARTERY EXCEPT TIBI/PERONE W/INTRAVASC LITHO/ATHER INCL ANGIO WITHIN SAME VESSEL,56250.0,39375.0,,,0
CDM,36100992,HC REVASCULARENDOVASC OPEN/PERCUTAN TIBI/PERONE W/INTRAVASC LITHOTRIPSY INCL ANGIO WITHIN SAME VESSEL,44801.0,31360.7,,,0
CDM,36100993,HC REVASCULAR ENDOVASC OPEN/PERCU TIBI/PERONE W/INTRAVASC LITHOTR-STENT INCL ANGIO WITHIN SAME VESSEL,71661.0,50162.7,,,0
CDM,36100994,HC REVASCULAR ENDOVASC OPEN/PERCU TIBI/PERONE W/INTRAVASC LITHO/ATHER INCL ANGIO WITHIN SAME VESSEL,71661.0,50162.7,,,0
CDM,36100995,HC REVASCULAR ENDOVASC OPEN/PERCU TIBI/PERONE W/INTRAVASC LITH-STENT PLACE/ATHER INCL ANGIO WITHIN SAME VESSELS,71661.0,50162.7,,,0
CDM,36100996,HC REVASCULAR ENDOVASC OPEN/PERCU LOW EXTREM ARTERY EXCEPT TIBI/PERONE W/INTRAVASC LITHO-STENT-ATHER INCL ANGIO WITHIN SAME VESSEL,71108.0,49775.6,,,0
CDM,36100997,HC REMOVAL INFLATABLE PENILE PROSTHESIS W/O RPLCMT PROSTHESIS,12066.0,8446.2,,,0
CDM,36100998,HC UNLISTED PROCEDURE ABDOMEN MUSCULOSKELETAL SYSTEM,203.0,142.1,,,0
CDM,36100999,HC SIGMOIDOSCOPY FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILATION,3620.0,2534.0,,,0
CDM,36101000,HC UNLISTED LAPAROSCOPY PROCEDURE ABDOMEN PERITONEUM & OMENTUM,18008.0,12605.6,,,0
CDM,36101001,HC UNLISTED LAPAROSCOPY PROCEDURE STOMACH,31396.0,21977.2,,,0
CDM,36101002,HC RESEARCH ONLY EVASC VEN ARTLZ TIBL/PRNL VN W/TRANSCATH PLACE INTRAVASC STENT GRAFT/CLOSE INCL PERCUT/OPEN VASC ACCESS US VASC ACCESS CATH/INTRAPROC ROADMAP/IMAGE GUIDE RAD SUPERVISON,54125.0,37887.5,,,0
CDM,36101003,HC ESOPHAGOSCOPY FLEXIBLE TRANSORAL W/BIOPSY SINGLE/ MULTIPLE,3608.0,2525.6,,,0
CDM,36101004,HC PUNCTURE OF SHUNT TUBING OR RESERVOIR FOR ASPIRATION/INJECTION PROCEDURE,2227.0,1558.9,,,0
CDM,36101005,HC ENDOVENOUS FEMORAL POPLITEAL ARTERIAL REVSC W/TRANSCATH PLMT INTRAVAS STENT GRAFT/CLSR INCL PERCUT/OPEN VASC ACCESS US GUIDE FOR VASC ACCESS CATH/INTRAPROC ROADMAP/IMAGE GUIDE RAD S&I,39081.0,27356.7,,,0
CDM,36101006,HC REPOSITIONING NASO-OR ORO-GASTRIC FEEDING TUBE THRU DUODENUM FOR ENTERIC NUTRITION,2583.0,1808.1,,,0
CDM,36101007,HC INJECTION ANESTHETIC AGENT/STEROID PUDENDAL NERVE,3440.0,2408.0,,,0
CDM,36101008,HC TRANSVERSUS ABDOMINIS PLANE BLOCK UNILATERAL BY INJECTION,222.0,155.4,,,0
CDM,36101009,HC TRANSVERSUS ABDOMINIS PLANE BLOCK UNILATERAL BY CONTINUOUS INFUSION,256.0,179.2,,,0
CDM,36101010,HC TRANSVERSUS ABDOMINIS PLANE BLOCK BILATERAL BY INJECTIONS,279.0,195.3,,,0
CDM,36101011,HC TRANSVERSUS ABDOMINIS PLANE BLOCK BY CONTINUOUS INFUSIONS,314.0,219.8,,,0
CDM,36101012,HC PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODE ARRAY EPIDURAL,29045.0,20331.5,,,0
CDM,36101013,HC AMPUTATION TOE INTERPHALANGEAL JOINT,11385.0,7969.5,,,0
CDM,36101014,HC INJECTION PROCEDURE LYMPHANGIOGRAPHY,815.0,570.5,,,0
CDM,36101015,HC INJECTION(S) ANESTHETIC AGENT(S) AND/OR STEROID VAGUS NERVE,2015.0,1410.5,,,0
CDM,36101016,HC INJECTION(S) ANESTHETIC AGENT(S) AND/OR STEROID BRACHIAL PLEXUS INCL IMAGE GUIDE,3294.0,2305.8,,,0
CDM,36101017,HC INJECTION(S) ANESTHETIC AGENT(S) AND/OR STEROID BRACHIAL PLEXUS CONT INFUSION BY CATHETER INCL IMAGE GUIDE,3789.0,2652.3,,,0
CDM,36101018,HC INJECTION(S) ANESTHETIC AGENT(S) AND/OR STEROID PARACERVICAL UTERINE NERVE,2499.0,1749.3,,,0
CDM,36101019,HC INJECTION(S) ANESTHETIC AGENT(S) AND/OR STEROID SCIATIC NERVE CONT INFUSION BY CATHETER INCL IMAGE GUIDE,4306.0,3014.2,,,0
CDM,36101020,HC INJECTION(S) ANESTHETIC AGENT(S) AND/OR STEROID FEMORAL NERVE CONT INFUSION BY CATHETER INCL IMAGE GUIDE,3294.0,2305.8,,,0
CDM,36101021,HC INJECTION(S) AGENT(S) AND/OR STEROID LUMBAR PLEXUS POSTERIOR APPROACH CONT INFUSION BY CATHETER INCL CATHETER PLACEMENT,3789.0,2652.3,,,0
CDM,36101022,HC UNLISTED PROCEDURE PELVIS OR HIP JOINT,1071.0,749.7,,,0
CDM,36101023,HC INITIATION SELECTIVE HEAD/TOTAL BODY HYPOTHERMIA NEONATE,771.0,539.7,,,0
CDM,36101024,HC REMOVAL OF SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELECTRODE,14363.0,10054.1,,,0
CDM,36101025,HC ENDOVASCULAR REPAIR DESCENDING THORACIC AORTA LEFT SUBCLAVIAN ARTERY ORIGIN INITIAL ENDOPROSTHESIS PLUS DESCENDING THORACIC AORTIC EXTENSION(S),2207.0,1544.9,,,0
CDM,36101026,HC INJECTION FOR HIP ARTHROGRAPHY W/ANESTHESIA,866.0,606.2,,,0
CDM,36101036,HC UNLISTED PROCEDURE FEMALE GENITAL SYSTEM,3082.0,2157.4,,,0
CDM,36101037,HC INSERTION OF PERIPHERALLY INSERTED CENTRAL VENOUS ACCESS DEVICE W/SUBQ PORT UNDER 5 YRS,12111.0,8477.7,,,0
CDM,36101038,HC TRANSCATHETER TRICUSPID VALVE REPAIR PERQ APPROACH INITIAL PROSTHESIS,6686.0,4680.2,,,0
CDM,36101039,HC TRANSCATHETER TRICUSPID VALVE REPAIR PERQ APPROACH EACH ADDTL PROSTHESIS,1577.0,1103.9,,,0
CDM,36101040,HC TTVI/REPLACEMENT PROSTC VALVE PERQ W/RIGHT HEART CATH & ANGRPH,4649.0,3254.3,,,0
CDM,36101042,HC MECHANICAL RMVL PRICATH OBSTR  MATRL FROM CENTRAL VENOUS DEVICE VIA SEPARATE VENOUS ACCESS,12111.0,8477.7,,,0
CDM,36101043,HC PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODE ARRAY PERIPHERAL NERVE,26489.0,18542.3,,,0
CDM,36101044,HC SUTURE PHARYNX FOR WOUND OR INJURY,5979.0,4185.3,,,0
CDM,36101046,HC MANOMETRIC STUDIES THRU NEPHROSTOMY/PYELOSTOMY TUBE/INDWELLING URETERAL CATHETER,2695.0,1886.5,,,0
CDM,36101048,HC THORACIC FASCIAL PLANE BLOCK UNILATERAL BY INJECTION INCL IMAGE GUIDE WHEN PERFORMED,2949.0,2064.3,,,0
CDM,36101049,HC LOWER EXTREMITY FASCIAL PLANE BLOCK UNILATERAL BY INJECTION INCL IMAGE GUIDE WHEN PERFORMED,2949.0,2064.3,,,0
CDM,36101050,HC THORACIC FASCIAL PLANE BLOCK UNILATERAL CONT INFUSION INCL IMAGE GUIDE WHEN PERFORMED,2949.0,2064.3,,,0
CDM,36101051,HC THORACIC FASCIAL PLANE BLOCK BILATERAL INJECTION INCL IMAGE GUIDE WHEN PERFORMED,2949.0,2064.3,,,0
CDM,36101052,HC THORACIC FASCIAL PLANE BLOCK BILATERAL CONT INFUSION INCL IMAGE GUIDE WHEN PERFORMED,2949.0,2064.3,,,0
CDM,36101053,HC LOWER EXTREMITY FASCIAL PLANE BLOCK UNILATERAL CONT INFUSION INCL IMAGE GUIDE WHEN PERFORMED,2949.0,2064.3,,,0
CDM,36101054,HC EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBFASCIAL LESS THAN 1.5CM,12185.0,8529.5,,,0
CDM,36101055,HC REMOVAL SPINAL NEUROSTIMULATOR ELECTRODE PERCUTANEOUS ARRAY(S) INCL FLUORO,8314.0,5819.8,,,0
CDM,36101056,HC REMOVAL SPINAL NEUOSTIMULATOR ELECTRODE PLATE/PADDLE(S) LAMINOTOMY/LAMINECTOMY INCL FLUORO,14641.0,10248.7,,,0
CDM,36101057,HC REVISION INCL REPLACEMENT SPINAL NEUROSTIMULATOR ELECTRODE PERCUTANEOUS ARRAY(S) INCL FLUORO,27940.0,19558.0,,,0
CDM,36101058,HC REVISION INCL REPLACEMENT SPINAL NEUROSTIMULATOR ELECTRODE PLATE/PADDLE(S) LAMINOTOMY/LAMINECTOMY INCL FLUORO,53090.0,37163.0,,,0
CDM,36101059,HC REVISION/REMOVAL IMPLANTED SPINAL NEUROSTIMULATOR PULSE GENERATOR/RECEIVER DETACH CONNECTION ELECTORDE ARRAY,14641.0,10248.7,,,0
CDM,36101060,HC UNLISTED LAPAROSCOPY PROCEDURE ESOPHAGUS,44324.0,31026.8,,,0
CDM,36101061,HC ABLATION IRREVERSIBLE ELECTROPORATION 1 OR MORE TUMORS PER ORGAN INCLUDING IMAGING GUIDANCE PERCUATANEOUS,44324.0,31026.8,,,0
CDM,36101062,HC ABLATION IRREVERSIBLE ELECTROPORATION 1 OR MORE TUMORS PER ORGAN INCLUDING FLUOROSCOPIC AND ULTRASOUND GUIDANCE OPEN,44324.0,31026.8,,,0
CDM,36221,IOPAMIDOL 61 % IV SOLN,329.0,230.3,,,0
CDM,36221,IOPAMIDOL 76 % IV SOLN,285.0,199.5,,,0
CDM,36333,BCG LIVE 50 MG IVES SUSR,564.0,394.79999999999995,,,0
CDM,36333,LIDOCAINE HCL  2 % MM JELP,47.0,32.9,,,0
CDM,36481,"TRASTUZUMAB-HYALURONIDASE-OYSK 600 MG-10,000 UNIT/5 ML SUBQ SOLN",12904.0,9032.8,,,0
CDM,36561,FAM-TRASTUZUMAB DERUXTECAN-NXKI 100 MG IV SOLR,17110.5,11977.349999999999,,,0
CDM,36564,LUSPATERCEPT-AAMT 25 MG SUBQ SOLR,4991.0,3493.7,,,0
CDM,36564,LUSPATERCEPT-AAMT 75 MG SUBQ SOLR,22747.5,15923.25,,,0
CDM,36569,ENFORTUMAB VEDOTIN-EJFV 20 MG IV SOLR,2476.0,1733.2,,,0
CDM,36569,ENFORTUMAB VEDOTIN-EJFV 30 MG IV SOLR,8517.5,5962.25,,,0
CDM,36896,CARBOPLATIN 10 MG/ML IV,350.0,245.0,,,0
CDM,36917,REGADENOSON 0.4 MG/5 ML IV SYRG,531.5,372.05,,,0
CDM,37000001,HC ISOFLURANE INH,5.0,3.5,,,0
CDM,37000002,HC SEVOFLURANE INH,248.0,173.6,,,0
CDM,37000003,HC DESFLURANE INH,292.0,204.4,,,0
CDM,37000008,HC ANESTHESIA PX HEART PERICARDIAL SAC GREAT VESSELS OF CHEST W/O PUMP OXYGENATOR,358.0,250.6,,,0
CDM,37000015,HC MOD SEDATION SAME PHYS/QHP ENDOSCOPIC SERVICE INITIAL 15 MIN PATIENT 5 YEARS OR OLDER,445.0,311.5,,,0
CDM,37100005,HC MOD SEDATION SAME PHYS/QHP INITIAL 15 MIN PATIENT YOUNGER THAN 5 YEARS OF AGE,223.0,156.1,,,0
CDM,37100006,HC MOD SEDATION SAME PHYS/QHP INITIAL 15 MIN PATIENT AGE 5 YEARS OR OLDER,423.0,296.1,,,0
CDM,37100007,HC MOD SEDATION SAME PHYS/QHP EACH ADDTL 15 MIN INTRASERVICE TIME (LIST SEP  IN ADDT TO CODE FOR PRIMARY SERVICE),114.0,79.8,,,0
CDM,37100008,HC MOD SEDATION OTHER PHYS/QHP INITIAL 15 MIN INTRASERVICE TIME PATIENT YOUNGER THAN 5 YEARS OF AGE,307.0,214.9,,,0
CDM,37100009,HC MOD SEDATION OTHER PHYS/QHP INITIAL 15 MIN INTRASERVICE TIME PATIENT AGE 5 YEARS OR OLDER,307.0,214.9,,,0
CDM,37100010,HC MOD SEDATION OTHER PHYS/QHP EACH ADDTL 15 MIN INTRASERVICE TIME (LIST SEP IN ADDT TO CODE FOR PRIMARY SERVICE),154.0,107.8,,,0
CDM,3746,BCG LIVE 50 MG IVES SUSR,382.0,267.4,,,0
CDM,3746,SODIUM CHLORIDE 0.9 % IV SOLP,19.0,13.3,,,0
CDM,3755,COPPER 380 SQUARE MM IU IUD,2000.0,1400.0,,,0
CDM,3755,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,47.5,33.25,,,0
CDM,3755,DEXTROSE 5% IN WATER (D5W) IV,23.0,16.1,,,0
CDM,3755,ETONOGESTREL 68 MG SDRM IMPL,2258.0,1580.6,,,0
CDM,3755,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) BLADDER INSTILLATION,392.0,274.4,,,0
CDM,3755,LEUPROLIDE (3 MONTH) 22.5 MG IM SYRG,1176.0,823.2,,,0
CDM,3755,LEVONORGESTREL 14 MCG/24 HOUR (3 YEARS) IU IUD,1973.0,1381.1,,,0
CDM,3755,LEVONORGESTREL 20 MCG/24 HR IU IUD,2369.0,1658.3,,,0
CDM,3755,"LIDOCAINE-EPINEPHRINE 2 %-1:200,000 INJ SOLN",19.0,13.3,,,0
CDM,3755,SODIUM CHLORIDE 0.9 % INJ SYRG,16.0,11.2,,,0
CDM,37581,ARIPIPRAZOLE LAUROXIL 441 MG/1.6 ML IM SERS,3788.0,2651.6,,,0
CDM,37581,ARIPIPRAZOLE LAUROXIL 662 MG/2.4 ML IM SERS,6592.0,4614.4,,,0
CDM,37581,ARIPIPRAZOLE LAUROXIL 882 MG/3.2 ML IM SERS,7575.0,5302.5,,,0
CDM,37759,ROMOSOZUMAB-AQQG 105 MG/1.17 ML SUBQ SYRG,5349.0,3744.3,,,0
CDM,38133,CEMIPLIMAB-RWLC 50 MG/ML IV SOLN,25491.0,17843.7,,,0
CDM,38189,TAFASITAMAB-CXIX 200 MG IV SOLR,11485.5,8039.85,,,0
CDM,38791,TRASTUZUMAB-QYYP 420 MG IV SOLR,7911.5,5538.05,,,0
CDM,38796,RITUXIMAB-PVVR 10 MG/ML IV SOLN,3759.0,2631.3,,,0
CDM,38950,"RHO(D) IMMUNE GLOBULIN (RHOPHYLAC) 1,500 UNIT (300 MCG)/2 ML INJ SYRG",693.0,485.1,,,0
CDM,38999,SODIUM CHLORIDE 0.9 % IV SOLP,30.0,21.0,,,0
CDM,39000001,HC RBC LEUKOC REDUCED EA UNIT,337.0,235.9,,,0
CDM,39000003,HC RBC WASHED EA UNIT,498.0,348.6,,,0
CDM,39000004,HC PLATE LEU REDUC PHER IRR EA UNIT,910.0,637.0,,,0
CDM,39000005,HC PLASMA CRYOPREC REDUC EA UNIT,295.0,206.5,,,0
CDM,39000006,HC CRYOPRECIPITATE EA UNIT,157.0,109.9,,,0
CDM,39000007,HC POOLED CRYOPRECIPITATE EA UNIT,706.0,494.2,,,0
CDM,39000008,FRESH FROZEN PLASMA 50ML,43.0,30.1,,,0
CDM,39000009,HC FRESH FROZEN PLASMA 10ML,13.0,9.1,,,0
CDM,39000010,HC FRESH FROZEN PLASMA 20ML,22.0,15.4,,,0
CDM,39000011,HC FRESH FROZEN PLASMA 100ML,84.0,58.8,,,0
CDM,39000012,HC FRESH FROZEN PLASMA SINGLE DONOR,164.0,114.8,,,0
CDM,39000017,HC PLATELETS PHERESIS LEUKOCYTES REDUCED EACH UNIT,577.0,403.9,,,0
CDM,39000018,HC PLATELET PHERESIS LEUKOCYTE REDUCED,794.0,555.8,,,0
CDM,39000019,HC RED BLD CELLS LEUKOREDUCED IRRAD 100ML,170.0,119.0,,,0
CDM,39000020,HC RED BLD CELLS LEUKOREDUCED IRRAD 50ML,87.0,60.9,,,0
CDM,39000021,HC RED BLD CELLS LEUKOREDUCED IRRAD 20ML,44.0,30.8,,,0
CDM,39000022,HC RED BLD CELLS LEUKOREDUCED IRRAD 10ML,23.0,16.1,,,0
CDM,39000023,HC RBC LEUKO REDUCED/IRRADIATED EA UNIT,453.0,317.1,,,0
CDM,39000024,HC RED BLOOD CELLS LEUKOREDUCED 10ML,793.0,555.1,,,0
CDM,39000026,HC RED BLOOD CELLS LEUKOREDUCED 50ML,88.0,61.6,,,0
CDM,39000027,HC RED BLOOD CELLS LEUKOREDUCED100ML,169.0,118.3,,,0
CDM,39000031,HC PLATELET PHERESIS LEUKOCYTE REDUCED 50ML,289.0,202.3,,,0
CDM,39000033,HC PLATELETS PHERESIS LEUKO REDUC/IRRAD 20M,115.0,80.5,,,0
CDM,39000034,HC PLATELETS PHERESIS LEUKO REDUC/IRRAD 50M,228.0,159.6,,,0
CDM,39000035,HC PLATE PHERESIS LEUKO REDUC/IRRAD 100ML,456.0,319.2,,,0
CDM,39000036,HC FRESH FRZN PLSMA 8-24HR COLLECT EACH,164.0,114.8,,,0
CDM,39000038,HC PLSMA 8-24HR COLLECT 20ML,22.0,15.4,,,0
CDM,39000039,HC PLSMA 8-24HR COLLECT 50ML,43.0,30.1,,,0
CDM,39000040,HC PLSMA 8-24HR COLLECT 100ML,84.0,58.8,,,0
CDM,39045,FERUMOXYTOL 510 MG/17 ML (30 MG/ML) IV SOLN,2897.0,2027.9,,,0
CDM,39046,TECHNETIUM TC 99M SESTAMIBI - CARDIOLITE,214.0,149.8,,,0
CDM,39100001,HC BLOOD ADMINISTRATION,1602.0,1121.4,,,0
CDM,39100002,HC BLOOD TRANSFUSION LEVEL 2 2-4,1486.0,1040.2,,,0
CDM,39100003,HC BLOOD TRANSFUSION LEVEL 3 4-6,1691.0,1183.7,,,0
CDM,39100004,HC BLOOD TRANSFUSION LEVEL 4 6-9,1894.0,1325.8,,,0
CDM,39100005,HC BLOOD TRANSFUSION LEVEL 5 9+ H,2099.0,1469.3,,,0
CDM,39588,BEVACIZUMAB-BVZR 25 MG/ML IV SOLN,5757.0,4029.9,,,0
CDM,39714,IRON SUCROSE 100 MG/5 ML IV SOLN,651.5,456.04999999999995,,,0
CDM,3985,GENTAMICIN 40 MG/ML INJ SOLN,70.0,49.0,,,0
CDM,39886,SACITUZUMAB GOVITECAN-HZIY 180 MG IV SOLR,13397.5,9378.25,,,0
CDM,4,DUMMY EAP FOR NSA - IMPLANTS - $500 INCREMENT,500.0,350.0,,,0
CDM,40184,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,49.0,34.3,,,0
CDM,40184,"DIPHTH,PERTUS(ACELL),TETANUS SYRG(BOOSTRIX) 2.5-8-5 LF-MCG-LF/0.5ML IM SYRG",247.0,172.9,,,0
CDM,40184,FLU VACCINE TS 2025-26 6 MO UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,120.0,84.0,,,0
CDM,40184,FLU VACCINE TS 2025-26 65 YR UP (PF) 180 MCG/0.5 ML IM SYRG,387.5,271.25,,,0
CDM,40200001,HC US BRAIN,425.0,297.5,,,0
CDM,40200002,HC US SOFT TISSUE HEAD NECK,425.0,297.5,,,0
CDM,40200003,HC US CHEST,425.0,297.5,,,0
CDM,40200005,HC US ABDOMEN,690.0,483.0,,,0
CDM,40200006,HC US ABDOMEN SINGLE ORGAN,634.0,443.8,,,0
CDM,40200007,HC US RETROPERITONEAL,450.0,315.0,,,0
CDM,40200008,HC US RETROPERITONEAL LIMITED,450.0,315.0,,,0
CDM,40200009,US TRANSPLANTED KIDNEY,581.0,406.7,,,0
CDM,40200010,HC US SPINAL CANAL,233.0,163.1,,,0
CDM,40200011,HC US OB <14 WKS SINGL/1ST GESTAT,487.0,340.9,,,0
CDM,40200012,HC US OB < 14 WKS ADD'L GESTAT,246.0,172.2,,,0
CDM,40200013,HC US OB >=14 WKS SINGL/1ST GESTAT,487.0,340.9,,,0
CDM,40200014,HC US OB >=14 WKS ADD'L GESTAT,573.0,401.1,,,0
CDM,40200015,HC US OB LIMITED FETUS(S),425.0,297.5,,,0
CDM,40200016,HC OB US FOLLOW-UP PER FETUS,428.0,299.6,,,0
CDM,40200017,HC US OB TRANSVAGINAL,425.0,297.5,,,0
CDM,40200018,HC FETAL BIOPHYS PROFIL W/O NST,410.0,287.0,,,0
CDM,40200019,HC US NOT OB TRANSVAGINAL,537.0,375.9,,,0
CDM,40200020,SONOHYSTEROGRAPHY,424.0,296.8,,,0
CDM,40200021,HC US NOT OB PELVIC COMPLETE,569.0,398.3,,,0
CDM,40200022,HC US NOT OB PELVIC LIMITED FUP,425.0,297.5,,,0
CDM,40200023,HC US SCROTUM,425.0,297.5,,,0
CDM,40200024,HC US TRANSRECTAL,555.0,388.5,,,0
CDM,40200026,HC US COMPLETE JOINT REAL-TIME W/ IMAGE DOCUMENTATION,425.0,297.5,,,0
CDM,40200027,HC US LIMITED JOINT/FOCAL EVAL NONVASC EXTREMITY STRUCTURE(S) REAL-TIME W/IMAGE DOC,425.0,297.5,,,0
CDM,40200028,US INFANT HIPS DYNAMIC,453.0,317.1,,,0
CDM,40200031,HC US GUIDE VASCULAR ACCESS,201.0,140.7,,,0
CDM,40200032,HC US GUIDE TISSUE ABLATION,621.0,434.7,,,0
CDM,40200033,HC US GUIDE NEEDLE PLACEMENT SI,656.0,459.2,,,0
CDM,40200034,HC US GUIDE FOR AMNIO SI,573.0,401.1,,,0
CDM,40200036,HC US GUIDE PLACE INTERSTITIAL RAD,1166.0,816.2,,,0
CDM,40200037,HC US GUIDE INTRAOP,509.0,356.3,,,0
CDM,40200038,HC US UNLISTED PROC,145.0,101.5,,,0
CDM,40200039,US FOR AAA SCREEN,425.0,297.5,,,0
CDM,40200040,HC FETAL BIOPHYS PROFILE W/NST,642.0,449.4,,,0
CDM,40200043,HC US BREAST UNILAT INCL AXILLA WHEN PERFORMED LIMITED,314.0,219.8,,,0
CDM,40200044,HC DUPLEX SCAN HEMODIALYSIS ACCESS,223.0,156.1,,,0
CDM,40200051,HC DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY,431.0,301.7,,,0
CDM,40200054,HC ULTRASOUND ELASTOGRAPHY PARENCHYMA,507.0,354.9,,,0
CDM,40200057,HC DOPPLER VELOCIMETRY FETAL MIDDLE CEREBRAL ATERY,496.0,347.2,,,0
CDM,40327,OXALIPLATIN 100 MG/20 ML IV SOLN,107.5,75.25,,,0
CDM,40342,"HYALURONATE SOD, CROSS-LINKED 30 MG/3 ML IATC SYRG",3174.0,2221.8,,,0
CDM,40400002,HC PET IMAGE SKULL-THIGH,5996.0,4197.2,,,0
CDM,40400003,HC PET IMAGE FULL BODY,6896.0,4827.2,,,0
CDM,40400004,HC PET IMAGE W/CT SKULL-THIGH,5416.0,3791.2,,,0
CDM,40400005,HC PET IMAGE W/CT FULL BODY,5416.0,3791.2,,,0
CDM,40400006,HC PET W/CT FOR ATTENUATION CORRECTION/ANATOMICAL LOCALIZATION IMAGING LIMITED AREA,4513.0,3159.1,,,0
CDM,40688,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,84.0,58.8,,,0
CDM,40688,TECHNETIUM TC 99M SESTAMIBI - CARDIOLITE,214.0,149.8,,,0
CDM,40805,PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG,972.0,680.4,,,0
CDM,40955,"DIPH,PERTUS(ACEL),TET,POLIO(PF)(KINRIX) 25 LF-58 MCG-10 LF/0.5 ML IM SYRINGE",318.0,222.6,,,0
CDM,40956,"DIP,PER(A)TET-HEPB-POL-HIB(PF) 15 UNIT-5 UNIT- 10 MCG/0.5 ML IM SYRG",421.0,294.7,,,0
CDM,40956,DIP-PERT(A)-TET-POLIO-HIB (PF) 15LF-20MCG-5LF- 62 DU/0.5 ML IM KIT,504.5,353.15,,,0
CDM,40956,"HIB CONJ-TET,COMPNT 2 OF 2(PF) 10 MCG/0.5 ML IM SOLR",493.0,345.1,,,0
CDM,41000001,HC VENT MGMT INPAT INIT DAY,2919.0,2043.3,,,0
CDM,41000002,HC VENT MGMT INPAT SUBQ DAY,2919.0,2043.3,,,0
CDM,41000003,HC SURFACTANT ADMIN THRU TUBE,277.0,193.9,,,0
CDM,41000004,HC INHALAT THERAPY TREATMENT,247.0,172.9,,,0
CDM,41000005,HC AEROSOL INHALATION TREATMENT,247.0,172.9,,,0
CDM,41000006,HC INHALAT TX CONTINUOUS 1ST HOUR,194.0,135.8,,,0
CDM,41000007,HC INHALAT TX CONTINUOUS EA ADDL HR,141.0,98.7,,,0
CDM,41000008,HC CPAP INITIATION AND MGMT DAILY,902.0,631.4,,,0
CDM,41000009,EVALUATE PT USE OF INHALER,247.0,172.9,,,0
CDM,41000010,HC MANIP CHEST WALL INITIAL,247.0,172.9,,,0
CDM,41000011,HC MANIP CHEST WALL SUBSQ,147.0,102.9,,,0
CDM,41000012,BEHAV CHNG SMOKING > 10 MIN,94.0,65.8,,,0
CDM,41000013,HC NEWBORN RESUSCITATION,628.0,439.6,,,0
CDM,41000014,HC PULM THERAPY 1-1 EA 15 MIN,75.0,52.5,,,0
CDM,41000015,HC PULM REHAB GROUP,315.0,220.5,,,0
CDM,41000016,HC HIGH FREQ VENT INITIAL,5564.0,3894.8,,,0
CDM,41000017,HC HIGH FREQ VENT SUBSEQUENT,5564.0,3894.8,,,0
CDM,41000021,HC MECHANICAL CHEST WALL OSCILLATION,855.0,598.5,,,0
CDM,41000022,HC PHYS/QHP SVS OP PULM RHAB W/O CONT OXIMETRY MONITORING PER SESSION,317.0,221.9,,,0
CDM,41000023,HC PHYS/QHP SVCS OP PULM REHAB W/CONT OXIMTRY MONITORING PER SESSION,317.0,221.9,,,0
CDM,41086,AZACITIDINE 100 MG INJ SOLR,350.0,245.0,,,0
CDM,41089,PACLITAXEL 6 MG/ML IV CONC,265.0,185.5,,,0
CDM,41092,ARSENIC TRIOXIDE 10 MG/10 ML IV SOLN,613.5,429.45,,,0
CDM,41094,CETUXIMAB 100 MG/50 ML IV SOLN,15582.0,10907.400000000001,,,0
CDM,41094,CETUXIMAB 200 MG/100 ML IV SOLN,1253.5,877.45,,,0
CDM,41096,PACLITAXEL-PROTEIN BOUND 100 MG IV SOLR,6447.0,4512.9,,,0
CDM,41099,PEMBROLIZUMAB 100 MG/4 ML (25 MG/ML) IV SOLN,36272.5,25390.75,,,0
CDM,41102,NIVOLUMAB 240 MG/24 ML IV SOLN,10132.0,7092.4,,,0
CDM,41102,NIVOLUMAB 40 MG/4 ML IV SOLN,3512.0,2458.3999999999996,,,0
CDM,41109,CABAZITAXEL 10 MG/ML (FINAL) IV SOLN,10913.0,7639.1,,,0
CDM,41413,TIRZEPATIDE  2.5 MG/0.5 ML SUBQ PNIJ,956.0,669.2,,,0
CDM,41482,FULVESTRANT 250 MG/5 ML IM SYRG,2760.0,1932.0,,,0
CDM,42000001,HC CANALITH REPOSITIONING,131.0,91.7,,,0
CDM,42000003,TEAM CONF 1-1 NONPHYS >30 MIN,75.0,52.5,,,0
CDM,42000004,HC TEAM CONF NONPHYS >30 MIN,54.0,37.8,,,0
CDM,42000028,HC BIOFEEDBACK PERI/ANORECTAL/URETHRAL SPHINCTER INCL EMG/MANOMETRY 15 MIN,152.0,106.4,,,0
CDM,42000029,HC BIOFEEDBACK PERI/ANORECTAL/URETHRAL SPHINCTER INCL EMG/MANOMETRY EACH ADDTL 15 MIN,75.0,52.5,,,0
CDM,42000030,HC THER INTERVENT COGNITIVE FUNCTION DIRECT PATIENT CONTACT INITIAL 15 MIN,392.0,274.4,,,0
CDM,42000031,HC THER INTERVENT COGNITIVE FUNCTION DIRECT PATIENT CONTACT EACH ADDITIONAL 15 MINUTES,83.0,58.1,,,0
CDM,42100002,HC MECHANICAL TRACTION THERAPY,114.0,79.8,,,0
CDM,42100003,HC ELECT STIM OTHER THAN WND CARE,109.0,76.3,,,0
CDM,42100004,HC VASOPNEUMATIC DEVICE THERAPY,90.0,63.0,,,0
CDM,42100005,HC PARAFFIN BATH THERAPY,72.0,50.4,,,0
CDM,42100006,HC DIATHERMY THERAPY,26.0,18.2,,,0
CDM,42100007,HC INFRARED THERAPY,59.0,41.3,,,0
CDM,42100008,HC ELECTRICAL STIMULATION EA 15 MIN,109.0,76.3,,,0
CDM,42100009,IONTOPHORESIS EA 15 MIN,106.0,74.2,,,0
CDM,42100010,HC ULTRASOUND THERAPY EA 15 MIN,169.0,118.3,,,0
CDM,42100012,HC THERAPEUTIC EXERCISES EA 15 MIN,139.0,97.3,,,0
CDM,42100013,HC NEUROMUSC REEDUCAT EA 15 MIN,175.0,122.5,,,0
CDM,42100014,HC AQUA THER/EXERCISES EA 15 MIN,124.0,86.8,,,0
CDM,42100015,HC GAIT TRAINING EA 15 MIN,95.0,66.5,,,0
CDM,42100018,HC MANUAL THERAPY EA 15 MIN,99.0,69.3,,,0
CDM,42100019,HC THER ACTIVITIES 1-1 EA 15 MIN,116.0,81.2,,,0
CDM,42100021,HC SENS INTEGRATION 1-1 EA 15 MIN,131.0,91.7,,,0
CDM,42100022,HC ADL TRAINING 1-1 EA 15 MIN,102.0,71.4,,,0
CDM,42100023,REINTER TRAIN 1-1 EA 15 MIN,70.0,49.0,,,0
CDM,42100024,HC WHEELCHAIR TRAIN EA 15 MIN,61.0,42.7,,,0
CDM,42100025,HC DEBRIDEMENT OPEN WOUND FIRST 20 SQ CM OR LESS,296.0,207.2,,,0
CDM,42100026,HC RMVL DEVITAL TISSUE ADDL 20 SQ CM,347.0,242.9,,,0
CDM,42100027,HC NEG PRESS WOUND THERAPY DME LESS THAN OR EQUAL TO 50 SQ CM,408.0,285.6,,,0
CDM,42100028,HC NEG PRESS WOUND THERAPY DME GREATER THAN 50 SQ CM,520.0,364.0,,,0
CDM,42100029,HC ORTHOTIC(S) MGMT AND TRAINING INITIAL ENCOUNTER 15 MIN,162.0,113.4,,,0
CDM,42100030,HC PROSTHETIC(S) TRAINING INITIAL ENCOUNTER 15 MIN,172.0,120.4,,,0
CDM,42100033,HC PHYSICAL PERFORMANCE TEST EA 15 MIN,143.0,100.1,,,0
CDM,42100040,HC NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,45.0,31.5,,,0
CDM,42100041,HC COLD LASER,102.0,71.4,,,0
CDM,42100042,HC CUPPING,102.0,71.4,,,0
CDM,42100044,HC ORTHOTIC/PROSTHETIC MGMT AND/OR TRAINING SUBSEQUENT ENCOUNTER 15 MIN,93.0,65.1,,,0
CDM,42100046,HC NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,67.0,46.9,,,0
CDM,42100048,HC CAREGIVER TRAINING STRATEGIES/TECHNIQUES FACILITATE THE PATIENT FUNCTIONAL PERFORMANCE IN HOME/COMMUNITY FACE TO FACE INITIAL 30 MIN,112.0,78.4,,,0
CDM,42100049,HC CAREGIVER TRAINING STRATEGIES/TECHNIQUES TO FACILITATE THE PATIENT FUNCTIONAL PERFORMANCE IN HOME/COMMUNITY FACE TO FACE EA ADDTL 15 MIN,52.0,36.4,,,0
CDM,42100050,HC GROUP CAREGIVER TRAINING STRATEGIES/TECHNIQUES TO FACILITATE THE PATIENT FUNCTIONAL PERFORMANCE IN HOME/COMMUNITY FACE TO FACE W/MULTIPLE SETS OF CAREGIVERS,46.0,32.2,,,0
CDM,42300001,HC GROUP THERAPEUTIC PROCEDURES,128.0,89.6,,,0
CDM,42339,FERRIC CARBOXYMALTOSE (INJECTAFER) 50 MG IRON/ML IV SOLN,4234.0,2963.8,,,0
CDM,42343,CARFILZOMIB 10 MG IV SOLR,1027.5,719.25,,,0
CDM,42343,CARFILZOMIB 30 MG IV SOLR,2186.0,1530.2,,,0
CDM,42343,CARFILZOMIB 60 MG IV SOLR,4531.0,3171.7,,,0
CDM,42347,RAMUCIRUMAB 10 MG/ML IV SOLN,4585.5,3209.85,,,0
CDM,42351,"ALBUMIN, HUMAN 25 % IV SOLN (MERGE)",427.0,298.9,,,0
CDM,42351,"ALBUMIN, HUMAN 25 % IV SOLP",1210.5,847.3499999999999,,,0
CDM,42392,CEFEPIME 1 GRAM INJ SOLR,100.0,70.0,,,0
CDM,42392,CEFEPIME 2 GRAM INJ SOLR,198.0,138.6,,,0
CDM,42396,DECITABINE 50 MG IV SOLR,320.0,224.0,,,0
CDM,42400005,HC PT EVAL LOW COMPLEXITY 20 MIN,291.0,203.7,,,0
CDM,42400006,HC PT EVAL MODERATE COMPLEXITY 30 MIN,335.0,234.5,,,0
CDM,42400007,HC PT EVAL HIGH COMPLEXITY 45 MIN,384.0,268.8,,,0
CDM,42400008,HC RE-EVAL PT ESTABLISHED POC 20 MIN,186.0,130.2,,,0
CDM,42873,HYLAN G-F 20 16 MG/2 ML IATC SYRG,2521.0,1764.7,,,0
CDM,42873,HYLAN G-F 20 48 MG/6 ML IATC SYRG,2521.0,1764.7,,,0
CDM,42949,ATROPINE 0.1 MG/ML INJ SYRG,17.0,11.9,,,0
CDM,42949,ATROPINE 1 MG/ML INJ SOLN,74.0,51.8,,,0
CDM,42949,ATROPINE 1 MG/ML IV SOLN,37.5,26.25,,,0
CDM,42950,COSYNTROPIN 0.25 MG INJ SOLR,435.0,304.5,,,0
CDM,43100001,HC APPLY FOREARM SPLINT STATIC,221.0,154.7,,,0
CDM,43100002,HC APPLY FOREARM SPLINT DYNAMIC,294.0,205.8,,,0
CDM,43100003,HC APPLY FINGER SPLINT,169.0,118.3,,,0
CDM,43100006,HC ULTRAVIOLET THERAPY,38.0,26.6,,,0
CDM,43100010,HC FLUIDOTHERAPY,102.0,71.4,,,0
CDM,43179,RASBURICASE 1.5 MG IV SOLR,7197.5,5038.25,,,0
CDM,43182,VEDOLIZUMAB 300 MG IV SOLR,11084.0,7758.8,,,0
CDM,43208,BENDAMUSTINE 25 MG/ML IV SOLN,9252.0,6476.4,,,0
CDM,43210,BORTEZOMIB 3.5 MG IV SOLR,182.5,127.75,,,0
CDM,43219,BRENTUXIMAB VEDOTIN 50 MG IV SOLR,27071.5,18950.050000000003,,,0
CDM,43231,ERIBULIN 0.5 MG/ML IV SOLN,5200.0,3640.0,,,0
CDM,43289,OBINUTUZUMAB 900 MG IN NS 286 ML (STOCK DOSE),6046.0,4232.2,,,0
CDM,43293,PANITUMUMAB 400 MG/20 ML (20 MG/ML) IV SOLN,16751.0,11725.7,,,0
CDM,43295,PEMETREXED 100 MG IV SOLR,335.0,234.5,,,0
CDM,43295,PEMETREXED 500 MG IV SOLR,558.0,390.6,,,0
CDM,43302,TRASTUZUMAB EMTANSINE 100 MG IV SOLR,4147.0,2902.8999999999996,,,0
CDM,43302,TRASTUZUMAB EMTANSINE 160 MG IV SOLR,9250.0,6475.0,,,0
CDM,43400004,HC OT EVAL LOW COMPLEXITY 30 MIN,291.0,203.7,,,0
CDM,43400005,HC OT EVAL  MODERATE COMPLEXITY 45 MIN,335.0,234.5,,,0
CDM,43400006,HC OT EVAL HIGH COMPLEXITY 60 MIN,384.0,268.8,,,0
CDM,43400007,HC RE-EVAL OT ESTABLISHED POC 30 MIN,186.0,130.2,,,0
CDM,43444,CALCIUM GLUCONATE (FOR EMERGENCY) 100 MG/ML (10%) IV SOLN,118.0,82.6,,,0
CDM,44100001,HC SPEECH/HEARING THERAPY,186.0,130.2,,,0
CDM,44100002,HC ORAL/SWALLOW FUNCTION THERAPY,177.0,123.9,,,0
CDM,44100004,HC USE OF SPEECH DEVICE SERVICE,157.0,109.9,,,0
CDM,44100007,HC DEVELOPMENTAL TEST LIMITED,50.0,35.0,,,0
CDM,44100008,HC ORAL SPEECH DEVICE EVAL,447.0,312.9,,,0
CDM,44100009,HC SPEECH/HEARING THERAPY GROUP,135.0,94.5,,,0
CDM,44100010,HC ASSESSMENT OF APHASIA PER HOUR,218.0,152.6,,,0
CDM,44221,"PERTUZUMAB-TRASTUZUMAB-HY-ZZXF 1,200 MG-600MG- 30000 UNIT/15ML SUBQ SOLN",35072.0,24550.4,,,0
CDM,44221,PERTUZUMAB-TRASTUZUMAB-HY-ZZXF 600 MG-600 MG- 20000 UNIT/10ML SUBQ SOLN,23380.0,16366.0,,,0
CDM,44276,CABOTEGRAVIR 600 MG/3 ML (200 MG/ML) IM SPER,11110.0,7777.0,,,0
CDM,44400002,HC EX FOR SPEECH DEVICE TRAIN 1HR,236.0,165.2,,,0
CDM,44400003,HC EVALUATE SWALLOWING FUNCTION,491.0,343.7,,,0
CDM,44400004,HC MOTION FLUOROSCOPY/SWALLOW,410.0,287.0,,,0
CDM,44400005,HC ENDOSCOPY SWALLOW TST (FEES),295.0,206.5,,,0
CDM,44400006,HC COGN TEST FACE TO FACE PER HOUR,361.0,252.7,,,0
CDM,44400007,HC HB EVALUATION OF SPEECH FLUENCY,261.0,182.7,,,0
CDM,44400008,HC EVALUATE SPEECH PRODUCTION,261.0,182.7,,,0
CDM,44400009,HC SPEECH SOUND LANG COMPREHEN,261.0,182.7,,,0
CDM,44400010,HC BEHAVORIAL AND QUAL ANALYSIS VOICE,261.0,182.7,,,0
CDM,44400012,HC FLEXIBLE ENDOSCOPIC EVAL SWALLOWING/LARYNGEAL SENSORY TESTING BY CINE OR VIDEO RECORDING,366.0,256.2,,,0
CDM,44455,TRABECTEDIN 1 MG IV SOLR,7825.0,5477.5,,,0
CDM,44919,SIROLIMUS-PROTEIN BOUND 100 MG IV SUSR (WET SUSR VIAL),10843.5,7590.45,,,0
CDM,45000001,I&D SKIN SUBQ ABSCESS COMPLEX,287.0,200.9,,,0
CDM,45000002,I&D PILONIDAL CYST SIMPLE,287.0,200.9,,,0
CDM,45000003,HC I&D PILONIDAL CYST COMPLEX,1361.0,952.7,,,0
CDM,45000004,I&D REM FB SUBQ SIMPLE,424.0,296.8,,,0
CDM,45000005,I&D REM FB SUBQ COMPLICAT,1886.0,1320.2,,,0
CDM,45000006,HC REM NAIL PLATE SINGL,218.0,152.6,,,0
CDM,45000007,HC AVULSION NAIL PLATE COMPLETE/SIMPLE EACH ADDITIONAL NAIL PLATE,97.0,67.9,,,0
CDM,45000008,HC DRAIN BLOOD FROM UNDER NAIL,112.0,78.4,,,0
CDM,45000009,HC EXC NAIL BED,578.0,404.6,,,0
CDM,45000011,HC REPAIR NAIL BED,352.0,246.4,,,0
CDM,45000012,HC SIMPLE REPAIR SUPRFCL WNDS S/N/A/GEN/TNK EXT INCL HANDS & FEET 2.5 CM OR LESS,413.0,289.1,,,0
CDM,45000013,HC SIMPLE REPAIR SUPRFCL WNDS S/N/AX/GEN/TRNK EXT INCL HANDS & FEET 2.6--7.5 CM,455.0,318.5,,,0
CDM,45000014,HC SIMPLE REPAIR SUPRFCL WNDS S/N/AX/GEN/TRK EXT INCL HANDS & FEET 7.6-12.5 CM,478.0,334.6,,,0
CDM,45000015,HC SIMPLE REPAIR SUPRFCL WNDS S/N/A/GEN/TRK EXT INCL HANDS & FEET 12.6-20.0 CM,500.0,350.0,,,0
CDM,45000016,HC SIMPLE REPAIR SUPRFCL WNDS S/N/A/GEN/TRK EXT INCL HANDS & FEET 20.1-30.0 CM,525.0,367.5,,,0
CDM,45000017,HC SIMPLE REPAIR SUPRFCL WNDS S/N/A/GEN/TRNK EXT INCL HANDS & FEET OVER 30.0 CM,553.0,387.1,,,0
CDM,45000018,HC SIMPLE REPAIR SUPRFCL WNDS F/E/E/N/L/M 2.5 CM LESS,413.0,289.1,,,0
CDM,45000019,HC SIMPLE REPAIR SUPRFCL WNDS F/E/E/N/L/M 2.6-5.0 CM,435.0,304.5,,,0
CDM,45000020,HC SIMPLE REPAIR SUPRFCL WNDS F/E/E/N/L/M 5.1-7.5 CM,455.0,318.5,,,0
CDM,45000021,HC SIMPLE REPAIR SUPRFCL WNDS F/E/E/N/L/M 7.6-12.5 CM,478.0,334.6,,,0
CDM,45000022,HC SIMPLE REPAIR SUPRFCL WNDS F/E/E/N/L/M 12.6-20.0 CM,500.0,350.0,,,0
CDM,45000023,HC SIMPLE REPAIR SUPRFCL WNDS F/E/E/N/L/M OVER 30.0 CM,1483.0,1038.1,,,0
CDM,45000024,HC REP INT WND S/A/T/EXT <2.5 CM,455.0,318.5,,,0
CDM,45000025,HC REP INT WND S/A/T/EXT 2.6-7.5 CM,500.0,350.0,,,0
CDM,45000026,HC REP INT WND S/A/T/EXT 7.6-12.5,525.0,367.5,,,0
CDM,45000027,HC REP INT WND S/A/T/EXT 12.6-20.0,553.0,387.1,,,0
CDM,45000028,HC REP INT WND S/A/T/EXT 20.1-30,575.0,402.5,,,0
CDM,45000029,HC REPAIR INTERMED WND S/A/T/EXT (EXCL HANDS & FEET) OVER 30.0 CM,601.0,420.7,,,0
CDM,45000030,HC REP INT WND N/H/F/GNT<2.5 CM,455.0,318.5,,,0
CDM,45000031,HC REP INT WND N/H/F/GNT2.6-7.5,500.0,350.0,,,0
CDM,45000032,HC REP INT WND N/H/F/GNT7.6-12.5,525.0,367.5,,,0
CDM,45000033,HC REP INT WND N/H/F/GNT 12.6-20.0,548.0,383.6,,,0
CDM,45000034,HC REP INT WND N/H/F/GNT20.1-30,575.0,402.5,,,0
CDM,45000035,HC REPAIR INTERMED WNDS F/E/E/N/L/M 2.5 CM OR LESS,455.0,318.5,,,0
CDM,45000036,HC REPAIR INTERMED WNDS F/E/E/N/L/M 2.6-5.0 CM,478.0,334.6,,,0
CDM,45000037,HC REPAIR INTERMED WNDS F/E/E/N/L/M 5.1-7.5 CM,500.0,350.0,,,0
CDM,45000038,HC REPAIR INTERMED WNDS F/E/E/N/L/M 7.6-12.5 CM,525.0,367.5,,,0
CDM,45000039,HC REPAIR INTERMED WNDS F/E/E/N/L/M 12.6-20.0 CM,553.0,387.1,,,0
CDM,45000041,HC REPAIR INTERMED WNDS F/E/E/N/L/M OVER 30.0 CM,601.0,420.7,,,0
CDM,45000042,HC REP COM WND S/A/L 1.1-2.5CM,598.0,418.6,,,0
CDM,45000043,HC REP COM WND S/A/L 2.6-7.5CM,661.0,462.7,,,0
CDM,45000044,HC REP COM WND F/H/F/A/G/N1.1-2.5,630.0,441.0,,,0
CDM,45000045,HC REPAIR COMPLEX FOREHEAD/CHEEKS/CHIN/MOUTH/NECK/AXILLAE/GENITALIA/HANDS/FEET 2.6-7.5 CM,661.0,462.7,,,0
CDM,45000047,HC REP COM WND E/N/E/L 1.0-2.5CM,1504.0,1052.8,,,0
CDM,45000048,HC REP COM WND E/N/E/L2.6-7.5CM,1730.0,1211.0,,,0
CDM,45000049,HC TREAT 1ST DEG BURN LOCAL INITIAL,401.0,280.7,,,0
CDM,45000050,HC DRESSINGS/DEBRIDEMENT PARTIAL THICKNESS BURNS INITIAL/SUBSEQUENT SM,456.0,319.2,,,0
CDM,45000051,HC DRESSING/DEBRIDEMENT PARTIAL THICKNESS BURNS INITIAL/SUBSEQUENT LARGE,604.0,422.8,,,0
CDM,45000052,HC REMOVAL FB MUSCLE/TENDON SIMPLE,1197.0,837.9,,,0
CDM,45000055,HC RESET DISLOCATED JAW,341.0,238.7,,,0
CDM,45000056,HC CLOSED TX CLAVICULAR FX W/O MANIPULATION,275.0,192.5,,,0
CDM,45000057,HC CLOSED TX ACROMIOCLAVICULAR DISLOCATION W/O MANIPULATION,852.0,596.4,,,0
CDM,45000058,HC CLOSED TX PROXIMAL HUMERAL FX W/MANIPULATION W/WO SKELETAL TRACTION,2480.0,1736.0,,,0
CDM,45000059,HC TREAT HUM GR TUB FX W/MAN,2192.0,1534.4,,,0
CDM,45000060,HC TREAT SHOULDER DISLOCATION,275.0,192.5,,,0
CDM,45000061,HC DRAIN UPPER ARM ELBOW LESION,2442.0,1709.4,,,0
CDM,45000062,HC TREAT HUM SHAFT FX,836.0,585.2,,,0
CDM,45000063,HC CLOSED TX HUMERAL SHAFT FX W/MANIPULATION W/WO SKELETAL TRACTION,1666.0,1166.2,,,0
CDM,45000064,HC TREAT HUM SUPRAC FX W/ MAN,980.0,686.0,,,0
CDM,45000065,HC TREAT ELBOW DISL W/O ANESTH,693.0,485.1,,,0
CDM,45000066,HC TREAT RAD HEAD DISL W/MAN,361.0,252.7,,,0
CDM,45000067,HC CLOSED TX RADIAL HEAD NECK FX W/O MANIPULATION,361.0,252.7,,,0
CDM,45000068,HC TREAT RAD HEAD NECK FX W/ MAN,600.0,420.0,,,0
CDM,45000069,HC CLOSED TX RADIAL SHAFT FX W/ MANIPULATION,1066.0,746.2,,,0
CDM,45000070,HC CLOSED TX ULNAR SHAFT FX W/MANIPULATION,898.0,628.6,,,0
CDM,45000071,HC TREAT FX RAD ULNA SHAFT W/ MAN,735.0,514.5,,,0
CDM,45000072,HC TREAT FX RADIUS/ULNA DISTAL,716.0,501.2,,,0
CDM,45000073,HC TREAT FX RAD/ULNA DISTAL W/ MAN,1826.0,1278.2,,,0
CDM,45000075,HC CLOSED TX METACARPAL FX SINGLE W/MANIPULATION EACH BONE,973.0,681.1,,,0
CDM,45000076,HC TX MP DISLOC W/ MANIP,357.0,249.9,,,0
CDM,45000077,HC CLOSED TX PHALANGEAL SHAFT FX PROXIMAL/MIDDLE PHALANX FINGER/THUMB W/O MANIPULATION EACH,357.0,249.9,,,0
CDM,45000078,HC CLOSED TX PHALANGEAL SHAFT FX PROXIMAL/MIDDLE PHALANX FINGER/THUMB W/MANIPULATE W/WO SKIN/SKELETAL TRACTION EACH,357.0,249.9,,,0
CDM,45000079,TREAT FINGER DISLOCATION,716.0,501.2,,,0
CDM,45000081,HC TREAT HIP DISL W/O ANESTH,499.0,349.3,,,0
CDM,45000082,HC CLOSED TX POST HIP ARTHROPLASTY DISLOCATION W/O ANESTHESIA,332.0,232.4,,,0
CDM,45000083,TREAT KNEECAP DISL W/O ANESTH,653.0,457.1,,,0
CDM,45000084,TREAT KNEECAP DISL W/ ANESTH,3899.0,2729.3,,,0
CDM,45000085,HC CLOSED TX TIBIAL SHAFT FX W/WO FIBULAR FX W/MANIPULATION W/W/O SKELETAL TRACTION,2063.0,1444.1,,,0
CDM,45000086,HC CLOSED TX MEDIAL MALLEOLUS FX W/O MANIPULATION,852.0,596.4,,,0
CDM,45000087,HC CLOSED TX MEDIAL MALLEOLUS FX W/MANIPULATION W/WO SKIN OR SKELETAL TRACTION,2063.0,1444.1,,,0
CDM,45000088,HC CLOSED TX PROXIMAL FIBULA/SHAFT FX W/O MANIPULATION,852.0,596.4,,,0
CDM,45000089,HC TREAT PROX FIBULA FX W/ MANIP,4729.0,3310.3,,,0
CDM,45000090,HC TREAT LAT MALLEOLUS FX W/ MAN,825.0,577.5,,,0
CDM,45000091,HC TREAT BIMALLEOLAR FX W/O MANIP,349.0,244.3,,,0
CDM,45000092,HC TREAT BIMALLEOLAR FX W/ MAN,1113.0,779.1,,,0
CDM,45000093,HC TREAT TRIMALLEOLAR FX W/O MANIP,852.0,596.4,,,0
CDM,45000094,HC TREAT TRIMALLEOLAR FX W/ MAN,1113.0,779.1,,,0
CDM,45000095,HC TX CLOSED ANKLE DISLOCATION W/O ANESTHESIA,614.0,429.8,,,0
CDM,45000096,HC REM OF FOOT FB SUBQ,1233.0,863.1,,,0
CDM,45000097,HC CLOSED TX CALCANEAL FX W/O MANIPULATION,852.0,596.4,,,0
CDM,45000099,HC TREAT TALUS FX,1959.0,1371.3,,,0
CDM,45000100,HC CLOSED TX FX PHALANX/PHALANGES OTHER THAN GREAT TOE W/MANIPULATION EACH,961.0,672.7,,,0
CDM,45000101,HC TREAT MP TOE DISLOC,320.0,224.0,,,0
CDM,45000102,HC CLSD TRMT INTRPHLNGL JT DL W/O,207.0,144.9,,,0
CDM,45000104,HC APPLY SHORT ARM CAST,939.0,657.3,,,0
CDM,45000105,HC APPLY LONG ARM SPLINT,200.0,140.0,,,0
CDM,45000107,HC STRAPPING SHOULDER VELPEAU,341.0,238.7,,,0
CDM,45000108,HC STRAPPING HAND OR FINGER,119.0,83.3,,,0
CDM,45000109,HC APPLY SHORT LEG CAST,483.0,338.1,,,0
CDM,45000110,HC APPLY LONG LEG SPLINT,854.0,597.8,,,0
CDM,45000111,HC APPLY LOWER LEG SPLINT,431.0,301.7,,,0
CDM,45000113,HC STRAPPING ANKLE AND/OR FOOT,637.0,445.9,,,0
CDM,45000114,HC STRAPPING TOES,169.0,118.3,,,0
CDM,45000115,HC REMOVAL/BIVALVING GAUNTLET BOOT/BODY CAST,970.0,679.0,,,0
CDM,45000116,HC REM/REVISE FULL ARM/LEG CAST,283.0,198.1,,,0
CDM,45000117,REMOVE NASAL FB,299.0,209.3,,,0
CDM,45000118,HC CONTROL OF NOSEBLEED SIMPLE,247.0,172.9,,,0
CDM,45000119,HC CONTROL OF NOSEBLEED COMPLEX,297.0,207.9,,,0
CDM,45000120,CONTROL OF NOSEBLEED POSTERIOR INITIAL,390.0,273.0,,,0
CDM,45000121,HC THROMBOLYSIS CEREBRAL IV,236.0,165.2,,,0
CDM,45000122,HC REP MOUTH LACERATION <2.5CM,1036.0,725.2,,,0
CDM,45000123,HC REP ANT TONG MOUTH FLOOR <2.5CM,448.0,313.6,,,0
CDM,45000124,HC REP TONG MOUTH FLOOR >2.5 CM,922.0,645.4,,,0
CDM,45000125,HC I&D GUM LESION,271.0,189.7,,,0
CDM,45000126,HC DRAINAGE ABSC PALATE UVULA,863.0,604.1,,,0
CDM,45000127,I&D TONSIL ABSCESS,574.0,401.8,,,0
CDM,45000129,REM FB PHARYNX,197.0,137.9,,,0
CDM,45000130,HC INTUBATE GASTRIC WITH ASP,173.0,121.1,,,0
CDM,45000132,HC REM RECTAL OBSTRUCT W/ANESTH,3903.0,2732.1,,,0
CDM,45000133,HC I&D PERIANAL ABSCESS SUPERFICIAL,1522.0,1065.4,,,0
CDM,45000134,HC INCISE EXTERNAL HEMORRHOID,325.0,227.5,,,0
CDM,45000135,HC ANOSCOPY DIAGNOSTIC,153.0,107.1,,,0
CDM,45000136,PARACENTESIS ABD,768.0,537.6,,,0
CDM,45000137,HC INJ CORPORA CAVERNOSA W/PHARM,320.0,224.0,,,0
CDM,45000138,HC I&D GLAND ABSCESS,347.0,242.9,,,0
CDM,45000139,HC REMOVE IUD,301.0,210.7,,,0
CDM,45000140,HC VAGINAL DELIVERY,10132.0,7092.4,,,0
CDM,45000141,DELIVER PLACENTA,11285.0,7899.5,,,0
CDM,45000142,INJ NERVE BLOCK TRIGEMINAL,801.0,560.7,,,0
CDM,45000143,HC INJECTION ANESTHETIC AGENT(S)/STEROID FEMORAL NERVE INCL IMAGE GUIDE,600.0,420.0,,,0
CDM,45000144,HC REM FB EYE EXTERNAL,313.0,219.1,,,0
CDM,45000145,HC REM FB EYE EMBEDDED,313.0,219.1,,,0
CDM,45000146,REM FB CORNEA W/O SLIT LAMP,313.0,219.1,,,0
CDM,45000147,REM FB CORNEA W/ SLIT LAMP,344.0,240.8,,,0
CDM,45000148,REM FB EXTERNAL EAR CANAL,192.0,134.4,,,0
CDM,45000149,HC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILATERAL,151.0,105.7,,,0
CDM,45000150,HC EMERGENCY DEPT VISIT LEVEL 1,183.0,128.1,,,0
CDM,45000151,HC EMERGENCY DEPT VISIT LEVEL 2,247.0,172.9,,,0
CDM,45000152,HC EMERGENCY DEPT VISIT LEVEL 3,535.0,374.5,,,0
CDM,45000153,HC EMERGENCY DEPT VISIT LEVEL 4,1025.0,717.5,,,0
CDM,45000154,HC EMERGENCY DEPT VISIT LEVEL 5,1798.0,1258.6,,,0
CDM,45000155,HC CRITICAL CARE 1ST 31-74 MIN,2320.0,1624.0,,,0
CDM,45000156,HC CRITICAL CARE EA ADDL 30 MIN,1162.0,813.4,,,0
CDM,45000159,HC REP COM WND S/A/L ADDL 5CM OR LESS,130.0,91.0,,,0
CDM,45000160,HC INCISION OF BREAST LESION,6448.0,4513.6,,,0
CDM,45000162,HC CLOSED TX STERNOCLAVICULAR DISL W/ MANIP,542.0,379.4,,,0
CDM,45000163,HC CLOSED TX SHOULDER DISLOC W/ FX,1066.0,746.2,,,0
CDM,45000164,HC CLOSED TX POST HIP ARTHROPL DISLOC REQ ANESTH,1735.0,1214.5,,,0
CDM,45000165,HC IRRIGATION OF BLADDER SIMPLE,320.0,224.0,,,0
CDM,45000167,HC I&D ISCHIORECTAL/PERIRECTAL ABSCESS,7232.0,5062.4,,,0
CDM,45000171,HC CLOSED TX ULNAR FX PROX END W/ MANIP,1404.0,982.8,,,0
CDM,45000172,HC EXCISION THROMBOSED HEMORRHOID EXTERNAL,1921.0,1344.7,,,0
CDM,45000184,HC CL TX DIST PHALANG FX FINGER/THUMB W/ MANIP,773.0,541.1,,,0
CDM,45000187,HC SHLDR DISLOC MANIP REQ ANESTHESIA,1745.0,1221.5,,,0
CDM,45000188,HC TREAT KNEE DISLOCATION,261.0,182.7,,,0
CDM,45000190,HC DRAIN EXTERNAL EAR ABSCESS/HEMATOMA COMPLICATED,1278.0,894.6,,,0
CDM,45000191,HC REPAIR LIP HALF VERTICAL,965.0,675.5,,,0
CDM,45000192,HC EXPLORE WOUND EXTREMITY,1294.0,905.8,,,0
CDM,45000193,HC DRAIN THIGH/KNEE LESION,2373.0,1661.1,,,0
CDM,45000194,HC TX CLOSED TX ANKLE DISLOCATION W/ANESTHESIA W/ OR W/O PERCUT SKELETAL FIXATION,1561.0,1092.7,,,0
CDM,45000195,HC REPAIR LIP VERMILION ONLY,965.0,675.5,,,0
CDM,45000196,HC DRAINAGE OF SCROTUM ABSCESS,1278.0,894.6,,,0
CDM,45000197,HC REMOVAL OF FOOT FOREIGN BODY,1759.0,1231.3,,,0
CDM,45000198,HC TREAT WRIST DISLOCATION,5564.0,3894.8,,,0
CDM,45000199,HC CLOSURE OF SPLIT WOUND,592.0,414.4,,,0
CDM,45000200,HC AMPUTATION OF FINGER/THUMB,12299.0,8609.3,,,0
CDM,45000201,HC CLSD TX INTERPHALANGEAL JOINT DISLOCATION W/ANESTHESIA,335.0,234.5,,,0
CDM,45000202,HC REPAIR ACHILLES TENDON,6228.0,4359.6,,,0
CDM,45000203,HC ANOSCOPY W/ REM FOREIGN BODY,960.0,672.0,,,0
CDM,45000204,HC DRAINAGE OF ABSCESS/CYST/HEMATOMA/VESTIBULE OF MOUTH SIMPLE,243.0,170.1,,,0
CDM,45000205,HC CLSD TX CARPOMETACARP DISL W/ MANIP EA JOINT W/O ANESTH,253.0,177.1,,,0
CDM,45000206,HC REPAIR BLOOD VESSEL DIRECT LWR EXTREMITY,7377.0,5163.9,,,0
CDM,45000208,HC CLSD TX FX OF DISTAL TIBIA W/ OR W/O ANESTH W/ TRACTION OR MANIP,1977.0,1383.9,,,0
CDM,45000209,HC CLOSED TX ELBOW DISL REQ ANESTHESIA,1745.0,1221.5,,,0
CDM,45000212,HC REPAIR LIP FULL THICKNESS OVER ONE-HALF VERTICAL HEIGHT OR COMPLEX,825.0,577.5,,,0
CDM,45000213,HC TREAT ELBOW FRACTURE,1893.0,1325.1,,,0
CDM,45000214,HC DX LARYNGOSCOPY EXCL NB,1428.0,999.6,,,0
CDM,45000215,HC CRPRA CVRNSA SAPHNS VEIN SHUNT UNI/BIL,4827.0,3378.9,,,0
CDM,45000217,HC TREAT CLAVICLE FRACTURE W/MANIP,1066.0,746.2,,,0
CDM,45000218,HC DRAINAGE OF MOUTH LESION,1842.0,1289.4,,,0
CDM,45000219,HC TREAT HIP DISLOCATION REQ ANES,1161.0,812.7,,,0
CDM,45000221,HC CORPORA CAVERNOSA-GLANS PENIS FISTULIZATION FOR PRIAPISM,3797.0,2657.9,,,0
CDM,45000223,HC SIMPLE RPR WND 20.1-30.0 CM,1289.0,902.3,,,0
CDM,45000225,HC CLSD TX FEMORAL FX DISTAL END MEDIAL/LATERAL CONDYLE MANIP,3078.0,2154.6,,,0
CDM,45000231,HC CLOSED TX TIBAL FX PROXIMAL PLATEAU W/O MANIPULATION,320.0,224.0,,,0
CDM,45000232,HC CLSD TX OF INTER/PERI/SUBTROCHANTERIC FEMORAL FX W/MANIPULATION W/W/O SKIN/SKELETAL TRACTION,13140.0,9198.0,,,0
CDM,45000233,HC DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS,2540.0,1778.0,,,0
CDM,45000236,HC ESOPHAGOGASTRIC TAMPONADE W/BALLOON,4004.0,2802.8,,,0
CDM,45000237,HC DRAINAGE OF FINGER ABSCESS COMPLICATED,1377.0,963.9,,,0
CDM,45000239,HC CLOSED TX PROXIMAL HUMERAL FX W/O MANIPULATION,836.0,585.2,,,0
CDM,45000242,HC TX TARSAL BONE FX W/O MANIPULATION EACH,915.0,640.5,,,0
CDM,45000243,HC CLOSED TX FX PHALANX/PHALANGES OTHER THAN GREAT TOE W/O MANIPULATION EACH,836.0,585.2,,,0
CDM,45000244,HC CLOSED TX SCAPULAR FX W/O MANIPULATION,852.0,596.4,,,0
CDM,45000245,HC CLOSED TX PATELLAR FX W/O MANIPULATION,852.0,596.4,,,0
CDM,45000247,HC CLOSED TX KNEE DISLOCATION W/ANESTHESIA,1872.0,1310.4,,,0
CDM,45000248,HC REPAIR CMPLX E/N/E/L EACH ADDL 5CM/<,447.0,312.9,,,0
CDM,45000249,HC REPAIR LACERATION 2.5CM/< POSTERIOR ONE-THIRD TONGUE,1036.0,725.2,,,0
CDM,45000250,HC CLSD TX SHOULDER DISLOCATION W/SURGICAL/ANATOMICAL NECK FX W/MANIP,320.0,224.0,,,0
CDM,45000251,HC THERAPEUTIC PROPHYLACTIC DX INJECTION INTRA-ARTERIAL,134.0,93.8,,,0
CDM,45000253,HC INTRAORAL INCISION & DRAINAGE OF ABSCESS/CYST/HEMATOMA OF TONGUE/FLOOR OF MOUTH LINGUAL,965.0,675.5,,,0
CDM,45000257,HC EXTRACTION ERUPTED TOOTH OR EXPOSED ROOT (EVELATION AND/OR FORCEPS REMOVAL),439.0,307.3,,,0
CDM,45000258,HC CLSD TX TIBIAL FX PROXIMAL (PLATEAU) W/WO MANIP W/SKELETAL TRACTION,1603.0,1122.1,,,0
CDM,45000300,HC ARTHROCENTESIS ASPIRATION/INJECTION INTERMEDIATE JOINT OR BURSA W/ US GUIDE W/RECORDING & REPORTING,1268.0,887.6,,,0
CDM,45000308,HC CLOSED TREATMENT OF RADIOCARPAL/INTERCARPAL DISLOCATION 1 OR MORE BONES W/ MANIPULATION,330.0,231.0,,,0
CDM,45000309,HC REDUCTION OF PROCIDENTIA UNDER ANESTHESIA,1913.0,1339.1,,,0
CDM,45000350,HC INCISION & DRAINAGE EPIDIDYMIS/TESTIS/SCROTAL SPACE,2091.0,1463.7,,,0
CDM,45000351,HC REMOVAL FOREIGN BODY INTRANASAL REQUIRING GENERAL ANESTHESIA,11486.0,8040.2,,,0
CDM,45000353,HC REMOVAL EMBEDDED FOREIGN BODY FROM EYELID,1023.0,716.1,,,0
CDM,45000354,HC UNLISTED PROCEDURE ANUS,4265.0,2985.5,,,0
CDM,45000355,HC UNLISTED PROCEDURE RECTUM,2812.0,1968.4,,,0
CDM,45000356,HC MANIPULATION OF TEMPROMANDIBULAR JOINT(S) THERAPEUTIC REQUIRING AN ANESTHESIA SERVICE,4373.0,3061.1,,,0
CDM,45000359,HC UNLISTED PROCEDURE URINARY SYSTEM,17700.0,12390.0,,,0
CDM,45000362,HC CLOSED TX OF TALOTARSAL JOINT DISLOCATION REQUIRING ANESTHESIA,9425.0,6597.5,,,0
CDM,45000368,HC UNLISTED PROCEDURE COLON,3772.0,2640.4,,,0
CDM,45000370,HC CLOSED TX ACROMIOCLAVICULAR DISLOCATION W/MANIPULATION,1375.0,962.5,,,0
CDM,45000371,HC TREAT HIP DISLOC BY ABDUCTION/SPLINT/TRACT W/ MANIP REQ ANESTH,2824.0,1976.8,,,0
CDM,45000372,HC CLOSED TX POSTERIOR MALLEOLUS FRACTURE W/ MANIP,5523.0,3866.1,,,0
CDM,45000373,HC INJECTION ANESTHETIC AGENT(S)/STEROID SCIATIC NERVE INCL IMAGE GUIDE,3744.0,2620.8,,,0
CDM,45000375,HC REPLACE OF GASTRO TUBE PERCUTANEOUS INCL REMOVE W/O IMAGE OR ENDO GUIDE REQ REVISE GASTRO TRACT,922.0,645.4,,,0
CDM,45000376,HC REPLACE OF GASTRO TUBE PERCUTANEOUS INCL REMOVE W/O IMAGE OR ENDO GUIDE NOT REQ REV GASTRO TRACT,922.0,645.4,,,0
CDM,45000379,HC CLOSED TX RADIAL SHAFT & DISLOCATION DISTAL RADIOULNAR JOINT,3078.0,2154.6,,,0
CDM,45000380,HC CLSD TX UNLAR FRACTURE PROXIMAL END W/O MANIP,794.0,555.8,,,0
CDM,45000381,HC CLOSED TX VERTEBRAL BODY FX(S) W/O MANIP INCL CASTING/BRACING,1578.0,1104.6,,,0
CDM,45000383,HC OPEN TX BIMALLEOLAR ANKLE FX INCL INTERNAL FIX,29049.0,20334.3,,,0
CDM,45000384,HC UNLISTED PROCEDURE PHARYNX ADENOIDS AND TONSILS,462.0,323.4,,,0
CDM,45000385,HC OPEN TX TRIMALLEOLAR ANKLE FX INCL INT FIXATION MEDIAL/ LATERAL MALLEOLUS W/O FIXATION POST LIP,25921.0,18144.7,,,0
CDM,45000386,HC CLOSED TREATMENT OF DISTAL PHLNGL FRACTURE FINGER OR THUMB W/O MANIPULATION EACH,672.0,470.4,,,0
CDM,45000387,HC OPEN TX DISTAL RADIAL EXTRA ARTICULAR FX/EPIPHYSEAL SEP W/INT FIX,23479.0,16435.3,,,0
CDM,45000388,HC IMPLANT BIO IMPLANT SOFT TISSUE REINFORCE ADD-ON,6011.0,4207.7,,,0
CDM,45000389,HC REPAIR ANT ABDOMINAL HERNIA(S) ANY APPROACH RECURRENT INCL IMPLANT MESH/PROSTHESIS LESS THAN 3 CM REDUCIBLE,12237.0,8565.9,,,0
CDM,45000390,HC REPAIR ANT ABDOMINAL HERNIA(S) ANY APPROACH RECURRENT INCL IMPLANT MESH/PROSTHESIS LESS THAN 3 CM INCARCERATED OR STRANGULATED,18008.0,12605.6,,,0
CDM,45000391,HC REPAIR ANT ABDOMINAL HERNIA(S) ANY APPROACH RECURRENT INCL IMPLANT MESH/PROSTHESIS 3-10 CM REDUCIBLE,12237.0,8565.9,,,0
CDM,45000392,HC REPAIR ANT ABDOMINAL HERNIA(S) ANY APPROACH RECURRENT INCL IMPLANT MESH/PROSTHESIS 3-10 CM INCARCERATED OR STRANGULATED,19620.0,13734.0,,,0
CDM,45000393,HC REPAIR ANT ABDOMINAL HERNIA(S) ANY APPROACH RECURRENT INCL IMPLANT MESH/PROSTHESIS GREATER THAN 10 CM REDUCIBLE,13333.0,9333.1,,,0
CDM,45000394,HC REPAIR ANT ABDOMINAL HERNIA(S) ANY APPROACH RECURRENT INCL IMPLANT MESH/PROSTHESIS GREATER THAN 10 CM INCARCERATED OR STRANGULATED,15334.0,10733.8,,,0
CDM,45000395,HC REMOVAL OF FOREIGN BODY DEEP THIGH REGION OR KNEE AREA,8925.0,6247.5,,,0
CDM,45000396,HC CLOSED TREATMENT  MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX,10709.0,7496.3,,,0
CDM,45000397,HC REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP OR COMPLICATED,8925.0,6247.5,,,0
CDM,45000398,HC TX OF MISSED ABORTION COMPLETED SURGICALLY FIRST TRIMESTER,9498.0,6648.6,,,0
CDM,45000399,HC INDUCED ABORTION 1 OR MORE VAGINAL SUPPOSITORIES W/WO CERVICAL DILATION INCL DELIVERY FETUS/SECUNDINES,6065.0,4245.5,,,0
CDM,45000400,HC INDUCED ABORTION 1 OR MORE VAGINAL SUPPOSITORIES W/WO CERVICAL DILATION & CURETTAGE/EVACUATION,6975.0,4882.5,,,0
CDM,45000401,HC INDUCED ABORTION 1 OR MORE VAGINAL SUPPOSITORIES W/WO CERVICAL DILATION INCL DELIVERY FETUS/SECUNDINES W/HYSTEROTOMY,8021.0,5614.7,,,0
CDM,45000402,HC COLPORRHAPHY SUTURE OF INJURY OF VAGINA NON-OBSTETRICAL,12436.0,8705.2,,,0
CDM,45000403,HC CLOSED TX CARPAL SCAPHOID (NAVICULAR) FX W/O MANIPULATION,852.0,596.4,,,0
CDM,45000404,HC CLOSED TREATMENT OF GREATER HUMERAL TUBEROSITY FRACTURE W/O MANIPULATION,852.0,596.4,,,0
CDM,45000406,HC CLOSED TX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/O MANIPULATION,852.0,596.4,,,0
CDM,45000407,HC REMOVAL FOREIGN BODY IN SCROTUM,7352.0,5146.4,,,0
CDM,45000408,HC ALCOHOL AND/OR DRUG SERVICES BRIEF INTERVENTION PER 15 MINUTES,128.0,89.6,,,0
CDM,45000409,HC REMOVAL FOREIGN BODY FROM DEEP PENILE TISSUE,10257.0,7179.9,,,0
CDM,45000412,HC ALCOHOL AND/OR DRUG SCREENING,75.0,52.5,,,0
CDM,45000413,HC HYMENOTOMY SIMPLE INCISION,11879.0,8315.3,,,0
CDM,45000414,HC CLOSED TX TARSAL BONE DISLOCATION OTHER THAN TALOTARSAL REQUIRING ANESTHESIA,12299.0,8609.3,,,0
CDM,45000415,HC CYSTOSCOPY W/REMOVAL FOREIGN BODY CALCULUS/URETERAL STENT FROM URETHRA/BLADDER SIMPLE,8772.0,6140.4,,,0
CDM,45000416,HC REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS,6898.0,4828.6,,,0
CDM,45000417,HC DRAINAGE ABSCESS/CYST/HEMATOMA/VESTIBULE OF MOUTH COMPLICATED,2393.0,1675.1,,,0
CDM,45100001,HC E&M SERVICE UNLISTED,161.0,112.7,,,0
CDM,45374,"HYALURONATE SODIUM, STABILIZED 60 MG/3 ML IATC SYRG",1978.0,1384.6,,,0
CDM,45429,PNEUMOC 13-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG,814.5,570.15,,,0
CDM,45535,MIFEPRISTONE 200 MG ORAL TAB,285.0,199.5,,,0
CDM,45955,ETONOGESTREL 68 MG SDRM IMPL,2104.5,1473.15,,,0
CDM,45955,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN",24.5,17.15,,,0
CDM,46000001,HC SPIROMETRY,480.0,336.0,,,0
CDM,46000002,HC SPIR PRE POST BRONCHODILATOR,624.0,436.8,,,0
CDM,46000003,HC VITAL CAPACITY / WEANING PARAMETERS,273.0,191.1,,,0
CDM,46000004,HC LUNG FUNCTION TEST (MBC/MVV),576.0,403.2,,,0
CDM,46000006,HC EXHALED AIR ANALYSIS O2/CO2,262.0,183.4,,,0
CDM,46000012,HC PULSE OXIMETRY SNGL DETERMIN,140.0,98.0,,,0
CDM,46000013,HC PULSE OXIMETRY MULT DETERMIN,205.0,143.5,,,0
CDM,46000014,HC PULSE OXIMETRY CONTIN MONITOR,245.0,171.5,,,0
CDM,46000024,HC CAR SEAT/BED TEST 1ST 60 MIN,189.0,132.3,,,0
CDM,46000025,HC CAR SEAT/BED TEST EA ADDL 30 MIN,159.0,111.3,,,0
CDM,46241,TISOTUMAB VEDOTIN-TFTV 40 MG IV SOLR,47249.0,33074.3,,,0
CDM,46257,METHYLPREDNISOLONE 40 MG/ML SUSP (DEPO-MEDROL) INJECTION,51.5,36.05,,,0
CDM,46257,METHYLPREDNISOLONE 80 MG/ML SUSP FOR INJECTION,72.0,50.4,,,0
CDM,46259,METHYLPREDNISOLONE 125 MG INJECTION SOLR,69.0,48.3,,,0
CDM,46259,METHYLPREDNISOLONE 40 MG SOLUTION FOR INJECTION,30.0,21.0,,,0
CDM,46259,METHYLPREDNISOLONE SOD SUC(PF) 125 MG/2 ML INJ SOLR,19.5,13.65,,,0
CDM,46259,METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML INJ SOLR,44.0,30.8,,,0
CDM,46273,CYCLOPHOSPHAMIDE 2 GRAM IV SOLUTION,3044.0,2130.8,,,0
CDM,46273,CYCLOPHOSPHAMIDE 20 MG/ML IN NS,792.0,554.4000000000001,,,0
CDM,46273,CYCLOPHOSPHAMIDE 500 MG IV SOLR,314.0,219.8,,,0
CDM,46289,BUPRENORPHINE 64 MG/0.18 ML SUBQ SLSY,4047.0,2832.9,,,0
CDM,46427,TREMELIMUMAB-ACTL 20 MG/ML IV SOLN,67275.0,47092.5,,,0
CDM,46555,HC IV INFUSION PEMIVIBART,15939.0,11157.3,,,0
CDM,46561,HC IV INFUSION PEMIVIBART,15939.0,11157.3,,,0
CDM,46784,DOSTARLIMAB-GXLY 50 MG/ML IV SOLN,46012.5,32208.75,,,0
CDM,47045,PENICILLIN G BENZATHINE 1200000 UNIT/2 ML IM SYRG,3043.0,2130.1,,,0
CDM,47045,PENICILLIN G BENZATHINE 2400000 UNIT/4 ML IM SYRG,1898.0,1328.6,,,0
CDM,47045,PENICILLIN G BENZATHINE 600000 UNIT/ML IM SYRG,1188.0,831.6,,,0
CDM,47100016,HC HEARING SCREEN-JOHN HOPKINS CONTRACT,26.0,18.2,,,0
CDM,47100038,HC AUDITOR EVOKE POTENT SCEEN AUDITOR POTENT W/BROADBAND  STIMULI AUTO ANALYSIS,535.0,374.5,,,0
CDM,47100039,HC AUDITOR EVOKE POTENT HEARING STATUS DETER BROADBAND STIMULI W/INTERP & REPORT,611.0,427.7,,,0
CDM,47119,"PENICILLIN G BENZATHINE&PROCAIN 1,200,000 UNIT/2 ML IM SYRINGE",861.0,602.7,,,0
CDM,47126,EPINEPHRINE 0.15 MG/0.3 ML IM PNIJ,675.0,472.5,,,0
CDM,47126,EPINEPHRINE 0.3 MG/0.3 ML IM PNIJ,876.5,613.55,,,0
CDM,47126,EPINEPHRINE 1 MG/ML (1ML) INJ SOLN,88.0,61.6,,,0
CDM,47433,NIVOLUMAB-RELATLIMAB-RMBW 240-80 MG/20 ML IV SOLN,56695.0,39686.5,,,0
CDM,47474,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN,34.0,23.8,,,0
CDM,47474,BUPIVACAINE 0.25 % (2.5 MG/ML) INJ SOLN,36.0,25.2,,,0
CDM,47676,PEGFILGRASTIM-PBBK 6 MG/0.6 ML SUBQ SYRG,6900.0,4830.0,,,0
CDM,47684,FUROSEMIDE 10 MG/ML INJ SOLN,26.0,18.200000000000003,,,0
CDM,47937,COVID VACCINE 24-25 (6M-4Y)(PFI)-PF 3 MCG/0.3 ML IM SUSP,249.0,174.3,,,0
CDM,47941,COVID VACCINE 24-25 (5-11Y)(PFI)-PF 10 MCG/0.3 ML IM SUSP,392.0,274.4,,,0
CDM,47945,COVID VAC 25-26(12UP)(PFI)(PF) 30 MCG/0.3 ML IM SYRG,639.0,447.3,,,0
CDM,47945,COVID VACCINE 24-25 (12UP)(PFI)(PF) 30 MCG/0.3 ML IM SYRG,910.5,637.35,,,0
CDM,47949,COVID VAC 25-26(6M-11Y)(MOD)PF 25 MCG/0.25 ML IM SYRG,558.0,390.6,,,0
CDM,47949,COVID VACCINE 24-25 (6M-11Y)(MOD)PF 25 MCG/0.25 ML IM SYRG,836.5,585.55,,,0
CDM,47953,COVID VAC 25-26(12UP)(MOD)(PF) 50 MCG/0.5 ML IM SYRG,613.0,429.1,,,0
CDM,47953,COVID VACCINE 24-25 (12UP)(MOD)(PF) 50 MCG/0.5 ML IM SYRG,613.0,429.1,,,0
CDM,47959,"RSV VAC, PREF A AND PREF B(PF) 120 MCG/0.5 ML IM SOLR",1066.0,746.2,,,0
CDM,48000001,HC HEART/LUNG RESUSCITATION CPR,962.0,673.4,,,0
CDM,48000002,HC TEMPORARY EXTERNAL PACING,937.0,655.9,,,0
CDM,48000003,CARDIOVERSION ELECTRIC EXT,1742.0,1219.4,,,0
CDM,48000004,HC PERQ CORONARY THROMBECT,5916.0,4141.2,,,0
CDM,48000005,HC THROMBOL CORONARY ANGIO,2306.0,1614.2,,,0
CDM,48000006,HC THROMBOL CORONARY IV INFUSION,1118.0,782.6,,,0
CDM,48000007,HC INTRAVASCULAR HEART ADD-ON INITIAL VESSEL (LIST SEP IN ADDT TO CODE FOR PRIMARY PROCEDURE),3055.0,2138.5,,,0
CDM,48000008,HC INTRAVASCULAR HEART ADD-ON EACH ADDTL VESSEL (LIST SEP IN ADDT TO CODE FOR PRIMARY PROCEDURE),1869.0,1308.3,,,0
CDM,48000009,HC INSERT INTRACORON STENT SINGL,13060.0,9142.0,,,0
CDM,48000010,HC INSERT INTRACORON STENT ADDL EA,8885.0,6219.5,,,0
CDM,48000011,HC PTA CORONARY SINGL,11109.0,7776.3,,,0
CDM,48000012,HC PTA CORONARY ADDL EA,7738.0,5416.6,,,0
CDM,48000013,HC REVISION OF AORTIC VALVE,36231.0,25361.7,,,0
CDM,48000014,HC REVISION OF PULMONARY VALVE,13691.0,9583.7,,,0
CDM,48000016,HC PTA PULMONARY ARTERY BALLOON ANGIOPLASTY SINGLE VESSEL,18545.0,12981.5,,,0
CDM,48000017,HC PTA PULMONARY ARTERY BALLOON ANGIOPLASTY EA ADDTL VESSEL,13653.0,9557.1,,,0
CDM,48000018,ECHO TRANSESOPH CARD ANOMAL,771.0,539.7,,,0
CDM,48000019,HC ECHO SPECTRAL DOPPLER ADD-ON,377.0,263.9,,,0
CDM,48000020,HC ECHO COLOR FLOW ADD-ON,121.0,84.7,,,0
CDM,48000021,HC HEART FLOW RESERVE MEASURE,3755.0,2628.5,,,0
CDM,48000022,HC HEART FLOW RESERVE MEASURE,3786.0,2650.2,,,0
CDM,48000023,HC PERQ TRCATH CLOSURE OF ASD IMPLA,20512.0,14358.4,,,0
CDM,48000024,HC BUNDLE OF HIS RECORDING,6592.0,4614.4,,,0
CDM,48000025,HC MAP TACHYCARDIA ADD-ON,144.0,100.8,,,0
CDM,48000026,HC ELECTROPHYS MAP 3D ADD-ON,15496.0,10847.2,,,0
CDM,48000027,HC COMP ELECTROPH EVAL,29138.0,20396.6,,,0
CDM,48000028,HC COMP ELECTROPH EVAL R HRT,10776.0,7543.2,,,0
CDM,48000029,HC EVAL DEFIB PUL GEN AND LEADS,1516.0,1061.2,,,0
CDM,48000030,HC EVAL DEFIB PUL GEN,5715.0,4000.5,,,0
CDM,48000031,HC TILT TABLE EVALUATION W/WO RX,1873.0,1311.1,,,0
CDM,48000034,HC ECHO TRAN 2D W-INTRP SUP,844.0,590.8,,,0
CDM,48000035,HC ECHOC REAL-T,2372.0,1660.4,,,0
CDM,48000038,HC INSERT VAD ARTERY ACCESS LEFT HEART,6710.0,4697.0,,,0
CDM,48000039,HC REMOVE VAD DISTINCT SESSION ARTERIAL OR ARTERIAL & VENOUS CANNULA(S),6710.0,4697.0,,,0
CDM,48000040,HC REPOSITION VAD DISTINCT SESSION RT OR LT HEART,6710.0,4697.0,,,0
CDM,48000041,HC REMOVE AORTIC ASSIST DEVICE,3522.0,2465.4,,,0
CDM,48000042,HC PERC DRUG EL COR STENT SING,17552.0,12286.4,,,0
CDM,48000043,HC PERC D E COR REVASC W AMI S,21111.0,14777.7,,,0
CDM,48000044,HC PERC DRUG-EL STENT BRAN,11109.0,7776.3,,,0
CDM,48000045,HC PERC D-E STENT ATHER S,21111.0,14777.7,,,0
CDM,48000046,HC PERC D-E STENT ATHER BR,11109.0,7776.3,,,0
CDM,48000047,HC PERC D-E REVASC T CABG S,14693.0,10285.1,,,0
CDM,48000048,HC D-E COR REVASC T CABG B,11109.0,7776.3,,,0
CDM,48000049,HC PERC D-E COR REVASC CHRO SIN,21111.0,14777.7,,,0
CDM,48000050,HC PERC D-E REVASC CHRO ADD,11109.0,7776.3,,,0
CDM,48000051,HC REVISION OF MITRAL VALVE,13501.0,9450.7,,,0
CDM,48000052,HC ELECTROPHYSIOLOGIC EVAL OF SUBCU IMPLANTABLE DEFIBRILLATOR,3065.0,2145.5,,,0
CDM,48000055,HC SHOCKWAVE CORONARY IVL,18988.0,13291.6,,,0
CDM,48000058,HC TRANSESOPHAGEAL ECHO CONGENITAL CARDIAC ANOMALIES PLACEMENT OF TRANSESOPHAGEAL PROBE ONLY,2605.0,1823.5,,,0
CDM,48000059,HC PERIPHERAL ARTERIAL DISEASE (PAD) REHABILITATION PER SESSION,241.0,168.7,,,0
CDM,48000060,HC PM/ICD REMOTE TECH SERV,278.0,194.6,,,0
CDM,48000061,HC TRANSCATHETER INSERT/REPLACE PERM LEADLESS PACEMAKER RT VENT INCL IMAGE GUIDE/DEVICE EVAL,55766.0,39036.2,,,0
CDM,48000062,HC TRANSCATHETER REMOVAL PERMANENT LEADLESS PACEMAKER RT VENTRICULAR,11658.0,8160.6,,,0
CDM,48000063,HC INTRA-ATRIAL PACING,27316.0,19121.2,,,0
CDM,48000065,HC CARDIOVERSION ELECTRIC INT,2069.0,1448.3,,,0
CDM,48000067,HC MYOCARDIAL STRAIN IMG USING SPECKLE TRACKING-DERIVED ASSESSMENT OF MYOCARDIAL MECHANICS,40.0,28.0,,,0
CDM,48000068,HC TIS CREATION BY STENT CGEN CAR ANOMAL INCL ALL IMG GUIDE WHEN PERFORM LT/RT HEART DIAGNOS CARDIAC CATH CGEN CAR ANOMAL INITIAL INTRACARDIAC SHUNT,3814.0,2669.8,,,0
CDM,48000069,HC TIS CREATION BY STENT CGEN CAR ANOMALINCL ALL IMG GUIDE WHEN PERFORM LT/RT HEART DIAGNOS CARDIAC CGEN CATH CAR ANOMAL EA ADDL,1501.0,1050.7,,,0
CDM,48000070,HC INSERTION OF VENTRICULAR ASSIST DEVICE PERCUTANEOUS INCL RADIOLOGICAL SUPERVISON & INTERP RT HEART VENOUS ACCESS ONLY,1301.0,910.7,,,0
CDM,48000071,HC REMOVAL OF PERQ RT HEART VENTRICULAR ASSIST DEVICE VENOUS CANNULA AT SEPARATE & DISTINCT SESSION FROM INSERTION,580.0,406.0,,,0
CDM,48000073,HC PERCUTANEOUS PULM ARTERY REVASCULAR STENT PLACEMENT INITIAL NORMAL NATIVE CONNECT UNILATERAL,33448.0,23413.6,,,0
CDM,48000074,HC PERCUTANEOUS PULM ARTERY REVASCULAR STENT PLACEMENT INITIAL NORMAL NATIVE CONNECT BILATERAL,33448.0,23413.6,,,0
CDM,48000075,HC PERCUTANEOUS PULM ARTERY REVASCULAR STENT PLACEMENT INITIAL ABNORMAL CONNECT UNILATERAL,71877.0,50313.9,,,0
CDM,48000076,HC PERCUTANEOUS PULM ARTERY REVASCULAR STENT PLACEMENT INITIAL ABNORMAL CONNECT BILATERAL,82658.0,57860.6,,,0
CDM,48000077,HC PERCUTANEOUS PULM ARTERY REVASCULAR STENT PLACEMENT EA ADDTL VESSEL/SEPARATE LESION NORMAL/ABNORMAL CONNECTIONS,16725.0,11707.5,,,0
CDM,48000078,HC PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY NATIVE/RECURRENT COARCTATION OF THE AORTA,19271.0,13489.7,,,0
CDM,48000079,HC PERCUTANEOUS TRANSLUMINAL CORONARY LITHOTRIPSY,10942.0,7659.4,,,0
CDM,48000085,HC INSERTION/REPLACEMENT IMPLANT CARDIOVERTER-DEFIBRILLATOR SYSTEM W/SUBSTERNAL ELECTRODE(S) INCL IMAGE GUIDE/ELECTROPHYSIOLOGICAL EVAL,58680.0,41076.0,,,0
CDM,48000086,HC INSERT VAD PERQ INCL RS&I LT HEART BOTH ARTERIAL/VENOUS ACCESS W/TRANSSEPTAL PUNCTURE,2098.0,1468.6,,,0
CDM,48000087,HC ENDOVASCULAR STENT REPAIR COARCTATION ASCENDING/TRANSVERSE/DESCENDING THORACIC ABDOMINAL AORTA STENT PLACEMENT ACROSS MAJOR SIDE BRANCHES,1114.0,779.8,,,0
CDM,48000088,HC ENDOVASCULAR STENT REPAIR COARCTATION ASCENDING/TRANSVERSE/DESCENDING THORACIC ABDOMINAL AORTA STENT PLACEMENT NOT CROSSING MAJOR SIDE BRANCHES,887.0,620.9,,,0
CDM,48000089,HC INJECTION CARDIAC CATH INCL IMAGE S I & REPORT SELECTIVE PULM VENOUS ANGIOGRAPHY EACH DISTINCT PULM VEIN,79.0,55.3,,,0
CDM,48000090,HC INJECTION CARDIAC CATH INCL IMAGE S I & REPORT SELECTIVE PULM ANGIOGRAPHY MAJOR AORTOPULM COLLATERAL ARTERIES EACH DISTINCT VESSEL,104.0,72.8,,,0
CDM,48000091,HC VENOGRAPHY CONGENITAL HEART DEFECT(S) INCL CATH PLACEMENT S&I ANOMALOUS PERSISTENT SUPERIOR VENA CAVA SECOND CONTRALATERAL W/NATIVE DRAINAGE TO HEART,66.0,46.2,,,0
CDM,48000092,HC VENOGRAPHY CONGENITAL HEART DEFECT(S) INCL CATH PLACEMENT S&I AZYGOS/HEMIAZYGOS VENOUS SYSTEM,63.0,44.1,,,0
CDM,48000093,HC VENOGRAPHY CONGENITAL HEART DEFECT(S) INCL CATH PLACEMENT S&I CORONARY SINUS,79.0,55.3,,,0
CDM,48000094,HC VENOGRAPHY CONGENITAL HEART DEFECT(S) INCL CATH PLACEMENT S&I VENOVENOUS COLLATERALS AT OR ABOVE THE HEART,116.0,81.2,,,0
CDM,48000095,HC VENOGRAPHY CONGENITAL HEART DEFECT(S) INCL CATH PLACEMENT S&I VENOVENOUS COLLATERALS BELOW THE HEART,117.0,81.9,,,0
CDM,48000097,HC ELECTROPHYSIOLOGIC EVALUATION OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR SYSTEM WITH SUBSTERNAL ELECTRODE,5169.0,3618.3,,,0
CDM,48000098,HC REMOVAL OF SUBSTERNAL IMPLANTABLE DEFIBRILLATOR PULSE GENERATOR ONLY,15494.0,10845.8,,,0
CDM,48000099,HC REMOVAL AND REPLACEMENT OF SUBSTERNAL IMPLANTABLE DEFIBRILLATOR PULSE GENERATOR,95560.0,66892.0,,,0
CDM,48000100,HC REPOSITIONING OF PREVIOUSLY IMPLANTABLE DEFIBRILLATOR-PACING ELECTRODE,15494.0,10845.8,,,0
CDM,48000101,HC INSERTION OF SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELECTRODE,35233.0,24663.1,,,0
CDM,48081,MIRVETUXIMAB SORAVTANSINE-GYNX 5 MG/ML IV SOLN,17324.5,12127.15,,,0
CDM,48100001,HC REPOSITION PACING-DEFIB LEAD,2452.0,1716.4,,,0
CDM,48100002,HC INSERT PACING LEAD & CONNECT,36248.0,25373.6,,,0
CDM,48100003,HC L VENTR PACING LEAD ADD-ON,36248.0,25373.6,,,0
CDM,48100005,HC CATH RIGHT HEART,6485.0,4539.5,,,0
CDM,48100006,HC CATH LEFT HEART,3967.0,2776.9,,,0
CDM,48100007,HC CATH RIGHT AND LEFT HEART,4289.0,3002.3,,,0
CDM,48100008,HC CORONARY ARTERY ANGIO SI,6485.0,4539.5,,,0
CDM,48100009,HC CORONARY ART/GRFT ANGIO SI,6485.0,4539.5,,,0
CDM,48100010,HC R HRT CORONARY ARTERY ANGIO SI,12714.0,8899.8,,,0
CDM,48100011,HC R HRT ART/GRFT ANGIO SI,3967.0,2776.9,,,0
CDM,48100012,HC L HRT ARTERY/VENTR ANGIO SI,12714.0,8899.8,,,0
CDM,48100013,HC L HRT ART/GRFT VENTR ANGIO SI,3967.0,2776.9,,,0
CDM,48100014,HC R&L HRT ART/VENTRICLE ANGIO SI,12714.0,8899.8,,,0
CDM,48100015,HC R&L HRT ART/VENTRICLE ANGIO SI,3967.0,2776.9,,,0
CDM,48100016,HC L HRT CATH TRNSPTL PUNCTURE,3967.0,2776.9,,,0
CDM,48100017,HC DRUG ADMIN & HEMODYN MEAS,196.0,137.2,,,0
CDM,48100018,HC EXERCISE W/HEMODYN MEAS,589.0,412.3,,,0
CDM,48100022,HC INJ ANG COR DURIN HRT CATH CONG,196.0,137.2,,,0
CDM,48100023,HC INJ ANG L HRT DURIN HRT CATH CONG,196.0,137.2,,,0
CDM,48100024,HC INJ ANG R HRT DURIN HRT CATH CONG,196.0,137.2,,,0
CDM,48100025,HC INJ ANG AORT DURIN HRT CATH CONG,196.0,137.2,,,0
CDM,48100026,HC INJECTION PX DURING CARDIAC CATH INCL IMAGE SI & REPORT NONSELECT PULM ARTERIAL ANGIOGRAPHY,196.0,137.2,,,0
CDM,48100027,HC PERQ TRCATH CLOSURE OF VSD IMPLA,64135.0,44894.5,,,0
CDM,48100028,HC COMP ELECTROPH EVAL L ATRIUM +,12058.0,8440.6,,,0
CDM,48100029,HC COMP ELECTROPH EVAL L VENT +,12058.0,8440.6,,,0
CDM,48100030,HC STIMULATION PACING HEART,5292.0,3704.4,,,0
CDM,48100031,HC ABLATION AV NODE,17214.0,12049.8,,,0
CDM,48100032,HC COMP ELECTRO EVAL W/INSERT REPOSITION MULTI ELECTRODE CATH INDUCT INCL INTRACARDIAC ELECTRO 3D MAPPING SVT,98159.0,68711.3,,,0
CDM,48100033,HC COMP ELECTRO EVAL W/INSERT REPOSITION MULTI ELECTRODE CATH INDUCT INCL INTRACARDIAC ELECTRO 3D MAPPING VT,41479.0,29035.3,,,0
CDM,48100034,HC ECHO INTRACARD DURING INTERVENT,306.0,214.2,,,0
CDM,48100037,HC INTRAVENTRICULAR PACING,27316.0,19121.2,,,0
CDM,48100039,HC ENDOMYOCARDIAL BIOPSY,2242.0,1569.4,,,0
CDM,48100040,HC PRQ CARD STENT/ATH/ANGIO SNGL MAJ CORON ART/BRANCH,21111.0,14777.7,,,0
CDM,48100041,HC PRQ CARD STENT/ATH/ANGIO EA ADD BRANCH MAJ CORON ART,31448.0,22013.6,,,0
CDM,48100042,HC PRQ REVASC BYP GRAFT SINGLE VESSEL,13691.0,9583.7,,,0
CDM,48100044,HC PRQ CARD REVASC MI SINGLE VESSEL,13691.0,9583.7,,,0
CDM,48100045,HC PRQ CARD REVASC CHRONIC OCCL SINGLE VESSEL,13691.0,9583.7,,,0
CDM,48100046,HC PRQ CARD REVASC CHRONIC OCCL EA ADD,9008.0,6305.6,,,0
CDM,48100047,HC PRQ CARD ANGIO/ATHRECT EA ADD BRANCH,11307.0,7914.9,,,0
CDM,48100048,HC ABLATE ARRHYTHMIA ADD ON,12452.0,8716.4,,,0
CDM,48100049,HC COMP ELECTRO EVAL W/ TRANSSEPTAL CATH INSERT/REPOSITION MULTI ELECTRODE CATH & INTRACARDIAC CATH ABLATION ATRIAL FIB PULM VEIN ISOL INCL ELECT 3D MAPPING W/IMAGING S&I,98159.0,68711.3,,,0
CDM,48100050,HC TX L/R ATRIAL FIB ADDL,12452.0,8716.4,,,0
CDM,48100051,HC PERCU TRANSCATH CLOSURE PDA,18493.0,12945.1,,,0
CDM,48100052,HC PERCU TRANSCATH SEPTAL REDUCTION THERAPY,1484.0,1038.8,,,0
CDM,48100054,HC PRQ CARD ANGIO/ANTHRECT SINGLE MAJOR ART/BRANCH,13691.0,9583.7,,,0
CDM,48100059,HC RT HEART CATH CHD INCL IMAGE GUIDE NORMAL NATIVE CONNECTIONS,11427.0,7998.9,,,0
CDM,48100060,HC RT HEART CATH CHD INCL IMAGE GUIDE ABNORMAL NATIVE CONNECTIONS,11427.0,7998.9,,,0
CDM,48100061,HC RT & LT HEART CATH CHD INCL IMAGE GUIDE NORMAL NATIVE CONNECTIONS,11427.0,7998.9,,,0
CDM,48100062,HC RT & LT HEART CATH CHD INCL IMAGE GUIDE ABNORMAL NATIVE CONNECTIONS,11427.0,7998.9,,,0
CDM,48100063,HC LT HEART CATH CONGENITAL HEART DEFECT(S) NORMAL/ABNORMAL NATIVE CONNECTIONS,13794.0,9655.8,,,0
CDM,48100064,HC TRANSCATHETER RENAL SYMPATHETIC DENERVATION PERQ BILATERAL,24273.0,16991.1,,,0
CDM,48100065,HC INJECT PROCEDURE CARDIAC CATHETERIZATION INCL IMAGE SI & REPORT PULMONARY ARTERIAL ANGIOGRAPHY BILATERAL,457.0,319.9,,,0
CDM,48100066,HC INJECT PROCEDURE CARDIAC CATHETERIZATION INCL IMAGE SI & REPORT PULMONARY ARTERIAL ANGIOGRAPHY UNILATERAL,236.0,165.2,,,0
CDM,48100067,HC ELECTROPHYSIOLOGIC FOLLOW-UP STUDY W/PACING AND RECORDING INCL INDCUTION/ATTEMPTED INDCUTION OF ARRHYTHMIA,30627.0,21438.9,,,0
CDM,48100068,HC PERQ TRANSCATHER THERAPEUTIC DRUG DELIVERY INTRACORONARY DRUG-DELIVERY BALLOON SINGLE MAJOR CORONARY ARTERY OR BRANCH,24273.0,16991.1,,,0
CDM,48100069,HC PERQ TRANSCATHER THERAPEUTIC DRUG DELIVERY INTRACORONARY DRUG-DELIVERY BALLOON SEP TARGET LESION SINGLE MAJOR CORONARY ARTERY OR BRANCH,6069.0,4248.3,,,0
CDM,48100070,HC RIGHT VENTRICULAR RECORDING,5169.0,3618.3,,,0
CDM,48100071,HC TRANSCATHETER RENAL SYMPATHETIC DENERVATION PREQ INCL ARTERIAL PUNCTURE UNILATERAL,24273.0,16991.1,,,0
CDM,48105,GLOFITAMAB-GXBM 1 MG/ML IV SOLN (>10 MG DOSE 10 ML MIXTURE COMPONENT),84614.0,59229.8,,,0
CDM,48200001,HC CV STRESS TEST TRACING ONLY,1200.0,840.0,,,0
CDM,48264,ELRANATAMAB-BCMM 40 MG/ML SUBQ SOLN,8820.0,6174.0,,,0
CDM,48300001,HC ECHO TRANSTHOR W/ DOPPLER,2559.0,1791.3,,,0
CDM,48300002,HC ECHO TRANSTHOR W/WO DYE,1396.0,977.2,,,0
CDM,48300003,HC ECHO TRANSTHOR LIMITED FUP,916.0,641.2,,,0
CDM,48300004,ECHO TRANSESOPHAGEAL,2569.0,1798.3,,,0
CDM,48300005,ECHO DOPPLER LIMITED FUP ADD-ON,133.0,93.1,,,0
CDM,48300006,HC ECHO TRANSTHOR STRESS TEST,1544.0,1080.8,,,0
CDM,48300008,HC TRNSTH ECHO CONGENITAL CAR ANOM COMPLETE,844.0,590.8,,,0
CDM,48300009,HC TRNSTH ECHO CONGENITAL CAR ANOM FOLLOW-UP/LTD,606.0,424.2,,,0
CDM,48300010,HC TRNSTH ECHO CONGENITAL CAR ANOM INTERP/REPORT ONLY,758.0,530.6,,,0
CDM,48300011,HC ECHO TRANSEOPHAGEAL INTRAOP,844.0,590.8,,,0
CDM,48300012,HC ECHO FETAL CARDIOVASCULAR SYSTEM (2D) W/WITHOUT M-MODE RECORDING,2142.0,1499.4,,,0
CDM,48300013,HC DOPPLER ECHO FETAL PULSED WAVE AND/OR CONT WAVE W/SPECTRAL DISPLAY COMPLETE,445.0,311.5,,,0
CDM,48300014,HC PEDIATRIC ECHO COMPLETE,2252.0,1576.4,,,0
CDM,48300015,HC PEDIATRIC ECHO LIMITED,1118.0,782.6,,,0
CDM,48300016,HC TEE FOR GUIDANCE OF TRANSCATH/GREAT VESSEL(S) STRUCTURAL INTERVENT,865.0,605.5,,,0
CDM,48300017,HC TRANSTHORACIC ECHOCARDIO W/CONTRAST OR W/O FOL BY W/CONTRAST REAL-TIME W/IMAGE DOC (2D) INCL M-MO,2299.0,1609.3,,,0
CDM,48300018,HC ECHO FETAL CARDIOVASC SYS REAL TIME W/IMAGE DOC W/WO M-MODE RECORDING F/U OR REPEAT STUDY,1622.0,1135.4,,,0
CDM,48300019,HC DOPPLER ECHO FETAL PULSED WAVE AND/OR CONT WAVE W/SPECTRAL DISPLAY F/U OR REPEAT STUDY,445.0,311.5,,,0
CDM,48300021,HC TRANSTHOR ECHO W/WO CONTRAST REAL-TIME W/IMAGE DOC (2D) INCL M-MO WHEN PERFORM F/U OR LIMITED STUDY,2036.0,1425.2,,,0
CDM,48300022,HC TRANSESOPHAGEAL ECHO W/WO CONTRAST REAL-TIME W/IMAGE DOC (2D) INCL PROBE PLACEMENT IMAGE ACQUISITION INTERP/REPORT,2522.0,1765.4,,,0
CDM,48300023,HC TTE W/CONTRAST OR W/O CONTRAST W/CONTRAST REAL TIME W/IMAGE DOC (2D) INCL PROBE PLACE IMAGE ACUQUISITION INTERP/REPORT,2303.0,1612.1,,,0
CDM,48300024,HC TTE W/CONTRAST OR W/O CONTRAST W/CONTRAST CONGENITAL CARDIAC ANOMALIES FOLLOW-UP OR LIMITED STUDY,2303.0,1612.1,,,0
CDM,48300027,HC TTE W/CONTRAST W/O CONTRAST W/CONTRAST INCL PROBE PLACE REAL-TIME 2D IMAGE ACQUISITION/INTERP ONGOING ASSESSMENT,2303.0,1612.1,,,0
CDM,48300028,HC ECHOCARDIOGRAPHY TRANSESOPHAGEAL REAL-TIME W/IMAGE DOCUMENT 2D PLACEMENT OF TRANSESOPHAGEAL PROBE ONLY,2097.0,1467.9,,,0
CDM,48300029,HC ECHOCARDIOGRAPHY TRANSESOPHAGEAL REAL-TIME W/IMAGE DOCUMENT 2D IMAGE ACQUISITION INTERP/REPORT ONLY,758.0,530.6,,,0
CDM,48300030,HC NONINVASIVE DETECTION HEART FAILURE AUGMENTATIVE ANALYSIS ECHOCARDIOGRAM W/INTERP & REPORT,23780.0,16646.0,,,0
CDM,48306,HC ADMIN RESPIRATORY SYNCYTIAL VIRUS MONOCLONAL ANTIBODY SEASONAL DOSE INTRAMUSCULAR INJECTION,1485.0,1039.5,,,0
CDM,48306,NIRSEVIMAB-ALIP 50 MG/0.5 ML IM SYRG,1485.0,1039.5,,,0
CDM,48357,HC ADMIN RESPIRATORY SYNCYTIAL VIRUS MONOCLONAL ANTIBODY SEASONAL DOSE INTRAMUSCULAR INJECTION,2202.5,1541.75,,,0
CDM,48357,NIRSEVIMAB-ALIP 100 MG/ML IM SYRG,1485.0,1039.5,,,0
CDM,48357,NIRSEVIMAB-ALIP 50 MG/0.5 ML IM SYRG,3070.0,2149.0,,,0
CDM,48414,EMTRICITABINE-TENOFOVIR 200 MG-300 MG TAB,305.0,213.5,,,0
CDM,48675,EPCORITAMAB-BYSP  4 MG/0.8 ML SUBQ SOLN,1031.0,721.7,,,0
CDM,48675,EPCORITAMAB-BYSP 48 MG/0.8 ML SUBQ SOLN,44594.0,31215.8,,,0
CDM,48705,FLU VACCINE TS 2024-25 6MOS UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,190.0,133.0,,,0
CDM,48706,FLU VACCINE 2024-25 65YR UP ADJMF59C (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,373.0,261.1,,,0
CDM,48711,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,40.0,28.0,,,0
CDM,48711,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,24.5,17.15,,,0
CDM,48711,LIDOCAINE 1% 10MG/ML (1ML-UD) OR SYRINGE,14.5,10.15,,,0
CDM,48711,LIDOCAINE 10 MG/ML (1 %) INJECTION,26.0,18.200000000000003,,,0
CDM,48711,LIDOCAINE 2% 20MG/ML (5ML-UD) OR SYRINGE,16.0,11.2,,,0
CDM,48711,LIDOCAINE 20 MG/ML (2 %) INJECTION,28.0,19.6,,,0
CDM,48722,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN",33.0,23.1,,,0
CDM,48722,"LIDOCAINE-EPINEPHRINE 1 %-1:200,000 INJ SOLN",60.0,42.0,,,0
CDM,48722,"LIDOCAINE-EPINEPHRINE 2 %-1:200,000 INJ SOLN",21.0,14.7,,,0
CDM,48723,TARLATAMAB-DLLE 10 MG IV SOLR,41390.5,28973.35,,,0
CDM,48729,NADOFARAGENE FIRADENOVEC-VNCG 3X10EXP11 VP/ML IVES SUSP,87000.0,60900.0,,,0
CDM,48772,ZOLBETUXIMAB-CLZB 100 MG IV SOLR (WET SOLR VIAL),3293.0,2305.1,,,0
CDM,48772,ZOLBETUXIMAB-CLZB 300 MG IV SOLR (WET SOLR VIAL),26496.0,18547.2,,,0
CDM,48851,BENDAMUSTINE 25 MG/ML IV SOLN,10925.0,7647.5,,,0
CDM,48994,APREPITANT 130 MG/18 ML (7.2 MG/ML) IV EMUL,1218.5,852.95,,,0
CDM,49107,LONCASTUXIMAB TESIRINE-LPYL 10 MG IV SOLR,46505.5,32553.85,,,0
CDM,49118,TARLATAMAB-DLLE 10 MG IV SOLR,41390.5,28973.35,,,0
CDM,49119,IMETELSTAT  47 MG IV SOLR,12100.5,8470.35,,,0
CDM,49119,IMETELSTAT 188 MG IV SOLR,51468.5,36027.95,,,0
CDM,49225,TORIPALIMAB-TPZI 240 MG/6 ML (40 MG/ML) IV SOLN,25650.0,17955.0,,,0
CDM,49393,VANCOMYCIN IN D5W 1 GRAM/200 ML IV PGBK,135.0,94.5,,,0
CDM,49399,EPINEPHRINE 0.3 MG/0.3 ML IM PNIJ,757.5,530.25,,,0
CDM,49404,ZOLBETUXIMAB-CLZB 100 MG IV SOLR (WET SOLR VIAL),4416.0,3091.2,,,0
CDM,49404,ZOLBETUXIMAB-CLZB 300 MG IV SOLR (WET SOLR VIAL),26496.0,18547.2,,,0
CDM,49437,DENOSUMAB-BBDZ 120 MG/1.7 ML (70 MG/ML) SUBQ SOLN,8855.0,6198.5,,,0
CDM,49437,DENOSUMAB-BBDZ 60 MG/ML SUBQ SYRG,4428.0,3099.6,,,0
CDM,49614,"MENING A,C,Y,W TT-N. MEN B(PF) 5-120 MCG/0.5 ML IM KIT (CAM USE ONLY)",829.0,580.3,,,0
CDM,49675,GLUCAGON 1 MG/ML INJ (MERGE),895.0,626.5,,,0
CDM,49689,EPINEPHRINE 0.3 MG/0.3 ML IM PNIJ,675.0,472.5,,,0
CDM,49698,DATOPOTAMAB DERUXTECAN-DLNK 100 MG IV SOLR,38209.5,26746.65,,,0
CDM,49775,TISLELIZUMAB-JSGR 10 MG/ML IV SOLN,13211.0,9247.7,,,0
CDM,49798,DATOPOTAMAB DERUXTECAN-DLNK 100 MG IV SOLR,38209.5,26746.65,,,0
CDM,50823,HC IV INFUSION HYDRAT 31-60 MIN,2392.0,1674.4,,,0
CDM,50857,FLUCICLOVINE F18 10 MCI (370 MBQ) IV SOLN,12529.0,8770.3,,,0
CDM,50857,GALLIUM-67 CITRATE 74 MBQ/ML (2 MCI/ML) IV SOLN,338.0,236.6,,,0
CDM,50857,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,109.0,76.3,,,0
CDM,50857,INDIUM IN-111 LABELED AUTOLOGOUS WHITE BLOOD CELLS,6136.0,4295.2,,,0
CDM,50857,INDIUM IN-111 PENTETATE,13053.0,9137.1,,,0
CDM,50857,"IOBENGUANE, I-123",8818.0,6172.6,,,0
CDM,50857,IODINE (I-131) CAPSULE FOR THYROID THERAPY,5304.0,3712.8,,,0
CDM,50857,IODINE (I-131) CAPSULE FOR UPTAKE DIAGNOSTIC,191.0,133.7,,,0
CDM,50857,IODINE I-123 CAPSULE FOR WHOLE BODY SCAN,1681.0,1176.7,,,0
CDM,50857,IODINE I-123 SODIUM IODINE CAPSULE,423.0,296.1,,,0
CDM,50857,IOFLUPANE I 123 5 MCI/2.5 ML (185 MBQ/2.5ML) IV SOLN,2080.0,1456.0,,,0
CDM,50857,KIT FOR PREP OF GA 68-DOTATATE 40 MCG IV SOLR,13212.5,9248.75,,,0
CDM,50857,KIT PREP OF GA-68-GOZETOTIDE 25 MCG IV SOLR,10591.0,7413.7,,,0
CDM,50857,KIT PREP TC-99M-SOD OXIDRONATE 3.15 MG IV SOLR,274.5,192.15,,,0
CDM,50857,TECHNETIUM TC 99M SESTAMIBI - CARDIOLITE,214.0,149.8,,,0
CDM,50863,0.2 MICRON FILTER ATTACHMENT MISC MISC,105.0,73.5,,,0
CDM,50863,0.45 % NACL-POTASSIUM CHLORIDE 20 MEQ/L IV SOLP (PEDS ONC),50.0,35.0,,,0
CDM,50863,23.4% SODIUM CHLORIDE (4 MEQ/ML) INJECTION,30.0,21.0,,,0
CDM,50863,ABACAVIR 300 MG ORAL TAB,99.0,69.3,,,0
CDM,50863,ABACAVIR-DOLUTEGRAVIR-LAMIVUD 600-50-300 MG ORAL TAB,562.0,393.4,,,0
CDM,50863,ABATACEPT 250 MG IV SOLR,12534.0,8773.8,,,0
CDM,50863,ABOBOTULINUMTOXINA 300 UNITS IM SOLR,4425.0,3097.5,,,0
CDM,50863,ABOBOTULINUMTOXINA 500 UNITS IM SOLR,3629.5,2540.65,,,0
CDM,50863,ACAMPROSATE 333 MG ORAL TBEC,16.0,11.2,,,0
CDM,50863,ACARBOSE  25 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,ACARBOSE  50 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,ACETAMINOPHEN  120 MG RECT SUPP,8.5,5.95,,,0
CDM,50863,ACETAMINOPHEN  160 MG ORAL CHEW,7.0,4.9,,,0
CDM,50863,ACETAMINOPHEN  325 MG ORAL TAB,7.5,5.25,,,0
CDM,50863,ACETAMINOPHEN  325 MG RECT SUPP,8.0,5.6,,,0
CDM,50863,ACETAMINOPHEN  500 MG ORAL TAB,5.0,3.5,,,0
CDM,50863,ACETAMINOPHEN  650 MG ORAL TBSR,7.0,4.9,,,0
CDM,50863,ACETAMINOPHEN  650 MG RECT SUPP,5.0,3.5,,,0
CDM,50863,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN FOR PERI-OPERATIVE",45.0,31.5,,,0
CDM,50863,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IVPB (PEDIATRICS/ADULT NON-FORM)",39.0,27.3,,,0
CDM,50863,ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSP,15.5,10.85,,,0
CDM,50863,ACETAMINOPHEN 160 MG/5 ML ORAL (PHS ERX MERGE),22.5,15.75,,,0
CDM,50863,ACETAMINOPHEN 160 MG/5 ML ORAL LIQD,5.0,3.5,,,0
CDM,50863,ACETAMINOPHEN 650 MG/20.3 ML ORAL SOLN,27.0,18.9,,,0
CDM,50863,ACETAMINOPHEN-CODEINE 300 MG-15 MG TAB,7.0,4.9,,,0
CDM,50863,ACETAZOLAMIDE 125 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,ACETAZOLAMIDE 250 MG ORAL TAB,24.5,17.15,,,0
CDM,50863,ACETAZOLAMIDE 25MG/ML SUSPENSION (REPACK),7.0,4.9,,,0
CDM,50863,ACETAZOLAMIDE 500 MG ORAL CPSR,40.0,28.0,,,0
CDM,50863,ACETAZOLAMIDE SODIUM 500 (100 MG/ML) INJ SOLR,169.0,118.3,,,0
CDM,50863,ACETIC ACID  2 % OTIC SOLN,864.0,604.8,,,0
CDM,50863,ACETIC ACID (VINEGAR) 5% IRRIGATION 12 ML (REPACK),64.0,44.8,,,0
CDM,50863,ACETIC ACID 0.25 % IR SOLN,55.0,38.5,,,0
CDM,50863,ACETYLCYSTEINE 10 % (100 MG/ML) MISC SOLN,67.0,46.9,,,0
CDM,50863,ACETYLCYSTEINE 20 % (200 MG/ML) IV SOLN,606.0,424.2,,,0
CDM,50863,ACETYLCYSTEINE 20 % (200 MG/ML) MISC SOLN,47.0,32.900000000000006,,,0
CDM,50863,ACIDOPHILUS-PECTIN W CITRUS 25 MILLION-100 CELL MG TAB,18.0,12.6,,,0
CDM,50863,ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSP,160.0,112.0,,,0
CDM,50863,ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSP,49.5,34.65,,,0
CDM,50863,ACYCLOVIR 200 MG ORAL CAP,13.0,9.1,,,0
CDM,50863,ACYCLOVIR 200 MG/5 ML ORAL SUSP,29.0,20.299999999999997,,,0
CDM,50863,ACYCLOVIR 5 % TOP OINT,1363.0,954.1,,,0
CDM,50863,ACYCLOVIR 800 MG ORAL TAB,17.0,11.899999999999999,,,0
CDM,50863,ACYCLOVIR NEO/PEDS INFUSION (CDS FROM PREMIX),31.0,21.7,,,0
CDM,50863,ACYCLOVIR SODIUM 50 MG/ML IV SOLN,105.0,73.5,,,0
CDM,50863,ADENOSINE (DIAGNOSTIC) 3 MG/ML IV SOLN,858.0,600.6,,,0
CDM,50863,ADENOSINE 3 MG/ML IV SYRG,247.0,172.9,,,0
CDM,50863,ADENOSINE 300 MCG/ML BOLUS (NEO),16.0,11.2,,,0
CDM,50863,ADENOSINE 3000 MCG/ML INJECTION,83.5,58.45,,,0
CDM,50863,ADVATE: FACTOR VIII CONCENTRATE (MERGE RECORD),7651.0,5355.700000000001,,,0
CDM,50863,AGALSIDASE BETA  5 MG IV SOLR,4295.0,3006.5,,,0
CDM,50863,AGALSIDASE BETA 35 MG IV SOLR,34859.0,24401.3,,,0
CDM,50863,ALBENDAZOLE 200 MG ORAL TAB,1351.0,945.7,,,0
CDM,50863,"ALBUMIN, HUMAN 25 % IV SOLN (MERGE)",427.0,298.9,,,0
CDM,50863,"ALBUMIN, HUMAN 25 % IV SOLP",807.0,564.9,,,0
CDM,50863,"ALBUMIN, HUMAN 25 % IV SOLP (FOR DIALYSIS)",826.0,578.2,,,0
CDM,50863,"ALBUMIN, HUMAN 5 % IV SOLP MERGE",829.0,580.3,,,0
CDM,50863,ALBUTEROL SULFATE 2.5 MG/0.5 ML INHL NEBU,25.0,17.5,,,0
CDM,50863,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) NEB SOLUTION,27.0,18.9,,,0
CDM,50863,ALBUTEROL SULFATE 5 MG/ML INHL NEB CONTINUOUS,171.5,120.05,,,0
CDM,50863,ALBUTEROL SULFATE 90 MCG/ACTUATION INHL HFAA,23.0,16.1,,,0
CDM,50863,"ALDESLEUKIN 360,000 UNITS/ ML SOLUTION",5121.0,3584.7,,,0
CDM,50863,ALGLUCOSIDASE ALFA 50 MG IV SOLR,47864.0,33504.8,,,0
CDM,50863,ALLOPURINOL 100 MG ORAL TAB,6.0,4.2,,,0
CDM,50863,ALLOPURINOL 20 MG/ML ORAL SUSPENSION (REPACK),7.5,5.25,,,0
CDM,50863,ALLOPURINOL 300 MG ORAL TAB,6.0,4.2,,,0
CDM,50863,ALLOPURINOL SODIUM 500 MG IV SOLR,2153.0,1507.1,,,0
CDM,50863,ALPHA-1 PROTEINASE INHIB.(HUM) 1000 MG (+/-)/20 ML IV SOLN,7111.0,4977.7,,,0
CDM,50863,"ALPHA-1-PROTEINASE INHIBITOR (HUMAN) 1,000 MG IV SUSP (PROLASTIN-C)",5813.0,4069.1,,,0
CDM,50863,ALPRAZOLAM 0.25 MG ORAL TAB,8.5,5.949999999999999,,,0
CDM,50863,ALPRAZOLAM 0.5 MG ORAL TAB,10.0,7.0,,,0
CDM,50863,ALPROSTADIL 500 MCG/ML INJ SOLN,680.5,476.35,,,0
CDM,50863,ALTEPLASE 1 MG/ML (1ML) SYRINGE (REPACK),1168.0,817.6,,,0
CDM,50863,ALTEPLASE 100 MG IV SOLR,1336.5,935.55,,,0
CDM,50863,ALTEPLASE 1MG/ML SYRINGE (FOR IR USE ONLY),950.5,665.35,,,0
CDM,50863,ALTEPLASE 2 MG INJ SOLR,1752.5,1226.75,,,0
CDM,50863,ALTEPLASE IV BOLUS (STROKE) 100 MG (2 X 50 MG VIALS),12145.0,8501.5,,,0
CDM,50863,ALTEPLASE IV INFUSION (PULMONARY EMBOLISM) 100 MG (2 X 50 MG VIALS),36433.5,25503.449999999997,,,0
CDM,50863,ALUM-MAG HYDROXIDE-SIMETH 200 MG-200 MG-20 MG/5 ML ORAL SUSP,24.0,16.8,,,0
CDM,50863,ALUM-MAG HYDROXIDE-SIMETH 400 MG-400 MG-40 MG/5 ML ORAL SUSP,14.0,9.8,,,0
CDM,50863,ALVIMOPAN 12 MG ORAL CAP,711.0,497.7,,,0
CDM,50863,AMANTADINE 100 MG ORAL CAP,12.0,8.4,,,0
CDM,50863,AMANTADINE 50 MG/5 ML ORAL SYRP,14.0,9.8,,,0
CDM,50863,AMBRISENTAN  5 MG ORAL TAB,1005.0,703.5,,,0
CDM,50863,AMIKACIN 1000 MG/4 ML INJ SOLN,92.5,64.75,,,0
CDM,50863,AMILORIDE 5 MG ORAL TAB,11.0,7.7,,,0
CDM,50863,AMINOCAPROIC ACID  500 MG ORAL TAB,565.0,395.5,,,0
CDM,50863,AMINOCAPROIC ACID 25 % ORAL SYRP,364.0,254.8,,,0
CDM,50863,AMINOCAPROIC ACID 250 MG/ML IV SOLN,111.0,77.7,,,0
CDM,50863,AMINOPHYLLINE 500 MG/20 ML IV SOLN,63.0,44.1,,,0
CDM,50863,AMIODARONE 100 MG ORAL TAB,57.5,40.25,,,0
CDM,50863,AMIODARONE 200 MG ORAL TAB,16.5,11.55,,,0
CDM,50863,AMIODARONE 50 MG/ML IV SOLN,28.0,19.6,,,0
CDM,50863,AMIODARONE BOLUS PEDS/NEO IV SYRINGE (1.5MG/ML FROM PREMIX),204.0,142.8,,,0
CDM,50863,"AMIODARONE IN DEXTROSE,ISO-OSM 150 MG/100 ML (PREMIX)",611.0,427.7,,,0
CDM,50863,"AMIODARONE IN DEXTROSE,ISO-OSM 360 MG/200 ML (1.8 MG/ML) IV SOLN",181.0,126.7,,,0
CDM,50863,AMITRIPTYLINE  10 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,AMITRIPTYLINE  25 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,AMITRIPTYLINE  50 MG ORAL TAB,7.5,5.25,,,0
CDM,50863,AMITRIPTYLINE  75 MG ORAL TAB,9.5,6.65,,,0
CDM,50863,AMITRIPTYLINE 100 MG ORAL TAB,15.0,10.5,,,0
CDM,50863,AMITRIPTYLINE 150 MG ORAL TAB,15.0,10.5,,,0
CDM,50863,AMLODIPINE  2.5 MG ORAL TAB,11.0,7.7,,,0
CDM,50863,AMLODIPINE  5 MG ORAL TAB,37.0,25.9,,,0
CDM,50863,AMLODIPINE (NORVASC) 1MG/ML SUSPENSION (REPACK),7.0,4.9,,,0
CDM,50863,AMLODIPINE 1 MG/ML ORAL SOLN,20.5,14.350000000000001,,,0
CDM,50863,AMLODIPINE 10 MG ORAL TAB,14.0,9.8,,,0
CDM,50863,AMMONIUM LACTATE 12 % TOP LOTN,198.5,138.95,,,0
CDM,50863,AMOXICILLIN 250 MG ORAL CAP,30.0,21.0,,,0
CDM,50863,AMOXICILLIN 250 MG/5 ML ORAL SUSR,11.0,7.7,,,0
CDM,50863,AMOXICILLIN 400 MG/5 ML ORAL SUSR,10.0,7.0,,,0
CDM,50863,AMOXICILLIN 500 MG ORAL CAP,35.5,24.85,,,0
CDM,50863,AMOXICILLIN-POT CLAVULANATE 250 MG-125 MG TAB,54.0,37.8,,,0
CDM,50863,AMOXICILLIN-POT CLAVULANATE 250 MG-62.5 MG/5 ML ORAL SUSP,29.0,20.3,,,0
CDM,50863,AMOXICILLIN-POT CLAVULANATE 400 MG-57 MG/5 ML ORAL SUSP,27.0,18.9,,,0
CDM,50863,AMOXICILLIN-POT CLAVULANATE 500 MG-125 MG TAB,93.5,65.45,,,0
CDM,50863,AMOXICILLIN-POT CLAVULANATE 600 MG-42.9 MG/5 ML ORAL SUSP,24.5,17.15,,,0
CDM,50863,AMOXICILLIN-POT CLAVULANATE 875 MG-125 MG TAB,215.0,150.5,,,0
CDM,50863,AMPHETAMINE-DEXTROAMPHETAMINE  5 MG ORAL CP24,71.0,49.7,,,0
CDM,50863,AMPHETAMINE-DEXTROAMPHETAMINE 10 MG ORAL TAB,17.0,11.9,,,0
CDM,50863,AMPHOTERICIN B 5 MCG/0.1 ML INTRAVITREAL INJECTION,55886.0,39120.200000000004,,,0
CDM,50863,AMPHOTERICIN B LIPOSOME 50 MG IV SUSR,3608.0,2525.6,,,0
CDM,50863,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,60.0,42.0,,,0
CDM,50863,AMPICILLIN 250 MG SOLUTION FOR INJECTION,26.5,18.549999999999997,,,0
CDM,50863,AMPICILLIN 500 MG SOLUTION FOR INJECTION,20.5,14.35,,,0
CDM,50863,AMPICILLIN PEDS INFUSION (CDS MIXTURE),34.5,24.15,,,0
CDM,50863,AMPICILLIN SODIUM  2 GRAM INJ SOLR,50.0,35.0,,,0
CDM,50863,AMPICILLIN-SULBACTAM  1.5 GRAM INJ SOLR,46.0,32.2,,,0
CDM,50863,AMPICILLIN-SULBACTAM  3 GRAM INJ SOLR,53.0,37.1,,,0
CDM,50863,AMPICILLIN-SULBACTAM NEO/PEDS (CDS MIXTURE),28.0,19.6,,,0
CDM,50863,ANAGRELIDE 0.5 MG ORAL CAP,110.0,77.0,,,0
CDM,50863,ANAKINRA 100 MG/0.67 ML SUBQ SYRG,562.0,393.4,,,0
CDM,50863,ANASTROZOLE 1 MG ORAL TAB,39.0,27.3,,,0
CDM,50863,ANIFROLUMAB-FNIA 300 MG/2 ML (150 MG/ML) IV SOLN,12698.0,8888.6,,,0
CDM,50863,ANTI-INHIBITOR COAGULANT CMPLX (PHS MERGE),3803.0,2662.1,,,0
CDM,50863,"ANTI-INHIBITOR COAGULANT CMPLX 1,750-3,250 UNIT IV SOLR",11055.5,7738.85,,,0
CDM,50863,ANTI-INHIBITOR COAGULANT CMPLX 350-650 UNIT IV SOLR,873.5,611.4499999999999,,,0
CDM,50863,ANTI-THYMOCYTE GLOB (RABBIT) 25 MG IV SOLR,9099.0,6369.3,,,0
CDM,50863,"ANTIHEMOPHILIC FACTOR-VWF 1,000-2,400 UNIT IV KIT",2818.0,1972.6,,,0
CDM,50863,ANTIVENIN CROTALIDAE (EQUINE) INJ SOLR,21860.0,15302.0,,,0
CDM,50863,ANTIVENIN LATRODECTUS MACTANS INJ CMPK,163.0,114.1,,,0
CDM,50863,APIXABAN 2.5 MG ORAL TAB,117.0,81.9,,,0
CDM,50863,APIXABAN 5 MG ORAL TAB,273.5,191.45,,,0
CDM,50863,APREPITANT  40 MG ORAL CAP,594.0,415.79999999999995,,,0
CDM,50863,APREPITANT  80 MG ORAL CAP,550.5,385.34999999999997,,,0
CDM,50863,APREPITANT 125 MG ORAL CAP,940.0,658.0,,,0
CDM,50863,ARGATROBAN 100 MG/ML IV SOLN,962.0,673.4,,,0
CDM,50863,ARGININE HCL (L-ARGININE) 10 % IV SOLP,214.0,149.8,,,0
CDM,50863,ARIPIPRAZOLE  2 MG ORAL TAB,76.0,53.2,,,0
CDM,50863,ARIPIPRAZOLE  5 MG ORAL TAB,152.0,106.4,,,0
CDM,50863,ARIPIPRAZOLE 10 MG ORAL TAB,152.0,106.4,,,0
CDM,50863,ARIPIPRAZOLE 15 MG ORAL TAB,79.0,55.3,,,0
CDM,50863,ARIPIPRAZOLE LAUROXIL 662 MG/2.4 ML IM SERS,6592.0,4614.4,,,0
CDM,50863,ARIPIPRAZOLE LAUROXIL 882 MG/3.2 ML IM SERS,7575.0,5302.5,,,0
CDM,50863,ARSENIC TRIOXIDE 10 MG/10 ML IV SOLN,432.5,302.75,,,0
CDM,50863,ARTIFICIAL TEAR(DXTRN-HPM-GLY) 0.1-0.3-0.2 % OPHT DROP,44.0,30.8,,,0
CDM,50863,ARTIFICIAL TEARS(HYPROMELLOSE) 0.3 % OPHT GEL,53.0,37.1,,,0
CDM,50863,ASCORBIC ACID  250 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,ASCORBIC ACID  500 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,ASCORBIC ACID 500 MG/ML INJ SOLN,29.5,20.65,,,0
CDM,50863,ASPIRIN   81 MG ORAL TBEC,4.0,2.8,,,0
CDM,50863,ASPIRIN  300 MG RECT SUPP,13.0,9.1,,,0
CDM,50863,ASPIRIN  325 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,ASPIRIN  325 MG ORAL TBEC,5.0,3.5,,,0
CDM,50863,ASPIRIN 81 MG ORAL CHEW,5.0,3.5,,,0
CDM,50863,ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TAB,6.0,4.2,,,0
CDM,50863,ATENOLOL  25 MG ORAL TAB,8.0,5.6,,,0
CDM,50863,ATENOLOL  50 MG ORAL TAB,10.0,7.0,,,0
CDM,50863,ATENOLOL 100 MG ORAL TAB,44.0,30.799999999999997,,,0
CDM,50863,ATENOLOL 2MG/ML SUSP (REPACK),7.0,4.9,,,0
CDM,50863,"ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) IV SOLN",23792.0,16654.4,,,0
CDM,50863,ATOMOXETINE  10 MG ORAL CAP,209.0,146.3,,,0
CDM,50863,ATOMOXETINE  40 MG ORAL CAP,76.0,53.2,,,0
CDM,50863,ATORVASTATIN 10 MG ORAL TAB,11.0,7.7,,,0
CDM,50863,ATORVASTATIN 20 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,ATORVASTATIN 40 MG ORAL TAB,7.5,5.25,,,0
CDM,50863,ATORVASTATIN 80 MG ORAL TAB,11.0,7.7,,,0
CDM,50863,ATOVAQUONE 750 MG/5 ML ORAL SUSP,302.0,211.4,,,0
CDM,50863,ATRACURIUM 10 MG/ML IV SOLN,38.0,26.6,,,0
CDM,50863,ATROPINE 0.1 MG/ML INJ SYRG,64.0,44.8,,,0
CDM,50863,ATROPINE 0.4 MG/ML INJ SOLN,42.0,29.4,,,0
CDM,50863,ATROPINE 1 % OPHT DROP,235.0,164.5,,,0
CDM,50863,ATROPINE 1 MG/ML IV SOLN,50.0,35.0,,,0
CDM,50863,AXATILIMAB-CSFR 50 MG/ML IV SOLN,25286.0,17700.2,,,0
CDM,50863,AZACITIDINE 100 MG INJ SOLR,467.0,326.9,,,0
CDM,50863,AZATHIOPRINE  50 MG ORAL TAB,10.0,7.0,,,0
CDM,50863,AZITHROMYCIN 200 MG/5 ML ORAL SUSR,39.5,27.65,,,0
CDM,50863,AZITHROMYCIN 250 MG ORAL TAB,43.0,30.1,,,0
CDM,50863,AZITHROMYCIN 500 MG IV SOLR,32.0,22.4,,,0
CDM,50863,AZITHROMYCIN 500 MG ORAL TAB,54.0,37.8,,,0
CDM,50863,AZITHROMYCIN 600 MG ORAL TAB,183.0,128.1,,,0
CDM,50863,AZITHROMYCIN NEO/PEDS IV SYRINGE (CDS MIXTURE),36.0,25.2,,,0
CDM,50863,AZTREONAM 1 GRAM INJ SOLR,150.0,105.0,,,0
CDM,50863,AZTREONAM 2 GRAM INJ SOLR,262.0,183.4,,,0
CDM,50863,AZTREONAM 20 MG/ML IV SYRINGE (FOR NEO/PEDS),18.0,12.6,,,0
CDM,50863,B COMPLEX-VITAMIN C-FOLIC ACID 100-1 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,BACITRACIN 500 UNIT/G TOP OINT (MERGE),33.0,23.1,,,0
CDM,50863,BACITRACIN 500 UNIT/G TOP PACK,7.0,4.9,,,0
CDM,50863,BACITRACIN 500 UNITS/1 GRAM PACKET (MERGE RECORD),7.5,5.25,,,0
CDM,50863,BACITRACIN ZINC 500 UNIT/G TOP PACK,7.0,4.9,,,0
CDM,50863,"BACITRACIN ZINC-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM OINTMENT",37.0,25.9,,,0
CDM,50863,"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/G EYE OINTMENT",134.5,94.15,,,0
CDM,50863,BACLOFEN 10 MG ORAL TAB,10.5,7.35,,,0
CDM,50863,BACLOFEN 20 MG ORAL TAB,8.0,5.6,,,0
CDM,50863,BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSP,64.5,45.15,,,0
CDM,50863,BACTERIOSTATIC SALINE 0.9 % INJ SOLN,16.0,11.2,,,0
CDM,50863,BALANCED SALT IRRIG SOLN COMB2 INTRAOCULAR,75.0,52.5,,,0
CDM,50863,BALANCED SALT SOLN NON-SURG #3 EYE,118.0,82.6,,,0
CDM,50863,BALSALAZIDE 750 MG ORAL CAP,27.0,18.9,,,0
CDM,50863,BARICITINIB 2 MG ORAL TAB (COVID ONLY),790.0,553.0,,,0
CDM,50863,BASILIXIMAB 20 MG IV SOLR,12584.0,8808.8,,,0
CDM,50863,BECLOMETHASONE DIPROPIONATE 40 MCG/ACTUATION INHL HFAB,14.0,9.8,,,0
CDM,50863,BECLOMETHASONE DIPROPIONATE 80 MCG/ACTUATION INHL HFAB,33.0,23.1,,,0
CDM,50863,BELATACEPT 250 MG IV SOLR,3292.0,2304.3999999999996,,,0
CDM,50863,BELIMUMAB 120 MG IV SOLR,3699.5,2589.6499999999996,,,0
CDM,50863,BELIMUMAB 400 MG IV SOLR,8471.0,5929.7,,,0
CDM,50863,BELLADONNA ALKALOIDS-OPIUM 16.2 MG-30 MG RECTAL SUPPOSITORY,135.0,94.5,,,0
CDM,50863,BENAZEPRIL  5 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,BENAZEPRIL 10 MG ORAL TAB,12.0,8.4,,,0
CDM,50863,BENAZEPRIL 20 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,BENDAMUSTINE 25 MG/ML IV SOLN,11095.5,7766.85,,,0
CDM,50863,BENEFIX: FIX CONCENTRATE (MERGE RECORD),38704.0,27092.8,,,0
CDM,50863,BENRALIZUMAB 30 MG/ML SUBQ ATIN,14769.0,10338.3,,,0
CDM,50863,BENRALIZUMAB 30 MG/ML SUBQ SYRG,13116.0,9181.2,,,0
CDM,50863,BENZOCAINE 20 % MM SPRY,126.0,88.2,,,0
CDM,50863,BENZOCAINE-MENTHOL 15-2.6 MG MM LOZG,6.0,4.2,,,0
CDM,50863,BENZOCAINE-MENTHOL 15-3.6 MG MM LOZG,10.0,7.0,,,0
CDM,50863,BENZOCAINE-MENTHOL 20 %-0.5 % TOPICAL AEROSOL,44.5,31.15,,,0
CDM,50863,BENZOCAINE-MENTHOL 20-0.26 % MM GEL,20.0,14.0,,,0
CDM,50863,BENZOCAINE-MENTHOL 6-10 MG MM LOZG,10.5,7.35,,,0
CDM,50863,BENZONATATE 100 MG ORAL CAP,40.0,28.0,,,0
CDM,50863,BENZOYL PEROXIDE  5 % TOP GEL,32.0,22.4,,,0
CDM,50863,BENZTROPINE 0.5 MG ORAL TAB,5.5,3.85,,,0
CDM,50863,BENZTROPINE 1 MG ORAL TAB,5.5,3.85,,,0
CDM,50863,BENZTROPINE 1 MG/ML INJ SOLN,177.0,123.9,,,0
CDM,50863,BENZTROPINE 2 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,BETAMETHASONE ACET & SOD PHOS 6 MG/ML INJ SUSP,100.0,70.0,,,0
CDM,50863,BETAMETHASONE DIPROPIONATE 0.05 % TOP LOTN,235.0,164.5,,,0
CDM,50863,BETAMETHASONE DIPROPIONATE 0.05 % TOP OINT,261.0,182.7,,,0
CDM,50863,"BETAMETHASONE, AUGMENTED 0.05 % TOP CREA",106.0,74.19999999999999,,,0
CDM,50863,"BETAMETHASONE, AUGMENTED 0.05 % TOP OINT",270.0,189.0,,,0
CDM,50863,BETHANECHOL CHLORIDE 10 MG ORAL TAB,23.0,16.1,,,0
CDM,50863,BETHANECHOL CHLORIDE 25 MG ORAL TAB,15.0,10.5,,,0
CDM,50863,BEVACIZUMAB 25 MG/ML IV SOLN,12041.0,8428.7,,,0
CDM,50863,BEVACIZUMAB-AWWB 25 MG/ML IV SOLN,5778.0,4044.6,,,0
CDM,50863,BEVACIZUMAB-BVZR 25 MG/ML IV SOLN,5079.0,3555.3,,,0
CDM,50863,BEVACIZUMAB-MALY 25 MG/ML IV SOLN,5951.0,4165.7,,,0
CDM,50863,BEZLOTOXUMAB 25 MG/ML IV SOLN,7342.0,5139.4,,,0
CDM,50863,BICALUTAMIDE 50 MG ORAL TAB,90.5,63.35,,,0
CDM,50863,"BICARB DIAL SOLN13-NO CA,K,DEX MG 1.2 MEQ/L HEMO SOLN",412.0,288.4,,,0
CDM,50863,BICARB FOR OR,95.5,66.85,,,0
CDM,50863,BICARBONATE DIALYSIS SOLN NO.9 K (4 MEQ/L)-CA (2.5)-MG (1.5) HEMO SOLN,172.0,120.4,,,0
CDM,50863,BICTEGRAV-EMTRICIT-TENOFOV ALA 50-200-25 MG ORAL TAB,591.0,413.70000000000005,,,0
CDM,50863,BIFIDO ANIM-B.INF-S.THERMOPHL 1 BILLION CELL ORAL PWPK,7.0,4.9,,,0
CDM,50863,BIMATOPROST 0.01 % OPHT DROP,935.0,654.5,,,0
CDM,50863,BISACODYL  5 MG ORAL TBEC,7.0,4.9,,,0
CDM,50863,BISACODYL 10 MG RECT SUPP,8.0,5.6,,,0
CDM,50863,BISMUTH SUBSALICYLATE 262 MG ORAL CHEW,62.0,43.400000000000006,,,0
CDM,50863,BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSP,7.0,4.9,,,0
CDM,50863,BISOPROLOL FUMARATE  5 MG ORAL TAB,13.0,9.1,,,0
CDM,50863,BIVALIRUDIN 250 MG IV SOLR,713.0,499.1,,,0
CDM,50863,BIVALIRUDIN 250 MG/50 ML (5 MG/ML) IV SOLN,303.5,212.45,,,0
CDM,50863,BLEOMYCIN 15 UNITS/5 ML INJ SOLR (WET SOLR VIAL),461.0,322.7,,,0
CDM,50863,BLEOMYCIN 30 UNIT INJ SOLR,284.0,198.8,,,0
CDM,50863,BLEOMYCIN 30 UNITS/10 ML INJ SOLR (WET SOLR VIAL),389.0,272.3,,,0
CDM,50863,BLINATUMOMAB 12.5 MCG/ML IV SOLR,11056.0,7739.2,,,0
CDM,50863,BLINATUMOMAB 35 MCG IV KIT,9203.0,6442.1,,,0
CDM,50863,BORTEZOMIB 3.5 MG IV SOLR,229.0,160.3,,,0
CDM,50863,BOSENTAN 62.5 MG ORAL TAB,413.0,289.1,,,0
CDM,50863,BOTULINUM TOXIN TYPE A 100 UNIT IM SOLR,1439.0,1007.3,,,0
CDM,50863,BRENTUXIMAB VEDOTIN 50 MG IV SOLR,32957.0,23069.899999999998,,,0
CDM,50863,BRIMONIDINE 0.2 % OPHT DROP,89.0,62.3,,,0
CDM,50863,BRIVARACETAM 10 MG/ML ORAL SOLN,373.5,261.45000000000005,,,0
CDM,50863,BROMOCRIPTINE 2.5 MG ORAL TAB,34.5,24.150000000000002,,,0
CDM,50863,BUDESONIDE 0.25 MG/2 ML INHL NBSP,93.0,65.1,,,0
CDM,50863,BUDESONIDE 0.5 MG/2 ML INHL NBSP,82.0,57.4,,,0
CDM,50863,BUDESONIDE 1 MG/2 ML INHL NBSP,86.0,60.199999999999996,,,0
CDM,50863,BUDESONIDE 180 MCG/INHALATION INHL AEPB,937.0,655.9,,,0
CDM,50863,BUDESONIDE 3 MG ORAL CP24,77.5,54.25,,,0
CDM,50863,BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION,28.5,19.95,,,0
CDM,50863,BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION,28.0,19.6,,,0
CDM,50863,BUMETANIDE 0.25 MG/ML INJ SOLN,66.0,46.2,,,0
CDM,50863,BUMETANIDE 0.5 MG ORAL TAB,21.5,15.05,,,0
CDM,50863,BUMETANIDE 1 MG ORAL TAB,27.5,19.25,,,0
CDM,50863,BUMETANIDE 2 MG ORAL TAB,20.5,14.350000000000001,,,0
CDM,50863,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN,40.0,28.0,,,0
CDM,50863,BUPIVACAINE (PF) 0.25 % (LEFT) (PHS CUSTOM PAIN BALL),62.5,43.75,,,0
CDM,50863,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN,36.0,25.2,,,0
CDM,50863,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN,27.0,18.9,,,0
CDM,50863,BUPIVACAINE 0.25 % (2.5 MG/ML) INJ SOLN,34.5,24.15,,,0
CDM,50863,BUPIVACAINE 0.25%/EPINEPHRINE 1:100K INJECTION,48.0,33.6,,,0
CDM,50863,BUPIVACAINE 0.5 % (5 MG/ML) INJ SOLN,35.0,24.5,,,0
CDM,50863,BUPIVACAINE 0.5% W/EPINEPHRINE 1:200K INJECTION,56.0,39.2,,,0
CDM,50863,BUPIVACAINE 0.5%/EPINEPHRINE 1:300K INJECTION,34.0,23.8,,,0
CDM,50863,BUPIVACAINE LIPOSOME (PF) 266 MG/20 ML (13.3 MG/ML) LINF SUSP,1116.0,781.2,,,0
CDM,50863,BUPIVACAINE-DEXTROSE-WATER(PF) 7.5 MG/ML (0.75 %) INJ SOLN,29.0,20.3,,,0
CDM,50863,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN",98.0,68.6,,,0
CDM,50863,"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN",56.0,39.2,,,0
CDM,50863,"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJ SOLN",58.5,40.95,,,0
CDM,50863,"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN",82.5,57.75,,,0
CDM,50863,BUPRENORPHINE 0.5 MG SL (1/4 TAB) SUBL,10.0,7.0,,,0
CDM,50863,BUPRENORPHINE 100 MG/0.5 ML SUBQ SLSY,3368.5,2357.95,,,0
CDM,50863,BUPRENORPHINE 128 MG/0.36 ML SUBQ SLSY,4047.0,2832.9,,,0
CDM,50863,BUPRENORPHINE 2 MG SL SUBL,26.0,18.2,,,0
CDM,50863,BUPRENORPHINE 8 MG SL SUBL,43.0,30.1,,,0
CDM,50863,BUPRENORPHINE HCL 0.3 MG/ML INJ (MERGE),85.0,59.5,,,0
CDM,50863,BUPRENORPHINE-NALOXONE 2-0.5 MG SL SUBL,41.0,28.7,,,0
CDM,50863,BUPRENORPHINE-NALOXONE 8-2 MG SL SUBL,52.0,36.4,,,0
CDM,50863,BUPROPION HCL  75 MG ORAL TAB,9.0,6.3,,,0
CDM,50863,BUPROPION HCL 100 MG ORAL TAB,15.0,10.5,,,0
CDM,50863,BUPROPION HCL 100 MG ORAL TBSR,19.0,13.3,,,0
CDM,50863,BUPROPION HCL 150 MG ORAL TB24,28.0,19.6,,,0
CDM,50863,BUPROPION HCL 150 MG ORAL TBSR,11.0,7.7,,,0
CDM,50863,BUPROPION HCL 300 MG ORAL TB24,20.5,14.350000000000001,,,0
CDM,50863,BUSPIRONE  5 MG ORAL TAB,13.0,9.1,,,0
CDM,50863,BUSPIRONE 10 MG ORAL TAB,12.0,8.4,,,0
CDM,50863,BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TAB,13.0,9.1,,,0
CDM,50863,CABAZITAXEL 10 MG/ML (FINAL) IV SOLN,33467.0,23426.9,,,0
CDM,50863,CABERGOLINE 0.5 MG ORAL TAB,180.0,126.0,,,0
CDM,50863,CABOTEGRAVIR 600 MG/3 ML (200 MG/ML) IM SPER,11110.0,7777.0,,,0
CDM,50863,CAFFEINE 200 MG ORAL TAB,14.5,10.15,,,0
CDM,50863,CAFFEINE CITRATE 20 MG/ML ORAL SOLN,49.0,34.3,,,0
CDM,50863,CAFFEINE CITRATE PEDS/NEO IV SYR (CDS MIX) LD,31.5,22.049999999999997,,,0
CDM,50863,CAFFEINE CITRATED 20 MG/ML IV SOLN,17.0,11.9,,,0
CDM,50863,CAFFEINE-SODIUM BENZOATE 250 MG/ML INJ SOLN,207.5,145.25,,,0
CDM,50863,CALAMINE-ZINC OXIDE 8 %-8 % TOPICAL SUSP,13.5,9.45,,,0
CDM,50863,CALASPARGASE PEGOL-MKNL 750 UNITS/ML IV SOLN,75551.0,52885.7,,,0
CDM,50863,CALCITONIN (SALMON) 200 UNIT/ACTUATION NASL SPRA,427.0,298.9,,,0
CDM,50863,CALCITONIN (SALMON) 200 UNIT/ML INJ SOLN,3198.5,2238.95,,,0
CDM,50863,CALCITRIOL 0.25 MCG ORAL CAP,10.5,7.35,,,0
CDM,50863,CALCITRIOL 0.5 MCG ORAL CAP,33.0,23.1,,,0
CDM,50863,CALCITRIOL 1 MCG/ML IV SOLN,52.0,36.4,,,0
CDM,50863,CALCITRIOL 1 MCG/ML ORAL SOLN,47.0,32.9,,,0
CDM,50863,CALCIUM ACETATE 667 MG ORAL CAP,20.0,14.0,,,0
CDM,50863,CALCIUM CARBONATE 1250 MG/5 ML SUSPENSION (500 MG/5 ML ELEMENTAL),18.0,12.6,,,0
CDM,50863,"CALCIUM CARBONATE 500 MG (1,250 MG) ORAL TAB",7.0,4.9,,,0
CDM,50863,CALCIUM CARBONATE 500 MG (200 MG ELEMENTAL) CHEW TAB,15.0,10.5,,,0
CDM,50863,CALCIUM CARBONATE-VITAMIN D3 250 MG-125 UNIT TAB,5.5,3.85,,,0
CDM,50863,"CALCIUM CARBONATE-VITAMIN D3 500 MG(1,250MG) -200 UNIT ORAL TAB",7.0,4.9,,,0
CDM,50863,CALCIUM CHLORIDE (FOR CODE) 10% (100 MG/ML) IV SYRINGE,68.5,47.95,,,0
CDM,50863,CALCIUM CHLORIDE (FOR CODE) 10% IV SOLN,238.0,166.6,,,0
CDM,50863,CALCIUM CITRATE-VITAMIN D3 200 MG CALCIUM -250 UNIT ORAL TAB,7.0,4.9,,,0
CDM,50863,"CALCIUM GLUC IN NACL, ISO-OSM 1 G/100 ML IV SOLN",112.0,78.4,,,0
CDM,50863,"CALCIUM GLUC IN NACL, ISO-OSM 1 GRAM/50 ML IV SOLN",464.0,324.8,,,0
CDM,50863,CALCIUM GLUCONATE (FOR EMERGENCY) 100 MG/ML (10%) IV SOLN,177.0,123.9,,,0
CDM,50863,CALCIUM GLUCONATE 20MG/ML IV SYRINGE (PEDS/NEO),40.5,28.35,,,0
CDM,50863,CALCIUM GLUCONATE IN 0.9% NACL 3 GRAM/100 ML IV SOLN,170.0,119.0,,,0
CDM,50863,CAMPHOR 9% -MENTHOL 1.3% -BORIC ACID OINTMENT (PHS),10.0,7.0,,,0
CDM,50863,CANAKINUMAB (PF) 150 MG/ML SUBQ SOLN,55390.5,38773.350000000006,,,0
CDM,50863,CANDESARTAN  8 MG ORAL TAB,17.0,11.9,,,0
CDM,50863,CANDESARTAN 16 MG ORAL TAB,17.0,11.9,,,0
CDM,50863,CANGRELOR 50 MG IV SOLR,4016.5,2811.55,,,0
CDM,50863,CAPECITABINE 500 MG ORAL TAB,74.0,51.8,,,0
CDM,50863,CAPSAICIN 0.025 % TOP CREA,56.0,39.2,,,0
CDM,50863,CAPTOPRIL  12.5 MG ORAL TAB,14.5,10.15,,,0
CDM,50863,CAPTOPRIL  25 MG ORAL TAB,10.0,7.0,,,0
CDM,50863,CAPTOPRIL  50 MG ORAL TAB,17.0,11.9,,,0
CDM,50863,CAPTOPRIL 1 MG/ML SOLUTION (REPACK),7.0,4.9,,,0
CDM,50863,CARBAMAZEPINE 100 MG ORAL CHEW,12.0,8.4,,,0
CDM,50863,CARBAMAZEPINE 100 MG ORAL TB12,13.0,9.1,,,0
CDM,50863,CARBAMAZEPINE 100 MG/5 ML ORAL SUSP,16.0,11.2,,,0
CDM,50863,CARBAMAZEPINE 200 MG ORAL CM12,16.5,11.55,,,0
CDM,50863,CARBAMAZEPINE 200 MG ORAL TAB,12.0,8.4,,,0
CDM,50863,CARBAMAZEPINE 200 MG ORAL TB12,34.5,24.15,,,0
CDM,50863,CARBAMAZEPINE 300 MG ORAL CM12,11.0,7.7,,,0
CDM,50863,CARBAMIDE PEROXIDE 6.5 % OTIC DROP,31.0,21.7,,,0
CDM,50863,CARBIDOPA 25 MG ORAL TAB,20.0,14.0,,,0
CDM,50863,CARBIDOPA-LEVODOPA 10 MG-100 MG TAB,8.0,5.6,,,0
CDM,50863,CARBIDOPA-LEVODOPA 25 MG-100 MG TAB,9.5,6.65,,,0
CDM,50863,CARBIDOPA-LEVODOPA 25 MG-250 MG TAB,10.0,7.0,,,0
CDM,50863,CARBIDOPA-LEVODOPA SR 25 MG-100 MG TAB,10.0,7.0,,,0
CDM,50863,CARBIDOPA-LEVODOPA SR 50 MG-200 MG TAB,11.0,7.7,,,0
CDM,50863,CARBOPLATIN 10 MG/ML IV,279.0,195.3,,,0
CDM,50863,CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN,457.0,319.9,,,0
CDM,50863,CARBOXYMETHYLCELLULOSE SODIUM 1 % OPHT DLGL,51.0,35.7,,,0
CDM,50863,CARBOXYMETHYLCELLULOSE SODIUM 1 % OPHT DPGE,7.0,4.9,,,0
CDM,50863,"CARDIOPLEGIC SOLUTION NO.16 26 MEQ/1,052.8 ML (POTASSIUM) PERF SOLN",535.0,374.5,,,0
CDM,50863,CARDIOPLEGIC SOLUTION NO.25 29 MMOL/L (POTASSIUM) PERF SOLN,1260.0,882.0,,,0
CDM,50863,CARISOPRODOL 350 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,CARVEDILOL  3.125 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,CARVEDILOL  6.25 MG ORAL TAB,23.0,16.1,,,0
CDM,50863,CARVEDILOL 12.5 MG ORAL TAB,15.0,10.5,,,0
CDM,50863,CARVEDILOL 25 MG ORAL TAB,9.5,6.65,,,0
CDM,50863,CARVEDILOL PHOSPHATE 10 MG ORAL CM24,102.0,71.4,,,0
CDM,50863,CEFAZOLIN   1 GRAM INJ SOLR,39.0,27.3,,,0
CDM,50863,CEFAZOLIN   2 G INJ SOLR,41.0,28.7,,,0
CDM,50863,CEFAZOLIN   2 G IV SOLR,39.0,27.3,,,0
CDM,50863,CEFAZOLIN  10 GRAM INJ SOLR,18.5,12.95,,,0
CDM,50863,CEFAZOLIN 1000 MG IN NS 1000 ML IRRIGATION (REPACK),57.5,40.25,,,0
CDM,50863,CEFAZOLIN 1000 MG IN NS 500 ML IRRIGATION (REPACK),69.0,48.300000000000004,,,0
CDM,50863,CEFAZOLIN 5 MG/ML AND HEPARIN 5000 UNITS/ML CATHETER LOCK FOR INTERCATHETER DWELL (USE PANEL),156.0,109.2,,,0
CDM,50863,CEFAZOLIN IN DEXTROSE (ISO-OS) 2 GRAM/100 ML IV PGBK,55.0,38.5,,,0
CDM,50863,CEFAZOLIN IN DEXTROSE (ISO-OS) 2 GRAM/50 ML IV PGBK,87.0,60.9,,,0
CDM,50863,CEFAZOLIN IN DEXTROSE (ISO-OS) 3 GRAM/150 ML IV PGBK,35.0,24.5,,,0
CDM,50863,CEFAZOLIN IN DEXTROSE (ISO-OSMOTIC) 1 GRAM/50 ML IV PIGGY BACK,48.5,33.95,,,0
CDM,50863,CEFAZOLIN IN STERILE WATER 2 GRAM/20 ML IV SYRG,261.0,182.7,,,0
CDM,50863,CEFAZOLIN PEDS SYRINGE (20MG/ML) IN DEXTROSE (CDS MIX,76.5,53.55,,,0
CDM,50863,CEFAZOLIN SODIUM-STERILE WATER 1 GRAM/10 ML IV SYRG,54.0,37.8,,,0
CDM,50863,CEFDINIR 250 MG/5 ML ORAL SUSR,32.0,22.4,,,0
CDM,50863,CEFDINIR 300 MG ORAL CAP,47.5,33.25,,,0
CDM,50863,CEFEPIME 1 GRAM INJ SOLR,69.0,48.3,,,0
CDM,50863,CEFEPIME 2 GRAM INJ SOLR,198.0,138.6,,,0
CDM,50863,CEFEPIME 40 MG/ML IV SYRINGE (CDS MIXTURE),54.5,38.15,,,0
CDM,50863,CEFIDEROCOL 1 G IV SOLR,1649.0,1154.3,,,0
CDM,50863,CEFIXIME 100 MG/5 ML ORAL SUSR,98.0,68.6,,,0
CDM,50863,CEFPODOXIME 200 MG ORAL TAB,47.0,32.9,,,0
CDM,50863,CEFTAROLINE FOSAMIL 400 MG IV SOLR,890.5,623.3499999999999,,,0
CDM,50863,CEFTAROLINE FOSAMIL 600 MG IV SOLR,290.0,203.0,,,0
CDM,50863,CEFTAZIDIME   1 GRAM INJ SOLR,43.0,30.1,,,0
CDM,50863,CEFTAZIDIME NEO IV SYRINGE (CDS MIXTURE),20.5,14.35,,,0
CDM,50863,CEFTAZIDIME-AVIBACTAM 2.5 GRAM (2 GRAM-0.5 GRAM) IV SOLR,527.0,368.9,,,0
CDM,50863,CEFTOLOZANE-TAZOBACTAM 1.5 G IV SOLR,891.5,624.05,,,0
CDM,50863,CEFTRIAXONE   1 GRAM IV SOLR,42.0,29.4,,,0
CDM,50863,CEFTRIAXONE   2 GRAM INJ SOLR,70.0,49.0,,,0
CDM,50863,CEFTRIAXONE   2 GRAM IV SOLR,54.0,37.8,,,0
CDM,50863,CEFTRIAXONE 1 GRAM INJ SOLR,125.0,87.5,,,0
CDM,50863,CEFTRIAXONE 100 MG/ML FROM 1 GRAM VIAL (PRMC PEDS ONLY),82.0,57.4,,,0
CDM,50863,CEFTRIAXONE 250 MG INJ SOLR,146.0,102.2,,,0
CDM,50863,CEFTRIAXONE 500 MG INJ SOLR,23.0,16.1,,,0
CDM,50863,CEFTRIAXONE IN DEXTROSE (ISO-OSMOTIC) 1 GRAM/50 ML IV PIGGY BACK,116.0,81.2,,,0
CDM,50863,CEFTRIAXONE NEO/PEDS (CDS MIXTURE),96.0,67.2,,,0
CDM,50863,CEFUROXIME AXETIL 250 MG ORAL TAB,47.5,33.25,,,0
CDM,50863,CEFUROXIME AXETIL 500 MG ORAL TAB,50.0,35.0,,,0
CDM,50863,CELECOXIB 100 MG ORAL CAP,37.5,26.25,,,0
CDM,50863,CELECOXIB 200 MG ORAL CAP,34.5,24.15,,,0
CDM,50863,CELECOXIB 400 MG ORAL CAP,56.0,39.2,,,0
CDM,50863,CEMIPLIMAB-RWLC 50 MG/ML IV SOLN,25491.0,17843.7,,,0
CDM,50863,CENOBAMATE  50 MG ORAL TAB,238.0,166.6,,,0
CDM,50863,CENOBAMATE 200 MG ORAL TAB,238.0,166.6,,,0
CDM,50863,CEPHALEXIN 250 MG ORAL CAP,8.5,5.949999999999999,,,0
CDM,50863,CEPHALEXIN 250 MG/5 ML ORAL SUSR,15.0,10.5,,,0
CDM,50863,CEPHALEXIN 250 MG/5 ML SUSPENSION KIT (REPACK),7.0,4.9,,,0
CDM,50863,CEPHALEXIN 500 MG ORAL CAP,56.0,39.2,,,0
CDM,50863,CERTOLIZUMAB PEGOL 400 MG (200 MG X 2) SUBQ KIT,3323.0,2326.1,,,0
CDM,50863,CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X 2) SUBQ SYKT,11839.0,8287.3,,,0
CDM,50863,CETIRIZINE  5 MG ORAL TAB,28.0,19.6,,,0
CDM,50863,CETIRIZINE 10 MG ORAL TAB,21.0,14.700000000000001,,,0
CDM,50863,CETIRIZINE 5 MG/5 ML ORAL SOLN,32.0,22.4,,,0
CDM,50863,CETUXIMAB 100 MG/50 ML IV SOLN,20577.0,14403.9,,,0
CDM,50863,CETUXIMAB 200 MG/100 ML IV SOLN,1267.0,886.9,,,0
CDM,50863,CEVIMELINE 30 MG ORAL CAP,52.0,36.4,,,0
CDM,50863,CHERRY SYRUP,7.0,4.9,,,0
CDM,50863,CHLORDIAZEPOXIDE 10 MG CAP,30.0,21.0,,,0
CDM,50863,CHLORDIAZEPOXIDE 25 MG CAP,18.0,12.6,,,0
CDM,50863,CHLORHEXIDINE GLUCONATE  0.12 % MM MWSH,10.0,7.0,,,0
CDM,50863,CHLORHEXIDINE GLUCONATE  4 % TOP LIQD,21.0,14.7,,,0
CDM,50863,CHLOROPROCAINE 2 % INJ SOLN,109.0,76.3,,,0
CDM,50863,CHLOROPROCAINE 3 % INJ SOLN,26.0,18.2,,,0
CDM,50863,CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSP,9.0,6.3,,,0
CDM,50863,CHLOROTHIAZIDE SODIUM 28 MG/ML IV (PEDS) REPACK,38.0,26.6,,,0
CDM,50863,CHLOROTHIAZIDE SODIUM 500 MG IV SOLR,115.0,80.5,,,0
CDM,50863,CHLORPROMAZINE  10 MG ORAL TAB,76.0,53.2,,,0
CDM,50863,CHLORPROMAZINE  25 MG ORAL TAB,75.0,52.5,,,0
CDM,50863,CHLORPROMAZINE 100 MG ORAL TAB,128.0,89.6,,,0
CDM,50863,CHLORPROMAZINE 25 MG/ML INJ SOLN,272.0,190.4,,,0
CDM,50863,CHLORTHALIDONE  25 MG ORAL TAB,32.5,22.75,,,0
CDM,50863,CHLORZOXAZONE 500 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,CHOLECALCIFEROL (VITAMIN D3)   400 UNIT ORAL TAB,11.5,8.05,,,0
CDM,50863,CHOLECALCIFEROL (VITAMIN D3)  1000 UNIT ORAL TAB,5.5,3.85,,,0
CDM,50863,CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/ML ORAL DROP,17.5,12.25,,,0
CDM,50863,CHOLECALCIFEROL 400 UNIT/ML ORAL DROP (REPACK),20.0,14.0,,,0
CDM,50863,CHOLESTYRAMINE 4 G ORAL PWPK,29.0,20.3,,,0
CDM,50863,CHOLESTYRAMINE-ASPARTAME 4 GRAM ORAL PACK,19.0,13.3,,,0
CDM,50863,CHOLESTYRAMINE-SUCROSE 4 GRAM ORAL PACK,14.5,10.15,,,0
CDM,50863,CILOSTAZOL 100 MG ORAL TAB,11.0,7.7,,,0
CDM,50863,CINACALCET 30 MG ORAL TAB,261.5,183.05,,,0
CDM,50863,CIPROFLOXACIN 0.3 % OPHT DROP,123.0,86.1,,,0
CDM,50863,CIPROFLOXACIN 0.3 % OPHT OINT,963.0,674.1,,,0
CDM,50863,CIPROFLOXACIN 250 MG ORAL TAB,66.0,46.2,,,0
CDM,50863,CIPROFLOXACIN 500 MG ORAL TAB,17.0,11.9,,,0
CDM,50863,CIPROFLOXACIN 500 MG/5 ML ORAL SUMC,27.5,19.25,,,0
CDM,50863,CIPROFLOXACIN 750 MG ORAL TAB,235.0,164.5,,,0
CDM,50863,CIPROFLOXACIN IN D5W 200 MG/100 ML IV PGBK,22.0,15.4,,,0
CDM,50863,CIPROFLOXACIN IN D5W 400 MG/200 ML IV PGBK,117.0,81.9,,,0
CDM,50863,"CIPROFLOXACIN-DEXAMETHASONE 0.3 %-0.1 % EAR DROPS, SUSP",794.0,555.8,,,0
CDM,50863,"CIPROFLOXACIN-HYDROCORTISONE 0.2 %-1 % EAR DROPS, SUSP",1119.0,783.3,,,0
CDM,50863,CISATRACURIUM  2 MG/ML IV SOLN,154.0,107.80000000000001,,,0
CDM,50863,CISATRACURIUM 10 MG/ML IV SOLN,1966.0,1376.2,,,0
CDM,50863,CISATRACURIUM IN NS 400 MG/200 ML (2 MG/ML) IV SOLN,1503.0,1052.1,,,0
CDM,50863,CISPLATIN 1 MG/ML IV,128.5,89.95,,,0
CDM,50863,CITALOPRAM 10 MG ORAL TAB,28.0,19.6,,,0
CDM,50863,CITALOPRAM 20 MG ORAL TAB,19.0,13.3,,,0
CDM,50863,CITALOPRAM 40 MG ORAL TAB,13.0,9.1,,,0
CDM,50863,CLADRIBINE 1 MG/ML IV SOLN,1770.0,1239.0,,,0
CDM,50863,CLARITHROMYCIN 250 MG ORAL TAB,46.5,32.55,,,0
CDM,50863,CLARITHROMYCIN 250 MG/5 ML ORAL SUSR,107.0,74.9,,,0
CDM,50863,CLARITHROMYCIN 500 MG ORAL TAB,36.5,25.55,,,0
CDM,50863,CLEVIDIPINE 50 MG/100 ML IV EMUL,1120.5,784.3499999999999,,,0
CDM,50863,CLINDAMYCIN 1 % TOPICAL GEL,361.0,252.7,,,0
CDM,50863,CLINDAMYCIN 1 % TOPICAL SOLN,171.0,119.7,,,0
CDM,50863,CLINDAMYCIN 150 MG CAP,29.0,20.3,,,0
CDM,50863,CLINDAMYCIN 150 MG/ML INJECTION,32.0,22.4,,,0
CDM,50863,CLINDAMYCIN 300 MG CAP,11.5,8.05,,,0
CDM,50863,CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,41.5,29.049999999999997,,,0
CDM,50863,CLINDAMYCIN IN D5W 300 MG/50 ML IV PGBK,55.0,38.5,,,0
CDM,50863,CLINDAMYCIN IN D5W 600 MG/50 ML IV PGBK,94.0,65.8,,,0
CDM,50863,CLINDAMYCIN IN D5W 900 MG/50 ML IV PGBK,68.5,47.95,,,0
CDM,50863,CLINDAMYCIN PEDS IV INFUSION 12 MG/ML (CDS MIXTURE FROM PREMIX),53.0,37.1,,,0
CDM,50863,CLOBAZAM 10 MG ORAL TAB,26.5,18.55,,,0
CDM,50863,CLOBAZAM 2.5 MG/ML ORAL SUSP,130.5,91.35,,,0
CDM,50863,CLOMIPRAMINE 25 MG ORAL CAP,32.5,22.75,,,0
CDM,50863,CLOMIPRAMINE 50 MG ORAL CAP,82.5,57.75,,,0
CDM,50863,CLOMIPRAMINE 75 MG ORAL CAP,95.0,66.5,,,0
CDM,50863,CLONAZEPAM 0.1MG/ML SUSPENSION (REPACK),11.5,8.05,,,0
CDM,50863,CLONAZEPAM 0.5 MG ORAL TAB,8.0,5.6,,,0
CDM,50863,CLONAZEPAM 1 MG ORAL TAB,9.0,6.3,,,0
CDM,50863,CLONAZEPAM 1 MG ORAL TBDL,25.0,17.5,,,0
CDM,50863,CLONAZEPAM 2 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,CLONIDINE (PF) 1000 MCG/10 ML EPID SOLN,218.5,152.95,,,0
CDM,50863,CLONIDINE 0.1 MG ORAL TAB,8.0,5.6,,,0
CDM,50863,CLONIDINE 0.1 MG/24 HR TD PTWK,163.0,114.1,,,0
CDM,50863,CLONIDINE 0.1MG/ML ORAL SOLUTION (HIGH CONC FOR PEDS),7.0,4.9,,,0
CDM,50863,CLONIDINE 0.2 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,CLONIDINE 0.2 MG/24 HR TD PTWK,237.0,165.9,,,0
CDM,50863,CLONIDINE 0.3 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,CLONIDINE 0.3 MG/24 HR TD PTWK,329.0,230.3,,,0
CDM,50863,CLONIDINE 20 MCG/ML ORAL SYRUP (LOW CONC NEONATAL ONLY),7.0,4.9,,,0
CDM,50863,CLOPIDOGREL  75 MG ORAL TAB,55.0,38.5,,,0
CDM,50863,CLOPIDOGREL 300 MG ORAL TAB,95.0,66.5,,,0
CDM,50863,CLORAZEPATE DIPOTASSIUM  3.75 MG ORAL TAB,23.0,16.1,,,0
CDM,50863,CLOTRIMAZOLE  10 MG MM TROC,14.5,10.15,,,0
CDM,50863,CLOTRIMAZOLE 1 % TOP CREA,48.0,33.6,,,0
CDM,50863,CLOTRIMAZOLE 1 % VAGL CREA,31.0,21.7,,,0
CDM,50863,CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,184.0,128.8,,,0
CDM,50863,CLOZAPINE  25 MG ORAL TAB,26.5,18.55,,,0
CDM,50863,CLOZAPINE 100 MG ORAL TAB,48.0,33.6,,,0
CDM,50863,COCAINE  4 % TOP SOLN (MERGE),1041.0,728.7,,,0
CDM,50863,CODEINE-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD (REPACK),24.0,16.8,,,0
CDM,50863,COENZYME Q10  30 MG ORAL CAP,7.0,4.9,,,0
CDM,50863,COENZYME Q10 100 MG ORAL CAP,7.0,4.9,,,0
CDM,50863,COLCHICINE 0.6 MG ORAL TAB,49.5,34.65,,,0
CDM,50863,COLESEVELAM 625 MG ORAL TAB,23.0,16.1,,,0
CDM,50863,COLLAGENASE 250 UNIT/G TOP OINT,1071.0,749.7,,,0
CDM,50863,COMPOUNDING VEHICLE SYRUP NO23 ORAL SYRP,7.0,4.9,,,0
CDM,50863,CONJUGATED ESTROGENS  0.3 MG ORAL TAB,65.5,45.85,,,0
CDM,50863,CONJUGATED ESTROGENS  0.625 MG ORAL TAB,82.0,57.4,,,0
CDM,50863,CONJUGATED ESTROGENS 0.625 MG/G VAGL CREA,1272.0,890.4,,,0
CDM,50863,CONJUGATED ESTROGENS 25 MG INJ SOLR,1319.0,923.3,,,0
CDM,50863,COPPER 380 SQUARE MM IU IUD,858.0,600.6,,,0
CDM,50863,COSYNTROPIN 0.25 MG INJ SOLR,381.0,266.7,,,0
CDM,50863,COVID VACCINE 24-25 (12UP)(MOD)(PF) 50 MCG/0.5 ML IM SYRG,613.0,429.1,,,0
CDM,50863,COVID VACCINE 24-25 (12UP)(PFI)(PF) 30 MCG/0.3 ML IM SYRG,615.0,430.5,,,0
CDM,50863,COVID VACCINE 24-25 (5-11Y)(PFI)-PF 10 MCG/0.3 ML IM SUSP,392.0,274.4,,,0
CDM,50863,COVID VACCINE 24-25 (6M-11Y)(MOD)PF 25 MCG/0.25 ML IM SYRG,558.0,390.6,,,0
CDM,50863,COVID VACCINE 24-25 (6M-4Y)(PFI)-PF 3 MCG/0.3 ML IM SUSP,249.0,174.3,,,0
CDM,50863,CROMOLYN 4 % OPHT DROP,182.0,127.4,,,0
CDM,50863,CROTALIDAE POLYVAL IMMUNE FAB SOLUTION FOR INJECTION,26479.5,18535.65,,,0
CDM,50863,CRRT-HEPARIN 1000 UNITS/ML IN NS INTERMITTENT BOLUS,208.0,145.6,,,0
CDM,50863,CUPRIC CHLORIDE 0.4 MG/ML IV SOLN,154.0,107.8,,,0
CDM,50863,CYANOCOBALAMIN  100 MCG ORAL TAB,7.0,4.9,,,0
CDM,50863,CYANOCOBALAMIN 1000 MCG ORAL TAB,5.5,3.85,,,0
CDM,50863,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,46.0,32.2,,,0
CDM,50863,CYCLOBENZAPRINE  5 MG ORAL TAB,24.0,16.8,,,0
CDM,50863,CYCLOBENZAPRINE 10 MG ORAL TAB,12.0,8.4,,,0
CDM,50863,CYCLOPENTOLATE 1 % OPHT DROP,81.5,57.05,,,0
CDM,50863,CYCLOPENTOLATE-PHENYLEPHRINE 0.2 %-1 % EYE DROPS,212.5,148.75,,,0
CDM,50863,CYCLOPHOSPHAMIDE  25 MG ORAL CAP,50.0,35.0,,,0
CDM,50863,CYCLOPHOSPHAMIDE  50 MG ORAL CAP,477.5,334.25,,,0
CDM,50863,CYCLOPHOSPHAMIDE 2 GRAM IV SOLUTION,3548.5,2483.95,,,0
CDM,50863,CYCLOPHOSPHAMIDE 20 MG/ML IN NS,727.0,508.9,,,0
CDM,50863,CYCLOPHOSPHAMIDE 500 MG IV SOLR,1216.0,851.2,,,0
CDM,50863,CYCLOSPORINE  25 MG ORAL CAP,54.0,37.8,,,0
CDM,50863,CYCLOSPORINE 0.05 % OPHT DPET,60.0,42.0,,,0
CDM,50863,CYCLOSPORINE 100 MG ORAL CAP,107.0,74.9,,,0
CDM,50863,CYCLOSPORINE 250 MG/5 ML IV SOLN,356.0,249.2,,,0
CDM,50863,CYCLOSPORINE MODIFIED  25 MG ORAL CAP,35.0,24.5,,,0
CDM,50863,CYCLOSPORINE MODIFIED 100 MG ORAL CAP,48.0,33.6,,,0
CDM,50863,CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLN,25.0,17.5,,,0
CDM,50863,CYPROHEPTADINE 2 MG/5 ML ORAL SYRP,8.0,5.6,,,0
CDM,50863,CYPROHEPTADINE 4 MG ORAL TAB,13.0,9.100000000000001,,,0
CDM,50863,CYTARABINE 100 MG/ML INJ SOLN,239.0,167.3,,,0
CDM,50863,CYTOMEGALOVIRUS IMMUNE GLOB 50 MG/ML IV SOLN,2475.0,1732.5,,,0
CDM,50863,D5-0.9%NACL-POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,61.5,43.05,,,0
CDM,50863,D5-0.9%NACL-POTASSIUM CHLORIDE 20 MEQ/L IV SOLP (PED ONC),23.0,16.1,,,0
CDM,50863,D5-1/2 NS AND POTASSIUM CHLORIDE 10 MEQ/L IV,59.0,41.3,,,0
CDM,50863,D5-1/2 NS AND POTASSIUM CHLORIDE 20 MEQ/L IV (PEDS CHEMO),36.5,25.55,,,0
CDM,50863,D5-1/2 NS AND POTASSIUM CHLORIDE 30 MEQ/L IV,54.0,37.8,,,0
CDM,50863,D5-1/2 NS AND POTASSIUM CHLORIDE 40 MEQ/L IV,59.0,41.3,,,0
CDM,50863,D5-1/4 NS & POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,54.0,37.8,,,0
CDM,50863,D5-LR WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,59.0,41.3,,,0
CDM,50863,D5-NS WITH POTASSIUM CHLORIDE 40 MEQ/L IV SOLP,56.5,39.55,,,0
CDM,50863,D5W WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,38.0,26.599999999999998,,,0
CDM,50863,DABIGATRAN  150 MG ORAL CAP,22.0,15.4,,,0
CDM,50863,DABIGATRAN  75 MG ORAL CAP,33.0,23.1,,,0
CDM,50863,DACARBAZINE 200 MG IV SOLR,177.0,123.9,,,0
CDM,50863,DACTINOMYCIN 0.5 MG IV SOLR,2341.5,1639.05,,,0
CDM,50863,DALBAVANCIN 500 MG IV SOLN,9821.5,6875.049999999999,,,0
CDM,50863,DANTROLENE  25 MG ORAL CAP,17.0,11.9,,,0
CDM,50863,DAPAGLIFLOZIN PROPANEDIOL  5 MG ORAL TAB,109.0,76.3,,,0
CDM,50863,DAPAGLIFLOZIN PROPANEDIOL 10 MG ORAL TAB,84.0,58.8,,,0
CDM,50863,DAPSONE  25 MG ORAL TAB,28.0,19.6,,,0
CDM,50863,DAPSONE 100 MG ORAL TAB,16.0,11.2,,,0
CDM,50863,DAPTOMYCIN 500 MG IV SOLR,627.5,439.25,,,0
CDM,50863,DAPTOMYCIN IN 0.9 % SOD CHLOR 350 MG/50 ML IV PGBK,269.0,188.3,,,0
CDM,50863,DAPTOMYCIN IN 0.9 % SOD CHLOR 500 MG/50 ML IV PGBK,238.5,166.95,,,0
CDM,50863,"DARATUMUMAB-HYALURONIDASE-FIHJ 1,800 MG-30,000 UNIT/15 ML SUBQ SOLN",20905.0,14633.5,,,0
CDM,50863,DARBEPOETIN ALFA IN POLYSORBAT  10 MCG/0.4 ML INJ SYRG,788.0,551.6,,,0
CDM,50863,DARBEPOETIN ALFA IN POLYSORBAT  25 MCG/ML INJ SOLN,1254.0,877.8000000000001,,,0
CDM,50863,DARBEPOETIN ALFA IN POLYSORBAT  40 MCG/0.4 ML INJ SYRG,1644.0,1150.8000000000002,,,0
CDM,50863,DARBEPOETIN ALFA IN POLYSORBAT  60 MCG/0.3 ML INJ SYRG,1069.0,748.3,,,0
CDM,50863,DARBEPOETIN ALFA IN POLYSORBAT 100 MCG/0.5 ML INJ SYRG,2137.0,1495.9,,,0
CDM,50863,DARBEPOETIN ALFA IN POLYSORBAT 200 MCG/0.4 ML INJ SYRG,4273.0,2991.1,,,0
CDM,50863,DARBEPOETIN ALFA IN POLYSORBAT 25 MCG/0.42 ML INJ SYRG,836.0,585.2,,,0
CDM,50863,DARBEPOETIN ALFA IN POLYSORBAT 300 MCG/0.6 ML INJ SYRG,6409.0,4486.3,,,0
CDM,50863,DARBEPOETIN ALFA IN POLYSORBAT 500 MCG/ML INJ SYRG,10682.0,7477.4,,,0
CDM,50863,DARIFENACIN  7.5 MG ORAL TB24,82.0,57.4,,,0
CDM,50863,DARUNAVIR-COBI-EMTRI-TENOF ALA 800-150-200-10 MG ORAL TAB,6849.5,4794.65,,,0
CDM,50863,DASATINIB  20 MG ORAL TAB,1135.0,794.5,,,0
CDM,50863,DASATINIB  50 MG ORAL TAB,1816.5,1271.55,,,0
CDM,50863,DASATINIB 100 MG ORAL TAB,1679.0,1175.3,,,0
CDM,50863,DATOPOTAMAB DERUXTECAN-DLNK 100 MG IV SOLR,38209.5,26746.65,,,0
CDM,50863,DAUNORUBICIN 5 MG/ML IV INJ,1122.0,785.4,,,0
CDM,50863,DAY 1 NEO SOLUTION (D12.5W/AA 2%/HEPARIN 0.5 UNITS/ML),167.0,116.9,,,0
CDM,50863,DAY 1 NEO SOLUTION (D5W/AA 2%/HEPARIN 0.5 UNITS/ML),84.0,58.8,,,0
CDM,50863,DECITABINE 50 MG IV SOLR,1656.0,1159.2,,,0
CDM,50863,DEFEROXAMINE 2 GRAM INJ SOLR,242.0,169.4,,,0
CDM,50863,DEFEROXAMINE 500 MG INJ SOLR,152.0,106.4,,,0
CDM,50863,DEFIBROTIDE 80 MG/ML IV SOLN,2450.0,1715.0,,,0
CDM,50863,DEGARELIX 120 MG SUBQ SOLR,4207.0,2944.9,,,0
CDM,50863,DEMECLOCYCLINE 150 MG ORAL TAB,92.0,64.4,,,0
CDM,50863,DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBQ SOLN,9295.0,6506.5,,,0
CDM,50863,DENOSUMAB 60 MG/ML SUBQ SYRG,5053.5,3537.45,,,0
CDM,50863,DENOSUMAB-BBDZ 120 MG/1.7 ML (70 MG/ML) SUBQ SOLN,8855.0,6198.5,,,0
CDM,50863,DENOSUMAB-BBDZ 60 MG/ML SUBQ SYRG,4428.0,3099.6,,,0
CDM,50863,DESIPRAMINE  10 MG ORAL TAB,14.5,10.15,,,0
CDM,50863,DESIPRAMINE  25 MG ORAL TAB,39.5,27.65,,,0
CDM,50863,DESMOPRESSIN 0.1 MG ORAL TAB,30.0,21.0,,,0
CDM,50863,DESMOPRESSIN 0.2 MG ORAL TAB,46.0,32.2,,,0
CDM,50863,DESMOPRESSIN 10 MCG/SPRAY NASL SPRA,887.0,620.9,,,0
CDM,50863,DESMOPRESSIN 4 MCG/ML INJECTION SOLN,787.0,550.9000000000001,,,0
CDM,50863,DESONIDE 0.05 % TOP OINT,341.0,238.7,,,0
CDM,50863,DESVENLAFAXINE  50 MG ORAL TB24,59.0,41.3,,,0
CDM,50863,DEXAMETHASONE 0.1 % EYE DROPS,275.0,192.5,,,0
CDM,50863,DEXAMETHASONE 0.1 MG/ML IV SYRINGE (NEO/INFANT),27.5,19.25,,,0
CDM,50863,DEXAMETHASONE 0.4MG/ML ORAL SOLUTION (REPACK),31.0,21.7,,,0
CDM,50863,DEXAMETHASONE 0.5 MG ORAL TAB,3.0,2.1,,,0
CDM,50863,DEXAMETHASONE 0.5 MG/5 ML ORAL SOLN,17.0,11.899999999999999,,,0
CDM,50863,DEXAMETHASONE 1 MG ORAL TAB,7.5,5.25,,,0
CDM,50863,DEXAMETHASONE 10 MG/ML INJECTION,10.5,7.35,,,0
CDM,50863,DEXAMETHASONE 20MG/55 ML IVPB IN NS (ONCOLOGY),80.5,56.35,,,0
CDM,50863,DEXAMETHASONE 4 MG ORAL TAB,21.0,14.7,,,0
CDM,50863,DEXAMETHASONE 4 MG/ML INJECTION,33.0,23.1,,,0
CDM,50863,DEXAMETHASONE SODIUM PHOS (PF) 10MG/ML INJ SOLN,34.0,23.8,,,0
CDM,50863,DEXMEDETOMIDINE 100 MCG/ML IV SOLN,52.0,36.4,,,0
CDM,50863,DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) IV SOLN,87.0,60.9,,,0
CDM,50863,DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN,176.5,123.55,,,0
CDM,50863,DEXMEDETOMIDINE IN NS 20 MCG/5 ML (4 MCG/ML) IV POST OP SHIVERING,59.0,41.3,,,0
CDM,50863,DEXRAZOXANE 250 MG IV SOLR,913.0,639.1,,,0
CDM,50863,DEXRAZOXANE 500 MG IV SOLR,1411.0,987.7,,,0
CDM,50863,DEXTROMETHORPHAN POLY COMPLEX ER 30 MG/5 ML ORAL SU12,27.5,19.25,,,0
CDM,50863,DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML SYRUP,41.0,28.7,,,0
CDM,50863,DEXTROMETHORPHAN-GUAIFENESIN SR 30 MG-600 MG 12 HR TAB,19.0,13.3,,,0
CDM,50863,DEXTROSE 10% IN WATER (D10) IV SOLN,39.0,27.3,,,0
CDM,50863,DEXTROSE 10% IN WATER (NEO) 2 - 3.99 KG,50.0,35.0,,,0
CDM,50863,DEXTROSE 10%-1/2 NORMAL SALINE IV,55.0,38.5,,,0
CDM,50863,DEXTROSE 15% IN WATER,58.5,40.95,,,0
CDM,50863,DEXTROSE 2.5 %-1/2 NORMAL SALINE IV,30.5,21.35,,,0
CDM,50863,DEXTROSE 20% IN WATER (NEO) 500ML,69.0,48.3,,,0
CDM,50863,DEXTROSE 25% IN WATER (D25W) IV SYRINGE,110.0,77.0,,,0
CDM,50863,DEXTROSE 25% IN WATER (NEO),150.0,105.0,,,0
CDM,50863,DEXTROSE 30% IN WATER (NEO),85.5,59.849999999999994,,,0
CDM,50863,DEXTROSE 40 % ORAL GEL,433.5,303.45,,,0
CDM,50863,DEXTROSE 40 % ORAL GEL (NEONATAL/PEDIATRIC),22.0,15.4,,,0
CDM,50863,DEXTROSE 5% IN NORMAL SALINE IV,36.5,25.55,,,0
CDM,50863,DEXTROSE 5% IN WATER (D5W) IV,38.0,26.6,,,0
CDM,50863,DEXTROSE 5% IN WATER (D5W) IV MBP,155.5,108.85,,,0
CDM,50863,DEXTROSE 5% IN WATER (NEO) <2 KG,28.0,19.6,,,0
CDM,50863,DEXTROSE 5% IN WATER FLUSH,23.0,16.1,,,0
CDM,50863,DEXTROSE 5%-1/2 NORMAL SALINE IV,32.5,22.75,,,0
CDM,50863,DEXTROSE 5%-1/2 NORMAL SALINE IV (PEDS ONCOLOGY),36.5,25.55,,,0
CDM,50863,DEXTROSE 5%-1/4 NORMAL SALINE IV,24.5,17.15,,,0
CDM,50863,DEXTROSE 5%-LACTATED RINGERS IV,24.0,16.8,,,0
CDM,50863,DEXTROSE 50% IN WATER (MERGE RECORD),107.0,74.9,,,0
CDM,50863,DEXTROSE 70% IN WATER (D70W) IV,16.0,11.2,,,0
CDM,50863,DIAZEPAM  2 MG ORAL TAB,5.5,3.85,,,0
CDM,50863,DIAZEPAM  5 MG ORAL TAB,12.0,8.4,,,0
CDM,50863,DIAZEPAM 2.5 MG RECT KIT,1047.0,732.9,,,0
CDM,50863,DIAZEPAM 5 MG/5 ML (5 ML) ORAL SOLN,51.0,35.7,,,0
CDM,50863,DIAZEPAM 5 MG/ML INJ SYRG,487.0,340.9,,,0
CDM,50863,DIAZEPAM 5-7.5-10 MG RECT KIT,1074.0,751.8,,,0
CDM,50863,DIAZOXIDE (DIABETIC USE) 50 MG/ML ORAL SUSP,76.0,53.2,,,0
CDM,50863,DIBUCAINE 1 % TOP OINT,33.0,23.1,,,0
CDM,50863,DICLOFENAC 0.1 % EYE DROPS,152.5,106.75,,,0
CDM,50863,DICLOFENAC 1 % TOPICAL GEL,71.5,50.05,,,0
CDM,50863,"DICLOFENAC 25 MG TAB, DELAYED RELEASE",16.0,11.2,,,0
CDM,50863,"DICLOFENAC 50 MG TAB, DELAYED RELEASE",8.0,5.6,,,0
CDM,50863,"DICLOFENAC 75 MG TAB, DELAYED RELEASE",8.5,5.95,,,0
CDM,50863,DICLOXACILLIN 250 MG ORAL CAP,17.0,11.9,,,0
CDM,50863,DICLOXACILLIN 500 MG ORAL CAP,14.0,9.8,,,0
CDM,50863,DICYCLOMINE 10 MG ORAL CAP,15.0,10.5,,,0
CDM,50863,DICYCLOMINE 10 MG/5 ML ORAL SOLN,9.0,6.3,,,0
CDM,50863,DICYCLOMINE 10 MG/ML IM SOLN,187.0,130.9,,,0
CDM,50863,DICYCLOMINE 20 MG ORAL TAB,28.0,19.6,,,0
CDM,50863,DIFLUPREDNATE 0.05 % OPHT DROP,788.0,551.6,,,0
CDM,50863,DIGOXIN  50 MCG/ML ORAL SOLN,306.0,214.2,,,0
CDM,50863,DIGOXIN 125 MCG ORAL TAB,19.0,13.3,,,0
CDM,50863,DIGOXIN 250 MCG ORAL TAB,10.0,7.0,,,0
CDM,50863,DIGOXIN 250 MCG/ML INJ SOLN,21.0,14.7,,,0
CDM,50863,DIHYDROERGOTAMINE 1 MG/ML INJ SOLN,511.0,357.70000000000005,,,0
CDM,50863,DILTIAZEM 12 MG/ML ORAL SUSPENSION,9.0,6.3,,,0
CDM,50863,DILTIAZEM 120 MG TAB,16.0,11.2,,,0
CDM,50863,DILTIAZEM 30 MG TAB,9.0,6.3,,,0
CDM,50863,DILTIAZEM 5 MG/ML IV,26.0,18.2,,,0
CDM,50863,DILTIAZEM 60 MG TAB,7.0,4.9,,,0
CDM,50863,DILTIAZEM 90 MG TAB,12.0,8.4,,,0
CDM,50863,DILTIAZEM IN D5W 125 MG/125 ML (1 MG/ML) IV SOLN (PREMIX),71.0,49.7,,,0
CDM,50863,DILTIAZEM SR 120 MG 12 HR CAP,53.0,37.1,,,0
CDM,50863,DILTIAZEM SR 120 MG 24 HR CAP,8.0,5.6,,,0
CDM,50863,DILTIAZEM SR 180 MG 24 HR CAP,7.0,4.9,,,0
CDM,50863,DILTIAZEM SR 300 MG 24 HR CAP,21.0,14.7,,,0
CDM,50863,DILTIAZEM SR 420 MG CAP,10.0,7.0,,,0
CDM,50863,DILTIAZEM SR 60 MG 12 HR CAP,45.0,31.5,,,0
CDM,50863,DILTIAZEM SR 90 MG 12 HR CAP,52.0,36.4,,,0
CDM,50863,DIMENHYDRINATE 50 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,"DIP,PER(A)TET-HEPB-POL-HIB(PF) 15 UNIT-5 UNIT- 10 MCG/0.5 ML IM INJ MERGE (CAM USE ONLY)",652.5,456.75,,,0
CDM,50863,"DIP,PER(A)TET-HEPB-POL-HIB(PF) 15 UNIT-5 UNIT- 10 MCG/0.5 ML IM SYRG",421.0,294.7,,,0
CDM,50863,DIP-PERT(A)-TET-POLIO-HIB (PF) 15LF-20MCG-5LF- 62 DU/0.5 ML IM KIT,504.5,353.15,,,0
CDM,50863,"DIPH,PERTUS(ACEL),TET,POLIO(PF)(KINRIX) 25 LF-58 MCG-10 LF/0.5 ML IM SYRINGE",318.0,222.6,,,0
CDM,50863,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,16.0,11.2,,,0
CDM,50863,DIPHENHYDRAMINE 25 MG CAP,5.5,3.85,,,0
CDM,50863,DIPHENHYDRAMINE 50 MG CAP,7.0,4.9,,,0
CDM,50863,DIPHENHYDRAMINE 50 MG/ML INJECTION,26.0,18.2,,,0
CDM,50863,DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,29.0,20.3,,,0
CDM,50863,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TAB,7.5,5.25,,,0
CDM,50863,"DIPHTH,PERTUS(ACELL),TETANUS SYRG (INFANRIX) 25 LF UNIT-58MCG-10 LF/0.5ML IM SYRINGE",334.0,233.8,,,0
CDM,50863,"DIPHTH,PERTUS(ACELL),TETANUS SYRG(BOOSTRIX) 2.5-8-5 LF-MCG-LF/0.5ML IM SYRG",243.5,170.45,,,0
CDM,50863,"DIPHTH,PERTUS(ACELL),TETANUS VIAL (BOOSTRIX*) 2.5-8-5 LF-MCG-LF/0.5ML IM SUSP",240.0,168.0,,,0
CDM,50863,DIPYRIDAMOLE-ASPIRIN SR 200 MG-25 MG MULTIPHASE 12 HR CAP,47.0,32.9,,,0
CDM,50863,DISOPYRAMIDE 150 MG ORAL CAP,19.0,13.3,,,0
CDM,50863,DIVALPROEX 125 MG ORAL CPSP,19.0,13.3,,,0
CDM,50863,DIVALPROEX 125 MG ORAL TBEC,11.0,7.7,,,0
CDM,50863,DIVALPROEX 250 MG ORAL TB24,22.0,15.4,,,0
CDM,50863,DIVALPROEX 250 MG ORAL TBEC,11.0,7.7,,,0
CDM,50863,DIVALPROEX 500 MG ORAL TB24,42.5,29.75,,,0
CDM,50863,DIVALPROEX 500 MG ORAL TBEC,9.0,6.3,,,0
CDM,50863,DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) IV,87.0,60.9,,,0
CDM,50863,"DOBUTAMINE IN D5W 1,000 MG/250 ML (4,000 MCG/ML) IV SOLP",135.0,94.5,,,0
CDM,50863,DOBUTAMINE IN D5W 500 MG/250 ML (2 MG/ML) INFUSION (PREMIX),108.0,75.6,,,0
CDM,50863,DOCETAXEL 160 MG/16 ML (10 MG/ML) IV SOLN,1454.0,1017.8,,,0
CDM,50863,DOCETAXEL 20 MG/ML (1 ML) IV SOLN,5708.0,3995.6,,,0
CDM,50863,DOCOSANOL 10 % TOP CREAM,92.0,64.4,,,0
CDM,50863,DOCUSATE SODIUM 100 MG ORAL CAP,5.5,3.85,,,0
CDM,50863,DOFETILIDE 125 MCG ORAL CAP,75.0,52.5,,,0
CDM,50863,DOFETILIDE 250 MCG ORAL CAP,69.0,48.3,,,0
CDM,50863,DOFETILIDE 500 MCG ORAL CAP,51.0,35.7,,,0
CDM,50863,DOLUTEGRAVIR 50 MG ORAL TAB,389.0,272.3,,,0
CDM,50863,DOLUTEGRAVIR-RILPIVIRINE 50-25 MG ORAL TAB,516.0,361.2,,,0
CDM,50863,DONANEMAB-AZBT 17.5 MG/ML IV SOLN,4001.0,2800.7,,,0
CDM,50863,DONEPEZIL  5 MG ORAL TAB,9.0,6.3,,,0
CDM,50863,DONEPEZIL 10 MG ORAL TAB,9.0,6.3,,,0
CDM,50863,DOPAMINE 200 MG/5 ML (40 MG/ML) IV,22.0,15.4,,,0
CDM,50863,DOPAMINE IN D5W 400 MG/250 ML (1.6 MG/ML) IV,93.0,65.1,,,0
CDM,50863,DOPAMINE INFUSION NEO IV SYRINGE (FROM PREMIX),81.0,56.7,,,0
CDM,50863,DOPAMINE INFUSION NEO IV SYRINGE (FROM PREMIX) 3200 MIG/ML,21.0,14.7,,,0
CDM,50863,DOPAMINE INFUSION PEDS IV SYRINGE (FROM PREMIX),19.0,13.3,,,0
CDM,50863,DORAVIRINE 100 MG ORAL TAB,313.0,219.1,,,0
CDM,50863,DORNASE ALFA 1 MG/ML INHL SOLN,749.0,524.3,,,0
CDM,50863,DORZOLAMIDE 2 % OPHT DROP,225.0,157.5,,,0
CDM,50863,DORZOLAMIDE-TIMOLOL 2 %-0.5 % EYE DROPS,363.5,254.45,,,0
CDM,50863,DOXAZOSIN 1 MG ORAL TAB,10.0,7.0,,,0
CDM,50863,DOXAZOSIN 2 MG ORAL TAB,7.5,5.25,,,0
CDM,50863,DOXAZOSIN 4 MG ORAL TAB,9.0,6.3,,,0
CDM,50863,DOXAZOSIN 8 MG ORAL TAB,9.0,6.3,,,0
CDM,50863,DOXEPIN  10 MG ORAL CAP,8.0,5.6,,,0
CDM,50863,DOXEPIN  25 MG ORAL CAP,10.0,7.0,,,0
CDM,50863,DOXEPIN  50 MG ORAL CAP,14.0,9.8,,,0
CDM,50863,DOXEPIN 10 MG/ML ORAL CONC,8.5,5.95,,,0
CDM,50863,DOXEPIN 100 MG ORAL CAP,23.0,16.1,,,0
CDM,50863,DOXERCALCIFEROL 4 MCG/2 ML IV SOLN,20.0,14.0,,,0
CDM,50863,DOXORUBICIN 2 MG/ML IV SOLN,69.0,48.3,,,0
CDM,50863,DOXORUBICIN 50 MG/25 ML IV SOLN,138.0,96.6,,,0
CDM,50863,DOXORUBICIN LIPOSOMAL 2 MG/ML IV INJ,7021.0,4914.7,,,0
CDM,50863,DOXYCYCLINE 100 MG CAP,7.0,4.9,,,0
CDM,50863,DOXYCYCLINE 100 MG TAB,220.5,154.35000000000002,,,0
CDM,50863,DOXYCYCLINE 25 MG/5 ML ORAL SUSP,25.0,17.5,,,0
CDM,50863,DOXYCYCLINE HYCLATE  50 MG ORAL CAP,23.5,16.45,,,0
CDM,50863,DOXYCYCLINE HYCLATE 100 MG IV SOLR,171.5,120.05,,,0
CDM,50863,DOXYCYCLINE HYCLATE 100 MG ORAL TAB,90.0,63.0,,,0
CDM,50863,DOXYLAMINE SUCCINATE 25 MG ORAL TAB,5.5,3.85,,,0
CDM,50863,DRONABINOL  2.5 MG ORAL CAP,56.0,39.2,,,0
CDM,50863,DRONEDARONE 400 MG ORAL TAB,79.5,55.65,,,0
CDM,50863,DROPERIDOL 2.5 MG/ML INJ SOLN,63.0,44.1,,,0
CDM,50863,DROXIDOPA 100 MG ORAL CAP,410.5,287.35,,,0
CDM,50863,DULOXETINE 20 MG ORAL CPDR,66.0,46.2,,,0
CDM,50863,DULOXETINE 30 MG ORAL CPDR,43.5,30.450000000000003,,,0
CDM,50863,DULOXETINE 60 MG ORAL CPDR,43.5,30.450000000000003,,,0
CDM,50863,DURVALUMAB 50 MG/ML IV SOLN,28805.0,20163.5,,,0
CDM,50863,DUTASTERIDE 0.5 MG ORAL CAP,34.0,23.8,,,0
CDM,50863,ECULIZUMAB 300 MG/30 ML IV SOLN,43181.0,30226.7,,,0
CDM,50863,EFGARTIGIMOD ALFA-FCAB 20 MG/ML IV SOLN,30791.5,21554.05,,,0
CDM,50863,"EFGARTIGIMOD-HYALURONIDAS-QVFC 1,008 MG-11,200 UNIT/5.6 ML SUBQ SOLN",43534.0,30473.8,,,0
CDM,50863,ELECTROLYTE-A IV,250.0,175.0,,,0
CDM,50863,ELTROMBOPAG 25 MG ORAL TAB,1296.0,907.2,,,0
CDM,50863,ELTROMBOPAG 75 MG ORAL TAB,1887.0,1320.9,,,0
CDM,50863,EMOLLIENT COMBINATION NO.10 TOPICAL EMULSION,145.5,101.85,,,0
CDM,50863,EMTRICITABINE-TENOFOVIR 200 MG-300 MG TAB,168.0,117.60000000000001,,,0
CDM,50863,EMTRICITABINE-TENOFOVIR ALAFEN 200-25 MG ORAL TAB,374.0,261.8,,,0
CDM,50863,ENALAPRIL MALEATE  2.5 MG ORAL TAB,14.0,9.8,,,0
CDM,50863,ENALAPRIL MALEATE  5 MG ORAL TAB,16.0,11.2,,,0
CDM,50863,ENALAPRIL MALEATE 1 MG/ML ORAL SOLN,34.0,23.8,,,0
CDM,50863,ENALAPRIL MALEATE 10 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,ENALAPRIL MALEATE 20 MG ORAL TAB,16.0,11.2,,,0
CDM,50863,ENALAPRILAT 1.25 MG/ML IV INJ,28.0,19.6,,,0
CDM,50863,ENFORTUMAB VEDOTIN-EJFV 20 MG IV SOLR,5412.5,3788.75,,,0
CDM,50863,ENFORTUMAB VEDOTIN-EJFV 30 MG IV SOLR,26207.0,18344.9,,,0
CDM,50863,ENOXAPARIN 100 MG/1 ML SUBQ SYRG,132.0,92.4,,,0
CDM,50863,ENOXAPARIN 120 MG/0.8 ML SUBQ SYRG,141.0,98.7,,,0
CDM,50863,ENOXAPARIN 150 MG/1 ML SUBQ SYRG,133.0,93.1,,,0
CDM,50863,ENOXAPARIN 20 MG/ML IN NS NEONATAL INJECTION (REPACK),72.0,50.4,,,0
CDM,50863,ENOXAPARIN 30 MG/0.3 ML SUBQ SYRG,46.5,32.55,,,0
CDM,50863,ENOXAPARIN 300 MG/3 ML SUBQ SOLN,23.0,16.1,,,0
CDM,50863,ENOXAPARIN 40 MG/0.4 ML SUBQ SYRG,54.0,37.8,,,0
CDM,50863,ENOXAPARIN 60 MG/0.6 ML SUBQ SYRG,82.0,57.4,,,0
CDM,50863,ENOXAPARIN 80 MG/0.8 ML SUBQ SYRG,67.0,46.900000000000006,,,0
CDM,50863,ENOXAPARIN NEO/PEDIATRIC SYRINGE < 30 MG,21.0,14.7,,,0
CDM,50863,ENTACAPONE 200 MG ORAL TAB,28.0,19.6,,,0
CDM,50863,ENTECAVIR 0.5 MG ORAL TAB,218.0,152.6,,,0
CDM,50863,EPHEDRINE 5 MG/ML IN NS IV SYRINGE,54.0,37.8,,,0
CDM,50863,EPHEDRINE 50 MG/ML IV SOLN (MERGE),110.5,77.35,,,0
CDM,50863,EPHEDRINE SULFATE  25 MG/5 ML (5 MG/ML) IV SYRG (MERGE),116.0,81.2,,,0
CDM,50863,EPINEPHRINE (PF) 1 MG/ML INJ SOLN,642.5,449.75,,,0
CDM,50863,EPINEPHRINE 0.1 % NASAL SOLN,10818.0,7572.6,,,0
CDM,50863,EPINEPHRINE 0.1 MG/ML SYRINGE (ERX MERGE),441.0,308.7,,,0
CDM,50863,EPINEPHRINE 0.15 MG/0.3 ML IM PNIJ,1024.0,716.8,,,0
CDM,50863,EPINEPHRINE 0.3 MG/0.3 ML IM PNIJ,1051.0,735.7,,,0
CDM,50863,EPINEPHRINE 1 MG/ML (1ML) INJ SOLN,245.5,171.85,,,0
CDM,50863,EPINEPHRINE 1 MG/ML INJ KIT,10685.0,7479.5,,,0
CDM,50863,EPINEPHRINE 1 MG/ML INJ SOLN,154.0,107.8,,,0
CDM,50863,EPINEPHRINE HCL IN 0.9 % NACL 4 MG/250 ML (16 MCG/ML) IV SOLN,147.0,102.9,,,0
CDM,50863,EPINEPHRINE HCL IN 0.9% NS 100 MCG/10 ML (10 MCG/ML) NON-CARDIAC LOW-DOSE (PEDS/NEO),25.0,17.5,,,0
CDM,50863,EPINEPHRINE HCL IN 5% DEXTROSE 100 MCG/10 ML (10 MCG/ML) IV SYRG,39.5,27.65,,,0
CDM,50863,EPINEPHRINE HCL IN D5W 4 MG/250 ML (16 MCG/ML) IV SOLN,631.0,441.7,,,0
CDM,50863,EPINEPHRINE IN 0.9 % NACL 4 MG/250 ML (16 MCG/ML) IV SOLN (MERGE),616.5,431.54999999999995,,,0
CDM,50863,EPINEPHRINE IN 0.9 % SOD CHLOR 4 MG/250 ML (16 MCG/ML) IV SOLN,389.0,272.3,,,0
CDM,50863,EPLERENONE  25 MG ORAL TAB,26.0,18.200000000000003,,,0
CDM,50863,EPOETIN ALFA  4000 UNIT/ML INJ SOLN,693.0,485.09999999999997,,,0
CDM,50863,EPOETIN ALFA 10000 UNIT/ML INJ SOLN,852.0,596.4,,,0
CDM,50863,EPOETIN ALFA 2000 UNIT/ML IV SYRINGE (PED/NEO),115.0,80.5,,,0
CDM,50863,EPOETIN ALFA 20000 UNIT/ML INJ SOLN,1325.0,927.5,,,0
CDM,50863,EPOETIN ALFA-EPBX 10000 UNITS/ML INJ SOLN,334.0,233.79999999999998,,,0
CDM,50863,EPOPROSTENOL (ARGNININE) (VELETRI) CONTINUOUS NEB 1.5 MG IN NS 50 ML,243.0,170.1,,,0
CDM,50863,EPTINEZUMAB-JJMR 100 MG/ML IV SOLN,8253.0,5777.099999999999,,,0
CDM,50863,ERGOCALCIFEROL (VITAMIN D2) 50000 UNIT ORAL CAP,9.0,6.300000000000001,,,0
CDM,50863,ERTAPENEM 1 GRAM INJ SOLR,469.0,328.29999999999995,,,0
CDM,50863,ERYTHROMYCIN 250 MG ORAL TBEC,83.0,58.1,,,0
CDM,50863,ERYTHROMYCIN 5 MG/G OPHT OINT,95.5,66.85,,,0
CDM,50863,ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL SUSR,52.0,36.4,,,0
CDM,50863,ESCITALOPRAM 10 MG ORAL TAB,36.0,25.2,,,0
CDM,50863,ESCITALOPRAM 20 MG ORAL TAB,32.0,22.4,,,0
CDM,50863,ESMOLOL  100 MG/10 ML IV SOLN,106.0,74.2,,,0
CDM,50863,"ESMOLOL IN SALINE (ISO-OSMOTIC) 2,000 MG/100 ML (20 MG/ML) IV",949.5,664.6500000000001,,,0
CDM,50863,"ESMOLOL IN SALINE (ISO-OSMOTIC) 2,500 MG/250 ML (10 MG/ML) IV",604.0,422.8,,,0
CDM,50863,ESTRADIOL 0.025 MG/24 HR TD PTSW,56.0,39.2,,,0
CDM,50863,ESTRADIOL 0.025 MG/24 HR TD PTWK,217.0,151.9,,,0
CDM,50863,ESTRADIOL 0.05 MG/24 HR TD PTWK,202.0,141.4,,,0
CDM,50863,ESTRADIOL 0.1 MG/24 HR TD PTWK,114.0,79.8,,,0
CDM,50863,ESTRADIOL 1 MG ORAL TAB,8.0,5.6,,,0
CDM,50863,ESTRADIOL 2 MG ORAL TAB,17.5,12.25,,,0
CDM,50863,ESTRADIOL CYPIONATE 5 MG/ML IM OIL,878.0,614.6,,,0
CDM,50863,ETHACRYNATE SODIUM 50 MG IV SOLR,10488.0,7341.6,,,0
CDM,50863,ETHACRYNIC ACID 25 MG ORAL TAB,178.0,124.6,,,0
CDM,50863,ETHAMBUTOL 100 MG ORAL TAB,8.0,5.6,,,0
CDM,50863,ETHAMBUTOL 400 MG ORAL TAB,20.0,14.0,,,0
CDM,50863,ETHIODIZED OIL 48 % INJ SOLN,4954.0,3467.8,,,0
CDM,50863,ETHOSUXIMIDE 250 MG ORAL CAP,39.0,27.299999999999997,,,0
CDM,50863,ETHOSUXIMIDE 250 MG/5 ML ORAL SYRP,14.0,9.8,,,0
CDM,50863,ETHYL ALCOHOL  99 % IART SOLN,13793.5,9655.45,,,0
CDM,50863,ETHYL CHLORIDE 100 % TOP SPRA,168.5,117.95,,,0
CDM,50863,ETODOLAC 300 MG ORAL CAP,9.0,6.3,,,0
CDM,50863,ETODOLAC 400 MG ORAL TAB,8.0,5.6,,,0
CDM,50863,ETOMIDATE 2 MG/ML IV SOLN,42.0,29.4,,,0
CDM,50863,ETONOGESTREL 68 MG SDRM IMPL,2258.0,1580.6,,,0
CDM,50863,ETOPOSIDE 20 MG/ML IV SOLN,74.0,51.8,,,0
CDM,50863,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG ORAL TAB,197.0,137.9,,,0
CDM,50863,EVINACUMAB-DGNB 150 MG/ML IV SOLN,93288.0,65301.6,,,0
CDM,50863,EXEMESTANE 25 MG ORAL TAB,81.5,57.05,,,0
CDM,50863,EXENATIDE 10 MCG/0.04 ML SUBQ PNIJ,609.5,426.65,,,0
CDM,50863,EXENATIDE 5 MCG/0.02 ML SUBQ PNIJ,2346.0,1642.2,,,0
CDM,50863,EZETIMIBE 10 MG ORAL TAB,51.0,35.7,,,0
CDM,50863,FAMCICLOVIR 125 MG ORAL TAB,33.0,23.1,,,0
CDM,50863,FAMCICLOVIR 250 MG ORAL TAB,64.0,44.8,,,0
CDM,50863,FAMCICLOVIR 500 MG ORAL TAB,64.0,44.8,,,0
CDM,50863,FAMOTIDINE (PF) 20 MG/2 ML IV SOLN,18.0,12.6,,,0
CDM,50863,FAMOTIDINE 20 MG ORAL TAB,12.0,8.4,,,0
CDM,50863,FAMOTIDINE 40 MG/5 ML ORAL SUSP,37.0,25.9,,,0
CDM,50863,FAT EMUL-SOY-MCT-OLIV-FISH OIL 20 % IV EMUL,40.0,28.0,,,0
CDM,50863,FAT EMUL-SOY-MCT-OLIV-FISH OIL 20 % IV EMUL (NEO/PEDS),24.0,16.8,,,0
CDM,50863,FAT EMULSION 20 % IV BOLUS (FOR OVERDOSE),406.0,284.2,,,0
CDM,50863,FAT EMULSION 20 % IV EMUL,176.5,123.55000000000001,,,0
CDM,50863,FEBUXOSTAT 40 MG ORAL TAB,55.5,38.85,,,0
CDM,50863,FELBAMATE 400 MG ORAL TAB,52.0,36.4,,,0
CDM,50863,FELBAMATE 600 MG ORAL TAB,59.0,41.3,,,0
CDM,50863,FELBAMATE 600 MG/5 ML ORAL SUSP,50.0,35.0,,,0
CDM,50863,FELODIPINE  2.5 MG ORAL TB24,13.5,9.45,,,0
CDM,50863,FELODIPINE  5 MG ORAL TB24,13.5,9.45,,,0
CDM,50863,FELODIPINE 10 MG ORAL TB24,16.0,11.2,,,0
CDM,50863,FENOFIBRATE NANOCRYSTALLIZED  48 MG ORAL TAB,19.0,13.3,,,0
CDM,50863,FENOFIBRATE NANOCRYSTALLIZED 145 MG ORAL TAB,13.0,9.1,,,0
CDM,50863,FENTANYL  12 MCG/HR TD PT72,100.0,70.0,,,0
CDM,50863,FENTANYL  25 MCG/HR TD PT72,87.5,61.25,,,0
CDM,50863,FENTANYL  50 MCG/HR TD PT72,191.0,133.7,,,0
CDM,50863,FENTANYL  75 MCG/HR TD PT72,340.0,238.0,,,0
CDM,50863,FENTANYL 100 MCG/HR TD PT72,359.5,251.65,,,0
CDM,50863,FENTANYL 5 MCG/ML INJECTION,25.0,17.5,,,0
CDM,50863,FENTANYL CITRATE (PF) 50 MCG/ML (ANESTHESIA INTRAOP ONLY),50.0,35.0,,,0
CDM,50863,FENTANYL CITRATE (PF) 50 MCG/ML INJ (REPACK)(MERGE) (FOR PCA),147.0,102.9,,,0
CDM,50863,FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN,46.5,32.55,,,0
CDM,50863,FENTANYL CITRATE (PF) 50 MCG/ML IV (MERGE) (FOR VENT),104.0,72.8,,,0
CDM,50863,FENTANYL CITRATE (PF) 50 MCG/ML IV SOLN,147.0,102.9,,,0
CDM,50863,FENTANYL-ROPIVACAINE-NACL (PF) 2-0.2 MCG/ML-% INJ (MERGE ERX),620.0,434.0,,,0
CDM,50863,FERRIC CARBOXYMALTOSE (INJECTAFER) 50 MG IRON/ML IV SOLN,4340.0,3038.0,,,0
CDM,50863,FERRIC DERISOMALTOSE 100 MG IRON/ML IV SOLN,8962.0,6273.4,,,0
CDM,50863,FERRIC SUBSULFATE 0.2 TO 0.22 GRAM/ML MISC SOLA,89.0,62.3,,,0
CDM,50863,FERRIC SUBSULFATE 0.2 TO 0.22 GRAM/ML SOLN BULK,227.0,158.9,,,0
CDM,50863,FERROUS GLUCONATE 324 MG (37.5 MG IRON) ORAL TAB,7.0,4.9,,,0
CDM,50863,FERROUS GLUCONATE 324 MG (38 MG IRON) TAB,7.0,4.9,,,0
CDM,50863,FERROUS SULFATE 220 MG (44 MG IRON)/5 ML ORAL ELIX,7.0,4.9,,,0
CDM,50863,FERROUS SULFATE 220 MG (44 MG IRON)/5 ML ORAL SOLN,7.0,4.9,,,0
CDM,50863,FERROUS SULFATE 324 MG (65 MG IRON) ORAL TBEC,7.0,4.9,,,0
CDM,50863,FERROUS SULFATE 325 MG (65 MG IRON) TAB,7.0,4.9,,,0
CDM,50863,FERROUS SULFATE 75 MG/ML (ELEMENTAL IRON 15 MG/ML) 0.1 ML ORAL SYRINGE (REPACK),7.0,4.9,,,0
CDM,50863,FERROUS SULFATE 75 MG/ML (ELEMENTAL IRON 15 MG/ML) 0.2 ML ORAL SYRINGE (REPACK),10.0,7.0,,,0
CDM,50863,FERROUS SULFATE 75 MG/ML (ELEMENTAL IRON 15 MG/ML) ORAL DROP,7.0,4.9,,,0
CDM,50863,FERUMOXYTOL 510 MG/17 ML (30 MG/ML) IV SOLN,3295.0,2306.5,,,0
CDM,50863,FIDAXOMICIN 200 MG ORAL TAB,2093.5,1465.45,,,0
CDM,50863,FILGRASTIM 300 (NEUPOGEN) MCG/ML INJ SOLN,636.0,445.2,,,0
CDM,50863,FILGRASTIM-SNDZ 300 MCG/0.5 ML INJ SYRG,976.0,683.2,,,0
CDM,50863,FILGRASTIM-SNDZ 480 MCG/0.8 ML INJ SYRG,1212.0,848.4,,,0
CDM,50863,FINASTERIDE 1 MG ORAL TAB,16.0,11.2,,,0
CDM,50863,FINASTERIDE 5 MG ORAL TAB,13.5,9.45,,,0
CDM,50863,FLECAINIDE  50 MG ORAL TAB,17.0,11.9,,,0
CDM,50863,FLECAINIDE 100 MG ORAL TAB,32.0,22.4,,,0
CDM,50863,FLECAINIDE 20MG/ML SUSPENSION (REPACK),12.0,8.4,,,0
CDM,50863,FLU VACCINE 2024-25 65YR UP ADJMF59C (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,373.0,261.1,,,0
CDM,50863,FLU VACCINE TS 2024-25 65 YR UP (PF) 180 MCG/0.5 ML IM SYRG,373.0,261.1,,,0
CDM,50863,FLU VACCINE TS 2024-25 6MOS UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,121.0,84.7,,,0
CDM,50863,FLU VACCINE TS 2025-26 6 MO UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,121.0,84.7,,,0
CDM,50863,FLU VACCINE TS 2025-26 65 YR UP (PF) 180 MCG/0.5 ML IM SYRG,387.5,271.25,,,0
CDM,50863,FLUCONAZOLE 10 MG/ML ORAL SUSR,173.0,121.1,,,0
CDM,50863,FLUCONAZOLE 100 MG ORAL TAB,65.0,45.5,,,0
CDM,50863,FLUCONAZOLE 200 MG ORAL TAB,130.5,91.35,,,0
CDM,50863,FLUCONAZOLE 200 MG/100 ML IVPB (MERGE),51.5,36.05,,,0
CDM,50863,FLUCONAZOLE 40 MG/ML ORAL SUSR,62.0,43.4,,,0
CDM,50863,FLUCONAZOLE IN SALINE (ISO-OSM) 400 MG/200 ML IV PIGGY BACK,60.0,42.0,,,0
CDM,50863,FLUCONAZOLE PEDS SYRINGE (CDS MIXTURE),33.0,23.1,,,0
CDM,50863,FLUCYTOSINE 500 MG ORAL CAP,1462.0,1023.4,,,0
CDM,50863,FLUDARABINE 50 MG IV SOLR,817.0,571.9,,,0
CDM,50863,FLUDARABINE 50 MG/2 ML IV SOLN,1925.0,1347.5,,,0
CDM,50863,FLUDROCORTISONE 0.1 MG ORAL TAB,12.0,8.4,,,0
CDM,50863,FLUMAZENIL 0.1 MG/ML IV SOLN,70.5,49.35,,,0
CDM,50863,FLUORESCEIN 1 MG OPHT STRP,7.0,4.9,,,0
CDM,50863,FLUORESCEIN 500 MG/5 ML (10 %) IV SOLN,367.0,256.9,,,0
CDM,50863,FLUOROMETHOLONE 0.1 % OPHT DRPS,395.0,276.5,,,0
CDM,50863,FLUOROURACIL 1 GRAM/20 ML IV SOLN,34.5,24.150000000000002,,,0
CDM,50863,FLUOROURACIL 500 MG/10 ML IV SOLN,91.0,63.7,,,0
CDM,50863,FLUOXETINE 10 MG ORAL CAP,28.0,19.6,,,0
CDM,50863,FLUOXETINE 10 MG ORAL TAB,33.0,23.1,,,0
CDM,50863,FLUOXETINE 20 MG ORAL CAP,14.5,10.15,,,0
CDM,50863,FLUOXETINE 20 MG/5 ML ORAL SOLN,38.0,26.6,,,0
CDM,50863,FLUPHENAZINE 1 MG TAB,37.0,25.9,,,0
CDM,50863,FLUPHENAZINE 2.5 MG TAB,59.5,41.650000000000006,,,0
CDM,50863,FLUPHENAZINE 5 MG TAB,58.5,40.95,,,0
CDM,50863,FLUPHENAZINE DECANOATE 25 MG/ML INJ SOLN,195.0,136.5,,,0
CDM,50863,FLUTICASONE  100 MCG/ACTUATION INHL DSDV,840.0,588.0,,,0
CDM,50863,FLUTICASONE  250 MCG/ACTUATION INHL DSDV,921.0,644.7,,,0
CDM,50863,FLUTICASONE  50 MCG/ACTUATION NASL SPSN,379.0,265.3,,,0
CDM,50863,FLUTICASONE 110 MCG/ACTUATION INHL AERO,29.0,20.3,,,0
CDM,50863,FLUTICASONE 220 MCG/ACTUATION INHL AERO,25.0,17.5,,,0
CDM,50863,FLUTICASONE 44 MCG/ACTUATION INHL AERO,17.0,11.9,,,0
CDM,50863,FLUTICASONE-SALMETEROL 100 MCG-50 MCG/DOSE DISK DEVICE FOR INHALATION,674.0,471.8,,,0
CDM,50863,FLUTICASONE-SALMETEROL 250 MCG-50 MCG/DOSE DISK DEVICE FOR INHALATION,1311.0,917.7,,,0
CDM,50863,FLUTICASONE-SALMETEROL 500 MCG-50 MCG/DOSE DISK DEVICE FOR INHALATION,1345.0,941.5,,,0
CDM,50863,FLUVOXAMINE  50 MG ORAL TAB,36.0,25.2,,,0
CDM,50863,FLUVOXAMINE 100 MG ORAL TAB,18.5,12.95,,,0
CDM,50863,FOLIC ACID  1 MG ORAL TAB,5.5,3.85,,,0
CDM,50863,FOLIC ACID  5 MG/ML INJ SOLN,16.0,11.2,,,0
CDM,50863,FOLIC ACID 1 MG / 0.2 ML SYRINGE (CDS ADS REPACK),8.0,5.6,,,0
CDM,50863,FOLIC ACID 400 MCG ORAL TAB,7.0,4.9,,,0
CDM,50863,FOMEPIZOLE 1 GRAM/ML IV SOLN,4140.0,2898.0,,,0
CDM,50863,FONDAPARINUX 10 MG/0.8 ML SUBQ SYRG,370.0,259.0,,,0
CDM,50863,FONDAPARINUX 2.5 MG/0.5 ML SUBQ SYRG,204.5,143.15,,,0
CDM,50863,FONDAPARINUX 5 MG/0.4 ML SUBQ SYRG,489.0,342.3,,,0
CDM,50863,FONDAPARINUX 7.5 MG/0.6 ML SUBQ SYRG,476.0,333.20000000000005,,,0
CDM,50863,FOSAPREPITANT 150 MG IV SOLR,540.0,378.0,,,0
CDM,50863,FOSCARNET 24 MG/ML IV SOLN,1315.0,920.5,,,0
CDM,50863,FOSINOPRIL 10 MG ORAL TAB,20.5,14.35,,,0
CDM,50863,FOSINOPRIL 20 MG ORAL TAB,10.5,7.3500000000000005,,,0
CDM,50863,FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN,69.5,48.650000000000006,,,0
CDM,50863,FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN,242.0,169.4,,,0
CDM,50863,FUROSEMIDE 10 MG/ML INJ SOLN,54.0,37.8,,,0
CDM,50863,FUROSEMIDE 10 MG/ML INJ SOLN (NEO),21.0,14.7,,,0
CDM,50863,FUROSEMIDE 10 MG/ML ORAL SOLN,29.0,20.3,,,0
CDM,50863,FUROSEMIDE 20 MG ORAL TAB,9.0,6.3,,,0
CDM,50863,FUROSEMIDE 40 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,FUROSEMIDE 40 MG/4 ML ORAL SOLN,10.5,7.3500000000000005,,,0
CDM,50863,FUROSEMIDE 80 MG ORAL TAB,9.0,6.3,,,0
CDM,50863,GABAPENTIN 100 MG ORAL CAP,14.0,9.8,,,0
CDM,50863,GABAPENTIN 250 MG/5 ML (5 ML) ORAL SOLN,31.0,21.7,,,0
CDM,50863,GABAPENTIN 250 MG/5 ML ORAL SOLN,17.0,11.9,,,0
CDM,50863,GABAPENTIN 300 MG ORAL CAP,15.0,10.5,,,0
CDM,50863,GABAPENTIN 300 MG/6 ML (6 ML) ORAL SOLN,10.0,7.0,,,0
CDM,50863,GABAPENTIN 400 MG ORAL CAP,10.0,7.0,,,0
CDM,50863,GALANTAMINE  4 MG ORAL TAB,41.5,29.049999999999997,,,0
CDM,50863,GAMMAGARD LIQUID 10 % IV SOLN,5565.0,3895.5,,,0
CDM,50863,GAMMAGARD S-D (IGA < 1 MCG/ML) 10 GRAM IV SOLR,11641.0,8148.7,,,0
CDM,50863,GAMMAGARD S/D  5 GRAM IV SOLR,2329.0,1630.3,,,0
CDM,50863,GANCICLOVIR 500 MG IV SOLUTION,101.0,70.7,,,0
CDM,50863,GANCICLOVIR NEO IV SYRINGE (CDS MIXTURE),9.5,6.65,,,0
CDM,50863,GANCICLOVIR SODIUM 50 MG/ML IV SOLN,184.0,128.8,,,0
CDM,50863,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) IV SOLN,435.0,304.5,,,0
CDM,50863,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) BLADDER INSTILLATION,450.0,315.0,,,0
CDM,50863,GEMFIBROZIL 600 MG ORAL TAB,13.5,9.45,,,0
CDM,50863,GEMTUZUMAB OZOGAMICIN 4.5 MG (1 MG/ML INITIAL CONC) IV SOLR,19757.5,13830.25,,,0
CDM,50863,GENTAMICIN (PF) 10 MG/ML INJECTION (NEONATAL IM USE),513.5,359.45,,,0
CDM,50863,GENTAMICIN (PF) NEO IV SYRINGE (CDS MIXTURE),14.5,10.15,,,0
CDM,50863,GENTAMICIN 0.1 % TOP CREA,242.0,169.4,,,0
CDM,50863,GENTAMICIN 0.1 % TOP OINT,242.0,169.4,,,0
CDM,50863,GENTAMICIN 0.3 % OPHT DROP,210.0,147.0,,,0
CDM,50863,GENTAMICIN 10 MG/1 ML SUBCONJUNCTIVAL INJECTION,21.0,14.7,,,0
CDM,50863,GENTAMICIN 40 MG/ML INJ SOLN,82.5,57.75,,,0
CDM,50863,GENTAMICIN IN SALINE (ISO-OSMOTIC) 100 MG/50 ML IV PIGGY BACK,86.0,60.199999999999996,,,0
CDM,50863,GENTAMICIN IN SALINE (ISO-OSMOTIC) 80 MG/100 ML IV PIGGY BACK,120.0,84.0,,,0
CDM,50863,GENTIAN VIOLET 1 % TOP SOLN,47.0,32.9,,,0
CDM,50863,GLIMEPIRIDE 1 MG ORAL TAB,6.5,4.550000000000001,,,0
CDM,50863,GLIMEPIRIDE 2 MG ORAL TAB,10.0,7.0,,,0
CDM,50863,GLIMEPIRIDE 4 MG ORAL TAB,10.5,7.3500000000000005,,,0
CDM,50863,GLIPIZIDE  2.5 MG ORAL TO24,13.5,9.45,,,0
CDM,50863,GLIPIZIDE  5 MG ORAL TAB,5.5,3.85,,,0
CDM,50863,GLIPIZIDE  5 MG ORAL TO24,8.0,5.6,,,0
CDM,50863,GLIPIZIDE 10 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,GLIPIZIDE 10 MG ORAL TO24,12.5,8.75,,,0
CDM,50863,GLUCAGON 1 MG/ML INJ (MERGE),1679.5,1175.65,,,0
CDM,50863,GLUCARPIDASE 1000 UNIT IV SOLR,113217.0,79251.9,,,0
CDM,50863,GLUCOSAMINE SULFATE  500 MG ORAL CAP,7.0,4.9,,,0
CDM,50863,GLUCOSE (TOLERANCE TEST) 100 GRAM/180 ML ORAL LIQD,46.0,32.2,,,0
CDM,50863,GLYBURIDE 5 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,GLYCERIN (ADULT) RECTAL SUPPOSITORY,7.0,4.9,,,0
CDM,50863,GLYCERIN (CHILD) RECTAL SUPPOSITORY,7.0,4.9,,,0
CDM,50863,GLYCERIN (LAXATIVE) 2.8 GRAM/2.7 ML RECT SOLN,7.0,4.9,,,0
CDM,50863,GLYCERIN 99.5 % TOP SOLN,24.5,17.15,,,0
CDM,50863,GLYCERIN-WITCH HAZEL 12.5 %-50 % TOPICAL PADS,18.0,12.6,,,0
CDM,50863,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,56.0,39.2,,,0
CDM,50863,GLYCOPYRROLATE 0.2 MG/ML ORAL SOLUTION (CDS),69.0,48.3,,,0
CDM,50863,GLYCOPYRROLATE 1 MG ORAL TAB,8.0,5.6,,,0
CDM,50863,GOLIMUMAB  12.5 MG/ML IV SOLN,13574.0,9501.8,,,0
CDM,50863,GOSERELIN  3.6 MG SUBQ IMPL,1670.0,1169.0,,,0
CDM,50863,GOSERELIN 10.8 MG SUBQ IMPL,5010.0,3507.0,,,0
CDM,50863,GRANISETRON (PF) 1 MG/ML (1 ML) IV SOLN,118.0,82.6,,,0
CDM,50863,GRANISETRON 1 MG ORAL TAB,251.0,175.7,,,0
CDM,50863,GRANISETRON 1 MG/ML (1 ML) IV SOLN,17.0,11.9,,,0
CDM,50863,GRISEOFULVIN MICROSIZE 500 MG ORAL TAB,115.0,80.5,,,0
CDM,50863,GUAIFENESIN  200 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,GUAIFENESIN 100 MG/5 ML ORAL LIQD,44.0,30.8,,,0
CDM,50863,GUAIFENESIN 600 MG ORAL TP12,20.0,14.0,,,0
CDM,50863,GUANFACINE 1 MG ORAL TAB,12.0,8.4,,,0
CDM,50863,GUANFACINE 1 MG ORAL TB24,128.5,89.94999999999999,,,0
CDM,50863,GUANFACINE 2 MG ORAL TB24,77.5,54.25,,,0
CDM,50863,GUSELKUMAB 200 MG/20 ML (10 MG/ML) IV SOLN,38289.0,26802.3,,,0
CDM,50863,HAEMOPH B POLYSAC CONJ-MENING (PF) 7.5 MCG/0.5 ML IM,179.0,125.3,,,0
CDM,50863,HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX (PF) 10 MCG IM,77.0,53.900000000000006,,,0
CDM,50863,HALOBETASOL PROPIONATE 0.05 % TOP CREA,336.0,235.2,,,0
CDM,50863,HALOPERIDOL  0.5 MG ORAL TAB,4.5,3.1500000000000004,,,0
CDM,50863,HALOPERIDOL  1 MG ORAL TAB,8.5,5.949999999999999,,,0
CDM,50863,HALOPERIDOL  2 MG ORAL TAB,8.5,5.95,,,0
CDM,50863,HALOPERIDOL  5 MG ORAL TAB,11.5,8.05,,,0
CDM,50863,HALOPERIDOL 10 MG ORAL TAB,11.0,7.7,,,0
CDM,50863,HALOPERIDOL 2 MG/ML ORAL CONCENTRATE,10.0,7.0,,,0
CDM,50863,HALOPERIDOL DECANOATE  50 MG/ML IM SOLN,367.0,256.9,,,0
CDM,50863,HALOPERIDOL DECANOATE 100 MG/ML IM SOLN,297.0,207.9,,,0
CDM,50863,HALOPERIDOL LACTATE 5 MG/ML INJECTION (MERGE),34.0,23.8,,,0
CDM,50863,HC ADMIN RESPIRATORY SYNCYTIAL VIRUS MONOCLONAL ANTIBODY SEASONAL DOSE INTRAMUSCULAR INJECTION,1485.0,1039.5,,,0
CDM,50863,HC IV INFUSION HYDRAT 31-60 MIN,415.0,290.5,,,0
CDM,50863,HC IV INFUSION PEMIVIBART,15939.0,11157.3,,,0
CDM,50863,HC MCARE ADMIN HEPATITIS B VACC,262.0,183.4,,,0
CDM,50863,HEP B-DP(ACELL)T-POLIO VACC-PF 10MCG-25LF-25MCG-10LF-40-8-32 IM SYRING,433.0,303.1,,,0
CDM,50863,HEPARIN (PORCINE)  1000 UNIT/ML INJ SOLN,90.0,63.0,,,0
CDM,50863,HEPARIN (PORCINE)  5000 UNIT/ML INJ SOLN,20.0,14.0,,,0
CDM,50863,HEPARIN (PORCINE) 1000 UNITS/ML INJ SOL (FOR DIALYSIS ONLY),20.0,14.0,,,0
CDM,50863,HEPARIN (PORCINE) 20000 UNIT/ML INJ SOLN,33.0,23.1,,,0
CDM,50863,"HEPARIN (PORCINE) IN 0.9% NACL 2,500 UNIT/250 ML (10 UNIT/ML) IV SOLP",16.0,11.2,,,0
CDM,50863,HEPARIN (PORCINE) IN D5W 20000 UNIT/500 ML,19.0,13.3,,,0
CDM,50863,HEPARIN (PORCINE) IN D5W 25000 UNIT/250 ML (ANTI-XA MONITORING),63.0,44.1,,,0
CDM,50863,HEPARIN (PORCINE) IN D5W 25000 UNIT/250 ML (PTT MONITORING),91.5,64.05000000000001,,,0
CDM,50863,HEPARIN (PORCINE) IN NACL (PF) 1000 UNIT/500 ML IV SOLP,70.5,49.349999999999994,,,0
CDM,50863,HEPARIN 0.5 UNITS/ML IN 0.45% SODIUM CHLORIDE (REPACK REC),16.0,11.2,,,0
CDM,50863,HEPARIN 0.5 UNITS/ML IN DEXTROSE 10% FOR TRANSPORT (REPACK REC),13.0,9.1,,,0
CDM,50863,HEPARIN 1 UNIT/ML IN NS 20 ML SYRINGE (CDS ADS MIXTURE),46.0,32.2,,,0
CDM,50863,HEPARIN LOCK FLUSH (PORCINE)  10 UNIT/ML IV SOLN,262.5,183.75,,,0
CDM,50863,HEPARIN LOCK FLUSH (PORCINE) 10 UNIT/ML IV SOLN (PEDS),16.0,11.2,,,0
CDM,50863,HEPARIN LOCK FLUSH 100 UNIT/ML IV SOLN,37.5,26.25,,,0
CDM,50863,"HEPARIN, PORCINE (PF)   10 UNIT/ML IV SYRG",17.0,11.9,,,0
CDM,50863,"HEPARIN, PORCINE (PF)  100 UNIT/ML IV SYRG",16.0,11.2,,,0
CDM,50863,"HEPARIN, PORCINE (PF) 1 UNIT/ML IV SYRG NEONATE",63.0,44.1,,,0
CDM,50863,HEPATITIS A & B VIRUS VACCINE (PF) 720 ELISA UNIT-20 MCG/ML IM SYRINGE,572.0,400.4,,,0
CDM,50863,HEPATITIS A VIRUS VACCINE (PF) 1440 ELISA UNIT/ML IM SYRG,396.5,277.54999999999995,,,0
CDM,50863,HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML IM MERGE (CAM USE ONLY),231.0,161.7,,,0
CDM,50863,HEPATITIS A VIRUS VACCINE (PF) 720 EL UNIT/0.5 ML IM SYRG,226.0,158.2,,,0
CDM,50863,HEPATITIS B IMMUNE GLOBULIN 110 UNIT/0.5 ML IM SYRG,304.5,213.15,,,0
CDM,50863,HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML (5 ML) IM SOLN,2120.5,1484.35,,,0
CDM,50863,HEPATITIS B IMMUNE GLOBULIN >312 UNIT/ML IM SOLN,721.0,504.7,,,0
CDM,50863,HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML IM SYRINGE,367.0,256.9,,,0
CDM,50863,HETASTARCH 6 % IN NORMAL SALINE IV,151.0,105.7,,,0
CDM,50863,"HIB CONJ-TET,COMPNT 2 OF 2(PF) 10 MCG/0.5 ML IM SOLR",504.5,353.15,,,0
CDM,50863,HISTRELIN 50 MG (65 MCG/DAY) IMPL KIT,74263.0,51984.1,,,0
CDM,50863,"HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM INJ MERGE (CAM USE ONLY)",1089.0,762.3,,,0
CDM,50863,"HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM SYRG",1089.0,762.3,,,0
CDM,50863,HUMAN PROTHROMBIN COMPLEX 500 UNIT IV SOLR,7565.0,5295.5,,,0
CDM,50863,HYALURONIDASE 150 UNIT INJ SOLR,452.0,316.4,,,0
CDM,50863,HYALURONIDASE 150 UNIT/ML INJ SOLN,284.0,198.8,,,0
CDM,50863,HYDRALAZINE  10 MG ORAL TAB,9.5,6.65,,,0
CDM,50863,HYDRALAZINE  25 MG ORAL TAB,10.5,7.35,,,0
CDM,50863,HYDRALAZINE  50 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,HYDRALAZINE 1MG/ML IV SYRINGE (PEDS/NEO),18.0,12.6,,,0
CDM,50863,HYDRALAZINE 20 MG/ML INJ SOLN,46.0,32.2,,,0
CDM,50863,HYDROCHLOROTHIAZIDE  25 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,HYDROCHLOROTHIAZIDE  50 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,HYDROCODONE-ACETAMINOPHEN 10 MG-325 MG TAB,12.0,8.4,,,0
CDM,50863,HYDROCODONE-ACETAMINOPHEN 5 MG-325 MG TAB,13.0,9.1,,,0
CDM,50863,HYDROCODONE-ACETAMINOPHEN 7.5 MG-325 MG TAB,12.0,8.4,,,0
CDM,50863,HYDROCODONE-ACETAMINOPHEN 7.5 MG-325 MG/15 ML ORAL SOLN (REPACK),16.0,11.2,,,0
CDM,50863,HYDROCORTISONE  1 % TOP CREA,36.0,25.2,,,0
CDM,50863,HYDROCORTISONE  1 % TOP OINT,23.0,16.1,,,0
CDM,50863,HYDROCORTISONE  2.5 % RECT CREA,357.0,249.9,,,0
CDM,50863,HYDROCORTISONE 10 MG ORAL TAB,23.0,16.1,,,0
CDM,50863,HYDROCORTISONE 100 MG SOLUTION FOR INJECTION,74.0,51.8,,,0
CDM,50863,HYDROCORTISONE 100 MG/60 ML RECT ENEM,126.0,88.2,,,0
CDM,50863,HYDROCORTISONE 2 MG/ML SUSPENSION,7.0,4.9,,,0
CDM,50863,HYDROCORTISONE 20 MG ORAL TAB,16.0,11.2,,,0
CDM,50863,HYDROCORTISONE 5 MG ORAL TAB,10.5,7.35,,,0
CDM,50863,HYDROCORTISONE ACETATE 25 MG RECT SUPP,88.5,61.95,,,0
CDM,50863,HYDROCORTISONE SOD SUCC (PF) 100 MG/2 ML INJ SOLR,260.5,182.35000000000002,,,0
CDM,50863,HYDROCORTISONE-ACETIC ACID 1 %-2 % EAR DROPS,813.0,569.1,,,0
CDM,50863,HYDROCORTISONE-PRAMOXINE 1 %-1 % RECTAL FOAM,840.0,588.0,,,0
CDM,50863,HYDROCORTISONE-PRAMOXINE 1 %-1 % TOPICAL FOAM,412.0,288.4,,,0
CDM,50863,HYDROCORTISONE-PRAMOXINE 2.5 %-1 % RECTAL CREAM,806.0,564.2,,,0
CDM,50863,HYDROMORPHONE  1 MG/ML INJ SYRG,43.5,30.45,,,0
CDM,50863,HYDROMORPHONE  2 MG ORAL TAB,10.0,7.0,,,0
CDM,50863,HYDROMORPHONE  4 MG ORAL TAB,9.0,6.3,,,0
CDM,50863,HYDROMORPHONE  8 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,HYDROMORPHONE (PF) 1 MG/ML INJ SOLN,16.0,11.2,,,0
CDM,50863,HYDROMORPHONE (PF) 1 MG/ML IV SOLN (PHS ERX MERGE),36.0,25.2,,,0
CDM,50863,HYDROMORPHONE (PF) 10 MG/ML INJ SOLN,111.0,77.7,,,0
CDM,50863,HYDROMORPHONE (PF) 2 MG/ML IV SOLN (PRMC ERX MERGE),41.0,28.7,,,0
CDM,50863,HYDROMORPHONE (PF)-0.9 % NACL 0.2 MG/ML IV SOLN BAG (FOR VENT),72.0,50.4,,,0
CDM,50863,HYDROMORPHONE 0.5 MG/0.5 ML INJ SYRG (PHS ERX MERGE),41.0,28.700000000000003,,,0
CDM,50863,HYDROMORPHONE 10 MG/50 ML (0.2MG/ML) PCA IN NS (MERGE),144.0,100.8,,,0
CDM,50863,HYDROPHILLIC OINTMENT (AQUAPHOR),62.0,43.4,,,0
CDM,50863,HYDROXOCOBALAMIN 5 GRAM IV SOLR,2755.0,1928.5,,,0
CDM,50863,HYDROXYCHLOROQUINE 200 MG ORAL TAB,23.0,16.1,,,0
CDM,50863,HYDROXYUREA  500 MG ORAL CAP,25.0,17.5,,,0
CDM,50863,HYDROXYZINE 10 MG TAB,7.5,5.25,,,0
CDM,50863,HYDROXYZINE 10 MG/5 ML SYRUP,36.0,25.2,,,0
CDM,50863,HYDROXYZINE 25 MG TAB,7.5,5.25,,,0
CDM,50863,HYDROXYZINE 50 MG TAB,7.5,5.25,,,0
CDM,50863,HYDROXYZINE 50 MG/ML IM,174.0,121.8,,,0
CDM,50863,HYDROXYZINE PAMOATE  25 MG ORAL CAP,5.5,3.85,,,0
CDM,50863,HYDROXYZINE PAMOATE  50 MG ORAL CAP,5.5,3.85,,,0
CDM,50863,HYOSCYAMINE 0.125 MG SUBLINGUAL TAB,7.0,4.9,,,0
CDM,50863,"HYOSCYAMINE 0.125 MG TAB, RAPID DISSOLVE",8.5,5.95,,,0
CDM,50863,HYOSCYAMINE 0.5 MG/ML INJECTION,350.5,245.35,,,0
CDM,50863,HYOSCYAMINE SULFATE 0.375 MG ORAL TB12,9.0,6.3,,,0
CDM,50863,IBANDRONATE 3 MG/3 ML IV SYKT,1162.0,813.4,,,0
CDM,50863,IBUPROFEN 100 MG ORAL CHEW,7.0,4.9,,,0
CDM,50863,IBUPROFEN 100 MG/5 ML ORAL SUSP,20.5,14.35,,,0
CDM,50863,IBUPROFEN 200 MG ORAL TAB,7.5,5.25,,,0
CDM,50863,IBUPROFEN 400 MG ORAL TAB,10.5,7.3500000000000005,,,0
CDM,50863,IBUPROFEN 600 MG ORAL TAB,13.0,9.1,,,0
CDM,50863,IBUPROFEN 800 MG ORAL TAB,20.0,14.0,,,0
CDM,50863,IBUPROFEN LYSINE (PF) 20 MG/2 ML IV SOLN,1235.0,864.5,,,0
CDM,50863,IBUTILIDE FUMARATE 0.1 MG/ML IV SOLN,1100.0,770.0,,,0
CDM,50863,ICATIBANT 30 MG/3 ML SUBQ SYRG,29229.0,20460.3,,,0
CDM,50863,IDARUBICIN 1 MG/ML IV SOLN,729.0,510.3,,,0
CDM,50863,IFOSFAMIDE 1 GRAM IV SOLR,432.0,302.4,,,0
CDM,50863,IFOSFAMIDE 3 GRAM IV SOLR,930.0,651.0,,,0
CDM,50863,IMATINIB 100 MG ORAL TAB,110.0,77.0,,,0
CDM,50863,IMIPENEM-CILASTATIN 500 MG IV SOLR,248.5,173.95,,,0
CDM,50863,IMIPENEM-CILASTATIN-RELEBACTAM 1.25 G IV SOLR,1120.0,784.0,,,0
CDM,50863,IMIPRAMINE 10 MG TAB,7.0,4.9,,,0
CDM,50863,IMIPRAMINE 25 MG TAB,4.0,2.8,,,0
CDM,50863,IMIPRAMINE 50 MG TAB,11.5,8.05,,,0
CDM,50863,IMIPRAMINE PAMOATE 100 MG ORAL CAP,83.0,58.1,,,0
CDM,50863,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 1 GRAM/10 ML (10 %) INJ SOLN",1329.0,930.3,,,0
CDM,50863,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 10 GRAM/100 ML (10%) INJ SOLN",11316.0,7921.2,,,0
CDM,50863,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 2.5 GRAM/25 ML (10 %) INJ SOLN",1361.5,953.05,,,0
CDM,50863,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 20 GRAM/200 ML (10%) INJ SOLN",10608.0,7425.6,,,0
CDM,50863,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 40 GRAM/400 ML (10 %) INJ SOLN",9194.0,6435.799999999999,,,0
CDM,50863,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 5 GRAM/50 ML (10 %) INJ SOLN",8487.0,5940.9,,,0
CDM,50863,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 5 GRAM/50 ML (10 %) INJ SOLN (NEW TX NON-NEURO INDICATION)",2829.0,1980.3,,,0
CDM,50863,INCLISIRAN 284 MG/1.5 ML SUBQ SYRG,8970.0,6279.0,,,0
CDM,50863,INDAPAMIDE 2.5 MG ORAL TAB,8.0,5.6,,,0
CDM,50863,INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) IV SOLN,581.0,406.7,,,0
CDM,50863,INDIGOTINDISULFONATE SODIUM 8 MG/ML INJ SOLN,98.5,68.95,,,0
CDM,50863,INDOCYANINE GREEN 25 MG INJ,716.0,501.2,,,0
CDM,50863,INDOMETHACIN 100 MG RECT SUPP,677.0,473.90000000000003,,,0
CDM,50863,INDOMETHACIN 25 MG ORAL CAP,5.5,3.85,,,0
CDM,50863,INDOMETHACIN 50 MG ORAL CAP,7.0,4.9,,,0
CDM,50863,INDOMETHACIN 50 MG RECT SUPP,1998.0,1398.6,,,0
CDM,50863,INEBILIZUMAB-CDON 10 MG/ML IV SOLN,540888.5,378621.95,,,0
CDM,50863,INFLIXIMAB 100 MG IV SOLR,10637.0,7445.9,,,0
CDM,50863,INFLIXIMAB-ABDA 100 MG IV SOLR,10397.0,7277.9,,,0
CDM,50863,INFLIXIMAB-AXXQ 100 MG IV SOLR,8418.0,5892.6,,,0
CDM,50863,INFLIXIMAB-DYYB 100 MG IV SOLR,8750.0,6125.0,,,0
CDM,50863,INOTUZUMAB OZOGAMICIN 0.9 MG (0.25 MG/ML INITIAL) IV SOLR,28057.5,19640.25,,,0
CDM,50863,INSULIN ASP PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBQ SOLN,23.0,16.1,,,0
CDM,50863,INSULIN DEGLUDEC 100 UNITS/ML SUBQ SOLN,29.0,20.3,,,0
CDM,50863,INSULIN DETEMIR 100 UNIT/ML SUBQ SOLN,18.0,12.6,,,0
CDM,50863,INSULIN GLARGINE 100 UNIT/ML SUBQ SOLN,23.5,16.450000000000003,,,0
CDM,50863,INSULIN GLARGINE 100 UNIT/ML SUBQ SOLN (LANTUS/SEMGLEE) (MERGE),22.0,15.4,,,0
CDM,50863,INSULIN INFUSION PEDS IV SYRINGE (FROM PREMIX),103.0,72.1,,,0
CDM,50863,INSULIN LISPRO 100 UNIT/ML (PEDS CALCLUATOR 0.5),28.0,19.6,,,0
CDM,50863,INSULIN LISPRO 100 UNIT/ML SUBQ SOLN (HUMALOG/ADMELOG),23.0,16.1,,,0
CDM,50863,INSULIN LISPRO PROTAM & LISPRO 100 UNIT/ML (75-25) SUBQ SUSP,16.0,11.2,,,0
CDM,50863,INSULIN NPH & REGULAR HUMAN 100 UNIT/ML (70-30) SUBQ SUSP,17.0,11.899999999999999,,,0
CDM,50863,INSULIN NPH HUMAN RECOMB 100 UNIT/ML SUBQ SUSP,19.0,13.3,,,0
CDM,50863,INSULIN PUMP LISPRO (PATIENT OWN PUMP PHS SUPPLIED),177.0,123.89999999999999,,,0
CDM,50863,INSULIN REGULAR HUM U-500 CONC 500 UNIT/ML INJ SOLN,32.0,22.4,,,0
CDM,50863,INSULIN REGULAR HUMAN 100 UNIT/ML INJ SOLN,137.0,95.9,,,0
CDM,50863,INSULIN REGULAR IN 0.9% NACL 100 UNIT/100 ML (1 UNIT/ML) INFUSION FOR OB,308.5,215.95,,,0
CDM,50863,IODINE STRONG (LUGOLS) 5 % ORAL SOLN,136.0,95.2,,,0
CDM,50863,IOHEXOL   9 MG IODINE/ML ORAL SOLN,83.0,58.1,,,0
CDM,50863,IOPAMIDOL 61 % IV SOLN,269.0,188.3,,,0
CDM,50863,IPILIMUMAB 50 MG/10 ML (5 MG/ML) IV SOLN,44585.5,31209.85,,,0
CDM,50863,IPRATROPIUM BROMIDE 0.02 % INHL SOLN,11.0,7.7,,,0
CDM,50863,IPRATROPIUM BROMIDE 0.03 % NASL SPRA,313.0,219.1,,,0
CDM,50863,IPRATROPIUM BROMIDE 17 MCG/ACTUATION INHL AERO,21.0,14.7,,,0
CDM,50863,IPRATROPIUM-ALBUTEROL 0.5 MG-2.5 MG/3 ML NEB SOLUTION,130.0,91.0,,,0
CDM,50863,IPRATROPIUM-ALBUTEROL 20-100 MCG/ACTUATION INHL MIST,1371.5,960.05,,,0
CDM,50863,IRBESARTAN  75 MG ORAL TAB,17.0,11.9,,,0
CDM,50863,IRBESARTAN 150 MG ORAL TAB,22.0,15.399999999999999,,,0
CDM,50863,IRBESARTAN 300 MG ORAL TAB,16.0,11.2,,,0
CDM,50863,IRINOTECAN 100 MG/5 ML IV SOLN,353.0,247.1,,,0
CDM,50863,IRON DEXTRAN 50 MG/ML INJ SOLN,1586.5,1110.5500000000002,,,0
CDM,50863,IRON SUCROSE 100 MG/5 ML IV SOLN,312.0,218.4,,,0
CDM,50863,IRON SUCROSE 200 MG/10 ML IRON IV SOLN,545.0,381.5,,,0
CDM,50863,ISAVUCONAZONIUM SULFATE 186 MG ORAL CAP,820.0,574.0,,,0
CDM,50863,ISONIAZID 300 MG ORAL TAB,15.0,10.5,,,0
CDM,50863,ISONIAZID 50 MG/5 ML ORAL SYRP,106.0,74.2,,,0
CDM,50863,ISOPROTERENOL 0.2 MG/ML INJECTION,864.0,604.8,,,0
CDM,50863,ISOSORBIDE DINITRATE  5 MG ORAL TAB,9.5,6.65,,,0
CDM,50863,ISOSORBIDE DINITRATE 10 MG ORAL TAB,11.0,7.699999999999999,,,0
CDM,50863,ISOSORBIDE DINITRATE 20 MG ORAL TAB,10.0,7.0,,,0
CDM,50863,ISOSORBIDE DINITRATE 40 MG ORAL TAB,16.0,11.2,,,0
CDM,50863,ISOSORBIDE MONONITRATE  20 MG ORAL TAB,9.5,6.65,,,0
CDM,50863,ISOSORBIDE MONONITRATE  30 MG ORAL TB24,16.5,11.55,,,0
CDM,50863,ISOSORBIDE MONONITRATE  60 MG ORAL TB24,23.5,16.450000000000003,,,0
CDM,50863,ISOSORBIDE MONONITRATE 120 MG ORAL TB24,31.0,21.7,,,0
CDM,50863,ISOSULFAN BLUE 1 % INJ SOLN,1370.0,959.0,,,0
CDM,50863,ISRADIPINE  2.5 MG ORAL CAP,16.0,11.2,,,0
CDM,50863,ITRACONAZOLE 10 MG/ML ORAL SOLN,61.0,42.7,,,0
CDM,50863,ITRACONAZOLE 100 MG ORAL CAP,45.0,31.5,,,0
CDM,50863,IV EPINEPHRINE 0.1 MG/ML SYRINGE (NEO-CODE IV),57.0,39.9,,,0
CDM,50863,IVABRADINE 5 MG ORAL TAB,54.0,37.8,,,0
CDM,50863,IVABRADINE 5 MG/5 ML ORAL SOLN,46.0,32.2,,,0
CDM,50863,IVABRADINE 7.5 MG ORAL TAB,85.0,59.5,,,0
CDM,50863,IVERMECTIN 3 MG ORAL TAB,134.0,93.80000000000001,,,0
CDM,50863,K PHOS DI & MONO-SOD PHOS MONO 250 MG ORAL TAB,10.5,7.35,,,0
CDM,50863,KETAMINE  50 MG/ML INJ SOLN,112.0,78.4,,,0
CDM,50863,KETAMINE 100 MG/ML INJ SOLN,35.0,24.5,,,0
CDM,50863,KETAMINE 2 MG/ML IN NS 50ML INFUSION (STOCK DOSE),79.5,55.650000000000006,,,0
CDM,50863,KETAMINE 50 MG/5ML (10 MG/ML) SYRINGE (PHS MERGE),54.5,38.15,,,0
CDM,50863,KETAMINE 50MG/5ML (10MG/ML) ORAL SOLUTION (REPACK),27.0,18.9,,,0
CDM,50863,KETAMINE IN 0.9 % SOD CHLORIDE 100 MG/10 ML (10 MG/ML) IV SYRG,143.5,100.44999999999999,,,0
CDM,50863,"KETAMINE IN NACL, 10 MG/ML IV SOLN (PHS MERGE RECORD)",147.0,102.9,,,0
CDM,50863,KETAMINE INFUSION 2MG/ML 100ML (FOR ANESTHESIA USE ONLY),39.0,27.3,,,0
CDM,50863,KETOCONAZOLE 2 % TOP CREA,473.0,331.1,,,0
CDM,50863,KETOCONAZOLE 2 % TOP SHAM,148.0,103.6,,,0
CDM,50863,KETOCONAZOLE 200 MG ORAL TAB,42.0,29.4,,,0
CDM,50863,KETOROLAC TROMETHAMINE 0.5 % OPHT DROP,380.0,266.0,,,0
CDM,50863,KETOROLAC TROMETHAMINE 15 MG/ML INJ SOLN,22.5,15.75,,,0
CDM,50863,KETOROLAC TROMETHAMINE 30 MG/ML INJ SOLN,24.5,17.15,,,0
CDM,50863,KETOROLAC TROMETHAMINE 60 MG/2 ML IM SOLN,12.0,8.399999999999999,,,0
CDM,50863,L. ACIDOPHILUS-B. LACTIS-FOS 5 BILLION CELL ORAL PWPK,7.5,5.25,,,0
CDM,50863,L. ACIDOPHILUS-B. LACTIS-FOS 5 BILLION CELL ORAL PWPK (NEONATAL),7.0,4.9,,,0
CDM,50863,LABETALOL (5 MG/ML) IV SYRG (CONTAINS PRESERVATIVE),54.0,37.8,,,0
CDM,50863,LABETALOL (5 MG/ML) IV SYRG PF,37.0,25.9,,,0
CDM,50863,LABETALOL 100 MG ORAL TAB,9.5,6.65,,,0
CDM,50863,LABETALOL 200 MG ORAL TAB,9.0,6.3,,,0
CDM,50863,LABETALOL 300 MG ORAL TAB,10.0,7.0,,,0
CDM,50863,LABETALOL 5 MG/ML IV SOLN,46.0,32.2,,,0
CDM,50863,LACOSAMIDE  50 MG ORAL TAB,70.5,49.35,,,0
CDM,50863,LACOSAMIDE 10 MG/ML ORAL SOLUTION (REPACK),91.5,64.05,,,0
CDM,50863,LACOSAMIDE 200 MG ORAL TAB,22.0,15.4,,,0
CDM,50863,LACOSAMIDE 200 MG/20 ML IV SOLN,317.0,221.9,,,0
CDM,50863,LACTASE 3000 UNIT ORAL TAB,7.0,4.9,,,0
CDM,50863,LACTATED RINGERS IRRIGATION SOLN,200.0,140.0,,,0
CDM,50863,LACTATED RINGERS IV,191.5,134.05,,,0
CDM,50863,LACTATED RINGERS IV (BOLUS),43.0,30.1,,,0
CDM,50863,LACTOBACILLUS ACIDOPH-PECTIN 75 MILLION CELL -100 MG ORAL CAP,7.0,4.9,,,0
CDM,50863,LACTOBACILLUS ACIDOPHILUS 500 MILLION CELLS ORAL CAP,5.5,3.85,,,0
CDM,50863,LACTULOSE 10 GRAM/15 ML ORAL SOLN,19.0,13.3,,,0
CDM,50863,LACTULOSE 20 GRAM/30 ML ORAL SOLN,23.0,16.1,,,0
CDM,50863,LACTULOSE ENEMA 200G IN SW (1000 ML TOTAL VOLUME),48.0,33.6,,,0
CDM,50863,LAMIVUDINE 10 MG/ML ORAL SOLN,58.0,40.6,,,0
CDM,50863,LAMIVUDINE 150 MG ORAL TAB,70.0,49.0,,,0
CDM,50863,LAMIVUDINE-ZIDOVUDINE 150 MG-300 MG TAB,72.0,50.4,,,0
CDM,50863,LAMOTRIGINE  25 MG ORAL TAB,14.0,9.8,,,0
CDM,50863,LAMOTRIGINE 100 MG ORAL TAB,5.5,3.85,,,0
CDM,50863,LAMOTRIGINE 1MG/ML SUSPENSION (REPACK),13.0,9.1,,,0
CDM,50863,LANOLIN OINTMENT (MODIFIED),14.0,9.8,,,0
CDM,50863,LANREOTIDE 120 MG/0.5 ML SUBQ SYRG,25468.0,17827.6,,,0
CDM,50863,LANREOTIDE 90 MG/0.3 ML SUBQ SYRG,22379.0,15665.3,,,0
CDM,50863,LANSOPRAZOLE 15 MG ORAL TBLD,78.0,54.6,,,0
CDM,50863,LANSOPRAZOLE 3 MG/ML ORAL SUSR,14.5,10.15,,,0
CDM,50863,LANSOPRAZOLE 30 MG ORAL TBLD,80.0,56.0,,,0
CDM,50863,LANTHANUM  500 MG ORAL CHEW,102.5,71.75,,,0
CDM,50863,LATANOPROST 0.005 % OPHT DROP,403.0,282.1,,,0
CDM,50863,LECANEMAB-IRMB 100 MG/ML IV SOLN,2491.0,1743.7,,,0
CDM,50863,LEFLUNOMIDE  10 MG ORAL TAB,22.0,15.4,,,0
CDM,50863,LEFLUNOMIDE  20 MG ORAL TAB,63.5,44.45,,,0
CDM,50863,LET TOPICAL GEL 3 ML,56.0,39.2,,,0
CDM,50863,LET TOPICAL SOLUTION 4ML (REPACK),92.0,64.4,,,0
CDM,50863,LETROZOLE 2.5 MG ORAL TAB,133.0,93.1,,,0
CDM,50863,LEUCOVORIN 1 MG/ML INJECTION (PEDS ONCOLOGY),37.0,25.9,,,0
CDM,50863,LEUCOVORIN CALCIUM   5 MG ORAL TAB,28.0,19.6,,,0
CDM,50863,LEUCOVORIN CALCIUM  25 MG ORAL TAB,55.0,38.5,,,0
CDM,50863,LEUCOVORIN CALCIUM  50 MG INJ SOLR,45.5,31.85,,,0
CDM,50863,LEUCOVORIN CALCIUM 100 MG INJ SOLR,105.5,73.85,,,0
CDM,50863,LEUCOVORIN CALCIUM 200 MG INJ SOLR,134.0,93.8,,,0
CDM,50863,LEUCOVORIN CALCIUM 350 MG INJ SOLR,207.5,145.25,,,0
CDM,50863,LEUPROLIDE  7.5 MG IM SYKT,1176.0,823.2,,,0
CDM,50863,LEUPROLIDE  7.5 MG SUBQ SYRG,1176.0,823.2,,,0
CDM,50863,LEUPROLIDE (3 MONTH) 11.25 MG IM KIT,14559.0,10191.3,,,0
CDM,50863,LEUPROLIDE (3 MONTH) 22.5 MG IM SYRG,1176.0,823.2,,,0
CDM,50863,LEUPROLIDE (4-MONTH) 30 MG SUBQ SYRG,1176.0,823.2,,,0
CDM,50863,LEUPROLIDE (6 MONTH) 45 MG IM SYKT,1176.0,823.2,,,0
CDM,50863,LEUPROLIDE (6 MONTH) 45 MG SUBCUTANOUS KIT,1176.0,823.2,,,0
CDM,50863,LEUPROLIDE (PEDIATRIC 3 MONTH) 30 MG IM SYKT,35020.0,24514.0,,,0
CDM,50863,LEUPROLIDE (PEDIATRIC 6 MONTH) 45 MG IM SYKT,71748.0,50223.6,,,0
CDM,50863,LEUPROLIDE (PEDIATRIC 6 MONTH) 45 MG SUBQ SYRG,75743.0,53020.1,,,0
CDM,50863,LEUPROLIDE 1 MG/0.2 ML SUBQ KIT,76.5,53.55,,,0
CDM,50863,LEUPROLIDE 22.5 MG SUBQ SYRG,1176.0,823.2,,,0
CDM,50863,LEVALBUTEROL 1.25 MG/3 ML NEB SOLUTION,36.0,25.2,,,0
CDM,50863,LEVETIRACETAM  250 MG ORAL TAB,5.5,3.85,,,0
CDM,50863,LEVETIRACETAM  500 MG ORAL TAB,14.0,9.8,,,0
CDM,50863,LEVETIRACETAM  750 MG ORAL TAB,12.5,8.75,,,0
CDM,50863,LEVETIRACETAM 100 MG/ML ORAL SOLN,20.5,14.350000000000001,,,0
CDM,50863,LEVETIRACETAM 500 MG/5 ML IV SOLN,102.5,71.75,,,0
CDM,50863,LEVETIRACETAM 500 MG/5 ML ORAL SOLN,55.0,38.5,,,0
CDM,50863,LEVETIRACETAM IN NACL (ISO-OS) 1000 MG/100 ML IV PGBK,129.0,90.30000000000001,,,0
CDM,50863,LEVETIRACETAM IN NACL (ISO-OS) 1500 MG/100 ML IV PGBK,178.0,124.6,,,0
CDM,50863,LEVETIRACETAM IN NACL (ISO-OS) 500 MG/100 ML IV PGBK,165.0,115.5,,,0
CDM,50863,LEVETIRACETAM NEO IV SYRINGE (PHS FROM PREMIX),26.0,18.2,,,0
CDM,50863,LEVETIRACETAM PEDS IVPB (FROM PREMIX),109.0,76.3,,,0
CDM,50863,LEVOCARNITINE (WITH SUCROSE) 100 MG/ML ORAL SOLN,17.5,12.25,,,0
CDM,50863,LEVOCARNITINE 200 MG/ML IV SOLN,324.0,226.79999999999998,,,0
CDM,50863,LEVOCARNITINE 330 MG ORAL TAB,19.0,13.3,,,0
CDM,50863,LEVOFLOXACIN 250 MG/10 ML ORAL SOLN,271.5,190.05,,,0
CDM,50863,LEVOFLOXACIN 500 MG ORAL TAB,83.0,58.1,,,0
CDM,50863,LEVOFLOXACIN 750 MG ORAL TAB,217.5,152.25,,,0
CDM,50863,LEVOFLOXACIN IN D5W 500 MG/100 ML IV PGBK,41.0,28.7,,,0
CDM,50863,LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK,71.0,49.7,,,0
CDM,50863,LEVONORGESTREL 1.5 MG ORAL TAB,165.0,115.5,,,0
CDM,50863,LEVONORGESTREL 17.5 MCG/24 HR (5 YEARS) IU IUD,2509.0,1756.3,,,0
CDM,50863,LEVONORGESTREL 20 MCG/24 HR IU IUD,2369.0,1658.3,,,0
CDM,50863,LEVOTHYROXINE  50 MCG ORAL TAB,11.5,8.05,,,0
CDM,50863,LEVOTHYROXINE  75 MCG ORAL TAB,8.5,5.949999999999999,,,0
CDM,50863,LEVOTHYROXINE  88 MCG ORAL TAB,8.5,5.949999999999999,,,0
CDM,50863,LEVOTHYROXINE 100 MCG IV SOLR,433.0,303.1,,,0
CDM,50863,LEVOTHYROXINE 100 MCG ORAL TAB,9.0,6.3,,,0
CDM,50863,LEVOTHYROXINE 112 MCG ORAL TAB,8.0,5.6,,,0
CDM,50863,LEVOTHYROXINE 125 MCG ORAL TAB,8.0,5.6,,,0
CDM,50863,LEVOTHYROXINE 150 MCG ORAL TAB,7.5,5.25,,,0
CDM,50863,LEVOTHYROXINE 175 MCG ORAL TAB,7.0,4.9,,,0
CDM,50863,LEVOTHYROXINE 20 MCG/ML IV SYRINGE (PEDIATRIC),80.0,56.0,,,0
CDM,50863,LEVOTHYROXINE 200 MCG INJ SOLR,934.0,653.8,,,0
CDM,50863,LEVOTHYROXINE 200 MCG ORAL TAB,7.0,4.9,,,0
CDM,50863,LEVOTHYROXINE 25 MCG ORAL TAB,13.5,9.45,,,0
CDM,50863,LEVOTHYROXINE 300 MCG ORAL TAB,5.5,3.85,,,0
CDM,50863,LEVOTHYROXINE 500 MCG INJ SOLR,1458.0,1020.6,,,0
CDM,50863,LEVOXYL 25 MCG ORAL TAB (FOR NEONATAL PATIENTS),7.5,5.25,,,0
CDM,50863,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,67.5,47.25,,,0
CDM,50863,LIDOCAINE (PF) 15 MG/ML (1.5 %) INJ SOLN,30.0,21.0,,,0
CDM,50863,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,79.5,55.65,,,0
CDM,50863,LIDOCAINE (PF) 20 MG/ML (2 %) IV SYRG,129.0,90.30000000000001,,,0
CDM,50863,LIDOCAINE (PF) 40 MG/ML (4 %) INJ SOLN (FOR NEBULIZATION),26.0,18.2,,,0
CDM,50863,LIDOCAINE (PF) 5 MG/ML (0.5 %) INJ SOLN,32.0,22.4,,,0
CDM,50863,LIDOCAINE 1% (BUFFERED W/NAHCO3 8.4%) 10 ML SYRINGE (MERGE),233.0,163.1,,,0
CDM,50863,LIDOCAINE 1% 10MG/ML (1ML-UD) OR SYRINGE,10.0,7.0,,,0
CDM,50863,LIDOCAINE 1%/EPINEPHRINE 1:200K INJECTION (PF),31.5,22.049999999999997,,,0
CDM,50863,LIDOCAINE 10 MG/ML (1 %) INJECTION,23.0,16.1,,,0
CDM,50863,LIDOCAINE 2 % MUCOSAL GEL,77.0,53.9,,,0
CDM,50863,LIDOCAINE 2 % MUCOSAL SOLN (VISCOUS),26.0,18.2,,,0
CDM,50863,LIDOCAINE 2%/EPINEPHRINE 1:200K INJECTION (PF),100.0,70.0,,,0
CDM,50863,LIDOCAINE 20 MG/ML (2 %) INJECTION,26.5,18.549999999999997,,,0
CDM,50863,LIDOCAINE 4 % MUCOSAL TOPICAL SOLN,36.0,25.2,,,0
CDM,50863,LIDOCAINE 4 % TOP CREA,47.0,32.9,,,0
CDM,50863,LIDOCAINE 4 % TOPICAL SOLN,701.0,490.7,,,0
CDM,50863,LIDOCAINE 4% TOP PATCH,29.0,20.3,,,0
CDM,50863,LIDOCAINE 5 % TOP OINT,887.5,621.25,,,0
CDM,50863,LIDOCAINE 5 MG/ML (0.5 %) INJECTION,16.0,11.2,,,0
CDM,50863,LIDOCAINE HCL  2 % MM JELP,72.5,50.75,,,0
CDM,50863,LIDOCAINE IN D5W (PF) 4 MG/ML (0.4 %) IV SOLP,45.0,31.5,,,0
CDM,50863,LIDOCAINE IN D7.5W (PF) 50 MG/ML (5 %) IT SOLN,55.0,38.5,,,0
CDM,50863,LIDOCAINE-DIPHENHYD-AL-MAG-SIM 200-25-400-40 MG/30 ML MM MWSH,36.0,25.2,,,0
CDM,50863,LIDOCAINE-EPINEPHR-TETRACAINE 4-0.18-0.5 % TOPICAL GEL,45.0,31.5,,,0
CDM,50863,"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN",27.5,19.25,,,0
CDM,50863,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN",32.0,22.4,,,0
CDM,50863,"LIDOCAINE-EPINEPHRINE 1 %-1:200,000 INJ SOLN",85.5,59.85,,,0
CDM,50863,"LIDOCAINE-EPINEPHRINE 1.5 %-1:200,000 INJ SOLN",105.0,73.5,,,0
CDM,50863,"LIDOCAINE-EPINEPHRINE 2 %-1:200,000 INJ SOLN",49.0,34.3,,,0
CDM,50863,"LIDOCAINE-EPINEPHRINE BIT 2 %-1:100,000 INJ CRTG",8.0,5.6,,,0
CDM,50863,LIDOCAINE-PHENYLEPHRINE 4%-0.25% NASAL SPRAY,38.0,26.6,,,0
CDM,50863,LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,51.0,35.7,,,0
CDM,50863,LINACLOTIDE  72 MCG ORAL CAP,112.0,78.4,,,0
CDM,50863,LINACLOTIDE 145 MCG ORAL CAP,112.0,78.4,,,0
CDM,50863,LINEZOLID 100 MG/5 ML ORAL SUSR,377.0,263.9,,,0
CDM,50863,LINEZOLID 600 MG ORAL TAB,1690.0,1183.0,,,0
CDM,50863,LINEZOLID 600 MG/300 ML IV SOLP,194.0,135.8,,,0
CDM,50863,LINEZOLID NEO IV SYRINGE (CDS MIXTURE),121.5,85.05000000000001,,,0
CDM,50863,LIOTHYRONINE  5 MCG ORAL TAB,14.5,10.15,,,0
CDM,50863,LIOTHYRONINE 10 MCG/ML IV SOLN,1825.0,1277.5,,,0
CDM,50863,LIOTHYRONINE 25 MCG ORAL TAB,10.0,7.0,,,0
CDM,50863,"LIPASE-PROTEASE-AMYLASE (PORK) 3,000-9,500- 15,000 UNIT ORAL CPDR",12.0,8.4,,,0
CDM,50863,"LIPASE-PROTEASE-AMYLASE (PORK) 36,000-114,000- 180,000 UNIT ORAL CPDR",149.5,104.65,,,0
CDM,50863,"LIPASE-PROTEASE-AMYLASE 12,000-38,000- 60,000 UNIT ORAL CAP, DELAY REL",66.0,46.2,,,0
CDM,50863,"LIPASE-PROTEASE-AMYLASE 24,000-76,000- 120,000 UNIT ORAL CAP, DELAY REL",145.0,101.5,,,0
CDM,50863,"LIPASE-PROTEASE-AMYLASE 5,000-17,000- 24,000 UNIT ORAL CPDR",28.0,19.6,,,0
CDM,50863,LIRAGLUTIDE 0.6 MG/0.1 ML (18 MG/3 ML) SUBQ PNIJ,1675.5,1172.85,,,0
CDM,50863,LISINOPRIL  2.5 MG ORAL TAB,7.5,5.25,,,0
CDM,50863,LISINOPRIL  5 MG ORAL TAB,16.5,11.55,,,0
CDM,50863,LISINOPRIL 10 MG ORAL TAB,11.5,8.05,,,0
CDM,50863,LISINOPRIL 20 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,LITHIUM CARBONATE 150 MG ORAL CAP,5.5,3.85,,,0
CDM,50863,LITHIUM CARBONATE 300 MG ORAL CAP,7.0,4.9,,,0
CDM,50863,LITHIUM CARBONATE 300 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,LITHIUM CARBONATE 300 MG ORAL TBSR,7.5,5.25,,,0
CDM,50863,LITHIUM CARBONATE 450 MG ORAL TBSR,8.0,5.6,,,0
CDM,50863,LONCASTUXIMAB TESIRINE-LPYL 10 MG IV SOLR,87367.0,61156.9,,,0
CDM,50863,LOPERAMIDE 1 MG/7.5 ML ORAL LIQD,25.0,17.5,,,0
CDM,50863,LOPERAMIDE 2 MG ORAL CAP,23.0,16.1,,,0
CDM,50863,LORATADINE 10 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,LORATADINE 5 MG/5 ML ORAL SOLN,7.0,4.9,,,0
CDM,50863,LORAZEPAM 0.25 MG/0.5 ML (0.5 MG/1 ML) ORAL SUSPENSION (REPACK),11.0,7.7,,,0
CDM,50863,LORAZEPAM 0.5 MG ORAL TAB,11.0,7.7,,,0
CDM,50863,LORAZEPAM 1 MG ORAL TAB,9.0,6.3,,,0
CDM,50863,LORAZEPAM 2 MG ORAL TAB,8.0,5.6,,,0
CDM,50863,LORAZEPAM 2 MG/ML INJ SOLN,23.0,16.1,,,0
CDM,50863,LORAZEPAM 2 MG/ML IV SOLN (PHS MERGE - ALL SITES),26.0,18.2,,,0
CDM,50863,LORAZEPAM 2 MG/ML IV SOLN (PRMC ERX MERGE),12.0,8.4,,,0
CDM,50863,LORAZEPAM 2 MG/ML ORAL CONC,9.0,6.3,,,0
CDM,50863,LORAZEPAM NEONATAL INJECTION 0.2 MG/0.5 ML,69.0,48.3,,,0
CDM,50863,LOSARTAN  25 MG ORAL TAB,19.5,13.65,,,0
CDM,50863,LOSARTAN  50 MG ORAL TAB,14.5,10.15,,,0
CDM,50863,LOSARTAN 100 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,LOVASTATIN 10 MG ORAL TAB,8.0,5.6,,,0
CDM,50863,LOVASTATIN 20 MG ORAL TAB,20.0,14.0,,,0
CDM,50863,LOXAPINE 25 MG CAP,11.0,7.7,,,0
CDM,50863,LOXAPINE 50 MG CAP,25.0,17.5,,,0
CDM,50863,LUBIPROSTONE  8 MCG ORAL CAP,67.5,47.25,,,0
CDM,50863,LUBIPROSTONE 24 MCG ORAL CAP,38.0,26.6,,,0
CDM,50863,LUMATEPERONE 42 MG ORAL CAP,291.0,203.7,,,0
CDM,50863,LUPRON 3.75MG IM KIT,4972.0,3480.4,,,0
CDM,50863,LURASIDONE  60 MG ORAL TAB,12.0,8.4,,,0
CDM,50863,LURASIDONE  80 MG ORAL TAB,241.0,168.7,,,0
CDM,50863,LURASIDONE 20 MG ORAL TAB,43.5,30.45,,,0
CDM,50863,LUSPATERCEPT-AAMT 75 MG SUBQ SOLR,21515.0,15060.5,,,0
CDM,50863,"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML IV",133041.0,93128.7,,,0
CDM,50863,MAGIC MOUTHWASH REPACK (BMX 1:1:1),33.5,23.45,,,0
CDM,50863,MAGNESIUM CITRATE ORAL SOLN,10.0,7.0,,,0
CDM,50863,MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSP,14.0,9.8,,,0
CDM,50863,MAGNESIUM OXIDE 400 MG ORAL TAB,7.5,5.25,,,0
CDM,50863,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IV PGBK,54.0,37.8,,,0
CDM,50863,MAGNESIUM SULFATE 20 GRAM/500 ML IV SOLP,39.5,27.65,,,0
CDM,50863,MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IV PGBK,25.0,17.5,,,0
CDM,50863,MAGNESIUM SULFATE 40 MG/ML IV SYRINGE,54.0,37.8,,,0
CDM,50863,MAGNESIUM SULFATE 50 % (4 MEQ/ML) INJ SOLN,53.5,37.45,,,0
CDM,50863,MAGNESIUM SULFATE IN D5W 1 GRAM/100 ML IV PGBK,86.0,60.2,,,0
CDM,50863,MANNITOL 20% IV SOLP,85.0,59.5,,,0
CDM,50863,MANNITOL 25 % IV SOLN,141.0,98.7,,,0
CDM,50863,"MEASLES,MUMPS&RUBELLA VACCIN(PF) 1,000-12,500 TCID50/0.5 ML SUB-Q SUSP",580.5,406.34999999999997,,,0
CDM,50863,"MEASLES,MUMPS,RUB,VARICEL (PF) 10EXP3-4.3-3-3.99TCID50/0.5ML SUB-Q",776.0,543.2,,,0
CDM,50863,"MEASLES,MUMPS,RUBELLA VACC(PF) 10EXP3.4-4.2- 3.3CCID50/0.5ML SUBQ SUSR",398.0,278.6,,,0
CDM,50863,MECLIZINE 12.5 MG ORAL TAB,8.0,5.6,,,0
CDM,50863,MECLIZINE 25 MG ORAL TAB,6.0,4.2,,,0
CDM,50863,MEDIUM CHAIN TRIGLYCERIDES OIL ORAL,7.0,4.9,,,0
CDM,50863,MEDROXYPROGESTERONE  2.5 MG ORAL TAB,10.5,7.3500000000000005,,,0
CDM,50863,MEDROXYPROGESTERONE  5 MG ORAL TAB,16.0,11.2,,,0
CDM,50863,MEDROXYPROGESTERONE (CONTRACEPTIVE) 150 MG/ML IM (MERGE),318.5,222.95,,,0
CDM,50863,MEDROXYPROGESTERONE (CONTRACEPTIVE) 150 MG/ML IM SUSP,216.0,151.2,,,0
CDM,50863,MEDROXYPROGESTERONE 10 MG ORAL TAB,10.0,7.0,,,0
CDM,50863,MEDROXYPROGESTERONE 150 MG/ML IM SYRG,147.0,102.9,,,0
CDM,50863,MEGESTROL 20 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,MEGESTROL 40 MG ORAL TAB,10.0,7.0,,,0
CDM,50863,MEGESTROL 400 MG/10 ML (10 ML) ORAL SUSP,26.0,18.200000000000003,,,0
CDM,50863,MELATONIN  1 MG/ML ORAL LIQD,9.5,6.65,,,0
CDM,50863,MELATONIN  3 MG ORAL TAB,8.5,5.949999999999999,,,0
CDM,50863,MELOXICAM  7.5 MG ORAL TAB,36.0,25.2,,,0
CDM,50863,MEMANTINE  5 MG ORAL TAB,10.0,7.0,,,0
CDM,50863,MEMANTINE 10 MG ORAL TAB,11.5,8.05,,,0
CDM,50863,"MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM KIT (CAM USE ONLY)",680.0,476.0,,,0
CDM,50863,"MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM SOLN",720.0,504.0,,,0
CDM,50863,"MENING VAC A,C,Y,W135,TET (PF) 10 MCG/0.5 ML IM SOLN",732.0,512.4,,,0
CDM,50863,"MENINGOCOCCAL B VACC,4-CMP(PF) 50-50-50-25 MCG/0.5 ML IM SYRG",839.0,587.3,,,0
CDM,50863,MENTHOL-ZINC OXIDE 0.44-20.625 % TOP OINT,34.0,23.8,,,0
CDM,50863,MENTHOLATUM CAMPHOR 9% -MENTHOL 1.3% OINTMENT,26.0,18.2,,,0
CDM,50863,MEPERIDINE (PF) 100 MG/ML IV SOLN (PHS MERGE),16.0,11.2,,,0
CDM,50863,MEPERIDINE (PF) 25 MG/ML IV SOLN (PHS MERGE),31.5,22.05,,,0
CDM,50863,MEPERIDINE (PF) 50 MG/ML IV SOLN (PHS MERGE),26.0,18.2,,,0
CDM,50863,MEPIVACAINE (PF) 10 MG/ML (1 %) INJ SOLN,62.0,43.400000000000006,,,0
CDM,50863,MEPIVACAINE (PF) 20 MG/ML (2 %) INJ SOLN,50.5,35.349999999999994,,,0
CDM,50863,MEPOLIZUMAB 100 MG SUBQ SOLR,14214.0,9949.8,,,0
CDM,50863,MERCAPTOPURINE 25 MG SPLIT TABLET,46.0,32.2,,,0
CDM,50863,MERCAPTOPURINE 50 MG ORAL TAB,46.0,32.2,,,0
CDM,50863,MEROPENEM 1 GRAM IV SOLR,236.0,165.2,,,0
CDM,50863,MEROPENEM 2000 MG IV SOLR,184.0,128.8,,,0
CDM,50863,MEROPENEM 500 MG IV SOLR,61.0,42.7,,,0
CDM,50863,MEROPENEM NEO/PED INFUSION (CDS MIXTURE),108.0,75.6,,,0
CDM,50863,MESALAMINE  250 MG ORAL CPSR,63.0,44.099999999999994,,,0
CDM,50863,MESALAMINE 1.2 G ORAL TBEC,50.0,35.0,,,0
CDM,50863,MESALAMINE 1000 MG RECT SUPP,216.0,151.2,,,0
CDM,50863,MESALAMINE 4 GRAM/60 ML RECT ENEM,119.0,83.3,,,0
CDM,50863,MESALAMINE 400 MG ORAL CAPSULE-WITH DR TABLETS (CDTI),82.0,57.4,,,0
CDM,50863,MESNA 100 MG/ML IV SOLN,165.0,115.5,,,0
CDM,50863,METFORMIN  500 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,METFORMIN  500 MG ORAL TB24,10.0,7.0,,,0
CDM,50863,METFORMIN  750 MG ORAL TB24,14.0,9.8,,,0
CDM,50863,METFORMIN  850 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,METHACHOLINE CHLORIDE STERILE INHALATION SOLUTION (PF) KIT,2865.0,2005.5,,,0
CDM,50863,METHADONE  5 MG ORAL TAB,16.5,11.55,,,0
CDM,50863,METHADONE 1 MG/1 ML ORAL SOLN,14.0,9.8,,,0
CDM,50863,METHADONE 10 MG ORAL TAB,30.5,21.35,,,0
CDM,50863,METHADONE 10 MG/ML INJ SOLN,41.0,28.7,,,0
CDM,50863,METHADONE 10 MG/ML ORAL CONC,62.0,43.4,,,0
CDM,50863,METHADONE 3 MG/ 3ML ORAL SOLUTION (PEDS),7.0,4.9,,,0
CDM,50863,METHENAMINE HIPPURATE 1 GRAM ORAL TAB,16.5,11.55,,,0
CDM,50863,METHIMAZOLE  5 MG ORAL TAB,8.0,5.6,,,0
CDM,50863,METHIMAZOLE 10 MG ORAL TAB,10.5,7.35,,,0
CDM,50863,METHOCARBAMOL 100 MG/ML INJ SOLN,53.0,37.1,,,0
CDM,50863,METHOCARBAMOL 500 MG ORAL TAB,19.0,13.3,,,0
CDM,50863,METHOCARBAMOL 750 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,METHOTREXATE (PF) 25 MG/ML INJ SOLN (FOR ECTOPIC PREGNANCY),42.0,29.4,,,0
CDM,50863,METHOTREXATE NA (PRESERV FREE) 25 MG/ML INJ SOLN,1207.5,845.25,,,0
CDM,50863,METHOTREXATE SODIUM 2.5 MG ORAL TAB,140.5,98.35,,,0
CDM,50863,METHOTREXATE SODIUM 25 MG/ML INJ SOLN,89.0,62.3,,,0
CDM,50863,METHOXSALEN 20 MCG/ML INJ SOLN,403.0,282.1,,,0
CDM,50863,METHYL SALICYLATE-MENTHOL 15 %-10 % TOPICAL CREAM,24.5,17.15,,,0
CDM,50863,METHYL SALICYLATE-MENTHOL 15-1 % TOPICAL CREAM,32.0,22.4,,,0
CDM,50863,METHYLENE BLUE (ANTIDOTE) 1 % INJ SOLN,164.0,114.8,,,0
CDM,50863,METHYLENE BLUE (ANTIDOTE) 5 MG/ML (0.5 %) IV SOLN,273.0,191.1,,,0
CDM,50863,METHYLERGONOVINE 0.2 MG ORAL TAB,286.0,200.2,,,0
CDM,50863,METHYLERGONOVINE 0.2 MG/ML (1 ML) INJ SOLN,207.0,144.9,,,0
CDM,50863,METHYLNALTREXONE 12 MG/0.6 ML SUBQ SOLN,714.0,499.8,,,0
CDM,50863,METHYLNALTREXONE 12 MG/0.6 ML SUBQ SYRG,490.0,343.0,,,0
CDM,50863,METHYLPHENIDATE  5 MG ORAL TAB,17.0,11.9,,,0
CDM,50863,METHYLPHENIDATE 18 MG ORAL TO24,76.0,53.2,,,0
CDM,50863,METHYLPHENIDATE 20 MG ORAL TBSR,43.0,30.1,,,0
CDM,50863,METHYLPHENIDATE 27 MG ORAL TO24,65.0,45.5,,,0
CDM,50863,METHYLPREDNISOLONE  4 MG ORAL TAB,31.0,21.7,,,0
CDM,50863,"METHYLPREDNISOLONE 1,000 MG SOLUTION FOR INJECTION",212.5,148.75,,,0
CDM,50863,METHYLPREDNISOLONE 125 MG INJECTION SOLR,69.0,48.3,,,0
CDM,50863,METHYLPREDNISOLONE 16 MG ORAL TAB,30.0,21.0,,,0
CDM,50863,METHYLPREDNISOLONE 40 MG/ML SUSP (DEPO-MEDROL) INJECTION,57.0,39.9,,,0
CDM,50863,METHYLPREDNISOLONE 500 MG SOLUTION FOR INJECTION,143.0,100.1,,,0
CDM,50863,METHYLPREDNISOLONE 80 MG/ML SUSP FOR INJECTION,106.0,74.2,,,0
CDM,50863,METHYLPREDNISOLONE SOD SUC(PF) 10 MG/ML INJ (REPACK),16.0,11.2,,,0
CDM,50863,METHYLPREDNISOLONE SOD SUC(PF) 1000 MG/8 ML IV SOLR,702.0,491.4,,,0
CDM,50863,METHYLPREDNISOLONE SOD SUC(PF) 125 MG/2 ML INJ SOLR,36.0,25.2,,,0
CDM,50863,METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML INJ SOLR,46.0,32.2,,,0
CDM,50863,METOCLOPRAMIDE  5 MG ORAL TAB,9.5,6.65,,,0
CDM,50863,METOCLOPRAMIDE  5 MG/ML INJ SOLN,25.0,17.5,,,0
CDM,50863,METOCLOPRAMIDE 10 MG ORAL TAB,8.0,5.6,,,0
CDM,50863,METOCLOPRAMIDE HCL 5 MG/5 ML ORAL SOLN,27.0,18.9,,,0
CDM,50863,METOLAZONE  2.5 MG ORAL TAB,30.0,21.0,,,0
CDM,50863,METOLAZONE  5 MG ORAL TAB,33.5,23.45,,,0
CDM,50863,METOLAZONE 10 MG ORAL TAB,14.0,9.8,,,0
CDM,50863,METOLAZONE 1MG/ML SUSPENSION (REPACK),7.0,4.9,,,0
CDM,50863,METOPROLOL 10MG/1ML SUSPENSION (REPACK),7.0,4.9,,,0
CDM,50863,METOPROLOL SUCCINATE SR 100 MG 24 HR TAB,16.0,11.2,,,0
CDM,50863,METOPROLOL SUCCINATE SR 25 MG 24 HR TAB,23.5,16.45,,,0
CDM,50863,METOPROLOL SUCCINATE SR 50 MG 24 HR TAB,19.0,13.3,,,0
CDM,50863,METOPROLOL TARTRATE 100 MG TAB,5.5,3.85,,,0
CDM,50863,METOPROLOL TARTRATE 25 MG TAB,7.0,4.9,,,0
CDM,50863,METOPROLOL TARTRATE 5 MG/5 ML IV,20.0,14.0,,,0
CDM,50863,METOPROLOL TARTRATE 50 MG TAB,7.0,4.9,,,0
CDM,50863,METRONIDAZOLE 0.75 % TOP GEL,943.0,660.1,,,0
CDM,50863,METRONIDAZOLE 0.75 % VAGL GEL,569.0,398.29999999999995,,,0
CDM,50863,METRONIDAZOLE 1 % TOP GEL,818.0,572.6,,,0
CDM,50863,METRONIDAZOLE 250 MG ORAL TAB,53.5,37.45,,,0
CDM,50863,METRONIDAZOLE 50 MG/ML SUSPENSION (10ML REPACK),8.0,5.6,,,0
CDM,50863,METRONIDAZOLE 500 MG ORAL TAB,35.0,24.5,,,0
CDM,50863,METRONIDAZOLE IN SODIUM CHLORIDE (ISO-OSM) 500 MG/100 ML IV PIGGY BACK,27.0,18.9,,,0
CDM,50863,MEXILETINE 150 MG ORAL CAP,22.0,15.4,,,0
CDM,50863,MEXILETINE 200 MG ORAL CAP,17.0,11.9,,,0
CDM,50863,MEXILETINE 250 MG ORAL CAP,20.0,14.0,,,0
CDM,50863,MICAFUNGIN 100 MG IV SOLR,247.5,173.25,,,0
CDM,50863,MICONAZOLE NITRATE 2 % TOP POWD,32.0,22.4,,,0
CDM,50863,MIDAZOLAM (PF) 1 MG/ML INJ (MERGE),21.0,14.7,,,0
CDM,50863,MIDAZOLAM (PF) 1 MG/ML INJ SOLN,26.0,18.200000000000003,,,0
CDM,50863,MIDAZOLAM (PF) 5 MG/ML INJ SOLN,28.0,19.6,,,0
CDM,50863,MIDAZOLAM (PF) IN 0.9 % NACL 1 MG/ML IV SOLN,110.0,77.0,,,0
CDM,50863,MIDAZOLAM 1 MG/ML IN NS (PREMIX),55.5,38.85,,,0
CDM,50863,MIDAZOLAM 1 MG/ML INJ SOLN,20.0,14.0,,,0
CDM,50863,MIDAZOLAM 1 MG/ML INJ SOLN (PULMONARY USE),9.5,6.65,,,0
CDM,50863,MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRP (MERGE/REPACK),34.0,23.8,,,0
CDM,50863,MIDAZOLAM 250 MG/50 ML CONCENTRATED DRIP (RSE),162.0,113.4,,,0
CDM,50863,MIDAZOLAM 5 MG/ML INJ SOLN,33.0,23.1,,,0
CDM,50863,MIDAZOLAM 50 MG/50 ML (1 MG/ML) IN D5W (INFUSION),53.0,37.1,,,0
CDM,50863,MIDAZOLAM 500 MG/100 ML CONCENTRATED DRIP 100 ML (RSE),33.0,23.1,,,0
CDM,50863,MIDODRINE  2.5 MG ORAL TAB,13.0,9.1,,,0
CDM,50863,MIDODRINE  5 MG ORAL TAB,22.5,15.75,,,0
CDM,50863,MIDOSTAURIN 25 MG ORAL CAP,1203.0,842.1,,,0
CDM,50863,MIFEPRISTONE 200 MG ORAL TAB,285.0,199.5,,,0
CDM,50863,MILRINONE 1 MG/ML IV SOLN,34.5,24.15,,,0
CDM,50863,MILRINONE IN D5W 20 MG/100 ML (0.2 MG/ML) INFUSION,89.0,62.3,,,0
CDM,50863,MILRINONE INFUSION PED/NEO IV SYRINGE (CDS MIXTURE),178.0,124.6,,,0
CDM,50863,MILTEFOSINE 50 MG ORAL CAP,1368.0,957.6,,,0
CDM,50863,MINERAL OIL,54.0,37.8,,,0
CDM,50863,MINERAL OIL ENEMA,20.0,14.0,,,0
CDM,50863,MINERAL OIL ORAL (REPACK),11.0,7.7,,,0
CDM,50863,MINOCYCLINE  50 MG ORAL CAP,10.0,7.0,,,0
CDM,50863,MINOCYCLINE 100 MG ORAL CAP,13.5,9.45,,,0
CDM,50863,MINOXIDIL  2.5 MG ORAL TAB,29.0,20.3,,,0
CDM,50863,MIRTAZAPINE  7.5 MG ORAL TAB,34.0,23.8,,,0
CDM,50863,MIRTAZAPINE 15 MG ORAL TAB,14.0,9.8,,,0
CDM,50863,MIRTAZAPINE 30 MG ORAL TAB,13.5,9.45,,,0
CDM,50863,MISOPROSTOL 100 MCG ORAL TAB,37.0,25.9,,,0
CDM,50863,MISOPROSTOL 200 MCG ORAL TAB,38.5,26.950000000000003,,,0
CDM,50863,MISOPROSTOL 25 MCG ORAL TAB,25.5,17.85,,,0
CDM,50863,MISOPROSTOL 50 MCG ORAL SPLIT TAB,154.0,107.8,,,0
CDM,50863,MISOPROSTOL 800 MCG (4 X 200 MCG TAB) PACKAGE,34.0,23.8,,,0
CDM,50863,MITOMYCIN 20 MG IV SOLR,1552.5,1086.75,,,0
CDM,50863,MITOXANTRONE 2 MG/ML IV CONC,183.0,128.1,,,0
CDM,50863,MODAFINIL 100 MG ORAL TAB,232.0,162.4,,,0
CDM,50863,MOMETASONE 110 MCG (30 DOSES) INHL AEPB,402.0,281.4,,,0
CDM,50863,MOMETASONE 220 MCG (14 DOSES) INHL AEPB,228.0,159.6,,,0
CDM,50863,MOMETASONE 220 MCG (60 DOSES) INHL AEPB,796.0,557.2,,,0
CDM,50863,MONTELUKAST  4 MG ORAL CHEW,32.0,22.4,,,0
CDM,50863,MONTELUKAST  5 MG ORAL CHEW,32.0,22.4,,,0
CDM,50863,MONTELUKAST 10 MG ORAL TAB,13.5,9.45,,,0
CDM,50863,MORPHINE  10 MG/5 ML ORAL SOLN,12.0,8.4,,,0
CDM,50863,MORPHINE  15 MG ORAL TAB,13.5,9.45,,,0
CDM,50863,MORPHINE  15 MG ORAL TBSR,23.0,16.1,,,0
CDM,50863,MORPHINE  2 MG/ML INJ SYRG,41.0,28.700000000000003,,,0
CDM,50863,MORPHINE  20 MG/5 ML ORAL SOLN,8.0,5.6,,,0
CDM,50863,MORPHINE  30 MG ORAL TBSR,23.0,16.1,,,0
CDM,50863,MORPHINE  4 MG/ML INJ SYRG,169.0,118.3,,,0
CDM,50863,MORPHINE  60 MG ORAL TBSR,15.5,10.850000000000001,,,0
CDM,50863,MORPHINE (PF) IN 0.9 % NACL 1 MG/ML VENT INFUSION,87.0,60.9,,,0
CDM,50863,MORPHINE (PF-DURAMORPH/ASTRAMORPH) 0.5 MG/ML INJ SOLN,68.5,47.95,,,0
CDM,50863,MORPHINE 1 MG/ML PCA (PDS MERGE),138.0,96.6,,,0
CDM,50863,MORPHINE 10 MG/ML (PF) IV SOLN,16.5,11.55,,,0
CDM,50863,MORPHINE 10 MG/ML INJ SYRG,16.0,11.2,,,0
CDM,50863,MORPHINE 10 MG/ML IV SOLN (PHS/CDS MERGE),28.5,19.95,,,0
CDM,50863,MORPHINE 100 MG ORAL TBSR,37.5,26.25,,,0
CDM,50863,MORPHINE 2 MG/ML IV SOLN (PHS/CDS MERGE),29.0,20.3,,,0
CDM,50863,MORPHINE 4 MG/ML IV SOLN (PHS/CDS MERGE),25.5,17.85,,,0
CDM,50863,MORPHINE CONCENTRATE 10 MG/ 0.5 ML ORAL SYRINGE (0.5ML UD MERGE),17.5,12.25,,,0
CDM,50863,MORPHINE CONCENTRATE 20 MG/ML ORAL SOLN,14.0,9.8,,,0
CDM,50863,MOXIFLOXACIN 0.5 % OPHT DROP,336.0,235.20000000000002,,,0
CDM,50863,MOXIFLOXACIN 400 MG ORAL TAB,200.5,140.35000000000002,,,0
CDM,50863,MOXIFLOXACIN 400 MG/250 ML IVPB PREMIX (MERGE),583.5,408.45,,,0
CDM,50863,MULTIVIT-IRON-FA-CALCIUM &MINS 9 MG IRON-400 MCG ORAL TAB,7.0,4.9,,,0
CDM,50863,MULTIVIT-MIN-FERROUS GLUCONATE 9 MG IRON/ 15 ML (15 ML) ORAL LIQD,15.0,10.5,,,0
CDM,50863,MULTIVIT-MIN-IRON FUM-FOLIC AC 7.5 MG IRON-400 MCG ORAL TAB,7.0,4.9,,,0
CDM,50863,MULTIVITAMIN W/IRON ORAL DROP 0.5 ML (PEDS/NEO),8.0,5.6,,,0
CDM,50863,MULTIVITAMIN W/IRON ORAL DROP 1 ML (PEDS/NEO),9.0,6.3,,,0
CDM,50863,MULTIVITAMIN WITH FOLIC ACID 400 MCG ORAL TAB,7.0,4.9,,,0
CDM,50863,MUPIROCIN 2 % TOP OINT,210.0,147.0,,,0
CDM,50863,"MVI, ADULT INJECTION (PHS)",53.0,37.1,,,0
CDM,50863,"MYCOPHENOLATE 180 MG TAB, DELAYED RELEASE",33.0,23.1,,,0
CDM,50863,MYCOPHENOLATE 200 MG/ML ORAL SUSP,82.5,57.75,,,0
CDM,50863,MYCOPHENOLATE 250 MG CAP,22.0,15.4,,,0
CDM,50863,MYCOPHENOLATE 500 MG IV SOLUTION,461.5,323.05,,,0
CDM,50863,MYCOPHENOLATE 500 MG TAB,35.0,24.5,,,0
CDM,50863,MYCOPHENOLATE SODIUM 360 MG ORAL TBEC,94.0,65.8,,,0
CDM,50863,NA FERRIC GLUC CPLX IN SUCROSE 12.5 MG/ML IV SOLN,374.0,261.8,,,0
CDM,50863,NABUMETONE 500 MG ORAL TAB,10.0,7.0,,,0
CDM,50863,NADOLOL  20 MG ORAL TAB,31.0,21.700000000000003,,,0
CDM,50863,NADOLOL  40 MG ORAL TAB,26.5,18.55,,,0
CDM,50863,NADOLOL  80 MG ORAL TAB,30.0,21.0,,,0
CDM,50863,NAFCILLIN  1 GRAM INJ SOLR,97.5,68.25,,,0
CDM,50863,NAFCILLIN  2 GRAM INJ SOLR,255.0,178.5,,,0
CDM,50863,NAFCILLIN 10 GRAM INJ SOLR,497.0,347.9,,,0
CDM,50863,NAFCILLIN NEO/PEDS (CDS MIXTURE),28.0,19.6,,,0
CDM,50863,NALBUPHINE 10 MG/ML INJ SOLN,23.0,16.1,,,0
CDM,50863,NALOXONE 0.4 MG/ML INJ SOLN,140.0,98.0,,,0
CDM,50863,NALOXONE 1 MG/ML NEEDLELESS SYRG,194.0,135.8,,,0
CDM,50863,NALOXONE 4 MG/ACTUATION NASL SPRY,246.0,172.2,,,0
CDM,50863,NALTREXONE 50 MG ORAL TAB,20.0,14.0,,,0
CDM,50863,NALTREXONE MICROSPHERES 380 MG IM SERR,4530.0,3171.0,,,0
CDM,50863,NAPHAZOLINE-GLYCERIN 0.012-0.25 % OPHT DROP,25.0,17.5,,,0
CDM,50863,NAPHAZOLINE-PHENIRAMINE 0.025 %-0.3 % EYE DROPS,39.5,27.65,,,0
CDM,50863,NAPROXEN 250 MG ORAL TAB,8.0,5.6,,,0
CDM,50863,NAPROXEN 375 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,NAPROXEN 500 MG ORAL TAB,12.0,8.4,,,0
CDM,50863,NATALIZUMAB 300 MG/15 ML IV SOLN,16000.0,11200.0,,,0
CDM,50863,NEBIVOLOL  2.5 MG ORAL TAB,56.0,39.2,,,0
CDM,50863,NEBIVOLOL  5 MG ORAL TAB,39.0,27.3,,,0
CDM,50863,NELARABINE 250 MG/50 ML IV SOLN (PEDS ONCOLOGY),4839.0,3387.3,,,0
CDM,50863,NEO TPN SODIUM ACETATE 2 MEQ/ML IV SOLN,66.0,46.2,,,0
CDM,50863,NEO TPN SODIUM CHLORIDE 4 MEQ/ML IV SOLN,38.5,26.950000000000003,,,0
CDM,50863,NEOMYCIN 500 MG ORAL TAB,17.5,12.25,,,0
CDM,50863,NEOMYCIN-BACITRACIN ZN-POLYMYXIN 3.5 MG-400 UN*,37.5,26.25,,,0
CDM,50863,"NEOMYCIN-BACITRACIN-POLYMYXIN 3.5 MG-400 UNIT-10,000 UNIT/G EYE OINT",242.0,169.4,,,0
CDM,50863,NEOMYCIN-BACITRACN ZN-POLYMYXIN 3.5 MG-400 U*,10.5,7.35,,,0
CDM,50863,"NEOMYCIN-POLYMYXIN B GU 40 MG-200,000 UNIT/ML IRRIGATION SOLN",70.0,49.0,,,0
CDM,50863,"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG-10,000 UNIT/G-0.1 % EYE OINTMENT",157.0,109.89999999999999,,,0
CDM,50863,"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",216.0,151.2,,,0
CDM,50863,NEOMYCIN-POLYMYXIN-GRAMICIDIN 1.75-10K-0.025 MG-UNIT-MG/ML OPHT DROP,260.0,182.0,,,0
CDM,50863,"NEOMYCIN-POLYMYXIN-HC 3.5 MG-10,000 UNIT-10 MG/ML EYE DROPS, SUSP",674.0,471.8,,,0
CDM,50863,"NEOMYCIN-POLYMYXIN-HC 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS, SUSP",370.5,259.35,,,0
CDM,50863,"NEOMYCIN-POLYMYXIN-HC 3.5 MG-10,000 UNIT/ML-1 % EAR SOLN",370.5,259.35,,,0
CDM,50863,"NEOMYCIN-POLYMYXIN-PRAMOXINE 3.5 MG-10,000 UNIT-10 MG/G TOPICAL CREAM",26.0,18.2,,,0
CDM,50863,NEOSTIGMINE 1MG/ML (UD) OR SYRINGE,213.0,149.10000000000002,,,0
CDM,50863,NEOSTIGMINE METHYLSULFATE 1 MG/ML IV SOLN,25.0,17.5,,,0
CDM,50863,NEOSTIGMINE METHYLSULFATE 3 MG/3 ML (1 MG/ML) IV SYRG,92.5,64.75,,,0
CDM,50863,NIACIN  250 MG ORAL CPSR,7.0,4.9,,,0
CDM,50863,NIACIN  250 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,NICARDIPINE 20 MG ORAL CAP,76.0,53.2,,,0
CDM,50863,NICARDIPINE 25 MG/10 ML IV SOLN,287.0,200.9,,,0
CDM,50863,NICARDIPINE 30 MG ORAL CAP,109.0,76.3,,,0
CDM,50863,NICARDIPINE IN NACL (ISO-OS) 20 MG/200 ML IV PGBK,334.5,234.15,,,0
CDM,50863,NICARDIPINE INFUSION 100 MCG/ML 50ML (PEDIATRIC),86.0,60.2,,,0
CDM,50863,NICOTINE  7 MG/24 HR TD PT24,12.0,8.4,,,0
CDM,50863,NICOTINE (POLACRILEX) 2 MG BUCL GUM,7.0,4.9,,,0
CDM,50863,NICOTINE (POLACRILEX) 2 MG MM LOZG,4.0,2.8,,,0
CDM,50863,NICOTINE (POLACRILEX) 4 MG BUCL GUM,18.0,12.600000000000001,,,0
CDM,50863,NICOTINE (POLACRILEX) 4 MG MM LOZG,8.0,5.6,,,0
CDM,50863,NICOTINE 14 MG/24 HR TD PT24,24.5,17.15,,,0
CDM,50863,NICOTINE 21 MG/24 HR TD PT24,26.0,18.200000000000003,,,0
CDM,50863,NIFEDIPINE 10 MG ORAL CAP,15.0,10.5,,,0
CDM,50863,NIFEDIPINE 20 MG ORAL CAP,7.0,4.9,,,0
CDM,50863,NIFEDIPINE 30 MG ORAL TO24,16.0,11.2,,,0
CDM,50863,NIFEDIPINE 60 MG ORAL TO24,17.0,11.9,,,0
CDM,50863,NIFEDIPINE 90 MG ORAL TO24,14.5,10.15,,,0
CDM,50863,NIMODIPINE 30 MG ORAL CAP,138.0,96.6,,,0
CDM,50863,NIMODIPINE 30 MG/5 ML ORAL SYRG,367.0,256.9,,,0
CDM,50863,NIMODIPINE 60 MG/10 ML ORAL SYRG,416.0,291.2,,,0
CDM,50863,NIRMATRELVIR-RITONAVIR 150 MG (10)- 100 MG (10) ORAL DSPK,647.0,452.9,,,0
CDM,50863,NIRMATRELVIR-RITONAVIR 300 MG (150 MG X 2)-100 MG ORAL DSPK,647.0,452.9,,,0
CDM,50863,NIRMATRELVIR-RITONAVIR 300-100 MG ORAL TAB DOSEPACK (FOR ED/IP TAKE HOME PANEL),4010.0,2807.0,,,0
CDM,50863,NIRSEVIMAB-ALIP 50 MG/0.5 ML IM SYRG,1435.0,1004.5,,,0
CDM,50863,NITAZOXANIDE 500 MG ORAL TAB,595.0,416.5,,,0
CDM,50863,NITROFURANTOIN (25% MACROCRYSTAL FORM) 100 MG CAP,19.0,13.3,,,0
CDM,50863,NITROFURANTOIN MACROCRYSTAL  50 MG ORAL CAP,13.0,9.1,,,0
CDM,50863,NITROFURANTOIN MACROCRYSTAL 100 MG ORAL CAP,278.5,194.95,,,0
CDM,50863,NITROGLYCERIN 0.1 MG/HR TD PT24,11.0,7.7,,,0
CDM,50863,NITROGLYCERIN 0.2 MG/HR TD PT24,11.0,7.7,,,0
CDM,50863,NITROGLYCERIN 0.4 MG SL SUBL,12.0,8.4,,,0
CDM,50863,NITROGLYCERIN 0.4 MG/HR TD PT24,25.0,17.5,,,0
CDM,50863,NITROGLYCERIN 0.6 MG/HR TD PT24,14.0,9.8,,,0
CDM,50863,NITROGLYCERIN 2 % TD OINT,25.5,17.85,,,0
CDM,50863,NITROGLYCERIN 2 MG/10 ML (200 MCG/ML) IN D5W VIAL-CVL/IR USE (REPACK),19.0,13.3,,,0
CDM,50863,NITROGLYCERIN 50 MG/10 ML (5 MG/ML) IV SOLN,18.0,12.600000000000001,,,0
CDM,50863,NITROPRUSSIDE 25 MG/ML IV SOLN,123.0,86.1,,,0
CDM,50863,NIVOLUMAB 240 MG/24 ML IV SOLN,15503.5,10852.45,,,0
CDM,50863,NIVOLUMAB 40 MG/4 ML IV SOLN,2728.0,1909.6,,,0
CDM,50863,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,236.0,165.2,,,0
CDM,50863,NOREPINEPHRINE BITARTRATE-D5W 16 MG/250 ML (64 MCG/ML) IV SOLN (CENTRAL ONLY),283.5,198.45,,,0
CDM,50863,NOREPINEPHRINE BITARTRATE-D5W 4 MG/250 ML (16 MCG/ML) IV SOLN,115.5,80.85,,,0
CDM,50863,NOREPINEPHRINE BITARTRATE-NACL 4 MG/250 ML (16 MCG/ML) IV SOLN (CENTRAL ONLY),327.0,228.89999999999998,,,0
CDM,50863,NORETHINDRONE ACETATE 5 MG ORAL TAB,30.0,21.0,,,0
CDM,50863,NORETHINDRONE-ETHINYL ESTRADIOL 1 MG-35 MCG TAB,10.0,7.0,,,0
CDM,50863,NORGESTREL-ETHINYL ESTRADIOL 0.3 MG-30 MCG TAB,7.0,4.9,,,0
CDM,50863,NORTRIPTYLINE 10 MG ORAL CAP,9.0,6.3,,,0
CDM,50863,NORTRIPTYLINE 25 MG ORAL CAP,17.0,11.9,,,0
CDM,50863,NORTRIPTYLINE 50 MG ORAL CAP,18.0,12.6,,,0
CDM,50863,NS WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,59.0,41.3,,,0
CDM,50863,NS WITH POTASSIUM CHLORIDE 40 MEQ/L IV SOLP,66.5,46.55,,,0
CDM,50863,NYSTATIN  100000 UNIT/G TOP CREA,172.0,120.4,,,0
CDM,50863,NYSTATIN  100000 UNIT/G TOP OINT,86.0,60.2,,,0
CDM,50863,NYSTATIN  100000 UNIT/G TOP POWD,137.0,95.9,,,0
CDM,50863,NYSTATIN 100000 UNIT/ML ORAL SUSP,18.0,12.6,,,0
CDM,50863,NYSTATIN 500000 UNIT ORAL TAB,8.0,5.6,,,0
CDM,50863,OBINUTUZUMAB 900 MG IN NS 286 ML (STOCK DOSE),13905.0,9733.5,,,0
CDM,50863,OCRELIZUMAB 30 MG/ML IV SOLN,67275.0,47092.5,,,0
CDM,50863,"OCRELIZUMAB-HYALURONIDASE-OCSQ 920 MG-23,000 UNIT/23 ML SUBQ SOLN",113939.0,79757.3,,,0
CDM,50863,OCTAGAM 10 % IV SOLN,11021.5,7715.05,,,0
CDM,50863,OCTREOTIDE ACETATE   50 MCG/ML INJ SOLN,58.0,40.6,,,0
CDM,50863,OCTREOTIDE ACETATE  100 MCG/ML INJ SOLN,59.0,41.3,,,0
CDM,50863,OCTREOTIDE ACETATE  500 MCG/ML INJ SOLN,165.0,115.5,,,0
CDM,50863,"OCTREOTIDE,MICROSPHERES 10 MG IM SERR",9725.0,6807.5,,,0
CDM,50863,"OCTREOTIDE,MICROSPHERES 20 MG IM SERR",19111.5,13378.050000000001,,,0
CDM,50863,"OCTREOTIDE,MICROSPHERES 30 MG IM SERR",19079.0,13355.3,,,0
CDM,50863,OFLOXACIN 0.3 % OPHT DROP,171.5,120.05,,,0
CDM,50863,OFLOXACIN 0.3 % OTIC DROP,739.0,517.3,,,0
CDM,50863,OLANZAPINE  2.5 MG ORAL TAB,137.5,96.25,,,0
CDM,50863,OLANZAPINE  5 MG ORAL TAB,102.0,71.4,,,0
CDM,50863,OLANZAPINE  5 MG ORAL TBDL,57.5,40.25,,,0
CDM,50863,OLANZAPINE  7.5 MG ORAL TAB,158.0,110.6,,,0
CDM,50863,OLANZAPINE 10 MG IM SOLR,102.0,71.4,,,0
CDM,50863,OLANZAPINE 10 MG ORAL TAB,130.0,91.0,,,0
CDM,50863,OLANZAPINE 10 MG ORAL TBDL,102.5,71.75,,,0
CDM,50863,OLMESARTAN  5 MG ORAL TAB,53.0,37.1,,,0
CDM,50863,OLMESARTAN 20 MG ORAL TAB,52.0,36.4,,,0
CDM,50863,OLMESARTAN 40 MG ORAL TAB,53.0,37.1,,,0
CDM,50863,OLOPATADINE 0.1 % OPHT DROP,53.5,37.45,,,0
CDM,50863,OMALIZUMAB 150 MG SUBQ SOLR,3914.0,2739.8,,,0
CDM,50863,OMALIZUMAB 150 MG/ML SUBQ SYRG,4672.5,3270.75,,,0
CDM,50863,OMALIZUMAB 75 MG/0.5 ML SUBQ SYRG,1558.0,1090.6,,,0
CDM,50863,"OMEGA-3 FATTY ACIDS-FISH OIL 360-1,200 MG ORAL CAP (ERX MERGE)",5.5,3.85,,,0
CDM,50863,OMEPRAZOLE 10 MG ORAL CPDR,43.0,30.1,,,0
CDM,50863,OMEPRAZOLE 20 MG ORAL CPDR,7.0,4.9,,,0
CDM,50863,OMEPRAZOLE-SODIUM BICARBONATE 2-84 MG/ML ORAL SUSR,27.0,18.9,,,0
CDM,50863,ONABOTULINUMTOXINA 200 UNIT INJ SOLR,3197.0,2237.9,,,0
CDM,50863,ONDANSETRON 4 MG ORAL TBDL,378.5,264.95000000000005,,,0
CDM,50863,ONDANSETRON 8 MG ORAL TBDL,189.0,132.3,,,0
CDM,50863,ONDANSETRON HCL  4 MG ORAL TAB,523.0,366.1,,,0
CDM,50863,ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN,24.5,17.15,,,0
CDM,50863,ONDANSETRON HCL 4 MG/5 ML ORAL SOLN,52.5,36.75,,,0
CDM,50863,OPIUM TINCTURE 10 MG/ML ORAL TINC,35.0,24.5,,,0
CDM,50863,ORA-SWEET SF (COMPOUNDING VEHICLE SF NO.9 ORAL LIQD),7.0,4.9,,,0
CDM,50863,ORAL ELECTROLYTES ORAL SOLN,36.5,25.55,,,0
CDM,50863,ORAL PLUS ORAL VEHICLES ORAL LIQUID,7.0,4.9,,,0
CDM,50863,ORPHENADRINE CITRATE 100 MG ORAL TBSR,13.0,9.1,,,0
CDM,50863,ORPHENADRINE CITRATE 30 MG/ML INJ SOLN,58.5,40.95,,,0
CDM,50863,OSELTAMIVIR  6 MG/ML ORAL SUSR,62.0,43.4,,,0
CDM,50863,OSELTAMIVIR PHOSPHATE 30 MG ORAL CAP,156.5,109.55,,,0
CDM,50863,OSELTAMIVIR PHOSPHATE 75 MG ORAL CAP,390.0,273.0,,,0
CDM,50863,OXALIPLATIN 100 MG/20 ML IV SOLN,87.5,61.25,,,0
CDM,50863,OXAZEPAM 10 MG ORAL CAP,7.0,4.9,,,0
CDM,50863,OXAZEPAM 15 MG ORAL CAP,35.0,24.5,,,0
CDM,50863,OXCARBAZEPINE 150 MG ORAL TAB,19.0,13.3,,,0
CDM,50863,OXCARBAZEPINE 300 MG ORAL TAB,16.0,11.2,,,0
CDM,50863,OXCARBAZEPINE 300 MG/5 ML ORAL SUSP,48.5,33.95,,,0
CDM,50863,OXYBUTYNIN CHLORIDE  5 MG ORAL TAB,10.5,7.35,,,0
CDM,50863,OXYBUTYNIN CHLORIDE  5 MG ORAL TO24,42.0,29.400000000000002,,,0
CDM,50863,OXYBUTYNIN CHLORIDE 5 MG/5 ML ORAL SYRP,7.0,4.9,,,0
CDM,50863,OXYCODONE  10 MG ORAL TR12,83.0,58.1,,,0
CDM,50863,OXYCODONE  15 MG ORAL TAB,16.0,11.2,,,0
CDM,50863,OXYCODONE  20 MG ORAL TR12,154.0,107.8,,,0
CDM,50863,OXYCODONE  40 MG ORAL TR12,205.0,143.5,,,0
CDM,50863,OXYCODONE 20MG/ML (1ML-UD) SYRINGE (REPACK),16.0,11.2,,,0
CDM,50863,OXYCODONE 5 MG ORAL TAB,15.0,10.5,,,0
CDM,50863,OXYCODONE 5 MG/5 ML ORAL SOLN,34.0,23.8,,,0
CDM,50863,OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TAB,16.0,11.2,,,0
CDM,50863,OXYMETAZOLINE 0.05 % NASAL (MERGE)(ENT PRE-PROCEDURE),14.0,9.8,,,0
CDM,50863,OXYMETAZOLINE 0.05 % NASAL MERGE,18.0,12.6,,,0
CDM,50863,OXYMETAZOLINE 0.05 % NASL SPRA,30.0,21.0,,,0
CDM,50863,OXYMETAZOLINE 0.05 % NASL SPRAY (BLUE DYE FOR OR),14.0,9.8,,,0
CDM,50863,OXYTOCIN 10 UNIT/ML INJ SOLN,82.0,57.400000000000006,,,0
CDM,50863,OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN,103.0,72.1,,,0
CDM,50863,PACLITAXEL 6 MG/ML IV CONC,162.5,113.75,,,0
CDM,50863,PACLITAXEL-PROTEIN BOUND 100 MG IV SOLR,8957.0,6269.9,,,0
CDM,50863,PALIPERIDONE PALMITATE 117 MG/0.75 ML IM SYRG,4926.0,3448.2,,,0
CDM,50863,PALIPERIDONE PALMITATE 234 MG/1.5 ML IM SYRG,9726.5,6808.549999999999,,,0
CDM,50863,PALIPERIDONE PALMITATE 39 MG/0.25 ML IM SYRG,1642.0,1149.4,,,0
CDM,50863,PALIPERIDONE PALMITATE 78 MG/0.5 ML IM SYRG,3242.5,2269.75,,,0
CDM,50863,PALONOSETRON 0.25 MG/5 ML IV INJECTION (MERGE),220.5,154.35,,,0
CDM,50863,PAMIDRONATE 3 MG/ML IV SOLN,170.0,119.0,,,0
CDM,50863,PAMIDRONATE 9 MG/ML IV SOLN,312.5,218.75,,,0
CDM,50863,PAMIDRONATE 90 MG IV SOLR,519.0,363.3,,,0
CDM,50863,PANTOPRAZOLE 20 MG ORAL TBEC,33.0,23.1,,,0
CDM,50863,PANTOPRAZOLE 40 MG IV SOLR,37.0,25.9,,,0
CDM,50863,PANTOPRAZOLE 40 MG ORAL TBEC,49.0,34.3,,,0
CDM,50863,PAPAVERINE 30 MG/ML INJ SOLN,232.0,162.39999999999998,,,0
CDM,50863,PAROMOMYCIN 250 MG ORAL CAP,761.0,532.7,,,0
CDM,50863,PAROXETINE 10 MG/5 ML ORAL SUSP,97.0,67.9,,,0
CDM,50863,PAROXETINE 20 MG TAB,25.0,17.5,,,0
CDM,50863,PAROXETINE 30 MG TAB,21.0,14.7,,,0
CDM,50863,PAROXETINE SR 12.5 MG 24 HR TAB,31.0,21.7,,,0
CDM,50863,PAROXETINE SR 25 MG 24 HR TAB,45.0,31.5,,,0
CDM,50863,PAROXETINE SR 37.5 MG 24 HR TAB,12.0,8.4,,,0
CDM,50863,PATIROMER CALCIUM SORBITEX  8.4 G ORAL PWPK,355.0,248.5,,,0
CDM,50863,PEDI MULTIVIT NO.128-VITAMIN K 500 MCG/ML ORAL LIQD,7.0,4.9,,,0
CDM,50863,PEDI MV NO.189-FERROUS SULFATE 11 MG IRON/ML ORAL DROP,7.0,4.9,,,0
CDM,50863,PEDIATRIC MULTIVITAMIN NO.192 250 MCG-50 MG- 10 MCG/ML ORAL DROP,10.5,7.3500000000000005,,,0
CDM,50863,PEDIATRIC MULTIVITAMIN NO.42 ORAL CHEW,7.0,4.9,,,0
CDM,50863,PEG 3350-ELECTROLYTES 236 G-22.74 G-6.74 G-5.86 G ORAL SOLUTION,157.0,109.9,,,0
CDM,50863,PEG 400-PROPYLENE GLYCOL 0.4-0.3 % OPHT DRPG,61.0,42.7,,,0
CDM,50863,PEGASPARGASE 750 UNIT/ML INJ SOLN,64175.5,44922.85,,,0
CDM,50863,PEGFILGRASTIM (NEULASTA) 6 MG/0.6ML SUBQ SYRG,17714.0,12399.8,,,0
CDM,50863,PEGFILGRASTIM 6 MG/0.6 ML SUBQ W/ ON BODY INJECTOR,17714.0,12399.8,,,0
CDM,50863,PEGFILGRASTIM-JMDB (FULPHILA) 6 MG/0.6 ML SUBQ SYRG,8642.5,6049.75,,,0
CDM,50863,PEGFILGRASTIM-PBBK 6 MG/0.6 ML SUBQ SYRG,6900.0,4830.0,,,0
CDM,50863,PEGLOTICASE 8 MG/ML IV SOLN,51290.0,35903.0,,,0
CDM,50863,PEMBROLIZUMAB 100 MG/4 ML (25 MG/ML) IV SOLN,36273.0,25391.100000000002,,,0
CDM,50863,PEMETREXED 100 MG IV SOLR,229.5,160.65,,,0
CDM,50863,PEMETREXED 500 MG IV SOLR,1212.0,848.4000000000001,,,0
CDM,50863,PENICILLIN G BENZATHINE 1200000 UNIT/2 ML IM SYRG,1898.0,1328.6,,,0
CDM,50863,PENICILLIN G BENZATHINE 2400000 UNIT/4 ML IM SYRG,1898.0,1328.6,,,0
CDM,50863,PENICILLIN G BENZATHINE 600000 UNIT/ML IM SYRG,1591.5,1114.05,,,0
CDM,50863,PENICILLIN G POTASSIUM  5000000 UNIT INJ SOLR,58.0,40.6,,,0
CDM,50863,PENICILLIN G POTASSIUM 20000000 UNIT INJ SOLR,238.0,166.60000000000002,,,0
CDM,50863,PENICILLIN GK 2.5 MU IN NS 100ML IVPB (PDS ADS MIXTURE),159.0,111.3,,,0
CDM,50863,PENICILLIN V POTASSIUM 250 MG ORAL TAB,19.0,13.3,,,0
CDM,50863,PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SUSR,7.0,4.9,,,0
CDM,50863,PENICILLIN V POTASSIUM 500 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,PENTAMIDINE 300 MG INHL SOLR,650.0,455.0,,,0
CDM,50863,PENTAMIDINE 300 MG INJ SOLR,223.5,156.45,,,0
CDM,50863,PENTOBARBITAL 75 MG/1.5 ML SYRINGE (REPACK),116.0,81.19999999999999,,,0
CDM,50863,PENTOXIFYLLINE 400 MG ORAL TBSR,8.0,5.6,,,0
CDM,50863,PERMETHRIN 1 % TOP LIQD (REPACK),58.0,40.599999999999994,,,0
CDM,50863,PERMETHRIN 5 % TOP CREA,426.5,298.55,,,0
CDM,50863,PERPHENAZINE  2 MG ORAL TAB,39.0,27.3,,,0
CDM,50863,PERPHENAZINE  4 MG ORAL TAB,16.0,11.2,,,0
CDM,50863,PERPHENAZINE  8 MG ORAL TAB,22.0,15.4,,,0
CDM,50863,PERTUZUMAB 420 MG/14 ML (30 MG/ML) IV SOLN,14062.0,9843.4,,,0
CDM,50863,PHENAZOPYRIDINE 100 MG ORAL TAB,11.0,7.7,,,0
CDM,50863,PHENAZOPYRIDINE 200 MG ORAL TAB,15.0,10.5,,,0
CDM,50863,PHENOBARBITAL  32.4 MG ORAL TAB,11.0,7.7,,,0
CDM,50863,PHENOBARBITAL  97.2 MG ORAL TAB,9.0,6.3,,,0
CDM,50863,PHENOBARBITAL 20 MG/5 ML ORAL ELIX,30.5,21.35,,,0
CDM,50863,PHENOBARBITAL SODIUM  65 MG/ML INJ SOLN,139.0,97.3,,,0
CDM,50863,PHENOBARBITAL SODIUM 130 MG/ML INJ SOLN,555.5,388.85,,,0
CDM,50863,PHENOL 1.4 % MM SPRA,19.0,13.3,,,0
CDM,50863,PHENOL-PHENOLATE SODIUM AEROSOL,14.0,9.8,,,0
CDM,50863,PHENOXYBENZAMINE 10 MG ORAL CAP,955.0,668.5,,,0
CDM,50863,PHENTOLAMINE 5 MG INJ SOLR,1231.0,861.7,,,0
CDM,50863,PHENYLEPH-MIN OIL-PETROLATUM 0.25-14-74.9 % RECT OINT,49.0,34.3,,,0
CDM,50863,PHENYLEPHRINE 0.25 % NASAL SPRAY,22.0,15.4,,,0
CDM,50863,PHENYLEPHRINE 0.5% NASAL DROPS (REPACK),15.5,10.85,,,0
CDM,50863,PHENYLEPHRINE 1 % NASAL SPRAY AEROSOL,25.0,17.5,,,0
CDM,50863,PHENYLEPHRINE 10 MG/ML INJECTION,395.0,276.5,,,0
CDM,50863,PHENYLEPHRINE 2.5 % EYE DROPS,302.0,211.4,,,0
CDM,50863,PHENYLEPHRINE HCL  0.5 % NASL SPRY,23.0,16.1,,,0
CDM,50863,PHENYLEPHRINE HCL IN 0.9% NACL 1 MG/10 ML (100 MCG/ML) IV SYRG,35.0,24.5,,,0
CDM,50863,PHENYLEPHRINE HCL IN NS 10 MG/250 ML (0.04 MG/ML) IV SOLN (PDS MERGE),291.0,203.7,,,0
CDM,50863,PHENYLEPHRINE IN 0.9% NS (PF) 1 MG/10 ML (100 MCG/ML) IV SYRG(PDS MERGE),48.0,33.6,,,0
CDM,50863,PHENYLEPHRINE PEDS IV INFUSION (CDS MIXTURE),16.0,11.2,,,0
CDM,50863,PHENYTOIN 100 MG/4 ML ORAL SUSP,51.0,35.7,,,0
CDM,50863,PHENYTOIN 125 MG/5 ML ORAL SUSP,10.0,7.0,,,0
CDM,50863,PHENYTOIN 50 MG ORAL CHEW,18.0,12.6,,,0
CDM,50863,PHENYTOIN SODIUM 50 MG/ML IV SOLN,67.0,46.9,,,0
CDM,50863,PHENYTOIN SODIUM EXTENDED  30 MG ORAL CAP,15.0,10.5,,,0
CDM,50863,PHENYTOIN SODIUM EXTENDED 100 MG ORAL CAP,24.0,16.8,,,0
CDM,50863,PHYTONADIONE 1 MG/0.5 ML INJ SOLN,63.5,44.45,,,0
CDM,50863,PHYTONADIONE 1 MG/0.5 ML INJ SYRG,87.5,61.25,,,0
CDM,50863,PHYTONADIONE 1 MG/ML ORAL SOLN,168.0,117.60000000000001,,,0
CDM,50863,PHYTONADIONE 10 MG/ML INJ SOLN,75.0,52.5,,,0
CDM,50863,PHYTONADIONE 5 MG ORAL TAB,343.0,240.1,,,0
CDM,50863,PILOCARPINE 1 % EYE DROPS,418.0,292.6,,,0
CDM,50863,PILOCARPINE 2 % EYE DROPS,363.0,254.1,,,0
CDM,50863,PILOCARPINE 5 MG TAB,17.0,11.9,,,0
CDM,50863,PIOGLITAZONE 15 MG ORAL TAB,18.0,12.6,,,0
CDM,50863,PIOGLITAZONE 30 MG ORAL TAB,53.0,37.1,,,0
CDM,50863,PIOGLITAZONE 45 MG ORAL TAB,90.0,63.0,,,0
CDM,50863,PIPERACILLIN-TAZOBACTAM  2.25 GRAM IV SOLR,59.5,41.650000000000006,,,0
CDM,50863,PIPERACILLIN-TAZOBACTAM  3.375 GRAM IV SOLR,74.0,51.8,,,0
CDM,50863,PIPERACILLIN-TAZOBACTAM  4.5 GRAM IV SOLR,72.5,50.75,,,0
CDM,50863,PIPERACILLIN-TAZOBACTAM NEO/PEDS INFUSION (CDS MIXTURE),63.0,44.1,,,0
CDM,50863,PIPERACILLIN-TAZOBACTAM-DEXTROSE (ISO) 3.375 GRAM/50 ML IV PIGGY BACK,89.0,62.3,,,0
CDM,50863,PIPERACILLIN-TAZOBACTAM-DEXTRS 4.5 GRAM/100 ML IV PGBK,111.0,77.7,,,0
CDM,50863,PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG,963.5,674.45,,,0
CDM,50863,PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML INJ SYRG,506.0,354.2,,,0
CDM,50863,PNEUMOCOCCAL 23-VALPS VACCINE 25 MCG/0.5 ML INJ,506.0,354.2,,,0
CDM,50863,POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML INJ SUSP,124.0,86.8,,,0
CDM,50863,POLYETHYLENE GLYCOL 3350 100 % ORAL POWD,49.0,34.3,,,0
CDM,50863,POLYETHYLENE GLYCOL 3350 100 % ORAL POWDER 238 GRAMS,51.0,35.7,,,0
CDM,50863,POLYETHYLENE GLYCOL 3350 17 GRAM (100 %) ORAL PWPK,38.0,26.6,,,0
CDM,50863,PORACTANT ALFA 240 MG/3 ML INTR SUSP,4960.0,3472.0,,,0
CDM,50863,POSACONAZOLE 100 MG ORAL TBEC,533.0,373.1,,,0
CDM,50863,POTASSIUM & SODIUM PHOSPHATES 280-160-250 MG ORAL PWPK,13.0,9.1,,,0
CDM,50863,POTASSIUM ACETATE 2 MEQ/ML IV SOLN,26.0,18.2,,,0
CDM,50863,POTASSIUM BICARB-CITRIC ACID 20 MEQ ORAL TBEF,9.0,6.3,,,0
CDM,50863,POTASSIUM BICARBONATE-CITRIC ACID 25 MEQ EFFERVESCENT TAB,18.0,12.6,,,0
CDM,50863,POTASSIUM CHLORIDE  10 MEQ ORAL CPSR,23.0,16.1,,,0
CDM,50863,POTASSIUM CHLORIDE  10 MEQ ORAL TBSR,8.0,5.6,,,0
CDM,50863,POTASSIUM CHLORIDE  10 MEQ ORAL TBTQ,10.0,7.0,,,0
CDM,50863,POTASSIUM CHLORIDE  20 MEQ ORAL PACK,106.0,74.2,,,0
CDM,50863,POTASSIUM CHLORIDE 10 MEQ/100 ML IV PGBK,129.0,90.3,,,0
CDM,50863,POTASSIUM CHLORIDE 10 MEQ/100 ML IV PGBK (USE NON-PROTOCOL PANEL),66.0,46.2,,,0
CDM,50863,POTASSIUM CHLORIDE 10 MEQ/50 ML IV PGBK,59.0,41.3,,,0
CDM,50863,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLP,26.5,18.549999999999997,,,0
CDM,50863,POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLUTION (FOR PEDIATRIC USE),18.5,12.95,,,0
CDM,50863,POTASSIUM CHLORIDE 20 MEQ/100 ML IV PGBK,34.0,23.8,,,0
CDM,50863,POTASSIUM CITRATE  5 MEQ ORAL TBER,30.0,21.0,,,0
CDM,50863,POTASSIUM CITRATE 10 MEQ ORAL TBER,33.0,23.1,,,0
CDM,50863,"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLN",8.0,5.6,,,0
CDM,50863,POTASSIUM IODIDE 1 GRAM/ML ORAL SOLN,36.0,25.2,,,0
CDM,50863,POTASSIUM IODIDE 130 MG ORAL TAB,7.5,5.25,,,0
CDM,50863,POTASSIUM PHOS IN 0.9 % NACL 15 MMOL/250 ML IVPB PREMIX,211.0,147.7,,,0
CDM,50863,POTASSIUM PHOSPHATE 0.06 MMOL/ML IVPB (FOR PEDIATRICS),352.0,246.4,,,0
CDM,50863,POTASSIUM PHOSPHATE 4.4 MEQ/ML ORAL SOLUTION (CDS),19.0,13.3,,,0
CDM,50863,POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML IV SOLP,28.0,19.6,,,0
CDM,50863,"POTASSIUM PHOSPHATE, MONOBASIC 500 MG ORAL TBSO",7.5,5.25,,,0
CDM,50863,POVIDONE-IODINE 10 % TOP OINT,24.0,16.8,,,0
CDM,50863,PRAMIPEXOLE 0.125 MG ORAL TAB,50.0,35.0,,,0
CDM,50863,PRAMIPEXOLE 0.25 MG ORAL TAB,4.5,3.1500000000000004,,,0
CDM,50863,PRAMIPEXOLE 0.5 MG ORAL TAB,9.0,6.3,,,0
CDM,50863,PRAMIPEXOLE 1 MG ORAL TAB,17.0,11.9,,,0
CDM,50863,PRASUGREL 10 MG ORAL TAB,120.0,84.0,,,0
CDM,50863,PRASUGREL 5 MG ORAL TAB,81.0,56.7,,,0
CDM,50863,PRAVASTATIN 10 MG ORAL TAB,18.0,12.6,,,0
CDM,50863,PRAVASTATIN 20 MG ORAL TAB,20.0,14.0,,,0
CDM,50863,PRAVASTATIN 40 MG ORAL TAB,27.0,18.9,,,0
CDM,50863,PRAZOSIN 1 MG ORAL CAP,29.0,20.299999999999997,,,0
CDM,50863,PRAZOSIN 2 MG ORAL CAP,32.0,22.4,,,0
CDM,50863,PRAZOSIN 5 MG ORAL CAP,37.0,25.9,,,0
CDM,50863,PREDNISOLONE ACETATE 0.12 % OPHT DRPS,871.0,609.7,,,0
CDM,50863,PREDNISOLONE ACETATE 1 % OPHT DROPS,399.0,279.3,,,0
CDM,50863,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (5 ML) ORAL SOLN,21.5,15.05,,,0
CDM,50863,PREDNISONE  1 MG ORAL TAB,20.0,14.0,,,0
CDM,50863,PREDNISONE  2.5 MG ORAL TAB,32.5,22.75,,,0
CDM,50863,PREDNISONE  5 MG ORAL TAB,11.5,8.05,,,0
CDM,50863,PREDNISONE 10 MG ORAL TAB,8.0,5.6,,,0
CDM,50863,PREDNISONE 20 MG ORAL TAB,12.0,8.4,,,0
CDM,50863,PREDNISONE 50 MG ORAL TAB,6.0,4.2,,,0
CDM,50863,PREGABALIN  25 MG ORAL CAP,50.0,35.0,,,0
CDM,50863,PREGABALIN  50 MG ORAL CAP,41.0,28.7,,,0
CDM,50863,PREGABALIN  75 MG ORAL CAP,24.0,16.8,,,0
CDM,50863,PREGABALIN 100 MG ORAL CAP,17.0,11.9,,,0
CDM,50863,PREGABALIN 150 MG ORAL CAP,30.0,21.0,,,0
CDM,50863,PRENATAL VIT NO.130-IRON-FOLIC 27 MG IRON- 800 MCG ORAL TAB,7.0,4.9,,,0
CDM,50863,PRIMAQUINE 26.3 MG ORAL TAB,15.0,10.5,,,0
CDM,50863,PRIMIDONE  50 MG ORAL TAB,14.0,9.8,,,0
CDM,50863,PRIMIDONE 250 MG ORAL TAB,6.0,4.2,,,0
CDM,50863,PRIVIGEN 10 % IV SOLN,14352.0,10046.4,,,0
CDM,50863,PROBENECID 500 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,PROCAINAMIDE 100 MG/ML INJ SOLN,577.0,403.9,,,0
CDM,50863,PROCAINAMIDE 100 MG/ML INJECTION (MERGE),911.0,637.7,,,0
CDM,50863,PROCAINAMIDE 100 MG/ML IV SYRG,368.0,257.6,,,0
CDM,50863,PROCHLORPERAZINE 25 MG RECT SUPP,62.0,43.4,,,0
CDM,50863,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN,30.0,21.0,,,0
CDM,50863,PROCHLORPERAZINE MALEATE  5 MG ORAL TAB,13.5,9.45,,,0
CDM,50863,PROCHLORPERAZINE MALEATE 10 MG ORAL TAB,10.0,7.0,,,0
CDM,50863,PROGESTERONE 50 MG/ML IM OIL,154.0,107.8,,,0
CDM,50863,PROGESTERONE MICRONIZED  8 % VAGL GEL,226.0,158.2,,,0
CDM,50863,PROGESTERONE MICRONIZED 100 MG ORAL CAP,24.0,16.8,,,0
CDM,50863,PROMETHAZINE  6.25 MG/5 ML ORAL SYRP,14.0,9.8,,,0
CDM,50863,PROMETHAZINE 12.5 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,PROMETHAZINE 12.5 MG RECT SUPP,130.5,91.35,,,0
CDM,50863,PROMETHAZINE 25 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,PROMETHAZINE 25 MG RECT SUPP,68.5,47.95,,,0
CDM,50863,PROMETHAZINE 25 MG/ML INJ SOLN,24.0,16.8,,,0
CDM,50863,PROPAFENONE 150 MG ORAL TAB,10.5,7.3500000000000005,,,0
CDM,50863,PROPAFENONE 225 MG ORAL TAB,13.0,9.1,,,0
CDM,50863,PROPARACAINE 0.5 % OPHT DROP,214.0,149.8,,,0
CDM,50863,PROPOFOL 10 MG/ML 100ML INFUSION IV EMUL,110.0,77.0,,,0
CDM,50863,PROPOFOL 10 MG/ML 20ML BOLUS IV EMUL,39.0,27.3,,,0
CDM,50863,PROPOFOL IV BOLUS 10MG/ML (ANESTHESIA ONLY),108.0,75.6,,,0
CDM,50863,PROPRANOLOL  1 MG/ML IV SOLN,135.0,94.5,,,0
CDM,50863,PROPRANOLOL  10 MG ORAL TAB,8.5,5.95,,,0
CDM,50863,PROPRANOLOL  20 MG ORAL TAB,8.0,5.6,,,0
CDM,50863,PROPRANOLOL  40 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,PROPRANOLOL  60 MG ORAL CS24,17.5,12.25,,,0
CDM,50863,PROPRANOLOL  60 MG ORAL TAB,8.5,5.95,,,0
CDM,50863,PROPRANOLOL  80 MG ORAL CS24,20.5,14.35,,,0
CDM,50863,PROPRANOLOL 120 MG ORAL CS24,25.5,17.85,,,0
CDM,50863,PROPRANOLOL 160 MG ORAL CS24,22.0,15.4,,,0
CDM,50863,PROPRANOLOL 20 MG/5 ML ORAL SOLN,7.0,4.9,,,0
CDM,50863,PROPYLTHIOURACIL 50 MG ORAL TAB,20.0,14.0,,,0
CDM,50863,PROPYLTHIOURACIL 5MG/ML SUSPENSION (REPACK),14.0,9.8,,,0
CDM,50863,PROTAMINE 10 MG/ML IV SOLN,86.5,60.55,,,0
CDM,50863,PSEUDOEPHEDRINE 30 MG TAB,7.0,4.9,,,0
CDM,50863,PSEUDOEPHEDRINE SR 120 MG TAB,7.0,4.9,,,0
CDM,50863,PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL PWPK,8.5,5.95,,,0
CDM,50863,PSYLLIUM HUSK (WITH SUGAR) 3.4 GRAM ORAL PWPK,7.0,4.9,,,0
CDM,50863,PYRAZINAMIDE 500 MG ORAL TAB,86.0,60.199999999999996,,,0
CDM,50863,PYRIDOSTIGMINE BROMIDE  60 MG ORAL TAB,14.0,9.8,,,0
CDM,50863,PYRIDOSTIGMINE BROMIDE 180 MG ORAL TBSR,181.5,127.05,,,0
CDM,50863,PYRIDOSTIGMINE BROMIDE 5 MG/ML INJ SOLN,188.0,131.6,,,0
CDM,50863,PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRP,70.0,49.0,,,0
CDM,50863,PYRIDOXINE  50 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,PYRIDOXINE 100 MG/ML INJ SOLN,128.0,89.6,,,0
CDM,50863,QUETIAPINE  25 MG ORAL TAB,18.0,12.6,,,0
CDM,50863,QUETIAPINE 10 MG/ML ORAL SUSPENSION,7.0,4.9,,,0
CDM,50863,QUETIAPINE 100 MG ORAL TAB,49.5,34.65,,,0
CDM,50863,QUETIAPINE 200 MG ORAL TAB,54.0,37.8,,,0
CDM,50863,QUETIAPINE 300 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,QUINIDINE SR 324 MG TAB,51.0,35.7,,,0
CDM,50863,RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML IM SOLN,7604.5,5323.15,,,0
CDM,50863,"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM KIT",1333.0,933.1,,,0
CDM,50863,"RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT IM",1246.0,872.2,,,0
CDM,50863,RACEPINEPHRINE 2.25 % INHL NEBU,11.0,7.7,,,0
CDM,50863,RALOXIFENE 60 MG ORAL TAB,40.5,28.35,,,0
CDM,50863,RALTEGRAVIR 400 MG ORAL TAB,575.5,402.85,,,0
CDM,50863,RAMIPRIL  1.25 MG ORAL CAP,13.0,9.1,,,0
CDM,50863,RAMIPRIL  5 MG ORAL CAP,16.0,11.2,,,0
CDM,50863,RAMIPRIL 10 MG ORAL CAP,19.0,13.3,,,0
CDM,50863,RAMUCIRUMAB 10 MG/ML IV SOLN,11241.0,7868.7,,,0
CDM,50863,RANOLAZINE  500 MG ORAL TB12,15.0,10.5,,,0
CDM,50863,RASBURICASE 1.5 MG IV SOLR,1287.5,901.25,,,0
CDM,50863,RASBURICASE 7.5 MG IV SOLR,13214.0,9249.8,,,0
CDM,50863,RAVULIZUMAB-CWVZ 100 MG/ML IV SOLN,29459.0,20621.3,,,0
CDM,50863,REGADENOSON 0.4 MG/5 ML IV SYRG,913.0,639.1,,,0
CDM,50863,REMDESIVIR 100 MG IV SOLR,1196.0,837.2,,,0
CDM,50863,REMIFENTANIL 1 MG IV SOLR,468.0,327.6,,,0
CDM,50863,REMIFENTANIL 2 MG IV SOLR,556.0,389.2,,,0
CDM,50863,REPAGLINIDE 2 MG ORAL TAB,11.0,7.7,,,0
CDM,50863,"RHO(D) IMMUNE GLOBULIN (RHOPHYLAC) 1,500 UNIT (300 MCG)/2 ML INJ SYRG",693.0,485.1,,,0
CDM,50863,RIBAVIRIN 200 MG ORAL CAP,53.0,37.1,,,0
CDM,50863,RIBOFLAVIN 100 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,RIFABUTIN 150 MG ORAL CAP,85.5,59.849999999999994,,,0
CDM,50863,RIFAMPIN 150 MG ORAL CAP,39.5,27.65,,,0
CDM,50863,RIFAMPIN 25MG/ML SUSPENSION (REPACK),18.0,12.6,,,0
CDM,50863,RIFAMPIN 300 MG ORAL CAP,19.0,13.3,,,0
CDM,50863,RIFAMPIN 600 MG IV SOLR,366.5,256.55,,,0
CDM,50863,RIFAPENTINE 150 MG ORAL TAB,175.0,122.5,,,0
CDM,50863,RIFAXIMIN 550 MG ORAL TAB,294.0,205.8,,,0
CDM,50863,RISANKIZUMAB-RZAA  60 MG/ML IV SOLN,42603.0,29822.1,,,0
CDM,50863,RISPERIDONE 0.25 MG ORAL TAB,51.0,35.7,,,0
CDM,50863,RISPERIDONE 0.5 MG ORAL TAB,5.5,3.85,,,0
CDM,50863,RISPERIDONE 0.5 MG ORAL TBDL,41.5,29.05,,,0
CDM,50863,RISPERIDONE 1 MG ORAL TAB,10.0,7.0,,,0
CDM,50863,RISPERIDONE 1 MG ORAL TBDL,55.5,38.849999999999994,,,0
CDM,50863,RISPERIDONE 1 MG/ML ORAL SOLN,30.0,21.0,,,0
CDM,50863,RISPERIDONE 2 MG ORAL TAB,8.0,5.6,,,0
CDM,50863,RISPERIDONE 3 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,RISPERIDONE MICROSPHERES 25 MG/2 ML IM SYRG,1782.0,1247.4,,,0
CDM,50863,RITONAVIR 100 MG ORAL TAB,52.0,36.4,,,0
CDM,50863,RITUXIMAB 10 MG/ML IV CONC,8866.5,6206.55,,,0
CDM,50863,RITUXIMAB-ABBS 10 MG/ML IV SOLN,17503.5,12252.45,,,0
CDM,50863,RITUXIMAB-PVVR 10 MG/ML IV SOLN,4155.0,2908.5,,,0
CDM,50863,RIVAROXABAN  2.5 MG ORAL TAB,168.0,117.6,,,0
CDM,50863,RIVAROXABAN 10 MG ORAL TAB,170.0,119.0,,,0
CDM,50863,RIVAROXABAN 15 MG ORAL TAB,314.5,220.14999999999998,,,0
CDM,50863,RIVAROXABAN 20 MG ORAL TAB,117.0,81.9,,,0
CDM,50863,RIVASTIGMINE 1.5 MG ORAL CAP,44.0,30.8,,,0
CDM,50863,RIVASTIGMINE 3 MG ORAL CAP,34.0,23.8,,,0
CDM,50863,RIVASTIGMINE 4.6 MG/24 HOUR TD PT24,109.0,76.3,,,0
CDM,50863,RIVASTIGMINE 9.5 MG/24 HOUR TD PT24,109.0,76.3,,,0
CDM,50863,RIZATRIPTAN  5 MG ORAL TBDL,222.5,155.75,,,0
CDM,50863,RIZATRIPTAN 10 MG ORAL TBDL,215.0,150.5,,,0
CDM,50863,ROCURONIUM 10 MG/ML (1ML-UD) OR SYRINGE,54.0,37.8,,,0
CDM,50863,ROCURONIUM 10 MG/ML IV SOLN,80.0,56.0,,,0
CDM,50863,ROCURONIUM 50 MG/5 ML (10 MG/ML) IV SYRG,73.5,51.45,,,0
CDM,50863,ROMIPLOSTIM 125 MCG SUBQ SOLR,1693.5,1185.45,,,0
CDM,50863,ROMIPLOSTIM 250 MCG SUBQ SOLR,3907.0,2734.9,,,0
CDM,50863,ROMIPLOSTIM 500 MCG SUBQ SOLR,7024.0,4916.8,,,0
CDM,50863,ROMOSOZUMAB-AQQG 105 MG/1.17 ML SUBQ SYRG,4012.0,2808.4,,,0
CDM,50863,ROMOSOZUMAB-AQQG 210MG/2.34ML ( 105MG/1.17MLX2) SUBQ SYRG,5893.0,4125.1,,,0
CDM,50863,ROPINIROLE  0.25 MG ORAL TAB,9.0,6.3,,,0
CDM,50863,ROPINIROLE  1 MG ORAL TAB,10.0,7.0,,,0
CDM,50863,ROPINIROLE  2 MG ORAL TAB,7.5,5.25,,,0
CDM,50863,ROPINIROLE  4 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,ROPINIROLE  5 MG ORAL TAB,3.0,2.1,,,0
CDM,50863,ROPIVACAINE  2 MG/ML INJ SOLN,101.5,71.05000000000001,,,0
CDM,50863,ROPIVACAINE (PF) 0.2 % 330 ML (RIGHT) (PHS CUSTOM PAIN BALL),580.0,406.0,,,0
CDM,50863,ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN,36.0,25.2,,,0
CDM,50863,ROPIVACAINE 0.5%/EPINEPHRINE 1:100K INJECTION,130.5,91.35,,,0
CDM,50863,ROPIVACAINE 10 MG/ML INJ SOLN,100.5,70.35,,,0
CDM,50863,ROPIVACAINE IN NACL(PF) 0.15 % EPID SOLN,514.0,359.8,,,0
CDM,50863,ROPIVACAINE(PF)-0.9 % SODCHLOR 0.2 % 745 ML LINF ELPH,1315.0,920.5,,,0
CDM,50863,ROPIVACAINE(PF)0.2 % ELASTOMERIC PUMP (ONQ) 545ML (PREFILLED),2341.5,1639.0500000000002,,,0
CDM,50863,ROPIVACAINE-EPI-CLONID-KETOROL 2.46-0.005- 0.0008-0.3MG/ML PATC SYRG,637.0,445.9,,,0
CDM,50863,ROSUVASTATIN  5 MG ORAL TAB,32.0,22.4,,,0
CDM,50863,ROSUVASTATIN 10 MG ORAL TAB,44.5,31.15,,,0
CDM,50863,ROSUVASTATIN 20 MG ORAL TAB,40.0,28.0,,,0
CDM,50863,ROSUVASTATIN 40 MG ORAL TAB,17.5,12.25,,,0
CDM,50863,"ROTAVIRUS VACCINE LIVE, PENTA 2 ML ORAL SUSP",435.5,304.85,,,0
CDM,50863,"ROTAVIRUS VACCINE, LIVE, 89-12 10EXP6 CCID50 /1.5 ML ORAL SUSP",599.0,419.3,,,0
CDM,50863,"RSV VAC, PREF A AND PREF B(PF) 120 MCG/0.5 ML IM SOLR",1066.0,746.2,,,0
CDM,50863,SACCHAROMYCES BOULARDII 250 MG ORAL CAP,27.0,18.9,,,0
CDM,50863,SACITUZUMAB GOVITECAN-HZIY 180 MG IV SOLR,28606.0,20024.2,,,0
CDM,50863,SACUBITRIL-VALSARTAN 24-26 MG ORAL TAB,57.5,40.25,,,0
CDM,50863,SACUBITRIL-VALSARTAN 49-51 MG ORAL TAB,69.0,48.3,,,0
CDM,50863,SACUBITRIL-VALSARTAN 97-103 MG ORAL TAB,68.5,47.95,,,0
CDM,50863,SALIVA STIMULANT AGENTS COMB.3 MM SPRY (BIOTENE) (REPACK),38.5,26.95,,,0
CDM,50863,SALIVA SUBSTITUTE COMB NO.11 351 MG MM PWPK,60.5,42.35,,,0
CDM,50863,SALMETEROL 50 MCG/DOSE INHL DSDV,47.0,32.9,,,0
CDM,50863,SCOPOLAMINE TRANSDERMAL PATCH 1MG OVER 3 DAYS,113.0,79.1,,,0
CDM,50863,SECUKINUMAB  25 MG/ML IV SOLN,10377.0,7263.9,,,0
CDM,50863,SELEGILINE 5 MG TAB,9.5,6.65,,,0
CDM,50863,SELENIUM SULFIDE 2.5 % TOPICAL LOTN,97.0,67.9,,,0
CDM,50863,SENNOSIDES  8.6 MG ORAL TAB,5.5,3.85,,,0
CDM,50863,SENNOSIDES 15 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,SENNOSIDES 8.8 MG/5 ML ORAL SYRP,9.0,6.3,,,0
CDM,50863,SENNOSIDES-DOCUSATE SODIUM 8.6 MG-50 MG TAB,5.5,3.85,,,0
CDM,50863,SERTRALINE  25 MG ORAL TAB,9.0,6.3,,,0
CDM,50863,SERTRALINE  50 MG ORAL TAB,8.0,5.6,,,0
CDM,50863,SERTRALINE 100 MG ORAL TAB,12.0,8.4,,,0
CDM,50863,SERTRALINE 20 MG/ML ORAL CONC,27.5,19.25,,,0
CDM,50863,SEVELAMER CARBONATE 0.8 GRAM ORAL PWPK,184.0,128.8,,,0
CDM,50863,SEVELAMER CARBONATE 800 MG ORAL TAB,85.0,59.5,,,0
CDM,50863,SILDENAFIL  20 MG ORAL TAB,65.0,45.5,,,0
CDM,50863,SILDENAFIL (PULM.HYPERTENSION) 10 MG/12.5 ML IV SOLN,403.0,282.1,,,0
CDM,50863,SILDENAFIL 100 MG ORAL TAB,28.0,19.6,,,0
CDM,50863,SILDENAFIL 2.5 MG/ML SUSPENSION,17.0,11.9,,,0
CDM,50863,SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,22.0,15.4,,,0
CDM,50863,SILVER SULFADIAZINE 1 % TOP CREA,102.0,71.4,,,0
CDM,50863,SIMETHICONE  80 MG ORAL CHEW,11.0,7.7,,,0
CDM,50863,SIMETHICONE 40 MG/0.6 ML ORAL DRPS,7.0,4.9,,,0
CDM,50863,SIMETHICONE 40MG/0.6ML (0.6ML-UD) SYRINGE (REPACK),9.0,6.3,,,0
CDM,50863,SIMPLE SYRUP,7.0,4.9,,,0
CDM,50863,SIMVASTATIN  5 MG ORAL TAB,20.5,14.35,,,0
CDM,50863,SIMVASTATIN 10 MG ORAL TAB,8.0,5.6,,,0
CDM,50863,SIMVASTATIN 20 MG ORAL TAB,27.5,19.25,,,0
CDM,50863,SIMVASTATIN 40 MG ORAL TAB,21.0,14.700000000000001,,,0
CDM,50863,SIMVASTATIN 80 MG ORAL TAB,27.0,18.9,,,0
CDM,50863,SINCALIDE 5 MCG INJ SOLR,225.0,157.5,,,0
CDM,50863,SIROLIMUS 0.5 MG ORAL TAB,47.5,33.25,,,0
CDM,50863,SIROLIMUS 1 MG ORAL TAB,224.0,156.8,,,0
CDM,50863,SIROLIMUS 1 MG/ML ORAL SOLN,109.0,76.3,,,0
CDM,50863,SITAGLIPTIN  25 MG ORAL TAB,224.0,156.8,,,0
CDM,50863,SITAGLIPTIN 100 MG ORAL TAB,89.0,62.3,,,0
CDM,50863,SOD CHLOR&BICARB-SQUEEZ BOTTLE NASL PKDV,1239.0,867.3,,,0
CDM,50863,SODIUM ACETATE 0.45% IV INFUSION (PEDIATRIC),81.0,56.7,,,0
CDM,50863,SODIUM ACETATE 0.9% WITH HEPARIN IV SYRINGE (NEONATAL),16.0,11.2,,,0
CDM,50863,SODIUM ACETATE 2 MEQ/ML IV SOLN,9.0,6.3,,,0
CDM,50863,SODIUM BICARBONATE   4.2 % IV SOLN,89.0,62.3,,,0
CDM,50863,SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) IV (NEO) EMERGENCY SYRINGE,190.5,133.35000000000002,,,0
CDM,50863,SODIUM BICARBONATE 650 MG ORAL TAB,5.5,3.85,,,0
CDM,50863,SODIUM BICARBONATE 8.4 % (1 MEQ/ML) IV 50 ML EMERGENCY SYRINGE,155.0,108.5,,,0
CDM,50863,SODIUM BICARBONATE 8.4 % IV (PHS ERX MERGE),211.0,147.7,,,0
CDM,50863,SODIUM BICARBONATE 8.4 % IV SOLN,289.0,202.3,,,0
CDM,50863,SODIUM BICARBONATE 8.4% (1 MEQ/1 ML) IV 10 ML EMERGENCY SYRINGE,763.0,534.1,,,0
CDM,50863,SODIUM BICARBONATE IV CONCENTRATED INFUSION (1 MEQ/ML),249.0,174.3,,,0
CDM,50863,SODIUM CHLORIDE  0.65 % NASL SPRA,14.0,9.8,,,0
CDM,50863,SODIUM CHLORIDE  3 % INHL NEBU,7.0,4.9,,,0
CDM,50863,SODIUM CHLORIDE  5 % OPHT DROP,30.0,21.0,,,0
CDM,50863,SODIUM CHLORIDE  7 % INHL NEBU,7.0,4.9,,,0
CDM,50863,SODIUM CHLORIDE 0.45 % 0.45 % IV SOLP,27.0,18.9,,,0
CDM,50863,SODIUM CHLORIDE 0.45% (1/2 NS) INFUSION (PEDS ONC),45.0,31.5,,,0
CDM,50863,SODIUM CHLORIDE 0.9 % INHL NEBU,9.0,6.3,,,0
CDM,50863,SODIUM CHLORIDE 0.9 % INJ SOLN (VIAL),18.5,12.95,,,0
CDM,50863,SODIUM CHLORIDE 0.9 % INJ SYRG,21.0,14.7,,,0
CDM,50863,SODIUM CHLORIDE 0.9 % IR SOLN,111.0,77.7,,,0
CDM,50863,SODIUM CHLORIDE 0.9 % IV (BOLUS),56.0,39.2,,,0
CDM,50863,SODIUM CHLORIDE 0.9 % IV SOLN 400ML (PHS REPACK),20.0,14.0,,,0
CDM,50863,SODIUM CHLORIDE 0.9 % IV SOLP,74.0,51.8,,,0
CDM,50863,SODIUM CHLORIDE 0.9 % MBP,207.5,145.25,,,0
CDM,50863,SODIUM CHLORIDE 0.9% IV (PEDS) BOLUS,21.0,14.7,,,0
CDM,50863,SODIUM CHLORIDE 10 % INHL NEBU,48.0,33.6,,,0
CDM,50863,SODIUM CHLORIDE 1000 MG MISC TBSO,7.5,5.25,,,0
CDM,50863,SODIUM CHLORIDE 3 % IV INFUSION,63.0,44.099999999999994,,,0
CDM,50863,SODIUM CHLORIDE 3% IV BOLUS (ED ONLY),39.0,27.3,,,0
CDM,50863,SODIUM CHLORIDE 4 MEQ/ML IV SOLP (COMPOUNDED 30ML),48.0,33.6,,,0
CDM,50863,SODIUM CHLORIDE 4 MEQ/ML ORAL SOLUTION (CDS),23.0,16.1,,,0
CDM,50863,SODIUM CHLORIDE-ALOE VERA NASL SPRY,31.0,21.7,,,0
CDM,50863,SODIUM CHLORIDE-ALOE VERA TOPICAL GEL,18.5,12.95,,,0
CDM,50863,SODIUM CITRATE 4 % (3 ML) MISC SYRG,42.5,29.75,,,0
CDM,50863,SODIUM CITRATE 4% (3 ML) SYRINGE (FOR DIALYSIS),16.0,11.2,,,0
CDM,50863,SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLN,17.0,11.899999999999999,,,0
CDM,50863,SODIUM HYPOCHLORITE 0.125 % MISC SOLN,91.0,63.7,,,0
CDM,50863,SODIUM HYPOCHLORITE 0.25 % MISC SOLN,91.0,63.7,,,0
CDM,50863,SODIUM HYPOCHLORITE 0.5 % MISC SOLN,79.5,55.650000000000006,,,0
CDM,50863,SODIUM PHOSPHATE 3 MMOL/ML IV SOLN,81.0,56.7,,,0
CDM,50863,SODIUM PHOSPHATES 19 GRAM-7 GRAM ENEMA,7.0,4.9,,,0
CDM,50863,SODIUM POLYSTYRENE SULF-SORBTL 15-20 GRAM/60 ML ORAL SUSP,208.0,145.60000000000002,,,0
CDM,50863,SODIUM POLYSTYRENE SULFONATE ORAL POWDER,133.0,93.1,,,0
CDM,50863,SODIUM TETRADECYL SULFATE 3 % IV SOLN,796.0,557.2,,,0
CDM,50863,SODIUM THIOSULFATE 25 % IV SOLN,413.0,289.1,,,0
CDM,50863,SODIUM ZIRCONIUM CYCLOSILICATE  5 G ORAL PWPK (USE PANEL),293.0,205.1,,,0
CDM,50863,SODIUM ZIRCONIUM CYCLOSILICATE 10 G ORAL PWPK (USE PANEL),161.0,112.7,,,0
CDM,50863,SOMATROPIN  5.8 MG SUBQ SOLR,1207.0,844.9,,,0
CDM,50863,SORBITOL 70 % MISC SOLN,44.0,30.8,,,0
CDM,50863,SOTALOL  80 MG ORAL TAB,17.5,12.25,,,0
CDM,50863,SOTALOL 150 MG/10 ML (15 MG/ML) IV SOLN,3900.0,2730.0,,,0
CDM,50863,SOTALOL 240 MG ORAL TAB,29.0,20.3,,,0
CDM,50863,SOTALOL 5 MG/ML ORAL SOLN,32.0,22.4,,,0
CDM,50863,SPIRONOLACTONE  25 MG ORAL TAB,7.5,5.25,,,0
CDM,50863,SPIRONOLACTONE  50 MG ORAL TAB,9.5,6.65,,,0
CDM,50863,SPIRONOLACTONE 100 MG ORAL TAB,8.5,5.949999999999999,,,0
CDM,50863,SPIRONOLACTONE 5MG/ML SUSPENSION (REPACK),7.0,4.9,,,0
CDM,50863,STERILE TALC 3 G INPL AERP,450.0,315.0,,,0
CDM,50863,STERILE TALC 4 G INPL SUSR,234.5,164.15,,,0
CDM,50863,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ (MERGE),77.0,53.900000000000006,,,0
CDM,50863,SUCCINYLCHOLINE CHLORIDE 200 MG/10 ML (20 MG/ML) IV SYRG,50.0,35.0,,,0
CDM,50863,SUCRALFATE 1 GRAM ORAL TAB,8.0,5.6,,,0
CDM,50863,SUCRALFATE 100 MG/ML ORAL SUSP,57.0,39.9,,,0
CDM,50863,SUCROFERRIC OXYHYDROXIDE 500 MG ORAL CHEW,50.0,35.0,,,0
CDM,50863,SUFENTANIL CITRATE 50 MCG/ML IV SOLN,214.0,149.8,,,0
CDM,50863,SUGAMMADEX 100 MG/ML IV SOLN,2003.0,1402.1,,,0
CDM,50863,SULFACETAMIDE SODIUM 10 % OPHT DROP,259.0,181.3,,,0
CDM,50863,SULFADIAZINE 500 MG ORAL TAB,165.0,115.5,,,0
CDM,50863,SULFASALAZINE 500 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,SULFASALAZINE 500 MG ORAL TBEC,7.0,4.9,,,0
CDM,50863,SUMATRIPTAN  5 MG/ACTUATION NASL SPRY,443.0,310.1,,,0
CDM,50863,SUMATRIPTAN 20 MG/ACTUATION NASL SPRY,345.0,241.5,,,0
CDM,50863,SUMATRIPTAN 25 MG TAB,230.0,161.0,,,0
CDM,50863,SUMATRIPTAN 50 MG TAB,123.0,86.1,,,0
CDM,50863,SUMATRIPTAN 6 MG/0.5 ML SUB-Q,68.0,47.6,,,0
CDM,50863,SUMATRIPTAN 6 MG/0.5 ML SUBQ PEN KIT,322.5,225.75,,,0
CDM,50863,SYRSPEND SF (COMPOUND VEH.SUSP SUGAR-FREE 3) ORAL SUSP,7.0,4.9,,,0
CDM,50863,TACROLIMUS 0.1 % TOP OINT,411.5,288.04999999999995,,,0
CDM,50863,TACROLIMUS 0.5 MG ORAL CAP,28.0,19.6,,,0
CDM,50863,TACROLIMUS 0.5 MG/ML ORAL SUSPENSION (REPACK),38.0,26.6,,,0
CDM,50863,TACROLIMUS 0.75 MG (ENVARSUS XR) 24-HOUR EXTENDED-RELEASE TABLET,48.0,33.6,,,0
CDM,50863,TACROLIMUS 1 MG (ENVARSUS XR) 24-HOUR EXTENDED-RELEASE TABLET,99.0,69.3,,,0
CDM,50863,TACROLIMUS 1 MG ORAL CAP,50.5,35.35,,,0
CDM,50863,TACROLIMUS 4 MG (ENVARSUS XR) 24-HOUR EXTENDED-RELEASE TABLET,141.0,98.7,,,0
CDM,50863,TACROLIMUS 5 MG ORAL CAP,27.0,18.9,,,0
CDM,50863,TACROLIMUS 5 MG/ML IV SOLN,890.0,623.0,,,0
CDM,50863,TAFASITAMAB-CXIX 200 MG IV SOLR,14904.0,10432.8,,,0
CDM,50863,TALQUETAMAB-TGVS  2 MG/ML SUBQ SOLN,2145.0,1501.5,,,0
CDM,50863,TALQUETAMAB-TGVS 40 MG/ML SUBQ SOLN,10163.5,7114.45,,,0
CDM,50863,TAMOXIFEN 10 MG ORAL TAB,26.5,18.549999999999997,,,0
CDM,50863,TAMSULOSIN 0.4 MG ORAL CP24,124.0,86.8,,,0
CDM,50863,TARLATAMAB-DLLE  1 MG IV SOLR,4140.0,2898.0,,,0
CDM,50863,TARLATAMAB-DLLE 10 MG IV SOLR,41381.0,28966.7,,,0
CDM,50863,TECLISTAMAB-CQYV 10 MG/ML SUBQ SOLN,4886.0,3420.2,,,0
CDM,50863,TECLISTAMAB-CQYV 90 MG/ML SUBQ SOLN,24915.0,17440.5,,,0
CDM,50863,TELMISARTAN 40 MG ORAL TAB,31.0,21.7,,,0
CDM,50863,TEMAZEPAM  7.5 MG ORAL CAP,76.0,53.2,,,0
CDM,50863,TEMAZEPAM 15 MG ORAL CAP,9.0,6.3,,,0
CDM,50863,TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FINAL) IV SOLR,10681.0,7476.7,,,0
CDM,50863,TENECTEPLASE 25 MG IV SOLR,22901.0,16030.7,,,0
CDM,50863,TENECTEPLASE 50 MG IV (MERGE ERX) (STEMI),17176.0,12023.2,,,0
CDM,50863,TENECTEPLASE 50 MG IV (MERGE) (STROKE),6767.5,4737.25,,,0
CDM,50863,TENOFOVIR DISOPROXIL FUMARATE 300 MG ORAL TAB,31.0,21.7,,,0
CDM,50863,TEPLIZUMAB-MZWV 2 MG/20 ML IV SOLN,7987.5,5591.25,,,0
CDM,50863,TEPROTUMUMAB-TRBW 500 MG IV SOLR,70458.0,49320.6,,,0
CDM,50863,TERAZOSIN  1 MG ORAL CAP,18.0,12.6,,,0
CDM,50863,TERAZOSIN  2 MG ORAL CAP,13.5,9.45,,,0
CDM,50863,TERAZOSIN  5 MG ORAL CAP,14.5,10.15,,,0
CDM,50863,TERBINAFINE 250 MG ORAL TAB,611.0,427.7,,,0
CDM,50863,TERBUTALINE 1 MG/ML SUBQ SOLN,324.0,226.79999999999998,,,0
CDM,50863,TESTOSTERONE CYPIONATE 200 MG/ML IM OIL,97.5,68.25,,,0
CDM,50863,TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP,214.0,149.8,,,0
CDM,50863,TETANUS IMMUNE GLOBULIN (PF) 250 UNIT IM SYRG,1262.0,883.4,,,0
CDM,50863,TETRABENAZINE 12.5 MG ORAL TAB,304.5,213.14999999999998,,,0
CDM,50863,TETRABENAZINE 25 MG ORAL TAB,386.0,270.2,,,0
CDM,50863,TETRACAINE HCL (PF) 0.5 % OPHT DROP (STANDARD STOCK),80.0,56.0,,,0
CDM,50863,TETRACYCLINE 500 MG ORAL CAP,78.0,54.6,,,0
CDM,50863,TEZEPELUMAB-EKKO 210 MG/1.91 ML (110 MG/ML) SUBQ SYRG,10028.0,7019.6,,,0
CDM,50863,THEOPHYLLINE 100 MG ORAL CP24,47.5,33.25,,,0
CDM,50863,THEOPHYLLINE 300 MG ORAL TB12,15.5,10.850000000000001,,,0
CDM,50863,THEOPHYLLINE 80 MG/15 ML ORAL SOLN,25.0,17.5,,,0
CDM,50863,THIAMINE 100 MG TAB,7.0,4.9,,,0
CDM,50863,THIAMINE 100 MG/ML INJECTION,54.0,37.8,,,0
CDM,50863,THIAMINE IN 0.9 % SOD CHLORIDE 500 MG/100 ML IV SOLN,161.0,112.7,,,0
CDM,50863,THIAMINE MONONITRATE 100 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,THIORIDAZINE  25 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,THROMBIN (BOVINE)  5000 UNIT TOP SOLR,386.0,270.2,,,0
CDM,50863,THROMBIN (RECOMBINANT) 20000 UNIT TOP SOLR,4872.0,3410.4,,,0
CDM,50863,THROMBIN (RECOMBINANT) 5000 UNIT TOP SOLR,1487.0,1040.9,,,0
CDM,50863,THYROID (PORK)  30 MG ORAL TAB,15.0,10.5,,,0
CDM,50863,THYROID (PORK)  60 MG ORAL TAB,13.0,9.1,,,0
CDM,50863,THYROID (PORK)  90 MG ORAL TAB,9.0,6.3,,,0
CDM,50863,THYROID (PORK) 15 MG ORAL TAB,11.5,8.05,,,0
CDM,50863,THYROTROPIN ALFA 0.9 MG IM SOLR,8208.0,5745.6,,,0
CDM,50863,TICAGRELOR 60 MG ORAL TAB,52.0,36.4,,,0
CDM,50863,TICAGRELOR 90 MG ORAL TAB,89.0,62.3,,,0
CDM,50863,TIGECYCLINE 50 MG IV SOLR,491.0,343.7,,,0
CDM,50863,TIMOLOL MALEATE 0.25 % OPHT DROP,105.0,73.5,,,0
CDM,50863,TIMOLOL MALEATE 0.5 % OPHT DROP,74.5,52.15,,,0
CDM,50863,TIOTROPIUM BROMIDE 1.25 MCG/ACTUATION INHL MIST,7.0,4.9,,,0
CDM,50863,TIOTROPIUM BROMIDE 18 MCG INHL CPDV,96.0,67.2,,,0
CDM,50863,TIOTROPIUM BROMIDE 2.5 MCG/ACTUATION INHL MIST,919.0,643.3,,,0
CDM,50863,TIROFIBAN-0.9% SODIUM CHLORIDE 5 MG/100 ML (50 MCG/ML) IV SOLN,105.0,73.5,,,0
CDM,50863,TISLELIZUMAB-JSGR 10 MG/ML IV SOLN,13211.0,9247.7,,,0
CDM,50863,TIZANIDINE 4 MG ORAL TAB,14.0,9.8,,,0
CDM,50863,TOBRAMYCIN (FORTIFIED) 15MG/ML OPHTHALMIC DROP (15ML),42.0,29.4,,,0
CDM,50863,TOBRAMYCIN 0.3 % EYE DROPS,101.0,70.7,,,0
CDM,50863,TOBRAMYCIN 0.3 % EYE OINTMENT,947.0,662.9,,,0
CDM,50863,TOBRAMYCIN 1.2 G POWDER VIAL,398.0,278.6,,,0
CDM,50863,TOBRAMYCIN 150 MG/3.75 ML NEBULIZER SOLN (REPACK),21.0,14.7,,,0
CDM,50863,TOBRAMYCIN 300 MG/5 ML INHL NEBU (REPACK),396.0,277.2,,,0
CDM,50863,TOBRAMYCIN SULFATE 40 MG/ML INJ SOLN,61.5,43.05,,,0
CDM,50863,"TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE DROPS, SUSP",283.0,198.1,,,0
CDM,50863,TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT,1056.0,739.2,,,0
CDM,50863,TOCILIZUMAB 80 MG/4 ML (20 MG/ML) IV SOLN,4765.5,3335.8500000000004,,,0
CDM,50863,TOCILIZUMAB-AAZG 80 MG/4 ML (20 MG/ML) IV SOLN,4160.0,2912.0,,,0
CDM,50863,TOLTERODINE 1 MG ORAL TAB,28.0,19.6,,,0
CDM,50863,TOLTERODINE 2 MG ORAL CP24,79.0,55.3,,,0
CDM,50863,TOLTERODINE 2 MG ORAL TAB,19.0,13.3,,,0
CDM,50863,TOLVAPTAN 15 MG ORAL TAB,1293.0,905.1,,,0
CDM,50863,TOPIRAMATE  15 MG ORAL CPSP,50.5,35.35,,,0
CDM,50863,TOPIRAMATE  25 MG ORAL CPSP,66.0,46.2,,,0
CDM,50863,TOPIRAMATE  25 MG ORAL TAB,35.0,24.5,,,0
CDM,50863,TOPIRAMATE 100 MG ORAL TAB,51.5,36.05,,,0
CDM,50863,TOPIRAMATE 200 MG ORAL TAB,25.5,17.85,,,0
CDM,50863,TOPOTECAN 4 MG/4 ML (1 MG/ML) IV SOLN,353.0,247.1,,,0
CDM,50863,TORIPALIMAB-TPZI 240 MG/6 ML (40 MG/ML) IV SOLN,25650.0,17955.0,,,0
CDM,50863,TORSEMIDE   5 MG ORAL TAB,14.5,10.15,,,0
CDM,50863,TORSEMIDE  20 MG ORAL TAB,14.0,9.8,,,0
CDM,50863,TRABECTEDIN 1 MG IV SOLR,18630.0,13041.0,,,0
CDM,50863,TRAMADOL  50 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,TRANEXAMIC ACID (FOR TOPICAL USE),97.0,67.9,,,0
CDM,50863,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN",120.0,84.0,,,0
CDM,50863,TRANEXAMIC ACID 1000 MG/10 ML FOR NEBULIZATION,116.0,81.2,,,0
CDM,50863,TRANEXAMIC ACID 650 MG ORAL TAB,51.0,35.7,,,0
CDM,50863,"TRANEXAMIC ACID IN NACL,ISO-OS 1,000 MG/100 ML (10 MG/ML) IV PGBK",122.5,85.75,,,0
CDM,50863,TRASTUZUMAB-QYYP 420 MG IV SOLR,8246.0,5772.2,,,0
CDM,50863,TRAZODONE  50 MG ORAL TAB,8.0,5.6,,,0
CDM,50863,TRAZODONE 100 MG ORAL TAB,14.0,9.8,,,0
CDM,50863,TRAZODONE 150 MG ORAL TAB,9.0,6.3,,,0
CDM,50863,TRETINOIN (CHEMOTHERAPY) 10 MG ORAL CAP,546.0,382.2,,,0
CDM,50863,TRIAMCINOLONE ACETONIDE 0.1 % DENT PSTE,342.0,239.4,,,0
CDM,50863,TRIAMCINOLONE ACETONIDE 0.1 % TOP CREAM,33.0,23.1,,,0
CDM,50863,TRIAMCINOLONE ACETONIDE 0.1 % TOP LOTN,295.0,206.5,,,0
CDM,50863,TRIAMCINOLONE ACETONIDE 0.1 % TOP OINT,55.0,38.5,,,0
CDM,50863,TRIAMCINOLONE ACETONIDE 0.5 % TOP OINT,50.0,35.0,,,0
CDM,50863,TRIAMCINOLONE ACETONIDE 10 MG/ML INJ SUSP,71.0,49.7,,,0
CDM,50863,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,43.5,30.45,,,0
CDM,50863,TRIAMTERENE  50 MG ORAL CAP,88.0,61.6,,,0
CDM,50863,TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5 MG-25 MG CAP,7.0,4.9,,,0
CDM,50863,TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5 MG-25 MG TAB,9.0,6.300000000000001,,,0
CDM,50863,TRIAMTERENE-HYDROCHLOROTHIAZIDE 75 MG-50 MG TAB,7.0,4.9,,,0
CDM,50863,TRIHEXYPHENIDYL 2 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,TRIHEXYPHENIDYL 5 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,"TRIMETHOPRIM-POLYMYXIN B 0.1 %-10,000 UNIT/ML EYE DROPS",76.0,53.2,,,0
CDM,50863,TRIMETHOPRIM-SULFAMETHOXAZOLE 160 MG-800 MG TAB,24.0,16.8,,,0
CDM,50863,TRIMETHOPRIM-SULFAMETHOXAZOLE 40 MG-200 MG/5 ML ORAL SUSP,36.0,25.2,,,0
CDM,50863,TRIMETHOPRIM-SULFAMETHOXAZOLE 80 MG-400 MG TAB,7.5,5.25,,,0
CDM,50863,TRIMETHOPRIM-SULFAMETHOXAZOLE 80 MG-400 MG/5 ML IV,153.5,107.45,,,0
CDM,50863,TROPICAMIDE 0.5 % OPHT DROP,131.0,91.7,,,0
CDM,50863,TROSPIUM 20 MG ORAL TAB,24.0,16.8,,,0
CDM,50863,TUBERCULIN PPD 5 UNIT/0.1 ML IDRM SOLN,62.5,43.75,,,0
CDM,50863,UBLITUXIMAB-XIIY 25 MG/ML IV SOLN,57809.0,40466.3,,,0
CDM,50863,UREA 15 GRAM PACKET,28.0,19.6,,,0
CDM,50863,URSODIOL 300 MG ORAL CAP,41.0,28.7,,,0
CDM,50863,URSODIOL 60 MG/ML ORAL SUSPENSION (REPACK),7.0,4.9,,,0
CDM,50863,USTEKINUMAB 130 MG/26 ML IV SOLN,11040.0,7728.0,,,0
CDM,50863,USTEKINUMAB-KFCE 130 MG/26 ML IV SOLN,4248.0,2973.6,,,0
CDM,50863,VALACYCLOVIR 500 MG ORAL TAB,51.5,36.05,,,0
CDM,50863,VALGANCICLOVIR 450 MG ORAL TAB,382.0,267.4,,,0
CDM,50863,VALGANCICLOVIR 50 MG/ML ORAL SOLR,202.0,141.4,,,0
CDM,50863,VALPROATE SODIUM 100 MG/ML IV SOLN,74.0,51.8,,,0
CDM,50863,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLN,22.5,15.75,,,0
CDM,50863,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SYRP,7.0,4.9,,,0
CDM,50863,VALPROIC ACID 250 MG ORAL CAP,11.0,7.7,,,0
CDM,50863,VALSARTAN  40 MG ORAL TAB,17.5,12.25,,,0
CDM,50863,VALSARTAN  80 MG ORAL TAB,24.5,17.15,,,0
CDM,50863,VALSARTAN 160 MG ORAL TAB,15.0,10.5,,,0
CDM,50863,VANCOMYCIN   1.25 G IV SOLR,130.0,91.0,,,0
CDM,50863,VANCOMYCIN   1.5 G IV SOLR,142.5,99.75,,,0
CDM,50863,VANCOMYCIN  125 MG ORAL CAP,210.0,147.0,,,0
CDM,50863,VANCOMYCIN  5 GRAM IV SOLR,116.0,81.2,,,0
CDM,50863,VANCOMYCIN  500 MG IV SOLR,43.5,30.45,,,0
CDM,50863,VANCOMYCIN  750 MG IV SOLR,57.0,39.9,,,0
CDM,50863,VANCOMYCIN (FORTIFIED) 50MG/ML OPHTHALMIC DROP (15ML),326.0,228.2,,,0
CDM,50863,VANCOMYCIN 10 GRAM IV SOLR,50.0,35.0,,,0
CDM,50863,VANCOMYCIN 1000 MG IN NS 500 ML IRRIGATION (REPACK),97.0,67.9,,,0
CDM,50863,VANCOMYCIN 1000 MG IV SOLR,115.0,80.5,,,0
CDM,50863,VANCOMYCIN 125 MG/5 ML (25MG/ML) ORAL SYRINGE (REPACK),71.0,49.7,,,0
CDM,50863,VANCOMYCIN ENEMA 500MG IN 100ML NS,48.0,33.599999999999994,,,0
CDM,50863,VANCOMYCIN IN 0.9 % SODIUM CHL 1.5 GRAM/500 ML IV SOLN,105.5,73.85,,,0
CDM,50863,VANCOMYCIN IN 0.9 % SODIUM CHL 2 GRAM/500 ML IV SOLN,138.0,96.6,,,0
CDM,50863,VANCOMYCIN IN 0.9% SODIUM CL 1 GRAM/250 ML IV SOLN,80.0,56.0,,,0
CDM,50863,VANCOMYCIN IN 0.9% SODIUM CL 1.25 GRAM/250 ML IV SOLN,112.0,78.4,,,0
CDM,50863,VANCOMYCIN IN D5W 1 GRAM/200 ML IV PGBK,472.5,330.75,,,0
CDM,50863,VANCOMYCIN IN DEXTROSE 500 MG/100 ML IV PGBK,44.0,30.8,,,0
CDM,50863,VANCOMYCIN NEO IV SYRINGE (CDS MIXTURE),36.0,25.2,,,0
CDM,50863,VANCOMYCIN PEDS IVPB (CDS MIXTURE),43.0,30.1,,,0
CDM,50863,VANCOMYCIN-DILUENT COMBO NO.1 1.25 GRAM/250 ML IV PGBK,112.0,78.4,,,0
CDM,50863,VARENICLINE 0.5 MG ORAL TAB,69.0,48.3,,,0
CDM,50863,"VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUB-Q SOLN",465.0,325.5,,,0
CDM,50863,"VARICELLA-ZOSTER GE VAC,2 OF 2 50 MCG IM SUSR",763.0,534.1,,,0
CDM,50863,VARICELLA-ZOSTER GE-AS01B (PF) 50 MCG/0.5 ML IM SUSR,655.0,458.5,,,0
CDM,50863,VARICELLA-ZOSTER IG-MALTOSE 125 UNIT/1.2 ML IM SOLN,25935.0,18154.5,,,0
CDM,50863,VASOPRESSIN  0.4 UNITS/ML IV SOLN,802.5,561.75,,,0
CDM,50863,VASOPRESSIN 20 UNIT/ML IV SOLN,61.0,42.7,,,0
CDM,50863,VASOPRESSIN 20 UNITS IN 100 ML NS,120.0,84.0,,,0
CDM,50863,VASOPRESSIN IN 0.9 % NS 40 UNIT/100 ML (0.4 UNIT/ML) IV SOLN,343.0,240.1,,,0
CDM,50863,VASOPRESSIN INFUSION PEDS IV SYRINGE IN D5W (FROM PREMIX),752.0,526.4,,,0
CDM,50863,VECURONIUM 1 MG/ML IV SYRINGE (NEO),34.0,23.799999999999997,,,0
CDM,50863,VECURONIUM BROMIDE 10 MG IV SOLR,45.5,31.849999999999998,,,0
CDM,50863,VECURONIUM BROMIDE 20 MG IV SOLR,58.5,40.95,,,0
CDM,50863,VEDOLIZUMAB 300 MG IV SOLR,11084.0,7758.8,,,0
CDM,50863,VENETOCLAX  50 MG ORAL TAB,259.0,181.3,,,0
CDM,50863,VENETOCLAX 10 MG ORAL TAB,94.0,65.8,,,0
CDM,50863,VENETOCLAX 100 MG ORAL TAB,689.0,482.3,,,0
CDM,50863,VENLAFAXINE  25 MG ORAL TAB,12.0,8.4,,,0
CDM,50863,VENLAFAXINE  37.5 MG ORAL CP24,47.0,32.9,,,0
CDM,50863,VENLAFAXINE  37.5 MG ORAL TAB,17.5,12.25,,,0
CDM,50863,VENLAFAXINE  50 MG ORAL TAB,18.0,12.6,,,0
CDM,50863,VENLAFAXINE  75 MG ORAL CP24,35.0,24.5,,,0
CDM,50863,VENLAFAXINE  75 MG ORAL TAB,19.0,13.3,,,0
CDM,50863,VENLAFAXINE  75 MG ORAL TR24,113.0,79.1,,,0
CDM,50863,VENLAFAXINE 150 MG ORAL CP24,30.5,21.35,,,0
CDM,50863,VERAPAMIL  80 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,VERAPAMIL 120 MG ORAL TAB,7.0,4.9,,,0
CDM,50863,VERAPAMIL 120 MG ORAL TBSR,8.5,5.95,,,0
CDM,50863,VERAPAMIL 180 MG ORAL TBSR,13.0,9.100000000000001,,,0
CDM,50863,VERAPAMIL 2.5 MG/ML IV SOLN,77.0,53.900000000000006,,,0
CDM,50863,VERAPAMIL 240 MG ORAL TBSR,10.0,7.0,,,0
CDM,50863,VILAZODONE 40 MG ORAL TAB,72.0,50.4,,,0
CDM,50863,VINBLASTINE 1 MG/ML IV SOLN,411.0,287.70000000000005,,,0
CDM,50863,VINCRISTINE 2 MG/2 ML IV SOLN,141.0,98.7,,,0
CDM,50863,VITAMIN A 10000 UNIT ORAL CAP,7.0,4.9,,,0
CDM,50863,"VITAMIN E (DL, ACETATE) 22.5 MG (50 UNIT)/ML ORAL DROP",53.0,37.1,,,0
CDM,50863,VITAMINS A & D-WHITE PETROLATUM-LANOLIN OINTMENT,15.0,10.5,,,0
CDM,50863,VORICONAZOLE  50 MG ORAL TAB,123.0,86.1,,,0
CDM,50863,VORICONAZOLE 200 MG IV SOLN,761.0,532.7,,,0
CDM,50863,VORICONAZOLE 200 MG ORAL TAB,253.5,177.45,,,0
CDM,50863,VUTRISIRAN 25 MG/0.5 ML SUBQ SYRG,329409.0,230586.3,,,0
CDM,50863,WARFARIN  2 MG ORAL TAB,8.0,5.6,,,0
CDM,50863,WARFARIN  2.5 MG ORAL TAB,8.0,5.6,,,0
CDM,50863,WARFARIN  3 MG ORAL TAB,8.0,5.6,,,0
CDM,50863,WARFARIN  4 MG ORAL TAB,7.5,5.25,,,0
CDM,50863,WARFARIN  5 MG ORAL TAB,8.5,5.949999999999999,,,0
CDM,50863,WARFARIN  6 MG ORAL TAB,7.5,5.25,,,0
CDM,50863,WARFARIN  7.5 MG ORAL TAB,9.0,6.300000000000001,,,0
CDM,50863,WARFARIN 1 MG ORAL TAB,13.0,9.100000000000001,,,0
CDM,50863,WARFARIN 10 MG ORAL TAB,6.5,4.550000000000001,,,0
CDM,50863,"WATER FOR INJECTION, STERILE INJECTION",44.5,31.15,,,0
CDM,50863,"WATER FOR INJECTION, STERILE IV",48.0,33.6,,,0
CDM,50863,"WATER FOR IRRIGATION, STERILE SOLUTION",109.0,76.3,,,0
CDM,50863,WHITE PETROLATUM TOP OIPK,7.0,4.9,,,0
CDM,50863,WHITE PETROLATUM TOPICAL GEL,7.0,4.9,,,0
CDM,50863,WHITE PETROLATUM-MINERAL OIL 57.3-42.5 % OPHT OINT,51.0,35.7,,,0
CDM,50863,WHITE PETROLATUM-MINERAL OIL 80 %-20 % EYE OINTMENT,38.0,26.6,,,0
CDM,50863,WHITE PETROLATUM-MINERAL OIL OPHT OINT (PDS MERGE),53.5,37.45,,,0
CDM,50863,WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM (MERGE),66.0,46.2,,,0
CDM,50863,ZAFIRLUKAST 20 MG ORAL TAB,16.0,11.2,,,0
CDM,50863,ZINC OXIDE 16 % TOP PSTE,42.0,29.4,,,0
CDM,50863,ZINC OXIDE 20 % TOP OINT (REPACK),16.0,11.2,,,0
CDM,50863,ZINC SULFATE 220 MG (50 MG) CAP,7.0,4.9,,,0
CDM,50863,ZIPRASIDONE 20 MG CAP,46.5,32.55,,,0
CDM,50863,ZIPRASIDONE 20 MG IM,120.0,84.0,,,0
CDM,50863,ZIPRASIDONE 40 MG CAP,63.0,44.1,,,0
CDM,50863,ZOLBETUXIMAB-CLZB 300 MG IV SOLR (WET SOLR VIAL),17875.5,12512.85,,,0
CDM,50863,ZOLEDRONIC ACID 4 MG/5 ML IV SOLN,382.0,267.4,,,0
CDM,50863,ZOLEDRONIC ACID IN MANNITOL & WATER 5 MG/100 ML IV SOLN,832.0,582.4,,,0
CDM,50863,ZOLEDRONIC ACID-MANNITOL-WATER 4 MG/100 ML IV PGBK,778.0,544.6,,,0
CDM,50863,ZOLPIDEM  5 MG ORAL TAB,20.0,14.0,,,0
CDM,50863,ZONISAMIDE 10 MG/ML ORAL SYRUP (REPACK),27.0,18.9,,,0
CDM,50863,ZONISAMIDE 100 MG ORAL CAP,23.5,16.45,,,0
CDM,51000001,HC DEBRIDE SUBQ TISSUE FIRST 20 SQ CM OR LESS,789.0,552.3,,,0
CDM,51000002,HC APPLY TOTAL CONTACT LEG CAST,689.0,482.3,,,0
CDM,51000004,BLOOD COLLECT PICC,294.0,205.8,,,0
CDM,51000007,HC TELEHEALTH FACILITY FEE,72.0,50.4,,,0
CDM,51000013,HC NASOPHARYNGOSCOPY,493.0,345.1,,,0
CDM,51000024,HC NEG PRESS WOUND NON-DME LESS THAN OR EQUAL TO 50 SQ CM,416.0,291.2,,,0
CDM,51000025,HC NEG PRESS WOUND NON-DME GREATER THAN 50 SQ CM,330.0,231.0,,,0
CDM,51000027,HC APPLICATION MULTI-LAYER COMPRESSION SYSTEM UPPER ARM/FOREARM/HAND/FINGERS,672.0,470.4,,,0
CDM,51012,HC IV INFUSION HYDRAT 31-60 MIN,1196.0,837.2,,,0
CDM,51014,HC IV INFUSION HYDRAT 31-60 MIN,415.0,290.5,,,0
CDM,51014,REMDESIVIR 100 MG IV SOLR,1196.0,837.2,,,0
CDM,51016,HC IV INFUSION HYDRAT 31-60 MIN,2392.0,1674.4,,,0
CDM,51018,HC IV INFUSION HYDRAT 31-60 MIN,1196.0,837.2,,,0
CDM,51022,ABOBOTULINUMTOXINA 300 UNITS IM SOLR,4425.0,3097.5,,,0
CDM,51022,ABOBOTULINUMTOXINA 500 UNITS IM SOLR,3791.0,2653.7,,,0
CDM,51022,"ALDESLEUKIN 360,000 UNITS/ ML SOLUTION",5121.0,3584.7,,,0
CDM,51022,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,48.0,33.6,,,0
CDM,51022,AMPICILLIN 250 MG SOLUTION FOR INJECTION,24.0,16.8,,,0
CDM,51022,ANAKINRA 100 MG/0.67 ML SUBQ SYRG,562.0,393.4,,,0
CDM,51022,ARIPIPRAZOLE LAUROXIL 662 MG/2.4 ML IM SERS,6592.0,4614.4,,,0
CDM,51022,ARIPIPRAZOLE LAUROXIL 882 MG/3.2 ML IM SERS,7575.0,5302.5,,,0
CDM,51022,BENRALIZUMAB 30 MG/ML SUBQ SYRG,13116.0,9181.2,,,0
CDM,51022,BENZTROPINE 1 MG/ML INJ SOLN,177.0,123.9,,,0
CDM,51022,BETAMETHASONE ACET & SOD PHOS 6 MG/ML INJ SUSP,98.0,68.6,,,0
CDM,51022,BORTEZOMIB 3.5 MG IV SOLR,253.5,177.45,,,0
CDM,51022,BOTULINUM TOXIN TYPE A 100 UNIT IM SOLR,2717.5,1902.25,,,0
CDM,51022,"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN",40.0,28.0,,,0
CDM,51022,BUPRENORPHINE 100 MG/0.5 ML SUBQ SLSY,3368.5,2357.95,,,0
CDM,51022,BUPRENORPHINE 128 MG/0.36 ML SUBQ SLSY,4047.0,2832.9,,,0
CDM,51022,CALCITONIN (SALMON) 200 UNIT/ML INJ SOLN,3209.0,2246.3,,,0
CDM,51022,CANAKINUMAB (PF) 150 MG/ML SUBQ SOLN,55390.5,38773.350000000006,,,0
CDM,51022,CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN,457.0,319.9,,,0
CDM,51022,CEFAZOLIN   1 GRAM INJ SOLR,22.0,15.4,,,0
CDM,51022,CEFAZOLIN PEDS SYRINGE (20MG/ML) IN DEXTROSE (CDS MIX,84.0,58.8,,,0
CDM,51022,CEFEPIME 1 GRAM INJ SOLR,48.0,33.6,,,0
CDM,51022,CEFTAZIDIME   1 GRAM INJ SOLR,29.0,20.3,,,0
CDM,51022,CEFTRIAXONE   2 GRAM INJ SOLR,40.0,28.0,,,0
CDM,51022,CEFTRIAXONE 1 GRAM INJ SOLR,40.0,28.0,,,0
CDM,51022,CEFTRIAXONE 100 MG/ML FROM 1 GRAM VIAL (PRMC PEDS ONLY),16.0,11.2,,,0
CDM,51022,CEFTRIAXONE 250 MG INJ SOLR,44.5,31.15,,,0
CDM,51022,CEFTRIAXONE 500 MG INJ SOLR,76.5,53.550000000000004,,,0
CDM,51022,CERTOLIZUMAB PEGOL 400 MG (200 MG X 2) SUBQ KIT,4984.5,3489.1499999999996,,,0
CDM,51022,CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X 2) SUBQ SYKT,11839.0,8287.3,,,0
CDM,51022,CHLORPROMAZINE 25 MG/ML INJ SOLN,292.0,204.4,,,0
CDM,51022,CLINDAMYCIN 150 MG/ML INJECTION,20.0,14.0,,,0
CDM,51022,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,46.0,32.2,,,0
CDM,51022,CYTARABINE 100 MG/ML INJ SOLN,120.0,84.0,,,0
CDM,51022,DARBEPOETIN ALFA IN POLYSORBAT  10 MCG/0.4 ML INJ SYRG,591.0,413.70000000000005,,,0
CDM,51022,DARBEPOETIN ALFA IN POLYSORBAT  25 MCG/ML INJ SOLN,836.0,585.2,,,0
CDM,51022,DARBEPOETIN ALFA IN POLYSORBAT  40 MCG/0.4 ML INJ SYRG,1644.0,1150.8000000000002,,,0
CDM,51022,DARBEPOETIN ALFA IN POLYSORBAT  60 MCG/0.3 ML INJ SYRG,1175.5,822.8499999999999,,,0
CDM,51022,DARBEPOETIN ALFA IN POLYSORBAT 100 MCG/0.5 ML INJ SYRG,2137.0,1495.9,,,0
CDM,51022,DARBEPOETIN ALFA IN POLYSORBAT 200 MCG/0.4 ML INJ SYRG,4273.0,2991.1,,,0
CDM,51022,DARBEPOETIN ALFA IN POLYSORBAT 25 MCG/0.42 ML INJ SYRG,836.0,585.2,,,0
CDM,51022,DARBEPOETIN ALFA IN POLYSORBAT 300 MCG/0.6 ML INJ SYRG,6409.0,4486.3,,,0
CDM,51022,DARBEPOETIN ALFA IN POLYSORBAT 500 MCG/ML INJ SYRG,10682.0,7477.4,,,0
CDM,51022,DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBQ SOLN,9295.0,6506.5,,,0
CDM,51022,DENOSUMAB 60 MG/ML SUBQ SYRG,5053.5,3537.45,,,0
CDM,51022,DENOSUMAB-BBDZ 60 MG/ML SUBQ SYRG,4428.0,3099.6,,,0
CDM,51022,DESMOPRESSIN 4 MCG/ML INJECTION SOLN,123.0,86.1,,,0
CDM,51022,DEXAMETHASONE 10 MG/ML INJECTION,16.0,11.2,,,0
CDM,51022,DEXAMETHASONE 4 MG/ML INJECTION,24.0,16.8,,,0
CDM,51022,DEXAMETHASONE SODIUM PHOS (PF) 10MG/ML INJ SOLN,33.0,23.1,,,0
CDM,51022,DEXMEDETOMIDINE 100 MCG/ML IV SOLN,16.0,11.2,,,0
CDM,51022,DIAZEPAM 5 MG/ML INJ SYRG,243.5,170.45,,,0
CDM,51022,DICYCLOMINE 10 MG/ML IM SOLN,187.0,130.9,,,0
CDM,51022,DIHYDROERGOTAMINE 1 MG/ML INJ SOLN,646.0,452.2,,,0
CDM,51022,DIPHENHYDRAMINE 50 MG/ML INJECTION,18.5,12.95,,,0
CDM,51022,DROPERIDOL 2.5 MG/ML INJ SOLN,63.0,44.1,,,0
CDM,51022,ENOXAPARIN 100 MG/1 ML SUBQ SYRG,132.0,92.4,,,0
CDM,51022,ENOXAPARIN 120 MG/0.8 ML SUBQ SYRG,146.0,102.2,,,0
CDM,51022,ENOXAPARIN 150 MG/1 ML SUBQ SYRG,163.0,114.1,,,0
CDM,51022,ENOXAPARIN 20 MG/ML IN NS NEONATAL INJECTION (REPACK),72.0,50.4,,,0
CDM,51022,ENOXAPARIN 30 MG/0.3 ML SUBQ SYRG,46.5,32.55,,,0
CDM,51022,ENOXAPARIN 40 MG/0.4 ML SUBQ SYRG,58.5,40.95,,,0
CDM,51022,ENOXAPARIN 60 MG/0.6 ML SUBQ SYRG,100.0,70.0,,,0
CDM,51022,ENOXAPARIN 80 MG/0.8 ML SUBQ SYRG,101.0,70.7,,,0
CDM,51022,ENOXAPARIN NEO/PEDIATRIC SYRINGE < 30 MG,21.0,14.7,,,0
CDM,51022,EPHEDRINE 50 MG/ML IV SOLN (MERGE),122.5,85.75,,,0
CDM,51022,EPHEDRINE SULFATE  25 MG/5 ML (5 MG/ML) IV SYRG (MERGE),85.0,59.5,,,0
CDM,51022,EPINEPHRINE (PF) 1 MG/ML INJ SOLN,86.0,60.2,,,0
CDM,51022,EPINEPHRINE 0.1 MG/ML SYRINGE (ERX MERGE),81.0,56.7,,,0
CDM,51022,EPINEPHRINE 0.15 MG/0.3 ML IM PNIJ,675.0,472.5,,,0
CDM,51022,EPINEPHRINE 0.3 MG/0.3 ML IM PNIJ,1051.0,735.7,,,0
CDM,51022,EPINEPHRINE 1 MG/ML (1ML) INJ SOLN,30.0,21.0,,,0
CDM,51022,EPINEPHRINE 1 MG/ML INJ SOLN,42.0,29.400000000000002,,,0
CDM,51022,EPOETIN ALFA  4000 UNIT/ML INJ SOLN,693.0,485.09999999999997,,,0
CDM,51022,EPOETIN ALFA 10000 UNIT/ML INJ SOLN,665.5,465.85,,,0
CDM,51022,EPOETIN ALFA 2000 UNIT/ML IV SYRINGE (PED/NEO),55.0,38.5,,,0
CDM,51022,EPOETIN ALFA 20000 UNIT/ML INJ SOLN,1476.0,1033.2,,,0
CDM,51022,EPOETIN ALFA-EPBX 10000 UNITS/ML INJ SOLN,477.0,333.9,,,0
CDM,51022,ERTAPENEM 1 GRAM INJ SOLR,235.0,164.5,,,0
CDM,51022,ESTRADIOL CYPIONATE 5 MG/ML IM OIL,878.0,614.6,,,0
CDM,51022,EXENATIDE 10 MCG/0.04 ML SUBQ PNIJ,609.5,426.65,,,0
CDM,51022,EXENATIDE 5 MCG/0.02 ML SUBQ PNIJ,2346.0,1642.2,,,0
CDM,51022,FAMOTIDINE (PF) 20 MG/2 ML IV SOLN,16.0,11.2,,,0
CDM,51022,FENTANYL CITRATE (PF) 50 MCG/ML (ANESTHESIA INTRAOP ONLY),22.5,15.75,,,0
CDM,51022,FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN,17.5,12.25,,,0
CDM,51022,FILGRASTIM 300 (NEUPOGEN) MCG/ML INJ SOLN,1115.0,780.5,,,0
CDM,51022,FILGRASTIM-SNDZ 300 MCG/0.5 ML INJ SYRG,976.0,683.2,,,0
CDM,51022,FILGRASTIM-SNDZ 480 MCG/0.8 ML INJ SYRG,1212.0,848.4,,,0
CDM,51022,FLUPHENAZINE DECANOATE 25 MG/ML INJ SOLN,195.0,136.5,,,0
CDM,51022,FONDAPARINUX 10 MG/0.8 ML SUBQ SYRG,370.0,259.0,,,0
CDM,51022,FONDAPARINUX 2.5 MG/0.5 ML SUBQ SYRG,204.5,143.15,,,0
CDM,51022,FONDAPARINUX 5 MG/0.4 ML SUBQ SYRG,489.0,342.3,,,0
CDM,51022,FONDAPARINUX 7.5 MG/0.6 ML SUBQ SYRG,476.0,333.20000000000005,,,0
CDM,51022,FUROSEMIDE 10 MG/ML INJ SOLN,27.0,18.9,,,0
CDM,51022,GENTAMICIN (PF) 10 MG/ML INJECTION (NEONATAL IM USE),42.0,29.4,,,0
CDM,51022,GENTAMICIN 40 MG/ML INJ SOLN,73.5,51.449999999999996,,,0
CDM,51022,GLUCAGON 1 MG/ML INJ (MERGE),991.0,693.7,,,0
CDM,51022,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,19.0,13.3,,,0
CDM,51022,HALOPERIDOL DECANOATE  50 MG/ML IM SOLN,367.0,256.9,,,0
CDM,51022,HALOPERIDOL DECANOATE 100 MG/ML IM SOLN,297.0,207.9,,,0
CDM,51022,HALOPERIDOL LACTATE 5 MG/ML INJECTION (MERGE),30.5,21.35,,,0
CDM,51022,HEPARIN (PORCINE)  5000 UNIT/ML INJ SOLN,16.0,11.2,,,0
CDM,51022,HEPARIN (PORCINE) 20000 UNIT/ML INJ SOLN,33.0,23.1,,,0
CDM,51022,"HIB CONJ-TET,COMPNT 2 OF 2(PF) 10 MCG/0.5 ML IM SOLR",493.0,345.1,,,0
CDM,51022,HYALURONIDASE 150 UNIT/ML INJ SOLN,284.0,198.8,,,0
CDM,51022,HYDRALAZINE 20 MG/ML INJ SOLN,45.0,31.5,,,0
CDM,51022,HYDROCORTISONE 100 MG SOLUTION FOR INJECTION,94.0,65.8,,,0
CDM,51022,HYDROCORTISONE SOD SUCC (PF) 100 MG/2 ML INJ SOLR,126.0,88.2,,,0
CDM,51022,HYDROMORPHONE (PF) 1 MG/ML IV SOLN (PHS ERX MERGE),23.0,16.1,,,0
CDM,51022,HYDROMORPHONE 0.5 MG/0.5 ML INJ SYRG (PHS ERX MERGE),28.0,19.6,,,0
CDM,51022,HYDROXYZINE 50 MG/ML IM,178.0,124.6,,,0
CDM,51022,ICATIBANT 30 MG/3 ML SUBQ SYRG,16408.5,11485.949999999999,,,0
CDM,51022,INCLISIRAN 284 MG/1.5 ML SUBQ SYRG,8970.0,6279.0,,,0
CDM,51022,INSULIN ASP PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBQ SOLN,23.0,16.1,,,0
CDM,51022,INSULIN DEGLUDEC 100 UNITS/ML SUBQ SOLN,29.0,20.3,,,0
CDM,51022,INSULIN DETEMIR 100 UNIT/ML SUBQ SOLN,18.0,12.6,,,0
CDM,51022,INSULIN GLARGINE 100 UNIT/ML SUBQ SOLN,23.5,16.450000000000003,,,0
CDM,51022,INSULIN GLARGINE 100 UNIT/ML SUBQ SOLN (LANTUS/SEMGLEE) (MERGE),22.0,15.4,,,0
CDM,51022,INSULIN LISPRO 100 UNIT/ML (PEDS CALCLUATOR 0.5),28.0,19.6,,,0
CDM,51022,INSULIN LISPRO 100 UNIT/ML SUBQ SOLN (HUMALOG/ADMELOG),23.0,16.1,,,0
CDM,51022,INSULIN LISPRO PROTAM & LISPRO 100 UNIT/ML (75-25) SUBQ SUSP,16.0,11.2,,,0
CDM,51022,INSULIN NPH & REGULAR HUMAN 100 UNIT/ML (70-30) SUBQ SUSP,17.0,11.899999999999999,,,0
CDM,51022,INSULIN NPH HUMAN RECOMB 100 UNIT/ML SUBQ SUSP,19.0,13.3,,,0
CDM,51022,INSULIN PUMP LISPRO (PATIENT OWN PUMP PHS SUPPLIED),177.0,123.89999999999999,,,0
CDM,51022,INSULIN REGULAR HUM U-500 CONC 500 UNIT/ML INJ SOLN,32.0,22.4,,,0
CDM,51022,INSULIN REGULAR HUMAN 100 UNIT/ML INJ SOLN,76.5,53.550000000000004,,,0
CDM,51022,KETAMINE 100 MG/ML INJ SOLN,31.0,21.7,,,0
CDM,51022,KETAMINE 2 MG/ML IN NS 50ML INFUSION (STOCK DOSE),16.0,11.2,,,0
CDM,51022,KETAMINE 50 MG/5ML (10 MG/ML) SYRINGE (PHS MERGE),104.5,73.15,,,0
CDM,51022,KETAMINE INFUSION 2MG/ML 100ML (FOR ANESTHESIA USE ONLY),56.0,39.2,,,0
CDM,51022,KETOROLAC TROMETHAMINE 15 MG/ML INJ SOLN,17.0,11.9,,,0
CDM,51022,KETOROLAC TROMETHAMINE 30 MG/ML INJ SOLN,29.0,20.3,,,0
CDM,51022,KETOROLAC TROMETHAMINE 60 MG/2 ML IM SOLN,25.0,17.5,,,0
CDM,51022,LANREOTIDE 120 MG/0.5 ML SUBQ SYRG,25468.0,17827.6,,,0
CDM,51022,LANREOTIDE 90 MG/0.3 ML SUBQ SYRG,22379.0,15665.3,,,0
CDM,51022,LEUPROLIDE (3 MONTH) 11.25 MG IM KIT,14559.0,10191.3,,,0
CDM,51022,LEUPROLIDE (PEDIATRIC 3 MONTH) 30 MG IM SYKT,35020.0,24514.0,,,0
CDM,51022,LEUPROLIDE (PEDIATRIC 6 MONTH) 45 MG IM SYKT,71748.0,50223.6,,,0
CDM,51022,LEUPROLIDE (PEDIATRIC 6 MONTH) 45 MG SUBQ SYRG,75743.0,53020.1,,,0
CDM,51022,LEVOTHYROXINE 100 MCG IV SOLR,2042.0,1429.4,,,0
CDM,51022,LEVOTHYROXINE 200 MCG INJ SOLR,934.0,653.8,,,0
CDM,51022,LEVOTHYROXINE 500 MCG INJ SOLR,1458.0,1020.6,,,0
CDM,51022,LIDOCAINE 20 MG/ML (2 %) INJECTION,27.0,18.9,,,0
CDM,51022,LIRAGLUTIDE 0.6 MG/0.1 ML (18 MG/3 ML) SUBQ PNIJ,1675.5,1172.85,,,0
CDM,51022,LORAZEPAM 2 MG/ML INJ SOLN,21.0,14.7,,,0
CDM,51022,LORAZEPAM 2 MG/ML IV SOLN (PHS MERGE - ALL SITES),22.5,15.75,,,0
CDM,51022,LUPRON 3.75MG IM KIT,4972.0,3480.4,,,0
CDM,51022,MAGNESIUM SULFATE 50 % (4 MEQ/ML) INJ SOLN,16.0,11.2,,,0
CDM,51022,MEDROXYPROGESTERONE (CONTRACEPTIVE) 150 MG/ML IM (MERGE),280.0,196.0,,,0
CDM,51022,MEDROXYPROGESTERONE (CONTRACEPTIVE) 150 MG/ML IM SUSP,216.0,151.2,,,0
CDM,51022,MEDROXYPROGESTERONE 150 MG/ML IM SYRG,147.0,102.9,,,0
CDM,51022,"MENING VAC A,C,Y,W135,TET (PF) 10 MCG/0.5 ML IM SOLN",732.0,512.4,,,0
CDM,51022,MEPERIDINE (PF) 50 MG/ML IV SOLN (PHS MERGE),26.0,18.2,,,0
CDM,51022,MEPOLIZUMAB 100 MG SUBQ SOLR,14214.0,9949.8,,,0
CDM,51022,MEROPENEM 500 MG IV SOLR,179.0,125.3,,,0
CDM,51022,METHOTREXATE (PF) 25 MG/ML INJ SOLN (FOR ECTOPIC PREGNANCY),42.0,29.4,,,0
CDM,51022,METHOTREXATE NA (PRESERV FREE) 25 MG/ML INJ SOLN,1401.5,981.05,,,0
CDM,51022,METHOTREXATE SODIUM 25 MG/ML INJ SOLN,28.0,19.6,,,0
CDM,51022,METHYLERGONOVINE 0.2 MG/ML (1 ML) INJ SOLN,207.0,144.9,,,0
CDM,51022,METHYLNALTREXONE 12 MG/0.6 ML SUBQ SOLN,714.0,499.8,,,0
CDM,51022,METHYLNALTREXONE 12 MG/0.6 ML SUBQ SYRG,505.0,353.5,,,0
CDM,51022,METHYLPREDNISOLONE 40 MG/ML SUSP (DEPO-MEDROL) INJECTION,128.5,89.95,,,0
CDM,51022,METHYLPREDNISOLONE SOD SUC(PF) 125 MG/2 ML INJ SOLR,34.0,23.8,,,0
CDM,51022,METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML INJ SOLR,65.0,45.5,,,0
CDM,51022,METOCLOPRAMIDE  5 MG/ML INJ SOLN,19.5,13.65,,,0
CDM,51022,MIDAZOLAM (PF) 1 MG/ML INJ (MERGE),20.0,14.0,,,0
CDM,51022,MIDAZOLAM (PF) 1 MG/ML INJ SOLN,22.0,15.4,,,0
CDM,51022,MIDAZOLAM (PF) 5 MG/ML INJ SOLN,16.0,11.2,,,0
CDM,51022,MORPHINE  2 MG/ML INJ SYRG,22.5,15.75,,,0
CDM,51022,MORPHINE 10 MG/ML (PF) IV SOLN,16.5,11.55,,,0
CDM,51022,MORPHINE 2 MG/ML IV SOLN (PHS/CDS MERGE),48.5,33.95,,,0
CDM,51022,MORPHINE 4 MG/ML IV SOLN (PHS/CDS MERGE),25.5,17.85,,,0
CDM,51022,NALOXONE 0.4 MG/ML INJ SOLN,93.0,65.1,,,0
CDM,51022,NALTREXONE MICROSPHERES 380 MG IM SERR,4530.0,3171.0,,,0
CDM,51022,NEOSTIGMINE 1MG/ML (UD) OR SYRINGE,142.0,99.4,,,0
CDM,51022,NEOSTIGMINE METHYLSULFATE 1 MG/ML IV SOLN,16.0,11.2,,,0
CDM,51022,OCTREOTIDE ACETATE   50 MCG/ML INJ SOLN,59.0,41.3,,,0
CDM,51022,OCTREOTIDE ACETATE  100 MCG/ML INJ SOLN,55.5,38.849999999999994,,,0
CDM,51022,"OCTREOTIDE,MICROSPHERES 20 MG IM SERR",19111.5,13378.050000000001,,,0
CDM,51022,"OCTREOTIDE,MICROSPHERES 30 MG IM SERR",19079.0,13355.3,,,0
CDM,51022,OLANZAPINE 10 MG IM SOLR,130.0,91.0,,,0
CDM,51022,OMALIZUMAB 150 MG SUBQ SOLR,4566.5,3196.55,,,0
CDM,51022,OMALIZUMAB 75 MG/0.5 ML SUBQ SYRG,1558.0,1090.6,,,0
CDM,51022,ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN,16.0,11.2,,,0
CDM,51022,ORPHENADRINE CITRATE 30 MG/ML INJ SOLN,71.0,49.7,,,0
CDM,51022,OXYTOCIN 10 UNIT/ML INJ SOLN,47.0,32.900000000000006,,,0
CDM,51022,PALIPERIDONE PALMITATE 117 MG/0.75 ML IM SYRG,4926.0,3448.2,,,0
CDM,51022,PALIPERIDONE PALMITATE 234 MG/1.5 ML IM SYRG,9726.5,6808.549999999999,,,0
CDM,51022,PALIPERIDONE PALMITATE 39 MG/0.25 ML IM SYRG,1642.0,1149.4,,,0
CDM,51022,PALIPERIDONE PALMITATE 78 MG/0.5 ML IM SYRG,3242.5,2269.75,,,0
CDM,51022,PEGFILGRASTIM (NEULASTA) 6 MG/0.6ML SUBQ SYRG,17714.0,12399.8,,,0
CDM,51022,PEGFILGRASTIM-JMDB (FULPHILA) 6 MG/0.6 ML SUBQ SYRG,5762.0,4033.4,,,0
CDM,51022,PENICILLIN G BENZATHINE 1200000 UNIT/2 ML IM SYRG,1898.0,1328.6,,,0
CDM,51022,PENICILLIN G BENZATHINE 2400000 UNIT/4 ML IM SYRG,1898.0,1328.6,,,0
CDM,51022,PENICILLIN G BENZATHINE 600000 UNIT/ML IM SYRG,1591.5,1114.05,,,0
CDM,51022,PHENOBARBITAL SODIUM  65 MG/ML INJ SOLN,257.0,179.9,,,0
CDM,51022,PHENOBARBITAL SODIUM 130 MG/ML INJ SOLN,349.0,244.3,,,0
CDM,51022,PHENTOLAMINE 5 MG INJ SOLR,1846.0,1292.2,,,0
CDM,51022,PHYTONADIONE 1 MG/0.5 ML INJ SOLN,32.0,22.4,,,0
CDM,51022,PHYTONADIONE 1 MG/0.5 ML INJ SYRG,87.5,61.25,,,0
CDM,51022,PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG,955.0,668.5,,,0
CDM,51022,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN,36.5,25.549999999999997,,,0
CDM,51022,PROGESTERONE 50 MG/ML IM OIL,154.0,107.8,,,0
CDM,51022,PROMETHAZINE 25 MG/ML INJ SOLN,23.0,16.1,,,0
CDM,51022,RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML IM SOLN,8946.0,6262.2,,,0
CDM,51022,"RHO(D) IMMUNE GLOBULIN (RHOPHYLAC) 1,500 UNIT (300 MCG)/2 ML INJ SYRG",693.0,485.1,,,0
CDM,51022,RISPERIDONE MICROSPHERES 25 MG/2 ML IM SYRG,1782.0,1247.4,,,0
CDM,51022,ROCURONIUM 10 MG/ML IV SOLN,26.0,18.2,,,0
CDM,51022,ROMIPLOSTIM 125 MCG SUBQ SOLR,2462.5,1723.75,,,0
CDM,51022,ROMIPLOSTIM 250 MCG SUBQ SOLR,6585.0,4609.5,,,0
CDM,51022,ROMIPLOSTIM 500 MCG SUBQ SOLR,7024.0,4916.8,,,0
CDM,51022,ROMOSOZUMAB-AQQG 105 MG/1.17 ML SUBQ SYRG,4012.0,2808.4,,,0
CDM,51022,ROMOSOZUMAB-AQQG 210MG/2.34ML ( 105MG/1.17MLX2) SUBQ SYRG,5893.0,4125.1,,,0
CDM,51022,SODIUM BICARBONATE 8.4 % IV (PHS ERX MERGE),54.0,37.8,,,0
CDM,51022,SODIUM CHLORIDE 0.9 % INJ SOLN (VIAL),16.0,11.2,,,0
CDM,51022,SODIUM CHLORIDE 0.9 % INJ SYRG,16.0,11.2,,,0
CDM,51022,SODIUM CHLORIDE 0.9 % IV SOLP,16.0,11.2,,,0
CDM,51022,SOMATROPIN  5.8 MG SUBQ SOLR,1207.0,844.9,,,0
CDM,51022,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ (MERGE),46.0,32.2,,,0
CDM,51022,SUMATRIPTAN 6 MG/0.5 ML SUBQ PEN KIT,322.5,225.75,,,0
CDM,51022,TALQUETAMAB-TGVS  2 MG/ML SUBQ SOLN,2145.0,1501.5,,,0
CDM,51022,TALQUETAMAB-TGVS 40 MG/ML SUBQ SOLN,18300.0,12810.0,,,0
CDM,51022,TECLISTAMAB-CQYV 10 MG/ML SUBQ SOLN,4886.0,3420.2,,,0
CDM,51022,TECLISTAMAB-CQYV 90 MG/ML SUBQ SOLN,24915.0,17440.5,,,0
CDM,51022,TERBUTALINE 1 MG/ML SUBQ SOLN,27.0,18.9,,,0
CDM,51022,TESTOSTERONE CYPIONATE 200 MG/ML IM OIL,110.0,77.0,,,0
CDM,51022,TETANUS IMMUNE GLOBULIN (PF) 250 UNIT IM SYRG,1262.0,883.4,,,0
CDM,51022,TEZEPELUMAB-EKKO 210 MG/1.91 ML (110 MG/ML) SUBQ SYRG,10028.0,7019.6,,,0
CDM,51022,THIAMINE 100 MG/ML INJECTION,66.0,46.2,,,0
CDM,51022,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,52.0,36.4,,,0
CDM,51022,VARICELLA-ZOSTER IG-MALTOSE 125 UNIT/1.2 ML IM SOLN,25935.0,18154.5,,,0
CDM,51022,VUTRISIRAN 25 MG/0.5 ML SUBQ SYRG,329409.0,230586.3,,,0
CDM,51022,"WATER FOR INJECTION, STERILE INJECTION",26.5,18.55,,,0
CDM,51022,ZIPRASIDONE 20 MG IM,120.0,84.0,,,0
CDM,51024,HC IV INFUSION HYDRAT 31-60 MIN,2392.0,1674.4,,,0
CDM,51026,HC IV INFUSION HYDRAT 31-60 MIN,1196.0,837.2,,,0
CDM,51028,HC IV INFUSION HYDRAT 31-60 MIN,1794.0,1255.8000000000002,,,0
CDM,51900001,OFFICE/OUTPAT VISIT NEW LEVEL 1,241.0,168.7,,,0
CDM,51900002,OFFICE/OUTPAT VISIT NEW LEVEL 2,289.0,202.3,,,0
CDM,51900003,OFFICE/OUTPAT VISIT NEW LEVEL 3,347.0,242.9,,,0
CDM,51900004,OFFICE/OUTPAT VISIT NEW LEVEL 4,417.0,291.9,,,0
CDM,51900005,OFFICE/OUTPAT VISIT NEW LEVEL 5,500.0,350.0,,,0
CDM,51900006,HC OFFICE/OUTPAT VISIT EST LEVEL 1,241.0,168.7,,,0
CDM,51900007,HC OFFICE/OUTPAT VISIT EST LEVEL 2,289.0,202.3,,,0
CDM,51900008,HC OFFICE/OUTPAT VISIT EST LEVEL 3,347.0,242.9,,,0
CDM,51900009,HC OFFICE/OUTPAT VISIT EST LEVEL 4,417.0,291.9,,,0
CDM,51900010,HC OFFICE/OUTPAT VISIT EST LEVEL 5,500.0,350.0,,,0
CDM,51900011,HC T1017 INITIAL ASSESSMENT,1002.0,701.4,,,0
CDM,51900012,HC T2022 CASE MANAGEMENT SUBSEQUENT,792.0,554.4,,,0
CDM,51900013,HC CPHP ASSESSMENT PRIMARY,94.0,65.8,,,0
CDM,51900014,HC CPHP CASE MANAGEMENT,772.0,540.4,,,0
CDM,51900016,HC OFFICE/OP VISIT NEW LEVEL 1,241.0,168.7,,,0
CDM,51900017,HC OFFICE/OP VISIT NEW LEVEL 2,289.0,202.3,,,0
CDM,51900018,HC OFFICE/OP VISIT NEW LEVEL 3,347.0,242.9,,,0
CDM,51900019,HC OFFICE/OP VISIT NEW LEVEL 4,417.0,291.9,,,0
CDM,51900020,HC OFFICE/OP VISIT NEW LEVEL 5,500.0,350.0,,,0
CDM,51900021,HC OFFICE/OP VISIT EST LEVEL 1,241.0,168.7,,,0
CDM,51900022,HC OFFICE/OP VISIT EST LEVEL 2,289.0,202.3,,,0
CDM,51900023,HC OFFICE/OP VISIT EST LEVEL 3,347.0,242.9,,,0
CDM,51900024,HC OFFICE/OP VISIT EST LEVEL 4,417.0,291.9,,,0
CDM,51900025,HC OFFICE/OP VISIT EST LEVEL 5,500.0,350.0,,,0
CDM,51900026,HC LACTATION CLASSES NON-PHYSICIAN PROVIDER PER SESSION,76.0,53.2,,,0
CDM,51900027,HC LACTATION CLASSES NON-PHYSICIAN PROVIDER PER SESSION 15 MIN,55.0,38.5,,,0
CDM,51900028,HC LACTATION CLASSES NON-PHYSICIAN PROVIDER PER SESSION 30 MIN,76.0,53.2,,,0
CDM,51900029,HC LACTATION CLASSES NON-PHYSICIAN PROVIDER PER SESSION 45 MIN,99.0,69.3,,,0
CDM,51900030,HC LACTATION CLASSES NON-PHYSICIAN PROVIDER PER SESSION 60 MIN,120.0,84.0,,,0
CDM,52836,"ALDESLEUKIN 360,000 UNITS/ ML SOLUTION",5121.0,3584.7,,,0
CDM,52836,AZACITIDINE 100 MG INJ SOLR,2030.0,1421.0,,,0
CDM,52836,METHOTREXATE (PF) 25 MG/ML INJ SOLN (FOR ECTOPIC PREGNANCY),42.0,29.4,,,0
CDM,52836,METHOTREXATE SODIUM 25 MG/ML INJ SOLN,95.0,66.5,,,0
CDM,52838,DEGARELIX 120 MG SUBQ SOLR,4207.0,2944.9,,,0
CDM,52838,LEUPROLIDE (3 MONTH) 22.5 MG IM SYRG,1176.0,823.2,,,0
CDM,52838,LEUPROLIDE (4-MONTH) 30 MG SUBQ SYRG,1176.0,823.2,,,0
CDM,52838,LEUPROLIDE (6 MONTH) 45 MG IM SYKT,1176.0,823.2,,,0
CDM,52838,LEUPROLIDE (6 MONTH) 45 MG SUBCUTANOUS KIT,1176.0,823.2,,,0
CDM,52838,LEUPROLIDE 1 MG/0.2 ML SUBQ KIT,76.5,53.55,,,0
CDM,52838,LEUPROLIDE 22.5 MG SUBQ SYRG,1176.0,823.2,,,0
CDM,52840,METHOTREXATE SODIUM 25 MG/ML INJ SOLN,78.0,54.6,,,0
CDM,5451,GENTAMICIN 40 MG/ML INJ SOLN,78.0,54.6,,,0
CDM,54864,FLU VACCINE TS 2024-25 65 YR UP (PF) 180 MCG/0.5 ML IM SYRG,373.0,261.1,,,0
CDM,54864,FLU VACCINE TS 2025-26 65 YR UP (PF) 180 MCG/0.5 ML IM SYRG,387.5,271.25,,,0
CDM,54864,PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML INJ SYRG,506.0,354.2,,,0
CDM,54866,PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML INJ SYRG,506.0,354.2,,,0
CDM,54866,PNEUMOCOCCAL 23-VALPS VACCINE 25 MCG/0.5 ML INJ,506.0,354.2,,,0
CDM,55468,TOPOTECAN 4 MG IV SOLR,832.0,582.4,,,0
CDM,55468,TOPOTECAN 4 MG/4 ML (1 MG/ML) IV SOLN,476.5,333.55,,,0
CDM,61000001,HC MRI ORBIT/FACE/NECK W/O DYE,1963.0,1374.1,,,0
CDM,61000002,HC MRI CHEST W/O DYE,2133.0,1493.1,,,0
CDM,61000003,HC MRI CHEST W/WO DYE,2574.0,1801.8,,,0
CDM,61000004,HC MRA CHEST W/WO DYE,2176.0,1523.2,,,0
CDM,61000005,HC MRI PELVIS W/O DYE,1890.0,1323.0,,,0
CDM,61000006,HC MRI PELVIS W/DYE,2194.0,1535.8,,,0
CDM,61000007,HC MRI PELVIS W/WO DYE,2605.0,1823.5,,,0
CDM,61000008,HC MRI UPPER EXTR NOT JNT W/O DYE,1335.0,934.5,,,0
CDM,61000009,HC MRI UPPER EXTR NOT JNT W/DYE,1660.0,1162.0,,,0
CDM,61000010,HC MRI UPPR EXTREMITY W/WO DYE,1879.0,1315.3,,,0
CDM,61000011,HC MRI ANY JNT UPR EXT W/O DYE,1528.0,1069.6,,,0
CDM,61000012,HC MRI ANY JNT UPR EXT W/DYE,1794.0,1255.8,,,0
CDM,61000013,HC MRI ANY JOINT UPR EXT W/WO DYE,2377.0,1663.9,,,0
CDM,61000014,HC MRA UPPER EXT W/WO DYE,1630.0,1141.0,,,0
CDM,61000015,HC MRI LWR EXT NOT JNT W/O DYE,1470.0,1029.0,,,0
CDM,61000016,HC MRI LOWER EXT W/DYE,1537.0,1075.9,,,0
CDM,61000017,HC MRI LWR EXT W/WO DYE,2422.0,1695.4,,,0
CDM,61000018,HC MRI ANY JNT OF LWR EXT W/O DYE,1269.0,888.3,,,0
CDM,61000019,HC MRI ANY JOINT OF LWR EXT W/DYE,1978.0,1384.6,,,0
CDM,61000020,HC MRI ANY JOINT LWR EXT W/WO DYE,2356.0,1649.2,,,0
CDM,61000021,HC MRA LWR EXT W/WO DYE,1538.0,1076.6,,,0
CDM,61000022,HC MRI ABDOMEN W/O DYE,1329.0,930.3,,,0
CDM,61000023,HC MRI ABDOMEN W/DYE,1544.0,1080.8,,,0
CDM,61000024,HC MRI ABDOMEN W/WO DYE,1851.0,1295.7,,,0
CDM,61000025,HC MRA ABD W/WO DYE,1234.0,863.8,,,0
CDM,61000026,HC CARDIAC MRI FOR MORPH W/O DYE,1530.0,1071.0,,,0
CDM,61000027,HC CARDIAC MRI FOR MORPH W/DYE,1765.0,1235.5,,,0
CDM,61000028,HC CARD MRI VELOC FLOW MAPPING,1265.0,885.5,,,0
CDM,61000029,HC MRI SPECTROSCOPY,808.0,565.6,,,0
CDM,61000036,HC MAGNETIC RESONANCE ELASTOGRAPHY,1008.0,705.6,,,0
CDM,61000038,HC MRI FETAL INCL PLACENTAL/MATERNAL PELVIC IMG WHEN PERFORMED SINGLE OR FIRST GESTATION,879.0,615.3,,,0
CDM,61000040,HC CARDIAC MRI W/O CONTRAST W/STRESS IMAGING,1492.0,1044.4,,,0
CDM,61000041,HC CARDIAC MRI W/W/O CONTRAST W/STRESS,3304.0,2312.8,,,0
CDM,61000042,HC MAGNETIC RESONANCE ALYS TISSUE COMPOSITION W/MRI SINGLE ORGAN,100.0,70.0,,,0
CDM,61100002,HC MRI ORBT/FAC/NCK W/WO DYE,2596.0,1817.2,,,0
CDM,61100003,HC MRI BRAIN W/O DYE,1834.0,1283.8,,,0
CDM,61100004,HC MRI BRAIN W/DYE,2107.0,1474.9,,,0
CDM,61100005,HC MRI BRAIN/STEM W/WO DYE,2530.0,1771.0,,,0
CDM,61200001,HC MRI NECK SPINE W/O DYE,1518.0,1062.6,,,0
CDM,61200002,HC MRI NECK SPINE W/DYE,1744.0,1220.8,,,0
CDM,61200003,HC MRI THORACIC SPINAL CANAL W/O DYE,1654.0,1157.8,,,0
CDM,61200004,HC MRI THORACIC SPINAL CANAL W/ DYE,1920.0,1344.0,,,0
CDM,61200005,HC MRI LUMBAR SPINE W/O DYE,1572.0,1100.4,,,0
CDM,61200006,HC MRI LUMBAR SPINE W/DYE,1825.0,1277.5,,,0
CDM,61200007,HC MRI CERVICAL SPINE W/WO DYE,2094.0,1465.8,,,0
CDM,61200008,HC MRI THORACIC SPINAL CANAL W/WO DYE,2284.0,1598.8,,,0
CDM,61200009,HC MRI LUMBAR SPINE W/WO DYE,2169.0,1518.3,,,0
CDM,61200010,HC MR ANGIO SPINE W/WO DYE,1218.0,852.6,,,0
CDM,61200011,HC MRA PELVIS W/WO DYE,1925.0,1347.5,,,0
CDM,61408,DIATRIZOATE MEGLUMINE 18 % URTH SOLN,215.0,150.5,,,0
CDM,61408,DIATRIZOATE MEGLUMINE 30 % URTH SOLN,245.0,171.5,,,0
CDM,61408,GADOBENATE DIMEGLUMINE 529 MG/ML (0.1 MMOL/0.2 ML) IV SOLN,297.5,208.25,,,0
CDM,61408,GADOPICLENOL 0.5 MMOL/ML IV SOLN,397.0,277.9,,,0
CDM,61408,GADOTERIDOL 279.3 MG/ML IV SOLN,85.5,59.849999999999994,,,0
CDM,61408,GADOXETATE 2.5 MMOL/10 ML IV SOLN,392.5,274.75,,,0
CDM,61408,IODIXANOL 320 MG/ML IV SOLN,273.0,191.10000000000002,,,0
CDM,61408,IOHEXOL 180 MG/ML IT SOLN,267.0,186.9,,,0
CDM,61408,IOHEXOL 240 MG/ML IV SOLN,260.5,182.35,,,0
CDM,61408,IOPAMIDOL 41 % (410 MG/ML) IV SOLN,117.0,81.9,,,0
CDM,61408,IOPAMIDOL 41 % INJ SOLN,25.0,17.5,,,0
CDM,61408,IOPAMIDOL 41 % IT SOLN,118.0,82.6,,,0
CDM,61408,IOPAMIDOL 51 % IV SOLN,239.5,167.64999999999998,,,0
CDM,61408,IOPAMIDOL 61 % IT SOLN,371.0,259.7,,,0
CDM,61408,IOPAMIDOL 61 % IV SOLN,168.0,117.6,,,0
CDM,61408,IOPAMIDOL 76 % IV SOLN,372.0,260.4,,,0
CDM,61408,IOXAGLATE MEGLUMINE & SODIUM INJ SOLN 39.3 %-19.6 % PHS,147.0,102.9,,,0
CDM,61408,PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML IV SUSP,1029.0,720.3,,,0
CDM,61500001,HC MR ANGIO HEAD W/O DYE,1483.0,1038.1,,,0
CDM,61500002,HC MR ANGIO HEAD W/DYE,1799.0,1259.3,,,0
CDM,61500003,HC MR ANGIO HEAD W/WO DYE,2272.0,1590.4,,,0
CDM,61500004,HC MRA NECK W/O DYE,1589.0,1112.3,,,0
CDM,61500005,HC MRA NECK W/DYE,1853.0,1297.1,,,0
CDM,61500006,HC MRA NECK W/WO DYE,2331.0,1631.7,,,0
CDM,62300271,HC DRESSING FOAM SILICONE SMALL/MED,17.0,11.9,,,0
CDM,62300272,HC DRESSING FOAM SILICONE 7 X 7,42.0,29.4,,,0
CDM,62300273,HC BIATAIN ALGINATE AG 4 X 4 (COLOPLAST),63.0,44.1,,,0
CDM,62300274,HC BIATAIN SOFT-HOLD 4 X 4 (COLOPLAST),18.0,12.6,,,0
CDM,62300275,HC DRAWTEX 4 X 4,48.0,33.6,,,0
CDM,62300276,HC CUTIMED SORBACT WCL 4 X 5 (BSN),41.0,28.7,,,0
CDM,62300277,HC CUTIMED SORBACT HYDROACTIVE B 2.8 X 3.3 (BSN),52.0,36.4,,,0
CDM,62300278,HC CUTIMED SORBACT RIBBON .8 X 19.7 (BSN),54.0,37.8,,,0
CDM,62300295,"HC DRESSING AG AQUACEL 3.5""X10""",61.0,42.7,,,0
CDM,62300475,HC EDEMAWEAR SMALL,24.0,16.8,,,0
CDM,62300476,HC EDEMAWEAR MEDIUM,36.0,25.2,,,0
CDM,62300477,HC EDEMAWEAR LARGE,66.0,46.2,,,0
CDM,62300488,HC PLUROGEL,61.0,42.7,,,0
CDM,62300547,HC SILICONE TRANSPARENT FILM 4X5IN,9.0,6.3,,,0
CDM,62300548,HC SILICONE TRANSPARENT FILM 2X3IN,4.0,2.8,,,0
CDM,62300718,HC MEPILEX BORDER FLEX 3 X 3 IN,12.0,8.4,,,0
CDM,62300719,HC MEPILEX BORDER FLEX 6 X 6 IN,28.0,19.6,,,0
CDM,62300720,HC MEPILEX BORDER FLEX OVAL 5.1 X 6.3 IN,31.0,21.7,,,0
CDM,62300721,HC MEPILEX BORDER FLEX OVAL 6 X 7.5 IN,38.0,26.6,,,0
CDM,62300722,HC MEPILEX BORDER FLEX LITE 1.6 X 2 IN,8.0,5.6,,,0
CDM,62300723,HC MEPILEX BORDER FLEX LITE 3 X 3 IN,10.0,7.0,,,0
CDM,62300724,HC MEPILEX BORDER HEEL 8.7 X 9.1 IN,60.0,42.0,,,0
CDM,62300725,HC MEPILEX 4 X 4 IN,15.0,10.5,,,0
CDM,62300726,HC MEPILEX 4 X 8 IN,30.0,21.0,,,0
CDM,62300727,HC MEPILEX LITE 2.4 X 3.4 IN,11.0,7.7,,,0
CDM,62300728,HC MEPITEL BOTH SIDES 2 X 3 IN,17.0,11.9,,,0
CDM,62300729,HC MEPITEL BOTH SIDES 4 X 7 IN,43.0,30.1,,,0
CDM,62300730,HC MEPITEL BOTH SIDES 8 X 12 IN,119.0,83.3,,,0
CDM,62300731,HC MEPILEX TRANSFER 6 X 8 IN,31.0,21.7,,,0
CDM,62300732,HC MEPILEX TRANSFER AG 6 X 8 IN,133.0,93.1,,,0
CDM,62300733,HC EXUFIBER PEDS/NICU 4 X 4.8 IN,16.0,11.2,,,0
CDM,62300734,HC MELGISORB PLUS CALCIUM ALGINATE 2 X 2 IN,7.0,4.9,,,0
CDM,62300735,HC MELGISORB PLUS CALCIUM ALGINATE 4 X 4 IN,12.0,8.4,,,0
CDM,62300736,HC MELGISORB PLUS CALCIUM ALGINATE 1.25 X 17.7 IN,13.0,9.1,,,0
CDM,62300737,HC MELGISORB AG 2 X 2 IN,11.0,7.7,,,0
CDM,62300738,HC MELGISORB AG 4 X 4 IN,31.0,21.7,,,0
CDM,62300739,HC MELGISORB AG 1.2 X 18 IN,42.0,29.4,,,0
CDM,62300740,HC MEXTRA SUPERABSORBENT 5 X 7 IN,14.0,9.8,,,0
CDM,62300741,HC MEXTRA SUPERABSORBENT 7 X 9 IN,16.0,11.2,,,0
CDM,62300742,HC MEXTRA SUPERABSORBENT 9 X 11 IN,26.0,18.2,,,0
CDM,62300743,HC MEPORE PRO 3.6 X 4 IN,2.0,1.4,,,0
CDM,62300744,HC MEPORE ALL SIZES,3.0,2.1,,,0
CDM,62300745,HC MESALT 2 X 2 IN FOLDED / 4 X 4 IN,5.0,3.5,,,0
CDM,62300750,"HC DRESSING TRANSPARENT  MEPITEL NON-ADHERENT 3"" X 4""",27.0,18.9,,,0
CDM,62300751,HC DRESSING WOUND MEPITEL 4IN X 7IN 1- SIDED MESH TRANSPARENT,51.0,35.7,,,0
CDM,62300752,HC TAPE MEFIX ADHESIVE ROLL 4IN X 11YD,42.0,29.4,,,0
CDM,62400001,HC RESEARCH ONLY STEMI IMPELLA ALC PUMP SET 2.5 / 3.4 / 3.5,55000.0,38500.0,,,0
CDM,62400007,HC RESEARCH ONLY BEAT HF STUDY IMPLANT/REPLACE CAROTID SINUS BAROREFLEX ACTIVATION DEVICE PULSE GEN,15372.0,10760.4,,,0
CDM,62400008,HC PRO RESEARCH ONLY BEAT HF STUDY IMPLANT/REPLACE CAROTID SINUS BAROREFLEX ACTIVATION DEVICE PULSE GEN,850.0,595.0,,,0
CDM,62400009,HC RESEARCH ONLY PROMISE III LIMFLOW STENT GRAFT SYSTEM,25000.0,17500.0,,,0
CDM,63600061,HC NC NATALIZUMAB INJ 1 MG,0.01,0.007,,,0
CDM,63600062,HC NC EPO ALFA NON ESRD PER 1000,0.01,0.007,,,0
CDM,63600063,HC NC INFLIXIMAB INJ 10MG IVPB,0.01,0.007,,,0
CDM,63600064,HC NC AGALSIDASE BETA PER 1MG,0.01,0.007,,,0
CDM,63600065,HC NC ALDESLEUKIN 22 MIL UNIT SOLR 2ND DOSE,0.01,0.007,,,0
CDM,63600068,HC APLIGRAF APPLIED PER SQ CM (TOTAL 44 SQ CM),132.0,92.4,,,0
CDM,63600078,HC NC GAMMUNEX IVIG,0.01,0.007,,,0
CDM,63600080,HC NC XOLAIR,0.01,0.007,,,0
CDM,63600085,HC NC PRIVIGEN IVIG 500 MG,0.01,0.007,,,0
CDM,63600103,HC APLIGRAF WASTED PER SQ CM (TOTAL 44 SQ CM),33.0,23.1,,,0
CDM,63600104,HC NC INJECT IMMUNE GLOBULIN INTRA LYOPHILIZED (POWDER) NOS 500 MG,0.01,0.007,,,0
CDM,63600109,HC NC ENTYVIO,0.01,0.007,,,0
CDM,63600121,HC NC NUCALA (MEPOLIZUMAB) 1 MG,0.01,0.007,,,0
CDM,63600128,HC NC BELATACEPT 250 MG SOLR 1 EACH VIAL,0.01,0.007,,,0
CDM,63600130,HC NC INFLIXIMAB-ABDA 100 MG SOLR 1 EACH VIAL,0.01,0.007,,,0
CDM,63600131,HC NC NALTREXONE MICROSPHERES 380MG SERR,0.01,0.007,,,0
CDM,63600132,HC NC LUPRON 7.5 MG,0.01,0.007,,,0
CDM,63600133,HC NC LUPRON 3.75MG,0.01,0.007,,,0
CDM,63600135,HC NC RAVULIZUMAB-CWVZ 10 MG,0.01,0.007,,,0
CDM,63600138,HC NC RITUXIMAB-ABBS (TRUXIMA),0.01,0.007,,,0
CDM,65100001,HC HOSPICE SERVICE ROUTINE HOME CARE,258.0,180.6,,,0
CDM,65500001,HC HOSPICE SERVICE INPATIENT RESPITE CARE,599.0,419.3,,,0
CDM,65600001,HC HOSPICE SERVICE GENERAL INPATIENT CARE (NONRESPITE),1351.0,945.7,,,0
CDM,65656,JAPANESE ENCEPHALITIS VACC(PF) 6 MCG/0.5 ML IM SYRG,862.0,603.4,,,0
CDM,65700002,HC PRO IP/OBS CONSULT NEW/ESTABLISHED LOW LEVEL 45 MIN,316.0,221.2,,,0
CDM,66275,FLU VACCINE TS 2024-25 65 YR UP (PF) 180 MCG/0.5 ML IM SYRG,373.0,261.1,,,0
CDM,66275,FLU VACCINE TS 2025-26 65 YR UP (PF) 180 MCG/0.5 ML IM SYRG,387.5,271.25,,,0
CDM,66385,ADVATE: FACTOR VIII CONCENTRATE (MERGE RECORD),15732.0,11012.4,,,0
CDM,66385,"ANTIHEMOPHILIC FACTOR-VWF 1,000-2,400 UNIT IV KIT",4025.0,2817.5,,,0
CDM,66385,ANTITHROMBIN III IV (PHS ERX MERGE),3307.0,2314.9,,,0
CDM,66385,COAGULATION FACTOR VIIA RECOMB (PHS ERX MERGE),24840.0,17388.0,,,0
CDM,66385,HUMATE-P: VWF CONCENTRATE (MERGE RECORD),3208.5,2245.95,,,0
CDM,6640,"DIPH,PERTUS(ACEL),TET,POLIO(PF)(KINRIX) 25 LF-58 MCG-10 LF/0.5 ML IM SYRINGE",318.0,222.6,,,0
CDM,6640,"DIPHTH,PERTUS(ACELL),TETANUS SYRG (INFANRIX) 25 LF UNIT-58MCG-10 LF/0.5ML IM SYRINGE",334.0,233.8,,,0
CDM,6647,"DIPH,PERTUS(ACEL),TET,POLIO(PF)(KINRIX) 25 LF-58 MCG-10 LF/0.5 ML IM SYRINGE",776.0,543.2,,,0
CDM,6647,"MEASLES,MUMPS&RUBELLA VACCIN(PF) 1,000-12,500 TCID50/0.5 ML SUB-Q SUSP",398.5,278.95,,,0
CDM,6647,"MEASLES,MUMPS,RUBELLA VACC(PF) 10EXP3.4-4.2- 3.3CCID50/0.5ML SUBQ SUSR",404.0,282.8,,,0
CDM,6650,"DIPH,PERTUS(ACEL),TET,POLIO(PF)(KINRIX) 25 LF-58 MCG-10 LF/0.5 ML IM SYRINGE",1164.0,814.8000000000001,,,0
CDM,6650,"MEASLES,MUMPS,RUB,VARICEL (PF) 10EXP3-4.3-3-3.99TCID50/0.5ML SUB-Q",776.0,543.2,,,0
CDM,6653,POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML INJ SUSP,121.0,84.69999999999999,,,0
CDM,6654,TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP,217.0,151.9,,,0
CDM,6654,TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE,214.0,149.8,,,0
CDM,6655,"VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUB-Q SOLN",465.0,325.5,,,0
CDM,6656,YELLOW FEVER VACCINE (PF) 10 EXP4.74 UNIT/0.5 ML SUB-Q SUSP,1206.0,844.2,,,0
CDM,6667,PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML INJ SYRG,506.0,354.2,,,0
CDM,6667,PNEUMOCOCCAL 23-VALPS VACCINE 25 MCG/0.5 ML INJ MERGE (CAM USE ONLY),506.0,354.2,,,0
CDM,6667,PNEUMOVAX 23 25 MCG/0.5 ML INJ SYRG,506.0,354.2,,,0
CDM,6673,HC MCARE ADMIN HEPATITIS B VACC,333.0,233.1,,,0
CDM,6673,HEPATITIS B VIRUS VACCINE (PF)  5 MCG/0.5 ML IM SYRG,164.0,114.8,,,0
CDM,6673,HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE,171.0,119.7,,,0
CDM,6675,HC MCARE ADMIN HEPATITIS B VACC,353.0,247.1,,,0
CDM,6675,HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML IM INJ MERGE (CAM USE ONLY),367.0,256.9,,,0
CDM,6675,HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML IM SYRINGE,360.0,252.0,,,0
CDM,66885,"ALDESLEUKIN 360,000 UNITS/ ML SOLUTION",5121.0,3584.7,,,0
CDM,66997,ZOLEDRONIC ACID 4 MG/5 ML IV SOLN,193.0,135.1,,,0
CDM,66997,ZOLEDRONIC ACID IN MANNITOL & WATER 5 MG/100 ML IV SOLN,1150.5,805.3499999999999,,,0
CDM,66997,ZOLEDRONIC ACID-MANNITOL-WATER 4 MG/100 ML IV PGBK,778.0,544.6,,,0
CDM,67227,CERTOLIZUMAB PEGOL 400 MG (200 MG X 2) SUBQ KIT,3323.0,2326.1,,,0
CDM,67227,CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X 2) SUBQ SYKT,12032.5,8422.75,,,0
CDM,67372,LIDOCAINE HCL  2 % MM JELP,47.0,32.9,,,0
CDM,71000001,HC EXTENDED RECOVERY TIME EA 15 MIN,85.0,59.5,,,0
CDM,71000002,HC RECOVERY MIN CHARGE 1 HR,2447.0,1712.9,,,0
CDM,71000032,HC RECOVERY ROOM 8.5,4549.0,3184.3,,,0
CDM,71000040,HC RECOVERY ROOM 1ST HOUR EA 15 MIN,635.0,444.5,,,0
CDM,71000041,HC RECOVERY ROOM EA 15 MIN,69.0,48.3,,,0
CDM,72000003,HC EXTERNAL CEPHALIC VERSION,11458.0,8020.6,,,0
CDM,72000004,HC OUT OF HOSPITAL DELIVERY,2063.0,1444.1,,,0
CDM,72000005,HC LEVEL 1 LABOR/DELIVERY/RECOVERY,5398.0,3778.6,,,0
CDM,72000006,HC LEVEL 2 LABOR/DELIVERY/RECOVERY,7196.0,5037.2,,,0
CDM,72000007,HC LEVEL 1 RECOVERY LOW RISK,416.0,291.2,,,0
CDM,72000008,HC LEVEL 2 RECOVERY HIGH RISK,733.0,513.1,,,0
CDM,72000009,HC LEVEL 3 LABOR/DELIVERY/RECOVERY,9246.0,6472.2,,,0
CDM,72100001,HC LEVEL 1 LABOR < 12 HOURS,537.0,375.9,,,0
CDM,72100002,HC LEVEL 2 LABOR < 12 HOURS,551.0,385.7,,,0
CDM,72200001,HC LEVEL 1 DELIVERY,1762.0,1233.4,,,0
CDM,72200002,HC LEVEL 2 DELIVERY,1762.0,1233.4,,,0
CDM,72300001,HC CIRCUMCISION W/REGIONL BLOCK,2389.0,1672.3,,,0
CDM,7270,BCG LIVE 50 MG IVES SUSR,764.0,534.8,,,0
CDM,7274,SODIUM CHLORIDE 0.9 % INJ SYRG,16.0,11.2,,,0
CDM,73000001,HC ECG TRACING ONLY,320.0,224.0,,,0
CDM,73000002,HC RHYTHM ECG TRACING,62.0,43.4,,,0
CDM,73000003,HC REMOTE 30 DAY ECG RECORDING,124.0,86.8,,,0
CDM,73000007,PRE-OP PM DEVICE EVAL,96.0,67.2,,,0
CDM,73000008,HC PERI-PROCEDURAL DEVICE EVALUATION (IN PERSON) SINGLE/DUAL/MULTIPLE LEAD IMPLANTABLE DEFIBRILLATOR SYSTEM,134.0,93.8,,,0
CDM,73000010,HC EKG TRACING ONLY,320.0,224.0,,,0
CDM,73000016,HC EXT ECG > 48HR UP TO 7 DAYS RCRD INCL CONNECT INITIAL RCRD,388.0,271.6,,,0
CDM,73000017,HC EXT ECG > 7 DAYS UP TO 15 DAYS RCRD INCL CONNECT INITIAL RCRD,388.0,271.6,,,0
CDM,73000018,HC EXT ECG> 48HR UP TO 7 DAYS SCAN ANLYS W/REPORT,388.0,271.6,,,0
CDM,73000019,HC EXT ECG> 7 DAYS UP TO 15 DAYS SCAN ANLYS W/REPORT,418.0,292.6,,,0
CDM,73100001,HC ECG EXTER MONIT UP TO 48 HOURS,469.0,328.3,,,0
CDM,73100002,HC ECG EXTER MONIT REPORT,416.0,291.2,,,0
CDM,73100003,HC REMOTE 30 DAY ECG TRANSMISSION AND ANALYSIS,556.0,389.2,,,0
CDM,74000001,HC ACTIGRAPHY TESTING 3-14 DAYS,123.0,86.1,,,0
CDM,74000002,HC MULTIPLE SLEEP LATENCY TEST,2611.0,1827.7,,,0
CDM,74000003,SLEEP STUDY ATTENDED,2653.0,1857.1,,,0
CDM,74000004,HC POLYSOMNOGRAPHY 6 YRS OR OLDER 4> PARAM,4303.0,3012.1,,,0
CDM,74000005,HC POLYSOMNOG 4> PARAM W/ CPAP,4304.0,3012.8,,,0
CDM,74000006,HC EEG 41-60 MINUTES,561.0,392.7,,,0
CDM,74000007,HC EEG OVER 1 HOUR,643.0,450.1,,,0
CDM,74000008,HC EEG AWAKE AND DROWSY,672.0,470.4,,,0
CDM,74000009,HC EEG AWAKE AND ASLEEP,663.0,464.1,,,0
CDM,74000010,HC EEG COMA OR SLEEP ONLY,539.0,377.3,,,0
CDM,74000013,HC POLYSOMNOGRAPHY 6 YRS OR OLDER 4 > PARAM DISCONTINUED,2151.0,1505.7,,,0
CDM,74000014,HC POLYSOM > 4 PARAM W/ CPAP/BIPAP DISCONT,4303.0,3012.1,,,0
CDM,74000015,HC POLYSOMNOGRAPHY 6 YRS OR OLDER 4+ XTRA MON A,5198.0,3638.6,,,0
CDM,74000016,HC POLYSOM <6 YRS 4/> PARAMTRS,5198.0,3638.6,,,0
CDM,74000017,HC POLYSOM <6 YRS CPAP/BILVL,5198.0,3638.6,,,0
CDM,74000018,HC VEEG 2-12 HOURS W/INTERMITTENT MONITORING & MAINTENANCE,935.0,654.5,,,0
CDM,74000019,HC VEEG 12-26 HOURS W/INTERMITTENT MONITORING & MAINTENANCE,1795.0,1256.5,,,0
CDM,74000020,HC EEG CONTINUOUS RECORD W/VIDEO SETUP PATIENT EDUCATION & TAKEDOWN BY EEG TECH 8 CHANNELS,969.0,678.3,,,0
CDM,74000021,HC POLYSOMNOGRAPHY YOUNGER THAN 6YRS 4> PARAM DISCONTINUED,2151.0,1505.7,,,0
CDM,74000022,HC VEEG BY TECH 2-12 HR CONTINUOUS REAL TIME MONITORING,2262.0,1583.4,,,0
CDM,74000023,HC VEEG BY TECH EA INCREMENT 12-26 HR CONTINUOUS REAL TIME MONITORING,4332.0,3032.4,,,0
CDM,75000001,HC ESOPHAGUS MOTILITY STUDY,2155.0,1508.5,,,0
CDM,75000002,GASTROESOPHAGEAL REFLUX TEST,4396.0,3077.2,,,0
CDM,75000003,GI TRACT CAPSULE ENDOSCOPY,1058.0,740.6,,,0
CDM,75000006,HC ABLATION/ARGON,497.0,347.9,,,0
CDM,75000007,HC DILATION,600.0,420.0,,,0
CDM,75000008,HC BIOPSY,400.0,280.0,,,0
CDM,75000009,HC BLEEDING CONTROL,991.0,693.7,,,0
CDM,75000010,HC BOTOX INJECTION,497.0,347.9,,,0
CDM,75000011,HC BRUSHING,301.0,210.7,,,0
CDM,75000012,HC COLONOSCOPY DIAGNOSTIC,3772.0,2640.4,,,0
CDM,75000013,HC COLONOSCOPY W/ BIOPSY,4172.0,2920.4,,,0
CDM,75000014,HC COLONOSCOPY W/ POLYP & BIOPSY,3300.0,2310.0,,,0
CDM,75000015,HC DECOMPRESSION,2266.0,1586.2,,,0
CDM,75000016,HC EGD,3208.0,2245.6,,,0
CDM,75000019,HC EGD W/ POLYPECTOMY,1613.0,1129.1,,,0
CDM,75000020,HC EGD W/ CONTROL BLEEDING,2138.0,1496.6,,,0
CDM,75000021,HC EGD W/ FOREIGN BODY REMOVAL,2982.0,2087.4,,,0
CDM,75000022,HC ERCP,4714.0,3299.8,,,0
CDM,75000023,HC ESPOHAGEAL STENT PLACEMENT,1966.0,1376.2,,,0
CDM,75000024,HC STENT PLACEMENT,986.0,690.2,,,0
CDM,75000025,HC STENT REMOVAL,400.0,280.0,,,0
CDM,75000026,HC EXTENDED GI LAB 15 MINUTES,381.0,266.7,,,0
CDM,75000027,HC FLEXIBLE SIGMOIDOSCOPY,3020.0,2114.0,,,0
CDM,75000028,HC EGD W/US FINE NEEDLE ASPIRATION/BIOPSY,5378.0,3764.6,,,0
CDM,75000029,HC FOREIGN BODY REMOVAL,758.0,530.6,,,0
CDM,75000030,HC LIGATOR/BANDER,1594.0,1115.8,,,0
CDM,75000031,HC LITHOTRIPSY,945.0,661.5,,,0
CDM,75000032,HC PAPILLOTOMY,475.0,332.5,,,0
CDM,75000033,HC PEG,2266.0,1586.2,,,0
CDM,75000034,HC POLYPECTOMY,497.0,347.9,,,0
CDM,75000035,HC PROCTOSIGMOIDOSCOPY FLEXIBLE,1359.0,951.3,,,0
CDM,75000036,HC REMOVE/REPLACE CATH/NON-INCIS,595.0,416.5,,,0
CDM,75000037,HC SUBMUCOSAL INJECTION,991.0,693.7,,,0
CDM,75000038,HC TATOO INJECTION,991.0,693.7,,,0
CDM,75000039,HC ULTRASOUND EXAMINATION,1058.0,740.6,,,0
CDM,75000041,HC ERCP W/ BIOPSY SINGLE/MULTIPLE,5114.0,3579.8,,,0
CDM,75000042,HC ERCP W/DESTRUCTION/LITHOTRIPSY OF CALCULI,5659.0,3961.3,,,0
CDM,75000043,HC ERCP DUCT SENT PLACEMENT BILLIARY/PANCREATIC DUCT,5700.0,3990.0,,,0
CDM,75000045,HC ERCP W/SPHINCTEROTOMY/PAPILLOTOMY,5189.0,3632.3,,,0
CDM,75000046,HC ERCP W/REMOVAL/EXCHANGE STENT/BILLIARY/PANCREATIC DUCT W/DILATE & GUIDEWIRE,6100.0,4270.0,,,0
CDM,75000047,HC ERCP W/SPECIMEN COLLECTION BY BRUSHING OR WASHING,5015.0,3510.5,,,0
CDM,75000048,HC EGD W/ ESOPHAGEAL STENT PLACEMENT,4797.0,3357.9,,,0
CDM,75000051,HC COLONOSCOPY W/ BLEEDING CONTROL,4763.0,3334.1,,,0
CDM,75000052,HC COLONOSCOPY W/ DILATION,4372.0,3060.4,,,0
CDM,75000053,HC COLONOSCOPY W/ FOREIGN BODY REMOVAL,4530.0,3171.0,,,0
CDM,75000054,HC FLEXIBLE SIGMOIDOSCOPY W/ BIOPSY,3420.0,2394.0,,,0
CDM,75000055,HC FLEXIBLE SIGMOIDOSCOPY W/ BLEEDING CONTROL,4011.0,2807.7,,,0
CDM,75000058,HC SIGMOIDOSCOPY W/REMOVAL TUMOR/POLYP/LESION,3517.0,2461.9,,,0
CDM,75000059,HC STONE EXTRACTION,813.0,569.1,,,0
CDM,75000060,HC FECAL MICROBIOTA PREP INSTIL,4012.0,2808.4,,,0
CDM,75000061,HC COLONOSCOPY W/LESION REMOVAL BY SNARE TECHNIQUE,4269.0,2988.3,,,0
CDM,75000062,HC EGD DIAGNOSTIC BRUSH WASH,3509.0,2456.3,,,0
CDM,75000063,HC LIGATION OF HEMORRHOID(S) BY RUBBER BAND,3651.0,2555.7,,,0
CDM,75000064,HC ENDOSCOPY OF BOWEL POUCH BRUSHING/WASHING,1213.0,849.1,,,0
CDM,75000065,HC ENDOSCOPY OF BOWEL POUCH W/BIOPSY SINGLE/MULTIPLE,1312.0,918.4,,,0
CDM,75000067,HC BANDING,1896.0,1327.2,,,0
CDM,75000068,HC BREATH HYDROGEN OR METHANE TEST,650.0,455.0,,,0
CDM,75000069,HC ANORECTAL MANOMETRY,1213.0,849.1,,,0
CDM,75000070,HC ENDOSCOPIC SUBMUCOSAL DISSECTION (ESD),3772.0,2640.4,,,0
CDM,75000071,HC ILEOSCOPY THRU STOMA DX INCL COLLECTION SPECIMEN BRUSHING/WASHING,4263.0,2984.1,,,0
CDM,75000072,HC UNLISTED PROCEDURE SMALL INTESTINE,9207.0,6444.9,,,0
CDM,75000076,HC SIGMOIDOSCOPY W/BAND LIGATION,6671.0,4669.7,,,0
CDM,75000077,HC ESOPHAGEAL FUNCTION TEST GASTROESOPHAGEAL REFLEX W/IMPEDANCE,6551.0,4585.7,,,0
CDM,75000078,HC SIGMOIDOSCOPY W/ULTRASOUND,4078.0,2854.6,,,0
CDM,75000079,HC UNLISTED DX GI PROCEDURE,6551.0,4585.7,,,0
CDM,75000080,HC SIGMOIDOSCOPY W/ABLATION,3517.0,2461.9,,,0
CDM,75000081,HC SIGMOIDOSCOPY W/RESECTION,4011.0,2807.7,,,0
CDM,75000082,HC SIGMOIDOSCOPY W/SUBMUCOSAL INJECTION,4011.0,2807.7,,,0
CDM,75000083,HC ILEOSCOPY THRU STOMA W/BIOPSY SINGLE/MULTIPLE,1312.0,918.4,,,0
CDM,75000084,HC SMALL BOWEL ENDOSCOPY W/BIOPSY INCL ILEUM SINGLE/MULTIPLE,4172.0,2920.4,,,0
CDM,75000085,HC SMALL BOWEL ENDOSCOPY W/BIOPSY NOT INCL ILEUM SINGLE/MULTIPLE,3608.0,2525.6,,,0
CDM,75000086,HC UNLISTED PROCEDURE PANCREAS,3208.0,2245.6,,,0
CDM,75000088,HC COLONOSCOPY W/SUBMUCOSAL INJECTION,4763.0,3334.1,,,0
CDM,75000089,HC COLONOSCOPY W/ LESION REMOVAL BY HOT BIOPSY FORCEPS,4269.0,2988.3,,,0
CDM,75000090,HC COLONOSCOPY W/ABLATION,4269.0,2988.3,,,0
CDM,75000091,HC COLONOSCOPY W/STENT PLACEMENT,4758.0,3330.6,,,0
CDM,75000092,HC COLONOSCOPY W/RESECTION,4269.0,2988.3,,,0
CDM,75000093,HC COLONOSCOPY W/ENDOSCOPE US,4830.0,3381.0,,,0
CDM,75000094,HC COLONOSCOPY W/ENDOSCOPIC US FINE NEEDLE BIOPSY,5942.0,4159.4,,,0
CDM,75000095,HC COLONOSCOPY W/DECOMPRESSION,6038.0,4226.6,,,0
CDM,75000096,HC COLONOSCOPY W/BAND LIGATION,7423.0,5196.1,,,0
CDM,75000097,HC COLONOSCOPY THRU STOMA W/BIOPSY SINGLE/MULTIPLE,4172.0,2920.4,,,0
CDM,75000098,HC COLONOSCOPY THRU STOMA DX INCL COLLECTION OF SPECIMEN,4073.0,2851.1,,,0
CDM,75000099,HC COLONOSCOPY THRU STOMA W/SUBMUCOSAL INJECTION,4763.0,3334.1,,,0
CDM,75000100,HC COLONOSCOPY THRU STOMA W/REMOVAL TUMOR/POLYP/OTHER LESIONS BY SNARE,4269.0,2988.3,,,0
CDM,75000101,HC COLONOSCOPY SCREENING NOT HIGH RISK IND,3772.0,2640.4,,,0
CDM,75000102,HC COLONOSCOPY SCREENING HIGH RISK IND,3772.0,2640.4,,,0
CDM,75000103,HC ESOPHAGOSCOPY FLEXIBLE DX INCL COLLECTION OF SPECIMEN BRUSHING/WASHING,3509.0,2456.3,,,0
CDM,75000104,HC EGD BALLOON DILATION ESOPHAGUS 30MM OR LARGER,3808.0,2665.6,,,0
CDM,75000105,HC EGD FLEXIBLE TRANSORAL W/SUBMUCOSAL INJECTION,4199.0,2939.3,,,0
CDM,75000106,HC EGD FLEXIBLE TRANSORAL W/ULTRASOUND ESOPHAGUS/STOMACH/DUODENUM,4266.0,2986.2,,,0
CDM,75000107,HC EGD FLEXIBLE TRANSORAL W/TRANSMURAL DRAIN CYST AND ENDOSCOPIC US,4194.0,2935.8,,,0
CDM,75000108,HC EGD W/US FINE NEEDLE ASPIRATION/BIOPSY ALTERED ANATOMY,5378.0,3764.6,,,0
CDM,75000109,HC EGD DILATE STRICTURE,3808.0,2665.6,,,0
CDM,75000110,HC EGD W/BALLOON DILATION ESOPH LESS THAN 30MM,3808.0,2665.6,,,0
CDM,75000111,HC EGD CAUTERY TUMOR/POLYP/LESIONS,3705.0,2593.5,,,0
CDM,75000112,HC EGD REMOVAL OF TUMOR/POLYP/LESIONS BY SNARE,3705.0,2593.5,,,0
CDM,75000113,HC EGD ENDO MUCOSAL RESECTION,4199.0,2939.3,,,0
CDM,75000114,HC EGD US EXAM ESOPH/STOMACH/DUODENUM/JEJUNUM,4266.0,2986.2,,,0
CDM,75000115,HC EGD W/ABLATION TUMOR/POLYP/LESION,3705.0,2593.5,,,0
CDM,75000116,HC ERCP REMOVE FOREIGN BODY/STENT FROM BILLIARY/PANCREATIC DUCT,5872.0,4110.4,,,0
CDM,75000117,HC ERCP BALLOON DILATION BILLIARY/PNACREATIC DUCT AMPULLA,4714.0,3299.8,,,0
CDM,75000118,HC ERCP W/ABLATION TUMOR/POLYP/LESION W/DILATION & GUIDEWIRE,5211.0,3647.7,,,0
CDM,75000119,HC ILEOSCOPY THRU STOMA W/BALLOON DILATION,4562.0,3193.4,,,0
CDM,75000120,HC COLONOSCOPY THRU STOMA US FINE NEEDLE ASPIRATION/BIOPSY,5942.0,4159.4,,,0
CDM,75000121,HC ILEOSCOPY THRU STOMA W/STENT PLACEMENT,4948.0,3463.6,,,0
CDM,75000122,HC COLONOSCOPY THRU STOMA W/ENDO US,4830.0,3381.0,,,0
CDM,75000123,HC SIGMOIDOSCOPY FLEXIBLE W/TRANSENDO US GUIDED FINE NEEDLE ASPIRATON/BIOPSY,5190.0,3633.0,,,0
CDM,75000124,HC ERCP REMOVAL CALCULI/DEBRIS BILLIARY/PANCREATIC DUCT,5527.0,3868.9,,,0
CDM,75000125,HC ESOPH FLEX TRANSORAL W/ABLATION TUMOR/POLYP/OTHER LESIONS,16197.0,11337.9,,,0
CDM,75000126,HC LOWER ESOPHAGEAL MYOTOMY TRANSORAL (POEM),25343.0,17740.1,,,0
CDM,75000127,HC ENDOSCOPIC CANNULATION OF PAPILLA WITH DIRECT VISUALIZATION OF PANCREATIC/COMMON BILE DUCT(S),7099.0,4969.3,,,0
CDM,75000128,HC DUODENAL INTUBATION/ASPIRATION DX INCL IMAGE GUIDANCE COLLECT MULTIPLE SPECIMENS SINGLE OR DOUBLE LUMEN  TUBE INCL DRUG ADMIN,3912.0,2738.4,,,0
CDM,75000129,HC EGD FLEXIBLE TRANSNASAL DX INCL COLLECT SPECIMEN(S) BRUSHING/WASHING,7915.0,5540.5,,,0
CDM,75000130,HC EGD FLEXIBLE TRANSNASAL W/BIOPSY SINGLE/MULTIPLE,7915.0,5540.5,,,0
CDM,75000131,HC EGD FLEXIBLE TRANSNASAL W/INSERTION INTRALUMINAL TUBE/CATHETER,15873.0,11111.1,,,0
CDM,76000004,HC DRAINAGE OF FINGER ABSCESS,243.0,170.1,,,0
CDM,76100001,HC CHANGE OF WINDPIPE AIRWAY,160.0,112.0,,,0
CDM,76100006,HC TRANSCATHETER MITRAL VALVE REPAIR PERCUTANEOUS INCL TRANSSEPTAL PUNCTURE INITIAL PROSTHESIS,2139.0,1497.3,,,0
CDM,76100008,HC TRANSCATHETER MITRAL VALVE REPAIR PERCU INCL TRANSSEPTAL PUNCT ADDTL PROSTHESIS(ES) SAME SESSION,539.0,377.3,,,0
CDM,76100013,HC ESOPH FUNCT TEST GASTROESOPH REFLUX TEST W/ NASAL CATH INTRALUMINAL IMPED ELECTRODE(S) PLACE/RECORD/ANALYSIS/INTERP PROLONG (GREATER THAN 1 HR UP TO 24 HRS),2155.0,1508.5,,,0
CDM,76100014,HC TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVR/TAVI) W/PROSTHETIC VALVE PERCUTANEOUS FEMORAL ARTERY,27691.0,19383.7,,,0
CDM,76100015,HC TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVR/TAVI) W/PROSTHETIC VALVE OPEN FEMORAL ARTERY APPROAC,27691.0,19383.7,,,0
CDM,76100016,HC TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVR/TAVI) W/PROSTHETIC VALVE OPEN AXILLARY ARTERY APPROA,24079.0,16855.3,,,0
CDM,76100035,HC FINE NEEDLE ASPIRATION BIOPSY INCL ULTRASOUND GUIDANCE FIRST LESION,2308.0,1615.6,,,0
CDM,76100036,HC FINE NEEDLE ASPIRATION BIOPSY INCL ULTRASOUND GUIDANCE EACH ADDTL LESION,1154.0,807.8,,,0
CDM,76100037,HC FINE NEEDLE ASPIRATION BIOPSY INCL FLUORO GUIDANCE FIRST LESION,2308.0,1615.6,,,0
CDM,76100039,HC FINE NEEDLE ASPIRATION BIOPSY INCL CT GUIDANCE FIRST LESION,2539.0,1777.3,,,0
CDM,76100040,HC FINE NEEDLE ASPIRATION BIOPSY INCL CT GUIDANCE EACH ADDTL LESION,294.0,205.8,,,0
CDM,76100041,HC FINE NEEDLE ASPIRATION BIOPSY INCL MRI GUIDANCE FIRST LESION,2542.0,1779.4,,,0
CDM,76100042,HC FINE NEEDLE ASPIRATION BIOPSY INCL MRI GUIDANCE EACH ADDTL LESION,947.0,662.9,,,0
CDM,76100043,HC FINE NEEDLE ASPIRATION BIOPSY W/O IMAGE GUIDE EACH ADDTL LESION,213.0,149.1,,,0
CDM,76100044,HC OPTHALMOSCOPY EXTENDED W/RETINAL DRAWING/SCLERAL DEPRESSION W/INTERP & REPORT UNILAT/BILAT,298.0,208.6,,,0
CDM,76200004,ROOM & CARE OBS ACUTE,39.9,27.93,,,0
CDM,76200005,HC ROOM & CARE OBS SAC,100.8,70.56,,,0
CDM,76200006,HC ROOM & CARE OBS ICU,145.95,102.16,,,0
CDM,76200007,OBSERVATION DA,2566.0,1796.2,,,0
CDM,76200008,HC OBS CARVE OUT ACUTE,40.0,28.0,,,0
CDM,76200009,HC OBS CARVE OUT SAC,101.0,70.7,,,0
CDM,76200013,HC OBS CARVE OUT ICU,146.0,102.2,,,0
CDM,7663,TECHNETIUM TC 99M SESTAMIBI - CARDIOLITE,214.0,149.8,,,0
CDM,77100001,IMMUN ADMIN I VAC,221.0,154.7,,,0
CDM,77100002,IMMUN ADMIN EA ADDL VAC,54.0,37.8,,,0
CDM,77100003,HC MCARE ADMIN FLU VACC,221.0,154.7,,,0
CDM,77100004,HC MCARE ADMIN PNEUMO VACC,221.0,154.7,,,0
CDM,77100005,HC MCARE ADMIN HEPATITIS B VACC,221.0,154.7,,,0
CDM,77100013,HC ADMIN TOCILIZUMAB COVID-19 1ST DOSE,474.0,331.8,,,0
CDM,77100014,HC ADMIN TOCILIZUMAB COVID-19 2ND DOSE,474.0,331.8,,,0
CDM,77100048,HC ADMIN RESPIRATORY SYNCYTIAL VIRUS MONOCLONAL ANTIBODY SEASONAL DOSE INTRAMUSCULAR INJECTION W/COUNSELING PHYSICIAN/OTH QUALIFIED HEALTH CARE PROFESSIONAL,47.0,32.9,,,0
CDM,77100049,HC ADMIN RESPIRATORY SYNCYTIAL VIRUS MONOCLONAL ANTIBODY SEASONAL DOSE INTRAMUSCULAR INJECTION,41.0,28.7,,,0
CDM,77100050,HC IV INFUSION PEMIVIBART,475.0,332.5,,,0
CDM,78000020,HC TELEPHONE ASSESS/MGMT SERV NONPHYSICIAN  5-10 MIN,38.0,26.6,,,0
CDM,78000021,HC TELEPHONE ASSESS/MGMT SERV NONPHYSICIAN 11-20 MIN,73.0,51.1,,,0
CDM,78000022,HC TELEPHONE ASSESS/MGMT SERV NONPHYSICIAN 21-30 MIN,106.0,74.2,,,0
CDM,80100001,HEMODIALYSIS ONE EVALUATION,2129.0,1490.3,,,0
CDM,80100002,HC CVVH SET UP FEE,2084.0,1458.8,,,0
CDM,80100003,HC HEMODIALYSIS INITITAION,1073.0,751.1,,,0
CDM,81100001,HC KIDNEY ACQUISITION LIVE,100000.0,70000.0,,,0
CDM,81200001,HC KIDNEY ACQUISITION CADAVER,100000.0,70000.0,,,0
CDM,81200002,HC KIDNEY AND PANCREAS ACQUISITION,200000.0,140000.0,,,0
CDM,81200003,HC PANCREAS ACQUISITION CADAVER,100000.0,70000.0,,,0
CDM,8505,FLU VACCINE TS 2024-25 65 YR UP (PF) 180 MCG/0.5 ML IM SYRG,373.0,261.1,,,0
CDM,8505,FLU VACCINE TS 2024-25 6MOS UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,121.0,84.7,,,0
CDM,8505,FLU VACCINE TS 2025-26 6 MO UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,122.0,85.4,,,0
CDM,8548,AMINOPHYLLINE 500 MG/20 ML IV SOLN,72.5,50.75,,,0
CDM,8555,HYDRALAZINE 20 MG/ML INJ SOLN,85.0,59.5,,,0
CDM,8572,BOTULINUM TOXIN TYPE A 100 UNIT IM SOLR,525.0,367.5,,,0
CDM,8572,ONABOTULINUMTOXINA 200 UNIT INJ SOLR,1239.0,867.3,,,0
CDM,8579,LEUCOVORIN CALCIUM  50 MG INJ SOLR,59.0,41.3,,,0
CDM,8579,LEUCOVORIN CALCIUM 100 MG INJ SOLR,124.0,86.8,,,0
CDM,8579,LEUCOVORIN CALCIUM 350 MG INJ SOLR,289.0,202.3,,,0
CDM,8581,CEFAZOLIN   1 GRAM INJ SOLR,17.5,12.25,,,0
CDM,8584,CEFTRIAXONE   2 GRAM INJ SOLR,35.0,24.5,,,0
CDM,8584,CEFTRIAXONE 1 GRAM INJ SOLR,33.5,23.45,,,0
CDM,8584,CEFTRIAXONE 100 MG/ML FROM 1 GRAM VIAL (PRMC PEDS ONLY),18.5,12.95,,,0
CDM,8584,CEFTRIAXONE 250 MG INJ SOLR,78.0,54.6,,,0
CDM,8584,CEFTRIAXONE 500 MG INJ SOLR,51.0,35.7,,,0
CDM,8584,CEFTRIAXONE IN DEXTROSE (ISO-OSMOTIC) 1 GRAM/50 ML IV PIGGY BACK,116.0,81.2,,,0
CDM,8584,CEFTRIAXONE NEO/PEDS (CDS MIXTURE),16.0,11.2,,,0
CDM,8587,BETAMETHASONE ACET & SOD PHOS 6 MG/ML INJ SUSP,95.0,66.5,,,0
CDM,8599,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN,34.0,23.799999999999997,,,0
CDM,8612,MEDROXYPROGESTERONE (CONTRACEPTIVE) 150 MG/ML IM (MERGE),280.0,196.0,,,0
CDM,8612,MEDROXYPROGESTERONE (CONTRACEPTIVE) 150 MG/ML IM SUSP,242.0,169.39999999999998,,,0
CDM,8612,MEDROXYPROGESTERONE 150 MG/ML IM SYRG,147.0,102.9,,,0
CDM,8618,DEXAMETHASONE 10 MG/ML FOR ORAL OR INJECTION (PEDS ONC),7.0,4.9,,,0
CDM,8618,DEXAMETHASONE 10 MG/ML INJECTION,17.5,12.25,,,0
CDM,8618,DEXAMETHASONE 20MG/55 ML IVPB IN NS (ONCOLOGY),80.5,56.35,,,0
CDM,8618,DEXAMETHASONE 4 MG/ML INJECTION,21.0,14.7,,,0
CDM,8618,DEXAMETHASONE SODIUM PHOS (PF) 10MG/ML INJ SOLN,24.5,17.15,,,0
CDM,8618,FUROSEMIDE 10 MG/ML INJ SOLN,24.0,16.8,,,0
CDM,8618,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,27.0,18.9,,,0
CDM,8625,DIPHENHYDRAMINE 50 MG/ML INJECTION,18.5,12.95,,,0
CDM,8631,DOBUTAMINE IN D5W 500 MG/250 ML (2 MG/ML) INFUSION (PREMIX),235.0,164.5,,,0
CDM,8636,ESTRADIOL VALERATE 20 MG/ML IM OIL,67.0,46.900000000000006,,,0
CDM,8655,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 1 GRAM/10 ML (10 %) INJ SOLN",14390.0,10073.0,,,0
CDM,8655,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 10 GRAM/100 ML (10%) INJ SOLN",11316.0,7921.2,,,0
CDM,8655,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 20 GRAM/200 ML (10%) INJ SOLN",7779.5,5445.65,,,0
CDM,8655,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 40 GRAM/400 ML (10 %) INJ SOLN",12730.0,8911.0,,,0
CDM,8655,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 5 GRAM/50 ML (10 %) INJ SOLN",15559.0,10891.3,,,0
CDM,8655,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 5 GRAM/50 ML (10 %) INJ SOLN (NEW TX NON-NEURO INDICATION)",11316.0,7921.2,,,0
CDM,8658,GENTAMICIN 40 MG/ML INJ SOLN,73.0,51.1,,,0
CDM,8660,GLUCAGON 1 MG/ML INJ (MERGE),785.0,549.5,,,0
CDM,8663,HALOPERIDOL LACTATE 5 MG/ML INJECTION (MERGE),16.0,11.2,,,0
CDM,8664,HALOPERIDOL DECANOATE 100 MG/ML IM SOLN,317.0,221.9,,,0
CDM,8665,HEPARIN LOCK FLUSH 100 UNIT/ML IV SOLN,21.0,14.7,,,0
CDM,8666,HEPARIN (PORCINE)  1000 UNIT/ML INJ SOLN,27.0,18.9,,,0
CDM,8666,HEPARIN (PORCINE)  5000 UNIT/ML INJ SOLN,27.0,18.9,,,0
CDM,8666,HEPARIN (PORCINE) 10000 UNIT/ML INJ SOLN,35.0,24.5,,,0
CDM,8667,ENOXAPARIN 100 MG/1 ML SUBQ SYRG,53.5,37.45,,,0
CDM,8667,ENOXAPARIN 120 MG/0.8 ML SUBQ SYRG,141.0,98.7,,,0
CDM,8667,ENOXAPARIN 30 MG/0.3 ML SUBQ SYRG,43.0,30.1,,,0
CDM,8667,ENOXAPARIN 40 MG/0.4 ML SUBQ SYRG,52.0,36.400000000000006,,,0
CDM,8667,ENOXAPARIN 60 MG/0.6 ML SUBQ SYRG,71.0,49.7,,,0
CDM,8667,ENOXAPARIN 80 MG/0.8 ML SUBQ SYRG,86.0,60.2,,,0
CDM,8672,HYDROCORTISONE 100 MG SOLUTION FOR INJECTION,108.0,75.6,,,0
CDM,8672,HYDROCORTISONE SOD SUCC (PF) 100 MG/2 ML INJ SOLR,142.0,99.4,,,0
CDM,8680,DROPERIDOL 2.5 MG/ML INJ SOLN,63.0,44.1,,,0
CDM,8687,KETOROLAC TROMETHAMINE 15 MG/ML INJ SOLN,16.0,11.2,,,0
CDM,8687,KETOROLAC TROMETHAMINE 30 MG/ML INJ SOLN,22.0,15.4,,,0
CDM,8687,KETOROLAC TROMETHAMINE 60 MG/2 ML IM SOLN,16.0,11.2,,,0
CDM,8690,LANREOTIDE 120 MG/0.5 ML SUBQ SYRG,19794.0,13855.800000000001,,,0
CDM,8690,LANREOTIDE 60 MG/0.2 ML SUBQ SYRG,16803.0,11762.1,,,0
CDM,8691,FUROSEMIDE 10 MG/ML INJ SOLN,37.5,26.25,,,0
CDM,8692,LEUPROLIDE (3 MONTH) 11.25 MG IM KIT,14204.0,9942.8,,,0
CDM,8692,LUPRON 3.75MG IM KIT,4972.0,3480.4,,,0
CDM,8702,LORAZEPAM 2 MG/ML INJ SOLN,16.0,11.2,,,0
CDM,8702,LORAZEPAM 2 MG/ML IV SOLN (PHS MERGE - ALL SITES),16.0,11.2,,,0
CDM,8703,MANNITOL 25 % IV SOLN,31.5,22.05,,,0
CDM,8704,MEPERIDINE (PF) 25 MG/ML IV SOLN (PHS MERGE),30.5,21.35,,,0
CDM,8708,MIDAZOLAM (PF) 5 MG/ML INJ SOLN,16.0,11.2,,,0
CDM,8710,MORPHINE 4 MG/ML IV SOLN (PHS/CDS MERGE),16.5,11.55,,,0
CDM,8713,NALOXONE 0.4 MG/ML INJ SOLN,200.0,140.0,,,0
CDM,8719,ORPHENADRINE CITRATE 30 MG/ML INJ SOLN,92.0,64.4,,,0
CDM,8722,ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN,16.0,11.2,,,0
CDM,8724,PAMIDRONATE 9 MG/ML IV SOLN,217.0,151.9,,,0
CDM,8733,PROMETHAZINE 25 MG/ML INJ SOLN,19.5,13.65,,,0
CDM,8741,FLUPHENAZINE DECANOATE 25 MG/ML INJ SOLN,402.0,281.4,,,0
CDM,8749,METOCLOPRAMIDE  5 MG/ML INJ SOLN,19.5,13.65,,,0
CDM,8750,RHO D IMMUNE GLOBULIN 300 MCG IM SYRG,422.0,295.4,,,0
CDM,8750,RHO(D) IMMUNE GLOBULIN IV (PHS ERX MERGE),405.0,283.5,,,0
CDM,8766,SUMATRIPTAN 6 MG/0.5 ML SUB-Q,68.0,47.6,,,0
CDM,8766,SUMATRIPTAN 6 MG/0.5 ML SUBQ PEN KIT,392.5,274.75,,,0
CDM,8775,THYROTROPIN ALFA 0.9 MG IM SOLR,8208.0,5745.6,,,0
CDM,8781,TRIAMCINOLONE ACETONIDE 10 MG/ML INJ SUSP,43.5,30.450000000000003,,,0
CDM,8781,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,47.0,32.9,,,0
CDM,8788,DIAZEPAM 5 MG/ML INJ SYRG,198.0,138.6,,,0
CDM,8791,VANCOMYCIN IN D5W 1 GRAM/200 ML IV PGBK,135.0,94.5,,,0
CDM,8794,HYDROXYZINE 50 MG/ML IM,190.0,133.0,,,0
CDM,8795,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,25.0,17.5,,,0
CDM,8796,PHYTONADIONE 1 MG/0.5 ML INJ SYRG,146.0,102.2,,,0
CDM,8796,PHYTONADIONE 10 MG/ML INJ SOLN,250.0,175.0,,,0
CDM,8799,MAGNESIUM SULFATE 50 % (4 MEQ/ML) INJ SOLN,19.0,13.3,,,0
CDM,8799,MAGNESIUM SULFATE IN D5W 1 GRAM/100 ML IV PGBK,55.0,38.5,,,0
CDM,8800,NS WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,64.0,44.8,,,0
CDM,8800,POTASSIUM CHLORIDE 10 MEQ/100 ML IV PGBK (USE NON-PROTOCOL PANEL),27.0,18.9,,,0
CDM,8800,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLP,29.5,20.65,,,0
CDM,88000001,HC UNSCHED/EMERGENT DIALYSIS,2129.0,1490.3,,,0
CDM,88000002,HC PERITONEAL DIALYSIS,668.0,467.6,,,0
CDM,8801,DEXTROSE 5% IN WATER (D5W) IV,16.0,11.2,,,0
CDM,8801,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,32.0,22.4,,,0
CDM,8801,LIDOCAINE 20 MG/ML (2 %) INJECTION,17.5,12.25,,,0
CDM,8806,SODIUM CHLORIDE 0.9 % IV (BOLUS),17.0,11.9,,,0
CDM,8806,SODIUM CHLORIDE 0.9 % IV SOLP,47.0,32.9,,,0
CDM,8806,SODIUM CHLORIDE 0.9% IV (PEDS) BOLUS,16.5,11.55,,,0
CDM,8807,SODIUM CHLORIDE 0.9 % IV SOLP,37.0,25.9,,,0
CDM,8808,DEXTROSE 5%-1/2 NORMAL SALINE IV (PEDS ONCOLOGY),58.5,40.95,,,0
CDM,8809,SODIUM CHLORIDE 0.9 % IV (BOLUS),372.0,260.4,,,0
CDM,8809,SODIUM CHLORIDE 0.9 % IV (CLINIC BOLUS),39.0,27.3,,,0
CDM,8809,SODIUM CHLORIDE 0.9 % IV SOLP,104.0,72.8,,,0
CDM,8811,DEXTROSE 5% IN WATER (D5W) IV,26.5,18.549999999999997,,,0
CDM,8811,DEXTROSE 5% IN WATER (NEO) <2 KG,28.0,19.6,,,0
CDM,8811,DEXTROSE 5% IN WATER FLUSH,37.5,26.25,,,0
CDM,8815,LACTATED RINGERS IRRIGATION SOLN,74.0,51.8,,,0
CDM,8815,LACTATED RINGERS IV,34.0,23.8,,,0
CDM,8815,LACTATED RINGERS IV (BOLUS),25.5,17.85,,,0
CDM,8815,LACTATED RINGERS IV (CLINIC BOLUS),34.0,23.8,,,0
CDM,8825,COPPER 380 SQUARE MM IU IUD,3142.0,2199.4,,,0
CDM,8836,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (5 ML) ORAL SOLN,15.0,10.5,,,0
CDM,8865,DOXORUBICIN 2 MG/ML IV SOLN,160.5,112.35,,,0
CDM,8865,DOXORUBICIN 50 MG/25 ML IV SOLN,158.0,110.6,,,0
CDM,8870,BLEOMYCIN 15 UNITS/5 ML INJ SOLR (WET SOLR VIAL),509.0,356.3,,,0
CDM,8870,BLEOMYCIN 30 UNIT INJ SOLR,216.5,151.55,,,0
CDM,8870,BLEOMYCIN 30 UNITS/10 ML INJ SOLR (WET SOLR VIAL),389.0,272.3,,,0
CDM,8871,CARBOPLATIN 10 MG/ML IV,236.5,165.55,,,0
CDM,8873,CISPLATIN 1 MG/ML IV,125.5,87.85,,,0
CDM,8886,CYTARABINE 100 MG/ML INJ SOLN,120.0,84.0,,,0
CDM,8889,DACARBAZINE 100 MG IV SOLR,62.0,43.400000000000006,,,0
CDM,8889,DACARBAZINE 200 MG IV SOLR,231.0,161.7,,,0
CDM,8893,ETOPOSIDE 20 MG/ML IV SOLN,76.5,53.55,,,0
CDM,8896,FLUOROURACIL 1 GRAM/20 ML IV SOLN,34.5,24.150000000000002,,,0
CDM,8896,FLUOROURACIL 5 GRAM/100 ML IV SOLN,209.5,146.65,,,0
CDM,8896,FLUOROURACIL 500 MG/10 ML IV SOLN,57.0,39.900000000000006,,,0
CDM,8898,GOSERELIN  3.6 MG SUBQ IMPL,1670.0,1169.0,,,0
CDM,8898,GOSERELIN 10.8 MG SUBQ IMPL,4784.5,3349.15,,,0
CDM,8900,MESNA 100 MG/ML IV SOLN,114.5,80.15,,,0
CDM,8906,LEUPROLIDE  7.5 MG IM SYKT,2351.5,1646.0500000000002,,,0
CDM,8906,LEUPROLIDE  7.5 MG SUBQ SYRG,1176.0,823.2,,,0
CDM,8906,LEUPROLIDE (3 MONTH) 22.5 MG IM SYRG,1176.0,823.2,,,0
CDM,8906,LEUPROLIDE (4 MONTH) 30 MG IM KIT,23131.5,16192.05,,,0
CDM,8906,LEUPROLIDE (4-MONTH) 30 MG SUBQ SYRG,1176.0,823.2,,,0
CDM,8906,LEUPROLIDE (6 MONTH) 45 MG IM SYKT,1176.0,823.2,,,0
CDM,8906,LEUPROLIDE (6 MONTH) 45 MG SUBCUTANOUS KIT,588.0,411.6,,,0
CDM,8906,LEUPROLIDE 22.5 MG SUBQ SYRG,1175.5,822.85,,,0
CDM,8911,METHOTREXATE SODIUM 25 MG/ML INJ SOLN,52.0,36.400000000000006,,,0
CDM,8916,MITOMYCIN  5 MG IV SOLR,707.0,494.9,,,0
CDM,8916,MITOMYCIN 20 MG IV SOLR,1151.0,805.7,,,0
CDM,8922,VINBLASTINE 1 MG/ML IV SOLN,411.0,287.70000000000005,,,0
CDM,8923,VINCRISTINE 2 MG/2 ML IV SOLN,98.0,68.6,,,0
CDM,8925,TECLISTAMAB-CQYV 10 MG/ML SUBQ SOLN,4886.0,3420.2,,,0
CDM,8925,TECLISTAMAB-CQYV 90 MG/ML SUBQ SOLN,24915.0,17440.5,,,0
CDM,8927,IMETELSTAT  47 MG IV SOLR,6725.0,4707.5,,,0
CDM,8927,IMETELSTAT 188 MG IV SOLR,68232.0,47762.4,,,0
CDM,8927,ROPEGINTERFERON ALFA-2B-NJFT 500 MCG/ML SUBQ SYRG,23234.0,16263.8,,,0
CDM,90100001,HC ELECTROCONVULSIVE THERAPY,2366.0,1656.2,,,0
CDM,91500001,HC GROUP PSYCHOTHERAPY,370.0,259.0,,,0
CDM,91500003,HC MULTI-FAM GROUP BHV MGMT/MODIFICAJ TRAINING FACE-TO-FACE W/MULTI SETS PARENT/GUARDIAN/CAREGIVER INITIAL 60 MIN,45.0,31.5,,,0
CDM,91500004,HC MULTI-FAM GROUP BHV MGMT/MODIFICAJ TRAINING FACE-TO-FACE W/MULTI SETS PARENT/GUARDIAN/CAREGIVER EA ADDTL 15 MIN,12.0,8.4,,,0
CDM,92000001,HC UNLISTED PROCEDURE HEMIC OR LYMPHATIC SYSTEM,7888.0,5521.6,,,0
CDM,92000003,HC FETAL CONTRACT STRESS TEST,707.0,494.9,,,0
CDM,92000004,HC FETAL NON-STRESS TEST,490.0,343.0,,,0
CDM,92000006,HC SLEEP STUDY UNATTENDED W/RECORDING OF HEART RATE/OXYGEN SATURATION/RESPIRATORY AIRFLOW/RESPIRATOR,529.0,370.3,,,0
CDM,92000013,HC HOME SLEEP TEST W/TYPE III PORTABLE MONITOR UNATTEND MIN 4 CHANNELS 2 RESPIRATORY MOV/AIRFLOW 1 ECG/HEARL RATE & 1 OXYGEN SATURATION,641.0,448.7,,,0
CDM,92000015,HC ELEC ANALYSIS IMPLT NEUROSTIM PULSE GENERATOR PHYS/QHP W/O PROGRAMMING,145.0,101.5,,,0
CDM,92100001,HC US EXTRACRANIAL ARTERIES BILAT,1036.0,725.2,,,0
CDM,92100004,HC DOPP UP OR LWR EXTR  1-2 ART BILAT,535.0,374.5,,,0
CDM,92100005,HC DOPP UP OR LWR EXTR  3> ART BILAT,821.0,574.7,,,0
CDM,92100006,HC US LWR EXT ART BYPASS  BILAT,1244.0,870.8,,,0
CDM,92100007,HC US LWR EXT ART BYPASS  UNILAT,255.0,178.5,,,0
CDM,92100008,HC US UPPER EXT ART BYPASS BILAT,555.0,388.5,,,0
CDM,92100009,HC US UPPER EXT ART BYPASS UNILAT,371.0,259.7,,,0
CDM,92100011,HC DUP SCAN EXT VEINS INCL COMPR/MNVR COMP BILAT,634.0,443.8,,,0
CDM,92100012,HC US EXT VEINS UNILAT MANEUVERS,409.0,286.3,,,0
CDM,92100013,HC DUPLEX SCAN ARTERIAL INFLOW AND VENOUS OUTFLOW OF ABDOMNINAL PELVIC SCROTAL AND/OR RETROPERITONEAL ORGANS COMPLETE STUDY,757.0,529.9,,,0
CDM,92100014,HC US VASC ABD PEL SCROT RETPER LMTD,239.0,167.3,,,0
CDM,92100015,HC US AORTA INFVC ILIAC COMP,596.0,417.2,,,0
CDM,92100016,HC US AORTA INFVC ILIAC LMTD,361.0,252.7,,,0
CDM,92100031,HC DUPLEX SCAN ARTERIAL INFLOW AND VENOUS OUTFLOW PREOP VESSEL ASSESS COMPLETE BILAT STUDY,749.0,524.3,,,0
CDM,92100032,HC DUPLEX SCAN ARTERIAL INFLOW AND VENOUS OUTFLOW PREOP BESSEL ASSESS COMPLETE UNILATERAL STUDY,360.0,252.0,,,0
CDM,92100034,HC VASOREACTIVITY STUDY PERFORMED W/TRANSCRANIAL DOPPLER STUDY OF INTRACRANIAL ARTERIES COMPLETE,454.0,317.8,,,0
CDM,92200001,HC EMG ONE LIMB,132.0,92.4,,,0
CDM,92200002,HC EMG TWO LIMBS,238.0,166.6,,,0
CDM,92200009,HC SOMATOSEN TEST UP LIMBS,1278.0,894.6,,,0
CDM,92200011,HC VISUAL EVOKED POTENTIAL CHECKERBOARD/FLASH TESTING CENTRAL NERVOUS SYST EXCEPT GLAUCOMA W/I&R,500.0,350.0,,,0
CDM,92200014,HC ELEC STIM FOR GUIDE,119.0,83.3,,,0
CDM,92200015,HC NEEDLE EMG FOR GUIDE,128.0,89.6,,,0
CDM,92200028,HC NERVE CONDUCTION STUDIES 3-4 STUDIES,1326.0,928.2,,,0
CDM,92200029,HC NERVE CONDUCTION STUDIES 5-6 STUDIES,459.0,321.3,,,0
CDM,92200030,HC NERVE CONDUCTION STUDIES 7-8 STUDIES,459.0,321.3,,,0
CDM,93010,ELECTROCARDIOGRAM REPORT,20.0,14.0,,,0
CDM,94000001,HC PLACE NEEDLE / CATH IN VEIN,154.0,107.8,,,0
CDM,94000002,HC APHERESIS WBC,3360.0,2352.0,,,0
CDM,94000003,HC APHERESIS RBC,3360.0,2352.0,,,0
CDM,94000004,HC APHERESIS PLATELETS,3360.0,2352.0,,,0
CDM,94000005,HC APHERESIS PLASMA,3360.0,2352.0,,,0
CDM,94000006,HC PHOTOPHERESIS,8954.0,6267.8,,,0
CDM,94000007,ARTERIAL BLOOD DRAW,198.0,138.6,,,0
CDM,94000008,HC REFILL IMPLANTABLE PUMP,256.0,179.2,,,0
CDM,94000009,HC REFILL/MAINT PORTABLE PUMP,271.0,189.7,,,0
CDM,94000010,HC IRRIGATE CENTRAL LINE/DEVICE,202.0,141.4,,,0
CDM,94000011,PHLEBOTOMY,361.0,252.7,,,0
CDM,94000012,HC INTENSIVE INFANT RECOVERY,1206.0,844.2,,,0
CDM,94000013,HC PROLONGED ECMO INITAL 24 HRS,53236.0,37265.2,,,0
CDM,94000014,HC PROLONGED ECMO EA. ADD'L 24 HR,19102.0,13371.4,,,0
CDM,94000018,HC XRAY CYSTOGRAPHY,225.0,157.5,,,0
CDM,94200001,HC BEHAV CHNG SMOKING 3-10 MIN,45.0,31.5,,,0
CDM,94300001,HC PHYSN SERV CARD REHAB W/O ECG,275.0,192.5,,,0
CDM,94300002,PHYSN SERV CARD REHAB /W ECG,548.0,383.6,,,0
CDM,96000002,HC PRO DRESS/DEBRID P-THICK BURN SMALL < 5%,247.0,172.9,,,0
CDM,96000003,HC PRO DRESS/DEBRID P-THICK BURN MED 5% - 10%,246.0,172.2,,,0
CDM,96000004,HC PRO DRESS/DEBRID P-THICK BURN LARGE > 10%,173.0,121.1,,,0
CDM,96000005,HC PRO ARTHROCENTESIS ASPIRATION/INJ MAJOR JOINT/BURSA W/O US GUIDE,365.0,255.5,,,0
CDM,96000006,HC  PRO ARTHROCENTESIS ASPIRATION/INJ INTERMEDIATE JOINT/BURSA W/O US GUIDE,192.0,134.4,,,0
CDM,96000007,HC PRO ARTHROCENTESIS ASPIRATION/INJ SMALL JOINT/BURSA W/O US GUIDE,147.0,102.9,,,0
CDM,96000010,HC PRO INSERT TEMP INDWELLING BLADDER CATH SIMPLE,79.0,55.3,,,0
CDM,96000011,HC PRO INSERT TEMP INDWELLING BLADDER CATH COMPLICATED,289.0,202.3,,,0
CDM,96000012,HC PRO INSERT NON-TUNN CV CATH >5 YRS,531.0,371.7,,,0
CDM,96000014,HC PRO CARDIOVERSION ELECTRIC EXT,648.0,453.6,,,0
CDM,96000016,HC PRO REMOVAL OF ARM FOREIGN BODY,382.0,267.4,,,0
CDM,96000018,HC PRO REMOVAL FOREIGN BODY MOUTH,285.0,199.5,,,0
CDM,96000019,HC PRO REMV VAG FOREIGN BODY,406.0,284.2,,,0
CDM,96000020,HC PRO DRAINAGE OF FINGER ABSCESS,189.0,132.3,,,0
CDM,96000022,HC PRO DRAINAGE ABSCESS PALATE UVULA,177.0,123.9,,,0
CDM,96000023,HC PRO I&D TONSIL ABSCESS,459.0,321.3,,,0
CDM,96000024,HC PRO I&D VULVA/PERINEUM ABSCESS,163.0,114.1,,,0
CDM,96000025,HC PRO I&D BARTHOLIN'S GLAND ABSCESS,266.0,186.2,,,0
CDM,96000028,HC PRO DRAIN EXTRNL EAR LESN SMPL,243.0,170.1,,,0
CDM,96000029,HC PRO I&D SKIN SUBQ ABSCESS SIMPLE,347.0,242.9,,,0
CDM,96000030,HC PRO I&D SKIN SUBQ ABSCESS COMPLEX,1030.0,721.0,,,0
CDM,96000031,HC PRO I&D HEMATOMA SEROMA,215.0,150.5,,,0
CDM,96000032,HC PRO EXC NAIL BED,299.0,209.3,,,0
CDM,96000033,HC PRO REPAIR NAIL BED,1041.0,728.7,,,0
CDM,96000034,HC PRO EXCISION OF NAIL FOLD TOE,194.0,135.8,,,0
CDM,96000035,HC PRO REM NAIL PLATE SINGLE,157.0,109.9,,,0
CDM,96000036,HC PRO AVULSION NAIL PLATE COMPLETE/SIMPLE EACH ADDITIONAL NAIL PLATE,68.0,47.6,,,0
CDM,96000037,HC PRO NERVE BLOCK TRIGEMINAL,116.0,81.2,,,0
CDM,96000038,HC PRO INJ NERVE BLOCK OCCIPITAL,120.0,84.0,,,0
CDM,96000043,HC PRO INJECTION ANESTHETIC AGENT(S)/STEROID FEMORAL NERVE INCL IMAGE GUIDE,166.0,116.2,,,0
CDM,96000044,HC PRO INJ NERVE BLOCK OTHER PERIPH,659.0,461.3,,,0
CDM,96000049,HC PRO TREAT HUM GR TUB FX W/ MAN,460.0,322.0,,,0
CDM,96000050,HC PRO CLOSED TX SHOULDER DISLOC W/ FX,515.0,360.5,,,0
CDM,96000052,HC PRO CLOSED TX HUMERAL SHAFT FX W/MANIPULATION W/WO SKELETAL TRACTION,933.0,653.1,,,0
CDM,96000054,HC PRO TREAT HUM SUPRAC FX W/ MAN,887.0,620.9,,,0
CDM,96000057,HC PRO TREAT RAD HEAD NECK FX W/ MAN,791.0,553.7,,,0
CDM,96000059,HC PRO TREAT FX RAD SHAFT W/ MAN,987.0,690.9,,,0
CDM,96000061,HC PRO CLOSED TX ULNAR SHAFT FX W/MANIPULATION,988.0,691.6,,,0
CDM,96000063,HC PRO TREAT FX RAD ULNA SHAFT W/ MAN,1029.0,720.3,,,0
CDM,96000064,HC PRO TREAT FX RAD ULNA DISTAL,862.0,603.4,,,0
CDM,96000065,HC PRO TREAT FX RAD ULNA DISTAL W/ MAN,1100.0,770.0,,,0
CDM,96000069,HC PRO CLOSED TX ULNAR STYLOID FX,696.0,487.2,,,0
CDM,96000070,HC PRO CLOSED TX METACARPAL FX SINGLE W/O MANIPULATION EACH BONE,728.0,509.6,,,0
CDM,96000071,HC PRO TREAT METACARPAL FX EA W/ MAN,987.0,690.9,,,0
CDM,96000072,HC PRO TREAT THUMB FX,635.0,444.5,,,0
CDM,96000073,HC PRO CLOSED TX PHALANGEAL SHAFT FX PROXIMAL/MIDDLE PHALANX FINGER/THUMB W/MANIPULATE W/WO SKIN/SKELETAL TRACTION EACH,821.0,574.7,,,0
CDM,96000074,HC PRO TREAT FINGER FX EA W/O MANIP,506.0,354.2,,,0
CDM,96000078,HC PRO TREAT THIGH FX,1297.0,907.9,,,0
CDM,96000082,HC PRO CLOSED RX TIBIA,521.0,364.7,,,0
CDM,96000084,HC PRO TX MEDIAL MALLEOLUS FX W/O MANIPULATION,1004.0,702.8,,,0
CDM,96000085,HC PRO CLOSED TX MEDIAL MALLEOLUS FX W/MANIPULATION W/WO SKIN OR SKELETAL TRACTION,978.0,684.6,,,0
CDM,96000087,HC PRO TREAT PROX FIBULA FX W/O MANIP,609.0,426.3,,,0
CDM,96000088,HC PRO TREAT PROX FIBULA FX W/ MANIP,814.0,569.8,,,0
CDM,96000089,HC PRO CLOSED TX DISTAL FIBULAR FX W/O MANIPULATION,764.0,534.8,,,0
CDM,96000090,HC PRO TREAT LAT MALLEOLUS FX W/ MAN,959.0,671.3,,,0
CDM,96000091,HC PRO TREAT BIMALLEOLAR FX W/O MANIP,775.0,542.5,,,0
CDM,96000092,HC PRO TREAT BIMALLEOLAR FX W/ MAN,1011.0,707.7,,,0
CDM,96000095,HC PRO TREAT TRIMALLEOLAR FX W/MANIP,1028.0,719.6,,,0
CDM,96000096,HC PRO CLOSED TX CALCANEAL FX W/O MANIPULATION,516.0,361.2,,,0
CDM,96000098,HC PRO TREAT TALUS FX,418.0,292.6,,,0
CDM,96000099,HC PRO TREAT TOE FX W/ MANIP,255.0,178.5,,,0
CDM,96000100,HC PRO RESET DISLOCATED JAW,379.0,265.3,,,0
CDM,96000103,HC PRO TREAT SHOULDER DISLOCATION,1339.0,937.3,,,0
CDM,96000104,HC PRO TREAT ELBOW DISL W/O ANESTH,583.0,408.1,,,0
CDM,96000105,HC PRO TREAT RAD HEAD DISL W/ MANIP,227.0,158.9,,,0
CDM,96000107,HC PRO CLSD TX DISTAL RADIOULNAR DISLOC,649.0,454.3,,,0
CDM,96000108,HC PRO TREAT THUMB DISLOCATION,401.0,280.7,,,0
CDM,96000109,HC PRO TREAT FINGER DISLOCATION,718.0,502.6,,,0
CDM,96000110,HC PRO TREAT HIP DISL W/O ANESTH,1088.0,761.6,,,0
CDM,96000111,HC PRO CLOSED TX POST HIP ARTHROPLASTY DISLOCATION W/O ANESTHESIA,493.0,345.1,,,0
CDM,96000112,HC PRO CLOSED TX POST HIP ARTHROPL DISLOC REQ ANESTH,717.0,501.9,,,0
CDM,96000113,HC PRO TREAT KNEECAP DISL W/O ANESTH,601.0,420.7,,,0
CDM,96000114,HC PRO TREAT KNEECAP DISL W/ ANESTH,1592.0,1114.4,,,0
CDM,96000115,HC PRO TX CLOSED ANKLE DISLOCATION W/O ANESTHESIA,1983.0,1388.1,,,0
CDM,96000116,HC PRO CLSD FOOT DISLOC W/O ANESTH,204.0,142.8,,,0
CDM,96000117,HC PRO TARSOMETATRSL DIS W/O ANESTH,431.0,301.7,,,0
CDM,96000118,HC PRO TARSOMETATRSL DIS W/ ANESTH,687.0,480.9,,,0
CDM,96000119,HC PRO TREAT MP TOE DISLOC,478.0,334.6,,,0
CDM,96000120,HC PRO CLSD TRMT INTRPHLNGL JT DL W/O,180.0,126.0,,,0
CDM,96000121,HC PRO APPLY LONG ARM SPLINT,831.0,581.7,,,0
CDM,96000122,HC PRO APPLY FOREARM SPLINT,295.0,206.5,,,0
CDM,96000124,HC PRO APPLY FINGER SPLINT,154.0,107.8,,,0
CDM,96000125,HC PRO APPLY LOWER LEG SPLINT,328.0,229.6,,,0
CDM,96000126,HC PRO APPLY LONG LEG SPLINT,380.0,266.0,,,0
CDM,96000130,HC PRO HEART/LUNG RESUSCITATION CPR,1449.0,1014.3,,,0
CDM,96000131,HC PRO INSERT EMERGENCY AIRWAY,229.0,160.3,,,0
CDM,96000136,HC PRO DX BRONCHOSCOPE/WASH,573.0,401.1,,,0
CDM,96000137,HC PRO PARACENTESIS ABD,669.0,468.3,,,0
CDM,96000139,HC PRO ABDOMINAL PARACENTESIS DX/THERAPEUTIC W/IMAGING GUIDANCE,374.0,261.8,,,0
CDM,96000140,HC PRO INSERT CANNULA FOR HEMODIALYSIS,300.0,210.0,,,0
CDM,96000153,HC PRO OPEN BX BREAST W/O IMAGE,380.0,266.0,,,0
CDM,96000157,HC PRO OPERATIVE UPPER GI ENDOSCOPY W/ REM FB,850.0,595.0,,,0
CDM,96000160,HC PRO REMOVE IUD,154.0,107.8,,,0
CDM,96000163,HC PRO REMOVAL OF SKIN TAGS,106.0,74.2,,,0
CDM,96000164,HC PRO IRRIGATION CORPORA CAVERNOSA FOR PRIAPRISM,234.0,163.8,,,0
CDM,96000167,HC PRO CHANGE BLADDER CATH SIMPLE,143.0,100.1,,,0
CDM,96000168,HC PRO CHANGE OF CYSTOSTOMY TUBE COMPLICATED,189.0,132.3,,,0
CDM,96000173,HC PRO INSERTION CHEST TUBE,912.0,638.4,,,0
CDM,96000174,HC PRO REMOVE IMPACTED CERUMEN,338.0,236.6,,,0
CDM,96000175,HC PRO I&D GUM LESION,227.0,158.9,,,0
CDM,96000176,HC PRO INSERT NEEDLE BONE CAVITY,508.0,355.6,,,0
CDM,96000177,HC PRO INSERT EMERGENCY AIRWAY,627.0,438.9,,,0
CDM,96000178,HC PRO LUMBAR PUNCTURE,853.0,597.1,,,0
CDM,96000182,HC PRO SIMPLE REPAIR SUPRFCL WNDS S/N/A/GEN/TNK EXT INCL HANDS & FEET 2.5 CM OR LESS,569.0,398.3,,,0
CDM,96000183,HC PRO SIMPLE REPAIR SUPRFCL WNDS S/N/AX/GEN/TRNK EXT INCL HANDS & FEET 2.6 -7.5 CM,711.0,497.7,,,0
CDM,96000184,HC PRO SIMPLE REPAIR SUPRFCL WNDS S/N/AX/GEN/TRK EXT INCL HANDS & FEET 7.6-12.5 CM,851.0,595.7,,,0
CDM,96000185,HC PRO SIMPLE REPAIR SUPRFCL WNDS S/N/A/GEN/TRK EXT INCL HANDS & FEET 12.6-20.0 CM,1088.0,761.6,,,0
CDM,96000186,HC PRO SIMPLE REPAIR SUPRFCL WNDS S/N/A/GEN/TRK EXT INCL HANDS & FEET 20.1-30.0 CM,1378.0,964.6,,,0
CDM,96000187,HC PRO SIMPLE REPAIR SUPRFCL WNDS S/N/A/GEN/TRNK EXT INCL HANDS & FEET OVER 30.0 CM,1357.0,949.9,,,0
CDM,96000188,HC PRO SIMPLE REPAIR SUPRFCL WNDS F/E/E/N/L/M 2.5 CM LESS,621.0,434.7,,,0
CDM,96000189,HC PRO SIMPLE REPAIR SUPRFCL WNDS F/E/E/N/L/M 2.6-5.0 CM,858.0,600.6,,,0
CDM,96000190,HC PRO SIMPLE REPAIR SUPRFCL WNDS F/E/E/N/L/M 5.1-7.5 CM,980.0,686.0,,,0
CDM,96000191,HC PRO SIMPLE REPAIR SUPRFCL WNDS F/E/E/N/L/M 5.1-7.5 CM,1008.0,705.6,,,0
CDM,96000192,HC PRO SIMPLE REPAIR SUPRFCL WNDS F/E/E/N/L/M 12.6-20.0 CM,1092.0,764.4,,,0
CDM,96000195,HC PRO REP INT WND S/A/T/EXT <2.5CM,822.0,575.4,,,0
CDM,96000196,HC PRO REP INT WND S/A/T/EXT 2.6-7.5CM,880.0,616.0,,,0
CDM,96000197,HC PRO REP INT WND S/A/T/EXT 7.6-12.5,1518.0,1062.6,,,0
CDM,96000198,HC PRO REP INT WND S/A/T/EXT 12.6-20.0,1093.0,765.1,,,0
CDM,96000199,HC PRO REP INT WND S/A/T/EXT 20.1-30,1376.0,963.2,,,0
CDM,96000200,HC PRO REPAIR INTERMED WND S/A/T/EXT (EXCL HANDS & FEET) OVER 30.0 CM,1682.0,1177.4,,,0
CDM,96000201,HC PRO REP INT WND N/H/F/GNT<2.5CM,803.0,562.1,,,0
CDM,96000202,HC PRO REP INT WND N/H/F/GNT2.6-7.5,983.0,688.1,,,0
CDM,96000203,HC PRO REP INT WND N/H/F/GNT7.6-12.5,271.0,189.7,,,0
CDM,96000204,HC PRO REP INT WND N/H/F/GNT 12.6-20.0,1167.0,816.9,,,0
CDM,96000205,HC PRO REP INT WND N/H/F/GNT20.1-30,836.0,585.2,,,0
CDM,96000206,HC PRO REPAIR INTERMED WOUNDS NCK/HNDS/FT/EXTERNAL GENITALIA OVER 30.0 CM,812.0,568.4,,,0
CDM,96000207,HC PRO REPAIR INTERMED WNDS F/E/E/N/L/M 2.5 CM OR LESS,873.0,611.1,,,0
CDM,96000208,HC PRO REPAIR INTERMED WNDS F/E/E/N/L/M 2.6-5.0 CM,1070.0,749.0,,,0
CDM,96000209,HC PRO REPAIR INTERMED WNDS F/E/E/N/L/M 5.1-7.5 CM,1230.0,861.0,,,0
CDM,96000210,HC PRO REPAIR INTERMED WNDS F/E/E/N/L/M 7.6-12.5 CM,1674.0,1171.8,,,0
CDM,96000212,HC PRO REPAIR INTERMED WNDS F/E/E/N/L/M 20.1-30.0 CM,851.0,595.7,,,0
CDM,96000216,HC PRO REPAIR COMPLEX TRUNK EACH ADDL 5 CM OR LESS,136.0,95.2,,,0
CDM,96000218,HC PRO REP COM WND S/A/L 2.6-7.5CM,776.0,543.2,,,0
CDM,96000219,HC PRO REP COM WND S/A/L ADDL 5CM OR LESS,148.0,103.6,,,0
CDM,96000221,HC PRO REP COM WND E/N/E/L 1.0-2.5CM,931.0,651.7,,,0
CDM,96000222,HC PRO REP COM WND E/N/E/L 2.6-7.5CM,1200.0,840.0,,,0
CDM,96000223,HC PRO CMPLX RPR E/N/E/L ADDL 5CM/<,171.0,119.7,,,0
CDM,96000225,HC PRO REPAIR LIP> 1/2 HEIGHT,744.0,520.8,,,0
CDM,96000226,HC PRO REP MOUTH LACERATION <2.5CM,202.0,141.4,,,0
CDM,96000227,HC PRO MOUTH LACRTN >2.5CM,517.0,361.9,,,0
CDM,96000228,HC PRO REP ANT TONGUE MOUTH FLOOR <2.5CM,236.0,165.2,,,0
CDM,96000229,HC PRO REP TONGUE MOUTH FLOOR >2.5 CM,446.0,312.2,,,0
CDM,96000235,HC PRO THORACENTESIS NEEDLE/CATH W/O IMAGE GUIDE,214.0,149.8,,,0
CDM,96000236,HC PRO THORACENTESIS NEEDLE/CATH W/ IMAGE GUIDE,612.0,428.4,,,0
CDM,96000243,HC PRO CIRCUMCISION W/ REGIONAL DORSAL OR RING BLOCK,1786.0,1250.2,,,0
CDM,96000244,HC PRO HEART MUSC IMAGE SPECT MULT,769.0,538.3,,,0
CDM,96000245,HC PRO REMOTE 30 DAY ECG REVIEW AND INTERP,54.0,37.8,,,0
CDM,96000247,HC PRO CV STRESS TEST INTERP AND REPORT,30.0,21.0,,,0
CDM,96000249,HC PRO ECHO TRANSESOPHAGEAL,1379.0,965.3,,,0
CDM,96000250,HC PRO ECHO TRANSTHOR W/ DOPPLER,269.0,188.3,,,0
CDM,96000251,HC PRO ECHO DOPPLER FLOW MAP ADD-ON,8.0,5.6,,,0
CDM,96000252,HC PRO ECHO DOPPLER LIMITED FUP ADD-ON,33.0,23.1,,,0
CDM,96000253,HC PRO ECHO TRANSTHOR LIMITED FUP,147.0,102.9,,,0
CDM,96000262,HC PRO US EXTRACRANIAL ARTERIES BILAT,403.0,282.1,,,0
CDM,96000265,HC PRO US EXT VEINS UNILAT MANEUVERS,149.0,104.3,,,0
CDM,96000270,HC PRO US EXT VEINS BILAT MANEUVERS,233.0,163.1,,,0
CDM,96000273,HC PRO DOPP UP OR LWR EXTR 1-2 ART BILAT,200.0,140.0,,,0
CDM,96000277,HC PRO ANESTH PROCEDURE ON MOUTH,156.0,109.2,,,0
CDM,96000278,HC PRO ANESTH FACIAL BONE SURGERY,156.0,109.2,,,0
CDM,96000279,HC PRO ANESTH SKIN SURG HEAD / NECK,353.0,247.1,,,0
CDM,96000281,HC PRO ANESTH ANORECTAL SURGERY,156.0,109.2,,,0
CDM,96000282,HC PRO ANESTH HIP JOINT PROCEDURE,125.0,87.5,,,0
CDM,96000283,HC PRO ANESTH CLOSED PROC UPPER 2/3 FEMUR,125.0,87.5,,,0
CDM,96000284,HC PRO ANESTH OPEN PROC UPPER 2/3 FEMUR,188.0,131.6,,,0
CDM,96000285,HC PRO ANESTH KNEE AREA SURGERY,125.0,87.5,,,0
CDM,96000286,HC PRO ANESTH LOWER 1/3 FEMUR CLOSED PROC,125.0,87.5,,,0
CDM,96000287,HC PRO ANESTH KNEE JOINT CLOSED PROCEDURE,94.0,65.8,,,0
CDM,96000288,HC PRO ANESTH UPPER LEG CLOSED PROCEDURE,94.0,65.8,,,0
CDM,96000289,HC PRO ANESTH LOWER LEG CLOSED PROCEDURE,94.0,65.8,,,0
CDM,96000290,HC PRO ANESTH SHOULDER CLOSED PROCEDURE,125.0,87.5,,,0
CDM,96000291,HC PRO ANESTH ARM / ELBOW BONES CLOSED PROCEDURE,94.0,65.8,,,0
CDM,96000292,HC PRO ANESTH FOREARM BONES CLOSED PROC,94.0,65.8,,,0
CDM,96000293,HC PRO ANESTH CAT / MRI SCAN RADIATION THERAPY,218.0,152.6,,,0
CDM,96000296,HC PRO INSERT CATH ARTERY,100.0,70.0,,,0
CDM,96000298,HC PRO OFFICE/OUTPT E&M  NP 15 MIN,67.0,46.9,,,0
CDM,96000299,HC PRO OFFICE/OUTPT E&M NP 30 MIN,86.0,60.2,,,0
CDM,96000300,HC PRO OFFICE/OUTPT E&M NP 45 MIN,170.0,119.0,,,0
CDM,96000301,HC PRO OFFICE/OUTPT E&M NP 60 MIN,220.0,154.0,,,0
CDM,96000302,HC PRO OFFICE/OUTPT E&M EST 5 MIN,34.0,23.8,,,0
CDM,96000303,HC PRO OFFICE/OUTPT E&M EST 10 MIN,129.0,90.3,,,0
CDM,96000304,HC PRO OFFICE/OUTPT E&M EST 20 MIN,159.0,111.3,,,0
CDM,96000305,HC PRO OFFICE/OUTPT E&M EST 30 MIN,219.0,153.3,,,0
CDM,96000306,HC PRO OFFICE/OUTPT E&M EST 40 MIN,304.0,212.8,,,0
CDM,96000310,HC PRO INSERT VAG BRACHYTX DEVICE,244.0,170.8,,,0
CDM,96000312,HC PRO SUBSEQUENT HOSPITAL INPT OR OBS CARE PER DAY 35 MIN,147.0,102.9,,,0
CDM,96000314,HC PRO SUBSEQUENT HOSPITAL INPT OR OBS CARE PER DAY 50 MIN,210.0,147.0,,,0
CDM,96000322,HC PRO NEG PRESS WOUND THERAPY DME LESS THAN OR EQUAL TO 50 SQ CM,137.0,95.9,,,0
CDM,96000324,HC PRO APPLICATION OF TOTAL CONTRACT CAST (TCC),377.0,263.9,,,0
CDM,96000327,HC PRO ANESTH CARDIAC ELECTROPHYS,225.0,157.5,,,0
CDM,96000329,HC PRO APPLY MULTILAY COMPRS LWR LEG,60.0,42.0,,,0
CDM,96000330,HC PRO APPLC SKIN SUB 25SQ CM,109.0,76.3,,,0
CDM,96000331,HC PRO APPLIC SKIN SUB EA ADD 25SQ CM,24.0,16.8,,,0
CDM,96000332,HC PRO SKIN SUB APP FT 1ST 25SQ CM,227.0,158.9,,,0
CDM,96000333,HC PRO DEBRID SKIN UP TO 10% BODY SURF,56.0,39.2,,,0
CDM,96000340,HC PRO ANESTH SKIN EXT/PER/ATRUNK,93.0,65.1,,,0
CDM,96000343,HC PRO SPLIT-THICKNESS AUTOGRAFT TRUNK/ARMS/LEGS FIRST 100 SQ CM OR LESS OR 1% OF BODY AREA OF INFANTS/CHILDREN,1366.0,956.2,,,0
CDM,96000346,HC PRO CLSD TX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/MANIPULATION,1170.0,819.0,,,0
CDM,96000353,HC PRO CLOSED TX NASAL BONE FX W/MANIP W/O STABLIZATION,257.0,179.9,,,0
CDM,96000364,HC PRO FNA W/O IMAGE,125.0,87.5,,,0
CDM,96000376,HC PRO BIOPSY OROPHARYNX,213.0,149.1,,,0
CDM,96000378,HC PRO BIOPSY OF MOUTH LESION,137.0,95.9,,,0
CDM,96000388,HC PRO BIOPSY BONE OPEN SUPERFICIAL,274.0,191.8,,,0
CDM,96000389,HC PRO BIOPSY BONE OPEN DEEP,780.0,546.0,,,0
CDM,96000400,HC PRO ANESTHESIA PX LUMBAR REGION DIAGNOSTIC/THERAPEUTIC PUNCTURE,123.0,86.1,,,0
CDM,96000409,HC PRO ASP PUNCTURE CYST BREA,123.0,86.1,,,0
CDM,96000451,HC PRO CLSD TX OF INTER/PERI/SUBTROCHANTERIC FEMORAL FX W/MANIPULATION W/W/O SKIN/SKELETAL TRACTION,1220.0,854.0,,,0
CDM,96000453,HC PRO BONE MARROW ASPIRATION W/BONE MARROW BIOPSY SAME INCISION SAME DOS,244.0,170.8,,,0
CDM,96000454,HC PRO PT CAT PN CAT/HISTOLOGICAL GRADE NOT DOC IN PATH REPORT REASON NOT GIVEN,0.01,0.007,,,0
CDM,96000455,HC PRO SPECIMEN SITE NOT ANATOMIC LOCATION OF ESOPHAGUS,0.01,0.007,,,0
CDM,96000456,HC PRO SPECIMEN SITE NOT ANATOMIC LOCATION OF PROSTATE,0.01,0.007,,,0
CDM,96000459,HC PRO CLOSED TX ULNAR FX PROX END W/MANIP,514.0,359.8,,,0
CDM,96000460,HC PRO CLSD TX FEMORAL FX DISTAL END MEDIAL/LATERAL CONDYLE MANIP,863.0,604.1,,,0
CDM,96000461,HC PRO TX MIDFOOT FRACTURE EACH,618.0,432.6,,,0
CDM,96000462,HC PRO METATARSAL FX W/MANIP,377.0,263.9,,,0
CDM,96000464,HC PRO CLOSED TX KNEE DISLOCATION W/ANESTHESIA,791.0,553.7,,,0
CDM,96000465,HC PRO REPAIR LACERATION 2.5CM/< POSTERIOR ONE-THIRD TONGUE,235.0,164.5,,,0
CDM,96000466,HC PRO CLSD TX SHOULDER DISLOCATION W/SURGICAL/ANATOMICAL NECK FX W/MANIP,632.0,442.4,,,0
CDM,96000472,HC PRO REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNILATERAL,15.0,10.5,,,0
CDM,96000473,HC PRO  INTRAORAL INCISION & DRAINAGE OF ABSCESS/CYST/HEMATOMA OF TONGUE/FLOOR OF MOUTH LINGUAL,144.0,100.8,,,0
CDM,96000475,HC PRO XRAY SURGICAL SPECIMEN,11.0,7.7,,,0
CDM,96000478,HC PRO BONE BX TROCAR/NEEDLE SUP,93.0,65.1,,,0
CDM,96000484,HC PRO CLSD TX TIBIAL FX PROXIMAL (PLATEAU) W/WO MANIP W/SKELETAL TRACTION,913.0,639.1,,,0
CDM,96000487,HC PRO TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL,290.0,203.0,,,0
CDM,96000500,HC PRO ARTHROCENTESIS ASPIRATION/INJECTION INTERMEDIATE JOINT OR BURSA W/ US GUIDE W/RECORDING & REPORTING,68.0,47.6,,,0
CDM,96000508,HC PRO PINCH GRAFT SINGLE/MULTIPLE COVER SMALL ULCER/TIP OF DIGIT/MINIMAL OPEN AREA UP TO 2CM DIAMETER,555.0,388.5,,,0
CDM,96000512,HC PRO PARTIAL EXCISION (CRATERIZATION/SAUCERIZATION/SEQUESTRECTOMY/DIAPHYSECTOMY) BONE PHALANX OF TOE,806.0,564.2,,,0
CDM,96000527,HC PRO ANESTHESIA FOR PROCEDURES ON UPPER ANTERIOR ABDOMINAL WALL NOT OTHERWISE SPECIFIED,273.0,191.1,,,0
CDM,96000528,HC PRO ANESTHESIA FOR PROCEDURES ON LOWER ANTERIOR ABDOMINAL WALL NOT OTHERWISE SPECIFIED,248.0,173.6,,,0
CDM,96000529,HC PRO ESOPH FUNCT TEST GASTROESOPH REFLUX TEST W/ NASAL CATH INTRALUMINAL IMPED ELECTRODE(S) PLACE/RECORD/ANALYSIS/INTERP PROLONG (GREATER THAN 1 HR UP TO 24 HRS),660.0,462.0,,,0
CDM,96000530,HC PRO REMOVAL EMBEDDED FOREIGN BODY FROM EYELID,259.0,181.3,,,0
CDM,96000548,HC PRO VAGINAL DELIVERY,1393.0,975.1,,,0
CDM,96000549,HC PRO UNLISTED PROCEDURE RECTUM,499.0,349.3,,,0
CDM,96000550,HC PRO CLOSED TX ACROMIOCLAVICULAR DISLOCATION W/MANIPULATION,745.0,521.5,,,0
CDM,96000551,HC PRO REMOVAL CONTRACEPTIVE CAP,162.0,113.4,,,0
CDM,96000559,HC PRO BRONCHOSCOPY RIGID/FLEX INCL FLUORO GUIDE W/BRONCHIAL OR ENDOBRON BIOPSY(S) SINGLE/MULTI SITE,287.0,200.9,,,0
CDM,96000561,HC PRO TANGENTIAL BIOPSY OF SKIN SINGLE LESION,112.0,78.4,,,0
CDM,96000562,HC PRO PUNCH BIOPSY OF SKIN INCL SIMPLE CLOSURE SINGLE LESION,234.0,163.8,,,0
CDM,96000563,HC PRO INCISIONAL BIOPSY OF SKIN INCL SIMPLE CLOSURE SINGLE LESION,106.0,74.2,,,0
CDM,96000564,HC PRO TANGENTIAL BIOPSY OF SKIN EACH SEPARATE/ADDTL LESION,60.0,42.0,,,0
CDM,96000565,HC PRO PUNCH BIOPSY OF SKIN INCL SIMPLE CLOSURE EACH SEPARATE/ADDTL LESION,84.0,58.8,,,0
CDM,96000566,HC PRO INCISIONAL BIOPSY OF SKIN EACH SEPARATE/ADDT LESION,102.0,71.4,,,0
CDM,96000567,HC PRO FINE NEEDLE ASPIRATION BIOPSY INCL ULTRASOUND GUIDANCE FIRST LESION,172.0,120.4,,,0
CDM,96000575,HC PRO REMOTE MONITOR OF PHYSIOLOGIC PARAMETER INITIAL SET-UP/PATIENT EDUCATION ON USE OF EQUIPMENT,33.0,23.1,,,0
CDM,96000576,HC PRO REMOTE MONITOR OF PHYSIOLOGIC PARAMETER INITIAL DEVICE SUPPLY W/DIALY REC/PROGRAM ALERT,106.0,74.2,,,0
CDM,96000577,HC PRO REMOTE PHYSIOLOGIC MONITOR TREATMENT MGMT SERV 20 MIN/MORE OF CLIN STAFF/PHYSICIAN/QUAL PROFN,55.0,38.5,,,0
CDM,96000581,HC PRO ARTHOCENTISIS ASPIR/INJECT SM JOINT/BURSA W/ULTRA SOUND GUIDE W/PERM RECORDING & REPORTING,106.0,74.2,,,0
CDM,96000583,HC PRO FINE NEEDLE ASPIRATION BIOPSY W/O IMAGE GUIDE EACH ADDTL LESION,79.0,55.3,,,0
CDM,96000588,HC PRO CACNA1A GENE ANALYSIS FULL GENE SEQUENCE,356.0,249.2,,,0
CDM,96000590,HC PRO EXTRACTION ERUPTED TOOTH OR EXPOSED ROOT (EVELATION AND/OR FORCEPS REMOVAL),84.0,58.8,,,0
CDM,96000591,HC PRO INCISION AND DRAINAGE OF ABSCESS-INTRAORAL SOFT TISSUE,166.0,116.2,,,0
CDM,96000592,HC PRO INCISION AND DRAINAGE OF ABSCESS-INTRAORAL SOFT TISSUE COMPLICATED,250.0,175.0,,,0
CDM,96000593,HC PRO TELEHEALTH PSYCHOTHERAPY W/PATIENT 30 MINUTES,100.0,70.0,,,0
CDM,96000594,HC PRO TELEHEALTH PSYCHOTHERAPY W/PATIENT 45 MINUTES,133.0,93.1,,,0
CDM,96000597,HC PRO TELEHEALTH PSYCHOTHERAPY 30 MIN W/PATIENT WHEN PERFORMED WITH E&M SERVICE,103.0,72.1,,,0
CDM,96000598,HC PRO TELEHEALTH PSYCHOTHERAPY 45 MIN W/PATIENT WHEN PERFORMED WITH E&M SERVICE,129.0,90.3,,,0
CDM,96000599,HC PRO TELEHEALTH TRACKING PSYCHOTHERAPY 60 MIN W/PATIENT WHEN PERFORMED WITH E&M SERVICE,185.0,129.5,,,0
CDM,96000600,HC PRO TELEHEALTH PSYCHOTHERAPY FOR CRISIS FIRST 60 MIN,203.0,142.1,,,0
CDM,96000601,HC PRO TELEHEALTH PSYCHOTHERAPY FOR CRISIS EACH ADDITIONAL 30 MIN,97.0,67.9,,,0
CDM,96000602,HC PRO TELEHEALTH PSYCHOANALYSIS,139.0,97.3,,,0
CDM,96000625,HC PRO TELEHEALTH ADVANCE CARE PLANNING INCL E & D OF ADVANCE DIRECTIVES FIRST 30 MINUTES FACE-TO-FACE W/PATIENT/FAMILY MEMBER/SURROGATE,134.0,93.8,,,0
CDM,96000626,HC PRO TELEHEALTH ADVANCE CARE PLANNING INCL E &D OF ADVANCE DIRECTIVES EACH ADDTL 30 MIN,109.0,76.3,,,0
CDM,96000629,HC PRO PERINEOPLASTY REPAIR OF PERINEUM NONOBSTETRICAL,614.0,429.8,,,0
CDM,96000633,HC PRO ASPIRATE/INJ GANGLION CYST(S),94.0,65.8,,,0
CDM,96000641,HC PRO CORPORA CAVERNOSA-GLANS PENIS FISTULIZATION FOR PRIAPISM,1231.0,861.7,,,0
CDM,96000666,HC PRO EXT ECG>48HR UPT TO 7 DAYS REVIEW & INTERP,162.0,113.4,,,0
CDM,96000667,HC PRO EXT ECG>7 DAYS UP TO 15 DAYS REVIEW & INTERP,162.0,113.4,,,0
CDM,96000668,HC PRO ANESTH CLOSED CHEST INCL BRONCHOSCOPY,327.0,228.9,,,0
CDM,96000671,HC PRO ANESTH THORACOTOMY/THORACOSCOPY,781.0,546.7,,,0
CDM,96000675,HC PRO INJ N BLOCK SPHENOPAL GANG,260.0,182.0,,,0
CDM,96000676,HC PRO CLOSED TX VERTEBRAL BODY FX(S) W/O MANIP INCL CASTING/BRACING,654.0,457.8,,,0
CDM,96000681,HC PRO STRAPPING HAND OR FINGER,63.0,44.1,,,0
CDM,96000682,HC PRO INJECTION(S) ANESTHETIC AGENT(S) AND/OR STERIOD GENICULAR NERVE BRANCHES INCL IMAGE GUIDE WHEN PERFORMED,222.0,155.4,,,0
CDM,96000683,HC PRO USE OF ECHO CONTRAST AGENT DURING STRESS ECHOCARDIOGRAPHY,74.0,51.8,,,0
CDM,96000684,HC PRO BIOPSY MUSCLE SUPERFICIAL,215.0,150.5,,,0
CDM,96000685,HC PRO BIOPSY MUSCLE DEEP,353.0,247.1,,,0
CDM,96000686,HC PRO CARDIOVASCULAR STRESS TEST USING MAXIMAL OR SUBMAXIMAL TREADMILL OR BICYCLE EXERCISE CONT ECG W/O INTERP & REPORT,50.0,35.0,,,0
CDM,96000687,HC PRO NASO/OROGASTRIC TUBE PLACE FLUORO GUIDE,93.0,65.1,,,0
CDM,96000689,HC PRO INCISION & DRAINAGE COMPLEX POSTOPERATIVE WOUND INFECTION,409.0,286.3,,,0
CDM,96000690,HC PRO OPEN TX BIMALLEOLAR ANKLE FX INCL INTERNAL FIX,1771.0,1239.7,,,0
CDM,96000691,HC PRO UNLISTED PROCEDURE PHARYNX ADENOIDS AND TONSILS,887.0,620.9,,,0
CDM,96000692,HC PRO AMPUTATION TOE METATARSOPHALANGEAL JOINT,700.0,490.0,,,0
CDM,96000693,HC PRO EXC H-F-NK-SP BEN MARG 2.1-3,351.0,245.7,,,0
CDM,96000694,HC PRO OPEN TX DISTAL PHALANGEAL FRACTURE FINGER/THUMB INCL INTERNAL FIXATION EA,1148.0,803.6,,,0
CDM,96000695,HC  PRO EXTRAORAL INCISION & DRAINAGE ABSCESS/CYSTS/HEMATOMA OF MOUTH MASTICATOR SPACE,905.0,633.5,,,0
CDM,96000697,HC PRO INTRAORAL INCISION/DRAINAGE OF ABSCESS/CYST/HEMATOMA OF TONGUE OR FLOOR OF MOUTH SUBMENTAL SPACE,501.0,350.7,,,0
CDM,96000698,HC PRO DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM,271.0,189.7,,,0
CDM,96000699,HC PRO I&D SUBMUCOSAL ABSCESS RECTUM,377.0,263.9,,,0
CDM,96000700,HC PRO PUNCTURE ASPIRATION HYDROCELE TUNICA VAGIS W/WO INJECTION OF MEDICATION,194.0,135.8,,,0
CDM,96000701,HC PRO ANESTH VAGINAL PX INCL BIOPSY CULDOSCOPY,197.0,137.9,,,0
CDM,96000702,HC PRO PLACEMENT OF NEEDLE PELVIC ORGAN RADIOELEMENT APPL,1045.0,731.5,,,0
CDM,96000703,HC PRO PLACEMENT SOFT TISS LOC DEVICE PLMT W/GUIDANCE 1ST LESION,589.0,412.3,,,0
CDM,96000704,HC PRO PLACEMENT SOFT TISS LOC DEVICE PLMT W/GUIDANCE EACH ADDTL LESION,509.0,356.3,,,0
CDM,96000705,HC PRO INJECTION ANESTHETIC AGENT(S)/STEROID AXILLARY NERVE INCL IMAGE GUIDE,152.0,106.4,,,0
CDM,96000706,HC PRO OPEN TX DISTAL RADIAL EXTRA ARTICULAR FX/EPIPHYSEAL SEP W/INT FIX,1700.0,1190.0,,,0
CDM,96000707,HC PRO IMPLANT BIO IMPLANT SOFT TISSUE REINFORCE ADD-ON,502.0,351.4,,,0
CDM,96000708,HC PRO EGD INTRALUMINAL TUBE/CATHETER INSERTION,328.0,229.6,,,0
CDM,96000709,HC PRO FLEXIBLE ENDOSCOPIC EVAL LARYNGEAL SENSORY TESTING BY CINE/VIDEO REC INTERP & REPORT ONLY,261.0,182.7,,,0
CDM,96000710,HC PRO ANESTH HERNIA REPAIRS LOWER ABDOMEN NOS,318.0,222.6,,,0
CDM,96000711,HC PRO REMOVAL INFLATABLE PENILE PROSTHESIS W/O RPLCMT PROSTHESIS,1622.0,1135.4,,,0
CDM,96000712,HC PRO CLOSD TX METACARPOPHALANGEAL DISLOCATION SINGLE W/ MANIP & ANES,892.0,624.4,,,0
CDM,96000713,HC PRO TRIMMING NONDYSTROPHIC NAILS ANY NUMBER,20.0,14.0,,,0
CDM,96000714,HC PRO REMOVAL OF SUTURES OR STAPLES NOT REQ ANESTHESIA,24.0,16.8,,,0
CDM,96000715,HC PRO REMOVAL OF SUTURES & STAPLES NOT REQ ANESTHESIA,34.0,23.8,,,0
CDM,96000716,HC PRO CLOSED TREATMENT OF DISTAL PHLNGL FRACTURE FINGER OR THUMB W/O MANIPULATION EACH,426.0,298.2,,,0
CDM,96000717,HC PRO ANESTH MALE GENITALIA INCL OPEN URETHRAL PROCEDURES NOS,395.0,276.5,,,0
CDM,96000718,HC PRO REMOVAL OF FOREIGN BODY DEEP THIGH REGION OR KNEE AREA,919.0,643.3,,,0
CDM,96000720,HC PRO CLOSED TREATMENT MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX,1213.0,849.1,,,0
CDM,96000721,HC PRO VENIPUNCTURE YOUNGER THAN AGE 3 YEAR NECESSITATING SKILL OF A PHYSICIAN OTHER VEIN,32.0,22.4,,,0
CDM,96000722,HC PRO ANESTHESIA PX HEART PERICARDIAL SAC GREAT VESSELS OF CHEST W/O PUMP OXYGENATOR,794.0,555.8,,,0
CDM,96000723,HC PRO HC BL DRAW < 3 YRS SCALP VEIN,34.0,23.8,,,0
CDM,96000724,HC PRO INSERT PICC CATH <5 YRS,562.0,393.4,,,0
CDM,96000725,HC PRO INSERT OF PICC W/O SUB PORT/PUMP INCLUD ALL IMAGE GUIDE IMAGE DOC/ASSOC RADIOLOGICAL < 5 YRS,468.0,327.6,,,0
CDM,96000726,HC PRO INSERT OF PICC W/O SUB PORT/PUMP INCLUD ALL IMAGE GUIDE IMAGE DOC/ASSOC RADIOLOGICAL >5 YRS,441.0,308.7,,,0
CDM,96000727,HC PRO CLOSED TREATMENT OF GREATER HUMERAL TUBEROSITY FRACTURE W/O MANIPULATION,590.0,413.0,,,0
CDM,96000728,HC PRO INJECTION(S) ANESTHETIC AGENT(S) AND/OR STEROID VAGUS NERVE,211.0,147.7,,,0
CDM,96000729,HC PRO INJECTION(S) ANESTHETIC AGENT(S) AND/OR STEROID BRACHIAL PLEXUS INCL IMAGE GUIDE,192.0,134.4,,,0
CDM,96000730,HC PRO INJECTION(S) ANESTHETIC AGENT(S) AND/OR STEROID BRACHIAL PLEXUS CONT INFUSION BY CATHETER INCL IMAGE GUIDE,409.0,286.3,,,0
CDM,96000731,HC PRO INJECTION(S) ANESTHETIC AGENT(S) AND/OR STEROID PARACERVICAL UTERINE NERVE,204.0,142.8,,,0
CDM,96000732,HC PRO INJECTION(S) ANESTHETIC AGENT(S) AND/OR STEROID SCIATIC NERVE CONT INFUSION BY CATHETER INCL IMAGE GUIDE,400.0,280.0,,,0
CDM,96000733,HC PRO INJECTION(S) ANESTHETIC AGENT(S) AND/OR STEROID FEMORAL NERVE CONT INFUSION BY CATHETER INCL IMAGE GUIDE,358.0,250.6,,,0
CDM,96000734,HC PRO INJECTION(S) AGENT(S) AND/OR STEROID LUMBAR PLEXUS POSTERIOR APPROACH CONT INFUSION BY CATHETER INCL CATHETER PLACEMENT,367.0,256.9,,,0
CDM,96000735,HC PRO SHAVING EPIDERMAL/DERMAL LESION SINGLE LESION TRUNK/ARMS/LEGS 0.6-1.0 CM,173.0,121.1,,,0
CDM,96000736,HC PRO CLOSED TX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/O MANIPULATION,725.0,507.5,,,0
CDM,96000737,HC PRO REMOVAL FOREIGN BODY IN SCROTUM,858.0,600.6,,,0
CDM,96000738,HC PRO PTA PULMONARY ARTERY BALLOON ANGIOPLASTY SINGLE VESSEL,1556.0,1089.2,,,0
CDM,96000739,HC PRO PTA PULMONARY ARTERY BALLOON ANGIOPLASTY EA ADDTL VESSEL,778.0,544.6,,,0
CDM,96000740,HC PRO REMOVAL FOREIGN BODY FROM DEEP PENILE TISSUE,967.0,676.9,,,0
CDM,96000750,HC PRO BRIEF COMMUNICATION TECH-BASED SERVICE PHYSICIAN OR QHP ESTABLISHED PATIENT 5-10 MINUTES,29.0,20.3,,,0
CDM,96000752,HC PRO SUTURE PHARYNX FOR WOUND OR INJURY,840.0,588.0,,,0
CDM,96000756,HC PRO EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBFASCIAL LESS THAN 1.5CM,796.0,557.2,,,0
CDM,96900002,HC PRO PT NO GRADE MED REASON,0.01,0.007,,,0
CDM,9693250F,HC PRO SPECIMEN SITE NOT PRIM TUMOR,0.01,0.007,,,0
CDM,9693260F,HC PRO PATH REPORT HISTOLOGIC GRADE,0.01,0.007,,,0
CDM,9693267F,HC PRO PATH RPRT W/ PT PN CAT ET AL,0.01,0.007,,,0
CDM,9693394F,HC PRO QUANT HER2 IHC EVAL BRST CX,0.01,0.007,,,0
CDM,9693395F,HC PRO QUANT NONHER2 IHC BRST CX,0.01,0.007,,,0
CDM,96984166,HC PRO PROTEIN E-PHORESIS/URINE/CSF,58.0,40.6,,,0
CDM,969G8721,HC PRO PT PN HIST GRADE DOC,0.01,0.007,,,0
CDM,97100004,HC PRO ESOPHAGEAL BIOPSY REPORT WITH A STATEMENT ABOUT DYSPLASIA,0.01,0.007,,,0
CDM,97100005,HC PRO CONSULTATION AND REPORT ON REFERRED MATERIAL REQUIRING PREP OF SLIDES,183.0,128.1,,,0
CDM,97100006,HC PRO CONSULTATION COMPREHENSIVE W/ REVIEW OF RECORDS/SPECIMENS W/ REPORT ON REFERRED MATERIAL,169.0,118.3,,,0
CDM,97100007,HC PRO ELECTRON MICROSCOPY DIAGNOSTIC,407.0,284.9,,,0
CDM,97100009,HC PRO SURG PATH GROSS/MICROSCOPIC EXAM PROSTATE NEEDLE BIOPSY ANY METHOD,758.0,530.6,,,0
CDM,97100011,HC PRO MICRODISSECTION MANUAL,461.0,322.7,,,0
CDM,97100012,HC PRO CYTOPATH EVAL OF FNA EA ADDTL EVAL EPISODE,44.0,30.8,,,0
CDM,97100013,HC PQRS PATHOLOGY REPORT INCL PT CATEGORY THICKNESS/ULCERATION/MITOTIC RATE PERIPHERAL DEEP MARGIN STATUS & PRESENCE/ABSENCE MICROSATELLITOSIS INVASIVE TUMORS,0.01,0.007,,,0
CDM,97100015,HC PQRS SPECIMEN SITE OTHER THAN ANATOMIC CUTANEOUS LOCATION,0.01,0.007,,,0
CDM,97100016,HC PQRS PATHOLOGY REPORT DOES NOT INCL PT CATEGORY THICKNESS/ULCERATION/MITOTIC RATE PERIPHERAL DEEP MARGIN STATUS & PRESENCE/ABSENCE MICROSATELLITOSIS INVASIVE TUMORS,0.01,0.007,,,0
CDM,97100017,HC PQRS NON-SMALL CELL LUNG CANCER BIOPSY AND CYTOLOGY SPECIMEN REPORT DOCUMENTS CLASSIFICATION INTO SPECIFIC HISTOLOGIC TYPE OR CLASSIFIED AS NSCLC-NOS WITH AN EXPLANATION,0.01,0.007,,,0
CDM,97100018,HC PQRS DOCUMENTATION OF MEDICAL REASON(S) FOR NOT REPORTING THE HISTOLOGICAL TYPE OR NSCLC-NOS CLASSIFICATION WITH AN EXPLANATION (EQ A SOLITARY FIBROUS TUMOR IN A PERSON WITH A HISTORY O*,0.01,0.007,,,0
CDM,97100019,HC PQRS SPECIMEN SITE OTHER THAN ANATOMIC LOCATION OF LUNG IS NOT CLASSIFIED AS NON-SMALL CELL LUNG CANCER OR CLASSIFIED AS NSCLC-NOS,0.01,0.007,,,0
CDM,97100020,HC PQRS NON SMALL CELL LUNG CANCER BIOPSY AND CYTOLOGY SPECIMEN REPORT DOES NOT DOCUMENT CLASSIFICATION INTO SPECIFIC HISTOLGIC TYPE OR CLASSIFIED AS NSCLC-NOS WITH AN EXPLANATION,0.01,0.007,,,0
CDM,97100021,HC PQRS PRIMARY NON-SMALL CELL LUNG CANCER LUNG BIOPSY/CYTOLOGY SPECIMEN REP DOCS CLASS SPECIFIC HISTOLOGIC TYPE FOLLOWING IASLC GUIDE OR CLASS,0.01,0.007,,,0
CDM,97100022,HC PQRS DOCUMENTATION OF MEDICAL REASON(S) FOR NOT REPORTING THE HISTOLOGICAL TYPE OR NSCLC-NOS CLASSIFICATION WITH AN EXPLANATION,0.01,0.007,,,0
CDM,97100023,HC PQRS SPECIMEN SITE OTHER THAN ANATOMIC LOCATION OF LUNG OR IS NOT CLASSIFIED AS PRIMARY NON-SMALL CELL LUNG CANCER,0.01,0.007,,,0
CDM,97100024,HC PQRS PRIMARY NON-SMALL CELL LUNG CANCER LUNG BIOPSY AND CYTOLOGY SPECIMEN REPORT DOES NOT DOCUMENT CLASSIFICATION INTO SPECIFIC HISTOLIGIC TYPE OR CLASS,0.01,0.007,,,0
CDM,97100025,HC PRO IMMUNOFLUORESCENCE PER SPECIMEN EA ADDTL SINGLE ANTIBODY STAIN PROCEDURE,86.0,60.2,,,0
CDM,97100051,HC PRO FIBRINOLYSINS OR COAGULOPATHY SCREEN INTERP AND REPORT,20.0,14.0,,,0
CDM,97100053,HC PRO SURG PATH GROSS/MICROSCOPIC EXAM PROSTATE NEEDLE BIOPSY ANY METHOD,1366.0,956.2,,,0
CDM,97100060,HC PRO PATH CLINICAL CONSULT LIMITED 5-20 MINUTES,51.0,35.7,,,0
CDM,97100061,HC PRO PATH CLINICAL CONSULT MODERATELY COMPLEX 21-40 MINUTES,109.0,76.3,,,0
CDM,97100062,HC PRO PATH CLINICAL CONSULT HIGHLY COMPLEX 41-60 MINUTES,205.0,143.5,,,0
CDM,97100063,HC PRO PATH CLINICAL CONSULT PROLONGED SERVICE EA ADDTL 30 MINUTES,98.0,68.6,,,0
CDM,97100064,HC PRO DPYD GENE ANALYSIS COMMON VARIANTS,156.0,109.2,,,0
CDM,97100065,HC PRO CYTOGEN CONSTITUT CHROMOSMAL ABNORM GENOMIC REGIONS COPY NUMBER VARIANTS CGH,1390.0,973.0,,,0
CDM,97100066,HC PRO CNS DNA/RNA AMP PROBE MULTIPLE SUBTYPES 12-25,485.0,339.5,,,0
CDM,97100067,HC PRO GENETIC TEST SEVERE INHERITED CONDITIONS GENOMIC SEQ ALYS PANEL MUST INCL SEQ AT LEAST 15 GENES,2174.0,1521.8,,,0
CDM,97100068,HC PRO MORPHOMETRIC ALYS ISH QUANT/SEM-QUANT COMPUTER ASSISTED TECH EA MULTI PROBE STAIN PROCEDURE,313.0,219.1,,,0
CDM,97100069,HC PRO UNLISTED MOLECULAR PATHOLOGY PROCEDURE,232.0,162.4,,,0
CDM,97100070,HC PRO MOLECULAR PATHOLOGY PROCEDURE LEVEL 5,477.0,333.9,,,0
CDM,97100071,HC PRO MOLECULAR PATHOLOGY PROCEDURE LEVEL 6,867.0,606.9,,,0
CDM,97100072,HC PRO MOLECULAR PATHOLOGY PROCEDURE LEVEL 7,1201.0,840.7,,,0
CDM,97100073,HC PRO MOLECULAR PATHOLOGY PROCEDURE LEVEL 9,3941.0,2758.7,,,0
CDM,97100075,HC PRO MICROBE SUSCEPT MACROBROTH,8.0,5.6,,,0
CDM,97100076,HC PRO SCRN CYTO CERVICAL/VAGINAL AUTO THIN LAYER PREP REQUIRE INTERP,51.0,35.7,,,0
CDM,97100077,HC PRO HEREDITARY BRST CANCER-RELATED GEN SEQ ANALYSIS PANEL 5 OR MORE GENES INTERROGATION FOR SEQUENCE VARIANTS & COPY NUMBER VARIANTS,603.0,422.1,,,0
CDM,97100079,HC PRO HLA CLASS II TYPING HIGH RESOLUTION ON LOCUS EA,144.0,100.8,,,0
CDM,97100080,HC PRO BRCA1 BRCA2 GENE ANALYSIS FULL SEQ FULL DUPLICATION/DELETION ANALYSIS,2121.0,1484.7,,,0
CDM,97100081,HC PRO PDGFRA GENE ANALYSIS TARGETED SEQ ANALYSIS,293.0,205.1,,,0
CDM,97100082,HC PRO NOONAN SPECTRUM DISORDERS GENOMIC SEQ ANALYSIS PANEL INCL SEQ 12 GENES BRAF/CBL/HRAS/KRAS/MAP2K1/MAP2K2/NRAS/PTPN11/RAF1/RIT1/SHOC2/SOS1,1903.0,1332.1,,,0
CDM,97100083,HC PRO AORTIC DYSFUNCTION/DILATION GENOMIC SEQ ANALYSIS PANEL INC SEQ 9 GENES FBN1/TGFBR1/TGFBR2/COL3A1/MYH11/ACTA2/SLC2A10/SMAD3/MYLK,448.0,313.6,,,0
CDM,97100084,HC PRO ONCOLOGY (TUMOR UNKNOWN ORIGIN) MRNA GENE EXPRESS PROFIL REAL-TIME RT-PCR 92 GENES CLASSIFY MAIN CANCER TYPE/SUBTYPE USE FORMALIN-FIXED PARRIFIN-EMBEDDED TISSUE,3329.0,2330.3,,,0
CDM,97100086,HC PRO SOLID ORGAN/HEMATOLYMPHOID NEOPLASM/DISORDER 51 OR GREATER GENES GENOMIC SEQ ANALYSIS PANEL DNA ANALYSIS/COMBINED DNA & RNA ANALYSIS,2592.0,1814.4,,,0
CDM,97100087,HC PRO PROTEIN ANALYSIS W/ PROBE,57.0,39.9,,,0
CDM,97100088,HC PRO CYTPTH CERV/VAG FLUID THIN AUTO,51.0,35.7,,,0
CDM,97100089,HC PRO PALB2 GENE ANALYSIS FULL GENE SEQUENCE,1394.0,975.8,,,0
CDM,97100090,HC PRO PTEN GENE ANALYSIS FULL SEQUENCE ANALYSIS,1484.0,1038.8,,,0
CDM,97100091,HC PRO PTEN GENE ANALYSIS DUPLICATION/DELETION VARIANT,618.0,432.6,,,0
CDM,97100092,HC PRO PMP22 GENE ANALYSIS FULL SEQUENCE ANALYSIS,1586.0,1110.2,,,0
CDM,97100093,HC PRO MICRODISSECTION LASER CAPTURE,277.0,193.9,,,0
CDM,97100094,HC PRO ONCOLOGY BREAST MRNA GENE EXPRESSION PROFILING REAL-TIME RT-PCR OF 11 GENE FORMALIN-FIXED PARAFFIN-EMBEDDED TISSUE,9575.0,6702.5,,,0
CDM,97100095,HC PRO CFTR GENE DUP/DELET VARIANTS,843.0,590.1,,,0
CDM,97100096,HC PRO CFTR GENE FULL SEQUENCE,2975.0,2082.5,,,0
CDM,97100097,HC PRO TP53 GENE ANALYSIS TARGETED SEQUENCE ANALYSIS,293.0,205.1,,,0
CDM,97100098,HC PRO BRAF GENE ANALYSIS V600 VARIANT(S),434.0,303.8,,,0
CDM,97100099,HC PRO KRAS GENE ANALYSIS VARIANTS IN EXON 2,478.0,334.6,,,0
CDM,97100100,HC PRO KRAS GENE ANALYSIS VARIANT(S) ADDITIONAL VARIANT(S),172.0,120.4,,,0
CDM,97100101,HC PRO NRAS GENE ANALYSIS VARIANTS IN EXON 2 AND EXON 3,263.0,184.1,,,0
CDM,97100102,HC PRO ATXN1 GENE ANALYSIS EVAL TO DETECT ABNORMAL ALLELES,122.0,85.4,,,0
CDM,97100103,HC PRO ATXN2 GENE ANALYSIS EVAL TO DETECT ABNORMAL ALLELES,122.0,85.4,,,0
CDM,97100104,HC PRO CACNA1A GENE ANALYSIS EVAL TO DETECT ABNORMAL ALLELES,122.0,85.4,,,0
CDM,97100105,HC PRO ATXN7 GENE ANALYSIS EVAL TO DETECT ABNORMAL ALLELES,122.0,85.4,,,0
CDM,97100106,HC PRO MSH2 GENE ANALYSIS FULL SEQUENCE ANALYSIS,944.0,660.8,,,0
CDM,97100107,HC PRO MSH2 GENE ANALYSIS DUPLICATION/DELETION VARIANTS,528.0,369.6,,,0
CDM,97100108,HC PRO MSH6 GENE ANALYSIS FULL SEQUENCE ANALYSIS,1587.0,1110.9,,,0
CDM,97100109,HC PRO MSH6 GENE ANALYSIS DUPLICATION/DELETION VARIANTS,589.0,412.3,,,0
CDM,97100110,HC PRO SOLID ORGAN NEOPLASM GENOMIC SEQ ANALYSIS PANEL 5-50 GENES DNA ANALYSIS/COMBINED DNA & RNA ANALYSIS,531.0,371.7,,,0
CDM,97100111,HC PRO EGFR GENE COM VARIANTS,803.0,562.1,,,0
CDM,97100112,HC PRO MOPATH PROCEDURE LEVEL 4,695.0,486.5,,,0
CDM,97100113,HC PRO HEMATOLYMPHOID NEOPLASM/DISORDER GENOMIC SEQ ANALYSIS PANEL 5-50 GENES DNA ANALYSIS/COMBINED DNA & RNA ANALYSIS,675.0,472.5,,,0
CDM,97100114,HC PRO HC TPMT GENE ANALYSIS COMMON VARIANTS,156.0,109.2,,,0
CDM,97100115,HC PRO DMD DELETION ANALYSIS AND DUPLICATION ANALYSIS,248.0,173.6,,,0
CDM,97100116,HC PRO ATXN3 GENE ANALYSIS EVAL DETECT ABNORMAL ALLELES,122.0,85.4,,,0
CDM,97100117,HC PRO ABL1 GENE ANALYSIS VARIANTS IN KINASE DOMAIN,618.0,432.6,,,0
CDM,97100118,HC PRO HBB FULL GENE SEQUENCE,669.0,468.3,,,0
CDM,97138220,HC PRO DIAGNOSTIC BONE MARROW ASPIRATION(S),126.0,88.2,,,0
CDM,97181407,HC PRO MOPATH PROCEDURE LEVEL 8,3370.0,2359.0,,,0
CDM,97185060,HC PRO BLOOD SMEAR INTERP,77.0,53.9,,,0
CDM,97185097,HC PRO BONE MARROW SMEAR INTERP,283.0,198.1,,,0
CDM,97186335,HC PRO IMMNFIX ELECT OTR FLUID PATH INTERP,25.0,17.5,,,0
CDM,97188108,HC PRO CYTOPATH CONCENTRATE TECH,170.0,119.0,,,0
CDM,97188112,HC PRO CYTOPATH CELL ENHANCE TECH,233.0,163.1,,,0
CDM,97188120,HC PRO CYTP URNE 3-5 PROBES EA SPEC,721.0,504.7,,,0
CDM,97188141,HC PRO CYTOPATH C/V INTERPRET,40.0,28.0,,,0
CDM,97188172,HC PRO CYTP DX EVAL FNA 1ST EA SITE,84.0,58.8,,,0
CDM,97188173,HC PRO CYTOPATH EVAL FNA REPORT,175.0,122.5,,,0
CDM,97188185,HC PRO FLOWCYTOMETRY/TC ADD-ON,59.0,41.3,,,0
CDM,97188187,HC PRO FLOWCYTOMETRY/READ 2-8,89.0,62.3,,,0
CDM,97188189,HC PRO FLOWCYTOMETRY/READ 16 & >,140.0,98.0,,,0
CDM,97188271,HC PRO CYTOGENETICS DNA PROBE,53.0,37.1,,,0
CDM,97188291,HC PRO CYTO/MOLECULAR REPORT,146.0,102.2,,,0
CDM,97188300,HC PRO SURGICAL PATH GROSS,57.0,39.9,,,0
CDM,97188302,HC PRO SURG PATH GROSS AND MICROSCOP II,106.0,74.2,,,0
CDM,97188304,HC PRO TISSUE EXAM BY PATHOLOGIST,139.0,97.3,,,0
CDM,97188305,HC PRO TISSUE EXAM BY PATHOLOGIST,182.0,127.4,,,0
CDM,97188307,HC PRO SURG PATH GROSS AND MICROSC V,423.0,296.1,,,0
CDM,97188309,HC PRO SURG PATH GROSS AND MICROSC VI,510.0,357.0,,,0
CDM,97188311,HC PRO DECALCIFY TISSUE,37.0,25.9,,,0
CDM,97188312,HC PRO SPECIAL STAINS GROUP 2,115.0,80.5,,,0
CDM,97188313,HC PRO SPECIAL STAINS GROUP 2,83.0,58.1,,,0
CDM,97188319,HC PRO ENZYME HISTOCHEMISTRY,105.0,73.5,,,0
CDM,97188321,HC PRO MICROSLIDE CONSULTATION,129.0,90.3,,,0
CDM,97188329,HC PRO PATH CONSULT INTROP,154.0,107.8,,,0
CDM,97188331,HC PRO PATH CONSULT INTRAOP 1 BLOC,233.0,163.1,,,0
CDM,97188332,HC PRO PATH CONSULT INTRAOP ADDL,160.0,112.0,,,0
CDM,97188333,HC PRO INTRAOP CYTO PATH CONSULT 1ST,131.0,91.7,,,0
CDM,97188334,HC PRO INTRAOP CYTO PATH CONSULT ADDL,67.0,46.9,,,0
CDM,97188341,HC PRO IMMHISTO/CYTO PER SPEC EA ADDL SINGLE ANTIBODY,80.0,56.0,,,0
CDM,97188342,HC PRO IMMUNOHISTOCHEMISTRY,128.0,89.6,,,0
CDM,97188344,HC PRO IMMHISTO/CYTO PER SPEC EA MULTI ANTIBODY STAIN,138.0,96.6,,,0
CDM,97188346,HC PRO IMMUNOFLUORESCENCE PER SPECIMEN INITIAL SINGLE ANTIBODY STAIN PROCEDURE,117.0,81.9,,,0
CDM,97188360,HC PRO TUMOR IMMUNOHISTOCHEM/MAN,170.0,119.0,,,0
CDM,97188364,HC PRO INSITU HYBRIDIZATION (FISH) PER SPEC EA ADDTL SINGLE STAIN,114.0,79.8,,,0
CDM,97188365,HC PRO INSITU HYBRIDIZATION (FISH),197.0,137.9,,,0
CDM,97188366,HC PRO INSITU HYBRIDIZATION PER SPECIMEN EACH MULTIPLEX PROBE STAIN,177.0,123.9,,,0
CDM,97188368,HC PRO FISH ALK,125.0,87.5,,,0
CDM,97188369,HC PRO MORPHOMETRIC ANALYSIS IN SITU HYBRIDIZATION MANUAL PER SPECIMEN EACH ADDITIONAL SINGLE PROBE STAIN,171.0,119.7,,,0
CDM,97188377,"HC PRO MORPHOMETRIC ANALYSIS, IN SITU HYBRIDIZATION, MANUAL, PER SPECIMEN",81.0,56.7,,,0
CDM,971G0452,HC PRO MOLECULAR PATHOLOGY INTERP,42.0,29.4,,,0
CDM,971G8723,HC PRO SPEC SIT NOT PRIM TUMOR,0.01,0.007,,,0
CDM,97200002,HC PRO US GUIDE VASCULAR ACCESS,38.0,26.6,,,0
CDM,97200004,HC PRO US EVAL ABDOMINAL AORTA REAL TIME W/IMAGE DOC SCREENING ABDOMINAL AORTIC ANEURYSM (AAA),201.0,140.7,,,0
CDM,97200009,HC PRO CARDIAC MRI FOR MORPH W/O DYE,893.0,625.1,,,0
CDM,97200010,HC PRO CARD MRI VELOC FLOW MAPPING,182.0,127.4,,,0
CDM,97200011,HC PRO CARDIAC MRI FOR MORPH W/DYE,1261.0,882.7,,,0
CDM,97200012,HC PRO CARDIAC MRI W/W/O CONTRAST W/STRESS,1313.0,919.1,,,0
CDM,97200013,HC PRO CT ANGIO HEART W/3D IMAGE,796.0,557.2,,,0
CDM,97200014,HC PRO CT HEART W/3D IMAGE,591.0,413.7,,,0
CDM,97200015,HC PRO CT HEART  W/CONTRAST EVAL CHD INCL 3D IMAGE LV RV EVAL VASCULAR STRUCTURES,775.0,542.5,,,0
CDM,97200016,HC PRO CT HEART W/O CONTRAST W/ QUAL EVAL CORONARY CALCIUM,226.0,158.2,,,0
CDM,97200017,HC PRO CARDIAC MRI W/O CONTRAST W/STRESS IMAGING,1007.0,704.9,,,0
CDM,97200018,HC PRO MAGNETIC RESONANCE ALYS TISSUE COMPOSITION W/MRI SINGLE ORGAN,35.0,24.5,,,0
CDM,97200021,HC PRO NONINVASIVE EST CORONARY FFR DERIVED SOFTWARE ANALYSIS DATA SET FROM CTA W/INTERP /REPORT BY PHY/QHP,1907.0,1334.9,,,0
CDM,97200022,HC PRO MRA ABD W/WO DYE,1270.0,889.0,,,0
CDM,97200023,HC PRO MRA CHEST W/WO DYE,1271.0,889.7,,,0
CDM,97200024,HC PRO 3D RENDER W/O POSTPROCESS,201.0,140.7,,,0
CDM,97300001,HC PRO LARYNGOSCOPY FLEXIBLE DIAGNOSTIC,186.0,130.2,,,0
CDM,97300002,HC PRO DIAGNOSTIC BONE MARROW BIOPSY(IES),403.0,282.1,,,0
CDM,97300004,HC PRO PLACE INTERST DEVICE(S) RAD THER GUIDE SING/MULT,199.0,139.3,,,0
CDM,97300005,HC PRO INSRT UTERINE TANDEM/VAG OVOIDS BRACHYTHERAPY,1414.0,989.8,,,0
CDM,97300008,HC PRO US GUIDE INTERSTITIAL RADIOELEMENT APPLICATION,234.0,163.8,,,0
CDM,97300009,HC PRO CT GUIDE STEREOTACTIC LOCALIZATION,244.0,170.8,,,0
CDM,97300010,HC PRO 3D CT GUIDE FOR PLACEMENT OF RADIATION THERAPY FIELDS,296.0,207.2,,,0
CDM,97300011,HC PRO THERAPEUTIC RAD TX PLANNING SIMPLE,678.0,474.6,,,0
CDM,97300012,HC PRO THERAPEUTIC RAD TX PLANNING INTERMEDIATE,905.0,633.5,,,0
CDM,97300013,HC PRO THERAPEUTIC RAD TX PLANNING COMPLEX,1357.0,949.9,,,0
CDM,97300014,HC PRO THERAPEUTIC RAD SIM-AIDED FIELD SETTING SIMPLE,277.0,193.9,,,0
CDM,97300015,HC PRO THERAPEUTIC RAD SIM-AIDED FIELD SETTING INTERMED,431.0,301.7,,,0
CDM,97300016,HC PRO THERAPEUTIC RAD SIM-AIDED FIELD SETTING COMPLEX,633.0,443.1,,,0
CDM,97300017,HC PRO THERAPEUTIC RAD SIM-AIDED FIELD SETTING 3D,1185.0,829.5,,,0
CDM,97300018,HC PRO RAD DOSIMETRY CALCULATION,158.0,110.6,,,0
CDM,97300019,HC PRO IMRT PLAN,2266.0,1586.2,,,0
CDM,97300023,HC PRO SPECIAL TELETHERAPY PORT PLAN,250.0,175.0,,,0
CDM,97300027,HC PRO SPECIAL DOSIMETRY,201.0,140.7,,,0
CDM,97300028,HC PRO TX DEVICES SIMPLE,122.0,85.4,,,0
CDM,97300029,HC PRO TX DEVICES INTERMEDIATE,203.0,142.1,,,0
CDM,97300030,HC PRO TX DEVICES COMPLEX,314.0,219.8,,,0
CDM,97300031,HC PRO MULTI-LEAF COLLIMATOR DEVICE(S) FOR IMRT,930.0,651.0,,,0
CDM,97300033,HC PRO RADIATION TX MANAGEMENT 5 TX,1330.0,931.0,,,0
CDM,97300034,HC PRO RADIATION TX MANAGEMENT 1-2 FRACTIONS,699.0,489.3,,,0
CDM,97300035,HC PRO SPECIAL RAD TX,796.0,557.2,,,0
CDM,97300036,HC PRO INTRACAVITARY RAD SOURCE APPLICATION SIMPLE,934.0,653.8,,,0
CDM,97300037,HC PRO INTRACAVITARY RAD SOURCE APPLICATION INTERMEDIATE,1445.0,1011.5,,,0
CDM,97300038,HC PRO INTRACAVITARY RAD SOURCE APPLICATION COMPLEX,2105.0,1473.5,,,0
CDM,97300041,HC PRO INTERSTITIAL RAD SOURCE APPLICATION COMPLEX,3599.0,2519.3,,,0
CDM,97300044,HC PRO SURFACE APPLICATION RADIATION SOURCE,279.0,195.3,,,0
CDM,97300047,HC PRO SBRT MANAGEMENT NOT TO EXCEED 5 FRACTIONS,778.0,544.6,,,0
CDM,97300048,HC PRO RESPIRATORY MOTION MGMT SIMULATION,536.0,375.2,,,0
CDM,97300049,HC PRO GUIDE FOR LOCALIZATION OF TARGET VOLUME FOR RADIATION TREATMENT DELIVERY,101.0,70.7,,,0
CDM,97300050,HC PRO TELETHERAPY ISODOSE PLAN SIMPLE INCLUDES BASIC DOSIMETRY CALCULATION(S),161.0,112.7,,,0
CDM,97300051,HC PRO TELETHERAPY ISODOSE PLAN COMPLEX INCLUDES BASIC DOSIMETRY CALCULATION(S),352.0,246.4,,,0
CDM,97300052,HC PRO BRACHYTHERAPY ISODOSE PLAN SIMPLE INCLUDES BASIC DOSIMETRY CALCULATION(S),223.0,156.1,,,0
CDM,97300053,HC PRO BRACHYTHERAPY ISODOSE PLAN INTERMEDIATE INCLUDES BASIC DOSIMETRY CALCULATION(S),354.0,247.8,,,0
CDM,97300054,HC PRO BRACHYTHERAPY ISODOSE PLAN COMPLEX INCLUDES BASIC DOSIMETRY CALCULATION(S),346.0,242.2,,,0
CDM,97300060,HC PRO HC REMOTE AFTERLOADING HIGH DOSE RATE RADIONUCLIDE INTERSTITIAL/INTRACAVITARY BRACHYTHERAPY INCL BASIC DOSIMETRY 1 CHANNEL,464.0,324.8,,,0
CDM,97300061,HC PRO REMOTE AFTERLOADING HIGH DOSE RATE RADIONUCLIDE INTERSTITIAL/INTRACAVITARY BRACHYTHERAPY INCL BASIC DOSIMETRY 2-12 CHANNELS,579.0,405.3,,,0
CDM,97300062,HC PRO REMOTE AFTERLOADING HIGH DOSE RATE RADIONUCLIDE INTERSTITIAL/INTRACAVITARY BRACHYTHERAPY INCL BASIC DOSIMETRY OVER 12 CHANNELS,1822.0,1275.4,,,0
CDM,97300063,HC PRO 4D CT GUIDE FOR PLACEMENT OF RADIATION THERAPY FIELDS,296.0,207.2,,,0
CDM,97300064,HC PRO STEREOTACTIC RADIATION TX MGMT CRANIAL LESION(S) 1 SESSION,1000.0,700.0,,,0
CDM,97400001,HC PRO TUMOR IMAGING PLANAR SINGLE AREA SINGLE DAY IMAGING,1351.0,945.7,,,0
CDM,97400002,HC PRO TUMOR SPECT SINGLE AREA/ACQUISITION SINGLE DAY IMAGING,4664.0,3264.8,,,0
CDM,97400003,HC PRO CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS,522.0,365.4,,,0
CDM,98100001,HC PRO CRITICAL CARE 1ST 30-74 MIN,1479.0,1035.3,,,0
CDM,98100002,HC PRO CRITICAL CARE EA ADDL 30 MIN,556.0,389.2,,,0
CDM,98100003,HC PRO CONTROL OF NOSEBLEED,631.0,441.7,,,0
CDM,98100004,HC PRO CONTROL OF NOSEBLEED SIMPLE,469.0,328.3,,,0
CDM,98100005,HC PRO CONTROL OF NOSEBLEED,1182.0,827.4,,,0
CDM,98100007,HC PRO REM OF FOOT FB SUBQ,217.0,151.9,,,0
CDM,98100008,HC PRO REMOVE NASAL FB,385.0,269.5,,,0
CDM,98100009,HC PRO REM FB CORNEA W/SLIT LAMP,99.0,69.3,,,0
CDM,98100010,HC PRO REM FB CORNEA /WO SLIT LAMP,298.0,208.6,,,0
CDM,98100011,HC PRO REM FB EXTERNAL EAR CANAL,401.0,280.7,,,0
CDM,98100012,HC PRO I&D REM FB SUBQ SIMPLE,411.0,287.7,,,0
CDM,98100013,HC PRO  I&D REM FB SUBQ COMPLICAT,781.0,546.7,,,0
CDM,98100014,HC PRO I&D PILONIDAL CYST SIMPLE,455.0,318.5,,,0
CDM,98100015,HC PRO I&D PILONIDAL CYST COMPLEX,554.0,387.8,,,0
CDM,98100016,HC PRO DRAIN BLOOD FROM UNDER NAIL,106.0,74.2,,,0
CDM,98100021,HC PRO CL TX DIS PHALANG FX FNGR/THUMB W/ MANIP,383.0,268.1,,,0
CDM,98100027,HC PRO PUNCTURE ASPIRATION ABSCESS/HEMATOMA/BULLA/CYST,157.0,109.9,,,0
CDM,98100029,HC PRO DEBRIDE SUBQ TISSUE FIRST 20 SQ CM OR LESS,101.0,70.7,,,0
CDM,98100030,HC PRO DEBRIDE MUSC/FASCIA FIRST 20SQ CM OR LESS,1008.0,705.6,,,0
CDM,98100034,HC PRO RPR CMPLX FRHD 1.1 TO 2.5CM,675.0,472.5,,,0
CDM,98100035,HC PRO REPAIR COMPLEX FOREHEAD/CHEEKS/CHIN/MOUTH/NECK/AXILLAE/GENITALIA/HANDS/FEET 2.6-7.5 CM,1028.0,719.6,,,0
CDM,98100036,HC PRO RPR CMPLX F/C/C/M/N/AX/G/H/F EA AD 5CM OR LESS,373.0,261.1,,,0
CDM,98100038,HC PRO CHEMICAL CAUTERY TISSUE,143.0,100.1,,,0
CDM,98100039,HC PRO INCISION OF BREAST LESION/ABSC,716.0,501.2,,,0
CDM,98100041,HC PRO REMOVE FB SIMPLE,368.0,257.6,,,0
CDM,98100042,HC PRO REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP OR COMPLICATED,662.0,463.4,,,0
CDM,98100043,HC PRO INJ TENDON SHEATH/LIGAMENT,91.0,63.7,,,0
CDM,98100045,HC PRO INJ SING/MULT TRIGGER POINT(S) 1 OR 2 MUSC,121.0,84.7,,,0
CDM,98100046,HC PRO SING/MULT TRIGGER POINT(S) 3 OR MORE MUSC,131.0,91.7,,,0
CDM,98100052,HC PRO CLOSED TX PROX HUMERUS FX W/O MANIPULATION,716.0,501.2,,,0
CDM,98100053,HC PRO CLOSED TX SHOULDER DISL W/ MANIP W/ ANESTH,486.0,340.2,,,0
CDM,98100055,HC PRO CLOSED TX ELBOW DISL REQ ANESTHESIA,769.0,538.3,,,0
CDM,98100057,HC PRO DRAIN FINGER ABSCESS COMPLICATED,472.0,330.4,,,0
CDM,98100058,HC PRO CLOSED TX KNUCKLE DISL SINGLE W/ MANIP W/O ANESTH,752.0,526.4,,,0
CDM,98100059,HC PRO CLOSED TX PHALANGEAL SHAFT FX PROXIMAL/MIDDLE PHALANX FINGER/THUMB W/O MANIPULATION EACH,452.0,316.4,,,0
CDM,98100060,HC PRO CLOSED TX HIP SOCKET FX W/ MANIP,2418.0,1692.6,,,0
CDM,98100061,HC PRO CLOSED TX FEMORAL FX W/O MANIPULATION,1098.0,768.6,,,0
CDM,98100062,HC PRO CLOSED TX PATELLAR FX W/O MANIPULATION,683.0,478.1,,,0
CDM,98100063,HC PRO CLOSED TX TIBIAL FX PROXIMAL W/O MANIP,486.0,340.2,,,0
CDM,98100064,HC PRO CLOSED TX TIBIAL SHAFT FX W/WO FIBULAR FX W/MANIPULATION W/W/O SKELETAL TRACTION,926.0,648.2,,,0
CDM,98100068,HC PRO CLOSED TX TALUS FX W/O MANIPULATION,441.0,308.7,,,0
CDM,98100069,HC PRO TX TARSAL BONE FX W/O MANIP EACH,414.0,289.8,,,0
CDM,98100070,HC PRO CLOSED TX METATARSAL FX W/O MANIP EACH,472.0,330.4,,,0
CDM,98100071,HC PRO CLOSED TX GREAT TOE FX W/O MANIPULATION,275.0,192.5,,,0
CDM,98100072,HC PRO CLOSED TX GREAT TOE FX W/ MANIPULATION,271.0,189.7,,,0
CDM,98100073,HC PRO CLOSED TX OTH THAN GREAT TOE FX W/O MANIP EACH,271.0,189.7,,,0
CDM,98100077,HC PRO STRAPPING THORAX,92.0,64.4,,,0
CDM,98100083,HC PRO STRAPPING TOES,140.0,98.0,,,0
CDM,98100089,HC PRO LARYNOGOSCOP,252.0,176.4,,,0
CDM,98100091,HC PRO TRACH EMERG CRICOTHYROID,537.0,375.9,,,0
CDM,98100094,HC PRO NON-ROUTINE BLD DRAW>3 YRS,72.0,50.4,,,0
CDM,98100098,HC PRO DRAIN THROAT ABSCSS INTRAORAL,885.0,619.5,,,0
CDM,98100100,HC PRO INTUBATE GASTRIC WITH ASP,394.0,275.8,,,0
CDM,98100101,HC PRO INC ISCHRCTL/PERIRECTAL ABSCES,642.0,449.4,,,0
CDM,98100102,HC PRO INCISION OF ANAL ABSCESS,112.0,78.4,,,0
CDM,98100103,HC PRO INCISE EXTERNAL HEMORRHOID,316.0,221.2,,,0
CDM,98100105,HC PRO REMOVAL OF HEMORRHOID CLOT,226.0,158.2,,,0
CDM,98100106,HC PRO ANOSCOPY DIAGNOSTIC,107.0,74.9,,,0
CDM,98100107,HC PRO ANOSCOPY REMOVE FOR BODY,664.0,464.8,,,0
CDM,98100111,HC PRO PENILE INJECTION,113.0,79.1,,,0
CDM,98100112,HC PRO INCISION & DRAINAGE EPIDIDYMIS/TESTIS/SCROTAL SPACE,258.0,180.6,,,0
CDM,98100117,HC PRO N BLOCK INJ INTERCOST MLT,181.0,126.7,,,0
CDM,98100118,HC PRO REMOVAL OF FOREGIN BODY EYE,276.0,193.2,,,0
CDM,98100119,HC PRO REMOVE FB EYE,364.0,254.8,,,0
CDM,98100120,HC PRO DRAINAGE OF EYELID ABSCESS,338.0,236.6,,,0
CDM,98100123,HC PRO CANALITH REPOSITIONING PROC,125.0,87.5,,,0
CDM,98100124,HC PRO DEBRIDEMENT OPEN WOUND FIRST 20 SQ CM OR LESS,92.0,64.4,,,0
CDM,98100125,HC PRO RMVL DEVITAL TISSUE ADDL 20 SQ CM,116.0,81.2,,,0
CDM,98100132,HC PRO EMERGENCY DEPT VISIT LEVEL 1,178.0,124.6,,,0
CDM,98100133,HC PRO EMERGENCY DEPT VISIT LEVEL 2,232.0,162.4,,,0
CDM,98100134,HC PRO EMERGENCY DEPT VISIT LEVEL 3,363.0,254.1,,,0
CDM,98100135,HC PRO EMERGENCY DEPT VISIT LEVEL 4,610.0,427.0,,,0
CDM,98100136,HC PRO EMERGENCY DEPT VISIT LEVEL 5,1036.0,725.2,,,0
CDM,98100137,HC PRO SMOKING CESSATION < 10 MIN,28.0,19.6,,,0
CDM,98100139,HC PRO PQRS O2 SATURATION DOC REV,0.01,0.007,,,0
CDM,98100140,HC PRO PQRS 12 LEAD ECG PERFORMED (EM),0.01,0.007,,,0
CDM,98100141,HC PRO WOUND CLOSU,108.0,75.6,,,0
CDM,98100147,HC PRO PQRS VITAL SIGNS RECORDED,0.01,0.007,,,0
CDM,98100153,HC PRO MED REASON FOR NO GRADE REPORT,0.01,0.007,,,0
CDM,98100154,HC PRO PQRS ASPIRIN RECEIVED WITHIN 24 HOURS,0.01,0.007,,,0
CDM,98100155,HC PRO PQRS EMPIRIC ANTIBIOTIC RX,0.01,0.007,,,0
CDM,98100156,HC PRO PQRS TRANSABD/TRANSVAG ULTRASOUND,0.01,0.007,,,0
CDM,98100157,HC PRO PQRS TRANSABD/TRANSVAG US NOT PERF DOC REASONS,0.01,0.007,,,0
CDM,98100158,HC PRO PQRS TRANSABD/TRANSVAG US NOT PERF REAS NOT GIVEN,0.01,0.007,,,0
CDM,98100163,HC PRO-TREAT ELBOW FRACTURE,900.0,630.0,,,0
CDM,98100164,HC PRO CLOSED TX KNEE DISLOC W/O ANESTH,608.0,425.6,,,0
CDM,98100165,HC PRO DRAIN EXTERNAL EAR ABSCESS/HEMATOMA COMPLICATED,355.0,248.5,,,0
CDM,98100166,HC PRO REPAIR LIP HALF VERTICAL,608.0,425.6,,,0
CDM,98100167,HC PRO DEBRID BONE 1ST 20 SQ CM,390.0,273.0,,,0
CDM,98100168,HC PRO DRAIN THIGH/KNEE LESION,801.0,560.7,,,0
CDM,98100169,HC PRO TX CLOSED TX ANKLE DISLOCATION W/ANESTHESIA W/ OR W/O PERCUT SKELETAL FIXATION,604.0,422.8,,,0
CDM,98100170,HC PRO REPAIR LIP VERMILION ONLY,548.0,383.6,,,0
CDM,98100171,HC PRO DRAINAGE OF SCROTUM ABSCESS,262.0,183.4,,,0
CDM,98100172,HC PRO FORESKIN MANIPULATION INCL LYSIS PREPUTIAL ADHESIONS AND STRETCHING,86.0,60.2,,,0
CDM,98100173,HC PRO TREAT WRIST DISLOCATION,589.0,412.3,,,0
CDM,98100174,HC PRO CLOSURE OF SPLIT WOUND,341.0,238.7,,,0
CDM,98100176,HC PRO EXC TR-EXT BEN MARG 0.5<CM,145.0,101.5,,,0
CDM,98100179,HC PRO DRAIN ABSC/CYST/HEMA MOUTH SIMPLE,257.0,179.9,,,0
CDM,98100180,HC PRO CLSD TX CARPOMETACARP DISL W/ MANIP EA JOINT W/O ANESTH,379.0,265.3,,,0
CDM,98100182,HC PRO DRAINAGE OF ARM BURSA,430.0,301.0,,,0
CDM,98100184,HC PRO CLSD TX FX DISTAL TIBIA W/ OR W/O ANESTH W/ TRACTION OR MANIP,625.0,437.5,,,0
CDM,98100185,HC PRO DX LARYNGOSCOPY EXCL NB,203.0,142.1,,,0
CDM,98100186,HC PRO HC CRPRA CVRNSA SAPHNS VEIN SHUNT UNI/BIL,876.0,613.2,,,0
CDM,98100188,HC PRO TREAT CLAVICLE FRACTURE W/MANIP,408.0,285.6,,,0
CDM,98100189,HC PRO DRAINAGE OF MOUTH LESION,579.0,405.3,,,0
CDM,98100190,HC PRO TREAT HIP DISLOCATION REQ ANES,947.0,662.9,,,0
CDM,98100195,HC PRO CANTHOTOMY,132.0,92.4,,,0
CDM,98100196,HC PRO CLOSED TX INTERPHALANGEAL JOINT DISLOC SINGLE W/ MANIP REQ ANESTH,427.0,298.9,,,0
CDM,98100197,HC PRO ANESTH FOR PROCEDURES ON INTEGUMENTARY SYST ON EXTREMITIES/ANTERIOR TRUNK/PERINEUM ELECTRICAL CONVERSION OF ARRHYTHMIAS,128.0,89.6,,,0
CDM,98100198,HC PRO ARTHROCENTESIS ASPIRATION/INJECTION MAJOR JOINT/BURSA W/ ULTRASOUND GUIDANCE,93.0,65.1,,,0
CDM,98100199,HC PRO MOD SEDATION SAME PHYS/QHP INITIAL 15 MIN PATIENT YOUNGER THAN 5 YEARS OF AGE,145.0,101.5,,,0
CDM,98100200,HC PRO MOD SEDATION SAME PHYS/QHP INITIAL 15 MIN PATIENT AGE 5 YEARS OR OLDER,145.0,101.5,,,0
CDM,98100202,HC PRO MOD SEDATION OTHER PHYS/QHP INITIAL 15 MIN INTRASERVICE TIME PATIENT YOUNGER THAN 5 YEARS OF AGE,76.0,53.2,,,0
CDM,98100203,HC PRO MOD SEDATION OTHER PHYS/QHP INITIAL 15 MIN INTRASERVICE TIME PATIENT AGE 5 YEARS OR OLDER,112.0,78.4,,,0
CDM,98100204,HC PRO MOD SEDATION OTHER PHYS/QHP EACH ADDTL 15 MIN INTRASERVICE TIME (LIST SEP IN ADDT TO CODE FOR PRIMARY SERVICE),71.0,49.7,,,0
CDM,98100205,HC PRO CLOSED TREATMENT OF RADIOCARPAL/INTERCARPAL DISLOCATION 1 OR MORE BONES W/ MANIPULATION,507.0,354.9,,,0
CDM,98100206,HC PRO OSTEOPATHIC MANIPULATIVE TREATMENT (OMT) 1-2 BODY REGIONS INVOLVED,28.0,19.6,,,0
CDM,98100207,HC PRO REDUCTION OF PROCIDENTIA UNDER ANESTHESIA,524.0,366.8,,,0
CDM,98100208,HC PRO ANESTHESIA FOR PROCEDURES ON NOSE AND ACCESSORY SINUSES NOT OTHERWISE SPECIFIED,302.0,211.4,,,0
CDM,98100209,HC PRO REMOVAL FOREIGN BODY INTRANASAL REQUIRING GENERAL ANESTHESIA,468.0,327.6,,,0
CDM,98100221,HC PRO CLOSED TX OF TARSAL BONE DISLOCATION OTHER THAN TALOTARSAL W/O ANESTH,418.0,292.6,,,0
CDM,98100223,HC PRO ARTERIAL PUNCTURE WITHDRAWAL OF BLOOD FOR DIAGNOSIS,26.0,18.2,,,0
CDM,98100227,HC PRO REPLACE OF GASTRO TUBE PERCUTANEOUS INCL REMOVE W/O IMAGE OR ENDO GUIDE NOT REQ REV OF GASTRO,59.0,41.3,,,0
CDM,98100228,HC PRO REPLACE OF GASTRO TUBE PERCUTANEOUS INCL REMOVE W/O IMAGE OR ENDO GUIDE REQ REV OF GASTRO,146.0,102.2,,,0
CDM,98100233,HC PRO INITIATION OF MED FOR TX OPIOID USE DISORDER IN THE ER,148.0,103.6,,,0
CDM,98100234,HC PRO OPEN TX TRIMALLEOLAR ANKLE FX INCL INT FIXATION MEDIAL/ LATERAL MALLEOLUS W/O FIXATION POST LIP,2022.0,1415.4,,,0
CDM,98100235,HC PRO TX OF MISSED ABORTION COMPLETED SURGICALLY FIRST TRIMESTER,895.0,626.5,,,0
CDM,98100236,HC PRO INDUCED ABORTION 1 OR MORE VAGINAL SUPPOSITORIES W/WO CERVICAL DILATION INCL DELIVERY FETUS/SECUNDINES,1000.0,700.0,,,0
CDM,98100237,HC PRO INDUCED ABORTION 1 OR MORE VAGINAL SUPPOSITORIES W/WO CERVICAL DILATION & CURETTAGE/EVACUATION,1173.0,821.1,,,0
CDM,98100238,HC PRO INDUCED ABORTION 1 OR MORE VAGINAL SUPPOSITORIES W/WO CERVICAL DILATION INCL DELIVERY FETUS/SECUNDINES W/HYSTEROTOMY,1370.0,959.0,,,0
CDM,98100239,HC PRO COLPORRHAPHY SUTURE OF INJURY OF VAGINA NON-OBSTETRICAL,757.0,529.9,,,0
CDM,98100240,HC PRO INJ AA(S) / STEROID INTERCOSTAL NERVE SINGLE LEVEL,139.0,97.3,,,0
CDM,98100241,HC PRO PELVIC EXAMINATION,48.0,33.6,,,0
CDM,98100242,HC PRO CLOSED TX RADIAL HEAD NECK FX W/O MANIPULATION,559.0,391.3,,,0
CDM,98100243,HC PRO HYMENOTOMY SIMPLE INCISION,116.0,81.2,,,0
CDM,98100244,HC PRO CLOSED TX TARSAL BONE DISLOCATION OTHER THAN TALOTARSAL REQUIRING ANESTHESIA,621.0,434.7,,,0
CDM,98100245,HC PRO DRAINAGE ABSCESS/CYST/HEMATOMA/VESTIBULE OF MOUTH COMPLICATED,503.0,352.1,,,0
CDM,98500001,HC PRO EXTERNAL PATIENT WHEN PERFORMED AUTO ACTIVATED ECG RHYTHM EVENT RECORDING REMOTE DOWNLOAD 30 DAYS 24 HR MONITORING TRANSMISSION/ANALYSIS,414.0,289.8,,,0
CDM,98500002,HC PRO TRNSTH ECHO CONGENITAL CAR ANOM INTERP/REPORT ONLY,459.0,321.3,,,0
CDM,99900001,HC APHERESIS SET-UP CBT-STUDY,899.0,629.3,,,0
CDM,99900002,HC LEUKOPHERESIS CBT STUDY,1723.0,1206.1,,,0
HCPCS,0001A,Adm sarscov2 30mcg/0.3ml 1st,,,125.81,156.95,4
HCPCS,0001U,Rbc dna hea 35 ag 11 bld grp,,,648.0,1260.0,7
HCPCS,0002A,Adm sarscov2 30mcg/0.3ml 2nd,,,125.81,156.95,4
HCPCS,0002M,Liver dis 10 assays w/ash,,,453.06,880.95,7
HCPCS,0002U,Onc clrct 3 ur metab alg plp,,,22.5,43.75,7
HCPCS,0003A,Fee covid-19 vac 1 booster,,,125.81,156.95,4
HCPCS,0003M,Liver dis 10 assays w/nash,,,453.06,880.95,7
HCPCS,0003U,Onc ovar 5 prtn ser alg scor,,,855.0,1662.5,7
HCPCS,0004A,Fee covid-19 vac 1 res,,,125.81,156.95,4
HCPCS,0004M,Scoliosis dna alys,,,71.1,138.25,7
HCPCS,0005U,Onco prst8 3 gene ur alg,,,684.0,1330.0,7
HCPCS,0006M,Onc hep gene risk classifier,,,135.0,262.5,7
HCPCS,0007M,Onc gastro 51 gene nomogram,,,337.5,656.25,7
HCPCS,0007U,Rx test prsmv ur w/def conf,,,102.99,200.25,7
HCPCS,0008U,Hpylori detcj abx rstnc dna,,,538.12,1046.34,7
HCPCS,0009U,Onc brst ca erbb2 amp/nonamp,,,96.3,187.25,7
HCPCS,0010U,Nfct ds strn typ whl gen seq,,,384.53,747.7,7
HCPCS,0011A,Adm sarscov2 100mcg/0.5ml1st,,,125.81,156.95,4
HCPCS,0011M,Onc prst8 ca mrna 12 gen alg,,,684.0,1330.0,7
HCPCS,0011U,Rx mntr lc-ms/ms oral fluid,,,102.99,200.25,7
HCPCS,0012A,Adm sarscov2 100mcg/0.5ml2nd,,,125.81,156.95,4
HCPCS,0012M,Onc mrna 5 gen rsk urthl ca,,,684.0,1330.0,7
HCPCS,0013A,Fee covid-19 vac 2 booster,,,125.81,156.95,4
HCPCS,0013M,Onc mrna 5 gen recr urthl ca,,,684.0,1330.0,7
HCPCS,0015M,Adrnl cortcl tum bchm asy 25,,,1174.83,2284.4,7
HCPCS,0016M,Onc bladder mrna 209 gen alg,,,3140.67,6106.85,7
HCPCS,0016U,Onc hmtlmf neo rna bcr/abl1,,,147.56,286.93,7
HCPCS,0017M,Onc dlbcl mrna 20 genes alg,,,2259.19,4392.87,7
HCPCS,0017U,Onc hmtlmf neo jak2 mut dna,,,82.49,160.4,7
HCPCS,0018M,Trnsplj rnl meas cd154+cll,,,576.66,1121.28,7
HCPCS,0018U,Onc thyr 10 microrna seq alg,,,2701.88,5253.66,7
HCPCS,0019M,Cv ds plasma alys prtn bmrk,,,641.16,1246.7,7
HCPCS,0019U,Onc rna tiss predict alg,,,3307.5,6431.25,7
HCPCS,0021U,Onc prst8 detcj 8 autoantb,,,684.0,1330.0,7
HCPCS,0022U,Trgt gen seq dna&rna 23 gene,,,1755.0,3412.5,7
HCPCS,0023U,Onc aml dna detcj/nondetcj,,,223.66,434.89,7
HCPCS,0024U,Glyca nuc mr spectrsc quan,,,30.77,59.83,7
HCPCS,0025U,Tenofovir liq chrom ur quan,,,102.99,200.25,7
HCPCS,0026U,Onc thyr dna&mrna 112 genes,,,3240.0,6300.0,7
HCPCS,0027U,Jak2 gene trgt seq alys,,,109.72,213.34,7
HCPCS,0029U,Rx metab advrs trgt seq alys,,,668.04,1298.97,7
HCPCS,0030U,Rx metab warf trgt seq alys,,,120.72,234.73,7
HCPCS,0031A,Fee covid-19 vac 4 dose 1,,,125.81,156.95,4
HCPCS,0031U,Cyp1a2 gene,,,157.33,305.92,7
HCPCS,0032U,Comt gene,,,157.33,305.92,7
HCPCS,0034A,Fee covid-19 vac 4 res,,,125.81,156.95,4
HCPCS,0034U,Tpmt nudt15 genes,,,419.55,815.8,7
HCPCS,0035U,HC NEUROLOGY CSF DECT PRION PROTEIN QUALITATIVE,1124.0,786.8,,,0
HCPCS,0035U,Neuro csf prion prtn qual,,,486.89,946.73,7
HCPCS,0036U,Xome tum & nml spec seq alys,,,4302.0,8365.0,7
HCPCS,0037U,Trgt gen seq dna 324 genes,,,3150.0,6125.0,7
HCPCS,0038U,Vitamin d srm microsamp quan,,,26.64,51.8,7
HCPCS,0039U,Dna antb 2strand hi avidity,,,12.37,24.04,7
HCPCS,0040U,Bcr/abl1 gene major bp quan,,,368.91,717.32,7
HCPCS,0041A,Fee covid-19 vac 5 dose 1,,,125.81,156.95,4
HCPCS,0041U,B brgdrferi antb 5 prtn igm,,,15.49,30.12,7
HCPCS,0042A,Fee covid-19 vac 5 dose 2,,,125.81,156.95,4
HCPCS,0042T,HC CEREBRAL PERFUSION ANALYSIS USING CT W/ CONTRAST ADMIN INCL POST-PROCESSING OF PARAMETRIC MAPS,2660.0,1862.0,,,0
HCPCS,0042U,B brgdrferi antb 12 prtn igg,,,15.49,30.12,7
HCPCS,0043U,Tbrf b grp antb 4 prtn igm,,,13.37,26.0,7
HCPCS,0044A,Fee covid-19 vac 5 res,,,125.81,156.95,4
HCPCS,0044U,Tbrf b grp antb 4 prtn igg,,,13.37,26.0,7
HCPCS,0045U,Onc brst dux carc is 12 gene,,,3485.7,6777.75,7
HCPCS,0046U,Flt3 gene itd variants quan,,,366.69,713.0,7
HCPCS,0047U,Onc prst8 mrna 17 gene alg,,,3485.7,6777.75,7
HCPCS,0048U,Onc sld org neo dna 468 gene,,,2627.64,5109.3,7
HCPCS,0049U,Npm1 gene analysis quan,,,366.69,713.0,7
HCPCS,0050U,Trgt gen seq dna 194 genes,,,2624.94,5104.05,7
HCPCS,0051A,Fee covid-19 vac 6 dose 1,,,125.81,156.95,4
HCPCS,0051U,Rx mntr lc-ms/ms ur 31 pnl,,,222.23,432.11,7
HCPCS,0052A,Fee covid-19 vac 6 dose 2,,,125.81,156.95,4
HCPCS,0052U,Lpoprtn bld w/5 maj classes,,,30.47,59.26,7
HCPCS,0053A,Fee covid-19 vac 6 booster,,,125.81,156.95,4
HCPCS,0054A,Fee covid-19 vac 6 res,,,125.81,156.95,4
HCPCS,0054U,Rx mntr 14+ drugs & sbsts,,,178.87,347.8,7
HCPCS,0055U,Card hrt trnspl 96 dna seq,,,2916.0,5670.0,7
HCPCS,0058U,Onc merkel cll carc srm quan,,,290.66,565.18,7
HCPCS,0059U,Onc merkel cll carc srm +/-,,,290.66,565.18,7
HCPCS,0060U,Twn zyg gen seq alys chrms2,,,683.14,1328.34,7
HCPCS,0061U,Tc meas 5 bmrk sfdi m-s alys,,,22.59,43.92,7
HCPCS,0062U,Ai sle igg&igm alys 80 bmrk,,,342.65,666.26,7
HCPCS,0063U,Neuro autism 32 amines alg,,,675.0,1312.5,7
HCPCS,0064A,Fee covid-19 vac 7 res,,,125.81,156.95,4
HCPCS,0064U,Antb tp total&rpr ia qual,,,28.2,54.83,7
HCPCS,0065U,Syfls tst nontreponemal antb,,,16.28,31.66,7
HCPCS,0067U,Onc brst imhchem prfl 4 bmrk,,,1707.3,3319.75,7
HCPCS,0068U,Candida species pnl amp prb,,,128.37,249.6,7
HCPCS,0069U,Onc clrct microrna mir-31-3p,,,342.0,665.0,7
HCPCS,0070U,Cyp2d6 gen com&slct rar vrnt,,,608.73,1183.65,7
HCPCS,0071A,Fee covid-19 vac 8 dose 1,,,125.81,156.95,4
HCPCS,0071T,Us leiomyomata ablate <200,,,3204.65,15397.94,11
HCPCS,0071U,Cyp2d6 full gene sequence,,,540.0,1139.1,11
HCPCS,0072A,Fee covid-19 vac 8 dose 2,,,125.81,156.95,4
HCPCS,0072T,Us leiomyomata ablate >200,,,3204.65,15397.94,11
HCPCS,0072U,Cyp2d6 gen cyp2d6-2d7 hybrid,,,405.82,1704.44,11
HCPCS,0073A,Fee covid-19 vac 8 booster,,,125.81,156.95,4
HCPCS,0073U,Cyp2d6 gen cyp2d7-2d6 hybrid,,,405.82,1704.44,11
HCPCS,0074A,Fee covid-19 vac 8 res,,,125.81,156.95,4
HCPCS,0074U,Cyp2d6 nonduplicated gene,,,405.82,1704.44,11
HCPCS,0075U,Cyp2d6 5' gene dup/mlt,,,405.82,1704.44,11
HCPCS,0076U,Cyp2d6 3' gene dup/mlt,,,405.82,1704.44,11
HCPCS,0077U,Ig paraprotein qual bld/ur,,,39.09,76.0,7
HCPCS,0080U,Onc lng 5 clin rsk factr alg,,,3168.0,13305.6,11
HCPCS,0081A,Fee covid-19 vac 9 dose 1,,,125.81,156.95,4
HCPCS,0082A,Fee covid-19 vac 9 dose 2,,,125.81,156.95,4
HCPCS,0082U,Rx test def 90+ rx/sbsts ur,,,222.23,933.36,11
HCPCS,0083A,Fee covid-19 vac 9 booster,,,125.81,156.95,4
HCPCS,0083U,Onc rspse chemo cntrst tomog,,,150.62,292.86,7
HCPCS,0084U,Rbc dna gnotyp 10 bld groups,,,648.0,2721.6,11
HCPCS,0086U,Nfct ds bact&fng org id 6+,,,180.0,350.0,7
HCPCS,0087U,Crd hrt trnspl mrna 1283 gen,,,2843.48,5528.98,7
HCPCS,0088U,Trnsplj kdn algrft rej 1494,,,2843.48,5528.98,7
HCPCS,0089U,Onc mlnma prame & linc00518,,,684.0,2872.8,11
HCPCS,0090U,Onc cutan mlnma mrna 23 gene,,,1755.0,7371.0,11
HCPCS,0091A,Fee covid-19 vac 10 dose 1,,,125.81,156.95,4
HCPCS,0092A,Fee covid-19 vac 10 dose 2,,,125.81,156.95,4
HCPCS,0092U,Onc lng 3 prtn bmrk plsm alg,,,2239.2,4354.0,7
HCPCS,0093A,Fee covid-19 vac 10 booster,,,125.81,156.95,4
HCPCS,0093U,Rx mntr 65 com drugs urine,,,55.93,234.89,11
HCPCS,0094A,Fee covid-19 vac 10 res,,,125.81,156.95,4
HCPCS,0094U,Genome rapid sequence alys,,,6823.98,13268.85,7
HCPCS,0095U,Inflm ee elisa alys alg,,,694.78,1350.96,7
HCPCS,0096U,Hpv hi risk types male urine,,,31.58,132.64,11
HCPCS,0100T,Prosth Retina Receive&Gen,,,7443.65,9286.14,4
HCPCS,0101T,Extracorp shockwv tx hi enrg,,,244.19,7285.12,11
HCPCS,0101U,Hered colon ca do 15 genes,,,1569.56,4421.84,11
HCPCS,0102T,Extracorp shockwv tx anesth,,,3239.17,14371.12,11
HCPCS,0102U,Hered brst ca rltd do 17 gen,,,1173.56,4225.96,11
HCPCS,0103U,Hered ova ca pnl 24 genes,,,1569.56,4225.96,11
HCPCS,0105U,Neph ckd mult eclia tum nec,,,855.0,3591.0,11
HCPCS,0106T,Touch Quant Sensory Test,,,16.91,164.05,11
HCPCS,0106U,Gstr emptg 7 timed brth spec,,,787.04,1530.36,7
HCPCS,0107T,Vibrate Quant Sensory Test,,,16.91,164.05,11
HCPCS,0107U,C diff tox ag detcj ia stool,,,14.4,60.48,11
HCPCS,0108T,Cool Quant Sensory Test,,,16.91,259.1,11
HCPCS,0108U,Gi barrett esoph 9 prtn bmrk,,,4455.0,8662.5,7
HCPCS,0109T,Heat Quant Sensory Test,,,16.91,164.05,11
HCPCS,0109U,Id aspergillus dna 4 species,,,128.37,539.14,11
HCPCS,0110T,Nos Quant Sensory Test,,,16.91,584.37,11
HCPCS,0110U,Rx mntr 1+oral onc rx&sbsts,,,24.4,102.48,11
HCPCS,0111A,Adm sarscov2 25mcg/0.25ml1st,,,121.2,151.2,4
HCPCS,0111U,Onc colon ca kras&nras alys,,,614.06,2579.06,11
HCPCS,0112A,Adm sarscov2 25mcg/0.25ml2nd,,,121.2,151.2,4
HCPCS,0112U,Iadi 16s&18s rrna genes,,,320.52,623.23,7
HCPCS,0113A,Adm sarscov2 25mcg/0.25ml3rd,,,121.2,151.2,4
HCPCS,0113U,Onc prst8 pca3&tmprss2-erg,,,684.0,2872.8,11
HCPCS,0114U,Gi barretts esoph vim&ccna1,,,1744.21,3391.52,7
HCPCS,0115U,HC RESPIRATORY  INFECT AGENT DETECT (DNA/RNA) TYPE & SUBTYPES 2 BACTERIAL TARGETS,802.0,561.4,,,0
HCPCS,0115U,Respir iadna 18 viral&2 bact,,,247.82,481.86,7
HCPCS,0116U,Rx mntr nzm ia 35+oral flu,,,222.23,933.36,11
HCPCS,0117U,Pain mgmt 11 endogenous anal,,,756.58,1471.14,7
HCPCS,0118U,HC TRANSPLANTATION MED QUAN DONOR-DERIVED CELL FREE DNA PLASMA,5887.0,4120.9,,,0
HCPCS,0118U,Trnsplj don-drv cll-fr dna,,,2477.93,4818.19,7
HCPCS,0119U,Crd ceramides liq chrom plsm,,,75.38,146.58,7
HCPCS,0120U,Onc b cll lymphm mrna 58 gen,,,2259.19,10542.87,11
HCPCS,0121U,Sc dis vcam-1 whole blood,,,458.28,891.1,7
HCPCS,0122U,Sc dis p-selectin whl blood,,,473.61,920.9,7
HCPCS,0123U,Mchnl fragility rbc prflg,,,321.87,625.85,7
HCPCS,0124A,Adm sarscv2 bvl 30mcg/.3ml b,,,121.2,151.2,4
HCPCS,0129U,Hered brst ca rltd do panel,,,1173.56,4225.96,11
HCPCS,0130U,Hered colon ca do mrna pnl,,,526.41,2210.92,11
HCPCS,0133U,Hered prst8 ca rltd do 11,,,621.26,1208.01,7
HCPCS,0134A,Adm sarscv2 bvl 50mcg/.5ml b,,,121.2,151.2,4
HCPCS,0134U,Hered pan ca mrna pnl 18 gen,,,673.55,1309.68,7
HCPCS,0136U,Atm mrna seq alys,,,366.69,713.0,7
HCPCS,0137U,Palb2 mrna seq alys,,,254.59,495.04,7
HCPCS,0138U,Brca1 brca2 mrna seq alys,,,421.5,819.58,7
HCPCS,0140U,HC INFECT DISEASE FUNGAL PATH ID DNA BLOOD CULTURE AMPLIFIED PROBE EA TARGET,88.0,61.6,,,0
HCPCS,0140U,Nfct ds fungi dna 15 trgt,,,141.08,274.31,7
HCPCS,0141U,HC INFECT DISEASE GRAM-POSITIVE ORG ID AND DRUG RESIST DNA BLOOD CULTURE AMPLIFIED PROBE EA TARGET,154.0,107.8,,,0
HCPCS,0141U,Nfct ds bact&fng gram pos,,,141.08,274.31,7
HCPCS,0142U,HC INFECT DISEASE GRAM-NEG BACT ID AND DRUG RESIST DNA AMPLIFIED PROBE TECH EA TARGET,154.0,107.8,,,0
HCPCS,0142U,Nfct ds bact&fng gram neg,,,141.08,274.31,7
HCPCS,0144A,Adm srscv2 bvl 25mcg/.25ml b,,,121.2,151.2,4
HCPCS,0152U,Nfct bct fng prst dna >1000,,,1913.58,3720.85,7
HCPCS,0153U,Onc breast mrna 101 genes,,,2843.48,5528.98,7
HCPCS,0154A,Adm sarscv2 bvl 10mcg/.2ml b,,,121.2,151.2,4
HCPCS,0154U,Fgfr3 gene analysis,,,433.93,843.74,7
HCPCS,0155U,Pik3ca gene analysis,,,247.35,480.95,7
HCPCS,0156U,Copy number sequence alys,,,1566.0,3045.0,7
HCPCS,0157U,Apc mrna seq alys,,,254.59,495.04,7
HCPCS,0158U,Mlh1 mrna seq alys,,,254.59,495.04,7
HCPCS,0159U,Msh2 mrna seq alys,,,254.59,495.04,7
HCPCS,0160U,Msh6 mrna seq alys,,,254.59,495.04,7
HCPCS,0161U,Pms2 mrna seq alys,,,254.59,495.04,7
HCPCS,0162U,Hered colon ca trgt mrna pnl,,,437.89,851.44,7
HCPCS,0164U,Gi ibs ia anti-cdtb&vinculin,,,100.82,196.04,7
HCPCS,0165U,Peanut allg spec asmt 64 epi,,,417.38,811.58,7
HCPCS,0166U,Liver ds 10 biochem asy srm,,,453.06,880.95,7
HCPCS,0169U,Nudt15&tpmt gene com vrnt,,,419.55,815.8,7
HCPCS,0170U,Neuro asd rna next gen seq,,,1755.0,3412.5,7
HCPCS,0171U,Trgt gen seq alys pnl dna 23,,,1367.15,2658.36,7
HCPCS,0172U,Onc sld tum alys brca1 brca2,,,2727.0,5302.5,7
HCPCS,0173U,Psyc gen alys panel 14 genes,,,419.55,815.8,7
HCPCS,0174A,Adm sarscv2 bvl 3mcg/0.2ml b,,,121.2,151.2,4
HCPCS,0174U,Onc solid tumor 30 prtn trgt,,,1174.83,2284.4,7
HCPCS,0175U,Psyc gen alys panel 15 genes,,,1202.48,2338.16,7
HCPCS,0176U,Cdtb&vinculin igg antb ia,,,57.77,112.33,7
HCPCS,0177U,Onc brst ca dna pik3ca 11,,,247.35,480.95,7
HCPCS,0178U,Peanut allg asmt epi clin rx,,,413.87,804.76,7
HCPCS,0179U,Onc nonsm cll lng ca alys 23,,,1748.89,3400.62,7
HCPCS,0180U,Abo gnotyp abo 7 exons,,,247.35,480.95,7
HCPCS,0181U,Co gnotyp aqp1 exon 1,,,166.68,324.1,7
HCPCS,0182U,Crom gnotyp cd55 exons 1-10,,,271.22,527.36,7
HCPCS,0183U,Di gnotyp slc4a1 exon 19,,,166.68,324.1,7
HCPCS,0184T,Exc rectal tumor endoscopic,,,6009.99,26664.3,11
HCPCS,0184U,Do gnotyp art4 exon 2,,,166.68,324.1,7
HCPCS,0185U,Fut1 gnotyp fut1 exon 4,,,166.68,324.1,7
HCPCS,0186U,Fut2 gnotyp fut2 exon 2,,,166.68,324.1,7
HCPCS,0187U,Fy gnotyp ackr1 exons 1-2,,,247.35,480.95,7
HCPCS,0188U,Ge gnotyp gypc exons 1-4,,,247.35,480.95,7
HCPCS,0189U,Gypa gnotyp ntrns 1 5 exon 2,,,247.35,480.95,7
HCPCS,0190U,Gypb gnotyp ntrns 1 5 seux 3,,,247.35,480.95,7
HCPCS,0191U,In gnotyp cd44 exons 2 3 6,,,247.35,480.95,7
HCPCS,0192U,Jk gnotyp slc14a1 exon 9,,,247.35,480.95,7
HCPCS,0193U,Jr gnotyp abcg2 exons 2-26,,,254.59,495.04,7
HCPCS,0194U,Kel gnotyp kel exon 8,,,166.68,324.1,7
HCPCS,0195U,Klf1 targeted sequencing,,,337.72,656.69,7
HCPCS,0196U,Lu gnotyp bcam exon 3,,,166.68,324.1,7
HCPCS,0197U,Lw gnotyp icam4 exon 1,,,166.68,324.1,7
HCPCS,0198T,Ocular blood flow measure,,,131.71,584.37,11
HCPCS,0198U,Rhd&rhce gntyp rhd1-10&rhce5,,,254.59,495.04,7
HCPCS,0199U,Sc gnotyp ermap exons 4 12,,,247.35,480.95,7
HCPCS,0200T,Perq sacral augmt unilat inj,,,6989.51,31870.39,11
HCPCS,0200U,Xk gnotyp xk exons 1-3,,,247.35,480.95,7
HCPCS,0201T,HC SACROPLASTY INJ BILAT 2> NEEDLES,3260.0,2282.0,,,0
HCPCS,0201T,Perq sacral augmt bilat inj,,,6989.51,31870.39,11
HCPCS,0201U,Yt gnotyp ache exon 2,,,166.68,324.1,7
HCPCS,0202T,Post vert arthrplst 1 lumbar,,,12709.88,56389.43,11
HCPCS,0202U,Nfct ds 22 trgt sars-cov-2,,,375.1,729.36,7
HCPCS,0203U,Ai ibd mrna xprsn prfl 17,,,684.0,1330.0,7
HCPCS,0205U,Oph amd alys 3 gene variants,,,42.3,82.25,7
HCPCS,0206U,Neuro alzheimer cell aggregj,,,1993.86,3876.95,7
HCPCS,0207T,Clear eyelid gland w/heat,,,131.71,584.37,11
HCPCS,0208T,Audiometry air only,,,36.98,164.05,11
HCPCS,0209T,Audiometry air & bone,,,36.98,164.05,11
HCPCS,0209U,Cytog const alys interrog,,,708.44,1377.51,7
HCPCS,0210T,Speech audiometry threshold,,,36.98,164.05,11
HCPCS,0210U,Syphilis tst antb ia quan,,,16.77,32.6,7
HCPCS,0211T,Speech audiom thresh & recog,,,36.98,164.05,11
HCPCS,0211U,Onc pan-tum dna&rna gnrj seq,,,7609.5,14796.25,7
HCPCS,0212T,Compre audiometry evaluation,,,127.38,565.15,11
HCPCS,0212U,Rare ds gen dna alys proband,,,4927.68,9581.6,7
HCPCS,0213T,Njx paravert w/us cer/thor,,,875.6,3884.74,11
HCPCS,0213U,Rare ds gen dna alys ea comp,,,2438.96,4742.41,7
HCPCS,0214T,Njx paravert w/us cer/thor,,,553.31,690.27,4
HCPCS,0214U,Rare ds xom dna alys proband,,,4702.14,9143.05,7
HCPCS,0215T,Njx paravert w/us cer/thor,,,553.31,690.27,4
HCPCS,0215U,Rare ds xom dna alys ea comp,,,2317.18,4505.64,7
HCPCS,0216T,Njx paravert w/us lumb/sac,,,875.6,3884.74,11
HCPCS,0216U,Neuro inh ataxia dna 12 com,,,1383.32,2689.78,7
HCPCS,0217T,Njx paravert w/us lumb/sac,,,553.31,690.27,4
HCPCS,0217U,Neuro inh ataxia dna 51 gene,,,1978.52,3847.11,7
HCPCS,0218T,Njx paravert w/us lumb/sac,,,553.31,690.27,4
HCPCS,0218U,Neuro musc dys dmd seq alys,,,2051.1,3988.25,7
HCPCS,0219T,Plmt post facet implt cerv,,,12709.88,56389.43,11
HCPCS,0219U,Nfct agt hiv gnrj seq alys,,,652.5,1268.75,7
HCPCS,0220T,Plmt post facet implt thor,,,12709.88,56389.43,11
HCPCS,0220U,Onc brst ca ai assmt 12 feat,,,635.62,1235.94,7
HCPCS,0221T,Plmt post facet implt lumb,,,6989.51,31870.39,11
HCPCS,0221U,Abo gnotyp next gnrj seq abo,,,247.35,1038.86,11
HCPCS,0222T,Plmt post facet implt addl,,,6989.51,8719.59,4
HCPCS,0222U,Rhd&rhce gntyp next gnrj seq,,,254.59,1069.29,11
HCPCS,0223U,Nfct ds 22 trgt sars-cov-2,,,375.1,1575.43,11
HCPCS,0224U,Antibody sars-cov-2 titer(s),,,46.29,159.25,11
HCPCS,0225U,HC NFCT DS DNA & RNA 21 TARGETS SARS-COV-2 AMP PROBE,620.0,434.0,,,0
HCPCS,0225U,Nfct ds dna&rna 21 sarscov2,,,375.1,1575.43,11
HCPCS,0226U,Svnt sarscov2 elisa plsm srm,,,38.05,159.82,11
HCPCS,0227U,Rx asy prsmv 30+rx/metablt,,,55.93,234.89,11
HCPCS,0228U,Onc prst8 ma molec prfl alg,,,155.73,302.8,7
HCPCS,0229U,Bcat1 promoter mthyltn alys,,,345.6,725.76,11
HCPCS,0230U,Ar full sequence analysis,,,271.22,1139.1,11
HCPCS,0231U,Cacna1a full gene analysis,,,761.64,3198.9,11
HCPCS,0232T,Njx platelet plasma,,,150.41,1962.08,11
HCPCS,0232U,Cstb full gene analysis,,,247.35,480.95,7
HCPCS,0233U,Fxn gene analysis,,,247.35,480.95,7
HCPCS,0234T,Trluml perip athrc renal art,,,11428.37,50703.82,11
HCPCS,0234U,Mecp2 full gene analysis,,,475.08,923.77,7
HCPCS,0235U,Pten full gene analysis,,,540.0,1050.0,7
HCPCS,0236T,Trluml perip athrc abd aorta,,,11428.37,50703.82,11
HCPCS,0236U,Smn1&smn2 full gene analysis,,,542.43,1054.73,7
HCPCS,0237T,Trluml perip athrc brchiocph,,,11428.37,50703.82,11
HCPCS,0237U,Car ion chnlpthy gen seq pnl,,,526.41,1023.58,7
HCPCS,0238T,HC TRNSLUM PERIPH ARTHRE ILIAC EA,22164.0,15514.8,,,0
HCPCS,0238T,Trluml perip athrc iliac art,,,18147.73,80515.32,11
HCPCS,0238U,Onc lnch syn gen dna seq aly,,,526.41,1023.58,7
HCPCS,0239U,Trgt gen seq alys pnl 311+,,,3150.0,6125.0,7
HCPCS,0240U,Nfct ds vir resp rna 3 trgt,,,432.17,539.14,4
HCPCS,0241U,Nfct ds vir resp rna 4 trgt,,,432.17,539.14,4
HCPCS,0242U,Trgt gen seq alys pnl 55-74,,,4500.0,8750.0,7
HCPCS,0243U,Ob pe biochem assay pgf alg,,,57.97,112.72,7
HCPCS,0244U,Onc solid orgn dna 257 genes,,,3150.0,6125.0,7
HCPCS,0245U,Onc thyr mut alys 10 gen&37,,,1139.46,2215.62,7
HCPCS,0246U,Rbc dna gnotyp 16 bld groups,,,648.0,1260.0,7
HCPCS,0247U,Ob prtrm brth ibp4 shbg meas,,,675.0,1312.5,7
HCPCS,0248U,Onc brn sphrd cll 12 rx pnl,,,2730.47,5309.26,7
HCPCS,0249U,Onc brst alys 32 phsprtn alg,,,1997.22,3883.48,7
HCPCS,0250U,Onc sld org neo dna 505 gene,,,2627.64,5109.3,7
HCPCS,0251U,Hepcidin-25 elisa serum/plsm,,,15.54,30.22,7
HCPCS,0252U,Ftl aneuploidy str alys dna,,,683.14,1328.34,7
HCPCS,0253T,Insert aqueous drain device,,,4091.95,18154.62,11
HCPCS,0253U,Rprdtve med rna gen prfl 238,,,2843.48,5528.98,7
HCPCS,0254U,Reprdtve med alys 24 chrmsm,,,683.14,1328.34,7
HCPCS,0255U,Andrology infertility assmt,,,28.44,55.3,7
HCPCS,0256U,Tma/tmao prfl ms/ms ur alg,,,143.95,279.91,7
HCPCS,0257U,Vlcad leuk nzm actv whl bld,,,641.22,1246.82,7
HCPCS,0258U,Ai psor mrna 50-100 gen alg,,,3307.5,6431.25,7
HCPCS,0259U,Neph ckd nuc mrs meas gfr,,,47.44,92.24,7
HCPCS,0260U,Rare ds id opt genome mapg,,,1137.18,2211.18,7
HCPCS,0261U,Onc clrct ca img alys w/ai,,,2261.93,4398.19,7
HCPCS,0262U,Onc sld tum rt-pcr 7 gen,,,2880.0,5600.0,7
HCPCS,0263T,Im b1 mrw cel ther cmpl,,,4311.81,19130.02,11
HCPCS,0263U,Neuro asd meas 16 c metblt,,,675.0,1312.5,7
HCPCS,0264T,Im b1 mrw cel ther xcl hrvst,,,4311.81,19130.02,11
HCPCS,0264U,Rare ds id opt genome mapg,,,1137.18,2211.18,7
HCPCS,0265T,Im b1 mrw cel ther hrvst onl,,,4311.81,19130.02,11
HCPCS,0265U,Rar do whl gn&mtcdrl dna als,,,4928.22,9582.65,7
HCPCS,0266T,Implt/rpl crtd sns dev total,,,89216.9,111300.29,4
HCPCS,0266U,Unxpl cnst hrtbl do gn xprsn,,,2880.0,5600.0,7
HCPCS,0267T,Implt/rpl crtd sns dev lead,,,4578.57,5711.88,4
HCPCS,0267U,Rare do id opt gen mapg&seq,,,6065.4,11793.83,7
HCPCS,0268T,HC PRO RESEARCH ONLY BEAT HF STUDY IMPLANT/REPLACE CAROTID SINUS BAROREFLEX ACTIVATION DEVICE PULSE GEN,850.0,595.0,,,0
HCPCS,0268T,HC RESEARCH ONLY BEAT HF STUDY IMPLANT/REPLACE CAROTID SINUS BAROREFLEX ACTIVATION DEVICE PULSE GEN,15372.0,10760.4,,,0
HCPCS,0268T,Implt/rpl crtd sns dev gen,,,49676.03,61972.08,4
HCPCS,0268U,Hem ahus gen seq alys 15 gen,,,547.35,1064.3,7
HCPCS,0269T,Rev/remvl crtd sns dev total,,,7519.19,9380.37,4
HCPCS,0269U,Hem aut dm cgen trmbctpna 14,,,547.35,1064.3,7
HCPCS,0270T,Rev/remvl crtd sns dev lead,,,4578.57,5711.88,4
HCPCS,0270U,Hem cgen coagj do 20 genes,,,547.35,1064.3,7
HCPCS,0271T,Rev/remvl crtd sns dev gen,,,7872.73,9821.42,4
HCPCS,0271U,Hem cgen neutropenia 23 gen,,,547.35,1064.3,7
HCPCS,0272T,Interrogate crtd sns dev,,,241.88,301.76,4
HCPCS,0272U,Hem genetic bld do 51 genes,,,547.35,1064.3,7
HCPCS,0273T,Interrogate crtd sns w/pgrmg,,,241.88,301.76,4
HCPCS,0273U,Hem gen hyprfibrnlysis 8 gen,,,547.35,1064.3,7
HCPCS,0274T,Perq lamot/lam crv/thrc,,,7183.42,31870.39,11
HCPCS,0274U,Hem gen pltlt do 43 genes,,,547.35,1064.3,7
HCPCS,0275T,Perq lamot/lam lumbar,,,11388.53,14207.47,4
HCPCS,0275U,Hem heprn nduc trmbctpna srm,,,16.53,32.15,7
HCPCS,0276U,Hem inh thrombocytopenia 23,,,2203.7,4284.98,7
HCPCS,0277U,Hem gen pltlt funcj do 31,,,547.35,1064.3,7
HCPCS,0278T,Tempr,,,127.38,565.15,11
HCPCS,0278U,Hem gen thrombosis 12 genes,,,547.35,1064.3,7
HCPCS,0279U,Hem vw factor&clgn iii bndg,,,10.38,20.18,7
HCPCS,0280U,Hem vw factor&clgn iv bndg,,,15.54,30.22,7
HCPCS,0281U,Hem vwd propeptide ag lvl,,,15.54,30.22,7
HCPCS,0282U,Rbc dna gntyp 12 bld grp gen,,,648.0,1260.0,7
HCPCS,0283U,Vw factor type 2b eval plsm,,,16.56,32.2,7
HCPCS,0284U,Vw factor type 2n eval plsm,,,15.54,30.22,7
HCPCS,0285U,Onc rsps radj cll fr dna tox,,,398.98,775.79,7
HCPCS,0286U,Cep72 nudt15&tpmt gene alys,,,120.72,234.73,7
HCPCS,0287U,Onc thyr dna&mrna 112 genes,,,3240.0,6300.0,7
HCPCS,0288U,Onc lung mrna quan pcr 11&3,,,3485.7,6777.75,7
HCPCS,0289U,Neuro alzheimer mrna 24 gen,,,684.0,1330.0,7
HCPCS,0290U,Pain mgmt mrna gen xprsn 36,,,684.0,1330.0,7
HCPCS,0291U,Psyc mood do mrna 144 genes,,,1579.5,3071.25,7
HCPCS,0292U,Psyc strs do mrna 72 genes,,,1579.5,3071.25,7
HCPCS,0293U,Psyc suicidal idea mrna 54,,,684.0,1330.0,7
HCPCS,0295U,Onc brst dux carc 7 proteins,,,4891.5,9511.25,7
HCPCS,0296U,Onc orl&/orop ca 20 mlc feat,,,1755.0,3412.5,7
HCPCS,0297U,Onc pan tum whl gen seq dna,,,2627.64,5109.3,7
HCPCS,0298U,Onc pan tum whl trns seq rna,,,2627.64,5109.3,7
HCPCS,0299U,Onc pan tum whl gen opt mapg,,,1676.9,3260.64,7
HCPCS,0300U,Onc pan tum whl gen seq&opt,,,3764.82,7320.48,7
HCPCS,0301U,Iadna bartonella ddpcr,,,236.45,459.76,7
HCPCS,0302U,Iadna brtnla ddpcr flwg liq,,,325.23,632.4,7
HCPCS,0303U,Hem rbc ads whl bld hypoxic,,,1981.46,3852.84,7
HCPCS,0304U,Hem rbc ads whl bld normoxic,,,1868.22,3632.65,7
HCPCS,0305U,Hem rbc fnclty&dfrm shr strs,,,596.32,1159.52,7
HCPCS,0306U,Onc mrd nxt-gnrj alys 1st,,,3490.6,6787.29,7
HCPCS,0307U,Onc mrd nxt-gnrj alys sbsq,,,715.04,1390.36,7
HCPCS,0308T,Insj ocular telescope prosth,,,5080.16,72298.44,11
HCPCS,0308U,Crd cad alys 3 prtn plsm alg,,,351.68,683.81,7
HCPCS,0309U,Crd cv ds aly 4 prtn plm alg,,,351.68,683.81,7
HCPCS,0310U,Ped vsclts kd alys 3 bmrks,,,351.68,683.81,7
HCPCS,0311U,Nfct ds bct quan antmcrb sc,,,7.27,14.14,7
HCPCS,0312U,Ai ds sle alys 8 igg autoant,,,756.58,1471.14,7
HCPCS,0313U,Onc pncrs dna&mrna seq 74,,,3240.0,6300.0,7
HCPCS,0314U,Onc cutan mlnma mrna 35 gene,,,1755.0,3412.5,7
HCPCS,0315U,Onc cutan sq cll ca mrna 40,,,7650.0,14875.0,7
HCPCS,0316U,B brgdrferi lyme ds ospa evl,,,16.79,32.66,7
HCPCS,0317U,Onc lung ca 4-prb fish assay,,,1827.0,3552.5,7
HCPCS,0318U,Ped whl gen mthyltn alys 50+,,,1593.43,3098.34,7
HCPCS,0319U,Neph rna pretrnspl perph bld,,,2385.0,4637.5,7
HCPCS,0320U,Neph rna psttrnspl perph bld,,,2385.0,4637.5,7
HCPCS,0321U,Iadna gu pthgn 20bct&fng org,,,571.36,1110.97,7
HCPCS,0322U,Neuro asd meas 14 acyl carn,,,675.0,1312.5,7
HCPCS,0323U,Iadna cns pthgn next gen seq,,,1913.58,3720.85,7
HCPCS,0326U,Trgt gen seq alys pnl 83+,,,4500.0,8750.0,7
HCPCS,0327U,Ftl aneuploidy trsmy dna seq,,,715.5,1391.25,7
HCPCS,0328U,Drug assay 120+ rx&metablt,,,102.99,200.25,7
HCPCS,0329U,Onc neo xome&trns seq alys,,,3094.18,6016.46,7
HCPCS,0330T,Tear film img uni/bi w/i&r,,,36.98,182.99,11
HCPCS,0330U,Iadna vag pthgn panel 27 org,,,375.1,729.36,7
HCPCS,0331T,Heart symp image plnr,,,936.24,5686.29,11
HCPCS,0331U,Onc hl neo opt gen mapping,,,1676.9,3260.64,7
HCPCS,0332T,Heart symp image plnr spect,,,936.24,5686.29,11
HCPCS,0332U,Onc pan tum gen prflg 8 dna,,,1027.85,1998.6,7
HCPCS,0333U,Onc lvr surveilanc hcc cfdna,,,596.09,1159.06,7
HCPCS,0334U,Onc sld orgn tgsa dna 84/+,,,3150.0,6125.0,7
HCPCS,0335T,Extraosseous joint stblztion,,,6189.23,31870.39,11
HCPCS,0335U,Rare ds whl gen seq fetal,,,4702.14,9143.05,7
HCPCS,0336U,Rare ds whl gen seq bld/slv,,,2317.18,4505.64,7
HCPCS,0337U,Onc plsm cell do&myeloma id,,,2191.5,4261.25,7
HCPCS,0338T,HC TRANSCATHETER RENAL SYMPATHETIC DENERVATION PREQ INCL ARTERIAL PUNCTURE UNILATERAL,24273.0,16991.1,,,0
HCPCS,0338T,Trnscth renal symp denrv unl,,,5634.46,24998.21,11
HCPCS,0338U,Onc sld tum crcg tum cl slct,,,2191.5,4261.25,7
HCPCS,0339T,HC TRANSCATHETER RENAL SYMPATHETIC DENERVATION PERQ BILATERAL,24273.0,16991.1,,,0
HCPCS,0339T,Trnscth renal symp denrv bil,,,5634.46,24998.21,11
HCPCS,0339U,Onc prst8 mrna hoxc6 & dlx1,,,684.0,1330.0,7
HCPCS,0340U,Onc pan ca alys mrd plasma,,,3231.0,6282.5,7
HCPCS,0341U,Ftl aneup dna seq cmpr alys,,,1710.18,3325.35,7
HCPCS,0342T,Thxp apheresis w/hdl delip,,,4311.81,19130.02,11
HCPCS,0343U,Onc prst8 xom aly 442 sncrna,,,684.0,1330.0,7
HCPCS,0344U,Hep nafld semiq evl 28 lipid,,,712.95,1386.3,7
HCPCS,0345U,Psyc genom alys pnl 15 gen,,,1202.48,2338.16,7
HCPCS,0347T,Ins bone device for rsa,,,58.4,498.02,11
HCPCS,0347U,Rx metab/pcx dna 16 gen alys,,,1202.48,2338.16,7
HCPCS,0348T,RSA spine exam,,,103.5,459.18,11
HCPCS,0348U,Rx metab/pcx dna 25 gen alys,,,668.04,1298.97,7
HCPCS,0349T,RSA upper extr exam,,,103.5,459.18,11
HCPCS,0349U,Rx metab/pcx dna 27gen rx ia,,,668.04,1298.97,7
HCPCS,0350T,RSA lower extr exam,,,86.15,382.23,11
HCPCS,0350U,Rx metab/pcx dna 27 gen alys,,,1202.48,2338.16,7
HCPCS,0351U,Nfct ds bct/viral trail ip10,,,234.45,455.88,7
HCPCS,0355U,Apol1 risk variants,,,123.3,239.75,7
HCPCS,0356U,Onc orop 17 dna ddpcr alg,,,1620.0,3150.0,7
HCPCS,0358T,BIA whole body,,,28.63,197.96,11
HCPCS,0358U,Neuro alys b-amyl 1-42&1-40,,,234.45,455.88,7
HCPCS,0359U,Onc prst8 ca alys all psa,,,684.0,1330.0,7
HCPCS,0360U,Onc lung elisa 7 autoant alg,,,756.58,1471.14,7
HCPCS,0362T,Expose behav assessment,,,37.09,401.7,11
HCPCS,0362U,Onc pap thyr ca rna 82&10,,,3240.0,6300.0,7
HCPCS,0363U,Onc urthl mrna 5 gen alg,,,684.0,1330.0,7
HCPCS,0364U,Onc hl neo gen seq alys alg,,,1806.52,3512.69,7
HCPCS,0365U,Onc bldr 10 prb bldr ca,,,807.3,1569.75,7
HCPCS,0366U,Onc bldr 10 prb recr bldr ca,,,807.3,1569.75,7
HCPCS,0367U,Onc bldr 10 flwg trurl rescj,,,811.96,1578.81,7
HCPCS,0371U,Iadna gu pthgn semiq dna16&1,,,375.1,729.36,7
HCPCS,0372U,Nfct ds gu pthgn arg detcj,,,375.1,729.36,7
HCPCS,0373T,Exposure behavior treatment,,,37.09,436.67,11
HCPCS,0375U,Onc ovrn bchm asy 7 prtn alg,,,807.3,1569.75,7
HCPCS,0376U,Onc prst8 ca img alys 128,,,635.62,1235.94,7
HCPCS,0377U,Cv ds quan advsrm/plsm lprtn,,,42.82,83.26,7
HCPCS,0378U,Rfc1 repeat xpnsj vrnt alys,,,123.3,239.75,7
HCPCS,0379T,Vis field assmnt tech suppt,,,36.98,196.79,11
HCPCS,0379U,Tgsap sl or neo dna523&rna55,,,2959.66,5754.89,7
HCPCS,0381U,Maple syrup ur ds mntr quan,,,39.71,77.21,7
HCPCS,0382U,Hyprphenylalninmia mntr quan,,,46.48,90.37,7
HCPCS,0383U,Tyrosinemia typ i mntr quan,,,46.84,91.09,7
HCPCS,0384U,Neph ckd rsk hi stg kdn ds,,,675.0,1312.5,7
HCPCS,0385U,Neph ckd alg rsk dbtc kdn ds,,,351.68,683.81,7
HCPCS,0387U,Onc mlnma ambra1&amlo,,,853.65,1659.88,7
HCPCS,0388U,Onc nonsm cll lng ca 37 gen,,,3150.0,6125.0,7
HCPCS,0389U,Ped fbrl kd ifi27&mcemp1 rna,,,63.18,122.85,7
HCPCS,0390U,Ob pe kdr eng&rbp4 ia alg,,,57.97,112.72,7
HCPCS,0391U,Onc sld tum dna&rna 437 gen,,,3240.0,6300.0,7
HCPCS,0392U,Rx metab genrx ia 16 genes,,,1202.48,2338.16,7
HCPCS,0393U,Neu prksn msfl ?-syncln prtn,,,486.89,946.73,7
HCPCS,0394T,Hdr elctrnc skn surf brchytx,,,588.88,734.64,4
HCPCS,0394U,Pfas 16 pfas compnd lc ms/ms,,,178.87,347.8,7
HCPCS,0395T,Hdr elctr ntrst/ntrcv brchtx,,,689.49,3059.02,11
HCPCS,0395U,Onc lng multiomics plsm alg,,,717.7,1395.54,7
HCPCS,0398T,Mrgfus strtctc les abltj,,,29544.02,36856.89,4
HCPCS,0398U,Gi baret esph dna mthyln aly,,,1579.5,3071.25,7
HCPCS,0399U,Neuro cere folate defncy srm,,,270.0,525.0,7
HCPCS,0401U,Crd c hrt ds 9 gen 12 vrnts,,,440.71,856.94,7
HCPCS,0402T,Collagen crosslinking cornea,,,2111.03,10442.27,11
HCPCS,0402U,Nfct agt sti mult amp prb tq,,,128.37,249.6,7
HCPCS,0403U,Onc prst8 mrna 18 gen dre ur,,,684.0,1330.0,7
HCPCS,0404T,Trnscrv uterin fibroid abltj,,,17267.82,21542.03,4
HCPCS,0404U,Onc brst semiq meas thym kn,,,290.66,565.18,7
HCPCS,0405U,Onc pncrtc 59 mthltn blk mrk,,,1593.43,3098.34,7
HCPCS,0406U,Onc lung flow cytmtry 5 mrk,,,684.0,1330.0,7
HCPCS,0407U,Neph dbtc ckd mult eclia alg,,,855.0,1662.5,7
HCPCS,0408T,Insj/rplc cardiac modulj sys,,,31073.96,137864.64,11
HCPCS,0408U,Iaad blk ac wv bsnsr sarscv2,,,12.72,24.73,7
HCPCS,0409T,Insj/rplc car modulj pls gn,,,22020.42,97697.15,11
HCPCS,0409U,Onc sld tum dna 80 & rna 36,,,2627.64,5109.3,7
HCPCS,0410T,Insj/rplc car modulj atr elt,,,8192.37,36346.76,11
HCPCS,0410U,Onc pncrtc dna whl gn seq 5-,,,1044.0,2030.0,7
HCPCS,0411T,Insj/rplc car modulj vnt elt,,,8192.37,36346.76,11
HCPCS,0411U,Psyc genom alys pnl 15 gen,,,1202.48,2338.16,7
HCPCS,0412T,Rmvl cardiac modulj pls gen,,,3699.47,16413.29,11
HCPCS,0412U,Beta amyloid a?42/40 imprcip,,,675.0,1312.5,7
HCPCS,0413T,Rmvl car modulj tranvns elt,,,3699.47,16413.29,11
HCPCS,0413U,Onc hl neo opt gen mapg dna,,,1137.18,2211.18,7
HCPCS,0414T,Rmvl & rpl car modulj pls gn,,,22020.42,97697.15,11
HCPCS,0414U,Onc lng aug alg aly whl sld8,,,635.62,1235.94,7
HCPCS,0415T,Repos car modulj tranvns elt,,,621.01,3260.29,11
HCPCS,0415U,Cv ds acs bld alg 5 yr score,,,351.68,683.81,7
HCPCS,0416T,Reloc skin pocket pls gen,,,2042.58,9062.24,11
HCPCS,0417T,Prgrmg eval cardiac modulj,,,36.95,163.92,11
HCPCS,0417U,Rare ds alys 335 nuc genes,,,2558.28,4974.43,7
HCPCS,0418T,Interro eval cardiac modulj,,,36.95,163.92,11
HCPCS,0418U,Onc brst aug alg aly whl sl8,,,635.62,1235.94,7
HCPCS,0419T,Dstrj neurofibroma xtnsv,,,731.66,3246.12,11
HCPCS,0419U,Nrpsyc gen seq vrnt aly 13,,,1202.48,2338.16,7
HCPCS,0420T,Dstrj neurofibroma xtnsv,,,731.66,3246.12,11
HCPCS,0420U,Onc urthl mrna xprsn 6 snp,,,1195.49,2324.56,7
HCPCS,0422T,Tactile breast img uni/bi,,,86.15,382.23,11
HCPCS,0422U,Onc pan solid tum alys dna,,,1748.89,3400.62,7
HCPCS,0423U,Psyc genomic alys pnl 26 gen,,,375.1,729.36,7
HCPCS,0424T,Insj/rplc nstim apnea compl,,,80987.02,101033.31,4
HCPCS,0424U,Onc prst8 xom alys 53 sncrna,,,684.0,1330.0,7
HCPCS,0425T,Insj/rplc nstim apnea sen ld,,,15890.44,19823.72,4
HCPCS,0425U,Genom rpd seq alys ea cmprtr,,,3684.95,7165.18,7
HCPCS,0426T,Insj/rplc nstim apnea stm ld,,,52598.89,65618.42,4
HCPCS,0426U,Genome ultra-rapid seq alys,,,6823.98,13268.85,7
HCPCS,0427T,Insj/rplc nstim apnea pls gn,,,52598.89,65618.42,4
HCPCS,0427U,Monocyte dstrbj wdth whl bld,,,4.03,7.84,7
HCPCS,0428T,Rmvl nstim apnea pls gen,,,6631.58,8273.06,4
HCPCS,0429T,Rmvl nstim apnea sen ld,,,6631.58,8273.06,4
HCPCS,0429U,Hpv orop swab 14 hi-risk typ,,,31.58,61.41,7
HCPCS,0430T,Rmvl nstim apnea stimj ld,,,6631.58,8273.06,4
HCPCS,0430U,Gi malabs aat calpro pncrtc,,,55.39,107.7,7
HCPCS,0431T,Rmvl/rplc nstim apnea pls gn,,,52598.89,65618.42,4
HCPCS,0431U,Gly rcptr alpha1 igg srm/csf,,,32.91,64.0,7
HCPCS,0432T,Repos nstim apnea stimj ld,,,6631.58,8273.06,4
HCPCS,0432U,Klhl11 antb sr/csf asy qual,,,32.91,64.0,7
HCPCS,0433T,Repos nstim apnea sensing ld,,,6631.58,8273.06,4
HCPCS,0433U,Onc prst8 5 dna reg mrk pcr,,,684.0,1330.0,7
HCPCS,0434T,Interro eval npgs apnea,,,322.51,402.34,4
HCPCS,0434U,Rx metab advrs vrnt alys 25,,,375.1,729.36,7
HCPCS,0435T,Prgrmg eval npgs apnea 1 ses,,,322.51,402.34,4
HCPCS,0435U,Onc chemo rx cytox csc 14 rx,,,2730.47,5309.26,7
HCPCS,0436T,Prgrmg eval npgs apnea study,,,2595.01,3237.34,4
HCPCS,0436U,Onc lng plsm alys 388 prtn,,,1353.82,2632.42,7
HCPCS,0437U,Psyc anxiety do mrna 15 bmrk,,,684.0,1330.0,7
HCPCS,0438U,Rx metab advrs vrnt alys 33,,,375.1,729.36,7
HCPCS,0439U,Crd chd dna alys 5 snp 3 dna,,,768.6,1494.5,7
HCPCS,0440T,Abltj perc uxtr/perph nrv,,,1933.13,15694.03,11
HCPCS,0440U,Crd chd dna alys 10 snp 6dna,,,768.6,1494.5,7
HCPCS,0441T,Abltj perc lxtr/perph nrv,,,1933.13,15694.03,11
HCPCS,0441U,Nfct ds bct fngl/viral semiq,,,399.67,777.14,7
HCPCS,0442T,Abltj perc plex/trncl nrv,,,8687.81,38544.86,11
HCPCS,0442U,Nfct ds respir nfctj mxa&crp,,,37.24,72.42,7
HCPCS,0443U,Neurflmnt lt chn ultrsens ia,,,104.61,203.4,7
HCPCS,0444U,Onc sld orgn neo tgsap 361,,,2627.64,5109.3,7
HCPCS,0445U,Abeta42 & ptau181 eclia csf,,,234.45,455.88,7
HCPCS,0446T,Insj impltbl glucose sensor,,,1372.89,18273.05,11
HCPCS,0446U,Ai ds sle alys 10 cytokine,,,756.58,1471.14,7
HCPCS,0447T,Rmvl impltbl glucose sensor,,,198.62,881.22,11
HCPCS,0447U,Ai ds sle alys 11 cytokine,,,756.58,1471.14,7
HCPCS,0448T,Remvl insj impltbl gluc sens,,,1372.89,18273.05,11
HCPCS,0449T,Insj aqueous drain dev 1st,,,5267.92,23371.97,11
HCPCS,0452U,Onc bldr mthyl penk lte-qmsp,,,172.8,336.0,7
HCPCS,0453U,Onc clrct ca cfdna qpcr asy,,,172.8,336.0,7
HCPCS,0454U,U rare ds id opt genome mapg,,,1137.18,2211.18,7
HCPCS,0455U,Nfct agt sti mult amp prb ur,,,128.37,249.6,7
HCPCS,0457U,Pfas 9 cmpnd lcms/ms pls/sr,,,178.87,347.8,7
HCPCS,0458U,Onc brst ca s100 a8&a9 elisa,,,234.45,455.88,7
HCPCS,0459U,Abeta42 & ttau eclia csf,,,234.45,455.88,7
HCPCS,0460U,Onc whl bld/bucc rtpcr 24gen,,,825.37,1604.89,7
HCPCS,0461U,Onc rxgenom alys rtpcr 24gen,,,825.37,1604.89,7
HCPCS,0462U,Melatonin lvl tst slp std7/9,,,15.54,30.22,7
HCPCS,0463U,Onc crvx mrna genxprsn 14bmk,,,684.0,1330.0,7
HCPCS,0464T,Visual ep test for glaucoma,,,127.38,565.15,11
HCPCS,0464U,Onc clrct scr qrtsa dna mrk,,,532.73,1035.86,7
HCPCS,0465T,Supchrdl njx rxw/o supply,,,846.73,1056.32,4
HCPCS,0465U,Onc urthl carc dna qmsp 2gen,,,1744.21,3391.52,7
HCPCS,0466U,Crd cad dna gwas 564856 snp,,,310.89,604.5,7
HCPCS,0467U,Onc bldr dna ngs 60gen&aneup,,,1367.15,2658.36,7
HCPCS,0468U,Hep nash mir34a5p ?2m ykl40,,,226.53,440.48,7
HCPCS,0469U,Rare ds whl gen seq ftl samp,,,1078.15,2096.4,7
HCPCS,0470U,Onc orop detcj mrd 8 dna hpv,,,538.12,1046.34,7
HCPCS,0471U,Onc clrc ca 35 vrn kras&nras,,,684.0,1330.0,7
HCPCS,0472T,Prgrmg io rta eltrd ra,,,304.06,1348.99,11
HCPCS,0472U,Ca vi psp&sp1 antb sj?gren,,,25.11,48.82,7
HCPCS,0473T,Reprgrmg io rta eltrd ra,,,94.12,444.3,11
HCPCS,0473U,Onc sld tum bld/slv 648 gene,,,4050.0,7875.0,7
HCPCS,0474T,Insj aqueous drg dev io rsvr,,,1115.1,1391.12,4
HCPCS,0474U,Hered pan ca gsap 88gene ngs,,,1173.56,2281.91,7
HCPCS,0475U,Hered prst8 ca gsap 23 genes,,,1173.56,2281.91,7
HCPCS,0476U,Rx metab psyc 14gen&cyp2d6,,,375.1,729.36,7
HCPCS,0477U,Rx metab psy 14&cyp2d6 gn-rx,,,375.1,729.36,7
HCPCS,0478U,Onc nsclc dna&rna dpcr 9 gen,,,497.69,967.73,7
HCPCS,0479T,Fxjl abl lsr 1st 100 sq cm,,,731.66,3246.12,11
HCPCS,0479U,Tau phosphorylated ptau217,,,15.54,30.22,7
HCPCS,0480T,Fxjl abl lsr ea addl 100sqcm,,,225.43,281.23,4
HCPCS,0480U,Nfct ds csf metag ngs alys,,,1913.58,3720.85,7
HCPCS,0481T,Njx autol wbc concentrate,,,442.24,1962.08,11
HCPCS,0481U,Idh1 idh2&tert promoter ngs,,,606.82,1179.92,7
HCPCS,0482U,Ob pe biochem asy sfit1&pigf,,,115.94,225.44,7
HCPCS,0483T,HC TRANSCATHETER MITRAL VALVE IMPLANTATION/REPLACEMENT W/PROSTHETIC VALVE PERCUTANEOUS APPROACH,4795.0,3356.5,,,0
HCPCS,0483T,Tmvi percutaneous approach,,,4303.21,5368.36,4
HCPCS,0483U,Nfct ds ng gyra s91f pt mut,,,31.58,61.41,7
HCPCS,0484T,Tmvi transthoracic exposure,,,5434.49,6779.66,4
HCPCS,0484U,Nfct ds mgen 23s rrna pt mut,,,31.58,61.41,7
HCPCS,0485T,Oct mid ear i&r unilateral,,,36.98,164.05,11
HCPCS,0485U,Onc sol tum cfdna&rna ngs gm,,,3284.53,6386.59,7
HCPCS,0486T,Oct mid ear i&r bilateral,,,36.98,164.05,11
HCPCS,0486U,Onc pan sol tum ngs cfctdna,,,1479.82,2877.44,7
HCPCS,0487U,Onc sol tum cfcdna tgsap 84,,,2627.64,5109.3,7
HCPCS,0490U,Onc cutan/uveal mlnma cd146,,,2191.5,4261.25,7
HCPCS,0491U,Onc sol tum ctc slct er prtn,,,2191.5,4261.25,7
HCPCS,0492U,Onc sol tum ctc slctn pd-l1,,,2191.5,4261.25,7
HCPCS,0493U,Trnspl med quan dd-cfdna ngs,,,2477.93,4818.19,7
HCPCS,0494U,Rbc ag ftl rhd gene alys ngs,,,683.14,1328.34,7
HCPCS,0495U,Onc prst8 alys crcg plsm prt,,,684.0,1330.0,7
HCPCS,0496U,Onc clrct cfdna 8/7 genes,,,437.27,850.26,7
HCPCS,0497U,Onc prst8 mrna rt-pcr 6 gene,,,3485.7,6777.75,7
HCPCS,0498U,Onc clrct ngs mut detc 43gen,,,1210.78,2354.29,7
HCPCS,0499T,Cysto f/urtl strix/stenosis,,,5271.44,6576.26,4
HCPCS,0499U,Onc clrct&lng dna ngs 8gene,,,538.12,1046.34,7
HCPCS,0500U,Autoinflam ds vexas synd dna,,,157.86,306.95,7
HCPCS,0501T,Cor ffr derived cor cta data,,,237.52,296.31,4
HCPCS,0502T,Cor ffr data prep & transmis,,,147.23,183.67,4
HCPCS,0502U,Hpv e6/e7 mrk hi-rsk typ crv,,,31.58,61.41,7
HCPCS,0503T,Cor ffr alys gnrj ffr mdl,,,4395.02,5482.89,4
HCPCS,0503U,Neuro alz ds ?amyl&tau prtn,,,675.0,1312.5,7
HCPCS,0504T,Cor ffr data review i&r,,,159.41,198.87,4
HCPCS,0504U,Nfct ds uti id 17 path orgs,,,375.1,729.36,7
HCPCS,0505T,Ev fempop artl revsc,,,11428.37,50703.82,11
HCPCS,0505T,HC ENDOVENOUS FEMORAL POPLITEAL ARTERIAL REVSC W/TRANSCATH PLMT INTRAVAS STENT GRAFT/CLSR INCL PERCUT/OPEN VASC ACCESS US GUIDE FOR VASC ACCESS CATH/INTRAPROC ROADMAP/IMAGE GUIDE RAD S&I,39081.0,27356.7,,,0
HCPCS,0505U,Nfct ds vag infctj id 32orgs,,,611.79,1189.6,7
HCPCS,0506T,Mac pgmt opt dns meas hfp,,,58.4,259.1,11
HCPCS,0506U,Gi barretts esophgl cell 89,,,1744.21,3391.52,7
HCPCS,0507T,Near ifr 2img mibmn glnd i&r,,,58.4,259.1,11
HCPCS,0507U,Onc ovr dna whole gen w/5hmc,,,1044.0,2030.0,7
HCPCS,0508T,Pls echo us b1 dns meas tib,,,340.91,425.29,4
HCPCS,0509T,Pattern erg w/i&r,,,213.76,948.37,11
HCPCS,0510T,Rmvl sinus tarsi implant,,,3239.17,14371.12,11
HCPCS,0510U,Onc pncrtc ca alg alys 16gen,,,426.52,829.34,7
HCPCS,0511T,Rmvl&rinsj sinus tarsi implt,,,7183.42,31870.39,11
HCPCS,0511U,Onc sol tum 3dmicroenvir 36+,,,2730.47,5309.26,7
HCPCS,0512T,Esw integ wnd hlg 1st wnd,,,198.62,1187.22,11
HCPCS,0512U,Onc prst8 alys dgtz img msi,,,635.62,1235.94,7
HCPCS,0513U,Onc prst8 alg alys msi&hrd,,,635.62,1235.94,7
HCPCS,0514U,Gi ibd ia quan deter adl lvl,,,34.71,67.5,7
HCPCS,0515T,Insj wcs lv compl sys,,,22020.42,97697.15,11
HCPCS,0515U,Gi ibd ia quan deter ifx lvl,,,34.71,67.5,7
HCPCS,0516T,Insj wcs lv eltrd only,,,10347.14,45906.74,11
HCPCS,0516U,Rx metab rxgenomic gnotyp 40,,,375.1,729.36,7
HCPCS,0517T,Insj wcs lv pg compnt,,,10347.14,45906.74,11
HCPCS,0517U,Ther rx mntr 80+ psyactiv rx,,,222.23,432.11,7
HCPCS,0518T,Rmvl pg compnt wcs,,,3699.47,16413.29,11
HCPCS,0518U,Ther rx mntr 90+ pn&mtl hlth,,,222.23,432.11,7
HCPCS,0519T,Rmvl & rplcmt pg compnt wcs,,,9485.51,45906.74,11
HCPCS,0519U,Ther rx mntr meds p/d/a 110+,,,222.23,432.11,7
HCPCS,0520T,Rmvl&rplcmt pg wcs new eltrd,,,10347.14,83146.62,11
HCPCS,0520U,Ther rx mntr 200+ rx/sbsts,,,222.23,432.11,7
HCPCS,0521T,Interrog dev eval wcs ip,,,28.63,127.04,11
HCPCS,0521U,Rf iga&igm ccp antb sr-a ia,,,46.62,90.65,7
HCPCS,0522T,Prgrmg dev eval wcs ip,,,36.95,163.92,11
HCPCS,0522U,Ca vi psp&sp1 antb cl semiql,,,234.45,455.88,7
HCPCS,0523U,Onc soltum dna ngs snv 22gen,,,1216.88,2366.16,7
HCPCS,0524T,Ev cath dir chem abltj w/img,,,3125.8,13868.13,11
HCPCS,0524U,Ob pe sflt-1/plgf ia srm/pls,,,115.94,225.44,7
HCPCS,0525T,Insj/rplcmt compl iims,,,19068.45,84600.26,11
HCPCS,0525U,Onc sphrd cell cul 11-rx pnl,,,2730.47,5309.26,7
HCPCS,0526T,Insj/rplcmt iims eltrd only,,,8192.37,36346.76,11
HCPCS,0527T,Insj/rplcmt iims implt mntr,,,8192.37,36346.76,11
HCPCS,0527U,Hsv 1&2 vzv amp prb tq pthgn,,,128.37,249.6,7
HCPCS,0528T,Prgrmg dev eval iims ip,,,36.95,163.92,11
HCPCS,0528U,Lrt iad 18bct/8vir&7arg rna,,,571.36,1110.97,7
HCPCS,0529T,Interrog dev eval iims ip,,,36.95,163.92,11
HCPCS,0530T,Removal complete iims,,,3699.47,16413.29,11
HCPCS,0530U,Onc pan-sol tum ctdna 77 gen,,,2627.64,5109.3,7
HCPCS,0531T,Removal iims electrode only,,,3699.47,16413.29,11
HCPCS,0532T,Removal iims implt mntr only,,,3699.47,16413.29,11
HCPCS,0532U,Rare ds whlgen&mitochdrl dna,,,4528.08,8804.6,7
HCPCS,0533U,Rx metab advrs gnotyp 16gens,,,375.1,729.36,7
HCPCS,0534T,Cont rec mvmt do setup&train,,,112.59,140.46,4
HCPCS,0535T,Cont rec mvmt do reprt cnfig,,,112.59,140.46,4
HCPCS,0535U,Pfas lc-ms/ms plsm/srm quan,,,55.93,108.74,7
HCPCS,0536U,Rbcag ftl rhd pcr alys exon4,,,172.8,336.0,7
HCPCS,0537U,Onc clrct ca cfdna >2500 dmr,,,1345.5,2616.25,7
HCPCS,0538U,Onc sol tum ngts ffpe 600gen,,,2690.6,5231.71,7
HCPCS,0539U,Onc sol tumor cfctdna 152gen,,,2959.66,5754.89,7
HCPCS,0540T,Car-t cll admn autologous,,,873.79,1090.08,4
HCPCS,0540U,Trnsplj med quan dd-cfdna,,,2477.93,4818.19,7
HCPCS,0541T,Myocardial imaging mcg,,,369.41,1835.61,11
HCPCS,0543T,Ta mv rpr w/artif chord tend,,,6127.72,7644.48,4
HCPCS,0543U,Onc sol tum ngs dna 517 gens,,,2690.6,5231.71,7
HCPCS,0544T,Tcat mv annulus rcnstj,,,5699.25,7109.95,4
HCPCS,0545T,Tcat tv annulus rcnstj,,,5521.08,6887.69,4
HCPCS,0545U,Achr antb id imfluor livecll,,,33.96,66.03,7
HCPCS,0546U,Ldns lrp4 antb imflr livecll,,,33.96,66.03,7
HCPCS,0547U,Neurflmnt lt chn cleia plsm,,,104.61,203.4,7
HCPCS,0548U,Gfap cleia plasma,,,104.61,203.4,7
HCPCS,0549U,Onc urthl dna mthyltd rt pcr,,,684.0,1330.0,7
HCPCS,0553T,Perq tcat iliac anast implt,,,8605.44,10735.5,4
HCPCS,0553U,Repr med pga embry te strux,,,683.14,1328.34,7
HCPCS,0554T,B1 str & fx rsk analysis,,,111.69,139.33,4
HCPCS,0554U,Repr med pga 24chrm te bx qc,,,683.14,1328.34,7
HCPCS,0555T,B1 str&fx rsk transmis data,,,28.63,127.04,11
HCPCS,0555U,Repr med pga embryonic te qc,,,683.14,1328.34,7
HCPCS,0556T,B1 str & fx rsk assessment,,,236.21,1047.98,11
HCPCS,0556U,Nfct ds p-s dna&rna 12 trgts,,,128.37,249.6,7
HCPCS,0557T,B1 str & fx rsk i&r,,,27.94,34.85,4
HCPCS,0557U,Nfct ds bv dna mrk vag fluid,,,236.69,460.23,7
HCPCS,0558T,Ct scan f/biomchn ct alys,,,86.15,382.23,11
HCPCS,0558U,Onc clrct elisa bf7 ag serum,,,18.73,36.42,7
HCPCS,0559T,Antmc mdl 3d print 1st cmpnt,,,131.71,584.37,11
HCPCS,0559U,Onc brs quan elisa bf9ag srm,,,18.73,36.42,7
HCPCS,0560U,Onc mrd gsa cfdna baseline,,,3490.6,6787.29,7
HCPCS,0561T,Antmc guide 3d print 1st gd,,,131.71,584.37,11
HCPCS,0561U,Onc mrd gsa cfdna subsequent,,,715.04,1390.36,7
HCPCS,0562U,Onc sol tum tgsa 33gens snvs,,,538.12,1046.34,7
HCPCS,0563T,Evac meibomian glnd heat bi,,,58.4,259.1,11
HCPCS,0563U,Nfct ds pthgn-sna 11vir&4bct,,,375.1,729.36,7
HCPCS,0564T,Onc chemo rx cytotox csc 14,,,149.89,187.0,4
HCPCS,0564U,Nfct ds pthgn-sna 10vir&4bct,,,375.1,729.36,7
HCPCS,0565T,Autol cell implt adps hrvg,,,166.68,207.94,4
HCPCS,0565U,Onc hcc ngs detc 6626epigalt,,,1044.0,2030.0,7
HCPCS,0566T,Autol cell implt adps njx,,,793.16,989.49,4
HCPCS,0566U,Onc lng qpcr-bsd alys 13dmrs,,,375.1,729.36,7
HCPCS,0567U,Rare ds whl gen seq srs&lrs,,,4528.08,8804.6,7
HCPCS,0568U,Neurol dementia ?amyl ptau,,,807.3,1569.75,7
HCPCS,0569T,HC TRANSCATHETER TRICUSPID VALVE REPAIR PERQ APPROACH INITIAL PROSTHESIS,6686.0,4680.2,,,0
HCPCS,0570T,HC TRANSCATHETER TRICUSPID VALVE REPAIR PERQ APPROACH EACH ADDTL PROSTHESIS,1577.0,1103.9,,,0
HCPCS,0570U,Neurol tbi alys gfap&uch-l1,,,234.45,455.88,7
HCPCS,0571T,HC INSERTION/REPLACEMENT IMPLANT CARDIOVERTER-DEFIBRILLATOR SYSTEM W/SUBSTERNAL ELECTRODE(S) INCL IMAGE GUIDE/ELECTROPHYSIOLOGICAL EVAL,58680.0,41076.0,,,0
HCPCS,0571T,Insj/rplcmt icds ss eltrd,,,31073.96,137864.64,11
HCPCS,0571U,Onc sol tum dna80&rna10g ngs,,,2627.64,5109.3,7
HCPCS,0572T,HC INSERTION OF SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELECTRODE,35233.0,24663.1,,,0
HCPCS,0572T,Insertion ss dfb electrode,,,8192.37,36346.76,11
HCPCS,0573T,HC REMOVAL OF SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELECTRODE,14363.0,10054.1,,,0
HCPCS,0573T,Removal ss dfb electrode,,,3699.47,16413.29,11
HCPCS,0574T,HC REPOSITIONING OF PREVIOUSLY IMPLANTABLE DEFIBRILLATOR-PACING ELECTRODE,15494.0,10845.8,,,0
HCPCS,0574T,Repos prev ss impl dfb eltrd,,,3699.47,16413.29,11
HCPCS,0575T,Prgrmg dev eval icds ss ip,,,36.95,163.92,11
HCPCS,0575U,Trnsplj med lar rtpcr 4genes,,,342.0,665.0,7
HCPCS,0576T,Interrog dev eval icds ss ip,,,36.95,163.92,11
HCPCS,0576U,Trnsplj med lar quan ddcfdna,,,2916.0,5670.0,7
HCPCS,0577T,Ephys eval icds ss,,,1205.32,5347.61,11
HCPCS,0577T,HC ELECTROPHYSIOLOGIC EVALUATION OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR SYSTEM WITH SUBSTERNAL ELECTRODE,5169.0,3618.3,,,0
HCPCS,0577U,Onc ovr serum alys 39 gps,,,222.23,432.11,7
HCPCS,0578U,Onc cutan mln rna qpcr 10gen,,,3485.7,6777.75,7
HCPCS,0579T,Rem interrog dev icds tech,,,36.95,163.92,11
HCPCS,0579U,Nfro dbtc ckd elisa apoa4,,,351.68,683.81,7
HCPCS,0580T,HC REMOVAL OF SUBSTERNAL IMPLANTABLE DEFIBRILLATOR PULSE GENERATOR ONLY,15494.0,10845.8,,,0
HCPCS,0580T,Rmvl ss impl dfb pg only,,,3699.47,16413.29,11
HCPCS,0580U,Bbrgdrferi antb detc 24rprtn,,,15.49,30.12,7
HCPCS,0581T,Abltj mal brst tum perq crtx,,,3876.15,17197.18,7
HCPCS,0581U,Trnspl med antb nohla 39trgt,,,293.22,570.15,7
HCPCS,0582U,Rare ds rpd whlgen dna vrnts,,,6823.98,13268.85,7
HCPCS,0583T,Tmpst auto tube dlvr sys,,,1536.02,6814.79,11
HCPCS,0583U,Rare ds rpd whlgen cmptr dna,,,3411.99,6634.42,7
HCPCS,0584U,Neuro csf prion prtn qual,,,486.89,946.73,7
HCPCS,0585U,Tgsap so neo cfdna 521 genes,,,2627.64,5109.3,7
HCPCS,0586U,Onc mrna gen xprsn 216 genes,,,2627.64,5109.3,7
HCPCS,0587T,Perq impltj/rplcmt isdns ptn,,,1893.9,27991.15,11
HCPCS,0587U,Ther rx mntr 60-150rx&metabl,,,102.99,200.25,7
HCPCS,0588T,Revision/removal isdns ptn,,,793.16,15355.43,11
HCPCS,0588U,Nfct ds bct/vir 32genes mrna,,,684.0,1330.0,7
HCPCS,0589T,Elec alys smpl prgrmg iins,,,94.12,428.77,11
HCPCS,0589U,Pfas24cmpnd hi-perf lc-ms/ms,,,178.87,347.8,7
HCPCS,0590T,Elec alys cplx prgrmg iins,,,94.12,428.77,11
HCPCS,0591U,Onc prst8 ca 3prtns plsm srm,,,684.0,1330.0,7
HCPCS,0592U,Onc hl neo dna tgs 417 genes,,,2627.64,5109.3,7
HCPCS,0593U,Nfct ds gu pthgn dna 46trgt,,,571.36,1110.97,7
HCPCS,0594T,Osteot hum xtrnl lngth dev,,,7183.42,31870.39,11
HCPCS,0595U,Nfct ds tfp vctrbrn&zoonotic,,,236.69,460.23,7
HCPCS,0596T,Temp fml iu vlv-pmp 1st insj,,,690.3,3062.63,11
HCPCS,0597T,Temp fml iu valve-pmp rplcmt,,,690.3,3062.63,11
HCPCS,0598T,Ncntc r-t fluor wnd img 1st,,,213.76,999.62,11
HCPCS,0598U,Gi ibs igg antb 18food items,,,270.0,525.0,7
HCPCS,0599U,Onc pncrtc ca mult ia serum,,,807.3,1569.75,7
HCPCS,0600T,HC ABLATION IRREVERSIBLE ELECTROPORATION 1 OR MORE TUMORS PER ORGAN INCLUDING IMAGING GUIDANCE PERCUATANEOUS,44324.0,31026.8,,,0
HCPCS,0600T,Ire abltj 1+tum organ perq,,,10523.19,46687.84,11
HCPCS,0601T,HC ABLATION IRREVERSIBLE ELECTROPORATION 1 OR MORE TUMORS PER ORGAN INCLUDING FLUOROSCOPIC AND ULTRASOUND GUIDANCE OPEN,44324.0,31026.8,,,0
HCPCS,0601T,Ire abltj 1+tumors open,,,10523.19,46687.84,11
HCPCS,0604T,Rem oct rta dev setup&educaj,,,359.78,448.84,4
HCPCS,0605T,Rem oct rta techl sprt min 8,,,112.56,140.43,4
HCPCS,0607T,Rem mntr pulm flu mntr setup,,,359.78,448.84,4
HCPCS,0608T,Rem mntr pulm flu mntr alys,,,112.56,140.43,4
HCPCS,0609T,Mrs disc pain acquisj data,,,236.21,1047.98,11
HCPCS,0611T,Mrs disc pain alg alys data,,,236.21,1047.98,11
HCPCS,0614T,HC REMOVAL AND REPLACEMENT OF SUBSTERNAL IMPLANTABLE DEFIBRILLATOR PULSE GENERATOR,95560.0,66892.0,,,0
HCPCS,0614T,Rmvl&rplcmt ss impl dfb pg,,,22020.42,97697.15,11
HCPCS,0615T,Eye mvmt alys w/o calbrj i&r,,,131.71,584.37,11
HCPCS,0616T,Insertion of iris prosthesis,,,6299.85,7859.22,4
HCPCS,0617T,Insj iris prosth w/rmvl&insj,,,11870.75,14809.06,4
HCPCS,0618T,Insj iris prosth sec io lens,,,11870.75,14809.06,4
HCPCS,0619T,Cysto w/prst8 commissurotomy,,,13374.12,16684.54,4
HCPCS,0620T,Evasc ven artlz tibl/prnl vn,,,43604.58,193458.78,11
HCPCS,0620T,HC RESEARCH ONLY EVASC VEN ARTLZ TIBL/PRNL VN W/TRANSCATH PLACE INTRAVASC STENT GRAFT/CLOSE INCL PERCUT/OPEN VASC ACCESS US VASC ACCESS CATH/INTRAPROC ROADMAP/IMAGE GUIDE RAD SUPERVISON,54125.0,37887.5,,,0
HCPCS,0625T,Auto quan c plaq cptr alys,,,2880.02,3592.89,4
HCPCS,0627T,Perq njx algc fluor lmbr 1st,,,12709.88,56389.43,11
HCPCS,0629T,Perq njx algc ct lmbr 1st,,,12709.88,56389.43,11
HCPCS,0631T,Tc vis lit hyperspectral img,,,74.75,93.25,4
HCPCS,0632T,Perq tcat us abltj nrv p-art,,,18147.73,80515.32,11
HCPCS,0633T,Ct breast w/3d uni c-,,,103.5,459.18,11
HCPCS,0634T,Ct breast w/3d uni c+,,,173.64,770.39,11
HCPCS,0635T,Ct breast w/3d uni c-/c+,,,173.64,770.39,11
HCPCS,0636T,Ct breast w/3d bi c-,,,236.21,1047.98,11
HCPCS,0637T,Ct breast w/3d bi c+,,,345.37,1532.31,11
HCPCS,0638T,Ct breast w/3d bi c-/c+,,,345.37,1532.31,11
HCPCS,0640T,Ncntc nr ifr spctrsc wnd,,,36.98,164.05,7
HCPCS,0641T,Ncntc nr ifr spctrsc wnd img,,,104.75,130.67,4
HCPCS,0644T,Tcat rmvl/dblk icar mas perq,,,5634.46,24998.21,11
HCPCS,0645T,Tcat impltj c sins rdctj dev,,,18147.73,80515.32,11
HCPCS,0646T,HC TTVI/REPLACEMENT PROSTC VALVE PERQ W/RIGHT HEART CATH & ANGRPH,4649.0,3254.3,,,0
HCPCS,0647T,Insj gtube perq mag gastrpxy,,,1899.66,8428.13,11
HCPCS,0648T,Quan mr alys tiss w/o mri,,,921.02,4086.23,11
HCPCS,0649T,Quan mr alys tiss w/mri,,,921.02,4086.23,11
HCPCS,0650T,Prgrmg dev eval scrms remote,,,36.95,163.92,11
HCPCS,0651T,Mag ctrld capsule endoscopy,,,897.89,3983.62,11
HCPCS,0652T,Egd flx transnasal dx br/wa,,,1899.66,8428.13,11
HCPCS,0652T,HC EGD FLEXIBLE TRANSNASAL DX INCL COLLECT SPECIMEN(S) BRUSHING/WASHING,7915.0,5540.5,,,0
HCPCS,0653T,Egd flx transnasal bx 1/ml,,,1899.66,8428.13,11
HCPCS,0653T,HC EGD FLEXIBLE TRANSNASAL W/BIOPSY SINGLE/MULTIPLE,7915.0,5540.5,,,0
HCPCS,0654T,Egd flx transnasal tube/cath,,,3816.79,16933.82,11
HCPCS,0654T,HC EGD FLEXIBLE TRANSNASAL W/INSERTION INTRALUMINAL TUBE/CATHETER,15873.0,11111.1,,,0
HCPCS,0655T,Tprnl focal abltj mal prst8,,,5308.0,23549.82,11
HCPCS,0656T,Vrt bdy tethering ant,,,17357.91,77011.17,7
HCPCS,0657T,Vrt bdy tethering ant 8+ seg,,,17357.91,77011.17,7
HCPCS,0658T,Elec impd spectrsc 1+skn les,,,58.4,259.1,11
HCPCS,0662T,Scalp cool 1st meas&calbrj,,,5607.02,6994.89,4
HCPCS,0671T,Insj ant sgm aq drg dev 1+,,,5267.92,23371.97,11
HCPCS,0673T,Abltj b9 thyr ndul perq lasr,,,1635.03,7254.06,11
HCPCS,0674T,Laps insj nw/rpcmt prm isdss,,,30548.12,135531.68,7
HCPCS,0677T,Laps repos lead isdss 1st ld,,,10523.19,46687.84,7
HCPCS,0679T,Laps rmvl lead isdss,,,10523.19,46687.84,7
HCPCS,0680T,Insj/rplcmt pg only isdss,,,19205.48,85208.23,7
HCPCS,0681T,Rlcj pulse gen only isdss,,,3461.03,15355.43,7
HCPCS,0682T,Removal pulse gen only isdss,,,3461.03,15355.43,7
HCPCS,0686T,Histotripsy mal hepatcel tis,,,16957.63,75235.29,11
HCPCS,0689T,Quan us tis charac w/o dx us,,,86.15,382.23,11
HCPCS,0692T,Therapeutic ultrafiltration,,,1228.27,6840.45,11
HCPCS,0693T,Compre ful bdy 3d mtn alys,,,339.63,1506.81,11
HCPCS,0694T,HC MAGNETIC RESONANCE ALYS TISSUE COMPOSITION W/MRI SINGLE ORGAN,100.0,70.0,,,0
HCPCS,0694T,HC PRO MAGNETIC RESONANCE ALYS TISSUE COMPOSITION W/MRI SINGLE ORGAN,35.0,24.5,,,0
HCPCS,0696T,Bdy surf mapg pm/cvdfb f/up,,,36.95,163.92,11
HCPCS,0697T,Quan mr tis wo mri mlt orgn,,,712.05,4086.23,11
HCPCS,0699T,Njx pst chmbr eye medication,,,2284.67,10136.31,11
HCPCS,0707T,Njx b1 sub mtrl sbchdrl dfct,,,3239.17,14371.12,11
HCPCS,0712T,N-nvs artl plaq alys quan,,,213.76,948.37,11
HCPCS,0714T,Tprnl lsr ablt b9 prst8 hypr,,,5308.0,23549.82,11
HCPCS,0716T,Car acous wavfrm rec cad rsk,,,58.4,259.1,11
HCPCS,0717T,Adrc ther prtl rc tear,,,3508.17,15564.58,7
HCPCS,0718T,Adrc ther prtl rc tear njx,,,3508.17,15564.58,7
HCPCS,0720T,Prq elc nrv stim cn wo implt,,,818.98,1021.7,4
HCPCS,0721T,Quan ct tiss charac w/o ct,,,630.32,2796.52,11
HCPCS,0723T,Qmrcp w/o dx mri sm anat ses,,,921.02,4086.23,11
HCPCS,0731T,Augmnt ai-based fcl phnt a/r,,,58.4,259.1,11
HCPCS,0733T,Rem bdy&lmb knmtc ther sply,,,115.23,1506.81,11
HCPCS,0736T,Colonic lavage 35+l water,,,127.38,565.15,11
HCPCS,0737T,Xenograft impltj artclr surf,,,12709.88,56389.43,7
HCPCS,0740T,Rem auton alg nsln cal setup,,,58.4,259.1,11
HCPCS,0741T,Rem auton alg nsln data coll,,,36.95,163.92,11
HCPCS,0743T,B1 str & fx rsk vrt fx assmt,,,236.21,1047.98,7
HCPCS,0744T,Insj bioprostc vlv fem vn,,,5508.66,24440.06,11
HCPCS,0764T,Asstv alg ecg rsk asmt cncrt,,,131.71,584.37,7
HCPCS,0765T,Asstv alg ecg rsk asmt prev,,,131.71,584.37,7
HCPCS,0766T,Tc mag stimj pn 1st tx 1nrv,,,213.76,948.37,11
HCPCS,0768T,Tc mag stimj pn sbsq tx 1nrv,,,440.65,549.73,4
HCPCS,0775T,Arthrd si jt prq iartic impl,,,66349.82,82773.04,4
HCPCS,0778T,Smmg cncrnt appl imu snr,,,127.38,565.15,11
HCPCS,0779T,Gi myoelectrical actv study,,,369.41,1827.37,11
HCPCS,0780T,Instlj fecal microbiota ssp,,,131.71,584.37,7
HCPCS,0783T,Tc auriculr neurostimulation,,,127.38,565.15,11
HCPCS,0784T,Ins/rplmt eltrd ra spi nstim,,,11030.91,49111.5,11
HCPCS,0785T,Revj/rmvl nea spi w/nstim,,,3461.03,15355.43,11
HCPCS,0786T,Insj/rplcmt prq ra sac nstim,,,11030.91,49111.5,11
HCPCS,0787T,Revj/rmvl nea sac w/nstim,,,3461.03,15355.43,11
HCPCS,0788T,Elec aly smp iins sp/sac nrv,,,94.12,417.57,11
HCPCS,0789T,Elec aly cpx iins sp/sac nrv,,,94.12,417.57,11
HCPCS,0790T,Revj rplcmt/rmvl vrt tethrg,,,17357.91,77011.17,7
HCPCS,0793T,Prq tcat thrm ablt nrv p-art,,,18147.73,80515.32,11
HCPCS,0794T,Pt spec alg rx-onc tx option,,,58.4,259.1,11
HCPCS,0795T,Tcat ins 2chmbr ldls pm cmpl,,,19068.45,84600.26,11
HCPCS,0796T,Tcat ins 2chmbr ldls pm ra,,,22020.42,97697.15,11
HCPCS,0797T,Tcat ins 2chmbr ldls pm rv,,,19068.45,84600.26,11
HCPCS,0798T,Tcat rmv 2chmbr ldls pm cmpl,,,3125.8,13868.13,11
HCPCS,0799T,Tcat rmvl 2chmbr ldls pm ra,,,3125.8,13868.13,11
HCPCS,0800T,Tcat rmvl 2chmbr ldls pm rv,,,3125.8,13868.13,11
HCPCS,0801T,Tcat rmv&rpl 2chmbr ldls pm,,,19068.45,84600.26,11
HCPCS,0802T,Tcat rmv&rpl2chmb ldls pm ra,,,19068.45,84600.26,11
HCPCS,0803T,Tcat rmv&rpl2chmb ldls pm rv,,,19068.45,84600.26,11
HCPCS,0804T,Prgrmg evl ldls pm 2chmbr ip,,,36.95,163.92,11
HCPCS,0807T,Pulm tiss vntj alys prev ct,,,213.76,1131.62,11
HCPCS,0808T,Pulm tiss vntj alys w/ct,,,213.76,1131.62,11
HCPCS,0810T,Subrta njx rx agt w/vtrc,,,4118.65,18273.05,11
HCPCS,0811T,Rem mlt day uroflow setup,,,131.8,584.75,11
HCPCS,0812T,Rem mlt day uroflow dev sply,,,109.02,565.15,11
HCPCS,0813T,Egd vol adjmt bariatric balo,,,897.89,3983.62,11
HCPCS,0816T,Opn insj/rplcmt ins ptn subq,,,19205.48,85208.23,11
HCPCS,0817T,Opn insj/rplcmt ins ptn subf,,,19205.48,85208.23,11
HCPCS,0818T,Revj/rmvl ins ptn subq,,,3461.03,15355.43,11
HCPCS,0819T,Revj/rmvl ins ptn subf,,,3461.03,15355.43,11
HCPCS,0823T,Tcat ins 1chmbr ldls pm ra,,,22020.42,97697.15,11
HCPCS,0824T,Tcat rmv 1chmbr ldls pm ra,,,3125.8,13868.13,11
HCPCS,0825T,Tcat rmv&rpl1chmb ldls pm ra,,,19068.45,84600.26,11
HCPCS,0826T,Prgrmg evl ldls pm 1chmbr ip,,,36.95,163.92,11
HCPCS,0857T,Opto-acoustic img breast uni,,,103.5,459.18,11
HCPCS,0861T,Rmvl pg wcs lv both compnt,,,3699.47,16413.29,11
HCPCS,0862T,Rlcj pg wcs lv battery only,,,2042.58,9062.24,11
HCPCS,0863T,Rlcj pg wcs lv trnsmtr only,,,2042.58,9062.24,11
HCPCS,0864T,Low ntsty eswt corpus cvrnsm,,,247.34,1097.37,11
HCPCS,0865T,Quan mri alys brn w/o dx mri,,,236.21,1047.98,11
HCPCS,0866T,Quan mri alys brn w/dx mri,,,236.21,1047.98,11
HCPCS,0867T,Tpla b9 prst8 hyprplsa>=50ml,,,5308.0,23549.82,7
HCPCS,0868T,Hi-res gastric ep mapping,,,369.41,1638.96,7
HCPCS,0869T,Njx b1 sub mtrl hw fixj aug,,,3239.17,14371.12,7
HCPCS,0872T,Rplcmt ndwllg bldr&prtl cath,,,3544.48,15725.66,7
HCPCS,0873T,Revj subq prtl asct pmp sys,,,3544.48,15725.66,7
HCPCS,0874T,Rmvl pertl ascites pmp sys,,,3544.48,15725.66,7
HCPCS,0884T,Esphgsc flx 1st tndsc dilat,,,6009.99,26664.3,7
HCPCS,0885T,Colsc flx 1st tndsc dilat,,,6009.99,26664.3,7
HCPCS,0886T,Sgmdsc flx 1st tndsc dilat,,,6009.99,26664.3,7
HCPCS,0893T,N-invas assmt bld oxygnation,,,131.71,584.37,7
HCPCS,0897T,N-invas augmnt arrhyt alys,,,850.12,3771.72,7
HCPCS,0898T,N-invas prst8 cancer est map,,,850.12,3771.72,7
HCPCS,0902T,Qtc ntrvl augmnt alg aly ecg,,,131.71,584.37,7
HCPCS,0904T,Ecg alg 12 ld rdcd trcg only,,,58.4,259.1,7
HCPCS,0906T,Coms ther 1st appl<=50 sq cm,,,198.62,881.22,7
HCPCS,0908T,Opn imp int nstm sys vgs nrv,,,30548.12,135531.68,7
HCPCS,0909T,Rplcmt int nstim sys vgs nrv,,,30548.12,135531.68,7
HCPCS,0910T,Rmvl int nstim sys vagus nrv,,,3461.03,15355.43,7
HCPCS,0911T,Elec aly nstm sys vgs nrv wo,,,58.4,259.1,7
HCPCS,0913T,HC PERQ TRANSCATHER THERAPEUTIC DRUG DELIVERY INTRACORONARY DRUG-DELIVERY BALLOON SINGLE MAJOR CORONARY ARTERY OR BRANCH,24273.0,16991.1,,,0
HCPCS,0913T,Prq tcat ther rx ntrac balo1,,,11428.37,50703.82,7
HCPCS,0914T,HC PERQ TRANSCATHER THERAPEUTIC DRUG DELIVERY INTRACORONARY DRUG-DELIVERY BALLOON SEP TARGET LESION SINGLE MAJOR CORONARY ARTERY OR BRANCH,6069.0,4248.3,,,0
HCPCS,0915T,Insj perm ccm-d sys pg&eltrd,,,31073.96,137864.64,7
HCPCS,0916T,Insj perm ccm-d sys pg only,,,22020.42,97697.15,7
HCPCS,0917T,Insj perm ccm-d sys 1 lead,,,8192.37,36346.76,7
HCPCS,0918T,Insj perm ccm-d sys dual ld,,,8192.37,36346.76,7
HCPCS,0923T,Rmvl&rplcmt perm ccm-d pg,,,22020.42,97697.15,7
HCPCS,0924T,Rpos prv ccm-d trnsvns eltrd,,,621.01,2755.21,7
HCPCS,0925T,Rlcj skin pocket ccm-d pg,,,2042.58,9062.24,7
HCPCS,0932T,HC NONINVASIVE DETECTION HEART FAILURE AUGMENTATIVE ANALYSIS ECHOCARDIOGRAM W/INTERP & REPORT,23780.0,16646.0,,,0
HCPCS,0932T,N-invs det hrt fail aug echo,,,304.06,1348.99,7
HCPCS,0933T,Tcat impl wrls l atr prs snr,,,3209.41,14239.05,7
HCPCS,0941T,Cysto flx ins&xpns urtl scaf,,,9371.49,41578.13,7
HCPCS,0942T,Cysto flx rmv&rplc urtl scaf,,,9371.49,41578.13,7
HCPCS,0943T,Cysto flx rmvl urtl scaffold,,,2069.41,9181.28,7
HCPCS,0944T,3d cntr simula trgt lvr les,,,236.21,1047.98,7
HCPCS,0946T,Ortho impl mvmt alys pair ct,,,103.5,459.18,7
HCPCS,0950T,Abltj b9 prst8 tissue hifu,,,9371.49,41578.13,7
HCPCS,0957T,Rev s-sclp eltr ra rcvr&tlmt,,,1591.86,7062.54,7
HCPCS,0958T,Rmv s-sclp eltr ra rcvr&tlmt,,,3239.17,14371.12,7
HCPCS,0959T,Rmv/rplc magnet coil assem,,,1635.03,7254.06,7
HCPCS,0962T,Asstv alg alys acous&ecg rec,,,131.71,584.37,7
HCPCS,0963T,Anosc sbmcsl njx bulking agt,,,1184.64,5255.83,7
HCPCS,0964T,I&cust prep jaw xpnsj 1arch,,,3282.2,14562.0,7
HCPCS,0965T,I&cst prp jw xpn dl arch non,,,3282.2,14562.0,7
HCPCS,0966T,I&cst prp jw xpn dl arch fxd,,,3282.2,14562.0,7
HCPCS,0967T,Tranal ins tmp clrc anst dev,,,1184.64,5255.83,7
HCPCS,0970T,Ablt b9 brst tum perq lsr ea,,,3876.15,17197.18,7
HCPCS,0971T,Ablt mal brst tum pq lsr uni,,,3876.15,17197.18,7
HCPCS,0973T,Slctv nzmtc dbrdmt t/a/l 1st,,,402.44,1785.48,7
HCPCS,0975T,Slctv nzmtc dbrdmt s/n/hf 1,,,402.44,1785.48,7
HCPCS,0977T,Upr gi bld detcj snr capsule,,,897.89,3983.62,7
HCPCS,0981T,Tcat impl wrls ivc snr,,,18147.73,80515.32,7
HCPCS,0982T,Rem mntr impl ivc snr set-up,,,131.8,584.75,7
HCPCS,0989T,Revj/rmvl ins ptn subq&subf,,,3461.03,15355.43,7
HCPCS,0991T,Cysto lo-nrg lithtrp&mcrsphr,,,9371.49,41578.13,7
HCPCS,0992T,N-invas assmt car rsk w/o ct,,,236.21,1047.98,7
HCPCS,0993T,N-invas assmt car rsk w/ct,,,236.21,1047.98,7
HCPCS,1,"DUMMY EAP FOR NSA - SUPPLIES  - $1,000 INCREMENT",1000.0,700.0,,,0
HCPCS,10004,Fna bx w/o img gdn ea addl,,,134.9,168.29,4
HCPCS,10004,HC FINE NEEDLE ASPIRATION BIOPSY W/O IMAGE GUIDE EACH ADDTL LESION,213.0,149.1,,,0
HCPCS,10004,HC PRO FINE NEEDLE ASPIRATION BIOPSY W/O IMAGE GUIDE EACH ADDTL LESION,79.0,55.3,,,0
HCPCS,10005,Fna bx w/us gdn 1st les,,,701.03,3110.22,11
HCPCS,10005,HC FINE NEEDLE ASPIRATION BIOPSY INCL ULTRASOUND GUIDANCE FIRST LESION,2308.0,1615.6,,,0
HCPCS,10005,HC PRO FINE NEEDLE ASPIRATION BIOPSY INCL ULTRASOUND GUIDANCE FIRST LESION,172.0,120.4,,,0
HCPCS,10006,Fna bx w/us gdn ea addl,,,152.89,190.74,4
HCPCS,10006,HC FINE NEEDLE ASPIRATION BIOPSY INCL ULTRASOUND GUIDANCE EACH ADDTL LESION,1154.0,807.8,,,0
HCPCS,10007,Fna bx w/fluor gdn 1st les,,,701.03,3110.22,11
HCPCS,10007,HC FINE NEEDLE ASPIRATION BIOPSY INCL FLUORO GUIDANCE FIRST LESION,2308.0,1615.6,,,0
HCPCS,10008,Fna bx w/fluor gdn ea addl,,,189.25,236.1,4
HCPCS,10009,Fna bx w/ct gdn 1st les,,,701.03,3110.22,11
HCPCS,10009,HC FINE NEEDLE ASPIRATION BIOPSY INCL CT GUIDANCE FIRST LESION,2539.0,1777.3,,,0
HCPCS,10010,Fna bx w/ct gdn ea addl,,,256.0,319.37,4
HCPCS,10010,HC FINE NEEDLE ASPIRATION BIOPSY INCL CT GUIDANCE EACH ADDTL LESION,294.0,205.8,,,0
HCPCS,10011,Fna bx w/mr gdn 1st les,,,701.03,3110.22,11
HCPCS,10011,HC FINE NEEDLE ASPIRATION BIOPSY INCL MRI GUIDANCE FIRST LESION,2542.0,1779.4,,,0
HCPCS,10012,Fna bx w/mr gdn ea addl,,,871.43,1087.13,4
HCPCS,10012,HC FINE NEEDLE ASPIRATION BIOPSY INCL MRI GUIDANCE EACH ADDTL LESION,947.0,662.9,,,0
HCPCS,10021,FNA W/O IMAGE,424.0,296.8,,,0
HCPCS,10021,Fna w/o image,,,222.01,1785.48,11
HCPCS,10021,HC PRO FNA W/O IMAGE,125.0,87.5,,,0
HCPCS,1002T,Air displacmnt plethysmograp,,,28.63,127.04,7
HCPCS,10030,Guide cathet fluid drainage,,,701.03,3110.22,11
HCPCS,10030,HC IMAGE GUIDED FLUID COLLECTION BY CATH PERCU SOFT TISSUE,1294.0,905.8,,,0
HCPCS,10035,HC PLACEMENT SOFT TISS LOC DEVICE PLMT W/GUIDANCE 1ST LESION,2682.0,1877.4,,,0
HCPCS,10035,HC PRO PLACEMENT SOFT TISS LOC DEVICE PLMT W/GUIDANCE 1ST LESION,589.0,412.3,,,0
HCPCS,10035,Perq dev soft tiss 1st imag,,,701.03,3110.22,11
HCPCS,10036,HC PLACEMENT SOFT TISS LOC DEVICE PLMT W/GUIDANCE EACH ADDTL LESION,175.0,122.5,,,0
HCPCS,10036,HC PRO PLACEMENT SOFT TISS LOC DEVICE PLMT W/GUIDANCE EACH ADDTL LESION,509.0,356.3,,,0
HCPCS,10036,Perq dev soft tiss add imag,,,135.44,168.97,4
HCPCS,1003T,Arthrp 1st crp/mtcrpl prostc,,,12709.88,56389.43,7
HCPCS,10040,Acne surgery,,,158.65,881.22,11
HCPCS,1004T,Elec alys s-scl eeg wo prgrm,,,131.71,584.37,7
HCPCS,10060,Drainage of skin abscess,,,198.62,949.72,11
HCPCS,10060,HC PRO I&D SKIN SUBQ ABSCESS SIMPLE,347.0,242.9,,,0
HCPCS,10060,I&D SKIN SUBQ ABSCESS SIMPLE,287.0,200.9,,,0
HCPCS,10061,Drainage of skin abscess,,,216.28,1785.48,11
HCPCS,10061,HC PRO I&D SKIN SUBQ ABSCESS COMPLEX,1030.0,721.0,,,0
HCPCS,10061,I&D SKIN SUBQ ABSCESS COMPLEX,287.0,200.9,,,0
HCPCS,10080,Drainage of pilonidal cyst,,,175.46,3110.22,11
HCPCS,10080,HC PRO I&D PILONIDAL CYST SIMPLE,455.0,318.5,,,0
HCPCS,10080,I&D PILONIDAL CYST SIMPLE,287.0,200.9,,,0
HCPCS,10081,Drainage of pilonidal cyst,,,701.03,3110.22,11
HCPCS,10081,HC I&D PILONIDAL CYST COMPLEX,1361.0,952.7,,,0
HCPCS,10081,HC PRO I&D PILONIDAL CYST COMPLEX,554.0,387.8,,,0
HCPCS,1008T,Rem mntr s-scl eeg sys setup,,,131.8,584.75,7
HCPCS,1010T,Cptr oph alys monoc eye mvmt,,,131.71,584.37,7
HCPCS,10120,HC PRO I&D REM FB SUBQ SIMPLE,411.0,287.7,,,0
HCPCS,10120,I&D REM FB SUBQ SIMPLE,424.0,296.8,,,0
HCPCS,10120,Remove foreign body,,,402.44,1867.31,11
HCPCS,10121,HC PRO  I&D REM FB SUBQ COMPLICAT,781.0,546.7,,,0
HCPCS,10121,I&D REM FB SUBQ COMPLICAT,1886.0,1320.2,,,0
HCPCS,10121,Remove foreign body,,,1635.03,7254.06,11
HCPCS,10140,Drainage of hematoma/fluid,,,1635.03,10205.34,11
HCPCS,10140,HC I&D HEMATOMA SEROMA,1369.0,958.3,,,0
HCPCS,10140,HC PRO I&D HEMATOMA SEROMA,215.0,150.5,,,0
HCPCS,10160,HC PRO PUNCTURE ASPIRATION ABSCESS/HEMATOMA/BULLA/CYST,157.0,109.9,,,0
HCPCS,10160,HC PUNCTURE ASPIRATION ABSCESS/HEMATOMA/BULLA/CYST,336.0,235.2,,,0
HCPCS,10160,Puncture drainage of lesion,,,402.44,3978.44,11
HCPCS,10180,Complex drainage wound,,,2875.57,12757.95,11
HCPCS,10180,HC COMPLEX DRAINAGE WOUND,8925.0,6247.5,,,0
HCPCS,10180,HC PRO INCISION & DRAINAGE COMPLEX POSTOPERATIVE WOUND INFECTION,409.0,286.3,,,0
HCPCS,1019T,Lymphovenous bypass per xtr,,,6573.55,29164.62,7
HCPCS,1020T,Raman spectroscopy 1+skn les,,,58.4,259.1,7
HCPCS,1021T,Active thrc irrigation spx,,,621.01,2755.21,7
HCPCS,1025T,Alt elec fld dos&dlv sim mdl,,,133.06,590.34,7
HCPCS,11000,Debride infected skin,,,402.44,1785.48,11
HCPCS,11000,HC DEBRID SKIN UP TO 10% BODY SURF,424.0,296.8,,,0
HCPCS,11000,HC PRO DEBRID SKIN UP TO 10% BODY SURF,56.0,39.2,,,0
HCPCS,11001,Debride infected skin add-on,,,158.65,197.92,4
HCPCS,11010,Debride skin at fx site,,,701.03,3110.22,11
HCPCS,11011,Debride skin musc at fx site,,,701.03,3110.22,11
HCPCS,11011,HC DEBRIDE SKIN/MUSCLE FX,2563.0,1794.1,,,0
HCPCS,11012,Deb skin bone at fx site,,,2171.2,12757.95,11
HCPCS,11042,Deb subq tissue 20 sq cm/<,,,402.44,5017.3,11
HCPCS,11042,HC DEBRIDE SUBQ TISSUE FIRST 20 SQ CM OR LESS,789.0,552.3,,,0
HCPCS,11042,HC PRO DEBRIDE SUBQ TISSUE FIRST 20 SQ CM OR LESS,101.0,70.7,,,0
HCPCS,11043,Deb musc/fascia 20 sq cm/<,,,731.66,3246.12,11
HCPCS,11043,HC DEBRID MUSC/FASCIA FIRST 20 SQ CM OR LESS,424.0,296.8,,,0
HCPCS,11043,HC PRO DEBRIDE MUSC/FASCIA FIRST 20SQ CM OR LESS,1008.0,705.6,,,0
HCPCS,11044,Deb bone 20 sq cm/<,,,1635.03,7254.06,11
HCPCS,11044,HC DEBRID BONE 1ST 20 SQ CM,1233.0,863.1,,,0
HCPCS,11044,HC PRO DEBRID BONE 1ST 20 SQ CM,390.0,273.0,,,0
HCPCS,11045,Deb subq tissue add-on,,,570.12,711.24,4
HCPCS,11045,HC DBRDMT SUB TIS EACH ADDL 20 SQ CM,68.0,47.6,,,0
HCPCS,11046,Deb musc/fascia add-on,,,1499.32,1870.44,4
HCPCS,11046,HC DBRDMT MUSCLE AND/OR FASCIA EA ADDTL 20 SQ CM,171.0,119.7,,,0
HCPCS,11047,Deb bone add-on,,,1772.43,2211.15,4
HCPCS,11047,HC DBRMT BONE EA ADDL 20 SQ CM,341.0,238.7,,,0
HCPCS,11055,Trim skin lesion,,,158.65,881.22,11
HCPCS,11056,Trim skin lesions 2 to 4,,,158.65,881.22,11
HCPCS,11057,Trim skin lesions over 4,,,198.62,881.22,11
HCPCS,11102,HC PRO TANGENTIAL BIOPSY OF SKIN SINGLE LESION,112.0,78.4,,,0
HCPCS,11102,HC TANGENTIAL BIOPSY OF SKIN SINGLE LESION,704.0,492.8,,,0
HCPCS,11102,Tangntl bx skin single les,,,402.44,1785.48,11
HCPCS,11103,HC PRO TANGENTIAL BIOPSY OF SKIN EACH SEPARATE/ADDTL LESION,60.0,42.0,,,0
HCPCS,11103,HC TANGENTIAL BIOPSY OF SKIN EACH SEPARATE/ADDTL LESION,79.0,55.3,,,0
HCPCS,11103,Tangntl bx skin ea sep/addl,,,69.57,86.79,4
HCPCS,11104,HC PRO PUNCH BIOPSY OF SKIN INCL SIMPLE CLOSURE SINGLE LESION,234.0,163.8,,,0
HCPCS,11104,HC PUNCH BIOPSY OF SKIN INCL SIMPLE CLOSURE SINGLE LESION,740.0,518.0,,,0
HCPCS,11104,Punch bx skin single lesion,,,402.44,1785.48,11
HCPCS,11105,HC PRO PUNCH BIOPSY OF SKIN INCL SIMPLE CLOSURE EACH SEPARATE/ADDTL LESION,84.0,58.8,,,0
HCPCS,11105,HC PUNCH BIOPSY OF SKIN INCL SIMPLE CLOSURE EACH SEPARATE/ADDTL LESION,352.0,246.4,,,0
HCPCS,11105,Punch bx skin ea sep/addl,,,81.14,101.23,4
HCPCS,11106,HC INCISIONAL BIOPSY OF SKIN INCL SIMPLE CLOSURE SINGLE LESION,1251.0,875.7,,,0
HCPCS,11106,HC PRO INCISIONAL BIOPSY OF SKIN INCL SIMPLE CLOSURE SINGLE LESION,106.0,74.2,,,0
HCPCS,11106,Incal bx skn single les,,,731.66,3246.12,11
HCPCS,11107,HC INCISIONAL BIOPSY OF SKIN EACH SEPARATE/ADDT LESION,626.0,438.2,,,0
HCPCS,11107,HC PRO INCISIONAL BIOPSY OF SKIN EACH SEPARATE/ADDT LESION,102.0,71.4,,,0
HCPCS,11107,Incal bx skn ea sep/addl,,,96.84,120.81,4
HCPCS,11200,HC PRO REMOVAL OF SKIN TAGS,106.0,74.2,,,0
HCPCS,11200,HC REMOVAL OF SKIN TAGS,198.0,138.6,,,0
HCPCS,11200,Removal of skin tags <w/15,,,198.62,6731.32,11
HCPCS,11201,Remove skin tags add-on,,,291.97,364.24,4
HCPCS,11300,Shave skin lesion 0.5 cm/<,,,158.65,1785.48,11
HCPCS,11301,HC PRO SHAVING EPIDERMAL/DERMAL LESION SINGLE LESION TRUNK/ARMS/LEGS 0.6-1.0 CM,173.0,121.1,,,0
HCPCS,11301,HC SHAVING EPIDERMAL/DERMAL LESION SINGLE LESION TRUNK/ARMS/LEGS 0.6-1.0 CM,724.0,506.8,,,0
HCPCS,11301,Shave skin lesion 0.6-1.0 cm,,,158.65,881.22,11
HCPCS,11302,Shave skin lesion 1.1-2.0 cm,,,198.62,2785.39,11
HCPCS,11303,Shave skin lesion >2.0 cm,,,402.44,3360.79,11
HCPCS,11305,Shave skin lesion 0.5 cm/<,,,158.65,881.22,11
HCPCS,11306,Shave skin lesion 0.6-1.0 cm,,,158.65,881.22,11
HCPCS,11307,Shave skin lesion 1.1-2.0 cm,,,158.65,881.22,11
HCPCS,11308,Shave skin lesion >2.0 cm,,,158.65,1785.48,11
HCPCS,11310,Shave skin lesion 0.5 cm/<,,,158.65,881.22,11
HCPCS,11311,Shave skin lesion 0.6-1.0 cm,,,158.65,881.22,11
HCPCS,11312,Shave skin lesion 1.1-2.0 cm,,,158.65,1785.48,11
HCPCS,11313,Shave skin lesion >2.0 cm,,,158.65,1785.48,11
HCPCS,11400,Exc tr-ext b9+marg 0.5 cm<,,,701.03,5098.34,11
HCPCS,11400,HC EXC TR-EXT BEN MARG 0.5 <CM,4687.0,3280.9,,,0
HCPCS,11400,HC PRO EXC TR-EXT BEN MARG 0.5<CM,145.0,101.5,,,0
HCPCS,11401,Exc tr-ext b9+marg 0.6-1 cm,,,402.44,1785.48,11
HCPCS,11402,Exc tr-ext b9+marg 1.1-2 cm,,,701.03,3110.22,11
HCPCS,11403,Exc tr-ext b9+marg 2.1-3cm/<,,,701.03,4932.1,11
HCPCS,11404,Exc tr-ext b9+marg 3.1-4 cm,,,1635.03,7254.06,11
HCPCS,11406,Exc tr-ext b9+marg >4.0 cm,,,1635.03,7254.06,11
HCPCS,11420,Exc h-f-nk-sp b9+marg 0.5/<,,,1635.03,7254.06,11
HCPCS,11421,Exc h-f-nk-sp b9+marg 0.6-1,,,701.03,3711.87,11
HCPCS,11422,Exc h-f-nk-sp b9+marg 1.1-2,,,1635.03,7254.06,11
HCPCS,11423,Exc h-f-nk-sp b9+marg 2.1-3,,,1635.03,7254.06,11
HCPCS,11423,HC PRO EXC H-F-NK-SP BEN MARG 2.1-3,351.0,245.7,,,0
HCPCS,11424,Exc h-f-nk-sp b9+marg 3.1-4,,,1635.03,7254.06,11
HCPCS,11426,Exc h-f-nk-sp b9+marg >4 cm,,,2803.52,12757.95,11
HCPCS,11440,Exc face-mm b9+marg 0.5 cm/<,,,701.03,6721.57,11
HCPCS,11441,EXC FACE-MM B9+MARG 0.6-1CM,6671.0,4669.7,,,0
HCPCS,11441,Exc face-mm b9+marg 0.6-1 cm,,,701.03,7657.8,11
HCPCS,11442,EXC FACE-MM B9+MARG 1.1-2 CM,7671.0,5369.7,,,0
HCPCS,11442,Exc face-mm b9+marg 1.1-2 cm,,,701.03,3110.22,11
HCPCS,11443,Exc face-mm b9+marg 2.1-3 cm,,,1635.03,7254.06,11
HCPCS,11444,Exc face-mm b9+marg 3.1-4 cm,,,1635.03,7254.06,11
HCPCS,11446,Exc face-mm b9+marg >4 cm,,,2875.57,12757.95,11
HCPCS,11450,Removal sweat gland lesion,,,2875.57,12757.95,11
HCPCS,11451,Removal sweat gland lesion,,,2875.57,12757.95,11
HCPCS,11462,Removal sweat gland lesion,,,2875.57,12757.95,11
HCPCS,11463,Removal sweat gland lesion,,,2875.57,12757.95,11
HCPCS,11470,Removal sweat gland lesion,,,2875.57,12757.95,11
HCPCS,11471,Removal sweat gland lesion,,,2875.57,12757.95,11
HCPCS,11500001,HC ROOM&CARE HOSPICE,1163.0,814.1,,,0
HCPCS,11600,Exc tr-ext mal+marg 0.5 cm/<,,,701.03,3110.22,11
HCPCS,11601,Exc tr-ext mal+marg 0.6-1 cm,,,701.03,3913.2,11
HCPCS,11602,Exc tr-ext mal+marg 1.1-2 cm,,,402.44,1785.48,11
HCPCS,11603,Exc tr-ext mal+marg 2.1-3 cm,,,701.03,3360.79,11
HCPCS,11604,Exc tr-ext mal+marg 3.1-4 cm,,,701.03,3360.79,11
HCPCS,11606,Exc tr-ext mal+marg >4 cm,,,1635.03,7254.06,11
HCPCS,11620,Exc h-f-nk-sp mal+marg 0.5/<,,,1635.03,7254.06,11
HCPCS,11621,Exc s/n/h/f/g mal+mrg 0.6-1,,,701.03,6721.57,11
HCPCS,11622,Exc s/n/h/f/g mal+mrg 1.1-2,,,701.03,3110.22,11
HCPCS,11623,Exc s/n/h/f/g mal+mrg 2.1-3,,,1635.03,7254.06,11
HCPCS,11624,Exc s/n/h/f/g mal+mrg 3.1-4,,,1635.03,7254.06,11
HCPCS,11626,Exc s/n/h/f/g mal+mrg >4 cm,,,2693.96,12757.95,11
HCPCS,11640,Exc f/e/e/n/l mal+mrg 0.5cm<,,,701.03,3110.22,11
HCPCS,11641,Exc f/e/e/n/l mal+mrg 0.6-1,,,701.03,3110.22,11
HCPCS,11642,Exc f/e/e/n/l mal+mrg 1.1-2,,,701.03,5336.73,11
HCPCS,11643,Exc f/e/e/n/l mal+mrg 2.1-3,,,1440.79,7254.06,11
HCPCS,11644,Exc f/e/e/n/l mal+mrg 3.1-4,,,1635.03,7254.06,11
HCPCS,11646,Exc f/e/e/n/l mal+mrg >4 cm,,,2651.47,12757.95,11
HCPCS,11719,HC PRO TRIMMING NONDYSTROPHIC NAILS ANY NUMBER,20.0,14.0,,,0
HCPCS,11719,HC TRIMMING NONDYSTROPHIC NAILS ANY NUMBER,223.0,156.1,,,0
HCPCS,11719,Trim nail(s) any number,,,58.4,259.1,11
HCPCS,11720,Debride nail 1-5,,,58.4,259.1,11
HCPCS,11721,Debride nail 6 or more,,,58.4,259.1,11
HCPCS,11730,HC PRO REM NAIL PLATE SINGLE,157.0,109.9,,,0
HCPCS,11730,HC REM NAIL PLATE SINGL,218.0,152.6,,,0
HCPCS,11730,Removal of nail plate,,,198.62,881.22,11
HCPCS,11732,HC AVULSION NAIL PLATE COMPLETE/SIMPLE EACH ADDITIONAL NAIL PLATE,97.0,67.9,,,0
HCPCS,11732,HC PRO AVULSION NAIL PLATE COMPLETE/SIMPLE EACH ADDITIONAL NAIL PLATE,68.0,47.6,,,0
HCPCS,11732,Remove nail plate add-on,,,780.52,973.72,4
HCPCS,11740,Drain blood from under nail,,,84.25,584.37,11
HCPCS,11740,HC DRAIN BLOOD FROM UNDER NAIL,112.0,78.4,,,0
HCPCS,11740,HC PRO DRAIN BLOOD FROM UNDER NAIL,106.0,74.2,,,0
HCPCS,11750,HC EXC NAIL BED,578.0,404.6,,,0
HCPCS,11750,HC PRO EXC NAIL BED,299.0,209.3,,,0
HCPCS,11750,Removal of nail bed,,,402.44,4787.48,11
HCPCS,11755,Biopsy nail unit,,,701.03,3110.22,11
HCPCS,11760,HC PRO REPAIR NAIL BED,1041.0,728.7,,,0
HCPCS,11760,HC REPAIR NAIL BED,352.0,246.4,,,0
HCPCS,11760,Repair of nail bed,,,264.92,3246.12,11
HCPCS,11762,Reconstruction of nail bed,,,2042.58,9062.24,11
HCPCS,11765,Excision of nail fold toe,,,291.97,1785.48,11
HCPCS,11765,HC EXCISION OF NAIL FOLD TOE,163.0,114.1,,,0
HCPCS,11765,HC PRO EXCISION OF NAIL FOLD TOE,194.0,135.8,,,0
HCPCS,11770,Remove pilonidal cyst simple,,,2875.57,12757.95,11
HCPCS,11771,Remove pilonidal cyst exten,,,2875.57,12757.95,11
HCPCS,11772,Remove pilonidal cyst compl,,,2875.57,12757.95,11
HCPCS,11900,HC INJ INTRALESIONAL UP TO AND INCL 7 LESIONS,724.0,506.8,,,0
HCPCS,11900,Inject skin lesions <=w 7,,,158.65,881.22,11
HCPCS,11901,HC INJECTION INTRALESIONAL MORE THAN 7 LESIONS,833.0,583.1,,,0
HCPCS,11901,Inject skin lesions >7,,,158.65,881.22,11
HCPCS,11920,Correct skin color 6.0 cm/<,,,421.14,3246.12,11
HCPCS,11921,Correct skn color 6.1-20.0cm,,,421.14,3246.12,11
HCPCS,11922,Correct skin color ea 20.0cm,,,421.14,525.38,4
HCPCS,11950,Tx contour defects 1 cc/<,,,198.62,881.22,11
HCPCS,11951,Tx contour defects 1.1-5.0cc,,,255.91,3246.12,11
HCPCS,11952,Tx contour defects 5.1-10cc,,,255.91,3246.12,11
HCPCS,11954,Tx contour defects >10.0 cc,,,255.91,3246.12,11
HCPCS,11960,Insert tissue expander(s),,,3508.17,15564.58,11
HCPCS,11970,Replace tissue expander,,,4905.27,31870.39,11
HCPCS,11971,Remove tissue expander(s),,,2745.28,12757.95,11
HCPCS,11976,HC PRO REMOVAL CONTRACEPTIVE CAP,162.0,113.4,,,0
HCPCS,11976,HC REMOVAL CONTRACEPTIVE CAP,335.0,234.5,,,0
HCPCS,11976,Remove contraceptive capsule,,,701.03,3110.22,11
HCPCS,11980,Implant hormone pellet(s),,,126.23,1962.08,11
HCPCS,11981,HC INSERT DRUG IMPLANT DEVICE,501.0,350.7,,,0
HCPCS,11981,Insert drug implant device,,,126.23,584.37,11
HCPCS,11982,HC REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,198.0,138.6,,,0
HCPCS,11982,Remove drug implant device,,,442.24,3360.79,11
HCPCS,11983,Remove/insert drug implant,,,126.23,1962.08,11
HCPCS,1200,HC PRO ANESTH HIP JOINT PROCEDURE,125.0,87.5,,,0
HCPCS,12000001,HC ROOM&CARE ACUTE,1198.0,838.6,,,0
HCPCS,12000004,HC ROOM&CARE SNF SEMI,847.0,592.9,,,0
HCPCS,12000008,HC ROOM & CARE ACUTE HOSPITAL AT HOME,1198.0,838.6,,,0
HCPCS,12000009,HC ROOM & CARE ACUTE HOSPICE HOUSE,1163.0,814.1,,,0
HCPCS,12001,HC PRO SIMPLE REPAIR SUPRFCL WNDS S/N/A/GEN/TNK EXT INCL HANDS & FEET 2.5 CM OR LESS,569.0,398.3,,,0
HCPCS,12001,HC SIMPLE REPAIR SUPRFCL WNDS S/N/A/GEN/TNK EXT INCL HANDS & FEET 2.5 CM OR LESS,413.0,289.1,,,0
HCPCS,12001,Rpr s/n/ax/gen/trnk 2.5cm/<,,,198.62,881.22,11
HCPCS,12002,HC PRO SIMPLE REPAIR SUPRFCL WNDS S/N/AX/GEN/TRNK EXT INCL HANDS & FEET 2.6 -7.5 CM,711.0,497.7,,,0
HCPCS,12002,HC SIMPLE REPAIR SUPRFCL WNDS S/N/AX/GEN/TRNK EXT INCL HANDS & FEET 2.6--7.5 CM,455.0,318.5,,,0
HCPCS,12002,Rpr s/n/ax/gen/trnk2.6-7.5cm,,,198.62,881.22,11
HCPCS,12004,HC PRO SIMPLE REPAIR SUPRFCL WNDS S/N/AX/GEN/TRK EXT INCL HANDS & FEET 7.6-12.5 CM,851.0,595.7,,,0
HCPCS,12004,HC SIMPLE REPAIR SUPRFCL WNDS S/N/AX/GEN/TRK EXT INCL HANDS & FEET 7.6-12.5 CM,478.0,334.6,,,0
HCPCS,12004,Rpr s/n/ax/gen/trk7.6-12.5cm,,,198.62,881.22,11
HCPCS,12005,HC PRO SIMPLE REPAIR SUPRFCL WNDS S/N/A/GEN/TRK EXT INCL HANDS & FEET 12.6-20.0 CM,1088.0,761.6,,,0
HCPCS,12005,HC SIMPLE REPAIR SUPRFCL WNDS S/N/A/GEN/TRK EXT INCL HANDS & FEET 12.6-20.0 CM,500.0,350.0,,,0
HCPCS,12005,Rpr s/n/a/gen/trk12.6-20.0cm,,,392.61,1785.48,11
HCPCS,12006,HC PRO SIMPLE REPAIR SUPRFCL WNDS S/N/A/GEN/TRK EXT INCL HANDS & FEET 20.1-30.0 CM,1378.0,964.6,,,0
HCPCS,12006,HC SIMPLE REPAIR SUPRFCL WNDS S/N/A/GEN/TRK EXT INCL HANDS & FEET 20.1-30.0 CM,525.0,367.5,,,0
HCPCS,12006,Rpr s/n/a/gen/trk20.1-30.0cm,,,402.44,1785.48,11
HCPCS,12007,HC PRO SIMPLE REPAIR SUPRFCL WNDS S/N/A/GEN/TRNK EXT INCL HANDS & FEET OVER 30.0 CM,1357.0,949.9,,,0
HCPCS,12007,HC SIMPLE REPAIR SUPRFCL WNDS S/N/A/GEN/TRNK EXT INCL HANDS & FEET OVER 30.0 CM,553.0,387.1,,,0
HCPCS,12007,Rpr s/n/ax/gen/trnk >30.0 cm,,,198.62,881.22,11
HCPCS,12011,HC PRO SIMPLE REPAIR SUPRFCL WNDS F/E/E/N/L/M 2.5 CM LESS,621.0,434.7,,,0
HCPCS,12011,HC SIMPLE REPAIR SUPRFCL WNDS F/E/E/N/L/M 2.5 CM LESS,413.0,289.1,,,0
HCPCS,12011,Rpr f/e/e/n/l/m 2.5 cm/<,,,198.62,881.22,11
HCPCS,12013,HC PRO SIMPLE REPAIR SUPRFCL WNDS F/E/E/N/L/M 2.6-5.0 CM,858.0,600.6,,,0
HCPCS,12013,HC SIMPLE REPAIR SUPRFCL WNDS F/E/E/N/L/M 2.6-5.0 CM,435.0,304.5,,,0
HCPCS,12013,Rpr f/e/e/n/l/m 2.6-5.0 cm,,,198.62,881.22,11
HCPCS,12014,HC PRO SIMPLE REPAIR SUPRFCL WNDS F/E/E/N/L/M 5.1-7.5 CM,980.0,686.0,,,0
HCPCS,12014,HC SIMPLE REPAIR SUPRFCL WNDS F/E/E/N/L/M 5.1-7.5 CM,455.0,318.5,,,0
HCPCS,12014,Rpr f/e/e/n/l/m 5.1-7.5 cm,,,198.62,881.22,11
HCPCS,12015,HC PRO SIMPLE REPAIR SUPRFCL WNDS F/E/E/N/L/M 5.1-7.5 CM,1008.0,705.6,,,0
HCPCS,12015,HC SIMPLE REPAIR SUPRFCL WNDS F/E/E/N/L/M 7.6-12.5 CM,478.0,334.6,,,0
HCPCS,12015,Rpr f/e/e/n/l/m 7.6-12.5 cm,,,198.62,881.22,11
HCPCS,12016,HC PRO SIMPLE REPAIR SUPRFCL WNDS F/E/E/N/L/M 12.6-20.0 CM,1092.0,764.4,,,0
HCPCS,12016,HC SIMPLE REPAIR SUPRFCL WNDS F/E/E/N/L/M 12.6-20.0 CM,500.0,350.0,,,0
HCPCS,12016,Rpr fe/e/en/l/m 12.6-20.0 cm,,,376.1,1785.48,11
HCPCS,12017,HC SIMPLE RPR WND 20.1-30.0 CM,1289.0,902.3,,,0
HCPCS,12017,Rpr fe/e/en/l/m 20.1-30.0 cm,,,255.91,1785.48,11
HCPCS,12018,HC SIMPLE REPAIR SUPRFCL WNDS F/E/E/N/L/M OVER 30.0 CM,1483.0,1038.1,,,0
HCPCS,12018,Rpr f/e/e/n/l/m >30.0 cm,,,198.62,881.22,11
HCPCS,12020,Closure of split wound,,,731.66,4116.6,11
HCPCS,12020,HC CLOSURE OF SPLIT WOUND,592.0,414.4,,,0
HCPCS,12020,HC PRO CLOSURE OF SPLIT WOUND,341.0,238.7,,,0
HCPCS,12021,Closure of split wound,,,402.44,1785.48,11
HCPCS,12031,HC PRO REP INT WND S/A/T/EXT <2.5CM,822.0,575.4,,,0
HCPCS,12031,HC REP INT WND S/A/T/EXT <2.5 CM,455.0,318.5,,,0
HCPCS,12031,Intmd rpr s/a/t/ext 2.5 cm/<,,,402.44,1785.48,11
HCPCS,12032,HC PRO REP INT WND S/A/T/EXT 2.6-7.5CM,880.0,616.0,,,0
HCPCS,12032,HC REP INT WND S/A/T/EXT 2.6-7.5 CM,500.0,350.0,,,0
HCPCS,12032,Intmd rpr s/a/t/ext 2.6-7.5,,,402.44,1785.48,11
HCPCS,12034,HC PRO REP INT WND S/A/T/EXT 7.6-12.5,1518.0,1062.6,,,0
HCPCS,12034,HC REP INT WND S/A/T/EXT 7.6-12.5,525.0,367.5,,,0
HCPCS,12034,Intmd rpr s/tr/ext 7.6-12.5,,,402.44,2281.74,11
HCPCS,12035,HC PRO REP INT WND S/A/T/EXT 12.6-20.0,1093.0,765.1,,,0
HCPCS,12035,HC REP INT WND S/A/T/EXT 12.6-20.0,553.0,387.1,,,0
HCPCS,12035,Intmd rpr s/a/t/ext 12.6-20,,,402.44,1785.48,11
HCPCS,12036,HC PRO REP INT WND S/A/T/EXT 20.1-30,1376.0,963.2,,,0
HCPCS,12036,HC REP INT WND S/A/T/EXT 20.1-30,575.0,402.5,,,0
HCPCS,12036,Intmd rpr s/a/t/ext 20.1-30,,,432.56,3246.12,11
HCPCS,12037,HC PRO REPAIR INTERMED WND S/A/T/EXT (EXCL HANDS & FEET) OVER 30.0 CM,1682.0,1177.4,,,0
HCPCS,12037,HC REPAIR INTERMED WND S/A/T/EXT (EXCL HANDS & FEET) OVER 30.0 CM,601.0,420.7,,,0
HCPCS,12037,Intmd rpr s/tr/ext >30.0 cm,,,2042.58,9062.24,11
HCPCS,12041,HC PRO REP INT WND N/H/F/GNT<2.5CM,803.0,562.1,,,0
HCPCS,12041,HC REP INT WND N/H/F/GNT<2.5 CM,455.0,318.5,,,0
HCPCS,12041,Intmd rpr n-hf/genit 2.5cm/<,,,402.44,2011.43,11
HCPCS,12042,HC PRO REP INT WND N/H/F/GNT2.6-7.5,983.0,688.1,,,0
HCPCS,12042,HC REP INT WND N/H/F/GNT2.6-7.5,500.0,350.0,,,0
HCPCS,12042,Intmd rpr n-hf/genit2.6-7.5,,,402.44,1785.48,11
HCPCS,12044,HC PRO REP INT WND N/H/F/GNT7.6-12.5,271.0,189.7,,,0
HCPCS,12044,HC REP INT WND N/H/F/GNT7.6-12.5,525.0,367.5,,,0
HCPCS,12044,Intmd rpr n-hf/genit7.6-12.5,,,731.66,3828.9,11
HCPCS,12045,HC PRO REP INT WND N/H/F/GNT 12.6-20.0,1167.0,816.9,,,0
HCPCS,12045,HC REP INT WND N/H/F/GNT 12.6-20.0,548.0,383.6,,,0
HCPCS,12045,Intmd rpr n-hf/genit12.6-20,,,731.66,3246.12,11
HCPCS,12046,HC PRO REP INT WND N/H/F/GNT20.1-30,836.0,585.2,,,0
HCPCS,12046,HC REP INT WND N/H/F/GNT20.1-30,575.0,402.5,,,0
HCPCS,12046,Intmd rpr n-hf/genit20.1-30,,,421.14,3246.12,11
HCPCS,12047,HC PRO REPAIR INTERMED WOUNDS NCK/HNDS/FT/EXTERNAL GENITALIA OVER 30.0 CM,812.0,568.4,,,0
HCPCS,12047,HC REPAIR INTERMED WOUNDS NCK/HNDS/FT/EXTERNAL GENITALIA OVER 30.0,5963.0,4174.1,,,0
HCPCS,12047,Intmd rpr n-hf/genit >30.0cm,,,421.14,9062.24,11
HCPCS,12051,HC PRO REPAIR INTERMED WNDS F/E/E/N/L/M 2.5 CM OR LESS,873.0,611.1,,,0
HCPCS,12051,HC REPAIR INTERMED WNDS F/E/E/N/L/M 2.5 CM OR LESS,455.0,318.5,,,0
HCPCS,12051,Intmd rpr face/mm 2.5 cm/<,,,402.44,2406.85,11
HCPCS,12052,HC PRO REPAIR INTERMED WNDS F/E/E/N/L/M 2.6-5.0 CM,1070.0,749.0,,,0
HCPCS,12052,HC REPAIR INTERMED WNDS F/E/E/N/L/M 2.6-5.0 CM,478.0,334.6,,,0
HCPCS,12052,Intmd rpr face/mm 2.6-5.0 cm,,,364.38,1785.48,11
HCPCS,12053,HC PRO REPAIR INTERMED WNDS F/E/E/N/L/M 5.1-7.5 CM,1230.0,861.0,,,0
HCPCS,12053,HC REPAIR INTERMED WNDS F/E/E/N/L/M 5.1-7.5 CM,500.0,350.0,,,0
HCPCS,12053,Intmd rpr face/mm 5.1-7.5 cm,,,402.44,1785.48,11
HCPCS,12054,HC PRO REPAIR INTERMED WNDS F/E/E/N/L/M 7.6-12.5 CM,1674.0,1171.8,,,0
HCPCS,12054,HC REPAIR INTERMED WNDS F/E/E/N/L/M 7.6-12.5 CM,525.0,367.5,,,0
HCPCS,12054,Intmd rpr face/mm 7.6-12.5cm,,,402.44,1785.48,11
HCPCS,12055,HC REPAIR INTERMED WNDS F/E/E/N/L/M 12.6-20.0 CM,553.0,387.1,,,0
HCPCS,12055,Intmd rpr face/mm 12.6-20 cm,,,402.44,1785.48,11
HCPCS,12056,HC PRO REPAIR INTERMED WNDS F/E/E/N/L/M 20.1-30.0 CM,851.0,595.7,,,0
HCPCS,12056,Intmd rpr face/mm 20.1-30.0,,,402.44,1785.48,11
HCPCS,12057,HC REPAIR INTERMED WNDS F/E/E/N/L/M OVER 30.0 CM,601.0,420.7,,,0
HCPCS,12057,Intmd rpr face/mm >30.0 cm,,,402.44,1785.48,11
HCPCS,1220,HC PRO ANESTH CLOSED PROC UPPER 2/3 FEMUR,125.0,87.5,,,0
HCPCS,1230,HC PRO ANESTH OPEN PROC UPPER 2/3 FEMUR,188.0,131.6,,,0
HCPCS,12300001,HC ROOM&CARE ACUTE PEDS,1198.0,838.6,,,0
HCPCS,12400001,HC ROOM&CARE BEHAVIORAL,1961.0,1372.7,,,0
HCPCS,13100,Cmplx rpr trunk 1.1-2.5 cm,,,731.66,3246.12,11
HCPCS,13101,Cmplx rpr trunk 2.6-7.5 cm,,,731.66,4062.96,11
HCPCS,13101,RPR CMPLX TRNK 2.6-7.5CM,656.0,459.2,,,0
HCPCS,13102,Cmplx rpr trunk addl 5cm/<,,,545.67,680.73,4
HCPCS,13102,HC PRO REPAIR COMPLEX TRUNK EACH ADDL 5 CM OR LESS,136.0,95.2,,,0
HCPCS,13102,HC REPAIR COMPLEX TRUNK EACH ADDL 5 CM OR LESS,431.0,301.7,,,0
HCPCS,13120,Cmplx rpr s/a/l 1.1-2.5 cm,,,402.44,4025.93,11
HCPCS,13120,HC REP COM WND S/A/L 1.1-2.5CM,598.0,418.6,,,0
HCPCS,13121,Cmplx rpr s/a/l 2.6-7.5 cm,,,402.44,1785.48,11
HCPCS,13121,HC PRO REP COM WND S/A/L 2.6-7.5CM,776.0,543.2,,,0
HCPCS,13121,HC REP COM WND S/A/L 2.6-7.5CM,661.0,462.7,,,0
HCPCS,13122,Cmplx rpr s/a/l addl 5 cm/>,,,1921.05,2396.55,4
HCPCS,13122,HC PRO REP COM WND S/A/L ADDL 5CM OR LESS,148.0,103.6,,,0
HCPCS,13122,HC REP COM WND S/A/L ADDL 5CM OR LESS,130.0,91.0,,,0
HCPCS,13131,Cmplx rpr f/c/c/m/n/ax/g/h/f,,,402.44,3360.79,11
HCPCS,13131,HC PRO RPR CMPLX FRHD 1.1 TO 2.5CM,675.0,472.5,,,0
HCPCS,13131,HC REP COM WND F/H/F/A/G/N1.1-2.5,630.0,441.0,,,0
HCPCS,13132,Cmplx rpr f/c/c/m/n/ax/g/h/f,,,402.44,1785.48,11
HCPCS,13132,HC PRO REPAIR COMPLEX FOREHEAD/CHEEKS/CHIN/MOUTH/NECK/AXILLAE/GENITALIA/HANDS/FEET 2.6-7.5 CM,1028.0,719.6,,,0
HCPCS,13132,HC REPAIR COMPLEX FOREHEAD/CHEEKS/CHIN/MOUTH/NECK/AXILLAE/GENITALIA/HANDS/FEET 2.6-7.5 CM,661.0,462.7,,,0
HCPCS,13133,Cmplx rpr f/c/c/m/n/ax/g/h/f,,,1921.05,2396.55,4
HCPCS,13133,HC PRO RPR CMPLX F/C/C/M/N/AX/G/H/F EA AD 5CM OR LESS,373.0,261.1,,,0
HCPCS,13133,HC RPR CMPLX F/C/C/M/N/AX/G/H/F EA AD 5CM OR LESS,453.0,317.1,,,0
HCPCS,13151,Cmplx rpr e/n/e/l 1.1-2.5 cm,,,731.66,3594.84,11
HCPCS,13151,HC PRO REP COM WND E/N/E/L 1.0-2.5CM,931.0,651.7,,,0
HCPCS,13151,HC REP COM WND E/N/E/L 1.0-2.5CM,1504.0,1052.8,,,0
HCPCS,13152,Cmplx rpr e/n/e/l 2.6-7.5 cm,,,731.66,3246.12,11
HCPCS,13152,HC PRO REP COM WND E/N/E/L 2.6-7.5CM,1200.0,840.0,,,0
HCPCS,13152,HC REP COM WND E/N/E/L2.6-7.5CM,1730.0,1211.0,,,0
HCPCS,13153,Cmplx rpr e/n/e/l addl 5cm/<,,,421.14,525.38,4
HCPCS,13153,HC PRO CMPLX RPR E/N/E/L ADDL 5CM/<,171.0,119.7,,,0
HCPCS,13153,HC REPAIR CMPLX E/N/E/L EACH ADDL 5CM/<,447.0,312.9,,,0
HCPCS,13160,Late closure of wound,,,3508.17,15564.58,11
HCPCS,1320,HC PRO ANESTH KNEE AREA SURGERY,125.0,87.5,,,0
HCPCS,1340,HC PRO ANESTH LOWER 1/3 FEMUR CLOSED PROC,125.0,87.5,,,0
HCPCS,1380,HC PRO ANESTH KNEE JOINT CLOSED PROCEDURE,94.0,65.8,,,0
HCPCS,1390,HC PRO ANESTH UPPER LEG CLOSED PROCEDURE,94.0,65.8,,,0
HCPCS,14000,Tis trnfr trunk 10 sq cm/<,,,2042.58,9062.24,11
HCPCS,14001,Tis trnfr trunk 10.1-30sqcm,,,2042.58,9062.24,11
HCPCS,14020,Tis trnfr s/a/l 10 sq cm/<,,,2042.58,9062.24,11
HCPCS,14021,Tis trnfr s/a/l 10.1-30 sqcm,,,2042.58,9062.24,11
HCPCS,14040,Tis trnfr f/c/c/m/n/a/g/h/f,,,2042.58,9062.24,11
HCPCS,14041,Tis trnfr f/c/c/m/n/a/g/h/f,,,2042.58,9062.24,11
HCPCS,14060,Tis trnfr e/n/e/l 10 sq cm/<,,,2042.58,9062.24,11
HCPCS,14061,Tis trnfr e/n/e/l10.1-30sqcm,,,2042.58,9062.24,11
HCPCS,14301,Tis trnfr any 30.1-60 sq cm,,,3508.17,15564.58,11
HCPCS,14302,Tis trnfr addl 30 sq cm/<,,,1168.63,1457.9,4
HCPCS,14350,Filleted finger/toe flap,,,2042.58,9062.24,11
HCPCS,1462,HC PRO ANESTH LOWER LEG CLOSED PROCEDURE,94.0,65.8,,,0
HCPCS,15002,Wound prep trk/arm/leg,,,731.66,3246.12,11
HCPCS,15003,Wound prep addl 100 cm,,,905.52,1129.65,4
HCPCS,15004,Wound prep f/n/hf/g,,,402.44,5336.73,11
HCPCS,15005,Wnd prep f/n/hf/g addl cm,,,905.52,1129.65,4
HCPCS,15011,Hrv skn cll ssp agrft 1st 25,,,2042.58,9062.24,7
HCPCS,15015,App skn cl ssp agrft t/a/l 1,,,2042.58,9062.24,7
HCPCS,15017,App skn cll ssp f/n/g/hf 1st,,,2042.58,9062.24,7
HCPCS,15040,Harvest cultured skin graft,,,421.14,9062.24,11
HCPCS,15050,HC PINCH GRAFT SINGLE/MULTIPLE COVER SMALL ULCER/TIP OF DIGIT/MINIMAL OPEN AREA UP TO 2CM DIAMETER,595.0,416.5,,,0
HCPCS,15050,HC PRO PINCH GRAFT SINGLE/MULTIPLE COVER SMALL ULCER/TIP OF DIGIT/MINIMAL OPEN AREA UP TO 2CM DIAMETER,555.0,388.5,,,0
HCPCS,15050,Skin pinch graft,,,731.66,3246.12,11
HCPCS,15100,HC PRO SPLIT-THICKNESS AUTOGRAFT TRUNK/ARMS/LEGS FIRST 100 SQ CM OR LESS OR 1% OF BODY AREA OF INFANTS/CHILDREN,1366.0,956.2,,,0
HCPCS,15100,HC SPLIT-THICKNESS AUTOGRAFT TRUNK/ARMS/LEGS FIRST 100 SQ CM OR LESS OR 1% OF BODY AREA OF INFANTS/CHILDREN,2966.0,2076.2,,,0
HCPCS,15100,Skin splt grft trnk/arm/leg,,,2042.58,11609.69,11
HCPCS,15101,Skin splt grft t/a/l add-on,,,4042.54,5043.16,4
HCPCS,15110,Epidrm autogrft trnk/arm/leg,,,905.52,9062.24,11
HCPCS,15111,Epidrm autogrft t/a/l add-on,,,905.52,1129.65,4
HCPCS,15115,Epidrm a-grft face/nck/hf/g,,,905.52,9062.24,11
HCPCS,15116,Epidrm a-grft f/n/hf/g addl,,,905.52,1129.65,4
HCPCS,15120,Skn splt a-grft fac/nck/hf/g,,,3508.17,15564.58,11
HCPCS,15121,Skn splt a-grft f/n/hf/g add,,,4042.54,5043.16,4
HCPCS,15130,Derm autograft trnk/arm/leg,,,2042.58,9062.24,11
HCPCS,15131,Derm autograft t/a/l add-on,,,3010.0,3755.05,4
HCPCS,15135,Derm autograft face/nck/hf/g,,,3010.0,15564.58,11
HCPCS,15136,Derm autograft f/n/hf/g add,,,3010.0,3755.05,4
HCPCS,15150,Cult skin grft t/arm/leg,,,905.52,9062.24,11
HCPCS,15151,Cult skin grft t/a/l addl,,,905.52,1129.65,4
HCPCS,15152,Cult skin graft t/a/l +%,,,905.52,1129.65,4
HCPCS,15155,Cult skin graft f/n/hf/g,,,905.52,15564.58,11
HCPCS,15156,Cult skin grft f/n/hfg add,,,905.52,1129.65,4
HCPCS,15157,Cult epiderm grft f/n/hfg +%,,,905.52,1129.65,4
HCPCS,15200,Skin full graft trunk,,,2042.58,9062.24,11
HCPCS,15201,Skin full graft trunk add-on,,,3010.0,3755.05,4
HCPCS,15220,Skin full graft sclp/arm/leg,,,2042.58,9062.24,11
HCPCS,15221,Skin full graft add-on,,,905.52,1129.65,4
HCPCS,15240,Skin full grft face/genit/hf,,,2042.58,9062.24,11
HCPCS,15241,Skin full graft add-on,,,905.52,1129.65,4
HCPCS,15260,Skin full graft een & lips,,,2042.58,9062.24,11
HCPCS,15261,Skin full graft add-on,,,3010.0,3755.05,4
HCPCS,15271,HC PRO APPLC SKIN SUB 25SQ CM,109.0,76.3,,,0
HCPCS,15271,HC SKIN ALLOGRAFT T/A/L 1ST 25 SQ CM,2390.0,1673.0,,,0
HCPCS,15271,Skin sub graft trnk/arm/leg,,,731.66,3430.41,11
HCPCS,15272,HC PRO APPLIC SKIN SUB EA ADD 25SQ CM,24.0,16.8,,,0
HCPCS,15272,HC SKIN ALLOGRAFT T/A/L ADDL 25 SQ CM,394.0,275.8,,,0
HCPCS,15272,Skin sub graft t/a/l add-on,,,259.82,324.14,4
HCPCS,15273,Skin sub grft t/arm/lg child,,,1191.94,9062.24,11
HCPCS,15274,Skn sub grft t/a/l child add,,,761.98,950.59,4
HCPCS,15275,HC PRO SKIN SUB APP FT 1ST 25SQ CM,227.0,158.9,,,0
HCPCS,15275,HC SKIN SUBSTITUTE APPLICATION TO FOOT FIRST 25 SQ CM,7384.0,5168.8,,,0
HCPCS,15275,Skin sub graft face/nk/hf/g,,,731.66,3246.12,11
HCPCS,15276,Skin sub graft f/n/hf/g addl,,,259.82,324.14,4
HCPCS,15277,Skn sub grft f/n/hf/g child,,,2042.58,9062.24,11
HCPCS,15278,Skn sub grft f/n/hf/g ch add,,,761.98,950.59,4
HCPCS,15570,Skin pedicle flap trunk,,,2042.58,9062.24,11
HCPCS,15572,Skin pedicle flap arms/legs,,,3508.17,15564.58,11
HCPCS,15574,Pedcle fh/ch/ch/m/n/ax/g/h/f,,,2042.58,9062.24,11
HCPCS,15576,Pedicle e/n/e/l/ntroral,,,2042.58,9062.24,11
HCPCS,15600,Delay flap trunk,,,3508.17,15564.58,11
HCPCS,15610,Delay flap arms/legs,,,2042.58,9062.24,11
HCPCS,15620,Delay flap f/c/c/n/ax/g/h/f,,,2042.58,9062.24,11
HCPCS,15630,Delay flap eye/nos/ear/lip,,,2042.58,9062.24,11
HCPCS,15650,Transfer skin pedicle flap,,,2042.58,9062.24,11
HCPCS,15730,Mdfc flap w/prsrv vasc pedcl,,,3508.17,15564.58,11
HCPCS,15731,Forehead Flap w/Vasc Pedicle,,,3508.17,15564.58,11
HCPCS,15733,Musc myoq/fscq flp h&n pedcl,,,3508.17,15564.58,11
HCPCS,15734,Muscle-skin graft trunk,,,2921.69,15564.58,11
HCPCS,15736,Muscle-skin graft arm,,,2042.58,9062.24,11
HCPCS,15738,Muscle-skin graft leg,,,3508.17,15564.58,11
HCPCS,15740,Island pedicle flap graft,,,2042.58,9062.24,11
HCPCS,15750,Neurovascular pedicle flap,,,3508.17,15564.58,11
HCPCS,15760,Composite skin graft,,,2042.58,9062.24,11
HCPCS,15769,Grfg autol soft tiss dir exc,,,3508.17,15564.58,11
HCPCS,15770,Derma-fat-fascia graft,,,3508.17,15564.58,11
HCPCS,15771,Grfg autol fat lipo 50 cc/<,,,3508.17,15564.58,11
HCPCS,15772,Grfg autol fat lipo ea addl,,,440.59,549.65,4
HCPCS,15773,Grfg autol fat lipo 25 cc/<,,,2042.58,9062.24,11
HCPCS,15774,Gfrg autol fat lipo ea addl,,,422.93,527.61,4
HCPCS,15775,Hair trnspl 1-15 punch grfts,,,255.91,1785.48,11
HCPCS,15776,Hair trnspl >15 punch grafts,,,255.91,1785.48,11
HCPCS,15777,Acellular derm matrix implt,,,2619.12,3267.42,4
HCPCS,15777,HC IMPLANT BIO IMPLANT SOFT TISSUE REINFORCE ADD-ON,6011.0,4207.7,,,0
HCPCS,15777,HC PRO IMPLANT BIO IMPLANT SOFT TISSUE REINFORCE ADD-ON,502.0,351.4,,,0
HCPCS,15780,Dermabrasion total face,,,2875.57,12757.95,11
HCPCS,15781,Dermabrasion segmental face,,,701.03,3110.22,11
HCPCS,15782,Dermabrasion other than face,,,861.0,12757.95,11
HCPCS,15783,Dermabrasion suprfl any site,,,402.44,1785.48,11
HCPCS,15786,Abrasion lesion single,,,158.65,881.22,11
HCPCS,15787,Abrasion lesions add-on,,,158.65,197.92,4
HCPCS,15788,Chemical peel face epiderm,,,158.65,1785.48,11
HCPCS,15789,Chemical peel face dermal,,,291.97,3246.12,11
HCPCS,15792,Chemical peel nonfacial,,,291.97,3246.12,11
HCPCS,15793,Chemical peel nonfacial,,,158.65,1785.48,11
HCPCS,15819,Plastic surgery neck,,,421.14,525.38,4
HCPCS,15820,Revision of lower eyelid,,,2042.58,9062.24,11
HCPCS,15821,Revision of lower eyelid,,,2042.58,9062.24,11
HCPCS,15822,Revision of upper eyelid,,,2042.58,9062.24,11
HCPCS,15823,Revision of upper eyelid,,,2042.58,9062.24,11
HCPCS,15824,Removal of forehead wrinkles,,,2042.58,9062.24,11
HCPCS,15825,Removal of neck wrinkles,,,3508.17,15564.58,11
HCPCS,15826,Removal of brow wrinkles,,,3508.17,15564.58,11
HCPCS,15828,Removal of face wrinkles,,,3508.17,15564.58,11
HCPCS,15829,Removal of skin wrinkles,,,3508.17,15564.58,11
HCPCS,15830,Exc Skin Abd,,,5746.66,29164.62,11
HCPCS,15832,Excise excessive skin thigh,,,2875.57,12757.95,11
HCPCS,15833,Excise excessive skin leg,,,2875.57,12757.95,11
HCPCS,15834,Excise excessive skin hip,,,2875.57,12757.95,11
HCPCS,15835,Excise excessive skin buttck,,,2875.57,12757.95,11
HCPCS,15836,Excise excessive skin arm,,,2875.57,12757.95,11
HCPCS,15837,Excise excess skin arm/hand,,,2875.57,12757.95,11
HCPCS,15838,Excise excess skin fat pad,,,2875.57,12757.95,11
HCPCS,15839,Excise excess skin & tissue,,,2875.57,12757.95,11
HCPCS,15840,Nerve palsy fascial graft,,,3508.17,15564.58,11
HCPCS,15841,Nerve palsy muscle graft,,,3508.17,15564.58,11
HCPCS,15842,Nerve palsy microsurg graft,,,2042.58,9062.24,11
HCPCS,15845,Skin and muscle repair face,,,3508.17,15564.58,11
HCPCS,15847,Exc Skin Abd Add-on,,,4223.15,5268.49,4
HCPCS,15851,Remove sutures diff surgeon,,,2042.58,9062.24,11
HCPCS,15852,Dressing change not for burn,,,731.66,3360.79,11
HCPCS,15852,HC DRESSING CHANGE W/ ANESTHESIA,3030.0,2121.0,,,0
HCPCS,15853,HC PRO REMOVAL OF SUTURES OR STAPLES NOT REQ ANESTHESIA,24.0,16.8,,,0
HCPCS,15854,HC PRO REMOVAL OF SUTURES & STAPLES NOT REQ ANESTHESIA,34.0,23.8,,,0
HCPCS,15860,Test for blood flow in graft,,,126.23,1962.08,11
HCPCS,15876,Suction lipectomy head&neck,,,3508.17,15564.58,11
HCPCS,15877,Suction lipectomy trunk,,,3508.17,15564.58,11
HCPCS,15878,Suction lipectomy upr extrem,,,2042.58,9062.24,11
HCPCS,15879,Suction lipectomy lwr extrem,,,3508.17,15564.58,11
HCPCS,15920,Removal of tail bone ulcer,,,861.0,12757.95,11
HCPCS,15922,Removal of tail bone ulcer,,,3508.17,15564.58,11
HCPCS,15931,Remove sacrum pressure sore,,,2875.57,12757.95,11
HCPCS,15933,Remove sacrum pressure sore,,,2875.57,12757.95,11
HCPCS,15934,Remove sacrum pressure sore,,,3508.17,15564.58,11
HCPCS,15935,Remove sacrum pressure sore,,,3508.17,15564.58,11
HCPCS,15936,Remove sacrum pressure sore,,,2042.58,9062.24,11
HCPCS,15937,Remove sacrum pressure sore,,,2042.58,9062.24,11
HCPCS,15940,Remove hip pressure sore,,,2875.57,12757.95,11
HCPCS,15941,Remove hip pressure sore,,,2875.57,12757.95,11
HCPCS,15944,Remove hip pressure sore,,,3508.17,15564.58,11
HCPCS,15945,Remove hip pressure sore,,,2042.58,9062.24,11
HCPCS,15946,Remove hip pressure sore,,,2042.58,9062.24,11
HCPCS,15950,Remove thigh pressure sore,,,1635.03,7254.06,11
HCPCS,15951,Remove thigh pressure sore,,,2875.57,12757.95,11
HCPCS,15952,Remove thigh pressure sore,,,2042.58,9062.24,11
HCPCS,15953,Remove thigh pressure sore,,,3010.0,15564.58,11
HCPCS,15956,Remove thigh pressure sore,,,2042.58,9062.24,11
HCPCS,15958,Remove thigh pressure sore,,,3010.0,15564.58,11
HCPCS,15999,Removal of pressure sore,,,701.03,3110.22,11
HCPCS,160,HC PRO ANESTHESIA FOR PROCEDURES ON NOSE AND ACCESSORY SINUSES NOT OTHERWISE SPECIFIED,302.0,211.4,,,0
HCPCS,16000,HC TREAT 1ST DEG BURN LOCAL INITIAL,401.0,280.7,,,0
HCPCS,16000,Initial treatment of burn(s),,,198.62,881.22,11
HCPCS,16020,Dress/debrid p-thick burn s,,,198.62,881.22,11
HCPCS,16020,HC DRESSINGS/DEBRIDEMENT PARTIAL THICKNESS BURNS INITIAL/SUBSEQUENT SM,456.0,319.2,,,0
HCPCS,16020,HC PRO DRESS/DEBRID P-THICK BURN SMALL < 5%,247.0,172.9,,,0
HCPCS,16025,Dress/debrid p-thick burn m,,,198.62,881.22,11
HCPCS,16025,HC DRESSING/DEBRIDEMENT PARTIAL THICKNESS BURNS INITIAL/SUBSEQUENT MEDIUM,525.0,367.5,,,0
HCPCS,16025,HC PRO DRESS/DEBRID P-THICK BURN MED 5% - 10%,246.0,172.2,,,0
HCPCS,16030,Dress/debrid p-thick burn l,,,319.64,1785.48,11
HCPCS,16030,HC DRESSING/DEBRIDEMENT PARTIAL THICKNESS BURNS INITIAL/SUBSEQUENT LARGE,604.0,422.8,,,0
HCPCS,16030,HC PRO DRESS/DEBRID P-THICK BURN LARGE > 10%,173.0,121.1,,,0
HCPCS,16035,Incision of burn scab initi,,,402.44,1785.48,11
HCPCS,1620,HC PRO ANESTH SHOULDER CLOSED PROCEDURE,125.0,87.5,,,0
HCPCS,16900001,HC ROOM & CARE CHILD AWAIT PLACEMENT,2197.0,1537.9,,,0
HCPCS,170,HC PRO ANESTH PROCEDURE ON MOUTH,156.0,109.2,,,0
HCPCS,17000,Destruct premalg lesion,,,158.65,881.22,11
HCPCS,17003,Destruct premalg les 2-14,,,59.27,73.94,4
HCPCS,17004,Destroy premal lesions 15/>,,,402.44,1785.48,11
HCPCS,17100001,HC ROOM & CARE NURSERY,1440.0,1008.0,,,0
HCPCS,17106,Destruction of skin lesions,,,402.44,1785.48,11
HCPCS,17107,Destruction of skin lesions,,,532.22,3246.12,11
HCPCS,17108,Destruction of skin lesions,,,532.22,9062.24,11
HCPCS,17110,Destruct b9 lesion 1-14,,,158.65,881.22,11
HCPCS,17111,Destruct lesion 15 or more,,,198.62,881.22,11
HCPCS,17200001,HC ROOM&CARE EXT NURSERY,2551.0,1785.7,,,0
HCPCS,17250,Chemical cautery tissue,,,170.25,881.22,11
HCPCS,17250,HC CAUTERY TISSUE CHEMICAL,740.0,518.0,,,0
HCPCS,17250,HC PRO CHEMICAL CAUTERY TISSUE,143.0,100.1,,,0
HCPCS,17260,Destruction of skin lesions,,,198.62,881.22,11
HCPCS,17261,Destruction of skin lesions,,,198.62,881.22,11
HCPCS,17262,Destruction of skin lesions,,,198.62,881.22,11
HCPCS,17263,Destruction of skin lesions,,,198.62,881.22,11
HCPCS,17264,Destruction of skin lesions,,,291.97,1785.48,11
HCPCS,17266,Destruction of skin lesions,,,402.44,1785.48,11
HCPCS,17270,Destruction of skin lesions,,,198.62,881.22,11
HCPCS,17271,Destruction of skin lesions,,,198.62,881.22,11
HCPCS,17272,Destruction of skin lesions,,,198.62,881.22,11
HCPCS,17273,Destruction of skin lesions,,,402.44,1785.48,11
HCPCS,17274,Destruction of skin lesions,,,402.44,1785.48,11
HCPCS,17276,Destruction of skin lesions,,,402.44,1785.48,11
HCPCS,17280,Destruction of skin lesions,,,198.62,1680.39,11
HCPCS,17281,Destruction of skin lesions,,,198.62,881.22,11
HCPCS,17282,Destruction of skin lesions,,,198.62,881.22,11
HCPCS,17283,Destruction of skin lesions,,,402.44,1785.48,11
HCPCS,17284,Destruction of skin lesions,,,532.22,3246.12,11
HCPCS,17286,Destruction of skin lesions,,,532.22,3246.12,11
HCPCS,1730,HC PRO ANESTH ARM / ELBOW BONES CLOSED PROCEDURE,94.0,65.8,,,0
HCPCS,17300001,HC ROOM&CARE SAC NURSERY,3350.0,2345.0,,,0
HCPCS,17311,Mohs 1 stage h/n/hf/g,,,726.62,3246.12,11
HCPCS,17312,Mohs Addl Stage,,,726.62,906.48,4
HCPCS,17313,Mohs 1 stage t/a/l,,,726.62,3246.12,11
HCPCS,17314,Mohs addl stage t/a/l,,,726.62,906.48,4
HCPCS,17315,Mohs surg addl block,,,726.62,906.48,4
HCPCS,17340,Cryotherapy of skin,,,58.4,259.1,11
HCPCS,17360,Skin peel therapy,,,158.65,881.22,11
HCPCS,17380,Hair removal by electrolysis,,,158.65,3246.12,11
HCPCS,17400001,HC ROOM&CARE NIC,4752.0,3326.4,,,0
HCPCS,17999,HC UNLISTED PROCEDURE SKIN MUCOUS MEMBRANE & SUBCUTANEOUS TISSUE,674.0,471.8,,,0
HCPCS,17999,Skin tissue procedure,,,59.27,881.22,11
HCPCS,1820,HC PRO ANESTH FOREARM BONES CLOSED PROC,94.0,65.8,,,0
HCPCS,190,HC PRO ANESTH FACIAL BONE SURGERY,156.0,109.2,,,0
HCPCS,19000,Drainage of breast lesion,,,394.34,3110.22,11
HCPCS,19000,HC ASP PUNCTURE CYST BREA,2620.0,1834.0,,,0
HCPCS,19000,HC PRO ASP PUNCTURE CYST BREA,123.0,86.1,,,0
HCPCS,19001,Drain breast lesion add-on,,,222.01,276.96,4
HCPCS,19020,HC INCISION OF BREAST LESION,6448.0,4513.6,,,0
HCPCS,19020,HC PRO INCISION OF BREAST LESION/ABSC,716.0,501.2,,,0
HCPCS,19020,Incision of breast lesion,,,1635.03,7254.06,11
HCPCS,19081,Bx breast 1st lesion strtctc,,,1635.03,7254.06,11
HCPCS,19082,Bx breast add lesion strtctc,,,259.61,323.87,4
HCPCS,19083,Bx breast 1st lesion us imag,,,1635.03,7254.06,11
HCPCS,19083,HC BREAST BX 1ST LES W/ PLACE LOCALIZATION DEVICE,4482.0,3137.4,,,0
HCPCS,19084,Bx breast add lesion us imag,,,244.52,305.05,4
HCPCS,19085,Bx breast 1st lesion mr imag,,,1635.03,7254.06,11
HCPCS,19086,Bx breast add lesion mr imag,,,293.79,366.51,4
HCPCS,19100,Bx breast percut w/o image,,,865.64,7254.06,11
HCPCS,19101,Biopsy of breast open,,,2881.58,17197.18,11
HCPCS,19101,HC OPEN BX BREAST WO IMAG,2692.0,1884.4,,,0
HCPCS,19101,HC PRO OPEN BX BREAST W/O IMAGE,380.0,266.0,,,0
HCPCS,19105,Cryosurg ablate fa each,,,3876.15,17197.18,11
HCPCS,19110,Nipple exploration,,,3876.15,17197.18,11
HCPCS,19112,Excise breast duct fistula,,,3876.15,17197.18,11
HCPCS,19120,Removal of breast lesion,,,3876.15,17197.18,11
HCPCS,19125,Excision breast lesion,,,3729.52,17197.18,11
HCPCS,19126,Excision addl breast lesion,,,3069.2,3828.9,4
HCPCS,1922,HC PRO ANESTH CAT / MRI SCAN RADIATION THERAPY,218.0,152.6,,,0
HCPCS,19281,Perq device breast 1st imag,,,399.2,7254.06,11
HCPCS,19282,Perq device breast ea imag,,,160.26,199.92,4
HCPCS,19283,Perq dev breast 1st strtctc,,,701.03,3110.22,11
HCPCS,19284,Perq dev breast add strtctc,,,161.26,201.17,4
HCPCS,19285,Perq dev breast 1st us imag,,,701.03,3629.84,11
HCPCS,19286,Perq dev breast add us imag,,,136.53,170.33,4
HCPCS,19287,Perq dev breast 1st mr guide,,,399.2,3110.22,11
HCPCS,19288,Perq dev breast add mr guide,,,207.59,258.97,4
HCPCS,19294,Prep tum cav iort prtl mast,,,528.04,658.74,4
HCPCS,19296,Place po breast cath for rad,,,8091.39,35898.76,11
HCPCS,19297,Place breast cath for rad,,,11318.66,14120.3,4
HCPCS,19298,Place breast rad tube/caths,,,11318.66,60528.02,11
HCPCS,19300,Removal of Breast Tissue,,,3632.05,17197.18,11
HCPCS,19301,Partial Mastectomy,,,3876.15,17197.18,11
HCPCS,19302,P-Mastectomy w/LN Removal,,,4873.65,29164.62,11
HCPCS,19303,Mast simple complete,,,4592.03,29164.62,11
HCPCS,19307,Mast mod rad,,,6573.55,29164.62,11
HCPCS,19316,Suspension of breast,,,3345.1,29164.62,11
HCPCS,19318,Reduction of large breast,,,6573.55,29164.62,11
HCPCS,19325,Enlarge breast with implant,,,2378.88,35898.76,11
HCPCS,19328,Removal of breast implant,,,2881.58,17197.18,11
HCPCS,19330,Removal of implant material,,,2804.21,17197.18,11
HCPCS,19340,Immediate breast prosthesis,,,3304.51,35898.76,11
HCPCS,19342,Delayed breast prosthesis,,,3819.67,35898.76,11
HCPCS,19350,Breast reconstruction,,,3876.15,17197.18,11
HCPCS,19355,Correct inverted nipple(s),,,3876.15,17197.18,11
HCPCS,19357,Breast reconstruction,,,3282.24,60528.02,11
HCPCS,19361,Breast reconstr w/lat flap,,,4728.08,5898.39,4
HCPCS,19370,Surgery of breast capsule,,,2898.01,17197.18,11
HCPCS,19371,Removal of breast capsule,,,3876.15,17197.18,11
HCPCS,19380,Revise breast reconstruction,,,4830.59,29164.62,11
HCPCS,19396,Design custom breast implant,,,3876.15,17197.18,11
HCPCS,19499,Breast surgery procedure,,,3876.15,17197.18,11
HCPCS,2,DUMMY EAP FOR NSA - SUPPLIES  - $500 INCREMENT,500.0,350.0,,,0
HCPCS,20000002,HC ROOM&CARE INTENSIVE,3953.0,2767.1,,,0
HCPCS,20100,Explore wound neck,,,533.92,2404.42,11
HCPCS,20101,Explore wound chest,,,2042.58,9062.24,11
HCPCS,20102,Explore wound abdomen,,,2042.58,9062.24,11
HCPCS,20103,Explore wound extremity,,,1635.03,7254.06,11
HCPCS,20103,HC EXPLORE WOUND EXTREMITY,1294.0,905.8,,,0
HCPCS,2010F,HC PRO PQRS VITAL SIGNS RECORDED,0.01,0.007,,,0
HCPCS,20150,Excise epiphyseal bar,,,3239.17,14371.12,11
HCPCS,20200,HC BIOPSY MUSCLE SUPERFICIAL,5815.0,4070.5,,,0
HCPCS,20200,HC PRO BIOPSY MUSCLE SUPERFICIAL,215.0,150.5,,,0
HCPCS,20200,Muscle biopsy,,,1635.03,7254.06,11
HCPCS,20205,Deep muscle biopsy,,,2875.57,12757.95,11
HCPCS,20205,HC BIOPSY MUSCLE DEEP,9794.0,6855.8,,,0
HCPCS,20205,HC PRO BIOPSY MUSCLE DEEP,353.0,247.1,,,0
HCPCS,20206,HC BIOPSY MUSCLE PERCUTANEOUS NEEDLE,1571.0,1099.7,,,0
HCPCS,20206,Needle biopsy muscle,,,1183.9,7254.06,11
HCPCS,20220,Bone biopsy trocar/needle,,,1016.26,7254.06,11
HCPCS,20220,HC BONE BX TROCAR/NEEDLE,1350.0,945.0,,,0
HCPCS,20220,HC PRO BONE BX TROCAR/NEEDLE SUP,93.0,65.1,,,0
HCPCS,20225,Bone biopsy trocar/needle,,,1588.67,7254.06,11
HCPCS,20225,HC BONE BX TROCAR/NEEDLE DEEP,2109.0,1476.3,,,0
HCPCS,20240,Bone biopsy open superficial,,,2875.57,12757.95,11
HCPCS,20240,HC BONE BX EXCISIONAL SUPERFICIAL,10428.0,7299.6,,,0
HCPCS,20240,HC PRO BIOPSY BONE OPEN SUPERFICIAL,274.0,191.8,,,0
HCPCS,20245,Bone biopsy open deep,,,2875.57,12757.95,11
HCPCS,20245,HC BIOPSY BONE OPEN DEEP,10428.0,7299.6,,,0
HCPCS,20245,HC PRO BIOPSY BONE OPEN DEEP,780.0,546.0,,,0
HCPCS,20250,Open bone biopsy,,,3239.17,14371.12,11
HCPCS,20251,Open bone biopsy,,,4254.97,31870.39,11
HCPCS,20300001,HC ROOM&CARE PEDS INTENSIVE,3953.0,2767.1,,,0
HCPCS,20500,HC INJECTION OF SINUS TRACT THERAPEUTIC,965.0,675.5,,,0
HCPCS,20500,Injection of sinus tract,,,500.19,6814.79,11
HCPCS,20501,HC INJ SINUS TRACT FOR X-RAY,272.0,190.4,,,0
HCPCS,20520,HC PRO REMOVE FB SIMPLE,368.0,257.6,,,0
HCPCS,20520,HC REMOVAL FB MUSCLE/TENDON SIMPLE,1197.0,837.9,,,0
HCPCS,20520,Removal of foreign body,,,1635.03,7254.06,11
HCPCS,20525,HC PRO REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP OR COMPLICATED,662.0,463.4,,,0
HCPCS,20525,HC REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP OR COMPLICATED,8925.0,6247.5,,,0
HCPCS,20525,Removal of foreign body,,,1440.79,12757.95,11
HCPCS,20526,Ther injection carp tunnel,,,303.87,2084.5,11
HCPCS,20527,Inj dupuytren cord w/enzyme,,,303.87,1348.18,11
HCPCS,20550,HC INJ TENDON SHEATH/LIGAMENT,406.0,284.2,,,0
HCPCS,20550,HC PRO INJ TENDON SHEATH/LIGAMENT,91.0,63.7,,,0
HCPCS,20550,Inj tendon sheath/ligament,,,303.87,3893.92,11
HCPCS,20551,Inj tendon origin/insertion,,,303.87,1348.18,11
HCPCS,20552,HC INJ TRIGGER POINT 1/2 MUSCL,276.0,193.2,,,0
HCPCS,20552,HC PRO INJ SING/MULT TRIGGER POINT(S) 1 OR 2 MUSC,121.0,84.7,,,0
HCPCS,20552,Inj trigger point 1/2 muscl,,,207.6,1348.18,11
HCPCS,20553,HC INJ TRIGGER POINTS => 3,276.0,193.2,,,0
HCPCS,20553,HC PRO SING/MULT TRIGGER POINT(S) 3 OR MORE MUSC,131.0,91.7,,,0
HCPCS,20553,Inject trigger points 3/>,,,221.82,1348.18,11
HCPCS,20555,Place ndl musc/tis for rt,,,3239.17,14371.12,11
HCPCS,20560,HC NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,45.0,31.5,,,0
HCPCS,20560,Ndl insj w/o njx 1 or 2 musc,,,28.63,127.04,11
HCPCS,20561,HC NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,67.0,46.9,,,0
HCPCS,20561,Ndl insj w/o njx 3+ musc,,,28.63,127.04,11
HCPCS,20600,Drain/inj joint/bursa w/o us,,,303.87,1348.18,11
HCPCS,20600,HC ARTHROCENTESIS ASPIRATION/INJ SMALL JOINT/BURSA W/O US GUIDE,540.0,378.0,,,0
HCPCS,20600,HC PRO ARTHROCENTESIS ASPIRATION/INJ SMALL JOINT/BURSA W/O US GUIDE,147.0,102.9,,,0
HCPCS,20600001,HC ROOM & CARE PROGRESSIVE,2786.0,1950.2,,,0
HCPCS,20604,Drain/inj joint/bursa w/us,,,303.87,1348.18,11
HCPCS,20604,HC ARTHOCENTISIS ASPIR/INJECT SM JOINT/BURSA W/ULTRA SOUND GUIDE W/PERM RECORDING & REPORTING,1103.0,772.1,,,0
HCPCS,20604,HC PRO ARTHOCENTISIS ASPIR/INJECT SM JOINT/BURSA W/ULTRA SOUND GUIDE W/PERM RECORDING & REPORTING,106.0,74.2,,,0
HCPCS,20605,Drain/inj joint/bursa w/o us,,,303.87,1348.18,11
HCPCS,20605,HC  PRO ARTHROCENTESIS ASPIRATION/INJ INTERMEDIATE JOINT/BURSA W/O US GUIDE,192.0,134.4,,,0
HCPCS,20605,HC ARTHROCENTESIS ASPIRATION/INJ INTERMEDIATE JOINT/BURSA W/O US GUIDE,620.0,434.0,,,0
HCPCS,20606,Drain/inj joint/bursa w/us,,,639.97,3100.34,11
HCPCS,20606,HC ARTHROCENTESIS ASPIRATION/INJECTION INTERMEDIATE JOINT OR BURSA W/ US GUIDE W/RECORDING & REPORTING,1268.0,887.6,,,0
HCPCS,20606,HC PRO ARTHROCENTESIS ASPIRATION/INJECTION INTERMEDIATE JOINT OR BURSA W/ US GUIDE W/RECORDING & REPORTING,68.0,47.6,,,0
HCPCS,20610,Drain/inj joint/bursa w/o us,,,303.87,1348.18,11
HCPCS,20610,HC ARTHROCENTESIS ASPIRATION/INJ MAJOR JOINT/BURSA W/O US GUIDE,714.0,499.8,,,0
HCPCS,20610,HC PRO ARTHROCENTESIS ASPIRATION/INJ MAJOR JOINT/BURSA W/O US GUIDE,365.0,255.5,,,0
HCPCS,20611,Drain/inj joint/bursa w/us,,,303.87,1348.18,11
HCPCS,20611,HC ARTHROCENTESIS ASPIRATION/INJECTION MAJOR JOINT/BURSA W/ ULTRASOUND GUIDANCE,1459.0,1021.3,,,0
HCPCS,20611,HC PRO ARTHROCENTESIS ASPIRATION/INJECTION MAJOR JOINT/BURSA W/ ULTRASOUND GUIDANCE,93.0,65.1,,,0
HCPCS,20612,Aspirate/inj ganglion cyst,,,303.87,3360.79,11
HCPCS,20612,HC ASPIRATE/INJ GANGLION CYST(S),3485.0,2439.5,,,0
HCPCS,20612,HC PRO ASPIRATE/INJ GANGLION CYST(S),94.0,65.8,,,0
HCPCS,20615,Treatment of bone cyst,,,701.03,3110.22,11
HCPCS,20650,Insert and remove bone pin,,,3239.17,14371.12,11
HCPCS,20660,Apply rem fixation device,,,1591.86,7062.54,11
HCPCS,20661,Application of head brace,,,1591.86,10698.91,11
HCPCS,20662,Application of pelvis brace,,,1591.86,7062.54,11
HCPCS,20663,Application of thigh brace,,,3239.17,14371.12,11
HCPCS,20664,Application of halo,,,1591.86,10698.91,11
HCPCS,20665,Removal of fixation device,,,126.23,1962.08,11
HCPCS,20670,HC RMVL SUPPRT IMPLNT SPRFCL,5803.0,4062.1,,,0
HCPCS,20670,Removal of support implant,,,1635.03,7254.06,11
HCPCS,20680,HC REMOVAL OF IMPLANT DEEP,12185.0,8529.5,,,0
HCPCS,20680,Removal of support implant,,,2875.57,12757.95,11
HCPCS,20690,Apply bone fixation device,,,4653.09,31870.39,11
HCPCS,20692,Apply bone fixation device,,,3069.2,56389.43,11
HCPCS,20693,Adjust bone fixation device,,,4254.97,31870.39,11
HCPCS,20694,Remove bone fixation device,,,1591.86,7062.54,11
HCPCS,20696,Comp multiplane ext fixation,,,3009.52,119176.72,11
HCPCS,20697,Comp ext fixate strut change,,,1591.86,7062.54,11
HCPCS,20700,Mnl prep&insj dp rx dlvr dev,,,264.55,330.03,4
HCPCS,20701,Rmvl deep rx delivery device,,,197.04,245.81,4
HCPCS,20702,Mnl prep&insj imed rx dev,,,440.59,549.65,4
HCPCS,20703,Rmvl imed rx delivery device,,,315.21,393.23,4
HCPCS,20704,Mnl prep&insj i-artic rx dev,,,459.01,572.63,4
HCPCS,20705,Rmvl i-artic rx delivery dev,,,377.24,470.61,4
HCPCS,20802,Replantation arm complete,,,17357.91,77011.17,11
HCPCS,20805,Replant forearm complete,,,17357.91,77011.17,11
HCPCS,20808,Replantation hand complete,,,17357.91,77011.17,11
HCPCS,20816,Replantation digit complete,,,1591.86,23681.51,11
HCPCS,20822,Replantation digit complete,,,1591.86,7062.54,11
HCPCS,20824,Replantation thumb complete,,,1591.86,23681.51,11
HCPCS,20827,Replantation thumb complete,,,1591.86,23681.51,11
HCPCS,20838,Replantation foot complete,,,17357.91,77011.17,11
HCPCS,20900,Removal of bone for graft,,,3632.05,31870.39,11
HCPCS,20902,Removal of bone for graft,,,2645.39,31870.39,11
HCPCS,20910,Remove cartilage for graft,,,731.66,5043.16,11
HCPCS,20912,Remove cartilage for graft,,,2326.55,15564.58,11
HCPCS,20920,Removal of fascia for graft,,,2042.58,9062.24,11
HCPCS,20922,Removal of fascia for graft,,,2042.58,9062.24,11
HCPCS,20924,Removal of tendon for graft,,,3234.56,31870.39,11
HCPCS,20932,Osteoart algrft w/surf & b1,,,2231.41,2783.74,4
HCPCS,20933,Hemicrt intrclry algrft prtl,,,2051.1,2558.8,4
HCPCS,20934,Intercalary algrft compl,,,2230.32,2782.38,4
HCPCS,20936,Sp bone agrft local add-on,,,807.92,1007.9,4
HCPCS,20939,Bone marrow aspir bone grfg,,,222.1,277.07,4
HCPCS,20950,Fluid pressure muscle,,,281.4,3110.22,11
HCPCS,20955,Fibula bone graft microvasc,,,7183.42,31870.39,11
HCPCS,20956,Iliac bone graft microvasc,,,7183.42,31870.39,11
HCPCS,20957,Mt bone graft microvasc,,,7183.42,31870.39,11
HCPCS,20962,Other bone graft microvasc,,,7183.42,31870.39,11
HCPCS,20969,Bone/skin graft microvasc,,,7183.42,31870.39,11
HCPCS,20970,Bone/skin graft iliac crest,,,7183.42,31870.39,11
HCPCS,20972,Bone/skin graft metatarsal,,,7183.42,31870.39,11
HCPCS,20973,Bone/skin graft great toe,,,7183.42,31870.39,11
HCPCS,20974,Electrical bone stimulation,,,49.74,3065.1,10
HCPCS,20979,Us bone stimulation,,,28.63,157.47,11
HCPCS,20982,Ablate bone tumor(s) perq,,,4018.14,77011.17,11
HCPCS,20982,HC ABLATE BONE TUMOR(S) PERQ,5618.0,3932.6,,,0
HCPCS,20983,Ablate bone tumor(s) perq,,,7183.42,31870.39,11
HCPCS,20999,Musculoskeletal surgery,,,244.19,3243.76,11
HCPCS,21000001,HC ROOM & CARE CORONARY CARE,3953.0,2767.1,,,0
HCPCS,21010,Incision of jaw joint,,,3282.2,14562.0,11
HCPCS,21011,Exc face les sc <2 cm,,,1635.03,7254.06,11
HCPCS,21012,Exc face les sbq 2 cm/>,,,1635.03,7254.06,11
HCPCS,21013,Exc face tum deep < 2 cm,,,1635.03,7254.06,11
HCPCS,21014,Exc face tum deep 2 cm/>,,,1736.67,12757.95,11
HCPCS,21015,Resect face/scalp tum < 2 cm,,,2875.57,12757.95,11
HCPCS,21016,Resect face/scalp tum 2 cm/>,,,2875.57,12757.95,11
HCPCS,21025,Excision of bone lower jaw,,,5860.44,26000.79,11
HCPCS,21026,Excision of facial bone(s),,,5860.44,26000.79,11
HCPCS,21029,Contour of face bone lesion,,,3282.2,14562.0,11
HCPCS,21030,Excise max/zygoma b9 tumor,,,5860.44,26000.79,11
HCPCS,21031,Remove exostosis mandible,,,3282.2,14562.0,11
HCPCS,21032,Remove exostosis maxilla,,,3282.2,14562.0,11
HCPCS,21034,Excise max/zygoma mal tumor,,,5860.44,26000.79,11
HCPCS,21040,Excise mandible lesion,,,3282.2,14562.0,11
HCPCS,21044,Removal of jaw bone lesion,,,5860.44,26000.79,11
HCPCS,21045,Extensive jaw surgery,,,5860.44,26000.79,11
HCPCS,21046,Remove mandible cyst complex,,,5387.93,26000.79,11
HCPCS,21047,Excise lwr jaw cyst w/repair,,,5860.44,26000.79,11
HCPCS,21048,Remove maxilla cyst complex,,,5860.44,26000.79,11
HCPCS,21049,Excis uppr jaw cyst w/repair,,,5860.44,26000.79,11
HCPCS,21050,Removal of jaw joint,,,5860.44,26000.79,11
HCPCS,21060,Remove jaw joint cartilage,,,5860.44,26000.79,11
HCPCS,21070,Remove coronoid process,,,1722.22,26000.79,11
HCPCS,21073,HC MANIPULATION OF TEMPROMANDIBULAR JOINT(S) THERAPEUTIC REQUIRING AN ANESTHESIA SERVICE,4373.0,3061.1,,,0
HCPCS,21073,Mnpj of tmj w/anesth,,,1489.88,6814.79,11
HCPCS,21076,Prepare face/oral prosthesis,,,1536.02,6814.79,11
HCPCS,21077,Prepare face/oral prosthesis,,,5860.44,26000.79,11
HCPCS,21079,Prepare face/oral prosthesis,,,3282.2,14562.0,11
HCPCS,21080,Prepare face/oral prosthesis,,,3282.2,14562.0,11
HCPCS,21081,Prepare face/oral prosthesis,,,5860.44,26000.79,11
HCPCS,21082,Prepare face/oral prosthesis,,,3282.2,14562.0,11
HCPCS,21083,Prepare face/oral prosthesis,,,3282.2,14562.0,11
HCPCS,21084,Prepare face/oral prosthesis,,,3282.2,14562.0,11
HCPCS,21085,Prepare face/oral prosthesis,,,234.47,4075.29,11
HCPCS,21086,Prepare face/oral prosthesis,,,3282.2,14562.0,11
HCPCS,21087,Prepare face/oral prosthesis,,,5860.44,26000.79,11
HCPCS,21088,Prepare face/oral prosthesis,,,3282.2,14562.0,11
HCPCS,21089,Prepare face/oral prosthesis,,,234.47,1040.28,11
HCPCS,21100,Maxillofacial fixation,,,5860.44,26000.79,11
HCPCS,21110,Interdental fixation,,,1489.88,6814.79,11
HCPCS,21120,Reconstruction of chin,,,4796.64,26000.79,11
HCPCS,21121,Reconstruction of chin,,,3282.2,14562.0,11
HCPCS,21122,Reconstruction of chin,,,4796.64,26000.79,11
HCPCS,21123,Reconstruction of chin,,,3282.2,14562.0,11
HCPCS,21125,Augmentation lower jaw bone,,,4796.64,26000.79,11
HCPCS,21127,Augmentation lower jaw bone,,,5860.44,26000.79,11
HCPCS,21137,Reduction of forehead,,,3282.2,14562.0,11
HCPCS,21138,Reduction of forehead,,,5860.44,26000.79,11
HCPCS,21139,Reduction of forehead,,,5860.44,26000.79,11
HCPCS,21141,Lefort i-1 piece w/o graft,,,3578.2,26000.79,11
HCPCS,21142,Lefort i-2 piece w/o graft,,,3956.04,26000.79,11
HCPCS,21143,Lefort i-3/> piece w/o graft,,,4459.83,26000.79,11
HCPCS,21145,Lefort i-1 piece w/ graft,,,5860.44,26000.79,11
HCPCS,21146,Lefort i-2 piece w/ graft,,,5860.44,26000.79,11
HCPCS,21147,Lefort i-3/> piece w/ graft,,,5860.44,26000.79,11
HCPCS,21150,Lefort ii anterior intrusion,,,5860.44,26000.79,11
HCPCS,21151,Lefort ii w/bone grafts,,,5860.44,26000.79,11
HCPCS,21154,Lefort iii w/o lefort i,,,5860.44,26000.79,11
HCPCS,21155,Lefort iii w/ lefort i,,,5860.44,26000.79,11
HCPCS,21159,Lefort iii w/fhdw/o lefort i,,,5860.44,26000.79,11
HCPCS,21160,Lefort iii w/fhd w/ lefort i,,,5860.44,26000.79,11
HCPCS,21172,Reconstruct orbit/forehead,,,5860.44,26000.79,11
HCPCS,21175,Reconstruct orbit/forehead,,,5860.44,26000.79,11
HCPCS,21179,Reconstruct entire forehead,,,5860.44,26000.79,11
HCPCS,21180,Reconstruct entire forehead,,,5860.44,26000.79,11
HCPCS,21181,Contour cranial bone lesion,,,4796.64,26000.79,11
HCPCS,21182,Reconstruct cranial bone,,,5860.44,26000.79,11
HCPCS,21183,Reconstruct cranial bone,,,5860.44,26000.79,11
HCPCS,21184,Reconstruct cranial bone,,,5860.44,26000.79,11
HCPCS,21188,Reconstruction of midface,,,5860.44,26000.79,11
HCPCS,21193,Reconst lwr jaw w/o graft,,,5860.44,26000.79,11
HCPCS,21194,Reconst lwr jaw w/graft,,,5860.44,26000.79,11
HCPCS,21195,Reconst lwr jaw w/o fixation,,,5860.44,26000.79,11
HCPCS,21196,Reconst lwr jaw w/fixation,,,5550.91,26000.79,11
HCPCS,21198,Reconstr lwr jaw segment,,,5860.44,26000.79,11
HCPCS,21199,Reconstr Lwr Jaw W/Advance,,,5860.44,26000.79,11
HCPCS,21206,Reconstruct upper jaw bone,,,5860.44,26000.79,11
HCPCS,21208,Augmentation of facial bones,,,5860.44,26000.79,11
HCPCS,21209,Reduction of facial bones,,,5860.44,26000.79,11
HCPCS,21210,Face bone graft,,,3819.67,26000.79,11
HCPCS,21215,Lower jaw bone graft,,,5860.44,26000.79,11
HCPCS,21230,Rib cartilage graft,,,5860.44,26000.79,11
HCPCS,21235,Ear cartilage graft,,,3694.59,26000.79,11
HCPCS,21240,Reconstruction of jaw joint,,,5860.44,26000.79,11
HCPCS,21242,Reconstruction of jaw joint,,,5860.44,26000.79,11
HCPCS,21243,Reconstruction of jaw joint,,,7977.75,119176.72,11
HCPCS,21244,Reconstruction of lower jaw,,,5860.44,26000.79,11
HCPCS,21245,Reconstruction of jaw,,,5860.44,26000.79,11
HCPCS,21246,Reconstruction of jaw,,,5860.44,26000.79,11
HCPCS,21247,Reconstruct lower jaw bone,,,5860.44,26000.79,11
HCPCS,21248,Reconstruction of jaw,,,5860.44,26000.79,11
HCPCS,21249,Reconstruction of jaw,,,5860.44,26000.79,11
HCPCS,21255,Reconstruct lower jaw bone,,,5860.44,26000.79,11
HCPCS,21256,Reconstruction of orbit,,,5860.44,26000.79,11
HCPCS,21260,Revise eye sockets,,,5860.44,26000.79,11
HCPCS,21261,Revise eye sockets,,,5860.44,26000.79,11
HCPCS,21263,Revise eye sockets,,,5860.44,26000.79,11
HCPCS,21267,Revise eye sockets,,,5860.44,26000.79,11
HCPCS,21268,Revise eye sockets,,,5860.44,26000.79,11
HCPCS,21270,Augmentation cheek bone,,,2171.2,26000.79,11
HCPCS,21275,Revision orbitofacial bones,,,5860.44,26000.79,11
HCPCS,21280,Revision of eyelid,,,3282.2,14562.0,11
HCPCS,21282,Revision of eyelid,,,3266.7,14562.0,11
HCPCS,21295,Revision of jaw muscle/bone,,,1489.88,6814.79,11
HCPCS,21296,Revision of jaw muscle/bone,,,3282.2,14562.0,11
HCPCS,21299,Cranio/maxillofacial surgery,,,234.47,1040.28,11
HCPCS,21315,Closed tx nose fx w/o stablj,,,1536.02,6814.79,11
HCPCS,21315,HC CLOSED TX NASAL BONE FX W/MANIP W/O STABLIZATION,5591.0,3913.7,,,0
HCPCS,21315,HC PRO CLOSED TX NASAL BONE FX W/MANIP W/O STABLIZATION,257.0,179.9,,,0
HCPCS,21320,Closed tx nose fx w/ stablj,,,3282.2,14562.0,11
HCPCS,21325,Open tx nose fx uncomplicatd,,,3282.2,14562.0,11
HCPCS,21330,Open tx nose fx w/skele fixj,,,4796.64,26000.79,11
HCPCS,21335,Open tx nose & septal fx,,,3282.2,14562.0,11
HCPCS,21336,Open tx septal fx w/wo stabj,,,3239.17,14371.12,11
HCPCS,21337,Closed tx septal&nose fx,,,2506.35,14562.0,11
HCPCS,21338,Open nasoethmoid fx w/o fixj,,,4796.64,26000.79,11
HCPCS,21339,Open nasoethmoid fx w/ fixj,,,4796.64,26000.79,11
HCPCS,21340,Perq tx nasoethmoid fx,,,3282.2,14562.0,11
HCPCS,21343,Open tx dprsd front sinus fx,,,5860.44,26000.79,11
HCPCS,21344,Open tx compl front sinus fx,,,5860.44,26000.79,11
HCPCS,21345,Closed tx nose/jaw fx,,,1536.02,6814.79,11
HCPCS,21346,Opn tx nasomax fx w/fixj,,,5860.44,26000.79,11
HCPCS,21347,Opn tx nasomax fx multple,,,5860.44,26000.79,11
HCPCS,21348,Opn tx nasomax fx w/graft,,,5860.44,26000.79,11
HCPCS,21355,Perq tx malar fracture,,,3282.2,14562.0,11
HCPCS,21356,Opn tx dprsd zygomatic arch,,,4796.64,26000.79,11
HCPCS,21360,Opn tx dprsd malar fracture,,,4796.64,26000.79,11
HCPCS,21365,Opn tx complx malar fx,,,5860.44,26000.79,11
HCPCS,21366,Opn tx complx malar w/grft,,,5860.44,26000.79,11
HCPCS,21385,Opn tx orbit fx transantral,,,5860.44,26000.79,11
HCPCS,21386,Opn tx orbit fx periorbital,,,5860.44,26000.79,11
HCPCS,21387,Opn tx orbit fx combined,,,5860.44,26000.79,11
HCPCS,21390,Opn tx orbit periorbtl implt,,,5763.16,26000.79,11
HCPCS,21395,Opn tx orbit periorbt w/grft,,,5860.44,26000.79,11
HCPCS,21400,Closed tx orbit w/o manipulj,,,533.92,2368.81,11
HCPCS,21401,Closed tx orbit w/manipulj,,,1536.02,6814.79,11
HCPCS,21406,Opn tx orbit fx w/o implant,,,5860.44,26000.79,11
HCPCS,21407,Opn tx orbit fx w/implant,,,5860.44,26000.79,11
HCPCS,21408,Opn tx orbit fx w/bone grft,,,5860.44,26000.79,11
HCPCS,21421,Treat mouth roof fracture,,,3282.2,14562.0,11
HCPCS,21422,Treat mouth roof fracture,,,5860.44,26000.79,11
HCPCS,21423,Treat mouth roof fracture,,,5860.44,26000.79,11
HCPCS,21431,Treat craniofacial fracture,,,5860.44,26000.79,11
HCPCS,21432,Treat craniofacial fracture,,,5860.44,26000.79,11
HCPCS,21433,Treat craniofacial fracture,,,5860.44,26000.79,11
HCPCS,21435,Treat craniofacial fracture,,,5860.44,26000.79,11
HCPCS,21436,Treat craniofacial fracture,,,5860.44,26000.79,11
HCPCS,21440,HC CLOSED TREATMENT  MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX,10709.0,7496.3,,,0
HCPCS,21440,HC PRO CLOSED TREATMENT MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX,1213.0,849.1,,,0
HCPCS,21440,Treat dental ridge fracture,,,3282.2,14562.0,11
HCPCS,21445,Treat dental ridge fracture,,,4796.64,26000.79,11
HCPCS,21450,Treat lower jaw fracture,,,500.19,2368.81,11
HCPCS,21451,Treat lower jaw fracture,,,1489.88,6814.79,11
HCPCS,21452,Treat lower jaw fracture,,,3266.7,26000.79,11
HCPCS,21453,Treat lower jaw fracture,,,5860.44,26000.79,11
HCPCS,21454,Treat lower jaw fracture,,,4796.64,26000.79,11
HCPCS,21461,Treat lower jaw fracture,,,5860.44,26000.79,11
HCPCS,21462,Treat lower jaw fracture,,,5860.44,26000.79,11
HCPCS,21465,Treat lower jaw fracture,,,5860.44,26000.79,11
HCPCS,21470,Treat lower jaw fracture,,,5860.44,26000.79,11
HCPCS,21480,HC PRO RESET DISLOCATED JAW,379.0,265.3,,,0
HCPCS,21480,HC RESET DISLOCATED JAW,341.0,238.7,,,0
HCPCS,21480,Reset dislocated jaw,,,244.19,1083.4,11
HCPCS,21485,Reset dislocated jaw,,,1536.02,6814.79,11
HCPCS,21490,Repair dislocated jaw,,,3282.2,14562.0,11
HCPCS,21497,Interdental wiring,,,1536.02,6814.79,11
HCPCS,21499,Head surgery procedure,,,234.47,1040.28,11
HCPCS,21501,Drain neck/chest lesion,,,2875.57,12757.95,11
HCPCS,21501,HC I&D DEEP ABSCESS/HEMATOMA SOFT TISS NECK/THORAX,2442.0,1709.4,,,0
HCPCS,21502,Drain chest lesion,,,3239.17,14371.12,11
HCPCS,21510,Drainage of bone lesion,,,3239.17,23681.51,11
HCPCS,21550,Biopsy of neck/chest,,,1635.03,7254.06,11
HCPCS,21550,HC BX OF NECK/CHEST SFT TISSUE,2244.0,1570.8,,,0
HCPCS,21552,Exc neck les sc 3 cm/>,,,2875.57,12757.95,11
HCPCS,21554,Exc neck tum deep 5 cm/>,,,2875.57,12757.95,11
HCPCS,21555,Exc neck les sc < 3 cm,,,1635.03,7254.06,11
HCPCS,21556,Exc neck tum deep < 5 cm,,,2875.57,12757.95,11
HCPCS,21557,Resect neck thorax tumor<5cm,,,2875.57,12757.95,11
HCPCS,21558,Resect neck tumor 5 cm/>,,,2875.57,12757.95,11
HCPCS,21600,Partial removal of rib,,,5839.66,31870.39,11
HCPCS,21601,Exc chest wall tumor w/ribs,,,2875.57,12757.95,11
HCPCS,21602,Exc ch wal tum w/o lymphadec,,,4914.27,31870.39,11
HCPCS,21603,Exc ch wal tum w/lymphadec,,,5452.7,31870.39,11
HCPCS,21610,Partial removal of rib,,,3239.17,14371.12,11
HCPCS,21615,Removal of rib,,,7183.42,31870.39,11
HCPCS,21616,Removal of rib and nerves,,,7183.42,31870.39,11
HCPCS,21620,Partial removal of sternum,,,3239.17,23681.51,11
HCPCS,21627,Sternal debridement,,,3239.17,23681.51,11
HCPCS,21630,Extensive sternum surgery,,,7183.42,31870.39,11
HCPCS,21632,Extensive sternum surgery,,,18982.8,23681.51,4
HCPCS,21685,Hyoid myotomy & suspension,,,1489.88,26000.79,11
HCPCS,21700,Revision of neck muscle,,,4254.97,31870.39,11
HCPCS,21705,Revision of neck muscle/rib,,,7183.42,31870.39,11
HCPCS,21720,Revision of neck muscle,,,3239.17,14371.12,11
HCPCS,21725,Revision of neck muscle,,,281.4,3110.22,11
HCPCS,21740,Reconstruction of sternum,,,7183.42,31870.39,11
HCPCS,21742,Repair stern/nuss w/o scope,,,3239.17,14371.12,11
HCPCS,21743,Repair sternum/nuss w/scope,,,3239.17,14371.12,11
HCPCS,21750,HC CLOSURE MEDIAN STERNOTOMY SEPARATION W/WO DEBRIDEMENT,2966.0,2076.2,,,0
HCPCS,21750,Repair of sternum separation,,,7183.42,31870.39,11
HCPCS,21811,Optx of rib fx w/fixj scope,,,6189.23,31870.39,11
HCPCS,21812,Treatment of rib fracture,,,6189.23,31870.39,11
HCPCS,21813,Treatment of rib fracture,,,1591.86,7721.22,11
HCPCS,21820,Treat sternum fracture,,,244.19,1083.4,11
HCPCS,21825,Treat sternum fracture,,,7183.42,31870.39,11
HCPCS,21899,Neck/chest surgery procedure,,,234.47,1040.28,11
HCPCS,21920,Biopsy soft tissue of back,,,1635.03,7254.06,11
HCPCS,21925,Biopsy soft tissue of back,,,1635.03,7254.06,11
HCPCS,21930,Exc back les sc < 3 cm,,,1280.7,7254.06,11
HCPCS,21931,Exc back les sc 3 cm/>,,,1635.03,7254.06,11
HCPCS,21932,Exc back tum deep < 5 cm,,,2875.57,12757.95,11
HCPCS,21933,Exc back tum deep 5 cm/>,,,2875.57,12757.95,11
HCPCS,21935,Resect back tum < 5 cm,,,2875.57,12757.95,11
HCPCS,21936,Resect back tum 5 cm/>,,,2875.57,12757.95,11
HCPCS,22010,I&d p-spine c/t/cerv-thor,,,7183.42,31870.39,11
HCPCS,22015,I&d abscess p-spine l/s/ls,,,7183.42,31870.39,11
HCPCS,22100,Remove part of neck vertebra,,,7183.42,31870.39,11
HCPCS,22101,Remove part thorax vertebra,,,7183.42,31870.39,11
HCPCS,22102,Remove part lumbar vertebra,,,7183.42,31870.39,11
HCPCS,22103,Remove extra spine segment,,,9357.12,11673.24,4
HCPCS,22110,Remove part of neck vertebra,,,7183.42,31870.39,11
HCPCS,22112,Remove part thorax vertebra,,,7183.42,31870.39,11
HCPCS,22114,Remove part lumbar vertebra,,,7183.42,31870.39,11
HCPCS,22206,Incis spine 3 column thorac,,,7183.42,31870.39,11
HCPCS,22207,Incis spine 3 column lumbar,,,7183.42,31870.39,11
HCPCS,22210,Incis 1 vertebral seg cerv,,,7183.42,31870.39,11
HCPCS,22212,Incis 1 vertebral seg thorac,,,7183.42,31870.39,11
HCPCS,22214,Incis 1 vertebral seg lumbar,,,7183.42,31870.39,11
HCPCS,22220,Incis w/discectomy cervical,,,7183.42,31870.39,11
HCPCS,22222,Incis w/discectomy thoracic,,,7183.42,31870.39,11
HCPCS,22224,Incis w/discectomy lumbar,,,7183.42,31870.39,11
HCPCS,22310,Closed tx vert fx w/o manj,,,244.19,1083.4,11
HCPCS,22310,HC CLOSED TX VERTEBRAL BODY FX(S) W/O MANIP INCL CASTING/BRACING,1578.0,1104.6,,,0
HCPCS,22310,HC PRO CLOSED TX VERTEBRAL BODY FX(S) W/O MANIP INCL CASTING/BRACING,654.0,457.8,,,0
HCPCS,22315,Closed tx vert fx w/manj,,,353.72,14371.12,11
HCPCS,22318,Treat odontoid fx w/o graft,,,12709.88,56389.43,11
HCPCS,22319,Treat odontoid fx w/graft,,,12709.88,56389.43,11
HCPCS,22325,Treat spine fracture,,,12709.88,56389.43,11
HCPCS,22326,Treat neck spine fracture,,,12709.88,56389.43,11
HCPCS,22327,Treat thorax spine fracture,,,12709.88,56389.43,11
HCPCS,22505,Manipulation of spine,,,1591.86,7062.54,11
HCPCS,22510,HC PERCU VRTBRPLSTY 1 VERT BODY UNI/BIL INJ INCL IMG GUID CERVICOTHORA,11791.0,8253.7,,,0
HCPCS,22510,Perq cervicothoracic inject,,,3239.17,14371.12,11
HCPCS,22511,HC PERCU VERTEBROPLASTY 1 VERT BODY UNILAT/BILAT INJ LUMB INCLUDES ALL IMAGING GUIDANCE,4420.0,3094.0,,,0
HCPCS,22511,Perq lumbosacral injection,,,3239.17,14371.12,11
HCPCS,22512,Vertebroplasty addl inject,,,660.66,824.19,4
HCPCS,22513,HC PERCU KYPHOPLASTY 1 VERT BODY UNILAT/BILAT CANN THORACIC INCLUDES ALL IMAGING GUIDANCE,10737.0,7515.9,,,0
HCPCS,22513,Perq vertebral augmentation,,,6138.4,31870.39,11
HCPCS,22514,HC PERCU KYPHOPLASTY 1 VERT BODY UNILAT/BILAT CANN LUMBAR INCLUDES ALL IMAGING GUIDANCE,10737.0,7515.9,,,0
HCPCS,22514,Perq vertebral augmentation,,,7183.42,31870.39,11
HCPCS,22515,HC PERCU KYPHOPLASTY 1 VERT BODY UNILAT/BILAT CANN EA ADD THOR/LUMB VERT BODY,10737.0,7515.9,,,0
HCPCS,22515,Perq vertebral augmentation,,,715.75,892.91,4
HCPCS,22526,Idet single level,,,5839.66,7285.12,4
HCPCS,22527,Idet 1 or more levels,,,5839.66,7285.12,4
HCPCS,22532,Lat thorax spine fusion,,,12709.88,59981.53,11
HCPCS,22533,Lat lumbar spine fusion,,,17357.91,77011.17,11
HCPCS,22548,Neck spine fusion,,,12709.88,59981.53,11
HCPCS,22551,Neck spine fuse&remov bel c2,,,3102.07,56389.43,11
HCPCS,22552,Addl neck spine fusion,,,2637.89,3290.83,4
HCPCS,22554,Neck spine fusion,,,12709.88,56389.43,11
HCPCS,22556,Thorax spine fusion,,,17357.91,77011.17,11
HCPCS,22558,Lumbar spine fusion,,,9944.01,119176.72,11
HCPCS,22586,Prescrl fuse w/ instr l5-s1,,,4572.91,77011.17,11
HCPCS,22590,Spine & skull spinal fusion,,,12709.88,59981.53,11
HCPCS,22595,Neck spinal fusion,,,12709.88,59981.53,11
HCPCS,22600,Neck spine fusion,,,17357.91,77011.17,11
HCPCS,22610,Thorax spine fusion,,,17357.91,77011.17,11
HCPCS,22612,Lumbar spine fusion,,,9357.12,77011.17,11
HCPCS,22614,Spine fusion extra segment,,,9357.12,11673.24,4
HCPCS,22630,Lumbar spine fusion,,,10179.06,119176.72,11
HCPCS,22633,Lumbar spine fusion combined,,,5452.85,119176.72,11
HCPCS,22634,Spine fusion extra segment,,,1471.91,1836.25,4
HCPCS,22800,Post fusion <=6 vert seg,,,17357.91,77011.17,11
HCPCS,22802,Post fusion 7-12 vert seg,,,17357.91,77011.17,11
HCPCS,22804,Post fusion 13/> vert seg,,,17357.91,77011.17,11
HCPCS,22808,Ant fusion 2-3 vert seg,,,17357.91,77011.17,11
HCPCS,22810,Ant fusion 4-7 vert seg,,,17357.91,77011.17,11
HCPCS,22812,Ant fusion 8/> vert seg,,,17357.91,77011.17,11
HCPCS,22818,Kyphectomy 1-2 segments,,,17357.91,77011.17,11
HCPCS,22819,Kyphectomy 3 or more,,,17357.91,77011.17,11
HCPCS,22830,Exploration of spinal fusion,,,7183.42,46549.79,11
HCPCS,22836,Ant thrc vrt body tethrg <7,,,17357.91,77011.17,7
HCPCS,22837,Ant thrc vrt body tethrg 8+,,,17357.91,77011.17,7
HCPCS,22838,Rev rplc/rmv thrc vrt tethrg,,,17357.91,77011.17,7
HCPCS,22840,Insert spine fixation device,,,5003.95,6242.55,4
HCPCS,22845,Insert spine fixation device,,,2976.98,3713.85,4
HCPCS,22849,Reinsert spinal fixation,,,12709.88,59981.53,11
HCPCS,22850,Remove spine fixation device,,,7183.42,46549.79,11
HCPCS,22852,Remove spine fixation device,,,7183.42,46549.79,11
HCPCS,22853,Insj biomechanical device,,,843.31,1052.05,4
HCPCS,22854,Insj biomechanical device,,,1091.63,1361.83,4
HCPCS,22855,Remove spine fixation device,,,7183.42,46549.79,11
HCPCS,22856,Cerv artific diskectomy,,,8930.95,77011.17,11
HCPCS,22857,Lumbar Artif Diskectomy,,,17357.91,77011.17,11
HCPCS,22858,Second level cer diskectomy,,,1584.9,1977.2,4
HCPCS,22859,Insj biomechanical device,,,1091.63,1361.83,4
HCPCS,22861,Revise cerv artific disc,,,5603.71,77011.17,11
HCPCS,22862,Revise Lumbar Artif Disc,,,17357.91,77011.17,11
HCPCS,22864,Remove cerv artif disc,,,5228.23,31870.39,11
HCPCS,22865,Remove Lumb Artif Disc,,,7183.42,46549.79,11
HCPCS,22867,Insj stablj dev w/dcmprn,,,17357.91,77011.17,11
HCPCS,22868,Insj stablj dev w/dcmprn,,,786.78,981.53,4
HCPCS,22869,Insj stablj dev w/o dcmprn,,,12709.88,56389.43,11
HCPCS,22870,Insj stablj dev w/o dcmprn,,,457.85,571.17,4
HCPCS,22899,Spine surgery procedure,,,244.19,5308.18,11
HCPCS,22900,Exc abdl tum deep < 5 cm,,,2875.57,12757.95,11
HCPCS,22901,Exc abdl tum deep 5 cm/>,,,2875.57,12757.95,11
HCPCS,22902,Exc abd les sc < 3 cm,,,1635.03,7254.06,11
HCPCS,22903,Exc abd les sc 3 cm/>,,,2875.57,12757.95,11
HCPCS,22904,Radical resect abd tumor<5cm,,,2875.57,12757.95,11
HCPCS,22905,Rad resect abd tumor 5 cm/>,,,2875.57,12757.95,11
HCPCS,22999,Abdomen surgery procedure,,,244.19,5308.18,11
HCPCS,22999,HC UNLISTED PROCEDURE ABDOMEN MUSCULOSKELETAL SYSTEM,203.0,142.1,,,0
HCPCS,23000,Removal of calcium deposits,,,2875.57,12757.95,11
HCPCS,23020,Release shoulder joint,,,3239.17,14371.12,11
HCPCS,23030,Drain shoulder lesion,,,2875.57,12757.95,11
HCPCS,23031,Drain shoulder bursa,,,2875.57,12757.95,11
HCPCS,23035,Drain shoulder bone lesion,,,1591.86,7062.54,11
HCPCS,23040,Exploratory shoulder surgery,,,3239.17,14371.12,11
HCPCS,23044,Exploratory shoulder surgery,,,3239.17,14371.12,11
HCPCS,23065,Biopsy shoulder tissues,,,1635.03,7254.06,11
HCPCS,23066,Biopsy shoulder tissues,,,2875.57,12757.95,11
HCPCS,23071,Exc shoulder les sc 3 cm/>,,,1635.03,7254.06,11
HCPCS,23073,Exc shoulder tum deep 5 cm/>,,,2875.57,12757.95,11
HCPCS,23075,Exc shoulder les sc < 3 cm,,,1635.03,7254.06,11
HCPCS,23076,Exc shoulder tum deep < 5 cm,,,2875.57,12757.95,11
HCPCS,23077,Resect shoulder tumor < 5 cm,,,2875.57,12757.95,11
HCPCS,23078,Resect shoulder tumor 5 cm/>,,,2875.57,12757.95,11
HCPCS,23100,Biopsy of shoulder joint,,,3239.17,14371.12,11
HCPCS,23101,Shoulder joint surgery,,,3239.17,14371.12,11
HCPCS,23105,Remove shoulder joint lining,,,5839.66,31870.39,11
HCPCS,23106,Incision of collarbone joint,,,3239.17,14371.12,11
HCPCS,23107,Explore treat shoulder joint,,,5839.66,31870.39,11
HCPCS,23120,Partial removal collar bone,,,3239.17,14371.12,11
HCPCS,23125,Removal of collar bone,,,3239.17,14371.12,11
HCPCS,23130,Remove shoulder bone part,,,3239.17,14371.12,11
HCPCS,23140,Removal of bone lesion,,,3239.17,14371.12,11
HCPCS,23145,Removal of bone lesion,,,3239.17,14371.12,11
HCPCS,23146,Removal of bone lesion,,,5839.66,31870.39,11
HCPCS,23150,Removal of humerus lesion,,,3239.17,14371.12,11
HCPCS,23155,Removal of humerus lesion,,,5839.66,31870.39,11
HCPCS,23156,Removal of humerus lesion,,,5839.66,31870.39,11
HCPCS,23170,Remove collar bone lesion,,,3239.17,14371.12,11
HCPCS,23172,Remove shoulder blade lesion,,,3239.17,14371.12,11
HCPCS,23174,Remove humerus lesion,,,5839.66,31870.39,11
HCPCS,23180,Remove collar bone lesion,,,5839.66,31870.39,11
HCPCS,23182,Remove shoulder blade lesion,,,5839.66,31870.39,11
HCPCS,23184,Remove humerus lesion,,,5839.66,31870.39,11
HCPCS,23190,Partial removal of scapula,,,3239.17,14371.12,11
HCPCS,23195,Removal of head of humerus,,,5839.66,31870.39,11
HCPCS,23200,Resect clavicle tumor,,,7183.42,31870.39,11
HCPCS,23210,Resect scapula tumor,,,7183.42,31870.39,11
HCPCS,23220,Resect prox humerus tumor,,,7183.42,31870.39,11
HCPCS,23330,HC REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS,6898.0,4828.6,,,0
HCPCS,23330,Remove shoulder foreign body,,,1635.03,7254.06,11
HCPCS,23333,Remove shoulder fb deep,,,2504.54,12757.95,11
HCPCS,23334,Shoulder prosthesis removal,,,5527.66,31870.39,11
HCPCS,23335,Shoulder prosthesis removal,,,3925.61,31870.39,11
HCPCS,23350,HC INJ FOR SHOULDER X-RAY,275.0,192.5,,,0
HCPCS,23395,Muscle transfer shoulder/arm,,,7183.42,31870.39,11
HCPCS,23397,Muscle transfers,,,7183.42,31870.39,11
HCPCS,23400,Fixation of shoulder blade,,,5839.66,31870.39,11
HCPCS,23405,Incision of tendon & muscle,,,3536.73,31870.39,11
HCPCS,23406,Incise tendon(s) & muscle(s),,,5839.66,31870.39,11
HCPCS,23410,Repair rotator cuff acute,,,3772.04,31870.39,11
HCPCS,23412,Repair rotator cuff chronic,,,3540.9,31870.39,11
HCPCS,23415,Release of shoulder ligament,,,2770.83,31870.39,11
HCPCS,23420,Repair of shoulder,,,4397.29,31870.39,11
HCPCS,23430,Repair biceps tendon,,,2551.69,31870.39,11
HCPCS,23440,Remove/transplant tendon,,,7183.42,31870.39,11
HCPCS,23450,Repair shoulder capsule,,,7183.42,31870.39,11
HCPCS,23455,Repair shoulder capsule,,,7183.42,31870.39,11
HCPCS,23460,Repair shoulder capsule,,,7183.42,31870.39,11
HCPCS,23462,Repair shoulder capsule,,,7183.42,31870.39,11
HCPCS,23465,Repair shoulder capsule,,,7183.42,31870.39,11
HCPCS,23466,Repair shoulder capsule,,,7183.42,31870.39,11
HCPCS,23470,Reconstruct shoulder joint,,,12709.88,56389.43,11
HCPCS,23472,Reconstruct shoulder joint,,,9452.72,77011.17,11
HCPCS,23473,Revis reconst shoulder joint,,,12709.88,56389.43,11
HCPCS,23474,Revis reconst shoulder joint,,,11419.52,56389.43,11
HCPCS,23480,Revision of collar bone,,,7183.42,31870.39,11
HCPCS,23485,Revision of collar bone,,,12709.88,56389.43,11
HCPCS,23490,Reinforce clavicle,,,7183.42,31870.39,11
HCPCS,23491,Reinforce shoulder bones,,,12709.88,56389.43,11
HCPCS,23500,HC CLOSED TX CLAVICULAR FX W/O MANIPULATION,275.0,192.5,,,0
HCPCS,23500,Treat clavicle fracture,,,244.19,1083.4,11
HCPCS,23505,HC PRO TREAT CLAVICLE FRACTURE W/MANIP,408.0,285.6,,,0
HCPCS,23505,HC TREAT CLAVICLE FRACTURE W/MANIP,1066.0,746.2,,,0
HCPCS,23505,Treat clavicle fracture,,,353.72,7062.54,11
HCPCS,23515,Treat clavicle fracture,,,7013.95,31870.39,11
HCPCS,23520,Treat clavicle dislocation,,,353.72,7062.54,11
HCPCS,23525,HC CLOSED TX STERNOCLAVICULAR DISL W/ MANIP,542.0,379.4,,,0
HCPCS,23525,Treat clavicle dislocation,,,244.19,1083.4,11
HCPCS,23530,Treat clavicle dislocation,,,7183.42,31870.39,11
HCPCS,23532,Treat clavicle dislocation,,,5233.29,31870.39,11
HCPCS,23540,HC CLOSED TX ACROMIOCLAVICULAR DISLOCATION W/O MANIPULATION,852.0,596.4,,,0
HCPCS,23540,Treat clavicle dislocation,,,244.19,1083.4,11
HCPCS,23545,HC CLOSED TX ACROMIOCLAVICULAR DISLOCATION W/MANIPULATION,1375.0,962.5,,,0
HCPCS,23545,HC PRO CLOSED TX ACROMIOCLAVICULAR DISLOCATION W/MANIPULATION,745.0,521.5,,,0
HCPCS,23545,Treat clavicle dislocation,,,244.19,1083.4,11
HCPCS,23550,Treat clavicle dislocation,,,7183.42,31870.39,11
HCPCS,23552,Treat clavicle dislocation,,,7183.42,31870.39,11
HCPCS,23570,HC CLOSED TX SCAPULAR FX W/O MANIPULATION,852.0,596.4,,,0
HCPCS,23570,Treat shoulder blade fx,,,244.19,1083.4,11
HCPCS,23575,Treat shoulder blade fx,,,353.72,7062.54,11
HCPCS,23585,Treat scapula fracture,,,7183.42,31870.39,11
HCPCS,23600,HC CLOSED TX PROXIMAL HUMERAL FX W/O MANIPULATION,836.0,585.2,,,0
HCPCS,23600,HC PRO CLOSED TX PROX HUMERUS FX W/O MANIPULATION,716.0,501.2,,,0
HCPCS,23600,Treat humerus fracture,,,244.19,1083.4,11
HCPCS,23605,HC CLOSED TX PROXIMAL HUMERAL FX W/MANIPULATION W/WO SKELETAL TRACTION,2480.0,1736.0,,,0
HCPCS,23605,Treat humerus fracture,,,353.72,7062.54,11
HCPCS,23615,Treat humerus fracture,,,11848.0,56389.43,11
HCPCS,23616,Treat humerus fracture,,,11848.0,77011.17,11
HCPCS,23620,HC CLOSED TREATMENT OF GREATER HUMERAL TUBEROSITY FRACTURE W/O MANIPULATION,852.0,596.4,,,0
HCPCS,23620,HC PRO CLOSED TREATMENT OF GREATER HUMERAL TUBEROSITY FRACTURE W/O MANIPULATION,590.0,413.0,,,0
HCPCS,23620,Treat humerus fracture,,,244.19,1083.4,11
HCPCS,23625,HC PRO TREAT HUM GR TUB FX W/ MAN,460.0,322.0,,,0
HCPCS,23625,HC TREAT HUM GR TUB FX W/MAN,2192.0,1534.4,,,0
HCPCS,23625,Treat humerus fracture,,,353.72,7062.54,11
HCPCS,23630,Treat humerus fracture,,,7183.42,31870.39,11
HCPCS,23650,HC PRO TREAT SHOULDER DISLOCATION,1339.0,937.3,,,0
HCPCS,23650,HC TREAT SHOULDER DISLOCATION,275.0,192.5,,,0
HCPCS,23650,Treat shoulder dislocation,,,203.14,1083.4,11
HCPCS,23655,HC PRO CLOSED TX SHOULDER DISL W/ MANIP W/ ANESTH,486.0,340.2,,,0
HCPCS,23655,HC SHLDR DISLOC MANIP REQ ANESTHESIA,1745.0,1221.5,,,0
HCPCS,23655,Treat shoulder dislocation,,,1307.37,7062.54,11
HCPCS,23660,Treat shoulder dislocation,,,7183.42,31870.39,11
HCPCS,23665,HC CLOSED TX SHOULDER DISLOC W/ FX,1066.0,746.2,,,0
HCPCS,23665,HC PRO CLOSED TX SHOULDER DISLOC W/ FX,515.0,360.5,,,0
HCPCS,23665,Treat dislocation/fracture,,,353.72,7062.54,11
HCPCS,23670,Treat dislocation/fracture,,,7183.42,31870.39,11
HCPCS,23675,HC CLSD TX SHOULDER DISLOCATION W/SURGICAL/ANATOMICAL NECK FX W/MANIP,320.0,224.0,,,0
HCPCS,23675,HC PRO CLSD TX SHOULDER DISLOCATION W/SURGICAL/ANATOMICAL NECK FX W/MANIP,632.0,442.4,,,0
HCPCS,23675,Treat dislocation/fracture,,,353.72,7062.54,11
HCPCS,23680,Treat dislocation/fracture,,,8224.12,56389.43,11
HCPCS,23700,Fixation of shoulder,,,1591.86,7062.54,11
HCPCS,23800,Fusion of shoulder joint,,,7183.42,31870.39,11
HCPCS,23802,Fusion of shoulder joint,,,8599.44,56389.43,11
HCPCS,23900,Amputation of arm & girdle,,,12709.88,56389.43,11
HCPCS,23920,Amputation at shoulder joint,,,12709.88,56389.43,11
HCPCS,23921,Amputation follow-up surgery,,,2042.58,9062.24,11
HCPCS,23929,Shoulder surgery procedure,,,244.19,8594.03,11
HCPCS,23930,Drainage of arm lesion,,,2875.57,12757.95,11
HCPCS,23930,HC DRAIN UPPER ARM ELBOW LESION,2442.0,1709.4,,,0
HCPCS,23931,Drainage of arm bursa,,,1635.03,7254.06,11
HCPCS,23931,HC DRAINAGE OF ARM BURSA,5970.0,4179.0,,,0
HCPCS,23931,HC PRO DRAINAGE OF ARM BURSA,430.0,301.0,,,0
HCPCS,23935,Drain arm/elbow bone lesion,,,3239.17,14371.12,11
HCPCS,24000,Exploratory elbow surgery,,,3239.17,14371.12,11
HCPCS,24006,Release elbow joint,,,3239.17,14371.12,11
HCPCS,24065,Biopsy arm/elbow soft tissue,,,1635.03,7254.06,11
HCPCS,24066,Biopsy arm/elbow soft tissue,,,2875.57,12757.95,11
HCPCS,24071,Exc arm/elbow les sc 3 cm/>,,,2875.57,12757.95,11
HCPCS,24073,Ex arm/elbow tum deep 5 cm/>,,,2875.57,12757.95,11
HCPCS,24075,Exc arm/elbow les sc < 3 cm,,,1152.63,7254.06,11
HCPCS,24076,Ex arm/elbow tum deep < 5 cm,,,2875.57,12757.95,11
HCPCS,24077,Resect arm/elbow tum < 5 cm,,,2875.57,12757.95,11
HCPCS,24079,Resect arm/elbow tum 5 cm/>,,,2875.57,12757.95,11
HCPCS,24100,Biopsy elbow joint lining,,,3239.17,14371.12,11
HCPCS,24101,Explore/treat elbow joint,,,3239.17,14371.12,11
HCPCS,24102,Remove elbow joint lining,,,3239.17,14371.12,11
HCPCS,24105,Removal of elbow bursa,,,3239.17,14371.12,11
HCPCS,24110,Remove humerus lesion,,,3239.17,14371.12,11
HCPCS,24115,Remove/graft bone lesion,,,5839.66,31870.39,11
HCPCS,24116,Remove/graft bone lesion,,,5839.66,31870.39,11
HCPCS,24120,Remove elbow lesion,,,3239.17,14371.12,11
HCPCS,24125,Remove/graft bone lesion,,,3239.17,14371.12,11
HCPCS,24126,Remove/graft bone lesion,,,5839.66,31870.39,11
HCPCS,24130,Removal of head of radius,,,3239.17,14371.12,11
HCPCS,24134,Removal of arm bone lesion,,,5839.66,31870.39,11
HCPCS,24136,Remove radius bone lesion,,,3239.17,14371.12,11
HCPCS,24138,Remove elbow bone lesion,,,5839.66,31870.39,11
HCPCS,24140,Partial removal of arm bone,,,3239.17,14371.12,11
HCPCS,24145,Partial removal of radius,,,5839.66,31870.39,11
HCPCS,24147,Partial removal of elbow,,,3239.17,14371.12,11
HCPCS,24149,Radical resection of elbow,,,5839.66,31870.39,11
HCPCS,24150,Resect distal humerus tumor,,,7183.42,31870.39,11
HCPCS,24152,Resect radius tumor,,,7183.42,31870.39,11
HCPCS,24155,Removal of elbow joint,,,3239.17,14371.12,11
HCPCS,24160,Remove elbow joint implant,,,3239.17,14371.12,11
HCPCS,24164,Remove radius head implant,,,3239.17,14371.12,11
HCPCS,24200,HC PRO REMOVAL OF ARM FOREIGN BODY,382.0,267.4,,,0
HCPCS,24200,HC REMOVAL FOREIGN BODY UPPER ARM/ELBOW AREA SUBCUTANEOUS,2004.0,1402.8,,,0
HCPCS,24200,Removal of arm foreign body,,,861.0,7254.06,11
HCPCS,24201,HC REMOVAL FOREIGN BODY UPPER ARM/ELBOW AREA DEEP (SUBFASCIAL/INTRAMUSCULAR),6053.0,4237.1,,,0
HCPCS,24201,Removal of arm foreign body,,,2875.57,12757.95,11
HCPCS,24300,Manipulate elbow w/anesth,,,1591.86,7062.54,11
HCPCS,24301,Muscle/tendon transfer,,,5839.66,31870.39,11
HCPCS,24305,Arm tendon lengthening,,,3239.17,14371.12,11
HCPCS,24310,Revision of arm tendon,,,3239.17,14371.12,11
HCPCS,24320,Repair of arm tendon,,,7183.42,31870.39,11
HCPCS,24330,Revision of arm muscles,,,7183.42,31870.39,11
HCPCS,24331,Revision of arm muscles,,,7183.42,31870.39,11
HCPCS,24332,Tenolysis triceps,,,3239.17,14371.12,11
HCPCS,24340,Repair of biceps tendon,,,3471.07,31870.39,11
HCPCS,24341,Repair arm tendon/muscle,,,7183.42,31870.39,11
HCPCS,24342,Repair of ruptured tendon,,,7183.42,31870.39,11
HCPCS,24343,Repr elbow lat ligmnt w/tiss,,,2386.57,14371.12,11
HCPCS,24344,Reconstruct elbow lat ligmnt,,,7183.42,31870.39,11
HCPCS,24345,Repr elbw med ligmnt w/tissu,,,2386.57,31870.39,11
HCPCS,24346,Reconstruct elbow med ligmnt,,,8599.44,56389.43,11
HCPCS,24357,Repair elbow perc,,,3239.17,14371.12,11
HCPCS,24358,Repair elbow w/deb open,,,3239.17,14371.12,11
HCPCS,24359,Repair elbow deb/attch open,,,3239.17,14371.12,11
HCPCS,24360,Reconstruct elbow joint,,,7182.83,31870.39,11
HCPCS,24361,Reconstruct elbow joint,,,17357.91,77011.17,11
HCPCS,24362,Reconstruct elbow joint,,,10180.38,56389.43,11
HCPCS,24363,Replace elbow joint,,,17357.91,77011.17,11
HCPCS,24365,Reconstruct head of radius,,,7182.83,56389.43,11
HCPCS,24366,Reconstruct head of radius,,,2386.57,56389.43,11
HCPCS,24370,Revise reconst elbow joint,,,12709.88,56389.43,11
HCPCS,24371,Revise reconst elbow joint,,,17357.91,77011.17,11
HCPCS,24400,Revision of humerus,,,5839.66,31870.39,11
HCPCS,24410,Revision of humerus,,,5839.66,56389.43,11
HCPCS,24420,Revision of humerus,,,7183.42,31870.39,11
HCPCS,24430,Repair of humerus,,,12709.88,56389.43,11
HCPCS,24435,Repair humerus with graft,,,11932.83,56389.43,11
HCPCS,24470,Revision of elbow joint,,,3239.17,14371.12,11
HCPCS,24495,Decompression of forearm,,,5839.66,31870.39,11
HCPCS,24498,Reinforce humerus,,,12709.88,56389.43,11
HCPCS,24500,HC TREAT HUM SHAFT FX,836.0,585.2,,,0
HCPCS,24500,Treat humerus fracture,,,244.19,1083.4,11
HCPCS,24505,HC CLOSED TX HUMERAL SHAFT FX W/MANIPULATION W/WO SKELETAL TRACTION,1666.0,1166.2,,,0
HCPCS,24505,HC PRO CLOSED TX HUMERAL SHAFT FX W/MANIPULATION W/WO SKELETAL TRACTION,933.0,653.1,,,0
HCPCS,24505,Treat humerus fracture,,,353.72,7062.54,11
HCPCS,24515,Treat humerus fracture,,,8389.81,56389.43,11
HCPCS,24516,Treat humerus fracture,,,11848.0,56389.43,11
HCPCS,24530,RX HUMERUS FX,852.0,596.4,,,0
HCPCS,24530,Treat humerus fracture,,,244.19,1083.4,11
HCPCS,24535,HC PRO TREAT HUM SUPRAC FX W/ MAN,887.0,620.9,,,0
HCPCS,24535,HC TREAT HUM SUPRAC FX W/ MAN,980.0,686.0,,,0
HCPCS,24535,Treat humerus fracture,,,353.72,7062.54,11
HCPCS,24538,Treat humerus fracture,,,6138.4,31870.39,11
HCPCS,24545,Treat humerus fracture,,,8780.68,56389.43,11
HCPCS,24546,Treat humerus fracture,,,11848.0,56389.43,11
HCPCS,24560,HC CLOSED TX HUMERAL EPICONDYLAR FX MEDIAL/LATERAL W/O MANIPULATION,852.0,596.4,,,0
HCPCS,24560,Treat humerus fracture,,,244.19,1083.4,11
HCPCS,24565,Treat humerus fracture,,,353.72,7062.54,11
HCPCS,24566,Treat humerus fracture,,,1591.86,7062.54,11
HCPCS,24575,Treat humerus fracture,,,11848.0,56389.43,11
HCPCS,24576,HC CLOSED TX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/O MANIPULATION,852.0,596.4,,,0
HCPCS,24576,HC PRO CLOSED TX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/O MANIPULATION,725.0,507.5,,,0
HCPCS,24576,Treat humerus fracture,,,244.19,1083.4,11
HCPCS,24577,HC PRO CLSD TX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/MANIPULATION,1170.0,819.0,,,0
HCPCS,24577,Treat humerus fracture,,,353.72,7062.54,11
HCPCS,24579,Treat humerus fracture,,,11848.0,56389.43,11
HCPCS,24582,Treat humerus fracture,,,5233.29,31870.39,11
HCPCS,24586,Treat elbow fracture,,,7639.34,56389.43,11
HCPCS,24587,Treat elbow fracture,,,11848.0,56389.43,11
HCPCS,24600,HC PRO TREAT ELBOW DISL W/O ANESTH,583.0,408.1,,,0
HCPCS,24600,HC TREAT ELBOW DISL W/O ANESTH,693.0,485.1,,,0
HCPCS,24600,Treat elbow dislocation,,,244.19,1083.4,11
HCPCS,24605,HC CLOSED TX ELBOW DISL REQ ANESTHESIA,1745.0,1221.5,,,0
HCPCS,24605,HC PRO CLOSED TX ELBOW DISL REQ ANESTHESIA,769.0,538.3,,,0
HCPCS,24605,Treat elbow dislocation,,,1591.86,7062.54,11
HCPCS,24615,Treat elbow dislocation,,,7183.42,31870.39,11
HCPCS,24620,HC PRO-TREAT ELBOW FRACTURE,900.0,630.0,,,0
HCPCS,24620,HC TREAT ELBOW FRACTURE,1893.0,1325.1,,,0
HCPCS,24620,Treat elbow fracture,,,1354.15,7062.54,11
HCPCS,24635,Treat elbow fracture,,,7183.42,31870.39,11
HCPCS,24640,HC PRO TREAT RAD HEAD DISL W/ MANIP,227.0,158.9,,,0
HCPCS,24640,HC TREAT RAD HEAD DISL W/MAN,361.0,252.7,,,0
HCPCS,24640,Treat elbow dislocation,,,244.19,1083.4,11
HCPCS,24650,HC CLOSED TX RADIAL HEAD NECK FX W/O MANIPULATION,361.0,252.7,,,0
HCPCS,24650,HC PRO CLOSED TX RADIAL HEAD NECK FX W/O MANIPULATION,559.0,391.3,,,0
HCPCS,24650,Treat radius fracture,,,244.19,1083.4,11
HCPCS,24655,HC PRO TREAT RAD HEAD NECK FX W/ MAN,791.0,553.7,,,0
HCPCS,24655,HC TREAT RAD HEAD NECK FX W/ MAN,600.0,420.0,,,0
HCPCS,24655,Treat radius fracture,,,452.54,7062.54,11
HCPCS,24665,Treat radius fracture,,,7183.42,31870.39,11
HCPCS,24666,Treat radius fracture,,,11848.0,56389.43,11
HCPCS,24670,HC CLSD TX UNLAR FRACTURE PROXIMAL END W/O MANIP,794.0,555.8,,,0
HCPCS,24670,Treat ulnar fracture,,,244.19,1083.4,11
HCPCS,24675,HC CLOSED TX ULNAR FX PROX END W/ MANIP,1404.0,982.8,,,0
HCPCS,24675,HC PRO CLOSED TX ULNAR FX PROX END W/MANIP,514.0,359.8,,,0
HCPCS,24675,Treat ulnar fracture,,,482.07,7062.54,11
HCPCS,24685,Treat ulnar fracture,,,2386.57,31870.39,11
HCPCS,24800,Fusion of elbow joint,,,7183.42,31870.39,11
HCPCS,24802,Fusion/graft of elbow joint,,,8599.44,56389.43,11
HCPCS,24900,Amputation of upper arm,,,12709.88,56389.43,11
HCPCS,24920,Amputation of upper arm,,,12709.88,56389.43,11
HCPCS,24925,Amputation follow-up surgery,,,3239.17,14371.12,11
HCPCS,24930,Amputation follow-up surgery,,,7183.42,31870.39,11
HCPCS,24931,Amputate upper arm & implant,,,12709.88,56389.43,11
HCPCS,24935,Revision of amputation,,,7183.42,31870.39,11
HCPCS,24940,Revision of upper arm,,,12709.88,56389.43,11
HCPCS,24999,Upper arm/elbow surgery,,,244.19,1083.4,11
HCPCS,25000,Incision of tendon sheath,,,1591.86,7062.54,11
HCPCS,25000000,HC PROLACTA 4 CAL 10ML,284.0,198.8,,,0
HCPCS,25000005,HC PROLACTA 4 CAL 20ML,426.0,298.2,,,0
HCPCS,25000006,HC PROLACTA 6 CAL 30ML,638.0,446.6,,,0
HCPCS,25000007,HC PROLACTA 8 CAL 40 ML,851.0,595.7,,,0
HCPCS,25000008,HC PROLACTA CR 10 ML,205.0,143.5,,,0
HCPCS,25000010,HC PROLACT RTF 24 100ML,508.0,355.6,,,0
HCPCS,25000011,HC PROLACT RTF 26 100 ML,725.0,507.5,,,0
HCPCS,25000012,HC PROLACT RTF 28 100ML,943.0,660.1,,,0
HCPCS,25000013,HC NC DUPIXENT (DUPILUMAB),0.01,0.007,,,0
HCPCS,25001,Incise flexor carpi radialis,,,3239.17,14371.12,11
HCPCS,25020,Decompress forearm 1 space,,,1591.86,7062.54,11
HCPCS,25023,Decompress forearm 1 space,,,3239.17,14371.12,11
HCPCS,25024,Decompress forearm 2 spaces,,,3239.17,14371.12,11
HCPCS,25024,HC DECOMPRESSION FASCIOTOMY FOREARM/WRIST FLEXOR AND EXTENSOR COMPARTMENT W/O DEBRIDEMENT NONVIABLE MUSCLE/NERVE,9421.0,6594.7,,,0
HCPCS,25025,Decompress forearm 2 spaces,,,1591.86,7285.12,11
HCPCS,25028,Drainage of forearm lesion,,,3239.17,14371.12,11
HCPCS,25031,Drainage of forearm bursa,,,1591.86,7062.54,11
HCPCS,25035,Treat forearm bone lesion,,,4254.97,31870.39,11
HCPCS,25040,Explore/treat wrist joint,,,3239.17,14371.12,11
HCPCS,25065,Biopsy forearm soft tissues,,,1635.03,7254.06,11
HCPCS,25066,Biopsy forearm soft tissues,,,2875.57,12757.95,11
HCPCS,25071,Exc forearm les sc 3 cm/>,,,1635.03,7254.06,11
HCPCS,25073,Exc forearm tum deep 3 cm/>,,,2875.57,12757.95,11
HCPCS,25075,Exc forearm les sc < 3 cm,,,768.42,7254.06,11
HCPCS,25076,Exc forearm tum deep < 3 cm,,,1635.03,7254.06,11
HCPCS,25077,Resect forearm/wrist tum<3cm,,,2875.57,12757.95,11
HCPCS,25078,Resect forarm/wrist tum 3cm>,,,2875.57,12757.95,11
HCPCS,25085,Incision of wrist capsule,,,3239.17,14371.12,11
HCPCS,25100,Biopsy of wrist joint,,,3239.17,14371.12,11
HCPCS,25101,Explore/treat wrist joint,,,3239.17,14371.12,11
HCPCS,25105,Remove wrist joint lining,,,3239.17,14371.12,11
HCPCS,25107,Remove wrist joint cartilage,,,3239.17,14371.12,11
HCPCS,25109,Excise tendon forearm/wrist,,,3239.17,14371.12,11
HCPCS,25110,Remove wrist tendon lesion,,,1591.86,7062.54,11
HCPCS,25111,Remove wrist tendon lesion,,,1591.86,7062.54,11
HCPCS,25112,Reremove wrist tendon lesion,,,1591.86,7062.54,11
HCPCS,25115,Remove wrist/forearm lesion,,,1591.86,7062.54,11
HCPCS,25116,Remove wrist/forearm lesion,,,3239.17,14371.12,11
HCPCS,25118,Excise wrist tendon sheath,,,1591.86,7285.12,11
HCPCS,25119,Partial removal of ulna,,,3239.17,14371.12,11
HCPCS,25120,Removal of forearm lesion,,,3239.17,14371.12,11
HCPCS,25125,Remove/graft forearm lesion,,,1591.86,7285.12,11
HCPCS,25126,Remove/graft forearm lesion,,,3239.17,14371.12,11
HCPCS,25130,Removal of wrist lesion,,,3239.17,14371.12,11
HCPCS,25135,Remove & graft wrist lesion,,,5839.66,31870.39,11
HCPCS,25136,Remove & graft wrist lesion,,,5839.66,31870.39,11
HCPCS,25145,Remove forearm bone lesion,,,3239.17,14371.12,11
HCPCS,25150,Partial removal of ulna,,,3239.17,14371.12,11
HCPCS,25151,Partial removal of radius,,,3239.17,14371.12,11
HCPCS,25170,Resect radius/ulnar tumor,,,7183.42,31870.39,11
HCPCS,25210,Removal of wrist bone,,,3239.17,14371.12,11
HCPCS,25215,Removal of wrist bones,,,3239.17,14371.12,11
HCPCS,25230,Partial removal of radius,,,3239.17,14371.12,11
HCPCS,25240,Partial removal of ulna,,,2836.85,14371.12,11
HCPCS,25246,HC INJ FOR WRIST ARTHROGRAPHY,369.0,258.3,,,0
HCPCS,25248,Remove forearm foreign body,,,1591.86,7062.54,11
HCPCS,25250,Removal of wrist prosthesis,,,1591.86,7285.12,11
HCPCS,25251,Removal of wrist prosthesis,,,3239.17,14371.12,11
HCPCS,25259,Manipulate wrist w/anesthes,,,353.72,7062.54,11
HCPCS,25260,Repair forearm tendon/muscle,,,3239.17,14371.12,11
HCPCS,25263,Repair forearm tendon/muscle,,,5839.66,31870.39,11
HCPCS,25265,Repair forearm tendon/muscle,,,3239.17,14371.12,11
HCPCS,25270,Repair forearm tendon/muscle,,,3239.17,14371.12,11
HCPCS,25272,Repair forearm tendon/muscle,,,3239.17,14371.12,11
HCPCS,25274,Repair forearm tendon/muscle,,,3239.17,14371.12,11
HCPCS,25275,Repair forearm tendon sheath,,,3239.17,14371.12,11
HCPCS,25280,Revise wrist/forearm tendon,,,3239.17,14371.12,11
HCPCS,25290,Incise wrist/forearm tendon,,,3239.17,14371.12,11
HCPCS,25295,Release wrist/forearm tendon,,,3239.17,14371.12,11
HCPCS,25300,Fusion of tendons at wrist,,,3239.17,14371.12,11
HCPCS,25301,Fusion of tendons at wrist,,,3239.17,14371.12,11
HCPCS,25310,Transplant forearm tendon,,,3239.17,14371.12,11
HCPCS,25312,Transplant forearm tendon,,,3239.17,14371.12,11
HCPCS,25315,Revise palsy hand tendon(s),,,7183.42,31870.39,11
HCPCS,25316,Revise palsy hand tendon(s),,,7183.42,31870.39,11
HCPCS,25320,Repair/revise wrist joint,,,4101.09,31870.39,11
HCPCS,25332,Revise wrist joint,,,3239.17,14371.12,11
HCPCS,25335,Realignment of hand,,,3239.17,14371.12,11
HCPCS,25337,Reconstruct ulna/radioulnar,,,7183.42,31870.39,11
HCPCS,25350,Revision of radius,,,7183.42,31870.39,11
HCPCS,25355,Revision of radius,,,3239.17,14371.12,11
HCPCS,25360,Revision of ulna,,,5839.66,31870.39,11
HCPCS,25365,Revise radius & ulna,,,5839.66,56389.43,11
HCPCS,25370,Revise radius or ulna,,,3239.17,14371.12,11
HCPCS,25375,Revise radius & ulna,,,3239.17,14371.12,11
HCPCS,25390,Shorten radius or ulna,,,5839.66,31870.39,11
HCPCS,25391,Lengthen radius or ulna,,,8599.44,56389.43,11
HCPCS,25392,Shorten radius & ulna,,,5839.66,31870.39,11
HCPCS,25393,Lengthen radius & ulna,,,7183.42,31870.39,11
HCPCS,25394,Repair carpal bone shorten,,,3239.17,14371.12,11
HCPCS,25400,Repair radius or ulna,,,5591.18,31870.39,11
HCPCS,25405,Repair/graft radius or ulna,,,7183.42,31870.39,11
HCPCS,25415,Repair radius & ulna,,,7183.42,31870.39,11
HCPCS,25420,Repair/graft radius & ulna,,,7183.42,31870.39,11
HCPCS,25425,Repair/graft radius or ulna,,,7183.42,31870.39,11
HCPCS,25426,Repair/graft radius & ulna,,,3239.17,14371.12,11
HCPCS,25430,Vasc graft into carpal bone,,,3239.17,14371.12,11
HCPCS,25431,Repair nonunion carpal bone,,,5263.59,31870.39,11
HCPCS,25440,Repair/graft wrist bone,,,6888.87,31870.39,11
HCPCS,25441,Reconstruct wrist joint,,,12709.88,56389.43,11
HCPCS,25442,Reconstruct wrist joint,,,17357.91,77011.17,11
HCPCS,25443,Reconstruct wrist joint,,,7183.42,31870.39,11
HCPCS,25444,Reconstruct wrist joint,,,10180.38,56389.43,11
HCPCS,25445,Reconstruct wrist joint,,,7183.42,31870.39,11
HCPCS,25446,Wrist replacement,,,17357.91,77011.17,11
HCPCS,25447,Repair wrist joints,,,3239.17,14371.12,11
HCPCS,25448,Arthrp ntrcrpl/crp/mtcrp ssp,,,3239.17,14371.12,7
HCPCS,25449,Remove wrist joint implant,,,7182.83,31870.39,11
HCPCS,25450,Revision of wrist joint,,,3239.17,14371.12,11
HCPCS,25455,Revision of wrist joint,,,3239.17,14371.12,11
HCPCS,25490,Reinforce radius,,,7183.42,31870.39,11
HCPCS,25491,Reinforce ulna,,,8599.44,56389.43,11
HCPCS,25492,Reinforce radius and ulna,,,3239.17,14371.12,11
HCPCS,25500,HC CLOSED TREATMENT RADIAL SHAFT FX W/O MANIPULATION,914.0,639.8,,,0
HCPCS,25500,Treat fracture of radius,,,244.19,1083.4,11
HCPCS,25505,HC CLOSED TX RADIAL SHAFT FX W/ MANIPULATION,1066.0,746.2,,,0
HCPCS,25505,HC PRO TREAT FX RAD SHAFT W/ MAN,987.0,690.9,,,0
HCPCS,25505,Treat fracture of radius,,,802.59,7062.54,11
HCPCS,25515,Treat fracture of radius,,,7010.62,31870.39,11
HCPCS,25520,HC CLOSED TX RADIAL SHAFT & DISLOCATION DISTAL RADIOULNAR JOINT,3078.0,2154.6,,,0
HCPCS,25520,Treat fracture of radius,,,353.72,7062.54,11
HCPCS,25525,Treat fracture of radius,,,7183.42,31870.39,11
HCPCS,25526,Treat fracture of radius,,,7183.42,31870.39,11
HCPCS,25530,HC CLSD ULNAR W/O MANIP,852.0,596.4,,,0
HCPCS,25530,Treat fracture of ulna,,,244.19,1083.4,11
HCPCS,25535,HC CLOSED TX ULNAR SHAFT FX W/MANIPULATION,898.0,628.6,,,0
HCPCS,25535,HC PRO CLOSED TX ULNAR SHAFT FX W/MANIPULATION,988.0,691.6,,,0
HCPCS,25535,Treat fracture of ulna,,,244.19,1083.4,11
HCPCS,25545,Treat fracture of ulna,,,5906.26,31870.39,11
HCPCS,25560,HC TREAT FX RAD & ULNA SHAFT,440.0,308.0,,,0
HCPCS,25560,Treat fracture radius & ulna,,,244.19,1083.4,11
HCPCS,25565,HC PRO TREAT FX RAD ULNA SHAFT W/ MAN,1029.0,720.3,,,0
HCPCS,25565,HC TREAT FX RAD ULNA SHAFT W/ MAN,735.0,514.5,,,0
HCPCS,25565,Treat fracture radius & ulna,,,553.3,7062.54,11
HCPCS,25574,Treat fracture radius & ulna,,,7183.42,31870.39,11
HCPCS,25575,Treat fracture radius/ulna,,,7183.42,31870.39,11
HCPCS,25600,HC PRO TREAT FX RAD ULNA DISTAL,862.0,603.4,,,0
HCPCS,25600,HC TREAT FX RADIUS/ULNA DISTAL,716.0,501.2,,,0
HCPCS,25600,Treat fracture radius/ulna,,,244.19,10205.34,11
HCPCS,25605,HC PRO TREAT FX RAD ULNA DISTAL W/ MAN,1100.0,770.0,,,0
HCPCS,25605,HC TREAT FX RAD/ULNA DISTAL W/ MAN,1826.0,1278.2,,,0
HCPCS,25605,Treat fracture radius/ulna,,,780.06,7062.54,11
HCPCS,25606,Treat Fx Distal Radial,,,3239.17,14371.12,11
HCPCS,25607,HC OPEN TX DISTAL RADIAL EXTRA ARTICULAR FX/EPIPHYSEAL SEP W/INT FIX,23479.0,16435.3,,,0
HCPCS,25607,HC PRO OPEN TX DISTAL RADIAL EXTRA ARTICULAR FX/EPIPHYSEAL SEP W/INT FIX,1700.0,1190.0,,,0
HCPCS,25607,Treat Fx Rad Extra-Articul,,,7183.42,31870.39,11
HCPCS,25608,Treat Fx Rad Intra-Articul,,,7183.42,31870.39,11
HCPCS,25609,Treat Fx Radial 3+ Frag,,,7183.42,31870.39,11
HCPCS,25622,HC CLOSED TX CARPAL SCAPHOID (NAVICULAR) FX W/O MANIPULATION,852.0,596.4,,,0
HCPCS,25622,Treat wrist bone fracture,,,244.19,1083.4,11
HCPCS,25624,Treat wrist bone fracture,,,1591.86,7062.54,11
HCPCS,25628,Treat wrist bone fracture,,,3632.05,31870.39,11
HCPCS,25630,HC CLOSED TX CARPAL BONE FX W/O MANIPULATION EACH BONE,852.0,596.4,,,0
HCPCS,25630,Treat wrist bone fracture,,,244.19,1083.4,11
HCPCS,25635,Treat wrist bone fracture,,,353.72,7062.54,11
HCPCS,25645,Treat wrist bone fracture,,,3239.17,14371.12,11
HCPCS,25650,HC CLOSED TX ULNAR STYLOID FX,852.0,596.4,,,0
HCPCS,25650,HC PRO CLOSED TX ULNAR STYLOID FX,696.0,487.2,,,0
HCPCS,25650,Treat wrist bone fracture,,,244.19,1083.4,11
HCPCS,25651,Pin ulnar styloid fracture,,,3239.17,14371.12,11
HCPCS,25652,Treat fracture ulnar styloid,,,2788.64,31870.39,11
HCPCS,25660,HC CLOSED TREATMENT OF RADIOCARPAL/INTERCARPAL DISLOCATION 1 OR MORE BONES W/ MANIPULATION,330.0,231.0,,,0
HCPCS,25660,HC PRO CLOSED TREATMENT OF RADIOCARPAL/INTERCARPAL DISLOCATION 1 OR MORE BONES W/ MANIPULATION,507.0,354.9,,,0
HCPCS,25660,Treat wrist dislocation,,,244.19,1083.4,11
HCPCS,25670,Treat wrist dislocation,,,5233.29,31870.39,11
HCPCS,25671,Pin radioulnar dislocation,,,3239.17,14371.12,11
HCPCS,25675,HC CLSD TX DISTAL RADIO DISLOC,898.0,628.6,,,0
HCPCS,25675,HC PRO CLSD TX DISTAL RADIOULNAR DISLOC,649.0,454.3,,,0
HCPCS,25675,Treat wrist dislocation,,,244.19,1083.4,11
HCPCS,25676,Treat wrist dislocation,,,5233.29,31870.39,11
HCPCS,25680,Treat wrist fracture,,,244.19,1083.4,11
HCPCS,25685,Treat wrist fracture,,,5233.29,31870.39,11
HCPCS,25690,HC PRO TREAT WRIST DISLOCATION,589.0,412.3,,,0
HCPCS,25690,HC TREAT WRIST DISLOCATION,5564.0,3894.8,,,0
HCPCS,25690,Treat wrist dislocation,,,353.72,7062.54,11
HCPCS,25695,Treat wrist dislocation,,,5233.29,31870.39,11
HCPCS,25800,Fusion of wrist joint,,,7183.42,31870.39,11
HCPCS,25805,Fusion/graft of wrist joint,,,7183.42,31870.39,11
HCPCS,25810,Fusion/graft of wrist joint,,,12709.88,56389.43,11
HCPCS,25820,Fusion of hand bones,,,3293.67,31870.39,11
HCPCS,25825,Fuse hand bones with graft,,,7183.42,31870.39,11
HCPCS,25830,Fusion radioulnar jnt/ulna,,,7183.42,31870.39,11
HCPCS,25900,Amputation of forearm,,,7183.42,46549.79,11
HCPCS,25905,Amputation of forearm,,,7183.42,46549.79,11
HCPCS,25907,Amputation follow-up surgery,,,3239.17,14371.12,11
HCPCS,25909,Amputation follow-up surgery,,,7183.42,31870.39,11
HCPCS,25915,Amputation of forearm,,,7183.42,31870.39,11
HCPCS,25920,Amputate hand at wrist,,,3239.17,23681.51,11
HCPCS,25922,Amputate hand at wrist,,,1591.86,7062.54,11
HCPCS,25924,Amputation follow-up surgery,,,3239.17,23681.51,11
HCPCS,25927,Amputation of hand,,,3239.17,14371.12,11
HCPCS,25929,Amputation follow-up surgery,,,2042.58,9062.24,11
HCPCS,25931,Amputation follow-up surgery,,,3239.17,14371.12,11
HCPCS,25999,Forearm or wrist surgery,,,244.19,1083.4,11
HCPCS,26010,Drainage of finger abscess,,,167.93,881.22,11
HCPCS,26010,HC DRAINAGE OF FINGER ABSCESS,243.0,170.1,,,0
HCPCS,26010,HC PRO DRAINAGE OF FINGER ABSCESS,189.0,132.3,,,0
HCPCS,26011,Drainage of finger abscess,,,1635.03,7254.06,11
HCPCS,26011,HC DRAINAGE OF FINGER ABSCESS COMPLICATED,1377.0,963.9,,,0
HCPCS,26011,HC PRO DRAIN FINGER ABSCESS COMPLICATED,472.0,330.4,,,0
HCPCS,26020,Drain hand tendon sheath,,,3239.17,14371.12,11
HCPCS,26025,Drainage of palm bursa,,,3239.17,14371.12,11
HCPCS,26030,Drainage of palm bursas,,,3239.17,14371.12,11
HCPCS,26034,Treat hand bone lesion,,,1591.86,7062.54,11
HCPCS,26035,Decompress fingers/hand,,,3239.17,14371.12,11
HCPCS,26037,Decompress fingers/hand,,,3239.17,14371.12,11
HCPCS,26040,Release palm contracture,,,1591.86,7062.54,11
HCPCS,26045,Release palm contracture,,,3239.17,14371.12,11
HCPCS,26055,Incise finger tendon sheath,,,1591.86,7062.54,11
HCPCS,26060,Incision of finger tendon,,,1591.86,7062.54,11
HCPCS,26070,Explore/treat hand joint,,,1591.86,7062.54,11
HCPCS,26075,Explore/treat finger joint,,,3239.17,14371.12,11
HCPCS,26080,Explore/treat finger joint,,,1591.86,10470.83,11
HCPCS,26100,Biopsy hand joint lining,,,3239.17,14371.12,11
HCPCS,26105,Biopsy finger joint lining,,,3239.17,14371.12,11
HCPCS,26110,Biopsy finger joint lining,,,1591.86,7062.54,11
HCPCS,26111,Exc hand les sc 1.5 cm/>,,,1635.03,7254.06,11
HCPCS,26111,HC EXC HAND LES SC > 1.5 CM,6544.0,4580.8,,,0
HCPCS,26113,Exc hand tum deep 1.5 cm/>,,,1635.03,7254.06,11
HCPCS,26115,Exc hand les sc < 1.5 cm,,,1635.03,7254.06,11
HCPCS,26116,Exc hand tum deep < 1.5 cm,,,1635.03,7254.06,11
HCPCS,26117,Rad resect hand tumor < 3 cm,,,2875.57,12757.95,11
HCPCS,26118,Rad resect hand tumor 3 cm/>,,,2875.57,12757.95,11
HCPCS,26121,Release palm contracture,,,3239.17,14371.12,11
HCPCS,26123,Release palm contracture,,,3239.17,14371.12,11
HCPCS,26125,Release palm contracture,,,3293.67,4108.94,4
HCPCS,26130,Remove wrist joint lining,,,3239.17,14371.12,11
HCPCS,26135,Revise finger joint each,,,3239.17,14371.12,11
HCPCS,26140,Revise finger joint each,,,1591.86,7062.54,11
HCPCS,26145,Tendon excision palm/finger,,,1591.86,7062.54,11
HCPCS,26160,Remove tendon sheath lesion,,,1591.86,7062.54,11
HCPCS,26170,Removal of palm tendon each,,,1591.86,7062.54,11
HCPCS,26180,Removal of finger tendon,,,1591.86,7062.54,11
HCPCS,26185,Remove finger bone,,,1591.86,7062.54,11
HCPCS,26200,Remove hand bone lesion,,,1591.86,7062.54,11
HCPCS,26205,Remove/graft bone lesion,,,5263.59,31870.39,11
HCPCS,26210,Removal of finger lesion,,,1591.86,7062.54,11
HCPCS,26215,Remove/graft finger lesion,,,3239.17,14371.12,11
HCPCS,26230,Partial removal of hand bone,,,3239.17,14371.12,11
HCPCS,26235,Partial removal finger bone,,,1591.86,7062.54,11
HCPCS,26236,Partial removal finger bone,,,1591.86,7062.54,11
HCPCS,26250,Extensive hand surgery,,,3239.17,14371.12,11
HCPCS,26260,Resect prox finger tumor,,,3239.17,14371.12,11
HCPCS,26262,Resect distal finger tumor,,,1591.86,7062.54,11
HCPCS,26320,Removal of implant from hand,,,1635.03,7254.06,11
HCPCS,26340,Manipulate finger w/anesth,,,353.72,7062.54,11
HCPCS,26341,Manipulat palm cord post inj,,,244.19,1507.69,11
HCPCS,26350,Repair finger/hand tendon,,,3239.17,14371.12,11
HCPCS,26352,Repair/graft hand tendon,,,5263.59,31870.39,11
HCPCS,26356,Repair finger/hand tendon,,,3239.17,14371.12,11
HCPCS,26357,Repair finger/hand tendon,,,3239.17,14371.12,11
HCPCS,26358,Repair/graft hand tendon,,,5263.59,31870.39,11
HCPCS,26370,Repair finger/hand tendon,,,3239.17,14371.12,11
HCPCS,26372,Repair/graft hand tendon,,,5263.59,31870.39,11
HCPCS,26373,Repair finger/hand tendon,,,3239.17,14371.12,11
HCPCS,26390,Revise hand/finger tendon,,,5263.59,31870.39,11
HCPCS,26392,Repair/graft hand tendon,,,5263.59,31870.39,11
HCPCS,26410,Repair hand tendon,,,1520.92,7062.54,11
HCPCS,26412,Repair/graft hand tendon,,,3239.17,14371.12,11
HCPCS,26415,Excision hand/finger tendon,,,3239.17,14371.12,11
HCPCS,26416,Graft hand or finger tendon,,,3239.17,14371.12,11
HCPCS,26418,Repair finger tendon,,,1591.86,7062.54,11
HCPCS,26420,Repair/graft finger tendon,,,3239.17,14371.12,11
HCPCS,26426,Repair finger/hand tendon,,,3239.17,14371.12,11
HCPCS,26428,Repair/graft finger tendon,,,3239.17,14371.12,11
HCPCS,26432,Repair finger tendon,,,1591.86,7062.54,11
HCPCS,26433,Repair finger tendon,,,3239.17,14371.12,11
HCPCS,26434,Repair/graft finger tendon,,,3239.17,14371.12,11
HCPCS,26437,Realignment of tendons,,,3239.17,14371.12,11
HCPCS,26440,Release palm/finger tendon,,,1591.86,7062.54,11
HCPCS,26442,Release palm & finger tendon,,,3239.17,14371.12,11
HCPCS,26445,Release hand/finger tendon,,,3239.17,14371.12,11
HCPCS,26449,Release forearm/hand tendon,,,3239.17,14371.12,11
HCPCS,26450,Incision of palm tendon,,,3239.17,14371.12,11
HCPCS,26455,Incision of finger tendon,,,1591.86,7062.54,11
HCPCS,26460,Incise hand/finger tendon,,,1591.86,7062.54,11
HCPCS,26471,Fusion of finger tendons,,,3239.17,14371.12,11
HCPCS,26474,Fusion of finger tendons,,,1591.86,7062.54,11
HCPCS,26476,Tendon lengthening,,,3239.17,14371.12,11
HCPCS,26477,Tendon shortening,,,3239.17,14371.12,11
HCPCS,26478,Lengthening of hand tendon,,,3239.17,14371.12,11
HCPCS,26479,Shortening of hand tendon,,,3239.17,14371.12,11
HCPCS,26480,Transplant hand tendon,,,3239.17,14371.12,11
HCPCS,26483,Transplant/graft hand tendon,,,3239.17,14371.12,11
HCPCS,26485,Transplant palm tendon,,,3239.17,14371.12,11
HCPCS,26489,Transplant/graft palm tendon,,,3239.17,14371.12,11
HCPCS,26490,Revise thumb tendon,,,3239.17,14371.12,11
HCPCS,26492,Tendon transfer with graft,,,3239.17,14371.12,11
HCPCS,26494,Hand tendon/muscle transfer,,,3239.17,14371.12,11
HCPCS,26496,Revise thumb tendon,,,3239.17,14371.12,11
HCPCS,26497,Finger tendon transfer,,,3239.17,14371.12,11
HCPCS,26498,Finger tendon transfer,,,3239.17,14371.12,11
HCPCS,26499,Revision of finger,,,3239.17,14371.12,11
HCPCS,26500,Hand tendon reconstruction,,,3293.67,31870.39,11
HCPCS,26502,Hand tendon reconstruction,,,3239.17,14371.12,11
HCPCS,26508,Release thumb contracture,,,3239.17,14371.12,11
HCPCS,26510,Thumb tendon transfer,,,3239.17,14371.12,11
HCPCS,26516,Fusion of knuckle joint,,,3239.17,14371.12,11
HCPCS,26517,Fusion of knuckle joints,,,3239.17,14371.12,11
HCPCS,26518,Fusion of knuckle joints,,,5263.59,31870.39,11
HCPCS,26520,Release knuckle contracture,,,3239.17,14371.12,11
HCPCS,26525,Release finger contracture,,,1591.86,7062.54,11
HCPCS,26530,Revise knuckle joint,,,2046.14,31870.39,11
HCPCS,26531,Revise knuckle with implant,,,7183.42,31870.39,11
HCPCS,26535,Revise finger joint,,,3239.17,14371.12,11
HCPCS,26536,Revise/implant finger joint,,,3120.88,31870.39,11
HCPCS,26540,Repair hand joint,,,3239.17,14371.12,11
HCPCS,26541,Repair hand joint with graft,,,3239.17,14371.12,11
HCPCS,26542,Repair hand joint with graft,,,3239.17,14371.12,11
HCPCS,26545,Reconstruct finger joint,,,3239.17,14371.12,11
HCPCS,26546,Repair nonunion hand,,,5263.59,31870.39,11
HCPCS,26548,Reconstruct finger joint,,,3239.17,14371.12,11
HCPCS,26550,Construct thumb replacement,,,3239.17,14371.12,11
HCPCS,26551,Great toe-hand transfer,,,7183.42,31870.39,11
HCPCS,26553,Single transfer toe-hand,,,7183.42,31870.39,11
HCPCS,26554,Double transfer toe-hand,,,7183.42,31870.39,11
HCPCS,26555,Positional change of finger,,,5263.59,31870.39,11
HCPCS,26556,Toe joint transfer,,,7183.42,31870.39,11
HCPCS,26560,Repair of web finger,,,1591.86,7062.54,11
HCPCS,26561,Repair of web finger,,,3239.17,14371.12,11
HCPCS,26562,Repair of web finger,,,3239.17,14371.12,11
HCPCS,26565,Correct metacarpal flaw,,,3239.17,14371.12,11
HCPCS,26567,Correct finger deformity,,,3239.17,14371.12,11
HCPCS,26568,Lengthen metacarpal/finger,,,5263.59,31870.39,11
HCPCS,26580,Repair hand deformity,,,3239.17,14371.12,11
HCPCS,26587,Reconstruct extra finger,,,3239.17,14371.12,11
HCPCS,26590,Repair finger deformity,,,1591.86,7062.54,11
HCPCS,26591,Repair muscles of hand,,,3239.17,14371.12,11
HCPCS,26593,Release muscles of hand,,,3239.17,14371.12,11
HCPCS,26596,Excision constricting tissue,,,3239.17,14371.12,11
HCPCS,26600,HC CLOSED TX METACARPAL FX SINGLE W/O MANIPULATION EACH BONE,846.0,592.2,,,0
HCPCS,26600,HC PRO CLOSED TX METACARPAL FX SINGLE W/O MANIPULATION EACH BONE,728.0,509.6,,,0
HCPCS,26600,Treat metacarpal fracture,,,244.19,1083.4,11
HCPCS,26605,HC CLOSED TX METACARPAL FX SINGLE W/MANIPULATION EACH BONE,973.0,681.1,,,0
HCPCS,26605,HC PRO TREAT METACARPAL FX EA W/ MAN,987.0,690.9,,,0
HCPCS,26605,Treat metacarpal fracture,,,244.19,1083.4,11
HCPCS,26607,Treat metacarpal fracture,,,353.72,14371.12,11
HCPCS,26608,Treat metacarpal fracture,,,3239.17,14371.12,11
HCPCS,26615,Treat metacarpal fracture,,,3239.17,14371.12,11
HCPCS,26641,HC PRO TREAT THUMB DISLOCATION,401.0,280.7,,,0
HCPCS,26641,HC TREAT THUMB DISLOCATION,320.0,224.0,,,0
HCPCS,26641,Treat thumb dislocation,,,244.19,1083.4,11
HCPCS,26645,HC PRO TREAT THUMB FX,635.0,444.5,,,0
HCPCS,26645,TREAT THUMB FRACTURE,5792.0,4054.4,,,0
HCPCS,26645,Treat thumb fracture,,,353.72,7062.54,11
HCPCS,26650,Treat thumb fracture,,,3239.17,14371.12,11
HCPCS,26665,Treat thumb fracture,,,3239.17,14371.12,11
HCPCS,26670,HC CLSD TX CARPOMETACARP DISL W/ MANIP EA JOINT W/O ANESTH,253.0,177.1,,,0
HCPCS,26670,HC PRO CLSD TX CARPOMETACARP DISL W/ MANIP EA JOINT W/O ANESTH,379.0,265.3,,,0
HCPCS,26670,Treat hand dislocation,,,190.22,1083.4,11
HCPCS,26675,Treat hand dislocation,,,353.72,7062.54,11
HCPCS,26676,Pin hand dislocation,,,3239.17,14371.12,11
HCPCS,26685,Treat hand dislocation,,,3239.17,14371.12,11
HCPCS,26686,Treat hand dislocation,,,3239.17,14780.67,11
HCPCS,26700,HC PRO CLOSED TX KNUCKLE DISL SINGLE W/ MANIP W/O ANESTH,752.0,526.4,,,0
HCPCS,26700,HC TX MP DISLOC W/ MANIP,357.0,249.9,,,0
HCPCS,26700,Treat knuckle dislocation,,,244.19,1083.4,11
HCPCS,26705,HC CLOSED TX METACARPOPHALANGEAL DISLOCATION SINGLE W/ MANIP & ANES,6326.0,4428.2,,,0
HCPCS,26705,HC PRO CLOSD TX METACARPOPHALANGEAL DISLOCATION SINGLE W/ MANIP & ANES,892.0,624.4,,,0
HCPCS,26705,Treat knuckle dislocation,,,1591.86,7062.54,11
HCPCS,26706,Pin knuckle dislocation,,,353.72,14371.12,11
HCPCS,26715,Treat knuckle dislocation,,,3239.17,14371.12,11
HCPCS,26720,HC CLOSED TX PHALANGEAL SHAFT FX PROXIMAL/MIDDLE PHALANX FINGER/THUMB W/O MANIPULATION EACH,357.0,249.9,,,0
HCPCS,26720,HC PRO CLOSED TX PHALANGEAL SHAFT FX PROXIMAL/MIDDLE PHALANX FINGER/THUMB W/O MANIPULATION EACH,452.0,316.4,,,0
HCPCS,26720,Treat finger fracture each,,,244.19,1083.4,11
HCPCS,26725,HC CLOSED TX PHALANGEAL SHAFT FX PROXIMAL/MIDDLE PHALANX FINGER/THUMB W/MANIPULATE W/WO SKIN/SKELETAL TRACTION EACH,357.0,249.9,,,0
HCPCS,26725,HC PRO CLOSED TX PHALANGEAL SHAFT FX PROXIMAL/MIDDLE PHALANX FINGER/THUMB W/MANIPULATE W/WO SKIN/SKELETAL TRACTION EACH,821.0,574.7,,,0
HCPCS,26725,Treat finger fracture each,,,244.19,1481.1,11
HCPCS,26727,Treat finger fracture each,,,3239.17,14371.12,11
HCPCS,26735,Treat finger fracture each,,,3239.17,14371.12,11
HCPCS,26740,HC PRO TREAT FINGER FX EA W/O MANIP,506.0,354.2,,,0
HCPCS,26740,Treat finger fracture each,,,244.19,1083.4,11
HCPCS,26742,HC CLSD TX ARTICULAR FX INCL METACARPOPHALANGEAL/INTERPHANLANGEAL JOINT W/MANIP EACH,5523.0,3866.1,,,0
HCPCS,26742,Treat finger fracture each,,,353.72,7062.54,11
HCPCS,26746,Treat finger fracture each,,,3239.17,14371.12,11
HCPCS,26750,HC CLOSED TREATMENT OF DISTAL PHLNGL FRACTURE FINGER OR THUMB W/O MANIPULATION EACH,672.0,470.4,,,0
HCPCS,26750,HC PRO CLOSED TREATMENT OF DISTAL PHLNGL FRACTURE FINGER OR THUMB W/O MANIPULATION EACH,426.0,298.2,,,0
HCPCS,26750,Treat finger fracture each,,,244.19,1083.4,11
HCPCS,26755,HC CL TX DIST PHALANG FX FINGER/THUMB W/ MANIP,773.0,541.1,,,0
HCPCS,26755,HC PRO CL TX DIS PHALANG FX FNGR/THUMB W/ MANIP,383.0,268.1,,,0
HCPCS,26755,Treat finger fracture each,,,240.6,1083.4,11
HCPCS,26756,Pin finger fracture each,,,3239.17,14371.12,11
HCPCS,26765,HC PRO OPEN TX DISTAL PHALANGEAL FRACTURE FINGER/THUMB INCL INTERNAL FIXATION EA,1148.0,803.6,,,0
HCPCS,26765,Treat finger fracture each,,,3239.17,14371.12,11
HCPCS,26770,HC PRO TREAT FINGER DISLOCATION,718.0,502.6,,,0
HCPCS,26770,TREAT FINGER DISLOCATION,716.0,501.2,,,0
HCPCS,26770,Treat finger dislocation,,,244.19,1083.4,11
HCPCS,26775,HC CLOSED TX INTERPHALANGEAL JOINT DISLOC SINGLE W/MANIP REQ ANESTH,1253.0,877.1,,,0
HCPCS,26775,HC PRO CLOSED TX INTERPHALANGEAL JOINT DISLOC SINGLE W/ MANIP REQ ANESTH,427.0,298.9,,,0
HCPCS,26775,Treat finger dislocation,,,276.89,3685.16,11
HCPCS,26776,Pin finger dislocation,,,3239.17,14371.12,11
HCPCS,26785,Treat finger dislocation,,,2421.36,14371.12,11
HCPCS,26820,Thumb fusion with graft,,,5263.59,31870.39,11
HCPCS,26841,Fusion of thumb,,,5263.59,31870.39,11
HCPCS,26842,Thumb fusion with graft,,,5263.59,31870.39,11
HCPCS,26843,Fusion of hand joint,,,5263.59,31870.39,11
HCPCS,26844,Fusion/graft of hand joint,,,5263.59,31870.39,11
HCPCS,26850,Fusion of knuckle,,,5263.59,31870.39,11
HCPCS,26852,Fusion of knuckle with graft,,,5263.59,31870.39,11
HCPCS,26860,Fusion of finger joint,,,2693.96,14371.12,11
HCPCS,26861,Fusion of finger jnt add-on,,,5263.59,6566.46,4
HCPCS,26862,Fusion/graft of finger joint,,,3239.17,14371.12,11
HCPCS,26863,Fuse/graft added joint,,,5263.59,6566.46,4
HCPCS,26910,Amputate metacarpal bone,,,3239.17,14371.12,11
HCPCS,26951,Amputation of finger/thumb,,,3239.17,14371.12,11
HCPCS,26951,HC AMPUTATION OF FINGER/THUMB,12299.0,8609.3,,,0
HCPCS,26952,Amputation of finger/thumb,,,2561.94,14371.12,11
HCPCS,26989,Hand/finger surgery,,,244.19,1083.4,11
HCPCS,26990,Drainage of pelvis lesion,,,3239.17,14371.12,11
HCPCS,26991,Drainage of pelvis bursa,,,1591.86,7062.54,11
HCPCS,26992,Drainage of bone lesion,,,3239.17,23681.51,11
HCPCS,27000,Incision of hip tendon,,,1591.86,7062.54,11
HCPCS,27000001,HC PER DIEM SUPPLY ACUTE ROOM & CARE,16.0,11.2,,,0
HCPCS,27000002,HC PER DIEM SUPPLY SPECIAL ACUTE CARE,15.0,10.5,,,0
HCPCS,27000003,HC PER DIEM SUPPLY INTENSIVE CARE,58.0,40.6,,,0
HCPCS,27000004,HC PER DIEM SUPPLY CORONARY CARE,63.0,44.1,,,0
HCPCS,27000005,HC PER DIEM SUPPLY EXTENDED NURSERY,9.0,6.3,,,0
HCPCS,27000006,HC PER DIEM SUPPLY NURSERY,9.0,6.3,,,0
HCPCS,27000007,HC PER DIEM SUPPLY OBSERVATION,16.0,11.2,,,0
HCPCS,27000008,HC AVAMAX PLUS BONE CEMENT DELIVERY SYSTEM,2164.0,1514.8,,,0
HCPCS,27000009,HC AVAMAX VERTEBRAL BALLOON TRAY,4659.0,3261.3,,,0
HCPCS,27000010,HC AVAMAX VERTEBRAL AUGMENTATION DRILL,480.0,336.0,,,0
HCPCS,27000011,HC NEEDLE ASPIRATION,301.0,210.7,,,0
HCPCS,27000012,HC SET BLADE SHAPER SPINEOLOGY,1649.0,1154.3,,,0
HCPCS,27000013,HC SET DILATOR SPINEOLOGY,879.0,615.3,,,0
HCPCS,27000014,HC SET LIVER ACCESS ROSCH-UCHIDA,999.0,699.3,,,0
HCPCS,27000015,HC TUBE FEEDING LOW PROFILE MIC,999.0,699.3,,,0
HCPCS,27000016,HC ADAPTIC DRESSINGS ALL SIZES,7.0,4.9,,,0
HCPCS,27000498,HC FORTEX PTA BALLOON CATH 80MM,281.0,196.7,,,0
HCPCS,27000499,HC RAPIDCROSS PTA BALLOON CATH 90CM,305.0,213.5,,,0
HCPCS,27000557,HC SET EXT SM BORE 7IN BIFUSE,16.0,11.2,,,0
HCPCS,27000558,HC SET EXT SM BORE TRIFUSE 4IN,44.0,30.8,,,0
HCPCS,27000559,HC SET EXTENSION SMLLBOR QDFUSE,21.0,14.7,,,0
HCPCS,27000561,HC COOK ENDOBRONCHIAL BLOCKER SET,731.0,511.7,,,0
HCPCS,27000562,HC PLEURX-LOCKABLE DRAINAGE KIT,132.0,92.4,,,0
HCPCS,27000654,HC CATH SCEPTER C BLLN,4490.0,3143.0,,,0
HCPCS,27000655,HC CATH SCEPTER XC BLLN,5452.0,3816.4,,,0
HCPCS,27000658,HC DISPOSABLE MASK SM/MED/LG,44.0,30.8,,,0
HCPCS,27000659,HC PORTER DISPOSABLE BREATHING CIRCUIT (6FT),160.0,112.0,,,0
HCPCS,27000660,HC SENSOR FORE SIGHT,504.0,352.8,,,0
HCPCS,27000670,"HC EEF GRASS DISPOSABLE 10MM AG/AGCL DEEP-CUP ELECTRODE 39"" WIRE",126.0,88.2,,,0
HCPCS,27000672,HC ESOPHAGEAL BALLOON CATHETER,261.0,182.7,,,0
HCPCS,27000681,HC MARKER DELIVERY KIT,506.0,354.2,,,0
HCPCS,27000705,HC DRESSING ALLEVYN LIFE SACRUM (SMALL) 6.75X6.875,41.0,28.7,,,0
HCPCS,27000706,HC DRESSING ALLEVYN LIFE SACRUM (LARGE) 8.5X9,64.0,44.8,,,0
HCPCS,27000707,HC SNAP CARTRIDGE 75/100/125 MM HG,489.0,342.3,,,0
HCPCS,27000708,HC SNAP 10X10CM DRSNG KIT W/FOAM,261.0,182.7,,,0
HCPCS,27000709,HC SNAP 15X15CM DRSNG KIT W/FOAM,278.0,194.6,,,0
HCPCS,27000710,HC SNAP 20X20CM DRSNG KIT W/FOAM,277.0,193.9,,,0
HCPCS,27000711,HC SNAP 14X11CM BRG DRSG KT W/FM,308.0,215.6,,,0
HCPCS,27000712,HC SNAP 14X34CM LONG DRSNG KIT,388.0,271.6,,,0
HCPCS,27000713,HC SNAP SM/MED/LG STRAP,80.0,56.0,,,0
HCPCS,27000714,HC CERARING 2IN SLIM,13.0,9.1,,,0
HCPCS,27000740,HC CONTROL BOX ENPOWER,5539.0,3877.3,,,0
HCPCS,27000741,HC CABLE ENPOWER CONNECTING,479.0,335.3,,,0
HCPCS,27000774,HC SMART GUARD,148.0,103.6,,,0
HCPCS,27000796,HC AEROBIKA,213.0,149.1,,,0
HCPCS,27000797,HC RETRACTOR ABDOMINAL PANNICULUS,293.0,205.1,,,0
HCPCS,27000902,HC GLIDESCOPE SPECTRUM LOPRO SZ1/SZ2,272.0,190.4,,,0
HCPCS,27000903,HC GLIDESCOPE SPECTRUM LOPRO SZ3/SZ4,236.0,165.2,,,0
HCPCS,27000961,HC CANN CAPNOLINE NASAL ETCO2,95.0,66.5,,,0
HCPCS,27001,Incision of hip tendon,,,3239.17,14371.12,11
HCPCS,27001020,HC FEMALE EXTERNAL PUREWICK CATHETER,58.0,40.6,,,0
HCPCS,27001133,HC BFLEX 3.8 BRONCHOSCOPE,4732.0,3312.4,,,0
HCPCS,27001134,HC BFLEX 5.0 BRONCHOSCOPE,4732.0,3312.4,,,0
HCPCS,27001135,HC BFLEX 5.8 BRONCHOSCOPE,5454.0,3817.8,,,0
HCPCS,27001184,HC COMPRESSION WRAP COBAN 2 LITE,70.0,49.0,,,0
HCPCS,27001185,HC COMPRESSION WRAP COBAN 2,70.0,49.0,,,0
HCPCS,27001186,HC COMPRESSION WRAP COBAN 2XL,70.0,49.0,,,0
HCPCS,27001208,HC VASHE EACH BOTTLE,98.0,68.6,,,0
HCPCS,27001218,HC DISPOSABLE SUCTION CUPS FOR LUCUS CPR DEVICE,427.0,298.9,,,0
HCPCS,27001219,HC LIFESPARC PROTEKDUO 31 FR TANDEMLIFE PROCEDURE KIT,22990.0,16093.0,,,0
HCPCS,27001242,HC ELBOW RESTRAINT PEDI-WRAPS SMALL,172.0,120.4,,,0
HCPCS,27001243,HC ELBOW RESTRAINT PEDI-WRAPS LARGE,213.0,149.1,,,0
HCPCS,27001261,HC SET TLAB TRNSJUG LIVER BX,1862.0,1303.4,,,0
HCPCS,27001270,"HC HYPODERMIC EMG NEEDLES BIONEN 25MM (1"") X THIN 30 GAUGE ORANGE",84.0,58.8,,,0
HCPCS,27001318,HC KT EEG DISP NON-METAL MRI/CT LEADS 3A 26LD 1M,493.0,345.1,,,0
HCPCS,27001324,HC MICRO G JET BUTTON 14FR FEEDING TUBE,3369.0,2358.3,,,0
HCPCS,27001344,HC KIT TRANSFER SYS AIRTAP LC REPOSITION STANDARD 37IN X 65IN 600LB,884.0,618.8,,,0
HCPCS,27001345,HC KIT SYS PREVALON AIRTAP 2XLARGE 46IN X 51IN 800LB,1047.0,732.9,,,0
HCPCS,27001346,HC KIT CV SAFETY 7FRX16CM PU 3-LUM,300.0,210.0,,,0
HCPCS,27001349,HC STRYKER SAGE PRIMO FIT MALE EXTERNAL CATHETER,131.0,91.7,,,0
HCPCS,27001401,HC ORTHOSIS MULTI PODUS ALL SIZES,442.0,309.4,,,0
HCPCS,27001418,HC SNUGGLE UPS XSMALL SMALL MED LG,73.0,51.1,,,0
HCPCS,27001419,HC PHILIPS SQUISHON JELL PILLOW,53.0,37.1,,,0
HCPCS,27001451,HC FLOTRAC SENSOR,1143.0,800.1,,,0
HCPCS,27001485,HC AG CUFFILL CUFF PRESSURE MANOMETER 10CC,119.0,83.3,,,0
HCPCS,27001511,HC STRYKER MUL-T BLANKET PEDIATRIC/ADULT,66.0,46.2,,,0
HCPCS,27001535,HC KIT PREVALON AIRTAP XXL PATIENT REPOSITIONING SYSTEM 43IN X 81IN 1200LB,1015.0,710.5,,,0
HCPCS,27001561,HC BARD INTRA-ABDOMINAL PRESSURE MONITORING KIT,207.0,144.9,,,0
HCPCS,27001562,HC DRESSING ALLEVYN CLASSIC NON-ADHERENT 4IN X 4IN,16.0,11.2,,,0
HCPCS,27001582,HC CANISTER RENASYS WITH SOLIDIFIER 800ML,173.0,121.1,,,0
HCPCS,27001794,HC SURGICEL FIBRILLAR ABSORBABLE HEMOSTAT 2IN X 4IN,436.0,305.2,,,0
HCPCS,27001796,HC STATSEAL ADVANCED PLUS 2.2 CM 24 APPLICATIONS,182.0,127.4,,,0
HCPCS,27001926,HC PORT REMOVAL TRAY,344.0,240.8,,,0
HCPCS,27001943,HC MEFIX 2 IN 11 YD,23.0,16.1,,,0
HCPCS,27002001,HC KT MICINTRO CAPELLA COAX 4FR W/0.18IN X45CM GUIDEWIRE/ 21GA X 7CM NEEDLE,123.0,86.1,,,0
HCPCS,27002031,HC SET KENDALL ECG LEADWIRE 5LD 144IN,90.0,63.0,,,0
HCPCS,27002036,"HC PREVALON MOBILE AIR TRANSFER SYSTEM 39"" X 81""",282.0,197.4,,,0
HCPCS,27002068,HC SAGE CATHETER PRIMAFIT URETHRAL ADULT FEMALE,68.0,47.6,,,0
HCPCS,27002103,HC AFFERA LOCATION REFERENCE PATCH KIT,3713.0,2599.1,,,0
HCPCS,27002121,HC AIRVO AIRSPIRAL TUBE & CHAMBER KIT,424.0,296.8,,,0
HCPCS,27002139,HC ALRM POSEY MTRS PAD 13X32IN,78.0,54.6,,,0
HCPCS,27002140,HC ALRM POSEY CHR PAD 13X13IN,69.0,48.3,,,0
HCPCS,27003,Incision of hip tendon,,,5839.66,31870.39,11
HCPCS,27005,Incision of hip tendon,,,3239.17,23681.51,11
HCPCS,27006,Incision of hip tendons,,,3239.17,14371.12,11
HCPCS,27025,Incision of hip/thigh fascia,,,3239.17,23681.51,11
HCPCS,27027,Buttock fasciotomy,,,2372.37,31870.39,11
HCPCS,27030,Drainage of hip joint,,,7183.42,31870.39,11
HCPCS,27033,Exploration of hip joint,,,7183.42,31870.39,11
HCPCS,27035,Denervation of hip joint,,,3239.17,14371.12,11
HCPCS,27036,Excision of hip joint/muscle,,,7183.42,31870.39,11
HCPCS,27040,Biopsy of soft tissues,,,1635.03,7254.06,11
HCPCS,27041,Biopsy of soft tissues,,,1635.03,7254.06,11
HCPCS,27043,Exc hip pelvis les sc 3 cm/>,,,2875.57,12757.95,11
HCPCS,27045,Exc hip/pelv tum deep 5 cm/>,,,2875.57,12757.95,11
HCPCS,27047,Exc hip/pelvis les sc < 3 cm,,,2875.57,12757.95,11
HCPCS,27048,Exc hip/pelv tum deep < 5 cm,,,2875.57,12757.95,11
HCPCS,27049,Resect hip/pelv tum < 5 cm,,,2875.57,12757.95,11
HCPCS,27050,Biopsy of sacroiliac joint,,,1591.86,7062.54,11
HCPCS,27052,Biopsy of hip joint,,,1591.86,7062.54,11
HCPCS,27054,Removal of hip joint lining,,,3239.17,14371.12,11
HCPCS,27057,Buttock fasciotomy w/dbrdmt,,,1591.86,7062.54,11
HCPCS,27059,Resect hip/pelv tum 5 cm/>,,,2875.57,12757.95,11
HCPCS,27060,Removal of ischial bursa,,,4254.97,31870.39,11
HCPCS,27062,Remove femur lesion/bursa,,,3239.17,14371.12,11
HCPCS,27065,Remove hip bone les super,,,4254.97,31870.39,11
HCPCS,27066,Remove hip bone les deep,,,3239.17,14371.12,11
HCPCS,27067,Remove/graft hip bone lesion,,,5839.66,31870.39,11
HCPCS,27070,Part remove hip bone super,,,3239.17,23681.51,11
HCPCS,27071,Part removal hip bone deep,,,3239.17,23681.51,11
HCPCS,27075,Resect hip tumor,,,7183.42,31870.39,11
HCPCS,27076,Resect hip tum incl acetabul,,,7183.42,31870.39,11
HCPCS,27077,Resect hip tum w/innom bone,,,7183.42,46549.79,11
HCPCS,27078,Rsect hip tum incl femur,,,7183.42,46549.79,11
HCPCS,27080,Removal of tail bone,,,3239.17,14371.12,11
HCPCS,27086,Remove hip foreign body,,,1737.49,12757.95,11
HCPCS,27087,Remove hip foreign body,,,3239.17,14371.12,11
HCPCS,27090,Removal of hip prosthesis,,,7181.13,31870.39,11
HCPCS,27091,Removal of hip prosthesis,,,7181.13,56389.43,11
HCPCS,27093,HC INJECTION FOR HIP ARTHROGRAPHY W/O ANESTHESIA,753.0,527.1,,,0
HCPCS,27095,HC INJECTION FOR HIP ARTHROGRAPHY W/ANESTHESIA,866.0,606.2,,,0
HCPCS,27096,HC INJ SACROILIAC ARTHRGRPHY/ANES/STEROID W/IMAGE GUIDE,791.0,553.7,,,0
HCPCS,27096,Inject sacroiliac joint,,,196.62,245.28,4
HCPCS,27097,Revision of hip tendon,,,3239.17,14371.12,11
HCPCS,27098,Transfer tendon to pelvis,,,3239.17,14371.12,11
HCPCS,27100,Transfer of abdominal muscle,,,7183.42,31870.39,11
HCPCS,27100002,HC OXYGEN 24HR,477.0,333.9,,,0
HCPCS,27100003,HC OXYGEN SET UP,109.0,76.3,,,0
HCPCS,27100004,HC OXYGEN PER HOUR,22.0,15.4,,,0
HCPCS,27100005,HC NITRIC OXIDE HOURLY,288.0,201.6,,,0
HCPCS,27100006,HC NITRIC OXIDE SET UP,1093.0,765.1,,,0
HCPCS,27100007,HC H2O BELLOWS,447.0,312.9,,,0
HCPCS,27100008,HC OSCILLATOR CIRCUIT 3100A,490.0,343.0,,,0
HCPCS,27100009,HC AERO CHAMBER,169.0,118.3,,,0
HCPCS,27100011,HC TEDS KNEE HIGH,32.0,22.4,,,0
HCPCS,27100012,HC ADAPTER FLO-SWITCH,32.0,22.4,,,0
HCPCS,27100013,HC ADAPTER Y TUOY-BORST,69.0,48.3,,,0
HCPCS,27100014,HC ADHESIVE LIQ MASSITOL HAZ,176.0,123.2,,,0
HCPCS,27100015,HC AEROSOL THERAPY PER HOUR,94.0,65.8,,,0
HCPCS,27100016,HC APNEA MONITOR/DAY,90.0,63.0,,,0
HCPCS,27100017,HC BAG AMBU ADULT,55.0,38.5,,,0
HCPCS,27100018,HC BAG AMBU,81.0,56.7,,,0
HCPCS,27100019,HC BAG AMBU DISP,372.0,260.4,,,0
HCPCS,27100020,HC BAG DRAIN ABSCESS,59.0,41.3,,,0
HCPCS,27100021,HC BAG DRAIN LEG,75.0,52.5,,,0
HCPCS,27100022,HC BAG DRAIN SUCTION,169.0,118.3,,,0
HCPCS,27100023,HC BAG HYPERINFLATION 1/2 L,46.0,32.2,,,0
HCPCS,27100024,HC BAG RESUSCITATION PUL DISP,169.0,118.3,,,0
HCPCS,27100025,HC BAG URINARY,32.0,22.4,,,0
HCPCS,27100026,HC BAND HEMOSTASIS 14 INCH,112.0,78.4,,,0
HCPCS,27100029,HC DERMABOND / ETHICON,137.0,95.9,,,0
HCPCS,27100030,HC BELT ABDOMINAL OBESE,164.0,114.8,,,0
HCPCS,27100031,HC ELASTIC BANDAGE,16.0,11.2,,,0
HCPCS,27100032,HC BELT/BELLY BAND TRANSDUCER DISPOSABLE,21.0,14.7,,,0
HCPCS,27100033,HC BILI CHECK CALIBRATION TIPS,44.0,30.8,,,0
HCPCS,27100034,HC BILIARY BRUSH BIOPSY SET,427.0,298.9,,,0
HCPCS,27100035,HC BINDER ABDOMINAL,76.0,53.2,,,0
HCPCS,27100036,HC BINDER UNIVERSAL,76.0,53.2,,,0
HCPCS,27100037,HC BIOCLUSIVE 4X5,5.0,3.5,,,0
HCPCS,27100038,HC BIOPSY NEEDLE DEVICE,294.0,205.8,,,0
HCPCS,27100040,HC BREAST FEEDING UNIT,53.0,37.1,,,0
HCPCS,27100041,HC BUNNY BOOT,136.0,95.2,,,0
HCPCS,27100042,HC BURITROL,48.0,33.6,,,0
HCPCS,27100043,HC CAP SENSOR CO2 DETECTOR ADULT,58.0,40.6,,,0
HCPCS,27100044,HC CASKET INFANT 19 INCH,400.0,280.0,,,0
HCPCS,27100045,HC CATHETER SUCTION,5.0,3.5,,,0
HCPCS,27100046,HC CD MEDICAL GRADE,21.0,14.7,,,0
HCPCS,27100047,HC CHITO-SEAL,253.0,177.1,,,0
HCPCS,27100050,HC CONTAINER URINE 24 HR,9.0,6.3,,,0
HCPCS,27100051,HC DIAL A FLOW,29.0,20.3,,,0
HCPCS,27100052,HC ELECTRODE GROUNDING PAD,18.0,12.6,,,0
HCPCS,27100053,HC ELECTRODE PACING EXTERNAL,489.0,342.3,,,0
HCPCS,27100054,HC FEMSTOP,478.0,334.6,,,0
HCPCS,27100065,HC HEEL PROTECTOR SAGE,324.0,226.8,,,0
HCPCS,27100066,HC HIGHFLOW OXYGEN EA ADDT'L HOUR,22.0,15.4,,,0
HCPCS,27100067,HC HIGHFLOW OXYGEN INITIAL HOUR,141.0,98.7,,,0
HCPCS,27100068,HC INCENTIVE SPIROMETER,21.0,14.7,,,0
HCPCS,27100069,HC INT DELIVERY SET CLOSED,82.0,57.4,,,0
HCPCS,27100070,HC JET VENT CARTRIDGE,1017.0,711.9,,,0
HCPCS,27100071,HC J-LOOP IV W/INJ,15.0,10.5,,,0
HCPCS,27100073,HC KIT QUICKDRAW ABG 3CC 22G,9.0,6.3,,,0
HCPCS,27100074,HC KIT/TRAY TROCAR CATH,158.0,110.6,,,0
HCPCS,27100075,HC K-PAD DISPOSABLE,55.0,38.5,,,0
HCPCS,27100076,HC LEUR LOCK MALE/FEMALE,8.0,5.6,,,0
HCPCS,27100077,HC MASK ANES INFANT W/VALVE,16.0,11.2,,,0
HCPCS,27100078,HC MASK BILI DISP EA,24.0,16.8,,,0
HCPCS,27100079,HC MASK NEONATE W/VALVE,16.0,11.2,,,0
HCPCS,27100080,HC MONITOR BLOOD PRESSURE ARTERIAL,262.0,183.4,,,0
HCPCS,27100081,HC NELCOR OXISENSOR PEDIATRIC,105.0,73.5,,,0
HCPCS,27100083,HC OXYGEN PER HOUR,20.0,14.0,,,0
HCPCS,27100085,HC PAD 72,267.0,186.9,,,0
HCPCS,27100086,HC PAD COOLING ARCTIC DISPOSABLE SM/MED/LG,2863.0,2004.1,,,0
HCPCS,27100087,HC PAD COOLING ARCTIC DISPOSABLE UNIVERSAL,1140.0,798.0,,,0
HCPCS,27100088,HC PAD RADIATION PROTECTION,400.0,280.0,,,0
HCPCS,27100089,HC PAD W/TUBING,139.0,97.3,,,0
HCPCS,27100090,HC PAPER FETAL MONITOR,15.0,10.5,,,0
HCPCS,27100091,HC PELVIC EXAM COMPLETE ASST-SUPPLY,112.0,78.4,,,0
HCPCS,27100092,HC PILLOW ABDUCTION DISP,130.0,91.0,,,0
HCPCS,27100093,HC PILLOW ABDUCTION DISP LARGE,131.0,91.7,,,0
HCPCS,27100094,HC PRIMARY W/O CASSETTE 79C-0593,22.0,15.4,,,0
HCPCS,27100095,HC PROTECTION MANIFOLD STATION,249.0,174.3,,,0
HCPCS,27100096,HC PROTECTOR HEEL SAGE,324.0,226.8,,,0
HCPCS,27100098,HC SEAL RECTAL FECAL,1028.0,719.6,,,0
HCPCS,27100099,HC SEAL RECTALFECAL SPEC ORDER,1028.0,719.6,,,0
HCPCS,27100100,HC SET ADMIN CONTINUE FLOW,22.0,15.4,,,0
HCPCS,27100101,HC SET ANCHOR GI SCOPE,390.0,273.0,,,0
HCPCS,27100102,HC SET DRSSNG OPERICARDIAL PUHRA PLEURA,509.0,356.3,,,0
HCPCS,27100103,HC SET EZ,13.0,9.1,,,0
HCPCS,27100104,HC SET G-J TUBE,840.0,588.0,,,0
HCPCS,27100105,HC SET IV SECONDARY,9.0,6.3,,,0
HCPCS,27100106,HC SET POSSIS PUMP SUPPLY,1080.0,756.0,,,0
HCPCS,27100107,HC SET SECONDARY VENTED W/LL,9.0,6.3,,,0
HCPCS,27100108,HC SET TRANSDUCER MONITORING,149.0,104.3,,,0
HCPCS,27100109,HC SETUP AEROSOL /HUMIDITY,148.0,103.6,,,0
HCPCS,27100110,HC SETUP END TIDAL CARB DIOX,160.0,112.0,,,0
HCPCS,27100111,HC SETUP INITIAL BIPAP SUPPLIES,671.0,469.7,,,0
HCPCS,27100112,HC SHIELD BREAST,77.0,53.9,,,0
HCPCS,27100113,HC SHIELD BREAST 30,16.0,11.2,,,0
HCPCS,27100114,HC SHIELD BREAST PRSNL 36  NON STERILE,24.0,16.8,,,0
HCPCS,27100115,HC SHIELD NIPPLE,39.0,27.3,,,0
HCPCS,27100116,HC SLEEVE CMPR REG SCD EXP FT CUF,146.0,102.2,,,0
HCPCS,27100117,HC SLEEVE CMPR THIGH ALL SIZES,282.0,197.4,,,0
HCPCS,27100118,HC TUBE CHEST DRAINAGE THORAKLEX,238.0,166.6,,,0
HCPCS,27100119,HC SLEEVE ELECTRI COOL DISPOSABLE,236.0,165.2,,,0
HCPCS,27100120,HC SLEEVE SCD REPLACEMENT ONLY,214.0,149.8,,,0
HCPCS,27100121,HC SLING AND SWATHE DELUX UNIL BLUE,58.0,40.6,,,0
HCPCS,27100122,HC SOFT BAND KERLIX,13.0,9.1,,,0
HCPCS,27100123,HC SPIROMETER ADULT 4000ML,18.0,12.6,,,0
HCPCS,27100124,HC STRAINER CALCULI,13.0,9.1,,,0
HCPCS,27100125,HC SUCTION UNITS KIWI DISPOSABLE,148.0,103.6,,,0
HCPCS,27100126,HC SUPPORTER ATHLETIC ADULT SMALL,39.0,27.3,,,0
HCPCS,27100127,HC TEDS SCD LARGE,270.0,189.0,,,0
HCPCS,27100128,HC TEDS SEQUENTIAL,187.0,130.9,,,0
HCPCS,27100129,HC TEDS THIGH LENGTH,39.0,27.3,,,0
HCPCS,27100132,HC TRAP SPECIMEN,11.0,7.7,,,0
HCPCS,27100133,HC TRAY PERICARDIOCENTESIS,600.0,420.0,,,0
HCPCS,27100134,HC TRAY UROLOGY OBSTRUCTED URETHRA URO,959.0,671.3,,,0
HCPCS,27100135,HC TRAY UV CARGYLE NEO-SERT W/O CATH,277.0,193.9,,,0
HCPCS,27100136,HC TUBE BLAKEMORE,1190.0,833.0,,,0
HCPCS,27100137,HC TUBE CHEST DRAINAGE DOUBLE,242.0,169.4,,,0
HCPCS,27100138,HC TUBE FEEDING 5FR 15,5.0,3.5,,,0
HCPCS,27100139,HC TUBE GEL IODASORB 40G,203.0,142.1,,,0
HCPCS,27100140,HC TUBING BLOOD IV,40.0,28.0,,,0
HCPCS,27100141,HC TUBING BLOOD IV,40.0,28.0,,,0
HCPCS,27100142,HC TUBING BURITROL LINE 6.5,30.0,21.0,,,0
HCPCS,27100143,HC TUBING EPIDURAL NOT PORT,57.0,39.9,,,0
HCPCS,27100144,HC TUBING FOR HOT LINE,66.0,46.2,,,0
HCPCS,27100145,HC URINE COLLECTOR PED,10.0,7.0,,,0
HCPCS,27100146,HC VALVE DRAIN HEIMLICK,181.0,126.7,,,0
HCPCS,27100147,HC WIRE CUTTERS,72.0,50.4,,,0
HCPCS,27100150,HC HEMOVAC 1/4,52.0,36.4,,,0
HCPCS,27100151,HC ELASTIC STOCKINGS THIGH,32.0,22.4,,,0
HCPCS,27100154,HC LINER CANISTER SUCT BOTTLE,10.0,7.0,,,0
HCPCS,27100155,HC AMBU BAG,90.0,63.0,,,0
HCPCS,27100156,HC DRAIN SALEM SUMP,29.0,20.3,,,0
HCPCS,27100157,HC VALVE SALEM SUMP,31.0,21.7,,,0
HCPCS,27100158,HC IV SET NITRO W/LL,37.0,25.9,,,0
HCPCS,27100159,HC TRANSDUCER TRUWAVE PRESSURE CABLE,64.0,44.8,,,0
HCPCS,27100160,HC MANIFOLD 4-VALVE,151.0,105.7,,,0
HCPCS,27100161,HC SITZ BATH,16.0,11.2,,,0
HCPCS,27100168,HC BAG DRAINAGE BECKER 700L,214.0,149.8,,,0
HCPCS,27100169,HC BLANKET UPPER BODY SM W/ STRAPS,40.0,28.0,,,0
HCPCS,27100170,HC TRAY UVC ARGYLE NEO-SERT W/O CATH,277.0,193.9,,,0
HCPCS,27100171,HC 3M BLOOD SET,13.0,9.1,,,0
HCPCS,27100172,HC LEUR LOCK MALE/FEMALE,16.0,11.2,,,0
HCPCS,27100173,HC SET ADMIN CONTINUE FLOW,22.0,15.4,,,0
HCPCS,27100174,HC SET SECONDARY VENTED W/LL,11.0,7.7,,,0
HCPCS,27100175,HC TUBING BURITROL LINE 6.5,30.0,21.0,,,0
HCPCS,27100178,HC COMMODE CONTAINER HAT,4.0,2.8,,,0
HCPCS,27100179,HC CONTAINER URINE 24 HR,10.0,7.0,,,0
HCPCS,27100180,HC STRAINER CALCULI,13.0,9.1,,,0
HCPCS,27100181,HC PLEXIPULSE EACH,151.0,105.7,,,0
HCPCS,27100231,HC KIT PLEURAL SGL BOTTLE DRAIN,284.0,198.8,,,0
HCPCS,27100232,HC QUIK-CLOT 4X4 DRESSING,61.0,42.7,,,0
HCPCS,27100244,HC CATH INDIGO 3 STR TIP 150 CM,4144.0,2900.8,,,0
HCPCS,27100245,HC CATH INDIGO 6 STR TIP 135 CM,6490.0,4543.0,,,0
HCPCS,27100246,HC CATH INDIGO 8 STR TIP 85 CM,9818.0,6872.6,,,0
HCPCS,27100247,HC SEPARATOR INDIGO 3,2547.0,1782.9,,,0
HCPCS,27100248,HC SEPARATOR INDIGO 6,3845.0,2691.5,,,0
HCPCS,27100249,HC SEPARATOR INDIGO 8,6507.0,4554.9,,,0
HCPCS,27100250,HC TUBING ASPIRATION INDIGO,1778.0,1244.6,,,0
HCPCS,27100251,HC CANISTER PENUMBRA MAX,1414.0,989.8,,,0
HCPCS,27100288,HC PULMONARY AMBU BAG,55.0,38.5,,,0
HCPCS,27100289,HC DELIVERY SYS EVOLUT R 16FR,6768.0,4737.6,,,0
HCPCS,27100290,HC LOADING SYS EVOLUT R 34FR,1511.0,1057.7,,,0
HCPCS,27100299,HC POWER PULSE Y ADAPTER,201.0,140.7,,,0
HCPCS,27100313,HC CATH PROWLER MICRO 20CM,3429.0,2400.3,,,0
HCPCS,27100314,HC CATH PROWLER MICRO STRT,3349.0,2344.3,,,0
HCPCS,27100315,HC CATH ENVOY MPD,1771.0,1239.7,,,0
HCPCS,27100319,HC DANDLE ROO LITE BILI WRAP SM - LG,119.0,83.3,,,0
HCPCS,27100424,HC INFANT TRANSPORT MATTRESS,203.0,142.1,,,0
HCPCS,27100425,HC REPOSITIONING SYS QUICK CONNECT NON STERILE PREVALON AIRTRP SYSTEM,659.0,461.3,,,0
HCPCS,27100452,HC BRIDLE NG TUBE HOLDER,377.0,263.9,,,0
HCPCS,27100453,HC PATIENT MONITOR NOT RETURNED,200.0,140.0,,,0
HCPCS,27105,Transfer of spinal muscle,,,3239.17,14371.12,11
HCPCS,27110,Transfer of iliopsoas muscle,,,7183.42,31870.39,11
HCPCS,27111,Transfer of iliopsoas muscle,,,3239.17,14371.12,11
HCPCS,27120,Reconstruction of hip socket,,,12709.88,56389.43,11
HCPCS,27122,Reconstruction of hip socket,,,7183.42,46549.79,11
HCPCS,27125,Partial hip replacement,,,12709.88,56389.43,11
HCPCS,27130,Total hip arthroplasty,,,12709.88,56389.43,11
HCPCS,27132,Total hip arthroplasty,,,12709.88,56389.43,11
HCPCS,27134,Revise hip joint replacement,,,12709.88,56389.43,11
HCPCS,27137,Revise hip joint replacement,,,12709.88,56389.43,11
HCPCS,27138,Revise hip joint replacement,,,12709.88,56389.43,11
HCPCS,27140,Transplant femur ridge,,,7183.42,46549.79,11
HCPCS,27146,Incision of hip bone,,,7183.42,31870.39,11
HCPCS,27147,Revision of hip bone,,,7183.42,31870.39,11
HCPCS,27151,Incision of hip bones,,,7183.42,31870.39,11
HCPCS,27156,Revision of hip bones,,,7183.42,31870.39,11
HCPCS,27158,Revision of pelvis,,,7183.42,31870.39,11
HCPCS,27161,Incision of neck of femur,,,7183.42,31870.39,11
HCPCS,27165,Incision/fixation of femur,,,7183.42,31870.39,11
HCPCS,27170,Repair/graft femur head/neck,,,7183.42,31870.39,11
HCPCS,27175,Treat slipped epiphysis,,,3239.17,23681.51,11
HCPCS,27176,Treat slipped epiphysis,,,3239.17,46549.79,11
HCPCS,27177,Treat slipped epiphysis,,,3239.17,23681.51,11
HCPCS,27178,Treat slipped epiphysis,,,3239.17,23681.51,11
HCPCS,27179,Revise head/neck of femur,,,7183.42,31870.39,11
HCPCS,27181,Treat slipped epiphysis,,,7183.42,31870.39,11
HCPCS,27185,Revision of femur epiphysis,,,3239.17,23681.51,11
HCPCS,27187,Reinforce hip bones,,,7183.42,31870.39,11
HCPCS,27197,Clsd tx pelvic ring fx,,,244.19,1083.4,11
HCPCS,27198,Clsd tx pelvic ring fx,,,244.19,1083.4,11
HCPCS,27200,Treat tail bone fracture,,,244.19,1083.4,11
HCPCS,27200185,HC NEEDLE CRV RF 18 GA 145 MM,150.0,105.0,,,0
HCPCS,27200186,HC PEAK PLASMA BLADE,1099.0,769.3,,,0
HCPCS,27200187,HC AVAMAX COAXIAL BONE BIOPSY SYSTEM,440.0,308.0,,,0
HCPCS,27200188,HC ON CONTROL BONE BIOPSY SYSTEM,520.0,364.0,,,0
HCPCS,27200189,HC MORPH ACCESSPRO SYSTEM,1916.0,1341.2,,,0
HCPCS,27200190,HC DEFLECTABLE GUIDE CATHETER,2913.0,2039.1,,,0
HCPCS,27200191,HC ONYX LIQUID EMBOLIC SYSTEM,8852.0,6196.4,,,0
HCPCS,27200192,HC CONCERTO EMBOLIZATION COIL,2497.0,1747.9,,,0
HCPCS,27200193,HC NEEDLE CERVICAL STRAIGHT 22 GA 100 MM,142.0,99.4,,,0
HCPCS,27200194,HC NEEDLE SPINAL 22 GA X 3.5,11.0,7.7,,,0
HCPCS,27200195,HC NEEDLE CHIBA 22 GA X 5.0,69.0,48.3,,,0
HCPCS,27200196,HC NEEDLE NERVE ROOT BLOCK 22 GA X 6.0,39.0,27.3,,,0
HCPCS,27200197,HC NEEDLE SPINAL 22 GA X 8.0,104.0,72.8,,,0
HCPCS,27200198,HC NEEDLE SPINAL 23 GA X 3.5,32.0,22.4,,,0
HCPCS,27200199,HC NEEDLE SPINAL 23 GA X 5.0,43.0,30.1,,,0
HCPCS,27200200,HC NEEDLE SPINAL 25 GA X 2.5,36.0,25.2,,,0
HCPCS,27200201,HC NEEDLE SPINAL 25 GA X 3.5,10.0,7.0,,,0
HCPCS,27200202,HC NEEDLE NERVE ROOT BLOCK 25 GA X 6.0,129.0,90.3,,,0
HCPCS,27200203,HC NEEDLE NERVE ROOT BLOCK 25 GA X 8.0,95.0,66.5,,,0
HCPCS,27200204,HC CANN RF OD20GA 145 MM STR,66.0,46.2,,,0
HCPCS,27200205,HC NEEDLE CATH STRAIGHT 16 GA X 3.5,290.0,203.0,,,0
HCPCS,27200206,HC NEEDLE CATH STRAIGHT 18 GA X 3.5,290.0,203.0,,,0
HCPCS,27200207,HC GROUNDING PADS,138.0,96.6,,,0
HCPCS,27200208,HC VERSA KATH 21 GA X 12.0,358.0,250.6,,,0
HCPCS,27200209,HC MANO METRIC DEVICE,504.0,352.8,,,0
HCPCS,27200210,HC REFILL KIT / IMPLANT INF PUMP,134.0,93.8,,,0
HCPCS,27200211,HC NEEDLE RF CURVED EXTRA LONG 145 MM,139.0,97.3,,,0
HCPCS,27200212,HC NEEDLE CANNULA RFK C15D,227.0,158.9,,,0
HCPCS,27200213,HC SET TUBING IV LL 110 IN,17.0,11.9,,,0
HCPCS,27200214,HC SYRINGE UNIVERSAL FLUID DISPENSING,504.0,352.8,,,0
HCPCS,27200215,HC TUN-L-KATH 19 GA X 12.0,323.0,226.1,,,0
HCPCS,27200216,HC BRONCHAVEOLAR LAVAGE CATH / SUPPLIES,396.0,277.2,,,0
HCPCS,27200217,HC DIAPHRAGM CAP,213.0,149.1,,,0
HCPCS,27200218,HC AIRWAY LARYNGEAL DIS INTUB,118.0,82.6,,,0
HCPCS,27200219,HC FORCEPS BIOPSY PULM,194.0,135.8,,,0
HCPCS,27200220,HC PASSEY MUIR SPEAKING VALVE,330.0,231.0,,,0
HCPCS,27200221,HC ANESTHESIA SUPPLY CHARGE,341.0,238.7,,,0
HCPCS,27200224,HC ACCUSTICK,465.0,325.5,,,0
HCPCS,27200227,HC ADAPTER MALE,16.0,11.2,,,0
HCPCS,27200228,HC ADVISER TRANSDUCER POLE MOUNT,454.0,317.8,,,0
HCPCS,27200229,HC AERO NEB SOLO SUPPLY,288.0,201.6,,,0
HCPCS,27200230,HC AMNIHOOK STERILE,13.0,9.1,,,0
HCPCS,27200232,HC BAG COLLECTION FLEXI-SEAL  F,283.0,198.1,,,0
HCPCS,27200233,HC BAG FOLEY PRECON,97.0,67.9,,,0
HCPCS,27200236,HC BALLOON INTRAAORTIC,2830.0,1981.0,,,0
HCPCS,27200237,HC BALLOON RIPENING CERVICAL COOK,350.0,245.0,,,0
HCPCS,27200238,HC BALLOON STINGRAY,3828.0,2679.6,,,0
HCPCS,27200239,HC BALLOON VENOGRAM MEDTRONIC,640.0,448.0,,,0
HCPCS,27200240,HC BANDAGE BULKY 4X4,6.0,4.2,,,0
HCPCS,27200241,HC BARRIER ADHESION INTERCEED,1041.0,728.7,,,0
HCPCS,27200242,HC BIO PATCH,44.0,30.8,,,0
HCPCS,27200243,HC BLAKE FLAT FULL FLUTED 10MM,163.0,114.1,,,0
HCPCS,27200245,HC BLANKET BILI COVER S DISP,70.0,49.0,,,0
HCPCS,27200246,HC BLANKET HYPO/HYPER ADULT/OR 25X64,83.0,58.1,,,0
HCPCS,27200247,HC BOTTLE CHEST ADULT,306.0,214.2,,,0
HCPCS,27200248,HC BOTTLE PERFUSION REPLACEMENT,470.0,329.0,,,0
HCPCS,27200250,HC CARTRIDGE STAPLE RELOAD TR45W,439.0,307.3,,,0
HCPCS,27200251,HC CATHETER AIRWAY EXCHANGE,275.0,192.5,,,0
HCPCS,27200252,HC CATHETER AIRWAY INTUB,2859.0,2001.3,,,0
HCPCS,27200253,HC CATHETER AORTIC DIAG RAD MEASURING,632.0,442.4,,,0
HCPCS,27200254,HC CATHETER ARTERIAL LINE 20G 55IN (12C,213.0,149.1,,,0
HCPCS,27200255,HC CATHETER COUDE,49.0,34.3,,,0
HCPCS,27200256,HC CATHETER CROSSER CTO RECANALIZATION,6655.0,4658.5,,,0
HCPCS,27200257,HC CATHETER CRYO 4MM,7650.0,5355.0,,,0
HCPCS,27200258,HC CATHETER DIAG PCG SWAN 5FR PED,336.0,235.2,,,0
HCPCS,27200259,HC CATHETER DIAG RAD W/MARKERS,200.0,140.0,,,0
HCPCS,27200260,HC CATHETER DIAGNOSTIC,77.0,53.9,,,0
HCPCS,27200261,HC CATHETER DIAGNOSTIC JKYRADIAL,281.0,196.7,,,0
HCPCS,27200262,HC CATHETER DIAGNOSTIC RADIOLOGIC,541.0,378.7,,,0
HCPCS,27200263,HC CATHETER EPIDURAL 18G,61.0,42.7,,,0
HCPCS,27200264,HC CATHETER FLEXCATH ARCTIC FRONT,3993.0,2795.1,,,0
HCPCS,27200265,HC CATHETER FLOW DIRECTED,567.0,396.9,,,0
HCPCS,27200266,HC CATHETER FOLEY,28.0,19.6,,,0
HCPCS,27200267,HC CATHETER FOLEY MEDIUM,66.0,46.2,,,0
HCPCS,27200268,HC CATHETER FOLEY SILA 30CC 16FR,35.0,24.5,,,0
HCPCS,27200269,HC CATHETER FOLEY SILA 30CC 18FR,59.0,41.3,,,0
HCPCS,27200270,HC CATHETER FOLEY SILA 30CC 20FR,25.0,17.5,,,0
HCPCS,27200271,HC TUBE FEEDING DOBBHOFF,28.0,19.6,,,0
HCPCS,27200273,HC CATHETER GUIDING PERIPHERAL,488.0,341.6,,,0
HCPCS,27200274,HC CATHETER INTRA-UTERINE PRESS,149.0,104.3,,,0
HCPCS,27200275,HC CATHETER INTRODUCER 1.9 FR NEONATAL,204.0,142.8,,,0
HCPCS,27200276,HC CATHETER IV,16.0,11.2,,,0
HCPCS,27200277,HC CATHETER IV 14 INCH,11.0,7.7,,,0
HCPCS,27200278,HC CATHETER IV 16 X 1 1/4,15.0,10.5,,,0
HCPCS,27200279,HC CATHETER IV 16 X 1 1/4,13.0,9.1,,,0
HCPCS,27200280,HC CATHETER IV 18 X 1 1/4 LATEX FREE,13.0,9.1,,,0
HCPCS,27200281,HC CATHETER IV 18 X 1 1/4 LATEX FREE,13.0,9.1,,,0
HCPCS,27200282,HC CATHETER IV 18 X 1 3/4 LATEX FREE,13.0,9.1,,,0
HCPCS,27200283,HC CATHETER IV 18 X 1 3/4 LATEX FREE,13.0,9.1,,,0
HCPCS,27200284,HC CATHETER IV 20 X 1 1/4 LATEX FREE,13.0,9.1,,,0
HCPCS,27200285,HC CATHETER IV 20 X 1 1/4 LATEX FREE,13.0,9.1,,,0
HCPCS,27200286,HC CATHETER IV 22 INCH,16.0,11.2,,,0
HCPCS,27200287,HC CATHETER J-TUBE REPLACEMENT,999.0,699.3,,,0
HCPCS,27200288,HC CATHETER LATEX FREE 30CC 16FR,39.0,27.3,,,0
HCPCS,27200289,HC CATHETER LEAD EXTRACTION LASER,6092.0,4264.4,,,0
HCPCS,27200290,HC CATHETER MULTI TRACK BRAUN,1534.0,1073.8,,,0
HCPCS,27200291,HC CATHETER OUTBACK RE ENTRY,7188.0,5031.6,,,0
HCPCS,27200292,HC CATHETER PICC 1.9 FR X 50 CM,271.0,189.7,,,0
HCPCS,27200293,HC CATHETER PICC ALL SIZES,599.0,419.3,,,0
HCPCS,27200294,HC CATHETER PIONEER PLUS,10617.0,7431.9,,,0
HCPCS,27200295,HC CATHETER POSSIS E-TRAIN 110,2402.0,1681.4,,,0
HCPCS,27200296,HC CATHETER PRO TRACK MICRO,720.0,504.0,,,0
HCPCS,27200297,HC CATHETER RE ENTRY CROSSBOSS,2913.0,2039.1,,,0
HCPCS,27200298,HC CATHETER RED ROBINSON 18FR,5.0,3.5,,,0
HCPCS,27200299,HC CATHETER RE-ENTRY OUTBACK LTD,6757.0,4729.9,,,0
HCPCS,27200300,HC CATHETER ROB NEL 14 FR,5.0,3.5,,,0
HCPCS,27200301,HC CATHETER SUCTION 10FR,6.0,4.2,,,0
HCPCS,27200302,HC CATHETER SUCTION 14FR,5.0,3.5,,,0
HCPCS,27200303,HC CATHETER SUCTION 5/6 FR,6.0,4.2,,,0
HCPCS,27200304,HC CATHETER SUCTION 8FR,5.0,3.5,,,0
HCPCS,27200305,HC CATHETER SUPPORT EV3,700.0,490.0,,,0
HCPCS,27200306,HC CATHETER SWAN GANZ CCO,823.0,576.1,,,0
HCPCS,27200307,HC CATHETER THORACIC,32.0,22.4,,,0
HCPCS,27200308,HC CATHETER TROCAR,32.0,22.4,,,0
HCPCS,27200309,HC CATHETER UMBILICAL ARTERY,488.0,341.6,,,0
HCPCS,27200310,HC CATHETER UMBILICAL VESSEL DUAL,189.0,132.3,,,0
HCPCS,27200311,HC CATHETERIZATION INTERMITTENT,39.0,27.3,,,0
HCPCS,27200312,HC CAUTERY HI-TEMP FINE TIP ACCUTEMP,71.0,49.7,,,0
HCPCS,27200313,HC CIRCUIT BREATHING NEONATAL,63.0,44.1,,,0
HCPCS,27200314,HC CIRCUIT BREATHNG FLXB HT WR L51IN,151.0,105.7,,,0
HCPCS,27200315,HC CIRCUMCISION SET DISPOSABLE,104.0,72.8,,,0
HCPCS,27200316,HC COAGULANT SRGICEL 1/2X2,104.0,72.8,,,0
HCPCS,27200317,HC COAGULANT SRGICEL 2X3,172.0,120.4,,,0
HCPCS,27200318,HC COLLECTOR NEWBORN URIN STER,10.0,7.0,,,0
HCPCS,27200319,HC COVER PROBE ULTRASOUND,53.0,37.1,,,0
HCPCS,27200320,HC CUP BREAST PROTECTIVE MEMBRANES,76.0,53.2,,,0
HCPCS,27200321,HC CUP VACUUM DISPOSAL STER,143.0,100.1,,,0
HCPCS,27200322,HC DEVICE EZ-PAP,302.0,211.4,,,0
HCPCS,27200323,HC DEVICE GUIDEWIRE TORQUE,24.0,16.8,,,0
HCPCS,27200324,HC DEVICE INFLATION GUARD DOG CO2,1738.0,1216.6,,,0
HCPCS,27200325,HC DEVICE SAFEGUARD PRESSURE ASSISTED,315.0,220.5,,,0
HCPCS,27200326,HC DEVICE SAFEGUARD PRESSURE ASSISTED,315.0,220.5,,,0
HCPCS,27200327,HC DEVICE VERIFYING OPTIMESH,999.0,699.3,,,0
HCPCS,27200328,HC DRAIN HEMOVAC 1/8,31.0,21.7,,,0
HCPCS,27200329,"HC DRESSING AQUACEL 3.5"" X 14""",224.0,156.8,,,0
HCPCS,27200338,HC DRESSING GELFOAM,137.0,95.9,,,0
HCPCS,27200341,HC DRESSING HYDROGEL ELASTOGEL,24.0,16.8,,,0
HCPCS,27200347,HC DRESSING RELEASE SPEC ABSORP,8.0,5.6,,,0
HCPCS,27200348,HC DRESSING SORBAVIEW STABILIZATION,22.0,15.4,,,0
HCPCS,27200350,HC DRILL HAND 10G,427.0,298.9,,,0
HCPCS,27200354,HC DRSG TEGADERM SMALL (BIOCLUSIVE),5.0,3.5,,,0
HCPCS,27200355,HC DRSG VAC GRANUFOAM MEDIUM,266.0,186.2,,,0
HCPCS,27200356,HC DRSG VAC GRANUFOAM SMALL,212.0,148.4,,,0
HCPCS,27200357,HC DRSG VAC GRANUFOAM XLARGE,442.0,309.4,,,0
HCPCS,27200358,HC DRSG WND 4.24SQIN HX SVRFBRCL ALGNT CLGN,64.0,44.8,,,0
HCPCS,27200359,HC DRSG WOUND MEPITEL MESH 3X4,37.0,25.9,,,0
HCPCS,27200360,HC DRSG WOUND MEPITEL MESH 4X8,80.0,56.0,,,0
HCPCS,27200361,HC DUAL LUMEN PIG,516.0,361.2,,,0
HCPCS,27200362,HC ELECTRODE SCALP LIFE TRAC,22.0,15.4,,,0
HCPCS,27200363,HC EXT IV WITH FILTER,19.0,13.3,,,0
HCPCS,27200364,HC EXTRACTOR KIWI OMNI CUP W/TRACTION,547.0,382.9,,,0
HCPCS,27200368,HC FILTER IV,8.0,5.6,,,0
HCPCS,27200369,HC FOLEY BAG PRECON,63.0,44.1,,,0
HCPCS,27200370,HC FOLEY METER PRECON,76.0,53.2,,,0
HCPCS,27200371,HC FUHRMAN PLEURAL&PNEUM ALL SIZES,509.0,356.3,,,0
HCPCS,27200372,HC GASTROSTOMY TUBE SET,212.0,148.4,,,0
HCPCS,27200373,HC GAUZE HYROGEL,25.0,17.5,,,0
HCPCS,27200374,HC GAUZE NON-ELASTIC STERILE YD,6.0,4.2,,,0
HCPCS,27200375,HC GAUZE NON-STERILE SURGINET,17.0,11.9,,,0
HCPCS,27200376,HC GAUZE SALINE/HYDR ADAPTIC 3X16,6.0,4.2,,,0
HCPCS,27200377,HC GAUZE SALINE/HYDR ADAPTIC 3X3,4.0,2.8,,,0
HCPCS,27200378,HC GAUZE SALINE/HYDR ADAPTIC 3X8,5.0,3.5,,,0
HCPCS,27200380,HC GENERAL/SPINAL/EPIDURAL SUPPLY,150.0,105.0,,,0
HCPCS,27200381,HC GLIDESCOPE RANGER 3 AND 4 DISPOSABLE,106.0,74.2,,,0
HCPCS,27200382,HC GLIDEWIRE EXCHANGE,269.0,188.3,,,0
HCPCS,27200383,HC GUIDE NEEDLE RADIO-FREQUENCY,1061.0,742.7,,,0
HCPCS,27200384,HC GUIDE WIRE STINGRAY,999.0,699.3,,,0
HCPCS,27200385,HC GUIDEWIRE NITREX,383.0,268.1,,,0
HCPCS,27200386,HC HYDROCOIL EMBOLIZATION,900.0,630.0,,,0
HCPCS,27200387,HC INTRODUCER RADIAL 6FR,275.0,192.5,,,0
HCPCS,27200389,HC IV PRIMARY INTERLINK AB,69.0,48.3,,,0
HCPCS,27200390,HC IV SECONDARY INTERLINK,11.0,7.7,,,0
HCPCS,27200391,HC IV SET NITRO W/LL,40.0,28.0,,,0
HCPCS,27200392,HC IVAS 10G 15MM (2/15),4327.0,3028.9,,,0
HCPCS,27200393,HC IVUS SLED,216.0,151.2,,,0
HCPCS,27200394,HC CUP EXTRACT W/ TRACTION KIWI OMNI,31.0,21.7,,,0
HCPCS,27200395,HC JACKSON PRATT RESERVOIR,43.0,30.1,,,0
HCPCS,27200396,HC CATHETER INTRAUTERINE PRESSURE ACCUTRACE,31.0,21.7,,,0
HCPCS,27200397,HC JACKSON PRATT ROUND/FLAT,118.0,82.6,,,0
HCPCS,27200398,HC KIT BREAST PUMP MEDELA,157.0,109.9,,,0
HCPCS,27200399,HC KIT CANNISTER VACUUM W/GEL,225.0,157.5,,,0
HCPCS,27200400,HC KIT CATH DRESSING,106.0,74.2,,,0
HCPCS,27200402,HC KIT CATHETER FOLEY W/BAG 16/18FR,59.0,41.3,,,0
HCPCS,27200403,HC KIT CENTRAL LINE FLUSH,76.0,53.2,,,0
HCPCS,27200404,HC KIT DRAINAGE BECKER EXTERNAL SYS,630.0,441.0,,,0
HCPCS,27200405,HC KIT DRESSING WOUND TRAC GRANUFOAM LG,285.0,199.5,,,0
HCPCS,27200406,HC KIT FEEDING ALL SIZES BUTTON RPLCT GAS,480.0,336.0,,,0
HCPCS,27200408,HC KIT INDEFLATOR,224.0,156.8,,,0
HCPCS,27200409,HC KIT MICRO PUNCTURE 3-5FR 21G,174.0,121.8,,,0
HCPCS,27200410,HC PHERESIS KIT NON-PHOTO,1291.0,903.7,,,0
HCPCS,27200411,HC KIT QCARE ORAL ANTISEPTIC W/SC,128.0,89.6,,,0
HCPCS,27200412,HC KIT RADIAL ACCESS,360.0,252.0,,,0
HCPCS,27200413,HC KIT TIPS ACCESS,1916.0,1341.2,,,0
HCPCS,27200414,HC KIT TRANSDUCER MONITORING SING LINE 84IN,65.0,45.5,,,0
HCPCS,27200415,HC KIT UMBILICAL DRAW,9.0,6.3,,,0
HCPCS,27200416,HC KIT VAS CATH/TESIO DRESSING,105.0,73.5,,,0
HCPCS,27200417,HC KPHYX ONE-STEP OSTEO INTRO SYSTEM SIZE 3,3212.0,2248.4,,,0
HCPCS,27200418,HC KYPHON INFLATION SYRINGE,720.0,504.0,,,0
HCPCS,27200419,HC KYPHOPAK EXPR TRAY 15/2 ADDT'L FX,7971.0,5579.7,,,0
HCPCS,27200420,HC KYPHOPAK EXPR TRAY 15/2 FIRST FRACTURE,11964.0,8374.8,,,0
HCPCS,27200421,HC KYPHX EXPR OSTEO INTRO DEV BEVEL/DIAMOND,3113.0,2179.1,,,0
HCPCS,27200422,HC KYPHX EXPRESS BONE BIOPSY DEVICE SIZE 2,520.0,364.0,,,0
HCPCS,27200423,HC KYPHX EXPRESS BONE BIOPSY DEVICE SIZE 3,520.0,364.0,,,0
HCPCS,27200424,HC KYPHX EXPRESS BONE FILLER DEVICE SIZE 2,460.0,322.0,,,0
HCPCS,27200425,HC KYPHX EXPRESS BONE FILLER DEVICE SIZE 3,495.0,346.5,,,0
HCPCS,27200426,HC KYPHX EXPRESS INFLATABLE BONE TAMP 15/2,3479.0,2435.3,,,0
HCPCS,27200427,HC KYPHX EXPRESS OSTEO INTRO DEVICE TROCAR,1598.0,1118.6,,,0
HCPCS,27200428,HC KYPHX HV-R BONE CEMENT/MIXER PACK,759.0,531.3,,,0
HCPCS,27200429,HC KYPHX ONE-STEP BEVEL DEVICE SIZE 3,600.0,420.0,,,0
HCPCS,27200430,HC LOCAL/MAC/BLOCK SUPPLY,66.0,46.2,,,0
HCPCS,27200431,HC LOCK LEVER INTERLINK,4.0,2.8,,,0
HCPCS,27200432,HC MANIFOLD 3-VALVE,132.0,92.4,,,0
HCPCS,27200433,HC MASK BI-PAP SM/MD/LG,139.0,97.3,,,0
HCPCS,27200434,HC MECONIUM SUCTION DEVICE,68.0,47.6,,,0
HCPCS,27200435,HC MEDITECH INTRO SHEATH NONLASER,291.0,203.7,,,0
HCPCS,27200436,HC MEDRAD SYRINGE,31.0,21.7,,,0
HCPCS,27200440,HC MICROPUNCTURE A,255.0,178.5,,,0
HCPCS,27200441,HC MICROWAVE ABLATION PROBE,5511.0,3857.7,,,0
HCPCS,27200443,HC MINI-CATH,284.0,198.8,,,0
HCPCS,27200444,HC MONITOR CATH FOLEY SIL 10FR TMP,130.0,91.0,,,0
HCPCS,27200445,HC MONITOR CATH FOLEY SIL 12FR TMP,132.0,92.4,,,0
HCPCS,27200446,HC MONITOR CATH FOLEY SIL 14FR TMP,112.0,78.4,,,0
HCPCS,27200447,HC MONITOR CATH FOLEY SIL 16FR TMP,76.0,53.2,,,0
HCPCS,27200448,HC MONITOR CATH FOLEY SIL 18FR TMP,76.0,53.2,,,0
HCPCS,27200449,HC MONITOR CATH FOLEY SIL 8FR TMP,132.0,92.4,,,0
HCPCS,27200450,HC MULLINS SHEATH,435.0,304.5,,,0
HCPCS,27200451,HC NEEDLE BX TRANSBRONCHIAL,294.0,205.8,,,0
HCPCS,27200452,HC NEEDLE CHIBA,106.0,74.2,,,0
HCPCS,27200453,HC NEEDLE HUBER,43.0,30.1,,,0
HCPCS,27200454,HC NEEDLE HUBER NON-CORING,128.0,89.6,,,0
HCPCS,27200455,HC NEEDLE HUBER NON-CORING,113.0,79.1,,,0
HCPCS,27200456,HC NEEDLE INTRODUCER OPTIMESH,427.0,298.9,,,0
HCPCS,27200457,HC NEEDLE LUMBAR CURVED 18 GAUGE 100MM,142.0,99.4,,,0
HCPCS,27200458,HC NEEDLE LUMBAR CURVED 20 GAUGE 100MM,142.0,99.4,,,0
HCPCS,27200459,HC NEEDLE SPINAL 22 X 3 1/2 WH,42.0,29.4,,,0
HCPCS,27200460,HC DERMABOND .5CC,40.0,28.0,,,0
HCPCS,27200461,HC NEEDLE SPINAL TUOHY 18 GAUGE X 5.0,57.0,39.9,,,0
HCPCS,27200462,HC NEEDLE SPINAL TUOHY 20 GAUGE X 3.5,54.0,37.8,,,0
HCPCS,27200463,HC NEEDLE SPINAL TUOHY 20 GUAGE X 6.0,82.0,57.4,,,0
HCPCS,27200464,HC NEEDLE TOUHY 18 GAUGE X 3 1/2 IN,39.0,27.3,,,0
HCPCS,27200465,HC NEPTUNE HEMOSTASIS PAD,148.0,103.6,,,0
HCPCS,27200466,HC NIPPLE BTL W DBL CLFT PAL,55.0,38.5,,,0
HCPCS,27200467,HC NIPPLE BTL XCUT LF INF PGN,24.0,16.8,,,0
HCPCS,27200468,HC NO PORT TUBING,18.0,12.6,,,0
HCPCS,27200469,HC OXISENSOR TRANSDUCER,82.0,57.4,,,0
HCPCS,27200470,HC PACK BASIC PROCEDURE,88.0,61.6,,,0
HCPCS,27200471,HC PACK PROCEDURE DISPOSABLE,238.0,166.6,,,0
HCPCS,27200472,HC PACKAGE INJECTOR,178.0,124.6,,,0
HCPCS,27200473,HC PACKING VAGINAL,6.0,4.2,,,0
HCPCS,27200475,HC PAD CHITO-SEAL TOPICAL HEMOSTASIS 4X4C,236.0,165.2,,,0
HCPCS,27200476,HC PAD HEMOSTASIS CLCM ALGNT 2X2,148.0,103.6,,,0
HCPCS,27200477,HC PATCH EXTERNAL REFERENCE,1997.0,1397.9,,,0
HCPCS,27200478,HC PATCH EXTERNAL REFERENCE CARTO 3D,1543.0,1080.1,,,0
HCPCS,27200479,HC PATCH REFERENCE ENSITE X,2996.0,2097.2,,,0
HCPCS,27200480,HC PBC PRECISION SYS VERTAPLEX HV CEMENT,1798.0,1258.6,,,0
HCPCS,27200481,HC PENCIL CAUTERY DISP,51.0,35.7,,,0
HCPCS,27200482,HC PERCU-STAY,83.0,58.1,,,0
HCPCS,27200483,HC PLUG VASCULAR AMPLATZER,2913.0,2039.1,,,0
HCPCS,27200484,HC PORTAL OPTIMESH,427.0,298.9,,,0
HCPCS,27200486,HC POUCH OSTOMY DRAINABLE EXTENDED,33.0,23.1,,,0
HCPCS,27200487,HC POUCH OSTOMY DRAINABLE STANDARD,9.0,6.3,,,0
HCPCS,27200488,HC POUCH OSTOMY URINARY,48.0,33.6,,,0
HCPCS,27200489,HC POUCH OSTOMY URINARY EXT WEAR,79.0,55.3,,,0
HCPCS,27200490,HC PROBE INJECTION 7/10 FR,990.0,693.0,,,0
HCPCS,27200491,HC PROBE RF ABLATION,4077.0,2853.9,,,0
HCPCS,27200493,HC PTI W/TRACH TUBE,1399.0,979.3,,,0
HCPCS,27200494,HC RED ROBIN INSERTION,44.0,30.8,,,0
HCPCS,27200495,HC RESPIRATORY CARE SYSTEM INFANT,226.0,158.2,,,0
HCPCS,27200496,HC RETRACTOR ALEXIS-O DISPOSABLE,360.0,252.0,,,0
HCPCS,27200498,HC SENSOR BIS QUATRO,240.0,168.0,,,0
HCPCS,27200499,HC SENSOR OXYGEN FOREHEAD ADULT,145.0,101.5,,,0
HCPCS,27200500,HC SENSOR OXYGEN INFANT SAT PROBE,51.0,35.7,,,0
HCPCS,27200501,HC SENSOR OXYPEDS DISP,88.0,61.6,,,0
HCPCS,27200502,HC SET BLOOD 3M,13.0,9.1,,,0
HCPCS,27200503,HC SET CATH FEM ARTERY 3 FR 8 C SNGL LUM,263.0,184.1,,,0
HCPCS,27200504,HC SET CATH RADIAL ARTERY 2.5FR 5C SGL LUM,179.0,125.3,,,0
HCPCS,27200505,HC SET EXTENSION,6.0,4.2,,,0
HCPCS,27200506,HC SET INFUSION BLD COMPONENT FIL 13 IN LON,35.0,24.5,,,0
HCPCS,27200507,HC SET IV EXTENSION INTERLINK Y TYPE 5IN,22.0,15.4,,,0
HCPCS,27200508,HC SET IV TUBING BLOOD INTERLINK Y-TYPE,40.0,28.0,,,0
HCPCS,27200509,HC SET TRANSJUGULAR LIVER BIOPSY,1773.0,1241.1,,,0
HCPCS,27200510,HC SET TUBING PUMP COOLFLOW,321.0,224.7,,,0
HCPCS,27200511,HC SHIELD BREAST,30.0,21.0,,,0
HCPCS,27200512,HC SHIELD BREAST ALL SIZES,30.0,21.0,,,0
HCPCS,27200513,HC SHIELD BREAST PERSONAL FIT 24,44.0,30.8,,,0
HCPCS,27200514,HC SHOE POST-OP,25.0,17.5,,,0
HCPCS,27200515,HC SHUNT TRACKER COOK,165.0,115.5,,,0
HCPCS,27200516,HC SLEEVE CMPR KNEE SCD EXP LRG,209.0,146.3,,,0
HCPCS,27200517,HC SLEEVE CMPR KNEE SCD EXP MED,130.0,91.0,,,0
HCPCS,27200518,HC SLEEVE CMPR KNEE SCD EXP XLG,318.0,222.6,,,0
HCPCS,27200519,HC SLING ARM,19.0,13.3,,,0
HCPCS,27200520,HC SOLN IV 0.9% NACL 1L VFLX LF,9.0,6.3,,,0
HCPCS,27200521,HC SPECULUM DISPOSABLE,16.0,11.2,,,0
HCPCS,27200522,HC STAPLER PREMIUM POLLY,1906.0,1334.2,,,0
HCPCS,27200523,HC STAPLER SKIN 35W,54.0,37.8,,,0
HCPCS,27200524,HC STOPCOCK 3 WAY,5.0,3.5,,,0
HCPCS,27200525,HC SUCT SYST ETT PED 10FR Y ADAPTER,108.0,75.6,,,0
HCPCS,27200526,HC SURGIFOAM ABSORBABLE GELATIN SPONGE SIZE 12-7 2CM X 6CM X 0.7CM,137.0,95.9,,,0
HCPCS,27200528,HC SUTURE CATAGORY 7,41.0,28.7,,,0
HCPCS,27200529,HC SUTURE CATEGORY 8,24.0,16.8,,,0
HCPCS,27200530,HC SUTURE CATEGORY 8,24.0,16.8,,,0
HCPCS,27200531,HC SUTURE SKIN STAPLES TW-35,39.0,27.3,,,0
HCPCS,27200532,HC SYRINGE INFLATION,240.0,168.0,,,0
HCPCS,27200533,HC SYST FECAL FLEXI-SEAL FS,900.0,630.0,,,0
HCPCS,27200534,HC SYST FEM ARCH FEMOSTOP,512.0,358.4,,,0
HCPCS,27200535,HC SYSTEM AUTOPLEX W/VERTAPLEX HV CEMENT,2662.0,1863.4,,,0
HCPCS,27200536,HC SYSTEM SHEATH AMPLATZER,935.0,654.5,,,0
HCPCS,27200538,HC TAPER DILATOR COONS COOK,132.0,92.4,,,0
HCPCS,27200539,HC TIP BOVIE TEFLON,39.0,27.3,,,0
HCPCS,27200540,HC TIPSUCTION YANKUER CLEAR,5.0,3.5,,,0
HCPCS,27200541,HC TR BAND HEMOSTASIS COMPRESSION DEVICE,196.0,137.2,,,0
HCPCS,27200542,HC TRANSCATH DELIVERY SYSTEM ENSEMBLE,17303.0,12112.1,,,0
HCPCS,27200543,HC KT TRUWAVE TRANSDUCER,68.0,47.6,,,0
HCPCS,27200544,HC TRANSDUCER NEONATAL/PEDIACTRIC DISP,65.0,45.5,,,0
HCPCS,27200545,HC TRANSDUCER TRIPLE CUSTOM,228.0,159.6,,,0
HCPCS,27200546,HC TRAY AMNIOCENTESIS 20G X 3,72.0,50.4,,,0
HCPCS,27200547,HC TRAY BIOPSY BONE PROCEDURE 10G,373.0,261.1,,,0
HCPCS,27200548,HC TRAY CATHETER FOLEY,52.0,36.4,,,0
HCPCS,27200549,HC TRAY EPIDURAL,172.0,120.4,,,0
HCPCS,27200550,HC TRAY EPIDURAL 18 GAUGE,149.0,104.3,,,0
HCPCS,27200551,HC TRAY EPIDURAL CUSTOM,184.0,128.8,,,0
HCPCS,27200552,HC TRAY EXCHANGE TRANSFUSION,466.0,326.2,,,0
HCPCS,27200554,HC TRAY IRRIGATION,11.0,7.7,,,0
HCPCS,27200555,HC TRAY LUMBAR CATH L30CM OD1.9FR 2,528.0,369.6,,,0
HCPCS,27200556,HC TRAY LUMBAR PUNCTURE ADULT DIS,72.0,50.4,,,0
HCPCS,27200557,HC TRAY LUMBAR PUNCTURE PEDS DIS,64.0,44.8,,,0
HCPCS,27200558,HC TRAY PERICARDIALCENTESIS,520.0,364.0,,,0
HCPCS,27200559,HC TRAY PICC CATH DRESSING,101.0,70.7,,,0
HCPCS,27200560,HC TRAY PORT ACCESS LONG TERM,79.0,55.3,,,0
HCPCS,27200561,HC TRAY PROCEDURE NEO/PED,215.0,150.5,,,0
HCPCS,27200562,HC TRAY PUNDENDAL,84.0,58.8,,,0
HCPCS,27200563,HC TRAY SPINAL W/O LIDOCAINE,95.0,66.5,,,0
HCPCS,27200564,HC TRAY THORACENTESIS DISP,181.0,126.7,,,0
HCPCS,27200565,HC TRAY TRACH CARE DISPOSABLE,15.0,10.5,,,0
HCPCS,27200566,HC TRAY URETHRAL PRECONNEC 1,18.0,12.6,,,0
HCPCS,27200567,HC TRUEPATH CTO DEVICE,6389.0,4472.3,,,0
HCPCS,27200568,HC TUBE CHEST DRAINAGE SGL COLL DRY SUCTION,197.0,137.9,,,0
HCPCS,27200569,HC TUBE CHEST THAL QUICK ALL SIZES,468.0,327.6,,,0
HCPCS,27200570,HC TUBE ENDO TRACH,10.0,7.0,,,0
HCPCS,27200571,HC TUBE FEEDING KEOFEED,124.0,86.8,,,0
HCPCS,27200572,HC TUBE HYDROGEL,21.0,14.7,,,0
HCPCS,27200573,HC TUBE NASAL GASTRIC,52.0,36.4,,,0
HCPCS,27200574,HC TUBE TRACH ADULT,226.0,158.2,,,0
HCPCS,27200575,HC TUBE TRACH ADULT HYPERFLEX,424.0,296.8,,,0
HCPCS,27200576,HC TUBE TRACH COMPLEX,850.0,595.0,,,0
HCPCS,27200577,HC TUBE TRACH EXT CUFFED,348.0,243.6,,,0
HCPCS,27200578,HC TUBE TRACH HYPERFLEX ANY SIZE,737.0,515.9,,,0
HCPCS,27200579,HC TUBE TRACH INTERMEDIATE,341.0,238.7,,,0
HCPCS,27200580,HC TUBE TRACH NONFENESTRATED UNCUFFED,214.0,149.8,,,0
HCPCS,27200581,HC TUBE TRACH PEDS,239.0,167.3,,,0
HCPCS,27200582,HC TUBE TRACH SET BLUE RHINO,1399.0,979.3,,,0
HCPCS,27200583,HC TUBE TRACH SHILEY ANY SIZE,258.0,180.6,,,0
HCPCS,27200584,HC TUBE TRACH TTS 7.0,405.0,283.5,,,0
HCPCS,27200585,HC TUBE TRACH TTS 8.0,405.0,283.5,,,0
HCPCS,27200586,HC TUBE TRACH TTS SZ 6,405.0,283.5,,,0
HCPCS,27200587,HC TUBECONNECTINGSUCTION5MM X 6FT,5.0,3.5,,,0
HCPCS,27200589,HC TUBING CONNECT 10 FT 5MM,6.0,4.2,,,0
HCPCS,27200590,HC TUBING CONNECT 6FT 5MM,5.0,3.5,,,0
HCPCS,27200591,HC TUBING EXTENSION HIGH PRESSURE,51.0,35.7,,,0
HCPCS,27200592,HC TUBING IV PRIMARY,22.0,15.4,,,0
HCPCS,27200593,HC TUCKER SLING VARIOUS SIZES,156.0,109.2,,,0
HCPCS,27200594,HC TUCKER SLING VARIOUS SIZES,156.0,109.2,,,0
HCPCS,27200595,HC URIMETER,55.0,38.5,,,0
HCPCS,27200596,HC VERTEPORT CEMENT CANNULA 10G,373.0,261.1,,,0
HCPCS,27200597,HC VERTEPORT SHORT STYLET ACCESS NEEDLE,294.0,205.8,,,0
HCPCS,27200598,HC VESSEL DILATOR,52.0,36.4,,,0
HCPCS,27200601,HC WC SUPPLIES MINOR W/O SUTURES,79.0,55.3,,,0
HCPCS,27200602,HC WEDGE FOR TUCKER SLING,457.0,319.9,,,0
HCPCS,27200603,HC WEDGE FOR TUCKER SLING,457.0,319.9,,,0
HCPCS,27200606,HC WIRE ROTO SCIMED,587.0,410.9,,,0
HCPCS,27200607,HC WIRE TIGER,480.0,336.0,,,0
HCPCS,27200609,HC WOUND CARE INTER W/O SUTURES,102.0,71.4,,,0
HCPCS,27200610,HC WOUND CARE MAJOR W/O SUTURES,168.0,117.6,,,0
HCPCS,27200611,HC WOUND CARE MINOR W/O SUTURES,68.0,47.6,,,0
HCPCS,27200612,HC SLV CMPR MR KNEE REG SCD EXP,93.0,65.1,,,0
HCPCS,27200613,HC CATHETER SUCTION 10FR 14FR 16FR,16.0,11.2,,,0
HCPCS,27200614,HC CONN SUCT ARG PLAS 5 IN 1 BRB,21.0,14.7,,,0
HCPCS,27200615,HC DRESSING TEGADERM BIOCLUSIVE,4.0,2.8,,,0
HCPCS,27200616,HC STOPCOCK 3-WAY STD BORE,6.0,4.2,,,0
HCPCS,27200617,HC CATHETER ROB NEL,5.0,3.5,,,0
HCPCS,27200619,HC BLOOD FILTER,46.0,32.2,,,0
HCPCS,27200620,HC BOTTLE CHEST ADULT,242.0,169.4,,,0
HCPCS,27200621,HC DRESSING TELFA NON-ADHER,3.0,2.1,,,0
HCPCS,27200622,HC DRESSING SOFT BAND KERLIX,6.0,4.2,,,0
HCPCS,27200623,HC BANDAGE ELASTIC,8.0,5.6,,,0
HCPCS,27200624,HC PREP URETHRAL BOAT,13.0,9.1,,,0
HCPCS,27200625,HC TOURNIQUET STERILE 24IN 30IN,202.0,141.4,,,0
HCPCS,27200626,HC DERMABOND,121.0,84.7,,,0
HCPCS,27200627,HC SLV MR CMPR REG KNEE SCD EXP,93.0,65.1,,,0
HCPCS,27200628,HC PRIMARY IV TUBING,22.0,15.4,,,0
HCPCS,27200629,HC IV EXTENSION TUBING,13.0,9.1,,,0
HCPCS,27200630,HC KIT CATH STERILE INFANT,17.0,11.9,,,0
HCPCS,27200631,HC FEMALE CATH KIT,15.0,10.5,,,0
HCPCS,27200633,HC SKIN STAPLE EXTRACTOR,16.0,11.2,,,0
HCPCS,27200634,HC WIRE MICRO-INFUSION,1177.0,823.9,,,0
HCPCS,27200635,HC CATHETER AXIS SUREFIRE,799.0,559.3,,,0
HCPCS,27200636,HC MICROCATHETER SUREFIRE,1346.0,942.2,,,0
HCPCS,27200637,HC NEEDLE AVAMAX 11G,358.0,250.6,,,0
HCPCS,27200638,HC PROBE ABLATION MICROWAVE PMTA,10449.0,7314.3,,,0
HCPCS,27200639,HC BIOPSY NEEDLE,54.0,37.8,,,0
HCPCS,27200640,HC RENTAL DIOMED LASER W/FIBER,605.0,423.5,,,0
HCPCS,27200641,HC RENTAL OMNI GUIDE LASER 2HRS,733.0,513.1,,,0
HCPCS,27200642,HC FEE OMNI GUIDE LASER ADDL HRS,134.0,93.8,,,0
HCPCS,27200645,HC CATH ANGIOPLASTY 5X40X130CML,2816.0,1971.2,,,0
HCPCS,27200685,HC LAMINARIA,90.0,63.0,,,0
HCPCS,27200686,HC NEEDLE SPINAL 27 X 4 11/16,40.0,28.0,,,0
HCPCS,27200687,HC NEEDLE DISCYPHOR DIRECT REG,799.0,559.3,,,0
HCPCS,27200690,HC AVAFLEX PLUS CURVED INJECTION NEEDLE,1916.0,1341.2,,,0
HCPCS,27200692,HC CATHETER DUAL LUMEN UMBILICAL VESSEL,189.0,132.3,,,0
HCPCS,27200693,HC CATHETER UMBILICAL VESSEL,93.0,65.1,,,0
HCPCS,27200694,HC ICD ANTI-BACTERIAL POCKET,2980.0,2086.0,,,0
HCPCS,27200695,HC PTVP ANTI-BACTERIAL POCKET,2315.0,1620.5,,,0
HCPCS,27200696,HC WIRE RADIOFREQUENCY NYKANAN,2830.0,1981.0,,,0
HCPCS,27200697,HC ELECTRODE DISPERSIVE INFANT MACROLYTE,200.0,140.0,,,0
HCPCS,27200704,HC DRAINAGE CHEST PEDI/INFANT,253.0,177.1,,,0
HCPCS,27200705,HC CATH POLYURETHANE TRIPLE LUMEN 5FR,229.0,160.3,,,0
HCPCS,27200706,HC CATH IV INSYTE WNGD SAFETY 24G,13.0,9.1,,,0
HCPCS,27200707,HC GLIDESCOPE RANGER 0 1 AND 2 DISPOSABLE,143.0,100.1,,,0
HCPCS,27200708,HC POUCH URO ODOR PROOF W/ PLAIN BARR 9 IN,46.0,32.2,,,0
HCPCS,27200709,HC TUBE ET ANG TP ESCHANN 15FR,49.0,34.3,,,0
HCPCS,27200711,HC SPECULUM DISPOSABLE,16.0,11.2,,,0
HCPCS,27200712,HC EXTENSION SET,9.0,6.3,,,0
HCPCS,27200713,HC CATH IV 16 X 1 1/4,15.0,10.5,,,0
HCPCS,27200714,HC CATH IV 18 X 1 3/4 LATEX FREE,39.0,27.3,,,0
HCPCS,27200715,HC CATH IV 20 X 1 1/4 LATEX FREE,39.0,27.3,,,0
HCPCS,27200716,HC OXISENSOR TRANSDUCER,91.0,63.7,,,0
HCPCS,27200717,HC MIDSTREAM VACUTAINER,8.0,5.6,,,0
HCPCS,27200719,HC URIMETER,59.0,41.3,,,0
HCPCS,27200727,HC HEAMONETIC CELL SAVER,2584.0,1808.8,,,0
HCPCS,27200728,HC DAVINCI SUPPLY,2929.0,2050.3,,,0
HCPCS,27200730,HC HEART PUMP PERFUSIONIST SUPPLY,8771.0,6139.7,,,0
HCPCS,27200731,HC CARTRIDGE BN CORTOSS 10CC,4792.0,3354.4,,,0
HCPCS,27200732,HC NOZZLE DLV MIX TIPS LUER 3PK,700.0,490.0,,,0
HCPCS,27200733,HC GUN CORTOSS MIX DELIVERY,1198.0,838.6,,,0
HCPCS,27200734,HC CARTRIDGE CORTOSS BN AUG 5CC,2330.0,1631.0,,,0
HCPCS,27200737,HC COCHLEAR PROCESSOR Z185554,16620.0,11634.0,,,0
HCPCS,27200738,HC COCHLEAR PROCESSOR DISCOUNTED Z185554,8310.0,5817.0,,,0
HCPCS,27200739,HC STRYKER CURETTE 10G,1806.0,1264.2,,,0
HCPCS,27200740,HC RETRIEVAL DEVICE AIRWAY,940.0,658.0,,,0
HCPCS,27200741,HC AXO TRACK ACCESS KIT,283.0,198.1,,,0
HCPCS,27200742,HC CATHETER CRYO 6MM,4427.0,3098.9,,,0
HCPCS,27200743,HC INTERLOCK COILS,1898.0,1328.6,,,0
HCPCS,27200744,HC SENSOR OXY RECYCLED NEONAT/ADULT DISP,36.0,25.2,,,0
HCPCS,27200751,HC SALEM SUMP TUBE,27.0,18.9,,,0
HCPCS,27200753,HC FOLEY CATHETER 2 WAY,77.0,53.9,,,0
HCPCS,27200757,HC FEEDING TUBE - 12 FRENCH,29.0,20.3,,,0
HCPCS,27200759,HC DRSG DUODERM EXT THIN (TEGASORB),22.0,15.4,,,0
HCPCS,27200763,HC AVATEX BONE CEMENT INJECTOR,1180.0,826.0,,,0
HCPCS,27200764,HC ANGIOVAC CANNULA,34606.0,24224.2,,,0
HCPCS,27200765,HC IV CATH ALL SIZES,15.0,10.5,,,0
HCPCS,27200766,HC CATH ANGIOPLASTY 4X120X130CML,3116.0,2181.2,,,0
HCPCS,27200767,HC CATH H1 ATHERECTMY STD,6490.0,4543.0,,,0
HCPCS,27200769,HC PACIFIC EXTREME PERIPHERAL ANGIOPLASTY BALLOON CATH 250.0X5.0 MILL,371.0,259.7,,,0
HCPCS,27200770,HC FORCEP BIOPSY DISP,1140.0,798.0,,,0
HCPCS,27200773,HC OUTBACK LTD RE-ENTRY CATHETER,6757.0,4729.9,,,0
HCPCS,27200774,HC MARKER CATHETER,560.0,392.0,,,0
HCPCS,27200779,HC AVAFLEX VERTEBRAL BALLOON,9983.0,6988.1,,,0
HCPCS,27200787,HC MULTI-LUMEN CENTRAL VENOUS KIT,116.0,81.2,,,0
HCPCS,27200794,HC DRAGONFLY INTRAVASCULAR IMAGING,2662.0,1863.4,,,0
HCPCS,27200795,HC RES Q WEDGE,670.0,469.0,,,0
HCPCS,27200796,HC RES Q SLING,307.0,214.9,,,0
HCPCS,27200797,HC AMPLATZER TORQUE PDA DELIVERY SYSTEM,2450.0,1715.0,,,0
HCPCS,27200798,HC BRITE BLADE (ALL SIZES),207.0,144.9,,,0
HCPCS,27200802,HC DEVICE SUT DLV LARIAT,16473.0,11531.1,,,0
HCPCS,27200803,HC CUTTER SUT SURECUT LARIAT,1598.0,1118.6,,,0
HCPCS,27200804,HC CANNULA SOFTIP LNG 4.3MM,1198.0,838.6,,,0
HCPCS,27200805,HC PULLER SUT TENSURE LARIAT,799.0,559.3,,,0
HCPCS,27200808,HC GLIDECATH STRAIGHT,299.0,209.3,,,0
HCPCS,27200813,HC KIT INTVN CLSR + .018IN L7CM,185.0,129.5,,,0
HCPCS,27200814,HC DEV MAX30 20ML SYR MNMTR INFL,252.0,176.4,,,0
HCPCS,27200816,HC GJ TUBE PEDS,1646.0,1152.2,,,0
HCPCS,27200817,HC RIGHT ANGLE BOLUS/Y G-J FEEDING SET,533.0,373.1,,,0
HCPCS,27200820,HC GENCUT CORE BIOPSY SYSTEM,1399.0,979.3,,,0
HCPCS,27200826,HC BROVIAC REPAIR KIT 4.2FR,693.0,485.1,,,0
HCPCS,27200827,HC BARD ULTRAVERSE 035 PTA DILATATION CATHETER 4MM AND 6MM DIAMETER,460.0,322.0,,,0
HCPCS,27200829,HC CENTRAL LINE PLACEMENT SUPPLIES,1955.0,1368.5,,,0
HCPCS,27200830,HC ARTERIAL LINE SUPPLIES,1242.0,869.4,,,0
HCPCS,27200831,HC SWAN GANZ SUPPLIES,3850.0,2695.0,,,0
HCPCS,27200836,HC SITZMARKS,501.0,350.7,,,0
HCPCS,27200838,HC MULTILAYER COMPRESSION BANDAGE,80.0,56.0,,,0
HCPCS,27200839,HC TCC-EZ CAST SYSTEM W/2 REG BOOTS 3-4 INCH,435.0,304.5,,,0
HCPCS,27200840,HC TCC-EZ REGULAR BOOT MENS 6-10/WOMENS 5-11.5,362.0,253.4,,,0
HCPCS,27200841,HC TCC EZ-LARGE BOOT MENS 10.5-13/WOMENS 11.5+ WIDE,432.0,302.4,,,0
HCPCS,27200842,HC TCC-EZ XL BOOT 13.5-18 WIDE,454.0,317.8,,,0
HCPCS,27200843,HC TCC-EZ LARGE CHARCOT BOOT,495.0,346.5,,,0
HCPCS,27200844,HC TCC-EZ XL CHARCOT BOOT,523.0,366.1,,,0
HCPCS,27200847,HC LOCATOR PLUS,840.0,588.0,,,0
HCPCS,27200848,HC GELOCAST UNNA BOOT,409.0,286.3,,,0
HCPCS,27200849,HC MEDELA STARTER SNS,156.0,109.2,,,0
HCPCS,27200851,HC EYE EXAM KITS ROP,161.0,112.7,,,0
HCPCS,27200852,HC DRSG OPN PORE HYDPHB NEG PRSS,128.0,89.6,,,0
HCPCS,27200853,HC DRSG L15 X W 10CM LG S LF VAC,92.0,64.4,,,0
HCPCS,27200854,HC DRSG L60 X W 30CM OPN PORE,532.0,372.4,,,0
HCPCS,27200855,HC OSTOMY BELT LRG,10.0,7.0,,,0
HCPCS,27200857,HC CONNECTOR DRN Y-TYPE CA/10,15.0,10.5,,,0
HCPCS,27200858,HC DILATOR PLST TPRD 14F 70CM,264.0,184.8,,,0
HCPCS,27200859,HC ESOPHAGEAL TEMP PROBE,1997.0,1397.9,,,0
HCPCS,27200861,HC PROTACK PIGTAIL WIRE 0.025IN DIAMETER 230CM LENGTH,1978.0,1384.6,,,0
HCPCS,27200862,HC NRG RF TRANSSEPTAL NEEDLE 71CM,860.0,602.0,,,0
HCPCS,27200865,HC HUMMI MICRO DRAW BLOOD TRANSFER DEVICE,39.0,27.3,,,0
HCPCS,27200866,HC HUMMINGBIRD T CONNECTOR,16.0,11.2,,,0
HCPCS,27200867,HC 1CC VNTD SYRINGE W/HEP NO NEEDLE,6.0,4.2,,,0
HCPCS,27200868,HC 3CC VNTD SYRINGE NO HEP NO NEEDLE,6.0,4.2,,,0
HCPCS,27200869,HC NEEDLE ANESTHESIA EPIDURAL 17GX5 WEISS THIN WALL,54.0,37.8,,,0
HCPCS,27200870,HC MONGOOSE PEDIATRIC ANGIOGRAPHY CATHETER 4F 60 CM,501.0,350.7,,,0
HCPCS,27200871,HC BOSTON SCIENTIFIC WATCHMAN ANTERIOR CURVE 14F,3328.0,2329.6,,,0
HCPCS,27200879,HC DEPLOYMENT CATH AND LOADER HUD,2497.0,1747.9,,,0
HCPCS,27200880,HC KIT AIRWAY SIZING HUD,960.0,672.0,,,0
HCPCS,27200917,HC INFLATION GUN,1678.0,1174.6,,,0
HCPCS,27200918,HC PULMONARY BALLOON DILATOR,1180.0,826.0,,,0
HCPCS,27200947,HC PULMONARY INFLATION SYRINGE,184.0,128.8,,,0
HCPCS,27201015,HC BRIDGE OCCLUSION BALLOON CATHETER,2727.0,1908.9,,,0
HCPCS,27201016,HC BRIDGE PREP KIT,1027.0,718.9,,,0
HCPCS,27201017,HC TIGHTRAIL ROTATING DILATOR SHEATH 11FR,6078.0,4254.6,,,0
HCPCS,27201018,HC TIGHTRAIL SUB-C ROTATING DILATOR SHEATH 9FR,5437.0,3805.9,,,0
HCPCS,27201043,HC BOSTON SCIENTIFIC PULM SNARE DEVICE,466.0,326.2,,,0
HCPCS,27201076,HC TURKEL PNEUMOTHORAX PROC TRAY,395.0,276.5,,,0
HCPCS,27201120,HC 5MAX REPERFUSION CATHETER 6FR,9092.0,6364.4,,,0
HCPCS,27201121,HC 3MAX REPERFUSION CATHETER 4.7FR,6527.0,4568.9,,,0
HCPCS,27201122,HC SHEATH NEURON MAX,1898.0,1328.6,,,0
HCPCS,27201123,HC BENCHMARK INTRACRANIAL ACCESS SYSTEM,3161.0,2212.7,,,0
HCPCS,27201124,HC CATH SELECT SIMV 6FR,484.0,338.8,,,0
HCPCS,27201148,HC INZONE 2.0 DETACHMENT SYSTEM,829.0,580.3,,,0
HCPCS,27201150,HC CATH EXCELSION SL10 MICRO J,3124.0,2186.8,,,0
HCPCS,27201152,HC GUIDE CATH MERCI BLLN 9F X 80CM,3947.0,2762.9,,,0
HCPCS,27201153,HC SHEATH AXS INFINITY LS LNG 70,1822.0,1275.4,,,0
HCPCS,27201154,HC RETRIEVER TERO XP PROVUE 4 X 20M,18819.0,13173.3,,,0
HCPCS,27201163,"HC MARKSMAN MICRO CATHETER 3.2 > 2.8F 0.027"" DIA 160CM",3513.0,2459.1,,,0
HCPCS,27201164,HC SOLITAIRE PLATINUM REVASC DEVICE 4 X 20MM / 4 X 40MM / 6 X 40MM,17039.0,11927.3,,,0
HCPCS,27201165,HC APOLLO ONYX DELIVERY MICRO CATHETER 2.7F,5629.0,3940.3,,,0
HCPCS,27201167,HC SET EPIX PROBE TUNING 5MM X 33CM,371.0,259.7,,,0
HCPCS,27201168,HC SET EPIX VLV W DUAL BAG TUBING,345.0,241.5,,,0
HCPCS,27201174,HC LUTONIX 035 DRUG COATED BALLOON PTA CATH 5F,1634.0,1143.8,,,0
HCPCS,27201184,HC OSSEOFLEX STEERABLE NEEDLE 10GA,4154.0,2907.8,,,0
HCPCS,27201185,HC OSSEOFLEX STEERABLE BALLOON 10GA,6078.0,4254.6,,,0
HCPCS,27201186,HC OSSEOFLEX VERTEBRAL ACCESS KIT 10GA,1918.0,1342.6,,,0
HCPCS,27201187,HC BASIXTOUCH INFLATION DEVICE,1531.0,1071.7,,,0
HCPCS,27201188,HC OSSEOFLEX CEMENT BONE POLYMER MEDIUM/HIGH VISCOSITY,3192.0,2234.4,,,0
HCPCS,27201189,HC OSSEOFLEX CEMENT MIXER,1143.0,800.1,,,0
HCPCS,27201190,HC OSSEOFLEX CD-H HYDRAULIC CEMENT DELIVERY SYSTEM,3192.0,2234.4,,,0
HCPCS,27201191,HC OSSEOFLEX HAND DRILL 10GA COMPATIBLE,1268.0,887.6,,,0
HCPCS,27201192,HC OSSEOFLEX BONE FILLER TUBE 10GA,1909.0,1336.3,,,0
HCPCS,27201194,HC SALIENT SURGICAL AQUAMANTYS,1627.0,1138.9,,,0
HCPCS,27201195,HC AVECURE PROBE MINI - LARGE,9620.0,6734.0,,,0
HCPCS,27201197,HC OSSEOFLEX BALLOON SB STRAIGHT 10GA 4ML,4795.0,3356.5,,,0
HCPCS,27201199,HC KIT STABILIT MX W/ PWRCRV 10GA,8002.0,5601.4,,,0
HCPCS,27201200,HC BAG DRAINAGE REPLACEMENT FOR DUET,259.0,181.3,,,0
HCPCS,27201201,HC CATH SET BACTISEAL EVD,2457.0,1719.9,,,0
HCPCS,27201210,HC COSEAL SURGICAL SEALANT 8ML,3072.0,2150.4,,,0
HCPCS,27201211,HC TREVO MICROCATHETER,2438.0,1706.6,,,0
HCPCS,27201227,HC CATH ENVOY DA MPD,2514.0,1759.8,,,0
HCPCS,27201245,HC DEVICE SEALING 10MM OD 20CML STRAIGHT NON-ABSORB BLUNT JAW BILAT F/FORCETRIAD ENERGY PLATFORM LIG,1559.0,1091.3,,,0
HCPCS,27201259,HC CATH PHENOM + DIST ACCESS,5757.0,4029.9,,,0
HCPCS,27201281,HC CATALYST 6 132CM,6992.0,4894.4,,,0
HCPCS,27201282,HC TREVO FAST PACK,24128.0,16889.6,,,0
HCPCS,27201364,HC FIBER WAVEGUIDE FEE,968.0,677.6,,,0
HCPCS,27201374,HC PLEURX-PATIENT STARTER KIT,1408.0,985.6,,,0
HCPCS,27201375,HC DRSG RELIATECT W-CHG 8CMX15CM,125.0,87.5,,,0
HCPCS,27201376,HC DRSG RELIATECT W-CHG 10CMX25CM,197.0,137.9,,,0
HCPCS,27201396,HC SVC FEE HOLMIUM LASER,545.0,381.5,,,0
HCPCS,27201397,HC FIBER HOLMIUM SNGL USE 150-300,242.0,169.4,,,0
HCPCS,27201398,HC FIBER HOLMIUM SNGL USE 300-400,273.0,191.1,,,0
HCPCS,27201399,HC SVC FEE LITHROTRIPSY,1936.0,1355.2,,,0
HCPCS,27201400,HC SVC FEE LITHROTRIPSY XTRA SHOCK,495.0,346.5,,,0
HCPCS,27201401,HC EMERGENCY/AFTER HOURS,303.0,212.1,,,0
HCPCS,27201489,HC CLAMP CIRC W/BELL 1.1/1.3/1.45 CM DISP,168.0,117.6,,,0
HCPCS,27201532,HC SVC FEE ULTRASOUND HLTHRONICS,2904.0,2032.8,,,0
HCPCS,27201572,HC PENUMBRA ENGINE CANISTER,1414.0,989.8,,,0
HCPCS,27201573,HC INDIGO 12 XTORQ TIP & LIGHTING ASPIRATION TUBING 12FR 100CM .014-.038 INCHES,17407.0,12184.9,,,0
HCPCS,27201574,HC SEPARATOR 12 .110IN X 150CM WIRE,6398.0,4478.6,,,0
HCPCS,27201641,HC CATH CLEAN THRMB 15-7FRX135CM ARGON,4971.0,3479.7,,,0
HCPCS,27201665,HC WIRE CATH PRFR RF NYKANEN,2727.0,1908.9,,,0
HCPCS,27201670,HC ABRE STENT 60MM AND 100MM,5437.0,3805.9,,,0
HCPCS,27201671,HC ABRE STENT 150MM,6175.0,4322.5,,,0
HCPCS,27201672,HC STEERABLE BALLOON 10G 15MM,6767.0,4736.9,,,0
HCPCS,27201673,HC BS EXALT MODEL B BRONCHOSCOPE,1531.0,1071.7,,,0
HCPCS,27201702,HC CASSETTE IMPELLA IABP PRG 2.5,3209.0,2246.3,,,0
HCPCS,27201712,HC CATHETER BALLON WEDGE PRESSURE,444.0,310.8,,,0
HCPCS,27201748,HC CODMAN CRANIAL ACCESS KIT,1410.0,987.0,,,0
HCPCS,27201749,HC MEDTRONIC BARIUM IMPREGNATED VENTRICULAR CATHETER,674.0,471.8,,,0
HCPCS,27201761,HC MICRO CATHETER 2.3FR X 150 CM,7055.0,4938.5,,,0
HCPCS,27201812,HC MICROCATHETER SNIPER OCCLUSION 150CM,4330.0,3031.0,,,0
HCPCS,27201865,HC KIT DRESSING RENASYS-G GAUZE SMALL,148.0,103.6,,,0
HCPCS,27201866,HC KIT DRESSING RENASYS-G GAUZE MEDIUM,186.0,130.2,,,0
HCPCS,27201867,HC KIT DRESSING RENASYS-G GAUZE LARGE,264.0,184.8,,,0
HCPCS,27201868,HC PATCH RENASYS ADHESIVE GEL 7X10CM,33.0,23.1,,,0
HCPCS,27201869,HC KIT DRESSING RENASYS-F FOAM SMALL,148.0,103.6,,,0
HCPCS,27201870,HC KIT DRESSING RENASYS-F FOAM MEDIUM,186.0,130.2,,,0
HCPCS,27201871,HC KIT DRESSING RENASYS-F FOAM LARGE,264.0,184.8,,,0
HCPCS,27201872,HC KIT DRESSING RENASYS-F FOAM XLARGE,450.0,315.0,,,0
HCPCS,27201873,HC PORT SOFT RENASYS STAND ALONE,104.0,72.8,,,0
HCPCS,27201874,HC CONNECTOR Y SHAPED RENASYS,66.0,46.2,,,0
HCPCS,27201875,HC FOAM FILLER RENASYS NPWT 4X5X0.5IN,58.0,40.6,,,0
HCPCS,27201876,HC FILM TRANSPARENT RENASYS 20X30CM,58.0,40.6,,,0
HCPCS,27201877,HC FOAM RENASYS WHITE LARGE,77.0,53.9,,,0
HCPCS,27201880,HC AGNT ARISTA AH HEMOSTATIC COLL 5GM,2902.0,2031.4,,,0
HCPCS,27201881,HC MUSTANG 0.035 BALLOON DILATION CATHETER 6.0MM X 200MM  X 35CM,728.0,509.6,,,0
HCPCS,27201896,HC ARGENT SURGICAL CAUTERY TIPS,58.0,40.6,,,0
HCPCS,27201915,HC STERADIAN SHIELD RADIATION ATTENUATION PAD,257.0,179.9,,,0
HCPCS,27201939,HC MEDTRONIC STYLET KIT,160.0,112.0,,,0
HCPCS,27201940,HC MEDTRONIC KIT LEAD PACING SPRINT QUATTRO,160.0,112.0,,,0
HCPCS,27201953,HC STABILIT ER SATURATE MIXING SYSTEM,1947.0,1362.9,,,0
HCPCS,27201954,HC STABILIT MASTER SYRINGE ASSEMBLY,1015.0,710.5,,,0
HCPCS,27201962,HC ROTAGLIDE LUBRICANT MIXTURE 20 CC VIALS,406.0,284.2,,,0
HCPCS,27201967,HC PROBE COVER W/GUIDE,120.0,84.0,,,0
HCPCS,27201968,HC ARTHROGRAM TRAY,66.0,46.2,,,0
HCPCS,27201970,HC RENTAL GREENLIGHT LASER,500.0,350.0,,,0
HCPCS,27201975,HC LEVEL 1 NORMOTHERMIC IV FLUID ADMINISTRATION SET,321.0,224.7,,,0
HCPCS,27202,Treat tail bone fracture,,,3239.17,14371.12,11
HCPCS,27202003,HC HIGH DENSITY CATHETER FOCAL CATH TO GEN STERILE CBL,1456.0,1019.2,,,0
HCPCS,27202010,HC MERIT ASPIRA PERITONEAL DRAINAGE CATHETER INSERTION TRAY PERITONEAL 15.5FR,1708.0,1195.6,,,0
HCPCS,27202011,HC MERIT ASPIRA PERITONEAL DRAINAGE SYSTEM STARTER KIT 15.5FR 1L,1931.0,1351.7,,,0
HCPCS,27202012,HC MERIT ASPIRA UNIVERSAL TUBING ADAPTER,111.0,77.7,,,0
HCPCS,27202013,HC MERIT ASPIRA PLEURAL DRAINAGE CATHETER INSERTION TRAY 15.5FR,1708.0,1195.6,,,0
HCPCS,27202014,HC MERIT ASPIRA PLEURAL DRAINAGE STARTER KIT 15.5FR 1L,1931.0,1351.7,,,0
HCPCS,27202016,HC JADA POSTPARTUM BALLOON SYSTEM,4144.0,2900.8,,,0
HCPCS,27202017,HC DVT INARI SYSTEM,23100.0,16170.0,,,0
HCPCS,27202018,HC 365U LASER FIBER PL SINGLE USE,195.0,136.5,,,0
HCPCS,27202045,HC ARCADIA CURVED DELIVERY CANNULA,2480.0,1736.0,,,0
HCPCS,27202054,HC SYSTEM LOADING NAVITOR TAVI SMALL,1810.0,1267.0,,,0
HCPCS,27202055,HC SYSTEM CATHETER DELIVERY FEXNAV 5.0 VES 15 FR,5955.0,4168.5,,,0
HCPCS,27202056,HC TOOL EPSILA EV  LEAD TRANSV/STERNAL TNL,3564.0,2494.8,,,0
HCPCS,27202082,HC CATHETER ARROW THERMODILUTION 5FR X 10MM X 80CM,797.0,557.9,,,0
HCPCS,27202084,HC INDIGO CATHETER 12 100CM XTORQ INCLUDING LIGHTNING BOLT ASPIRATION TUBING,22546.0,15782.2,,,0
HCPCS,27202085,HC KT MINIONE LOW PROFILE BALLON BUTTON G-TUBE 14FR X 1.5 CM,388.0,271.6,,,0
HCPCS,27202100,HC CATH PERFORMA 4FR 70CM JL2,128.0,89.6,,,0
HCPCS,27202101,HC CATH PERFORM INF PGTL 4FR 65CM,168.0,117.6,,,0
HCPCS,27202102,HC CATH PERFORM INF PGTL 4FR 80CM,74.0,51.8,,,0
HCPCS,27202106,HC HAMILTON T1/C1/MRI EXPIRATORY VALVE SET SINGLE USE,151.0,105.7,,,0
HCPCS,27202121,HC STYLET INTUBATION GLIDERITE 6MM TUBE LARGE,75.0,52.5,,,0
HCPCS,27202124,HC CABLE VARIPULSE INTERFACE,2296.0,1607.2,,,0
HCPCS,27202137,HC INTRODUCER CATHETER BRITE TIP 9/10 FR X 35/45 MM X 23 CM,118.0,82.6,,,0
HCPCS,27202145,HC PROC WATCHMAN TRUSTEER ACCESS SYSTEM,4455.0,3118.5,,,0
HCPCS,27202153,HC CABLE AFFERA EXTENSION CATHETER,5940.0,4158.0,,,0
HCPCS,27202154,HC SET TUBING AFFERA HEXAFLOW,905.0,633.5,,,0
HCPCS,27202161,HC NANOKNIFE SINGLE ELECTRODE ACTIVATION PROBE 15 CM,9801.0,6860.7,,,0
HCPCS,27202169,HC KIT STYLET LEAD J CURVED 53 CM,157.0,109.9,,,0
HCPCS,27216,Treat pelvic ring fracture,,,5839.66,7285.12,4
HCPCS,27220,Treat hip socket fracture,,,244.19,1083.4,11
HCPCS,27222,HC PRO CLOSED TX HIP SOCKET FX W/ MANIP,2418.0,1692.6,,,0
HCPCS,27222,Treat hip socket fracture,,,244.19,1083.4,11
HCPCS,27226,Treat hip wall fracture,,,7183.42,31870.39,11
HCPCS,27227,Treat hip fracture(s),,,7183.42,31870.39,11
HCPCS,27228,Treat hip fracture(s),,,7183.42,31870.39,11
HCPCS,27230,HC PRO CLOSED TX FEMORAL FX W/O MANIPULATION,1098.0,768.6,,,0
HCPCS,27230,Treat thigh fracture,,,244.19,1083.4,11
HCPCS,27232,Treat thigh fracture,,,1591.86,7062.54,11
HCPCS,27235,Treat thigh fracture,,,5839.66,31870.39,11
HCPCS,27236,Treat thigh fracture,,,7183.42,31870.39,11
HCPCS,27238,Treat thigh fracture,,,353.72,7062.54,11
HCPCS,27240,HC CLSD TX OF INTER/PERI/SUBTROCHANTERIC FEMORAL FX W/MANIPULATION W/W/O SKIN/SKELETAL TRACTION,13140.0,9198.0,,,0
HCPCS,27240,HC PRO CLSD TX OF INTER/PERI/SUBTROCHANTERIC FEMORAL FX W/MANIPULATION W/W/O SKIN/SKELETAL TRACTION,1220.0,854.0,,,0
HCPCS,27240,Treat thigh fracture,,,1591.86,7062.54,11
HCPCS,27244,Treat thigh fracture,,,7183.42,31870.39,11
HCPCS,27245,Treat thigh fracture,,,7183.42,31870.39,11
HCPCS,27246,Treat thigh fracture,,,244.19,1083.4,11
HCPCS,27248,Treat thigh fracture,,,7183.42,31870.39,11
HCPCS,27250,HC PRO TREAT HIP DISL W/O ANESTH,1088.0,761.6,,,0
HCPCS,27250,HC TREAT HIP DISL W/O ANESTH,499.0,349.3,,,0
HCPCS,27250,Treat hip dislocation,,,244.19,1083.4,11
HCPCS,27252,HC PRO TREAT HIP DISLOCATION REQ ANES,947.0,662.9,,,0
HCPCS,27252,HC TREAT HIP DISLOCATION REQ ANES,1161.0,812.7,,,0
HCPCS,27252,Treat hip dislocation,,,1591.86,7062.54,11
HCPCS,27253,Treat hip dislocation,,,3239.17,14371.12,11
HCPCS,27254,Treat hip dislocation,,,7183.42,31870.39,11
HCPCS,27256,Treat hip dislocation,,,244.19,1083.4,11
HCPCS,27257,HC TREAT HIP DISLOC BY ABDUCTION/SPLINT/TRACT W/ MANIP REQ ANESTH,2824.0,1976.8,,,0
HCPCS,27257,Treat hip dislocation,,,1591.86,7062.54,11
HCPCS,27258,Treat hip dislocation,,,3239.17,14371.12,11
HCPCS,27259,Treat hip dislocation,,,3239.17,14371.12,11
HCPCS,27265,HC CLOSED TX POST HIP ARTHROPLASTY DISLOCATION W/O ANESTHESIA,332.0,232.4,,,0
HCPCS,27265,HC PRO CLOSED TX POST HIP ARTHROPLASTY DISLOCATION W/O ANESTHESIA,493.0,345.1,,,0
HCPCS,27265,Treat hip dislocation,,,244.19,1083.4,11
HCPCS,27266,HC CLOSED TX POST HIP ARTHROPL DISLOC REQ ANESTH,1735.0,1214.5,,,0
HCPCS,27266,HC PRO CLOSED TX POST HIP ARTHROPL DISLOC REQ ANESTH,717.0,501.9,,,0
HCPCS,27266,Treat hip dislocation,,,1306.37,7062.54,11
HCPCS,27267,Cltx thigh fx,,,353.72,14371.12,11
HCPCS,27268,Cltx thigh fx w/mnpj,,,1591.86,10698.91,11
HCPCS,27269,Optx thigh fx,,,4218.82,31870.39,11
HCPCS,27275,Manipulation of hip joint,,,1591.86,7062.54,11
HCPCS,27278,Arthrd si jt prq wo tfxj dev,,,17357.91,77011.17,11
HCPCS,27279,Arthrodesis sacroiliac joint,,,17357.91,77011.17,11
HCPCS,27280,Fusion of sacroiliac joint,,,17357.91,77011.17,11
HCPCS,27282,Fusion of pubic bones,,,3239.17,46549.79,11
HCPCS,27284,Fusion of hip joint,,,12709.88,59981.53,11
HCPCS,27286,Fusion of hip joint,,,12709.88,59981.53,11
HCPCS,27290,Amputation of leg at hip,,,17357.91,77011.17,11
HCPCS,27295,Amputation of leg at hip,,,17357.91,77011.17,11
HCPCS,27299,HC UNLISTED PROCEDURE PELVIS OR HIP JOINT,1071.0,749.7,,,0
HCPCS,27299,Pelvis/hip joint surgery,,,244.19,10673.46,11
HCPCS,27301,Drain thigh/knee lesion,,,2875.57,12757.95,11
HCPCS,27301,HC DRAIN THIGH/KNEE LESION,2373.0,1661.1,,,0
HCPCS,27301,HC PRO DRAIN THIGH/KNEE LESION,801.0,560.7,,,0
HCPCS,27303,Drainage of bone lesion,,,3239.17,23681.51,11
HCPCS,27305,Incise thigh tendon & fascia,,,3239.17,14371.12,11
HCPCS,27306,Incision of thigh tendon,,,3239.17,14371.12,11
HCPCS,27307,Incision of thigh tendons,,,3239.17,14371.12,11
HCPCS,27310,Exploration of knee joint,,,3239.17,14371.12,11
HCPCS,27323,Biopsy thigh soft tissues,,,1635.03,7254.06,11
HCPCS,27324,Biopsy thigh soft tissues,,,2875.57,12757.95,11
HCPCS,27325,Neurectomy hamstring,,,1933.13,8576.66,11
HCPCS,27326,Neurectomy popliteal,,,1933.13,8576.66,11
HCPCS,27327,Exc thigh/knee les sc < 3 cm,,,1635.03,7254.06,11
HCPCS,27328,Exc thigh/knee tum deep <5cm,,,2875.57,12757.95,11
HCPCS,27329,Resect thigh/knee tum < 5 cm,,,2875.57,12757.95,11
HCPCS,27330,Biopsy knee joint lining,,,3239.17,14371.12,11
HCPCS,27331,Explore/treat knee joint,,,3239.17,14371.12,11
HCPCS,27332,Removal of knee cartilage,,,3239.17,14371.12,11
HCPCS,27333,Removal of knee cartilage,,,3239.17,14371.12,11
HCPCS,27334,Remove knee joint lining,,,3239.17,14371.12,11
HCPCS,27335,Remove knee joint lining,,,5839.66,31870.39,11
HCPCS,27337,Exc thigh/knee les sc 3 cm/>,,,2875.57,12757.95,11
HCPCS,27339,Exc thigh/knee tum dep 5cm/>,,,2875.57,12757.95,11
HCPCS,27340,Removal of kneecap bursa,,,3239.17,14371.12,11
HCPCS,27345,Removal of knee cyst,,,3239.17,14371.12,11
HCPCS,27347,Remove knee cyst,,,3239.17,14371.12,11
HCPCS,27350,Removal of kneecap,,,5839.66,31870.39,11
HCPCS,27355,Remove femur lesion,,,3239.17,14371.12,11
HCPCS,27356,Remove femur lesion/graft,,,5839.66,56389.43,11
HCPCS,27357,Remove femur lesion/graft,,,5839.66,31870.39,11
HCPCS,27358,Remove femur lesion/fixation,,,5839.66,7285.12,4
HCPCS,27360,Partial removal leg bone(s),,,3239.17,14371.12,11
HCPCS,27364,Resect thigh/knee tum 5 cm/>,,,2875.57,12757.95,11
HCPCS,27365,Resect femur/knee tumor,,,3239.17,23681.51,11
HCPCS,27369,HC INJECTION PROCEDURE FOR CONTRAST KNEE ARTHROGRAPY/CONTRAST ENCHANCED CT/MRI KNEE ARTHROGRAPY,265.0,185.5,,,0
HCPCS,27369,Njx cntrst kne arthg/ct/mri,,,127.02,158.46,4
HCPCS,27372,HC PRO REMOVAL OF FOREIGN BODY DEEP THIGH REGION OR KNEE AREA,919.0,643.3,,,0
HCPCS,27372,HC REMOVAL OF FOREIGN BODY DEEP THIGH REGION OR KNEE AREA,8925.0,6247.5,,,0
HCPCS,27372,Removal of foreign body,,,2875.57,12757.95,11
HCPCS,27380,Repair of kneecap tendon,,,4254.97,31870.39,11
HCPCS,27381,Repair/graft kneecap tendon,,,4254.97,31870.39,11
HCPCS,27385,Repair of thigh muscle,,,7183.42,31870.39,11
HCPCS,27386,Repair/graft of thigh muscle,,,4254.97,31870.39,11
HCPCS,27390,Incision of thigh tendon,,,3239.17,14371.12,11
HCPCS,27391,Incision of thigh tendons,,,3239.17,14371.12,11
HCPCS,27392,Incision of thigh tendons,,,3239.17,14371.12,11
HCPCS,27393,Lengthening of thigh tendon,,,5839.66,31870.39,11
HCPCS,27394,Lengthening of thigh tendons,,,5839.66,31870.39,11
HCPCS,27395,Lengthening of thigh tendons,,,3239.17,14371.12,11
HCPCS,27396,Transplant of thigh tendon,,,5839.66,31870.39,11
HCPCS,27397,Transplants of thigh tendons,,,7183.42,31870.39,11
HCPCS,27400,Revise thigh muscles/tendons,,,7183.42,31870.39,11
HCPCS,27403,Repair of knee cartilage,,,5839.66,31870.39,11
HCPCS,27405,Repair of knee ligament,,,7183.42,31870.39,11
HCPCS,27407,Repair of knee ligament,,,7183.42,31870.39,11
HCPCS,27409,Repair of knee ligaments,,,4465.47,31870.39,11
HCPCS,27412,Autochondrocyte implant knee,,,7183.42,31870.39,11
HCPCS,27415,Osteochondral knee allograft,,,8555.71,56389.43,11
HCPCS,27416,Osteochondral knee autograft,,,7183.42,31870.39,11
HCPCS,27418,Repair degenerated kneecap,,,3019.23,31870.39,11
HCPCS,27420,Revision of unstable kneecap,,,7183.42,31870.39,11
HCPCS,27422,Revision of unstable kneecap,,,3797.22,31870.39,11
HCPCS,27424,Revision/removal of kneecap,,,7183.42,31870.39,11
HCPCS,27425,Lat retinacular release open,,,3239.17,14371.12,11
HCPCS,27427,Reconstruction knee,,,5238.31,31870.39,11
HCPCS,27428,Reconstruction knee,,,4581.78,56389.43,11
HCPCS,27429,Reconstruction knee,,,4465.47,56389.43,11
HCPCS,27430,Revision of thigh muscles,,,7183.42,31870.39,11
HCPCS,27435,Incision of knee joint,,,3239.17,14371.12,11
HCPCS,27437,Revise kneecap,,,7182.83,31870.39,11
HCPCS,27438,Revise kneecap with implant,,,10180.38,56389.43,11
HCPCS,27440,Revision of knee joint,,,7182.83,56389.43,11
HCPCS,27441,Revision of knee joint,,,7182.83,56389.43,11
HCPCS,27442,Revision of knee joint,,,7182.83,56389.43,11
HCPCS,27443,Revision of knee joint,,,7182.83,56389.43,11
HCPCS,27445,Revision of knee joint,,,37313.72,46549.79,4
HCPCS,27446,Revision of knee joint,,,12709.88,56389.43,11
HCPCS,27447,Total knee arthroplasty,,,8697.95,56389.43,11
HCPCS,27448,Incision of thigh,,,7183.42,31870.39,11
HCPCS,27450,Incision of thigh,,,7183.42,31870.39,11
HCPCS,27454,Realignment of thigh bone,,,7183.42,31870.39,11
HCPCS,27455,Realignment of knee,,,7183.42,31870.39,11
HCPCS,27457,Realignment of knee,,,7183.42,31870.39,11
HCPCS,27458,Osteot femur imed lngth dev,,,7183.42,31870.39,7
HCPCS,27465,Shortening of thigh bone,,,7183.42,31870.39,11
HCPCS,27466,Lengthening of thigh bone,,,7183.42,31870.39,11
HCPCS,27468,Shorten/lengthen thighs,,,18982.8,23681.51,4
HCPCS,27470,Repair of thigh,,,7183.42,31870.39,11
HCPCS,27472,Repair/graft of thigh,,,7183.42,31870.39,11
HCPCS,27475,Surgery to stop leg growth,,,5839.66,31870.39,11
HCPCS,27477,Surgery to stop leg growth,,,7183.42,31870.39,11
HCPCS,27479,Surgery to stop leg growth,,,7183.42,31870.39,11
HCPCS,27485,Surgery to stop leg growth,,,7183.42,31870.39,11
HCPCS,27486,Revise/replace knee joint,,,12709.88,56389.43,11
HCPCS,27487,Revise/replace knee joint,,,17357.91,77011.17,11
HCPCS,27488,Removal of knee prosthesis,,,12709.88,56389.43,11
HCPCS,27495,Reinforce thigh,,,7183.42,31870.39,11
HCPCS,27496,Decompression of thigh/knee,,,3239.17,14371.12,11
HCPCS,27497,Decompression of thigh/knee,,,3239.17,14371.12,11
HCPCS,27498,Decompression of thigh/knee,,,1591.86,7062.54,11
HCPCS,27499,Decompression of thigh/knee,,,4254.97,31870.39,11
HCPCS,27500,Treatment of thigh fracture,,,244.19,1083.4,11
HCPCS,27501,Treatment of thigh fracture,,,244.19,1083.4,11
HCPCS,27502,HC CLOSED TX FEMORAL SHAFT FRACTURE W/MANIPULATION W/ OR W/O SKIN/SKELETAL TRACTION,3078.0,2154.6,,,0
HCPCS,27502,HC PRO TREAT THIGH FX,1297.0,907.9,,,0
HCPCS,27502,Treatment of thigh fracture,,,353.72,7062.54,11
HCPCS,27503,Treatment of thigh fracture,,,353.72,7062.54,11
HCPCS,27506,Treatment of thigh fracture,,,7183.42,31870.39,11
HCPCS,27507,Treatment of thigh fracture,,,7183.42,31870.39,11
HCPCS,27508,HC CLOSED TX FEMORAL FRACTURE DISTAL END MEDIAL/LATERAL CONDYLE W/O MANIPULATION,852.0,596.4,,,0
HCPCS,27508,Treatment of thigh fracture,,,244.19,1083.4,11
HCPCS,27509,Treatment of thigh fracture,,,5233.29,31870.39,11
HCPCS,27510,HC CLSD TX FEMORAL FX DISTAL END MEDIAL/LATERAL CONDYLE MANIP,3078.0,2154.6,,,0
HCPCS,27510,HC PRO CLSD TX FEMORAL FX DISTAL END MEDIAL/LATERAL CONDYLE MANIP,863.0,604.1,,,0
HCPCS,27510,Treatment of thigh fracture,,,353.72,7062.54,11
HCPCS,27511,Treatment of thigh fracture,,,12709.88,56389.43,11
HCPCS,27513,Treatment of thigh fracture,,,12709.88,56389.43,11
HCPCS,27514,Treatment of thigh fracture,,,12709.88,56389.43,11
HCPCS,27516,Treat thigh fx growth plate,,,244.19,1083.4,11
HCPCS,27517,Treat thigh fx growth plate,,,353.72,7062.54,11
HCPCS,27519,Treat thigh fx growth plate,,,7183.42,31870.39,11
HCPCS,27520,HC CLOSED TX PATELLAR FX W/O MANIPULATION,852.0,596.4,,,0
HCPCS,27520,HC PRO CLOSED TX PATELLAR FX W/O MANIPULATION,683.0,478.1,,,0
HCPCS,27520,Treat kneecap fracture,,,244.19,1083.4,11
HCPCS,27524,Treat kneecap fracture,,,7183.42,31870.39,11
HCPCS,27530,HC CLOSED TX TIBAL FX PROXIMAL PLATEAU W/O MANIPULATION,320.0,224.0,,,0
HCPCS,27530,HC PRO CLOSED TX TIBIAL FX PROXIMAL W/O MANIP,486.0,340.2,,,0
HCPCS,27530,Treat knee fracture,,,244.19,1083.4,11
HCPCS,27532,HC CLSD TX TIBIAL FX PROXIMAL (PLATEAU) W/WO MANIP W/SKELETAL TRACTION,1603.0,1122.1,,,0
HCPCS,27532,HC PRO CLSD TX TIBIAL FX PROXIMAL (PLATEAU) W/WO MANIP W/SKELETAL TRACTION,913.0,639.1,,,0
HCPCS,27532,Treat knee fracture,,,353.72,14371.12,11
HCPCS,27535,Treat knee fracture,,,7183.42,31870.39,11
HCPCS,27536,Treat knee fracture,,,7183.42,31870.39,11
HCPCS,27538,Treat knee fracture(s),,,244.19,1083.4,11
HCPCS,27540,Treat knee fracture,,,7183.42,31870.39,11
HCPCS,27550,HC PRO CLOSED TX KNEE DISLOC W/O ANESTH,608.0,425.6,,,0
HCPCS,27550,HC TREAT KNEE DISLOCATION,261.0,182.7,,,0
HCPCS,27550,Treat knee dislocation,,,192.39,1083.4,11
HCPCS,27552,HC CLOSED TX KNEE DISLOCATION W/ANESTHESIA,1872.0,1310.4,,,0
HCPCS,27552,HC PRO CLOSED TX KNEE DISLOCATION W/ANESTHESIA,791.0,553.7,,,0
HCPCS,27552,Treat knee dislocation,,,1591.86,7062.54,11
HCPCS,27556,Treat knee dislocation,,,7183.42,31870.39,11
HCPCS,27557,Treat knee dislocation,,,7183.42,31870.39,11
HCPCS,27558,Treat knee dislocation,,,7183.42,31870.39,11
HCPCS,27560,HC PRO TREAT KNEECAP DISL W/O ANESTH,601.0,420.7,,,0
HCPCS,27560,TREAT KNEECAP DISL W/O ANESTH,653.0,457.1,,,0
HCPCS,27560,Treat kneecap dislocation,,,244.19,1083.4,11
HCPCS,27562,HC PRO TREAT KNEECAP DISL W/ ANESTH,1592.0,1114.4,,,0
HCPCS,27562,TREAT KNEECAP DISL W/ ANESTH,3899.0,2729.3,,,0
HCPCS,27562,Treat kneecap dislocation,,,244.19,3685.16,11
HCPCS,27566,Treat kneecap dislocation,,,7183.42,31870.39,11
HCPCS,27570,Fixation of knee joint,,,1591.86,7062.54,11
HCPCS,27580,Fusion of knee,,,12709.88,56389.43,11
HCPCS,27590,Amputate leg at thigh,,,3239.17,59981.53,11
HCPCS,27591,Amputate leg at thigh,,,3239.17,59981.53,11
HCPCS,27592,Amputate leg at thigh,,,3239.17,59981.53,11
HCPCS,27594,Amputation follow-up surgery,,,3239.17,14371.12,11
HCPCS,27596,Amputation follow-up surgery,,,3239.17,23681.51,11
HCPCS,27598,Amputate lower leg at knee,,,3239.17,46549.79,11
HCPCS,27599,Leg surgery procedure,,,244.19,9269.11,11
HCPCS,27600,Decompression of lower leg,,,3239.17,14371.12,11
HCPCS,27601,Decompression of lower leg,,,3239.17,14371.12,11
HCPCS,27602,Decompression of lower leg,,,3239.17,14371.12,11
HCPCS,27603,Drain lower leg lesion,,,2875.57,12757.95,11
HCPCS,27604,Drain lower leg bursa,,,3239.17,14371.12,11
HCPCS,27605,Incision of achilles tendon,,,1591.86,7062.54,11
HCPCS,27606,Incision of achilles tendon,,,2601.74,14371.12,11
HCPCS,27607,Treat lower leg bone lesion,,,3239.17,14371.12,11
HCPCS,27610,Explore/treat ankle joint,,,3239.17,14371.12,11
HCPCS,27612,Exploration of ankle joint,,,3239.17,14371.12,11
HCPCS,27613,Biopsy lower leg soft tissue,,,1635.03,7254.06,11
HCPCS,27614,Biopsy lower leg soft tissue,,,2875.57,12757.95,11
HCPCS,27615,Resect leg/ankle tum < 5 cm,,,2875.57,12757.95,11
HCPCS,27616,Resect leg/ankle tum 5 cm/>,,,2875.57,12757.95,11
HCPCS,27618,Exc leg/ankle tum < 3 cm,,,1635.03,7254.06,11
HCPCS,27619,Exc leg/ankle tum deep <5 cm,,,2875.57,12757.95,11
HCPCS,27620,Explore/treat ankle joint,,,3239.17,14371.12,11
HCPCS,27625,Remove ankle joint lining,,,3239.17,14371.12,11
HCPCS,27626,Remove ankle joint lining,,,3239.17,14371.12,11
HCPCS,27630,Removal of tendon lesion,,,2046.14,14371.12,11
HCPCS,27632,Exc leg/ankle les sc 3 cm/>,,,2651.47,12757.95,11
HCPCS,27634,Exc leg/ankle tum dep 5 cm/>,,,2875.57,12757.95,11
HCPCS,27635,Remove lower leg bone lesion,,,3239.17,14371.12,11
HCPCS,27637,Remove/graft leg bone lesion,,,5839.66,31870.39,11
HCPCS,27638,Remove/graft leg bone lesion,,,5839.66,31870.39,11
HCPCS,27640,Partial removal of tibia,,,2546.46,14371.12,11
HCPCS,27641,Partial removal of fibula,,,3239.17,14371.12,11
HCPCS,27645,Resect tibia tumor,,,3239.17,23681.51,11
HCPCS,27646,Resect fibula tumor,,,3239.17,23681.51,11
HCPCS,27647,Resect talus/calcaneus tum,,,3239.17,14371.12,11
HCPCS,27648,HC INJECTION PX FOR ANKLE ARTHROGRAPHY,958.0,670.6,,,0
HCPCS,27650,HC REPAIR ACHILLES TENDON,6228.0,4359.6,,,0
HCPCS,27650,Repair achilles tendon,,,6936.76,31870.39,11
HCPCS,27652,Repair/graft achilles tendon,,,7183.42,31870.39,11
HCPCS,27654,Repair of achilles tendon,,,4465.47,31870.39,11
HCPCS,27656,Repair leg fascia defect,,,3239.17,14371.12,11
HCPCS,27658,Repair of leg tendon each,,,3239.17,14371.12,11
HCPCS,27659,Repair of leg tendon each,,,4254.97,31870.39,11
HCPCS,27664,Repair of leg tendon each,,,4254.97,31870.39,11
HCPCS,27665,Repair of leg tendon each,,,2693.96,31870.39,11
HCPCS,27675,Repair lower leg tendons,,,3239.17,14371.12,11
HCPCS,27676,Repair lower leg tendons,,,4194.9,31870.39,11
HCPCS,27680,Release of lower leg tendon,,,3239.17,14371.12,11
HCPCS,27681,Release of lower leg tendons,,,3239.17,14371.12,11
HCPCS,27685,Revision of lower leg tendon,,,3146.37,14371.12,11
HCPCS,27686,Revise lower leg tendons,,,3239.17,14371.12,11
HCPCS,27687,Revision of calf tendon,,,2815.78,14371.12,11
HCPCS,27690,Revise lower leg tendon,,,4704.08,31870.39,11
HCPCS,27691,Revise lower leg tendon,,,5811.34,31870.39,11
HCPCS,27692,Revise additional leg tendon,,,8599.44,10728.02,4
HCPCS,27695,Repair of ankle ligament,,,4862.97,31870.39,11
HCPCS,27696,Repair of ankle ligaments,,,5020.51,31870.39,11
HCPCS,27698,Repair of ankle ligament,,,3906.77,31870.39,11
HCPCS,27700,Revision of ankle joint,,,7182.83,31870.39,11
HCPCS,27702,Reconstruct ankle joint,,,26861.8,119176.72,11
HCPCS,27703,Reconstruction ankle joint,,,17357.91,77011.17,11
HCPCS,27704,Removal of ankle implant,,,3239.17,14371.12,11
HCPCS,27705,Incision of tibia,,,7183.42,31870.39,11
HCPCS,27707,Incision of fibula,,,3239.17,14371.12,11
HCPCS,27709,Incision of tibia & fibula,,,5839.66,56389.43,11
HCPCS,27712,Realignment of lower leg,,,12709.88,56389.43,11
HCPCS,27713,Osteot tibia imed lngth dev,,,7183.42,31870.39,7
HCPCS,27715,Revision of lower leg,,,12709.88,56389.43,11
HCPCS,27720,Repair of tibia,,,7183.42,31870.39,11
HCPCS,27722,Repair/graft of tibia,,,7183.42,31870.39,11
HCPCS,27724,Repair/graft of tibia,,,7183.42,31870.39,11
HCPCS,27725,Repair of lower leg,,,7183.42,31870.39,11
HCPCS,27726,Repair fibula nonunion,,,5233.29,31870.39,11
HCPCS,27727,Repair of lower leg,,,3239.17,23681.51,11
HCPCS,27730,Repair of tibia epiphysis,,,3239.17,14371.12,11
HCPCS,27732,Repair of fibula epiphysis,,,3239.17,14371.12,11
HCPCS,27734,Repair lower leg epiphyses,,,3239.17,14371.12,11
HCPCS,27740,Repair of leg epiphyses,,,3239.17,14371.12,11
HCPCS,27742,Repair of leg epiphyses,,,3239.17,14371.12,11
HCPCS,27745,Reinforce tibia,,,7183.42,31870.39,11
HCPCS,27750,HC CLOSED RX TIBIA,383.0,268.1,,,0
HCPCS,27750,HC PRO CLOSED RX TIBIA,521.0,364.7,,,0
HCPCS,27750,Treatment of tibia fracture,,,244.19,1083.4,11
HCPCS,27752,HC CLOSED TX TIBIAL SHAFT FX W/WO FIBULAR FX W/MANIPULATION W/W/O SKELETAL TRACTION,2063.0,1444.1,,,0
HCPCS,27752,HC PRO CLOSED TX TIBIAL SHAFT FX W/WO FIBULAR FX W/MANIPULATION W/W/O SKELETAL TRACTION,926.0,648.2,,,0
HCPCS,27752,Treatment of tibia fracture,,,1554.79,7062.54,11
HCPCS,27756,Treatment of tibia fracture,,,5233.29,31870.39,11
HCPCS,27758,Treatment of tibia fracture,,,8224.12,56389.43,11
HCPCS,27759,Treatment of tibia fracture,,,10056.65,56389.43,11
HCPCS,27760,Cltx medial ankle fx,,,244.19,1083.4,11
HCPCS,27760,HC CLOSED TX MEDIAL MALLEOLUS FX W/O MANIPULATION,852.0,596.4,,,0
HCPCS,27760,HC PRO TX MEDIAL MALLEOLUS FX W/O MANIPULATION,1004.0,702.8,,,0
HCPCS,27762,Cltx med ankle fx w/mnpj,,,1413.21,7062.54,11
HCPCS,27762,HC CLOSED TX MEDIAL MALLEOLUS FX W/MANIPULATION W/WO SKIN OR SKELETAL TRACTION,2063.0,1444.1,,,0
HCPCS,27762,HC PRO CLOSED TX MEDIAL MALLEOLUS FX W/MANIPULATION W/WO SKIN OR SKELETAL TRACTION,978.0,684.6,,,0
HCPCS,27766,Optx medial ankle fx,,,4473.58,31870.39,11
HCPCS,27767,Cltx post ankle fx,,,244.19,1083.4,11
HCPCS,27768,Cltx post ankle fx w/mnpj,,,353.72,7062.54,11
HCPCS,27768,HC CLOSED TX POSTERIOR MALLEOLUS FRACTURE W/ MANIP,5523.0,3866.1,,,0
HCPCS,27769,Optx post ankle fx,,,7183.42,31870.39,11
HCPCS,27780,HC CLOSED TX PROXIMAL FIBULA/SHAFT FX W/O MANIPULATION,852.0,596.4,,,0
HCPCS,27780,HC PRO TREAT PROX FIBULA FX W/O MANIP,609.0,426.3,,,0
HCPCS,27780,Treatment of fibula fracture,,,244.19,1083.4,11
HCPCS,27781,HC PRO TREAT PROX FIBULA FX W/ MANIP,814.0,569.8,,,0
HCPCS,27781,HC TREAT PROX FIBULA FX W/ MANIP,4729.0,3310.3,,,0
HCPCS,27781,Treatment of fibula fracture,,,1591.86,7062.54,11
HCPCS,27784,Treatment of fibula fracture,,,4840.71,31870.39,11
HCPCS,27786,HC CLOSED TX DISTAL FIBULAR FX W/O MANIPULATION,716.0,501.2,,,0
HCPCS,27786,HC PRO CLOSED TX DISTAL FIBULAR FX W/O MANIPULATION,764.0,534.8,,,0
HCPCS,27786,Treatment of ankle fracture,,,244.19,1083.4,11
HCPCS,27788,HC PRO TREAT LAT MALLEOLUS FX W/ MAN,959.0,671.3,,,0
HCPCS,27788,HC TREAT LAT MALLEOLUS FX W/ MAN,825.0,577.5,,,0
HCPCS,27788,Treatment of ankle fracture,,,224.97,1083.4,11
HCPCS,27792,Treatment of ankle fracture,,,6453.26,31870.39,11
HCPCS,27800102,HC INTERLOCK COILS 2D,1918.0,1342.6,,,0
HCPCS,27800103,HC EMBOLIZATION PRODUCT J COIL DETACH CONTR,799.0,559.3,,,0
HCPCS,27800104,HC VASCULAR PLUG,1985.0,1389.5,,,0
HCPCS,27800105,HC EMBOLIZATION PRODUCT I DETACH FRAM COIL,3993.0,2795.1,,,0
HCPCS,27800106,HC EMBOLIZATION PRODUCT H DETACH HELI COIL,4327.0,3028.9,,,0
HCPCS,27800107,HC EMBOLIZATION PRODUCT K DRUG ELUTING SPHERES EACH VIAL,6450.0,4515.0,,,0
HCPCS,27800108,HC MELODY VALVE PB1018,63888.0,44721.6,,,0
HCPCS,27800124,HC PROPEL MINI,5559.0,3891.3,,,0
HCPCS,27800127,HC IMPELLA 25 ALC PUMP SET US,66550.0,46585.0,,,0
HCPCS,27800132,HC TRANSLUMINAL BILIARY BIOPSY FORCEPS,2271.0,1589.7,,,0
HCPCS,27800134,HC IMPELLA 5.0 ALC PUMP SET,74536.0,52175.2,,,0
HCPCS,27800135,HC IMPELLA 3.4 ALC PUMP SET,66550.0,46585.0,,,0
HCPCS,27800137,HC AMPLATZER DUCT OCCLUDER PDA 4F 90 DEG CURVE,13644.0,9550.8,,,0
HCPCS,27800149,HC MITRA CLIP SYSTEM KIT,79860.0,55902.0,,,0
HCPCS,27800158,HC SURESCAN PATIENT RECHARGING SYSTEM,2980.0,2086.0,,,0
HCPCS,27800166,HC VALVE IN CARTRIDGE HUD,8819.0,6173.3,,,0
HCPCS,27800167,HC BARE CP STENT SHORT,9152.0,6406.4,,,0
HCPCS,27800168,HC BARE CP STENT LONG,9818.0,6872.6,,,0
HCPCS,27800169,HC COVERED CP STENT SHORT,14242.0,9969.4,,,0
HCPCS,27800170,HC COVERED CP STENT LONG,14775.0,10342.5,,,0
HCPCS,27800171,HC MOUNTED COVERED CP STENT SHORT,17437.0,12205.9,,,0
HCPCS,27800172,HC MOUNTED COVERED CP STENT LONG,17969.0,12578.3,,,0
HCPCS,27800185,HC LD DBL STENT,2396.0,1677.2,,,0
HCPCS,27800187,HC RUBY COIL POD OCCLUSION J 60,3713.0,2599.1,,,0
HCPCS,27800188,HC RUBY COIL CMPLX SOFT 3MM X 5CM,2228.0,1559.6,,,0
HCPCS,27800189,HC HARMONY TRANSCATHETER PULM SYSTEM,19635.0,13744.5,,,0
HCPCS,27800190,HC HARMONY VALVE PULMONARY TRANSCATHETER,76230.0,53361.0,,,0
HCPCS,27800192,HC SMOOTH RESPONSIVE (SR),901.0,630.7,,,0
HCPCS,27800193,HC SMOOTH SOFT TOUCH (SS),1241.0,868.7,,,0
HCPCS,27800194,HC SMOOTH COHESIVE (SC),1241.0,868.7,,,0
HCPCS,27800316,HC SENSATION PLUS 7.5FR 40CC FIBER-OPTIC BALLOON CATH,3288.0,2301.6,,,0
HCPCS,27800317,HC VALVE IN CARTRIDGE 9MM,11064.0,7744.8,,,0
HCPCS,27800318,HC VLV COREVALVE EVOLUT R 34MM,76230.0,53361.0,,,0
HCPCS,27800319,HC KIT VALVE SAPIEN 3 W COMMANDER 20MM,82583.0,57808.1,,,0
HCPCS,27800327,HC MONITOR LINQ IMPLANT CARD,13456.0,9419.2,,,0
HCPCS,27800334,HC COIL TARGET 360 ULTRA 2MM X 3CM,6687.0,4680.9,,,0
HCPCS,27800335,HC COIL TARGET HELLCAL ULTRA DETACHABLE 2MM X 1CM,4571.0,3199.7,,,0
HCPCS,27800336,HC COIL TARGET XL 360 STANDARD DETACHABLE 6MM X 20CM,8836.0,6185.2,,,0
HCPCS,27800337,HC COIL TARGET XL HELLCAL DETACHABLE 5MM X 15CM,6322.0,4425.4,,,0
HCPCS,27800338,HC COIL TARGET 3D DETACHABLE 3MM X 6CM,6703.0,4692.1,,,0
HCPCS,27800339,HC SYS NEUROFORM ATLAS STENT 3 X 15,8335.0,5834.5,,,0
HCPCS,27800340,HC SYS WINGSPAN STENT 2.5 X 9MM,17611.0,12327.7,,,0
HCPCS,27800341,HC CATH GATEWAY PTA BLLN 1.5 X 9,3657.0,2559.9,,,0
HCPCS,27800345,HC GLUE TRUFILL LIQ EMBOLIC 2GM,17844.0,12490.8,,,0
HCPCS,27800346,HC IMPL PULSRIDER Y ARCH,15125.0,10587.5,,,0
HCPCS,27800351,HC DEV PIPELINE FLX EMBOL,33607.0,23524.9,,,0
HCPCS,27800352,HC DEV PIPELINE FLX EMBOL LONG,36148.0,25303.6,,,0
HCPCS,27800355,HC COIL MICROFRAME,6065.0,4245.5,,,0
HCPCS,27800356,HC MICRUSFRAME,5729.0,4010.3,,,0
HCPCS,27800357,HC GALAXY G3,46945.0,32861.5,,,0
HCPCS,27800372,HC SYSTEM INDIGO SEPARATOR,5064.0,3544.8,,,0
HCPCS,27800377,HC VALVE COREVALVE EVOLUT PRO 29MM,69300.0,48510.0,,,0
HCPCS,27800378,HC KIT VALVE SAPIEN 3 W COMMANDER 29MM,75075.0,52552.5,,,0
HCPCS,27800379,HC RUBY COIL POD OCCLUSION 4,4927.0,3448.9,,,0
HCPCS,27800380,HC COIL EMBOLIZATION OCCLUSION 2MM X 3MM X 2.3CM,1268.0,887.6,,,0
HCPCS,27800381,HC COIL EMBOLIZATION INTERLOCK 10MM X 50CM,2048.0,1433.6,,,0
HCPCS,27800382,HC INTERLOCK 35 COIL 2D 6/8 MM X 20CM,2133.0,1493.1,,,0
HCPCS,27800383,HC INTERLOCK 35 COIL 2D 10/12/15 MM X 40CM,2467.0,1726.9,,,0
HCPCS,27803839,HC KIT VALVE SAPIEN 3 RESILIA,82500.0,57750.0,,,0
HCPCS,27803856,HC NAVITOR TRANSCATHETER AORTIC VALVE IMPLANT VISION 23 MM,57750.0,40425.0,,,0
HCPCS,27803857,HC NAVITOR TRANSCATHETER AORTIC VALVE IMPLANT VISION 25 MM,57750.0,40425.0,,,0
HCPCS,27803860,HC TRICLIP G4,90090.0,63063.0,,,0
HCPCS,27808,HC PRO TREAT BIMALLEOLAR FX W/O MANIP,775.0,542.5,,,0
HCPCS,27808,HC TREAT BIMALLEOLAR FX W/O MANIP,349.0,244.3,,,0
HCPCS,27808,Treatment of ankle fracture,,,244.19,1083.4,11
HCPCS,27810,HC PRO TREAT BIMALLEOLAR FX W/ MAN,1011.0,707.7,,,0
HCPCS,27810,HC TREAT BIMALLEOLAR FX W/ MAN,1113.0,779.1,,,0
HCPCS,27810,Treatment of ankle fracture,,,838.2,7062.54,11
HCPCS,27814,HC OPEN TX BIMALLEOLAR ANKLE FX INCL INTERNAL FIX,29049.0,20334.3,,,0
HCPCS,27814,HC PRO OPEN TX BIMALLEOLAR ANKLE FX INCL INTERNAL FIX,1771.0,1239.7,,,0
HCPCS,27814,Treatment of ankle fracture,,,5709.45,31870.39,11
HCPCS,27816,HC TREAT TRIMALLEOLAR FX W/O MANIP,852.0,596.4,,,0
HCPCS,27816,Treatment of ankle fracture,,,244.19,1083.4,11
HCPCS,27818,HC PRO TREAT TRIMALLEOLAR FX W/MANIP,1028.0,719.6,,,0
HCPCS,27818,HC TREAT TRIMALLEOLAR FX W/ MAN,1113.0,779.1,,,0
HCPCS,27818,Treatment of ankle fracture,,,838.2,7062.54,11
HCPCS,27822,HC OPEN TX TRIMALLEOLAR ANKLE FX INCL INT FIXATION MEDIAL/ LATERAL MALLEOLUS W/O FIXATION POST LIP,25921.0,18144.7,,,0
HCPCS,27822,HC PRO OPEN TX TRIMALLEOLAR ANKLE FX INCL INT FIXATION MEDIAL/ LATERAL MALLEOLUS W/O FIXATION POST LIP,2022.0,1415.4,,,0
HCPCS,27822,Treatment of ankle fracture,,,3977.61,31870.39,11
HCPCS,27823,Treatment of ankle fracture,,,4979.03,31870.39,11
HCPCS,27824,Treat lower leg fracture,,,244.19,1083.4,11
HCPCS,27825,HC CLSD TX FX OF DISTAL TIBIA W/ OR W/O ANESTH W/ TRACTION OR MANIP,1977.0,1383.9,,,0
HCPCS,27825,HC PRO CLSD TX FX DISTAL TIBIA W/ OR W/O ANESTH W/ TRACTION OR MANIP,625.0,437.5,,,0
HCPCS,27825,Treat lower leg fracture,,,353.72,7062.54,11
HCPCS,27826,Treat lower leg fracture,,,7183.42,31870.39,11
HCPCS,27827,Treat lower leg fracture,,,4682.77,56389.43,11
HCPCS,27828,Treat lower leg fracture,,,5174.47,56389.43,11
HCPCS,27829,Treat lower leg joint,,,4279.38,31870.39,11
HCPCS,27830,Treat lower leg dislocation,,,244.19,1083.4,11
HCPCS,27831,Treat lower leg dislocation,,,353.72,14371.12,11
HCPCS,27832,Treat lower leg dislocation,,,7183.42,31870.39,11
HCPCS,27840,HC PRO TX CLOSED ANKLE DISLOCATION W/O ANESTHESIA,1983.0,1388.1,,,0
HCPCS,27840,HC TX CLOSED ANKLE DISLOCATION W/O ANESTHESIA,614.0,429.8,,,0
HCPCS,27840,Treat ankle dislocation,,,244.19,1083.4,11
HCPCS,27842,HC PRO TX CLOSED TX ANKLE DISLOCATION W/ANESTHESIA W/ OR W/O PERCUT SKELETAL FIXATION,604.0,422.8,,,0
HCPCS,27842,HC TX CLOSED TX ANKLE DISLOCATION W/ANESTHESIA W/ OR W/O PERCUT SKELETAL FIXATION,1561.0,1092.7,,,0
HCPCS,27842,Treat ankle dislocation,,,1146.55,7062.54,11
HCPCS,27846,Treat ankle dislocation,,,7183.42,31870.39,11
HCPCS,27848,Treat ankle dislocation,,,7183.42,31870.39,11
HCPCS,27860,Fixation of ankle joint,,,2214.06,14371.12,11
HCPCS,27870,Fusion of ankle joint open,,,3287.13,56389.43,11
HCPCS,27871,Fusion of tibiofibular joint,,,4559.28,56389.43,11
HCPCS,27880,Amputation of lower leg,,,7183.42,59981.53,11
HCPCS,27881,Amputation of lower leg,,,3239.17,23681.51,11
HCPCS,27882,Amputation of lower leg,,,3239.17,23681.51,11
HCPCS,27884,Amputation follow-up surgery,,,3239.17,14371.12,11
HCPCS,27886,Amputation follow-up surgery,,,3239.17,23681.51,11
HCPCS,27888,Amputation of foot at ankle,,,3239.17,46549.79,11
HCPCS,27889,Amputation of foot at ankle,,,5839.66,31870.39,11
HCPCS,27892,Decompression of leg,,,3239.17,14371.12,11
HCPCS,27893,Decompression of leg,,,4254.97,31870.39,11
HCPCS,27894,Decompression of leg,,,3239.17,14371.12,11
HCPCS,27899,Leg/ankle surgery procedure,,,244.19,1083.4,11
HCPCS,28001,Drainage of bursa of foot,,,1635.03,7254.06,11
HCPCS,28002,Treatment of foot infection,,,1591.86,7062.54,11
HCPCS,28003,Treatment of foot infection,,,3239.17,14371.12,11
HCPCS,28005,Treat foot bone lesion,,,3239.17,14371.12,11
HCPCS,28008,Incision of foot fascia,,,3239.17,14371.12,11
HCPCS,28010,Incision of toe tendon,,,1591.86,7062.54,11
HCPCS,28011,Incision of toe tendons,,,1591.86,7062.54,11
HCPCS,28020,Exploration of foot joint,,,3239.17,14371.12,11
HCPCS,28022,Exploration of foot joint,,,3239.17,14371.12,11
HCPCS,28024,Exploration of toe joint,,,1591.86,7062.54,11
HCPCS,28035,Decompression of tibia nerve,,,1933.13,8576.66,11
HCPCS,28039,Exc foot/toe tum sc 1.5 cm/>,,,2875.57,12757.95,11
HCPCS,28041,Exc foot/toe tum dep 1.5cm/>,,,2875.57,12757.95,11
HCPCS,28043,Exc foot/toe tum sc < 1.5 cm,,,1635.03,7254.06,11
HCPCS,28045,Exc foot/toe tum deep <1.5cm,,,2875.57,12757.95,11
HCPCS,28045,HC EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBFASCIAL LESS THAN 1.5CM,12185.0,8529.5,,,0
HCPCS,28045,HC PRO EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBFASCIAL LESS THAN 1.5CM,796.0,557.2,,,0
HCPCS,28046,Resect foot/toe tumor < 3 cm,,,2875.57,12757.95,11
HCPCS,28047,Resect foot/toe tumor 3 cm/>,,,1168.63,12757.95,11
HCPCS,28050,Biopsy of foot joint lining,,,3239.17,14371.12,11
HCPCS,28052,Biopsy of foot joint lining,,,3239.17,14371.12,11
HCPCS,28054,Biopsy of toe joint lining,,,3239.17,14371.12,11
HCPCS,28055,Neurectomy foot,,,1933.13,8576.66,11
HCPCS,28060,Partial removal foot fascia,,,3239.17,14371.12,11
HCPCS,28062,Removal of foot fascia,,,3239.17,14371.12,11
HCPCS,28070,Removal of foot joint lining,,,4166.86,31870.39,11
HCPCS,28072,Removal of foot joint lining,,,3239.17,14371.12,11
HCPCS,28080,Removal of foot lesion,,,1591.86,7062.54,11
HCPCS,28086,Excise foot tendon sheath,,,3239.17,14371.12,11
HCPCS,28088,Excise foot tendon sheath,,,3239.17,14371.12,11
HCPCS,28090,Removal of foot lesion,,,1591.86,7062.54,11
HCPCS,28092,Removal of toe lesions,,,1591.86,7062.54,11
HCPCS,28100,Removal of ankle/heel lesion,,,3239.17,14371.12,11
HCPCS,28102,Remove/graft foot lesion,,,7183.42,31870.39,11
HCPCS,28103,Remove/graft foot lesion,,,7183.42,31870.39,11
HCPCS,28104,Removal of foot lesion,,,2232.74,14371.12,11
HCPCS,28106,Remove/graft foot lesion,,,7183.42,31870.39,11
HCPCS,28107,Remove/graft foot lesion,,,7183.42,31870.39,11
HCPCS,28108,Removal of toe lesions,,,1591.86,7062.54,11
HCPCS,28110,Part removal of metatarsal,,,2470.54,14371.12,11
HCPCS,28111,Part removal of metatarsal,,,3239.17,14371.12,11
HCPCS,28112,Part removal of metatarsal,,,3239.17,14371.12,11
HCPCS,28113,Part removal of metatarsal,,,3239.17,14371.12,11
HCPCS,28114,Removal of metatarsal heads,,,3239.17,14371.12,11
HCPCS,28116,Revision of foot,,,3239.17,14371.12,11
HCPCS,28118,Removal of heel bone,,,3239.17,14371.12,11
HCPCS,28119,Removal of heel spur,,,3239.17,14371.12,11
HCPCS,28120,Part removal of ankle/heel,,,3239.17,14371.12,11
HCPCS,28122,Partial removal of foot bone,,,3239.17,14371.12,11
HCPCS,28124,HC PRO PARTIAL EXCISION (CRATERIZATION/SAUCERIZATION/SEQUESTRECTOMY/DIAPHYSECTOMY) BONE PHALANX OF TOE,806.0,564.2,,,0
HCPCS,28124,Partial removal of toe,,,1670.91,14371.12,11
HCPCS,28126,Partial removal of toe,,,3239.17,14371.12,11
HCPCS,28130,Removal of ankle bone,,,4166.86,31870.39,11
HCPCS,28140,Removal of metatarsal,,,3239.17,14371.12,11
HCPCS,28150,Removal of toe,,,3239.17,14371.12,11
HCPCS,28153,Partial removal of toe,,,1602.91,14371.12,11
HCPCS,28160,Partial removal of toe,,,2693.96,14371.12,11
HCPCS,28171,Resect tarsal tumor,,,3239.17,14371.12,11
HCPCS,28173,Resect metatarsal tumor,,,3239.17,14371.12,11
HCPCS,28175,Resect phalanx of toe tumor,,,1591.86,7062.54,11
HCPCS,28190,HC PRO REM OF FOOT FB SUBQ,217.0,151.9,,,0
HCPCS,28190,HC REM OF FOOT FB SUBQ,1233.0,863.1,,,0
HCPCS,28190,Removal of foot foreign body,,,701.03,4535.95,11
HCPCS,28192,HC REMOVAL OF FOOT FOREIGN BODY,1759.0,1231.3,,,0
HCPCS,28192,Removal of foot foreign body,,,1635.03,7254.06,11
HCPCS,28193,Removal of foot foreign body,,,1635.03,7254.06,11
HCPCS,28200,Repair of foot tendon,,,3239.17,14371.12,11
HCPCS,28202,Repair/graft of foot tendon,,,4166.86,31870.39,11
HCPCS,28208,Repair of foot tendon,,,3239.17,14371.12,11
HCPCS,28210,Repair/graft of foot tendon,,,7183.42,31870.39,11
HCPCS,28220,Release of foot tendon,,,1591.86,7062.54,11
HCPCS,28222,Release of foot tendons,,,3239.17,14371.12,11
HCPCS,28225,Release of foot tendon,,,3239.17,14371.12,11
HCPCS,28226,Release of foot tendons,,,3239.17,14371.12,11
HCPCS,28230,Incision of foot tendon(s),,,1591.86,7062.54,11
HCPCS,28232,Incision of toe tendon,,,1300.88,7062.54,11
HCPCS,28234,Incision of foot tendon,,,1591.86,7062.54,11
HCPCS,28238,Revision of foot tendon,,,7183.42,31870.39,11
HCPCS,28240,Release of big toe,,,3239.17,14371.12,11
HCPCS,28250,Revision of foot fascia,,,2420.35,14371.12,11
HCPCS,28260,Release of midfoot joint,,,3239.17,14371.12,11
HCPCS,28261,Revision of foot tendon,,,1591.86,7062.54,11
HCPCS,28262,Revision of foot and ankle,,,4166.86,31870.39,11
HCPCS,28264,Release of midfoot joint,,,1591.86,11048.37,11
HCPCS,28270,Release of foot contracture,,,1753.89,14371.12,11
HCPCS,28272,Release of toe joint each,,,1300.87,7062.54,11
HCPCS,28280,Fusion of toes,,,1227.68,14371.12,11
HCPCS,28285,Repair of hammertoe,,,2471.06,14371.12,11
HCPCS,28286,Repair of hammertoe,,,2232.74,14371.12,11
HCPCS,28288,Partial removal of foot bone,,,1595.17,14371.12,11
HCPCS,28289,Corrj halux rigdus w/o implt,,,3239.17,14371.12,11
HCPCS,28291,Corrj halux rigdus w/implt,,,4784.09,31870.39,11
HCPCS,28292,Correction hallux valgus,,,3239.17,14371.12,11
HCPCS,28295,Correction hallux valgus,,,3239.17,14371.12,11
HCPCS,28296,Correction hallux valgus,,,3239.17,14371.12,11
HCPCS,28297,Correction hallux valgus,,,3352.21,56389.43,11
HCPCS,28298,Correction hallux valgus,,,1210.18,31870.39,11
HCPCS,28299,Correction hallux valgus,,,2594.02,31870.39,11
HCPCS,28300,Incision of heel bone,,,4277.86,31870.39,11
HCPCS,28302,Incision of ankle bone,,,4166.86,31870.39,11
HCPCS,28304,Incision of midfoot bones,,,7183.42,31870.39,11
HCPCS,28305,Incise/graft midfoot bones,,,7183.42,31870.39,11
HCPCS,28306,Incision of metatarsal,,,4840.71,31870.39,11
HCPCS,28307,Incision of metatarsal,,,4166.86,31870.39,11
HCPCS,28308,Incision of metatarsal,,,2759.41,14371.12,11
HCPCS,28309,Incision of metatarsals,,,7183.42,31870.39,11
HCPCS,28310,Revision of big toe,,,2232.64,31870.39,11
HCPCS,28312,Revision of toe,,,3239.17,14371.12,11
HCPCS,28313,Repair deformity of toe,,,2976.98,14371.12,11
HCPCS,28315,Removal of sesamoid bone,,,3239.17,14371.12,11
HCPCS,28320,Repair of foot bones,,,8856.24,56389.43,11
HCPCS,28322,Repair of metatarsals,,,4007.29,31870.39,11
HCPCS,28340,Resect enlarged toe tissue,,,3239.17,14371.12,11
HCPCS,28341,Resect enlarged toe,,,3239.17,14371.12,11
HCPCS,28344,Repair extra toe(s),,,3239.17,14371.12,11
HCPCS,28345,Repair webbed toe(s),,,1591.86,7062.54,11
HCPCS,28360,Reconstruct cleft foot,,,7183.42,31870.39,11
HCPCS,28400,HC CLOSED TX CALCANEAL FX W/O MANIPULATION,852.0,596.4,,,0
HCPCS,28400,HC PRO CLOSED TX CALCANEAL FX W/O MANIPULATION,516.0,361.2,,,0
HCPCS,28400,Treatment of heel fracture,,,244.19,1083.4,11
HCPCS,28405,Treatment of heel fracture,,,244.19,1083.4,11
HCPCS,28406,Treatment of heel fracture,,,5233.29,31870.39,11
HCPCS,28415,Treat heel fracture,,,7183.42,31870.39,11
HCPCS,28420,Treat/graft heel fracture,,,8224.12,56389.43,11
HCPCS,28430,HC PRO CLOSED TX TALUS FX W/O MANIPULATION,441.0,308.7,,,0
HCPCS,28430,Treatment of ankle fracture,,,244.19,1083.4,11
HCPCS,28435,HC PRO TREAT TALUS FX,418.0,292.6,,,0
HCPCS,28435,HC TREAT TALUS FX,1959.0,1371.3,,,0
HCPCS,28435,Treatment of ankle fracture,,,353.72,7062.54,11
HCPCS,28436,Treatment of ankle fracture,,,5233.29,31870.39,11
HCPCS,28445,Treat ankle fracture,,,6138.4,31870.39,11
HCPCS,28446,Osteochondral talus autogrft,,,7183.42,31870.39,11
HCPCS,28450,HC PRO TX TARSAL BONE FX W/O MANIP EACH,414.0,289.8,,,0
HCPCS,28450,HC TX TARSAL BONE FX W/O MANIPULATION EACH,915.0,640.5,,,0
HCPCS,28450,Treat midfoot fracture each,,,244.19,1083.4,11
HCPCS,28455,HC PRO TX MIDFOOT FRACTURE EACH,618.0,432.6,,,0
HCPCS,28455,Treat midfoot fracture each,,,353.72,7062.54,11
HCPCS,28456,Treat midfoot fracture,,,5233.29,31870.39,11
HCPCS,28465,Treat midfoot fracture each,,,3902.62,31870.39,11
HCPCS,28470,HC METATARSAL FX W/O MANIP,792.0,554.4,,,0
HCPCS,28470,HC PRO CLOSED TX METATARSAL FX W/O MANIP EACH,472.0,330.4,,,0
HCPCS,28470,Treat metatarsal fracture,,,244.19,1083.4,11
HCPCS,28475,HC METATARSAL FX W/MANIP,880.0,616.0,,,0
HCPCS,28475,HC PRO METATARSAL FX W/MANIP,377.0,263.9,,,0
HCPCS,28475,Treat metatarsal fracture,,,244.19,1083.4,11
HCPCS,28476,Treat metatarsal fracture,,,3239.17,14371.12,11
HCPCS,28485,Treat metatarsal fracture,,,3552.66,31870.39,11
HCPCS,28490,HC CLOSED TX OF FX GREAT TOE PHALANX/PHALANGES W/O MANIPULATION,836.0,585.2,,,0
HCPCS,28490,HC PRO CLOSED TX GREAT TOE FX W/O MANIPULATION,275.0,192.5,,,0
HCPCS,28490,Treat big toe fracture,,,244.19,1083.4,11
HCPCS,28495,HC CLOSED TX FX GREAT TOE PHALANX/PHALANGES W/MANIPULATION,961.0,672.7,,,0
HCPCS,28495,HC PRO CLOSED TX GREAT TOE FX W/ MANIPULATION,271.0,189.7,,,0
HCPCS,28495,Treat big toe fracture,,,244.19,1083.4,11
HCPCS,28496,Treat big toe fracture,,,3239.17,14371.12,11
HCPCS,28505,Treat big toe fracture,,,3239.17,14371.12,11
HCPCS,28510,HC CLOSED TX FX PHALANX/PHALANGES OTHER THAN GREAT TOE W/O MANIPULATION EACH,836.0,585.2,,,0
HCPCS,28510,HC PRO CLOSED TX OTH THAN GREAT TOE FX W/O MANIP EACH,271.0,189.7,,,0
HCPCS,28510,Treatment of toe fracture,,,244.19,1083.4,11
HCPCS,28515,HC CLOSED TX FX PHALANX/PHALANGES OTHER THAN GREAT TOE W/MANIPULATION EACH,961.0,672.7,,,0
HCPCS,28515,HC PRO TREAT TOE FX W/ MANIP,255.0,178.5,,,0
HCPCS,28515,Treatment of toe fracture,,,240.6,1083.4,11
HCPCS,28525,Treat toe fracture,,,3239.17,14371.12,11
HCPCS,28530,Treat sesamoid bone fracture,,,244.19,1083.4,11
HCPCS,28531,Treat sesamoid bone fracture,,,5233.29,31870.39,11
HCPCS,28540,HC PRO CLOSED TX OF TARSAL BONE DISLOCATION OTHER THAN TALOTARSAL W/O ANESTH,418.0,292.6,,,0
HCPCS,28540,Treat foot dislocation,,,244.19,1083.4,11
HCPCS,28545,HC CLOSED TX TARSAL BONE DISLOCATION OTHER THAN TALOTARSAL REQUIRING ANESTHESIA,12299.0,8609.3,,,0
HCPCS,28545,HC PRO CLOSED TX TARSAL BONE DISLOCATION OTHER THAN TALOTARSAL REQUIRING ANESTHESIA,621.0,434.7,,,0
HCPCS,28545,Treat foot dislocation,,,3239.17,14371.12,11
HCPCS,28546,Treat foot dislocation,,,1591.86,7062.54,11
HCPCS,28555,Repair foot dislocation,,,7183.42,31870.39,11
HCPCS,28570,HC CLSD FOOT DISLOC W/O ANEST,885.0,619.5,,,0
HCPCS,28570,HC PRO CLSD FOOT DISLOC W/O ANESTH,204.0,142.8,,,0
HCPCS,28570,Treat foot dislocation,,,244.19,1083.4,11
HCPCS,28575,HC CLOSED TX OF TALOTARSAL JOINT DISLOCATION REQUIRING ANESTHESIA,9425.0,6597.5,,,0
HCPCS,28575,Treat foot dislocation,,,353.72,14371.12,11
HCPCS,28576,Treat foot dislocation,,,5233.29,31870.39,11
HCPCS,28585,Repair foot dislocation,,,5233.29,31870.39,11
HCPCS,28600,HC PRO TARSOMETATRSL DIS W/O ANESTH,431.0,301.7,,,0
HCPCS,28600,HC TARSOMETATRSL DIS W/O ANES,914.0,639.8,,,0
HCPCS,28600,Treat foot dislocation,,,244.19,1083.4,11
HCPCS,28605,HC PRO TARSOMETATRSL DIS W/ ANESTH,687.0,480.9,,,0
HCPCS,28605,Treat foot dislocation,,,244.19,1083.4,11
HCPCS,28606,Treat foot dislocation,,,1816.03,14371.12,11
HCPCS,28615,Repair foot dislocation,,,3251.46,31870.39,11
HCPCS,28630,HC PRO TREAT MP TOE DISLOC,478.0,334.6,,,0
HCPCS,28630,HC TREAT MP TOE DISLOC,320.0,224.0,,,0
HCPCS,28630,Treat toe dislocation,,,180.67,1083.4,11
HCPCS,28635,Treat toe dislocation,,,1591.86,7062.54,11
HCPCS,28636,Treat toe dislocation,,,3239.17,14371.12,11
HCPCS,28645,Repair toe dislocation,,,3239.17,14371.12,11
HCPCS,28660,HC CLSD TRMT INTRPHLNGL JT DL W/O,207.0,144.9,,,0
HCPCS,28660,HC PRO CLSD TRMT INTRPHLNGL JT DL W/O,180.0,126.0,,,0
HCPCS,28660,Treat toe dislocation,,,244.19,1083.4,11
HCPCS,28665,HC CLSD TX INTERPHALANGEAL JOINT DISLOCATION W/ANESTHESIA,335.0,234.5,,,0
HCPCS,28665,Treat toe dislocation,,,276.89,3685.16,11
HCPCS,28666,Treat toe dislocation,,,3239.17,14371.12,11
HCPCS,28675,Repair of toe dislocation,,,3239.17,14371.12,11
HCPCS,28705,Fusion of foot bones,,,8856.24,77011.17,11
HCPCS,28715,Fusion of foot bones,,,12709.88,56389.43,11
HCPCS,28725,Fusion of foot bones,,,4007.29,56389.43,11
HCPCS,28730,Fusion of foot bones,,,4142.57,56389.43,11
HCPCS,28735,Fusion of foot bones,,,8856.24,56389.43,11
HCPCS,28737,Revision of foot bones,,,3444.43,56389.43,11
HCPCS,28740,Fusion of foot bones,,,4189.26,31870.39,11
HCPCS,28750,Fusion of big toe joint,,,5465.05,31870.39,11
HCPCS,28755,Fusion of big toe joint,,,4291.61,31870.39,11
HCPCS,28760,Fusion of big toe joint,,,6138.4,31870.39,11
HCPCS,28800,Amputation of midfoot,,,3239.17,14371.12,11
HCPCS,28805,Amputation thru metatarsal,,,3239.17,14371.12,11
HCPCS,28810,Amputation toe & metatarsal,,,3102.06,14371.12,11
HCPCS,28820,Amputation of toe,,,3239.17,14371.12,11
HCPCS,28820,HC AMPUTATION TOE METATARSOPHALANGEAL JOINT,12082.0,8457.4,,,0
HCPCS,28820,HC PRO AMPUTATION TOE METATARSOPHALANGEAL JOINT,700.0,490.0,,,0
HCPCS,28825,HC AMPUTATION TOE INTERPHALANGEAL JOINT,11385.0,7969.5,,,0
HCPCS,28825,Partial amputation of toe,,,2601.74,14371.12,11
HCPCS,28890,Hi enrgy eswt plantar fascia,,,1591.86,7285.12,11
HCPCS,28899,Foot/toes surgery procedure,,,244.19,2890.26,11
HCPCS,29000,Application of body cast,,,218.68,1228.45,11
HCPCS,29010,Application of body cast,,,276.89,1228.45,11
HCPCS,29015,Application of body cast,,,276.89,1228.45,11
HCPCS,29035,Application of body cast,,,276.89,1228.45,11
HCPCS,29040,Application of body cast,,,218.68,1228.45,11
HCPCS,29044,Application of body cast,,,160.87,713.73,11
HCPCS,29046,Application of body cast,,,276.89,1228.45,11
HCPCS,29049,Application of figure eight,,,218.68,1228.45,11
HCPCS,29055,Application of shoulder cast,,,276.89,1228.45,11
HCPCS,29058,Application of shoulder cast,,,218.68,1228.45,11
HCPCS,29065,Application of long arm cast,,,238.87,1228.45,11
HCPCS,29075,Application of forearm cast,,,276.89,1228.45,11
HCPCS,29075,HC APPLY SHORT ARM CAST,939.0,657.3,,,0
HCPCS,29085,Apply hand/wrist cast,,,160.87,713.73,11
HCPCS,29085,HC APPLY HAND/WRIST CAST,335.0,234.5,,,0
HCPCS,29086,Apply finger cast,,,160.87,713.73,11
HCPCS,29105,Apply long arm splint,,,155.31,713.73,11
HCPCS,29105,HC APPLY LONG ARM SPLINT,200.0,140.0,,,0
HCPCS,29105,HC PRO APPLY LONG ARM SPLINT,831.0,581.7,,,0
HCPCS,29125,Apply forearm splint,,,131.71,584.37,11
HCPCS,29125,HC APPLY FOREARM SPLINT STATIC,221.0,154.7,,,0
HCPCS,29125,HC PRO APPLY FOREARM SPLINT,295.0,206.5,,,0
HCPCS,29126,Apply forearm splint,,,131.71,584.37,11
HCPCS,29126,HC APPLY FOREARM SPLINT DYNAMIC,294.0,205.8,,,0
HCPCS,29130,Application of finger splint,,,126.82,584.37,11
HCPCS,29130,HC APPLY FINGER SPLINT,169.0,118.3,,,0
HCPCS,29130,HC PRO APPLY FINGER SPLINT,154.0,107.8,,,0
HCPCS,29131,Application of finger splint,,,58.4,272.8,11
HCPCS,29200,HC PRO STRAPPING THORAX,92.0,64.4,,,0
HCPCS,29200,Strapping of chest,,,160.87,713.73,11
HCPCS,29240,HC STRAPPING SHOULDER VELPEAU,341.0,238.7,,,0
HCPCS,29240,Strapping of shoulder,,,131.71,584.37,11
HCPCS,29260,Strapping of elbow or wrist,,,58.4,272.8,11
HCPCS,29280,HC PRO STRAPPING HAND OR FINGER,63.0,44.1,,,0
HCPCS,29280,HC STRAPPING HAND OR FINGER,119.0,83.3,,,0
HCPCS,29280,Strapping of hand or finger,,,58.4,272.8,11
HCPCS,29305,Application of hip cast,,,276.89,1228.45,11
HCPCS,29325,Application of hip casts,,,276.89,1228.45,11
HCPCS,29345,Application of long leg cast,,,276.89,1228.45,11
HCPCS,29355,Application of long leg cast,,,276.89,1228.45,11
HCPCS,29358,Apply long leg cast brace,,,276.89,1228.45,11
HCPCS,29365,Application of long leg cast,,,276.89,1228.45,11
HCPCS,29405,Apply short leg cast,,,276.89,1228.45,11
HCPCS,29405,HC APPLY SHORT LEG CAST,483.0,338.1,,,0
HCPCS,29425,Apply short leg cast,,,276.89,1228.45,11
HCPCS,29435,Apply short leg cast,,,276.89,1228.45,11
HCPCS,29440,Addition of walker to cast,,,160.87,713.73,11
HCPCS,29445,Apply rigid leg cast,,,276.89,1228.45,11
HCPCS,29445,HC APPLY TOTAL CONTACT LEG CAST,689.0,482.3,,,0
HCPCS,29445,HC PRO APPLICATION OF TOTAL CONTRACT CAST (TCC),377.0,263.9,,,0
HCPCS,29450,Application of leg cast,,,160.87,713.73,11
HCPCS,29505,Application long leg splint,,,160.87,755.45,11
HCPCS,29505,HC APPLY LONG LEG SPLINT,854.0,597.8,,,0
HCPCS,29505,HC PRO APPLY LONG LEG SPLINT,380.0,266.0,,,0
HCPCS,29515,Application lower leg splint,,,160.87,713.73,11
HCPCS,29515,HC APPLY LOWER LEG SPLINT,431.0,301.7,,,0
HCPCS,29515,HC PRO APPLY LOWER LEG SPLINT,328.0,229.6,,,0
HCPCS,29520,Strapping of hip,,,131.71,584.37,11
HCPCS,29530,Strapping of knee,,,131.71,584.37,11
HCPCS,29540,HC STRAPPING ANKLE AND/OR FOOT,637.0,445.9,,,0
HCPCS,29540,Strapping of ankle and/or ft,,,160.87,713.73,11
HCPCS,29550,HC PRO STRAPPING TOES,140.0,98.0,,,0
HCPCS,29550,HC STRAPPING TOES,169.0,118.3,,,0
HCPCS,29550,Strapping of toes,,,58.4,272.8,11
HCPCS,29580,Application of paste boot,,,160.87,713.73,11
HCPCS,29581,Apply multlay comprs lwr leg,,,144.19,713.73,11
HCPCS,29581,HC APPLY MULTLAY COMPRS LWR LEG,552.0,386.4,,,0
HCPCS,29581,HC PRO APPLY MULTILAY COMPRS LWR LEG,60.0,42.0,,,0
HCPCS,29584,Appl multlay comprs arm/hand,,,160.87,713.73,11
HCPCS,29584,HC APPLICATION MULTI-LAYER COMPRESSION SYSTEM UPPER ARM/FOREARM/HAND/FINGERS,672.0,470.4,,,0
HCPCS,29700,HC REMOVAL/BIVALVING GAUNTLET BOOT/BODY CAST,970.0,679.0,,,0
HCPCS,29700,Removal/revision of cast,,,218.68,1228.45,11
HCPCS,29705,HC REM/REVISE FULL ARM/LEG CAST,283.0,198.1,,,0
HCPCS,29705,Removal/revision of cast,,,202.38,1228.45,11
HCPCS,29710,Removal/revision of cast,,,276.89,1228.45,11
HCPCS,29720,Repair of body cast,,,160.87,713.73,11
HCPCS,29730,Windowing of cast,,,160.87,713.73,11
HCPCS,29740,Wedging of cast,,,218.68,1228.45,11
HCPCS,29750,Wedging of clubfoot cast,,,218.68,1228.45,11
HCPCS,29799,Casting/strapping procedure,,,160.87,713.73,11
HCPCS,29800,Jaw arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29804,Jaw arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29805,Shoulder arthroscopy dx,,,3239.17,14371.12,11
HCPCS,29806,Shoulder arthroscopy/surgery,,,6888.87,31870.39,11
HCPCS,29807,Shoulder arthroscopy/surgery,,,5705.83,31870.39,11
HCPCS,29819,Shoulder arthroscopy/surgery,,,3069.2,14371.12,11
HCPCS,29820,Shoulder arthroscopy/surgery,,,7183.42,31870.39,11
HCPCS,29821,Shoulder arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29822,Shoulder arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29823,Shoulder arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29824,Shoulder arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29825,Shoulder arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29826,Shoulder arthroscopy/surgery,,,3804.26,4745.91,4
HCPCS,29827,Arthroscop rotator cuff repr,,,3827.9,31870.39,11
HCPCS,29828,Arthroscopy biceps tenodesis,,,4588.99,31870.39,11
HCPCS,29830,Elbow arthroscopy,,,3239.17,14371.12,11
HCPCS,29834,Elbow arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29835,Elbow arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29836,Elbow arthroscopy/surgery,,,5757.67,31870.39,11
HCPCS,29837,Elbow arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29838,Elbow arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29840,Wrist arthroscopy,,,3102.06,14371.12,11
HCPCS,29843,Wrist arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29844,Wrist arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29845,Wrist arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29846,Wrist arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29847,Wrist arthroscopy/surgery,,,7183.42,31870.39,11
HCPCS,29848,Wrist endoscopy/surgery,,,1591.86,7182.83,11
HCPCS,29850,Knee arthroscopy/surgery,,,1591.86,7182.83,11
HCPCS,29851,Knee arthroscopy/surgery,,,1591.86,11407.36,11
HCPCS,29855,Tibial arthroscopy/surgery,,,7183.42,31870.39,11
HCPCS,29856,Tibial arthroscopy/surgery,,,9143.99,56389.43,11
HCPCS,29860,Hip arthroscopy dx,,,7183.42,31870.39,11
HCPCS,29861,Hip arthro w/fb removal,,,7183.42,31870.39,11
HCPCS,29862,Hip arthr0 w/debridement,,,7183.42,31870.39,11
HCPCS,29863,Hip arthr0 w/synovectomy,,,3239.17,14371.12,11
HCPCS,29866,Autgrft implnt knee w/scope,,,3227.14,31870.39,11
HCPCS,29867,Allgrft implnt knee w/scope,,,6183.71,56389.43,11
HCPCS,29868,Meniscal trnspl knee w/scpe,,,7183.42,31870.39,11
HCPCS,29870,Knee arthroscopy dx,,,3239.17,14371.12,11
HCPCS,29871,Knee arthroscopy/drainage,,,3239.17,14371.12,11
HCPCS,29873,Knee arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29874,Knee arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29875,Knee arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29876,Knee arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29877,Knee arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29879,Knee arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29880,Knee arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29881,Knee arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29882,Knee arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29883,Knee arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29884,Knee arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29885,Knee arthroscopy/surgery,,,7183.42,31870.39,11
HCPCS,29886,Knee arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29887,Knee arthroscopy/surgery,,,5757.67,31870.39,11
HCPCS,29888,Knee arthroscopy/surgery,,,6227.86,31870.39,11
HCPCS,29889,Knee arthroscopy/surgery,,,5778.8,56389.43,11
HCPCS,29891,Ankle arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29892,Ankle arthroscopy/surgery,,,2976.98,31870.39,11
HCPCS,29893,Scope plantar fasciotomy,,,3239.17,14371.12,11
HCPCS,29894,Ankle arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29895,Ankle arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29897,Ankle arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29898,Ankle arthroscopy/surgery,,,3239.17,14371.12,11
HCPCS,29899,Ankle arthroscopy/surgery,,,5215.94,31870.39,11
HCPCS,29900,Mcp joint arthroscopy dx,,,3239.17,14371.12,11
HCPCS,29901,Mcp joint arthroscopy surg,,,3239.17,14371.12,11
HCPCS,29902,Mcp joint arthroscopy surg,,,1591.86,7182.83,11
HCPCS,29904,Subtalar arthro w/fb rmvl,,,3239.17,14371.12,11
HCPCS,29905,Subtalar arthro w/exc,,,5757.67,31870.39,11
HCPCS,29906,Subtalar arthro w/deb,,,3239.17,14371.12,11
HCPCS,29907,Subtalar arthro w/fusion,,,9143.99,56389.43,11
HCPCS,29914,Hip arthro w/femoroplasty,,,5132.99,31870.39,11
HCPCS,29915,Hip arthro acetabuloplasty,,,7183.42,31870.39,11
HCPCS,29916,Hip arthro w/labral repair,,,5132.99,31870.39,11
HCPCS,29999,Arthroscopy of joint,,,244.19,5167.96,11
HCPCS,3,"DUMMY EAP FOR NSA - IMPLANTS - $1,000 INCREMENT",1000.0,700.0,,,0
HCPCS,300,HC PRO ANESTH SKIN SURG HEAD / NECK,353.0,247.1,,,0
HCPCS,30000,Drainage of nose lesion,,,234.47,1040.28,11
HCPCS,30020,Drainage of nose lesion,,,500.19,2368.81,11
HCPCS,30020,HC DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM,1926.0,1348.2,,,0
HCPCS,30020,HC PRO DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM,271.0,189.7,,,0
HCPCS,30100,INTRANASAL BIOPSY,965.0,675.5,,,0
HCPCS,30100,Intranasal biopsy,,,1489.88,6814.79,11
HCPCS,30110,Removal of nose polyp(s),,,1536.02,6814.79,11
HCPCS,30115,Removal of nose polyp(s),,,3266.7,14562.0,11
HCPCS,30117,Removal of intranasal lesion,,,3282.2,14562.0,11
HCPCS,30118,Removal of intranasal lesion,,,3282.2,14562.0,11
HCPCS,30120,Revision of nose,,,3266.7,14562.0,11
HCPCS,30124,Removal of nose lesion,,,1489.88,6814.79,11
HCPCS,30125,Removal of nose lesion,,,5860.44,26000.79,11
HCPCS,30130,Excise inferior turbinate,,,3282.2,14562.0,11
HCPCS,30140,Resect inferior turbinate,,,3139.07,14562.0,11
HCPCS,30150,Partial removal of nose,,,5860.44,26000.79,11
HCPCS,30160,Removal of nose,,,5860.44,26000.79,11
HCPCS,30200,Injection treatment of nose,,,533.92,2368.81,11
HCPCS,30210,Nasal sinus therapy,,,1489.88,6814.79,11
HCPCS,30220,Insert nasal septal button,,,1489.88,6814.79,11
HCPCS,3028F,HC PRO PQRS O2 SATURATION DOC REV,0.01,0.007,,,0
HCPCS,30300,HC PRO REMOVE NASAL FB,385.0,269.5,,,0
HCPCS,30300,REMOVE NASAL FB,299.0,209.3,,,0
HCPCS,30300,Remove nasal foreign body,,,131.71,584.37,11
HCPCS,30310,HC PRO REMOVAL FOREIGN BODY INTRANASAL REQUIRING GENERAL ANESTHESIA,468.0,327.6,,,0
HCPCS,30310,HC REMOVAL FOREIGN BODY INTRANASAL REQUIRING GENERAL ANESTHESIA,11486.0,8040.2,,,0
HCPCS,30310,Remove nasal foreign body,,,3266.7,14562.0,11
HCPCS,30320,Remove nasal foreign body,,,1536.02,6814.79,11
HCPCS,30400,Reconstruction of nose,,,3139.12,26000.79,11
HCPCS,30410,Reconstruction of nose,,,5860.44,26000.79,11
HCPCS,30420,Reconstruction of nose,,,4800.06,26000.79,11
HCPCS,30430,Revision of nose,,,4796.64,26000.79,11
HCPCS,30435,Revision of nose,,,5860.44,26000.79,11
HCPCS,30450,Revision of nose,,,5860.44,26000.79,11
HCPCS,30460,Revision of nose,,,4007.29,26000.79,11
HCPCS,30462,Revision of nose,,,5860.44,26000.79,11
HCPCS,30465,Repair Nasal Stenosis,,,2754.95,26000.79,11
HCPCS,30468,Rpr nsl vlv collapse w/implt,,,5860.44,26000.79,11
HCPCS,30469,Rpr nsl vlv collapse w/rmdlg,,,5860.44,26000.79,11
HCPCS,30520,Repair of nasal septum,,,3027.89,14562.0,11
HCPCS,30540,Repair nasal defect,,,5860.44,26000.79,11
HCPCS,30545,Repair nasal defect,,,5860.44,26000.79,11
HCPCS,30560,Release of nasal adhesions,,,533.92,3126.73,11
HCPCS,30580,Repair upper jaw fistula,,,5860.44,26000.79,11
HCPCS,30600,Repair mouth/nose fistula,,,5860.44,26000.79,11
HCPCS,30620,Intranasal reconstruction,,,5860.44,26000.79,11
HCPCS,30630,Repair nasal septum defect,,,2691.78,14562.0,11
HCPCS,30801,Ablate inf turbinate superf,,,1536.02,6814.79,11
HCPCS,30802,Ablate inf turbinate submuc,,,1536.02,6814.79,11
HCPCS,30901,Control of nosebleed,,,131.71,584.37,11
HCPCS,30901,HC CONTROL OF NOSEBLEED SIMPLE,247.0,172.9,,,0
HCPCS,30901,HC PRO CONTROL OF NOSEBLEED SIMPLE,469.0,328.3,,,0
HCPCS,30903,Control of nosebleed,,,131.71,584.37,11
HCPCS,30903,HC CONTROL OF NOSEBLEED COMPLEX,297.0,207.9,,,0
HCPCS,30903,HC PRO CONTROL OF NOSEBLEED,631.0,441.7,,,0
HCPCS,30905,CONTROL OF NOSEBLEED POSTERIOR INITIAL,390.0,273.0,,,0
HCPCS,30905,Control of nosebleed,,,131.71,584.37,11
HCPCS,30905,HC PRO CONTROL OF NOSEBLEED,1182.0,827.4,,,0
HCPCS,30906,HC REPEAT CONTROL OF NOSEBLEED,195.0,136.5,,,0
HCPCS,30906,Repeat control of nosebleed,,,225.07,1040.28,11
HCPCS,30915,Ligation nasal sinus artery,,,3125.8,13868.13,11
HCPCS,30920,Ligation upper jaw artery,,,3125.8,13868.13,11
HCPCS,30930,Ther fx nasal inf turbinate,,,3282.2,14562.0,11
HCPCS,30999,Nasal surgery procedure,,,234.47,3019.45,11
HCPCS,31000,Irrigation maxillary sinus,,,234.47,1040.28,11
HCPCS,31002,Irrigation sphenoid sinus,,,1489.88,6814.79,11
HCPCS,31020,Exploration maxillary sinus,,,3282.2,14562.0,11
HCPCS,31030,Exploration maxillary sinus,,,5860.44,26000.79,11
HCPCS,31032,Explore sinus remove polyps,,,5860.44,26000.79,11
HCPCS,31040,Exploration behind upper jaw,,,4796.64,26000.79,11
HCPCS,31050,Exploration sphenoid sinus,,,5860.44,26000.79,11
HCPCS,31051,Sphenoid sinus surgery,,,5860.44,26000.79,11
HCPCS,31070,Exploration of frontal sinus,,,4796.64,26000.79,11
HCPCS,31075,Exploration of frontal sinus,,,5860.44,26000.79,11
HCPCS,31080,Removal of frontal sinus,,,5860.44,26000.79,11
HCPCS,31081,Removal of frontal sinus,,,5860.44,26000.79,11
HCPCS,31084,Removal of frontal sinus,,,5860.44,26000.79,11
HCPCS,31085,Removal of frontal sinus,,,5860.44,26000.79,11
HCPCS,31086,Removal of frontal sinus,,,5860.44,26000.79,11
HCPCS,31087,Removal of frontal sinus,,,5860.44,26000.79,11
HCPCS,31090,Exploration of sinuses,,,5860.44,26000.79,11
HCPCS,31200,Removal of ethmoid sinus,,,5860.44,26000.79,11
HCPCS,31201,Removal of ethmoid sinus,,,1536.02,9952.44,11
HCPCS,31205,Removal of ethmoid sinus,,,3282.2,14562.0,11
HCPCS,3120F,HC PRO PQRS 12 LEAD ECG PERFORMED (EM),0.01,0.007,,,0
HCPCS,31231,HC NASAL ENDOSCOPY DX UNILATERAL/BILATERAL,176.0,123.2,,,0
HCPCS,31231,Nasal endoscopy dx,,,197.6,2888.59,11
HCPCS,31233,Nasal/sinus endoscopy dx,,,322.39,1717.85,11
HCPCS,31235,Nasal/sinus endoscopy dx,,,1762.04,7817.58,11
HCPCS,31237,NASAL/SINUS ENDOS W/ BX,1812.0,1268.4,,,0
HCPCS,31237,Nasal/sinus endoscopy surg,,,1762.04,7817.58,11
HCPCS,31238,HC NASAL/SINUS ENDOSCOPY SURG W/ CONTROL NASAL HEMORRHAGE,1461.0,1022.7,,,0
HCPCS,31238,Nasal/sinus endoscopy surg,,,1762.04,9737.23,11
HCPCS,31239,Nasal/sinus endoscopy surg,,,3690.94,16375.46,11
HCPCS,31240,Nasal/sinus endoscopy surg,,,1762.04,7817.58,11
HCPCS,31241,Nsl/sins ndsc w/artery lig,,,1762.04,7817.58,11
HCPCS,31242,Nsl/sinus ndsc rf abltj pnn,,,5860.44,26000.79,11
HCPCS,31243,Nsl/sinus ndsc cryoabltj pnn,,,5860.44,26000.79,11
HCPCS,31253,Nsl/sins ndsc total,,,6986.66,30997.43,11
HCPCS,31254,Revision of ethmoid sinus,,,2719.43,30997.43,11
HCPCS,31255,Removal of ethmoid sinus,,,1966.77,30997.43,11
HCPCS,31256,Exploration maxillary sinus,,,2349.35,16375.46,11
HCPCS,31257,Nsl/sins ndsc tot w/sphendt,,,6986.66,30997.43,11
HCPCS,31259,Nsl/sins ndsc sphn tiss rmvl,,,6986.66,30997.43,11
HCPCS,31267,Endoscopy maxillary sinus,,,2131.03,30997.43,11
HCPCS,3126F,HC PRO ESOPHAGEAL BIOPSY REPORT WITH A STATEMENT ABOUT DYSPLASIA,0.01,0.007,,,0
HCPCS,31276,Sinus endoscopy surgical,,,2002.78,30997.43,11
HCPCS,31287,Nasal/sinus endoscopy surg,,,1959.66,30997.43,11
HCPCS,31288,Nasal/sinus endoscopy surg,,,1747.59,30997.43,11
HCPCS,31292,Nasal/sinus endoscopy surg,,,4545.09,30997.43,11
HCPCS,31293,Nasal/sinus endoscopy surg,,,4545.09,30997.43,11
HCPCS,31294,Nasal/sinus endoscopy surg,,,4545.09,30997.43,11
HCPCS,31295,Sinus endo w/balloon dil,,,6458.32,30997.43,11
HCPCS,31296,Sinus endo w/balloon dil,,,1579.97,30997.43,11
HCPCS,31297,Sinus endo w/balloon dil,,,2273.99,30997.43,11
HCPCS,31298,Nsl/sins ndsc w/sins dilat,,,6986.66,30997.43,11
HCPCS,31299,Sinus surgery procedure,,,234.47,1040.28,11
HCPCS,31300,Removal of larynx lesion,,,3282.2,14562.0,11
HCPCS,31400,Revision of larynx,,,5860.44,26000.79,11
HCPCS,31420,Removal of epiglottis,,,5860.44,26000.79,11
HCPCS,31500,HC INSERT EMERGENCY AIRWAY,773.0,541.1,,,0
HCPCS,31500,HC PRO INSERT EMERGENCY AIRWAY,428.0,299.6,,,0
HCPCS,31500,Insert emergency airway,,,234.47,1040.28,11
HCPCS,31502,Change of windpipe airway,,,234.47,1040.28,11
HCPCS,31502,HC CHANGE OF WINDPIPE AIRWAY,160.0,112.0,,,0
HCPCS,31505,Diagnostic laryngoscopy,,,164.53,876.7,11
HCPCS,31505,HC LARYNGOSCOPY INDIRECT DIAGNOSTIC (SEPARATE PROCEDURE),684.0,478.8,,,0
HCPCS,31510,Laryngoscopy with biopsy,,,3404.17,16375.46,11
HCPCS,31511,HC PRO LARYNOGOSCOP,252.0,176.4,,,0
HCPCS,31511,Remove foreign body larynx,,,197.6,876.7,11
HCPCS,31512,Removal of larynx lesion,,,3404.17,16375.46,11
HCPCS,31513,Injection into vocal cord,,,322.39,1717.85,11
HCPCS,31515,Laryngoscopy for aspiration,,,387.19,4246.79,11
HCPCS,31520,Dx laryngoscopy newborn,,,322.39,1717.85,11
HCPCS,31525,Dx laryngoscopy excl nb,,,1762.04,7817.58,11
HCPCS,31525,HC DX LARYNGOSCOPY EXCL NB,1428.0,999.6,,,0
HCPCS,31525,HC PRO DX LARYNGOSCOPY EXCL NB,203.0,142.1,,,0
HCPCS,31526,Dx laryngoscopy w/oper scope,,,1762.04,7817.58,11
HCPCS,31527,Laryngoscopy for treatment,,,3690.94,16375.46,11
HCPCS,31528,Laryngoscopy and dilation,,,3690.94,16375.46,11
HCPCS,31529,Laryngoscopy and dilation,,,3404.17,16375.46,11
HCPCS,31530,Laryngoscopy w/fb removal,,,1762.04,7817.58,11
HCPCS,31531,HC LARYNGOSCOPY FOREIGN BODY REMVL W/OPERATING MICROSCOPE OR TELESCOPE,9952.0,6966.4,,,0
HCPCS,31531,Laryngoscopy w/fb & op scope,,,3690.94,16375.46,11
HCPCS,31535,Laryngoscopy w/biopsy,,,3690.94,16375.46,11
HCPCS,31536,Laryngoscopy w/bx & op scope,,,3690.94,16375.46,11
HCPCS,31540,Laryngoscopy w/exc of tumor,,,3690.94,16375.46,11
HCPCS,31541,Larynscop w/tumr exc + scope,,,3690.94,16375.46,11
HCPCS,31545,Remove vc lesion w/scope,,,3690.94,16375.46,11
HCPCS,31546,Remove vc lesion scope/graft,,,4545.09,30997.43,11
HCPCS,31551,Laryngoplasty laryngeal sten,,,5860.44,26000.79,11
HCPCS,31552,Laryngoplasty laryngeal sten,,,5860.44,26000.79,11
HCPCS,31553,Laryngoplasty laryngeal sten,,,5860.44,26000.79,11
HCPCS,31554,Laryngoplasty laryngeal sten,,,5860.44,26000.79,11
HCPCS,31560,Laryngoscop w/arytenoidectom,,,4545.09,30997.43,11
HCPCS,31561,Larynscop remve cart + scop,,,4545.09,30997.43,11
HCPCS,31570,Laryngoscope w/vc inj,,,3404.17,16375.46,11
HCPCS,31571,Laryngoscop w/vc inj + scope,,,3690.94,16375.46,11
HCPCS,31572,Largsc w/laser dstrj les,,,3690.94,16375.46,11
HCPCS,31573,Largsc w/ther injection,,,1762.04,7817.58,11
HCPCS,31574,Largsc w/njx augmentation,,,1762.04,7817.58,11
HCPCS,31575,Diagnostic laryngoscopy,,,197.6,876.7,11
HCPCS,31575,HC LARYNGOSCOPY FLEXIBLE DIAGNOSTIC,786.0,550.2,,,0
HCPCS,31575,HC PRO LARYNGOSCOPY FLEXIBLE DIAGNOSTIC,186.0,130.2,,,0
HCPCS,31576,FLEX LARYNGOSCOPY BX,1668.0,1167.6,,,0
HCPCS,31576,Laryngoscopy with biopsy,,,1762.04,7817.58,11
HCPCS,31577,HC LARYNGOSCOPY FLEX FIBEROPTIC W/ REM,1919.0,1343.3,,,0
HCPCS,31577,Largsc w/rmvl foreign bdy(s),,,387.19,1717.85,11
HCPCS,31578,Largsc w/removal lesion,,,3690.94,16375.46,11
HCPCS,31579,Laryngoscopy telescopic,,,387.19,1717.85,11
HCPCS,31580,Laryngoplasty laryngeal web,,,5860.44,26000.79,11
HCPCS,31584,Laryngoplasty fx rdctj fixj,,,5860.44,26000.79,11
HCPCS,31587,Laryngoplasty cricoid split,,,5860.44,26000.79,11
HCPCS,31590,Reinnervate larynx,,,5860.44,26000.79,11
HCPCS,31591,Laryngoplasty medialization,,,5860.44,26000.79,11
HCPCS,31592,Cricotracheal resection,,,5860.44,26000.79,11
HCPCS,31599,Larynx surgery procedure,,,234.47,3828.9,11
HCPCS,31600,HC TRACHEOSTOMY PLANNED SEPARATE PROCEDURE,2689.0,1882.3,,,0
HCPCS,31600,Incision of windpipe,,,3282.2,14562.0,11
HCPCS,31601,Incision of windpipe,,,4796.64,26000.79,11
HCPCS,31603,HC PRO TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL,290.0,203.0,,,0
HCPCS,31603,HC TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL,1148.0,803.6,,,0
HCPCS,31603,Incision of windpipe,,,1489.88,6814.79,11
HCPCS,31605,HC PRO TRACH EMERG CRICOTHYROID,537.0,375.9,,,0
HCPCS,31605,HC TRACHEOSTOMY EMERGENCY PROCEDURE CRICOTHYROID MEMBRANE,2089.0,1462.3,,,0
HCPCS,31605,Incision of windpipe,,,234.47,1858.66,11
HCPCS,31610,Incision of windpipe,,,4796.64,26000.79,11
HCPCS,31611,Surgery/speech prosthesis,,,3282.2,14562.0,11
HCPCS,31612,Puncture/clear windpipe,,,3282.2,14562.0,11
HCPCS,31613,Repair windpipe opening,,,3282.2,14562.0,11
HCPCS,31614,Repair windpipe opening,,,5860.44,26000.79,11
HCPCS,31615,HC TRACHEOBRONCH THROUGH ESTAB TRACH INCISION,750.0,525.0,,,0
HCPCS,31615,Visualization of windpipe,,,533.92,2485.12,11
HCPCS,31622,Dx bronchoscope/wash,,,1132.65,7817.58,11
HCPCS,31622,HC BRONCHOSCOPY RIGID/FLEX INCL FLUORO DX W/ CELL WASHING,2833.0,1983.1,,,0
HCPCS,31622,HC PRO DX BRONCHOSCOPE/WASH,573.0,401.1,,,0
HCPCS,31623,DX BRONCHOSCOPE/BRUSH,3258.0,2280.6,,,0
HCPCS,31623,Dx bronchoscope/brush,,,767.07,7817.58,11
HCPCS,31624,Dx bronchoscope/lavage,,,813.61,7817.58,11
HCPCS,31624,HC DX BRONCHOSCOPE/LAVAGE,3748.0,2623.6,,,0
HCPCS,31625,Bronchoscopy w/biopsy(s),,,986.22,7817.58,11
HCPCS,31625,HC BRONCHOSCOPY RIGID/FLEX INCL FLUORO GUIDE W/BRONCHIAL OR ENDOBRONC BIOPSY(S) SINGLE/MULTI SITES,4310.0,3017.0,,,0
HCPCS,31625,HC PRO BRONCHOSCOPY RIGID/FLEX INCL FLUORO GUIDE W/BRONCHIAL OR ENDOBRON BIOPSY(S) SINGLE/MULTI SITE,287.0,200.9,,,0
HCPCS,31626,Bronchoscopy w/markers,,,2195.66,30997.43,11
HCPCS,31627,NAVIGATIONAL BRONCHOSCOPY,314.0,219.8,,,0
HCPCS,31628,Bronchoscopy/lung bx each,,,1456.35,16375.46,11
HCPCS,31628,HC BRONCHOSCOPY RIGID/FLEX INCL FLUORO GUIDE W/TRANSBRONCHIAL LUNG BIOPSY(S) SINGLE LOBE,2979.0,2085.3,,,0
HCPCS,31629,BRONCH NEEDLE ASP BX EACH,3427.0,2398.9,,,0
HCPCS,31629,Bronchoscopy/needle bx each,,,3690.94,16375.46,11
HCPCS,31630,Bronchoscopy dilate/fx repr,,,3690.94,16375.46,11
HCPCS,31630,HC BRONCHOSCOPY RIGID/FLEX INCL FLURO GUIDE W/TRACHEAL/BRONCHIAL DILATION OR CLSD REDUCTION OF FX,3942.0,2759.4,,,0
HCPCS,31631,BRONCH DILATE W/STENT,6489.0,4542.3,,,0
HCPCS,31631,Bronchoscopy dilate w/stent,,,4814.43,30997.43,11
HCPCS,31632,Bronchoscopy/lung bx addl,,,982.67,1225.91,4
HCPCS,31632,HC BRONCHOSCOPY RIGID/FLEXIBLE INCLUDE FLUOROSCOPIC GUIDE WHEN PERFORMED W/TRANSBRONCHIAL LUNG BIOPSY EA ADDTL LOBE,3256.0,2279.2,,,0
HCPCS,31633,BRONCH NEEDLE BX ADDL LOBE,753.0,527.1,,,0
HCPCS,31633,Bronchoscopy/needle bx addl,,,1992.04,2485.12,4
HCPCS,31634,BRONCH W/BALLOON OCCLUSION,6489.0,4542.3,,,0
HCPCS,31634,Bronch w/balloon occlusion,,,2191.42,30997.43,11
HCPCS,31635,Bronchoscopy w/fb removal,,,1762.04,7817.58,11
HCPCS,31635,HC BRONCH FB REMOVAL,2833.0,1983.1,,,0
HCPCS,31636,BRONCH W/PLMT BRONC STENT INIT,7463.0,5224.1,,,0
HCPCS,31636,Bronchoscopy bronch stents,,,4814.43,30997.43,11
HCPCS,31637,BRONCH W/PCMT BRONC STENT ADDI,794.0,555.8,,,0
HCPCS,31637,Bronchoscopy stent add-on,,,1992.04,2485.12,4
HCPCS,31638,Bronchoscopy revise stent,,,4814.43,30997.43,11
HCPCS,31640,Bronchoscopy w/tumor excise,,,3690.94,16375.46,11
HCPCS,31640,HC BRONCHOSCOPY RIGID/FLEXIBLE INCL FLUORO GUIDE W/EXCISION OF TUMOR,13532.0,9472.4,,,0
HCPCS,31641,Bronchoscopy treat blockage,,,3690.94,16375.46,11
HCPCS,31643,Diag bronchoscope/catheter,,,1762.04,7817.58,11
HCPCS,31645,Bronchoscopy clear airways,,,1762.04,7817.58,11
HCPCS,31645,HC BRONCHOSCOPY W/THERAPEUTIC ASPIRATION OF TRACHBRNCL TREE INITIAL,4722.0,3305.4,,,0
HCPCS,31646,Bronchoscopy reclear airway,,,387.19,2485.12,11
HCPCS,31646,HC BRONCHOSCOPY W/THERAPEUTIC ASPIRATION OF TRACHBRNCL TREE SUBSEQUENT,2543.0,1780.1,,,0
HCPCS,31647,Bronchial valve init insert,,,4763.77,30997.43,11
HCPCS,31647,HC BRONCHIAL VALVE INSERT INIT,5523.0,3866.1,,,0
HCPCS,31648,Bronchial valve remov init,,,3690.94,16375.46,11
HCPCS,31648,HC BRONCHIAL VALVE REMOV INIT,4694.0,3285.8,,,0
HCPCS,31649,Bronchial valve remov addl,,,1762.04,7817.58,11
HCPCS,31649,HC BRONCHIAL VALVE REMOV ADDL,1224.0,856.8,,,0
HCPCS,31651,Bronchial valve addl insert,,,4763.77,5942.92,4
HCPCS,31651,HC BRONCHIAL VALVE INSERT ADDL,1073.0,751.1,,,0
HCPCS,31652,Bronch ebus samplng 1/2 node,,,1456.36,16375.46,11
HCPCS,31652,HC BRONCH RIGID/FLEX W/ EBUS SAMPLING 1 OR 2 NODE,8379.0,5865.3,,,0
HCPCS,31653,Bronch ebus samplng 3/> node,,,1760.95,16375.46,11
HCPCS,31653,HC BRONCH RIGID/FLEX INCL FLUORO W/ EBUS 3 OR MORE NODES STATNS/STRCT,9636.0,6745.2,,,0
HCPCS,31654,Bronch ebus ivntj perph les,,,210.13,262.14,4
HCPCS,31654,US ENDOBRONCHIAL ADD-ON,2496.0,1747.2,,,0
HCPCS,31660,Bronch thermoplsty 1 lobe,,,4763.77,30997.43,11
HCPCS,31661,Bronch thermoplsty 2/> lobes,,,4763.77,30997.43,11
HCPCS,31717,Bronchial brush biopsy,,,387.19,1717.85,11
HCPCS,31720,Clearance of airways,,,148.53,961.78,11
HCPCS,31720,HC CATH ASP NASOTRACHEAL,198.0,138.6,,,0
HCPCS,31725,Clearance of airways,,,309.22,385.76,4
HCPCS,31725,HC CATH ASP TRACHEOBRONCH W/ FIBERSCOPE BEDSIDE,446.0,312.2,,,0
HCPCS,31730,HC INTRO WINDPIPE WIRE/TUBE,596.0,417.2,,,0
HCPCS,31730,Intro windpipe wire/tube,,,799.01,7817.58,11
HCPCS,31750,Repair of windpipe,,,5860.44,26000.79,11
HCPCS,31755,Repair of windpipe,,,5860.44,26000.79,11
HCPCS,31785,Remove windpipe lesion,,,4796.64,26000.79,11
HCPCS,31820,Closure of windpipe lesion,,,3266.7,14562.0,11
HCPCS,31825,Repair of windpipe defect,,,3282.2,14562.0,11
HCPCS,31830,Revise windpipe scar,,,3282.2,14562.0,11
HCPCS,31899,Airways surgical procedure,,,197.6,2485.12,11
HCPCS,32096,Open wedge/bx lung infiltr,,,2437.79,3041.2,4
HCPCS,32097,Open wedge/bx lung nodule,,,2437.79,3041.2,4
HCPCS,32098,Open biopsy of lung pleura,,,2358.89,2942.77,4
HCPCS,32400,HC NEEDLE BX CHEST LINING,1568.0,1097.6,,,0
HCPCS,32400,Needle biopsy chest lining,,,1084.88,7254.06,11
HCPCS,32408,Core ndl bx lng/med perq,,,1635.03,7254.06,11
HCPCS,32408,HC CORE NEEDLE BIOPSY LUNG/MED PERQ INCL IMAGE GUIDE,3021.0,2114.7,,,0
HCPCS,32491,HC REMOVAL OF LUNG OTH/THN PNEUMONEC W/RESECTION-PLICATION OF EMPHYSEMATOUS LUNG FOR LUNG VOL REDUCT STERNAL SPLIT /TRANSTHORACIC APPROACH,3141.0,2198.7,,,0
HCPCS,32505,Wedge resect of lung initial,,,2877.62,3589.9,4
HCPCS,32506,Wedge resect of lung add-on,,,497.44,620.56,4
HCPCS,32507,Wedge resect of lung diag,,,497.44,620.56,4
HCPCS,3250F,HC PRO SPECIMEN SITE NOT PRIM TUMOR,0.01,0.007,,,0
HCPCS,32550,INSERT PLEURAL CATH,3250.0,2275.0,,,0
HCPCS,32550,Insert pleural cath,,,2406.6,15725.66,11
HCPCS,32551,HC PRO INSERTION CHEST TUBE,912.0,638.4,,,0
HCPCS,32551,INSERTION CHEST TUBE,690.0,483.0,,,0
HCPCS,32551,Insertion of chest tube,,,661.29,6913.93,11
HCPCS,32552,HC REMOVAL INDWELLING TUNNELED PLEURAL CATH W/ CUFF,699.0,489.3,,,0
HCPCS,32552,Remove lung catheter,,,499.45,2755.21,11
HCPCS,32553,Ins mark thor for rt perq,,,1370.24,6079.31,11
HCPCS,32554,Aspirate pleura w/o imaging,,,621.01,2755.21,11
HCPCS,32554,HC PRO THORACENTESIS NEEDLE/CATH W/O IMAGE GUIDE,214.0,149.8,,,0
HCPCS,32554,HC THORACENTESIS NEEDLE/CATH W/O IMAGE GUIDE,586.0,410.2,,,0
HCPCS,32555,Aspirate pleura w/ imaging,,,621.01,2755.21,11
HCPCS,32555,HC PRO THORACENTESIS NEEDLE/CATH W/ IMAGE GUIDE,612.0,428.4,,,0
HCPCS,32555,HC THORACENTESIS NEEDLE/CATH W/ IMAGE GUIDE,1681.0,1176.7,,,0
HCPCS,32556,HC PLEURAL DRAINAGE PERCUTANEOUS W/INSERTION OF INDWELLING CATHETER W/O IMAGING GUIDE,2504.0,1752.8,,,0
HCPCS,32556,Insert cath pleura w/o image,,,1249.54,8428.13,11
HCPCS,32557,HC PLEURAL DRAIN PERCU W/ INDWELLING CATH W/ IMAGE GUIDE,2879.0,2015.3,,,0
HCPCS,32557,Insert cath pleura w/ image,,,1249.54,6913.93,11
HCPCS,32560,HC TREAT PLEUROSESIS W/ AGENT,731.0,511.7,,,0
HCPCS,32560,Treat pleurodesis w/agent,,,621.01,2755.21,11
HCPCS,32561,HC INSTL CH TUBE/CATH FBRN 1ST DAY,460.0,322.0,,,0
HCPCS,32561,Lyse chest fibrin init day,,,621.01,2755.21,11
HCPCS,32562,HC INSTL CH TUBE/CATH FBRN SBSQ DAY,460.0,322.0,,,0
HCPCS,32562,Lyse chest fibrin subq day,,,621.01,2755.21,11
HCPCS,32601,Thoracoscopy diagnostic,,,5984.88,26552.87,11
HCPCS,32604,Thoracoscopy wbx sac,,,6515.17,46687.84,11
HCPCS,32606,Thoracoscopy w/bx med space,,,5984.88,26552.87,11
HCPCS,32607,Thoracoscopy w/bx infiltrate,,,7771.19,46687.84,11
HCPCS,32608,Thoracoscopy w/bx nodule,,,7771.19,46687.84,11
HCPCS,32609,Thoracoscopy w/bx pleura,,,5984.88,26552.87,11
HCPCS,3260F,HC PRO PATH REPORT HISTOLOGIC GRADE,0.01,0.007,,,0
HCPCS,3260F,HC PRO PT NO GRADE MED REASON,0.01,0.007,,,0
HCPCS,32650,HC THORACOSCOPY W/ PLEURODESIS,13655.0,9558.5,,,0
HCPCS,32666,Thoracoscopy w/wedge resect,,,2677.97,3340.84,4
HCPCS,32667,Thoracoscopy w/w resect addl,,,497.44,620.56,4
HCPCS,32668,Thoracoscopy w/w resect diag,,,499.5,623.13,4
HCPCS,32669,Thoracoscopy remove segment,,,4044.66,5045.81,4
HCPCS,32670,Thoracoscopy bilobectomy,,,4827.0,6021.8,4
HCPCS,32671,Thoracoscopy pneumonectomy,,,5354.56,6679.94,4
HCPCS,32672,HC THORACOSCOPY SURGICAL W/RESECTION-PLICATION EMPHYSEMA LUNG FOR LUNG VOL REDUCT UNILAT INCL PLEURAL PROCEDURE,4380.0,3066.0,,,0
HCPCS,32672,Thoracoscopy for lvrs,,,4579.72,5713.32,4
HCPCS,32673,Thoracoscopy w/thymus resect,,,3602.19,4493.82,4
HCPCS,32674,Thoracoscopy lymph node exc,,,649.94,810.81,4
HCPCS,3267F,HC PRO PATH RPRT W/ PT PN CAT ET AL,0.01,0.007,,,0
HCPCS,32701,Thorax stereo rad targetw/tx,,,663.48,827.71,4
HCPCS,32960,Therapeutic pneumothorax,,,621.01,2755.21,11
HCPCS,32994,Ablate pulm tumor perq crybl,,,10523.19,46687.84,11
HCPCS,32994,HC ABLATION THER 1 OR MORE PULM TUMORS INCL PLEURA/CHEST WALL WHEN INVOL BY TUMOR EXT PERQ  INCL GUIDE WHEN PEF UNILATERAL CRYOABLATION,3210.0,2247.0,,,0
HCPCS,32998,HC ABLATE THER REDUCT/ERAD 1+ PULM TUMOR(S) INCL PLEURA/CHEST WALL PERQ INCL IMAGE GUIDE UNILATL RF,7144.0,5000.8,,,0
HCPCS,32998,Perq rf ablate tx pul tumor,,,5984.88,26552.87,11
HCPCS,32999,Chest surgery procedure,,,621.01,2755.21,11
HCPCS,33016,HC PERICARDIOCENTESIS INCL IMAGE GUIDE WHEN PERFORMED,6288.0,4401.6,,,0
HCPCS,33016,Pericardiocentesis w/imaging,,,1558.36,6913.93,11
HCPCS,33017,HC PERICARDIAL DRAINAGE W/INSERT INDWELLING CATH PERQ INCL FLURO AND/OR US GUIDE 6 YEARS AND OLDER W/O CONGENTIAL CARDIAC ANOMALY,6107.0,4274.9,,,0
HCPCS,33017,Prcrd drg 6yr+ w/o cgen car,,,775.83,967.87,4
HCPCS,33018,HC PERICARDIAL DRAINAGE W/INSERT INDEWLLING CATH PERQ INCL FLURO AND/OR US GUIDE BIRTH THROUGH 5 YEARS OF AGE OR ANY AGE W/CONGENTIAL CARDIAC ANOMALY,6107.0,4274.9,,,0
HCPCS,33018,Prcrd drg 0-5yr or w/anomly,,,881.76,1100.02,4
HCPCS,33019,Perq prcrd drg insj cath ct,,,717.29,894.84,4
HCPCS,33206,HC INSERT NEW/REPL PERM PMKR W/ TRNSVN ELECTRODE(S) ATRIAL,11462.0,8023.4,,,0
HCPCS,33206,Insert heart pm atrial,,,9466.87,45906.74,11
HCPCS,33207,HC INSERT HEART PM VENTRICULAR,12422.0,8695.4,,,0
HCPCS,33207,Insert heart pm ventricular,,,10347.14,45906.74,11
HCPCS,33208,HC INSRT HEART PM ATRIAL & VENT,18009.0,12606.3,,,0
HCPCS,33208,Insrt heart pm atrial & vent,,,10347.14,45906.74,11
HCPCS,33210,HC INSERT ELECTRD/PM CATH SNGL,9309.0,6516.3,,,0
HCPCS,33210,Insert electrd/pm cath sngl,,,8192.37,36346.76,11
HCPCS,33211,Insert card electrodes dual,,,8192.37,36346.76,11
HCPCS,33212,Insert pulse gen sngl lead,,,8192.37,36346.76,11
HCPCS,33213,HC INSERT PULSE GEN DUAL LEADS,13809.0,9666.3,,,0
HCPCS,33213,Insert pulse gen dual leads,,,10347.14,45906.74,11
HCPCS,33214,Upgrade of pacemaker system,,,10347.14,45906.74,11
HCPCS,33215,HC REPOSITION PACING-DEFIB LEAD,2452.0,1716.4,,,0
HCPCS,33215,Reposition pacing-defib lead,,,1932.64,13868.13,11
HCPCS,33216,HC INSERT 1 ELECTRODE PM-DEFIB,7522.0,5265.4,,,0
HCPCS,33216,Insert 1 electrode pm-defib,,,5647.64,36346.76,11
HCPCS,33217,HC INSERT 2 ELECTRODE PM-DEFIB,12318.0,8622.6,,,0
HCPCS,33217,Insert 2 electrode pm-defib,,,8192.37,36346.76,11
HCPCS,33218,HC REPAIR LEAD PACE-DEFIB ONE,4851.0,3395.7,,,0
HCPCS,33218,Repair lead pace-defib one,,,3699.47,16413.29,11
HCPCS,33220,HC REP TWO TRANSVENOUS ELECTRODES FOR PERM PACEMAKER/IMPLANTABLE DEFIBRILLATOR,10559.0,7391.3,,,0
HCPCS,33220,Repair lead pace-defib dual,,,3699.47,16413.29,11
HCPCS,33221,HC INSERT PULSE GEN MULT LEADS,23331.0,16331.7,,,0
HCPCS,33221,Insert pulse gen mult leads,,,1071.41,84600.26,11
HCPCS,33222,HC REVISE POCKET PACEMAKER,2222.0,1555.4,,,0
HCPCS,33222,Relocation pocket pacemaker,,,2042.58,9062.24,11
HCPCS,33223,HC REVISE POCKET FOR DEFIB,2532.0,1772.4,,,0
HCPCS,33223,Relocate pocket for defib,,,2042.58,9062.24,11
HCPCS,33224,HC INSERT PACING LEAD & CONNECT,36248.0,25373.6,,,0
HCPCS,33224,Insert pacing lead & connect,,,10347.14,45906.74,11
HCPCS,33225,HC L VENTR PACING LEAD ADD-ON,36248.0,25373.6,,,0
HCPCS,33225,L ventric pacing lead add-on,,,29938.04,37348.44,4
HCPCS,33226,Reposition l ventric lead,,,3125.8,13868.13,11
HCPCS,33227,HC REMV/REPLC PM GEN SINGL,16794.0,11755.8,,,0
HCPCS,33227,Remove&replace pm gen singl,,,8192.37,36346.76,11
HCPCS,33228,HC REMV/REPLC PM GEN DUAL LEAD,18774.0,13141.8,,,0
HCPCS,33228,Remv&replc pm gen dual lead,,,10347.14,45906.74,11
HCPCS,33229,HC REMOVE & REPLACE PERM PM GEN MULTI LEADS,18774.0,13141.8,,,0
HCPCS,33229,Remv&replc pm gen mult leads,,,14095.64,84600.26,11
HCPCS,33230,HC INSERT PULSE GEN W/ DUAL LEADS,34916.0,24441.2,,,0
HCPCS,33230,Insrt pulse gen w/dual leads,,,22020.42,97697.15,11
HCPCS,33231,HC INSRT PULSE GEN W/MULT LEADS,43822.0,30675.4,,,0
HCPCS,33231,Insrt pulse gen w/mult leads,,,31073.96,137864.64,11
HCPCS,33233,HC REMV PM GENERATOR,9309.0,6516.3,,,0
HCPCS,33233,Removal of pm generator,,,7687.98,36346.76,11
HCPCS,33234,HC REMV PM SYSTEM,16857.0,11799.9,,,0
HCPCS,33234,Removal of pacemaker system,,,3699.47,17369.02,11
HCPCS,33235,HC REMV PM ELECTRODE,12318.0,8622.6,,,0
HCPCS,33235,Removal pacemaker electrode,,,3699.47,16413.29,11
HCPCS,33240,HC INSERT PACING CARDIOVERTER-DEFIBRILLATOR PULSE GEN ONLY W/ EXISTING SINGLE LEAD,92369.0,64658.3,,,0
HCPCS,33240,Insrt pulse gen w/singl lead,,,22020.42,97697.15,11
HCPCS,33241,HC REMOVAL OF IMPLANTABLE DEFIBRILLATOR PULSE GENERATOR ONLY,4965.0,3475.5,,,0
HCPCS,33241,Remove pulse generator,,,3699.47,16413.29,11
HCPCS,33244,HC REMV ELTRD TRANSVEN,8108.0,5675.6,,,0
HCPCS,33244,Remove elctrd transvenously,,,3699.47,16413.29,11
HCPCS,33249,HC INSERT PACE-DEFIB W/LEAD,44794.0,31355.8,,,0
HCPCS,33249,Insj/rplcmt defib w/lead(s),,,31073.96,137864.64,11
HCPCS,33262,HC REMOVE AND REPLACE PACING CARDIOVERTER-DEFIBRILLATOR PULSE GEN SINGLE LEAD SYSTEM,32573.0,22801.1,,,0
HCPCS,33262,Rmvl& replc pulse gen 1 lead,,,22020.42,97697.15,11
HCPCS,33263,HC REMOVE AND REPLACE PACING CARDIOVERTER-DEFIBRILLATOR PULSE GEN DUAL LEAD SYSTEM,32573.0,22801.1,,,0
HCPCS,33263,Rmvl & rplcmt dfb gen 2 lead,,,22020.42,97697.15,11
HCPCS,33264,HC REMOVE AND REPLACE PACING CARDIOVERTER-DEFIBRILLATOR PULSE GEN MULTIPLE LEAD SYSTEM,128359.0,89851.3,,,0
HCPCS,33264,Rmvl & rplcmt dfb gen mlt ld,,,31073.96,137864.64,11
HCPCS,33270,HC INSERT/REPLACE PERM SUBCU IMPLANTABLE DEFIB SYSTEM INCL PRO/REPROGRAMMING WHEN PERFORMED,43805.0,30663.5,,,0
HCPCS,33270,Ins/rep subq defibrillator,,,31073.96,137864.64,11
HCPCS,33271,Insj subq impltbl dfb elctrd,,,8192.37,36346.76,11
HCPCS,33272,HC REMOVE SUBCU IMPLANTABLE DEFIBRILLATOR ELECTRODE,3336.0,2335.2,,,0
HCPCS,33272,Rmvl of subq defibrillator,,,3699.47,16413.29,11
HCPCS,33273,HC REPOSITION PREVIOUSLY IMPLANTED SUBCU IMPLANTABLE DEFIBRILLATOR ELECTRODE,10559.0,7391.3,,,0
HCPCS,33273,Repos prev impltbl subq dfb,,,3699.47,16413.29,11
HCPCS,33274,HC TRANSCATHETER INSERT/REPLACE PERM LEADLESS PACEMAKER RT VENT INCL IMAGE GUIDE/DEVICE EVAL,55766.0,39036.2,,,0
HCPCS,33274,Tcat insj/rpl perm ldls pm,,,19068.45,84600.26,11
HCPCS,33275,HC TRANSCATHETER REMOVAL PERMANENT LEADLESS PACEMAKER RT VENTRICULAR,11658.0,8160.6,,,0
HCPCS,33275,Tcat rmvl perm ldls pm,,,3125.8,13868.13,11
HCPCS,33276,Insj phrnc nrv stim sys,,,43604.58,193458.78,11
HCPCS,33278,Rmvl phrnc nrv stim sys,,,3461.03,15355.43,11
HCPCS,33279,Rmvl phrnc nrv stim transvns,,,3461.03,15355.43,11
HCPCS,33280,Rmvl phrnc nrv stim pg only,,,3461.03,15355.43,11
HCPCS,33281,Reposg phrnc nrv stim trnsvn,,,3461.03,15355.43,11
HCPCS,33285,HC INSERTION SUBCUTANEOUS CARDIAC RHYTHM MONITOR INCL PROGRAMMING,26892.0,18824.4,,,0
HCPCS,33285,Insj subq car rhythm mntr,,,8192.37,36346.76,11
HCPCS,33286,HC REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR,2104.0,1472.8,,,0
HCPCS,33286,Rmvl subq car rhythm mntr,,,701.03,3110.22,11
HCPCS,33287,Rmv&rplcmt phrnc nrv stim pg,,,30548.12,135531.68,11
HCPCS,33288,Rmv&rplcmt phrnc nrv stim ld,,,11030.91,49111.5,11
HCPCS,33289,Tcat impl wrls p-art prs snr,,,28395.59,125981.63,11
HCPCS,33340,HC PERCUT TRANSCATH CLOSURE LEFT ATRIAL APPENDAGE W/ENDOCARDIAL IMPLANT INCL FLUORO  RAD S&I,11522.0,8065.4,,,0
HCPCS,33340,Perq clsr tcat l atr apndge,,,2539.92,3168.61,4
HCPCS,33361,HC TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVR/TAVI) W/PROSTHETIC VALVE PERCUTANEOUS FEMORAL ARTERY,27691.0,19383.7,,,0
HCPCS,33361,Replace aortic valve perq,,,4018.05,5012.62,4
HCPCS,33362,HC TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVR/TAVI) W/PROSTHETIC VALVE OPEN FEMORAL ARTERY APPROAC,27691.0,19383.7,,,0
HCPCS,33362,Replace aortic valve open,,,4396.35,5484.55,4
HCPCS,33363,HC TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVR/TAVI) W/PROSTHETIC VALVE OPEN AXILLARY ARTERY APPROA,24079.0,16855.3,,,0
HCPCS,33363,Replace aortic valve open,,,4552.09,5678.85,4
HCPCS,33364,Replace aortic valve open,,,4839.88,6037.87,4
HCPCS,33365,Replace aortic valve open,,,5314.38,6629.82,4
HCPCS,33366,Trcath replace aortic valve,,,6116.66,7630.69,4
HCPCS,33367,Replace aortic valve w/byp,,,1868.81,2331.39,4
HCPCS,33368,Replace aortic valve w/byp,,,2264.86,2825.47,4
HCPCS,33369,Replace aortic valve w/byp,,,2990.09,3730.22,4
HCPCS,33390,Valvuloplasty aortic valve,,,6069.63,7572.02,4
HCPCS,33391,Valvuloplasty aortic valve,,,7192.32,8972.59,4
HCPCS,33418,HC TRANSCATHETER MITRAL VALVE REPAIR PERCUTANEOUS INCL TRANSSEPTAL PUNCTURE INITIAL PROSTHESIS,2139.0,1497.3,,,0
HCPCS,33418,Repair tcat mitral valve,,,5844.69,7291.39,4
HCPCS,33419,HC TRANSCATHETER MITRAL VALVE REPAIR PERCU INCL TRANSSEPTAL PUNCT ADDTL PROSTHESIS(ES) SAME SESSION,539.0,377.3,,,0
HCPCS,33419,Repair tcat mitral valve,,,1378.38,1719.56,4
HCPCS,33440,Rplcmt a-valve tlcj autol pv,,,10927.03,13631.74,4
HCPCS,33477,HC TRANSCATH PULM VALVE IMPLANT PERQ INCL PRE-STENTING VALVE DELIVERY SITE,20826.0,14578.2,,,0
HCPCS,33477,Implant tcat pulm vlv perq,,,4064.11,5070.08,4
HCPCS,33620,Apply r&l pulm art bands,,,4427.28,5523.15,4
HCPCS,33621,Transthor cath for stent,,,2631.4,3282.74,4
HCPCS,33622,Redo compl cardiac anomaly,,,10353.66,12916.45,4
HCPCS,33741,HC TAS CONGENTIAL CARDIAC ANOMALIES INCL IMAGING GUIDANCE ANY METHOD,5764.0,4034.8,,,0
HCPCS,33745,HC TIS CREATION BY STENT CGEN CAR ANOMAL INCL ALL IMG GUIDE WHEN PERFORM LT/RT HEART DIAGNOS CARDIAC CATH CGEN CAR ANOMAL INITIAL INTRACARDIAC SHUNT,3814.0,2669.8,,,0
HCPCS,33746,HC TIS CREATION BY STENT CGEN CAR ANOMALINCL ALL IMG GUIDE WHEN PERFORM LT/RT HEART DIAGNOS CARDIAC CGEN CATH CAR ANOMAL EA ADDL,1501.0,1050.7,,,0
HCPCS,33858,As-aort grf f/aortic dsj,,,10826.1,13505.83,4
HCPCS,33859,As-aort grf f/ds oth/thn dsj,,,7763.98,9685.76,4
HCPCS,33866,Aortic hemiarch graft,,,2948.01,3677.71,4
HCPCS,33871,Transvrs a-arch grf hypthrm,,,10412.11,12989.37,4
HCPCS,33880,HC ENDOVASCULAR REPAIR DESCENDING THORACIC AORTA LEFT SUBCLAVIAN ARTERY ORIGIN INITIAL ENDOPROSTHESIS PLUS DESCENDING THORACIC AORTIC EXTENSION(S),2207.0,1544.9,,,0
HCPCS,33881,HC EVASC TTA REPAIR W/O SUBCLAVIAN ARTERY ORIGIN TO LEVEL OF CELIAC ATETERY ORIGIN,18516.0,12961.2,,,0
HCPCS,33894,HC ENDOVASCULAR STENT REPAIR COARCTATION ASCENDING/TRANSVERSE/DESCENDING THORACIC ABDOMINAL AORTA STENT PLACEMENT ACROSS MAJOR SIDE BRANCHES,1114.0,779.8,,,0
HCPCS,33895,HC ENDOVASCULAR STENT REPAIR COARCTATION ASCENDING/TRANSVERSE/DESCENDING THORACIC ABDOMINAL AORTA STENT PLACEMENT NOT CROSSING MAJOR SIDE BRANCHES,887.0,620.9,,,0
HCPCS,33897,HC PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY NATIVE/RECURRENT COARCTATION OF THE AORTA,19271.0,13489.7,,,0
HCPCS,33900,HC PERCUTANEOUS PULM ARTERY REVASCULAR STENT PLACEMENT INITIAL NORMAL NATIVE CONNECT UNILATERAL,33448.0,23413.6,,,0
HCPCS,33900,Perq p-art revsc 1 nm nt uni,,,11428.37,50703.82,11
HCPCS,33901,HC PERCUTANEOUS PULM ARTERY REVASCULAR STENT PLACEMENT INITIAL NORMAL NATIVE CONNECT BILATERAL,33448.0,23413.6,,,0
HCPCS,33901,Perq p-art revsc 1 nm nt bi,,,11428.37,50703.82,11
HCPCS,33902,HC PERCUTANEOUS PULM ARTERY REVASCULAR STENT PLACEMENT INITIAL ABNORMAL CONNECT UNILATERAL,71877.0,50313.9,,,0
HCPCS,33902,Perq p-art revsc 1 abnor uni,,,18147.73,80515.32,11
HCPCS,33903,HC PERCUTANEOUS PULM ARTERY REVASCULAR STENT PLACEMENT INITIAL ABNORMAL CONNECT BILATERAL,82658.0,57860.6,,,0
HCPCS,33903,Perq p-art revsc 1 abnor bi,,,11428.37,50703.82,11
HCPCS,33904,HC PERCUTANEOUS PULM ARTERY REVASCULAR STENT PLACEMENT EA ADDTL VESSEL/SEPARATE LESION NORMAL/ABNORMAL CONNECTIONS,16725.0,11707.5,,,0
HCPCS,33927,Impltj tot rplcmt hrt sys,,,8160.06,10179.88,4
HCPCS,33928,Rmvl & rplcmt tot hrt sys,,,7761.86,9683.11,4
HCPCS,33929,Rmvl rplcmt hrt sys f/trnspl,,,4996.44,6233.18,4
HCPCS,33946,Ecmo/ecls initiation venous,,,977.33,1219.24,4
HCPCS,33947,Ecmo/ecls initiation artery,,,1079.59,1346.81,4
HCPCS,33948,Ecmo/ecls daily mgmt-venous,,,770.41,961.1,4
HCPCS,33949,Ecmo/ecls daily mgmt artery,,,749.83,935.44,4
HCPCS,3394F,HC PRO QUANT HER2 IHC EVAL BRST CX,0.01,0.007,,,0
HCPCS,33951,Ecmo/ecls insj prph cannula,,,1407.25,1755.58,4
HCPCS,33952,Ecmo/ecls insj prph cannula,,,1369.56,1708.56,4
HCPCS,33953,Ecmo/ecls insj prph cannula,,,1569.51,1958.0,4
HCPCS,33954,Ecmo/ecls insj prph cannula,,,1530.39,1909.2,4
HCPCS,33955,Ecmo/ecls insj ctr cannula,,,2826.63,3526.29,4
HCPCS,33956,Ecmo/ecls insj ctr cannula,,,2687.25,3352.41,4
HCPCS,33957,Ecmo/ecls repos perph cnula,,,627.03,782.23,4
HCPCS,33958,Ecmo/ecls repos perph cnula,,,608.12,758.65,4
HCPCS,33959,Ecmo/ecls repos perph cnula,,,796.8,994.03,4
HCPCS,3395F,HC PRO QUANT NONHER2 IHC BRST CX,0.01,0.007,,,0
HCPCS,33962,Ecmo/ecls repos perph cnula,,,751.99,938.12,4
HCPCS,33963,Ecmo/ecls repos perph cnula,,,1592.39,1986.54,4
HCPCS,33964,Ecmo/ecls repos perph cnula,,,1635.29,2040.07,4
HCPCS,33965,Ecmo/ecls rmvl perph cannula,,,627.03,782.23,4
HCPCS,33966,Ecmo/ecls rmvl prph cannula,,,757.5,945.0,4
HCPCS,33967,HC PERQ INSERT AORTA BALLOON DEVICE,6137.0,4295.9,,,0
HCPCS,33968,HC REMOVE AORTIC ASSIST DEVICE,3522.0,2465.4,,,0
HCPCS,33969,Ecmo/ecls rmvl perph cannula,,,923.27,1151.8,4
HCPCS,33984,Ecmo/ecls rmvl prph cannula,,,911.03,1136.53,4
HCPCS,33985,Ecmo/ecls rmvl ctr cannula,,,1740.55,2171.38,4
HCPCS,33986,Ecmo/ecls rmvl ctr cannula,,,1662.65,2074.2,4
HCPCS,33987,Artery expos/graft artery,,,667.15,832.28,4
HCPCS,33988,Insertion of left heart vent,,,2479.09,3092.72,4
HCPCS,33989,Removal of left heart vent,,,1575.66,1965.68,4
HCPCS,33990,HC INSERT VAD ARTERY ACCESS LEFT HEART,6710.0,4697.0,,,0
HCPCS,33990,Insert vad artery access,,,1306.75,1630.2,4
HCPCS,33991,HC INSERT VAD PERQ INCL RS&I LT HEART BOTH ARTERIAL/VENOUS ACCESS W/TRANSSEPTAL PUNCTURE,2098.0,1468.6,,,0
HCPCS,33991,Insert vad art&vein access,,,1904.08,2375.39,4
HCPCS,33992,HC REMOVE VAD DISTINCT SESSION ARTERIAL OR ARTERIAL & VENOUS CANNULA(S),6710.0,4697.0,,,0
HCPCS,33992,Remove vad different session,,,622.82,776.98,4
HCPCS,33993,HC REPOSITION VAD DISTINCT SESSION RT OR LT HEART,6710.0,4697.0,,,0
HCPCS,33993,Reposition vad diff session,,,546.82,682.18,4
HCPCS,33995,HC INSERTION OF VENTRICULAR ASSIST DEVICE PERCUTANEOUS INCL RADIOLOGICAL SUPERVISON & INTERP RT HEART VENOUS ACCESS ONLY,1301.0,910.7,,,0
HCPCS,33997,HC REMOVAL OF PERQ RT HEART VENTRICULAR ASSIST DEVICE VENOUS CANNULA AT SEPARATE & DISTINCT SESSION FROM INSERTION,580.0,406.0,,,0
HCPCS,33999,Cardiac surgery procedure,,,621.01,2755.21,11
HCPCS,33999,HC CARDIAC SURG PROCEDURE UNLIS,558.0,390.6,,,0
HCPCS,34101,Removal of artery clot,,,5508.66,24440.06,11
HCPCS,34111,Removal of arm artery clot,,,5508.66,24440.06,11
HCPCS,34201,Removal of artery clot,,,5508.66,24440.06,11
HCPCS,34203,Removal of leg artery clot,,,5508.66,24440.06,11
HCPCS,34421,Removal of vein clot,,,3125.8,13868.13,11
HCPCS,34471,Removal of vein clot,,,621.01,9675.33,11
HCPCS,34490,Removal of vein clot,,,3125.8,13868.13,11
HCPCS,34501,Repair valve femoral vein,,,5508.66,24440.06,11
HCPCS,34510,Transposition of vein valve,,,5508.66,24440.06,11
HCPCS,34520,Cross-over vein graft,,,5508.66,24440.06,11
HCPCS,34530,Leg vein fusion,,,3125.8,13868.13,11
HCPCS,34701,Evasc rpr a-ao ndgft,,,3981.18,4966.62,4
HCPCS,34702,Evasc rpr a-ao ndgft rpt,,,5953.92,7427.66,4
HCPCS,34703,Evasc rpr a-unilac ndgft,,,4396.98,5485.35,4
HCPCS,34704,Evasc rpr a-unilac ndgft rpt,,,7341.11,9158.22,4
HCPCS,34705,Evac rpr a-biiliac ndgft,,,4908.36,6123.3,4
HCPCS,34706,Evasc rpr a-biiliac rpt,,,7408.65,9242.48,4
HCPCS,34707,Evasc rpr ilio-iliac ndgft,,,3716.3,4636.17,4
HCPCS,34708,Evasc rpr ilio-iliac rpt,,,5942.89,7413.9,4
HCPCS,34709,Plmt xtn prosth evasc rpr,,,1042.65,1300.74,4
HCPCS,34710,Dlyd plmt xtn prosth 1st vsl,,,2560.14,3193.84,4
HCPCS,34711,Dlyd plmt xtn prosth ea addl,,,960.78,1198.6,4
HCPCS,34712,Tcat dlvr enhncd fixj dev,,,2102.61,2623.06,4
HCPCS,34713,Perq access & clsr fem art,,,401.14,500.43,4
HCPCS,34714,Opn fem art expos cndt crtj,,,868.06,1082.93,4
HCPCS,34715,HC OPEN AXILLARY/SUBCL ARTERY EXPOSE DELIVERY ENDOVASCULAR PROSTHESIS UNILATERAL,1201.0,840.7,,,0
HCPCS,34715,Opn ax/subcla art expos,,,965.72,1204.76,4
HCPCS,34716,Opn ax/subcla art expos cndt,,,1190.12,1484.71,4
HCPCS,34717,Evasc rpr a-iliac ndgft,,,1433.52,1788.36,4
HCPCS,34718,Evasc rpr n/a a-iliac ndgft,,,3979.75,4964.84,4
HCPCS,35011,Repair defect of artery,,,5508.66,24440.06,11
HCPCS,35045,Repair defect of arm artery,,,5508.66,24440.06,11
HCPCS,35180,Repair blood vessel lesion,,,1558.36,7519.55,11
HCPCS,35184,Repair blood vessel lesion,,,3125.8,13868.13,11
HCPCS,35188,Repair blood vessel lesion,,,5508.66,24440.06,11
HCPCS,35190,Repair blood vessel lesion,,,5508.66,24440.06,11
HCPCS,35201,Repair blood vessel lesion,,,5508.66,24440.06,11
HCPCS,35206,Repair blood vessel lesion,,,3125.8,13868.13,11
HCPCS,35207,Repair blood vessel lesion,,,3125.8,13868.13,11
HCPCS,35226,HC REPAIR BLOOD VESSEL DIRECT LWR EXTREMITY,7377.0,5163.9,,,0
HCPCS,35226,Repair blood vessel lesion,,,701.03,7519.55,11
HCPCS,35231,Repair blood vessel lesion,,,3125.8,13868.13,11
HCPCS,35236,Repair blood vessel lesion,,,5508.66,24440.06,11
HCPCS,35256,Repair blood vessel lesion,,,5508.66,24440.06,11
HCPCS,35261,Repair blood vessel lesion,,,3125.8,13868.13,11
HCPCS,35266,Repair blood vessel lesion,,,5508.66,24440.06,11
HCPCS,35286,Repair blood vessel lesion,,,5508.66,24440.06,11
HCPCS,35321,Rechanneling of artery,,,5508.66,24440.06,11
HCPCS,35372,Rechanneling of artery,,,5508.66,24440.06,11
HCPCS,35500,Harvest vein for bypass,,,2932.34,3658.17,4
HCPCS,35535,Art byp grft hepatorenal,,,6099.94,7609.82,4
HCPCS,35570,Art byp tibial-tib/peroneal,,,4702.5,5866.48,4
HCPCS,35632,Art byp ilio-celiac,,,5790.88,7224.26,4
HCPCS,35633,Art byp ilio-mesenteric,,,6255.37,7803.73,4
HCPCS,35634,Art byp iliorenal,,,5666.95,7069.66,4
HCPCS,35685,Bypass graft patency/patch,,,6027.58,7519.55,4
HCPCS,35686,Bypass graft/av fist patency,,,6027.58,7519.55,4
HCPCS,35702,Expl n/flwd surg uxtr art,,,1296.08,1616.9,4
HCPCS,35703,Expl n/flwd surg lxtr art,,,1322.26,1649.55,4
HCPCS,35800,Explore neck vessels,,,5508.66,24440.06,11
HCPCS,35860,Explore limb vessels,,,3125.8,13868.13,11
HCPCS,35875,Removal of clot in graft,,,5508.66,24440.06,11
HCPCS,35876,Removal of clot in graft,,,5508.66,24440.06,11
HCPCS,35879,Revise graft w/vein,,,5508.66,24440.06,11
HCPCS,35881,Revise graft w/vein,,,5508.66,24440.06,11
HCPCS,35883,Revise Graft w/Nonauto Graft,,,5508.66,24440.06,11
HCPCS,35884,Revise graft w/vein,,,5508.66,24440.06,11
HCPCS,35903,Excision graft extremity,,,3125.8,13868.13,11
HCPCS,36000,HC PLACE NEEDLE / CATH IN VEIN,154.0,107.8,,,0
HCPCS,36000013,HC REP OF OMPHALOCELE,3632.0,2542.4,,,0
HCPCS,36000014,HC PDA LIGATION,6576.0,4603.2,,,0
HCPCS,36000028,HC BRONCH W/REVI TRAC/BRONC STENT,3878.0,2714.6,,,0
HCPCS,36000035,HC OR ACUITY 1,4455.0,3118.5,,,0
HCPCS,36000036,HC OR ACUITY 2,8105.0,5673.5,,,0
HCPCS,36000037,HC OR ACUITY 3,12329.0,8630.3,,,0
HCPCS,36000038,HC OR ACUITY 4,18147.0,12702.9,,,0
HCPCS,36000039,HC OR ACUITY 5,27329.0,19130.3,,,0
HCPCS,36000044,HC C-SECTION FIRST HALF HOUR,8018.0,5612.6,,,0
HCPCS,36000045,HC ABDOMINAL HYSTERECTOMY FIRST HALF HOUR,9778.0,6844.6,,,0
HCPCS,36000046,HC D & C FIRST HALF HOUR,5902.0,4131.4,,,0
HCPCS,36000047,HC LAC REPAIR FIRST HALF HOUR,6811.0,4767.7,,,0
HCPCS,36000048,HC 4TH DEGREE LAC REP FIRST HALF HOUR,2651.0,1855.7,,,0
HCPCS,36000050,HC OR L&D STAFF 2 15 MIN,608.0,425.6,,,0
HCPCS,36000051,HC OR L&D STAFF 3 15 MIN,810.0,567.0,,,0
HCPCS,36000052,HC OR L&D STAFF > 3 15 MIN,1013.0,709.1,,,0
HCPCS,36000079,HC OR STAFF 1 15 MIN,440.0,308.0,,,0
HCPCS,36000080,HC OR STAFF 2 15 MIN,656.0,459.2,,,0
HCPCS,36000081,HC OR STAFF 3 15 MIN,876.0,613.2,,,0
HCPCS,36000082,HC OR STAFF > 3 15 MIN,1095.0,766.5,,,0
HCPCS,36000086,HC COSMETIC SURGERY 1 HR,1400.0,980.0,,,0
HCPCS,36000088,HC COSMETIC SURGERY 1.5 HRS,2100.0,1470.0,,,0
HCPCS,36000090,HC COSMETIC SURGERY 2 HRS,2800.0,1960.0,,,0
HCPCS,36000092,HC COSMETIC SURGERY 2.5 HRS,3500.0,2450.0,,,0
HCPCS,36000094,HC COSMETIC SURGERY 3 HRS,4200.0,2940.0,,,0
HCPCS,36000096,HC COSMETIC SURGERY 3.5 HRS,4900.0,3430.0,,,0
HCPCS,36000098,HC COSMETIC SURGERY 4 HRS,5600.0,3920.0,,,0
HCPCS,36000100,HC COSMETIC SURGERY 4.5 HRS,6300.0,4410.0,,,0
HCPCS,36000102,HC COSMETIC SURGERY 5 HRS,7000.0,4900.0,,,0
HCPCS,36000104,HC COSMETIC SURGERY 5.5 HRS,7700.0,5390.0,,,0
HCPCS,36000106,HC COSMETIC SURGERY 6 HRS,8400.0,5880.0,,,0
HCPCS,36000110,HC COSMETIC SECONDARY EA ADDTL 15 MIN,71.0,49.7,,,0
HCPCS,36000111,HC COSMETIC OVERNIGHT STAY,711.0,497.7,,,0
HCPCS,36000112,HC ESOPH ENDOSCOPY ABLA (HALO BARX),14105.0,9873.5,,,0
HCPCS,36000113,HC PERIURETHRAL LACERATION REPAIR,5605.0,3923.5,,,0
HCPCS,36000114,HC CIRCLAGE CERVIX INSERT/REMOVAL,2516.0,1761.2,,,0
HCPCS,36000116,HC UTERINE INVERSION,8714.0,6099.8,,,0
HCPCS,36000118,HC REMOVAL CERVICAL CERCLAGE,635.0,444.5,,,0
HCPCS,36000119,HC EVACUATION OF HEMATOMA,7355.0,5148.5,,,0
HCPCS,36000122,HC PERFUSIONIST,6680.0,4676.0,,,0
HCPCS,36002,HC INJ PSEUDOANEURYSM,506.0,354.2,,,0
HCPCS,36002,Pseudoaneurysm injection trt,,,475.98,2755.21,11
HCPCS,36005,HC INJ FOR EXT VENOGRAPHY,381.0,266.7,,,0
HCPCS,36010,HC PLACE CATH SUP INF VENA CAVA,558.0,390.6,,,0
HCPCS,36011,HC PLACE CATH VEIN 1ST ORDER,750.0,525.0,,,0
HCPCS,36012,HC PLACE CATH IN VEIN 2ND>  ORDER,1060.0,742.0,,,0
HCPCS,36013,HC PLACE CATH RT HEART OR MAIN PULM ARTERY,1410.0,987.0,,,0
HCPCS,36014,HC PLACE CATH LT OR RT PULM ARTERY,1357.0,949.9,,,0
HCPCS,36015,HC PLACE CATH IN PULM ARTERY,1598.0,1118.6,,,0
HCPCS,36140,HC INTRO OF NEEDLE/INTRACATHETER UPPER OR LOWER EXTREMITY ARTERY,267.0,186.9,,,0
HCPCS,36200,HC PLACE CATHETER IN AORTA,665.0,465.5,,,0
HCPCS,36215,HC PLACE CATH 1ST THOR BRACHIO,731.0,511.7,,,0
HCPCS,36216,HC PLACE CATH 2ND THOR BRACHIO,2087.0,1460.9,,,0
HCPCS,36217,HC PLACE CATH 3RD> THOR BRACHIO,1497.0,1047.9,,,0
HCPCS,36218,HC PLACE CATH ADD 2ND 3RD THOR BRACH,749.0,524.3,,,0
HCPCS,36221,HC NON-SELECT CATHETER PLACE W/ANGIOGRAPHY EXTRACRANIAL CAROTID VERTEBRAL/INTRACRANIAL VESSESLS UNILAT OR BILAT,10264.0,7184.8,,,0
HCPCS,36221,Place cath thoracic aorta,,,2457.27,13868.13,11
HCPCS,36222,HC COMMON CAROTID AND EXTERNAL CAROTID IMAGING W/CATHETER,2277.0,1593.9,,,0
HCPCS,36222,Place cath carotid/inom art,,,2457.27,13868.13,11
HCPCS,36223,HC SELECTIVE CATH PLACE CAROTID/INOM ART,2277.0,1593.9,,,0
HCPCS,36223,Place cath carotid/inom art,,,2457.27,24440.06,11
HCPCS,36224,HC SELECTIVE CATH PLACE CAROTID ART,5269.0,3688.3,,,0
HCPCS,36224,Place cath carotd art,,,5508.66,24440.06,11
HCPCS,36225,HC PLACE CATH SUBCLAVIAN ART,2277.0,1593.9,,,0
HCPCS,36225,Place cath subclavian art,,,2712.51,13868.13,11
HCPCS,36226,HC SELECTIVE CATH PLACE VETEBRAL ART,5269.0,3688.3,,,0
HCPCS,36226,Place cath vertebral art,,,5508.66,24440.06,11
HCPCS,36227,Place cath xtrnl carotid,,,324.91,405.33,4
HCPCS,36228,Place cath intracranial art,,,661.87,825.7,4
HCPCS,36245,HC PLACE CATH 1ST ABD PELVIC LWR EXT,1071.0,749.7,,,0
HCPCS,36246,HC PLACE CATH 2ND ABD PELVIC LWR EXT,1885.0,1319.5,,,0
HCPCS,36247,HC PLACE CATH 3D> ABD PELVIC LWR EXT,2358.0,1650.6,,,0
HCPCS,36248,HC CATH ADD 2D 3D ABD PEL LWR EXT,317.0,221.9,,,0
HCPCS,36251,HC PLACE CATH 1ST RENAL UNILAT SI,6468.0,4527.6,,,0
HCPCS,36251,Ins cath ren art 1st unilat,,,3125.8,13868.13,11
HCPCS,36252,HC PLACE CATH 1ST RENAL BILAT SI,9703.0,6792.1,,,0
HCPCS,36252,Ins cath ren art 1st bilat,,,3125.8,13868.13,11
HCPCS,36253,HC PLACE CATH 2D> RENAL UNILAT SI,6601.0,4620.7,,,0
HCPCS,36253,Ins cath ren art 2nd+ unilat,,,5508.66,24440.06,11
HCPCS,36254,Ins cath ren art 2nd+ bilat,,,3125.8,13868.13,11
HCPCS,36260,Insertion of infusion pump,,,5508.66,24440.06,11
HCPCS,36261,Revision of infusion pump,,,3699.47,16413.29,11
HCPCS,36262,Removal of infusion pump,,,3699.47,16413.29,11
HCPCS,36405,HC PRO HC BL DRAW < 3 YRS SCALP VEIN,34.0,23.8,,,0
HCPCS,36406,HC PRO VENIPUNCTURE YOUNGER THAN AGE 3 YEAR NECESSITATING SKILL OF A PHYSICIAN OTHER VEIN,32.0,22.4,,,0
HCPCS,36406,HC VENIPUNCTURE YOUNGER THAN AGE 3 YEAR NECESSITATING SKILL OF A PHYSICIAN OTHER VEIN,306.0,214.2,,,0
HCPCS,36410,HC NON-ROUTINE BL DRAW > 3 YRS,133.0,93.1,,,0
HCPCS,36410,HC PRO NON-ROUTINE BLD DRAW>3 YRS,72.0,50.4,,,0
HCPCS,36415,HC VENOUS BLOOD DRAW,40.0,28.0,,,0
HCPCS,36415,Routine venipuncture,,,8.41,45.97,11
HCPCS,36416,HC CAPILLARY BLOOD DRAW,13.0,9.1,,,0
HCPCS,36420,Vein access cutdown < 1 yr,,,42.87,584.37,11
HCPCS,36425,Vein access cutdown > 1 yr,,,42.87,1962.08,11
HCPCS,36430,Blood transfusion service,,,436.75,1937.7,11
HCPCS,36430,HC BLOOD ADMINISTRATION,1602.0,1121.4,,,0
HCPCS,36430,HC BLOOD TRANSFUSION LEVEL 2 2-4,1486.0,1040.2,,,0
HCPCS,36430,HC BLOOD TRANSFUSION LEVEL 3 4-6,1691.0,1183.7,,,0
HCPCS,36430,HC BLOOD TRANSFUSION LEVEL 4 6-9,1894.0,1325.8,,,0
HCPCS,36430,HC BLOOD TRANSFUSION LEVEL 5 9+ H,2099.0,1469.3,,,0
HCPCS,36440,Bl push transfuse 2 yr/<,,,436.75,1937.7,11
HCPCS,36450,Bl exchange/transfuse nb,,,436.75,1937.7,11
HCPCS,36455,Bl exchange/transfuse non-nb,,,436.75,1937.7,11
HCPCS,36456,Prtl exchange transfuse nb,,,436.75,1937.7,11
HCPCS,36460,Transfusion service fetal,,,436.75,1937.7,11
HCPCS,36465,Njx noncmpnd sclrsnt 1 vein,,,2042.58,9062.24,11
HCPCS,36466,Njx noncmpnd sclrsnt mlt vn,,,2042.58,9062.24,11
HCPCS,36468,Injection(s) spider veins,,,158.65,1785.48,11
HCPCS,36470,HC INJECT SCLEROSANT SINGLE INCOMPETENT VEIN,527.0,368.9,,,0
HCPCS,36470,Injection therapy of vein,,,158.65,1785.48,11
HCPCS,36471,Injection therapy of veins,,,158.65,1785.48,11
HCPCS,36473,Endovenous mchnchem 1st vein,,,3125.8,13868.13,11
HCPCS,36473,HC ENDOVENOUS ABLATION THERAPY INCOMP VEIN EXTREMITY IMAGE GUIDE & MONITORING FIRST VEIN TX,11932.0,8352.4,,,0
HCPCS,36474,Endovenous mchnchem add-on,,,274.98,343.04,4
HCPCS,36474,HC ENDOVENOUS ABLATION THERAPY INCOM VEIN EXTREMITY IMAGE GUIDE & MONITOR SUBQ VEIN(S) TX IN SINGLE EXTREMITY EA SEP ACESS SITES,100.0,70.0,,,0
HCPCS,36475,Endovenous rf 1st vein,,,3125.8,13868.13,11
HCPCS,36476,Endovenous rf vein add-on,,,3632.05,4531.07,4
HCPCS,36478,Endovenous laser 1st vein,,,3125.8,13868.13,11
HCPCS,36479,Endovenous laser vein addon,,,5169.66,6449.28,4
HCPCS,36481,HC PERCUTANEOUS PORTAL VEIN CATH ANY METHOD,5333.0,3733.1,,,0
HCPCS,36482,Endoven ther chem adhes 1st,,,5508.66,24440.06,11
HCPCS,36483,Endoven ther chem adhes sbsq,,,286.94,357.97,4
HCPCS,36500,HC INSERTION CATH VEIN,1275.0,892.5,,,0
HCPCS,36510,HC INSERTION CATH VEIN,386.0,270.2,,,0
HCPCS,36511,Apheresis wbc,,,1541.8,6840.45,11
HCPCS,36511,HC APHERESIS WBC,3360.0,2352.0,,,0
HCPCS,36512,Apheresis rbc,,,1541.8,6840.45,11
HCPCS,36512,HC APHERESIS RBC,3360.0,2352.0,,,0
HCPCS,36513,Apheresis platelets,,,436.75,2871.55,11
HCPCS,36513,HC APHERESIS PLATELETS,3360.0,2352.0,,,0
HCPCS,36514,Apheresis plasma,,,1541.8,6840.45,11
HCPCS,36514,HC APHERESIS PLASMA,3360.0,2352.0,,,0
HCPCS,36516,Apheresis selective,,,4311.81,19130.02,11
HCPCS,36522,HC PHOTOPHERESIS,8954.0,6267.8,,,0
HCPCS,36522,Photopheresis,,,4311.81,19130.02,11
HCPCS,36555,INSERT NON-TUNN CV CATH <5 YRS,1512.0,1058.4,,,0
HCPCS,36555,Insert non-tunnel cv cath,,,2182.45,13868.13,11
HCPCS,36556,HC INSERT NON-TUNN CV CATH >5 YRS,1308.0,915.6,,,0
HCPCS,36556,HC PRO INSERT NON-TUNN CV CATH >5 YRS,531.0,371.7,,,0
HCPCS,36556,Insert non-tunnel cv cath,,,916.5,13868.13,11
HCPCS,36557,HC INSRT TUNNELED CENTRALLY INSRTD CV CATH W/O SUBCU PORT/PUMP < 5 YRS,3338.0,2336.6,,,0
HCPCS,36557,Insert tunneled cv cath,,,4822.73,24440.06,11
HCPCS,36558,HC INSERT TUNNEL CV CATH >5 YRS,3338.0,2336.6,,,0
HCPCS,36558,Insert tunneled cv cath,,,2514.6,13868.13,11
HCPCS,36560,HC INSRT TUNNELED CENTRALLY INSRTD CV ACCESS DEVICE W/ SUBCU PORT < 5 YRS,10198.0,7138.6,,,0
HCPCS,36560,Insert tunneled cv cath,,,3125.8,13868.13,11
HCPCS,36561,HC INSERT TUNNEL CV DEVICE >5 YRS,7179.0,5025.3,,,0
HCPCS,36561,Insert tunneled cv cath,,,3125.8,13868.13,11
HCPCS,36563,Insert tunneled cv cath,,,5508.66,24440.06,11
HCPCS,36565,Insert tunneled cv cath,,,3125.8,13868.13,11
HCPCS,36566,Insert tunneled cv cath,,,5508.66,24440.06,11
HCPCS,36568,HC PRO INSERT PICC CATH <5 YRS,562.0,393.4,,,0
HCPCS,36568,INSERT PICC CATH <5 YRS,1309.0,916.3,,,0
HCPCS,36568,Insert picc cath,,,1558.36,6913.93,11
HCPCS,36569,HC INSERT PICC CATH >5 YRS,1217.0,851.9,,,0
HCPCS,36569,Insert picc cath,,,917.24,6913.93,11
HCPCS,36570,HC INSERTION OF PERIPHERALLY INSERTED CENTRAL VENOUS ACCESS DEVICE W/SUBQ PORT UNDER 5 YRS,12111.0,8477.7,,,0
HCPCS,36570,Insert picvad cath,,,3125.8,13868.13,11
HCPCS,36571,HC INSERT PICVAD CATH,4788.0,3351.6,,,0
HCPCS,36571,Insert picvad cath,,,3125.8,13868.13,11
HCPCS,36572,HC INSERT OF PICC W/O SUB PORT/PUMP INCLUD ALL IMAGE GUIDE IMAGE DOC/ASSOC RADIOLOGICAL < 5 YRS,2470.0,1729.0,,,0
HCPCS,36572,HC PRO INSERT OF PICC W/O SUB PORT/PUMP INCLUD ALL IMAGE GUIDE IMAGE DOC/ASSOC RADIOLOGICAL < 5 YRS,468.0,327.6,,,0
HCPCS,36572,Insj picc rs&i <5 yr,,,621.01,2755.21,11
HCPCS,36573,HC INSERT OF PICC W/O SUB PORT/PUMP INCLUD ALL IMAGE GUIDE IMAGE DOC/ASSOC RADIOLOGICAL >5 YRS,4356.0,3049.2,,,0
HCPCS,36573,HC PRO INSERT OF PICC W/O SUB PORT/PUMP INCLUD ALL IMAGE GUIDE IMAGE DOC/ASSOC RADIOLOGICAL >5 YRS,441.0,308.7,,,0
HCPCS,36573,Insj picc rs&i 5 yr+,,,1558.36,6913.93,11
HCPCS,36575,Repair tunneled cv cath,,,621.01,2755.21,11
HCPCS,36576,HC REPAIR CV DEVICE,1344.0,940.8,,,0
HCPCS,36576,Repair tunneled cv cath,,,961.54,6913.93,11
HCPCS,36578,HC REPLACE CATH ONLY CV DEVICE W/SUBCU PORT/PUMP CENTRAL/PERIPH INSERT SITE,12370.0,8659.0,,,0
HCPCS,36578,Replace tunneled cv cath,,,3125.8,13868.13,11
HCPCS,36580,HC REPLACE NON-TUNN CV CATH,1092.0,764.4,,,0
HCPCS,36580,Replace cvad cath,,,1558.36,6913.93,11
HCPCS,36581,HC REPLACE TUNNEL CV CATH,2712.0,1898.4,,,0
HCPCS,36581,Replace tunneled cv cath,,,3125.8,13868.13,11
HCPCS,36582,HC REPLACE TUNNELED CV CATH COMPLETE,3546.0,2482.2,,,0
HCPCS,36582,Replace tunneled cv cath,,,3125.8,13868.13,11
HCPCS,36583,Replace tunneled cv cath,,,5508.66,24440.06,11
HCPCS,36584,HC REPLACE PICC CATH,2807.0,1964.9,,,0
HCPCS,36584,Replace picc cath,,,1558.36,6913.93,11
HCPCS,36585,HC REPLACE CV DEVICE,4353.0,3047.1,,,0
HCPCS,36585,Replace picvad cath,,,3125.8,13868.13,11
HCPCS,36589,HC REMOV TUNNEL CV CATH,920.0,644.0,,,0
HCPCS,36589,Removal tunneled cv cath,,,621.01,2755.21,11
HCPCS,36590,HC REMOV TUNNEL CV DEVICE,3020.0,2114.0,,,0
HCPCS,36590,Removal tunneled cv cath,,,1308.77,6913.93,11
HCPCS,36591,Draw blood off venous device,,,131.71,584.37,11
HCPCS,36591,HC BLOOD COLLECT CV DEVICE,294.0,205.8,,,0
HCPCS,36592,BLOOD COLLECT PICC,294.0,205.8,,,0
HCPCS,36592,Collect blood from picc,,,131.71,584.37,11
HCPCS,36593,DECLOT VASCULAR CATH DEVICE,629.0,440.3,,,0
HCPCS,36593,Declot vascular device,,,326.99,1450.75,11
HCPCS,36595,HC MECHANICAL RMVL PRICATH OBSTR  MATRL FROM CENTRAL VENOUS DEVICE VIA SEPARATE VENOUS ACCESS,12111.0,8477.7,,,0
HCPCS,36595,Mech remov tunneled cv cath,,,2712.51,13868.13,11
HCPCS,36596,HC MECHANICAL RMVL INTRAL OBSTRUCTIVE CENTRAL VENOUS DEVICE LUMEN,5272.0,3690.4,,,0
HCPCS,36596,Mech remov tunneled cv cath,,,1558.36,6913.93,11
HCPCS,36597,HC REPOSITION VENOUS CATH FLUORO,1123.0,786.1,,,0
HCPCS,36597,Reposition venous catheter,,,1558.36,6913.93,11
HCPCS,36598,HC X-RAY CV DEVICE FLUORO,262.0,183.4,,,0
HCPCS,36598,Inj w/fluor eval cv device,,,210.57,934.22,11
HCPCS,36600,ARTERIAL BLOOD DRAW,198.0,138.6,,,0
HCPCS,36600,HC PRO ARTERIAL PUNCTURE WITHDRAWAL OF BLOOD FOR DIAGNOSIS,26.0,18.2,,,0
HCPCS,36600,Withdrawal of arterial blood,,,131.71,584.37,11
HCPCS,36620,HC INSERT CATH ARTERY,285.0,199.5,,,0
HCPCS,36620,HC PRO INSERT CATH ARTERY,100.0,70.0,,,0
HCPCS,36625,HC CUTDWN ARTERY CATH SMPLNG,2256.0,1579.2,,,0
HCPCS,36640,Insertion catheter artery,,,3125.8,13868.13,11
HCPCS,36660,HC INSERT CATH UMBIL ARTERY,568.0,397.6,,,0
HCPCS,36680,HC INSERT NEEDLE BONE CAVITY,300.0,210.0,,,0
HCPCS,36680,HC PRO INSERT NEEDLE BONE CAVITY,508.0,355.6,,,0
HCPCS,36680,Insert needle bone cavity,,,214.54,1962.08,11
HCPCS,36800,HC PRO INSERT CANNULA FOR HEMODIALYSIS,300.0,210.0,,,0
HCPCS,36800,Insertion of cannula,,,5508.66,24440.06,11
HCPCS,36810,Insertion of cannula,,,3125.8,13868.13,11
HCPCS,36815,Insertion of cannula,,,5508.66,24440.06,11
HCPCS,36818,Av fuse uppr arm cephalic,,,5508.66,24440.06,11
HCPCS,36819,Av fuse uppr arm basilic,,,5508.66,24440.06,11
HCPCS,36820,Av fusion/forearm vein,,,5508.66,24440.06,11
HCPCS,36821,Av fusion direct any site,,,3125.8,13868.13,11
HCPCS,36825,Artery-vein autograft,,,5508.66,24440.06,11
HCPCS,36830,Artery-vein nonautograft,,,5508.66,24440.06,11
HCPCS,36831,Open thrombect av fistula,,,5508.66,24440.06,11
HCPCS,36832,Av fistula revision open,,,5508.66,24440.06,11
HCPCS,36833,Av fistula revision,,,5508.66,24440.06,11
HCPCS,36835,Artery to vein shunt,,,3125.8,13868.13,11
HCPCS,36836,Prq av fstl crtj uxtr 1 acs,,,18147.73,80515.32,11
HCPCS,36837,Prq av fstl crt uxtr sep acs,,,18147.73,80515.32,11
HCPCS,36838,Dist revas ligation hemo,,,5508.66,24440.06,11
HCPCS,36860,External cannula declotting,,,496.62,6913.93,11
HCPCS,36861,Cannula declotting,,,5508.66,24440.06,11
HCPCS,36901,HC INTRO CATH DIALYSIS CIRCUIT W/DX ANGIO INCL DIRECT PUNCT/CATH PLACE/INJECT CONTRAST INCL INFERIOR/SUPERIOR VENA CAVA FLUORO GUIDE RAD S&I IMAGE DOC/REPORT,1704.0,1192.8,,,0
HCPCS,36901,Intro cath dialysis circuit,,,1558.36,6913.93,11
HCPCS,36902,HC INTRO CATH DIALYSIS CIRCUIT W/TRANSLUMINAL BALLOON ANGIO PERIPHERAL DIALYSIS SEG INCL IMAGE  RAD S&I,15822.0,11075.4,,,0
HCPCS,36902,Intro cath dialysis circuit,,,5634.46,24998.21,11
HCPCS,36903,Intro cath dialysis circuit,,,11428.37,50703.82,11
HCPCS,36904,HC PERCUT TRANSLUMINAL MECHANICAL THROMBECTOMY/INFUSION ANY METHOD INCL IMAGE/RAD S&I INTERP,19271.0,13489.7,,,0
HCPCS,36904,Thrmbc/nfs dialysis circuit,,,5634.46,24998.21,11
HCPCS,36905,HC THRMBC/NFS DIALYSIS CIRCUIT W/TRANSLUMINAL BALLOON ANGIO PERIPHERAL DIALYSIS SEG INCL IMAGE RAD S&I INTERP,37814.0,26469.8,,,0
HCPCS,36905,Thrmbc/nfs dialysis circuit,,,11428.37,50703.82,11
HCPCS,36906,HC THRMBC/NFS DIALYSIS CIRCUIT W/TRANSCATH PLACE INTRAVASCULAR STENT PERIPHERAL DIALYSIS SEG INCL IMAGE RAD S&I INTERP,21291.0,14903.7,,,0
HCPCS,36906,Thrmbc/nfs dialysis circuit,,,18147.73,80515.32,11
HCPCS,36907,Balo angiop ctr dialysis seg,,,395.39,493.26,4
HCPCS,36907,HC TRANSLUMINAL BALLOON ANGIO CENTRAL DIALYSIS SEG DIALYSIS CIRCUIT INCL IMAGE RAD S&I  (LIST SEP IN ADDITION TO CODE FOR PRIMARY PX),15822.0,11075.4,,,0
HCPCS,36908,Stent plmt ctr dialysis seg,,,592.83,739.57,4
HCPCS,36909,Dialysis circuit embolj,,,562.41,701.62,4
HCPCS,37000001,HC ISOFLURANE INH,5.0,3.5,,,0
HCPCS,37000002,HC SEVOFLURANE INH,248.0,173.6,,,0
HCPCS,37000003,HC DESFLURANE INH,292.0,204.4,,,0
HCPCS,37182,HC INSERT HEPATIC SHUNT (TIPS),13661.0,9562.7,,,0
HCPCS,37182,Insert hepatic shunt (tips),,,5365.77,80515.32,11
HCPCS,37183,HC REVJ TRANSVNS INTRAHEPATIC PORTOSYSTEMIC SHUNT,12254.0,8577.8,,,0
HCPCS,37183,Remove hepatic shunt (tips),,,5634.46,24998.21,11
HCPCS,37184,HC PRIMARY PERCU TRANSLUM MECH THROMBECTOMY NONCORONARY/NONINTRACRANIAL ARTERIAL/ARTERIAL BYPASS GRAFT INCL FLUORO & INTRAPROCEDURAL PHARMACOLOGICAL THROMBOLYTIC INJECTION(S) INITIAL VESSEL,21596.0,15117.2,,,0
HCPCS,37184,Prim art m-thrmbc 1st vsl,,,3352.21,80515.32,11
HCPCS,37185,HC PRIMARY PERCU TRANSLUM MECH THROMBECTOMY NONCORONARY/NONINTRACRANIAL ARTERIAL/ARTERIAL BYPASS GRAFT INCL FLUORO & INTRAPROCEDURAL PHARMACOLOGICAL THROMBOLYTIC INJECTION(S) EACH ADDTL VE*,12777.0,8943.9,,,0
HCPCS,37185,Prim art m-thrmbc sbsq vsl,,,7755.62,9675.33,4
HCPCS,37186,HC SECONDARY PERCU TRANSLUM THROMBECTOMY NONCORONARY/NONINTRACRANIAL ARTERIAL/ARTERIAL BYPASS GRAFT INCL FLUORO & INTRAPROCEDURAL PHARMACOLOGICAL THROMBOLYTIC INJECTION(S),12285.0,8599.5,,,0
HCPCS,37186,Sec art thrombectomy add-on,,,7755.62,9675.33,4
HCPCS,37187,HC PRIM PERQ MECH VEN THROMB,17677.0,12373.9,,,0
HCPCS,37187,Venous mech thrombectomy,,,11110.26,50703.82,11
HCPCS,37188,HC PRIM PERQ MECH VEN THROMB ADDL,15274.0,10691.8,,,0
HCPCS,37188,Venous m-thrombectomy add-on,,,2712.51,13868.13,11
HCPCS,37191,HC INSERT VENA CAVA FILTER,8290.0,5803.0,,,0
HCPCS,37191,Ins endovas vena cava filtr,,,5209.86,24440.06,11
HCPCS,37192,Redo endovas vena cava filtr,,,3125.8,13868.13,11
HCPCS,37193,HC REM ENDOVAS VENA CAVA FILTER,11476.0,8033.2,,,0
HCPCS,37193,Rem endovas vena cava filter,,,3125.8,13868.13,11
HCPCS,37195,HC THROMBOLYSIS CEREBRAL IV,236.0,165.2,,,0
HCPCS,37195,Thrombolytic therapy stroke,,,326.99,1450.75,11
HCPCS,37197,HC TRANSCATHETER RETRIVAL PERCUTANEOUS INTRAVASCULAR FOREIGN BODY,3924.0,2746.8,,,0
HCPCS,37197,Remove intrvas foreign body,,,3125.8,13868.13,11
HCPCS,37200,HC TRANSCATHETER BX,4839.0,3387.3,,,0
HCPCS,37200,Transcatheter biopsy,,,3041.84,24440.06,11
HCPCS,37211,HC TRANSCATH THERAPY ARTERIAL INFUSION FOR THROMBOLYSIS OTHER THAN CORONARY/INTRACRANIAL ANY METHOD INCL RAD S & I INTIAL TX DAY,2631.0,1841.7,,,0
HCPCS,37211,Thrombolytic art therapy,,,2381.82,24440.06,11
HCPCS,37212,HC THROMBOLYTIC VENOUS THERAPY,3770.0,2639.0,,,0
HCPCS,37212,Thrombolytic venous therapy,,,2381.82,13868.13,11
HCPCS,37213,HC THROMBLYTIC ART/VEN THERAPY,3800.0,2660.0,,,0
HCPCS,37213,Thromblytic art/ven therapy,,,3125.8,13868.13,11
HCPCS,37214,Cessj therapy cath removal,,,3125.8,13868.13,11
HCPCS,37214,HC CESSJ THERAPY CATH REMOVAL,3090.0,2163.0,,,0
HCPCS,37215,HC PERQ TRANSCATH STENT CERV CAROTID,7247.0,5072.9,,,0
HCPCS,37216,HC TRANSCATH STENT CCA W/O EPS,40376.0,28263.2,,,0
HCPCS,37217,Stent placemt retro carotid,,,3586.61,4474.39,4
HCPCS,37218,HC TRANSCATH PLACE INTRAVASC STENT(S) INTRATHOR COMM CAROTID ART/INNOM ART OPEN/PERCUT ANTEGRADE APPROACH INCLUD ANGIO WHEN PEF RAD S & I,2873.0,2011.1,,,0
HCPCS,37218,Stent placemt ante carotid,,,2608.89,3254.66,4
HCPCS,37220,HC ILIAC ARTERY REVASC,5498.0,3848.6,,,0
HCPCS,37220,Iliac revasc,,,2419.11,3017.9,4
HCPCS,37221,HC ILIAC ARTERY REVASC STENT,12763.0,8934.1,,,0
HCPCS,37221,Iliac revasc w/stent,,,7597.21,9477.71,4
HCPCS,37222,HC REVASCULARIZATION ENDOVASCULAR OPEN/PERCUTANEOUS ILIAC ARTERY EACH ADDTL IPSILATERAL ILIAC VESSEL W/TRANSLUMINAL ANGIOPLASTY,14351.0,10045.7,,,0
HCPCS,37222,Iliac revasc add-on,,,4653.09,5804.85,4
HCPCS,37223,HC REVASCULARIZATION ENDOVASCULAR OPEN/PERCUTANEOUS ILIAC ARTERY EACH ADDTL IPSILATERAL ILIAC VESSEL W/TRANSLUMINAL STENT PLACEMENT(S) INCL ANGIOPLASTY WITHIN SAME VESSEL,16504.0,11552.8,,,0
HCPCS,37223,Iliac revasc w/stent add-on,,,6693.0,8349.68,4
HCPCS,37224,Fem/popl revas w/tla,,,3876.75,4836.34,4
HCPCS,37224,HC FEM/POPL ART REVASC W/TLA,5498.0,3848.6,,,0
HCPCS,37225,Fem/popl revas w/ather,,,9640.59,12026.88,4
HCPCS,37225,HC FEM/POPL ART REVASC ATHERECT,68415.0,47890.5,,,0
HCPCS,37226,Fem/popl revasc w/stent,,,9360.9,11677.96,4
HCPCS,37226,HC FEM/POPL ART REVASC STENT,42923.0,30046.1,,,0
HCPCS,37227,Fem/popl revasc stnt & ather,,,10431.89,13014.04,4
HCPCS,37227,HC FEM/POPL ART REVASC STENT ARTHR,20213.0,14149.1,,,0
HCPCS,37228,HC TIB/PER ART REVASC W/TLA,17218.0,12052.6,,,0
HCPCS,37228,Tib/per revasc w/tla,,,4042.29,5042.86,4
HCPCS,37229,HC TIB/PER ART REVASC W/ATHERECT,21111.0,14777.7,,,0
HCPCS,37229,Tib/per revasc w/ather,,,24316.2,30335.07,4
HCPCS,37230,HC TIB/PER ART REVASC STENT,21111.0,14777.7,,,0
HCPCS,37230,Tib/per revasc w/stent,,,17436.28,21752.19,4
HCPCS,37231,HC TIB/PER ARAT REVASC STENT ATHER,64135.0,44894.5,,,0
HCPCS,37231,Tib/per revasc stent & ather,,,42113.09,52537.12,4
HCPCS,37232,HC TIB/PER ART REVASC W/TLA ADDL,5498.0,3848.6,,,0
HCPCS,37232,Tib/per revasc add-on,,,1676.11,2090.98,4
HCPCS,37233,HC TIBPER REVASC W/ ATHER ADD-ON,11673.0,8171.1,,,0
HCPCS,37233,Tibper revasc w/ather add-on,,,24316.51,30335.45,4
HCPCS,37234,HC REVSC OPN/PRQ TIB/PERO STENT,5498.0,3848.6,,,0
HCPCS,37234,Revsc opn/prq tib/pero stent,,,11453.95,14289.08,4
HCPCS,37235,HC TIB/PER REVASC STENT & ATHER,17231.0,12061.7,,,0
HCPCS,37235,Tib/per revasc stnt & ather,,,11453.95,14289.08,4
HCPCS,37236,HC TRNSCATH PLACE INTRAVASC STENT OPEN/PERCU INIT ARTERY,13132.0,9192.4,,,0
HCPCS,37236,Open/perq place stent 1st,,,9860.35,50703.82,11
HCPCS,37237,HC TRNSCATH PLACE INTRAVASC STENT OPEN/PERCU EA ADD ART,6351.0,4445.7,,,0
HCPCS,37237,Open/perq place stent ea add,,,692.63,864.07,4
HCPCS,37238,HC TRANSCATH PLACE INTRAVASC OPEN/PERCU INITIAL VEIN,13132.0,9192.4,,,0
HCPCS,37238,Open/perq place stent same,,,9860.35,50703.82,11
HCPCS,37239,HC TRNSCATH PLACE INTRAVASC STENT OPEN/PERCU EA ADD VEIN,6351.0,4445.7,,,0
HCPCS,37239,Open/perq place stent ea add,,,483.89,603.67,4
HCPCS,37241,HC VASC EMBOLIZE/OCCLUDE VENOUS,15212.0,10648.4,,,0
HCPCS,37241,Vasc embolize/occlude venous,,,11428.37,50703.82,11
HCPCS,37242,HC VASC EMBOLIZE/OCCLUDE ARTERY,15212.0,10648.4,,,0
HCPCS,37242,Vasc embolize/occlude artery,,,10517.01,80515.32,11
HCPCS,37243,HC VASC EMBOLIZE/OCCLUDE ORGAN,15212.0,10648.4,,,0
HCPCS,37243,Vasc embolize/occlude organ,,,9879.46,50703.82,11
HCPCS,37244,HC VASC EMBOLIZE/OCCLUDE ART/VENOUS HEMORRHAGE,15212.0,10648.4,,,0
HCPCS,37244,Vasc embolize/occlude bleed,,,11428.37,50703.82,11
HCPCS,37246,HC TRANSLUMINAL BALLOON ANGIO OPEN/ PERCUT INCL IMAGE RAD S&I INITIAL ARTERY,14865.0,10405.5,,,0
HCPCS,37246,Trluml balo angiop 1st art,,,5634.46,24998.21,11
HCPCS,37247,HC TRANSLUMINAL BALLOON ANGIO OPEN/PERCUT INCL IMAGE RAD S&I EACH ADDL ARTERY (LIST SEP IN ADDITION TO CODE FOR PRIMARY PX),623.0,436.1,,,0
HCPCS,37247,Trluml balo angiop addl art,,,559.2,697.61,4
HCPCS,37248,HC TRANSLUMINAL BALLOON ANGIO (EXCEPT DIALYSIS CIRCUIT) OPEN/PERCUT INCL IMAGE RAD S&I INITIAL VEIN,14118.0,9882.6,,,0
HCPCS,37248,Trluml balo angiop 1st vein,,,2712.51,24998.21,11
HCPCS,37249,HC TRANSLUMINAL BALLOON ANGIO OPEN/PERCUT INCL IMAGE RAD S&I EACH ADDL VEIN (LIST SEP IN ADDITION TO CODE FOR PRIMARY PX),4096.0,2867.2,,,0
HCPCS,37249,Trluml balo angiop addl vein,,,475.78,593.54,4
HCPCS,37252,HC IVUS FIRST VESSEL ADD-ON,2540.0,1778.0,,,0
HCPCS,37252,Intrvasc us noncoronary 1st,,,295.52,368.66,4
HCPCS,37253,HC IVUS EA ADD VESSEL ADD -ON,2117.0,1481.9,,,0
HCPCS,37253,Intrvasc us noncoronary addl,,,236.67,295.26,4
HCPCS,37254,Revsc evasc ivt angio sf 1st,,,5634.46,24998.21,7
HCPCS,37256,Revsc evasc ivt angio cplx 1,,,5634.46,24998.21,7
HCPCS,37258,Revsc evasc ivt stent sf 1st,,,11428.37,50703.82,7
HCPCS,37260,Revsc evasc ivt st cplx 1st,,,11428.37,50703.82,7
HCPCS,37263,Revsc evasc fpvt angio sf 1,,,5634.46,24998.21,7
HCPCS,37265,Revsc evsc fpvt angio cplx 1,,,5634.46,24998.21,7
HCPCS,37267,Revsc evsc fpvt stent sf 1st,,,11428.37,50703.82,7
HCPCS,37269,Revsc evasc fpvt st cplx 1st,,,11428.37,50703.82,7
HCPCS,37271,Revsc evsc fpvt athrc sf 1st,,,18147.73,80515.32,7
HCPCS,37273,Revsc evsc fpvt athrc cplx 1,,,18147.73,80515.32,7
HCPCS,37275,Rvsc evsc fpvt st athrc sf 1,,,18147.73,80515.32,7
HCPCS,37277,Rvsc evsc fpvt st athr cpx 1,,,18147.73,80515.32,7
HCPCS,37280,Revsc evsc tpvt angio sf 1st,,,11428.37,50703.82,7
HCPCS,37282,Rvsc evsc tpvt angio cplx 1,,,11428.37,50703.82,7
HCPCS,37284,Revsc evasc tpvt st sf 1st,,,18147.73,80515.32,7
HCPCS,37286,Revsc evasc tpvt st cplx 1st,,,18147.73,80515.32,7
HCPCS,37288,Revsc evsc tpvt athrc sf 1st,,,18147.73,80515.32,7
HCPCS,37290,Revsc evsc tpvt athrc cplx 1,,,18147.73,80515.32,7
HCPCS,37292,Rvsc evsc tpvt st athrc sf 1,,,18147.73,80515.32,7
HCPCS,37294,Rvsc evsc tpvt st athr cpx 1,,,18147.73,80515.32,7
HCPCS,37296,Revsc evasc imvt angio sf 1,,,11428.37,50703.82,7
HCPCS,37298,Revsc evsc imvt angio cplx 1,,,11428.37,50703.82,7
HCPCS,37500,Endoscopy ligate perf veins,,,8524.69,10634.77,4
HCPCS,37501,Vascular endoscopy procedure,,,621.01,6449.28,11
HCPCS,37565,Ligation of neck vein,,,3125.8,13868.13,11
HCPCS,37600,Ligation of neck artery,,,3125.8,13868.13,11
HCPCS,37605,Ligation of neck artery,,,3125.8,13868.13,11
HCPCS,37606,Ligation of neck artery,,,3125.8,13868.13,11
HCPCS,37607,Ligation of a-v fistula,,,3125.8,13868.13,11
HCPCS,37609,Temporal artery procedure,,,1635.03,7891.86,11
HCPCS,37615,Ligation of neck artery,,,3125.8,13868.13,11
HCPCS,37617,Ligation of abdomen artery,,,5508.66,24440.06,11
HCPCS,37619,Ligation of inf vena cava,,,5508.66,24440.06,11
HCPCS,37650,Revision of major vein,,,3125.8,13868.13,11
HCPCS,37700,Revise leg vein,,,3125.8,13868.13,11
HCPCS,37718,Ligate/strip short leg vein,,,3125.8,13868.13,11
HCPCS,37722,Ligate/strip long leg vein,,,3125.8,13868.13,11
HCPCS,37735,Removal of leg veins/lesion,,,3125.8,13868.13,11
HCPCS,37760,Ligate leg veins radical,,,3125.8,13868.13,11
HCPCS,37761,Ligate leg veins open,,,3125.8,13868.13,11
HCPCS,37765,Stab phleb veins xtr 10-20,,,3125.8,13868.13,11
HCPCS,37766,Phleb veins - extrem 20+,,,3125.8,13868.13,11
HCPCS,37780,Revision of leg vein,,,3125.8,13868.13,11
HCPCS,37785,Ligate/divide/excise vein,,,3125.8,13868.13,11
HCPCS,37790,Penile venous occlusion,,,3489.62,15482.25,11
HCPCS,37799,HC UNLISTED PROCEDURE VASCULAR SURGERY,3849.0,2694.3,,,0
HCPCS,37799,Vascular surgery procedure,,,621.01,3828.9,11
HCPCS,38120,Laparoscopy splenectomy,,,8930.95,46687.84,11
HCPCS,38129,Laparoscope proc spleen,,,5984.88,26552.87,11
HCPCS,38205,Harvest allogeneic stem cell,,,2301.8,2871.55,4
HCPCS,38206,Harvest auto stem cells,,,1541.8,6840.45,11
HCPCS,38207,Cryopreserve stem cells,,,436.75,2198.62,11
HCPCS,38208,Thaw preserved stem cells,,,436.75,1937.7,11
HCPCS,38209,Wash harvest stem cells,,,436.75,1937.7,11
HCPCS,38210,T-cell depletion of harvest,,,436.75,1937.7,11
HCPCS,38211,Tumor cell deplete of harvst,,,436.75,1937.7,11
HCPCS,38212,Rbc depletion of harvest,,,436.75,1937.7,11
HCPCS,38213,Platelet deplete of harvest,,,436.75,1937.7,11
HCPCS,38214,Volume deplete of harvest,,,436.75,1937.7,11
HCPCS,38215,Harvest stem cell concentrte,,,436.75,1937.7,11
HCPCS,38220,Bone marrow aspiration,,,1131.06,7254.06,11
HCPCS,38220,HC DIAGNOSTIC BONE MARROW ASPIRATION(S),2867.0,2006.9,,,0
HCPCS,38220,HC PRO DIAGNOSTIC BONE MARROW ASPIRATION(S),126.0,88.2,,,0
HCPCS,38221,Bone marrow biopsy,,,929.4,7254.06,11
HCPCS,38221,HC DIAGNOSTIC BONE MARROW BIOPSY(IES),2952.0,2066.4,,,0
HCPCS,38221,HC PRO DIAGNOSTIC BONE MARROW BIOPSY(IES),403.0,282.1,,,0
HCPCS,38222,Dx bone marrow bx & aspir,,,2875.57,12757.95,11
HCPCS,38222,HC BONE MARROW ASPIRATION W/BONE MARROW BIOPSY SAME INCISION SAME DOS,3259.0,2281.3,,,0
HCPCS,38222,HC PRO BONE MARROW ASPIRATION W/BONE MARROW BIOPSY SAME INCISION SAME DOS,244.0,170.8,,,0
HCPCS,38228,Car-t admn autologous,,,326.99,1450.75,7
HCPCS,38230,Bone marrow harvest allogen,,,1541.8,7637.87,11
HCPCS,38232,Bone marrow harvest autolog,,,4311.81,19130.02,11
HCPCS,38240,Transplt allo hct/donor,,,6122.42,276271.21,11
HCPCS,38241,Transplt autol hct/donor,,,1541.8,7637.87,11
HCPCS,38242,Transplt allo lymphocytes,,,1541.8,6840.45,11
HCPCS,38243,Transplj hematopoietic boost,,,1541.8,6840.45,11
HCPCS,38300,Drainage lymph node lesion,,,2312.53,12757.95,11
HCPCS,38305,Drainage lymph node lesion,,,2875.57,12757.95,11
HCPCS,38308,Incision of lymph channels,,,3876.15,17197.18,11
HCPCS,38500,Biopsy/removal lymph nodes,,,3876.15,17197.18,11
HCPCS,38500,HC BIOPSY/EXCISION LYMPH NODE(S) OPEN SUPERFICIAL,16303.0,11412.1,,,0
HCPCS,38505,NEEDLE BIOPSY LYMPH NODES,1571.0,1099.7,,,0
HCPCS,38505,Needle biopsy lymph nodes,,,1183.9,7254.06,11
HCPCS,38510,Biopsy/removal lymph nodes,,,3876.15,17197.18,11
HCPCS,38520,Biopsy/removal lymph nodes,,,3876.15,17197.18,11
HCPCS,38525,Biopsy/removal lymph nodes,,,3103.42,17197.18,11
HCPCS,38530,Biopsy/removal lymph nodes,,,3876.15,17197.18,11
HCPCS,38531,Open bx/exc inguinofem nodes,,,3876.15,17197.18,11
HCPCS,38542,Explore deep node(s) neck,,,5984.88,26552.87,11
HCPCS,38550,Removal neck/armpit lesion,,,3876.15,17197.18,11
HCPCS,38555,Removal neck/armpit lesion,,,4592.96,29164.62,11
HCPCS,38562,Removal pelvic lymph nodes,,,8091.39,35898.76,11
HCPCS,38570,Laparoscopy lymph node biop,,,5984.88,26552.87,11
HCPCS,38571,Laparoscopy lymphadenectomy,,,6200.65,46687.84,11
HCPCS,38572,Laparoscopy lymphadenectomy,,,4462.0,46687.84,11
HCPCS,38573,Laps pelvic lymphadec,,,10523.19,46687.84,11
HCPCS,38589,Laparoscope proc lymphatic,,,5984.88,26552.87,11
HCPCS,38700,Removal of lymph nodes neck,,,6573.55,29164.62,11
HCPCS,38720,Removal of lymph nodes neck,,,6573.55,29164.62,11
HCPCS,38724,Removal of lymph nodes neck,,,5933.04,7401.61,4
HCPCS,38740,Remove armpit lymph nodes,,,1988.8,26552.87,11
HCPCS,38745,Remove armpit lymph nodes,,,3170.82,26552.87,11
HCPCS,38760,Remove groin lymph nodes,,,3069.2,29164.62,11
HCPCS,38790,HC INJECTION PROCEDURE LYMPHANGIOGRAPHY,815.0,570.5,,,0
HCPCS,38792,HC RA TRACER ID OF SENTINL NODE,1561.0,1092.7,,,0
HCPCS,38792,Ra tracer id of sentinl node,,,395.76,1755.86,11
HCPCS,38999,Blood/lymph system procedure,,,436.75,7657.8,11
HCPCS,38999,HC UNLISTED PROCEDURE HEMIC OR LYMPHATIC SYSTEM,7888.0,5521.6,,,0
HCPCS,39401,Mediastinoscpy w/medstnl bx,,,5984.88,26552.87,11
HCPCS,39402,Mediastinoscpy w/lmph nod bx,,,5984.88,26552.87,11
HCPCS,4,DUMMY EAP FOR NSA - IMPLANTS - $500 INCREMENT,500.0,350.0,,,0
HCPCS,400,HC PRO ANESTH SKIN EXT/PER/ATRUNK,93.0,65.1,,,0
HCPCS,4045F,HC PRO PQRS EMPIRIC ANTIBIOTIC RX,0.01,0.007,,,0
HCPCS,40490,Biopsy of lip,,,234.47,1040.28,11
HCPCS,40500,Partial excision of lip,,,3266.7,14562.0,11
HCPCS,40510,Partial excision of lip,,,3282.2,14562.0,11
HCPCS,40520,Partial excision of lip,,,3266.7,14562.0,11
HCPCS,40525,Reconstruct lip with flap,,,3282.2,14562.0,11
HCPCS,40527,Reconstruct lip with flap,,,4796.64,26000.79,11
HCPCS,40530,Partial removal of lip,,,3282.2,14562.0,11
HCPCS,40650,HC PRO REPAIR LIP VERMILION ONLY,548.0,383.6,,,0
HCPCS,40650,HC REPAIR LIP VERMILION ONLY,965.0,675.5,,,0
HCPCS,40650,Repair lip,,,533.92,2368.81,11
HCPCS,40652,HC PRO REPAIR LIP HALF VERTICAL,608.0,425.6,,,0
HCPCS,40652,HC REPAIR LIP HALF VERTICAL,965.0,675.5,,,0
HCPCS,40652,Repair lip,,,533.92,2368.81,11
HCPCS,40654,HC PRO REPAIR LIP> 1/2 HEIGHT,744.0,520.8,,,0
HCPCS,40654,HC REPAIR LIP FULL THICKNESS OVER ONE-HALF VERTICAL HEIGHT OR COMPLEX,825.0,577.5,,,0
HCPCS,40654,Repair lip,,,1536.02,9269.11,11
HCPCS,40700,Repair cleft lip/nasal,,,5860.44,26000.79,11
HCPCS,40701,Repair cleft lip/nasal,,,5860.44,26000.79,11
HCPCS,40702,Repair cleft lip/nasal,,,5860.44,26000.79,11
HCPCS,40720,Repair cleft lip/nasal,,,3282.2,14562.0,11
HCPCS,40761,Repair cleft lip/nasal,,,5860.44,26000.79,11
HCPCS,40799,Lip surgery procedure,,,234.47,1040.28,11
HCPCS,40800,Drainage of mouth lesion,,,701.03,3360.79,11
HCPCS,40800,HC DRAINAGE OF ABSCESS/CYST/HEMATOMA/VESTIBULE OF MOUTH SIMPLE,243.0,170.1,,,0
HCPCS,40800,HC PRO DRAIN ABSC/CYST/HEMA MOUTH SIMPLE,257.0,179.9,,,0
HCPCS,40801,Drainage of mouth lesion,,,533.92,2368.81,11
HCPCS,40801,HC DRAINAGE ABSCESS/CYST/HEMATOMA/VESTIBULE OF MOUTH COMPLICATED,2393.0,1675.1,,,0
HCPCS,40801,HC PRO DRAINAGE ABSCESS/CYST/HEMATOMA/VESTIBULE OF MOUTH COMPLICATED,503.0,352.1,,,0
HCPCS,40804,HC PRO REMOVAL FOREIGN BODY MOUTH,285.0,199.5,,,0
HCPCS,40804,REMOVAL FOREIGN BODY MOUTH,198.0,138.6,,,0
HCPCS,40804,Removal foreign body mouth,,,126.23,3983.62,11
HCPCS,40805,Removal foreign body mouth,,,533.92,2368.81,11
HCPCS,40806,HC INCISION LABIAL FRENUM,543.0,380.1,,,0
HCPCS,40806,Incision of lip fold,,,500.19,2368.81,11
HCPCS,40808,BIOPSY OF MOUTH LESION,543.0,380.1,,,0
HCPCS,40808,Biopsy of mouth lesion,,,500.19,2368.81,11
HCPCS,40808,HC PRO BIOPSY OF MOUTH LESION,137.0,95.9,,,0
HCPCS,40810,Excision of mouth lesion,,,3282.2,14562.0,11
HCPCS,40812,Excise/repair mouth lesion,,,1536.02,6814.79,11
HCPCS,40814,Excise/repair mouth lesion,,,3266.7,14562.0,11
HCPCS,40816,Excision of mouth lesion,,,3282.2,14562.0,11
HCPCS,40818,Excise oral mucosa for graft,,,500.19,2368.81,11
HCPCS,40819,Excise lip or cheek fold,,,256.46,6814.79,11
HCPCS,40820,Treatment of mouth lesion,,,3266.7,14562.0,11
HCPCS,40830,HC PRO REP MOUTH LACERATION <2.5CM,202.0,141.4,,,0
HCPCS,40830,HC REP MOUTH LACERATION <2.5CM,1036.0,725.2,,,0
HCPCS,40830,Repair mouth laceration,,,234.47,1040.28,11
HCPCS,40831,HC CLOSURE OF LACERATION VESTIBULE OF MOUTH OVER 2.5 CM OR COMPLEX,2393.0,1675.1,,,0
HCPCS,40831,HC PRO MOUTH LACRTN >2.5CM,517.0,361.9,,,0
HCPCS,40831,Repair mouth laceration,,,533.92,2368.81,11
HCPCS,40840,Reconstruction of mouth,,,4796.64,26000.79,11
HCPCS,40842,Reconstruction of mouth,,,4796.64,26000.79,11
HCPCS,40843,Reconstruction of mouth,,,4796.64,26000.79,11
HCPCS,40844,Reconstruction of mouth,,,5860.44,26000.79,11
HCPCS,40845,Reconstruction of mouth,,,5860.44,26000.79,11
HCPCS,4084F,HC PRO PQRS ASPIRIN RECEIVED WITHIN 24 HOURS,0.01,0.007,,,0
HCPCS,40899,Mouth surgery procedure,,,234.47,1040.28,11
HCPCS,410,HC PRO ANESTH FOR PROCEDURES ON INTEGUMENTARY SYST ON EXTREMITIES/ANTERIOR TRUNK/PERINEUM ELECTRICAL CONVERSION OF ARRHYTHMIAS,128.0,89.6,,,0
HCPCS,41000,Drainage of mouth lesion,,,533.92,4075.29,11
HCPCS,41000,HC INTRAORAL INCISION & DRAINAGE OF ABSCESS/CYST/HEMATOMA OF TONGUE/FLOOR OF MOUTH LINGUAL,965.0,675.5,,,0
HCPCS,41000,HC PRO  INTRAORAL INCISION & DRAINAGE OF ABSCESS/CYST/HEMATOMA OF TONGUE/FLOOR OF MOUTH LINGUAL,144.0,100.8,,,0
HCPCS,41005,Drainage of mouth lesion,,,234.47,1040.28,11
HCPCS,41006,Drainage of mouth lesion,,,1536.02,6814.79,11
HCPCS,41007,Drainage of mouth lesion,,,1536.02,6814.79,11
HCPCS,41007,HC INTRAORAL INCISION/DRAINAGE OF ABSCESS/CYST/HEMATOMA OF TONGUE OR FLOOR OF MOUTH SUBMENTAL SPACE,5758.0,4030.6,,,0
HCPCS,41007,HC PRO INTRAORAL INCISION/DRAINAGE OF ABSCESS/CYST/HEMATOMA OF TONGUE OR FLOOR OF MOUTH SUBMENTAL SPACE,501.0,350.7,,,0
HCPCS,41008,Drainage of mouth lesion,,,3266.7,14562.0,11
HCPCS,41008,HC DRAINAGE OF MOUTH LESION,1842.0,1289.4,,,0
HCPCS,41008,HC PRO DRAINAGE OF MOUTH LESION,579.0,405.3,,,0
HCPCS,41009,Drainage of mouth lesion,,,500.19,2368.81,11
HCPCS,41010,HC INCISION OF LINGUAL FRENUM (FRENOTOMY),965.0,675.5,,,0
HCPCS,41010,Incision of tongue fold,,,1536.02,6814.79,11
HCPCS,41015,Drainage of mouth lesion,,,533.92,3360.79,11
HCPCS,41016,Drainage of mouth lesion,,,1489.88,26000.79,11
HCPCS,41017,Drainage of mouth lesion,,,1489.88,14562.0,11
HCPCS,41018,Drainage of mouth lesion,,,1489.88,6814.79,11
HCPCS,41018,HC  PRO EXTRAORAL INCISION & DRAINAGE ABSCESS/CYSTS/HEMATOMA OF MOUTH MASTICATOR SPACE,905.0,633.5,,,0
HCPCS,41018,HC EXTRAORAL INCISION & DRAINAGE ABSCESS/CYSTS/HEMATOMA OF MOUTH MASTICATOR SPACE,5758.0,4030.6,,,0
HCPCS,41019,Place needles h&n for rt,,,4796.64,26000.79,11
HCPCS,41100,Biopsy of tongue,,,533.92,2368.81,11
HCPCS,41105,Biopsy of tongue,,,3266.7,14562.0,11
HCPCS,41108,Biopsy of floor of mouth,,,1489.88,7254.06,11
HCPCS,41110,Excision of tongue lesion,,,3266.7,14562.0,11
HCPCS,41112,Excision of tongue lesion,,,3282.2,14562.0,11
HCPCS,41113,Excision of tongue lesion,,,3266.7,14562.0,11
HCPCS,41114,Excision of tongue lesion,,,3282.2,14562.0,11
HCPCS,41115,Excision of tongue fold,,,1489.88,6814.79,11
HCPCS,41115,HC EXC LINGUAL FRENUM,801.0,560.7,,,0
HCPCS,41116,Excision of mouth lesion,,,3266.7,14562.0,11
HCPCS,41120,Partial removal of tongue,,,5012.69,26000.79,11
HCPCS,41250,HC PRO REP ANT TONGUE MOUTH FLOOR <2.5CM,236.0,165.2,,,0
HCPCS,41250,HC REP ANT TONG MOUTH FLOOR <2.5CM,448.0,313.6,,,0
HCPCS,41250,Repair tongue laceration,,,310.09,1962.08,11
HCPCS,41251,HC PRO REPAIR LACERATION 2.5CM/< POSTERIOR ONE-THIRD TONGUE,235.0,164.5,,,0
HCPCS,41251,HC REPAIR LACERATION 2.5CM/< POSTERIOR ONE-THIRD TONGUE,1036.0,725.2,,,0
HCPCS,41251,Repair tongue laceration,,,234.47,1040.28,11
HCPCS,41252,HC PRO REP TONGUE MOUTH FLOOR >2.5 CM,446.0,312.2,,,0
HCPCS,41252,HC REP TONG MOUTH FLOOR >2.5 CM,922.0,645.4,,,0
HCPCS,41252,Repair tongue laceration,,,234.47,1858.66,11
HCPCS,41510,Tongue to lip surgery,,,3266.7,14562.0,11
HCPCS,41512,Tongue suspension,,,1614.38,26000.79,11
HCPCS,41520,Reconstruction tongue fold,,,1489.88,14562.0,11
HCPCS,41530,Tongue base vol reduction,,,1346.98,14562.0,11
HCPCS,41599,Tongue and mouth surgery,,,234.47,4047.11,11
HCPCS,41800,Drainage of gum lesion,,,131.71,584.37,11
HCPCS,41800,HC I&D GUM LESION,271.0,189.7,,,0
HCPCS,41800,HC PRO I&D GUM LESION,227.0,158.9,,,0
HCPCS,41805,Removal foreign body gum,,,1536.02,6814.79,11
HCPCS,41806,Removal foreign body jawbone,,,1536.02,6814.79,11
HCPCS,41820,Excision gum each quadrant,,,1489.88,14562.0,11
HCPCS,41821,Excision of gum flap,,,1489.88,6814.79,11
HCPCS,41822,Excision of gum lesion,,,1536.02,6814.79,11
HCPCS,41823,Excision of gum lesion,,,4796.64,26000.79,11
HCPCS,41825,Excision of gum lesion,,,3266.7,14562.0,11
HCPCS,41826,Excision of gum lesion,,,3266.7,14562.0,11
HCPCS,41827,Excision of gum lesion,,,4796.64,26000.79,11
HCPCS,41828,Excision of gum lesion,,,1536.02,6814.79,11
HCPCS,41830,Removal of gum tissue,,,3266.7,14562.0,11
HCPCS,41850,Treatment of gum lesion,,,1536.02,6814.79,11
HCPCS,41870,Gum graft,,,1536.02,6814.79,11
HCPCS,41872,Repair gum,,,3266.7,14562.0,11
HCPCS,41874,Repair tooth socket,,,3282.2,14562.0,11
HCPCS,41899,Dental surgery procedure,,,234.47,6413.83,11
HCPCS,42000,Drainage mouth roof lesion,,,234.47,1040.28,11
HCPCS,42000,HC DRAINAGE ABSC PALATE UVULA,863.0,604.1,,,0
HCPCS,42000,HC PRO DRAINAGE ABSCESS PALATE UVULA,177.0,123.9,,,0
HCPCS,42100,Biopsy roof of mouth,,,1489.88,6814.79,11
HCPCS,42104,Excision lesion mouth roof,,,3282.2,14562.0,11
HCPCS,42106,Excision lesion mouth roof,,,3282.2,14562.0,11
HCPCS,42107,Excision lesion mouth roof,,,4796.64,26000.79,11
HCPCS,42120,Remove palate/lesion,,,5860.44,26000.79,11
HCPCS,42140,Excision of uvula,,,2560.87,14562.0,11
HCPCS,42145,Repair palate pharynx/uvula,,,5387.93,26000.79,11
HCPCS,42160,Treatment mouth roof lesion,,,3266.7,14562.0,11
HCPCS,42180,Repair palate,,,500.19,2368.81,11
HCPCS,42182,Repair palate,,,5860.44,26000.79,11
HCPCS,42200,Reconstruct cleft palate,,,5028.33,26000.79,11
HCPCS,42205,Reconstruct cleft palate,,,3282.2,14562.0,11
HCPCS,42210,Reconstruct cleft palate,,,5860.44,26000.79,11
HCPCS,42215,Reconstruct cleft palate,,,5860.44,26000.79,11
HCPCS,42220,Reconstruct cleft palate,,,5860.44,26000.79,11
HCPCS,42225,Reconstruct cleft palate,,,5860.44,26000.79,11
HCPCS,42226,Lengthening of palate,,,5860.44,26000.79,11
HCPCS,42227,Lengthening of palate,,,5860.44,26000.79,11
HCPCS,42235,Repair palate,,,3266.7,26000.79,11
HCPCS,42260,Repair nose to lip fistula,,,4796.64,26000.79,11
HCPCS,42280,Preparation palate mold,,,500.19,2368.81,11
HCPCS,42281,Insertion palate prosthesis,,,3266.7,26000.79,11
HCPCS,42299,Palate/uvula surgery,,,234.47,1040.28,11
HCPCS,42300,Drainage of salivary gland,,,1536.02,6814.79,11
HCPCS,42305,Drainage of salivary gland,,,3266.7,14562.0,11
HCPCS,42310,Drainage of salivary gland,,,533.92,5570.79,11
HCPCS,42320,Drainage of salivary gland,,,500.19,2368.81,11
HCPCS,42330,Removal of salivary stone,,,3266.7,14562.0,11
HCPCS,42335,Removal of salivary stone,,,3266.7,14562.0,11
HCPCS,42340,Removal of salivary stone,,,3266.7,14562.0,11
HCPCS,42400,Biopsy of salivary gland,,,701.03,3110.22,11
HCPCS,42400,NDLE BX SALIVARY GLAND,729.0,510.3,,,0
HCPCS,42405,Biopsy of salivary gland,,,1536.02,6814.79,11
HCPCS,42408,Excision of salivary cyst,,,3266.7,14562.0,11
HCPCS,42409,Drainage of salivary cyst,,,3266.7,14562.0,11
HCPCS,42409,HC DRAINAGE OF SALIVARY CYST,10709.0,7496.3,,,0
HCPCS,42410,Excise parotid gland/lesion,,,5860.44,26000.79,11
HCPCS,42415,Excise parotid gland/lesion,,,5860.44,26000.79,11
HCPCS,42420,Excise parotid gland/lesion,,,5860.44,26000.79,11
HCPCS,42425,Excise parotid gland/lesion,,,5860.44,26000.79,11
HCPCS,42440,Excise submaxillary gland,,,5860.44,26000.79,11
HCPCS,42450,Excise sublingual gland,,,4796.64,26000.79,11
HCPCS,42500,Repair salivary duct,,,4796.64,26000.79,11
HCPCS,42505,Repair salivary duct,,,5860.44,26000.79,11
HCPCS,42507,Parotid duct diversion,,,5860.44,26000.79,11
HCPCS,42509,Parotid duct diversion,,,5860.44,26000.79,11
HCPCS,42510,Parotid duct diversion,,,3282.2,14562.0,11
HCPCS,42600,Closure of salivary fistula,,,3266.7,14562.0,11
HCPCS,42650,Dilation of salivary duct,,,1489.88,6814.79,11
HCPCS,42660,Dilation of salivary duct,,,500.19,2368.81,11
HCPCS,42665,Ligation of salivary duct,,,3282.2,14562.0,11
HCPCS,42699,Salivary surgery procedure,,,234.47,1040.28,11
HCPCS,42700,Drainage of tonsil abscess,,,234.47,1040.28,11
HCPCS,42700,HC PRO I&D TONSIL ABSCESS,459.0,321.3,,,0
HCPCS,42700,I&D TONSIL ABSCESS,574.0,401.8,,,0
HCPCS,42720,Drainage of throat abscess,,,3266.7,14562.0,11
HCPCS,42720,HC PRO DRAIN THROAT ABSCSS INTRAORAL,885.0,619.5,,,0
HCPCS,42725,Drainage of throat abscess,,,5860.44,26000.79,11
HCPCS,42800,Biopsy of throat,,,1536.02,6814.79,11
HCPCS,42800,HC BIOPSY OROPHARYNX,965.0,675.5,,,0
HCPCS,42800,HC PRO BIOPSY OROPHARYNX,213.0,149.1,,,0
HCPCS,42804,Biopsy of upper nose/throat,,,2976.98,14562.0,11
HCPCS,42806,Biopsy of upper nose/throat,,,3282.2,14562.0,11
HCPCS,42808,Excise pharynx lesion,,,3266.7,14562.0,11
HCPCS,42809,REM FB PHARYNX,197.0,137.9,,,0
HCPCS,42809,Remove pharynx foreign body,,,126.23,1962.08,11
HCPCS,42810,Excision of neck cyst,,,3282.2,14562.0,11
HCPCS,42815,Excision of neck cyst,,,5860.44,26000.79,11
HCPCS,42820,Remove tonsils and adenoids,,,5860.44,26000.79,11
HCPCS,42821,Remove tonsils and adenoids,,,3282.2,14562.0,11
HCPCS,42825,Removal of tonsils,,,5860.44,26000.79,11
HCPCS,42826,Removal of tonsils,,,3282.2,14562.0,11
HCPCS,42830,Removal of adenoids,,,3282.2,14562.0,11
HCPCS,42831,Removal of adenoids,,,2376.4,14562.0,11
HCPCS,42835,Removal of adenoids,,,3282.2,14562.0,11
HCPCS,42836,Removal of adenoids,,,3282.2,14562.0,11
HCPCS,42842,Extensive surgery of throat,,,4796.64,26000.79,11
HCPCS,42844,Extensive surgery of throat,,,5860.44,26000.79,11
HCPCS,42860,Excision of tonsil tags,,,3282.2,14562.0,11
HCPCS,42870,Excision of lingual tonsil,,,4452.37,26000.79,11
HCPCS,42890,Partial removal of pharynx,,,5860.44,26000.79,11
HCPCS,42892,Revision of pharyngeal walls,,,5860.44,26000.79,11
HCPCS,42900,HC PRO SUTURE PHARYNX FOR WOUND OR INJURY,840.0,588.0,,,0
HCPCS,42900,HC SUTURE PHARYNX FOR WOUND OR INJURY,5979.0,4185.3,,,0
HCPCS,42900,Repair throat wound,,,1489.88,6814.79,11
HCPCS,42950,Reconstruction of throat,,,5860.44,26000.79,11
HCPCS,42955,Surgical opening of throat,,,1536.02,6814.79,11
HCPCS,42960,Control throat bleeding,,,533.92,6370.48,11
HCPCS,42962,Control throat bleeding,,,3282.2,14562.0,11
HCPCS,42970,Control nose/throat bleeding,,,225.07,1040.28,11
HCPCS,42972,Control nose/throat bleeding,,,3266.7,14562.0,11
HCPCS,42975,Dise eval slp do brth flx dx,,,509.4,7817.58,11
HCPCS,42999,HC PRO UNLISTED PROCEDURE PHARYNX ADENOIDS AND TONSILS,887.0,620.9,,,0
HCPCS,42999,HC UNLISTED PROCEDURE PHARYNX ADENOIDS AND TONSILS,462.0,323.4,,,0
HCPCS,42999,Throat surgery procedure,,,234.47,10205.34,11
HCPCS,43020,Incision of esophagus,,,1489.88,6814.79,11
HCPCS,43030,Throat muscle surgery,,,3266.7,26000.79,11
HCPCS,43130,Removal of esophagus pouch,,,5860.44,26000.79,11
HCPCS,43180,Esophagoscopy rigid trnso,,,5860.44,26000.79,11
HCPCS,43191,Esophagoscopy rigid trnso dx,,,1899.66,8428.13,11
HCPCS,43192,Esophagoscp rig trnso inject,,,1899.66,8428.13,11
HCPCS,43193,Esophagoscp rig trnso biopsy,,,1899.66,8428.13,11
HCPCS,43194,Esophagoscp rig trnso rem fb,,,1899.66,8428.13,11
HCPCS,43195,Esophagoscopy rigid balloon,,,3226.53,16933.82,11
HCPCS,43196,Esophagoscp guide wire dilat,,,1899.66,8428.13,11
HCPCS,43197,Esophagoscopy flex dx brush,,,897.89,3983.62,11
HCPCS,43198,Esophagosc flex trnsn biopsy,,,897.89,3983.62,11
HCPCS,43200,Esophagoscopy flexible brush,,,897.89,3983.62,11
HCPCS,43200,HC ESOPHAGOSCOPY FLEXIBLE DX INCL COLLECTION OF SPECIMEN BRUSHING/WASHING,3509.0,2456.3,,,0
HCPCS,43201,Esoph scope w/submucous inj,,,1701.07,8428.13,11
HCPCS,43202,Esophagoscopy flex biopsy,,,1701.07,8428.13,11
HCPCS,43202,HC ESOPHAGOSCOPY FLEXIBLE TRANSORAL W/BIOPSY SINGLE/ MULTIPLE,3608.0,2525.6,,,0
HCPCS,43204,Esoph scope w/sclerosis inj,,,1701.07,8428.13,11
HCPCS,43205,Esophagus endoscopy/ligation,,,1701.07,8428.13,11
HCPCS,43206,Esoph optical endomicroscopy,,,1899.66,8428.13,11
HCPCS,43210,Egd esophagogastrc fndoplsty,,,10523.19,46687.84,11
HCPCS,43210,HC EGD ESOPHAGOGASTRC FUNDOPLASTY,3208.0,2245.6,,,0
HCPCS,43211,Esophagoscop mucosal resect,,,1899.66,8428.13,11
HCPCS,43212,Esophagoscop stent placement,,,6009.99,26664.3,11
HCPCS,43213,Esophagoscopy retro balloon,,,1899.66,8428.13,11
HCPCS,43214,Esophagosc dilate balloon 30,,,1899.66,8428.13,11
HCPCS,43215,Esophagoscopy flex remove fb,,,1701.07,8428.13,11
HCPCS,43216,Esophagoscopy lesion removal,,,1701.07,8428.13,11
HCPCS,43217,Esophagoscopy snare les remv,,,1701.07,8428.13,11
HCPCS,43220,Esophagoscopy balloon <30mm,,,1899.66,8428.13,11
HCPCS,43226,Esoph endoscopy dilation,,,1701.07,8428.13,11
HCPCS,43227,Esophagoscopy control bleed,,,1701.07,8428.13,11
HCPCS,43229,Esophagoscopy lesion ablate,,,3092.8,16933.82,11
HCPCS,43229,HC ESOPH FLEX TRANSORAL W/ABLATION TUMOR/POLYP/OTHER LESIONS,16197.0,11337.9,,,0
HCPCS,43231,Esophagoscop ultrasound exam,,,1701.07,8428.13,11
HCPCS,43232,Esophagoscopy w/us needle bx,,,1701.07,8428.13,11
HCPCS,43233,Egd balloon dil esoph30 mm/>,,,1261.21,8428.13,11
HCPCS,43233,HC EGD BALLOON DILATION ESOPHAGUS 30MM OR LARGER,3808.0,2665.6,,,0
HCPCS,43235,Egd diagnostic brush wash,,,897.89,3983.62,11
HCPCS,43235,HC EGD DIAGNOSTIC BRUSH WASH,3509.0,2456.3,,,0
HCPCS,43236,HC EGD FLEXIBLE TRANSORAL W/SUBMUCOSAL INJECTION,4199.0,2939.3,,,0
HCPCS,43236,Uppr gi scope w/submuc inj,,,897.89,3983.62,11
HCPCS,43237,Endoscopic us exam esoph,,,1698.82,8428.13,11
HCPCS,43237,HC EGD FLEXIBLE TRANSORAL W/ULTRASOUND ESOPHAGUS/STOMACH/DUODENUM,4266.0,2986.2,,,0
HCPCS,43238,Egd us fine needle bx/aspir,,,880.93,8428.13,11
HCPCS,43238,HC EGD W/US FINE NEEDLE ASPIRATION/BIOPSY,5378.0,3764.6,,,0
HCPCS,43239,Egd biopsy single/multiple,,,897.89,3983.62,11
HCPCS,43239,HC EGD W/BIOPSY SINGLE/MULTIPLE,3608.0,2525.6,,,0
HCPCS,43240,Egd w/transmural drain cyst,,,1701.07,26664.3,11
HCPCS,43240,HC EGD FLEXIBLE TRANSORAL W/TRANSMURAL DRAIN CYST AND ENDOSCOPIC US,4194.0,2935.8,,,0
HCPCS,43241,Egd tube/cath insertion,,,1701.07,8428.13,11
HCPCS,43241,HC EGD INTRALUMINAL TUBE/CATHETER INSERTION,3803.0,2662.1,,,0
HCPCS,43241,HC PRO EGD INTRALUMINAL TUBE/CATHETER INSERTION,328.0,229.6,,,0
HCPCS,43242,Egd us fine needle bx/aspir,,,1899.66,8428.13,11
HCPCS,43242,HC EGD W/US FINE NEEDLE ASPIRATION/BIOPSY ALTERED ANATOMY,5378.0,3764.6,,,0
HCPCS,43243,Egd injection varices,,,1701.07,8428.13,11
HCPCS,43244,Egd varices ligation,,,1899.66,8428.13,11
HCPCS,43244,HC EGD FLEXIBLE/TRANSORAL W/BAND LIGATION ESOPHAGEAL/GASTRIC VARICES,5104.0,3572.8,,,0
HCPCS,43245,Egd dilate stricture,,,1701.07,8428.13,11
HCPCS,43245,HC EGD DILATE STRICTURE,3808.0,2665.6,,,0
HCPCS,43246,Egd place gastrostomy tube,,,1899.66,8428.13,11
HCPCS,43246,HC EGD PLACE GASTROSTOMY TUBE,5474.0,3831.8,,,0
HCPCS,43247,Egd remove foreign body,,,897.89,3983.62,11
HCPCS,43247,HC EGD REMOVE FOREIGN BODY,3966.0,2776.2,,,0
HCPCS,43247,HC PRO OPERATIVE UPPER GI ENDOSCOPY W/ REM FB,850.0,595.0,,,0
HCPCS,43248,Egd guide wire insertion,,,897.89,3983.62,11
HCPCS,43248,HC EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS,3208.0,2245.6,,,0
HCPCS,43249,Esoph egd dilation <30 mm,,,1457.31,8428.13,11
HCPCS,43249,HC EGD W/BALLOON DILATION ESOPH LESS THAN 30MM,3808.0,2665.6,,,0
HCPCS,43250,Egd cautery tumor polyp,,,864.04,8428.13,11
HCPCS,43250,HC EGD CAUTERY TUMOR/POLYP/LESIONS,3705.0,2593.5,,,0
HCPCS,43251,Egd remove lesion snare,,,1391.19,8428.13,11
HCPCS,43251,HC EGD REMOVAL OF TUMOR/POLYP/LESIONS BY SNARE,3705.0,2593.5,,,0
HCPCS,43252,Egd optical endomicroscopy,,,1899.66,8428.13,11
HCPCS,43253,Egd us transmural injxn/mark,,,1899.66,8428.13,11
HCPCS,43254,Egd endo mucosal resection,,,1899.66,8428.13,11
HCPCS,43254,HC EGD ENDO MUCOSAL RESECTION,4199.0,2939.3,,,0
HCPCS,43255,Egd control bleeding any,,,1378.47,8428.13,11
HCPCS,43255,HC EGD CONTROL BLEEDING ANY METHOD,4199.0,2939.3,,,0
HCPCS,43257,Egd w/thrml txmnt gerd,,,3816.79,16933.82,11
HCPCS,43259,Egd us exam duodenum/jejunum,,,997.33,8428.13,11
HCPCS,43259,HC EGD US EXAM ESOPH/STOMACH/DUODENUM/JEJUNUM,4266.0,2986.2,,,0
HCPCS,43260,Ercp w/specimen collection,,,3134.78,16933.82,11
HCPCS,43260,HC ERCP W/SPECIMEN COLLECTION BY BRUSHING OR WASHING,5015.0,3510.5,,,0
HCPCS,43261,Endo cholangiopancreatograph,,,1791.05,16933.82,11
HCPCS,43261,HC ERCP W/ BIOPSY SINGLE/MULTIPLE,5114.0,3579.8,,,0
HCPCS,43262,Endo cholangiopancreatograph,,,1880.23,16933.82,11
HCPCS,43262,HC ERCP W/SPHINCTEROTOMY/PAPILLOTOMY,5189.0,3632.3,,,0
HCPCS,43263,Ercp sphincter pressure meas,,,1899.66,8428.13,11
HCPCS,43264,Ercp remove duct calculi,,,1880.22,16933.82,11
HCPCS,43264,HC ERCP REMOVAL CALCULI/DEBRIS BILLIARY/PANCREATIC DUCT,5527.0,3868.9,,,0
HCPCS,43265,Ercp lithotripsy calculi,,,4191.37,26664.3,11
HCPCS,43265,HC ERCP W/DESTRUCTION/LITHOTRIPSY OF CALCULI,5659.0,3961.3,,,0
HCPCS,43266,Egd endoscopic stent place,,,6009.99,26664.3,11
HCPCS,43266,HC EGD W/ ESOPHAGEAL STENT PLACEMENT,4797.0,3357.9,,,0
HCPCS,43270,Egd lesion ablation,,,1899.66,8428.13,11
HCPCS,43270,HC EGD W/ABLATION TUMOR/POLYP/LESION,3705.0,2593.5,,,0
HCPCS,43273,Endoscopic pancreatoscopy,,,1840.27,2295.78,4
HCPCS,43273,HC ENDOSCOPIC CANNULATION OF PAPILLA WITH DIRECT VISUALIZATION OF PANCREATIC/COMMON BILE DUCT(S),7099.0,4969.3,,,0
HCPCS,43274,Ercp duct stent placement,,,1791.05,26664.3,11
HCPCS,43274,HC ERCP DUCT SENT PLACEMENT BILLIARY/PANCREATIC DUCT,5700.0,3990.0,,,0
HCPCS,43275,Ercp remove forgn body duct,,,1899.66,8428.13,11
HCPCS,43275,HC ERCP REMOVE FOREIGN BODY/STENT FROM BILLIARY/PANCREATIC DUCT,5872.0,4110.4,,,0
HCPCS,43276,Ercp stent exchange w/dilate,,,6009.99,26664.3,11
HCPCS,43276,HC ERCP W/REMOVAL/EXCHANGE STENT/BILLIARY/PANCREATIC DUCT W/DILATE & GUIDEWIRE,6100.0,4270.0,,,0
HCPCS,43277,Ercp ea duct/ampulla dilate,,,1791.05,16933.82,11
HCPCS,43277,HC ERCP BALLOON DILATION BILLIARY/PNACREATIC DUCT AMPULLA,4714.0,3299.8,,,0
HCPCS,43278,Ercp lesion ablate w/dilate,,,3816.79,16933.82,11
HCPCS,43278,HC ERCP W/ABLATION TUMOR/POLYP/LESION W/DILATION & GUIDEWIRE,5211.0,3647.7,,,0
HCPCS,43279,Lap myotomy heller,,,8394.52,10472.38,4
HCPCS,43280,Laparoscopy fundoplasty,,,9392.87,46687.84,11
HCPCS,43281,Lap paraesophag hern repair,,,10523.19,46687.84,11
HCPCS,43282,Lap paraesoph her rpr w/mesh,,,10523.19,46687.84,11
HCPCS,43283,Lap esoph lengthening,,,5028.33,6272.96,4
HCPCS,43284,Laps esophgl sphnctr agmntj,,,10523.19,46687.84,11
HCPCS,43285,Rmvl esophgl sphnctr dev,,,5984.88,26552.87,11
HCPCS,43286,Esphg tot w/laps moblj,,,10054.66,12543.44,4
HCPCS,43287,Esphg dstl 2/3 w/laps moblj,,,11426.65,14255.02,4
HCPCS,43288,Esphg thrsc moblj,,,11988.53,14955.99,4
HCPCS,43289,HC UNLISTED LAPAROSCOPY PROCEDURE ESOPHAGUS,44324.0,31026.8,,,0
HCPCS,43289,Laparoscope proc esoph,,,5984.88,26552.87,11
HCPCS,43290,Egd flx trnsorl dplmnt balo,,,1899.66,8428.13,11
HCPCS,43291,Egd flx trnsorl rmvl balo,,,897.89,3983.62,11
HCPCS,43327,Esoph fundoplasty lap,,,2419.82,3018.78,4
HCPCS,43328,Esoph fundoplasty thor,,,3470.9,4330.03,4
HCPCS,43332,Transab esoph hiat hern rpr,,,3451.32,4305.61,4
HCPCS,43333,Transab esoph hiat hern rpr,,,3752.69,4681.57,4
HCPCS,43334,Transthor diaphrag hern rpr,,,3729.51,4652.65,4
HCPCS,43335,Transthor diaphrag hern rpr,,,3979.03,4963.93,4
HCPCS,43336,Thorabd diaphr hern repair,,,4536.82,5659.79,4
HCPCS,43337,Thorabd diaphr hern repair,,,4885.81,6095.17,4
HCPCS,43338,Esoph lengthening,,,348.15,434.32,4
HCPCS,43420,Repair esophagus opening,,,3282.2,14562.0,11
HCPCS,43450,Dilate esophagus 1/mult pass,,,897.89,3983.62,11
HCPCS,43450,HC DILATION OF ESOPHAGUS SINGLE/MULTIPLE PASSES,3628.0,2539.6,,,0
HCPCS,43453,Dilate esophagus,,,1594.45,8428.13,11
HCPCS,43460,HC ESOPHAGOGASTRIC TAMPONADE W/BALLOON,4004.0,2802.8,,,0
HCPCS,43497,HC LOWER ESOPHAGEAL MYOTOMY TRANSORAL (POEM),25343.0,17740.1,,,0
HCPCS,43497,Transorl lwr esophgl myotomy,,,6009.99,26664.3,11
HCPCS,43499,Esophagus surgery procedure,,,897.89,3983.62,11
HCPCS,43510,Surgical opening of stomach,,,897.89,3983.62,11
HCPCS,43647,Lap impl electrode antrum,,,11030.91,48940.4,11
HCPCS,43648,Lap revise/remv eltrd antrum,,,6881.1,46687.84,11
HCPCS,43651,Laparoscopy vagus nerve,,,5984.88,26552.87,11
HCPCS,43652,Laparoscopy vagus nerve,,,5984.88,26552.87,11
HCPCS,43653,Laparoscopy gastrostomy,,,5763.16,26552.87,11
HCPCS,43659,HC UNLISTED LAPAROSCOPY PROCEDURE STOMACH,31396.0,21977.2,,,0
HCPCS,43659,Laparoscope proc stom,,,5984.88,26552.87,11
HCPCS,43752,HC NASO/OROGASTRIC TUBE PLACE FLUORO GUIDE,234.0,163.8,,,0
HCPCS,43752,HC PRO NASO/OROGASTRIC TUBE PLACE FLUORO GUIDE,93.0,65.1,,,0
HCPCS,43752,Nasal/orogastric w/tube plmt,,,265.49,1962.08,11
HCPCS,43753,HC INTUBATE GASTRIC WITH ASP,173.0,121.1,,,0
HCPCS,43753,HC PRO INTUBATE GASTRIC WITH ASP,394.0,275.8,,,0
HCPCS,43753,Tx gastro intub w/asp,,,117.26,948.37,11
HCPCS,43754,Dx gastr intub w/asp spec,,,140.08,948.37,11
HCPCS,43755,Dx gastr intub w/asp specs,,,127.38,565.15,11
HCPCS,43756,Dx duod intub w/asp spec,,,253.01,3983.62,11
HCPCS,43757,Dx duod intub w/asp specs,,,253.01,3983.62,11
HCPCS,43757,HC DUODENAL INTUBATION/ASPIRATION DX INCL IMAGE GUIDANCE COLLECT MULTIPLE SPECIMENS SINGLE OR DOUBLE LUMEN  TUBE INCL DRUG ADMIN,3912.0,2738.4,,,0
HCPCS,43761,HC REPOSITIONING NASO-OR ORO-GASTRIC FEEDING TUBE THRU DUODENUM FOR ENTERIC NUTRITION,2583.0,1808.1,,,0
HCPCS,43761,Reposition gastrostomy tube,,,247.34,2122.13,11
HCPCS,43762,HC PRO REPLACE OF GASTRO TUBE PERCUTANEOUS INCL REMOVE W/O IMAGE OR ENDO GUIDE NOT REQ REV OF GASTRO,59.0,41.3,,,0
HCPCS,43762,HC REPLACE OF GASTRO TUBE PERCUTANEOUS INCL REMOVE W/O IMAGE OR ENDO GUIDE NOT REQ REV GASTRO TRACT,922.0,645.4,,,0
HCPCS,43762,Rplc gtube no revj trc,,,247.34,1097.37,11
HCPCS,43763,HC PRO REPLACE OF GASTRO TUBE PERCUTANEOUS INCL REMOVE W/O IMAGE OR ENDO GUIDE REQ REV OF GASTRO,146.0,102.2,,,0
HCPCS,43763,HC REPLACE OF GASTRO TUBE PERCUTANEOUS INCL REMOVE W/O IMAGE OR ENDO GUIDE REQ REVISE GASTRO TRACT,922.0,645.4,,,0
HCPCS,43763,Rplc gtube  revj gstrst trc,,,247.34,1097.37,11
HCPCS,43770,Lap place gastr adj device,,,10523.19,46687.84,11
HCPCS,43772,Lap rmvl gastr adj device,,,3816.79,16933.82,11
HCPCS,43773,Lap replace gastr adj device,,,5984.88,26552.87,11
HCPCS,43774,Lap rmvl gastr adj all parts,,,3816.79,16933.82,11
HCPCS,43830,Place gastrostomy tube,,,1899.66,8428.13,11
HCPCS,43831,Place gastrostomy tube,,,897.89,3983.62,11
HCPCS,43840,Repair of stomach lesion,,,3816.79,19007.81,11
HCPCS,43870,Repair stomach opening,,,1701.07,16933.82,11
HCPCS,43886,Revise gastric port open,,,3508.17,15564.58,11
HCPCS,43887,Remove gastric port open,,,905.52,9062.24,11
HCPCS,43888,Change gastric port open,,,3508.17,15564.58,11
HCPCS,43889,Gstr rstcv px trnsorl esg,,,10523.19,46687.84,7
HCPCS,43999,Stomach surgery procedure,,,897.89,3983.62,11
HCPCS,44100,Biopsy of bowel,,,897.89,3983.62,11
HCPCS,44180,Lap enterolysis,,,2881.58,26552.87,11
HCPCS,44186,Lap jejunostomy,,,5984.88,26552.87,11
HCPCS,44206,Lap part colectomy w/stoma,,,13936.97,17386.71,4
HCPCS,44207,L colectomy/coloproctostomy,,,13936.97,17386.71,4
HCPCS,44208,L colectomy/coloproctostomy,,,13936.97,17386.71,4
HCPCS,44213,Lap mobil splenic fl add-on,,,6881.1,8584.34,4
HCPCS,44238,Laparoscope proc intestine,,,5984.88,26552.87,11
HCPCS,44300,Open bowel to skin,,,1899.66,8428.13,11
HCPCS,44312,Revision of ileostomy,,,3508.17,15564.58,11
HCPCS,44314,Revision of ileostomy,,,3508.17,15564.58,11
HCPCS,44340,Revision of colostomy,,,3508.17,15564.58,11
HCPCS,44345,Revision of colostomy,,,3508.17,15564.58,11
HCPCS,44346,Revision of colostomy,,,3508.17,15564.58,11
HCPCS,44360,Small bowel endoscopy,,,1899.66,8428.13,11
HCPCS,44361,HC SMALL BOWEL ENDOSCOPY W/BIOPSY NOT INCL ILEUM SINGLE/MULTIPLE,3608.0,2525.6,,,0
HCPCS,44361,Small bowel endoscopy/biopsy,,,1899.66,8428.13,11
HCPCS,44363,Small bowel endoscopy,,,1899.66,8428.13,11
HCPCS,44364,Small bowel endoscopy,,,1899.66,8428.13,11
HCPCS,44365,Small bowel endoscopy,,,1899.66,8428.13,11
HCPCS,44366,Small bowel endoscopy,,,1899.66,8428.13,11
HCPCS,44369,Small bowel endoscopy,,,1899.66,8428.13,11
HCPCS,44370,Small Bowel Endoscopy/Stent,,,4997.71,26664.3,11
HCPCS,44372,Small bowel endoscopy,,,1899.66,8428.13,11
HCPCS,44373,Small bowel endoscopy,,,1899.66,8428.13,11
HCPCS,44376,Small bowel endoscopy,,,1899.66,8428.13,11
HCPCS,44377,HC SMALL BOWEL ENDOSCOPY W/BIOPSY INCL ILEUM SINGLE/MULTIPLE,4172.0,2920.4,,,0
HCPCS,44377,Small bowel endoscopy/biopsy,,,1554.5,8428.13,11
HCPCS,44378,Small bowel endoscopy,,,1899.66,8428.13,11
HCPCS,44379,S Bowel Endoscope W/Stent,,,4997.71,26664.3,11
HCPCS,44380,HC ILEOSCOPY THRU STOMA DX INCL COLLECTION SPECIMEN BRUSHING/WASHING,4263.0,2984.1,,,0
HCPCS,44380,Small bowel endoscopy br/wa,,,897.89,3983.62,11
HCPCS,44381,HC ILEOSCOPY THRU STOMA W/BALLOON DILATION,4562.0,3193.4,,,0
HCPCS,44381,Small bowel endoscopy br/wa,,,1899.66,8428.13,11
HCPCS,44382,HC ILEOSCOPY THRU STOMA W/BIOPSY SINGLE/MULTIPLE,1312.0,918.4,,,0
HCPCS,44382,Small bowel endoscopy,,,897.89,3983.62,11
HCPCS,44384,HC ILEOSCOPY THRU STOMA W/STENT PLACEMENT,4948.0,3463.6,,,0
HCPCS,44384,Small bowel endoscopy,,,1899.66,8428.13,11
HCPCS,44385,Endoscopy of bowel pouch,,,920.63,4084.51,11
HCPCS,44385,HC ENDOSCOPY OF BOWEL POUCH BRUSHING/WASHING,1213.0,849.1,,,0
HCPCS,44386,Endoscopy bowel pouch/biop,,,920.63,4084.51,11
HCPCS,44386,HC ENDOSCOPY OF BOWEL POUCH W/BIOPSY SINGLE/MULTIPLE,1312.0,918.4,,,0
HCPCS,44388,Colonoscopy thru stoma spx,,,920.63,4084.51,11
HCPCS,44388,HC COLONOSCOPY THRU STOMA DX INCL COLLECTION OF SPECIMEN,4073.0,2851.1,,,0
HCPCS,44389,Colonoscopy with biopsy,,,1184.64,5255.83,11
HCPCS,44389,HC COLONOSCOPY THRU STOMA W/BIOPSY SINGLE/MULTIPLE,4172.0,2920.4,,,0
HCPCS,44390,Colonoscopy for foreign body,,,920.63,4084.51,11
HCPCS,44391,Colonoscopy for bleeding,,,1184.64,5255.83,11
HCPCS,44392,Colonoscopy & polypectomy,,,1184.64,5255.83,11
HCPCS,44394,Colonoscopy w/snare,,,1184.64,5255.83,11
HCPCS,44394,HC COLONOSCOPY THRU STOMA W/REMOVAL TUMOR/POLYP/OTHER LESIONS BY SNARE,4269.0,2988.3,,,0
HCPCS,44401,Colonoscopy with ablation,,,1184.64,5255.83,11
HCPCS,44402,Colonoscopy w/stent plcmt,,,2393.28,26664.3,11
HCPCS,44403,Colonoscopy w/resection,,,1184.64,5255.83,11
HCPCS,44404,Colonoscopy w/injection,,,1184.64,5255.83,11
HCPCS,44404,HC COLONOSCOPY THRU STOMA W/SUBMUCOSAL INJECTION,4763.0,3334.1,,,0
HCPCS,44405,Colonoscopy w/dilation,,,1184.64,5255.83,11
HCPCS,44406,Colonoscopy w/ultrasound,,,1184.64,5255.83,11
HCPCS,44406,HC COLONOSCOPY THRU STOMA W/ENDO US,4830.0,3381.0,,,0
HCPCS,44407,Colonoscopy w/ndl aspir/bx,,,1184.64,5255.83,11
HCPCS,44407,HC COLONOSCOPY THRU STOMA US FINE NEEDLE ASPIRATION/BIOPSY,5942.0,4159.4,,,0
HCPCS,44408,Colonoscopy w/decompression,,,920.63,4084.51,11
HCPCS,44500,HC PLACEMENT LONG GI TUBE,655.0,458.5,,,0
HCPCS,44500,Intro gastrointestinal tube,,,647.84,3983.62,11
HCPCS,44602,Suture small intestine,,,3816.79,16933.82,11
HCPCS,44705,HC FECAL MICROBIOTA PREP INSTIL,4012.0,2808.4,,,0
HCPCS,44799,HC UNLISTED PROCEDURE SMALL INTESTINE,9207.0,6444.9,,,0
HCPCS,44799,Unlisted px small intestine,,,897.89,6412.77,11
HCPCS,44950,Appendectomy,,,6408.87,28434.0,11
HCPCS,44970,Laparoscopy appendectomy,,,5984.88,26552.87,11
HCPCS,44979,Laparoscope proc app,,,4090.24,26552.87,11
HCPCS,45000,Drainage of pelvic abscess,,,1184.64,5255.83,11
HCPCS,45005,Drainage of rectal abscess,,,1184.64,5255.83,11
HCPCS,45005,HC DRAINAGE OF RECTAL ABSCESS,4388.0,3071.6,,,0
HCPCS,45005,HC PRO I&D SUBMUCOSAL ABSCESS RECTUM,377.0,263.9,,,0
HCPCS,45020,Drainage of rectal abscess,,,2183.27,12191.12,11
HCPCS,45100,Biopsy of rectum,,,359.6,12191.12,11
HCPCS,45108,Removal of anorectal lesion,,,2747.81,12191.12,11
HCPCS,45150,Excision of rectal stricture,,,1184.64,5676.62,11
HCPCS,45160,Excision of rectal lesion,,,2747.81,12191.12,11
HCPCS,45171,Exc rect tum transanal part,,,2747.81,12191.12,11
HCPCS,45172,Exc rect tum transanal full,,,2747.81,12191.12,11
HCPCS,45190,Destruction rectal tumor,,,2747.81,12191.12,11
HCPCS,45300,Proctosigmoidoscopy dx,,,920.63,4116.6,11
HCPCS,45303,Proctosigmoidoscopy dilate,,,1184.64,5255.83,11
HCPCS,45305,Proctosigmoidoscopy w/bx,,,1184.64,5255.83,11
HCPCS,45307,Proctosigmoidoscopy fb,,,2747.81,12191.12,11
HCPCS,45308,Proctosigmoidoscopy removal,,,1741.13,12191.12,11
HCPCS,45309,Proctosigmoidoscopy removal,,,1184.64,5255.83,11
HCPCS,45315,Proctosigmoidoscopy removal,,,1184.64,5255.83,11
HCPCS,45317,Proctosigmoidoscopy bleed,,,1184.64,5255.83,11
HCPCS,45320,Proctosigmoidoscopy ablate,,,2747.81,12191.12,11
HCPCS,45321,Proctosigmoidoscopy volvul,,,2747.81,12191.12,11
HCPCS,45327,Proctosigmoidoscopy W/Stent,,,4997.71,26664.3,11
HCPCS,45330,Diagnostic sigmoidoscopy,,,920.63,4084.51,11
HCPCS,45330,HC DIAGNOSTIC SIGMOIDOSCOPY,3020.0,2114.0,,,0
HCPCS,45331,HC FLEXIBLE SIGMOIDOSCOPY W/ BIOPSY,3420.0,2394.0,,,0
HCPCS,45331,Sigmoidoscopy and biopsy,,,920.63,4084.51,11
HCPCS,45332,Sigmoidoscopy w/fb removal,,,1019.72,5255.83,11
HCPCS,45333,Sigmoidoscopy & polypectomy,,,920.63,4084.51,11
HCPCS,45334,HC FLEXIBLE SIGMOIDOSCOPY W/ BLEEDING CONTROL,4011.0,2807.7,,,0
HCPCS,45334,Sigmoidoscopy for bleeding,,,1184.64,5255.83,11
HCPCS,45335,HC SIGMOIDOSCOPY W/SUBMUCOSAL INJECTION,4011.0,2807.7,,,0
HCPCS,45335,Sigmoidoscopy w/submuc inj,,,920.63,4084.51,11
HCPCS,45337,Sigmoidoscopy & decompress,,,920.63,4084.51,11
HCPCS,45338,HC SIGMOIDOSCOPY W/REMOVAL TUMOR/POLYP/LESION,3517.0,2461.9,,,0
HCPCS,45338,Sigmoidoscopy w/tumr remove,,,1184.64,5255.83,11
HCPCS,45340,HC SIGMOIDOSCOPY FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILATION,3620.0,2534.0,,,0
HCPCS,45340,Sig w/tndsc balloon dilation,,,1184.64,5255.83,11
HCPCS,45341,HC SIGMOIDOSCOPY W/ULTRASOUND,4078.0,2854.6,,,0
HCPCS,45341,Sigmoidoscopy W/Ultrasound,,,920.63,4084.51,11
HCPCS,45342,HC SIGMOIDOSCOPY FLEXIBLE W/TRANSENDO US GUIDED FINE NEEDLE ASPIRATON/BIOPSY,5190.0,3633.0,,,0
HCPCS,45342,Sigmoidoscopy W/Us Guide Bx,,,1184.64,5255.83,11
HCPCS,45346,HC SIGMOIDOSCOPY W/ABLATION,3517.0,2461.9,,,0
HCPCS,45346,Sigmoidoscopy w/ablation,,,1184.64,5255.83,11
HCPCS,45347,Sigmoidoscopy w/plcmt stent,,,2507.08,26664.3,11
HCPCS,45349,HC SIGMOIDOSCOPY W/RESECTION,4011.0,2807.7,,,0
HCPCS,45349,Sigmoidoscopy w/resection,,,508.7,12191.12,11
HCPCS,45350,HC SIGMOIDOSCOPY W/BAND LIGATION,6671.0,4669.7,,,0
HCPCS,45350,Sgmdsc w/band ligation,,,1184.64,5255.83,11
HCPCS,45378,Diagnostic colonoscopy,,,172.86,4084.51,15
HCPCS,45378,HC COLONOSCOPY DIAGNOSTIC,3772.0,2640.4,,,0
HCPCS,45379,Colonoscopy w/fb removal,,,1184.64,5255.83,11
HCPCS,45379,HC COLONOSCOPY W/ FOREIGN BODY REMOVAL,4530.0,3171.0,,,0
HCPCS,45380,Colonoscopy and biopsy,,,1184.64,5255.83,11
HCPCS,45380,HC COLONOSCOPY W/ BIOPSY,4172.0,2920.4,,,0
HCPCS,45381,Colonoscopy submucous njx,,,1184.64,5255.83,11
HCPCS,45381,HC COLONOSCOPY W/SUBMUCOSAL INJECTION,4763.0,3334.1,,,0
HCPCS,45382,Colonoscopy w/control bleed,,,1184.64,5255.83,11
HCPCS,45382,HC COLONOSCOPY W/ BLEEDING CONTROL,4763.0,3334.1,,,0
HCPCS,45384,Colonoscopy w/lesion removal,,,1184.64,5255.83,11
HCPCS,45384,HC COLONOSCOPY W/ LESION REMOVAL BY HOT BIOPSY FORCEPS,4269.0,2988.3,,,0
HCPCS,45385,Colonoscopy w/lesion removal,,,1184.64,5255.83,11
HCPCS,45385,HC COLONOSCOPY W/LESION REMOVAL BY SNARE TECHNIQUE,4269.0,2988.3,,,0
HCPCS,45386,Colonoscopy w/balloon dilat,,,1184.64,5255.83,11
HCPCS,45386,HC COLONOSCOPY W/ DILATION,4372.0,3060.4,,,0
HCPCS,45388,Colonoscopy w/ablation,,,1184.64,5255.83,11
HCPCS,45388,HC COLONOSCOPY W/ABLATION,4269.0,2988.3,,,0
HCPCS,45389,Colonoscopy w/stent plcmt,,,2393.28,26664.3,11
HCPCS,45389,HC COLONOSCOPY W/STENT PLACEMENT,4758.0,3330.6,,,0
HCPCS,45390,Colonoscopy w/resection,,,1779.94,12191.12,11
HCPCS,45390,HC COLONOSCOPY W/RESECTION,4269.0,2988.3,,,0
HCPCS,45391,Colonoscopy w/endoscope us,,,1184.64,5255.83,11
HCPCS,45391,HC COLONOSCOPY W/ENDOSCOPE US,4830.0,3381.0,,,0
HCPCS,45392,Colonoscopy w/endoscopic fnb,,,1184.64,5255.83,11
HCPCS,45392,HC COLONOSCOPY W/ENDOSCOPIC US FINE NEEDLE BIOPSY,5942.0,4159.4,,,0
HCPCS,45393,Colonoscopy w/decompression,,,1184.64,5255.83,11
HCPCS,45393,HC COLONOSCOPY W/DECOMPRESSION,6038.0,4226.6,,,0
HCPCS,45398,Colonoscopy w/band ligation,,,1184.64,5255.83,11
HCPCS,45398,HC COLONOSCOPY W/BAND LIGATION,7423.0,5196.1,,,0
HCPCS,45399,HC UNLISTED PROCEDURE COLON,3772.0,2640.4,,,0
HCPCS,45399,Unlisted procedure colon,,,920.63,4084.51,11
HCPCS,45499,Laparoscope proc rectum,,,5984.88,26552.87,11
HCPCS,45500,Repair of rectum,,,2747.81,12191.12,11
HCPCS,45505,Repair of rectum,,,2747.81,12191.12,11
HCPCS,45520,Treatment of rectal prolapse,,,158.65,4084.51,11
HCPCS,45541,Correct rectal prolapse,,,2747.81,12191.12,11
HCPCS,45560,Repair of rectocele,,,2747.81,12191.12,11
HCPCS,45900,HC PRO REDUCTION OF PROCIDENTIA UNDER ANESTHESIA,524.0,366.8,,,0
HCPCS,45900,HC REDUCTION OF PROCIDENTIA UNDER ANESTHESIA,1913.0,1339.1,,,0
HCPCS,45900,Reduction of rectal prolapse,,,920.63,4084.51,11
HCPCS,45905,Dilation of anal sphincter,,,1184.64,5676.62,11
HCPCS,45910,Dilation of rectal narrowing,,,1184.64,5676.62,11
HCPCS,45915,HC REM RECTAL OBSTRUCT W/ANESTH,3903.0,2732.1,,,0
HCPCS,45915,Remove rectal obstruction,,,1184.64,5255.83,11
HCPCS,45990,Surg dx exam anorectal,,,2747.81,12191.12,11
HCPCS,45999,HC PRO UNLISTED PROCEDURE RECTUM,499.0,349.3,,,0
HCPCS,45999,HC UNLISTED PROCEDURE RECTUM,2812.0,1968.4,,,0
HCPCS,45999,Rectum surgery procedure,,,920.63,4084.51,11
HCPCS,46020,Placement of seton,,,2747.81,12191.12,11
HCPCS,46030,Removal of rectal marker,,,1184.64,6253.46,11
HCPCS,46040,HC I&D ISCHIORECTAL/PERIRECTAL ABSCESS,7232.0,5062.4,,,0
HCPCS,46040,HC PRO INC ISCHRCTL/PERIRECTAL ABSCES,642.0,449.4,,,0
HCPCS,46040,Incision of rectal abscess,,,1184.64,6253.46,11
HCPCS,46045,Incision of rectal abscess,,,2747.81,12191.12,11
HCPCS,46050,HC I&D PERIANAL ABSCESS SUPERFICIAL,1522.0,1065.4,,,0
HCPCS,46050,HC PRO INCISION OF ANAL ABSCESS,112.0,78.4,,,0
HCPCS,46050,Incision of anal abscess,,,920.63,4084.51,11
HCPCS,46060,Incision of rectal abscess,,,2747.81,12191.12,11
HCPCS,46070,Incision of anal septum,,,2183.27,12191.12,11
HCPCS,46080,Incision of anal sphincter,,,2747.81,12191.12,11
HCPCS,46083,HC INCISE EXTERNAL HEMORRHOID,325.0,227.5,,,0
HCPCS,46083,HC PRO INCISE EXTERNAL HEMORRHOID,316.0,221.2,,,0
HCPCS,46083,Incise external hemorrhoid,,,247.34,1675.52,11
HCPCS,46200,Removal of anal fissure,,,2747.81,12191.12,11
HCPCS,46220,Excise anal ext tag/papilla,,,1184.64,5676.62,11
HCPCS,46221,Ligation of hemorrhoid(s),,,920.63,4084.51,11
HCPCS,46230,Removal of anal tags,,,2747.81,12191.12,11
HCPCS,46250,Remove ext hem groups 2+,,,2747.81,12191.12,11
HCPCS,46255,Remove int/ext hem 1 group,,,2747.81,12191.12,11
HCPCS,46257,Remove in/ex hem grp & fiss,,,2747.81,12191.12,11
HCPCS,46258,Remove in/ex hem grp w/fistu,,,2747.81,12191.12,11
HCPCS,46260,Remove in/ex hem groups 2+,,,2747.81,12191.12,11
HCPCS,46261,Remove in/ex hem grps & fiss,,,2747.81,12191.12,11
HCPCS,46262,Remove in/ex hem grps w/fist,,,2747.81,12191.12,11
HCPCS,46270,Remove anal fist subq,,,2747.81,12191.12,11
HCPCS,46275,Remove anal fist inter,,,2747.81,12191.12,11
HCPCS,46280,Remove anal fist complex,,,2747.81,12191.12,11
HCPCS,46285,Remove anal fist 2 stage,,,2747.81,12191.12,11
HCPCS,46288,Repair anal fistula,,,2747.81,12191.12,11
HCPCS,46320,HC EXCISION THROMBOSED HEMORRHOID EXTERNAL,1921.0,1344.7,,,0
HCPCS,46320,HC PRO REMOVAL OF HEMORRHOID CLOT,226.0,158.2,,,0
HCPCS,46320,Removal of hemorrhoid clot,,,1184.64,5676.62,11
HCPCS,46500,Injection into hemorrhoid(s),,,920.63,4084.51,11
HCPCS,46505,Chemodenervation anal musc,,,958.96,5255.83,11
HCPCS,46600,Diagnostic anoscopy spx,,,131.71,584.37,11
HCPCS,46600,HC ANOSCOPY DIAGNOSTIC,153.0,107.1,,,0
HCPCS,46600,HC PRO ANOSCOPY DIAGNOSTIC,107.0,74.9,,,0
HCPCS,46601,Diagnostic anoscopy,,,399.2,1962.08,11
HCPCS,46604,Anoscopy and dilation,,,1184.64,5255.83,11
HCPCS,46606,Anoscopy and biopsy,,,1184.64,5255.83,11
HCPCS,46607,Diagnostic anoscopy & biopsy,,,1184.64,5255.83,11
HCPCS,46608,Anoscopy remove for body,,,920.63,4084.51,11
HCPCS,46608,HC ANOSCOPY W/ REM FOREIGN BODY,960.0,672.0,,,0
HCPCS,46608,HC PRO ANOSCOPY REMOVE FOR BODY,664.0,464.8,,,0
HCPCS,46610,Anoscopy remove lesion,,,2747.81,12191.12,11
HCPCS,46611,Anoscopy,,,920.63,4084.51,11
HCPCS,46612,Anoscopy remove lesions,,,2747.81,12191.12,11
HCPCS,46614,Anoscopy control bleeding,,,1019.72,5255.83,11
HCPCS,46615,Anoscopy,,,1921.07,12191.12,11
HCPCS,46700,Repair of anal stricture,,,2747.81,12191.12,11
HCPCS,46706,Repr of anal fistula w/glue,,,2747.81,12191.12,11
HCPCS,46707,Repair anorectal fist w/plug,,,2747.81,12191.12,11
HCPCS,46750,Repair of anal sphincter,,,2747.81,12191.12,11
HCPCS,46753,Reconstruction of anus,,,2747.81,12191.12,11
HCPCS,46754,Removal of suture from anus,,,2747.81,12191.12,11
HCPCS,46760,Repair of anal sphincter,,,2747.81,12191.12,11
HCPCS,46761,Repair of anal sphincter,,,2747.81,12191.12,11
HCPCS,46900,Destruction anal lesion(s),,,402.44,1785.48,11
HCPCS,46910,Destruction anal lesion(s),,,2042.58,9062.24,11
HCPCS,46916,Cryosurgery anal lesion(s),,,198.62,881.22,11
HCPCS,46917,Laser surgery anal lesions,,,2747.81,12191.12,11
HCPCS,46922,Excision of anal lesion(s),,,2693.96,12191.12,11
HCPCS,46924,Destruction anal lesion(s),,,2747.81,12191.12,11
HCPCS,46930,Destroy internal hemorrhoids,,,1184.64,6721.57,11
HCPCS,46940,Treatment of anal fissure,,,2747.81,12191.12,11
HCPCS,46942,Treatment of anal fissure,,,920.63,4084.51,11
HCPCS,46945,Remove by ligat int hem grp,,,2183.27,12191.12,11
HCPCS,46946,Remove by ligat int hem grps,,,2747.81,12191.12,11
HCPCS,46947,Hemorrhoidopexy by stapling,,,2747.81,12191.12,11
HCPCS,46948,Int hrhc tranal dartlzj 2+,,,2747.81,12191.12,11
HCPCS,46999,Anus surgery procedure,,,920.63,4084.51,11
HCPCS,46999,HC UNLISTED PROCEDURE ANUS,4265.0,2985.5,,,0
HCPCS,47000,HC PERQ NEEDLE BX LIVER,1521.0,1064.7,,,0
HCPCS,47000,Needle biopsy of liver,,,1301.97,7254.06,11
HCPCS,47100016,HC HEARING SCREEN-JOHN HOPKINS CONTRACT,26.0,18.2,,,0
HCPCS,47370,Laparo ablate liver tumor rf,,,10523.19,46687.84,11
HCPCS,47371,Laparo ablate liver cryosurg,,,9108.91,46687.84,11
HCPCS,47379,Laparoscope procedure liver,,,5692.37,26552.87,11
HCPCS,47382,HC PERQ RF ABLATION 1> LIVER TUMORS,6771.0,4739.7,,,0
HCPCS,47382,Percut ablate liver rf,,,5984.88,26552.87,11
HCPCS,47383,Perq abltj lvr cryoablation,,,10523.19,46687.84,11
HCPCS,47384,Abltj ire liver 1+ tum perq,,,10523.19,46687.84,7
HCPCS,47399,Liver surgery procedure,,,701.03,3110.22,11
HCPCS,47490,HC PERQ CHOLECYSTOSTOMY SI,3394.0,2375.8,,,0
HCPCS,47490,Incision of gallbladder,,,3544.48,15725.66,11
HCPCS,47531,HC INJ CHOLANGIO PERCU COMPLETE DX PX INCL IMAGE GUIDE ASSOC RAD S & I EXISTING ACCESS,652.0,456.4,,,0
HCPCS,47531,Injection for cholangiogram,,,492.5,15725.66,11
HCPCS,47532,HC INJ CHOLANGIO PERCU COMPLETE DX PX INCL IMAGE GUIDE ASSOC RAD S & I NEW ACCESS,2109.0,1476.3,,,0
HCPCS,47532,Injection for cholangiogram,,,3544.48,15725.66,11
HCPCS,47533,HC PLACEMENT BILIARY DRAIN CATH PERCU INCL DX CHOLANGIO IMAGE GUIDE ASSOC RAD  S & I EXTERNAL,8004.0,5602.8,,,0
HCPCS,47533,Plmt biliary drainage cath,,,3544.48,15725.66,11
HCPCS,47534,HC PLACEMENT BILIARY DRAIN CATH PERCU INCL DX CHOLANGIO IMAGE GUIDE ASSOC RAD  S & I INTERNAL/EXTERNAL,11276.0,7893.2,,,0
HCPCS,47534,Plmt biliary drainage cath,,,3544.48,15725.66,11
HCPCS,47535,Conversion ext bil drg cath,,,3544.48,15725.66,11
HCPCS,47535,HC CONVERSION EXTERNAL BILIARY DRAIN CATH TO INTERNAL-EXTERNAL BILIARY DRAIN CATH PERCU INCL DX CHOLANGIO IMAGE GUIDE ASSOC RAD S & I,10538.0,7376.6,,,0
HCPCS,47536,Exchange biliary drg cath,,,2503.31,15725.66,11
HCPCS,47536,HC EXCHANGE BILIARY DRAIN CATH PERCU INCL DX CHOLANGIO IMAGE GUIDE ASSOC RAD S & I,3620.0,2534.0,,,0
HCPCS,47537,HC REMOVAL BILIARY DRAIN CATH PERCU FLUORO GUIDE INCL DX CHOLANGIO IMAGE GUIDE ASSOC RAD S & I,1120.0,784.0,,,0
HCPCS,47537,Removal biliary drg cath,,,897.89,3983.62,11
HCPCS,47538,HC PLACE STENT(S) BILE DUCTS PERCU INCL DX CHOLANGIO IMAGE GUIDE BALLOON DILATION CATH EXCHANGE(S) & CATH REMOVAL(S) ASSOC RAD S & I EACH STENT EXISTING ACCESS,11304.0,7912.8,,,0
HCPCS,47538,Perq plmt bile duct stent,,,5984.88,26552.87,11
HCPCS,47539,HC PLACE STENT(S) BILE DUCTS PERCU INCL DX CHOLANGIO IMAGE GUIDE BALLOON DILATION CATH EXCHANGE(S)  & CATH REMOVAL(S) ASSOC RAD S & I NEW ACCESS W/O SEP BILIARY DRAIN CATH,14164.0,9914.8,,,0
HCPCS,47539,Perq plmt bile duct stent,,,5984.88,26552.87,11
HCPCS,47540,Perq plmt bile duct stent,,,5984.88,26552.87,11
HCPCS,47541,Plmt access bil tree sm bwl,,,6408.87,28434.0,11
HCPCS,47542,Dilate biliary duct/ampulla,,,424.29,529.31,4
HCPCS,47542,HC BALLOON DILATION BILIARY DUCT(S) OR AMPULLA PERCU INCL IMAGE GUIDE ASSOC RAD S & I EACH DUCT,7184.0,5028.8,,,0
HCPCS,47543,Endoluminal bx biliary tree,,,532.67,664.52,4
HCPCS,47543,HC ENDOLUMINAL BX(S) BILIARY TREE PERCU ANY METHOD(S) INCL IMAGE GUIDE ASSOC RAD S & I SINGLE/MULTI,2471.0,1729.7,,,0
HCPCS,47544,Removal duct glbldr calculi,,,675.27,842.41,4
HCPCS,47552,Biliary endo perq dx w/speci,,,5739.3,28434.0,11
HCPCS,47553,Biliary endoscopy thru skin,,,5739.3,28434.0,11
HCPCS,47554,Biliary endoscopy thru skin,,,5739.3,46687.84,11
HCPCS,47555,Biliary endoscopy thru skin,,,5739.3,28434.0,11
HCPCS,47556,Biliary endoscopy thru skin,,,5739.3,46687.84,11
HCPCS,47556,HC DILAT BILIARY DUCT ENDO W/ STENT,18937.0,13255.9,,,0
HCPCS,47562,Laparoscopic cholecystectomy,,,5984.88,26552.87,11
HCPCS,47563,Laparo cholecystectomy/graph,,,5984.88,26552.87,11
HCPCS,47564,Laparo cholecystectomy/explr,,,9108.91,46687.84,11
HCPCS,47579,Laparoscope proc biliary,,,5984.88,26552.87,11
HCPCS,47999,Bile tract surgery procedure,,,897.89,7159.92,11
HCPCS,48102,HC PERQ NEEDLE BX PANCREAS,1699.0,1189.3,,,0
HCPCS,48102,Needle biopsy pancreas,,,1635.03,7254.06,11
HCPCS,48300014,HC PEDIATRIC ECHO COMPLETE,2252.0,1576.4,,,0
HCPCS,48300015,HC PEDIATRIC ECHO LIMITED,1118.0,782.6,,,0
HCPCS,48999,HC UNLISTED PROCEDURE PANCREAS,3208.0,2245.6,,,0
HCPCS,48999,Pancreas surgery procedure,,,701.03,3110.22,11
HCPCS,49000,Exploration of abdomen,,,8180.47,10205.34,4
HCPCS,49000,HC EXPLORATORY LAP/CELIOTOMY W/WO BIOPSY,10057.0,7039.9,,,0
HCPCS,49010,Exploration behind abdomen,,,6408.87,28434.0,11
HCPCS,49013,Prpertl pel pack hemrrg trma,,,1383.62,1726.1,4
HCPCS,49014,Reexploration pelvic wound,,,1141.83,1424.46,4
HCPCS,49082,Abd paracentesis,,,482.07,3983.62,11
HCPCS,49082,HC PRO PARACENTESIS ABD,669.0,468.3,,,0
HCPCS,49082,PARACENTESIS ABD,768.0,537.6,,,0
HCPCS,49083,Abd paracentesis w/imaging,,,897.89,3983.62,11
HCPCS,49083,HC ABDOMINAL PARACENTESIS DX/THERAPEUTIC W/IMAGING GUIDANCE,2047.0,1432.9,,,0
HCPCS,49083,HC PRO ABDOMINAL PARACENTESIS DX/THERAPEUTIC W/IMAGING GUIDANCE,374.0,261.8,,,0
HCPCS,49084,Peritoneal lavage,,,897.89,3983.62,11
HCPCS,49180,Biopsy abdominal mass,,,1037.98,7254.06,11
HCPCS,49180,HC BIOPSY ABDOMINAL/RETROPERITONEAL MASS PERCUTANEOUS NEEDLE,1378.0,964.6,,,0
HCPCS,49185,HC SCLEROTHERAPY OF FLUID COLLECT PERCU INCL CONTRAST INJECT(S) SCLEROSANT INJECT(S) DX STUDY IMAGE GUIDE RAD S& I,1377.0,963.9,,,0
HCPCS,49185,Sclerotx fluid collection,,,1635.03,7254.06,11
HCPCS,49250,Excision of umbilicus,,,3544.48,15725.66,11
HCPCS,49255,Removal of omentum,,,2432.58,28434.0,11
HCPCS,49320,Diag laparo separate proc,,,4526.2,26552.87,11
HCPCS,49321,Laparoscopy biopsy,,,3517.73,26552.87,11
HCPCS,49322,Laparoscopy aspiration,,,4926.7,26552.87,11
HCPCS,49323,Laparo drain lymphocele,,,5984.88,26552.87,11
HCPCS,49324,Lap insert tunnel ip cath,,,5984.88,26552.87,11
HCPCS,49325,Lap Revision Perm IP Cath,,,5984.88,26552.87,11
HCPCS,49326,Lap w/Omentopexy Add-on,,,6881.1,8584.34,4
HCPCS,49327,Lap ins device for rt,,,8066.31,10062.93,4
HCPCS,49329,HC UNLISTED LAPAROSCOPY PROCEDURE ABDOMEN PERITONEUM & OMENTUM,18008.0,12605.6,,,0
HCPCS,49329,Laparo proc abdm/per/oment,,,4211.83,26552.87,11
HCPCS,49402,Remove foreign body adbomen,,,3544.48,15725.66,11
HCPCS,49405,HC IMAGE GUIDED FLUID CATH COLLECT PERCU VISCERAL,2104.0,1472.8,,,0
HCPCS,49405,Image cath fluid colxn visc,,,1454.91,7254.06,11
HCPCS,49406,HC IMAGE GUIDED FLUID CATH COLLECT PERI/RETROPERI,2104.0,1472.8,,,0
HCPCS,49406,Image cath fluid peri/retro,,,1322.88,7254.06,11
HCPCS,49407,HC IMAGE GUIDED FLUID CATH COLLECT TRNSVAG/TRNSRECT,1787.0,1250.9,,,0
HCPCS,49407,Image cath fluid trns/vgnl,,,1236.02,7254.06,11
HCPCS,49411,HC PERQ RAD DEVICE ABD PELVIC,1331.0,931.7,,,0
HCPCS,49411,Ins mark abd/pel for rt perq,,,1370.24,6079.31,11
HCPCS,49412,Ins device for rt guide open,,,241.19,300.89,4
HCPCS,49418,HC INSERT TUN IP CATH PERC,3262.0,2283.4,,,0
HCPCS,49418,HC PERQ INSERT TUNN CATH ABD PELV,3262.0,2283.4,,,0
HCPCS,49418,Insert tun ip cath perc,,,2395.16,15725.66,11
HCPCS,49419,Insert tun ip cath w/port,,,5508.66,24440.06,11
HCPCS,49421,Ins tun ip cath for dial opn,,,3544.48,15725.66,11
HCPCS,49422,HC REMOVAL TUNN CATH ABD PELV,2673.0,1871.1,,,0
HCPCS,49422,Remove tunneled ip cath,,,2834.68,13868.13,11
HCPCS,49423,Exchange drainage catheter,,,1327.22,8428.13,11
HCPCS,49423,HC EXCHANGE DRAINAGE CATH,1920.0,1344.0,,,0
HCPCS,49424,HC INJECT CONTRAST ASSESS CYST,474.0,331.8,,,0
HCPCS,49426,Revise abdomen-venous shunt,,,3544.48,15725.66,11
HCPCS,49429,Removal of shunt,,,3125.8,13868.13,11
HCPCS,49435,Insert Subq Exten to IP Cath,,,3071.75,3832.09,4
HCPCS,49436,Embedded IP Cath Exit-Site,,,1899.66,8428.13,11
HCPCS,49440,HC PERQ PLACE GASTRO TUBE,3452.0,2416.4,,,0
HCPCS,49440,Place gastrostomy tube perc,,,1899.66,8428.13,11
HCPCS,49441,HC PERQ PLACE DUOD JEJUN TUBE,1358.0,950.6,,,0
HCPCS,49441,Place duod/jej tube perc,,,1701.07,8428.13,11
HCPCS,49442,HC INSERT CECOSTOMY/COLONIC TUBE PERCU UNDER FLUORO INCL CONTRAST INJ,2147.0,1502.9,,,0
HCPCS,49442,Place cecostomy tube perc,,,1184.64,5255.83,11
HCPCS,49446,Change g-tube to g-j perc,,,1701.07,8428.13,11
HCPCS,49446,HC PERQ CHANGE G-TUBE TO G-J TUBE,1358.0,950.6,,,0
HCPCS,49450,HC PERQ REPLACE G/C TUBE,2266.0,1586.2,,,0
HCPCS,49450,Replace g/c tube perc,,,493.36,3983.62,11
HCPCS,49451,HC PERQ REPLACE DOUD JEJUN TUBE,655.0,458.5,,,0
HCPCS,49451,Replace duod/jej tube perc,,,468.18,3983.62,11
HCPCS,49452,HC REPLACE GASTROJEJUNOSTOMY TUBE PERQ  UNDER FLUORO GUIDE INCL CONTRAST INJECTION(S) IMAGE DOC & REPORT,655.0,458.5,,,0
HCPCS,49452,Replace g-j tube perc,,,647.84,3983.62,11
HCPCS,49460,Fix g/colon tube w/device,,,647.84,3983.62,11
HCPCS,49465,Fluoro exam of g/colon tube,,,157.22,1047.98,11
HCPCS,49465,HC FLUORO EXAM OF G/COLON TUBE,220.0,154.0,,,0
HCPCS,49491,Rpr hern preemie reduc,,,5984.88,26552.87,11
HCPCS,49492,Rpr ing hern premie blocked,,,3544.48,15725.66,11
HCPCS,49495,Rpr ing hernia baby reduc,,,3544.48,15725.66,11
HCPCS,49496,Rpr ing hernia baby blocked,,,3544.48,15725.66,11
HCPCS,49500,Rpr ing hernia init reduce,,,4465.47,28434.0,11
HCPCS,49501,Rpr ing hernia init blocked,,,3544.48,15725.66,11
HCPCS,49505,Prp i/hern init reduc >5 yr,,,3544.48,15725.66,11
HCPCS,49507,Prp i/hern init block >5 yr,,,3544.48,15725.66,11
HCPCS,49520,Rerepair ing hernia reduce,,,3544.48,15725.66,11
HCPCS,49521,Rerepair ing hernia blocked,,,6408.87,28434.0,11
HCPCS,49525,Repair ing hernia sliding,,,3544.48,15725.66,11
HCPCS,49540,Repair lumbar hernia,,,5984.88,26552.87,11
HCPCS,49550,Rpr rem hernia init reduce,,,3544.48,15725.66,11
HCPCS,49553,Rpr fem hernia init blocked,,,1628.41,15725.66,11
HCPCS,49555,Rerepair fem hernia reduce,,,3544.48,15725.66,11
HCPCS,49557,Rerepair fem hernia blocked,,,3544.48,15725.66,11
HCPCS,49591,Rpr aa hrn 1st < 3 cm rdc,,,3544.48,15725.66,11
HCPCS,49592,Rpr aa hrn 1st < 3 ncr/strn,,,5984.88,26552.87,11
HCPCS,49593,Rpr aa hrn 1st 3-10 rdc,,,6408.87,28434.0,11
HCPCS,49594,Rpr aa hrn 1st 3-10 ncr/strn,,,5984.88,26552.87,11
HCPCS,49595,Rpr aa hrn 1st > 10 rdc,,,6408.87,28434.0,11
HCPCS,49600,Repair umbilical lesion,,,3544.48,15725.66,11
HCPCS,49605,HC REPAIR UMBILICAL LESION,11808.0,8265.6,,,0
HCPCS,49613,HC REPAIR ANT ABDOMINAL HERNIA(S) ANY APPROACH RECURRENT INCL IMPLANT MESH/PROSTHESIS LESS THAN 3 CM REDUCIBLE,12237.0,8565.9,,,0
HCPCS,49613,Rpr aa hrn rcr < 3 rdc,,,3544.48,15725.66,11
HCPCS,49614,HC REPAIR ANT ABDOMINAL HERNIA(S) ANY APPROACH RECURRENT INCL IMPLANT MESH/PROSTHESIS LESS THAN 3 CM INCARCERATED OR STRANGULATED,18008.0,12605.6,,,0
HCPCS,49614,Rpr aa hrn rcr < 3 ncr/strn,,,5984.88,26552.87,11
HCPCS,49615,HC REPAIR ANT ABDOMINAL HERNIA(S) ANY APPROACH RECURRENT INCL IMPLANT MESH/PROSTHESIS 3-10 CM REDUCIBLE,12237.0,8565.9,,,0
HCPCS,49615,Rpr aa hrn rcr 3-10 rdc,,,6408.87,28434.0,11
HCPCS,49616,HC REPAIR ANT ABDOMINAL HERNIA(S) ANY APPROACH RECURRENT INCL IMPLANT MESH/PROSTHESIS 3-10 CM INCARCERATED OR STRANGULATED,19620.0,13734.0,,,0
HCPCS,49617,HC REPAIR ANT ABDOMINAL HERNIA(S) ANY APPROACH RECURRENT INCL IMPLANT MESH/PROSTHESIS GREATER THAN 10 CM REDUCIBLE,13333.0,9333.1,,,0
HCPCS,49618,HC REPAIR ANT ABDOMINAL HERNIA(S) ANY APPROACH RECURRENT INCL IMPLANT MESH/PROSTHESIS GREATER THAN 10 CM INCARCERATED OR STRANGULATED,15334.0,10733.8,,,0
HCPCS,49650,Lap ing hernia repair init,,,5834.49,26552.87,11
HCPCS,49651,Lap ing hernia repair recur,,,5984.88,26552.87,11
HCPCS,49659,Laparo proc hernia repair,,,5984.88,26552.87,11
HCPCS,49999,Abdomen surgery procedure,,,897.89,4531.07,11
HCPCS,50020,Renal abscess open drain,,,2069.41,9181.28,11
HCPCS,50080,HC PERCUTANEOUS/NEPHROLITHOTOMY/PYELOLITHOTOMY/LITHOTRIPSY STONE EXTRACTION INCL IMAGE GUIDE SIMPLE UP TO 2 CM KIDNEY/RENAL PELVIS,38852.0,27196.4,,,0
HCPCS,50080,Removal of kidney stone,,,9043.4,41578.13,11
HCPCS,50081,Removal of kidney stone,,,5084.06,41578.13,11
HCPCS,50200,HC RENAL BIOPSY PERCUTANEOUS BY TROCAR/NEEDLE,1697.0,1187.9,,,0
HCPCS,50200,Renal biopsy perq,,,1341.6,7254.06,11
HCPCS,50382,Change ureter stent percut,,,2069.41,9181.28,11
HCPCS,50382,HC PERC URETER STENT CHANGE,7217.0,5051.9,,,0
HCPCS,50384,HC PERCUTANEOUS REMOVAL OF URETERAL STENT VIA SNARE/CAPTURE,6917.0,4841.9,,,0
HCPCS,50384,Remove ureter stent percut,,,2069.41,9181.28,11
HCPCS,50385,Change stent via transureth,,,2069.41,9181.28,11
HCPCS,50385,HC TRANSURETHERAL REPLACEMENT OF INTERNAL URETERAL STENT B,7360.0,5152.0,,,0
HCPCS,50386,HC REMOVAL DWELLING URETERAL STENT VIA TRANSURETHERAL W/CYSTOSCOPY,8159.0,5711.3,,,0
HCPCS,50386,Remove stent via transureth,,,1195.06,9181.28,11
HCPCS,50387,Change nephroureteral cath,,,2069.41,9181.28,11
HCPCS,50387,HC REMOVE & REPLACE EXTERNALLY ACCESSIBLE NEPHROURETERAL CATHETER,3461.0,2422.7,,,0
HCPCS,50389,HC REM RENAL TUBE W/ FLUORO,2759.0,1931.3,,,0
HCPCS,50389,Remove renal tube w/fluoro,,,690.3,3062.63,11
HCPCS,50390,Drainage of kidney lesion,,,701.03,3110.22,11
HCPCS,50390,HC PERC NEEDLE ASP/INJ RENAL CYST,1571.0,1099.7,,,0
HCPCS,50391,Instll rx agnt into rnal tub,,,207.16,1097.37,11
HCPCS,50396,HC MANOMETRIC STUDIES THRU NEPHROSTOMY/PYELOSTOMY TUBE/INDWELLING URETERAL CATHETER,2695.0,1886.5,,,0
HCPCS,50396,Measure kidney pressure,,,401.66,3062.63,11
HCPCS,50430,HC INJECT PX ANTEGRADE NEPHROSTOGRAM AND/OR URETEROGRAM COMPLETE DX PX INCL IMAGE GUIDE ASSOC RAD S & I NEW ACCESS,689.0,482.3,,,0
HCPCS,50430,Njx px nfrosgrm &/urtrgrm,,,690.3,3062.63,11
HCPCS,50431,HC INJECT PX ANTEGRADE NEPHROSTOGRAM AND/OR URETEROGRAM COMPLETE DX PX INCL IMAGE GUIDE ASSOC RAD S & I EXISTING ACCESS,689.0,482.3,,,0
HCPCS,50431,Njx px nfrosgrm &/urtrgrm,,,690.3,3062.63,11
HCPCS,50432,HC PLACE NEPHROSTOMY CATH PERCU INC DX NEPHROSTOGRAM URETOGRAM IMAGE GUIDE  ASSOC  RAD S & I,6976.0,4883.2,,,0
HCPCS,50432,Plmt nephrostomy catheter,,,2069.41,9181.28,11
HCPCS,50433,HC PLACE NEPHROURETERAL CATH PERCU INCL DX NEPHROSTOGRAM/URETEROGRAM IMAGE GUIDE ASSOC RAD S & I NEW ACCESS,9952.0,6966.4,,,0
HCPCS,50433,Plmt nephroureteral catheter,,,3489.62,15482.25,11
HCPCS,50434,Convert nephrostomy catheter,,,2069.41,9181.28,11
HCPCS,50434,HC CONVERT NEPHROSTOMY CATH TO NEPHROURETERAL CATH PERCU INCL DX NEPHROSTOGRAM/URETERGRAM IMAGE GUIDE ASSOC RAD S & I VIA PRE-EXISTING NEPHROSTOMY TRACT,8578.0,6004.6,,,0
HCPCS,50435,Exchange nephrostomy cath,,,2069.41,9181.28,11
HCPCS,50435,HC EXCHANGE NEPHROSTOMY CATH PERCU INCL DX NEPHROSTOGRAM URETEROGRAM IMAGE GUIDE  ASSOC RAD S & I,2817.0,1971.9,,,0
HCPCS,50436,Dilat xst trc ndurlgc px,,,3489.62,15482.25,11
HCPCS,50436,HC DILATION OF EXISIT TRAC PERCUTANEOUS FOR ENDOURO PX INCL IMAGE GUID RAD S&I,7549.0,5284.3,,,0
HCPCS,50437,Dilat xst trc new access rcs,,,3489.62,15482.25,11
HCPCS,50437,HC DILATION OF EXIST TRACT ENDOURO PX INCL IMAGE GUIDE RAD S&I W/POST PX TUBE PLCMT,13563.0,9494.1,,,0
HCPCS,50541,Laparo ablate renal cyst,,,6881.1,46687.84,11
HCPCS,50542,Laparo ablate renal mass,,,10523.19,46687.84,11
HCPCS,50543,Laparo partial nephrectomy,,,10523.19,46687.84,11
HCPCS,50544,Laparoscopy pyeloplasty,,,8205.37,46687.84,11
HCPCS,50549,Laparoscope proc renal,,,5984.88,26552.87,11
HCPCS,50551,Kidney endoscopy,,,1195.06,23549.82,11
HCPCS,50553,Kidney endoscopy,,,4956.38,23549.82,11
HCPCS,50555,Kidney endoscopy & biopsy,,,1195.06,41578.13,11
HCPCS,50557,Kidney endoscopy & treatment,,,4956.38,41578.13,11
HCPCS,50561,Kidney endoscopy & treatment,,,4956.38,23549.82,11
HCPCS,50562,Renal scope w/tumor resect,,,1195.06,41578.13,11
HCPCS,50570,Kidney endoscopy,,,1195.06,15482.25,11
HCPCS,50572,Kidney endoscopy,,,690.3,3062.63,11
HCPCS,50574,Kidney endoscopy & biopsy,,,1195.06,15482.25,11
HCPCS,50575,Kidney endoscopy,,,5308.0,23549.82,11
HCPCS,50576,Kidney endoscopy & treatment,,,3589.43,41578.13,11
HCPCS,50580,Kidney endoscopy & treatment,,,3589.43,23549.82,11
HCPCS,50590,Fragmenting of kidney stone,,,3489.62,15482.25,11
HCPCS,50592,HC PERC RF ABLATE 1 OR MORE RENAL TUMOR(S),5271.0,3689.7,,,0
HCPCS,50592,Perc rf ablate renal tumor,,,5984.88,26552.87,11
HCPCS,50593,HC PERC ABLAT CRYO REN TUMOR UNILAT,5271.0,3689.7,,,0
HCPCS,50593,Perc cryo ablate renal tum,,,3768.86,46687.84,11
HCPCS,50606,Endoluminal bx urtr rnl plvs,,,491.59,613.27,4
HCPCS,50606,HC ENDOLUMINAL BX URETER/RENAL PELVIS NON-ENDOSCOPIC INCL IMAGE GUIDE ASSOC RAD S & I,602.0,421.4,,,0
HCPCS,50684,HC INJECTION FOR URETER X-RAY,107.0,74.9,,,0
HCPCS,50686,Measure ureter pressure,,,127.38,565.15,11
HCPCS,50688,Change of ureter tube/stent,,,2069.41,9181.28,11
HCPCS,50688,HC CHANGE OF URETER TUBE/STENT,1583.0,1108.1,,,0
HCPCS,50690,HC INJECTION FOR URETER X-RAY,136.0,95.2,,,0
HCPCS,50693,HC PLACE URETERAL STENT PERCU INCL DX NEPHROSTOGRAM AND/OR URETEROGRAM IMAGE GUIDE ASSOC RAD S & I PRE-EXISTING NEPHROSTOMY TRACT,7874.0,5511.8,,,0
HCPCS,50693,Plmt ureteral stent prq,,,3489.62,15482.25,11
HCPCS,50694,Plmt ureteral stent prq,,,3489.62,15482.25,11
HCPCS,50695,HC PLACE URETERAL STENT PERCU INCL DX NEPHROSTOGRAM AND/OR URETEROGRAM IMAGE GUIDE ASSOC RAD S & I NEW ACCESS W/SEP NEPHROSTOMY CATH,13191.0,9233.7,,,0
HCPCS,50695,Plmt ureteral stent prq,,,3489.62,15482.25,11
HCPCS,50705,HC URETERAL EMBOLIZATION/OCCLUSION INCL IMAGE GUIDE ASSOC RAD S & I,771.0,539.7,,,0
HCPCS,50705,Ureteral embolization/occl,,,630.0,785.94,4
HCPCS,50706,Balloon dilate urtrl strix,,,584.21,728.82,4
HCPCS,50706,HC BALLOON DILATION URETERAL STRICTURE INCL IMAGE GUIDE ASSOC RAD S & I,1754.0,1227.8,,,0
HCPCS,50727,Revise ureter,,,3489.62,15482.25,11
HCPCS,50945,Laparoscopy ureterolithotomy,,,5984.88,26552.87,11
HCPCS,50947,Laparo New Ureter/Bladder,,,9108.91,46687.84,11
HCPCS,50948,Laparo New Ureter/Bladder,,,9108.91,46687.84,11
HCPCS,50949,Laparoscope proc ureter,,,5984.88,26552.87,11
HCPCS,50951,Endoscopy of ureter,,,1195.06,15482.25,11
HCPCS,50953,Endoscopy of ureter,,,1195.06,15482.25,11
HCPCS,50955,Ureter endoscopy & biopsy,,,4956.38,23549.82,11
HCPCS,50957,Ureter endoscopy & treatment,,,4956.38,23549.82,11
HCPCS,50961,Ureter endoscopy & treatment,,,4956.38,23549.82,11
HCPCS,50970,Ureter endoscopy,,,1195.06,15482.25,11
HCPCS,50972,Ureter endoscopy & catheter,,,1195.06,15482.25,11
HCPCS,50974,Ureter endoscopy & biopsy,,,3589.43,23549.82,11
HCPCS,50976,Ureter endoscopy & treatment,,,3589.43,23549.82,11
HCPCS,50980,Ureter endoscopy & treatment,,,4956.38,23549.82,11
HCPCS,51020,Incise & treat bladder,,,3489.62,15482.25,11
HCPCS,51030,Incise & treat bladder,,,4956.38,6183.21,4
HCPCS,51040,Incise & drain bladder,,,2069.41,9181.28,11
HCPCS,51045,Incise bladder/drain ureter,,,1195.06,9181.28,11
HCPCS,51050,Removal of bladder stone,,,4956.38,23549.82,11
HCPCS,51060,Removal of ureter stone,,,2069.41,9181.28,11
HCPCS,51065,Remove ureter calculus,,,3489.62,15482.25,11
HCPCS,51080,Drainage of bladder abscess,,,2875.57,12757.95,11
HCPCS,51100,Drain bladder by needle,,,247.34,1097.37,11
HCPCS,51101,Drain bladder by trocar/cath,,,207.16,3771.72,11
HCPCS,51101,HC DRAIN BLADDER BY TROCAR/CATH,3973.0,2781.1,,,0
HCPCS,51102,DRAIN BL VIA SUPRAPUBIC CATH,2844.0,1990.8,,,0
HCPCS,51102,Drain bl w/cath insertion,,,2034.26,9181.28,11
HCPCS,51500,Removal of bladder cyst,,,5984.88,26552.87,11
HCPCS,51520,Removal of bladder lesion,,,3489.62,15482.25,11
HCPCS,51535,Repair of ureter lesion,,,3489.62,15482.25,11
HCPCS,51600,HC XRAY CYSTOGRAPHY,225.0,157.5,,,0
HCPCS,51610,HC INJECTION PX FOR RETROGRADE URETHROCYSTOGRAPHY,227.0,158.9,,,0
HCPCS,51700,HC IRRIGATION OF BLADDER SIMPLE,320.0,224.0,,,0
HCPCS,51700,Irrigation of bladder,,,228.44,1097.37,11
HCPCS,51701,INSERT NON-INDWELLING BL CATH,256.0,179.2,,,0
HCPCS,51701,Insert bladder catheter,,,131.71,584.37,11
HCPCS,51702,HC INSERT TEMP INDWELLING BLADDER CATH SIMPLE,198.0,138.6,,,0
HCPCS,51702,HC PRO INSERT TEMP INDWELLING BLADDER CATH SIMPLE,79.0,55.3,,,0
HCPCS,51702,Insert temp bladder cath,,,131.71,584.37,11
HCPCS,51703,HC INSERT TEMP INDWELLING BLADDER CATH COMPLICATED,379.0,265.3,,,0
HCPCS,51703,HC PRO INSERT TEMP INDWELLING BLADDER CATH COMPLICATED,289.0,202.3,,,0
HCPCS,51703,Insert bladder cath complex,,,127.38,565.15,11
HCPCS,51705,Change of bladder tube,,,247.34,1097.37,11
HCPCS,51705,HC CHANGE BLADDER CATH SIMPLE,440.0,308.0,,,0
HCPCS,51705,HC PRO CHANGE BLADDER CATH SIMPLE,143.0,100.1,,,0
HCPCS,51710,Change of bladder tube,,,690.3,3062.63,11
HCPCS,51710,HC CHANGE OF CYSTOSTOMY TUBE COMPLICATED,1598.0,1118.6,,,0
HCPCS,51710,HC PRO CHANGE OF CYSTOSTOMY TUBE COMPLICATED,189.0,132.3,,,0
HCPCS,51715,Endoscopic injection/implant,,,3489.62,15482.25,11
HCPCS,51720,Treatment of bladder lesion,,,690.3,3126.73,11
HCPCS,51725,Simple cystometrogram,,,247.34,1097.37,11
HCPCS,51726,Complex cystometrogram,,,247.34,1097.37,11
HCPCS,51727,Cystometrogram w/up,,,639.66,3062.63,11
HCPCS,51728,Cystometrogram w/vp,,,639.66,3062.63,11
HCPCS,51729,Cystometrogram w/vp&up,,,639.66,3062.63,11
HCPCS,51736,Urine flow measurement,,,60.54,584.37,11
HCPCS,51741,Electro-uroflowmetry first,,,71.45,948.37,11
HCPCS,51784,Anal/urinary muscle study,,,127.38,565.15,11
HCPCS,51785,Anal/urinary muscle study,,,247.34,1097.37,11
HCPCS,51792,Urinary reflex study,,,58.4,599.39,11
HCPCS,51797,Intraabdominal pressure test,,,287.06,358.12,4
HCPCS,51798,HC US URINE CAPACITY MEASURE,230.0,161.0,,,0
HCPCS,51798,Us urine capacity measure,,,58.4,259.1,11
HCPCS,51840,Attach bladder/urethra,,,4148.03,21971.51,11
HCPCS,51845,Repair bladder neck,,,4952.26,21971.51,11
HCPCS,51860,Repair of bladder wound,,,9371.49,41578.13,11
HCPCS,51880,Repair of bladder opening,,,3489.62,15482.25,11
HCPCS,51900013,HC CPHP ASSESSMENT PRIMARY,94.0,65.8,,,0
HCPCS,51900014,HC CPHP CASE MANAGEMENT,772.0,540.4,,,0
HCPCS,51990,Laparo urethral suspension,,,4462.0,26552.87,11
HCPCS,51992,Laparo sling operation,,,3632.05,26552.87,11
HCPCS,51999,Laparoscope proc bla,,,5984.88,26552.87,11
HCPCS,520,HC PRO ANESTH CLOSED CHEST INCL BRONCHOSCOPY,327.0,228.9,,,0
HCPCS,52000,Cystoscopy,,,690.3,5762.58,11
HCPCS,52000,HC CYSTOSCOPY,4417.0,3091.9,,,0
HCPCS,52001,Cystoscopy removal of clots,,,3489.62,15482.25,11
HCPCS,52005,Cystoscopy & ureter catheter,,,2069.41,9181.28,11
HCPCS,52005,HC CYSTOURETHROSCOPY W/URETERAL CATH W/WO IRRIGATION/INSTILLATION/URETEROPYELOGRAPHY EXCLUSIVE OF RA,4726.0,3308.2,,,0
HCPCS,52007,Cystoscopy and biopsy,,,3489.62,15482.25,11
HCPCS,52010,Cystoscopy & duct catheter,,,690.3,3062.63,11
HCPCS,52204,Cystoscopy w/biopsy(s),,,2069.41,9181.28,11
HCPCS,52214,Cystoscopy and treatment,,,3489.62,15482.25,11
HCPCS,52224,Cystoscopy and treatment,,,3489.62,15482.25,11
HCPCS,52234,Cystoscopy and treatment,,,3489.62,15482.25,11
HCPCS,52235,Cystoscopy and treatment,,,3489.62,15482.25,11
HCPCS,52240,Cystoscopy and treatment,,,5308.0,23549.82,11
HCPCS,52250,Cystoscopy and radiotracer,,,3489.62,15482.25,11
HCPCS,52260,Cystoscopy and treatment,,,2069.41,9181.28,11
HCPCS,52265,Cystoscopy and treatment,,,1195.06,9181.28,11
HCPCS,52270,Cystoscopy & revise urethra,,,2069.41,9181.28,11
HCPCS,52275,Cystoscopy & revise urethra,,,2069.41,9181.28,11
HCPCS,52276,Cystoscopy and treatment,,,2069.41,9181.28,11
HCPCS,52277,Cystoscopy and treatment,,,3489.62,15482.25,11
HCPCS,52281,Cystoscopy and treatment,,,2069.41,9181.28,11
HCPCS,52282,Cystoscopy implant stent,,,2506.35,15482.25,11
HCPCS,52283,Cystoscopy and treatment,,,2069.41,9181.28,11
HCPCS,52284,Cysto rx balo cath urtl strx,,,5308.0,23549.82,11
HCPCS,52285,Cystoscopy and treatment,,,690.3,4477.9,11
HCPCS,52287,Cystoscopy chemodenervation,,,2069.41,9181.28,11
HCPCS,52290,Cystoscopy and treatment,,,2069.41,9181.28,11
HCPCS,52300,Cystoscopy and treatment,,,3489.62,15482.25,11
HCPCS,52301,Cystoscopy and treatment,,,3489.62,15482.25,11
HCPCS,52305,Cystoscopy and treatment,,,4956.38,23549.82,11
HCPCS,52310,Cystoscopy and treatment,,,2069.41,9181.28,11
HCPCS,52310,HC CYSTOSCOPY W/REMOVAL FOREIGN BODY CALCULUS/URETERAL STENT FROM URETHRA/BLADDER SIMPLE,8772.0,6140.4,,,0
HCPCS,52315,Cystoscopy and treatment,,,2069.41,9181.28,11
HCPCS,52317,Remove bladder stone,,,3489.62,15482.25,11
HCPCS,52318,Remove bladder stone,,,3489.62,15482.25,11
HCPCS,52320,Cystoscopy and treatment,,,3444.43,15482.25,11
HCPCS,52325,Cystoscopy stone removal,,,4956.38,23549.82,11
HCPCS,52327,Cystoscopy inject material,,,4956.38,23549.82,11
HCPCS,52330,Cystoscopy and treatment,,,3489.62,15482.25,11
HCPCS,52332,Cystoscopy and treatment,,,3489.62,15482.25,11
HCPCS,52334,Create passage to kidney,,,3489.62,15482.25,11
HCPCS,52341,Cysto W/Ureter Stricture Tx,,,2647.06,15482.25,11
HCPCS,52342,Cysto W/Up Stricture Tx,,,3489.62,15482.25,11
HCPCS,52343,Cysto W/Renal Stricture Tx,,,3489.62,15482.25,11
HCPCS,52344,Cysto/uretero stricture tx,,,2453.83,15482.25,11
HCPCS,52345,Cysto/Uretero W/Up Stricture,,,3256.82,15482.25,11
HCPCS,52346,Cystouretero W/Renal Strict,,,4956.38,23549.82,11
HCPCS,52351,Cystouretero & or pyeloscope,,,3489.62,15482.25,11
HCPCS,52352,Cystouretero w/stone remove,,,2213.7,15482.25,11
HCPCS,52353,Cystouretero W/Lithotripsy,,,5308.0,23549.82,11
HCPCS,52354,Cystouretero W/Biopsy,,,4228.56,23549.82,11
HCPCS,52355,Cystouretero W/Excise Tumor,,,4956.38,23549.82,11
HCPCS,52356,Cysto/uretero w/lithotripsy,,,5308.0,23549.82,11
HCPCS,52400,Cystouretero W/Congen Repr,,,3489.62,15482.25,11
HCPCS,52402,Cystourethro cut ejacul duct,,,3489.62,15482.25,11
HCPCS,52441,Cystourethro w/implant,,,704.26,878.59,4
HCPCS,52442,Cystourethro w/addl implant,,,188.44,235.08,4
HCPCS,52443,Cysto 1st trurl prst8 comis,,,9371.49,41578.13,7
HCPCS,52450,Incision of prostate,,,3489.62,15482.25,11
HCPCS,52500,Revision of bladder neck,,,3489.62,15482.25,11
HCPCS,52597,Trurl rbtc wtrjt rescj prst8,,,9371.49,41578.13,7
HCPCS,52601,Prostatectomy (TURP),,,5308.0,23549.82,11
HCPCS,52630,Remove prostate regrowth,,,5308.0,23549.82,11
HCPCS,52640,Relieve bladder contracture,,,3489.62,15482.25,11
HCPCS,52647,Laser surgery of prostate,,,9043.4,11281.86,4
HCPCS,52648,Laser surgery of prostate,,,5308.0,23549.82,11
HCPCS,52649,Prostate laser enucleation,,,5308.0,23549.82,11
HCPCS,52700,Drainage of prostate abscess,,,3489.62,15482.25,11
HCPCS,53000,Incision of urethra,,,2069.41,9181.28,11
HCPCS,53010,Incision of urethra,,,3831.16,23549.82,11
HCPCS,53020,Incision of urethra,,,2069.41,9181.28,11
HCPCS,53025,Incision of urethra,,,2069.41,9181.28,11
HCPCS,53040,Drainage of urethra abscess,,,3489.62,15482.25,11
HCPCS,53060,Drainage of urethra abscess,,,2069.41,9181.28,11
HCPCS,53080,Drainage of urinary leakage,,,690.3,4779.47,11
HCPCS,53085,Drainage of urinary leakage,,,2069.41,9181.28,11
HCPCS,53200,Biopsy of urethra,,,2069.41,9181.28,11
HCPCS,53210,Removal of urethra,,,3069.2,15482.25,11
HCPCS,53215,Removal of urethra,,,3831.16,23549.82,11
HCPCS,53220,Treatment of urethra lesion,,,3489.62,15482.25,11
HCPCS,53230,Removal of urethra lesion,,,4194.9,23549.82,11
HCPCS,53235,Removal of urethra lesion,,,3831.16,23549.82,11
HCPCS,53240,Surgery for urethra pouch,,,3489.62,15482.25,11
HCPCS,53250,Removal of urethra gland,,,3489.62,15482.25,11
HCPCS,53260,Treatment of urethra lesion,,,3489.62,15482.25,11
HCPCS,53265,Treatment of urethra lesion,,,2069.41,9181.28,11
HCPCS,53270,Removal of urethra gland,,,3489.62,15482.25,11
HCPCS,53275,Repair of urethra defect,,,3489.62,15482.25,11
HCPCS,53400,Revise urethra stage 1,,,5308.0,23549.82,11
HCPCS,53405,Revise urethra stage 2,,,5308.0,23549.82,11
HCPCS,53410,Reconstruction of urethra,,,5308.0,23549.82,11
HCPCS,53420,Reconstruct urethra stage 1,,,5308.0,23549.82,11
HCPCS,53425,Reconstruct urethra stage 2,,,5308.0,23549.82,11
HCPCS,53430,Reconstruction of urethra,,,5308.0,23549.82,11
HCPCS,53431,Reconstruct urethra/bladder,,,5308.0,23549.82,11
HCPCS,53440,Male sling procedure,,,13061.09,57947.66,11
HCPCS,53442,Remove/revise male sling,,,5308.0,23549.82,11
HCPCS,53444,Insert tandem cuff,,,16732.02,91032.27,11
HCPCS,53445,Insert uro/ves nck sphincter,,,20518.19,91032.27,11
HCPCS,53446,Remove uro sphincter,,,5308.0,23549.82,11
HCPCS,53447,Remove/replace ur sphincter,,,20518.19,91032.27,11
HCPCS,53449,Repair uro sphincter,,,5958.95,41578.13,11
HCPCS,53450,Revision of urethra,,,3489.62,15482.25,11
HCPCS,53451,Tprnl balo cntnc dev bi,,,13061.09,57947.66,11
HCPCS,53452,Tprnl balo cntnc dev uni,,,9371.49,41578.13,11
HCPCS,53453,Tprnl balo cntnc dev rmvl ea,,,3489.62,15482.25,11
HCPCS,53454,Tprnl balo cntnc dev adjmt,,,247.34,1097.37,11
HCPCS,53460,Revision of urethra,,,3489.62,15482.25,11
HCPCS,53500,Urethrlys transvag w/ scope,,,3489.62,15482.25,11
HCPCS,53502,Repair of urethra injury,,,2881.58,15482.25,11
HCPCS,53505,Repair of urethra injury,,,5308.0,23549.82,11
HCPCS,53510,Repair of urethra injury,,,3831.16,23549.82,11
HCPCS,53515,Repair of urethra injury,,,5308.0,23549.82,11
HCPCS,53520,Repair of urethra defect,,,5308.0,23549.82,11
HCPCS,53600,Dilate urethra stricture,,,247.34,1097.37,11
HCPCS,53600,HC DILT URETHRA STRCTR INIT,1133.0,793.1,,,0
HCPCS,53601,Dilate urethra stricture,,,131.71,584.37,11
HCPCS,53605,Dilate urethra stricture,,,3489.62,15482.25,11
HCPCS,53620,Dilate urethra stricture,,,690.3,4827.14,11
HCPCS,53620,HC DILATION URETHRAL STRICTURE BY PASSAGE OF FILLIFORM AND FOLLOWER MALE INITIAL,5120.0,3584.0,,,0
HCPCS,53621,Dilate urethra stricture,,,247.34,1097.37,11
HCPCS,53660,Dilation of urethra,,,127.38,565.15,11
HCPCS,53661,Dilation of urethra,,,131.71,584.37,11
HCPCS,53665,Dilation of urethra,,,2069.41,9181.28,11
HCPCS,537,HC PRO ANESTH CARDIAC ELECTROPHYS,225.0,157.5,,,0
HCPCS,53850,Prostatic microwave thermotx,,,3489.62,15482.25,11
HCPCS,53852,Prostatic rf thermotx,,,3489.62,15482.25,11
HCPCS,53854,Trurl dstrj prst8 tiss rf wv,,,3489.62,15482.25,11
HCPCS,53855,Insert prost urethral stent,,,2069.41,9181.28,11
HCPCS,53860,Transurethral rf treatment,,,2069.41,9181.28,11
HCPCS,53865,Cysto insj dev ischmc rmdlg,,,9371.49,41578.13,7
HCPCS,53866,Cathj rmvl dev ischmc rmdlg,,,247.34,1097.37,7
HCPCS,53899,HC UNLISTED PROCEDURE URINARY SYSTEM,17700.0,12390.0,,,0
HCPCS,53899,Urology surgery procedure,,,247.34,2708.65,11
HCPCS,540,HC PRO ANESTH THORACOTOMY/THORACOSCOPY,781.0,546.7,,,0
HCPCS,54000,Slitting of prepuce,,,3489.62,15482.25,11
HCPCS,54001,Slitting of prepuce,,,2069.41,9181.28,11
HCPCS,54015,Drain penis lesion,,,1635.03,7254.06,11
HCPCS,54050,Destruction penis lesion(s),,,291.97,1785.48,11
HCPCS,54055,Destruction penis lesion(s),,,2042.58,9062.24,11
HCPCS,54056,Cryosurgery penis lesion(s),,,158.65,881.22,11
HCPCS,54057,Laser surg penis lesion(s),,,2042.58,9062.24,11
HCPCS,54060,Excision of penis lesion(s),,,2042.58,9062.24,11
HCPCS,54065,Destruction penis lesion(s),,,2042.58,9062.24,11
HCPCS,54100,Biopsy of penis,,,1635.03,7254.06,11
HCPCS,54105,Biopsy of penis,,,2875.57,12757.95,11
HCPCS,54110,Treatment of penis lesion,,,3489.62,15482.25,11
HCPCS,54111,Treat penis lesion graft,,,5308.0,23549.82,11
HCPCS,54112,Treat penis lesion graft,,,6788.05,41578.13,11
HCPCS,54115,HC PRO REMOVAL FOREIGN BODY FROM DEEP PENILE TISSUE,967.0,676.9,,,0
HCPCS,54115,HC REMOVAL FOREIGN BODY FROM DEEP PENILE TISSUE,10257.0,7179.9,,,0
HCPCS,54115,Treatment of penis lesion,,,2875.57,12757.95,11
HCPCS,54120,Partial removal of penis,,,3489.62,15482.25,11
HCPCS,54150,Circumcision w/regionl block,,,2069.41,9181.28,11
HCPCS,54150,HC CIRCUMCISION W/REGIONL BLOCK,2389.0,1672.3,,,0
HCPCS,54150,HC PRO CIRCUMCISION W/ REGIONAL DORSAL OR RING BLOCK,1786.0,1250.2,,,0
HCPCS,54160,Circumcision neonate,,,690.3,5571.76,11
HCPCS,54161,Circum 28 days or older,,,2069.41,9181.28,11
HCPCS,54162,Lysis penil circumic lesion,,,2069.41,9181.28,11
HCPCS,54163,Repair of circumcision,,,2069.41,9181.28,11
HCPCS,54164,Frenulotomy of penis,,,2069.41,9181.28,11
HCPCS,54200,Treatment of penis lesion,,,247.34,1097.37,11
HCPCS,54205,Treatment of penis lesion,,,5308.0,23549.82,11
HCPCS,54220,HC IRRIGATION CORPORA CAVERNOSA FOR PRIAPRISM,320.0,224.0,,,0
HCPCS,54220,HC PRO IRRIGATION CORPORA CAVERNOSA FOR PRIAPRISM,234.0,163.8,,,0
HCPCS,54220,Treatment of penis lesion,,,247.34,4297.02,11
HCPCS,54231,Dynamic cavernosometry,,,247.34,4827.14,11
HCPCS,54235,HC INJ CORPORA CAVERNOSA W/PHARM,320.0,224.0,,,0
HCPCS,54235,HC PRO PENILE INJECTION,113.0,79.1,,,0
HCPCS,54235,Penile injection,,,247.34,1097.37,11
HCPCS,54240,Penis study,,,97.63,948.37,11
HCPCS,54250,Penis study,,,34.48,1097.37,11
HCPCS,54300,Revision of penis,,,3489.62,15482.25,11
HCPCS,54304,Revision of penis,,,3489.62,15482.25,11
HCPCS,54308,Reconstruction of urethra,,,5308.0,23549.82,11
HCPCS,54312,Reconstruction of urethra,,,3489.62,15482.25,11
HCPCS,54316,Reconstruction of urethra,,,6788.05,41578.13,11
HCPCS,54318,Reconstruction of urethra,,,3489.62,15482.25,11
HCPCS,54322,Reconstruction of urethra,,,3489.62,15482.25,11
HCPCS,54324,Reconstruction of urethra,,,3489.62,15482.25,11
HCPCS,54326,Reconstruction of urethra,,,3489.62,15482.25,11
HCPCS,54328,Revise penis/urethra,,,3489.62,15482.25,11
HCPCS,54332,Revise penis/urethra,,,3489.62,15482.25,11
HCPCS,54336,Revise penis/urethra,,,3489.62,15482.25,11
HCPCS,54340,Secondary urethral surgery,,,3489.62,15482.25,11
HCPCS,54344,Secondary urethral surgery,,,6788.05,41578.13,11
HCPCS,54348,Secondary urethral surgery,,,5308.0,23549.82,11
HCPCS,54352,Reconstruct urethra/penis,,,5308.0,23549.82,11
HCPCS,54360,Penis plastic surgery,,,3489.62,15482.25,11
HCPCS,54380,Repair penis,,,2069.41,9181.28,11
HCPCS,54385,Repair penis,,,2069.41,9181.28,11
HCPCS,54400,Insert semi-rigid prosthesis,,,13061.09,57947.66,11
HCPCS,54401,Insert self-contd prosthesis,,,20518.19,91032.27,11
HCPCS,54405,Insert multi-comp penis pros,,,20518.19,91032.27,11
HCPCS,54406,HC PRO REMOVAL INFLATABLE PENILE PROSTHESIS W/O RPLCMT PROSTHESIS,1622.0,1135.4,,,0
HCPCS,54406,HC REMOVAL INFLATABLE PENILE PROSTHESIS W/O RPLCMT PROSTHESIS,12066.0,8446.2,,,0
HCPCS,54406,Remove muti-comp penis pros,,,3489.62,15482.25,11
HCPCS,54408,Repair multi-comp penis pros,,,5308.0,23549.82,11
HCPCS,54410,Remove/replace penis prosth,,,8668.19,91032.27,11
HCPCS,54411,Remov/replc penis pros comp,,,20518.19,91032.27,11
HCPCS,54415,Remove self-contd penis pros,,,3489.62,15482.25,11
HCPCS,54416,Remv/repl penis contain pros,,,20518.19,91032.27,11
HCPCS,54417,Remv/replc penis pros compl,,,20518.19,91032.27,11
HCPCS,54420,HC CRPRA CVRNSA SAPHNS VEIN SHUNT UNI/BIL,4827.0,3378.9,,,0
HCPCS,54420,HC PRO HC CRPRA CVRNSA SAPHNS VEIN SHUNT UNI/BIL,876.0,613.2,,,0
HCPCS,54420,Revision of penis,,,3489.62,15482.25,11
HCPCS,54435,HC CORPORA CAVERNOSA-GLANS PENIS FISTULIZATION FOR PRIAPISM,3797.0,2657.9,,,0
HCPCS,54435,HC PRO CORPORA CAVERNOSA-GLANS PENIS FISTULIZATION FOR PRIAPISM,1231.0,861.7,,,0
HCPCS,54435,Revision of penis,,,3489.62,15482.25,11
HCPCS,54437,Repair corporeal tear,,,3444.43,15482.25,11
HCPCS,54438,Replantation of penis,,,4238.39,5287.5,4
HCPCS,54440,Repair of penis,,,3489.62,15482.25,11
HCPCS,54450,HC FORESKIN MANIPULATION INCL LYSIS PREPUTIAL ADHESIONS AND STRETCHING,320.0,224.0,,,0
HCPCS,54450,HC PRO FORESKIN MANIPULATION INCL LYSIS PREPUTIAL ADHESIONS AND STRETCHING,86.0,60.2,,,0
HCPCS,54450,Preputial stretching,,,247.34,5785.34,11
HCPCS,54500,Biopsy of testis,,,2716.06,12757.95,11
HCPCS,54505,Biopsy of testis,,,3489.62,15482.25,11
HCPCS,54512,Excise Lesion Testis,,,3489.62,15482.25,11
HCPCS,54520,Removal of testis,,,3489.62,15482.25,11
HCPCS,54522,Orchiectomy partial,,,3489.62,15482.25,11
HCPCS,54530,Removal of testis,,,3544.48,15725.66,11
HCPCS,54535,Extensive testis surgery,,,3489.62,15482.25,11
HCPCS,54550,Exploration for testis,,,3544.48,15725.66,11
HCPCS,54560,Exploration for testis,,,2069.41,9181.28,11
HCPCS,54600,Reduce testis torsion,,,3489.62,15482.25,11
HCPCS,54620,Suspension of testis,,,3489.62,15482.25,11
HCPCS,54640,Suspension of testis,,,3544.48,15725.66,11
HCPCS,54650,Orchiopexy (Fowler-Stephens),,,3544.48,15725.66,11
HCPCS,54660,Revision of testis,,,4466.25,23549.82,11
HCPCS,54670,Repair testis injury,,,3489.62,15482.25,11
HCPCS,54680,Relocation of testis(es),,,3489.62,15482.25,11
HCPCS,54690,Laparoscopy orchiectomy,,,5984.88,26552.87,11
HCPCS,54692,Laparoscopy orchiopexy,,,5984.88,26552.87,11
HCPCS,54699,Laparoscope proc testis,,,5984.88,26552.87,11
HCPCS,54700,Drainage of scrotum,,,2069.41,9181.28,11
HCPCS,54700,HC INCISION & DRAINAGE EPIDIDYMIS/TESTIS/SCROTAL SPACE,2091.0,1463.7,,,0
HCPCS,54700,HC PRO INCISION & DRAINAGE EPIDIDYMIS/TESTIS/SCROTAL SPACE,258.0,180.6,,,0
HCPCS,54800,Biopsy of epididymis,,,865.64,7254.06,11
HCPCS,54830,Remove epididymis lesion,,,3489.62,15482.25,11
HCPCS,54840,Remove epididymis lesion,,,2069.41,9181.28,11
HCPCS,54860,Removal of epididymis,,,3256.82,15482.25,11
HCPCS,54861,Removal of epididymis,,,3489.62,15482.25,11
HCPCS,54865,Explore Epididymis,,,3489.62,15482.25,11
HCPCS,54900,Fusion of spermatic ducts,,,2069.41,9181.28,11
HCPCS,54901,Fusion of spermatic ducts,,,3489.62,15482.25,11
HCPCS,55000,Drainage of hydrocele,,,701.03,3110.22,11
HCPCS,55000,HC PRO PUNCTURE ASPIRATION HYDROCELE TUNICA VAGIS W/WO INJECTION OF MEDICATION,194.0,135.8,,,0
HCPCS,55000,HC PUNCTURE ASPIRATION HYDROCELE TUNICA VAGIS W/WO INJECTION OF MEDICATION,2689.0,1882.3,,,0
HCPCS,55040,Removal of hydrocele,,,3544.48,15725.66,11
HCPCS,55041,Removal of hydroceles,,,3544.48,15725.66,11
HCPCS,55060,Repair of hydrocele,,,2881.58,15482.25,11
HCPCS,55100,Drainage of scrotum abscess,,,1635.03,7254.06,11
HCPCS,55100,HC DRAINAGE OF SCROTUM ABSCESS,1278.0,894.6,,,0
HCPCS,55100,HC PRO DRAINAGE OF SCROTUM ABSCESS,262.0,183.4,,,0
HCPCS,55110,Explore scrotum,,,3489.62,15482.25,11
HCPCS,55120,HC PRO REMOVAL FOREIGN BODY IN SCROTUM,858.0,600.6,,,0
HCPCS,55120,HC REMOVAL FOREIGN BODY IN SCROTUM,7352.0,5146.4,,,0
HCPCS,55120,Removal of scrotum lesion,,,2069.41,9181.28,11
HCPCS,55150,Removal of scrotum,,,3489.62,15482.25,11
HCPCS,55175,Revision of scrotum,,,3489.62,15482.25,11
HCPCS,55180,Revision of scrotum,,,4466.25,23549.82,11
HCPCS,55200,Incision of sperm duct,,,3489.62,15482.25,11
HCPCS,55250,Removal of sperm duct(s),,,2069.41,9181.28,11
HCPCS,55400,Repair of sperm duct,,,3489.62,15482.25,11
HCPCS,55500,Removal of hydrocele,,,3069.2,15482.25,11
HCPCS,55520,Removal of sperm cord lesion,,,2981.0,15482.25,11
HCPCS,55530,Revise spermatic cord veins,,,3489.62,15482.25,11
HCPCS,55535,Revise spermatic cord veins,,,5763.16,28434.0,11
HCPCS,55540,Revise hernia & sperm veins,,,3544.48,15725.66,11
HCPCS,55550,Laparo ligate spermatic vein,,,5984.88,26552.87,11
HCPCS,55559,Laparo proc spermatic cord,,,5984.88,26552.87,11
HCPCS,55600,Incise sperm duct pouch,,,2069.41,9181.28,11
HCPCS,55680,Remove sperm pouch lesion,,,3489.62,15482.25,11
HCPCS,55700,Biopsy of prostate,,,1649.91,2058.3,4
HCPCS,55700,HC BIOPSY PROSTATE,7739.0,5417.3,,,0
HCPCS,55705,Biopsy of prostate,,,2207.39,15482.25,11
HCPCS,55706,Prostate saturation sampling,,,1145.76,15482.25,11
HCPCS,55707,Bx prst8 trct us guided,,,3489.62,15482.25,7
HCPCS,55708,Bx prst8 trct us w/mri fus 1,,,3489.62,15482.25,7
HCPCS,55709,Bx prst8 tprnl us guided,,,3489.62,15482.25,7
HCPCS,55710,Bx prst8 tprn us w/mri fus 1,,,3489.62,15482.25,7
HCPCS,55711,Bx prst8 trct mri-us 1st,,,3489.62,15482.25,7
HCPCS,55712,Bx prst8 tprnl mri-us 1st,,,3489.62,15482.25,7
HCPCS,55713,Bx prst8 in-bore ct/mri bx 1,,,5308.0,23549.82,7
HCPCS,55714,Bx prst8 in-bore ct/mri 1,,,5308.0,23549.82,7
HCPCS,55720,Drainage of prostate abscess,,,3489.62,15482.25,11
HCPCS,55725,Drainage of prostate abscess,,,3489.62,15482.25,11
HCPCS,55860,Surgical exposure prostate,,,3869.37,23549.82,11
HCPCS,55866,Laparo radical prostatectomy,,,6341.65,46687.84,11
HCPCS,55867,Laps surg prst8ect smpl stot,,,10523.19,46687.84,11
HCPCS,55868,Lap srg prst8ct lymph nod bx,,,10523.19,46687.84,7
HCPCS,55869,Lap srg prst8ct bi pl lmphad,,,10523.19,46687.84,7
HCPCS,55870,Electroejaculation,,,551.82,4045.39,11
HCPCS,55873,Cryoablate Prostate,,,9371.49,41578.13,11
HCPCS,55874,Tprnl plmt biodegrdabl matrl,,,5308.0,23549.82,11
HCPCS,55875,Transperi needle place pros,,,5308.0,23549.82,11
HCPCS,55876,HC PRO PLACE INTERST DEVICE(S) RAD THER GUIDE SING/MULT,199.0,139.3,,,0
HCPCS,55876,PLACE RAD THER DEVICE PROSTATE,1608.0,1125.6,,,0
HCPCS,55876,Place rt device/marker pros,,,1111.81,6079.31,11
HCPCS,55877,Abltj ire prst8 1+ tum perq,,,10523.19,46687.84,7
HCPCS,55880,Abltj mal prst8 tiss hifu,,,9371.49,41578.13,11
HCPCS,55899,Genital surgery procedure,,,247.34,3360.79,11
HCPCS,55920,HC PLACEMENT OF NEEDLE PELVIC ORGAN RADIOELEMENT APPL,17148.0,12003.6,,,0
HCPCS,55920,HC PRO PLACEMENT OF NEEDLE PELVIC ORGAN RADIOELEMENT APPL,1045.0,731.5,,,0
HCPCS,55920,Place needles pelvic for rt,,,4952.26,21971.51,11
HCPCS,55970,Sex transformation m to f,,,4952.26,21971.51,11
HCPCS,55980,Sex transformation f to m,,,3489.62,15482.25,11
HCPCS,560,HC ANESTHESIA PX HEART PERICARDIAL SAC GREAT VESSELS OF CHEST W/O PUMP OXYGENATOR,358.0,250.6,,,0
HCPCS,560,HC PRO ANESTHESIA PX HEART PERICARDIAL SAC GREAT VESSELS OF CHEST W/O PUMP OXYGENATOR,794.0,555.8,,,0
HCPCS,56405,HC PRO I&D VULVA/PERINEUM ABSCESS,163.0,114.1,,,0
HCPCS,56405,I & D OF VULVA/PERINEUM,1146.0,802.2,,,0
HCPCS,56405,I & D of vulva/perineum,,,224.1,1338.42,11
HCPCS,56420,Drainage of gland abscess,,,200.14,887.97,11
HCPCS,56420,HC I&D GLAND ABSCESS,347.0,242.9,,,0
HCPCS,56420,HC PRO I&D BARTHOLIN'S GLAND ABSCESS,266.0,186.2,,,0
HCPCS,56440,Surgery for vulva lesion,,,3204.65,14217.94,11
HCPCS,56441,Lysis of labial lesion(s),,,3204.65,14217.94,11
HCPCS,56442,HC HYMENOTOMY SIMPLE INCISION,11879.0,8315.3,,,0
HCPCS,56442,HC PRO HYMENOTOMY SIMPLE INCISION,116.0,81.2,,,0
HCPCS,56442,Hymenotomy,,,3204.65,14217.94,11
HCPCS,56501,Destroy vulva lesions sim,,,1921.05,9062.24,11
HCPCS,56515,Destroy vulva lesion/s compl,,,2042.58,9062.24,11
HCPCS,56605,Biopsy of vulva/perineum,,,911.81,4045.39,11
HCPCS,56605,HC BX VULVA/PERINEUM ONE,3290.0,2303.0,,,0
HCPCS,56606,Biopsy of vulva/perineum,,,501.27,625.35,4
HCPCS,56620,Partial removal of vulva,,,3204.65,14217.94,11
HCPCS,56625,Complete removal of vulva,,,3204.65,14217.94,11
HCPCS,56630,Extensive vulva surgery,,,4952.26,21971.51,11
HCPCS,56700,Partial removal of hymen,,,3204.65,14217.94,11
HCPCS,56740,Remove vagina gland lesion,,,3204.65,14217.94,11
HCPCS,56800,Repair of vagina,,,3204.65,14217.94,11
HCPCS,56805,Repair clitoris,,,3204.65,14217.94,11
HCPCS,56810,HC PRO PERINEOPLASTY REPAIR OF PERINEUM NONOBSTETRICAL,614.0,429.8,,,0
HCPCS,56810,Repair of perineum,,,3204.65,14217.94,11
HCPCS,56820,Exam of vulva w/scope,,,200.14,887.97,11
HCPCS,56821,Exam/biopsy of vulva w/scope,,,301.67,3126.73,11
HCPCS,57000,Exploration of vagina,,,3204.65,14217.94,11
HCPCS,57010,Drainage of pelvic abscess,,,3204.65,14217.94,11
HCPCS,57020,Drainage of pelvic fluid,,,1216.0,21971.51,11
HCPCS,57022,I & d vaginal hematoma pp,,,2312.53,12757.95,11
HCPCS,57023,I & d vag hematoma non-ob,,,2875.57,12757.95,11
HCPCS,57061,Destroy vag lesions simple,,,1921.05,14217.94,11
HCPCS,57065,Destroy vag lesions complex,,,3204.65,14217.94,11
HCPCS,57100,Biopsy of vagina,,,911.81,4045.39,11
HCPCS,57100,HC BX VAGINAL MUCOSA SIMPLE,922.0,645.4,,,0
HCPCS,57105,Biopsy of vagina,,,3204.65,14217.94,11
HCPCS,57106,Remove vagina wall partial,,,3204.65,14217.94,11
HCPCS,57107,Remove vagina tissue part,,,3204.65,14217.94,11
HCPCS,57109,Vaginectomy partial w/nodes,,,3204.65,14217.94,11
HCPCS,57120,Closure of vagina,,,2285.07,21971.51,11
HCPCS,57130,Remove vagina lesion,,,3204.65,14217.94,11
HCPCS,57135,Remove vagina lesion,,,3204.65,14217.94,11
HCPCS,57150,Treat vagina infection,,,58.4,337.4,11
HCPCS,57155,HC PRO INSRT UTERINE TANDEM/VAG OVOIDS BRACHYTHERAPY,1414.0,989.8,,,0
HCPCS,57155,Insert uteri tandem/ovoids,,,4552.48,21971.51,11
HCPCS,57156,HC PRO INSERT VAG BRACHYTX DEVICE,244.0,170.8,,,0
HCPCS,57156,INSERT VAG BRACHYTX DEVICE,825.0,577.5,,,0
HCPCS,57156,Ins vag brachytx device,,,301.67,1338.42,11
HCPCS,57160,Insert pessary/other device,,,200.14,887.97,11
HCPCS,57170,Fitting of diaphragm/cap,,,26.21,887.97,11
HCPCS,57180,Treat vaginal bleeding,,,200.14,887.97,11
HCPCS,57200,HC COLPORRHAPHY SUTURE OF INJURY OF VAGINA NON-OBSTETRICAL,12436.0,8705.2,,,0
HCPCS,57200,HC PRO COLPORRHAPHY SUTURE OF INJURY OF VAGINA NON-OBSTETRICAL,757.0,529.9,,,0
HCPCS,57200,Repair of vagina,,,3204.65,14217.94,11
HCPCS,57210,Repair vagina/perineum,,,3204.65,14217.94,11
HCPCS,57220,Revision of urethra,,,4952.26,21971.51,11
HCPCS,57230,Repair of urethral lesion,,,3204.65,14217.94,11
HCPCS,57240,Repair bladder & vagina,,,4509.99,21971.51,11
HCPCS,57250,Repair rectum & vagina,,,4952.26,21971.51,11
HCPCS,57260,Repair of vagina,,,3513.74,21971.51,11
HCPCS,57265,Extensive repair of vagina,,,4570.14,21971.51,11
HCPCS,57267,Insert mesh/pelvic flr addon,,,2494.17,3111.54,4
HCPCS,57268,Repair of bowel bulge,,,3283.96,21971.51,11
HCPCS,57282,Colpopexy extraperitoneal,,,4514.98,32569.71,11
HCPCS,57283,Colpopexy intraperitoneal,,,3046.75,32569.71,11
HCPCS,57284,Repair paravag defect open,,,4952.26,21971.51,11
HCPCS,57285,Repair paravag defect vag,,,5087.39,32569.71,11
HCPCS,57287,Revise/Remove Sling Repair,,,3204.65,14217.94,11
HCPCS,57288,Repair bladder defect,,,4638.19,21971.51,11
HCPCS,57289,Repair bladder & vagina,,,6486.59,32569.71,11
HCPCS,57291,Construction of vagina,,,4952.26,21971.51,11
HCPCS,57292,Construct vagina with graft,,,4952.26,21971.51,11
HCPCS,57295,Revise vag graft via vagina,,,3204.65,14217.94,11
HCPCS,57300,Repair rectum-vagina fistula,,,3204.65,14217.94,11
HCPCS,57310,Repair urethrovaginal lesion,,,7341.04,32569.71,11
HCPCS,57320,Repair bladder-vagina lesion,,,4952.26,21971.51,11
HCPCS,57330,Repair bladder-vagina lesion,,,6486.59,32569.71,11
HCPCS,57335,Repair vagina,,,4952.26,21971.51,11
HCPCS,57400,Dilation of vagina,,,3204.65,14217.94,11
HCPCS,57410,HC PELVIC EXAMINATION UNDER ANESTHESIA,2879.0,2015.3,,,0
HCPCS,57410,Pelvic examination,,,3204.65,14217.94,11
HCPCS,57415,HC PRO REMV VAG FOREIGN BODY,406.0,284.2,,,0
HCPCS,57415,REMV VAG FOREIGN BODY,12352.0,8646.4,,,0
HCPCS,57415,Remove vaginal foreign body,,,3204.65,14217.94,11
HCPCS,57420,Exam of vagina w/scope,,,301.67,3594.84,11
HCPCS,57421,Exam/biopsy of vag w/scope,,,551.82,4045.39,11
HCPCS,57423,Repair paravag defect lap,,,8544.39,46687.84,11
HCPCS,57425,Laparoscopy surg colpopexy,,,4895.45,46687.84,11
HCPCS,57426,Revise prosth vag graft lap,,,4243.88,32569.71,11
HCPCS,57452,Exam of cervix w/scope,,,200.14,887.97,11
HCPCS,57454,Bx/curett of cervix w/scope,,,301.67,4062.96,11
HCPCS,57455,Biopsy of cervix w/scope,,,301.67,3594.84,11
HCPCS,57456,Endocerv curettage w/scope,,,301.67,4062.96,11
HCPCS,57460,Bx of cervix w/scope leep,,,3204.65,14217.94,11
HCPCS,57461,Conz of cervix w/scope leep,,,3204.65,14217.94,11
HCPCS,57500,Biopsy of cervix,,,911.81,4045.39,11
HCPCS,57505,Endocervical curettage,,,911.81,4045.39,11
HCPCS,57510,Cauterization of cervix,,,3204.65,14217.94,11
HCPCS,57511,Cryocautery of cervix,,,270.46,1338.42,11
HCPCS,57513,Laser surgery of cervix,,,3204.65,14217.94,11
HCPCS,57520,Conization of cervix,,,3204.65,14217.94,11
HCPCS,57522,Conization of cervix,,,3204.65,14217.94,11
HCPCS,57530,Removal of cervix,,,4952.26,21971.51,11
HCPCS,57550,Removal of residual cervix,,,4952.26,21971.51,11
HCPCS,57555,Remove cervix/repair vagina,,,4952.26,21971.51,11
HCPCS,57556,Remove cervix repair bowel,,,4952.26,21971.51,11
HCPCS,57558,D&C oF Cervical Stump,,,3204.65,14217.94,11
HCPCS,57700,Revision of cervix,,,3204.65,14217.94,11
HCPCS,57720,Revision of cervix,,,3204.65,14217.94,11
HCPCS,57800,Dilation of cervical canal,,,3204.65,14217.94,11
HCPCS,58100,Biopsy of uterus lining,,,200.14,2396.55,11
HCPCS,58100,HC ENDOMETRIAL BIOPSY W/ OR W/O ENDOCERVIX BIOPSY W/O CERVICAL DILATION ANY METHOD,590.0,413.0,,,0
HCPCS,58120,Dilation and curettage,,,3204.65,14217.94,11
HCPCS,58120,HC DILATION AND CURETTAGE,9300.0,6510.0,,,0
HCPCS,58145,Myomectomy vag method,,,3204.65,14217.94,11
HCPCS,58150,Total hysterectomy,,,8656.25,10798.89,4
HCPCS,58260,Vaginal hysterectomy,,,4952.26,21971.51,11
HCPCS,58262,Vag hyst including t/o,,,4410.84,21971.51,11
HCPCS,58263,Vag hyst w/t/o & vag repair,,,4952.26,21971.51,11
HCPCS,58270,Vag hyst w/enterocele repair,,,3808.45,21971.51,11
HCPCS,58290,Vag hyst complex,,,3819.67,32569.71,11
HCPCS,58291,Vag hyst incl t/o complex,,,4952.26,21971.51,11
HCPCS,58292,Vag hyst t/o & repair compl,,,7341.04,32569.71,11
HCPCS,58294,Vag hyst w/enterocele compl,,,4952.26,21971.51,11
HCPCS,58300,Insert intrauterine device,,,2693.96,3360.79,4
HCPCS,58301,HC PRO REMOVE IUD,154.0,107.8,,,0
HCPCS,58301,HC REMOVE IUD,301.0,210.7,,,0
HCPCS,58301,Remove intrauterine device,,,301.67,3965.98,11
HCPCS,58321,Artificial insemination,,,301.67,1338.42,11
HCPCS,58322,Artificial insemination,,,200.14,887.97,11
HCPCS,58323,Sperm washing,,,200.14,887.97,11
HCPCS,58340,HC CATHETERIZE FOR HYSTEROGRAPHY,227.0,158.9,,,0
HCPCS,58345,Reopen fallopian tube,,,3204.65,14217.94,11
HCPCS,58346,Insert heyman uteri capsule,,,3805.13,21971.51,11
HCPCS,58350,Reopen fallopian tube,,,2452.23,21971.51,11
HCPCS,58353,Endometr ablate thermal,,,3647.01,21971.51,11
HCPCS,58356,Endometrial cryoablation,,,4952.26,21971.51,11
HCPCS,58541,Lsh uterus 250 g or less,,,9108.91,46687.84,11
HCPCS,58542,Lsh w/t/o ut 250 g or less,,,6888.87,46687.84,11
HCPCS,58543,LSH Uterus Above 250 g,,,9108.91,46687.84,11
HCPCS,58544,LSH w/t/o Uterus Above 250 g,,,9108.91,46687.84,11
HCPCS,58545,Laparoscopic myomectomy,,,3256.82,26552.87,11
HCPCS,58546,Laparo-myomectomy complex,,,9108.91,46687.84,11
HCPCS,58548,Lap Radical Hyst,,,9758.07,12173.43,4
HCPCS,58550,Laparo-asst vag hysterectomy,,,5984.88,26552.87,11
HCPCS,58552,Laparo-vag hyst incl t/o,,,7259.03,46687.84,11
HCPCS,58553,Laparo-vag hyst complex,,,9108.91,46687.84,11
HCPCS,58554,Laparo-vag hyst w/t/o compl,,,6464.94,46687.84,11
HCPCS,58555,Hysteroscopy dx sep proc,,,3204.65,14217.94,11
HCPCS,58558,Hysteroscopy biopsy,,,3204.65,14217.94,11
HCPCS,58559,Hysteroscopy lysis,,,2046.13,21971.51,11
HCPCS,58560,Hysteroscopy resect septum,,,4427.4,21971.51,11
HCPCS,58561,Hysteroscopy remove myoma,,,4859.44,21971.51,11
HCPCS,58562,Hysteroscopy remove fb,,,3204.65,14217.94,11
HCPCS,58563,Hysteroscopy ablation,,,4796.19,21971.51,11
HCPCS,58565,Hysteroscopy sterilization,,,4952.26,21971.51,11
HCPCS,58570,Tlh uterus 250 g or less,,,8798.92,46687.84,11
HCPCS,58571,Tlh w/t/o 250 g or less,,,8891.23,46687.84,11
HCPCS,58572,Tlh uterus over 250 g,,,9108.91,46687.84,11
HCPCS,58573,Tlh w/t/o uterus over 250 g,,,8924.62,46687.84,11
HCPCS,58575,Laps tot hyst resj mal,,,5911.14,7374.29,4
HCPCS,58578,Laparo proc uterus,,,3171.85,26552.87,11
HCPCS,58579,Hysteroscope procedure,,,200.14,6272.96,11
HCPCS,58580,Transcrv abltj utrn fibrd rf,,,7341.04,32569.71,11
HCPCS,58600,Division of fallopian tube,,,3069.2,14217.94,11
HCPCS,58615,Occlude fallopian tube(s),,,3204.65,14217.94,11
HCPCS,58660,Laparoscopy lysis,,,5984.88,26552.87,11
HCPCS,58661,Laparoscopy remove adnexa,,,4979.16,26552.87,11
HCPCS,58662,Laparoscopy excise lesions,,,5097.07,26552.87,11
HCPCS,58670,Laparoscopy tubal cautery,,,4405.99,26552.87,11
HCPCS,58671,Laparoscopy tubal block,,,4618.86,26552.87,11
HCPCS,58672,Laparoscopy fimbrioplasty,,,5984.88,26552.87,11
HCPCS,58673,Laparoscopy salpingostomy,,,4416.18,46687.84,11
HCPCS,58674,Laps abltj uterine fibroids,,,10523.19,46687.84,11
HCPCS,58679,Laparo proc oviduct-ovary,,,5984.88,26552.87,11
HCPCS,58700,Removal of fallopian tube,,,3632.05,4531.07,4
HCPCS,58770,Create new tubal opening,,,3204.65,14217.94,11
HCPCS,58800,Drainage of ovarian cyst(s),,,3204.65,14217.94,11
HCPCS,58805,Drainage of ovarian cyst(s),,,3204.65,14217.94,11
HCPCS,58820,Drain ovary abscess open,,,3204.65,14217.94,11
HCPCS,58900,Biopsy of ovary(s),,,3204.65,14217.94,11
HCPCS,58920,Partial removal of ovary(s),,,6486.59,32569.71,11
HCPCS,58925,Removal of ovarian cyst(s),,,3703.06,21971.51,11
HCPCS,58970,Retrieval of oocyte,,,551.82,4045.39,11
HCPCS,58974,Transfer of embryo,,,551.82,4045.39,11
HCPCS,58976,Transfer of embryo,,,301.67,1338.42,11
HCPCS,58999,Genital surgery procedure,,,200.14,7615.6,11
HCPCS,58999,HC UNLISTED PROCEDURE FEMALE GENITAL SYSTEM,3082.0,2157.4,,,0
HCPCS,59000,Amniocentesis diagnostic,,,551.82,4045.39,11
HCPCS,59000,HC AMNIOCENTESIS DIAGNOSTIC,2691.0,1883.7,,,0
HCPCS,59001,Amniocentesis therapeutic,,,301.67,1516.99,11
HCPCS,59012,Fetal cord puncture prenatal,,,301.67,1338.42,11
HCPCS,59015,Chorion biopsy,,,551.82,4045.39,11
HCPCS,59020,Fetal contract stress test,,,87.84,887.97,11
HCPCS,59020,HC FETAL CONTRACT STRESS TEST,707.0,494.9,,,0
HCPCS,59025,Fetal non-stress test,,,42.27,887.97,11
HCPCS,59025,HC FETAL NON-STRESS TEST,490.0,343.0,,,0
HCPCS,59030,Fetal scalp blood sample,,,301.67,1338.42,11
HCPCS,59051,Fetal monitor/interpret only,,,123.59,154.19,4
HCPCS,59070,Transabdom amnioinfus w/us,,,301.67,1338.42,11
HCPCS,59072,Umbilical cord occlud w/us,,,301.67,1338.42,11
HCPCS,59074,Fetal fluid drainage w/us,,,301.67,1338.42,11
HCPCS,59074,HC FETAL FLUID DRAINAGE W/ US GUIDANCE,401.0,280.7,,,0
HCPCS,59076,Fetal shunt placement w/us,,,301.67,1338.42,11
HCPCS,59100,Remove uterus lesion,,,4952.26,21971.51,11
HCPCS,59150,Treat ectopic pregnancy,,,5984.88,26552.87,11
HCPCS,59151,Treat ectopic pregnancy,,,5984.88,26552.87,11
HCPCS,59160,D & c after delivery,,,3204.65,14217.94,11
HCPCS,59200,Insert cervical dilator,,,301.67,1338.42,11
HCPCS,59300,Episiotomy or vaginal repair,,,3204.65,14217.94,11
HCPCS,59320,Revision of cervix,,,3204.65,14217.94,11
HCPCS,59400,Obstetrical care,,,5018.2,6260.32,4
HCPCS,59409,HC PRO VAGINAL DELIVERY,1393.0,975.1,,,0
HCPCS,59409,HC VAGINAL DELIVERY,10132.0,7092.4,,,0
HCPCS,59409,Obstetrical care,,,3204.65,14217.94,11
HCPCS,59410,Obstetrical care,,,2626.49,3276.62,4
HCPCS,59412,Antepartum manipulation,,,2168.89,14217.94,11
HCPCS,59412,HC EXTERNAL CEPHALIC VERSION,11458.0,8020.6,,,0
HCPCS,59414,DELIVER PLACENTA,11285.0,7899.5,,,0
HCPCS,59414,Deliver placenta,,,3204.65,14217.94,11
HCPCS,59425,Antepartum care only,,,993.29,1239.16,4
HCPCS,59426,Antepartum care only,,,1755.82,2190.43,4
HCPCS,59430,Care after delivery,,,369.48,460.93,4
HCPCS,59510,Cesarean delivery,,,5683.58,7090.41,4
HCPCS,59515,Cesarean delivery,,,3155.41,3936.45,4
HCPCS,59610,Vbac delivery,,,5288.59,6597.65,4
HCPCS,59612,Vbac delivery only,,,3204.65,14217.94,11
HCPCS,59614,Vbac care after delivery,,,2844.96,3549.16,4
HCPCS,59618,Attempted vbac delivery,,,5950.19,7423.01,4
HCPCS,59622,Attempted vbac after care,,,3421.29,4268.15,4
HCPCS,59812,Treatment of miscarriage,,,3204.65,14217.94,11
HCPCS,59820,Care of miscarriage,,,3204.65,14217.94,11
HCPCS,59820,HC PRO TX OF MISSED ABORTION COMPLETED SURGICALLY FIRST TRIMESTER,895.0,626.5,,,0
HCPCS,59820,HC TX OF MISSED ABORTION COMPLETED SURGICALLY FIRST TRIMESTER,9498.0,6648.6,,,0
HCPCS,59821,Treatment of miscarriage,,,3204.65,14217.94,11
HCPCS,59840,Abortion,,,3204.65,14217.94,11
HCPCS,59841,Abortion,,,3204.65,14217.94,11
HCPCS,59855,HC INDUCED ABORTION 1 OR MORE VAGINAL SUPPOSITORIES W/WO CERVICAL DILATION INCL DELIVERY FETUS/SECUNDINES,6065.0,4245.5,,,0
HCPCS,59855,HC PRO INDUCED ABORTION 1 OR MORE VAGINAL SUPPOSITORIES W/WO CERVICAL DILATION INCL DELIVERY FETUS/SECUNDINES,1000.0,700.0,,,0
HCPCS,59856,HC INDUCED ABORTION 1 OR MORE VAGINAL SUPPOSITORIES W/WO CERVICAL DILATION & CURETTAGE/EVACUATION,6975.0,4882.5,,,0
HCPCS,59856,HC PRO INDUCED ABORTION 1 OR MORE VAGINAL SUPPOSITORIES W/WO CERVICAL DILATION & CURETTAGE/EVACUATION,1173.0,821.1,,,0
HCPCS,59857,HC INDUCED ABORTION 1 OR MORE VAGINAL SUPPOSITORIES W/WO CERVICAL DILATION INCL DELIVERY FETUS/SECUNDINES W/HYSTEROTOMY,8021.0,5614.7,,,0
HCPCS,59857,HC PRO INDUCED ABORTION 1 OR MORE VAGINAL SUPPOSITORIES W/WO CERVICAL DILATION INCL DELIVERY FETUS/SECUNDINES W/HYSTEROTOMY,1370.0,959.0,,,0
HCPCS,59866,Abortion (mpr),,,301.67,1338.42,11
HCPCS,59870,Evacuate mole of uterus,,,3204.65,14217.94,11
HCPCS,59871,Remove cerclage suture,,,3204.65,14217.94,11
HCPCS,59897,Fetal invas px w/us,,,200.14,887.97,11
HCPCS,59898,Laparo proc ob care/deliver,,,5984.88,26552.87,11
HCPCS,59899,Maternity care procedure,,,26.21,887.97,11
HCPCS,60000,Drain thyroid/tongue cyst,,,1489.88,6814.79,11
HCPCS,60100,Biopsy of thyroid,,,701.03,3110.22,11
HCPCS,60100,HC BIOPSY THYROID PERCUTANEOUS CORE NEEDLE,932.0,652.4,,,0
HCPCS,60200,Remove thyroid lesion,,,4653.09,26552.87,11
HCPCS,60210,Partial thyroid excision,,,5984.88,26552.87,11
HCPCS,60212,Partial thyroid excision,,,5984.88,26552.87,11
HCPCS,60220,Partial removal of thyroid,,,5984.88,26552.87,11
HCPCS,60225,Partial removal of thyroid,,,5984.88,26552.87,11
HCPCS,60240,Removal of thyroid,,,5984.88,26552.87,11
HCPCS,60252,Removal of thyroid,,,5359.77,26000.79,11
HCPCS,60254,Extensive thyroid surgery,,,10600.68,13224.61,4
HCPCS,60260,Repeat thyroid surgery,,,5860.44,26000.79,11
HCPCS,60271,Removal of thyroid,,,5860.44,26000.79,11
HCPCS,60280,Remove thyroid duct lesion,,,5984.88,26552.87,11
HCPCS,60281,Remove thyroid duct lesion,,,5984.88,26552.87,11
HCPCS,60300,Aspir/inj thyroid cyst,,,701.03,3110.22,11
HCPCS,60300,HC ASPIRATION AND/OR INJECTION THYRIOD CYST,751.0,525.7,,,0
HCPCS,60500,Explore parathyroid glands,,,5860.44,26000.79,11
HCPCS,60502,Re-explore parathyroids,,,5860.44,26000.79,11
HCPCS,60512,Autotransplant parathyroid,,,5105.86,6369.69,4
HCPCS,60520,Removal of thymus gland,,,5860.44,26000.79,11
HCPCS,60659,Laparo proc endocrine,,,5984.88,26552.87,11
HCPCS,60660,Abltj 1/+thyr ndul 1lobe prq,,,1635.03,7254.06,7
HCPCS,60699,Endocrine surgery procedure,,,5984.88,26552.87,11
HCPCS,61000,Remove cranial cavity fluid,,,698.8,3100.34,11
HCPCS,61001,Remove cranial cavity fluid,,,698.8,3100.34,11
HCPCS,61020,Remove brain cavity fluid,,,875.6,3884.74,11
HCPCS,61026,Injection into brain canal,,,698.8,3100.34,11
HCPCS,61050,Remove brain canal fluid,,,303.87,2127.95,11
HCPCS,61055,HC CISTERNAL/LATERAL C1-C2 PUNCTURE W/INJECTION OF MEDICATION/OTH SUBSTANCE DX/TREATMENT,2328.0,1629.6,,,0
HCPCS,61055,Injection into brain canal,,,303.87,2127.95,11
HCPCS,61070,Brain canal shunt procedure,,,647.84,3100.34,11
HCPCS,61070,HC PUNCTURE OF SHUNT TUBING OR RESERVOIR FOR ASPIRATION/INJECTION PROCEDURE,2227.0,1558.9,,,0
HCPCS,61210,HC BURR HOLE IMPLANT VENTRICULAR CATH/OTHER DEVICE,23290.0,16303.0,,,0
HCPCS,61215,Insert brain-fluid device,,,7257.4,38544.86,11
HCPCS,61330,Decompress eye socket,,,3282.2,14562.0,11
HCPCS,61623,Endovasc tempory vessel occl,,,11428.37,50703.82,11
HCPCS,61624,Transcath occlusion cns,,,18147.73,80515.32,11
HCPCS,61626,Transcath occlusion non-cns,,,11428.37,50703.82,11
HCPCS,61645,Perq art m-thrombect &/nfs,,,2464.87,3074.99,4
HCPCS,61650,Evasc prlng admn rx agnt 1st,,,1637.87,2043.28,4
HCPCS,61651,Evasc prlng admn rx agnt add,,,695.63,867.81,4
HCPCS,61720,Incise skull/brain surgery,,,6656.0,38544.86,11
HCPCS,61770,Incise skull for treatment,,,3381.88,15004.24,11
HCPCS,61790,Treat trigeminal nerve,,,1933.13,8576.66,11
HCPCS,61791,Treat trigeminal tract,,,1933.13,8576.66,11
HCPCS,61796,Srs cranial lesion simple,,,2161.6,2696.65,4
HCPCS,61797,Srs cran les simple addl,,,596.88,744.62,4
HCPCS,61798,Srs cranial lesion complex,,,2161.6,2696.65,4
HCPCS,61799,Srs cran les complex addl,,,825.34,1029.63,4
HCPCS,61800,Apply srs headframe add-on,,,422.11,526.59,4
HCPCS,61880,Revise/remove neuroelectrode,,,3461.03,15355.43,11
HCPCS,61885,Insrt/redo neurostim 1 array,,,3819.67,135531.68,11
HCPCS,61886,Implant neurostim arrays,,,8180.47,135531.68,11
HCPCS,61888,Revise/remove neuroreceiver,,,6885.25,48940.4,11
HCPCS,61891,Rev/rplcmt sk-mnt crnl nstm,,,30548.12,135531.68,11
HCPCS,61892,Rmv sk-mnt crnl nstm pg/rcvr,,,3239.17,14371.12,11
HCPCS,62000,Treat skull fracture,,,3282.2,14562.0,11
HCPCS,62194,Replace/irrigate catheter,,,1705.74,8576.66,11
HCPCS,62225,Replace/irrigate catheter,,,3071.75,15004.24,11
HCPCS,62230,Replace/revise brain shunt,,,7257.4,38544.86,11
HCPCS,62252,Csf Shunt Reprogram,,,132.71,1348.99,11
HCPCS,62263,Epidural lysis mult sessions,,,875.6,3884.74,11
HCPCS,62264,Epidural lysis on single day,,,875.6,3884.74,11
HCPCS,62267,HC PERQ ASPIR INTERDISCAL DX,1510.0,1057.0,,,0
HCPCS,62267,Interdiscal perq aspir dx,,,467.26,3110.22,11
HCPCS,62268,Drain spinal cord cyst,,,875.6,3884.74,11
HCPCS,62269,Needle biopsy spinal cord,,,1635.03,7254.06,11
HCPCS,62270,HC PRO LUMBAR PUNCTURE,853.0,597.1,,,0
HCPCS,62270,HC PUNCTURE SPINAL LUMB DX,664.0,464.8,,,0
HCPCS,62270,Spinal fluid tap diagnostic,,,496.97,3100.34,11
HCPCS,62272,Drain cerebro spinal fluid,,,698.8,3100.34,11
HCPCS,62272,HC PUNCTURE DRAIN CSF,974.0,681.8,,,0
HCPCS,62273,HC INJECT EPIDURAL BLOOD PATCH,1727.0,1208.9,,,0
HCPCS,62273,Inject epidural patch,,,698.8,3100.34,11
HCPCS,62280,Treat spinal cord lesion,,,875.6,3884.74,11
HCPCS,62281,HC INJECT/INFUSION NEUROLYTIC SUBST W/WO THERAP SUBST EPIDURAL/CERVICAL/THORACIC,3558.0,2490.6,,,0
HCPCS,62281,Treat spinal cord lesion,,,875.6,3884.74,11
HCPCS,62282,HC INJECT/INFUSION NEUROLYTIC SUBST W/WO THERAP SUBST EPIDURAL/LUMBAR/SACRAL,3876.0,2713.2,,,0
HCPCS,62282,Treat spinal canal lesion,,,875.6,3884.74,11
HCPCS,62284,HC MYLEGRAM NOT C1-C2,637.0,445.9,,,0
HCPCS,62287,Percutaneous diskectomy,,,1933.13,8576.66,11
HCPCS,62292,Injection into disk lesion,,,1705.74,8576.66,11
HCPCS,62294,Injection into spinal artery,,,875.6,3884.74,11
HCPCS,62300295,"HC DRESSING AG AQUACEL 3.5""X10""",61.0,42.7,,,0
HCPCS,62300718,HC MEPILEX BORDER FLEX 3 X 3 IN,12.0,8.4,,,0
HCPCS,62300720,HC MEPILEX BORDER FLEX OVAL 5.1 X 6.3 IN,31.0,21.7,,,0
HCPCS,62300722,HC MEPILEX BORDER FLEX LITE 1.6 X 2 IN,8.0,5.6,,,0
HCPCS,62300723,HC MEPILEX BORDER FLEX LITE 3 X 3 IN,10.0,7.0,,,0
HCPCS,62300724,HC MEPILEX BORDER HEEL 8.7 X 9.1 IN,60.0,42.0,,,0
HCPCS,62300725,HC MEPILEX 4 X 4 IN,15.0,10.5,,,0
HCPCS,62300726,HC MEPILEX 4 X 8 IN,30.0,21.0,,,0
HCPCS,62300727,HC MEPILEX LITE 2.4 X 3.4 IN,11.0,7.7,,,0
HCPCS,62300729,HC MEPITEL BOTH SIDES 4 X 7 IN,43.0,30.1,,,0
HCPCS,62300731,HC MEPILEX TRANSFER 6 X 8 IN,31.0,21.7,,,0
HCPCS,62300732,HC MEPILEX TRANSFER AG 6 X 8 IN,133.0,93.1,,,0
HCPCS,62300733,HC EXUFIBER PEDS/NICU 4 X 4.8 IN,16.0,11.2,,,0
HCPCS,62300734,HC MELGISORB PLUS CALCIUM ALGINATE 2 X 2 IN,7.0,4.9,,,0
HCPCS,62300735,HC MELGISORB PLUS CALCIUM ALGINATE 4 X 4 IN,12.0,8.4,,,0
HCPCS,62300736,HC MELGISORB PLUS CALCIUM ALGINATE 1.25 X 17.7 IN,13.0,9.1,,,0
HCPCS,62300737,HC MELGISORB AG 2 X 2 IN,11.0,7.7,,,0
HCPCS,62300738,HC MELGISORB AG 4 X 4 IN,31.0,21.7,,,0
HCPCS,62300739,HC MELGISORB AG 1.2 X 18 IN,42.0,29.4,,,0
HCPCS,62300740,HC MEXTRA SUPERABSORBENT 5 X 7 IN,14.0,9.8,,,0
HCPCS,62300741,HC MEXTRA SUPERABSORBENT 7 X 9 IN,16.0,11.2,,,0
HCPCS,62300743,HC MEPORE PRO 3.6 X 4 IN,2.0,1.4,,,0
HCPCS,62300744,HC MEPORE ALL SIZES,3.0,2.1,,,0
HCPCS,62300745,HC MESALT 2 X 2 IN FOLDED / 4 X 4 IN,5.0,3.5,,,0
HCPCS,62300750,"HC DRESSING TRANSPARENT  MEPITEL NON-ADHERENT 3"" X 4""",27.0,18.9,,,0
HCPCS,62300751,HC DRESSING WOUND MEPITEL 4IN X 7IN 1- SIDED MESH TRANSPARENT,51.0,35.7,,,0
HCPCS,62300752,HC TAPE MEFIX ADHESIVE ROLL 4IN X 11YD,42.0,29.4,,,0
HCPCS,62302,HC MYELOGRAPHY VIA LUMBAR INJECTION INC RAD S&I CERVICAL,1738.0,1216.6,,,0
HCPCS,62302,Myelography lumbar injection,,,776.06,3443.1,11
HCPCS,62303,Myelography lumbar injection,,,776.06,3443.1,11
HCPCS,62304,HC MYELOGRAPHY LUMBAR INJ INCL RADIOLOGICAL SUPRVSON/INTERP LOMBOSACRAL,960.0,672.0,,,0
HCPCS,62304,Myelography lumbar injection,,,722.68,3443.1,11
HCPCS,62305,HC MYELOGRAPHY VIA LUMBAR INJECT INCL RAD S&I 2 OR MORE REGIONS,1738.0,1216.6,,,0
HCPCS,62305,Myelography lumbar injection,,,776.06,3443.1,11
HCPCS,62320,HC INJECT DX/THERPEUTIC SUBSTANCE INCL NEEDLE/CATH PLACE INTERLAMINAR EPIDURAL/SUBARACHNOID/CERVICAL/THORACIC W/O IMAGE GUIDE,2499.0,1749.3,,,0
HCPCS,62320,Njx interlaminar crv/thrc,,,698.8,3100.34,11
HCPCS,62321,HC INJECT DX/THERPEUTIC SUBSTANCE INCL NEEDLE/CATH PLACE INTERLAMINAR EPIDURAL/SUBARACHNOID/CERVICAL/THORACIC W/IMAGE GUIDE (IE FLUORO OR CT),1727.0,1208.9,,,0
HCPCS,62321,Njx interlaminar crv/thrc,,,698.8,3100.34,11
HCPCS,62322,HC INJECT DX/THERAPEUTIC SUBSTANCE INCL NEEDLE/CATH PLACE INTERLAMINAR EPIDURAL/SUBARACHNOID/ LUMBAR/SACRAL (CAUDAL) W/O IMAGE GUIDE,2945.0,2061.5,,,0
HCPCS,62322,Njx interlaminar lmbr/sac,,,875.6,3884.74,11
HCPCS,62323,HC INJECT DX/THERAPEUTIC SUBSTANCE INCL NEEDLE/ CATH PLACE INTERLAMINAR EPIDURAL/SUBARACHNOID/LUMBAR/SACRAL (CAUDAL) W/IMAGE GUIDE (IE FLUORO OR CT),1504.0,1052.8,,,0
HCPCS,62323,Njx interlaminar lmbr/sac,,,698.8,3100.34,11
HCPCS,62324,HC INJECT INCL INDWELLING CATH PLACE CONT INFUSION/INTERMIT BOLUS INTERLAMINAR EPIDURAL/SUBARACHNOID/CERVICAL/THORACIC W/O IMAGE GUIDE,3294.0,2305.8,,,0
HCPCS,62324,Njx interlaminar crv/thrc,,,875.6,3884.74,11
HCPCS,62325,HC INJECT INCL INDWELLING CATH PLACE CONT INFUSION/INTERMIT BOLUS INTERLAMINAR EPIDURAL/SUBARACHNOID/CERVICAL/THORACIC W/IMAGE GUIDE (IE FLUORO OR CT),3788.0,2651.6,,,0
HCPCS,62325,Njx interlaminar crv/thrc,,,875.6,3884.74,11
HCPCS,62326,HC INJECT INCL INDWELLING CATH PLACE CONT INFUSION/INTERMIT BOLUS INTERLAMINAR EPIDURAL/SUBARACHNOID/LUMBAR/SACRAL (CAUDAL) W/O IMAGE GUIDE,1323.0,926.1,,,0
HCPCS,62326,Njx interlaminar lmbr/sac,,,875.6,3884.74,11
HCPCS,62327,HC INJECT INCL INDWELLING CATH PLACE CONT INFUSION/INTERMIT BOLUS INTERLAMINAR EPIDURAL/ SUBARACHNOID/LUMBAR/SACRAL (CAUDAL) W/IMAGE GUIDE (IE FLUORO OR CT),3294.0,2305.8,,,0
HCPCS,62327,Njx interlaminar lmbr/sac,,,875.6,3884.74,11
HCPCS,62328,Dx lmbr spi pnxr w/fluor/ct,,,698.8,3100.34,11
HCPCS,62328,HC DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT,2802.0,1961.4,,,0
HCPCS,62329,HC SPINAL PUNCTURE THERAPEUTIC DRAINAGE OF CSF W/FLUORO OR CT GUIDE,2884.0,2018.8,,,0
HCPCS,62329,Ther spi pnxr csf fluor/ct,,,698.8,3100.34,11
HCPCS,62330,Dcmprn prq rmv lig flv 1lmbr,,,7183.42,31870.39,7
HCPCS,62350,Implant spinal canal cath,,,7257.4,38544.86,11
HCPCS,62351,Implant spinal canal cath,,,7183.42,31870.39,11
HCPCS,62355,Remove spinal canal catheter,,,1933.13,8576.66,11
HCPCS,62360,Insert spine infusion device,,,7257.4,79163.49,11
HCPCS,62361,Implant spine infusion pump,,,17843.03,79163.49,11
HCPCS,62362,Implant spine infusion pump,,,17843.03,79163.49,11
HCPCS,62365,Remove spine infusion device,,,3381.88,15004.24,11
HCPCS,62367,Analyze spine infus pump,,,304.06,1348.99,11
HCPCS,62368,Analyze sp inf pump w/reprog,,,304.06,1348.99,11
HCPCS,62369,Anal sp inf pmp w/reprg&fill,,,304.06,1348.99,11
HCPCS,62370,Anl sp inf pmp w/mdreprg&fil,,,304.06,1348.99,11
HCPCS,62370,HC PUMP REFILL REPROGRAM,897.0,627.9,,,0
HCPCS,62380,Ndsc dcmprn 1 ntrspc lumbar,,,7183.42,31870.39,11
HCPCS,62400001,HC RESEARCH ONLY STEMI IMPELLA ALC PUMP SET 2.5 / 3.4 / 3.5,55000.0,38500.0,,,0
HCPCS,62400009,HC RESEARCH ONLY PROMISE III LIMFLOW STENT GRAFT SYSTEM,25000.0,17500.0,,,0
HCPCS,63001,Remove spine lamina 1/2 crvl,,,7183.42,31870.39,11
HCPCS,63003,Remove spine lamina 1/2 thrc,,,7183.42,31870.39,11
HCPCS,63005,Remove spine lamina 1/2 lmbr,,,7183.42,31870.39,11
HCPCS,63011,Remove spine lamina 1/2 scrl,,,7183.42,31870.39,11
HCPCS,63012,Remove lamina/facets lumbar,,,7183.42,31870.39,11
HCPCS,63015,Remove spine lamina >2 crvcl,,,7183.42,31870.39,11
HCPCS,63016,Remove spine lamina >2 thrc,,,7183.42,31870.39,11
HCPCS,63017,Remove spine lamina >2 lmbr,,,7183.42,31870.39,11
HCPCS,63020,Neck spine disk surgery,,,7183.42,31870.39,11
HCPCS,63030,Low back disk surgery,,,7183.42,31870.39,11
HCPCS,63035,Spinal disk surgery add-on,,,3039.52,3791.88,4
HCPCS,63040,Laminotomy single cervical,,,7183.42,31870.39,11
HCPCS,63042,Laminotomy single lumbar,,,7183.42,31870.39,11
HCPCS,63045,Remove spine lamina 1 crvl,,,7183.42,31870.39,11
HCPCS,63046,Remove spine lamina 1 thrc,,,7183.42,31870.39,11
HCPCS,63047,Remove spine lamina 1 lmbr,,,7183.42,31870.39,11
HCPCS,63048,Remove spinal lamina add-on,,,4840.71,6038.9,4
HCPCS,63055,Decompress spinal cord thrc,,,7183.42,31870.39,11
HCPCS,63056,Decompress spinal cord lmbr,,,7183.42,31870.39,11
HCPCS,63057,Decompress spine cord add-on,,,9357.12,11673.24,4
HCPCS,63064,Decompress spinal cord thrc,,,7183.42,31870.39,11
HCPCS,63066,Decompress spine cord add-on,,,9357.12,11673.24,4
HCPCS,63075,Neck spine disk surgery,,,3227.14,31870.39,11
HCPCS,63265,Excise intraspinl lesion crv,,,7183.42,31870.39,11
HCPCS,63266,Excise intrspinl lesion thrc,,,7183.42,31870.39,11
HCPCS,63267,Excise intrspinl lesion lmbr,,,6510.59,31870.39,11
HCPCS,63268,Excise intrspinl lesion scrl,,,7183.42,31870.39,11
HCPCS,635,HC PRO ANESTHESIA PX LUMBAR REGION DIAGNOSTIC/THERAPEUTIC PUNCTURE,123.0,86.1,,,0
HCPCS,63600,Remove spinal cord lesion,,,1933.13,8576.66,11
HCPCS,63610,Stimulation of spinal cord,,,1933.13,8576.66,11
HCPCS,63620,Srs spinal lesion,,,2161.6,2696.65,4
HCPCS,63621,Srs spinal lesion addl,,,686.33,856.21,4
HCPCS,63650,HC PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODE ARRAY EPIDURAL,29045.0,20331.5,,,0
HCPCS,63650,Implant neuroelectrodes,,,6309.06,27991.15,11
HCPCS,63655,Implant neuroelectrodes,,,1816.03,85208.23,11
HCPCS,63661,HC REMOVAL SPINAL NEUROSTIMULATOR ELECTRODE PERCUTANEOUS ARRAY(S) INCL FLUORO,8314.0,5819.8,,,0
HCPCS,63661,Remove spine eltrd perq aray,,,1933.13,8576.66,11
HCPCS,63662,HC REMOVAL SPINAL NEUOSTIMULATOR ELECTRODE PLATE/PADDLE(S) LAMINOTOMY/LAMINECTOMY INCL FLUORO,14641.0,10248.7,,,0
HCPCS,63662,Remove spine eltrd plate,,,3461.03,15355.43,11
HCPCS,63663,HC REVISION INCL REPLACEMENT SPINAL NEUROSTIMULATOR ELECTRODE PERCUTANEOUS ARRAY(S) INCL FLUORO,27940.0,19558.0,,,0
HCPCS,63663,Revise spine eltrd perq aray,,,4157.71,27991.15,11
HCPCS,63664,HC REVISION INCL REPLACEMENT SPINAL NEUROSTIMULATOR ELECTRODE PLATE/PADDLE(S) LAMINOTOMY/LAMINECTOMY INCL FLUORO,53090.0,37163.0,,,0
HCPCS,63664,Revise spine eltrd plate,,,4157.71,48940.4,11
HCPCS,63685,Insrt/redo spine n generator,,,3632.05,135531.68,11
HCPCS,63688,HC REVISION/REMOVAL IMPLANTED SPINAL NEUROSTIMULATOR PULSE GENERATOR/RECEIVER DETACH CONNECTION ELECTORDE ARRAY,14641.0,10248.7,,,0
HCPCS,63688,Revise/remove neuroreceiver,,,3461.03,15355.43,11
HCPCS,63741,Install spinal shunt,,,7257.4,38544.86,11
HCPCS,63744,Revision of spinal shunt,,,3381.88,15004.24,11
HCPCS,63746,Removal of spinal shunt,,,1132.61,8576.66,11
HCPCS,64400,HC PRO NERVE BLOCK TRIGEMINAL,116.0,81.2,,,0
HCPCS,64400,INJ NERVE BLOCK TRIGEMINAL,801.0,560.7,,,0
HCPCS,64400,N block inj trigeminal,,,303.87,1348.18,11
HCPCS,64405,HC INJ NERVE BLOCK OCCIPITAL,1095.0,766.5,,,0
HCPCS,64405,HC PRO INJ NERVE BLOCK OCCIPITAL,120.0,84.0,,,0
HCPCS,64405,N block inj occipital,,,303.87,1348.18,11
HCPCS,64408,HC INJECTION(S) ANESTHETIC AGENT(S) AND/OR STEROID VAGUS NERVE,2015.0,1410.5,,,0
HCPCS,64408,HC PRO INJECTION(S) ANESTHETIC AGENT(S) AND/OR STEROID VAGUS NERVE,211.0,147.7,,,0
HCPCS,64408,N block inj vagus,,,303.87,1348.18,11
HCPCS,64415,HC INJECTION(S) ANESTHETIC AGENT(S) AND/OR STEROID BRACHIAL PLEXUS INCL IMAGE GUIDE,3294.0,2305.8,,,0
HCPCS,64415,HC PRO INJECTION(S) ANESTHETIC AGENT(S) AND/OR STEROID BRACHIAL PLEXUS INCL IMAGE GUIDE,192.0,134.4,,,0
HCPCS,64415,N block inj brachial plexus,,,875.6,3884.74,11
HCPCS,64416,HC INJECTION(S) ANESTHETIC AGENT(S) AND/OR STEROID BRACHIAL PLEXUS CONT INFUSION BY CATHETER INCL IMAGE GUIDE,3789.0,2652.3,,,0
HCPCS,64416,HC PRO INJECTION(S) ANESTHETIC AGENT(S) AND/OR STEROID BRACHIAL PLEXUS CONT INFUSION BY CATHETER INCL IMAGE GUIDE,409.0,286.3,,,0
HCPCS,64416,N block cont infuse b plex,,,875.6,3884.74,11
HCPCS,64417,HC INJECTION ANESTHETIC AGENT(S)/STEROID AXILLARY NERVE INCL IMAGE GUIDE,3086.0,2160.2,,,0
HCPCS,64417,HC PRO INJECTION ANESTHETIC AGENT(S)/STEROID AXILLARY NERVE INCL IMAGE GUIDE,152.0,106.4,,,0
HCPCS,64417,N block inj axillary,,,819.52,3884.74,11
HCPCS,64418,HC INJ NERVE BLOCK SUPRASCAP,884.0,618.8,,,0
HCPCS,64418,N block inj suprascapular,,,698.8,3100.34,11
HCPCS,64420,HC INJ AA(S) / STEROID INTERCOSTAL NERVE SINGLE LEVEL,2464.0,1724.8,,,0
HCPCS,64420,HC PRO INJ AA(S) / STEROID INTERCOSTAL NERVE SINGLE LEVEL,139.0,97.3,,,0
HCPCS,64420,N block inj intercost sng,,,559.38,3100.34,11
HCPCS,64421,HC INJ NERVE BLOCK INTERCOST MULT,3259.0,2281.3,,,0
HCPCS,64421,HC PRO N BLOCK INJ INTERCOST MLT,181.0,126.7,,,0
HCPCS,64421,N block inj intercost mlt,,,819.52,3884.74,11
HCPCS,64425,HC INJ NERVE BLOCK ILIOING HYPOGI,1423.0,996.1,,,0
HCPCS,64425,N block inj ilio-ing/hypogi,,,698.8,3100.34,11
HCPCS,64430,HC INJECTION ANESTHETIC AGENT/STEROID PUDENDAL NERVE,3440.0,2408.0,,,0
HCPCS,64430,N block inj pudendal,,,875.6,3884.74,11
HCPCS,64435,HC INJECTION(S) ANESTHETIC AGENT(S) AND/OR STEROID PARACERVICAL UTERINE NERVE,2499.0,1749.3,,,0
HCPCS,64435,HC PRO INJECTION(S) ANESTHETIC AGENT(S) AND/OR STEROID PARACERVICAL UTERINE NERVE,204.0,142.8,,,0
HCPCS,64435,N block inj paracervical,,,698.8,3100.34,11
HCPCS,64445,HC INJECTION ANESTHETIC AGENT(S)/STEROID SCIATIC NERVE INCL IMAGE GUIDE,3744.0,2620.8,,,0
HCPCS,64445,N block inj sciatic sng,,,698.8,4297.02,11
HCPCS,64446,HC INJECTION(S) ANESTHETIC AGENT(S) AND/OR STEROID SCIATIC NERVE CONT INFUSION BY CATHETER INCL IMAGE GUIDE,4306.0,3014.2,,,0
HCPCS,64446,HC PRO INJECTION(S) ANESTHETIC AGENT(S) AND/OR STEROID SCIATIC NERVE CONT INFUSION BY CATHETER INCL IMAGE GUIDE,400.0,280.0,,,0
HCPCS,64446,N blk inj sciatic cont inf,,,875.6,3884.74,11
HCPCS,64447,HC INJECTION ANESTHETIC AGENT(S)/STEROID FEMORAL NERVE INCL IMAGE GUIDE,600.0,420.0,,,0
HCPCS,64447,HC PRO INJECTION ANESTHETIC AGENT(S)/STEROID FEMORAL NERVE INCL IMAGE GUIDE,166.0,116.2,,,0
HCPCS,64447,N block inj fem single,,,698.8,5804.85,11
HCPCS,64448,HC INJECTION(S) ANESTHETIC AGENT(S) AND/OR STEROID FEMORAL NERVE CONT INFUSION BY CATHETER INCL IMAGE GUIDE,3294.0,2305.8,,,0
HCPCS,64448,HC PRO INJECTION(S) ANESTHETIC AGENT(S) AND/OR STEROID FEMORAL NERVE CONT INFUSION BY CATHETER INCL IMAGE GUIDE,358.0,250.6,,,0
HCPCS,64448,N block inj fem cont inf,,,819.52,3884.74,11
HCPCS,64449,HC INJECTION(S) AGENT(S) AND/OR STEROID LUMBAR PLEXUS POSTERIOR APPROACH CONT INFUSION BY CATHETER INCL CATHETER PLACEMENT,3789.0,2652.3,,,0
HCPCS,64449,HC PRO INJECTION(S) AGENT(S) AND/OR STEROID LUMBAR PLEXUS POSTERIOR APPROACH CONT INFUSION BY CATHETER INCL CATHETER PLACEMENT,367.0,256.9,,,0
HCPCS,64449,N block inj lumbar plexus,,,875.6,3884.74,11
HCPCS,64450,HC INJ NERVE BLOCK OTHER PERIPH,921.0,644.7,,,0
HCPCS,64450,HC PRO INJ NERVE BLOCK OTHER PERIPH,659.0,461.3,,,0
HCPCS,64450,N block other peripheral,,,693.14,3100.34,11
HCPCS,64451,HC INJECTION ANESTHETIC AGENT(S)/STEROID NERVES INNERVATING THE SACROILIAC JOINT W/IMAGE GUIDANCE,2566.0,1796.2,,,0
HCPCS,64451,Njx aa&/strd nrv nrvtg si jt,,,698.8,3100.34,11
HCPCS,64454,HC INJECTION(S) ANESTHETIC AGENT(S) AND/OR STERIOD GENICULAR NERVE BRANCHES INCL IMAGE GUIDE WHEN PERFORMED,2800.0,1960.0,,,0
HCPCS,64454,HC PRO INJECTION(S) ANESTHETIC AGENT(S) AND/OR STERIOD GENICULAR NERVE BRANCHES INCL IMAGE GUIDE WHEN PERFORMED,222.0,155.4,,,0
HCPCS,64454,Njx aa&/strd gnclr nrv brnch,,,698.8,3100.34,11
HCPCS,64455,HC INJECTION(S) ANESTHERIC AGENT(S)/STERIOD PLANTAR DIGITAL NERVE(S),4649.0,3254.3,,,0
HCPCS,64455,N block inj plantar digit,,,303.87,5336.73,11
HCPCS,64461,HC PARAVERTEBRAL BLOCK (PVB) THORACIC SINGLE INJECT SITE,2499.0,1749.3,,,0
HCPCS,64461,Pvb thoracic single inj site,,,698.8,3100.34,11
HCPCS,64462,HC PARAVERTEBRAL BLOCK (PVB) THORACIC SECOND & ADDL INJECT SITE(S),184.0,128.8,,,0
HCPCS,64462,Pvb thoracic 2nd+ inj site,,,168.83,210.62,4
HCPCS,64463,HC PARAVERTEBRAL BLOCK (PVB) THORACIC CONTINUOUS INFUSION BY CATHETER,2499.0,1749.3,,,0
HCPCS,64463,Pvb thoracic cont infusion,,,698.8,3100.34,11
HCPCS,64466,HC THORACIC FASCIAL PLANE BLOCK UNILATERAL BY INJECTION INCL IMAGE GUIDE WHEN PERFORMED,2949.0,2064.3,,,0
HCPCS,64467,HC THORACIC FASCIAL PLANE BLOCK UNILATERAL CONT INFUSION INCL IMAGE GUIDE WHEN PERFORMED,2949.0,2064.3,,,0
HCPCS,64468,HC THORACIC FASCIAL PLANE BLOCK BILATERAL INJECTION INCL IMAGE GUIDE WHEN PERFORMED,2949.0,2064.3,,,0
HCPCS,64469,HC THORACIC FASCIAL PLANE BLOCK BILATERAL CONT INFUSION INCL IMAGE GUIDE WHEN PERFORMED,2949.0,2064.3,,,0
HCPCS,64473,HC LOWER EXTREMITY FASCIAL PLANE BLOCK UNILATERAL BY INJECTION INCL IMAGE GUIDE WHEN PERFORMED,2949.0,2064.3,,,0
HCPCS,64474,HC LOWER EXTREMITY FASCIAL PLANE BLOCK UNILATERAL CONT INFUSION INCL IMAGE GUIDE WHEN PERFORMED,2949.0,2064.3,,,0
HCPCS,64479,HC INJ FORA EPIDU CERV THOR SINGL,2545.0,1781.5,,,0
HCPCS,64479,Inj foramen epidural c/t,,,875.6,3884.74,11
HCPCS,64480,HC INJ FORA EPIDU CERV THOR ADDL,1159.0,811.3,,,0
HCPCS,64480,Inj foramen epidural add-on,,,819.52,1022.38,4
HCPCS,64483,HC INJ FORA EPIDU LUMB SACR SINGL,1805.0,1263.5,,,0
HCPCS,64483,Inj foramen epidural l/s,,,875.6,3884.74,11
HCPCS,64484,HC INJ FORA EPIDU LUMB SACR ADDL,1214.0,849.8,,,0
HCPCS,64484,Inj foramen epidural add-on,,,1003.56,1251.96,4
HCPCS,64486,HC TRANSVERSUS ABDOMINIS PLANE BLOCK UNILATERAL BY INJECTION,222.0,155.4,,,0
HCPCS,64486,Tap block unil by injection,,,193.98,242.0,4
HCPCS,64487,HC TRANSVERSUS ABDOMINIS PLANE BLOCK UNILATERAL BY CONTINUOUS INFUSION,256.0,179.2,,,0
HCPCS,64487,Tap block uni by infusion,,,222.95,278.13,4
HCPCS,64488,HC TRANSVERSUS ABDOMINIS PLANE BLOCK BILATERAL BY INJECTIONS,279.0,195.3,,,0
HCPCS,64488,Tap block bi injection,,,243.19,303.38,4
HCPCS,64489,HC TRANSVERSUS ABDOMINIS PLANE BLOCK BY CONTINUOUS INFUSIONS,314.0,219.8,,,0
HCPCS,64489,Tap block bi by infusion,,,273.61,341.33,4
HCPCS,64490,HC INJ FACET CERV THOR FLUORO SINGL,1699.0,1189.3,,,0
HCPCS,64490,Inj paravert f jnt c/t 1 lev,,,875.6,3884.74,11
HCPCS,64491,HC INJ FACET CERV THOR FLUORO 2ND,860.0,602.0,,,0
HCPCS,64491,Inj paravert f jnt c/t 2 lev,,,806.05,1005.56,4
HCPCS,64492,HC INJECTION(S) PARAVERTEBRAL FACET JOINT W/ IMAGE GUIDE CERVICAL/THORACIC THIRD AND ANY ADDITIONAL LEVEL(S),881.0,616.7,,,0
HCPCS,64492,Inj paravert f jnt c/t 3 lev,,,743.05,926.97,4
HCPCS,64493,HC INJ FACET LUMB SACR FLUORO SINGL,1278.0,894.6,,,0
HCPCS,64493,Inj paravert f jnt l/s 1 lev,,,875.6,3884.74,11
HCPCS,64494,HC INJ FACET LUMB SACR FLUORO 2ND,645.0,451.5,,,0
HCPCS,64494,Inj paravert f jnt l/s 2 lev,,,647.4,807.64,4
HCPCS,64495,HC INJ FACET LUMB SACR FLUORO 3RD>,600.0,420.0,,,0
HCPCS,64495,Inj paravert f jnt l/s 3 lev,,,598.45,746.59,4
HCPCS,64505,HC INJ N BLOCK SPHENOPAL GANG,1081.0,756.7,,,0
HCPCS,64505,HC PRO INJ N BLOCK SPHENOPAL GANG,260.0,182.0,,,0
HCPCS,64505,N block spenopalatine gangl,,,303.87,1348.18,11
HCPCS,64510,HC INJ N BLOCK STELLATE GANG,1484.0,1038.8,,,0
HCPCS,64510,N block stellate ganglion,,,875.6,3884.74,11
HCPCS,64517,HC INJECTION ANESTHETIC AGENT SUPERIOR HYPOGASTRIC PLEXUS,3294.0,2305.8,,,0
HCPCS,64517,N block inj hypogas plxs,,,875.6,3884.74,11
HCPCS,64520,HC INJ N BLOCK LUMB THOR SYMPH,3294.0,2305.8,,,0
HCPCS,64520,N block lumbar/thoracic,,,875.6,3884.74,11
HCPCS,64530,HC INJ N BLOCK CELIAC PLEXUS,3294.0,2305.8,,,0
HCPCS,64530,N block inj celiac pelus,,,875.6,3884.74,11
HCPCS,64553,Implant neuroelectrodes,,,3819.67,48940.4,11
HCPCS,64555,HC PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODE ARRAY PERIPHERAL NERVE,26489.0,18542.3,,,0
HCPCS,64555,Implant neuroelectrodes,,,6309.06,27991.15,11
HCPCS,64561,Implant neuroelectrodes,,,6309.06,27991.15,11
HCPCS,64566,Neuroeltrd stim post tibial,,,303.87,1348.18,11
HCPCS,64567,Perq elec nrv field stimj cn,,,897.89,3983.62,7
HCPCS,64568,Inc for vagus n elect impl,,,43604.58,193458.78,11
HCPCS,64569,Revise/repl vagus n eltrd,,,4533.33,48940.4,11
HCPCS,64570,Remove vagus n eltrd,,,3381.88,15004.24,11
HCPCS,64575,Implant neuroelectrodes,,,11030.91,48940.4,11
HCPCS,64580,Implant neuroelectrodes,,,16576.61,85208.23,11
HCPCS,64581,Implant neuroelectrodes,,,4090.24,27991.15,11
HCPCS,64582,Opn mpltj hpglsl nstm ary pg,,,30548.12,135531.68,11
HCPCS,64583,Rev/rplct hpglsl nstm ary pg,,,11030.91,48940.4,11
HCPCS,64584,Rmvl hpglsl nstim ary pg,,,3381.88,22014.53,11
HCPCS,64585,Revise/remove neuroelectrode,,,3461.03,15355.43,11
HCPCS,64590,Insrt/redo pn/gastr stimul,,,6041.55,85208.23,11
HCPCS,64595,Revise/rmv pn/gastr stimul,,,3461.03,15355.43,11
HCPCS,64596,Ins/rplcmt prq eltrd ra pn 1,,,11030.91,49111.5,11
HCPCS,64598,Revj/rmvl nea pn w/int nstim,,,3461.03,15355.43,11
HCPCS,64600,Injection treatment of nerve,,,875.6,3884.74,11
HCPCS,64605,Injection treatment of nerve,,,1933.13,8576.66,11
HCPCS,64610,Injection treatment of nerve,,,1933.13,8576.66,11
HCPCS,64611,Chemodenerv saliv glands,,,303.87,1348.18,11
HCPCS,64611,HC CHEMODENERV PAROTID&SUBMANDIBL SALIVARY GLNDS BILATERAL,1211.0,847.7,,,0
HCPCS,64612,Destroy nerve face muscle,,,303.87,1348.18,11
HCPCS,64612,HC DESTROY NERVE FACE MUSCLE,1112.0,778.4,,,0
HCPCS,64615,Chemodenerv musc migraine,,,303.87,1348.18,11
HCPCS,64615,HC CHEMODENERV MUSC MIGRAINE,1112.0,778.4,,,0
HCPCS,64616,Chemodenerv musc neck dyston,,,303.87,1409.03,11
HCPCS,64616,HC CHEMODENERV MUSC NECK DYSTONIA,1542.0,1079.4,,,0
HCPCS,64617,Chemodener muscle larynx emg,,,698.8,3360.79,11
HCPCS,64617,HC CHEMODENERV MUSCLE LARYNX UNILAT INCL GUIDE NEEDLE EMG WHEN PERFORMED,3675.0,2572.5,,,0
HCPCS,64620,HC DESTRUCTION NEUROLYTIC AGENT INTERCOSTAL NERVE,3501.0,2450.7,,,0
HCPCS,64620,Injection treatment of nerve,,,875.6,3884.74,11
HCPCS,64624,Dstrj nulyt agt gnclr nrv,,,1933.13,8576.66,11
HCPCS,64624,HC DESTRUCTION NEUROLYTIC AGT W/IMG,7058.0,4940.6,,,0
HCPCS,64625,HC RADIOFREQUENCY ABLTJ NERVE SI JOINT W/IMG GUIDANCE,8165.0,5715.5,,,0
HCPCS,64625,Rf abltj nrv nrvtg si jt,,,1933.13,8576.66,11
HCPCS,64628,Trml dstrj ios bvn 1st 2 l/s,,,12709.88,56389.43,11
HCPCS,64630,HC DESTRUCTION NEUROLYTIC AGENT PUDENDAL NERVE,3501.0,2450.7,,,0
HCPCS,64630,Injection treatment of nerve,,,875.6,3884.74,11
HCPCS,64632,HC DESTRUCTION BY NEUROLYTIC AGENT PLANTAR COMMON DIGITAL NERVE,1112.0,778.4,,,0
HCPCS,64632,N block inj common digit,,,198.4,1348.18,11
HCPCS,64633,Destroy cerv/thor facet jnt,,,1933.13,8576.66,11
HCPCS,64633,HC DESTROY CERV/THOR FACET JNT SINGL,2981.0,2086.7,,,0
HCPCS,64634,Destroy c/th facet jnt addl,,,1035.37,1291.65,4
HCPCS,64634,HC DESTROY CERV/THOR FACET JNT ADDL,1498.0,1048.6,,,0
HCPCS,64635,Destroy lumb/sac facet jnt,,,1933.13,8576.66,11
HCPCS,64635,HC DESTROY LUMB/SAC FACET JNT,2628.0,1839.6,,,0
HCPCS,64636,Destroy l/s facet jnt addl,,,1182.82,1475.6,4
HCPCS,64636,HC DESTROY LUMB/SAC FACET JNT ADDL,1200.0,840.0,,,0
HCPCS,64640,HC DESTROY PERIPHER NERVE,1121.0,784.7,,,0
HCPCS,64640,Injection treatment of nerve,,,823.0,3884.74,11
HCPCS,64642,Chemodenerv 1 extremity 1-4,,,698.8,3100.34,11
HCPCS,64642,HC CHEMODENERV 1 EXTREMITY 1-4 MUSC,1096.0,767.2,,,0
HCPCS,64643,Chemodenerv 1 extrem 1-4 ea,,,230.64,287.73,4
HCPCS,64643,HC CHEMODENERV 1 EXTREMITY 1-4 EA ADD MUSC,801.0,560.7,,,0
HCPCS,64644,Chemodenerv 1 extrem 5/> mus,,,698.8,3100.34,11
HCPCS,64644,HC CHEMODENERV 1 EXTREMITY 5 OR MORE MUSC,1261.0,882.7,,,0
HCPCS,64645,Chemodenerv 1 extrem 5/> ea,,,260.79,325.34,4
HCPCS,64645,HC CHEMODENERV 1 EXTREMITY EA ADD EXTREMITY 5 OR MORE MUSC,697.0,487.9,,,0
HCPCS,64646,Chemodenerv trunk musc 1-5,,,698.8,3100.34,11
HCPCS,64646,HC CHEMODENERV TRUNK 1-5 MUSC,356.0,249.2,,,0
HCPCS,64647,Chemodenerv trunk musc 6/>,,,698.8,3100.34,11
HCPCS,64647,HC CHEMODENERV TRUNK 6 OR MORE MUSC,2702.0,1891.4,,,0
HCPCS,64650,Chemodenerv eccrine glands,,,303.87,1348.18,11
HCPCS,64650,HC CHEMODEN ECCRINE BOTH AXIL,2760.0,1932.0,,,0
HCPCS,64653,Chemodenerv eccrine glands,,,303.87,1348.18,11
HCPCS,64655,Revj/rplcmt bat mod sys lead,,,3461.03,15355.43,7
HCPCS,64656,Revj/rplcmt bat mod sys pg,,,30548.12,135531.68,7
HCPCS,64658,Rmvl bat modul sys lead only,,,3461.03,15355.43,7
HCPCS,64659,Rmvl bat modulj sys pg only,,,3461.03,15355.43,7
HCPCS,64680,HC DESTRUCTION BY NEUROLYTIC AGENT CELIAC PLEXUS,1112.0,778.4,,,0
HCPCS,64680,Injection treatment of nerve,,,875.6,3884.74,11
HCPCS,64681,Injection treatment of nerve,,,875.6,3884.74,11
HCPCS,64702,Revise finger/toe nerve,,,1933.13,8576.66,11
HCPCS,64704,Revise hand/foot nerve,,,1933.13,8576.66,11
HCPCS,64708,Revise arm/leg nerve,,,1933.13,8576.66,11
HCPCS,64712,Revision of sciatic nerve,,,1933.13,8576.66,11
HCPCS,64713,Revision of arm nerve(s),,,1933.13,8576.66,11
HCPCS,64714,Revise low back nerve(s),,,1933.13,8576.66,11
HCPCS,64716,Revision of cranial nerve,,,1933.13,8576.66,11
HCPCS,64718,Revise ulnar nerve at elbow,,,1933.13,8666.11,11
HCPCS,64719,Revise ulnar nerve at wrist,,,1933.13,8576.66,11
HCPCS,64721,Carpal tunnel surgery,,,1933.13,8576.66,11
HCPCS,64722,Relieve pressure on nerve(s),,,1933.13,8576.66,11
HCPCS,64726,Release foot/toe nerve,,,1933.13,8576.66,11
HCPCS,64727,Internal nerve revision,,,3611.37,4505.27,4
HCPCS,64728,Dcmprn median nrv carpl tunl,,,1933.13,8576.66,7
HCPCS,64732,Incision of brow nerve,,,1933.13,8576.66,11
HCPCS,64734,Incision of cheek nerve,,,1933.13,8576.66,11
HCPCS,64736,Incision of chin nerve,,,1933.13,8576.66,11
HCPCS,64738,Incision of jaw nerve,,,1933.13,8576.66,11
HCPCS,64740,Incision of tongue nerve,,,1933.13,8576.66,11
HCPCS,64742,Incision of facial nerve,,,1933.13,8576.66,11
HCPCS,64744,Incise nerve back of head,,,1933.13,8576.66,11
HCPCS,64746,Incise diaphragm nerve,,,1933.13,8576.66,11
HCPCS,64763,Incise hip/thigh nerve,,,1933.13,8576.66,11
HCPCS,64766,Incise hip/thigh nerve,,,1933.13,8576.66,11
HCPCS,64771,Sever cranial nerve,,,1933.13,8576.66,11
HCPCS,64772,Incision of spinal nerve,,,1933.13,8576.66,11
HCPCS,64774,Remove skin nerve lesion,,,1933.13,8576.66,11
HCPCS,64776,Remove digit nerve lesion,,,1933.13,8576.66,11
HCPCS,64778,Digit nerve surgery add-on,,,3611.37,4505.27,4
HCPCS,64782,Remove limb nerve lesion,,,1933.13,9269.11,11
HCPCS,64783,Limb nerve surgery add-on,,,3611.37,4505.27,4
HCPCS,64784,Remove nerve lesion,,,1933.13,8576.66,11
HCPCS,64786,Remove sciatic nerve lesion,,,3381.88,15004.24,11
HCPCS,64787,Implant nerve end,,,1023.06,1276.3,4
HCPCS,64788,Remove skin nerve lesion,,,1933.13,8576.66,11
HCPCS,64790,Removal of nerve lesion,,,1933.13,8576.66,11
HCPCS,64792,Removal of nerve lesion,,,3381.88,15004.24,11
HCPCS,64795,Biopsy of nerve,,,1933.13,8576.66,11
HCPCS,64802,Sympathectomy cervical,,,1933.13,8576.66,11
HCPCS,64804,Remove sympathetic nerves,,,1933.13,8576.66,11
HCPCS,64820,Sympathectomy digital artery,,,1933.13,8576.66,11
HCPCS,64821,Remove sympathetic nerves,,,3239.17,14371.12,11
HCPCS,64822,Remove sympathetic nerves,,,3239.17,14371.12,11
HCPCS,64823,Sympathectomy supfc palmar,,,3239.17,14371.12,11
HCPCS,64831,Repair of digit nerve,,,1933.13,8576.66,11
HCPCS,64832,Repair nerve add-on,,,2546.44,3176.75,4
HCPCS,64834,Repair of hand or foot nerve,,,3381.88,15004.24,11
HCPCS,64835,Repair of hand or foot nerve,,,3381.88,15004.24,11
HCPCS,64836,Repair of hand or foot nerve,,,3381.88,15004.24,11
HCPCS,64837,Repair nerve add-on,,,6656.0,8303.53,4
HCPCS,64840,Repair of leg nerve,,,6656.0,38544.86,11
HCPCS,64856,Repair/transpose nerve,,,6656.0,38544.86,11
HCPCS,64857,Repair arm/leg nerve,,,3381.88,15004.24,11
HCPCS,64858,Repair sciatic nerve,,,1933.13,8576.66,11
HCPCS,64859,Nerve surgery,,,6656.0,8303.53,4
HCPCS,64861,Repair of arm nerves,,,1933.13,8576.66,11
HCPCS,64862,Repair of low back nerves,,,3381.88,15004.24,11
HCPCS,64864,Repair of facial nerve,,,6656.0,38544.86,11
HCPCS,64865,Repair of facial nerve,,,3381.88,15004.24,11
HCPCS,64872,Subsequent repair of nerve,,,6656.0,8303.53,4
HCPCS,64874,Repair & revise nerve add-on,,,6656.0,8303.53,4
HCPCS,64876,Repair nerve/shorten bone,,,6656.0,8303.53,4
HCPCS,64885,Nerve graft head/neck <=4 cm,,,6656.0,38544.86,11
HCPCS,64886,Nerve graft head/neck >4 cm,,,6656.0,38544.86,11
HCPCS,64890,Nerve graft hand/foot <=4 cm,,,6656.0,38544.86,11
HCPCS,64891,Nerve graft hand/foot >4 cm,,,6656.0,38544.86,11
HCPCS,64892,Nerve graft arm/leg <4 cm,,,6656.0,38544.86,11
HCPCS,64893,Nerve graft arm/leg >4 cm,,,3381.88,15004.24,11
HCPCS,64895,Nerve graft hand/foot <=4 cm,,,6656.0,38544.86,11
HCPCS,64896,Nerve graft hand/foot >4 cm,,,6656.0,38544.86,11
HCPCS,64897,Nerve graft arm/leg <=4 cm,,,6656.0,38544.86,11
HCPCS,64898,Nerve graft arm/leg >4 cm,,,6656.0,38544.86,11
HCPCS,64901,Nerve graft add-on,,,6656.0,8303.53,4
HCPCS,64902,Nerve graft add-on,,,6656.0,8303.53,4
HCPCS,64905,Nerve pedicle transfer,,,6656.0,38544.86,11
HCPCS,64907,Nerve pedicle transfer,,,6656.0,38544.86,11
HCPCS,64910,Nerve repair w/allograft,,,3632.05,38544.86,11
HCPCS,64911,Neurorraphy w/vein autograft,,,3611.37,38544.86,11
HCPCS,64912,Nrv rpr w/nrv algrft 1st,,,8687.81,38544.86,11
HCPCS,64913,Nrv rpr w/nrv algrft ea addl,,,554.94,692.31,4
HCPCS,64999,HC NERV SYS SURG UNLISTED,2020.0,1414.0,,,0
HCPCS,64999,Nervous system surgery,,,303.87,3869.89,11
HCPCS,65091,Revise eye,,,3891.96,17267.29,11
HCPCS,65093,Revise eye with implant,,,3891.96,17267.29,11
HCPCS,65100001,HC HOSPICE SERVICE ROUTINE HOME CARE,258.0,180.6,,,0
HCPCS,65101,Removal of eye,,,3891.96,17267.29,11
HCPCS,65103,Remove eye/insert implant,,,3891.96,17267.29,11
HCPCS,65105,Remove eye/attach implant,,,3891.96,17267.29,11
HCPCS,65110,Removal of eye,,,3891.96,17267.29,11
HCPCS,65112,Remove eye/revise socket,,,3891.96,17267.29,11
HCPCS,65114,Remove eye/revise socket,,,3891.96,17267.29,11
HCPCS,65125,Revise ocular implant,,,2353.63,10442.27,11
HCPCS,65130,Insert ocular implant,,,3891.96,17267.29,11
HCPCS,65135,Insert ocular implant,,,3891.96,17267.29,11
HCPCS,65140,Attach ocular implant,,,3891.96,17267.29,11
HCPCS,65150,Revise ocular implant,,,3891.96,17267.29,11
HCPCS,65155,Reinsert ocular implant,,,3891.96,17267.29,11
HCPCS,65175,Removal of ocular implant,,,3747.17,17267.29,11
HCPCS,65205,HC PRO REMOVAL OF FOREGIN BODY EYE,276.0,193.2,,,0
HCPCS,65205,HC REM FB EYE EXTERNAL,313.0,219.1,,,0
HCPCS,65205,Remove foreign body from eye,,,131.71,584.37,11
HCPCS,65210,HC PRO REMOVE FB EYE,364.0,254.8,,,0
HCPCS,65210,HC REM FB EYE EMBEDDED,313.0,219.1,,,0
HCPCS,65210,Remove foreign body from eye,,,173.98,1962.08,11
HCPCS,65220,HC PRO REM FB CORNEA /WO SLIT LAMP,298.0,208.6,,,0
HCPCS,65220,REM FB CORNEA W/O SLIT LAMP,313.0,219.1,,,0
HCPCS,65220,Remove foreign body from eye,,,336.58,1962.08,11
HCPCS,65222,HC PRO REM FB CORNEA W/SLIT LAMP,99.0,69.3,,,0
HCPCS,65222,REM FB CORNEA W/ SLIT LAMP,344.0,240.8,,,0
HCPCS,65222,Remove foreign body from eye,,,131.71,584.37,11
HCPCS,65235,Remove foreign body from eye,,,2284.67,10136.31,11
HCPCS,65260,Remove foreign body from eye,,,2284.67,10136.31,11
HCPCS,65265,Remove foreign body from eye,,,2284.67,10136.31,11
HCPCS,65270,Repair of eye wound,,,2353.63,10442.27,11
HCPCS,65272,Repair of eye wound,,,2353.63,10442.27,11
HCPCS,65275,Repair of eye wound,,,3891.96,17267.29,11
HCPCS,65280,Repair of eye wound,,,3648.03,23371.97,11
HCPCS,65285,Repair of eye wound,,,5267.92,23371.97,11
HCPCS,65286,Repair of eye wound,,,1023.69,10136.31,11
HCPCS,65290,Repair of eye socket wound,,,3891.96,17267.29,11
HCPCS,65400,Removal of eye lesion,,,986.88,4378.44,11
HCPCS,65410,Biopsy of cornea,,,2353.63,10442.27,11
HCPCS,65420,Removal of eye lesion,,,2353.63,10442.27,11
HCPCS,65426,Removal of eye lesion,,,2353.63,14358.78,11
HCPCS,65430,Corneal smear,,,173.98,1962.08,11
HCPCS,65435,Curette/treat cornea,,,986.88,4378.44,11
HCPCS,65436,Curette/treat cornea,,,2353.63,10442.27,11
HCPCS,65450,Treatment of corneal lesion,,,314.22,1394.09,11
HCPCS,65500001,HC HOSPICE SERVICE INPATIENT RESPITE CARE,599.0,419.3,,,0
HCPCS,65600,Revision of cornea,,,2353.63,10442.27,11
HCPCS,65600001,HC HOSPICE SERVICE GENERAL INPATIENT CARE (NONRESPITE),1351.0,945.7,,,0
HCPCS,65710,Corneal transplant,,,5267.92,23371.97,11
HCPCS,65730,Corneal transplant,,,4091.95,18154.62,11
HCPCS,65750,Corneal transplant,,,5267.92,23371.97,11
HCPCS,65755,Corneal transplant,,,4091.95,18154.62,11
HCPCS,65756,Corneal trnspl endothelial,,,2888.92,18154.62,11
HCPCS,65770,Revise cornea with implant,,,14360.57,63713.01,11
HCPCS,65772,Correction of astigmatism,,,986.88,4378.44,11
HCPCS,65775,Correction of astigmatism,,,2353.63,10442.27,11
HCPCS,65778,Cover eye w/membrane,,,986.88,4378.44,11
HCPCS,65779,Cover eye w/membrane suture,,,1572.33,17267.29,11
HCPCS,65780,Ocular reconst transplant,,,3891.96,17267.29,11
HCPCS,65781,Ocular reconst transplant,,,5267.92,23371.97,11
HCPCS,65782,Ocular reconst transplant,,,3891.96,17267.29,11
HCPCS,65785,Impltj ntrstrml crnl rng seg,,,4091.95,18154.62,11
HCPCS,65800,Drainage of eye,,,2284.67,10136.31,11
HCPCS,65810,Drainage of eye,,,2284.67,10136.31,11
HCPCS,65815,Drainage of eye,,,2284.67,10136.31,11
HCPCS,65820,Relieve inner eye pressure,,,1023.69,18154.62,11
HCPCS,65850,Incision of eye,,,2284.67,10136.31,11
HCPCS,65855,Trabeculoplasty laser surg,,,544.48,2415.67,11
HCPCS,65860,Incise inner eye adhesions,,,544.48,2415.67,11
HCPCS,65865,Incise inner eye adhesions,,,2284.67,10136.31,11
HCPCS,65870,Incise inner eye adhesions,,,2284.67,10136.31,11
HCPCS,65875,Incise inner eye adhesions,,,2284.67,10136.31,11
HCPCS,65880,Incise inner eye adhesions,,,3235.13,18154.62,11
HCPCS,65900,Remove eye lesion,,,2284.67,10136.31,11
HCPCS,65920,Remove implant of eye,,,2284.67,10136.31,11
HCPCS,65930,Remove blood clot from eye,,,2284.67,10136.31,11
HCPCS,66020,Injection treatment of eye,,,2284.67,10136.31,11
HCPCS,66030,Injection treatment of eye,,,2284.67,10136.31,11
HCPCS,66130,Remove eye lesion,,,2353.63,10442.27,11
HCPCS,66150,Glaucoma surgery,,,4091.95,18154.62,11
HCPCS,66155,Glaucoma surgery,,,4091.95,18154.62,11
HCPCS,66160,Glaucoma surgery,,,2284.67,10136.31,11
HCPCS,66170,Glaucoma surgery,,,2284.67,10136.31,11
HCPCS,66172,Incision of eye,,,2284.67,10136.31,11
HCPCS,66174,Translum dil eye canal,,,4091.95,18154.62,11
HCPCS,66175,Trnslum dil eye canal w/stnt,,,5267.92,23371.97,11
HCPCS,66179,Aqueous shunt eye w/o graft,,,5267.92,23371.97,11
HCPCS,66180,Aqueous shunt eye w/graft,,,5267.92,23371.97,11
HCPCS,66183,Insert ant drainage device,,,4091.95,18154.62,11
HCPCS,66184,Revision of aqueous shunt,,,2284.67,10136.31,11
HCPCS,66185,Revise aqueous shunt eye,,,2284.67,10136.31,11
HCPCS,66225,Repair/graft eye lesion,,,5267.92,23371.97,11
HCPCS,66250,Follow-up surgery of eye,,,2353.63,10442.27,11
HCPCS,66500,Incision of iris,,,1023.69,10136.31,11
HCPCS,66505,Incision of iris,,,1023.69,10136.31,11
HCPCS,66600,Remove iris and lesion,,,4091.95,18154.62,11
HCPCS,66605,Removal of iris,,,2284.67,10136.31,11
HCPCS,66625,Removal of iris,,,1023.69,10136.31,11
HCPCS,66630,Removal of iris,,,2284.67,10136.31,11
HCPCS,66635,Removal of iris,,,2284.67,10136.31,11
HCPCS,66680,Repair iris & ciliary body,,,2284.67,10136.31,11
HCPCS,66682,Repair iris & ciliary body,,,2284.67,10136.31,11
HCPCS,66700,Destruction ciliary body,,,2284.67,10136.31,11
HCPCS,66710,Ciliary transsleral therapy,,,2353.63,10442.27,11
HCPCS,66711,Ciliary endoscopic ablation,,,2284.67,10136.31,11
HCPCS,66720,Destruction ciliary body,,,2353.63,10442.27,11
HCPCS,66740,Destruction ciliary body,,,2353.63,10442.27,11
HCPCS,66761,Revision of iris,,,544.48,2415.67,11
HCPCS,66762,Revision of iris,,,544.48,2415.67,11
HCPCS,66770,Removal of inner eye lesion,,,544.48,2415.67,11
HCPCS,66820,Incision secondary cataract,,,1023.69,10136.31,11
HCPCS,66821,After cataract laser surgery,,,544.48,2415.67,11
HCPCS,66825,Reposition intraocular lens,,,2284.67,10136.31,11
HCPCS,66830,Removal of lens lesion,,,1023.69,10136.31,11
HCPCS,66840,Removal of lens material,,,2284.67,10136.31,11
HCPCS,66850,Removal of lens material,,,2284.67,10136.31,11
HCPCS,66852,Removal of lens material,,,4091.95,18154.62,11
HCPCS,66920,Extraction of lens,,,2284.67,10136.31,11
HCPCS,66930,Extraction of lens,,,4091.95,18154.62,11
HCPCS,66940,Extraction of lens,,,2284.67,10136.31,11
HCPCS,66982,Cataract surgery complex,,,2284.67,10136.31,11
HCPCS,66983,Cataract surg w/iol 1 stage,,,2284.67,10136.31,11
HCPCS,66984,Cataract surg w/iol 1 stage,,,2284.67,10136.31,11
HCPCS,66985,Insert lens prosthesis,,,2284.67,10136.31,11
HCPCS,66986,Exchange lens prosthesis,,,2284.67,10136.31,11
HCPCS,66987,Xcapsl ctrc rmvl cplx w/ecp,,,4091.95,18154.62,11
HCPCS,66988,Xcapsl ctrc rmvl w/ecp,,,4091.95,18154.62,11
HCPCS,66989,Xcpsl ctrc rmvl cplx insj 1+,,,5267.92,23371.97,11
HCPCS,66991,Xcapsl ctrc rmvl insj 1+,,,5267.92,23371.97,11
HCPCS,66999,Eye surgery procedure,,,2284.67,10136.31,11
HCPCS,67005,Partial removal of eye fluid,,,2284.67,10136.31,11
HCPCS,67010,Partial removal of eye fluid,,,2284.67,10136.31,11
HCPCS,67015,Release of eye fluid,,,2284.67,10136.31,11
HCPCS,67025,Replace eye fluid,,,2005.99,10136.31,11
HCPCS,67027,Implant eye drug system,,,8930.95,61283.49,11
HCPCS,67028,Injection eye drug,,,326.99,4425.05,11
HCPCS,67030,Incise inner eye strands,,,2284.67,10136.31,11
HCPCS,67031,Laser surgery eye strands,,,544.48,2415.67,11
HCPCS,67036,Removal of inner eye fluid,,,4001.4,18154.62,11
HCPCS,67039,Laser treatment of retina,,,4091.95,18154.62,11
HCPCS,67040,Laser treatment of retina,,,4091.95,18154.62,11
HCPCS,67041,Vit for macular pucker,,,4091.95,18154.62,11
HCPCS,67042,Vit for macular hole,,,4091.95,18154.62,11
HCPCS,67043,Vit for membrane dissect,,,4091.95,18154.62,11
HCPCS,67101,Repair detached retina crtx,,,2284.67,10136.31,11
HCPCS,67105,Repair detached retina pc,,,544.48,4727.61,11
HCPCS,67107,Repair detached retina,,,4091.95,18154.62,11
HCPCS,67108,Repair detached retina,,,4091.95,18154.62,11
HCPCS,67110,Repair detached retina,,,1921.05,10136.31,11
HCPCS,67113,Repair retinal detach cplx,,,5267.92,23371.97,11
HCPCS,67115,Release encircling material,,,3648.03,18154.62,11
HCPCS,67120,Remove eye implant material,,,2284.67,10136.31,11
HCPCS,67121,Remove eye implant material,,,2284.67,10136.31,11
HCPCS,67141,Treatment of retina,,,314.22,1394.09,11
HCPCS,67145,Treatment of retina,,,544.48,2708.63,11
HCPCS,67208,Treatment of retinal lesion,,,314.22,4551.01,11
HCPCS,67210,Treatment of retinal lesion,,,544.48,2415.67,11
HCPCS,67218,Treatment of retinal lesion,,,3648.03,17267.29,11
HCPCS,67220,Treatment of choroid lesion,,,544.48,2415.67,11
HCPCS,67221,Ocular Photodynamic Ther,,,544.48,2415.67,11
HCPCS,67225,Eye photodynamic ther add-on,,,826.83,1031.49,4
HCPCS,67227,Dstrj extensive retinopathy,,,1848.36,17267.29,11
HCPCS,67228,Treatment x10sv retinopathy,,,544.48,2415.67,11
HCPCS,67229,Tr retinal les preterm inf,,,544.48,2415.67,11
HCPCS,67250,Reinforce eye wall,,,2353.63,10442.27,11
HCPCS,67255,Reinforce/graft eye wall,,,4091.95,18154.62,11
HCPCS,67299,Eye surgery procedure,,,826.83,10136.31,11
HCPCS,67311,Revise eye muscle,,,2353.63,10442.27,11
HCPCS,67312,Revise two eye muscles,,,3069.2,17267.29,11
HCPCS,67314,Revise eye muscle,,,2353.63,10442.27,11
HCPCS,67316,Revise two eye muscles,,,2353.63,10442.27,11
HCPCS,67318,Revise eye muscle(s),,,2353.63,10442.27,11
HCPCS,67320,Revise eye muscle(s) add-on,,,4827.18,6022.03,4
HCPCS,67331,Eye surgery follow-up add-on,,,4827.18,6022.03,4
HCPCS,67332,Rerevise eye muscles add-on,,,4827.18,6022.03,4
HCPCS,67334,Revise eye muscle w/suture,,,4827.18,6022.03,4
HCPCS,67335,Eye suture during surgery,,,1921.05,2396.55,4
HCPCS,67340,Revise eye muscle add-on,,,4827.18,6022.03,4
HCPCS,67343,Release eye tissue,,,2353.63,10442.27,11
HCPCS,67345,Destroy nerve of eye muscle,,,314.22,1394.09,11
HCPCS,67346,Biopsy eye muscle,,,2749.82,17267.29,11
HCPCS,67399,Unlisted px extraocular musc,,,314.22,6022.03,11
HCPCS,67400,Explore/biopsy eye socket,,,3891.96,17267.29,11
HCPCS,67405,Explore/drain eye socket,,,2353.63,10442.27,11
HCPCS,67412,Explore/treat eye socket,,,2353.63,10442.27,11
HCPCS,67413,Explore/treat eye socket,,,2353.63,10442.27,11
HCPCS,67414,Explr/decompress eye socket,,,3891.96,17267.29,11
HCPCS,67415,Aspiration orbital contents,,,2353.63,10442.27,11
HCPCS,67420,Explore/treat eye socket,,,3891.96,17267.29,11
HCPCS,67430,Explore/treat eye socket,,,3891.96,17267.29,11
HCPCS,67440,Explore/drain eye socket,,,3891.96,17267.29,11
HCPCS,67445,Explr/decompress eye socket,,,3891.96,17267.29,11
HCPCS,67450,Explore/biopsy eye socket,,,3891.96,17267.29,11
HCPCS,67500,Inject/treat eye socket,,,314.22,1394.09,11
HCPCS,67505,Inject/treat eye socket,,,314.22,1394.09,11
HCPCS,67515,Inject/treat eye socket,,,314.22,1394.09,11
HCPCS,67516,Sprchoroidal spc njx rx agt,,,326.99,1450.75,11
HCPCS,67550,Insert eye socket implant,,,3891.96,17267.29,11
HCPCS,67560,Revise eye socket implant,,,3891.96,17267.29,11
HCPCS,67570,Decompress optic nerve,,,3891.96,17267.29,11
HCPCS,67599,Orbit surgery procedure,,,314.22,1394.09,11
HCPCS,67700,Drainage of eyelid abscess,,,314.22,1394.09,11
HCPCS,67700,HC BLEPHAROTOMY DRAINAGE OF ABSCESS EYELID,446.0,312.2,,,0
HCPCS,67700,HC PRO DRAINAGE OF EYELID ABSCESS,338.0,236.6,,,0
HCPCS,67710,Incision of eyelid,,,986.88,4378.44,11
HCPCS,67715,HC CANTHOTOMY,14518.0,10162.6,,,0
HCPCS,67715,HC PRO CANTHOTOMY,132.0,92.4,,,0
HCPCS,67715,Incision of eyelid fold,,,2353.63,10442.27,11
HCPCS,67800,Remove eyelid lesion,,,314.22,1394.09,11
HCPCS,67801,Remove eyelid lesions,,,986.88,4378.44,11
HCPCS,67805,Remove eyelid lesions,,,314.22,1394.09,11
HCPCS,67808,Remove eyelid lesion(s),,,2353.63,10442.27,11
HCPCS,67810,Biopsy eyelid & lid margin,,,314.22,1394.09,11
HCPCS,67820,Revise eyelashes,,,131.71,584.37,11
HCPCS,67825,Revise eyelashes,,,314.22,1394.09,11
HCPCS,67830,Revise eyelashes,,,986.88,4378.44,11
HCPCS,67835,Revise eyelashes,,,2353.63,10442.27,11
HCPCS,67840,Remove eyelid lesion,,,986.88,4378.44,11
HCPCS,67850,Treat eyelid lesion,,,986.88,4378.44,11
HCPCS,67875,Closure of eyelid by suture,,,986.88,4378.44,11
HCPCS,67880,Revision of eyelid,,,2353.63,10442.27,11
HCPCS,67882,Revision of eyelid,,,2353.63,10442.27,11
HCPCS,67900,Repair brow defect,,,2353.63,10442.27,11
HCPCS,67901,Repair eyelid defect,,,2353.63,10442.27,11
HCPCS,67902,Repair eyelid defect,,,3747.17,17267.29,11
HCPCS,67903,Repair eyelid defect,,,2353.63,10442.27,11
HCPCS,67904,Repair eyelid defect,,,2353.63,10442.27,11
HCPCS,67906,Repair eyelid defect,,,3747.17,17267.29,11
HCPCS,67908,Repair eyelid defect,,,2353.63,10442.27,11
HCPCS,67909,Revise eyelid defect,,,2353.63,10442.27,11
HCPCS,67911,Revise eyelid defect,,,2353.63,10442.27,11
HCPCS,67912,Correction eyelid w/implant,,,2353.63,10442.27,11
HCPCS,67914,Repair eyelid defect,,,2353.63,10442.27,11
HCPCS,67915,Repair eyelid defect,,,2353.63,10442.27,11
HCPCS,67916,Repair eyelid defect,,,2353.63,10442.27,11
HCPCS,67917,Repair eyelid defect,,,2353.63,10442.27,11
HCPCS,67921,Repair eyelid defect,,,2353.63,10442.27,11
HCPCS,67922,Repair eyelid defect,,,2353.63,10442.27,11
HCPCS,67923,Repair eyelid defect,,,2353.63,10442.27,11
HCPCS,67924,Repair eyelid defect,,,2353.63,10442.27,11
HCPCS,67930,Repair eyelid wound,,,2353.63,10442.27,11
HCPCS,67935,Repair eyelid wound,,,2353.63,10442.27,11
HCPCS,67938,HC PRO REMOVAL EMBEDDED FOREIGN BODY FROM EYELID,259.0,181.3,,,0
HCPCS,67938,HC REMOVAL EMBEDDED FOREIGN BODY FROM EYELID,1023.0,716.1,,,0
HCPCS,67938,Remove eyelid foreign body,,,314.22,1394.09,11
HCPCS,67950,Revision of eyelid,,,2171.2,10442.27,11
HCPCS,67961,Revision of eyelid,,,2353.63,10442.27,11
HCPCS,67966,Revision of eyelid,,,2353.63,10442.27,11
HCPCS,67971,Reconstruction of eyelid,,,2353.63,10442.27,11
HCPCS,67973,Reconstruction of eyelid,,,2353.63,10442.27,11
HCPCS,67974,Reconstruction of eyelid,,,3891.96,17267.29,11
HCPCS,67975,Reconstruction of eyelid,,,2353.63,10442.27,11
HCPCS,67999,Revision of eyelid,,,314.22,1394.09,11
HCPCS,68020,Incise/drain eyelid lining,,,986.88,4674.69,11
HCPCS,68040,Treatment of eyelid lesions,,,173.98,1394.09,11
HCPCS,68100,Biopsy of eyelid lining,,,2353.63,10442.27,11
HCPCS,68110,Remove eyelid lining lesion,,,2353.63,10442.27,11
HCPCS,68115,Remove eyelid lining lesion,,,2353.63,10442.27,11
HCPCS,68130,Remove eyelid lining lesion,,,2353.63,10442.27,11
HCPCS,68135,Remove eyelid lining lesion,,,1457.34,10442.27,11
HCPCS,68200,Treat eyelid by injection,,,173.98,1962.08,11
HCPCS,68320,Revise/graft eyelid lining,,,2353.63,10442.27,11
HCPCS,68325,Revise/graft eyelid lining,,,2693.96,17267.29,11
HCPCS,68326,Revise/graft eyelid lining,,,3891.96,17267.29,11
HCPCS,68328,Revise/graft eyelid lining,,,2353.63,10442.27,11
HCPCS,68330,Revise eyelid lining,,,2284.67,10136.31,11
HCPCS,68335,Revise/graft eyelid lining,,,3891.96,17267.29,11
HCPCS,68340,Separate eyelid adhesions,,,2353.63,10442.27,11
HCPCS,68360,Revise eyelid lining,,,3891.96,17267.29,11
HCPCS,68362,Revise eyelid lining,,,2353.63,10442.27,11
HCPCS,68371,Harvest eye tissue alograft,,,2353.63,10442.27,11
HCPCS,68399,Eyelid lining surgery,,,314.22,1394.09,11
HCPCS,68400,Incise/drain tear gland,,,580.61,4378.44,11
HCPCS,68420,Incise/drain tear sac,,,2353.63,10442.27,11
HCPCS,68440,Incise tear duct opening,,,314.22,1394.09,11
HCPCS,68500,Removal of tear gland,,,3891.96,17267.29,11
HCPCS,68505,Partial removal tear gland,,,3891.96,17267.29,11
HCPCS,68510,Biopsy of tear gland,,,2353.63,10442.27,11
HCPCS,68520,Removal of tear sac,,,3891.96,17267.29,11
HCPCS,68525,Biopsy of tear sac,,,2353.63,10442.27,11
HCPCS,68530,Clearance of tear duct,,,314.22,4674.69,11
HCPCS,68540,Remove tear gland lesion,,,2353.63,10442.27,11
HCPCS,68550,Remove tear gland lesion,,,3891.96,17267.29,11
HCPCS,68700,Repair tear ducts,,,2353.63,10442.27,11
HCPCS,68705,Revise tear duct opening,,,314.22,1394.09,11
HCPCS,68720,Create tear sac drain,,,3891.96,17267.29,11
HCPCS,68745,Create tear duct drain,,,3891.96,17267.29,11
HCPCS,68750,Create tear duct drain,,,3891.96,17267.29,11
HCPCS,68760,Close tear duct opening,,,314.22,1394.09,11
HCPCS,68761,Close tear duct opening,,,314.22,1394.09,11
HCPCS,68770,Close tear system fistula,,,2353.63,10442.27,11
HCPCS,68801,Dilate tear duct opening,,,173.98,1962.08,11
HCPCS,68810,Probe nasolacrimal duct,,,314.22,1824.24,11
HCPCS,68811,Probe nasolacrimal duct,,,2353.63,10442.27,11
HCPCS,68815,Probe nasolacrimal duct,,,2353.63,10442.27,11
HCPCS,68816,Probe nl duct w/balloon,,,2353.63,10442.27,11
HCPCS,68840,Explore/irrigate tear ducts,,,314.22,1394.09,11
HCPCS,68841,Insj rx elut implt lac canal,,,986.69,10442.27,11
HCPCS,68899,Tear duct system surgery,,,314.22,1394.09,11
HCPCS,69000,Drain external ear lesion,,,183.27,3110.22,11
HCPCS,69000,HC DRAIN EXTRNL EAR LESN SMPL,243.0,170.1,,,0
HCPCS,69000,HC PRO DRAIN EXTRNL EAR LESN SMPL,243.0,170.1,,,0
HCPCS,69005,Drain external ear lesion,,,1635.03,7254.06,11
HCPCS,69005,HC DRAIN EXTERNAL EAR ABSCESS/HEMATOMA COMPLICATED,1278.0,894.6,,,0
HCPCS,69005,HC PRO DRAIN EXTERNAL EAR ABSCESS/HEMATOMA COMPLICATED,355.0,248.5,,,0
HCPCS,69020,Drain outer ear canal lesion,,,281.4,3110.22,11
HCPCS,69020,HC DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS,2540.0,1778.0,,,0
HCPCS,69100,BIOPSY OF EXTERNAL EAR,959.0,671.3,,,0
HCPCS,69100,Biopsy of external ear,,,234.47,1040.28,11
HCPCS,69105,Biopsy of external ear canal,,,1536.02,6814.79,11
HCPCS,69110,Remove external ear partial,,,2875.57,12757.95,11
HCPCS,69120,Removal of external ear,,,4796.64,26000.79,11
HCPCS,69140,Remove ear canal lesion(s),,,4796.64,26000.79,11
HCPCS,69145,Remove ear canal lesion(s),,,2875.57,12757.95,11
HCPCS,69150,Extensive ear canal surgery,,,1489.88,26000.79,11
HCPCS,69200,Clear outer ear canal,,,131.71,584.37,11
HCPCS,69200,HC PRO REM FB EXTERNAL EAR CANAL,401.0,280.7,,,0
HCPCS,69200,REM FB EXTERNAL EAR CANAL,192.0,134.4,,,0
HCPCS,69205,Clear outer ear canal,,,1635.03,7254.06,11
HCPCS,69209,HC PRO REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNILATERAL,15.0,10.5,,,0
HCPCS,69209,HC REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE UNILATERAL,84.0,58.8,,,0
HCPCS,69209,Remove impacted ear wax uni,,,58.4,259.1,11
HCPCS,69210,HC PRO REMOVE IMPACTED CERUMEN,338.0,236.6,,,0
HCPCS,69210,HC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILATERAL,151.0,105.7,,,0
HCPCS,69210,Remove impacted ear wax uni,,,58.4,1669.67,11
HCPCS,69220,Clean out mastoid cavity,,,158.65,881.22,11
HCPCS,69222,Clean out mastoid cavity,,,533.92,4075.29,11
HCPCS,69300,Revise external ear,,,3282.2,14562.0,11
HCPCS,69310,Rebuild outer ear canal,,,5860.44,26000.79,11
HCPCS,69320,Rebuild outer ear canal,,,5860.44,26000.79,11
HCPCS,69399,Outer ear surgery procedure,,,234.47,1040.28,11
HCPCS,69420,Incision of eardrum,,,234.47,1040.28,11
HCPCS,69421,Incision of eardrum,,,3282.2,14562.0,11
HCPCS,69424,Remove ventilating tube,,,1274.67,14562.0,11
HCPCS,69433,Create eardrum opening,,,533.92,2368.81,11
HCPCS,69436,Create eardrum opening,,,1536.02,6814.79,11
HCPCS,69440,Exploration of middle ear,,,3282.2,14562.0,11
HCPCS,69450,Eardrum revision,,,3282.2,14562.0,11
HCPCS,69501,Mastoidectomy,,,4194.9,26000.79,11
HCPCS,69502,Mastoidectomy,,,3069.2,26000.79,11
HCPCS,69505,Remove mastoid structures,,,5860.44,26000.79,11
HCPCS,69511,Extensive mastoid surgery,,,5860.44,26000.79,11
HCPCS,69530,Extensive mastoid surgery,,,5860.44,26000.79,11
HCPCS,69540,Remove ear lesion,,,1536.02,6814.79,11
HCPCS,69550,Remove ear lesion,,,5860.44,26000.79,11
HCPCS,69552,Remove ear lesion,,,3069.2,26000.79,11
HCPCS,69601,Mastoid surgery revision,,,5860.44,26000.79,11
HCPCS,69602,Mastoid surgery revision,,,5860.44,26000.79,11
HCPCS,69603,Mastoid surgery revision,,,5860.44,26000.79,11
HCPCS,69604,Mastoid surgery revision,,,5860.44,26000.79,11
HCPCS,69610,Repair of eardrum,,,1536.02,6814.79,11
HCPCS,69620,Repair of eardrum,,,3282.2,14562.0,11
HCPCS,69631,Repair eardrum structures,,,3983.23,26000.79,11
HCPCS,69632,Rebuild eardrum structures,,,5860.44,26000.79,11
HCPCS,69633,Rebuild eardrum structures,,,5489.55,26000.79,11
HCPCS,69635,Repair eardrum structures,,,5860.44,26000.79,11
HCPCS,69636,Rebuild eardrum structures,,,5860.44,26000.79,11
HCPCS,69637,Rebuild eardrum structures,,,5860.44,26000.79,11
HCPCS,69641,Revise middle ear & mastoid,,,3819.67,26000.79,11
HCPCS,69642,Revise middle ear & mastoid,,,5860.44,26000.79,11
HCPCS,69643,Revise middle ear & mastoid,,,4382.52,26000.79,11
HCPCS,69644,Revise middle ear & mastoid,,,5860.44,26000.79,11
HCPCS,69645,Revise middle ear & mastoid,,,5860.44,26000.79,11
HCPCS,69646,Revise middle ear & mastoid,,,5860.44,26000.79,11
HCPCS,69650,Release middle ear bone,,,3282.2,14562.0,11
HCPCS,69660,Revise middle ear bone,,,5860.44,26000.79,11
HCPCS,69661,Revise middle ear bone,,,5860.44,26000.79,11
HCPCS,69662,Revise middle ear bone,,,2546.46,26000.79,11
HCPCS,69666,Repair middle ear structures,,,3282.2,14562.0,11
HCPCS,69667,Repair middle ear structures,,,3282.2,14562.0,11
HCPCS,69670,Remove mastoid air cells,,,5860.44,26000.79,11
HCPCS,69676,Remove middle ear nerve,,,3282.2,14562.0,11
HCPCS,69700,Close mastoid fistula,,,1536.02,9952.44,11
HCPCS,69705,Nps surg dilat eust tube uni,,,5860.44,26000.79,11
HCPCS,69706,Nps surg dilat eust tube bi,,,5860.44,26000.79,11
HCPCS,69711,Remove/repair hearing aid,,,3282.2,14562.0,11
HCPCS,69714,Implant Temple Bone W/Stimul,,,8368.09,56389.43,11
HCPCS,69716,Impltj oi implt skl tc esp,,,12709.88,56389.43,11
HCPCS,69717,Temple Bone Implant Revision,,,7183.42,31870.39,11
HCPCS,69719,Revj/rplcmt oi implt tc esp,,,12709.88,56389.43,11
HCPCS,69720,Release facial nerve,,,5860.44,26000.79,11
HCPCS,69725,Release facial nerve,,,5860.44,26000.79,11
HCPCS,69726,Rmvl oi implt skl perq esp,,,3239.17,14371.12,11
HCPCS,69727,Rmvl oi implt skl tc esp,,,3239.17,14371.12,11
HCPCS,69728,Rmv ntr oi imp sktc esp>=100,,,3239.17,14371.12,11
HCPCS,69729,Impl oi implt sk tc esp>=100,,,12709.88,56389.43,11
HCPCS,69730,Rplc oi implt sk tc esp>=100,,,12709.88,56389.43,11
HCPCS,69740,Repair facial nerve,,,5860.44,26000.79,11
HCPCS,69745,Repair facial nerve,,,5860.44,26000.79,11
HCPCS,69799,Middle ear surgery procedure,,,234.47,1040.28,11
HCPCS,69801,Incise inner ear,,,1536.02,9952.44,11
HCPCS,69805,Explore inner ear,,,4194.9,26000.79,11
HCPCS,69806,Explore inner ear,,,5860.44,26000.79,11
HCPCS,69905,Remove inner ear,,,5860.44,26000.79,11
HCPCS,69910,Remove inner ear & mastoid,,,5860.44,26000.79,11
HCPCS,69915,Incise inner ear nerve,,,3282.2,14562.0,11
HCPCS,69930,Implant cochlear device,,,11057.28,144818.54,11
HCPCS,69949,Inner ear surgery procedure,,,234.47,1040.28,11
HCPCS,69955,Release facial nerve,,,5860.44,26000.79,11
HCPCS,69960,Release inner ear canal,,,5860.44,26000.79,11
HCPCS,69970,Remove inner ear lesion,,,5860.44,26000.79,11
HCPCS,69979,Temporal bone surgery,,,234.47,1040.28,11
HCPCS,700,HC PRO ANESTHESIA FOR PROCEDURES ON UPPER ANTERIOR ABDOMINAL WALL NOT OTHERWISE SPECIFIED,273.0,191.1,,,0
HCPCS,70010,Contrast x-ray of brain,,,345.37,1886.52,11
HCPCS,70015,Contrast x-ray of brain,,,776.06,3443.1,11
HCPCS,70015,HC CISTERNOGRAPHY POSITIVE CONTRAST RS&I,3545.0,2481.5,,,0
HCPCS,70030,HC RADIOLOGIC EXAM EYE FOR DETECTION OF FOREIGN BODY,67.0,46.9,,,0
HCPCS,70030,X-ray eye for foreign body,,,37.09,382.23,11
HCPCS,70100,HC XRAY OF JAW < 4 VIEWS,348.0,243.6,,,0
HCPCS,70100,X-ray exam of jaw <4views,,,86.15,382.23,11
HCPCS,70110,HC XRAY OF JAW 4 OR MORE VIEWS,383.0,268.1,,,0
HCPCS,70110,X-ray exam of jaw 4/> views,,,103.5,459.18,11
HCPCS,70120,X-ray exam of mastoids,,,103.5,459.18,11
HCPCS,70130,X-ray exam of mastoids,,,103.5,459.18,11
HCPCS,70130,XRAY MASTOIDS 3> VIEWS PER SIDE,180.0,126.0,,,0
HCPCS,70134,X-ray exam of middle ear,,,231.46,2399.94,11
HCPCS,70140,X-ray exam of facial bones,,,86.15,382.23,11
HCPCS,70140,XRAY FACIAL BONES < 3 VIEWS,356.0,249.2,,,0
HCPCS,70150,HC XRAY FACIAL BONES  3> VIEWS,433.0,303.1,,,0
HCPCS,70150,X-ray exam of facial bones,,,103.5,459.18,11
HCPCS,70160,HC XRAY NASAL BONES 3> VIEWS,287.0,200.9,,,0
HCPCS,70160,X-ray exam of nasal bones,,,86.15,382.23,11
HCPCS,70170,X-ray exam of tear duct,,,236.21,1338.31,11
HCPCS,70190,X-ray exam of eye sockets,,,86.15,382.23,11
HCPCS,70200,HC XRAY EYE SOCKETS 4> VIEWS,404.0,282.8,,,0
HCPCS,70200,X-ray exam of eye sockets,,,103.5,459.18,11
HCPCS,70210,HC XRAY SINUSES < 3 VIEWS,218.0,152.6,,,0
HCPCS,70210,X-ray exam of sinuses,,,86.15,382.23,11
HCPCS,70220,HC XRAY SINUSES 3> VIEWS,370.0,259.0,,,0
HCPCS,70220,X-ray exam of sinuses,,,86.15,382.23,11
HCPCS,70240,X-ray exam pituitary saddle,,,86.15,382.23,11
HCPCS,70250,HC XRAY SKULL < 4 VIEWS,316.0,221.2,,,0
HCPCS,70250,X-ray exam of skull,,,103.5,459.18,11
HCPCS,70260,HC XRAY SKULL 4> VIEWS,385.0,269.5,,,0
HCPCS,70260,X-ray exam of skull,,,103.5,459.18,11
HCPCS,70300,X-ray exam of teeth,,,86.15,382.23,11
HCPCS,70310,X-ray exam of teeth,,,115.02,1047.98,11
HCPCS,70320,Full mouth x-ray of teeth,,,91.69,1047.98,11
HCPCS,70320,HC FULL MOUTH XRAY OF TEETH,169.0,118.3,,,0
HCPCS,70328,HC XRAY TMJ OPEN AND CLD UNILAT,267.0,186.9,,,0
HCPCS,70328,X-ray exam of jaw joint,,,86.15,382.23,11
HCPCS,70330,HC XRAY TMJ OPEN AND CLD BILAT,370.0,259.0,,,0
HCPCS,70330,X-ray exam of jaw joints,,,86.15,382.23,11
HCPCS,70332,X-ray exam of jaw joint,,,236.21,1047.98,11
HCPCS,70336,Magnetic image jaw joint,,,236.21,1218.67,11
HCPCS,70350,X-ray head for orthodontia,,,86.15,382.23,11
HCPCS,70355,HC ORTHOPANTOGRAM,278.0,194.6,,,0
HCPCS,70355,Panoramic x-ray of jaws,,,86.15,382.23,11
HCPCS,70360,HC XRAY EXAM OF NECK SOFT TISSUE,342.0,239.4,,,0
HCPCS,70360,X-ray exam of neck,,,86.15,382.23,11
HCPCS,70370,Throat x-ray & fluoroscopy,,,86.15,382.23,11
HCPCS,70371,Speech evaluation complex,,,236.21,1047.98,11
HCPCS,70380,X-ray exam of salivary gland,,,86.15,382.23,11
HCPCS,70390,X-ray exam of salivary duct,,,236.21,1047.98,11
HCPCS,70450,Ct head/brain w/o dye,,,103.5,488.87,11
HCPCS,70450,HC CT HEAD/BRAIN W/O DYE,1071.0,749.7,,,0
HCPCS,70460,Ct head/brain w/dye,,,173.64,1041.77,11
HCPCS,70460,HC CT HEAD/BRAIN W/DYE,1986.0,1390.2,,,0
HCPCS,70470,Ct head/brain w/o & w/dye,,,173.64,898.9,11
HCPCS,70470,HC CT HEAD/BRAIN W/WO DYE,2111.0,1477.7,,,0
HCPCS,70471,Cta h&n c+ w/noncontrast img,,,345.37,1532.31,7
HCPCS,70473,Ct cere prfu aly c+wo ct/cta,,,173.64,770.39,7
HCPCS,70480,Ct orbit/ear/fossa w/o dye,,,103.5,587.1,11
HCPCS,70480,HC CT ORBIT/EAR/FOSSA W/O DYE,1322.0,925.4,,,0
HCPCS,70481,Ct orbit/ear/fossa w/dye,,,173.64,770.39,11
HCPCS,70481,HC CT ORBIT/EAR/FOSSA W/DYE,1605.0,1123.5,,,0
HCPCS,70482,Ct orbit/ear/fossa w/o&w/dye,,,173.64,1140.67,11
HCPCS,70482,HC CT ORBIT/EAR/FOSSA W/WO DYE,2116.0,1481.2,,,0
HCPCS,70486,Ct maxillofacial w/o dye,,,103.5,490.1,11
HCPCS,70486,HC CT MAXILLOFACIAL W/O DYE,1036.0,725.2,,,0
HCPCS,70487,Ct maxillofacial w/dye,,,173.64,770.39,11
HCPCS,70487,HC CT MAXILLOFACIAL W/DYE,1595.0,1116.5,,,0
HCPCS,70488,Ct maxillofacial w/o & w/dye,,,173.64,936.33,11
HCPCS,70488,HC CT MAXILLOFACIAL W/WO DYE,2109.0,1476.3,,,0
HCPCS,70490,Ct soft tissue neck w/o dye,,,103.5,564.64,11
HCPCS,70490,HC CT SOFT TISSUE NECK W/O DYE,1152.0,806.4,,,0
HCPCS,70491,Ct soft tissue neck w/dye,,,173.64,801.24,11
HCPCS,70491,HC CT SOFT TISSUE NECK W/DYE,1790.0,1253.0,,,0
HCPCS,70492,Ct sft tsue nck w/o & w/dye,,,173.64,1039.41,11
HCPCS,70492,HC CT SFT TSUE NCK W/WO DYE,2362.0,1653.4,,,0
HCPCS,70496,Ct angiography head,,,173.64,1458.06,11
HCPCS,70496,HC CT ANGIO HEAD W/WO DYE,3284.0,2298.8,,,0
HCPCS,70498,Ct angiography neck,,,173.64,1489.31,11
HCPCS,70498,HC CT ANGIO NECK W/WO DYE,3284.0,2298.8,,,0
HCPCS,70540,HC MRI ORBIT/FACE/NECK W/O DYE,1963.0,1374.1,,,0
HCPCS,70540,Mri orbit/face/neck w/o dye,,,236.21,1047.98,11
HCPCS,70542,Mri Orbit/Face/Neck W/Dye,,,345.37,1612.28,11
HCPCS,70543,HC MRI ORBT/FAC/NCK W/WO DYE,2596.0,1817.2,,,0
HCPCS,70543,Mri orbt/fac/nck w/o &w/dye,,,345.37,1532.31,11
HCPCS,70544,HC MR ANGIO HEAD W/O DYE,1483.0,1038.1,,,0
HCPCS,70544,Mr Angiography Head W/O Dye,,,236.21,1047.98,11
HCPCS,70545,HC MR ANGIO HEAD W/DYE,1799.0,1259.3,,,0
HCPCS,70545,Mr Angiography Head W/Dye,,,345.37,1532.31,11
HCPCS,70546,HC MR ANGIO HEAD W/WO DYE,2272.0,1590.4,,,0
HCPCS,70546,Mr angiograph head w/o&w/dye,,,345.37,1532.31,11
HCPCS,70547,HC MRA NECK W/O DYE,1589.0,1112.3,,,0
HCPCS,70547,Mr Angiography Neck W/O Dye,,,236.21,1047.98,11
HCPCS,70548,HC MRA NECK W/DYE,1853.0,1297.1,,,0
HCPCS,70548,Mr Angiography Neck W/Dye,,,345.37,1556.07,11
HCPCS,70549,HC MRA NECK W/WO DYE,2331.0,1631.7,,,0
HCPCS,70549,Mr angiograph neck w/o&w/dye,,,345.37,1532.31,11
HCPCS,70551,HC MRI BRAIN W/O DYE,1834.0,1283.8,,,0
HCPCS,70551,Mri brain stem w/o dye,,,236.21,1047.98,11
HCPCS,70552,HC MRI BRAIN W/DYE,2107.0,1474.9,,,0
HCPCS,70552,Mri brain stem w/dye,,,345.37,1532.31,11
HCPCS,70553,HC MRI BRAIN/STEM W/WO DYE,2530.0,1771.0,,,0
HCPCS,70553,Mri brain stem w/o & w/dye,,,345.37,1532.31,11
HCPCS,70554,Fmri brain by tech,,,236.21,1346.02,11
HCPCS,70555,Fmri brain by phys/psych,,,236.21,1346.02,11
HCPCS,70557,Mri brain w/o dye,,,540.93,2399.94,11
HCPCS,70558,Mri brain w/dye,,,173.64,1556.07,11
HCPCS,70559,Mri brain w/o & w/dye,,,173.64,2058.06,11
HCPCS,71000001,HC EXTENDED RECOVERY TIME EA 15 MIN,85.0,59.5,,,0
HCPCS,71000002,HC RECOVERY MIN CHARGE 1 HR,2447.0,1712.9,,,0
HCPCS,71000032,HC RECOVERY ROOM 8.5,4549.0,3184.3,,,0
HCPCS,71000040,HC RECOVERY ROOM 1ST HOUR EA 15 MIN,635.0,444.5,,,0
HCPCS,71000041,HC RECOVERY ROOM EA 15 MIN,69.0,48.3,,,0
HCPCS,71045,HC XRAY CHEST SINGLE VIEW,236.0,165.2,,,0
HCPCS,71045,X-ray exam chest 1 view,,,86.15,382.23,11
HCPCS,71046,HC XRAY CHEST 2 VIEWS,281.0,196.7,,,0
HCPCS,71046,X-ray exam chest 2 views,,,86.15,382.23,11
HCPCS,71047,HC XRAY CHEST 3 VIEWS,323.0,226.1,,,0
HCPCS,71047,X-ray exam chest 3 views,,,86.15,382.23,11
HCPCS,71048,HC XRAY CHEST 4 OR MORE VIEWS,363.0,254.1,,,0
HCPCS,71048,X-ray exam chest 4+ views,,,103.5,459.18,11
HCPCS,71100,HC XRAY RIBS 2 VIEWS UNILAT,279.0,195.3,,,0
HCPCS,71100,X-ray exam ribs uni 2 views,,,86.15,382.23,11
HCPCS,71101,HC XRAY RIBS 3 VIEWS UNILAT INCL PA,332.0,232.4,,,0
HCPCS,71101,X-ray exam unilat ribs/chest,,,103.5,459.18,11
HCPCS,71110,HC XRAY RIBS 3 VIEWS BILAT,385.0,269.5,,,0
HCPCS,71110,X-ray exam ribs bil 3 views,,,103.5,459.18,11
HCPCS,71111,HC XRAY RIBS 3 VIEWS BILAT INCL PA,442.0,309.4,,,0
HCPCS,71111,X-ray exam ribs/chest4/> vws,,,103.5,459.18,11
HCPCS,71120,HC XRAY STERNUM 2 VIEWS,295.0,206.5,,,0
HCPCS,71120,X-ray exam breastbone 2/>vws,,,86.15,382.23,11
HCPCS,71130,HC XRAY STERNUM 3> VIEWS,290.0,203.0,,,0
HCPCS,71130,X-ray strenoclavic jt 3/>vws,,,86.15,382.23,11
HCPCS,71250,Ct thorax w/o dye,,,103.5,558.99,11
HCPCS,71250,HC CT THORAX DIAGNOSTIC W/O DYE,1222.0,855.4,,,0
HCPCS,71260,Ct thorax w/dye,,,173.64,910.52,11
HCPCS,71260,HC CT THORAX DIAGNOSTIC W/DYE,2047.0,1432.9,,,0
HCPCS,71270,Ct thorax w/o & w/dye,,,173.64,1123.41,11
HCPCS,71270,HC CT THORAX DIAGNOSTIC W/WO DYE,2471.0,1729.7,,,0
HCPCS,71271,Ct thorax lung cancer scr c-,,,103.5,459.18,11
HCPCS,71271,HC CT THORAX LUNG CANCER SCR C-,276.0,193.2,,,0
HCPCS,71275,Ct angiography chest,,,173.64,1529.66,11
HCPCS,71275,HC CT ANGIO CHEST W/CONTRAST INCL NONCONTRAST IMAGE,3337.0,2335.9,,,0
HCPCS,71550,HC MRI CHEST W/O DYE,2133.0,1493.1,,,0
HCPCS,71550,Mri chest w/o dye,,,236.21,1047.98,11
HCPCS,71551,Mri Chest W/Dye,,,776.06,3443.1,11
HCPCS,71552,HC MRI CHEST W/WO DYE,2574.0,1801.8,,,0
HCPCS,71552,Mri chest w/o & w/dye,,,345.37,1532.31,11
HCPCS,71555,HC MRA CHEST W/WO DYE,2176.0,1523.2,,,0
HCPCS,71555,HC PRO MRA CHEST W/WO DYE,1271.0,889.7,,,0
HCPCS,71555,Mri angio chest w or w/o dye,,,1438.07,1794.03,4
HCPCS,72000004,HC OUT OF HOSPITAL DELIVERY,2063.0,1444.1,,,0
HCPCS,72000005,HC LEVEL 1 LABOR/DELIVERY/RECOVERY,5398.0,3778.6,,,0
HCPCS,72000006,HC LEVEL 2 LABOR/DELIVERY/RECOVERY,7196.0,5037.2,,,0
HCPCS,72000007,HC LEVEL 1 RECOVERY LOW RISK,416.0,291.2,,,0
HCPCS,72000008,HC LEVEL 2 RECOVERY HIGH RISK,733.0,513.1,,,0
HCPCS,72000009,HC LEVEL 3 LABOR/DELIVERY/RECOVERY,9246.0,6472.2,,,0
HCPCS,72020,HC XRAY SPINE 1 VIEW,168.0,117.6,,,0
HCPCS,72020,X-ray exam of spine 1 view,,,86.15,382.23,11
HCPCS,72040,HC XRAY CERVICAL SPINE 2 OR 3 VIEWS,232.0,162.4,,,0
HCPCS,72040,X-ray exam neck spine 2-3 vw,,,86.15,382.23,11
HCPCS,72050,HC XRAY CERVICAL SPINE 4> VIEWS,337.0,235.9,,,0
HCPCS,72050,X-ray exam neck spine 4/5vws,,,103.5,459.18,11
HCPCS,72052,HC XRAY CERV SPINE COMPL W/FLEX EXT,427.0,298.9,,,0
HCPCS,72052,X-ray exam neck spine 6/>vws,,,103.5,459.18,11
HCPCS,72070,HC XRAY THORACIC SPINE 2 VIEWS,305.0,213.5,,,0
HCPCS,72070,X-ray exam thorac spine 2vws,,,103.5,459.18,11
HCPCS,72072,HC XRAY THORACIC SPINE 3 VIEWS,378.0,264.6,,,0
HCPCS,72072,X-ray exam thorac spine 3vws,,,103.5,459.18,11
HCPCS,72074,HC XRAY THOR SPINE 4> VIEWS,478.0,334.6,,,0
HCPCS,72074,X-ray exam thorac spine4/>vw,,,103.5,459.18,11
HCPCS,72080,HC XRAY THORACOLUMBAR JUNCTION MINIMUM OF 2 VIEWS,280.0,196.0,,,0
HCPCS,72080,X-ray exam thoracolmb 2/> vw,,,86.15,382.23,11
HCPCS,72081,HC RADIOLOGIC EXAM SPINE ENTIRE THORACIC & LUMBAR INCL SKULL CERVICAL & SACRAL SPINE ONE VIEW,212.0,148.4,,,0
HCPCS,72081,X-ray exam entire spi 1 vw,,,86.15,382.23,11
HCPCS,72082,HC RADIOLOGIC EXAM SPINE ENTIRE THORACIC & LUMBAR INCL SKULL CERVICAL & SACRAL SPINE 2 OR 3 VIEWS,212.0,148.4,,,0
HCPCS,72082,X-ray exam entire spi 2/3 vw,,,103.5,459.18,11
HCPCS,72083,X-ray exam entire spi 4/5 vw,,,103.5,725.65,11
HCPCS,72084,X-ray exam entire spi 6/> vw,,,103.5,725.65,11
HCPCS,72100,HC XRAY LUMB SPINE 2 OR 3 VIEWS,326.0,228.2,,,0
HCPCS,72100,X-ray exam l-s spine 2/3 vws,,,103.5,459.18,11
HCPCS,72100001,HC LEVEL 1 LABOR < 12 HOURS,537.0,375.9,,,0
HCPCS,72100002,HC LEVEL 2 LABOR < 12 HOURS,551.0,385.7,,,0
HCPCS,72110,HC XRAY LUMB SPINE 4> VIEWS,455.0,318.5,,,0
HCPCS,72110,X-ray exam l-2 spine 4/>vws,,,103.5,459.18,11
HCPCS,72114,HC XRAY LUMB SPINE COMPL W/ BEND,578.0,404.6,,,0
HCPCS,72114,X-ray exam l-s spine bending,,,103.5,459.18,11
HCPCS,72120,HC XRAY LUMB SPINE FLEX EXT 2/3 VIEWS,185.0,129.5,,,0
HCPCS,72120,X-ray bend only l-s spine,,,103.5,459.18,11
HCPCS,72125,Ct neck spine w/o dye,,,103.5,937.63,11
HCPCS,72125,HC CT C-SPINE W/O DYE,2068.0,1447.6,,,0
HCPCS,72126,Ct neck spine w/dye,,,345.37,1532.31,11
HCPCS,72126,HC CT C-SPINE W/DYE,2523.0,1766.1,,,0
HCPCS,72127,Ct neck spine w/o & w/dye,,,173.64,1232.83,11
HCPCS,72127,HC CT C-SPINE W/WO DYE,2777.0,1943.9,,,0
HCPCS,72128,Ct chest spine w/o dye,,,103.5,843.96,11
HCPCS,72128,HC THORACIC SPINE W/O DYE,722.0,505.4,,,0
HCPCS,72129,Ct chest spine w/dye,,,173.64,1070.45,11
HCPCS,72129,HC THORACIC SPINE W/DYE,1102.0,771.4,,,0
HCPCS,72130,Ct chest spine w/o & w/dye,,,173.64,1275.98,11
HCPCS,72130,HC THORACIC SPINE W/WO DYE,1235.0,864.5,,,0
HCPCS,72131,Ct lumbar spine w/o dye,,,103.5,771.73,11
HCPCS,72131,HC CT LUMBAR SPINE W/O DYE,1609.0,1126.3,,,0
HCPCS,72132,Ct lumbar spine w/dye,,,345.37,1532.31,11
HCPCS,72132,HC CT LUMBAR SPINE W/DYE,2349.0,1644.3,,,0
HCPCS,72133,Ct lumbar spine w/o & w/dye,,,173.64,1639.84,11
HCPCS,72133,HC CT LUMBAR SPINE W/WO DYE,2586.0,1810.2,,,0
HCPCS,72141,HC MRI NECK SPINE W/O DYE,1518.0,1062.6,,,0
HCPCS,72141,Mri neck spine w/o dye,,,236.21,1047.98,11
HCPCS,72142,HC MRI NECK SPINE W/DYE,1744.0,1220.8,,,0
HCPCS,72142,Mri neck spine w/dye,,,345.37,1556.07,11
HCPCS,72146,HC MRI THORACIC SPINAL CANAL W/O DYE,1654.0,1157.8,,,0
HCPCS,72146,Mri chest spine w/o dye,,,236.21,1047.98,11
HCPCS,72147,HC MRI THORACIC SPINAL CANAL W/ DYE,1920.0,1344.0,,,0
HCPCS,72147,Mri chest spine w/dye,,,345.37,1532.31,11
HCPCS,72148,HC MRI LUMBAR SPINE W/O DYE,1572.0,1100.4,,,0
HCPCS,72148,Mri lumbar spine w/o dye,,,236.21,1047.98,11
HCPCS,72149,HC MRI LUMBAR SPINE W/DYE,1825.0,1277.5,,,0
HCPCS,72149,Mri lumbar spine w/dye,,,345.37,1532.31,11
HCPCS,72156,HC MRI CERVICAL SPINE W/WO DYE,2094.0,1465.8,,,0
HCPCS,72156,Mri neck spine w/o & w/dye,,,345.37,1532.31,11
HCPCS,72157,HC MRI THORACIC SPINAL CANAL W/WO DYE,2284.0,1598.8,,,0
HCPCS,72157,Mri chest spine w/o & w/dye,,,345.37,1532.31,11
HCPCS,72158,HC MRI LUMBAR SPINE W/WO DYE,2169.0,1518.3,,,0
HCPCS,72158,Mri lumbar spine w/o & w/dye,,,345.37,1532.31,11
HCPCS,72159,HC MR ANGIO SPINE W/WO DYE,1218.0,852.6,,,0
HCPCS,72170,HC XRAY PELVIS 1 OR 2 VIEWS,203.0,142.1,,,0
HCPCS,72170,X-ray exam of pelvis,,,103.5,459.18,11
HCPCS,72190,HC XRAY PELVIS 3> VIEWS,370.0,259.0,,,0
HCPCS,72190,X-ray exam of pelvis,,,103.5,459.18,11
HCPCS,72191,Ct angiograph pelv w/o&w/dye,,,173.64,1288.83,11
HCPCS,72191,HC CT ANGIOGRAPH PELV W/WO DYE,3319.0,2323.3,,,0
HCPCS,72192,Ct pelvis w/o dye,,,103.5,752.58,11
HCPCS,72192,HC CT PELVIS W/O DYE,1662.0,1163.4,,,0
HCPCS,72193,Ct pelvis w/dye,,,173.64,964.5,11
HCPCS,72193,HC CT PELVIS W/DYE,2121.0,1484.7,,,0
HCPCS,72194,Ct pelvis w/o & w/dye,,,173.64,1179.69,11
HCPCS,72194,HC CT PELVIS W/WO DYE,2657.0,1859.9,,,0
HCPCS,72195,HC MRI PELVIS W/O DYE,1890.0,1323.0,,,0
HCPCS,72195,Mri Pelvis W/O Dye,,,236.21,1047.98,11
HCPCS,72196,HC MRI PELVIS W/DYE,2194.0,1535.8,,,0
HCPCS,72196,Mri pelvis w/dye,,,345.37,1556.07,11
HCPCS,72197,HC MRI PELVIS W/WO DYE,2605.0,1823.5,,,0
HCPCS,72197,Mri pelvis w/o & w/dye,,,345.37,1532.31,11
HCPCS,72198,HC MRA PELVIS W/WO DYE,1925.0,1347.5,,,0
HCPCS,72198,Mr angio pelvis w/o & w/dye,,,1435.04,1790.25,4
HCPCS,72200,HC XRAY SI JOINTS 1 OR 2 VIEWS,166.0,116.2,,,0
HCPCS,72200,X-ray exam si joints,,,103.5,459.18,11
HCPCS,72200001,HC LEVEL 1 DELIVERY,1762.0,1233.4,,,0
HCPCS,72200002,HC LEVEL 2 DELIVERY,1762.0,1233.4,,,0
HCPCS,72202,HC XRAY SI JOINTS 3> VIEWS,333.0,233.1,,,0
HCPCS,72202,X-ray exam si joints 3/> vws,,,103.5,459.18,11
HCPCS,72220,HC XRAY SACRUM/COCC 2> VIEWS,305.0,213.5,,,0
HCPCS,72220,X-ray exam sacrum tailbone,,,86.15,382.23,11
HCPCS,72240,HC CONTRAST XRAY OF CERV SPINE SI,1303.0,912.1,,,0
HCPCS,72240,Myelography neck spine,,,583.61,3443.1,11
HCPCS,72255,Myelography thoracic spine,,,776.06,3443.1,11
HCPCS,72265,HC CONTRAST XRAY L-S SPINE SI,1270.0,889.0,,,0
HCPCS,72265,Myelography l-s spine,,,568.67,3443.1,11
HCPCS,72270,HC CONTR XRAY SPINE 2> REGIONS SI,1520.0,1064.0,,,0
HCPCS,72270,Myelogphy 2/> spine regions,,,776.06,3443.1,11
HCPCS,72285,Discography cerv/thor spine,,,1933.13,8576.66,11
HCPCS,72295,X-ray of lower spine disk,,,1933.13,8576.66,11
HCPCS,73000,HC XRAY COLLAR BONE,211.0,147.7,,,0
HCPCS,73000,X-ray exam of collar bone,,,86.15,382.23,11
HCPCS,73010,HC XRAY SHOULDER BLADE,245.0,171.5,,,0
HCPCS,73010,X-ray exam of shoulder blade,,,103.5,459.18,11
HCPCS,73020,HC XRAY SHOULDER 1 VIEW,197.0,137.9,,,0
HCPCS,73020,X-ray exam of shoulder,,,86.15,382.23,11
HCPCS,73030,X-ray exam of shoulder,,,86.15,382.23,11
HCPCS,73030,XRAY SHOULDER 2> VIEWS,225.0,157.5,,,0
HCPCS,73040,Contrast x-ray of shoulder,,,321.42,1532.31,11
HCPCS,73040,HC XRAY SHOULDER ARTHROGRAM SI,718.0,502.6,,,0
HCPCS,73050,HC XRAY SHOULDERS W/WO WEIGHT,330.0,231.0,,,0
HCPCS,73050,X-ray exam of shoulders,,,86.15,382.23,11
HCPCS,73060,HC XRAY HUMERUS 2> VIEWS,278.0,194.6,,,0
HCPCS,73060,X-ray exam of humerus,,,86.15,382.23,11
HCPCS,73070,HC XRAY ELBOW 2 VIEWS,209.0,146.3,,,0
HCPCS,73070,X-ray exam of elbow,,,86.15,382.23,11
HCPCS,73080,HC XRAY ELBOW 3> VIEWS,286.0,200.2,,,0
HCPCS,73080,X-ray exam of elbow,,,86.15,382.23,11
HCPCS,73085,Contrast x-ray of elbow,,,345.37,1532.31,11
HCPCS,73090,HC XRAY FOREARM 2 VIEWS,246.0,172.2,,,0
HCPCS,73090,X-ray exam of forearm,,,86.15,382.23,11
HCPCS,73092,HC XRAY ARM INFANT 2> VIEWS,218.0,152.6,,,0
HCPCS,73092,X-ray exam of arm infant,,,103.5,459.18,11
HCPCS,73100,HC XRAY WRIST 2 VIEWS,198.0,138.6,,,0
HCPCS,73100,X-ray exam of wrist,,,86.15,382.23,11
HCPCS,73110,HC XRAY WRIST 3> VIEWS,263.0,184.1,,,0
HCPCS,73110,X-ray exam of wrist,,,86.15,382.23,11
HCPCS,73115,Contrast x-ray of wrist,,,345.37,1532.31,11
HCPCS,73115,HC XRAY WRIST ARTHROGRAM,509.0,356.3,,,0
HCPCS,73120,HC XRAY HAND 2 VIEWS,232.0,162.4,,,0
HCPCS,73120,X-ray exam of hand,,,103.5,459.18,11
HCPCS,73130,HC XRAY HAND 3> VIEWS,265.0,185.5,,,0
HCPCS,73130,X-ray exam of hand,,,86.15,382.23,11
HCPCS,73140,HC XRAY FINGER(S) 2> VIEWS,180.0,126.0,,,0
HCPCS,73140,X-ray exam of finger(s),,,86.15,382.23,11
HCPCS,73200,Ct upper extremity w/o dye,,,103.5,607.77,11
HCPCS,73200,HC CT UPPER EXTREMITY W/O DYE,1369.0,958.3,,,0
HCPCS,73201,Ct upper extremity w/dye,,,345.37,1532.31,11
HCPCS,73201,HC CT UPPER EXTREMITY W/DYE,1926.0,1348.2,,,0
HCPCS,73202,Ct uppr extremity w/o&w/dye,,,173.64,1005.5,11
HCPCS,73202,HC CT UPPR EXTREMITY W/O&W/DYE,2265.0,1585.5,,,0
HCPCS,73206,Ct angio upr extrm w/o&w/dye,,,173.64,1334.9,11
HCPCS,73206,HC CT ANGIO UPR EXTRM W/WO DYE,3007.0,2104.9,,,0
HCPCS,73218,HC MRI UPPER EXTR NOT JNT W/O DYE,1335.0,934.5,,,0
HCPCS,73218,Mri Upper Extremity W/O Dye,,,236.21,1047.98,11
HCPCS,73219,HC MRI UPPER EXTR NOT JNT W/DYE,1660.0,1162.0,,,0
HCPCS,73219,Mri Upper Extremity W/Dye,,,345.37,1556.07,11
HCPCS,73220,HC MRI UPPR EXTREMITY W/WO DYE,1879.0,1315.3,,,0
HCPCS,73220,Mri uppr extremity w/o&w/dye,,,345.37,1532.31,11
HCPCS,73221,HC MRI ANY JNT UPR EXT W/O DYE,1528.0,1069.6,,,0
HCPCS,73221,Mri joint upr extrem w/o dye,,,236.21,1047.98,11
HCPCS,73222,HC MRI ANY JNT UPR EXT W/DYE,1794.0,1255.8,,,0
HCPCS,73222,Mri joint upr extrem w/dye,,,638.3,3443.1,11
HCPCS,73223,HC MRI ANY JOINT UPR EXT W/WO DYE,2377.0,1663.9,,,0
HCPCS,73223,Mri joint upr extr w/o&w/dye,,,345.37,1532.31,11
HCPCS,73225,HC MRA UPPER EXT W/WO DYE,1630.0,1141.0,,,0
HCPCS,73501,HC XRAY HIP UNILATERAL W/PELVIS 1 VIEW,132.0,92.4,,,0
HCPCS,73501,X-ray exam hip uni 1 view,,,71.6,382.23,11
HCPCS,73502,HC XRAY HIP UNILATERAL W/PELVIS 2-3 VIEWS,240.0,168.0,,,0
HCPCS,73502,X-ray exam hip uni 2-3 views,,,86.15,382.23,11
HCPCS,73503,X-ray exam hip uni 4/> views,,,103.5,459.18,11
HCPCS,73521,HC XRAY HIPS BILATERAL W/PELVIS 2 VIEWS,428.0,299.6,,,0
HCPCS,73521,X-ray exam hips bi 2 views,,,103.5,459.18,11
HCPCS,73522,HC XRAY HIPS BILATERAL W/PELVIS 3-4 VIEWS,493.0,345.1,,,0
HCPCS,73522,X-ray exam hips bi 3-4 views,,,50.25,459.18,11
HCPCS,73523,HC XRAY HIPS BILATERAL W/PELVIS MINIMUM 5 VIEWS,895.0,626.5,,,0
HCPCS,73523,X-ray exam hips bi 5/> views,,,103.5,725.65,11
HCPCS,73525,Contrast x-ray of hip,,,332.24,1532.31,11
HCPCS,73525,HC XRAY HIP ARTHROGRAM SI,742.0,519.4,,,0
HCPCS,73551,X-ray exam of femur 1,,,86.15,382.23,11
HCPCS,73552,HC XRAY FEMUR MINIMUM 2 VIEWS,194.0,135.8,,,0
HCPCS,73552,X-ray exam of femur 2/>,,,86.15,382.23,11
HCPCS,73560,HC XRAY KNEE 1 OR 2 VIEWS,170.0,119.0,,,0
HCPCS,73560,X-ray exam of knee 1 or 2,,,86.15,382.23,11
HCPCS,73562,HC XRAY KNEE 3 VIEWS,308.0,215.6,,,0
HCPCS,73562,X-ray exam of knee 3,,,86.15,382.23,11
HCPCS,73564,HC XRAY KNEE 4> VIEWS,308.0,215.6,,,0
HCPCS,73564,X-ray exam knee 4 or more,,,103.5,459.18,11
HCPCS,73565,HC XRAY KNEES STANDING AP,201.0,140.7,,,0
HCPCS,73565,X-ray exam of knees,,,86.15,382.23,11
HCPCS,73580,Contrast x-ray of knee joint,,,345.37,1532.31,11
HCPCS,73580,HC XRAY KNEE ARTHROGRAM SI,542.0,379.4,,,0
HCPCS,73590,HC XRAY TIB-FIB 2 VIEWS,248.0,173.6,,,0
HCPCS,73590,X-ray exam of lower leg,,,86.15,382.23,11
HCPCS,73592,HC XRAY LEG INFANT 2> VIEWS,227.0,158.9,,,0
HCPCS,73592,X-ray exam of leg infant,,,27.3,382.23,11
HCPCS,73600,HC XRAY ANKLE 2 VIEWS,199.0,139.3,,,0
HCPCS,73600,X-ray exam of ankle,,,86.15,382.23,11
HCPCS,73610,HC XRAY ANKLE 3 VIEWS,265.0,185.5,,,0
HCPCS,73610,X-ray exam of ankle,,,86.15,382.23,11
HCPCS,73615,Contrast x-ray of ankle,,,345.37,1532.31,11
HCPCS,73615,HC X-RAY ANKLE ARTHROGRAPHY RAD S & I,1319.0,923.3,,,0
HCPCS,73620,HC XRAY FOOT 2 VIEWS,200.0,140.0,,,0
HCPCS,73620,X-ray exam of foot,,,86.15,382.23,11
HCPCS,73630,HC XRAY FOOT 3> VIEWS,262.0,183.4,,,0
HCPCS,73630,X-ray exam of foot,,,86.15,382.23,11
HCPCS,73650,HC XRAY HEEL 2> VIEWS,242.0,169.4,,,0
HCPCS,73650,X-ray exam of heel,,,86.15,382.23,11
HCPCS,73660,HC XRAY TOE(S) 2> VIEWS,180.0,126.0,,,0
HCPCS,73660,X-ray exam of toe(s),,,86.15,382.23,11
HCPCS,73700,Ct lower extremity w/o dye,,,103.5,594.16,11
HCPCS,73700,HC CT LOWER EXT W/O DYE,1309.0,916.3,,,0
HCPCS,73701,Ct lower extremity w/dye,,,173.64,911.93,11
HCPCS,73701,HC CT LOWER EXT W/DYE,1889.0,1322.3,,,0
HCPCS,73702,Ct lwr extremity w/o&w/dye,,,173.64,986.1,11
HCPCS,73702,HC CT LWR EXT W/WO DYE,2221.0,1554.7,,,0
HCPCS,73706,Ct angio lwr extr w/o&w/dye,,,173.64,1995.18,11
HCPCS,73706,HC CT ANGIO LWR EXT W/WO DYE,2983.0,2088.1,,,0
HCPCS,73718,HC MRI LWR EXT NOT JNT W/O DYE,1470.0,1029.0,,,0
HCPCS,73718,Mri Lower Extremity W/O Dye,,,236.21,1047.98,11
HCPCS,73719,HC MRI LOWER EXT W/DYE,1537.0,1075.9,,,0
HCPCS,73719,Mri Lower Extremity W/Dye,,,345.37,1556.07,11
HCPCS,73720,HC MRI LWR EXT W/WO DYE,2422.0,1695.4,,,0
HCPCS,73720,Mri lwr extremity w/o&w/dye,,,345.37,1532.31,11
HCPCS,73721,HC MRI ANY JNT OF LWR EXT W/O DYE,1269.0,888.3,,,0
HCPCS,73721,Mri jnt of lwr extre w/o dye,,,236.21,1047.98,11
HCPCS,73722,HC MRI ANY JOINT OF LWR EXT W/DYE,1978.0,1384.6,,,0
HCPCS,73722,Mri Joint Of Lwr Extr W/Dye,,,703.89,3443.1,11
HCPCS,73723,HC MRI ANY JOINT LWR EXT W/WO DYE,2356.0,1649.2,,,0
HCPCS,73723,Mri joint lwr extr w/o&w/dye,,,345.37,1532.31,11
HCPCS,73725,HC MRA LWR EXT W/WO DYE,1538.0,1076.6,,,0
HCPCS,73725,Mr ang lwr ext w or w/o dye,,,1439.37,1795.65,4
HCPCS,74018,HC XRAY ABDOMEN 1 VIEW,237.0,165.9,,,0
HCPCS,74018,X-ray exam abdomen 1 view,,,86.15,382.23,11
HCPCS,74019,HC XRAY ABDOMEN 2 VIEWS,307.0,214.9,,,0
HCPCS,74019,X-ray exam abdomen 2 views,,,103.5,459.18,11
HCPCS,74021,HC XRAY ABDOMEN 3 OR MORE VIEWS,312.0,218.4,,,0
HCPCS,74021,X-ray exam abdomen 3+ views,,,103.5,459.18,11
HCPCS,74022,HC XRAY ABDOMEN ACUTE SERIES,480.0,336.0,,,0
HCPCS,74022,X-ray exam series abdomen,,,103.5,459.18,11
HCPCS,74150,Ct abdomen w/o dye,,,103.5,699.71,11
HCPCS,74150,HC CT ABDOMEN W/O DYE,1409.0,986.3,,,0
HCPCS,74160,Ct abdomen w/dye,,,173.64,1010.1,11
HCPCS,74160,HC CT ABDOMEN W/DYE,2163.0,1514.1,,,0
HCPCS,74170,Ct abdomen w/o & w/dye,,,173.64,1168.72,11
HCPCS,74170,HC CT ABDOMEN W/WO DYE,2632.0,1842.4,,,0
HCPCS,74174,Ct angio abd&pelv w/o&w/dye,,,345.37,2075.1,11
HCPCS,74174,HC CT ANGIO ABD&PELV W/WO DYE,4674.0,3271.8,,,0
HCPCS,74175,Ct angio abdom w/o & w/dye,,,173.64,1478.3,11
HCPCS,74175,HC CT ANGIO ABDOM W/WO DYE,3330.0,2331.0,,,0
HCPCS,74176,Ct abd & pelvis w/o contrast,,,236.21,1546.38,11
HCPCS,74176,HC CT ABD & PELVIS W/O DYE,3293.0,2305.1,,,0
HCPCS,74177,CT ABD & PELV W/ DYE,4178.0,2924.6,,,0
HCPCS,74177,Ct abd & pelv w/contrast,,,345.37,1898.09,11
HCPCS,74178,Ct abd & pelv 1/> regns,,,345.37,2149.48,11
HCPCS,74178,HC CT ABD & PELV 1/> REGNS W/WO DYE,4674.0,3271.8,,,0
HCPCS,74181,HC MRI ABDOMEN W/O DYE,1329.0,930.3,,,0
HCPCS,74181,Mri abdomen w/o dye,,,236.21,1047.98,11
HCPCS,74182,HC MRI ABDOMEN W/DYE,1544.0,1080.8,,,0
HCPCS,74182,Mri Abdomen W/Dye,,,345.37,1556.07,11
HCPCS,74183,HC MRI ABDOMEN W/WO DYE,1851.0,1295.7,,,0
HCPCS,74183,Mri abdomen w/o & w/dye,,,345.37,1532.31,11
HCPCS,74185,HC MRA ABD W/WO DYE,1234.0,863.8,,,0
HCPCS,74185,HC PRO MRA ABD W/WO DYE,1270.0,889.0,,,0
HCPCS,74185,Mri angio abdom w orw/o dye,,,1435.25,1790.51,4
HCPCS,74190,X-ray exam of peritoneum,,,540.93,2399.94,11
HCPCS,74210,Contrst x-ray exam of throat,,,173.64,770.39,11
HCPCS,74220,Contrast x-ray esophagus,,,173.64,770.39,11
HCPCS,74220,HC XRAY ESOPHAGUS,554.0,387.8,,,0
HCPCS,74221,X-ray xm esophagus 2cntrst,,,173.64,770.39,11
HCPCS,74230,Cine/vid x-ray throat/esoph,,,173.64,770.39,11
HCPCS,74230,HC SWALLOW W/ VIDEO,508.0,355.6,,,0
HCPCS,74240,HC XRAY UPPER GI INCL SCOUT ABDOMINAL RADIOGRAPH/DELAYED IMAGE SINGLE CONTRAST,858.0,600.6,,,0
HCPCS,74240,X-ray upper gi delay w/o kub,,,173.64,770.39,11
HCPCS,74246,Contrst x-ray uppr gi tract,,,173.64,770.39,11
HCPCS,74246,HC XRAY UPPER GI INCL SCOUNT ABDOMINAL RADIOGAPH & DELAYED IMAGE DOUBLE CONTRAST STUDY INCL GLUCAGON WHEN ADMIN,987.0,690.9,,,0
HCPCS,74248,HC RADIOLOGIC SMALL INTESTINE FOLLOW-THROUGH STUDY INCLUDING MULTIPLE SERIAL IMAGES,121.0,84.7,,,0
HCPCS,74248,X-ray sm int f-thru std,,,105.57,131.7,4
HCPCS,74250,HC XRAY SMALL BOWEL,584.0,408.8,,,0
HCPCS,74250,X-ray exam of small bowel,,,173.64,770.39,11
HCPCS,74251,X-ray exam of small bowel,,,173.64,770.39,11
HCPCS,74261,Ct colonography dx,,,103.5,764.35,11
HCPCS,74262,Ct colonography dx w/dye,,,173.64,1163.86,11
HCPCS,74263,Ct colonography screening,,,236.21,1047.98,7
HCPCS,74270,Contrast x-ray exam of colon,,,173.64,770.39,11
HCPCS,74270,HC XRAY COLON BARIUM W/WO KUB,739.0,517.3,,,0
HCPCS,74280,Contrast x-ray exam of colon,,,173.64,770.39,11
HCPCS,74280,HC XRAY COLON BARIUM AIR CONTR,1046.0,732.2,,,0
HCPCS,74283,Contrast x-ray exam of colon,,,173.64,770.39,11
HCPCS,74283,HC BE REDUCE INTUSSUSCEPTION,659.0,461.3,,,0
HCPCS,74290,Contrast x-ray gallbladder,,,173.64,770.39,11
HCPCS,74300,HC XRAY BILE DUCTS/PANC DURING SURG,665.0,465.5,,,0
HCPCS,74328,HC XRAY BILE DUCT ENDOS CATHETER,629.0,440.3,,,0
HCPCS,74329,HC XRAY PANC DUCT ENDOS CATHETER,629.0,440.3,,,0
HCPCS,74330,HC XRAY PANC/BILE ENDOS CATHETER,629.0,440.3,,,0
HCPCS,74340,HC INTRO LONG GASTROINTESTINAL TUBE INCL MULTI FLUORO IMAGES RAD S&I,301.0,210.7,,,0
HCPCS,74360,HC XRAY GUIDE GI DILATION,583.0,408.1,,,0
HCPCS,74363,HC XRAY GUIDE BILE DUCT DILATION,1707.0,1194.9,,,0
HCPCS,74400,Contrst x-ray urinary tract,,,173.64,770.39,11
HCPCS,74410,Contrst x-ray urinary tract,,,173.64,770.39,11
HCPCS,74410,HC UROGRAPHY INFUSION DRIP TECH OR BOLUS,750.0,525.0,,,0
HCPCS,74415,Contrst x-ray urinary tract,,,173.64,770.39,11
HCPCS,74420,Contrst x-ray urinary tract,,,271.46,1532.31,11
HCPCS,74420,HC XRAY U T  RETROGRADE W/WO KUB,677.0,473.9,,,0
HCPCS,74425,Contrst x-ray urinary tract,,,345.37,1532.31,11
HCPCS,74425,HC XRAY UROGRAPHY ANTEGRADE RAD S&I,514.0,359.8,,,0
HCPCS,74430,Contrast x-ray bladder,,,228.7,1532.31,11
HCPCS,74430,HC XRAY BLADDER 3> VIEWS,588.0,411.6,,,0
HCPCS,74440,X-ray male genital tract,,,236.21,1047.98,11
HCPCS,74445,X-ray exam of penis,,,103.5,651.94,11
HCPCS,74450,HC XRAY URETH/BLADD RETROGRADE,374.0,261.8,,,0
HCPCS,74450,X-ray urethra/bladder,,,208.1,1047.98,11
HCPCS,74455,HC XRAY URETH/BLADD VOIDING,758.0,530.6,,,0
HCPCS,74455,X-ray urethra/bladder,,,236.21,1047.98,11
HCPCS,74470,X-ray exam of kidney lesion,,,536.92,2399.94,11
HCPCS,74485,HC XRAY GUIDE GU DILATION,1513.0,1059.1,,,0
HCPCS,74485,X-ray guide gu dilation,,,1072.77,9181.28,11
HCPCS,74710,X-ray measurement of pelvis,,,231.46,288.75,4
HCPCS,74712,HC MRI FETAL INCL PLACENTAL/MATERNAL PELVIC IMG WHEN PERFORMED SINGLE OR FIRST GESTATION,879.0,615.3,,,0
HCPCS,74712,Mri fetal sngl/1st gestation,,,236.21,1047.98,11
HCPCS,74713,Mri fetal ea addl gestation,,,668.57,834.06,4
HCPCS,74740,HC XRAY FEMALE GENITAL TRACT,627.0,438.9,,,0
HCPCS,74740,X-ray female genital tract,,,236.21,1047.98,11
HCPCS,74775,X-ray exam of perineum,,,236.21,1047.98,11
HCPCS,75000003,GI TRACT CAPSULE ENDOSCOPY,1058.0,740.6,,,0
HCPCS,75000006,HC ABLATION/ARGON,497.0,347.9,,,0
HCPCS,75000007,HC DILATION,600.0,420.0,,,0
HCPCS,75000008,HC BIOPSY,400.0,280.0,,,0
HCPCS,75000009,HC BLEEDING CONTROL,991.0,693.7,,,0
HCPCS,75000010,HC BOTOX INJECTION,497.0,347.9,,,0
HCPCS,75000011,HC BRUSHING,301.0,210.7,,,0
HCPCS,75000014,HC COLONOSCOPY W/ POLYP & BIOPSY,3300.0,2310.0,,,0
HCPCS,75000015,HC DECOMPRESSION,2266.0,1586.2,,,0
HCPCS,75000016,HC EGD,3208.0,2245.6,,,0
HCPCS,75000019,HC EGD W/ POLYPECTOMY,1613.0,1129.1,,,0
HCPCS,75000020,HC EGD W/ CONTROL BLEEDING,2138.0,1496.6,,,0
HCPCS,75000021,HC EGD W/ FOREIGN BODY REMOVAL,2982.0,2087.4,,,0
HCPCS,75000022,HC ERCP,4714.0,3299.8,,,0
HCPCS,75000023,HC ESPOHAGEAL STENT PLACEMENT,1966.0,1376.2,,,0
HCPCS,75000024,HC STENT PLACEMENT,986.0,690.2,,,0
HCPCS,75000025,HC STENT REMOVAL,400.0,280.0,,,0
HCPCS,75000026,HC EXTENDED GI LAB 15 MINUTES,381.0,266.7,,,0
HCPCS,75000027,HC FLEXIBLE SIGMOIDOSCOPY,3020.0,2114.0,,,0
HCPCS,75000029,HC FOREIGN BODY REMOVAL,758.0,530.6,,,0
HCPCS,75000030,HC LIGATOR/BANDER,1594.0,1115.8,,,0
HCPCS,75000031,HC LITHOTRIPSY,945.0,661.5,,,0
HCPCS,75000032,HC PAPILLOTOMY,475.0,332.5,,,0
HCPCS,75000033,HC PEG,2266.0,1586.2,,,0
HCPCS,75000034,HC POLYPECTOMY,497.0,347.9,,,0
HCPCS,75000035,HC PROCTOSIGMOIDOSCOPY FLEXIBLE,1359.0,951.3,,,0
HCPCS,75000036,HC REMOVE/REPLACE CATH/NON-INCIS,595.0,416.5,,,0
HCPCS,75000037,HC SUBMUCOSAL INJECTION,991.0,693.7,,,0
HCPCS,75000038,HC TATOO INJECTION,991.0,693.7,,,0
HCPCS,75000039,HC ULTRASOUND EXAMINATION,1058.0,740.6,,,0
HCPCS,75000059,HC STONE EXTRACTION,813.0,569.1,,,0
HCPCS,75000063,HC LIGATION OF HEMORRHOID(S) BY RUBBER BAND,3651.0,2555.7,,,0
HCPCS,75000067,HC BANDING,1896.0,1327.2,,,0
HCPCS,75000069,HC ANORECTAL MANOMETRY,1213.0,849.1,,,0
HCPCS,75557,Cardiac mri for morph,,,236.21,1047.98,11
HCPCS,75557,HC CARDIAC MRI FOR MORPH W/O DYE,1530.0,1071.0,,,0
HCPCS,75557,HC PRO CARDIAC MRI FOR MORPH W/O DYE,893.0,625.1,,,0
HCPCS,75559,Cardiac mri w/stress img,,,540.93,2399.94,11
HCPCS,75559,HC CARDIAC MRI W/O CONTRAST W/STRESS IMAGING,1492.0,1044.4,,,0
HCPCS,75559,HC PRO CARDIAC MRI W/O CONTRAST W/STRESS IMAGING,1007.0,704.9,,,0
HCPCS,75561,Cardiac mri for morph w/dye,,,345.37,1532.31,11
HCPCS,75561,HC CARDIAC MRI FOR MORPH W/DYE,1765.0,1235.5,,,0
HCPCS,75561,HC PRO CARDIAC MRI FOR MORPH W/DYE,1261.0,882.7,,,0
HCPCS,75563,Card mri w/stress img & dye,,,776.06,3443.1,11
HCPCS,75563,HC CARDIAC MRI W/W/O CONTRAST W/STRESS,3304.0,2312.8,,,0
HCPCS,75563,HC PRO CARDIAC MRI W/W/O CONTRAST W/STRESS,1313.0,919.1,,,0
HCPCS,75565,HC CARD MRI VELOC FLOW MAPPING,1265.0,885.5,,,0
HCPCS,75565,HC PRO CARD MRI VELOC FLOW MAPPING,182.0,127.4,,,0
HCPCS,75571,Ct hrt w/o dye w/ca test,,,70.66,382.23,11
HCPCS,75571,HC CT HEART W/O CONTRAST W/ QUAL EVAL CORONARY CALCIUM,298.0,208.6,,,0
HCPCS,75571,HC PRO CT HEART W/O CONTRAST W/ QUAL EVAL CORONARY CALCIUM,226.0,158.2,,,0
HCPCS,75572,Ct hrt w/3d image,,,345.37,1532.31,11
HCPCS,75572,HC CT HEART W/3D IMAGE,1618.0,1132.6,,,0
HCPCS,75572,HC PRO CT HEART W/3D IMAGE,591.0,413.7,,,0
HCPCS,75573,Ct hrt w/3d image congen,,,345.37,1532.31,11
HCPCS,75573,HC CT HEART  W/CONTRAST EVAL CHD INCL 3D IMAGE LV RV EVAL VASCULAR STRUCTURES,1618.0,1132.6,,,0
HCPCS,75573,HC PRO CT HEART  W/CONTRAST EVAL CHD INCL 3D IMAGE LV RV EVAL VASCULAR STRUCTURES,775.0,542.5,,,0
HCPCS,75574,Ct angio hrt w/3d image,,,345.37,1532.31,11
HCPCS,75574,HC CT ANGIO HEART W/3D IMAGE,1618.0,1132.6,,,0
HCPCS,75574,HC PRO CT ANGIO HEART W/3D IMAGE,796.0,557.2,,,0
HCPCS,75580,HC NONINVASIVE EST CORONARY FFR DERIVED SOFTWARE ANALYSIS DATA SET FROM CTA W/INTERP/REPORT BY PHY/QHP,3973.0,2781.1,,,0
HCPCS,75580,HC PRO NONINVASIVE EST CORONARY FFR DERIVED SOFTWARE ANALYSIS DATA SET FROM CTA W/INTERP /REPORT BY PHY/QHP,1907.0,1334.9,,,0
HCPCS,75580,N-invas est c ffr sw aly cta,,,850.12,3771.72,11
HCPCS,75600,Contrast exam thoracic aorta,,,3125.8,13868.13,11
HCPCS,75605,Contrast exam thoracic aorta,,,5508.66,24440.06,11
HCPCS,75605,HC XRAY THOR AORTA SERIALOGRAPHY,2374.0,1661.8,,,0
HCPCS,75625,Contrast exam abdominl aorta,,,1356.26,13868.13,11
HCPCS,75625,HC XRAY ABD AORTA SERIALOGRAPHY SI,3028.0,2119.6,,,0
HCPCS,75630,HC XRAY ABD AORTA LWR EXTR BILAT,3557.0,2489.9,,,0
HCPCS,75630,X-ray aorta leg arteries,,,3125.8,13868.13,11
HCPCS,75635,Ct Angio Abdominal Arteries,,,173.64,1493.48,11
HCPCS,75635,HC CT ANGIO ABD AORTA LWR EXTR BILAT,3364.0,2354.8,,,0
HCPCS,75705,Artery x-rays spine,,,5508.66,24440.06,11
HCPCS,75705,HC XRAY ANGIO SPINAL SI,5269.0,3688.3,,,0
HCPCS,75710,Artery x-rays arm/leg,,,1249.63,13868.13,11
HCPCS,75710,HC XRAY ANGIO EXTREMITY UNILAT SI,2790.0,1953.0,,,0
HCPCS,75716,Artery x-rays arms/legs,,,3125.8,13868.13,11
HCPCS,75716,HC XRAY ANGIO EXTREMEITY BILAT SI,3611.0,2527.7,,,0
HCPCS,75726,Artery x-rays abdomen,,,2360.19,24440.06,11
HCPCS,75726,HC XRAY ANGIO VISCERAL SI,5269.0,3688.3,,,0
HCPCS,75731,Artery x-rays adrenal gland,,,3125.8,13868.13,11
HCPCS,75733,Artery x-rays adrenals,,,3125.8,13868.13,11
HCPCS,75736,Artery x-rays pelvis,,,5508.66,24440.06,11
HCPCS,75736,HC XRAY ANGIO PELVIC SI,4411.0,3087.7,,,0
HCPCS,75741,Artery x-rays lung,,,1218.73,13868.13,11
HCPCS,75741,HC XRAY ANGIO PULMON SI,2721.0,1904.7,,,0
HCPCS,75743,Artery x-rays lungs,,,3125.8,13868.13,11
HCPCS,75743,HC ANGIOGRAPHY PULM UNILAT SELECT RAD S&I,3230.0,2261.0,,,0
HCPCS,75746,Artery x-rays lung,,,1870.66,13868.13,11
HCPCS,75746,HC ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I,4011.0,2807.7,,,0
HCPCS,75756,Artery x-rays chest,,,1870.66,13868.13,11
HCPCS,75756,HC X-RAY ANGIO INTER MAMM SI,12111.0,8477.7,,,0
HCPCS,75774,HC XRAY ANGIO EACH ADDL VESSEL SI,1287.0,900.9,,,0
HCPCS,75801,Lymph vessel x-ray arm/leg,,,621.01,2755.21,11
HCPCS,75803,Lymph vessel x-ray arms/legs,,,1072.77,6913.93,11
HCPCS,75805,HC LYMPHANGIOGRAPHY PELVIC/ABDOMINAL UNILATERAL RADIOLOGICAL SUPERVISION/INTERPRETATION,12111.0,8477.7,,,0
HCPCS,75805,Lymph vessel x-ray trunk,,,1072.77,13868.13,11
HCPCS,75807,HC LYMPHANGIOGRAPHY PELVIC/ABDOMINAL BILATERAL RADIOLOGICAL SUPERVISION/INTERPRETATION,13928.0,9749.6,,,0
HCPCS,75807,Lymph vessel x-ray trunk,,,1072.77,13868.13,11
HCPCS,75809,HC XRAY SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RAD S&I,707.0,494.9,,,0
HCPCS,75809,Nonvascular shunt x-ray,,,103.5,669.82,11
HCPCS,75810,HC SPLENOPORTOGRAPHY RADIOLOGICAL SUPERVISION & INTERPRETATION,12111.0,8477.7,,,0
HCPCS,75810,Vein x-ray spleen/liver,,,3125.8,13868.13,11
HCPCS,75820,HC XRAY VEIN EXTR UNILAT SI,766.0,536.2,,,0
HCPCS,75820,Vein x-ray arm/leg,,,490.38,6913.93,11
HCPCS,75822,HC XRAY VEIN EXTR BILAT SI,974.0,681.8,,,0
HCPCS,75822,Vein x-ray arms/legs,,,436.29,6913.93,11
HCPCS,75825,HC XRAY VEIN INFERIOR CAVAL SI,2279.0,1595.3,,,0
HCPCS,75825,Vein x-ray trunk,,,3125.8,13868.13,11
HCPCS,75827,HC XRAY VEIN SUP CAVAL SERIALO SI,2279.0,1595.3,,,0
HCPCS,75827,Vein x-ray chest,,,1458.76,6913.93,11
HCPCS,75831,HC XRAY VEIN RENAL UNILAT SI,2535.0,1774.5,,,0
HCPCS,75831,Vein x-ray kidney,,,3125.8,13868.13,11
HCPCS,75833,HC XRAY VEIN RENAL BILAT SI,13400.0,9380.0,,,0
HCPCS,75833,Vein x-ray kidneys,,,3125.8,13868.13,11
HCPCS,75840,HC XRAY VEIN ADRENAL UNILATERAL SI,1488.0,1041.6,,,0
HCPCS,75840,Vein x-ray adrenal gland,,,3125.8,13868.13,11
HCPCS,75842,HC XRAY VEIN ADRENAL BILAT SI,2975.0,2082.5,,,0
HCPCS,75842,Vein x-ray adrenal glands,,,5777.39,7207.44,4
HCPCS,75860,HC XRAY VEIN VENOUS SINUS/JUGULAR SI,2656.0,1859.2,,,0
HCPCS,75860,Vein x-ray neck,,,1699.83,13868.13,11
HCPCS,75870,Vein x-ray skull,,,1870.66,13868.13,11
HCPCS,75872,Vein x-ray skull epidural,,,621.01,2755.21,11
HCPCS,75880,Vein x-ray eye socket,,,621.01,2755.21,11
HCPCS,75885,PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY W/HEMODYNAMIC EVAL,2535.0,1774.5,,,0
HCPCS,75885,Vein x-ray liver w/hemodynam,,,3125.8,13868.13,11
HCPCS,75887,HC XRAY VEIN LIVER W/O HEMOD PERQ SI,879.0,615.3,,,0
HCPCS,75887,Vein x-ray liver w/o hemodyn,,,1870.66,13868.13,11
HCPCS,75889,HC XRAY VEIN LIVER W/ HEMODYN SI,5849.0,4094.3,,,0
HCPCS,75889,Vein x-ray liver w/hemodynam,,,1357.8,13868.13,11
HCPCS,75891,HC XRAY VEIN LIVER W/O HEMODYN SI,4628.0,3239.6,,,0
HCPCS,75891,Vein x-ray liver,,,966.84,13868.13,11
HCPCS,75893,HC VENOUS SAMP W/WO ANGIO CATH SI,20692.0,14484.4,,,0
HCPCS,75893,Venous sampling by catheter,,,1621.53,24440.06,11
HCPCS,75894,HC XRAY TRANSCATH THER EMBOLIZ ANY METH SI,5918.0,4142.6,,,0
HCPCS,75898,Follow-up angiography,,,1412.92,13868.13,11
HCPCS,75898,HC XRAY ANGIO F/UP THRU CATHETER,2208.0,1545.6,,,0
HCPCS,75901,HC MECHANICAL RMVL PRICATH OBSTR  MATRL FROM CENTRAL VENOUS DEVICE VIA SEPARATE VENOUS ACCESS RS&I,233.0,163.1,,,0
HCPCS,75902,HC MECHANICAL RMVL INTRALUMINAL OBSTRUCTIVE MATERIAL RAD SUPERVISION & INTERP,191.0,133.7,,,0
HCPCS,75957,HC EVASC REPAIR DESCND THORCIC AORTA CELIAC ORG RAD S&I,354.0,247.8,,,0
HCPCS,75970,HC VASCULAR BIOPSY TRANSCATH SI,2071.0,1449.7,,,0
HCPCS,75984,HC XRAY CHANGE DRAIN TUBE CATH SI,929.0,650.3,,,0
HCPCS,75989,HC XRAY PERQ DRAIN FOR ABSCESS SI,757.0,529.9,,,0
HCPCS,76000,Fluoroscope examination,,,236.21,1047.98,11
HCPCS,76000,HC FLUOROSCOPY UP TO 1 HOUR,1042.0,729.4,,,0
HCPCS,76010,HC XRAY NOSE TO RECTUM FOR FB,209.0,146.3,,,0
HCPCS,76010,X-ray nose to rectum,,,81.39,382.23,11
HCPCS,76014,HC MR SAFETY IMPLANT/FOREIGN BODY ASSESS BY CLINICAL STAFF INCL ID & VERIFICATION OF IMPLANT COMPONENTS INITIAL 15 MINUTES,105.0,73.5,,,0
HCPCS,76014,Mr sfty implt&/fb asmt stf 1,,,28.63,127.04,7
HCPCS,76015,HC MR SAFETY IMPLANT/FOREIGN BODY ASSESS BY CLINICAL STAFF INCL ID & VERIFICATION OF IMPLANT COMPONENTS EACH ADDTL 30 MINUTES,121.0,84.7,,,0
HCPCS,76016,HC MR SAFETY DETERMINATION BY PHYSICIAN/QHP FOR SAFETY OF PROCEDURE  W/REPORT,375.0,262.5,,,0
HCPCS,76016,Mr safety deter phys/qhp,,,86.15,382.23,7
HCPCS,76017,HC MR SAFETY MEDICAL PHYSICS EXAM CUSTOMIZATION PLANNING/PERFORMANCE W/REPORT,1030.0,721.0,,,0
HCPCS,76017,Mr sfty med physics xm cstmz,,,236.21,1047.98,7
HCPCS,76018,HC MR SAFETY IMPLANT ELECTRONICS PREP INCL MR-SPECIFIC PROGRAM PULSE GENERATOR/TRANSMITTER W/REPORT,391.0,273.7,,,0
HCPCS,76019,HC MR SAFETY IMPLANT POSITIONING/IMMOBILIZATION W/REPORT,253.0,177.1,,,0
HCPCS,76019,Mr safety implt pos&/immoblj,,,58.4,259.1,7
HCPCS,76080,HC XRAY ABSCESS FISTULA SINUS TRACT,776.0,543.2,,,0
HCPCS,76080,X-ray exam of fistula,,,302.36,2399.94,11
HCPCS,76098,HC PRO XRAY SURGICAL SPECIMEN,11.0,7.7,,,0
HCPCS,76098,HC XRAY SURGICAL SPECIMEN,382.0,267.4,,,0
HCPCS,76098,X-ray exam breast specimen,,,139.11,2399.94,11
HCPCS,76100,X-ray exam of body section,,,103.5,459.18,11
HCPCS,76120,Cine/video x-rays,,,103.5,459.18,11
HCPCS,76120,HC CINERADIOGRAPHY/VIDEORADIOGRAPHY EXCEPT WHERE SPECIFICALLY INCLUDED,697.0,487.9,,,0
HCPCS,76145,Med physic dos eval rad exps,,,369.41,1638.96,11
HCPCS,76376,HC 3D RENDER W/O POSTPROCESS,375.0,262.5,,,0
HCPCS,76376,HC PRO 3D RENDER W/O POSTPROCESS,201.0,140.7,,,0
HCPCS,76377,HC 3D RENDERING W/POSTPROCESS,401.0,280.7,,,0
HCPCS,76380,CAT scan follow-up study,,,86.15,382.23,11
HCPCS,76380,HC CT LIMITED OR FOLLOW-UP STUDY,413.0,289.1,,,0
HCPCS,76390,HC MRI SPECTROSCOPY,808.0,565.6,,,0
HCPCS,76390,Mr spectroscopy,,,86.15,382.23,7
HCPCS,76391,HC MAGNETIC RESONANCE ELASTOGRAPHY,1008.0,705.6,,,0
HCPCS,76391,Mr elastography,,,236.21,1047.98,11
HCPCS,76496,Fluoroscopic procedure,,,86.15,382.23,11
HCPCS,76497,Ct procedure,,,86.15,395.27,11
HCPCS,76498,Mri procedure,,,86.15,1218.67,11
HCPCS,76499,HC UNLISTED DIAGNOSTIC RADIOGRAPHIC PROCEDURE,375.0,262.5,,,0
HCPCS,76499,Radiographic procedure,,,86.15,382.23,7
HCPCS,76506,Echo exam of head,,,103.5,459.18,11
HCPCS,76506,HC US BRAIN,425.0,297.5,,,0
HCPCS,76510,Ophth us b & quant a,,,131.71,1277.07,11
HCPCS,76511,Ophth us quant a only,,,103.5,459.18,11
HCPCS,76512,Ophth us b w/non-quant a,,,103.5,459.18,11
HCPCS,76513,Echo exam of eye water bath,,,103.5,459.18,11
HCPCS,76514,Echo exam of eye thickness,,,28.63,147.34,11
HCPCS,76516,Echo exam of eye,,,103.5,459.18,11
HCPCS,76519,Echo exam of eye,,,103.5,459.18,11
HCPCS,76529,Echo exam of eye,,,86.15,382.23,11
HCPCS,76536,HC US SOFT TISSUE HEAD NECK,425.0,297.5,,,0
HCPCS,76536,Us exam of head and neck,,,103.5,459.18,11
HCPCS,76604,HC US CHEST,425.0,297.5,,,0
HCPCS,76604,Us exam chest,,,103.5,459.18,11
HCPCS,76641,Ultrasound breast complete,,,103.5,459.18,11
HCPCS,76642,HC US BREAST UNILAT INCL AXILLA WHEN PERFORMED LIMITED,314.0,219.8,,,0
HCPCS,76642,Ultrasound breast limited,,,86.15,382.23,11
HCPCS,76700,HC US ABDOMEN,690.0,483.0,,,0
HCPCS,76700,Us exam abdom complete,,,103.5,459.18,11
HCPCS,76705,Echo exam of abdomen,,,103.5,459.18,11
HCPCS,76705,HC US ABDOMEN SINGLE ORGAN,634.0,443.8,,,0
HCPCS,76706,HC PRO US EVAL ABDOMINAL AORTA REAL TIME W/IMAGE DOC SCREENING ABDOMINAL AORTIC ANEURYSM (AAA),201.0,140.7,,,0
HCPCS,76706,US FOR AAA SCREEN,425.0,297.5,,,0
HCPCS,76706,Us abdl aorta screen aaa,,,47.9,459.18,11
HCPCS,76770,HC US RETROPERITONEAL,450.0,315.0,,,0
HCPCS,76770,Us exam abdo back wall comp,,,103.5,459.18,11
HCPCS,76775,HC US RETROPERITONEAL LIMITED,450.0,315.0,,,0
HCPCS,76775,Us exam abdo back wall lim,,,103.5,459.18,11
HCPCS,76776,US TRANSPLANTED KIDNEY,581.0,406.7,,,0
HCPCS,76776,Us exam k transpl w/doppler,,,103.5,459.18,11
HCPCS,76800,HC US SPINAL CANAL,233.0,163.1,,,0
HCPCS,76800,Us exam spinal canal,,,103.5,459.18,11
HCPCS,76801,HC US OB <14 WKS SINGL/1ST GESTAT,487.0,340.9,,,0
HCPCS,76801,Ob us < 14 wks single fetus,,,103.5,459.18,11
HCPCS,76802,HC US OB < 14 WKS ADD'L GESTAT,246.0,172.2,,,0
HCPCS,76802,Ob us < 14 wks addl fetus,,,165.35,206.27,4
HCPCS,76805,HC US OB >=14 WKS SINGL/1ST GESTAT,487.0,340.9,,,0
HCPCS,76805,Ob us >/= 14 wks sngl fetus,,,103.5,459.18,11
HCPCS,76810,HC US OB >=14 WKS ADD'L GESTAT,573.0,401.1,,,0
HCPCS,76810,Ob us >/= 14 wks addl fetus,,,269.91,336.72,4
HCPCS,76811,Ob us detailed sngl fetus,,,236.21,1047.98,11
HCPCS,76812,Ob us detailed addl fetus,,,191.47,238.86,4
HCPCS,76813,Ob us nuchal meas 1 gest,,,103.5,459.18,11
HCPCS,76814,Ob us nuchal meas add-on,,,191.47,238.86,4
HCPCS,76815,HC US OB LIMITED FETUS(S),425.0,297.5,,,0
HCPCS,76815,Ob us limited fetus(s),,,103.5,459.18,11
HCPCS,76816,HC OB US FOLLOW-UP PER FETUS,428.0,299.6,,,0
HCPCS,76816,Ob us follow-up per fetus,,,103.5,459.18,11
HCPCS,76817,HC US OB TRANSVAGINAL,425.0,297.5,,,0
HCPCS,76817,Transvaginal us obstetric,,,103.5,459.18,11
HCPCS,76818,Fetal biophys profile w/nst,,,103.5,459.18,11
HCPCS,76818,HC FETAL BIOPHYS PROFILE W/NST,642.0,449.4,,,0
HCPCS,76819,Fetal biophys profil w/o nst,,,103.5,459.18,11
HCPCS,76819,HC FETAL BIOPHYS PROFIL W/O NST,410.0,287.0,,,0
HCPCS,76820,HC DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY,431.0,301.7,,,0
HCPCS,76820,Umbilical artery echo,,,103.5,459.18,11
HCPCS,76821,HC DOPPLER VELOCIMETRY FETAL MIDDLE CEREBRAL ATERY,496.0,347.2,,,0
HCPCS,76821,Middle cerebral artery echo,,,103.5,459.18,11
HCPCS,76825,Echo exam of fetal heart,,,301.97,2399.94,11
HCPCS,76825,HC ECHO FETAL CARDIOVASCULAR SYSTEM (2D) W/WITHOUT M-MODE RECORDING,2142.0,1499.4,,,0
HCPCS,76826,Echo exam of fetal heart,,,191.47,1047.98,11
HCPCS,76826,HC ECHO FETAL CARDIOVASC SYS REAL TIME W/IMAGE DOC W/WO M-MODE RECORDING F/U OR REPEAT STUDY,1622.0,1135.4,,,0
HCPCS,76827,Echo exam of fetal heart,,,103.5,459.18,11
HCPCS,76827,HC DOPPLER ECHO FETAL PULSED WAVE AND/OR CONT WAVE W/SPECTRAL DISPLAY COMPLETE,445.0,311.5,,,0
HCPCS,76828,Echo exam of fetal heart,,,103.5,459.18,11
HCPCS,76828,HC DOPPLER ECHO FETAL PULSED WAVE AND/OR CONT WAVE W/SPECTRAL DISPLAY F/U OR REPEAT STUDY,445.0,311.5,,,0
HCPCS,76830,HC US NOT OB TRANSVAGINAL,537.0,375.9,,,0
HCPCS,76830,Transvaginal us non-ob,,,103.5,459.18,11
HCPCS,76831,Echo exam uterus,,,199.86,1047.98,11
HCPCS,76831,SONOHYSTEROGRAPHY,424.0,296.8,,,0
HCPCS,76856,HC US NOT OB PELVIC COMPLETE,569.0,398.3,,,0
HCPCS,76856,Us exam pelvic complete,,,103.5,459.18,11
HCPCS,76857,HC US NOT OB PELVIC LIMITED FUP,425.0,297.5,,,0
HCPCS,76857,Us exam pelvic limited,,,103.5,459.18,11
HCPCS,76870,HC US SCROTUM,425.0,297.5,,,0
HCPCS,76870,Us exam scrotum,,,103.5,459.18,11
HCPCS,76872,HC US TRANSRECTAL,555.0,388.5,,,0
HCPCS,76872,Us transrectal,,,103.5,459.18,11
HCPCS,76873,Echograp trans r pros study,,,103.5,459.18,11
HCPCS,76881,HC US COMPLETE JOINT REAL-TIME W/ IMAGE DOCUMENTATION,425.0,297.5,,,0
HCPCS,76881,Us xtr non-vasc complete,,,72.37,459.18,11
HCPCS,76882,HC US LIMITED JOINT/FOCAL EVAL NONVASC EXTREMITY STRUCTURE(S) REAL-TIME W/IMAGE DOC,425.0,297.5,,,0
HCPCS,76882,Us xtr non-vasc lmtd,,,41.85,459.18,11
HCPCS,76883,Us nrv&acc strux 1xtr compre,,,103.5,459.18,11
HCPCS,76885,US INFANT HIPS DYNAMIC,453.0,317.1,,,0
HCPCS,76885,Us exam infant hips dynamic,,,86.15,382.23,11
HCPCS,76886,Us exam infant hips static,,,86.15,382.23,11
HCPCS,76936,Echo guide for artery repair,,,213.76,948.37,11
HCPCS,76937,HC PRO US GUIDE VASCULAR ACCESS,38.0,26.6,,,0
HCPCS,76937,HC US GUIDE VASCULAR ACCESS,201.0,140.7,,,0
HCPCS,76940,HC US GUIDE TISSUE ABLATION,621.0,434.7,,,0
HCPCS,76942,HC US GUIDE NEEDLE PLACEMENT SI,656.0,459.2,,,0
HCPCS,76946,HC US GUIDE FOR AMNIO SI,573.0,401.1,,,0
HCPCS,76965,HC PRO US GUIDE INTERSTITIAL RADIOELEMENT APPLICATION,234.0,163.8,,,0
HCPCS,76965,HC US GUIDE PLACE INTERSTITIAL RAD,1166.0,816.2,,,0
HCPCS,76975,GI endoscopic ultrasound,,,236.21,1047.98,11
HCPCS,76977,Us bone density measure,,,103.5,459.18,11
HCPCS,76978,Us trgt dyn mbubb 1st les,,,345.37,1532.31,11
HCPCS,76979,Us trgt dyn mbubb ea addl,,,130.71,163.07,4
HCPCS,76981,HC ULTRASOUND ELASTOGRAPHY PARENCHYMA,507.0,354.9,,,0
HCPCS,76981,Use parenchyma,,,103.5,459.18,11
HCPCS,76982,Use 1st target lesion,,,103.5,459.18,11
HCPCS,76983,Use ea addl target lesion,,,75.63,94.35,4
HCPCS,76998,HC US GUIDE INTRAOP,509.0,356.3,,,0
HCPCS,76999,Echo examination procedure,,,86.15,382.23,7
HCPCS,76999,HC US UNLISTED PROC,145.0,101.5,,,0
HCPCS,77001,Fluoroguide for Vein Device,,,287.15,358.23,4
HCPCS,77001,HC FLUORO GUIDE VEIN DEVICE SI,82.0,57.4,,,0
HCPCS,77002,HC FLUORO GUIDE NEEDLE PLACEMENT,1003.0,702.1,,,0
HCPCS,77002,Needle localization by xray,,,199.16,248.46,4
HCPCS,77003,Fluoroguide for Spine Inject,,,168.98,210.81,4
HCPCS,77003,HC FLUOR GUIDE NEEDLE CATH INJ SPI,485.0,339.5,,,0
HCPCS,77011,CT GUIDE FOR STEREO LOCALIZATION,843.0,590.1,,,0
HCPCS,77011,HC PRO CT GUIDE STEREOTACTIC LOCALIZATION,244.0,170.8,,,0
HCPCS,77012,HC CT GUIDE NDL ASPIRATE BX,1100.0,770.0,,,0
HCPCS,77013,HC CT GUIDE TISSUE ABLATION,2027.0,1418.9,,,0
HCPCS,77014,HC 3D CT GUIDE FOR PLACEMENT OF RADIATION THERAPY FIELDS,529.0,370.3,,,0
HCPCS,77014,HC 4D CT GUIDE FOR PLACEMENT OF RADIATION THERAPY FIELDS,529.0,370.3,,,0
HCPCS,77014,HC PRO 3D CT GUIDE FOR PLACEMENT OF RADIATION THERAPY FIELDS,296.0,207.2,,,0
HCPCS,77014,HC PRO 4D CT GUIDE FOR PLACEMENT OF RADIATION THERAPY FIELDS,296.0,207.2,,,0
HCPCS,77046,Mri breast c- unilateral,,,236.21,1047.98,11
HCPCS,77047,Mri breast c- bilateral,,,236.21,1047.98,11
HCPCS,77048,Mri breast c-+ w/cad uni,,,316.67,395.05,4
HCPCS,77049,Mri breast c-+ w/cad bi,,,347.9,434.02,4
HCPCS,77053,X-Ray of Mammary Duct,,,236.21,1047.98,11
HCPCS,77054,X-ray of mammary ducts,,,236.21,1047.98,11
HCPCS,77063,Breast tomosynthesis bi,,,21.44,202.87,10
HCPCS,77065,Dx mammo incl cad uni,,,79.12,161.36,10
HCPCS,77066,Dx mammo incl cad bi,,,101.57,200.13,10
HCPCS,77067,Scr mammo bi incl cad,,,83.71,165.15,10
HCPCS,77071,X-Ray Stress View,,,86.15,382.23,7
HCPCS,77072,HC XRAY FOR BONE AGE,200.0,140.0,,,0
HCPCS,77072,X-Rays for Bone Age,,,103.5,459.18,11
HCPCS,77073,HC XRAY FOR BONE LENGTH,501.0,350.7,,,0
HCPCS,77073,X-rays bone length studies,,,103.5,459.18,11
HCPCS,77074,X-rays bone survey limited,,,103.5,459.18,11
HCPCS,77075,HC XRAY FOR BONE SURVEY COMPLETE,632.0,442.4,,,0
HCPCS,77075,X-rays bone survey complete,,,103.5,459.18,11
HCPCS,77076,X-rays bone survey infant,,,103.5,459.18,11
HCPCS,77077,Joint survey single view,,,103.5,459.18,11
HCPCS,77078,Ct bone density axial,,,86.15,382.23,11
HCPCS,77080,Dxa bone density axial,,,103.5,459.18,11
HCPCS,77080,HC XRAY BONE DENSITY AXIAL,453.0,317.1,,,0
HCPCS,77081,Dxa bone density/peripheral,,,86.15,382.23,11
HCPCS,77084,Magnetic image bone marrow,,,236.21,1218.67,11
HCPCS,77085,Dxa bone density study,,,103.5,459.18,11
HCPCS,77086,Fracture assessment via dxa,,,86.15,382.23,11
HCPCS,77090,HC TBS STRUCTURAL CONDITION BONE MICROARCHITECTURE TECH PREP & TRANSMISSION DATA ALYS PFRMD ELSEWHERE,415.0,290.5,,,0
HCPCS,77090,Tbs techl prep&transmis data,,,86.15,382.23,11
HCPCS,77091,Tbs techl calculation only,,,86.15,382.23,11
HCPCS,77261,HC PRO THERAPEUTIC RAD TX PLANNING SIMPLE,678.0,474.6,,,0
HCPCS,77261,Radiation therapy planning,,,209.89,261.84,4
HCPCS,77262,HC PRO THERAPEUTIC RAD TX PLANNING INTERMEDIATE,905.0,633.5,,,0
HCPCS,77262,Radiation therapy planning,,,315.73,393.88,4
HCPCS,77263,HC PRO THERAPEUTIC RAD TX PLANNING COMPLEX,1357.0,949.9,,,0
HCPCS,77263,Radiation therapy planning,,,468.32,584.24,4
HCPCS,77280,HC PRO THERAPEUTIC RAD SIM-AIDED FIELD SETTING SIMPLE,277.0,193.9,,,0
HCPCS,77280,SET RAD THERAPY FIELD SIMPLE,1784.0,1248.8,,,0
HCPCS,77280,Set radiation therapy field,,,133.06,1054.51,11
HCPCS,77285,HC PRO THERAPEUTIC RAD SIM-AIDED FIELD SETTING INTERMED,431.0,301.7,,,0
HCPCS,77285,SET RAD THERAPY FIELD INTERMED,1956.0,1369.2,,,0
HCPCS,77285,Set radiation therapy field,,,370.67,1644.55,11
HCPCS,77290,HC PRO THERAPEUTIC RAD SIM-AIDED FIELD SETTING COMPLEX,633.0,443.1,,,0
HCPCS,77290,SET RAD THERAPY FIELD COMPLEX,3824.0,2676.8,,,0
HCPCS,77290,Set radiation therapy field,,,370.67,1978.57,11
HCPCS,77293,HC PRO RESPIRATORY MOTION MGMT SIMULATION,536.0,375.2,,,0
HCPCS,77293,HC RESPIRATORY MOTION MGMT SIMULATION,1174.0,821.8,,,0
HCPCS,77293,Respirator motion mgmt simul,,,1313.99,1639.23,4
HCPCS,77295,3-d radiotherapy plan,,,1370.24,6079.31,11
HCPCS,77295,HC PRO THERAPEUTIC RAD SIM-AIDED FIELD SETTING 3D,1185.0,829.5,,,0
HCPCS,77295,SET RAD THERAPY FIELD 3D,9493.0,6645.1,,,0
HCPCS,77299,Radiation therapy planning,,,133.06,590.34,7
HCPCS,77300,HC PRO RAD DOSIMETRY CALCULATION,158.0,110.6,,,0
HCPCS,77300,RADIATION THERAPY DOSE PLAN,662.0,463.4,,,0
HCPCS,77300,Radiation therapy dose plan,,,133.06,590.34,11
HCPCS,77301,HC PRO IMRT PLAN,2266.0,1586.2,,,0
HCPCS,77301,RADIOTHERAPY DOSE PLAN IMRT,4262.0,2983.4,,,0
HCPCS,77301,Radiotherapy dose plan imrt,,,1370.24,6079.31,11
HCPCS,77306,HC PRO TELETHERAPY ISODOSE PLAN SIMPLE INCLUDES BASIC DOSIMETRY CALCULATION(S),161.0,112.7,,,0
HCPCS,77306,HC TELETHERAPY ISODOSE PLAN SIMPLE INCLUDES BASIC DOSIMETRY CALCULATION(S),627.0,438.9,,,0
HCPCS,77306,Telethx isodose plan simple,,,342.91,1644.55,11
HCPCS,77307,HC PRO TELETHERAPY ISODOSE PLAN COMPLEX INCLUDES BASIC DOSIMETRY CALCULATION(S),352.0,246.4,,,0
HCPCS,77307,HC TELETHERAPY ISODOSE PLAN COMPLEX INCLUDES BASIC DOSIMETRY CALCULATION(S),2655.0,1858.5,,,0
HCPCS,77307,Telethx isodose plan cplx,,,370.67,1644.55,11
HCPCS,77316,Brachytx isodose plan simple,,,289.49,1644.55,11
HCPCS,77316,HC BRACHYTHERAPY ISODOSE PLAN SIMPLE INCLUDES BASIC DOSIMETRY CALCULATION(S),502.0,351.4,,,0
HCPCS,77316,HC PRO BRACHYTHERAPY ISODOSE PLAN SIMPLE INCLUDES BASIC DOSIMETRY CALCULATION(S),223.0,156.1,,,0
HCPCS,77317,Brachytx isodose intermed,,,370.67,1644.55,11
HCPCS,77317,HC BRACHYTHERAPY ISODOSE PLAN INTERMEDIATE INCLUDES BASIC DOSIMETRY CALCULATION(S),657.0,459.9,,,0
HCPCS,77317,HC PRO BRACHYTHERAPY ISODOSE PLAN INTERMEDIATE INCLUDES BASIC DOSIMETRY CALCULATION(S),354.0,247.8,,,0
HCPCS,77318,Brachytx isodose complex,,,370.67,1644.55,11
HCPCS,77318,HC BRACHYTHERAPY ISODOSE PLAN COMPLEX INCLUDES BASIC DOSIMETRY CALCULATION(S),771.0,539.7,,,0
HCPCS,77318,HC PRO BRACHYTHERAPY ISODOSE PLAN COMPLEX INCLUDES BASIC DOSIMETRY CALCULATION(S),346.0,242.2,,,0
HCPCS,77321,HC PRO SPECIAL TELETHERAPY PORT PLAN,250.0,175.0,,,0
HCPCS,77321,SPECIAL TELETX PORT PLAN,955.0,668.5,,,0
HCPCS,77321,Special teletx port plan,,,370.67,1644.55,11
HCPCS,77331,HC PRO SPECIAL DOSIMETRY,201.0,140.7,,,0
HCPCS,77331,HC SPECIAL DOSIMETRY ONLY WHEN PRESCRIBED BY TREATING PHYS,381.0,266.7,,,0
HCPCS,77331,Special radiation dosimetry,,,133.06,590.34,11
HCPCS,77332,HC PRO TX DEVICES SIMPLE,122.0,85.4,,,0
HCPCS,77332,RAD TX AID(S)SIMPLE,634.0,443.8,,,0
HCPCS,77332,Radiation treatment aid(s),,,133.06,590.34,11
HCPCS,77333,HC PRO TX DEVICES INTERMEDIATE,203.0,142.1,,,0
HCPCS,77333,RAD TX AID(S) INTERMED,723.0,506.1,,,0
HCPCS,77333,Radiation treatment aid(s),,,133.06,590.34,11
HCPCS,77334,HC FIELD BLOCK DESIGN,2014.0,1409.8,,,0
HCPCS,77334,HC PRO TX DEVICES COMPLEX,314.0,219.8,,,0
HCPCS,77334,Radiation treatment aid(s),,,370.67,1644.55,11
HCPCS,77336,RADIATION PHYSICS CONSULT,571.0,399.7,,,0
HCPCS,77336,Radiation physics consult,,,133.06,590.34,7
HCPCS,77338,DESIGN MLC DEVICE FOR IMRT,938.0,656.6,,,0
HCPCS,77338,Design mlc device for imrt,,,370.67,1644.55,11
HCPCS,77338,HC PRO MULTI-LEAF COLLIMATOR DEVICE(S) FOR IMRT,930.0,651.0,,,0
HCPCS,77370,RAD PHYSICS CONSULT SPECIAL,698.0,488.6,,,0
HCPCS,77370,Radiation physics consult,,,133.06,590.34,7
HCPCS,77371,Srs multisource,,,7291.4,32349.47,11
HCPCS,77372,Srs linear based,,,2184.48,32349.47,11
HCPCS,77373,LIN ACC STEREOTAC RADIOSURG,7770.0,5439.0,,,0
HCPCS,77373,SBRT Delivery,,,1770.11,7853.39,11
HCPCS,77385,HC IMRT INCLUDES GUIDANCE/TRACKING SIMPLE,3669.0,2568.3,,,0
HCPCS,77385,Ntsty modul rad tx dlvr smpl,,,2326.71,2902.62,4
HCPCS,77386,HC IMRT INCLUDES GUIDANCE/TRACKING COMPLEX,3758.0,2630.6,,,0
HCPCS,77386,Ntsty modul rad tx dlvr cplx,,,2383.37,2973.31,4
HCPCS,77387,HC GUIDE FOR LOCALIZATION OF TARGET VOLUME FOR RADIATION TREATMENT DELIVERY BAT,540.0,378.0,,,0
HCPCS,77387,HC GUIDE FOR LOCALIZATION OF TARGET VOLUME FOR RADIATION TREATMENT DELIVERY CT,722.0,505.4,,,0
HCPCS,77387,HC GUIDE FOR LOCALIZATION OF TARGET VOLUME FOR RADIATION TREATMENT DELIVERY KV,540.0,378.0,,,0
HCPCS,77387,HC PRO GUIDE FOR LOCALIZATION OF TARGET VOLUME FOR RADIATION TREATMENT DELIVERY,101.0,70.7,,,0
HCPCS,77399,External radiation dosimetry,,,133.06,590.34,7
HCPCS,77401,Radiation treatment delivery,,,284.67,355.13,4
HCPCS,77402,HC RADIATION TX DELIVERY >= 1 MEV SIMPLE,507.0,354.9,,,0
HCPCS,77402,Radiation treatment delivery,,,101.01,448.13,11
HCPCS,77407,HC RADIATION TX DELIVERY >= 1 MEV INTERMEDIATE,534.0,373.8,,,0
HCPCS,77407,Radiation treatment delivery,,,308.03,1694.04,11
HCPCS,77412,HC RADIATION TX DELIVERY >= 1 MEV COMPLEX,1196.0,837.2,,,0
HCPCS,77412,Radiation treatment delivery,,,451.87,2426.85,11
HCPCS,77417,HC XRAY PORT FILMS - 1,273.0,191.1,,,0
HCPCS,77417,HC XRAY PORT FILMS - 2,257.0,179.9,,,0
HCPCS,77417,HC XRAY PORT FILMS - 3,313.0,219.1,,,0
HCPCS,77417,HC XRAY PORT FILMS - 4,364.0,254.8,,,0
HCPCS,77423,Neutron beam tx complex,,,443.47,2426.85,11
HCPCS,77424,Io rad tx delivery by x-ray,,,2964.1,32349.47,11
HCPCS,77425,Io rad tx deliver by elctrns,,,2964.1,32349.47,11
HCPCS,77427,HC PRO RADIATION TX MANAGEMENT 5 TX,1330.0,931.0,,,0
HCPCS,77427,Radiation tx management x5,,,556.01,693.63,4
HCPCS,77431,HC PRO RADIATION TX MANAGEMENT 1-2 FRACTIONS,699.0,489.3,,,0
HCPCS,77431,Radiation therapy management,,,283.46,353.62,4
HCPCS,77432,HC PRO STEREOTACTIC RADIATION TX MGMT CRANIAL LESION(S) 1 SESSION,1000.0,700.0,,,0
HCPCS,77432,Stereotactic radiation trmt,,,1185.0,1478.32,4
HCPCS,77435,HC PRO SBRT MANAGEMENT NOT TO EXCEED 5 FRACTIONS,778.0,544.6,,,0
HCPCS,77435,SBRT MANAGEMENT  UP TO 5 FRACT,434.0,303.8,,,0
HCPCS,77436,Surf radj ther tx planning,,,36.98,164.05,7
HCPCS,77469,Io radiation tx management,,,889.43,1109.58,4
HCPCS,77470,HC PRO SPECIAL RAD TX,796.0,557.2,,,0
HCPCS,77470,SPECIAL RADIATION TREATMENT,2853.0,1997.1,,,0
HCPCS,77470,Special radiation treatment,,,547.0,2426.85,11
HCPCS,77520,Proton trmt simple w/o comp,,,547.0,3199.69,11
HCPCS,77522,Proton trmt simple w/comp,,,1237.2,5489.05,11
HCPCS,77523,Proton trmt intermediate,,,1237.2,5489.05,11
HCPCS,77525,Proton treatment complex,,,1237.2,5489.05,11
HCPCS,77600,Hyperthermia treatment,,,381.83,1694.04,11
HCPCS,77605,Hyperthermia treatment,,,689.49,3059.02,11
HCPCS,77610,Hyperthermia treatment,,,547.0,2426.85,11
HCPCS,77615,Hyperthermia treatment,,,547.0,2426.85,11
HCPCS,77620,Hyperthermia treatment,,,547.0,2426.85,11
HCPCS,77750,Infuse radioactive materials,,,381.83,1694.04,11
HCPCS,77761,Apply intrcav radiat simple,,,547.0,2426.85,11
HCPCS,77761,HC PRO INTRACAVITARY RAD SOURCE APPLICATION SIMPLE,934.0,653.8,,,0
HCPCS,77762,Apply intrcav radiat interm,,,547.0,2426.85,11
HCPCS,77762,HC PRO INTRACAVITARY RAD SOURCE APPLICATION INTERMEDIATE,1445.0,1011.5,,,0
HCPCS,77763,Apply intrcav radiat compl,,,689.49,3059.02,11
HCPCS,77763,HC PRO INTRACAVITARY RAD SOURCE APPLICATION COMPLEX,2105.0,1473.5,,,0
HCPCS,77767,Hdr rdncl skn surf brachytx,,,381.83,1694.04,11
HCPCS,77768,Hdr rdncl skn surf brachytx,,,381.83,1694.04,11
HCPCS,77770,HC PRO HC REMOTE AFTERLOADING HIGH DOSE RATE RADIONUCLIDE INTERSTITIAL/INTRACAVITARY BRACHYTHERAPY INCL BASIC DOSIMETRY 1 CHANNEL,464.0,324.8,,,0
HCPCS,77770,HC REMOTE AFTERLOADING HIGH DOSE RATE RADIONUCLIDE INTERSTITIAL/INTRACAVITARY BRACHYTHERAPY INCL BASIC DOSIMETRY 1 CHANNEL,1182.0,827.4,,,0
HCPCS,77770,Hdr rdncl ntrstl/icav brchtx,,,681.99,3059.02,11
HCPCS,77771,HC PRO REMOTE AFTERLOADING HIGH DOSE RATE RADIONUCLIDE INTERSTITIAL/INTRACAVITARY BRACHYTHERAPY INCL BASIC DOSIMETRY 2-12 CHANNELS,579.0,405.3,,,0
HCPCS,77771,HC REMOTE AFTERLOADING HIGH DOSE RATE RADIONUCLIDE INTERSTITIAL/INTRACAVITARY BRACHYTHERAPY INCL BASIC DOSIMETRY 2-12 CHANNELS,1673.0,1171.1,,,0
HCPCS,77771,Hdr rdncl ntrstl/icav brchtx,,,689.49,3059.02,11
HCPCS,77772,HC PRO REMOTE AFTERLOADING HIGH DOSE RATE RADIONUCLIDE INTERSTITIAL/INTRACAVITARY BRACHYTHERAPY INCL BASIC DOSIMETRY OVER 12 CHANNELS,1822.0,1275.4,,,0
HCPCS,77772,HC REMOTE AFTERLOADING HIGH DOSE RATE RADIONUCLIDE INTERSTITIAL/INTRACAVITARY BRACHYTHERAPY INCL BASIC DOSIMETRY OVER 12 CHANNELS,4627.0,3238.9,,,0
HCPCS,77772,Hdr rdncl ntrstl/icav brchtx,,,689.49,3059.02,11
HCPCS,77778,Apply interstit radiat compl,,,689.49,3059.02,11
HCPCS,77778,HC APPLY INTERSTIT RADIATION COMPLEX,4095.0,2866.5,,,0
HCPCS,77778,HC PRO INTERSTITIAL RAD SOURCE APPLICATION COMPLEX,3599.0,2519.3,,,0
HCPCS,77789,Apply surf ldr radionuclide,,,101.01,448.13,11
HCPCS,77789,HC PRO SURFACE APPLICATION RADIATION SOURCE,279.0,195.3,,,0
HCPCS,77790,HC SUPERVISION/HANDLING/LOADING OF RADIATION SOURCE,466.0,326.2,,,0
HCPCS,78012,HC THYROID SINGLE UPTAKE,297.0,207.9,,,0
HCPCS,78012,Thyroid uptake measurement,,,147.83,1755.86,11
HCPCS,78013,HC THYROID IMAGING W/ BLOOD FLOW,199.0,139.3,,,0
HCPCS,78013,Thyroid imaging w/blood flow,,,395.76,1755.86,11
HCPCS,78014,HC THYROID IMAGING W/ BLOOD FLOW W/ SNGL/MULT UPTAKE(S),308.0,215.6,,,0
HCPCS,78014,Thyroid imaging w/blood flow,,,166.65,1755.86,11
HCPCS,78015,Thyroid met imaging,,,395.76,1755.86,11
HCPCS,78016,HC THYROID METS IMAGING/STUDIES,417.0,291.9,,,0
HCPCS,78016,Thyroid met imaging/studies,,,226.13,1755.86,11
HCPCS,78018,HC THYROID METS IMAGING BODY,2039.0,1427.3,,,0
HCPCS,78018,Thyroid met imaging body,,,537.52,2384.8,11
HCPCS,78070,Parathyroid planar imaging,,,395.76,1755.86,11
HCPCS,78071,HC PARATHYROID IMAGING W/ TOMOGRAPHIC (SPECT),1600.0,1120.0,,,0
HCPCS,78071,Parathyrd planar w/wo subtrj,,,395.76,1755.86,11
HCPCS,78072,HC PARATHYRD PLANAR IMAG INCL SUBTRACTION W/TOMOGRAHIC (SPECT) AND CT FOR ANATOMICAL LOCALIZATION,1807.0,1264.9,,,0
HCPCS,78072,Parathyrd planar w/spect&ct,,,537.52,2384.8,11
HCPCS,78075,Adrenal cortex & medulla img,,,1030.2,5686.29,11
HCPCS,78075,HC ADRENAL IMAGING,1900.0,1330.0,,,0
HCPCS,78099,Endocrine nuclear procedure,,,395.76,1755.86,7
HCPCS,78102,Bone marrow imaging ltd,,,395.76,1755.86,11
HCPCS,78102,HC BONE MARROW IMAGING LTD,1565.0,1095.5,,,0
HCPCS,78103,Bone marrow imaging mult,,,395.76,1755.86,11
HCPCS,78103,HC BONE MARROW IMAGING MULTIPLE AREAS,1800.0,1260.0,,,0
HCPCS,78104,Bone marrow imaging body,,,395.76,1755.86,11
HCPCS,78110,Plasma volume single,,,1138.73,5686.29,11
HCPCS,78111,Plasma volume multiple,,,1138.73,5686.29,11
HCPCS,78120,Red cell mass single,,,395.76,1755.86,11
HCPCS,78121,Red cell mass multiple,,,537.52,2384.8,11
HCPCS,78122,Blood volume,,,537.52,2384.8,11
HCPCS,78130,Red cell survival study,,,395.76,1755.86,11
HCPCS,78140,HC RED CELL SEQUESTRATION,801.0,560.7,,,0
HCPCS,78140,Red cell sequestration,,,395.76,1755.86,11
HCPCS,78185,Spleen imaging,,,395.76,1755.86,11
HCPCS,78191,Platelet survival,,,395.76,1755.86,11
HCPCS,78195,HC LYMPH SYSTEM IMAGING,1581.0,1106.7,,,0
HCPCS,78195,Lymph system imaging,,,537.52,2384.8,11
HCPCS,78199,Blood/lymph nuclear exam,,,395.76,1755.86,7
HCPCS,78201,Liver imaging,,,537.52,2384.8,11
HCPCS,78202,HC LIVER IMAGING WITH VASCULAR FLOW,4055.0,2838.5,,,0
HCPCS,78202,Liver imaging with flow,,,537.52,2384.8,11
HCPCS,78215,HC LIVER AND SPLEEN IMAGING STATIC,2071.0,1449.7,,,0
HCPCS,78215,Liver and spleen imaging,,,395.76,1755.86,11
HCPCS,78216,Liver & spleen image/flow,,,395.76,1755.86,11
HCPCS,78226,HC HEPATOBILIARY SYSTEM IMAGING,1202.0,841.4,,,0
HCPCS,78226,Hepatobiliary system imaging,,,395.76,1755.86,11
HCPCS,78227,HC HEPATOBIL SYST IMAGE W/DRUG,1941.0,1358.7,,,0
HCPCS,78227,Hepatobil syst image w/drug,,,537.52,2384.8,11
HCPCS,78230,Salivary gland imaging,,,395.76,1755.86,11
HCPCS,78231,Serial salivary imaging,,,395.76,1755.86,11
HCPCS,78232,Salivary gland function exam,,,395.76,1755.86,11
HCPCS,78258,Esophageal motility study,,,395.76,1755.86,11
HCPCS,78258,HC ESOPHAGEAL MOTILITY,1340.0,938.0,,,0
HCPCS,78261,Gastric mucosa imaging,,,395.76,1755.86,11
HCPCS,78262,Gastroesophageal reflux exam,,,395.76,1755.86,11
HCPCS,78262,HC GASTROESOPHAGEAL REFLUX EXAM,839.0,587.3,,,0
HCPCS,78264,Gastric emptying imag study,,,395.76,1755.86,11
HCPCS,78264,HC GASTRIC EMPTYING IMAGING STUDY,1340.0,938.0,,,0
HCPCS,78265,Gastric emptying imag study,,,395.76,1755.86,11
HCPCS,78265,HC GASTRIC EMPTYING IMAGING STUDY W/SMALL BOWEL TRANSIT,1412.0,988.4,,,0
HCPCS,78266,Gastric emptying imag study,,,273.52,2384.8,11
HCPCS,78266,HC GASTRIC EMPTYING IMAGING STUDY W/SMALL BOWEL & COLON TRANSIT MULTI DAYS,1873.0,1311.1,,,0
HCPCS,78267,Breath tst attain/anal c-14,,,9.95,43.39,11
HCPCS,78268,Breath test analysis c-14,,,84.97,359.4,11
HCPCS,78278,Acute GI blood loss imaging,,,395.76,1755.86,11
HCPCS,78278,HC ACUTE GI BLOOD LOSS IMAGING,1770.0,1239.0,,,0
HCPCS,78282,GI protein loss exam,,,395.76,1755.86,11
HCPCS,78290,HC MECKELS DIVERTICULUM,970.0,679.0,,,0
HCPCS,78290,Meckels divert exam,,,395.76,1755.86,11
HCPCS,78291,Leveen/shunt patency exam,,,395.76,1755.86,11
HCPCS,78299,GI nuclear procedure,,,395.76,1755.86,7
HCPCS,78300,Bone imaging limited area,,,395.76,1755.86,11
HCPCS,78300,HC BONE AND/OR JOINT IMAGING LIMITED AREA,1404.0,982.8,,,0
HCPCS,78305,Bone imaging multiple areas,,,395.76,1755.86,11
HCPCS,78305,HC BONE AND/OR JOINT IMAGING MULTIPLE AREAS,1738.0,1216.6,,,0
HCPCS,78306,Bone imaging whole body,,,395.76,1755.86,11
HCPCS,78306,HC BONE AND/OR JOINT IMAGING WHOLE BODY,1946.0,1362.2,,,0
HCPCS,78315,Bone imaging 3 phase,,,395.76,1755.86,11
HCPCS,78315,HC BONE AND/OR JOINT IMAGING 3 PHASE STUDY,1986.0,1390.2,,,0
HCPCS,78399,Musculoskeletal nuclear exam,,,395.76,1755.86,7
HCPCS,78414,Non-imaging heart function,,,537.52,2384.8,11
HCPCS,78428,Cardiac shunt imaging,,,395.76,1755.86,11
HCPCS,78429,Myocrd img pet 1 std w/ct,,,1415.6,6280.55,11
HCPCS,78430,Myocrd img pet rst/strs w/ct,,,1415.6,6280.55,11
HCPCS,78431,Myocrd img pet rst&strs ct,,,2180.69,9674.98,11
HCPCS,78432,Myocrd img pet 2rtracer,,,1502.4,10396.89,11
HCPCS,78433,Myocrd img pet 2rtracer ct,,,2180.69,10396.89,11
HCPCS,78434,Aqmbf pet rest & rx stress,,,93.69,116.88,4
HCPCS,78445,Vascular flow imaging,,,395.76,1755.86,11
HCPCS,78451,Ht muscle image spect sing,,,1281.66,5686.29,11
HCPCS,78452,HC HEART MUSC IMAGE SPECT MULT,2202.0,1541.4,,,0
HCPCS,78452,HC PRO HEART MUSC IMAGE SPECT MULT,769.0,538.3,,,0
HCPCS,78452,Ht muscle image spect mult,,,765.84,5686.29,11
HCPCS,78453,Ht muscle image planar sing,,,1281.66,5686.29,11
HCPCS,78454,Ht musc image planar mult,,,1281.66,5686.29,11
HCPCS,78456,Acute venous thrombus image,,,628.85,5686.29,11
HCPCS,78457,Venous thrombosis imaging,,,537.52,2384.8,11
HCPCS,78458,Ven thrombosis images bilat,,,395.76,1755.86,11
HCPCS,78459,Heart muscle imaging (PET),,,1281.66,5686.29,11
HCPCS,78466,Heart infarct image,,,395.76,1755.86,11
HCPCS,78468,Heart infarct image (ef),,,537.52,2384.8,11
HCPCS,78469,Heart infarct image (3D),,,537.52,2384.8,11
HCPCS,78472,Gated heart planar single,,,395.76,1755.86,11
HCPCS,78472,HC CARDIAC BLOOD POOL IMAGING,1695.0,1186.5,,,0
HCPCS,78472,HC PRO CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS,522.0,365.4,,,0
HCPCS,78473,Gated heart multiple,,,395.76,1755.86,11
HCPCS,78481,Heart first pass single,,,537.52,2384.8,11
HCPCS,78483,Heart first pass multiple,,,537.52,2384.8,11
HCPCS,78491,Heart image (pet) single,,,1415.6,6280.55,11
HCPCS,78492,Heart image (pet) multiple,,,1415.6,6280.55,11
HCPCS,78494,Heart image spect,,,326.59,1755.86,11
HCPCS,78499,Cardiovascular nuclear exam,,,395.76,1755.86,7
HCPCS,78579,HC LUNG VENTILATION IMAGING,1568.0,1097.6,,,0
HCPCS,78579,Lung ventilation imaging,,,395.76,1755.86,11
HCPCS,78580,HC LUNG PERFUSION IMAGING,845.0,591.5,,,0
HCPCS,78580,Lung perfusion imaging,,,395.76,1755.86,11
HCPCS,78582,HC LUNG VENTILAT&PERFUS IMAG,1482.0,1037.4,,,0
HCPCS,78582,Lung ventilat&perfus imaging,,,537.52,2384.8,11
HCPCS,78597,Lung perfusion differential,,,395.76,1755.86,11
HCPCS,78598,HC LUNG VENTILAT&PERFUS DIFFERENTL,1326.0,928.2,,,0
HCPCS,78598,Lung perf&ventilat diferentl,,,537.52,2384.8,11
HCPCS,78599,HC UNLISTED RESPIRATORY PROCEDURE DX NUCLEAR MED,1322.0,925.4,,,0
HCPCS,78599,Respiratory nuclear exam,,,395.76,1755.86,7
HCPCS,78600,Brain image < 4 views,,,395.76,1755.86,11
HCPCS,78601,Brain image w/flow < 4 views,,,395.76,1755.86,11
HCPCS,78605,Brain image 4+ views,,,537.52,2384.8,11
HCPCS,78606,Brain image w/flow 4 + views,,,537.52,2384.8,11
HCPCS,78606,HC BRAIN IMAGE W/FLOW 4 + VIEWS,1477.0,1033.9,,,0
HCPCS,78608,Brain imaging (PET),,,1415.6,6280.55,11
HCPCS,78609,HC BRAIN IMAGING PET PERFUSION EVALUATION,4864.0,3404.8,,,0
HCPCS,78610,Brain flow imaging only,,,537.52,2384.8,11
HCPCS,78630,Cerebrospinal fluid scan,,,537.52,2384.8,11
HCPCS,78630,HC CEREBROSPINAL FLUID SCAN,1523.0,1066.1,,,0
HCPCS,78635,CSF ventriculography,,,537.52,2384.8,11
HCPCS,78645,CSF shunt evaluation,,,537.52,2384.8,11
HCPCS,78645,HC CSF SHUNT EVALUATION,877.0,613.9,,,0
HCPCS,78650,CSF leakage imaging,,,1281.66,5686.29,11
HCPCS,78660,Nuclear exam of tear flow,,,395.76,1755.86,11
HCPCS,78699,Nervous system nuclear exam,,,395.76,1755.86,7
HCPCS,78700,Kidney imaging morphol,,,395.76,1755.86,11
HCPCS,78701,Kidney imaging with flow,,,395.76,1755.86,11
HCPCS,78707,HC K FLOW/FUNCT IMAGE W/O DRUG,1277.0,893.9,,,0
HCPCS,78707,K flow/funct image w/o drug,,,537.52,2384.8,11
HCPCS,78708,HC K FLOW/FUNCT IMAGE W/DRUG,1888.0,1321.6,,,0
HCPCS,78708,K flow/funct image w/drug,,,537.52,2384.8,11
HCPCS,78709,K flow/funct image multiple,,,537.52,2384.8,11
HCPCS,78725,Kidney function study,,,395.76,1755.86,11
HCPCS,78730,Urinary bladder retention,,,363.9,453.98,4
HCPCS,78740,HC URETERAL REFLUX STUDY,796.0,557.2,,,0
HCPCS,78740,Ureteral reflux study,,,395.76,1755.86,11
HCPCS,78761,Testicular imaging w/flow,,,395.76,1755.86,11
HCPCS,78799,Genitourinary nuclear exam,,,395.76,1755.86,7
HCPCS,78800,HC PRO TUMOR IMAGING PLANAR SINGLE AREA SINGLE DAY IMAGING,1351.0,945.7,,,0
HCPCS,78800,HC TUMOR IMAGING PLANAR SINGLE AREA SINGLE DAY IMAGING,1357.0,949.9,,,0
HCPCS,78800,Tumor imaging limited area,,,395.76,1755.86,11
HCPCS,78801,Tumor imaging mult areas,,,395.76,1755.86,11
HCPCS,78802,HC TUMOR IMAGING PLANAR WHOLE BODY SINGLE DAY IMAGING,2661.0,1862.7,,,0
HCPCS,78802,Tumor imaging whole body,,,537.52,2384.8,11
HCPCS,78803,HC PRO TUMOR SPECT SINGLE AREA/ACQUISITION SINGLE DAY IMAGING,4664.0,3264.8,,,0
HCPCS,78803,HC TUMOR SPECT SINGLE AREA/ACQUISITION SINGLE DAY IMAGING,3804.0,2662.8,,,0
HCPCS,78803,Tumor imaging (3D),,,537.52,2384.8,11
HCPCS,78804,HC TUMOR IMAGING WHOLE BODY 2 DAYS,3951.0,2765.7,,,0
HCPCS,78804,Tumor imaging whole body,,,537.52,2538.91,11
HCPCS,78808,Iv inj ra drug dx study,,,395.76,1755.86,7
HCPCS,78811,Pet image ltd area,,,1281.66,5686.29,11
HCPCS,78812,HC PET IMAGE SKULL-THIGH,5996.0,4197.2,,,0
HCPCS,78812,Pet image skull-thigh,,,1415.6,6280.55,11
HCPCS,78813,HC PET IMAGE FULL BODY,6896.0,4827.2,,,0
HCPCS,78813,Pet image full body,,,1415.6,6280.55,11
HCPCS,78814,HC PET W/CT FOR ATTENUATION CORRECTION/ANATOMICAL LOCALIZATION IMAGING LIMITED AREA,4513.0,3159.1,,,0
HCPCS,78814,Pet image w/ct lmtd,,,1415.6,6280.55,11
HCPCS,78815,HC PET IMAGE W/CT SKULL-THIGH,5416.0,3791.2,,,0
HCPCS,78815,Pet image w/ct skull-thigh,,,1415.6,6280.55,11
HCPCS,78816,HC PET IMAGE W/CT FULL BODY,5416.0,3791.2,,,0
HCPCS,78816,Pet image w/ct full body,,,1415.6,6280.55,11
HCPCS,78830,HC TUMOR SPECT W/CT SINGLE AREA/ACQUISITION SINGLE DAY IMAGING,4529.0,3170.3,,,0
HCPCS,78830,Rp loclzj tum spect w/ct 1,,,1281.66,5686.29,11
HCPCS,78831,Rp loclzj tum spect 2 areas,,,1281.66,5686.29,11
HCPCS,78832,HC TUMOR SPECT W/CT MIN 2 AREAS SINGLE DAY IMAGING OR SINGLE AREA IMAGING OVER 2 OR MORE DAYS,5138.0,3596.6,,,0
HCPCS,78832,Rp loclzj tum spect w/ct 2,,,1415.6,6280.55,11
HCPCS,78835,HC RADIOPHARM QUANT MEASURE SINGLE AREA,77.0,53.9,,,0
HCPCS,78835,Rp quan meas single area,,,68.42,85.35,4
HCPCS,78999,Nuclear diagnostic exam,,,395.76,1755.86,7
HCPCS,79005,HC THYROID THERAPY,1609.0,1126.3,,,0
HCPCS,79005,Nuclear rx oral admin,,,231.0,1088.56,11
HCPCS,79101,Nuclear rx iv admin,,,231.0,1024.85,11
HCPCS,79200,Nuclear rx intracav admin,,,231.0,1316.31,11
HCPCS,79300,Nuclr rx interstit colloid,,,231.0,1024.85,11
HCPCS,79403,Hematopoietic nuclear tx,,,231.0,1316.31,11
HCPCS,79440,Nuclear rx intra-articular,,,231.0,1316.31,11
HCPCS,79445,HC RADIOPHARM THERAPY BY INTRA-ART PARTICULATE ADMIN,1265.0,885.5,,,0
HCPCS,79445,Nuclear rx intra-arterial,,,231.0,1024.85,11
HCPCS,79999,Nuclear medicine therapy,,,231.0,1024.85,7
HCPCS,800,HC PRO ANESTHESIA FOR PROCEDURES ON LOWER ANTERIOR ABDOMINAL WALL NOT OTHERWISE SPECIFIED,248.0,173.6,,,0
HCPCS,80047,HC POC BASIC METABOLIC PANEL CALCIUM IONIZED,45.0,31.5,,,0
HCPCS,80047,Metabolic panel ionized ca,,,12.36,46.72,11
HCPCS,80048,HC POC BMP,89.0,62.3,,,0
HCPCS,80048,METABOLIC PANEL W/ TOTAL CA,89.0,62.3,,,0
HCPCS,80048,Metabolic panel total ca,,,7.61,104.37,11
HCPCS,80050,GENERAL HEALTH PANEL,434.0,303.8,,,0
HCPCS,80051,Electrolyte panel,,,6.31,22.21,11
HCPCS,80051,HC ELECTROLYTE PANEL,104.0,72.8,,,0
HCPCS,80053,Comprehen metabolic panel,,,9.5,110.55,11
HCPCS,80053,HC COMPREHEN METABOLIC PANEL,92.0,64.4,,,0
HCPCS,80055,Obstetric panel,,,43.03,96.25,11
HCPCS,80061,LIPID PANEL,165.0,115.5,,,0
HCPCS,80061,Lipid panel,,,12.05,100.94,11
HCPCS,80069,HC RENAL FUNCTION PANEL,99.0,69.3,,,0
HCPCS,80069,Renal function panel,,,7.81,40.28,11
HCPCS,80074,ACUTE HEPATITIS PANEL,256.0,179.2,,,0
HCPCS,80074,Acute hepatitis panel,,,42.87,156.88,11
HCPCS,80076,HC HEPATIC FUNCTION PANEL,142.0,99.4,,,0
HCPCS,80076,HC POC LIVER PNL ISTAT,142.0,99.4,,,0
HCPCS,80076,Hepatic function panel,,,7.35,100.39,11
HCPCS,80081,Obstetric panel,,,67.37,166.03,11
HCPCS,80100002,HC CVVH SET UP FEE,2084.0,1458.8,,,0
HCPCS,80100003,HC HEMODIALYSIS INITITAION,1073.0,751.1,,,0
HCPCS,80143,Drug assay acetaminophen,,,16.78,32.62,7
HCPCS,80143,HC DRUG ASSAY ACETAMINOPHEN,33.0,23.1,,,0
HCPCS,80145,Drug assay adalimumab,,,34.71,145.79,11
HCPCS,80145,HC DRUG ASSAY ADALIMUMAB,35.0,24.5,,,0
HCPCS,80150,Assay of amikacin,,,13.57,83.2,11
HCPCS,80150,HC ASSAY OF AMIKACIN,33.0,23.1,,,0
HCPCS,80151,Drug assay amiodarone,,,16.78,32.62,7
HCPCS,80151,HC DRUG ASSAY AMIODARONE,33.0,23.1,,,0
HCPCS,80155,Drug assay caffeine,,,34.71,72.77,11
HCPCS,80156,Assay carbamazepine total,,,13.11,163.63,11
HCPCS,80156,HC ASSAY CARBAMAZEPINE TOTAL,229.0,160.3,,,0
HCPCS,80157,Assay carbamazepine free,,,11.92,73.18,11
HCPCS,80157,HC ASSAY CARBAMAZEPINE FREE,57.0,39.9,,,0
HCPCS,80158,Drug assay cyclosporine,,,16.24,172.51,11
HCPCS,80158,HC ASSAY OF CYCLOSPORINE,200.0,140.0,,,0
HCPCS,80159,Drug assay clozapine,,,18.13,95.14,11
HCPCS,80159,HC CLOZAPINE,65.0,45.5,,,0
HCPCS,80161,"Asy carbamazepin 10,11-epxid",,,16.78,32.62,7
HCPCS,80161,HC DRUG ASSAY CARBAMAZEPINE--10 11-EPOXIDE,33.0,23.1,,,0
HCPCS,80162,Assay of digoxin total,,,11.95,67.38,11
HCPCS,80162,HC ASSAY OF DIGOXIN,103.0,72.1,,,0
HCPCS,80163,Assay of digoxin free,,,11.95,68.3,11
HCPCS,80164,Assay dipropylacetic acd tot,,,12.19,41.46,11
HCPCS,80164,HC VALPROIC ACID (DIPROPYLACETIC ACID) TOTAL,58.0,40.6,,,0
HCPCS,80165,Dipropylacetic acid free,,,12.19,69.7,11
HCPCS,80165,HC VALPROIC ACID (DIPROPYLACETIC ACID) FREE,58.0,40.6,,,0
HCPCS,80167,Drug assay felbamate,,,16.78,32.62,7
HCPCS,80167,HC DRUG ASSAY FELBAMATE,33.0,23.1,,,0
HCPCS,80168,Assay of ethosuximide,,,14.71,90.19,11
HCPCS,80168,HC ASSAY OF ETHOSUXIMIDE,85.0,59.5,,,0
HCPCS,80169,Drug assay everolimus,,,12.36,70.65,11
HCPCS,80169,HC EVEROLIMUS,48.0,33.6,,,0
HCPCS,80170,Assay of gentamicin,,,14.74,90.46,11
HCPCS,80170,HC ASSAY OF GENTAMICIN,223.0,156.1,,,0
HCPCS,80171,Drug screen quant gabapentin,,,19.5,68.19,11
HCPCS,80171,HC GABAPENTIN WHOLE BLOOD/SERUM/PLASMA,47.0,32.9,,,0
HCPCS,80173,Assay Of Haloperidol,,,14.2,80.36,11
HCPCS,80173,HC ASSAY OF HALOPERIDOL,63.0,44.1,,,0
HCPCS,80175,Drug screen quan lamotrigine,,,11.92,40.72,11
HCPCS,80175,HC LAMOTRIGINE,47.0,32.9,,,0
HCPCS,80176,Assay of lidocaine,,,13.22,81.08,11
HCPCS,80176,HC ASSAY OF LIDOCAINE,87.0,60.9,,,0
HCPCS,80177,Drug scrn quan levetiracetam,,,11.92,31.93,11
HCPCS,80177,HC KEPRA/LEVETIRACTAM/ELEPSIA,34.0,23.8,,,0
HCPCS,80178,Assay of lithium,,,5.95,80.42,11
HCPCS,80178,HC ASSAY OF LITHIUM,116.0,81.2,,,0
HCPCS,80179,Drug assay salicylate,,,16.78,32.62,7
HCPCS,80179,HC DRUG ASSAY SALICYLATE,33.0,23.1,,,0
HCPCS,80180,Drug scrn quan mycophenolate,,,16.24,92.87,11
HCPCS,80180,HC DRUG SCRN QUAN MYCOPHENOLATE,63.0,44.1,,,0
HCPCS,80181,Drug assay flecainide,,,16.78,32.62,7
HCPCS,80181,HC DRUG ASSAY FLECAINIDE,33.0,23.1,,,0
HCPCS,80183,Drug scrn quant oxcarbazepin,,,11.92,40.72,11
HCPCS,80183,HC OXCARBAZEPINE,47.0,32.9,,,0
HCPCS,80184,Assay of phenobarbital,,,13.77,63.2,11
HCPCS,80184,HC ASSAY OF PHENOBARBITAL,138.0,96.6,,,0
HCPCS,80185,ASSAY OF PHENYTOIN TOTAL,187.0,130.9,,,0
HCPCS,80185,Assay of phenytoin total,,,11.92,102.73,11
HCPCS,80186,Assay of phenytoin free,,,12.38,75.98,11
HCPCS,80186,HC ASSAY OF PHENYTOIN FREE,72.0,50.4,,,0
HCPCS,80187,Drug assay posaconazole,,,24.4,102.48,11
HCPCS,80188,Assay of primidone,,,14.93,91.59,11
HCPCS,80188,HC ASSAY OF PRIMIDONE,207.0,144.9,,,0
HCPCS,80189,Drug assay itraconzaole,,,24.4,47.44,7
HCPCS,80189,HC DRUG ASSAY ITRACONAZOLE,48.0,33.6,,,0
HCPCS,80190,Assay of procainamide,,,54.0,105.0,11
HCPCS,80192,Assay of procainamide,,,15.08,92.46,11
HCPCS,80193,Drug assay leflunomide,,,34.71,67.5,7
HCPCS,80193,HC DRUG ASSAY LEFLUNOMIDE,67.0,46.9,,,0
HCPCS,80194,Assay of quinidine,,,13.14,80.55,11
HCPCS,80195,Assay of sirolimus,,,12.36,46.64,11
HCPCS,80195,HC ASSAY OF SIROLIMUS,65.0,45.5,,,0
HCPCS,80197,Assay of tacrolimus,,,12.36,70.65,11
HCPCS,80197,HC ASSAY OF TACROLIMUS,98.0,68.6,,,0
HCPCS,80198,Assay of theophylline,,,12.73,122.16,11
HCPCS,80198,HC ASSAY OF THEOPHYLLINE,196.0,137.2,,,0
HCPCS,80199,Drug screen quant tiagabine,,,24.4,92.91,11
HCPCS,80200,Assay of tobramycin,,,14.52,88.94,11
HCPCS,80200,HC ASSAY OF TOBRAMYCIN,252.0,176.4,,,0
HCPCS,80201,Assay of topiramate,,,10.73,51.83,11
HCPCS,80201,HC ASSAY OF TOPIRAMATE,72.0,50.4,,,0
HCPCS,80202,Assay of vancomycin,,,12.19,114.76,11
HCPCS,80202,HC ASSAY OF VANCOMYCIN,190.0,133.0,,,0
HCPCS,80203,Drug screen quant zonisamide,,,11.92,40.72,11
HCPCS,80203,HC DRUG SCREEN QUANT ZONISAMIDE,47.0,32.9,,,0
HCPCS,80204,Drug assay methotrexate,,,34.71,67.5,7
HCPCS,80204,HC DRUG ASSAY METHOTREXATE,33.0,23.1,,,0
HCPCS,80210,Drug assay rufinamide,,,24.4,47.44,7
HCPCS,80220,Drug asy hydroxychloroquine,,,16.78,70.46,11
HCPCS,80230,Drug assay infliximab,,,34.71,145.79,11
HCPCS,80230,HC DRUG ASSAY INFLIXIMAB,35.0,24.5,,,0
HCPCS,80235,Drug assay lacosamide,,,24.4,102.48,11
HCPCS,80235,HC DRUG ASSAY LACOSAMIDE,33.0,23.1,,,0
HCPCS,80280,Drug assay vedolizumab,,,34.71,145.79,11
HCPCS,80285,Drug assay voriconazole,,,24.4,102.48,11
HCPCS,80285,HC DRUG ASSAY VORICONAZOLE,26.0,18.2,,,0
HCPCS,80299,HC QUANTITATIVE ASSAY DRUG NES,241.0,168.7,,,0
HCPCS,80299,Quantitative assay drug,,,16.78,171.77,11
HCPCS,80305,Drug test prsmv dir opt obs,,,11.34,46.46,11
HCPCS,80305,HC DRUG TEST PRESUMP DIRECT OPTICAL OBS PER DATE OF SERVICE,168.0,117.6,,,0
HCPCS,80305,HC POC DRUG TEST PRESUMP DIRECT OPTICAL OBS PER DATE OF SERVICE,51.0,35.7,,,0
HCPCS,80306,Drug test prsmv instrmnt,,,15.43,159.38,11
HCPCS,80306,HC DRUG TEST PRESUMP INSTRUMENT ASSISTED DIRECT OPTICAL OBS PER DATE OF SERVICE,177.0,123.9,,,0
HCPCS,80307,Drug test prsmv chem anlyzr,,,55.93,146.09,11
HCPCS,80307,HC DRUG TEST PRESUMP INSTRUMENT CHEMISTRY ANALYZER CHROMATOGRAPHY/MASS SPECTROMETRY  W/WO CHROMATOGRAPHY PER DATE OF SERVICE,168.0,117.6,,,0
HCPCS,80307,HC POC DRUG TEST PRESUMP INSTRUMENT CHEM ANALYZER CHROMATOGRAPHY/MASS SPECTROMETRY  W/WO CHROMATOGRAPHY PER DOS,168.0,117.6,,,0
HCPCS,80320,HC ALCOHOLS,141.0,98.7,,,0
HCPCS,80321,HC ALCOHOLS BIOMARKERS 1OR 2,313.0,219.1,,,0
HCPCS,80322,HC ALCOHOLS 3 OR MORE,128.0,89.6,,,0
HCPCS,80323,HC ALKALOIDS NOT OTHERWISE SPECIFIED,206.0,144.2,,,0
HCPCS,80324,HC AMPHETAMINES 1 OR 2,206.0,144.2,,,0
HCPCS,80325,HC AMPHETAMINES 3 OR 4,206.0,144.2,,,0
HCPCS,80326,HC AMPHETAMINES 5 OR MORE,206.0,144.2,,,0
HCPCS,80329,HC ANALGESICS NON-OPIOID (ACETAMINOPHEN) 1 OR 2,222.0,155.4,,,0
HCPCS,80332,HC ANTIDEPRESSANTS SEROTONERGIC CLASS 1 OR 2,206.0,144.2,,,0
HCPCS,80335,HC ANTIDEPRESSANTS TRICYCLIC & OTHER CYCLICALS 1 OR 2,206.0,144.2,,,0
HCPCS,80336,HC ANTIDEPRESSANT TRICYCLIC AND OTHER CYCLICALS 3-5,29.0,20.3,,,0
HCPCS,80336,HC ANTIDEPRESSANTS TRICYCLIC AND OTHER CYCLICALS 3-5,122.0,85.4,,,0
HCPCS,80337,HC ANTIDEPRESSANTS TRICYCLIC AND OTHER CYCLICALS 1-7 CLASSES,141.0,98.7,,,0
HCPCS,80338,HC ANTIDEPRESSANTS NOT OTHERWISE SPECIFIED,206.0,144.2,,,0
HCPCS,80339,HC ANTIEPILEPTICS NOT OTHERWISE SPECIFIED 1-3,206.0,144.2,,,0
HCPCS,80342,HC ANTIPSYCHOTICS NOT OTHERWISE SPECIFIED 1-3,206.0,144.2,,,0
HCPCS,80345,HC ASSAY OF BARBITURATES,206.0,144.2,,,0
HCPCS,80346,HC BENZODIAZAPINES 1-12,206.0,144.2,,,0
HCPCS,80347,HC BENZODIAZAPINES 13 OR MORE,316.0,221.2,,,0
HCPCS,80348,HC DRUG SCREENING BUPRENORPHINE,206.0,144.2,,,0
HCPCS,80349,HC CANNABINOIDS NATURAL,206.0,144.2,,,0
HCPCS,80353,HC COCAINE,206.0,144.2,,,0
HCPCS,80354,HC DRUG SCREENING FENTANYL,206.0,144.2,,,0
HCPCS,80355,HC DRUG SCREENING GABAPENTIN NON BLOOD,302.0,211.4,,,0
HCPCS,80356,HC HEROIN METABOLITE,206.0,144.2,,,0
HCPCS,80358,HC METHADONE,206.0,144.2,,,0
HCPCS,80359,HC METHYLENEDIOXYAMPHETAMINES,206.0,144.2,,,0
HCPCS,80360,HC DRUG SCREEN METHYLPHENIDATE,222.0,155.4,,,0
HCPCS,80361,HC OPIATES 1 OR MORE,206.0,144.2,,,0
HCPCS,80362,HC OPIOIDS AND OPIATE ANALOGS 1 OR 2,206.0,144.2,,,0
HCPCS,80364,HC OPIOIDS AND OPIATE ANALOGS 5 OR MORE,302.0,211.4,,,0
HCPCS,80365,HC OXYCODONE,206.0,144.2,,,0
HCPCS,80366,HC DRUG SCREENING PREGABALIN,206.0,144.2,,,0
HCPCS,80367,HC PROPOXYPHENE,206.0,144.2,,,0
HCPCS,80368,HC SEDATIVE HYPNOTICS (NON-BENZODIAZEPINES),206.0,144.2,,,0
HCPCS,80369,HC SKELETAL MUSCLE RELAXANTS 1 OR 2,206.0,144.2,,,0
HCPCS,80371,HC STIMULANTS SYNTHETIC,206.0,144.2,,,0
HCPCS,80373,HC TRAMADOL,206.0,144.2,,,0
HCPCS,80375,HC DRUG(S)/SUBSTANCE(S) DEFINITIVE QUALITATIVE/QUANTITATIVE NOT OTHERWISE SPECIFIED 1-3,206.0,144.2,,,0
HCPCS,80377,HC DRUG(S)/SUBSTANCE(S) DEFINITIVE QUALITATIVE/QUANTITATIVE NOT OTHERWISE SPECIFIED 7 OR MORE,206.0,144.2,,,0
HCPCS,80400,Acth stimulation panel,,,29.36,192.5,11
HCPCS,80400,HC ACTH STIMULATION PANEL,270.0,189.0,,,0
HCPCS,80402,Acth stimulation panel,,,78.26,479.83,11
HCPCS,80406,Acth stimulation panel,,,70.43,431.9,11
HCPCS,80408,Aldosterone suppression eval,,,112.95,692.65,11
HCPCS,80410,Calcitonin stimul panel,,,72.33,443.39,11
HCPCS,80412,CRH stimulation panel,,,721.46,1819.16,11
HCPCS,80414,Testosterone response,,,46.48,285.01,11
HCPCS,80415,Estradiol response panel,,,50.3,308.45,11
HCPCS,80416,Renin stimulation panel,,,188.39,728.48,11
HCPCS,80417,Renin stimulation panel,,,39.59,242.83,11
HCPCS,80418,Pituitary evaluation panel,,,521.53,3198.79,11
HCPCS,80420,Dexamethasone panel,,,145.69,397.58,11
HCPCS,80422,Glucagon tolerance panel,,,41.46,254.24,11
HCPCS,80424,Glucagon tolerance panel,,,45.45,197.16,11
HCPCS,80426,Gonadotropin hormone panel,,,133.57,819.2,11
HCPCS,80428,Growth hormone panel,,,60.03,368.02,11
HCPCS,80430,Growth hormone panel,,,116.4,433.0,11
HCPCS,80432,Insulin suppression panel,,,149.05,740.65,11
HCPCS,80434,Insulin tolerance panel,,,256.53,558.31,11
HCPCS,80435,Insulin tolerance panel,,,92.7,568.32,11
HCPCS,80436,Metyrapone panel,,,82.04,503.12,11
HCPCS,80438,TRH stimulation panel,,,45.37,278.17,11
HCPCS,80439,TRH stimulation panel,,,60.49,370.89,11
HCPCS,80503,HC PATH CLINICAL CONSULT LIMITED 5-20 MINUTES,194.0,135.8,,,0
HCPCS,80503,HC PATHOLOGY CLIN CONSULATION SF MEDICAL DECSION MAKING 5-20 MIN,194.0,135.8,,,0
HCPCS,80503,HC PRO PATH CLINICAL CONSULT LIMITED 5-20 MINUTES,51.0,35.7,,,0
HCPCS,80503,Path clin consltj sf 5-20,,,51.59,228.88,11
HCPCS,80504,HC PATH CLINICAL CONSULT MODERATELY COMPLEX 21-40 MINUTES,580.0,406.0,,,0
HCPCS,80504,HC PRO PATH CLINICAL CONSULT MODERATELY COMPLEX 21-40 MINUTES,109.0,76.3,,,0
HCPCS,80504,Path clin consltj mod 21-40,,,168.66,748.29,11
HCPCS,80505,HC PATH CLINICAL CONSULT HIGHLY COMPLEX 41-60 MINUTES,580.0,406.0,,,0
HCPCS,80505,HC PRO PATH CLINICAL CONSULT HIGHLY COMPLEX 41-60 MINUTES,205.0,143.5,,,0
HCPCS,80505,Path clin consltj high 41-60,,,168.66,748.29,11
HCPCS,80506,HC PATH CLINICAL CONSULT PROLONGED SERVICE EA ADDTL 30 MINUTES,291.0,203.7,,,0
HCPCS,80506,HC PRO PATH CLINICAL CONSULT PROLONGED SERVICE EA ADDTL 30 MINUTES,98.0,68.6,,,0
HCPCS,81000,Urinalysis nonauto w/scope,,,3.62,17.5,11
HCPCS,81001,URINALYSIS AUTO W/SCOPE,92.0,64.4,,,0
HCPCS,81001,Urinalysis auto w/scope,,,2.85,60.17,11
HCPCS,81002,HC POC URINALYSIS NON-AUTO W/O SCOPE,58.0,40.6,,,0
HCPCS,81002,HC URINALYSIS NONAUTO W/O SCOPE,58.0,40.6,,,0
HCPCS,81002,Urinalysis nonauto w/o scope,,,3.13,32.21,11
HCPCS,81003,HC POC URINE DIPSTICK,65.0,45.5,,,0
HCPCS,81003,URINALYSIS AUTO W/O SCOPE,65.0,45.5,,,0
HCPCS,81003,Urinalysis auto w/o scope,,,2.02,42.14,11
HCPCS,81005,Urinalysis,,,1.95,11.94,11
HCPCS,81007,Urine screen for bacteria,,,11.36,52.46,11
HCPCS,81015,Microscopic exam of urine,,,2.74,9.63,11
HCPCS,81020,Urinalysis glass test,,,4.23,20.34,11
HCPCS,81025,HC POC URINE PREGNANCY,97.0,67.9,,,0
HCPCS,81025,HC URINE PREGNANCY TEST,97.0,67.9,,,0
HCPCS,81025,Urine pregnancy test,,,7.75,68.09,11
HCPCS,81050,HC URINALYSIS VOLUME MEASURE TIMED COLLECTION EACH,13.0,9.1,,,0
HCPCS,81050,Urinalysis volume measure,,,3.28,9.63,11
HCPCS,81100001,HC KIDNEY ACQUISITION LIVE,100000.0,70000.0,,,0
HCPCS,81105,Hpa-1 genotyping,,,110.0,213.88,7
HCPCS,81106,Hpa-2 genotyping,,,110.0,213.88,7
HCPCS,81107,Hpa-3 genotyping,,,110.0,213.88,7
HCPCS,81108,Hpa-4 genotyping,,,110.0,213.88,7
HCPCS,81109,Hpa-5 genotyping,,,110.0,213.88,7
HCPCS,81110,Hpa-6 genotyping,,,110.0,213.88,7
HCPCS,81111,Hpa-9 genotyping,,,110.0,213.88,7
HCPCS,81112,Hpa-15 genotyping,,,110.0,213.88,7
HCPCS,81120,HC IDH1 COMMON VARIANTS,264.0,184.8,,,0
HCPCS,81120,Idh1 common variants,,,173.92,338.19,7
HCPCS,81121,HC IDH2 COMMON VARIANTS,405.0,283.5,,,0
HCPCS,81121,Idh2 common variants,,,266.21,517.63,7
HCPCS,81161,DMD dup/delet analysis,,,251.1,488.25,7
HCPCS,81161,HC DMD DELETION ANALYSIS AND DUPLICATION ANALYSIS,1179.0,825.3,,,0
HCPCS,81161,HC PRO DMD DELETION ANALYSIS AND DUPLICATION ANALYSIS,248.0,173.6,,,0
HCPCS,81162,Brca1&2 seq & full dup/del,,,1642.39,71591.46,11
HCPCS,81162,HC BRCA1 BRCA2 GENE ANALYSIS FULL SEQ ANALYSIS & FULL DUPLICATION/DELETION ANALYSIS,72001.0,50400.7,,,0
HCPCS,81162,HC PRO BRCA1 BRCA2 GENE ANALYSIS FULL SEQ FULL DUPLICATION/DELETION ANALYSIS,2121.0,1484.7,,,0
HCPCS,81163,Brca1&2 gene full seq alys,,,421.2,819.0,7
HCPCS,81164,Brca1&2 gen ful dup/del alys,,,525.81,1022.4,7
HCPCS,81165,Brca1 gene full seq alys,,,254.59,495.04,7
HCPCS,81166,Brca1 gene full dup/del alys,,,271.22,527.36,7
HCPCS,81167,Brca2 gene full dup/del alys,,,254.59,495.04,7
HCPCS,81168,Ccnd1/igh translocation alys,,,186.58,362.79,7
HCPCS,81170,Abl1 gene,,,270.0,921.72,11
HCPCS,81170,HC ABL1 GENE ANALYSIS VARIANTS IN KINASE DOMAIN,1205.0,843.5,,,0
HCPCS,81170,HC PRO ABL1 GENE ANALYSIS VARIANTS IN KINASE DOMAIN,618.0,432.6,,,0
HCPCS,81171,Aff2 gene detc abnor alleles,,,123.3,239.75,7
HCPCS,81172,Aff2 gene charac alleles,,,247.35,480.95,7
HCPCS,81173,Ar gene full gene sequence,,,271.22,527.36,7
HCPCS,81174,Ar gene known famil variant,,,166.68,324.1,7
HCPCS,81175,Asxl1 full gene sequence,,,608.85,1183.88,7
HCPCS,81176,Asxl1 gene target seq alys,,,217.71,423.32,7
HCPCS,81177,Atn1 gene detc abnor alleles,,,123.3,239.75,7
HCPCS,81178,Atxn1 gene detc abnor allele,,,123.3,239.75,7
HCPCS,81178,HC ATXN1 GENE ANALYSIS EVAL TO DETECT ABNORMAL ALLELES,579.0,405.3,,,0
HCPCS,81178,HC PRO ATXN1 GENE ANALYSIS EVAL TO DETECT ABNORMAL ALLELES,122.0,85.4,,,0
HCPCS,81179,Atxn2 gene detc abnor allele,,,123.3,239.75,7
HCPCS,81179,HC ATXN2 GENE ANALYSIS EVAL TO DETECT ABNORMAL ALLELES,579.0,405.3,,,0
HCPCS,81179,HC PRO ATXN2 GENE ANALYSIS EVAL TO DETECT ABNORMAL ALLELES,122.0,85.4,,,0
HCPCS,81180,Atxn3 gene detc abnor allele,,,123.3,239.75,7
HCPCS,81180,HC ATXN3 GENE ANALYSIS EVAL DETECT ABNORMAL ALLELES,579.0,405.3,,,0
HCPCS,81180,HC PRO ATXN3 GENE ANALYSIS EVAL DETECT ABNORMAL ALLELES,122.0,85.4,,,0
HCPCS,81181,Atxn7 gene detc abnor allele,,,123.3,239.75,7
HCPCS,81181,HC ATXN7 GENE ANALYSIS EVAL TO DETECT ABNORMAL ALLELES,579.0,405.3,,,0
HCPCS,81181,HC PRO ATXN7 GENE ANALYSIS EVAL TO DETECT ABNORMAL ALLELES,122.0,85.4,,,0
HCPCS,81182,Atxn8os gen detc abnor allel,,,123.3,239.75,7
HCPCS,81183,Atxn10 gene detc abnor allel,,,123.3,239.75,7
HCPCS,81184,Cacna1a gen detc abnor allel,,,123.3,239.75,7
HCPCS,81184,HC CACNA1A GENE ANALYSIS EVAL TO DETECT ABNORMAL ALLELES,579.0,405.3,,,0
HCPCS,81184,HC PRO CACNA1A GENE ANALYSIS EVAL TO DETECT ABNORMAL ALLELES,122.0,85.4,,,0
HCPCS,81185,Cacna1a gene full gene seq,,,761.64,1480.97,7
HCPCS,81185,HC CACNA1A GENE ANALYSIS FULL GENE SEQUENCE,925.0,647.5,,,0
HCPCS,81185,HC PRO CACNA1A GENE ANALYSIS FULL GENE SEQUENCE,356.0,249.2,,,0
HCPCS,81186,Cacna1a gen known famil vrnt,,,166.68,324.1,7
HCPCS,81187,Cnbp gene detc abnor allele,,,123.3,239.75,7
HCPCS,81188,Cstb gene detc abnor allele,,,123.3,239.75,7
HCPCS,81189,Cstb gene full gene sequence,,,247.35,480.95,7
HCPCS,81190,Cstb gene known famil vrnt,,,166.68,324.1,7
HCPCS,81191,Ntrk1 translocation analysis,,,186.58,362.79,7
HCPCS,81192,Ntrk2 translocation analysis,,,186.58,362.79,7
HCPCS,81193,Ntrk3 translocation analysis,,,186.58,362.79,7
HCPCS,81194,Ntrk translocation analysis,,,466.45,906.99,7
HCPCS,81195,Cytog genom-wid alys hem mal,,,1676.9,3260.64,7
HCPCS,81200,Aspa gene,,,42.52,354.94,11
HCPCS,81200001,HC KIDNEY ACQUISITION CADAVER,100000.0,70000.0,,,0
HCPCS,81200002,HC KIDNEY AND PANCREAS ACQUISITION,200000.0,140000.0,,,0
HCPCS,81200003,HC PANCREAS ACQUISITION CADAVER,100000.0,70000.0,,,0
HCPCS,81201,Apc gene full sequence,,,702.0,2834.7,11
HCPCS,81202,Apc gene known fam variants,,,252.0,490.0,11
HCPCS,81203,Apc gene dup/delet variants,,,180.0,2154.79,11
HCPCS,81204,Ar gene charac alleles,,,123.3,239.75,7
HCPCS,81205,Bckdhb gene,,,85.49,466.3,11
HCPCS,81206,Bcr/abl1 gene major bp,,,147.56,658.21,11
HCPCS,81206,HC BCR/ABL1 GENE MAJOR BP,971.0,679.7,,,0
HCPCS,81207,Bcr/abl1 gene minor bp,,,130.36,539.74,11
HCPCS,81207,HC BCR ABL1 GENE MINOR BP,796.0,557.2,,,0
HCPCS,81208,Bcr/abl1 gene other bp,,,193.16,567.64,11
HCPCS,81209,Blm gene,,,35.38,354.94,11
HCPCS,81210,Braf gene,,,157.86,306.95,11
HCPCS,81210,HC BRAF GENE ANALYSIS V600 VARIANT(S),391.0,273.7,,,0
HCPCS,81210,HC PRO BRAF GENE ANALYSIS V600 VARIANT(S),434.0,303.8,,,0
HCPCS,81212,Brca1&2 185&5385&6174 var,,,396.0,770.0,11
HCPCS,81215,Brca1 gene known fam variant,,,284.64,656.69,11
HCPCS,81216,Brca2 gene full sequence,,,166.61,6603.81,11
HCPCS,81217,Brca2 gene known fam variant,,,284.64,656.69,11
HCPCS,81218,Cebpa gene full sequence,,,217.71,921.72,11
HCPCS,81219,Calr gene com variants,,,109.47,463.43,11
HCPCS,81219,HC CALR GENE ANALYSIS COMMON VARIANTS IN EXON 9,544.0,380.8,,,0
HCPCS,81220,Cftr gene com variants,,,500.94,5078.69,11
HCPCS,81220,HC CFTR GENE COM VARIANTS,1703.0,1192.1,,,0
HCPCS,81221,Cftr gene known fam variants,,,87.5,355.09,11
HCPCS,81221,HC CFTR GENE KNOWN FAM VARIANTS,1703.0,1192.1,,,0
HCPCS,81222,Cftr gene dup/delet variants,,,391.56,1738.99,11
HCPCS,81222,HC CFTR GENE DUP/DELET VARIANTS,1703.0,1192.1,,,0
HCPCS,81222,HC PRO CFTR GENE DUP/DELET VARIANTS,843.0,590.1,,,0
HCPCS,81223,Cftr gene full sequence,,,449.1,5875.86,11
HCPCS,81223,HC CFTR GENE FULL SEQUENCE,1703.0,1192.1,,,0
HCPCS,81223,HC PRO CFTR GENE FULL SEQUENCE,2975.0,2082.5,,,0
HCPCS,81224,Cftr gene intron poly t,,,151.88,312.15,11
HCPCS,81225,Cyp2c19 gene com variants,,,262.22,511.28,11
HCPCS,81226,Cyp2d6 gene com variants,,,405.82,789.09,11
HCPCS,81226,HC CYP2D6 GENE ANALYSIS COMMON VARIANTS,1478.0,1034.6,,,0
HCPCS,81227,Cyp2c9 gene com variants,,,157.33,365.83,11
HCPCS,81227,HC CYP2C9 GENE ANAKYSIS COMMON VARIANTS,394.0,275.8,,,0
HCPCS,81228,Cytogen micrarray copy nmbr,,,810.0,2442.41,11
HCPCS,81228,HC CYTOGEN CONSTITUT CHROMOSMAL ABNORM GENOMIC REGIONS COPY NUMBER VARIANTS CGH,1092.0,764.4,,,0
HCPCS,81228,HC PRO CYTOGEN CONSTITUT CHROMOSMAL ABNORM GENOMIC REGIONS COPY NUMBER VARIANTS CGH,1390.0,973.0,,,0
HCPCS,81229,Cytogen m array copy no&snp,,,1044.0,2553.62,11
HCPCS,81229,HC CYTOGEN ANALYSIS CONSTITUT CHROMOSMAL ABNORM GENOMIC REGIONS CGH,2535.0,1774.5,,,0
HCPCS,81230,Cyp3a4 gene common variants,,,157.33,305.92,7
HCPCS,81231,Cyp3a5 gene common variants,,,157.33,305.92,7
HCPCS,81232,Dpyd gene common variants,,,157.33,305.92,7
HCPCS,81232,HC DPYD GENE ANALYSIS COMMON VARIANTS,394.0,275.8,,,0
HCPCS,81232,HC PRO DPYD GENE ANALYSIS COMMON VARIANTS,156.0,109.2,,,0
HCPCS,81233,Btk gene common variants,,,157.86,306.95,7
HCPCS,81234,Dmpk gene detc abnor allele,,,123.3,239.75,7
HCPCS,81235,Egfr gene com variants,,,292.12,918.82,11
HCPCS,81235,HC EGFR GENE COM VARIANTS,1356.0,949.2,,,0
HCPCS,81235,HC PRO EGFR GENE COM VARIANTS,803.0,562.1,,,0
HCPCS,81236,Ezh2 gene full gene sequence,,,254.59,495.04,7
HCPCS,81237,Ezh2 gene common variants,,,157.86,306.95,7
HCPCS,81238,F9 full gene sequence,,,540.0,1050.0,7
HCPCS,81239,Dmpk gene charac alleles,,,247.35,480.95,7
HCPCS,81240,F2 gene,,,59.12,554.47,11
HCPCS,81240,HC F2 GENE,883.0,618.1,,,0
HCPCS,81241,F5 gene,,,66.03,558.85,11
HCPCS,81241,HC F5 GENE,883.0,618.1,,,0
HCPCS,81242,Fancc gene,,,32.96,354.94,11
HCPCS,81243,Fmr1 gene detection,,,51.34,228.73,11
HCPCS,81243,HC FMR1 GENE ANALYSIS EVAL DETECT ABNORMAL ALLELES,899.0,629.3,,,0
HCPCS,81244,Fmr1 gene characterization,,,40.4,378.34,11
HCPCS,81244,HC FMR1 GENE ANALYSIS CHARACTERIZATION OF ALLELES,330.0,231.0,,,0
HCPCS,81245,Flt3 gene,,,148.96,423.36,11
HCPCS,81245,HC FLT3 GENE ANALYSIS,801.0,560.7,,,0
HCPCS,81246,Flt3 gene analysis,,,74.7,145.25,7
HCPCS,81247,G6pd gene alys cmn variant,,,157.33,305.92,7
HCPCS,81248,G6pd known familial variant,,,337.72,656.69,7
HCPCS,81249,G6pd full gene sequence,,,540.0,1050.0,7
HCPCS,81249,HC G6PD GENE ANALYSIS FULL GENE SEQUENCE,2603.0,1822.1,,,0
HCPCS,81250,G6pc gene,,,52.64,354.94,11
HCPCS,81251,Gba gene,,,42.52,354.94,11
HCPCS,81252,Gjb2 gene full sequence,,,91.01,592.1,11
HCPCS,81253,Gjb2 gene known fam variants,,,55.37,308.3,11
HCPCS,81254,Gjb6 gene com variants,,,31.5,283.39,11
HCPCS,81255,Hexa gene,,,46.31,354.94,11
HCPCS,81256,HC HFE GENE,1273.0,891.1,,,0
HCPCS,81256,Hfe gene,,,58.82,862.55,11
HCPCS,81257,Hba1/hba2 gene,,,92.03,692.57,11
HCPCS,81258,Hba1/hba2 gene fam vrnt,,,337.72,656.69,7
HCPCS,81259,HC HBA1/HBA2 GENE ANALYSIS FULL GENE SEQUENCE,2408.0,1685.6,,,0
HCPCS,81259,Hba1/hba2 full gene sequence,,,540.0,1050.0,7
HCPCS,81260,Ikbkap gene,,,35.38,354.94,11
HCPCS,81261,HC IGH GENE REARRANGE AMP METH,533.0,373.1,,,0
HCPCS,81261,Igh gene rearrange amp meth,,,178.19,361.31,11
HCPCS,81262,Igh gene rearrang dir probe,,,61.7,193.23,11
HCPCS,81263,HC IGH VARI REGIONAL MUTATION,533.0,373.1,,,0
HCPCS,81263,Igh vari regional mutation,,,265.07,515.41,11
HCPCS,81264,Igk rearrangeabn clonal pop,,,155.46,423.28,11
HCPCS,81265,HC STR MARKERS SPECIMEN ANAL,1439.0,1007.3,,,0
HCPCS,81265,Str markers specimen anal,,,209.76,1568.47,11
HCPCS,81266,Str markers spec anal addl,,,274.33,533.42,7
HCPCS,81267,Chimerism anal no cell selec,,,186.71,565.94,11
HCPCS,81267,HC ENGRAFTMENT POST TRANSPLANT,3809.0,2666.3,,,0
HCPCS,81268,Chimerism anal w/cell select,,,234.71,565.94,11
HCPCS,81268,HC CHIMERSIM ANALYSIS POST TRANSPLANTATION SPECIMEN COMP TO BASELINE W/CELL SELECTION EACH CELL TYPE,1102.0,771.4,,,0
HCPCS,81269,HC HBA1/HBA2 GENE ANALYSIS DUP/DEL VARIANTS,456.0,319.2,,,0
HCPCS,81269,Hba1/hba2 gene dup/del vrnts,,,182.16,354.2,7
HCPCS,81270,HC JAK2 GENE,371.0,259.7,,,0
HCPCS,81270,Jak2 gene,,,82.49,251.73,11
HCPCS,81271,HC HTT GENE ANALYSIS EVAL TO DETECT ABNORMAL ALLELES,309.0,216.3,,,0
HCPCS,81271,Htt gene detc abnor alleles,,,123.3,239.75,7
HCPCS,81272,HC KIT GENE ANALYSIS TARGETED SEQ ANALYSIS,1080.0,756.0,,,0
HCPCS,81272,Kit gene targeted seq analys,,,296.56,921.72,11
HCPCS,81273,HC KIT GENE ANALYSIS D816 VARIANT,409.0,286.3,,,0
HCPCS,81273,Kit gene analys d816 variant,,,112.38,349.27,11
HCPCS,81274,Htt gene charac alleles,,,247.35,480.95,7
HCPCS,81275,HC KRAS GENE ANALYSIS VARIANTS IN EXON 2,573.0,401.1,,,0
HCPCS,81275,HC PRO KRAS GENE ANALYSIS VARIANTS IN EXON 2,478.0,334.6,,,0
HCPCS,81275,Kras gene variants exon 2,,,173.92,387.96,11
HCPCS,81276,HC KRAS GENE ANALYSIS VARIANT(S) ADDITIONAL VARIANT(S),647.0,452.9,,,0
HCPCS,81276,HC PRO KRAS GENE ANALYSIS VARIANT(S) ADDITIONAL VARIANT(S),172.0,120.4,,,0
HCPCS,81276,Kras gene addl variants,,,173.92,551.58,11
HCPCS,81277,Cytogenomic neo microra alys,,,1044.0,4384.8,11
HCPCS,81278,Igh@/bcl2 translocation alys,,,186.58,362.79,7
HCPCS,81279,HC JAK2 TARGETED SEQUENCE ANALYSIS,407.0,284.9,,,0
HCPCS,81279,Jak2 gene trgt sequence alys,,,166.68,324.1,7
HCPCS,81283,Ifnl3 gene,,,66.03,128.4,7
HCPCS,81284,Fxn gene detc abnor alleles,,,123.3,239.75,7
HCPCS,81285,Fxn gene charac alleles,,,247.35,480.95,7
HCPCS,81286,Fxn gene full gene sequence,,,247.35,480.95,7
HCPCS,81287,HC MGMT METHYLATION ANALYSIS,274.0,191.8,,,0
HCPCS,81287,Mgmt gene methylation anal,,,112.18,218.12,7
HCPCS,81288,HC MLH1 GENE ANALYSIS PROMOTER METHYLATION ANALYSIS,9733.0,6813.1,,,0
HCPCS,81288,Mlh1 gene,,,173.09,336.56,7
HCPCS,81289,Fxn gene known famil variant,,,166.68,324.1,7
HCPCS,81290,Mcoln1 gene,,,35.38,354.94,11
HCPCS,81291,HC MTHFR MUTATION,657.0,459.9,,,0
HCPCS,81291,Mthfr gene,,,58.81,351.24,11
HCPCS,81292,HC MLH1 GENE ANALYSIS FULL SEQUENCE ANALYSIS,2854.0,1997.8,,,0
HCPCS,81292,Mlh1 gene full seq,,,607.86,3036.4,11
HCPCS,81293,Mlh1 gene known variants,,,284.64,579.25,11
HCPCS,81294,HC MLH1 GENE ANALYSIS DUPLICATION/DELETION VARIANTS,1706.0,1194.2,,,0
HCPCS,81294,Mlh1 gene dup/delete variant,,,182.16,1859.61,11
HCPCS,81295,HC MSH2 GENE ANALYSIS FULL SEQUENCE ANALYSIS,2729.0,1910.3,,,0
HCPCS,81295,HC PRO MSH2 GENE ANALYSIS FULL SEQUENCE ANALYSIS,944.0,660.8,,,0
HCPCS,81295,Msh2 gene full seq,,,343.53,2975.69,11
HCPCS,81296,Msh2 gene known variants,,,284.64,591.03,11
HCPCS,81297,HC MSH2 GENE ANALYSIS DUPLICATION/DELETION VARIANTS,1882.0,1317.4,,,0
HCPCS,81297,HC PRO MSH2 GENE ANALYSIS DUPLICATION/DELETION VARIANTS,528.0,369.6,,,0
HCPCS,81297,Msh2 gene dup/delete variant,,,191.97,2051.67,11
HCPCS,81298,HC MSH6 GENE ANALYSIS FULL SEQUENCE ANALYSIS,3366.0,2356.2,,,0
HCPCS,81298,HC PRO MSH6 GENE ANALYSIS FULL SEQUENCE ANALYSIS,1587.0,1110.9,,,0
HCPCS,81298,Msh6 gene full seq,,,577.67,2334.57,11
HCPCS,81299,Msh6 gene known variants,,,277.2,539.0,11
HCPCS,81300,HC MSH6 GENE ANALYSIS DUPLICATION/DELETION VARIANTS,1751.0,1225.7,,,0
HCPCS,81300,HC PRO MSH6 GENE ANALYSIS DUPLICATION/DELETION VARIANTS,589.0,412.3,,,0
HCPCS,81300,Msh6 gene dup/delete variant,,,214.2,1909.47,11
HCPCS,81301,HC MICROSATELLITE INSTABILITY,2179.0,1525.3,,,0
HCPCS,81301,Microsatellite instability,,,313.7,1477.08,11
HCPCS,81302,HC RETT SYNDROME MECP2,2118.0,1482.6,,,0
HCPCS,81302,Mecp2 gene full seq,,,475.08,1182.91,11
HCPCS,81303,Mecp2 gene known variant,,,108.0,444.83,11
HCPCS,81304,HC RETT SYNDROME MECP2,602.0,421.4,,,0
HCPCS,81304,Mecp2 gene dup/delet variant,,,135.0,322.89,11
HCPCS,81305,HC MYD88 GENE ANALYSIS P.LEU265PRO VARIANT,385.0,269.5,,,0
HCPCS,81305,Myd88 gene p.leu265pro vrnt,,,157.86,306.95,7
HCPCS,81306,HC NUDT15 GENE ANALYSIS COMMON VARIANTS,656.0,459.2,,,0
HCPCS,81306,Nudt15 gene common variants,,,262.22,509.88,7
HCPCS,81307,HC PALB2 GENE ANALYSIS FULL GENE SEQUENCE,2715.0,1900.5,,,0
HCPCS,81307,HC PRO PALB2 GENE ANALYSIS FULL GENE SEQUENCE,1394.0,975.8,,,0
HCPCS,81307,Palb2 gene full gene seq,,,608.85,1183.88,11
HCPCS,81308,Palb2 gene known famil vrnt,,,271.22,1139.1,11
HCPCS,81309,Pik3ca gene trgt seq alys,,,247.35,1038.86,11
HCPCS,81310,HC NPM1 GENE ANALYSIS,801.0,560.7,,,0
HCPCS,81310,Npm1 gene,,,178.29,431.41,11
HCPCS,81311,HC NRAS GENE ANALYSIS VARIANTS IN EXON 2 AND EXON 3,970.0,679.0,,,0
HCPCS,81311,HC PRO NRAS GENE ANALYSIS VARIANTS IN EXON 2 AND EXON 3,263.0,184.1,,,0
HCPCS,81311,Nras gene variants exon 2&3,,,266.21,827.37,11
HCPCS,81312,HC PABPN1 GENE ANALYSIS EVAL TO DETECT ABNORMAL ALLELES,300.0,210.0,,,0
HCPCS,81312,Pabpn1 gene detc abnor allel,,,123.3,239.75,7
HCPCS,81313,Pca3/klk3 antigen,,,229.54,446.34,7
HCPCS,81314,HC PDGFRA GENE ANALYSIS TARGETED SEQ ANALYSIS,1088.0,761.6,,,0
HCPCS,81314,HC PRO PDGFRA GENE ANALYSIS TARGETED SEQ ANALYSIS,293.0,205.1,,,0
HCPCS,81314,Pdgfra gene,,,296.56,921.72,11
HCPCS,81315,HC PML/RARALPHA COM BREAKPOINTS,1279.0,895.3,,,0
HCPCS,81315,Pml/raralpha com breakpoints,,,186.58,444.3,11
HCPCS,81316,Pml/raralpha 1 breakpoint,,,186.58,1626.57,11
HCPCS,81317,Pms2 gene full seq analysis,,,608.85,2428.95,11
HCPCS,81318,Pms2 known familial variants,,,284.64,579.25,11
HCPCS,81319,Pms2 gene dup/delet variants,,,183.15,1747.95,11
HCPCS,81320,Plcg2 gene common variants,,,262.22,509.88,7
HCPCS,81321,HC PRO PTEN GENE ANALYSIS FULL SEQUENCE ANALYSIS,1484.0,1038.8,,,0
HCPCS,81321,HC PTEN GENE ANALYSIS FULL SEQUENCE ANALYSIS,2408.0,1685.6,,,0
HCPCS,81321,Pten gene full sequence,,,540.0,2287.81,11
HCPCS,81322,Pten gene known fam variant,,,41.94,222.42,11
HCPCS,81323,HC PRO PTEN GENE ANALYSIS DUPLICATION/DELETION VARIANT,618.0,432.6,,,0
HCPCS,81323,HC PTEN GENE ANALYSIS DUPLICATION/DELETION VARIANT,1205.0,843.5,,,0
HCPCS,81323,Pten gene dup/delet variant,,,267.43,525.0,11
HCPCS,81324,Pmp22 gene dup/delet,,,682.52,1837.68,11
HCPCS,81325,HC PMP22 GENE ANALYSIS FULL SEQUENCE ANALYSIS,3088.0,2161.6,,,0
HCPCS,81325,HC PRO PMP22 GENE ANALYSIS FULL SEQUENCE ANALYSIS,1586.0,1110.2,,,0
HCPCS,81325,Pmp22 gene full sequence,,,692.62,1346.76,11
HCPCS,81326,Pmp22 gene known fam variant,,,41.94,355.09,11
HCPCS,81327,Sept9 methylation analysis,,,172.8,336.0,11
HCPCS,81328,Slco1b1 gene com variants,,,157.33,305.92,7
HCPCS,81329,HC SMN1 GENE ANALYSIS DOSAGE/DELETION ANALYSIS INCL SMN2 ANALYSIS IF PERFORMED,150.0,105.0,,,0
HCPCS,81329,Smn1 gene dos/deletion alys,,,123.3,239.75,7
HCPCS,81330,Smpd1 gene common variants,,,42.3,354.94,11
HCPCS,81331,HC PRADER-WILLI OR ANGELMAN SYNDROME,450.0,315.0,,,0
HCPCS,81331,Snrpn/ube3a gene,,,45.96,276.77,11
HCPCS,81332,Serpina1 gene,,,39.28,265.36,11
HCPCS,81333,Tgfbi gene common variants,,,123.3,239.75,7
HCPCS,81334,Runx1 gene targeted seq alys,,,296.56,576.64,7
HCPCS,81335,HC PRO HC TPMT GENE ANALYSIS COMMON VARIANTS,156.0,109.2,,,0
HCPCS,81335,HC TPMT GENE ANALYSIS COMMON VARIANTS,574.0,401.8,,,0
HCPCS,81335,Tpmt gene com variants,,,157.33,305.92,7
HCPCS,81336,Smn1 gene full gene sequence,,,271.22,527.36,7
HCPCS,81337,Smn1 gen nown famil seq vrnt,,,166.68,324.1,7
HCPCS,81338,HC MPL GENE COMMON VARIANTS,330.0,231.0,,,0
HCPCS,81338,Mpl gene common variants,,,135.3,263.08,7
HCPCS,81339,Mpl gene seq alys exon 10,,,166.68,324.1,7
HCPCS,81340,Trb@ gene rearrange amplify,,,188.03,559.89,11
HCPCS,81341,Trb@ gene rearrange dirprobe,,,44.63,171.76,11
HCPCS,81342,HC TRG GENE REARRANGEMENT ANAL,701.0,490.7,,,0
HCPCS,81342,Trg gene rearrangement anal,,,181.35,475.33,11
HCPCS,81343,Ppp2r2b gen detc abnor allel,,,123.3,239.75,7
HCPCS,81344,Tbp gene detc abnor alleles,,,123.3,239.75,7
HCPCS,81345,Tert gene targeted seq alys,,,166.68,324.1,7
HCPCS,81346,Tyms gene com variants,,,157.33,305.92,7
HCPCS,81347,Sf3b1 gene common variants,,,173.92,338.19,7
HCPCS,81348,Srsf2 gene common variants,,,157.86,306.95,7
HCPCS,81349,Cytog alys chrml abnr lw-ps,,,1078.15,2096.4,7
HCPCS,81350,Ugt1a1 gene,,,203.77,409.5,11
HCPCS,81351,HC TP53 GENE FULL GENE SEQUENCE,1404.0,982.8,,,0
HCPCS,81351,Tp53 gene full gene sequence,,,577.67,1123.24,7
HCPCS,81352,HC PRO TP53 GENE ANALYSIS TARGETED SEQUENCE ANALYSIS,293.0,205.1,,,0
HCPCS,81352,HC TP53 GENE ANALYSIS TARGETED SEQUENCE ANALYSIS,1322.0,925.4,,,0
HCPCS,81352,Tp53 gene trgt sequence alys,,,296.56,576.64,7
HCPCS,81353,Tp53 gene known famil vrnt,,,277.2,539.0,7
HCPCS,81354,Cytog alys chrml abnor ogm,,,1137.18,2211.18,7
HCPCS,81355,Vkorc1 gene,,,79.38,314.46,11
HCPCS,81357,U2af1 gene common variants,,,173.92,338.19,7
HCPCS,81360,Zrsr2 gene common variants,,,173.92,338.19,7
HCPCS,81361,Hbb gene com variants,,,157.33,305.92,7
HCPCS,81362,Hbb gene known fam variant,,,337.72,656.69,7
HCPCS,81363,Hbb gene dup/del variants,,,182.16,354.2,7
HCPCS,81364,HC HBB FULL GENE SEQUENCE,1408.0,985.6,,,0
HCPCS,81364,HC PRO HBB FULL GENE SEQUENCE,669.0,468.3,,,0
HCPCS,81364,Hbb full gene sequence,,,292.12,568.02,7
HCPCS,81370,HC LOW RES HLA TYPE,2024.0,1416.8,,,0
HCPCS,81370,Hla i & ii typing lr,,,361.91,2324.08,11
HCPCS,81371,Hla i & ii type verify lr,,,364.07,1250.58,11
HCPCS,81372,HC A B C LOCI LOW RES,3430.0,2401.0,,,0
HCPCS,81372,Hla i typing complete lr,,,363.23,1147.76,11
HCPCS,81373,HC A B C OR HLA LOW RES LOCUS,4663.0,3264.1,,,0
HCPCS,81373,Hla i typing 1 locus lr,,,114.69,578.64,11
HCPCS,81374,HC HLA B5701 OR B27 TEST,960.0,672.0,,,0
HCPCS,81374,Hla i typing 1 antigen lr,,,66.9,184.36,11
HCPCS,81375,HC DRDQDRP LOCI LOW RES,999.0,699.3,,,0
HCPCS,81375,Hla ii typing ag equiv lr,,,198.67,1146.97,11
HCPCS,81376,HC DQ OR DR LOCUS LOW RES,1243.0,870.1,,,0
HCPCS,81376,Hla ii typing 1 locus lr,,,110.0,213.88,11
HCPCS,81377,Hla ii type 1 ag equiv lr,,,85.27,477.04,11
HCPCS,81378,HC HLA I & II TYPING HR,4267.0,2986.9,,,0
HCPCS,81378,Hla i & ii typing hr,,,311.01,1795.5,11
HCPCS,81379,Hla i typing complete hr,,,301.84,1742.58,11
HCPCS,81380,Hla i typing 1 locus hr,,,159.52,920.96,11
HCPCS,81381,HC HLA CLASS I TYPING HIGH RESOLUTION B5701,423.0,296.1,,,0
HCPCS,81381,Hla i typing 1 allele hr,,,152.91,491.4,11
HCPCS,81382,HC HLA II TYPING 1 LOC HR,4399.0,3079.3,,,0
HCPCS,81382,HC PRO HLA CLASS II TYPING HIGH RESOLUTION ON LOCUS EA,144.0,100.8,,,0
HCPCS,81382,Hla ii typing 1 loc hr,,,111.31,642.6,11
HCPCS,81383,Hla ii typing 1 allele hr,,,98.22,567.0,11
HCPCS,81400,HC MOLECULAR PATHOLOGY PROCEDURE LEVEL 1,257.0,179.9,,,0
HCPCS,81400,Mopath procedure level 1,,,57.56,111.93,7
HCPCS,81401,HC MOPATH PROCEDURE LEVEL 2,1361.0,952.7,,,0
HCPCS,81401,Mopath procedure level 2,,,123.3,239.75,7
HCPCS,81402,HC MOPATH PROCEDURE LEVEL 3,391.0,273.7,,,0
HCPCS,81402,Mopath procedure level 3,,,135.3,265.06,11
HCPCS,81403,HC MOPATH PROCEDURE LEVEL 4,662.0,463.4,,,0
HCPCS,81403,HC PRO MOPATH PROCEDURE LEVEL 4,695.0,486.5,,,0
HCPCS,81403,Mopath procedure level 4,,,166.68,324.1,7
HCPCS,81404,HC MOPATH PROCEDURE LEVEL 5,1338.0,936.6,,,0
HCPCS,81404,HC PRO MOLECULAR PATHOLOGY PROCEDURE LEVEL 5,477.0,333.9,,,0
HCPCS,81404,Mopath procedure level 5,,,247.35,480.95,7
HCPCS,81405,HC MOPATH PROCEDURE LEVEL 6,4238.0,2966.6,,,0
HCPCS,81405,HC PRO MOLECULAR PATHOLOGY PROCEDURE LEVEL 6,867.0,606.9,,,0
HCPCS,81405,Mopath procedure level 6,,,271.22,527.36,7
HCPCS,81406,HC MOPATH PROCEDURE LEVEL 7,2185.0,1529.5,,,0
HCPCS,81406,HC PRO MOLECULAR PATHOLOGY PROCEDURE LEVEL 7,1201.0,840.7,,,0
HCPCS,81406,Mopath procedure level 7,,,254.59,495.04,7
HCPCS,81407,HC MOPATH PROCEDURE LEVEL 8,2588.0,1811.6,,,0
HCPCS,81407,HC PRO MOPATH PROCEDURE LEVEL 8,3370.0,2359.0,,,0
HCPCS,81407,Mopath procedure level 8,,,761.64,1480.97,7
HCPCS,81408,HC MOPATH PROCEDURE LEVEL 9,2731.0,1911.7,,,0
HCPCS,81408,HC PRO MOLECULAR PATHOLOGY PROCEDURE LEVEL 9,3941.0,2758.7,,,0
HCPCS,81408,Mopath procedure level 9,,,1800.0,3500.0,7
HCPCS,81410,Aortic dysfunction/dilation,,,453.6,1905.12,11
HCPCS,81410,HC AORTIC DYSFUNCTION/DILATION GENOMIC SEQ ANALYSIS PANEL INCL SEQ 9 GENES FBN1/TGFBR1/TGFBR2/COL3A1/MYH11/ACTA2/SLC2A10/SMAD3/MYLK,2024.0,1416.8,,,0
HCPCS,81410,HC PRO AORTIC DYSFUNCTION/DILATION GENOMIC SEQ ANALYSIS PANEL INC SEQ 9 GENES FBN1/TGFBR1/TGFBR2/COL3A1/MYH11/ACTA2/SLC2A10/SMAD3/MYLK,448.0,313.6,,,0
HCPCS,81411,Aortic dysfunction/dilation,,,1215.17,5103.72,11
HCPCS,81411,HC AORTIC DYSFUNCTION OR DILATION DUPLICATION/DELETION ANALYSIS PANEL MUST INCLUDE ANALYSES FOR TGFBR1/TGFBR2/MYH11/COL3A1,5857.0,4099.9,,,0
HCPCS,81412,Ashkenazi jewish assoc dis,,,2203.7,4284.98,7
HCPCS,81413,Car ion chnnlpath inc 10 gns,,,526.41,3032.81,11
HCPCS,81414,Car ion chnnlpath inc 2 gns,,,526.41,3032.81,11
HCPCS,81415,Exome sequence analysis,,,4302.0,18068.4,11
HCPCS,81415,HC EXOME SEQUENCE ANALYSIS,20192.0,14134.4,,,0
HCPCS,81416,Exome sequence analysis,,,10800.0,45360.0,11
HCPCS,81417,Exome re-evaluation,,,288.0,1209.6,11
HCPCS,81418,Rx metab gen seq alys pnl 6,,,825.37,1604.89,7
HCPCS,81419,Epilepsy gen seq alys panel,,,2203.7,4284.98,7
HCPCS,81419,HC EPILEPSY GEN SEQ ANALYSIS PANEL,5352.0,3746.4,,,0
HCPCS,81420,Fetal chrmoml aneuploidy,,,683.14,2869.21,11
HCPCS,81420,HC FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYSIS PANEL,2630.0,1841.0,,,0
HCPCS,81422,Fetal chrmoml microdeltj,,,683.14,3032.81,11
HCPCS,81425,Genome sequence analysis,,,4528.08,19017.94,11
HCPCS,81426,Genome sequence analysis,,,2438.96,10243.61,11
HCPCS,81427,Genome re-evaluation,,,2103.89,8836.32,11
HCPCS,81430,Hearing loss sequence analys,,,1462.5,6142.5,11
HCPCS,81431,HC HEARING LOSS DUPLICATION/DELETION ANALYSIS PANE,1114.0,779.8,,,0
HCPCS,81431,Hearing loss dup/del analys,,,611.61,2568.77,11
HCPCS,81432,HC HEREDITARY BRST CANCER-RELATED GEN SEQ ANALYSIS PANEL 5 OR MORE GENES INTERROGATION FOR SEQUENCE VARIANTS & COPY NUMBER VARIANTS,1529.0,1070.3,,,0
HCPCS,81432,HC PRO HEREDITARY BRST CANCER-RELATED GEN SEQ ANALYSIS PANEL 5 OR MORE GENES INTERROGATION FOR SEQUENCE VARIANTS & COPY NUMBER VARIANTS,603.0,422.1,,,0
HCPCS,81432,Hrdtry brst ca-rlatd dsordrs,,,1173.56,2281.91,7
HCPCS,81434,Hereditary retinal disorders,,,538.12,1046.34,7
HCPCS,81435,Hereditary colon ca dsordrs,,,1173.56,2281.91,11
HCPCS,81436,Hereditary colon ca dsordrs,,,1772.25,2210.92,4
HCPCS,81437,Heredtry nurondcrn tum dsrdr,,,1173.56,2281.91,7
HCPCS,81439,Inherited cardmypthy 5 gns,,,526.41,3032.81,11
HCPCS,81440,Mitochondrial gene,,,2991.6,12564.72,11
HCPCS,81441,Ibmfs seq alys pnl 30 genes,,,2203.7,4284.98,7
HCPCS,81442,HC NOONAN SPECTRUM DISORDERS GENOMIC SEQ ANALYSIS PANEL INCL SEQ 12 GENES BRAF/CBL/HRAS/KRAS/MAP2K1/MAP2K2/NRAS/PTPN11/RAF1/RIT1/SHOC2/SOS1,8603.0,6022.1,,,0
HCPCS,81442,HC PRO NOONAN SPECTRUM DISORDERS GENOMIC SEQ ANALYSIS PANEL INCL SEQ 12 GENES BRAF/CBL/HRAS/KRAS/MAP2K1/MAP2K2/NRAS/PTPN11/RAF1/RIT1/SHOC2/SOS1,1903.0,1332.1,,,0
HCPCS,81442,Noonan spectrum disorders,,,1929.24,3751.3,7
HCPCS,81443,Genetic tstg severe inh cond,,,2203.7,4284.98,7
HCPCS,81443,HC GENETIC TESTING FOR SEVERE INHERITED CONDITIONS GENOMIC SEQUENCE ANALYSIS PANEL MUST INCLUDE SEQUENCING OF AT LEAST 15 GENES,2675.0,1872.5,,,0
HCPCS,81443,HC PRO GENETIC TEST SEVERE INHERITED CONDITIONS GENOMIC SEQ ALYS PANEL MUST INCL SEQ AT LEAST 15 GENES,2174.0,1521.8,,,0
HCPCS,81445,HC PRO SOLID ORGAN NEOPLASM GENOMIC SEQ ANALYSIS PANEL 5-50 GENES DNA ANALYSIS/COMBINED DNA & RNA ANALYSIS,531.0,371.7,,,0
HCPCS,81445,HC SOLID ORGAN NEOPLASM GENOMIC SEQ ANALYSIS PANEL 5-50 GENES DNA ANALYSIS/COMBINED DNA & RNA ANALYSIS,1960.0,1372.0,,,0
HCPCS,81445,Targeted genomic seq analys,,,538.12,2260.1,11
HCPCS,81448,Hrdtry perph neurphy panel,,,526.41,1023.58,7
HCPCS,81449,Tgsap so neo 5-50 rna alys,,,538.12,1046.34,7
HCPCS,81450,HC HEMATOLYMPHOID NEOPLASM/DISORDER GENOMIC SEQ ANALYSIS PANEL 5-50 GENES DNA ANALYSIS/COMBINED DNA & RNA ANALYSIS,2140.0,1498.0,,,0
HCPCS,81450,HC PRO HEMATOLYMPHOID NEOPLASM/DISORDER GENOMIC SEQ ANALYSIS PANEL 5-50 GENES DNA ANALYSIS/COMBINED DNA & RNA ANALYSIS,675.0,472.5,,,0
HCPCS,81450,Targeted genomic seq analys,,,683.58,2871.02,11
HCPCS,81451,Tgsap hl neo 5-50 rna alys,,,683.58,1329.18,7
HCPCS,81455,HC PRO SOLID ORGAN/HEMATOLYMPHOID NEOPLASM/DISORDER 51 OR GREATER GENES GENOMIC SEQ ANALYSIS PANEL DNA ANALYSIS/COMBINED DNA & RNA ANALYSIS,2592.0,1814.4,,,0
HCPCS,81455,HC SOLID ORGAN/HEMATOLYMPHOID NEOPLASM/DISORDER 51 OR GREATER GENES GENOMIC SEQ ANALYSIS PANEL DNA ANALYSIS/COMBINED DNA & RNA ANALYSIS,2140.0,1498.0,,,0
HCPCS,81455,Targeted genomic seq analys,,,2627.64,11036.09,11
HCPCS,81456,Tgsap so/hl 51/< rna alys,,,2627.64,5109.3,7
HCPCS,81457,So neo gsap dna mcrstl ins,,,807.18,1569.52,7
HCPCS,81458,So gsap dna cpy nmbr&mcrstl,,,941.71,1831.11,7
HCPCS,81459,So neo gsap dna/dna&rna,,,2690.6,5231.71,7
HCPCS,81460,Whole mitochondrial genome,,,1158.3,4864.86,11
HCPCS,81462,So gsap cll fr dna/dna&rna,,,1076.25,2092.7,7
HCPCS,81463,So gsap cl fr cpy nmbr&mcrst,,,1210.78,2354.29,7
HCPCS,81464,So gsap cll fr mcrstl ins,,,2959.66,5754.89,7
HCPCS,81465,Whole mitochondrial genome,,,842.4,3538.08,11
HCPCS,81470,X-linked intellectual dblt,,,822.6,3454.92,11
HCPCS,81471,X-linked intellectual dblt,,,822.6,3454.92,11
HCPCS,81479,HC PRO UNLISTED MOLECULAR PATHOLOGY PROCEDURE,232.0,162.4,,,0
HCPCS,81479,HC UNLISTED MOLECULAR PATHOLOGY PROCEDURE,804.0,562.8,,,0
HCPCS,81490,Autoimmune rheumatoid arthr,,,756.58,1471.14,7
HCPCS,81493,Cor artery disease mrna,,,945.0,1837.5,7
HCPCS,81500,Onco (ovar) two proteins,,,234.45,455.88,7
HCPCS,81503,HC OVA 1 FIVE PROTEINS (OVAR),1012.0,708.4,,,0
HCPCS,81503,Onco (ovar) five proteins,,,807.3,1569.75,7
HCPCS,81504,Oncology tissue of origin,,,468.0,910.0,7
HCPCS,81506,Endo assay seven anal,,,62.03,120.61,7
HCPCS,81507,Fetal aneuploidy trisom risk,,,715.5,1391.25,7
HCPCS,81508,Ftl cgen abnor two proteins,,,48.87,95.02,7
HCPCS,81508,HC 1ST TRIMESTER SEQ SC,218.0,152.6,,,0
HCPCS,81509,Ftl cgen abnor 3 proteins,,,1338.63,2602.9,7
HCPCS,81510,Ftl cgen abnor three anal,,,49.99,97.2,7
HCPCS,81511,Ftl cgen abnor four anal,,,138.15,268.62,7
HCPCS,81511,HC 2ND TRIMESTER SEQ SC,617.0,431.9,,,0
HCPCS,81512,Ftl cgen abnor five anal,,,62.57,121.66,7
HCPCS,81513,HC INFECTIOUS DISEASE BACTERIAL VAGINOSIS RNA VAGINAL-FLUID ALG,305.0,213.5,,,0
HCPCS,81513,Nfct ds bv rna vag flu alg,,,128.37,539.14,11
HCPCS,81514,HC INFECTIOUS DISEASE BACTERIAL VAGINOSIS&VAGINITIS DNA VAG FLU ALG,562.0,393.4,,,0
HCPCS,81514,Nfct ds bv&vaginitis dna alg,,,236.69,994.1,11
HCPCS,81515,Nfct ds bv&vaginitis dna alg,,,236.69,460.23,7
HCPCS,81517,HC LIVER DISEASE ANALYSIS OF 3 BIOMARKERS IA SRM PROGNOSTIC ALG RPT RISK SCORE/RISK LIVER FIBROSIS/LIVER RELATED CLIN EVENT W/I 5 YRS,765.0,535.5,,,0
HCPCS,81517,Liver ds alys 3 bmrk srm alg,,,158.57,308.33,7
HCPCS,81518,HC ONCOLOGY BREAST MRNA GENE EXPRESSION PROFILING REAL-TIME RT-PCR OF 11 GENE FORMALIN-FIXED PARAFFIN-EMBEDDED TISSUE,15543.0,10880.1,,,0
HCPCS,81518,HC PRO ONCOLOGY BREAST MRNA GENE EXPRESSION PROFILING REAL-TIME RT-PCR OF 11 GENE FORMALIN-FIXED PARAFFIN-EMBEDDED TISSUE,9575.0,6702.5,,,0
HCPCS,81518,Onc brst mrna 11 genes,,,3485.7,6777.75,7
HCPCS,81519,HC ONCOLOGY (BREAST) MRNA GENE EXPRESS PROFILING REAL-TIME RT-PCR OF 21 GENES FORMALIN-FIXED PARRAFIN EMBEDDED TISSUE,10648.0,7453.6,,,0
HCPCS,81519,Oncology breast mrna,,,3485.7,14639.94,11
HCPCS,81520,Onc breast mrna 58 genes,,,2259.19,4392.87,7
HCPCS,81521,Onc breast mrna 70 genes,,,3485.7,6777.75,7
HCPCS,81522,Onc breast mrna 12 genes,,,3485.7,14639.94,11
HCPCS,81523,Onc brst mrna 70 cnt 31 gene,,,3485.7,14639.94,11
HCPCS,81525,Oncology colon mrna,,,2804.4,5453.0,7
HCPCS,81528,Oncology colorectal scr,,,457.98,1379.62,11
HCPCS,81529,Onc cutan mlnma mrna 31 gene,,,6473.7,12587.75,7
HCPCS,81535,Oncology gynecologic,,,521.51,2190.36,11
HCPCS,81536,Oncology gynecologic,,,159.8,671.18,11
HCPCS,81538,Oncology lung,,,2583.9,5024.25,7
HCPCS,81539,Oncology prostate prob score,,,684.0,2275.94,11
HCPCS,81540,HC ONCOLOGY (TUMOR UNKNOWN ORIGIN) MRNA GENE EXPRESS PROFIL REAL-TIME RT-PCR 92 GENES CLASSIFY MAIN CANCER TYPE/SUBTYPE USE FORMALIN-FIXED PARRIFIN-EMBEDDED TISSUE,14297.0,10007.9,,,0
HCPCS,81540,HC PRO ONCOLOGY (TUMOR UNKNOWN ORIGIN) MRNA GENE EXPRESS PROFIL REAL-TIME RT-PCR 92 GENES CLASSIFY MAIN CANCER TYPE/SUBTYPE USE FORMALIN-FIXED PARRIFIN-EMBEDDED TISSUE,3329.0,2330.3,,,0
HCPCS,81540,Oncology tum unknown origin,,,3375.0,6562.5,7
HCPCS,81541,Onc prostate mrna 46 genes,,,3485.7,6777.75,7
HCPCS,81542,Onc prostate mrna 22 cnt gen,,,3485.7,6777.75,7
HCPCS,81546,"Onc thyr mrna 10,196 gen alg",,,3240.0,6300.0,7
HCPCS,81551,Onc prostate 3 genes,,,1827.0,3552.5,7
HCPCS,81552,Onc uveal mlnma mrna 15 gene,,,6998.4,13608.0,7
HCPCS,81554,Pulm ds ipf mrna 190 gen alg,,,4868.64,9466.8,7
HCPCS,81558,Trnspl rej kdn mrna qpcr 139,,,2916.0,5670.0,7
HCPCS,81560,Trnsplj pd lvr&bwl cd154+cll,,,576.66,1121.28,7
HCPCS,81595,Cardiology hrt trnspl mrna,,,2916.0,5670.0,7
HCPCS,81596,Nfct ds chrnc hcv 6 assays,,,64.97,126.33,7
HCPCS,82009,Test for acetone/ketones,,,4.07,44.02,11
HCPCS,82010,Acetone assay,,,7.35,38.5,11
HCPCS,82010,HC KETONE BODY QUANTITATIVE,54.0,37.8,,,0
HCPCS,82010,HC POC KETONE BODY QUANTITATIVE,54.0,37.8,,,0
HCPCS,82013,Acetylcholinesterase assay,,,11.06,61.65,11
HCPCS,82016,Acylcarnitines qual,,,14.84,76.51,11
HCPCS,82017,Acylcarnitines quant,,,15.18,52.57,11
HCPCS,82017,HC ACYLCARNITINES QUANT,76.0,53.2,,,0
HCPCS,82024,Assay of acth,,,34.76,299.29,11
HCPCS,82024,HC ASSAY OF ACTH,82.0,57.4,,,0
HCPCS,82030,Assay of adp & amp,,,23.22,142.39,11
HCPCS,82040,Assay of serum albumin,,,4.46,99.92,11
HCPCS,82040,HC ASSAY OF SERUM ALBUMIN,141.0,98.7,,,0
HCPCS,82042,Assay of urine albumin,,,7.0,31.1,11
HCPCS,82042,HC ALBUMIN OTHER SOURCE QUANTITATIVE EACH SPECIMEN,44.0,30.8,,,0
HCPCS,82043,HC ALBUMIN URINE (EG MICROALBUMIN) QUANTITATIVE,223.0,156.1,,,0
HCPCS,82043,Microalbumin quantitative,,,5.2,65.43,11
HCPCS,82044,Microalbumin semiquant,,,5.61,25.25,11
HCPCS,82045,Albumin ischemia modified,,,30.55,187.34,11
HCPCS,82075,Assay of breath ethanol,,,27.0,52.5,11
HCPCS,82075,HC POC ASSAY OF BREATH ETHANOL,52.0,36.4,,,0
HCPCS,82077,Assay spec xcp ur&breath ia,,,15.54,30.22,7
HCPCS,82077,HC ALCOHOL SPECIMEN EXCEPT URINE & BREATH IA,37.0,25.9,,,0
HCPCS,82085,Assay of aldolase,,,8.74,112.91,11
HCPCS,82085,HC ASSAY OF ALDOLASE,275.0,192.5,,,0
HCPCS,82088,Assay of aldosterone,,,36.68,286.98,11
HCPCS,82088,HC ASSAY OF ALDOSTERONE,552.0,386.4,,,0
HCPCS,82103,Alpha-1-antitrypsin total,,,12.1,67.13,11
HCPCS,82103,HC ALPHA-1-ANTITRYPSIN TOTAL,172.0,120.4,,,0
HCPCS,82104,Alpha-1-antitrypsin pheno,,,13.01,99.95,11
HCPCS,82104,HC ALPHA-1-ANTITRYPSIN PHENO,270.0,189.0,,,0
HCPCS,82105,ALPHA-FETOPROTEIN SERUM,242.0,169.4,,,0
HCPCS,82105,Alpha-fetoprotein serum,,,15.09,83.66,11
HCPCS,82106,Alpha-fetoprotein amniotic,,,15.3,92.57,11
HCPCS,82107,Alpha-Fetoprotein L3,,,57.97,355.47,11
HCPCS,82108,Assay of aluminum,,,22.93,103.23,11
HCPCS,82108,HC ASSAY OF ALUMINUM,276.0,193.2,,,0
HCPCS,82120,Amines vaginal fluid qual,,,5.39,20.75,11
HCPCS,82127,Amino acid single qual,,,12.76,76.51,11
HCPCS,82128,Amino acids mult qual,,,12.48,76.51,11
HCPCS,82131,Amino acids single quant,,,20.68,93.1,11
HCPCS,82131,HC AMINO ACIDS SINGLE QUANT,352.0,246.4,,,0
HCPCS,82135,Assay aminolevulinic acid,,,14.8,90.87,11
HCPCS,82135,HC ASSAY AMINOLEVULINIC ACID,252.0,176.4,,,0
HCPCS,82136,Amino acids quant 2-5,,,17.65,93.1,11
HCPCS,82139,Amino acids quan 6 or more,,,15.18,784.81,11
HCPCS,82139,HC AMINO ACIDS QUAN 6 OR MORE,1100.0,770.0,,,0
HCPCS,82140,Assay of ammonia,,,13.11,84.67,11
HCPCS,82140,HC ASSAY OF AMMONIA,124.0,86.8,,,0
HCPCS,82143,Amniotic fluid scan,,,8.41,37.91,11
HCPCS,82150,Assay of amylase,,,5.83,66.52,11
HCPCS,82150,HC ASSAY OF AMYLASE,137.0,95.9,,,0
HCPCS,82154,Androstanediol glucuronide,,,25.95,159.14,11
HCPCS,82157,Assay of androstenedione,,,26.35,161.56,11
HCPCS,82157,HC ASSAY OF ANDROSTENEDIONE,44.0,30.8,,,0
HCPCS,82160,Assay of androsterone,,,23.0,138.01,11
HCPCS,82163,Assay of angiotensin II,,,18.47,62.19,11
HCPCS,82163,HC ANGIOTENSIN II,87.0,60.9,,,0
HCPCS,82164,Angiotensin I enzyme test,,,13.14,163.63,11
HCPCS,82164,HC ANGIOTENSIN I ENZYME TEST,229.0,160.3,,,0
HCPCS,82166,Assay anti-mullerian horm,,,34.76,67.58,7
HCPCS,82166,HC ANTI-MULLERIAN HORMONE,156.0,109.2,,,0
HCPCS,82172,Assay of apolipoprotein,,,18.98,85.5,11
HCPCS,82172,HC ASSAY OF APOLIPOPROTEIN,154.0,107.8,,,0
HCPCS,82175,Assay of arsenic,,,17.07,59.23,11
HCPCS,82175,HC ASSAY OF ARSENIC,184.0,128.8,,,0
HCPCS,82180,Assay of ascorbic acid,,,8.9,54.55,11
HCPCS,82180,HC ASSAY OF ASCORBIC ACID,296.0,207.2,,,0
HCPCS,82190,Atomic absorption,,,14.31,82.29,11
HCPCS,82232,Assay of beta-2 protein,,,14.56,70.34,11
HCPCS,82232,HC ASSAY OF BETA-2 PROTEIN,147.0,102.9,,,0
HCPCS,82233,Beta-amyloid 1-40 (abeta 40),,,116.03,225.61,7
HCPCS,82234,Beta-amyloid 1-42 (abeta 42),,,116.03,225.61,7
HCPCS,82234,HC BETA-AMYLOID 1-42,177.0,123.9,,,0
HCPCS,82239,Bile acids total,,,15.41,53.31,11
HCPCS,82239,HC BILE ACIDS TOTAL,75.0,52.5,,,0
HCPCS,82240,Bile acids cholylglycine,,,23.92,146.7,11
HCPCS,82247,Bilirubin total,,,4.52,84.91,11
HCPCS,82247,HC BILIRUBIN TOTAL,124.0,86.8,,,0
HCPCS,82247,HC POC BILIRUBIN TOTAL,124.0,86.8,,,0
HCPCS,82248,Bilirubin direct,,,4.52,71.86,11
HCPCS,82248,HC BILIRUBIN DIRECT,104.0,72.8,,,0
HCPCS,82252,Fecal bilirubin test,,,4.1,25.1,11
HCPCS,82261,Assay of biotinidase,,,15.18,93.1,11
HCPCS,82261,HC BIOTINIDASE,78.0,54.6,,,0
HCPCS,82270,HC POC OCCULT BLOOD FECES,41.0,28.7,,,0
HCPCS,82270,OCCULT BLOOD FECES,41.0,28.7,,,0
HCPCS,82270,Occult blood feces,,,3.94,23.54,11
HCPCS,82271,HC POC OCCULT BLOOD OTHER SOURCES,15.0,10.5,,,0
HCPCS,82271,Occult blood other sources,,,4.79,17.96,11
HCPCS,82272,HC OCCULT BLOOD FECES 1-3 TESTS PERFORMED FOR OTHER THAN COLORECTRAL NEOPLASM SCREENING,14.0,9.8,,,0
HCPCS,82272,Occult bld feces 1-3 tests,,,3.81,9.63,11
HCPCS,82274,Assay test for blood fecal,,,14.33,51.83,11
HCPCS,82274,HC ASSAY TEST FOR BLOOD FECAL,65.0,45.5,,,0
HCPCS,82286,Assay of bradykinin,,,4.64,38.03,11
HCPCS,82300,Assay of cadmium,,,21.28,127.73,11
HCPCS,82300,HC ASSAY OF CADMIUM,36.0,25.2,,,0
HCPCS,82306,VITAMIN D 25 HYDROXY,118.0,82.6,,,0
HCPCS,82306,Vitamin d 25 hydroxy,,,26.64,86.02,11
HCPCS,82308,Assay of calcitonin,,,24.11,83.66,11
HCPCS,82308,HC ASSAY OF CALCITONIN,304.0,212.8,,,0
HCPCS,82310,Assay of calcium,,,4.64,60.53,11
HCPCS,82310,HC ASSAY OF CALCIUM TOTAL,88.0,61.6,,,0
HCPCS,82330,Assay of calcium,,,12.31,159.42,11
HCPCS,82330,HC ASSAY OF CALCIUM IONIZED,230.0,161.0,,,0
HCPCS,82330,HC POC ASSAY OF CALCIUM IONIZED,230.0,161.0,,,0
HCPCS,82331,Calcium infusion test,,,12.01,28.58,11
HCPCS,82340,Assay of calcium in urine,,,5.43,41.96,11
HCPCS,82340,HC ASSAY OF CA IN URINE TIMED,138.0,96.6,,,0
HCPCS,82355,Calculus analysis qual,,,10.42,63.84,11
HCPCS,82360,Calculus assay quant,,,11.58,71.06,11
HCPCS,82365,Calculus spectroscopy,,,11.61,120.72,11
HCPCS,82365,HC CALCULUS INFRARED SPECTROSCOPY,172.0,120.4,,,0
HCPCS,82370,X-ray assay calculus,,,11.27,69.14,11
HCPCS,82373,Assay c-d transfer measure,,,16.25,99.68,11
HCPCS,82373,HC ASSAY C-D TRANSFER MEASURE,69.0,48.3,,,0
HCPCS,82374,Assay blood carbon dioxide,,,4.39,26.99,11
HCPCS,82374,HC ASSAY BLOOD CARBON DIOXIDE,90.0,63.0,,,0
HCPCS,82374,HC POC ASSAY BLOOD CARBON DIOXIDE,25.0,17.5,,,0
HCPCS,82375,Assay carboxyhb quant,,,11.09,108.1,11
HCPCS,82375,HC ASSAY CARBOXYHB QUANT,164.0,114.8,,,0
HCPCS,82375,HC POC ASSAY CARBOXYHB QUANT,164.0,114.8,,,0
HCPCS,82376,Assay carboxyhb qual,,,12.66,28.77,11
HCPCS,82378,Carcinoembryonic antigen,,,17.06,123.65,11
HCPCS,82378,HC CARCINOEMBRYONIC ANTIGEN,184.0,128.8,,,0
HCPCS,82379,Assay of carnitine,,,15.18,52.57,11
HCPCS,82379,HC ASSAY OF CARNITINE,36.0,25.2,,,0
HCPCS,82380,Assay of carotene,,,8.3,95.51,11
HCPCS,82380,HC ASSAY OF CAROTENE,141.0,98.7,,,0
HCPCS,82382,Assay urine catecholamines,,,24.57,94.88,11
HCPCS,82383,Assay blood catecholamines,,,26.17,138.31,11
HCPCS,82384,Assay three catecholamines,,,22.72,299.86,11
HCPCS,82384,HC ASSAY CATECHOLAMINES FRACTION,60.0,42.0,,,0
HCPCS,82387,Assay of cathepsin-d,,,16.25,114.84,11
HCPCS,82390,Assay of ceruloplasmin,,,9.67,81.15,11
HCPCS,82390,HC ASSAY OF CERULOPLASMIN,158.0,110.6,,,0
HCPCS,82397,CHEMILUMINESCENT ASSAY,84.0,58.8,,,0
HCPCS,82397,Chemiluminescent assay,,,12.71,59.97,11
HCPCS,82415,Assay of chloramphenicol,,,11.4,69.93,11
HCPCS,82435,ASSAY OF BLOOD CHLORIDE,94.0,65.8,,,0
HCPCS,82435,Assay of blood chloride,,,4.14,52.24,11
HCPCS,82435,HC POC ASSAY OF BLOOD CHLORIDE,94.0,65.8,,,0
HCPCS,82436,Assay of urine chloride,,,5.18,64.41,11
HCPCS,82436,HC ASSAY OF URINE CHLORIDE,94.0,65.8,,,0
HCPCS,82438,Assay other fluid chlorides,,,4.5,21.05,11
HCPCS,82438,HC ASSAY OTHER FLUID CHLORIDES,28.0,19.6,,,0
HCPCS,82441,Test for chlorohydrocarbons,,,5.41,33.11,11
HCPCS,82465,Assay bld/serum cholesterol,,,3.91,40.47,11
HCPCS,82465,HC ASSAY BLD/SERUM CHOLESTEROL,34.0,23.8,,,0
HCPCS,82480,Assay serum cholinesterase,,,7.08,43.51,11
HCPCS,82480,HC ASSAY SERUM CHOLINESTERASE,48.0,33.6,,,0
HCPCS,82482,Assay rbc cholinesterase,,,8.83,42.41,11
HCPCS,82482,HC RBC CHOLINESTERASE,174.0,121.8,,,0
HCPCS,82485,Assay chondroitin sulfate,,,18.58,113.97,11
HCPCS,82495,Assay of chromium,,,18.25,107.35,11
HCPCS,82495,HC ASSAY OF CHROMIUM,85.0,59.5,,,0
HCPCS,82507,Assay of citrate,,,25.02,111.06,11
HCPCS,82507,HC ASSAY OF CITRATE,394.0,275.8,,,0
HCPCS,82523,COLLAGEN CROSSLINKS,102.0,71.4,,,0
HCPCS,82523,Collagen crosslinks,,,16.81,107.65,11
HCPCS,82525,Assay of copper,,,11.17,90.33,11
HCPCS,82525,HC ASSAY OF COPPER,55.0,38.5,,,0
HCPCS,82528,Assay of corticosterone,,,20.27,124.21,11
HCPCS,82530,Cortisol free,,,15.04,141.41,11
HCPCS,82530,HC CORTISOL FREE,235.0,164.5,,,0
HCPCS,82533,HC TOTAL CORTISOL,174.0,121.8,,,0
HCPCS,82533,Total cortisol,,,14.67,111.61,11
HCPCS,82540,Assay of creatine,,,4.18,25.55,11
HCPCS,82540,HC ASSAY OF CREATINE,20.0,14.0,,,0
HCPCS,82542,Col chromotography qual/quan,,,21.68,71.23,11
HCPCS,82542,HC COLUMN CHROMATOGRAPHY INCL MASS SPECTROMETRY IF PERFORMED NON-DRUG ANALYTE(S) NOT ELSEWHERE SPECIFIED QUALITATIVE/QUANTITATIVE EACH SPECIMEN,105.0,73.5,,,0
HCPCS,82550,Assay of ck (cpk),,,5.86,43.51,11
HCPCS,82550,HC ASSAY OF CK (CPK) TOTAL,65.0,45.5,,,0
HCPCS,82552,Assay of cpk in blood,,,12.05,42.2,11
HCPCS,82552,HC ASSAY OF CPK IN BLOOD,130.0,91.0,,,0
HCPCS,82553,Creatine mb fraction,,,10.4,69.97,11
HCPCS,82553,HC CREATINE MB FRACTION,104.0,72.8,,,0
HCPCS,82554,Creatine isoforms,,,10.68,65.51,11
HCPCS,82565,Assay of creatinine,,,4.61,55.96,11
HCPCS,82565,HC ASSAY OF CREATININE,85.0,59.5,,,0
HCPCS,82565,HC POC CREATININE ISTAT,85.0,59.5,,,0
HCPCS,82570,Assay of urine creatinine,,,4.66,46.55,11
HCPCS,82570,HC ASSAY OF CREATININE OTHER SOURCE,94.0,65.8,,,0
HCPCS,82575,Creatinine clearance test,,,8.51,52.57,11
HCPCS,82575,HC CREATININE CLEARANCE TEST,265.0,185.5,,,0
HCPCS,82585,Assay of cryofibrinogen,,,12.73,47.33,11
HCPCS,82585,HC ASSAY OF CRYOFIBRINOGEN,116.0,81.2,,,0
HCPCS,82595,Assay of cryoglobulin,,,5.82,19.99,11
HCPCS,82595,HC ASSAY OF CRYOGLOBULIN,81.0,56.7,,,0
HCPCS,82600,Assay of cyanide,,,17.46,107.09,11
HCPCS,82600,HC ASSAY OF CYANIDE,168.0,117.6,,,0
HCPCS,82607,VITAMIN B-12,154.0,107.8,,,0
HCPCS,82607,Vitamin B-12,,,13.57,82.89,11
HCPCS,82608,B-12 binding capacity,,,12.89,79.04,11
HCPCS,82608,HC B-12 BINDING CAPACITY,23.0,16.1,,,0
HCPCS,82610,Cystatin c,,,16.67,45.16,11
HCPCS,82610,HC CYSTATIN C,58.0,40.6,,,0
HCPCS,82615,Test for urine cystines,,,8.6,45.06,11
HCPCS,82626,Dehydroepiandrosterone,,,22.74,215.45,11
HCPCS,82626,HC DHEA,494.0,345.8,,,0
HCPCS,82627,Dehydroepiandrosterone,,,20.01,77.25,11
HCPCS,82627,HC DHEA SO4,369.0,258.3,,,0
HCPCS,82633,Desoxycorticosterone,,,27.88,170.97,11
HCPCS,82634,Deoxycortisol,,,26.35,161.56,11
HCPCS,82634,HC DEOXYCORTISOL,124.0,86.8,,,0
HCPCS,82638,Assay of dibucaine number,,,11.02,67.59,11
HCPCS,82638,HC DIBUCAINE NUMBER,53.0,37.1,,,0
HCPCS,82642,Dihydrotestosterone,,,26.35,51.24,7
HCPCS,82652,VIT D 1 25-DIHYDROXY,617.0,431.9,,,0
HCPCS,82652,Vit d 1 25-dihydroxy,,,34.65,439.79,11
HCPCS,82653,El-1 fecal quantitative,,,20.67,86.83,11
HCPCS,82653,HC ELASTASE PANCREATIC FECAL QUANTITATIVE,49.0,34.3,,,0
HCPCS,82656,Pancreatic elastase fecal,,,10.38,63.69,11
HCPCS,82657,Enzyme cell activity,,,19.95,63.67,11
HCPCS,82657,HC ENZYME CELL ACTIVITY,89.0,62.3,,,0
HCPCS,82658,Enzyme cell activity ra,,,39.63,99.68,11
HCPCS,82664,Electrophoretic test,,,55.35,189.6,11
HCPCS,82664,HC ELECTROPHORETIC TECHNIQUE NOT ELSEWHERE SPECIFIED,260.0,182.0,,,0
HCPCS,82668,Assay of erythropoietin,,,16.91,138.64,11
HCPCS,82668,HC ASSAY OF ERYTHROPOIETIN,161.0,112.7,,,0
HCPCS,82670,Assay of estradiol,,,25.15,150.97,11
HCPCS,82670,HC ASSAY OF TOTAL ESTRADIOL,336.0,235.2,,,0
HCPCS,82671,Assay of estrogens,,,29.07,111.06,11
HCPCS,82671,HC ASSAY OF ESTROGENS,563.0,394.1,,,0
HCPCS,82672,Assay of estrogen,,,19.53,119.67,11
HCPCS,82677,Assay of estriol,,,21.76,93.59,11
HCPCS,82679,Assay of estrone,,,22.46,77.74,11
HCPCS,82681,Assay dir meas fr estradiol,,,25.15,48.9,7
HCPCS,82693,Assay of ethylene glycol,,,13.41,136.48,11
HCPCS,82693,HC ASSAY OF ETHYLENE GLYCOL,255.0,178.5,,,0
HCPCS,82696,Assay of etiocholanolone,,,23.62,130.15,11
HCPCS,82705,Fats/lipids feces qual,,,4.59,31.54,11
HCPCS,82705,HC FATS/LIPIDS FECES QUAL,110.0,77.0,,,0
HCPCS,82710,FATS/LIPIDS FECES QUANT,301.0,210.7,,,0
HCPCS,82710,Fats/lipids feces quant,,,15.12,92.72,11
HCPCS,82715,Assay of fecal fat,,,20.67,49.25,11
HCPCS,82725,Assay of blood fatty acids,,,16.89,73.48,11
HCPCS,82725,HC ASSAY OF BLOOD FATTY ACIDS,65.0,45.5,,,0
HCPCS,82726,HC LONG CHAIN FATTY ACIDS,96.0,67.2,,,0
HCPCS,82726,Long chain fatty acids,,,17.78,99.68,11
HCPCS,82728,Assay of ferritin,,,12.27,83.72,11
HCPCS,82728,HC ASSAY OF FERRITIN,161.0,112.7,,,0
HCPCS,82731,Assay of fetal fibronectin,,,57.97,315.34,11
HCPCS,82731,HC ASSAY OF FETAL FIBRONECTIN,456.0,319.2,,,0
HCPCS,82735,Assay of fluoride,,,16.69,102.36,11
HCPCS,82746,Assay of folic acid serum,,,13.23,121.05,11
HCPCS,82746,HC BLOOD FOLIC ACID SERUM,243.0,170.1,,,0
HCPCS,82747,Assay of folic acid rbc,,,15.88,95.6,11
HCPCS,82747,HC ASSAY OF FOLIC ACID RBC,76.0,53.2,,,0
HCPCS,82757,Assay of semen fructose,,,15.61,95.71,11
HCPCS,82759,Assay of rbc galactokinase,,,19.33,118.58,11
HCPCS,82760,Assay of galactose,,,10.08,61.8,11
HCPCS,82775,Assay galactose transferase,,,18.96,116.24,11
HCPCS,82776,Galactose transferase test,,,10.57,46.27,11
HCPCS,82777,Galectin-3,,,39.83,77.44,11
HCPCS,82784,Assay iga/igd/igg/igm each,,,8.37,212.08,11
HCPCS,82784,HC ASSAY IGA/IGD/IGG/IGM EACH,455.0,318.5,,,0
HCPCS,82785,Assay of ige,,,14.81,75.24,11
HCPCS,82785,HC ASSAY OF IGE,177.0,123.9,,,0
HCPCS,82787,HC IGG 1 2 3 OR 4 EACH,684.0,478.8,,,0
HCPCS,82787,Igg 1 2 3 or 4 each,,,7.22,256.55,11
HCPCS,82800,Blood pH,,,9.9,42.94,11
HCPCS,82800,HC BLOOD GASES PH,124.0,86.8,,,0
HCPCS,82803,BLOOD GASES ANY COMBINATION,212.0,148.4,,,0
HCPCS,82803,Blood gases any combination,,,23.46,186.31,11
HCPCS,82803,HC POC BLOOD GASES ANY COMBINATION,212.0,148.4,,,0
HCPCS,82805,BLOOD GASES W/ O2 SATURATION,212.0,148.4,,,0
HCPCS,82805,Blood gases w/o2 saturation,,,70.89,149.83,11
HCPCS,82805,HC POC BLOOD GASES W/ O2 SATURATION,212.0,148.4,,,0
HCPCS,82810,Blood gases o2 sat only,,,8.79,48.16,11
HCPCS,82810,HC BLOOD GASES O2 SAT ONLY,129.0,90.3,,,0
HCPCS,82820,Hemoglobin-oxygen affinity,,,12.01,55.15,11
HCPCS,82930,Gastric analy w/ph ea spec,,,6.04,17.4,11
HCPCS,82930,HC GASTRIC ANALY W/ PH EA SPEC,28.0,19.6,,,0
HCPCS,82938,Gastrin test,,,15.92,97.64,11
HCPCS,82941,Assay of gastrin,,,15.87,54.79,11
HCPCS,82941,HC ASSAY OF GASTRIN,208.0,145.6,,,0
HCPCS,82943,Assay of glucagon,,,12.86,44.42,11
HCPCS,82943,HC ASSAY OF GLUCAGON,283.0,198.1,,,0
HCPCS,82945,Glucose Other Fluid,,,3.54,72.56,11
HCPCS,82945,HC GLUCOSE FLUID NOT BLOOD,104.0,72.8,,,0
HCPCS,82946,Glucagon tolerance test,,,15.99,83.2,11
HCPCS,82947,ASSAY GLUCOSE BLOOD QUANT,89.0,62.3,,,0
HCPCS,82947,Assay glucose blood quant,,,3.54,43.26,11
HCPCS,82947,HC POC ASSAY GLUCOSE BLOOD QUANT,89.0,62.3,,,0
HCPCS,82948,Reagent strip/blood glucose,,,4.54,17.5,11
HCPCS,82950,Glucose test,,,4.28,31.84,11
HCPCS,82950,HC ASSAY POCT GLUCOSE SCREEN,62.0,43.4,,,0
HCPCS,82951,Glucose tolerance test (GTT),,,11.58,77.07,11
HCPCS,82951,HC GLUC TOLER TEST (GTT) 3 SPECIM,193.0,135.1,,,0
HCPCS,82952,GTT-added samples,,,3.53,14.81,11
HCPCS,82952,HC GTT-ADDED SAMPLES,47.0,32.9,,,0
HCPCS,82955,Assay of g6pd enzyme,,,8.73,71.08,11
HCPCS,82955,HC ASSAY OF G6PD ENZYME,182.0,127.4,,,0
HCPCS,82960,Test for G6PD enzyme,,,5.44,33.42,11
HCPCS,82962,Glucose blood test,,,2.95,52.19,11
HCPCS,82962,HC POC GLUC BLD TEST MONITORING DEVICE,45.0,31.5,,,0
HCPCS,82963,Assay of glucosidase,,,19.33,118.58,11
HCPCS,82965,Assay of gdh enzyme,,,11.84,42.68,11
HCPCS,82977,Assay of GGT,,,6.48,64.69,11
HCPCS,82977,HC ASSAY OF GGT,123.0,86.1,,,0
HCPCS,82978,Assay of glutathione,,,13.9,78.66,11
HCPCS,82979,Assay rbc glutathione,,,8.5,38.03,11
HCPCS,82985,Assay of glycated protein,,,15.08,47.38,11
HCPCS,82985,HC GLYCATED PROTEIN,46.0,32.2,,,0
HCPCS,830,HC PRO ANESTH HERNIA REPAIRS LOWER ABDOMEN NOS,318.0,222.6,,,0
HCPCS,83001,Assay of gonadotropin (fsh),,,16.72,81.72,11
HCPCS,83001,HC GONADOTROPIN (FSH),177.0,123.9,,,0
HCPCS,83002,Assay of gonadotropin (lh),,,16.67,88.31,11
HCPCS,83002,HC GONADOTROPIN (LH),206.0,144.2,,,0
HCPCS,83003,Assay growth hormone (hgh),,,15.0,216.93,11
HCPCS,83003,HC ASSAY GROWTH HORMONE (HGH),304.0,212.8,,,0
HCPCS,83006,Growth stimulation gene 2,,,68.04,132.3,11
HCPCS,83009,H pylori (c-13) blood,,,60.62,359.4,11
HCPCS,83010,Assay of haptoglobin quant,,,11.32,134.01,11
HCPCS,83010,HC ASSAY OF HAPTOGLOBIN QUANT,188.0,131.6,,,0
HCPCS,83012,Assay of haptoglobins,,,24.2,94.88,11
HCPCS,83013,H pylori (c-13) breath,,,60.62,359.4,11
HCPCS,83014,H pylori drug admin,,,7.07,43.39,11
HCPCS,83015,Heavy metal qual any anal,,,18.85,65.73,11
HCPCS,83018,HC QUANTITATIVE SCREEN METALS,180.0,126.0,,,0
HCPCS,83018,Heavy metal quant each nes,,,19.76,68.86,11
HCPCS,83020,HC HEMOGLOBIN ELECTROPHORESIS,212.0,148.4,,,0
HCPCS,83020,Hemoglobin electrophoresis,,,11.58,124.14,11
HCPCS,83021,Hemoglobin chromotography,,,16.25,99.68,11
HCPCS,83026,Hemoglobin copper sulfate,,,3.61,13.04,11
HCPCS,83030,Fetal hemoglobin chemical,,,9.67,45.66,11
HCPCS,83033,Fetal hemoglobin assay qual,,,7.2,32.89,11
HCPCS,83036,GLYCOSYLATED HEMOGLOBIN TEST,61.0,42.7,,,0
HCPCS,83036,Glycosylated hemoglobin test,,,8.74,42.45,11
HCPCS,83037,Glycosylated hb home device,,,8.74,53.56,11
HCPCS,83045,Blood methemoglobin test,,,5.84,27.37,11
HCPCS,83050,Blood methemoglobin assay,,,7.38,91.81,11
HCPCS,83050,HC BLOOD METHEMOGLOBIN ASSAY,129.0,90.3,,,0
HCPCS,83051,Assay of plasma hemoglobin,,,6.58,40.33,11
HCPCS,83051,HC ASSAY OF PLASMA HEMOGLOBIN,180.0,126.0,,,0
HCPCS,83060,Blood sulfhemoglobin assay,,,7.92,45.66,11
HCPCS,83065,Assay of hemoglobin heat,,,8.1,38.03,11
HCPCS,83068,Hemoglobin stability screen,,,8.52,46.76,11
HCPCS,83069,Assay of urine hemoglobin,,,3.56,21.77,11
HCPCS,83070,Assay of hemosiderin qual,,,4.28,26.2,11
HCPCS,83070,HC ASSAY OF HEMOSIDERIN QUAL,15.0,10.5,,,0
HCPCS,83080,Assay of b hexosaminidase,,,15.18,93.1,11
HCPCS,83088,Assay of histamine,,,26.58,162.99,11
HCPCS,83088,HC ASSAY OF HISTAMINE,196.0,137.2,,,0
HCPCS,83090,Assay Of Homocystine,,,16.13,200.79,11
HCPCS,83090,HC ASSAY OF HOMOCYSTINE,324.0,226.8,,,0
HCPCS,83150,Assay of homovanillic acid,,,20.17,61.69,11
HCPCS,83150,HC ASSAY OF FOR HVA,254.0,177.8,,,0
HCPCS,83491,Assay of corticosteroids 17,,,16.11,96.65,11
HCPCS,83497,Assay of 5-hiaa,,,11.61,40.72,11
HCPCS,83497,HC ASSAY OF 5-HIAA,21.0,14.7,,,0
HCPCS,83498,Assay of progesterone 17-d,,,24.45,132.65,11
HCPCS,83498,HC ASSAY OF PROGESTERONE 17-D,301.0,210.7,,,0
HCPCS,83500,Assay free hydroxyproline,,,20.38,125.0,11
HCPCS,83505,Assay total hydroxyproline,,,21.87,134.15,11
HCPCS,83516,HC IMMUNOASSAY NONANTIBODY,256.0,179.2,,,0
HCPCS,83516,Immunoassay nonantibody,,,10.38,88.37,11
HCPCS,83518,Immunoassay dipstick,,,8.68,46.8,11
HCPCS,83519,HC RIA NONANTIBODY,163.0,114.1,,,0
HCPCS,83519,Ria nonantibody,,,16.56,91.56,11
HCPCS,83520,HC MATRIX METALLOPROTEINASE 9,56.0,39.2,,,0
HCPCS,83520,Immunoassay quant nos nonab,,,15.54,104.22,11
HCPCS,83521,HC IMMUNOGLOBULIN LIGHTS CHAINS FREE EACH,37.0,25.9,,,0
HCPCS,83521,Ig light chains free each,,,15.54,65.28,11
HCPCS,83525,Assay of insulin,,,10.29,79.72,11
HCPCS,83525,HC ASSAY OF INSULIN,194.0,135.8,,,0
HCPCS,83527,Assay of insulin,,,11.66,71.48,11
HCPCS,83528,Assay of intrinsic factor,,,17.84,87.77,11
HCPCS,83529,Asay of interleukin-6 (il-6),,,15.54,65.28,11
HCPCS,83529,HC ASSAY OF INTERLEUKIN-6,37.0,25.9,,,0
HCPCS,83540,Assay of iron,,,5.82,46.68,11
HCPCS,83540,HC ASSAY OF IRON,85.0,59.5,,,0
HCPCS,83550,HC IRON BINDING TEST,171.0,119.7,,,0
HCPCS,83550,Iron binding test,,,7.87,87.81,11
HCPCS,83570,Assay of idh enzyme,,,7.96,48.8,11
HCPCS,83582,Assay of ketogenic steroids,,,13.92,78.21,11
HCPCS,83586,Assay 17- ketosteroids,,,11.52,70.65,11
HCPCS,83586,HC ASSAY 17- KETOSTEROIDS TOTAL,169.0,118.3,,,0
HCPCS,83593,Fractionation ketosteroids,,,25.65,145.15,11
HCPCS,83605,ASSAY OF LACTIC ACID,188.0,131.6,,,0
HCPCS,83605,Assay of lactic acid,,,10.41,124.65,11
HCPCS,83605,HC POC ASSAY OF LACTIC ACID,188.0,131.6,,,0
HCPCS,83615,HC LACTATE (LD) (LDH) ENZYME,123.0,86.1,,,0
HCPCS,83615,Lactate (LD) (LDH) enzyme,,,5.44,76.3,11
HCPCS,83625,Assay of ldh enzymes,,,11.51,162.15,11
HCPCS,83625,HC ASSAY OF LDH ENZYMES,227.0,158.9,,,0
HCPCS,83630,HC LACTOFERRIN FECAL (QUAL),56.0,39.2,,,0
HCPCS,83630,Lactoferrin fecal (qual),,,17.73,61.45,11
HCPCS,83631,Lactoferrin fecal (quant),,,17.67,108.33,11
HCPCS,83632,Placental lactogen,,,18.2,111.55,11
HCPCS,83633,Test urine for lactose,,,10.12,30.39,11
HCPCS,83655,Assay of lead,,,10.9,46.46,11
HCPCS,83655,HC ASSAY OF LEAD,137.0,95.9,,,0
HCPCS,83661,L/s ratio fetal lung,,,19.79,121.3,11
HCPCS,83662,Foam stability fetal lung,,,17.02,104.4,11
HCPCS,83663,Fluoro polarize fetal lung,,,17.02,104.4,11
HCPCS,83664,HC LAMELLAR BODY DENSITY,58.0,40.6,,,0
HCPCS,83664,Lamellar bdy fetal lung,,,17.39,104.4,11
HCPCS,83670,Assay of lap enzyme,,,8.83,50.58,11
HCPCS,83690,Assay of lipase,,,6.2,126.27,11
HCPCS,83690,HC ASSAY OF LIPASE,184.0,128.8,,,0
HCPCS,83690,HC POC ASSAY OF LIPASE,116.0,81.2,,,0
HCPCS,83695,Assay of lipoprotein(a),,,12.89,71.48,11
HCPCS,83695,HC ASSAY OF LIPOPROTEIN(A),88.0,61.6,,,0
HCPCS,83698,Assay Lipoprotein Pla2,,,41.68,187.34,11
HCPCS,83698,HC ASSAY LIPOPROTEIN PLA2,201.0,140.7,,,0
HCPCS,83700,Lipopro bld electrophoretic,,,10.13,62.14,11
HCPCS,83701,Lipoprotein bld hr fraction,,,30.47,136.99,11
HCPCS,83704,Lipoprotein bld quan part,,,30.77,98.47,11
HCPCS,83718,Assay of lipoprotein,,,7.37,82.18,11
HCPCS,83718,HC ASSAY OF LIPOPROTEIN,68.0,47.6,,,0
HCPCS,83719,Assay of blood lipoprotein,,,11.48,39.01,11
HCPCS,83721,Assay of blood lipoprotein,,,9.45,36.34,11
HCPCS,83721,HC ASSAY OF BLOOD LIPOPRO LDL,118.0,82.6,,,0
HCPCS,83722,Lipoprtn dir meas sd ldl chl,,,30.77,59.83,7
HCPCS,83727,Assay of lrh hormone,,,15.47,94.88,11
HCPCS,83727,HC LUTEINIZING RELEASING FACTOR (LRH),74.0,51.8,,,0
HCPCS,83735,Assay of magnesium,,,6.03,54.27,11
HCPCS,83735,HC ASSAY OF MAGNESIUM,81.0,56.7,,,0
HCPCS,83735,HC POC ASSAY OF MAGNESIUM,50.0,35.0,,,0
HCPCS,83775,Assay malate dehydrogenase,,,6.63,40.71,11
HCPCS,83785,Assay of manganese,,,23.98,77.0,11
HCPCS,83785,HC ASSAY OF MANGANESE,87.0,60.9,,,0
HCPCS,83789,HC MASS SPECTOMETRY AND TANDEM MASS SPECTROMETRY NON-DRUG ANALYTE(S) NOT ELSEWHERE SPECIFIED QUALITATIVE/QUANTITATIVE EACH SPECIMEN,90.0,63.0,,,0
HCPCS,83789,Mass spectrometry qual/quan,,,21.7,62.38,11
HCPCS,83825,Assay of mercury,,,14.63,51.09,11
HCPCS,83825,HC ASSAY OF MERCURY,171.0,119.7,,,0
HCPCS,83835,Assay of metanephrines,,,15.25,59.97,11
HCPCS,83835,HC ASSAY OF METANEPHRINES,94.0,65.8,,,0
HCPCS,83857,Assay of methemalbumin,,,9.67,59.27,11
HCPCS,83861,Microfluid analy tears,,,20.23,85.84,11
HCPCS,83864,HC MUCOPOLYSACCHARIDES ACIDE QUANT,121.0,84.7,,,0
HCPCS,83864,Mucopolysaccharides,,,25.65,109.88,11
HCPCS,83872,Assay synovial fluid mucin,,,5.27,32.36,11
HCPCS,83873,Assay of csf protein,,,15.48,207.31,11
HCPCS,83873,HC ASSAY OF CSF PROTEIN,291.0,203.7,,,0
HCPCS,83874,Assay of myoglobin,,,11.63,153.26,11
HCPCS,83874,HC ASSAY OF MYOGLOBIN,292.0,204.4,,,0
HCPCS,83876,Assay myeloperoxidase,,,45.77,89.0,11
HCPCS,83880,Assay of natriuretic peptide,,,35.33,112.71,11
HCPCS,83880,HC NATRIURETIC PEPTIDE,162.0,113.4,,,0
HCPCS,83880,HC POC BNP,162.0,113.4,,,0
HCPCS,83883,Assay nephelometry not spec,,,12.24,50.8,11
HCPCS,83883,HC ASSAY NEPHELOMETRY NES,69.0,48.3,,,0
HCPCS,83884,Assay neurflmnt light chain,,,104.61,203.4,7
HCPCS,83885,Assay of nickel,,,22.06,135.21,11
HCPCS,83885,HC ASSAY OF NICKEL,130.0,91.0,,,0
HCPCS,83915,Assay of nucleotidase,,,10.04,61.58,11
HCPCS,83915,HC 5 NUCLEOTIDASE,186.0,130.2,,,0
HCPCS,83916,HC OLIGOCLONAL BANDS,154.0,107.8,,,0
HCPCS,83916,Oligoclonal bands,,,24.65,109.58,11
HCPCS,83918,HC ORGANIC ACIDS TOTAL QUANT EA,134.0,93.8,,,0
HCPCS,83918,Organic acids total quant,,,21.24,90.87,11
HCPCS,83919,Organic acids qual each,,,14.8,90.87,11
HCPCS,83921,HC ORGANIC ACID SINGLE QUANT,209.0,146.3,,,0
HCPCS,83921,Organic acid single quant,,,19.09,70.78,11
HCPCS,83930,Assay of blood osmolality,,,5.95,66.64,11
HCPCS,83930,HC ASSAY OF BLOOD OSMOLALITY,94.0,65.8,,,0
HCPCS,83935,Assay of urine osmolality,,,6.14,66.64,11
HCPCS,83935,HC ASSAY OF URINE OSMOLALITY,94.0,65.8,,,0
HCPCS,83937,Assay of osteocalcin,,,26.86,156.0,11
HCPCS,83945,Assay of oxalate,,,13.0,113.28,11
HCPCS,83945,HC ASSAY OF OXALATE,55.0,38.5,,,0
HCPCS,83950,Oncoprotein her-2/neu,,,57.97,355.47,11
HCPCS,83951,Oncoprotein dcp,,,57.97,355.47,11
HCPCS,83970,Assay of parathormone,,,37.15,266.9,11
HCPCS,83970,HC ASSAY OF PARATHORMONE,565.0,395.5,,,0
HCPCS,83986,Assay ph body fluid nos,,,3.22,39.24,11
HCPCS,83986,HC ASSAY PH BODY FLUID NOS,55.0,38.5,,,0
HCPCS,83986,HC POC ASSAY PH BODY FLUID NOS,55.0,38.5,,,0
HCPCS,83987,Exhaled breath condensate,,,3.22,85.96,11
HCPCS,83992,Assay for phencyclidine,,,65.02,81.12,4
HCPCS,83992,HC ASSAY FOR PHENCYCLIDINE,249.0,174.3,,,0
HCPCS,83993,Assay for calprotectin fecal,,,17.67,61.9,11
HCPCS,83993,HC ASSAY FOR CALPROTECTIN FECAL,89.0,62.3,,,0
HCPCS,84030,Assay of blood pku,,,4.95,30.39,11
HCPCS,84035,Assay of phenylketones,,,3.58,20.19,11
HCPCS,84060,Assay acid phosphatase,,,6.88,40.75,11
HCPCS,84066,Assay prostate phosphatase,,,8.69,53.3,11
HCPCS,84075,Assay alkaline phosphatase,,,4.66,51.83,11
HCPCS,84075,HC ASSAY ALK PHOS ISOENZYMES,123.0,86.1,,,0
HCPCS,84078,Assay alkaline phosphatase,,,7.43,40.29,11
HCPCS,84080,Assay alkaline phosphatases,,,13.3,45.9,11
HCPCS,84080,HC ASSAY ALK PHOS ISOENZYMES,334.0,233.8,,,0
HCPCS,84081,Assay phosphatidylglycerol,,,14.87,91.17,11
HCPCS,84085,Assay of rbc pg6d enzyme,,,8.5,37.2,11
HCPCS,84087,Assay phosphohexose enzymes,,,9.66,56.96,11
HCPCS,84100,Assay of phosphorus,,,4.27,57.5,11
HCPCS,84100,HC ASSAY OF PHOSPHORUS,96.0,67.2,,,0
HCPCS,84105,Assay of urine phosphorus,,,5.2,59.23,11
HCPCS,84105,HC ASSAY OF URINE PHOSPHORUS,10.0,7.0,,,0
HCPCS,84106,Test for porphobilinogen,,,5.24,23.63,11
HCPCS,84110,Assay of porphobilinogen,,,7.6,46.65,11
HCPCS,84110,HC ASSAY OF PORPHOBILINOGEN,184.0,128.8,,,0
HCPCS,84112,Eval amniotic fluid protein,,,58.98,171.69,11
HCPCS,84112,HC EVAL AMNIOTIC FLUID PROTEIN,98.0,68.6,,,0
HCPCS,84112,HC POC EVAL CERVICOVAGINAL FLUID AMNIOTIC FLUID PROTEIN QUALITATIVE EACH SPECIMAN,98.0,68.6,,,0
HCPCS,84119,Test urine for porphyrins,,,12.02,47.51,11
HCPCS,84120,Assay of urine porphyrins,,,13.24,45.9,11
HCPCS,84120,HC ASSAY OF URINE PORPHYRINS,23.0,16.1,,,0
HCPCS,84126,Assay of feces porphyrins,,,35.2,140.58,11
HCPCS,84126,HC ASSAY OF FECES PORPHYRINS,292.0,204.4,,,0
HCPCS,84132,Assay of serum potassium,,,4.28,32.37,11
HCPCS,84132,HC POC POTASSIUM SERUM PLASMA/WHOLE BLOOD,82.0,57.4,,,0
HCPCS,84132,HC POTASSIUM SERUM PLASMA/WHOLE BLOOD,82.0,57.4,,,0
HCPCS,84133,Assay of urine potassium,,,4.26,69.6,11
HCPCS,84133,HC ASSAY OF URINE POTASSIUM,98.0,68.6,,,0
HCPCS,84134,Assay of prealbumin,,,13.13,33.32,11
HCPCS,84134,HC ASSAY OF PREALBUMIN,45.0,31.5,,,0
HCPCS,84135,Assay of pregnanediol,,,19.14,105.61,11
HCPCS,84138,Assay of pregnanetriol,,,18.94,104.52,11
HCPCS,84140,Assay of pregnenolone,,,18.6,114.12,11
HCPCS,84143,Assay of 17-hydroxypregneno,,,20.53,125.95,11
HCPCS,84143,HC ASSAY OF 17-HYDROXYPREG,109.0,76.3,,,0
HCPCS,84144,Assay of progesterone,,,18.77,110.81,11
HCPCS,84144,HC ASSAY OF PROGESTERONE,213.0,149.1,,,0
HCPCS,84145,HC PROCALCITONIN (PCT),114.0,79.8,,,0
HCPCS,84145,Procalcitonin (PCT),,,24.5,83.48,11
HCPCS,84146,Assay of prolactin,,,17.44,103.39,11
HCPCS,84146,HC ASSAY OF PROLACTIN,281.0,196.7,,,0
HCPCS,84150,Assay of prostaglandin,,,37.59,137.78,11
HCPCS,84152,Assay of psa complexed,,,16.55,101.49,11
HCPCS,84153,Assay of psa total,,,16.55,85.39,11
HCPCS,84153,HC PSA SPECIFIC ANTIGEN TOTAL,199.0,139.3,,,0
HCPCS,84154,Assay of psa free,,,16.55,60.55,11
HCPCS,84154,HC ASSAY OF PSA FREE,86.0,60.2,,,0
HCPCS,84155,Assay of protein serum,,,3.3,64.43,11
HCPCS,84155,HC ASSAY OF PROTEIN SERUM,98.0,68.6,,,0
HCPCS,84156,Assay of protein urine,,,3.3,58.9,11
HCPCS,84156,HC ASSAY OF PROTEIN URINE,89.0,62.3,,,0
HCPCS,84157,Assay of protein other,,,3.6,82.81,11
HCPCS,84157,HC ASSAY OF PROTEIN OTHER SOURCE,118.0,82.6,,,0
HCPCS,84160,Assay of protein any source,,,5.05,28.58,11
HCPCS,84163,HC PAPPA SERUM,73.0,51.1,,,0
HCPCS,84163,Pappa serum,,,13.55,83.08,11
HCPCS,84165,HC PROTEIN E-PHORESIS SERUM,218.0,152.6,,,0
HCPCS,84165,Protein e-phoresis serum,,,9.67,64.41,11
HCPCS,84166,HC PRO PROTEIN E-PHORESIS/URINE/CSF,58.0,40.6,,,0
HCPCS,84166,HC PROTEIN E-PHORESIS/URINE/CSF,86.0,60.2,,,0
HCPCS,84166,Protein e-phoresis/urine/csf,,,16.05,61.45,11
HCPCS,84181,Western blot test,,,15.33,94.01,11
HCPCS,84182,HC WESTERN BLOT TEST IMMUN PROBE,94.0,65.8,,,0
HCPCS,84182,Protein western blot test,,,26.29,99.34,11
HCPCS,84202,Assay RBC protoporphyrin,,,12.92,79.19,11
HCPCS,84202,HC ASSAY RBC PROTOPORPHYRIN,317.0,221.9,,,0
HCPCS,84203,Test RBC protoporphyrin,,,8.77,47.51,11
HCPCS,84206,Assay of proinsulin,,,24.02,55.53,11
HCPCS,84206,HC ASSAY OF PROINSULIN,242.0,169.4,,,0
HCPCS,84207,Assay of vitamin b-6,,,25.29,113.82,11
HCPCS,84207,HC ASSAY OF VITAMIN B-6,192.0,134.4,,,0
HCPCS,84210,Assay of pyruvate,,,13.03,32.58,11
HCPCS,84210,HC ASSAY OF PYRUVATE,77.0,53.9,,,0
HCPCS,84220,Assay of pyruvate kinase,,,8.5,52.05,11
HCPCS,84220,HC ASSAY OF PYRUVATE KINASE,52.0,36.4,,,0
HCPCS,84228,Assay of quinine,,,10.47,64.22,11
HCPCS,84233,Assay of estrogen,,,79.09,355.47,11
HCPCS,84234,Assay of progesterone,,,58.39,358.04,11
HCPCS,84235,Assay of endocrine hormone,,,64.11,288.83,11
HCPCS,84238,Assay nonendocrine receptor,,,32.91,308.0,11
HCPCS,84238,HC ASSAY NONENDOCRINE RECEPTOR,56.0,39.2,,,0
HCPCS,84244,Assay of renin,,,19.79,68.86,11
HCPCS,84244,HC ASSAY OF RENIN,265.0,185.5,,,0
HCPCS,84252,Assay of vitamin b-2,,,18.22,111.7,11
HCPCS,84252,HC ASSAY OF VITAMIN B-2,63.0,44.1,,,0
HCPCS,84255,Assay of selenium,,,20.18,44.68,11
HCPCS,84255,HC ASSAY OF SELENIUM,127.0,88.9,,,0
HCPCS,84260,Assay of serotonin,,,27.88,64.41,11
HCPCS,84260,HC ASSAY OF SEROTONIN,479.0,335.3,,,0
HCPCS,84270,Assay of sex hormone globul,,,19.56,82.22,11
HCPCS,84270,HC ASSAY OF SEX HORMONE GLOBUL,134.0,93.8,,,0
HCPCS,84275,Assay of sialic acid,,,12.1,74.13,11
HCPCS,84285,Assay of silica,,,22.69,129.96,11
HCPCS,84295,Assay of serum sodium,,,4.33,45.79,11
HCPCS,84295,HC ASSAY OF SERUM SODIUM,82.0,57.4,,,0
HCPCS,84295,HC POC ASSAY OF SERUM SODIUM,82.0,57.4,,,0
HCPCS,84300,Assay of urine sodium,,,4.55,58.24,11
HCPCS,84300,HC ASSAY OF URINE SODIUM,98.0,68.6,,,0
HCPCS,84302,Assay of sweat sodium,,,4.37,26.84,11
HCPCS,84302,HC ASSAY OF SODIUM OTHER SOURCE,26.0,18.2,,,0
HCPCS,84305,Assay of somatomedin,,,19.13,183.1,11
HCPCS,84305,HC ASSAY OF SOMATOMEDIN,302.0,211.4,,,0
HCPCS,84307,Assay of somatostatin,,,16.45,100.93,11
HCPCS,84307,HC ASSAY OF SOMATOSTATIN,78.0,54.6,,,0
HCPCS,84311,SPECTROPHOTOMETRY NES,13.0,9.1,,,0
HCPCS,84311,Spectrophotometry,,,7.29,64.41,11
HCPCS,84315,Body fluid specific gravity,,,2.95,13.83,11
HCPCS,84315,HC BODY FLUID SPECIF GRAV NOT URINE,13.0,9.1,,,0
HCPCS,84375,Chromatogram assay sugars,,,35.1,108.18,11
HCPCS,84376,HC SUGARS SINGLE QUAL EA,28.0,19.6,,,0
HCPCS,84376,Sugars single qual,,,4.95,30.39,11
HCPCS,84377,Sugars multiple qual,,,4.95,30.39,11
HCPCS,84378,HC SUGARS SINGLE QUANTITATIVE EA SPECIMEN,53.0,37.1,,,0
HCPCS,84378,Sugars single quant,,,10.38,63.62,11
HCPCS,84379,Sugars multiple quant,,,10.38,63.62,11
HCPCS,84392,Assay of urine sulfate,,,4.94,26.2,11
HCPCS,84393,HC TAU PHOSPHORYLATED EACH,177.0,123.9,,,0
HCPCS,84393,Tau phosphorylated ea,,,116.03,225.61,7
HCPCS,84394,HC TOTAL TAU,177.0,123.9,,,0
HCPCS,84394,Total tau,,,116.03,225.61,7
HCPCS,84402,Assay of free testosterone,,,22.92,140.54,11
HCPCS,84402,HC ASSAY OF TESTOSTERONE FREE,87.0,60.9,,,0
HCPCS,84403,Assay of total testosterone,,,23.23,102.88,11
HCPCS,84403,HC ASSAY OF TOTAL TESTOSTERONE,261.0,182.7,,,0
HCPCS,84410,Testosterone bioavailable,,,46.15,274.24,11
HCPCS,84425,ASSAY OF VITAMIN B-1,68.0,47.6,,,0
HCPCS,84425,Assay of vitamin b-1,,,19.11,72.08,11
HCPCS,84430,Assay of thiocyanate,,,10.47,202.13,11
HCPCS,84430,HC ASSAY OF THIOCYANATE,283.0,198.1,,,0
HCPCS,84431,Thromboxane urine,,,31.6,70.08,11
HCPCS,84432,Assay of thyroglobulin,,,14.45,148.57,11
HCPCS,84432,HC ASSAY OF THYROGLOBULIN,301.0,210.7,,,0
HCPCS,84433,Asy thiopurin s-mthyltrnsfrs,,,19.95,38.8,7
HCPCS,84433,HC ASSAY THIOPURINE S-METHYLTRANSFERASE,42.0,29.4,,,0
HCPCS,84436,Assay of total thyroxine,,,6.18,94.03,11
HCPCS,84436,HC ASSAY OF TOTAL THYROXINE,133.0,93.1,,,0
HCPCS,84437,Assay of neonatal thyroxine,,,5.82,35.72,11
HCPCS,84439,Assay of free thyroxine,,,8.12,73.74,11
HCPCS,84439,HC ASSAY OF FREE THYROXINE,62.0,43.4,,,0
HCPCS,84442,Assay of thyroid activity,,,13.3,81.61,11
HCPCS,84442,HC ASSAY OF THYROID ACTIVITY,124.0,86.8,,,0
HCPCS,84443,ASSAY THYROID STIM HORMONE,70.0,49.0,,,0
HCPCS,84443,Assay thyroid stim hormone,,,15.12,83.74,11
HCPCS,84445,Assay of tsi globulin,,,45.77,204.35,11
HCPCS,84445,HC ASSAY THYROID STIM IMM GLOB,673.0,471.1,,,0
HCPCS,84446,Assay of vitamin e,,,12.76,44.42,11
HCPCS,84446,HC ASSAY OF VITAMIN E,90.0,63.0,,,0
HCPCS,84449,Assay of transcortin,,,16.2,99.34,11
HCPCS,84449,HC ASSAY OF TRANSCORTIN,74.0,51.8,,,0
HCPCS,84450,HC TRANSFERASE (AST) (SGOT),123.0,86.1,,,0
HCPCS,84450,Transferase (AST) (SGOT),,,4.66,83.93,11
HCPCS,84460,ALANINE AMINO (ALT) (SGPT),123.0,86.1,,,0
HCPCS,84460,Alanine amino (ALT) (SGPT),,,4.77,84.11,11
HCPCS,84466,Assay of transferrin,,,11.48,70.71,11
HCPCS,84466,HC ASSAY OF TRANSFERRIN,142.0,99.4,,,0
HCPCS,84478,Assay of triglycerides,,,5.17,74.04,11
HCPCS,84478,HC ASSAY OF TRIGLYCERIDES,63.0,44.1,,,0
HCPCS,84479,Assay of thyroid (t3 or t4),,,5.82,36.03,11
HCPCS,84479,HC ASSAY OF THYROID (T3 OR T4),101.0,70.7,,,0
HCPCS,84480,Assay triiodothyronine (t3),,,12.76,56.31,11
HCPCS,84480,HC ASSAY TRIIODOTHYRONINE (T3) TOTAL,161.0,112.7,,,0
HCPCS,84481,Free assay (FT-3),,,15.25,99.71,11
HCPCS,84481,HC ASSAY T3 TOTAL,313.0,219.1,,,0
HCPCS,84482,HC ASSAY T3 REVERSE,26.0,18.2,,,0
HCPCS,84482,T3 reverse,,,14.18,46.64,11
HCPCS,84484,Assay of troponin quant,,,11.22,156.0,11
HCPCS,84484,HC ASSAY OF TROPONIN QUANT,223.0,156.1,,,0
HCPCS,84484,HC POC TROPONIN,223.0,156.1,,,0
HCPCS,84485,Assay duodenal fluid trypsin,,,6.48,41.43,11
HCPCS,84488,Test feces for trypsin,,,6.57,40.29,11
HCPCS,84490,Assay of feces for trypsin,,,8.94,42.0,11
HCPCS,84510,Assay of tyrosine,,,9.57,57.38,11
HCPCS,84512,Assay of troponin qual,,,9.08,42.49,11
HCPCS,84520,Assay of urea nitrogen,,,3.56,53.0,11
HCPCS,84520,HC ASSAY OF UREA NITROGEN,89.0,62.3,,,0
HCPCS,84520,HC POC ASSAY OF UREA NITROGEN,89.0,62.3,,,0
HCPCS,84525,Urea nitrogen semi-quant,,,4.62,20.75,11
HCPCS,84540,Assay of urine/urea-n,,,5.0,74.04,11
HCPCS,84540,HC ASSAY OF URINE/UREA-N,70.0,49.0,,,0
HCPCS,84545,Urea-N clearance test,,,6.48,36.44,11
HCPCS,84550,Assay of blood/uric acid,,,4.07,63.67,11
HCPCS,84550,HC ASSAY OF BLOOD/URIC ACID,116.0,81.2,,,0
HCPCS,84560,Assay of urine/uric acid,,,4.57,62.69,11
HCPCS,84560,HC ASSAY OF URIC ACID OTHER SOURCE,21.0,14.7,,,0
HCPCS,84577,Assay of feces/urobilinogen,,,15.12,68.87,11
HCPCS,84578,Test urine urobilinogen,,,4.02,17.92,11
HCPCS,84580,Assay of urine urobilinogen,,,8.6,20.0,11
HCPCS,84583,Assay of urine urobilinogen,,,5.44,27.75,11
HCPCS,84585,Assay of urine vma,,,13.95,85.58,11
HCPCS,84585,HC ASSAY OF URINE VMA,242.0,169.4,,,0
HCPCS,84586,Assay of vip,,,31.8,195.01,11
HCPCS,84586,HC ASSAY OF VIP,534.0,373.8,,,0
HCPCS,84588,Assay of vasopressin,,,30.55,180.66,11
HCPCS,84588,HC ASSAY OF VASOPRESSIN,254.0,177.8,,,0
HCPCS,84590,Assay of vitamin a,,,10.45,36.28,11
HCPCS,84590,HC ASSAY OF VITAMIN A,222.0,155.4,,,0
HCPCS,84591,ASSAY VITAMIN NOS,70.0,49.0,,,0
HCPCS,84591,Assay Of Nos Vitamin,,,15.35,64.0,11
HCPCS,84597,Assay of vitamin k,,,12.35,75.64,11
HCPCS,84597,HC ASSAY OF VITAMIN K,81.0,56.7,,,0
HCPCS,84600,Assay of volatiles,,,15.4,146.3,11
HCPCS,84620,Xylose tolerance test,,,11.62,65.36,11
HCPCS,84630,Assay of zinc,,,10.25,53.1,11
HCPCS,84630,HC ASSAY OF ZINC,222.0,155.4,,,0
HCPCS,84681,Assay of c-peptide,,,18.73,71.08,11
HCPCS,84681,HC ASSAY OF C-PEPTIDE,238.0,166.6,,,0
HCPCS,84702,CHORIONIC GONADOTROPIN QUANT,209.0,146.3,,,0
HCPCS,84702,Chorionic gonadotropin test,,,13.55,141.61,11
HCPCS,84702,HC POC B-HCG ISTAT,209.0,146.3,,,0
HCPCS,84703,Chorionic gonadotropin assay,,,6.77,71.08,11
HCPCS,84703,HC CHORIONIC GONADOTROPIN QUANL,111.0,77.7,,,0
HCPCS,84703,HC POC URINE PREGNANCY (HCG),111.0,77.7,,,0
HCPCS,84704,Hcg free betachain test,,,13.76,83.08,11
HCPCS,84830,Ovulation tests,,,11.43,55.38,11
HCPCS,84999,HC UNLISTED CHEMISTRY PROCEDURE,3653.0,2557.1,,,0
HCPCS,85002,Bleeding time test,,,4.34,24.83,11
HCPCS,85004,Automated diff wbc count,,,5.82,35.72,11
HCPCS,85004,HC BLOOD COUNT AUTOMATED DIFFERENTIAL WBC COUNT,28.0,19.6,,,0
HCPCS,85007,Bl smear w/diff wbc count,,,3.42,18.98,11
HCPCS,85008,Bl smear w/o diff wbc count,,,3.09,18.98,11
HCPCS,85009,Manual diff wbc count b-coat,,,4.56,20.53,11
HCPCS,85013,Spun microhematocrit,,,6.3,13.08,11
HCPCS,85014,HC HEMATOCRIT,48.0,33.6,,,0
HCPCS,85014,HC POC HEMATOCRIT ISTAT,48.0,33.6,,,0
HCPCS,85014,Hematocrit,,,2.13,32.49,11
HCPCS,85018,HC POC HEMOGLOBIN,49.0,34.3,,,0
HCPCS,85018,HEMOGLOBIN,49.0,34.3,,,0
HCPCS,85018,Hemoglobin,,,2.13,33.5,11
HCPCS,85025,Complete cbc w/auto diff wbc,,,6.99,68.57,11
HCPCS,85025,HC COMPLETE CBC W/AUTO DIFF WBC,66.0,46.2,,,0
HCPCS,85025,HC POC COMPLETE CBC W/AUTO DIFF WBC,66.0,46.2,,,0
HCPCS,85027,Complete cbc automated,,,5.82,46.81,11
HCPCS,85027,HC COMPLETE CBC AUTO W/O DIFF,40.0,28.0,,,0
HCPCS,85027,HC POC COMPLETE CBC AUTO W/O DIFF,40.0,28.0,,,0
HCPCS,85032,Manual cell count each,,,3.88,23.74,11
HCPCS,85041,Automated rbc count,,,2.72,16.63,11
HCPCS,85044,MANUAL RETICULOCYTE COUNT,50.0,35.0,,,0
HCPCS,85044,Manual reticulocyte count,,,3.88,23.74,11
HCPCS,85045,Automated reticulocyte count,,,3.59,53.05,11
HCPCS,85046,HC BLOOD COUNT RETICULOCYTES AUTO INCL 1 OR MORE CELLULAR PARAMETERS DIRECT MEASUREMENT,26.0,18.2,,,0
HCPCS,85046,Reticyte/hgb concentrate,,,5.01,30.81,11
HCPCS,85048,Automated leukocyte count,,,2.29,37.39,11
HCPCS,85048,HC AUTOMATED LEUKOCYTE COUNT,8.0,5.6,,,0
HCPCS,85049,Automated platelet count,,,4.03,54.79,11
HCPCS,85049,HC AUTOMATED PLATELET COUNT,77.0,53.9,,,0
HCPCS,85055,HC RETICULATED PLATELET ASSAY,114.0,79.8,,,0
HCPCS,85055,Reticulated platelet assay,,,32.17,81.44,11
HCPCS,85060,Blood smear interpretation,,,66.18,82.56,4
HCPCS,85060,HC PRO BLOOD SMEAR INTERP,77.0,53.9,,,0
HCPCS,85097,Bone marrow interpretation,,,102.87,3538.67,11
HCPCS,85097,HC PRO BONE MARROW SMEAR INTERP,283.0,198.1,,,0
HCPCS,85130,Chromogenic substrate assay,,,10.7,65.66,11
HCPCS,85130,HC CHROMOGENIC SUBSTRATE ASSAY,27.0,18.9,,,0
HCPCS,85170,Blood clot retraction,,,14.67,28.52,11
HCPCS,85175,Blood clot lysis time,,,18.33,35.65,11
HCPCS,85210,Clot factor ii prothrom spec,,,11.68,71.67,11
HCPCS,85210,HC BLOOD CLOT FACTOR II TEST,442.0,309.4,,,0
HCPCS,85220,Blooc clot factor v test,,,15.88,97.41,11
HCPCS,85220,HC BLOOD CLOT FACTOR V TEST,442.0,309.4,,,0
HCPCS,85230,Clot factor vii proconvertin,,,16.11,314.67,11
HCPCS,85230,HC BLOOD CLOT FACTOR VII TEST,39.0,27.3,,,0
HCPCS,85240,Clot factor viii ahg 1 stage,,,16.11,165.11,11
HCPCS,85240,HC BLOOD CLOT FACTOR VIII TEST,442.0,309.4,,,0
HCPCS,85244,Clot factor viii reltd antgn,,,18.38,112.68,11
HCPCS,85245,Clot factor viii vw ristoctn,,,20.65,134.38,11
HCPCS,85245,HC BLOOD CLOT FACTOR VIII VW FACTOR,486.0,340.2,,,0
HCPCS,85246,Clot factor viii vw antigen,,,20.65,91.44,11
HCPCS,85246,HC BLOOD CLOT FACTOR VIII VW ANTIGEN,180.0,126.0,,,0
HCPCS,85247,Clot factor viii multimetric,,,20.65,126.67,11
HCPCS,85247,HC VW MULTIMERS,200.0,140.0,,,0
HCPCS,85250,Clot factor ix ptc/chrstmas,,,17.14,105.05,11
HCPCS,85250,HC BLOOD CLOT FACTOR IX TEST,442.0,309.4,,,0
HCPCS,85260,Clot factor x stuart-power,,,16.11,314.67,11
HCPCS,85260,HC BLOOD CLOT FACTOR X TEST,39.0,27.3,,,0
HCPCS,85270,Clot factor xi pta,,,16.11,98.81,11
HCPCS,85270,HC BLOOD CLOT FACTOR XI TEST,39.0,27.3,,,0
HCPCS,85280,Clot factor xii hageman,,,17.42,60.71,11
HCPCS,85280,HC BLOOD CLOT FACTOR XII TEST,42.0,29.4,,,0
HCPCS,85290,Clot factor xiii fibrin stab,,,14.71,90.19,11
HCPCS,85290,HC CLOT FACTOR XIII FIBRIN STAB,35.0,24.5,,,0
HCPCS,85291,Clot factor xiii fibrin scrn,,,8.2,49.06,11
HCPCS,85292,Clot factor fletcher fact,,,17.04,104.52,11
HCPCS,85292,HC CLOTTING PREKALLIKREIN ASSAY,96.0,67.2,,,0
HCPCS,85293,Clot factor wght kininogen,,,17.04,104.52,11
HCPCS,85300,ANTITHROMBIN III TEST,261.0,182.7,,,0
HCPCS,85300,Antithrombin iii activity,,,10.66,146.04,11
HCPCS,85301,Antithrombin iii antigen,,,9.73,59.69,11
HCPCS,85302,Clot inhibit prot c antigen,,,10.81,39.24,11
HCPCS,85303,BLOOD CLOT INHIBITOR C ACTIVITY,442.0,309.4,,,0
HCPCS,85303,Clot inhibit prot c activity,,,12.46,234.46,11
HCPCS,85305,Clot inhibit prot s total,,,10.45,64.0,11
HCPCS,85306,BLOOD CLOT INHIBITOR S FREE,180.0,126.0,,,0
HCPCS,85306,Clot inhibit prot s free,,,13.79,109.33,11
HCPCS,85307,Assay Activated Protein C,,,13.79,84.56,11
HCPCS,85307,HC ASSAY ACTIVATED PROTEIN C,24.0,16.8,,,0
HCPCS,85335,Factor inhibitor test,,,11.58,71.06,11
HCPCS,85335,HC FACTOR INHIBITOR TEST,118.0,82.6,,,0
HCPCS,85337,Thrombomodulin,,,15.54,57.53,11
HCPCS,85345,Coagulation time lee & white,,,4.22,23.74,11
HCPCS,85347,Coagulation time activated,,,3.85,44.42,11
HCPCS,85347,HC POC COAGULATION TIME ACTIVATED,63.0,44.1,,,0
HCPCS,85348,Coagulation time otr method,,,4.04,20.56,11
HCPCS,85360,Euglobulin lysis,,,7.57,46.34,11
HCPCS,85362,Fibrin degradation products,,,6.2,32.89,11
HCPCS,85366,Fibrinogen test,,,38.09,140.8,11
HCPCS,85370,Fibrinogen test,,,11.19,62.67,11
HCPCS,85378,Fibrin degrade semiquant,,,8.75,39.35,11
HCPCS,85379,Fibrin degradation quant,,,9.16,116.69,11
HCPCS,85379,HC FIBRIN DEGRADATION QUANT,162.0,113.4,,,0
HCPCS,85379,HC POC D-DIMER TRIAGE,162.0,113.4,,,0
HCPCS,85380,Fibrin degradj d-dimer,,,9.16,56.13,11
HCPCS,85384,Fibrinogen activity,,,8.75,83.91,11
HCPCS,85384,HC FIBRINOGEN,138.0,96.6,,,0
HCPCS,85385,Fibrinogen antigen,,,13.01,46.87,11
HCPCS,85390,Fibrinolysins screen i&r,,,13.06,27.09,11
HCPCS,85390,HC FIBRINOLYSINS OR COAGULOPATHY SCREEN INTERP AND REPORT,68.0,47.6,,,0
HCPCS,85390,HC PRO FIBRINOLYSINS OR COAGULOPATHY SCREEN INTERP AND REPORT,20.0,14.0,,,0
HCPCS,85396,HC COAGULATION/FIBRINOLYSIS ASSAY WHOLE BLOOD INCL INTERP/REPORT ADDITIVE/DAY,82.0,57.4,,,0
HCPCS,85397,Clotting funct activity,,,27.77,126.67,11
HCPCS,85397,HC CLOTTING FUNCT ACTIVITY NOS,64.0,44.8,,,0
HCPCS,85400,Fibrinolytic plasmin,,,6.94,48.8,11
HCPCS,85410,Fibrinolytic antiplasmin,,,6.94,42.56,11
HCPCS,85410,HC FIBRINOLYTIC ANTIPLASMIN,18.0,12.6,,,0
HCPCS,85415,Fibrinolytic plasminogen,,,15.47,94.88,11
HCPCS,85415,HC FIBRINOLYTIC PLASMINOGEN,89.0,62.3,,,0
HCPCS,85420,Fibrinolytic plasminogen,,,5.88,20.73,11
HCPCS,85420,HC FIBRINOLYTIC PLASMINOGEN,289.0,202.3,,,0
HCPCS,85421,Fibrinolytic plasminogen,,,9.16,56.21,11
HCPCS,85441,Heinz bodies direct,,,3.78,23.21,11
HCPCS,85445,Heinz bodies induced,,,6.14,37.61,11
HCPCS,85460,HC HEMOGLOBIN FETAL,227.0,158.9,,,0
HCPCS,85460,Hemoglobin fetal,,,6.96,162.15,11
HCPCS,85461,HC HEMOGLOBIN FETAL ROSETTE,67.0,46.9,,,0
HCPCS,85461,Hemoglobin fetal,,,8.42,48.13,11
HCPCS,85475,Hemolysin acid,,,7.98,48.95,11
HCPCS,85520,HC HEPARIN ASSAY,89.0,62.3,,,0
HCPCS,85520,HC POC HEPARIN ASSAY,89.0,62.3,,,0
HCPCS,85520,Heparin assay,,,11.78,63.67,11
HCPCS,85525,Heparin neutralization,,,10.66,65.39,11
HCPCS,85530,HC POC HEPARIN PROTAMINE TOLERANCE TEST,66.0,46.2,,,0
HCPCS,85530,Heparin-protamine tolerance,,,11.78,78.25,11
HCPCS,85536,Iron Stain Peripheral Blood,,,6.19,35.72,11
HCPCS,85540,Wbc alkaline phosphatase,,,7.74,47.48,11
HCPCS,85547,RBC mechanical fragility,,,7.74,47.48,11
HCPCS,85549,HC MURAMIDASE,218.0,152.6,,,0
HCPCS,85549,Muramidase,,,16.88,103.53,11
HCPCS,85555,HC RBC OSMOTIC FRAGILITY,46.0,32.2,,,0
HCPCS,85555,RBC osmotic fragility,,,6.72,32.58,11
HCPCS,85557,RBC osmotic fragility,,,12.02,73.71,11
HCPCS,85576,Blood platelet aggregation,,,22.42,442.38,11
HCPCS,85576,HC BLOOD PLATELET AGGREGATION,496.0,347.2,,,0
HCPCS,85597,Phospholipid pltlt neutraliz,,,16.18,56.86,11
HCPCS,85598,Hexagnal phosph pltlt neutrl,,,16.18,31.46,7
HCPCS,85610,HC POC PROTHROMBIN TIME,35.0,24.5,,,0
HCPCS,85610,HC PROTHROMBIN TIME,35.0,24.5,,,0
HCPCS,85610,Prothrombin time,,,3.86,41.45,11
HCPCS,85611,Prothrombin test,,,3.55,21.74,11
HCPCS,85612,Viper venom prothrombin time,,,15.74,52.81,11
HCPCS,85613,RUSSELL VIPER VENOM DILUTED,295.0,206.5,,,0
HCPCS,85613,Russell viper venom diluted,,,8.62,146.07,11
HCPCS,85635,Reptilase test,,,8.86,54.36,11
HCPCS,85651,HC RBC SED RATE NONAUTOMATED,91.0,63.7,,,0
HCPCS,85651,Rbc sed rate nonautomated,,,3.84,40.77,11
HCPCS,85652,HC RBC SED RATE AUTOMATED,99.0,69.3,,,0
HCPCS,85652,Rbc sed rate automated,,,2.43,56.04,11
HCPCS,85660,HC RBC SICKLE CELL TEST,77.0,53.9,,,0
HCPCS,85660,RBC sickle cell test,,,4.96,30.47,11
HCPCS,85670,HC THROMBIN TIME PLASMA,169.0,118.3,,,0
HCPCS,85670,Thrombin time plasma,,,5.19,86.63,11
HCPCS,85675,Thrombin time titer,,,6.16,37.8,11
HCPCS,85705,Thromboplastin inhibition,,,8.67,53.15,11
HCPCS,85730,HC THROMBOPLASTIN TIME PARTIAL (PTT) PLASMA OR WHOLE BLOOD,84.0,58.8,,,0
HCPCS,85730,Thromboplastin time partial,,,5.41,57.42,11
HCPCS,85732,Thromboplastin time partial,,,5.82,35.72,11
HCPCS,85810,Blood viscosity examination,,,10.5,144.38,11
HCPCS,85810,HC BLOOD VISCOSITY EXAMINATION,136.0,95.2,,,0
HCPCS,86000,Agglutinins febrile antigen,,,6.28,38.52,11
HCPCS,86000,HC AGGLUTININS FEBRILE,246.0,172.2,,,0
HCPCS,86001,Allergen Specific Igg,,,7.04,16.29,11
HCPCS,86001,HC ALLERGEN SPECIFIC IGG,20.0,14.0,,,0
HCPCS,86003,Allergen specific IgE,,,4.7,34.72,11
HCPCS,86003,HC ALLERGEN SPECIFIC IGE QUANTITATIVE/SEMIQUANTITATIVE CRUDE ALLERGEN EXTRACT EACH,94.0,65.8,,,0
HCPCS,86005,Allergen specific IgE,,,7.17,44.0,11
HCPCS,86008,Allg spec ige recomb ea,,,16.14,31.38,7
HCPCS,86008,HC ALLERGEN SPECIFIC IGE QUANTITATIVES/SEMIQUANTITATIVE RECOMBINAT/PURIFIED COMPONENT EACH,76.0,53.2,,,0
HCPCS,86015,Actin antibody each,,,10.84,43.58,11
HCPCS,86015,HC ACTIN SMOOTH MUSCLE ANTIBODY EACH,28.0,19.6,,,0
HCPCS,86021,HC WBC ANTIBODY IDENTIFICATION,146.0,102.2,,,0
HCPCS,86021,WBC antibody identification,,,13.55,140.3,11
HCPCS,86022,HC PLATELET ANTIBODIES,244.0,170.8,,,0
HCPCS,86022,Platelet antibodies,,,16.53,176.58,11
HCPCS,86023,HC PLATELET IMMUNOGLOB ASSAY,104.0,72.8,,,0
HCPCS,86023,Immunoglobulin assay,,,11.21,83.66,11
HCPCS,86036,Anca screen each antibody,,,10.84,45.55,11
HCPCS,86036,HC ANTINEUTROPHIL CYTOPLASMI ANTB SCREEN EA ANTIBODY,29.0,20.3,,,0
HCPCS,86037,Anca titer each antibody,,,10.84,45.55,11
HCPCS,86037,HC ANTINEUTROPHIL CYTOPLASMIC ANTB TITER EACH ANTIBODY,29.0,20.3,,,0
HCPCS,86038,Antinuclear antibodies,,,10.88,56.74,11
HCPCS,86038,HC ANTINUCLEAR ANTIBODIES (ANA),136.0,95.2,,,0
HCPCS,86039,Antinuclear antibodies (ANA),,,10.04,59.68,11
HCPCS,86039,HC ANTINUCLEAR ANTIBODIES (ANA) TITER,213.0,149.1,,,0
HCPCS,86041,Acetylcholn rcptr bndng antb,,,16.56,32.2,7
HCPCS,86041,HC ACETYLCHOLINE RECEPTOR BINDING ANTIBODY,78.0,54.6,,,0
HCPCS,86042,Acetylcholn rcptr blckg antb,,,16.56,32.2,7
HCPCS,86042,HC ACETYLCHOLINE RECEPTOR BLOCKING ANTIBODY,78.0,54.6,,,0
HCPCS,86043,Acetylcholn rcptr modlg antb,,,10.84,21.09,7
HCPCS,86043,HC ACETYLCHOLINE RECEPTOR MODULATING ANTIBODY,51.0,35.7,,,0
HCPCS,86051,Aquaporin-4 antb elisa,,,10.38,43.58,11
HCPCS,86051,HC AQUAPORIN-4 ANTIBODY ELISA,28.0,19.6,,,0
HCPCS,86052,Aquaporin-4 antb cba each,,,10.84,45.55,11
HCPCS,86052,HC AQUAPORIN-4 ANTIBODY CELL-BASED IMFLUOR ASSAY EA,53.0,37.1,,,0
HCPCS,86053,Aqaprn-4 antb flo cytmtry ea,,,33.96,66.03,11
HCPCS,86053,HC QUAPORIN-4 ANITBODY FLOW CYTOMETRY EACH,29.0,20.3,,,0
HCPCS,86060,Antistreptolysin o titer,,,6.57,85.04,11
HCPCS,86060,HC ANTISTREPTOLYSIN O TITER,90.0,63.0,,,0
HCPCS,86063,Antistreptolysin o screen,,,5.19,31.9,11
HCPCS,86077,Phys blood bank serv xmatch,,,28.63,127.04,11
HCPCS,86078,HC BLOOD BANK PHYS SERV INVEST TRANSFUSION REACT INCL INTERP & REPORT,91.0,63.7,,,0
HCPCS,86078,Phys blood bank serv reactj,,,102.87,748.29,11
HCPCS,86079,Phys blood bank serv authrj,,,47.96,228.88,11
HCPCS,86140,C-reactive protein,,,4.66,21.5,11
HCPCS,86140,HC C-REACTIVE PROTEIN FOR DETECTION OF INFECTION/INFLAMMATION,20.0,14.0,,,0
HCPCS,86141,C-reactive protein hs,,,11.66,45.9,11
HCPCS,86141,HC C-REACTIVE PROTEIN HIGH SENSIT,69.0,48.3,,,0
HCPCS,86146,Beta-2 glycoprotein antibody,,,22.9,86.51,11
HCPCS,86146,GLYCOPROTEIN ANTIBODY,138.0,96.6,,,0
HCPCS,86147,CARDIOLIPIN ANTIBODY EA IG CLASS,618.0,432.6,,,0
HCPCS,86147,Cardiolipin antibody ea ig,,,22.9,318.92,11
HCPCS,86148,Anti-phospholipid antibody,,,14.46,88.64,11
HCPCS,86152,Cell enumeration & id,,,38.51,438.86,11
HCPCS,86153,Cell enumeration phys interp,,,38.51,48.04,4
HCPCS,86155,Chemotaxis assay,,,14.39,88.19,11
HCPCS,86156,Cold agglutinin screen,,,7.26,36.97,11
HCPCS,86157,COLD AGGLUTININ TITER,44.0,30.8,,,0
HCPCS,86157,Cold agglutinin titer,,,7.25,25.17,11
HCPCS,86160,Complement antigen,,,10.8,93.61,11
HCPCS,86160,HC COMPLEMENT ANTIGEN EA COMP,279.0,195.3,,,0
HCPCS,86161,Complement/function activity,,,10.8,57.75,11
HCPCS,86161,HC COMPLEMENT/FUNCTION ACTIVITY,90.0,63.0,,,0
HCPCS,86162,Complement total (ch50),,,18.29,86.77,11
HCPCS,86162,HC COMPLEMENT TOTAL (CH50),91.0,63.7,,,0
HCPCS,86171,Complement fixation each,,,9.01,55.3,11
HCPCS,86200,Ccp antibody,,,11.66,46.18,11
HCPCS,86200,HC CCP ANTIBODY,87.0,60.9,,,0
HCPCS,86215,Deoxyribonuclease antibody,,,11.92,163.63,11
HCPCS,86215,HC DEOXYRIBONUCLEASE ANTIBODY,444.0,310.8,,,0
HCPCS,86225,Dna antibody native,,,12.37,83.29,11
HCPCS,86225,HC DNA ANTIBODY,181.0,126.7,,,0
HCPCS,86226,Dna antibody single strand,,,10.9,66.83,11
HCPCS,86231,Ema each ig class,,,10.88,45.7,11
HCPCS,86231,HC ENDOMYSIAL ANTIBODY EACH IMMUNOGLOBULIN CLASS,29.0,20.3,,,0
HCPCS,86235,HC NUCLEAR ANTIGEN ANTIBODY,279.0,195.3,,,0
HCPCS,86235,Nuclear antigen antibody,,,16.14,74.52,11
HCPCS,86255,FLUORES ANTIBODY SCREEN EA,361.0,252.7,,,0
HCPCS,86255,Fluorescent antibody screen,,,10.84,127.68,11
HCPCS,86256,Fluorescent antibody titer,,,10.84,73.3,11
HCPCS,86256,HC FLUORES ANTIBODY TITER  EA ANTI,128.0,89.6,,,0
HCPCS,86258,Dgp antibody each ig class,,,10.84,43.58,11
HCPCS,86258,HC GLIADIN ANTIBODY EACH IMMUNOGLOBULIN CLASS,28.0,19.6,,,0
HCPCS,86277,Growth hormone antibody,,,14.17,86.86,11
HCPCS,86280,Hemagglutination inhibition,,,7.37,45.21,11
HCPCS,86294,Immunoassay tumor qual,,,23.01,63.73,11
HCPCS,86300,HC IMMUNOA TUMOR ANTIGENCA15-3,242.0,169.4,,,0
HCPCS,86300,Immunoassay tumor ca 15-3,,,18.73,116.69,11
HCPCS,86301,HC IMMUNOA TUMOR ANTIGENCA19-9,361.0,252.7,,,0
HCPCS,86301,Immunoassay tumor ca 19-9,,,18.73,232.48,11
HCPCS,86304,HC IMMUNOA TUMOR ANTIGENCA125,361.0,252.7,,,0
HCPCS,86304,Immunoassay tumor ca 125,,,18.73,181.15,11
HCPCS,86305,HC HUMAN EPIDIDYMIS PROTEIN 4,98.0,68.6,,,0
HCPCS,86305,Human epididymis protein 4,,,18.73,57.83,11
HCPCS,86308,HC HETEROPHILE ANTIBODIES,144.0,100.8,,,0
HCPCS,86308,Heterophile antibody screen,,,4.66,71.92,11
HCPCS,86309,Heterophile antibody titer,,,5.82,35.72,11
HCPCS,86310,Heterophile antibody absrbj,,,6.63,40.71,11
HCPCS,86316,HC IMMUNOA TUMOR ANTIGEN OTHER,229.0,160.3,,,0
HCPCS,86316,Immunoassay tumor other,,,18.73,65.15,11
HCPCS,86317,HC IMMUNOASSAY INFECTIOUS AGENT,75.0,52.5,,,0
HCPCS,86317,Immunoassay infectious agent,,,13.49,48.13,11
HCPCS,86318,Immunoassay infectious agent,,,16.28,71.48,11
HCPCS,86320,Serum immunoelectrophoresis,,,26.93,123.68,11
HCPCS,86325,Other immunoelectrophoresis,,,20.82,123.42,11
HCPCS,86327,Immunoelectrophoresis assay,,,100.38,125.23,4
HCPCS,86328,Ia nfct ab sarscov2 covid19,,,40.75,170.97,11
HCPCS,86329,Immunodiffusion nes,,,12.65,77.53,11
HCPCS,86331,IMMUNODIFFUSION GEL DIFF EA,104.0,72.8,,,0
HCPCS,86331,Immunodiffusion ouchterlony,,,10.78,56.76,11
HCPCS,86332,HC IMMUNE COMPLEX ASSAY,758.0,530.6,,,0
HCPCS,86332,Immune complex assay,,,21.93,134.53,11
HCPCS,86334,IMMUNOFIX E-PHORESIS SERUM,291.0,203.7,,,0
HCPCS,86334,Immunofix e-phoresis serum,,,20.11,281.35,11
HCPCS,86335,HC IMMUNFIX E-PHORSIS/URINE/CSF,87.0,60.9,,,0
HCPCS,86335,HC PRO IMMNFIX ELECT OTR FLUID PATH INTERP,25.0,17.5,,,0
HCPCS,86335,Immunfix e-phorsis/urine/csf,,,26.42,161.97,11
HCPCS,86336,HC INHIBIN A,108.0,75.6,,,0
HCPCS,86336,Inhibin A,,,14.03,60.42,11
HCPCS,86337,HC INSULIN ANTIBODIES,359.0,251.3,,,0
HCPCS,86337,Insulin antibodies,,,19.27,66.64,11
HCPCS,86340,HC INTRINSIC FACTOR ANTIBODY,55.0,38.5,,,0
HCPCS,86340,Intrinsic factor antibody,,,13.57,217.67,11
HCPCS,86341,HC ISLET CELL ANTIBODY,97.0,67.9,,,0
HCPCS,86341,Islet cell antibody,,,21.21,61.64,11
HCPCS,86343,Leukocyte histamine release,,,11.21,68.8,11
HCPCS,86344,Leukocyte phagocytosis,,,9.35,44.07,11
HCPCS,86352,Cell function assay w/stim,,,122.27,237.76,11
HCPCS,86352,HC CELL FUNCTION ASSAY W/STIM,346.0,242.2,,,0
HCPCS,86353,HC LYMPHOCYTE TRANSFORMATION,414.0,289.8,,,0
HCPCS,86353,Lymphocyte transformation,,,44.13,270.57,11
HCPCS,86355,B cells total count,,,33.96,169.12,11
HCPCS,86355,HC B CELLS TOTAL COUNT,145.0,101.5,,,0
HCPCS,86356,HC MONONUCLEAR CELL ANTIGEN,122.0,85.4,,,0
HCPCS,86356,HC POC MONONUCLEAR CELL ANTIGEN,114.0,79.8,,,0
HCPCS,86356,Mononuclear cell antigen,,,24.1,78.48,11
HCPCS,86357,HC NK CELLS TOTAL COUNT,145.0,101.5,,,0
HCPCS,86357,Nk cells total count,,,33.96,169.12,11
HCPCS,86359,HC T CELLS TOTAL COUNT,145.0,101.5,,,0
HCPCS,86359,T cells total count,,,33.96,169.12,11
HCPCS,86360,HC T CELL ABSOLUTE COUNT/RATIO,92.0,64.4,,,0
HCPCS,86360,T cell absolute count/ratio,,,42.28,259.31,11
HCPCS,86361,T CELL ABSOLUTE CD4 COUNT,398.0,278.6,,,0
HCPCS,86361,T cell absolute count,,,24.1,256.18,11
HCPCS,86362,Mog-igg1 antb cba each,,,10.84,45.55,11
HCPCS,86363,HC MYELIN OLIGODENDROCYTE GLYCOPROTEIN ANTIBODY FLOW SYTOMETRY EACH,29.0,20.3,,,0
HCPCS,86363,Mog-igg1 antb flo cytmtry ea,,,33.96,66.03,11
HCPCS,86364,HC TISSUE TRANSGLTMNASE EA IMMUNOGLOBULIN CLASS,28.0,19.6,,,0
HCPCS,86364,Tiss trnsgltmnase ea ig clas,,,10.38,43.58,11
HCPCS,86366,HC MUSCLE-SPECIFIC KINASE ANTIBODY,78.0,54.6,,,0
HCPCS,86366,Muscle-specific kinase antb,,,16.56,32.2,7
HCPCS,86367,Stem cells total count,,,70.0,169.12,11
HCPCS,86376,HC MICROSOMAL ANTIBODY,106.0,74.2,,,0
HCPCS,86376,Microsomal antibody each,,,13.1,53.14,11
HCPCS,86381,HC MITOCHONDRIAL ANTIBODY EACH,61.0,42.7,,,0
HCPCS,86381,Mitochondrial antibody each,,,22.9,96.2,11
HCPCS,86382,HC NEUTRALIZATION TEST VIRAL,170.0,119.0,,,0
HCPCS,86382,Neutralization test viral,,,15.22,93.33,11
HCPCS,86384,Nitroblue tetrazolium dye,,,12.25,62.86,11
HCPCS,86386,Nuclear matrix protein 22,,,19.6,82.97,11
HCPCS,86403,Particle agglut antbdy scrn,,,10.39,25.17,11
HCPCS,86406,Particle agglut antbdy titr,,,9.58,58.7,11
HCPCS,86408,Neutrlzg antb sarscov2 scr,,,37.92,159.25,11
HCPCS,86409,Neutrlzg antb sarscov2 titer,,,71.65,398.15,11
HCPCS,86413,Sars-cov-2 antb quantitative,,,46.29,159.25,11
HCPCS,86430,Rheumatoid factor test qual,,,5.53,31.34,11
HCPCS,86431,HC RHEUMATOID FACTOR QUANT,116.0,81.2,,,0
HCPCS,86431,Rheumatoid factor quant,,,5.1,46.33,11
HCPCS,86480,HC TB TEST CELL IMMUN MEASURE,324.0,226.8,,,0
HCPCS,86480,Tb test cell immun measure,,,55.78,193.7,11
HCPCS,86481,Tb ag response t-cell susp,,,90.0,175.0,7
HCPCS,86485,Skin test candida,,,16.91,127.04,11
HCPCS,86486,HC POC SKIN TEST NOS ANTIGEN,17.0,11.9,,,0
HCPCS,86486,Skin test nos antigen,,,14.06,127.04,11
HCPCS,86490,Coccidioidomycosis skin test,,,16.91,21.09,4
HCPCS,86510,Histoplasmosis skin test,,,16.91,164.05,11
HCPCS,86580,HC POC TB INTRADERMAL TEST,70.0,49.0,,,0
HCPCS,86580,HC TB INTRADERMAL TEST,70.0,49.0,,,0
HCPCS,86580,TB intradermal test,,,11.28,127.04,11
HCPCS,86581,HC STREPTOCOCCUS PNEUM ANTIBODY IGG SEROTYPES MLT IMMUNOASSAY QUAN,56.0,39.2,,,0
HCPCS,86581,Strptcs pneum antb serot ia,,,82.83,161.05,7
HCPCS,86590,Streptokinase antibody,,,11.39,60.9,11
HCPCS,86592,HC SYPHILIS TEST NON-TREP QUAL,115.0,80.5,,,0
HCPCS,86592,Syphilis test non-trep qual,,,3.84,74.04,11
HCPCS,86593,HC SYPHILIS TEST NON-TREP QUANT,26.0,18.2,,,0
HCPCS,86593,Syphilis test non-trep quant,,,3.96,14.07,11
HCPCS,86596,HC VOLTAGE-GATED CALCIUM CHANNEL ANTIBODY EACH,44.0,30.8,,,0
HCPCS,86596,Voltage-gtd ca chnl antb ea,,,10.84,69.55,11
HCPCS,86602,Antinomyces antibody,,,9.16,50.61,11
HCPCS,86603,Adenovirus antibody,,,11.58,71.03,11
HCPCS,86606,Aspergillus antibody,,,13.55,112.54,11
HCPCS,86606,HC ASPERGILLUS ANTIBODY,175.0,122.5,,,0
HCPCS,86609,Bacterium antibody,,,11.59,53.26,11
HCPCS,86609,HC BACTERIUM ANTIBODY NES,130.0,91.0,,,0
HCPCS,86611,Bartonella Antibody,,,9.16,64.41,11
HCPCS,86611,HC BARTONELLA ANTIBODY,100.0,70.0,,,0
HCPCS,86612,Blastomyces antibody,,,11.61,122.9,11
HCPCS,86612,HC BLASTOMYCES ANTIBODY,191.0,133.7,,,0
HCPCS,86615,BORDETELLA ANTIBODY,135.0,94.5,,,0
HCPCS,86615,Bordetella antibody,,,11.87,72.77,11
HCPCS,86617,HC LYME DISEASE ANTIBODY CONFIRMATORY,85.0,59.5,,,0
HCPCS,86617,Lyme disease antibody,,,13.94,45.9,11
HCPCS,86618,HC LYME DISEASE ANTIBODY,320.0,224.0,,,0
HCPCS,86618,Lyme disease antibody,,,15.33,190.65,11
HCPCS,86619,Borrelia antibody,,,12.04,73.86,11
HCPCS,86622,Brucella antibody,,,8.04,49.33,11
HCPCS,86622,HC BRUCELLA ANTIBODY,106.0,74.2,,,0
HCPCS,86625,Campylobacter antibody,,,11.81,72.42,11
HCPCS,86625,HC CAMPYLOBACTER ANTIBODY,70.0,49.0,,,0
HCPCS,86628,Candida antibody,,,10.81,45.9,11
HCPCS,86628,HC CANDIDA ANTIBODY,71.0,49.7,,,0
HCPCS,86631,Chlamydia antibody,,,10.64,72.56,11
HCPCS,86631,HC CHLAMYDIA ANTIBODY,113.0,79.1,,,0
HCPCS,86632,Chlamydia igm antibody,,,11.41,60.71,11
HCPCS,86632,HC CHLAMYDIA IGM ANTIBODY,94.0,65.8,,,0
HCPCS,86635,Coccidioides antibody,,,10.32,205.09,11
HCPCS,86635,HC COCCIDIOIDES ANTIBODY,443.0,310.1,,,0
HCPCS,86638,HC Q FEVER ANTIBODY,22.0,15.4,,,0
HCPCS,86638,Q fever antibody,,,10.91,131.05,11
HCPCS,86641,Cryptococcus antibody,,,12.97,79.57,11
HCPCS,86644,CMV antibody,,,12.95,70.55,11
HCPCS,86644,HC CMV ANTIBODY,139.0,97.3,,,0
HCPCS,86645,Cmv antibody igm,,,15.16,49.24,11
HCPCS,86645,HC CMV ANTIBODY IGM,71.0,49.7,,,0
HCPCS,86648,Diphtheria antibody,,,13.69,83.95,11
HCPCS,86651,Encephalitis californ antbdy,,,11.87,72.77,11
HCPCS,86651,HC ENCEPHALITIS ANTIBODY CALIF,72.0,50.4,,,0
HCPCS,86652,Encephaltis east eqne anbdy,,,11.87,72.77,11
HCPCS,86652,HC ENCEPHALITIS ANTIBODY EAST EQUIN,72.0,50.4,,,0
HCPCS,86653,Encephaltis st louis antbody,,,11.87,72.77,11
HCPCS,86653,HC ENCEPHALITIS ANTIBODY ST LOUIS,72.0,50.4,,,0
HCPCS,86654,Encephaltis west eqne antbdy,,,11.87,72.77,11
HCPCS,86654,HC ENCEPHALITIS ANTIBODY WESTERN,72.0,50.4,,,0
HCPCS,86658,Enterovirus antibody,,,11.73,58.98,11
HCPCS,86658,HC ENTEROVIRUS ANTIBODY,106.0,74.2,,,0
HCPCS,86663,Epstein-barr antibody,,,11.81,82.18,11
HCPCS,86663,HC EPSTEIN-BARR EARLY ANTIGEN,128.0,89.6,,,0
HCPCS,86664,Epstein-barr nuclear antigen,,,13.76,82.18,11
HCPCS,86664,HC EPSTEIN-BARR NUCLEAR ANTIGEN,128.0,89.6,,,0
HCPCS,86665,Epstein-barr capsid vca,,,16.33,74.99,11
HCPCS,86665,HC EPSTEIN-BARR VIRAL CAPSID,128.0,89.6,,,0
HCPCS,86666,Ehrlichia Antibody,,,9.16,43.68,11
HCPCS,86666,HC EHRLICHIA ANTIBODY,68.0,47.6,,,0
HCPCS,86668,Francisella tularensis,,,12.74,57.38,11
HCPCS,86668,HC FRANCISELLA TULARENSIS,246.0,172.2,,,0
HCPCS,86671,Fungus nes antibody,,,11.02,38.5,11
HCPCS,86671,HC FUNGUS ANTIBODY NES,260.0,182.0,,,0
HCPCS,86674,Giardia lamblia antibody,,,13.25,81.27,11
HCPCS,86674,HC GIARDIA LAMBLIA ANTIBODY,97.0,67.9,,,0
HCPCS,86677,Helicobacter pylori antibody,,,15.16,83.19,11
HCPCS,86682,HC HELMINTH ANTIBODY,132.0,92.4,,,0
HCPCS,86682,Helminth antibody,,,11.71,85.14,11
HCPCS,86684,Hemophilus influenza antibdy,,,14.26,87.43,11
HCPCS,86687,Htlv-i antibody,,,8.18,46.31,11
HCPCS,86688,Htlv-ii antibody,,,12.6,35.42,11
HCPCS,86689,HTLV/HIV CONFIRMATORY TEST,606.0,424.2,,,0
HCPCS,86689,Htlv/hiv confirmj antibody,,,17.42,322.81,11
HCPCS,86692,HC ANTIBODY HEPATITIS DELTA AGENT,87.0,60.9,,,0
HCPCS,86692,Hepatitis delta agent antbdy,,,15.44,94.73,11
HCPCS,86694,HC HERPES SIMPLEX TEST NONSPECIFIC,401.0,280.7,,,0
HCPCS,86694,Herpes simplex nes antbdy,,,12.95,71.82,11
HCPCS,86695,HC HERPES SIMPLEX TYPE 1,85.0,59.5,,,0
HCPCS,86695,Herpes simplex type 1 test,,,11.87,45.23,11
HCPCS,86696,HC HERPES SIMPLEX TYPE 2,104.0,72.8,,,0
HCPCS,86696,Herpes simplex type 2 test,,,17.42,59.64,11
HCPCS,86698,HC HISTOPLASMA,63.0,44.1,,,0
HCPCS,86698,Histoplasma antibody,,,12.41,59.97,11
HCPCS,86701,Hiv-1antibody,,,8.0,48.99,11
HCPCS,86702,Hiv-2 antibody,,,12.17,74.62,11
HCPCS,86703,HC HIV-1/HIV-2 SINGLE RESULT,63.0,44.1,,,0
HCPCS,86703,Hiv-1/hiv-2 1 result antbdy,,,12.34,40.09,11
HCPCS,86704,HC HEP B CORE ANTIBODY TOTAL,58.0,40.6,,,0
HCPCS,86704,Hep b core antibody total,,,10.84,36.28,11
HCPCS,86705,HC HEP B CORE ANTIBODY IGM,187.0,130.9,,,0
HCPCS,86705,Hep b core antibody igm,,,10.59,37.02,11
HCPCS,86706,HC HEP B SURFACE ANTIBODY,224.0,156.8,,,0
HCPCS,86706,Hep b surface antibody,,,9.67,58.79,11
HCPCS,86707,HC HEP B ANTIBODY,187.0,130.9,,,0
HCPCS,86707,Hepatitis be antibody,,,10.41,36.28,11
HCPCS,86708,HC HEP A ANTIBODY TOTAL,70.0,49.0,,,0
HCPCS,86708,Hepatitis a antibody,,,11.15,33.32,11
HCPCS,86709,HC HEP A ANTIBODY IGM,121.0,84.7,,,0
HCPCS,86709,Hepatitis a igm antibody,,,10.13,37.51,11
HCPCS,86710,HC INFLUENZA VIRUS ANTIBODY,129.0,90.3,,,0
HCPCS,86710,Influenza virus antibody,,,12.2,82.92,11
HCPCS,86711,HC ANTIBODY JC (JOHN CUNNINGHAM) VIRUS,30.0,21.0,,,0
HCPCS,86711,John cunningham antibody,,,15.2,93.06,11
HCPCS,86713,HC LEGIONELLA ANTIBODY,132.0,92.4,,,0
HCPCS,86713,Legionella antibody,,,13.77,84.48,11
HCPCS,86717,HC LEISHMANIA ANTIBODY,47.0,32.9,,,0
HCPCS,86717,Leishmania antibody,,,11.02,50.61,11
HCPCS,86720,HC LEPTOSPIRA ANTIBODY,196.0,137.2,,,0
HCPCS,86720,Leptospira antibody,,,14.58,72.77,11
HCPCS,86723,Listeria monocytogenes,,,11.87,39.98,11
HCPCS,86727,HC LYMPH CHORIOMENINGITIS,72.0,50.4,,,0
HCPCS,86727,Lymph choriomeningitis ab,,,11.58,71.03,11
HCPCS,86732,Mucormycosis antibody,,,13.5,72.77,11
HCPCS,86735,HC MUMPS ANTIBODY,240.0,168.0,,,0
HCPCS,86735,Mumps antibody,,,11.74,49.7,11
HCPCS,86738,HC MYCOPLASMA ANTIBODY,132.0,92.4,,,0
HCPCS,86738,Mycoplasma antibody,,,11.92,77.0,11
HCPCS,86741,Neisseria meningitidis,,,11.87,72.77,11
HCPCS,86744,Nocardia antibody,,,14.39,72.77,11
HCPCS,86747,HC PARVOVIRUS ANTIBODY,143.0,100.1,,,0
HCPCS,86747,Parvovirus antibody,,,13.53,91.81,11
HCPCS,86750,Malaria antibody,,,11.87,50.61,11
HCPCS,86753,HC PROTOZOA ANTIBODY NOS,83.0,58.1,,,0
HCPCS,86753,Protozoa antibody nos,,,11.15,53.31,11
HCPCS,86756,Respiratory virus antibody,,,14.3,71.14,11
HCPCS,86757,HC RICKETTSIA ANTIBODY,128.0,89.6,,,0
HCPCS,86757,Rickettsia Antibody,,,17.42,82.18,11
HCPCS,86759,Rotavirus antibody,,,16.41,72.77,11
HCPCS,86762,HC RUBELLA ANTIBODY,121.0,84.7,,,0
HCPCS,86762,Rubella antibody,,,12.95,53.03,11
HCPCS,86765,HC RUBEOLA ANTIBODY,223.0,156.1,,,0
HCPCS,86765,Rubeola antibody,,,11.59,46.54,11
HCPCS,86768,HC SALMONELLA ANTIBODY,87.0,60.9,,,0
HCPCS,86768,Salmonella antibody,,,11.87,50.61,11
HCPCS,86769,HC ANTIBODY SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2,122.0,85.4,,,0
HCPCS,86769,Sars-cov-2 covid-19 antibody,,,37.92,159.25,11
HCPCS,86771,Shigella antibody,,,22.03,72.77,11
HCPCS,86774,Tetanus antibody,,,13.32,81.69,11
HCPCS,86777,HC TOXOPLASMA ANTIBODY,70.0,49.0,,,0
HCPCS,86777,Toxoplasma antibody,,,12.95,45.16,11
HCPCS,86778,HC TOXOPLASMA ANTIBODY IGM,70.0,49.0,,,0
HCPCS,86778,Toxoplasma antibody igm,,,12.97,45.16,11
HCPCS,86780,TREPONEMA PALLIDUM,224.0,156.8,,,0
HCPCS,86780,Treponema pallidum,,,11.92,47.7,11
HCPCS,86784,HC TRICHINELLA ANTIBODY,59.0,41.3,,,0
HCPCS,86784,Trichinella antibody,,,11.3,69.33,11
HCPCS,86787,VARICELLA-ZOSTER ANTIBODY,170.0,119.0,,,0
HCPCS,86787,Varicella-zoster antibody,,,11.59,63.73,11
HCPCS,86788,HC WEST NILE VIRUS AB IGM,102.0,71.4,,,0
HCPCS,86788,West nile virus ab igm,,,15.16,64.72,11
HCPCS,86789,HC WEST NILE VIRUS ANTIBODY,90.0,63.0,,,0
HCPCS,86789,West Nile Virus Antibody,,,12.95,56.58,11
HCPCS,86790,HC VIRUS ANTIBODY NES,124.0,86.8,,,0
HCPCS,86790,Virus antibody nos,,,11.59,79.96,11
HCPCS,86793,HC YERSINIA ANTIBODY,66.0,46.2,,,0
HCPCS,86793,Yersinia antibody,,,11.87,72.77,11
HCPCS,86794,Zika virus igm antibody,,,15.16,29.49,7
HCPCS,86800,HC THYROGLOBULIN ANTIBODY,143.0,100.1,,,0
HCPCS,86800,Thyroglobulin antibody,,,14.32,56.48,11
HCPCS,86803,HC HEPATITIS C ANTIBODY,130.0,91.0,,,0
HCPCS,86803,Hepatitis c ab test,,,12.84,57.95,11
HCPCS,86804,Hep c ab test confirm,,,13.94,85.47,11
HCPCS,86805,Lymphocytotoxicity assay,,,170.56,331.64,11
HCPCS,86806,Lymphocytotoxicity assay,,,42.83,262.63,11
HCPCS,86807,Cytotoxic antibody screening,,,70.79,218.37,11
HCPCS,86808,Cytotoxic antibody screening,,,26.71,163.79,11
HCPCS,86812,Hla typing a b or c,,,23.23,142.43,11
HCPCS,86813,Hla typing a b or c,,,52.2,162.77,11
HCPCS,86816,Hla typing dr/dq,,,27.15,153.73,11
HCPCS,86817,Hla typing dr/dq,,,95.53,355.32,11
HCPCS,86821,Lymphocyte culture mixed,,,32.9,311.62,11
HCPCS,86825,HC HUMAN LEUKOCYTE ANTIGEN (HLA) CROSSMATCH NON-CYTOTOXIC FIRST SERUM SAMPLE OR DILUTION,463.0,324.1,,,0
HCPCS,86825,Hla x-math non-cytotoxic,,,98.54,434.85,11
HCPCS,86826,Hla x-match noncytotoxc addl,,,32.88,144.96,11
HCPCS,86828,HC HLA AB SCR L PST TXP,107.0,74.9,,,0
HCPCS,86828,Hla class i&ii antibody qual,,,57.77,125.13,11
HCPCS,86829,Hla class i/ii antibody qual,,,57.77,154.22,11
HCPCS,86830,Hla class i phenotype qual,,,85.97,419.54,11
HCPCS,86831,Hla class ii phenotype qual,,,73.69,359.59,11
HCPCS,86832,HC PRA SA CI ABS PTX-L,616.0,431.2,,,0
HCPCS,86832,Hla class i high defin qual,,,291.38,566.56,11
HCPCS,86833,HC PRA SA CII ABS PTX-L,561.0,392.7,,,0
HCPCS,86833,Hla class ii high defin qual,,,293.22,599.32,11
HCPCS,86834,Hla class i semiquant panel,,,321.8,1857.83,11
HCPCS,86835,Hla class ii semiquant panel,,,290.66,1678.06,11
HCPCS,86850,HC RBC ANTIBODY SCREEN EA TECHNIQ,212.0,148.4,,,0
HCPCS,86850,RBC antibody screen,,,51.59,228.88,11
HCPCS,86860,HC RBC ANTIBODY ELUTION,233.0,163.1,,,0
HCPCS,86860,RBC antibody elution,,,66.93,748.29,11
HCPCS,86870,HC RBC ANTIBO ID EA PANEL EA TECH,478.0,334.6,,,0
HCPCS,86870,RBC antibody identification,,,259.95,1574.35,11
HCPCS,86880,Coombs test direct,,,58.4,259.1,11
HCPCS,86880,HC COOMBS TEST DIRECT EA ANTISERUM,257.0,179.9,,,0
HCPCS,86885,Coombs test indirect qual,,,87.68,748.29,11
HCPCS,86886,Coombs test indirect titer,,,168.66,748.29,11
HCPCS,86886,HC COOMBS TST INDIRECT EA TITER,305.0,213.5,,,0
HCPCS,86890,Autologous blood process,,,154.8,748.29,11
HCPCS,86891,Autologous blood op salvage,,,66.93,3538.67,11
HCPCS,86900,Blood typing serologic abo,,,54.17,584.37,11
HCPCS,86900,HC BLOOD TYPING ABO,98.0,68.6,,,0
HCPCS,86901,Blood typing serologic rh(d),,,36.98,164.05,11
HCPCS,86901,HC BLOOD TYPING RH (D),81.0,56.7,,,0
HCPCS,86902,Blood type antigen donor ea,,,55.79,1574.35,11
HCPCS,86902,HC BLOOD TYPE ANTIGEN DONOR EA,98.0,68.6,,,0
HCPCS,86904,Blood typing patient serum,,,58.4,259.1,11
HCPCS,86905,Blood typing rbc antigens,,,47.83,1574.35,11
HCPCS,86905,HC BLOOD TYPING RBC ANTIGENS,94.0,65.8,,,0
HCPCS,86906,Bld typing serologic rh phnt,,,36.98,164.05,11
HCPCS,86920,Compatibility test spin,,,66.93,748.29,11
HCPCS,86920,HC COMPATIBILITY TEST SPIN,160.0,112.0,,,0
HCPCS,86921,Compatibility test incubate,,,42.81,748.29,11
HCPCS,86922,Compatibility test antiglob,,,103.15,748.29,11
HCPCS,86923,Compatibility test electric,,,87.47,748.29,11
HCPCS,86923,HC COMPATIBILITY TEST ELECTRIC,160.0,112.0,,,0
HCPCS,86927,HC PLASMA FRESH FROZEN THAWING EA,134.0,93.8,,,0
HCPCS,86927,Plasma fresh frozen,,,42.81,748.29,11
HCPCS,86930,Frozen blood prep,,,154.8,748.29,11
HCPCS,86931,Frozen blood thaw,,,154.8,748.29,11
HCPCS,86932,Frozen blood freeze/thaw,,,36.98,193.12,11
HCPCS,86940,Hemolysins/agglutinins auto,,,7.89,45.25,11
HCPCS,86941,Hemolysins/agglutinins,,,10.9,66.83,11
HCPCS,86945,Blood product/irradiation,,,36.98,164.05,11
HCPCS,86945,HC BLOOD PRODUCT/IRRADIATION EA UNIT,111.0,77.7,,,0
HCPCS,86950,Leukacyte transfusion,,,42.81,748.29,11
HCPCS,86960,Vol reduction of blood/prod,,,42.81,748.29,11
HCPCS,86965,HC POOLING BLOOD PLATELETS,174.0,121.8,,,0
HCPCS,86965,Pooling blood platelets,,,66.93,748.29,11
HCPCS,86970,Rbc pretx incubatj w/chemicl,,,42.81,259.1,11
HCPCS,86971,Rbc pretx incubatj w/enzymes,,,42.81,748.29,11
HCPCS,86972,Rbc pretx incubatj w/density,,,66.93,748.29,11
HCPCS,86975,Rbc serum pretx incubj drugs,,,66.93,1962.08,11
HCPCS,86976,Rbc serum pretx id dilution,,,28.63,127.04,11
HCPCS,86977,Rbc serum pretx incubj/inhib,,,66.93,748.29,11
HCPCS,86978,Rbc pretreatment serum,,,58.4,259.1,11
HCPCS,86985,Split blood or products,,,42.81,748.29,11
HCPCS,86999,Transfusion procedure,,,28.63,127.04,11
HCPCS,87003,Small animal inoculation,,,15.16,92.91,11
HCPCS,87015,HC CONCENTRATION FOR INFECT AGENTS,87.0,60.9,,,0
HCPCS,87015,Specimen infect agnt concntj,,,6.01,59.81,11
HCPCS,87040,Blood culture for bacteria,,,9.29,133.0,11
HCPCS,87040,HC BLOOD CULTURE FOR BACTERIA,205.0,143.5,,,0
HCPCS,87045,Feces culture aerobic bact,,,8.5,86.75,11
HCPCS,87046,HC FECES CULT OTHER PATHOGENS,64.0,44.8,,,0
HCPCS,87046,Stool cultr aerobic bact ea,,,8.5,38.07,11
HCPCS,87070,Culture othr specimn aerobic,,,7.76,112.63,11
HCPCS,87070,HC CULTURE BACTERIA OTHER SOURCES,172.0,120.4,,,0
HCPCS,87071,Culture aerobic quant other,,,8.9,45.9,11
HCPCS,87071,HC CULT BACT AEROBIC OTHER SOURCES,64.0,44.8,,,0
HCPCS,87073,Culture Bacteria Anaerobic,,,8.69,52.05,11
HCPCS,87075,Cultr bacteria except blood,,,8.52,220.76,11
HCPCS,87075,HC CULT BACT ANAEROBIC NOT BLOOD,348.0,243.6,,,0
HCPCS,87076,Culture anaerobe ident each,,,7.27,41.05,11
HCPCS,87077,Culture Aerobic Identify,,,7.27,60.87,11
HCPCS,87077,HC CULT BACT AEROBIC ISOLATE,104.0,72.8,,,0
HCPCS,87081,Culture screen only,,,5.97,66.06,11
HCPCS,87081,HC CULTURE SCREEN ONLY,104.0,72.8,,,0
HCPCS,87084,Culture of specimen by kit,,,24.36,47.37,11
HCPCS,87086,HC CULTURE BACT URINE,63.0,44.1,,,0
HCPCS,87086,Urine culture/colony count,,,7.26,41.19,11
HCPCS,87088,HC CULTURE BACT URINE IDENT EA,58.0,40.6,,,0
HCPCS,87088,Urine bacteria culture,,,7.28,39.02,11
HCPCS,87101,HC CULTURE FUNGI SKIN NAILS HAIR,57.0,39.9,,,0
HCPCS,87101,Skin fungi culture,,,6.94,41.05,11
HCPCS,87102,Fungus isolation culture,,,7.57,154.39,11
HCPCS,87102,HC CULTURE FUNGI SOURCE NOT BLOOD,243.0,170.1,,,0
HCPCS,87103,Blood fungus culture,,,18.41,49.78,11
HCPCS,87106,Fungi identification yeast,,,9.29,56.96,11
HCPCS,87107,Fungi identification mold,,,9.29,45.16,11
HCPCS,87107,HC CULTURE FUNGI DEF IDENT EA ORG MOLD,63.0,44.1,,,0
HCPCS,87109,HC CULTURE MYCOPLASMA,174.0,121.8,,,0
HCPCS,87109,Mycoplasma,,,13.85,48.13,11
HCPCS,87110,Chlamydia culture,,,17.64,108.11,11
HCPCS,87110,HC CULTURE CHLAMYDIA,155.0,108.5,,,0
HCPCS,87116,HC CULTURE ACID FACT BACILLI,242.0,169.4,,,0
HCPCS,87116,Mycobacteria culture,,,9.72,169.2,11
HCPCS,87118,HC MYCOBACTERIAL DEF ID 1,58.0,40.6,,,0
HCPCS,87118,Mycobacteric identification,,,13.15,60.4,11
HCPCS,87140,Culture type immunofluoresc,,,5.01,30.77,11
HCPCS,87140,HC CULT TYPE IMMUNOFLUORESC EA,32.0,22.4,,,0
HCPCS,87143,Culture typing glc/hplc,,,11.27,69.14,11
HCPCS,87147,Culture type immunologic,,,4.66,24.36,11
HCPCS,87147,HC CULTURE TYPE IMMUNOLOGIC,34.0,23.8,,,0
HCPCS,87149,Dna/rna direct probe,,,18.05,110.64,11
HCPCS,87149,HC CULTURE IDENT DNA RNA PROBE,72.0,50.4,,,0
HCPCS,87150,Dna/rna amplified probe,,,31.58,106.62,11
HCPCS,87150,HC CULTURE TYPING ID BY NUCLEIC ACID (DNA/RNA) PROBE PER CULTURE OR ISOLATE,150.0,105.0,,,0
HCPCS,87152,Culture Type Pulse Field Gel,,,6.97,28.88,11
HCPCS,87153,Dna/rna sequencing,,,103.82,348.72,11
HCPCS,87153,HC ACID-FAST BACILLUS (AFB) ID,489.0,342.3,,,0
HCPCS,87154,Cul typ id bld pthgn 6+ trgt,,,196.25,824.27,11
HCPCS,87158,Culture typing added method,,,6.97,28.88,11
HCPCS,87158,HC CULTURE TYPING OTHER METHODS,23.0,16.1,,,0
HCPCS,87164,Dark field examination,,,9.67,59.27,11
HCPCS,87166,Dark field examination,,,10.17,62.33,11
HCPCS,87168,Macroscopic Exam Arthropod,,,3.84,23.55,11
HCPCS,87169,HC MACROSCOPIC EXAM PARASITE,9.0,6.3,,,0
HCPCS,87169,Macroscopic exam parasite,,,3.88,35.54,11
HCPCS,87172,HC PINWORM EXAM,18.0,12.6,,,0
HCPCS,87172,Pinworm Exam,,,3.84,13.33,11
HCPCS,87176,HC TISSUE HOMOGENIZATION CULTR,52.0,36.4,,,0
HCPCS,87176,Tissue homogenization cultr,,,5.29,37.02,11
HCPCS,87177,HC OVA AND PARASITES SMEARS,190.0,133.0,,,0
HCPCS,87177,Ova and parasites smears,,,8.01,57.94,11
HCPCS,87181,HC MICROBE SUSCEPTIBLE DIFFUSE,40.0,28.0,,,0
HCPCS,87181,Microbe susceptible diffuse,,,4.28,26.2,11
HCPCS,87183,Sc std carbapenem resist gen,,,31.58,61.41,7
HCPCS,87184,HC MICROBE SUSCEPTIBLE DISK,99.0,69.3,,,0
HCPCS,87184,Microbe susceptible disk,,,6.73,62.32,11
HCPCS,87185,HC MICROBE SUSCEPTIBLE ENZYME,58.0,40.6,,,0
HCPCS,87185,Microbe susceptible enzyme,,,4.28,41.46,11
HCPCS,87186,MICROBE SUSCEPTIBLE MICRODIL,109.0,76.3,,,0
HCPCS,87186,Microbe susceptible mic,,,7.78,70.65,11
HCPCS,87187,Microbe susceptible mlc,,,35.78,70.3,11
HCPCS,87188,HC MICROBE SUSCEPT MACROBROTH,40.0,28.0,,,0
HCPCS,87188,HC PRO MICROBE SUSCEPT MACROBROTH,8.0,5.6,,,0
HCPCS,87188,Microbe suscept macrobroth,,,5.98,36.63,11
HCPCS,87190,Microbe suscept mycobacteri,,,6.58,24.61,11
HCPCS,87197,Bactericidal level serum,,,13.52,82.9,11
HCPCS,87205,HC SMEAR GRAM STAIN,52.0,36.4,,,0
HCPCS,87205,Smear gram stain,,,3.84,35.25,11
HCPCS,87206,HC SMEAR FLUORESCENT/ACID STAI,124.0,86.8,,,0
HCPCS,87206,Smear fluorescent/acid stai,,,4.85,86.9,11
HCPCS,87207,HC SMEAR SPECIAL STAIN PARASITES,155.0,108.5,,,0
HCPCS,87207,Smear special stain,,,5.39,111.06,11
HCPCS,87209,HC SMEAR COMPLEX STAIN OVA PARASIT,37.0,25.9,,,0
HCPCS,87209,Smear complex stain,,,16.18,44.42,11
HCPCS,87210,HC SMEAR WET MOUNT SALINE/INK,50.0,35.0,,,0
HCPCS,87210,Smear wet mount saline/ink,,,5.24,36.04,11
HCPCS,87220,KOH PREP FUNGI OVA MITES,62.0,43.4,,,0
HCPCS,87220,Tissue exam for fungi,,,3.84,13.33,11
HCPCS,87230,Assay toxin or antitoxin,,,17.77,108.98,11
HCPCS,87250,Virus inoculate eggs/animal,,,17.6,107.92,11
HCPCS,87252,HC VIRUS INOCULATION TISSUE CULT,104.0,72.8,,,0
HCPCS,87252,Virus inoculation tissue,,,23.46,143.87,11
HCPCS,87253,Virus inoculate tissue addl,,,18.18,101.19,11
HCPCS,87254,HC VIRUS INOCULATION SHELL VIAL,140.0,98.0,,,0
HCPCS,87254,Virus inoculation shell via,,,17.6,99.95,11
HCPCS,87255,Genet virus isolate hsv,,,30.47,85.39,11
HCPCS,87260,Adenovirus ag if,,,12.99,66.23,11
HCPCS,87265,Pertussis ag if,,,10.78,66.23,11
HCPCS,87267,Enterovirus antibody dfa,,,12.08,66.23,11
HCPCS,87269,Giardia ag if,,,12.25,66.23,11
HCPCS,87270,Chlamydia trachomatis ag if,,,10.78,66.23,11
HCPCS,87271,Cytomegalovirus dfa,,,12.08,66.23,11
HCPCS,87272,Cryptosporidium ag if,,,10.78,66.23,11
HCPCS,87273,Herpes simplex 2 ag if,,,10.78,61.45,11
HCPCS,87274,Herpes simplex 1 ag if,,,10.78,79.96,11
HCPCS,87275,Influenza b ag if,,,11.02,66.23,11
HCPCS,87276,Influenza a ag if,,,14.46,66.23,11
HCPCS,87278,Legion pneumophilia ag if,,,14.04,66.23,11
HCPCS,87279,Parainfluenza ag if,,,14.79,66.23,11
HCPCS,87280,Respiratory syncytial ag if,,,12.08,66.23,11
HCPCS,87281,Pneumocystis carinii ag if,,,10.78,66.23,11
HCPCS,87283,Rubeola ag if,,,53.09,106.4,11
HCPCS,87285,Treponema pallidum ag if,,,10.96,66.23,11
HCPCS,87290,Varicella zoster ag if,,,12.08,66.23,11
HCPCS,87299,Antibody detection nos if,,,14.49,66.23,11
HCPCS,87300,Ag detection polyval if,,,10.78,66.23,11
HCPCS,87301,Adenovirus ag ia,,,10.78,66.23,11
HCPCS,87305,Aspergillus ag ia,,,10.78,66.23,11
HCPCS,87305,HC ASPERGILLUS AG EIA,20.0,14.0,,,0
HCPCS,87320,Chylmd trach ag ia,,,13.5,66.23,11
HCPCS,87324,Clostridium ag ia,,,10.78,111.8,11
HCPCS,87324,HC CLOSTRIDIUM AG EIA,218.0,152.6,,,0
HCPCS,87327,Cryptococcus neoform ag ia,,,12.08,31.39,11
HCPCS,87327,HC CRYPTOCOCCUS NEOFORM AG EIA,47.0,32.9,,,0
HCPCS,87328,Cryptosporidium ag ia,,,12.44,48.51,11
HCPCS,87328,HC CRYPTOSPORIDIUM AG EIA,85.0,59.5,,,0
HCPCS,87329,Giardia ag ia,,,10.78,50.87,11
HCPCS,87329,HC GIARDIA AG EIA,87.0,60.9,,,0
HCPCS,87332,Cytomegalovirus ag ia,,,10.78,66.23,11
HCPCS,87335,E coli 0157 ag ia,,,11.39,66.23,11
HCPCS,87336,Entamoeb hist dispr ag ia,,,14.4,66.23,11
HCPCS,87337,Entamoeb hist group ag ia,,,10.78,38.5,11
HCPCS,87337,HC ENTAMOEB HIST GROUP AG EIA,48.0,33.6,,,0
HCPCS,87338,HC HPYLORI STOOL EIA,47.0,32.9,,,0
HCPCS,87338,Hpylori stool ia,,,12.94,28.78,11
HCPCS,87339,H pylori ag ia,,,14.4,66.23,11
HCPCS,87340,HC HEPATITIS B SURFACE AG EIA,169.0,118.3,,,0
HCPCS,87340,Hepatitis b surface ag ia,,,9.3,42.05,11
HCPCS,87341,HC HEPATITIS B SURFACE AG EIA NEUTR,124.0,86.8,,,0
HCPCS,87341,Hepatitis b surface ag ia,,,9.3,57.0,11
HCPCS,87350,HC HEPATITIS BE AG EIA,169.0,118.3,,,0
HCPCS,87350,Hepatitis be ag ia,,,10.38,36.28,11
HCPCS,87380,HC HEPATITIS DELTA AG EIA,256.0,179.2,,,0
HCPCS,87380,Hepatitis delta ag ia,,,16.52,176.21,11
HCPCS,87385,HC HISTOPLASMA CAPSUL AG EIA,65.0,45.5,,,0
HCPCS,87385,Histoplasma capsul ag ia,,,11.92,46.64,11
HCPCS,87389,HC HIV-1 ANTIGEN(S) WITH HIV-1 AND HIV-2 ANTIBODIES SINGLE RESULT BY IMMUNOASSAY TECHNIQUE QUAL/SEMIQUAL MULTIPLE-STEP METHOD,103.0,72.1,,,0
HCPCS,87389,Hiv-1 ag w/hiv-1 & hiv-2 ab,,,21.67,91.67,11
HCPCS,87390,Hiv-1 ag ia,,,21.65,97.37,11
HCPCS,87391,Hiv-2 ag ia,,,19.71,97.37,11
HCPCS,87400,Influenza a/b ag ia,,,12.72,66.23,11
HCPCS,87420,Resp syncytial ag ia,,,12.52,66.23,11
HCPCS,87425,Rotavirus ag ia,,,10.78,33.32,11
HCPCS,87426,Coronavirus ag ia,,,31.8,170.97,11
HCPCS,87427,Shiga-like toxin ag ia,,,10.78,30.07,11
HCPCS,87428,Sarscov & inf vir a&b ag ia,,,53.09,123.01,11
HCPCS,87430,Strep a ag ia,,,15.13,63.49,11
HCPCS,87449,Ag detect nos ia mult,,,10.78,37.49,11
HCPCS,87449,HC AG DETECT EIA MULT NOS,49.0,34.3,,,0
HCPCS,87451,Ag detect polyval ia mult,,,9.46,52.88,11
HCPCS,87467,Hepatitis b surface ag quan,,,22.79,44.31,7
HCPCS,87468,Anaplsma phgcytophlm amp prb,,,31.58,61.41,7
HCPCS,87468,HC IADNA ANAPLASMA PHAGOCYTOPHILUM AMPLIFIED PROBE TECHNIQUE,66.0,46.2,,,0
HCPCS,87469,Babesia microti amp prb,,,31.58,61.41,7
HCPCS,87471,Bartonella dna amp probe,,,31.58,193.73,11
HCPCS,87472,Bartonella dna quant,,,38.56,236.4,11
HCPCS,87475,Lyme dis dna dir probe,,,18.05,110.64,11
HCPCS,87476,HC LYME DIS DNA AMP PROBE,190.0,133.0,,,0
HCPCS,87476,Lyme dis dna amp probe,,,31.58,135.49,11
HCPCS,87478,Borrelia miyamotoi amp prb,,,31.58,61.41,7
HCPCS,87480,Candida dna dir probe,,,18.05,63.29,11
HCPCS,87480,HC CANDIDA DNA DIR PROBE,92.0,64.4,,,0
HCPCS,87481,Candida dna amp probe,,,31.58,193.73,11
HCPCS,87481,HC INFECTIOUS AGENT (DNA OR RNA) CANDIDA SPECIES AMPLIFIED PROBE TECHNIQUE,154.0,107.8,,,0
HCPCS,87482,Candida dna quant,,,50.17,97.54,11
HCPCS,87483,Cns dna amp probe type 12-25,,,375.1,2161.1,11
HCPCS,87483,HC CNS DNA/RNA AMP PROBE MULTIPLE SUBTYPES 12-25,2065.0,1445.5,,,0
HCPCS,87483,HC PRO CNS DNA/RNA AMP PROBE MULTIPLE SUBTYPES 12-25,485.0,339.5,,,0
HCPCS,87484,Ehrlicha chaffeensis amp prb,,,31.58,61.41,7
HCPCS,87484,HC IADNA EHRLICHIA CHAFFEENSIS AMPLIFIED PROBE TECHNIQUE,66.0,46.2,,,0
HCPCS,87485,Chylmd pneum dna dir probe,,,18.05,110.64,11
HCPCS,87486,Chylmd pneum dna amp probe,,,31.58,193.73,11
HCPCS,87486,HC INFECT AGENT DETECT NUCLEIC ACID (DNA OR RNA) CHLAMYDIA PNEUMONIAE AMPLIFIED PROBE,154.0,107.8,,,0
HCPCS,87487,Chylmd pneum dna quant,,,38.56,236.4,11
HCPCS,87490,Chylmd trach dna dir probe,,,20.48,110.64,11
HCPCS,87491,Chylmd trach dna amp probe,,,31.58,127.16,11
HCPCS,87491,HC CHYLMD TRACH DNA AMP PROBE,209.0,146.3,,,0
HCPCS,87492,Chylmd trach dna quant,,,48.12,93.57,11
HCPCS,87493,C diff amplified probe,,,33.54,106.62,11
HCPCS,87493,HC C DIFF AMPLIFIED PROBE,150.0,105.0,,,0
HCPCS,87494,Chlmy trch&neisra gonor mult,,,63.16,122.82,7
HCPCS,87495,Cytomeg dna dir probe,,,27.03,110.64,11
HCPCS,87496,Cytomeg dna amp probe,,,31.58,193.73,11
HCPCS,87496,HC INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA/RNA) CYTOMEGALOVIRUS AMPLIFIED PROBE,75.0,52.5,,,0
HCPCS,87497,Cytomeg dna quant,,,38.56,139.93,11
HCPCS,87497,HC CYTOMEG DNA QUANT,196.0,137.2,,,0
HCPCS,87498,Enterovirus probe&revrs trns,,,31.58,112.91,11
HCPCS,87498,HC ENTEROVIRUS DNA AMP PROBE,167.0,116.9,,,0
HCPCS,87500,Vanomycin dna amp probe,,,31.58,193.73,11
HCPCS,87501,Influenza dna amp prob 1+,,,46.18,266.64,11
HCPCS,87502,HC POC FLU A/B COMBO,194.0,135.8,,,0
HCPCS,87502,Influenza dna amp probe,,,86.22,167.65,7
HCPCS,87503,Influenza dna amp prob addl,,,26.3,51.14,7
HCPCS,87505,HC INFECTIOUS AGENT DETECTION BY NUCLEIC ACID GASTROINTESTINAL PATHOGEN MULTIPLE TYPES/SUBTYPES 3-5 TARGETS,545.0,381.5,,,0
HCPCS,87505,Nfct agent detection gi,,,115.46,659.91,11
HCPCS,87506,HC INFECTIOUS AGENT DETECT NUCLEIC ACID GI PTHGN INCL MULTIPLEX REVERSE TRANSCRIPT WHEN PERFORM/MULTIPLEX AMPLIFIED PROBE TECH MULTI TYPES/SUBTYPES 6-11 TARGETS,2541.0,1778.7,,,0
HCPCS,87506,Iadna-dna/rna probe tq 6-11,,,236.69,1097.9,11
HCPCS,87507,Iadna-dna/rna probe tq 12-25,,,375.1,2143.94,11
HCPCS,87510,Gardner vag dna dir probe,,,18.05,63.29,11
HCPCS,87510,HC GARDNER VAG DNA DIR PROBE,92.0,64.4,,,0
HCPCS,87511,Gardner vag dna amp probe,,,31.58,193.73,11
HCPCS,87512,Gardner vag dna quant,,,37.58,88.49,11
HCPCS,87513,H pylri clrthmcn rst amp prb,,,31.58,61.41,7
HCPCS,87516,HC INFECTIOUS AGENT DETECT NUCLEIC ACID (DNA/RNA) HEPATITIS B AMP PROBE TECH,151.0,105.7,,,0
HCPCS,87516,Hepatitis b dna amp probe,,,31.58,193.73,11
HCPCS,87517,HC HEPATITIS B DNA QUANT,65.0,45.5,,,0
HCPCS,87517,Hepatitis b dna quant,,,38.56,236.4,11
HCPCS,87520,Hepatitis c rna dir probe,,,28.1,110.64,11
HCPCS,87521,HC INFECTIOUS AGENT DECT NUCLEIC ACID (DNA/RNA) HEPATITIS B AMP PROBE TECH INCL REVERSE TRANSCRIPTIO,151.0,105.7,,,0
HCPCS,87521,Hepatitis c probe&rvrs trnsc,,,31.58,193.73,11
HCPCS,87522,HC HEPATITIS C DNA QUANT,279.0,195.3,,,0
HCPCS,87522,Hepatitis c revrs trnscrpj,,,38.56,139.05,11
HCPCS,87523,Hepatitis d quantification,,,38.56,74.97,7
HCPCS,87525,Hepatitis g dna dir probe,,,26.82,110.64,11
HCPCS,87526,Hepatitis g dna amp probe,,,35.33,193.73,11
HCPCS,87527,Hepatitis g dna quant,,,37.58,88.49,11
HCPCS,87528,Hsv dna dir probe,,,18.05,110.64,11
HCPCS,87529,HC HSV DNA AMP PROBE,279.0,195.3,,,0
HCPCS,87529,Hsv dna amp probe,,,31.58,175.97,11
HCPCS,87530,Hsv dna quant,,,38.56,236.4,11
HCPCS,87531,Hhv-6 dna dir probe,,,52.2,110.64,11
HCPCS,87532,Hhv-6 dna amp probe,,,31.58,193.73,11
HCPCS,87533,HHV-6 QUANTIFICATION,186.0,130.2,,,0
HCPCS,87533,Hhv-6 dna quant,,,37.58,88.49,11
HCPCS,87534,Hiv-1 dna dir probe,,,19.73,110.64,11
HCPCS,87535,HC HIV-1 DNA AMP PROBE,194.0,135.8,,,0
HCPCS,87535,Hiv-1 probe&reverse trnscrpj,,,31.58,138.45,11
HCPCS,87536,HC HIV-1 DNA QUANT,614.0,429.8,,,0
HCPCS,87536,Hiv-1 quant&revrse trnscrpj,,,76.59,469.63,11
HCPCS,87537,Hiv-2 dna dir probe,,,19.73,110.64,11
HCPCS,87538,Hiv-2 probe&revrse trnscripj,,,31.58,193.73,11
HCPCS,87539,Hiv-2 quant&revrse trnscripj,,,52.76,102.58,11
HCPCS,87540,Legion pneumo dna dir prob,,,18.05,110.64,11
HCPCS,87541,Legion pneumo dna amp prob,,,31.58,193.73,11
HCPCS,87542,Legion pneumo dna quant,,,37.58,88.49,11
HCPCS,87550,Mycobacteria dna dir probe,,,18.05,110.64,11
HCPCS,87551,HC INFECT AGENT DET BY NUCLEIC ACID MYCOBACT AMPL PROBE TECHNIQ,186.0,130.2,,,0
HCPCS,87551,Mycobacteria dna amp probe,,,43.42,193.73,11
HCPCS,87552,Mycobacteria dna quant,,,38.56,236.4,11
HCPCS,87555,M.tuberculo dna dir probe,,,24.19,110.64,11
HCPCS,87556,M TUBERCULO DNA AMP PROBE,203.0,142.1,,,0
HCPCS,87556,M.tuberculo dna amp probe,,,37.51,193.73,11
HCPCS,87557,M.tuberculo dna quant,,,38.56,236.4,11
HCPCS,87560,M.avium-intra dna dir prob,,,24.56,110.64,11
HCPCS,87561,M.avium-intra dna amp prob,,,31.58,193.73,11
HCPCS,87562,M.avium-intra dna quant,,,38.56,236.4,11
HCPCS,87563,HC IADNA MYCOPLASMA GENITALIUM AMPLIFIED PROBE TECH,153.0,107.1,,,0
HCPCS,87563,M. genitalium amp probe,,,31.58,132.64,11
HCPCS,87564,HC IADNA MTB RIFAMPIN RESISTANCE AMPLIFIED PROBE TECHNIQUE,334.0,233.8,,,0
HCPCS,87564,Mtb rifampin rst amp prb tq,,,69.09,134.35,7
HCPCS,87580,M.pneumon dna dir probe,,,18.05,110.64,11
HCPCS,87581,HC M PNEUMON DNA AMP PROBE,203.0,142.1,,,0
HCPCS,87581,M.pneumon dna amp probe,,,31.58,193.73,11
HCPCS,87582,M.pneumon dna quant,,,70.93,529.58,11
HCPCS,87590,N.gonorrhoeae dna dir prob,,,24.19,110.64,11
HCPCS,87591,HC N GONORRHOEAE DNA AMP PROB,154.0,107.8,,,0
HCPCS,87591,N.gonorrhoeae dna amp prob,,,31.58,116.6,11
HCPCS,87592,N.gonorrhoeae dna quant,,,38.56,88.49,11
HCPCS,87593,HC INFECTIOUS AGENT (DNA OR RNA) ORTHPOXVIRUS AMPLIFIED PROBE TECHNIQUE EA,137.0,95.9,,,0
HCPCS,87593,Orthopoxvirus amp prb each,,,46.18,89.79,7
HCPCS,87594,HC IADNA PNEUMOCYSTIS JIROVECII AMPLIFIED PROBE TECHNIQUE,153.0,107.1,,,0
HCPCS,87594,Pneumcysts jirovecii amp prb,,,31.58,61.41,7
HCPCS,87623,Hpv low-risk types,,,31.58,180.53,11
HCPCS,87624,HC HPV HIGH-RISK TYPES POOLED RESULT,150.0,105.0,,,0
HCPCS,87624,Hpv high-risk types,,,31.58,180.53,11
HCPCS,87625,Hpv types 16 & 18 only,,,36.49,180.53,11
HCPCS,87626,HC IADNA HPV SEP HIGH-RISK TYPES  & HIGH-RISK POOLED RESULT(S),305.0,213.5,,,0
HCPCS,87626,HC IADNA HPV SEP RPRT HI-RISK TYP&HI-RISK POOLED RESULTS,305.0,213.5,,,0
HCPCS,87626,Hpv sep hi-rsk typ&pool rslt,,,63.18,122.85,7
HCPCS,87627,Jt spc pthgn&rx rsist gen26+,,,611.79,1189.6,7
HCPCS,87631,HC POC FLU A/B RSV,566.0,396.2,,,0
HCPCS,87631,HC RESP VIRUS 3-5 TARGETS,566.0,396.2,,,0
HCPCS,87631,Resp virus 3-5 targets,,,128.37,390.12,11
HCPCS,87632,Resp virus 6-11 targets,,,196.25,642.54,11
HCPCS,87633,HC RESP VIRUS PANEL PCR,1830.0,1281.0,,,0
HCPCS,87633,Resp virus 12-25 targets,,,375.1,2165.6,11
HCPCS,87634,HC POC IADNA DNA/RNA RSV AMPLIFIED PROBE TECHNIQUE,78.0,54.6,,,0
HCPCS,87634,Rsv dna/rna amp probe,,,63.18,122.85,7
HCPCS,87635,HC INFECT AGENT DETECT DNA/RNA SARS-COV-2 AMPLIFIED PROB TECH,96.0,67.2,,,0
HCPCS,87635,HC POC INFECT AGENT DETECT DNA/RNA SARS-COV-2 AMPLIFIED PROB TECH,96.0,67.2,,,0
HCPCS,87635,Sars-cov-2 covid-19 amp prb,,,46.18,194.03,11
HCPCS,87636,HC IADNA SARSCOV2 & INF A&B MULT AMPLIFIED PROBE TQ,454.0,317.8,,,0
HCPCS,87636,HC POC LIAT SARS-COV-2/FLUA/FLUB,454.0,317.8,,,0
HCPCS,87636,Sarscov2 & inf a&b amp prb,,,128.37,539.14,11
HCPCS,87637,HC IADNA SARSCOV2 INF A&B & RSV  MULTI AMPLIFIED PROBE TQ,472.0,330.4,,,0
HCPCS,87637,Sarscov2&inf a&b&rsv amp prb,,,128.37,539.14,11
HCPCS,87640,Staph a dna amp probe,,,31.58,193.73,11
HCPCS,87641,HC MRSA DNA AMP PROBE,167.0,116.9,,,0
HCPCS,87641,Mr-staph dna amp probe,,,31.58,119.2,11
HCPCS,87650,STREP A DNA DIR PROBE,92.0,64.4,,,0
HCPCS,87650,Strep a dna dir probe,,,18.05,64.07,11
HCPCS,87651,HC IADNA STREPTOCOCCUS GROUP A AMPLIFIED PROBE TECH,186.0,130.2,,,0
HCPCS,87651,HC POC GRP A STREP LIAT,186.0,130.2,,,0
HCPCS,87651,Strep a dna amp probe,,,31.58,193.73,11
HCPCS,87652,Strep a dna quant,,,37.58,88.49,11
HCPCS,87653,HC STREP B DNA AMP PROBE,154.0,107.8,,,0
HCPCS,87653,Strep b dna amp probe,,,31.58,114.09,11
HCPCS,87660,HC TRICHOMONAS VAGIN DIR PROBE,92.0,64.4,,,0
HCPCS,87660,Trichomonas vagin dir probe,,,18.05,63.29,11
HCPCS,87661,HC INFECT (DNA/RNA) TRICHOMONAS VAGINALIS AMPLIF PROBE TECH,169.0,118.3,,,0
HCPCS,87661,Trichomonas vaginalis amplif,,,31.58,180.53,11
HCPCS,87662,Zika virus dna/rna amp probe,,,46.18,89.79,7
HCPCS,87797,Detect agent nos dna dir,,,27.03,110.64,11
HCPCS,87798,Detect agent nos dna amp,,,31.58,143.31,11
HCPCS,87798,HC DETECT AGENT DNA AMP NOS,217.0,151.9,,,0
HCPCS,87799,Detect agent nos dna quant,,,38.56,164.7,11
HCPCS,87799,HC DETECT AGENT DNA QUANT NOS,433.0,303.1,,,0
HCPCS,87800,Detect agnt mult dna direc,,,39.3,221.36,11
HCPCS,87801,Detect agnt mult dna ampli,,,63.18,194.28,11
HCPCS,87801,HC DETECT AGNT MULT DNA AMPLI,242.0,169.4,,,0
HCPCS,87802,Strep b assay w/optic,,,11.46,66.23,11
HCPCS,87803,Clostridium toxin a w/optic,,,14.4,66.23,11
HCPCS,87804,Influenza assay w/optic,,,14.9,37.43,11
HCPCS,87806,Hiv antigen w/hiv antibodies,,,29.49,123.87,11
HCPCS,87807,Rsv assay w/optic,,,11.79,51.68,11
HCPCS,87808,Trichomonas assay w/optic,,,13.76,66.23,11
HCPCS,87809,Adenovirus assay w/optic,,,19.58,66.23,11
HCPCS,87810,Chylmd trach assay w/optic,,,31.76,66.23,11
HCPCS,87811,Sars-cov-2 covid19 w/optic,,,37.24,156.42,11
HCPCS,87812,Sarscov2&inf typ a&b w/optic,,,67.03,130.34,7
HCPCS,87850,N. gonorrhoeae assay w/optic,,,22.1,66.23,11
HCPCS,87880,HC POC RAPID STREP A,91.0,63.7,,,0
HCPCS,87880,HC STREP A ASSAY W/OPTIC,91.0,63.7,,,0
HCPCS,87880,Strep a assay w/optic,,,14.88,64.77,11
HCPCS,87899,Agent nos assay w/optic,,,14.46,45.9,11
HCPCS,87899,HC AGENT ASSAY W/OPTIC NOS,64.0,44.8,,,0
HCPCS,87900,HC INFECTIOUS AGENT DRUG SUSCEPTIBILITY PREDICTION USING REGULARLY UPDATED GENOTYPIC BIOINFORMATICS,558.0,390.6,,,0
HCPCS,87900,Phenotype infect agent drug,,,117.32,719.37,11
HCPCS,87901,Genotype dna hiv reverse t,,,231.7,1420.83,11
HCPCS,87901,HC GENOTYPE DNA HIV REVERSE T,1069.0,748.3,,,0
HCPCS,87902,GENOTYPE DNA HEPATITIS C,1213.0,849.1,,,0
HCPCS,87902,Genotype dna/rna hep c,,,231.7,799.62,11
HCPCS,87903,HC INFECTIOUS AGENT PHENOTYPE ANALYSIS NUCLEIC ACID HIV 1 FIRST THROUGH 10 DRUGS TESTED,2073.0,1451.1,,,0
HCPCS,87903,Phenotype dna hiv w/culture,,,439.79,2696.77,11
HCPCS,87904,HC INFECTIOUS AGENT PHENOTYPE ANALYSIS NUCLEIC ACID HIV 1 EACH ADDITIONAL DRUG TESTED (LIST SEP IN ADDITION TO PRIMARY PROCEDURE),111.0,77.7,,,0
HCPCS,87904,Phenotype dna hiv w/clt add,,,23.46,143.87,11
HCPCS,87905,Sialidase enzyme assay,,,11.0,67.44,11
HCPCS,87906,Genotype dna/rna hiv,,,115.86,225.28,7
HCPCS,87906,HC HIV-1 INTEGRASE SEQ.,546.0,382.2,,,0
HCPCS,87910,Genotype cytomegalovirus,,,231.7,1337.67,11
HCPCS,87912,Genotype dna hepatitis b,,,231.7,1337.67,11
HCPCS,87913,Nfct agt gntyp alys sarscov2,,,231.7,450.54,7
HCPCS,87999,HC UNLISTED MICROBIOLOGY PROCEDURE,154.0,107.8,,,0
HCPCS,88104,Cytopath fl nongyn smears,,,36.98,164.05,11
HCPCS,88104,HC CYTOPATH FL NONGYN SMEARS,86.0,60.2,,,0
HCPCS,88106,Cytopath fl nongyn filter,,,28.63,127.04,11
HCPCS,88108,Cytopath concentrate tech,,,36.98,164.05,11
HCPCS,88108,HC CYTOPATH CONCENTRATE TECH,103.0,72.1,,,0
HCPCS,88108,HC PRO CYTOPATH CONCENTRATE TECH,170.0,119.0,,,0
HCPCS,88112,CYTOPATH CELL ENHANCE TECH,132.0,92.4,,,0
HCPCS,88112,Cytopath cell enhance tech,,,51.59,228.88,11
HCPCS,88112,HC PRO CYTOPATH CELL ENHANCE TECH,233.0,163.1,,,0
HCPCS,88120,CYTP URNE 3-5 PROBES EA SPEC,317.0,221.9,,,0
HCPCS,88120,Cytp urne 3-5 probes ea spec,,,168.66,748.29,11
HCPCS,88120,HC PRO CYTP URNE 3-5 PROBES EA SPEC,721.0,504.7,,,0
HCPCS,88121,Cytp urine 3-5 probes cmptr,,,168.66,748.29,11
HCPCS,88125,Forensic cytopathology,,,47.96,228.88,11
HCPCS,88130,Sex chromatin identification,,,16.18,83.05,11
HCPCS,88140,Sex chromatin identification,,,7.19,41.05,11
HCPCS,88141,HC PRO CYTOPATH C/V INTERPRET,40.0,28.0,,,0
HCPCS,88142,CYTPTH CERV/VAG FLUID THIN AUTO,86.0,60.2,,,0
HCPCS,88142,Cytopath c/v thin layer,,,18.23,83.35,11
HCPCS,88142,HC PRO CYTPTH CERV/VAG FLUID THIN AUTO,51.0,35.7,,,0
HCPCS,88143,Cytopath c/v thin layer redo,,,20.74,75.86,11
HCPCS,88147,Cytopath c/v automated,,,45.5,88.48,11
HCPCS,88148,Cytopath c/v auto rescreen,,,16.69,58.29,11
HCPCS,88150,Cytopath c/v manual,,,16.69,58.29,11
HCPCS,88152,Cytopath c/v auto redo,,,24.88,58.29,11
HCPCS,88153,Cytopath c/v redo,,,21.63,58.29,11
HCPCS,88155,Cytopath c/v index add-on,,,13.18,33.08,11
HCPCS,88160,CYTOPATH SMEAR OTHER SOURCE,82.0,57.4,,,0
HCPCS,88160,Cytopath smear other source,,,28.63,127.04,11
HCPCS,88161,Cytopath smear other source,,,28.63,127.04,11
HCPCS,88162,Cytopath smear other source,,,51.59,228.88,11
HCPCS,88164,Cytopath tbs c/v manual,,,16.69,58.29,11
HCPCS,88165,Cytopath tbs c/v redo,,,38.0,73.88,11
HCPCS,88166,Cytopath tbs c/v auto redo,,,16.69,58.29,11
HCPCS,88167,Cytopath tbs c/v select,,,16.69,58.29,11
HCPCS,88172,CYTP DX EVAL FNA 1ST EA SITE,84.0,58.8,,,0
HCPCS,88172,Cytp dx eval fna 1st ea site,,,48.07,748.29,11
HCPCS,88172,HC PRO CYTP DX EVAL FNA 1ST EA SITE,84.0,58.8,,,0
HCPCS,88173,CYTOPATH EVAL FNA REPORT,136.0,95.2,,,0
HCPCS,88173,Cytopath eval fna report,,,51.59,228.88,11
HCPCS,88173,HC PRO CYTOPATH EVAL FNA REPORT,175.0,122.5,,,0
HCPCS,88174,Cytopath c/v auto in fluid,,,22.83,80.55,11
HCPCS,88175,Cytopath c/v auto fluid redo,,,23.95,80.06,11
HCPCS,88175,HC CYTOPATH CERV/VAG RESCREEN AUTO THIN LAYER PREP,144.0,100.8,,,0
HCPCS,88177,HC CYTOPATH EVAL OF FNA EA ADDTL EVAL EPISODE,154.0,107.8,,,0
HCPCS,88177,HC PRO CYTOPATH EVAL OF FNA EA ADDTL EVAL EPISODE,44.0,30.8,,,0
HCPCS,88182,Cell marker study,,,51.59,228.88,11
HCPCS,88182,HC FLOW CYTOMETRY CELL CYCLE OR DNA ANALYSIS,479.0,335.3,,,0
HCPCS,88184,FLOWCYTOMETRY/ TC 1 MARKER,470.0,329.0,,,0
HCPCS,88184,Flowcytometry/ tc 1 marker,,,268.85,1574.35,11
HCPCS,88185,Flowcytometry/tc add-on,,,268.85,335.4,4
HCPCS,88185,HC FLOWCYTOMETRY/TC ADD-ON,313.0,219.1,,,0
HCPCS,88185,HC PRO FLOWCYTOMETRY/TC ADD-ON,59.0,41.3,,,0
HCPCS,88187,Flowcytometry/read 2-8,,,47.96,59.84,4
HCPCS,88187,HC PRO FLOWCYTOMETRY/READ 2-8,89.0,62.3,,,0
HCPCS,88188,Flowcytometry/read 9-15,,,47.96,59.84,4
HCPCS,88189,Flowcytometry/read 16 & >,,,102.87,128.33,4
HCPCS,88189,HC PRO FLOWCYTOMETRY/READ 16 & >,140.0,98.0,,,0
HCPCS,88199,Cytopathology procedure,,,19.39,228.88,11
HCPCS,88230,HC TISSUE CULTURE LYMPHOCYTE,740.0,518.0,,,0
HCPCS,88230,Tissue culture lymphocyte,,,104.84,527.9,11
HCPCS,88233,HC TISS CULT SKIN SOLID TISSUE BX,277.0,193.9,,,0
HCPCS,88233,Tissue culture skin/biopsy,,,126.66,246.28,11
HCPCS,88235,Tissue culture placenta,,,135.27,812.7,11
HCPCS,88237,HC TISSUE CULTURE BONE MARROW,1037.0,725.9,,,0
HCPCS,88237,Tissue culture bone marrow,,,129.38,739.65,11
HCPCS,88239,HC TISSUE CULTURE SOLID TUMOR,709.0,496.3,,,0
HCPCS,88239,Tissue culture tumor,,,132.77,814.17,11
HCPCS,88240,Cell cryopreserve/storage,,,11.76,50.61,11
HCPCS,88241,Frozen cell preparation,,,10.88,50.61,11
HCPCS,88245,Chromosome analysis 20-25,,,155.85,821.58,11
HCPCS,88248,Chromosome analysis 50-100,,,155.85,955.74,11
HCPCS,88249,Chromosome analysis 100,,,155.85,955.74,11
HCPCS,88249,HC CHROMO ANALYSIS BREAK 100 CELLS,1666.0,1166.2,,,0
HCPCS,88261,Chromosome analysis 5,,,237.91,975.43,11
HCPCS,88262,Chromosome analysis 15-20,,,112.94,419.8,11
HCPCS,88262,HC CHROM ANALY SHORT 15-20 2K B,588.0,411.6,,,0
HCPCS,88263,Chromosome analysis 45,,,135.26,829.41,11
HCPCS,88264,Chromosome analysis 20-25,,,130.15,687.88,11
HCPCS,88264,HC CHROM ANALYZE 20-25 CELLS,1037.0,725.9,,,0
HCPCS,88267,Chromosome analys placenta,,,169.71,992.14,11
HCPCS,88269,Chromosome analys amniotic,,,156.29,917.94,11
HCPCS,88271,CYTOGENETICS DNA PROBE,207.0,144.9,,,0
HCPCS,88271,Cytogenetics dna probe,,,19.28,118.2,11
HCPCS,88271,HC PRO CYTOGENETICS DNA PROBE,53.0,37.1,,,0
HCPCS,88272,Cytogenetics 3-5,,,36.63,147.76,11
HCPCS,88273,Cytogenetics 10-30,,,31.33,177.32,11
HCPCS,88273,HC CYTOGENETICS 10-30,207.0,144.9,,,0
HCPCS,88274,Cytogenetics 25-99,,,38.14,192.1,11
HCPCS,88274,HC CYTOGENETICS 25-99,184.0,128.8,,,0
HCPCS,88275,Cytogenetics 100-300,,,46.07,221.66,11
HCPCS,88280,Chromosome karyotype study,,,30.12,138.5,11
HCPCS,88283,Chromosome banding study,,,61.74,378.57,11
HCPCS,88285,Chromosome count additional,,,24.22,104.86,11
HCPCS,88289,Chromosome study additional,,,30.99,190.06,11
HCPCS,88289,HC CHROMOSOME STUDY ADDITIONAL,487.0,340.9,,,0
HCPCS,88291,HC PRO CYTO/MOLECULAR REPORT,146.0,102.2,,,0
HCPCS,88299,Cytogenetic study,,,19.39,228.88,11
HCPCS,88300,HC PRO SURGICAL PATH GROSS,57.0,39.9,,,0
HCPCS,88300,HC SURGICAL PATH GROSS,33.0,23.1,,,0
HCPCS,88300,Surgical path gross,,,21.75,127.04,11
HCPCS,88302,HC PRO SURG PATH GROSS AND MICROSCOP II,106.0,74.2,,,0
HCPCS,88302,HC SURG PATH GROSS AND MICROSCOP II,69.0,48.3,,,0
HCPCS,88302,Tissue exam by pathologist,,,36.98,164.05,11
HCPCS,88304,HC PRO TISSUE EXAM BY PATHOLOGIST,139.0,97.3,,,0
HCPCS,88304,HC SURG PATH GROSS AND MICROSC LII,79.0,55.3,,,0
HCPCS,88304,Tissue exam by pathologist,,,46.78,228.88,11
HCPCS,88305,HC PRO SURG PATH GROSS/MICROSCOPIC EXAM PROSTATE NEEDLE BIOPSY ANY METHOD,758.0,530.6,,,0
HCPCS,88305,HC PRO TISSUE EXAM BY PATHOLOGIST,182.0,127.4,,,0
HCPCS,88305,HC SURG PATH GROSS/MIICROSCOPIC EXAM PROSTATE NEEDLE BIOPSY ANY METHOD,375.0,262.5,,,0
HCPCS,88305,SURG PATH GROSS AND MICROSC IV,375.0,262.5,,,0
HCPCS,88305,Tissue exam by pathologist,,,51.59,228.88,11
HCPCS,88307,HC PRO SURG PATH GROSS AND MICROSC V,423.0,296.1,,,0
HCPCS,88307,HC SURG PATH GROSS AND MICROSC V,338.0,236.6,,,0
HCPCS,88307,Tissue exam by pathologist,,,133.35,1574.35,11
HCPCS,88309,HC PRO SURG PATH GROSS AND MICROSC VI,510.0,357.0,,,0
HCPCS,88309,HC SURG PATH GROSS AND MICROSC VI,375.0,262.5,,,0
HCPCS,88309,Tissue exam by pathologist,,,214.84,3538.67,11
HCPCS,88311,Decalcify tissue,,,21.96,27.39,4
HCPCS,88311,HC DECALCIFY TISSUE,39.0,27.3,,,0
HCPCS,88311,HC PRO DECALCIFY TISSUE,37.0,25.9,,,0
HCPCS,88312,HC PRO SPECIAL STAINS GROUP 2,115.0,80.5,,,0
HCPCS,88312,HC SPECIAL STAINS GROUP 1,91.0,63.7,,,0
HCPCS,88312,Special stains group 1,,,51.59,228.88,11
HCPCS,88313,HC PRO SPECIAL STAINS GROUP 2,83.0,58.1,,,0
HCPCS,88313,HC SPECIAL STAIN GROUP II INCL INTERP AND REPORT,69.0,48.3,,,0
HCPCS,88313,Special stains group 2,,,39.76,584.37,11
HCPCS,88314,HC HISTOCH STAINS FZN TISS ADD-ON,199.0,139.3,,,0
HCPCS,88314,Histochemical stains add-on,,,113.36,141.41,4
HCPCS,88319,Enzyme histochemistry,,,214.84,3538.67,11
HCPCS,88319,HC PRO ENZYME HISTOCHEMISTRY,105.0,73.5,,,0
HCPCS,88319,HC SPECIAL STAIN GROUP III INCL INTERP AND REPORT,375.0,262.5,,,0
HCPCS,88321,HC PRO MICROSLIDE CONSULTATION,129.0,90.3,,,0
HCPCS,88321,Microslide consultation,,,36.98,164.05,11
HCPCS,88323,HC PRO CONSULTATION AND REPORT ON REFERRED MATERIAL REQUIRING PREP OF SLIDES,183.0,128.1,,,0
HCPCS,88323,Microslide consultation,,,51.59,228.88,11
HCPCS,88325,Comprehensive review of data,,,163.38,748.29,11
HCPCS,88325,HC CONSULT COMPREHENSIVE W/ REVIEW OF RECORDS/SPECIMENS W/ REPRT ON REFER MATERIAL,299.0,209.3,,,0
HCPCS,88325,HC PRO CONSULTATION COMPREHENSIVE W/ REVIEW OF RECORDS/SPECIMENS W/ REPORT ON REFERRED MATERIAL,169.0,118.3,,,0
HCPCS,88329,HC PRO PATH CONSULT INTROP,154.0,107.8,,,0
HCPCS,88329,Path consult introp,,,47.96,259.1,11
HCPCS,88331,HC PATH CONSULT INTRAOP 1 BLOC,235.0,164.5,,,0
HCPCS,88331,HC PRO PATH CONSULT INTRAOP 1 BLOC,233.0,163.1,,,0
HCPCS,88331,Path consult intraop 1 bloc,,,134.13,748.29,11
HCPCS,88332,HC PATH CONSULT INTRAOP ADDL,46.0,32.2,,,0
HCPCS,88332,HC PRO PATH CONSULT INTRAOP ADDL,160.0,112.0,,,0
HCPCS,88332,Path consult intraop addl,,,26.11,32.58,4
HCPCS,88333,HC PRO INTRAOP CYTO PATH CONSULT 1ST,131.0,91.7,,,0
HCPCS,88333,INTRAOP CYTO PATH CONSULT 1ST,375.0,262.5,,,0
HCPCS,88333,Intraop cyto path consult 1,,,214.84,3538.67,11
HCPCS,88334,HC PATHOLOGY CONSULT DURING SURGERY CYTOLOGIC EXAM EA ADDTL SITE,235.0,164.5,,,0
HCPCS,88334,HC PRO INTRAOP CYTO PATH CONSULT ADDL,67.0,46.9,,,0
HCPCS,88334,Intraop cyto path consult 2,,,134.13,167.33,4
HCPCS,88341,HC IMMHISTO/CYTO PER SPEC EA ADDL SINGLE ANTIBODY,122.0,85.4,,,0
HCPCS,88341,HC PRO IMMHISTO/CYTO PER SPEC EA ADDL SINGLE ANTIBODY,80.0,56.0,,,0
HCPCS,88341,Immunohisto antb addl slide,,,69.44,86.63,4
HCPCS,88342,HC IMMUNOHISTOCHEMISTRY INITIAL SINGLE ANTIBODY,235.0,164.5,,,0
HCPCS,88342,HC PRO IMMUNOHISTOCHEMISTRY,128.0,89.6,,,0
HCPCS,88342,Immunohisto antb 1st stain,,,135.5,748.29,11
HCPCS,88344,HC IMMHISTO/CYTO PER SPEC EA MULTI ANTIBODY,338.0,236.6,,,0
HCPCS,88344,HC PRO IMMHISTO/CYTO PER SPEC EA MULTI ANTIBODY STAIN,138.0,96.6,,,0
HCPCS,88344,Immunohisto antibody slide,,,134.13,1574.35,11
HCPCS,88346,HC IMMUNOFLUORESCENCE PER SPECIMEN INITIAL SINGLE ANTIBODY STAIN PROCEDURE,235.0,164.5,,,0
HCPCS,88346,HC PRO IMMUNOFLUORESCENCE PER SPECIMEN INITIAL SINGLE ANTIBODY STAIN PROCEDURE,117.0,81.9,,,0
HCPCS,88346,Immunofluor antb 1st stain,,,134.13,748.29,11
HCPCS,88348,ELECTRON MICROSCOPY,1264.0,884.8,,,0
HCPCS,88348,Electron microscopy,,,539.13,3538.67,11
HCPCS,88348,HC PRO ELECTRON MICROSCOPY DIAGNOSTIC,407.0,284.9,,,0
HCPCS,88350,HC IMMUNOFLUORESCENCE PER SPECIMEN EA ADDTL SINGLE ANTIBODY STAIN PROCEDURE,143.0,100.1,,,0
HCPCS,88350,HC PRO IMMUNOFLUORESCENCE PER SPECIMEN EA ADDTL SINGLE ANTIBODY STAIN PROCEDURE,86.0,60.2,,,0
HCPCS,88350,Immunofluor antb addl stain,,,206.71,257.87,4
HCPCS,88355,Analysis skeletal muscle,,,102.87,748.29,11
HCPCS,88356,Analysis nerve,,,51.59,228.88,11
HCPCS,88358,Analysis tumor,,,163.38,748.29,11
HCPCS,88360,HC PRO TUMOR IMMUNOHISTOCHEM/MAN,170.0,119.0,,,0
HCPCS,88360,TUMOR IMMUNOHISTOCHEM/MAN,235.0,164.5,,,0
HCPCS,88360,Tumor immunohistochem/manual,,,134.13,748.29,11
HCPCS,88361,HC TUMOR IMMUNOHISTOCHEM/COMPUT,330.0,231.0,,,0
HCPCS,88361,Tumor immunohistochem/comput,,,163.38,1574.35,11
HCPCS,88362,Nerve teasing preparations,,,163.38,3538.67,11
HCPCS,88363,Xm archive tissue molec anal,,,28.63,127.04,11
HCPCS,88364,HC INSITU HYBRIDIZATION (FISH) PER SPEC EA ADDTL SINGLE STAIN,69.0,48.3,,,0
HCPCS,88364,HC PRO INSITU HYBRIDIZATION (FISH) PER SPEC EA ADDTL SINGLE STAIN,114.0,79.8,,,0
HCPCS,88364,Insitu hybridization (fish),,,275.97,344.28,4
HCPCS,88365,HC INSITU HYBRIDIZATION (FISH),203.0,142.1,,,0
HCPCS,88365,HC PRO INSITU HYBRIDIZATION (FISH),197.0,137.9,,,0
HCPCS,88365,Insitu hybridization (fish),,,116.32,748.29,11
HCPCS,88366,HC INSITU HYBRIDIZATION PER SPECIMEN EACH MULTIPLEX PROBE STAIN,69.0,48.3,,,0
HCPCS,88366,HC PRO INSITU HYBRIDIZATION PER SPECIMEN EACH MULTIPLEX PROBE STAIN,177.0,123.9,,,0
HCPCS,88366,Insitu hybridization (fish),,,168.66,748.29,11
HCPCS,88367,Insitu hybridization auto,,,163.38,1574.35,11
HCPCS,88368,HC INSITU HYBRIDIZATION MANUAL,334.0,233.8,,,0
HCPCS,88368,HC PRO FISH ALK,125.0,87.5,,,0
HCPCS,88368,Insitu hybridization manual,,,102.87,1574.35,11
HCPCS,88369,HC MORPHOMETRIC ANALYSIS IN SITU HYBRIDIZATION MANUAL PER SPECIMEN EACH ADDITIONAL SINGLE PROBE STAIN,222.0,155.4,,,0
HCPCS,88369,HC PRO MORPHOMETRIC ANALYSIS IN SITU HYBRIDIZATION MANUAL PER SPECIMEN EACH ADDITIONAL SINGLE PROBE STAIN,171.0,119.7,,,0
HCPCS,88369,M/phmtrc alysishquant/semiq,,,210.28,262.33,4
HCPCS,88371,Protein western blot tissue,,,98.29,122.62,4
HCPCS,88372,HC PRO PROTEIN ANALYSIS W/ PROBE,57.0,39.9,,,0
HCPCS,88372,Protein analysis w/probe,,,100.66,125.57,4
HCPCS,88373,M/phmtrc alys ishquant/semiq,,,172.56,215.27,4
HCPCS,88374,HC MORPHOMETRIC ALYS ISH QUANT/SEM-QUANT COMPUTER ASSISTED TECH EA MULTI PROBE STAIN PROCEDURE,664.0,464.8,,,0
HCPCS,88374,HC PRO MORPHOMETRIC ALYS ISH QUANT/SEM-QUANT COMPUTER ASSISTED TECH EA MULTI PROBE STAIN PROCEDURE,313.0,219.1,,,0
HCPCS,88374,M/phmtrc alys ishquant/semiq,,,168.66,748.29,11
HCPCS,88375,Optical endomicroscpy interp,,,38.51,48.04,4
HCPCS,88377,HC MORPHOMETRIC ANALYSIS IN SITU HYBRIDIZATION MANUAL PER SPECIMEN,235.0,164.5,,,0
HCPCS,88377,"HC PRO MORPHOMETRIC ANALYSIS, IN SITU HYBRIDIZATION, MANUAL, PER SPECIMEN",81.0,56.7,,,0
HCPCS,88377,M/phmtrc alys ishquant/semiq,,,134.13,748.29,11
HCPCS,88380,HC PRO MICRODISSECTION LASER CAPTURE,277.0,193.9,,,0
HCPCS,88380,MICRODISSECTION LASER,203.0,142.1,,,0
HCPCS,88381,HC PRO MICRODISSECTION MANUAL,461.0,322.7,,,0
HCPCS,88399,Surgical pathology procedure,,,19.39,228.88,11
HCPCS,88720,Bilirubin total transcut,,,4.52,27.71,11
HCPCS,88720,HC POC BILIRUBIN TOTAL TRANSCUT,25.0,17.5,,,0
HCPCS,88738,Hgb quant transcutaneous,,,4.52,17.03,11
HCPCS,88740,Transcutaneous carboxyhb,,,8.43,27.71,11
HCPCS,88741,Transcutaneous methb,,,8.43,27.71,11
HCPCS,89049,Chct for mal hyperthermia,,,102.87,748.29,11
HCPCS,89050,BODY FLUID NOT BLD CELL COUNT,29.0,20.3,,,0
HCPCS,89050,Body fluid cell count,,,4.25,21.1,11
HCPCS,89051,BODY FLUID NOT BLD W/ DIFF COUNT,98.0,68.6,,,0
HCPCS,89051,Body fluid cell count,,,5.04,67.51,11
HCPCS,89055,Leukocyte assessment fecal,,,3.84,23.55,11
HCPCS,89060,Exam synovial fluid crystals,,,6.6,26.86,11
HCPCS,89060,HC CRYSTAL ID FROM TISSUE OR BODY FLUID,30.0,21.0,,,0
HCPCS,89125,Specimen fat stain,,,5.29,23.81,11
HCPCS,89160,Exam feces for meat fibers,,,4.36,20.34,11
HCPCS,89190,Nasal smear for eosinophils,,,5.21,26.2,11
HCPCS,89220,Sputum specimen collection,,,102.87,748.29,11
HCPCS,89230,Collect sweat for test,,,51.59,228.88,11
HCPCS,89230,HC COLLECT SWEAT FOR TEST,106.0,74.2,,,0
HCPCS,89240,Pathology lab procedure,,,19.39,228.88,11
HCPCS,89250,Cultr oocyte/embryo <4 days,,,163.38,748.29,11
HCPCS,89251,Cultr oocyte/embryo <4 days,,,163.38,748.29,11
HCPCS,89253,Embryo hatching,,,163.38,748.29,11
HCPCS,89254,Oocyte identification,,,163.38,748.29,11
HCPCS,89255,Prepare embryo for transfer,,,51.59,228.88,11
HCPCS,89257,Sperm identification,,,51.59,228.88,11
HCPCS,89258,Cryopreservation embryo(s),,,163.38,3538.67,11
HCPCS,89259,Cryopreservation sperm,,,163.38,748.29,11
HCPCS,89260,Sperm isolation simple,,,51.59,228.88,11
HCPCS,89261,Sperm isolation complex,,,51.59,228.88,11
HCPCS,89264,Identify sperm tissue,,,51.59,228.88,11
HCPCS,89268,Insemination of oocytes,,,163.38,748.29,11
HCPCS,89272,Extended culture of oocytes,,,163.38,3538.67,11
HCPCS,89280,Assist oocyte fertilization,,,163.38,3538.67,11
HCPCS,89281,Assist oocyte fertilization,,,163.38,748.29,11
HCPCS,89290,Biopsy oocyte polar body,,,163.38,748.29,11
HCPCS,89291,Biopsy oocyte polar body,,,163.38,748.29,11
HCPCS,89300,Semen analysis w/huhner,,,8.86,49.22,11
HCPCS,89310,Semen analysis w/count,,,7.75,47.51,11
HCPCS,89320,Semen anal vol/count/mot,,,11.08,37.76,11
HCPCS,89321,HC SEMEN ANALYS SPERM DETECTION,46.0,32.2,,,0
HCPCS,89321,Semen anal sperm detection,,,10.84,37.76,11
HCPCS,89322,Semen anal strict criteria,,,13.95,85.54,11
HCPCS,89325,Sperm antibody test,,,9.6,58.89,11
HCPCS,89329,Sperm evaluation test,,,17.63,115.71,11
HCPCS,89330,Evaluation cervical mucus,,,9.34,54.62,11
HCPCS,89331,Retrograde ejaculation anal,,,17.63,108.11,11
HCPCS,89335,Cryopreserve testicular tiss,,,51.59,228.88,11
HCPCS,89337,Cryopreservation oocyte(s),,,168.66,748.29,11
HCPCS,89342,Storage/year embryo(s),,,163.38,748.29,11
HCPCS,89343,Storage/year sperm/semen,,,163.38,748.29,11
HCPCS,89344,Storage/year reprod tissue,,,163.38,748.29,11
HCPCS,89346,Storage/year oocyte(s),,,163.38,748.29,11
HCPCS,89352,Thawing cryopresrved embryo,,,163.38,748.29,11
HCPCS,89353,Thawing cryopresrved sperm,,,51.59,228.88,11
HCPCS,89354,Thaw cryoprsvrd reprod tiss,,,163.38,748.29,11
HCPCS,89356,Thawing cryopresrved oocyte,,,163.38,748.29,11
HCPCS,89398,Unlisted reprod med lab proc,,,51.59,228.88,11
HCPCS,902,HC PRO ANESTH ANORECTAL SURGERY,156.0,109.2,,,0
HCPCS,90371,HEPATITIS B IMMUNE GLOBULIN 110 UNIT/0.5 ML IM SYRG,304.5,213.15,,,0
HCPCS,90371,HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML (5 ML) IM SOLN,2120.5,1484.35,,,0
HCPCS,90371,HEPATITIS B IMMUNE GLOBULIN >312 UNIT/ML IM SOLN,721.0,504.7,,,0
HCPCS,90371,Hep b ig im,,,140.21,480.78,11
HCPCS,90375,RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML IM SOLN,7604.5,5323.15,,,0
HCPCS,90375,Rabies ig im/sc,,,275.18,481.56,11
HCPCS,90376,Rabies ig heat treated,,,305.15,1563.66,11
HCPCS,90377,Rabies ig ht&sol human im/sc,,,242.18,911.74,11
HCPCS,90378,Rsv mab im 50mg,,,436.75,1937.71,11
HCPCS,90380,HC ADMIN RESPIRATORY SYNCYTIAL VIRUS MONOCLONAL ANTIBODY SEASONAL DOSE INTRAMUSCULAR INJECTION,1485.0,1039.5,,,0
HCPCS,90380,NIRSEVIMAB-ALIP 50 MG/0.5 ML IM SYRG,1485.0,1039.5,,,0
HCPCS,90381,HC ADMIN RESPIRATORY SYNCYTIAL VIRUS MONOCLONAL ANTIBODY SEASONAL DOSE INTRAMUSCULAR INJECTION,2202.5,1541.75,,,0
HCPCS,90381,NIRSEVIMAB-ALIP 100 MG/ML IM SYRG,1485.0,1039.5,,,0
HCPCS,90381,NIRSEVIMAB-ALIP 50 MG/0.5 ML IM SYRG,3070.0,2149.0,,,0
HCPCS,90385,Rh ig minidose im,,,80.0,572.33,11
HCPCS,90396,"VARICELLA-ZOSTER GE VAC,2 OF 2 50 MCG IM SUSR",763.0,534.1,,,0
HCPCS,90396,VARICELLA-ZOSTER IG-MALTOSE 125 UNIT/1.2 ML IM SOLN,25935.0,18154.5,,,0
HCPCS,90396,Varicella-zoster ig im,,,348.45,10484.94,11
HCPCS,90460,Im admin 1st/only component,,,73.33,91.48,4
HCPCS,90471,HC MCARE ADMIN FLU VACC,221.0,154.7,,,0
HCPCS,90471,HC MCARE ADMIN HEPATITIS B VACC,221.0,154.7,,,0
HCPCS,90471,HC MCARE ADMIN PNEUMO VACC,221.0,154.7,,,0
HCPCS,90471,IMMUN ADMIN I VAC,221.0,154.7,,,0
HCPCS,90471,Immunization admin,,,60.12,316.24,11
HCPCS,90472,IMMUN ADMIN EA ADDL VAC,54.0,37.8,,,0
HCPCS,90472,Immunization admin each add,,,26.93,33.59,4
HCPCS,90473,Immune admin oral/nasal,,,50.9,316.24,11
HCPCS,90474,Immune admin oral/nasal addl,,,50.9,63.5,4
HCPCS,90476,Adenovirus vaccine type 4,,,1084.68,1353.16,4
HCPCS,90480,Admn sarscov2 vacc 1 dose,,,40.23,178.5,11
HCPCS,90585,Bcg vaccine percut,,,367.45,458.4,4
HCPCS,90586,Bcg vaccine intravesical,,,379.81,473.82,4
HCPCS,90611,Smallpox&monkeypox vac 0.5ml,,,0.01,0.04,10
HCPCS,90619,"MENING VAC A,C,Y,W135,TET (PF) 10 MCG/0.5 ML IM SOLN",732.0,512.4,,,0
HCPCS,90620,"MENINGOCOCCAL B VACC,4-CMP(PF) 50-50-50-25 MCG/0.5 ML IM SYRG",792.0,554.4,,,0
HCPCS,90620,Menb rp w/omv vaccine im,,,474.5,591.95,4
HCPCS,90621,Menb rlp vaccine im,,,371.78,463.81,4
HCPCS,90622,Vaccinia vrs vac 0.3 ml perq,,,0.01,0.04,10
HCPCS,90623,"MENING A,C,Y,W TT-N. MEN B(PF) 5-120 MCG/0.5 ML IM KIT (CAM USE ONLY)",829.0,580.3,,,0
HCPCS,90632,HEPATITIS A VIRUS VACCINE (PF) 1440 ELISA UNIT/ML IM SYRG,396.5,277.54999999999995,,,0
HCPCS,90633,HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML IM MERGE (CAM USE ONLY),231.0,161.7,,,0
HCPCS,90633,HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML IM SYRG,228.0,159.6,,,0
HCPCS,90633,HEPATITIS A VIRUS VACCINE (PF) 720 EL UNIT/0.5 ML IM SYRG,229.0,160.3,,,0
HCPCS,90636,HEPATITIS A & B VIRUS VACCINE (PF) 720 ELISA UNIT-20 MCG/ML IM SYRINGE,558.5,390.95,,,0
HCPCS,90644,Hib-mency vacc 6wk-18m0 im,,,76.48,95.41,4
HCPCS,90647,HAEMOPH B POLYSAC CONJ-MENING (PF) 7.5 MCG/0.5 ML IM,181.5,127.05000000000001,,,0
HCPCS,90648,HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX (PF) 10 MCG IM,76.0,53.2,,,0
HCPCS,90649,4vhpv vaccine 3 dose im,,,456.05,568.93,4
HCPCS,90651,"HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM INJ MERGE (CAM USE ONLY)",1127.0,788.9,,,0
HCPCS,90651,"HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM SUSP",885.0,619.5,,,0
HCPCS,90651,"HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM SYRG",1127.0,788.9,,,0
HCPCS,90653,FLU VACCINE 2024-25 65YR UP ADJMF59C (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,373.0,261.1,,,0
HCPCS,90654,Flu vacc iiv3 no preserv id,,,57.51,71.74,4
HCPCS,90655,Iiv3 vacc no prsv 0.25 ml im,,,51.15,63.81,4
HCPCS,90656,FLU VACCINE TS 2024-25 6MOS UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,121.0,84.7,,,0
HCPCS,90656,FLU VACCINE TS 2025-26 6 MO UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,122.0,85.4,,,0
HCPCS,90656,Iiv3 vacc no prsv 0.5 ml im,,,55.15,68.8,4
HCPCS,90657,Iiv3 vaccine splt 0.25 ml im,,,20.03,24.99,4
HCPCS,90658,Iiv3 vaccine splt 0.5 ml im,,,40.06,49.97,4
HCPCS,90660,FLU VACC TV LIVE 2025(2-49YRS) 10EXP6.5-7.5 FF UNIT/0.2 ML NASL NSSY,153.0,107.1,,,0
HCPCS,90660,Laiv3 vaccine intranasal,,,67.63,84.37,4
HCPCS,90662,FLU VACCINE TS 2024-25 65 YR UP (PF) 180 MCG/0.5 ML IM SYRG,373.0,261.1,,,0
HCPCS,90662,FLU VACCINE TS 2025-26 65 YR UP (PF) 180 MCG/0.5 ML IM SYRG,387.5,271.25,,,0
HCPCS,90670,PNEUMOC 13-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG,814.5,570.15,,,0
HCPCS,90670,Pcv13 vaccine im,,,442.26,551.73,4
HCPCS,90672,Laiv4 vaccine intranasal,,,77.99,97.3,4
HCPCS,90673,Riv3 vaccine no preserv im,,,110.53,137.89,4
HCPCS,90674,Cciiv4 vac no prsv 0.5 ml im,,,64.02,79.87,4
HCPCS,90675,"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM KIT",1333.0,933.1,,,0
HCPCS,90675,"RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT IM",1246.0,872.2,,,0
HCPCS,90675,Rabies vaccine im,,,315.22,570.14,11
HCPCS,90676,Rabies vaccine id,,,236.86,1050.87,11
HCPCS,90677,PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG,972.0,680.4,,,0
HCPCS,90678,"RSV VAC, PREF A AND PREF B(PF) 120 MCG/0.5 ML IM SOLR",1066.0,746.2,,,0
HCPCS,90680,"ROTAVIRUS VACCINE LIVE, PENTA 2 ML ORAL SUSP",339.5,237.64999999999998,,,0
HCPCS,90681,"ROTAVIRUS VAC,LIVE ATT, 89-12 STRAIN G1P(8) 10EXP6 CCID50/ML ORAL SUSP",913.0,639.1,,,0
HCPCS,90681,"ROTAVIRUS VACCINE, LIVE, 89-12 10EXP6 CCID50 /1.5 ML ORAL SUSP",511.5,358.05,,,0
HCPCS,90685,Iiv4 vacc no prsv 0.25 ml im,,,72.42,90.34,4
HCPCS,90686,Iiv4 vacc no prsv 0.5 ml im,,,54.48,67.96,4
HCPCS,90687,Iiv4 vaccine splt 0.25 ml im,,,27.66,34.51,4
HCPCS,90688,Iiv4 vaccine splt 0.5 ml im,,,51.03,63.66,4
HCPCS,90690,"TYPHOID VACCINE 2 BILLION UNIT CAP, DELAYED RELEASE",165.0,115.5,,,0
HCPCS,90691,TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML IM SYRG,649.5,454.65,,,0
HCPCS,90696,"DIPH,PERTUS(ACEL),TET,POLIO(PF)(KINRIX) 25 LF-58 MCG-10 LF/0.5 ML IM SYRINGE",318.0,222.6,,,0
HCPCS,90697,"DIP,PER(A)TET-HEPB-POL-HIB(PF) 15 UNIT-5 UNIT- 10 MCG/0.5 ML IM INJ MERGE (CAM USE ONLY)",652.5,456.75,,,0
HCPCS,90697,"DIP,PER(A)TET-HEPB-POL-HIB(PF) 15 UNIT-5 UNIT- 10 MCG/0.5 ML IM SYRG",421.0,294.7,,,0
HCPCS,90698,"DIP,PER(A)TET-HEPB-POL-HIB(PF) 15 UNIT-5 UNIT- 10 MCG/0.5 ML IM SYRG",421.0,294.7,,,0
HCPCS,90698,DIP-PERT(A)-TET-POLIO-HIB (PF) 15LF-20MCG-5LF- 62 DU/0.5 ML IM KIT,504.5,353.15,,,0
HCPCS,90698,"HIB CONJ-TET,COMPNT 2 OF 2(PF) 10 MCG/0.5 ML IM SOLR",493.0,345.1,,,0
HCPCS,90700,"DIPHTH,PERTUS(ACELL),TETANUS SYRG (INFANRIX) 25 LF UNIT-58MCG-10 LF/0.5ML IM SYRINGE",334.0,233.8,,,0
HCPCS,90707,"MEASLES,MUMPS&RUBELLA VACCIN(PF) 1,000-12,500 TCID50/0.5 ML SUB-Q SUSP",410.0,287.0,,,0
HCPCS,90707,"MEASLES,MUMPS,RUBELLA VACC(PF) 10EXP3.4-4.2- 3.3CCID50/0.5ML SUBQ SUSR",398.0,278.6,,,0
HCPCS,90710,"DIPH,PERTUS(ACEL),TET,POLIO(PF)(KINRIX) 25 LF-58 MCG-10 LF/0.5 ML IM SYRINGE",1164.0,814.8000000000001,,,0
HCPCS,90710,"MEASLES,MUMPS,RUB,VARICEL (PF) 10EXP3-4.3-3-3.99TCID50/0.5ML SUB-Q",776.0,543.2,,,0
HCPCS,90710,Mmrv vaccine sc,,,484.8,604.8,4
HCPCS,90713,POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML INJ SUSP,121.0,84.69999999999999,,,0
HCPCS,90714,TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP,217.0,151.9,,,0
HCPCS,90714,TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE,214.0,149.8,,,0
HCPCS,90715,"DIPHTH,PERTUS(ACELL),TETANUS SYRG(BOOSTRIX) 2.5-8-5 LF-MCG-LF/0.5ML IM SYRG",243.5,170.45,,,0
HCPCS,90715,"DIPHTH,PERTUS(ACELL),TETANUS VIAL (ADACEL) 2 LF-(5-3-5MCG)-5 LF/0.5 ML IM SUSP",249.0,174.3,,,0
HCPCS,90715,"DIPHTH,PERTUS(ACELL),TETANUS VIAL (BOOSTRIX*) 2.5-8-5 LF-MCG-LF/0.5ML IM SUSP",240.0,168.0,,,0
HCPCS,90716,"VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUB-Q SOLN",465.0,325.5,,,0
HCPCS,90716,Var vaccine live subq,,,234.58,292.65,4
HCPCS,90717,YELLOW FEVER VACCINE (PF) 10 EXP4.74 UNIT/0.5 ML SUB-Q SUSP,1206.0,844.2,,,0
HCPCS,90723,HEP B-DP(ACELL)T-POLIO VACC-PF 10MCG-25LF-25MCG-10LF-40-8-32 IM SYRING,433.0,303.1,,,0
HCPCS,90732,PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML INJ SYRG,506.0,354.2,,,0
HCPCS,90732,PNEUMOCOCCAL 23-VALPS VACCINE 25 MCG/0.5 ML INJ,506.0,354.2,,,0
HCPCS,90732,PNEUMOCOCCAL 23-VALPS VACCINE 25 MCG/0.5 ML INJ MERGE (CAM USE ONLY),506.0,354.2,,,0
HCPCS,90732,PNEUMOVAX 23 25 MCG/0.5 ML INJ SYRG,506.0,354.2,,,0
HCPCS,90732,Ppsv23 vacc 2 yrs+ subq/im,,,99.08,123.61,4
HCPCS,90733,Mpsv4 vaccine subq,,,292.03,364.32,4
HCPCS,90734,"MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM KIT",680.0,476.0,,,0
HCPCS,90734,"MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM KIT (CAM USE ONLY)",680.0,476.0,,,0
HCPCS,90734,"MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM SOLN",700.0,490.0,,,0
HCPCS,90734,"MENINGOC VAC A,C,Y,W-135 DIP (PF) 4 MCG/0.5 ML IM",612.0,428.4,,,0
HCPCS,90734,Mcv4 menacwy vaccine im,,,255.13,318.28,4
HCPCS,90738,JAPANESE ENCEPHALITIS VACC(PF) 6 MCG/0.5 ML IM SYRG,862.0,603.4,,,0
HCPCS,90740,Hepb vacc 3 dose immunsup im,,,361.84,451.41,4
HCPCS,90743,Hepb vacc 2 dose adolesc im,,,73.39,91.55,4
HCPCS,90744,HC MCARE ADMIN HEPATITIS B VACC,333.0,233.1,,,0
HCPCS,90744,HEPATITIS B VIRUS VACCINE (PF)  5 MCG/0.5 ML IM SYRG,164.0,114.8,,,0
HCPCS,90744,HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE,171.0,119.7,,,0
HCPCS,90744,Hepb vacc 3 dose ped/adol im,,,73.39,91.55,4
HCPCS,90746,HC MCARE ADMIN HEPATITIS B VACC,360.0,252.0,,,0
HCPCS,90746,HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML IM INJ MERGE (CAM USE ONLY),367.0,256.9,,,0
HCPCS,90746,HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML IM SYRINGE,360.0,252.0,,,0
HCPCS,90746,Hepb vaccine 3 dose adult im,,,180.92,225.7,4
HCPCS,90747,Hepb vacc 4 dose immunsup im,,,361.84,451.41,4
HCPCS,90750,ADJUVANT AS01B (PF)VIAL 1 OF 2 IM SUSP,763.0,534.1,,,0
HCPCS,90750,"VARICELLA-ZOSTER GE VAC,2 OF 2 50 MCG IM SUSR",809.0,566.3,,,0
HCPCS,90750,VARICELLA-ZOSTER GE-AS01B (PF) 50 MCG/0.5 ML IM SUSR,763.0,534.1,,,0
HCPCS,90750,VARICELLA-ZOSTER GE-AS01B (PF) 50 MCG/0.5 ML IM SUSR (CAM USE ONLY),855.0,598.5,,,0
HCPCS,90785,Psytx complex interactive,,,14.27,17.8,4
HCPCS,90791,Psych diagnostic evaluation,,,175.71,779.59,11
HCPCS,90792,Psych diag eval w/med srvcs,,,175.71,779.59,11
HCPCS,90832,HC PRO TELEHEALTH PSYCHOTHERAPY W/PATIENT 30 MINUTES,100.0,70.0,,,0
HCPCS,90832,Psytx w pt 30 minutes,,,175.71,779.59,11
HCPCS,90833,HC PRO TELEHEALTH PSYCHOTHERAPY 30 MIN W/PATIENT WHEN PERFORMED WITH E&M SERVICE,103.0,72.1,,,0
HCPCS,90833,Psytx w pt w e/m 30 min,,,123.08,153.54,4
HCPCS,90834,HC PRO TELEHEALTH PSYCHOTHERAPY W/PATIENT 45 MINUTES,133.0,93.1,,,0
HCPCS,90834,Psytx w pt 45 minutes,,,175.71,779.59,11
HCPCS,90836,HC PRO TELEHEALTH PSYCHOTHERAPY 45 MIN W/PATIENT WHEN PERFORMED WITH E&M SERVICE,129.0,90.3,,,0
HCPCS,90836,Psytx w pt w e/m 45 min,,,201.31,251.14,4
HCPCS,90837,Psytx w pt 60 minutes,,,175.71,779.59,11
HCPCS,90838,HC PRO TELEHEALTH TRACKING PSYCHOTHERAPY 60 MIN W/PATIENT WHEN PERFORMED WITH E&M SERVICE,185.0,129.5,,,0
HCPCS,90838,Psytx w pt w e/m 60 min,,,323.3,403.33,4
HCPCS,90839,HC PRO TELEHEALTH PSYCHOTHERAPY FOR CRISIS FIRST 60 MIN,203.0,142.1,,,0
HCPCS,90839,Psytx crisis initial 60 min,,,175.71,779.59,11
HCPCS,90840,HC PRO TELEHEALTH PSYCHOTHERAPY FOR CRISIS EACH ADDITIONAL 30 MIN,97.0,67.9,,,0
HCPCS,90840,Psytx crisis ea addl 30 min,,,190.71,237.91,4
HCPCS,90845,HC PRO TELEHEALTH PSYCHOANALYSIS,139.0,97.3,,,0
HCPCS,90845,Psychoanalysis,,,175.71,779.59,11
HCPCS,90846,Family psytx w/o pt 50 min,,,175.71,779.59,11
HCPCS,90847,Family psytx w/pt 50 min,,,175.71,779.59,11
HCPCS,90849,Multiple family group psytx,,,175.71,779.59,11
HCPCS,90853,Group psychotherapy,,,100.57,446.2,11
HCPCS,90853,HC GROUP PSYCHOTHERAPY,370.0,259.0,,,0
HCPCS,90865,Narcosynthesis,,,175.71,779.59,11
HCPCS,90867,Tcranial magn stim tx plan,,,213.76,948.37,11
HCPCS,90868,Tcranial magn stim tx deli,,,213.76,948.37,11
HCPCS,90869,Tcran magn stim redetemine,,,213.76,948.37,11
HCPCS,90870,Electroconvulsive therapy,,,850.12,3771.72,11
HCPCS,90870,HC ELECTROCONVULSIVE THERAPY,2366.0,1656.2,,,0
HCPCS,90880,Hypnotherapy,,,100.57,446.2,11
HCPCS,90899,Psychiatric service/therapy,,,37.09,292.72,11
HCPCS,90901,Biofeedback train any meth,,,16.24,73.45,10
HCPCS,90912,Bfb training 1st 15 min,,,37.27,168.17,10
HCPCS,90912,HC BIOFEEDBACK PERI/ANORECTAL/URETHRAL SPHINCTER INCL EMG/MANOMETRY 15 MIN,152.0,106.4,,,0
HCPCS,90913,Bfb training ea addl 15 min,,,20.97,93.52,10
HCPCS,90913,HC BIOFEEDBACK PERI/ANORECTAL/URETHRAL SPHINCTER INCL EMG/MANOMETRY EACH ADDTL 15 MIN,75.0,52.5,,,0
HCPCS,90935,HEMODIALYSIS ONE EVALUATION,2129.0,1490.3,,,0
HCPCS,90935,Hemodialysis one evaluation,,,679.43,3014.4,11
HCPCS,90937,Hemodialysis repeated eval,,,320.66,400.04,4
HCPCS,90945,Dialysis one evaluation,,,413.08,1832.68,11
HCPCS,90945,HC PERITONEAL DIALYSIS,668.0,467.6,,,0
HCPCS,90947,Dialysis repeated eval,,,328.09,409.3,4
HCPCS,90951,Esrd serv 4 visits p mo <2yr,,,2829.6,3529.99,4
HCPCS,90952,Esrd serv 2-3 vsts p mo <2yr,,,2052.67,2560.76,4
HCPCS,90953,Esrd serv 1 visit p mo <2yrs,,,1367.44,1705.91,4
HCPCS,90954,Esrd serv 4 vsts p mo 2-11,,,2329.86,2906.56,4
HCPCS,90955,Esrd srv 2-3 vsts p mo 2-11,,,1317.72,1643.88,4
HCPCS,90956,Esrd srv 1 visit p mo 2-11,,,892.03,1112.83,4
HCPCS,90957,Esrd srv 4 vsts p mo 12-19,,,1866.66,2328.71,4
HCPCS,90958,Esrd srv 2-3 vsts p mo 12-19,,,1259.09,1570.74,4
HCPCS,90959,Esrd serv 1 vst p mo 12-19,,,825.64,1030.01,4
HCPCS,90960,Esrd srv 4 visits p mo 20+,,,825.71,1030.09,4
HCPCS,90961,Esrd srv 2-3 vsts p mo 20+,,,667.12,832.24,4
HCPCS,90962,Esrd serv 1 visit p mo 20+,,,482.65,602.12,4
HCPCS,90963,Esrd home pt serv p mo <2yrs,,,1599.78,1995.76,4
HCPCS,90964,Esrd home pt serv p mo 2-11,,,1337.93,1669.1,4
HCPCS,90965,Esrd home pt serv p mo 12-19,,,1271.33,1586.01,4
HCPCS,90966,Esrd home pt serv p mo 20+,,,660.3,823.74,4
HCPCS,90967,Esrd home pt serv p day <2,,,56.96,71.06,4
HCPCS,90968,Esrd home pt srv p day 2-11,,,44.69,55.76,4
HCPCS,90969,Esrd home pt srv p day 12-19,,,43.6,54.39,4
HCPCS,90970,Esrd home pt serv p day 20+,,,23.3,29.07,4
HCPCS,90989,Dialysis training complete,,,1006.51,1255.64,4
HCPCS,90993,Dialysis training incompl,,,217.86,271.78,4
HCPCS,90997,Hemoperfusion,,,262.73,327.76,4
HCPCS,91010,Esophagus motility study,,,369.41,1987.42,11
HCPCS,91010,HC ESOPHAGUS MOTILITY STUDY,2155.0,1508.5,,,0
HCPCS,91013,Esophgl motil w/stim/perfus,,,855.91,1067.77,4
HCPCS,91020,Gastric motility studies,,,369.41,1638.96,11
HCPCS,91022,Duodenal motility study,,,288.27,1638.96,11
HCPCS,91030,Acid perfusion of esophagus,,,229.98,1638.96,11
HCPCS,91034,GASTROESOPHAGEAL REFLUX TEST,4396.0,3077.2,,,0
HCPCS,91034,Gastroesophageal reflux test,,,369.41,1638.96,11
HCPCS,91035,G-esoph reflx tst w/electrod,,,850.12,3771.72,11
HCPCS,91037,Esoph imped function test,,,213.76,948.37,11
HCPCS,91037,HC ESOPHAGEAL FUNCTION TEST GASTROESOPHAGEAL REFLEX W/IMPEDANCE,6551.0,4585.7,,,0
HCPCS,91038,Esoph imped funct test > 1hr,,,211.43,1638.96,11
HCPCS,91038,HC ESOPH FUNCT TEST GASTROESOPH REFLUX TEST W/ NASAL CATH INTRALUMINAL IMPED ELECTRODE(S) PLACE/RECORD/ANALYSIS/INTERP PROLONG (GREATER THAN 1 HR UP TO 24 HRS),2155.0,1508.5,,,0
HCPCS,91038,HC PRO ESOPH FUNCT TEST GASTROESOPH REFLUX TEST W/ NASAL CATH INTRALUMINAL IMPED ELECTRODE(S) PLACE/RECORD/ANALYSIS/INTERP PROLONG (GREATER THAN 1 HR UP TO 24 HRS),660.0,462.0,,,0
HCPCS,91040,Esoph balloon distension tst,,,369.41,1638.96,11
HCPCS,91065,Breath hydrogen/methane test,,,144.41,948.37,11
HCPCS,91065,HC BREATH HYDROGEN OR METHANE TEST,650.0,455.0,,,0
HCPCS,91110,Gi tract capsule endoscopy,,,897.89,3983.62,11
HCPCS,91111,Esophageal Capsule Endoscopy,,,897.89,3983.62,11
HCPCS,91112,Gi wireless capsule measure,,,897.89,3983.62,7
HCPCS,91113,Gi trc img intral colon i&r,,,920.63,4084.51,11
HCPCS,91117,Colon motility 6 hr study,,,213.76,948.37,11
HCPCS,91120,Rectal sensation test,,,887.91,1107.69,4
HCPCS,91122,Anal pressure record,,,368.48,459.69,4
HCPCS,91124,Rct snsatn tone&cmplianc std,,,213.76,948.37,7
HCPCS,91125,Anrct mano rct snsatn&balo,,,369.41,1638.96,7
HCPCS,91132,Electrogastrography,,,213.76,948.37,11
HCPCS,91133,Electrogastrography W/Test,,,131.71,584.37,11
HCPCS,91200,Liver elastography,,,127.38,565.15,11
HCPCS,91299,Gastroenterology procedure,,,127.38,565.15,7
HCPCS,91299,HC UNLISTED DX GI PROCEDURE,6551.0,4585.7,,,0
HCPCS,91300,Sarscov2 vac 30mcg/0.3ml im,,,0.03,0.04,3
HCPCS,91301,Sarscov2 vac 100mcg/0.5ml im,,,0.03,0.04,3
HCPCS,91303,Coronavirus vaccine 4,,,0.03,0.04,3
HCPCS,91304,Coronavirus vaccine 5,,,0.03,0.04,3
HCPCS,91305,Coronavirus vaccine 6,,,0.03,0.04,3
HCPCS,91306,Coronavirus vaccine 7,,,0.03,0.04,3
HCPCS,91307,Coronavirus vaccine 8,,,0.03,0.04,3
HCPCS,91308,Coronavirus vaccine 9,,,0.03,0.04,3
HCPCS,91309,Coronavirus vaccine 10,,,0.03,0.04,3
HCPCS,91311,Sarscov2 vac 25mcg/0.25ml im,,,0.03,0.04,3
HCPCS,91312,Sarscov2 vac bvl 30mcg/0.3ml,,,0.03,0.04,3
HCPCS,91313,Sarscov2 vac bvl 50mcg/0.5ml,,,0.03,0.04,3
HCPCS,91314,Sarscov2 vac bvl 25mcg/.25ml,,,0.03,0.04,3
HCPCS,91315,Sarscov2 vac bvl 10mcg/0.2ml,,,0.03,0.04,3
HCPCS,91318,COVID VACCINE 24-25 (6M-4Y)(PFI)-PF 3 MCG/0.3 ML IM SUSP,249.0,174.3,,,0
HCPCS,91319,COVID VACCINE 24-25 (5-11Y)(PFI)-PF 10 MCG/0.3 ML IM SUSP,392.0,274.4,,,0
HCPCS,91320,COVID VAC 25-26(12UP)(PFI)(PF) 30 MCG/0.3 ML IM SYRG,639.0,447.3,,,0
HCPCS,91320,COVID VACCINE 24-25 (12UP)(PFI)(PF) 30 MCG/0.3 ML IM SYRG,910.5,637.35,,,0
HCPCS,91321,COVID VAC 25-26(6M-11Y)(MOD)PF 25 MCG/0.25 ML IM SYRG,558.0,390.6,,,0
HCPCS,91321,COVID VACCINE 24-25 (6M-11Y)(MOD)PF 25 MCG/0.25 ML IM SYRG,836.5,585.55,,,0
HCPCS,91322,COVID VAC 25-26(12UP)(MOD)(PF) 50 MCG/0.5 ML IM SYRG,613.0,429.1,,,0
HCPCS,91322,COVID VACCINE 24-25 (12UP)(MOD)(PF) 50 MCG/0.5 ML IM SYRG,613.0,429.1,,,0
HCPCS,920,HC PRO ANESTH MALE GENITALIA INCL OPEN URETHRAL PROCEDURES NOS,395.0,276.5,,,0
HCPCS,92002,Eye exam new patient,,,131.8,584.75,11
HCPCS,92004,Eye exam new patient,,,131.8,584.75,11
HCPCS,92012,Eye exam establish patient,,,131.8,584.75,11
HCPCS,92014,Eye exam&tx estab pt 1/>vst,,,131.8,584.75,11
HCPCS,92018,New eye exam & treatment,,,1921.05,10442.27,11
HCPCS,92019,Eye exam & treatment,,,2353.63,10442.27,11
HCPCS,92020,Special eye evaluation,,,118.11,584.37,11
HCPCS,92025,Corneal Topography,,,36.21,259.1,11
HCPCS,92060,Special eye evaluation,,,50.81,259.1,11
HCPCS,92065,Orthoptic/pleoptic training,,,66.36,82.78,4
HCPCS,92066,Orthop traing supvj phys/qhp,,,58.4,259.1,11
HCPCS,92071,Contact lens fitting for tx,,,89.57,111.74,4
HCPCS,92072,Fit contac lens for managmnt,,,289.94,361.71,4
HCPCS,92081,Visual field examination(s),,,58.4,259.1,11
HCPCS,92082,Visual field examination(s),,,58.4,259.1,11
HCPCS,92083,Visual field examination(s),,,127.62,584.37,11
HCPCS,92132,Cmptr ophth dx img ant segmt,,,58.4,259.1,11
HCPCS,92133,Cmptr ophth img optic nerve,,,58.4,259.1,11
HCPCS,92134,Cptr ophth dx img post segmt,,,58.4,259.1,11
HCPCS,92136,Ophthalmic biometry,,,130.93,584.37,11
HCPCS,92137,Cptrz oph img pst sg rta oct,,,213.76,948.37,7
HCPCS,92145,Corneal hysteresis deter,,,58.4,259.1,11
HCPCS,92201,HC OPTHALMOSCOPY EXTENDED W/RETINAL DRAWING/SCLERAL DEPRESSION W/INTERP & REPORT UNILAT/BILAT,298.0,208.6,,,0
HCPCS,92201,Opscpy extnd rta draw uni/bi,,,58.4,259.1,11
HCPCS,92202,Opscpy extnd on/mac draw,,,58.4,259.1,11
HCPCS,92227,Remote dx retinal imaging,,,55.81,259.1,11
HCPCS,92228,Remote retinal imaging mgmt,,,36.98,164.05,11
HCPCS,92229,Img rta detc/mntr ds poc aly,,,58.4,259.1,11
HCPCS,92230,Eye exam with photos,,,369.41,1638.96,11
HCPCS,92235,Fluorescein angrph uni/bi,,,203.65,948.37,11
HCPCS,92240,Icg angiography uni/bi,,,213.76,948.37,11
HCPCS,92242,Fluorescein icg angiography,,,213.76,948.37,11
HCPCS,92250,Eye exam with photos,,,116.93,584.37,11
HCPCS,92260,Ophthalmoscopy/dynamometry,,,36.98,164.05,11
HCPCS,92265,Eye muscle evaluation,,,58.4,259.1,11
HCPCS,92270,Electro-oculography,,,112.29,584.37,11
HCPCS,92273,Full field erg w/i&r,,,213.76,953.73,11
HCPCS,92274,Multifocal erg w/i&r,,,127.38,565.15,11
HCPCS,92283,Color vision examination,,,58.4,259.1,11
HCPCS,92284,Dark adaptation eye exam,,,118.9,1962.08,11
HCPCS,92285,Eye photography,,,36.98,164.05,11
HCPCS,92286,Internal eye photography,,,131.71,584.37,11
HCPCS,92287,Internal eye photography,,,131.71,584.37,11
HCPCS,92311,Contact lens fitting,,,173.98,1962.08,11
HCPCS,92312,Contact lens fitting,,,131.71,584.37,11
HCPCS,92313,Contact lens fitting,,,118.11,584.37,11
HCPCS,92315,Rx cntact lens aphakia 1 eye,,,118.11,584.37,11
HCPCS,92316,Rx cntact lens aphakia 2 eye,,,131.71,584.37,11
HCPCS,92317,Rx corneoscleral cntact lens,,,36.98,164.05,11
HCPCS,92325,Modification of contact lens,,,118.11,584.37,11
HCPCS,92326,Replacement of contact lens,,,58.4,259.1,11
HCPCS,92352,Fit aphakia spectcl monofocl,,,58.4,259.1,11
HCPCS,92353,Fit aphakia spectcl multifoc,,,58.4,259.1,11
HCPCS,92354,Fit spectacles single system,,,36.98,164.05,11
HCPCS,92355,Fit spectacles compound lens,,,36.98,164.05,11
HCPCS,92358,Aphakia prosth service temp,,,58.4,259.1,11
HCPCS,92371,Repair & adjust spectacles,,,58.4,259.1,11
HCPCS,92499,Eye service or procedure,,,28.63,127.04,7
HCPCS,92502,Ear and throat examination,,,500.19,2368.81,11
HCPCS,92507,HC SPEECH/HEARING THERAPY,186.0,130.2,,,0
HCPCS,92507,Speech/hearing therapy,,,73.53,191.86,10
HCPCS,92508,HC SPEECH/HEARING THERAPY GROUP,135.0,94.5,,,0
HCPCS,92508,Speech/hearing therapy,,,23.06,49.06,10
HCPCS,92511,HC NASOPHARYNGOSCOPY,493.0,345.1,,,0
HCPCS,92511,Nasopharyngoscopy,,,164.53,876.7,11
HCPCS,92512,Nasal function studies,,,161.38,948.37,11
HCPCS,92516,Facial nerve function test,,,213.76,948.37,11
HCPCS,92517,Vemp test i&r cervical,,,127.38,565.15,11
HCPCS,92518,Vemp test i&r ocular,,,127.38,565.15,11
HCPCS,92519,Vemp tst i&r cervical&ocular,,,213.76,999.62,11
HCPCS,92520,Laryngeal function studies,,,131.71,584.37,11
HCPCS,92521,Evaluation of speech fluency,,,128.51,271.98,10
HCPCS,92521,HC HB EVALUATION OF SPEECH FLUENCY,261.0,182.7,,,0
HCPCS,92522,Evaluate speech production,,,108.31,271.98,10
HCPCS,92522,HC EVALUATE SPEECH PRODUCTION,261.0,182.7,,,0
HCPCS,92523,HC SPEECH SOUND LANG COMPREHEN,261.0,182.7,,,0
HCPCS,92523,Speech sound lang comprehen,,,209.12,382.2,10
HCPCS,92524,Behavral qualit analys voice,,,106.07,271.98,10
HCPCS,92524,HC BEHAVORIAL AND QUAL ANALYSIS VOICE,261.0,182.7,,,0
HCPCS,92526,HC ORAL/SWALLOW FUNCTION THERAPY,177.0,123.9,,,0
HCPCS,92526,Oral function therapy,,,80.99,184.21,10
HCPCS,92537,Caloric vstblr test w/rec,,,127.38,832.92,11
HCPCS,92538,Caloric vstblr test w/rec,,,213.76,948.37,11
HCPCS,92540,Basic vestibular evaluation,,,213.76,948.37,11
HCPCS,92541,Spontaneous nystagmus test,,,99.66,584.37,11
HCPCS,92542,Positional nystagmus test,,,115.23,584.37,11
HCPCS,92544,Optokinetic nystagmus test,,,93.81,565.15,11
HCPCS,92545,Oscillating tracking test,,,89.93,948.37,11
HCPCS,92546,Sinusoidal rotational test,,,127.38,565.15,11
HCPCS,92548,Posturography,,,131.71,584.37,11
HCPCS,92549,Cdp-sot 6 cond w/i&r mct&adt,,,131.71,584.37,11
HCPCS,92550,Tympanometry & reflex thresh,,,99.52,948.37,11
HCPCS,92552,Pure tone audiometry air,,,89.84,584.37,11
HCPCS,92553,Audiometry air & bone,,,127.38,565.15,11
HCPCS,92555,Speech threshold audiometry,,,58.4,259.1,11
HCPCS,92556,Speech audiometry complete,,,58.4,259.1,11
HCPCS,92557,Comprehensive hearing test,,,127.38,565.15,11
HCPCS,92558,Evoked auditory test qual,,,27.48,34.28,4
HCPCS,92562,Loudness balance test,,,89.84,948.37,11
HCPCS,92563,Tone decay hearing test,,,36.98,164.05,11
HCPCS,92565,Stenger test pure tone,,,58.4,259.1,11
HCPCS,92567,Tympanometry,,,36.98,164.05,11
HCPCS,92568,Acoustic refl threshold tst,,,36.98,164.05,11
HCPCS,92570,Acoustic immitance testing,,,127.38,565.15,11
HCPCS,92571,Filtered speech hearing test,,,36.98,164.05,11
HCPCS,92572,Staggered spondaic word test,,,127.38,565.15,11
HCPCS,92575,Sensorineural acuity test,,,36.98,164.05,11
HCPCS,92576,Synthetic sentence test,,,36.98,164.05,11
HCPCS,92577,Stenger test speech,,,352.57,1638.96,11
HCPCS,92579,Visual audiometry (vra),,,95.55,948.37,11
HCPCS,92582,Conditioning play audiometry,,,127.38,565.15,11
HCPCS,92583,Select picture audiometry,,,58.4,259.1,11
HCPCS,92584,Electrocochleography,,,127.38,670.01,11
HCPCS,92587,Evoked auditory test limited,,,88.05,948.37,11
HCPCS,92588,Evoked auditory tst complete,,,123.53,1638.96,11
HCPCS,92596,Ear protector evaluation,,,36.98,164.05,11
HCPCS,92597,HC ORAL SPEECH DEVICE EVAL,447.0,312.9,,,0
HCPCS,92597,Oral speech device eval,,,68.84,162.99,10
HCPCS,92601,Cochlear implt f/up exam <7,,,127.38,565.15,11
HCPCS,92602,Reprogram cochlear implt 7/>,,,127.38,565.15,11
HCPCS,92603,Cochlear implt f/up exam 7/>,,,127.38,565.15,11
HCPCS,92604,Reprogram cochlear implt 7/>,,,127.38,565.15,11
HCPCS,92607,Ex for speech device rx 1hr,,,117.32,507.39,10
HCPCS,92607,HC EX FOR SPEECH DEVICE TRAIN 1HR,236.0,165.2,,,0
HCPCS,92608,Ex for speech device rx addl,,,45.74,99.68,10
HCPCS,92609,HC USE OF SPEECH DEVICE SERVICE,157.0,109.9,,,0
HCPCS,92609,Use of speech device service,,,98.28,270.5,10
HCPCS,92610,Evaluate swallowing function,,,56.69,512.54,10
HCPCS,92610,HC EVALUATE SWALLOWING FUNCTION,491.0,343.7,,,0
HCPCS,92611,HC MOTION FLUOROSCOPY/SWALLOW,410.0,287.0,,,0
HCPCS,92611,Motion fluoroscopy/swallow,,,88.03,432.15,10
HCPCS,92612,Endoscopy swallow (fees) vid,,,53.53,239.8,10
HCPCS,92612,HC ENDOSCOPY SWALLOW TST (FEES),295.0,206.5,,,0
HCPCS,92613,Endoscopy swallow (fees) i&r,,,111.78,139.44,4
HCPCS,92614,Laryngoscopic sensory vid,,,53.63,239.8,10
HCPCS,92615,HC PRO FLEXIBLE ENDOSCOPIC EVAL LARYNGEAL SENSORY TESTING BY CINE/VIDEO REC INTERP & REPORT ONLY,261.0,182.7,,,0
HCPCS,92616,Fees w/laryngeal sense test,,,78.94,353.85,10
HCPCS,92616,HC FLEXIBLE ENDOSCOPIC EVAL SWALLOWING/LARYNGEAL SENSORY TESTING BY CINE OR VIDEO RECORDING,366.0,256.2,,,0
HCPCS,92618,Ex for nonspeech dev rx add,,,94.66,118.09,4
HCPCS,92620,Auditory function 60 min,,,127.38,565.15,11
HCPCS,92622,Dx aly aud oi snd prcsr 1st,,,127.38,565.15,11
HCPCS,92625,Tinnitus assessment,,,127.38,565.15,11
HCPCS,92626,Eval aud rehab status,,,127.38,565.15,11
HCPCS,92640,Aud brainstem implt programg,,,127.38,565.15,11
HCPCS,92650,HC AUDITOR EVOKE POTENT SCEEN AUDITOR POTENT W/BROADBAND  STIMULI AUTO ANALYSIS,535.0,374.5,,,0
HCPCS,92651,Aep hearing status deter i&r,,,213.76,948.37,11
HCPCS,92651,HC AUDITOR EVOKE POTENT HEARING STATUS DETER BROADBAND STIMULI W/INTERP & REPORT,611.0,427.7,,,0
HCPCS,92652,Aep thrshld est mlt freq i&r,,,213.76,999.62,11
HCPCS,92653,Aep neurodiagnostic i&r,,,213.76,999.62,11
HCPCS,92700,Ent procedure/service,,,28.63,127.04,11
HCPCS,92920,HC PTA CORONARY SINGL,11109.0,7776.3,,,0
HCPCS,92920,Prq cardiac angioplast 1 art,,,5634.46,24998.21,11
HCPCS,92921,HC PTA CORONARY ADDL EA,7738.0,5416.6,,,0
HCPCS,92921,Prq cardiac angio addl art,,,5809.2,7247.12,4
HCPCS,92924,HC PRQ CARD ANGIO/ANTHRECT SINGLE MAJOR ART/BRANCH,13691.0,9583.7,,,0
HCPCS,92924,Prq card angio/athrect 1 art,,,10279.88,50703.82,11
HCPCS,92925,HC PRQ CARD ANGIO/ATHRECT EA ADD BRANCH,11307.0,7914.9,,,0
HCPCS,92925,Prq card angio/athrect addl,,,23243.68,28997.06,4
HCPCS,92928,HC INSERT INTRACORON STENT SINGL,13060.0,9142.0,,,0
HCPCS,92928,Prq card stent w/angio 1 vsl,,,11428.37,50703.82,11
HCPCS,92929,HC INSERT INTRACORON STENT ADDL EA,8885.0,6219.5,,,0
HCPCS,92929,Prq card stent w/angio addl,,,18514.63,23097.46,4
HCPCS,92930,Prq tcat plmt ntrac st 2+les,,,18147.73,80515.32,7
HCPCS,92933,HC PRQ CARD STENT/ATH/ANGIO SNGL MAJ CORON ART/BRANCH,21111.0,14777.7,,,0
HCPCS,92933,Prq card stent/ath/angio,,,15851.08,80515.32,11
HCPCS,92934,HC PRQ CARD STENT/ATH/ANGIO EA ADD BRANCH MAJ CORON ART,31448.0,22013.6,,,0
HCPCS,92934,Prq card stent/ath/angio,,,18514.63,23097.46,4
HCPCS,92937,HC PRQ REVASC BYP GRAFT SINGLE VESSEL,13691.0,9583.7,,,0
HCPCS,92937,Prq revasc byp graft 1 vsl,,,11428.37,50703.82,11
HCPCS,92938,Prq revasc byp graft addl,,,18514.63,23097.46,4
HCPCS,92941,HC PRQ CARD REVASC MI SINGLE VESSEL,13691.0,9583.7,,,0
HCPCS,92941,Prq card revasc mi 1 vsl,,,18514.63,23097.46,4
HCPCS,92943,HC PRQ CARD REVASC CHRONIC OCCL SINGLE VESSEL,13691.0,9583.7,,,0
HCPCS,92943,Prq card revasc chronic 1vsl,,,11428.37,50703.82,11
HCPCS,92944,HC PRQ CARD REVASC CHRONIC OCCL EA ADD,9008.0,6305.6,,,0
HCPCS,92944,Prq card revasc chronic addl,,,18514.63,23097.46,4
HCPCS,92945,Prq trl rvs ch occ ant&rtrgr,,,11428.37,50703.82,7
HCPCS,92950,HC HEART/LUNG RESUSCITATION CPR,962.0,673.4,,,0
HCPCS,92950,HC PRO HEART/LUNG RESUSCITATION CPR,1449.0,1014.3,,,0
HCPCS,92950,Heart/lung resuscitation cpr,,,213.76,1009.19,11
HCPCS,92953,HC TEMPORARY EXTERNAL PACING,937.0,655.9,,,0
HCPCS,92953,Temporary external pacing,,,491.92,2902.97,11
HCPCS,92960,CARDIOVERSION ELECTRIC EXT,1742.0,1219.4,,,0
HCPCS,92960,Cardioversion electric ext,,,654.31,2902.97,11
HCPCS,92960,HC PRO CARDIOVERSION ELECTRIC EXT,648.0,453.6,,,0
HCPCS,92961,Cardioversion electric int,,,654.31,2902.97,11
HCPCS,92961,HC CARDIOVERSION ELECTRIC INT,2069.0,1448.3,,,0
HCPCS,92972,HC PERCUTANEOUS TRANSLUMINAL CORONARY LITHOTRIPSY,10942.0,7659.4,,,0
HCPCS,92973,HC PERQ CORONARY THROMBECT,5916.0,4141.2,,,0
HCPCS,92973,Prq coronary mech thrombect,,,4442.02,5541.53,4
HCPCS,92974,Cath place cardio brachytx,,,2932.34,3658.17,4
HCPCS,92975,HC THROMBOL CORONARY ANGIO,2306.0,1614.2,,,0
HCPCS,92977,Dissolve clot heart vessel,,,496.62,619.54,4
HCPCS,92977,HC THROMBOL CORONARY IV INFUSION,1118.0,782.6,,,0
HCPCS,92978,HC INTRAVASCULAR HEART ADD-ON INITIAL VESSEL (LIST SEP IN ADDT TO CODE FOR PRIMARY PROCEDURE),3055.0,2138.5,,,0
HCPCS,92979,HC INTRAVASCULAR HEART ADD-ON EACH ADDTL VESSEL (LIST SEP IN ADDT TO CODE FOR PRIMARY PROCEDURE),1869.0,1308.3,,,0
HCPCS,92986,HC REVISION OF AORTIC VALVE,36231.0,25361.7,,,0
HCPCS,92986,Revision of aortic valve,,,5634.46,24998.21,11
HCPCS,92987,HC REVISION OF MITRAL VALVE,13501.0,9450.7,,,0
HCPCS,92987,Revision of mitral valve,,,10136.56,50703.82,11
HCPCS,92990,HC REVISION OF PULMONARY VALVE,13691.0,9583.7,,,0
HCPCS,92990,Revision of pulmonary valve,,,11308.3,50703.82,11
HCPCS,92997,HC PRO PTA PULMONARY ARTERY BALLOON ANGIOPLASTY SINGLE VESSEL,1556.0,1089.2,,,0
HCPCS,92997,HC PTA PULMONARY ARTERY BALLOON ANGIOPLASTY SINGLE VESSEL,18545.0,12981.5,,,0
HCPCS,92997,Pul art balloon repr percut,,,11428.37,50703.82,11
HCPCS,92998,HC PRO PTA PULMONARY ARTERY BALLOON ANGIOPLASTY EA ADDTL VESSEL,778.0,544.6,,,0
HCPCS,92998,HC PTA PULMONARY ARTERY BALLOON ANGIOPLASTY EA ADDTL VESSEL,13653.0,9557.1,,,0
HCPCS,92998,Pul art balloon repr percut,,,9079.46,11326.85,4
HCPCS,93000,Electrocardiogram complete,,,59.12,73.75,4
HCPCS,93005,Electrocardiogram tracing,,,58.4,332.51,11
HCPCS,93005,HC ECG TRACING ONLY,320.0,224.0,,,0
HCPCS,93005,HC EKG TRACING ONLY,320.0,224.0,,,0
HCPCS,93010,ELECTROCARDIOGRAM REPORT,20.0,14.0,,,0
HCPCS,93010,Electrocardiogram report,,,26.57,33.15,4
HCPCS,93015,Cardiovascular stress test,,,282.55,352.49,4
HCPCS,93016,Cardiovascular stress test,,,71.99,89.81,4
HCPCS,93016,HC PRO CARDIOVASCULAR STRESS TEST USING MAXIMAL OR SUBMAXIMAL TREADMILL OR BICYCLE EXERCISE CONT ECG W/O INTERP & REPORT,50.0,35.0,,,0
HCPCS,93017,Cardiovascular stress test,,,213.76,1150.94,11
HCPCS,93017,HC CV STRESS TEST TRACING ONLY,1200.0,840.0,,,0
HCPCS,93018,Cardiovascular stress test,,,47.6,59.38,4
HCPCS,93018,HC PRO CV STRESS TEST INTERP AND REPORT,30.0,21.0,,,0
HCPCS,93024,Cardiac drug stress test,,,160.35,1962.08,11
HCPCS,93025,Microvolt t-wave assess,,,127.38,581.86,11
HCPCS,93040,Rhythm ECG with report,,,38.36,47.85,4
HCPCS,93041,HC RHYTHM ECG TRACING,62.0,43.4,,,0
HCPCS,93041,Rhythm ecg tracing,,,58.4,259.1,11
HCPCS,93042,Rhythm ecg report,,,23.54,29.37,4
HCPCS,93050,Art pressure waveform analys,,,28.63,127.04,11
HCPCS,93145,Interrog crtd sins bat ip wo,,,127.38,565.15,7
HCPCS,93146,Interrog crtd sins bat ip w/,,,127.38,565.15,7
HCPCS,93150,Therapy activation ipnss,,,94.12,417.57,11
HCPCS,93151,Interrog&prgrmg ipnss,,,94.12,417.57,11
HCPCS,93152,Interrog&prgrmg ipnss polysm,,,304.06,1348.99,11
HCPCS,93153,Interrog w/o prgrmg ipnss,,,94.12,417.57,11
HCPCS,93224,Ecg monit/reprt up to 48 hrs,,,333.57,416.14,4
HCPCS,93225,Ecg monit/reprt up to 48 hrs,,,131.71,584.37,11
HCPCS,93225,HC ECG EXTER MONIT UP TO 48 HOURS,469.0,328.3,,,0
HCPCS,93226,Ecg monit/reprt up to 48 hrs,,,58.4,259.1,11
HCPCS,93226,HC ECG EXTER MONIT REPORT,416.0,291.2,,,0
HCPCS,93227,Ecg monit/reprt up to 48 hrs,,,83.54,104.21,4
HCPCS,93228,Remote 30 day ecg rev/report,,,75.75,94.5,4
HCPCS,93229,Remote 30 day ecg tech supp,,,369.41,1638.96,11
HCPCS,93242,Ext ecg>48hr<7d recording,,,36.98,164.05,11
HCPCS,93242,HC EXT ECG > 48HR UP TO 7 DAYS RCRD INCL CONNECT INITIAL RCRD,388.0,271.6,,,0
HCPCS,93243,Ext ecg>48hr<7d scan a/r,,,131.71,584.37,11
HCPCS,93243,HC EXT ECG> 48HR UP TO 7 DAYS SCAN ANLYS W/REPORT,388.0,271.6,,,0
HCPCS,93244,HC PRO EXT ECG>48HR UPT TO 7 DAYS REVIEW & INTERP,162.0,113.4,,,0
HCPCS,93246,Ext ecg>7d<15d recording,,,36.98,210.39,11
HCPCS,93246,HC EXT ECG > 7 DAYS UP TO 15 DAYS RCRD INCL CONNECT INITIAL RCRD,388.0,271.6,,,0
HCPCS,93247,Ext ecg>7d<15d scan a/r,,,131.71,584.37,11
HCPCS,93247,HC EXT ECG> 7 DAYS UP TO 15 DAYS SCAN ANLYS W/REPORT,418.0,292.6,,,0
HCPCS,93248,HC PRO EXT ECG>7 DAYS UP TO 15 DAYS REVIEW & INTERP,162.0,113.4,,,0
HCPCS,93260,Prgrmg dev eval impltbl sys,,,36.95,163.92,11
HCPCS,93261,Interrogate subq defib,,,36.95,163.92,11
HCPCS,93264,Rem mntr wrls p-art prs snr,,,36.95,163.92,11
HCPCS,93268,ECG record/review,,,728.38,908.67,4
HCPCS,93270,HC REMOTE 30 DAY ECG RECORDING,124.0,86.8,,,0
HCPCS,93270,Remote 30 day ecg rev/report,,,36.95,163.92,11
HCPCS,93271,Ecg/monitoring and analysis,,,94.12,417.57,11
HCPCS,93271,HC PRO EXTERNAL PATIENT WHEN PERFORMED AUTO ACTIVATED ECG RHYTHM EVENT RECORDING REMOTE DOWNLOAD 30 DAYS 24 HR MONITORING TRANSMISSION/ANALYSIS,414.0,289.8,,,0
HCPCS,93271,HC REMOTE 30 DAY ECG TRANSMISSION AND ANALYSIS,556.0,389.2,,,0
HCPCS,93272,Ecg/review interpret only,,,80.63,100.59,4
HCPCS,93272,HC PRO REMOTE 30 DAY ECG REVIEW AND INTERP,54.0,37.8,,,0
HCPCS,93278,ECG/signal-averaged,,,58.4,259.1,11
HCPCS,93279,Pm device progr eval sngl,,,36.95,163.92,11
HCPCS,93280,Pm device progr eval dual,,,36.95,163.92,11
HCPCS,93281,Pm device progr eval multi,,,36.95,163.92,11
HCPCS,93282,Prgrmg eval implantable dfb,,,36.95,163.92,11
HCPCS,93283,Prgrmg eval implantable dfb,,,36.95,163.92,11
HCPCS,93284,Prgrmg eval implantable dfb,,,36.95,163.92,11
HCPCS,93285,Ilr device eval progr,,,36.95,163.92,11
HCPCS,93286,PRE-OP PM DEVICE EVAL,96.0,67.2,,,0
HCPCS,93286,Peri-px pacemaker device evl,,,33.51,41.81,4
HCPCS,93287,HC PERI-PROCEDURAL DEVICE EVALUATION (IN PERSON) SINGLE/DUAL/MULTIPLE LEAD IMPLANTABLE DEFIBRILLATOR SYSTEM,134.0,93.8,,,0
HCPCS,93287,Peri-px device eval & prgr,,,38.84,48.46,4
HCPCS,93288,Pm device eval in person,,,36.95,163.92,11
HCPCS,93289,Interrog device eval heart,,,36.95,163.92,11
HCPCS,93290,Icm device eval,,,30.09,163.92,11
HCPCS,93291,Ilr device interrogate,,,28.63,127.04,11
HCPCS,93292,Wcd device interrogate,,,36.88,163.92,11
HCPCS,93293,Pm phone r-strip device eval,,,36.95,163.92,11
HCPCS,93294,Pm device interrogate remote,,,107.69,134.34,4
HCPCS,93295,Dev interrog remote 1/2/mlt,,,193.92,241.92,4
HCPCS,93296,HC PM/ICD REMOTE TECH SERV,278.0,194.6,,,0
HCPCS,93296,Pm/icd remote tech serv,,,36.95,163.92,11
HCPCS,93297,Icm device interrogat remote,,,36.95,163.92,11
HCPCS,93298,Ilr device interrogat remote,,,36.95,163.92,11
HCPCS,93303,Echo transthoracic,,,407.84,2399.94,11
HCPCS,93303,HC TRNSTH ECHO CONGENITAL CAR ANOM COMPLETE,844.0,590.8,,,0
HCPCS,93304,Echo transthoracic,,,261.64,2399.94,11
HCPCS,93304,HC TRNSTH ECHO CONGENITAL CAR ANOM FOLLOW-UP/LTD,606.0,424.2,,,0
HCPCS,93306,HC ECHO TRANSTHOR W/ DOPPLER,2559.0,1791.3,,,0
HCPCS,93306,HC PRO ECHO TRANSTHOR W/ DOPPLER,269.0,188.3,,,0
HCPCS,93306,Tte w/doppler complete,,,535.55,2399.94,11
HCPCS,93307,HC ECHO TRANSTHOR W/WO DYE,1396.0,977.2,,,0
HCPCS,93307,Tte w/o doppler complete,,,236.21,1047.98,11
HCPCS,93308,HC ECHO TRANSTHOR LIMITED FUP,916.0,641.2,,,0
HCPCS,93308,HC PRO ECHO TRANSTHOR LIMITED FUP,147.0,102.9,,,0
HCPCS,93308,Tte f-up or lmtd,,,225.64,1047.98,11
HCPCS,93312,ECHO TRANSESOPHAGEAL,2569.0,1798.3,,,0
HCPCS,93312,Echo transesophageal,,,540.93,2399.94,11
HCPCS,93312,HC PRO ECHO TRANSESOPHAGEAL,1379.0,965.3,,,0
HCPCS,93313,Echo transesophageal,,,540.93,2399.94,11
HCPCS,93313,HC ECHOCARDIOGRAPHY TRANSESOPHAGEAL REAL-TIME W/IMAGE DOCUMENT 2D PLACEMENT OF TRANSESOPHAGEAL PROBE ONLY,2097.0,1467.9,,,0
HCPCS,93314,HC ECHOCARDIOGRAPHY TRANSESOPHAGEAL REAL-TIME W/IMAGE DOCUMENT 2D IMAGE ACQUISITION INTERP/REPORT ONLY,758.0,530.6,,,0
HCPCS,93315,ECHO TRANSESOPH CARD ANOMAL,771.0,539.7,,,0
HCPCS,93315,Echo transesophageal,,,540.93,2399.94,11
HCPCS,93316,Echo transesophageal,,,540.93,2399.94,11
HCPCS,93316,HC TRANSESOPHAGEAL ECHO CONGENITAL CARDIAC ANOMALIES PLACEMENT OF TRANSESOPHAGEAL PROBE ONLY,2605.0,1823.5,,,0
HCPCS,93317,HC PRO TRNSTH ECHO CONGENITAL CAR ANOM INTERP/REPORT ONLY,459.0,321.3,,,0
HCPCS,93317,HC TRNSTH ECHO CONGENITAL CAR ANOM INTERP/REPORT ONLY,758.0,530.6,,,0
HCPCS,93318,Echo Transesophageal Intraop,,,540.93,2399.94,11
HCPCS,93318,HC ECHO TRANSEOPHAGEAL INTRAOP,844.0,590.8,,,0
HCPCS,93320,HC ECHO SPECTRAL DOPPLER ADD-ON,377.0,263.9,,,0
HCPCS,93321,ECHO DOPPLER LIMITED FUP ADD-ON,133.0,93.1,,,0
HCPCS,93321,HC PRO ECHO DOPPLER LIMITED FUP ADD-ON,33.0,23.1,,,0
HCPCS,93325,HC ECHO COLOR FLOW ADD-ON,121.0,84.7,,,0
HCPCS,93325,HC PRO ECHO DOPPLER FLOW MAP ADD-ON,8.0,5.6,,,0
HCPCS,93350,HC ECHO TRANSTHOR STRESS TEST,1544.0,1080.8,,,0
HCPCS,93350,Stress tte only,,,356.96,2399.94,11
HCPCS,93351,HC ECHO TRAN 2D W-INTRP SUP,844.0,590.8,,,0
HCPCS,93351,Stress tte complete,,,540.93,2399.94,11
HCPCS,93352,Admin ecg contrast agent,,,107.26,133.81,4
HCPCS,93352,HC PRO USE OF ECHO CONTRAST AGENT DURING STRESS ECHOCARDIOGRAPHY,74.0,51.8,,,0
HCPCS,93355,Echo transesophageal (tee),,,689.48,860.14,4
HCPCS,93355,HC TEE FOR GUIDANCE OF TRANSCATH/GREAT VESSEL(S) STRUCTURAL INTERVENT,865.0,605.5,,,0
HCPCS,93356,HC MYOCARDIAL STRAIN IMG USING SPECKLE TRACKING-DERIVED ASSESSMENT OF MYOCARDIAL MECHANICS,40.0,28.0,,,0
HCPCS,93356,Myocrd strain img spckl trck,,,36.57,45.62,4
HCPCS,93451,HC CATH RIGHT HEART,6485.0,4539.5,,,0
HCPCS,93451,Right heart cath,,,3209.41,14239.05,11
HCPCS,93452,HC CATH LEFT HEART,3967.0,2776.9,,,0
HCPCS,93452,Left hrt cath w/ventrclgrphy,,,3209.41,14239.05,11
HCPCS,93453,HC CATH RIGHT AND LEFT HEART,4289.0,3002.3,,,0
HCPCS,93453,R&l hrt cath w/ventriclgrphy,,,3209.41,14239.05,11
HCPCS,93454,Coronary artery angio s&i,,,3209.41,14239.05,11
HCPCS,93454,HC CORONARY ARTERY ANGIO SI,6485.0,4539.5,,,0
HCPCS,93455,Coronary art/grft angio s&i,,,3209.41,14239.05,11
HCPCS,93455,HC CORONARY ART/GRFT ANGIO SI,6485.0,4539.5,,,0
HCPCS,93456,HC R HRT CORONARY ARTERY ANGIO SI,12714.0,8899.8,,,0
HCPCS,93456,R hrt coronary artery angio,,,3209.41,14239.05,11
HCPCS,93457,HC R HRT ART/GRFT ANGIO SI,3967.0,2776.9,,,0
HCPCS,93457,R hrt art/grft angio,,,3209.41,14239.05,11
HCPCS,93458,HC L HRT ARTERY/VENTR ANGIO SI,12714.0,8899.8,,,0
HCPCS,93458,L hrt artery/ventricle angio,,,3209.41,14239.05,11
HCPCS,93459,HC L HRT ART/GRFT VENTR ANGIO SI,3967.0,2776.9,,,0
HCPCS,93459,L hrt art/grft angio,,,3209.41,14239.05,11
HCPCS,93460,HC R&L HRT ART/VENTRICLE ANGIO SI,12714.0,8899.8,,,0
HCPCS,93460,R&l hrt art/ventricle angio,,,3209.41,14239.05,11
HCPCS,93461,HC R&L HRT ART/VENTRICLE ANGIO SI,3967.0,2776.9,,,0
HCPCS,93461,R&l hrt art/ventricle angio,,,2978.43,14239.05,11
HCPCS,93462,HC L HRT CATH TRNSPTL PUNCTURE,3967.0,2776.9,,,0
HCPCS,93462,L hrt cath trnsptl puncture,,,3276.36,4087.34,4
HCPCS,93463,HC DRUG ADMIN & HEMODYN MEAS,196.0,137.2,,,0
HCPCS,93464,HC EXERCISE W/HEMODYN MEAS,589.0,412.3,,,0
HCPCS,93503,HC INSERT/PLACE HEART CATH SWAN GANZ,2242.0,1569.4,,,0
HCPCS,93503,Insert/place heart catheter,,,1558.36,6913.93,11
HCPCS,93505,Biopsy of heart lining,,,1354.56,13868.13,11
HCPCS,93505,HC ENDOMYOCARDIAL BIOPSY,2242.0,1569.4,,,0
HCPCS,93563,HC INJ ANG COR DURIN HRT CATH CONG,196.0,137.2,,,0
HCPCS,93565,HC INJ ANG L HRT DURIN HRT CATH CONG,196.0,137.2,,,0
HCPCS,93566,HC INJ ANG R HRT DURIN HRT CATH CONG,196.0,137.2,,,0
HCPCS,93567,HC INJ ANG AORT DURIN HRT CATH CONG,196.0,137.2,,,0
HCPCS,93568,HC INJECTION PX DURING CARDIAC CATH INCL IMAGE SI & REPORT NONSELECT PULM ARTERIAL ANGIOGRAPHY,196.0,137.2,,,0
HCPCS,93569,HC INJECT PROCEDURE CARDIAC CATHETERIZATION INCL IMAGE SI & REPORT PULMONARY ARTERIAL ANGIOGRAPHY UNILATERAL,236.0,165.2,,,0
HCPCS,93571,HC HEART FLOW RESERVE MEASURE,3755.0,2628.5,,,0
HCPCS,93572,HC HEART FLOW RESERVE MEASURE,3786.0,2650.2,,,0
HCPCS,93573,HC INJECT PROCEDURE CARDIAC CATHETERIZATION INCL IMAGE SI & REPORT PULMONARY ARTERIAL ANGIOGRAPHY BILATERAL,457.0,319.9,,,0
HCPCS,93574,HC INJECTION CARDIAC CATH INCL IMAGE S I & REPORT SELECTIVE PULM VENOUS ANGIOGRAPHY EACH DISTINCT PULM VEIN,79.0,55.3,,,0
HCPCS,93575,HC INJECTION CARDIAC CATH INCL IMAGE S I & REPORT SELECTIVE PULM ANGIOGRAPHY MAJOR AORTOPULM COLLATERAL ARTERIES EACH DISTINCT VESSEL,104.0,72.8,,,0
HCPCS,93580,HC PERQ TRCATH CLOSURE OF ASD IMPLA,20512.0,14358.4,,,0
HCPCS,93580,Transcath closure of asd,,,15401.15,80515.32,11
HCPCS,93581,HC PERQ TRCATH CLOSURE OF VSD IMPLA,64135.0,44894.5,,,0
HCPCS,93581,Transcath closure of vsd,,,18147.73,80515.32,11
HCPCS,93582,HC PERCU TRANSCATH CLOSURE PDA,18493.0,12945.1,,,0
HCPCS,93582,Perq transcath closure pda,,,13884.57,80515.32,11
HCPCS,93583,HC PERCU TRANSCATH SEPTAL REDUCTION THERAPY,1484.0,1038.8,,,0
HCPCS,93583,Perq transcath septal reduxn,,,2367.22,2953.16,4
HCPCS,93584,HC VENOGRAPHY CONGENITAL HEART DEFECT(S) INCL CATH PLACEMENT S&I ANOMALOUS PERSISTENT SUPERIOR VENA CAVA SECOND CONTRALATERAL W/NATIVE DRAINAGE TO HEART,66.0,46.2,,,0
HCPCS,93585,HC VENOGRAPHY CONGENITAL HEART DEFECT(S) INCL CATH PLACEMENT S&I AZYGOS/HEMIAZYGOS VENOUS SYSTEM,63.0,44.1,,,0
HCPCS,93586,HC VENOGRAPHY CONGENITAL HEART DEFECT(S) INCL CATH PLACEMENT S&I CORONARY SINUS,79.0,55.3,,,0
HCPCS,93587,HC VENOGRAPHY CONGENITAL HEART DEFECT(S) INCL CATH PLACEMENT S&I VENOVENOUS COLLATERALS AT OR ABOVE THE HEART,116.0,81.2,,,0
HCPCS,93588,HC VENOGRAPHY CONGENITAL HEART DEFECT(S) INCL CATH PLACEMENT S&I VENOVENOUS COLLATERALS BELOW THE HEART,117.0,81.9,,,0
HCPCS,93590,Perq transcath cls mitral,,,18147.73,80515.32,11
HCPCS,93591,Perq transcath cls aortic,,,18147.73,80515.32,11
HCPCS,93592,Perq transcath closure each,,,1396.9,1742.66,4
HCPCS,93593,HC RT HEART CATH CHD INCL IMAGE GUIDE NORMAL NATIVE CONNECTIONS,11427.0,7998.9,,,0
HCPCS,93593,R hrt cath chd nml nt cnj,,,3209.41,14239.05,11
HCPCS,93594,HC RT HEART CATH CHD INCL IMAGE GUIDE ABNORMAL NATIVE CONNECTIONS,11427.0,7998.9,,,0
HCPCS,93594,R hrt cath chd abnl nt cnj,,,3209.41,14239.05,11
HCPCS,93595,HC LT HEART CATH CONGENITAL HEART DEFECT(S) NORMAL/ABNORMAL NATIVE CONNECTIONS,13794.0,9655.8,,,0
HCPCS,93595,L hrt cath chd nm/abn nt cnj,,,3209.41,14239.05,11
HCPCS,93596,HC RT & LT HEART CATH CHD INCL IMAGE GUIDE NORMAL NATIVE CONNECTIONS,11427.0,7998.9,,,0
HCPCS,93596,R&l hrt cath chd nml nt cnj,,,3209.41,14239.05,11
HCPCS,93597,HC RT & LT HEART CATH CHD INCL IMAGE GUIDE ABNORMAL NATIVE CONNECTIONS,11427.0,7998.9,,,0
HCPCS,93597,R&l hrt cath chd abnl nt cnj,,,3209.41,14239.05,11
HCPCS,93600,Bundle of His recording,,,1917.23,34257.3,11
HCPCS,93600,HC BUNDLE OF HIS RECORDING,6592.0,4614.4,,,0
HCPCS,93602,Intra-atrial recording,,,1917.23,34257.3,11
HCPCS,93603,HC RIGHT VENTRICULAR RECORDING,5169.0,3618.3,,,0
HCPCS,93603,Right ventricular recording,,,1205.32,5347.61,11
HCPCS,93609,HC MAP TACHYCARDIA ADD-ON,144.0,100.8,,,0
HCPCS,93610,HC INTRA-ATRIAL PACING,27316.0,19121.2,,,0
HCPCS,93610,Intra-atrial pacing,,,1917.23,34257.3,11
HCPCS,93612,HC INTRAVENTRICULAR PACING,27316.0,19121.2,,,0
HCPCS,93612,Intraventricular pacing,,,1917.23,34257.3,11
HCPCS,93613,HC ELECTROPHYS MAP 3D ADD-ON,15496.0,10847.2,,,0
HCPCS,93615,Esophageal recording,,,1205.32,5347.61,11
HCPCS,93616,Esophageal recording,,,1205.32,5347.61,11
HCPCS,93618,Heart rhythm pacing,,,1205.32,5347.61,11
HCPCS,93619,Electrophysiology evaluation,,,5346.23,34257.3,11
HCPCS,93619,HC COMP ELECTROPH EVAL,29138.0,20396.6,,,0
HCPCS,93620,Electrophysiology evaluation,,,939.94,34257.3,11
HCPCS,93620,HC COMP ELECTROPH EVAL R HRT,10776.0,7543.2,,,0
HCPCS,93621,HC COMP ELECTROPH EVAL L ATRIUM +,12058.0,8440.6,,,0
HCPCS,93622,HC COMP ELECTROPH EVAL L VENT +,12058.0,8440.6,,,0
HCPCS,93623,HC STIMULATION PACING HEART,5292.0,3704.4,,,0
HCPCS,93624,Electrophysiologic study,,,7721.41,34257.3,11
HCPCS,93624,HC ELECTROPHYSIOLOGIC FOLLOW-UP STUDY W/PACING AND RECORDING INCL INDCUTION/ATTEMPTED INDCUTION OF ARRHYTHMIA,30627.0,21438.9,,,0
HCPCS,93641,HC EVAL DEFIB PUL GEN AND LEADS,1516.0,1061.2,,,0
HCPCS,93642,Electrophysiology evaluation,,,551.19,5347.61,11
HCPCS,93642,HC EVAL DEFIB PUL GEN,5715.0,4000.5,,,0
HCPCS,93644,Electrophysiology evaluation,,,891.52,1112.19,4
HCPCS,93644,HC ELECTROPHYSIOLOGIC EVAL OF SUBCU IMPLANTABLE DEFIBRILLATOR,3065.0,2145.5,,,0
HCPCS,93650,Ablate heart dysrhythm focus,,,7721.41,34257.3,11
HCPCS,93650,HC ABLATION AV NODE,17214.0,12049.8,,,0
HCPCS,93653,Ep & ablate supravent arrhyt,,,19363.7,114801.42,11
HCPCS,93653,HC COMP ELECTRO EVAL W/INSERT REPOSITION MULTI ELECTRODE CATH INDUCT INCL INTRACARDIAC ELECTRO 3D MAPPING SVT,98159.0,68711.3,,,0
HCPCS,93654,Ep & ablate ventric tachy,,,20955.84,114801.42,11
HCPCS,93654,HC COMP ELECTRO EVAL W/INSERT REPOSITION MULTI ELECTRODE CATH INDUCT INCL INTRACARDIAC ELECTRO 3D MAPPING VT,41479.0,29035.3,,,0
HCPCS,93655,Ablate arrhythmia add on,,,1220.21,1522.24,4
HCPCS,93655,HC ABLATE ARRHYTHMIA ADD ON,12452.0,8716.4,,,0
HCPCS,93656,HC COMP ELECTRO EVAL W/ TRANSSEPTAL CATH INSERT/REPOSITION MULTI ELECTRODE CATH & INTRACARDIAC CATH ABLATION ATRIAL FIB PULM VEIN ISOL INCL ELECT 3D MAPPING W/IMAGING S&I,98159.0,68711.3,,,0
HCPCS,93656,Tx atrial fib pulm vein isol,,,13568.4,114801.42,11
HCPCS,93657,HC TX L/R ATRIAL FIB ADDL,12452.0,8716.4,,,0
HCPCS,93657,Tx l/r atrial fib addl,,,1221.24,1523.53,4
HCPCS,93660,HC TILT TABLE EVALUATION W/WO RX,1873.0,1311.1,,,0
HCPCS,93660,Tilt table evaluation,,,182.32,1638.96,11
HCPCS,93662,HC ECHO INTRACARD DURING INTERVENT,306.0,214.2,,,0
HCPCS,93668,HC PERIPHERAL ARTERIAL DISEASE (PAD) REHABILITATION PER SESSION,241.0,168.7,,,0
HCPCS,93668,Peripheral Vascular Rehab,,,58.4,259.1,7
HCPCS,93701,Bioimpedance cv analysis,,,67.33,584.37,11
HCPCS,93702,Bis xtracell fluid analysis,,,127.38,565.15,11
HCPCS,93724,Analyze pacemaker system,,,187.28,1348.99,11
HCPCS,93740,Temperature gradient studies,,,5.09,565.15,11
HCPCS,93745,Set-up cardiovert-defibrill,,,117.78,1348.99,11
HCPCS,93750,Interrogation vad in person,,,94.12,419.96,11
HCPCS,93786,Ambulatory BP recording,,,131.71,584.37,11
HCPCS,93788,Ambulatory BP analysis,,,131.71,584.37,11
HCPCS,93790,Review/report BP recording,,,56.33,70.27,4
HCPCS,93792,Pt/caregiver trainj home inr,,,183.68,229.14,4
HCPCS,93793,Anticoag mgmt pt warfarin,,,34.69,43.28,4
HCPCS,93797,Cardiac rehab,,,127.61,566.18,11
HCPCS,93797,HC PHYSN SERV CARD REHAB W/O ECG,275.0,192.5,,,0
HCPCS,93798,Cardiac rehab/monitor,,,127.61,566.18,11
HCPCS,93798,PHYSN SERV CARD REHAB /W ECG,548.0,383.6,,,0
HCPCS,93799,Cardiovascular procedure,,,127.38,565.15,7
HCPCS,93799,HC SHOCKWAVE CORONARY IVL,18988.0,13291.6,,,0
HCPCS,93880,Extracranial bilat study,,,236.21,1047.98,11
HCPCS,93880,HC PRO US EXTRACRANIAL ARTERIES BILAT,403.0,282.1,,,0
HCPCS,93880,HC US EXTRACRANIAL ARTERIES BILAT,1036.0,725.2,,,0
HCPCS,93882,Extracranial uni/ltd study,,,103.5,487.88,11
HCPCS,93886,Intracranial complete study,,,236.21,1047.98,11
HCPCS,93888,Intracranial limited study,,,103.5,459.18,11
HCPCS,93890,Tcd vasoreactivity study,,,267.64,333.89,4
HCPCS,93892,Tcd emboli detect w/o inj,,,103.5,459.18,11
HCPCS,93893,Tcd emboli detect w/inj,,,103.5,459.18,11
HCPCS,93895,Carotid intima atheroma eval,,,158.68,197.96,4
HCPCS,93896,HC VASOREACTIVITY STUDY PERFORMED W/TRANSCRANIAL DOPPLER STUDY OF INTRACRANIAL ARTERIES COMPLETE,454.0,317.8,,,0
HCPCS,93922,HC DOPP UP OR LWR EXTR  1-2 ART BILAT,535.0,374.5,,,0
HCPCS,93922,HC PRO DOPP UP OR LWR EXTR 1-2 ART BILAT,200.0,140.0,,,0
HCPCS,93922,Upr/l xtremity art 2 levels,,,131.71,584.37,11
HCPCS,93923,HC DOPP UP OR LWR EXTR  3> ART BILAT,821.0,574.7,,,0
HCPCS,93923,Upr/lxtr art stdy 3+ lvls,,,213.76,948.37,11
HCPCS,93924,Lwr xtr vasc stdy bilat,,,213.76,948.37,11
HCPCS,93925,HC US LWR EXT ART BYPASS  BILAT,1244.0,870.8,,,0
HCPCS,93925,Lower extremity study,,,236.21,1047.98,11
HCPCS,93926,HC US LWR EXT ART BYPASS  UNILAT,255.0,178.5,,,0
HCPCS,93926,Lower extremity study,,,103.5,459.18,11
HCPCS,93930,HC US UPPER EXT ART BYPASS BILAT,555.0,388.5,,,0
HCPCS,93930,Upper extremity study,,,236.21,1047.98,11
HCPCS,93931,HC US UPPER EXT ART BYPASS UNILAT,371.0,259.7,,,0
HCPCS,93931,Upper extremity study,,,103.5,459.18,11
HCPCS,93970,Extremity study,,,236.21,1047.98,11
HCPCS,93970,HC DUP SCAN EXT VEINS INCL COMPR/MNVR COMP BILAT,634.0,443.8,,,0
HCPCS,93970,HC PRO US EXT VEINS BILAT MANEUVERS,233.0,163.1,,,0
HCPCS,93971,Extremity study,,,103.5,459.18,11
HCPCS,93971,HC PRO US EXT VEINS UNILAT MANEUVERS,149.0,104.3,,,0
HCPCS,93971,HC US EXT VEINS UNILAT MANEUVERS,409.0,286.3,,,0
HCPCS,93975,HC DUPLEX SCAN ARTERIAL INFLOW AND VENOUS OUTFLOW OF ABDOMNINAL PELVIC SCROTAL AND/OR RETROPERITONEAL ORGANS COMPLETE STUDY,757.0,529.9,,,0
HCPCS,93975,Vascular study,,,236.21,1047.98,11
HCPCS,93976,HC US VASC ABD PEL SCROT RETPER LMTD,239.0,167.3,,,0
HCPCS,93976,Vascular study,,,103.5,522.62,11
HCPCS,93978,HC US AORTA INFVC ILIAC COMP,596.0,417.2,,,0
HCPCS,93978,Vascular study,,,236.21,1047.98,11
HCPCS,93979,HC US AORTA INFVC ILIAC LMTD,361.0,252.7,,,0
HCPCS,93979,Vascular study,,,103.5,459.18,11
HCPCS,93980,Penile vascular study,,,103.5,459.18,11
HCPCS,93981,Penile vascular study,,,103.5,459.18,11
HCPCS,93985,Dup-scan hemo compl bi std,,,236.21,1047.98,11
HCPCS,93985,HC DUPLEX SCAN ARTERIAL INFLOW AND VENOUS OUTFLOW PREOP VESSEL ASSESS COMPLETE BILAT STUDY,749.0,524.3,,,0
HCPCS,93986,Dup-scan hemo compl uni std,,,103.5,459.18,11
HCPCS,93986,HC DUPLEX SCAN ARTERIAL INFLOW AND VENOUS OUTFLOW PREOP BESSEL ASSESS COMPLETE UNILATERAL STUDY,360.0,252.0,,,0
HCPCS,93990,Doppler flow testing,,,103.5,459.18,11
HCPCS,93990,HC DUPLEX SCAN HEMODIALYSIS ACCESS,223.0,156.1,,,0
HCPCS,93998,Noninvas vasc dx study proc,,,28.63,127.04,11
HCPCS,94000012,HC INTENSIVE INFANT RECOVERY,1206.0,844.2,,,0
HCPCS,94000013,HC PROLONGED ECMO INITAL 24 HRS,53236.0,37265.2,,,0
HCPCS,94000014,HC PROLONGED ECMO EA. ADD'L 24 HR,19102.0,13371.4,,,0
HCPCS,94002,HC HIGH FREQ VENT INITIAL,5564.0,3894.8,,,0
HCPCS,94002,HC VENT MGMT INPAT INIT DAY,2919.0,2043.3,,,0
HCPCS,94002,Vent mgmt inpat init day,,,611.59,2713.42,11
HCPCS,94003,HC HIGH FREQ VENT SUBSEQUENT,5564.0,3894.8,,,0
HCPCS,94003,HC VENT MGMT INPAT SUBQ DAY,2919.0,2043.3,,,0
HCPCS,94003,Vent mgmt inpat subq day,,,495.8,2713.42,11
HCPCS,94004,Vent Mgmt NF per day,,,137.41,171.42,4
HCPCS,94010,Breathing capacity test,,,66.6,948.37,11
HCPCS,94010,HC SPIROMETRY,480.0,336.0,,,0
HCPCS,94011,Spirometry up to 2 yrs old,,,127.38,565.15,11
HCPCS,94012,Spirmtry w/brnchdil inf-2 yr,,,179.86,948.37,11
HCPCS,94013,Meas lung vol thru 2 yrs,,,369.41,1638.96,11
HCPCS,94014,Patient recorded spirometry,,,113.56,1962.08,11
HCPCS,94015,Patient recorded spirometry,,,113.56,948.37,11
HCPCS,94016,Review patient spirometry,,,24.27,92.08,10
HCPCS,94060,Evaluation of wheezing,,,118.05,1638.96,11
HCPCS,94060,HC SPIR PRE POST BRONCHODILATOR,624.0,436.8,,,0
HCPCS,94070,Evaluation of wheezing,,,87.84,1638.96,11
HCPCS,94150,HC VITAL CAPACITY / WEANING PARAMETERS,273.0,191.1,,,0
HCPCS,94150,Vital capacity test,,,49.81,565.15,11
HCPCS,94200,HC LUNG FUNCTION TEST (MBC/MVV),576.0,403.2,,,0
HCPCS,94200,Lung function test (MBC/MVV),,,46.18,259.1,11
HCPCS,94375,Respiratory flow volume loop,,,60.75,948.37,11
HCPCS,94450,Hypoxia response curve,,,85.05,565.15,11
HCPCS,94452,Hast w/report,,,109.38,584.37,11
HCPCS,94453,Hast w/oxygen titrate,,,131.71,584.37,11
HCPCS,94610,HC SURFACTANT ADMIN THRU TUBE,277.0,193.9,,,0
HCPCS,94610,Surfactant Admin Thru Tube,,,77.54,961.78,11
HCPCS,94617,Exercise tst brncspsm,,,131.71,584.37,11
HCPCS,94618,Pulmonary stress testing,,,131.71,584.37,11
HCPCS,94619,Exercise tst brncspsm wo ecg,,,58.4,259.1,11
HCPCS,94621,Pulm stress test/complex,,,246.37,1638.96,11
HCPCS,94625,HC PHYS/QHP SVS OP PULM RHAB W/O CONT OXIMETRY MONITORING PER SESSION,317.0,221.9,,,0
HCPCS,94625,Phy/qhp op pulm rhb w/o mntr,,,58.4,259.1,11
HCPCS,94626,HC PHYS/QHP SVCS OP PULM REHAB W/CONT OXIMTRY MONITORING PER SESSION,317.0,221.9,,,0
HCPCS,94626,Phy/qhp op pulm rhb w/mntr,,,58.4,259.1,11
HCPCS,94640,Airway inhalation treatment,,,166.76,961.78,11
HCPCS,94640,HC INHALAT THERAPY TREATMENT,247.0,172.9,,,0
HCPCS,94642,Aerosol inhalation treatment,,,185.88,961.78,11
HCPCS,94642,HC AEROSOL INHALATION TREATMENT,247.0,172.9,,,0
HCPCS,94644,Cbt 1st hour,,,111.18,584.37,11
HCPCS,94644,HC INHALAT TX CONTINUOUS 1ST HOUR,194.0,135.8,,,0
HCPCS,94645,Cbt each addl hour,,,89.47,111.61,4
HCPCS,94645,HC INHALAT TX CONTINUOUS EA ADDL HR,141.0,98.7,,,0
HCPCS,94660,HC CPAP INITIATION AND MGMT DAILY,902.0,631.4,,,0
HCPCS,94660,Pos airway pressure cpap,,,216.78,961.78,11
HCPCS,94662,Neg press ventilation cnp,,,495.8,618.52,4
HCPCS,94664,EVALUATE PT USE OF INHALER,247.0,172.9,,,0
HCPCS,94664,Evaluate pt use of inhaler,,,87.73,961.78,11
HCPCS,94667,Chest wall manipulation,,,131.71,584.37,11
HCPCS,94667,HC MANIP CHEST WALL INITIAL,247.0,172.9,,,0
HCPCS,94668,Chest wall manipulation,,,111.18,584.37,11
HCPCS,94668,HC MANIP CHEST WALL SUBSQ,147.0,102.9,,,0
HCPCS,94669,HC MECHANICAL CHEST WALL OSCILLATION,855.0,598.5,,,0
HCPCS,94669,Mechanical chest wall oscill,,,216.78,961.78,11
HCPCS,94680,Exhaled air analysis o2,,,122.93,565.15,11
HCPCS,94681,Exhaled air analysis o2/co2,,,146.65,1638.96,11
HCPCS,94681,HC EXHALED AIR ANALYSIS O2/CO2,262.0,183.4,,,0
HCPCS,94690,Exhaled air analysis,,,58.4,259.1,11
HCPCS,94726,Pulm funct tst plethysmograp,,,133.32,1638.96,11
HCPCS,94727,Pulm function test by gas,,,96.41,948.37,11
HCPCS,94728,Pulm funct test oscillometry,,,91.69,565.15,11
HCPCS,94729,Co/membane diffuse capacity,,,147.41,183.9,4
HCPCS,94760,HC PULSE OXIMETRY SNGL DETERMIN,140.0,98.0,,,0
HCPCS,94761,HC PULSE OXIMETRY MULT DETERMIN,205.0,143.5,,,0
HCPCS,94762,HC PULSE OXIMETRY CONTIN MONITOR,245.0,171.5,,,0
HCPCS,94762,Measure blood oxygen level,,,127.38,565.15,11
HCPCS,94772,Breath recording infant,,,369.41,1638.96,11
HCPCS,94775,Ped home apnea rec hk-up,,,127.38,565.15,11
HCPCS,94776,Ped home apnea rec downld,,,127.38,565.15,11
HCPCS,94780,Car seat/bed test 60 min,,,36.98,187.64,11
HCPCS,94780,HC CAR SEAT/BED TEST 1ST 60 MIN,189.0,132.3,,,0
HCPCS,94781,Car seat/bed test + 30 min,,,150.41,187.64,4
HCPCS,94781,HC CAR SEAT/BED TEST EA ADDL 30 MIN,159.0,111.3,,,0
HCPCS,94799,Pulmonary service/procedure,,,127.38,565.15,7
HCPCS,950,HC PRO ANESTH VAGINAL PX INCL BIOPSY CULDOSCOPY,197.0,137.9,,,0
HCPCS,95004,Percut allergy skin tests,,,55.48,3771.72,11
HCPCS,95012,Exhaled Nitric Oxide Meas,,,36.98,164.05,11
HCPCS,95017,Perq & icut allg test venoms,,,28.63,127.04,11
HCPCS,95018,Perq&ic allg test drugs/biol,,,36.98,164.05,11
HCPCS,95024,Icut allergy test drug/bug,,,55.48,259.1,11
HCPCS,95027,Icut allergy titrate-airborn,,,28.63,127.04,11
HCPCS,95028,Icut allergy test-delayed,,,36.98,164.05,11
HCPCS,95044,Allergy patch tests,,,55.48,3771.72,11
HCPCS,95052,Photo patch test,,,55.48,259.1,11
HCPCS,95056,Photosensitivity tests,,,131.71,584.37,11
HCPCS,95060,Eye allergy tests,,,131.71,584.37,11
HCPCS,95065,Nose allergy test,,,36.98,164.05,11
HCPCS,95070,Bronchial allergy tests,,,369.41,1638.96,11
HCPCS,95076,Ingest challenge ini 120 min,,,369.41,1638.96,11
HCPCS,95079,Ingest challenge addl 60 min,,,415.93,518.88,4
HCPCS,95115,Immunotherapy one injection,,,46.36,205.67,11
HCPCS,95117,Immunotherapy injections,,,46.36,205.67,11
HCPCS,95144,Antigen therapy services,,,46.36,205.67,11
HCPCS,95145,Antigen therapy services,,,46.36,205.67,11
HCPCS,95146,Antigen therapy services,,,46.36,205.67,11
HCPCS,95147,Antigen therapy services,,,71.28,316.24,11
HCPCS,95148,Antigen therapy services,,,71.28,316.24,11
HCPCS,95149,Antigen therapy services,,,71.28,316.24,11
HCPCS,95165,Antigen therapy services,,,46.36,205.67,11
HCPCS,95170,Antigen therapy services,,,46.36,205.67,11
HCPCS,95180,Rapid desensitization,,,208.65,1962.08,11
HCPCS,95199,Allergy immunology services,,,28.63,127.04,11
HCPCS,95249,Cont gluc mntr pt prov eqp,,,58.4,259.1,11
HCPCS,95250,Glucose monitoring cont,,,131.8,584.75,11
HCPCS,95251,Gluc monitor cont phys i&r,,,117.65,146.78,4
HCPCS,95700,Eeg cont rec w/vid eeg tech,,,213.76,956.72,11
HCPCS,95700,HC EEG CONTINUOUS RECORD W/VIDEO SETUP PATIENT EDUCATION & TAKEDOWN BY EEG TECH 8 CHANNELS,969.0,678.3,,,0
HCPCS,95705,Eeg w/o vid 2-12 hr unmntr,,,213.76,956.72,11
HCPCS,95706,Eeg wo vid 2-12hr intmt mntr,,,213.76,956.72,11
HCPCS,95707,Eeg w/o vid 2-12hr cont mntr,,,213.76,956.72,11
HCPCS,95708,Eeg wo vid ea 12-26hr unmntr,,,369.41,1835.61,11
HCPCS,95709,Eeg w/o vid ea 12-26hr intmt,,,369.41,1835.61,11
HCPCS,95710,Eeg w/o vid ea 12-26hr cont,,,369.41,1835.61,11
HCPCS,95711,Veeg 2-12 hr unmonitored,,,213.76,956.72,11
HCPCS,95712,HC VEEG 2-12 HOURS W/INTERMITTENT MONITORING & MAINTENANCE,935.0,654.5,,,0
HCPCS,95712,Veeg 2-12 hr intmt mntr,,,369.41,1638.96,11
HCPCS,95713,HC VEEG BY TECH 2-12 HR CONTINUOUS REAL TIME MONITORING,2262.0,1583.4,,,0
HCPCS,95713,Veeg 2-12 hr cont mntr,,,369.41,1835.61,11
HCPCS,95714,Veeg ea 12-26 hr unmntr,,,369.41,1835.61,11
HCPCS,95715,HC VEEG 12-26 HOURS W/INTERMITTENT MONITORING & MAINTENANCE,1795.0,1256.5,,,0
HCPCS,95715,Veeg ea 12-26hr intmt mntr,,,369.41,1835.61,11
HCPCS,95716,HC VEEG BY TECH EA INCREMENT 12-26 HR CONTINUOUS REAL TIME MONITORING,4332.0,3032.4,,,0
HCPCS,95716,Veeg ea 12-26hr cont mntr,,,850.12,3771.72,11
HCPCS,95717,Eeg phys/qhp 2-12 hr w/o vid,,,309.79,386.47,4
HCPCS,95718,Eeg phys/qhp 2-12 hr w/veeg,,,406.6,507.24,4
HCPCS,95719,Eeg phys/qhp ea incr w/o vid,,,480.59,599.55,4
HCPCS,95720,Eeg phy/qhp ea incr w/veeg,,,629.57,785.41,4
HCPCS,95721,Eeg phy/qhp>36<60 hr w/o vid,,,631.57,787.9,4
HCPCS,95722,Eeg phy/qhp>36<60 hr w/veeg,,,768.5,958.72,4
HCPCS,95723,Eeg phy/qhp>60<84 hr w/o vid,,,782.5,976.19,4
HCPCS,95724,Eeg phy/qhp>60<84 hr w/veeg,,,979.69,1222.19,4
HCPCS,95725,Eeg phy/qhp>84 hr w/o vid,,,890.24,1110.6,4
HCPCS,95726,Eeg phy/qhp>84 hr w/veeg,,,1238.06,1544.51,4
HCPCS,95782,HC POLYSOM <6 YRS 4/> PARAMTRS,5198.0,3638.6,,,0
HCPCS,95782,HC POLYSOMNOGRAPHY YOUNGER THAN 6YRS 4> PARAM DISCONTINUED,2151.0,1505.7,,,0
HCPCS,95782,Polysom <6 yrs 4/> paramtrs,,,850.12,4482.85,11
HCPCS,95783,HC POLYSOM <6 YRS CPAP/BILVL,5198.0,3638.6,,,0
HCPCS,95783,Polysom <6 yrs cpap/bilvl,,,850.12,4482.85,11
HCPCS,95800,Slp stdy unattended,,,213.76,948.37,11
HCPCS,95801,Slp stdy unatnd w/anal,,,58.4,629.9,11
HCPCS,95803,Actigraphy testing,,,58.4,301.76,11
HCPCS,95803,HC ACTIGRAPHY TESTING 3-14 DAYS,123.0,86.1,,,0
HCPCS,95805,HC MULTIPLE SLEEP LATENCY TEST,2611.0,1827.7,,,0
HCPCS,95805,Multiple sleep latency test,,,850.12,3771.72,11
HCPCS,95806,HC SLEEP STUDY UNATTENDED W/RECORDING OF HEART RATE/OXYGEN SATURATION/RESPIRATORY AIRFLOW/RESPIRATOR,529.0,370.3,,,0
HCPCS,95806,Sleep study unatt&resp efft,,,213.76,948.37,11
HCPCS,95807,SLEEP STUDY ATTENDED,2653.0,1857.1,,,0
HCPCS,95807,Sleep study attended,,,369.41,1638.96,11
HCPCS,95808,Polysom any age 1-3> param,,,850.12,3771.72,11
HCPCS,95810,HC POLYSOMNOGRAPHY 6 YRS OR OLDER 4 > PARAM DISCONTINUED,2151.0,1505.7,,,0
HCPCS,95810,HC POLYSOMNOGRAPHY 6 YRS OR OLDER 4+ XTRA MON A,5198.0,3638.6,,,0
HCPCS,95810,HC POLYSOMNOGRAPHY 6 YRS OR OLDER 4> PARAM,4303.0,3012.1,,,0
HCPCS,95810,Polysom 6/> yrs 4/> param,,,850.12,3771.72,11
HCPCS,95811,HC POLYSOM > 4 PARAM W/ CPAP/BIPAP DISCONT,4303.0,3012.1,,,0
HCPCS,95811,HC POLYSOMNOG 4> PARAM W/ CPAP,4304.0,3012.8,,,0
HCPCS,95811,Polysom 6/>yrs cpap 4/> parm,,,850.12,3771.72,11
HCPCS,95812,Eeg 41-60 minutes,,,213.76,948.37,11
HCPCS,95812,HC EEG 41-60 MINUTES,561.0,392.7,,,0
HCPCS,95813,Eeg over 1 hour,,,213.76,948.37,11
HCPCS,95813,HC EEG OVER 1 HOUR,643.0,450.1,,,0
HCPCS,95816,Eeg awake and drowsy,,,213.76,948.37,11
HCPCS,95816,HC EEG AWAKE AND DROWSY,672.0,470.4,,,0
HCPCS,95819,Eeg awake and asleep,,,213.76,948.37,11
HCPCS,95819,HC EEG AWAKE AND ASLEEP,663.0,464.1,,,0
HCPCS,95822,Eeg coma or sleep only,,,213.76,948.37,11
HCPCS,95822,HC EEG COMA OR SLEEP ONLY,539.0,377.3,,,0
HCPCS,95824,Eeg cerebral death only,,,369.41,1638.96,11
HCPCS,95830,Insert electrodes for EEG,,,251.49,313.74,4
HCPCS,95836,Ecog impltd brn npgt <=30 d,,,36.95,163.92,11
HCPCS,95851,Range of motion measurements,,,6.66,29.37,10
HCPCS,95852,Range of motion measurements,,,4.99,21.36,10
HCPCS,95857,Cholinesterase challenge,,,213.76,948.37,11
HCPCS,95860,HC EMG ONE LIMB,132.0,92.4,,,0
HCPCS,95860,Muscle test one limb,,,85.05,584.37,11
HCPCS,95861,HC EMG TWO LIMBS,238.0,166.6,,,0
HCPCS,95861,Muscle test 2 limbs,,,105.41,584.37,11
HCPCS,95863,Muscle test 3 limbs,,,123.9,565.15,11
HCPCS,95864,Muscle test 4 limbs,,,127.38,565.15,11
HCPCS,95865,Muscle test larynx,,,84.32,584.37,11
HCPCS,95866,Muscle test hemidiaphragm,,,74.6,565.15,11
HCPCS,95867,Muscle test cran nerv unilat,,,82.6,948.37,11
HCPCS,95868,Muscle test cran nerve bilat,,,100.32,948.37,11
HCPCS,95869,Muscle test thor paraspinal,,,70.48,948.37,11
HCPCS,95870,Muscle test nonparaspinal,,,67.57,584.37,11
HCPCS,95872,Muscle test one fiber,,,73.08,948.37,11
HCPCS,95873,HC ELEC STIM FOR GUIDE,119.0,83.3,,,0
HCPCS,95874,HC NEEDLE EMG FOR GUIDE,128.0,89.6,,,0
HCPCS,95875,Limb exercise test,,,101.54,565.15,11
HCPCS,95885,Musc tst done w/nerv tst lim,,,119.08,148.55,4
HCPCS,95886,Musc test done w/n test comp,,,133.23,166.21,4
HCPCS,95887,Musc tst done w/n tst nonext,,,130.41,162.69,4
HCPCS,95905,Motor &/ sens nrve cndj test,,,129.87,1962.08,11
HCPCS,95907,Nvr cndj tst 1-2 studies,,,130.62,948.37,11
HCPCS,95908,HC NERVE CONDUCTION STUDIES 3-4 STUDIES,1326.0,928.2,,,0
HCPCS,95908,Nrv cndj tst 3-4 studies,,,130.62,948.37,11
HCPCS,95909,HC NERVE CONDUCTION STUDIES 5-6 STUDIES,459.0,321.3,,,0
HCPCS,95909,Nrv cndj tst 5-6 studies,,,130.62,948.37,11
HCPCS,95910,HC NERVE CONDUCTION STUDIES 7-8 STUDIES,459.0,321.3,,,0
HCPCS,95910,Nrv cndj test 7-8 studies,,,130.62,1638.96,11
HCPCS,95911,Nrv cndj test 9-10 studies,,,241.88,1638.96,11
HCPCS,95912,Nrv cndj test 11-12 studies,,,241.88,1638.96,11
HCPCS,95913,Nrv cndj test 13/> studies,,,241.88,1638.96,11
HCPCS,95919,Quan puplmtry phy/qhp uni/bi,,,131.71,584.37,11
HCPCS,95921,Autonomic nrv parasym inervj,,,76.33,565.15,11
HCPCS,95922,Autonomic nrv adrenrg inervj,,,106.47,584.37,11
HCPCS,95923,Autonomic nrv syst funj test,,,131.71,584.37,11
HCPCS,95924,Ans parasymp & symp w/tilt,,,169.1,948.37,11
HCPCS,95925,HC SOMATOSEN TEST UP LIMBS,1278.0,894.6,,,0
HCPCS,95925,Somatosensory testing,,,213.76,948.37,11
HCPCS,95926,Somatosensory testing,,,213.76,948.37,11
HCPCS,95927,Somatosensory testing,,,213.76,948.37,11
HCPCS,95928,C motor evoked uppr limbs,,,300.24,3771.72,11
HCPCS,95929,C motor evoked lwr limbs,,,326.51,1638.96,11
HCPCS,95930,HC VISUAL EVOKED POTENTIAL CHECKERBOARD/FLASH TESTING CENTRAL NERVOUS SYST EXCEPT GLAUCOMA W/I&R,500.0,350.0,,,0
HCPCS,95930,Visual evoked potential test,,,213.76,948.37,11
HCPCS,95933,Blink reflex test,,,58.4,259.1,11
HCPCS,95937,Neuromuscular junction test,,,60.75,565.15,11
HCPCS,95938,Somatosensory testing,,,801.95,3771.72,11
HCPCS,95939,C motor evoked upr&lwr limbs,,,850.12,3771.72,11
HCPCS,95940,Ionm in operatng room 15 min,,,94.2,117.52,4
HCPCS,95954,EEG monitoring/giving drugs,,,352.45,1638.96,11
HCPCS,95958,EEG monitoring/function test,,,452.26,3771.72,11
HCPCS,95961,Electrode stimulation brain,,,191.22,3771.72,11
HCPCS,95962,Electrode stim brain add-on,,,128.99,160.91,4
HCPCS,95965,Meg spontaneous,,,850.12,15397.94,11
HCPCS,95966,Meg evoked single,,,850.12,4140.73,11
HCPCS,95967,Meg evoked each addl,,,3319.15,4140.73,4
HCPCS,95970,Analyze neurostim no prog,,,131.71,584.37,11
HCPCS,95970,HC ELEC ANALYSIS IMPLT NEUROSTIM PULSE GENERATOR PHYS/QHP W/O PROGRAMMING,145.0,101.5,,,0
HCPCS,95971,Analyze neurostim simple,,,94.12,458.59,11
HCPCS,95971,HC ELECTRONIC ANALYSIS IMPLANTED NERUOSTIMULATOR PULSE GENERATOR/TRANSMITTER SIMPLE SPINAL CORD/PERIPHERAL NERVE PROGRAMMING,174.0,121.8,,,0
HCPCS,95972,Analyze neurostim complex,,,94.12,3401.78,11
HCPCS,95976,Alys smpl cn npgt prgrmg,,,36.95,163.92,11
HCPCS,95977,Alys cplx cn npgt prgrmg,,,94.12,444.3,11
HCPCS,95981,Io anal gast n-stim subsq,,,58.4,288.26,11
HCPCS,95982,Io ga n-stim subsq w/reprog,,,36.95,458.59,11
HCPCS,95983,Alys brn npgt prgrmg 15 min,,,94.12,417.57,11
HCPCS,95984,Alys brn npgt prgrmg addl 15,,,136.23,169.95,4
HCPCS,95990,Spin/brain pump refil & main,,,326.99,1450.75,11
HCPCS,95991,HC REFILL IMPLANTABLE PUMP,256.0,179.2,,,0
HCPCS,95991,Spin/brain pump refil & main,,,204.12,1348.18,11
HCPCS,95992,Canalith repositioning proc,,,29.47,107.9,10
HCPCS,95992,HC CANALITH REPOSITIONING,131.0,91.7,,,0
HCPCS,95992,HC PRO CANALITH REPOSITIONING PROC,125.0,87.5,,,0
HCPCS,95999,Neurological procedure,,,116.11,565.15,11
HCPCS,96000,Motion analysis video/3d,,,369.41,1638.96,11
HCPCS,96001,Motion test w/ft press meas,,,537.07,3771.72,11
HCPCS,96002,Dynamic surface emg,,,213.76,948.37,11
HCPCS,96003,Dynamic fine wire emg,,,116.11,144.85,4
HCPCS,96004,Phys review of motion tests,,,323.88,404.04,4
HCPCS,96040,Genetic counseling 30 min,,,108.17,134.95,4
HCPCS,96105,Assessment of aphasia,,,94.46,195.05,10
HCPCS,96105,HC ASSESSMENT OF APHASIA PER HOUR,218.0,152.6,,,0
HCPCS,96110,Developmental screen w/score,,,249.04,310.68,4
HCPCS,96110,HC DEVELOPMENTAL TEST LIMITED,50.0,35.0,,,0
HCPCS,96112,Devel tst phys/qhp 1st hr,,,127.38,565.15,11
HCPCS,96113,Devel tst phys/qhp ea addl,,,176.19,219.81,4
HCPCS,96116,Neurobehavioral status exam,,,213.76,948.37,11
HCPCS,96121,Nubhvl xm phy/qhp ea addl hr,,,238.7,297.79,4
HCPCS,96125,Cognitive test by hc pro,,,99.43,377.09,10
HCPCS,96125,HC COGN TEST FACE TO FACE PER HOUR,361.0,252.7,,,0
HCPCS,96127,Brief emotional/behav assmt,,,36.98,164.05,11
HCPCS,96130,Psycl tst eval phys/qhp 1st,,,213.76,948.37,11
HCPCS,96131,Psycl tst eval phys/qhp ea,,,255.82,319.15,4
HCPCS,96132,Nrpsyc tst eval phys/qhp 1st,,,369.41,1638.96,11
HCPCS,96133,Nrpsyc tst eval phys/qhp ea,,,252.52,315.03,4
HCPCS,96136,Psycl/nrpsyc tst phy/qhp 1st,,,52.03,584.37,11
HCPCS,96137,Psycl/nrpsyc tst phy/qhp ea,,,59.39,74.09,4
HCPCS,96138,Psycl/nrpsyc tech 1st,,,52.03,1962.08,11
HCPCS,96139,Psycl/nrpsyc tst tech ea,,,106.57,132.94,4
HCPCS,96146,Psycl/nrpsyc tst auto result,,,28.63,127.04,11
HCPCS,96156,Hlth bhv assmt/reassessment,,,100.57,446.2,11
HCPCS,96158,Hlth bhv ivntj indiv 1st 30,,,175.71,779.59,11
HCPCS,96159,Hlth bhv ivntj indiv ea addl,,,63.72,79.49,4
HCPCS,96160,Pt-focused hlth risk assmt,,,37.09,164.57,11
HCPCS,96161,Caregiver health risk assmt,,,37.09,164.57,11
HCPCS,96164,Hlth bhv ivntj grp 1st 30,,,37.09,164.57,11
HCPCS,96165,Hlth bhv ivntj grp ea addl,,,11.82,14.74,4
HCPCS,96167,Hlth bhv ivntj fam 1st 30,,,37.09,164.57,11
HCPCS,96168,Hlth bhv ivntj fam ea addl,,,70.11,87.47,4
HCPCS,96170,Hlth bhv ivntj fam wo pt 1st,,,234.49,292.53,4
HCPCS,96171,Hlth bhv ivntj fam w/o pt ea,,,85.9,107.16,4
HCPCS,96202,HC MULTI-FAM GROUP BHV MGMT/MODIFICAJ TRAINING FACE-TO-FACE W/MULTI SETS PARENT/GUARDIAN/CAREGIVER INITIAL 60 MIN,45.0,31.5,,,0
HCPCS,96202,Mlt fam grp bhv train 1st 60,,,17.21,30.12,6
HCPCS,96203,HC MULTI-FAM GROUP BHV MGMT/MODIFICAJ TRAINING FACE-TO-FACE W/MULTI SETS PARENT/GUARDIAN/CAREGIVER EA ADDTL 15 MIN,12.0,8.4,,,0
HCPCS,96203,Mlt fam grp bhv train ea add,,,5.02,8.78,6
HCPCS,96360,HC IV INFUSION HYDRAT 31-60 MIN,599.0,419.3,,,0
HCPCS,96360,Hydration iv infusion init,,,210.57,934.22,11
HCPCS,96361,Hydrate iv infusion add-on,,,46.36,261.57,11
HCPCS,96361,IV INFUSION HYDRAT EA ADDL HOUR,292.0,204.4,,,0
HCPCS,96365,IV THER/PROPHY/DX INITIAL HOUR,599.0,419.3,,,0
HCPCS,96365,Ther/proph/diag iv inf init,,,210.57,934.22,11
HCPCS,96366,IV THER/PROPHY/DX EA ADDL HOUR,214.0,149.8,,,0
HCPCS,96366,Ther/proph/diag iv inf addon,,,46.36,205.67,11
HCPCS,96367,IV THER/PROPHY/DX ADD NEW RX,600.0,420.0,,,0
HCPCS,96367,Tx/proph/dg addl seq iv inf,,,71.28,633.91,11
HCPCS,96368,IV CONCURR ADD-ON,599.0,419.3,,,0
HCPCS,96368,Ther/diag concurrent inf,,,58.39,72.84,4
HCPCS,96369,HC SUBQ INFUSION THERAPY/PROPHYLAXIS INITIAL  UP TO 1 HR,630.0,441.0,,,0
HCPCS,96369,Sc ther infusion up to 1 hr,,,210.57,934.22,11
HCPCS,96370,HC SUBQ INFUSION THERAPY/PROPHYLAXIS EA ADDTL HOUR,172.0,120.4,,,0
HCPCS,96370,Sc ther infusion addl hr,,,45.84,205.67,11
HCPCS,96371,HC SUBQ INFUSION THERAPY/PROPHYLAXIS ADDTL PUMP SET-UP NEW SITE,208.0,145.6,,,0
HCPCS,96371,Sc ther infusion reset pump,,,71.28,316.24,11
HCPCS,96372,INJ THER/PROPHY/DX IM SUBQ,107.0,74.9,,,0
HCPCS,96372,Ther/proph/diag inj sc/im,,,71.28,316.24,11
HCPCS,96373,HC THERAPEUTIC PROPHYLACTIC DX INJECTION INTRA-ARTERIAL,134.0,93.8,,,0
HCPCS,96373,Ther/proph/diag inj ia,,,121.98,934.22,11
HCPCS,96374,INJ THER/PROPHY/DX IV PUSH 1ST,453.0,317.1,,,0
HCPCS,96374,Ther/proph/diag inj iv push,,,210.57,934.22,11
HCPCS,96375,INJ THER/PRO/DX IV NEW DRUG,207.0,144.9,,,0
HCPCS,96375,Tx/pro/dx inj new drug addon,,,46.36,205.67,11
HCPCS,96376,HC INJ THER/PRO/DX SAME DRUG 2ND,296.0,207.2,,,0
HCPCS,96376,Tx/pro/dx inj same drug adon,,,57.81,72.12,4
HCPCS,96377,Applicaton on-body injector,,,46.36,205.67,11
HCPCS,96379,Ther/prop/diag inj/inf proc,,,46.36,205.67,11
HCPCS,96380,HC ADMIN RESPIRATORY SYNCYTIAL VIRUS MONOCLONAL ANTIBODY SEASONAL DOSE INTRAMUSCULAR INJECTION W/COUNSELING PHYSICIAN/OTH QUALIFIED HEALTH CARE PROFESSIONAL,47.0,32.9,,,0
HCPCS,96381,HC ADMIN RESPIRATORY SYNCYTIAL VIRUS MONOCLONAL ANTIBODY SEASONAL DOSE INTRAMUSCULAR INJECTION,41.0,28.7,,,0
HCPCS,96401,CHEMO ANTINEOPL IM SUBQ,267.0,186.9,,,0
HCPCS,96401,Chemo anti-neopl sq/im,,,71.28,316.24,11
HCPCS,96402,CHEMO HORM ANTINEOPL IM SUBQ,171.0,119.7,,,0
HCPCS,96402,Chemo hormon antineopl sq/im,,,71.28,316.24,11
HCPCS,96405,Chemo intralesional up to 7,,,71.28,316.24,11
HCPCS,96405,HC CHEMO ADMIN INTRALESIONAL UP TO AND INCL 7 LESIONS,76.0,53.2,,,0
HCPCS,96406,Chemo intralesional over 7,,,160.86,934.22,11
HCPCS,96409,CHEMO IV PUSH SINGL DRUG,493.0,345.1,,,0
HCPCS,96409,Chemo iv push sngl drug,,,326.99,1450.75,11
HCPCS,96411,CHEMO IV PUSH ADDL DRUG,284.0,198.8,,,0
HCPCS,96411,Chemo iv push addl drug,,,71.28,316.24,11
HCPCS,96413,CHEMO INFUS SINGL DRUG 1 HOUR,713.0,499.1,,,0
HCPCS,96413,Chemo iv infusion 1 hr,,,326.99,1450.75,11
HCPCS,96415,CHEMO INFUS SINGL DRUG EA ADD HR,239.0,167.3,,,0
HCPCS,96415,Chemo iv infusion addl hr,,,71.28,316.24,11
HCPCS,96416,CHEMO INFUS W/PUMP >8 HRS,671.0,469.7,,,0
HCPCS,96416,Chemo prolong infuse w/pump,,,137.24,1450.75,11
HCPCS,96417,CHEMO INFUS DIFF DRUG SEQ 1 HR,602.0,421.4,,,0
HCPCS,96417,Chemo iv infus each addl seq,,,71.28,628.49,11
HCPCS,96420,Chemo ia push tecnique,,,326.99,1450.75,11
HCPCS,96420,HC CHEMO INTRA-ARTERIAL PUSH,334.0,233.8,,,0
HCPCS,96422,Chemo ia infusion up to 1 hr,,,326.99,1450.75,11
HCPCS,96423,Chemo ia infuse each addl hr,,,46.36,205.67,11
HCPCS,96423,HC CHEMO ADMIN INTRA-ARTERIAL INFUSION TECH EA ADDT'L HOUR,314.0,219.8,,,0
HCPCS,96425,Chemotherapy infusion method,,,326.99,1450.75,11
HCPCS,96425,HC CHEMO ADMIN INTRA-ARTERIAL INFUS TECH INITIATION PROLONGED INFUSION > 8HRS PRTBLE/IMPLTBL PUMP,1223.0,856.1,,,0
HCPCS,96440,Chemotherapy intracavitary,,,326.99,1450.75,11
HCPCS,96440,HC CHEMO ADMIN INTO PLEURAL CAVITY REQ/INCLUDE THORACENTESIS,1223.0,856.1,,,0
HCPCS,96446,Chemotx admn prtl cavity,,,326.99,1450.75,11
HCPCS,96446,HC CHEMO ADMIN INTO PERITONEAL CAVITY IMPLANTED PORT/CATHETER,1223.0,856.1,,,0
HCPCS,96450,Chemotherapy into cns,,,326.99,1450.75,11
HCPCS,96450,HC CHEMO ADMIN INTO CNS REQ/INCLUDE SPINAL PUNCTURE,863.0,604.1,,,0
HCPCS,96521,HC REFILL/MAINT PORTABLE PUMP,271.0,189.7,,,0
HCPCS,96521,Refill/maint portable pump,,,179.8,934.22,11
HCPCS,96522,Refill/maint pump/resvr syst,,,210.57,934.22,11
HCPCS,96523,HC IRRIGATE CENTRAL LINE/DEVICE,202.0,141.4,,,0
HCPCS,96523,Irrig drug delivery device,,,58.4,259.1,11
HCPCS,96542,Chemotherapy injection,,,160.86,1450.75,11
HCPCS,96549,Chemotherapy unspecified,,,46.36,205.67,11
HCPCS,96567,Photodynamic tx skin,,,158.65,881.22,11
HCPCS,96570,Photodynmc tx 30 min add-on,,,291.97,364.24,4
HCPCS,96571,Photodynamic tx addl 15 min,,,291.97,364.24,4
HCPCS,96573,Pdt dstr prmlg les phys/qhp,,,198.62,881.22,11
HCPCS,96574,Dbrdmt prmlg les w/pdt,,,198.62,881.22,11
HCPCS,96900,Ultraviolet light therapy,,,36.98,164.05,11
HCPCS,96910,Photochemotherapy with UV-B,,,58.4,259.1,11
HCPCS,96912,Photochemotherapy with UV-A,,,58.4,259.1,11
HCPCS,96913,Photochemotherapy uv-a or b,,,402.44,1785.48,11
HCPCS,96920,Laser tx skin < 250 sq cm,,,198.62,881.22,11
HCPCS,96921,Laser tx skin 250-500 sq cm,,,198.62,881.22,11
HCPCS,96922,Laser tx skin >500 sq cm,,,291.97,1785.48,11
HCPCS,96932,Rcm celulr subcelulr img skn,,,92.45,115.33,4
HCPCS,96999,Dermatological procedure,,,59.27,881.22,11
HCPCS,97010,Hot or cold packs therapy,,,13.6,16.97,4
HCPCS,97012,HC MECHANICAL TRACTION THERAPY,114.0,79.8,,,0
HCPCS,97012,Mechanical traction therapy,,,13.93,103.86,10
HCPCS,97014,HC ELECT STIM OTHER THAN WND CARE,109.0,76.3,,,0
HCPCS,97016,HC VASOPNEUMATIC DEVICE THERAPY,90.0,63.0,,,0
HCPCS,97016,Vasopneumatic device therapy,,,11.62,83.42,10
HCPCS,97018,HC PARAFFIN BATH THERAPY,72.0,50.4,,,0
HCPCS,97018,Paraffin bath therapy,,,5.77,66.1,10
HCPCS,97022,HC FLUIDOTHERAPY,102.0,71.4,,,0
HCPCS,97022,Whirlpool therapy,,,14.96,94.14,10
HCPCS,97024,Diathermy eg microwave,,,7.0,19.39,10
HCPCS,97024,HC DIATHERMY THERAPY,26.0,18.2,,,0
HCPCS,97026,HC INFRARED THERAPY,59.0,41.3,,,0
HCPCS,97026,Infrared therapy,,,6.39,54.18,10
HCPCS,97028,HC ULTRAVIOLET THERAPY,38.0,26.6,,,0
HCPCS,97028,Ultraviolet therapy,,,7.97,22.11,10
HCPCS,97032,Electrical stimulation,,,14.26,101.74,10
HCPCS,97032,HC ELECTRICAL STIMULATION EA 15 MIN,109.0,76.3,,,0
HCPCS,97033,Electric current therapy,,,18.27,97.98,10
HCPCS,97033,IONTOPHORESIS EA 15 MIN,106.0,74.2,,,0
HCPCS,97034,Contrast bath therapy,,,13.54,53.18,10
HCPCS,97035,HC ULTRASOUND THERAPY EA 15 MIN,169.0,118.3,,,0
HCPCS,97035,Ultrasound therapy,,,13.85,155.53,10
HCPCS,97036,Hydrotherapy,,,32.72,89.4,10
HCPCS,97037,Appl modality 1+lllt po pain,,,36.98,164.05,11
HCPCS,97039,HC COLD LASER,102.0,71.4,,,0
HCPCS,97039,HC CUPPING,102.0,71.4,,,0
HCPCS,97110,HC THERAPEUTIC EXERCISES EA 15 MIN,139.0,97.3,,,0
HCPCS,97110,Therapeutic exercises,,,27.99,126.38,10
HCPCS,97112,HC NEUROMUSC REEDUCAT EA 15 MIN,175.0,122.5,,,0
HCPCS,97112,Neuromuscular reeducation,,,31.5,154.63,10
HCPCS,97113,Aquatic therapy/exercises,,,35.42,118.56,10
HCPCS,97113,HC AQUA THER/EXERCISES EA 15 MIN,124.0,86.8,,,0
HCPCS,97116,Gait training therapy,,,27.99,86.49,10
HCPCS,97116,HC GAIT TRAINING EA 15 MIN,95.0,66.5,,,0
HCPCS,97124,Massage therapy,,,28.32,80.74,10
HCPCS,97129,HC THER INTERVENT COGNITIVE FUNCTION DIRECT PATIENT CONTACT INITIAL 15 MIN,392.0,274.4,,,0
HCPCS,97129,Ther ivntj 1st 15 min,,,19.55,89.4,10
HCPCS,97130,HC THER INTERVENT COGNITIVE FUNCTION DIRECT PATIENT CONTACT EACH ADDITIONAL 15 MINUTES,83.0,58.1,,,0
HCPCS,97130,Ther ivntj ea addl 15 min,,,18.18,86.71,10
HCPCS,97140,HC MANUAL THERAPY EA 15 MIN,99.0,69.3,,,0
HCPCS,97140,Manual therapy 1/> regions,,,26.71,92.06,10
HCPCS,97150,Group therapeutic procedures,,,17.44,119.4,10
HCPCS,97150,HC GROUP THERAPEUTIC PROCEDURES,128.0,89.6,,,0
HCPCS,97151,Bhv id assmt by phys/qhp,,,100.57,446.2,11
HCPCS,97152,Bhv id suprt assmt by 1 tech,,,100.57,446.2,11
HCPCS,97153,Adaptive behavior tx by tech,,,100.57,446.2,11
HCPCS,97154,Grp adapt bhv tx by tech,,,37.09,164.57,11
HCPCS,97155,Adapt behavior tx phys/qhp,,,101.14,779.59,11
HCPCS,97156,Fam adapt bhv tx gdn phy/qhp,,,37.09,164.57,11
HCPCS,97157,Mult fam adapt bhv tx gdn,,,37.09,164.57,11
HCPCS,97158,Grp adapt bhv tx by phy/qhp,,,37.09,164.57,11
HCPCS,97161,HC PT EVAL LOW COMPLEXITY 20 MIN,291.0,203.7,,,0
HCPCS,97161,Pt eval low complex 20 min,,,94.11,293.34,10
HCPCS,97162,HC PT EVAL MODERATE COMPLEXITY 30 MIN,335.0,234.5,,,0
HCPCS,97162,Pt eval mod complex 30 min,,,94.11,288.6,10
HCPCS,97163,HC PT EVAL HIGH COMPLEXITY 45 MIN,384.0,268.8,,,0
HCPCS,97163,Pt eval high complex 45 min,,,94.11,288.28,10
HCPCS,97164,HC RE-EVAL PT ESTABLISHED POC 20 MIN,186.0,130.2,,,0
HCPCS,97164,Pt re-eval est plan care,,,64.63,113.92,10
HCPCS,97165,HC OT EVAL LOW COMPLEXITY 30 MIN,291.0,203.7,,,0
HCPCS,97165,Ot eval low complex 30 min,,,96.56,288.24,10
HCPCS,97166,HC OT EVAL  MODERATE COMPLEXITY 45 MIN,335.0,234.5,,,0
HCPCS,97166,Ot eval mod complex 45 min,,,96.56,287.6,10
HCPCS,97167,HC OT EVAL HIGH COMPLEXITY 60 MIN,384.0,268.8,,,0
HCPCS,97167,Ot eval high complex 60 min,,,96.56,288.24,10
HCPCS,97168,HC RE-EVAL OT ESTABLISHED POC 30 MIN,186.0,130.2,,,0
HCPCS,97168,Ot re-eval est plan care,,,65.54,139.13,10
HCPCS,97169,Athletic trn eval low cmplx,,,160.18,199.83,4
HCPCS,97170,Athletic trn eval mod cmplx,,,160.18,199.83,4
HCPCS,97171,Athletic trn eval high cmplx,,,160.18,199.83,4
HCPCS,97172,Athletic trn re-eval plan cr,,,80.13,99.97,4
HCPCS,97530,HC THER ACTIVITIES 1-1 EA 15 MIN,116.0,81.2,,,0
HCPCS,97530,Therapeutic activities,,,33.47,106.27,10
HCPCS,97533,HC SENS INTEGRATION 1-1 EA 15 MIN,131.0,91.7,,,0
HCPCS,97533,Sensory Integration,,,57.17,130.03,10
HCPCS,97535,HC ADL TRAINING 1-1 EA 15 MIN,102.0,71.4,,,0
HCPCS,97535,Self care mngment training,,,31.05,94.27,10
HCPCS,97537,Community/work reintegration,,,30.83,96.81,10
HCPCS,97537,REINTER TRAIN 1-1 EA 15 MIN,70.0,49.0,,,0
HCPCS,97542,HC WHEELCHAIR TRAIN EA 15 MIN,61.0,42.7,,,0
HCPCS,97542,Wheelchair mngment training,,,29.91,59.6,10
HCPCS,97545,Work hardening,,,331.42,413.46,4
HCPCS,97546,Work hardening add-on,,,131.99,164.66,4
HCPCS,97550,Caregiver traing 1st 30 min,,,39.32,68.81,6
HCPCS,97550,HC CAREGIVER TRAINING STRATEGIES/TECHNIQUES FACILITATE THE PATIENT FUNCTIONAL PERFORMANCE IN HOME/COMMUNITY FACE TO FACE INITIAL 30 MIN,112.0,78.4,,,0
HCPCS,97551,Caregiver traing ea addl 15,,,20.79,36.38,6
HCPCS,97551,HC CAREGIVER TRAINING STRATEGIES/TECHNIQUES TO FACILITATE THE PATIENT FUNCTIONAL PERFORMANCE IN HOME/COMMUNITY FACE TO FACE EA ADDTL 15 MIN,52.0,36.4,,,0
HCPCS,97552,Group caregiver training,,,9.31,16.29,6
HCPCS,97552,HC GROUP CAREGIVER TRAINING STRATEGIES/TECHNIQUES TO FACILITATE THE PATIENT FUNCTIONAL PERFORMANCE IN HOME/COMMUNITY FACE TO FACE W/MULTIPLE SETS OF CAREGIVERS,46.0,32.2,,,0
HCPCS,97597,HC DEBRIDEMENT OPEN WOUND FIRST 20 SQ CM OR LESS,296.0,207.2,,,0
HCPCS,97597,HC PRO DEBRIDEMENT OPEN WOUND FIRST 20 SQ CM OR LESS,92.0,64.4,,,0
HCPCS,97597,Rmvl devital tis 20 cm/<,,,198.62,881.22,11
HCPCS,97598,HC PRO RMVL DEVITAL TISSUE ADDL 20 SQ CM,116.0,81.2,,,0
HCPCS,97598,HC RMVL DEVITAL TISSUE ADDL 20 SQ CM,347.0,242.9,,,0
HCPCS,97598,Rmvl devital tis addl 20cm/<,,,261.45,326.16,4
HCPCS,97602,Wound(s) care non-selective,,,143.74,881.22,11
HCPCS,97605,HC NEG PRESS WOUND THERAPY DME LESS THAN OR EQUAL TO 50 SQ CM,408.0,285.6,,,0
HCPCS,97605,HC PRO NEG PRESS WOUND THERAPY DME LESS THAN OR EQUAL TO 50 SQ CM,137.0,95.9,,,0
HCPCS,97605,Neg press wound tx <=50 cm,,,198.62,938.06,11
HCPCS,97606,HC NEG PRESS WOUND THERAPY DME GREATER THAN 50 SQ CM,520.0,364.0,,,0
HCPCS,97606,Neg press wound tx >50 cm,,,402.44,6253.46,11
HCPCS,97607,HC NEG PRESS WOUND NON-DME LESS THAN OR EQUAL TO 50 SQ CM,416.0,291.2,,,0
HCPCS,97607,Neg press wnd tx <=50 sq cm,,,313.56,1785.48,11
HCPCS,97608,HC NEG PRESS WOUND NON-DME GREATER THAN 50 SQ CM,330.0,231.0,,,0
HCPCS,97608,Neg press wound tx >50 cm,,,402.44,1785.48,11
HCPCS,97610,Low frequency non-thermal us,,,198.62,881.22,11
HCPCS,97750,HC PHYSICAL PERFORMANCE TEST EA 15 MIN,143.0,100.1,,,0
HCPCS,97750,Physical performance test,,,32.28,140.01,10
HCPCS,97755,Assistive technology assess,,,36.42,121.49,10
HCPCS,97760,HC ORTHOTIC(S) MGMT AND TRAINING INITIAL ENCOUNTER 15 MIN,162.0,113.4,,,0
HCPCS,97760,Orthotic mgmt and training,,,43.75,148.45,10
HCPCS,97761,HC PROSTHETIC(S) TRAINING INITIAL ENCOUNTER 15 MIN,172.0,120.4,,,0
HCPCS,97761,Prosthetic training,,,38.54,129.76,10
HCPCS,97763,HC ORTHOTIC/PROSTHETIC MGMT AND/OR TRAINING SUBSEQUENT ENCOUNTER 15 MIN,93.0,65.1,,,0
HCPCS,97763,Orthc/prostc mgmt sbsq enc,,,47.37,82.9,6
HCPCS,97802,Medical nutrition indiv in,,,25.76,100.43,10
HCPCS,97803,Med nutrition indiv subseq,,,21.56,87.13,10
HCPCS,97804,Medical nutrition group,,,12.12,47.7,10
HCPCS,97810,Acupunct w/o stimul 15 min,,,28.63,127.04,7
HCPCS,97813,Acupunct w/stimul 15 min,,,28.63,127.04,7
HCPCS,98016,HC PRO BRIEF COMMUNICATION TECH-BASED SERVICE PHYSICIAN OR QHP ESTABLISHED PATIENT 5-10 MINUTES,29.0,20.3,,,0
HCPCS,98925,HC PRO OSTEOPATHIC MANIPULATIVE TREATMENT (OMT) 1-2 BODY REGIONS INVOLVED,28.0,19.6,,,0
HCPCS,98925,Osteopath manj 1-2 regions,,,21.38,94.84,11
HCPCS,98926,Osteopath manj 3-4 regions,,,21.38,111.85,11
HCPCS,98927,Osteopath manj 5-6 regions,,,21.38,111.85,11
HCPCS,98928,Osteopath manj 7-8 regions,,,21.38,111.85,11
HCPCS,98929,Osteopath manj 9-10 regions,,,21.38,111.85,11
HCPCS,98940,Chiropract manj 1-2 regions,,,21.38,111.85,11
HCPCS,98941,Chiropract manj 3-4 regions,,,21.38,111.85,11
HCPCS,98942,Chiropractic manj 5 regions,,,21.38,111.85,11
HCPCS,98966,HC TELEPHONE ASSESS/MGMT SERV NONPHYSICIAN  5-10 MIN,38.0,26.6,,,0
HCPCS,98966,Hc pro phone call 5-10 min,,,10.28,17.99,6
HCPCS,98967,HC TELEPHONE ASSESS/MGMT SERV NONPHYSICIAN 11-20 MIN,73.0,51.1,,,0
HCPCS,98967,Hc pro phone call 11-20 min,,,19.95,34.91,6
HCPCS,98968,HC TELEPHONE ASSESS/MGMT SERV NONPHYSICIAN 21-30 MIN,106.0,74.2,,,0
HCPCS,98968,Hc pro phone call 21-30 min,,,28.92,50.61,6
HCPCS,98970,Qnhp ol dig e/m svc 5-10min,,,10.28,45.32,10
HCPCS,98971,Qnhp ol dig em svc 11-20min,,,18.87,80.06,10
HCPCS,98972,Qnhp ol dig e/m svc 21+ min,,,28.84,124.14,10
HCPCS,98975,Rem ther mntr 1st setup&edu,,,131.8,584.75,11
HCPCS,98976,Rem ther mntr dev sply resp,,,36.95,163.92,11
HCPCS,98977,Rem ther mntr dv sply mscskl,,,36.95,163.92,11
HCPCS,98978,Rem ther mntr dev sply cbt,,,36.95,163.92,11
HCPCS,98979,Rtm tx mgmt 1st 10 min,,,11.37,19.9,6
HCPCS,98980,Rem ther mntr 1st 20 min,,,25.59,44.78,6
HCPCS,98981,Rem ther mntr ea addl 20 min,,,25.25,44.19,6
HCPCS,99001,HC HANDLING/CONVEYANCE OF SPECIMEN FOR TRANSFER FROM PATIENT TO A LABORATORY,62.0,43.4,,,0
HCPCS,99002,Device handling phys/qhp,,,21.48,26.8,4
HCPCS,99050,Medical services after hrs,,,57.33,71.52,4
HCPCS,99056,Med service out of office,,,55.27,68.95,4
HCPCS,99058,Office emergency care,,,67.42,84.11,4
HCPCS,99060,Out of office emerg med serv,,,76.75,95.75,4
HCPCS,99082,Unusual physician travel,,,2.61,3.25,4
HCPCS,99151,HC MOD SEDATION SAME PHYS/QHP INITIAL 15 MIN PATIENT YOUNGER THAN 5 YEARS OF AGE,223.0,156.1,,,0
HCPCS,99151,HC PRO MOD SEDATION SAME PHYS/QHP INITIAL 15 MIN PATIENT YOUNGER THAN 5 YEARS OF AGE,145.0,101.5,,,0
HCPCS,99151,Mod sed same phys/qhp <5 yrs,,,186.75,232.97,4
HCPCS,99152,HC MOD SEDATION SAME PHYS/QHP INITIAL 15 MIN PATIENT AGE 5 YEARS OR OLDER,423.0,296.1,,,0
HCPCS,99152,HC PRO MOD SEDATION SAME PHYS/QHP INITIAL 15 MIN PATIENT AGE 5 YEARS OR OLDER,145.0,101.5,,,0
HCPCS,99152,Mod sed same phys/qhp 5/>yrs,,,353.52,441.03,4
HCPCS,99153,HC MOD SEDATION SAME PHYS/QHP EACH ADDTL 15 MIN INTRASERVICE TIME (LIST SEP  IN ADDT TO CODE FOR PRIMARY SERVICE),114.0,79.8,,,0
HCPCS,99153,Mod sed same phys/qhp ea,,,95.55,119.2,4
HCPCS,99155,HC MOD SEDATION OTHER PHYS/QHP INITIAL 15 MIN INTRASERVICE TIME PATIENT YOUNGER THAN 5 YEARS OF AGE,307.0,214.9,,,0
HCPCS,99155,HC PRO MOD SEDATION OTHER PHYS/QHP INITIAL 15 MIN INTRASERVICE TIME PATIENT YOUNGER THAN 5 YEARS OF AGE,76.0,53.2,,,0
HCPCS,99155,Mod sed oth phys/qhp <5 yrs,,,284.89,355.41,4
HCPCS,99156,HC MOD SEDATION OTHER PHYS/QHP INITIAL 15 MIN INTRASERVICE TIME PATIENT AGE 5 YEARS OR OLDER,307.0,214.9,,,0
HCPCS,99156,HC PRO MOD SEDATION OTHER PHYS/QHP INITIAL 15 MIN INTRASERVICE TIME PATIENT AGE 5 YEARS OR OLDER,112.0,78.4,,,0
HCPCS,99156,Mod sed oth phys/qhp 5/>yrs,,,234.08,292.02,4
HCPCS,99157,HC MOD SEDATION OTHER PHYS/QHP EACH ADDTL 15 MIN INTRASERVICE TIME (LIST SEP IN ADDT TO CODE FOR PRIMARY SERVICE),154.0,107.8,,,0
HCPCS,99157,HC PRO MOD SEDATION OTHER PHYS/QHP EACH ADDTL 15 MIN INTRASERVICE TIME (LIST SEP IN ADDT TO CODE FOR PRIMARY SERVICE),71.0,49.7,,,0
HCPCS,99157,Mod sed other phys/qhp ea,,,177.34,221.24,4
HCPCS,99170,Anogenital exam child w imag,,,26.21,887.97,11
HCPCS,99183,Hyperbaric oxygen therapy,,,337.12,420.56,4
HCPCS,99184,HC INITIATION SELECTIVE HEAD/TOTAL BODY HYPOTHERMIA NEONATE,771.0,539.7,,,0
HCPCS,99184,Hypothermia ill neonate,,,709.08,884.6,4
HCPCS,99195,PHLEBOTOMY,361.0,252.7,,,0
HCPCS,99195,Phlebotomy,,,131.71,584.37,11
HCPCS,99202,HC PRO OFFICE/OUTPT E&M  NP 15 MIN,67.0,46.9,,,0
HCPCS,99203,HC PRO OFFICE/OUTPT E&M NP 30 MIN,86.0,60.2,,,0
HCPCS,99204,HC PRO OFFICE/OUTPT E&M NP 45 MIN,170.0,119.0,,,0
HCPCS,99205,HC PRO OFFICE/OUTPT E&M NP 60 MIN,220.0,154.0,,,0
HCPCS,99211,HC PRO OFFICE/OUTPT E&M EST 5 MIN,34.0,23.8,,,0
HCPCS,99212,HC PRO OFFICE/OUTPT E&M EST 10 MIN,129.0,90.3,,,0
HCPCS,99213,HC PRO OFFICE/OUTPT E&M EST 20 MIN,159.0,111.3,,,0
HCPCS,99214,HC PRO OFFICE/OUTPT E&M EST 30 MIN,219.0,153.3,,,0
HCPCS,99215,HC PRO OFFICE/OUTPT E&M EST 40 MIN,304.0,212.8,,,0
HCPCS,99221,Initial hospital care,,,266.37,332.3,4
HCPCS,99222,Initial hospital care,,,363.72,453.75,4
HCPCS,99223,Initial hospital care,,,534.67,667.02,4
HCPCS,99231,Subsequent hospital care,,,109.99,137.21,4
HCPCS,99232,HC PRO SUBSEQUENT HOSPITAL INPT OR OBS CARE PER DAY 35 MIN,147.0,102.9,,,0
HCPCS,99232,Subsequent hospital care,,,197.56,246.46,4
HCPCS,99233,HC PRO SUBSEQUENT HOSPITAL INPT OR OBS CARE PER DAY 50 MIN,210.0,147.0,,,0
HCPCS,99233,Subsequent hospital care,,,283.12,353.2,4
HCPCS,99234,Observ/hosp same date,,,377.02,470.35,4
HCPCS,99235,Observ/hosp same date,,,494.92,617.43,4
HCPCS,99236,Observ/hosp same date,,,614.73,766.89,4
HCPCS,99238,Hospital discharge day,,,195.47,243.85,4
HCPCS,99239,Hospital discharge day,,,284.09,354.41,4
HCPCS,99242,Office consultation,,,207.04,258.29,4
HCPCS,99243,Office consultation,,,288.12,359.44,4
HCPCS,99244,Office consultation,,,455.2,567.87,4
HCPCS,99245,Office consultation,,,568.46,709.17,4
HCPCS,99253,HC PRO IP/OBS CONSULT NEW/ESTABLISHED LOW LEVEL 45 MIN,316.0,221.2,,,0
HCPCS,99281,Emergency dept visit,,,83.48,370.36,7
HCPCS,99281,HC EMERGENCY DEPT VISIT LEVEL 1,183.0,128.1,,,0
HCPCS,99281,HC PRO EMERGENCY DEPT VISIT LEVEL 1,178.0,124.6,,,0
HCPCS,99282,Emergency dept visit,,,152.0,674.39,7
HCPCS,99282,HC EMERGENCY DEPT VISIT LEVEL 2,247.0,172.9,,,0
HCPCS,99282,HC PRO EMERGENCY DEPT VISIT LEVEL 2,232.0,162.4,,,0
HCPCS,99283,Emergency dept visit,,,270.24,1198.96,7
HCPCS,99283,HC EMERGENCY DEPT VISIT LEVEL 3,535.0,374.5,,,0
HCPCS,99283,HC PRO EMERGENCY DEPT VISIT LEVEL 3,363.0,254.1,,,0
HCPCS,99284,Emergency dept visit,,,413.08,1832.68,7
HCPCS,99284,HC EMERGENCY DEPT VISIT LEVEL 4,1025.0,717.5,,,0
HCPCS,99284,HC PRO EMERGENCY DEPT VISIT LEVEL 4,610.0,427.0,,,0
HCPCS,99285,Emergency dept visit,,,589.56,2615.66,7
HCPCS,99285,HC EMERGENCY DEPT VISIT LEVEL 5,1798.0,1258.6,,,0
HCPCS,99285,HC PRO EMERGENCY DEPT VISIT LEVEL 5,1036.0,725.2,,,0
HCPCS,99291,Critical care first hour,,,817.74,3628.04,7
HCPCS,99291,HC CRITICAL CARE 1ST 31-74 MIN,2320.0,1624.0,,,0
HCPCS,99291,HC PRO CRITICAL CARE 1ST 30-74 MIN,1479.0,1035.3,,,0
HCPCS,99292,HC CRITICAL CARE EA ADDL 30 MIN,1162.0,813.4,,,0
HCPCS,99292,HC PRO CRITICAL CARE EA ADDL 30 MIN,556.0,389.2,,,0
HCPCS,99304,Nursing facility care init,,,236.4,294.92,4
HCPCS,99305,Nursing facility care init,,,330.72,412.59,4
HCPCS,99306,Nursing facility care init,,,425.2,530.45,4
HCPCS,99307,Nursing fac care subseq,,,116.81,145.72,4
HCPCS,99308,Nursing fac care subseq,,,178.25,222.38,4
HCPCS,99309,Nursing fac care subseq,,,236.89,295.52,4
HCPCS,99310,Nursing fac care subseq,,,350.03,436.67,4
HCPCS,99315,Nursing fac discharge day,,,171.29,213.68,4
HCPCS,99316,Nursing fac discharge day,,,223.64,279.0,4
HCPCS,99341,Home visit new patient,,,159.17,198.56,4
HCPCS,99342,Home visit new patient,,,231.89,289.28,4
HCPCS,99344,Home visit new patient,,,489.98,611.26,4
HCPCS,99345,Home visit new patient,,,589.64,735.59,4
HCPCS,99347,Home visit est patient,,,154.92,193.27,4
HCPCS,99348,Home visit est patient,,,234.07,292.01,4
HCPCS,99349,Home visit est patient,,,341.27,425.74,4
HCPCS,99350,Home visit est patient,,,476.13,593.99,4
HCPCS,99360,Physician standby services,,,176.04,219.62,4
HCPCS,99366,TEAM CONF 1-1 NONPHYS >30 MIN,75.0,52.5,,,0
HCPCS,99368,HC TEAM CONF NONPHYS >30 MIN,54.0,37.8,,,0
HCPCS,99374,Home health care supervision,,,163.17,203.55,4
HCPCS,99377,Hospice care supervision,,,163.17,203.55,4
HCPCS,99379,Nursing fac care supervision,,,161.95,202.04,4
HCPCS,99380,Nursing fac care supervision,,,254.61,317.63,4
HCPCS,99406,HC BEHAV CHNG SMOKING 3-10 MIN,45.0,31.5,,,0
HCPCS,99406,HC PRO SMOKING CESSATION < 10 MIN,28.0,19.6,,,0
HCPCS,99407,BEHAV CHNG SMOKING > 10 MIN,94.0,65.8,,,0
HCPCS,99415,Prolong clincl staff svc,,,25.18,31.41,4
HCPCS,99416,Prolong clincl staff svc add,,,14.21,17.73,4
HCPCS,99421,Ol dig e/m svc 5-10 min,,,39.63,49.44,4
HCPCS,99422,Ol dig e/m svc 11-20 min,,,81.57,101.76,4
HCPCS,99423,Ol dig e/m svc 21+ min,,,129.93,162.09,4
HCPCS,99426,Prin care mgmt staff 1st 30,,,100.57,446.2,11
HCPCS,99451,Ntrprof ph1/ntrnet/ehr 5/>,,,111.17,138.69,4
HCPCS,99452,Ntrprof ph1/ntrnet/ehr rfrl,,,111.17,138.69,4
HCPCS,99453,HC PRO REMOTE MONITOR OF PHYSIOLOGIC PARAMETER INITIAL SET-UP/PATIENT EDUCATION ON USE OF EQUIPMENT,33.0,23.1,,,0
HCPCS,99453,Rem mntr physiol param setup,,,131.8,584.75,11
HCPCS,99454,HC PRO REMOTE MONITOR OF PHYSIOLOGIC PARAMETER INITIAL DEVICE SUPPLY W/DIALY REC/PROGRAM ALERT,106.0,74.2,,,0
HCPCS,99454,Rem mntr physiol param dev,,,36.95,163.92,11
HCPCS,99457,HC PRO REMOTE PHYSIOLOGIC MONITOR TREATMENT MGMT SERV 20 MIN/MORE OF CLIN STAFF/PHYSICIAN/QUAL PROFN,55.0,38.5,,,0
HCPCS,99457,Rem physiol mntr 20 min mo,,,97.44,121.56,4
HCPCS,99458,Rem physiol mntr ea addl 20,,,97.44,121.56,4
HCPCS,99459,HC PRO PELVIC EXAMINATION,48.0,33.6,,,0
HCPCS,99460,Init nb em per day hosp,,,131.8,584.75,7
HCPCS,99461,Init nb em per day non-fac,,,186.92,233.19,4
HCPCS,99462,Sbsq nb em per day hosp,,,88.63,110.57,4
HCPCS,99463,Same day nb discharge,,,131.8,584.75,7
HCPCS,99464,Attendance at delivery,,,210.01,261.99,4
HCPCS,99465,HC NEWBORN RESUSCITATION,628.0,439.6,,,0
HCPCS,99465,Nb resuscitation,,,654.31,2902.97,7
HCPCS,99466,Ped crit care transport,,,688.36,858.74,4
HCPCS,99467,Ped crit care transport addl,,,343.75,428.84,4
HCPCS,99468,Neonate crit care initial,,,2595.89,3238.44,4
HCPCS,99469,Neonate crit care subsq,,,1126.43,1405.25,4
HCPCS,99471,Ped critical care initial,,,2315.22,2888.3,4
HCPCS,99472,Ped critical care subsq,,,1142.01,1424.68,4
HCPCS,99473,Self-meas bp pt educaj/train,,,28.63,127.04,11
HCPCS,99474,Self-meas bp 2 readg bid 30d,,,26.75,33.38,4
HCPCS,99475,Ped crit care age 2-5 init,,,1599.29,1995.16,4
HCPCS,99476,Ped crit care age 2-5 subsq,,,948.51,1183.29,4
HCPCS,99478,Ic lbw inf < 1500 gm subsq,,,409.38,510.72,4
HCPCS,99479,Ic lbw inf 1500-2500 g subsq,,,361.42,450.88,4
HCPCS,99480,Ic inf pbw 2501-5000 g subsq,,,347.36,433.34,4
HCPCS,99483,Assmt & care pln pt cog imp,,,100.57,446.2,11
HCPCS,99484,Care mgmt svc bhvl hlth cond,,,37.09,164.57,11
HCPCS,99485,Suprv interfacilty transport,,,220.46,275.03,4
HCPCS,99486,Suprv interfac trnsport addl,,,192.28,239.88,4
HCPCS,99487,Cmplx chron care w/o pt vsit,,,175.71,779.59,11
HCPCS,99489,Cmplx chron care addl 30 min,,,118.84,148.25,4
HCPCS,99490,Chron care mgmt srvc 20 min,,,100.57,446.2,11
HCPCS,99491,Chrnc care mgmt svc 30 min,,,247.28,308.49,4
HCPCS,99492,1st psyc collab care mgmt,,,100.57,446.2,11
HCPCS,99493,Sbsq psyc collab care mgmt,,,100.57,446.2,11
HCPCS,99494,1st/sbsq psyc collab care,,,128.14,159.86,4
HCPCS,99495,Trans care mgmt 14 day disch,,,131.8,584.75,11
HCPCS,99496,Trans care mgmt 7 day disch,,,131.8,584.75,11
HCPCS,99497,Advncd care plan 30 min,,,100.57,446.2,11
HCPCS,99497,HC PRO TELEHEALTH ADVANCE CARE PLANNING INCL E & D OF ADVANCE DIRECTIVES FIRST 30 MINUTES FACE-TO-FACE W/PATIENT/FAMILY MEMBER/SURROGATE,134.0,93.8,,,0
HCPCS,99498,HC PRO TELEHEALTH ADVANCE CARE PLANNING INCL E &D OF ADVANCE DIRECTIVES EACH ADDTL 30 MIN,109.0,76.3,,,0
HCPCS,99499,HC E&M SERVICE UNLISTED,161.0,112.7,,,0
HCPCS,99900001,HC APHERESIS SET-UP CBT-STUDY,899.0,629.3,,,0
HCPCS,99900002,HC LEUKOPHERESIS CBT STUDY,1723.0,1206.1,,,0
HCPCS,A0382,Basic support routine suppls,,,19.45,24.27,4
HCPCS,A0384,Bls defibrillation supplies,,,95.32,118.92,4
HCPCS,A0392,Als defibrillation supplies,,,95.32,118.92,4
HCPCS,A0394,Als IV drug therapy supplies,,,45.72,57.04,4
HCPCS,A0396,Als esophageal intub suppls,,,75.87,94.65,4
HCPCS,A0398,Als routine disposble suppls,,,19.45,24.27,4
HCPCS,A0422,Ambulance 02 life sustaining,,,70.02,87.36,4
HCPCS,A0425,Ground mileage,,,9.42,16.48,10
HCPCS,A0426,Als 1,,,331.28,579.74,10
HCPCS,A0427,ALS1-emergency,,,524.53,917.93,10
HCPCS,A0428,bls,,,276.07,483.12,10
HCPCS,A0429,BLS-emergency,,,441.71,772.99,10
HCPCS,A0430,Fixed wing air transport,,,5552.04,10163.13,10
HCPCS,A0431,Rotary wing air transport,,,6455.09,11816.13,10
HCPCS,A0432,PI volunteer ambulance co,,,483.12,1338.08,10
HCPCS,A0433,als 2,,,759.19,1328.58,10
HCPCS,A0434,Specialty care transport,,,897.22,2485.05,10
HCPCS,A0435,Fixed wing air mileage,,,16.44,30.5,10
HCPCS,A0436,Rotary wing air mileage,,,43.85,81.38,10
HCPCS,A2004,Miscellaneous M <46.50 and A >=77.50,,,22.31,24.65,2
HCPCS,A2009,"Symphony, per sq cm",,,123.2,546.58,9
HCPCS,A2014,Omeza collag per 100 mg,,,101.89,112.58,2
HCPCS,A2015,"Phoenix wnd mtrx, per sq cm",,,123.2,2275.2,9
HCPCS,A2019,Kerecis marigen shld sq cm,,,123.2,1073.14,9
HCPCS,A4216,"Sterile water/saline, 10 ml",,,1.42,1.78,4
HCPCS,A4217,"Sterile water/saline, 500 ml",,,9.97,12.44,4
HCPCS,A4221,Supp non-insulin inf cath/wk,,,72.02,89.85,4
HCPCS,A4222,Infusion supplies with pump,,,148.68,185.48,4
HCPCS,A4224,Supply insulin inf cath/wk,,,58.78,73.33,4
HCPCS,A4225,Sup/ext insulin inf pump syr,,,7.88,9.83,4
HCPCS,A4233,Alkalin batt for glucose mon,,,2.55,3.18,4
HCPCS,A4234,J-cell batt for glucose mon,,,11.54,14.4,4
HCPCS,A4235,Lithium batt for glucose mon,,,7.45,9.3,4
HCPCS,A4236,Silvr oxide batt glucose mon,,,5.33,6.65,4
HCPCS,A4253,Blood glucose/reagent strips,,,105.44,131.54,4
HCPCS,A4255,Glucose monitor platforms,,,13.09,16.33,4
HCPCS,A4256,Calibrator solution/chips,,,31.36,45.4,8
HCPCS,A4257,Replace lensshield cartridge,,,40.57,50.61,4
HCPCS,A4258,Lancet device each,,,49.51,71.63,8
HCPCS,A4259,Lancets per box,,,33.06,47.85,8
HCPCS,A4265,Paraffin,,,10.79,13.46,4
HCPCS,A4280,Brst prsths adhsv attchmnt,,,16.97,21.17,4
HCPCS,A4300,HC SWAN GANZ CATHETER,284.0,198.8,,,0
HCPCS,A4310,Insert tray w/o bag/cath,,,24.57,30.66,4
HCPCS,A4311,Catheter w/o bag 2-way latex,,,47.21,58.89,4
HCPCS,A4312,Cath w/o bag 2-way silicone,,,57.39,71.59,4
HCPCS,A4313,Catheter w/bag 3-way,,,58.93,73.52,4
HCPCS,A4314,Cath w/drainage 2-way latex,,,74.81,93.33,4
HCPCS,A4315,Cath w/drainage 2-way silcne,,,74.81,93.33,4
HCPCS,A4316,Cath w/drainage 3-way,,,76.81,95.82,4
HCPCS,A4320,Irrigation tray,,,16.97,21.17,4
HCPCS,A4322,Irrigation syringe,,,9.57,11.94,4
HCPCS,A4326,Male external catheter,,,34.33,42.83,4
HCPCS,A4327,Fem urinary collect dev cup,,,141.93,177.06,4
HCPCS,A4328,Fem urinary collect pouch,,,33.24,41.47,4
HCPCS,A4330,Stool collection pouch,,,19.33,24.12,4
HCPCS,A4331,Extension drainage tubing,,,10.12,12.63,4
HCPCS,A4332,Lube sterile packet,,,0.39,0.49,4
HCPCS,A4333,Urinary cath anchor device,,,7.0,8.73,4
HCPCS,A4334,Urinary cath leg strap,,,15.7,19.58,4
HCPCS,A4336,Urethral insert,,,4.73,5.9,4
HCPCS,A4338,Indwelling catheter latex,,,33.15,41.35,4
HCPCS,A4340,Indwelling catheter special,,,92.14,114.95,4
HCPCS,A4344,Cath indw foley 2 way silicn,,,50.96,63.58,4
HCPCS,A4346,Cath indw foley 3 way,,,62.33,77.75,4
HCPCS,A4349,Disposable male external cat,,,6.42,8.01,4
HCPCS,A4351,Straight tip urine catheter,,,5.76,7.18,4
HCPCS,A4352,Coude tip urinary catheter,,,17.42,21.74,4
HCPCS,A4353,Intermittent urinary cath,,,22.27,27.78,4
HCPCS,A4354,Cath insertion tray w/bag,,,34.48,43.02,4
HCPCS,A4355,Bladder irrigation tubing,,,24.12,30.09,4
HCPCS,A4356,Ext ureth clmp or compr dvc,,,145.17,181.1,4
HCPCS,A4357,Bedside drainage bag,,,26.24,32.73,4
HCPCS,A4358,Urinary leg or abdomen bag,,,21.09,26.31,4
HCPCS,A4360,Disposable ext urethral dev,,,1.58,1.97,4
HCPCS,A4361,Ostomy face plate,,,49.69,61.99,4
HCPCS,A4362,Solid skin barrier,,,9.36,11.68,4
HCPCS,A4363,"Ostomy clamp, replacement",,,6.39,7.98,4
HCPCS,A4364,"Adhesive, liquid or equal",,,9.33,11.64,4
HCPCS,A4366,Ostomy vent,,,4.15,5.18,4
HCPCS,A4367,Ostomy belt,,,23.12,28.84,4
HCPCS,A4368,Ostomy filter,,,0.82,1.02,4
HCPCS,A4369,Skin barrier liquid per oz,,,7.7,9.6,4
HCPCS,A4371,Skin barrier powder per oz,,,11.6,14.48,4
HCPCS,A4372,Skin barrier solid 4x4 equiv,,,13.3,16.59,4
HCPCS,A4373,Skin barrier with flange,,,19.97,24.91,4
HCPCS,A4375,Drainable plastic pch w fcpl,,,54.66,68.19,4
HCPCS,A4376,Drainable rubber pch w fcplt,,,151.38,188.85,4
HCPCS,A4377,Drainable plstic pch w/o fp,,,13.64,17.01,4
HCPCS,A4378,Drainable rubber pch w/o fp,,,97.84,122.06,4
HCPCS,A4379,Urinary plastic pouch w fcpl,,,47.78,59.61,4
HCPCS,A4380,Urinary rubber pouch w fcplt,,,118.78,148.18,4
HCPCS,A4381,Urinary plastic pouch w/o fp,,,14.67,18.3,4
HCPCS,A4382,Urinary hvy plstc pch w/o fp,,,78.33,97.71,4
HCPCS,A4383,Urinary rubber pouch w/o fp,,,89.69,111.89,4
HCPCS,A4384,Ostomy faceplt/silicone ring,,,30.6,38.18,4
HCPCS,A4385,HC RING OSTOMY ADAPT,13.0,9.1,,,0
HCPCS,A4385,Ost skn barrier sld ext wear,,,16.24,20.26,4
HCPCS,A4388,Drainable pch w ex wear barr,,,13.88,17.31,4
HCPCS,A4389,Drainable pch w st wear barr,,,19.79,24.68,4
HCPCS,A4390,Drainable pch ex wear convex,,,30.57,38.14,4
HCPCS,A4391,Urinary pouch w ex wear barr,,,22.48,28.05,4
HCPCS,A4392,Urinary pouch w st wear barr,,,26.03,32.47,4
HCPCS,A4393,Urine pch w ex wear bar conv,,,28.75,35.87,4
HCPCS,A4394,Ostomy pouch liq deodorant,,,8.21,10.24,4
HCPCS,A4395,Ostomy pouch solid deodorant,,,0.15,0.19,4
HCPCS,A4396,Peristomal hernia supprt blt,,,128.78,160.65,4
HCPCS,A4398,Ostomy irrigation bag,,,43.94,54.81,4
HCPCS,A4399,Ostomy irrig cone/cath w brs,,,39.0,48.65,4
HCPCS,A4400,Ostomy irrigation set,,,155.47,193.95,4
HCPCS,A4402,Lubricant per ounce,,,4.42,5.52,4
HCPCS,A4404,Ostomy ring each,,,5.36,6.69,4
HCPCS,A4405,Nonpectin based ostomy paste,,,10.82,13.49,4
HCPCS,A4406,Pectin based ostomy paste,,,18.27,22.79,4
HCPCS,A4407,"Ext wear ost skn barr <=4sq""",,,27.88,34.78,4
HCPCS,A4407,HC WAFER OSTOMY CONVEX,11.0,7.7,,,0
HCPCS,A4408,"Ext wear ost skn barr >4sq""",,,31.39,39.16,4
HCPCS,A4409,HC WAFER SKIN OSTOMY FLAT,8.0,5.6,,,0
HCPCS,A4409,Ost skn barr convex <=4 sq i,,,19.79,24.68,4
HCPCS,A4410,Ost skn barr extnd >4 sq,,,28.75,35.87,4
HCPCS,A4411,Ost skn barr extnd =4sq,,,16.24,20.26,4
HCPCS,A4412,Ost pouch drain high output,,,8.61,10.74,4
HCPCS,A4413,2 pc drainable ost pouch,,,17.51,21.85,4
HCPCS,A4414,Ost sknbar w/o conv<=4 sq in,,,15.7,19.58,4
HCPCS,A4415,Ost skn barr w/o conv >4 sqi,,,19.09,23.81,4
HCPCS,A4416,Ost pch clsd w barrier/filtr,,,8.76,10.92,4
HCPCS,A4417,Ost pch w bar/bltinconv/fltr,,,11.85,14.78,4
HCPCS,A4418,Ost pch clsd w/o bar w filtr,,,5.76,7.18,4
HCPCS,A4419,Ost pch for bar w flange/flt,,,5.54,6.92,4
HCPCS,A4422,Ost pouch absorbent material,,,0.39,0.49,4
HCPCS,A4423,Ost pch for bar w lk fl/fltr,,,5.91,7.37,4
HCPCS,A4424,Ost pch drain w bar & filter,,,15.12,18.86,4
HCPCS,A4425,Ost pch drain for barrier fl,,,11.39,14.21,4
HCPCS,A4426,Ost pch drain 2 piece system,,,8.7,10.85,4
HCPCS,A4427,Ost pch drain/barr lk flng/f,,,8.85,11.04,4
HCPCS,A4428,Urine ost pouch w faucet/tap,,,20.73,25.86,4
HCPCS,A4429,Urine ost pouch w bltinconv,,,26.24,32.73,4
HCPCS,A4430,Ost urine pch w b/bltin conv,,,27.12,33.83,4
HCPCS,A4431,Ost pch urine w barrier/tapv,,,19.79,24.68,4
HCPCS,A4432,HC POUCH DRAINABLE/UROSTOMY,6.0,4.2,,,0
HCPCS,A4432,Os pch urine w bar/fange/tap,,,11.42,14.25,4
HCPCS,A4433,Urine ost pch bar w lock fln,,,10.64,13.27,4
HCPCS,A4434,Ost pch urine w lock flng/ft,,,11.97,14.93,4
HCPCS,A4435,1pc ost pch drain hgh output,,,18.97,23.66,4
HCPCS,A4450,Non-waterproof tape,,,0.27,0.45,8
HCPCS,A4452,HC SILICONE WATERPROOF TAPE PER 9 INCHES,4.0,2.8,,,0
HCPCS,A4452,HC TAPE DRESSING 2IN X 10YD PER 18SQ INCHES,8.0,5.6,,,0
HCPCS,A4452,Waterproof tape,,,1.15,1.59,8
HCPCS,A4455,Adhesive remover per ounce,,,3.88,4.84,4
HCPCS,A4456,"Adhesive remover, wipes",,,0.82,1.02,4
HCPCS,A4461,Surgicl dress hold non-reuse,,,10.45,13.04,4
HCPCS,A4463,Surgical dress holder reuse,,,42.36,52.84,4
HCPCS,A4481,Tracheostoma filter,,,1.21,1.51,4
HCPCS,A4556,"Electrodes, pair",,,38.63,48.2,4
HCPCS,A4557,"Lead wires, pair",,,66.78,83.31,4
HCPCS,A4558,Conductive gel or paste,,,14.73,18.37,4
HCPCS,A4559,Coupling gel or paste,,,0.33,0.42,4
HCPCS,A4563,Vag inser rectal control sys,,,392.39,2956.71,10
HCPCS,A4595,TENS suppl 2 lead per month,,,91.66,114.35,4
HCPCS,A4604,Tubing with heating element,,,183.19,228.54,4
HCPCS,A4605,Trach suction cath close sys,,,52.18,65.09,4
HCPCS,A4608,Transtracheal oxygen cath,,,159.47,198.94,4
HCPCS,A4611,Heavy duty battery,,,55.09,662.75,12
HCPCS,A4612,Battery cables,,,25.91,317.26,12
HCPCS,A4613,Battery charger,,,44.3,551.92,12
HCPCS,A4614,Hand-held PEFR meter,,,75.66,94.39,4
HCPCS,A4615,Cannula nasal,,,2.27,2.84,4
HCPCS,A4616,Tubing (oxygen) per foot,,,0.21,0.26,4
HCPCS,A4617,Mouth piece,,,9.85,12.29,4
HCPCS,A4618,Breathing circuits,,,2.79,35.04,12
HCPCS,A4619,Face tent,,,3.85,4.8,4
HCPCS,A4620,Variable concentration mask,,,1.97,2.46,4
HCPCS,A4623,Tracheostomy inner cannula,,,17.73,22.11,4
HCPCS,A4624,Tracheal suction tube,,,7.12,8.88,4
HCPCS,A4625,Trach care kit for new trach,,,22.06,27.52,4
HCPCS,A4626,Tracheostomy cleaning brush,,,10.15,12.66,4
HCPCS,A4628,Oropharyngeal suction cath,,,11.91,14.86,4
HCPCS,A4629,Tracheostomy care kit,,,14.73,18.37,4
HCPCS,A4630,Repl bat t.e.n.s. own by pt,,,16.91,21.09,4
HCPCS,A4633,Uvl replacement bulb,,,130.56,162.88,4
HCPCS,A4635,Underarm crutch pad,,,2.06,17.27,12
HCPCS,A4636,Handgrip for cane etc,,,1.0,12.25,12
HCPCS,A4637,Repl tip cane/crutch/walker,,,0.7,6.2,12
HCPCS,A4639,Infrared ht sys replcmnt pad,,,913.76,1139.93,4
HCPCS,A4640,Alternating pressure pad,,,20.51,251.33,12
HCPCS,A4648,HC GOLD ANCHOR FIDUCIAL MARKER,600.0,420.0,,,0
HCPCS,A4648,TISSUE MARKER-IMPLANTABLE (EACH),179.0,125.3,,,0
HCPCS,A4649,HC DEBRISOFT,77.0,53.9,,,0
HCPCS,A4649,HC MEDIHONEY HCS NON-ADHESIVE DRESSING 2 X 2 (DERMASCIENCES),28.0,19.6,,,0
HCPCS,A4649,HC MEDIHONEY HCS NON-ADHESIVE DRESSING 4 X 4 (DERMASCIENCES),64.0,44.8,,,0
HCPCS,A5051,Pouch clsd w barr attached,,,6.58,8.2,4
HCPCS,A5052,Clsd ostomy pouch w/o barr,,,4.73,5.9,4
HCPCS,A5053,Clsd ostomy pouch faceplate,,,4.73,5.9,4
HCPCS,A5054,Clsd ostomy pouch w/flange,,,5.7,7.11,4
HCPCS,A5055,Stoma cap,,,4.58,5.71,4
HCPCS,A5056,1 pc ost pouch w filter,,,15.3,19.09,4
HCPCS,A5057,1 pc ost pou w built-in conv,,,31.51,39.31,4
HCPCS,A5061,Pouch drainable w barrier at,,,11.21,13.99,4
HCPCS,A5062,Drnble ostomy pouch w/o barr,,,7.06,8.81,4
HCPCS,A5063,Drain ostomy pouch w/flange,,,8.61,10.74,4
HCPCS,A5071,Urinary pouch w/barrier,,,19.12,23.85,4
HCPCS,A5072,Urinary pouch w/o barrier,,,11.21,13.99,4
HCPCS,A5073,Urinary pouch on barr w/flng,,,10.06,12.55,4
HCPCS,A5081,"Stoma plug or seal, any type",,,8.94,11.15,4
HCPCS,A5082,Continent stoma catheter,,,37.81,47.17,4
HCPCS,A5083,Stoma absorptive cover,,,2.0,2.49,4
HCPCS,A5093,Ostomy accessory convex inse,,,5.82,7.26,4
HCPCS,A5102,"Expired, orthopedic, length of stay is 14 days or more",,,71.84,89.62,4
HCPCS,A5105,Urinary suspensory,,,121.65,151.77,4
HCPCS,A5112,Urinary leg bag,,,102.93,128.41,4
HCPCS,A5113,Latex leg strap,,,12.73,15.88,4
HCPCS,A5114,Foam/fabric leg strap,,,28.45,35.49,4
HCPCS,A5120,HC WIPE BARRIER SKIN PROTEC/EMOLI BARD,4.0,2.8,,,0
HCPCS,A5120,"Skin barrier, wipe or swab",,,0.76,0.95,4
HCPCS,A5121,Solid skin barrier 6x6,,,23.72,29.6,4
HCPCS,A5122,Solid skin barrier 8x8,,,40.87,50.99,4
HCPCS,A5126,Disk/foam pad +or- adhesive,,,3.58,4.46,4
HCPCS,A5131,Appliance cleaner,,,50.45,62.94,4
HCPCS,A5200,Percutaneous catheter anchor,,,35.97,44.87,4
HCPCS,A5500,Diab shoe for density insert,,,202.28,252.35,4
HCPCS,A5501,Diabetic custom molded shoe,,,606.76,756.95,4
HCPCS,A5503,Diabetic shoe w/roller/rockr,,,89.96,112.23,4
HCPCS,A5504,Diabetic shoe with wedge,,,89.96,112.23,4
HCPCS,A5505,Diab shoe w/metatarsal bar,,,89.96,112.23,4
HCPCS,A5506,Diabetic shoe w/off set heel,,,89.96,112.23,4
HCPCS,A5507,Modification diabetic shoe,,,89.96,112.23,4
HCPCS,A5512,Multi den insert direct form,,,82.54,102.97,4
HCPCS,A5513,Multi den insert custom mold,,,123.17,153.66,4
HCPCS,A5514,Mult den insert dir carv/cam,,,136.23,169.95,4
HCPCS,A6010,Collagen based wound filler,,,67.54,84.26,4
HCPCS,A6011,Collagen gel/paste wound fil,,,8.73,10.89,4
HCPCS,A6021,Collagen dressing <=16 sq in,,,66.87,83.42,4
HCPCS,A6021,HC DRESSING WOUND PRISMA,55.0,38.5,,,0
HCPCS,A6022,Collagen drsg>16<=48 sq in,,,66.87,83.42,4
HCPCS,A6023,Collagen dressing >48 sq in,,,605.45,755.32,4
HCPCS,A6024,Collagen dsg wound filler,,,18.24,22.76,4
HCPCS,A6154,Wound pouch each,,,45.75,57.08,4
HCPCS,A6196,Alginate dressing <=16 sq in,,,33.88,42.26,4
HCPCS,A6196,HC BIATAIN ALGINATE AG 4 X 4 (COLOPLAST),63.0,44.1,,,0
HCPCS,A6196,HC DRAWTEX 4 X 4,48.0,33.6,,,0
HCPCS,A6196,HC DRESSING KALTOSTAT PAD,9.0,6.3,,,0
HCPCS,A6196,HC ENLUXTRA 6X6,95.0,66.5,,,0
HCPCS,A6196,HC PAD AQUACEL,19.0,13.3,,,0
HCPCS,A6197,Alginate drsg >16 <=48 sq in,,,52.3,65.24,4
HCPCS,A6198,HC MEXTRA SUPERABSORBENT 9 X 11 IN,26.0,18.2,,,0
HCPCS,A6199,Alginate drsg wound filler,,,16.82,20.98,4
HCPCS,A6199,HC DRESSING AQUACEL ALGINATE ROPE 6 INCH,25.0,17.5,,,0
HCPCS,A6203,Composite drsg <= 16 sq in,,,10.67,13.31,4
HCPCS,A6204,Composite drsg >16<=48 sq in,,,19.82,24.72,4
HCPCS,A6206,Contact layer <= 16 sq in,,,9.34,11.65,4
HCPCS,A6206,HC DRSG ADPTC TOUCH SILIC 3X2IN,13.0,9.1,,,0
HCPCS,A6206,HC DRSG ADPTC TOUCH SILIC 3X4.25IN,16.0,11.2,,,0
HCPCS,A6206,HC MEPITEL BOTH SIDES 2 X 3 IN,17.0,11.9,,,0
HCPCS,A6207,Contact layer >16<= 48 sq in,,,23.36,29.14,4
HCPCS,A6207,HC CUTIMED SORBACT WCL 4 X 5 (BSN),41.0,28.7,,,0
HCPCS,A6208,HC MEPITEL BOTH SIDES 8 X 12 IN,119.0,83.3,,,0
HCPCS,A6209,Foam drsg <=16 sq in w/o bdr,,,6.84,8.53,4
HCPCS,A6209,HC BIATAIN SOFT-HOLD 4 X 4 (COLOPLAST),18.0,12.6,,,0
HCPCS,A6209,HC DRESSING FOAM HYDRASORB 4X4,9.0,6.3,,,0
HCPCS,A6209,HC DRSG POLYMEM WOUND,24.0,16.8,,,0
HCPCS,A6209,HC THERAHONEY FLEX FOAM,71.0,49.7,,,0
HCPCS,A6210,Foam drg >16<=48 sq in w/o b,,,34.58,43.15,4
HCPCS,A6210,HC DRESSING FOAM HYDRASORB 4X8,79.0,55.3,,,0
HCPCS,A6210,HC DRESSING POLYMEM SILVER,64.0,44.8,,,0
HCPCS,A6210,HC HYDROFERA BLUE READY 4X5,47.0,32.9,,,0
HCPCS,A6211,Foam drg > 48 sq in w/o brdr,,,59.93,74.77,4
HCPCS,A6211,HC HYDROFERA BLUE READY 8X8,84.0,58.8,,,0
HCPCS,A6212,Foam drg <=16 sq in w/border,,,14.77,18.42,4
HCPCS,A6212,HC DRESSING FOAM SILICONE SMALL/MED,17.0,11.9,,,0
HCPCS,A6212,HC DRESSING FOAM TIELLE 4X4,16.0,11.2,,,0
HCPCS,A6212,HC DRSNG BIATAIN SIL LITE 2X2IN-4X4IN,16.0,11.2,,,0
HCPCS,A6212,HC DRSNG BIATAIN SILICONE 3X3IN-7X7IN,42.0,29.4,,,0
HCPCS,A6212,HC MEPILEX BORDER 4X4IN,21.0,14.7,,,0
HCPCS,A6213,HC DRESSING FOAM SILICONE 7 X 7,42.0,29.4,,,0
HCPCS,A6213,HC DRESSING FOAM TIELLE SACRAL 7X7,35.0,24.5,,,0
HCPCS,A6213,HC MEPILEX BORDER 4X10IN,136.0,95.2,,,0
HCPCS,A6213,HC MEPILEX BORDER 4X12IN,140.0,98.0,,,0
HCPCS,A6213,HC MEPILEX BORDER 4X8IN,35.0,24.5,,,0
HCPCS,A6213,HC MEPILEX BORDER FLEX 6 X 6 IN,28.0,19.6,,,0
HCPCS,A6213,HC MEPILEX BORDER FLEX OVAL 6 X 7.5 IN,38.0,26.6,,,0
HCPCS,A6214,Foam drg > 48 sq in w/border,,,32.72,40.82,4
HCPCS,A6215,HC DRESSING POLYWIC PLAIN,30.0,21.0,,,0
HCPCS,A6215,HC DRESSING POLYWIC SILVER,53.0,37.1,,,0
HCPCS,A6216,Non-sterile gauze<=16 sq in,,,0.15,0.19,4
HCPCS,A6219,Gauze <= 16 sq in w/border,,,3.03,3.78,4
HCPCS,A6220,Gauze >16 <=48 sq in w/bordr,,,8.21,10.24,4
HCPCS,A6222,Gauze <=16 in no w/sal w/o b,,,6.79,8.47,4
HCPCS,A6223,Gauze >16<=48 no w/sal w/o b,,,7.7,9.6,4
HCPCS,A6224,Gauze > 48 in no w/sal w/o b,,,11.48,14.33,4
HCPCS,A6229,Gauze >16<=48 sq in watr/sal,,,11.48,14.33,4
HCPCS,A6231,Hydrogel dsg<=16 sq in,,,14.88,18.56,4
HCPCS,A6232,Hydrogel dsg>16<=48 sq in,,,21.88,27.29,4
HCPCS,A6233,HC GAUZE VASELINE/XEROFORM,5.0,3.5,,,0
HCPCS,A6233,Hydrogel dressing >48 sq in,,,61.05,76.17,4
HCPCS,A6234,HC DRESSING HYDROCOLLOID  4X4 OR <CGF,46.0,32.2,,,0
HCPCS,A6234,HC DRESSING HYDROCOLLOID 4X4 OR <THIN,46.0,32.2,,,0
HCPCS,A6234,Hydrocolld drg <=16 w/o bdr,,,32.14,40.09,4
HCPCS,A6235,HC DUODERM 6X6 OR SACRAL,58.0,40.6,,,0
HCPCS,A6235,Hydrocolld drg >16<=48 w/o b,,,37.35,46.59,4
HCPCS,A6236,Hydrocolld drg > 48 in w/o b,,,86.69,108.15,4
HCPCS,A6237,Hydrocolld drg <=16 in w/bdr,,,25.18,31.41,4
HCPCS,A6238,Hydrocolld drg >16<=48 w/bdr,,,72.51,90.46,4
HCPCS,A6240,Hydrocolld drg filler paste,,,38.94,48.57,4
HCPCS,A6241,Hydrocolloid drg filler dry,,,8.18,10.21,4
HCPCS,A6242,HC CUTIMED SORBACT HYDROACTIVE B 2.8 X 3.3 (BSN),52.0,36.4,,,0
HCPCS,A6242,HC CUTIMED SORBACT RIBBON .8 X 19.7 (BSN),54.0,37.8,,,0
HCPCS,A6242,Hydrogel drg <=16 in w/o bdr,,,19.3,24.08,4
HCPCS,A6243,Hydrogel drg >16<=48 w/o bdr,,,39.18,48.88,4
HCPCS,A6244,Hydrogel drg >48 in w/o bdr,,,124.96,155.89,4
HCPCS,A6245,Hydrogel drg <= 16 in w/bdr,,,23.12,28.84,4
HCPCS,A6246,Hydrogel drg >16<=48 in w/b,,,31.57,39.39,4
HCPCS,A6247,Hydrogel drg > 48 sq in w/b,,,75.66,94.39,4
HCPCS,A6248,HC PLUROGEL,61.0,42.7,,,0
HCPCS,A6248,Hydrogel drsg gel filler,,,51.66,64.45,4
HCPCS,A6250,"HC COLOPLAST INTERDRY MOISTURE WICKING DRESSING 10"" X 36""",185.0,129.5,,,0
HCPCS,A6250,HC PROTECTOR SKIN LOLLIPOP,9.0,6.3,,,0
HCPCS,A6250,Skin seal protect moisturizr,,,6.08,7.59,4
HCPCS,A6251,Absorpt drg <=16 sq in w/o b,,,6.33,7.9,4
HCPCS,A6252,Absorpt drg >16 <=48 w/o bdr,,,10.33,12.89,4
HCPCS,A6252,HC DRESSING EXUDRY SPEC ABSORP 4X6,10.0,7.0,,,0
HCPCS,A6253,Absorpt drg > 48 sq in w/o b,,,20.18,25.17,4
HCPCS,A6253,HC DRESSING EXUDRY SPEC ABSORP 6X9,13.0,9.1,,,0
HCPCS,A6253,HC SURGIPAD ABD,3.0,2.1,,,0
HCPCS,A6254,Absorpt drg <=16 sq in w/bdr,,,3.85,4.8,4
HCPCS,A6255,Absorpt drg >16<=48 in w/bdr,,,9.64,12.02,4
HCPCS,A6257,HC FILM TRANSPARENT 2.5X3 IN,4.0,2.8,,,0
HCPCS,A6257,HC SILICONE TRANSPARENT FILM 2X3IN,4.0,2.8,,,0
HCPCS,A6257,Transparent film <= 16 sq in,,,1.74,2.17,4
HCPCS,A6258,HC FILM TRANSPARENT 4X5 IN,9.0,6.3,,,0
HCPCS,A6258,HC FILM TRANSPARENT 6X8 IN,10.0,7.0,,,0
HCPCS,A6258,HC SILICONE TRANSPARENT FILM 4X5IN,9.0,6.3,,,0
HCPCS,A6258,Transparent film >16<=48 in,,,5.35,6.67,4
HCPCS,A6259,Transparent film > 48 sq in,,,34.81,43.43,4
HCPCS,A6260,HC CLEANSER SKN SPRAY 1OZ,5.0,3.5,,,0
HCPCS,A6260,HC MESALT RIBBON 3/4 X 39 IN,10.0,7.0,,,0
HCPCS,A6261,HC IODOSORB GEL TUBE 10MG,101.0,70.7,,,0
HCPCS,A6261,HC WND FILLIODOSORB GEL OZ,41.0,28.7,,,0
HCPCS,A6261,HC WND FILLMULTIDEX GEL 1 OZ,21.0,14.7,,,0
HCPCS,A6262,HC WNDFILL MULTIDEX PWD IODOFLEX,31.0,21.7,,,0
HCPCS,A6266,Impreg gauze no h20/sal/yard,,,6.12,7.64,4
HCPCS,A6402,Sterile gauze <= 16 sq in,,,0.39,0.49,4
HCPCS,A6403,Sterile gauze>16 <= 48 sq in,,,1.36,1.7,4
HCPCS,A6407,"Packing strips, non-impreg",,,5.97,7.45,4
HCPCS,A6410,Sterile eye pad,,,1.24,1.55,4
HCPCS,A6441,"Pad band w>=3"" <5""/yd",,,2.12,2.65,4
HCPCS,A6442,"Conform band n/s w<3""/yd",,,0.55,0.68,4
HCPCS,A6443,"Conform band n/s w>=3""<5""/yd",,,0.91,1.13,4
HCPCS,A6443,HC ELASTOMULL ELASTIC GAUZE 1 IN,44.0,30.8,,,0
HCPCS,A6444,"Conform band n/s w>=5""/yd",,,1.79,2.23,4
HCPCS,A6445,"Conform band s w <3""/yd",,,1.03,1.29,4
HCPCS,A6446,"Conform band s w>=3"" <5""/yd",,,1.3,1.63,4
HCPCS,A6447,"Conform band s w >=5""/yd",,,2.12,2.65,4
HCPCS,A6448,"Lt compres band <3""/yd",,,3.7,4.61,4
HCPCS,A6449,HC CMPRLN STRCH COMPRSS 10CM X 5CM,64.0,44.8,,,0
HCPCS,A6449,"Lt compres band >=3"" <5""/yd",,,5.58,6.96,4
HCPCS,A6452,"High compres band w>=3""<5""yd",,,18.82,23.47,4
HCPCS,A6453,"Self-adher band w <3""/yd",,,1.94,2.42,4
HCPCS,A6454,"Self-adher band w>=3"" <5""/yd",,,2.45,3.06,4
HCPCS,A6455,"Self-adher band >=5""/yd",,,4.42,5.52,4
HCPCS,A6456,"Zinc paste band w >=3""<5""/yd",,,4.06,5.07,4
HCPCS,A6457,HC EDEMAWEAR LARGE,66.0,46.2,,,0
HCPCS,A6457,HC EDEMAWEAR MEDIUM,36.0,25.2,,,0
HCPCS,A6457,HC EDEMAWEAR SMALL,24.0,16.8,,,0
HCPCS,A6457,HC TUBIGRIP SURG SUPPLY PER YARD,174.0,121.8,,,0
HCPCS,A6457,Tubular dressing,,,3.64,4.54,4
HCPCS,A6531,Compression stocking bk30-40,,,61.66,171.73,10
HCPCS,A6532,Compression stocking bk40-50,,,86.88,241.96,10
HCPCS,A6545,Grad comp non-elastic BK,,,121.41,348.63,10
HCPCS,A6550,Neg pres wound ther drsg set,,,75.2,93.82,4
HCPCS,A7000,Disposable canister for pump,,,26.15,32.62,4
HCPCS,A7001,Nondisposable pump canister,,,93.45,116.58,4
HCPCS,A7002,Tubing used w suction pump,,,10.36,12.93,4
HCPCS,A7003,Nebulizer administration set,,,8.7,10.85,4
HCPCS,A7004,Disposable nebulizer sml vol,,,4.88,6.09,4
HCPCS,A7005,Nondisposable nebulizer set,,,83.36,103.99,4
HCPCS,A7006,Filtered nebulizer admin set,,,30.36,37.88,4
HCPCS,A7007,Lg vol nebulizer disposable,,,13.88,17.31,4
HCPCS,A7008,Disposable nebulizer prefill,,,29.75,37.12,4
HCPCS,A7009,Nebulizer reservoir bottle,,,131.08,163.52,4
HCPCS,A7010,Disposable corrugated tubing,,,63.78,79.57,4
HCPCS,A7012,Nebulizer water collec devic,,,12.03,15.01,4
HCPCS,A7013,Disposable compressor filter,,,2.24,2.8,4
HCPCS,A7014,Compressor nondispos filter,,,14.27,17.8,4
HCPCS,A7015,Aerosol mask used w nebulize,,,5.97,7.45,4
HCPCS,A7016,Nebulizer dome & mouthpiece,,,21.85,27.25,4
HCPCS,A7017,Nebulizer not used w oxygen,,,42.63,532.0,12
HCPCS,A7018,Water distilled w/nebulizer,,,1.03,1.29,4
HCPCS,A7025,Replace chest compress vest,,,1383.77,1726.29,4
HCPCS,A7026,Replace chst cmprss sys hose,,,91.48,114.12,4
HCPCS,A7027,Combination oral/nasal mask,,,593.43,740.31,4
HCPCS,A7028,Repl oral cushion combo mask,,,157.62,196.64,4
HCPCS,A7029,Repl nasal pillow comb mask,,,64.39,80.33,4
HCPCS,A7030,CPAP full face mask,,,517.28,645.32,4
HCPCS,A7031,Replacement facemask interfa,,,191.31,238.67,4
HCPCS,A7032,Replacement nasal cushion,,,111.14,138.65,4
HCPCS,A7033,Replacement nasal pillows,,,77.9,97.18,4
HCPCS,A7034,Nasal application device,,,322.57,402.42,4
HCPCS,A7035,Pos airway press headgear,,,100.35,125.19,4
HCPCS,A7036,Pos airway press chinstrap,,,42.9,53.52,4
HCPCS,A7037,Pos airway pressure tubing,,,110.9,138.35,4
HCPCS,A7038,Pos airway pressure filter,,,14.79,18.45,4
HCPCS,A7039,"Filter, non disposable w pap",,,35.72,44.57,4
HCPCS,A7040,One way chest drain valve,,,129.41,161.44,4
HCPCS,A7041,Water seal drain container,,,243.16,303.35,4
HCPCS,A7044,PAP oral interface,,,331.54,413.61,4
HCPCS,A7045,Repl exhalation port for PAP,,,5.33,66.6,12
HCPCS,A7046,"Repl water chamber, PAP dev",,,53.51,66.75,4
HCPCS,A7048,Vacuum drain bottle/tube kit,,,143.05,178.45,4
HCPCS,A7501,Tracheostoma valve w diaphra,,,334.15,416.86,4
HCPCS,A7502,Replacement diaphragm/fplate,,,158.8,198.11,4
HCPCS,A7503,HMES filter holder or cap,,,36.06,44.98,4
HCPCS,A7504,Tracheostoma HMES filter,,,2.12,2.65,4
HCPCS,A7505,HMES or trach valve housing,,,14.88,18.56,4
HCPCS,A7506,HMES/trachvalve adhesivedisk,,,1.06,1.32,4
HCPCS,A7507,Integrated filter & holder,,,7.91,9.87,4
HCPCS,A7508,Housing & Integrated Adhesiv,,,9.12,11.38,4
HCPCS,A7509,Heat & moisture exchange sys,,,4.48,5.59,4
HCPCS,A7520,Trach/laryn tube non-cuffed,,,151.05,188.43,4
HCPCS,A7521,Trach/laryn tube cuffed,,,149.68,186.73,4
HCPCS,A7522,Trach/laryn tube stainless,,,143.68,179.25,4
HCPCS,A7524,Tracheostoma stent/stud/bttn,,,246.25,307.2,4
HCPCS,A7525,Tracheostomy mask,,,6.58,8.2,4
HCPCS,A7526,Tracheostomy tube collar,,,10.73,13.38,4
HCPCS,A7527,Trach/laryn tube plug/stop,,,11.39,14.21,4
HCPCS,A8000,Soft protect helmet prefab,,,48.78,608.66,12
HCPCS,A8001,Hard protect helmet prefab,,,48.78,608.66,12
HCPCS,A9270,HC ACTICOAT 7,92.0,64.4,,,0
HCPCS,A9272,HC SMITH & NEPHEW PICO NWPT SUPPLY (ALL SIZES),871.0,609.7,,,0
HCPCS,A9500,TECHNETIUM TC 99M SESTAMIBI - CARDIOLITE,214.0,149.8,,,0
HCPCS,A9500,Tc99m sestamibi,,,644.33,711.92,2
HCPCS,A9502,Tc99m tetrofosmin,,,139.01,153.59,2
HCPCS,A9503,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,210.0,147.0,,,0
HCPCS,A9503,Tc99m medronate,,,54.88,60.64,2
HCPCS,A9505,Tl201 thallium,,,191.25,211.31,2
HCPCS,A9509,IODINE I-123 CAPSULE FOR WHOLE BODY SCAN,1681.0,1176.7,,,0
HCPCS,A9509,IODINE I-123 SODIUM IODINE CAPSULE,423.0,296.1,,,0
HCPCS,A9512,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,76.0,53.2,,,0
HCPCS,A9512,Tc99m pertechnetate,,,2.55,2.81,2
HCPCS,A9513,Lutetium lu 177 dotatat ther,,,319.94,1419.48,11
HCPCS,A9515,Choline c-11,,,2516.43,21546.0,13
HCPCS,A9516,Iodine I-123 sod iodide mic,,,185.93,205.43,2
HCPCS,A9517,"I131 iodide cap, rx",,,9.34,106.79,13
HCPCS,A9517,IODINE (I-131) CAPSULE FOR THYROID THERAPY,5353.5,3747.45,,,0
HCPCS,A9520,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,1770.0,1239.0,,,0
HCPCS,A9520,Tc99 tilmanocept diag 0.5mci,,,727.2,5225.06,6
HCPCS,A9521,Tc99m exametazime,,,2794.11,3087.19,2
HCPCS,A9527,Iodine I-125 sodium iodide,,,38.11,1758.34,13
HCPCS,A9528,IODINE (I-131) CAPSULE FOR THYROID THERAPY,962.5,673.75,,,0
HCPCS,A9528,"Iodine i-131 iodide cap, dx",,,316.03,349.18,2
HCPCS,A9530,"I131 iodide sol, rx",,,16.99,92.15,13
HCPCS,A9531,I131 max 100uci,,,5.18,5.72,2
HCPCS,A9531,IODINE (I-131) CAPSULE FOR UPTAKE DIAGNOSTIC,191.0,133.7,,,0
HCPCS,A9537,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,237.0,165.9,,,0
HCPCS,A9537,Tc99m mebrofenin,,,162.25,179.27,2
HCPCS,A9538,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,255.0,178.5,,,0
HCPCS,A9538,Tc99m pyrophosphate,,,104.42,115.37,2
HCPCS,A9539,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,131.0,91.7,,,0
HCPCS,A9539,Tc99m pentetate,,,51.08,56.44,2
HCPCS,A9540,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,642.0,449.4,,,0
HCPCS,A9540,Tc99m maa,,,48.91,54.04,2
HCPCS,A9541,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,110.0,77.0,,,0
HCPCS,A9541,Tc99m sulfur colloid,,,47.32,52.28,2
HCPCS,A9543,"Y90 ibritumomab, rx",,,30574.72,252111.29,13
HCPCS,A9548,INDIUM IN-111 PENTETATE,13053.0,9137.1,,,0
HCPCS,A9551,Tc99m succimer,,,181.08,2927.89,9
HCPCS,A9552,F18 fdg,,,339.63,375.25,2
HCPCS,A9552,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,1170.0,819.0,,,0
HCPCS,A9555,Rb82 rubidium,,,7446.73,8227.85,2
HCPCS,A9556,GALLIUM-67 CITRATE 74 MBQ/ML (2 MCI/ML) IV SOLN,338.0,236.6,,,0
HCPCS,A9556,Ga67 gallium,,,220.11,243.19,2
HCPCS,A9557,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,4113.0,2879.1,,,0
HCPCS,A9557,Tc99m bicisate,,,775.52,6411.45,9
HCPCS,A9560,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,664.5,465.15000000000003,,,0
HCPCS,A9560,Tc99m labeled rbc,,,152.27,168.24,2
HCPCS,A9561,KIT PREP TC-99M-SOD OXIDRONATE 3.15 MG IV SOLR,274.5,192.15,,,0
HCPCS,A9562,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,1046.0,732.2,,,0
HCPCS,A9562,Tc99m mertiatide,,,1263.03,1395.52,2
HCPCS,A9563,P32 na phosphate,,,171.62,1234.46,13
HCPCS,A9564,P32 chromic phosphate,,,215.55,268.91,4
HCPCS,A9567,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,522.0,365.4,,,0
HCPCS,A9569,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,5381.0,3766.7,,,0
HCPCS,A9569,Technetium TC-99m auto WBC,,,934.13,4144.42,9
HCPCS,A9570,INDIUM IN-111 LABELED AUTOLOGOUS WHITE BLOOD CELLS,6136.0,4295.2,,,0
HCPCS,A9570,Indium In-111 auto WBC,,,1103.19,7582.97,9
HCPCS,A9572,Indium In-111 pentetreotide,,,2000.94,10223.61,9
HCPCS,A9573,"Inj, gadopiclenol, 1 ml",,,18.95,20.94,2
HCPCS,A9575,Inj gadoterate meglumi 0.1ml,,,0.76,0.95,4
HCPCS,A9576,GADOTERIDOL 279.3 MG/ML IV SOLN,85.5,59.849999999999994,,,0
HCPCS,A9577,GADOBENATE DIMEGLUMINE 529 MG/ML (0.1 MMOL/0.2 ML) IV SOLN,297.5,208.25,,,0
HCPCS,A9579,GADOPICLENOL 0.5 MMOL/ML IV SOLN,397.0,277.9,,,0
HCPCS,A9580,Sodium fluoride F-18,,,280.28,309.68,2
HCPCS,A9581,GADOXETATE 2.5 MMOL/10 ML IV SOLN,392.5,274.75,,,0
HCPCS,A9581,Gadoxetate disodium inj,,,40.3,50.27,4
HCPCS,A9582,"IOBENGUANE, I-123",8818.0,6172.6,,,0
HCPCS,A9583,Gadofosveset trisodium inj,,,35.51,44.3,4
HCPCS,A9584,IOFLUPANE I 123 5 MCI/2.5 ML (185 MBQ/2.5ML) IV SOLN,2080.0,1456.0,,,0
HCPCS,A9584,Iodine i-123 ioflupane,,,1387.74,6553.61,13
HCPCS,A9585,Gadobutrol injection,,,1.24,11.01,6
HCPCS,A9586,Florbetapir F18,,,1825.64,10417.68,13
HCPCS,A9587,Gallium ga-68,,,49.63,252.28,13
HCPCS,A9587,KIT FOR PREP OF GA 68-DOTATATE 40 MCG IV SOLR,13212.5,9248.75,,,0
HCPCS,A9588,FLUCICLOVINE F18 10 MCI (370 MBQ) IV SOLN,12529.0,8770.3,,,0
HCPCS,A9588,Fluciclovine f-18,,,322.27,1472.5,13
HCPCS,A9589,Insti hexaminolevulinate hcl,,,3469.83,4328.7,4
HCPCS,A9590,Iodine i-131 iobenguane 1mci,,,942.51,1175.81,4
HCPCS,A9591,Fluoroestradiol f 18,,,2.35,2042.73,13
HCPCS,A9592,Copper cu 64 dotatate diag,,,594.28,3472.02,11
HCPCS,A9593,Gallium ga-68 psma-11 ucsf,,,550.13,2770.21,11
HCPCS,A9594,"Gallium ga-68 psma-11, ucla",,,363.5,2712.32,11
HCPCS,A9595,"Piflu f-18, dia 1 millicurie",,,346.49,2047.92,13
HCPCS,A9596,Gallium illuccix 1 millicure,,,478.52,3766.39,11
HCPCS,A9596,KIT PREP OF GA-68-GOZETOTIDE 25 MCG IV SOLR,10591.0,7413.7,,,0
HCPCS,A9600,Sr89 strontium,,,2011.99,18395.89,13
HCPCS,A9602,Fluorodopa f-18 diag per mci,,,855.55,3795.79,11
HCPCS,A9604,Sm 153 lexidronam,,,3159.8,29934.8,13
HCPCS,A9606,Radium ra223 dichloride ther,,,171.09,456.06,13
HCPCS,A9607,Lutetium lu 177 vipivotide,,,259.6,165469.5,13
HCPCS,A9608,Flotufolastat f18 diag 1 mci,,,671.22,2977.97,13
HCPCS,A9800,Gallium locametz 1 millicuri,,,362.5,22438.08,11
HCPCS,B4034,Enter feed supkit syr by day,,,17.97,22.42,4
HCPCS,B4035,Enteral feed supp pump per d,,,34.24,42.71,4
HCPCS,B4036,Enteral feed sup kit grav by,,,23.51,29.33,4
HCPCS,B4081,Enteral ng tubing w/ stylet,,,63.51,79.23,4
HCPCS,B4082,Enteral ng tubing w/o stylet,,,47.24,58.93,4
HCPCS,B4083,Enteral stomach tube levine,,,7.24,9.03,4
HCPCS,B4087,"Gastro/jejuno tube, std",,,104.81,130.75,4
HCPCS,B4088,"Gastro/jejuno tube, low-pro",,,104.81,130.75,4
HCPCS,B4105,Enzyme cartridge enteral nut,,,220.71,243.86,2
HCPCS,B4149,EF blenderized foods,,,4.61,5.75,4
HCPCS,B4150,Ef complet w/intact nutrient,,,1.97,2.46,4
HCPCS,B4152,Ef calorie dense>/=1.5kcal,,,1.64,2.04,4
HCPCS,B4153,Ef hydrolyzed/amino acids,,,5.61,6.99,4
HCPCS,B4154,Ef spec metabolic noninherit,,,3.58,4.46,4
HCPCS,B4155,Ef incomplete/modular,,,2.79,3.48,4
HCPCS,B4164,Parenteral 50% dextrose solu,,,56.15,70.04,4
HCPCS,B4168,Parenteral sol amino acid 3.,,,81.84,102.1,4
HCPCS,B4176,Parenteral sol amino acid 7-,,,158.35,197.54,4
HCPCS,B4178,Parenteral sol amino acid >,,,190.1,237.16,4
HCPCS,B4180,Parenteral sol carb > 50%,,,80.57,100.51,4
HCPCS,B4185,Parenteral sol 10 gm lipids,,,37.12,46.31,4
HCPCS,B4189,Parenteral sol amino acid &,,,587.21,732.56,4
HCPCS,B4193,Parenteral sol 52-73 gm prot,,,758.83,946.66,4
HCPCS,B4197,Parenteral sol 74-100 gm pro,,,923.82,1152.48,4
HCPCS,B4199,Parenteral sol > 100gm prote,,,1055.65,1316.95,4
HCPCS,B4216,Parenteral nutrition additiv,,,25.51,31.83,4
HCPCS,B4220,Parenteral supply kit premix,,,26.45,33.0,4
HCPCS,B4222,Parenteral supply kit homemi,,,32.6,40.67,4
HCPCS,B4224,Parenteral administration ki,,,82.63,103.08,4
HCPCS,B5000,Parenteral sol renal-amirosy,,,39.27,48.99,4
HCPCS,B5100,Parenteral solution hepatic,,,15.36,19.16,4
HCPCS,B9002,Enter nutr inf pump any type,,,348.84,4493.44,12
HCPCS,B9004,Parenteral infus pump portab,,,1319.63,10399.2,12
HCPCS,B9006,Parenteral infus pump statio,,,1319.63,10399.2,12
HCPCS,C1603,HC CAVACLEAR LASER SHEATH 16 FR,9401.0,6580.7,,,0
HCPCS,C1604,HC DETOUR SYSTEM CAP ANY NUMBER OF TORUS STENT GRAFTS/ENDOCROSS DEVICE,57751.0,40425.7,,,0
HCPCS,C1713,HC ALLOGRAFT BONE TUBE,409.0,286.3,,,0
HCPCS,C1713,HC ALLOGRAFT BONE TUBE LARGE,1060.0,742.0,,,0
HCPCS,C1715,HC BRACHYTHERAPY NEEDLE,455.0,318.5,,,0
HCPCS,C1716,"Brachytx, non-str, Gold-198",,,409.96,2278.54,11
HCPCS,C1717,"Brachytx, non-str,hdr ir-192",,,357.49,1586.06,11
HCPCS,C1717,HC BRACHYTX SOURCE NON-STR HDR IR-192 PER SOURCE,746.0,522.2,,,0
HCPCS,C1719,"Brachytx, NS, Non-HDRIr-192",,,102.5,4031.59,11
HCPCS,C1724,CATH ATHEREC ROTA ADVNCR W/BURR,5597.0,3917.9,,,0
HCPCS,C1724,HC CATH ATHEREC ROTA PERIPH ROTAT,11162.0,7813.4,,,0
HCPCS,C1724,HC CATH DIAMONDBACK360 1.25 135CM,13310.0,9317.0,,,0
HCPCS,C1724,HC JETSTREAM SC ATHERECTOMY CATHETER ALL SIZES,9485.0,6639.5,,,0
HCPCS,C1725,HC  ATLAS GOLD BALLOON,1687.0,1180.9,,,0
HCPCS,C1725,HC ARMADA 14 CATH BALLOON,1043.0,730.1,,,0
HCPCS,C1725,HC ARMADA 18 PTA BALLOON,911.0,637.7,,,0
HCPCS,C1725,HC ARMADA 35 CATH BALLOON,572.0,400.4,,,0
HCPCS,C1725,HC BALLOON ABBOTT .035,700.0,490.0,,,0
HCPCS,C1725,HC BALLOON ATLAS,999.0,699.3,,,0
HCPCS,C1725,HC BALLOON CATH BIB,2497.0,1747.9,,,0
HCPCS,C1725,HC BALLOON CATH INFLAT UNIT POLAR,4061.0,2842.7,,,0
HCPCS,C1725,HC BALLOON CATH Z-MED II,1762.0,1233.4,,,0
HCPCS,C1725,HC BALLOON CUTTING SCIMED,2000.0,1400.0,,,0
HCPCS,C1725,HC BALLOON EV3 .035,541.0,378.7,,,0
HCPCS,C1725,HC BALLOON EV3 LONG .018,1558.0,1090.6,,,0
HCPCS,C1725,HC BALLOON PERIPHERAL,797.0,557.9,,,0
HCPCS,C1725,HC BALLOON PTA A,744.0,520.8,,,0
HCPCS,C1725,HC BALLOON PTA B,1061.0,742.7,,,0
HCPCS,C1725,HC BALLOON PTA C,369.0,258.3,,,0
HCPCS,C1725,HC BALLOON PTCA,466.0,326.2,,,0
HCPCS,C1725,HC BALLOON TYSHAK BRAUN,2033.0,1423.1,,,0
HCPCS,C1725,HC CATH GUIDEZILLA 6F LONG,1452.0,1016.4,,,0
HCPCS,C1725,HC CATH INQUE BALLN 28MM,7654.0,5357.8,,,0
HCPCS,C1725,HC CATH SAPPHIRE II PRO,775.0,542.5,,,0
HCPCS,C1725,HC CATH TRUE BALLOON,2830.0,1981.0,,,0
HCPCS,C1725,HC CATH TRUE DILATION 20MMX4.5CM,4901.0,3430.7,,,0
HCPCS,C1725,HC CATHETER ATLAS GOLD BALLON 20MMX2CM,2018.0,1412.6,,,0
HCPCS,C1725,HC CATHETER COYOTE OTW 2.5MM X 220MM X 150CM,1085.0,759.5,,,0
HCPCS,C1725,HC CATHETER SHOCKWAVE M5 IVL (CVL),9592.0,6714.4,,,0
HCPCS,C1725,HC CONQUEST BALLON 10 X2,719.0,503.3,,,0
HCPCS,C1725,HC FLASH MINI OSTIAL CATHETER BALLOON 3.0/3.5/4.0/4.5 X 8MM,2781.0,1946.7,,,0
HCPCS,C1725,HC FLASH OSTIAL CATHETER BALLOON 5.0/6.0 X 12MM,2781.0,1946.7,,,0
HCPCS,C1725,HC FLASH OSTIAL OTW CATHETER BALLON 6.0/7.0 X 12MM,2781.0,1946.7,,,0
HCPCS,C1725,HC GW CATH SASUKE GD TAPER TIP 145CM,1531.0,1071.7,,,0
HCPCS,C1725,HC LUTONIX DRUG COVERED BALLOON,5492.0,3844.4,,,0
HCPCS,C1725,HC PERIPHERAL IVL CATHETER,11064.0,7744.8,,,0
HCPCS,C1725,HC SABER 0.018 PTA DILATATION CATHETER,780.0,546.0,,,0
HCPCS,C1725,HC VIATRAC BALLOON,855.0,598.5,,,0
HCPCS,C1726,HC BALLOON CATH DIL NON-VASC AMPLATZ,1061.0,742.7,,,0
HCPCS,C1726,HC BALLOON CATH TAMPONADE BAKRI,816.0,571.2,,,0
HCPCS,C1726,HC MERIT MEDICAL ELATION BALLOON DILATOR,1065.0,745.5,,,0
HCPCS,C1728,HC CATHETER BRACHYTHERAPY SEED ADMINISTRATION,8320.0,5824.0,,,0
HCPCS,C1729,HC CATH DRAIN CHEST TUBE PLEURAGUIDE,511.0,357.7,,,0
HCPCS,C1729,HC CATH DRAIN PNEUM WYNE 14FR,609.0,426.3,,,0
HCPCS,C1729,HC CATH DRAIN PNEUMOTHORAX KIT,445.0,311.5,,,0
HCPCS,C1729,HC CATH DRAIN PNEUMOTHORAX KIT A,426.0,298.2,,,0
HCPCS,C1729,HC CATH DRAIN PNEUMOTHORAX KIT B,850.0,595.0,,,0
HCPCS,C1729,HC DRAINAGE CATHETER A,509.0,356.3,,,0
HCPCS,C1729,HC DRAINAGE CATHETER B,454.0,317.8,,,0
HCPCS,C1729,HC DRAINAGE CATHETER C,480.0,336.0,,,0
HCPCS,C1729,HC DRAINAGE CATHETER F,1748.0,1223.6,,,0
HCPCS,C1729,HC DRAINAGE CATHETER G,121.0,84.7,,,0
HCPCS,C1729,HC DRAINAGE CATHETER H,301.0,210.7,,,0
HCPCS,C1729,HC PLEURX-CATH ACCESS KIT,205.0,143.5,,,0
HCPCS,C1729,HC PLEURX-PLEURAL CATH KIT,1892.0,1324.4,,,0
HCPCS,C1729,HC THORACENTESIS KIT,176.0,123.2,,,0
HCPCS,C1730,HC CATH EP DX QUAD NON DEFL < 19 ELE,2439.0,1707.3,,,0
HCPCS,C1730,HC CATH SUPREME QUAD,1400.0,980.0,,,0
HCPCS,C1730,HC CATHETER OCTAPOLAR D-CRV 6FR X 92CM,392.0,274.4,,,0
HCPCS,C1730,HC CATHETER VIEWFLEX XTRA INTRACARDIAC ECHOCARDIOGRAPHY 9F,6825.0,4777.5,,,0
HCPCS,C1730,HC SURPREME ELECTROPHYSIOLOGY CATHETER 5MM CRD2 6FR X 120CM,193.0,135.1,,,0
HCPCS,C1731,HC CATHETER DUO-DECAPOLAR 7F,986.0,690.2,,,0
HCPCS,C1731,HC DIAG ER CATH W/20 OR MORE ELECTRODES,2330.0,1631.0,,,0
HCPCS,C1731,HC EP CATHETER HALO 20 ELECTRODES,3759.0,2631.3,,,0
HCPCS,C1732,HC CATH DECANAV MAP,3067.0,2146.9,,,0
HCPCS,C1732,HC CATH OCTARAY D-CRV,7059.0,4941.3,,,0
HCPCS,C1732,HC CATH VARIPULSE BI-DIRECTIONAL 8.5FR,14547.0,10182.9,,,0
HCPCS,C1732,HC EZ STEER BI-DIRECTIONAL CARTO 4MM,6670.0,4669.0,,,0
HCPCS,C1732,HC OPTRELL MAPPING CATHETER SMALL LOOP,6934.0,4853.8,,,0
HCPCS,C1732,HC QDOT MICRO BI-DIRECTIONAL CATHETER,4028.0,2819.6,,,0
HCPCS,C1732,HC QDOT MICRO UNI-DIRECTIONAL CATHETER,4028.0,2819.6,,,0
HCPCS,C1732,HC THERMACOOL SF NAV CATHETER,8120.0,5684.0,,,0
HCPCS,C1733,HC ABLATION CATHETER-WEBSTER,2996.0,2097.2,,,0
HCPCS,C1733,HC BALLOON ARCTIC FRONT,15972.0,11180.4,,,0
HCPCS,C1733,HC CATHETER SPHERE-9 AFFERA MAPPING AND ABLATION,25410.0,17787.0,,,0
HCPCS,C1733,HC EZ STEER BI DIRECTIONAL NON-CARTO 8MM,3495.0,2446.5,,,0
HCPCS,C1733,HC EZ STEER THERMOCOOL CARTO,6969.0,4878.3,,,0
HCPCS,C1750,HC TUNNELED DIALYSIS CATHETER,1399.0,979.3,,,0
HCPCS,C1751,CATH PICC DUAL LUMEN 1.9FRX30CM,360.0,252.0,,,0
HCPCS,C1751,HC CATH CV LINE POWERLINE,1080.0,756.0,,,0
HCPCS,C1751,HC CATH CVC SET,647.0,452.9,,,0
HCPCS,C1751,HC CATH CVL TUNNELED A,1400.0,980.0,,,0
HCPCS,C1751,HC CATH CVL TUNNELED B,1694.0,1185.8,,,0
HCPCS,C1751,HC CATH DOUBLE LUMEN SET 4.0,528.0,369.6,,,0
HCPCS,C1751,HC CATH DX PERIPH,416.0,291.2,,,0
HCPCS,C1751,HC CATH INF CENTRAL,468.0,327.6,,,0
HCPCS,C1751,HC CATH INF PER/CENT/MIDLINE,460.0,322.0,,,0
HCPCS,C1751,HC CATH INF UNIFUSE,668.0,467.6,,,0
HCPCS,C1751,HC CATH MICRO-INFUSION,1894.0,1325.8,,,0
HCPCS,C1751,HC CATH PICC 3FR 55CM 1L POWER INJECTION,734.0,513.8,,,0
HCPCS,C1751,HC CATH PICC A,509.0,356.3,,,0
HCPCS,C1751,HC CATH PICC B,509.0,356.3,,,0
HCPCS,C1751,HC CATH SINGLE LUMEN CVC,358.0,250.6,,,0
HCPCS,C1751,HC CATH SINGLE LUMEN UVC 3.5 FR,81.0,56.7,,,0
HCPCS,C1751,HC CATH TRIPLE LUMEN CVC KIT W/SHRP,146.0,102.2,,,0
HCPCS,C1751,HC CATHETER ULTRAFUSE SCIMED,1055.0,738.5,,,0
HCPCS,C1751,HC CENTRAL VENOUS 2 LUM CATHETER SET 5.0 FR / 8 CM / 0.18 DIAMETER,493.0,345.1,,,0
HCPCS,C1751,HC CENTRAL VENOUS CATHETER SET 5.0FR/15 CM,213.0,149.1,,,0
HCPCS,C1751,HC WIRE PACING TEMPORARY,427.0,298.9,,,0
HCPCS,C1752,HC TEMP DIALYSIS CATHETER B POWER-TRIALYSIS,660.0,462.0,,,0
HCPCS,C1752,HC TEMPORARY DIALYSIS CATHETER,341.0,238.7,,,0
HCPCS,C1753,HC ACUNAV CATHETER ICE DIAG GE 8F X 90CM,2411.0,1687.7,,,0
HCPCS,C1753,HC CATHETER ULTRASOUND OPTICROSS 0.018IN 4F X 135CM,2156.0,1509.2,,,0
HCPCS,C1753,HC CVIS ULTRACROSS CATH/SONICATH MDL 37-410,2613.0,1829.1,,,0
HCPCS,C1753,HC VOLCANO VISIONS PV DIGITAL IVUS CATHETER 0.035,3192.0,2234.4,,,0
HCPCS,C1757,HC ANGIOJET THROMBECTOMY CATHETER SOLENT OMNI 6FR 120CM,5196.0,3637.2,,,0
HCPCS,C1757,HC ANGIOJET THROMBECTOMY CATHETER SOLENT PROXI 6FR 90CM,4875.0,3412.5,,,0
HCPCS,C1757,HC ANGIOJET THROMBECTOMY CATHETER ZELANTE 8FR 105CM,9107.0,6374.9,,,0
HCPCS,C1757,HC ATRIUM XPRESSWAY CATH-ASPIRATION CATH,1261.0,882.7,,,0
HCPCS,C1757,HC AVX 50CM ULTRA,2086.0,1460.2,,,0
HCPCS,C1757,HC CATHETER ANGIOJET SOLENT DISTA 4F,6409.0,4486.3,,,0
HCPCS,C1757,HC CATHETER ANGIOJET ZELANTE DVT,12353.0,8647.1,,,0
HCPCS,C1757,HC CATHETER LIGHTNING EMBOL 16FR X 115CM,22662.0,15863.4,,,0
HCPCS,C1757,HC CLOTTRIEVER CATHETER,16517.0,11561.9,,,0
HCPCS,C1757,HC CLOTTRIEVER SHEATH 13F,4811.0,3367.7,,,0
HCPCS,C1757,HC CLOTTRIEVER SHEATH 16F,4811.0,3367.7,,,0
HCPCS,C1757,HC ECKOSONIC MACH 4 ENDOVASCULAR DEVICE 135CM,9605.0,6723.5,,,0
HCPCS,C1757,HC EMBOLIZATION PRODUCT A,1300.0,910.0,,,0
HCPCS,C1757,HC EMBOLIZATION PRODUCT C,999.0,699.3,,,0
HCPCS,C1757,HC EMBOLIZATION PRODUCT D,509.0,356.3,,,0
HCPCS,C1757,HC EMBOLIZATION PRODUCT E,509.0,356.3,,,0
HCPCS,C1757,HC INDIGO SYSTEM LIGHTNING 7,14358.0,10050.6,,,0
HCPCS,C1757,HC INDIGO SYSTEM LIGHTNING BOLT 7,18619.0,13033.3,,,0
HCPCS,C1757,HC KIT CATHETER THROMBECTOMY,10903.0,7632.1,,,0
HCPCS,C1757,HC PRONTO CATHETER,900.0,630.0,,,0
HCPCS,C1757,HC RHEOLYTIC CATHETER W/PUMP,5741.0,4018.7,,,0
HCPCS,C1757,HC SYSTEM INDIGO LIGHTNING,21966.0,15376.2,,,0
HCPCS,C1757,HC THROMBECTOMY DEVICE A,2497.0,1747.9,,,0
HCPCS,C1757,HC VTE INARI SYSTEM,26281.0,18396.7,,,0
HCPCS,C1759,HC ACUNAV/SOUNDSTAR INTRACARDIAC ECHO CATH,9651.0,6755.7,,,0
HCPCS,C1759,HC CATHETER SOUNDSTAR ECO ICE,2336.0,1635.2,,,0
HCPCS,C1759,HC SOUNDSTAR ECO DIAGNOSTIC ULTRASOUND CATHETER 8FR,7706.0,5394.2,,,0
HCPCS,C1759,HC SOUNDSTAR/RS,4792.0,3354.4,,,0
HCPCS,C1760,CLOSURE DEVICE,820.0,574.0,,,0
HCPCS,C1760,HC BOSTON SCIENTIFIC WATCHMAN LAA CLOSURE DEVICE 24 MM,45254.0,31677.8,,,0
HCPCS,C1760,HC CLOSURE E ANGIO-SEAL,820.0,574.0,,,0
HCPCS,C1760,HC NIT-OCCLUD PDA CLOSURE SYSTEM W/FLEX SHEATH ALL SIZES,5649.0,3954.3,,,0
HCPCS,C1760,HC OCLR AMULET LA APPNDG 16MM/34 MM,28875.0,20212.5,,,0
HCPCS,C1760,HC PERIPHERAL ROTALINK PLUS BURR CATHETER 1.50MM X 5F,4956.0,3469.2,,,0
HCPCS,C1760,HC PERIPHERAL ROTALINK PLUS BURR CATHETER 1.75/2.00MM X 6/7F,3779.0,2645.3,,,0
HCPCS,C1760,HC VASCULAR CLOSURE DEVICE,1061.0,742.7,,,0
HCPCS,C1761,HC CATHETER SHOCKWAVE C2 INTRAVASCULAR LITHOTRIPSY,13702.0,9591.4,,,0
HCPCS,C1761,HC SHOCKWAVE LITHOPLASTY CATHETER,15073.0,10551.1,,,0
HCPCS,C1764,HC LOOP RECORDER MEDTRONIC,11435.0,8004.5,,,0
HCPCS,C1764,HC LOOP RECORDER ST JUDE,11647.0,8152.9,,,0
HCPCS,C1764,HC SYSTEM LINQII INSERTABLE CARDIAC MONITOR,14896.0,10427.2,,,0
HCPCS,C1766,HC SHEATH AGILIS NXT STEERABLE INTRODUCER MED CURVE,2859.0,2001.3,,,0
HCPCS,C1766,HC SHEATH AGILIS NXT STEERABLE INTRODUCER SM CURVE,1599.0,1119.3,,,0
HCPCS,C1766,HC SHEATH VIZIGO BI DIRECT GD SM CURVE,2781.0,1946.7,,,0
HCPCS,C1766,HC STEERABLE GROIN SHEATH,5758.0,4030.6,,,0
HCPCS,C1766,HC TOURGUIDE STEERABLE SHEETH,1845.0,1291.5,,,0
HCPCS,C1766,HC VASCULAR SHEATH E,490.0,343.0,,,0
HCPCS,C1769,GW VASC L80CM L2MM OD.018IN,184.0,128.8,,,0
HCPCS,C1769,HC ATTAIN HYBRID GUIDE WIRE,522.0,365.4,,,0
HCPCS,C1769,HC BALLOON DILATATION CATHETER 3MM X 60MM X 150CM,912.0,638.4,,,0
HCPCS,C1769,HC DIAGNOSTIC GUIDE WIRE,59.0,41.3,,,0
HCPCS,C1769,HC DOPPLER PRESSURE WIRE,2081.0,1456.7,,,0
HCPCS,C1769,HC GLIDEWIRE,381.0,266.7,,,0
HCPCS,C1769,HC GUIDE WIRE A,230.0,161.0,,,0
HCPCS,C1769,HC GUIDE WIRE MAXXWIRE .035 X 180,484.0,338.8,,,0
HCPCS,C1769,HC GUIDEWIRE B,143.0,100.1,,,0
HCPCS,C1769,HC GUIDEWIRE C,253.0,177.1,,,0
HCPCS,C1769,HC GUIDEWIRE D,341.0,238.7,,,0
HCPCS,C1769,HC GUIDEWIRE E,396.0,277.2,,,0
HCPCS,C1769,HC GUIDEWIRE G,255.0,178.5,,,0
HCPCS,C1769,HC GUIDEWIRE H,321.0,224.7,,,0
HCPCS,C1769,HC GUIDEWIRE I,410.0,287.0,,,0
HCPCS,C1769,HC GUIDEWIRE J,521.0,364.7,,,0
HCPCS,C1769,HC GUIDEWIRE K,1198.0,838.6,,,0
HCPCS,C1769,HC GUIDEWIRE L,509.0,356.3,,,0
HCPCS,C1769,HC GUIDEWIRE THRUWAY 0.018 300CM,447.0,312.9,,,0
HCPCS,C1769,HC GUIDEWIRE TORQUE DEVICE,69.0,48.3,,,0
HCPCS,C1769,HC GW ASTATO 30 STRT 180CM,581.0,406.7,,,0
HCPCS,C1769,HC GW ASTATO XS 20 STRT 300CM,581.0,406.7,,,0
HCPCS,C1769,HC GW CONFIANZA PRO 12 STRT 180CM,446.0,312.2,,,0
HCPCS,C1769,HC GW CONFIANZA PRO STRT 180CM,446.0,312.2,,,0
HCPCS,C1769,HC GW EXTENSION ASAHI GW 165CM,366.0,256.2,,,0
HCPCS,C1769,HC GW FIELDER FC STRT 300CM,339.0,237.3,,,0
HCPCS,C1769,HC GW FIELDER XT STRT 190CM/300CM,446.0,312.2,,,0
HCPCS,C1769,HC GW FIELDER XT-A 0.6G STRT 190,446.0,312.2,,,0
HCPCS,C1769,HC GW GAIA NEXT 2 PRE-SHAPE 190CM,446.0,312.2,,,0
HCPCS,C1769,HC GW GLADIUS MONGO ES PRE-SHAPE 300CM,446.0,312.2,,,0
HCPCS,C1769,HC GW GLADIUS MONGO ES STRT 300CM,446.0,312.2,,,0
HCPCS,C1769,HC GW GLADIUS MONGO STRT 190CM,446.0,312.2,,,0
HCPCS,C1769,HC GW GLADIUS STRT 0.014/0.018INX300CM,659.0,461.3,,,0
HCPCS,C1769,HC GW GRAND SLAM J-TIP .014X 180/300CM,444.0,310.8,,,0
HCPCS,C1769,HC GW GRAND SLAM STRT .014X180CM,444.0,310.8,,,0
HCPCS,C1769,HC GW HALBRED STRT 0.014INX300CM,698.0,488.6,,,0
HCPCS,C1769,HC GW MINAMO J-TIP 190/300CM,366.0,256.2,,,0
HCPCS,C1769,HC GW MINAMO STRT TIP 190CM,366.0,256.2,,,0
HCPCS,C1769,HC GW MIRACLEBROS 3/12 STRT 300CM,446.0,312.2,,,0
HCPCS,C1769,HC GW MIRACLEBROS 6 STRT 180CM/300CM,446.0,312.2,,,0
HCPCS,C1769,HC GW NITINOL GLD,39.0,27.3,,,0
HCPCS,C1769,HC GW PROWATERFLEX WH J-TIP 180CM,339.0,237.3,,,0
HCPCS,C1769,HC GW RG3 CTO STRAIGHT 330CM,446.0,312.2,,,0
HCPCS,C1769,HC GW SION BLACK J-TIP 190CM,444.0,310.8,,,0
HCPCS,C1769,HC GW SION BLACK J-TIP 300CM,366.0,256.2,,,0
HCPCS,C1769,HC GW SION BLACK STRT 190/300 CM,444.0,310.8,,,0
HCPCS,C1769,HC GW SION BLUE FL J-TIP 190CM,417.0,291.9,,,0
HCPCS,C1769,HC GW SION BLUE FL STRT 300CM,417.0,291.9,,,0
HCPCS,C1769,HC GW SION BLUE STRT .014INX190CM,417.0,291.9,,,0
HCPCS,C1769,HC GW SION WH STRT 300CM,446.0,312.2,,,0
HCPCS,C1769,HC GW SUOH 03 STRAIGHT 190CM,446.0,312.2,,,0
HCPCS,C1769,HC GW THRUWAY .014 STRAIGHT,438.0,306.6,,,0
HCPCS,C1769,HC GW VASC .014/.018DIA 180CML,581.0,406.7,,,0
HCPCS,C1769,HC GW VASC .45MMDIA 300CM LGTH,698.0,488.6,,,0
HCPCS,C1769,HC GW VASC .45MMDIA 300CM STRT,427.0,298.9,,,0
HCPCS,C1769,HC PULMONARY JAGWIRE,480.0,336.0,,,0
HCPCS,C1769,HC SAFARI2 GUIDEWIRE XSMALL/SMALL/LARGE CURVE 0.035 IN X 275CM,967.0,676.9,,,0
HCPCS,C1769,HC SPRING WIRE GUIDE,48.0,33.6,,,0
HCPCS,C1769,HC STIFF ANGLED GLIDEWIRE 180CM .035,141.0,98.7,,,0
HCPCS,C1769,HC TAD WIRE,506.0,354.2,,,0
HCPCS,C1769,HC V-14/18 300 CM CONTROLWIRE,761.0,532.7,,,0
HCPCS,C1769,HC VASCULAR SPECIALTY GUIDEWIRE,65.0,45.5,,,0
HCPCS,C1769,HC VERSACORE GUIDE WIRE,536.0,375.2,,,0
HCPCS,C1769,MALLINCKRODT TAD WIRE,576.0,403.2,,,0
HCPCS,C1769,PTCA GUIDEWIRE,366.0,256.2,,,0
HCPCS,C1773,HC RETRIEVAL DEVICE INSERTABLE,1748.0,1223.6,,,0
HCPCS,C1773,HC RETRIEVAL DEVICE SNARE A,1168.0,817.6,,,0
HCPCS,C1773,HC RETRIEVAL DEVICE SNARE B,1485.0,1039.5,,,0
HCPCS,C1773,HC RETRIEVAL DEVICE SNARE CATH,2277.0,1593.9,,,0
HCPCS,C1776,HC SHEATH STEERABLE,2228.0,1559.6,,,0
HCPCS,C1781,HC OPTIMESH MESH POUCH LARGE,15972.0,11180.4,,,0
HCPCS,C1786,HC LEADLESS PACEMAKER AV MEDTRONIC DUAL CHAMBER,29391.0,20573.7,,,0
HCPCS,C1786,HC LEADLESS PACEMAKER SINGLE CHAMBER,23080.0,16156.0,,,0
HCPCS,C1788,HC BARD CATHETER/PORT,2035.0,1424.5,,,0
HCPCS,C1788,HC IMPLANTABLE CV PORT A,2055.0,1438.5,,,0
HCPCS,C1788,HC IMPLANTABLE CV PORT B,2648.0,1853.6,,,0
HCPCS,C1788,HC IMPLANTABLE CV PORT C,1957.0,1369.9,,,0
HCPCS,C1817,CARDIAC SEPTAL DEFECT IMPLANT SYSTEM,8718.0,6102.6,,,0
HCPCS,C1817,HC AMPLATZER DUCT OCCLUDER,3524.0,2466.8,,,0
HCPCS,C1817,HC AMPLATZER PFO OCCLUDER,25398.0,17778.6,,,0
HCPCS,C1817,HC CARDIOFORM SEPTAL OCCLUDER,18233.0,12763.1,,,0
HCPCS,C1874,HC AEROSIZER STENT SIZING DEVICE,968.0,677.6,,,0
HCPCS,C1874,HC ELUVIA STENT COVERED W/DELIVERY SYSTEM 6/7 X 100/120 X 130,9284.0,6498.8,,,0
HCPCS,C1874,HC GORE VIABAHN ENDOPROSTHESIS W/ HEPARIN 10MMX10CM 8FR 120CM CATH,11497.0,8047.9,,,0
HCPCS,C1874,HC GORE VIABAHN ENDOPROSTHESIS W/HEPARIN 10MMX15CM 8FR 120CM CATH,12834.0,8983.8,,,0
HCPCS,C1874,HC GORE VIABAHN VBX BALLOON EXPANDABLE ENDOPROSTHESIS 6MM X 8MM X 19MM,8605.0,6023.5,,,0
HCPCS,C1874,HC GUIDE EXTENDER,798.0,558.6,,,0
HCPCS,C1874,HC I-CAST BALLOON EXPANDABLE COVERED STENT,11314.0,7919.8,,,0
HCPCS,C1874,HC INTEGRITY DRUG ELUTING STENT,2677.0,1873.9,,,0
HCPCS,C1874,HC INTRAVASC COATED W/DEL STENT C,7396.0,5177.2,,,0
HCPCS,C1874,HC INTRAVASC COATED W/DEL STENT D,12978.0,9084.6,,,0
HCPCS,C1874,HC STENT ENDOPROSTHESIS WITH HEPARIN 5/6MM / 2.5/5.0 CM / 120CM,11660.0,8162.0,,,0
HCPCS,C1874,HC STENT PERIPHERAL ESPRIT EVROL 3.0/3.75 X 18/38 MM,8317.0,5821.9,,,0
HCPCS,C1874,HC STENT PK PAPYRUS,9620.0,6734.0,,,0
HCPCS,C1874,HC STENT RESOLUTE ONYX RX,4154.0,2907.8,,,0
HCPCS,C1874,HC STENT SYNERGY XD MR,3509.0,2456.3,,,0
HCPCS,C1874,HC STENT VIABAHN ENDOPROSTHESIS W/HEPARIN 6/7 MM X 25CM X 120CM,18213.0,12749.1,,,0
HCPCS,C1874,HC STENT VIABAHN ENDOPROSTHESIS W/HEPARIN 7MM X 15CM X 120CM,12865.0,9005.5,,,0
HCPCS,C1874,HC STENT VIABAHN ENDOPROSTHESIS W/HEPARIN 8MM X 10CM X 120CM,11550.0,8085.0,,,0
HCPCS,C1874,HC STENT VIABAHN VBX,11975.0,8382.5,,,0
HCPCS,C1874,HC STNT MINI TB CVRD,8337.0,5835.9,,,0
HCPCS,C1874,HC STNT TB CVRD,8337.0,5835.9,,,0
HCPCS,C1874,HC SYNERGY DRUG ELUTING STENT,2968.0,2077.6,,,0
HCPCS,C1874,HC WALLFLEX BILIARY STENT,9419.0,6593.3,,,0
HCPCS,C1874,WALLFLEX ESOPHAGEAL STENT W/ DEL SYSTEM,7821.0,5474.7,,,0
HCPCS,C1875,HC COVERED STENT,11237.0,7865.9,,,0
HCPCS,C1876,HC ABBOTT VASCULAR STENTS,5772.0,4040.4,,,0
HCPCS,C1876,HC ABRE VENOUS SELF-EXPANDING STENT SYSTEM,5437.0,3805.9,,,0
HCPCS,C1876,HC ABRE VENOUS SELF-EXPANDING STENT SYSTEM 12/14/16/18 MM X 150MM,6175.0,4322.5,,,0
HCPCS,C1876,HC ABSOLUTE STENT SYSTEM NON-COATED/NON-COVERED W/DELIVERY SYSTEM,2876.0,2013.2,,,0
HCPCS,C1876,HC BARE METAL STENT,3980.0,2786.0,,,0
HCPCS,C1876,HC HERCULINK STENT NON-COATED/NON-COVERED W/DELIVERY SYSTEM,2647.0,1852.9,,,0
HCPCS,C1876,HC INTRAVASC NONCOATED W/DEL STENT A,3178.0,2224.6,,,0
HCPCS,C1876,HC INTRAVASC NONCOATED W/DEL STENT B,3178.0,2224.6,,,0
HCPCS,C1876,HC LIFESTENT VASC STENT 170MM NON-COV,8257.0,5779.9,,,0
HCPCS,C1876,HC LIFESTENT VASC STENT < 100MM NON-COV,1947.0,1362.9,,,0
HCPCS,C1876,HC OMNILINK STENT NON-COATED/NON-COVERED W/DELIVERY SYSTEM,2317.0,1621.9,,,0
HCPCS,C1876,HC PERIPHERAL STENT,4228.0,2959.6,,,0
HCPCS,C1876,HC RENAL BALLON EXPANDABLE STENT NON COATED/NON-COVERED W/DELIVERY SYSTEM,3369.0,2358.3,,,0
HCPCS,C1876,HC STENT EPIC ILIAC,2330.0,1631.0,,,0
HCPCS,C1876,HC STENT EXPRESS NON-COATED/NON-COVERED W/DELIVERY SYSTEM,3615.0,2530.5,,,0
HCPCS,C1876,HC STENT WITH DELIVERY SYSTEM,4792.0,3354.4,,,0
HCPCS,C1876,HC VISION STENT,5550.0,3885.0,,,0
HCPCS,C1880,HC IVC FILTER,3328.0,2329.6,,,0
HCPCS,C1884,HC EMBOSHIELD PROTECTION SYSTEM,4161.0,2912.7,,,0
HCPCS,C1884,HC SENTINEL CEREBRAL PROTECTION SYSTEM,12826.0,8978.2,,,0
HCPCS,C1884,HC SYSEMBOLIC PROTECTION 190/300CM,5159.0,3611.3,,,0
HCPCS,C1885,HC CATH TRANSLUMINAL ANGIO LASER PERIPHERAL,6989.0,4892.3,,,0
HCPCS,C1885,HC CATH TRANSLUMINAL LASER TURBO ELITE .9MM,13295.0,9306.5,,,0
HCPCS,C1886,HC CATH EXTRAVASCULAR TISS ABLAT,830.0,581.0,,,0
HCPCS,C1887,HC CATH CROSSWALK,652.0,456.4,,,0
HCPCS,C1887,HC CATH GUIDELINER CRV 6/7 FR X .07X.078IN,1322.0,925.4,,,0
HCPCS,C1887,HC CATH ROYAL FLUSH PIGTAIL 5FR 100CM,126.0,88.2,,,0
HCPCS,C1887,HC CATH SOFT-VU COBRA1/MP 4FR/5FR X 100CM/65CM,162.0,113.4,,,0
HCPCS,C1887,HC CATH SOFTVU COBRA1 4FR 65CM,162.0,113.4,,,0
HCPCS,C1887,HC CATH SOFTVU OMNI .035 5FX65CM,214.0,149.8,,,0
HCPCS,C1887,HC CATHETER MICRO CANTATA,1203.0,842.1,,,0
HCPCS,C1887,HC COOK CURVED SHEATH,528.0,369.6,,,0
HCPCS,C1887,HC CORSAIR CATHETER 135,1832.0,1282.4,,,0
HCPCS,C1887,HC CS GUIDE CATHETER,2396.0,1677.2,,,0
HCPCS,C1887,HC ENB LOCATABLE GUIDE,3313.0,2319.1,,,0
HCPCS,C1887,HC GUIDE CATHETER,350.0,245.0,,,0
HCPCS,C1887,HC GW MICROCATH CARAVEL 1.9FX150CM,1364.0,954.8,,,0
HCPCS,C1887,HC GW MICROCATH CORSAIR PRO 2.6FX135,1765.0,1235.5,,,0
HCPCS,C1887,HC GW MICROCATH CORSAIR PRO XS 150CM,2727.0,1908.9,,,0
HCPCS,C1887,HC GW MICROCATH CORSAIR PRO XS 2.1F,1765.0,1235.5,,,0
HCPCS,C1887,HC INDIGO SYSTEM CAT7D KIT,8049.0,5634.3,,,0
HCPCS,C1887,HC INTRO R2P SLNDR STR 6FR 149/119 CM,1264.0,884.8,,,0
HCPCS,C1887,HC KIT CATHETER EKOS PLUS ENDOVASCULAR SYSTEM 106CM X 8CM/16CM,9870.0,6909.0,,,0
HCPCS,C1887,HC KIT INDIGO CATHETER ASPIRATION INCLUDING TUBING,6446.0,4512.2,,,0
HCPCS,C1887,HC MICROCATHETER TRUSELECT 0.021IN X 175CM,2327.0,1628.9,,,0
HCPCS,C1887,HC SELECTSITE DEFLECTABLE CATHETER W/PRESHAPED DISTAL CURVE,1449.0,1014.3,,,0
HCPCS,C1889,HC TEMPERATURE MANAGEMENT DEVICE ESOPHAGEAL,2447.0,1712.9,,,0
HCPCS,C1892,HC VASCULAR SHEATH D,290.0,203.0,,,0
HCPCS,C1893,HC FLEXCATH CROSS AG/VZ 71 CM,1931.0,1351.7,,,0
HCPCS,C1893,HC INTRO/SHEATH FIXED NON-PEEL VISISHEATH,900.0,630.0,,,0
HCPCS,C1893,HC TRANSSEPTAL NEEDLE,1104.0,772.8,,,0
HCPCS,C1894,HC AVANTI 23CM SHEATH 6FR,246.0,172.2,,,0
HCPCS,C1894,HC COOK BALKEN SHEATH,528.0,369.6,,,0
HCPCS,C1894,HC CORDIS BRITE-TIP SHEATH,289.0,202.3,,,0
HCPCS,C1894,HC DAIG SAFL SHEATH,864.0,604.8,,,0
HCPCS,C1894,HC DIAGNOSTIC SHEATH/INTRODUCER,55.0,38.5,,,0
HCPCS,C1894,HC INTRO DRYSEAL FLEX 33CM,1856.0,1299.2,,,0
HCPCS,C1894,HC INTRODUCER CATHETER MICROPUNCTURE ACCESS SET,141.0,98.7,,,0
HCPCS,C1894,HC INTRODUCER CATHETER PINNACLE 4/7/8 FR X 10 CM .038,58.0,40.6,,,0
HCPCS,C1894,HC INTRODUCER D VILL,888.0,621.6,,,0
HCPCS,C1894,HC KIT IMPELLA RP INTRODUCER,2246.0,1572.2,,,0
HCPCS,C1894,HC PERCUTANEOUS SHEATH INTRODUCER,285.0,199.5,,,0
HCPCS,C1894,HC PICC SHEATH INTRODUCER ONLY 1.4 FR,187.0,130.9,,,0
HCPCS,C1894,HC PLOY PICC COMPLETE KIT,476.0,333.2,,,0
HCPCS,C1894,HC RAPIDO CS GUIDING CATHETER,3594.0,2515.8,,,0
HCPCS,C1894,HC SHEATH DRYSEAL FLEX,2420.0,1694.0,,,0
HCPCS,C1894,HC SHEATH INTRODUCER COOK 14X30,381.0,266.7,,,0
HCPCS,C1894,HC SHEATH INTRODUCER COOK 16X30,478.0,334.6,,,0
HCPCS,C1894,HC SHEATH INTRODUCER MULLINS 85CM,477.0,333.9,,,0
HCPCS,C1894,HC SHEATH INTRODUCER SUPER SHEATH BOSTON SC,145.0,101.5,,,0
HCPCS,C1894,HC SHTH AMP TREVISIO 45D,1958.0,1370.6,,,0
HCPCS,C1894,HC VASCULAR SHEATH A,162.0,113.4,,,0
HCPCS,C1894,HC VASCULAR SHEATH B,225.0,157.5,,,0
HCPCS,C1894,HC VASCULAR SHEATH C,720.0,504.0,,,0
HCPCS,C1896,HC EPSILA EV QUADRIPOLAR LEAD W/SHAPED PASSIVE FIXATION,12451.0,8715.7,,,0
HCPCS,C1897,HC INTRODUCER AVANTI,47.0,32.9,,,0
HCPCS,C2616,"Brachytx, non-str,Yttrium-90",,,17771.01,78843.96,11
HCPCS,C2616,YTTRIUM-90 (SIR-SPHERES) MICROSPHERES,42831.0,29981.699999999997,,,0
HCPCS,C2616,YTTRIUM-90 (Y-90 THERASPHERE) GLASS MICROSPHERES,44379.0,31065.3,,,0
HCPCS,C2618,HC CRYOABLATION PROBE,4327.0,3028.9,,,0
HCPCS,C2618,HC FLEXIBLE CRYOPROBE SINGLE USE 1.1 MM LENGTH 1150 MM W/OVERSHEATH LENGTH 817MM,1434.0,1003.8,,,0
HCPCS,C2618,HC FLEXIBLE CRYOPROBE SINGLE USE 1.7/2.4 MM LENGTH 1150,1071.0,749.7,,,0
HCPCS,C2623,HC CATHETER RANGER DCB 4X100MM 135CM,5452.0,3816.4,,,0
HCPCS,C2623,HC CATHETER RANGER DCB OTW 4/5 X 150MM X 150CM,5934.0,4153.8,,,0
HCPCS,C2623,HC CATHETER RANGER DCB OTW 5/6/7 X 150/200MM X 150CM,7055.0,4938.5,,,0
HCPCS,C2625,HC DRAINAGE CATHETER E,554.0,387.8,,,0
HCPCS,C2625,HC NEPHRO-URETERAL STENT TEMP W/ DEL SYS,509.0,356.3,,,0
HCPCS,C2627,HC SUPRAPUBIC CATHETER,509.0,356.3,,,0
HCPCS,C2628,CATHETER VASCULAR VSD OCCLUDER,22764.0,15934.8,,,0
HCPCS,C2628,HC BALLOON CATH SIZING AMPLATZER,868.0,607.6,,,0
HCPCS,C2628,HC OCCLUSION CATHETER,2647.0,1852.9,,,0
HCPCS,C2630,HC CARTO NAVISTAR CATHETER,7787.0,5450.9,,,0
HCPCS,C2630,HC CATHETER WEBSTER CS BI-DIRECT D-F 7FR X 115CM,634.0,443.8,,,0
HCPCS,C2630,HC THERMOCOOL SF BI-DIRECTIONAL CATHETER,4660.0,3262.0,,,0
HCPCS,C2634,"Brachytx, non-str, HA, I-125",,,174.06,772.25,11
HCPCS,C2635,"Brachytx, non-str, HA, P-103",,,77.87,473.61,11
HCPCS,C2636,"Brachy linear, non-str,P-103",,,56.51,396.64,11
HCPCS,C2638,"Brachytx, stranded, I-125",,,35.26,156.44,11
HCPCS,C2639,"Brachytx, non-stranded,I-125",,,36.64,162.56,11
HCPCS,C2640,"Brachytx, stranded, P-103",,,88.26,391.58,11
HCPCS,C2641,"Brachytx, non-stranded,P-103",,,64.48,286.08,11
HCPCS,C2642,"Brachytx, stranded, C-131",,,119.11,528.45,11
HCPCS,C2643,"Brachytx, non-stranded,C-131",,,99.8,442.78,11
HCPCS,C2644,Brachytx cesium-131 chloride,,,40.15,50.09,4
HCPCS,C2645,"Brachytx planar, p-103",,,4.69,20.81,11
HCPCS,C2698,"Brachytx, stranded, NOS",,,35.26,156.44,11
HCPCS,C2699,"Brachytx, non-stranded, NOS",,,36.64,162.56,11
HCPCS,C5271,Low cost skin substitute app,,,1303.26,1625.85,4
HCPCS,C5273,Low cost skin substitute app,,,4264.48,5320.05,4
HCPCS,C5275,Low cost skin substitute app,,,1303.26,1625.85,4
HCPCS,C5277,Low cost skin substitute app,,,1303.26,1625.85,4
HCPCS,C7900,"Hopd mntl hlt, 15-29 min",,,37.09,164.57,11
HCPCS,C7901,"Hopd mntl hlt, 30-60 min",,,100.57,446.2,11
HCPCS,C7903,"Hopd mntl hlt, grp",,,37.09,164.57,11
HCPCS,C8001,3d anat seg imaging preop,,,127.38,565.15,7
HCPCS,C8003,Imp extar knee shck absrb,,,17357.91,77011.17,7
HCPCS,C8004,Sim ang w/prs cath rad emb,,,11428.37,50703.82,7
HCPCS,C8006,Inst pleu-perit shnt w pump,,,6408.87,28434.0,7
HCPCS,C8007,Opn mplnt hpgls ns ary ps gn,,,30548.12,135531.68,7
HCPCS,C8011,Opn mplnt hpgls ns ary rec,,,30548.12,135531.68,7
HCPCS,C8900,"Mra w/cont, abd",,,345.37,1556.07,11
HCPCS,C8901,"Mra w/o cont, abd",,,236.21,1346.02,11
HCPCS,C8902,"Mra w/o fol w/cont, abd",,,345.37,2058.06,11
HCPCS,C8903,"Mri w/cont, breast,  uni",,,173.64,1556.07,11
HCPCS,C8905,"Mri w/o fol w/cont, brst, un",,,345.37,2058.06,11
HCPCS,C8906,"Mri w/cont, breast,  bi",,,345.37,1556.07,11
HCPCS,C8908,"Mri w/o fol w/cont, breast,",,,345.37,2058.06,11
HCPCS,C8909,"MRA w/cont, chest",,,345.37,1556.07,11
HCPCS,C8910,"MRA w/o cont, chest",,,236.21,1346.02,11
HCPCS,C8911,"MRA w/o fol w/cont, chest",,,345.37,2058.06,11
HCPCS,C8912,"Mra w/cont, lwr ext",,,345.37,1556.07,11
HCPCS,C8913,"Mra w/o cont, lwr ext",,,236.21,1346.02,11
HCPCS,C8914,"Mra w/o fol w/cont, lwr ext",,,345.37,2058.06,11
HCPCS,C8918,"MRA w/cont, pelvis",,,345.37,1556.07,11
HCPCS,C8919,"MRA w/o cont, pelvis",,,236.21,1346.02,11
HCPCS,C8920,"Mra w/o fol w/cont, pelvis",,,345.37,2058.06,11
HCPCS,C8921,HC TTE W/CONTRAST OR W/O CONTRAST W/CONTRAST REAL TIME W/IMAGE DOC (2D) INCL PROBE PLACE IMAGE ACUQUISITION INTERP/REPORT,2303.0,1612.1,,,0
HCPCS,C8921,"Tte w or w/o fol w/cont, com",,,776.06,3443.1,11
HCPCS,C8922,HC TTE W/CONTRAST OR W/O CONTRAST W/CONTRAST CONGENITAL CARDIAC ANOMALIES FOLLOW-UP OR LIMITED STUDY,2303.0,1612.1,,,0
HCPCS,C8922,"Tte w or w/o fol w/cont, f/u",,,776.06,3443.1,11
HCPCS,C8923,"2d tte w or w/o fol w/con,co",,,776.06,3443.1,11
HCPCS,C8924,"2d tte w or w/o fol w/con,fu",,,345.37,2118.8,11
HCPCS,C8924,HC TRANSTHOR ECHO W/WO CONTRAST REAL-TIME W/IMAGE DOC (2D) INCL M-MO WHEN PERFORM F/U OR LIMITED STUDY,2036.0,1425.2,,,0
HCPCS,C8925,"2d tee w or w/o fol w/con,in",,,776.06,3443.1,11
HCPCS,C8925,HC TRANSESOPHAGEAL ECHO W/WO CONTRAST REAL-TIME W/IMAGE DOC (2D) INCL PROBE PLACEMENT IMAGE ACQUISITION INTERP/REPORT,2522.0,1765.4,,,0
HCPCS,C8926,"Tee w or w/o fol w/cont,cong",,,776.06,3443.1,11
HCPCS,C8927,HC TTE W/CONTRAST W/O CONTRAST W/CONTRAST INCL PROBE PLACE REAL-TIME 2D IMAGE ACQUISITION/INTERP ONGOING ASSESSMENT,2303.0,1612.1,,,0
HCPCS,C8927,"TEE w or w/o fol w/cont, mon",,,776.06,3443.1,11
HCPCS,C8928,HC ECHOC REAL-T,2372.0,1660.4,,,0
HCPCS,C8928,"Tte w or w/o fol w/con,stres",,,776.06,3443.1,11
HCPCS,C8929,HC TRANSTHORACIC ECHOCARDIO W/CONTRAST OR W/O FOL BY W/CONTRAST REAL-TIME W/IMAGE DOC (2D) INCL M-MO,2299.0,1609.3,,,0
HCPCS,C8929,"TTE w or wo fol wcon,Doppler",,,776.06,3443.1,11
HCPCS,C8930,"TTE w or w/o contr, cont ECG",,,776.06,3443.1,11
HCPCS,C8931,"MRA, w/dye, spinal canal",,,345.37,1718.24,11
HCPCS,C8932,"MRA, w/o dye, spinal canal",,,236.21,1279.49,11
HCPCS,C8933,"MRA, w/o&w/dye, spinal canal",,,345.37,2077.0,11
HCPCS,C8934,"MRA, w/dye, upper extremity",,,345.37,1718.24,11
HCPCS,C8935,"MRA, w/o dye, upper extr",,,236.21,1279.49,11
HCPCS,C8936,"MRA, w/o&w/dye, upper extr",,,345.37,2077.0,11
HCPCS,C8957,"Prolonged iv inf, req pump",,,210.57,934.22,11
HCPCS,C9046,COCAINE  4 % TOP SOLN (MERGE),1041.0,728.7,,,0
HCPCS,C9046,Cocaine hcl nasal solution,,,2.6,3.25,4
HCPCS,C9047,"Injection, caplacizumab-yhdp",,,801.26,3554.94,11
HCPCS,C9067,Gallium ga-68 dotatoc,,,3.61,32.66,11
HCPCS,C9088,"Instill, bupivac and meloxic",,,2.12,2.65,4
HCPCS,C9101,"Inj, oliceridine 0.1 mg",,,1.18,1.47,4
HCPCS,C9145,"Inj, aponvie, 1 mg",,,5.69,7.1,4
HCPCS,C9159,"Inj, balfaxar, per i.u",,,9.83,12.27,4
HCPCS,C9160,Inj daxibotulinumtoxina-lanm,,,16.19,20.19,4
HCPCS,C9161,"Inj, aflibercept hd, 1 mg",,,566.28,1277.52,6
HCPCS,C9162,"Inj, avacincaptad peg 0.1 mg",,,327.69,408.81,4
HCPCS,C9163,Inj talquetamab-tgvs 0.25 mg,,,202.08,252.1,4
HCPCS,C9164,"Cantharidin top, applicator",,,2137.82,2666.98,4
HCPCS,C9165,"Inj, elranatamab-bcmm, 1 mg",,,535.92,668.58,4
HCPCS,C9170,TARLATAMAB-DLLE  1 MG IV SOLR,4140.0,2898.0,,,0
HCPCS,C9170,TARLATAMAB-DLLE 10 MG IV SOLR,41390.5,28973.35,,,0
HCPCS,C9174,DATOPOTAMAB DERUXTECAN-DLNK 100 MG IV SOLR,38209.5,26746.65,,,0
HCPCS,C9248,CLEVIDIPINE 50 MG/100 ML IV EMUL,1120.5,784.3499999999999,,,0
HCPCS,C9248,"Inj, clevidipine butyrate",,,8.57,10.7,4
HCPCS,C9250,Artiss fibrin sealant,,,102.75,637.55,11
HCPCS,C9257,Bevacizumab injection,,,1.86,8.25,11
HCPCS,C9285,"Patch, lidocaine/tetracaine",,,39.91,49.78,4
HCPCS,C9290,"Inj, bupivacaine liposome",,,3.27,4.08,4
HCPCS,C9293,GLUCARPIDASE 1000 UNIT IV SOLR,113217.0,79251.9,,,0
HCPCS,C9293,"Injection, glucarpidase",,,449.1,1992.52,11
HCPCS,C9303,ZOLBETUXIMAB-CLZB 100 MG IV SOLR (WET SOLR VIAL),3293.0,2305.1,,,0
HCPCS,C9303,ZOLBETUXIMAB-CLZB 300 MG IV SOLR (WET SOLR VIAL),26496.0,18547.2,,,0
HCPCS,C9352,"Neuragen nerve guide, per cm",,,1537.94,1918.61,4
HCPCS,C9353,"Neurawrap nerve protector,cm",,,1249.81,1559.17,4
HCPCS,C9354,"Veritas collagen matrix, cm2",,,35.12,43.81,4
HCPCS,C9355,"Neuromatrix nerve cuff, cm",,,667.33,832.51,4
HCPCS,C9356,"TenoGlide tendon prot, cm2",,,88.96,110.98,4
HCPCS,C9358,"Surgimend, fetal",,,33.15,41.35,4
HCPCS,C9359,"Implnt,bon void filler-putty",,,178.13,222.23,4
HCPCS,C9360,"SurgiMend, neonatal",,,36.48,45.51,4
HCPCS,C9363,Integra Meshed Bil Wound Mat,,,88.39,546.58,11
HCPCS,C9399,TIRZEPATIDE  2.5 MG/0.5 ML SUBQ PNIJ,956.0,669.2,,,0
HCPCS,C9460,CANGRELOR 50 MG IV SOLR,4016.5,2811.55,,,0
HCPCS,C9460,"Injection, cangrelor",,,20.02,88.83,11
HCPCS,C9462,"Injection, delafloxacin",,,1.39,1.74,4
HCPCS,C9482,SOTALOL 150 MG/10 ML (15 MG/ML) IV SOLN,3900.0,2730.0,,,0
HCPCS,C9482,Sotalol hydrochloride IV,,,30.27,37.76,4
HCPCS,C9488,Conivaptan HCL,,,94.22,117.55,4
HCPCS,C9507,COVID-19 convalescent plasma,,,680.03,3017.06,11
HCPCS,C9600,HC PERC DRUG EL COR STENT SING,17552.0,12286.4,,,0
HCPCS,C9600,Perc drug-el cor stent sing,,,9175.02,50703.82,11
HCPCS,C9601,HC PERC DRUG-EL STENT BRAN,11109.0,7776.3,,,0
HCPCS,C9601,Perc drug-el cor stent bran,,,9175.02,11446.07,4
HCPCS,C9602,HC PERC D-E STENT ATHER S,21111.0,14777.7,,,0
HCPCS,C9602,Perc d-e cor stent ather s,,,17436.28,80515.32,11
HCPCS,C9603,HC PERC D-E STENT ATHER BR,11109.0,7776.3,,,0
HCPCS,C9603,Perc d-e cor stent ather br,,,23522.44,29344.82,4
HCPCS,C9604,HC PERC D-E REVASC T CABG S,14693.0,10285.1,,,0
HCPCS,C9604,Perc d-e cor revasc t cabg s,,,9175.02,50703.82,11
HCPCS,C9605,HC D-E COR REVASC T CABG B,11109.0,7776.3,,,0
HCPCS,C9605,Perc d-e cor revasc t cabg b,,,23522.44,29344.82,4
HCPCS,C9606,HC PERC D E COR REVASC W AMI S,21111.0,14777.7,,,0
HCPCS,C9606,Perc d-e cor revasc w AMI s,,,17436.28,21752.19,4
HCPCS,C9607,HC PERC D-E COR REVASC CHRO SIN,21111.0,14777.7,,,0
HCPCS,C9607,Perc d-e cor revasc chro sin,,,17436.28,80515.32,11
HCPCS,C9608,HC PERC D-E REVASC CHRO ADD,11109.0,7776.3,,,0
HCPCS,C9608,Perc d-e cor revasc chro add,,,23522.44,29344.82,4
HCPCS,C9610,HC CATHETER BALLOON DILATION AGENT PACLITAXEL 2.00/4.00 X 12MM/30MM,13052.0,9136.4,,,0
HCPCS,C9725,Place endorectal app,,,920.63,4084.51,11
HCPCS,C9726,Rxt breast appl place/remov,,,2041.58,2546.93,4
HCPCS,C9727,Insert palate implants,,,1536.02,6814.79,11
HCPCS,C9728,"Place device/marker, non pro",,,609.55,6079.31,11
HCPCS,C9733,Non-ophthalmic FVA,,,345.37,1532.31,11
HCPCS,C9734,"U/s trtmt, not leiomyomata",,,10000.94,56389.43,11
HCPCS,C9739,Cystoscopy prostatic imp 1-3,,,5308.0,23549.82,11
HCPCS,C9740,Cysto impl 4 or more,,,9371.49,41578.13,11
HCPCS,C9751,"Microwave bronch, 3d, ebus",,,24999.02,31186.89,4
HCPCS,C9757,Spine/lumbar disk surgery,,,12709.88,56389.43,11
HCPCS,C9758,Interatrial shunt IDE,,,16957.63,75235.29,11
HCPCS,C9760,Non-blind interatrial shunt,,,26647.43,118225.65,11
HCPCS,C9761,"Cysto, litho, vacuum kidney",,,9371.49,41578.13,11
HCPCS,C9762,Cardiac MRI seg dys strain,,,540.93,2399.94,11
HCPCS,C9763,Cardiac MRI seg dys stress,,,540.93,2399.94,11
HCPCS,C9764,HC REVASCULAR ENDOVASC OPEN/PERCU LOW EXTREM ARTERY EXCEPT TIBI/PERONE W/INTRAVASC LITHO INCL ANGIO WITHIN SAME VESSEL,35180.0,24626.0,,,0
HCPCS,C9764,Revasc intravasc lithotripsy,,,11428.37,50703.82,11
HCPCS,C9765,HC REVASCULAR ENDOVASC OPEN/PERCU LOW EXTREM ARTERY EXCEPT TIBI/PERONE W/INTRAVASC LITHO-STENT  INCL ANGIO WITHIN SAME VESSEL,56250.0,39375.0,,,0
HCPCS,C9765,Revasc intra lithotrip-stent,,,18147.73,80515.32,11
HCPCS,C9766,HC REVASCULAR ENDOVASC OPEN/PERCU LOW EXTREM ARTERY EXCEPT TIBI/PERONE W/INTRAVASC LITHO/ATHER INCL ANGIO WITHIN SAME VESSEL,56250.0,39375.0,,,0
HCPCS,C9766,Revasc intra lithotrip-ather,,,18147.73,80515.32,11
HCPCS,C9767,HC REVASCULAR ENDOVASC OPEN/PERCU LOW EXTREM ARTERY EXCEPT TIBI/PERONE W/INTRAVASC LITHO-STENT-ATHER INCL ANGIO WITHIN SAME VESSEL,71108.0,49775.6,,,0
HCPCS,C9767,Revasc lithotrip-stent-ather,,,18147.73,80515.32,11
HCPCS,C9769,Cysto w/temp pros implant,,,13374.12,16684.54,4
HCPCS,C9770,"Vitrec/mech pars, subret inj",,,9849.02,12286.89,4
HCPCS,C9771,Nsl/sins cryo post nasal tis,,,8291.26,10343.55,4
HCPCS,C9772,HC REVASCULARENDOVASC OPEN/PERCUTAN TIBI/PERONE W/INTRAVASC LITHOTRIPSY INCL ANGIO WITHIN SAME VESSEL,44801.0,31360.7,,,0
HCPCS,C9772,Revasc lithotrip tibi/perone,,,11428.37,50703.82,11
HCPCS,C9773,HC REVASCULAR ENDOVASC OPEN/PERCU TIBI/PERONE W/INTRAVASC LITHOTR-STENT INCL ANGIO WITHIN SAME VESSEL,71661.0,50162.7,,,0
HCPCS,C9773,Revasc lithotr-stent tib/per,,,18147.73,80515.32,11
HCPCS,C9774,HC REVASCULAR ENDOVASC OPEN/PERCU TIBI/PERONE W/INTRAVASC LITHO/ATHER INCL ANGIO WITHIN SAME VESSEL,71661.0,50162.7,,,0
HCPCS,C9774,Revasc lithotr-ather tib/per,,,18147.73,80515.32,11
HCPCS,C9775,HC REVASCULAR ENDOVASC OPEN/PERCU TIBI/PERONE W/INTRAVASC LITH-STENT PLACE/ATHER INCL ANGIO WITHIN SAME VESSELS,71661.0,50162.7,,,0
HCPCS,C9775,Revasc lith-sten-ath tib/per,,,18147.73,80515.32,11
HCPCS,C9777,Esophag mucosal integ add-on,,,3816.79,16933.82,11
HCPCS,C9778,"Colpopexy, min/inv, ex-perit",,,4952.26,21971.51,11
HCPCS,C9779,ESD endoscopy or colonoscopy,,,3816.79,16933.82,11
HCPCS,C9779,HC ENDOSCOPIC SUBMUCOSAL DISSECTION (ESD),3772.0,2640.4,,,0
HCPCS,C9780,Insert cv cath inf & sup app,,,7994.57,35469.2,11
HCPCS,C9781,Arthro/shoul surg; w/spacer,,,12709.88,56389.43,11
HCPCS,C9782,Blind myocar trpl bon marrow,,,16957.63,75235.29,11
HCPCS,C9783,Blind cor sinus reducer impl,,,11428.37,50703.82,11
HCPCS,C9784,Endo sleeve gastro w/tube,,,29748.45,37111.93,4
HCPCS,C9785,Endo outlet restrict w/tube,,,10523.19,46687.84,11
HCPCS,C9786,Echo cad for hf preserved ef,,,863.19,1076.85,4
HCPCS,C9787,Gastric ep mapg simult pt sx,,,1548.94,1932.34,4
HCPCS,C9789,Instill pharm renal pelvis,,,1211.71,8506.89,11
HCPCS,C9790,Kidney histotripsy w/image,,,37876.52,47251.89,4
HCPCS,C9791,Mri hyperpolarized xenon129,,,1211.71,5375.94,11
HCPCS,C9792,Blind/nonblind trans atrial,,,9448.04,41917.75,11
HCPCS,C9793,Pre-plan 3d model w/ccta,,,850.12,3771.72,11
HCPCS,C9794,Complex simulation w/pet-ct,,,5910.02,7372.89,4
HCPCS,C9795,Sbrt w/positron emission del,,,11364.02,14176.89,4
HCPCS,C9796,Rpr intst excl anrect fist,,,2747.81,12191.12,7
HCPCS,C9797,Vasc emb/occ w/prs cath,,,18147.73,80515.32,7
HCPCS,C9803,HOPD covid-19 spec collect,,,74.75,93.25,4
HCPCS,C9901,Endo defect closure GI tract,,,10523.19,46687.84,7
HCPCS,D0120,Periodic oral evaluation,,,131.8,584.75,7
HCPCS,D0140,Limit oral eval problm focus,,,131.8,584.75,7
HCPCS,D0150,Comprehensve oral evaluation,,,131.8,2288.03,11
HCPCS,D0160,Extensv oral eval prob focus,,,131.8,584.75,7
HCPCS,D0170,"Re-eval,est pt,problem focus",,,131.8,584.75,7
HCPCS,D0171,Re-eval post-op visit,,,131.8,584.75,7
HCPCS,D0180,Comp periodontal evaluation,,,131.8,584.75,7
HCPCS,D0191,Assessment of a patient,,,131.8,584.75,7
HCPCS,D0210,Intraor complete film series,,,236.21,1047.98,7
HCPCS,D0220,Intraoral periapical first,,,86.15,476.63,11
HCPCS,D0230,Intraoral periapical ea add,,,331.8,413.92,4
HCPCS,D0240,Intraoral occlusal film,,,86.15,401.34,11
HCPCS,D0250,Extraoral 2d project image,,,86.15,2288.03,11
HCPCS,D0251,Extraoral posterior image,,,86.15,382.23,11
HCPCS,D0270,Dental bitewing single image,,,86.15,382.23,11
HCPCS,D0272,Dental bitewings two images,,,86.15,421.35,11
HCPCS,D0273,Bitewings - three images,,,236.21,1047.98,7
HCPCS,D0274,Bitewings four images,,,236.21,1173.76,11
HCPCS,D0277,HC DENTAL VERT BITEWINGS-SEV TO EIGHT,1879.0,1315.3,,,0
HCPCS,D0277,Vert bitewings 7 to 8 images,,,236.21,2288.03,11
HCPCS,D0310,Dental saliography,,,236.21,1047.98,7
HCPCS,D0320,Dental tmj arthrogram incl i,,,236.21,1047.98,7
HCPCS,D0321,Other tmj images by report,,,86.15,382.23,7
HCPCS,D0322,Dental tomographic survey,,,103.5,459.18,7
HCPCS,D0330,Panoramic image,,,236.21,1047.98,7
HCPCS,D0340,2d cephalometric image,,,86.15,382.23,7
HCPCS,D0350,Oral/facial photo images,,,86.15,382.23,7
HCPCS,D0364,Cone beam ct capt & interp,,,103.5,459.18,7
HCPCS,D0365,Cone beam ct interprete man,,,103.5,459.18,7
HCPCS,D0366,Cone beam ct interprete max,,,103.5,459.18,7
HCPCS,D0367,Cone beam ct interp both jaw,,,103.5,459.18,7
HCPCS,D0368,Cone beam ct interprete TMJ,,,103.5,459.18,7
HCPCS,D0369,Max MRI capture & interprete,,,103.5,459.18,7
HCPCS,D0370,Max ultrasound capt & interp,,,103.5,459.18,7
HCPCS,D0371,Sialoendoscopy capt & interp,,,86.15,382.23,7
HCPCS,D0380,Cone beam ct capture limited,,,103.5,459.18,7
HCPCS,D0381,Cone beam ct capt mandible,,,103.5,459.18,7
HCPCS,D0382,Cone beam ct capt maxilla,,,103.5,459.18,7
HCPCS,D0383,Cone beam ct both jaws,,,103.5,459.18,7
HCPCS,D0384,Cone beam ct capture TMJ,,,103.5,459.18,7
HCPCS,D0385,Max MRI image capture,,,103.5,459.18,7
HCPCS,D0386,Max ultrasound image capture,,,103.5,459.18,7
HCPCS,D0393,Trtmnt simulation 3d image,,,86.15,382.23,7
HCPCS,D0394,Digital sub 2 or more images,,,86.15,382.23,7
HCPCS,D0395,Fusion 2 or more 3d images,,,86.15,382.23,7
HCPCS,D0416,Viral culture,,,372.69,464.94,4
HCPCS,D0431,Diag tst detect mucos abnorm,,,175.74,219.24,4
HCPCS,D0460,Pulp vitality test,,,640.0,2839.47,11
HCPCS,D0472,"Gross exam, prep & report",,,248.46,309.96,4
HCPCS,D0473,"Micro exam, prep & report",,,351.48,438.48,4
HCPCS,D0474,Micro w exam of surg margins,,,402.99,502.74,4
HCPCS,D0475,Decalcification procedure,,,436.32,544.32,4
HCPCS,D0476,Spec stains for microorganis,,,672.66,839.16,4
HCPCS,D0477,Spec stains not for microorg,,,684.78,854.28,4
HCPCS,D0478,Immunohistochemical stains,,,384.81,480.06,4
HCPCS,D0479,Tissue in-situ hybridization,,,502.98,627.48,4
HCPCS,D0480,Cytopath smear prep & report,,,378.75,472.5,4
HCPCS,D0481,Electron microscopy,,,396.93,495.18,4
HCPCS,D0482,Direct immunofluorescence,,,248.46,309.96,4
HCPCS,D0483,Indirect immunofluorescence,,,281.79,351.54,4
HCPCS,D0484,Consult slides prep elsewher,,,360.57,449.82,4
HCPCS,D0485,Consult inc prep of slides,,,375.72,468.72,4
HCPCS,D0502,Non-traumatic spinal cord injury M >=53.50 and M <60.50,,,390.87,487.62,4
HCPCS,D0600,Non-ionizing diag proc,,,640.0,2839.47,11
HCPCS,D0701,Fracture of lower extremity M >=61.50,,,86.15,382.23,7
HCPCS,D0702,Fracture of lower extremity M >=52.50 and M <61.50,,,86.15,382.23,7
HCPCS,D0703,Fracture of lower extremity M >=41.50 and M <52.50,,,86.15,382.23,7
HCPCS,D0705,Extra oral post radio image,,,86.15,382.23,7
HCPCS,D0706,Intraoral occlus radio image,,,86.15,382.23,7
HCPCS,D0707,Intraoral periap radio image,,,86.15,382.23,7
HCPCS,D0708,Intraoral bite radio image,,,86.15,382.23,7
HCPCS,D0709,Intraoral cmplt radio images,,,86.15,382.23,7
HCPCS,D1110,Dental prophylaxis adult,,,131.8,584.75,7
HCPCS,D1120,Dental prophylaxis child,,,343.33,428.32,4
HCPCS,D1208,Topical app fluorid ex vrnsh,,,408.92,510.14,4
HCPCS,D1351,Dental sealant per tooth,,,261.79,326.59,4
HCPCS,D1352,"Prev resin rest, perm tooth",,,218.16,272.16,4
HCPCS,D1510,Space maintainer fxd unilat,,,599.3,2839.47,11
HCPCS,D1516,"Fixed bilat space maint, max",,,640.0,3398.9,11
HCPCS,D1517,"Fixed bilat space maint, man",,,640.0,3398.9,11
HCPCS,D1520,Remove unilat space maintain,,,640.0,2839.47,11
HCPCS,D1526,"Remove bilat space main, max",,,640.0,3398.9,11
HCPCS,D1527,"Remove bilat space main, man",,,640.0,3398.9,11
HCPCS,D1551,Recement space maint - max,,,640.0,3685.76,11
HCPCS,D1552,Recement space maint - man,,,640.0,3685.76,11
HCPCS,D1553,Recement unilat space maint,,,640.0,3685.76,11
HCPCS,D1575,"Dist space maint, fixed unil",,,640.0,2839.47,11
HCPCS,D2140,Amalgam one surface permanen,,,640.0,2839.47,11
HCPCS,D2150,Amalgam two surfaces permane,,,640.0,2839.47,7
HCPCS,D2160,Amalgam three surfaces perma,,,352.81,2839.47,11
HCPCS,D2161,Amalgam 4 or > surfaces perm,,,640.0,2839.47,7
HCPCS,D2330,Resin one surface-anterior,,,411.77,2839.47,11
HCPCS,D2331,Resin two surfaces-anterior,,,403.68,2839.47,11
HCPCS,D2332,Resin three surfaces-anterio,,,316.27,2839.47,11
HCPCS,D2335,Resin 4/> surf or w incis an,,,355.06,2839.47,11
HCPCS,D2390,Ant resin-based cmpst crown,,,409.55,2839.47,11
HCPCS,D2391,Post 1 srfc resinbased cmpst,,,414.57,2839.47,11
HCPCS,D2392,Post 2 srfc resinbased cmpst,,,424.54,2839.47,11
HCPCS,D2393,Post 3 srfc resinbased cmpst,,,385.22,2839.47,11
HCPCS,D2394,Post >=4srfc resinbase cmpst,,,268.81,2839.47,11
HCPCS,D2410,Dental gold foil one surface,,,640.0,2839.47,7
HCPCS,D2420,Dental gold foil two surface,,,640.0,2839.47,7
HCPCS,D2430,Dental gold foil three surfa,,,640.0,2839.47,7
HCPCS,D2510,Dental inlay metalic 1 surf,,,640.0,2839.47,7
HCPCS,D2520,Dental inlay metallic 2 surf,,,640.0,2839.47,7
HCPCS,D2530,Dental inlay metl 3/more sur,,,640.0,2839.47,7
HCPCS,D2542,Dental onlay metallic 2 surf,,,640.0,2839.47,7
HCPCS,D2543,Dental onlay metallic 3 surf,,,640.0,2839.47,7
HCPCS,D2544,Dental onlay metl 4/more sur,,,640.0,2839.47,7
HCPCS,D2610,Inlay porcelain/ceramic 1 su,,,640.0,2839.47,7
HCPCS,D2620,Inlay porcelain/ceramic 2 su,,,640.0,2839.47,7
HCPCS,D2630,Dental onlay porc 3/more sur,,,640.0,2839.47,7
HCPCS,D2642,Dental onlay porcelin 2 surf,,,640.0,2839.47,7
HCPCS,D2643,Dental onlay porcelin 3 surf,,,640.0,2839.47,7
HCPCS,D2644,Dental onlay porc 4/more sur,,,640.0,2839.47,7
HCPCS,D2650,Inlay composite/resin one su,,,640.0,2839.47,7
HCPCS,D2651,Inlay composite/resin two su,,,640.0,2839.47,7
HCPCS,D2652,Dental inlay resin 3/mre sur,,,640.0,2839.47,7
HCPCS,D2662,Dental onlay resin 2 surface,,,640.0,2839.47,7
HCPCS,D2663,Dental onlay resin 3 surface,,,640.0,2839.47,7
HCPCS,D2664,Dental onlay resin 4/mre sur,,,640.0,2839.47,7
HCPCS,D2710,Crown resin-based indirect,,,640.0,2839.47,7
HCPCS,D2712,Crown 3/4 resin-based compos,,,640.0,2839.47,7
HCPCS,D2720,Crown resin w/ high noble me,,,640.0,2839.47,7
HCPCS,D2721,Crown resin w/ base metal,,,640.0,2839.47,7
HCPCS,D2722,Crown resin w/ noble metal,,,640.0,2839.47,7
HCPCS,D2740,Crown porcelain/ceramic subs,,,640.0,2839.47,7
HCPCS,D2750,Crown porcelain w/ h noble m,,,640.0,2839.47,7
HCPCS,D2751,Crown porcelain fused base m,,,640.0,2839.47,7
HCPCS,D2752,Crown porcelain w/ noble met,,,640.0,2839.47,7
HCPCS,D2753,Crown porc fused to titanium,,,640.0,2839.47,7
HCPCS,D2780,Crown 3/4 cast hi noble met,,,640.0,2839.47,7
HCPCS,D2781,Crown 3/4 cast base metal,,,640.0,2839.47,7
HCPCS,D2782,Crown 3/4 cast noble metal,,,640.0,2839.47,7
HCPCS,D2783,Crown 3/4 porcelain/ceramic,,,640.0,2839.47,7
HCPCS,D2790,Crown full cast high noble m,,,640.0,2839.47,7
HCPCS,D2791,Crown full cast base metal,,,640.0,2839.47,7
HCPCS,D2792,Crown full cast noble metal,,,640.0,2839.47,7
HCPCS,D2794,Crown-titanium,,,640.0,2839.47,7
HCPCS,D2799,Provisional crown,,,640.0,2839.47,7
HCPCS,D2910,Recement inlay onlay or part,,,640.0,2839.47,7
HCPCS,D2915,Recement cast or prefab post,,,640.0,2839.47,7
HCPCS,D2920,Re-cement or re-bond crown,,,640.0,2839.47,7
HCPCS,D2921,Reattach tooth fragment,,,640.0,2839.47,7
HCPCS,D2928,Prefab porc/cer crown perm,,,640.0,2839.47,7
HCPCS,D2929,Prefab porc/ceram crown pri,,,606.52,2839.47,11
HCPCS,D2930,Prefab stnlss steel crwn pri,,,376.2,2839.47,11
HCPCS,D2931,Prefab stnlss steel crown pe,,,472.07,2839.47,11
HCPCS,D2932,Prefabricated resin crown,,,384.24,2839.47,11
HCPCS,D2933,Prefab stainless steel crown,,,640.0,2839.47,7
HCPCS,D2934,Prefab steel crown primary,,,322.69,2839.47,11
HCPCS,D2940,Protective restoration,,,640.0,2839.47,7
HCPCS,D2949,Restorative foundation,,,640.0,2839.47,7
HCPCS,D2950,Core build-up incl any pins,,,640.0,2839.47,7
HCPCS,D2951,Tooth pin retention,,,640.0,2839.47,7
HCPCS,D2952,Post and core cast + crown,,,640.0,2839.47,7
HCPCS,D2954,Prefab post/core + crown,,,640.0,2839.47,7
HCPCS,D2957,Each addtnl prefab post,,,640.0,2839.47,7
HCPCS,D2960,Laminate labial veneer,,,640.0,2839.47,7
HCPCS,D2961,Lab labial veneer resin,,,640.0,2839.47,7
HCPCS,D2962,Lab labial veneer porcelain,,,640.0,2839.47,7
HCPCS,D2971,Add proc construct new crown,,,640.0,2839.47,7
HCPCS,D2975,Coping,,,640.0,2839.47,7
HCPCS,D2980,Crown repair,,,640.0,2839.47,7
HCPCS,D2981,Inlay repair,,,640.0,2839.47,7
HCPCS,D2982,Onlay repair,,,640.0,2839.47,7
HCPCS,D2983,Veneer repair,,,640.0,2839.47,7
HCPCS,D2990,Resin infiltration of lesion,,,640.0,2839.47,7
HCPCS,D2999,Dental unspec restorative pr,,,640.0,2839.47,11
HCPCS,D3110,Pulp cap direct,,,640.0,2839.47,7
HCPCS,D3120,Pulp cap indirect,,,640.0,2839.47,7
HCPCS,D3220,Therapeutic pulpotomy,,,337.54,2839.47,11
HCPCS,D3221,Gross pulpal debridement,,,640.0,2839.47,7
HCPCS,D3222,Part pulp for apexogenesis,,,640.0,2839.47,11
HCPCS,D3230,Pulpal therapy anterior prim,,,640.0,2839.47,7
HCPCS,D3240,Pulpal therapy posterior pri,,,640.0,2839.47,7
HCPCS,D3310,"End thxpy, anterior tooth",,,247.0,2839.47,11
HCPCS,D3320,"End thxpy, bicuspid tooth",,,640.0,2839.47,7
HCPCS,D3330,"End thxpy, molar",,,339.82,2839.47,11
HCPCS,D3331,Non-surg tx root canal obs,,,640.0,2839.47,7
HCPCS,D3332,Incomplete endodontic tx,,,640.0,2839.47,7
HCPCS,D3333,Internal root repair,,,640.0,2839.47,7
HCPCS,D3346,Retreat root canal anterior,,,640.0,2839.47,7
HCPCS,D3347,Retreat root canal bicuspid,,,640.0,2839.47,7
HCPCS,D3348,Retreat root canal molar,,,640.0,2839.47,7
HCPCS,D3351,Apexification/recalc initial,,,640.0,2839.47,7
HCPCS,D3352,Apexification/recalc interim,,,640.0,2839.47,7
HCPCS,D3353,Apexification/recalc final,,,640.0,2839.47,7
HCPCS,D3355,Pulpal regeneration initial,,,640.0,2839.47,7
HCPCS,D3356,Pulpal regeneration interim,,,640.0,2839.47,7
HCPCS,D3357,Pulpal regeneration complete,,,640.0,2839.47,7
HCPCS,D3410,Apicoectomy - anterior,,,640.0,2839.47,7
HCPCS,D3421,Root surgery bicuspid,,,640.0,2839.47,7
HCPCS,D3425,Root surgery molar,,,640.0,2839.47,7
HCPCS,D3428,Bone graft peri per tooth,,,640.0,2839.47,7
HCPCS,D3430,Retrograde filling,,,640.0,2839.47,7
HCPCS,D3431,Biological materials,,,640.0,2839.47,7
HCPCS,D3432,Guided tissue regeneration,,,640.0,2839.47,7
HCPCS,D3450,Root amputation,,,640.0,2839.47,7
HCPCS,D3460,Endodontic endosseous implan,,,640.0,2839.47,11
HCPCS,D3470,Intentional replantation,,,640.0,2839.47,7
HCPCS,D3471,Surg rep root res anterior,,,640.0,2839.47,7
HCPCS,D3472,Surg rep root res premolar,,,640.0,2839.47,7
HCPCS,D3473,Surg rep root res molar,,,640.0,2839.47,7
HCPCS,D3501,Surg exp root surf anterior,,,640.0,2839.47,7
HCPCS,D3502,Surg exp root surf premolar,,,640.0,2839.47,7
HCPCS,D3503,Surg exp root surf molar,,,640.0,2839.47,7
HCPCS,D3910,Isolation- tooth w rubb dam,,,640.0,2839.47,7
HCPCS,D3911,Intraorifice barrier,,,640.0,2839.47,7
HCPCS,D3920,Tooth splitting,,,640.0,2839.47,7
HCPCS,D3921,D?cor or submerg erupt tooth,,,640.0,2839.47,7
HCPCS,D3950,Canal prep/fitting of dowel,,,640.0,2839.47,7
HCPCS,D3999,Endodontic procedure,,,640.0,2839.47,11
HCPCS,D4210,Gingivectomy/plasty 4 or mor,,,3282.2,14562.0,7
HCPCS,D4211,Gingivectomy/plasty 1 to 3,,,3282.2,14562.0,7
HCPCS,D4212,Gingivectomy/plasty rest,,,3282.2,14562.0,7
HCPCS,D4230,Ana crown exp 4 or> per quad,,,3282.2,14562.0,7
HCPCS,D4231,Ana crown exp 1-3 per quad,,,1536.02,6814.79,7
HCPCS,D4240,Gingival flap proc w/ planin,,,3282.2,14562.0,7
HCPCS,D4241,Gngvl flap w rootplan 1-3 th,,,1536.02,6814.79,7
HCPCS,D4245,Apically positioned flap,,,1536.02,6814.79,7
HCPCS,D4249,Crown lengthen hard tissue,,,640.0,2839.47,7
HCPCS,D4260,Osseous surgery 4 or more,,,1834.06,26000.79,11
HCPCS,D4261,Osseous surg 1 to 3 teeth,,,3282.2,14562.0,7
HCPCS,D4263,Bone replce graft first site,,,640.0,2839.47,11
HCPCS,D4264,Bone replce graft each add,,,1834.06,2288.03,4
HCPCS,D4265,Bio mtrls to aid soft/os reg,,,640.0,2839.47,7
HCPCS,D4266,Guided tiss regen resorble,,,1536.02,6814.79,7
HCPCS,D4267,Guided tiss regen nonresorb,,,1536.02,6814.79,7
HCPCS,D4268,Surgical revision procedure,,,640.0,2839.47,11
HCPCS,D4270,Pedicle soft tissue graft pr,,,1536.02,6814.79,11
HCPCS,D4273,Auto tissue graft 1st tooth,,,1536.02,6814.79,11
HCPCS,D4274,Mesial/distal wedge proc,,,640.0,2839.47,7
HCPCS,D4275,Non-auto graft 1st tooth,,,1536.02,6814.79,7
HCPCS,D4276,Con tissue w dble ped graft,,,1536.02,6814.79,7
HCPCS,D4277,Soft tissue graft firsttooth,,,1536.02,6814.79,7
HCPCS,D4322,Splint intra-coronal,,,640.0,2839.47,7
HCPCS,D4323,Splint extra-coronal,,,640.0,2839.47,7
HCPCS,D4341,Periodontal scaling & root,,,400.29,2839.47,11
HCPCS,D4342,Periodontal scaling 1-3teeth,,,640.0,2839.47,7
HCPCS,D4346,Scaling gingiv inflammation,,,640.0,2839.47,7
HCPCS,D4355,Full mouth debridement,,,640.0,2839.47,11
HCPCS,D4381,Localized delivery antimicro,,,640.0,2839.47,11
HCPCS,D4910,Periodontal maint procedures,,,640.0,2839.47,7
HCPCS,D4920,Unscheduled dressing change,,,640.0,2839.47,7
HCPCS,D4921,Gingival irrigation per quad,,,131.8,584.75,7
HCPCS,D4999,Unspecified periodontal proc,,,234.47,1040.28,7
HCPCS,D5911,Facial moulage sectional,,,640.0,2839.47,11
HCPCS,D5912,Facial moulage complete,,,640.0,2839.47,11
HCPCS,D5983,Radiation applicator,,,640.0,2839.47,11
HCPCS,D5984,Radiation shield,,,640.0,2839.47,11
HCPCS,D5985,Radiation cone locator,,,640.0,2839.47,11
HCPCS,D5987,Commissure splint,,,640.0,2839.47,11
HCPCS,D5988,Surgical splint,,,640.0,2839.47,7
HCPCS,D5991,Vesiculobullous disease carr,,,427.23,532.98,4
HCPCS,D6920,Dental connector bar,,,640.0,2839.47,11
HCPCS,D7111,Extraction coronal remnants,,,640.0,2839.47,11
HCPCS,D7140,Extraction erupted tooth/exr,,,411.24,2839.47,11
HCPCS,D7140,HC EXTRACTION ERUPTED TOOTH OR EXPOSED ROOT (EVELATION AND/OR FORCEPS REMOVAL),439.0,307.3,,,0
HCPCS,D7140,HC PRO EXTRACTION ERUPTED TOOTH OR EXPOSED ROOT (EVELATION AND/OR FORCEPS REMOVAL),84.0,58.8,,,0
HCPCS,D7210,Rem imp tooth w mucoper flp,,,1536.02,6814.79,11
HCPCS,D7220,Impact tooth remov soft tiss,,,640.0,2839.47,11
HCPCS,D7230,Impact tooth remov part bony,,,640.0,2839.47,11
HCPCS,D7240,Impact tooth remov comp bony,,,640.0,3799.43,11
HCPCS,D7241,Impact tooth rem bony w/comp,,,640.0,2839.47,11
HCPCS,D7250,Tooth root removal,,,640.0,2839.47,11
HCPCS,D7251,Coronectomy,,,966.57,6814.79,11
HCPCS,D7260,Oral antral fistula closure,,,640.0,2839.47,11
HCPCS,D7261,Primary closure sinus perf,,,640.0,2839.47,11
HCPCS,D7270,Tooth reimplantation,,,640.0,2839.47,7
HCPCS,D7272,Tooth transplantation,,,640.0,2839.47,7
HCPCS,D7280,Exposure of unerupted tooth,,,640.0,2839.47,7
HCPCS,D7283,Place device impacted tooth,,,1151.4,1436.4,4
HCPCS,D7288,Brush biopsy,,,415.11,517.86,4
HCPCS,D7291,Transseptal fiberotomy,,,640.0,2839.47,11
HCPCS,D7310,Alveoplasty w/ extraction,,,1536.02,6814.79,7
HCPCS,D7311,Alveoloplasty w/extract 1-3,,,1536.02,6814.79,7
HCPCS,D7320,Alveoplasty w/o extraction,,,1536.02,6814.79,7
HCPCS,D7321,Alveoloplasty not w/extracts,,,960.51,6814.79,11
HCPCS,D7340,Vestibuloplasty ridge extens,,,5860.44,26000.79,7
HCPCS,D7350,Vestibuloplasty exten graft,,,5860.44,26000.79,7
HCPCS,D7410,Rad exc lesion up to 1.25 cm,,,1536.02,6814.79,7
HCPCS,D7411,Excision benign lesion>1.25c,,,1536.02,6814.79,7
HCPCS,D7412,Excision benign lesion compl,,,1536.02,6814.79,7
HCPCS,D7413,Excision malig lesion<=1.25c,,,1536.02,6814.79,7
HCPCS,D7414,Excision malig lesion>1.25cm,,,1536.02,6814.79,7
HCPCS,D7415,Excision malig les complicat,,,1536.02,6814.79,7
HCPCS,D7440,Malig tumor exc to 1.25 cm,,,3282.2,14562.0,7
HCPCS,D7441,Malig tumor > 1.25 cm,,,3282.2,14562.0,7
HCPCS,D7450,Rem odontogen cyst to 1.25cm,,,3282.2,14562.0,7
HCPCS,D7451,Rem odontogen cyst > 1.25 cm,,,3282.2,14562.0,7
HCPCS,D7460,Rem nonodonto cyst to 1.25cm,,,640.0,2839.47,7
HCPCS,D7461,Rem nonodonto cyst > 1.25 cm,,,640.0,2839.47,7
HCPCS,D7471,Rem exostosis any site,,,3282.2,14562.0,7
HCPCS,D7472,Removal of torus palatinus,,,640.0,2839.47,7
HCPCS,D7473,Remove torus mandibularis,,,640.0,2839.47,7
HCPCS,D7485,Surg reduct osseoustuberosit,,,5860.44,26000.79,7
HCPCS,D7510,HC PRO INCISION AND DRAINAGE OF ABSCESS-INTRAORAL SOFT TISSUE,166.0,116.2,,,0
HCPCS,D7510,I&d absc intraoral soft tiss,,,701.03,3110.22,7
HCPCS,D7511,HC PRO INCISION AND DRAINAGE OF ABSCESS-INTRAORAL SOFT TISSUE COMPLICATED,250.0,175.0,,,0
HCPCS,D7511,Incision/drain abscess intra,,,701.03,3110.22,11
HCPCS,D7520,I&d abscess extraoral,,,701.03,3110.22,7
HCPCS,D7521,Incision/drain abscess extra,,,701.03,3110.22,11
HCPCS,D7530,Removal fb skin/areolar tiss,,,640.0,2839.47,7
HCPCS,D7540,Removal of fb reaction,,,640.0,2839.47,7
HCPCS,D7550,Removal of sloughed off bone,,,640.0,2839.47,7
HCPCS,D7670,Closd rductn splint alveolus,,,3282.2,14562.0,7
HCPCS,D7671,Alveolus open reduction,,,5860.44,26000.79,7
HCPCS,D7770,Open reduc compd alveolus fx,,,5860.44,26000.79,7
HCPCS,D7771,Alveolus clsd reduc stblz te,,,3282.2,14562.0,7
HCPCS,D7874,Tmj arthroscopy disc reposit,,,3239.17,14371.12,7
HCPCS,D7922,Place intra-socket bio dress,,,640.0,2839.47,7
HCPCS,D7940,Reshaping bone orthognathic,,,640.0,2839.47,11
HCPCS,D7950,Mandible graft,,,5860.44,26000.79,7
HCPCS,D9630,Drugs/meds disp for home use,,,1834.06,2288.03,4
HCPCS,D9930,Treatment of complications,,,640.0,2839.47,11
HCPCS,D9944,"Occ guard, hard, full arch",,,640.0,3398.9,11
HCPCS,D9945,"Occ guard, soft, full arch",,,640.0,3398.9,11
HCPCS,D9946,"Occ guard, hard, part arch",,,640.0,3398.9,11
HCPCS,D9950,Occlusion analysis,,,640.0,2839.47,11
HCPCS,D9951,Limited occlusal adjustment,,,640.0,2839.47,11
HCPCS,D9952,Complete occlusal adjustment,,,640.0,2839.47,11
HCPCS,E0100,Cane adjust/fixed with tip,,,16.06,83.61,12
HCPCS,E0105,Cane adjust/fixed quad/3 pro,,,23.97,194.93,12
HCPCS,E0110,Crutch forearm pair,,,43.24,307.96,12
HCPCS,E0111,Crutch forearm each,,,22.79,211.38,12
HCPCS,E0112,Crutch underarm pair wood,,,26.88,124.82,12
HCPCS,E0113,Crutch underarm each wood,,,13.94,83.88,12
HCPCS,E0114,Crutch underarm pair no wood,,,23.18,159.21,12
HCPCS,E0116,Crutch underarm each no wood,,,14.6,110.11,12
HCPCS,E0117,Underarm springassist crutch,,,61.27,764.88,12
HCPCS,E0130,Walker rigid adjust/fixed ht,,,39.21,240.26,12
HCPCS,E0135,Walker folding adjust/fixed,,,40.24,286.83,12
HCPCS,E0140,Walker w trunk support,,,98.93,1233.94,12
HCPCS,E0141,Rigid wheeled walker adj/fix,,,52.12,384.73,12
HCPCS,E0143,Walker folding wheeled w/o s,,,50.33,411.19,12
HCPCS,E0144,Enclosed walker w rear seat,,,87.35,1089.4,12
HCPCS,E0147,Walker variable wheel resist,,,157.62,1966.36,12
HCPCS,E0148,Heavyduty walker no wheels,,,34.88,434.62,12
HCPCS,E0149,Heavy duty wheeled walker,,,61.21,763.56,12
HCPCS,E0153,Forearm crutch platform atta,,,21.21,245.06,12
HCPCS,E0154,Walker platform attachment,,,23.48,241.2,12
HCPCS,E0155,"Walker wheel attachment,pair",,,9.39,107.96,12
HCPCS,E0156,Walker seat attachment,,,8.18,90.42,12
HCPCS,E0157,Walker crutch attachment,,,24.66,280.25,12
HCPCS,E0158,Walker leg extenders set of4,,,9.61,110.07,12
HCPCS,E0159,Brake for wheeled walker,,,5.06,61.12,12
HCPCS,E0160,Sitz type bath or equipment,,,11.73,111.51,12
HCPCS,E0161,Sitz bath/equipment w/faucet,,,9.67,88.49,12
HCPCS,E0162,Sitz bath chair,,,41.33,491.55,12
HCPCS,E0163,Commode chair with fixed arm,,,66.05,437.72,12
HCPCS,E0165,Commode chair with detacharm,,,50.24,657.87,8
HCPCS,E0167,Commode chair pail or pan,,,4.0,47.63,12
HCPCS,E0168,Heavyduty/wide commode chair,,,48.27,599.02,12
HCPCS,E0170,Commode chair electric,,,511.34,6698.08,8
HCPCS,E0171,Commode chair non-electric,,,92.02,1205.4,8
HCPCS,E0175,Commode chair foot rest,,,21.06,262.86,12
HCPCS,E0181,Press pad alternating w/ pum,,,82.9,1085.92,8
HCPCS,E0182,"Replace pump, alt press pad",,,79.9,1046.64,8
HCPCS,E0184,Dry pressure mattress,,,66.45,656.85,12
HCPCS,E0185,Gel pressure mattress pad,,,136.74,1269.51,12
HCPCS,E0186,Air pressure mattress,,,54.9,719.18,8
HCPCS,E0187,Water pressure mattress,,,62.75,821.96,8
HCPCS,E0188,Synthetic sheepskin pad,,,8.39,89.17,12
HCPCS,E0189,Lambswool sheepskin pad,,,17.91,206.24,12
HCPCS,E0191,Protector heel or elbow,,,3.24,39.65,12
HCPCS,E0193,Powered air flotation bed,,,2191.24,28703.01,8
HCPCS,E0194,Air fluidized bed,,,8800.64,115279.61,8
HCPCS,E0196,Gel pressure mattress,,,93.6,1226.01,8
HCPCS,E0197,Air pressure pad for mattres,,,82.69,747.53,12
HCPCS,E0198,Water pressure pad for mattr,,,62.08,747.53,12
HCPCS,E0199,Dry pressure pad for mattres,,,9.64,119.52,12
HCPCS,E0200,Heat lamp without stand,,,29.12,299.68,12
HCPCS,E0202,Phototherapy light w/ photom,,,199.19,2609.22,8
HCPCS,E0205,Heat lamp with stand,,,67.9,770.21,12
HCPCS,E0210,Electric heat pad standard,,,8.3,110.11,12
HCPCS,E0215,Electric heat pad moist,,,20.03,238.97,12
HCPCS,E0217,Water circ heat pad w pump,,,157.92,1970.48,12
HCPCS,E0225,Hydrocollator unit,,,121.9,1542.54,12
HCPCS,E0235,Paraffin bath unit portable,,,46.66,611.23,8
HCPCS,E0236,Pump for water circulating p,,,131.56,1723.34,8
HCPCS,E0239,Hydrocollator unit portable,,,121.96,1521.26,12
HCPCS,E0249,Pad water circulating heat u,,,29.63,336.0,12
HCPCS,E0275,Bed pan standard,,,5.09,60.78,12
HCPCS,E0276,Bed pan fracture,,,5.0,52.81,12
HCPCS,E0277,Powered pres-redu air mattrs,,,1840.69,24111.26,8
HCPCS,E0280,Bed cradle,,,9.57,111.06,12
HCPCS,E0291,Hosp bed fx ht w/o rail w/o,,,126.56,1657.87,8
HCPCS,E0293,Hosp bed var ht no sr no mat,,,195.1,2555.62,8
HCPCS,E0295,Hosp bed semi-elect w/o matt,,,298.0,3903.49,8
HCPCS,E0297,Hosp bed total elect w/o mat,,,385.75,5052.92,8
HCPCS,E0300,Enclosed ped crib hosp grade,,,778.38,9710.63,12
HCPCS,E0301,"HD hosp bed, 350-600 lbs",,,643.63,8430.95,8
HCPCS,E0302,Ex hd hosp bed > 600 lbs,,,1961.83,25698.07,8
HCPCS,E0316,Bed safety enclosure,,,522.31,6841.76,8
HCPCS,E0325,Urinal male jug-type,,,4.09,40.14,12
HCPCS,E0326,Urinal female jug-type,,,3.21,35.46,12
HCPCS,E0371,Nonpower mattress overlay,,,1077.38,14112.59,8
HCPCS,E0372,Powered air mattress overlay,,,1307.32,17124.65,8
HCPCS,E0373,Nonpowered pressure mattress,,,1497.61,19617.18,8
HCPCS,E0424,Stationary compressed gas 02,,,532.64,664.49,4
HCPCS,E0431,Portable gaseous 02,,,9.09,108.75,8
HCPCS,E0434,Portable liquid 02,,,87.17,108.75,4
HCPCS,E0439,Stationary liquid 02,,,532.64,664.49,4
HCPCS,E0441,"Stationary o2 contents, gas",,,234.67,292.76,4
HCPCS,E0442,"Stationary o2 contents, liq",,,234.67,292.76,4
HCPCS,E0443,"Portable 02 contents, gas",,,234.67,292.76,4
HCPCS,E0444,"Portable 02 contents, liquid",,,234.67,292.76,4
HCPCS,E0447,"Port o2 cont, liq over 4 lpm",,,211.25,263.54,4
HCPCS,E0457,Chest shell,,,195.5,2439.01,12
HCPCS,E0459,Chest wrap,,,137.62,1802.72,8
HCPCS,E0462,Rocking bed w/ or w/o side r,,,927.09,12143.97,8
HCPCS,E0470,RAD w/o backup non-inv intfc,,,676.45,8860.81,8
HCPCS,E0471,RAD w/backup non inv intrfc,,,1496.79,19606.44,8
HCPCS,E0472,RAD w backup invasive intrfc,,,1496.79,19606.44,8
HCPCS,E0480,Percussor elect/pneum home m,,,139.8,1831.3,8
HCPCS,E0482,Cough stimulating device,,,1209.39,15841.87,8
HCPCS,E0483,Chest compression gen system,,,3382.36,44305.57,8
HCPCS,E0484,Non-elec oscillatory pep dvc,,,11.73,146.55,12
HCPCS,E0500,Ippb all types,,,349.24,435.68,4
HCPCS,E0550,Humidif extens supple w ippb,,,135.56,1775.73,8
HCPCS,E0560,Humidifier supplemental w/ i,,,51.12,586.77,12
HCPCS,E0561,Humidifier nonheated w PAP,,,29.3,366.06,12
HCPCS,E0562,Humidifier heated used w PAP,,,82.57,1030.43,12
HCPCS,E0565,Compressor air power source,,,194.1,2542.54,8
HCPCS,E0570,Nebulizer with compression,,,51.27,671.55,8
HCPCS,E0572,Aerosol compressor adjust pr,,,107.66,1410.17,8
HCPCS,E0574,Ultrasonic generator w svneb,,,113.9,1491.97,8
HCPCS,E0575,Nebulizer ultrasonic,,,312.24,389.53,4
HCPCS,E0580,Nebulizer for use w/ regulat,,,36.75,458.55,12
HCPCS,E0585,Nebulizer w/ compressor & he,,,96.54,1264.52,8
HCPCS,E0600,Suction pump portab hom modl,,,138.96,1820.18,8
HCPCS,E0601,Cont airway pressure device,,,306.33,4012.66,8
HCPCS,E0602,Manual breast pump,,,9.42,117.18,12
HCPCS,E0605,Vaporizer room type,,,8.3,89.17,12
HCPCS,E0606,Drainage board postural,,,72.72,952.56,8
HCPCS,E0607,Blood glucose monitor home,,,21.24,265.2,12
HCPCS,E0610,Pacemaker monitr audible/vis,,,67.84,829.94,12
HCPCS,E0615,Pacemaker monitr digital/vis,,,158.23,1615.38,12
HCPCS,E0617,Automatic ext defibrillator,,,967.33,12671.05,8
HCPCS,E0618,Apnea monitor,,,891.94,11683.53,8
HCPCS,E0620,Cap bld skin piercing laser,,,278.15,3470.46,12
HCPCS,E0621,Patient lift sling or seat,,,29.42,380.99,12
HCPCS,E0627,"Seat lift mech, electric any",,,105.23,1312.61,12
HCPCS,E0629,"Seat lift mech, non-electric",,,105.23,1312.61,12
HCPCS,E0630,Patient lift hydraulic,,,295.88,3875.75,8
HCPCS,E0635,Patient lift electric,,,389.29,5099.37,8
HCPCS,E0636,PT support & positioning sys,,,3355.09,43948.36,8
HCPCS,E0650,Pneuma compresor non-segment,,,282.73,2858.55,12
HCPCS,E0651,Pneum compressor segmental,,,293.21,3645.21,12
HCPCS,E0652,Pneum compres w/cal pressure,,,1666.95,21041.45,12
HCPCS,E0655,Pneumatic appliance half arm,,,40.33,428.35,12
HCPCS,E0660,Pneumatic appliance full leg,,,50.39,627.9,12
HCPCS,E0665,Pneumatic appliance full arm,,,44.75,543.72,12
HCPCS,E0666,Pneumatic appliance half leg,,,45.27,548.02,12
HCPCS,E0667,Seg pneumatic appl full leg,,,107.96,1285.05,12
HCPCS,E0668,Seg pneumatic appl full arm,,,138.74,1753.81,12
HCPCS,E0669,Seg pneumatic appli half leg,,,58.36,727.57,12
HCPCS,E0671,Pressure pneum appl full leg,,,132.17,1648.53,12
HCPCS,E0672,Pressure pneum appl full arm,,,102.69,1280.93,12
HCPCS,E0673,Pressure pneum appl half leg,,,85.32,1064.37,12
HCPCS,E0675,Pneumatic compression device,,,1223.45,16026.03,8
HCPCS,E0691,Uvl pnl 2 sq ft or less,,,285.88,3566.51,12
HCPCS,E0692,Uvl sys panel 4 ft,,,358.96,4478.51,12
HCPCS,E0693,Uvl sys panel 6 ft,,,442.56,5520.8,12
HCPCS,E0694,Uvl md cabinet sys 6 ft,,,1408.56,17572.12,12
HCPCS,E0705,Transfer device,,,17.85,218.79,12
HCPCS,E0720,Tens two lead,,,1169.46,1458.93,4
HCPCS,E0730,Tens four lead,,,1178.94,1470.76,4
HCPCS,E0731,Conductive garment for tens/,,,1134.8,1415.69,4
HCPCS,E0740,Non-implant pelv flr e-stim,,,166.35,2075.26,12
HCPCS,E0744,Neuromuscular stim for scoli,,,287.37,3764.2,8
HCPCS,E0745,Neuromuscular stim for shock,,,262.55,3439.16,8
HCPCS,E0762,Trans elec jt stim dev sys,,,349.84,4364.16,12
HCPCS,E0765,Nerve stimulator for tx n&v,,,26.82,333.93,12
HCPCS,E0776,Iv pole,,,50.42,556.49,12
HCPCS,E0779,Amb infusion pump mechanical,,,47.27,619.16,8
HCPCS,E0780,Mech amb infusion pump <8hrs,,,33.0,41.16,4
HCPCS,E0781,External ambulatory infus pu,,,744.9,9757.39,8
HCPCS,E0784,Ext amb infusn pump insulin,,,1328.5,17402.1,8
HCPCS,E0791,Parenteral infusion pump sta,,,1005.99,13177.5,8
HCPCS,E0840,Tract frame attach headboard,,,44.15,270.5,12
HCPCS,E0849,Cervical pneum trac equip,,,163.95,2045.28,12
HCPCS,E0850,Traction stand free standing,,,39.03,354.41,12
HCPCS,E0855,Cervical traction equipment,,,159.89,1994.93,12
HCPCS,E0856,Cervic collar w air bladders,,,49.06,611.34,12
HCPCS,E0860,Tract equip cervical tract,,,17.6,152.94,12
HCPCS,E0870,Tract frame attach footboard,,,42.63,461.65,12
HCPCS,E0880,Trac stand free stand extrem,,,53.33,423.55,12
HCPCS,E0890,Traction frame attach pelvic,,,88.78,477.91,12
HCPCS,E0900,Trac stand free stand pelvic,,,74.69,508.52,12
HCPCS,E0910,Trapeze bar attached to bed,,,46.63,610.85,8
HCPCS,E0911,Hd trapeze bar attach to bed,,,136.68,1790.43,8
HCPCS,E0912,Hd trapeze bar free standing,,,313.91,4111.88,8
HCPCS,E0920,Fracture frame attached to b,,,124.78,1634.43,8
HCPCS,E0930,Fracture frame free standing,,,127.87,1674.92,8
HCPCS,E0935,Cont pas motion exercise dev,,,61.48,76.7,4
HCPCS,E0940,Trapeze bar free standing,,,81.23,1064.07,8
HCPCS,E0941,Gravity assisted traction de,,,138.11,1809.07,8
HCPCS,E0942,Cervical head harness/halter,,,6.33,66.94,12
HCPCS,E0944,Pelvic belt/harness/boot,,,12.45,154.75,12
HCPCS,E0945,Belt/harness extremity,,,12.0,149.54,12
HCPCS,E0946,Fracture frame dual w cross,,,159.98,2095.63,8
HCPCS,E0947,Fracture frame attachmnts pe,,,200.07,2407.03,12
HCPCS,E0948,Fracture frame attachmnts ce,,,174.1,2171.87,12
HCPCS,E0950,Tray,,,28.54,355.58,12
HCPCS,E0951,Loop heel,,,5.36,64.94,12
HCPCS,E0952,"Toe loop/holder, each",,,5.36,64.41,12
HCPCS,E0955,Cushioned headrest,,,55.48,691.63,12
HCPCS,E0956,W/c lateral trunk/hip suppor,,,27.06,337.21,12
HCPCS,E0957,W/c medial thigh support,,,37.81,471.86,12
HCPCS,E0958,Whlchr att- conv 1 arm drive,,,125.81,1647.93,8
HCPCS,E0959,Amputee adapter,,,14.15,175.47,12
HCPCS,E0960,W/c shoulder harness/straps,,,24.97,311.25,12
HCPCS,E0961,Wheelchair brake extension,,,8.39,100.36,12
HCPCS,E0966,Wheelchair head rest extensi,,,22.39,283.27,12
HCPCS,E0967,Man wc rim/projection rep ea,,,20.91,260.71,12
HCPCS,E0968,Wheelchair commode seat,,,56.24,736.65,8
HCPCS,E0969,Wheelchair narrowing device,,,49.36,621.66,12
HCPCS,E0971,Wheelchair anti-tipping devi,,,13.82,172.22,12
HCPCS,E0973,W/ch access det adj armrest,,,25.51,334.3,12
HCPCS,E0974,W/ch access anti-rollback,,,26.45,311.21,12
HCPCS,E0978,"W/c acc,saf belt pelv strap",,,9.97,124.14,12
HCPCS,E0980,Wheelchair safety vest,,,10.3,128.63,12
HCPCS,E0981,"Seat upholstery, replacement",,,11.18,137.1,12
HCPCS,E0982,"Back upholstery, replacement",,,12.0,149.84,12
HCPCS,E0983,Add pwr joystick,,,700.99,9182.3,8
HCPCS,E0984,Add pwr tiller,,,565.0,7583.1,12
HCPCS,E0985,W/c seat lift mechanism,,,64.6,805.1,12
HCPCS,E0986,Man w/c push-rim powr system,,,1547.57,19306.16,12
HCPCS,E0988,Lever-activated wheel drive,,,982.05,15926.77,8
HCPCS,E0990,Wheelchair elevating leg res,,,31.91,398.37,12
HCPCS,E0992,Wheelchair solid seat insert,,,29.0,361.48,12
HCPCS,E0994,Wheelchair arm rest,,,5.67,69.97,12
HCPCS,E0995,"Wc calf rest, pad replacemnt",,,8.36,103.99,12
HCPCS,E1002,Pwr seat tilt,,,1111.43,13865.64,12
HCPCS,E1003,Pwr seat recline,,,1204.18,15022.21,12
HCPCS,E1004,Pwr seat recline mech,,,1335.14,16656.53,12
HCPCS,E1005,Pwr seat recline pwr,,,1445.19,18029.39,12
HCPCS,E1006,Pwr seat combo w/o shear,,,1770.19,22084.31,12
HCPCS,E1007,Pwr seat combo w/shear,,,2397.0,29903.01,12
HCPCS,E1008,Pwr seat combo pwr shear,,,2397.18,29905.7,12
HCPCS,E1010,Add pwr leg elevation,,,313.64,3912.79,12
HCPCS,E1014,Reclining back add ped w/c,,,116.2,1449.25,12
HCPCS,E1015,Shock absorber for man w/c,,,36.45,455.26,12
HCPCS,E1016,Shock absorber for power w/c,,,36.03,449.22,12
HCPCS,E1020,Residual limb support system,,,66.69,832.7,12
HCPCS,E1028,W/c manual swingaway,,,56.63,706.56,12
HCPCS,E1029,W/c vent tray fixed,,,101.32,1264.15,12
HCPCS,E1030,W/c vent tray gimbaled,,,319.54,3986.27,12
HCPCS,E1031,Rollabout chair with casters,,,136.59,1789.23,8
HCPCS,E1035,Patient transfer system <300,,,1950.9,25554.8,8
HCPCS,E1037,"Transport chair, ped size",,,345.15,4521.11,8
HCPCS,E1038,Transport chair pt wt<=300lb,,,57.36,751.35,8
HCPCS,E1039,Transport chair pt wt >300lb,,,108.81,1425.25,8
HCPCS,E1050,Whelchr fxd full length arms,,,324.0,4244.07,8
HCPCS,E1060,Wheelchair detachable arms,,,401.08,5253.75,8
HCPCS,E1070,Wheelchair detachable foot r,,,348.48,4564.77,8
HCPCS,E1083,Hemi-wheelchair fixed arms,,,250.52,3281.57,8
HCPCS,E1084,Hemi-wheelchair detachable a,,,312.12,4088.49,8
HCPCS,E1087,Wheelchair lightwt fixed arm,,,402.51,5272.42,8
HCPCS,E1088,Wheelchair lightweight det a,,,479.68,6283.31,8
HCPCS,E1092,Wheelchair wide w/ leg rests,,,408.87,5355.77,8
HCPCS,E1093,Wheelchair wide w/ foot rest,,,351.63,4606.04,8
HCPCS,E1100,Whchr s-recl fxd arm leg res,,,330.27,4326.21,8
HCPCS,E1110,Wheelchair semi-recl detach,,,323.42,4236.51,8
HCPCS,E1150,Wheelchair standard w/ leg r,,,235.31,3082.33,8
HCPCS,E1160,Wheelchair fixed arms,,,183.86,2408.39,8
HCPCS,E1161,Manual adult wc w tiltinspac,,,752.77,9390.99,12
HCPCS,E1170,Whlchr ampu fxd arm leg rest,,,284.15,3722.13,8
HCPCS,E1171,Wheelchair amputee w/o leg r,,,255.0,3340.31,8
HCPCS,E1172,Wheelchair amputee detach ar,,,311.64,4082.1,8
HCPCS,E1180,Wheelchair amputee w/ foot r,,,322.42,4223.43,8
HCPCS,E1190,Wheelchair amputee w/ leg re,,,372.45,4878.69,8
HCPCS,E1195,Wheelchair amputee heavy dut,,,399.69,5235.53,8
HCPCS,E1200,Wheelchair amputee fixed arm,,,276.82,3626.08,8
HCPCS,E1221,Wheelchair spec size w foot,,,128.5,1683.23,8
HCPCS,E1222,Wheelchair spec size w/ leg,,,183.32,2401.25,8
HCPCS,E1223,Wheelchair spec size w foot,,,200.16,2621.92,8
HCPCS,E1224,Wheelchair spec size w/ leg,,,235.25,3081.53,8
HCPCS,E1225,Manual semi-reclining back,,,136.17,1783.67,8
HCPCS,E1226,Manual fully reclining back,,,178.68,2165.68,12
HCPCS,E1227,Wheelchair spec sz spec ht a,,,88.29,1101.42,12
HCPCS,E1228,Wheelchair spec sz spec ht b,,,75.78,992.67,8
HCPCS,E1230,Power operated vehicle,,,707.72,8829.4,12
HCPCS,E1232,Folding ped wc tilt-in-space,,,680.36,8487.35,12
HCPCS,E1233,Rig ped wc tltnspc w/o seat,,,704.93,8794.25,12
HCPCS,E1234,Fld ped wc tltnspc w/o seat,,,613.76,7656.01,12
HCPCS,E1235,Rigid ped wc adjustable,,,590.97,7372.13,12
HCPCS,E1236,Folding ped wc adjustable,,,521.34,6504.13,12
HCPCS,E1237,Rgd ped wc adjstabl w/o seat,,,525.92,6560.95,12
HCPCS,E1238,Fld ped wc adjstabl w/o seat,,,521.34,6504.13,12
HCPCS,E1240,Whchr litwt det arm leg rest,,,327.76,4293.25,8
HCPCS,E1270,Wheelchair lightweight leg r,,,251.16,3289.89,8
HCPCS,E1280,Whchr h-duty det arm leg res,,,417.59,5470.08,8
HCPCS,E1295,Wheelchair heavy duty fixed,,,386.45,5062.06,8
HCPCS,E1296,Wheelchair special seat heig,,,158.89,1951.43,12
HCPCS,E1297,Wheelchair special seat dept,,,31.42,352.9,12
HCPCS,E1298,Wheelchair spec seat depth/w,,,137.93,1681.46,12
HCPCS,E1310,Whirlpool non-portable,,,576.25,7244.56,12
HCPCS,E1353,Oxygen supplies regulator,,,90.14,112.46,4
HCPCS,E1355,Oxygen supplies stand/rack,,,67.87,84.67,4
HCPCS,E1372,Oxy suppl heater for nebuliz,,,64.05,588.24,12
HCPCS,E1390,Oxygen concentrator,,,532.64,664.49,4
HCPCS,E1391,"Oxygen concentrator, dual",,,532.64,664.49,4
HCPCS,E1392,Portable oxygen concentrator,,,156.44,195.16,4
HCPCS,E1405,O2/water vapor enrich w/heat,,,629.18,784.92,4
HCPCS,E1406,O2/water vapor enrich w/o he,,,583.91,728.44,4
HCPCS,E1700,Jaw motion rehab system,,,107.6,1368.66,12
HCPCS,E1701,Repl cushions for jaw motion,,,33.75,42.11,4
HCPCS,E1702,Repl measr scales jaw motion,,,68.11,84.97,4
HCPCS,E1800,Adjust elbow ext/flex device,,,331.3,4339.7,8
HCPCS,E1801,Sps elbow device,,,362.87,4753.27,8
HCPCS,E1802,Adjst forearm pro/sup device,,,1039.71,13619.23,8
HCPCS,E1805,Adjust wrist ext/flex device,,,341.66,4475.44,8
HCPCS,E1806,Sps wrist device,,,297.85,3901.53,8
HCPCS,E1810,Adjust knee ext/flex device,,,336.91,4413.15,8
HCPCS,E1811,Sps knee device,,,377.24,4941.41,8
HCPCS,E1812,Knee ext/flex w act res ctrl,,,273.58,3583.63,8
HCPCS,E1815,Adjust ankle ext/flex device,,,341.66,4475.44,8
HCPCS,E1816,Sps ankle device,,,383.2,5019.61,8
HCPCS,E1818,Sps forearm device,,,391.14,5123.56,8
HCPCS,E1820,Soft interface material,,,26.0,324.44,12
HCPCS,E1821,Replacement interface spsd,,,33.45,417.73,12
HCPCS,E1825,Adjust finger ext/flex devc,,,341.66,4475.44,8
HCPCS,E1830,Adjust toe ext/flex device,,,341.66,4475.44,8
HCPCS,E1840,Adj shoulder ext/flex device,,,1057.68,13854.61,8
HCPCS,E1841,Static str shldr dev rom adj,,,1441.22,18878.53,8
HCPCS,E1905,Vr cbt therapy,,,674.77,1180.85,6
HCPCS,E2000,Gastric suction pump hme mdl,,,145.71,1908.71,8
HCPCS,E2100,Bld glucose monitor w voice,,,204.65,2552.82,12
HCPCS,E2101,Bld glucose monitor w lance,,,59.99,748.4,12
HCPCS,E2120,Pulse gen sys tx endolymp fl,,,902.03,11815.71,8
HCPCS,E2201,"Man w/ch acc seat w>=20""<24""",,,118.72,1480.85,12
HCPCS,E2202,Seat width 24-27 in,,,150.8,1881.23,12
HCPCS,E2203,Frame depth less than 22 in,,,152.35,1901.34,12
HCPCS,E2204,Frame depth 22 to 25 in,,,258.82,3228.38,12
HCPCS,E2205,"Manual wc accessory, handrim",,,10.33,129.65,12
HCPCS,E2206,Man wc whl lock comp repl ea,,,12.91,161.44,12
HCPCS,E2207,Crutch and cane holder,,,13.82,172.07,12
HCPCS,E2208,Cylinder tank carrier,,,32.54,406.35,12
HCPCS,E2209,Arm trough each,,,29.45,366.58,12
HCPCS,E2210,Wheelchair bearings,,,1.82,22.42,12
HCPCS,E2211,Pneumatic propulsion tire,,,12.76,162.39,12
HCPCS,E2212,Pneumatic prop tire tube,,,1.94,23.32,12
HCPCS,E2213,Pneumatic prop tire insert,,,9.7,120.7,12
HCPCS,E2214,Pneumatic caster tire each,,,12.6,142.88,12
HCPCS,E2215,Pneumatic caster tire tube,,,3.03,38.1,12
HCPCS,E2219,Foam caster tire any size ea,,,12.79,141.18,12
HCPCS,E2220,"Solid propuls tire, repl, ea",,,8.76,113.21,12
HCPCS,E2221,"Solid caster tire repl, each",,,8.21,101.42,12
HCPCS,E2222,"Solid caster integ whl, repl",,,6.64,83.58,12
HCPCS,E2224,Propulsion whl excl tire rep,,,31.27,389.19,12
HCPCS,E2225,Caster wheel excludes tire,,,5.54,69.06,12
HCPCS,E2226,Caster fork replacement only,,,12.06,150.6,12
HCPCS,E2227,Gear reduction drive wheel,,,499.28,6227.89,12
HCPCS,E2228,"Mwc acc, wheelchair brake",,,297.85,3716.0,12
HCPCS,E2231,Solid seat support base,,,48.9,609.94,12
HCPCS,E2310,Electro connect btw control,,,320.88,4003.28,12
HCPCS,E2311,Electro connect btw 2 sys,,,649.69,8104.81,12
HCPCS,E2312,Mini-prop remote joystick,,,641.6,8004.34,12
HCPCS,E2313,"PWC harness, expand control",,,101.9,1271.1,12
HCPCS,E2321,Hand interface joystick,,,435.77,5436.17,12
HCPCS,E2322,Mult mech switches,,,386.72,4824.72,12
HCPCS,E2323,Special joystick handle,,,18.97,236.59,12
HCPCS,E2324,Chin cup interface,,,11.97,149.91,12
HCPCS,E2325,Sip and puff interface,,,369.36,4607.37,12
HCPCS,E2326,Breath tube kit,,,95.23,1187.52,12
HCPCS,E2327,Head control interface mech,,,716.35,8936.68,12
HCPCS,E2328,Head/extremity control inter,,,1358.8,16951.64,12
HCPCS,E2329,Head control nonproportional,,,484.28,6041.76,12
HCPCS,E2330,Head control proximity switc,,,938.36,11706.62,12
HCPCS,E2340,W/c wdth 20-23 in seat frame,,,114.05,1422.34,12
HCPCS,E2341,W/c wdth 24-27 in seat frame,,,171.04,2133.66,12
HCPCS,E2342,W/c dpth 20-21 in seat frame,,,142.53,1778.04,12
HCPCS,E2343,W/c dpth 22-25 in seat frame,,,228.01,2844.9,12
HCPCS,E2351,Electronic SGD interface,,,191.62,2389.94,12
HCPCS,E2359,Gr34 sealed leadacid battery,,,57.15,712.68,8
HCPCS,E2360,22nf nonsealed leadacid,,,35.91,445.89,12
HCPCS,E2361,22nf sealed leadacid battery,,,38.24,477.11,12
HCPCS,E2362,Gr24 nonsealed leadacid,,,29.27,365.07,12
HCPCS,E2363,Gr24 sealed leadacid battery,,,51.03,636.29,12
HCPCS,E2364,U1nonsealed leadacid battery,,,35.91,445.89,12
HCPCS,E2365,U1 sealed leadacid battery,,,30.75,383.71,12
HCPCS,E2366,"Battery charger, single mode",,,61.6,766.55,12
HCPCS,E2367,"Battery charger, dual mode",,,114.93,1433.64,12
HCPCS,E2368,Pwr wc drivewheel motor repl,,,141.68,1767.15,12
HCPCS,E2369,Pwr wc drivewheel gear repl,,,123.41,1539.22,12
HCPCS,E2370,Pwr wc dr wh motor/gear comb,,,220.16,2746.43,12
HCPCS,E2371,Gr27 sealed leadacid battery,,,41.36,515.67,12
HCPCS,E2373,Hand/chin ctrl spec joystick,,,223.61,2790.13,12
HCPCS,E2374,Hand/chin ctrl std joystick,,,146.44,1826.84,12
HCPCS,E2375,Non-expandable controller,,,234.86,2930.22,12
HCPCS,E2376,"Expandable controller, repl",,,368.08,4591.76,12
HCPCS,E2377,"Expandable controller, initl",,,133.17,1661.57,12
HCPCS,E2381,Pneum drive wheel tire,,,20.94,260.59,12
HCPCS,E2382,"Tube, pneum wheel drive tire",,,5.67,71.06,12
HCPCS,E2383,"Insert, pneum wheel drive",,,41.66,519.56,12
HCPCS,E2384,Pneumatic caster tire,,,22.24,276.77,12
HCPCS,E2385,"Tube, pneumatic caster tire",,,13.6,169.34,12
HCPCS,E2386,Foam filled drive wheel tire,,,41.27,514.87,12
HCPCS,E2387,Foam filled caster tire,,,18.51,230.88,12
HCPCS,E2388,Foam drive wheel tire,,,13.82,172.37,12
HCPCS,E2389,Foam caster tire,,,7.51,93.59,12
HCPCS,E2390,Solid drive wheel tire,,,11.73,146.36,12
HCPCS,E2391,Solid caster tire,,,5.64,70.12,12
HCPCS,E2392,"Solid caster tire, integrate",,,14.82,184.31,12
HCPCS,E2394,Drive wheel excludes tire,,,21.09,262.56,12
HCPCS,E2395,Caster wheel excludes tire,,,14.97,186.62,12
HCPCS,E2396,Caster fork,,,16.6,193.38,12
HCPCS,E2397,"Pwc acc, lith-based battery",,,131.74,1643.7,12
HCPCS,E2402,Neg press wound therapy pump,,,4706.8,61654.45,8
HCPCS,E2500,SGD digitized pre-rec <=8min,,,124.44,1552.11,12
HCPCS,E2502,SGD prerec msg >8min <=20min,,,380.48,4746.13,12
HCPCS,E2504,SGD prerec msg>20min <=40min,,,501.92,6260.78,12
HCPCS,E2506,SGD prerec msg > 40 min,,,735.84,9180.15,12
HCPCS,E2508,SGD spelling phys contact,,,1137.92,14195.56,12
HCPCS,E2510,SGD w multi methods msg/accs,,,2153.3,26863.17,12
HCPCS,E2601,Gen w/c cushion wdth < 22 in,,,16.82,209.22,12
HCPCS,E2602,Gen w/c cushion wdth >=22 in,,,32.75,408.47,12
HCPCS,E2603,Skin protect wc cus wd <22in,,,41.6,518.58,12
HCPCS,E2604,Skin protect wc cus wd>=22in,,,51.63,644.53,12
HCPCS,E2605,Position wc cush wdth <22 in,,,73.84,920.81,12
HCPCS,E2606,Position wc cush wdth>=22 in,,,115.2,1436.55,12
HCPCS,E2607,Skin pro/pos wc cus wd <22in,,,79.51,991.53,12
HCPCS,E2608,Skin pro/pos wc cus wd>=22in,,,95.41,1190.78,12
HCPCS,E2611,Gen use back cush wdth <22in,,,85.63,1068.53,12
HCPCS,E2612,Gen use back cush wdth>=22in,,,115.87,1445.47,12
HCPCS,E2613,Position back cush wd <22in,,,107.81,1344.55,12
HCPCS,E2614,Position back cush wd>=22in,,,149.17,1860.74,12
HCPCS,E2615,Pos back post/lat wdth <22in,,,124.05,1547.34,12
HCPCS,E2616,Pos back post/lat wdth>=22in,,,166.89,2081.87,12
HCPCS,E2619,Replace cover w/c seat cush,,,14.06,175.54,12
HCPCS,E2620,WC planar back cush wd <22in,,,150.2,1873.63,12
HCPCS,E2621,WC planar back cush wd>=22in,,,157.59,1966.2,12
HCPCS,E2626,Seo mobile arm sup att to wc,,,198.56,2476.28,8
HCPCS,E2627,Arm supp att to wc rancho ty,,,325.24,4056.32,8
HCPCS,E2628,Mobile arm supports reclinin,,,212.43,2650.35,8
HCPCS,E2629,Friction dampening arm supp,,,287.21,3583.33,8
HCPCS,E2630,Monosuspension arm/hand supp,,,216.77,2704.21,8
HCPCS,E2631,Elevat proximal arm support,,,74.36,927.27,8
HCPCS,E2632,Offset/lat rocker arm w/ela,,,46.84,584.65,8
HCPCS,E2633,Mobile arm support supinator,,,45.78,570.63,8
HCPCS,FAMNOCHARGE,DEXAMETHASONE 4 MG ORAL TAB,18.0,12.6,,,0
HCPCS,FAMNOCHARGE,DEXTROSE 5% IN NORMAL SALINE IV,39.0,27.3,,,0
HCPCS,FAMNOCHARGE,HYDROXYZINE 25 MG TAB,9.0,6.300000000000001,,,0
HCPCS,FAMNOCHARGE,ONDANSETRON HCL 4 MG/5 ML ORAL SOLN,117.0,81.9,,,0
HCPCS,FAMNOCHARGE,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (5 ML) ORAL SOLN,30.0,21.0,,,0
HCPCS,FAMNOCHARGE,PREDNISONE  5 MG ORAL TAB,8.0,5.6,,,0
HCPCS,FAMNOCHARGE,PREDNISONE 20 MG ORAL TAB,5.5,3.85,,,0
HCPCS,FAMNOCHARGE,PROMETHAZINE 25 MG ORAL TAB,7.0,4.9,,,0
HCPCS,FAMNOCHARGE,SODIUM CHLORIDE 0.9 % IV SOLP,34.5,24.15,,,0
HCPCS,G0008,Admin influenza virus vac,,,35.61,205.67,11
HCPCS,G0009,Admin pneumococcal vaccine,,,46.36,205.67,11
HCPCS,G0010,Admin hepatitis b vaccine,,,46.36,205.67,11
HCPCS,G0012,Injection of hiv prep drug,,,71.28,316.24,7
HCPCS,G0019,Comm hlth intg svs sdoh 60mn,,,100.57,446.2,11
HCPCS,G0023,Pin service 60m per month,,,100.57,446.2,11
HCPCS,G0027,Semen analysis,,,5.85,35.87,11
HCPCS,G0076,Care manag h vst new pt 20 m,,,168.89,210.7,4
HCPCS,G0077,Care manag h vst new pt 30 m,,,240.95,300.59,4
HCPCS,G0078,Care manag h vst new pt 45 m,,,397.93,496.43,4
HCPCS,G0079,Care manag h vst new pt 60 m,,,555.46,692.95,4
HCPCS,G0080,Care manag h vst new pt 75 m,,,673.66,840.41,4
HCPCS,G0081,Care man h v ext pt 20 mi,,,168.8,210.58,4
HCPCS,G0082,Care man h v ext pt 30 m,,,256.22,319.64,4
HCPCS,G0083,Care man h v ext pt 45 m,,,392.17,489.25,4
HCPCS,G0084,Care man h v ext pt 60 m,,,545.61,680.66,4
HCPCS,G0085,Care man h v ext pt 75 m,,,673.66,840.41,4
HCPCS,G0086,Care man home care plan 30 m,,,231.61,288.94,4
HCPCS,G0087,Care man home care plan 60 m,,,323.24,403.25,4
HCPCS,G0101,CA screen;pelvic/breast exam,,,100.57,446.2,11
HCPCS,G0103,HC PROSTATE CANCER SCREEN PSA TEST,151.0,105.7,,,0
HCPCS,G0103,PSA Screening,,,17.38,74.77,11
HCPCS,G0104,CA screen;flexi sigmoidscope,,,920.63,4084.51,11
HCPCS,G0104,HC COLO CA SCRNG/SIGMOID,3020.0,2114.0,,,0
HCPCS,G0105,Colorectal scrn; hi risk ind,,,172.86,4084.51,15
HCPCS,G0105,HC COLONOSCOPY SCREENING HIGH RISK IND,3772.0,2640.4,,,0
HCPCS,G0106,Colon CA screen;barium enema,,,401.69,501.11,4
HCPCS,G0108,Diab manage trn  per indiv,,,54.02,94.54,10
HCPCS,G0109,Diab manage trn ind/group,,,15.49,43.96,10
HCPCS,G0117,Glaucoma scrn hgh risk direc,,,28.63,217.05,11
HCPCS,G0118,Glaucoma scrn hgh risk direc,,,36.98,164.05,11
HCPCS,G0120,Colon ca scrn; barium enema,,,401.69,501.11,4
HCPCS,G0121,Colon ca scrn not hi rsk ind,,,172.86,4084.51,15
HCPCS,G0121,HC COLONOSCOPY SCREENING NOT HIGH RISK IND,3772.0,2640.4,,,0
HCPCS,G0123,Screen cerv/vag thin layer,,,18.23,83.35,11
HCPCS,G0124,HC PRO SCRN CYTO CERVICAL/VAGINAL AUTO THIN LAYER PREP REQUIRE INTERP,51.0,35.7,,,0
HCPCS,G0124,Screen c/v thin layer by MD,,,78.45,97.86,4
HCPCS,G0127,Trim nail(s),,,58.4,259.1,11
HCPCS,G0128,CORF skilled nursing service,,,23.54,29.37,4
HCPCS,G0130,Single energy x-ray study,,,60.45,459.18,11
HCPCS,G0136,Adm of soc dtr assess 5-15 m,,,37.09,164.57,11
HCPCS,G0140,Nav srv peer sup 60 min pr m,,,100.57,446.2,11
HCPCS,G0141,"Scr c/v cyto,autosys and md",,,78.45,97.86,4
HCPCS,G0143,"Scr c/v cyto,thinlayer,rescr",,,24.35,75.86,11
HCPCS,G0144,"Scr c/v cyto,thinlayer,rescr",,,39.57,80.55,11
HCPCS,G0145,HC SCRN CYTO CERVICAL/ VAGINAL THIN LAYER W/SCRN AUTO SYSTEM & MANUAL RESCRN,110.0,77.0,,,0
HCPCS,G0145,"Scr c/v cyto,thinlayer,rescr",,,23.84,86.75,11
HCPCS,G0147,"Scr c/v cyto, automated sys",,,16.69,58.29,11
HCPCS,G0148,"Scr c/v cyto, autosys, rescr",,,28.75,58.29,11
HCPCS,G0166,"Extrnl counterpulse, per tx",,,131.71,584.37,11
HCPCS,G0168,HC PRO WOUND CLOSU,108.0,75.6,,,0
HCPCS,G0168,Wound closure by adhesive,,,73.2,91.32,4
HCPCS,G0175,"Opps service,sched team conf",,,413.08,1832.68,11
HCPCS,G0183,Software meas of cardiac vol,,,86.15,382.23,7
HCPCS,G0186,"Dstry eye lesn,fdr vssl tech",,,544.48,2415.67,11
HCPCS,G0235,PET not otherwise specified,,,395.76,1755.86,7
HCPCS,G0237,HC PULM THERAPY 1-1 EA 15 MIN,75.0,52.5,,,0
HCPCS,G0237,Therapeutic procd strg endur,,,28.63,127.04,11
HCPCS,G0238,"Oth resp proc, indiv",,,28.63,127.04,11
HCPCS,G0239,HC PULM REHAB GROUP,315.0,220.5,,,0
HCPCS,G0239,"Oth resp proc, group",,,36.98,296.91,11
HCPCS,G0245,Initial foot exam pt lops,,,131.8,584.75,11
HCPCS,G0246,Followup eval of foot pt lop,,,131.8,584.75,11
HCPCS,G0247,Routine footcare pt w lops,,,158.65,881.22,11
HCPCS,G0248,Demonstrate use home inr mon,,,131.8,584.75,11
HCPCS,G0249,Provide INR test mater/equip,,,131.8,584.75,11
HCPCS,G0257,HC UNSCHED/EMERGENT DIALYSIS,2129.0,1490.3,,,0
HCPCS,G0257,Unsched dialysis ESRD pt hos,,,679.43,3014.4,11
HCPCS,G0260,Inj for sacroiliac jt anesth,,,698.8,3100.34,11
HCPCS,G0269,HC PLACE OCC DEVICE POST PROCED,375.0,262.5,,,0
HCPCS,G0270,MNT subs tx for change dx,,,21.56,76.2,10
HCPCS,G0271,Group MNT 2 or more 30 mins,,,12.12,47.7,10
HCPCS,G0276,Pild/placebo control clin tr,,,7183.42,31870.39,11
HCPCS,G0277,"Hbot, full body chamber, 30m",,,136.23,850.63,11
HCPCS,G0279,"Tomosynthesis, mammo",,,11.64,204.46,10
HCPCS,G0281,Elec stim unattend for press,,,11.31,41.81,10
HCPCS,G0283,Elec stim other than wound,,,12.23,100.58,10
HCPCS,G0289,"Arthro, loose body + chondro",,,5757.67,7182.83,4
HCPCS,G0293,"Non-cov surg proc,clin trial",,,36.98,164.05,11
HCPCS,G0294,"Non-cov proc, clinical trial",,,36.98,164.05,11
HCPCS,G0296,Visit to determ ldct elig,,,100.57,446.2,11
HCPCS,G0302,Pre-op service LVRS complete,,,369.41,2815.76,11
HCPCS,G0303,Pre-op service LVRS 10-15dos,,,213.76,2815.76,11
HCPCS,G0304,Pre-op service LVRS 1-9 dos,,,369.41,1638.96,11
HCPCS,G0305,Post op service LVRS min 6,,,369.41,1638.96,11
HCPCS,G0306,CBC/diffwbc w/o platelet,,,6.99,42.9,11
HCPCS,G0307,CBC without platelet,,,5.82,35.72,11
HCPCS,G0323,Care manage beh svs 20mins,,,37.09,164.57,11
HCPCS,G0328,Fecal blood scrn immunoassay,,,16.24,40.74,11
HCPCS,G0329,Electromagntic tx for ulcers,,,10.06,27.86,10
HCPCS,G0330,Facility svs dental rehab,,,3282.2,14562.0,11
HCPCS,G0337,Hospice evaluation preelecti,,,201.95,251.94,4
HCPCS,G0339,"Robot lin-radsurg com, first",,,12342.8,15397.94,4
HCPCS,G0340,Robt lin-radsurg fractx 2-5,,,9016.4,11248.18,4
HCPCS,G0378,HC OBS CARVE OUT ACUTE,40.0,28.0,,,0
HCPCS,G0378,HC OBS CARVE OUT ICU,146.0,102.2,,,0
HCPCS,G0378,HC OBS CARVE OUT SAC,101.0,70.7,,,0
HCPCS,G0378,HC ROOM & CARE OBS ICU,145.95,102.16,,,0
HCPCS,G0378,HC ROOM & CARE OBS SAC,100.8,70.56,,,0
HCPCS,G0378,Hospital observation per hr,,,84.47,105.38,4
HCPCS,G0378,ROOM & CARE OBS ACUTE,39.9,27.93,,,0
HCPCS,G0379,Direct refer hospital observ,,,0.01,2615.66,9
HCPCS,G0379,OBSERVATION DA,2566.0,1796.2,,,0
HCPCS,G0380,Lev 1 hosp type B ED visit,,,73.58,326.47,11
HCPCS,G0381,Lev 2 hosp type B ED visit,,,91.96,407.98,11
HCPCS,G0382,Lev 3 hosp type B ED visit,,,170.16,754.95,11
HCPCS,G0383,Lev 4 hosp type B ED visit,,,261.65,1160.87,11
HCPCS,G0384,Lev 5 hosp type B ED visit,,,406.6,1803.96,11
HCPCS,G0390,Trauma Respons w/hosp criti,,,1037.38,5854.34,11
HCPCS,G0396,Alcohol/subs interv 15-30mn,,,37.09,164.57,11
HCPCS,G0397,Alcohol/subs interv >30 min,,,62.57,779.59,11
HCPCS,G0398,Home sleep test/type 2 porta,,,153.17,948.37,11
HCPCS,G0399,HC HOME SLEEP TEST W/TYPE III PORTABLE MONITOR UNATTEND MIN 4 CHANNELS 2 RESPIRATORY MOV/AIRFLOW 1 ECG/HEARL RATE & 1 OXYGEN SATURATION,641.0,448.7,,,0
HCPCS,G0399,Home sleep test/type 3 porta,,,107.23,948.37,11
HCPCS,G0400,Home sleep test/type 4 porta,,,91.9,948.37,11
HCPCS,G0402,Initial preventive exam,,,131.8,584.75,11
HCPCS,G0403,EKG for initial prevent exam,,,59.12,73.75,4
HCPCS,G0404,EKG tracing for initial prev,,,28.63,127.04,11
HCPCS,G0405,EKG interpret & report preve,,,24.63,30.73,4
HCPCS,G0406,Inpt/tele follow up 15,,,109.99,137.21,4
HCPCS,G0407,Inpt/tele follow up 25,,,197.56,246.46,4
HCPCS,G0408,Inpt/tele follow up 35,,,283.12,353.2,4
HCPCS,G0409,CORF related serv 15 mins ea,,,23.57,29.41,4
HCPCS,G0412,Open tx iliac spine uni/bil,,,2031.77,31870.39,11
HCPCS,G0413,Pelvic ring fracture uni/bil,,,2962.1,31870.39,11
HCPCS,G0414,Pelvic ring fx treat int fix,,,2796.33,31870.39,11
HCPCS,G0415,Open tx post pelvic fxcture,,,3239.17,14371.12,11
HCPCS,G0416,HC PRO SURG PATH GROSS/MICROSCOPIC EXAM PROSTATE NEEDLE BIOPSY ANY METHOD,1366.0,956.2,,,0
HCPCS,G0416,HC SURG PATH GROSS/MICROSCOPIC EXAM PROSTATE NEEDLE BIOPSY ANY METHOD,1002.0,701.4,,,0
HCPCS,G0416,"Prostate biopsy, any mthd",,,354.85,1574.35,11
HCPCS,G0420,Ed svc CKD ind per session,,,111.25,392.78,10
HCPCS,G0421,Ed svc CKD grp per session,,,26.79,91.7,10
HCPCS,G0422,Intens cardiac rehab w/exerc,,,127.61,566.18,11
HCPCS,G0423,Intens cardiac rehab no exer,,,127.61,566.18,11
HCPCS,G0425,Inpt/ed teleconsult30,,,293.88,366.62,4
HCPCS,G0426,Inpt/ed teleconsult50,,,398.38,496.99,4
HCPCS,G0427,Inpt/ed teleconsult70,,,585.43,730.33,4
HCPCS,G0429,Dermal filler injection(s),,,212.49,9062.24,11
HCPCS,G0432,EIA HIV-1/HIV-2 screen,,,17.61,71.25,11
HCPCS,G0433,ELISA HIV-1/HIV-2 screen,,,16.46,71.25,11
HCPCS,G0435,Oral hiv-1/hiv-2 screen,,,10.78,62.33,11
HCPCS,G0438,"PPPS, initial visit",,,168.7,614.17,10
HCPCS,G0439,"PPPS, subseq visit",,,132.75,404.08,10
HCPCS,G0442,Annual alcohol screen 15 min,,,37.09,169.57,11
HCPCS,G0443,Brief alcohol misuse counsel,,,100.57,446.2,11
HCPCS,G0444,Depression Screen annual,,,37.09,169.57,11
HCPCS,G0445,High inten beh couns STD 30m,,,100.57,446.2,11
HCPCS,G0446,Intens behave ther cardio dx,,,37.09,169.57,11
HCPCS,G0447,Behavior counsel obesity 15m,,,100.57,446.2,11
HCPCS,G0451,Devlopment test interpt&rep,,,100.57,446.2,11
HCPCS,G0452,HC PRO MOLECULAR PATHOLOGY INTERP,42.0,29.4,,,0
HCPCS,G0452,Molecular pathology interpr,,,55.39,69.1,4
HCPCS,G0453,Cont intraop neuro monitor,,,77.3,96.43,4
HCPCS,G0454,MD document visit by NPP,,,26.18,32.66,4
HCPCS,G0455,Fecal microbiota prep instil,,,150.41,4084.51,11
HCPCS,G0459,Telehealth inpt pharm mgmt,,,123.62,154.22,4
HCPCS,G0460,Autologous PRP for ulcers,,,216.77,9062.24,11
HCPCS,G0463,HC OFFICE/OP VISIT EST LEVEL 1,241.0,168.7,,,0
HCPCS,G0463,HC OFFICE/OP VISIT EST LEVEL 2,289.0,202.3,,,0
HCPCS,G0463,HC OFFICE/OP VISIT EST LEVEL 3,347.0,242.9,,,0
HCPCS,G0463,HC OFFICE/OP VISIT EST LEVEL 4,417.0,291.9,,,0
HCPCS,G0463,HC OFFICE/OP VISIT EST LEVEL 5,500.0,350.0,,,0
HCPCS,G0463,HC OFFICE/OP VISIT NEW LEVEL 1,241.0,168.7,,,0
HCPCS,G0463,HC OFFICE/OP VISIT NEW LEVEL 2,289.0,202.3,,,0
HCPCS,G0463,HC OFFICE/OP VISIT NEW LEVEL 3,347.0,242.9,,,0
HCPCS,G0463,HC OFFICE/OP VISIT NEW LEVEL 4,417.0,291.9,,,0
HCPCS,G0463,HC OFFICE/OP VISIT NEW LEVEL 5,500.0,350.0,,,0
HCPCS,G0463,HC OFFICE/OUTPAT VISIT EST LEVEL 1,241.0,168.7,,,0
HCPCS,G0463,HC OFFICE/OUTPAT VISIT EST LEVEL 2,289.0,202.3,,,0
HCPCS,G0463,HC OFFICE/OUTPAT VISIT EST LEVEL 3,347.0,242.9,,,0
HCPCS,G0463,HC OFFICE/OUTPAT VISIT EST LEVEL 4,417.0,291.9,,,0
HCPCS,G0463,HC OFFICE/OUTPAT VISIT EST LEVEL 5,500.0,350.0,,,0
HCPCS,G0463,Hospital outpt clinic visit,,,131.8,584.75,11
HCPCS,G0463,OFFICE/OUTPAT VISIT NEW LEVEL 1,241.0,168.7,,,0
HCPCS,G0463,OFFICE/OUTPAT VISIT NEW LEVEL 2,289.0,202.3,,,0
HCPCS,G0463,OFFICE/OUTPAT VISIT NEW LEVEL 3,347.0,242.9,,,0
HCPCS,G0463,OFFICE/OUTPAT VISIT NEW LEVEL 4,417.0,291.9,,,0
HCPCS,G0463,OFFICE/OUTPAT VISIT NEW LEVEL 5,500.0,350.0,,,0
HCPCS,G0465,Autolog prp diab wound ulcer,,,2042.58,9062.24,11
HCPCS,G0471,Ven blood coll snf/hha,,,10.21,19.84,11
HCPCS,G0472,Hep c screen high risk/other,,,41.72,81.11,7
HCPCS,G0473,Group behave couns 2-10,,,37.09,189.91,11
HCPCS,G0475,Hiv combination assay,,,21.67,42.14,7
HCPCS,G0476,Hpv combo assay ca screen,,,31.58,61.41,7
HCPCS,G0480,Drug test def 1-7 classes,,,102.99,266.19,11
HCPCS,G0480,HC DRUG TEST(S) DEFINITIVE QUAL/QUANT ALL SOURCE(S) 1-7 CLASS(ES),302.0,211.4,,,0
HCPCS,G0481,Drug test def 8-14 classes,,,140.93,608.54,11
HCPCS,G0481,HC DRUG TEST(S) DEFINITIVE QUAL/QUANT ALL SOURCES 8-14 CLASSES,486.0,340.2,,,0
HCPCS,G0482,Drug test def 15-21 classes,,,178.87,772.41,11
HCPCS,G0482,HC DRUG TEST(S) DEFINITIVE QUAL/QUANT ALL SOURCES 15-21 CLASSES,610.0,427.0,,,0
HCPCS,G0483,Drug test def 22+ classes,,,222.23,959.63,11
HCPCS,G0483,HC DRUG TEST(S) DEFINITIVE QUAL/QUANT ALL SOURCES 22+ CLASSES,758.0,530.6,,,0
HCPCS,G0498,Chemo extend iv infus w/pump,,,326.99,1450.75,11
HCPCS,G0499,Hepb screen high risk indiv,,,25.44,49.47,7
HCPCS,G0500,HC MOD SEDATION SAME PHYS/QHP ENDOSCOPIC SERVICE INITIAL 15 MIN PATIENT 5 YEARS OR OLDER,445.0,311.5,,,0
HCPCS,G0500,Mod sedat endo service >5yrs,,,17.49,21.82,4
HCPCS,G0506,Comp asses care plan ccm svc,,,138.48,172.75,4
HCPCS,G0508,Crit care telehea consult 60,,,604.38,753.98,4
HCPCS,G0509,Crit care telehea consult 50,,,582.84,727.11,4
HCPCS,G0513,"Prolong prev svcs, first 30m",,,186.19,232.28,4
HCPCS,G0514,"Prolong prev svcs, addl 30m",,,185.86,231.87,4
HCPCS,G0516,"Insert drug del implant, >4",,,442.24,1962.08,11
HCPCS,G0517,Remove drug implant,,,442.24,1962.08,11
HCPCS,G0518,Remove w insert drug implant,,,442.24,1962.08,11
HCPCS,G0539,Initial care training 30 m,,,39.32,68.81,6
HCPCS,G0540,Train for caregiver add 15,,,20.79,36.38,6
HCPCS,G0541,No pt prsnt train initial 30,,,28.63,127.04,7
HCPCS,G0543,Group train w/o patient,,,28.63,127.04,7
HCPCS,G0552,Supply of digital device,,,131.8,584.75,7
HCPCS,G0553,Monthly tx for dmht 20mins,,,131.8,584.75,7
HCPCS,G0555,Replacment pt electronic sys,,,850.12,3771.72,7
HCPCS,G0560,Safety plan interven,,,39.26,68.7,6
HCPCS,G0566,3d bn img algor drvd fr mri,,,127.38,565.15,7
HCPCS,G0567,Screening Hep C detect,,,31.58,61.41,7
HCPCS,G0659,Drug test def simple all cl,,,55.93,108.74,7
HCPCS,G2000,Blinded conv. Tx MDD clin tr,,,369.41,1720.92,11
HCPCS,G2001,Post d/c h vst new pt 20 m,,,168.89,210.7,4
HCPCS,G2002,Post-d/c h vst new pt 30 m,,,240.95,300.59,4
HCPCS,G2003,Post-d/c h vst new pt 45 m,,,397.93,496.43,4
HCPCS,G2004,Post-d/c h vst new pt 60 m,,,555.46,692.95,4
HCPCS,G2005,Post-d/c h vst new pt 75 m,,,673.66,840.41,4
HCPCS,G2006,Post-d/c h vst ext pt 20 m,,,168.8,210.58,4
HCPCS,G2007,Post-d/c h vst ext pt 30 m,,,256.22,319.64,4
HCPCS,G2008,Post-d/c h vst ext pt 45 m,,,392.17,489.25,4
HCPCS,G2009,Post-d/c h vst ext pt 60 m,,,545.61,680.66,4
HCPCS,G2010,Remot image submit by pt,,,27.75,34.62,4
HCPCS,G2011,Alcohol/sub abuse assess,,,28.63,127.04,11
HCPCS,G2012,Brief check in by MD/QHP,,,39.63,49.44,4
HCPCS,G2013,Post-d/c h vst ext pt 75 m,,,673.66,840.41,4
HCPCS,G2014,Post-d/c care plan overs 30m,,,231.61,288.94,4
HCPCS,G2015,Post-d/c care plan overs 60m,,,323.24,403.25,4
HCPCS,G2066,Inter devc remote 30d,,,109.84,137.03,4
HCPCS,G2082,Visit esketamine 56m or less,,,1017.91,4516.14,11
HCPCS,G2083,"Visit esketamine, > 56m",,,1599.3,7095.56,11
HCPCS,G2086,Off base opioid tx 70min,,,175.71,779.59,11
HCPCS,G2087,"Off base opioid tx, 60 m",,,175.71,779.59,11
HCPCS,G2088,"Off base opioid tx, add30",,,104.66,130.56,4
HCPCS,G2213,HC PRO INITIATION OF MED FOR TX OPIOID USE DISORDER IN THE ER,148.0,103.6,,,0
HCPCS,G2214,Init/sub psych care m 1st 30,,,100.57,446.2,11
HCPCS,G2250,"Remot img sub by pt, non e/m",,,7.94,13.9,6
HCPCS,G2251,"Brief chkin, 5-10, non-e/m",,,10.59,18.53,6
HCPCS,G2252,"Brief chkin by md/qhp, 11-20",,,22.29,39.01,6
HCPCS,G6001,Echo guidance radiotherapy,,,149.26,186.2,4
HCPCS,G6002,Stereoscopic x-ray guidance,,,213.28,266.07,4
HCPCS,G6003,Radiation treatment delivery,,,450.29,561.75,4
HCPCS,G6004,Radiation treatment delivery,,,348.72,435.04,4
HCPCS,G6005,Radiation treatment delivery,,,389.54,485.96,4
HCPCS,G6006,Radiation treatment delivery,,,387.57,483.5,4
HCPCS,G6007,Radiation treatment delivery,,,716.11,893.37,4
HCPCS,G6008,Radiation treatment delivery,,,482.13,601.47,4
HCPCS,G6009,Radiation treatment delivery,,,533.92,666.07,4
HCPCS,G6010,Radiation treatment delivery,,,533.92,666.07,4
HCPCS,G6011,Radiation treatment delivery,,,765.89,955.47,4
HCPCS,G6012,Radiation treatment delivery,,,634.48,791.53,4
HCPCS,G6013,Radiation treatment delivery,,,714.11,890.87,4
HCPCS,G6014,Radiation treatment delivery,,,714.11,890.87,4
HCPCS,G6015,Radiation tx delivery imrt,,,1115.13,1391.15,4
HCPCS,G6016,Delivery comp imrt,,,1111.37,1386.47,4
HCPCS,G8721,HC PRO PT PN HIST GRADE DOC,0.01,0.007,,,0
HCPCS,G8722,HC PRO MED REASON FOR NO GRADE REPORT,0.01,0.007,,,0
HCPCS,G8723,HC PRO SPEC SIT NOT PRIM TUMOR,0.01,0.007,,,0
HCPCS,G8724,HC PRO PT CAT PN CAT/HISTOLOGICAL GRADE NOT DOC IN PATH REPORT REASON NOT GIVEN,0.01,0.007,,,0
HCPCS,G8797,HC PRO SPECIMEN SITE NOT ANATOMIC LOCATION OF ESOPHAGUS,0.01,0.007,,,0
HCPCS,G8798,HC PRO SPECIMEN SITE NOT ANATOMIC LOCATION OF PROSTATE,0.01,0.007,,,0
HCPCS,G8806,HC PRO PQRS TRANSABD/TRANSVAG ULTRASOUND,0.01,0.007,,,0
HCPCS,G8807,HC PRO PQRS TRANSABD/TRANSVAG US NOT PERF DOC REASONS,0.01,0.007,,,0
HCPCS,G8808,HC PRO PQRS TRANSABD/TRANSVAG US NOT PERF REAS NOT GIVEN,0.01,0.007,,,0
HCPCS,G9143,Warfarin respon genetic test,,,502.77,627.22,4
HCPCS,G9157,Transesoph doppl cardiac mon,,,301.97,376.71,4
HCPCS,G9187,BPCI home visit,,,140.74,175.58,4
HCPCS,G9418,HC PQRS PRIMARY NON-SMALL CELL LUNG CANCER LUNG BIOPSY/CYTOLOGY SPECIMEN REP DOCS CLASS SPECIFIC HISTOLOGIC TYPE FOLLOWING IASLC GUIDE OR CLASS,0.01,0.007,,,0
HCPCS,G9419,HC PQRS DOCUMENTATION OF MEDICAL REASON(S) FOR NOT REPORTING THE HISTOLOGICAL TYPE OR NSCLC-NOS CLASSIFICATION WITH AN EXPLANATION,0.01,0.007,,,0
HCPCS,G9420,HC PQRS SPECIMEN SITE OTHER THAN ANATOMIC LOCATION OF LUNG OR IS NOT CLASSIFIED AS PRIMARY NON-SMALL CELL LUNG CANCER,0.01,0.007,,,0
HCPCS,G9421,HC PQRS PRIMARY NON-SMALL CELL LUNG CANCER LUNG BIOPSY AND CYTOLOGY SPECIMEN REPORT DOES NOT DOCUMENT CLASSIFICATION INTO SPECIFIC HISTOLIGIC TYPE OR CLASS,0.01,0.007,,,0
HCPCS,G9422,HC PQRS NON-SMALL CELL LUNG CANCER BIOPSY AND CYTOLOGY SPECIMEN REPORT DOCUMENTS CLASSIFICATION INTO SPECIFIC HISTOLOGIC TYPE OR CLASSIFIED AS NSCLC-NOS WITH AN EXPLANATION,0.01,0.007,,,0
HCPCS,G9423,HC PQRS DOCUMENTATION OF MEDICAL REASON(S) FOR NOT REPORTING THE HISTOLOGICAL TYPE OR NSCLC-NOS CLASSIFICATION WITH AN EXPLANATION (EQ A SOLITARY FIBROUS TUMOR IN A PERSON WITH A HISTORY O*,0.01,0.007,,,0
HCPCS,G9424,HC PQRS SPECIMEN SITE OTHER THAN ANATOMIC LOCATION OF LUNG IS NOT CLASSIFIED AS NON-SMALL CELL LUNG CANCER OR CLASSIFIED AS NSCLC-NOS,0.01,0.007,,,0
HCPCS,G9425,HC PQRS NON SMALL CELL LUNG CANCER BIOPSY AND CYTOLOGY SPECIMEN REPORT DOES NOT DOCUMENT CLASSIFICATION INTO SPECIFIC HISTOLGIC TYPE OR CLASSIFIED AS NSCLC-NOS WITH AN EXPLANATION,0.01,0.007,,,0
HCPCS,G9428,HC PQRS PATHOLOGY REPORT INCL PT CATEGORY THICKNESS/ULCERATION/MITOTIC RATE PERIPHERAL DEEP MARGIN STATUS & PRESENCE/ABSENCE MICROSATELLITOSIS INVASIVE TUMORS,0.01,0.007,,,0
HCPCS,G9430,HC PQRS SPECIMEN SITE OTHER THAN ANATOMIC CUTANEOUS LOCATION,0.01,0.007,,,0
HCPCS,G9431,HC PQRS PATHOLOGY REPORT DOES NOT INCL PT CATEGORY THICKNESS/ULCERATION/MITOTIC RATE PERIPHERAL DEEP MARGIN STATUS & PRESENCE/ABSENCE MICROSATELLITOSIS INVASIVE TUMORS,0.01,0.007,,,0
HCPCS,G9481,Remote E/M new pt 10mins,,,58.74,73.28,4
HCPCS,G9482,Remote E/M new pt 20mins,,,111.6,139.23,4
HCPCS,G9483,Remote E/M new pt 30mins,,,174.05,217.14,4
HCPCS,G9484,Remote E/M new pt 45mins,,,293.05,365.59,4
HCPCS,G9485,Remote E/M new pt 60mins,,,382.68,477.41,4
HCPCS,G9486,Remote E/M est. pt 10mins,,,57.43,71.65,4
HCPCS,G9487,Remote E/M est. pt 15mins,,,114.65,143.02,4
HCPCS,G9488,Remote E/M est. pt 25mins,,,176.21,219.82,4
HCPCS,G9489,Remote E/M est. pt 40mins,,,249.09,310.74,4
HCPCS,G9490,Joint replac mod home visit,,,128.55,160.37,4
HCPCS,G9685,Acute Nursing Facility Care,,,615.78,768.21,4
HCPCS,G9868,Next Gen ACO model <10min,,,86.6,108.03,4
HCPCS,G9869,Next Gen ACO model 10-20min,,,115.84,144.51,4
HCPCS,G9870,Next Gen ACO model >20min,,,145.08,180.99,4
HCPCS,G9873,1 EM core session,,,68.51,85.47,4
HCPCS,G9874,4 EM core sessions,,,138.02,172.18,4
HCPCS,G9875,9 EM core sessions,,,248.22,309.66,4
HCPCS,G9876,2 EM core MS mo 7-9 no WL,,,41.69,52.01,4
HCPCS,G9877,2 EM core MS mo 10-12 no WL,,,41.69,52.01,4
HCPCS,G9878,2 EM core MS mo 7-9  WL,,,165.8,206.84,4
HCPCS,G9879,2 EM core MS mo 10-12 WL,,,165.8,206.84,4
HCPCS,G9880,EM 5 percent WL,,,440.87,549.99,4
HCPCS,G9881,EM 9 percent WL,,,68.51,85.47,4
HCPCS,G9882,2 EM ongoing MS mo 13-15 WL,,,138.02,172.18,4
HCPCS,G9883,2 EM ongoing MS mo 16-18 WL,,,138.02,172.18,4
HCPCS,G9884,2 EM ongoing MS mo 19-21 WL,,,138.02,172.18,4
HCPCS,G9885,2 EM ongoing MS mo 22-24 WL,,,138.02,172.18,4
HCPCS,G9890,Mac exam perf,,,68.51,85.47,4
HCPCS,G9978,Remote E/M new pt 10mins,,,80.42,100.32,4
HCPCS,G9979,Remote E/M new pt 20mins,,,153.26,191.19,4
HCPCS,G9980,Remote E/M new pt 30 mins,,,229.46,286.26,4
HCPCS,G9981,Remote E/M new pt 45mins,,,392.39,489.51,4
HCPCS,G9982,Remote E/M new pt 60mins,,,512.19,638.97,4
HCPCS,G9983,Remote E/M est. pt 10mins,,,78.42,97.83,4
HCPCS,G9984,Remote E/M est. pt 15mins,,,155.29,193.73,4
HCPCS,G9985,Remote E/M est. pt 25mins,,,238.46,297.49,4
HCPCS,G9986,Remote E/M est. pt 40mins,,,336.6,419.92,4
HCPCS,G9987,BPCI Advanced In home visit,,,124.38,155.17,4
HCPCS,H0049,HC ALCOHOL AND/OR DRUG SCREENING,75.0,52.5,,,0
HCPCS,H0050,HC ALCOHOL AND/OR DRUG SERVICES BRIEF INTERVENTION PER 15 MINUTES,128.0,89.6,,,0
HCPCS,J0120,Tetracyclin injection,,,22.09,27.56,4
HCPCS,J0121,"Inj., omadacycline, 1 mg",,,4.13,13.2,13
HCPCS,J0122,"Inj., eravacycline, 1 mg",,,1.29,3.62,13
HCPCS,J0129,ABATACEPT 250 MG IV SOLR,12534.0,8773.8,,,0
HCPCS,J0129,Abatacept injection,,,44.72,215.97,13
HCPCS,J0130,Abciximab injection,,,1375.29,2556.16,6
HCPCS,J0131,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN FOR PERI-OPERATIVE",42.0,29.4,,,0
HCPCS,J0131,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IVPB (PEDIATRICS/ADULT NON-FORM)",42.0,29.4,,,0
HCPCS,J0131,Acetaminophen injection,,,0.19,0.49,6
HCPCS,J0132,ACETYLCYSTEINE 20 % (200 MG/ML) IV SOLN,606.0,424.2,,,0
HCPCS,J0132,Acetylcysteine injection,,,4.26,4.71,2
HCPCS,J0133,ACYCLOVIR NEO/PEDS INFUSION (CDS FROM PREMIX),31.0,21.7,,,0
HCPCS,J0133,ACYCLOVIR SODIUM 50 MG/ML IV SOLN,105.0,73.5,,,0
HCPCS,J0133,Acyclovir injection,,,0.2,0.22,2
HCPCS,J0134,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IVPB (PEDIATRICS/ADULT NON-FORM)",57.0,39.9,,,0
HCPCS,J0134,Inj acetaminophen -fresenius,,,0.17,0.19,2
HCPCS,J0135,Adalimumab injection,,,1073.53,3281.33,6
HCPCS,J0136,"Inj, acetaminophen (b braun)",,,0.17,0.19,2
HCPCS,J0137,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN FOR PERI-OPERATIVE",35.5,24.85,,,0
HCPCS,J0137,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IVPB (PEDIATRICS/ADULT NON-FORM)",35.0,24.5,,,0
HCPCS,J0137,"Inj, acetaminophen (hikma)",,,0.2,0.25,5
HCPCS,J0138,"Injection, acetaminoph 10 mg",,,0.09,0.44,9
HCPCS,J0153,ADENOSINE (DIAGNOSTIC) 3 MG/ML IV SOLN,858.0,600.6,,,0
HCPCS,J0153,ADENOSINE 3 MG/ML IV SYRG,247.0,172.9,,,0
HCPCS,J0153,ADENOSINE 3000 MCG/ML INJECTION,83.5,58.45,,,0
HCPCS,J0153,Adenosine inj 1mg,,,2.58,3.6,6
HCPCS,J0169,EPINEPHRINE (PF) 1 MG/ML INJ SOLN,343.0,240.1,,,0
HCPCS,J0169,EPINEPHRINE 0.1 MG/ML SYRINGE (ERX MERGE),444.0,310.8,,,0
HCPCS,J0169,EPINEPHRINE 0.15 MG/0.3 ML IM PNIJ,1462.5,1023.75,,,0
HCPCS,J0169,EPINEPHRINE 0.3 MG/0.3 ML IM PNIJ,932.0,652.4,,,0
HCPCS,J0169,EPINEPHRINE 1 MG/ML (1ML) INJ SOLN,74.0,51.8,,,0
HCPCS,J0169,EPINEPHRINE 1 MG/ML INJ SOLN,128.0,89.6,,,0
HCPCS,J0169,EPINEPHRINE HCL IN 0.9% NS 100 MCG/10 ML (10 MCG/ML) NON-CARDIAC LOW-DOSE (PEDS/NEO),25.0,17.5,,,0
HCPCS,J0169,EPINEPHRINE HCL IN 5% DEXTROSE 100 MCG/10 ML (10 MCG/ML) IV SYRG,39.5,27.65,,,0
HCPCS,J0169,EPINEPHRINE HCL IN D5W 4 MG/250 ML (16 MCG/ML) IV SOLN,421.0,294.7,,,0
HCPCS,J0169,IV EPINEPHRINE 0.1 MG/ML SYRINGE (NEO-CODE IV),57.0,39.9,,,0
HCPCS,J0171,Adrenalin epinephrine inject,,,0.21,39.03,6
HCPCS,J0171,EPINEPHRINE (PF) 1 MG/ML INJ SOLN,514.0,359.8,,,0
HCPCS,J0171,EPINEPHRINE 0.1 MG/ML SYRINGE (ERX MERGE),422.5,295.75,,,0
HCPCS,J0171,EPINEPHRINE 0.15 MG/0.3 ML IM PNIJ,849.5,594.65,,,0
HCPCS,J0171,EPINEPHRINE 0.3 MG/0.3 ML IM PNIJ,1051.0,735.7,,,0
HCPCS,J0171,EPINEPHRINE 1 MG/ML (1ML) INJ SOLN,84.0,58.8,,,0
HCPCS,J0171,EPINEPHRINE 1 MG/ML INJ SOLN,162.0,113.4,,,0
HCPCS,J0171,EPINEPHRINE HCL IN 0.9 % NACL 4 MG/250 ML (16 MCG/ML) IV SOLN,147.0,102.9,,,0
HCPCS,J0171,EPINEPHRINE HCL IN 0.9% NS 100 MCG/10 ML (10 MCG/ML) NON-CARDIAC LOW-DOSE (PEDS/NEO),25.0,17.5,,,0
HCPCS,J0171,EPINEPHRINE HCL IN 5% DEXTROSE 100 MCG/10 ML (10 MCG/ML) IV SYRG,39.5,27.65,,,0
HCPCS,J0171,EPINEPHRINE HCL IN D5W 4 MG/250 ML (16 MCG/ML) IV SOLN,526.0,368.2,,,0
HCPCS,J0171,EPINEPHRINE IN 0.9 % NACL 4 MG/250 ML (16 MCG/ML) IV SOLN (MERGE),308.5,215.95,,,0
HCPCS,J0171,EPINEPHRINE IN 0.9 % SOD CHLOR 4 MG/250 ML (16 MCG/ML) IV SOLN,389.0,272.3,,,0
HCPCS,J0171,IV EPINEPHRINE 0.1 MG/ML SYRINGE (NEO-CODE IV),57.0,39.9,,,0
HCPCS,J0171,NOREPINEPHRINE BITARTRATE-D5W 4 MG/250 ML (16 MCG/ML) IV SOLN,103.0,72.1,,,0
HCPCS,J0172,"Inj, aducanumab-avwa, 2 mg",,,9.68,44.88,6
HCPCS,J0173,"Inj, epinephrine (belcher)",,,139.47,154.1,2
HCPCS,J0174,"Inj, lecanemab-irmb",,,1.34,5.1,13
HCPCS,J0174,LECANEMAB-IRMB 100 MG/ML IV SOLN,2491.0,1743.7,,,0
HCPCS,J0175,DONANEMAB-AZBT 17.5 MG/ML IV SOLN,4001.0,2800.7,,,0
HCPCS,J0175,"Inj, donanemab-azbt, 2 mg",,,4.14,7.54,9
HCPCS,J0177,"Inj, aflibercept hd, 1 mg",,,301.18,625.68,9
HCPCS,J0178,Aflibercept injection,,,731.88,3706.29,13
HCPCS,J0179,"Inj, brolucizumab-dbll, 1 mg",,,353.07,1200.46,13
HCPCS,J0180,AGALSIDASE BETA  5 MG IV SOLR,4295.0,3006.5,,,0
HCPCS,J0180,AGALSIDASE BETA 35 MG IV SOLR,34859.0,24401.3,,,0
HCPCS,J0180,Agalsidase beta injection,,,227.58,503.0,13
HCPCS,J0180,HC NC AGALSIDASE BETA PER 1MG,0.01,0.007,,,0
HCPCS,J0184,"Inj, amisulpride, 1 mg",,,9.56,42.41,13
HCPCS,J0185,APREPITANT 130 MG/18 ML (7.2 MG/ML) IV EMUL,1218.5,852.95,,,0
HCPCS,J0185,"Inj., aprepitant, 1 mg",,,1.69,7.95,13
HCPCS,J0190,Inj biperiden lactate/5 mg,,,8.79,10.96,4
HCPCS,J0202,"Injection, alemtuzumab",,,2440.42,6591.64,13
HCPCS,J0205,Alglucerase injection,,,68.04,153.96,6
HCPCS,J0206,ALLOPURINOL SODIUM 500 MG IV SOLR,2153.0,1507.1,,,0
HCPCS,J0206,Inj allopurinol sodium 1 mg,,,3.81,21.3,13
HCPCS,J0207,Amifostine,,,807.88,1645.81,6
HCPCS,J0208,Inj sodium thiosulfate 100mg,,,95.45,423.47,13
HCPCS,J0209,"Inj, sod thiosulfate (hope)",,,0.88,3.91,9
HCPCS,J0210,Methyldopate hcl injection,,,39.3,79.0,6
HCPCS,J0211,"Inj, nithiodote, 3mg / 125mg",,,2.17,9.61,9
HCPCS,J0215,Alefacept,,,88.2,110.04,4
HCPCS,J0216,"Inj, alfentanil hcl, 500mcg",,,6.46,7.14,2
HCPCS,J0217,Inj velmanase alfa-tycv 1 mg,,,465.23,1602.72,13
HCPCS,J0218,Inj olipudase alfa-rpcp 1mg,,,395.6,1425.49,13
HCPCS,J0219,Inj aval alfa-nqpt 4mg,,,81.2,274.84,13
HCPCS,J0220,Alglucosidase alfa injection,,,334.62,493.71,6
HCPCS,J0221,ALGLUCOSIDASE ALFA 50 MG IV SOLR,47864.0,33504.8,,,0
HCPCS,J0221,Lumizyme injection,,,207.51,580.68,13
HCPCS,J0222,"Inj., patisiran, 0.1 mg",,,100.9,371.66,13
HCPCS,J0223,Inj givosiran 0.5 mg,,,120.98,404.01,13
HCPCS,J0224,"Inj. lumasiran, 0.5 mg",,,327.72,1142.58,13
HCPCS,J0225,"Inj, vutrisiran, 1 mg",,,5019.27,18045.91,13
HCPCS,J0225,VUTRISIRAN 25 MG/0.5 ML SUBQ SYRG,329409.0,230586.3,,,0
HCPCS,J0248,HC IV INFUSION HYDRAT 31-60 MIN,415.0,290.5,,,0
HCPCS,J0248,"Inj, remdesivir, 1 mg?",,,6.9,20.84,13
HCPCS,J0248,REMDESIVIR 100 MG IV SOLR,1196.0,837.2,,,0
HCPCS,J0256,ALPHA-1 PROTEINASE INHIB.(HUM) 1000 MG (+/-)/20 ML IV SOLN,7111.0,4977.7,,,0
HCPCS,J0256,"ALPHA-1-PROTEINASE INHIBITOR (HUMAN) 1,000 MG IV SUSP (PROLASTIN-C)",5813.0,4069.1,,,0
HCPCS,J0256,Alpha 1 proteinase inhibitor,,,5.14,14.29,13
HCPCS,J0257,Glassia injection,,,5.66,15.23,13
HCPCS,J0270,Alprostadil for injection,,,0.66,3.29,6
HCPCS,J0275,Alprostadil urethral suppos,,,70.37,92.42,6
HCPCS,J0278,AMIKACIN 1000 MG/4 ML INJ SOLN,92.5,64.75,,,0
HCPCS,J0278,Amikacin sulfate injection,,,2.7,2.99,2
HCPCS,J0280,AMINOPHYLLINE 500 MG/20 ML IV SOLN,69.0,48.3,,,0
HCPCS,J0280,Aminophyllin 250 MG inj,,,9.12,10.08,2
HCPCS,J0282,AMIODARONE 50 MG/ML IV SOLN,28.0,19.6,,,0
HCPCS,J0282,AMIODARONE BOLUS PEDS/NEO IV SYRINGE (1.5MG/ML FROM PREMIX),204.0,142.8,,,0
HCPCS,J0282,"AMIODARONE IN DEXTROSE,ISO-OSM 150 MG/100 ML (PREMIX)",611.0,427.7,,,0
HCPCS,J0282,"AMIODARONE IN DEXTROSE,ISO-OSM 360 MG/200 ML (1.8 MG/ML) IV SOLN",181.0,126.7,,,0
HCPCS,J0282,Amiodarone HCl,,,0.83,0.92,2
HCPCS,J0283,"Inj, amiodarone (nexterone)",,,9.25,10.22,2
HCPCS,J0285,Amphotericin B,,,85.8,94.8,2
HCPCS,J0287,Amphotericin b lipid complex,,,15.02,39.77,6
HCPCS,J0288,Ampho b cholesteryl sulfate,,,37.36,46.61,4
HCPCS,J0289,AMPHOTERICIN B LIPOSOME 50 MG IV SUSR,3608.0,2525.6,,,0
HCPCS,J0289,Amphotericin b liposome inj,,,22.81,96.6,13
HCPCS,J0290,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,60.0,42.0,,,0
HCPCS,J0290,AMPICILLIN 250 MG SOLUTION FOR INJECTION,26.5,18.549999999999997,,,0
HCPCS,J0290,AMPICILLIN 500 MG SOLUTION FOR INJECTION,20.5,14.35,,,0
HCPCS,J0290,AMPICILLIN PEDS INFUSION (CDS MIXTURE),34.5,24.15,,,0
HCPCS,J0290,AMPICILLIN SODIUM  2 GRAM INJ SOLR,50.0,35.0,,,0
HCPCS,J0290,Ampicillin 500 MG inj,,,5.68,6.27,2
HCPCS,J0291,"Inj., plazomicin, 5 mg",,,3.51,12.17,13
HCPCS,J0295,AMPICILLIN-SULBACTAM  1.5 GRAM INJ SOLR,46.0,32.2,,,0
HCPCS,J0295,AMPICILLIN-SULBACTAM  3 GRAM INJ SOLR,53.0,37.1,,,0
HCPCS,J0295,AMPICILLIN-SULBACTAM NEO/PEDS (CDS MIXTURE),28.0,19.6,,,0
HCPCS,J0295,Ampicillin sodium per 1.5 gm,,,8.58,9.48,2
HCPCS,J0300,Amobarbital 125 MG inj,,,588.61,734.3,4
HCPCS,J0330,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ (MERGE),77.0,53.900000000000006,,,0
HCPCS,J0330,SUCCINYLCHOLINE CHLORIDE 200 MG/10 ML (20 MG/ML) IV SYRG,50.0,35.0,,,0
HCPCS,J0330,Succinycholine chloride inj,,,1.79,1.98,2
HCPCS,J0348,Anidulafungin injection,,,3.27,5.29,6
HCPCS,J0349,"Inj, rezafungin, 1 mg",,,10.79,37.96,13
HCPCS,J0350,Injection anistreplase 30 u,,,5358.49,6684.85,4
HCPCS,J0360,HYDRALAZINE 1MG/ML IV SYRINGE (PEDS/NEO),18.0,12.6,,,0
HCPCS,J0360,HYDRALAZINE 20 MG/ML INJ SOLN,46.0,32.2,,,0
HCPCS,J0360,Hydralazine hcl injection,,,25.74,28.44,2
HCPCS,J0364,Apomorphine hydrochloride,,,75.82,83.77,2
HCPCS,J0365,"Aprotonin, 10,000 kiu",,,8.24,10.28,4
HCPCS,J0390,Chloroquine injection,,,500.62,624.53,4
HCPCS,J0391,"Inj, artesunate, 1mg",,,51.83,229.95,13
HCPCS,J0400,Aripiprazole injection,,,0.91,1.34,6
HCPCS,J0401,Inj aripiprazole ext rel 1mg,,,7.27,15.04,13
HCPCS,J0402,"Inj, abilify asimtufii, 1 mg",,,6.02,22.06,13
HCPCS,J0456,AZITHROMYCIN 500 MG IV SOLR,32.0,22.4,,,0
HCPCS,J0456,AZITHROMYCIN NEO/PEDS IV SYRINGE (CDS MIXTURE),36.0,25.2,,,0
HCPCS,J0456,Azithromycin,,,10.37,11.46,2
HCPCS,J0457,AZTREONAM 1 GRAM INJ SOLR,150.0,105.0,,,0
HCPCS,J0457,AZTREONAM 2 GRAM INJ SOLR,262.0,183.4,,,0
HCPCS,J0457,"Injection, aztreonam, 100 mg",,,5.62,9.52,6
HCPCS,J0461,ATROPINE 0.1 MG/ML INJ SYRG,62.0,43.4,,,0
HCPCS,J0461,ATROPINE 0.4 MG/ML INJ SOLN,42.0,29.4,,,0
HCPCS,J0461,ATROPINE 1 MG/ML INJ SOLN,74.0,51.8,,,0
HCPCS,J0461,ATROPINE 1 MG/ML IV SOLN,37.5,26.25,,,0
HCPCS,J0461,Atropine sulfate injection,,,0.09,0.19,6
HCPCS,J0470,Dimecaprol injection,,,91.78,142.92,6
HCPCS,J0475,Baclofen 10 mg injection,,,178.05,729.01,13
HCPCS,J0476,Baclofen intrathecal trial,,,75.5,269.59,6
HCPCS,J0480,BASILIXIMAB 20 MG IV SOLR,12584.0,8808.8,,,0
HCPCS,J0480,Basiliximab,,,4812.31,10694.26,13
HCPCS,J0485,BELATACEPT 250 MG IV SOLR,3292.0,2304.3999999999996,,,0
HCPCS,J0485,Belatacept injection,,,3.89,14.36,13
HCPCS,J0485,HC NC BELATACEPT 250 MG SOLR 1 EACH VIAL,0.01,0.007,,,0
HCPCS,J0490,BELIMUMAB 120 MG IV SOLR,3699.5,2589.6499999999996,,,0
HCPCS,J0490,BELIMUMAB 400 MG IV SOLR,8471.0,5929.7,,,0
HCPCS,J0490,Belimumab injection,,,57.19,144.51,13
HCPCS,J0491,ANIFROLUMAB-FNIA 300 MG/2 ML (150 MG/ML) IV SOLN,12698.0,8888.6,,,0
HCPCS,J0491,Inj anifrolumab-fnia 1mg,,,18.31,61.27,13
HCPCS,J0500,DICYCLOMINE 10 MG/ML IM SOLN,187.0,130.9,,,0
HCPCS,J0500,DICYCLOMINE 20 MG ORAL TAB,37.0,25.9,,,0
HCPCS,J0500,Dicyclomine injection,,,68.33,75.49,2
HCPCS,J0515,BENZTROPINE 1 MG/ML INJ SOLN,177.0,123.9,,,0
HCPCS,J0515,Inj benztropine mesylate,,,44.6,49.28,2
HCPCS,J0517,BENRALIZUMAB 30 MG/ML SUBQ ATIN,14769.0,10338.3,,,0
HCPCS,J0517,BENRALIZUMAB 30 MG/ML SUBQ SYRG,13116.0,9181.2,,,0
HCPCS,J0517,"Inj., benralizumab, 1 mg",,,163.36,633.04,13
HCPCS,J0558,"PENICILLIN G BENZATHINE&PROCAIN 1,200,000 UNIT/2 ML IM SYRINGE",861.0,602.7,,,0
HCPCS,J0558,PenG benzathine/procaine inj,,,12.06,38.43,13
HCPCS,J0561,PENICILLIN G BENZATHINE 1200000 UNIT/2 ML IM SYRG,1993.0,1395.1,,,0
HCPCS,J0561,PENICILLIN G BENZATHINE 2400000 UNIT/4 ML IM SYRG,1898.0,1328.6,,,0
HCPCS,J0561,PENICILLIN G BENZATHINE 600000 UNIT/ML IM SYRG,1307.0,914.9,,,0
HCPCS,J0561,Penicillin g benzathine inj,,,15.45,55.06,13
HCPCS,J0565,BEZLOTOXUMAB 25 MG/ML IV SOLN,7342.0,5139.4,,,0
HCPCS,J0565,"Inj, bezlotoxumab, 10 mg",,,39.83,151.81,13
HCPCS,J0567,"Inj., cerliponase alfa 1 mg",,,121.17,537.59,13
HCPCS,J0570,Buprenorphine implant 74.2mg,,,2123.55,4840.37,6
HCPCS,J0571,Buprenorphine oral 1mg,,,1.76,5.93,6
HCPCS,J0572,Bupren/nal up to 3mg bupreno,,,9.31,26.42,6
HCPCS,J0573,Bupren/nal 3.1 to 6mg bupren,,,15.47,39.09,6
HCPCS,J0574,Bupren/nal 6.1 to 10mg bupre,,,14.9,39.39,6
HCPCS,J0575,Bupren/nal over 10mg bupreno,,,25.17,42.56,6
HCPCS,J0576,Inj buprenorph (brixadi) 1mg,,,30.53,48.52,6
HCPCS,J0577,"Inj, brixadi, 7 days or less",,,417.21,2108.32,9
HCPCS,J0578,BUPRENORPHINE 128 MG/0.36 ML SUBQ SLSY,4047.0,2832.9,,,0
HCPCS,J0578,BUPRENORPHINE 64 MG/0.18 ML SUBQ SLSY,4047.0,2832.9,,,0
HCPCS,J0578,"Inj brixadi, more than 7 day",,,1668.84,11993.95,9
HCPCS,J0583,BIVALIRUDIN 250 MG IV SOLR,713.0,499.1,,,0
HCPCS,J0583,BIVALIRUDIN 250 MG/50 ML (5 MG/ML) IV SOLN,303.5,212.45,,,0
HCPCS,J0583,Bivalirudin,,,3.02,9.07,6
HCPCS,J0584,"Injection, burosumab-twza 1m",,,498.72,1362.31,13
HCPCS,J0585,BOTULINUM TOXIN TYPE A 100 UNIT IM SOLR,543.0,380.1,,,0
HCPCS,J0585,"Injection,onabotulinumtoxina",,,6.51,20.98,13
HCPCS,J0585,ONABOTULINUMTOXINA 200 UNIT INJ SOLR,1239.0,867.3,,,0
HCPCS,J0586,ABOBOTULINUMTOXINA 500 UNITS IM SOLR,3629.5,2540.65,,,0
HCPCS,J0586,Abobotulinumtoxina,,,8.9,26.31,13
HCPCS,J0587,"Inj, rimabotulinumtoxinb",,,13.28,35.38,13
HCPCS,J0588,Incobotulinumtoxin a,,,5.29,16.93,13
HCPCS,J0589,Inj daxibotulinumtoxina-lanm,,,3.09,7.96,9
HCPCS,J0592,BUPRENORPHINE HCL 0.3 MG/ML INJ (MERGE),85.0,59.5,,,0
HCPCS,J0592,Buprenorphine hydrochloride,,,7.79,8.61,2
HCPCS,J0593,"Inj., lanadelumab-flyo, 1 mg",,,86.85,288.58,13
HCPCS,J0594,Busulfan injection,,,0.68,47.17,13
HCPCS,J0595,Butorphanol tartrate 1 mg,,,4.1,4.53,2
HCPCS,J0596,"Injection, ruconest",,,36.67,96.77,13
HCPCS,J0597,"C-1 esterase, berinert",,,76.05,154.27,13
HCPCS,J0598,"C-1 esterase, cinryze",,,65.5,184.01,13
HCPCS,J0599,"Inj., haegarda 10 units",,,19.86,36.54,6
HCPCS,J0600,Edetate calcium disodium inj,,,156.29,12313.81,13
HCPCS,J0601,SEVELAMER CARBONATE 800 MG ORAL TAB,85.0,59.5,,,0
HCPCS,J0602,SEVELAMER CARBONATE 0.8 GRAM ORAL PWPK,211.0,147.7,,,0
HCPCS,J0604,"Cinacalcet, esrd on dialysis",,,1.46,1.61,2
HCPCS,J0605,SUCROFERRIC OXYHYDROXIDE 500 MG ORAL CHEW,50.0,35.0,,,0
HCPCS,J0606,"Inj, etelcalcetide, 0.1 mg",,,2.36,11.28,13
HCPCS,J0612,"CALCIUM GLUC IN NACL, ISO-OSM 1 G/100 ML IV SOLN",112.0,78.4,,,0
HCPCS,J0612,"CALCIUM GLUC IN NACL, ISO-OSM 1 GRAM/50 ML IV SOLN",348.0,243.6,,,0
HCPCS,J0612,CALCIUM GLUCONATE (FOR EMERGENCY) 100 MG/ML (10%) IV SOLN,177.0,123.9,,,0
HCPCS,J0612,CALCIUM GLUCONATE 20MG/ML IV SYRINGE (PEDS/NEO),40.5,28.35,,,0
HCPCS,J0612,CALCIUM GLUCONATE IN 0.9% NACL 3 GRAM/100 ML IV SOLN,170.0,119.0,,,0
HCPCS,J0612,Calcium glucon (fresenius),,,0.09,0.19,6
HCPCS,J0613,"CALCIUM GLUC IN NACL, ISO-OSM 1 G/100 ML IV SOLN",112.0,78.4,,,0
HCPCS,J0613,"CALCIUM GLUC IN NACL, ISO-OSM 1 GRAM/50 ML IV SOLN",464.0,324.8,,,0
HCPCS,J0613,Calcium glucon (wg critical),,,0.26,0.38,6
HCPCS,J0615,CALCIUM ACETATE 667 MG ORAL CAP,20.0,14.0,,,0
HCPCS,J0630,CALCITONIN (SALMON) 200 UNIT/ML INJ SOLN,3198.5,2238.95,,,0
HCPCS,J0630,Calcitonin salmon injection,,,5374.68,8699.93,6
HCPCS,J0636,CALCITRIOL 1 MCG/ML IV SOLN,52.0,36.4,,,0
HCPCS,J0636,Inj calcitriol per 0.1 mcg,,,1.53,1.69,2
HCPCS,J0637,Caspofungin acetate,,,16.47,57.23,6
HCPCS,J0638,CANAKINUMAB (PF) 150 MG/ML SUBQ SOLN,55390.5,38773.350000000006,,,0
HCPCS,J0638,Canakinumab injection,,,149.57,343.75,13
HCPCS,J0640,LEUCOVORIN 1 MG/ML INJECTION (PEDS ONCOLOGY),37.0,25.9,,,0
HCPCS,J0640,LEUCOVORIN CALCIUM   5 MG ORAL TAB,28.0,19.6,,,0
HCPCS,J0640,LEUCOVORIN CALCIUM  50 MG INJ SOLR,45.5,31.85,,,0
HCPCS,J0640,LEUCOVORIN CALCIUM 100 MG INJ SOLR,122.5,85.75,,,0
HCPCS,J0640,LEUCOVORIN CALCIUM 200 MG INJ SOLR,134.0,93.8,,,0
HCPCS,J0640,LEUCOVORIN CALCIUM 350 MG INJ SOLR,286.0,200.2,,,0
HCPCS,J0640,Leucovorin calcium injection,,,14.79,16.34,2
HCPCS,J0641,Levoleucovorin injection,,,0.73,3.97,6
HCPCS,J0642,"Injection, khapzory, 0.5 mg",,,3.73,7.71,6
HCPCS,J0650,"Inj, levothyroxine nos 10mcg",,,17.62,19.47,2
HCPCS,J0650,LEVOTHYROXINE 100 MCG IV SOLR,520.0,364.0,,,0
HCPCS,J0650,LEVOTHYROXINE 500 MCG INJ SOLR,1458.0,1020.6,,,0
HCPCS,J0651,"Inj, levothyroxine, freskabi",,,6.96,21.01,9
HCPCS,J0652,"Inj, levothyroxine, hikma",,,12.86,14.2,2
HCPCS,J0665,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN,34.5,24.15,,,0
HCPCS,J0665,BUPIVACAINE 0.25 % (2.5 MG/ML) INJ SOLN,35.0,24.5,,,0
HCPCS,J0665,"Inj, bupivacaine, nos, 0.5mg",,,0.04,0.06,4
HCPCS,J0670,Inj mepivacaine HCL/10 ml,,,6.11,6.75,2
HCPCS,J0670,MEPIVACAINE (PF) 10 MG/ML (1 %) INJ SOLN,62.0,43.400000000000006,,,0
HCPCS,J0670,MEPIVACAINE (PF) 20 MG/ML (2 %) INJ SOLN,50.5,35.349999999999994,,,0
HCPCS,J0687,Inj cefazolin (wg crit care),,,2.09,2.31,2
HCPCS,J0688,CEFAZOLIN   2 G IV SOLR,39.0,27.3,,,0
HCPCS,J0688,"Inj cefazolin sodium, hikma",,,2.52,2.78,2
HCPCS,J0689,CEFAZOLIN IN DEXTROSE (ISO-OS) 2 GRAM/100 ML IV PGBK,55.0,38.5,,,0
HCPCS,J0689,CEFAZOLIN IN DEXTROSE (ISO-OSMOTIC) 1 GRAM/50 ML IV PIGGY BACK,45.0,31.5,,,0
HCPCS,J0689,"Inj cefazolin sodium, baxter",,,0.07,0.08,2
HCPCS,J0690,CEFAZOLIN   1 GRAM INJ SOLR,39.0,27.3,,,0
HCPCS,J0690,CEFAZOLIN   2 G INJ SOLR,41.0,28.7,,,0
HCPCS,J0690,CEFAZOLIN  10 GRAM INJ SOLR,18.5,12.95,,,0
HCPCS,J0690,CEFAZOLIN 1000 MG IN NS 1000 ML IRRIGATION (REPACK),57.5,40.25,,,0
HCPCS,J0690,CEFAZOLIN 1000 MG IN NS 500 ML IRRIGATION (REPACK),69.0,48.300000000000004,,,0
HCPCS,J0690,CEFAZOLIN 5 MG/ML AND HEPARIN 5000 UNITS/ML CATHETER LOCK FOR INTERCATHETER DWELL (USE PANEL),156.0,109.2,,,0
HCPCS,J0690,CEFAZOLIN IN DEXTROSE (ISO-OS) 2 GRAM/100 ML IV PGBK,55.0,38.5,,,0
HCPCS,J0690,CEFAZOLIN IN DEXTROSE (ISO-OS) 2 GRAM/50 ML IV PGBK,87.0,60.9,,,0
HCPCS,J0690,CEFAZOLIN IN DEXTROSE (ISO-OS) 3 GRAM/150 ML IV PGBK,35.0,24.5,,,0
HCPCS,J0690,CEFAZOLIN IN DEXTROSE (ISO-OSMOTIC) 1 GRAM/50 ML IV PIGGY BACK,48.5,33.95,,,0
HCPCS,J0690,CEFAZOLIN IN STERILE WATER 2 GRAM/20 ML IV SYRG,157.0,109.9,,,0
HCPCS,J0690,CEFAZOLIN PEDS SYRINGE (20MG/ML) IN DEXTROSE (CDS MIX,75.0,52.5,,,0
HCPCS,J0690,CEFAZOLIN SODIUM-STERILE WATER 1 GRAM/10 ML IV SYRG,54.0,37.8,,,0
HCPCS,J0690,Cefazolin sodium injection,,,1.87,2.07,2
HCPCS,J0691,Inj lefamulin 1 mg,,,1.17,2.74,6
HCPCS,J0692,CEFEPIME 1 GRAM INJ SOLR,69.0,48.3,,,0
HCPCS,J0692,CEFEPIME 2 GRAM INJ SOLR,198.0,138.6,,,0
HCPCS,J0692,CEFEPIME 40 MG/ML IV SYRINGE (CDS MIXTURE),54.5,38.15,,,0
HCPCS,J0692,Cefepime hcl for injection,,,5.05,5.58,2
HCPCS,J0694,Cefoxitin sodium injection,,,15.74,17.4,2
HCPCS,J0695,CEFTOLOZANE-TAZOBACTAM 1.5 G IV SOLR,891.5,624.05,,,0
HCPCS,J0695,Inj ceftolozane tazobactam,,,8.84,16.18,13
HCPCS,J0696,CEFTRIAXONE   1 GRAM IV SOLR,42.0,29.4,,,0
HCPCS,J0696,CEFTRIAXONE   2 GRAM INJ SOLR,60.0,42.0,,,0
HCPCS,J0696,CEFTRIAXONE   2 GRAM IV SOLR,54.0,37.8,,,0
HCPCS,J0696,CEFTRIAXONE 1 GRAM INJ SOLR,135.0,94.5,,,0
HCPCS,J0696,CEFTRIAXONE 100 MG/ML FROM 1 GRAM VIAL (PRMC PEDS ONLY),87.0,60.900000000000006,,,0
HCPCS,J0696,CEFTRIAXONE 250 MG INJ SOLR,112.0,78.4,,,0
HCPCS,J0696,CEFTRIAXONE 500 MG INJ SOLR,25.0,17.5,,,0
HCPCS,J0696,CEFTRIAXONE IN DEXTROSE (ISO-OSMOTIC) 1 GRAM/50 ML IV PIGGY BACK,116.0,81.2,,,0
HCPCS,J0696,CEFTRIAXONE NEO/PEDS (CDS MIXTURE),96.0,67.2,,,0
HCPCS,J0696,Ceftriaxone sodium injection,,,11.07,12.23,2
HCPCS,J0697,Sterile cefuroxime injection,,,5.02,5.55,2
HCPCS,J0698,Cefotaxime sodium injection,,,8.64,9.54,2
HCPCS,J0699,CEFIDEROCOL 1 G IV SOLR,1649.0,1154.3,,,0
HCPCS,J0699,"Inj, cefiderocol, 10 mg",,,2.42,7.6,13
HCPCS,J0701,Inj. cefepime hcl (baxter),,,20.71,22.88,2
HCPCS,J0702,BETAMETHASONE ACET & SOD PHOS 6 MG/ML INJ SUSP,96.5,67.55,,,0
HCPCS,J0702,Betamethasone acet&sod phosp,,,14.27,15.77,2
HCPCS,J0703,"Inj, cefepime hcl (b braun)",,,14.84,16.4,2
HCPCS,J0706,CAFFEINE CITRATE PEDS/NEO IV SYR (CDS MIX) LD,31.0,21.7,,,0
HCPCS,J0706,CAFFEINE CITRATED 20 MG/ML IV SOLN,17.0,11.9,,,0
HCPCS,J0706,Caffeine citrate injection,,,2.85,3.14,2
HCPCS,J0712,CEFTAROLINE FOSAMIL 400 MG IV SOLR,890.5,623.3499999999999,,,0
HCPCS,J0712,CEFTAROLINE FOSAMIL 600 MG IV SOLR,290.0,203.0,,,0
HCPCS,J0712,Ceftaroline fosamil inj,,,2.48,9.69,13
HCPCS,J0713,CEFTAZIDIME   1 GRAM INJ SOLR,43.0,30.1,,,0
HCPCS,J0713,CEFTAZIDIME NEO IV SYRINGE (CDS MIXTURE),20.5,14.35,,,0
HCPCS,J0713,Inj ceftazidime per 500 mg,,,7.14,7.88,2
HCPCS,J0714,CEFTAZIDIME-AVIBACTAM 2.5 GRAM (2 GRAM-0.5 GRAM) IV SOLR,527.0,368.9,,,0
HCPCS,J0714,Ceftazidime and avibactam,,,104.75,279.23,13
HCPCS,J0716,Centruroides immune f(ab),,,11016.47,13743.32,4
HCPCS,J0717,CERTOLIZUMAB PEGOL 400 MG (200 MG X 2) SUBQ KIT,3323.0,2326.1,,,0
HCPCS,J0717,CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X 2) SUBQ SYKT,8280.0,5796.0,,,0
HCPCS,J0717,Certolizumab pegol inj 1mg,,,3.79,27.11,13
HCPCS,J0720,Chloramphenicol sodium injec,,,83.48,92.24,2
HCPCS,J0725,Chorionic gonadotropin/1000u,,,42.1,46.52,2
HCPCS,J0735,CLONIDINE (PF) 1000 MCG/10 ML EPID SOLN,218.5,152.95,,,0
HCPCS,J0735,Clonidine hydrochloride,,,59.17,250.84,6
HCPCS,J0736,CLINDAMYCIN IN D5W 300 MG/50 ML IV PGBK,55.0,38.5,,,0
HCPCS,J0736,CLINDAMYCIN IN D5W 600 MG/50 ML IV PGBK,94.0,65.8,,,0
HCPCS,J0736,CLINDAMYCIN IN D5W 900 MG/50 ML IV PGBK,68.5,47.95,,,0
HCPCS,J0736,CLINDAMYCIN PEDS IV INFUSION 12 MG/ML (CDS MIXTURE FROM PREMIX),53.0,37.1,,,0
HCPCS,J0736,"Inj, clindamycin phosp 300mg",,,3.02,8.22,6
HCPCS,J0737,"Inj, clindamycin (baxter)",,,6.62,10.13,6
HCPCS,J0739,CABOTEGRAVIR 600 MG/3 ML (200 MG/ML) IM SPER,11110.0,7777.0,,,0
HCPCS,J0739,"Injection, cabotegravir 1 mg",,,7.14,12.5,9
HCPCS,J0740,Cidofovir injection,,,560.79,2957.93,13
HCPCS,J0741,"Inj, cabote rilpivir 2mg 3mg",,,24.18,77.7,11
HCPCS,J0742,IMIPENEM-CILASTATIN-RELEBACTAM 1.25 G IV SOLR,1120.0,784.0,,,0
HCPCS,J0742,Inj imip 4 cilas 4 releb 2mg,,,4.22,8.53,6
HCPCS,J0743,Cilastatin sodium injection,,,24.6,27.18,2
HCPCS,J0743,IMIPENEM-CILASTATIN 500 MG IV SOLR,248.5,173.95,,,0
HCPCS,J0744,CIPROFLOXACIN IN D5W 200 MG/100 ML IV PGBK,22.0,15.4,,,0
HCPCS,J0744,CIPROFLOXACIN IN D5W 400 MG/200 ML IV PGBK,117.0,81.9,,,0
HCPCS,J0744,Ciprofloxacin iv,,,5.15,5.69,2
HCPCS,J0745,Inj codeine phosphate /30 MG,,,410.99,512.72,4
HCPCS,J0750,EMTRICITABINE-TENOFOVIR 200 MG-300 MG TAB,168.0,117.60000000000001,,,0
HCPCS,J0750,"Hiv prep, ftc/tdf 200/300mg",,,0.49,110.62,9
HCPCS,J0751,"Hiv prep, ftc/taf 200/25mg",,,71.44,139.18,9
HCPCS,J0759,CLEVIDIPINE 50 MG/100 ML IV EMUL,762.0,533.4,,,0
HCPCS,J0770,Colistimethate sodium inj,,,48.05,53.09,2
HCPCS,J0775,"Collagenase, clost hist inj",,,78.35,146.25,13
HCPCS,J0780,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN,30.0,21.0,,,0
HCPCS,J0780,Prochlorperazine injection,,,10.35,11.44,2
HCPCS,J0791,Inj crizanlizumab-tmca 5mg,,,129.94,462.77,13
HCPCS,J0795,Corticorelin ovine triflutal,,,13.67,17.3,6
HCPCS,J0800,Corticotropin injection,,,7325.36,9138.57,4
HCPCS,J0801,Inj. acthar gel to 40 units,,,4094.26,15460.53,13
HCPCS,J0802,"Inj. (ani), up to 40 units",,,3571.35,13145.11,13
HCPCS,J0834,COSYNTROPIN 0.25 MG INJ SOLR,381.0,266.7,,,0
HCPCS,J0834,Cosyntropin cortrosyn inj,,,151.31,250.65,6
HCPCS,J0840,CROTALIDAE POLYVAL IMMUNE FAB SOLUTION FOR INJECTION,26479.5,18535.65,,,0
HCPCS,J0840,Crotalidae poly immune fab,,,1841.02,8379.5,13
HCPCS,J0841,ANTIVENIN CROTALIDAE (EQUINE) INJ SOLR,21860.0,15302.0,,,0
HCPCS,J0841,Inj crotalidae im f(ab')2 eq,,,2265.12,4749.95,6
HCPCS,J0850,CYTOMEGALOVIRUS IMMUNE GLOB 50 MG/ML IV SOLN,2475.0,1732.5,,,0
HCPCS,J0850,Cytomegalovirus imm IV /vial,,,1808.61,3411.03,13
HCPCS,J0870,IMETELSTAT  47 MG IV SOLR,12100.5,8470.35,,,0
HCPCS,J0870,IMETELSTAT 188 MG IV SOLR,51468.5,36027.95,,,0
HCPCS,J0872,Daptomycin (xellia) unrefrig,,,0.24,0.27,2
HCPCS,J0873,"Inj, daptomycin (xellia)",,,0.2,0.22,2
HCPCS,J0874,DAPTOMYCIN IN 0.9 % SOD CHLOR 350 MG/50 ML IV PGBK,269.0,188.3,,,0
HCPCS,J0874,"Inj, daptomycin (baxter)",,,0.14,0.16,2
HCPCS,J0875,DALBAVANCIN 500 MG IV SOLN,9821.5,6875.049999999999,,,0
HCPCS,J0875,"Injection, dalbavancin",,,15.0,55.11,13
HCPCS,J0877,"Inj, daptomycin (hospira)",,,0.26,0.28,2
HCPCS,J0878,DAPTOMYCIN 500 MG IV SOLR,627.5,439.25,,,0
HCPCS,J0878,Daptomycin injection,,,1.09,1.52,6
HCPCS,J0879,"Difelikefalin, esrd on dialy",,,0.4,0.91,6
HCPCS,J0881,DARBEPOETIN ALFA IN POLYSORBAT  10 MCG/0.4 ML INJ SYRG,788.0,551.6,,,0
HCPCS,J0881,DARBEPOETIN ALFA IN POLYSORBAT  25 MCG/ML INJ SOLN,1254.0,877.8000000000001,,,0
HCPCS,J0881,DARBEPOETIN ALFA IN POLYSORBAT  40 MCG/0.4 ML INJ SYRG,1644.0,1150.8000000000002,,,0
HCPCS,J0881,DARBEPOETIN ALFA IN POLYSORBAT  60 MCG/0.3 ML INJ SYRG,1069.0,748.3,,,0
HCPCS,J0881,DARBEPOETIN ALFA IN POLYSORBAT 100 MCG/0.5 ML INJ SYRG,669.5,468.65,,,0
HCPCS,J0881,DARBEPOETIN ALFA IN POLYSORBAT 200 MCG/0.4 ML INJ SYRG,3205.0,2243.5,,,0
HCPCS,J0881,DARBEPOETIN ALFA IN POLYSORBAT 25 MCG/0.42 ML INJ SYRG,1421.5,995.0500000000001,,,0
HCPCS,J0881,DARBEPOETIN ALFA IN POLYSORBAT 300 MCG/0.6 ML INJ SYRG,5500.5,3850.3500000000004,,,0
HCPCS,J0881,DARBEPOETIN ALFA IN POLYSORBAT 500 MCG/ML INJ SYRG,8545.0,5981.5,,,0
HCPCS,J0881,"Darbepoetin alfa, non-esrd",,,3.07,14.68,13
HCPCS,J0882,"Darbepoetin alfa, esrd use",,,3.07,14.68,13
HCPCS,J0883,ARGATROBAN 100 MG/ML IV SOLN,962.0,673.4,,,0
HCPCS,J0883,Argatroban nonesrd use 1mg,,,1.01,7.03,13
HCPCS,J0884,Argatroban esrd dialysis 1mg,,,5.73,20.68,6
HCPCS,J0885,EPOETIN ALFA  4000 UNIT/ML INJ SOLN,462.0,323.4,,,0
HCPCS,J0885,EPOETIN ALFA 10000 UNIT/ML INJ SOLN,852.0,596.4,,,0
HCPCS,J0885,EPOETIN ALFA 20000 UNIT/ML INJ SOLN,1174.0,821.8,,,0
HCPCS,J0885,EPOETIN ALFA 40000 UNIT/ML INJ SOLN,2951.0,2065.7,,,0
HCPCS,J0885,"Epoetin alfa, non-esrd",,,7.3,35.31,13
HCPCS,J0885,HC NC EPO ALFA NON ESRD PER 1000,0.01,0.007,,,0
HCPCS,J0887,Epoetin beta esrd use,,,4.35,5.47,6
HCPCS,J0888,Epoetin beta non esrd,,,4.53,5.65,5
HCPCS,J0889,Daprodustat oral 1mg esrd,,,6.71,7.41,2
HCPCS,J0890,Peginesatide injection,,,24.85,31.0,4
HCPCS,J0891,Argatroban nonesrd (accord),,,1.72,8.05,13
HCPCS,J0892,Argatroban dialysis (accord),,,1.72,7.51,6
HCPCS,J0893,"Inj, decitabine (sun pharma)",,,52.8,58.33,2
HCPCS,J0894,DECITABINE 50 MG IV SOLR,320.0,224.0,,,0
HCPCS,J0894,Decitabine injection,,,14.09,103.76,6
HCPCS,J0895,DEFEROXAMINE 2 GRAM INJ SOLR,242.0,169.4,,,0
HCPCS,J0895,DEFEROXAMINE 500 MG INJ SOLR,152.0,106.4,,,0
HCPCS,J0895,Deferoxamine mesylate inj,,,22.22,24.55,2
HCPCS,J0896,Inj luspatercept-aamt 0.25mg,,,42.75,137.24,13
HCPCS,J0896,LUSPATERCEPT-AAMT 25 MG SUBQ SOLR,4991.0,3493.7,,,0
HCPCS,J0896,LUSPATERCEPT-AAMT 75 MG SUBQ SOLR,22747.5,15923.25,,,0
HCPCS,J0897,DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBQ SOLN,9295.0,6506.5,,,0
HCPCS,J0897,DENOSUMAB 60 MG/ML SUBQ SYRG,5053.5,3537.45,,,0
HCPCS,J0897,Denosumab injection,,,29.51,56.55,13
HCPCS,J0898,Argatroban nonesrd (auromed),,,6.36,8.33,6
HCPCS,J0899,"Argatroban dialysis, auromed",,,6.36,8.33,6
HCPCS,J0911,Inst tauro 1.35mg/hep 100u,,,5.03,22.29,9
HCPCS,J1000,Depo-estradiol cypionate inj,,,69.68,76.99,2
HCPCS,J1000,ESTRADIOL CYPIONATE 5 MG/ML IM OIL,878.0,614.6,,,0
HCPCS,J1010,"Inj, methylpred acetate 1 mg",,,0.31,0.35,2
HCPCS,J1010,METHYLPREDNISOLONE 40 MG/ML SUSP (DEPO-MEDROL) INJECTION,51.5,36.05,,,0
HCPCS,J1010,METHYLPREDNISOLONE 80 MG/ML SUSP FOR INJECTION,72.0,50.4,,,0
HCPCS,J1050,MEDROXYPROGESTERONE (CONTRACEPTIVE) 150 MG/ML IM (MERGE),280.0,196.0,,,0
HCPCS,J1050,MEDROXYPROGESTERONE (CONTRACEPTIVE) 150 MG/ML IM SUSP,216.0,151.2,,,0
HCPCS,J1050,MEDROXYPROGESTERONE 150 MG/ML IM SYRG,147.0,102.9,,,0
HCPCS,J1050,Medroxyprogesterone acetate,,,0.67,0.88,6
HCPCS,J1071,Inj testosterone cypionate,,,0.09,0.16,6
HCPCS,J1071,TESTOSTERONE CYPIONATE 100 MG/ML IM OIL,37.0,25.9,,,0
HCPCS,J1071,TESTOSTERONE CYPIONATE 200 MG/ML IM OIL,73.5,51.45,,,0
HCPCS,J1094,Inj dexamethasone acetate,,,1.07,1.19,2
HCPCS,J1095,"Injection, dexamethasone 9%",,,3.59,4.48,6
HCPCS,J1096,Dexametha opth insert 0.1 mg,,,92.55,572.33,13
HCPCS,J1097,Phenylep ketorolac opth soln,,,96.61,428.63,13
HCPCS,J1100,DEXAMETHASONE 0.1 MG/ML IV SYRINGE (NEO/INFANT),27.5,19.25,,,0
HCPCS,J1100,DEXAMETHASONE 0.4MG/ML ORAL SOLUTION (REPACK),31.0,21.7,,,0
HCPCS,J1100,DEXAMETHASONE 10 MG/ML FOR ORAL OR INJECTION (PEDS ONC),7.0,4.9,,,0
HCPCS,J1100,DEXAMETHASONE 10 MG/ML INJECTION,10.5,7.35,,,0
HCPCS,J1100,DEXAMETHASONE 20MG/55 ML IVPB IN NS (ONCOLOGY),80.5,56.35,,,0
HCPCS,J1100,DEXAMETHASONE 4 MG/ML INJECTION,29.0,20.3,,,0
HCPCS,J1100,DEXAMETHASONE SODIUM PHOS (PF) 10MG/ML INJ SOLN,34.5,24.15,,,0
HCPCS,J1100,Dexamethasone sodium phos,,,0.26,0.28,2
HCPCS,J1105,"Dexmedetomidine film, 1 mcg",,,1.26,1.39,2
HCPCS,J1110,DIHYDROERGOTAMINE 1 MG/ML INJ SOLN,511.0,357.70000000000005,,,0
HCPCS,J1110,Inj dihydroergotamine mesylt,,,240.97,266.25,2
HCPCS,J1120,ACETAZOLAMIDE SODIUM 500 (100 MG/ML) INJ SOLR,169.0,118.3,,,0
HCPCS,J1120,Acetazolamid sodium injectio,,,68.38,75.56,2
HCPCS,J1130,Inj diclofenac sodium 0.5mg,,,0.36,0.95,6
HCPCS,J1160,DIGOXIN 250 MCG/ML INJ SOLN,21.0,14.7,,,0
HCPCS,J1160,Digoxin injection,,,241.06,266.34,2
HCPCS,J1162,Digoxin immune fab (ovine),,,1536.82,9042.23,13
HCPCS,J1165,PHENYTOIN SODIUM 50 MG/ML IV SOLN,67.0,46.9,,,0
HCPCS,J1165,Phenytoin sodium injection,,,1.14,1.26,2
HCPCS,J1170,HYDROMORPHONE  1 MG/ML INJ SYRG,26.5,18.55,,,0
HCPCS,J1170,HYDROMORPHONE (PF) 1 MG/ML IV SOLN (PHS ERX MERGE),24.0,16.8,,,0
HCPCS,J1170,HYDROMORPHONE 0.5 MG/0.5 ML INJ SYRG (PHS ERX MERGE),19.5,13.65,,,0
HCPCS,J1170,Hydromorphone injection,,,16.33,18.04,2
HCPCS,J1171,HYDROMORPHONE  1 MG/ML INJ SYRG,43.5,30.45,,,0
HCPCS,J1171,HYDROMORPHONE (PF) 1 MG/ML INJ SOLN,16.0,11.2,,,0
HCPCS,J1171,HYDROMORPHONE (PF) 1 MG/ML IV SOLN (PHS ERX MERGE),36.0,25.2,,,0
HCPCS,J1171,HYDROMORPHONE (PF) 10 MG/ML INJ SOLN,111.0,77.7,,,0
HCPCS,J1171,HYDROMORPHONE (PF) 2 MG/ML IV SOLN (PRMC ERX MERGE),41.0,28.7,,,0
HCPCS,J1171,HYDROMORPHONE (PF)-0.9 % NACL 0.2 MG/ML IV SOLN BAG (FOR VENT),72.0,50.4,,,0
HCPCS,J1171,HYDROMORPHONE 0.5 MG/0.5 ML INJ SYRG (PHS ERX MERGE),41.0,28.700000000000003,,,0
HCPCS,J1171,HYDROMORPHONE 10 MG/50 ML (0.2MG/ML) PCA IN NS (MERGE),144.0,100.8,,,0
HCPCS,J1171,"Inj, hydromorphone, 0.1 mg",,,0.13,0.14,2
HCPCS,J1190,DEXRAZOXANE 250 MG IV SOLR,913.0,639.1,,,0
HCPCS,J1190,DEXRAZOXANE 500 MG IV SOLR,1411.0,987.7,,,0
HCPCS,J1190,Dexrazoxane hcl injection,,,49.74,1043.51,13
HCPCS,J1200,DIPHENHYDRAMINE 50 MG/ML INJECTION,26.0,18.2,,,0
HCPCS,J1200,Diphenhydramine hcl injectio,,,2.4,2.65,2
HCPCS,J1201,Inj. cetirizine hcl 0.5mg,,,16.92,58.18,13
HCPCS,J1202,Miglustat oral 65 mg,,,56.63,62.57,2
HCPCS,J1203,"Inj, cipaglucosidase, 5 mg",,,92.4,164.43,9
HCPCS,J1205,CHLOROTHIAZIDE SODIUM 28 MG/ML IV (PEDS) REPACK,38.0,26.6,,,0
HCPCS,J1205,CHLOROTHIAZIDE SODIUM 500 MG IV SOLR,115.0,80.5,,,0
HCPCS,J1205,Chlorothiazide sodium inj,,,286.0,749.99,6
HCPCS,J1212,Dimethyl sulfoxide 50% 50 ML,,,748.98,1881.68,13
HCPCS,J1230,METHADONE 10 MG/ML INJ SOLN,41.0,28.7,,,0
HCPCS,J1230,Methadone injection,,,31.7,35.03,2
HCPCS,J1240,Dimenhydrinate injection,,,19.79,21.87,2
HCPCS,J1245,Dipyridamole injection,,,4.56,5.04,2
HCPCS,J1246,"Inj, dinutuximab, 0.1 mg",,,283.81,354.06,4
HCPCS,J1250,DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) IV,87.0,60.9,,,0
HCPCS,J1250,"DOBUTAMINE IN D5W 1,000 MG/250 ML (4,000 MCG/ML) IV SOLP",172.0,120.4,,,0
HCPCS,J1250,DOBUTAMINE IN D5W 500 MG/250 ML (2 MG/ML) INFUSION (PREMIX),108.0,75.6,,,0
HCPCS,J1250,Inj dobutamine HCL/250 mg,,,12.54,13.86,2
HCPCS,J1260,Dolasetron mesylate,,,14.33,17.88,4
HCPCS,J1265,DOPAMINE 200 MG/5 ML (40 MG/ML) IV,22.0,15.4,,,0
HCPCS,J1265,DOPAMINE IN D5W 400 MG/250 ML (1.6 MG/ML) IV,93.0,65.1,,,0
HCPCS,J1265,DOPAMINE INFUSION NEO IV SYRINGE (FROM PREMIX),81.0,56.7,,,0
HCPCS,J1265,DOPAMINE INFUSION NEO IV SYRINGE (FROM PREMIX) 3200 MIG/ML,21.0,14.7,,,0
HCPCS,J1265,DOPAMINE INFUSION PEDS IV SYRINGE (FROM PREMIX),19.0,13.3,,,0
HCPCS,J1265,Dopamine injection,,,1.0,1.11,2
HCPCS,J1267,Doripenem injection,,,1.36,2.46,6
HCPCS,J1270,DOXERCALCIFEROL 4 MCG/2 ML IV SOLN,20.0,14.0,,,0
HCPCS,J1270,"Injection, doxercalciferol",,,1.93,2.13,2
HCPCS,J1290,Ecallantide injection,,,578.75,1196.56,13
HCPCS,J1299,ECULIZUMAB 300 MG/30 ML IV SOLN,34545.0,24181.5,,,0
HCPCS,J1300,ECULIZUMAB 300 MG/30 ML IV SOLN,51817.0,36271.9,,,0
HCPCS,J1300,Eculizumab injection,,,373.12,691.14,6
HCPCS,J1301,"Injection, edaravone, 1 mg",,,15.18,72.5,13
HCPCS,J1302,"Inj, sutimlimab-jome, 10 mg",,,19.64,64.3,13
HCPCS,J1303,HC NC RAVULIZUMAB-CWVZ 10 MG,0.01,0.007,,,0
HCPCS,J1303,"Inj., ravulizumab-cwvz 10 mg",,,223.68,855.32,13
HCPCS,J1303,RAVULIZUMAB-CWVZ 100 MG/ML IV SOLN,29459.0,20621.3,,,0
HCPCS,J1304,Inj tofersen intrathec 1 mg,,,160.01,554.03,13
HCPCS,J1305,EVINACUMAB-DGNB 150 MG/ML IV SOLN,93288.0,65301.6,,,0
HCPCS,J1305,"Inj, evinacumab-dgnb, 5mg",,,197.63,626.06,13
HCPCS,J1306,INCLISIRAN 284 MG/1.5 ML SUBQ SYRG,8970.0,6279.0,,,0
HCPCS,J1306,"Injection, inclisiran, 1 mg",,,12.61,44.57,13
HCPCS,J1322,"Elosulfase alfa, injection",,,311.95,838.03,13
HCPCS,J1323,ELRANATAMAB-BCMM 40 MG/ML SUBQ SOLN,8820.0,6174.0,,,0
HCPCS,J1323,"Inj, elranatamab-bcmm, 1 mg",,,186.79,338.28,9
HCPCS,J1324,Enfuvirtide injection,,,1.14,1.74,6
HCPCS,J1325,Epoprostenol injection,,,29.52,32.61,2
HCPCS,J1325,ZOLBETUXIMAB-CLZB 100 MG IV SOLR (WET SOLR VIAL),3667.5,2567.25,,,0
HCPCS,J1325,ZOLBETUXIMAB-CLZB 300 MG IV SOLR (WET SOLR VIAL),26496.0,18547.2,,,0
HCPCS,J1326,ZOLBETUXIMAB-CLZB 100 MG IV SOLR (WET SOLR VIAL),4416.0,3091.2,,,0
HCPCS,J1326,ZOLBETUXIMAB-CLZB 300 MG IV SOLR (WET SOLR VIAL),26496.0,18547.2,,,0
HCPCS,J1327,Eptifibatide injection,,,3.26,69.44,13
HCPCS,J1335,ERTAPENEM 1 GRAM INJ SOLR,469.0,328.29999999999995,,,0
HCPCS,J1335,Ertapenem injection,,,93.12,102.89,2
HCPCS,J1364,Erythro lactobionate /500 MG,,,150.51,225.67,6
HCPCS,J1380,ESTRADIOL VALERATE 20 MG/ML IM OIL,67.0,46.900000000000006,,,0
HCPCS,J1380,Estradiol valerate 10 MG inj,,,40.96,45.25,2
HCPCS,J1410,CONJUGATED ESTROGENS 25 MG INJ SOLR,1319.0,923.3,,,0
HCPCS,J1410,Inj estrogen conjugate 25 MG,,,235.19,697.82,13
HCPCS,J1411,"Inj, hemgenix, per tx dose",,,3691450.0,16377714.39,13
HCPCS,J1412,Inj roctavian ml 2x10^13vc g,,,12553.71,171825.0,13
HCPCS,J1413,Inj delandistrogene mox rokl,,,3321376.38,14735822.97,13
HCPCS,J1426,"Injection, casimersen, 10 mg",,,166.2,737.37,13
HCPCS,J1427,Inj. viltolarsen,,,96.78,222.84,6
HCPCS,J1428,"Inj, eteplirsen, 10 mg",,,167.51,743.2,13
HCPCS,J1429,Inj golodirsen 10 mg,,,274.56,628.2,6
HCPCS,J1430,Ethanolamine oleate 100 mg,,,466.59,907.6,13
HCPCS,J1435,Injection estrone per 1 MG,,,0.07,0.08,2
HCPCS,J1436,Etidronate disodium inj,,,222.16,277.15,4
HCPCS,J1437,FERRIC DERISOMALTOSE 100 MG IRON/ML IV SOLN,8962.0,6273.4,,,0
HCPCS,J1437,Inj. fe derisomaltose 10 mg,,,21.93,95.94,13
HCPCS,J1438,Etanercept injection,,,540.95,1806.87,6
HCPCS,J1439,FERRIC CARBOXYMALTOSE (INJECTAFER) 50 MG IRON/ML IV SOLN,4340.0,3038.0,,,0
HCPCS,J1439,Inj ferric carboxymaltos 1mg,,,1.1,4.01,13
HCPCS,J1440,Fecal?microbiota jslm 1 ml,,,64.32,235.96,13
HCPCS,J1442,FILGRASTIM 300 (NEUPOGEN) MCG/ML INJ SOLN,1115.0,780.5,,,0
HCPCS,J1442,Inj filgrastim excl biosimil,,,1.02,3.78,13
HCPCS,J1443,Inj ferric pyrophosphate cit,,,0.06,0.11,6
HCPCS,J1444,Fe pyro cit pow 0.1 mg iron,,,0.06,0.06,2
HCPCS,J1447,Inj tbo filgrastim 1 microg,,,0.25,2.91,13
HCPCS,J1448,"Injection, trilaciclib, 1mg",,,5.49,18.72,13
HCPCS,J1449,Inj eflapegrastim-xnst 0.1mg,,,38.96,118.48,13
HCPCS,J1450,FLUCONAZOLE 200 MG/100 ML IVPB (MERGE),51.5,36.05,,,0
HCPCS,J1450,FLUCONAZOLE IN SALINE (ISO-OSM) 400 MG/200 ML IV PIGGY BACK,72.5,50.75,,,0
HCPCS,J1450,FLUCONAZOLE PEDS SYRINGE (CDS MIXTURE),184.0,128.8,,,0
HCPCS,J1450,Fluconazole,,,12.41,13.71,2
HCPCS,J1451,FOMEPIZOLE 1 GRAM/ML IV SOLN,4140.0,2898.0,,,0
HCPCS,J1451,"Fomepizole, 15 mg",,,6.54,46.0,13
HCPCS,J1453,FOSAPREPITANT 150 MG IV SOLR,744.0,520.8,,,0
HCPCS,J1453,Fosaprepitant injection,,,3.07,5.93,6
HCPCS,J1454,"Inj fosnetupitant, palonoset",,,524.18,2043.47,13
HCPCS,J1455,FOSCARNET 24 MG/ML IV SOLN,1315.0,920.5,,,0
HCPCS,J1455,Foscarnet sodium injection,,,128.44,261.35,6
HCPCS,J1456,"Inj, fosaprepitant (teva)",,,0.04,3.82,9
HCPCS,J1457,Gallium nitrate injection,,,4.97,6.2,4
HCPCS,J1458,Galsulfase injection,,,513.6,1289.43,13
HCPCS,J1459,HC NC PRIVIGEN IVIG 500 MG,0.01,0.007,,,0
HCPCS,J1459,Inj IVIG privigen 500 mg,,,49.53,171.62,13
HCPCS,J1459,PRIVIGEN 10 % IV SOLN,14352.0,10046.4,,,0
HCPCS,J1460,Gamma globulin 1 CC inj,,,37.63,94.39,13
HCPCS,J1551,Inj cutaquig 100 mg,,,13.93,45.47,13
HCPCS,J1554,Inj. asceniv,,,500.93,1821.09,13
HCPCS,J1555,"Inj cuvitru, 100 mg",,,17.58,50.64,13
HCPCS,J1556,"Inj, imm glob bivigam, 500mg",,,79.44,145.42,13
HCPCS,J1557,Gammaplex injection,,,64.65,202.54,13
HCPCS,J1558,"Inj. xembify, 100 mg",,,15.37,55.52,13
HCPCS,J1559,Hizentra injection,,,14.52,43.12,13
HCPCS,J1560,Gamma globulin > 10 CC inj,,,160.29,469.21,11
HCPCS,J1561,Gamunex-c/gammaked,,,49.73,135.06,13
HCPCS,J1561,HC NC GAMMUNEX IVIG,0.01,0.007,,,0
HCPCS,J1561,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 1 GRAM/10 ML (10 %) INJ SOLN",12176.5,8523.55,,,0
HCPCS,J1561,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 10 GRAM/100 ML (10%) INJ SOLN",12730.0,8911.0,,,0
HCPCS,J1561,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 2.5 GRAM/25 ML (10 %) INJ SOLN",1361.5,953.05,,,0
HCPCS,J1561,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 20 GRAM/200 ML (10%) INJ SOLN",8487.0,5940.9,,,0
HCPCS,J1561,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 40 GRAM/400 ML (10 %) INJ SOLN",12730.0,8911.0,,,0
HCPCS,J1561,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 5 GRAM/50 ML (10 %) INJ SOLN",14144.5,9901.15,,,0
HCPCS,J1561,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 5 GRAM/50 ML (10 %) INJ SOLN (NEW TX NON-NEURO INDICATION)",11316.0,7921.2,,,0
HCPCS,J1562,"Vivaglobin, inj",,,22.03,27.48,4
HCPCS,J1566,GAMMAGARD S-D (IGA < 1 MCG/ML) 10 GRAM IV SOLR,11641.0,8148.7,,,0
HCPCS,J1566,GAMMAGARD S/D  5 GRAM IV SOLR,2329.0,1630.3,,,0
HCPCS,J1566,HC NC INJECT IMMUNE GLOBULIN INTRA LYOPHILIZED (POWDER) NOS 500 MG,0.01,0.007,,,0
HCPCS,J1566,"Immune globulin, powder",,,80.4,212.6,13
HCPCS,J1568,OCTAGAM 10 % IV SOLN,11021.5,7715.05,,,0
HCPCS,J1568,Octagam injection,,,47.04,184.15,13
HCPCS,J1569,GAMMAGARD LIQUID 10 % IV SOLN,5565.0,3895.5,,,0
HCPCS,J1569,Gammagard liquid injection,,,49.08,160.7,13
HCPCS,J1570,GANCICLOVIR 500 MG IV SOLUTION,101.0,70.7,,,0
HCPCS,J1570,GANCICLOVIR SODIUM 50 MG/ML IV SOLN,184.0,128.8,,,0
HCPCS,J1570,Ganciclovir sodium injection,,,110.17,121.72,2
HCPCS,J1571,HepaGam B IM injection,,,70.23,172.1,13
HCPCS,J1572,Flebogamma injection,,,90.74,402.58,13
HCPCS,J1573,"Hepagam B intravenous, inj",,,70.23,172.1,13
HCPCS,J1574,"Inj, ganciclovir (exela)",,,85.8,94.8,2
HCPCS,J1575,Hyqvia 100mg immuneglobulin,,,18.8,44.24,13
HCPCS,J1576,"Inj, panzyga, 500 mg",,,73.83,248.36,13
HCPCS,J1580,GENTAMICIN (PF) 10 MG/ML INJECTION (NEONATAL IM USE),513.5,359.45,,,0
HCPCS,J1580,GENTAMICIN (PF) NEO IV SYRINGE (CDS MIXTURE),14.5,10.15,,,0
HCPCS,J1580,GENTAMICIN 40 MG/ML INJ SOLN,84.0,58.8,,,0
HCPCS,J1580,GENTAMICIN IN SALINE (ISO-OSMOTIC) 100 MG/50 ML IV PIGGY BACK,86.0,60.199999999999996,,,0
HCPCS,J1580,GENTAMICIN IN SALINE (ISO-OSMOTIC) 80 MG/100 ML IV PIGGY BACK,120.0,84.0,,,0
HCPCS,J1580,Garamycin gentamicin inj,,,5.81,6.41,2
HCPCS,J1595,Injection glatiramer acetate,,,201.22,414.2,6
HCPCS,J1596,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,56.0,39.2,,,0
HCPCS,J1596,GLYCOPYRROLATE 0.2 MG/ML ORAL SOLUTION (CDS),136.0,95.2,,,0
HCPCS,J1596,"Inj, glycopyrrolate, 0.1 mg",,,5.13,5.67,2
HCPCS,J1597,"Inj glycopyrrolate, glyrx-pf",,,2.8,3.1,2
HCPCS,J1599,"Ivig non-lyophilized, NOS",,,150.15,228.09,6
HCPCS,J1602,GOLIMUMAB  12.5 MG/ML IV SOLN,13574.0,9501.8,,,0
HCPCS,J1602,Golimumab for iv use 1mg,,,11.29,90.42,13
HCPCS,J1610,GLUCAGON 1 MG/ML INJ (MERGE),1789.0,1252.3,,,0
HCPCS,J1610,Glucagon hydrochloride/1 mg,,,146.33,599.22,13
HCPCS,J1611,GLUCAGON 1 MG/ML INJ (MERGE),1124.0,786.8,,,0
HCPCS,J1611,"Inj glucagon hcl, fresenius",,,135.0,612.41,13
HCPCS,J1620,Gonadorelin hydroch/ 100 mcg,,,560.94,699.79,4
HCPCS,J1626,GRANISETRON (PF) 1 MG/ML (1 ML) IV SOLN,118.0,82.6,,,0
HCPCS,J1626,GRANISETRON 1 MG/ML (1 ML) IV SOLN,17.0,11.9,,,0
HCPCS,J1626,Granisetron hcl injection,,,3.1,16.82,6
HCPCS,J1627,"Inj, granisetron, xr, 0.1 mg",,,3.88,14.63,13
HCPCS,J1628,GUSELKUMAB 200 MG/20 ML (10 MG/ML) IV SOLN,38289.0,26802.3,,,0
HCPCS,J1628,"Inj., guselkumab, 1 mg",,,67.81,385.05,13
HCPCS,J1630,HALOPERIDOL LACTATE 5 MG/ML INJECTION (MERGE),34.0,23.8,,,0
HCPCS,J1630,Haloperidol injection,,,8.58,9.48,2
HCPCS,J1631,HALOPERIDOL DECANOATE  50 MG/ML IM SOLN,367.0,256.9,,,0
HCPCS,J1631,HALOPERIDOL DECANOATE 100 MG/ML IM SOLN,307.0,214.9,,,0
HCPCS,J1631,Haloperidol decanoate inj,,,37.75,41.71,2
HCPCS,J1632,"Inj., brexanolone, 1 mg",,,127.84,287.81,6
HCPCS,J1640,"Hemin, 1 mg",,,22.94,61.79,13
HCPCS,J1642,HEPARIN LOCK FLUSH (PORCINE)  10 UNIT/ML IV SOLN,262.5,183.75,,,0
HCPCS,J1642,HEPARIN LOCK FLUSH (PORCINE) 10 UNIT/ML IV SOLN (PEDS),16.0,11.2,,,0
HCPCS,J1642,HEPARIN LOCK FLUSH 100 UNIT/ML IV SOLN,62.0,43.4,,,0
HCPCS,J1642,"HEPARIN, PORCINE (PF)   10 UNIT/ML IV SYRG",17.0,11.9,,,0
HCPCS,J1642,"HEPARIN, PORCINE (PF)  100 UNIT/ML IV SYRG",16.0,11.2,,,0
HCPCS,J1642,"HEPARIN, PORCINE (PF) 1 UNIT/ML IV SYRG NEONATE",63.0,44.1,,,0
HCPCS,J1642,Inj heparin sodium per 10 u,,,0.26,0.28,2
HCPCS,J1643,"Inj heparin, pfizer, 1000u",,,0.57,0.63,2
HCPCS,J1644,HEPARIN (PORCINE)  1000 UNIT/ML INJ SOLN,90.0,63.0,,,0
HCPCS,J1644,HEPARIN (PORCINE)  5000 UNIT/ML INJ SOLN,21.0,14.7,,,0
HCPCS,J1644,HEPARIN (PORCINE) 1000 UNITS/ML INJ SOL (FOR DIALYSIS ONLY),20.0,14.0,,,0
HCPCS,J1644,HEPARIN (PORCINE) 10000 UNIT/ML INJ SOLN,35.0,24.5,,,0
HCPCS,J1644,HEPARIN (PORCINE) 20000 UNIT/ML INJ SOLN,33.0,23.1,,,0
HCPCS,J1644,HEPARIN (PORCINE) IN D5W 20000 UNIT/500 ML,19.0,13.3,,,0
HCPCS,J1644,HEPARIN (PORCINE) IN D5W 25000 UNIT/250 ML (ANTI-XA MONITORING),63.0,44.1,,,0
HCPCS,J1644,HEPARIN (PORCINE) IN D5W 25000 UNIT/250 ML (PTT MONITORING),91.5,64.05000000000001,,,0
HCPCS,J1644,HEPARIN (PORCINE) IN NACL (PF) 1000 UNIT/500 ML IV SOLP,70.5,49.349999999999994,,,0
HCPCS,J1644,HEPARIN LOCK FLUSH 100 UNIT/ML IV SOLN,21.5,15.05,,,0
HCPCS,J1644,Inj heparin sodium per 1000u,,,0.89,0.98,2
HCPCS,J1645,Dalteparin sodium,,,42.19,46.61,2
HCPCS,J1650,ENOXAPARIN 100 MG/1 ML SUBQ SYRG,114.0,79.8,,,0
HCPCS,J1650,ENOXAPARIN 120 MG/0.8 ML SUBQ SYRG,141.0,98.7,,,0
HCPCS,J1650,ENOXAPARIN 150 MG/1 ML SUBQ SYRG,133.0,93.1,,,0
HCPCS,J1650,ENOXAPARIN 20 MG/ML IN NS NEONATAL INJECTION (REPACK),72.0,50.4,,,0
HCPCS,J1650,ENOXAPARIN 30 MG/0.3 ML SUBQ SYRG,46.5,32.55,,,0
HCPCS,J1650,ENOXAPARIN 300 MG/3 ML SUBQ SOLN,23.0,16.1,,,0
HCPCS,J1650,ENOXAPARIN 40 MG/0.4 ML SUBQ SYRG,54.0,37.8,,,0
HCPCS,J1650,ENOXAPARIN 60 MG/0.6 ML SUBQ SYRG,82.0,57.4,,,0
HCPCS,J1650,ENOXAPARIN 80 MG/0.8 ML SUBQ SYRG,67.0,46.900000000000006,,,0
HCPCS,J1650,ENOXAPARIN NEO/PEDIATRIC SYRINGE < 30 MG,21.0,14.7,,,0
HCPCS,J1650,Inj enoxaparin sodium,,,3.42,3.78,2
HCPCS,J1652,FONDAPARINUX 10 MG/0.8 ML SUBQ SYRG,370.0,259.0,,,0
HCPCS,J1652,FONDAPARINUX 2.5 MG/0.5 ML SUBQ SYRG,204.5,143.15,,,0
HCPCS,J1652,FONDAPARINUX 5 MG/0.4 ML SUBQ SYRG,489.0,342.3,,,0
HCPCS,J1652,FONDAPARINUX 7.5 MG/0.6 ML SUBQ SYRG,476.0,333.20000000000005,,,0
HCPCS,J1652,Fondaparinux sodium,,,12.36,23.85,6
HCPCS,J1670,TETANUS IMMUNE GLOBULIN (PF) 250 UNIT IM SYRG,1262.0,883.4,,,0
HCPCS,J1670,Tetanus immune globulin inj,,,427.96,1230.82,13
HCPCS,J1700,Hydrocortisone acetate inj,,,0.51,0.57,2
HCPCS,J1720,HYDROCORTISONE 100 MG SOLUTION FOR INJECTION,94.0,65.8,,,0
HCPCS,J1720,HYDROCORTISONE SOD SUCC (PF) 100 MG/2 ML INJ SOLR,269.0,188.3,,,0
HCPCS,J1720,Hydrocortisone sodium succ i,,,36.75,40.61,2
HCPCS,J1726,"Makena, 10 mg",,,49.55,105.57,6
HCPCS,J1729,Inj hydroxyprogst capoat nos,,,32.75,53.93,6
HCPCS,J1730,Diazoxide injection,,,355.66,443.7,4
HCPCS,J1738,Inj. meloxicam 1 mg,,,5.38,12.3,6
HCPCS,J1740,IBANDRONATE 3 MG/3 ML IV SYKT,1162.0,813.4,,,0
HCPCS,J1740,Ibandronate sodium injection,,,240.81,544.55,6
HCPCS,J1741,Ibuprofen injection,,,4.97,6.2,6
HCPCS,J1742,IBUTILIDE FUMARATE 0.1 MG/ML IV SOLN,1100.0,770.0,,,0
HCPCS,J1742,Ibutilide fumarate injection,,,219.22,1440.41,13
HCPCS,J1743,Idursulfase injection,,,558.22,1782.99,13
HCPCS,J1744,ICATIBANT 30 MG/3 ML SUBQ SYRG,29229.0,20460.3,,,0
HCPCS,J1744,Icatibant injection,,,605.75,962.84,6
HCPCS,J1745,HC NC INFLIXIMAB INJ 10MG IVPB,0.01,0.007,,,0
HCPCS,J1745,INFLIXIMAB 100 MG IV SOLR,10637.0,7445.9,,,0
HCPCS,J1745,Infliximab not biosimil 10mg,,,31.04,221.55,13
HCPCS,J1746,"Inj., ibalizumab-uiyk, 10 mg",,,77.68,227.39,13
HCPCS,J1747,"Inj, spesolimab-sbzo, 1 mg",,,65.73,227.64,13
HCPCS,J1748,"Inj, zymfentra, 10 mg",,,883.54,976.22,2
HCPCS,J1750,GANCICLOVIR NEO IV SYRINGE (CDS MIXTURE),9.5,6.65,,,0
HCPCS,J1750,IRON DEXTRAN 50 MG/ML INJ SOLN,1532.0,1072.4,,,0
HCPCS,J1750,Inj iron dextran,,,18.1,44.53,13
HCPCS,J1756,IRON SUCROSE 100 MG/5 ML IV SOLN,312.0,218.4,,,0
HCPCS,J1756,IRON SUCROSE 200 MG/10 ML IRON IV SOLN,545.0,381.5,,,0
HCPCS,J1756,Iron sucrose injection,,,0.94,1.4,6
HCPCS,J1786,Imuglucerase injection,,,42.82,158.53,13
HCPCS,J1790,DROPERIDOL 2.5 MG/ML INJ SOLN,63.0,44.1,,,0
HCPCS,J1790,Droperidol injection,,,16.62,18.36,2
HCPCS,J1800,PROPRANOLOL  1 MG/ML IV SOLN,135.0,94.5,,,0
HCPCS,J1800,Propranolol injection,,,13.73,15.17,2
HCPCS,J1805,"ESMOLOL IN SALINE (ISO-OSMOTIC) 2,000 MG/100 ML (20 MG/ML) IV",949.5,664.6500000000001,,,0
HCPCS,J1805,"ESMOLOL IN SALINE (ISO-OSMOTIC) 2,500 MG/250 ML (10 MG/ML) IV",604.0,422.8,,,0
HCPCS,J1805,"Inj, esmolol hcl, 10mg",,,0.74,1.86,6
HCPCS,J1806,Inj esmolol hcl wg crit care,,,0.97,1.77,6
HCPCS,J1811,Fiasp for insulin pump use,,,20.22,27.43,6
HCPCS,J1812,Inj. Insulin (fiasp),,,3.07,3.4,2
HCPCS,J1813,Lyumjev for insulin pump use,,,23.57,59.25,6
HCPCS,J1814,Inj. insulin (lyumjev),,,3.03,3.35,2
HCPCS,J1815,INSULIN DEGLUDEC 100 UNITS/ML SUBQ SOLN,29.0,20.3,,,0
HCPCS,J1815,INSULIN DETEMIR 100 UNIT/ML SUBQ SOLN,18.0,12.6,,,0
HCPCS,J1815,INSULIN GLARGINE 100 UNIT/ML SUBQ SOLN,23.5,16.450000000000003,,,0
HCPCS,J1815,INSULIN GLARGINE 100 UNIT/ML SUBQ SOLN (LANTUS/SEMGLEE) (MERGE),22.0,15.4,,,0
HCPCS,J1815,INSULIN LISPRO 100 UNIT/ML (PEDS CALCLUATOR 0.5),28.0,19.6,,,0
HCPCS,J1815,INSULIN LISPRO 100 UNIT/ML SUBQ SOLN (HUMALOG/ADMELOG),23.0,16.1,,,0
HCPCS,J1815,INSULIN LISPRO PROTAM & LISPRO 100 UNIT/ML (75-25) SUBQ SUSP,16.0,11.2,,,0
HCPCS,J1815,INSULIN NPH & REGULAR HUMAN 100 UNIT/ML (70-30) SUBQ SUSP,17.0,11.899999999999999,,,0
HCPCS,J1815,INSULIN NPH HUMAN RECOMB 100 UNIT/ML SUBQ SUSP,19.0,13.3,,,0
HCPCS,J1815,INSULIN PUMP LISPRO (PATIENT OWN PUMP PHS SUPPLIED),177.0,123.89999999999999,,,0
HCPCS,J1815,INSULIN REGULAR HUM U-500 CONC 500 UNIT/ML INJ SOLN,32.0,22.4,,,0
HCPCS,J1815,INSULIN REGULAR HUMAN 100 UNIT/ML INJ SOLN,137.0,95.9,,,0
HCPCS,J1815,INSULIN REGULAR IN 0.9% NACL 100 UNIT/100 ML (1 UNIT/ML) INFUSION FOR OB,308.5,215.95,,,0
HCPCS,J1815,Insulin injection,,,0.74,0.82,2
HCPCS,J1817,INSULIN ASP PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBQ SOLN,23.0,16.1,,,0
HCPCS,J1817,INSULIN REGULAR HUMAN 100 UNIT/ML INJ SOLN,16.0,11.2,,,0
HCPCS,J1817,Insulin for insulin pump use,,,5.95,6.57,2
HCPCS,J1823,INEBILIZUMAB-CDON 10 MG/ML IV SOLN,540888.5,378621.95,,,0
HCPCS,J1823,"Inj. inebilizumab-cdon, 1 mg",,,495.54,1700.12,13
HCPCS,J1826,Interferon Beta-1A inj,,,3234.43,6503.9,6
HCPCS,J1830,Interferon beta-1b / .25 MG,,,342.24,836.58,6
HCPCS,J1833,"Injection, isavuconazonium",,,1.01,4.47,13
HCPCS,J1835,Itraconazole injection,,,116.81,145.72,4
HCPCS,J1836,"Inj, metronidazole, 10 mg",,,0.07,0.09,5
HCPCS,J1836,METRONIDAZOLE IN SODIUM CHLORIDE (ISO-OSM) 500 MG/100 ML IV PIGGY BACK,28.0,19.6,,,0
HCPCS,J1885,KETOROLAC TROMETHAMINE 15 MG/ML INJ SOLN,22.5,15.75,,,0
HCPCS,J1885,KETOROLAC TROMETHAMINE 30 MG/ML INJ SOLN,24.5,17.15,,,0
HCPCS,J1885,KETOROLAC TROMETHAMINE 60 MG/2 ML IM SOLN,16.0,11.2,,,0
HCPCS,J1885,Ketorolac tromethamine inj,,,0.34,1.67,9
HCPCS,J1920,"Inj, labetalol hcl, 5mg",,,0.39,0.69,6
HCPCS,J1921,"Inj labetalol hcl hikma, 5mg",,,0.6,10.29,6
HCPCS,J1921,LABETALOL 5 MG/ML IV SOLN,46.0,32.2,,,0
HCPCS,J1930,LANREOTIDE 120 MG/0.5 ML SUBQ SYRG,24544.0,17180.8,,,0
HCPCS,J1930,LANREOTIDE 60 MG/0.2 ML SUBQ SYRG,16803.0,11762.1,,,0
HCPCS,J1930,LANREOTIDE 90 MG/0.3 ML SUBQ SYRG,22379.0,15665.3,,,0
HCPCS,J1930,Lanreotide injection,,,35.72,152.28,13
HCPCS,J1931,Laronidase injection,,,39.95,94.5,13
HCPCS,J1932,"Inj, lanreotide, (cipla) 1mg",,,32.19,230.16,13
HCPCS,J1938,FUROSEMIDE 10 MG/ML INJ SOLN,39.5,27.65,,,0
HCPCS,J1938,FUROSEMIDE 10 MG/ML INJ SOLN (NEO),21.0,14.7,,,0
HCPCS,J1939,BUMETANIDE 0.25 MG/ML INJ SOLN,66.0,46.2,,,0
HCPCS,J1939,"Inj, bumetanide, 0.5 mg",,,1.96,2.16,2
HCPCS,J1940,FUROSEMIDE 10 MG/ML INJ SOLN,51.0,35.7,,,0
HCPCS,J1940,FUROSEMIDE 10 MG/ML INJ SOLN (NEO),18.0,12.6,,,0
HCPCS,J1940,Furosemide injection,,,1.72,1.9,2
HCPCS,J1941,"Inj, furoscix, 20 mg",,,406.45,449.08,2
HCPCS,J1943,"Inj., aristada initio, 1 mg",,,3.25,10.8,13
HCPCS,J1944,ARIPIPRAZOLE LAUROXIL 441 MG/1.6 ML IM SERS,3788.0,2651.6,,,0
HCPCS,J1944,ARIPIPRAZOLE LAUROXIL 662 MG/2.4 ML IM SERS,6592.0,4614.4,,,0
HCPCS,J1944,ARIPIPRAZOLE LAUROXIL 882 MG/3.2 ML IM SERS,7575.0,5302.5,,,0
HCPCS,J1944,Aripirazole lauroxil 1 mg,,,3.32,10.5,13
HCPCS,J1945,Lepirudin,,,549.61,685.65,4
HCPCS,J1950,HC NC LUPRON 3.75MG,0.01,0.007,,,0
HCPCS,J1950,LEUPROLIDE (3 MONTH) 11.25 MG IM KIT,14204.0,9942.8,,,0
HCPCS,J1950,LEUPROLIDE (PEDIATRIC 3 MONTH) 30 MG IM SYKT,35020.0,24514.0,,,0
HCPCS,J1950,LEUPROLIDE (PEDIATRIC 6 MONTH) 45 MG IM SYKT,71748.0,50223.6,,,0
HCPCS,J1950,LUPRON 3.75MG IM KIT,4972.0,3480.4,,,0
HCPCS,J1950,Leuprolide acetate /3.75 mg,,,1381.71,3089.75,13
HCPCS,J1951,Inj fensolvi 0.25 mg,,,140.71,480.23,13
HCPCS,J1951,LEUPROLIDE (PEDIATRIC 6 MONTH) 45 MG SUBQ SYRG,75743.0,53020.1,,,0
HCPCS,J1952,"Leuprolide inj, camcevi, 1mg",,,39.95,361.52,13
HCPCS,J1953,LEVETIRACETAM 500 MG/5 ML IV SOLN,102.5,71.75,,,0
HCPCS,J1953,LEVETIRACETAM IN NACL (ISO-OS) 1000 MG/100 ML IV PGBK,129.0,90.30000000000001,,,0
HCPCS,J1953,LEVETIRACETAM IN NACL (ISO-OS) 1500 MG/100 ML IV PGBK,178.0,124.6,,,0
HCPCS,J1953,LEVETIRACETAM IN NACL (ISO-OS) 500 MG/100 ML IV PGBK,165.0,115.5,,,0
HCPCS,J1953,LEVETIRACETAM NEO IV SYRINGE (PHS FROM PREMIX),26.0,18.2,,,0
HCPCS,J1953,LEVETIRACETAM PEDS IVPB (FROM PREMIX),109.0,76.3,,,0
HCPCS,J1953,Levetiracetam injection,,,0.29,1.63,6
HCPCS,J1954,Leuprolide depot cipla 7.5mg,,,693.56,1368.56,13
HCPCS,J1955,Inj levocarnitine per 1 gm,,,20.33,67.62,6
HCPCS,J1956,LEVOFLOXACIN IN D5W 500 MG/100 ML IV PGBK,41.0,28.7,,,0
HCPCS,J1956,LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK,71.0,49.7,,,0
HCPCS,J1956,Levofloxacin injection,,,8.94,9.88,2
HCPCS,J1961,"Inj, lenacapavir, 1 mg",,,22.3,82.38,13
HCPCS,J1980,HYOSCYAMINE 0.5 MG/ML INJECTION,350.5,245.35,,,0
HCPCS,J2001,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,38.0,26.6,,,0
HCPCS,J2001,LIDOCAINE (PF) 15 MG/ML (1.5 %) INJ SOLN,81.0,56.7,,,0
HCPCS,J2001,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,21.5,15.05,,,0
HCPCS,J2001,LIDOCAINE (PF) 20 MG/ML (2 %) IV SYRG,107.5,75.25,,,0
HCPCS,J2001,LIDOCAINE (PF) 40 MG/ML (4 %) INJ SOLN (FOR NEBULIZATION),20.0,14.0,,,0
HCPCS,J2001,LIDOCAINE 10 MG/ML (1 %) INJECTION,16.0,11.2,,,0
HCPCS,J2001,LIDOCAINE 20 MG/ML (2 %) INJECTION,23.0,16.1,,,0
HCPCS,J2001,Lidocaine injection,,,0.33,0.36,2
HCPCS,J2002,"Inj, lidocaine in d5w, 1 mg",,,0.01,0.02,2
HCPCS,J2003,"Inj, lidocaine hcl, 1 mg",,,0.06,0.06,2
HCPCS,J2003,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,65.5,45.85,,,0
HCPCS,J2003,LIDOCAINE (PF) 15 MG/ML (1.5 %) INJ SOLN,30.0,21.0,,,0
HCPCS,J2003,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,75.0,52.5,,,0
HCPCS,J2003,LIDOCAINE (PF) 20 MG/ML (2 %) IV SYRG,129.0,90.30000000000001,,,0
HCPCS,J2003,LIDOCAINE (PF) 40 MG/ML (4 %) INJ SOLN (FOR NEBULIZATION),29.5,20.65,,,0
HCPCS,J2003,LIDOCAINE (PF) 5 MG/ML (0.5 %) INJ SOLN,32.0,22.4,,,0
HCPCS,J2003,LIDOCAINE 1% 10MG/ML (1ML-UD) OR SYRINGE,10.0,7.0,,,0
HCPCS,J2003,LIDOCAINE 10 MG/ML (1 %) INJECTION,31.5,22.05,,,0
HCPCS,J2003,LIDOCAINE 2% 20MG/ML (5ML-UD) OR SYRINGE,16.0,11.2,,,0
HCPCS,J2003,LIDOCAINE 20 MG/ML (2 %) INJECTION,28.5,19.950000000000003,,,0
HCPCS,J2003,LIDOCAINE IN D5W (PF) 4 MG/ML (0.4 %) IV SOLP,45.0,31.5,,,0
HCPCS,J2003,LIDOCAINE IN D7.5W (PF) 50 MG/ML (5 %) IT SOLN,55.0,38.5,,,0
HCPCS,J2004,"Inj, lidocaine w epinephrine",,,0.04,0.05,2
HCPCS,J2004,LIDOCAINE 2%/EPINEPHRINE 1:200K INJECTION (PF),34.0,23.8,,,0
HCPCS,J2004,"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN",24.5,17.15,,,0
HCPCS,J2004,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN",32.5,22.75,,,0
HCPCS,J2004,"LIDOCAINE-EPINEPHRINE 1 %-1:200,000 INJ SOLN",72.5,50.75,,,0
HCPCS,J2004,"LIDOCAINE-EPINEPHRINE 1.5 %-1:200,000 INJ SOLN",105.0,73.5,,,0
HCPCS,J2004,"LIDOCAINE-EPINEPHRINE 2 %-1:200,000 INJ SOLN",38.5,26.950000000000003,,,0
HCPCS,J2010,Lincomycin injection,,,19.51,21.55,2
HCPCS,J2020,LINEZOLID 600 MG/300 ML IV SOLP,194.0,135.8,,,0
HCPCS,J2020,LINEZOLID NEO IV SYRINGE (CDS MIXTURE),121.5,85.05000000000001,,,0
HCPCS,J2020,Linezolid injection,,,37.24,111.47,6
HCPCS,J2021,"Inj, linezolid (hospira)",,,39.91,44.1,2
HCPCS,J2060,LORAZEPAM 2 MG/ML INJ SOLN,23.0,16.1,,,0
HCPCS,J2060,LORAZEPAM 2 MG/ML IV SOLN (PHS MERGE - ALL SITES),26.0,18.2,,,0
HCPCS,J2060,LORAZEPAM 2 MG/ML IV SOLN (PRMC ERX MERGE),12.0,8.4,,,0
HCPCS,J2060,LORAZEPAM NEONATAL INJECTION 0.2 MG/0.5 ML,69.0,48.3,,,0
HCPCS,J2060,Lorazepam injection,,,2.22,2.45,2
HCPCS,J2062,Loxapine for inhalation 1 mg,,,25.74,570.03,6
HCPCS,J2150,MANNITOL 20% IV SOLP,85.0,59.5,,,0
HCPCS,J2150,MANNITOL 25 % IV SOLN,101.0,70.7,,,0
HCPCS,J2150,Mannitol injection,,,7.72,8.53,2
HCPCS,J2151,MANNITOL 25 % IV SOLN,121.0,84.7,,,0
HCPCS,J2170,Mecasermin injection,,,56.42,266.81,6
HCPCS,J2175,MEPERIDINE (PF) 100 MG/ML IV SOLN (PHS MERGE),16.0,11.2,,,0
HCPCS,J2175,MEPERIDINE (PF) 25 MG/ML IV SOLN (PHS MERGE),34.0,23.8,,,0
HCPCS,J2175,MEPERIDINE (PF) 50 MG/ML IV SOLN (PHS MERGE),26.0,18.2,,,0
HCPCS,J2175,Meperidine hydrochl /100 MG,,,14.44,15.96,2
HCPCS,J2182,HC NC NUCALA (MEPOLIZUMAB) 1 MG,0.01,0.007,,,0
HCPCS,J2182,"Injection, mepolizumab, 1mg",,,31.82,100.81,13
HCPCS,J2182,MEPOLIZUMAB 100 MG SUBQ SOLR,14214.0,9949.8,,,0
HCPCS,J2183,Inj meropenem (wg crit care),,,2.82,3.11,2
HCPCS,J2184,"Inj, meropenem (b. braun)",,,6.08,6.72,2
HCPCS,J2185,MEROPENEM 1 GRAM IV SOLR,236.0,165.2,,,0
HCPCS,J2185,MEROPENEM 2000 MG IV SOLR,184.0,128.8,,,0
HCPCS,J2185,MEROPENEM 500 MG IV SOLR,61.0,42.7,,,0
HCPCS,J2185,MEROPENEM NEO/PED INFUSION (CDS MIXTURE),108.0,75.6,,,0
HCPCS,J2185,Meropenem,,,2.06,2.28,2
HCPCS,J2186,"Inj., meropenem, vaborbactam",,,2.17,9.64,13
HCPCS,J2210,METHYLERGONOVINE 0.2 MG/ML (1 ML) INJ SOLN,207.0,144.9,,,0
HCPCS,J2210,Methylergonovin maleate inj,,,51.35,56.74,2
HCPCS,J2212,METHYLNALTREXONE 12 MG/0.6 ML SUBQ SOLN,714.0,499.8,,,0
HCPCS,J2212,METHYLNALTREXONE 12 MG/0.6 ML SUBQ SYRG,490.0,343.0,,,0
HCPCS,J2212,Methylnaltrexone injection,,,1.21,2.53,6
HCPCS,J2246,"Inj, micafungin (baxter)",,,1.54,1.71,2
HCPCS,J2247,"Inj, micafungin (par pharm)",,,2.57,2.84,2
HCPCS,J2248,MICAFUNGIN 100 MG IV SOLR,247.5,173.25,,,0
HCPCS,J2248,Micafungin sodium injection,,,3.2,4.91,6
HCPCS,J2249,"Inj, remimazolam, 1 mg",,,3.55,3.92,2
HCPCS,J2250,Inj midazolam hydrochloride,,,0.51,0.57,2
HCPCS,J2250,MIDAZOLAM (PF) 1 MG/ML INJ (MERGE),21.0,14.7,,,0
HCPCS,J2250,MIDAZOLAM (PF) 1 MG/ML INJ SOLN,24.0,16.8,,,0
HCPCS,J2250,MIDAZOLAM (PF) 5 MG/ML INJ SOLN,28.0,19.6,,,0
HCPCS,J2250,MIDAZOLAM (PF) IN 0.9 % NACL 1 MG/ML IV SOLN,110.0,77.0,,,0
HCPCS,J2250,MIDAZOLAM 1 MG/ML IN NS (PREMIX),55.5,38.85,,,0
HCPCS,J2250,MIDAZOLAM 1 MG/ML INJ SOLN,20.0,14.0,,,0
HCPCS,J2250,MIDAZOLAM 1 MG/ML INJ SOLN (PULMONARY USE),9.5,6.65,,,0
HCPCS,J2250,MIDAZOLAM 250 MG/50 ML CONCENTRATED DRIP (RSE),162.0,113.4,,,0
HCPCS,J2250,MIDAZOLAM 5 MG/ML INJ SOLN,33.0,23.1,,,0
HCPCS,J2250,MIDAZOLAM 50 MG/50 ML (1 MG/ML) IN D5W (INFUSION),53.0,37.1,,,0
HCPCS,J2250,MIDAZOLAM 500 MG/100 ML CONCENTRATED DRIP 100 ML (RSE),33.0,23.1,,,0
HCPCS,J2251,Inj midazolam (wg crit care),,,0.63,0.7,2
HCPCS,J2252,Inj midazolam in 0.8% nacl,,,0.11,0.13,2
HCPCS,J2260,Inj milrinone lactate / 5 mg,,,4.73,9.53,6
HCPCS,J2260,MILRINONE 1 MG/ML IV SOLN,34.5,24.15,,,0
HCPCS,J2260,MILRINONE IN D5W 20 MG/100 ML (0.2 MG/ML) INFUSION,89.0,62.3,,,0
HCPCS,J2260,MILRINONE INFUSION PED/NEO IV SYRINGE (CDS MIXTURE),178.0,124.6,,,0
HCPCS,J2265,Minocycline hydrochloride,,,1.76,11.82,13
HCPCS,J2267,"Inj, mirikizumab-mrkz, 1 mg",,,42.09,98.21,9
HCPCS,J2270,MORPHINE  2 MG/ML INJ SYRG,41.0,28.700000000000003,,,0
HCPCS,J2270,MORPHINE  4 MG/ML INJ SYRG,169.0,118.3,,,0
HCPCS,J2270,MORPHINE 10 MG/ML (PF) IV SOLN,16.5,11.55,,,0
HCPCS,J2270,MORPHINE 10 MG/ML INJ SYRG,16.0,11.2,,,0
HCPCS,J2270,MORPHINE 10 MG/ML IV SOLN (PHS/CDS MERGE),28.5,19.95,,,0
HCPCS,J2270,MORPHINE 2 MG/ML IV SOLN (PHS/CDS MERGE),29.0,20.3,,,0
HCPCS,J2270,MORPHINE 4 MG/ML IV SOLN (PHS/CDS MERGE),26.0,18.2,,,0
HCPCS,J2270,Morphine sulfate injection,,,8.35,9.23,2
HCPCS,J2272,"Inj, morphine (fresenius)",,,9.85,10.89,2
HCPCS,J2274,In morphine preservativ free,,,17.85,35.08,6
HCPCS,J2274,MORPHINE (PF) IN 0.9 % NACL 1 MG/ML VENT INFUSION,87.0,60.9,,,0
HCPCS,J2274,MORPHINE (PF-DURAMORPH/ASTRAMORPH) 0.5 MG/ML INJ SOLN,68.5,47.95,,,0
HCPCS,J2274,MORPHINE 1 MG/ML PCA (PDS MERGE),122.0,85.4,,,0
HCPCS,J2277,"Inj, motixafortide, 0.25 mg",,,26.48,46.34,9
HCPCS,J2278,Ziconotide injection,,,10.46,25.21,13
HCPCS,J2280,"Inj, moxifloxacin 100 mg",,,21.91,24.21,2
HCPCS,J2280,MOXIFLOXACIN 400 MG/250 ML IVPB PREMIX (MERGE),583.5,408.45,,,0
HCPCS,J2281,Inj moxifloxacin (fres kabi),,,19.72,21.79,2
HCPCS,J2300,Inj nalbuphine hydrochloride,,,7.46,8.25,2
HCPCS,J2300,NALBUPHINE 10 MG/ML INJ SOLN,23.0,16.1,,,0
HCPCS,J2305,"Inj, nitroglycerin, 5 mg",,,2.77,4.89,6
HCPCS,J2305,NITROGLYCERIN 2 MG/10 ML (200 MCG/ML) IN D5W VIAL-CVL/IR USE (REPACK),133.0,93.1,,,0
HCPCS,J2305,NITROGLYCERIN 50 MG/10 ML (5 MG/ML) IV SOLN,18.0,12.600000000000001,,,0
HCPCS,J2310,Inj naloxone hydrochloride,,,39.9,44.08,2
HCPCS,J2310,NALOXONE 0.4 MG/ML INJ SOLN,117.0,81.9,,,0
HCPCS,J2310,NALOXONE 1 MG/ML NEEDLELESS SYRG,194.0,135.8,,,0
HCPCS,J2311,"Inj, naloxone hcl (zimhi)",,,21.45,23.7,2
HCPCS,J2312,NALOXONE 0.4 MG/ML INJ SOLN,129.0,90.3,,,0
HCPCS,J2312,NALOXONE 1 MG/ML NEEDLELESS SYRG,194.0,135.8,,,0
HCPCS,J2315,HC NC NALTREXONE MICROSPHERES 380MG SERR,0.01,0.007,,,0
HCPCS,J2315,NALTREXONE MICROSPHERES 380 MG IM SERR,4530.0,3171.0,,,0
HCPCS,J2315,"Naltrexone, depot form",,,4.25,8.09,13
HCPCS,J2320,Nandrolone decanoate 50 MG,,,404.08,504.1,4
HCPCS,J2323,HC NC NATALIZUMAB INJ 1 MG,0.01,0.007,,,0
HCPCS,J2323,NATALIZUMAB 300 MG/15 ML IV SOLN,16000.0,11200.0,,,0
HCPCS,J2323,Natalizumab injection,,,23.66,51.89,13
HCPCS,J2325,Nesiritide injection,,,107.53,134.15,6
HCPCS,J2326,"Inj, nusinersen, 0.1mg",,,1285.78,5704.58,13
HCPCS,J2327,Inj risankizumab-rzaa 1 mg,,,14.6,222.5,13
HCPCS,J2327,RISANKIZUMAB-RZAA  60 MG/ML IV SOLN,42603.0,29822.1,,,0
HCPCS,J2329,"Inj ublituximab-xiiy, 1 mg",,,68.75,253.55,13
HCPCS,J2329,UBLITUXIMAB-XIIY 25 MG/ML IV SOLN,57809.0,40466.3,,,0
HCPCS,J2350,HC NC OCREVUS (OCRELIZUMAB 300MG VIAL),0.01,0.007,,,0
HCPCS,J2350,"Injection, ocrelizumab, 1 mg",,,59.6,216.76,13
HCPCS,J2350,OCRELIZUMAB 30 MG/ML IV SOLN,67275.0,47092.5,,,0
HCPCS,J2351,"OCRELIZUMAB-HYALURONIDASE-OCSQ 920 MG-23,000 UNIT/23 ML SUBQ SOLN",113939.0,79757.3,,,0
HCPCS,J2353,"OCTREOTIDE,MICROSPHERES 10 MG IM SERR",9725.0,6807.5,,,0
HCPCS,J2353,"OCTREOTIDE,MICROSPHERES 20 MG IM SERR",19112.0,13378.4,,,0
HCPCS,J2353,"OCTREOTIDE,MICROSPHERES 30 MG IM SERR",12720.0,8904.0,,,0
HCPCS,J2353,"Octreotide injection, depot",,,188.35,437.63,13
HCPCS,J2354,OCTREOTIDE ACETATE   50 MCG/ML INJ SOLN,58.0,40.6,,,0
HCPCS,J2354,OCTREOTIDE ACETATE  100 MCG/ML INJ SOLN,59.0,41.3,,,0
HCPCS,J2354,OCTREOTIDE ACETATE  500 MCG/ML INJ SOLN,165.0,115.5,,,0
HCPCS,J2354,"Octreotide inj, non-depot",,,4.3,4.76,2
HCPCS,J2355,Oprelvekin injection,,,691.12,957.36,6
HCPCS,J2356,"Inj tezepelumab-ekko, 1mg",,,17.58,67.36,13
HCPCS,J2356,TEZEPELUMAB-EKKO 210 MG/1.91 ML (110 MG/ML) SUBQ SYRG,10028.0,7019.6,,,0
HCPCS,J2357,HC NC XOLAIR,0.01,0.007,,,0
HCPCS,J2357,OMALIZUMAB 150 MG SUBQ SOLR,3914.0,2739.8,,,0
HCPCS,J2357,OMALIZUMAB 150 MG/ML SUBQ SYRG,4672.5,3270.75,,,0
HCPCS,J2357,OMALIZUMAB 75 MG/0.5 ML SUBQ SYRG,1558.0,1090.6,,,0
HCPCS,J2357,Omalizumab injection,,,41.82,87.44,13
HCPCS,J2358,Olanzapine long-acting inj,,,4.86,10.4,6
HCPCS,J2359,"Inj. olanzapine, 0.5mg",,,2.68,3.37,6
HCPCS,J2359,OLANZAPINE 10 MG IM SOLR,102.0,71.4,,,0
HCPCS,J2360,ORPHENADRINE CITRATE 30 MG/ML INJ SOLN,81.5,57.050000000000004,,,0
HCPCS,J2360,Orphenadrine injection,,,26.77,29.58,2
HCPCS,J2371,Inj phenylephrine hcl 20 mcg,,,0.01,0.02,2
HCPCS,J2371,PHENYLEPHRINE 10 MG/ML INJECTION,395.0,276.5,,,0
HCPCS,J2371,PHENYLEPHRINE HCL IN NS 10 MG/250 ML (0.04 MG/ML) IV SOLN (PDS MERGE),291.0,203.7,,,0
HCPCS,J2372,"Inj, biorphen, 20 micrograms",,,0.34,0.68,6
HCPCS,J2373,"Inj, immphentiv, 20 mcg",,,0.34,0.38,2
HCPCS,J2401,CHLOROPROCAINE 2 % INJ SOLN,109.0,76.3,,,0
HCPCS,J2401,CHLOROPROCAINE 3 % INJ SOLN,26.0,18.2,,,0
HCPCS,J2401,Chloroprocaine hcl injection,,,0.07,0.08,2
HCPCS,J2402,Chloroprocaine (clorotekal),,,0.53,0.58,2
HCPCS,J2403,"Chloroprocaine opht gel, 1mg",,,1.22,2.67,6
HCPCS,J2404,"Inj, nicardipine 0.1 mg",,,0.14,0.16,2
HCPCS,J2405,ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN,24.5,17.15,,,0
HCPCS,J2405,Ondansetron hcl injection,,,0.34,0.76,6
HCPCS,J2406,"Injection, oritavancin 10 mg",,,43.72,158.46,13
HCPCS,J2407,"Injection, oritavancin",,,28.57,96.84,13
HCPCS,J2410,Oxymorphone hcl injection,,,5.36,5.93,2
HCPCS,J2425,Palifermin injection,,,35.45,64.26,13
HCPCS,J2426,PALIPERIDONE PALMITATE 117 MG/0.75 ML IM SYRG,4926.0,3448.2,,,0
HCPCS,J2426,PALIPERIDONE PALMITATE 156 MG/ML IM SYRG,6568.0,4597.6,,,0
HCPCS,J2426,PALIPERIDONE PALMITATE 234 MG/1.5 ML IM SYRG,9726.5,6808.549999999999,,,0
HCPCS,J2426,PALIPERIDONE PALMITATE 39 MG/0.25 ML IM SYRG,1642.0,1149.4,,,0
HCPCS,J2426,PALIPERIDONE PALMITATE 78 MG/0.5 ML IM SYRG,3242.5,2269.75,,,0
HCPCS,J2426,Paliperidone palmitate inj,,,15.08,28.14,13
HCPCS,J2427,"Inj, invega hafyera/trinza",,,12.95,46.11,13
HCPCS,J2430,PAMIDRONATE 3 MG/ML IV SOLN,170.0,119.0,,,0
HCPCS,J2430,PAMIDRONATE 9 MG/ML IV SOLN,220.0,154.0,,,0
HCPCS,J2430,PAMIDRONATE 90 MG IV SOLR,519.0,363.3,,,0
HCPCS,J2430,Pamidronate disodium /30 mg,,,46.33,113.48,6
HCPCS,J2440,PAPAVERINE 30 MG/ML INJ SOLN,232.0,162.39999999999998,,,0
HCPCS,J2440,Papaverin hcl injection,,,64.35,71.1,2
HCPCS,J2468,"Inj, palonosetron (avyxa)",,,55.29,109.97,9
HCPCS,J2469,PALONOSETRON 0.25 MG/5 ML IV INJECTION (MERGE),220.5,154.35,,,0
HCPCS,J2469,Palonosetron hcl,,,8.58,63.84,6
HCPCS,J2470,Inj pantoprazole sodium 40mg,,,8.58,9.48,2
HCPCS,J2471,Inj pantoprazole(hikma) 40mg,,,11.15,12.32,2
HCPCS,J2501,Paricalcitol,,,3.6,3.98,2
HCPCS,J2502,"Inj, pasireotide long acting",,,596.3,1203.87,13
HCPCS,J2503,Pegaptanib sodium injection,,,1271.63,3966.92,6
HCPCS,J2504,"Pegademase bovine, 25 iu",,,595.68,877.72,6
HCPCS,J2506,Inj pegfilgrast ex bio 0.5mg,,,127.38,1014.04,13
HCPCS,J2506,PEGFILGRASTIM (NEULASTA) 6 MG/0.6ML SUBQ SYRG,13749.0,9624.3,,,0
HCPCS,J2506,PEGFILGRASTIM 6 MG/0.6 ML SUBQ W/ ON BODY INJECTOR,17714.0,12399.8,,,0
HCPCS,J2507,PEGLOTICASE 8 MG/ML IV SOLN,51290.0,35903.0,,,0
HCPCS,J2507,Pegloticase injection,,,1281.87,6948.56,13
HCPCS,J2508,Pegunigalsidase alfa-iwxj,,,223.4,828.43,13
HCPCS,J2510,Penicillin g procaine inj,,,65.97,105.99,6
HCPCS,J2513,Pentastarch 10% solution,,,69.02,86.11,4
HCPCS,J2515,PENTOBARBITAL 75 MG/1.5 ML SYRINGE (REPACK),35.5,24.85,,,0
HCPCS,J2515,Pentobarbital sodium inj,,,36.84,186.88,13
HCPCS,J2540,PENICILLIN G POTASSIUM  5000000 UNIT INJ SOLR,35.5,24.85,,,0
HCPCS,J2540,PENICILLIN G POTASSIUM 20000000 UNIT INJ SOLR,238.0,166.60000000000002,,,0
HCPCS,J2540,PENICILLIN GK 2.5 MU IN NS 100ML IVPB (PDS ADS MIXTURE),159.0,111.3,,,0
HCPCS,J2543,PIPERACILLIN-TAZOBACTAM  2.25 GRAM IV SOLR,59.5,41.650000000000006,,,0
HCPCS,J2543,PIPERACILLIN-TAZOBACTAM  3.375 GRAM IV SOLR,74.0,51.8,,,0
HCPCS,J2543,PIPERACILLIN-TAZOBACTAM  4.5 GRAM IV SOLR,72.5,50.75,,,0
HCPCS,J2543,PIPERACILLIN-TAZOBACTAM NEO/PEDS INFUSION (CDS MIXTURE),63.0,44.1,,,0
HCPCS,J2543,PIPERACILLIN-TAZOBACTAM-DEXTROSE (ISO) 3.375 GRAM/50 ML IV PIGGY BACK,89.0,62.3,,,0
HCPCS,J2543,Piperacillin/tazobactam,,,6.69,7.39,2
HCPCS,J2545,Pentamidine non-comp unit,,,149.29,285.19,6
HCPCS,J2547,"Injection, peramivir",,,1.68,7.44,13
HCPCS,J2550,PROMETHAZINE 25 MG/ML INJ SOLN,24.0,16.8,,,0
HCPCS,J2550,Promethazine hcl injection,,,6.48,7.16,2
HCPCS,J2560,PHENOBARBITAL SODIUM  65 MG/ML INJ SOLN,139.0,97.3,,,0
HCPCS,J2560,PHENOBARBITAL SODIUM 130 MG/ML INJ SOLN,555.5,388.85,,,0
HCPCS,J2560,Phenobarbital sodium inj,,,69.11,172.58,6
HCPCS,J2561,"Inj, sezaby, 1 mg",,,1.13,5.03,9
HCPCS,J2562,Plerixafor injection,,,32.74,1121.37,13
HCPCS,J2590,OXYTOCIN 10 UNIT/ML INJ SOLN,82.0,57.400000000000006,,,0
HCPCS,J2590,OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN,103.0,72.1,,,0
HCPCS,J2590,Oxytocin injection,,,2.47,2.73,2
HCPCS,J2597,DESMOPRESSIN 4 MCG/ML INJECTION SOLN,787.0,550.9000000000001,,,0
HCPCS,J2597,Inj desmopressin acetate,,,22.21,50.5,6
HCPCS,J2598,"Inj, vasopressin, 1 unit",,,6.95,9.66,6
HCPCS,J2598,VASOPRESSIN  0.4 UNITS/ML IV SOLN,802.5,561.75,,,0
HCPCS,J2598,VASOPRESSIN 20 UNIT/ML IV SOLN,40.0,28.0,,,0
HCPCS,J2598,VASOPRESSIN INFUSION PEDS IV SYRINGE IN D5W (FROM PREMIX),752.0,526.4,,,0
HCPCS,J2599,Inj vasopressin (am reg) 1 u,,,1.7,10.76,6
HCPCS,J2599,VASOPRESSIN 20 UNIT/ML IV SOLN,77.0,53.9,,,0
HCPCS,J2601,"Inj, vasopressin (baxter)",,,1.53,7.11,9
HCPCS,J2601,VASOPRESSIN IN 0.9 % NS 40 UNIT/100 ML (0.4 UNIT/ML) IV SOLN,382.0,267.4,,,0
HCPCS,J2670,Totazoline hcl injection,,,4849.21,6049.51,4
HCPCS,J2675,Inj progesterone per 50 MG,,,5.56,6.15,2
HCPCS,J2675,PROGESTERONE 50 MG/ML IM OIL,154.0,107.8,,,0
HCPCS,J2679,Inj fluphenazine hcl 1.25 mg,,,16.47,18.2,2
HCPCS,J2680,FLUPHENAZINE DECANOATE 25 MG/ML INJ SOLN,195.0,136.5,,,0
HCPCS,J2680,Fluphenazine decanoate 25 MG,,,41.18,45.5,2
HCPCS,J2690,PROCAINAMIDE 100 MG/ML INJ SOLN,577.0,403.9,,,0
HCPCS,J2690,PROCAINAMIDE 100 MG/ML INJECTION (MERGE),911.0,637.7,,,0
HCPCS,J2690,PROCAINAMIDE 100 MG/ML IV SYRG,368.0,257.6,,,0
HCPCS,J2690,Procainamide hcl injection,,,151.92,375.92,9
HCPCS,J2700,Oxacillin sodium injeciton,,,5.06,5.59,2
HCPCS,J2704,"Inj, propofol, 10 mg",,,0.37,0.49,6
HCPCS,J2704,PROPOFOL 10 MG/ML 100ML INFUSION IV EMUL,110.0,77.0,,,0
HCPCS,J2704,PROPOFOL 10 MG/ML 20ML BOLUS IV EMUL,39.0,27.3,,,0
HCPCS,J2704,PROPOFOL IV BOLUS 10MG/ML (ANESTHESIA ONLY),108.0,75.6,,,0
HCPCS,J2710,NEOSTIGMINE 1MG/ML (UD) OR SYRINGE,213.0,149.10000000000002,,,0
HCPCS,J2710,NEOSTIGMINE METHYLSULFATE 1 MG/ML IV SOLN,25.0,17.5,,,0
HCPCS,J2710,NEOSTIGMINE METHYLSULFATE 3 MG/3 ML (1 MG/ML) IV SYRG,92.5,64.75,,,0
HCPCS,J2710,Neostigmine methylslfte inj,,,2.23,2.46,2
HCPCS,J2720,Inj protamine sulfate/10 MG,,,4.48,4.95,2
HCPCS,J2720,PROTAMINE 10 MG/ML IV SOLN,86.5,60.55,,,0
HCPCS,J2724,Protein C concentrate,,,15.05,47.33,13
HCPCS,J2730,Pralidoxime chloride inj,,,148.78,330.52,6
HCPCS,J2760,Phentolaine mesylate inj,,,257.45,1505.65,13
HCPCS,J2765,METOCLOPRAMIDE  5 MG/ML INJ SOLN,25.0,17.5,,,0
HCPCS,J2765,Metoclopramide hcl injection,,,4.56,5.04,2
HCPCS,J2770,Quinupristin/dalfopristin,,,434.9,542.54,4
HCPCS,J2777,"Inj, faricimab-svoa, 0.1mg",,,32.87,143.87,13
HCPCS,J2778,Ranibizumab injection,,,67.85,1587.64,13
HCPCS,J2779,"Inj, susvimo 0.1 mg",,,76.2,314.61,13
HCPCS,J2781,"Inj, pegcetacoplan, 1mg",,,147.81,580.31,13
HCPCS,J2782,Inj avacincaptad pegol 0.1mg,,,103.4,199.08,9
HCPCS,J2783,RASBURICASE 1.5 MG IV SOLR,1344.0,940.8,,,0
HCPCS,J2783,RASBURICASE 7.5 MG IV SOLR,13214.0,9249.8,,,0
HCPCS,J2783,Rasburicase,,,382.19,672.31,13
HCPCS,J2785,REGADENOSON 0.4 MG/5 ML IV SYRG,531.5,372.05,,,0
HCPCS,J2785,Regadenoson injection,,,69.71,179.17,6
HCPCS,J2786,"Injection, reslizumab, 1mg",,,11.53,33.45,13
HCPCS,J2787,Riboflavin 5?phos opth<=3ml,,,3560.7,3934.2,2
HCPCS,J2788,Rho d immune globulin 50 mcg,,,83.57,104.86,6
HCPCS,J2790,RHO D IMMUNE GLOBULIN 300 MCG IM SYRG,422.0,295.4,,,0
HCPCS,J2790,RHO(D) IMMUNE GLOBULIN IV (PHS ERX MERGE),405.0,283.5,,,0
HCPCS,J2790,Rho d immune globulin inj,,,180.38,328.18,6
HCPCS,J2791,"RHO(D) IMMUNE GLOBULIN (RHOPHYLAC) 1,500 UNIT (300 MCG)/2 ML INJ SYRG",693.0,485.1,,,0
HCPCS,J2791,Rhophylac injection,,,16.33,20.37,6
HCPCS,J2792,"Rho(D) immune globulin h, sd",,,34.26,68.67,13
HCPCS,J2793,Rilonacept injection,,,38.61,91.06,6
HCPCS,J2794,RISPERIDONE MICROSPHERES 25 MG/2 ML IM SYRG,1782.0,1247.4,,,0
HCPCS,J2794,"Risperidone, long acting",,,10.8,23.31,13
HCPCS,J2795,ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN,36.0,25.2,,,0
HCPCS,J2795,ROPIVACAINE 0.5%/EPINEPHRINE 1:100K INJECTION,128.0,89.6,,,0
HCPCS,J2795,ROPIVACAINE IN NACL(PF) 0.15 % EPID SOLN,514.0,359.8,,,0
HCPCS,J2795,Ropivacaine HCl injection,,,0.26,0.28,2
HCPCS,J2796,ROMIPLOSTIM 125 MCG SUBQ SOLR,2411.5,1688.05,,,0
HCPCS,J2796,ROMIPLOSTIM 250 MCG SUBQ SOLR,3512.0,2458.4,,,0
HCPCS,J2796,ROMIPLOSTIM 500 MCG SUBQ SOLR,6146.0,4302.2,,,0
HCPCS,J2796,Romiplostim injection,,,154.32,198.84,6
HCPCS,J2797,"Inj., rolapitant, 0.5 mg",,,2.85,3.55,4
HCPCS,J2798,"Inj., perseris, 0.5 mg",,,12.17,37.29,13
HCPCS,J2799,"Inj, uzedy, 1 mg",,,25.16,95.93,13
HCPCS,J2800,METHOCARBAMOL 100 MG/ML INJ SOLN,53.0,37.1,,,0
HCPCS,J2800,Methocarbamol injection,,,17.16,18.96,2
HCPCS,J2801,"Inj, rykindo, 0.5 mg",,,13.03,57.81,9
HCPCS,J2802,ROMIPLOSTIM 125 MCG SUBQ SOLR,1283.0,898.0999999999999,,,0
HCPCS,J2802,ROMIPLOSTIM 250 MCG SUBQ SOLR,3073.0,2151.1,,,0
HCPCS,J2802,ROMIPLOSTIM 500 MCG SUBQ SOLR,5268.0,3687.6,,,0
HCPCS,J2805,SINCALIDE 5 MCG INJ SOLR,225.0,157.5,,,0
HCPCS,J2805,Sincalide injection,,,213.01,235.36,2
HCPCS,J2810,Inj theophylline per 40 MG,,,1.36,1.5,2
HCPCS,J2820,Sargramostim injection,,,61.89,110.71,13
HCPCS,J2840,Inj sebelipase alfa 1 mg,,,540.17,2396.57,13
HCPCS,J2850,Inj secretin synthetic human,,,40.23,178.48,13
HCPCS,J2860,"Injection, siltuximab",,,27.27,304.63,13
HCPCS,J2916,NA FERRIC GLUC CPLX IN SUCROSE 12.5 MG/ML IV SOLN,374.0,261.8,,,0
HCPCS,J2916,Na ferric gluconate complex,,,10.91,12.06,2
HCPCS,J2919,"Inj, methylpred sod succ 5mg",,,0.96,1.06,2
HCPCS,J2919,"METHYLPREDNISOLONE 1,000 MG SOLUTION FOR INJECTION",212.5,148.75,,,0
HCPCS,J2919,METHYLPREDNISOLONE 125 MG INJECTION SOLR,69.0,48.3,,,0
HCPCS,J2919,METHYLPREDNISOLONE 40 MG SOLUTION FOR INJECTION,30.0,21.0,,,0
HCPCS,J2919,METHYLPREDNISOLONE 500 MG SOLUTION FOR INJECTION,143.0,100.1,,,0
HCPCS,J2919,METHYLPREDNISOLONE SOD SUC(PF) 10 MG/ML INJ (REPACK),16.0,11.2,,,0
HCPCS,J2919,METHYLPREDNISOLONE SOD SUC(PF) 1000 MG/8 ML IV SOLR,702.0,491.4,,,0
HCPCS,J2919,METHYLPREDNISOLONE SOD SUC(PF) 125 MG/2 ML INJ SOLR,34.0,23.8,,,0
HCPCS,J2919,METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML INJ SOLR,47.0,32.900000000000006,,,0
HCPCS,J2940,Somatrem injection,,,134.08,167.27,4
HCPCS,J2941,Somatropin injection,,,157.98,272.47,6
HCPCS,J2993,Reteplase injection,,,2626.53,12886.62,11
HCPCS,J2995,Inj streptokinase /250000 IU,,,65.6,81.84,4
HCPCS,J2997,ALTEPLASE 1 MG/ML (1ML) SYRINGE (REPACK),1168.0,817.6,,,0
HCPCS,J2997,ALTEPLASE 100 MG IV SOLR,1336.5,935.55,,,0
HCPCS,J2997,ALTEPLASE 1MG/ML SYRINGE (FOR IR USE ONLY),950.5,665.35,,,0
HCPCS,J2997,ALTEPLASE 2 MG INJ SOLR,1752.5,1226.75,,,0
HCPCS,J2997,ALTEPLASE IV BOLUS (STROKE) 100 MG (2 X 50 MG VIALS),12145.0,8501.5,,,0
HCPCS,J2997,ALTEPLASE IV INFUSION (PULMONARY EMBOLISM) 100 MG (2 X 50 MG VIALS),36433.5,25503.449999999997,,,0
HCPCS,J2997,Alteplase recombinant,,,95.09,167.01,13
HCPCS,J2998,Inj plasminogen tvmh 1mg,,,38.39,170.34,13
HCPCS,J3000,Streptomycin injection,,,134.06,148.13,2
HCPCS,J3010,FENTANYL 5 MCG/ML INJECTION,25.0,17.5,,,0
HCPCS,J3010,FENTANYL CITRATE (PF) 50 MCG/ML (ANESTHESIA INTRAOP ONLY),50.0,35.0,,,0
HCPCS,J3010,FENTANYL CITRATE (PF) 50 MCG/ML INJ (REPACK)(MERGE) (FOR PCA),147.0,102.9,,,0
HCPCS,J3010,FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN,46.5,32.55,,,0
HCPCS,J3010,FENTANYL CITRATE (PF) 50 MCG/ML IV (MERGE) (FOR VENT),104.0,72.8,,,0
HCPCS,J3010,FENTANYL CITRATE (PF) 50 MCG/ML IV SOLN,147.0,102.9,,,0
HCPCS,J3010,Fentanyl citrate injeciton,,,1.9,2.1,2
HCPCS,J3030,SUMATRIPTAN 6 MG/0.5 ML SUB-Q,68.0,47.6,,,0
HCPCS,J3030,SUMATRIPTAN 6 MG/0.5 ML SUBQ PEN KIT,379.0,265.3,,,0
HCPCS,J3030,Sumatriptan succinate / 6 MG,,,153.52,281.69,6
HCPCS,J3031,"Inj., fremanezumab-vfrm 1 mg",,,5.62,9.47,6
HCPCS,J3032,EPTINEZUMAB-JJMR 100 MG/ML IV SOLN,8253.0,5777.099999999999,,,0
HCPCS,J3032,Inj. eptinezumab-jjmr 1 mg,,,20.55,58.98,13
HCPCS,J3055,Inj talquetamab-tgvs 0.25 mg,,,74.88,131.03,9
HCPCS,J3055,TALQUETAMAB-TGVS  2 MG/ML SUBQ SOLN,2145.0,1501.5,,,0
HCPCS,J3055,TALQUETAMAB-TGVS 40 MG/ML SUBQ SOLN,10163.5,7114.45,,,0
HCPCS,J3060,"Inj, taliglucerace alfa 10 u",,,40.66,133.17,13
HCPCS,J3070,Pentazocine injection,,,38.44,531.05,6
HCPCS,J3090,Inj tedizolid phosphate,,,1.96,4.57,13
HCPCS,J3095,Telavancin injection,,,7.03,16.43,13
HCPCS,J3101,TENECTEPLASE 25 MG IV SOLR,22901.0,16030.7,,,0
HCPCS,J3101,TENECTEPLASE 50 MG IV (MERGE ERX) (STEMI),17176.0,12023.2,,,0
HCPCS,J3101,TENECTEPLASE 50 MG IV (MERGE) (STROKE),6767.5,4737.25,,,0
HCPCS,J3101,Tenecteplase injection,,,124.41,345.52,13
HCPCS,J3105,TERBUTALINE 1 MG/ML SUBQ SOLN,324.0,226.79999999999998,,,0
HCPCS,J3105,Terbutaline sulfate inj,,,6.86,7.58,2
HCPCS,J3110,Teriparatide injection,,,35.78,125.03,6
HCPCS,J3111,Inj. romosozumab-aqqg 1 mg,,,12.19,33.83,13
HCPCS,J3111,ROMOSOZUMAB-AQQG 105 MG/1.17 ML SUBQ SYRG,4012.0,2808.4,,,0
HCPCS,J3111,ROMOSOZUMAB-AQQG 210MG/2.34ML ( 105MG/1.17MLX2) SUBQ SYRG,5893.0,4125.1,,,0
HCPCS,J3121,Inj testostero enanthate 1mg,,,0.18,2.73,6
HCPCS,J3121,TESTOSTERONE ENANTHATE 200 MG/ML IM OIL,97.0,67.9,,,0
HCPCS,J3145,Testosterone undecanoate 1mg,,,2.13,4.77,13
HCPCS,J3230,CHLORPROMAZINE 25 MG/ML INJ SOLN,272.0,190.4,,,0
HCPCS,J3230,Chlorpromazine hcl injection,,,56.8,62.76,2
HCPCS,J3240,THYROTROPIN ALFA 0.9 MG IM SOLR,8208.0,5745.6,,,0
HCPCS,J3240,Thyrotropin injection,,,2125.34,3802.94,13
HCPCS,J3241,Inj. teprotumumab-trbw 10 mg,,,367.91,1194.03,13
HCPCS,J3241,TEPROTUMUMAB-TRBW 500 MG IV SOLR,70458.0,49320.6,,,0
HCPCS,J3243,TIGECYCLINE 50 MG IV SOLR,491.0,343.7,,,0
HCPCS,J3243,Tigecycline injection,,,3.45,4.46,6
HCPCS,J3244,Inj. tigecycline (accord),,,4.83,5.34,2
HCPCS,J3245,"Inj., tildrakizumab, 1 mg",,,118.2,515.93,13
HCPCS,J3246,TIROFIBAN-0.9% SODIUM CHLORIDE 5 MG/100 ML (50 MCG/ML) IV SOLN,105.0,73.5,,,0
HCPCS,J3246,Tirofiban hcl,,,7.49,28.43,6
HCPCS,J3247,Inj secukinumab intrav 1mg,,,18.04,32.41,9
HCPCS,J3247,SECUKINUMAB  25 MG/ML IV SOLN,10377.0,7263.9,,,0
HCPCS,J3250,Trimethobenzamide hcl inj,,,90.46,99.95,2
HCPCS,J3260,TOBRAMYCIN 1.2 G POWDER VIAL,398.0,278.6,,,0
HCPCS,J3260,TOBRAMYCIN SULFATE 40 MG/ML INJ SOLN,61.5,43.05,,,0
HCPCS,J3260,Tobramycin sulfate injection,,,3.6,3.98,2
HCPCS,J3262,TOCILIZUMAB 80 MG/4 ML (20 MG/ML) IV SOLN,4765.5,3335.8500000000004,,,0
HCPCS,J3262,Tocilizumab injection,,,5.53,13.99,13
HCPCS,J3263,"Inj, toripalimab-tpzi, 1 mg",,,39.99,71.65,9
HCPCS,J3263,TORIPALIMAB-TPZI 240 MG/6 ML (40 MG/ML) IV SOLN,25650.0,17955.0,,,0
HCPCS,J3265,Injection torsemide 10 mg/ml,,,5.11,5.64,2
HCPCS,J3285,Treprostinil injection,,,55.18,216.93,13
HCPCS,J3299,Inj xipere 1 mg,,,47.78,161.97,13
HCPCS,J3300,Triamcinolone A inj PRS-free,,,9.85,44.75,13
HCPCS,J3301,TRIAMCINOLONE ACETONIDE 10 MG/ML INJ SUSP,43.5,30.450000000000003,,,0
HCPCS,J3301,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,47.0,32.9,,,0
HCPCS,J3301,Triamcinolone acet inj nos,,,3.56,3.93,2
HCPCS,J3302,Triamcinolone diacetate inj,,,0.5,0.55,2
HCPCS,J3303,Triamcinolone hexacetonl inj,,,13.94,15.41,2
HCPCS,J3304,Inj triamcinolone ace xr 1mg,,,18.64,71.37,13
HCPCS,J3305,Inj trimetrexate glucoronate,,,465.8,581.1,4
HCPCS,J3315,Triptorelin pamoate,,,469.38,1588.23,13
HCPCS,J3316,"Inj., triptorelin xr 3.75 mg",,,3723.76,10684.8,13
HCPCS,J3350,Urea injection,,,72.96,91.02,4
HCPCS,J3355,"Urofollitropin, 75 iu",,,158.65,237.28,6
HCPCS,J3357,"Ustekinumab sub cu inj, 1 mg",,,419.02,585.97,6
HCPCS,J3358,USTEKINUMAB 130 MG/26 ML IV SOLN,11040.0,7728.0,,,0
HCPCS,J3358,"Ustekinumab, iv inject, 1 mg",,,11.62,46.42,13
HCPCS,J3360,DIAZEPAM 5 MG/ML INJ SYRG,487.0,340.9,,,0
HCPCS,J3360,Diazepam injection,,,21.12,23.34,2
HCPCS,J3365,"Urokinase 250,000 IU inj",,,1424.1,1776.6,4
HCPCS,J3370,VANCOMYCIN   1.25 G IV SOLR,130.0,91.0,,,0
HCPCS,J3370,VANCOMYCIN   1.5 G IV SOLR,142.5,99.75,,,0
HCPCS,J3370,VANCOMYCIN  5 GRAM IV SOLR,116.5,81.55000000000001,,,0
HCPCS,J3370,VANCOMYCIN  500 MG IV SOLR,34.0,23.8,,,0
HCPCS,J3370,VANCOMYCIN  750 MG IV SOLR,57.0,39.9,,,0
HCPCS,J3370,VANCOMYCIN 10 GRAM IV SOLR,62.0,43.4,,,0
HCPCS,J3370,VANCOMYCIN 1000 MG IN NS 500 ML IRRIGATION (REPACK),97.0,67.9,,,0
HCPCS,J3370,VANCOMYCIN 1000 MG IV SOLR,94.5,66.15,,,0
HCPCS,J3370,VANCOMYCIN 125 MG/5 ML (25MG/ML) ORAL SYRINGE (REPACK),83.0,58.1,,,0
HCPCS,J3370,VANCOMYCIN ENEMA 500MG IN 100ML NS,54.0,37.8,,,0
HCPCS,J3370,VANCOMYCIN IN 0.9 % SODIUM CHL 1.5 GRAM/500 ML IV SOLN,105.5,73.85,,,0
HCPCS,J3370,VANCOMYCIN IN 0.9 % SODIUM CHL 2 GRAM/500 ML IV SOLN,138.0,96.6,,,0
HCPCS,J3370,VANCOMYCIN IN 0.9% SODIUM CL 1.25 GRAM/250 ML IV SOLN,112.0,78.4,,,0
HCPCS,J3370,VANCOMYCIN IN D5W 1 GRAM/200 ML IV PGBK,270.0,189.0,,,0
HCPCS,J3370,VANCOMYCIN IN DEXTROSE 500 MG/100 ML IV PGBK,44.0,30.8,,,0
HCPCS,J3370,VANCOMYCIN NEO IV SYRINGE (CDS MIXTURE),76.0,53.2,,,0
HCPCS,J3370,VANCOMYCIN PEDS IVPB (CDS MIXTURE),43.0,30.1,,,0
HCPCS,J3370,VANCOMYCIN-DILUENT COMBO NO.1 1.25 GRAM/250 ML IV PGBK,112.0,78.4,,,0
HCPCS,J3370,Vancomycin hcl injection,,,11.83,13.07,2
HCPCS,J3371,"Inj, vancomycin hcl (mylan)",,,13.79,15.23,2
HCPCS,J3372,"Inj, vancomycin hcl (xellia)",,,13.16,14.54,2
HCPCS,J3373,VANCOMYCIN   1.25 G IV SOLR,118.0,82.6,,,0
HCPCS,J3373,VANCOMYCIN   1.5 G IV SOLR,142.5,99.75,,,0
HCPCS,J3373,VANCOMYCIN  5 GRAM IV SOLR,88.5,61.95,,,0
HCPCS,J3373,VANCOMYCIN  500 MG IV SOLR,27.0,18.9,,,0
HCPCS,J3373,VANCOMYCIN  750 MG IV SOLR,56.5,39.55,,,0
HCPCS,J3373,VANCOMYCIN 10 GRAM IV SOLR,46.0,32.2,,,0
HCPCS,J3373,VANCOMYCIN 1000 MG IN NS 500 ML IRRIGATION (REPACK),97.0,67.9,,,0
HCPCS,J3373,VANCOMYCIN 1000 MG IV SOLR,151.0,105.7,,,0
HCPCS,J3373,VANCOMYCIN 125 MG/5 ML (25MG/ML) ORAL SYRINGE (REPACK),77.5,54.25,,,0
HCPCS,J3373,VANCOMYCIN ENEMA 500MG IN 100ML NS,54.0,37.8,,,0
HCPCS,J3373,VANCOMYCIN IN 0.9 % SODIUM CHL 1.5 GRAM/500 ML IV SOLN,91.0,63.7,,,0
HCPCS,J3373,VANCOMYCIN IN 0.9 % SODIUM CHL 2 GRAM/500 ML IV SOLN,147.5,103.25,,,0
HCPCS,J3373,VANCOMYCIN IN 0.9% SODIUM CL 1 GRAM/250 ML IV SOLN,80.0,56.0,,,0
HCPCS,J3373,VANCOMYCIN IN 0.9% SODIUM CL 1.25 GRAM/250 ML IV SOLN,102.0,71.4,,,0
HCPCS,J3373,VANCOMYCIN IN D5W 1 GRAM/200 ML IV PGBK,202.5,141.75,,,0
HCPCS,J3373,VANCOMYCIN NEO IV SYRINGE (CDS MIXTURE),36.0,25.2,,,0
HCPCS,J3373,VANCOMYCIN PEDS IVPB (CDS MIXTURE),16.0,11.2,,,0
HCPCS,J3380,HC NC ENTYVIO,0.01,0.007,,,0
HCPCS,J3380,"Injection, vedolizumab",,,20.98,64.37,13
HCPCS,J3380,VEDOLIZUMAB 300 MG IV SOLR,11084.0,7758.8,,,0
HCPCS,J3385,Velaglucerase alfa,,,388.16,1317.86,13
HCPCS,J3393,"Inj, betibeglogene autotemce",,,2938320.0,13036331.45,9
HCPCS,J3394,"Inj, lovotibeglogene autotem",,,3245381.39,14398658.92,9
HCPCS,J3396,Verteporfin injection,,,11.57,36.21,13
HCPCS,J3397,"Inj., vestronidase alfa-vjbk",,,280.15,1242.95,13
HCPCS,J3398,Inj luxturna 1 billion vec g,,,3070.09,13620.95,13
HCPCS,J3399,Inj onase abepar-xioi treat,,,2587087.26,11478030.64,13
HCPCS,J3401,"Vyjuvek 5x10^9pfu/ml, 0.1 ml",,,1004.58,9716.49,13
HCPCS,J3410,HYDROXYZINE 50 MG/ML IM,178.0,124.6,,,0
HCPCS,J3410,Hydroxyzine hcl injection,,,24.98,27.6,2
HCPCS,J3411,THIAMINE 100 MG/ML INJECTION,55.0,38.5,,,0
HCPCS,J3411,Thiamine hcl 100 mg,,,7.85,8.67,2
HCPCS,J3415,PYRIDOXINE 100 MG/ML INJ SOLN,128.0,89.6,,,0
HCPCS,J3415,Pyridoxine hcl 100 mg,,,31.69,35.01,2
HCPCS,J3420,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,30.0,21.0,,,0
HCPCS,J3420,Vitamin b12 injection,,,5.95,6.57,2
HCPCS,J3424,HYDROXOCOBALAMIN 5 GRAM IV SOLR,2755.0,1928.5,,,0
HCPCS,J3424,Inj hydroxocobalamin iv 25mg,,,5.44,24.15,9
HCPCS,J3425,"Inj, hydroxocobalamin",,,0.01,0.02,2
HCPCS,J3430,PHYTONADIONE 1 MG/0.5 ML INJ SOLN,63.5,44.45,,,0
HCPCS,J3430,PHYTONADIONE 1 MG/0.5 ML INJ SYRG,87.5,61.25,,,0
HCPCS,J3430,PHYTONADIONE 1 MG/ML ORAL SOLN,250.0,175.0,,,0
HCPCS,J3430,PHYTONADIONE 10 MG/ML INJ SOLN,75.0,52.5,,,0
HCPCS,J3430,Vitamin k phytonadione inj,,,8.28,9.15,2
HCPCS,J3465,"Injection, voriconazole",,,5.18,20.53,6
HCPCS,J3465,VORICONAZOLE 200 MG IV SOLN,761.0,532.7,,,0
HCPCS,J3470,HYALURONIDASE 150 UNIT INJ SOLR,452.0,316.4,,,0
HCPCS,J3470,Hyaluronidase injection,,,95.75,105.8,2
HCPCS,J3471,"Ovine, up to 999 usp units",,,0.53,0.58,2
HCPCS,J3472,"Ovine, 1000 USP units",,,414.23,526.08,6
HCPCS,J3473,HYALURONIDASE 150 UNIT/ML INJ SOLN,284.0,198.8,,,0
HCPCS,J3473,Hyaluronidase recombinant,,,0.64,1.89,6
HCPCS,J3475,Inj magnesium sulfate,,,1.72,1.9,2
HCPCS,J3475,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IV PGBK,75.0,52.5,,,0
HCPCS,J3475,MAGNESIUM SULFATE 20 GRAM/500 ML IV SOLP,39.5,27.65,,,0
HCPCS,J3475,MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IV PGBK,42.0,29.4,,,0
HCPCS,J3475,MAGNESIUM SULFATE 40 MG/ML IV SYRINGE,54.0,37.8,,,0
HCPCS,J3475,MAGNESIUM SULFATE 50 % (4 MEQ/ML) INJ SOLN,44.5,31.150000000000002,,,0
HCPCS,J3475,MAGNESIUM SULFATE IN D5W 1 GRAM/100 ML IV PGBK,86.0,60.2,,,0
HCPCS,J3480,D5-0.9%NACL-POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,61.5,43.05,,,0
HCPCS,J3480,D5-0.9%NACL-POTASSIUM CHLORIDE 20 MEQ/L IV SOLP (PED ONC),23.0,16.1,,,0
HCPCS,J3480,Inj potassium chloride,,,0.97,1.07,2
HCPCS,J3480,NS WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,59.0,41.3,,,0
HCPCS,J3480,POTASSIUM CHLORIDE 10 MEQ/100 ML IV PGBK,129.0,90.3,,,0
HCPCS,J3480,POTASSIUM CHLORIDE 10 MEQ/100 ML IV PGBK (USE NON-PROTOCOL PANEL),66.0,46.2,,,0
HCPCS,J3480,POTASSIUM CHLORIDE 10 MEQ/50 ML IV PGBK,59.0,41.3,,,0
HCPCS,J3480,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLP,28.0,19.6,,,0
HCPCS,J3480,POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLUTION (FOR PEDIATRIC USE),18.5,12.95,,,0
HCPCS,J3480,POTASSIUM CHLORIDE 20 MEQ/100 ML IV PGBK,34.0,23.8,,,0
HCPCS,J3485,Zidovudine,,,1.51,2.77,9
HCPCS,J3486,ZIPRASIDONE 20 MG IM,120.0,84.0,,,0
HCPCS,J3486,Ziprasidone mesylate,,,55.28,61.08,2
HCPCS,J3489,ZOLEDRONIC ACID 4 MG/5 ML IV SOLN,208.5,145.95,,,0
HCPCS,J3489,ZOLEDRONIC ACID IN MANNITOL & WATER 5 MG/100 ML IV SOLN,832.0,582.4,,,0
HCPCS,J3489,ZOLEDRONIC ACID-MANNITOL-WATER 4 MG/100 ML IV PGBK,778.0,544.6,,,0
HCPCS,J3489,Zoledronic acid 1mg,,,105.11,156.08,6
HCPCS,J3490,0.2 MICRON FILTER ATTACHMENT MISC MISC,105.0,73.5,,,0
HCPCS,J3490,0.45 % NACL-POTASSIUM CHLORIDE 20 MEQ/L IV SOLP (PEDS ONC),50.0,35.0,,,0
HCPCS,J3490,2-OCTYL CYANOACRYLATE TOPICAL LIQD,117.0,81.9,,,0
HCPCS,J3490,23.4% SODIUM CHLORIDE (4 MEQ/ML) INJECTION,30.0,21.0,,,0
HCPCS,J3490,ABACAVIR 300 MG ORAL TAB,99.0,69.3,,,0
HCPCS,J3490,ABACAVIR-DOLUTEGRAVIR-LAMIVUD 600-50-300 MG ORAL TAB,562.0,393.4,,,0
HCPCS,J3490,ABOBOTULINUMTOXINA 300 UNITS IM SOLR,4425.0,3097.5,,,0
HCPCS,J3490,ACAMPROSATE 333 MG ORAL TBEC,16.0,11.2,,,0
HCPCS,J3490,ACARBOSE  25 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,ACARBOSE  50 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,ACETAMINOPHEN   80 MG ORAL CHEW,7.0,4.9,,,0
HCPCS,J3490,ACETAMINOPHEN  120 MG RECT SUPP,8.5,5.95,,,0
HCPCS,J3490,ACETAMINOPHEN  160 MG ORAL CHEW,7.0,4.9,,,0
HCPCS,J3490,ACETAMINOPHEN  325 MG ORAL TAB,7.5,5.25,,,0
HCPCS,J3490,ACETAMINOPHEN  325 MG RECT SUPP,8.0,5.6,,,0
HCPCS,J3490,ACETAMINOPHEN  500 MG ORAL TAB,5.0,3.5,,,0
HCPCS,J3490,ACETAMINOPHEN  650 MG ORAL TBSR,7.0,4.9,,,0
HCPCS,J3490,ACETAMINOPHEN  650 MG RECT SUPP,5.0,3.5,,,0
HCPCS,J3490,ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLN,9.0,6.3,,,0
HCPCS,J3490,ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSP,15.5,10.85,,,0
HCPCS,J3490,ACETAMINOPHEN 160 MG/5 ML ORAL (PHS ERX MERGE),24.0,16.8,,,0
HCPCS,J3490,ACETAMINOPHEN 160 MG/5 ML ORAL LIQD,5.0,3.5,,,0
HCPCS,J3490,ACETAMINOPHEN 650 MG/20.3 ML ORAL SOLN,27.0,18.9,,,0
HCPCS,J3490,ACETAMINOPHEN-CODEINE 300 MG-15 MG TAB,7.0,4.9,,,0
HCPCS,J3490,ACETAZOLAMIDE 125 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,ACETAZOLAMIDE 250 MG ORAL TAB,24.5,17.15,,,0
HCPCS,J3490,ACETAZOLAMIDE 25MG/ML SUSPENSION (REPACK),7.0,4.9,,,0
HCPCS,J3490,ACETAZOLAMIDE 500 MG ORAL CPSR,40.0,28.0,,,0
HCPCS,J3490,ACETIC ACID  2 % OTIC SOLN,864.0,604.8,,,0
HCPCS,J3490,ACETIC ACID (VINEGAR) 5% IRRIGATION 12 ML (REPACK),56.0,39.2,,,0
HCPCS,J3490,ACETIC ACID 0.25 % IR SOLN,55.0,38.5,,,0
HCPCS,J3490,ACETYLCYSTEINE 10 % (100 MG/ML) MISC SOLN,67.0,46.9,,,0
HCPCS,J3490,ACETYLCYSTEINE 20 % (200 MG/ML) MISC SOLN,47.0,32.900000000000006,,,0
HCPCS,J3490,ACIDOPHILUS-PECTIN W CITRUS 25 MILLION-100 CELL MG TAB,18.0,12.6,,,0
HCPCS,J3490,ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSP,160.0,112.0,,,0
HCPCS,J3490,ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSP,47.0,32.9,,,0
HCPCS,J3490,ACYCLOVIR 200 MG ORAL CAP,13.0,9.1,,,0
HCPCS,J3490,ACYCLOVIR 200 MG/5 ML ORAL SUSP,29.0,20.299999999999997,,,0
HCPCS,J3490,ACYCLOVIR 5 % TOP OINT,1363.0,954.1,,,0
HCPCS,J3490,ACYCLOVIR 800 MG ORAL TAB,17.0,11.899999999999999,,,0
HCPCS,J3490,ADENOSINE 300 MCG/ML BOLUS (NEO),16.0,11.2,,,0
HCPCS,J3490,ALBENDAZOLE 200 MG ORAL TAB,1351.0,945.7,,,0
HCPCS,J3490,ALBUTEROL SULFATE 1.25 MG/3 ML INHL NEBU,9.0,6.3,,,0
HCPCS,J3490,ALBUTEROL SULFATE 2.5 MG/0.5 ML INHL NEBU,26.5,18.55,,,0
HCPCS,J3490,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) NEB SOLUTION,18.0,12.6,,,0
HCPCS,J3490,ALBUTEROL SULFATE 5 MG/ML INHL NEB CONTINUOUS,98.0,68.6,,,0
HCPCS,J3490,ALBUTEROL SULFATE 90 MCG/ACTUATION INHL HFAA,23.0,16.1,,,0
HCPCS,J3490,ALLOPURINOL 100 MG ORAL TAB,6.0,4.2,,,0
HCPCS,J3490,ALLOPURINOL 20 MG/ML ORAL SUSPENSION (REPACK),7.5,5.25,,,0
HCPCS,J3490,ALLOPURINOL 300 MG ORAL TAB,6.0,4.2,,,0
HCPCS,J3490,ALPRAZOLAM 0.25 MG ORAL TAB,8.5,5.949999999999999,,,0
HCPCS,J3490,ALPRAZOLAM 0.5 MG ORAL TAB,10.0,7.0,,,0
HCPCS,J3490,ALPROSTADIL 500 MCG/ML INJ SOLN,680.5,476.35,,,0
HCPCS,J3490,ALUM-MAG HYDROXIDE-SIMETH 200 MG-200 MG-20 MG/5 ML ORAL SUSP,24.0,16.8,,,0
HCPCS,J3490,ALUM-MAG HYDROXIDE-SIMETH 400 MG-400 MG-40 MG/5 ML ORAL SUSP,13.0,9.100000000000001,,,0
HCPCS,J3490,ALUMINUM CHLORIDE 20 % TOP SOLN,52.0,36.4,,,0
HCPCS,J3490,ALUMINUM-MAGNESIUM HYDROXIDE 200 MG-200 MG/5 ML ORAL SUSP,44.0,30.8,,,0
HCPCS,J3490,ALVIMOPAN 12 MG ORAL CAP,711.0,497.7,,,0
HCPCS,J3490,AMANTADINE 100 MG ORAL CAP,12.0,8.4,,,0
HCPCS,J3490,AMANTADINE 50 MG/5 ML ORAL SYRP,14.0,9.8,,,0
HCPCS,J3490,AMBRISENTAN  5 MG ORAL TAB,1005.0,703.5,,,0
HCPCS,J3490,AMILORIDE 5 MG ORAL TAB,11.0,7.7,,,0
HCPCS,J3490,AMINOCAPROIC ACID  500 MG ORAL TAB,565.0,395.5,,,0
HCPCS,J3490,AMINOCAPROIC ACID 25 % ORAL SYRP,364.0,254.8,,,0
HCPCS,J3490,AMINOCAPROIC ACID 250 MG/ML IV SOLN,111.0,77.7,,,0
HCPCS,J3490,AMIODARONE 100 MG ORAL TAB,57.5,40.25,,,0
HCPCS,J3490,AMIODARONE 200 MG ORAL TAB,16.5,11.55,,,0
HCPCS,J3490,AMITRIPTYLINE  10 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,AMITRIPTYLINE  25 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,AMITRIPTYLINE  50 MG ORAL TAB,7.5,5.25,,,0
HCPCS,J3490,AMITRIPTYLINE  75 MG ORAL TAB,9.5,6.65,,,0
HCPCS,J3490,AMITRIPTYLINE 100 MG ORAL TAB,15.0,10.5,,,0
HCPCS,J3490,AMITRIPTYLINE 150 MG ORAL TAB,15.0,10.5,,,0
HCPCS,J3490,AMLODIPINE  2.5 MG ORAL TAB,11.0,7.7,,,0
HCPCS,J3490,AMLODIPINE  5 MG ORAL TAB,37.0,25.9,,,0
HCPCS,J3490,AMLODIPINE (NORVASC) 1MG/ML SUSPENSION (REPACK),7.0,4.9,,,0
HCPCS,J3490,AMLODIPINE 1 MG/ML ORAL SOLN,20.5,14.350000000000001,,,0
HCPCS,J3490,AMLODIPINE 10 MG ORAL TAB,14.0,9.8,,,0
HCPCS,J3490,AMMONIUM LACTATE 12 % TOP LOTN,198.5,138.95,,,0
HCPCS,J3490,AMOXICILLIN 250 MG ORAL CAP,21.0,14.7,,,0
HCPCS,J3490,AMOXICILLIN 250 MG/5 ML ORAL SUSR,11.0,7.7,,,0
HCPCS,J3490,AMOXICILLIN 400 MG/5 ML ORAL SUSR,10.0,7.0,,,0
HCPCS,J3490,AMOXICILLIN 500 MG ORAL CAP,32.5,22.75,,,0
HCPCS,J3490,AMOXICILLIN-POT CLAVULANATE 250 MG-125 MG TAB,54.0,37.8,,,0
HCPCS,J3490,AMOXICILLIN-POT CLAVULANATE 250 MG-62.5 MG/5 ML ORAL SUSP,29.0,20.3,,,0
HCPCS,J3490,AMOXICILLIN-POT CLAVULANATE 400 MG-57 MG/5 ML ORAL SUSP,27.5,19.25,,,0
HCPCS,J3490,AMOXICILLIN-POT CLAVULANATE 500 MG-125 MG TAB,93.5,65.45,,,0
HCPCS,J3490,AMOXICILLIN-POT CLAVULANATE 600 MG-42.9 MG/5 ML ORAL SUSP,26.0,18.2,,,0
HCPCS,J3490,AMOXICILLIN-POT CLAVULANATE 875 MG-125 MG TAB,206.5,144.55,,,0
HCPCS,J3490,AMPHETAMINE-DEXTROAMPHETAMINE  5 MG ORAL CP24,71.0,49.7,,,0
HCPCS,J3490,AMPHETAMINE-DEXTROAMPHETAMINE 10 MG ORAL TAB,17.0,11.9,,,0
HCPCS,J3490,AMPHOTERICIN B 5 MCG/0.1 ML INTRAVITREAL INJECTION,55886.0,39120.200000000004,,,0
HCPCS,J3490,ANAGRELIDE 0.5 MG ORAL CAP,110.0,77.0,,,0
HCPCS,J3490,ANASTROZOLE 1 MG ORAL TAB,39.0,27.3,,,0
HCPCS,J3490,APIXABAN 2.5 MG ORAL TAB,117.0,81.9,,,0
HCPCS,J3490,APIXABAN 5 MG ORAL TAB,273.5,191.45,,,0
HCPCS,J3490,ARGININE HCL (L-ARGININE) 10 % IV SOLP,214.0,149.8,,,0
HCPCS,J3490,ARIPIPRAZOLE  2 MG ORAL TAB,76.0,53.2,,,0
HCPCS,J3490,ARIPIPRAZOLE  5 MG ORAL TAB,152.0,106.4,,,0
HCPCS,J3490,ARIPIPRAZOLE 10 MG ORAL TAB,152.0,106.4,,,0
HCPCS,J3490,ARIPIPRAZOLE 15 MG ORAL TAB,79.0,55.3,,,0
HCPCS,J3490,ARTIFICIAL TEAR(DXTRN-HPM-GLY) 0.1-0.3-0.2 % OPHT DROP,44.0,30.8,,,0
HCPCS,J3490,ARTIFICIAL TEARS(HYPROMELLOSE) 0.3 % OPHT GEL,53.0,37.1,,,0
HCPCS,J3490,ASCORBIC ACID  250 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,ASCORBIC ACID  500 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,ASCORBIC ACID 500 MG/ML INJ SOLN,29.5,20.65,,,0
HCPCS,J3490,ASPIRIN   81 MG ORAL TBEC,4.0,2.8,,,0
HCPCS,J3490,ASPIRIN  300 MG RECT SUPP,13.0,9.1,,,0
HCPCS,J3490,ASPIRIN  325 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,ASPIRIN  325 MG ORAL TBEC,5.0,3.5,,,0
HCPCS,J3490,ASPIRIN 81 MG ORAL CHEW,5.0,3.5,,,0
HCPCS,J3490,ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TAB,6.0,4.2,,,0
HCPCS,J3490,ATENOLOL  25 MG ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,ATENOLOL  50 MG ORAL TAB,10.0,7.0,,,0
HCPCS,J3490,ATENOLOL 100 MG ORAL TAB,44.0,30.799999999999997,,,0
HCPCS,J3490,ATENOLOL 2MG/ML SUSP (REPACK),7.0,4.9,,,0
HCPCS,J3490,ATOMOXETINE  10 MG ORAL CAP,209.0,146.3,,,0
HCPCS,J3490,ATOMOXETINE  40 MG ORAL CAP,76.0,53.2,,,0
HCPCS,J3490,ATORVASTATIN 10 MG ORAL TAB,11.0,7.7,,,0
HCPCS,J3490,ATORVASTATIN 20 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,ATORVASTATIN 40 MG ORAL TAB,7.5,5.25,,,0
HCPCS,J3490,ATORVASTATIN 80 MG ORAL TAB,11.0,7.7,,,0
HCPCS,J3490,ATOVAQUONE 750 MG/5 ML ORAL SUSP,302.0,211.4,,,0
HCPCS,J3490,ATRACURIUM 10 MG/ML IV SOLN,38.0,26.6,,,0
HCPCS,J3490,ATROPINE 1 % OPHT DROP,235.0,164.5,,,0
HCPCS,J3490,AXATILIMAB-CSFR 50 MG/ML IV SOLN,25286.0,17700.2,,,0
HCPCS,J3490,AZITHROMYCIN 1 GRAM ORAL PACK,143.0,100.1,,,0
HCPCS,J3490,AZITHROMYCIN 200 MG/5 ML ORAL SUSR,42.0,29.4,,,0
HCPCS,J3490,AZITHROMYCIN 250 MG ORAL TAB,37.5,26.25,,,0
HCPCS,J3490,AZITHROMYCIN 500 MG ORAL TAB,54.0,37.8,,,0
HCPCS,J3490,AZITHROMYCIN 600 MG ORAL TAB,183.0,128.1,,,0
HCPCS,J3490,AZTREONAM 20 MG/ML IV SYRINGE (FOR NEO/PEDS),18.0,12.6,,,0
HCPCS,J3490,B COMPLEX-VITAMIN C-FOLIC ACID 100-1 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,BACITRACIN 500 UNIT/G TOP OINT (MERGE),33.0,23.1,,,0
HCPCS,J3490,BACITRACIN 500 UNIT/G TOP PACK,7.5,5.25,,,0
HCPCS,J3490,BACITRACIN 500 UNITS/1 GRAM PACKET (MERGE RECORD),8.0,5.6,,,0
HCPCS,J3490,BACITRACIN ZINC 500 UNIT/G TOP PACK,7.0,4.9,,,0
HCPCS,J3490,"BACITRACIN ZINC-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM OINTMENT",37.0,25.9,,,0
HCPCS,J3490,"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/G EYE OINTMENT",134.5,94.15,,,0
HCPCS,J3490,BACLOFEN 10 MG ORAL TAB,10.5,7.35,,,0
HCPCS,J3490,BACLOFEN 20 MG ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSP,64.5,45.15,,,0
HCPCS,J3490,BACTERIOSTATIC SALINE 0.9 % INJ SOLN,17.0,11.899999999999999,,,0
HCPCS,J3490,BALANCED SALT IRRIG SOLN COMB2 INTRAOCULAR,75.0,52.5,,,0
HCPCS,J3490,BALANCED SALT SOLN NON-SURG #3 EYE,118.0,82.6,,,0
HCPCS,J3490,BALSALAZIDE 750 MG ORAL CAP,27.0,18.9,,,0
HCPCS,J3490,BARICITINIB 2 MG ORAL TAB (COVID ONLY),790.0,553.0,,,0
HCPCS,J3490,BECLOMETHASONE DIPROPIONATE 40 MCG/ACTUATION INHL HFAB,14.0,9.8,,,0
HCPCS,J3490,BECLOMETHASONE DIPROPIONATE 80 MCG/ACTUATION INHL HFAB,33.0,23.1,,,0
HCPCS,J3490,BELLADONNA ALKALOIDS-OPIUM 16.2 MG-30 MG RECTAL SUPPOSITORY,135.0,94.5,,,0
HCPCS,J3490,BENAZEPRIL  5 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,BENAZEPRIL 10 MG ORAL TAB,12.0,8.4,,,0
HCPCS,J3490,BENAZEPRIL 20 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,BENZOCAINE 20 % MM SPRY,126.0,88.2,,,0
HCPCS,J3490,BENZOCAINE-MENTHOL 15-2.6 MG MM LOZG,6.0,4.2,,,0
HCPCS,J3490,BENZOCAINE-MENTHOL 15-3.6 MG MM LOZG,10.0,7.0,,,0
HCPCS,J3490,BENZOCAINE-MENTHOL 20 %-0.5 % TOPICAL AEROSOL,44.5,31.15,,,0
HCPCS,J3490,BENZOCAINE-MENTHOL 20-0.26 % MM GEL,20.0,14.0,,,0
HCPCS,J3490,BENZOCAINE-MENTHOL 6-10 MG MM LOZG,10.5,7.35,,,0
HCPCS,J3490,BENZONATATE 100 MG ORAL CAP,40.0,28.0,,,0
HCPCS,J3490,BENZOYL PEROXIDE  5 % TOP GEL,32.0,22.4,,,0
HCPCS,J3490,BENZTROPINE 0.5 MG ORAL TAB,5.5,3.85,,,0
HCPCS,J3490,BENZTROPINE 1 MG ORAL TAB,5.5,3.85,,,0
HCPCS,J3490,BENZTROPINE 2 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,BETAMETHASONE DIPROPIONATE 0.05 % TOP LOTN,235.0,164.5,,,0
HCPCS,J3490,BETAMETHASONE DIPROPIONATE 0.05 % TOP OINT,261.0,182.7,,,0
HCPCS,J3490,"BETAMETHASONE, AUGMENTED 0.05 % TOP CREA",106.0,74.19999999999999,,,0
HCPCS,J3490,"BETAMETHASONE, AUGMENTED 0.05 % TOP OINT",270.0,189.0,,,0
HCPCS,J3490,BETHANECHOL CHLORIDE 10 MG ORAL TAB,23.0,16.1,,,0
HCPCS,J3490,BETHANECHOL CHLORIDE 25 MG ORAL TAB,15.0,10.5,,,0
HCPCS,J3490,BICALUTAMIDE 50 MG ORAL TAB,90.5,63.35,,,0
HCPCS,J3490,"BICARB DIAL SOLN13-NO CA,K,DEX MG 1.2 MEQ/L HEMO SOLN",412.0,288.4,,,0
HCPCS,J3490,BICARB FOR OR,95.5,66.85,,,0
HCPCS,J3490,BICARBONATE DIALYSIS SOLN NO.9 K (4 MEQ/L)-CA (2.5)-MG (1.5) HEMO SOLN,172.0,120.4,,,0
HCPCS,J3490,BICTEGRAV-EMTRICIT-TENOFOV ALA 50-200-25 MG ORAL TAB,591.0,413.70000000000005,,,0
HCPCS,J3490,BIFIDO ANIM-B.INF-S.THERMOPHL 1 BILLION CELL ORAL PWPK,7.0,4.9,,,0
HCPCS,J3490,BIMATOPROST 0.01 % OPHT DROP,935.0,654.5,,,0
HCPCS,J3490,BISACODYL  5 MG ORAL TBEC,7.0,4.9,,,0
HCPCS,J3490,BISACODYL 10 MG RECT SUPP,8.0,5.6,,,0
HCPCS,J3490,BISMUTH SUBSALICYLATE 262 MG ORAL CHEW,62.0,43.400000000000006,,,0
HCPCS,J3490,BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSP,7.0,4.9,,,0
HCPCS,J3490,BISOPROLOL FUMARATE  5 MG ORAL TAB,13.0,9.1,,,0
HCPCS,J3490,BOSENTAN 62.5 MG ORAL TAB,413.0,289.1,,,0
HCPCS,J3490,BRIMONIDINE 0.2 % OPHT DROP,89.0,62.3,,,0
HCPCS,J3490,BRIVARACETAM 10 MG/ML ORAL SOLN,373.5,261.45000000000005,,,0
HCPCS,J3490,BROMOCRIPTINE 2.5 MG ORAL TAB,34.5,24.150000000000002,,,0
HCPCS,J3490,BUDESONIDE 0.25 MG/2 ML INHL NBSP,93.0,65.1,,,0
HCPCS,J3490,BUDESONIDE 0.5 MG/2 ML INHL NBSP,82.0,57.4,,,0
HCPCS,J3490,BUDESONIDE 1 MG/2 ML INHL NBSP,59.0,41.3,,,0
HCPCS,J3490,BUDESONIDE 180 MCG/INHALATION INHL AEPB,937.0,655.9,,,0
HCPCS,J3490,BUDESONIDE 3 MG ORAL CP24,77.5,54.25,,,0
HCPCS,J3490,BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION,28.5,19.95,,,0
HCPCS,J3490,BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION,28.0,19.6,,,0
HCPCS,J3490,BUMETANIDE 0.5 MG ORAL TAB,21.5,15.05,,,0
HCPCS,J3490,BUMETANIDE 1 MG ORAL TAB,27.5,19.25,,,0
HCPCS,J3490,BUMETANIDE 2 MG ORAL TAB,20.5,14.350000000000001,,,0
HCPCS,J3490,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN,34.0,23.8,,,0
HCPCS,J3490,BUPIVACAINE (PF) 0.25 % (LEFT) (PHS CUSTOM PAIN BALL),62.5,43.75,,,0
HCPCS,J3490,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN,35.5,24.85,,,0
HCPCS,J3490,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN,27.0,18.9,,,0
HCPCS,J3490,BUPIVACAINE 0.25%/EPINEPHRINE 1:100K INJECTION,48.0,33.6,,,0
HCPCS,J3490,BUPIVACAINE 0.5 % (5 MG/ML) INJ SOLN,36.0,25.2,,,0
HCPCS,J3490,BUPIVACAINE 0.5% W/EPINEPHRINE 1:200K INJECTION,56.0,39.2,,,0
HCPCS,J3490,BUPIVACAINE 0.5%/EPINEPHRINE 1:300K INJECTION,34.0,23.8,,,0
HCPCS,J3490,BUPIVACAINE LIPOSOME (PF) 266 MG/20 ML (13.3 MG/ML) LINF SUSP,1116.0,781.2,,,0
HCPCS,J3490,BUPIVACAINE-DEXTROSE-WATER(PF) 7.5 MG/ML (0.75 %) INJ SOLN,29.0,20.3,,,0
HCPCS,J3490,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN",69.0,48.3,,,0
HCPCS,J3490,"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN",57.0,39.9,,,0
HCPCS,J3490,"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJ SOLN",58.5,40.95,,,0
HCPCS,J3490,"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN",58.0,40.6,,,0
HCPCS,J3490,BUPRENORPHINE 0.5 MG SL (1/4 TAB) SUBL,10.0,7.0,,,0
HCPCS,J3490,BUPRENORPHINE 2 MG SL SUBL,26.0,18.2,,,0
HCPCS,J3490,BUPRENORPHINE 8 MG SL SUBL,43.0,30.1,,,0
HCPCS,J3490,BUPRENORPHINE-NALOXONE 2-0.5 MG SL SUBL,41.0,28.7,,,0
HCPCS,J3490,BUPRENORPHINE-NALOXONE 8-2 MG SL SUBL,52.0,36.4,,,0
HCPCS,J3490,BUPROPION HCL  75 MG ORAL TAB,9.0,6.3,,,0
HCPCS,J3490,BUPROPION HCL 100 MG ORAL TAB,15.0,10.5,,,0
HCPCS,J3490,BUPROPION HCL 100 MG ORAL TBSR,19.0,13.3,,,0
HCPCS,J3490,BUPROPION HCL 150 MG ORAL TB24,28.0,19.6,,,0
HCPCS,J3490,BUPROPION HCL 150 MG ORAL TBSR,11.0,7.7,,,0
HCPCS,J3490,BUPROPION HCL 300 MG ORAL TB24,20.5,14.350000000000001,,,0
HCPCS,J3490,BUSPIRONE  5 MG ORAL TAB,13.0,9.1,,,0
HCPCS,J3490,BUSPIRONE 10 MG ORAL TAB,12.0,8.4,,,0
HCPCS,J3490,BUSPIRONE 15 MG ORAL TAB,9.5,6.65,,,0
HCPCS,J3490,BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TAB,13.0,9.1,,,0
HCPCS,J3490,CABERGOLINE 0.5 MG ORAL TAB,180.0,126.0,,,0
HCPCS,J3490,CAFFEINE 200 MG ORAL TAB,14.5,10.15,,,0
HCPCS,J3490,CAFFEINE CITRATE 20 MG/ML ORAL SOLN,49.0,34.3,,,0
HCPCS,J3490,CAFFEINE CITRATE PEDS/NEO IV SYR (CDS MIX) LD,255.0,178.5,,,0
HCPCS,J3490,CAFFEINE-SODIUM BENZOATE 250 MG/ML INJ SOLN,207.5,145.25,,,0
HCPCS,J3490,CALAMINE-ZINC OXIDE 8 %-8 % TOPICAL SUSP,13.5,9.45,,,0
HCPCS,J3490,CALCITONIN (SALMON) 200 UNIT/ACTUATION NASL SPRA,427.0,298.9,,,0
HCPCS,J3490,CALCITRIOL 0.25 MCG ORAL CAP,10.5,7.35,,,0
HCPCS,J3490,CALCITRIOL 0.5 MCG ORAL CAP,33.0,23.1,,,0
HCPCS,J3490,CALCITRIOL 1 MCG/ML ORAL SOLN,47.0,32.9,,,0
HCPCS,J3490,CALCIUM ACETATE 667 MG ORAL CAP,19.5,13.65,,,0
HCPCS,J3490,CALCIUM CARBONATE 1250 MG/5 ML SUSPENSION (500 MG/5 ML ELEMENTAL),18.0,12.6,,,0
HCPCS,J3490,"CALCIUM CARBONATE 500 MG (1,250 MG) ORAL TAB",7.0,4.9,,,0
HCPCS,J3490,CALCIUM CARBONATE 500 MG (200 MG ELEMENTAL) CHEW TAB,15.0,10.5,,,0
HCPCS,J3490,CALCIUM CARBONATE-VITAMIN D3 250 MG-125 UNIT TAB,5.5,3.85,,,0
HCPCS,J3490,"CALCIUM CARBONATE-VITAMIN D3 500 MG(1,250MG) -200 UNIT ORAL TAB",7.0,4.9,,,0
HCPCS,J3490,CALCIUM CHLORIDE (FOR CODE) 10% (100 MG/ML) IV SYRINGE,68.5,47.95,,,0
HCPCS,J3490,CALCIUM CHLORIDE (FOR CODE) 10% IV SOLN,238.0,166.6,,,0
HCPCS,J3490,CALCIUM CITRATE-VITAMIN D3 200 MG CALCIUM -250 UNIT ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,CAMPHOR 9% -MENTHOL 1.3% -BORIC ACID OINTMENT (PHS),10.0,7.0,,,0
HCPCS,J3490,CANDESARTAN  8 MG ORAL TAB,17.0,11.9,,,0
HCPCS,J3490,CANDESARTAN 16 MG ORAL TAB,17.0,11.9,,,0
HCPCS,J3490,CAPSAICIN 0.025 % TOP CREA,56.0,39.2,,,0
HCPCS,J3490,CAPTOPRIL  12.5 MG ORAL TAB,14.5,10.15,,,0
HCPCS,J3490,CAPTOPRIL  25 MG ORAL TAB,10.0,7.0,,,0
HCPCS,J3490,CAPTOPRIL  50 MG ORAL TAB,17.0,11.9,,,0
HCPCS,J3490,CAPTOPRIL 1 MG/ML SOLUTION (REPACK),7.0,4.9,,,0
HCPCS,J3490,CARBAMAZEPINE 100 MG ORAL CHEW,12.0,8.4,,,0
HCPCS,J3490,CARBAMAZEPINE 100 MG ORAL TB12,13.0,9.1,,,0
HCPCS,J3490,CARBAMAZEPINE 100 MG/5 ML ORAL SUSP,16.0,11.2,,,0
HCPCS,J3490,CARBAMAZEPINE 200 MG ORAL CM12,16.5,11.55,,,0
HCPCS,J3490,CARBAMAZEPINE 200 MG ORAL TAB,12.0,8.4,,,0
HCPCS,J3490,CARBAMAZEPINE 200 MG ORAL TB12,34.5,24.15,,,0
HCPCS,J3490,CARBAMAZEPINE 300 MG ORAL CM12,11.0,7.7,,,0
HCPCS,J3490,CARBAMIDE PEROXIDE 6.5 % OTIC DROP,43.5,30.450000000000003,,,0
HCPCS,J3490,CARBIDOPA 25 MG ORAL TAB,20.0,14.0,,,0
HCPCS,J3490,CARBIDOPA-LEVODOPA 10 MG-100 MG TAB,8.0,5.6,,,0
HCPCS,J3490,CARBIDOPA-LEVODOPA 25 MG-100 MG TAB,9.5,6.65,,,0
HCPCS,J3490,CARBIDOPA-LEVODOPA 25 MG-250 MG TAB,10.0,7.0,,,0
HCPCS,J3490,CARBIDOPA-LEVODOPA SR 25 MG-100 MG TAB,10.0,7.0,,,0
HCPCS,J3490,CARBIDOPA-LEVODOPA SR 50 MG-200 MG TAB,11.0,7.7,,,0
HCPCS,J3490,CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN,457.0,319.9,,,0
HCPCS,J3490,CARBOXYMETHYLCELLULOSE SODIUM 1 % OPHT DLGL,51.0,35.7,,,0
HCPCS,J3490,CARBOXYMETHYLCELLULOSE SODIUM 1 % OPHT DPGE,7.0,4.9,,,0
HCPCS,J3490,"CARDIOPLEGIC SOLUTION NO.16 26 MEQ/1,052.8 ML (POTASSIUM) PERF SOLN",535.0,374.5,,,0
HCPCS,J3490,CARDIOPLEGIC SOLUTION NO.25 29 MMOL/L (POTASSIUM) PERF SOLN,1260.0,882.0,,,0
HCPCS,J3490,CARISOPRODOL 350 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,CARVEDILOL  3.125 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,CARVEDILOL  6.25 MG ORAL TAB,23.0,16.1,,,0
HCPCS,J3490,CARVEDILOL 12.5 MG ORAL TAB,15.0,10.5,,,0
HCPCS,J3490,CARVEDILOL 25 MG ORAL TAB,9.5,6.65,,,0
HCPCS,J3490,CARVEDILOL PHOSPHATE 10 MG ORAL CM24,102.0,71.4,,,0
HCPCS,J3490,CEFAZOLIN IN STERILE WATER 2 GRAM/20 ML IV SYRG,53.0,37.1,,,0
HCPCS,J3490,CEFDINIR 250 MG/5 ML ORAL SUSR,35.0,24.5,,,0
HCPCS,J3490,CEFDINIR 300 MG ORAL CAP,50.0,35.0,,,0
HCPCS,J3490,CEFIXIME 100 MG/5 ML ORAL SUSR,98.0,68.6,,,0
HCPCS,J3490,CEFPODOXIME 200 MG ORAL TAB,47.0,32.9,,,0
HCPCS,J3490,CEFUROXIME AXETIL 250 MG ORAL TAB,47.5,33.25,,,0
HCPCS,J3490,CEFUROXIME AXETIL 500 MG ORAL TAB,50.0,35.0,,,0
HCPCS,J3490,CELECOXIB 100 MG ORAL CAP,37.5,26.25,,,0
HCPCS,J3490,CELECOXIB 200 MG ORAL CAP,34.5,24.15,,,0
HCPCS,J3490,CELECOXIB 400 MG ORAL CAP,56.0,39.2,,,0
HCPCS,J3490,CENOBAMATE  50 MG ORAL TAB,238.0,166.6,,,0
HCPCS,J3490,CENOBAMATE 200 MG ORAL TAB,238.0,166.6,,,0
HCPCS,J3490,CEPHALEXIN 250 MG ORAL CAP,8.5,5.949999999999999,,,0
HCPCS,J3490,CEPHALEXIN 250 MG/5 ML ORAL SUSR,18.5,12.95,,,0
HCPCS,J3490,CEPHALEXIN 250 MG/5 ML SUSPENSION KIT (REPACK),7.0,4.9,,,0
HCPCS,J3490,CEPHALEXIN 500 MG ORAL CAP,56.0,39.2,,,0
HCPCS,J3490,CETIRIZINE  5 MG ORAL TAB,28.0,19.6,,,0
HCPCS,J3490,CETIRIZINE 10 MG ORAL TAB,21.0,14.700000000000001,,,0
HCPCS,J3490,CETIRIZINE 5 MG/5 ML ORAL SOLN,32.0,22.4,,,0
HCPCS,J3490,CEVIMELINE 30 MG ORAL CAP,52.0,36.4,,,0
HCPCS,J3490,CHERRY SYRUP,7.0,4.9,,,0
HCPCS,J3490,CHLORDIAZEPOXIDE 10 MG CAP,30.0,21.0,,,0
HCPCS,J3490,CHLORDIAZEPOXIDE 25 MG CAP,18.0,12.6,,,0
HCPCS,J3490,CHLORHEXIDINE GLUCONATE  0.12 % MM MWSH,10.0,7.0,,,0
HCPCS,J3490,CHLORHEXIDINE GLUCONATE  4 % TOP LIQD,21.0,14.7,,,0
HCPCS,J3490,CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSP,9.0,6.3,,,0
HCPCS,J3490,CHLORPROMAZINE  10 MG ORAL TAB,76.0,53.2,,,0
HCPCS,J3490,CHLORPROMAZINE  25 MG ORAL TAB,75.0,52.5,,,0
HCPCS,J3490,CHLORPROMAZINE 100 MG ORAL TAB,128.0,89.6,,,0
HCPCS,J3490,CHLORTHALIDONE  25 MG ORAL TAB,32.5,22.75,,,0
HCPCS,J3490,CHLORZOXAZONE 500 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,CHOLECALCIFEROL (VITAMIN D3)   400 UNIT ORAL TAB,11.5,8.05,,,0
HCPCS,J3490,CHOLECALCIFEROL (VITAMIN D3)  1000 UNIT ORAL TAB,5.5,3.85,,,0
HCPCS,J3490,CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/ML ORAL DROP,17.5,12.25,,,0
HCPCS,J3490,CHOLECALCIFEROL 400 UNIT/ML ORAL DROP (REPACK),20.0,14.0,,,0
HCPCS,J3490,CHOLESTYRAMINE 4 G ORAL PWPK,29.0,20.3,,,0
HCPCS,J3490,CHOLESTYRAMINE-ASPARTAME 4 GRAM ORAL PACK,19.0,13.3,,,0
HCPCS,J3490,CHOLESTYRAMINE-SUCROSE 4 GRAM ORAL PACK,14.5,10.15,,,0
HCPCS,J3490,CILOSTAZOL 100 MG ORAL TAB,11.0,7.7,,,0
HCPCS,J3490,CINACALCET 30 MG ORAL TAB,261.5,183.05,,,0
HCPCS,J3490,CIPROFLOXACIN 0.3 % OPHT DROP,123.0,86.1,,,0
HCPCS,J3490,CIPROFLOXACIN 0.3 % OPHT OINT,963.0,674.1,,,0
HCPCS,J3490,CIPROFLOXACIN 250 MG ORAL TAB,66.0,46.2,,,0
HCPCS,J3490,CIPROFLOXACIN 500 MG ORAL TAB,18.0,12.6,,,0
HCPCS,J3490,CIPROFLOXACIN 500 MG/5 ML ORAL SUMC,27.5,19.25,,,0
HCPCS,J3490,CIPROFLOXACIN 750 MG ORAL TAB,235.0,164.5,,,0
HCPCS,J3490,"CIPROFLOXACIN-DEXAMETHASONE 0.3 %-0.1 % EAR DROPS, SUSP",794.0,555.8,,,0
HCPCS,J3490,"CIPROFLOXACIN-HYDROCORTISONE 0.2 %-1 % EAR DROPS, SUSP",1119.0,783.3,,,0
HCPCS,J3490,CISATRACURIUM  2 MG/ML IV SOLN,154.0,107.80000000000001,,,0
HCPCS,J3490,CISATRACURIUM 10 MG/ML IV SOLN,1966.0,1376.2,,,0
HCPCS,J3490,CISATRACURIUM IN NS 400 MG/200 ML (2 MG/ML) IV SOLN,1503.0,1052.1,,,0
HCPCS,J3490,CITALOPRAM 10 MG ORAL TAB,28.0,19.6,,,0
HCPCS,J3490,CITALOPRAM 20 MG ORAL TAB,19.0,13.3,,,0
HCPCS,J3490,CITALOPRAM 40 MG ORAL TAB,13.0,9.1,,,0
HCPCS,J3490,CLARITHROMYCIN 250 MG ORAL TAB,46.5,32.55,,,0
HCPCS,J3490,CLARITHROMYCIN 250 MG/5 ML ORAL SUSR,107.0,74.9,,,0
HCPCS,J3490,CLARITHROMYCIN 500 MG ORAL TAB,36.5,25.55,,,0
HCPCS,J3490,CLINDAMYCIN 1 % TOPICAL GEL,361.0,252.7,,,0
HCPCS,J3490,CLINDAMYCIN 1 % TOPICAL SOLN,171.0,119.7,,,0
HCPCS,J3490,CLINDAMYCIN 150 MG CAP,15.5,10.850000000000001,,,0
HCPCS,J3490,CLINDAMYCIN 150 MG/ML INJECTION,32.0,22.4,,,0
HCPCS,J3490,CLINDAMYCIN 300 MG CAP,11.5,8.05,,,0
HCPCS,J3490,CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,41.5,29.049999999999997,,,0
HCPCS,J3490,CLOBAZAM 10 MG ORAL TAB,26.5,18.55,,,0
HCPCS,J3490,CLOBAZAM 2.5 MG/ML ORAL SUSP,130.5,91.35,,,0
HCPCS,J3490,CLOMIPRAMINE 25 MG ORAL CAP,32.5,22.75,,,0
HCPCS,J3490,CLOMIPRAMINE 50 MG ORAL CAP,82.5,57.75,,,0
HCPCS,J3490,CLOMIPRAMINE 75 MG ORAL CAP,95.0,66.5,,,0
HCPCS,J3490,CLONAZEPAM 0.1MG/ML SUSPENSION (REPACK),11.5,8.05,,,0
HCPCS,J3490,CLONAZEPAM 0.5 MG ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,CLONAZEPAM 1 MG ORAL TAB,9.0,6.3,,,0
HCPCS,J3490,CLONAZEPAM 1 MG ORAL TBDL,7.0,4.9,,,0
HCPCS,J3490,CLONAZEPAM 2 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,CLONIDINE 0.1 MG ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,CLONIDINE 0.1 MG/24 HR TD PTWK,163.0,114.1,,,0
HCPCS,J3490,CLONIDINE 0.1MG/ML ORAL SOLUTION (HIGH CONC FOR PEDS),7.0,4.9,,,0
HCPCS,J3490,CLONIDINE 0.2 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,CLONIDINE 0.2 MG/24 HR TD PTWK,237.0,165.9,,,0
HCPCS,J3490,CLONIDINE 0.3 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,CLONIDINE 0.3 MG/24 HR TD PTWK,329.0,230.3,,,0
HCPCS,J3490,CLONIDINE 20 MCG/ML ORAL SYRUP (LOW CONC NEONATAL ONLY),7.0,4.9,,,0
HCPCS,J3490,CLOPIDOGREL  75 MG ORAL TAB,55.0,38.5,,,0
HCPCS,J3490,CLOPIDOGREL 300 MG ORAL TAB,95.0,66.5,,,0
HCPCS,J3490,CLORAZEPATE DIPOTASSIUM  3.75 MG ORAL TAB,23.0,16.1,,,0
HCPCS,J3490,CLOTRIMAZOLE  10 MG MM TROC,14.5,10.15,,,0
HCPCS,J3490,CLOTRIMAZOLE 1 % TOP CREA,48.0,33.6,,,0
HCPCS,J3490,CLOTRIMAZOLE 1 % VAGL CREA,31.0,21.7,,,0
HCPCS,J3490,CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,184.0,128.8,,,0
HCPCS,J3490,CLOZAPINE  25 MG ORAL TAB,26.5,18.55,,,0
HCPCS,J3490,CLOZAPINE 100 MG ORAL TAB,48.0,33.6,,,0
HCPCS,J3490,CODEINE-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD (REPACK),24.0,16.8,,,0
HCPCS,J3490,COENZYME Q10  30 MG ORAL CAP,7.0,4.9,,,0
HCPCS,J3490,COENZYME Q10 100 MG ORAL CAP,7.0,4.9,,,0
HCPCS,J3490,COLCHICINE 0.6 MG ORAL TAB,55.0,38.5,,,0
HCPCS,J3490,COLESEVELAM 625 MG ORAL TAB,23.0,16.1,,,0
HCPCS,J3490,COLLAGENASE 250 UNIT/G TOP OINT,1071.0,749.7,,,0
HCPCS,J3490,COMPOUNDING VEHICLE SYRUP NO23 ORAL SYRP,7.0,4.9,,,0
HCPCS,J3490,CONJUGATED ESTROGENS  0.3 MG ORAL TAB,65.5,45.85,,,0
HCPCS,J3490,CONJUGATED ESTROGENS  0.625 MG ORAL TAB,82.0,57.4,,,0
HCPCS,J3490,CONJUGATED ESTROGENS 0.625 MG/G VAGL CREA,1272.0,890.4,,,0
HCPCS,J3490,CROMOLYN 4 % OPHT DROP,182.0,127.4,,,0
HCPCS,J3490,CRRT-HEPARIN 1000 UNITS/ML IN NS INTERMITTENT BOLUS,208.0,145.6,,,0
HCPCS,J3490,CUPRIC CHLORIDE 0.4 MG/ML IV SOLN,94.0,65.8,,,0
HCPCS,J3490,CYANOCOBALAMIN  100 MCG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,CYANOCOBALAMIN 1000 MCG ORAL TAB,5.5,3.85,,,0
HCPCS,J3490,CYCLOBENZAPRINE  5 MG ORAL TAB,24.0,16.8,,,0
HCPCS,J3490,CYCLOBENZAPRINE 10 MG ORAL TAB,12.0,8.4,,,0
HCPCS,J3490,CYCLOPENTOLATE 1 % OPHT DROP,81.5,57.05,,,0
HCPCS,J3490,CYCLOPENTOLATE-PHENYLEPHRINE 0.2 %-1 % EYE DROPS,212.5,148.75,,,0
HCPCS,J3490,CYCLOSPORINE 0.05 % OPHT DPET,60.0,42.0,,,0
HCPCS,J3490,CYPROHEPTADINE 2 MG/5 ML ORAL SYRP,8.0,5.6,,,0
HCPCS,J3490,CYPROHEPTADINE 4 MG ORAL TAB,13.0,9.100000000000001,,,0
HCPCS,J3490,D5-1/2 NS AND POTASSIUM CHLORIDE 10 MEQ/L IV,59.0,41.3,,,0
HCPCS,J3490,D5-1/2 NS AND POTASSIUM CHLORIDE 20 MEQ/L IV (PEDS CHEMO),36.5,25.55,,,0
HCPCS,J3490,D5-1/2 NS AND POTASSIUM CHLORIDE 30 MEQ/L IV,54.0,37.8,,,0
HCPCS,J3490,D5-1/2 NS AND POTASSIUM CHLORIDE 40 MEQ/L IV,59.0,41.3,,,0
HCPCS,J3490,D5-1/4 NS & POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,54.0,37.8,,,0
HCPCS,J3490,D5-LR WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,59.0,41.3,,,0
HCPCS,J3490,D5-NS WITH POTASSIUM CHLORIDE 40 MEQ/L IV SOLP,56.5,39.55,,,0
HCPCS,J3490,D5W WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,38.0,26.599999999999998,,,0
HCPCS,J3490,DABIGATRAN  150 MG ORAL CAP,22.0,15.4,,,0
HCPCS,J3490,DABIGATRAN  75 MG ORAL CAP,33.0,23.1,,,0
HCPCS,J3490,DANTROLENE  25 MG ORAL CAP,17.0,11.9,,,0
HCPCS,J3490,DAPAGLIFLOZIN PROPANEDIOL  5 MG ORAL TAB,109.0,76.3,,,0
HCPCS,J3490,DAPAGLIFLOZIN PROPANEDIOL 10 MG ORAL TAB,84.0,58.8,,,0
HCPCS,J3490,DAPSONE  25 MG ORAL TAB,28.0,19.6,,,0
HCPCS,J3490,DAPSONE 100 MG ORAL TAB,16.0,11.2,,,0
HCPCS,J3490,DAPTOMYCIN IN 0.9 % SOD CHLOR 500 MG/50 ML IV PGBK,238.5,166.95,,,0
HCPCS,J3490,DARIFENACIN  7.5 MG ORAL TB24,82.0,57.4,,,0
HCPCS,J3490,DARUNAVIR-COBI-EMTRI-TENOF ALA 800-150-200-10 MG ORAL TAB,6849.5,4794.65,,,0
HCPCS,J3490,DAY 1 NEO SOLUTION (D12.5W/AA 2%/HEPARIN 0.5 UNITS/ML),167.0,116.9,,,0
HCPCS,J3490,DAY 1 NEO SOLUTION (D5W/AA 2%/HEPARIN 0.5 UNITS/ML),84.0,58.8,,,0
HCPCS,J3490,DEFIBROTIDE 80 MG/ML IV SOLN,2450.0,1715.0,,,0
HCPCS,J3490,DEMECLOCYCLINE 150 MG ORAL TAB,92.0,64.4,,,0
HCPCS,J3490,DESIPRAMINE  10 MG ORAL TAB,14.5,10.15,,,0
HCPCS,J3490,DESIPRAMINE  25 MG ORAL TAB,39.5,27.65,,,0
HCPCS,J3490,DESMOPRESSIN 0.1 MG ORAL TAB,30.0,21.0,,,0
HCPCS,J3490,DESMOPRESSIN 0.2 MG ORAL TAB,46.0,32.2,,,0
HCPCS,J3490,DESMOPRESSIN 10 MCG/SPRAY NASL SPRA,887.0,620.9,,,0
HCPCS,J3490,DESONIDE 0.05 % TOP OINT,341.0,238.7,,,0
HCPCS,J3490,DESVENLAFAXINE  50 MG ORAL TB24,59.0,41.3,,,0
HCPCS,J3490,DEXAMETHASONE 0.1 % EYE DROPS,275.0,192.5,,,0
HCPCS,J3490,DEXAMETHASONE SODIUM PHOS (PF) 10MG/ML INJ SOLN,7.0,4.9,,,0
HCPCS,J3490,DEXMEDETOMIDINE 100 MCG/ML IV SOLN,52.0,36.4,,,0
HCPCS,J3490,DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) IV SOLN,87.0,60.9,,,0
HCPCS,J3490,DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN,176.5,123.55,,,0
HCPCS,J3490,DEXMEDETOMIDINE IN NS 20 MCG/5 ML (4 MCG/ML) IV POST OP SHIVERING,59.0,41.3,,,0
HCPCS,J3490,DEXTROMETHORPHAN POLY COMPLEX ER 30 MG/5 ML ORAL SU12,27.5,19.25,,,0
HCPCS,J3490,DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML SYRUP,41.0,28.7,,,0
HCPCS,J3490,DEXTROMETHORPHAN-GUAIFENESIN SR 30 MG-600 MG 12 HR TAB,19.0,13.3,,,0
HCPCS,J3490,DEXTROSE 10% IN WATER (D10) IV SOLN,39.0,27.3,,,0
HCPCS,J3490,DEXTROSE 10% IN WATER (NEO) 2 - 3.99 KG,50.0,35.0,,,0
HCPCS,J3490,DEXTROSE 10%-1/2 NORMAL SALINE IV,55.0,38.5,,,0
HCPCS,J3490,DEXTROSE 15% IN WATER,58.5,40.95,,,0
HCPCS,J3490,DEXTROSE 2.5 %-1/2 NORMAL SALINE IV,30.5,21.35,,,0
HCPCS,J3490,DEXTROSE 20% IN WATER (NEO) 500ML,69.0,48.3,,,0
HCPCS,J3490,DEXTROSE 25% IN WATER (D25W) IV SYRINGE,110.0,77.0,,,0
HCPCS,J3490,DEXTROSE 25% IN WATER (NEO),150.0,105.0,,,0
HCPCS,J3490,DEXTROSE 30% IN WATER (NEO),69.5,48.65,,,0
HCPCS,J3490,DEXTROSE 40 % ORAL GEL,433.5,303.45,,,0
HCPCS,J3490,DEXTROSE 40 % ORAL GEL (NEONATAL/PEDIATRIC),22.0,15.4,,,0
HCPCS,J3490,DEXTROSE 5%-1/4 NORMAL SALINE IV,24.5,17.15,,,0
HCPCS,J3490,DIAZEPAM  2 MG ORAL TAB,5.5,3.85,,,0
HCPCS,J3490,DIAZEPAM  5 MG ORAL TAB,12.0,8.4,,,0
HCPCS,J3490,DIAZEPAM 2.5 MG RECT KIT,1047.0,732.9,,,0
HCPCS,J3490,DIAZEPAM 5 MG/5 ML (5 ML) ORAL SOLN,51.0,35.7,,,0
HCPCS,J3490,DIAZEPAM 5-7.5-10 MG RECT KIT,1074.0,751.8,,,0
HCPCS,J3490,DIAZOXIDE (DIABETIC USE) 50 MG/ML ORAL SUSP,76.0,53.2,,,0
HCPCS,J3490,DIBUCAINE 1 % TOP OINT,33.0,23.1,,,0
HCPCS,J3490,DICLOFENAC 0.1 % EYE DROPS,152.5,106.75,,,0
HCPCS,J3490,DICLOFENAC 1 % TOPICAL GEL,71.5,50.05,,,0
HCPCS,J3490,"DICLOFENAC 25 MG TAB, DELAYED RELEASE",16.0,11.2,,,0
HCPCS,J3490,"DICLOFENAC 50 MG TAB, DELAYED RELEASE",8.0,5.6,,,0
HCPCS,J3490,"DICLOFENAC 75 MG TAB, DELAYED RELEASE",8.5,5.95,,,0
HCPCS,J3490,DICLOXACILLIN 250 MG ORAL CAP,17.0,11.9,,,0
HCPCS,J3490,DICLOXACILLIN 500 MG ORAL CAP,14.0,9.8,,,0
HCPCS,J3490,DICYCLOMINE 10 MG ORAL CAP,15.0,10.5,,,0
HCPCS,J3490,DICYCLOMINE 10 MG/5 ML ORAL SOLN,9.0,6.3,,,0
HCPCS,J3490,DIFLUPREDNATE 0.05 % OPHT DROP,788.0,551.6,,,0
HCPCS,J3490,DIGOXIN  50 MCG/ML ORAL SOLN,306.0,214.2,,,0
HCPCS,J3490,DIGOXIN 125 MCG ORAL TAB,19.0,13.3,,,0
HCPCS,J3490,DIGOXIN 250 MCG ORAL TAB,10.0,7.0,,,0
HCPCS,J3490,DILTIAZEM 12 MG/ML ORAL SUSPENSION,9.0,6.3,,,0
HCPCS,J3490,DILTIAZEM 120 MG TAB,16.0,11.2,,,0
HCPCS,J3490,DILTIAZEM 30 MG TAB,9.0,6.3,,,0
HCPCS,J3490,DILTIAZEM 5 MG/ML IV,26.0,18.2,,,0
HCPCS,J3490,DILTIAZEM 60 MG TAB,7.0,4.9,,,0
HCPCS,J3490,DILTIAZEM 90 MG TAB,12.0,8.4,,,0
HCPCS,J3490,DILTIAZEM IN D5W 125 MG/125 ML (1 MG/ML) IV SOLN (PREMIX),71.0,49.7,,,0
HCPCS,J3490,DILTIAZEM SR 120 MG 12 HR CAP,53.0,37.1,,,0
HCPCS,J3490,DILTIAZEM SR 120 MG 24 HR CAP,8.0,5.6,,,0
HCPCS,J3490,DILTIAZEM SR 180 MG 24 HR CAP,7.0,4.9,,,0
HCPCS,J3490,DILTIAZEM SR 300 MG 24 HR CAP,21.0,14.7,,,0
HCPCS,J3490,DILTIAZEM SR 60 MG 12 HR CAP,45.0,31.5,,,0
HCPCS,J3490,DILTIAZEM SR 90 MG 12 HR CAP,52.0,36.4,,,0
HCPCS,J3490,DIMENHYDRINATE 50 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,17.0,11.9,,,0
HCPCS,J3490,DIPHENHYDRAMINE 25 MG CAP,5.5,3.85,,,0
HCPCS,J3490,DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,29.0,20.3,,,0
HCPCS,J3490,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TAB,8.0,5.6,,,0
HCPCS,J3490,DIPYRIDAMOLE-ASPIRIN SR 200 MG-25 MG MULTIPHASE 12 HR CAP,47.0,32.9,,,0
HCPCS,J3490,DISOPYRAMIDE 150 MG ORAL CAP,19.0,13.3,,,0
HCPCS,J3490,DIVALPROEX 125 MG ORAL CPSP,18.0,12.6,,,0
HCPCS,J3490,DIVALPROEX 125 MG ORAL TBEC,11.0,7.7,,,0
HCPCS,J3490,DIVALPROEX 250 MG ORAL TB24,22.0,15.4,,,0
HCPCS,J3490,DIVALPROEX 250 MG ORAL TBEC,11.0,7.7,,,0
HCPCS,J3490,DIVALPROEX 500 MG ORAL TB24,42.5,29.75,,,0
HCPCS,J3490,DIVALPROEX 500 MG ORAL TBEC,9.0,6.3,,,0
HCPCS,J3490,DOCOSANOL 10 % TOP CREAM,92.0,64.4,,,0
HCPCS,J3490,DOCUSATE SODIUM 100 MG ORAL CAP,5.5,3.85,,,0
HCPCS,J3490,DOFETILIDE 125 MCG ORAL CAP,75.0,52.5,,,0
HCPCS,J3490,DOFETILIDE 250 MCG ORAL CAP,69.0,48.3,,,0
HCPCS,J3490,DOFETILIDE 500 MCG ORAL CAP,51.0,35.7,,,0
HCPCS,J3490,DOLUTEGRAVIR 50 MG ORAL TAB,389.0,272.3,,,0
HCPCS,J3490,DOLUTEGRAVIR-RILPIVIRINE 50-25 MG ORAL TAB,516.0,361.2,,,0
HCPCS,J3490,DONEPEZIL  5 MG ORAL TAB,9.0,6.3,,,0
HCPCS,J3490,DONEPEZIL 10 MG ORAL TAB,9.0,6.3,,,0
HCPCS,J3490,DORAVIRINE 100 MG ORAL TAB,313.0,219.1,,,0
HCPCS,J3490,DORNASE ALFA 1 MG/ML INHL SOLN,749.0,524.3,,,0
HCPCS,J3490,DORZOLAMIDE 2 % OPHT DROP,225.0,157.5,,,0
HCPCS,J3490,DORZOLAMIDE-TIMOLOL 2 %-0.5 % EYE DROPS,363.5,254.45,,,0
HCPCS,J3490,DOXAZOSIN 1 MG ORAL TAB,10.0,7.0,,,0
HCPCS,J3490,DOXAZOSIN 2 MG ORAL TAB,7.5,5.25,,,0
HCPCS,J3490,DOXAZOSIN 4 MG ORAL TAB,9.0,6.3,,,0
HCPCS,J3490,DOXAZOSIN 8 MG ORAL TAB,9.0,6.3,,,0
HCPCS,J3490,DOXEPIN  10 MG ORAL CAP,8.0,5.6,,,0
HCPCS,J3490,DOXEPIN  25 MG ORAL CAP,10.0,7.0,,,0
HCPCS,J3490,DOXEPIN  50 MG ORAL CAP,14.0,9.8,,,0
HCPCS,J3490,DOXEPIN 10 MG/ML ORAL CONC,8.5,5.95,,,0
HCPCS,J3490,DOXEPIN 100 MG ORAL CAP,23.0,16.1,,,0
HCPCS,J3490,DOXYCYCLINE 100 MG CAP,7.0,4.9,,,0
HCPCS,J3490,DOXYCYCLINE 100 MG TAB,217.0,151.9,,,0
HCPCS,J3490,DOXYCYCLINE 25 MG/5 ML ORAL SUSP,25.0,17.5,,,0
HCPCS,J3490,DOXYCYCLINE HYCLATE  50 MG ORAL CAP,23.5,16.45,,,0
HCPCS,J3490,DOXYCYCLINE HYCLATE 100 MG IV SOLR,171.5,120.05,,,0
HCPCS,J3490,DOXYCYCLINE HYCLATE 100 MG ORAL TAB,90.0,63.0,,,0
HCPCS,J3490,DOXYLAMINE SUCCINATE 25 MG ORAL TAB,5.5,3.85,,,0
HCPCS,J3490,DRONEDARONE 400 MG ORAL TAB,79.5,55.65,,,0
HCPCS,J3490,DROXIDOPA 100 MG ORAL CAP,410.5,287.35,,,0
HCPCS,J3490,DULOXETINE 20 MG ORAL CPDR,66.0,46.2,,,0
HCPCS,J3490,DULOXETINE 30 MG ORAL CPDR,43.5,30.450000000000003,,,0
HCPCS,J3490,DULOXETINE 60 MG ORAL CPDR,43.5,30.450000000000003,,,0
HCPCS,J3490,DUPILUMAB 200 MG/1.14 ML SUBQ PNIJ,5511.0,3857.7,,,0
HCPCS,J3490,DUPILUMAB 300 MG/2 ML SUBQ PNIJ,5511.0,3857.7,,,0
HCPCS,J3490,DUTASTERIDE 0.5 MG ORAL CAP,34.0,23.8,,,0
HCPCS,J3490,ELECTROLYTE-A IV,250.0,175.0,,,0
HCPCS,J3490,ELTROMBOPAG 25 MG ORAL TAB,1296.0,907.2,,,0
HCPCS,J3490,ELTROMBOPAG 75 MG ORAL TAB,1887.0,1320.9,,,0
HCPCS,J3490,EMOLLIENT COMBINATION NO.10 TOPICAL EMULSION,145.5,101.85,,,0
HCPCS,J3490,EMTRICITABINE-TENOFOVIR ALAFEN 200-25 MG ORAL TAB,374.0,261.8,,,0
HCPCS,J3490,ENALAPRIL MALEATE  2.5 MG ORAL TAB,14.0,9.8,,,0
HCPCS,J3490,ENALAPRIL MALEATE  5 MG ORAL TAB,16.0,11.2,,,0
HCPCS,J3490,ENALAPRIL MALEATE 1 MG/ML ORAL SOLN,34.0,23.8,,,0
HCPCS,J3490,ENALAPRIL MALEATE 10 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,ENALAPRIL MALEATE 20 MG ORAL TAB,16.0,11.2,,,0
HCPCS,J3490,ENALAPRILAT 1.25 MG/ML IV INJ,28.0,19.6,,,0
HCPCS,J3490,ENTACAPONE 200 MG ORAL TAB,28.0,19.6,,,0
HCPCS,J3490,ENTECAVIR 0.5 MG ORAL TAB,218.0,152.6,,,0
HCPCS,J3490,EPHEDRINE 5 MG/ML IN NS IV SYRINGE,54.0,37.8,,,0
HCPCS,J3490,EPHEDRINE 50 MG/ML IV SOLN (MERGE),110.5,77.35,,,0
HCPCS,J3490,EPHEDRINE SULFATE  25 MG/5 ML (5 MG/ML) IV SYRG (MERGE),116.0,81.2,,,0
HCPCS,J3490,EPINEPHRINE 0.1 % NASAL SOLN,10818.0,7572.6,,,0
HCPCS,J3490,EPINEPHRINE 1 MG/ML (1ML) INJ SOLN,830.5,581.3499999999999,,,0
HCPCS,J3490,EPINEPHRINE 1 MG/ML (1ML) INJ SOLN (FOR IRRIGATION ONLY),80.0,56.0,,,0
HCPCS,J3490,EPINEPHRINE 1 MG/ML INJ KIT,10685.0,7479.5,,,0
HCPCS,J3490,EPINEPHRINE IN 0.9 % NACL 4 MG/250 ML (16 MCG/ML) IV SOLN (MERGE),1027.5,719.25,,,0
HCPCS,J3490,EPINEPHRINE IN 0.9 % SOD CHLOR 4 MG/250 ML (16 MCG/ML) IV SOLN,389.0,272.3,,,0
HCPCS,J3490,EPLERENONE  25 MG ORAL TAB,26.0,18.200000000000003,,,0
HCPCS,J3490,EPOPROSTENOL (ARGNININE) (VELETRI) CONTINUOUS NEB 1.5 MG IN NS 50 ML,243.0,170.1,,,0
HCPCS,J3490,ERGOCALCIFEROL (VITAMIN D2) 50000 UNIT ORAL CAP,9.0,6.300000000000001,,,0
HCPCS,J3490,ERYTHROMYCIN 250 MG ORAL TBEC,83.0,58.1,,,0
HCPCS,J3490,ERYTHROMYCIN 5 MG/G OPHT OINT,95.5,66.85,,,0
HCPCS,J3490,ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL SUSR,52.0,36.4,,,0
HCPCS,J3490,ESCITALOPRAM 10 MG ORAL TAB,36.0,25.2,,,0
HCPCS,J3490,ESCITALOPRAM 20 MG ORAL TAB,32.0,22.4,,,0
HCPCS,J3490,ESKETAMINE 56 MG (28 MG X 2) NASL SPRY,1159.0,811.3,,,0
HCPCS,J3490,ESKETAMINE 84 MG (28 MG X 3) NASL SPRY,5213.0,3649.1,,,0
HCPCS,J3490,ESMOLOL  100 MG/10 ML IV SOLN,106.0,74.2,,,0
HCPCS,J3490,ESTRADIOL 1 MG ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,ESTRADIOL 2 MG ORAL TAB,17.5,12.25,,,0
HCPCS,J3490,ETHACRYNATE SODIUM 50 MG IV SOLR,10488.0,7341.6,,,0
HCPCS,J3490,ETHACRYNIC ACID 25 MG ORAL TAB,178.0,124.6,,,0
HCPCS,J3490,ETHAMBUTOL 100 MG ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,ETHAMBUTOL 400 MG ORAL TAB,20.0,14.0,,,0
HCPCS,J3490,ETHIODIZED OIL 48 % INJ SOLN,4954.0,3467.8,,,0
HCPCS,J3490,ETHOSUXIMIDE 250 MG ORAL CAP,39.0,27.299999999999997,,,0
HCPCS,J3490,ETHOSUXIMIDE 250 MG/5 ML ORAL SYRP,14.0,9.8,,,0
HCPCS,J3490,ETHYL ALCOHOL  99 % IART SOLN,13793.5,9655.45,,,0
HCPCS,J3490,ETHYL CHLORIDE 100 % TOP SPRA,180.0,126.0,,,0
HCPCS,J3490,ETODOLAC 300 MG ORAL CAP,9.0,6.3,,,0
HCPCS,J3490,ETODOLAC 400 MG ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,ETOMIDATE 2 MG/ML IV SOLN,42.0,29.4,,,0
HCPCS,J3490,EXENATIDE 10 MCG/0.04 ML SUBQ PNIJ,609.5,426.65,,,0
HCPCS,J3490,EXENATIDE 5 MCG/0.02 ML SUBQ PNIJ,2346.0,1642.2,,,0
HCPCS,J3490,EZETIMIBE 10 MG ORAL TAB,51.0,35.7,,,0
HCPCS,J3490,FAMCICLOVIR 125 MG ORAL TAB,33.0,23.1,,,0
HCPCS,J3490,FAMCICLOVIR 250 MG ORAL TAB,64.0,44.8,,,0
HCPCS,J3490,FAMCICLOVIR 500 MG ORAL TAB,64.0,44.8,,,0
HCPCS,J3490,FAMOTIDINE (PF) 20 MG/2 ML IV SOLN,18.0,12.6,,,0
HCPCS,J3490,FAMOTIDINE 20 MG ORAL TAB,12.0,8.4,,,0
HCPCS,J3490,FAMOTIDINE 40 MG/5 ML ORAL SUSP,42.0,29.4,,,0
HCPCS,J3490,FAT EMUL-SOY-MCT-OLIV-FISH OIL 20 % IV EMUL,40.0,28.0,,,0
HCPCS,J3490,FAT EMUL-SOY-MCT-OLIV-FISH OIL 20 % IV EMUL (NEO/PEDS),24.0,16.8,,,0
HCPCS,J3490,FAT EMULSION 20 % IV BOLUS (FOR OVERDOSE),406.0,284.2,,,0
HCPCS,J3490,FEBUXOSTAT 40 MG ORAL TAB,55.5,38.85,,,0
HCPCS,J3490,FELBAMATE 400 MG ORAL TAB,52.0,36.4,,,0
HCPCS,J3490,FELBAMATE 600 MG ORAL TAB,59.0,41.3,,,0
HCPCS,J3490,FELBAMATE 600 MG/5 ML ORAL SUSP,50.0,35.0,,,0
HCPCS,J3490,FELODIPINE  2.5 MG ORAL TB24,13.5,9.45,,,0
HCPCS,J3490,FELODIPINE  5 MG ORAL TB24,13.5,9.45,,,0
HCPCS,J3490,FELODIPINE 10 MG ORAL TB24,16.0,11.2,,,0
HCPCS,J3490,FENOFIBRATE NANOCRYSTALLIZED  48 MG ORAL TAB,19.0,13.3,,,0
HCPCS,J3490,FENOFIBRATE NANOCRYSTALLIZED 145 MG ORAL TAB,13.0,9.1,,,0
HCPCS,J3490,FENTANYL  12 MCG/HR TD PT72,100.0,70.0,,,0
HCPCS,J3490,FENTANYL  25 MCG/HR TD PT72,87.5,61.25,,,0
HCPCS,J3490,FENTANYL  50 MCG/HR TD PT72,191.0,133.7,,,0
HCPCS,J3490,FENTANYL  75 MCG/HR TD PT72,340.0,238.0,,,0
HCPCS,J3490,FENTANYL 100 MCG/HR TD PT72,359.5,251.65,,,0
HCPCS,J3490,FENTANYL CITRATE (PF) 50 MCG/ML INJ (REPACK)(MERGE) (FOR PCA),137.5,96.25,,,0
HCPCS,J3490,FENTANYL CITRATE (PF) 50 MCG/ML IV (MERGE) (FOR VENT),92.0,64.4,,,0
HCPCS,J3490,FENTANYL CITRATE (PF) 50 MCG/ML IV SOLN,147.0,102.9,,,0
HCPCS,J3490,FENTANYL-ROPIVACAINE-NACL (PF) 2-0.2 MCG/ML-% INJ (MERGE ERX),620.0,434.0,,,0
HCPCS,J3490,FERRIC SUBSULFATE 0.2 TO 0.22 GRAM/ML MISC SOLA,89.0,62.3,,,0
HCPCS,J3490,FERRIC SUBSULFATE 0.2 TO 0.22 GRAM/ML SOLN BULK,227.0,158.9,,,0
HCPCS,J3490,FERROUS GLUCONATE 324 MG (37.5 MG IRON) ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,FERROUS GLUCONATE 324 MG (38 MG IRON) TAB,7.0,4.9,,,0
HCPCS,J3490,FERROUS SULFATE 220 MG (44 MG IRON)/5 ML ORAL ELIX,7.0,4.9,,,0
HCPCS,J3490,FERROUS SULFATE 220 MG (44 MG IRON)/5 ML ORAL SOLN,7.0,4.9,,,0
HCPCS,J3490,FERROUS SULFATE 324 MG (65 MG IRON) ORAL TBEC,7.0,4.9,,,0
HCPCS,J3490,FERROUS SULFATE 325 MG (65 MG IRON) TAB,7.0,4.9,,,0
HCPCS,J3490,FERROUS SULFATE 75 MG/ML (ELEMENTAL IRON 15 MG/ML) 0.1 ML ORAL SYRINGE (REPACK),7.0,4.9,,,0
HCPCS,J3490,FERROUS SULFATE 75 MG/ML (ELEMENTAL IRON 15 MG/ML) 0.2 ML ORAL SYRINGE (REPACK),10.0,7.0,,,0
HCPCS,J3490,FERROUS SULFATE 75 MG/ML (ELEMENTAL IRON 15 MG/ML) ORAL DROP,7.0,4.9,,,0
HCPCS,J3490,FIDAXOMICIN 200 MG ORAL TAB,2093.5,1465.45,,,0
HCPCS,J3490,FINASTERIDE 1 MG ORAL TAB,16.0,11.2,,,0
HCPCS,J3490,FINASTERIDE 5 MG ORAL TAB,13.5,9.45,,,0
HCPCS,J3490,FLECAINIDE  50 MG ORAL TAB,17.0,11.9,,,0
HCPCS,J3490,FLECAINIDE 100 MG ORAL TAB,32.0,22.4,,,0
HCPCS,J3490,FLECAINIDE 20MG/ML SUSPENSION (REPACK),12.0,8.4,,,0
HCPCS,J3490,FLUCONAZOLE 10 MG/ML ORAL SUSR,173.0,121.1,,,0
HCPCS,J3490,FLUCONAZOLE 100 MG ORAL TAB,67.5,47.25,,,0
HCPCS,J3490,FLUCONAZOLE 200 MG ORAL TAB,130.5,91.35,,,0
HCPCS,J3490,FLUCONAZOLE 40 MG/ML ORAL SUSR,62.0,43.4,,,0
HCPCS,J3490,FLUCONAZOLE IN SALINE (ISO-OSM) 400 MG/200 ML IV PIGGY BACK,51.0,35.7,,,0
HCPCS,J3490,FLUCONAZOLE PEDS SYRINGE (CDS MIXTURE),25.5,17.85,,,0
HCPCS,J3490,FLUCYTOSINE 500 MG ORAL CAP,1462.0,1023.4,,,0
HCPCS,J3490,FLUDROCORTISONE 0.1 MG ORAL TAB,12.0,8.4,,,0
HCPCS,J3490,FLUMAZENIL 0.1 MG/ML IV SOLN,70.5,49.35,,,0
HCPCS,J3490,FLUORESCEIN 1 MG OPHT STRP,7.0,4.9,,,0
HCPCS,J3490,FLUORESCEIN 500 MG/5 ML (10 %) IV SOLN,367.0,256.9,,,0
HCPCS,J3490,FLUOROMETHOLONE 0.1 % OPHT DRPS,395.0,276.5,,,0
HCPCS,J3490,FLUOXETINE 10 MG ORAL CAP,28.0,19.6,,,0
HCPCS,J3490,FLUOXETINE 10 MG ORAL TAB,33.0,23.1,,,0
HCPCS,J3490,FLUOXETINE 20 MG ORAL CAP,14.5,10.15,,,0
HCPCS,J3490,FLUOXETINE 20 MG/5 ML ORAL SOLN,38.0,26.6,,,0
HCPCS,J3490,FLUPHENAZINE 1 MG TAB,37.0,25.9,,,0
HCPCS,J3490,FLUPHENAZINE 2.5 MG TAB,59.5,41.650000000000006,,,0
HCPCS,J3490,FLUPHENAZINE 5 MG TAB,58.5,40.95,,,0
HCPCS,J3490,FLUTICASONE  100 MCG/ACTUATION INHL DSDV,840.0,588.0,,,0
HCPCS,J3490,FLUTICASONE  250 MCG/ACTUATION INHL DSDV,921.0,644.7,,,0
HCPCS,J3490,FLUTICASONE  50 MCG/ACTUATION NASL SPSN,379.0,265.3,,,0
HCPCS,J3490,FLUTICASONE 110 MCG/ACTUATION INHL AERO,29.0,20.3,,,0
HCPCS,J3490,FLUTICASONE 220 MCG/ACTUATION INHL AERO,25.0,17.5,,,0
HCPCS,J3490,FLUTICASONE 44 MCG/ACTUATION INHL AERO,17.0,11.9,,,0
HCPCS,J3490,FLUTICASONE-SALMETEROL 100 MCG-50 MCG/DOSE DISK DEVICE FOR INHALATION,674.0,471.8,,,0
HCPCS,J3490,FLUTICASONE-SALMETEROL 250 MCG-50 MCG/DOSE DISK DEVICE FOR INHALATION,1311.0,917.7,,,0
HCPCS,J3490,FLUTICASONE-SALMETEROL 500 MCG-50 MCG/DOSE DISK DEVICE FOR INHALATION,1345.0,941.5,,,0
HCPCS,J3490,FLUVOXAMINE  50 MG ORAL TAB,36.0,25.2,,,0
HCPCS,J3490,FLUVOXAMINE 100 MG ORAL TAB,18.5,12.95,,,0
HCPCS,J3490,FOLIC ACID  1 MG ORAL TAB,5.5,3.85,,,0
HCPCS,J3490,FOLIC ACID  5 MG/ML INJ SOLN,16.0,11.2,,,0
HCPCS,J3490,FOLIC ACID 1 MG / 0.2 ML SYRINGE (CDS ADS REPACK),8.0,5.6,,,0
HCPCS,J3490,FOLIC ACID 400 MCG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,FOSINOPRIL 10 MG ORAL TAB,20.5,14.35,,,0
HCPCS,J3490,FOSINOPRIL 20 MG ORAL TAB,10.5,7.3500000000000005,,,0
HCPCS,J3490,FUROSEMIDE 10 MG/ML INJ SOLN,16.0,11.2,,,0
HCPCS,J3490,FUROSEMIDE 10 MG/ML ORAL SOLN,29.0,20.3,,,0
HCPCS,J3490,FUROSEMIDE 20 MG ORAL TAB,9.0,6.3,,,0
HCPCS,J3490,FUROSEMIDE 40 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,FUROSEMIDE 40 MG/4 ML ORAL SOLN,10.5,7.3500000000000005,,,0
HCPCS,J3490,FUROSEMIDE 80 MG ORAL TAB,9.0,6.3,,,0
HCPCS,J3490,GABAPENTIN 100 MG ORAL CAP,14.0,9.8,,,0
HCPCS,J3490,GABAPENTIN 250 MG/5 ML (5 ML) ORAL SOLN,31.0,21.7,,,0
HCPCS,J3490,GABAPENTIN 250 MG/5 ML ORAL SOLN,17.0,11.9,,,0
HCPCS,J3490,GABAPENTIN 300 MG ORAL CAP,15.0,10.5,,,0
HCPCS,J3490,GABAPENTIN 300 MG/6 ML (6 ML) ORAL SOLN,10.0,7.0,,,0
HCPCS,J3490,GABAPENTIN 400 MG ORAL CAP,10.0,7.0,,,0
HCPCS,J3490,GALANTAMINE  4 MG ORAL TAB,41.5,29.049999999999997,,,0
HCPCS,J3490,GEMFIBROZIL 600 MG ORAL TAB,13.5,9.45,,,0
HCPCS,J3490,GENTAMICIN 0.1 % TOP CREA,242.0,169.4,,,0
HCPCS,J3490,GENTAMICIN 0.1 % TOP OINT,242.0,169.4,,,0
HCPCS,J3490,GENTAMICIN 0.3 % OPHT DROP,210.0,147.0,,,0
HCPCS,J3490,GENTAMICIN 10 MG/1 ML SUBCONJUNCTIVAL INJECTION,21.0,14.7,,,0
HCPCS,J3490,GENTIAN VIOLET 1 % TOP SOLN,47.0,32.9,,,0
HCPCS,J3490,GLIMEPIRIDE 1 MG ORAL TAB,6.5,4.550000000000001,,,0
HCPCS,J3490,GLIMEPIRIDE 2 MG ORAL TAB,10.0,7.0,,,0
HCPCS,J3490,GLIMEPIRIDE 4 MG ORAL TAB,10.5,7.3500000000000005,,,0
HCPCS,J3490,GLIPIZIDE  2.5 MG ORAL TO24,13.5,9.45,,,0
HCPCS,J3490,GLIPIZIDE  5 MG ORAL TAB,5.5,3.85,,,0
HCPCS,J3490,GLIPIZIDE  5 MG ORAL TO24,8.0,5.6,,,0
HCPCS,J3490,GLIPIZIDE 10 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,GLIPIZIDE 10 MG ORAL TO24,12.5,8.75,,,0
HCPCS,J3490,GLUCOSAMINE SULFATE  500 MG ORAL CAP,7.0,4.9,,,0
HCPCS,J3490,GLYBURIDE 5 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,GLYCERIN (ADULT) RECTAL SUPPOSITORY,7.0,4.9,,,0
HCPCS,J3490,GLYCERIN (CHILD) RECTAL SUPPOSITORY,7.0,4.9,,,0
HCPCS,J3490,GLYCERIN (LAXATIVE) 2.8 GRAM/2.7 ML RECT SOLN,7.0,4.9,,,0
HCPCS,J3490,GLYCERIN 99.5 % TOP SOLN,24.5,17.15,,,0
HCPCS,J3490,GLYCERIN-WITCH HAZEL 12.5 %-50 % TOPICAL PADS,18.0,12.6,,,0
HCPCS,J3490,GLYCOPYRROLATE 0.2 MG/ML ORAL SOLUTION (CDS),51.5,36.05,,,0
HCPCS,J3490,GLYCOPYRROLATE 1 MG ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,GRISEOFULVIN MICROSIZE 500 MG ORAL TAB,115.0,80.5,,,0
HCPCS,J3490,GUAIFENESIN  200 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,GUAIFENESIN 100 MG/5 ML ORAL LIQD,44.0,30.8,,,0
HCPCS,J3490,GUAIFENESIN 600 MG ORAL TP12,20.0,14.0,,,0
HCPCS,J3490,GUANFACINE 1 MG ORAL TAB,12.0,8.4,,,0
HCPCS,J3490,GUANFACINE 1 MG ORAL TB24,128.5,89.94999999999999,,,0
HCPCS,J3490,GUANFACINE 2 MG ORAL TB24,77.5,54.25,,,0
HCPCS,J3490,HALOBETASOL PROPIONATE 0.05 % TOP CREA,336.0,235.2,,,0
HCPCS,J3490,HALOPERIDOL  0.5 MG ORAL TAB,4.5,3.1500000000000004,,,0
HCPCS,J3490,HALOPERIDOL  1 MG ORAL TAB,8.5,5.949999999999999,,,0
HCPCS,J3490,HALOPERIDOL  2 MG ORAL TAB,8.5,5.95,,,0
HCPCS,J3490,HALOPERIDOL  5 MG ORAL TAB,11.5,8.05,,,0
HCPCS,J3490,HALOPERIDOL 10 MG ORAL TAB,11.0,7.7,,,0
HCPCS,J3490,HALOPERIDOL 2 MG/ML ORAL CONCENTRATE,10.0,7.0,,,0
HCPCS,J3490,"HEPARIN (PORCINE) IN 0.9% NACL 2,500 UNIT/250 ML (10 UNIT/ML) IV SOLP",16.0,11.2,,,0
HCPCS,J3490,HEPARIN 0.5 UNITS/ML IN 0.45% SODIUM CHLORIDE (REPACK REC),16.0,11.2,,,0
HCPCS,J3490,HEPARIN 0.5 UNITS/ML IN DEXTROSE 10% FOR TRANSPORT (REPACK REC),13.0,9.1,,,0
HCPCS,J3490,HEPARIN 1 UNIT/ML IN NS 20 ML SYRINGE (CDS ADS MIXTURE),46.0,32.2,,,0
HCPCS,J3490,HETASTARCH 6 % IN NORMAL SALINE IV,151.0,105.7,,,0
HCPCS,J3490,HONEY 100 % TOP PSTE,59.0,41.3,,,0
HCPCS,J3490,HYDRALAZINE  10 MG ORAL TAB,9.5,6.65,,,0
HCPCS,J3490,HYDRALAZINE  25 MG ORAL TAB,10.5,7.35,,,0
HCPCS,J3490,HYDRALAZINE  50 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,HYDROCHLOROTHIAZIDE  25 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,HYDROCHLOROTHIAZIDE  50 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,HYDROCODONE-ACETAMINOPHEN 10 MG-325 MG TAB,12.0,8.4,,,0
HCPCS,J3490,HYDROCODONE-ACETAMINOPHEN 5 MG-325 MG TAB,13.0,9.1,,,0
HCPCS,J3490,HYDROCODONE-ACETAMINOPHEN 7.5 MG-325 MG TAB,12.0,8.4,,,0
HCPCS,J3490,HYDROCODONE-ACETAMINOPHEN 7.5 MG-325 MG/15 ML ORAL SOLN (REPACK),16.0,11.2,,,0
HCPCS,J3490,HYDROCORTISONE  1 % TOP CREA,36.0,25.2,,,0
HCPCS,J3490,HYDROCORTISONE  1 % TOP OINT,23.0,16.1,,,0
HCPCS,J3490,HYDROCORTISONE  2.5 % RECT CREA,357.0,249.9,,,0
HCPCS,J3490,HYDROCORTISONE 10 MG ORAL TAB,23.0,16.1,,,0
HCPCS,J3490,HYDROCORTISONE 100 MG/60 ML RECT ENEM,126.0,88.2,,,0
HCPCS,J3490,HYDROCORTISONE 2 MG/ML SUSPENSION,7.0,4.9,,,0
HCPCS,J3490,HYDROCORTISONE 20 MG ORAL TAB,16.0,11.2,,,0
HCPCS,J3490,HYDROCORTISONE 5 MG ORAL TAB,10.5,7.35,,,0
HCPCS,J3490,HYDROCORTISONE ACETATE 25 MG RECT SUPP,88.5,61.95,,,0
HCPCS,J3490,HYDROCORTISONE-ACETIC ACID 1 %-2 % EAR DROPS,813.0,569.1,,,0
HCPCS,J3490,HYDROCORTISONE-ALOE VERA 1 % TOP CREA,22.0,15.4,,,0
HCPCS,J3490,HYDROCORTISONE-PRAMOXINE 1 %-1 % RECTAL FOAM,840.0,588.0,,,0
HCPCS,J3490,HYDROCORTISONE-PRAMOXINE 1 %-1 % TOPICAL FOAM,412.0,288.4,,,0
HCPCS,J3490,HYDROCORTISONE-PRAMOXINE 2.5 %-1 % RECTAL CREAM,806.0,564.2,,,0
HCPCS,J3490,HYDROMORPHONE  2 MG ORAL TAB,10.0,7.0,,,0
HCPCS,J3490,HYDROMORPHONE  4 MG ORAL TAB,9.0,6.3,,,0
HCPCS,J3490,HYDROMORPHONE  8 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,HYDROPHILLIC OINTMENT (AQUAPHOR),62.0,43.4,,,0
HCPCS,J3490,HYDROXYCHLOROQUINE 200 MG ORAL TAB,23.0,16.1,,,0
HCPCS,J3490,HYOSCYAMINE 0.125 MG SUBLINGUAL TAB,7.0,4.9,,,0
HCPCS,J3490,"HYOSCYAMINE 0.125 MG TAB, RAPID DISSOLVE",8.5,5.95,,,0
HCPCS,J3490,HYOSCYAMINE SULFATE 0.125 MG ORAL TAB,12.0,8.4,,,0
HCPCS,J3490,HYOSCYAMINE SULFATE 0.375 MG ORAL TB12,9.0,6.3,,,0
HCPCS,J3490,IBUPROFEN 100 MG ORAL CHEW,7.0,4.9,,,0
HCPCS,J3490,IBUPROFEN 100 MG/5 ML ORAL SUSP,19.0,13.3,,,0
HCPCS,J3490,IBUPROFEN 200 MG ORAL TAB,7.5,5.25,,,0
HCPCS,J3490,IBUPROFEN 400 MG ORAL TAB,10.5,7.3500000000000005,,,0
HCPCS,J3490,IBUPROFEN 600 MG ORAL TAB,13.0,9.1,,,0
HCPCS,J3490,IBUPROFEN 800 MG ORAL TAB,20.0,14.0,,,0
HCPCS,J3490,IBUPROFEN LYSINE (PF) 20 MG/2 ML IV SOLN,1235.0,864.5,,,0
HCPCS,J3490,IMIPRAMINE 10 MG TAB,7.0,4.9,,,0
HCPCS,J3490,IMIPRAMINE 25 MG TAB,4.0,2.8,,,0
HCPCS,J3490,IMIPRAMINE 50 MG TAB,11.5,8.05,,,0
HCPCS,J3490,IMIPRAMINE PAMOATE 100 MG ORAL CAP,83.0,58.1,,,0
HCPCS,J3490,INDAPAMIDE 2.5 MG ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) IV SOLN,667.0,466.9,,,0
HCPCS,J3490,INDIGOTINDISULFONATE SODIUM 8 MG/ML INJ SOLN,66.0,46.2,,,0
HCPCS,J3490,INDOCYANINE GREEN 25 MG INJ,716.0,501.2,,,0
HCPCS,J3490,INDOMETHACIN 100 MG RECT SUPP,677.0,473.90000000000003,,,0
HCPCS,J3490,INDOMETHACIN 25 MG ORAL CAP,5.5,3.85,,,0
HCPCS,J3490,INDOMETHACIN 50 MG ORAL CAP,7.0,4.9,,,0
HCPCS,J3490,INDOMETHACIN 50 MG RECT SUPP,1998.0,1398.6,,,0
HCPCS,J3490,INSULIN INFUSION PEDS IV SYRINGE (FROM PREMIX),103.0,72.1,,,0
HCPCS,J3490,INSULIN REGULAR HUMAN 100 UNIT/ML INJ SOLN,16.0,11.2,,,0
HCPCS,J3490,IODINE STRONG (LUGOLS) 5 % ORAL SOLN,136.0,95.2,,,0
HCPCS,J3490,IOHEXOL   9 MG IODINE/ML ORAL SOLN,83.0,58.1,,,0
HCPCS,J3490,IPRATROPIUM BROMIDE 0.02 % INHL SOLN,11.0,7.7,,,0
HCPCS,J3490,IPRATROPIUM BROMIDE 0.03 % NASL SPRA,313.0,219.1,,,0
HCPCS,J3490,IPRATROPIUM BROMIDE 17 MCG/ACTUATION INHL AERO,21.0,14.7,,,0
HCPCS,J3490,IPRATROPIUM-ALBUTEROL 0.5 MG-2.5 MG/3 ML NEB SOLUTION,130.0,91.0,,,0
HCPCS,J3490,IPRATROPIUM-ALBUTEROL 20-100 MCG/ACTUATION INHL MIST,1371.5,960.05,,,0
HCPCS,J3490,IRBESARTAN  75 MG ORAL TAB,17.0,11.9,,,0
HCPCS,J3490,IRBESARTAN 150 MG ORAL TAB,22.0,15.399999999999999,,,0
HCPCS,J3490,IRBESARTAN 300 MG ORAL TAB,16.0,11.2,,,0
HCPCS,J3490,ISAVUCONAZONIUM SULFATE 186 MG ORAL CAP,820.0,574.0,,,0
HCPCS,J3490,ISONIAZID 300 MG ORAL TAB,15.0,10.5,,,0
HCPCS,J3490,ISONIAZID 50 MG/5 ML ORAL SYRP,106.0,74.2,,,0
HCPCS,J3490,ISOPROTERENOL 0.2 MG/ML INJECTION,864.0,604.8,,,0
HCPCS,J3490,ISOSORBIDE DINITRATE  5 MG ORAL TAB,9.5,6.65,,,0
HCPCS,J3490,ISOSORBIDE DINITRATE 10 MG ORAL TAB,11.0,7.699999999999999,,,0
HCPCS,J3490,ISOSORBIDE DINITRATE 20 MG ORAL TAB,10.0,7.0,,,0
HCPCS,J3490,ISOSORBIDE DINITRATE 40 MG ORAL TAB,16.0,11.2,,,0
HCPCS,J3490,ISOSORBIDE MONONITRATE  20 MG ORAL TAB,9.5,6.65,,,0
HCPCS,J3490,ISOSORBIDE MONONITRATE  30 MG ORAL TB24,16.5,11.55,,,0
HCPCS,J3490,ISOSORBIDE MONONITRATE  60 MG ORAL TB24,23.5,16.450000000000003,,,0
HCPCS,J3490,ISOSORBIDE MONONITRATE 120 MG ORAL TB24,31.0,21.7,,,0
HCPCS,J3490,ISRADIPINE  2.5 MG ORAL CAP,16.0,11.2,,,0
HCPCS,J3490,ITRACONAZOLE 10 MG/ML ORAL SOLN,61.0,42.7,,,0
HCPCS,J3490,ITRACONAZOLE 100 MG ORAL CAP,45.0,31.5,,,0
HCPCS,J3490,IVABRADINE 5 MG ORAL TAB,31.5,22.049999999999997,,,0
HCPCS,J3490,IVABRADINE 5 MG/5 ML ORAL SOLN,46.0,32.2,,,0
HCPCS,J3490,IVABRADINE 7.5 MG ORAL TAB,85.0,59.5,,,0
HCPCS,J3490,IVERMECTIN 3 MG ORAL TAB,134.0,93.80000000000001,,,0
HCPCS,J3490,K PHOS DI & MONO-SOD PHOS MONO 250 MG ORAL TAB,10.5,7.35,,,0
HCPCS,J3490,KETAMINE  50 MG/ML INJ SOLN,112.0,78.4,,,0
HCPCS,J3490,KETAMINE 100 MG/ML INJ SOLN,35.0,24.5,,,0
HCPCS,J3490,KETAMINE 2 MG/ML IN NS 50ML INFUSION (STOCK DOSE),79.5,55.650000000000006,,,0
HCPCS,J3490,KETAMINE 50 MG/5ML (10 MG/ML) SYRINGE (PHS MERGE),54.5,38.15,,,0
HCPCS,J3490,KETAMINE 50MG/5ML (10MG/ML) ORAL SOLUTION (REPACK),27.0,18.9,,,0
HCPCS,J3490,KETAMINE IN 0.9 % SOD CHLORIDE 100 MG/10 ML (10 MG/ML) IV SYRG,143.5,100.44999999999999,,,0
HCPCS,J3490,"KETAMINE IN NACL, 10 MG/ML IV SOLN (PHS MERGE RECORD)",147.0,102.9,,,0
HCPCS,J3490,KETAMINE INFUSION 2MG/ML 100ML (FOR ANESTHESIA USE ONLY),39.0,27.3,,,0
HCPCS,J3490,KETOCONAZOLE 2 % TOP CREA,473.0,331.1,,,0
HCPCS,J3490,KETOCONAZOLE 2 % TOP SHAM,148.0,103.6,,,0
HCPCS,J3490,KETOCONAZOLE 200 MG ORAL TAB,42.0,29.4,,,0
HCPCS,J3490,KETOROLAC TROMETHAMINE 0.5 % OPHT DROP,380.0,266.0,,,0
HCPCS,J3490,L. ACIDOPHILUS-B. LACTIS-FOS 5 BILLION CELL ORAL PWPK,7.5,5.25,,,0
HCPCS,J3490,L. ACIDOPHILUS-B. LACTIS-FOS 5 BILLION CELL ORAL PWPK (NEONATAL),7.0,4.9,,,0
HCPCS,J3490,LABETALOL (5 MG/ML) IV SYRG (CONTAINS PRESERVATIVE),54.0,37.8,,,0
HCPCS,J3490,LABETALOL (5 MG/ML) IV SYRG PF,37.0,25.9,,,0
HCPCS,J3490,LABETALOL 100 MG ORAL TAB,9.5,6.65,,,0
HCPCS,J3490,LABETALOL 200 MG ORAL TAB,9.0,6.3,,,0
HCPCS,J3490,LABETALOL 300 MG ORAL TAB,10.0,7.0,,,0
HCPCS,J3490,LACOSAMIDE  50 MG ORAL TAB,70.5,49.35,,,0
HCPCS,J3490,LACOSAMIDE 10 MG/ML ORAL SOLUTION (REPACK),91.5,64.05,,,0
HCPCS,J3490,LACOSAMIDE 200 MG ORAL TAB,22.0,15.4,,,0
HCPCS,J3490,LACOSAMIDE 200 MG/20 ML IV SOLN,317.0,221.9,,,0
HCPCS,J3490,LACTASE 3000 UNIT ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,LACTOBACILLUS ACIDOPH-PECTIN 75 MILLION CELL -100 MG ORAL CAP,7.0,4.9,,,0
HCPCS,J3490,LACTOBACILLUS ACIDOPHILUS 500 MILLION CELLS ORAL CAP,5.5,3.85,,,0
HCPCS,J3490,LACTULOSE 10 GRAM/15 ML ORAL SOLN,19.0,13.3,,,0
HCPCS,J3490,LACTULOSE 20 GRAM/30 ML ORAL SOLN,23.0,16.1,,,0
HCPCS,J3490,LACTULOSE ENEMA 200G IN SW (1000 ML TOTAL VOLUME),48.0,33.6,,,0
HCPCS,J3490,LAMIVUDINE 10 MG/ML ORAL SOLN,58.0,40.6,,,0
HCPCS,J3490,LAMIVUDINE 150 MG ORAL TAB,70.0,49.0,,,0
HCPCS,J3490,LAMIVUDINE-ZIDOVUDINE 150 MG-300 MG TAB,72.0,50.4,,,0
HCPCS,J3490,LAMOTRIGINE  25 MG ORAL TAB,14.0,9.8,,,0
HCPCS,J3490,LAMOTRIGINE 100 MG ORAL TAB,5.5,3.85,,,0
HCPCS,J3490,LAMOTRIGINE 1MG/ML SUSPENSION (REPACK),13.0,9.1,,,0
HCPCS,J3490,LANOLIN OINTMENT (MODIFIED),14.0,9.8,,,0
HCPCS,J3490,LANSOPRAZOLE 15 MG ORAL TBLD,78.0,54.6,,,0
HCPCS,J3490,LANSOPRAZOLE 3 MG/ML ORAL SUSR,14.5,10.15,,,0
HCPCS,J3490,LANSOPRAZOLE 30 MG ORAL TBLD,80.0,56.0,,,0
HCPCS,J3490,LANTHANUM  500 MG ORAL CHEW,102.5,71.75,,,0
HCPCS,J3490,LATANOPROST 0.005 % OPHT DROP,403.0,282.1,,,0
HCPCS,J3490,LEFLUNOMIDE  10 MG ORAL TAB,22.0,15.4,,,0
HCPCS,J3490,LEFLUNOMIDE  20 MG ORAL TAB,63.5,44.45,,,0
HCPCS,J3490,LET TOP SOLN 5ML (COMPOUNDED),115.0,80.5,,,0
HCPCS,J3490,LET TOPICAL GEL 3 ML,56.0,39.2,,,0
HCPCS,J3490,LET TOPICAL SOLUTION 4ML (REPACK),92.0,64.4,,,0
HCPCS,J3490,LEUCOVORIN CALCIUM  25 MG ORAL TAB,55.0,38.5,,,0
HCPCS,J3490,LEVALBUTEROL 1.25 MG/3 ML NEB SOLUTION,36.0,25.2,,,0
HCPCS,J3490,LEVETIRACETAM  250 MG ORAL TAB,5.5,3.85,,,0
HCPCS,J3490,LEVETIRACETAM  500 MG ORAL TAB,15.0,10.5,,,0
HCPCS,J3490,LEVETIRACETAM  750 MG ORAL TAB,12.5,8.75,,,0
HCPCS,J3490,LEVETIRACETAM 100 MG/ML ORAL SOLN,20.5,14.350000000000001,,,0
HCPCS,J3490,LEVETIRACETAM 500 MG/5 ML ORAL SOLN,55.0,38.5,,,0
HCPCS,J3490,LEVOCARNITINE (WITH SUCROSE) 100 MG/ML ORAL SOLN,17.5,12.25,,,0
HCPCS,J3490,LEVOCARNITINE 200 MG/ML IV SOLN,324.0,226.79999999999998,,,0
HCPCS,J3490,LEVOCARNITINE 330 MG ORAL TAB,19.0,13.3,,,0
HCPCS,J3490,LEVOFLOXACIN 250 MG/10 ML ORAL SOLN,271.5,190.05,,,0
HCPCS,J3490,LEVOFLOXACIN 500 MG ORAL TAB,83.0,58.1,,,0
HCPCS,J3490,LEVOFLOXACIN 750 MG ORAL TAB,217.5,152.25,,,0
HCPCS,J3490,LEVONORGESTREL 1.5 MG ORAL TAB,165.0,115.5,,,0
HCPCS,J3490,LEVOTHYROXINE  50 MCG ORAL TAB,11.5,8.05,,,0
HCPCS,J3490,LEVOTHYROXINE  75 MCG ORAL TAB,8.5,5.949999999999999,,,0
HCPCS,J3490,LEVOTHYROXINE  88 MCG ORAL TAB,8.5,5.949999999999999,,,0
HCPCS,J3490,LEVOTHYROXINE 100 MCG IV SOLR,433.0,303.1,,,0
HCPCS,J3490,LEVOTHYROXINE 100 MCG ORAL TAB,9.0,6.3,,,0
HCPCS,J3490,LEVOTHYROXINE 112 MCG ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,LEVOTHYROXINE 125 MCG ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,LEVOTHYROXINE 150 MCG ORAL TAB,7.5,5.25,,,0
HCPCS,J3490,LEVOTHYROXINE 175 MCG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,LEVOTHYROXINE 20 MCG/ML IV SYRINGE (PEDIATRIC),80.0,56.0,,,0
HCPCS,J3490,LEVOTHYROXINE 200 MCG INJ SOLR,934.0,653.8,,,0
HCPCS,J3490,LEVOTHYROXINE 200 MCG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,LEVOTHYROXINE 25 MCG ORAL TAB,13.5,9.45,,,0
HCPCS,J3490,LEVOTHYROXINE 300 MCG ORAL TAB,5.5,3.85,,,0
HCPCS,J3490,LEVOTHYROXINE 500 MCG INJ SOLR,1458.0,1020.6,,,0
HCPCS,J3490,LEVOXYL 25 MCG ORAL TAB (FOR NEONATAL PATIENTS),7.5,5.25,,,0
HCPCS,J3490,"LIDO-EPI WITH 8.4% SOD BICARB 1 %- 1:100,000 (3 ML) INJ SYRG",72.0,50.400000000000006,,,0
HCPCS,J3490,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,64.5,45.150000000000006,,,0
HCPCS,J3490,LIDOCAINE (PF) 15 MG/ML (1.5 %) INJ SOLN,45.0,31.5,,,0
HCPCS,J3490,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,64.5,45.15,,,0
HCPCS,J3490,LIDOCAINE (PF) 20 MG/ML (2 %) IV SYRG,97.0,67.9,,,0
HCPCS,J3490,LIDOCAINE (PF) 40 MG/ML (4 %) INJ SOLN (FOR NEBULIZATION),26.0,18.2,,,0
HCPCS,J3490,LIDOCAINE (PF) 5 MG/ML (0.5 %) INJ SOLN,32.0,22.4,,,0
HCPCS,J3490,LIDOCAINE 1% (BUFFERED W/NAHCO3 8.4%) 10 ML SYRINGE (MERGE),233.0,163.1,,,0
HCPCS,J3490,LIDOCAINE 1% 10MG/ML (1ML-UD) OR SYRINGE,14.5,10.15,,,0
HCPCS,J3490,LIDOCAINE 1%/EPINEPHRINE 1:200K INJECTION (PF),31.5,22.049999999999997,,,0
HCPCS,J3490,LIDOCAINE 10 MG/ML (1 %) INJECTION,22.5,15.75,,,0
HCPCS,J3490,LIDOCAINE 2 % MUCOSAL GEL,105.0,73.5,,,0
HCPCS,J3490,LIDOCAINE 2 % MUCOSAL SOLN (VISCOUS),27.0,18.9,,,0
HCPCS,J3490,LIDOCAINE 2% 20MG/ML (5ML-UD) OR SYRINGE,19.5,13.65,,,0
HCPCS,J3490,LIDOCAINE 2%/EPINEPHRINE 1:200K INJECTION (PF),133.0,93.1,,,0
HCPCS,J3490,LIDOCAINE 20 MG/ML (2 %) INJECTION,26.5,18.549999999999997,,,0
HCPCS,J3490,LIDOCAINE 4 % MUCOSAL TOPICAL SOLN,36.0,25.2,,,0
HCPCS,J3490,LIDOCAINE 4 % TOP CREA,50.5,35.349999999999994,,,0
HCPCS,J3490,LIDOCAINE 4 % TOPICAL SOLN,701.0,490.7,,,0
HCPCS,J3490,LIDOCAINE 4% TOP PATCH,29.0,20.3,,,0
HCPCS,J3490,LIDOCAINE 5 % TOP OINT,887.5,621.25,,,0
HCPCS,J3490,LIDOCAINE 5 MG/ML (0.5 %) INJECTION,16.0,11.2,,,0
HCPCS,J3490,LIDOCAINE HCL  2 % MM JELP,69.0,48.3,,,0
HCPCS,J3490,LIDOCAINE IN D5W (PF) 4 MG/ML (0.4 %) IV SOLP,45.0,31.5,,,0
HCPCS,J3490,LIDOCAINE-DIPHENHYD-AL-MAG-SIM 200-25-400-40 MG/30 ML MM MWSH,36.0,25.2,,,0
HCPCS,J3490,LIDOCAINE-EPINEPHR-TETRACAINE 4-0.18-0.5 % TOPICAL GEL,45.0,31.5,,,0
HCPCS,J3490,"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN",33.0,23.1,,,0
HCPCS,J3490,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN",28.0,19.6,,,0
HCPCS,J3490,"LIDOCAINE-EPINEPHRINE 1 %-1:200,000 INJ SOLN",78.0,54.6,,,0
HCPCS,J3490,"LIDOCAINE-EPINEPHRINE 2 %-1:200,000 INJ SOLN",56.0,39.2,,,0
HCPCS,J3490,"LIDOCAINE-EPINEPHRINE BIT 2 %-1:100,000 INJ CRTG",8.0,5.6,,,0
HCPCS,J3490,LIDOCAINE-PHENYLEPHRINE 4%-0.25% NASAL SPRAY,38.0,26.6,,,0
HCPCS,J3490,LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,51.0,35.7,,,0
HCPCS,J3490,LINACLOTIDE  72 MCG ORAL CAP,167.5,117.25,,,0
HCPCS,J3490,LINACLOTIDE 145 MCG ORAL CAP,112.0,78.4,,,0
HCPCS,J3490,LINEZOLID 100 MG/5 ML ORAL SUSR,377.0,263.9,,,0
HCPCS,J3490,LINEZOLID 600 MG ORAL TAB,1690.0,1183.0,,,0
HCPCS,J3490,LIOTHYRONINE  5 MCG ORAL TAB,14.5,10.15,,,0
HCPCS,J3490,LIOTHYRONINE 10 MCG/ML IV SOLN,1825.0,1277.5,,,0
HCPCS,J3490,LIOTHYRONINE 25 MCG ORAL TAB,10.0,7.0,,,0
HCPCS,J3490,"LIPASE-PROTEASE-AMYLASE (PORK) 3,000-9,500- 15,000 UNIT ORAL CPDR",12.0,8.4,,,0
HCPCS,J3490,"LIPASE-PROTEASE-AMYLASE (PORK) 36,000-114,000- 180,000 UNIT ORAL CPDR",149.5,104.65,,,0
HCPCS,J3490,"LIPASE-PROTEASE-AMYLASE 12,000-38,000- 60,000 UNIT ORAL CAP, DELAY REL",66.0,46.2,,,0
HCPCS,J3490,"LIPASE-PROTEASE-AMYLASE 24,000-76,000- 120,000 UNIT ORAL CAP, DELAY REL",145.0,101.5,,,0
HCPCS,J3490,"LIPASE-PROTEASE-AMYLASE 5,000-17,000- 24,000 UNIT ORAL CPDR",28.0,19.6,,,0
HCPCS,J3490,LISINOPRIL  2.5 MG ORAL TAB,7.5,5.25,,,0
HCPCS,J3490,LISINOPRIL  5 MG ORAL TAB,16.5,11.55,,,0
HCPCS,J3490,LISINOPRIL 10 MG ORAL TAB,11.5,8.05,,,0
HCPCS,J3490,LISINOPRIL 20 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,LITHIUM CARBONATE 150 MG ORAL CAP,5.5,3.85,,,0
HCPCS,J3490,LITHIUM CARBONATE 300 MG ORAL CAP,7.0,4.9,,,0
HCPCS,J3490,LITHIUM CARBONATE 300 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,LITHIUM CARBONATE 300 MG ORAL TBSR,7.5,5.25,,,0
HCPCS,J3490,LITHIUM CARBONATE 450 MG ORAL TBSR,8.0,5.6,,,0
HCPCS,J3490,LOPERAMIDE 1 MG/7.5 ML ORAL LIQD,25.0,17.5,,,0
HCPCS,J3490,LOPERAMIDE 2 MG ORAL CAP,23.0,16.1,,,0
HCPCS,J3490,LORATADINE 10 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,LORATADINE 5 MG/5 ML ORAL SOLN,7.0,4.9,,,0
HCPCS,J3490,LORAZEPAM 0.25 MG/0.5 ML (0.5 MG/1 ML) ORAL SUSPENSION (REPACK),11.0,7.7,,,0
HCPCS,J3490,LORAZEPAM 0.5 MG ORAL TAB,15.0,10.5,,,0
HCPCS,J3490,LORAZEPAM 1 MG ORAL TAB,9.0,6.3,,,0
HCPCS,J3490,LORAZEPAM 2 MG ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,LORAZEPAM 2 MG/ML ORAL CONC,9.0,6.3,,,0
HCPCS,J3490,LOSARTAN  25 MG ORAL TAB,19.5,13.65,,,0
HCPCS,J3490,LOSARTAN  50 MG ORAL TAB,14.5,10.15,,,0
HCPCS,J3490,LOSARTAN 100 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,LOVASTATIN 10 MG ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,LOVASTATIN 20 MG ORAL TAB,20.0,14.0,,,0
HCPCS,J3490,LOXAPINE 25 MG CAP,11.0,7.7,,,0
HCPCS,J3490,LOXAPINE 50 MG CAP,25.0,17.5,,,0
HCPCS,J3490,LUBIPROSTONE  8 MCG ORAL CAP,67.5,47.25,,,0
HCPCS,J3490,LUBIPROSTONE 24 MCG ORAL CAP,38.0,26.6,,,0
HCPCS,J3490,LURASIDONE  60 MG ORAL TAB,12.0,8.4,,,0
HCPCS,J3490,LURASIDONE  80 MG ORAL TAB,241.0,168.7,,,0
HCPCS,J3490,LURASIDONE 20 MG ORAL TAB,43.5,30.45,,,0
HCPCS,J3490,MAGIC MOUTHWASH REPACK (BMX 1:1:1),33.5,23.45,,,0
HCPCS,J3490,MAGNESIUM CITRATE ORAL SOLN,10.0,7.0,,,0
HCPCS,J3490,MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSP,14.5,10.15,,,0
HCPCS,J3490,MAGNESIUM OXIDE 400 MG ORAL TAB,7.5,5.25,,,0
HCPCS,J3490,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IV PGBK,45.0,31.5,,,0
HCPCS,J3490,MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IV PGBK,18.0,12.6,,,0
HCPCS,J3490,MECLIZINE 12.5 MG ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,MECLIZINE 25 MG ORAL TAB,6.0,4.2,,,0
HCPCS,J3490,MEDIUM CHAIN TRIGLYCERIDES OIL ORAL,7.0,4.9,,,0
HCPCS,J3490,MEDROXYPROGESTERONE  2.5 MG ORAL TAB,10.5,7.3500000000000005,,,0
HCPCS,J3490,MEDROXYPROGESTERONE  5 MG ORAL TAB,16.0,11.2,,,0
HCPCS,J3490,MEDROXYPROGESTERONE 10 MG ORAL TAB,10.0,7.0,,,0
HCPCS,J3490,MEGESTROL 400 MG/10 ML (10 ML) ORAL SUSP,26.0,18.200000000000003,,,0
HCPCS,J3490,MELATONIN  1 MG/ML ORAL LIQD,9.5,6.65,,,0
HCPCS,J3490,MELATONIN  3 MG ORAL TAB,8.5,5.949999999999999,,,0
HCPCS,J3490,MELOXICAM  7.5 MG ORAL TAB,36.0,25.2,,,0
HCPCS,J3490,MEMANTINE  5 MG ORAL TAB,10.0,7.0,,,0
HCPCS,J3490,MEMANTINE 10 MG ORAL TAB,11.5,8.05,,,0
HCPCS,J3490,"MENING A,C,Y,W TT-N. MEN B(PF) 5-120 MCG/0.5 ML IM KIT",817.0,571.9,,,0
HCPCS,J3490,"MENING A,C,Y,W TT-N. MEN B(PF) 5-120 MCG/0.5 ML IM KIT (CAM USE ONLY)",727.0,508.9,,,0
HCPCS,J3490,MENTHOL-ZINC OXIDE 0.44-20.625 % TOP OINT,34.0,23.8,,,0
HCPCS,J3490,MENTHOLATUM CAMPHOR 9% -MENTHOL 1.3% OINTMENT,26.0,18.2,,,0
HCPCS,J3490,MERCAPTOPURINE 25 MG SPLIT TABLET,46.0,32.2,,,0
HCPCS,J3490,MESALAMINE  250 MG ORAL CPSR,63.0,44.099999999999994,,,0
HCPCS,J3490,MESALAMINE 1.2 G ORAL TBEC,50.0,35.0,,,0
HCPCS,J3490,MESALAMINE 1000 MG RECT SUPP,216.0,151.2,,,0
HCPCS,J3490,MESALAMINE 4 GRAM/60 ML RECT ENEM,119.0,83.3,,,0
HCPCS,J3490,MESALAMINE 400 MG ORAL CAPSULE-WITH DR TABLETS (CDTI),82.0,57.4,,,0
HCPCS,J3490,METFORMIN  500 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,METFORMIN  500 MG ORAL TB24,10.0,7.0,,,0
HCPCS,J3490,METFORMIN  750 MG ORAL TB24,14.0,9.8,,,0
HCPCS,J3490,METFORMIN  850 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,METHADONE  5 MG ORAL TAB,16.5,11.55,,,0
HCPCS,J3490,METHADONE 1 MG/1 ML ORAL SOLN,14.0,9.8,,,0
HCPCS,J3490,METHADONE 10 MG ORAL TAB,30.5,21.35,,,0
HCPCS,J3490,METHADONE 10 MG/ML ORAL CONC,62.0,43.4,,,0
HCPCS,J3490,METHADONE 3 MG/ 3ML ORAL SOLUTION (PEDS),7.0,4.9,,,0
HCPCS,J3490,METHENAMINE HIPPURATE 1 GRAM ORAL TAB,16.5,11.55,,,0
HCPCS,J3490,METHIMAZOLE  5 MG ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,METHIMAZOLE 10 MG ORAL TAB,10.5,7.35,,,0
HCPCS,J3490,METHOCARBAMOL 500 MG ORAL TAB,19.0,13.3,,,0
HCPCS,J3490,METHOCARBAMOL 750 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,METHYL SALICYLATE-MENTHOL 15 %-10 % TOPICAL CREAM,24.5,17.15,,,0
HCPCS,J3490,METHYL SALICYLATE-MENTHOL 15-1 % TOPICAL CREAM,32.0,22.4,,,0
HCPCS,J3490,METHYLERGONOVINE 0.2 MG ORAL TAB,286.0,200.2,,,0
HCPCS,J3490,METHYLPHENIDATE  5 MG ORAL TAB,17.0,11.9,,,0
HCPCS,J3490,METHYLPHENIDATE 18 MG ORAL TO24,76.0,53.2,,,0
HCPCS,J3490,METHYLPHENIDATE 20 MG ORAL TBSR,43.0,30.1,,,0
HCPCS,J3490,METHYLPHENIDATE 27 MG ORAL TO24,65.0,45.5,,,0
HCPCS,J3490,METOCLOPRAMIDE  5 MG ORAL TAB,9.5,6.65,,,0
HCPCS,J3490,METOCLOPRAMIDE 10 MG ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,METOCLOPRAMIDE HCL 5 MG/5 ML ORAL SOLN,27.0,18.9,,,0
HCPCS,J3490,METOLAZONE  2.5 MG ORAL TAB,30.0,21.0,,,0
HCPCS,J3490,METOLAZONE  5 MG ORAL TAB,33.5,23.45,,,0
HCPCS,J3490,METOLAZONE 10 MG ORAL TAB,14.0,9.8,,,0
HCPCS,J3490,METOLAZONE 1MG/ML SUSPENSION (REPACK),7.0,4.9,,,0
HCPCS,J3490,METOPROLOL 10MG/1ML SUSPENSION (REPACK),7.0,4.9,,,0
HCPCS,J3490,METOPROLOL SUCCINATE SR 100 MG 24 HR TAB,16.0,11.2,,,0
HCPCS,J3490,METOPROLOL SUCCINATE SR 25 MG 24 HR TAB,23.5,16.45,,,0
HCPCS,J3490,METOPROLOL SUCCINATE SR 50 MG 24 HR TAB,19.0,13.3,,,0
HCPCS,J3490,METOPROLOL TARTRATE 100 MG TAB,5.5,3.85,,,0
HCPCS,J3490,METOPROLOL TARTRATE 25 MG TAB,7.0,4.9,,,0
HCPCS,J3490,METOPROLOL TARTRATE 5 MG/5 ML IV,20.0,14.0,,,0
HCPCS,J3490,METOPROLOL TARTRATE 50 MG TAB,7.0,4.9,,,0
HCPCS,J3490,METRONIDAZOLE 0.75 % TOP GEL,943.0,660.1,,,0
HCPCS,J3490,METRONIDAZOLE 0.75 % VAGL GEL,569.0,398.29999999999995,,,0
HCPCS,J3490,METRONIDAZOLE 1 % TOP GEL,818.0,572.6,,,0
HCPCS,J3490,METRONIDAZOLE 250 MG ORAL TAB,53.5,37.45,,,0
HCPCS,J3490,METRONIDAZOLE 50 MG/ML SUSPENSION (10ML REPACK),8.0,5.6,,,0
HCPCS,J3490,METRONIDAZOLE 500 MG ORAL TAB,35.0,24.5,,,0
HCPCS,J3490,METRONIDAZOLE IN SODIUM CHLORIDE (ISO-OSM) 500 MG/100 ML IV PIGGY BACK,15.0,10.5,,,0
HCPCS,J3490,MEXILETINE 150 MG ORAL CAP,22.0,15.4,,,0
HCPCS,J3490,MEXILETINE 200 MG ORAL CAP,17.0,11.9,,,0
HCPCS,J3490,MEXILETINE 250 MG ORAL CAP,20.0,14.0,,,0
HCPCS,J3490,MICONAZOLE NITRATE 2 % TOP POWD,32.0,22.4,,,0
HCPCS,J3490,MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRP (MERGE/REPACK),34.0,23.8,,,0
HCPCS,J3490,MIDODRINE  2.5 MG ORAL TAB,13.0,9.1,,,0
HCPCS,J3490,MIDODRINE  5 MG ORAL TAB,22.5,15.75,,,0
HCPCS,J3490,MILTEFOSINE 50 MG ORAL CAP,1368.0,957.6,,,0
HCPCS,J3490,MINERAL OIL,54.0,37.8,,,0
HCPCS,J3490,MINERAL OIL ENEMA,20.0,14.0,,,0
HCPCS,J3490,MINERAL OIL ORAL (REPACK),11.0,7.7,,,0
HCPCS,J3490,MINOCYCLINE  50 MG ORAL CAP,10.0,7.0,,,0
HCPCS,J3490,MINOCYCLINE 100 MG ORAL CAP,13.5,9.45,,,0
HCPCS,J3490,MINOXIDIL  2.5 MG ORAL TAB,29.0,20.3,,,0
HCPCS,J3490,MIRTAZAPINE  7.5 MG ORAL TAB,34.0,23.8,,,0
HCPCS,J3490,MIRTAZAPINE 15 MG ORAL TAB,14.0,9.8,,,0
HCPCS,J3490,MIRTAZAPINE 30 MG ORAL TAB,13.5,9.45,,,0
HCPCS,J3490,MISOPROSTOL 200 MCG ORAL TAB,54.0,37.8,,,0
HCPCS,J3490,MODAFINIL 100 MG ORAL TAB,232.0,162.4,,,0
HCPCS,J3490,MOMETASONE 110 MCG (30 DOSES) INHL AEPB,402.0,281.4,,,0
HCPCS,J3490,MOMETASONE 220 MCG (14 DOSES) INHL AEPB,228.0,159.6,,,0
HCPCS,J3490,MOMETASONE 220 MCG (60 DOSES) INHL AEPB,796.0,557.2,,,0
HCPCS,J3490,MONTELUKAST  4 MG ORAL CHEW,32.0,22.4,,,0
HCPCS,J3490,MONTELUKAST  5 MG ORAL CHEW,32.0,22.4,,,0
HCPCS,J3490,MONTELUKAST 10 MG ORAL TAB,16.0,11.2,,,0
HCPCS,J3490,MORPHINE  10 MG/5 ML ORAL SOLN,12.0,8.4,,,0
HCPCS,J3490,MORPHINE  15 MG ORAL TAB,13.5,9.45,,,0
HCPCS,J3490,MORPHINE  15 MG ORAL TBSR,23.0,16.1,,,0
HCPCS,J3490,MORPHINE  20 MG/5 ML ORAL SOLN,8.0,5.6,,,0
HCPCS,J3490,MORPHINE  30 MG ORAL TBSR,23.0,16.1,,,0
HCPCS,J3490,MORPHINE  60 MG ORAL TBSR,15.5,10.850000000000001,,,0
HCPCS,J3490,MORPHINE 1 MG/ML PCA (PDS MERGE),138.0,96.6,,,0
HCPCS,J3490,MORPHINE 100 MG ORAL TBSR,37.5,26.25,,,0
HCPCS,J3490,MORPHINE 4 MG/ML IV SOLN (PHS/CDS MERGE),19.5,13.649999999999999,,,0
HCPCS,J3490,MORPHINE CONCENTRATE 10 MG/ 0.5 ML ORAL SYRINGE (0.5ML UD MERGE),17.5,12.25,,,0
HCPCS,J3490,MORPHINE CONCENTRATE 20 MG/ML ORAL SOLN,14.0,9.8,,,0
HCPCS,J3490,MOXIFLOXACIN 0.5 % OPHT DROP,336.0,235.20000000000002,,,0
HCPCS,J3490,MOXIFLOXACIN 400 MG ORAL TAB,200.5,140.35000000000002,,,0
HCPCS,J3490,MULTIVIT-IRON-FA-CALCIUM &MINS 9 MG IRON-400 MCG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,MULTIVIT-MIN-FERROUS GLUCONATE 9 MG IRON/ 15 ML (15 ML) ORAL LIQD,15.0,10.5,,,0
HCPCS,J3490,MULTIVIT-MIN-IRON FUM-FOLIC AC 7.5 MG IRON-400 MCG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,MULTIVITAMIN W/IRON ORAL DROP 0.5 ML (PEDS/NEO),8.0,5.6,,,0
HCPCS,J3490,MULTIVITAMIN W/IRON ORAL DROP 1 ML (PEDS/NEO),9.0,6.3,,,0
HCPCS,J3490,MULTIVITAMIN WITH FOLIC ACID 400 MCG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,MUPIROCIN 2 % TOP OINT,210.0,147.0,,,0
HCPCS,J3490,"MVI, ADULT INJECTION (PHS)",53.0,37.1,,,0
HCPCS,J3490,MYCOPHENOLATE 500 MG IV SOLUTION,461.5,323.05,,,0
HCPCS,J3490,"N.MENINGITIDIS B,LIPID FHBP RC 120 MCG/0.5 ML IM SYRG",859.0,601.3,,,0
HCPCS,J3490,NABUMETONE 500 MG ORAL TAB,10.0,7.0,,,0
HCPCS,J3490,NADOLOL  20 MG ORAL TAB,31.0,21.700000000000003,,,0
HCPCS,J3490,NADOLOL  40 MG ORAL TAB,26.5,18.55,,,0
HCPCS,J3490,NADOLOL  80 MG ORAL TAB,30.0,21.0,,,0
HCPCS,J3490,NAFCILLIN  1 GRAM INJ SOLR,97.5,68.25,,,0
HCPCS,J3490,NAFCILLIN  2 GRAM INJ SOLR,255.0,178.5,,,0
HCPCS,J3490,NAFCILLIN 10 GRAM INJ SOLR,497.0,347.9,,,0
HCPCS,J3490,NAFCILLIN NEO/PEDS (CDS MIXTURE),28.0,19.6,,,0
HCPCS,J3490,NALOXONE 4 MG/ACTUATION NASL SPRY,246.0,172.2,,,0
HCPCS,J3490,NALTREXONE 50 MG ORAL TAB,20.0,14.0,,,0
HCPCS,J3490,NAPHAZOLINE-GLYCERIN 0.012-0.25 % OPHT DROP,25.0,17.5,,,0
HCPCS,J3490,NAPHAZOLINE-PHENIRAMINE 0.025 %-0.3 % EYE DROPS,39.5,27.65,,,0
HCPCS,J3490,NAPROXEN 250 MG ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,NAPROXEN 375 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,NAPROXEN 500 MG ORAL TAB,12.0,8.4,,,0
HCPCS,J3490,NEBIVOLOL  2.5 MG ORAL TAB,56.0,39.2,,,0
HCPCS,J3490,NEBIVOLOL  5 MG ORAL TAB,39.0,27.3,,,0
HCPCS,J3490,NEMOLIZUMAB-ILTO 30 MG SUBQ PNIJ,9752.0,6826.4,,,0
HCPCS,J3490,NEO TPN SODIUM ACETATE 2 MEQ/ML IV SOLN,66.0,46.2,,,0
HCPCS,J3490,NEO TPN SODIUM CHLORIDE 4 MEQ/ML IV SOLN,38.5,26.950000000000003,,,0
HCPCS,J3490,NEOMYCIN 500 MG ORAL TAB,17.5,12.25,,,0
HCPCS,J3490,NEOMYCIN-BACITRACIN ZN-POLYMYXIN 3.5 MG-400 UN*,27.0,18.9,,,0
HCPCS,J3490,"NEOMYCIN-BACITRACIN-POLYMYXIN 3.5 MG-400 UNIT-10,000 UNIT/G EYE OINT",242.0,169.4,,,0
HCPCS,J3490,NEOMYCIN-BACITRACN ZN-POLYMYXIN 3.5 MG-400 U*,10.5,7.35,,,0
HCPCS,J3490,"NEOMYCIN-POLYMYXIN B GU 40 MG-200,000 UNIT/ML IRRIGATION SOLN",70.0,49.0,,,0
HCPCS,J3490,"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG-10,000 UNIT/G-0.1 % EYE OINTMENT",157.0,109.89999999999999,,,0
HCPCS,J3490,"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",216.0,151.2,,,0
HCPCS,J3490,NEOMYCIN-POLYMYXIN-GRAMICIDIN 1.75-10K-0.025 MG-UNIT-MG/ML OPHT DROP,260.0,182.0,,,0
HCPCS,J3490,"NEOMYCIN-POLYMYXIN-HC 3.5 MG-10,000 UNIT-10 MG/ML EYE DROPS, SUSP",674.0,471.8,,,0
HCPCS,J3490,"NEOMYCIN-POLYMYXIN-HC 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS, SUSP",370.5,259.35,,,0
HCPCS,J3490,"NEOMYCIN-POLYMYXIN-HC 3.5 MG-10,000 UNIT/ML-1 % EAR SOLN",370.5,259.35,,,0
HCPCS,J3490,"NEOMYCIN-POLYMYXIN-PRAMOXINE 3.5 MG-10,000 UNIT-10 MG/G TOPICAL CREAM",26.0,18.2,,,0
HCPCS,J3490,NIACIN  250 MG ORAL CPSR,7.0,4.9,,,0
HCPCS,J3490,NIACIN  250 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,NICARDIPINE 20 MG ORAL CAP,76.0,53.2,,,0
HCPCS,J3490,NICARDIPINE 25 MG/10 ML IV SOLN,287.0,200.9,,,0
HCPCS,J3490,NICARDIPINE 30 MG ORAL CAP,109.0,76.3,,,0
HCPCS,J3490,NICARDIPINE IN NACL (ISO-OS) 20 MG/200 ML IV PGBK,334.5,234.15,,,0
HCPCS,J3490,NICARDIPINE INFUSION 100 MCG/ML 50ML (PEDIATRIC),86.0,60.2,,,0
HCPCS,J3490,NICOTINE  7 MG/24 HR TD PT24,18.0,12.600000000000001,,,0
HCPCS,J3490,NICOTINE (POLACRILEX) 2 MG BUCL GUM,7.0,4.9,,,0
HCPCS,J3490,NICOTINE (POLACRILEX) 2 MG MM LOZG,4.0,2.8,,,0
HCPCS,J3490,NICOTINE (POLACRILEX) 4 MG BUCL GUM,18.0,12.600000000000001,,,0
HCPCS,J3490,NICOTINE (POLACRILEX) 4 MG MM LOZG,8.0,5.6,,,0
HCPCS,J3490,NICOTINE 14 MG/24 HR TD PT24,24.5,17.15,,,0
HCPCS,J3490,NICOTINE 21 MG/24 HR TD PT24,26.0,18.200000000000003,,,0
HCPCS,J3490,NIFEDIPINE 10 MG ORAL CAP,15.0,10.5,,,0
HCPCS,J3490,NIFEDIPINE 20 MG ORAL CAP,7.0,4.9,,,0
HCPCS,J3490,NIFEDIPINE 30 MG ORAL TO24,16.0,11.2,,,0
HCPCS,J3490,NIFEDIPINE 60 MG ORAL TO24,17.0,11.9,,,0
HCPCS,J3490,NIFEDIPINE 90 MG ORAL TO24,14.5,10.15,,,0
HCPCS,J3490,NIMODIPINE 30 MG ORAL CAP,138.0,96.6,,,0
HCPCS,J3490,NIMODIPINE 30 MG/5 ML ORAL SYRG,367.0,256.9,,,0
HCPCS,J3490,NIMODIPINE 60 MG/10 ML ORAL SYRG,416.0,291.2,,,0
HCPCS,J3490,NIRMATRELVIR-RITONAVIR 150 MG (10)- 100 MG (10) ORAL DSPK,647.0,452.9,,,0
HCPCS,J3490,NIRMATRELVIR-RITONAVIR 300 MG (150 MG X 2)-100 MG ORAL DSPK,647.0,452.9,,,0
HCPCS,J3490,NIRMATRELVIR-RITONAVIR 300-100 MG ORAL TAB DOSEPACK (FOR ED/IP TAKE HOME PANEL),4010.0,2807.0,,,0
HCPCS,J3490,NITAZOXANIDE 500 MG ORAL TAB,595.0,416.5,,,0
HCPCS,J3490,NITROFURANTOIN (25% MACROCRYSTAL FORM) 100 MG CAP,19.0,13.3,,,0
HCPCS,J3490,NITROFURANTOIN MACROCRYSTAL  50 MG ORAL CAP,13.0,9.1,,,0
HCPCS,J3490,NITROFURANTOIN MACROCRYSTAL 100 MG ORAL CAP,278.5,194.95,,,0
HCPCS,J3490,NITROGLYCERIN 0.1 MG/HR TD PT24,11.0,7.7,,,0
HCPCS,J3490,NITROGLYCERIN 0.2 MG/HR TD PT24,11.0,7.7,,,0
HCPCS,J3490,NITROGLYCERIN 0.4 MG SL SUBL,12.0,8.4,,,0
HCPCS,J3490,NITROGLYCERIN 0.4 MG/HR TD PT24,25.0,17.5,,,0
HCPCS,J3490,NITROGLYCERIN 0.6 MG/HR TD PT24,14.0,9.8,,,0
HCPCS,J3490,NITROGLYCERIN 2 % TD OINT,25.5,17.85,,,0
HCPCS,J3490,NITROGLYCERIN 2 MG/10 ML (200 MCG/ML) IN D5W VIAL-CVL/IR USE (REPACK),17.5,12.25,,,0
HCPCS,J3490,NITROPRUSSIDE 25 MG/ML IV SOLN,123.0,86.1,,,0
HCPCS,J3490,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,236.0,165.2,,,0
HCPCS,J3490,NOREPINEPHRINE BITARTRATE-D5W 16 MG/250 ML (64 MCG/ML) IV SOLN (CENTRAL ONLY),283.5,198.45,,,0
HCPCS,J3490,NOREPINEPHRINE BITARTRATE-D5W 4 MG/250 ML (16 MCG/ML) IV SOLN,128.0,89.6,,,0
HCPCS,J3490,NOREPINEPHRINE BITARTRATE-NACL 4 MG/250 ML (16 MCG/ML) IV SOLN (CENTRAL ONLY),327.0,228.89999999999998,,,0
HCPCS,J3490,NORETHINDRONE ACETATE 5 MG ORAL TAB,30.0,21.0,,,0
HCPCS,J3490,NORETHINDRONE-ETHINYL ESTRADIOL 1 MG-35 MCG TAB,10.0,7.0,,,0
HCPCS,J3490,NORGESTREL-ETHINYL ESTRADIOL 0.3 MG-30 MCG TAB,7.0,4.9,,,0
HCPCS,J3490,NORTRIPTYLINE 10 MG ORAL CAP,9.0,6.3,,,0
HCPCS,J3490,NORTRIPTYLINE 25 MG ORAL CAP,17.0,11.9,,,0
HCPCS,J3490,NORTRIPTYLINE 50 MG ORAL CAP,18.0,12.6,,,0
HCPCS,J3490,NS WITH POTASSIUM CHLORIDE 40 MEQ/L IV SOLP,66.5,46.55,,,0
HCPCS,J3490,NYSTATIN  100000 UNIT/G TOP CREA,172.0,120.4,,,0
HCPCS,J3490,NYSTATIN  100000 UNIT/G TOP OINT,86.0,60.2,,,0
HCPCS,J3490,NYSTATIN  100000 UNIT/G TOP POWD,137.0,95.9,,,0
HCPCS,J3490,NYSTATIN 100000 UNIT/ML ORAL SUSP,18.0,12.6,,,0
HCPCS,J3490,NYSTATIN 500000 UNIT ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,OFLOXACIN 0.3 % OPHT DROP,171.5,120.05,,,0
HCPCS,J3490,OFLOXACIN 0.3 % OTIC DROP,739.0,517.3,,,0
HCPCS,J3490,OLANZAPINE  2.5 MG ORAL TAB,137.5,96.25,,,0
HCPCS,J3490,OLANZAPINE  5 MG ORAL TAB,102.0,71.4,,,0
HCPCS,J3490,OLANZAPINE  5 MG ORAL TBDL,57.5,40.25,,,0
HCPCS,J3490,OLANZAPINE  7.5 MG ORAL TAB,158.0,110.6,,,0
HCPCS,J3490,OLANZAPINE 10 MG ORAL TAB,130.0,91.0,,,0
HCPCS,J3490,OLANZAPINE 10 MG ORAL TBDL,102.5,71.75,,,0
HCPCS,J3490,OLMESARTAN  5 MG ORAL TAB,53.0,37.1,,,0
HCPCS,J3490,OLMESARTAN 20 MG ORAL TAB,52.0,36.4,,,0
HCPCS,J3490,OLMESARTAN 40 MG ORAL TAB,53.0,37.1,,,0
HCPCS,J3490,OLOPATADINE 0.1 % OPHT DROP,53.5,37.45,,,0
HCPCS,J3490,"OMEGA-3 FATTY ACIDS-FISH OIL 360-1,200 MG ORAL CAP (ERX MERGE)",5.5,3.85,,,0
HCPCS,J3490,OMEPRAZOLE 10 MG ORAL CPDR,43.0,30.1,,,0
HCPCS,J3490,OMEPRAZOLE 20 MG ORAL CPDR,7.0,4.9,,,0
HCPCS,J3490,OMEPRAZOLE-SODIUM BICARBONATE 2-84 MG/ML ORAL SUSR,27.0,18.9,,,0
HCPCS,J3490,ONDANSETRON 4 MG ORAL TBDL,289.0,202.3,,,0
HCPCS,J3490,ONDANSETRON HCL 4 MG/5 ML ORAL SOLN,117.5,82.25,,,0
HCPCS,J3490,OPIUM TINCTURE 10 MG/ML ORAL TINC,35.0,24.5,,,0
HCPCS,J3490,ORA-SWEET SF (COMPOUNDING VEHICLE SF NO.9 ORAL LIQD),7.0,4.9,,,0
HCPCS,J3490,ORAL ELECTROLYTES ORAL SOLN,36.5,25.55,,,0
HCPCS,J3490,ORAL PLUS ORAL VEHICLES ORAL LIQUID,7.0,4.9,,,0
HCPCS,J3490,ORPHENADRINE CITRATE 100 MG ORAL TBSR,13.0,9.1,,,0
HCPCS,J3490,OSELTAMIVIR  6 MG/ML ORAL SUSR,62.0,43.4,,,0
HCPCS,J3490,OSELTAMIVIR PHOSPHATE 30 MG ORAL CAP,156.5,109.55,,,0
HCPCS,J3490,OSELTAMIVIR PHOSPHATE 75 MG ORAL CAP,390.0,273.0,,,0
HCPCS,J3490,OXAZEPAM 10 MG ORAL CAP,7.0,4.9,,,0
HCPCS,J3490,OXAZEPAM 15 MG ORAL CAP,35.0,24.5,,,0
HCPCS,J3490,OXCARBAZEPINE 150 MG ORAL TAB,19.0,13.3,,,0
HCPCS,J3490,OXCARBAZEPINE 300 MG ORAL TAB,16.0,11.2,,,0
HCPCS,J3490,OXCARBAZEPINE 300 MG/5 ML ORAL SUSP,48.5,33.95,,,0
HCPCS,J3490,OXYBUTYNIN CHLORIDE  5 MG ORAL TAB,10.5,7.35,,,0
HCPCS,J3490,OXYBUTYNIN CHLORIDE  5 MG ORAL TO24,42.0,29.400000000000002,,,0
HCPCS,J3490,OXYBUTYNIN CHLORIDE 5 MG/5 ML ORAL SYRP,7.0,4.9,,,0
HCPCS,J3490,OXYCODONE  10 MG ORAL TR12,83.0,58.1,,,0
HCPCS,J3490,OXYCODONE  15 MG ORAL TAB,17.0,11.899999999999999,,,0
HCPCS,J3490,OXYCODONE  20 MG ORAL TR12,154.0,107.8,,,0
HCPCS,J3490,OXYCODONE  40 MG ORAL TR12,205.0,143.5,,,0
HCPCS,J3490,OXYCODONE 20MG/ML (1ML-UD) SYRINGE (REPACK),16.0,11.2,,,0
HCPCS,J3490,OXYCODONE 5 MG ORAL TAB,15.0,10.5,,,0
HCPCS,J3490,OXYCODONE 5 MG/5 ML ORAL SOLN,34.0,23.8,,,0
HCPCS,J3490,OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TAB,16.0,11.2,,,0
HCPCS,J3490,OXYMETAZOLINE 0.05 % NASAL (MERGE)(ENT PRE-PROCEDURE),14.0,9.8,,,0
HCPCS,J3490,OXYMETAZOLINE 0.05 % NASAL MERGE,18.0,12.6,,,0
HCPCS,J3490,OXYMETAZOLINE 0.05 % NASL SPRA,30.0,21.0,,,0
HCPCS,J3490,PANTOPRAZOLE 20 MG ORAL TBEC,33.0,23.1,,,0
HCPCS,J3490,PANTOPRAZOLE 40 MG IV SOLR,37.0,25.9,,,0
HCPCS,J3490,PANTOPRAZOLE 40 MG ORAL TBEC,49.0,34.3,,,0
HCPCS,J3490,PAROMOMYCIN 250 MG ORAL CAP,761.0,532.7,,,0
HCPCS,J3490,PAROXETINE 10 MG/5 ML ORAL SUSP,97.0,67.9,,,0
HCPCS,J3490,PAROXETINE 20 MG TAB,25.0,17.5,,,0
HCPCS,J3490,PAROXETINE 30 MG TAB,21.0,14.7,,,0
HCPCS,J3490,PAROXETINE SR 12.5 MG 24 HR TAB,31.0,21.7,,,0
HCPCS,J3490,PAROXETINE SR 25 MG 24 HR TAB,45.0,31.5,,,0
HCPCS,J3490,PAROXETINE SR 37.5 MG 24 HR TAB,12.0,8.4,,,0
HCPCS,J3490,PATIROMER CALCIUM SORBITEX  8.4 G ORAL PWPK,355.0,248.5,,,0
HCPCS,J3490,PEDI MULTIVIT NO.128-VITAMIN K 500 MCG/ML ORAL LIQD,7.0,4.9,,,0
HCPCS,J3490,PEDI MV NO.189-FERROUS SULFATE 11 MG IRON/ML ORAL DROP,7.0,4.9,,,0
HCPCS,J3490,PEDIATRIC MULTIVITAMIN NO.192 250 MCG-50 MG- 10 MCG/ML ORAL DROP,10.5,7.3500000000000005,,,0
HCPCS,J3490,PEDIATRIC MULTIVITAMIN NO.42 ORAL CHEW,7.0,4.9,,,0
HCPCS,J3490,PEG 3350-ELECTROLYTES 236 G-22.74 G-6.74 G-5.86 G ORAL SOLUTION,157.0,109.9,,,0
HCPCS,J3490,PEG 400-PROPYLENE GLYCOL 0.4-0.3 % OPHT DRPG,61.0,42.7,,,0
HCPCS,J3490,PEGINTERFERON ALFA-2A 180 MCG/ML SUBQ SOLN,1794.5,1256.15,,,0
HCPCS,J3490,PENICILLIN V POTASSIUM 250 MG ORAL TAB,19.0,13.3,,,0
HCPCS,J3490,PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SUSR,7.0,4.9,,,0
HCPCS,J3490,PENICILLIN V POTASSIUM 500 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,PENTAMIDINE 300 MG INHL SOLR,650.0,455.0,,,0
HCPCS,J3490,PENTAMIDINE 300 MG INJ SOLR,223.5,156.45,,,0
HCPCS,J3490,PENTOBARBITAL 75 MG/1.5 ML SYRINGE (REPACK),131.0,91.7,,,0
HCPCS,J3490,PENTOXIFYLLINE 400 MG ORAL TBSR,8.0,5.6,,,0
HCPCS,J3490,PERMETHRIN 1 % TOP LIQD (REPACK),58.0,40.599999999999994,,,0
HCPCS,J3490,PERMETHRIN 5 % TOP CREA,426.5,298.55,,,0
HCPCS,J3490,PERPHENAZINE  2 MG ORAL TAB,39.0,27.3,,,0
HCPCS,J3490,PERPHENAZINE  4 MG ORAL TAB,16.0,11.2,,,0
HCPCS,J3490,PERPHENAZINE  8 MG ORAL TAB,22.0,15.4,,,0
HCPCS,J3490,PHENAZOPYRIDINE 100 MG ORAL TAB,11.0,7.7,,,0
HCPCS,J3490,PHENAZOPYRIDINE 200 MG ORAL TAB,15.0,10.5,,,0
HCPCS,J3490,PHENOBARBITAL  32.4 MG ORAL TAB,11.0,7.7,,,0
HCPCS,J3490,PHENOBARBITAL  97.2 MG ORAL TAB,9.0,6.3,,,0
HCPCS,J3490,PHENOBARBITAL 20 MG/5 ML ORAL ELIX,30.5,21.35,,,0
HCPCS,J3490,PHENOL 1.4 % MM SPRA,19.0,13.3,,,0
HCPCS,J3490,PHENOL-PHENOLATE SODIUM AEROSOL,14.0,9.8,,,0
HCPCS,J3490,PHENOXYBENZAMINE 10 MG ORAL CAP,955.0,668.5,,,0
HCPCS,J3490,PHENTOLAMINE 5 MG INJ SOLR,1231.0,861.7,,,0
HCPCS,J3490,PHENYLEPH-MIN OIL-PETROLATUM 0.25-14-74.9 % RECT OINT,49.0,34.3,,,0
HCPCS,J3490,PHENYLEPHRINE 0.25 % NASAL SPRAY,22.0,15.4,,,0
HCPCS,J3490,PHENYLEPHRINE 0.5% NASAL DROPS (REPACK),15.5,10.85,,,0
HCPCS,J3490,PHENYLEPHRINE 1 % NASAL SPRAY AEROSOL,25.0,17.5,,,0
HCPCS,J3490,PHENYLEPHRINE 2.5 % EYE DROPS,302.0,211.4,,,0
HCPCS,J3490,PHENYLEPHRINE HCL  0.5 % NASL SPRY,23.0,16.1,,,0
HCPCS,J3490,PHENYLEPHRINE HCL IN 0.9% NACL 1 MG/10 ML (100 MCG/ML) IV SYRG,35.0,24.5,,,0
HCPCS,J3490,PHENYLEPHRINE IN 0.9% NS (PF) 1 MG/10 ML (100 MCG/ML) IV SYRG(PDS MERGE),47.5,33.25,,,0
HCPCS,J3490,PHENYLEPHRINE PEDS IV INFUSION (CDS MIXTURE),16.0,11.2,,,0
HCPCS,J3490,PHENYTOIN 100 MG/4 ML ORAL SUSP,51.0,35.7,,,0
HCPCS,J3490,PHENYTOIN 125 MG/5 ML ORAL SUSP,10.0,7.0,,,0
HCPCS,J3490,PHENYTOIN 50 MG ORAL CHEW,18.0,12.6,,,0
HCPCS,J3490,PHENYTOIN SODIUM EXTENDED  30 MG ORAL CAP,15.0,10.5,,,0
HCPCS,J3490,PHENYTOIN SODIUM EXTENDED 100 MG ORAL CAP,24.0,16.8,,,0
HCPCS,J3490,PHYTONADIONE 1 MG/ML ORAL SOLN,112.0,78.4,,,0
HCPCS,J3490,PHYTONADIONE 5 MG ORAL TAB,148.5,103.94999999999999,,,0
HCPCS,J3490,PILOCARPINE 1 % EYE DROPS,418.0,292.6,,,0
HCPCS,J3490,PILOCARPINE 2 % EYE DROPS,363.0,254.1,,,0
HCPCS,J3490,PILOCARPINE 5 MG TAB,17.0,11.9,,,0
HCPCS,J3490,PIOGLITAZONE 15 MG ORAL TAB,18.0,12.6,,,0
HCPCS,J3490,PIOGLITAZONE 30 MG ORAL TAB,53.0,37.1,,,0
HCPCS,J3490,PIOGLITAZONE 45 MG ORAL TAB,90.0,63.0,,,0
HCPCS,J3490,PIPERACILLIN-TAZOBACTAM-DEXTRS 4.5 GRAM/100 ML IV PGBK,111.0,77.7,,,0
HCPCS,J3490,POLYETHYLENE GLYCOL 3350 100 % ORAL POWD,49.0,34.3,,,0
HCPCS,J3490,POLYETHYLENE GLYCOL 3350 100 % ORAL POWDER 238 GRAMS,51.0,35.7,,,0
HCPCS,J3490,POLYETHYLENE GLYCOL 3350 17 GRAM (100 %) ORAL PWPK,38.0,26.6,,,0
HCPCS,J3490,PORACTANT ALFA 240 MG/3 ML INTR SUSP,4960.0,3472.0,,,0
HCPCS,J3490,POSACONAZOLE 100 MG ORAL TBEC,533.0,373.1,,,0
HCPCS,J3490,POTASSIUM & SODIUM PHOSPHATES 280-160-250 MG ORAL PWPK,13.0,9.1,,,0
HCPCS,J3490,POTASSIUM ACETATE 2 MEQ/ML IV SOLN,26.0,18.2,,,0
HCPCS,J3490,POTASSIUM BICARB-CITRIC ACID 20 MEQ ORAL TBEF,9.0,6.3,,,0
HCPCS,J3490,POTASSIUM BICARBONATE-CITRIC ACID 25 MEQ EFFERVESCENT TAB,18.0,12.6,,,0
HCPCS,J3490,POTASSIUM CHLORIDE  10 MEQ ORAL CPSR,26.0,18.200000000000003,,,0
HCPCS,J3490,POTASSIUM CHLORIDE  10 MEQ ORAL TBSR,8.0,5.6,,,0
HCPCS,J3490,POTASSIUM CHLORIDE  10 MEQ ORAL TBTQ,10.0,7.0,,,0
HCPCS,J3490,POTASSIUM CHLORIDE  20 MEQ ORAL PACK,106.0,74.2,,,0
HCPCS,J3490,POTASSIUM CHLORIDE  20 MEQ ORAL TBTQ,7.0,4.9,,,0
HCPCS,J3490,POTASSIUM CITRATE  5 MEQ ORAL TBER,30.0,21.0,,,0
HCPCS,J3490,POTASSIUM CITRATE 10 MEQ ORAL TBER,33.0,23.1,,,0
HCPCS,J3490,"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLN",8.0,5.6,,,0
HCPCS,J3490,POTASSIUM IODIDE 1 GRAM/ML ORAL SOLN,36.0,25.2,,,0
HCPCS,J3490,POTASSIUM IODIDE 130 MG ORAL TAB,7.5,5.25,,,0
HCPCS,J3490,POTASSIUM PHOS IN 0.9 % NACL 15 MMOL/250 ML IVPB PREMIX,211.0,147.7,,,0
HCPCS,J3490,POTASSIUM PHOSPHATE 0.06 MMOL/ML IVPB (FOR PEDIATRICS),352.0,246.4,,,0
HCPCS,J3490,POTASSIUM PHOSPHATE 4.4 MEQ/ML ORAL SOLUTION (CDS),19.0,13.3,,,0
HCPCS,J3490,POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML IV SOLP,52.5,36.75,,,0
HCPCS,J3490,"POTASSIUM PHOSPHATE, MONOBASIC 500 MG ORAL TBSO",7.5,5.25,,,0
HCPCS,J3490,POVIDONE-IODINE 10 % TOP OINT,24.0,16.8,,,0
HCPCS,J3490,PRAMIPEXOLE 0.125 MG ORAL TAB,50.0,35.0,,,0
HCPCS,J3490,PRAMIPEXOLE 0.25 MG ORAL TAB,4.5,3.1500000000000004,,,0
HCPCS,J3490,PRAMIPEXOLE 0.5 MG ORAL TAB,9.0,6.3,,,0
HCPCS,J3490,PRAMIPEXOLE 1 MG ORAL TAB,17.0,11.9,,,0
HCPCS,J3490,PRASUGREL 10 MG ORAL TAB,120.0,84.0,,,0
HCPCS,J3490,PRASUGREL 5 MG ORAL TAB,81.0,56.7,,,0
HCPCS,J3490,PRAVASTATIN 10 MG ORAL TAB,18.0,12.6,,,0
HCPCS,J3490,PRAVASTATIN 20 MG ORAL TAB,20.0,14.0,,,0
HCPCS,J3490,PRAVASTATIN 40 MG ORAL TAB,27.0,18.9,,,0
HCPCS,J3490,PRAZOSIN 1 MG ORAL CAP,29.0,20.299999999999997,,,0
HCPCS,J3490,PRAZOSIN 2 MG ORAL CAP,32.0,22.4,,,0
HCPCS,J3490,PRAZOSIN 5 MG ORAL CAP,37.0,25.9,,,0
HCPCS,J3490,PREDNISOLONE ACETATE 0.12 % OPHT DRPS,871.0,609.7,,,0
HCPCS,J3490,PREDNISOLONE ACETATE 1 % OPHT DROPS,399.0,279.3,,,0
HCPCS,J3490,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (5 ML) ORAL SOLN,12.0,8.4,,,0
HCPCS,J3490,PREGABALIN  25 MG ORAL CAP,50.0,35.0,,,0
HCPCS,J3490,PREGABALIN  50 MG ORAL CAP,43.0,30.1,,,0
HCPCS,J3490,PREGABALIN  75 MG ORAL CAP,24.0,16.8,,,0
HCPCS,J3490,PREGABALIN 100 MG ORAL CAP,17.0,11.9,,,0
HCPCS,J3490,PREGABALIN 150 MG ORAL CAP,30.0,21.0,,,0
HCPCS,J3490,PRENATAL VIT NO.130-IRON-FOLIC 27 MG IRON- 800 MCG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,PRIMAQUINE 26.3 MG ORAL TAB,15.0,10.5,,,0
HCPCS,J3490,PRIMIDONE  50 MG ORAL TAB,14.0,9.8,,,0
HCPCS,J3490,PRIMIDONE 250 MG ORAL TAB,6.0,4.2,,,0
HCPCS,J3490,PROBENECID 500 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,PROCHLORPERAZINE 25 MG RECT SUPP,62.0,43.4,,,0
HCPCS,J3490,PROGESTERONE MICRONIZED 100 MG ORAL CAP,24.0,16.8,,,0
HCPCS,J3490,PROMETHAZINE 12.5 MG RECT SUPP,130.5,91.35,,,0
HCPCS,J3490,PROMETHAZINE 25 MG RECT SUPP,68.5,47.95,,,0
HCPCS,J3490,PROPAFENONE 150 MG ORAL TAB,10.5,7.3500000000000005,,,0
HCPCS,J3490,PROPAFENONE 225 MG ORAL TAB,13.0,9.1,,,0
HCPCS,J3490,PROPARACAINE 0.5 % OPHT DROP,214.0,149.8,,,0
HCPCS,J3490,PROPRANOLOL  10 MG ORAL TAB,8.5,5.95,,,0
HCPCS,J3490,PROPRANOLOL  20 MG ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,PROPRANOLOL  40 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,PROPRANOLOL  60 MG ORAL CS24,17.5,12.25,,,0
HCPCS,J3490,PROPRANOLOL  60 MG ORAL TAB,8.5,5.95,,,0
HCPCS,J3490,PROPRANOLOL  80 MG ORAL CS24,20.5,14.35,,,0
HCPCS,J3490,PROPRANOLOL 120 MG ORAL CS24,25.5,17.85,,,0
HCPCS,J3490,PROPRANOLOL 160 MG ORAL CS24,22.0,15.4,,,0
HCPCS,J3490,PROPRANOLOL 20 MG/5 ML ORAL SOLN,7.0,4.9,,,0
HCPCS,J3490,PROPYLTHIOURACIL 50 MG ORAL TAB,20.0,14.0,,,0
HCPCS,J3490,PROPYLTHIOURACIL 5MG/ML SUSPENSION (REPACK),14.0,9.8,,,0
HCPCS,J3490,PSEUDOEPHEDRINE 30 MG TAB,7.0,4.9,,,0
HCPCS,J3490,PSEUDOEPHEDRINE SR 120 MG TAB,7.0,4.9,,,0
HCPCS,J3490,PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL PWPK,8.5,5.95,,,0
HCPCS,J3490,PSYLLIUM HUSK (WITH SUGAR) 3.4 GRAM ORAL PWPK,7.0,4.9,,,0
HCPCS,J3490,PYRAZINAMIDE 500 MG ORAL TAB,86.0,60.199999999999996,,,0
HCPCS,J3490,PYRIDOSTIGMINE BROMIDE  60 MG ORAL TAB,14.0,9.8,,,0
HCPCS,J3490,PYRIDOSTIGMINE BROMIDE 180 MG ORAL TBSR,181.5,127.05,,,0
HCPCS,J3490,PYRIDOSTIGMINE BROMIDE 5 MG/ML INJ SOLN,188.0,131.6,,,0
HCPCS,J3490,PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRP,70.0,49.0,,,0
HCPCS,J3490,PYRIDOXINE  50 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,QUETIAPINE  25 MG ORAL TAB,18.0,12.6,,,0
HCPCS,J3490,QUETIAPINE 10 MG/ML ORAL SUSPENSION,7.0,4.9,,,0
HCPCS,J3490,QUETIAPINE 100 MG ORAL TAB,49.5,34.65,,,0
HCPCS,J3490,QUETIAPINE 200 MG ORAL TAB,54.0,37.8,,,0
HCPCS,J3490,QUETIAPINE 300 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,QUINIDINE SR 324 MG TAB,51.0,35.7,,,0
HCPCS,J3490,RACEPINEPHRINE 2.25 % INHL NEBU,11.0,7.7,,,0
HCPCS,J3490,RALOXIFENE 60 MG ORAL TAB,40.5,28.35,,,0
HCPCS,J3490,RALTEGRAVIR 400 MG ORAL TAB,575.5,402.85,,,0
HCPCS,J3490,RAMIPRIL  1.25 MG ORAL CAP,13.0,9.1,,,0
HCPCS,J3490,RAMIPRIL  5 MG ORAL CAP,16.0,11.2,,,0
HCPCS,J3490,RAMIPRIL 10 MG ORAL CAP,19.0,13.3,,,0
HCPCS,J3490,RANOLAZINE  500 MG ORAL TB12,15.0,10.5,,,0
HCPCS,J3490,REMIFENTANIL 1 MG IV SOLR,468.0,327.6,,,0
HCPCS,J3490,REMIFENTANIL 2 MG IV SOLR,556.0,389.2,,,0
HCPCS,J3490,REPAGLINIDE 2 MG ORAL TAB,11.0,7.7,,,0
HCPCS,J3490,RIBAVIRIN 200 MG ORAL CAP,53.0,37.1,,,0
HCPCS,J3490,RIBOFLAVIN 100 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,RIFABUTIN 150 MG ORAL CAP,85.5,59.849999999999994,,,0
HCPCS,J3490,RIFAMPIN 150 MG ORAL CAP,39.5,27.65,,,0
HCPCS,J3490,RIFAMPIN 25MG/ML SUSPENSION (REPACK),18.0,12.6,,,0
HCPCS,J3490,RIFAMPIN 300 MG ORAL CAP,19.0,13.3,,,0
HCPCS,J3490,RIFAMPIN 600 MG IV SOLR,366.5,256.55,,,0
HCPCS,J3490,RIFAPENTINE 150 MG ORAL TAB,175.0,122.5,,,0
HCPCS,J3490,RIFAXIMIN 550 MG ORAL TAB,294.0,205.8,,,0
HCPCS,J3490,RISPERIDONE 0.25 MG ORAL TAB,51.0,35.7,,,0
HCPCS,J3490,RISPERIDONE 0.5 MG ORAL TAB,5.5,3.85,,,0
HCPCS,J3490,RISPERIDONE 0.5 MG ORAL TBDL,41.5,29.05,,,0
HCPCS,J3490,RISPERIDONE 1 MG ORAL TAB,10.0,7.0,,,0
HCPCS,J3490,RISPERIDONE 1 MG ORAL TBDL,55.5,38.849999999999994,,,0
HCPCS,J3490,RISPERIDONE 1 MG/ML ORAL SOLN,30.0,21.0,,,0
HCPCS,J3490,RISPERIDONE 2 MG ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,RISPERIDONE 3 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,RITONAVIR 100 MG ORAL TAB,52.0,36.4,,,0
HCPCS,J3490,RIVAROXABAN  2.5 MG ORAL TAB,168.0,117.6,,,0
HCPCS,J3490,RIVAROXABAN 10 MG ORAL TAB,170.0,119.0,,,0
HCPCS,J3490,RIVAROXABAN 15 MG ORAL TAB,314.5,220.14999999999998,,,0
HCPCS,J3490,RIVAROXABAN 20 MG ORAL TAB,117.0,81.9,,,0
HCPCS,J3490,RIVASTIGMINE 1.5 MG ORAL CAP,44.0,30.8,,,0
HCPCS,J3490,RIVASTIGMINE 3 MG ORAL CAP,34.0,23.8,,,0
HCPCS,J3490,RIVASTIGMINE 4.6 MG/24 HOUR TD PT24,109.0,76.3,,,0
HCPCS,J3490,RIVASTIGMINE 9.5 MG/24 HOUR TD PT24,109.0,76.3,,,0
HCPCS,J3490,RIZATRIPTAN  5 MG ORAL TBDL,222.5,155.75,,,0
HCPCS,J3490,RIZATRIPTAN 10 MG ORAL TBDL,215.0,150.5,,,0
HCPCS,J3490,ROCURONIUM 10 MG/ML (1ML-UD) OR SYRINGE,54.0,37.8,,,0
HCPCS,J3490,ROCURONIUM 10 MG/ML IV SOLN,80.0,56.0,,,0
HCPCS,J3490,ROCURONIUM 50 MG/5 ML (10 MG/ML) IV SYRG,73.5,51.45,,,0
HCPCS,J3490,ROPINIROLE  0.25 MG ORAL TAB,9.0,6.3,,,0
HCPCS,J3490,ROPINIROLE  1 MG ORAL TAB,10.0,7.0,,,0
HCPCS,J3490,ROPINIROLE  2 MG ORAL TAB,7.5,5.25,,,0
HCPCS,J3490,ROPINIROLE  4 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,ROPINIROLE  5 MG ORAL TAB,3.0,2.1,,,0
HCPCS,J3490,ROPIVACAINE  2 MG/ML INJ SOLN,101.5,71.05000000000001,,,0
HCPCS,J3490,ROPIVACAINE (PF) 0.2 % 330 ML (RIGHT) (PHS CUSTOM PAIN BALL),580.0,406.0,,,0
HCPCS,J3490,ROPIVACAINE 0.5%/EPINEPHRINE 1:100K INJECTION,130.5,91.35,,,0
HCPCS,J3490,ROPIVACAINE 10 MG/ML INJ SOLN,100.5,70.35,,,0
HCPCS,J3490,ROPIVACAINE(PF)-0.9 % SODCHLOR 0.2 % 745 ML LINF ELPH,1315.0,920.5,,,0
HCPCS,J3490,ROPIVACAINE(PF)0.2 % ELASTOMERIC PUMP (ONQ) 545ML (PREFILLED),2341.5,1639.0500000000002,,,0
HCPCS,J3490,ROPIVACAINE-EPI-CLONID-KETOROL 2.46-0.005- 0.0008-0.3MG/ML PATC SYRG,637.0,445.9,,,0
HCPCS,J3490,ROSUVASTATIN  5 MG ORAL TAB,32.0,22.4,,,0
HCPCS,J3490,ROSUVASTATIN 10 MG ORAL TAB,44.5,31.15,,,0
HCPCS,J3490,ROSUVASTATIN 20 MG ORAL TAB,40.0,28.0,,,0
HCPCS,J3490,ROSUVASTATIN 40 MG ORAL TAB,17.5,12.25,,,0
HCPCS,J3490,SACCHAROMYCES BOULARDII 250 MG ORAL CAP,27.0,18.9,,,0
HCPCS,J3490,SACUBITRIL-VALSARTAN 24-26 MG ORAL TAB,57.5,40.25,,,0
HCPCS,J3490,SACUBITRIL-VALSARTAN 49-51 MG ORAL TAB,69.0,48.3,,,0
HCPCS,J3490,SACUBITRIL-VALSARTAN 97-103 MG ORAL TAB,68.5,47.95,,,0
HCPCS,J3490,SALIVA STIMULANT AGENTS COMB.3 MM SPRY (BIOTENE) (REPACK),38.5,26.95,,,0
HCPCS,J3490,SALIVA SUBSTITUTE COMB NO.11 351 MG MM PWPK,60.5,42.35,,,0
HCPCS,J3490,SALMETEROL 50 MCG/DOSE INHL DSDV,47.0,32.9,,,0
HCPCS,J3490,SCOPOLAMINE TRANSDERMAL PATCH 1MG OVER 3 DAYS,113.0,79.1,,,0
HCPCS,J3490,SELEGILINE 5 MG TAB,9.5,6.65,,,0
HCPCS,J3490,SELENIUM SULFIDE 2.5 % TOPICAL LOTN,97.0,67.9,,,0
HCPCS,J3490,SEMAGLUTIDE 1 MG/DOSE (4 MG/3 ML) SUBQ PNIJ,2754.0,1927.8,,,0
HCPCS,J3490,SENNOSIDES  8.6 MG ORAL TAB,5.5,3.85,,,0
HCPCS,J3490,SENNOSIDES 15 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,SENNOSIDES 8.8 MG/5 ML ORAL SYRP,9.0,6.3,,,0
HCPCS,J3490,SENNOSIDES-DOCUSATE SODIUM 8.6 MG-50 MG TAB,5.5,3.85,,,0
HCPCS,J3490,SERTRALINE  25 MG ORAL TAB,9.0,6.3,,,0
HCPCS,J3490,SERTRALINE  50 MG ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,SERTRALINE 100 MG ORAL TAB,12.0,8.4,,,0
HCPCS,J3490,SERTRALINE 20 MG/ML ORAL CONC,27.5,19.25,,,0
HCPCS,J3490,SEVELAMER CARBONATE 0.8 GRAM ORAL PWPK,184.0,128.8,,,0
HCPCS,J3490,SEVELAMER CARBONATE 800 MG ORAL TAB,85.0,59.5,,,0
HCPCS,J3490,SILDENAFIL  20 MG ORAL TAB,65.0,45.5,,,0
HCPCS,J3490,SILDENAFIL (PULM.HYPERTENSION) 10 MG/12.5 ML IV SOLN,403.0,282.1,,,0
HCPCS,J3490,SILDENAFIL 100 MG ORAL TAB,28.0,19.6,,,0
HCPCS,J3490,SILDENAFIL 2.5 MG/ML SUSPENSION,17.0,11.9,,,0
HCPCS,J3490,SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,22.5,15.75,,,0
HCPCS,J3490,SILVER SULFADIAZINE 1 % TOP CREA,135.5,94.85,,,0
HCPCS,J3490,SIMETHICONE  80 MG ORAL CHEW,11.0,7.7,,,0
HCPCS,J3490,SIMETHICONE 40 MG/0.6 ML ORAL DRPS,7.0,4.9,,,0
HCPCS,J3490,SIMETHICONE 40MG/0.6ML (0.6ML-UD) SYRINGE (REPACK),9.0,6.3,,,0
HCPCS,J3490,SIMPLE SYRUP,7.0,4.9,,,0
HCPCS,J3490,SIMVASTATIN  5 MG ORAL TAB,20.5,14.35,,,0
HCPCS,J3490,SIMVASTATIN 10 MG ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,SIMVASTATIN 20 MG ORAL TAB,27.5,19.25,,,0
HCPCS,J3490,SIMVASTATIN 40 MG ORAL TAB,21.0,14.700000000000001,,,0
HCPCS,J3490,SIMVASTATIN 80 MG ORAL TAB,27.0,18.9,,,0
HCPCS,J3490,SITAGLIPTIN  25 MG ORAL TAB,224.0,156.8,,,0
HCPCS,J3490,SITAGLIPTIN 100 MG ORAL TAB,89.0,62.3,,,0
HCPCS,J3490,SOD CHLOR&BICARB-SQUEEZ BOTTLE NASL PKDV,1239.0,867.3,,,0
HCPCS,J3490,SODIUM ACETATE 0.45% IV INFUSION (PEDIATRIC),81.0,56.7,,,0
HCPCS,J3490,SODIUM ACETATE 0.9% WITH HEPARIN IV SYRINGE (NEONATAL),16.0,11.2,,,0
HCPCS,J3490,SODIUM ACETATE 2 MEQ/ML IV SOLN,9.0,6.3,,,0
HCPCS,J3490,SODIUM BICARBONATE   4.2 % IV SOLN,89.0,62.3,,,0
HCPCS,J3490,SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) IV (NEO) EMERGENCY SYRINGE,190.5,133.35000000000002,,,0
HCPCS,J3490,SODIUM BICARBONATE 650 MG ORAL TAB,5.5,3.85,,,0
HCPCS,J3490,SODIUM BICARBONATE 8.4 % (1 MEQ/ML) IV 50 ML EMERGENCY SYRINGE,155.0,108.5,,,0
HCPCS,J3490,SODIUM BICARBONATE 8.4 % IV (PHS ERX MERGE),211.0,147.7,,,0
HCPCS,J3490,SODIUM BICARBONATE 8.4 % IV SOLN,289.0,202.3,,,0
HCPCS,J3490,SODIUM BICARBONATE 8.4% (1 MEQ/1 ML) IV 10 ML EMERGENCY SYRINGE,763.0,534.1,,,0
HCPCS,J3490,SODIUM BICARBONATE IV CONCENTRATED INFUSION (1 MEQ/ML),249.0,174.3,,,0
HCPCS,J3490,SODIUM CHLORIDE  0.65 % NASL SPRA,14.0,9.8,,,0
HCPCS,J3490,SODIUM CHLORIDE  3 % INHL NEBU,7.0,4.9,,,0
HCPCS,J3490,SODIUM CHLORIDE  5 % OPHT DROP,30.0,21.0,,,0
HCPCS,J3490,SODIUM CHLORIDE  7 % INHL NEBU,7.0,4.9,,,0
HCPCS,J3490,SODIUM CHLORIDE 0.45 % 0.45 % IV SOLP,28.0,19.6,,,0
HCPCS,J3490,SODIUM CHLORIDE 0.45% (1/2 NS) INFUSION (PEDS ONC),45.0,31.5,,,0
HCPCS,J3490,SODIUM CHLORIDE 0.9 % INHL NEBU,9.0,6.3,,,0
HCPCS,J3490,SODIUM CHLORIDE 0.9 % INJ SOLN (VIAL),28.0,19.6,,,0
HCPCS,J3490,SODIUM CHLORIDE 0.9 % INJ SYRG,21.0,14.7,,,0
HCPCS,J3490,SODIUM CHLORIDE 0.9 % IR SOLN,111.0,77.7,,,0
HCPCS,J3490,SODIUM CHLORIDE 0.9 % IV SOLP,40.0,28.0,,,0
HCPCS,J3490,SODIUM CHLORIDE 0.9 % MBP,207.5,145.25,,,0
HCPCS,J3490,SODIUM CHLORIDE 10 % INHL NEBU,48.0,33.6,,,0
HCPCS,J3490,SODIUM CHLORIDE 1000 MG MISC TBSO,7.5,5.25,,,0
HCPCS,J3490,SODIUM CHLORIDE 3 % IV INFUSION,63.0,44.099999999999994,,,0
HCPCS,J3490,SODIUM CHLORIDE 3% IV BOLUS (ED ONLY),39.0,27.3,,,0
HCPCS,J3490,SODIUM CHLORIDE 4 MEQ/ML IV SOLP (COMPOUNDED 30ML),48.0,33.6,,,0
HCPCS,J3490,SODIUM CHLORIDE 4 MEQ/ML ORAL SOLUTION (CDS),23.0,16.1,,,0
HCPCS,J3490,SODIUM CHLORIDE-ALOE VERA NASL SPRY,31.0,21.7,,,0
HCPCS,J3490,SODIUM CHLORIDE-ALOE VERA TOPICAL GEL,18.5,12.95,,,0
HCPCS,J3490,SODIUM CITRATE 4 % (3 ML) MISC SYRG,42.5,29.75,,,0
HCPCS,J3490,SODIUM CITRATE 4% (3 ML) SYRINGE (FOR DIALYSIS),16.0,11.2,,,0
HCPCS,J3490,SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLN,17.0,11.899999999999999,,,0
HCPCS,J3490,SODIUM HYPOCHLORITE 0.125 % MISC SOLN,91.0,63.7,,,0
HCPCS,J3490,SODIUM HYPOCHLORITE 0.25 % MISC SOLN,91.0,63.7,,,0
HCPCS,J3490,SODIUM HYPOCHLORITE 0.5 % MISC SOLN,79.5,55.650000000000006,,,0
HCPCS,J3490,SODIUM PHOSPHATE 3 MMOL/ML IV SOLN,81.0,56.7,,,0
HCPCS,J3490,SODIUM PHOSPHATES 19 GRAM-7 GRAM ENEMA,7.0,4.9,,,0
HCPCS,J3490,SODIUM POLYSTYRENE SULF-SORBTL 15-20 GRAM/60 ML ORAL SUSP,208.0,145.60000000000002,,,0
HCPCS,J3490,SODIUM POLYSTYRENE SULFONATE ORAL POWDER,133.0,93.1,,,0
HCPCS,J3490,SODIUM TETRADECYL SULFATE 3 % IV SOLN,796.0,557.2,,,0
HCPCS,J3490,SODIUM THIOSULFATE 25 % IV SOLN,413.0,289.1,,,0
HCPCS,J3490,SODIUM ZIRCONIUM CYCLOSILICATE  5 G ORAL PWPK (USE PANEL),293.0,205.1,,,0
HCPCS,J3490,SODIUM ZIRCONIUM CYCLOSILICATE 10 G ORAL PWPK (USE PANEL),161.0,112.7,,,0
HCPCS,J3490,SOMATROPIN  5.8 MG SUBQ SOLR,1207.0,844.9,,,0
HCPCS,J3490,SORBITOL 70 % MISC SOLN,44.0,30.8,,,0
HCPCS,J3490,SOTALOL  80 MG ORAL TAB,17.5,12.25,,,0
HCPCS,J3490,SOTALOL 240 MG ORAL TAB,29.0,20.3,,,0
HCPCS,J3490,SOTALOL 5 MG/ML ORAL SOLN,32.0,22.4,,,0
HCPCS,J3490,SPIRONOLACTONE  25 MG ORAL TAB,7.5,5.25,,,0
HCPCS,J3490,SPIRONOLACTONE  50 MG ORAL TAB,9.5,6.65,,,0
HCPCS,J3490,SPIRONOLACTONE 100 MG ORAL TAB,8.5,5.949999999999999,,,0
HCPCS,J3490,SPIRONOLACTONE 5MG/ML SUSPENSION (REPACK),7.0,4.9,,,0
HCPCS,J3490,STERILE TALC 3 G INPL AERP,450.0,315.0,,,0
HCPCS,J3490,STERILE TALC 4 G INPL SUSR,234.5,164.15,,,0
HCPCS,J3490,SUCCINYLCHOLINE CHLORIDE 200 MG/10 ML (20 MG/ML) IV SYRG,50.0,35.0,,,0
HCPCS,J3490,SUCRALFATE 1 GRAM ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,SUCRALFATE 100 MG/ML ORAL SUSP,55.0,38.5,,,0
HCPCS,J3490,SUFENTANIL CITRATE 50 MCG/ML IV SOLN,214.0,149.8,,,0
HCPCS,J3490,SUGAMMADEX 100 MG/ML IV SOLN,2003.0,1402.1,,,0
HCPCS,J3490,SULFACETAMIDE SODIUM 10 % OPHT DROP,259.0,181.3,,,0
HCPCS,J3490,SULFADIAZINE 500 MG ORAL TAB,165.0,115.5,,,0
HCPCS,J3490,SULFASALAZINE 500 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,SULFASALAZINE 500 MG ORAL TBEC,7.0,4.9,,,0
HCPCS,J3490,SUMATRIPTAN  5 MG/ACTUATION NASL SPRY,443.0,310.1,,,0
HCPCS,J3490,SUMATRIPTAN 20 MG/ACTUATION NASL SPRY,345.0,241.5,,,0
HCPCS,J3490,SUMATRIPTAN 25 MG TAB,230.0,161.0,,,0
HCPCS,J3490,SUMATRIPTAN 50 MG TAB,123.0,86.1,,,0
HCPCS,J3490,SYRSPEND SF (COMPOUND VEH.SUSP SUGAR-FREE 3) ORAL SUSP,7.0,4.9,,,0
HCPCS,J3490,TAMSULOSIN 0.4 MG ORAL CP24,124.0,86.8,,,0
HCPCS,J3490,TELMISARTAN 40 MG ORAL TAB,31.0,21.7,,,0
HCPCS,J3490,TEMAZEPAM  7.5 MG ORAL CAP,76.0,53.2,,,0
HCPCS,J3490,TEMAZEPAM 15 MG ORAL CAP,9.0,6.3,,,0
HCPCS,J3490,TENOFOVIR DISOPROXIL FUMARATE 300 MG ORAL TAB,31.0,21.7,,,0
HCPCS,J3490,TERAZOSIN  1 MG ORAL CAP,18.0,12.6,,,0
HCPCS,J3490,TERAZOSIN  2 MG ORAL CAP,13.5,9.45,,,0
HCPCS,J3490,TERAZOSIN  5 MG ORAL CAP,14.5,10.15,,,0
HCPCS,J3490,TERBINAFINE 250 MG ORAL TAB,611.0,427.7,,,0
HCPCS,J3490,TESTOSTERONE  75 MG IMPL PLLT,10333.5,7233.45,,,0
HCPCS,J3490,TETRABENAZINE 12.5 MG ORAL TAB,304.5,213.14999999999998,,,0
HCPCS,J3490,TETRABENAZINE 25 MG ORAL TAB,386.0,270.2,,,0
HCPCS,J3490,TETRACAINE 0.5 % EYE DROPS,159.0,111.3,,,0
HCPCS,J3490,TETRACAINE HCL (PF) 0.5 % OPHT DROP (STANDARD STOCK),80.0,56.0,,,0
HCPCS,J3490,TETRACYCLINE 500 MG ORAL CAP,78.0,54.6,,,0
HCPCS,J3490,THEOPHYLLINE 100 MG ORAL CP24,47.5,33.25,,,0
HCPCS,J3490,THEOPHYLLINE 300 MG ORAL TB12,15.5,10.850000000000001,,,0
HCPCS,J3490,THEOPHYLLINE 80 MG/15 ML ORAL SOLN,25.0,17.5,,,0
HCPCS,J3490,THIAMINE 100 MG TAB,7.0,4.9,,,0
HCPCS,J3490,THIAMINE IN 0.9 % SOD CHLORIDE 500 MG/100 ML IV SOLN,161.0,112.7,,,0
HCPCS,J3490,THIAMINE MONONITRATE 100 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,THIORIDAZINE  25 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,THROMBIN (BOVINE)  5000 UNIT TOP SOLR,386.0,270.2,,,0
HCPCS,J3490,THROMBIN (RECOMBINANT) 20000 UNIT TOP SOLR,4872.0,3410.4,,,0
HCPCS,J3490,THROMBIN (RECOMBINANT) 5000 UNIT TOP SOLR,1487.0,1040.9,,,0
HCPCS,J3490,THYROID (PORK)  30 MG ORAL TAB,15.0,10.5,,,0
HCPCS,J3490,THYROID (PORK)  60 MG ORAL TAB,13.0,9.1,,,0
HCPCS,J3490,THYROID (PORK)  90 MG ORAL TAB,9.0,6.3,,,0
HCPCS,J3490,THYROID (PORK) 15 MG ORAL TAB,11.5,8.05,,,0
HCPCS,J3490,TICAGRELOR 60 MG ORAL TAB,52.0,36.4,,,0
HCPCS,J3490,TICAGRELOR 90 MG ORAL TAB,89.0,62.3,,,0
HCPCS,J3490,TIMOLOL MALEATE 0.25 % OPHT DROP,105.0,73.5,,,0
HCPCS,J3490,TIMOLOL MALEATE 0.5 % OPHT DROP,74.5,52.15,,,0
HCPCS,J3490,TIOTROPIUM BROMIDE 1.25 MCG/ACTUATION INHL MIST,7.0,4.9,,,0
HCPCS,J3490,TIOTROPIUM BROMIDE 18 MCG INHL CPDV,96.0,67.2,,,0
HCPCS,J3490,TIOTROPIUM BROMIDE 2.5 MCG/ACTUATION INHL MIST,919.0,643.3,,,0
HCPCS,J3490,TIZANIDINE 4 MG ORAL TAB,14.0,9.8,,,0
HCPCS,J3490,TOBRAMYCIN (FORTIFIED) 15MG/ML OPHTHALMIC DROP (15ML),42.0,29.4,,,0
HCPCS,J3490,TOBRAMYCIN 0.3 % EYE DROPS,101.0,70.7,,,0
HCPCS,J3490,TOBRAMYCIN 0.3 % EYE OINTMENT,947.0,662.9,,,0
HCPCS,J3490,TOBRAMYCIN 150 MG/3.75 ML NEBULIZER SOLN (REPACK),21.0,14.7,,,0
HCPCS,J3490,TOBRAMYCIN 300 MG/5 ML INHL NEBU (REPACK),396.0,277.2,,,0
HCPCS,J3490,"TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE DROPS, SUSP",283.0,198.1,,,0
HCPCS,J3490,TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT,1056.0,739.2,,,0
HCPCS,J3490,TOLTERODINE 1 MG ORAL TAB,28.0,19.6,,,0
HCPCS,J3490,TOLTERODINE 2 MG ORAL CP24,79.0,55.3,,,0
HCPCS,J3490,TOLTERODINE 2 MG ORAL TAB,19.0,13.3,,,0
HCPCS,J3490,TOLVAPTAN 15 MG ORAL TAB,1293.0,905.1,,,0
HCPCS,J3490,TOPIRAMATE  15 MG ORAL CPSP,50.5,35.35,,,0
HCPCS,J3490,TOPIRAMATE  25 MG ORAL CPSP,66.0,46.2,,,0
HCPCS,J3490,TOPIRAMATE  25 MG ORAL TAB,35.0,24.5,,,0
HCPCS,J3490,TOPIRAMATE 100 MG ORAL TAB,51.5,36.05,,,0
HCPCS,J3490,TOPIRAMATE 200 MG ORAL TAB,25.5,17.85,,,0
HCPCS,J3490,TORSEMIDE   5 MG ORAL TAB,14.5,10.15,,,0
HCPCS,J3490,TORSEMIDE  20 MG ORAL TAB,14.0,9.8,,,0
HCPCS,J3490,TRAMADOL  50 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,TRANEXAMIC ACID (FOR TOPICAL USE),97.0,67.9,,,0
HCPCS,J3490,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN",120.0,84.0,,,0
HCPCS,J3490,TRANEXAMIC ACID 1000 MG/10 ML FOR NEBULIZATION,116.0,81.2,,,0
HCPCS,J3490,TRANEXAMIC ACID 650 MG ORAL TAB,51.0,35.7,,,0
HCPCS,J3490,"TRANEXAMIC ACID IN NACL,ISO-OS 1,000 MG/100 ML (10 MG/ML) IV PGBK",122.5,85.75,,,0
HCPCS,J3490,TRAZODONE  50 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,TRAZODONE 100 MG ORAL TAB,14.0,9.8,,,0
HCPCS,J3490,TRAZODONE 150 MG ORAL TAB,9.0,6.3,,,0
HCPCS,J3490,TRIAMCINOLONE ACETONIDE 0.025 % TOP OINT,34.0,23.8,,,0
HCPCS,J3490,TRIAMCINOLONE ACETONIDE 0.1 % DENT PSTE,342.0,239.4,,,0
HCPCS,J3490,TRIAMCINOLONE ACETONIDE 0.1 % TOP CREAM,33.0,23.1,,,0
HCPCS,J3490,TRIAMCINOLONE ACETONIDE 0.1 % TOP LOTN,295.0,206.5,,,0
HCPCS,J3490,TRIAMCINOLONE ACETONIDE 0.1 % TOP OINT,55.0,38.5,,,0
HCPCS,J3490,TRIAMCINOLONE ACETONIDE 0.5 % TOP OINT,50.0,35.0,,,0
HCPCS,J3490,TRIAMTERENE  50 MG ORAL CAP,88.0,61.6,,,0
HCPCS,J3490,TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5 MG-25 MG CAP,7.0,4.9,,,0
HCPCS,J3490,TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5 MG-25 MG TAB,9.0,6.300000000000001,,,0
HCPCS,J3490,TRIAMTERENE-HYDROCHLOROTHIAZIDE 75 MG-50 MG TAB,7.0,4.9,,,0
HCPCS,J3490,TRICHLOROACETIC ACID 80 % TOP SOLN,329.0,230.3,,,0
HCPCS,J3490,TRIHEXYPHENIDYL 2 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,TRIHEXYPHENIDYL 5 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,"TRIMETHOPRIM-POLYMYXIN B 0.1 %-10,000 UNIT/ML EYE DROPS",76.0,53.2,,,0
HCPCS,J3490,TRIMETHOPRIM-SULFAMETHOXAZOLE 160 MG-800 MG TAB,24.0,16.8,,,0
HCPCS,J3490,TRIMETHOPRIM-SULFAMETHOXAZOLE 40 MG-200 MG/5 ML ORAL SUSP,36.0,25.2,,,0
HCPCS,J3490,TRIMETHOPRIM-SULFAMETHOXAZOLE 80 MG-400 MG TAB,7.5,5.25,,,0
HCPCS,J3490,TRIMETHOPRIM-SULFAMETHOXAZOLE 80 MG-400 MG/5 ML IV,153.5,107.45,,,0
HCPCS,J3490,TROPICAMIDE 0.5 % OPHT DROP,127.0,88.9,,,0
HCPCS,J3490,TROPICAMIDE 1 % OPHT DROP,69.0,48.3,,,0
HCPCS,J3490,TROSPIUM 20 MG ORAL TAB,24.0,16.8,,,0
HCPCS,J3490,TUBERCULIN PPD 5 UNIT/0.1 ML IDRM SOLN,62.5,43.75,,,0
HCPCS,J3490,UREA 15 GRAM PACKET,28.0,19.6,,,0
HCPCS,J3490,URSODIOL 300 MG ORAL CAP,41.0,28.7,,,0
HCPCS,J3490,VALACYCLOVIR 500 MG ORAL TAB,51.5,36.05,,,0
HCPCS,J3490,VALGANCICLOVIR 450 MG ORAL TAB,382.0,267.4,,,0
HCPCS,J3490,VALGANCICLOVIR 50 MG/ML ORAL SOLR,202.0,141.4,,,0
HCPCS,J3490,VALPROATE SODIUM 100 MG/ML IV SOLN,74.0,51.8,,,0
HCPCS,J3490,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLN,22.5,15.75,,,0
HCPCS,J3490,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SYRP,7.0,4.9,,,0
HCPCS,J3490,VALPROIC ACID 250 MG ORAL CAP,11.0,7.7,,,0
HCPCS,J3490,VALSARTAN  40 MG ORAL TAB,17.5,12.25,,,0
HCPCS,J3490,VALSARTAN  80 MG ORAL TAB,24.5,17.15,,,0
HCPCS,J3490,VALSARTAN 160 MG ORAL TAB,15.0,10.5,,,0
HCPCS,J3490,VANCOMYCIN  125 MG ORAL CAP,210.0,147.0,,,0
HCPCS,J3490,VANCOMYCIN (FORTIFIED) 50MG/ML OPHTHALMIC DROP (15ML),326.0,228.2,,,0
HCPCS,J3490,VANCOMYCIN ENEMA 500MG IN 100ML NS,42.0,29.4,,,0
HCPCS,J3490,VARENICLINE 0.5 MG ORAL TAB,69.0,48.3,,,0
HCPCS,J3490,VASOPRESSIN 20 UNITS IN 100 ML NS,120.0,84.0,,,0
HCPCS,J3490,VASOPRESSIN IN 0.9 % NS 40 UNIT/100 ML (0.4 UNIT/ML) IV SOLN,333.5,233.45,,,0
HCPCS,J3490,VECURONIUM 1 MG/ML IV SYRINGE (NEO),34.0,23.799999999999997,,,0
HCPCS,J3490,VECURONIUM BROMIDE 10 MG IV SOLR,45.5,31.849999999999998,,,0
HCPCS,J3490,VECURONIUM BROMIDE 20 MG IV SOLR,58.5,40.95,,,0
HCPCS,J3490,VENLAFAXINE  25 MG ORAL TAB,12.0,8.4,,,0
HCPCS,J3490,VENLAFAXINE  37.5 MG ORAL CP24,47.0,32.9,,,0
HCPCS,J3490,VENLAFAXINE  37.5 MG ORAL TAB,17.5,12.25,,,0
HCPCS,J3490,VENLAFAXINE  50 MG ORAL TAB,18.0,12.6,,,0
HCPCS,J3490,VENLAFAXINE  75 MG ORAL CP24,35.0,24.5,,,0
HCPCS,J3490,VENLAFAXINE  75 MG ORAL TAB,19.0,13.3,,,0
HCPCS,J3490,VENLAFAXINE  75 MG ORAL TR24,113.0,79.1,,,0
HCPCS,J3490,VENLAFAXINE 150 MG ORAL CP24,30.5,21.35,,,0
HCPCS,J3490,VERAPAMIL  80 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,VERAPAMIL 120 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J3490,VERAPAMIL 120 MG ORAL TBSR,8.5,5.95,,,0
HCPCS,J3490,VERAPAMIL 180 MG ORAL TBSR,13.0,9.100000000000001,,,0
HCPCS,J3490,VERAPAMIL 2.5 MG/ML IV SOLN,77.0,53.900000000000006,,,0
HCPCS,J3490,VERAPAMIL 240 MG ORAL TBSR,10.0,7.0,,,0
HCPCS,J3490,VILAZODONE 40 MG ORAL TAB,72.0,50.4,,,0
HCPCS,J3490,VITAMIN A 10000 UNIT ORAL CAP,7.0,4.9,,,0
HCPCS,J3490,"VITAMIN E (DL, ACETATE) 22.5 MG (50 UNIT)/ML ORAL DROP",53.0,37.1,,,0
HCPCS,J3490,VITAMINS A & D-WHITE PETROLATUM-LANOLIN OINTMENT,15.0,10.5,,,0
HCPCS,J3490,VORICONAZOLE  50 MG ORAL TAB,123.0,86.1,,,0
HCPCS,J3490,VORICONAZOLE 200 MG ORAL TAB,253.5,177.45,,,0
HCPCS,J3490,WARFARIN  2 MG ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,WARFARIN  2.5 MG ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,WARFARIN  3 MG ORAL TAB,8.0,5.6,,,0
HCPCS,J3490,WARFARIN  4 MG ORAL TAB,7.5,5.25,,,0
HCPCS,J3490,WARFARIN  5 MG ORAL TAB,8.5,5.949999999999999,,,0
HCPCS,J3490,WARFARIN  6 MG ORAL TAB,7.5,5.25,,,0
HCPCS,J3490,WARFARIN  7.5 MG ORAL TAB,9.0,6.300000000000001,,,0
HCPCS,J3490,WARFARIN 1 MG ORAL TAB,13.0,9.100000000000001,,,0
HCPCS,J3490,WARFARIN 10 MG ORAL TAB,6.5,4.550000000000001,,,0
HCPCS,J3490,"WATER FOR INJECTION, STERILE INJECTION",45.5,31.85,,,0
HCPCS,J3490,"WATER FOR INJECTION, STERILE IV",48.0,33.6,,,0
HCPCS,J3490,"WATER FOR IRRIGATION, STERILE SOLUTION",109.0,76.3,,,0
HCPCS,J3490,WHITE PETROLATUM TOP OIPK,7.0,4.9,,,0
HCPCS,J3490,WHITE PETROLATUM TOPICAL GEL,7.0,4.9,,,0
HCPCS,J3490,WHITE PETROLATUM-MINERAL OIL 57.3-42.5 % OPHT OINT,51.0,35.7,,,0
HCPCS,J3490,WHITE PETROLATUM-MINERAL OIL 80 %-20 % EYE OINTMENT,38.0,26.6,,,0
HCPCS,J3490,WHITE PETROLATUM-MINERAL OIL OPHT OINT (PDS MERGE),53.5,37.45,,,0
HCPCS,J3490,WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM (MERGE),66.0,46.2,,,0
HCPCS,J3490,ZAFIRLUKAST 20 MG ORAL TAB,16.0,11.2,,,0
HCPCS,J3490,ZINC OXIDE 16 % TOP PSTE,42.0,29.4,,,0
HCPCS,J3490,ZINC OXIDE 20 % TOP OINT (REPACK),16.0,11.2,,,0
HCPCS,J3490,ZINC SULFATE 220 MG (50 MG) CAP,7.0,4.9,,,0
HCPCS,J3490,ZIPRASIDONE 20 MG CAP,46.5,32.55,,,0
HCPCS,J3490,ZIPRASIDONE 40 MG CAP,63.0,44.1,,,0
HCPCS,J3490,ZOLPIDEM  5 MG ORAL TAB,20.0,14.0,,,0
HCPCS,J3490,ZONISAMIDE 10 MG/ML ORAL SYRUP (REPACK),27.0,18.9,,,0
HCPCS,J3490,ZONISAMIDE 100 MG ORAL CAP,23.5,16.45,,,0
HCPCS,J3520,Edetate disodium per 150 mg,,,2.13,2.35,2
HCPCS,J3590,ANAKINRA 100 MG/0.67 ML SUBQ SYRG,562.0,393.4,,,0
HCPCS,J3590,ANTIVENIN LATRODECTUS MACTANS INJ CMPK,163.0,114.1,,,0
HCPCS,J3590,LIRAGLUTIDE 0.6 MG/0.1 ML (18 MG/3 ML) SUBQ PNIJ,1675.5,1172.85,,,0
HCPCS,J5083,BIVALIRUDIN 250 MG/50 ML (5 MG/ML) IV SOLN,365.0,255.5,,,0
HCPCS,J7030,Normal saline solution infus,,,9.88,10.92,2
HCPCS,J7030,SODIUM CHLORIDE 0.9 % IV (BOLUS),17.0,11.9,,,0
HCPCS,J7030,SODIUM CHLORIDE 0.9 % IV SOLP,52.0,36.4,,,0
HCPCS,J7030,SODIUM CHLORIDE 0.9% IV (PEDS) BOLUS,16.5,11.55,,,0
HCPCS,J7040,Normal saline solution infus,,,9.01,9.95,2
HCPCS,J7040,SODIUM CHLORIDE 0.9 % IV (BOLUS),74.5,52.15,,,0
HCPCS,J7040,SODIUM CHLORIDE 0.9 % IV SOLN 400ML (PHS REPACK),20.0,14.0,,,0
HCPCS,J7040,SODIUM CHLORIDE 0.9 % IV SOLP,88.5,61.95,,,0
HCPCS,J7040,SODIUM CHLORIDE 0.9% IV (PEDS) BOLUS,21.0,14.7,,,0
HCPCS,J7042,5% dextrose/normal saline,,,5.96,6.59,2
HCPCS,J7042,DEXTROSE 5% IN NORMAL SALINE IV,36.5,25.55,,,0
HCPCS,J7042,DEXTROSE 5%-1/2 NORMAL SALINE IV,32.5,22.75,,,0
HCPCS,J7042,DEXTROSE 5%-1/2 NORMAL SALINE IV (PEDS ONCOLOGY),39.0,27.3,,,0
HCPCS,J7050,Normal saline solution infus,,,8.04,8.88,2
HCPCS,J7050,SODIUM CHLORIDE 0.9 % IV (BOLUS),372.0,260.4,,,0
HCPCS,J7050,SODIUM CHLORIDE 0.9 % IV (CLINIC BOLUS),39.0,27.3,,,0
HCPCS,J7050,SODIUM CHLORIDE 0.9 % IV SOLP,54.0,37.8,,,0
HCPCS,J7060,5% dextrose/water,,,9.01,9.95,2
HCPCS,J7060,DEXTROSE 30% IN WATER (NEO),32.0,22.4,,,0
HCPCS,J7060,DEXTROSE 5% IN WATER (D5W) IV,35.0,24.5,,,0
HCPCS,J7060,DEXTROSE 5% IN WATER (D5W) IV MBP,155.5,108.85,,,0
HCPCS,J7060,DEXTROSE 5% IN WATER (NEO) <2 KG,32.5,22.75,,,0
HCPCS,J7060,DEXTROSE 5% IN WATER FLUSH,24.0,16.8,,,0
HCPCS,J7060,DEXTROSE 50% IN WATER (MERGE RECORD),106.0,74.2,,,0
HCPCS,J7070,D5w infusion,,,8.19,9.05,2
HCPCS,J7070,DEXTROSE 30% IN WATER (NEO),86.5,60.55,,,0
HCPCS,J7070,DEXTROSE 50% IN WATER (MERGE RECORD),421.0,294.7,,,0
HCPCS,J7070,DEXTROSE 70% IN WATER (D70W) IV,16.0,11.2,,,0
HCPCS,J7100,Dextran 40 infusion,,,67.0,74.02,2
HCPCS,J7120,DEXTROSE 5%-LACTATED RINGERS IV,24.0,16.8,,,0
HCPCS,J7120,LACTATED RINGERS IRRIGATION SOLN,175.0,122.5,,,0
HCPCS,J7120,LACTATED RINGERS IV,191.5,134.05,,,0
HCPCS,J7120,LACTATED RINGERS IV (BOLUS),43.0,30.1,,,0
HCPCS,J7120,LACTATED RINGERS IV (CLINIC BOLUS),34.0,23.8,,,0
HCPCS,J7120,Ringers lactate infusion,,,12.67,14.0,2
HCPCS,J7121,5% dextrose in lac ringers,,,8.79,9.72,2
HCPCS,J7131,Hypertonic saline sol,,,0.03,0.19,6
HCPCS,J7165,"Inj, human-lans, per i.u",,,1.72,7.61,9
HCPCS,J7168,HUMAN PROTHROMBIN COMPLEX 500 UNIT IV SOLR,7565.0,5295.5,,,0
HCPCS,J7168,Prothrombin complex kcentra,,,2.05,9.11,13
HCPCS,J7169,"Inj andexxa, 10 mg",,,131.16,1101.87,13
HCPCS,J7170,EMICIZUMAB-KXWH 105 MG/0.7 ML SUBQ SOLN,45550.0,31885.0,,,0
HCPCS,J7170,EMICIZUMAB-KXWH 150 MG/ML SUBQ SOLN,67574.0,47301.8,,,0
HCPCS,J7170,EMICIZUMAB-KXWH 300 MG/2 ML (150 MG/ML) SUBQ SOLN,100109.0,70076.3,,,0
HCPCS,J7170,"Inj., emicizumab-kxwh 0.5 mg",,,55.64,184.69,13
HCPCS,J7171,"Inj, adzynma, 10 iu",,,35.58,62.26,9
HCPCS,J7175,"Inj, factor x, (human), 1iu",,,9.95,24.65,13
HCPCS,J7177,"Inj., fibryga, 1 mg",,,1.24,4.01,13
HCPCS,J7178,Human fibrinogen conc inj,,,1.52,3.48,13
HCPCS,J7179,Vonvendi inj 1 iu vwf:rco,,,1.83,8.73,13
HCPCS,J7180,Factor XIII anti-hem factor,,,10.78,24.27,13
HCPCS,J7181,Factor xiii recomb a-subunit,,,18.33,52.2,13
HCPCS,J7182,Factor viii recomb novoeight,,,1.41,4.88,13
HCPCS,J7183,Wilate injection,,,1.32,3.44,13
HCPCS,J7185,Xyntha inj,,,1.49,4.2,13
HCPCS,J7186,Antihemophilic viii/vwf comp,,,1.25,3.25,13
HCPCS,J7187,"ANTIHEMOPHILIC FACTOR-VWF 1,000-2,400 UNIT IV KIT",3019.0,2113.3,,,0
HCPCS,J7187,HUMATE-P: VWF CONCENTRATE (MERGE RECORD),3208.5,2245.95,,,0
HCPCS,J7187,"Humate-P, inj",,,1.49,3.44,13
HCPCS,J7188,Factor viii recomb obizur,,,3.24,17.99,13
HCPCS,J7189,COAGULATION FACTOR VIIA RECOMB (PHS ERX MERGE),24840.0,17388.0,,,0
HCPCS,J7189,Factor viia,,,2.64,5.09,13
HCPCS,J7190,ADVATE: FACTOR VIII CONCENTRATE (MERGE RECORD),15732.0,11012.4,,,0
HCPCS,J7190,Factor viii,,,1.39,3.21,13
HCPCS,J7191,Factor viii (porcine),,,0.61,24.22,11
HCPCS,J7192,ADVATE: FACTOR VIII CONCENTRATE (MERGE RECORD),7248.0,5073.6,,,0
HCPCS,J7192,Factor viii recombinant nos,,,1.57,4.2,13
HCPCS,J7193,Factor ix non-recombinant,,,1.37,3.48,13
HCPCS,J7194,Factor ix complex,,,1.7,3.18,12
HCPCS,J7195,BENEFIX: FIX CONCENTRATE (MERGE RECORD),38704.0,27092.8,,,0
HCPCS,J7195,Factor ix recombinant nos,,,1.84,4.16,13
HCPCS,J7196,Antithrombin recombinant,,,167.31,390.66,6
HCPCS,J7197,ANTITHROMBIN III IV (PHS ERX MERGE),3307.0,2314.9,,,0
HCPCS,J7197,Antithrombin iii injection,,,4.1,8.54,13
HCPCS,J7198,ANTI-INHIBITOR COAGULANT CMPLX (PHS MERGE),3803.0,2662.1,,,0
HCPCS,J7198,"ANTI-INHIBITOR COAGULANT CMPLX 1,750-3,250 UNIT IV SOLR",11055.5,7738.85,,,0
HCPCS,J7198,ANTI-INHIBITOR COAGULANT CMPLX 350-650 UNIT IV SOLR,873.5,611.4499999999999,,,0
HCPCS,J7198,Anti-inhibitor,,,2.42,5.75,13
HCPCS,J7200,Factor ix recombinan rixubis,,,1.74,4.69,13
HCPCS,J7201,Factor ix alprolix recomb,,,3.58,10.66,13
HCPCS,J7202,Factor ix idelvion inj,,,5.32,15.65,13
HCPCS,J7203,Factor ix recomb gly rebinyn,,,4.5,14.68,13
HCPCS,J7204,Inj recombin esperoct per iu,,,2.22,8.5,13
HCPCS,J7205,Factor viii fc fusion recomb,,,2.46,7.14,13
HCPCS,J7207,Factor viii pegylated recomb,,,2.14,6.58,13
HCPCS,J7208,Inj. jivi 1 iu,,,2.66,7.63,13
HCPCS,J7209,ADVATE: FACTOR VIII CONCENTRATE (MERGE RECORD),13075.5,9152.85,,,0
HCPCS,J7209,Factor viii nuwiq recomb 1iu,,,1.18,6.43,13
HCPCS,J7210,"Inj, afstyla, 1 i.u.",,,1.57,5.14,13
HCPCS,J7211,"Inj, kovaltry, 1 i.u.",,,1.56,4.78,13
HCPCS,J7212,Factor viia recomb sevenfact,,,2.2,9.77,13
HCPCS,J7213,"Inj, ixinity, 1 i.u.",,,1.97,6.67,13
HCPCS,J7214,Altuviiio per factor viii iu,,,4.49,17.89,13
HCPCS,J7294,Seg acet and eth estr yearly,,,4153.66,4589.36,2
HCPCS,J7295,Eth estr and eton monthly,,,265.12,292.93,2
HCPCS,J7296,"Kyleena, 19.5 mg",,,1985.05,2193.28,2
HCPCS,J7296,LEVONORGESTREL 17.5 MCG/24 HR (5 YEARS) IU IUD,3763.5,2634.45,,,0
HCPCS,J7297,"Liletta, 52 mg",,,1522.71,2835.0,6
HCPCS,J7298,LEVONORGESTREL 20 MCG/24 HR IU IUD,3553.5,2487.45,,,0
HCPCS,J7298,"Mirena, 52 mg",,,1985.05,3676.47,6
HCPCS,J7300,COPPER 380 SQUARE MM IU IUD,3142.0,2199.4,,,0
HCPCS,J7300,Intraut copper contraceptive,,,1861.86,2057.16,2
HCPCS,J7301,LEVONORGESTREL 14 MCG/24 HOUR (3 YEARS) IU IUD,1973.0,1381.1,,,0
HCPCS,J7301,"Skyla, 13.5 mg",,,1652.88,2949.84,6
HCPCS,J7304,Contraceptive hormone patch,,,279.08,308.35,2
HCPCS,J7304,ESTRADIOL 0.025 MG/24 HR TD PTSW,56.0,39.2,,,0
HCPCS,J7304,ESTRADIOL 0.025 MG/24 HR TD PTWK,217.0,151.9,,,0
HCPCS,J7304,ESTRADIOL 0.05 MG/24 HR TD PTWK,202.0,141.4,,,0
HCPCS,J7304,ESTRADIOL 0.1 MG/24 HR TD PTWK,114.0,79.8,,,0
HCPCS,J7306,Levonorgestrel implant sys,,,279.08,308.35,2
HCPCS,J7307,ETONOGESTREL 68 MG SDRM IMPL,2104.5,1473.15,,,0
HCPCS,J7307,Etonogestrel implant system,,,1984.18,2192.31,2
HCPCS,J7308,Aminolevulinic acid hcl top,,,365.6,745.54,13
HCPCS,J7309,"Methyl aminolevulinate, top",,,141.13,316.35,6
HCPCS,J7310,Ganciclovir long act implant,,,52767.09,65828.25,4
HCPCS,J7311,Fluocinolone acetonide implt,,,338.79,75085.35,13
HCPCS,J7312,Dexamethasone intra implant,,,203.79,740.46,13
HCPCS,J7313,Fluocinol acet intravit imp,,,509.81,1855.79,13
HCPCS,J7314,"Inj., yutiq, 0.01 mg",,,529.89,1856.48,13
HCPCS,J7315,Ophthalmic mitomycin,,,1149.1,1433.53,4
HCPCS,J7316,"Inj, ocriplasmin, 0.125 mg",,,1694.84,3956.72,6
HCPCS,J7318,"HYALURONATE SODIUM, STABILIZED 60 MG/3 ML IATC SYRG",1978.0,1384.6,,,0
HCPCS,J7318,"Inj, durolane 1 mg",,,6.73,3906.63,13
HCPCS,J7320,"Genvisc 850, inj, 1mg",,,3.68,30.26,13
HCPCS,J7321,Hyalgan/supartz inj per dose,,,307.64,383.78,6
HCPCS,J7321,SODIUM HYALURONATE (VISCOSUP) 10 MG/ML IATC SYRG,672.0,470.4,,,0
HCPCS,J7322,Hymovis injection 1 mg,,,18.13,61.08,13
HCPCS,J7323,Euflexxa inj per dose,,,105.58,683.75,13
HCPCS,J7323,SODIUM HYALURONATE (VISCOSUP) 10 MG/ML(MW 2.4 -3.6 MILLION) IATC SYRG,1915.5,1340.85,,,0
HCPCS,J7324,Orthovisc inj per dose,,,109.09,696.69,13
HCPCS,J7324,SODIUM HYALURONATE 30 MG/2 ML IATC SYRG,1320.0,924.0,,,0
HCPCS,J7325,HYLAN G-F 20 16 MG/2 ML IATC SYRG,2521.0,1764.7,,,0
HCPCS,J7325,HYLAN G-F 20 48 MG/6 ML IATC SYRG,2521.0,1764.7,,,0
HCPCS,J7325,Synvisc or Synvisc-One,,,6.96,54.1,13
HCPCS,J7326,Gel-one,,,526.79,2343.98,13
HCPCS,J7326,"HYALURONATE SOD, CROSS-LINKED 30 MG/3 ML IATC SYRG",3174.0,2221.8,,,0
HCPCS,J7327,"HYALURONATE SODIUM, STABILIZED 88 MG/4 ML IATC SYRG",3105.0,2173.5,,,0
HCPCS,J7327,Monovisc inj per dose,,,655.34,3736.08,13
HCPCS,J7328,Gel-syn injection 0.1 mg,,,0.68,4.23,9
HCPCS,J7329,"Inj, trivisc 1 mg",,,3.27,34.19,13
HCPCS,J7330,Cultured chondrocytes implnt,,,66983.3,115020.84,6
HCPCS,J7331,"Synojoynt, inj., 1 mg",,,18.57,23.17,4
HCPCS,J7332,"Inj., triluron, 1 mg",,,10.54,95.2,13
HCPCS,J7336,Capsaicin 8% patch,,,3.42,10.32,13
HCPCS,J7340,Carbidopa levodopa ent 100ml,,,6.48,428.39,13
HCPCS,J7342,Ciprofloxacin otic susp 6 mg,,,48.59,113.25,6
HCPCS,J7345,"Aminolevulinic acid, 10% gel",,,1.77,5.23,13
HCPCS,J7351,Inj bimatoprost itc imp 1mcg,,,214.02,780.1,13
HCPCS,J7352,"Afamelanotide implant, 1 mg",,,2943.42,13058.96,11
HCPCS,J7353,Anacaulase-bcdb 8.8% gel 1 g,,,98.28,108.59,2
HCPCS,J7354,"Cantharidin top, applicator",,,667.07,1298.76,9
HCPCS,J7355,Inj travoprost intra impl,,,196.88,351.77,9
HCPCS,J7402,Mometasone sinus sinuva,,,11.34,39.92,13
HCPCS,J7500,AZATHIOPRINE  50 MG ORAL TAB,10.0,7.0,,,0
HCPCS,J7500,Azathioprine oral 50mg,,,3.36,3.71,2
HCPCS,J7501,Azathioprine parenteral,,,254.76,1130.28,13
HCPCS,J7502,CYCLOSPORINE 100 MG ORAL CAP,107.0,74.9,,,0
HCPCS,J7502,CYCLOSPORINE MODIFIED 100 MG ORAL CAP,48.0,33.6,,,0
HCPCS,J7502,CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLN,25.0,17.5,,,0
HCPCS,J7502,Cyclosporine oral 100 mg,,,11.42,20.29,6
HCPCS,J7503,TACROLIMUS 0.75 MG (ENVARSUS XR) 24-HOUR EXTENDED-RELEASE TABLET,48.0,33.6,,,0
HCPCS,J7503,Tacrol envarsus ex rel oral,,,2.93,4.42,6
HCPCS,J7504,"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML IV",133041.0,93128.7,,,0
HCPCS,J7504,Lymphocyte immune globulin,,,1367.32,9261.76,13
HCPCS,J7505,Monoclonal antibodies,,,3435.38,4285.73,4
HCPCS,J7507,TACROLIMUS 0.5 MG ORAL CAP,28.0,19.6,,,0
HCPCS,J7507,TACROLIMUS 0.5 MG/ML ORAL SUSPENSION (REPACK),38.0,26.6,,,0
HCPCS,J7507,TACROLIMUS 1 MG ORAL CAP,50.5,35.35,,,0
HCPCS,J7507,TACROLIMUS 5 MG ORAL CAP,27.0,18.9,,,0
HCPCS,J7507,Tacrolimus imme rel oral 1mg,,,6.38,15.12,6
HCPCS,J7508,TACROLIMUS 1 MG (ENVARSUS XR) 24-HOUR EXTENDED-RELEASE TABLET,99.0,69.3,,,0
HCPCS,J7508,TACROLIMUS 4 MG (ENVARSUS XR) 24-HOUR EXTENDED-RELEASE TABLET,141.0,98.7,,,0
HCPCS,J7508,Tacrol astagraf ex rel oral,,,0.96,1.47,6
HCPCS,J7509,METHYLPREDNISOLONE  4 MG ORAL TAB,31.0,21.7,,,0
HCPCS,J7509,METHYLPREDNISOLONE 16 MG ORAL TAB,30.0,21.0,,,0
HCPCS,J7509,Methylprednisolone oral,,,1.53,1.69,2
HCPCS,J7510,PREDNISOLONE 15 MG/5 ML ORAL SOLN,16.0,11.2,,,0
HCPCS,J7510,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (5 ML) ORAL SOLN,23.5,16.450000000000003,,,0
HCPCS,J7510,PREDNISONE  2.5 MG ORAL TAB,32.5,22.75,,,0
HCPCS,J7510,Prednisolone oral per 5 mg,,,4.36,4.82,2
HCPCS,J7511,ANTI-THYMOCYTE GLOB (RABBIT) 25 MG IV SOLR,9099.0,6369.3,,,0
HCPCS,J7511,Antithymocyte globuln rabbit,,,1023.12,2021.44,13
HCPCS,J7512,PREDNISONE  1 MG ORAL TAB,21.5,15.05,,,0
HCPCS,J7512,PREDNISONE  5 MG ORAL TAB,11.5,8.05,,,0
HCPCS,J7512,PREDNISONE 10 MG ORAL TAB,8.0,5.6,,,0
HCPCS,J7512,PREDNISONE 20 MG ORAL TAB,12.5,8.75,,,0
HCPCS,J7512,PREDNISONE 50 MG ORAL TAB,6.5,4.550000000000001,,,0
HCPCS,J7512,Prednisone ir or dr oral 1mg,,,0.06,0.11,6
HCPCS,J7513,"Daclizumab, parenteral",,,1071.98,1337.33,4
HCPCS,J7515,CYCLOSPORINE  25 MG ORAL CAP,54.0,37.8,,,0
HCPCS,J7515,CYCLOSPORINE MODIFIED  25 MG ORAL CAP,35.0,24.5,,,0
HCPCS,J7515,Cyclosporine oral 25 mg,,,4.59,5.07,2
HCPCS,J7516,CYCLOSPORINE 250 MG/5 ML IV SOLN,356.0,249.2,,,0
HCPCS,J7516,Cyclosporin parenteral 250mg,,,117.4,129.72,2
HCPCS,J7517,MYCOPHENOLATE 200 MG/ML ORAL SUSP,82.5,57.75,,,0
HCPCS,J7517,MYCOPHENOLATE 250 MG CAP,22.0,15.4,,,0
HCPCS,J7517,MYCOPHENOLATE 500 MG TAB,35.0,24.5,,,0
HCPCS,J7517,Mycophenolate mofetil oral,,,5.68,12.21,6
HCPCS,J7518,"MYCOPHENOLATE 180 MG TAB, DELAYED RELEASE",33.0,23.1,,,0
HCPCS,J7518,MYCOPHENOLATE SODIUM 360 MG ORAL TBEC,94.0,65.8,,,0
HCPCS,J7518,Mycophenolic acid,,,6.54,10.09,6
HCPCS,J7519,Inj. mycophenolate mofetil,,,2.25,2.8,6
HCPCS,J7520,SIROLIMUS 0.5 MG ORAL TAB,47.5,33.25,,,0
HCPCS,J7520,SIROLIMUS 1 MG ORAL TAB,224.0,156.8,,,0
HCPCS,J7520,SIROLIMUS 1 MG/ML ORAL SOLN,109.0,76.3,,,0
HCPCS,J7520,"Sirolimus, oral",,,24.31,32.58,6
HCPCS,J7525,TACROLIMUS 5 MG/ML IV SOLN,890.0,623.0,,,0
HCPCS,J7525,Tacrolimus injection,,,259.96,541.86,13
HCPCS,J7527,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG ORAL TAB,197.0,137.9,,,0
HCPCS,J7527,Oral everolimus,,,19.57,31.87,6
HCPCS,J7605,Arformoterol non-comp unit,,,32.19,35.57,2
HCPCS,J7606,"Formoterol fumarate, inh",,,12.67,33.48,6
HCPCS,J7607,Levalbuterol comp con,,,7.66,8.47,2
HCPCS,J7608,Acetylcysteine non-comp unit,,,26.01,28.74,2
HCPCS,J7611,Albuterol non-comp con,,,0.83,0.92,2
HCPCS,J7612,Levalbuterol non-comp con,,,1.92,2.12,2
HCPCS,J7613,Albuterol non-comp unit,,,0.8,0.88,2
HCPCS,J7614,Levalbuterol non-comp unit,,,6.79,7.51,2
HCPCS,J7620,Albuterol ipratrop non-comp,,,2.6,2.88,2
HCPCS,J7626,Budesonide non-comp unit,,,15.97,17.65,2
HCPCS,J7631,Cromolyn sodium noncomp unit,,,4.82,5.32,2
HCPCS,J7639,Dornase alfa non-comp unit,,,89.15,98.5,2
HCPCS,J7643,Glycopyrrolate comp unit,,,1295.92,1431.86,2
HCPCS,J7644,Ipratropium bromide non-comp,,,3.78,4.17,2
HCPCS,J7665,Mannitol for inhaler,,,1.69,2.53,6
HCPCS,J7674,METHACHOLINE CHLORIDE STERILE INHALATION SOLUTION (PF) KIT,2865.0,2005.5,,,0
HCPCS,J7674,"Methacholine chloride, neb",,,1.43,1.58,2
HCPCS,J7677,Revefenacin inh non-com 1mcg,,,0.49,0.54,2
HCPCS,J7682,Tobramycin non-comp unit,,,184.14,203.46,2
HCPCS,J7686,"Treprostinil, non-comp unit",,,1355.28,1740.46,6
HCPCS,J7999,CEFAZOLIN IN STERILE WATER 2 GRAM/20 ML IV SYRG,157.0,109.9,,,0
HCPCS,J7999,CEFAZOLIN PEDS SYRINGE (20MG/ML) IN DEXTROSE (CDS MIX,91.0,63.7,,,0
HCPCS,J7999,CEFAZOLIN SODIUM-STERILE WATER 1 GRAM/10 ML IV SYRG,49.0,34.3,,,0
HCPCS,J7999,PHENYLEPHRINE 10 MG/ML INJECTION,17.0,11.9,,,0
HCPCS,J8499,DICYCLOMINE 20 MG ORAL TAB,13.0,9.100000000000001,,,0
HCPCS,J8501,APREPITANT  40 MG ORAL CAP,594.0,415.79999999999995,,,0
HCPCS,J8501,APREPITANT  80 MG ORAL CAP,550.5,385.34999999999997,,,0
HCPCS,J8501,APREPITANT 125 MG ORAL CAP,940.0,658.0,,,0
HCPCS,J8501,Oral aprepitant,,,16.6,20.71,6
HCPCS,J8510,Oral busulfan,,,8.7,547.56,13
HCPCS,J8515,"Cabergoline, oral 0.25mg",,,26.21,28.96,2
HCPCS,J8520,"Capecitabine, oral, 150 mg",,,15.3,19.09,6
HCPCS,J8521,"Capecitabine, oral, 500 mg",,,50.84,63.43,6
HCPCS,J8522,CAPECITABINE 500 MG ORAL TAB,74.0,51.8,,,0
HCPCS,J8522,"Capecitabine, oral, 50 mg",,,0.03,6.18,9
HCPCS,J8530,CYCLOPHOSPHAMIDE  25 MG ORAL CAP,50.0,35.0,,,0
HCPCS,J8530,CYCLOPHOSPHAMIDE  50 MG ORAL CAP,477.5,334.25,,,0
HCPCS,J8530,Cyclophosphamide oral 25 MG,,,12.77,14.11,2
HCPCS,J8540,DEXAMETHASONE 0.5 MG ORAL TAB,3.0,2.1,,,0
HCPCS,J8540,DEXAMETHASONE 0.5 MG/5 ML ORAL SOLN,17.0,11.899999999999999,,,0
HCPCS,J8540,DEXAMETHASONE 0.75 MG ORAL TAB,9.0,6.3,,,0
HCPCS,J8540,DEXAMETHASONE 1 MG ORAL TAB,7.5,5.25,,,0
HCPCS,J8540,DEXAMETHASONE 4 MG ORAL TAB,22.0,15.4,,,0
HCPCS,J8540,Oral dexamethasone,,,0.13,0.14,2
HCPCS,J8541,"Oral, hemady, 0.25 mg",,,0.59,0.65,2
HCPCS,J8560,Etoposide oral 50 mg,,,86.84,158.7,13
HCPCS,J8562,Oral fludarabine phosphate,,,247.76,309.09,4
HCPCS,J8565,Gefitinib oral,,,423.25,467.65,2
HCPCS,J8600,Melphalan oral 2 MG,,,14.54,20.38,6
HCPCS,J8610,METHOTREXATE SODIUM 2.5 MG ORAL TAB,140.5,98.35,,,0
HCPCS,J8610,Methotrexate oral 2.5 MG,,,5.79,6.4,2
HCPCS,J8611,Oral methotrexate (jylamvo),,,18.71,34.62,9
HCPCS,J8612,Oral methotrexate (xatmep),,,22.3,39.02,9
HCPCS,J8650,Nabilone oral,,,52.75,74.32,6
HCPCS,J8655,Netupitant palonosetron oral,,,397.79,1867.62,13
HCPCS,J8670,"Rolapitant, oral, 1mg",,,6.31,9.26,6
HCPCS,J8700,Temozolomide,,,20.19,32.02,6
HCPCS,J8705,Topotecan oral,,,125.22,264.18,13
HCPCS,J9000,DOXORUBICIN 2 MG/ML IV SOLN,148.0,103.6,,,0
HCPCS,J9000,DOXORUBICIN 50 MG/25 ML IV SOLN,148.0,103.6,,,0
HCPCS,J9000,Doxorubicin hcl injection,,,12.87,14.22,2
HCPCS,J9011,DATOPOTAMAB DERUXTECAN-DLNK 100 MG IV SOLR,38209.5,26746.65,,,0
HCPCS,J9015,"ALDESLEUKIN 360,000 UNITS/ ML SOLUTION",5121.0,3584.7,,,0
HCPCS,J9015,Aldesleukin injection,,,2513.93,14813.44,13
HCPCS,J9015,HC NC ALDESLEUKIN 22 MIL UNIT SOLR 2ND DOSE,0.01,0.007,,,0
HCPCS,J9017,ARSENIC TRIOXIDE 10 MG/10 ML IV SOLN,432.5,302.75,,,0
HCPCS,J9017,Arsenic trioxide injection,,,65.05,134.04,6
HCPCS,J9019,Erwinaze injection,,,691.69,1295.56,6
HCPCS,J9020,"Asparaginase, nos",,,104.52,225.4,6
HCPCS,J9021,"Inj, aspara, rylaze, 0.1 mg",,,56.29,170.92,13
HCPCS,J9022,"ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) IV SOLN",23792.0,16654.4,,,0
HCPCS,J9022,ATEZOLIZUMAB 840 MG/14 ML (60 MG/ML) IV SOLN,26644.5,18651.15,,,0
HCPCS,J9022,"Inj, atezolizumab,10 mg",,,94.0,290.73,13
HCPCS,J9023,AVELUMAB 20 MG/ML IV SOLN,14907.0,10434.9,,,0
HCPCS,J9023,"Injection, avelumab, 10 mg",,,105.54,309.28,13
HCPCS,J9025,AZACITIDINE 100 MG INJ SOLR,416.0,291.2,,,0
HCPCS,J9025,Azacitidine injection,,,8.84,17.8,6
HCPCS,J9026,TARLATAMAB-DLLE  1 MG IV SOLR,4140.0,2898.0,,,0
HCPCS,J9026,TARLATAMAB-DLLE 10 MG IV SOLR,41381.0,28966.7,,,0
HCPCS,J9027,Clofarabine injection,,,10.94,449.44,13
HCPCS,J9029,"Inj, adstiladrin, per tx dos",,,25740.0,233604.0,13
HCPCS,J9029,NADOFARAGENE FIRADENOVEC-VNCG 3X10EXP11 VP/ML IVES SUSP,87000.0,60900.0,,,0
HCPCS,J9030,BCG LIVE 50 MG IVES SUSR,564.0,394.79999999999995,,,0
HCPCS,J9030,Bcg live intravesical 1mg,,,3.39,10.66,13
HCPCS,J9032,"Injection, belinostat, 10mg",,,53.11,122.85,13
HCPCS,J9033,"Inj., treanda 1 mg",,,2.16,70.35,13
HCPCS,J9034,BENDAMUSTINE 25 MG/ML IV SOLN,9252.0,6476.4,,,0
HCPCS,J9034,"Inj., bendeka 1 mg",,,12.9,89.55,13
HCPCS,J9035,BEVACIZUMAB 25 MG/ML IV SOLN,6008.0,4205.6,,,0
HCPCS,J9035,Bevacizumab injection,,,74.36,222.68,13
HCPCS,J9036,BENDAMUSTINE 25 MG/ML IV SOLN,12290.5,8603.35,,,0
HCPCS,J9036,Inj. belrapzo/bendamustine,,,13.94,92.06,13
HCPCS,J9037,Inj belantamab mafodont blmf,,,75.73,163.63,6
HCPCS,J9039,BLINATUMOMAB 12.5 MCG/ML IV SOLR,11056.0,7739.2,,,0
HCPCS,J9039,BLINATUMOMAB 35 MCG IV KIT,9203.0,6442.1,,,0
HCPCS,J9039,"Injection, blinatumomab",,,163.96,360.65,13
HCPCS,J9040,BLEOMYCIN 15 UNITS/5 ML INJ SOLR (WET SOLR VIAL),485.0,339.5,,,0
HCPCS,J9040,BLEOMYCIN 30 UNIT INJ SOLR,226.0,158.2,,,0
HCPCS,J9040,BLEOMYCIN 30 UNITS/10 ML INJ SOLR (WET SOLR VIAL),389.0,272.3,,,0
HCPCS,J9040,Bleomycin sulfate injection,,,68.0,135.17,6
HCPCS,J9041,BORTEZOMIB 3.5 MG IV SOLR,185.5,129.85,,,0
HCPCS,J9041,Bortezomib injection,,,12.27,137.18,6
HCPCS,J9042,BRENTUXIMAB VEDOTIN 50 MG IV SOLR,27071.5,18950.050000000003,,,0
HCPCS,J9042,Brentuximab vedotin inj,,,268.73,470.27,13
HCPCS,J9043,CABAZITAXEL 10 MG/ML (FINAL) IV SOLN,10913.0,7639.1,,,0
HCPCS,J9043,Cabazitaxel injection,,,231.05,528.18,13
HCPCS,J9045,CARBOPLATIN 10 MG/ML IV,235.0,164.5,,,0
HCPCS,J9045,Carboplatin injection,,,14.87,37.31,6
HCPCS,J9046,"Inj, bortezomib, dr. reddy's",,,3.46,86.92,13
HCPCS,J9047,CARFILZOMIB 10 MG IV SOLR,1027.5,719.25,,,0
HCPCS,J9047,CARFILZOMIB 30 MG IV SOLR,2186.0,1530.2,,,0
HCPCS,J9047,CARFILZOMIB 60 MG IV SOLR,4531.0,3171.7,,,0
HCPCS,J9047,"Injection, carfilzomib, 1 mg",,,56.24,113.51,13
HCPCS,J9048,"Inj, bortezomib freseniuskab",,,6.97,51.6,13
HCPCS,J9049,"Inj, bortezomib, hospira",,,13.18,26.95,6
HCPCS,J9050,Carmustine injection,,,241.8,2830.48,13
HCPCS,J9052,"Inj, carmustine (accord)",,,1800.07,3562.55,6
HCPCS,J9055,CETUXIMAB 100 MG/50 ML IV SOLN,15582.0,10907.400000000001,,,0
HCPCS,J9055,CETUXIMAB 200 MG/100 ML IV SOLN,1267.0,886.9,,,0
HCPCS,J9055,Cetuximab injection,,,80.46,193.12,13
HCPCS,J9056,"Inj, bendamustine, 1 mg",,,31.74,125.43,13
HCPCS,J9057,"Inj., copanlisib, 1 mg",,,150.55,294.47,6
HCPCS,J9058,Inj apotex/bendamustine 1 mg,,,55.9,124.96,6
HCPCS,J9059,"Inj bendamustine, baxter 1mg",,,40.15,87.43,6
HCPCS,J9060,CISPLATIN 1 MG/ML IV,131.5,92.05000000000001,,,0
HCPCS,J9060,Cisplatin 10 mg injection,,,6.92,7.65,2
HCPCS,J9061,AMIVANTAMAB-VMJW 50 MG/ML IV SOLN,28823.5,20176.45,,,0
HCPCS,J9061,"Inj, amivantamab-vmjw",,,22.63,67.68,13
HCPCS,J9063,"Inj, elahere, 1 mg",,,71.13,248.55,13
HCPCS,J9063,MIRVETUXIMAB SORAVTANSINE-GYNX 5 MG/ML IV SOLN,17324.5,12127.15,,,0
HCPCS,J9065,CLADRIBINE 1 MG/ML IV SOLN,1770.0,1239.0,,,0
HCPCS,J9065,Inj cladribine per 1 mg,,,8.73,113.89,13
HCPCS,J9070,Cyclophosphamide 100 mg inj,,,128.2,159.93,4
HCPCS,J9071,Inj cyclophosphamd auromedic,,,0.52,14.21,13
HCPCS,J9072,Inj cyclophos dr.reddy's 5mg,,,9.1,16.59,13
HCPCS,J9073,Inj cyclophosphamd (ingenus),,,0.5,6.95,9
HCPCS,J9074,"Inj, cyclophosphamd, sandoz",,,3.65,8.31,9
HCPCS,J9075,CYCLOPHOSPHAMIDE 2 GRAM IV SOLUTION,3052.0,2136.4,,,0
HCPCS,J9075,CYCLOPHOSPHAMIDE 20 MG/ML IN NS,739.0,517.3,,,0
HCPCS,J9075,CYCLOPHOSPHAMIDE 500 MG IV SOLR,326.0,228.2,,,0
HCPCS,J9075,"Inj, cyclophosphamide, nos",,,0.77,6.26,9
HCPCS,J9098,Cytarabine liposome inj,,,1017.24,1739.52,6
HCPCS,J9100,CYTARABINE 100 MG/ML INJ SOLN,239.0,167.3,,,0
HCPCS,J9100,Cytarabine hcl 100 mg inj,,,3.78,4.17,2
HCPCS,J9118,CALASPARGASE PEGOL-MKNL 750 UNITS/ML IV SOLN,75551.0,52885.7,,,0
HCPCS,J9118,Inj. calaspargase pegol-mknl,,,82.08,143.63,9
HCPCS,J9119,CEMIPLIMAB-RWLC 50 MG/ML IV SOLN,25491.0,17843.7,,,0
HCPCS,J9119,"Inj., cemiplimab-rwlc, 1 mg",,,29.76,103.75,13
HCPCS,J9120,DACTINOMYCIN 0.5 MG IV SOLR,2341.5,1639.05,,,0
HCPCS,J9120,Dactinomycin injection,,,337.67,2879.69,13
HCPCS,J9130,DACARBAZINE 100 MG IV SOLR,62.0,43.400000000000006,,,0
HCPCS,J9130,DACARBAZINE 200 MG IV SOLR,210.0,147.0,,,0
HCPCS,J9130,Dacarbazine 100 mg inj,,,10.3,11.38,2
HCPCS,J9144,"DARATUMUMAB-HYALURONIDASE-FIHJ 1,800 MG-30,000 UNIT/15 ML SUBQ SOLN",20904.5,14633.15,,,0
HCPCS,J9144,"Daratumumab, hyaluronidase",,,55.03,165.76,13
HCPCS,J9145,DARATUMUMAB 20 MG/ML IV SOLN,1491.0,1043.7,,,0
HCPCS,J9145,"Injection, daratumumab 10 mg",,,70.77,177.36,13
HCPCS,J9150,DAUNORUBICIN 5 MG/ML IV INJ,1122.0,785.4,,,0
HCPCS,J9150,Daunorubicin injection,,,52.57,127.17,6
HCPCS,J9151,Daunorubicin citrate inj,,,174.53,218.04,6
HCPCS,J9153,"Inj daunorubicin, cytarabine",,,261.2,705.74,13
HCPCS,J9155,DEGARELIX 120 MG SUBQ SOLR,3155.5,2208.85,,,0
HCPCS,J9155,DEGARELIX 80 MG SUBQ SOLR,1348.5,943.95,,,0
HCPCS,J9155,Degarelix injection,,,4.46,11.79,13
HCPCS,J9160,Denileukin diftitox inj,,,197.34,5559.28,6
HCPCS,J9165,Diethylstilbestrol injection,,,197.34,218.04,2
HCPCS,J9171,DOCETAXEL 160 MG/16 ML (10 MG/ML) IV SOLN,902.0,631.4,,,0
HCPCS,J9171,DOCETAXEL 160 MG/16 ML (10 MG/ML) IV SOLN- NONSTANDARD DOSING,362.5,253.75,,,0
HCPCS,J9171,DOCETAXEL 20 MG/ML (1 ML) IV SOLN,5708.0,3995.6,,,0
HCPCS,J9171,Docetaxel injection,,,5.99,17.99,6
HCPCS,J9172,"Docetaxel (ingenus), 1 mg",,,50.61,93.85,9
HCPCS,J9173,DURVALUMAB 50 MG/ML IV SOLN,9602.0,6721.4,,,0
HCPCS,J9173,"Inj., durvalumab, 10 mg",,,86.15,279.61,13
HCPCS,J9175,Elliotts b solution per ml,,,16.5,18.23,2
HCPCS,J9176,"Injection, elotuzumab, 1mg",,,8.04,23.55,13
HCPCS,J9177,ENFORTUMAB VEDOTIN-EJFV 20 MG IV SOLR,2476.0,1733.2,,,0
HCPCS,J9177,ENFORTUMAB VEDOTIN-EJFV 30 MG IV SOLR,8517.5,5962.25,,,0
HCPCS,J9177,Inj enfort vedo-ejfv 0.25mg,,,36.71,105.68,13
HCPCS,J9178,"Inj, epirubicin hcl, 2 mg",,,4.15,21.13,6
HCPCS,J9179,ERIBULIN 0.5 MG/ML IV SOLN,5200.0,3640.0,,,0
HCPCS,J9179,Eribulin mesylate injection,,,76.76,370.14,13
HCPCS,J9181,ETOPOSIDE 20 MG/ML IV SOLN,75.0,52.5,,,0
HCPCS,J9181,Etoposide injection,,,1.63,1.8,2
HCPCS,J9185,FLUDARABINE 50 MG IV SOLR,817.0,571.9,,,0
HCPCS,J9185,FLUDARABINE 50 MG/2 ML IV SOLN,1925.0,1347.5,,,0
HCPCS,J9185,Fludarabine phosphate inj,,,373.23,858.59,6
HCPCS,J9190,FLUOROURACIL 1 GRAM/20 ML IV SOLN,34.5,24.150000000000002,,,0
HCPCS,J9190,FLUOROURACIL 5 GRAM/100 ML IV SOLN,209.5,146.65,,,0
HCPCS,J9190,FLUOROURACIL 500 MG/10 ML IV SOLN,60.0,42.0,,,0
HCPCS,J9190,Fluorouracil injection,,,9.84,10.87,2
HCPCS,J9196,Inj gemcitabine hcl (accord),,,11.18,23.64,6
HCPCS,J9198,"Inj. infugem, 100 mg",,,65.21,147.95,6
HCPCS,J9200,Floxuridine injection,,,157.23,7439.19,13
HCPCS,J9201,GEMCITABINE 1 GRAM IV SOLR,259.0,181.3,,,0
HCPCS,J9201,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) IV SOLN,204.0,142.8,,,0
HCPCS,J9201,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) BLADDER INSTILLATION,333.5,233.45,,,0
HCPCS,J9201,Gemcitabine hcl injection,,,15.77,524.32,6
HCPCS,J9202,GOSERELIN  3.6 MG SUBQ IMPL,1670.0,1169.0,,,0
HCPCS,J9202,GOSERELIN 10.8 MG SUBQ IMPL,4784.5,3349.15,,,0
HCPCS,J9202,Goserelin acetate implant,,,589.43,1820.73,6
HCPCS,J9203,GEMTUZUMAB OZOGAMICIN 4.5 MG (1 MG/ML INITIAL CONC) IV SOLR,19757.5,13830.25,,,0
HCPCS,J9203,Gemtuzumab ozogamicin 0.1 mg,,,240.16,730.13,13
HCPCS,J9204,"Inj mogamulizumab-kpkc, 1 mg",,,253.47,759.29,13
HCPCS,J9205,IRINOTECAN LIPOSOMAL 4.3 MG/ML IV DISP,8489.5,5942.65,,,0
HCPCS,J9205,Inj irinotecan liposome 1 mg,,,66.37,149.35,13
HCPCS,J9206,IRINOTECAN 100 MG/5 ML IV SOLN,243.0,170.1,,,0
HCPCS,J9206,Irinotecan injection,,,12.87,143.6,6
HCPCS,J9207,Ixabepilone injection,,,139.75,244.56,13
HCPCS,J9208,IFOSFAMIDE 1 GRAM IV SOLR,432.0,302.4,,,0
HCPCS,J9208,IFOSFAMIDE 3 GRAM IV SOLR,930.0,651.0,,,0
HCPCS,J9208,Ifosfamide injection,,,63.05,131.2,6
HCPCS,J9209,MESNA 100 MG/ML IV SOLN,165.5,115.85,,,0
HCPCS,J9209,Mesna injection,,,8.58,27.03,6
HCPCS,J9210,"Inj., emapalumab-lzsg, 1 mg",,,384.14,2948.58,13
HCPCS,J9211,IDARUBICIN 1 MG/ML IV SOLN,729.0,510.3,,,0
HCPCS,J9211,Idarubicin hcl injection,,,95.51,910.22,6
HCPCS,J9212,Interferon alfacon-1 inj,,,15.39,24.38,6
HCPCS,J9213,Interferon alfa-2a inj,,,126.08,157.29,4
HCPCS,J9214,Interferon alfa-2b inj,,,45.81,58.27,6
HCPCS,J9215,Interferon alfa-n3 inj,,,51.68,70.76,6
HCPCS,J9216,Interferon gamma 1-b inj,,,1094.5,15437.42,6
HCPCS,J9217,HC NC LUPRON 7.5 MG,0.01,0.007,,,0
HCPCS,J9217,LEUPROLIDE  7.5 MG IM SYKT,2351.5,1646.0500000000002,,,0
HCPCS,J9217,LEUPROLIDE  7.5 MG SUBQ SYRG,1176.0,823.2,,,0
HCPCS,J9217,LEUPROLIDE (3 MONTH) 22.5 MG IM SYRG,1176.0,823.2,,,0
HCPCS,J9217,LEUPROLIDE (4 MONTH) 30 MG IM KIT,23131.5,16192.05,,,0
HCPCS,J9217,LEUPROLIDE (4-MONTH) 30 MG SUBQ SYRG,1176.0,823.2,,,0
HCPCS,J9217,LEUPROLIDE (6 MONTH) 45 MG IM SYKT,1176.0,823.2,,,0
HCPCS,J9217,LEUPROLIDE (6 MONTH) 45 MG SUBCUTANOUS KIT,588.0,411.6,,,0
HCPCS,J9217,LEUPROLIDE 22.5 MG SUBQ SYRG,1175.5,822.85,,,0
HCPCS,J9217,Leuprolide acetate suspnsion,,,176.2,856.58,13
HCPCS,J9218,LEUPROLIDE 1 MG/0.2 ML SUBQ KIT,76.5,53.55,,,0
HCPCS,J9218,Leuprolide acetate injeciton,,,20.79,275.93,6
HCPCS,J9219,Leuprolide acetate implant,,,5268.62,8980.72,6
HCPCS,J9220,INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) IV SOLN,692.0,484.4,,,0
HCPCS,J9220,INDIGOTINDISULFONATE SODIUM 8 MG/ML INJ SOLN,66.0,46.2,,,0
HCPCS,J9223,"Inj. lurbinectedin, 0.1 mg",,,212.1,645.62,13
HCPCS,J9223,LURBINECTEDIN 4 MG IV SOLR,36615.0,25630.5,,,0
HCPCS,J9225,Vantas implant,,,4492.73,9240.84,6
HCPCS,J9226,HISTRELIN 50 MG (65 MCG/DAY) IMPL KIT,74263.0,51984.1,,,0
HCPCS,J9226,Supprelin LA implant,,,41173.43,92462.93,13
HCPCS,J9227,Inj. isatuximab-irfc 10 mg,,,83.58,250.89,13
HCPCS,J9228,IPILIMUMAB 200 MG/40 ML (5 MG/ML) IV SOLN,69955.5,48968.850000000006,,,0
HCPCS,J9228,IPILIMUMAB 50 MG/10 ML (5 MG/ML) IV SOLN,22013.0,15409.1,,,0
HCPCS,J9228,Ipilimumab injection,,,187.17,480.25,13
HCPCS,J9229,INOTUZUMAB OZOGAMICIN 0.9 MG (0.25 MG/ML INITIAL) IV SOLR,28057.5,19640.25,,,0
HCPCS,J9229,Inj inotuzumab ozogam 0.1 mg,,,2816.77,8325.24,13
HCPCS,J9230,Mechlorethamine hcl inj,,,450.17,561.59,4
HCPCS,J9245,Inj melphalan hydrochl 50 MG,,,120.67,6305.68,13
HCPCS,J9246,"Inj., evomela, 1 mg",,,19.43,89.21,13
HCPCS,J9247,"Inj, melphalan flufenami 1mg",,,815.1,1880.3,6
HCPCS,J9248,Inj melphalan (hepzato) 1 mg,,,795.0,1391.25,9
HCPCS,J9259,Paclitaxel (american regent),,,28.13,61.33,6
HCPCS,J9260,METHOTREXATE (PF) 25 MG/ML INJ SOLN (FOR ECTOPIC PREGNANCY),42.0,29.4,,,0
HCPCS,J9260,METHOTREXATE NA (PRESERV FREE) 25 MG/ML INJ SOLN,1207.5,845.25,,,0
HCPCS,J9260,METHOTREXATE SODIUM 25 MG/ML INJ SOLN,87.0,60.9,,,0
HCPCS,J9260,Methotrexate sodium inj,,,3.86,4.27,2
HCPCS,J9261,NELARABINE 250 MG/50 ML IV SOLN (PEDS ONCOLOGY),4839.0,3387.3,,,0
HCPCS,J9261,Nelarabine injection,,,52.71,376.53,13
HCPCS,J9262,"Inj, omacetaxine mep, 0.01mg",,,7.51,9.37,4
HCPCS,J9263,OXALIPLATIN 100 MG/20 ML IV SOLN,112.5,78.75,,,0
HCPCS,J9263,Oxaliplatin,,,1.72,37.12,6
HCPCS,J9264,PACLITAXEL-PROTEIN BOUND 100 MG IV SOLR,6786.0,4750.2,,,0
HCPCS,J9264,Paclitaxel protein bound,,,6.02,34.36,13
HCPCS,J9266,PEGASPARGASE 750 UNIT/ML INJ SOLN,64175.5,44922.85,,,0
HCPCS,J9266,Pegaspargase injection,,,8146.94,49742.1,13
HCPCS,J9267,PACLITAXEL 6 MG/ML IV CONC,252.0,176.4,,,0
HCPCS,J9267,Paclitaxel injection,,,0.48,0.63,6
HCPCS,J9268,Pentostatin injection,,,2626.33,6298.12,13
HCPCS,J9269,Inj. tagraxofusp-erzs 10 mcg,,,357.28,978.86,13
HCPCS,J9270,Plicamycin (mithramycin) inj,,,62.24,77.64,4
HCPCS,J9271,Inj pembrolizumab,,,61.25,172.75,13
HCPCS,J9271,PEMBROLIZUMAB 100 MG/4 ML (25 MG/ML) IV SOLN,36272.5,25390.75,,,0
HCPCS,J9272,DOSTARLIMAB-GXLY 50 MG/ML IV SOLN,46012.5,32208.75,,,0
HCPCS,J9272,"Inj, dostarlimab-gxly, 10 mg",,,247.08,813.14,13
HCPCS,J9273,"Inj tisotu vedotin-tftv, 1mg",,,196.12,589.49,13
HCPCS,J9273,TISOTUMAB VEDOTIN-TFTV 40 MG IV SOLR,47249.0,33074.3,,,0
HCPCS,J9274,"Inj, tebentafusp-tebn, 1 mcg",,,222.49,751.69,13
HCPCS,J9280,MITOMYCIN  5 MG IV SOLR,707.0,494.9,,,0
HCPCS,J9280,MITOMYCIN 20 MG IV SOLR,1151.0,805.7,,,0
HCPCS,J9280,Mitomycin injection,,,28.46,299.55,13
HCPCS,J9281,Mitomycin instillation,,,323.17,1066.61,13
HCPCS,J9285,"Inj, olaratumab, 10 mg",,,84.28,192.93,6
HCPCS,J9286,GLOFITAMAB-GXBM 1 MG/ML IV SOLN (>10 MG DOSE 10 ML MIXTURE COMPONENT),84614.0,59229.8,,,0
HCPCS,J9286,"Inj glofitamab gxbm, 2.5 mg",,,2840.68,9946.62,13
HCPCS,J9293,MITOXANTRONE 2 MG/ML IV CONC,183.0,128.1,,,0
HCPCS,J9293,Mitoxantrone hydrochl / 5 MG,,,38.61,338.42,13
HCPCS,J9294,"Inj pemetrexed, hospira 10mg",,,5.2,18.88,13
HCPCS,J9295,"Injection, necitumumab, 1 mg",,,5.73,19.88,13
HCPCS,J9296,Inj pemetrexed (accord) 10mg,,,9.66,36.5,11
HCPCS,J9297,Inj pemetrexed (sandoz) 10mg,,,6.92,133.08,6
HCPCS,J9298,Inj nivol relatlimab 3mg/1mg,,,201.76,682.82,13
HCPCS,J9298,NIVOLUMAB-RELATLIMAB-RMBW 240-80 MG/20 ML IV SOLN,56695.0,39686.5,,,0
HCPCS,J9299,"Injection, nivolumab",,,33.62,95.9,13
HCPCS,J9299,NIVOLUMAB 240 MG/24 ML IV SOLN,10132.0,7092.4,,,0
HCPCS,J9299,NIVOLUMAB 40 MG/4 ML IV SOLN,3512.0,2458.3999999999996,,,0
HCPCS,J9301,OBINUTUZUMAB 900 MG IN NS 286 ML (STOCK DOSE),6046.0,4232.2,,,0
HCPCS,J9301,Obinutuzumab inj,,,81.81,205.03,13
HCPCS,J9302,Ofatumumab injection,,,62.23,276.11,11
HCPCS,J9303,PANITUMUMAB 400 MG/20 ML (20 MG/ML) IV SOLN,16751.0,11725.7,,,0
HCPCS,J9303,Panitumumab injection,,,174.39,327.14,13
HCPCS,J9304,"Inj. pemetrexed, 10 mg",,,7.99,299.57,13
HCPCS,J9305,PEMETREXED 100 MG IV SOLR,335.0,234.5,,,0
HCPCS,J9305,PEMETREXED 500 MG IV SOLR,577.5,404.25,,,0
HCPCS,J9305,Pemetrexed injection,,,4.04,183.56,13
HCPCS,J9306,"Injection, pertuzumab, 1 mg",,,17.02,38.63,13
HCPCS,J9306,PERTUZUMAB 420 MG/14 ML (30 MG/ML) IV SOLN,9375.0,6562.5,,,0
HCPCS,J9307,Pralatrexate injection,,,392.72,690.15,13
HCPCS,J9308,"Injection, ramucirumab",,,75.47,204.2,13
HCPCS,J9308,RAMUCIRUMAB 10 MG/ML IV SOLN,4585.5,3209.85,,,0
HCPCS,J9309,"Inj, polatuzumab vedotin 1mg",,,137.23,417.15,13
HCPCS,J9309,POLATUZUMAB VEDOTIN-PIIQ 20 MG/ML IV WET SOLR VIAL (RECON 140 MG VIAL),25834.0,18083.8,,,0
HCPCS,J9311,"Inj rituximab, hyaluronidase",,,36.28,172.83,13
HCPCS,J9311,"RITUXIMAB-HYALURONIDASE,HUMAN 1400 MG/11.7 ML (120 MG/ML) SUBQ SOLN",13985.0,9789.5,,,0
HCPCS,J9312,"Inj., rituximab, 10 mg",,,74.16,347.7,13
HCPCS,J9312,RITUXIMAB 10 MG/ML IV CONC,8866.5,6206.55,,,0
HCPCS,J9313,"Inj., lumoxiti, 0.01 mg",,,23.39,103.79,13
HCPCS,J9314,Inj pemetrexed (teva) 10mg,,,10.99,50.22,13
HCPCS,J9316,"PERTUZUMAB-TRASTUZUMAB-HY-ZZXF 1,200 MG-600MG- 30000 UNIT/15ML SUBQ SOLN",35072.0,24550.4,,,0
HCPCS,J9316,PERTUZUMAB-TRASTUZUMAB-HY-ZZXF 600 MG-600 MG- 20000 UNIT/10ML SUBQ SOLN,23380.0,16366.0,,,0
HCPCS,J9316,"Pertuzu, trastuzu, 10 mg",,,60.22,274.84,13
HCPCS,J9317,SACITUZUMAB GOVITECAN-HZIY 180 MG IV SOLR,13858.0,9700.6,,,0
HCPCS,J9317,Sacituzumab govitecan-hziy,,,36.8,111.53,13
HCPCS,J9318,Inj romidepsin non-lyo 0.1mg,,,28.52,128.16,13
HCPCS,J9319,Inj romidepsin lyophil 0.1mg,,,30.8,125.6,13
HCPCS,J9320,Streptozocin injection,,,599.28,763.52,6
HCPCS,J9321,EPCORITAMAB-BYSP  4 MG/0.8 ML SUBQ SOLN,1031.0,721.7,,,0
HCPCS,J9321,EPCORITAMAB-BYSP 48 MG/0.8 ML SUBQ SOLN,44594.0,31215.8,,,0
HCPCS,J9321,Inj epcoritamab-bysp 0.16 mg,,,56.92,197.6,13
HCPCS,J9323,Inj pemetrexed ditromethamin,,,17.98,26.75,6
HCPCS,J9324,"Inj, pemrydi rtu, 10 mg",,,70.48,151.49,9
HCPCS,J9325,Inj talimogene laherparepvec,,,73.94,174.37,13
HCPCS,J9328,Temozolomide injection,,,10.4,19.02,13
HCPCS,J9329,"Inj, tislelizumab-jsgr",,,58.27,101.97,9
HCPCS,J9329,TISLELIZUMAB-JSGR 10 MG/ML IV SOLN,13211.0,9247.7,,,0
HCPCS,J9330,TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FINAL) IV SOLR,10681.0,7476.7,,,0
HCPCS,J9330,Temsirolimus injection,,,30.08,181.1,13
HCPCS,J9331,Inj sirolimus prot part 1 mg,,,87.11,383.97,13
HCPCS,J9331,SIROLIMUS-PROTEIN BOUND 100 MG IV SUSR (WET SUSR VIAL),10843.5,7590.45,,,0
HCPCS,J9332,EFGARTIGIMOD ALFA-FCAB 20 MG/ML IV SOLN,30791.5,21554.05,,,0
HCPCS,J9332,Inj efgartigimod 2mg,,,32.61,119.18,13
HCPCS,J9333,Inj ronzanolixizum-noli 1 mg,,,23.4,86.58,13
HCPCS,J9334,"EFGARTIGIMOD-HYALURONIDAS-QVFC 1,008 MG-11,200 UNIT/5.6 ML SUBQ SOLN",43534.0,30473.8,,,0
HCPCS,J9334,Inj efgart-alfa 2mg hya-qvfc,,,34.33,125.39,13
HCPCS,J9340,Thiotepa injection,,,294.15,1336.68,6
HCPCS,J9345,"Inj, retifanlimab-dlwr, 1 mg",,,30.4,110.88,13
HCPCS,J9347,"Inj, tremelimumab-actl, 1 mg",,,143.23,515.24,13
HCPCS,J9347,TREMELIMUMAB-ACTL 20 MG/ML IV SOLN,67275.0,47092.5,,,0
HCPCS,J9348,"Inj. naxitamab-gqgk, 1 mg",,,686.09,2036.98,13
HCPCS,J9349,"Inj., tafasitamab-cxix",,,14.17,48.38,13
HCPCS,J9349,TAFASITAMAB-CXIX 200 MG IV SOLR,11485.5,8039.85,,,0
HCPCS,J9350,"Inj mosunetuzumab-axgb, 1 mg",,,654.54,2380.28,13
HCPCS,J9351,TOPOTECAN 4 MG IV SOLR,832.0,582.4,,,0
HCPCS,J9351,TOPOTECAN 4 MG/4 ML (1 MG/ML) IV SOLN,476.5,333.55,,,0
HCPCS,J9351,Topotecan injection,,,6.45,11.14,6
HCPCS,J9352,Injection trabectedin 0.1mg,,,391.07,1071.03,13
HCPCS,J9352,TRABECTEDIN 1 MG IV SOLR,7825.0,5477.5,,,0
HCPCS,J9353,"Inj. margetuximab-cmkb, 5 mg",,,53.27,165.4,13
HCPCS,J9354,"Inj, ado-trastuzumab emt 1mg",,,42.2,110.26,13
HCPCS,J9354,TRASTUZUMAB EMTANSINE 100 MG IV SOLR,4147.0,2902.8999999999996,,,0
HCPCS,J9354,TRASTUZUMAB EMTANSINE 160 MG IV SOLR,9250.0,6475.0,,,0
HCPCS,J9355,TRASTUZUMAB 150 MG IV SOLR,17205.0,12043.5,,,0
HCPCS,J9355,Trastuzumab injection,,,73.42,238.67,13
HCPCS,J9356,"Inj. herceptin hylecta, 10mg",,,59.91,303.38,13
HCPCS,J9356,"TRASTUZUMAB-HYALURONIDASE-OYSK 600 MG-10,000 UNIT/5 ML SUBQ SOLN",12904.0,9032.8,,,0
HCPCS,J9357,Valrubicin injection,,,689.08,4330.95,13
HCPCS,J9358,FAM-TRASTUZUMAB DERUXTECAN-NXKI 100 MG IV SOLR,17110.5,11977.349999999999,,,0
HCPCS,J9358,Inj fam-trastu deru-nxki 1mg,,,31.26,93.06,13
HCPCS,J9359,Inj lon tesirin-lpyl 0.075mg,,,221.49,706.22,13
HCPCS,J9359,LONCASTUXIMAB TESIRINE-LPYL 10 MG IV SOLR,46505.5,32553.85,,,0
HCPCS,J9360,VINBLASTINE 1 MG/ML IV SOLN,411.0,287.70000000000005,,,0
HCPCS,J9360,Vinblastine sulfate inj,,,9.22,10.19,2
HCPCS,J9370,VINCRISTINE 2 MG/2 ML IV SOLN,98.0,68.6,,,0
HCPCS,J9370,Vincristine sulfate 1 MG inj,,,20.61,22.77,2
HCPCS,J9371,"Inj, vincristine sul lip 1mg",,,5901.91,8099.03,6
HCPCS,J9376,"Inj pozelimab-bbfg, 1 mg",,,91.73,406.97,9
HCPCS,J9380,Inj teclistamab cqyv 0.5 mg,,,34.5,116.8,13
HCPCS,J9380,TECLISTAMAB-CQYV 10 MG/ML SUBQ SOLN,4886.0,3420.2,,,0
HCPCS,J9380,TECLISTAMAB-CQYV 90 MG/ML SUBQ SOLN,24915.0,17440.5,,,0
HCPCS,J9381,Inj teplizumab mzwv 5 mcg,,,38.39,136.95,13
HCPCS,J9381,TEPLIZUMAB-MZWV 2 MG/20 ML IV SOLN,7987.5,5591.25,,,0
HCPCS,J9390,Vinorelbine tartrate inj,,,36.89,64.34,6
HCPCS,J9393,"Inj, fulvestrant (teva)",,,41.67,184.88,11
HCPCS,J9394,"Inj, fulvestrant (fresenius)",,,23.77,94.8,13
HCPCS,J9395,FULVESTRANT 250 MG/5 ML IM SYRG,3675.5,2572.85,,,0
HCPCS,J9395,"Injection, Fulvestrant",,,133.46,315.33,6
HCPCS,J9400,"Inj, ziv-aflibercept, 1mg",,,8.61,30.34,13
HCPCS,J9600,Porfimer sodium injection,,,7897.73,44220.41,6
HCPCS,J9920,INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) IV SOLN,1555.5,1088.85,,,0
HCPCS,J9920,INDIGOTINDISULFONATE SODIUM 8 MG/ML INJ SOLN,66.0,46.2,,,0
HCPCS,J9999,DASATINIB  20 MG ORAL TAB,1135.0,794.5,,,0
HCPCS,J9999,DASATINIB  50 MG ORAL TAB,1816.5,1271.55,,,0
HCPCS,J9999,DASATINIB 100 MG ORAL TAB,1679.0,1175.3,,,0
HCPCS,J9999,EXEMESTANE 25 MG ORAL TAB,81.5,57.05,,,0
HCPCS,J9999,HYDROXYUREA  500 MG ORAL CAP,25.0,17.5,,,0
HCPCS,J9999,IMATINIB 100 MG ORAL TAB,110.0,77.0,,,0
HCPCS,J9999,IMETELSTAT  47 MG IV SOLR,6725.0,4707.5,,,0
HCPCS,J9999,IMETELSTAT 188 MG IV SOLR,68232.0,47762.4,,,0
HCPCS,J9999,LETROZOLE 2.5 MG ORAL TAB,133.0,93.1,,,0
HCPCS,J9999,MEGESTROL 20 MG ORAL TAB,7.0,4.9,,,0
HCPCS,J9999,MEGESTROL 40 MG ORAL TAB,10.0,7.0,,,0
HCPCS,J9999,MERCAPTOPURINE 50 MG ORAL TAB,46.0,32.2,,,0
HCPCS,J9999,METHOXSALEN 20 MCG/ML INJ SOLN,403.0,282.1,,,0
HCPCS,J9999,MIDOSTAURIN 25 MG ORAL CAP,1203.0,842.1,,,0
HCPCS,J9999,ROPEGINTERFERON ALFA-2B-NJFT 500 MCG/ML SUBQ SYRG,23234.0,16263.8,,,0
HCPCS,J9999,TAMOXIFEN 10 MG ORAL TAB,26.5,18.549999999999997,,,0
HCPCS,J9999,TRETINOIN (CHEMOTHERAPY) 10 MG ORAL CAP,546.0,382.2,,,0
HCPCS,J9999,VENETOCLAX  50 MG ORAL TAB,259.0,181.3,,,0
HCPCS,J9999,VENETOCLAX 10 MG ORAL TAB,94.0,65.8,,,0
HCPCS,J9999,VENETOCLAX 100 MG ORAL TAB,689.0,482.3,,,0
HCPCS,K0001,Standard wheelchair,,,152.83,2001.96,8
HCPCS,K0002,Stnd hemi (low seat) whlchr,,,260.34,3410.16,8
HCPCS,K0003,Lightweight wheelchair,,,285.03,3733.62,8
HCPCS,K0004,High strength ltwt whlchr,,,425.17,5569.3,8
HCPCS,K0005,Ultralightweight wheelchair,,,588.12,7337.74,12
HCPCS,K0006,Heavy duty wheelchair,,,398.99,5226.38,8
HCPCS,K0007,Extra heavy duty wheelchair,,,508.8,6664.74,8
HCPCS,K0010,Stnd wt frame power whlchr,,,1355.29,17752.96,8
HCPCS,K0011,Stnd wt pwr whlchr w control,,,1489.61,19512.4,8
HCPCS,K0012,Ltwt portbl power whlchr,,,913.76,11969.33,8
HCPCS,K0015,Detach non-adj ht armrst rep,,,49.84,621.58,12
HCPCS,K0017,Detach adjust armrest base,,,14.0,174.83,12
HCPCS,K0018,Detach adjust armrst upper,,,7.79,97.68,12
HCPCS,K0019,"Arm pad repl, each",,,4.73,58.97,12
HCPCS,K0020,Fixed adjust armrest pair,,,12.76,158.95,12
HCPCS,K0037,Hi mount flip-up ftrest repl,,,11.48,143.15,12
HCPCS,K0038,Leg strap each,,,6.67,83.01,12
HCPCS,K0039,Leg strap h style each,,,14.82,184.31,12
HCPCS,K0040,Adjustable angle footplate,,,20.42,255.45,12
HCPCS,K0041,Large size footplate each,,,14.57,181.02,12
HCPCS,K0042,Standard size ftplate rep ea,,,9.97,124.63,12
HCPCS,K0043,Ftrst lowr exten tube rep ea,,,5.33,66.79,12
HCPCS,K0044,Ftrst upr hanger brac rep ea,,,4.58,56.93,12
HCPCS,K0045,Ftrst compl assembly repl ea,,,16.03,193.69,12
HCPCS,K0046,Elev lgrst lwr exten repl ea,,,5.33,66.79,12
HCPCS,K0047,Elev legrst upr hangr rep ea,,,21.03,261.61,12
HCPCS,K0050,Ratchet assembly replacement,,,8.88,111.17,12
HCPCS,K0051,Cam rel asm ft/legrst rep ea,,,14.51,179.97,12
HCPCS,K0052,Swingaway detach ftrest repl,,,25.33,316.23,12
HCPCS,K0053,Elevate footrest articulate,,,27.94,348.97,12
HCPCS,K0056,Seat ht <17 or >=21 ltwt wc,,,30.27,377.47,12
HCPCS,K0065,Spoke protectors,,,14.15,176.45,12
HCPCS,K0069,Rr whl compl sol tire rep ea,,,33.12,396.6,12
HCPCS,K0070,Rr whl compl pne tire rep ea,,,58.33,726.97,12
HCPCS,K0071,Fr cstr comp pne tire rep ea,,,34.78,433.6,12
HCPCS,K0072,Fr cstr semi-pne tire rep ea,,,20.91,261.01,12
HCPCS,K0073,Caster pin lock each,,,11.06,138.12,12
HCPCS,K0077,Fr cstr asmb sol tire rep ea,,,18.7,233.57,12
HCPCS,K0098,"Drive belt for pwc, repl",,,7.45,93.1,12
HCPCS,K0105,Iv hanger,,,31.6,394.63,12
HCPCS,K0195,Elevating whlchair leg rests,,,52.21,683.84,8
HCPCS,K0455,Pump uninterrupted infusion,,,744.9,929.28,4
HCPCS,K0552,Sup/ext non-ins inf pump syr,,,8.42,10.51,4
HCPCS,K0601,Repl batt silver oxide 1.5 v,,,3.51,4.38,4
HCPCS,K0602,Repl batt silver oxide 3 v,,,20.24,25.25,4
HCPCS,K0603,Repl batt alkaline 1.5 v,,,1.82,2.27,4
HCPCS,K0604,Repl batt lithium 3.6 v,,,19.36,24.15,4
HCPCS,K0605,Repl batt lithium 4.5 v,,,46.45,57.95,4
HCPCS,K0606,Aed garment w elec analysis,,,7216.28,94526.12,8
HCPCS,K0607,Repl batt for aed,,,61.81,770.89,12
HCPCS,K0608,Repl garment for AED,,,38.63,481.08,12
HCPCS,K0609,Repl electrode for AED,,,2564.56,3552.1,8
HCPCS,K0672,Removable soft interface le,,,104.75,291.78,10
HCPCS,K0730,Ctrl dose inh drug deliv sys,,,548.49,6842.63,12
HCPCS,K0733,12-24hr sealed lead acid,,,8.33,103.35,12
HCPCS,K0738,Portable gas oxygen system,,,156.44,195.16,4
HCPCS,K0800,Pov group 1 std up to 300lbs,,,354.51,4422.45,12
HCPCS,K0801,POV group 1 hd 301-450 lbs,,,571.46,7129.91,12
HCPCS,K0802,POV group 1 vhd 451-600 lbs,,,646.75,8068.75,12
HCPCS,K0806,POV group 2 std up to 300lbs,,,428.84,5349.99,12
HCPCS,K0807,POV group 2 hd 301-450 lbs,,,650.72,8117.97,12
HCPCS,K0808,POV group 2 vhd 451-600 lbs,,,1006.78,12560.18,12
HCPCS,K0813,PWC gp 1 std port seat/back,,,661.51,8665.12,8
HCPCS,K0814,PWC gp 1 std port cap chair,,,846.73,11091.39,8
HCPCS,K0815,PWC gp 1 std seat/back,,,964.24,12630.57,8
HCPCS,K0816,PWC gp 1 std cap chair,,,923.39,12095.55,8
HCPCS,K0820,PWC gp 2 std port seat/back,,,706.54,9254.91,8
HCPCS,K0821,PWC gp 2 std port cap chair,,,907.03,11881.22,8
HCPCS,K0822,PWC gp 2 std seat/back,,,1096.16,14358.63,8
HCPCS,K0823,PWC gp 2 std cap chair,,,1103.34,14452.72,8
HCPCS,K0824,PWC gp 2 hd seat/back,,,1327.93,17394.54,8
HCPCS,K0825,PWC gp 2 hd cap chair,,,1215.64,15923.63,8
HCPCS,K0826,Pwc gp 2 vhd seat/back,,,1719.13,22518.9,8
HCPCS,K0827,Pwc gp vhd cap chair,,,1461.82,19148.46,8
HCPCS,K0828,PWC gp 2 xtra hd seat/back,,,1894.33,24813.81,8
HCPCS,K0829,PWC gp 2 xtra hd cap chair,,,1739.52,22786.03,8
HCPCS,K0835,PWC gp2 std sing pow opt s/b,,,1112.59,14573.79,8
HCPCS,K0836,PWC gp2 std sing pow opt cap,,,1153.76,15113.16,8
HCPCS,K0837,PWC gp 2 hd sing pow opt s/b,,,1327.93,17394.54,8
HCPCS,K0838,PWC gp 2 hd sing pow opt cap,,,1187.97,15561.28,8
HCPCS,K0839,PWC gp2 vhd sing pow opt s/b,,,1719.13,22518.9,8
HCPCS,K0840,PWC gp2 xhd sing pow opt s/b,,,2604.59,34117.52,8
HCPCS,K0841,PWC gp2 std mult pow opt s/b,,,1184.21,15512.02,8
HCPCS,K0842,PWC gp2 std mult pow opt cap,,,1184.21,15512.02,8
HCPCS,K0843,PWC gp2 hd mult pow opt s/b,,,1425.8,18676.53,8
HCPCS,K0848,PWC gp 3 std seat/back,,,1449.07,18981.35,8
HCPCS,K0849,PWC gp 3 std cap chair,,,1393.19,18249.46,8
HCPCS,K0850,PWC gp 3 hd seat/back,,,1680.89,22018.05,8
HCPCS,K0851,PWC gp 3 hd cap chair,,,1616.14,21169.85,8
HCPCS,K0852,PWC gp 3 vhd seat/back,,,1942.17,25440.5,8
HCPCS,K0853,PWC gp 3 vhd cap chair,,,1995.07,26133.48,8
HCPCS,K0854,PWC gp 3 xhd seat/back,,,2643.04,34621.17,8
HCPCS,K0855,PWC gp 3 xhd cap chair,,,2496.75,32704.98,8
HCPCS,K0856,PWC gp3 std sing pow opt s/b,,,1555.42,20374.46,8
HCPCS,K0857,PWC gp3 std sing pow opt cap,,,1586.6,20782.89,8
HCPCS,K0858,PWC gp3 hd sing pow opt s/b,,,1929.81,25278.56,8
HCPCS,K0859,PWC gp3 hd sing pow opt cap,,,1840.45,24108.08,8
HCPCS,K0860,PWC gp3 vhd sing pow opt s/b,,,2757.0,36113.93,8
HCPCS,K0861,PWC gp3 std mult pow opt s/b,,,1557.94,20407.39,8
HCPCS,K0862,PWC gp3 hd mult pow opt s/b,,,1929.81,25278.56,8
HCPCS,K0863,PWC gp3 vhd mult pow opt s/b,,,2757.0,37625.93,8
HCPCS,K0864,PWC gp3 xhd mult pow opt s/b,,,3280.85,42975.95,8
HCPCS,L0112,Cranial cervical orthosis,,,1729.24,4815.91,10
HCPCS,L0113,Cranial cervical torticollis,,,352.36,1011.87,10
HCPCS,L0120,Cerv flex n/adj foam pre ots,,,30.5,84.9,10
HCPCS,L0130,Flex thermoplastic collar mo,,,187.48,522.13,10
HCPCS,L0140,Cervical semi-rigid adjustab,,,75.05,209.03,10
HCPCS,L0150,Cerv semi-rig adj molded chn,,,124.18,345.83,10
HCPCS,L0160,Cerv sr wire occ/man pre ots,,,239.97,668.3,10
HCPCS,L0170,Cervical collar molded to pt,,,786.01,2189.07,10
HCPCS,L0172,Cerv col sr foam 2pc pre ots,,,161.96,451.03,10
HCPCS,L0174,Cerv sr 2pc thor ext pre ots,,,315.67,879.15,10
HCPCS,L0180,Cer post col occ/man sup adj,,,473.0,1317.33,10
HCPCS,L0190,Cerv collar supp adj cerv ba,,,612.51,1705.84,10
HCPCS,L0200,Cerv col supp adj bar & thor,,,684.43,1906.03,10
HCPCS,L0220,Thor rib belt custom fabrica,,,187.65,522.59,10
HCPCS,L0450,Tlso flex trunk/thor pre ots,,,136.83,556.19,10
HCPCS,L0454,Tlso trnk sj-t9 pre cst,,,428.5,1193.35,10
HCPCS,L0455,Tlso flex trnk sj-t9 pre ots,,,254.02,1261.46,10
HCPCS,L0456,Tlso flex trnk sj-ss pre cst,,,1228.79,3422.22,10
HCPCS,L0457,Tlso flex trnk sj-ss pre ots,,,728.43,3617.61,10
HCPCS,L0458,TLSO 2Mod symphis-xipho pre,,,1101.88,3068.76,10
HCPCS,L0460,Tlso 2 shl symphys-stern cst,,,1240.27,3454.09,10
HCPCS,L0462,TLSO 3Mod sacro-scap pre,,,1542.64,4296.2,10
HCPCS,L0464,TLSO 4Mod sacro-scap pre,,,1836.48,5114.6,10
HCPCS,L0466,Tlso r fram soft ant pre cst,,,491.93,1369.95,10
HCPCS,L0467,Tlso r fram soft pre ots,,,284.88,1448.19,10
HCPCS,L0468,Tlso rig fram pelvic pre cst,,,569.51,1586.09,10
HCPCS,L0469,Tlso rig fram pelvic pre ots,,,362.99,1676.66,10
HCPCS,L0470,TLSO rigid frame pre subclav,,,732.62,2040.37,10
HCPCS,L0472,TLSO rigid frame hyperex pre,,,511.39,1424.23,10
HCPCS,L0480,TLSO rigid plastic custom fa,,,1762.06,4907.35,10
HCPCS,L0482,TLSO rigid lined custom fab,,,1781.97,4962.76,10
HCPCS,L0484,TLSO rigid plastic cust fab,,,2042.14,5687.35,10
HCPCS,L0486,TLSO rigidlined cust fab two,,,2203.61,6137.02,10
HCPCS,L0488,TLSO rigid lined pre one pie,,,1240.27,3454.09,10
HCPCS,L0490,TLSO rigid plastic pre one,,,349.48,973.31,10
HCPCS,L0491,TLSO 2 piece rigid shell,,,948.87,2642.6,10
HCPCS,L0492,TLSO 3 piece rigid shell,,,614.96,1712.68,10
HCPCS,L0621,Sio flex pelvic/sacr pre ots,,,72.14,319.67,10
HCPCS,L0622,Sio flex pelvisacral custom,,,296.87,826.76,10
HCPCS,L0625,Lo flex l1-below l5 pre ots,,,40.36,189.6,10
HCPCS,L0626,Lo sag rig pnl stays pre cst,,,96.31,268.23,10
HCPCS,L0627,Lo sag ri an/pos pnl pre cst,,,507.88,1414.4,10
HCPCS,L0628,Lso flex no ri stays pre ots,,,61.45,288.64,10
HCPCS,L0630,Lso r post pnl sj-t9 pre cst,,,200.06,557.21,10
HCPCS,L0631,Lso sag r an/pos pnl pre cst,,,1268.37,3532.33,10
HCPCS,L0633,Lso sc r pos/lat pnl pre cst,,,354.31,986.69,10
HCPCS,L0635,Lso sagit rigid panel prefab,,,1222.44,3404.53,10
HCPCS,L0636,Lso sagittal rigid panel cus,,,1657.19,4615.3,10
HCPCS,L0637,Lso sc r ant/pos pnl pre cst,,,1501.02,4180.34,10
HCPCS,L0638,Lso sag-coronal panel custom,,,1629.51,4538.15,10
HCPCS,L0639,Lso s/c shell/panel prefab,,,1501.02,4180.34,10
HCPCS,L0640,Lso s/c shell/panel custom,,,1292.78,3600.37,10
HCPCS,L0641,Lo rig pos pnl l1-l5 pre ots,,,57.1,283.54,10
HCPCS,L0642,Lo sag ri an/pos pnl pre ots,,,301.13,1495.18,10
HCPCS,L0643,Lso sag ctr rigi pos pre ots,,,118.63,589.0,10
HCPCS,L0648,Lso sag r an/pos pnl pre ots,,,752.04,3734.07,10
HCPCS,L0649,Lso sc r pos/lat pnl pre ots,,,210.07,1043.05,10
HCPCS,L0650,Lso sc r ant/pos pnl pre ots,,,870.15,4419.01,10
HCPCS,L0651,LSO sag-co shell pnl pre ots,,,870.15,4419.01,10
HCPCS,L0700,Ctlso a-p-l control molded,,,2358.12,6567.41,10
HCPCS,L0710,Ctlso a-p-l control w/ inter,,,2540.31,7074.76,10
HCPCS,L0810,Halo cervical into jckt vest,,,3147.13,8764.76,10
HCPCS,L0820,Halo cervical into body jack,,,2654.79,7393.57,10
HCPCS,L0830,Halo cerv into milwaukee typ,,,4253.6,11846.22,10
HCPCS,L0859,MRI compatible system,,,1866.53,5198.29,10
HCPCS,L0861,Halo repl liner/interface,,,266.31,741.67,10
HCPCS,L0970,Tlso corset front,,,167.07,465.28,10
HCPCS,L0972,Lso corset front,,,152.77,425.48,10
HCPCS,L0974,Tlso full corset,,,230.94,643.2,10
HCPCS,L0976,Lso full corset,,,216.26,602.31,10
HCPCS,L0978,Axillary crutch extension,,,226.58,631.0,10
HCPCS,L0980,Peroneal straps pair pre ots,,,26.75,74.5,10
HCPCS,L0982,Stocking sup grips 4 pre ots,,,24.95,69.48,10
HCPCS,L0984,Protect body sock ea pre ots,,,69.77,194.33,10
HCPCS,L1000,Ctlso milwauke initial model,,,2536.39,7063.88,10
HCPCS,L1005,Tension based scoliosis orth,,,3954.38,11012.95,10
HCPCS,L1010,Ctlso axilla sling,,,90.9,253.11,10
HCPCS,L1020,Kyphosis pad,,,125.95,350.71,10
HCPCS,L1025,Kyphosis pad floating,,,143.3,399.05,10
HCPCS,L1030,Lumbar bolster pad,,,97.47,271.44,10
HCPCS,L1040,Lumbar or lumbar rib pad,,,101.89,283.84,10
HCPCS,L1050,Sternal pad,,,123.34,343.49,10
HCPCS,L1060,Thoracic pad,,,119.7,333.36,10
HCPCS,L1070,Trapezius sling,,,117.1,326.03,10
HCPCS,L1080,Outrigger,,,65.87,183.44,10
HCPCS,L1085,Outrigger bil w/ vert extens,,,198.91,553.96,10
HCPCS,L1090,Lumbar sling,,,117.8,328.07,10
HCPCS,L1100,Ring flange plastic/leather,,,203.03,565.41,10
HCPCS,L1110,Ring flange plas/leather mol,,,296.08,824.61,10
HCPCS,L1120,Covers for upright each,,,53.66,149.46,10
HCPCS,L1200,Furnsh initial orthosis only,,,2070.7,5766.92,10
HCPCS,L1210,Lateral thoracic extension,,,300.68,837.38,10
HCPCS,L1220,Anterior thoracic extension,,,290.99,810.39,10
HCPCS,L1230,Milwaukee type superstructur,,,653.22,1819.2,10
HCPCS,L1240,Lumbar derotation pad,,,96.35,268.34,10
HCPCS,L1250,Anterior asis pad,,,93.47,260.33,10
HCPCS,L1260,Anterior thoracic derotation,,,94.04,261.95,10
HCPCS,L1270,Abdominal pad,,,90.43,251.82,10
HCPCS,L1280,Rib gusset (elastic) each,,,99.14,276.05,10
HCPCS,L1290,Lateral trochanteric pad,,,90.32,251.52,10
HCPCS,L1300,Body jacket mold to patient,,,2212.58,6162.04,10
HCPCS,L1310,Post-operative body jacket,,,2131.4,5936.0,10
HCPCS,L1600,Ho flex frejka w/cov pre cst,,,197.44,549.84,10
HCPCS,L1610,Ho frejka cov only pre cst,,,52.32,145.68,10
HCPCS,L1620,Ho flex pavlik harns pre cst,,,153.96,428.77,10
HCPCS,L1630,Abduct control hip semi-flex,,,194.72,542.28,10
HCPCS,L1640,Pelv band/spread bar thigh c,,,610.6,1700.47,10
HCPCS,L1650,HO abduction hip adjustable,,,280.4,780.95,10
HCPCS,L1652,HO bi thighcuffs w sprdr bar,,,440.44,1226.57,10
HCPCS,L1660,HO abduction static plastic,,,262.21,730.26,10
HCPCS,L1680,Pelvic & hip control thigh c,,,1655.15,4609.63,10
HCPCS,L1685,Post-op hip abduct custom fa,,,1366.86,3806.69,10
HCPCS,L1686,HO post-op hip abduction,,,1048.22,2919.29,10
HCPCS,L1690,Combination bilateral HO,,,2389.17,6653.75,10
HCPCS,L1700,Leg perthes orth toronto typ,,,1971.13,5489.58,10
HCPCS,L1710,Legg perthes orth newington,,,2534.68,7059.11,10
HCPCS,L1720,Legg perthes orthosis trilat,,,1880.37,5236.77,10
HCPCS,L1730,Legg perthes orth scottish r,,,1488.44,4145.34,10
HCPCS,L1755,Legg perthes patten bottom t,,,1819.35,5066.83,10
HCPCS,L1810,Ko elastic with joints,,,122.9,342.32,10
HCPCS,L1812,Ko elastic w/joints pre ots,,,70.12,361.82,10
HCPCS,L1820,Ko elas w/ condyle pads & jo,,,165.33,460.44,10
HCPCS,L1830,Ko immob canvas long pre ots,,,63.18,279.95,10
HCPCS,L1831,Knee orth pos locking joint,,,363.62,1012.74,10
HCPCS,L1832,Ko adj jnt pos r sup pre cst,,,698.63,1945.68,10
HCPCS,L1833,Ko adj jnt pos r sup pre ots,,,455.16,2056.77,10
HCPCS,L1834,Ko w/0 joint rigid molded to,,,892.02,2484.25,10
HCPCS,L1836,Ko rigid w/o joints pre ots,,,89.34,459.04,10
HCPCS,L1840,Ko derot ant cruciate custom,,,1298.28,3615.72,10
HCPCS,L1843,Ko single upright pre cst,,,1108.58,3087.35,10
HCPCS,L1844,Ko w/adj jt rot cntrl molded,,,1917.72,5340.8,10
HCPCS,L1845,Ko double upright pre cst,,,1076.32,2997.54,10
HCPCS,L1846,Ko w adj flex/ext rotat mold,,,1348.79,3756.34,10
HCPCS,L1847,Ko dbl upright w/air pre cst,,,710.64,1979.09,10
HCPCS,L1848,Ko dbl upright w/air pre ots,,,710.64,2092.08,10
HCPCS,L1850,Ko swedish type pre ots,,,205.78,1065.2,10
HCPCS,L1851,Ko single upright prefab ots,,,600.78,3273.29,10
HCPCS,L1852,Ko double upright prefab ots,,,573.13,3178.11,10
HCPCS,L1860,Ko supracondylar socket mold,,,1256.72,3499.98,10
HCPCS,L1900,Afo sprng wir drsflx calf bd,,,398.09,1108.71,10
HCPCS,L1902,Afo ankle gauntlet pre ots,,,122.31,340.62,10
HCPCS,L1904,Afo molded ankle gauntlet,,,540.36,1504.93,10
HCPCS,L1906,Afo multilig ank sup pre ots,,,138.2,384.88,10
HCPCS,L1907,AFO supramalleolar custom,,,695.21,1936.19,10
HCPCS,L1910,Afo sing bar clasp attach sh,,,346.21,964.2,10
HCPCS,L1920,Afo sing upright w/ adjust s,,,415.96,1158.42,10
HCPCS,L1930,Afo plastic,,,362.45,1009.45,10
HCPCS,L1932,Afo rig ant tib prefab TCF/=,,,1102.55,3070.49,10
HCPCS,L1940,Afo molded to patient plasti,,,581.88,1620.49,10
HCPCS,L1945,Afo molded plas rig ant tib,,,1063.73,2962.5,10
HCPCS,L1950,Afo spiral molded to pt plas,,,858.83,2391.87,10
HCPCS,L1951,AFO spiral prefabricated,,,1037.61,2889.73,10
HCPCS,L1960,Afo pos solid ank plastic mo,,,636.95,1773.88,10
HCPCS,L1970,Afo plastic molded w/ankle j,,,817.68,2277.22,10
HCPCS,L1971,"AFO w/ankle joint, prefab",,,579.11,1612.81,10
HCPCS,L1980,Afo sing solid stirrup calf,,,440.87,1227.74,10
HCPCS,L1990,Afo doub solid stirrup calf,,,512.22,1426.53,10
HCPCS,L2000,Kafo sing fre stirr thi/calf,,,1165.54,3246.04,10
HCPCS,L2005,KAFO sng/dbl mechanical act,,,5062.71,14099.63,10
HCPCS,L2010,Kafo sng solid stirrup w/o j,,,1138.18,3169.83,10
HCPCS,L2020,Kafo dbl solid stirrup band/,,,1341.77,3736.83,10
HCPCS,L2030,Kafo dbl solid stirrup w/o j,,,1176.93,3277.75,10
HCPCS,L2034,Kafo pla sin up w/wo k/a cus,,,2594.53,7225.73,10
HCPCS,L2035,KAFO plastic pediatric size,,,214.05,596.11,10
HCPCS,L2036,Kafo plas doub free knee mol,,,2240.26,6239.12,10
HCPCS,L2037,Kafo plas sing free knee mol,,,1913.97,5330.4,10
HCPCS,L2038,Kafo w/o joint multi-axis an,,,1642.94,4575.58,10
HCPCS,L2040,Hkafo torsion bil rot straps,,,204.02,568.17,10
HCPCS,L2050,Hkafo torsion cable hip pelv,,,649.33,1808.39,10
HCPCS,L2060,Hkafo torsion ball bearing j,,,751.28,2092.27,10
HCPCS,L2070,Hkafo torsion unilat rot str,,,155.7,433.57,10
HCPCS,L2080,Hkafo unilat torsion cable,,,441.61,1229.94,10
HCPCS,L2090,Hkafo unilat torsion ball br,,,535.22,1490.57,10
HCPCS,L2106,Afo tib fx cast plaster mold,,,961.61,2678.02,10
HCPCS,L2108,Afo tib fx cast molded to pt,,,1335.93,3720.5,10
HCPCS,L2112,Afo tibial fracture soft,,,650.87,1812.74,10
HCPCS,L2114,Afo tib fx semi-rigid,,,753.46,2098.47,10
HCPCS,L2116,Afo tibial fracture rigid,,,902.69,2514.0,10
HCPCS,L2126,Kafo fem fx cast thermoplas,,,1376.03,3832.2,10
HCPCS,L2128,Kafo fem fx cast molded to p,,,1970.44,5487.65,10
HCPCS,L2132,Kafo femoral fx cast soft,,,1045.73,2912.38,10
HCPCS,L2134,Kafo fem fx cast semi-rigid,,,1307.92,3642.56,10
HCPCS,L2136,Kafo femoral fx cast rigid,,,1480.79,4123.94,10
HCPCS,L2180,Plas shoe insert w ank joint,,,179.43,499.72,10
HCPCS,L2182,Drop lock knee,,,131.81,367.15,10
HCPCS,L2184,Limited motion knee joint,,,171.28,477.0,10
HCPCS,L2186,Adj motion knee jnt lerman t,,,173.0,481.8,10
HCPCS,L2188,Quadrilateral brim,,,402.57,1121.11,10
HCPCS,L2190,Waist belt,,,115.04,320.43,10
HCPCS,L2192,Pelvic band & belt thigh fla,,,453.23,1262.22,10
HCPCS,L2200,Limited ankle motion ea jnt,,,72.84,202.87,10
HCPCS,L2210,Dorsiflexion assist each joi,,,77.24,215.12,10
HCPCS,L2220,Dorsi & plantar flex ass/res,,,100.4,279.57,10
HCPCS,L2230,Split flat caliper stirr & p,,,92.77,258.4,10
HCPCS,L2232,"Rocker bottom, contact AFO",,,119.38,332.45,10
HCPCS,L2240,Round caliper and plate atta,,,96.11,267.62,10
HCPCS,L2250,Foot plate molded stirrup at,,,408.31,1137.18,10
HCPCS,L2260,Reinforced solid stirrup,,,237.72,662.07,10
HCPCS,L2265,Long tongue stirrup,,,180.44,502.51,10
HCPCS,L2270,Varus/valgus strap padded/li,,,61.71,171.88,10
HCPCS,L2275,Plastic mod low ext pad/line,,,150.13,418.14,10
HCPCS,L2280,Molded inner boot,,,520.33,1449.14,10
HCPCS,L2300,Abduction bar jointed adjust,,,412.52,1148.86,10
HCPCS,L2310,Abduction bar-straight,,,188.49,524.93,10
HCPCS,L2320,Non-molded lacer,,,257.98,718.35,10
HCPCS,L2330,Lacer molded to patient mode,,,478.23,1331.85,10
HCPCS,L2335,Anterior swing band,,,261.05,727.01,10
HCPCS,L2340,Pre-tibial shell molded to p,,,636.87,1773.65,10
HCPCS,L2350,Prosthetic type socket molde,,,1091.08,3038.67,10
HCPCS,L2360,Extended steel shank,,,79.27,220.79,10
HCPCS,L2370,Patten bottom,,,337.23,939.18,10
HCPCS,L2375,Torsion ank & half solid sti,,,173.12,482.14,10
HCPCS,L2380,Torsion straight knee joint,,,188.63,525.31,10
HCPCS,L2385,Straight knee joint heavy du,,,198.72,553.43,10
HCPCS,L2387,Add le poly knee custom kafo,,,190.18,529.65,10
HCPCS,L2390,Offset knee joint each,,,125.79,350.33,10
HCPCS,L2395,Offset knee joint heavy duty,,,239.73,667.62,10
HCPCS,L2397,Suspension sleeve lower ext,,,134.68,375.09,10
HCPCS,L2405,Knee joint drop lock ea jnt,,,107.73,300.02,10
HCPCS,L2415,Knee joint cam lock each joi,,,150.07,417.99,10
HCPCS,L2425,Knee disc/dial lock/adj flex,,,177.11,493.18,10
HCPCS,L2430,Knee jnt ratchet lock ea jnt,,,177.11,493.18,10
HCPCS,L2492,Knee lift loop drop lock rin,,,130.79,364.28,10
HCPCS,L2500,Thi/glut/ischia wgt bearing,,,422.73,1177.28,10
HCPCS,L2510,Th/wght bear quad-lat brim m,,,958.79,2670.23,10
HCPCS,L2520,Th/wght bear quad-lat brim c,,,605.28,1685.69,10
HCPCS,L2525,Th/wght bear nar m-l brim mo,,,1400.77,3901.15,10
HCPCS,L2526,Th/wght bear nar m-l brim cu,,,787.09,2192.02,10
HCPCS,L2530,Thigh/wght bear lacer non-mo,,,272.2,758.12,10
HCPCS,L2540,Thigh/wght bear lacer molded,,,516.79,1439.2,10
HCPCS,L2550,Thigh/wght bear high roll cu,,,330.04,919.14,10
HCPCS,L2570,Hip clevis type 2 posit jnt,,,729.78,2032.43,10
HCPCS,L2580,Pelvic control pelvic sling,,,533.32,1485.28,10
HCPCS,L2600,Hip clevis/thrust bearing fr,,,314.68,876.36,10
HCPCS,L2610,Hip clevis/thrust bearing lo,,,372.09,1036.25,10
HCPCS,L2620,Pelvic control hip heavy dut,,,359.52,1001.25,10
HCPCS,L2622,Hip joint adjustable flexion,,,469.85,1308.52,10
HCPCS,L2624,Hip adj flex ext abduct cont,,,408.59,1137.93,10
HCPCS,L2627,Plastic mold recipro hip & c,,,1969.94,5486.25,10
HCPCS,L2628,Metal frame recipro hip & ca,,,1925.23,5361.74,10
HCPCS,L2630,Pelvic control band & belt u,,,336.48,937.1,10
HCPCS,L2640,Pelvic control band & belt b,,,442.33,1231.94,10
HCPCS,L2650,Pelv & thor control gluteal,,,166.13,462.67,10
HCPCS,L2660,Thoracic control thoracic ba,,,258.68,720.43,10
HCPCS,L2670,Thorac cont paraspinal uprig,,,261.36,727.88,10
HCPCS,L2680,Thorac cont lat support upri,,,239.76,667.74,10
HCPCS,L2750,Plating chrome/nickel pr bar,,,126.3,351.73,10
HCPCS,L2755,Carbon graphite lamination,,,161.48,449.71,10
HCPCS,L2760,Extension per extension per,,,93.09,259.27,10
HCPCS,L2768,Ortho sidebar disconnect,,,160.94,448.31,10
HCPCS,L2780,Non-corrosive finish,,,77.77,216.59,10
HCPCS,L2785,Drop lock retainer each,,,36.42,101.42,10
HCPCS,L2795,Knee control full kneecap,,,112.56,313.4,10
HCPCS,L2800,Knee cap medial or lateral p,,,122.57,341.37,10
HCPCS,L2810,Knee control condylar pad,,,99.9,278.25,10
HCPCS,L2820,Soft interface below knee se,,,99.79,277.91,10
HCPCS,L2830,Soft interface above knee se,,,107.96,300.66,10
HCPCS,L2840,Tibial length sock fx or equ,,,66.94,186.43,10
HCPCS,L2850,Femoral lgth sock fx or equa,,,76.56,213.23,10
HCPCS,L3000,Ft insert ucb berkeley shell,,,388.12,1080.89,10
HCPCS,L3001,Foot insert remov molded spe,,,163.39,455.04,10
HCPCS,L3002,Foot insert plastazote or eq,,,199.51,555.7,10
HCPCS,L3003,Foot insert silicone gel eac,,,215.28,599.51,10
HCPCS,L3010,Foot longitudinal arch suppo,,,215.28,599.51,10
HCPCS,L3020,Foot longitud/metatarsal sup,,,245.12,682.63,10
HCPCS,L3030,Foot arch support remov prem,,,94.3,262.56,10
HCPCS,L3040,Ft arch suprt premold longit,,,58.14,161.9,10
HCPCS,L3050,Foot arch supp premold metat,,,58.14,161.9,10
HCPCS,L3060,Foot arch supp longitud/meta,,,91.13,253.79,10
HCPCS,L3070,Arch suprt att to sho longit,,,39.27,109.39,10
HCPCS,L3080,Arch supp att to shoe metata,,,39.27,109.39,10
HCPCS,L3090,Arch supp att to shoe long/m,,,50.31,140.12,10
HCPCS,L3100,Hallus-valgus nt dyn pre ots,,,53.41,148.74,10
HCPCS,L3140,Abduction rotation bar shoe,,,110.03,306.37,10
HCPCS,L3150,Abduct rotation bar w/o shoe,,,100.56,280.02,10
HCPCS,L3170,Foot plas heel stabi pre ots,,,62.84,175.09,10
HCPCS,L3224,Woman's shoe oxford brace,,,67.57,188.21,10
HCPCS,L3225,Man's shoe oxford brace,,,79.22,220.64,10
HCPCS,L3300,Sho lift taper to metatarsal,,,64.41,179.4,10
HCPCS,L3310,Shoe lift elev heel/sole neo,,,100.56,280.02,10
HCPCS,L3330,Lifts elevation metal extens,,,699.23,1947.38,10
HCPCS,L3332,Shoe lifts tapered to one-ha,,,91.13,253.79,10
HCPCS,L3334,Shoe lifts elevation heel /i,,,47.13,131.28,10
HCPCS,L3340,Shoe wedge sach,,,105.25,293.21,10
HCPCS,L3350,Shoe heel wedge,,,28.26,78.7,10
HCPCS,L3360,Shoe sole wedge outside sole,,,44.0,122.51,10
HCPCS,L3370,Shoe sole wedge between sole,,,61.28,170.63,10
HCPCS,L3380,Shoe clubfoot wedge,,,61.28,170.63,10
HCPCS,L3390,Shoe outflare wedge,,,61.28,170.63,10
HCPCS,L3400,Shoe metatarsal bar wedge ro,,,50.31,140.12,10
HCPCS,L3410,Shoe metatarsal bar between,,,114.74,319.56,10
HCPCS,L3420,Full sole/heel wedge btween,,,67.55,188.13,10
HCPCS,L3430,Sho heel count plast reinfor,,,197.99,551.43,10
HCPCS,L3440,Heel leather reinforced,,,94.3,262.56,10
HCPCS,L3450,Shoe heel sach cushion type,,,130.4,363.18,10
HCPCS,L3455,Shoe heel new leather standa,,,50.31,140.12,10
HCPCS,L3460,Shoe heel new rubber standar,,,42.41,118.09,10
HCPCS,L3465,Shoe heel thomas with wedge,,,72.28,201.29,10
HCPCS,L3470,Shoe heel thomas extend to b,,,76.99,214.4,10
HCPCS,L3480,Shoe heel pad & depress for,,,76.99,214.4,10
HCPCS,L3500,Ortho shoe add leather insol,,,36.18,100.74,10
HCPCS,L3510,Orthopedic shoe add rub insl,,,36.18,100.74,10
HCPCS,L3520,O shoe add felt w leath insl,,,39.27,109.39,10
HCPCS,L3530,Ortho shoe add half sole,,,39.27,109.39,10
HCPCS,L3540,Ortho shoe add full sole,,,62.84,175.09,10
HCPCS,L3550,O shoe add standard toe tap,,,11.02,30.69,10
HCPCS,L3560,O shoe add horseshoe toe tap,,,28.26,78.7,10
HCPCS,L3570,O shoe add instep extension,,,105.25,293.21,10
HCPCS,L3580,O shoe add instep velcro clo,,,80.14,223.17,10
HCPCS,L3590,O shoe convert to sof counte,,,66.01,183.82,10
HCPCS,L3595,Ortho shoe add march bar,,,51.84,144.36,10
HCPCS,L3600,Trans shoe calip plate exist,,,94.3,262.56,10
HCPCS,L3610,Trans shoe caliper plate new,,,124.12,345.76,10
HCPCS,L3620,Trans shoe solid stirrup exi,,,94.3,262.56,10
HCPCS,L3630,Trans shoe solid stirrup new,,,124.12,345.76,10
HCPCS,L3640,Shoe dennis browne splint bo,,,53.41,148.74,10
HCPCS,L3650,So 8 abd restraint pre ots,,,73.08,203.52,10
HCPCS,L3660,So 8 ab rstr can/web pre ots,,,115.57,321.87,10
HCPCS,L3670,So acro/clav can web pre ots,,,50.11,231.04,10
HCPCS,L3671,SO cap design w/o jnts CF,,,1013.18,2821.69,10
HCPCS,L3674,SO airplane w/wo joint CF,,,1329.12,3816.89,10
HCPCS,L3675,So vest canvas/web pre ots,,,197.33,549.57,10
HCPCS,L3702,EO w/o joints CF,,,324.71,904.25,10
HCPCS,L3710,Eo elas w/metal jnts pre ots,,,167.05,465.2,10
HCPCS,L3720,Forearm/arm cuffs free motio,,,853.15,2376.07,10
HCPCS,L3730,Forearm/arm cuffs ext/flex a,,,1247.88,3475.41,10
HCPCS,L3740,Cuffs adj lock w/ active con,,,1602.37,4462.59,10
HCPCS,L3760,"EO withjoint, Prefabricated",,,562.31,1566.05,10
HCPCS,L3762,Eo rigid w/o joints pre ots,,,120.93,336.76,10
HCPCS,L3763,EWHO rigid w/o jnts CF,,,787.21,2192.4,10
HCPCS,L3764,EWHO w/joint(s) CF,,,855.35,2382.16,10
HCPCS,L3765,EWHFO rigid w/o jnts CF,,,1441.77,4015.34,10
HCPCS,L3766,EWHFO w/joint(s) CF,,,1526.74,4251.93,10
HCPCS,L3806,WHFO w/joint(s) custom fab,,,510.77,1422.49,10
HCPCS,L3807,Whfo w/o joints pre cst,,,281.17,783.03,10
HCPCS,L3808,"WHFO, rigid w/o joints",,,375.75,1046.49,10
HCPCS,L3809,Whfo w/o joints pre ots,,,281.17,827.78,10
HCPCS,L3900,Hinge extension/flex wrist/f,,,1469.84,4093.48,10
HCPCS,L3901,Hinge ext/flex wrist finger,,,1807.05,5032.62,10
HCPCS,L3904,Whfo electric custom fitted,,,3292.96,9170.88,10
HCPCS,L3905,Who w/nontorsion jnt(s) cf,,,1115.05,3105.46,10
HCPCS,L3906,Who w/o joints cf,,,444.32,1237.42,10
HCPCS,L3908,Who cock-up nonmolde pre ots,,,67.37,187.64,10
HCPCS,L3912,Hfo flexion glove pre ots,,,140.19,390.4,10
HCPCS,L3913,HFO w/o joints CF,,,304.55,848.12,10
HCPCS,L3915,Who nontorsion jnts pre cst,,,597.72,1664.64,10
HCPCS,L3916,Who nontorsion jnts pre ots,,,597.72,1759.67,10
HCPCS,L3917,Metacarp fx orthosis pre cst,,,118.75,330.71,10
HCPCS,L3918,Metacarp fx orthosis pre ots,,,118.75,349.61,10
HCPCS,L3919,HO w/o joints CF,,,304.55,848.12,10
HCPCS,L3921,HFO w/joint(s) CF,,,361.14,1005.82,10
HCPCS,L3923,Hfo without joints pre cst,,,97.81,272.42,10
HCPCS,L3924,Hfo without joints pre ots,,,97.81,287.96,10
HCPCS,L3925,Fo pip dip jnt/sprng pre ots,,,60.42,168.21,10
HCPCS,L3927,Fo pip dip no jt spr pre ots,,,39.34,109.58,10
HCPCS,L3929,Hfo nontorsion jnts pre cst,,,103.43,288.04,10
HCPCS,L3930,Hfo nontorsion jnts pre ots,,,103.43,304.48,10
HCPCS,L3931,WHFO nontorsion joint prefab,,,230.98,643.32,10
HCPCS,L3933,FO w/o joints CF,,,239.91,668.23,10
HCPCS,L3935,FO nontorsion joint CF,,,248.46,691.89,10
HCPCS,L3960,Sewho airplan desig abdu pos,,,1007.62,2806.16,10
HCPCS,L3961,Sewho cap design w/o jnts cf,,,1889.14,5261.31,10
HCPCS,L3962,Sewho erbs palsey design abd,,,806.8,2246.95,10
HCPCS,L3967,Sewho airplane w/o jnts cf,,,2230.51,6211.9,10
HCPCS,L3971,Sewho cap design w/jnt(s) cf,,,2117.21,5896.38,10
HCPCS,L3973,Sewho airplane w/jnt(s) cf,,,2230.51,6211.9,10
HCPCS,L3975,Sewhfo cap design w/o jnt cf,,,1889.14,5261.31,10
HCPCS,L3976,Sewhfo airplane w/o jnts cf,,,1889.14,5261.31,10
HCPCS,L3977,Sewhfo cap desgn w/jnt(s) cf,,,2117.21,5896.38,10
HCPCS,L3978,Sewhfo airplane w/jnt(s) cf,,,2230.51,6211.9,10
HCPCS,L3980,Up ext fx orthos humeral nos,,,413.94,1152.82,10
HCPCS,L3981,Ue fx orth shoul cap forearm,,,1131.82,3332.03,10
HCPCS,L3982,Upper ext fx orthosis rad/ul,,,467.12,1300.92,10
HCPCS,L3984,Upper ext fx orthosis wrist,,,406.39,1131.81,10
HCPCS,L3995,Sock fracture or equal each,,,47.94,133.55,10
HCPCS,L4000,Repl girdle milwaukee orth,,,1548.39,4312.26,10
HCPCS,L4010,Replace trilateral socket br,,,791.32,2203.85,10
HCPCS,L4020,Replace quadlat socket brim,,,1157.21,3222.83,10
HCPCS,L4030,Replace socket brim cust fit,,,756.75,2107.58,10
HCPCS,L4040,Replace molded thigh lacer,,,493.23,1373.61,10
HCPCS,L4045,Replace non-molded thigh lac,,,376.94,1049.78,10
HCPCS,L4050,Replace molded calf lacer,,,474.4,1321.22,10
HCPCS,L4055,Replace non-molded calf lace,,,312.94,871.48,10
HCPCS,L4060,Replace high roll cuff,,,365.19,1017.05,10
HCPCS,L4070,Replace prox & dist upright,,,407.08,1133.77,10
HCPCS,L4080,Repl met band kafo-afo prox,,,116.23,323.68,10
HCPCS,L4090,Repl met band kafo-afo calf/,,,131.28,365.68,10
HCPCS,L4100,Repl leath cuff kafo prox th,,,134.81,375.47,10
HCPCS,L4110,Repl leath cuff kafo-afo cal,,,107.83,300.32,10
HCPCS,L4130,Replace pretibial shell,,,664.47,1850.5,10
HCPCS,L4350,Ankle control ortho pre ots,,,105.64,294.2,10
HCPCS,L4360,Pneumat walking boot pre cst,,,318.18,886.11,10
HCPCS,L4361,Pneuma/vac walk boot pre ots,,,318.18,936.72,10
HCPCS,L4370,Pneum full leg splnt pre ots,,,216.94,604.16,10
HCPCS,L4386,Non-pneum walk boot pre cst,,,195.88,545.57,10
HCPCS,L4387,Non-pneum walk boot pre ots,,,195.88,576.71,10
HCPCS,L4392,Replace AFO soft interface,,,29.1,81.04,10
HCPCS,L4394,Replace foot drop spint,,,21.24,59.16,10
HCPCS,L4396,Static or dynami afo pre cst,,,207.4,577.55,10
HCPCS,L4397,Static or dynami afo pre ots,,,207.4,610.55,10
HCPCS,L4398,Foot drop splint pre ots,,,95.45,265.77,10
HCPCS,L4631,"Afo, walk boot type, cus fab",,,1827.5,5248.23,10
HCPCS,L5000,Sho insert w arch toe filler,,,824.75,2296.92,10
HCPCS,L5010,Mold socket ank hgt w/ toe f,,,1872.71,5215.46,10
HCPCS,L5020,Tibial tubercle hgt w/ toe f,,,2813.27,7834.92,10
HCPCS,L5050,Ank symes mold sckt sach ft,,,3541.48,9863.0,10
HCPCS,L5060,Symes met fr leath socket ar,,,4001.69,11144.69,10
HCPCS,L5100,Molded socket shin sach foot,,,3480.09,9692.0,10
HCPCS,L5105,Plast socket jts/thgh lacer,,,4252.97,11844.52,10
HCPCS,L5150,Mold sckt ext knee shin sach,,,5069.47,14118.41,10
HCPCS,L5160,Mold socket bent knee shin s,,,5333.68,14854.27,10
HCPCS,L5200,Kne sing axis fric shin sach,,,4635.37,12909.49,10
HCPCS,L5210,No knee/ankle joints w/ ft b,,,3426.3,9542.19,10
HCPCS,L5220,No knee joint with artic ali,,,4304.46,11987.89,10
HCPCS,L5230,Fem focal defic constant fri,,,5101.97,14208.98,10
HCPCS,L5250,Hip canad sing axi cons fric,,,6907.11,19236.27,10
HCPCS,L5270,Tilt table locking hip sing,,,6563.13,18278.34,10
HCPCS,L5280,Hemipelvect canad sing axis,,,7144.39,19897.05,10
HCPCS,L5301,Bk mold socket sach ft endo,,,3376.36,9403.2,10
HCPCS,L5312,"Knee disart, SACH ft, endo",,,4506.48,12941.55,10
HCPCS,L5321,Ak open end sach,,,4710.53,13118.75,10
HCPCS,L5331,Hip disart canadian sach ft,,,7091.52,19749.82,10
HCPCS,L5341,Hemipelvectomy canadian sach,,,7400.44,20610.15,10
HCPCS,L5400,Postop dress & 1 cast chg bk,,,1745.96,4862.52,10
HCPCS,L5410,Postop dsg bk ea add cast ch,,,682.01,1899.41,10
HCPCS,L5420,Postop dsg & 1 cast chg ak/d,,,2235.96,6227.13,10
HCPCS,L5430,Postop dsg ak ea add cast ch,,,821.42,2287.62,10
HCPCS,L5450,Postop app non-wgt bear dsg,,,665.02,1852.09,10
HCPCS,L5460,Postop app non-wgt bear dsg,,,890.08,2478.85,10
HCPCS,L5500,Init bk ptb plaster direct,,,1756.84,4892.79,10
HCPCS,L5505,Init ak ischal plstr direct,,,2839.14,7907.0,10
HCPCS,L5510,Prep BK ptb plaster molded,,,2088.64,5816.85,10
HCPCS,L5520,Perp BK ptb thermopls direct,,,2347.37,6537.43,10
HCPCS,L5530,Prep BK ptb thermopls molded,,,2425.89,6756.11,10
HCPCS,L5535,Prep BK ptb open end socket,,,2430.65,6769.3,10
HCPCS,L5540,Prep BK ptb laminated socket,,,2606.1,7257.98,10
HCPCS,L5560,Prep AK ischial plast molded,,,3134.29,8728.93,10
HCPCS,L5570,Prep AK ischial direct form,,,3094.56,8618.32,10
HCPCS,L5580,Prep AK ischial thermo mold,,,3455.29,9623.01,10
HCPCS,L5585,Prep AK ischial open end,,,3466.68,9654.69,10
HCPCS,L5590,Prep AK ischial laminated,,,3391.89,9446.37,10
HCPCS,L5595,Hip disartic sach thermopls,,,4929.43,13728.43,10
HCPCS,L5600,Hip disart sach laminat mold,,,5443.57,15160.29,10
HCPCS,L5610,Above knee hydracadence,,,2937.63,8181.32,10
HCPCS,L5611,Ak 4 bar link w/fric swing,,,1972.47,5493.32,10
HCPCS,L5613,Ak 4 bar ling w/hydraul swig,,,3038.19,8461.38,10
HCPCS,L5614,4-bar link above knee w/swng,,,2088.9,5817.57,10
HCPCS,L5616,Ak univ multiplex sys frict,,,2216.96,6174.21,10
HCPCS,L5617,AK/BK self-aligning unit ea,,,692.6,1928.93,10
HCPCS,L5618,Test socket symes,,,369.85,1030.01,10
HCPCS,L5620,Test socket below knee,,,453.81,1263.88,10
HCPCS,L5622,Test socket knee disarticula,,,591.76,1648.04,10
HCPCS,L5624,Test socket above knee,,,593.44,1652.77,10
HCPCS,L5626,Test socket hip disarticulat,,,651.69,1814.97,10
HCPCS,L5628,Test socket hemipelvectomy,,,703.32,1958.76,10
HCPCS,L5629,Below knee acrylic socket,,,518.74,1444.72,10
HCPCS,L5630,Syme typ expandabl wall sckt,,,633.26,1763.63,10
HCPCS,L5631,Ak/knee disartic acrylic soc,,,717.21,1997.43,10
HCPCS,L5632,Symes type ptb brim design s,,,271.83,757.06,10
HCPCS,L5634,Symes type poster opening so,,,372.4,1037.16,10
HCPCS,L5636,Symes type medial opening so,,,311.94,868.76,10
HCPCS,L5637,Below knee total contact,,,471.56,1313.29,10
HCPCS,L5638,Below knee leather socket,,,617.95,1721.03,10
HCPCS,L5639,Below knee wood socket,,,1372.6,3822.68,10
HCPCS,L5640,Knee disarticulat leather so,,,782.83,2180.15,10
HCPCS,L5642,Above knee leather socket,,,782.3,2178.68,10
HCPCS,L5643,Hip flex inner socket ext fr,,,2049.39,5707.54,10
HCPCS,L5644,Above knee wood socket,,,862.59,2402.38,10
HCPCS,L5645,Bk flex inner socket ext fra,,,978.8,2725.95,10
HCPCS,L5646,Below knee cushion socket,,,870.73,2424.95,10
HCPCS,L5647,Below knee suction socket,,,973.84,2712.11,10
HCPCS,L5648,Above knee cushion socket,,,949.75,2645.06,10
HCPCS,L5649,Isch containmt/narrow m-l so,,,2974.58,8284.13,10
HCPCS,L5650,Tot contact ak/knee disart s,,,701.34,1953.16,10
HCPCS,L5651,Ak flex inner socket ext fra,,,1960.29,5459.38,10
HCPCS,L5652,Suction susp ak/knee disart,,,622.71,1734.23,10
HCPCS,L5653,Knee disart expand wall sock,,,729.34,2031.22,10
HCPCS,L5654,Socket insert symes,,,482.61,1344.05,10
HCPCS,L5655,Socket insert below knee,,,375.45,1045.66,10
HCPCS,L5656,Socket insert knee articulat,,,465.36,1295.97,10
HCPCS,L5658,Socket insert above knee,,,445.13,1239.69,10
HCPCS,L5661,Multi-durometer symes,,,745.01,2074.84,10
HCPCS,L5665,Multi-durometer below knee,,,669.92,1865.73,10
HCPCS,L5666,Below knee cuff suspension,,,114.26,318.24,10
HCPCS,L5668,Bk molded distal cushion,,,164.84,459.04,10
HCPCS,L5670,Bk molded supracondylar susp,,,442.94,1233.57,10
HCPCS,L5671,Bk/ak locking mechanism,,,703.88,1960.31,10
HCPCS,L5672,Bk removable medial brim sus,,,365.06,1016.67,10
HCPCS,L5673,Socket insert w lock mech,,,896.9,2497.86,10
HCPCS,L5676,Bk knee joints single axis p,,,577.76,1609.07,10
HCPCS,L5677,Bk knee joints polycentric p,,,804.82,2241.46,10
HCPCS,L5678,Bk joint covers pair,,,64.81,180.5,10
HCPCS,L5679,Socket insert w/o lock mech,,,747.37,2081.46,10
HCPCS,L5680,Bk thigh lacer non-molded,,,399.64,1112.91,10
HCPCS,L5681,Intl custm cong/latyp insert,,,1628.34,4534.94,10
HCPCS,L5682,Bk thigh lacer glut/ischia m,,,781.15,2175.54,10
HCPCS,L5683,Initial custom socket insert,,,1628.34,4534.94,10
HCPCS,L5684,Bk fork strap,,,65.9,183.52,10
HCPCS,L5685,Below knee sus/seal sleeve,,,158.53,441.54,10
HCPCS,L5686,Bk back check,,,66.14,184.2,10
HCPCS,L5688,Bk waist belt webbing,,,94.01,261.84,10
HCPCS,L5690,Bk waist belt padded and lin,,,132.07,367.87,10
HCPCS,L5692,Ak pelvic control belt light,,,216.9,604.08,10
HCPCS,L5694,Ak pelvic control belt pad/l,,,296.13,824.72,10
HCPCS,L5695,Ak sleeve susp neoprene/equa,,,266.2,741.37,10
HCPCS,L5696,Ak/knee disartic pelvic join,,,271.74,756.79,10
HCPCS,L5697,Ak/knee disartic pelvic band,,,98.28,273.71,10
HCPCS,L5698,Ak/knee disartic silesian ba,,,146.51,408.05,10
HCPCS,L5699,Shoulder harness,,,228.26,635.72,10
HCPCS,L5700,Replace socket below knee,,,3507.38,9767.97,10
HCPCS,L5701,Replace socket above knee,,,4212.11,11730.66,10
HCPCS,L5702,Replace socket hip,,,5328.96,14841.07,10
HCPCS,L5703,Symes ankle w/o (sach) foot,,,3262.87,9087.04,10
HCPCS,L5704,Custom shape cover bk,,,656.17,1827.37,10
HCPCS,L5705,Custom shape cover ak,,,1172.4,3265.13,10
HCPCS,L5706,Custom shape cvr knee disart,,,1149.3,3200.75,10
HCPCS,L5707,Custom shape cvr hip disart,,,1515.21,4219.8,10
HCPCS,L5710,Kne-shin exo sng axi mnl loc,,,523.99,1459.31,10
HCPCS,L5711,Knee-shin exo mnl lock ultra,,,663.71,1848.5,10
HCPCS,L5712,Knee-shin exo frict swg & st,,,695.57,1937.14,10
HCPCS,L5714,Knee-shin exo variable frict,,,587.64,1636.63,10
HCPCS,L5716,Knee-shin exo mech stance ph,,,1038.73,2892.87,10
HCPCS,L5718,Knee-shin exo frct swg & sta,,,1145.99,3191.57,10
HCPCS,L5722,Knee-shin pneum swg frct exo,,,1114.06,3102.62,10
HCPCS,L5724,Knee-shin exo fluid swing ph,,,2463.86,6861.83,10
HCPCS,L5726,Knee-shin ext jnts fld swg e,,,2839.54,7908.14,10
HCPCS,L5728,Knee-shin fluid swg & stance,,,3033.7,8448.83,10
HCPCS,L5780,Knee-shin pneum/hydra pneum,,,1614.94,4497.6,10
HCPCS,L5781,Lower limb pros vacuum pump,,,4953.14,13794.43,10
HCPCS,L5782,HD low limb pros vacuum pump,,,5221.68,14542.38,10
HCPCS,L5785,Exoskeletal bk ultralt mater,,,709.19,1975.01,10
HCPCS,L5790,Exoskeletal ak ultra-light m,,,1173.68,3268.68,10
HCPCS,L5795,Exoskel hip ultra-light mate,,,1752.61,4881.04,10
HCPCS,L5810,Endoskel knee-shin mnl lock,,,658.08,1832.77,10
HCPCS,L5811,Endo knee-shin mnl lck ultra,,,974.83,2714.87,10
HCPCS,L5812,Endo knee-shin frct swg & st,,,737.66,2054.39,10
HCPCS,L5814,Endo knee-shin hydral swg ph,,,4597.46,12803.88,10
HCPCS,L5816,Endo knee-shin polyc mch sta,,,1186.56,3304.59,10
HCPCS,L5818,Endo knee-shin frct swg & st,,,1189.74,3313.43,10
HCPCS,L5822,Endo knee-shin pneum swg frc,,,2084.77,5806.08,10
HCPCS,L5824,Endo knee-shin fluid swing p,,,2236.51,6228.68,10
HCPCS,L5826,Miniature knee joint,,,3865.87,10766.42,10
HCPCS,L5828,Endo knee-shin fluid swg/sta,,,3457.19,9628.26,10
HCPCS,L5830,Endo knee-shin pneum/swg pha,,,2549.61,7100.65,10
HCPCS,L5840,Multi-axial knee/shin system,,,4294.9,11961.32,10
HCPCS,L5845,Knee-shin sys stance flexion,,,2218.82,6179.36,10
HCPCS,L5848,Knee-shin sys hydraul stance,,,1331.15,3707.24,10
HCPCS,L5850,Endo ak/hip knee extens assi,,,208.81,581.55,10
HCPCS,L5855,Mech hip extension assist,,,420.79,1171.88,10
HCPCS,L5856,Elec knee-shin swing/stance,,,29717.2,82762.16,10
HCPCS,L5857,Elec knee-shin swing only,,,10544.8,29367.2,10
HCPCS,L5858,Stance phase only,,,23006.91,64074.06,10
HCPCS,L5859,Knee-shin pro flex/ext cont,,,17961.29,52878.0,10
HCPCS,L5910,Endo below knee alignable sy,,,591.19,1646.45,10
HCPCS,L5920,Endo ak/hip alignable system,,,866.11,2412.06,10
HCPCS,L5925,Above knee manual lock,,,548.48,1527.5,10
HCPCS,L5930,High activity knee frame,,,4166.69,11604.22,10
HCPCS,L5940,Endo bk ultra-light material,,,818.79,2280.32,10
HCPCS,L5950,Endo ak ultra-light material,,,1269.97,3536.83,10
HCPCS,L5960,Endo hip ultra-light materia,,,1573.63,4382.57,10
HCPCS,L5961,"Endo poly hip, pneu/hyd/rot",,,5837.22,16763.09,10
HCPCS,L5962,Below knee flex cover system,,,776.67,2162.99,10
HCPCS,L5964,Above knee flex cover system,,,1146.54,3193.12,10
HCPCS,L5966,Hip flexible cover system,,,1460.97,4068.79,10
HCPCS,L5968,Multiaxial ankle w dorsiflex,,,4498.47,12528.21,10
HCPCS,L5969,Ak/ft power asst incl motors,,,41759.94,52096.56,4
HCPCS,L5970,Foot external keel sach foot,,,278.64,776.07,10
HCPCS,L5971,"SACH foot, replacement",,,278.64,776.07,10
HCPCS,L5972,Flexible keel foot,,,524.57,1460.86,10
HCPCS,L5973,Ank-foot sys dors-plant flex,,,21297.95,61162.86,10
HCPCS,L5974,Foot single axis ankle/foot,,,324.52,903.76,10
HCPCS,L5975,Combo ankle/foot prosthesis,,,573.92,1598.37,10
HCPCS,L5976,Energy storing foot,,,743.14,2069.63,10
HCPCS,L5978,Ft prosth multiaxial ankl/ft,,,416.66,1160.38,10
HCPCS,L5979,Multi-axial ankle/ft prosth,,,2793.44,7779.69,10
HCPCS,L5980,Flex foot system,,,4801.22,13371.33,10
HCPCS,L5981,Flex-walk sys low ext prosth,,,3666.67,10211.63,10
HCPCS,L5982,Exoskeletal axial rotation u,,,766.26,2134.04,10
HCPCS,L5984,Endoskeletal axial rotation,,,823.06,2292.27,10
HCPCS,L5985,Lwr ext dynamic prosth pylon,,,349.54,973.5,10
HCPCS,L5986,Multi-axial rotation unit,,,818.99,2280.78,10
HCPCS,L5987,Shank ft w vert load pylon,,,8905.25,24801.03,10
HCPCS,L5988,Vertical shock reducing pylo,,,2472.98,6887.24,10
HCPCS,L5990,User adjustable heel height,,,2245.81,6254.61,10
HCPCS,L6000,Part hand thumb rem,,,4090.68,5103.23,4
HCPCS,L6010,Part hand little/ring,,,4115.65,5134.37,4
HCPCS,L6020,Part hand no fingers,,,4093.86,5107.2,4
HCPCS,L6026,Part hand myo exclu term dev,,,4589.94,13512.78,10
HCPCS,L6050,Wrst MLd sck flx hng tri pad,,,2817.16,7845.81,10
HCPCS,L6055,Wrst mold sock w/exp interfa,,,3475.2,9678.43,10
HCPCS,L6100,Elb mold sock flex hinge pad,,,2890.34,8049.55,10
HCPCS,L6110,Elbow mold sock suspension t,,,3068.14,8544.77,10
HCPCS,L6120,Elbow mold doub splt soc ste,,,3459.34,9634.24,10
HCPCS,L6130,Elbow stump activated lock h,,,3205.49,8927.3,10
HCPCS,L6200,Elbow mold outsid lock hinge,,,3900.09,10861.72,10
HCPCS,L6205,Elbow molded w/ expand inter,,,4458.17,12415.98,10
HCPCS,L6250,Elbow inter loc elbow forarm,,,4044.42,11263.72,10
HCPCS,L6300,Shlder disart int lock elbow,,,4870.31,13563.77,10
HCPCS,L6310,Shoulder passive restor comp,,,3910.46,10890.56,10
HCPCS,L6320,Shoulder passive restor cap,,,2352.61,6551.95,10
HCPCS,L6350,Thoracic intern lock elbow,,,4795.29,13354.85,10
HCPCS,L6360,Thoracic passive restor comp,,,3899.44,10859.94,10
HCPCS,L6370,Thoracic passive restor cap,,,2718.61,7571.34,10
HCPCS,L6380,Postop dsg cast chg wrst/elb,,,1607.09,4475.67,10
HCPCS,L6382,Postop dsg cast chg elb dis/,,,1906.55,5309.77,10
HCPCS,L6384,Postop dsg cast chg shlder/t,,,2363.5,6582.34,10
HCPCS,L6386,Postop ea cast chg & realign,,,547.3,1524.21,10
HCPCS,L6388,Postop applicat rigid dsg on,,,611.64,1703.42,10
HCPCS,L6400,Below elbow prosth tiss shap,,,3070.68,8551.8,10
HCPCS,L6450,Elb disart prosth tiss shap,,,3774.46,10511.84,10
HCPCS,L6500,Above elbow prosth tiss shap,,,3808.49,10606.6,10
HCPCS,L6550,Shldr disar prosth tiss shap,,,4668.36,13001.35,10
HCPCS,L6570,Scap thorac prosth tiss shap,,,5358.37,14923.02,10
HCPCS,L6580,Wrist/elbow bowden cable mol,,,2011.74,5602.68,10
HCPCS,L6582,Wrist/elbow bowden cbl dir f,,,1865.69,5195.91,10
HCPCS,L6584,Elbow fair lead cable molded,,,2725.54,7590.58,10
HCPCS,L6586,Elbow fair lead cable dir fo,,,2681.6,7468.26,10
HCPCS,L6588,Shdr fair lead cable molded,,,3691.92,10281.98,10
HCPCS,L6590,Shdr fair lead cable direct,,,3620.76,10083.79,10
HCPCS,L6600,Polycentric hinge pair,,,306.19,852.73,10
HCPCS,L6605,Single pivot hinge pair,,,302.33,842.0,10
HCPCS,L6610,Flexible metal hinge pair,,,247.59,689.59,10
HCPCS,L6611,"Additional switch, ext power",,,509.68,1419.47,10
HCPCS,L6615,Disconnect locking wrist uni,,,237.69,661.95,10
HCPCS,L6616,Disconnect insert locking wr,,,101.03,281.35,10
HCPCS,L6620,Flexion/extension wrist unit,,,410.7,1143.79,10
HCPCS,L6621,Flex/ext wrist w/wo friction,,,2831.48,7885.65,10
HCPCS,L6623,Spring-ass rot wrst w/ latch,,,824.65,2296.61,10
HCPCS,L6624,Flex/ext/rotation wrist unit,,,4662.11,12983.88,10
HCPCS,L6625,Rotation wrst w/ cable lock,,,868.15,2417.8,10
HCPCS,L6628,Quick disconn hook adapter o,,,631.93,1760.01,10
HCPCS,L6629,Lamination collar w/ couplin,,,217.28,605.14,10
HCPCS,L6630,Stainless steel any wrist,,,351.8,979.78,10
HCPCS,L6632,Latex suspension sleeve each,,,79.54,221.51,10
HCPCS,L6635,Lift assist for elbow,,,270.85,754.34,10
HCPCS,L6637,Nudge control elbow lock,,,527.81,1469.89,10
HCPCS,L6638,Elec lock on manual pw elbow,,,3095.69,8621.42,10
HCPCS,L6640,Shoulder abduction joint pai,,,441.57,1229.86,10
HCPCS,L6641,Excursion amplifier pulley t,,,238.81,665.05,10
HCPCS,L6642,Excursion amplifier lever ty,,,284.29,791.87,10
HCPCS,L6645,Shoulder flexion-abduction j,,,493.1,1373.24,10
HCPCS,L6646,Multipo locking shoulder jnt,,,3904.35,10873.59,10
HCPCS,L6647,Shoulder lock actuator,,,642.79,1790.13,10
HCPCS,L6648,Ext pwrd shlder lock/unlock,,,4026.82,11214.62,10
HCPCS,L6650,Shoulder universal joint,,,517.73,1441.88,10
HCPCS,L6655,Standard control cable extra,,,113.34,315.71,10
HCPCS,L6660,Heavy duty control cable,,,126.38,351.92,10
HCPCS,L6665,Teflon or equal cable lining,,,75.17,209.37,10
HCPCS,L6670,Hook to hand cable adapter,,,78.28,217.99,10
HCPCS,L6672,Harness chest/shlder saddle,,,217.81,606.65,10
HCPCS,L6675,Harness figure of 8 sing con,,,152.75,425.4,10
HCPCS,L6676,Harness figure of 8 dual con,,,160.58,447.17,10
HCPCS,L6677,UE triple control harness,,,367.25,1022.75,10
HCPCS,L6680,Test sock wrist disart/bel e,,,378.71,1054.73,10
HCPCS,L6682,Test sock elbw disart/above,,,370.84,1032.73,10
HCPCS,L6684,Test socket shldr disart/tho,,,426.74,1188.47,10
HCPCS,L6686,Suction socket,,,793.42,2209.64,10
HCPCS,L6687,Frame typ socket bel elbow/w,,,706.16,1966.66,10
HCPCS,L6688,Frame typ sock above elb/dis,,,834.62,2324.4,10
HCPCS,L6689,Frame typ socket shoulder di,,,873.35,2432.28,10
HCPCS,L6690,Frame typ sock interscap-tho,,,947.61,2639.12,10
HCPCS,L6691,Removable insert each,,,422.6,1176.94,10
HCPCS,L6692,Silicone gel insert or equal,,,871.1,2425.97,10
HCPCS,L6693,Lockingelbow forearm cntrbal,,,3514.41,9787.63,10
HCPCS,L6694,Elbow socket ins use w/lock,,,896.9,2497.86,10
HCPCS,L6695,Elbow socket ins use w/o lck,,,747.37,2081.46,10
HCPCS,L6696,Cus elbo skt in for con/atyp,,,1628.34,4534.94,10
HCPCS,L6697,Cus elbo skt in not con/atyp,,,1628.34,4534.94,10
HCPCS,L6698,Below/above elbow lock mech,,,703.88,1960.31,10
HCPCS,L6703,"Term dev, passive hand mitt",,,404.88,1127.61,10
HCPCS,L6704,"Term dev, sport/rec/work att",,,949.5,2644.34,10
HCPCS,L6706,Term dev mech hook vol open,,,492.59,1371.88,10
HCPCS,L6707,Term dev mech hook vol close,,,1752.8,4881.49,10
HCPCS,L6708,Term dev mech hand vol open,,,1178.02,3280.78,10
HCPCS,L6709,Term dev mech hand vol close,,,1728.38,4813.53,10
HCPCS,L6711,"Ped term dev, hook, vol open",,,832.27,2317.86,10
HCPCS,L6712,"Ped term dev, hook, vol clos",,,1532.4,4267.7,10
HCPCS,L6713,"Ped term dev, hand, vol open",,,1933.98,5386.2,10
HCPCS,L6714,"Ped term dev, hand, vol clos",,,1638.09,4562.08,10
HCPCS,L6715,"Term device, multi art digit",,,3908.27,11223.73,10
HCPCS,L6721,"Hook/hand, hvy dty, vol open",,,2911.54,8108.59,10
HCPCS,L6722,"Hook/hand, hvy dty, vol clos",,,2509.94,6990.17,10
HCPCS,L6805,Term dev modifier wrist unit,,,520.97,1450.84,10
HCPCS,L6810,Term dev precision pinch dev,,,304.48,848.01,10
HCPCS,L6880,Elec hand ind art digits,,,29576.84,84938.0,10
HCPCS,L6881,Term dev auto grasp feature,,,5060.9,14094.56,10
HCPCS,L6882,Microprocessor control uplmb,,,3838.95,10691.43,10
HCPCS,L6883,Replc sockt below e/w disa,,,2284.39,6362.12,10
HCPCS,L6884,Replc sockt above elbow disa,,,3428.45,9548.24,10
HCPCS,L6885,Replc sockt shldr dis/interc,,,3899.44,10859.94,10
HCPCS,L6890,Prefab glove for term device,,,225.71,628.54,10
HCPCS,L6895,Custom glove for term device,,,683.61,1903.83,10
HCPCS,L6900,Hand restorat thumb/1 finger,,,1892.87,5271.66,10
HCPCS,L6905,Hand restoration multiple fi,,,1797.45,5005.89,10
HCPCS,L6910,Hand restoration no fingers,,,1771.25,4932.86,10
HCPCS,L6915,Hand restoration replacmnt g,,,766.41,2134.45,10
HCPCS,L6920,Wrist disarticul switch ctrl,,,8971.39,24985.27,10
HCPCS,L6925,Wrist disart myoelectronic c,,,9473.02,26382.28,10
HCPCS,L6930,Below elbow switch control,,,9631.82,26824.62,10
HCPCS,L6935,Below elbow myoelectronic ct,,,10594.92,29506.79,10
HCPCS,L6940,Elbow disarticulation switch,,,12037.72,33524.97,10
HCPCS,L6945,Elbow disart myoelectronic c,,,13617.48,37924.55,10
HCPCS,L6950,Above elbow switch control,,,12798.41,35643.47,10
HCPCS,L6955,Above elbow myoelectronic ct,,,16060.21,44727.57,10
HCPCS,L6960,Shldr disartic switch contro,,,15836.16,44103.64,10
HCPCS,L6965,Shldr disartic myoelectronic,,,23134.38,64429.08,10
HCPCS,L6970,Interscapular-thor switch ct,,,23514.53,65487.78,10
HCPCS,L6975,Interscap-thor myoelectronic,,,23640.73,65839.28,10
HCPCS,L7007,Adult electric hand,,,5616.95,15643.19,10
HCPCS,L7008,Pediatric electric hand,,,8840.49,24620.69,10
HCPCS,L7009,Adult electric hook,,,5731.07,15960.97,10
HCPCS,L7040,Prehensile actuator,,,4601.82,12816.05,10
HCPCS,L7045,Pediatric electric hook,,,2638.38,7347.9,10
HCPCS,L7170,Electronic elbow hosmer swit,,,9571.18,26655.65,10
HCPCS,L7180,Electronic elbow sequential,,,50007.15,139269.6,10
HCPCS,L7181,Electronic elbo simultaneous,,,49600.83,138138.02,10
HCPCS,L7185,Electron elbow adolescent sw,,,9692.1,26992.41,10
HCPCS,L7186,Electron elbow child switch,,,13988.06,38956.64,10
HCPCS,L7190,Elbow adolescent myoelectron,,,12331.36,34342.74,10
HCPCS,L7191,Elbow child myoelectronic ct,,,14868.87,41409.67,10
HCPCS,L7259,Electronic wrist rotator any,,,4700.78,13839.07,10
HCPCS,L7360,Six volt bat otto bock/eq ea,,,294.78,821.02,10
HCPCS,L7362,Battery chrgr six volt otto,,,354.56,987.41,10
HCPCS,L7364,Twelve volt battery utah/equ,,,645.85,1798.71,10
HCPCS,L7366,Battery chrgr 12 volt utah/e,,,876.17,2440.14,10
HCPCS,L7367,Replacemnt lithium ionbatter,,,481.93,1342.2,10
HCPCS,L7368,Lithium ion battery charger,,,624.79,1740.01,10
HCPCS,L7400,"Add ue prost be/wd, ultlite",,,379.41,1056.62,10
HCPCS,L7401,Add ue prost a/e ultlite mat,,,424.75,1182.88,10
HCPCS,L7402,Add ue prost s/d ultlite mat,,,458.68,1277.41,10
HCPCS,L7403,Add UE prost b/e acrylic,,,455.88,1269.63,10
HCPCS,L7404,Add UE prost a/e acrylic,,,688.03,1916.16,10
HCPCS,L7405,Add UE prost s/d acrylic,,,899.88,2506.06,10
HCPCS,L7900,Male vacuum erection system,,,1495.7,1865.92,4
HCPCS,L7902,"Tension ring, vac erect dev",,,54.96,68.57,4
HCPCS,L8000,Mastectomy bra,,,45.92,127.92,10
HCPCS,L8001,Breast prosthesis bra & form,,,155.27,432.39,10
HCPCS,L8002,Brst prsth bra & bilat form,,,204.23,568.81,10
HCPCS,L8015,Ext breastprosthesis garment,,,74.19,206.65,10
HCPCS,L8020,Mastectomy form,,,278.14,774.67,10
HCPCS,L8030,Breast prosthes w/o adhesive,,,408.38,1137.33,10
HCPCS,L8031,Breast prosthesis w adhesive,,,408.38,1172.75,10
HCPCS,L8032,Reusable nipple prosthesis,,,48.49,139.26,10
HCPCS,L8035,Custom breast prosthesis,,,4535.25,12630.61,10
HCPCS,L8040,Nasal prosthesis,,,2634.71,8217.38,18
HCPCS,L8041,Midfacial prosthesis,,,3175.77,9904.73,18
HCPCS,L8042,Orbital prosthesis,,,3568.31,11128.89,18
HCPCS,L8043,Upper facial prosthesis,,,3996.54,12464.29,18
HCPCS,L8044,Hemi-facial prosthesis,,,4424.74,13799.76,18
HCPCS,L8045,Auricular prosthesis,,,2770.72,8641.38,18
HCPCS,L8046,Partial facial prosthesis,,,2854.62,8903.03,18
HCPCS,L8047,Nasal septal prosthesis,,,1462.97,4562.84,18
HCPCS,L8300,Truss single w/ standard pad,,,103.28,287.58,10
HCPCS,L8310,Truss double w/ standard pad,,,163.05,454.09,10
HCPCS,L8320,Truss addition to std pad wa,,,75.29,209.64,10
HCPCS,L8330,Truss add to std pad scrotal,,,80.58,224.46,10
HCPCS,L8400,Sheath below knee,,,19.27,53.68,10
HCPCS,L8410,Sheath above knee,,,28.16,78.51,10
HCPCS,L8415,Sheath upper limb,,,28.64,79.72,10
HCPCS,L8417,Pros sheath/sock w gel cushn,,,93.09,259.23,10
HCPCS,L8420,Prosthetic sock multi ply BK,,,25.45,70.91,10
HCPCS,L8430,Prosthetic sock multi ply AK,,,27.95,77.87,10
HCPCS,L8435,Pros sock multi ply upper lm,,,29.52,82.22,10
HCPCS,L8440,Shrinker below knee,,,54.07,150.63,10
HCPCS,L8460,Shrinker above knee,,,94.08,262.07,10
HCPCS,L8465,Shrinker upper limb,,,67.04,186.73,10
HCPCS,L8470,Pros sock single ply BK,,,9.8,27.33,10
HCPCS,L8480,Pros sock single ply AK,,,12.87,35.83,10
HCPCS,L8485,Pros sock single ply upper l,,,13.62,37.91,10
HCPCS,L8500,Artificial larynx,,,951.76,2650.69,10
HCPCS,L8501,Tracheostomy speaking valve,,,147.88,411.87,10
HCPCS,L8507,Trach-esoph voice pros pt in,,,51.85,144.4,10
HCPCS,L8509,Trach-esoph voice pros md in,,,135.2,376.49,10
HCPCS,L8510,Voice amplifier,,,312.83,871.21,10
HCPCS,L8511,Indwelling trach insert,,,90.03,250.77,10
HCPCS,L8512,Gel cap for trach voice pros,,,2.7,7.56,10
HCPCS,L8513,Trach pros cleaning device,,,6.47,17.96,10
HCPCS,L8514,Repl trach puncture dilator,,,116.73,325.16,10
HCPCS,L8515,Gel cap app device for trach,,,78.14,217.61,10
HCPCS,L8605,Inj bulking agent anal canal,,,2040.98,2546.17,4
HCPCS,L8607,Inj vocal cord bulking agent,,,124.81,155.7,4
HCPCS,L8615,Coch implant headset replace,,,558.34,1554.94,10
HCPCS,L8616,Coch implant microphone repl,,,130.05,362.16,10
HCPCS,L8617,Coch implant trans coil repl,,,113.62,316.35,10
HCPCS,L8618,Coch implant tran cable repl,,,32.46,90.34,10
HCPCS,L8619,Coch imp ext proc/contr rplc,,,10172.28,28329.74,10
HCPCS,L8621,Repl zinc air battery,,,0.77,2.12,10
HCPCS,L8622,Repl alkaline battery,,,0.4,1.13,10
HCPCS,L8623,"Lith ion batt cid,non-earlvl",,,80.05,223.02,10
HCPCS,L8624,"Lith ion batt cid, ear level",,,199.61,555.85,10
HCPCS,L8627,CID ext speech process repl,,,8640.87,24814.6,10
HCPCS,L8628,CID ext controller repl,,,1531.43,4397.84,10
HCPCS,L8629,CID transmit coil and cable,,,221.65,636.59,10
HCPCS,L8679,Imp neurosti pls gn any type,,,24375.56,30409.12,4
HCPCS,L8680,Implt neurostim elctr each,,,1269.42,1583.63,4
HCPCS,L8681,Pt prgrm for implt neurostim,,,1320.72,3678.17,10
HCPCS,L8683,Radiofq trsmtr for implt neu,,,6496.09,18091.61,10
HCPCS,L8684,Radiof trsmtr implt scrl neu,,,955.74,2661.76,10
HCPCS,L8685,Implt nrostm pls gen sng rec,,,36138.23,45083.34,4
HCPCS,L8686,Implt nrostm pls gen sng non,,,23059.06,28766.75,4
HCPCS,L8687,Implt nrostm pls gen dua rec,,,47030.33,58671.5,4
HCPCS,L8688,Implt nrostm pls gen dua non,,,30009.09,37437.08,4
HCPCS,L8689,External recharg sys intern,,,2135.37,5946.92,10
HCPCS,L8690,"Aud osseo dev, int/ext comp",,,13146.56,16400.66,4
HCPCS,L8691,Osseointegrated snd proc rpl,,,2131.89,9193.15,10
HCPCS,L8693,"Aud osseo dev, abutment",,,1877.12,5390.62,10
HCPCS,L8695,External recharg sys extern,,,20.61,57.46,10
HCPCS,L8696,Ext antenna phren nerve stim,,,268.31,789.87,10
HCPCS,M0201,Covid-19 vaccine home admin,,,35.71,158.42,11
HCPCS,M0220,Tixagev and cilgav inj,,,456.02,568.89,4
HCPCS,M0221,Tixagev and cilgav inj hm,,,759.02,946.89,4
HCPCS,M0222,Bebtelovimab injection,,,1062.02,1324.89,4
HCPCS,M0223,Bebtelovimab injection home,,,1668.02,2080.89,4
HCPCS,M0224,HC IV INFUSION PEMIVIBART,475.0,332.5,,,0
HCPCS,M0224,Pemivibart infusion,,,436.53,1936.72,7
HCPCS,M0233,"Intra inf, toci, first dose",,,436.53,1936.72,7
HCPCS,M0234,"Intra inf, toci, second dos",,,436.53,1936.72,7
HCPCS,M0235,"Intrav inf, mon anti, fir do",,,436.53,1936.72,7
HCPCS,M0236,"Intrav inf, mon anti, sec do",,,436.53,1936.72,7
HCPCS,M0237,"Intrav inf, toci, first dose",,,436.53,1936.72,7
HCPCS,M0238,"Intrav inf, toci, second dos",,,436.53,1936.72,7
HCPCS,M0240,Casiri and imdev repeat,,,1365.02,1702.89,4
HCPCS,M0241,Casiri and imdev repeat hm,,,2274.02,2836.89,4
HCPCS,M0243,Casirivi and imdevi infusion,,,1363.5,1701.0,4
HCPCS,M0244,Casirivi and imdevi infus hm,,,2274.02,2836.89,4
HCPCS,M0245,Bamlan and etesev infusion,,,1365.02,1702.89,4
HCPCS,M0246,Bamlan and etesev infus home,,,2274.02,2836.89,4
HCPCS,M0247,Sotrovimab infusion,,,1365.02,1702.89,4
HCPCS,M0248,"Sotrovimab inf, home admin",,,2274.02,2836.89,4
HCPCS,M0249,Adm tocilizu covid-19 1st,,,436.53,1936.72,11
HCPCS,M0249,HC ADMIN TOCILIZUMAB COVID-19 1ST DOSE,474.0,331.8,,,0
HCPCS,M0250,Adm tocilizu covid-19 2nd,,,436.53,1936.72,11
HCPCS,M0250,HC ADMIN TOCILIZUMAB COVID-19 2ND DOSE,474.0,331.8,,,0
HCPCS,P2028,Cephalin floculation test,,,4.46,8.66,7
HCPCS,P2029,Congo red blood test,,,4.46,8.66,7
HCPCS,P2033,Blood thymol turbidity,,,4.46,8.66,7
HCPCS,P2038,Blood mucoprotein,,,4.46,27.75,11
HCPCS,P3000,Screen pap by tech w md supv,,,16.69,58.29,11
HCPCS,P3001,Screening pap smear by phys,,,78.45,97.86,4
HCPCS,P9010,Whole blood for transfusion,,,189.84,998.6,11
HCPCS,P9011,Blood split unit,,,155.84,691.41,11
HCPCS,P9012,Cryoprecipitate each unit,,,71.95,319.22,11
HCPCS,P9012,HC CRYOPRECIPITATE EA UNIT,157.0,109.9,,,0
HCPCS,P9012,HC POOLED CRYOPRECIPITATE EA UNIT,706.0,494.2,,,0
HCPCS,P9016,HC RBC LEUKOC REDUCED EA UNIT,337.0,235.9,,,0
HCPCS,P9016,HC RED BLOOD CELLS LEUKOREDUCED 10ML,793.0,555.1,,,0
HCPCS,P9016,HC RED BLOOD CELLS LEUKOREDUCED 50ML,88.0,61.6,,,0
HCPCS,P9016,HC RED BLOOD CELLS LEUKOREDUCED100ML,169.0,118.3,,,0
HCPCS,P9016,Rbc leukocytes reduced,,,184.91,820.38,11
HCPCS,P9017,FRESH FROZEN PLASMA 50ML,43.0,30.1,,,0
HCPCS,P9017,HC FRESH FROZEN PLASMA 100ML,84.0,58.8,,,0
HCPCS,P9017,HC FRESH FROZEN PLASMA 10ML,13.0,9.1,,,0
HCPCS,P9017,HC FRESH FROZEN PLASMA 20ML,22.0,15.4,,,0
HCPCS,P9017,HC FRESH FROZEN PLASMA SINGLE DONOR,164.0,114.8,,,0
HCPCS,P9017,Plasma 1 donor frz w/in 8 hr,,,85.98,381.46,11
HCPCS,P9019,"Platelets, each unit",,,53.17,272.31,11
HCPCS,P9020,Plaelet rich plasma unit,,,559.79,2483.6,11
HCPCS,P9021,Red blood cells unit,,,150.57,668.03,11
HCPCS,P9022,HC RBC WASHED EA UNIT,498.0,348.6,,,0
HCPCS,P9022,Washed red blood cells unit,,,368.58,1635.26,11
HCPCS,P9023,"Frozen plasma, pooled, sd",,,55.96,289.43,11
HCPCS,P9025,Plasma cryo redu path each,,,133.76,593.45,11
HCPCS,P9026,Cryo fib comp path redu each,,,247.04,2436.97,11
HCPCS,P9031,Platelets leukocytes reduced,,,144.26,640.03,11
HCPCS,P9032,"Platelets, irradiated",,,382.3,1743.47,11
HCPCS,P9033,Platelets leukoreduced irrad,,,189.59,841.15,11
HCPCS,P9034,"Platelets, pheresis",,,308.96,1728.1,11
HCPCS,P9035,HC PLATELET PHERESIS LEUKOCYTE REDUCED,794.0,555.8,,,0
HCPCS,P9035,HC PLATELET PHERESIS LEUKOCYTE REDUCED 50ML,289.0,202.3,,,0
HCPCS,P9035,HC PLATELETS PHERESIS LEUKOCYTES REDUCED EACH UNIT,577.0,403.9,,,0
HCPCS,P9035,Platelet pheres leukoreduced,,,511.59,2269.75,11
HCPCS,P9036,Platelet pheresis irradiated,,,949.13,4210.97,11
HCPCS,P9037,HC PLATE LEU REDUC PHER IRR EA UNIT,910.0,637.0,,,0
HCPCS,P9037,HC PLATE PHERESIS LEUKO REDUC/IRRAD 100ML,456.0,319.2,,,0
HCPCS,P9037,HC PLATELETS PHERESIS LEUKO REDUC/IRRAD 20M,115.0,80.5,,,0
HCPCS,P9037,HC PLATELETS PHERESIS LEUKO REDUC/IRRAD 50M,228.0,159.6,,,0
HCPCS,P9037,Plate pheres leukoredu irrad,,,680.61,3019.64,11
HCPCS,P9038,RBC irradiated,,,145.22,764.77,11
HCPCS,P9039,RBC deglycerolized,,,313.0,1388.68,11
HCPCS,P9040,HC RBC LEUKO REDUCED/IRRADIATED EA UNIT,453.0,317.1,,,0
HCPCS,P9040,HC RED BLD CELLS LEUKOREDUCED IRRAD 100ML,170.0,119.0,,,0
HCPCS,P9040,HC RED BLD CELLS LEUKOREDUCED IRRAD 10ML,23.0,16.1,,,0
HCPCS,P9040,HC RED BLD CELLS LEUKOREDUCED IRRAD 20ML,44.0,30.8,,,0
HCPCS,P9040,HC RED BLD CELLS LEUKOREDUCED IRRAD 50ML,87.0,60.9,,,0
HCPCS,P9040,RBC leukoreduced irradiated,,,265.41,1177.53,11
HCPCS,P9041,"Albumin (human),5%, 50ml",,,10.62,85.2,11
HCPCS,P9043,"Plasma protein fract,5%,50ml",,,8.11,367.87,11
HCPCS,P9044,Cryoprecipitatereducedplasma,,,132.05,585.86,11
HCPCS,P9044,HC PLASMA CRYOPREC REDUC EA UNIT,295.0,206.5,,,0
HCPCS,P9045,"ALBUMIN, HUMAN 5 % IV SOLP MERGE",829.0,580.3,,,0
HCPCS,P9045,"Albumin (human), 5%, 250 ml",,,53.08,274.2,11
HCPCS,P9046,"Albumin (human), 25%, 20 ml",,,21.23,102.78,11
HCPCS,P9047,"ALBUMIN, HUMAN 25 % IV SOLN (MERGE)",427.0,298.9,,,0
HCPCS,P9047,"ALBUMIN, HUMAN 25 % IV SOLP",807.0,564.9,,,0
HCPCS,P9047,"ALBUMIN, HUMAN 25 % IV SOLP (FOR DIALYSIS)",826.0,578.2,,,0
HCPCS,P9047,"Albumin (human), 25%, 50ml",,,53.08,283.58,11
HCPCS,P9048,"Plasmaprotein fract,5%,250ml",,,35.32,843.36,11
HCPCS,P9050,"Granulocytes, pheresis unit",,,4358.14,5436.89,4
HCPCS,P9051,"Blood, l/r, cmv-neg",,,151.58,672.51,11
HCPCS,P9052,"Platelets, hla-m, l/r, unit",,,708.06,3141.42,11
HCPCS,P9053,"Plt, pher, l/r cmv-neg, irr",,,503.45,2690.11,11
HCPCS,P9054,"Blood, l/r, froz/degly/wash",,,265.19,1176.56,11
HCPCS,P9055,"Plt, aph/pher, l/r, cmv-neg",,,250.49,1915.06,11
HCPCS,P9056,"Blood, l/r, irradiated",,,84.55,576.49,11
HCPCS,P9057,"RBC, frz/deg/wsh, l/r, irrad",,,422.69,1875.33,11
HCPCS,P9058,"RBC, l/r, cmv-neg, irrad",,,249.4,1106.5,11
HCPCS,P9059,HC FRESH FRZN PLSMA 8-24HR COLLECT EACH,164.0,114.8,,,0
HCPCS,P9059,HC PLSMA 8-24HR COLLECT 100ML,84.0,58.8,,,0
HCPCS,P9059,HC PLSMA 8-24HR COLLECT 20ML,22.0,15.4,,,0
HCPCS,P9059,HC PLSMA 8-24HR COLLECT 50ML,43.0,30.1,,,0
HCPCS,P9059,"Plasma, frz between 8-24hour",,,73.77,327.29,11
HCPCS,P9060,Fr frz plasma donor retested,,,53.25,236.25,11
HCPCS,P9070,Pathogen reduced plasma pool,,,55.78,276.24,11
HCPCS,P9071,Pathogen reduced plasma sing,,,219.86,1306.51,11
HCPCS,P9073,"Platelets, pathogen reduced",,,607.43,2694.96,11
HCPCS,P9100,Pathogen test for platelets,,,58.4,259.1,11
HCPCS,P9604,One-way allow prorated trip,,,7.79,9.71,4
HCPCS,P9612,Catheterize for urine spec,,,8.41,16.34,11
HCPCS,Q0035,Cardiokymography,,,29.63,164.05,11
HCPCS,Q0081,Infusion ther other than che,,,70.02,87.36,4
HCPCS,Q0083,Chemo by other than infusion,,,129.35,161.37,4
HCPCS,Q0084,Chemotherapy by infusion,,,219.8,274.2,4
HCPCS,Q0091,Obtaining screen pap smear,,,26.21,127.04,11
HCPCS,Q0111,Wet mounts/ w preparations,,,16.69,32.44,11
HCPCS,Q0112,Potassium hydroxide preps,,,5.25,23.55,11
HCPCS,Q0113,Pinworm examinations,,,3.84,29.86,11
HCPCS,Q0114,Fern test,,,8.77,39.46,11
HCPCS,Q0115,Post-coital mucous exam,,,22.5,54.62,11
HCPCS,Q0138,FERUMOXYTOL 510 MG/17 ML (30 MG/ML) IV SOLN,3295.0,2306.5,,,0
HCPCS,Q0138,"Ferumoxytol, non-esrd",,,0.23,3.9,13
HCPCS,Q0139,"Ferumoxytol, esrd use",,,0.23,3.9,13
HCPCS,Q0162,ONDANSETRON 8 MG ORAL TBDL,180.0,126.0,,,0
HCPCS,Q0162,ONDANSETRON HCL  4 MG ORAL TAB,272.5,190.75,,,0
HCPCS,Q0162,ONDANSETRON HCL 4 MG/5 ML ORAL SOLN,54.0,37.8,,,0
HCPCS,Q0162,Ondansetron oral,,,0.12,8.17,6
HCPCS,Q0163,DIPHENHYDRAMINE 50 MG CAP,7.0,4.9,,,0
HCPCS,Q0163,Diphenhydramine HCl 50mg,,,0.21,0.24,2
HCPCS,Q0164,PROCHLORPERAZINE MALEATE  5 MG ORAL TAB,13.5,9.45,,,0
HCPCS,Q0164,PROCHLORPERAZINE MALEATE 10 MG ORAL TAB,10.0,7.0,,,0
HCPCS,Q0164,Prochlorperazine maleate 5mg,,,0.84,0.93,2
HCPCS,Q0166,GRANISETRON 1 MG ORAL TAB,251.0,175.7,,,0
HCPCS,Q0166,Granisetron HCl 1 mg oral,,,55.63,93.25,6
HCPCS,Q0167,DRONABINOL  2.5 MG ORAL CAP,56.0,39.2,,,0
HCPCS,Q0167,Dronabinol 2.5mg oral,,,8.42,9.31,2
HCPCS,Q0169,PROMETHAZINE  6.25 MG/5 ML ORAL SYRP,21.0,14.700000000000001,,,0
HCPCS,Q0169,PROMETHAZINE 12.5 MG ORAL TAB,7.0,4.9,,,0
HCPCS,Q0169,PROMETHAZINE 25 MG ORAL TAB,7.0,4.9,,,0
HCPCS,Q0169,Promethazine HCl 12.5mg oral,,,0.36,0.4,2
HCPCS,Q0177,HYDROXYZINE 10 MG TAB,7.5,5.25,,,0
HCPCS,Q0177,HYDROXYZINE 10 MG/5 ML SYRUP,36.0,25.2,,,0
HCPCS,Q0177,HYDROXYZINE 25 MG TAB,7.5,5.25,,,0
HCPCS,Q0177,HYDROXYZINE 50 MG TAB,7.5,5.25,,,0
HCPCS,Q0177,HYDROXYZINE PAMOATE  25 MG ORAL CAP,5.5,3.85,,,0
HCPCS,Q0177,HYDROXYZINE PAMOATE  50 MG ORAL CAP,5.5,3.85,,,0
HCPCS,Q0180,Dolasetron mesylate oral,,,177.59,227.16,6
HCPCS,Q0222,Bebtelovimab 175 mg,,,3603.6,9049.32,6
HCPCS,Q0224,HC IV INFUSION PEMIVIBART,15939.0,11157.3,,,0
HCPCS,Q0224,"Inj, pemivibart, 4500 mg",,,9909.9,10949.4,2
HCPCS,Q0247,Sotrovimab,,,3603.6,3981.6,2
HCPCS,Q0249,Tocilizumab for covid-19,,,11.4,12.59,2
HCPCS,Q0478,"Power adapter, combo vad",,,227.49,653.3,10
HCPCS,Q0479,"Power module combo vad, rep",,,14823.51,42936.42,10
HCPCS,Q0480,"driver pneumatic vad, rep",,,111492.17,310504.96,10
HCPCS,Q0481,"microprcsr cu elec vad, rep",,,17987.99,50096.42,10
HCPCS,Q0482,"microprcsr cu combo vad, rep",,,5634.16,15691.08,10
HCPCS,Q0483,"monitor elec vad, rep",,,23210.23,64640.38,10
HCPCS,Q0484,monitor elec or comb vad rep,,,4507.35,12552.93,10
HCPCS,Q0485,"monitor cable elec vad, rep",,,435.18,1212.02,10
HCPCS,Q0486,mon cable elec/pneum vad rep,,,362.18,1008.69,10
HCPCS,Q0487,"leads any type vad, rep only",,,422.56,1176.87,10
HCPCS,Q0489,"pwr pck base combo vad, rep",,,20122.03,56039.79,10
HCPCS,Q0490,"emr pwr source elec vad, rep",,,870.42,2424.04,10
HCPCS,Q0491,emr pwr source combo vad rep,,,1368.33,3810.77,10
HCPCS,Q0492,"emr pwr cbl elec vad, rep",,,110.27,307.09,10
HCPCS,Q0493,"emr pwr cbl combo vad, rep",,,313.83,874.13,10
HCPCS,Q0494,"emr hd pmp elec/combo, rep",,,265.56,739.67,10
HCPCS,Q0495,"charger elec/combo vad, rep",,,5170.85,14400.82,10
HCPCS,Q0496,"battery elec/combo vad, rep",,,1855.88,5168.62,10
HCPCS,Q0497,"bat clps elec/comb vad, rep",,,579.49,1613.91,10
HCPCS,Q0498,"holster elec/combo vad, rep",,,635.84,1770.82,10
HCPCS,Q0499,belt/vest elec/combo vad rep,,,206.61,575.35,10
HCPCS,Q0500,"filters elec/combo vad, rep",,,37.8,105.27,10
HCPCS,Q0501,"shwr cov elec/combo vad, rep",,,632.22,1760.72,10
HCPCS,Q0502,"mobility cart pneum vad, rep",,,804.84,2241.5,10
HCPCS,Q0503,battery pneum vad replacemnt,,,1609.77,4483.23,10
HCPCS,Q0504,"pwr adpt pneum vad, rep veh",,,849.41,2365.64,10
HCPCS,Q0506,Lith-ion batt elec/pneum VAD,,,1057.34,3036.4,10
HCPCS,Q0515,Sermorelin acetate injection,,,5.42,6.77,4
HCPCS,Q2009,FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN,69.5,48.650000000000006,,,0
HCPCS,Q2009,FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN,242.0,169.4,,,0
HCPCS,Q2009,Fosphenytoin inj pe,,,1.33,11.57,13
HCPCS,Q2017,"Teniposide, 50 mg",,,941.88,4732.32,6
HCPCS,Q2026,Radiesse injection,,,349.19,1549.24,11
HCPCS,Q2028,"Inj, sculptra, 0.5mg",,,2.16,9.58,11
HCPCS,Q2034,Agriflu vaccine,,,47.72,59.54,4
HCPCS,Q2035,"Afluria vacc, 3 yrs & >, im",,,34.97,43.62,6
HCPCS,Q2036,"Flulaval vacc, 3 yrs & >, im",,,26.84,37.16,6
HCPCS,Q2037,"Fluvirin vacc, 3 yrs & >, im",,,26.63,53.11,6
HCPCS,Q2038,"Fluzone vacc, 3 yrs & >, im",,,35.28,45.55,6
HCPCS,Q2039,"Influenza virus vaccine, nos",,,26.84,86.18,6
HCPCS,Q2041,Axicabtagene ciloleucel car+,,,531849.12,1494536.4,13
HCPCS,Q2042,Tisagenlecleucel car-pos t,,,614180.81,1851308.39,13
HCPCS,Q2043,Sipuleucel-t auto cd54+,,,56269.19,124152.59,13
HCPCS,Q2049,Imported Lipodox inj,,,298.74,1883.42,13
HCPCS,Q2050,DOXORUBICIN LIPOSOMAL 2 MG/ML IV INJ,3745.0,2621.5,,,0
HCPCS,Q2050,Doxorubicin inj 10mg,,,71.86,2061.76,13
HCPCS,Q2053,Brexucabtagene car pos t,,,489290.6,1546624.8,13
HCPCS,Q2054,Lisocabtagene mara car pos t,,,562260.84,1643990.04,13
HCPCS,Q2055,Idecabtagene vicleucel car,,,559781.08,1680852.6,13
HCPCS,Q2056,Ciltacabtagene car-pos t,,,588494.81,1810431.0,13
HCPCS,Q3014,HC TELEHEALTH FACILITY FEE,72.0,50.4,,,0
HCPCS,Q3027,Inj beta interferon im 1 mcg,,,111.17,261.73,6
HCPCS,Q3028,Inj beta interferon sq 1 mcg,,,68.6,88.79,6
HCPCS,Q4001,Cast sup body cast plaster,,,127.29,158.8,4
HCPCS,Q4002,Cast sup body cast fiberglas,,,481.19,600.3,4
HCPCS,Q4003,Cast sup shoulder cast plstr,,,91.45,114.08,4
HCPCS,Q4004,Cast sup shoulder cast fbrgl,,,316.6,394.97,4
HCPCS,Q4005,Cast sup long arm adult plst,,,33.69,42.03,4
HCPCS,Q4006,Cast sup long arm adult fbrg,,,75.99,94.8,4
HCPCS,Q4007,Cast sup long arm ped plster,,,16.91,21.09,4
HCPCS,Q4008,Cast sup long arm ped fbrgls,,,38.0,47.4,4
HCPCS,Q4009,Cast sup sht arm adult plstr,,,22.51,28.09,4
HCPCS,Q4010,Cast sup sht arm adult fbrgl,,,50.66,63.2,4
HCPCS,Q4011,Cast sup sht arm ped plaster,,,11.24,14.02,4
HCPCS,Q4012,Cast sup sht arm ped fbrglas,,,25.33,31.6,4
HCPCS,Q4013,Cast sup gauntlet plaster,,,40.97,51.11,4
HCPCS,Q4014,Cast sup gauntlet fiberglass,,,69.11,86.22,4
HCPCS,Q4015,Cast sup gauntlet ped plster,,,20.48,25.55,4
HCPCS,Q4016,Cast sup gauntlet ped fbrgls,,,34.54,43.09,4
HCPCS,Q4017,Cast sup lng arm splint plst,,,23.69,29.56,4
HCPCS,Q4018,Cast sup lng arm splint fbrg,,,37.78,47.14,4
HCPCS,Q4019,Cast sup lng arm splnt ped p,,,11.85,14.78,4
HCPCS,Q4020,Cast sup lng arm splnt ped f,,,18.91,23.59,4
HCPCS,Q4021,Cast sup sht arm splint plst,,,17.51,21.85,4
HCPCS,Q4022,Cast sup sht arm splint fbrg,,,31.63,39.46,4
HCPCS,Q4023,Cast sup sht arm splnt ped p,,,8.82,11.0,4
HCPCS,Q4024,Cast sup sht arm splnt ped f,,,15.82,19.73,4
HCPCS,Q4025,Cast sup hip spica plaster,,,98.32,122.66,4
HCPCS,Q4026,Cast sup hip spica fiberglas,,,306.94,382.91,4
HCPCS,Q4027,Cast sup hip spica ped plstr,,,49.18,61.35,4
HCPCS,Q4028,Cast sup hip spica ped fbrgl,,,153.5,191.49,4
HCPCS,Q4029,Cast sup long leg plaster,,,75.17,93.78,4
HCPCS,Q4030,Cast sup long leg fiberglass,,,197.89,246.87,4
HCPCS,Q4031,Cast sup lng leg ped plaster,,,37.6,46.91,4
HCPCS,Q4032,Cast sup lng leg ped fbrgls,,,98.93,123.42,4
HCPCS,Q4033,Cast sup lng leg cylinder pl,,,70.11,87.47,4
HCPCS,Q4034,Cast sup lng leg cylinder fb,,,174.41,217.58,4
HCPCS,Q4035,Cast sup lngleg cylndr ped p,,,35.06,43.73,4
HCPCS,Q4036,Cast sup lngleg cylndr ped f,,,87.23,108.83,4
HCPCS,Q4037,Cast sup shrt leg plaster,,,42.78,53.37,4
HCPCS,Q4038,Cast sup shrt leg fiberglass,,,107.17,133.7,4
HCPCS,Q4039,Cast sup shrt leg ped plster,,,21.45,26.76,4
HCPCS,Q4040,Cast sup shrt leg ped fbrgls,,,53.57,66.83,4
HCPCS,Q4041,Cast sup lng leg splnt plstr,,,51.99,64.86,4
HCPCS,Q4042,Cast sup lng leg splnt fbrgl,,,88.78,110.75,4
HCPCS,Q4043,Cast sup lng leg splnt ped p,,,26.03,32.47,4
HCPCS,Q4044,Cast sup lng leg splnt ped f,,,44.42,55.41,4
HCPCS,Q4045,Cast sup sht leg splnt plstr,,,30.18,37.65,4
HCPCS,Q4046,Cast sup sht leg splnt fbrgl,,,48.57,60.59,4
HCPCS,Q4047,Cast sup sht leg splnt ped p,,,15.06,18.79,4
HCPCS,Q4048,Cast sup sht leg splnt ped f,,,24.3,30.32,4
HCPCS,Q4049,"Finger splint, static",,,5.51,6.88,4
HCPCS,Q4074,Iloprost non-comp unit dose,,,232.67,402.25,6
HCPCS,Q4081,EPOETIN ALFA  4000 UNIT/ML INJ SOLN,693.0,485.09999999999997,,,0
HCPCS,Q4081,EPOETIN ALFA 2000 UNIT/ML IV SYRINGE (PED/NEO),115.0,80.5,,,0
HCPCS,Q4081,"Epoetin alfa, 100 units ESRD",,,2.79,3.48,6
HCPCS,Q4101,Apligraf,,,77.36,546.58,13
HCPCS,Q4101,HC APLIGRAF APPLIED PER SQ CM (TOTAL 44 SQ CM),132.0,92.4,,,0
HCPCS,Q4101,HC APLIGRAF WASTED PER SQ CM (TOTAL 44 SQ CM),33.0,23.1,,,0
HCPCS,Q4102,Oasis wound matrix,,,13.18,546.58,13
HCPCS,Q4103,Oasis burn matrix,,,13.18,546.58,13
HCPCS,Q4104,Integra bmwd,,,35.97,546.58,13
HCPCS,Q4105,Integra drt or omnigraft,,,35.97,546.58,13
HCPCS,Q4106,Dermagraft,,,72.84,145.34,6
HCPCS,Q4107,Graftjacket,,,123.2,546.58,13
HCPCS,Q4108,Integra matrix,,,57.12,546.58,13
HCPCS,Q4110,Primatrix,,,103.84,546.58,13
HCPCS,Q4111,Gammagraft,,,22.91,546.58,11
HCPCS,Q4112,Cymetra injectable,,,943.42,1176.94,4
HCPCS,Q4113,Graftjacket xpress,,,943.42,3156.05,6
HCPCS,Q4114,Integra flowable wound matri,,,2718.24,4472.22,6
HCPCS,Q4115,Alloskin,,,27.21,546.58,11
HCPCS,Q4116,Alloderm,,,97.57,546.58,11
HCPCS,Q4117,Hyalomatrix,,,41.76,546.58,9
HCPCS,Q4118,Matristem micromatrix,,,8.48,10.58,6
HCPCS,Q4121,Theraskin,,,70.75,546.58,11
HCPCS,Q4122,Dermacell,,,123.2,546.58,9
HCPCS,Q4123,Alloskin,,,47.75,546.58,13
HCPCS,Q4124,Oasis tri-layer wound matrix,,,21.48,546.58,13
HCPCS,Q4126,Memoderm/derma/tranz/integup,,,123.2,546.58,13
HCPCS,Q4127,Talymed,,,85.8,546.58,9
HCPCS,Q4132,Grafix core,,,123.2,891.07,13
HCPCS,Q4133,Grafix prime,,,123.2,546.58,13
HCPCS,Q4134,hMatrix,,,107.41,546.58,11
HCPCS,Q4137,"Amnioexcel or biodexcel, 1cm",,,123.2,546.58,9
HCPCS,Q4141,"Alloskin ac, 1 cm",,,123.2,546.58,9
HCPCS,Q4148,"Neox 1k, 1cm",,,123.2,546.58,9
HCPCS,Q4149,"Excellagen, 0.1 cc",,,109.08,274.92,6
HCPCS,Q4152,Dermapure 1 square cm,,,123.2,546.58,13
HCPCS,Q4153,"Dermavest, plurivest sq cm",,,123.2,546.58,9
HCPCS,Q4154,Biovance 1 square cm,,,123.2,711.0,9
HCPCS,Q4155,Neoxflo or clarixflo 1 mg,,,54.91,60.67,2
HCPCS,Q4156,Neox 100 1 square cm,,,123.2,674.73,13
HCPCS,Q4157,Revitalon 1 square cm,,,123.2,546.58,9
HCPCS,Q4158,HC MARIGEN 1.75X1.75 CM,1530.0,1071.0,,,0
HCPCS,Q4158,HC MARIGEN 16 MM CIRCULAR,1441.0,1008.7,,,0
HCPCS,Q4158,HC MARIGEN 3X3.5 CM,2108.0,1475.6,,,0
HCPCS,Q4158,HC MARIGEN 3X3.5 CM FENESTRATED,2319.0,1623.3,,,0
HCPCS,Q4158,HC MARIGEN 3X7 CM,3359.0,2351.3,,,0
HCPCS,Q4158,HC MARIGEN 3X7 CM FENESTRATED,3695.0,2586.5,,,0
HCPCS,Q4158,HC MARIGEN 5X7 CM,3998.0,2798.6,,,0
HCPCS,Q4158,HC MARIGEN MICRO 4 CM,1578.0,1104.6,,,0
HCPCS,Q4158,HC MARIGEN MICRO 8 CM,1863.0,1304.1,,,0
HCPCS,Q4158,Marigen 1 square cm,,,123.2,546.58,9
HCPCS,Q4159,Affinity1 square cm,,,123.2,2757.89,13
HCPCS,Q4160,Nushield 1 square cm,,,123.2,907.92,13
HCPCS,Q4161,Bio-connekt per square cm,,,123.2,4739.53,9
HCPCS,Q4162,Amnio bio and woundex flow,,,3146.0,3476.0,2
HCPCS,Q4163,Amnio bio and woundex sq cm,,,123.2,793.48,9
HCPCS,Q4164,"Helicoll, per square cm",,,123.2,2464.8,9
HCPCS,Q4165,"Keramatrix, per square cm",,,51.45,546.58,9
HCPCS,Q4166,"Cytal, per square centimeter",,,37.02,546.58,9
HCPCS,Q4167,"Truskin, per sq centimeter",,,123.2,546.58,9
HCPCS,Q4169,"Artacent wound, per sq cm",,,123.2,5256.12,9
HCPCS,Q4170,"Cygnus, per sq cm",,,123.2,1184.94,9
HCPCS,Q4171,"Interfyl, 1 mg",,,55.77,61.62,2
HCPCS,Q4173,Palingen or palingen xplus,,,123.2,1801.2,9
HCPCS,Q4174,Palingen or promatrx,,,1329.9,1469.4,2
HCPCS,Q4175,Miroderm,,,123.2,546.58,9
HCPCS,Q4176,"Neopatch, per sq centimeter",,,123.2,546.58,9
HCPCS,Q4177,"Floweramnioflo, 0.1 cc",,,257.4,284.4,2
HCPCS,Q4178,"Floweramniopatch, per sq cm",,,123.2,546.58,9
HCPCS,Q4180,"Revita, per sq cm",,,123.2,1501.16,9
HCPCS,Q4181,"Amnio wound, per square cm",,,123.2,546.58,9
HCPCS,Q4183,"Surgigraft, 1 sq cm",,,123.2,546.58,9
HCPCS,Q4184,"Cellesta, 1 sq cm",,,123.2,930.62,9
HCPCS,Q4186,Epifix 1 sq cm,,,123.2,633.26,13
HCPCS,Q4187,Epicord 1 sq cm,,,123.2,773.46,9
HCPCS,Q4188,Amnioarmor 1 sq cm,,,123.2,1548.4,9
HCPCS,Q4190,Artacent ac 1 sq cm,,,123.2,1536.06,9
HCPCS,Q4191,Restorigin 1 sq cm,,,123.2,2765.0,9
HCPCS,Q4193,Coll-e-derm 1 sq cm,,,123.2,3697.56,9
HCPCS,Q4194,Novachor 1 sq cm,,,123.2,1579.84,9
HCPCS,Q4195,Puraply 1 sq cm,,,123.2,546.58,13
HCPCS,Q4196,Puraply am 1 sq cm,,,123.2,546.58,13
HCPCS,Q4197,Puraply xt 1 sq cm,,,123.2,546.58,9
HCPCS,Q4199,"Cygnus matrix, per sq cm",,,123.2,748.92,9
HCPCS,Q4201,Matrion 1 sq cm,,,123.2,546.58,9
HCPCS,Q4203,"Derma-gide, 1 sq cm",,,123.2,546.58,9
HCPCS,Q4204,Xwrap 1 sq cm,,,123.2,5403.6,9
HCPCS,Q4205,Membrane graft or wrap sq cm,,,123.2,2654.4,9
HCPCS,Q4206,Fluid flow or fluid gf 1 cc,,,4118.4,4550.4,2
HCPCS,Q4210,Axolotl graf dualgraf sq cm,,,2904.69,3209.38,2
HCPCS,Q4213,"Ascent, 0.5 mg",,,98.64,108.99,2
HCPCS,Q4217,Woundfix biowound plus xplus,,,123.2,2291.0,9
HCPCS,Q4219,Surgigraft dual per sq cm,,,123.2,1896.0,9
HCPCS,Q4221,Amniowrap2 per sq cm,,,123.2,3033.6,9
HCPCS,Q4222,"Progenamatrix, per sq cm",,,123.2,546.58,9
HCPCS,Q4225,"Amniobind, per sq cm",,,123.2,2749.2,9
HCPCS,Q4226,Myown harv prep proc sq cm,,,2059.2,2275.2,2
HCPCS,Q4227,Amniocore per sq cm,,,123.2,2038.2,9
HCPCS,Q4229,Cogenex amnio memb per sq cm,,,123.2,1501.0,9
HCPCS,Q4230,Cogenex flow amnion 0.5 cc,,,1430.0,1580.0,2
HCPCS,Q4231,"Corplex p, per cc",,,5219.5,5767.0,2
HCPCS,Q4232,"Corplex, per sq cm",,,123.2,1106.11,9
HCPCS,Q4234,"Xcellerate, per sq cm",,,123.2,1975.0,9
HCPCS,Q4236,Carepatch per sq cm,,,123.2,2464.8,9
HCPCS,Q4237,"cryo-cord, per sq cm",,,123.2,789.02,9
HCPCS,Q4238,"Derm-maxx, per sq cm",,,123.2,2844.0,9
HCPCS,Q4239,Amnio-maxx or lite per sq cm,,,123.2,4266.85,9
HCPCS,Q4246,"Coretext or protext, per cc",,,4604.6,5087.6,2
HCPCS,Q4247,"Amniotext patch, per sq cm",,,123.2,3597.66,9
HCPCS,Q4248,Dermacyte Amn mem allo sq cm,,,123.2,2472.95,9
HCPCS,Q4249,"Amniply, per sq cm",,,123.2,2696.11,9
HCPCS,Q4250,AmnioAMP-MP per sq cm,,,123.2,4503.9,9
HCPCS,Q4251,"Vim, per square centimeter",,,123.2,546.58,9
HCPCS,Q4252,"Vendaje, per square centimet",,,123.2,1801.2,9
HCPCS,Q4253,Zenith amniotic membrane psc,,,123.2,1801.2,9
HCPCS,Q4256,"Mlg complet, per sq cm",,,123.2,3507.6,9
HCPCS,Q4257,"Relese, per sq cm",,,123.2,1501.0,9
HCPCS,Q4258,"Enverse, per sq cm",,,123.2,1105.97,9
HCPCS,Q4259,Celera per sq cm,,,123.2,2512.2,9
HCPCS,Q4261,"Tag, per square centimeter",,,123.2,1144.27,9
HCPCS,Q4262,"Dual layer impax, per sq cm",,,123.2,2559.85,9
HCPCS,Q4263,"Surgraft tl, per sq cm",,,123.2,1886.9,9
HCPCS,Q4264,"Cocoon membrane, per sq cm",,,123.2,5119.2,9
HCPCS,Q4265,Neostim tl per sq cm,,,123.2,3152.1,9
HCPCS,Q4266,Neostim per sq cm,,,123.2,2362.57,9
HCPCS,Q4267,Neostim dl per sq cm,,,123.2,1303.77,9
HCPCS,Q4268,Surgraft ft per sq cm,,,123.2,2726.86,9
HCPCS,Q4269,Surgraft xt per sq cm,,,123.2,1422.0,9
HCPCS,Q4271,Complete ft per sq cm,,,123.2,3128.4,9
HCPCS,Q4272,"Esano a, per sq cm",,,123.2,553.0,9
HCPCS,Q4274,"Esano ac, per sq cm",,,123.2,2330.5,9
HCPCS,Q4275,"Esano aca, per sq cm",,,123.2,4068.5,9
HCPCS,Q4276,"Orion, per sq cm",,,123.2,2749.2,9
HCPCS,Q4277,"Woundplus e-grat, per sq cm",,,2452.45,2709.7,2
HCPCS,Q4278,"Epieffect, per sq cm",,,123.2,948.0,9
HCPCS,Q4279,"Vendaje ac, per sq cm",,,123.2,4266.0,9
HCPCS,Q4281,Barrera slor dl per sq cm,,,123.2,2938.8,9
HCPCS,Q4282,Cygnus dual per sq cm,,,123.2,2559.85,9
HCPCS,Q4283,"Biovance tri or 3l, sq cm",,,123.2,2844.0,9
HCPCS,Q4285,Nudyn dl or dl mesh pr sq cm,,,123.2,546.58,9
HCPCS,Q4286,"Nudyn sl or slw, per sq cm",,,123.2,546.58,9
HCPCS,Q4289,"Revoshield+ amnio, per sq cm",,,123.2,3507.6,9
HCPCS,Q4290,Membrane wrap hydr per sq cm,,,123.2,3507.6,9
HCPCS,Q4292,"Lamellas, per sq cm",,,123.2,2324.42,9
HCPCS,Q4293,"Acesso dl, per sq cm",,,123.2,2362.34,9
HCPCS,Q4294,"Amnio quad-core, per sq cm",,,123.2,4503.0,9
HCPCS,Q4295,"Amnio tri-core, per sq cm",,,123.2,3981.6,9
HCPCS,Q4296,"Rebound matrix, per sq cm",,,123.2,4266.0,9
HCPCS,Q4297,"Emerge matrix, per sq cm",,,123.2,4076.4,9
HCPCS,Q4300,"Acesso tl, per sq cm",,,123.2,3152.42,9
HCPCS,Q4301,"Activate matrix, per sq cm",,,123.2,5100.24,9
HCPCS,Q4302,"Complete aca, per sq cm",,,123.2,2995.6,9
HCPCS,Q4303,"Complete aa, per sq cm",,,123.2,6259.93,9
HCPCS,Q4304,"Grafix plus, per sq cm",,,123.2,2558.57,9
HCPCS,Q4309,"Via matrix, per sq cm",,,123.2,3319.66,9
HCPCS,Q4310,"Procenta, per 100 mg",,,8494.2,9385.2,2
HCPCS,Q4313,"Dermabind fm, per sq cm",,,123.2,5451.0,9
HCPCS,Q4319,"Sanograft, per sq cm",,,123.2,1185.13,9
HCPCS,Q4320,"Pellograft, per sq cm",,,123.2,1422.14,9
HCPCS,Q4322,"Caregraft, per sq cm",,,123.2,3412.8,9
HCPCS,Q4323,"Alloply, per sq cm",,,123.2,2607.0,9
HCPCS,Q4324,"Amniotx, per sq cm",,,123.2,2607.0,9
HCPCS,Q4325,"Acapatch, per sq cm",,,123.2,3886.8,9
HCPCS,Q4326,"Woundplus, per sq cm",,,123.2,2962.5,9
HCPCS,Q4331,"Axolotl graft, per sq cm",,,123.2,3209.38,9
HCPCS,Q4332,"Axolotl dualgraft, per sq cm",,,123.2,3209.38,9
HCPCS,Q4333,"Ardeograft, per sq cm",,,123.2,1422.0,9
HCPCS,Q4339,"Artacent vericlen, per sq cm",,,123.2,4380.11,9
HCPCS,Q4343,Dermacyte ac matrx per sq cm,,,123.2,4399.86,9
HCPCS,Q4344,"Tri membrane wrap, per sq cm",,,123.2,4834.8,9
HCPCS,Q5100,USTEKINUMAB-KFCE 130 MG/26 ML IV SOLN,4248.0,2973.6,,,0
HCPCS,Q5101,FILGRASTIM-SNDZ 300 MCG/0.5 ML INJ SYRG,976.0,683.2,,,0
HCPCS,Q5101,FILGRASTIM-SNDZ 480 MCG/0.8 ML INJ SYRG,1212.0,848.4,,,0
HCPCS,Q5101,Inj filgrastim gcsf biosimil,,,0.35,3.67,13
HCPCS,Q5103,INFLIXIMAB-DYYB 100 MG IV SOLR,8750.0,6125.0,,,0
HCPCS,Q5103,"Injection, inflectra",,,26.04,231.95,13
HCPCS,Q5104,HC NC INFLIXIMAB-ABDA 100 MG SOLR 1 EACH VIAL,0.01,0.007,,,0
HCPCS,Q5104,INFLIXIMAB-ABDA 100 MG IV SOLR,10397.0,7277.9,,,0
HCPCS,Q5104,"Injection, renflexis",,,26.8,243.36,13
HCPCS,Q5105,Inj Retacrit esrd on dialysi,,,1.89,4.42,6
HCPCS,Q5106,EPOETIN ALFA-EPBX 10000 UNITS/ML INJ SOLN,334.0,233.79999999999998,,,0
HCPCS,Q5106,EPOETIN ALFA-EPBX 40000 UNITS/ML INJ SOLN,1218.0,852.6,,,0
HCPCS,Q5106,Inj Retacrit non-esrd use,,,7.88,44.2,13
HCPCS,Q5107,BEVACIZUMAB-AWWB 25 MG/ML IV SOLN,5778.0,4044.6,,,0
HCPCS,Q5107,Inj mvasi 10 mg,,,23.74,263.74,11
HCPCS,Q5108,"Injection, fulphila",,,79.5,1394.03,13
HCPCS,Q5108,PEGFILGRASTIM-JMDB (FULPHILA) 6 MG/0.6 ML SUBQ SYRG,8642.5,6049.75,,,0
HCPCS,Q5110,Nivestym,,,0.28,2.93,13
HCPCS,Q5111,"Injection, udenyca 0.5 mg",,,135.89,1311.87,13
HCPCS,Q5111,PEGFILGRASTIM-CBQV 6 MG/0.6 ML SUBQ SYRG,11523.0,8066.1,,,0
HCPCS,Q5112,Inj ontruzant 10 mg,,,29.81,167.45,9
HCPCS,Q5113,Inj herzuma 10 mg,,,56.02,177.29,9
HCPCS,Q5114,Inj  ogivri 10 mg,,,35.78,142.9,13
HCPCS,Q5115,HC NC RITUXIMAB-ABBS (TRUXIMA),0.01,0.007,,,0
HCPCS,Q5115,Inj truxima 10 mg,,,31.28,329.2,13
HCPCS,Q5115,RITUXIMAB-ABBS 10 MG/ML IV SOLN,17503.5,12252.45,,,0
HCPCS,Q5116,"Inj., trazimera, 10 mg",,,10.42,153.09,9
HCPCS,Q5116,TRASTUZUMAB-QYYP 420 MG IV SOLR,7911.5,5538.05,,,0
HCPCS,Q5117,"Inj., kanjinti, 10 mg",,,56.38,342.74,13
HCPCS,Q5118,BEVACIZUMAB-BVZR 25 MG/ML IV SOLN,5757.0,4029.9,,,0
HCPCS,Q5118,"Inj., zirabev, 10 mg",,,25.85,98.01,9
HCPCS,Q5119,"Inj ruxience, 10 mg",,,13.69,254.48,13
HCPCS,Q5119,RITUXIMAB-PVVR 10 MG/ML IV SOLN,3858.0,2700.6000000000004,,,0
HCPCS,Q5120,Inj pegfilgrastim-bmez 0.5mg,,,119.64,1126.3,13
HCPCS,Q5121,INFLIXIMAB-AXXQ 100 MG IV SOLR,8418.0,5892.6,,,0
HCPCS,Q5121,"Inj. avsola, 10 mg",,,28.04,194.67,13
HCPCS,Q5122,"Inj, nyvepria",,,133.31,1017.35,13
HCPCS,Q5123,"Inj. riabni, 10 mg",,,20.26,243.16,13
HCPCS,Q5124,"Inj. byooviz, 0.1 mg",,,70.9,891.89,13
HCPCS,Q5125,"Inj, releuko 1 mcg",,,0.32,3.06,13
HCPCS,Q5126,BEVACIZUMAB-MALY 25 MG/ML IV SOLN,5951.0,4165.7,,,0
HCPCS,Q5126,Inj alymsys 10 mg,,,51.59,287.93,13
HCPCS,Q5127,"Inj, stimufend, 0.5 mg",,,158.26,1319.75,13
HCPCS,Q5128,"Inj, cimerli, 0.1 mg",,,83.48,1032.94,13
HCPCS,Q5129,"Inj, vegzelma, 10 mg",,,34.65,263.74,13
HCPCS,Q5130,"Inj, fylnetra, 0.5 mg",,,112.13,789.25,13
HCPCS,Q5130,PEGFILGRASTIM-PBBK 6 MG/0.6 ML SUBQ SYRG,6900.0,4830.0,,,0
HCPCS,Q5132,"Inj, abrilada, 10 mg",,,1128.53,1246.9,2
HCPCS,Q5133,"Inj, tofidence, 1 mg",,,5.26,10.52,9
HCPCS,Q5135,"Inj, tyenne, 1 mg",,,4.44,9.29,9
HCPCS,Q5135,TOCILIZUMAB-AAZG 80 MG/4 ML (20 MG/ML) IV SOLN,4160.0,2912.0,,,0
HCPCS,Q5136,DENOSUMAB-BBDZ 60 MG/ML SUBQ SYRG,4428.0,3099.6,,,0
HCPCS,Q9950,Inj sulf hexa lipid microsph,,,49.81,124.97,6
HCPCS,Q9957,"Inj perflutren lip micros,ml",,,281.75,311.31,2
HCPCS,Q9957,PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML IV SUSP,882.0,617.4,,,0
HCPCS,Q9958,DIATRIZOATE MEGLUMINE 18 % URTH SOLN,215.0,150.5,,,0
HCPCS,Q9958,DIATRIZOATE MEGLUMINE 30 % URTH SOLN,245.0,171.5,,,0
HCPCS,Q9966,IOHEXOL 180 MG/ML IT SOLN,267.0,186.9,,,0
HCPCS,Q9966,IOHEXOL 240 MG/ML IV SOLN,150.5,105.35,,,0
HCPCS,Q9966,IOPAMIDOL 41 % (410 MG/ML) IV SOLN,117.0,81.9,,,0
HCPCS,Q9966,IOPAMIDOL 41 % INJ SOLN,25.0,17.5,,,0
HCPCS,Q9966,IOPAMIDOL 41 % IT SOLN,118.0,82.6,,,0
HCPCS,Q9966,IOPAMIDOL 51 % IV SOLN,239.5,167.64999999999998,,,0
HCPCS,Q9966,"LOCM 200-299mg/ml iodine,1ml",,,1.26,1.39,2
HCPCS,Q9967,IODIXANOL 320 MG/ML IV SOLN,273.0,191.10000000000002,,,0
HCPCS,Q9967,IOPAMIDOL 61 % IT SOLN,371.0,259.7,,,0
HCPCS,Q9967,IOPAMIDOL 61 % IV SOLN,168.0,117.6,,,0
HCPCS,Q9967,IOPAMIDOL 76 % IV SOLN,372.0,260.4,,,0
HCPCS,Q9967,IOXAGLATE MEGLUMINE & SODIUM INJ SOLN 39.3 %-19.6 % PHS,147.0,102.9,,,0
HCPCS,Q9967,"LOCM 300-399mg/ml iodine,1ml",,,1.64,1.82,2
HCPCS,Q9968,ISOSULFAN BLUE 1 % INJ SOLN,1370.0,959.0,,,0
HCPCS,Q9968,METHYLENE BLUE (ANTIDOTE) 1 % INJ SOLN,164.0,114.8,,,0
HCPCS,Q9968,METHYLENE BLUE (ANTIDOTE) 5 MG/ML (0.5 %) IV SOLN,273.0,191.1,,,0
HCPCS,Q9968,Visualization adjunct,,,4.33,45.64,11
HCPCS,Q9969,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,1.0,0.7,,,0
HCPCS,Q9969,Non-HEU TC-99M add-on/dose,,,30.3,37.8,4
HCPCS,Q9982,flutemetamol f18 diagnostic,,,1944.01,13222.44,13
HCPCS,Q9983,florbetaben f18 diagnostic,,,1584.67,11219.04,13
HCPCS,Q9991,BUPRENORPHINE 100 MG/0.5 ML SUBQ SLSY,3368.5,2357.95,,,0
HCPCS,Q9991,Buprenorph xr 100 mg or less,,,1996.56,6330.74,13
HCPCS,Q9992,Buprenorphine xr over 100 mg,,,1996.56,6330.74,13
HCPCS,R0070,Transport portable x-ray,,,726.84,906.75,4
HCPCS,R0075,Transport port x-ray multipl,,,726.84,906.75,4
HCPCS,R0076,Transport portable EKG,,,71.96,89.78,4
HCPCS,S0013,Description Not Available,,,23.67,26.15,2
HCPCS,S0017,"Injection, aminocaproic acid, 5mg",,,15.8,17.46,2
HCPCS,S0023,"Injection, cimetidine HCl, 300 mg",,,0.11,0.13,2
HCPCS,S0028,"Injection, famotidine, 20mg",,,1.54,1.71,2
HCPCS,S0032,"Injection, nafcillin sodium, 2 g",,,38.78,42.85,2
HCPCS,S0074,"Injection, cefotetan disodium, 500 mg",,,16.5,18.23,2
HCPCS,S0080,"Injection, pentamidine isethonate, 300 mg",,,212.88,235.21,2
HCPCS,S0090,"Sildenafil citrate, 25 mg",,,37.58,41.52,2
HCPCS,S0091,"Granisetron HCl, 1mg (for circumstances falling under the Medicare Statute, use Q0166)",,,154.8,171.04,2
HCPCS,S0104,"Zidovudine, oral, 100 mg",,,2.9,3.21,2
HCPCS,S0106,"Buproprion HCl sustained release tablit, 150 mg, per bottle of 60 tablets",,,13.51,14.93,2
HCPCS,S0108,"Mercaptopuine, oral, 50 mg",,,10.27,11.34,2
HCPCS,S0109,"Methadone, oral, 5 mg",,,0.39,0.43,2
HCPCS,S0119,Description Not Available,,,34.18,37.76,2
HCPCS,S0122,"Injection, menotropins, 75 IU",,,416.56,460.25,2
HCPCS,S0126,"Injection, follitropin alfa, 75 IU",,,414.43,457.9,2
HCPCS,S0128,"Injection, follitropin beta, 75 IU",,,373.23,412.38,2
HCPCS,S0132,"Injection, ganirelix acetate, 250 mcg",,,322.35,356.16,2
HCPCS,S0136,"Clozapine, 25 mg",,,1.47,1.63,2
HCPCS,S0137,"Didanosine (ddI), 25 mg",,,1.1,1.22,2
HCPCS,S0138,"Finasteride, 5 mg",,,4.48,4.95,2
HCPCS,S0139,"Minoxidil, 10 mg",,,1.84,2.04,2
HCPCS,S0140,"Saquinavir, 200 mg",,,7.48,8.26,2
HCPCS,S0145,"pegylated interferon alfa-2a, 180 mcg/ ml",,,1910.62,2111.04,2
HCPCS,S0148,Peg interferon alfa-2B/10,,,170.24,188.1,2
HCPCS,S0155,"Sterile dilutant for epoprostenol, 50 ml",,,20.18,22.29,2
HCPCS,S0156,"Exemestane, 25 mg",,,28.93,31.96,2
HCPCS,S0157,"Becaplermin gel 0.01%, 0.5 gm",,,74.07,81.84,2
HCPCS,S0160,"Dextoamphetamine sulfate, 5 mg",,,4.15,4.58,2
HCPCS,S0164,"Injection, pantoprazole sodium, 40 mg",,,8.71,9.62,2
HCPCS,S0170,"Anastrozole, oral, 1 mg",,,19.12,21.12,2
HCPCS,S0172,"Chlorambucil, oral, 2 mg",,,952.48,1052.39,2
HCPCS,S0174,"Dolasetron mesylate, oral 50 mg (for circumstances falling under the medicare statute, use q0180)",,,123.64,136.61,2
HCPCS,S0175,"Flutamide, oral, 125 mg",,,51.39,56.79,2
HCPCS,S0176,"Hydroxyurea, oral, 500 mg",,,2.22,2.45,2
HCPCS,S0178,"Lomustine, oral, 10 mg",,,193.04,213.28,2
HCPCS,S0179,"Megestrol acetate, oral, 20 mg",,,0.49,0.54,2
HCPCS,S0182,"Procarbazine HCl, oral, 50 mg",,,221.82,245.09,2
HCPCS,S0183,"Prochlorperazine maleate, oral, 5 mg (for circumstances falling under the medicare statute, use q0164)",,,0.84,0.93,2
HCPCS,S0187,"Tamoxifen citrate, oral, 10 mg",,,2.7,2.99,2
HCPCS,S0189,"testosterone pellet, 75 mg",,,185.64,205.12,2
HCPCS,S0190,MIFEPRISTONE 200 MG ORAL TAB,285.0,199.5,,,0
HCPCS,S0190,"Mitepristone, oral, 200 mg",,,73.65,81.37,2
HCPCS,S0191,MISOPROSTOL 100 MCG ORAL TAB,37.0,25.9,,,0
HCPCS,S0191,MISOPROSTOL 200 MCG ORAL TAB,38.5,26.950000000000003,,,0
HCPCS,S0191,MISOPROSTOL 25 MCG ORAL TAB,25.5,17.85,,,0
HCPCS,S0191,MISOPROSTOL 50 MCG ORAL SPLIT TAB,154.0,107.8,,,0
HCPCS,S0191,MISOPROSTOL 800 MCG (4 X 200 MCG TAB) PACKAGE,34.0,23.8,,,0
HCPCS,S0191,"Misoprostol, oral, 200 mcg",,,2.36,2.61,2
HCPCS,S1091,Description Not Available,,,2831.4,3128.4,2
HCPCS,S5012,5% dextrose with potassium,,,0.39,0.43,2
HCPCS,S5550,Insulin rapid 5 u,,,0.41,0.46,2
HCPCS,S5551,Insulin most rapid 5 u,,,0.6,0.66,2
HCPCS,S5552,Insulin intermed 5 u,,,0.4,0.44,2
HCPCS,S5553,Insulin long acting 5 u,,,0.56,0.62,2
HCPCS,S5561,Insulin reuse pen 3 ml,,,54.61,60.34,2
HCPCS,S5571,Insulin dispos pen 3 ml,,,54.61,60.34,2
HCPCS,S9443,HC LACTATION CLASSES NON-PHYSICIAN PROVIDER PER SESSION,76.0,53.2,,,0
HCPCS,S9443,HC LACTATION CLASSES NON-PHYSICIAN PROVIDER PER SESSION 15 MIN,55.0,38.5,,,0
HCPCS,S9443,HC LACTATION CLASSES NON-PHYSICIAN PROVIDER PER SESSION 30 MIN,76.0,53.2,,,0
HCPCS,S9443,HC LACTATION CLASSES NON-PHYSICIAN PROVIDER PER SESSION 45 MIN,99.0,69.3,,,0
HCPCS,S9443,HC LACTATION CLASSES NON-PHYSICIAN PROVIDER PER SESSION 60 MIN,120.0,84.0,,,0
HCPCS,T1017,HC T1017 INITIAL ASSESSMENT,1002.0,701.4,,,0
HCPCS,T2022,HC T2022 CASE MANAGEMENT SUBSEQUENT,792.0,554.4,,,0
HCPCS,T2101,HC HUMAN BREAST MILK PROCESSING STORAGE/DISTRIBUTION ONLY,22.0,15.4,,,0
HCPCS,U0001,2019 nCoV diagnostic P,,,32.33,135.78,11
HCPCS,U0001,HC CDC 2019-NCOV REAL-TIME RT-PCR DIAGNOSTIC PANEL,94.0,65.8,,,0
HCPCS,U0002,COVID-19 lab test non-CDC,,,46.18,194.03,11
HCPCS,U0002,HC COVID-19 MULTIPLE TYPES/SUBTYPES NON-CDC,134.0,93.8,,,0
HCPCS,U0003,Cov-19 amp prb hgh thruput,,,227.25,283.5,4
HCPCS,U0004,Cov-19 test non-cdc hgh thru,,,227.25,283.5,4
HCPCS,U0005,Infec agen detec ampli probe,,,75.75,94.5,4
HCPCS,V2020,Vision svcs frames purchases,,,82.43,229.52,10
HCPCS,V2100,Lens spher single plano 4.00,,,58.85,163.83,10
HCPCS,V2101,Single visn sphere 4.12-7.00,,,67.38,187.64,10
HCPCS,V2102,Singl visn sphere 7.12-20.00,,,74.88,208.58,10
HCPCS,V2103,Spherocylindr 4.00d/12-2.00d,,,44.55,124.1,10
HCPCS,V2104,Spherocylindr 4.00d/2.12-4d,,,52.7,146.7,10
HCPCS,V2105,Spherocylinder 4.00d/4.25-6d,,,51.58,143.68,10
HCPCS,V2106,Spherocylinder 4.00d/>6.00d,,,61.64,171.65,10
HCPCS,V2107,Spherocylinder 4.25d/12-2d,,,66.43,185.07,10
HCPCS,V2108,Spherocylinder 4.25d/2.12-4d,,,65.19,181.55,10
HCPCS,V2109,Spherocylinder 4.25d/4.25-6d,,,62.51,174.07,10
HCPCS,V2110,Spherocylinder 4.25d/over 6d,,,60.05,167.19,10
HCPCS,V2111,Spherocylindr 7.25d/.25-2.25,,,70.28,195.77,10
HCPCS,V2112,Spherocylindr 7.25d/2.25-4d,,,90.89,253.11,10
HCPCS,V2113,Spherocylindr 7.25d/4.25-6d,,,97.82,272.39,10
HCPCS,V2114,Spherocylinder over 12.00d,,,110.95,308.98,10
HCPCS,V2115,Lens lenticular bifocal,,,120.75,336.31,10
HCPCS,V2118,Lens aniseikonic single,,,89.78,250.05,10
HCPCS,V2121,"Lenticular lens, single",,,123.58,344.21,10
HCPCS,V2200,Lens spher bifoc plano 4.00d,,,72.49,201.89,10
HCPCS,V2201,Lens sphere bifocal 4.12-7.0,,,76.34,212.63,10
HCPCS,V2202,Lens sphere bifocal 7.12-20.,,,86.74,241.58,10
HCPCS,V2203,Lens sphcyl bifocal 4.00d/.1,,,71.22,198.26,10
HCPCS,V2204,Lens sphcy bifocal 4.00d/2.1,,,72.45,201.78,10
HCPCS,V2205,Lens sphcy bifocal 4.00d/4.2,,,75.59,210.55,10
HCPCS,V2206,Lens sphcy bifocal 4.00d/ove,,,77.3,215.23,10
HCPCS,V2207,Lens sphcy bifocal 4.25-7d/.,,,72.01,200.53,10
HCPCS,V2208,Lens sphcy bifocal 4.25-7/2.,,,79.92,222.57,10
HCPCS,V2209,Lens sphcy bifocal 4.25-7/4.,,,79.05,220.15,10
HCPCS,V2210,Lens sphcy bifocal 4.25-7/ov,,,90.37,251.67,10
HCPCS,V2211,Lens sphcy bifo 7.25-12/.25-,,,90.41,251.79,10
HCPCS,V2212,Lens sphcyl bifo 7.25-12/2.2,,,93.36,260.03,10
HCPCS,V2213,Lens sphcyl bifo 7.25-12/4.2,,,99.77,277.83,10
HCPCS,V2214,Lens sphcyl bifocal over 12.,,,102.51,285.5,10
HCPCS,V2215,Lens lenticular bifocal,,,116.89,325.57,10
HCPCS,V2218,Lens aniseikonic bifocal,,,123.83,344.89,10
HCPCS,V2219,Lens bifocal seg width over,,,62.94,175.35,10
HCPCS,V2220,Lens bifocal add over 3.25d,,,57.62,160.46,10
HCPCS,V2221,"Lenticular lens, bifocal",,,123.13,342.85,10
HCPCS,V2300,Lens sphere trifocal 4.00d,,,94.67,263.66,10
HCPCS,V2301,Lens sphere trifocal 4.12-7.,,,123.97,345.27,10
HCPCS,V2302,Lens sphere trifocal 7.12-20,,,124.56,346.93,10
HCPCS,V2303,Lens sphcy trifocal 4.0/.12-,,,89.96,250.58,10
HCPCS,V2304,Lens sphcy trifocal 4.0/2.25,,,87.84,244.6,10
HCPCS,V2305,Lens sphcy trifocal 4.0/4.25,,,109.09,303.76,10
HCPCS,V2306,Lens sphcyl trifocal 4.00/>6,,,130.86,364.43,10
HCPCS,V2307,Lens sphcy trifocal 4.25-7/.,,,98.37,273.9,10
HCPCS,V2308,Lens sphc trifocal 4.25-7/2.,,,102.33,284.97,10
HCPCS,V2309,Lens sphc trifocal 4.25-7/4.,,,114.45,318.73,10
HCPCS,V2310,Lens sphc trifocal 4.25-7/>6,,,104.83,291.93,10
HCPCS,V2311,Lens sphc trifo 7.25-12/.25-,,,131.08,365.07,10
HCPCS,V2312,Lens sphc trifo 7.25-12/2.25,,,123.93,345.15,10
HCPCS,V2313,Lens sphc trifo 7.25-12/4.25,,,129.43,360.5,10
HCPCS,V2314,Lens sphcyl trifocal over 12,,,131.58,366.43,10
HCPCS,V2315,Lens lenticular trifocal,,,146.08,406.84,10
HCPCS,V2318,Lens aniseikonic trifocal,,,179.58,500.13,10
HCPCS,V2319,Lens trifocal seg width > 28,,,68.64,191.12,10
HCPCS,V2320,Lens trifocal add over 3.25d,,,85.52,238.18,10
HCPCS,V2321,"Lenticular lens, trifocal",,,145.66,405.59,10
HCPCS,V2410,Lens variab asphericity sing,,,129.49,360.69,10
HCPCS,V2430,Lens variable asphericity bi,,,149.99,417.77,10
HCPCS,V2500,Contact lens pmma spherical,,,124.39,346.4,10
HCPCS,V2501,Cntct lens pmma-toric/prism,,,151.57,422.11,10
HCPCS,V2502,Contact lens pmma bifocal,,,186.72,520.01,10
HCPCS,V2503,Cntct lens pmma color vision,,,171.97,478.93,10
HCPCS,V2510,Cntct gas permeable sphericl,,,179.61,500.25,10
HCPCS,V2511,Cntct toric prism ballast,,,232.93,648.76,10
HCPCS,V2512,Cntct lens gas permbl bifocl,,,307.49,856.4,10
HCPCS,V2513,Contact lens extended wear,,,258.16,718.99,10
HCPCS,V2520,Contact lens hydrophilic,,,154.56,430.47,10
HCPCS,V2521,Cntct lens hydrophilic toric,,,236.36,658.25,10
HCPCS,V2522,Cntct lens hydrophil bifocl,,,288.43,803.29,10
HCPCS,V2523,Cntct lens hydrophil extend,,,225.33,627.52,10
HCPCS,V2524,Cntct lens hydrophil photoch,,,180.12,315.21,6
HCPCS,V2530,Contact lens gas impermeable,,,348.04,969.31,10
HCPCS,V2531,Contact lens gas permeable,,,670.24,1866.68,10
HCPCS,V2623,Plastic eye prosth custom,,,1465.24,4080.7,10
HCPCS,V2624,Polishing artifical eye,,,97.78,272.27,10
HCPCS,V2625,Enlargemnt of eye prosthesis,,,469.62,1307.88,10
HCPCS,V2626,Reduction of eye prosthesis,,,325.67,906.97,10
HCPCS,V2627,Scleral cover shell,,,1772.96,4937.66,10
HCPCS,V2628,Fabrication & fitting,,,461.21,1284.52,10
HCPCS,V2700,Balance lens,,,64.87,180.65,10
HCPCS,V2710,Glass/plastic slab off prism,,,97.39,271.18,10
HCPCS,V2715,Prism lens/es,,,16.08,44.76,10
HCPCS,V2718,Fresnell prism press-on lens,,,39.93,111.17,10
HCPCS,V2730,Special base curve,,,34.42,95.86,10
HCPCS,V2744,Tint photochromatic lens/es,,,25.56,71.25,10
HCPCS,V2745,"Tint, any color/solid/grad",,,16.76,46.68,10
HCPCS,V2750,Anti-reflective coating,,,31.15,86.75,10
HCPCS,V2755,UV lens/es,,,27.11,75.52,10
HCPCS,V2760,Scratch resistant coating,,,48.48,60.48,4
HCPCS,V2762,"Polarization, any lens",,,164.74,205.52,4
HCPCS,V2770,Occluder lens/es,,,26.2,72.95,10
HCPCS,V2780,Oversize lens/es,,,15.34,42.71,10
HCPCS,V2782,"Lens, 1.54-1.65 p/1.60-1.79g",,,79.68,221.92,10
HCPCS,V2783,"Lens, >= 1.66 p/>=1.80 g",,,89.83,250.24,10
HCPCS,V2784,Lens polycarb or equal,,,58.43,162.77,10
HCPCS,V5261,"Hearing aid, digit, bin, bte",,,13332.0,16632.0,4
HCPCS,c1876,HC CAROTID WALLSTENT 8X29 5FR MR,6374.0,4461.8,,,0
HCPCS,j3490,FAT EMULSION 20 % IV EMUL,176.5,123.55000000000001,,,0
HCPCS,j3490,GLUCOSE (TOLERANCE TEST) 100 GRAM/180 ML ORAL LIQD,46.0,32.2,,,0
HCPCS,j3490,OXYMETAZOLINE 0.05 % NASL SPRAY (BLUE DYE FOR OR),14.0,9.8,,,0
HCPCS,j3490,PROGESTERONE MICRONIZED  8 % VAGL GEL,226.0,158.2,,,0
HCPCS,j3490,TRAZODONE  50 MG ORAL TAB,8.0,5.6,,,0
HCPCS,j3490,URSODIOL 60 MG/ML ORAL SUSPENSION (REPACK),7.0,4.9,,,0
HCPCS,j3690,"HEPARIN (PORCINE) IN 0.9% NACL 2,500 UNIT/250 ML (10 UNIT/ML) IV SOLP",16.0,11.2,,,0
HCPCS,q5136,DENOSUMAB-BBDZ 120 MG/1.7 ML (70 MG/ML) SUBQ SOLN,8855.0,6198.5,,,0
MS-DRG,1,Heart Transplant Or Implant Of Heart Assist System With Mcc,,,217336.17,653009.82,16
MS-DRG,10,Pancreas Transplant,,,56511.92,184836.76,16
MS-DRG,100,Seizures With Mcc,,,15318.1,46024.88,16
MS-DRG,101,Seizures Without Mcc,,,7111.2,21366.37,16
MS-DRG,102,Headaches With Mcc,,,8946.1,26879.53,16
MS-DRG,103,Headaches Without Mcc,,,6560.27,19711.04,16
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,11,"Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc",,,41633.26,125091.59,16
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,,,17412.26,52317.01,16
MS-DRG,114,Orbital Procedures Without Cc/Mcc,,,9121.26,27405.81,16
MS-DRG,115,Extraocular Procedures Except Orbit,,,11812.65,35492.39,16
MS-DRG,116,Intraocular Procedures With Cc/Mcc,,,12874.4,38682.5,16
MS-DRG,117,Intraocular Procedures Without Cc/Mcc,,,8322.64,25006.26,16
MS-DRG,118,Cardiac Pacemaker Device Replacement,,,,,0
MS-DRG,119,Vein ligation & stripping,,,,,0
MS-DRG,12,"Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc",,,31662.45,95133.23,16
MS-DRG,120,Other circulatory system O.R. procedures,,,,,0
MS-DRG,121,Acute Major Eye Infections With Cc/Mcc,,,8974.65,26965.31,16
MS-DRG,122,Acute Major Eye Infections Without Cc/Mcc,,,5233.86,15725.71,16
MS-DRG,123,Neurological Eye Disorders,,,6197.61,18621.39,16
MS-DRG,124,Other Disorders Of The Eye With Mcc Or Thrombolytic Agent,,,10060.32,30227.3,16
MS-DRG,125,Other Disorders Of The Eye Without Mcc,,,6371.23,19143.03,16
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,13,"Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc",,,20446.25,61432.96,16
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,,,17777.78,55894.31,16
MS-DRG,136,Sinus And Mastoid Procedures Without Cc/Mcc,,,7547.94,22678.59,16
MS-DRG,137,Mouth Procedures With Cc/Mcc,,,10791.04,32422.82,16
MS-DRG,138,Mouth Procedures Without Cc/Mcc,,,6277.09,18860.18,16
MS-DRG,139,Salivary Gland Procedures,,,10548.16,31829.31,16
MS-DRG,14,Allogeneic Bone Marrow Transplant,,,93980.89,303731.27,16
MS-DRG,140,Major Head And Neck Procedures With Mcc,,,32631.6,98045.14,16
MS-DRG,141,Major Head And Neck Procedures With Cc,,,16576.61,49806.19,16
MS-DRG,142,Major Head And Neck Procedures Without Cc/Mcc,,,12132.1,36452.2,16
MS-DRG,143,"Other Ear, Nose, Mouth And Throat O.R. Procedures With Mcc",,,25476.41,76546.61,16
MS-DRG,144,"Other Ear, Nose, Mouth And Throat O.R. Procedures With Cc",,,13554.19,40725.01,16
MS-DRG,145,"Other Ear, Nose, Mouth And Throat O.R. Procedures Without Cc/Mcc",,,9141.32,27466.08,16
MS-DRG,146,"Ear, Nose, Mouth And Throat Malignancy With Mcc",,,17370.76,53181.78,16
MS-DRG,147,"Ear, Nose, Mouth And Throat Malignancy With Cc",,,9604.29,28857.12,16
MS-DRG,148,"Ear, Nose, Mouth And Throat Malignancy Without Cc/Mcc",,,6178.32,18563.43,16
MS-DRG,149,Dysequilibrium,,,5767.82,17330.04,16
MS-DRG,150,Epistaxis With Mcc,,,10664.49,32042.61,16
MS-DRG,151,Epistaxis Without Mcc,,,5848.84,17573.47,16
MS-DRG,152,Otitis Media And Uri With Mcc,,,8755.52,26306.88,16
MS-DRG,153,Otitis Media And Uri Without Mcc,,,5491.58,16500.05,16
MS-DRG,154,"Other Ear, Nose, Mouth And Throat Diagnoses With Mcc",,,12548.0,37701.82,16
MS-DRG,155,"Other Ear, Nose, Mouth And Throat Diagnoses With Cc",,,7203.8,21644.58,16
MS-DRG,156,"Other Ear, Nose, Mouth And Throat Diagnoses Without Cc/Mcc",,,5188.34,15588.92,16
MS-DRG,157,Dental And Oral Diseases With Mcc,,,12634.42,37961.48,16
MS-DRG,158,Dental And Oral Diseases With Cc,,,7257.04,21804.55,16
MS-DRG,159,Dental And Oral Diseases Without Cc/Mcc,,,5089.57,15292.17,16
MS-DRG,16,Autologous Bone Marrow Transplant With Cc/Mcc,,,46570.82,139927.03,16
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,,,35562.96,106852.74,16
MS-DRG,164,Major Chest Procedures With Cc,,,19420.01,58349.49,16
MS-DRG,165,Major Chest Procedures Without Cc/Mcc,,,14382.13,43212.66,16
MS-DRG,166,Other Respiratory System O.R. Procedures With Mcc,,,29714.89,89281.58,16
MS-DRG,167,Other Respiratory System O.R. Procedures With Cc,,,14098.18,42359.49,16
MS-DRG,168,Other Respiratory System O.R. Procedures Without Cc/Mcc,,,10446.12,31386.5,16
MS-DRG,169,Mouth Procedures w/o CC,,,,,0
MS-DRG,17,Autologous Bone Marrow Transplant Without Cc/Mcc,,,43021.47,139927.03,16
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,,,23676.23,71137.79,16
MS-DRG,174,G.I. hemorrhage w CC,,,,,0
MS-DRG,175,Pulmonary Embolism With Mcc Or Acute Cor Pulmonale,,,10872.83,32668.57,16
MS-DRG,176,Pulmonary Embolism Without Mcc,,,6284.8,18883.37,16
MS-DRG,177,Respiratory Infections And Inflammations With Mcc,,,12473.16,37476.94,16
MS-DRG,178,Respiratory Infections And Inflammations With Cc,,,7655.19,23000.85,16
MS-DRG,179,Respiratory Infections And Inflammations Without Cc/Mcc,,,5939.12,17844.72,16
MS-DRG,18,Chimeric Antigen Receptor (Car) T-Cell And Other Immunotherapies,,,290977.56,874273.28,16
MS-DRG,180,Respiratory Neoplasms With Mcc,,,13485.52,40518.68,16
MS-DRG,181,Respiratory Neoplasms With Cc,,,8566.47,25738.88,16
MS-DRG,182,Respiratory Neoplasms Without Cc/Mcc,,,6462.28,19416.6,16
MS-DRG,183,Major Chest Trauma With Mcc,,,12247.07,36797.64,16
MS-DRG,184,Major Chest Trauma With Cc,,,8240.85,24760.51,16
MS-DRG,185,Major Chest Trauma Without Cc/Mcc,,,6000.08,18027.88,16
MS-DRG,186,Pleural Effusion With Mcc,,,12191.52,36630.72,16
MS-DRG,187,Pleural Effusion With Cc,,,7746.24,23274.42,16
MS-DRG,188,Pleural Effusion Without Cc/Mcc,,,5664.43,17019.37,16
MS-DRG,189,Pulmonary Edema And Respiratory Failure,,,9548.74,28690.2,16
MS-DRG,19,Simultaneous Pancreas And Kidney Transplant With Hemodialysis,,,56193.88,183772.61,16
MS-DRG,190,Chronic Obstructive Pulmonary Disease With Mcc,,,8667.55,26042.59,16
MS-DRG,191,Chronic Obstructive Pulmonary Disease With Cc,,,6628.94,19917.37,16
MS-DRG,192,Chronic Obstructive Pulmonary Disease Without Cc/Mcc,,,4993.89,15004.68,16
MS-DRG,193,Simple Pneumonia And Pleurisy With Mcc,,,10168.34,30551.88,16
MS-DRG,194,Simple Pneumonia And Pleurisy With Cc,,,6327.24,19010.88,16
MS-DRG,195,Simple Pneumonia And Pleurisy Without Cc/Mcc,,,4805.62,14439.0,16
MS-DRG,196,Interstitial Lung Disease With Mcc,,,14538.77,43683.29,16
MS-DRG,197,Interstitial Lung Disease With Cc,,,7638.22,22949.84,16
MS-DRG,198,Interstitial Lung Disease Without Cc/Mcc,,,5404.39,16238.07,16
MS-DRG,199,Pneumothorax With Mcc,,,13620.55,40924.4,16
MS-DRG,2,Heart Transplant Or Implant Of Heart Assist System Without Mcc,,,85029.66,255480.72,16
MS-DRG,20,Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc,,,61875.12,186874.63,16
MS-DRG,200,Pneumothorax With Cc,,,8544.86,25673.96,16
MS-DRG,201,Pneumothorax Without Cc/Mcc,,,5223.06,15693.25,16
MS-DRG,202,Bronchitis And Asthma With Cc/Mcc,,,7459.2,22411.97,16
MS-DRG,203,Bronchitis And Asthma Without Cc/Mcc,,,5372.76,16143.02,16
MS-DRG,204,Respiratory Signs And Symptoms,,,6257.03,18799.91,16
MS-DRG,205,Other Respiratory System Diagnoses With Mcc,,,14565.78,43764.44,16
MS-DRG,206,Other Respiratory System Diagnoses Without Mcc,,,6989.29,21000.07,16
MS-DRG,207,Respiratory System Diagnosis With Ventilator Support >96 Hours,,,49905.74,149947.16,16
MS-DRG,208,Respiratory System Diagnosis With Ventilator Support <=96 Hours,,,20710.92,62228.17,16
MS-DRG,209,Complex Aortic Arch Procedures,,,88571.25,149038.16,6
MS-DRG,21,Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc,,,41949.76,128144.92,16
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,,,84052.79,252545.63,16
MS-DRG,213,Endovascular Abdominal Aorta With Iliac Branch Procedures,,,45146.33,75967.38,6
MS-DRG,214,No Longer Valid,,,,,0
MS-DRG,215,Other Heart Assist System Implant,,,78033.63,245615.93,16
MS-DRG,216,Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization With Mcc,,,74463.93,223734.87,16
MS-DRG,217,Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization With Cc,,,49826.27,149708.36,16
MS-DRG,218,Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization Without Cc/Mcc,,,45904.15,137923.93,16
MS-DRG,219,Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheterization With Mcc,,,59699.85,179374.61,16
MS-DRG,22,Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/Mcc,,,25573.05,81848.79,16
MS-DRG,220,Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheterization With Cc,,,40867.05,122789.42,16
MS-DRG,221,Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheterization Without Cc/M,,,35434.88,106467.88,16
MS-DRG,222,"Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock With Mcc",,,59079.47,177510.61,9
MS-DRG,223,"Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock Without Mcc",,,40268.27,120990.34,9
MS-DRG,224,"Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Shock With Mcc",,,54701.33,164356.01,9
MS-DRG,225,"Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Shock Without Mcc",,,39025.97,117257.72,9
MS-DRG,226,Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc,,,49390.3,148398.47,9
MS-DRG,227,Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc,,,38740.47,116399.91,9
MS-DRG,228,Other Cardiothoracic Procedures With Mcc,,,38448.8,115523.55,16
MS-DRG,229,Other Cardiothoracic Procedures Without Mcc,,,23967.13,72011.82,16
MS-DRG,23,Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis With Mcc Or Antineopla,,,44018.32,132257.76,16
MS-DRG,230,Other cardiothoracic procedures w/o CC/MCC,,,,,0
MS-DRG,231,Coronary Bypass With Ptca With Mcc,,,65382.03,196447.31,16
MS-DRG,232,Coronary Bypass With Ptca Without Mcc,,,47132.56,141614.83,16
MS-DRG,233,Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc,,,60144.91,181201.51,16
MS-DRG,234,Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc,,,41049.15,123336.56,16
MS-DRG,235,Coronary Bypass Without Cardiac Catheterization With Mcc,,,45400.28,136410.02,16
MS-DRG,236,Coronary Bypass Without Cardiac Catheterization Without Mcc,,,31727.27,95327.97,16
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,,,38862.39,116766.22,16
MS-DRG,24,Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Without Mcc,,,29332.17,88131.66,16
MS-DRG,240,Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc,,,22469.43,67511.81,16
MS-DRG,241,Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc/Mcc,,,11649.84,35003.2,16
MS-DRG,242,Permanent Cardiac Pacemaker Implant With Mcc,,,25692.21,78640.13,16
MS-DRG,243,Permanent Cardiac Pacemaker Implant With Cc,,,17382.17,52226.6,16
MS-DRG,244,Permanent Cardiac Pacemaker Implant Without Cc/Mcc,,,13925.34,41840.16,16
MS-DRG,245,Aicd Generator Procedures,,,36290.19,113288.62,16
MS-DRG,246,Percutaneous Cardiovascular Procedures With Drug-Eluting Stent With Mcc Or 4+ Arteries Or Stents,,,23112.96,69445.35,9
MS-DRG,247,Percutaneous Cardiovascular Procedures With Drug-Eluting Stent Without Mcc,,,14733.99,44269.85,9
MS-DRG,248,Percutaneous Cardiovascular Procedures With Non-Drug-Eluting Stent With Mcc Or 4+ Arteries Or Stents,,,23224.07,69779.2,9
MS-DRG,249,Percutaneous Cardiovascular Procedures With Non-Drug-Eluting Stent Without Mcc,,,14017.93,42118.37,9
MS-DRG,25,Craniotomy And Endovascular Intracranial Procedures With Mcc,,,34506.62,103678.85,16
MS-DRG,250,Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc,,,17845.14,53617.64,16
MS-DRG,251,Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc,,,12056.48,36225.0,16
MS-DRG,252,Other Vascular Procedures With Mcc,,,26467.94,79525.76,16
MS-DRG,253,Other Vascular Procedures With Cc,,,19698.56,59186.43,16
MS-DRG,254,Other Vascular Procedures Without Cc/Mcc,,,13497.86,40555.77,16
MS-DRG,255,Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc,,,20187.76,60656.3,16
MS-DRG,256,Upper Limb And Toe Amputation For Circulatory System Disorders With Cc,,,13068.07,39264.42,16
MS-DRG,257,Upper Limb And Toe Amputation For Circulatory System Disorders Without Cc/Mcc,,,6882.03,20677.81,16
MS-DRG,258,Cardiac Pacemaker Device Replacement With Mcc,,,21646.89,65040.39,16
MS-DRG,259,Cardiac Pacemaker Device Replacement Without Mcc,,,13561.91,40748.2,16
MS-DRG,26,Craniotomy And Endovascular Intracranial Procedures With Cc,,,23599.07,70905.95,16
MS-DRG,260,Cardiac Pacemaker Revision Except Device Replacement With Mcc,,,26156.49,78983.25,16
MS-DRG,261,Cardiac Pacemaker Revision Except Device Replacement With Cc,,,14640.62,43989.32,16
MS-DRG,262,Cardiac Pacemaker Revision Except Device Replacement Without Cc/Mcc,,,11710.8,35186.36,16
MS-DRG,263,Vein Ligation And Stripping,,,20693.94,62177.17,16
MS-DRG,264,Other Circulatory System O.R. Procedures,,,26835.89,81025.76,16
MS-DRG,265,Aicd Lead Procedures,,,27522.74,82695.01,16
MS-DRG,266,Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc,,,46222.82,138881.43,16
MS-DRG,267,Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc,,,36299.86,109066.81,16
MS-DRG,268,Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc,,,51445.12,154572.36,16
MS-DRG,269,Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc,,,32102.27,96454.71,16
MS-DRG,27,Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc,,,19040.37,57208.84,16
MS-DRG,270,Other Major Cardiovascular Procedures With Mcc,,,39605.45,118998.84,16
MS-DRG,271,Other Major Cardiovascular Procedures With Cc,,,26577.51,79854.97,16
MS-DRG,272,Other Major Cardiovascular Procedures Without Cc/Mcc,,,19305.81,58006.37,16
MS-DRG,273,Percutaneous And Other Intracardiac Procedures With Mcc,,,30170.15,90649.44,16
MS-DRG,274,Percutaneous And Other Intracardiac Procedures Without Mcc,,,24080.56,72352.63,16
MS-DRG,275,Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc,,,54526.17,163829.74,16
MS-DRG,276,Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator,,,47465.41,143601.7,16
MS-DRG,277,Cardiac Defibrillator Implant Without Mcc,,,35897.07,107856.6,16
MS-DRG,278,Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures With Mcc,,,38603.13,115987.23,16
MS-DRG,279,Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures Without Mcc,,,24724.09,74286.17,16
MS-DRG,28,Spinal Procedures With Mcc,,,46907.25,140937.85,16
MS-DRG,280,"Acute Myocardial Infarction, Discharged Alive With Mcc",,,12666.06,38056.54,16
MS-DRG,281,"Acute Myocardial Infarction, Discharged Alive With Cc",,,7112.75,21371.01,16
MS-DRG,282,"Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc",,,5594.98,16810.72,16
MS-DRG,283,"Acute Myocardial Infarction, Expired With Mcc",,,15088.16,45333.99,16
MS-DRG,284,"Acute Myocardial Infarction, Expired With Cc",,,5716.9,17177.03,16
MS-DRG,285,"Acute Myocardial Infarction, Expired Without Cc/Mcc",,,4331.07,13013.18,16
MS-DRG,286,"Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc",,,17078.15,51313.15,16
MS-DRG,287,"Circulatory Disorders Except Ami, With Cardiac Catheterization Without Mcc",,,8407.52,25261.29,16
MS-DRG,288,Acute And Subacute Endocarditis With Mcc,,,21075.12,63322.46,16
MS-DRG,289,Acute And Subacute Endocarditis With Cc,,,12165.28,36551.89,16
MS-DRG,29,Spinal Procedures With Cc Or Spinal Neurostimulators,,,25899.26,77817.1,16
MS-DRG,290,Acute And Subacute Endocarditis Without Cc/Mcc,,,7554.11,22697.14,16
MS-DRG,291,Heart Failure And Shock With Mcc,,,10068.8,30252.8,16
MS-DRG,292,Heart Failure And Shock With Cc,,,6645.92,19968.38,16
MS-DRG,293,Heart Failure And Shock Without Cc/Mcc,,,4236.17,12728.02,16
MS-DRG,294,Deep Vein Thrombophlebitis With Cc/Mcc,,,9474.66,28467.63,10
MS-DRG,295,Deep Vein Thrombophlebitis Without Cc/Mcc,,,6094.22,18310.72,10
MS-DRG,296,"Cardiac Arrest, Unexplained With Mcc",,,12641.37,37982.35,16
MS-DRG,297,"Cardiac Arrest, Unexplained With Cc",,,5435.26,16330.81,16
MS-DRG,298,"Cardiac Arrest, Unexplained Without Cc/Mcc",,,3407.45,10238.05,16
MS-DRG,299,Peripheral Vascular Disorders With Mcc,,,12482.42,37504.76,16
MS-DRG,3,"Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Neck With Major",,,165227.03,496837.76,16
MS-DRG,30,Spinal Procedures Without Cc/Mcc,,,17169.98,51589.04,16
MS-DRG,300,Peripheral Vascular Disorders With Cc,,,8260.14,24818.47,16
MS-DRG,301,Peripheral Vascular Disorders Without Cc/Mcc,,,5503.93,16537.15,16
MS-DRG,302,Atherosclerosis With Mcc,,,8975.43,26967.63,16
MS-DRG,303,Atherosclerosis Without Mcc,,,5188.34,15588.92,16
MS-DRG,304,Hypertension With Mcc,,,9064.93,27236.56,16
MS-DRG,305,Hypertension Without Mcc,,,5792.51,17404.23,16
MS-DRG,306,Cardiac Congenital And Valvular Disorders With Mcc,,,11554.16,34715.72,16
MS-DRG,307,Cardiac Congenital And Valvular Disorders Without Mcc,,,7147.47,21475.34,16
MS-DRG,308,Cardiac Arrhythmia And Conduction Disorders With Mcc,,,9305.68,27959.9,16
MS-DRG,309,Cardiac Arrhythmia And Conduction Disorders With Cc,,,5704.55,17139.93,16
MS-DRG,31,Ventricular Shunt Procedures With Mcc,,,32332.98,97147.92,16
MS-DRG,310,Cardiac Arrhythmia And Conduction Disorders Without Cc/Mcc,,,4317.19,12971.45,16
MS-DRG,311,Angina Pectoris,,,5389.73,16194.02,16
MS-DRG,312,Syncope And Collapse,,,6723.08,20200.22,16
MS-DRG,313,Chest Pain,,,5503.93,16537.15,16
MS-DRG,314,Other Circulatory System Diagnoses With Mcc,,,16615.96,49924.43,16
MS-DRG,315,Other Circulatory System Diagnoses With Cc,,,7425.25,22309.96,16
MS-DRG,316,Other Circulatory System Diagnoses Without Cc/Mcc,,,5267.04,15825.4,16
MS-DRG,317,Concomitant Left Atrial Appendage Closure And Cardiac Ablation,,,47732.1,143416.22,16
MS-DRG,318,Percutaneous Coronary Atherectomy Without Intraluminal Device,,,19729.3,33198.34,6
MS-DRG,319,Other Endovascular Cardiac Valve Procedures With Mcc,,,33893.19,101835.72,16
MS-DRG,32,Ventricular Shunt Procedures With Cc,,,16477.84,49509.43,16
MS-DRG,320,Other Endovascular Cardiac Valve Procedures Without Mcc,,,17859.8,53661.69,16
MS-DRG,321,Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ Arteries/Intraluminal,,,21965.56,65997.89,16
MS-DRG,322,Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc,,,13959.29,41942.17,16
MS-DRG,323,Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc,,,32864.63,98745.29,16
MS-DRG,324,Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc,,,24653.1,74072.88,16
MS-DRG,325,Coronary Intravascular Lithotripsy Without Intraluminal Device,,,22083.62,66352.61,16
MS-DRG,326,"Stomach, Esophageal And Duodenal Procedures With Mcc",,,39188.01,117744.58,16
MS-DRG,327,"Stomach, Esophageal And Duodenal Procedures With Cc",,,18735.58,56293.07,16
MS-DRG,328,"Stomach, Esophageal And Duodenal Procedures Without Cc/Mcc",,,12294.91,36941.39,16
MS-DRG,329,Major Small And Large Bowel Procedures With Mcc,,,35430.25,106453.97,16
MS-DRG,33,Ventricular Shunt Procedures Without Cc/Mcc,,,12310.35,36987.75,16
MS-DRG,330,Major Small And Large Bowel Procedures With Cc,,,18238.66,54800.02,16
MS-DRG,331,Major Small And Large Bowel Procedures Without Cc/Mcc,,,12739.36,38276.78,16
MS-DRG,332,Rectal Resection With Mcc,,,26763.47,80413.7,16
MS-DRG,333,Rectal Resection With Cc,,,16397.59,49268.32,16
MS-DRG,334,Rectal Resection Without Cc/Mcc,,,12796.46,38448.35,16
MS-DRG,335,Peritoneal Adhesiolysis With Mcc,,,27962.56,84016.5,16
MS-DRG,336,Peritoneal Adhesiolysis With Cc,,,16299.6,48973.88,16
MS-DRG,337,Peritoneal Adhesiolysis Without Cc/Mcc,,,11844.29,35587.44,16
MS-DRG,338,Appendectomy With Complicated Principal Diagnosis With Mcc,,,20497.95,61588.3,9
MS-DRG,339,Appendectomy With Complicated Principal Diagnosis With Cc,,,12564.98,37752.83,9
MS-DRG,34,Carotid Artery Stent Procedures With Mcc,,,30004.25,90150.98,16
MS-DRG,340,Appendectomy With Complicated Principal Diagnosis Without Cc/Mcc,,,9258.61,27818.48,9
MS-DRG,341,Appendectomy Without Complicated Principal Diagnosis With Mcc,,,17430.78,52372.66,9
MS-DRG,342,Appendectomy Without Complicated Principal Diagnosis With Cc,,,11213.11,33690.99,9
MS-DRG,343,Appendectomy Without Complicated Principal Diagnosis Without Cc/Mcc,,,8431.44,25333.16,9
MS-DRG,344,Minor Small And Large Bowel Procedures With Mcc,,,20790.39,62466.97,16
MS-DRG,345,Minor Small And Large Bowel Procedures With Cc,,,11490.89,34525.61,16
MS-DRG,346,Minor Small And Large Bowel Procedures Without Cc/Mcc,,,9608.15,28868.72,16
MS-DRG,347,Anal And Stomal Procedures With Mcc,,,18261.04,54867.25,16
MS-DRG,348,Anal And Stomal Procedures With Cc,,,9713.09,29184.02,16
MS-DRG,349,Anal And Stomal Procedures Without Cc/Mcc,,,6797.16,20422.79,16
MS-DRG,35,Carotid Artery Stent Procedures With Cc,,,17551.15,52734.33,16
MS-DRG,350,Inguinal And Femoral Hernia Procedures With Mcc,,,18671.54,56100.64,16
MS-DRG,351,Inguinal And Femoral Hernia Procedures With Cc,,,11610.49,34884.96,16
MS-DRG,352,Inguinal And Femoral Hernia Procedures Without Cc/Mcc,,,8507.06,25560.36,16
MS-DRG,353,Hernia Procedures Except Inguinal And Femoral With Mcc,,,22629.92,67994.04,16
MS-DRG,354,Hernia Procedures Except Inguinal And Femoral With Cc,,,13125.94,39438.3,16
MS-DRG,355,Hernia Procedures Except Inguinal And Femoral Without Cc/Mcc,,,10286.4,30906.59,16
MS-DRG,356,Other Digestive System O.R. Procedures With Mcc,,,32912.47,98889.03,16
MS-DRG,357,Other Digestive System O.R. Procedures With Cc,,,17376.0,52208.05,16
MS-DRG,358,Other Digestive System O.R. Procedures Without Cc/Mcc,,,10455.38,31414.32,16
MS-DRG,359,Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc,,,27594.22,46432.58,6
MS-DRG,36,Carotid Artery Stent Procedures Without Cc/Mcc,,,14143.7,42496.27,16
MS-DRG,360,Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc,,,19668.17,33095.48,6
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,,,12885.2,38714.96,16
MS-DRG,369,Major Esophageal Disorders With Cc,,,7851.95,23592.04,16
MS-DRG,37,Extracranial Procedures With Mcc,,,25623.02,76987.11,16
MS-DRG,370,Major Esophageal Disorders Without Cc/Mcc,,,5385.1,16180.11,16
MS-DRG,371,Major Gastrointestinal Disorders And Peritoneal Infections With Mcc,,,13490.15,40532.59,16
MS-DRG,372,Major Gastrointestinal Disorders And Peritoneal Infections With Cc,,,7942.23,23863.29,16
MS-DRG,373,Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/Mcc,,,5596.52,16815.36,16
MS-DRG,374,Digestive Malignancy With Mcc,,,16292.65,48953.02,16
MS-DRG,375,Digestive Malignancy With Cc,,,9480.83,28486.18,16
MS-DRG,376,Digestive Malignancy Without Cc/Mcc,,,6812.59,20469.15,16
MS-DRG,377,Gastrointestinal Hemorrhage With Mcc,,,14028.73,42150.83,16
MS-DRG,378,Gastrointestinal Hemorrhage With Cc,,,7607.35,22857.11,16
MS-DRG,379,Gastrointestinal Hemorrhage Without Cc/Mcc,,,4912.1,14758.93,16
MS-DRG,38,Extracranial Procedures With Cc,,,12431.49,37351.74,16
MS-DRG,380,Complicated Peptic Ulcer With Mcc,,,14848.19,44612.97,16
MS-DRG,381,Complicated Peptic Ulcer With Cc,,,8403.66,25249.69,16
MS-DRG,382,Complicated Peptic Ulcer Without Cc/Mcc,,,5781.71,17371.77,16
MS-DRG,383,Uncomplicated Peptic Ulcer With Mcc,,,9754.76,29309.21,16
MS-DRG,384,Uncomplicated Peptic Ulcer Without Mcc,,,6709.96,20160.81,16
MS-DRG,385,Inflammatory Bowel Disease With Mcc,,,12536.43,37667.04,16
MS-DRG,386,Inflammatory Bowel Disease With Cc,,,7657.51,23007.8,16
MS-DRG,387,Inflammatory Bowel Disease Without Cc/Mcc,,,5172.14,15540.24,16
MS-DRG,388,Gastrointestinal Obstruction With Mcc,,,11342.74,34080.48,16
MS-DRG,389,Gastrointestinal Obstruction With Cc,,,6186.04,18586.61,16
MS-DRG,39,Extracranial Procedures Without Cc/Mcc,,,8782.52,26388.03,16
MS-DRG,390,Gastrointestinal Obstruction Without Cc/Mcc,,,4221.51,12683.97,16
MS-DRG,391,"Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc",,,9914.48,29789.12,16
MS-DRG,392,"Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc",,,6020.91,18090.48,16
MS-DRG,393,Other Digestive System Diagnoses With Mcc,,,12777.17,38390.39,16
MS-DRG,394,Other Digestive System Diagnoses With Cc,,,7263.21,21823.1,16
MS-DRG,395,Other Digestive System Diagnoses Without Cc/Mcc,,,4910.56,14754.3,16
MS-DRG,396,Red Blood Cell Disorders Age 0-17,,,,,0
MS-DRG,397,Appendix Procedures With Mcc,,,19117.53,57440.68,16
MS-DRG,398,Appendix Procedures With Cc,,,11676.85,35084.35,16
MS-DRG,399,Appendix Procedures Without Cc/Mcc,,,8673.72,26061.13,16
MS-DRG,4,"Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Neck Without Major O.R.",,,108168.52,327569.05,16
MS-DRG,40,"Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc",,,29103.77,87445.41,16
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,,,30318.3,91094.57,16
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",,,41886.35,125852.03,16
MS-DRG,406,"Pancreas, Liver And Shunt Procedures With Cc",,,21668.49,65105.31,16
MS-DRG,407,"Pancreas, Liver And Shunt Procedures Without Cc/Mcc",,,16478.61,49511.75,16
MS-DRG,408,Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.D.E. With Mcc,,,27015.01,81169.5,16
MS-DRG,409,Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.D.E. With Cc,,,16175.37,48600.62,16
MS-DRG,41,"Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Peripheral Neurostimulator",,,17427.7,52363.38,16
MS-DRG,410,Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.D.E. Without Cc/Mcc,,,11967.75,35958.38,16
MS-DRG,411,Cholecystectomy With C.D.E. With Mcc,,,21114.47,63440.7,16
MS-DRG,412,Cholecystectomy With C.D.E. With Cc,,,16446.97,49416.7,16
MS-DRG,413,Cholecystectomy With C.D.E. Without Cc/Mcc,,,12827.33,38541.08,16
MS-DRG,414,Cholecystectomy Except By Laparoscope Without C.D.E. With Mcc,,,27034.3,81227.46,16
MS-DRG,415,Cholecystectomy Except By Laparoscope Without C.D.E. With Cc,,,15262.54,45857.95,16
MS-DRG,416,Cholecystectomy Except By Laparoscope Without C.D.E. Without Cc/Mcc,,,10572.67,31766.72,16
MS-DRG,417,Laparoscopic Cholecystectomy Without C.D.E. With Mcc,,,18337.43,55096.78,16
MS-DRG,418,Laparoscopic Cholecystectomy Without C.D.E. With Cc,,,12797.23,38450.66,16
MS-DRG,419,Laparoscopic Cholecystectomy Without C.D.E. Without Cc/Mcc,,,10166.8,30547.24,16
MS-DRG,42,"Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/Mcc",,,13561.13,40745.88,16
MS-DRG,420,Hepatobiliary Diagnostic Procedures With Mcc,,,27231.84,81820.97,16
MS-DRG,421,Hepatobiliary Diagnostic Procedures With Cc,,,12635.2,37963.8,16
MS-DRG,422,Hepatobiliary Diagnostic Procedures Without Cc/Mcc,,,11337.34,34064.25,16
MS-DRG,423,Other Hepatobiliary Or Pancreas O.R. Procedures With Mcc,,,31382.35,94291.65,16
MS-DRG,424,Other Hepatobiliary Or Pancreas O.R. Procedures With Cc,,,17616.74,52931.39,16
MS-DRG,425,Other Hepatobiliary Or Pancreas O.R. Procedures Without Cc/Mcc,,,11926.85,35835.51,16
MS-DRG,426,Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical With Mcc Or Custom-Made,,,80877.6,243005.41,16
MS-DRG,427,Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical With Cc,,,54774.63,164576.26,16
MS-DRG,428,Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Without Cc/Mcc,,,42478.95,127632.56,16
MS-DRG,429,Combined Anterior And Posterior Cervical Spinal Fusion With Mcc,,,64352.69,193354.56,16
MS-DRG,43,Hyphema,,,,,0
MS-DRG,430,Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc,,,42208.11,126818.8,16
MS-DRG,431,Childhood Mental Disorders,,,,,0
MS-DRG,432,Cirrhosis And Alcoholic Hepatitis With Mcc,,,15116.71,45419.77,16
MS-DRG,433,Cirrhosis And Alcoholic Hepatitis With Cc,,,8253.97,24799.92,16
MS-DRG,434,Cirrhosis And Alcoholic Hepatitis Without Cc/Mcc,,,5373.53,16145.34,16
MS-DRG,435,Malignancy Of Hepatobiliary System Or Pancreas With Mcc,,,14078.12,42299.21,16
MS-DRG,436,Malignancy Of Hepatobiliary System Or Pancreas With Cc,,,8700.73,26142.28,16
MS-DRG,437,Malignancy Of Hepatobiliary System Or Pancreas Without Cc/Mcc,,,6057.95,18201.76,16
MS-DRG,438,Disorders Of Pancreas Except Malignancy With Mcc,,,12838.13,38573.54,16
MS-DRG,439,Disorders Of Pancreas Except Malignancy With Cc,,,6637.43,19942.88,16
MS-DRG,44,Acute Major Eye Infections,,,,,0
MS-DRG,440,Disorders Of Pancreas Except Malignancy Without Cc/Mcc,,,4746.2,14260.48,16
MS-DRG,441,"Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc",,,14585.84,43824.72,16
MS-DRG,442,"Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc",,,7455.34,22400.38,16
MS-DRG,443,"Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis Without Cc/Mcc",,,5421.37,16289.08,16
MS-DRG,444,Disorders Of The Biliary Tract With Mcc,,,12997.85,39053.45,16
MS-DRG,445,Disorders Of The Biliary Tract With Cc,,,8367.39,25140.73,16
MS-DRG,446,Disorders Of The Biliary Tract Without Cc/Mcc,,,6151.31,18482.28,16
MS-DRG,447,Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-Made Anatomically Designed Interbody,,,51730.61,155430.17,16
MS-DRG,448,Multiple Level Spinal Fusion Except Cervical Without Mcc,,,31506.58,94664.91,16
MS-DRG,449,Poisoning & toxic Effects of Drugs Age >17 w CC,,,,,0
MS-DRG,45,Neurological eye disorders,,,,,0
MS-DRG,450,Single Level Spinal Fusion Except Cervical With Mcc Or Custom-Made Anatomically Designed Interbody F,,,39735.86,119390.64,16
MS-DRG,451,Single Level Spinal Fusion Except Cervical Without Mcc,,,23810.5,71541.19,16
MS-DRG,452,Complications of treatment w CC,,,,,0
MS-DRG,453,Combined Anterior And Posterior Spinal Fusion With Mcc,,,68375.89,205442.7,9
MS-DRG,454,Combined Anterior And Posterior Spinal Fusion With Cc,,,47194.29,141800.3,9
MS-DRG,455,Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc,,,35537.5,106776.23,9
MS-DRG,456,"Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Extensive Fusions With",,,65344.99,196336.02,16
MS-DRG,457,"Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Extensive Fusions With",,,44282.98,133052.98,16
MS-DRG,458,"Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Extensive Fusions With",,,33273.91,100101.56,16
MS-DRG,459,Spinal Fusion Except Cervical With Mcc,,,51175.82,153763.24,9
MS-DRG,46,Other Disorders of the Eye Age >17 w CC,,,,,0
MS-DRG,460,Spinal Fusion Except Cervical Without Mcc,,,28224.91,84804.75,9
MS-DRG,461,Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc,,,43723.32,142273.25,16
MS-DRG,462,Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc,,,21569.4,66389.7,16
MS-DRG,463,Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective Tissue Disorders Wit,,,41672.61,125209.83,16
MS-DRG,464,Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective Tissue Disorders Wit,,,22751.84,68360.34,16
MS-DRG,465,Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective Tissue Disorders Wit,,,13394.46,40245.11,16
MS-DRG,466,Revision Of Hip Or Knee Replacement With Mcc,,,39308.38,118106.25,16
MS-DRG,467,Revision Of Hip Or Knee Replacement With Cc,,,26427.04,79402.88,16
MS-DRG,468,Revision Of Hip Or Knee Replacement Without Cc/Mcc,,,20241.0,60816.27,16
MS-DRG,469,Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc Or Total Ankle Repl,,,24457.22,75776.9,16
MS-DRG,47,Other Disorders of the Eye Age >17 w/o CC,,,,,0
MS-DRG,470,Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without Mcc,,,14548.8,43713.43,16
MS-DRG,471,Cervical Spinal Fusion With Mcc,,,37477.34,112604.69,16
MS-DRG,472,Cervical Spinal Fusion With Cc,,,22353.69,67164.05,16
MS-DRG,473,Cervical Spinal Fusion Without Cc/Mcc,,,18265.67,54881.16,16
MS-DRG,474,Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc,,,34204.79,103966.33,16
MS-DRG,475,Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc,,,16644.51,50010.21,16
MS-DRG,476,Amputation For Musculoskeletal System And Connective Tissue Disorders Without Cc/Mcc,,,8973.88,26962.99,16
MS-DRG,477,Biopsies Of Musculoskeletal System And Connective Tissue With Mcc,,,26534.3,79725.14,16
MS-DRG,478,Biopsies Of Musculoskeletal System And Connective Tissue With Cc,,,18043.45,54213.47,16
MS-DRG,479,Biopsies Of Musculoskeletal System And Connective Tissue Without Cc/Mcc,,,13701.57,41167.83,16
MS-DRG,48,Other Disorders of the Eye Age 0-17,,,,,0
MS-DRG,480,Hip And Femur Procedures Except Major Joint With Mcc,,,22693.2,68184.14,16
MS-DRG,481,Hip And Femur Procedures Except Major Joint With Cc,,,16010.24,48104.48,16
MS-DRG,482,Hip And Femur Procedures Except Major Joint Without Cc/Mcc,,,12240.9,36779.1,16
MS-DRG,483,Major Joint Or Limb Reattachment Procedures Of Upper Extremities,,,19661.52,59075.15,16
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,,,24873.78,74735.94,16
MS-DRG,486,Knee Procedures With Principal Diagnosis Of Infection With Cc,,,16363.64,49166.31,16
MS-DRG,487,Knee Procedures With Principal Diagnosis Of Infection Without Cc/Mcc,,,12192.29,36633.04,16
MS-DRG,488,Knee Procedures Without Principal Diagnosis Of Infection With Cc/Mcc,,,14674.07,45563.52,16
MS-DRG,489,Knee Procedures Without Principal Diagnosis Of Infection Without Cc/Mcc,,,9557.22,28715.7,16
MS-DRG,49,Major Head & Neck Procedures,,,,,0
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",,,27400.05,82326.38,16
MS-DRG,493,"Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc",,,18526.48,55664.78,16
MS-DRG,494,"Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/Mcc",,,14548.8,43713.43,16
MS-DRG,495,Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur With Mcc,,,27163.16,81614.64,16
MS-DRG,496,Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur With Cc,,,14944.89,45739.71,16
MS-DRG,497,Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Without Cc/Mcc,,,10336.13,31136.11,16
MS-DRG,498,Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc/Mcc,,,19480.96,58532.64,16
MS-DRG,499,Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur Without Cc/Mcc,,,8956.91,27893.72,16
MS-DRG,5,Liver Transplant With Mcc Or Intestinal Transplant,,,80769.01,246877.14,16
MS-DRG,50,Sialoadenectomy,,,,,0
MS-DRG,500,Soft Tissue Procedures With Mcc,,,24448.62,73458.5,16
MS-DRG,501,Soft Tissue Procedures With Cc,,,13772.56,41381.12,16
MS-DRG,502,Soft Tissue Procedures Without Cc/Mcc,,,10780.23,32390.37,16
MS-DRG,503,Foot Procedures With Mcc,,,20420.79,61356.46,16
MS-DRG,504,Foot Procedures With Cc,,,13546.47,40701.83,16
MS-DRG,505,Foot Procedures Without Cc/Mcc,,,13546.47,40701.83,16
MS-DRG,506,Major Thumb Or Joint Procedures,,,11426.42,34752.82,16
MS-DRG,507,Major Shoulder Or Elbow Joint Procedures With Cc/Mcc,,,14954.67,44932.91,16
MS-DRG,508,Major Shoulder Or Elbow Joint Procedures Without Cc/Mcc,,,9958.46,29921.27,16
MS-DRG,509,Arthroscopy,,,13553.42,40722.7,10
MS-DRG,51,Salivary Gland Procedures Except Sialoadenectomy,,,,,0
MS-DRG,510,"Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc",,,22052.76,66259.87,16
MS-DRG,511,"Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc",,,15134.46,45473.1,16
MS-DRG,512,"Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures Without Cc/Mcc",,,12405.25,37272.92,16
MS-DRG,513,"Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures With Cc/Mcc",,,11616.66,34903.51,16
MS-DRG,514,"Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures Without Cc/Mcc",,,7867.39,23638.41,16
MS-DRG,515,Other Musculoskeletal System And Connective Tissue O.R. Procedures With Mcc,,,23859.88,71689.56,16
MS-DRG,516,Other Musculoskeletal System And Connective Tissue O.R. Procedures With Cc,,,15521.81,46636.93,16
MS-DRG,517,Other Musculoskeletal System And Connective Tissue O.R. Procedures Without Cc/Mcc,,,11517.13,34604.44,16
MS-DRG,518,Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurostimulator,,,27653.14,83086.82,16
MS-DRG,519,Back And Neck Procedures Except Spinal Fusion With Cc,,,15213.93,45711.89,16
MS-DRG,52,Spinal Disorders And Injuries With Cc/Mcc,,,15002.16,46655.48,16
MS-DRG,520,Back And Neck Procedures Except Spinal Fusion Without Cc/Mcc,,,11058.01,33224.99,16
MS-DRG,521,Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc,,,22489.49,67572.09,16
MS-DRG,522,Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc,,,16267.19,48876.51,16
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,53,Spinal Disorders And Injuries Without Cc/Mcc,,,7108.89,21359.42,16
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,,,11765.59,35350.96,16
MS-DRG,534,Fractures Of Femur Without Mcc,,,6280.17,18869.46,16
MS-DRG,535,Fractures Of Hip And Pelvis With Mcc,,,10261.71,30832.4,16
MS-DRG,536,Fractures Of Hip And Pelvis Without Mcc,,,6257.03,18799.91,16
MS-DRG,537,"Sprains, Strains, And Dislocations Of Hip, Pelvis And Thigh With Cc/Mcc",,,7090.37,21303.78,16
MS-DRG,538,"Sprains, Strains, And Dislocations Of Hip, Pelvis And Thigh Without Cc/Mcc",,,5181.39,15568.06,16
MS-DRG,539,Osteomyelitis With Mcc,,,15607.46,46894.28,16
MS-DRG,54,Nervous System Neoplasms With Mcc,,,11567.28,34755.13,16
MS-DRG,540,Osteomyelitis With Cc,,,9987.78,30009.37,16
MS-DRG,541,Osteomyelitis Without Cc/Mcc,,,6750.09,20281.36,16
MS-DRG,542,Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With Mcc,,,14389.85,43235.84,16
MS-DRG,543,Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With Cc,,,8185.29,24593.59,16
MS-DRG,544,Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy Without Cc/Mcc,,,5831.09,17520.15,16
MS-DRG,545,Connective Tissue Disorders With Mcc,,,19496.4,58579.01,16
MS-DRG,546,Connective Tissue Disorders With Cc,,,8932.99,26840.12,16
MS-DRG,547,Connective Tissue Disorders Without Cc/Mcc,,,5757.79,17299.9,16
MS-DRG,548,Septic Arthritis With Mcc,,,15544.18,46704.17,16
MS-DRG,549,Septic Arthritis With Cc,,,9297.96,27936.72,16
MS-DRG,55,Nervous System Neoplasms Without Mcc,,,8417.55,25291.43,16
MS-DRG,550,Septic Arthritis Without Cc/Mcc,,,6652.09,19986.93,16
MS-DRG,551,Medical Back Problems With Mcc,,,13166.07,39558.86,16
MS-DRG,552,Medical Back Problems Without Mcc,,,7436.83,22344.74,16
MS-DRG,553,Bone Diseases And Arthropathies With Mcc,,,10079.61,30285.26,16
MS-DRG,554,Bone Diseases And Arthropathies Without Mcc,,,6439.9,19349.37,16
MS-DRG,555,Signs And Symptoms Of Musculoskeletal System And Connective Tissue With Mcc,,,10389.8,31217.26,16
MS-DRG,556,Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc,,,6300.24,18929.74,16
MS-DRG,557,"Tendonitis, Myositis And Bursitis With Mcc",,,11957.72,35928.24,16
MS-DRG,558,"Tendonitis, Myositis And Bursitis Without Mcc",,,6665.21,20026.34,16
MS-DRG,559,"Aftercare, Musculoskeletal System And Connective Tissue With Mcc",,,14321.95,43031.82,16
MS-DRG,56,Degenerative Nervous System Disorders With Mcc,,,18962.47,58052.74,16
MS-DRG,560,"Aftercare, Musculoskeletal System And Connective Tissue With Cc",,,8787.15,26401.94,16
MS-DRG,561,"Aftercare, Musculoskeletal System And Connective Tissue Without Cc/Mcc",,,6308.72,18955.24,16
MS-DRG,562,"Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh With Mcc",,,11294.13,33934.42,16
MS-DRG,563,"Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Without Mcc",,,6895.92,20719.54,16
MS-DRG,564,Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc,,,12108.18,36380.33,16
MS-DRG,565,Other Musculoskeletal System And Connective Tissue Diagnoses With Cc,,,7867.39,23638.41,16
MS-DRG,566,Other Musculoskeletal System And Connective Tissue Diagnoses Without Cc/Mcc,,,5771.68,17341.63,16
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,57,Degenerative Nervous System Disorders Without Mcc,,,10298.75,30943.68,16
MS-DRG,570,Skin Debridement With Mcc,,,23228.7,69793.11,16
MS-DRG,571,Skin Debridement With Cc,,,12923.01,38828.56,16
MS-DRG,572,Skin Debridement Without Cc/Mcc,,,8814.93,26485.4,16
MS-DRG,573,Skin Graft For Skin Ulcer Or Cellulitis With Mcc,,,47514.51,142762.44,16
MS-DRG,574,Skin Graft For Skin Ulcer Or Cellulitis With Cc,,,26734.14,80325.6,16
MS-DRG,575,Skin Graft For Skin Ulcer Or Cellulitis Without Cc/Mcc,,,14891.5,46286.86,16
MS-DRG,576,Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc,,,38911.82,125075.36,16
MS-DRG,577,Skin Graft Except For Skin Ulcer Or Cellulitis With Cc,,,20545.02,61729.72,16
MS-DRG,578,Skin Graft Except For Skin Ulcer Or Cellulitis Without Cc/Mcc,,,13042.61,39187.92,16
MS-DRG,579,"Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc",,,25147.7,75558.97,16
MS-DRG,58,Multiple Sclerosis And Cerebellar Ataxia With Mcc,,,14214.43,42790.71,16
MS-DRG,580,"Other Skin, Subcutaneous Tissue And Breast Procedures With Cc",,,13679.96,41102.91,16
MS-DRG,581,"Other Skin, Subcutaneous Tissue And Breast Procedures Without Cc/Mcc",,,11104.31,33364.09,16
MS-DRG,582,Mastectomy For Malignancy With Cc/Mcc,,,13511.75,40597.5,16
MS-DRG,583,Mastectomy For Malignancy Without Cc/Mcc,,,12673.78,38079.72,16
MS-DRG,584,"Breast Biopsy, Local Excision And Other Breast Procedures With Cc/Mcc",,,15797.27,47464.6,16
MS-DRG,585,"Breast Biopsy, Local Excision And Other Breast Procedures Without Cc/Mcc",,,15316.56,46020.24,16
MS-DRG,59,Multiple Sclerosis And Cerebellar Ataxia With Cc,,,9440.71,28365.62,16
MS-DRG,592,Skin Ulcers With Mcc,,,15865.95,47670.94,16
MS-DRG,593,Skin Ulcers With Cc,,,9433.76,28344.76,16
MS-DRG,594,Skin Ulcers Without Cc/Mcc,,,6547.92,19673.94,16
MS-DRG,595,Major Skin Disorders With Mcc,,,16319.66,49034.16,16
MS-DRG,596,Major Skin Disorders Without Mcc,,,8341.16,25061.9,16
MS-DRG,597,Malignant Breast Disorders With Mcc,,,13553.42,40722.7,16
MS-DRG,598,Malignant Breast Disorders With Cc,,,8324.95,25013.22,16
MS-DRG,599,Malignant Breast Disorders Without Cc/Mcc,,,6596.54,19820.0,16
MS-DRG,6,Liver Transplant Without Mcc,,,36867.44,112416.9,16
MS-DRG,60,Multiple Sclerosis And Cerebellar Ataxia Without Cc/Mcc,,,6885.89,20689.4,16
MS-DRG,600,Non-Malignant Breast Disorders With Cc/Mcc,,,7385.9,22191.72,16
MS-DRG,601,Non-Malignant Breast Disorders Without Cc/Mcc,,,4625.83,13898.81,16
MS-DRG,602,Cellulitis With Mcc,,,11338.11,34066.57,16
MS-DRG,603,Cellulitis Without Mcc,,,6797.16,20422.79,16
MS-DRG,604,"Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc",,,11463.88,34444.47,16
MS-DRG,605,"Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc",,,7127.41,21415.06,16
MS-DRG,606,Minor Skin Disorders With Mcc,,,12423.77,37328.56,16
MS-DRG,607,Minor Skin Disorders Without Mcc,,,6669.07,20037.93,16
MS-DRG,61,"Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic Agent With Mcc",,,20858.3,62670.99,16
MS-DRG,614,Adrenal And Pituitary Procedures With Cc/Mcc,,,17583.56,52831.7,16
MS-DRG,615,Adrenal And Pituitary Procedures Without Cc/Mcc,,,11056.47,33220.35,16
MS-DRG,616,"Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With Mcc",,,27971.83,89603.84,16
MS-DRG,617,"Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With Cc",,,14909.15,44796.12,16
MS-DRG,618,"Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders Without Cc/Mcc",,,9606.61,28864.08,16
MS-DRG,619,O.R. Procedures For Obesity With Mcc,,,21037.31,63208.86,16
MS-DRG,62,"Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic Agent With Cc",,,13740.92,41286.07,16
MS-DRG,620,O.R. Procedures For Obesity With Cc,,,12321.92,37022.53,16
MS-DRG,621,O.R. Procedures For Obesity Without Cc/Mcc,,,11278.7,33888.05,16
MS-DRG,622,"Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disorders With Mcc",,,28527.42,86800.9,16
MS-DRG,623,"Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disorders With Cc",,,14768.71,44374.18,16
MS-DRG,624,"Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disorders Without Cc/Mcc",,,7740.07,23255.87,16
MS-DRG,625,"Thyroid, Parathyroid And Thyroglossal Procedures With Mcc",,,22121.43,66466.21,16
MS-DRG,626,"Thyroid, Parathyroid And Thyroglossal Procedures With Cc",,,11645.21,34989.29,16
MS-DRG,627,"Thyroid, Parathyroid And Thyroglossal Procedures Without Cc/Mcc",,,9774.82,29369.49,16
MS-DRG,628,"Other Endocrine, Nutritional And Metabolic O.R. Procedures With Mcc",,,29824.31,91491.02,16
MS-DRG,629,"Other Endocrine, Nutritional And Metabolic O.R. Procedures With Cc",,,17362.11,52166.32,16
MS-DRG,63,"Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic Agent Without Cc/Mcc",,,10838.88,32566.56,16
MS-DRG,630,"Other Endocrine, Nutritional And Metabolic O.R. Procedures Without Cc/Mcc",,,10811.87,32485.42,16
MS-DRG,637,Diabetes With Mcc,,,11237.03,33762.86,16
MS-DRG,638,Diabetes With Cc,,,7077.25,21264.36,16
MS-DRG,639,Diabetes Without Cc/Mcc,,,4834.94,14527.09,16
MS-DRG,64,Intracranial Hemorrhage Or Cerebral Infarction With Mcc,,,15348.19,46115.29,16
MS-DRG,640,"Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With Mcc",,,10247.82,30790.67,16
MS-DRG,641,"Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Without Mcc",,,6030.17,18118.3,16
MS-DRG,642,Inborn And Other Disorders Of Metabolism,,,9576.51,28773.66,16
MS-DRG,643,Endocrine Disorders With Mcc,,,12787.98,38422.84,16
MS-DRG,644,Endocrine Disorders With Cc,,,7974.64,23960.66,16
MS-DRG,645,Endocrine Disorders Without Cc/Mcc,,,6010.88,18060.34,16
MS-DRG,65,Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours,,,7847.32,23578.13,16
MS-DRG,650,Kidney Transplant With Hemodialysis With Mcc,,,35548.3,106808.69,16
MS-DRG,651,Kidney Transplant With Hemodialysis Without Mcc,,,26792.02,80499.48,16
MS-DRG,652,Kidney Transplant,,,23697.84,71202.7,16
MS-DRG,653,Major Bladder Procedures With Mcc,,,41196.07,129232.25,16
MS-DRG,654,Major Bladder Procedures With Cc,,,21774.2,65422.93,16
MS-DRG,655,Major Bladder Procedures Without Cc/Mcc,,,16027.99,48157.8,16
MS-DRG,656,Kidney And Ureter Procedures For Neoplasm With Mcc,,,25136.9,75526.52,16
MS-DRG,657,Kidney And Ureter Procedures For Neoplasm With Cc,,,14105.12,42380.35,16
MS-DRG,658,Kidney And Ureter Procedures For Neoplasm Without Cc/Mcc,,,11604.32,34866.42,16
MS-DRG,659,Kidney And Ureter Procedures For Non-Neoplasm With Mcc,,,19940.07,59912.09,16
MS-DRG,66,Intracranial Hemorrhage Or Cerebral Infarction Without Cc/Mcc,,,5311.03,15957.55,16
MS-DRG,660,Kidney And Ureter Procedures For Non-Neoplasm With Cc,,,10338.87,31064.24,16
MS-DRG,661,Kidney And Ureter Procedures For Non-Neoplasm Without Cc/Mcc,,,7921.4,23800.69,16
MS-DRG,662,Minor Bladder Procedures With Mcc,,,24069.76,72320.17,16
MS-DRG,663,Minor Bladder Procedures With Cc,,,11784.88,35408.92,16
MS-DRG,664,Minor Bladder Procedures Without Cc/Mcc,,,8331.9,25034.08,16
MS-DRG,665,Prostatectomy With Mcc,,,25138.17,79599.95,16
MS-DRG,666,Prostatectomy With Cc,,,12710.04,38188.68,16
MS-DRG,667,Prostatectomy Without Cc/Mcc,,,7929.89,23826.2,16
MS-DRG,668,Transurethral Procedures With Mcc,,,22501.07,67606.86,16
MS-DRG,669,Transurethral Procedures With Cc,,,11940.74,35877.24,16
MS-DRG,67,Precerebral Occlusion Without Infarction With Mcc,,,11233.17,33751.27,16
MS-DRG,670,Transurethral Procedures Without Cc/Mcc,,,7373.55,22154.63,16
MS-DRG,671,Urethral Procedures With Cc/Mcc,,,13299.56,39959.94,16
MS-DRG,672,Urethral Procedures Without Cc/Mcc,,,8443.78,25370.25,16
MS-DRG,673,Other Kidney And Urinary Tract Procedures With Mcc,,,32330.67,97140.96,16
MS-DRG,674,Other Kidney And Urinary Tract Procedures With Cc,,,17811.19,53515.63,16
MS-DRG,675,Other Kidney And Urinary Tract Procedures Without Cc/Mcc,,,12077.32,36287.6,16
MS-DRG,68,Precerebral Occlusion Without Infarction Without Mcc,,,6802.56,20439.01,16
MS-DRG,682,Renal Failure With Mcc,,,11589.66,34822.37,16
MS-DRG,683,Renal Failure With Cc,,,6858.89,20608.26,16
MS-DRG,684,Renal Failure Without Cc/Mcc,,,4687.56,14084.28,16
MS-DRG,685,Admit For Renal Dialysis,,,,,0
MS-DRG,686,Kidney And Urinary Tract Neoplasms With Mcc,,,14549.57,43715.75,16
MS-DRG,687,Kidney And Urinary Tract Neoplasms With Cc,,,8122.02,24403.48,16
MS-DRG,688,Kidney And Urinary Tract Neoplasms Without Cc/Mcc,,,5588.04,16789.85,16
MS-DRG,689,Kidney And Urinary Tract Infections With Mcc,,,9030.98,27134.55,16
MS-DRG,69,Transient Ischemia Without Thrombolytic,,,6174.46,18551.84,16
MS-DRG,690,Kidney And Urinary Tract Infections Without Mcc,,,6192.98,18607.48,16
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,,,11345.06,34087.44,16
MS-DRG,694,Urinary Stones Without Mcc,,,6029.4,18115.98,16
MS-DRG,695,Kidney And Urinary Tract Signs And Symptoms With Mcc,,,8701.5,26144.6,16
MS-DRG,696,Kidney And Urinary Tract Signs And Symptoms Without Mcc,,,5337.26,16036.37,16
MS-DRG,697,Urethral Stricture,,,7730.04,23225.73,16
MS-DRG,698,Other Kidney And Urinary Tract Diagnoses With Mcc,,,12970.08,38969.99,16
MS-DRG,699,Other Kidney And Urinary Tract Diagnoses With Cc,,,7868.93,23643.04,16
MS-DRG,7,Lung Transplant,,,100833.88,302966.19,16
MS-DRG,70,Other Cerebrovascular Disorders With Mcc,,,13416.07,40310.02,16
MS-DRG,700,Other Kidney And Urinary Tract Diagnoses Without Cc/Mcc,,,5355.78,16092.01,16
MS-DRG,707,Major Male Pelvic Procedures With Cc/Mcc,,,14973.19,44988.55,16
MS-DRG,708,Major Male Pelvic Procedures Without Cc/Mcc,,,11438.42,34367.96,16
MS-DRG,709,Penis Procedures With Cc/Mcc,,,17338.19,52094.45,16
MS-DRG,71,Other Cerebrovascular Disorders With Cc,,,8131.28,24431.3,16
MS-DRG,710,Penis Procedures Without Cc/Mcc,,,11584.26,34806.14,16
MS-DRG,711,Testes Procedures With Cc/Mcc,,,14742.48,44295.35,16
MS-DRG,712,Testes Procedures Without Cc/Mcc,,,8253.19,24797.61,16
MS-DRG,713,Transurethral Prostatectomy With Cc/Mcc,,,11156.78,33521.75,16
MS-DRG,714,Transurethral Prostatectomy Without Cc/Mcc,,,7250.09,21783.69,16
MS-DRG,715,Other Male Reproductive System O.R. Procedures For Malignancy With Cc/Mcc,,,17424.61,52354.11,16
MS-DRG,716,Other Male Reproductive System O.R. Procedures For Malignancy Without Cc/Mcc,,,10950.76,32902.73,16
MS-DRG,717,Other Male Reproductive System O.R. Procedures Except Malignancy With Cc/Mcc,,,14316.54,43015.59,16
MS-DRG,718,Other Male Reproductive System O.R. Procedures Except Malignancy Without Cc/Mcc,,,9504.75,28558.05,16
MS-DRG,72,Other Cerebrovascular Disorders Without Cc/Mcc,,,5787.88,17390.32,16
MS-DRG,722,"Malignancy, Male Reproductive System With Mcc",,,13339.68,40080.5,16
MS-DRG,723,"Malignancy, Male Reproductive System With Cc",,,8664.46,26033.31,16
MS-DRG,724,"Malignancy, Male Reproductive System Without Cc/Mcc",,,5621.99,16891.86,16
MS-DRG,725,Benign Prostatic Hypertrophy With Mcc,,,9746.27,29283.71,16
MS-DRG,726,Benign Prostatic Hypertrophy Without Mcc,,,5743.13,17255.85,16
MS-DRG,727,Inflammation Of The Male Reproductive System With Mcc,,,11337.34,34064.25,16
MS-DRG,728,Inflammation Of The Male Reproductive System Without Mcc,,,6304.87,18943.65,16
MS-DRG,729,Other Male Reproductive System Diagnoses With Cc/Mcc,,,8493.94,25520.95,16
MS-DRG,73,Cranial And Peripheral Nerve Disorders With Mcc,,,11925.31,35830.87,16
MS-DRG,730,Other Male Reproductive System Diagnoses Without Cc/Mcc,,,4682.93,14070.37,16
MS-DRG,734,"Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/Mcc",,,16224.75,48749.0,16
MS-DRG,735,"Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy Without Cc/Mcc",,,9365.86,28140.74,16
MS-DRG,736,Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc,,,28645.8,91282.36,16
MS-DRG,737,Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc,,,15419.18,46328.59,16
MS-DRG,738,Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy Without Cc/Mcc,,,11703.86,35165.49,16
MS-DRG,739,Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy With Mcc,,,28710.03,92288.55,16
MS-DRG,74,Cranial And Peripheral Nerve Disorders Without Mcc,,,8043.31,24167.0,16
MS-DRG,740,Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy With Cc,,,14029.5,42153.15,16
MS-DRG,741,Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy Without Cc/Mcc,,,10598.13,31843.22,16
MS-DRG,742,Uterine And Adnexa Procedures For Non-Malignancy With Cc/Mcc,,,14094.32,42347.89,16
MS-DRG,743,Uterine And Adnexa Procedures For Non-Malignancy Without Cc/Mcc,,,9248.58,27788.34,16
MS-DRG,744,"D&C, Conization, Laparoscopy And Tubal Interruption With Cc/Mcc",,,15076.59,45299.22,16
MS-DRG,745,"D&C, Conization, Laparoscopy And Tubal Interruption Without Cc/Mcc",,,7907.51,23758.96,16
MS-DRG,746,"Vagina, Cervix And Vulva Procedures With Cc/Mcc",,,12920.69,38821.61,16
MS-DRG,747,"Vagina, Cervix And Vulva Procedures Without Cc/Mcc",,,7369.69,22143.04,16
MS-DRG,748,Female Reproductive System Reconstructive Procedures,,,10510.94,31581.24,16
MS-DRG,749,Other Female Reproductive System O.R. Procedures With Cc/Mcc,,,19972.48,60009.47,16
MS-DRG,75,Viral Meningitis With Cc/Mcc,,,13290.3,39932.12,16
MS-DRG,750,Other Female Reproductive System O.R. Procedures Without Cc/Mcc,,,9949.98,29895.77,16
MS-DRG,754,"Malignancy, Female Reproductive System With Mcc",,,13960.06,41944.49,16
MS-DRG,755,"Malignancy, Female Reproductive System With Cc",,,8565.7,25736.56,16
MS-DRG,756,"Malignancy, Female Reproductive System Without Cc/Mcc",,,7368.15,22138.4,16
MS-DRG,757,"Infections, Female Reproductive System With Mcc",,,10919.9,32810.0,16
MS-DRG,758,"Infections, Female Reproductive System With Cc",,,7865.07,23631.45,16
MS-DRG,759,"Infections, Female Reproductive System Without Cc/Mcc",,,4937.56,14835.44,16
MS-DRG,76,Viral Meningitis Without Cc/Mcc,,,7074.94,21257.41,16
MS-DRG,760,Menstrual And Other Female Reproductive System Disorders With Cc/Mcc,,,7604.27,22847.83,16
MS-DRG,761,Menstrual And Other Female Reproductive System Disorders Without Cc/Mcc,,,4891.27,14696.34,16
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,,,8459.22,25416.62,16
MS-DRG,769,Postpartum And Post Abortion Diagnoses With O.R. Procedures,,,10721.59,32214.17,16
MS-DRG,77,Hypertensive Encephalopathy With Mcc,,,11930.71,35847.1,10
MS-DRG,770,"Abortion With D&C, Aspiration Curettage Or Hysterotomy",,,8301.81,24943.67,16
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,,,5504.7,16539.47,16
MS-DRG,777,Ectopic Pregnancy,,,,,0
MS-DRG,778,Threatened Abortion,,,,,0
MS-DRG,779,Abortion Without D&C,,,7212.29,21670.08,16
MS-DRG,78,Hypertensive Encephalopathy With Cc,,,7699.17,23133.0,10
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,,,14213.15,42704.93,16
MS-DRG,784,Cesarean Section With Sterilization With Cc,,,8356.59,25108.27,16
MS-DRG,785,Cesarean Section With Sterilization Without Cc/Mcc,,,6750.86,20283.68,16
MS-DRG,786,Cesarean Section Without Sterilization With Mcc,,,12467.76,37460.71,16
MS-DRG,787,Cesarean Section Without Sterilization With Cc,,,8193.01,24616.77,16
MS-DRG,788,Cesarean Section Without Sterilization Without Cc/Mcc,,,6983.12,20981.52,16
MS-DRG,789,"Neonates, Died Or Transferred To Another Acute Care Facility",,,13909.9,41793.8,16
MS-DRG,79,Hypertensive Encephalopathy Without Cc/Mcc,,,5144.36,15456.77,10
MS-DRG,790,"Extreme Immaturity Or Respiratory Distress Syndrome, Neonate",,,45872.51,137828.88,16
MS-DRG,791,Prematurity With Major Problems,,,31328.34,94129.36,16
MS-DRG,792,Prematurity Without Major Problems,,,18903.02,56796.16,16
MS-DRG,793,Full Term Neonate With Major Problems,,,32180.98,96691.19,16
MS-DRG,794,Neonate With Other Significant Problems,,,11390.58,34224.22,16
MS-DRG,795,Normal Newborn,,,1541.69,4632.16,16
MS-DRG,796,Vaginal Delivery With Sterilization And/Or D&C With Mcc,,,9850.44,29596.69,16
MS-DRG,797,Vaginal Delivery With Sterilization And/Or D&C With Cc,,,7470.78,22446.75,16
MS-DRG,798,Vaginal Delivery With Sterilization And/Or D&C Without Cc/Mcc,,,7470.78,22446.75,16
MS-DRG,799,Splenic Procedures With Mcc,,,36030.96,110228.33,16
MS-DRG,8,Simultaneous Pancreas And Kidney Transplant,,,41982.03,126139.51,16
MS-DRG,80,Nontraumatic Stupor And Coma With Mcc,,,14992.1,46085.16,16
MS-DRG,800,Splenic Procedures With Cc,,,22481.77,67548.9,16
MS-DRG,801,Splenic Procedures Without Cc/Mcc,,,12667.6,38061.17,16
MS-DRG,802,Other O.R. Procedures Of The Blood And Blood Forming Organs With Mcc,,,27659.31,83105.37,16
MS-DRG,803,Other O.R. Procedures Of The Blood And Blood Forming Organs With Cc,,,13733.98,41265.2,16
MS-DRG,804,Other O.R. Procedures Of The Blood And Blood Forming Organs Without Cc/Mcc,,,8530.2,25629.91,16
MS-DRG,805,Vaginal Delivery Without Sterilization Or D&C With Mcc,,,7699.95,23135.31,16
MS-DRG,806,Vaginal Delivery Without Sterilization Or D&C With Cc,,,5582.63,16773.62,16
MS-DRG,807,Vaginal Delivery Without Sterilization Or D&C Without Cc/Mcc,,,4916.73,14772.84,16
MS-DRG,808,Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Coagulation Disorders,,,17673.07,53100.63,16
MS-DRG,809,Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Coagulation Disorders,,,9556.45,28713.38,16
MS-DRG,81,Nontraumatic Stupor And Coma Without Mcc,,,6981.57,20976.88,16
MS-DRG,810,Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Coagulation Disorders,,,7343.46,22064.21,16
MS-DRG,811,Red Blood Cell Disorders With Mcc,,,10855.08,32615.25,16
MS-DRG,812,Red Blood Cell Disorders Without Mcc,,,7121.23,21396.51,16
MS-DRG,813,Coagulation Disorders,,,11943.83,35886.51,16
MS-DRG,814,Reticuloendothelial And Immunity Disorders With Mcc,,,16129.07,48461.52,16
MS-DRG,815,Reticuloendothelial And Immunity Disorders With Cc,,,7840.38,23557.26,16
MS-DRG,816,Reticuloendothelial And Immunity Disorders Without Cc/Mcc,,,5088.03,15287.53,16
MS-DRG,817,Other Antepartum Diagnoses With O.R. Procedures With Mcc,,,18641.33,58773.76,16
MS-DRG,818,Other Antepartum Diagnoses With O.R. Procedures With Cc,,,9938.4,29860.99,16
MS-DRG,819,Other Antepartum Diagnoses With O.R. Procedures Without Cc/Mcc,,,6300.24,18929.74,16
MS-DRG,82,Traumatic Stupor And Coma >1 Hour With Mcc,,,17902.24,53789.2,16
MS-DRG,820,Lymphoma And Leukemia With Major O.R. Procedures With Mcc,,,44922.65,134974.93,16
MS-DRG,821,Lymphoma And Leukemia With Major O.R. Procedures With Cc,,,17223.99,51751.32,16
MS-DRG,822,Lymphoma And Leukemia With Major O.R. Procedures Without Cc/Mcc,,,8824.19,26513.22,16
MS-DRG,823,Lymphoma And Non-Acute Leukemia With Other Procedures With Mcc,,,36105.41,108482.57,16
MS-DRG,824,Lymphoma And Non-Acute Leukemia With Other Procedures With Cc,,,16970.13,50988.57,16
MS-DRG,825,Lymphoma And Non-Acute Leukemia With Other Procedures Without Cc/Mcc,,,9496.27,28532.55,16
MS-DRG,826,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.R. Procedures With Mcc,,,36846.16,110708.24,16
MS-DRG,827,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.R. Procedures With Cc,,,18207.8,54707.28,16
MS-DRG,828,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.R. Procedures Without C,,,12367.45,37159.32,16
MS-DRG,829,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Procedures With Cc/Mcc,,,23793.52,71490.18,16
MS-DRG,83,Traumatic Stupor And Coma >1 Hour With Cc,,,10727.76,32232.72,16
MS-DRG,830,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Procedures Without Cc/Mcc,,,11284.1,33904.28,16
MS-DRG,831,Other Antepartum Diagnoses Without O.R. Procedures With Mcc,,,8880.52,26682.47,16
MS-DRG,832,Other Antepartum Diagnoses Without O.R. Procedures With Cc,,,5766.28,17325.4,16
MS-DRG,833,Other Antepartum Diagnoses Without O.R. Procedures Without Cc/Mcc,,,4010.85,12051.04,16
MS-DRG,834,Acute Leukemia With Mcc,,,42646.39,128135.65,16
MS-DRG,835,Acute Leukemia With Cc,,,16480.15,49516.39,16
MS-DRG,836,Acute Leukemia Without Cc/Mcc,,,9804.91,29459.91,16
MS-DRG,837,Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemotherapy Agent With Mc,,,38162.01,116077.65,16
MS-DRG,838,Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Chemotherapy Agent,,,15649.12,47019.47,16
MS-DRG,839,Chemotherapy With Acute Leukemia As Secondary Diagnosis Without Cc/Mcc,,,10573.44,31769.04,16
MS-DRG,84,Traumatic Stupor And Coma >1 Hour Without Cc/Mcc,,,7376.64,22163.9,16
MS-DRG,840,Lymphoma And Non-Acute Leukemia With Mcc,,,24609.89,73943.05,16
MS-DRG,841,Lymphoma And Non-Acute Leukemia With Cc,,,12098.15,36350.19,16
MS-DRG,842,Lymphoma And Non-Acute Leukemia Without Cc/Mcc,,,8115.85,24384.93,16
MS-DRG,843,Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses With Mcc,,,14607.44,43889.63,16
MS-DRG,844,Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses With Cc,,,9221.57,27707.2,16
MS-DRG,845,Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses Without Cc/Mcc,,,6456.1,19398.05,16
MS-DRG,846,Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc,,,19703.96,59202.66,16
MS-DRG,847,Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Cc,,,9804.14,29457.59,16
MS-DRG,848,Chemotherapy Without Acute Leukemia As Secondary Diagnosis Without Cc/Mcc,,,6318.76,18985.38,16
MS-DRG,849,Radiotherapy,,,20609.07,61922.15,16
MS-DRG,85,Traumatic Stupor And Coma <1 Hour With Mcc,,,17484.02,52532.63,16
MS-DRG,850,Acute Leukemia With Other Procedures,,,67993.57,213554.78,16
MS-DRG,853,Infectious And Parasitic Diseases With O.R. Procedures With Mcc,,,38592.32,115954.78,16
MS-DRG,854,Infectious And Parasitic Diseases With O.R. Procedures With Cc,,,15418.41,46326.27,16
MS-DRG,855,Infectious And Parasitic Diseases With O.R. Procedures Without Cc/Mcc,,,12542.6,37685.59,16
MS-DRG,856,Postoperative Or Post-Traumatic Infections With O.R. Procedures With Mcc,,,34809.87,104589.98,16
MS-DRG,857,Postoperative Or Post-Traumatic Infections With O.R. Procedures With Cc,,,16812.72,50515.62,16
MS-DRG,858,Postoperative Or Post-Traumatic Infections With O.R. Procedures Without Cc/Mcc,,,9941.49,29870.27,16
MS-DRG,86,Traumatic Stupor And Coma <1 Hour With Cc,,,10120.5,30408.13,16
MS-DRG,862,Postoperative And Post-Traumatic Infections With Mcc,,,14186.91,42626.1,16
MS-DRG,863,Postoperative And Post-Traumatic Infections Without Mcc,,,7715.38,23181.68,16
MS-DRG,864,Fever And Inflammatory Conditions,,,6928.33,20816.91,16
MS-DRG,865,Viral Illness With Mcc,,,11388.27,34217.27,16
MS-DRG,866,Viral Illness Without Mcc,,,6826.48,20510.88,16
MS-DRG,867,Other Infectious And Parasitic Diseases Diagnoses With Mcc,,,16544.97,49711.13,16
MS-DRG,868,Other Infectious And Parasitic Diseases Diagnoses With Cc,,,8101.96,24343.2,16
MS-DRG,869,Other Infectious And Parasitic Diseases Diagnoses Without Cc/Mcc,,,5551.77,16680.89,16
MS-DRG,87,Traumatic Stupor And Coma <1 Hour Without Cc/Mcc,,,6821.08,20494.66,16
MS-DRG,870,Septicemia Or Severe Sepsis With Mv >96 Hours,,,53677.4,161279.5,16
MS-DRG,871,Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc,,,15141.4,45493.96,16
MS-DRG,872,Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc,,,7955.35,23902.7,16
MS-DRG,876,O.R. Procedures With Principal Diagnosis Of Mental Illness,,,30319.84,91099.21,16
MS-DRG,88,Concussion With Mcc,,,10884.4,32703.35,16
MS-DRG,880,Acute Adjustment Reaction And Psychosocial Dysfunction,,,7396.7,22224.18,16
MS-DRG,881,Depressive Neuroses,,,7053.33,21192.49,16
MS-DRG,882,Neuroses Except Depressive,,,7422.16,22300.69,16
MS-DRG,883,Disorders Of Personality And Impulse Control,,,14324.26,43038.78,16
MS-DRG,884,Organic Disturbances And Intellectual Disability,,,12886.74,38719.6,16
MS-DRG,885,Psychoses,,,10875.91,32677.85,16
MS-DRG,886,Behavioral And Developmental Disorders,,,13861.29,41647.74,16
MS-DRG,887,Other Mental Disorder Diagnoses,,,9176.82,27572.73,16
MS-DRG,89,Concussion With Cc,,,8272.48,24855.57,16
MS-DRG,894,"Alcohol, Drug Abuse Or Dependence, Left Ama",,,4815.65,14469.13,16
MS-DRG,895,"Alcohol, Drug Abuse Or Dependence With Rehabilitation Therapy",,,11172.21,33568.11,16
MS-DRG,896,"Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc",,,13740.92,41286.07,16
MS-DRG,897,"Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc",,,6807.19,20452.92,16
MS-DRG,9,Bone marrow transplant,,,,,0
MS-DRG,90,Concussion Without Cc/Mcc,,,6614.28,19873.32,16
MS-DRG,901,Wound Debridements For Injuries With Mcc,,,33459.62,102709.76,16
MS-DRG,902,Wound Debridements For Injuries With Cc,,,14640.62,43989.32,16
MS-DRG,903,Wound Debridements For Injuries Without Cc/Mcc,,,9405.99,28261.3,16
MS-DRG,904,Skin Grafts For Injuries With Cc/Mcc,,,29408.78,89511.11,16
MS-DRG,905,Skin Grafts For Injuries Without Cc/Mcc,,,12464.86,38209.55,16
MS-DRG,906,Hand Procedures For Injuries,,,16186.07,50596.76,16
MS-DRG,907,Other O.R. Procedures For Injuries With Mcc,,,30694.83,92353.46,16
MS-DRG,908,Other O.R. Procedures For Injuries With Cc,,,15563.47,46762.13,16
MS-DRG,909,Other O.R. Procedures For Injuries Without Cc/Mcc,,,9785.62,29401.95,16
MS-DRG,91,Other Disorders Of Nervous System With Mcc,,,14065.0,42259.8,16
MS-DRG,913,Traumatic Injury With Mcc,,,12486.27,37516.35,16
MS-DRG,914,Traumatic Injury Without Mcc,,,7070.31,21243.5,16
MS-DRG,915,Allergic Reactions With Mcc,,,13409.13,40289.16,16
MS-DRG,916,Allergic Reactions Without Mcc,,,5123.52,15394.18,16
MS-DRG,917,Poisoning And Toxic Effects Of Drugs With Mcc,,,12651.4,38012.49,16
MS-DRG,918,Poisoning And Toxic Effects Of Drugs Without Mcc,,,6824.16,20503.93,16
MS-DRG,919,Complications Of Treatment With Mcc,,,14069.63,42273.71,16
MS-DRG,92,Other Disorders Of Nervous System With Cc,,,8169.86,24547.22,16
MS-DRG,920,Complications Of Treatment With Cc,,,7838.07,23550.31,16
MS-DRG,921,Complications Of Treatment Without Cc/Mcc,,,5305.62,15941.32,16
MS-DRG,922,"Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc",,,13034.12,39162.41,16
MS-DRG,923,"Other Injury, Poisoning And Toxic Effect Diagnoses Without Mcc",,,7868.93,23643.04,16
MS-DRG,927,Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft,,,166196.6,549989.4,16
MS-DRG,928,Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc,,,51532.31,154834.34,16
MS-DRG,929,Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc,,,24538.9,73729.76,16
MS-DRG,93,Other Disorders Of Nervous System Without Cc/Mcc,,,6090.36,18299.13,16
MS-DRG,933,Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft,,,31119.65,100310.21,16
MS-DRG,934,Full Thickness Burn Without Skin Graft Or Inhalation Injury,,,16556.54,49745.91,16
MS-DRG,935,Non-Extensive Burns,,,16926.59,50919.02,16
MS-DRG,939,O.R. Procedures With Diagnoses Of Other Contact With Health Services With Mcc,,,24489.52,73581.38,16
MS-DRG,94,Bacterial And Tuberculous Infections Of Nervous System With Mcc,,,28151.6,84584.51,16
MS-DRG,940,O.R. Procedures With Diagnoses Of Other Contact With Health Services With Cc,,,16291.11,48948.38,16
MS-DRG,941,O.R. Procedures With Diagnoses Of Other Contact With Health Services Without Cc/Mcc,,,15078.9,45306.17,16
MS-DRG,945,Rehabilitation With Cc/Mcc,,,11777.93,35388.06,16
MS-DRG,946,Rehabilitation Without Cc/Mcc,,,8614.31,25882.62,16
MS-DRG,947,Signs And Symptoms With Mcc,,,9923.74,29816.94,16
MS-DRG,948,Signs And Symptoms Without Mcc,,,6130.48,18419.69,16
MS-DRG,949,Aftercare With Cc/Mcc,,,8324.95,25013.22,16
MS-DRG,95,Bacterial And Tuberculous Infections Of Nervous System With Cc,,,18495.61,55572.05,16
MS-DRG,950,Aftercare Without Cc/Mcc,,,4522.44,13588.14,16
MS-DRG,951,Other Factors Influencing Health Status,,,4374.29,13143.01,16
MS-DRG,955,Craniotomy For Multiple Significant Trauma,,,52685.1,158298.03,16
MS-DRG,956,"Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma",,,29492.67,88613.88,16
MS-DRG,957,Other O.R. Procedures For Multiple Significant Trauma With Mcc,,,57591.03,173038.42,16
MS-DRG,958,Other O.R. Procedures For Multiple Significant Trauma With Cc,,,31709.52,95274.65,16
MS-DRG,959,Other O.R. Procedures For Multiple Significant Trauma Without Cc/Mcc,,,20399.19,61291.54,16
MS-DRG,96,Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc,,,18495.61,55572.05,16
MS-DRG,963,Other Multiple Significant Trauma With Mcc,,,20961.69,62981.65,16
MS-DRG,964,Other Multiple Significant Trauma With Cc,,,11575.77,34780.64,16
MS-DRG,965,Other Multiple Significant Trauma Without Cc/Mcc,,,7040.99,21155.4,16
MS-DRG,969,Hiv With Extensive O.R. Procedures With Mcc,,,48352.96,146613.3,16
MS-DRG,97,Non-Bacterial Infection Of Nervous System Except Viral Meningitis With Mcc,,,27660.85,83110.0,16
MS-DRG,970,Hiv With Extensive O.R. Procedures Without Mcc,,,20472.49,61511.79,16
MS-DRG,974,Hiv With Major Related Condition With Mcc,,,23040.42,69227.42,16
MS-DRG,975,Hiv With Major Related Condition With Cc,,,10966.96,32951.42,16
MS-DRG,976,Hiv With Major Related Condition Without Cc/Mcc,,,7738.53,23251.23,16
MS-DRG,977,Hiv With Or Without Other Related Condition,,,11027.91,33426.69,16
MS-DRG,98,Non-Bacterial Infection Of Nervous System Except Viral Meningitis With Cc,,,16737.1,50288.41,16
MS-DRG,981,Extensive O.R. Procedures Unrelated To Principal Diagnosis With Mcc,,,36684.89,110223.69,16
MS-DRG,982,Extensive O.R. Procedures Unrelated To Principal Diagnosis With Cc,,,18892.99,56766.02,16
MS-DRG,983,Extensive O.R. Procedures Unrelated To Principal Diagnosis Without Cc/Mcc,,,12871.31,38673.23,16
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,,,27029.67,81213.55,16
MS-DRG,988,Non-Extensive O.R. Procedures Unrelated To Principal Diagnosis With Cc,,,13240.91,39783.74,16
MS-DRG,989,Non-Extensive O.R. Procedures Unrelated To Principal Diagnosis Without Cc/Mcc,,,8915.24,26786.79,16
MS-DRG,99,Non-Bacterial Infection Of Nervous System Except Viral Meningitis Without Cc/Mcc,,,10750.14,32299.95,16
MS-DRG,998,Principal Diagnosis Invalid As Discharge Diagnosis,,,,,0
MS-DRG,999,Ungroupable,,,,,0
NDC,0002-1506-01,TIRZEPATIDE  2.5 MG/0.5 ML SUBQ PNIJ,956.0,669.2,,,0
NDC,0002-4115-30,OLANZAPINE  5 MG ORAL TAB,185.0,129.5,,,0
NDC,0002-4182-30,BARICITINIB 2 MG ORAL TAB (COVID ONLY),790.0,553.0,,,0
NDC,0002-5123-30,PRASUGREL 10 MG ORAL TAB,243.5,170.45,,,0
NDC,0002-7510-01,INSULIN PUMP LISPRO (PATIENT OWN PUMP PHS SUPPLIED),177.0,123.89999999999999,,,0
NDC,0002-7511-01,INSULIN LISPRO PROTAM & LISPRO 100 UNIT/ML (75-25) SUBQ SUSP,16.0,11.2,,,0
NDC,0002-7597-01,OLANZAPINE 10 MG IM SOLR,256.0,179.2,,,0
NDC,0002-7623-01,PEMETREXED 500 MG IV SOLR,11159.0,7811.3,,,0
NDC,0002-7640-01,PEMETREXED 100 MG IV SOLR,8927.0,6248.9,,,0
NDC,0002-7669-01,RAMUCIRUMAB 10 MG/ML IV SOLN,3994.0,2795.8,,,0
NDC,0002-7678-01,RAMUCIRUMAB 10 MG/ML IV SOLN,14495.0,10146.5,,,0
NDC,0002-7737-01,INSULIN LISPRO 100 UNIT/ML SUBQ SOLN (HUMALOG/ADMELOG),16.0,11.2,,,0
NDC,0002-8215-01,INSULIN REGULAR HUMAN 100 UNIT/ML INJ SOLN,100.5,70.35,,,0
NDC,0002-8215-17,INSULIN REGULAR HUMAN 100 UNIT/ML INJ SOLN,137.0,95.9,,,0
NDC,0002-8501-01,INSULIN REGULAR HUM U-500 CONC 500 UNIT/ML INJ SOLN,32.0,22.4,,,0
NDC,0002-8715-01,INSULIN NPH & REGULAR HUMAN 100 UNIT/ML (70-30) SUBQ SUSP,17.0,11.899999999999999,,,0
NDC,0002-9401-01,DONANEMAB-AZBT 17.5 MG/ML IV SOLN,4001.0,2800.7,,,0
NDC,0003-0293-05,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,55.0,38.5,,,0
NDC,0003-0293-20,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,50.5,35.349999999999994,,,0
NDC,0003-0293-28,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,57.0,39.9,,,0
NDC,0003-0371-13,BELATACEPT 250 MG IV SOLR,3292.0,2304.3999999999996,,,0
NDC,0003-0494-20,TRIAMCINOLONE ACETONIDE 10 MG/ML INJ SUSP,71.0,49.7,,,0
NDC,0003-0527-11,DASATINIB  20 MG ORAL TAB,962.0,673.4,,,0
NDC,0003-0528-11,DASATINIB  50 MG ORAL TAB,1863.0,1304.1,,,0
NDC,0003-0852-22,DASATINIB 100 MG ORAL TAB,1679.0,1175.3,,,0
NDC,0003-0893-21,APIXABAN 2.5 MG ORAL TAB,88.5,61.95,,,0
NDC,0003-0893-31,APIXABAN 2.5 MG ORAL TAB,117.0,81.9,,,0
NDC,0003-0894-21,APIXABAN 5 MG ORAL TAB,162.5,113.75,,,0
NDC,0003-0894-31,APIXABAN 5 MG ORAL TAB,118.0,82.6,,,0
NDC,0003-0894-70,APIXABAN 5 MG ORAL TAB,360.5,252.35,,,0
NDC,0003-2187-13,ABATACEPT 250 MG IV SOLR,12534.0,8773.8,,,0
NDC,0003-2327-11,IPILIMUMAB 50 MG/10 ML (5 MG/ML) IV SOLN,22013.0,15409.1,,,0
NDC,0003-2328-22,IPILIMUMAB 200 MG/40 ML (5 MG/ML) IV SOLN,69955.5,48968.850000000006,,,0
NDC,0003-2570-16,AZTREONAM 2 GRAM INJ SOLR,303.0,212.1,,,0
NDC,0003-3734-13,NIVOLUMAB 240 MG/24 ML IV SOLN,15921.5,11145.05,,,0
NDC,0003-3756-14,NIVOLUMAB 240 MG/24 ML IV SOLN,9356.0,6549.2,,,0
NDC,0003-3772-11,NIVOLUMAB 40 MG/4 ML IV SOLN,3512.0,2458.3999999999996,,,0
NDC,0003-3774-12,NIVOLUMAB 240 MG/24 ML IV SOLN,6137.0,4295.9,,,0
NDC,0003-7125-11,NIVOLUMAB-RELATLIMAB-RMBW 240-80 MG/20 ML IV SOLN,56695.0,39686.5,,,0
NDC,00035-0002-80,SODIUM CHLORIDE 0.9 % IV SOLP,31.0,21.7,,,0
NDC,0004-0038-22,VALGANCICLOVIR 450 MG ORAL TAB,382.0,267.4,,,0
NDC,0004-0350-09,PEGINTERFERON ALFA-2A 180 MCG/ML SUBQ SOLN,2820.0,1974.0,,,0
NDC,0004-0800-85,OSELTAMIVIR PHOSPHATE 75 MG ORAL CAP,90.0,63.0,,,0
NDC,0004-0802-85,OSELTAMIVIR PHOSPHATE 30 MG ORAL CAP,82.0,57.4,,,0
NDC,0004-0822-05,OSELTAMIVIR  6 MG/ML ORAL SUSR,57.5,40.25,,,0
NDC,0005-0100-01,"N.MENINGITIDIS B,LIPID FHBP RC 120 MCG/0.5 ML IM SYRG",859.0,601.3,,,0
NDC,0005-0100-10,"N.MENINGITIDIS B,LIPID FHBP RC 120 MCG/0.5 ML IM SYRG",859.0,601.3,,,0
NDC,0005-1971-01,PNEUMOC 13-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG,802.0,561.4,,,0
NDC,0005-1971-05,PNEUMOC 13-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG,827.0,578.9,,,0
NDC,0005-2000-01,PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG,1003.0,702.1,,,0
NDC,0005-2000-02,PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG,979.0,685.3,,,0
NDC,0005-2000-10,PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG,949.0,664.3,,,0
NDC,0006-0221-01,SITAGLIPTIN  25 MG ORAL TAB,177.0,123.9,,,0
NDC,0006-0221-54,SITAGLIPTIN  25 MG ORAL TAB,302.5,211.75,,,0
NDC,0006-0227-61,RALTEGRAVIR 400 MG ORAL TAB,575.5,402.85,,,0
NDC,0006-0277-01,SITAGLIPTIN 100 MG ORAL TAB,89.0,62.3,,,0
NDC,0006-0277-31,SITAGLIPTIN 100 MG ORAL TAB,89.0,62.3,,,0
NDC,0006-3025-01,BEZLOTOXUMAB 25 MG/ML IV SOLN,7342.0,5139.4,,,0
NDC,0006-3026-01,PEMBROLIZUMAB 100 MG/4 ML (25 MG/ML) IV SOLN,36272.5,25390.75,,,0
NDC,0006-3061-00,FOSAPREPITANT 150 MG IV SOLR,1185.0,829.5,,,0
NDC,0006-3061-01,FOSAPREPITANT 150 MG IV SOLR,1185.0,829.5,,,0
NDC,0006-3069-01,DORAVIRINE 100 MG ORAL TAB,313.0,219.1,,,0
NDC,0006-3801-01,RIZATRIPTAN 10 MG ORAL TBDL,215.0,150.5,,,0
NDC,0006-3856-02,IMIPENEM-CILASTATIN-RELEBACTAM 1.25 G IV SOLR,1120.0,784.0,,,0
NDC,0006-3941-01,FOSAPREPITANT 150 MG IV SOLR,994.0,695.8,,,0
NDC,0006-4047-01,"ROTAVIRUS VACCINE LIVE, PENTA 2 ML ORAL SUSP",435.5,304.85,,,0
NDC,0006-4047-02,"ROTAVIRUS VACCINE LIVE, PENTA 2 ML ORAL SUSP",427.0,298.9,,,0
NDC,0006-4047-41,"ROTAVIRUS VACCINE LIVE, PENTA 2 ML ORAL SUSP",427.0,298.9,,,0
NDC,0006-4093-01,HEPATITIS B VIRUS VACCINE (PF)  5 MCG/0.5 ML IM SYRG,164.0,114.8,,,0
NDC,0006-4095-01,HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML IM MERGE (CAM USE ONLY),231.0,161.7,,,0
NDC,0006-4095-02,HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML IM SYRG,228.0,159.6,,,0
NDC,0006-4119-01,"HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM SUSP",885.0,619.5,,,0
NDC,0006-4121-01,"HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM SYRG",1127.0,788.9,,,0
NDC,0006-4121-02,"HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM INJ MERGE (CAM USE ONLY)",1127.0,788.9,,,0
NDC,0006-4171-00,"MEASLES,MUMPS,RUB,VARICEL (PF) 10EXP3-4.3-3-3.99TCID50/0.5ML SUB-Q",776.0,543.2,,,0
NDC,0006-4171-01,"DIPH,PERTUS(ACEL),TET,POLIO(PF)(KINRIX) 25 LF-58 MCG-10 LF/0.5 ML IM SYRINGE",1164.0,814.8000000000001,,,0
NDC,0006-4305-01,INFLIXIMAB-ABDA 100 MG IV SOLR,6153.0,4307.1,,,0
NDC,0006-4681-00,"MEASLES,MUMPS&RUBELLA VACCIN(PF) 1,000-12,500 TCID50/0.5 ML SUB-Q SUSP",410.0,287.0,,,0
NDC,0006-4681-01,"MEASLES,MUMPS&RUBELLA VACCIN(PF) 1,000-12,500 TCID50/0.5 ML SUB-Q SUSP",580.5,406.34999999999997,,,0
NDC,0006-4827-00,"VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUB-Q SOLN",465.0,325.5,,,0
NDC,0006-4827-01,"VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUB-Q SOLN",465.0,325.5,,,0
NDC,0006-4837-01,PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML INJ SYRG,506.0,354.2,,,0
NDC,0006-4837-03,PNEUMOVAX 23 25 MCG/0.5 ML INJ SYRG,506.0,354.2,,,0
NDC,0006-4897-00,HAEMOPH B POLYSAC CONJ-MENING (PF) 7.5 MCG/0.5 ML IM,179.0,125.3,,,0
NDC,0006-4897-01,HAEMOPH B POLYSAC CONJ-MENING (PF) 7.5 MCG/0.5 ML IM,181.5,127.05000000000001,,,0
NDC,0006-4943-00,PNEUMOCOCCAL 23-VALPS VACCINE 25 MCG/0.5 ML INJ MERGE (CAM USE ONLY),506.0,354.2,,,0
NDC,0006-4943-01,PNEUMOCOCCAL 23-VALPS VACCINE 25 MCG/0.5 ML INJ,506.0,354.2,,,0
NDC,0006-5423-02,SUGAMMADEX 100 MG/ML IV SOLN,2003.0,1402.1,,,0
NDC,0006-5424-02,ANTIVENIN LATRODECTUS MACTANS INJ CMPK,163.0,114.1,,,0
NDC,0007-4401-01,NELARABINE 250 MG/50 ML IV SOLN (PEDS ONCOLOGY),6089.0,4262.3,,,0
NDC,0008-0100-01,INOTUZUMAB OZOGAMICIN 0.9 MG (0.25 MG/ML INITIAL) IV SOLR,28057.5,19640.25,,,0
NDC,0008-0923-51,PANTOPRAZOLE 40 MG IV SOLR,51.0,35.7,,,0
NDC,0008-0923-60,PANTOPRAZOLE 40 MG IV SOLR,34.0,23.8,,,0
NDC,0008-4510-01,GEMTUZUMAB OZOGAMICIN 4.5 MG (1 MG/ML INITIAL CONC) IV SOLR,19757.5,13830.25,,,0
NDC,0009-0011-03,HYDROCORTISONE SOD SUCC (PF) 100 MG/2 ML INJ SOLR,269.0,188.3,,,0
NDC,0009-0012-01,HYDROCORTISONE 5 MG ORAL TAB,7.0,4.9,,,0
NDC,0009-0018-20,METHYLPREDNISOLONE SOD SUC(PF) 1000 MG/8 ML IV SOLR,702.0,491.4,,,0
NDC,0009-0031-01,HYDROCORTISONE 2 MG/ML SUSPENSION,7.0,4.9,,,0
NDC,0009-0039-05,METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML INJ SOLR,39.5,27.65,,,0
NDC,0009-0039-28,METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML INJ SOLR,108.5,75.95,,,0
NDC,0009-0039-30,METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML INJ SOLR,40.0,28.0,,,0
NDC,0009-0039-32,METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML INJ SOLR,21.0,14.7,,,0
NDC,0009-0039-33,METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML INJ SOLR,21.0,14.7,,,0
NDC,0009-0047-03,METHYLPREDNISOLONE SOD SUC(PF) 125 MG/2 ML INJ SOLR,52.0,36.4,,,0
NDC,0009-0047-25,METHYLPREDNISOLONE SOD SUC(PF) 125 MG/2 ML INJ SOLR,33.0,23.1,,,0
NDC,0009-0047-26,METHYLPREDNISOLONE SOD SUC(PF) 125 MG/2 ML INJ SOLR,16.0,11.2,,,0
NDC,0009-0047-27,METHYLPREDNISOLONE SOD SUC(PF) 125 MG/2 ML INJ SOLR,33.0,23.1,,,0
NDC,0009-0082-02,IRINOTECAN 100 MG/5 ML IV SOLN,461.0,322.7,,,0
NDC,0009-0271-01,ESTRADIOL CYPIONATE 5 MG/ML IM OIL,878.0,614.6,,,0
NDC,0009-0280-02,METHYLPREDNISOLONE 40 MG/ML SUSP (DEPO-MEDROL) INJECTION,49.5,34.650000000000006,,,0
NDC,0009-0280-52,METHYLPREDNISOLONE 40 MG/ML SUSP (DEPO-MEDROL) INJECTION,84.5,59.15,,,0
NDC,0009-0306-02,METHYLPREDNISOLONE 80 MG/ML SUSP FOR INJECTION,90.5,63.35,,,0
NDC,0009-0417-01,TESTOSTERONE CYPIONATE 200 MG/ML IM OIL,140.0,98.0,,,0
NDC,0009-0436-01,ARGININE HCL (L-ARGININE) 10 % IV SOLP,214.0,149.8,,,0
NDC,0009-0698-01,"METHYLPREDNISOLONE 1,000 MG SOLUTION FOR INJECTION",336.0,235.20000000000002,,,0
NDC,0009-0746-30,MEDROXYPROGESTERONE (CONTRACEPTIVE) 150 MG/ML IM SUSP,268.0,187.6,,,0
NDC,0009-0746-35,MEDROXYPROGESTERONE (CONTRACEPTIVE) 150 MG/ML IM SUSP,268.0,187.6,,,0
NDC,0009-0758-01,METHYLPREDNISOLONE 500 MG SOLUTION FOR INJECTION,214.0,149.8,,,0
NDC,0009-0775-20,CLINDAMYCIN 150 MG/ML INJECTION,20.0,14.0,,,0
NDC,0009-0775-26,CLINDAMYCIN 150 MG/ML INJECTION,20.0,14.0,,,0
NDC,0009-0825-01,HYDROCORTISONE 100 MG SOLUTION FOR INJECTION,94.0,65.8,,,0
NDC,0009-0856-05,CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN,605.0,423.5,,,0
NDC,0009-0856-08,CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN,605.0,423.5,,,0
NDC,0009-0902-11,CLINDAMYCIN 150 MG/ML INJECTION,43.0,30.1,,,0
NDC,0009-3073-01,METHYLPREDNISOLONE 40 MG/ML SUSP (DEPO-MEDROL) INJECTION,67.0,46.9,,,0
NDC,0009-3073-03,METHYLPREDNISOLONE 40 MG/ML SUSP (DEPO-MEDROL) INJECTION,100.5,70.35,,,0
NDC,0009-3073-22,METHYLPREDNISOLONE 40 MG/ML SUSP (DEPO-MEDROL) INJECTION,51.0,35.7,,,0
NDC,0009-3169-01,ALPROSTADIL 500 MCG/ML INJ SOLN,697.0,487.9,,,0
NDC,0009-3375-01,CLINDAMYCIN IN D5W 600 MG/50 ML IV PGBK,103.0,72.1,,,0
NDC,0009-3382-01,CLINDAMYCIN IN D5W 900 MG/50 ML IV PGBK,125.0,87.5,,,0
NDC,0009-3475-01,METHYLPREDNISOLONE 80 MG/ML SUSP FOR INJECTION,116.0,81.2,,,0
NDC,0009-3475-03,METHYLPREDNISOLONE 80 MG/ML SUSP FOR INJECTION,116.0,81.2,,,0
NDC,0009-5135-02,LINEZOLID 600 MG ORAL TAB,662.0,463.4,,,0
NDC,0009-5136-01,LINEZOLID 100 MG/5 ML ORAL SUSR,390.0,273.0,,,0
NDC,0009-5140-01,LINEZOLID NEO IV SYRINGE (CDS MIXTURE),49.0,34.3,,,0
NDC,0009-7224-01,"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML IV",133041.0,93128.7,,,0
NDC,0009-7224-02,"LYMPHOCYTE,ANTI-THYMO IMMUNE GLOBULIN 50 MG/ML IV",13305.0,9313.5,,,0
NDC,0009-7376-11,MEDROXYPROGESTERONE (CONTRACEPTIVE) 150 MG/ML IM (MERGE),280.0,196.0,,,0
NDC,0009-7529-01,IRINOTECAN 100 MG/5 ML IV SOLN,165.5,115.85,,,0
NDC,0009-7529-03,IRINOTECAN 100 MG/5 ML IV SOLN,485.0,339.5,,,0
NDC,0009-7529-04,IRINOTECAN 100 MG/5 ML IV SOLN,146.0,102.2,,,0
NDC,0009-7807-01,LINEZOLID 600 MG/300 ML IV SOLP,194.0,135.8,,,0
NDC,0013-1114-01,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN",359.5,251.65,,,0
NDC,0013-1114-20,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN",235.0,164.5,,,0
NDC,0013-2586-91,IDARUBICIN 1 MG/ML IV SOLN,466.0,326.2,,,0
NDC,0013-2596-20,IDARUBICIN 1 MG/ML IV SOLN,729.0,510.3,,,0
NDC,0013-2596-91,IDARUBICIN 1 MG/ML IV SOLN,895.0,626.5,,,0
NDC,0013-8303-04,LATANOPROST 0.005 % OPHT DROP,936.0,655.2,,,0
NDC,0019-5505-08,IOXAGLATE MEGLUMINE & SODIUM INJ SOLN 39.3 %-19.6 % PHS,147.0,102.9,,,0
NDC,0023-0240-04,WHITE PETROLATUM-MINERAL OIL 57.3-42.5 % OPHT OINT,51.0,35.7,,,0
NDC,0023-0312-04,WHITE PETROLATUM-MINERAL OIL OPHT OINT (PDS MERGE),58.0,40.6,,,0
NDC,0023-1145-01,BOTULINUM TOXIN TYPE A 100 UNIT IM SOLR,543.0,380.1,,,0
NDC,0023-3205-03,BIMATOPROST 0.01 % OPHT DROP,935.0,654.5,,,0
NDC,0023-3513-60,TROSPIUM 20 MG ORAL TAB,24.0,16.8,,,0
NDC,0023-3921-02,ONABOTULINUMTOXINA 200 UNIT INJ SOLR,1239.0,867.3,,,0
NDC,0023-4554-30,CARBOXYMETHYLCELLULOSE SODIUM 1 % OPHT DPGE,7.0,4.9,,,0
NDC,0023-6082-01,IRON DEXTRAN 50 MG/ML INJ SOLN,1586.5,1110.5500000000002,,,0
NDC,0023-6151-09,PROGESTERONE MICRONIZED  8 % VAGL GEL,226.0,158.2,,,0
NDC,0023-7824-10,"TRIMETHOPRIM-POLYMYXIN B 0.1 %-10,000 UNIT/ML EYE DROPS",388.0,271.6,,,0
NDC,0023-9163-30,CYCLOSPORINE 0.05 % OPHT DPET,64.0,44.8,,,0
NDC,0023-9205-15,CARBOXYMETHYLCELLULOSE SODIUM 1 % OPHT DLGL,51.0,35.7,,,0
NDC,0024-1348-03,PHENYLEPHRINE 0.25 % NASAL SPRAY,22.0,15.4,,,0
NDC,0024-1352-02,PHENYLEPHRINE 1 % NASAL SPRAY AEROSOL,24.0,16.8,,,0
NDC,0024-1353-01,PHENYLEPHRINE HCL  0.5 % NASL SPRY,22.0,15.4,,,0
NDC,0024-2792-01,NA FERRIC GLUC CPLX IN SUCROSE 12.5 MG/ML IV SOLN,374.0,261.8,,,0
NDC,0024-4142-60,DRONEDARONE 400 MG ORAL TAB,79.5,55.65,,,0
NDC,0024-5150-10,RASBURICASE 1.5 MG IV SOLR,5758.0,4030.6,,,0
NDC,0024-5150-11,RASBURICASE 1.5 MG IV SOLR,8637.0,6045.9,,,0
NDC,0024-5151-74,RASBURICASE 7.5 MG IV SOLR,6511.5,4558.05,,,0
NDC,0024-5151-75,RASBURICASE 7.5 MG IV SOLR,22022.5,15415.75,,,0
NDC,0024-5154-11,RASBURICASE 1.5 MG IV SOLR,1231.0,861.7,,,0
NDC,0024-5823-15,CABAZITAXEL 10 MG/ML (FINAL) IV SOLN,10913.0,7639.1,,,0
NDC,0024-5915-00,DUPILUMAB 300 MG/2 ML SUBQ PNIJ,5511.0,3857.7,,,0
NDC,0024-5919-00,DUPILUMAB 200 MG/1.14 ML SUBQ PNIJ,5511.0,3857.7,,,0
NDC,0024-5924-10,INSULIN LISPRO 100 UNIT/ML (PEDS CALCLUATOR 0.5),28.0,19.6,,,0
NDC,0024-5926-05,INSULIN LISPRO 100 UNIT/ML SUBQ SOLN (HUMALOG/ADMELOG),23.0,16.1,,,0
NDC,0025-0061-31,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TAB,41.0,28.7,,,0
NDC,0032-0045-70,"LIPASE-PROTEASE-AMYLASE (PORK) 3,000-9,500- 15,000 UNIT ORAL CPDR",12.0,8.4,,,0
NDC,0032-0047-70,"LIPASE-PROTEASE-AMYLASE 12,000-38,000- 60,000 UNIT ORAL CAP, DELAY REL",66.0,46.2,,,0
NDC,0032-1203-70,"LIPASE-PROTEASE-AMYLASE (PORK) 3,000-9,500- 15,000 UNIT ORAL CPDR",12.0,8.4,,,0
NDC,0032-1212-01,"LIPASE-PROTEASE-AMYLASE 12,000-38,000- 60,000 UNIT ORAL CAP, DELAY REL",87.5,61.25,,,0
NDC,0032-1224-01,"LIPASE-PROTEASE-AMYLASE 24,000-76,000- 120,000 UNIT ORAL CAP, DELAY REL",145.0,101.5,,,0
NDC,0032-2636-01,"LIPASE-PROTEASE-AMYLASE 24,000-76,000- 120,000 UNIT ORAL CAP, DELAY REL",145.0,101.5,,,0
NDC,0032-3016-13,"LIPASE-PROTEASE-AMYLASE (PORK) 36,000-114,000- 180,000 UNIT ORAL CPDR",149.5,104.65,,,0
NDC,0037-0430-01,FELBAMATE 400 MG ORAL TAB,182.0,127.4,,,0
NDC,0037-6822-10,HYDROCORTISONE-PRAMOXINE 1 %-1 % RECTAL FOAM,840.0,588.0,,,0
NDC,0037-6824-10,HYDROCORTISONE-PRAMOXINE 1 %-1 % TOPICAL FOAM,412.0,288.4,,,0
NDC,0046-0749-05,CONJUGATED ESTROGENS 25 MG INJ SOLR,1319.0,923.3,,,0
NDC,0046-0872-21,CONJUGATED ESTROGENS 0.625 MG/G VAGL CREA,1908.0,1335.6,,,0
NDC,0046-0872-93,CONJUGATED ESTROGENS 0.625 MG/G VAGL CREA,574.0,401.8,,,0
NDC,0046-1100-81,CONJUGATED ESTROGENS  0.3 MG ORAL TAB,65.5,45.85,,,0
NDC,0046-1102-81,CONJUGATED ESTROGENS  0.625 MG ORAL TAB,82.0,57.4,,,0
NDC,0049-0013-81,AMPICILLIN-SULBACTAM  1.5 GRAM INJ SOLR,77.5,54.25,,,0
NDC,0049-0014-81,AMPICILLIN-SULBACTAM  3 GRAM INJ SOLR,86.0,60.2,,,0
NDC,0049-0014-83,AMPICILLIN-SULBACTAM  3 GRAM INJ SOLR,556.0,389.20000000000005,,,0
NDC,0049-0520-83,PENICILLIN G POTASSIUM  5000000 UNIT INJ SOLR,50.0,35.0,,,0
NDC,0049-0520-84,PENICILLIN G POTASSIUM  5000000 UNIT INJ SOLR,75.0,52.5,,,0
NDC,0049-0530-28,PENICILLIN G POTASSIUM 20000000 UNIT INJ SOLR,259.0,181.3,,,0
NDC,0049-3190-28,VORICONAZOLE 200 MG IV SOLN,307.0,214.9,,,0
NDC,0049-3450-19,FLUCONAZOLE 40 MG/ML ORAL SUSR,165.0,115.5,,,0
NDC,0049-3920-20,ZIPRASIDONE 20 MG IM,328.0,229.6,,,0
NDC,0052-0602-01,BCG LIVE 50 MG IVES SUSR,564.0,394.79999999999995,,,0
NDC,0052-0602-02,BCG LIVE 50 MG IVES SUSR,394.0,275.8,,,0
NDC,0052-4330-01,ETONOGESTREL 68 MG SDRM IMPL,1951.0,1365.7,,,0
NDC,0053-7680-32,"ALBUMIN, HUMAN 25 % IV SOLN (MERGE)",215.0,150.5,,,0
NDC,0054-0010-20,FLECAINIDE  50 MG ORAL TAB,17.0,11.9,,,0
NDC,0054-0010-21,FLECAINIDE  50 MG ORAL TAB,34.0,23.8,,,0
NDC,0054-0010-25,FLECAINIDE 20MG/ML SUSPENSION (REPACK),12.0,8.4,,,0
NDC,0054-0011-20,FLECAINIDE 100 MG ORAL TAB,25.0,17.5,,,0
NDC,0054-0011-21,FLECAINIDE 100 MG ORAL TAB,15.0,10.5,,,0
NDC,0054-0011-25,FLECAINIDE 20MG/ML SUSPENSION (REPACK),7.0,4.9,,,0
NDC,0054-0017-20,PREDNISONE 10 MG ORAL TAB,14.0,9.8,,,0
NDC,0054-0018-20,PREDNISONE 20 MG ORAL TAB,5.5,3.85,,,0
NDC,0054-0018-25,PREDNISONE 20 MG ORAL TAB,7.0,4.9,,,0
NDC,0054-0018-29,PREDNISONE 20 MG ORAL TAB,7.0,4.9,,,0
NDC,0054-0019-20,PREDNISONE 50 MG ORAL TAB,5.0,3.5,,,0
NDC,0054-0045-44,IPRATROPIUM BROMIDE 0.03 % NASL SPRA,402.0,281.4,,,0
NDC,0054-0057-46,DIGOXIN  50 MCG/ML ORAL SOLN,306.0,214.2,,,0
NDC,0054-0079-28,BALSALAZIDE 750 MG ORAL CAP,27.0,18.9,,,0
NDC,0054-0140-25,ACARBOSE  25 MG ORAL TAB,7.0,4.9,,,0
NDC,0054-0163-25,MYCOPHENOLATE 250 MG CAP,44.0,30.8,,,0
NDC,0054-0166-25,MYCOPHENOLATE 500 MG TAB,78.0,54.6,,,0
NDC,0054-0177-13,BUPRENORPHINE 8 MG SL SUBL,76.0,53.2,,,0
NDC,0054-0188-13,BUPRENORPHINE-NALOXONE 2-0.5 MG SL SUBL,45.0,31.5,,,0
NDC,0054-0235-24,MORPHINE  15 MG ORAL TAB,13.5,9.45,,,0
NDC,0054-0235-25,MORPHINE  15 MG ORAL TAB,8.0,5.6,,,0
NDC,0054-0237-63,MORPHINE  10 MG/5 ML ORAL SOLN,7.0,4.9,,,0
NDC,0054-0238-63,MORPHINE  20 MG/5 ML ORAL SOLN,8.0,5.6,,,0
NDC,0054-0319-50,LINEZOLID 100 MG/5 ML ORAL SUSR,377.0,263.9,,,0
NDC,0054-0326-56,FLUTICASONE-SALMETEROL 100 MCG-50 MCG/DOSE DISK DEVICE FOR INHALATION,1067.0,746.9,,,0
NDC,0054-0327-56,FLUTICASONE-SALMETEROL 250 MCG-50 MCG/DOSE DISK DEVICE FOR INHALATION,1325.0,927.5,,,0
NDC,0054-0328-56,FLUTICASONE-SALMETEROL 500 MCG-50 MCG/DOSE DISK DEVICE FOR INHALATION,1359.0,951.3,,,0
NDC,0054-0349-25,PHENOXYBENZAMINE 10 MG ORAL CAP,840.5,588.35,,,0
NDC,0054-0400-13,DESVENLAFAXINE  50 MG ORAL TB24,88.0,61.6,,,0
NDC,0054-0404-44,MORPHINE CONCENTRATE 20 MG/ML ORAL SOLN,14.0,9.8,,,0
NDC,0054-0548-44,LIDOCAINE 2 % MUCOSAL SOLN (VISCOUS),7.0,4.9,,,0
NDC,0054-0622-63,DICYCLOMINE 10 MG/5 ML ORAL SOLN,13.0,9.1,,,0
NDC,0054-0710-20,METHADONE 10 MG ORAL TAB,26.0,18.2,,,0
NDC,0054-0742-87,ALBUTEROL SULFATE 90 MCG/ACTUATION INHL HFAA,7.0,4.9,,,0
NDC,0054-2527-25,LITHIUM CARBONATE 300 MG ORAL CAP,7.0,4.9,,,0
NDC,0054-3120-41,CALCITRIOL 1 MCG/ML ORAL SOLN,645.0,451.5,,,0
NDC,0054-3177-63,DEXAMETHASONE 0.5 MG/5 ML ORAL SOLN,17.0,11.899999999999999,,,0
NDC,0054-3270-99,FLUTICASONE  50 MCG/ACTUATION NASL SPSN,396.0,277.2,,,0
NDC,0054-3294-46,FUROSEMIDE 10 MG/ML ORAL SOLN,51.0,35.7,,,0
NDC,0054-3294-50,FUROSEMIDE 10 MG/ML ORAL SOLN,7.0,4.9,,,0
NDC,0054-3500-49,LIDOCAINE 2 % MUCOSAL SOLN (VISCOUS),7.0,4.9,,,0
NDC,0054-3505-47,LIDOCAINE 4 % MUCOSAL TOPICAL SOLN,235.0,164.5,,,0
NDC,0054-3532-44,LORAZEPAM 2 MG/ML ORAL CONC,9.0,6.3,,,0
NDC,0054-3553-44,METHADONE 10 MG/ML ORAL CONC,62.0,43.4,,,0
NDC,0054-3555-63,METHADONE 3 MG/ 3ML ORAL SOLUTION (PEDS),7.0,4.9,,,0
NDC,0054-3727-63,PROPRANOLOL 20 MG/5 ML ORAL SOLN,7.0,4.9,,,0
NDC,0054-4180-25,DEXAMETHASONE 0.75 MG ORAL TAB,9.0,6.3,,,0
NDC,0054-4181-25,DEXAMETHASONE 1 MG ORAL TAB,7.0,4.9,,,0
NDC,0054-4184-25,DEXAMETHASONE 4 MG ORAL TAB,10.5,7.3500000000000005,,,0
NDC,0054-4527-25,LITHIUM CARBONATE 300 MG ORAL TAB,7.0,4.9,,,0
NDC,0054-4581-11,MERCAPTOPURINE 50 MG ORAL TAB,81.0,56.7,,,0
NDC,0054-4582-25,MORPHINE  15 MG ORAL TAB,7.0,4.9,,,0
NDC,0054-4728-31,PREDNISONE  5 MG ORAL TAB,4.0,2.8,,,0
NDC,0054-4742-25,PREDNISONE  2.5 MG ORAL TAB,7.0,4.9,,,0
NDC,0054-8146-22,CLOTRIMAZOLE  10 MG MM TROC,20.0,14.0,,,0
NDC,0054-8174-25,DEXAMETHASONE 1 MG ORAL TAB,5.0,3.5,,,0
NDC,0054-8175-25,DEXAMETHASONE 4 MG ORAL TAB,27.0,18.9,,,0
NDC,0054-8179-25,DEXAMETHASONE 0.5 MG ORAL TAB,7.0,4.9,,,0
NDC,0054-8297-25,FUROSEMIDE 20 MG ORAL TAB,9.0,6.3,,,0
NDC,0054-8299-25,FUROSEMIDE 40 MG ORAL TAB,8.5,5.95,,,0
NDC,0054-8301-25,FUROSEMIDE 80 MG ORAL TAB,9.0,6.3,,,0
NDC,0054-8496-19,LEUCOVORIN CALCIUM   5 MG ORAL TAB,16.0,11.2,,,0
NDC,0054-8500-16,LIDOCAINE 2 % MUCOSAL SOLN (VISCOUS),9.0,6.300000000000001,,,0
NDC,0054-8526-25,LITHIUM CARBONATE 150 MG ORAL CAP,5.5,3.85,,,0
NDC,0054-8527-25,LITHIUM CARBONATE 300 MG ORAL CAP,7.0,4.9,,,0
NDC,0054-8528-25,LITHIUM CARBONATE 300 MG ORAL TAB,7.0,4.9,,,0
NDC,0054-8553-24,METHADONE  5 MG ORAL TAB,7.0,4.9,,,0
NDC,0054-8554-24,METHADONE 10 MG ORAL TAB,14.5,10.15,,,0
NDC,0054-8724-25,PREDNISONE  5 MG ORAL TAB,7.0,4.9,,,0
NDC,0056-0174-01,WARFARIN 10 MG ORAL TAB,20.0,14.0,,,0
NDC,0056-0188-70,WARFARIN  3 MG ORAL TAB,15.0,10.5,,,0
NDC,0064-5010-30,COLLAGENASE 250 UNIT/G TOP OINT,885.0,619.5,,,0
NDC,0065-0085-15,NAPHAZOLINE-PHENIRAMINE 0.025 %-0.3 % EYE DROPS,53.0,37.1,,,0
NDC,0065-0092-65,FLUORESCEIN 500 MG/5 ML (10 %) IV SOLN,263.0,184.1,,,0
NDC,0065-0359-02,CYCLOPENTOLATE-PHENYLEPHRINE 0.2 %-1 % EYE DROPS,212.5,148.75,,,0
NDC,0065-0426-36,ARTIFICIAL TEAR(DXTRN-HPM-GLY) 0.1-0.3-0.2 % OPHT DROP,44.0,30.8,,,0
NDC,0065-0454-07,PEG 400-PROPYLENE GLYCOL 0.4-0.3 % OPHT DRPG,61.0,42.7,,,0
NDC,0065-0474-01,ARTIFICIAL TEARS(HYPROMELLOSE) 0.3 % OPHT GEL,58.0,40.6,,,0
NDC,0065-0530-01,BALANCED SALT SOLN NON-SURG #3 EYE,118.0,82.6,,,0
NDC,0065-0741-14,TETRACAINE HCL (PF) 0.5 % OPHT DROP (STANDARD STOCK),80.0,56.0,,,0
NDC,0065-0795-15,BALANCED SALT IRRIG SOLN COMB2 INTRAOCULAR,75.0,52.5,,,0
NDC,0065-0817-01,ATROPINE 1 % OPHT DROP,293.0,205.1,,,0
NDC,0065-0817-02,ATROPINE 1 % OPHT DROP,213.0,149.1,,,0
NDC,0065-8064-01,ARTIFICIAL TEARS(HYPROMELLOSE) 0.3 % OPHT GEL,48.0,33.6,,,0
NDC,0065-8531-10,"CIPROFLOXACIN-HYDROCORTISONE 0.2 %-1 % EAR DROPS, SUSP",1119.0,783.3,,,0
NDC,0067-0696-60,SENNOSIDES 15 MG ORAL TAB,7.0,4.9,,,0
NDC,0067-2039-91,ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TAB,6.0,4.2,,,0
NDC,0067-4345-04,SCOPOLAMINE TRANSDERMAL PATCH 1MG OVER 3 DAYS,105.0,73.5,,,0
NDC,0067-8152-02,DICLOFENAC 1 % TOPICAL GEL,77.0,53.9,,,0
NDC,0067-8152-03,DICLOFENAC 1 % TOPICAL GEL,103.5,72.44999999999999,,,0
NDC,0068-0597-01,RIFAMPIN 600 MG IV SOLR,514.5,360.15,,,0
NDC,0069-0006-01,ETOMIDATE 2 MG/ML IV SOLN,58.0,40.6,,,0
NDC,0069-0006-04,ETOMIDATE 2 MG/ML IV SOLN,59.0,41.3,,,0
NDC,0069-0058-01,HEPARIN (PORCINE) 1000 UNITS/ML INJ SOL (FOR DIALYSIS ONLY),16.0,11.2,,,0
NDC,0069-0059-01,CRRT-HEPARIN 1000 UNITS/ML IN NS INTERMITTENT BOLUS,208.0,145.6,,,0
NDC,0069-0112-01,RIFAMPIN 600 MG IV SOLR,331.0,231.7,,,0
NDC,0069-0207-01,"RSV VAC, PREF A AND PREF B(PF) 120 MCG/0.5 ML IM SOLR",1066.0,746.2,,,0
NDC,0069-0209-01,PROPOFOL 10 MG/ML 100ML INFUSION IV EMUL,92.0,64.4,,,0
NDC,0069-0238-01,RITUXIMAB-PVVR 10 MG/ML IV SOLN,3660.5,2562.3500000000004,,,0
NDC,0069-0248-01,PROPOFOL 10 MG/ML 100ML INFUSION IV EMUL,34.0,23.8,,,0
NDC,0069-0249-01,RITUXIMAB-PVVR 10 MG/ML IV SOLN,7914.0,5539.8,,,0
NDC,0069-0271-01,"MENING A,C,Y,W TT-N. MEN B(PF) 5-120 MCG/0.5 ML IM KIT (CAM USE ONLY)",829.0,580.3,,,0
NDC,0069-0305-01,TRASTUZUMAB-QYYP 420 MG IV SOLR,12034.0,8423.8,,,0
NDC,0069-0306-01,TRASTUZUMAB-QYYP 420 MG IV SOLR,7911.5,5538.05,,,0
NDC,0069-0315-01,BEVACIZUMAB-BVZR 25 MG/ML IV SOLN,4910.0,3437.0,,,0
NDC,0069-0332-01,"MENING A,C,Y,W TT-N. MEN B(PF) 5-120 MCG/0.5 ML IM KIT (CAM USE ONLY)",817.0,571.9,,,0
NDC,0069-0338-01,SILDENAFIL (PULM.HYPERTENSION) 10 MG/12.5 ML IV SOLN,673.0,471.1,,,0
NDC,0069-0342-01,BEVACIZUMAB-BVZR 25 MG/ML IV SOLN,5926.0,4148.2,,,0
NDC,0069-0344-01,"RSV VAC, PREF A AND PREF B(PF) 120 MCG/0.5 ML IM SOLR",1066.0,746.2,,,0
NDC,0069-0344-05,"RSV VAC, PREF A AND PREF B(PF) 120 MCG/0.5 ML IM SOLR",1045.0,731.5,,,0
NDC,0069-0345-30,NIRMATRELVIR-RITONAVIR 300-100 MG ORAL TAB DOSEPACK (FOR ED/IP TAKE HOME PANEL),3837.0,2685.9,,,0
NDC,0069-0600-01,"MENING A,C,Y,W TT-N. MEN B(PF) 5-120 MCG/0.5 ML IM KIT",817.0,571.9,,,0
NDC,0069-0600-05,"MENING A,C,Y,W TT-N. MEN B(PF) 5-120 MCG/0.5 ML IM KIT (CAM USE ONLY)",727.0,508.9,,,0
NDC,0069-0809-01,INFLIXIMAB-DYYB 100 MG IV SOLR,8750.0,6125.0,,,0
NDC,0069-0970-65,DOXYCYCLINE 25 MG/5 ML ORAL SUSP,28.0,19.6,,,0
NDC,0069-1308-01,EPOETIN ALFA-EPBX 10000 UNITS/ML INJ SOLN,334.0,233.79999999999998,,,0
NDC,0069-1308-10,EPOETIN ALFA-EPBX 10000 UNITS/ML INJ SOLN,477.0,333.9,,,0
NDC,0069-1309-01,EPOETIN ALFA-EPBX 40000 UNITS/ML INJ SOLN,1218.0,852.6,,,0
NDC,0069-1542-20,DOXORUBICIN 50 MG/25 ML IV SOLN,130.0,91.0,,,0
NDC,0069-2432-01,COVID VACCINE 24-25 (12UP)(PFI)(PF) 30 MCG/0.3 ML IM SYRG,886.5,620.55,,,0
NDC,0069-2432-10,COVID VACCINE 24-25 (12UP)(PFI)(PF) 30 MCG/0.3 ML IM SYRG,886.5,620.55,,,0
NDC,0069-2465-01,"RSV VAC, PREF A AND PREF B(PF) 120 MCG/0.5 ML IM SOLR",1087.0,760.9,,,0
NDC,0069-2522-01,ELRANATAMAB-BCMM 40 MG/ML SUBQ SOLN,8820.0,6174.0,,,0
NDC,0069-2528-01,COVID VACCINE 24-25 (12UP)(PFI)(PF) 30 MCG/0.3 ML IM SYRG,958.0,670.6,,,0
NDC,0069-2528-10,COVID VAC 25-26(12UP)(PFI)(PF) 30 MCG/0.3 ML IM SYRG,639.0,447.3,,,0
NDC,0069-2587-03,VANCOMYCIN  500 MG IV SOLR,25.0,17.5,,,0
NDC,0069-2589-03,VANCOMYCIN 1000 MG IV SOLR,62.5,43.75,,,0
NDC,0069-2599-99,VANCOMYCIN PEDS IVPB (CDS MIXTURE),43.0,30.1,,,0
NDC,0069-3032-20,DOXORUBICIN 50 MG/25 ML IV SOLN,289.0,202.3,,,0
NDC,0069-3033-20,DOXORUBICIN 2 MG/ML IV SOLN,196.5,137.55,,,0
NDC,0069-3034-20,DOXORUBICIN 2 MG/ML IV SOLN,105.5,73.85,,,0
NDC,0069-3150-14,AZITHROMYCIN 500 MG IV SOLR,169.0,118.3,,,0
NDC,0069-4494-01,ELRANATAMAB-BCMM 40 MG/ML SUBQ SOLN,18422.5,12895.75,,,0
NDC,0069-4547-01,DEXAMETHASONE 0.4MG/ML ORAL SOLUTION (REPACK),31.0,21.7,,,0
NDC,0069-4547-02,DEXAMETHASONE 4 MG/ML INJECTION,8.5,5.949999999999999,,,0
NDC,0069-5045-06,NIRMATRELVIR-RITONAVIR 300 MG (150 MG X 2)-100 MG ORAL DSPK,647.0,452.9,,,0
NDC,0069-5045-30,NIRMATRELVIR-RITONAVIR 300 MG (150 MG X 2)-100 MG ORAL DSPK,1990.5,1393.3500000000001,,,0
NDC,0069-5317-02,NIRMATRELVIR-RITONAVIR 150 MG (10)- 100 MG (10) ORAL DSPK,637.5,446.25,,,0
NDC,0069-5317-20,NIRMATRELVIR-RITONAVIR 150 MG (10)- 100 MG (10) ORAL DSPK,2319.0,1623.3,,,0
NDC,0069-5321-03,NIRMATRELVIR-RITONAVIR 300-100 MG ORAL TAB DOSEPACK (FOR ED/IP TAKE HOME PANEL),4070.0,2849.0,,,0
NDC,0069-5321-30,NIRMATRELVIR-RITONAVIR 300-100 MG ORAL TAB DOSEPACK (FOR ED/IP TAKE HOME PANEL),4070.0,2849.0,,,0
NDC,0069-6001-02,FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN,356.5,249.55,,,0
NDC,0069-6001-10,FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN,1074.5,752.1500000000001,,,0
NDC,0071-0369-24,PHENYTOIN SODIUM EXTENDED 100 MG ORAL CAP,28.5,19.950000000000003,,,0
NDC,0071-0369-40,PHENYTOIN SODIUM EXTENDED 100 MG ORAL CAP,38.0,26.6,,,0
NDC,0071-0418-13,NITROGLYCERIN 0.4 MG SL SUBL,11.0,7.7,,,0
NDC,0071-1013-41,PREGABALIN  50 MG ORAL CAP,131.0,91.7,,,0
NDC,0071-1014-41,PREGABALIN  75 MG ORAL CAP,98.5,68.95,,,0
NDC,0071-2012-23,GABAPENTIN 250 MG/5 ML ORAL SOLN,7.0,4.9,,,0
NDC,0071-3740-66,PHENYTOIN SODIUM EXTENDED  30 MG ORAL CAP,20.0,14.0,,,0
NDC,0074-0561-11,VENETOCLAX 10 MG ORAL TAB,94.0,65.8,,,0
NDC,0074-0566-11,VENETOCLAX  50 MG ORAL TAB,259.0,181.3,,,0
NDC,0074-0576-11,VENETOCLAX 100 MG ORAL TAB,689.0,482.3,,,0
NDC,0074-3346-03,LEUPROLIDE (3 MONTH) 22.5 MG IM SYRG,1176.0,823.2,,,0
NDC,0074-3473-03,LEUPROLIDE (6 MONTH) 45 MG IM SYKT,1176.0,823.2,,,0
NDC,0074-3575-01,LEUPROLIDE (PEDIATRIC 6 MONTH) 45 MG IM SYKT,71748.0,50223.6,,,0
NDC,0074-3641-03,LUPRON 3.75MG IM KIT,4972.0,3480.4,,,0
NDC,0074-3642-03,LEUPROLIDE  7.5 MG IM SYKT,2351.5,1646.0500000000002,,,0
NDC,0074-3663-03,LEUPROLIDE (3 MONTH) 11.25 MG IM KIT,14204.0,9942.8,,,0
NDC,0074-3683-03,LEUPROLIDE (4 MONTH) 30 MG IM KIT,23131.5,16192.05,,,0
NDC,0074-4341-90,LEVOTHYROXINE 25 MCG ORAL TAB,28.5,19.950000000000003,,,0
NDC,0074-4380-10,CISATRACURIUM  2 MG/ML IV SOLN,210.0,147.0,,,0
NDC,0074-4380-79,CISATRACURIUM  2 MG/ML IV SOLN,97.0,67.9,,,0
NDC,0074-4552-11,LEVOTHYROXINE  50 MCG ORAL TAB,34.0,23.8,,,0
NDC,0074-4552-90,LEVOTHYROXINE  50 MCG ORAL TAB,16.0,11.2,,,0
NDC,0074-5015-01,RISANKIZUMAB-RZAA  60 MG/ML IV SOLN,42603.0,29822.1,,,0
NDC,0074-6114-13,DIVALPROEX 125 MG ORAL CPSP,14.0,9.8,,,0
NDC,0074-6122-90,FENOFIBRATE NANOCRYSTALLIZED  48 MG ORAL TAB,7.5,5.25,,,0
NDC,0074-6212-13,DIVALPROEX 125 MG ORAL TBEC,18.0,12.600000000000001,,,0
NDC,0074-6594-90,LEVOTHYROXINE  88 MCG ORAL TAB,11.5,8.05,,,0
NDC,0074-7068-11,LEVOTHYROXINE 125 MCG ORAL TAB,17.5,12.25,,,0
NDC,0074-9296-19,LEVOTHYROXINE 112 MCG ORAL TAB,11.0,7.7,,,0
NDC,0074-9694-03,LEUPROLIDE (PEDIATRIC 3 MONTH) 30 MG IM SYKT,35020.0,24514.0,,,0
NDC,0075-0620-01,ENOXAPARIN 40 MG/0.4 ML SUBQ SYRG,59.0,41.3,,,0
NDC,0075-0621-01,ENOXAPARIN 40 MG/0.4 ML SUBQ SYRG,88.0,61.6,,,0
NDC,0075-0622-01,ENOXAPARIN 80 MG/0.8 ML SUBQ SYRG,80.5,56.35,,,0
NDC,0075-0623-00,ENOXAPARIN 100 MG/1 ML SUBQ SYRG,146.0,102.2,,,0
NDC,0075-0623-03,ENOXAPARIN 100 MG/1 ML SUBQ SYRG,139.0,97.30000000000001,,,0
NDC,0075-0624-01,ENOXAPARIN 30 MG/0.3 ML SUBQ SYRG,74.5,52.15,,,0
NDC,0075-2451-01,DESMOPRESSIN 4 MCG/ML INJECTION SOLN,337.0,235.9,,,0
NDC,0075-2912-00,ENOXAPARIN 120 MG/0.8 ML SUBQ SYRG,154.0,107.8,,,0
NDC,0078-0109-61,CYCLOSPORINE 250 MG/5 ML IV SOLN,356.0,249.2,,,0
NDC,0078-0240-15,CYCLOSPORINE  25 MG ORAL CAP,79.0,55.3,,,0
NDC,0078-0240-61,CYCLOSPORINE  25 MG ORAL CAP,54.0,37.8,,,0
NDC,0078-0241-61,CYCLOSPORINE 100 MG ORAL CAP,206.0,144.2,,,0
NDC,0078-0331-84,BASILIXIMAB 20 MG IV SOLR,12584.0,8808.8,,,0
NDC,0078-0359-34,VALSARTAN 160 MG ORAL TAB,59.0,41.3,,,0
NDC,0078-0387-25,ZOLEDRONIC ACID 4 MG/5 ML IV SOLN,2547.0,1782.9,,,0
NDC,0078-0435-61,ZOLEDRONIC ACID IN MANNITOL & WATER 5 MG/100 ML IV SOLN,2992.0,2094.4,,,0
NDC,0078-0501-61,RIVASTIGMINE 4.6 MG/24 HOUR TD PT24,135.0,94.5,,,0
NDC,0078-0502-61,RIVASTIGMINE 9.5 MG/24 HOUR TD PT24,135.0,94.5,,,0
NDC,0078-0508-83,CARBAMAZEPINE 100 MG/5 ML ORAL SUSP,30.0,21.0,,,0
NDC,0078-0510-05,CARBAMAZEPINE 100 MG ORAL TB12,11.0,7.7,,,0
NDC,0078-0659-20,SACUBITRIL-VALSARTAN 24-26 MG ORAL TAB,68.0,47.6,,,0
NDC,0078-0659-61,SACUBITRIL-VALSARTAN 24-26 MG ORAL TAB,52.0,36.4,,,0
NDC,0078-0659-67,SACUBITRIL-VALSARTAN 24-26 MG ORAL TAB,68.0,47.6,,,0
NDC,0078-0685-15,ELTROMBOPAG 25 MG ORAL TAB,1301.0,910.7,,,0
NDC,0078-0687-15,ELTROMBOPAG 75 MG ORAL TAB,1548.5,1083.95,,,0
NDC,0078-0696-20,SACUBITRIL-VALSARTAN 97-103 MG ORAL TAB,68.5,47.95,,,0
NDC,0078-0696-67,SACUBITRIL-VALSARTAN 97-103 MG ORAL TAB,68.5,47.95,,,0
NDC,0078-0698-02,MIDOSTAURIN 25 MG ORAL CAP,1203.0,842.1,,,0
NDC,0078-0734-61,CANAKINUMAB (PF) 150 MG/ML SUBQ SOLN,55390.5,38773.350000000006,,,0
NDC,0078-0777-20,SACUBITRIL-VALSARTAN 49-51 MG ORAL TAB,102.0,71.4,,,0
NDC,0078-0777-61,SACUBITRIL-VALSARTAN 49-51 MG ORAL TAB,52.0,36.4,,,0
NDC,0078-0777-67,SACUBITRIL-VALSARTAN 49-51 MG ORAL TAB,68.5,47.95,,,0
NDC,0078-0804-61,"OCTREOTIDE,MICROSPHERES 30 MG IM SERR",15899.5,11129.65,,,0
NDC,0078-0811-81,"OCTREOTIDE,MICROSPHERES 10 MG IM SERR",9725.0,6807.5,,,0
NDC,0078-0813-01,TOBRAMYCIN 0.3 % EYE OINTMENT,947.0,662.9,,,0
NDC,0078-0818-81,"OCTREOTIDE,MICROSPHERES 20 MG IM SERR",19112.0,13378.4,,,0
NDC,0078-0825-81,"OCTREOTIDE,MICROSPHERES 30 MG IM SERR",12720.0,8904.0,,,0
NDC,0078-0841-01,CIPROFLOXACIN 0.3 % OPHT OINT,963.0,674.1,,,0
NDC,0078-0855-26,"CIPROFLOXACIN-HYDROCORTISONE 0.2 %-1 % EAR DROPS, SUSP",1291.0,903.7,,,0
NDC,0078-0862-25,DIFLUPREDNATE 0.05 % OPHT DROP,788.0,551.6,,,0
NDC,0078-0876-01,TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT,1056.0,739.2,,,0
NDC,0078-1000-60,INCLISIRAN 284 MG/1.5 ML SUBQ SYRG,8970.0,6279.0,,,0
NDC,0078-1168-61,SECUKINUMAB  25 MG/ML IV SOLN,10377.0,7263.9,,,0
NDC,0081-0670-20,PSEUDOEPHEDRINE SR 120 MG TAB,7.0,4.9,,,0
NDC,0085-1341-02,MOMETASONE 220 MCG (60 DOSES) INHL AEPB,796.0,557.2,,,0
NDC,0088-2102-01,RIFAPENTINE 150 MG ORAL TAB,175.0,122.5,,,0
NDC,0088-2220-33,INSULIN GLARGINE 100 UNIT/ML SUBQ SOLN,21.0,14.7,,,0
NDC,0093-0012-98,PANTOPRAZOLE 40 MG ORAL TBEC,23.0,16.1,,,0
NDC,0093-0050-01,ACETAMINOPHEN-CODEINE 300 MG-15 MG TAB,7.0,4.9,,,0
NDC,0093-0053-01,BUSPIRONE  5 MG ORAL TAB,7.0,4.9,,,0
NDC,0093-0053-05,BUSPIRONE  5 MG ORAL TAB,38.0,26.6,,,0
NDC,0093-0058-01,TRAMADOL  50 MG ORAL TAB,8.5,5.95,,,0
NDC,0093-0073-01,ZOLPIDEM  5 MG ORAL TAB,32.5,22.75,,,0
NDC,0093-0135-01,CARVEDILOL  6.25 MG ORAL TAB,24.0,16.8,,,0
NDC,0093-0318-01,DILTIAZEM 30 MG TAB,9.5,6.65,,,0
NDC,0093-0319-01,DILTIAZEM 12 MG/ML ORAL SUSPENSION,9.0,6.3,,,0
NDC,0093-0320-01,DILTIAZEM 90 MG TAB,10.0,7.0,,,0
NDC,0093-0321-01,DILTIAZEM 120 MG TAB,16.0,11.2,,,0
NDC,0093-0576-06,LOVASTATIN 20 MG ORAL TAB,20.5,14.35,,,0
NDC,0093-0752-01,ATENOLOL  50 MG ORAL TAB,7.0,4.9,,,0
NDC,0093-0810-01,NORTRIPTYLINE 10 MG ORAL CAP,9.0,6.3,,,0
NDC,0093-0811-01,NORTRIPTYLINE 25 MG ORAL CAP,25.0,17.5,,,0
NDC,0093-0812-01,NORTRIPTYLINE 50 MG ORAL CAP,31.0,21.7,,,0
NDC,0093-0832-01,CLONAZEPAM 0.5 MG ORAL TAB,10.0,7.0,,,0
NDC,0093-0983-01,NYSTATIN 500000 UNIT ORAL TAB,8.0,5.6,,,0
NDC,0093-1010-42,MUPIROCIN 2 % TOP OINT,363.0,254.1,,,0
NDC,0093-1063-01,SOTALOL 240 MG ORAL TAB,29.0,20.3,,,0
NDC,0093-1177-01,NEOMYCIN 500 MG ORAL TAB,16.0,11.2,,,0
NDC,0093-1712-01,WARFARIN 1 MG ORAL TAB,9.0,6.300000000000001,,,0
NDC,0093-1721-01,WARFARIN  5 MG ORAL TAB,7.5,5.25,,,0
NDC,0093-2026-31,AZITHROMYCIN 200 MG/5 ML ORAL SUSR,60.5,42.349999999999994,,,0
NDC,0093-2026-94,AZITHROMYCIN 200 MG/5 ML ORAL SUSR,24.0,16.8,,,0
NDC,0093-2165-19,NALOXONE 4 MG/ACTUATION NASL SPRY,303.0,212.1,,,0
NDC,0093-2165-68,NALOXONE 4 MG/ACTUATION NASL SPRY,257.0,179.9,,,0
NDC,0093-2179-01,LIOTHYRONINE  5 MCG ORAL TAB,19.0,13.3,,,0
NDC,0093-2279-73,AMOXICILLIN-POT CLAVULANATE 400 MG-57 MG/5 ML ORAL SUSP,25.0,17.5,,,0
NDC,0093-3066-19,ICATIBANT 30 MG/3 ML SUBQ SYRG,29229.0,20460.3,,,0
NDC,0093-3066-34,ICATIBANT 30 MG/3 ML SUBQ SYRG,29229.0,20460.3,,,0
NDC,0093-3123-01,DICLOXACILLIN 250 MG ORAL CAP,17.0,11.9,,,0
NDC,0093-3129-01,DISOPYRAMIDE 150 MG ORAL CAP,19.0,13.3,,,0
NDC,0093-3145-01,CEPHALEXIN 250 MG ORAL CAP,10.0,7.0,,,0
NDC,0093-3147-01,CEPHALEXIN 500 MG ORAL CAP,12.0,8.399999999999999,,,0
NDC,0093-3174-31,ALBUTEROL SULFATE 90 MCG/ACTUATION INHL HFAA,11.0,7.7,,,0
NDC,0093-3212-01,CLONAZEPAM 1 MG ORAL TAB,8.5,5.95,,,0
NDC,0093-3301-01,TRAMADOL  50 MG ORAL TAB,7.0,4.9,,,0
NDC,0093-3425-01,LORAZEPAM 0.5 MG ORAL TAB,9.5,6.65,,,0
NDC,0093-3425-10,LORAZEPAM 0.5 MG ORAL TAB,8.0,5.6,,,0
NDC,0093-3426-01,LORAZEPAM 1 MG ORAL TAB,9.0,6.3,,,0
NDC,0093-3426-05,LORAZEPAM 1 MG ORAL TAB,8.5,5.95,,,0
NDC,0093-3426-10,LORAZEPAM 1 MG ORAL TAB,9.0,6.3,,,0
NDC,0093-3429-10,TACROLIMUS 0.1 % TOP OINT,54.0,37.8,,,0
NDC,0093-4127-73,PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SUSR,7.0,4.9,,,0
NDC,0093-4127-74,PENICILLIN V POTASSIUM 250 MG/5 ML ORAL SUSR,7.0,4.9,,,0
NDC,0093-4155-73,AMOXICILLIN 250 MG/5 ML ORAL SUSR,11.0,7.699999999999999,,,0
NDC,0093-4155-80,AMOXICILLIN 250 MG/5 ML ORAL SUSR,7.0,4.9,,,0
NDC,0093-4177-73,CEPHALEXIN 250 MG/5 ML ORAL SUSR,13.0,9.1,,,0
NDC,0093-4741-19,CITALOPRAM 20 MG ORAL TAB,21.0,14.700000000000001,,,0
NDC,0093-5061-01,HYDROXYZINE 25 MG TAB,7.0,4.9,,,0
NDC,0093-5343-01,SILDENAFIL 100 MG ORAL TAB,82.0,57.4,,,0
NDC,0093-5770-56,OLANZAPINE 10 MG ORAL TAB,195.0,136.5,,,0
NDC,0093-5786-56,ENTECAVIR 0.5 MG ORAL TAB,218.0,152.6,,,0
NDC,0093-5907-86,MESALAMINE 400 MG ORAL CAPSULE-WITH DR TABLETS (CDTI),57.5,40.25,,,0
NDC,0093-5938-54,LANTHANUM  500 MG ORAL CHEW,134.0,93.8,,,0
NDC,0093-5985-19,EPINEPHRINE 0.15 MG/0.3 ML IM PNIJ,1024.0,716.8,,,0
NDC,0093-5986-19,EPINEPHRINE 0.3 MG/0.3 ML IM PNIJ,1024.0,716.8,,,0
NDC,0093-6815-19,BUDESONIDE 0.25 MG/2 ML INHL NBSP,53.0,37.1,,,0
NDC,0093-6815-45,BUDESONIDE 0.25 MG/2 ML INHL NBSP,226.5,158.55,,,0
NDC,0093-6816-19,BUDESONIDE 0.5 MG/2 ML INHL NBSP,55.0,38.5,,,0
NDC,0093-6816-45,BUDESONIDE 0.5 MG/2 ML INHL NBSP,82.0,57.4,,,0
NDC,0093-6816-55,BUDESONIDE 0.5 MG/2 ML INHL NBSP,109.0,76.3,,,0
NDC,0093-6816-73,BUDESONIDE 0.5 MG/2 ML INHL NBSP,55.0,38.5,,,0
NDC,0093-6817-19,BUDESONIDE 1 MG/2 ML INHL NBSP,113.0,79.1,,,0
NDC,0093-6817-45,BUDESONIDE 1 MG/2 ML INHL NBSP,113.0,79.1,,,0
NDC,0093-7115-98,PAROXETINE 20 MG TAB,22.5,15.75,,,0
NDC,0093-7271-56,PIOGLITAZONE 15 MG ORAL TAB,39.0,27.3,,,0
NDC,0093-7295-01,CARVEDILOL 12.5 MG ORAL TAB,18.0,12.600000000000001,,,0
NDC,0093-7334-01,MYCOPHENOLATE 250 MG CAP,51.5,36.05,,,0
NDC,0093-7336-06,TOPIRAMATE  25 MG ORAL CPSP,115.0,80.5,,,0
NDC,0093-7381-01,VENLAFAXINE  50 MG ORAL TAB,23.0,16.1,,,0
NDC,0093-7387-56,MOXIFLOXACIN 400 MG ORAL TAB,393.0,275.1,,,0
NDC,0093-7518-31,FLUTICASONE-SALMETEROL 250 MCG-50 MCG/DOSE DISK DEVICE FOR INHALATION,1325.0,927.5,,,0
NDC,0093-7620-56,LETROZOLE 2.5 MG ORAL TAB,89.0,62.3,,,0
NDC,0093-7629-98,IMATINIB 100 MG ORAL TAB,1194.0,835.8,,,0
NDC,0093-7704-56,EMTRICITABINE-TENOFOVIR 200 MG-300 MG TAB,297.0,207.9,,,0
NDC,0093-8344-98,GLYBURIDE 5 MG ORAL TAB,7.0,4.9,,,0
NDC,0093-8947-01,ACYCLOVIR 800 MG ORAL TAB,21.0,14.7,,,0
NDC,0093-9018-19,CYCLOSPORINE MODIFIED  25 MG ORAL CAP,35.0,24.5,,,0
NDC,0093-9020-19,CYCLOSPORINE MODIFIED 100 MG ORAL CAP,56.0,39.2,,,0
NDC,0093-9149-01,VENLAFAXINE  50 MG ORAL TAB,18.0,12.6,,,0
NDC,0093-9293-19,CLONAZEPAM 1 MG ORAL TBDL,25.0,17.5,,,0
NDC,0096-0707-35,ALUMINUM CHLORIDE 20 % TOP SOLN,52.0,36.4,,,0
NDC,0096-0707-37,ALUMINUM CHLORIDE 20 % TOP SOLN,52.0,36.4,,,0
NDC,0113-0065-10,OXYMETAZOLINE 0.05 % NASL SPRA,7.0,4.9,,,0
NDC,0113-0588-40,ALUM-MAG HYDROXIDE-SIMETH 400 MG-400 MG-40 MG/5 ML ORAL SUSP,7.0,4.9,,,0
NDC,0115-1365-30,SEVELAMER CARBONATE 0.8 GRAM ORAL PWPK,189.0,132.3,,,0
NDC,0115-1694-30,EPINEPHRINE 0.3 MG/0.3 ML IM PNIJ,890.0,623.0,,,0
NDC,0115-1757-01,CYPROHEPTADINE 4 MG ORAL TAB,16.0,11.2,,,0
NDC,0115-1800-01,METHYLPHENIDATE  5 MG ORAL TAB,8.0,5.6,,,0
NDC,0115-3511-01,PYRIDOSTIGMINE BROMIDE  60 MG ORAL TAB,11.5,8.05,,,0
NDC,0115-4411-01,DANTROLENE  25 MG ORAL CAP,12.0,8.4,,,0
NDC,0115-6811-10,BUPROPION HCL 150 MG ORAL TB24,51.0,35.7,,,0
NDC,0116-2001-16,CHLORHEXIDINE GLUCONATE  0.12 % MM MWSH,7.0,4.9,,,0
NDC,0116-4005-30,LACTULOSE 10 GRAM/15 ML ORAL SOLN,16.0,11.2,,,0
NDC,0121-0431-30,MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSP,19.5,13.649999999999999,,,0
NDC,0121-0581-04,HALOPERIDOL 2 MG/ML ORAL CONCENTRATE,7.0,4.9,,,0
NDC,0121-0581-05,HALOPERIDOL 2 MG/ML ORAL CONCENTRATE,22.0,15.4,,,0
NDC,0121-0638-05,DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML SYRUP,28.0,19.6,,,0
NDC,0121-0638-10,DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML SYRUP,54.0,37.8,,,0
NDC,0121-0646-10,AMANTADINE 50 MG/5 ML ORAL SYRP,26.0,18.200000000000003,,,0
NDC,0121-0646-16,AMANTADINE 50 MG/5 ML ORAL SYRP,8.0,5.6,,,0
NDC,0121-0657-00,ACETAMINOPHEN 160 MG/5 ML ORAL (PHS ERX MERGE),44.0,30.8,,,0
NDC,0121-0657-05,ACETAMINOPHEN 160 MG/5 ML ORAL (PHS ERX MERGE),33.0,23.1,,,0
NDC,0121-0670-16,ETHOSUXIMIDE 250 MG/5 ML ORAL SYRP,14.0,9.8,,,0
NDC,0121-0721-04,FLUOXETINE 20 MG/5 ML ORAL SOLN,41.5,29.05,,,0
NDC,0121-0759-08,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (5 ML) ORAL SOLN,7.0,4.9,,,0
NDC,0121-0766-16,CALCIUM CARBONATE 1250 MG/5 ML SUSPENSION (500 MG/5 ML ELEMENTAL),7.0,4.9,,,0
NDC,0121-0799-16,LEVETIRACETAM 100 MG/ML ORAL SOLN,37.0,25.9,,,0
NDC,0121-0820-16,THEOPHYLLINE 80 MG/15 ML ORAL SOLN,25.0,17.5,,,0
NDC,0121-0853-20,TRIMETHOPRIM-SULFAMETHOXAZOLE 40 MG-200 MG/5 ML ORAL SUSP,94.5,66.15,,,0
NDC,0121-0865-05,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,10.0,7.0,,,0
NDC,0121-0867-20,VANCOMYCIN  125 MG ORAL CAP,154.0,107.8,,,0
NDC,0121-0868-02,NYSTATIN 100000 UNIT/ML ORAL SUSP,7.0,4.9,,,0
NDC,0121-0868-05,NYSTATIN 100000 UNIT/ML ORAL SUSP,13.0,9.1,,,0
NDC,0121-0873-16,LACTULOSE 10 GRAM/15 ML ORAL SOLN,108.0,75.6,,,0
NDC,0121-0873-32,LACTULOSE 10 GRAM/15 ML ORAL SOLN,67.5,47.25,,,0
NDC,0121-0893-15,CHLORHEXIDINE GLUCONATE  0.12 % MM MWSH,10.0,7.0,,,0
NDC,0121-0903-15,LIDOCAINE 2 % MUCOSAL SOLN (VISCOUS),59.0,41.300000000000004,,,0
NDC,0121-0904-05,MORPHINE  10 MG/5 ML ORAL SOLN,12.0,8.4,,,0
NDC,0121-0904-94,MORPHINE  10 MG/5 ML ORAL SOLN,14.0,9.8,,,0
NDC,0121-0905-05,DIAZEPAM 5 MG/5 ML (5 ML) ORAL SOLN,46.0,32.2,,,0
NDC,0121-0914-05,IBUPROFEN 100 MG/5 ML ORAL SUSP,20.0,14.0,,,0
NDC,0121-0917-05,IBUPROFEN 100 MG/5 ML ORAL SUSP,18.5,12.95,,,0
NDC,0121-0942-05,PHENOBARBITAL 20 MG/5 ML ORAL ELIX,31.0,21.7,,,0
NDC,0121-0945-00,MEGESTROL 400 MG/10 ML (10 ML) ORAL SUSP,17.5,12.25,,,0
NDC,0121-0945-10,MEGESTROL 400 MG/10 ML (10 ML) ORAL SUSP,23.5,16.450000000000003,,,0
NDC,0121-0970-01,LIDOCAINE 4% TOP PATCH,19.5,13.649999999999999,,,0
NDC,0121-0974-10,SUCRALFATE 100 MG/ML ORAL SUSP,55.0,38.5,,,0
NDC,0121-1016-05,ATOVAQUONE 750 MG/5 ML ORAL SUSP,351.0,245.7,,,0
NDC,0121-1022-05,IBUPROFEN 100 MG/5 ML ORAL SUSP,20.0,14.0,,,0
NDC,0121-1045-16,NYSTATIN 100000 UNIT/ML ORAL SUSP,7.0,4.9,,,0
NDC,0121-1154-00,LACTULOSE 20 GRAM/30 ML ORAL SOLN,11.0,7.7,,,0
NDC,0121-1154-30,LACTULOSE 20 GRAM/30 ML ORAL SOLN,23.0,16.1,,,0
NDC,0121-1276-10,DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML SYRUP,12.0,8.399999999999999,,,0
NDC,0121-1314-11,ACETAMINOPHEN 160 MG/5 ML ORAL (PHS ERX MERGE),13.5,9.45,,,0
NDC,0121-1488-10,GUAIFENESIN 100 MG/5 ML ORAL LIQD,22.0,15.4,,,0
NDC,0121-1550-10,CODEINE-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD (REPACK),22.0,15.4,,,0
NDC,0121-1576-10,METOCLOPRAMIDE HCL 5 MG/5 ML ORAL SOLN,27.0,18.9,,,0
NDC,0121-1744-05,GUAIFENESIN 100 MG/5 ML ORAL LIQD,22.0,15.4,,,0
NDC,0121-1760-30,ALUMINUM-MAGNESIUM HYDROXIDE 200 MG-200 MG/5 ML ORAL SUSP,44.0,30.8,,,0
NDC,0121-1761-30,ALUM-MAG HYDROXIDE-SIMETH 200 MG-200 MG-20 MG/5 ML ORAL SUSP,31.5,22.049999999999997,,,0
NDC,0121-1762-30,ALUM-MAG HYDROXIDE-SIMETH 400 MG-400 MG-40 MG/5 ML ORAL SUSP,26.0,18.2,,,0
NDC,0121-1775-05,CODEINE-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD (REPACK),36.0,25.200000000000003,,,0
NDC,0121-1781-05,ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSP,15.5,10.85,,,0
NDC,0121-1971-00,ACETAMINOPHEN 650 MG/20.3 ML ORAL SOLN,126.5,88.55000000000001,,,0
NDC,0121-1971-21,ACETAMINOPHEN 650 MG/20.3 ML ORAL SOLN,27.0,18.9,,,0
NDC,0121-2044-10,IBUPROFEN 100 MG/5 ML ORAL SUSP,13.5,9.45,,,0
NDC,0121-2316-15,HYDROCODONE-ACETAMINOPHEN 7.5 MG-325 MG/15 ML ORAL SOLN (REPACK),16.0,11.2,,,0
NDC,0121-4577-30,LACTULOSE 20 GRAM/30 ML ORAL SOLN,7.0,4.9,,,0
NDC,0121-4675-05,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLN,29.0,20.3,,,0
NDC,0121-4721-05,FLUOXETINE 20 MG/5 ML ORAL SOLN,52.5,36.75,,,0
NDC,0121-4766-05,CALCIUM CARBONATE 1250 MG/5 ML SUSPENSION (500 MG/5 ML ELEMENTAL),18.0,12.6,,,0
NDC,0121-4799-05,LEVETIRACETAM 500 MG/5 ML ORAL SOLN,68.0,47.6,,,0
NDC,0121-4827-05,OXYCODONE 5 MG/5 ML ORAL SOLN,25.0,17.5,,,0
NDC,0121-4950-15,LIDOCAINE 2 % MUCOSAL SOLN (VISCOUS),40.5,28.35,,,0
NDC,0121-4967-05,SENNOSIDES 8.8 MG/5 ML ORAL SYRP,26.0,18.2,,,0
NDC,0131-1810-67,LACOSAMIDE 200 MG/20 ML IV SOLN,429.0,300.3,,,0
NDC,0131-2477-35,LACOSAMIDE  50 MG ORAL TAB,142.0,99.4,,,0
NDC,0131-2477-60,LACOSAMIDE  50 MG ORAL TAB,156.0,109.2,,,0
NDC,0131-2480-35,LACOSAMIDE 200 MG ORAL TAB,118.0,82.6,,,0
NDC,0131-3266-46,VENLAFAXINE  75 MG ORAL TR24,113.0,79.1,,,0
NDC,0131-5410-71,LACOSAMIDE 10 MG/ML ORAL SOLUTION (REPACK),91.5,64.05,,,0
NDC,0132-0079-12,GLYCERIN (ADULT) RECTAL SUPPOSITORY,7.0,4.9,,,0
NDC,0132-0079-24,GLYCERIN (ADULT) RECTAL SUPPOSITORY,7.0,4.9,,,0
NDC,0132-0081-12,GLYCERIN (CHILD) RECTAL SUPPOSITORY,7.0,4.9,,,0
NDC,0132-0190-12,GLYCERIN (LAXATIVE) 2.8 GRAM/2.7 ML RECT SOLN,7.0,4.9,,,0
NDC,0132-0201-40,SODIUM PHOSPHATES 19 GRAM-7 GRAM ENEMA,7.0,4.9,,,0
NDC,0132-0301-40,MINERAL OIL ENEMA,15.0,10.5,,,0
NDC,0135-0117-88,ASPIRIN   81 MG ORAL TBEC,5.0,3.5,,,0
NDC,0135-0300-01,DOCOSANOL 10 % TOP CREAM,152.0,106.4,,,0
NDC,0143-1171-01,CAPTOPRIL 1 MG/ML SOLUTION (REPACK),7.0,4.9,,,0
NDC,0143-1480-01,PROPYLTHIOURACIL 5MG/ML SUSPENSION (REPACK),14.0,9.8,,,0
NDC,0143-1772-01,ISOSORBIDE DINITRATE 20 MG ORAL TAB,10.5,7.3500000000000005,,,0
NDC,0143-2112-50,DOXYCYCLINE HYCLATE 100 MG ORAL TAB,31.0,21.7,,,0
NDC,0143-9128-01,GENTAMICIN 40 MG/ML INJ SOLN,24.0,16.8,,,0
NDC,0143-9139-01,CEFAZOLIN   2 G INJ SOLR,39.0,27.3,,,0
NDC,0143-9139-25,CEFAZOLIN   2 G IV SOLR,39.0,27.3,,,0
NDC,0143-9156-01,FUROSEMIDE 10 MG/ML INJ SOLN (NEO),16.0,11.2,,,0
NDC,0143-9161-01,VANCOMYCIN  500 MG IV SOLR,24.5,17.15,,,0
NDC,0143-9161-10,VANCOMYCIN  500 MG IV SOLR,27.0,18.9,,,0
NDC,0143-9162-01,VANCOMYCIN 1000 MG IV SOLR,100.0,70.0,,,0
NDC,0143-9163-01,VANCOMYCIN  5 GRAM IV SOLR,65.0,45.5,,,0
NDC,0143-9164-01,VANCOMYCIN 10 GRAM IV SOLR,67.0,46.9,,,0
NDC,0143-9173-01,LIDOCAINE 20 MG/ML (2 %) INJECTION,16.0,11.2,,,0
NDC,0143-9180-01,CALCIUM GLUCONATE (FOR EMERGENCY) 100 MG/ML (10%) IV SOLN,118.0,82.6,,,0
NDC,0143-9184-01,CALCIUM GLUCONATE (FOR EMERGENCY) 100 MG/ML (10%) IV SOLN,286.0,200.2,,,0
NDC,0143-9210-01,CHLOROPROCAINE 3 % INJ SOLN,23.0,16.1,,,0
NDC,0143-9233-01,BENZTROPINE 1 MG/ML INJ SOLN,115.0,80.5,,,0
NDC,0143-9241-01,BLEOMYCIN 30 UNIT INJ SOLR,459.0,321.3,,,0
NDC,0143-9245-01,DACARBAZINE 200 MG IV SOLR,220.5,154.35000000000002,,,0
NDC,0143-9248-01,DEXRAZOXANE 500 MG IV SOLR,4451.0,3115.7,,,0
NDC,0143-9250-01,ROCURONIUM 10 MG/ML IV SOLN,35.0,24.5,,,0
NDC,0143-9252-01,DOPAMINE 200 MG/5 ML (40 MG/ML) IV,20.0,14.0,,,0
NDC,0143-9273-01,DIHYDROERGOTAMINE 1 MG/ML INJ SOLN,550.0,385.0,,,0
NDC,0143-9284-01,PANTOPRAZOLE 40 MG IV SOLR,31.5,22.05,,,0
NDC,0143-9318-01,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,339.0,237.3,,,0
NDC,0143-9319-01,HALOPERIDOL LACTATE 5 MG/ML INJECTION (MERGE),16.0,11.2,,,0
NDC,0143-9319-25,HALOPERIDOL LACTATE 5 MG/ML INJECTION (MERGE),16.0,11.2,,,0
NDC,0143-9328-01,BUPIVACAINE 0.25 % (2.5 MG/ML) INJ SOLN,26.0,18.2,,,0
NDC,0143-9329-01,BUPIVACAINE 0.5 % (5 MG/ML) INJ SOLN,40.5,28.35,,,0
NDC,0143-9329-10,BUPIVACAINE 0.5 % (5 MG/ML) INJ SOLN,16.0,11.2,,,0
NDC,0143-9333-01,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN,20.0,14.0,,,0
NDC,0143-9334-01,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN,16.0,11.2,,,0
NDC,0143-9334-10,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN,20.0,14.0,,,0
NDC,0143-9362-01,MICAFUNGIN 100 MG IV SOLR,184.0,128.8,,,0
NDC,0143-9379-01,MIDAZOLAM (PF) IN 0.9 % NACL 1 MG/ML IV SOLN,130.0,91.0,,,0
NDC,0143-9381-01,DOXYCYCLINE HYCLATE 100 MG IV SOLR,186.0,130.2,,,0
NDC,0143-9384-01,FOSAPREPITANT 150 MG IV SOLR,272.5,190.75,,,0
NDC,0143-9385-01,DECITABINE 50 MG IV SOLR,99.0,69.3,,,0
NDC,0143-9386-01,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN FOR PERI-OPERATIVE",34.0,23.8,,,0
NDC,0143-9387-01,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,18.0,12.6,,,0
NDC,0143-9387-25,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,18.0,12.6,,,0
NDC,0143-9398-01,ERTAPENEM 1 GRAM INJ SOLR,118.0,82.6,,,0
NDC,0143-9503-01,ACETAZOLAMIDE SODIUM 500 (100 MG/ML) INJ SOLR,224.0,156.8,,,0
NDC,0143-9504-01,CISPLATIN 1 MG/ML IV,68.0,47.599999999999994,,,0
NDC,0143-9506-01,ETOMIDATE 2 MG/ML IV SOLN,48.0,33.599999999999994,,,0
NDC,0143-9507-01,ETOMIDATE 2 MG/ML IV SOLN,22.0,15.4,,,0
NDC,0143-9507-10,ETOMIDATE 2 MG/ML IV SOLN,45.0,31.5,,,0
NDC,0143-9508-01,KETAMINE 2 MG/ML IN NS 50ML INFUSION (STOCK DOSE),79.5,55.650000000000006,,,0
NDC,0143-9509-01,KETAMINE 100 MG/ML INJ SOLN,32.0,22.4,,,0
NDC,0143-9511-01,ETOPOSIDE 20 MG/ML IV SOLN,72.0,50.400000000000006,,,0
NDC,0143-9514-01,DROPERIDOL 2.5 MG/ML INJ SOLN,85.5,59.849999999999994,,,0
NDC,0143-9519-01,METHOTREXATE (PF) 25 MG/ML INJ SOLN (FOR ECTOPIC PREGNANCY),42.0,29.4,,,0
NDC,0143-9525-01,DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN,94.0,65.8,,,0
NDC,0143-9533-01,ALLOPURINOL SODIUM 500 MG IV SOLR,2153.0,1507.1,,,0
NDC,0143-9534-01,LINEZOLID 600 MG/300 ML IV SOLP,83.0,58.1,,,0
NDC,0143-9546-01,DOXORUBICIN 2 MG/ML IV SOLN,315.0,220.5,,,0
NDC,0143-9550-01,DAUNORUBICIN 5 MG/ML IV INJ,828.5,579.95,,,0
NDC,0143-9551-01,DAUNORUBICIN 5 MG/ML IV INJ,1449.0,1014.3,,,0
NDC,0143-9552-01,LEUCOVORIN CALCIUM 350 MG INJ SOLR,300.0,210.0,,,0
NDC,0143-9553-01,LEUCOVORIN CALCIUM 200 MG INJ SOLR,139.0,97.3,,,0
NDC,0143-9554-01,LEUCOVORIN CALCIUM 100 MG INJ SOLR,124.0,86.8,,,0
NDC,0143-9555-01,LEUCOVORIN CALCIUM  50 MG INJ SOLR,59.0,41.3,,,0
NDC,0143-9564-01,PHENTOLAMINE 5 MG INJ SOLR,1231.0,861.7,,,0
NDC,0143-9570-01,NA FERRIC GLUC CPLX IN SUCROSE 12.5 MG/ML IV SOLN,280.5,196.35000000000002,,,0
NDC,0143-9575-01,LIDOCAINE 20 MG/ML (2 %) INJECTION,19.0,13.3,,,0
NDC,0143-9577-01,LIDOCAINE 10 MG/ML (1 %) INJECTION,17.5,12.25,,,0
NDC,0143-9577-10,LIDOCAINE 10 MG/ML (1 %) INJECTION,16.0,11.2,,,0
NDC,0143-9594-01,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,16.0,11.2,,,0
NDC,0143-9595-01,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,49.0,34.3,,,0
NDC,0143-9595-25,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,16.0,11.2,,,0
NDC,0143-9606-01,AZACITIDINE 100 MG INJ SOLR,220.5,154.35,,,0
NDC,0143-9619-01,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,25.5,17.85,,,0
NDC,0143-9619-10,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,16.0,11.2,,,0
NDC,0143-9620-01,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,16.0,11.2,,,0
NDC,0143-9620-10,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,22.0,15.4,,,0
NDC,0143-9621-01,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,31.5,22.049999999999997,,,0
NDC,0143-9621-25,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,47.0,32.9,,,0
NDC,0143-9622-01,LABETALOL 5 MG/ML IV SOLN,47.0,32.9,,,0
NDC,0143-9623-01,LABETALOL 5 MG/ML IV SOLN,83.0,58.1,,,0
NDC,0143-9634-01,NICARDIPINE IN NACL (ISO-OS) 20 MG/200 ML IV PGBK,621.0,434.70000000000005,,,0
NDC,0143-9637-01,VALPROATE SODIUM 100 MG/ML IV SOLN,268.0,187.6,,,0
NDC,0143-9638-01,SUMATRIPTAN 6 MG/0.5 ML SUB-Q,106.0,74.2,,,0
NDC,0143-9659-01,TESTOSTERONE CYPIONATE 200 MG/ML IM OIL,60.0,42.0,,,0
NDC,0143-9660-01,METOPROLOL TARTRATE 5 MG/5 ML IV,18.0,12.6,,,0
NDC,0143-9673-10,LEVETIRACETAM 500 MG/5 ML IV SOLN,160.0,112.0,,,0
NDC,0143-9674-01,ARGATROBAN 100 MG/ML IV SOLN,821.0,574.7,,,0
NDC,0143-9679-01,GLYCOPYRROLATE 0.2 MG/ML ORAL SOLUTION (CDS),83.0,58.1,,,0
NDC,0143-9680-01,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,43.0,30.099999999999998,,,0
NDC,0143-9682-01,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,33.0,23.1,,,0
NDC,0143-9682-25,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,35.0,24.5,,,0
NDC,0143-9689-01,NICARDIPINE 25 MG/10 ML IV SOLN,449.5,314.65,,,0
NDC,0143-9701-01,IRINOTECAN 100 MG/5 ML IV SOLN,318.0,222.6,,,0
NDC,0143-9702-01,IRINOTECAN 100 MG/5 ML IV SOLN,96.5,67.55,,,0
NDC,0143-9710-01,MILRINONE 1 MG/ML IV SOLN,42.0,29.4,,,0
NDC,0143-9719-01,MILRINONE INFUSION PED/NEO IV SYRINGE (CDS MIXTURE),133.5,93.44999999999999,,,0
NDC,0143-9720-01,LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK,42.0,29.4,,,0
NDC,0143-9721-01,LEVOFLOXACIN IN D5W 500 MG/100 ML IV PGBK,41.0,28.7,,,0
NDC,0143-9724-01,CLONIDINE (PF) 1000 MCG/10 ML EPID SOLN,214.0,149.8,,,0
NDC,0143-9726-01,TESTOSTERONE CYPIONATE 200 MG/ML IM OIL,86.5,60.55,,,0
NDC,0143-9729-01,BENZTROPINE 1 MG/ML INJ SOLN,477.0,333.9,,,0
NDC,0143-9744-01,GRANISETRON 1 MG/ML (1 ML) IV SOLN,16.5,11.55,,,0
NDC,0143-9746-01,TERBUTALINE 1 MG/ML SUBQ SOLN,279.5,195.64999999999998,,,0
NDC,0143-9750-01,TESTOSTERONE ENANTHATE 200 MG/ML IM OIL,97.0,67.9,,,0
NDC,0143-9784-01,FLUMAZENIL 0.1 MG/ML IV SOLN,91.0,63.7,,,0
NDC,0143-9785-01,VALPROATE SODIUM 100 MG/ML IV SOLN,254.0,177.8,,,0
NDC,0143-9785-10,VALPROATE SODIUM 100 MG/ML IV SOLN,203.5,142.45,,,0
NDC,0143-9786-01,ENALAPRILAT 1.25 MG/ML IV INJ,56.0,39.2,,,0
NDC,0143-9787-01,ENALAPRILAT 1.25 MG/ML IV INJ,36.0,25.2,,,0
NDC,0143-9852-01,LEVOCARNITINE 200 MG/ML IV SOLN,250.5,175.35,,,0
NDC,0143-9853-16,AMOXICILLIN-POT CLAVULANATE 600 MG-42.9 MG/5 ML ORAL SUSP,17.5,12.25,,,0
NDC,0143-9856-01,CEFTRIAXONE   2 GRAM INJ SOLR,70.0,49.0,,,0
NDC,0143-9857-01,CEFTRIAXONE 1 GRAM INJ SOLR,21.5,15.049999999999999,,,0
NDC,0143-9857-25,CEFTRIAXONE NEO/PEDS (CDS MIXTURE),96.0,67.2,,,0
NDC,0143-9871-01,CLADRIBINE 1 MG/ML IV SOLN,1770.0,1239.0,,,0
NDC,0143-9873-01,METOPROLOL TARTRATE 5 MG/5 ML IV,18.0,12.6,,,0
NDC,0143-9873-10,METOPROLOL TARTRATE 5 MG/5 ML IV,27.0,18.9,,,0
NDC,0143-9875-01,AMIODARONE 50 MG/ML IV SOLN,21.5,15.049999999999999,,,0
NDC,0143-9875-10,AMIODARONE 50 MG/ML IV SOLN,22.0,15.4,,,0
NDC,0143-9875-25,AMIODARONE 50 MG/ML IV SOLN,21.5,15.049999999999999,,,0
NDC,0143-9887-01,AMOXICILLIN 400 MG/5 ML ORAL SUSR,10.0,7.0,,,0
NDC,0143-9887-75,AMOXICILLIN 400 MG/5 ML ORAL SUSR,9.0,6.300000000000001,,,0
NDC,0143-9889-01,AMOXICILLIN 250 MG/5 ML ORAL SUSR,10.0,7.0,,,0
NDC,0143-9889-15,AMOXICILLIN 250 MG/5 ML ORAL SUSR,10.0,7.0,,,0
NDC,0143-9924-90,CEFAZOLIN   1 GRAM INJ SOLR,23.5,16.450000000000003,,,0
NDC,0143-9982-50,AMOXICILLIN-POT CLAVULANATE 400 MG-57 MG/5 ML ORAL SUSP,26.0,18.2,,,0
NDC,0143-9983-03,CEFAZOLIN  10 GRAM INJ SOLR,34.0,23.799999999999997,,,0
NDC,0143-9983-91,CEFAZOLIN  10 GRAM INJ SOLR,17.0,11.9,,,0
NDC,0168-0004-15,TRIAMCINOLONE ACETONIDE 0.1 % TOP CREAM,31.0,21.7,,,0
NDC,0168-0006-15,TRIAMCINOLONE ACETONIDE 0.1 % TOP OINT,43.0,30.1,,,0
NDC,0168-0006-16,TRIAMCINOLONE ACETONIDE 0.1 % TOP OINT,147.0,102.9,,,0
NDC,0168-0011-04,BACITRACIN 500 UNIT/G TOP OINT (MERGE),71.0,49.7,,,0
NDC,0168-0020-31,HYDROCORTISONE  1 % TOP OINT,63.5,44.45,,,0
NDC,0168-0053-45,WHITE PETROLATUM TOPICAL GEL,7.0,4.9,,,0
NDC,0168-0056-15,BETAMETHASONE DIPROPIONATE 0.05 % TOP OINT,261.0,182.7,,,0
NDC,0168-0057-60,BETAMETHASONE DIPROPIONATE 0.05 % TOP LOTN,235.0,164.5,,,0
NDC,0168-0062-31,ZINC OXIDE 20 % TOP OINT (REPACK),18.0,12.6,,,0
NDC,0168-0202-30,CLINDAMYCIN 1 % TOPICAL GEL,374.0,261.8,,,0
NDC,0168-0258-15,CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,99.0,69.3,,,0
NDC,0169-1833-11,INSULIN REGULAR HUMAN 100 UNIT/ML INJ SOLN,20.0,14.0,,,0
NDC,0169-1834-11,INSULIN NPH HUMAN RECOMB 100 UNIT/ML SUBQ SUSP,19.0,13.3,,,0
NDC,0169-1837-11,INSULIN NPH & REGULAR HUMAN 100 UNIT/ML (70-30) SUBQ SUSP,17.0,11.899999999999999,,,0
NDC,0169-2662-11,INSULIN DEGLUDEC 100 UNITS/ML SUBQ SOLN,12059.0,8441.3,,,0
NDC,0169-3685-12,INSULIN ASP PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBQ SOLN,23.0,16.1,,,0
NDC,0169-3687-12,INSULIN DETEMIR 100 UNIT/ML SUBQ SOLN,18.0,12.6,,,0
NDC,0169-4060-12,LIRAGLUTIDE 0.6 MG/0.1 ML (18 MG/3 ML) SUBQ PNIJ,1925.0,1347.5,,,0
NDC,0169-4130-01,SEMAGLUTIDE 1 MG/DOSE (4 MG/3 ML) SUBQ PNIJ,2754.0,1927.8,,,0
NDC,0169-7010-01,COAGULATION FACTOR VIIA RECOMB (PHS ERX MERGE),22310.0,15617.0,,,0
NDC,0169-7201-01,COAGULATION FACTOR VIIA RECOMB (PHS ERX MERGE),16560.0,11592.0,,,0
NDC,0169-7202-01,COAGULATION FACTOR VIIA RECOMB (PHS ERX MERGE),22080.0,15456.0,,,0
NDC,0169-7205-01,COAGULATION FACTOR VIIA RECOMB (PHS ERX MERGE),41400.0,28980.0,,,0
NDC,0169-7211-11,COAGULATION FACTOR VIIA RECOMB (PHS ERX MERGE),9280.5,6496.349999999999,,,0
NDC,0169-7212-11,COAGULATION FACTOR VIIA RECOMB (PHS ERX MERGE),30935.0,21654.5,,,0
NDC,0169-7215-11,COAGULATION FACTOR VIIA RECOMB (PHS ERX MERGE),46402.5,32481.75,,,0
NDC,0172-2083-60,HYDROCHLOROTHIAZIDE  25 MG ORAL TAB,7.0,4.9,,,0
NDC,0172-3758-70,LISINOPRIL  5 MG ORAL TAB,7.0,4.9,,,0
NDC,0172-3926-60,DIAZEPAM  5 MG ORAL TAB,9.0,6.3,,,0
NDC,0172-5728-60,FAMOTIDINE 20 MG ORAL TAB,14.0,9.8,,,0
NDC,0172-5728-80,FAMOTIDINE 20 MG ORAL TAB,14.0,9.8,,,0
NDC,0172-7313-20,CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLN,25.0,17.5,,,0
NDC,0173-0521-00,SALMETEROL 50 MCG/DOSE INHL DSDV,47.0,32.9,,,0
NDC,0173-0547-00,ATOVAQUONE 750 MG/5 ML ORAL SUSP,266.5,186.55,,,0
NDC,0173-0682-20,ALBUTEROL SULFATE 90 MCG/ACTUATION INHL HFAA,12.5,8.75,,,0
NDC,0173-0682-24,ALBUTEROL SULFATE 90 MCG/ACTUATION INHL HFAA,64.5,45.150000000000006,,,0
NDC,0173-0695-00,FLUTICASONE-SALMETEROL 100 MCG-50 MCG/DOSE DISK DEVICE FOR INHALATION,674.0,471.8,,,0
NDC,0173-0695-04,FLUTICASONE-SALMETEROL 100 MCG-50 MCG/DOSE DISK DEVICE FOR INHALATION,232.0,162.4,,,0
NDC,0173-0696-04,FLUTICASONE-SALMETEROL 250 MCG-50 MCG/DOSE DISK DEVICE FOR INHALATION,232.0,162.4,,,0
NDC,0173-0697-04,FLUTICASONE-SALMETEROL 500 MCG-50 MCG/DOSE DISK DEVICE FOR INHALATION,378.0,264.6,,,0
NDC,0173-0718-20,FLUTICASONE 44 MCG/ACTUATION INHL AERO,17.5,12.25,,,0
NDC,0173-0719-20,FLUTICASONE 110 MCG/ACTUATION INHL AERO,23.5,16.45,,,0
NDC,0173-0720-20,FLUTICASONE 220 MCG/ACTUATION INHL AERO,24.0,16.8,,,0
NDC,0173-0881-01,MEPOLIZUMAB 100 MG SUBQ SOLR,14214.0,9949.8,,,0
NDC,0173-0898-03,DOSTARLIMAB-GXLY 50 MG/ML IV SOLN,46012.5,32208.75,,,0
NDC,0173-0933-56,VALACYCLOVIR 500 MG ORAL TAB,63.0,44.1,,,0
NDC,0178-0320-03,METHYL SALICYLATE-MENTHOL 15-1 % TOPICAL CREAM,22.0,15.4,,,0
NDC,0185-0122-01,NITROFURANTOIN (25% MACROCRYSTAL FORM) 100 MG CAP,7.0,4.9,,,0
NDC,0185-0676-01,HYDROXYZINE PAMOATE  50 MG ORAL CAP,7.0,4.9,,,0
NDC,0185-0757-01,SULFADIAZINE 500 MG ORAL TAB,75.0,52.5,,,0
NDC,0185-0799-60,RIFAMPIN 25MG/ML SUSPENSION (REPACK),13.0,9.1,,,0
NDC,0185-0801-30,RIFAMPIN 25MG/ML SUSPENSION (REPACK),19.0,13.3,,,0
NDC,0185-5050-01,METOLAZONE  2.5 MG ORAL TAB,23.0,16.1,,,0
NDC,0186-0370-20,BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION,26.5,18.549999999999997,,,0
NDC,0186-0370-28,BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION,30.5,21.35,,,0
NDC,0186-0372-20,BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION,23.0,16.1,,,0
NDC,0186-0372-28,BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION,17.5,12.25,,,0
NDC,0186-0776-60,TICAGRELOR 60 MG ORAL TAB,52.0,36.4,,,0
NDC,0186-0777-39,TICAGRELOR 90 MG ORAL TAB,89.0,62.3,,,0
NDC,0186-0777-60,TICAGRELOR 90 MG ORAL TAB,70.5,49.349999999999994,,,0
NDC,0186-1092-05,METOPROLOL SUCCINATE SR 100 MG 24 HR TAB,12.0,8.4,,,0
NDC,0186-1988-04,BUDESONIDE 0.25 MG/2 ML INHL NBSP,103.0,72.1,,,0
NDC,0187-0063-01,LORAZEPAM 0.5 MG ORAL TAB,297.5,208.25,,,0
NDC,0187-0993-95,ACYCLOVIR 5 % TOP OINT,648.0,453.6,,,0
NDC,0187-3013-30,PYRIDOSTIGMINE BROMIDE 180 MG ORAL TBSR,241.0,168.7,,,0
NDC,0187-4302-02,NITROPRUSSIDE 25 MG/ML IV SOLN,1062.0,743.4,,,0
NDC,0206-8852-08,PIPERACILLIN-TAZOBACTAM NEO/PEDS INFUSION (CDS MIXTURE),63.0,44.1,,,0
NDC,0223-1760-01,SODIUM CHLORIDE 1000 MG MISC TBSO,5.5,3.85,,,0
NDC,0225-0800-47,LIDOCAINE-PHENYLEPHRINE 4%-0.25% NASAL SPRAY,38.0,26.6,,,0
NDC,0225-0805-47,PHENYLEPHRINE HCL  0.5 % NASL SPRY,23.0,16.1,,,0
NDC,0225-0810-47,PHENYLEPHRINE 1 % NASAL SPRAY AEROSOL,25.5,17.85,,,0
NDC,0228-2029-10,ALPRAZOLAM 0.5 MG ORAL TAB,11.0,7.7,,,0
NDC,0228-2067-10,OXAZEPAM 10 MG ORAL CAP,7.0,4.9,,,0
NDC,0228-2076-10,TEMAZEPAM 15 MG ORAL CAP,8.0,5.6,,,0
NDC,0228-2127-10,CLONIDINE 0.1 MG ORAL TAB,5.5,3.85,,,0
NDC,0228-2129-10,CLONIDINE 0.3 MG ORAL TAB,7.0,4.9,,,0
NDC,0228-2550-11,"DICLOFENAC 50 MG TAB, DELAYED RELEASE",7.0,4.9,,,0
NDC,0228-2551-06,"DICLOFENAC 75 MG TAB, DELAYED RELEASE",7.0,4.9,,,0
NDC,0228-2571-11,INDAPAMIDE 2.5 MG ORAL TAB,7.0,4.9,,,0
NDC,0228-2620-11,ISOSORBIDE MONONITRATE  20 MG ORAL TAB,7.0,4.9,,,0
NDC,0228-2890-06,DULOXETINE 20 MG ORAL CPDR,69.0,48.3,,,0
NDC,0228-3003-11,CLONAZEPAM 0.5 MG ORAL TAB,8.0,5.6,,,0
NDC,0228-3004-11,CLONAZEPAM 1 MG ORAL TAB,7.0,4.9,,,0
NDC,0228-3062-11,AMPHETAMINE-DEXTROAMPHETAMINE  5 MG ORAL CP24,86.5,60.55,,,0
NDC,0228-3153-03,BUPRENORPHINE 8 MG SL SUBL,47.0,32.9,,,0
NDC,0234-0575-04,CHLORHEXIDINE GLUCONATE  4 % TOP LIQD,21.0,14.7,,,0
NDC,0245-0036-89,CHOLESTYRAMINE 4 G ORAL PWPK,29.0,20.3,,,0
NDC,0245-0144-89,AMIODARONE 100 MG ORAL TAB,57.5,40.25,,,0
NDC,0245-0147-01,AMIODARONE 200 MG ORAL TAB,45.0,31.5,,,0
NDC,0245-0147-89,AMIODARONE 200 MG ORAL TAB,78.0,54.6,,,0
NDC,0245-0212-11,MIDODRINE  5 MG ORAL TAB,35.5,24.85,,,0
NDC,0245-0212-89,MIDODRINE  5 MG ORAL TAB,50.0,35.0,,,0
NDC,0245-0360-89,POTASSIUM CHLORIDE  20 MEQ ORAL PACK,89.5,62.65,,,0
NDC,0245-0860-70,METRONIDAZOLE 0.75 % VAGL GEL,587.0,410.9,,,0
NDC,0245-5316-89,POTASSIUM CHLORIDE  10 MEQ ORAL TBSR,8.0,5.6,,,0
NDC,0245-5317-01,POTASSIUM CHLORIDE  10 MEQ ORAL TBTQ,14.0,9.8,,,0
NDC,0245-5317-89,POTASSIUM CHLORIDE  10 MEQ ORAL TBTQ,7.0,4.9,,,0
NDC,0245-5317-90,POTASSIUM CHLORIDE  10 MEQ ORAL TBTQ,7.0,4.9,,,0
NDC,0245-5326-89,POTASSIUM BICARBONATE-CITRIC ACID 25 MEQ EFFERVESCENT TAB,18.0,12.6,,,0
NDC,0254-1010-19,DIAZOXIDE (DIABETIC USE) 50 MG/ML ORAL SUSP,76.0,53.2,,,0
NDC,0254-3028-02,LUBIPROSTONE  8 MCG ORAL CAP,66.0,46.2,,,0
NDC,0254-3029-02,LUBIPROSTONE 24 MCG ORAL CAP,38.0,26.6,,,0
NDC,0264-1510-31,DEXTROSE 5% IN WATER (D5W) IV,30.0,21.0,,,0
NDC,0264-1510-32,DEXTROSE 5% IN WATER (D5W) IV,17.0,11.9,,,0
NDC,0264-1800-31,SODIUM CHLORIDE 0.9 % IV SOLP,487.0,340.9,,,0
NDC,0264-1800-32,SODIUM CHLORIDE 0.9 % IV SOLP,19.0,13.3,,,0
NDC,0264-1800-36,SODIUM CHLORIDE 0.9 % IV SOLP,76.0,53.2,,,0
NDC,0264-1933-10,DAY 1 NEO SOLUTION (D12.5W/AA 2%/HEPARIN 0.5 UNITS/ML),172.5,120.75,,,0
NDC,0264-2101-10,"WATER FOR IRRIGATION, STERILE SOLUTION",16.0,11.2,,,0
NDC,0264-2201-00,SODIUM CHLORIDE 0.9 % IR SOLN,42.0,29.400000000000002,,,0
NDC,0264-2201-10,SODIUM CHLORIDE 0.9 % IR SOLN,16.0,11.2,,,0
NDC,0264-2304-00,ACETIC ACID 0.25 % IR SOLN,56.0,39.2,,,0
NDC,0264-3103-11,CEFAZOLIN IN DEXTROSE (ISO-OSMOTIC) 1 GRAM/50 ML IV PIGGY BACK,3622.0,2535.4,,,0
NDC,0264-3105-11,CEFAZOLIN IN DEXTROSE (ISO-OS) 2 GRAM/50 ML IV PGBK,87.0,60.9,,,0
NDC,0264-3153-11,CEFTRIAXONE IN DEXTROSE (ISO-OSMOTIC) 1 GRAM/50 ML IV PIGGY BACK,116.0,81.2,,,0
NDC,0264-4100-90,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN FOR PERI-OPERATIVE",29.5,20.65,,,0
NDC,0264-4204-52,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IV PGBK,24.5,17.15,,,0
NDC,0264-4206-54,MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IV PGBK,24.0,16.8,,,0
NDC,0264-4400-54,MAGNESIUM SULFATE IN D5W 1 GRAM/100 ML IV PGBK,40.0,28.0,,,0
NDC,0264-5009-90,LEVETIRACETAM IN NACL (ISO-OS) 500 MG/100 ML IV PGBK,91.0,63.7,,,0
NDC,0264-5535-32,METRONIDAZOLE IN SODIUM CHLORIDE (ISO-OSM) 500 MG/100 ML IV PIGGY BACK,22.0,15.4,,,0
NDC,0264-5802-00,SODIUM CHLORIDE 0.9 % IV (BOLUS),17.0,11.9,,,0
NDC,0264-5802-10,SODIUM CHLORIDE 0.9 % IV SOLP,15.0,10.5,,,0
NDC,0264-5804-00,SODIUM CHLORIDE 0.45% (1/2 NS) INFUSION (PEDS ONC),24.0,16.8,,,0
NDC,0264-7389-60,LACTATED RINGERS IRRIGATION SOLN,200.0,140.0,,,0
NDC,0264-7510-00,DEXTROSE 5% IN WATER (NEO) <2 KG,28.0,19.6,,,0
NDC,0264-7510-10,DEXTROSE 5% IN WATER (D5W) IV,28.0,19.6,,,0
NDC,0264-7510-20,DEXTROSE 5% IN WATER FLUSH,25.0,17.5,,,0
NDC,0264-7520-00,DEXTROSE 10% IN WATER (D10) IV SOLN,39.0,27.3,,,0
NDC,0264-7520-10,DEXTROSE 10% IN WATER (NEO) 2 - 3.99 KG,20.0,14.0,,,0
NDC,0264-7610-00,DEXTROSE 5% IN NORMAL SALINE IV,28.0,19.6,,,0
NDC,0264-7612-00,DEXTROSE 5%-1/2 NORMAL SALINE IV,23.0,16.1,,,0
NDC,0264-7616-10,DEXTROSE 5%-1/4 NORMAL SALINE IV,19.5,13.649999999999999,,,0
NDC,0264-7622-00,DEXTROSE 10%-1/2 NORMAL SALINE IV,55.0,38.5,,,0
NDC,0264-7625-00,D5W WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,17.0,11.9,,,0
NDC,0264-7635-00,D5-1/2 NS AND POTASSIUM CHLORIDE 20 MEQ/L IV (PEDS CHEMO),34.0,23.8,,,0
NDC,0264-7652-00,D5-0.9%NACL-POTASSIUM CHLORIDE 20 MEQ/L IV SOLP (PED ONC),23.0,16.1,,,0
NDC,0264-7750-00,LACTATED RINGERS IV (BOLUS),40.0,28.0,,,0
NDC,0264-7750-07,LACTATED RINGERS IV (BOLUS),40.0,28.0,,,0
NDC,0264-7750-10,LACTATED RINGERS IV (BOLUS),21.5,15.05,,,0
NDC,0264-7751-00,DEXTROSE 5%-LACTATED RINGERS IV,19.5,13.65,,,0
NDC,0264-7800-00,SODIUM CHLORIDE 0.9 % IV SOLP,137.0,95.9,,,0
NDC,0264-7800-09,SODIUM CHLORIDE 0.9% IV (PEDS) BOLUS,21.0,14.7,,,0
NDC,0264-7800-10,SODIUM CHLORIDE 0.9 % IV SOLP,35.5,24.85,,,0
NDC,0264-7800-20,SODIUM CHLORIDE 0.9 % IV SOLP,29.5,20.65,,,0
NDC,0264-7802-00,SODIUM CHLORIDE 0.45 % 0.45 % IV SOLP,27.0,18.9,,,0
NDC,0264-7805-10,SODIUM CHLORIDE 3% IV BOLUS (ED ONLY),39.0,27.3,,,0
NDC,0264-7865-00,NS WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,36.5,25.55,,,0
NDC,0264-9341-55,DAY 1 NEO SOLUTION (D5W/AA 2%/HEPARIN 0.5 UNITS/ML),84.0,58.8,,,0
NDC,0264-9376-88,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,16.0,11.2,,,0
NDC,0264-9567-10,HEPARIN (PORCINE) IN D5W 20000 UNIT/500 ML,19.0,13.3,,,0
NDC,0264-9587-20,HEPARIN (PORCINE) IN D5W 25000 UNIT/250 ML (PTT MONITORING),92.0,64.4,,,0
NDC,0264-9872-10,HEPARIN (PORCINE) IN NACL (PF) 1000 UNIT/500 ML IV SOLP,61.5,43.050000000000004,,,0
NDC,0270-0083-20,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,237.0,165.9,,,0
NDC,0270-0149-57,DIATRIZOATE MEGLUMINE 30 % URTH SOLN,214.5,150.15,,,0
NDC,0270-0149-60,DIATRIZOATE MEGLUMINE 30 % URTH SOLN,272.0,190.4,,,0
NDC,0270-0556-15,SINCALIDE 5 MCG INJ SOLR,564.0,394.8,,,0
NDC,0270-1111-01,GADOTERIDOL 279.3 MG/ML IV SOLN,253.5,177.45,,,0
NDC,0270-1111-02,GADOTERIDOL 279.3 MG/ML IV SOLN,384.0,268.8,,,0
NDC,0270-1111-03,GADOTERIDOL 279.3 MG/ML IV SOLN,249.5,174.65,,,0
NDC,0270-1111-04,GADOTERIDOL 279.3 MG/ML IV SOLN,46.5,32.55,,,0
NDC,0270-1314-15,IOPAMIDOL 41 % (410 MG/ML) IV SOLN,117.0,81.9,,,0
NDC,0270-1314-30,IOPAMIDOL 41 % INJ SOLN,25.5,17.85,,,0
NDC,0270-1315-25,IOPAMIDOL 61 % IV SOLN,49.0,34.3,,,0
NDC,0270-1315-30,IOPAMIDOL 61 % IV SOLN,26.0,18.2,,,0
NDC,0270-1315-35,IOPAMIDOL 61 % IV SOLN,113.0,79.1,,,0
NDC,0270-1315-41,IOPAMIDOL 61 % IV SOLN,699.0,489.3,,,0
NDC,0270-1315-45,IOPAMIDOL 61 % IV SOLN,279.0,195.3,,,0
NDC,0270-1315-47,IOPAMIDOL 61 % IV SOLN,446.0,312.2,,,0
NDC,0270-1315-50,IOPAMIDOL 61 % IV SOLN,392.0,274.4,,,0
NDC,0270-1315-95,IOPAMIDOL 61 % IV SOLN,286.0,200.2,,,0
NDC,0270-1315-98,IOPAMIDOL 61 % IV SOLN,843.0,590.1,,,0
NDC,0270-1316-01,IOPAMIDOL 76 % IV SOLN,56.0,39.2,,,0
NDC,0270-1316-04,IOPAMIDOL 76 % IV SOLN,347.5,243.25,,,0
NDC,0270-1316-35,IOPAMIDOL 76 % IV SOLN,252.5,176.75,,,0
NDC,0270-1316-37,IOPAMIDOL 76 % IV SOLN,379.0,265.3,,,0
NDC,0270-1316-41,IOPAMIDOL 76 % IV SOLN,477.0,333.9,,,0
NDC,0270-1316-52,IOPAMIDOL 76 % IV SOLN,231.0,161.7,,,0
NDC,0270-1316-95,IOPAMIDOL 76 % IV SOLN,254.0,177.8,,,0
NDC,0270-1316-98,IOPAMIDOL 76 % IV SOLN,230.0,161.0,,,0
NDC,0270-1317-02,IOPAMIDOL 51 % IV SOLN,133.0,93.1,,,0
NDC,0270-1317-05,IOPAMIDOL 51 % IV SOLN,31.5,22.05,,,0
NDC,0270-1317-09,IOPAMIDOL 51 % IV SOLN,647.5,453.25,,,0
NDC,0270-1317-41,IOPAMIDOL 51 % IV SOLN,553.0,387.1,,,0
NDC,0270-1410-30,DIATRIZOATE MEGLUMINE 18 % URTH SOLN,215.0,150.5,,,0
NDC,0270-1411-11,IOPAMIDOL 41 % IT SOLN,88.5,61.95,,,0
NDC,0270-1411-25,IOPAMIDOL 41 % IT SOLN,386.5,270.55,,,0
NDC,0270-1412-15,IOPAMIDOL 61 % IT SOLN,371.0,259.7,,,0
NDC,0270-5164-12,GADOBENATE DIMEGLUMINE 529 MG/ML (0.1 MMOL/0.2 ML) IV SOLN,123.5,86.44999999999999,,,0
NDC,0270-5164-13,GADOBENATE DIMEGLUMINE 529 MG/ML (0.1 MMOL/0.2 ML) IV SOLN,295.0,206.5,,,0
NDC,0270-5164-14,GADOBENATE DIMEGLUMINE 529 MG/ML (0.1 MMOL/0.2 ML) IV SOLN,325.0,227.5,,,0
NDC,0270-5164-15,GADOBENATE DIMEGLUMINE 529 MG/ML (0.1 MMOL/0.2 ML) IV SOLN,147.5,103.25,,,0
NDC,0270-7020-38,GADOPICLENOL 0.5 MMOL/ML IV SOLN,332.0,232.4,,,0
NDC,0270-7025-40,GADOPICLENOL 0.5 MMOL/ML IV SOLN,402.0,281.4,,,0
NDC,0270-7030-42,GADOPICLENOL 0.5 MMOL/ML IV SOLN,430.0,301.0,,,0
NDC,0281-0326-08,NITROGLYCERIN 2 % TD OINT,25.5,17.85,,,0
NDC,0283-0610-43,BENZOCAINE 20 % MM SPRY,126.0,88.2,,,0
NDC,0299-6220-15,NEMOLIZUMAB-ILTO 30 MG SUBQ PNIJ,9752.0,6826.4,,,0
NDC,0310-0321-30,MEROPENEM 1 GRAM IV SOLR,342.0,239.4,,,0
NDC,0310-0720-10,FULVESTRANT 250 MG/5 ML IM SYRG,5352.0,3746.4,,,0
NDC,0310-0950-36,GOSERELIN  3.6 MG SUBQ IMPL,3039.5,2127.65,,,0
NDC,0310-0951-30,GOSERELIN 10.8 MG SUBQ IMPL,4559.0,3191.3,,,0
NDC,0310-1105-01,SODIUM ZIRCONIUM CYCLOSILICATE  5 G ORAL PWPK (USE PANEL),293.0,205.1,,,0
NDC,0310-1110-01,SODIUM ZIRCONIUM CYCLOSILICATE 10 G ORAL PWPK (USE PANEL),161.0,112.7,,,0
NDC,0310-1730-30,BENRALIZUMAB 30 MG/ML SUBQ SYRG,13116.0,9181.2,,,0
NDC,0310-1830-30,BENRALIZUMAB 30 MG/ML SUBQ ATIN,14769.0,10338.3,,,0
NDC,0310-3040-00,ANIFROLUMAB-FNIA 300 MG/2 ML (150 MG/ML) IV SOLN,12698.0,8888.6,,,0
NDC,0310-4500-12,DURVALUMAB 50 MG/ML IV SOLN,5761.5,4033.05,,,0
NDC,0310-4505-25,TREMELIMUMAB-ACTL 20 MG/ML IV SOLN,26910.0,18837.0,,,0
NDC,0310-4535-30,TREMELIMUMAB-ACTL 20 MG/ML IV SOLN,107640.0,75348.0,,,0
NDC,0310-4611-50,DURVALUMAB 50 MG/ML IV SOLN,19204.0,13442.8,,,0
NDC,0310-6210-30,DAPAGLIFLOZIN PROPANEDIOL 10 MG ORAL TAB,116.0,81.19999999999999,,,0
NDC,0310-6210-39,DAPAGLIFLOZIN PROPANEDIOL 10 MG ORAL TAB,86.5,60.55,,,0
NDC,0310-6512-01,EXENATIDE 5 MCG/0.02 ML SUBQ PNIJ,2346.0,1642.2,,,0
NDC,0310-6524-01,EXENATIDE 10 MCG/0.04 ML SUBQ PNIJ,40.0,28.0,,,0
NDC,0310-7370-20,BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION,29.5,20.65,,,0
NDC,0310-7372-20,BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION,191.0,133.70000000000002,,,0
NDC,0316-0225-15,MICONAZOLE NITRATE 2 % TOP POWD,32.0,22.4,,,0
NDC,0338-0004-02,"WATER FOR IRRIGATION, STERILE SOLUTION",128.0,89.6,,,0
NDC,0338-0004-03,"WATER FOR IRRIGATION, STERILE SOLUTION",16.0,11.2,,,0
NDC,0338-0004-04,"WATER FOR IRRIGATION, STERILE SOLUTION",18.0,12.6,,,0
NDC,0338-0013-04,"WATER FOR INJECTION, STERILE IV",48.0,33.6,,,0
NDC,0338-0017-01,DEXTROSE 5% IN WATER (D5W) IV,24.0,16.8,,,0
NDC,0338-0017-02,DEXTROSE 5% IN WATER (D5W) IV,44.5,31.15,,,0
NDC,0338-0017-03,DEXTROSE 5% IN WATER (D5W) IV,39.5,27.65,,,0
NDC,0338-0017-04,DEXTROSE 5% IN WATER (D5W) IV,36.5,25.55,,,0
NDC,0338-0017-11,DEXTROSE 5% IN WATER (D5W) IV,17.5,12.25,,,0
NDC,0338-0017-31,DEXTROSE 5% IN WATER (D5W) IV,269.0,188.3,,,0
NDC,0338-0017-38,DEXTROSE 5% IN WATER (D5W) IV,32.0,22.4,,,0
NDC,0338-0017-41,DEXTROSE 5% IN WATER (NEO) <2 KG,37.0,25.9,,,0
NDC,0338-0017-48,DEXTROSE 5% IN WATER (D5W) IV,36.0,25.2,,,0
NDC,0338-0023-02,DEXTROSE 10% IN WATER (D10) IV SOLN,42.0,29.4,,,0
NDC,0338-0023-03,DEXTROSE 15% IN WATER,58.5,40.95,,,0
NDC,0338-0023-04,DEXTROSE 10% IN WATER (NEO) 2 - 3.99 KG,75.0,52.5,,,0
NDC,0338-0043-03,SODIUM CHLORIDE 0.45 % 0.45 % IV SOLP,23.5,16.45,,,0
NDC,0338-0043-04,SODIUM CHLORIDE 0.45% (1/2 NS) INFUSION (PEDS ONC),67.0,46.9,,,0
NDC,0338-0047-46,SODIUM CHLORIDE 0.9 % IR SOLN,125.0,87.5,,,0
NDC,0338-0047-47,SODIUM CHLORIDE 0.9 % IR SOLN,147.0,102.9,,,0
NDC,0338-0048-02,SODIUM CHLORIDE 0.9 % IR SOLN,32.0,22.4,,,0
NDC,0338-0048-03,SODIUM CHLORIDE 0.9 % IR SOLN,23.5,16.45,,,0
NDC,0338-0048-04,SODIUM CHLORIDE 0.9 % IR SOLN,28.0,19.6,,,0
NDC,0338-0049-01,SODIUM CHLORIDE 0.9 % IV SOLP,44.0,30.8,,,0
NDC,0338-0049-02,SODIUM CHLORIDE 0.9 % IV SOLP,83.5,58.45,,,0
NDC,0338-0049-03,SODIUM CHLORIDE 0.9 % IV SOLP,97.5,68.25,,,0
NDC,0338-0049-04,SODIUM CHLORIDE 0.9 % IV SOLP,100.0,70.0,,,0
NDC,0338-0049-10,SODIUM CHLORIDE 0.9 % IV (BOLUS),130.0,91.0,,,0
NDC,0338-0049-11,SODIUM CHLORIDE 0.9 % IV SOLP,71.5,50.05,,,0
NDC,0338-0049-18,SODIUM CHLORIDE 0.9 % IV SOLP,54.0,37.8,,,0
NDC,0338-0049-31,SODIUM CHLORIDE 0.9 % IV SOLP,52.0,36.4,,,0
NDC,0338-0049-38,SODIUM CHLORIDE 0.9 % IV SOLP,63.0,44.1,,,0
NDC,0338-0049-41,SODIUM CHLORIDE 0.9 % IV SOLP,109.0,76.3,,,0
NDC,0338-0049-48,SODIUM CHLORIDE 0.9 % IV SOLP,77.0,53.9,,,0
NDC,0338-0054-03,SODIUM CHLORIDE 3 % IV INFUSION,63.0,44.099999999999994,,,0
NDC,0338-0062-30,DEXTROSE 5% IN WATER FLUSH,21.0,14.7,,,0
NDC,0338-0063-01,DOXORUBICIN LIPOSOMAL 2 MG/ML IV INJ,3401.0,2380.7,,,0
NDC,0338-0069-10,KETOROLAC TROMETHAMINE 15 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,0338-0070-10,DEXTROSE 5% IN WATER (D5W) IV,36.5,25.55,,,0
NDC,0338-0072-25,KETOROLAC TROMETHAMINE 30 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,0338-0073-04,DEXTROSE 2.5 %-1/2 NORMAL SALINE IV,30.5,21.35,,,0
NDC,0338-0077-03,DEXTROSE 5%-1/4 NORMAL SALINE IV,34.0,23.8,,,0
NDC,0338-0077-04,DEXTROSE 5%-1/4 NORMAL SALINE IV,39.0,27.3,,,0
NDC,0338-0085-03,DEXTROSE 5%-1/2 NORMAL SALINE IV,46.0,32.2,,,0
NDC,0338-0085-04,DEXTROSE 5%-1/2 NORMAL SALINE IV (PEDS ONCOLOGY),39.0,27.3,,,0
NDC,0338-0089-03,DEXTROSE 5% IN NORMAL SALINE IV,31.0,21.7,,,0
NDC,0338-0089-04,DEXTROSE 5% IN NORMAL SALINE IV,53.0,37.1,,,0
NDC,0338-0096-06,CEFAZOLIN IN DEXTROSE (ISO-OS) 3 GRAM/150 ML IV PGBK,35.0,24.5,,,0
NDC,0338-0112-20,NOREPINEPHRINE BITARTRATE-D5W 4 MG/250 ML (16 MCG/ML) IV SOLN,467.0,326.9,,,0
NDC,0338-0116-20,NOREPINEPHRINE BITARTRATE-D5W 16 MG/250 ML (64 MCG/ML) IV SOLN (CENTRAL ONLY),340.0,238.0,,,0
NDC,0338-0117-02,LACTATED RINGERS IV (BOLUS),31.0,21.7,,,0
NDC,0338-0117-03,LACTATED RINGERS IV,198.5,138.95,,,0
NDC,0338-0117-04,LACTATED RINGERS IV,200.0,140.0,,,0
NDC,0338-0125-03,DEXTROSE 5%-LACTATED RINGERS IV,24.0,16.8,,,0
NDC,0338-0125-04,DEXTROSE 5%-LACTATED RINGERS IV,58.5,40.95,,,0
NDC,0338-0126-12,INSULIN REGULAR IN 0.9% NACL 100 UNIT/100 ML (1 UNIT/ML) INFUSION FOR OB,308.5,215.95,,,0
NDC,0338-0137-27,LACTATED RINGERS IRRIGATION SOLN,74.0,51.8,,,0
NDC,0338-0221-03,ELECTROLYTE-A IV,291.5,204.05,,,0
NDC,0338-0221-04,ELECTROLYTE-A IV,196.0,137.2,,,0
NDC,0338-0322-01,THROMBIN (RECOMBINANT) 5000 UNIT TOP SOLR,260.5,182.35,,,0
NDC,0338-0324-01,THROMBIN (RECOMBINANT) 5000 UNIT TOP SOLR,1672.5,1170.75,,,0
NDC,0338-0326-01,THROMBIN (RECOMBINANT) 20000 UNIT TOP SOLR,4872.0,3410.4,,,0
NDC,0338-0328-01,THROMBIN (RECOMBINANT) 20000 UNIT TOP SOLR,4872.0,3410.4,,,0
NDC,0338-0357-02,MANNITOL 20% IV SOLP,255.0,178.5,,,0
NDC,0338-0357-03,MANNITOL 20% IV SOLP,321.0,224.7,,,0
NDC,0338-0409-03,LIDOCAINE IN D5W (PF) 4 MG/ML (0.4 %) IV SOLP,45.0,31.5,,,0
NDC,0338-0503-48,GENTAMICIN IN SALINE (ISO-OSMOTIC) 80 MG/100 ML IV PIGGY BACK,120.0,84.0,,,0
NDC,0338-0511-41,GENTAMICIN IN SALINE (ISO-OSMOTIC) 100 MG/50 ML IV PIGGY BACK,86.0,60.199999999999996,,,0
NDC,0338-0519-02,FAT EMULSION 20 % IV BOLUS (FOR OVERDOSE),406.0,284.2,,,0
NDC,0338-0519-09,FAT EMULSION 20 % IV EMUL,240.0,168.0,,,0
NDC,0338-0551-11,DEXTROSE 5% IN WATER (D5W) IV MBP,45.0,31.5,,,0
NDC,0338-0551-18,DEXTROSE 5% IN WATER (D5W) IV MBP,155.5,108.85,,,0
NDC,0338-0553-11,SODIUM CHLORIDE 0.9 % MBP,67.0,46.9,,,0
NDC,0338-0553-18,SODIUM CHLORIDE 0.9 % MBP,253.5,177.45,,,0
NDC,0338-0656-04,ACETIC ACID 0.25 % IR SOLN,55.0,38.5,,,0
NDC,0338-0663-04,D5-1/4 NS & POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,54.0,37.8,,,0
NDC,0338-0669-04,D5-1/2 NS AND POTASSIUM CHLORIDE 10 MEQ/L IV,59.0,41.3,,,0
NDC,0338-0671-04,D5-1/2 NS AND POTASSIUM CHLORIDE 20 MEQ/L IV (PEDS CHEMO),39.0,27.3,,,0
NDC,0338-0673-04,D5-1/2 NS AND POTASSIUM CHLORIDE 30 MEQ/L IV,54.0,37.8,,,0
NDC,0338-0675-04,D5-1/2 NS AND POTASSIUM CHLORIDE 40 MEQ/L IV,59.0,41.3,,,0
NDC,0338-0683-04,D5W WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,59.0,41.3,,,0
NDC,0338-0691-04,NS WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,64.0,44.8,,,0
NDC,0338-0695-04,NS WITH POTASSIUM CHLORIDE 40 MEQ/L IV SOLP,66.5,46.55,,,0
NDC,0338-0704-34,0.45 % NACL-POTASSIUM CHLORIDE 20 MEQ/L IV SOLP (PEDS ONC),50.0,35.0,,,0
NDC,0338-0705-48,POTASSIUM CHLORIDE 20 MEQ/100 ML IV PGBK,41.5,29.05,,,0
NDC,0338-0709-48,POTASSIUM CHLORIDE 10 MEQ/100 ML IV PGBK (USE NON-PROTOCOL PANEL),66.0,46.2,,,0
NDC,0338-0712-24,DAPTOMYCIN IN 0.9 % SOD CHLOR 350 MG/50 ML IV PGBK,269.0,188.3,,,0
NDC,0338-0714-24,DAPTOMYCIN IN 0.9 % SOD CHLOR 500 MG/50 ML IV PGBK,238.5,166.95,,,0
NDC,0338-0719-06,DEXTROSE 70% IN WATER (D70W) IV,16.0,11.2,,,0
NDC,0338-0803-04,D5-0.9%NACL-POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,61.5,43.05,,,0
NDC,0338-0807-04,D5-NS WITH POTASSIUM CHLORIDE 40 MEQ/L IV SOLP,56.5,39.55,,,0
NDC,0338-0811-04,D5-LR WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,64.0,44.8,,,0
NDC,0338-1007-02,DOPAMINE INFUSION NEO IV SYRINGE (FROM PREMIX),50.0,35.0,,,0
NDC,0338-1049-02,NITROGLYCERIN 2 MG/10 ML (200 MCG/ML) IN D5W VIAL-CVL/IR USE (REPACK),19.0,13.3,,,0
NDC,0338-1055-48,METRONIDAZOLE IN SODIUM CHLORIDE (ISO-OSM) 500 MG/100 ML IV PIGGY BACK,21.0,14.7,,,0
NDC,0338-1075-02,DOBUTAMINE IN D5W 500 MG/250 ML (2 MG/ML) INFUSION (PREMIX),164.0,114.8,,,0
NDC,0338-1077-02,"DOBUTAMINE IN D5W 1,000 MG/250 ML (4,000 MCG/ML) IV SOLP",172.0,120.4,,,0
NDC,0338-1305-01,MESNA 100 MG/ML IV SOLN,169.0,118.3,,,0
NDC,0338-1708-40,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IV PGBK,74.0,51.8,,,0
NDC,0338-1709-40,MAGNESIUM SULFATE IN D5W 1 GRAM/100 ML IV PGBK,107.0,74.9,,,0
NDC,0338-1715-40,MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IV PGBK,18.0,12.6,,,0
NDC,0338-3410-50,CLINDAMYCIN IN D5W 300 MG/50 ML IV PGBK,71.5,50.05,,,0
NDC,0338-3503-41,CEFAZOLIN IN DEXTROSE (ISO-OSMOTIC) 1 GRAM/50 ML IV PIGGY BACK,30.0,21.0,,,0
NDC,0338-3508-41,CEFAZOLIN IN DEXTROSE (ISO-OS) 2 GRAM/100 ML IV PGBK,55.0,38.5,,,0
NDC,0338-3551-48,VANCOMYCIN IN DEXTROSE 500 MG/100 ML IV PGBK,44.0,30.8,,,0
NDC,0338-3552-48,VANCOMYCIN IN D5W 1 GRAM/200 ML IV PGBK,472.5,330.75,,,0
NDC,0338-3582-01,VANCOMYCIN NEO IV SYRINGE (CDS MIXTURE),36.0,25.2,,,0
NDC,0338-3612-24,CLINDAMYCIN PEDS IV INFUSION 12 MG/ML (CDS MIXTURE FROM PREMIX),53.0,37.1,,,0
NDC,0338-3612-50,CLINDAMYCIN IN D5W 600 MG/50 ML IV PGBK,94.0,65.8,,,0
NDC,0338-3616-50,CLINDAMYCIN IN D5W 600 MG/50 ML IV PGBK,47.5,33.25,,,0
NDC,0338-3814-50,CLINDAMYCIN IN D5W 900 MG/50 ML IV PGBK,77.0,53.9,,,0
NDC,0338-6010-48,MILRINONE INFUSION PED/NEO IV SYRINGE (CDS MIXTURE),198.0,138.6,,,0
NDC,0338-6045-37,FLUCONAZOLE PEDS SYRINGE (CDS MIXTURE),184.0,128.8,,,0
NDC,0338-6304-02,SODIUM CHLORIDE 0.9 % IV (BOLUS),25.0,17.5,,,0
NDC,0338-6307-03,LACTATED RINGERS IV (BOLUS),74.0,51.8,,,0
NDC,0338-9159-30,SODIUM CHLORIDE 0.9 % MBP,48.0,33.6,,,0
NDC,0338-9541-24,METRONIDAZOLE IN SODIUM CHLORIDE (ISO-OSM) 500 MG/100 ML IV PIGGY BACK,16.0,11.2,,,0
NDC,0338-9542-01,SODIUM CHLORIDE 0.9 % IV SOLP,25.0,17.5,,,0
NDC,0338-9543-02,SODIUM CHLORIDE 0.9 % IV SOLP,24.5,17.15,,,0
NDC,0338-9543-03,SODIUM CHLORIDE 0.9 % IV SOLP,31.0,21.7,,,0
NDC,0338-9557-12,DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN,165.0,115.5,,,0
NDC,0338-9616-30,SODIUM CHLORIDE 0.9 % MBP,34.0,23.8,,,0
NDC,0338-9636-01,PIPERACILLIN-TAZOBACTAM-DEXTROSE (ISO) 3.375 GRAM/50 ML IV PIGGY BACK,89.0,62.3,,,0
NDC,0338-9638-01,PIPERACILLIN-TAZOBACTAM-DEXTRS 4.5 GRAM/100 ML IV PGBK,111.0,77.7,,,0
NDC,0338-9647-12,VASOPRESSIN IN 0.9 % NS 40 UNIT/100 ML (0.4 UNIT/ML) IV SOLN,324.0,226.8,,,0
NDC,0338-9662-35,SODIUM CHLORIDE 0.9 % MBP,48.0,33.6,,,0
NDC,0338-9791-01,SODIUM CHLORIDE 0.9 % IV SOLP,25.5,17.85,,,0
NDC,0338-9799-01,DEXTROSE 5% IN NORMAL SALINE IV,39.0,27.3,,,0
NDC,0338-9806-01,SODIUM CHLORIDE 0.9 % IV SOLP,117.0,81.9,,,0
NDC,0363-0006-11,MINERAL OIL ENEMA,20.0,14.0,,,0
NDC,0363-0700-08,BENZOCAINE-MENTHOL 6-10 MG MM LOZG,5.0,3.5,,,0
NDC,0374-5080-01,CHLORHEXIDINE GLUCONATE  0.12 % MM MWSH,7.0,4.9,,,0
NDC,0378-0018-01,METOPROLOL TARTRATE 25 MG TAB,7.0,4.9,,,0
NDC,0378-0032-01,METOPROLOL TARTRATE 50 MG TAB,4.0,2.8,,,0
NDC,0378-0085-01,CARBIDOPA-LEVODOPA 25 MG-100 MG TAB,8.0,5.6,,,0
NDC,0378-0135-05,DILTIAZEM 90 MG TAB,12.0,8.4,,,0
NDC,0378-0144-91,TAMOXIFEN 10 MG ORAL TAB,16.0,11.2,,,0
NDC,0378-0156-01,PROBENECID 500 MG ORAL TAB,7.0,4.9,,,0
NDC,0378-0183-01,PROPRANOLOL  20 MG ORAL TAB,7.0,4.9,,,0
NDC,0378-0257-01,HALOPERIDOL  1 MG ORAL TAB,7.0,4.9,,,0
NDC,0378-0334-01,HALOPERIDOL 10 MG ORAL TAB,129.0,90.3,,,0
NDC,0378-0642-01,PREDNISONE 20 MG ORAL TAB,7.0,4.9,,,0
NDC,0378-0860-01,CLOZAPINE 100 MG ORAL TAB,34.0,23.8,,,0
NDC,0378-0871-16,CLONIDINE 0.1 MG/24 HR TD PTWK,221.5,155.05,,,0
NDC,0378-0871-99,CLONIDINE 0.1 MG/24 HR TD PTWK,162.0,113.4,,,0
NDC,0378-0872-16,CLONIDINE 0.2 MG/24 HR TD PTWK,237.0,165.9,,,0
NDC,0378-0873-16,CLONIDINE 0.3 MG/24 HR TD PTWK,329.0,230.3,,,0
NDC,0378-1101-01,PRAZOSIN 1 MG ORAL CAP,8.5,5.95,,,0
NDC,0378-1132-01,NADOLOL  80 MG ORAL TAB,30.0,21.0,,,0
NDC,0378-1133-01,CARBIDOPA-LEVODOPA 25 MG-250 MG TAB,7.0,4.9,,,0
NDC,0378-1811-77,LEVOTHYROXINE 112 MCG ORAL TAB,7.0,4.9,,,0
NDC,0378-2100-01,LOPERAMIDE 2 MG ORAL CAP,12.0,8.4,,,0
NDC,0378-3352-16,ESTRADIOL 0.1 MG/24 HR TD PTWK,114.0,79.8,,,0
NDC,0378-3547-52,MERCAPTOPURINE 50 MG ORAL TAB,34.0,23.8,,,0
NDC,0378-3635-01,CETIRIZINE  5 MG ORAL TAB,28.0,19.6,,,0
NDC,0378-4151-01,TRAMADOL  50 MG ORAL TAB,8.5,5.95,,,0
NDC,0378-4543-01,AMPHETAMINE-DEXTROAMPHETAMINE 10 MG ORAL TAB,12.0,8.4,,,0
NDC,0378-4644-16,ESTRADIOL 0.025 MG/24 HR TD PTSW,56.0,39.2,,,0
NDC,0378-5305-01,ZOLPIDEM  5 MG ORAL TAB,26.0,18.2,,,0
NDC,0378-5807-93,VALSARTAN  40 MG ORAL TAB,12.0,8.4,,,0
NDC,0378-6060-01,DILTIAZEM SR 60 MG 12 HR CAP,18.0,12.6,,,0
NDC,0378-6120-01,DILTIAZEM SR 120 MG 12 HR CAP,53.0,37.1,,,0
NDC,0378-6333-80,ACAMPROSATE 333 MG ORAL TBEC,12.0,8.399999999999999,,,0
NDC,0378-6470-16,SCOPOLAMINE TRANSDERMAL PATCH 1MG OVER 3 DAYS,99.0,69.3,,,0
NDC,0378-6985-01,SODIUM CHLORIDE 0.9 % INHL NEBU,7.0,4.9,,,0
NDC,0378-6987-89,SODIUM CHLORIDE 0.9 % INHL NEBU,7.0,4.9,,,0
NDC,0378-6998-89,SODIUM CHLORIDE 10 % INHL NEBU,48.0,33.6,,,0
NDC,0378-7401-78,MESALAMINE 1.2 G ORAL TBEC,50.0,35.0,,,0
NDC,0378-7732-93,ONDANSETRON 4 MG ORAL TBDL,284.0,198.8,,,0
NDC,0378-7970-62,IPRATROPIUM BROMIDE 0.02 % INHL SOLN,11.0,7.7,,,0
NDC,0378-8270-31,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) NEB SOLUTION,8.0,5.6,,,0
NDC,0378-8270-93,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) NEB SOLUTION,8.0,5.6,,,0
NDC,0378-9070-16,RIVASTIGMINE 4.6 MG/24 HOUR TD PT24,83.0,58.1,,,0
NDC,0378-9071-16,RIVASTIGMINE 9.5 MG/24 HOUR TD PT24,83.0,58.1,,,0
NDC,0378-9102-16,NITROGLYCERIN 0.1 MG/HR TD PT24,11.0,7.7,,,0
NDC,0378-9104-16,NITROGLYCERIN 0.2 MG/HR TD PT24,11.0,7.7,,,0
NDC,0378-9112-16,NITROGLYCERIN 0.4 MG/HR TD PT24,19.0,13.3,,,0
NDC,0378-9112-93,NITROGLYCERIN 0.4 MG/HR TD PT24,25.0,17.5,,,0
NDC,0378-9116-16,NITROGLYCERIN 0.6 MG/HR TD PT24,14.0,9.8,,,0
NDC,0378-9119-16,FENTANYL  12 MCG/HR TD PT72,100.0,70.0,,,0
NDC,0378-9121-16,FENTANYL  25 MCG/HR TD PT72,71.0,49.7,,,0
NDC,0378-9121-98,FENTANYL  25 MCG/HR TD PT72,71.0,49.7,,,0
NDC,0378-9122-16,FENTANYL  50 MCG/HR TD PT72,129.0,90.3,,,0
NDC,0378-9123-16,FENTANYL  75 MCG/HR TD PT72,197.0,137.9,,,0
NDC,0378-9124-16,FENTANYL 100 MCG/HR TD PT72,306.0,214.2,,,0
NDC,0378-9321-32,FLUTICASONE-SALMETEROL 250 MCG-50 MCG/DOSE DISK DEVICE FOR INHALATION,1325.0,927.5,,,0
NDC,0378-9322-32,FLUTICASONE-SALMETEROL 500 MCG-50 MCG/DOSE DISK DEVICE FOR INHALATION,1359.0,951.3,,,0
NDC,0378-9671-31,IPRATROPIUM-ALBUTEROL 0.5 MG-2.5 MG/3 ML NEB SOLUTION,13.0,9.1,,,0
NDC,0378-9671-93,IPRATROPIUM-ALBUTEROL 0.5 MG-2.5 MG/3 ML NEB SOLUTION,13.0,9.1,,,0
NDC,0395-1003-92,GENTIAN VIOLET 1 % TOP SOLN,47.0,32.9,,,0
NDC,0395-1031-96,GLYCERIN 99.5 % TOP SOLN,24.5,17.15,,,0
NDC,0404-6512-05,"LIDOCAINE-EPINEPHRINE BIT 2 %-1:100,000 INJ CRTG",8.0,5.6,,,0
NDC,0406-0123-01,HYDROCODONE-ACETAMINOPHEN 5 MG-325 MG TAB,10.0,7.0,,,0
NDC,0406-0123-23,HYDROCODONE-ACETAMINOPHEN 5 MG-325 MG TAB,13.5,9.45,,,0
NDC,0406-0124-23,HYDROCODONE-ACETAMINOPHEN 7.5 MG-325 MG TAB,12.0,8.4,,,0
NDC,0406-0125-23,HYDROCODONE-ACETAMINOPHEN 10 MG-325 MG TAB,11.0,7.7,,,0
NDC,0406-0127-01,METHYLPHENIDATE 27 MG ORAL TO24,49.5,34.65,,,0
NDC,0406-0366-23,HYDROCODONE-ACETAMINOPHEN 7.5 MG-325 MG TAB,7.0,4.9,,,0
NDC,0406-0367-23,HYDROCODONE-ACETAMINOPHEN 10 MG-325 MG TAB,10.0,7.0,,,0
NDC,0406-0512-23,OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TAB,16.0,11.2,,,0
NDC,0406-0552-01,OXYCODONE 5 MG ORAL TAB,8.0,5.6,,,0
NDC,0406-0552-23,OXYCODONE 5 MG ORAL TAB,14.0,9.8,,,0
NDC,0406-1142-01,METHYLPHENIDATE  5 MG ORAL TAB,13.0,9.1,,,0
NDC,0406-1170-03,NALTREXONE 50 MG ORAL TAB,24.0,16.8,,,0
NDC,0406-1236-01,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TAB,7.5,5.25,,,0
NDC,0406-1473-01,METHYLPHENIDATE 20 MG ORAL TBSR,43.0,30.1,,,0
NDC,0406-3243-01,HYDROMORPHONE  2 MG ORAL TAB,10.0,7.0,,,0
NDC,0406-3244-01,HYDROMORPHONE  4 MG ORAL TAB,7.5,5.25,,,0
NDC,0406-3249-01,HYDROMORPHONE  8 MG ORAL TAB,7.0,4.9,,,0
NDC,0406-5755-23,METHADONE  5 MG ORAL TAB,16.5,11.55,,,0
NDC,0406-5771-23,METHADONE 10 MG ORAL TAB,31.5,22.049999999999997,,,0
NDC,0406-5771-62,METHADONE 10 MG ORAL TAB,8.0,5.6,,,0
NDC,0406-8003-30,MORPHINE CONCENTRATE 10 MG/ 0.5 ML ORAL SYRINGE (0.5ML UD MERGE),7.0,4.9,,,0
NDC,0406-8315-01,MORPHINE  15 MG ORAL TBSR,19.0,13.3,,,0
NDC,0406-8315-23,MORPHINE  15 MG ORAL TBSR,27.5,19.25,,,0
NDC,0406-8330-23,MORPHINE  30 MG ORAL TBSR,39.5,27.65,,,0
NDC,0406-8330-62,MORPHINE  30 MG ORAL TBSR,29.5,20.65,,,0
NDC,0406-8380-23,MORPHINE  60 MG ORAL TBSR,37.5,26.25,,,0
NDC,0406-8380-62,MORPHINE  60 MG ORAL TBSR,30.0,21.0,,,0
NDC,0406-8390-62,MORPHINE 100 MG ORAL TBSR,51.0,35.7,,,0
NDC,0406-8515-23,OXYCODONE  15 MG ORAL TAB,19.0,13.3,,,0
NDC,0406-9050-76,FENTANYL  50 MCG/HR TD PT72,129.0,90.3,,,0
NDC,0406-9112-76,FENTANYL  12 MCG/HR TD PT72,100.0,70.0,,,0
NDC,0406-9175-76,FENTANYL  75 MCG/HR TD PT72,197.0,137.9,,,0
NDC,0406-9960-01,TEMAZEPAM  7.5 MG ORAL CAP,77.0,53.9,,,0
NDC,0406-9961-01,TEMAZEPAM 15 MG ORAL CAP,8.0,5.6,,,0
NDC,0407-1411-10,IOHEXOL 180 MG/ML IT SOLN,267.0,186.9,,,0
NDC,0407-1412-10,IOHEXOL 240 MG/ML IV SOLN,108.0,75.6,,,0
NDC,0407-1412-20,IOHEXOL 240 MG/ML IV SOLN,334.5,234.15,,,0
NDC,0407-1412-29,IOHEXOL 240 MG/ML IV SOLN,260.0,182.0,,,0
NDC,0407-1412-30,IOHEXOL 240 MG/ML IV SOLN,65.0,45.5,,,0
NDC,0407-1412-50,IOHEXOL 240 MG/ML IV SOLN,253.0,177.1,,,0
NDC,0407-1415-09,IOHEXOL   9 MG IODINE/ML ORAL SOLN,83.0,58.1,,,0
NDC,0407-2223-01,IODIXANOL 320 MG/ML IV SOLN,60.0,42.0,,,0
NDC,0407-2223-02,IODIXANOL 320 MG/ML IV SOLN,308.0,215.6,,,0
NDC,0407-2223-03,IODIXANOL 320 MG/ML IV SOLN,452.0,316.4,,,0
NDC,0407-2223-04,IODIXANOL 320 MG/ML IV SOLN,491.0,343.7,,,0
NDC,0409-0001-01,MIDAZOLAM (PF) 1 MG/ML INJ (MERGE),24.0,16.8,,,0
NDC,0409-0007-01,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN",20.0,14.0,,,0
NDC,0409-0007-10,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN",16.0,11.2,,,0
NDC,0409-0064-01,CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN,457.0,319.9,,,0
NDC,0409-0122-01,DAPTOMYCIN 500 MG IV SOLR,382.0,267.4,,,0
NDC,0409-0152-01,METRONIDAZOLE IN SODIUM CHLORIDE (ISO-OSM) 500 MG/100 ML IV PIGGY BACK,23.0,16.1,,,0
NDC,0409-0181-01,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) IV SOLN,210.0,147.0,,,0
NDC,0409-0181-25,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) BLADDER INSTILLATION,231.0,161.7,,,0
NDC,0409-0182-01,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) BLADDER INSTILLATION,314.0,219.8,,,0
NDC,0409-0183-01,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) IV SOLN,84.0,58.8,,,0
NDC,0409-0186-01,GEMCITABINE 1 GRAM IV SOLR,259.0,181.3,,,0
NDC,0409-0201-20,DOCETAXEL 160 MG/16 ML (10 MG/ML) IV SOLN,834.0,583.8,,,0
NDC,0409-0219-01,CEFEPIME 1 GRAM INJ SOLR,52.0,36.4,,,0
NDC,0409-0219-11,CEFEPIME 1 GRAM INJ SOLR,35.0,24.5,,,0
NDC,0409-0302-01,TOPOTECAN 4 MG/4 ML (1 MG/ML) IV SOLN,476.5,333.55,,,0
NDC,0409-0367-01,DOCETAXEL 20 MG/ML (1 ML) IV SOLN,2224.0,1556.8000000000002,,,0
NDC,0409-0805-01,CEFAZOLIN 5 MG/ML AND HEPARIN 5000 UNITS/ML CATHETER LOCK FOR INTERCATHETER DWELL (USE PANEL),156.0,109.2,,,0
NDC,0409-0829-11,AZTREONAM 1 GRAM INJ SOLR,147.0,102.9,,,0
NDC,0409-0830-11,AZTREONAM 2 GRAM INJ SOLR,251.0,175.7,,,0
NDC,0409-0996-01,"LIDOCAINE-EPINEPHRINE BIT 2 %-1:100,000 INJ CRTG",7.0,4.9,,,0
NDC,0409-1005-01,HEPARIN (PORCINE) IN NACL (PF) 1000 UNIT/500 ML IV SOLP,70.5,49.349999999999994,,,0
NDC,0409-1105-22,ATRACURIUM 10 MG/ML IV SOLN,42.0,29.4,,,0
NDC,0409-1109-11,ATRACURIUM 10 MG/ML IV SOLN,31.0,21.700000000000003,,,0
NDC,0409-1140-01,ARGATROBAN 100 MG/ML IV SOLN,962.0,673.4,,,0
NDC,0409-1141-02,23.4% SODIUM CHLORIDE (4 MEQ/ML) INJECTION,22.0,15.4,,,0
NDC,0409-1144-02,VERAPAMIL 2.5 MG/ML IV SOLN,190.0,133.0,,,0
NDC,0409-1151-70,HEPARIN LOCK FLUSH (PORCINE) 10 UNIT/ML IV SOLN (PEDS),16.0,11.2,,,0
NDC,0409-1158-01,BUPIVACAINE 0.25%/EPINEPHRINE 1:100K INJECTION,48.0,33.6,,,0
NDC,0409-1159-01,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN,16.0,11.2,,,0
NDC,0409-1159-02,BUPIVACAINE (PF) 0.25 % (LEFT) (PHS CUSTOM PAIN BALL),62.5,43.75,,,0
NDC,0409-1159-09,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN,30.0,21.0,,,0
NDC,0409-1159-19,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN,31.5,22.05,,,0
NDC,0409-1160-01,BUPIVACAINE 0.25 % (2.5 MG/ML) INJ SOLN,24.0,16.8,,,0
NDC,0409-1160-18,BUPIVACAINE 0.25 % (2.5 MG/ML) INJ SOLN,16.0,11.2,,,0
NDC,0409-1161-01,BUPIVACAINE 0.5%/EPINEPHRINE 1:300K INJECTION,34.0,23.8,,,0
NDC,0409-1162-01,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN,31.0,21.7,,,0
NDC,0409-1162-02,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN,18.0,12.6,,,0
NDC,0409-1162-18,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN,31.0,21.7,,,0
NDC,0409-1162-19,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN,16.0,11.2,,,0
NDC,0409-1163-01,BUPIVACAINE 0.5 % (5 MG/ML) INJ SOLN,40.0,28.0,,,0
NDC,0409-1163-18,BUPIVACAINE 0.5 % (5 MG/ML) INJ SOLN,18.0,12.6,,,0
NDC,0409-1165-02,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJ SOLN,27.0,18.9,,,0
NDC,0409-1176-03,MEPERIDINE (PF) 25 MG/ML IV SOLN (PHS MERGE),31.0,21.7,,,0
NDC,0409-1176-30,MEPERIDINE (PF) 25 MG/ML IV SOLN (PHS MERGE),40.5,28.35,,,0
NDC,0409-1178-03,MEPERIDINE (PF) 50 MG/ML IV SOLN (PHS MERGE),38.5,26.950000000000003,,,0
NDC,0409-1207-03,GENTAMICIN 40 MG/ML INJ SOLN,92.0,64.4,,,0
NDC,0409-1207-13,GENTAMICIN 40 MG/ML INJ SOLN,72.0,50.400000000000006,,,0
NDC,0409-1215-01,NALOXONE 0.4 MG/ML INJ SOLN,372.0,260.4,,,0
NDC,0409-1215-21,NALOXONE 0.4 MG/ML INJ SOLN,139.5,97.64999999999999,,,0
NDC,0409-1219-01,NALOXONE 0.4 MG/ML INJ SOLN,513.0,359.1,,,0
NDC,0409-1219-41,NALOXONE 0.4 MG/ML INJ SOLN,385.0,269.5,,,0
NDC,0409-1261-30,MORPHINE 10 MG/ML INJ SYRG,16.0,11.2,,,0
NDC,0409-1273-03,DIAZEPAM 5 MG/ML INJ SYRG,396.0,277.2,,,0
NDC,0409-1273-32,DIAZEPAM 5 MG/ML INJ SYRG,297.0,207.89999999999998,,,0
NDC,0409-1283-03,HYDROMORPHONE (PF) 1 MG/ML IV SOLN (PHS ERX MERGE),30.5,21.35,,,0
NDC,0409-1283-04,HYDROMORPHONE 0.5 MG/0.5 ML INJ SYRG (PHS ERX MERGE),57.5,40.25,,,0
NDC,0409-1283-05,HYDROMORPHONE 0.5 MG/0.5 ML INJ SYRG (PHS ERX MERGE),23.0,16.1,,,0
NDC,0409-1283-10,HYDROMORPHONE  1 MG/ML INJ SYRG,43.5,30.45,,,0
NDC,0409-1283-17,HYDROMORPHONE (PF) 1 MG/ML IV SOLN (PHS ERX MERGE),36.0,25.2,,,0
NDC,0409-1283-31,HYDROMORPHONE (PF) 1 MG/ML IV SOLN (PHS ERX MERGE),26.5,18.55,,,0
NDC,0409-1312-03,HYDROMORPHONE (PF) 2 MG/ML IV SOLN (PRMC ERX MERGE),45.0,31.5,,,0
NDC,0409-1312-10,HYDROMORPHONE (PF) 2 MG/ML IV SOLN (PRMC ERX MERGE),37.0,25.9,,,0
NDC,0409-1323-05,LIDOCAINE (PF) 20 MG/ML (2 %) IV SYRG,120.0,84.0,,,0
NDC,0409-1323-15,LIDOCAINE (PF) 20 MG/ML (2 %) IV SYRG,176.0,123.2,,,0
NDC,0409-1362-11,MEPERIDINE (PF) 25 MG/ML IV SOLN (PHS MERGE),43.5,30.450000000000003,,,0
NDC,0409-1390-21,MEROPENEM 500 MG IV SOLR,61.0,42.7,,,0
NDC,0409-1391-21,MEROPENEM 1 GRAM IV SOLR,182.5,127.75,,,0
NDC,0409-1391-22,MEROPENEM 1 GRAM IV SOLR,122.0,85.4,,,0
NDC,0409-1412-04,BUMETANIDE 0.25 MG/ML INJ SOLN,22.5,15.75,,,0
NDC,0409-1412-10,BUMETANIDE 0.25 MG/ML INJ SOLN,89.0,62.3,,,0
NDC,0409-1463-01,NALBUPHINE 10 MG/ML INJ SOLN,30.0,21.0,,,0
NDC,0409-1463-71,NALBUPHINE 10 MG/ML INJ SOLN,30.0,21.0,,,0
NDC,0409-1464-01,NALBUPHINE 10 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,0409-1541-01,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN",146.5,102.55,,,0
NDC,0409-1541-10,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN",195.0,136.5,,,0
NDC,0409-1559-10,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN,35.0,24.5,,,0
NDC,0409-1559-18,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN,16.0,11.2,,,0
NDC,0409-1559-19,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN,22.0,15.4,,,0
NDC,0409-1560-18,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN,32.0,22.4,,,0
NDC,0409-1560-19,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN,33.0,23.1,,,0
NDC,0409-1560-29,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN,16.0,11.2,,,0
NDC,0409-1610-50,BUPIVACAINE 0.5 % (5 MG/ML) INJ SOLN,42.0,29.4,,,0
NDC,0409-1630-15,ATROPINE 0.1 MG/ML INJ SYRG,68.5,47.95,,,0
NDC,0409-1631-10,CALCIUM CHLORIDE (FOR CODE) 10% (100 MG/ML) IV SYRINGE,149.0,104.3,,,0
NDC,0409-1631-40,CALCIUM CHLORIDE (FOR CODE) 10% (100 MG/ML) IV SYRINGE,149.0,104.3,,,0
NDC,0409-1632-21,VECURONIUM BROMIDE 10 MG IV SOLR,73.5,51.449999999999996,,,0
NDC,0409-1638-02,DEXMEDETOMIDINE 100 MCG/ML IV SOLN,40.0,28.0,,,0
NDC,0409-1638-32,DEXMEDETOMIDINE 100 MCG/ML IV SOLN,37.0,25.9,,,0
NDC,0409-1660-50,DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) IV SOLN,164.0,114.8,,,0
NDC,0409-1660-55,DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) IV SOLN,165.0,115.5,,,0
NDC,0409-1746-10,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN",41.0,28.7,,,0
NDC,0409-1746-30,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN",69.0,48.3,,,0
NDC,0409-1746-71,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN",69.0,48.3,,,0
NDC,0409-1749-29,BUPIVACAINE 0.5% W/EPINEPHRINE 1:200K INJECTION,56.0,39.2,,,0
NDC,0409-1749-70,"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN",54.0,37.8,,,0
NDC,0409-1749-71,"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN",49.0,34.3,,,0
NDC,0409-1752-50,"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJ SOLN",200.0,140.0,,,0
NDC,0409-1755-50,"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN",37.0,25.9,,,0
NDC,0409-1761-02,BUPIVACAINE-DEXTROSE-WATER(PF) 7.5 MG/ML (0.75 %) INJ SOLN,46.0,32.2,,,0
NDC,0409-1761-18,BUPIVACAINE-DEXTROSE-WATER(PF) 7.5 MG/ML (0.75 %) INJ SOLN,40.0,28.0,,,0
NDC,0409-1762-30,MORPHINE 2 MG/ML IV SOLN (PHS/CDS MERGE),16.0,11.2,,,0
NDC,0409-1775-10,DEXTROSE 25% IN WATER (D25W) IV SYRINGE,200.0,140.0,,,0
NDC,0409-1775-40,DEXTROSE 25% IN WATER (D25W) IV SYRINGE,105.0,73.5,,,0
NDC,0409-1778-05,METOPROLOL TARTRATE 5 MG/5 ML IV,16.0,11.2,,,0
NDC,0409-1778-15,METOPROLOL TARTRATE 5 MG/5 ML IV,16.5,11.55,,,0
NDC,0409-1886-22,LEVETIRACETAM 500 MG/5 ML IV SOLN,72.5,50.75,,,0
NDC,0409-1890-01,MORPHINE 2 MG/ML IV SOLN (PHS/CDS MERGE),22.5,15.75,,,0
NDC,0409-1890-03,MORPHINE  2 MG/ML INJ SYRG,20.0,14.0,,,0
NDC,0409-1890-13,MORPHINE  2 MG/ML INJ SYRG,52.0,36.400000000000006,,,0
NDC,0409-1891-01,MORPHINE 4 MG/ML IV SOLN (PHS/CDS MERGE),16.0,11.2,,,0
NDC,0409-1891-03,MORPHINE 4 MG/ML IV SOLN (PHS/CDS MERGE),18.5,12.95,,,0
NDC,0409-1893-03,MORPHINE 10 MG/ML IV SOLN (PHS/CDS MERGE),16.0,11.2,,,0
NDC,0409-1893-13,MORPHINE 10 MG/ML IV SOLN (PHS/CDS MERGE),28.5,19.95,,,0
NDC,0409-1902-11,PROCAINAMIDE 100 MG/ML INJ SOLN,577.0,403.9,,,0
NDC,0409-1966-01,BACTERIOSTATIC SALINE 0.9 % INJ SOLN,16.0,11.2,,,0
NDC,0409-1966-05,BACTERIOSTATIC SALINE 0.9 % INJ SOLN,16.0,11.2,,,0
NDC,0409-1966-06,BACTERIOSTATIC SALINE 0.9 % INJ SOLN,16.0,11.2,,,0
NDC,0409-1985-03,LORAZEPAM 2 MG/ML INJ SOLN,48.0,33.6,,,0
NDC,0409-1985-05,LORAZEPAM 2 MG/ML IV SOLN (PRMC ERX MERGE),12.0,8.4,,,0
NDC,0409-2045-01,MILRINONE IN D5W 20 MG/100 ML (0.2 MG/ML) INFUSION,70.5,49.349999999999994,,,0
NDC,0409-2050-01,MAGNESIUM SULFATE 20 GRAM/500 ML IV SOLP,42.0,29.4,,,0
NDC,0409-2051-05,KETAMINE INFUSION 2MG/ML 100ML (FOR ANESTHESIA USE ONLY),39.0,27.3,,,0
NDC,0409-2051-15,KETAMINE 100 MG/ML INJ SOLN,26.0,18.2,,,0
NDC,0409-2066-05,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,64.0,44.8,,,0
NDC,0409-2066-10,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,19.0,13.3,,,0
NDC,0409-2122-01,ENALAPRILAT 1.25 MG/ML IV INJ,16.0,11.2,,,0
NDC,0409-2122-02,ENALAPRILAT 1.25 MG/ML IV INJ,20.0,14.0,,,0
NDC,0409-2267-20,LABETALOL 5 MG/ML IV SOLN,16.0,11.2,,,0
NDC,0409-2267-54,LABETALOL 5 MG/ML IV SOLN,122.0,85.4,,,0
NDC,0409-2290-31,DIPHENHYDRAMINE 50 MG/ML INJECTION,26.0,18.2,,,0
NDC,0409-2300-01,CIPROFLOXACIN IN D5W 200 MG/100 ML IV PGBK,22.0,15.4,,,0
NDC,0409-2305-02,MIDAZOLAM (PF) 1 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,0409-2305-04,MIDAZOLAM (PF) 1 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,0409-2305-16,MIDAZOLAM (PF) 1 MG/ML INJ SOLN,26.0,18.200000000000003,,,0
NDC,0409-2305-17,MIDAZOLAM (PF) 1 MG/ML INJ (MERGE),23.0,16.1,,,0
NDC,0409-2308-01,MIDAZOLAM (PF) 5 MG/ML INJ SOLN,104.5,73.14999999999999,,,0
NDC,0409-2308-02,MIDAZOLAM (PF) 5 MG/ML INJ SOLN,28.0,19.6,,,0
NDC,0409-2308-21,MIDAZOLAM (PF) 5 MG/ML INJ SOLN,2.0,1.4,,,0
NDC,0409-2308-22,MIDAZOLAM (PF) 5 MG/ML INJ SOLN,23.0,16.1,,,0
NDC,0409-2339-24,LABETALOL (5 MG/ML) IV SYRG (CONTAINS PRESERVATIVE),67.0,46.9,,,0
NDC,0409-2339-34,LABETALOL (5 MG/ML) IV SYRG (CONTAINS PRESERVATIVE),80.5,56.35,,,0
NDC,0409-2347-31,DOBUTAMINE IN D5W 500 MG/250 ML (2 MG/ML) INFUSION (PREMIX),107.0,74.9,,,0
NDC,0409-2347-32,DOBUTAMINE IN D5W 500 MG/250 ML (2 MG/ML) INFUSION (PREMIX),123.0,86.1,,,0
NDC,0409-2596-05,MIDAZOLAM 5 MG/ML INJ SOLN,50.0,35.0,,,0
NDC,0409-2596-15,MIDAZOLAM 500 MG/100 ML CONCENTRATED DRIP 100 ML (RSE),33.0,23.1,,,0
NDC,0409-2634-01,HYDROMORPHONE (PF) 10 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,0409-2634-25,HYDROMORPHONE (PF) 10 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,0409-2720-02,HEPARIN (PORCINE)  1000 UNIT/ML INJ SOLN,18.0,12.6,,,0
NDC,0409-2720-03,HEPARIN (PORCINE)  1000 UNIT/ML INJ SOLN,44.5,31.15,,,0
NDC,0409-2720-30,HEPARIN (PORCINE)  1000 UNIT/ML INJ SOLN,38.0,26.6,,,0
NDC,0409-2720-31,HEPARIN (PORCINE)  1000 UNIT/ML INJ SOLN,40.0,28.0,,,0
NDC,0409-2723-01,HEPARIN (PORCINE)  5000 UNIT/ML INJ SOLN,33586.0,23510.2,,,0
NDC,0409-2723-02,HEPARIN (PORCINE)  5000 UNIT/ML INJ SOLN,16.0,11.2,,,0
NDC,0409-2723-30,HEPARIN (PORCINE)  5000 UNIT/ML INJ SOLN,22.0,15.4,,,0
NDC,0409-2776-23,MILRINONE INFUSION PED/NEO IV SYRINGE (CDS MIXTURE),94.0,65.8,,,0
NDC,0409-3024-01,NITROPRUSSIDE 25 MG/ML IV SOLN,546.0,382.2,,,0
NDC,0409-3178-01,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN",22.0,15.4,,,0
NDC,0409-3178-02,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN",30.5,21.35,,,0
NDC,0409-3178-03,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN",19.0,13.3,,,0
NDC,0409-3178-16,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN",27.0,18.9,,,0
NDC,0409-3178-17,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN",26.0,18.2,,,0
NDC,0409-3183-01,LIDOCAINE 2%/EPINEPHRINE 1:200K INJECTION (PF),100.0,70.0,,,0
NDC,0409-3183-11,"LIDOCAINE-EPINEPHRINE 2 %-1:200,000 INJ SOLN",27.5,19.25,,,0
NDC,0409-3299-15,SODIUM ACETATE 2 MEQ/ML IV SOLN,6.0,4.2,,,0
NDC,0409-3300-01,CIPROFLOXACIN IN D5W 400 MG/200 ML IV PGBK,27.0,18.9,,,0
NDC,0409-3382-11,SUFENTANIL CITRATE 50 MCG/ML IV SOLN,334.0,233.8,,,0
NDC,0409-3385-11,PIPERACILLIN-TAZOBACTAM  3.375 GRAM IV SOLR,62.0,43.4,,,0
NDC,0409-3390-11,PIPERACILLIN-TAZOBACTAM  4.5 GRAM IV SOLR,82.0,57.4,,,0
NDC,0409-3413-01,METOCLOPRAMIDE  5 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,0409-3414-01,METOCLOPRAMIDE  5 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,0409-3414-11,METOCLOPRAMIDE  5 MG/ML INJ SOLN,16.5,11.55,,,0
NDC,0409-3414-18,METOCLOPRAMIDE  5 MG/ML INJ SOLN,21.0,14.7,,,0
NDC,0409-3414-21,METOCLOPRAMIDE  5 MG/ML INJ SOLN,25.0,17.5,,,0
NDC,0409-3435-01,FLUCONAZOLE 200 MG/100 ML IVPB (MERGE),37.5,26.25,,,0
NDC,0409-3515-11,VANCOMYCIN   1.5 G IV SOLR,143.0,100.1,,,0
NDC,0409-3578-01,TOBRAMYCIN SULFATE 40 MG/ML INJ SOLN,60.0,42.0,,,0
NDC,0409-3718-01,AMPICILLIN 500 MG SOLUTION FOR INJECTION,16.0,11.2,,,0
NDC,0409-3724-11,"DOBUTAMINE IN D5W 1,000 MG/250 ML (4,000 MCG/ML) IV SOLP",98.0,68.6,,,0
NDC,0409-3726-10,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,48.0,33.6,,,0
NDC,0409-3795-01,KETOROLAC TROMETHAMINE 30 MG/ML INJ SOLN,33.0,23.1,,,0
NDC,0409-3795-19,KETOROLAC TROMETHAMINE 30 MG/ML INJ SOLN,22.5,15.75,,,0
NDC,0409-3796-01,KETOROLAC TROMETHAMINE 60 MG/2 ML IM SOLN,22.0,15.4,,,0
NDC,0409-3796-19,KETOROLAC TROMETHAMINE 60 MG/2 ML IM SOLN,9.5,6.6499999999999995,,,0
NDC,0409-3814-11,MORPHINE (PF-DURAMORPH/ASTRAMORPH) 0.5 MG/ML INJ SOLN,50.0,35.0,,,0
NDC,0409-3814-12,MORPHINE (PF-DURAMORPH/ASTRAMORPH) 0.5 MG/ML INJ SOLN,73.0,51.1,,,0
NDC,0409-4031-01,MANNITOL 25 % IV SOLN,20.0,14.0,,,0
NDC,0409-4031-16,MANNITOL 25 % IV SOLN,42.0,29.4,,,0
NDC,0409-4056-01,LIDOCAINE (PF) 15 MG/ML (1.5 %) INJ SOLN,54.0,37.8,,,0
NDC,0409-4092-01,CUPRIC CHLORIDE 0.4 MG/ML IV SOLN,94.0,65.8,,,0
NDC,0409-4121-01,MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IV PGBK,36.5,25.549999999999997,,,0
NDC,0409-4208-01,"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN",36.0,25.2,,,0
NDC,0409-4228-01,ZOLEDRONIC ACID IN MANNITOL & WATER 5 MG/100 ML IV SOLN,801.0,560.7,,,0
NDC,0409-4264-11,HYDROMORPHONE 0.5 MG/0.5 ML INJ SYRG (PHS ERX MERGE),41.0,28.700000000000003,,,0
NDC,0409-4275-16,LIDOCAINE 5 MG/ML (0.5 %) INJECTION,16.0,11.2,,,0
NDC,0409-4276-01,LIDOCAINE 10 MG/ML (1 %) INJECTION,19.0,13.3,,,0
NDC,0409-4276-02,LIDOCAINE 1% 10MG/ML (1ML-UD) OR SYRINGE,10.0,7.0,,,0
NDC,0409-4276-16,LIDOCAINE 10 MG/ML (1 %) INJECTION,19.0,13.3,,,0
NDC,0409-4276-17,LIDOCAINE 10 MG/ML (1 %) INJECTION,22.0,15.4,,,0
NDC,0409-4277-01,LIDOCAINE 20 MG/ML (2 %) INJECTION,27.0,18.9,,,0
NDC,0409-4277-02,LIDOCAINE 20 MG/ML (2 %) INJECTION,22.0,15.4,,,0
NDC,0409-4277-16,LIDOCAINE 20 MG/ML (2 %) INJECTION,27.0,18.9,,,0
NDC,0409-4277-17,LIDOCAINE 20 MG/ML (2 %) INJECTION,56.0,39.2,,,0
NDC,0409-4278-01,LIDOCAINE (PF) 5 MG/ML (0.5 %) INJ SOLN,43.5,30.450000000000003,,,0
NDC,0409-4279-02,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,55.0,38.5,,,0
NDC,0409-4279-16,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,20.5,14.350000000000001,,,0
NDC,0409-4282-01,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,29.0,20.3,,,0
NDC,0409-4282-02,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,57.0,39.9,,,0
NDC,0409-4282-12,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,173.0,121.1,,,0
NDC,0409-4283-11,LIDOCAINE (PF) 40 MG/ML (4 %) INJ SOLN (FOR NEBULIZATION),26.0,18.2,,,0
NDC,0409-4321-01,FLUCONAZOLE IN SALINE (ISO-OSM) 400 MG/200 ML IV PIGGY BACK,48.0,33.6,,,0
NDC,0409-4332-01,VANCOMYCIN  500 MG IV SOLR,55.0,38.5,,,0
NDC,0409-4332-11,VANCOMYCIN  500 MG IV SOLR,109.0,76.3,,,0
NDC,0409-4346-16,AMINOCAPROIC ACID 250 MG/ML IV SOLN,49.0,34.3,,,0
NDC,0409-4346-73,AMINOCAPROIC ACID 250 MG/ML IV SOLN,115.0,80.5,,,0
NDC,0409-4520-02,HEPARIN (PORCINE) IN D5W 25000 UNIT/250 ML (PTT MONITORING),65.0,45.5,,,0
NDC,0409-4688-02,FLUCONAZOLE IN SALINE (ISO-OSM) 400 MG/200 ML IV PIGGY BACK,100.0,70.0,,,0
NDC,0409-4688-16,FLUCONAZOLE IN SALINE (ISO-OSM) 400 MG/200 ML IV PIGGY BACK,96.0,67.2,,,0
NDC,0409-4688-22,FLUCONAZOLE 200 MG/100 ML IVPB (MERGE),50.0,35.0,,,0
NDC,0409-4698-01,LIDOCAINE 4 % TOPICAL SOLN,96.0,67.2,,,0
NDC,0409-4699-24,PROPOFOL 10 MG/ML 100ML INFUSION IV EMUL,254.0,177.8,,,0
NDC,0409-4699-53,PROPOFOL 10 MG/ML 100ML INFUSION IV EMUL,64.0,44.8,,,0
NDC,0409-4699-54,PROPOFOL IV BOLUS 10MG/ML (ANESTHESIA ONLY),110.0,77.0,,,0
NDC,0409-4712-11,LIDOCAINE IN D7.5W (PF) 50 MG/ML (5 %) IT SOLN,55.0,38.5,,,0
NDC,0409-4713-02,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,19.5,13.65,,,0
NDC,0409-4713-12,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,18.5,12.95,,,0
NDC,0409-4713-32,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,35.0,24.5,,,0
NDC,0409-4713-42,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,16.0,11.2,,,0
NDC,0409-4713-75,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,30.5,21.35,,,0
NDC,0409-4755-03,ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN,16.0,11.2,,,0
NDC,0409-4755-18,ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN,17.0,11.899999999999999,,,0
NDC,0409-4759-01,ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN,18.0,12.6,,,0
NDC,0409-4776-01,LIDOCAINE (PF) 15 MG/ML (1.5 %) INJ SOLN,60.0,42.0,,,0
NDC,0409-4776-10,LIDOCAINE (PF) 15 MG/ML (1.5 %) INJ SOLN,37.5,26.25,,,0
NDC,0409-4777-02,CIPROFLOXACIN IN D5W 400 MG/200 ML IV PGBK,70.0,49.0,,,0
NDC,0409-4857-02,FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN,16.0,11.2,,,0
NDC,0409-4887-10,"WATER FOR INJECTION, STERILE INJECTION",16.0,11.2,,,0
NDC,0409-4887-17,"WATER FOR INJECTION, STERILE INJECTION",22.0,15.4,,,0
NDC,0409-4887-20,"WATER FOR INJECTION, STERILE INJECTION",16.0,11.2,,,0
NDC,0409-4887-23,"WATER FOR INJECTION, STERILE INJECTION",21.0,14.7,,,0
NDC,0409-4887-24,"WATER FOR INJECTION, STERILE INJECTION",23.0,16.1,,,0
NDC,0409-4887-25,"WATER FOR INJECTION, STERILE INJECTION",37.0,25.9,,,0
NDC,0409-4888-01,SODIUM CHLORIDE 0.9 % INJ SOLN (VIAL),22.5,15.75,,,0
NDC,0409-4888-02,SODIUM CHLORIDE 0.9 % INJ SOLN (VIAL),14.5,10.149999999999999,,,0
NDC,0409-4888-03,SODIUM CHLORIDE 0.9 % INJ SOLN (VIAL),17.0,11.899999999999999,,,0
NDC,0409-4888-06,SODIUM CHLORIDE 0.9 % INJ SOLN (VIAL),28.5,19.95,,,0
NDC,0409-4888-10,SODIUM CHLORIDE 0.9 % INJ SOLN (VIAL),16.0,11.2,,,0
NDC,0409-4888-12,SODIUM CHLORIDE 0.9 % INJ SOLN (VIAL),16.0,11.2,,,0
NDC,0409-4888-20,SODIUM CHLORIDE 0.9 % INJ SOLN (VIAL),32.0,22.4,,,0
NDC,0409-4888-50,SODIUM CHLORIDE 0.9 % INJ SOLN (VIAL),20.0,14.0,,,0
NDC,0409-4900-24,SODIUM BICARBONATE 8.4% (1 MEQ/1 ML) IV 10 ML EMERGENCY SYRINGE,763.0,534.1,,,0
NDC,0409-4901-18,IV EPINEPHRINE 0.1 MG/ML SYRINGE (NEO-CODE IV),57.0,39.9,,,0
NDC,0409-4902-34,DEXTROSE 50% IN WATER (MERGE RECORD),98.0,68.6,,,0
NDC,0409-4902-64,DEXTROSE 50% IN WATER (MERGE RECORD),103.0,72.1,,,0
NDC,0409-4903-11,LIDOCAINE (PF) 20 MG/ML (2 %) IV SYRG,88.0,61.6,,,0
NDC,0409-4921-34,EPINEPHRINE 0.1 MG/ML SYRINGE (ERX MERGE),100.0,70.0,,,0
NDC,0409-4928-11,CALCIUM CHLORIDE (FOR CODE) 10% (100 MG/ML) IV SYRINGE,251.5,176.05,,,0
NDC,0409-5082-11,CEFTAZIDIME   1 GRAM INJ SOLR,43.0,30.1,,,0
NDC,0409-5082-16,CEFTAZIDIME   1 GRAM INJ SOLR,29.0,20.3,,,0
NDC,0409-5534-24,SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) IV (NEO) EMERGENCY SYRINGE,118.0,82.6,,,0
NDC,0409-5534-34,SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) IV (NEO) EMERGENCY SYRINGE,254.0,177.8,,,0
NDC,0409-5555-12,SODIUM BICARBONATE   4.2 % IV SOLN,103.0,72.1,,,0
NDC,0409-5820-01,DOPAMINE 200 MG/5 ML (40 MG/ML) IV,24.0,16.8,,,0
NDC,0409-5921-01,AMINOPHYLLINE 500 MG/20 ML IV SOLN,107.0,74.9,,,0
NDC,0409-5922-01,AMINOPHYLLINE 500 MG/20 ML IV SOLN,63.0,44.1,,,0
NDC,0409-5922-16,AMINOPHYLLINE 500 MG/20 ML IV SOLN,69.0,48.3,,,0
NDC,0409-6102-02,FUROSEMIDE 10 MG/ML INJ SOLN,153.0,107.1,,,0
NDC,0409-6102-04,FUROSEMIDE 10 MG/ML INJ SOLN,40.0,28.0,,,0
NDC,0409-6102-10,FUROSEMIDE 10 MG/ML INJ SOLN,39.0,27.3,,,0
NDC,0409-6102-18,FUROSEMIDE 10 MG/ML INJ SOLN,59.0,41.3,,,0
NDC,0409-6102-19,FUROSEMIDE 10 MG/ML INJ SOLN,42.0,29.400000000000002,,,0
NDC,0409-6102-20,FUROSEMIDE 10 MG/ML INJ SOLN,63.0,44.1,,,0
NDC,0409-6509-01,VANCOMYCIN  5 GRAM IV SOLR,127.0,88.9,,,0
NDC,0409-6533-11,VANCOMYCIN 1000 MG IV SOLR,239.5,167.65,,,0
NDC,0409-6557-01,TESTOSTERONE CYPIONATE 100 MG/ML IM OIL,37.0,25.9,,,0
NDC,0409-6562-01,TESTOSTERONE CYPIONATE 200 MG/ML IM OIL,49.0,34.3,,,0
NDC,0409-6625-02,SODIUM BICARBONATE IV CONCENTRATED INFUSION (1 MEQ/ML),249.0,174.3,,,0
NDC,0409-6625-14,SODIUM BICARBONATE 8.4 % IV (PHS ERX MERGE),375.5,262.85,,,0
NDC,0409-6625-22,SODIUM BICARBONATE 8.4 % IV SOLN,231.0,161.7,,,0
NDC,0409-6629-02,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ (MERGE),71.0,49.7,,,0
NDC,0409-6635-18,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLP,82.5,57.75,,,0
NDC,0409-6637-24,SODIUM BICARBONATE 8.4 % IV (PHS ERX MERGE),113.0,79.1,,,0
NDC,0409-6648-02,DEXTROSE 50% IN WATER (MERGE RECORD),61.0,42.7,,,0
NDC,0409-6648-16,DEXTROSE 30% IN WATER (NEO),85.5,59.849999999999994,,,0
NDC,0409-6651-19,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLP,21.0,14.7,,,0
NDC,0409-6653-18,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLP,25.5,17.85,,,0
NDC,0409-6695-01,ETOMIDATE 2 MG/ML IV SOLN,57.0,39.900000000000006,,,0
NDC,0409-6695-02,ETOMIDATE 2 MG/ML IV SOLN,44.0,30.8,,,0
NDC,0409-6727-11,MAGNESIUM SULFATE IN D5W 1 GRAM/100 ML IV PGBK,55.0,38.5,,,0
NDC,0409-6727-23,MAGNESIUM SULFATE IN D5W 1 GRAM/100 ML IV PGBK,82.5,57.75,,,0
NDC,0409-6727-55,MAGNESIUM SULFATE IN D5W 1 GRAM/100 ML IV PGBK,82.5,57.75,,,0
NDC,0409-6729-11,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IV PGBK,96.0,67.2,,,0
NDC,0409-6729-23,MAGNESIUM SULFATE 40 MG/ML IV SYRINGE,54.0,37.8,,,0
NDC,0409-6729-24,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IV PGBK,96.0,67.2,,,0
NDC,0409-6729-41,MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IV PGBK,35.0,24.5,,,0
NDC,0409-6778-02,LORAZEPAM 2 MG/ML INJ SOLN,19.5,13.65,,,0
NDC,0409-6780-02,LORAZEPAM 2 MG/ML IV SOLN (PHS MERGE - ALL SITES),150.0,105.0,,,0
NDC,0409-7074-26,POTASSIUM CHLORIDE 10 MEQ/100 ML IV PGBK,20.0,14.0,,,0
NDC,0409-7075-26,POTASSIUM CHLORIDE 20 MEQ/100 ML IV PGBK,18.0,12.6,,,0
NDC,0409-7248-13,HETASTARCH 6 % IN NORMAL SALINE IV,151.0,105.7,,,0
NDC,0409-7295-01,POTASSIUM PHOSPHATE 4.4 MEQ/ML ORAL SOLUTION (CDS),47.0,32.9,,,0
NDC,0409-7295-11,POTASSIUM PHOSPHATE 4.4 MEQ/ML ORAL SOLUTION (CDS),19.0,13.3,,,0
NDC,0409-7299-73,NEO TPN SODIUM ACETATE 2 MEQ/ML IV SOLN,54.0,37.800000000000004,,,0
NDC,0409-7299-83,NEO TPN SODIUM ACETATE 2 MEQ/ML IV SOLN,54.5,38.150000000000006,,,0
NDC,0409-7332-01,CEFTRIAXONE 1 GRAM INJ SOLR,16.0,11.2,,,0
NDC,0409-7332-11,CEFTRIAXONE 100 MG/ML FROM 1 GRAM VIAL (PRMC PEDS ONLY),87.0,60.900000000000006,,,0
NDC,0409-7332-21,CEFTRIAXONE 1 GRAM INJ SOLR,16.0,11.2,,,0
NDC,0409-7333-04,CEFTRIAXONE   1 GRAM IV SOLR,42.0,29.4,,,0
NDC,0409-7335-13,CEFTRIAXONE   2 GRAM INJ SOLR,20.0,14.0,,,0
NDC,0409-7336-04,CEFTRIAXONE   2 GRAM IV SOLR,54.0,37.8,,,0
NDC,0409-7337-11,CEFTRIAXONE 250 MG INJ SOLR,18.5,12.95,,,0
NDC,0409-7338-01,CEFTRIAXONE 500 MG INJ SOLR,16.0,11.2,,,0
NDC,0409-7338-11,CEFTRIAXONE 500 MG INJ SOLR,23.0,16.1,,,0
NDC,0409-7391-72,SODIUM CHLORIDE 4 MEQ/ML ORAL SOLUTION (CDS),16.0,11.2,,,0
NDC,0409-7391-82,SODIUM PHOSPHATE 3 MMOL/ML IV SOLN,53.0,37.1,,,0
NDC,0409-7517-66,DEXTROSE 50% IN WATER (MERGE RECORD),201.5,141.05,,,0
NDC,0409-7809-11,DOPAMINE INFUSION NEO IV SYRINGE (FROM PREMIX),49.5,34.65,,,0
NDC,0409-7809-22,DOPAMINE IN D5W 400 MG/250 ML (1.6 MG/ML) IV,93.0,65.1,,,0
NDC,0409-7922-02,DEXTROSE 5% IN WATER (D5W) IV,34.5,24.15,,,0
NDC,0409-7935-19,DEXTROSE 20% IN WATER (NEO) 500ML,69.0,48.3,,,0
NDC,0409-7953-09,LACTATED RINGERS IV,34.0,23.8,,,0
NDC,0409-7972-08,SODIUM CHLORIDE 0.9 % IR SOLN,50.0,35.0,,,0
NDC,0409-7983-02,SODIUM CHLORIDE 0.9 % IV SOLP,35.0,24.5,,,0
NDC,0409-7984-06,SODIUM ACETATE 0.9% WITH HEPARIN IV SYRINGE (NEONATAL),16.0,11.2,,,0
NDC,0409-7985-25,SODIUM CHLORIDE 0.45 % 0.45 % IV SOLP,16.0,11.2,,,0
NDC,0409-8183-11,POTASSIUM ACETATE 2 MEQ/ML IV SOLN,36.0,25.2,,,0
NDC,0409-9042-01,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN",16.0,11.2,,,0
NDC,0409-9042-11,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN",27.0,18.9,,,0
NDC,0409-9042-16,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN",16.0,11.2,,,0
NDC,0409-9042-17,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN",21.0,14.7,,,0
NDC,0409-9046-01,"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN",39.0,27.3,,,0
NDC,0409-9093-32,FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN,35.0,24.5,,,0
NDC,0409-9093-35,FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN,24.0,16.799999999999997,,,0
NDC,0409-9094-12,FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN,31.0,21.7,,,0
NDC,0409-9094-17,FENTANYL CITRATE (PF) 50 MCG/ML (ANESTHESIA INTRAOP ONLY),16.0,11.2,,,0
NDC,0409-9094-18,FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN,28.0,19.6,,,0
NDC,0409-9094-22,FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN,38.0,26.6,,,0
NDC,0409-9094-25,FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN,31.0,21.7,,,0
NDC,0409-9094-41,FENTANYL CITRATE (PF) 50 MCG/ML INJ (REPACK)(MERGE) (FOR PCA),128.0,89.6,,,0
NDC,0409-9157-31,PHYTONADIONE 1 MG/0.5 ML INJ SOLN,63.5,44.45,,,0
NDC,0409-9158-01,PHYTONADIONE 1 MG/ML ORAL SOLN,168.0,117.60000000000001,,,0
NDC,0409-9158-31,PHYTONADIONE 10 MG/ML INJ SOLN,50.0,35.0,,,0
NDC,0409-9158-50,PHYTONADIONE 10 MG/ML INJ SOLN,187.5,131.25,,,0
NDC,0409-9300-11,ROPIVACAINE  2 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,0409-9303-10,ROPIVACAINE 10 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,0409-9558-05,ROCURONIUM 10 MG/ML IV SOLN,45.0,31.5,,,0
NDC,0409-9566-01,CEFEPIME 1 GRAM INJ SOLR,18.5,12.95,,,0
NDC,0409-9566-10,CEFEPIME 1 GRAM INJ SOLR,41.0,28.7,,,0
NDC,0409-9735-01,CEFEPIME 2 GRAM INJ SOLR,30.0,21.0,,,0
NDC,0409-9735-10,CEFEPIME 2 GRAM INJ SOLR,59.0,41.3,,,0
NDC,0436-0672-16,SODIUM HYPOCHLORITE 0.125 % MISC SOLN,429.5,300.65000000000003,,,0
NDC,0436-0936-16,SODIUM HYPOCHLORITE 0.25 % MISC SOLN,135.0,94.5,,,0
NDC,0436-0946-16,SODIUM HYPOCHLORITE 0.5 % MISC SOLN,68.0,47.6,,,0
NDC,0456-0400-01,CEFTAROLINE FOSAMIL 400 MG IV SOLR,890.5,623.3499999999999,,,0
NDC,0456-0457-01,THYROID (PORK) 15 MG ORAL TAB,12.0,8.4,,,0
NDC,0456-0458-01,THYROID (PORK)  30 MG ORAL TAB,17.0,11.9,,,0
NDC,0456-0459-01,THYROID (PORK)  60 MG ORAL TAB,22.0,15.4,,,0
NDC,0456-0600-01,CEFTAROLINE FOSAMIL 600 MG IV SOLR,290.0,203.0,,,0
NDC,0456-1045-01,THYROID (PORK) 15 MG ORAL TAB,9.5,6.65,,,0
NDC,0456-1140-30,VILAZODONE 40 MG ORAL TAB,72.0,50.4,,,0
NDC,0456-1201-30,LINACLOTIDE 145 MCG ORAL CAP,112.0,78.4,,,0
NDC,0456-1203-30,LINACLOTIDE  72 MCG ORAL CAP,112.0,78.4,,,0
NDC,0456-2700-01,CEFTAZIDIME-AVIBACTAM 2.5 GRAM (2 GRAM-0.5 GRAM) IV SOLR,1280.5,896.35,,,0
NDC,0456-2700-10,CEFTAZIDIME-AVIBACTAM 2.5 GRAM (2 GRAM-0.5 GRAM) IV SOLR,304.5,213.15,,,0
NDC,0469-0520-01,ISAVUCONAZONIUM SULFATE 186 MG ORAL CAP,820.0,574.0,,,0
NDC,0469-0607-73,TACROLIMUS 0.5 MG ORAL CAP,25.0,17.5,,,0
NDC,0469-3016-01,TACROLIMUS 5 MG/ML IV SOLN,890.0,623.0,,,0
NDC,0469-3051-30,AMPHOTERICIN B LIPOSOME 50 MG IV SUSR,3283.0,2298.1,,,0
NDC,0469-3211-10,MICAFUNGIN 100 MG IV SOLR,1616.0,1131.2,,,0
NDC,0469-3425-10,ZOLBETUXIMAB-CLZB 100 MG IV SOLR (WET SOLR VIAL),4416.0,3091.2,,,0
NDC,0469-4425-30,ZOLBETUXIMAB-CLZB 300 MG IV SOLR (WET SOLR VIAL),26496.0,18547.2,,,0
NDC,0469-6501-89,REGADENOSON 0.4 MG/5 ML IV SYRG,913.0,639.1,,,0
NDC,0469-8234-12,ADENOSINE 3 MG/ML IV SYRG,423.0,296.1,,,0
NDC,0472-0166-15,NYSTATIN  100000 UNIT/G TOP OINT,86.0,60.2,,,0
NDC,0472-0321-26,HYDROCORTISONE  1 % TOP CREA,36.0,25.2,,,0
NDC,0472-1105-56,BACITRACIN 500 UNIT/G TOP OINT (MERGE),48.0,33.6,,,0
NDC,0472-1915-01,MESALAMINE 1000 MG RECT SUPP,216.0,151.2,,,0
NDC,0480-2596-34,FIDAXOMICIN 200 MG ORAL TAB,876.0,613.2,,,0
NDC,0480-3290-01,PACLITAXEL-PROTEIN BOUND 100 MG IV SOLR,7287.0,5100.9,,,0
NDC,0480-3479-06,LUBIPROSTONE  8 MCG ORAL CAP,69.0,48.3,,,0
NDC,0480-3667-19,LIRAGLUTIDE 0.6 MG/0.1 ML (18 MG/3 ML) SUBQ PNIJ,1426.0,998.2,,,0
NDC,0480-3667-20,LIRAGLUTIDE 0.6 MG/0.1 ML (18 MG/3 ML) SUBQ PNIJ,1426.0,998.2,,,0
NDC,0486-1111-01,"POTASSIUM PHOSPHATE, MONOBASIC 500 MG ORAL TBSO",7.5,5.25,,,0
NDC,0487-0201-00,IPRATROPIUM-ALBUTEROL 0.5 MG-2.5 MG/3 ML NEB SOLUTION,12.0,8.4,,,0
NDC,0487-0201-01,IPRATROPIUM-ALBUTEROL 0.5 MG-2.5 MG/3 ML NEB SOLUTION,167.5,117.25,,,0
NDC,0487-0201-03,IPRATROPIUM-ALBUTEROL 0.5 MG-2.5 MG/3 ML NEB SOLUTION,13.0,9.1,,,0
NDC,0487-0201-60,IPRATROPIUM-ALBUTEROL 0.5 MG-2.5 MG/3 ML NEB SOLUTION,12.0,8.4,,,0
NDC,0487-2784-01,RACEPINEPHRINE 2.25 % INHL NEBU,11.0,7.7,,,0
NDC,0487-5901-99,RACEPINEPHRINE 2.25 % INHL NEBU,12.0,8.4,,,0
NDC,0487-9301-02,SODIUM CHLORIDE 0.9 % INHL NEBU,7.0,4.9,,,0
NDC,0487-9301-03,SODIUM CHLORIDE 0.9 % INHL NEBU,9.0,6.3,,,0
NDC,0487-9301-33,SODIUM CHLORIDE 0.9 % INHL NEBU,7.0,4.9,,,0
NDC,0487-9501-00,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) NEB SOLUTION,79.0,55.3,,,0
NDC,0487-9501-01,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) NEB SOLUTION,14.0,9.8,,,0
NDC,0487-9501-03,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) NEB SOLUTION,7.0,4.9,,,0
NDC,0487-9501-25,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) NEB SOLUTION,8.0,5.6,,,0
NDC,0487-9501-60,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) NEB SOLUTION,7.0,4.9,,,0
NDC,0487-9601-01,BUDESONIDE 0.25 MG/2 ML INHL NBSP,73.0,51.099999999999994,,,0
NDC,0487-9701-01,BUDESONIDE 0.5 MG/2 ML INHL NBSP,82.5,57.75,,,0
NDC,0487-9801-01,IPRATROPIUM BROMIDE 0.02 % INHL SOLN,7.0,4.9,,,0
NDC,0487-9901-02,ALBUTEROL SULFATE 2.5 MG/0.5 ML INHL NEBU,26.0,18.2,,,0
NDC,0487-9901-30,ALBUTEROL SULFATE 2.5 MG/0.5 ML INHL NEBU,25.0,17.5,,,0
NDC,0487-9904-01,ALBUTEROL SULFATE 1.25 MG/3 ML INHL NEBU,9.0,6.3,,,0
NDC,0496-0799-04,HYDROCORTISONE-PRAMOXINE 2.5 %-1 % RECTAL CREAM,806.0,564.2,,,0
NDC,0496-0882-05,LIDOCAINE 4 % TOP CREA,65.0,45.5,,,0
NDC,0496-0882-06,LIDOCAINE 4 % TOP CREA,47.0,32.9,,,0
NDC,0517-0020-10,CAFFEINE CITRATE PEDS/NEO IV SYR (CDS MIX) LD,111.0,77.7,,,0
NDC,0517-0031-01,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,73.0,51.1,,,0
NDC,0517-0031-25,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,49.0,34.3,,,0
NDC,0517-0032-25,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,24.0,16.8,,,0
NDC,0517-0299-25,PHENYLEPHRINE 10 MG/ML INJECTION,258.0,180.6,,,0
NDC,0517-0301-10,METHYLENE BLUE (ANTIDOTE) 1 % INJ SOLN,104.5,73.15,,,0
NDC,0517-0374-01,METHYLENE BLUE (ANTIDOTE) 5 MG/ML (0.5 %) IV SOLN,2489.5,1742.65,,,0
NDC,0517-0375-01,INDIGOTINDISULFONATE SODIUM 8 MG/ML INJ SOLN,783.0,548.1,,,0
NDC,0517-0381-01,METHYLENE BLUE (ANTIDOTE) 5 MG/ML (0.5 %) IV SOLN,1278.0,894.6,,,0
NDC,0517-0401-25,ATROPINE 0.4 MG/ML INJ SOLN,40.5,28.349999999999998,,,0
NDC,0517-0420-01,ESTRADIOL VALERATE 20 MG/ML IM OIL,61.0,42.7,,,0
NDC,0517-0650-01,FERRIC CARBOXYMALTOSE (INJECTAFER) 50 MG IRON/ML IV SOLN,4340.0,3038.0,,,0
NDC,0517-0720-01,BETAMETHASONE ACET & SOD PHOS 6 MG/ML INJ SUSP,143.0,100.1,,,0
NDC,0517-0730-01,CLONIDINE (PF) 1000 MCG/10 ML EPID SOLN,223.0,156.1,,,0
NDC,0517-0740-01,METHYLERGONOVINE 0.2 MG/ML (1 ML) INJ SOLN,230.0,161.0,,,0
NDC,0517-0799-01,BETAMETHASONE ACET & SOD PHOS 6 MG/ML INJ SUSP,95.0,66.5,,,0
NDC,0517-0901-01,HYDRALAZINE 20 MG/ML INJ SOLN,133.0,93.1,,,0
NDC,0517-0901-25,HYDRALAZINE 20 MG/ML INJ SOLN,89.0,62.3,,,0
NDC,0517-1001-01,ATROPINE 1 MG/ML IV SOLN,25.0,17.5,,,0
NDC,0517-1001-25,ATROPINE 1 MG/ML IV SOLN,50.0,35.0,,,0
NDC,0517-1004-01,ATROPINE 0.4 MG/ML INJ SOLN,37.5,26.25,,,0
NDC,0517-1010-25,ATROPINE 1 MG/ML INJ SOLN,74.0,51.8,,,0
NDC,0517-1820-01,CHLOROTHIAZIDE SODIUM 500 MG IV SOLR,86.0,60.2,,,0
NDC,0517-1825-01,METHOCARBAMOL 100 MG/ML INJ SOLN,91.0,63.7,,,0
NDC,0517-2096-25,SODIUM ACETATE 2 MEQ/ML IV SOLN,45.0,31.5,,,0
NDC,0517-2305-25,POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML IV SOLP,26.0,18.2,,,0
NDC,0517-2310-01,IRON SUCROSE 200 MG/10 ML IRON IV SOLN,545.0,381.5,,,0
NDC,0517-2310-05,IRON SUCROSE 200 MG/10 ML IRON IV SOLN,545.0,381.5,,,0
NDC,0517-2315-25,POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML IV SOLP,28.0,19.6,,,0
NDC,0517-2325-01,IRON SUCROSE 100 MG/5 ML IV SOLN,149.0,104.3,,,0
NDC,0517-2340-01,IRON SUCROSE 100 MG/5 ML IV SOLN,632.5,442.75,,,0
NDC,0517-2340-10,IRON SUCROSE 100 MG/5 ML IV SOLN,642.0,449.4,,,0
NDC,0517-2340-99,IRON SUCROSE 100 MG/5 ML IV SOLN,432.0,302.4,,,0
NDC,0517-2350-25,POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML IV SOLP,19.0,13.3,,,0
NDC,0517-2502-01,CAFFEINE-SODIUM BENZOATE 250 MG/ML INJ SOLN,207.5,145.25,,,0
NDC,0517-2710-25,CALCIUM CHLORIDE (FOR CODE) 10% IV SOLN,397.5,278.25,,,0
NDC,0517-3020-01,"WATER FOR INJECTION, STERILE INJECTION",24.0,16.8,,,0
NDC,0517-4002-01,PAPAVERINE 30 MG/ML INJ SOLN,486.0,340.2,,,0
NDC,0517-4002-25,PAPAVERINE 30 MG/ML INJ SOLN,243.0,170.1,,,0
NDC,0517-4010-01,PAPAVERINE 30 MG/ML INJ SOLN,220.5,154.35000000000002,,,0
NDC,0517-4300-01,PACLITAXEL-PROTEIN BOUND 100 MG IV SOLR,4094.5,2866.15,,,0
NDC,0517-4601-01,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,80.0,56.0,,,0
NDC,0517-4601-25,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,100.0,70.0,,,0
NDC,0517-4605-25,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,82.0,57.400000000000006,,,0
NDC,0517-4620-25,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,54.5,38.150000000000006,,,0
NDC,0517-4810-01,NITROGLYCERIN 50 MG/10 ML (5 MG/ML) IV SOLN,17.0,11.9,,,0
NDC,0517-4810-25,NITROGLYCERIN 50 MG/10 ML (5 MG/ML) IV SOLN,18.0,12.600000000000001,,,0
NDC,0517-5601-01,HYDROXYZINE 50 MG/ML IM,190.0,133.0,,,0
NDC,0517-5601-25,HYDROXYZINE 50 MG/ML IM,174.0,121.8,,,0
NDC,0517-5602-25,HYDROXYZINE 50 MG/ML IM,239.0,167.3,,,0
NDC,0517-6710-01,CALCIUM CHLORIDE (FOR CODE) 10% IV SOLN,127.0,88.9,,,0
NDC,0517-7305-01,SODIUM PHOSPHATE 3 MMOL/ML IV SOLN,114.0,79.8,,,0
NDC,0517-7504-01,ACETYLCYSTEINE 10 % (100 MG/ML) MISC SOLN,65.5,45.849999999999994,,,0
NDC,0517-7604-01,ACETYLCYSTEINE 20 % (200 MG/ML) MISC SOLN,62.5,43.75,,,0
NDC,0517-9120-01,AMINOCAPROIC ACID 250 MG/ML IV SOLN,86.0,60.2,,,0
NDC,0517-9702-01,DROPERIDOL 2.5 MG/ML INJ SOLN,60.0,42.0,,,0
NDC,0517-9702-25,DROPERIDOL 2.5 MG/ML INJ SOLN,60.0,42.0,,,0
NDC,0527-1282-01,DICYCLOMINE 20 MG ORAL TAB,7.0,4.9,,,0
NDC,0527-1301-01,PRIMIDONE  50 MG ORAL TAB,8.0,5.6,,,0
NDC,0527-1313-01,PILOCARPINE 5 MG TAB,16.0,11.2,,,0
NDC,0527-1326-01,URSODIOL 60 MG/ML ORAL SUSPENSION (REPACK),7.0,4.9,,,0
NDC,0527-1790-01,FLUPHENAZINE 5 MG TAB,90.0,63.0,,,0
NDC,0527-1859-43,SUMATRIPTAN 20 MG/ACTUATION NASL SPRY,345.0,241.5,,,0
NDC,0527-1931-06,CLARITHROMYCIN 250 MG ORAL TAB,46.5,32.55,,,0
NDC,0527-1948-66,LEVOFLOXACIN 250 MG/10 ML ORAL SOLN,341.0,238.7,,,0
NDC,0527-1948-68,LEVOFLOXACIN 250 MG/10 ML ORAL SOLN,341.0,238.7,,,0
NDC,0527-2133-35,POSACONAZOLE 100 MG ORAL TBEC,533.0,373.1,,,0
NDC,0527-2395-32,AZITHROMYCIN 500 MG ORAL TAB,153.0,107.1,,,0
NDC,0527-2425-46,OLMESARTAN  5 MG ORAL TAB,43.5,30.45,,,0
NDC,0527-2427-46,OLMESARTAN 40 MG ORAL TAB,40.5,28.349999999999998,,,0
NDC,0527-3281-46,LEVOTHYROXINE  50 MCG ORAL TAB,5.0,3.5,,,0
NDC,0527-4116-37,PROPRANOLOL  60 MG ORAL CS24,17.5,12.25,,,0
NDC,0527-4117-37,PROPRANOLOL  80 MG ORAL CS24,20.5,14.35,,,0
NDC,0527-4118-37,PROPRANOLOL 120 MG ORAL CS24,25.5,17.85,,,0
NDC,0527-4119-37,PROPRANOLOL 160 MG ORAL CS24,22.0,15.4,,,0
NDC,0527-4591-13,OSELTAMIVIR PHOSPHATE 30 MG ORAL CAP,139.0,97.3,,,0
NDC,0527-5160-82,MYCOPHENOLATE 200 MG/ML ORAL SUSP,83.5,58.45,,,0
NDC,0527-6004-80,LIDOCAINE 4 % MUCOSAL TOPICAL SOLN,275.0,192.5,,,0
NDC,0536-1054-29,ASPIRIN  325 MG ORAL TAB,7.0,4.9,,,0
NDC,0536-1055-56,BENZOYL PEROXIDE  5 % TOP GEL,32.0,22.4,,,0
NDC,0536-1101-45,METHYL SALICYLATE-MENTHOL 15-1 % TOPICAL CREAM,42.0,29.4,,,0
NDC,0536-1142-63,LEVONORGESTREL 1.5 MG ORAL TAB,51.0,35.7,,,0
NDC,0536-1161-37,DEXTROMETHORPHAN-GUAIFENESIN SR 30 MG-600 MG 12 HR TAB,7.0,4.9,,,0
NDC,0536-1163-61,GUAIFENESIN 600 MG ORAL TP12,26.0,18.2,,,0
NDC,0536-1202-07,LIDOCAINE 4% TOP PATCH,15.0,10.5,,,0
NDC,0536-1202-15,LIDOCAINE 4% TOP PATCH,21.0,14.7,,,0
NDC,0536-1211-95,DIBUCAINE 1 % TOP OINT,33.0,23.1,,,0
NDC,0536-1228-58,PHENOL 1.4 % MM SPRA,19.0,13.3,,,0
NDC,0536-1232-01,ASPIRIN  325 MG ORAL TBEC,5.0,3.5,,,0
NDC,0536-1234-41,ASPIRIN   81 MG ORAL TBEC,5.0,3.5,,,0
NDC,0536-1247-01,SENNOSIDES-DOCUSATE SODIUM 8.6 MG-50 MG TAB,5.5,3.85,,,0
NDC,0536-1254-94,SODIUM CHLORIDE  5 % OPHT DROP,30.0,21.0,,,0
NDC,0536-1263-28,BACITRACIN 500 UNIT/G TOP OINT (MERGE),17.0,11.9,,,0
NDC,0536-1265-95,CLOTRIMAZOLE 1 % TOP CREA,20.5,14.35,,,0
NDC,0536-1266-59,SENNOSIDES 8.8 MG/5 ML ORAL SYRP,8.0,5.6,,,0
NDC,0536-1271-80,POVIDONE-IODINE 10 % TOP OINT,10.0,7.0,,,0
NDC,0536-1272-22,CLOTRIMAZOLE 1 % TOP CREA,20.5,14.35,,,0
NDC,0536-1286-36,BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSP,7.0,4.9,,,0
NDC,0536-1288-06,PHENYLEPH-MIN OIL-PETROLATUM 0.25-14-74.9 % RECT OINT,17.0,11.9,,,0
NDC,0536-1303-75,SIMETHICONE 40 MG/0.6 ML ORAL DRPS,7.0,4.9,,,0
NDC,0536-1308-40,OLOPATADINE 0.1 % OPHT DROP,54.0,37.8,,,0
NDC,0536-1314-85,GUAIFENESIN 100 MG/5 ML ORAL LIQD,7.0,4.9,,,0
NDC,0536-1316-28,ZINC OXIDE 20 % TOP OINT (REPACK),13.5,9.45,,,0
NDC,0536-1317-83,ALUM-MAG HYDROXIDE-SIMETH 200 MG-200 MG-20 MG/5 ML ORAL SUSP,7.0,4.9,,,0
NDC,0536-1326-01,ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TAB,5.0,3.5,,,0
NDC,0536-1327-06,ACETAMINOPHEN  325 MG ORAL TAB,5.0,3.5,,,0
NDC,0536-1327-10,ACETAMINOPHEN  325 MG ORAL TAB,4.0,2.8,,,0
NDC,0536-1349-57,METHYL SALICYLATE-MENTHOL 15 %-10 % TOPICAL CREAM,22.0,15.4,,,0
NDC,0536-1362-06,NICOTINE (POLACRILEX) 2 MG BUCL GUM,7.0,4.9,,,0
NDC,0536-1362-25,NICOTINE (POLACRILEX) 2 MG BUCL GUM,7.0,4.9,,,0
NDC,0536-1372-06,NICOTINE (POLACRILEX) 4 MG BUCL GUM,7.0,4.9,,,0
NDC,0536-1427-04,DOCOSANOL 10 % TOP CREAM,92.0,64.4,,,0
NDC,0536-2425-58,PHENOL 1.4 % MM SPRA,17.0,11.9,,,0
NDC,0536-2525-25,CAPSAICIN 0.025 % TOP CREA,56.0,39.2,,,0
NDC,0536-5894-88,NICOTINE  7 MG/24 HR TD PT24,12.0,8.4,,,0
NDC,0536-5895-88,NICOTINE 14 MG/24 HR TD PT24,17.5,12.25,,,0
NDC,0536-5896-88,NICOTINE 21 MG/24 HR TD PT24,18.0,12.600000000000001,,,0
NDC,05446-0607-01,LET TOPICAL GEL 3 ML,56.0,39.2,,,0
NDC,0548-1240-00,PHYTONADIONE 1 MG/0.5 ML INJ SYRG,29.0,20.3,,,0
NDC,0548-3013-00,LIDOCAINE HCL  2 % MM JELP,45.0,31.5,,,0
NDC,0548-5400-00,MEDROXYPROGESTERONE (CONTRACEPTIVE) 150 MG/ML IM SUSP,147.0,102.9,,,0
NDC,0548-5400-25,MEDROXYPROGESTERONE (CONTRACEPTIVE) 150 MG/ML IM (MERGE),147.0,102.9,,,0
NDC,0548-5601-00,ENOXAPARIN 30 MG/0.3 ML SUBQ SYRG,30.0,21.0,,,0
NDC,0548-5603-00,ENOXAPARIN 60 MG/0.6 ML SUBQ SYRG,53.0,37.1,,,0
NDC,0548-5604-00,ENOXAPARIN 80 MG/0.8 ML SUBQ SYRG,36.0,25.2,,,0
NDC,0548-5605-00,ENOXAPARIN 100 MG/1 ML SUBQ SYRG,53.5,37.45,,,0
NDC,0548-5606-00,ENOXAPARIN 120 MG/0.8 ML SUBQ SYRG,106.0,74.2,,,0
NDC,0548-5607-00,ENOXAPARIN 150 MG/1 ML SUBQ SYRG,112.5,78.75,,,0
NDC,0548-5608-00,ENOXAPARIN NEO/PEDIATRIC SYRINGE < 30 MG,21.0,14.7,,,0
NDC,0548-5701-00,MEDROXYPROGESTERONE 150 MG/ML IM SYRG,147.0,102.9,,,0
NDC,0548-5900-00,COSYNTROPIN 0.25 MG INJ SOLR,1151.5,806.0500000000001,,,0
NDC,0548-9061-00,EPINEPHRINE 1 MG/ML INJ SOLN,47.0,32.9,,,0
NDC,0548-9090-10,HYALURONIDASE 150 UNIT INJ SOLR,452.0,316.4,,,0
NDC,0548-9501-00,ISOPROTERENOL 0.2 MG/ML INJECTION,800.0,560.0,,,0
NDC,0548-9502-00,ISOPROTERENOL 0.2 MG/ML INJECTION,1728.0,1209.6,,,0
NDC,0555-0033-02,CHLORDIAZEPOXIDE 10 MG CAP,27.0,18.9,,,0
NDC,0555-0071-02,ISONIAZID 300 MG ORAL TAB,7.0,4.9,,,0
NDC,0555-0159-02,CHLORDIAZEPOXIDE 25 MG CAP,7.5,5.25,,,0
NDC,0555-0159-04,CHLORDIAZEPOXIDE 25 MG CAP,24.0,16.8,,,0
NDC,0555-0572-02,METHOTREXATE SODIUM 2.5 MG ORAL TAB,122.5,85.75,,,0
NDC,0555-0606-02,MEGESTROL 20 MG ORAL TAB,7.0,4.9,,,0
NDC,0555-0607-02,MEGESTROL 40 MG ORAL TAB,10.0,7.0,,,0
NDC,0555-0779-02,MEDROXYPROGESTERONE 10 MG ORAL TAB,7.0,4.9,,,0
NDC,0555-0872-02,MEDROXYPROGESTERONE  2.5 MG ORAL TAB,10.5,7.3500000000000005,,,0
NDC,0555-0873-02,MEDROXYPROGESTERONE  5 MG ORAL TAB,16.0,11.2,,,0
NDC,0555-0886-02,ESTRADIOL 1 MG ORAL TAB,12.0,8.399999999999999,,,0
NDC,0555-1009-16,CLONIDINE 0.1 MG/24 HR TD PTWK,163.0,114.1,,,0
NDC,0573-0179-20,IBUPROFEN 100 MG ORAL CHEW,7.0,4.9,,,0
NDC,0573-1191-20,OXYMETAZOLINE 0.05 % NASAL MERGE,27.0,18.9,,,0
NDC,0573-2871-93,PHENYLEPH-MIN OIL-PETROLATUM 0.25-14-74.9 % RECT OINT,119.0,83.3,,,0
NDC,0574-0106-03,BROMOCRIPTINE 2.5 MG ORAL TAB,34.5,24.150000000000002,,,0
NDC,0574-0107-70,CLOTRIMAZOLE  10 MG MM TROC,9.0,6.3,,,0
NDC,0574-0129-01,CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,42.0,29.4,,,0
NDC,0574-0181-01,POTASSIUM CHLORIDE  10 MEQ ORAL CPSR,12.0,8.4,,,0
NDC,0574-0292-01,AMILORIDE 5 MG ORAL TAB,7.0,4.9,,,0
NDC,0574-0521-74,ACTIVATED CHARCOAL 25 GRAM/120 ML ORAL SUSP,160.0,112.0,,,0
NDC,0574-0521-76,ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSP,40.0,28.0,,,0
NDC,0574-0805-00,ACETYLCYSTEINE 20 % (200 MG/ML) IV SOLN,2437.0,1705.9,,,0
NDC,0574-0805-30,ACETYLCYSTEINE 20 % (200 MG/ML) IV SOLN,2031.0,1421.7,,,0
NDC,0574-0820-01,TESTOSTERONE CYPIONATE 200 MG/ML IM OIL,44.0,30.8,,,0
NDC,0574-0827-01,TESTOSTERONE CYPIONATE 200 MG/ML IM OIL,50.5,35.35,,,0
NDC,0574-0850-05,DIHYDROERGOTAMINE 1 MG/ML INJ SOLN,568.0,397.6,,,0
NDC,0574-2008-15,NYSTATIN  100000 UNIT/G TOP POWD,135.0,94.5,,,0
NDC,0574-4021-35,"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/G EYE OINTMENT",128.0,89.6,,,0
NDC,0574-4024-11,ERYTHROMYCIN 5 MG/G OPHT OINT,49.0,34.3,,,0
NDC,0574-4024-50,ERYTHROMYCIN 5 MG/G OPHT OINT,131.0,91.69999999999999,,,0
NDC,0574-7034-12,ASPIRIN  300 MG RECT SUPP,13.0,9.1,,,0
NDC,0574-7045-01,BELLADONNA ALKALOIDS-OPIUM 16.2 MG-30 MG RECTAL SUPPOSITORY,135.0,94.5,,,0
NDC,0574-7050-12,BISACODYL 10 MG RECT SUPP,7.0,4.9,,,0
NDC,0574-7050-50,BISACODYL 10 MG RECT SUPP,8.0,5.6,,,0
NDC,0574-7226-12,PROCHLORPERAZINE 25 MG RECT SUPP,62.0,43.4,,,0
NDC,0574-9855-10,BUDESONIDE 3 MG ORAL CP24,17.0,11.9,,,0
NDC,0591-0240-01,LORAZEPAM 0.25 MG/0.5 ML (0.5 MG/1 ML) ORAL SUSPENSION (REPACK),11.0,7.7,,,0
NDC,0591-0345-01,VERAPAMIL 120 MG ORAL TAB,7.0,4.9,,,0
NDC,0591-0371-01,LOXAPINE 25 MG CAP,11.0,7.7,,,0
NDC,0591-0407-01,LISINOPRIL 10 MG ORAL TAB,11.0,7.7,,,0
NDC,0591-0444-01,GUANFACINE 1 MG ORAL TAB,12.5,8.75,,,0
NDC,0591-0460-01,GLIPIZIDE  5 MG ORAL TAB,5.5,3.85,,,0
NDC,0591-0461-01,GLIPIZIDE 10 MG ORAL TAB,5.5,3.85,,,0
NDC,0591-0605-01,LABETALOL 100 MG ORAL TAB,8.0,5.6,,,0
NDC,0591-0794-01,DICYCLOMINE 10 MG ORAL CAP,7.0,4.9,,,0
NDC,0591-2258-54,SCOPOLAMINE TRANSDERMAL PATCH 1MG OVER 3 DAYS,119.0,83.3,,,0
NDC,0591-2312-45,ALVIMOPAN 12 MG ORAL CAP,711.0,497.7,,,0
NDC,0591-2472-60,TAMOXIFEN 10 MG ORAL TAB,26.5,18.549999999999997,,,0
NDC,0591-2520-01,CHLORZOXAZONE 500 MG ORAL TAB,7.0,4.9,,,0
NDC,0591-2579-20,VALGANCICLOVIR 50 MG/ML ORAL SOLR,38.0,26.6,,,0
NDC,0591-2715-01,METHYLPHENIDATE 18 MG ORAL TO24,75.0,52.5,,,0
NDC,0591-3128-79,PROGESTERONE 50 MG/ML IM OIL,190.0,133.0,,,0
NDC,0591-3213-54,FENTANYL  75 MCG/HR TD PT72,197.0,137.9,,,0
NDC,0591-3540-60,BUPROPION HCL 100 MG ORAL TBSR,14.5,10.15,,,0
NDC,0591-3541-60,BUPROPION HCL 150 MG ORAL TBSR,27.5,19.25,,,0
NDC,0591-4012-01,VALPROIC ACID 250 MG ORAL CAP,11.5,8.05,,,0
NDC,0591-5335-01,TRIHEXYPHENIDYL 2 MG ORAL TAB,7.0,4.9,,,0
NDC,0591-5347-01,PROBENECID 500 MG ORAL TAB,7.0,4.9,,,0
NDC,0591-5443-01,PREDNISONE 20 MG ORAL TAB,5.5,3.85,,,0
NDC,0591-5555-01,PROPRANOLOL  20 MG ORAL TAB,12.0,8.4,,,0
NDC,0591-5658-01,CYCLOBENZAPRINE 10 MG ORAL TAB,7.0,4.9,,,0
NDC,0591-5694-60,MINOCYCLINE  50 MG ORAL CAP,10.0,7.0,,,0
NDC,0597-0024-02,IPRATROPIUM-ALBUTEROL 20-100 MCG/ACTUATION INHL MIST,1371.5,960.05,,,0
NDC,0597-0053-45,GLUCAGON 1 MG/ML INJ (MERGE),742.0,519.4,,,0
NDC,0597-0075-75,TIOTROPIUM BROMIDE 18 MCG INHL CPDV,96.0,67.2,,,0
NDC,0597-0087-17,IPRATROPIUM BROMIDE 17 MCG/ACTUATION INHL AERO,21.0,14.7,,,0
NDC,0597-0100-51,TIOTROPIUM BROMIDE 2.5 MCG/ACTUATION INHL MIST,382.0,267.4,,,0
NDC,0597-0100-61,TIOTROPIUM BROMIDE 2.5 MCG/ACTUATION INHL MIST,1456.0,1019.2,,,0
NDC,0597-0160-61,TIOTROPIUM BROMIDE 1.25 MCG/ACTUATION INHL MIST,7.0,4.9,,,0
NDC,0597-0183-90,PRAMIPEXOLE 0.125 MG ORAL TAB,115.0,80.5,,,0
NDC,0597-0355-56,DABIGATRAN  75 MG ORAL CAP,33.0,23.1,,,0
NDC,0597-0360-82,DABIGATRAN  150 MG ORAL CAP,22.0,15.4,,,0
NDC,0603-0441-50,BACITRACIN 500 UNIT/G TOP OINT (MERGE),33.0,23.1,,,0
NDC,0603-0599-50,POVIDONE-IODINE 10 % TOP OINT,36.0,25.2,,,0
NDC,0603-0823-54,MAGIC MOUTHWASH REPACK (BMX 1:1:1),22.5,15.75,,,0
NDC,0603-0823-58,MAGIC MOUTHWASH REPACK (BMX 1:1:1),78.0,54.6,,,0
NDC,0603-0894-50,SIMETHICONE 40 MG/0.6 ML ORAL DRPS,7.0,4.9,,,0
NDC,0603-1075-58,CODEINE-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD (REPACK),7.0,4.9,,,0
NDC,0603-1378-58,LACTULOSE 10 GRAM/15 ML ORAL SOLN,108.0,75.6,,,0
NDC,0603-1393-64,LIDOCAINE 2 % MUCOSAL SOLN (VISCOUS),20.0,14.0,,,0
NDC,0603-1841-58,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SYRP,7.0,4.9,,,0
NDC,0603-2438-21,BENZTROPINE 1 MG ORAL TAB,7.0,4.9,,,0
NDC,0603-3340-21,DIPHENHYDRAMINE 50 MG CAP,7.0,4.9,,,0
NDC,0603-3901-21,HYDROCORTISONE 20 MG ORAL TAB,7.0,4.9,,,0
NDC,0603-5062-21,PERPHENAZINE  8 MG ORAL TAB,22.0,15.4,,,0
NDC,0603-5335-21,PREDNISONE  1 MG ORAL TAB,5.5,3.85,,,0
NDC,0603-7818-74,NYSTATIN  100000 UNIT/G TOP CREA,86.0,60.2,,,0
NDC,0603-7862-74,TRIAMCINOLONE ACETONIDE 0.1 % TOP CREAM,31.0,21.7,,,0
NDC,0641-0367-21,DEXAMETHASONE 10 MG/ML INJECTION,17.5,12.25,,,0
NDC,0641-0367-25,DEXAMETHASONE 10 MG/ML INJECTION,16.0,11.2,,,0
NDC,0641-0376-21,DIPHENHYDRAMINE 50 MG/ML INJECTION,20.0,14.0,,,0
NDC,0641-0376-25,DIPHENHYDRAMINE 50 MG/ML INJECTION,16.0,11.2,,,0
NDC,0641-0400-12,HEPARIN (PORCINE)  5000 UNIT/ML INJ SOLN,18.0,12.6,,,0
NDC,0641-0400-37,HEPARIN (PORCINE)  5000 UNIT/ML INJ SOLN,16.5,11.55,,,0
NDC,0641-0410-12,HEPARIN (PORCINE) 10000 UNIT/ML INJ SOLN,35.0,24.5,,,0
NDC,0641-0410-37,HEPARIN (PORCINE) 10000 UNIT/ML INJ SOLN,35.0,24.5,,,0
NDC,0641-0476-21,PHENOBARBITAL SODIUM  65 MG/ML INJ SOLN,310.0,217.0,,,0
NDC,0641-0477-21,PHENOBARBITAL SODIUM 130 MG/ML INJ SOLN,1045.0,731.5,,,0
NDC,0641-0477-25,PHENOBARBITAL SODIUM 130 MG/ML INJ SOLN,697.0,487.9,,,0
NDC,0641-0928-21,PROMETHAZINE 25 MG/ML INJ SOLN,20.5,14.35,,,0
NDC,0641-1397-31,CHLORPROMAZINE 25 MG/ML INJ SOLN,340.0,238.0,,,0
NDC,0641-1397-35,CHLORPROMAZINE 25 MG/ML INJ SOLN,170.0,119.0,,,0
NDC,0641-1398-31,CHLORPROMAZINE 25 MG/ML INJ SOLN,292.0,204.4,,,0
NDC,0641-1410-31,DIGOXIN 250 MCG/ML INJ SOLN,26.5,18.549999999999997,,,0
NDC,0641-1495-31,PROMETHAZINE 25 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,0641-2555-41,PHENYTOIN SODIUM 50 MG/ML IV SOLN,67.0,46.9,,,0
NDC,0641-6001-01,LORAZEPAM 2 MG/ML IV SOLN (PHS MERGE - ALL SITES),21.0,14.7,,,0
NDC,0641-6001-25,LORAZEPAM 2 MG/ML IV SOLN (PHS MERGE - ALL SITES),16.0,11.2,,,0
NDC,0641-6007-01,BUMETANIDE 0.25 MG/ML INJ SOLN,88.0,61.6,,,0
NDC,0641-6008-01,BUMETANIDE 0.25 MG/ML INJ SOLN,51.0,35.7,,,0
NDC,0641-6008-10,BUMETANIDE 0.25 MG/ML INJ SOLN,51.0,35.7,,,0
NDC,0641-6013-01,DILTIAZEM 5 MG/ML IV,46.0,32.2,,,0
NDC,0641-6014-01,DILTIAZEM 5 MG/ML IV,42.0,29.4,,,0
NDC,0641-6015-01,DILTIAZEM 5 MG/ML IV,134.5,94.15,,,0
NDC,0641-6020-01,MORPHINE (PF-DURAMORPH/ASTRAMORPH) 0.5 MG/ML INJ SOLN,255.0,178.5,,,0
NDC,0641-6022-01,FAMOTIDINE (PF) 20 MG/2 ML IV SOLN,12.0,8.399999999999999,,,0
NDC,0641-6025-01,FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN,24.0,16.799999999999997,,,0
NDC,0641-6027-01,FENTANYL CITRATE (PF) 50 MCG/ML (ANESTHESIA INTRAOP ONLY),50.0,35.0,,,0
NDC,0641-6027-25,FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN,29.0,20.3,,,0
NDC,0641-6028-01,FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN,30.0,21.0,,,0
NDC,0641-6030-01,FENTANYL CITRATE (PF) 50 MCG/ML INJ (REPACK)(MERGE) (FOR PCA),147.0,102.9,,,0
NDC,0641-6033-01,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,0641-6041-01,KETOROLAC TROMETHAMINE 15 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,0641-6042-01,KETOROLAC TROMETHAMINE 30 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,0641-6042-25,KETOROLAC TROMETHAMINE 30 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,0641-6044-01,LORAZEPAM 2 MG/ML IV SOLN (PHS MERGE - ALL SITES),21.0,14.7,,,0
NDC,0641-6044-25,LORAZEPAM 2 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,0641-6046-01,LORAZEPAM NEONATAL INJECTION 0.2 MG/0.5 ML,69.0,48.3,,,0
NDC,0641-6052-01,MEPERIDINE (PF) 25 MG/ML IV SOLN (PHS MERGE),25.5,17.85,,,0
NDC,0641-6053-01,MEPERIDINE (PF) 50 MG/ML IV SOLN (PHS MERGE),18.0,12.6,,,0
NDC,0641-6054-01,MEPERIDINE (PF) 100 MG/ML IV SOLN (PHS MERGE),16.0,11.2,,,0
NDC,0641-6057-01,MIDAZOLAM 1 MG/ML INJ SOLN,8.5,5.949999999999999,,,0
NDC,0641-6059-01,MIDAZOLAM 1 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,0641-6060-01,MIDAZOLAM 250 MG/50 ML CONCENTRATED DRIP (RSE),162.0,113.4,,,0
NDC,0641-6061-01,MIDAZOLAM 5 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,0641-6070-01,MORPHINE 10 MG/ML IV SOLN (PHS/CDS MERGE),16.0,11.2,,,0
NDC,0641-6078-01,ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN,12.0,8.399999999999999,,,0
NDC,0641-6078-25,ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN,16.0,11.2,,,0
NDC,0641-6084-01,PROMETHAZINE 25 MG/ML INJ SOLN,23.0,16.1,,,0
NDC,0641-6084-25,PROMETHAZINE 25 MG/ML INJ SOLN,19.5,13.65,,,0
NDC,0641-6103-01,METHOCARBAMOL 100 MG/ML INJ SOLN,124.0,86.8,,,0
NDC,0641-6103-25,METHOCARBAMOL 100 MG/ML INJ SOLN,83.0,58.1,,,0
NDC,0641-6104-01,GLYCOPYRROLATE 0.2 MG/ML ORAL SOLUTION (CDS),39.0,27.3,,,0
NDC,0641-6116-01,AMPICILLIN-SULBACTAM  1.5 GRAM INJ SOLR,42.0,29.400000000000002,,,0
NDC,0641-6117-01,AMPICILLIN-SULBACTAM  3 GRAM INJ SOLR,51.0,35.7,,,0
NDC,0641-6125-01,MORPHINE 4 MG/ML IV SOLN (PHS/CDS MERGE),27.5,19.25,,,0
NDC,0641-6125-25,MORPHINE 4 MG/ML IV SOLN (PHS/CDS MERGE),17.0,11.9,,,0
NDC,0641-6127-01,MORPHINE 10 MG/ML (PF) IV SOLN,16.5,11.55,,,0
NDC,0641-6132-01,NALOXONE 0.4 MG/ML INJ SOLN,80.0,56.0,,,0
NDC,0641-6135-01,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN,29.0,20.3,,,0
NDC,0641-6135-25,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN,37.0,25.9,,,0
NDC,0641-6136-01,FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN,66.0,46.2,,,0
NDC,0641-6137-01,FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN,532.0,372.4,,,0
NDC,0641-6142-01,PHENYLEPHRINE 10 MG/ML INJECTION,881.0,616.7,,,0
NDC,0641-6142-25,PHENYLEPHRINE 10 MG/ML INJECTION,67.0,46.900000000000006,,,0
NDC,0641-6145-01,DEXAMETHASONE 4 MG/ML INJECTION,16.0,11.2,,,0
NDC,0641-6145-25,DEXAMETHASONE 4 MG/ML INJECTION,16.0,11.2,,,0
NDC,0641-6146-01,DEXAMETHASONE 4 MG/ML INJECTION,16.0,11.2,,,0
NDC,0641-6147-01,"WATER FOR INJECTION, STERILE INJECTION",31.5,22.049999999999997,,,0
NDC,0641-6173-01,DICYCLOMINE 10 MG/ML IM SOLN,107.5,75.25,,,0
NDC,0641-6174-01,OCTREOTIDE ACETATE   50 MCG/ML INJ SOLN,75.0,52.5,,,0
NDC,0641-6174-10,OCTREOTIDE ACETATE   50 MCG/ML INJ SOLN,60.0,42.0,,,0
NDC,0641-6175-01,OCTREOTIDE ACETATE  100 MCG/ML INJ SOLN,33.0,23.1,,,0
NDC,0641-6176-01,OCTREOTIDE ACETATE  500 MCG/ML INJ SOLN,83.0,58.099999999999994,,,0
NDC,0641-6182-01,ORPHENADRINE CITRATE 30 MG/ML INJ SOLN,733.0,513.1,,,0
NDC,0641-6182-10,ORPHENADRINE CITRATE 30 MG/ML INJ SOLN,69.0,48.300000000000004,,,0
NDC,0641-6188-01,PHENYLEPHRINE 10 MG/ML INJECTION,106.0,74.19999999999999,,,0
NDC,0641-6196-01,PROPOFOL 10 MG/ML 100ML INFUSION IV EMUL,177.0,123.9,,,0
NDC,0641-6206-01,HYDROMORPHONE 0.5 MG/0.5 ML INJ SYRG (PHS ERX MERGE),34.0,23.8,,,0
NDC,0641-6207-01,LORAZEPAM 2 MG/ML INJ SOLN,18.0,12.6,,,0
NDC,0641-6208-01,PROMETHAZINE 25 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,0641-6228-01,THIAMINE 100 MG/ML INJECTION,59.0,41.3,,,0
NDC,0641-6231-01,HYDRALAZINE 20 MG/ML INJ SOLN,41.0,28.7,,,0
NDC,0641-6236-01,EPHEDRINE SULFATE  25 MG/5 ML (5 MG/ML) IV SYRG (MERGE),73.0,51.1,,,0
NDC,0641-6244-01,DIAZEPAM 5 MG/ML INJ SYRG,578.0,404.6,,,0
NDC,0641-6253-01,REGADENOSON 0.4 MG/5 ML IV SYRG,177.0,123.9,,,0
NDC,0641-6262-01,SODIUM ACETATE 2 MEQ/ML IV SOLN,2.0,1.4,,,0
NDC,0641-6266-01,METHADONE 10 MG/ML INJ SOLN,33.0,23.1,,,0
NDC,0703-0018-01,HYDROMORPHONE (PF) 10 MG/ML INJ SOLN,224.0,156.8,,,0
NDC,0703-0031-01,METHYLPREDNISOLONE 40 MG/ML SUSP (DEPO-MEDROL) INJECTION,52.0,36.4,,,0
NDC,0703-0113-01,HYDROMORPHONE (PF) 10 MG/ML INJ SOLN,111.0,77.7,,,0
NDC,0703-0241-01,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,81.0,56.699999999999996,,,0
NDC,0703-0243-01,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,49.0,34.3,,,0
NDC,0703-1153-01,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,264.5,185.15,,,0
NDC,0703-1501-02,ALPROSTADIL 500 MCG/ML INJ SOLN,469.0,328.3,,,0
NDC,0703-2914-01,VECURONIUM BROMIDE 10 MG IV SOLR,38.0,26.6,,,0
NDC,0703-3155-01,BLEOMYCIN 30 UNIT INJ SOLR,459.0,321.3,,,0
NDC,0703-3217-01,PACLITAXEL 6 MG/ML IV CONC,324.5,227.15,,,0
NDC,0703-3671-01,METHOTREXATE NA (PRESERV FREE) 25 MG/ML INJ SOLN,4920.0,3444.0,,,0
NDC,0703-3675-01,METHOTREXATE SODIUM 25 MG/ML INJ SOLN,35.0,24.5,,,0
NDC,0703-3678-01,METHOTREXATE NA (PRESERV FREE) 25 MG/ML INJ SOLN,712.5,498.75,,,0
NDC,0703-4094-01,PALONOSETRON 0.25 MG/5 ML IV INJECTION (MERGE),206.0,144.2,,,0
NDC,0703-4239-01,CARBOPLATIN 10 MG/ML IV,231.5,162.05,,,0
NDC,0703-4246-01,CARBOPLATIN 10 MG/ML IV,247.0,172.9,,,0
NDC,0703-4248-01,CARBOPLATIN 10 MG/ML IV,496.5,347.54999999999995,,,0
NDC,0703-4412-11,VINCRISTINE 2 MG/2 ML IV SOLN,177.0,123.9,,,0
NDC,0703-4502-01,METOCLOPRAMIDE  5 MG/ML INJ SOLN,23.0,16.1,,,0
NDC,0703-4766-01,PACLITAXEL 6 MG/ML IV CONC,230.0,161.0,,,0
NDC,0703-4768-01,PACLITAXEL 6 MG/ML IV CONC,549.0,384.3,,,0
NDC,0703-5653-01,ETOPOSIDE 20 MG/ML IV SOLN,44.5,31.15,,,0
NDC,0703-5747-11,CISPLATIN 1 MG/ML IV,83.0,58.1,,,0
NDC,0703-5748-11,CISPLATIN 1 MG/ML IV,132.0,92.4,,,0
NDC,0703-6801-01,MEDROXYPROGESTERONE (CONTRACEPTIVE) 150 MG/ML IM (MERGE),415.0,290.5,,,0
NDC,0703-9514-01,TRIMETHOPRIM-SULFAMETHOXAZOLE 80 MG-400 MG/5 ML IV,184.5,129.14999999999998,,,0
NDC,0703-9514-03,TRIMETHOPRIM-SULFAMETHOXAZOLE 80 MG-400 MG/5 ML IV,148.0,103.6,,,0
NDC,0703-9526-01,TRIMETHOPRIM-SULFAMETHOXAZOLE 80 MG-400 MG/5 ML IV,331.5,232.04999999999998,,,0
NDC,0713-0118-06,ACETAMINOPHEN  120 MG RECT SUPP,7.5,5.25,,,0
NDC,0713-0164-06,ACETAMINOPHEN  325 MG RECT SUPP,8.0,5.6,,,0
NDC,0713-0268-31,NEOMYCIN-BACITRACIN ZN-POLYMYXIN 3.5 MG-400 UN*,30.0,21.0,,,0
NDC,0713-0280-31,BACITRACIN 500 UNIT/G TOP OINT (MERGE),20.0,14.0,,,0
NDC,0713-0351-02,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN,22.0,15.4,,,0
NDC,0713-0503-06,HYDROCORTISONE ACETATE 25 MG RECT SUPP,111.0,77.7,,,0
NDC,0713-0503-12,HYDROCORTISONE ACETATE 25 MG RECT SUPP,111.0,77.7,,,0
NDC,0713-0536-06,PROMETHAZINE 12.5 MG RECT SUPP,87.0,60.9,,,0
NDC,0713-0574-60,METRONIDAZOLE 1 % TOP GEL,818.0,572.6,,,0
NDC,0713-0676-53,TRIAMCINOLONE ACETONIDE 0.1 % TOP LOTN,382.0,267.4,,,0
NDC,0713-0678-15,NYSTATIN  100000 UNIT/G TOP CREA,86.0,60.2,,,0
NDC,0713-0882-30,PRASUGREL 10 MG ORAL TAB,120.0,84.0,,,0
NDC,0766-0801-00,DOCOSANOL 10 % TOP CREAM,70.0,49.0,,,0
NDC,0766-0801-35,DOCOSANOL 10 % TOP CREAM,70.0,49.0,,,0
NDC,0781-1061-01,ALPRAZOLAM 0.25 MG ORAL TAB,8.0,5.6,,,0
NDC,0781-1077-01,ALPRAZOLAM 0.5 MG ORAL TAB,10.0,7.0,,,0
NDC,0781-1078-01,ATENOLOL 2MG/ML SUSP (REPACK),7.0,4.9,,,0
NDC,0781-1556-01,ISOSORBIDE DINITRATE 10 MG ORAL TAB,13.0,9.1,,,0
NDC,0781-1695-01,ISOSORBIDE DINITRATE 20 MG ORAL TAB,10.5,7.3500000000000005,,,0
NDC,0781-1818-01,FUROSEMIDE 20 MG ORAL TAB,7.0,4.9,,,0
NDC,0781-1831-01,AMOXICILLIN-POT CLAVULANATE 500 MG-125 MG TAB,21.0,14.7,,,0
NDC,0781-1831-20,AMOXICILLIN-POT CLAVULANATE 500 MG-125 MG TAB,16.0,11.2,,,0
NDC,0781-1852-20,AMOXICILLIN-POT CLAVULANATE 875 MG-125 MG TAB,28.0,19.6,,,0
NDC,0781-2020-01,AMOXICILLIN 250 MG ORAL CAP,26.0,18.2,,,0
NDC,0781-2048-01,AMANTADINE 100 MG ORAL CAP,12.0,8.4,,,0
NDC,0781-2053-01,TERAZOSIN  5 MG ORAL CAP,13.5,9.45,,,0
NDC,0781-2074-01,TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5 MG-25 MG CAP,7.0,4.9,,,0
NDC,0781-2321-06,APREPITANT  40 MG ORAL CAP,594.0,415.79999999999995,,,0
NDC,0781-2823-01,FLUOXETINE 10 MG ORAL CAP,22.0,15.4,,,0
NDC,0781-3000-94,MEROPENEM 500 MG IV SOLR,90.0,63.0,,,0
NDC,0781-3000-95,MEROPENEM 500 MG IV SOLR,134.5,94.15,,,0
NDC,0781-3040-72,PYRIDOSTIGMINE BROMIDE 5 MG/ML INJ SOLN,188.0,131.6,,,0
NDC,0781-3040-95,PYRIDOSTIGMINE BROMIDE 5 MG/ML INJ SOLN,188.0,131.6,,,0
NDC,0781-3059-72,DIGOXIN 250 MCG/ML INJ SOLN,19.0,13.3,,,0
NDC,0781-3098-94,MEROPENEM 1 GRAM IV SOLR,179.0,125.3,,,0
NDC,0781-3098-95,MEROPENEM 1 GRAM IV SOLR,179.0,125.3,,,0
NDC,0781-3113-90,PIPERACILLIN-TAZOBACTAM  3.375 GRAM IV SOLR,91.0,63.7,,,0
NDC,0781-3114-91,PIPERACILLIN-TAZOBACTAM  4.5 GRAM IV SOLR,115.0,80.5,,,0
NDC,0781-3152-70,CISATRACURIUM  2 MG/ML IV SOLN,3094.0,2165.8,,,0
NDC,0781-3153-80,CISATRACURIUM 10 MG/ML IV SOLN,2016.0,1411.2,,,0
NDC,0781-3154-01,FERUMOXYTOL 510 MG/17 ML (30 MG/ML) IV SOLN,3748.5,2623.95,,,0
NDC,0781-3156-06,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN FOR PERI-OPERATIVE",106.0,74.2,,,0
NDC,0781-3158-94,BIVALIRUDIN 250 MG IV SOLR,2616.0,1831.2,,,0
NDC,0781-3159-72,OLANZAPINE 10 MG IM SOLR,76.5,53.550000000000004,,,0
NDC,0781-3177-80,CEFTAZIDIME NEO IV SYRINGE (CDS MIXTURE),20.5,14.35,,,0
NDC,0781-3206-85,CEFTRIAXONE 250 MG INJ SOLR,218.5,152.95,,,0
NDC,0781-3206-95,CEFTRIAXONE 250 MG INJ SOLR,146.0,102.2,,,0
NDC,0781-3208-85,CEFTRIAXONE 1 GRAM INJ SOLR,337.5,236.25,,,0
NDC,0781-3209-90,CEFTRIAXONE   2 GRAM INJ SOLR,194.0,135.8,,,0
NDC,0781-3209-95,CEFTRIAXONE   2 GRAM INJ SOLR,388.0,271.6,,,0
NDC,0781-3220-70,ROCURONIUM 10 MG/ML IV SOLN,370.0,259.0,,,0
NDC,0781-3220-75,ROCURONIUM 10 MG/ML IV SOLN,145.0,101.5,,,0
NDC,0781-3220-92,ROCURONIUM 10 MG/ML IV SOLN,93.0,65.1,,,0
NDC,0781-3232-94,PANTOPRAZOLE 40 MG IV SOLR,51.0,35.7,,,0
NDC,0781-3233-94,CYCLOPHOSPHAMIDE 500 MG IV SOLR,322.0,225.4,,,0
NDC,0781-3244-94,CYCLOPHOSPHAMIDE 20 MG/ML IN NS,1066.5,746.55,,,0
NDC,0781-3246-02,ENOXAPARIN 60 MG/0.6 ML SUBQ SYRG,82.0,57.4,,,0
NDC,0781-3246-64,ENOXAPARIN 40 MG/0.4 ML SUBQ SYRG,55.0,38.5,,,0
NDC,0781-3255-94,CYCLOPHOSPHAMIDE 2 GRAM IV SOLUTION,3029.0,2120.3,,,0
NDC,0781-3267-90,MEROPENEM NEO/PED INFUSION (CDS MIXTURE),108.0,75.6,,,0
NDC,0781-3268-05,ENOXAPARIN 100 MG/1 ML SUBQ SYRG,137.0,95.9,,,0
NDC,0781-3269-71,EPHEDRINE 50 MG/ML IV SOLN (MERGE),376.5,263.54999999999995,,,0
NDC,0781-3288-91,CLINDAMYCIN IN D5W 300 MG/50 ML IV PGBK,55.0,38.5,,,0
NDC,0781-3289-91,CLINDAMYCIN PEDS IV INFUSION 12 MG/ML (CDS MIXTURE FROM PREMIX),55.0,38.5,,,0
NDC,0781-3290-91,CLINDAMYCIN IN D5W 900 MG/50 ML IV PGBK,50.0,35.0,,,0
NDC,0781-3402-78,AMPICILLIN 250 MG SOLUTION FOR INJECTION,47.0,32.9,,,0
NDC,0781-3404-85,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,48.0,33.6,,,0
NDC,0781-3404-95,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,48.0,33.6,,,0
NDC,0781-3407-78,AMPICILLIN 500 MG SOLUTION FOR INJECTION,25.0,17.5,,,0
NDC,0781-3408-80,AMPICILLIN SODIUM  2 GRAM INJ SOLR,82.0,57.4,,,0
NDC,0781-3411-70,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ (MERGE),59.0,41.3,,,0
NDC,0781-3416-94,VORICONAZOLE 200 MG IV SOLN,761.0,532.7,,,0
NDC,0781-3422-92,PHENYLEPHRINE 10 MG/ML INJECTION,16.0,11.2,,,0
NDC,0781-3433-46,LINEZOLID NEO IV SYRINGE (CDS MIXTURE),331.0,231.7,,,0
NDC,0781-3440-71,COSYNTROPIN 0.25 MG INJ SOLR,141.5,99.05,,,0
NDC,0781-3451-70,CEFAZOLIN PEDS SYRINGE (20MG/ML) IN DEXTROSE (CDS MIX,76.5,53.55,,,0
NDC,0781-3458-75,PHENYLEPHRINE 10 MG/ML INJECTION,216.0,151.2,,,0
NDC,0781-3532-01,FULVESTRANT 250 MG/5 ML IM SYRG,5018.0,3512.6,,,0
NDC,0781-3532-12,FULVESTRANT 250 MG/5 ML IM SYRG,5017.5,3512.25,,,0
NDC,0781-4003-32,LEUPROLIDE 1 MG/0.2 ML SUBQ KIT,74.0,51.8,,,0
NDC,0781-4004-36,SOMATROPIN  5.8 MG SUBQ SOLR,1207.0,844.9,,,0
NDC,0781-5221-01,CARVEDILOL  3.125 MG ORAL TAB,18.0,12.600000000000001,,,0
NDC,0781-5311-06,RISPERIDONE 1 MG ORAL TBDL,56.0,39.2,,,0
NDC,0781-5317-01,ZOLPIDEM  5 MG ORAL TAB,39.0,27.299999999999997,,,0
NDC,0781-5668-31,VORICONAZOLE 200 MG ORAL TAB,230.0,161.0,,,0
NDC,0781-5690-92,EZETIMIBE 10 MG ORAL TAB,15.0,10.5,,,0
NDC,0781-5994-01,HYDROXYCHLOROQUINE 200 MG ORAL TAB,28.5,19.950000000000003,,,0
NDC,0781-6023-46,CLARITHROMYCIN 250 MG/5 ML ORAL SUSR,107.0,74.9,,,0
NDC,0781-6041-46,AMOXICILLIN 250 MG/5 ML ORAL SUSR,7.0,4.9,,,0
NDC,0781-6041-55,AMOXICILLIN 250 MG/5 ML ORAL SUSR,7.0,4.9,,,0
NDC,0781-6041-58,AMOXICILLIN 250 MG/5 ML ORAL SUSR,7.0,4.9,,,0
NDC,0781-6135-94,PENICILLIN G POTASSIUM  5000000 UNIT INJ SOLR,32.0,22.4,,,0
NDC,0781-6136-94,PENICILLIN G POTASSIUM 20000000 UNIT INJ SOLR,252.0,176.4,,,0
NDC,0781-6186-67,"CIPROFLOXACIN-DEXAMETHASONE 0.3 %-0.1 % EAR DROPS, SUSP",827.0,578.9,,,0
NDC,0781-7077-87,METRONIDAZOLE 0.75 % VAGL GEL,551.0,385.7,,,0
NDC,0781-7296-85,ALBUTEROL SULFATE 90 MCG/ACTUATION INHL HFAA,9.0,6.3,,,0
NDC,0781-8046-01,PERPHENAZINE  2 MG ORAL TAB,20.0,14.0,,,0
NDC,0781-8048-01,PERPHENAZINE  8 MG ORAL TAB,17.0,11.9,,,0
NDC,0832-0038-89,OXYBUTYNIN CHLORIDE  5 MG ORAL TAB,17.0,11.899999999999999,,,0
NDC,0832-0465-15,NYSTATIN  100000 UNIT/G TOP POWD,184.0,128.8,,,0
NDC,0832-0511-89,BETHANECHOL CHLORIDE 10 MG ORAL TAB,23.0,16.1,,,0
NDC,0832-0512-89,BETHANECHOL CHLORIDE 25 MG ORAL TAB,15.0,10.5,,,0
NDC,0832-0540-11,BUMETANIDE 0.5 MG ORAL TAB,20.5,14.35,,,0
NDC,0832-0590-11,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TAB,7.0,4.9,,,0
NDC,0832-1015-00,AMANTADINE 100 MG ORAL CAP,12.0,8.4,,,0
NDC,0832-1211-89,WARFARIN 1 MG ORAL TAB,12.0,8.4,,,0
NDC,0832-1213-89,WARFARIN  2.5 MG ORAL TAB,7.5,5.25,,,0
NDC,0832-1216-89,WARFARIN  5 MG ORAL TAB,7.0,4.9,,,0
NDC,0832-1410-03,MOXIFLOXACIN 0.5 % OPHT DROP,603.0,422.1,,,0
NDC,0832-1520-89,HALOPERIDOL  1 MG ORAL TAB,11.0,7.7,,,0
NDC,0832-1671-11,FLUVOXAMINE  50 MG ORAL TAB,39.5,27.65,,,0
NDC,0832-6045-50,FAMOTIDINE 40 MG/5 ML ORAL SUSP,7.0,4.9,,,0
NDC,0832-7123-89,DIVALPROEX 250 MG ORAL TBEC,9.5,6.65,,,0
NDC,0832-7124-89,DIVALPROEX 500 MG ORAL TBEC,14.0,9.8,,,0
NDC,0904-0430-04,DOXYCYCLINE HYCLATE 100 MG ORAL TAB,26.0,18.2,,,0
NDC,0904-0430-06,DOXYCYCLINE HYCLATE 100 MG ORAL TAB,109.5,76.65,,,0
NDC,0904-0734-31,NEOMYCIN-BACITRACIN ZN-POLYMYXIN 3.5 MG-400 UN*,18.0,12.6,,,0
NDC,0904-1313-09,BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSP,7.0,4.9,,,0
NDC,0904-1315-46,BISMUTH SUBSALICYLATE 262 MG ORAL CHEW,7.0,4.9,,,0
NDC,0904-1771-21,PHENOL-PHENOLATE SODIUM AEROSOL,14.0,9.8,,,0
NDC,0904-1982-61,ACETAMINOPHEN  325 MG ORAL TAB,5.0,3.5,,,0
NDC,0904-2051-59,DIMENHYDRINATE 50 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-2056-61,DIPHENHYDRAMINE 50 MG CAP,7.0,4.9,,,0
NDC,0904-2533-21,CALAMINE-ZINC OXIDE 8 %-8 % TOPICAL SUSP,13.0,9.1,,,0
NDC,0904-2725-61,TRIMETHOPRIM-SULFAMETHOXAZOLE 160 MG-800 MG TAB,21.0,14.7,,,0
NDC,0904-2924-61,VERAPAMIL 120 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-3854-61,CARBAMAZEPINE 100 MG ORAL CHEW,13.0,9.1,,,0
NDC,0904-3865-75,SODIUM CHLORIDE  0.65 % NASL SPRA,7.0,4.9,,,0
NDC,0904-5053-59,PSEUDOEPHEDRINE 30 MG TAB,7.0,4.9,,,0
NDC,0904-5154-60,GUAIFENESIN  200 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-5306-61,DIPHENHYDRAMINE 25 MG CAP,7.0,4.9,,,0
NDC,0904-5448-61,PENTOXIFYLLINE 400 MG ORAL TBSR,8.0,5.6,,,0
NDC,0904-5522-61,DOXAZOSIN 1 MG ORAL TAB,9.5,6.65,,,0
NDC,0904-5523-61,DOXAZOSIN 2 MG ORAL TAB,7.5,5.25,,,0
NDC,0904-5524-61,DOXAZOSIN 4 MG ORAL TAB,10.5,7.35,,,0
NDC,0904-5677-61,PAROXETINE 20 MG TAB,29.0,20.3,,,0
NDC,0904-5711-35,OXYMETAZOLINE 0.05 % NASAL MERGE,12.0,8.4,,,0
NDC,0904-5725-14,ALUM-MAG HYDROXIDE-SIMETH 400 MG-400 MG-40 MG/5 ML ORAL SUSP,7.0,4.9,,,0
NDC,0904-5784-61,FLUOXETINE 10 MG ORAL CAP,27.0,18.9,,,0
NDC,0904-5785-61,FLUOXETINE 20 MG ORAL CAP,28.0,19.6,,,0
NDC,0904-5789-61,ACYCLOVIR 200 MG ORAL CAP,17.0,11.9,,,0
NDC,0904-5791-46,ACETAMINOPHEN   80 MG ORAL CHEW,7.0,4.9,,,0
NDC,0904-5797-61,FUROSEMIDE 40 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-5798-61,FUROSEMIDE 80 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-5852-61,CETIRIZINE 10 MG ORAL TAB,14.0,9.8,,,0
NDC,0904-5853-61,IBUPROFEN 400 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-5854-61,IBUPROFEN 600 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-5855-60,IBUPROFEN 800 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-5855-61,IBUPROFEN 800 MG ORAL TAB,20.0,14.0,,,0
NDC,0904-5889-61,THEOPHYLLINE 300 MG ORAL TB12,7.0,4.9,,,0
NDC,0904-5891-61,PRAVASTATIN 10 MG ORAL TAB,21.0,14.7,,,0
NDC,0904-5892-61,PRAVASTATIN 20 MG ORAL TAB,24.5,17.15,,,0
NDC,0904-5893-61,PRAVASTATIN 40 MG ORAL TAB,36.0,25.200000000000003,,,0
NDC,0904-5921-61,DIGOXIN 125 MCG ORAL TAB,19.0,13.3,,,0
NDC,0904-5922-61,DIGOXIN 250 MCG ORAL TAB,14.5,10.15,,,0
NDC,0904-5959-61,CLINDAMYCIN 150 MG CAP,29.0,20.3,,,0
NDC,0904-6007-60,LORAZEPAM 0.5 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-6007-61,LORAZEPAM 0.5 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-6008-60,LORAZEPAM 1 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-6008-61,LORAZEPAM 1 MG ORAL TAB,4.0,2.8,,,0
NDC,0904-6052-61,LEVETIRACETAM  500 MG ORAL TAB,18.0,12.6,,,0
NDC,0904-6082-61,ZOLPIDEM  5 MG ORAL TAB,4.0,2.8,,,0
NDC,0904-6084-61,CITALOPRAM 10 MG ORAL TAB,34.0,23.799999999999997,,,0
NDC,0904-6085-61,CITALOPRAM 20 MG ORAL TAB,19.0,13.3,,,0
NDC,0904-6086-61,CITALOPRAM 40 MG ORAL TAB,20.0,14.0,,,0
NDC,0904-6172-61,CARBAMAZEPINE 200 MG ORAL TAB,13.0,9.1,,,0
NDC,0904-6187-61,PHENYTOIN SODIUM EXTENDED 100 MG ORAL CAP,13.0,9.1,,,0
NDC,0904-6221-61,URSODIOL 300 MG ORAL CAP,27.0,18.9,,,0
NDC,0904-6237-61,CARBIDOPA-LEVODOPA 25 MG-100 MG TAB,4.0,2.8,,,0
NDC,0904-6238-61,CARBIDOPA-LEVODOPA 25 MG-250 MG TAB,10.0,7.0,,,0
NDC,0904-6255-49,BENZOCAINE-MENTHOL 15-3.6 MG MM LOZG,5.0,3.5,,,0
NDC,0904-6269-45,ZIPRASIDONE 20 MG CAP,46.5,32.55,,,0
NDC,0904-6270-08,ZIPRASIDONE 40 MG CAP,69.0,48.3,,,0
NDC,0904-6283-61,OLANZAPINE  2.5 MG ORAL TAB,82.5,57.75,,,0
NDC,0904-6290-61,ATORVASTATIN 10 MG ORAL TAB,9.0,6.3,,,0
NDC,0904-6291-06,ATORVASTATIN 20 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-6291-61,ATORVASTATIN 20 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-6292-06,ATORVASTATIN 40 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-6292-61,ATORVASTATIN 40 MG ORAL TAB,6.5,4.550000000000001,,,0
NDC,0904-6293-04,ATORVASTATIN 80 MG ORAL TAB,9.0,6.300000000000001,,,0
NDC,0904-6294-61,CLOPIDOGREL  75 MG ORAL TAB,49.0,34.3,,,0
NDC,0904-6300-61,CARVEDILOL  3.125 MG ORAL TAB,12.0,8.4,,,0
NDC,0904-6301-61,CARVEDILOL  6.25 MG ORAL TAB,4.0,2.8000000000000003,,,0
NDC,0904-6302-61,CARVEDILOL 12.5 MG ORAL TAB,12.0,8.4,,,0
NDC,0904-6303-61,CARVEDILOL 25 MG ORAL TAB,12.0,8.4,,,0
NDC,0904-6305-21,PHENOL 1.4 % MM SPRA,16.0,11.2,,,0
NDC,0904-6322-06,METOPROLOL SUCCINATE SR 25 MG 24 HR TAB,11.0,7.7,,,0
NDC,0904-6322-61,METOPROLOL SUCCINATE SR 25 MG 24 HR TAB,21.0,14.7,,,0
NDC,0904-6323-61,METOPROLOL SUCCINATE SR 50 MG 24 HR TAB,16.0,11.2,,,0
NDC,0904-6337-24,PSEUDOEPHEDRINE 30 MG TAB,7.0,4.9,,,0
NDC,0904-6342-61,METOPROLOL TARTRATE 100 MG TAB,7.0,4.9,,,0
NDC,0904-6352-61,LEVOFLOXACIN 500 MG ORAL TAB,83.0,58.1,,,0
NDC,0904-6353-61,LEVOFLOXACIN 750 MG ORAL TAB,217.5,152.25,,,0
NDC,0904-6360-61,RISPERIDONE 2 MG ORAL TAB,55.0,38.5,,,0
NDC,0904-6361-61,RISPERIDONE 3 MG ORAL TAB,47.0,32.9,,,0
NDC,0904-6363-45,DIVALPROEX 250 MG ORAL TB24,27.5,19.25,,,0
NDC,0904-6363-61,DIVALPROEX 250 MG ORAL TB24,26.0,18.2,,,0
NDC,0904-6369-61,AMLODIPINE  2.5 MG ORAL TAB,18.0,12.6,,,0
NDC,0904-6370-61,AMLODIPINE  5 MG ORAL TAB,37.0,25.9,,,0
NDC,0904-6371-61,AMLODIPINE 10 MG ORAL TAB,19.0,13.3,,,0
NDC,0904-6373-61,ROPINIROLE  0.25 MG ORAL TAB,8.5,5.95,,,0
NDC,0904-6374-61,ROPINIROLE  1 MG ORAL TAB,9.0,6.3,,,0
NDC,0904-6376-61,OLANZAPINE 10 MG ORAL TAB,113.5,79.45,,,0
NDC,0904-6377-61,OLANZAPINE  5 MG ORAL TAB,65.0,45.5,,,0
NDC,0904-6401-61,TAMSULOSIN 0.4 MG ORAL CP24,155.0,108.5,,,0
NDC,0904-6406-06,MOXIFLOXACIN 400 MG ORAL TAB,317.5,222.25,,,0
NDC,0904-6407-61,BISACODYL  5 MG ORAL TBEC,7.0,4.9,,,0
NDC,0904-6412-92,CALCIUM CARBONATE 500 MG (200 MG ELEMENTAL) CHEW TAB,5.5,3.85,,,0
NDC,0904-6418-61,TIZANIDINE 4 MG ORAL TAB,12.5,8.75,,,0
NDC,0904-6426-61,ESCITALOPRAM 10 MG ORAL TAB,31.0,21.7,,,0
NDC,0904-6427-61,ESCITALOPRAM 20 MG ORAL TAB,26.0,18.2,,,0
NDC,0904-6436-04,TEMAZEPAM  7.5 MG ORAL CAP,61.5,43.05,,,0
NDC,0904-6440-61,HYDRALAZINE  10 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-6441-61,HYDRALAZINE  25 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-6449-61,ISOSORBIDE MONONITRATE  30 MG ORAL TB24,16.5,11.55,,,0
NDC,0904-6450-61,ISOSORBIDE MONONITRATE  60 MG ORAL TB24,17.5,12.25,,,0
NDC,0904-6455-61,DOCUSATE SODIUM 100 MG ORAL CAP,4.0,2.8,,,0
NDC,0904-6467-07,CLOPIDOGREL 300 MG ORAL TAB,142.0,99.4,,,0
NDC,0904-6467-10,CLOPIDOGREL 300 MG ORAL TAB,41.0,28.7,,,0
NDC,0904-6474-61,PANTOPRAZOLE 40 MG ORAL TBEC,23.0,16.1,,,0
NDC,0904-6475-61,BACLOFEN 10 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-6476-61,BACLOFEN 20 MG ORAL TAB,10.0,7.0,,,0
NDC,0904-6477-61,DONEPEZIL  5 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-6478-61,DONEPEZIL 10 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-6500-06,FLUCONAZOLE 100 MG ORAL TAB,16.0,11.2,,,0
NDC,0904-6500-61,FLUCONAZOLE 100 MG ORAL TAB,72.0,50.4,,,0
NDC,0904-6501-06,FLUCONAZOLE 200 MG ORAL TAB,10.0,7.0,,,0
NDC,0904-6501-61,FLUCONAZOLE 200 MG ORAL TAB,140.0,98.0,,,0
NDC,0904-6502-61,CELECOXIB 100 MG ORAL CAP,37.0,25.9,,,0
NDC,0904-6503-61,CELECOXIB 200 MG ORAL CAP,58.5,40.95,,,0
NDC,0904-6505-06,MEMANTINE  5 MG ORAL TAB,9.0,6.3,,,0
NDC,0904-6505-61,MEMANTINE  5 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-6506-06,MEMANTINE 10 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-6506-61,MEMANTINE 10 MG ORAL TAB,9.5,6.65,,,0
NDC,0904-6516-61,MECLIZINE 12.5 MG ORAL TAB,8.5,5.95,,,0
NDC,0904-6519-61,MIRTAZAPINE 15 MG ORAL TAB,24.0,16.8,,,0
NDC,0904-6522-61,SENNOSIDES  8.6 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-6538-06,BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TAB,13.0,9.1,,,0
NDC,0904-6550-61,PROPRANOLOL  10 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-6553-04,LINEZOLID 600 MG ORAL TAB,659.0,461.3,,,0
NDC,0904-6557-61,MORPHINE  15 MG ORAL TBSR,23.5,16.45,,,0
NDC,0904-6558-61,MORPHINE  30 MG ORAL TBSR,15.0,10.5,,,0
NDC,0904-6559-61,MORPHINE  60 MG ORAL TBSR,19.0,13.3,,,0
NDC,0904-6560-61,MORPHINE 100 MG ORAL TBSR,24.0,16.8,,,0
NDC,0904-6565-61,VALACYCLOVIR 500 MG ORAL TAB,45.5,31.85,,,0
NDC,0904-6570-06,OXYBUTYNIN CHLORIDE  5 MG ORAL TO24,28.5,19.950000000000003,,,0
NDC,0904-6570-61,OXYBUTYNIN CHLORIDE  5 MG ORAL TO24,46.0,32.2,,,0
NDC,0904-6572-61,ALLOPURINOL 300 MG ORAL TAB,6.0,4.2,,,0
NDC,0904-6575-61,PHENOBARBITAL  32.4 MG ORAL TAB,8.0,5.6,,,0
NDC,0904-6592-04,TOLTERODINE 2 MG ORAL CP24,80.5,56.35,,,0
NDC,0904-6596-04,VORICONAZOLE  50 MG ORAL TAB,96.0,67.2,,,0
NDC,0904-6600-61,PERPHENAZINE  4 MG ORAL TAB,20.0,14.0,,,0
NDC,0904-6615-61,DIVALPROEX 125 MG ORAL CPSP,15.0,10.5,,,0
NDC,0904-6617-61,HYDROXYZINE 25 MG TAB,9.0,6.300000000000001,,,0
NDC,0904-6618-61,HYDROXYZINE 50 MG TAB,5.5,3.85,,,0
NDC,0904-6619-61,ISOSORBIDE DINITRATE 10 MG ORAL TAB,8.0,5.6,,,0
NDC,0904-6620-61,ISOSORBIDE DINITRATE 20 MG ORAL TAB,7.5,5.25,,,0
NDC,0904-6622-61,PYRIDOSTIGMINE BROMIDE  60 MG ORAL TAB,14.0,9.8,,,0
NDC,0904-6623-61,TACROLIMUS 0.5 MG ORAL CAP,24.5,17.15,,,0
NDC,0904-6624-61,TACROLIMUS 5 MG ORAL CAP,27.0,18.9,,,0
NDC,0904-6627-35,CARBAMIDE PEROXIDE 6.5 % OTIC DROP,10.0,7.0,,,0
NDC,0904-6635-61,BUPROPION HCL  75 MG ORAL TAB,9.0,6.3,,,0
NDC,0904-6636-61,BUPROPION HCL 100 MG ORAL TAB,22.0,15.4,,,0
NDC,0904-6637-61,GLIPIZIDE  5 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-6638-61,QUETIAPINE  25 MG ORAL TAB,10.0,7.0,,,0
NDC,0904-6640-61,QUETIAPINE 100 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-6641-61,QUETIAPINE 200 MG ORAL TAB,16.0,11.2,,,0
NDC,0904-6642-61,QUETIAPINE 300 MG ORAL TAB,6.0,4.2,,,0
NDC,0904-6645-24,ACETAMINOPHEN  160 MG ORAL CHEW,7.0,4.9,,,0
NDC,0904-6663-61,ACETAZOLAMIDE 250 MG ORAL TAB,37.0,25.9,,,0
NDC,0904-6664-04,EZETIMIBE 10 MG ORAL TAB,65.0,45.5,,,0
NDC,0904-6665-61,GABAPENTIN 100 MG ORAL CAP,3.0,2.0999999999999996,,,0
NDC,0904-6666-61,GABAPENTIN 300 MG ORAL CAP,3.5,2.45,,,0
NDC,0904-6667-61,GABAPENTIN 400 MG ORAL CAP,4.5,3.15,,,0
NDC,0904-6671-04,SILDENAFIL  20 MG ORAL TAB,20.0,14.0,,,0
NDC,0904-6689-61,METFORMIN  500 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-6707-06,SEVELAMER CARBONATE 800 MG ORAL TAB,51.0,35.7,,,0
NDC,0904-6708-61,AZITHROMYCIN 250 MG ORAL TAB,28.0,19.6,,,0
NDC,0904-6709-61,GLYCOPYRROLATE 1 MG ORAL TAB,8.0,5.6,,,0
NDC,0904-6717-61,CETIRIZINE 10 MG ORAL TAB,4.0,2.8000000000000003,,,0
NDC,0904-6718-39,GUAIFENESIN 600 MG ORAL TP12,7.0,4.9,,,0
NDC,0904-6730-61,ACETAMINOPHEN  500 MG ORAL TAB,5.0,3.5,,,0
NDC,0904-6741-72,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,15.0,10.5,,,0
NDC,0904-6743-61,OXYCODONE  15 MG ORAL TAB,10.0,7.0,,,0
NDC,0904-6745-61,DRONABINOL  2.5 MG ORAL CAP,44.0,30.8,,,0
NDC,0904-6748-17,BISACODYL  5 MG ORAL TBEC,7.0,4.9,,,0
NDC,0904-6751-80,ASPIRIN   81 MG ORAL TBEC,5.0,3.5,,,0
NDC,0904-6761-30,OXYMETAZOLINE 0.05 % NASAL MERGE,15.0,10.5,,,0
NDC,0904-6773-61,ACETAMINOPHEN  325 MG ORAL TAB,4.0,2.8,,,0
NDC,0904-6778-61,ROSUVASTATIN  5 MG ORAL TAB,10.0,7.0,,,0
NDC,0904-6780-61,ROSUVASTATIN 20 MG ORAL TAB,9.0,6.3,,,0
NDC,0904-6781-61,ROSUVASTATIN 40 MG ORAL TAB,8.5,5.95,,,0
NDC,0904-6782-61,HALOPERIDOL  5 MG ORAL TAB,9.5,6.65,,,0
NDC,0904-6783-70,ASPIRIN   81 MG ORAL TBEC,4.0,2.8,,,0
NDC,0904-6785-61,"MYCOPHENOLATE 180 MG TAB, DELAYED RELEASE",45.5,31.85,,,0
NDC,0904-6786-04,MYCOPHENOLATE SODIUM 360 MG ORAL TBEC,100.5,70.35,,,0
NDC,0904-6786-61,MYCOPHENOLATE SODIUM 360 MG ORAL TBEC,115.0,80.5,,,0
NDC,0904-6789-61,BENZTROPINE 2 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-6794-30,ASPIRIN 81 MG ORAL CHEW,4.0,2.8,,,0
NDC,0904-6794-80,ASPIRIN 81 MG ORAL CHEW,4.0,2.8,,,0
NDC,0904-6794-89,ASPIRIN 81 MG ORAL CHEW,6.0,4.2,,,0
NDC,0904-6797-61,LISINOPRIL  5 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-6798-61,LISINOPRIL 10 MG ORAL TAB,4.0,2.8,,,0
NDC,0904-6799-61,LISINOPRIL 20 MG ORAL TAB,4.0,2.8,,,0
NDC,0904-6808-06,MONTELUKAST 10 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-6808-61,MONTELUKAST 10 MG ORAL TAB,11.0,7.7,,,0
NDC,0904-6817-06,MIDODRINE  2.5 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-6817-61,MIDODRINE  2.5 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-6818-61,MIDODRINE  5 MG ORAL TAB,10.5,7.35,,,0
NDC,0904-6822-07,ENTACAPONE 200 MG ORAL TAB,32.0,22.4,,,0
NDC,0904-6828-05,OXYCODONE 5 MG/5 ML ORAL SOLN,85.0,59.5,,,0
NDC,0904-6830-06,FINASTERIDE 5 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-6830-61,FINASTERIDE 5 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-6836-20,LOPERAMIDE 1 MG/7.5 ML ORAL LIQD,7.0,4.9,,,0
NDC,0904-6852-61,LORATADINE 10 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-6860-61,DIVALPROEX 250 MG ORAL TBEC,3.5,2.45,,,0
NDC,0904-6861-61,DIVALPROEX 500 MG ORAL TBEC,3.5,2.45,,,0
NDC,0904-6868-61,TRAZODONE  50 MG ORAL TAB,3.0,2.0999999999999996,,,0
NDC,0904-6869-61,TRAZODONE 100 MG ORAL TAB,3.5,2.45,,,0
NDC,0904-6914-61,METHYLPREDNISOLONE  4 MG ORAL TAB,34.0,23.799999999999997,,,0
NDC,0904-6917-61,OMEPRAZOLE 20 MG ORAL CPDR,7.0,4.9,,,0
NDC,0904-6923-61,PREDNISONE 10 MG ORAL TAB,4.0,2.8,,,0
NDC,0904-6924-61,SERTRALINE  25 MG ORAL TAB,6.0,4.2,,,0
NDC,0904-6925-61,SERTRALINE  50 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-6926-61,SERTRALINE 100 MG ORAL TAB,7.5,5.25,,,0
NDC,0904-6927-61,SPIRONOLACTONE  25 MG ORAL TAB,4.0,2.8,,,0
NDC,0904-6928-61,TOPIRAMATE  25 MG ORAL TAB,4.5,3.1500000000000004,,,0
NDC,0904-6930-61,POTASSIUM CHLORIDE  10 MEQ ORAL CPSR,12.0,8.4,,,0
NDC,0904-6931-86,POLYETHYLENE GLYCOL 3350 17 GRAM (100 %) ORAL PWPK,38.0,26.6,,,0
NDC,0904-6938-06,BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TAB,19.0,13.3,,,0
NDC,0904-6939-61,HYDROXYUREA  500 MG ORAL CAP,19.5,13.649999999999999,,,0
NDC,0904-6949-61,LEVOTHYROXINE 25 MCG ORAL TAB,11.0,7.7,,,0
NDC,0904-6950-61,LEVOTHYROXINE  50 MCG ORAL TAB,9.0,6.3,,,0
NDC,0904-6951-61,LEVOTHYROXINE  75 MCG ORAL TAB,7.5,5.25,,,0
NDC,0904-6952-61,LEVOTHYROXINE  88 MCG ORAL TAB,8.5,5.949999999999999,,,0
NDC,0904-6953-61,LEVOTHYROXINE 100 MCG ORAL TAB,7.0,4.9,,,0
NDC,0904-6954-61,LEVOTHYROXINE 112 MCG ORAL TAB,7.0,4.9,,,0
NDC,0904-6955-61,LEVOTHYROXINE 125 MCG ORAL TAB,7.0,4.9,,,0
NDC,0904-6956-61,LEVOTHYROXINE 150 MCG ORAL TAB,7.0,4.9,,,0
NDC,0904-6966-61,OXYCODONE 5 MG ORAL TAB,8.5,5.949999999999999,,,0
NDC,0904-6987-61,DICYCLOMINE 10 MG ORAL CAP,8.0,5.6,,,0
NDC,0904-6988-61,DICYCLOMINE 20 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-6990-61,PSEUDOEPHEDRINE 30 MG TAB,7.0,4.9,,,0
NDC,0904-6991-04,PREGABALIN  25 MG ORAL CAP,31.5,22.049999999999997,,,0
NDC,0904-6991-61,PREGABALIN  25 MG ORAL CAP,18.5,12.95,,,0
NDC,0904-6992-61,PREGABALIN  50 MG ORAL CAP,16.0,11.2,,,0
NDC,0904-6993-61,AMIODARONE 200 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-6998-60,DOCUSATE SODIUM 100 MG ORAL CAP,7.0,4.9,,,0
NDC,0904-7000-61,PREGABALIN  75 MG ORAL CAP,11.0,7.7,,,0
NDC,0904-7001-61,PREGABALIN 100 MG ORAL CAP,9.5,6.65,,,0
NDC,0904-7002-61,PREGABALIN 150 MG ORAL CAP,10.0,7.0,,,0
NDC,0904-7006-35,OXYMETAZOLINE 0.05 % NASAL (MERGE)(ENT PRE-PROCEDURE),14.0,9.8,,,0
NDC,0904-7007-61,LAMOTRIGINE  25 MG ORAL TAB,10.0,7.0,,,0
NDC,0904-7008-61,LAMOTRIGINE 100 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-7009-06,BUPRENORPHINE-NALOXONE 2-0.5 MG SL SUBL,42.0,29.4,,,0
NDC,0904-7010-06,BUPRENORPHINE-NALOXONE 8-2 MG SL SUBL,40.0,28.0,,,0
NDC,0904-7014-16,ACETAMINOPHEN 160 MG/5 ML ORAL LIQD,5.0,3.5,,,0
NDC,0904-7016-61,BUMETANIDE 1 MG ORAL TAB,9.0,6.3,,,0
NDC,0904-7020-61,PRAZOSIN 1 MG ORAL CAP,36.0,25.2,,,0
NDC,0904-7021-61,PRAZOSIN 2 MG ORAL CAP,35.0,24.5,,,0
NDC,0904-7023-67,BACITRACIN 500 UNITS/1 GRAM PACKET (MERGE RECORD),5.5,3.85,,,0
NDC,0904-7024-04,VORICONAZOLE 200 MG ORAL TAB,177.5,124.25,,,0
NDC,0904-7027-61,OXYBUTYNIN CHLORIDE  5 MG ORAL TAB,8.0,5.6,,,0
NDC,0904-7036-04,NALTREXONE 50 MG ORAL TAB,12.0,8.4,,,0
NDC,0904-7041-61,ALLOPURINOL 100 MG ORAL TAB,6.0,4.2,,,0
NDC,0904-7042-06,AMANTADINE 100 MG ORAL CAP,10.0,7.0,,,0
NDC,0904-7042-61,AMANTADINE 100 MG ORAL CAP,13.5,9.45,,,0
NDC,0904-7043-04,DULOXETINE 20 MG ORAL CPDR,25.0,17.5,,,0
NDC,0904-7043-61,DULOXETINE 20 MG ORAL CPDR,27.0,18.9,,,0
NDC,0904-7044-61,DULOXETINE 30 MG ORAL CPDR,24.5,17.15,,,0
NDC,0904-7045-61,DULOXETINE 60 MG ORAL CPDR,13.0,9.1,,,0
NDC,0904-7046-61,HYDROXYCHLOROQUINE 200 MG ORAL TAB,12.0,8.4,,,0
NDC,0904-7047-61,LOSARTAN  25 MG ORAL TAB,8.0,5.6,,,0
NDC,0904-7048-61,LOSARTAN  50 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-7054-61,DOXEPIN  50 MG ORAL CAP,13.5,9.45,,,0
NDC,0904-7057-61,METHOCARBAMOL 500 MG ORAL TAB,9.0,6.3,,,0
NDC,0904-7064-41,ATOVAQUONE 750 MG/5 ML ORAL SUSP,323.0,226.1,,,0
NDC,0904-7065-61,HYDROXYZINE PAMOATE  25 MG ORAL CAP,7.0,4.9,,,0
NDC,0904-7070-61,NADOLOL  20 MG ORAL TAB,24.0,16.8,,,0
NDC,0904-7073-41,ONDANSETRON HCL 4 MG/5 ML ORAL SOLN,57.0,39.9,,,0
NDC,0904-7074-61,MYCOPHENOLATE 250 MG CAP,17.0,11.9,,,0
NDC,0904-7075-61,VENLAFAXINE  37.5 MG ORAL CP24,7.0,4.9,,,0
NDC,0904-7076-61,VENLAFAXINE 150 MG ORAL CP24,7.0,4.9,,,0
NDC,0904-7077-61,VENLAFAXINE  75 MG ORAL CP24,7.0,4.9,,,0
NDC,0904-7083-95,CIPROFLOXACIN 500 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-7084-04,BUPROPION HCL 150 MG ORAL TB24,18.0,12.6,,,0
NDC,0904-7084-61,BUPROPION HCL 150 MG ORAL TB24,25.0,17.5,,,0
NDC,0904-7090-61,PIOGLITAZONE 15 MG ORAL TAB,13.5,9.45,,,0
NDC,0904-7097-61,TACROLIMUS 1 MG ORAL CAP,23.0,16.1,,,0
NDC,0904-7103-04,EZETIMIBE 10 MG ORAL TAB,42.5,29.75,,,0
NDC,0904-7105-61,CAPTOPRIL  12.5 MG ORAL TAB,14.5,10.15,,,0
NDC,0904-7106-61,CAPTOPRIL  25 MG ORAL TAB,10.0,7.0,,,0
NDC,0904-7107-61,RIVASTIGMINE 1.5 MG ORAL CAP,33.0,23.1,,,0
NDC,0904-7109-61,LABETALOL 100 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-7110-61,LABETALOL 200 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-7111-61,LABETALOL 300 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-7112-41,HALOPERIDOL 2 MG/ML ORAL CONCENTRATE,8.5,5.95,,,0
NDC,0904-7119-06,CALCIUM ACETATE 667 MG ORAL CAP,17.5,12.25,,,0
NDC,0904-7119-61,CALCIUM ACETATE 667 MG ORAL CAP,20.0,14.0,,,0
NDC,0904-7120-04,COLCHICINE 0.6 MG ORAL TAB,32.0,22.4,,,0
NDC,0904-7121-61,BUSPIRONE 10 MG ORAL TAB,4.0,2.8,,,0
NDC,0904-7122-61,BUSPIRONE  5 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-7123-61,LEVETIRACETAM  250 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-7124-61,LEVETIRACETAM  500 MG ORAL TAB,4.0,2.8,,,0
NDC,0904-7125-61,LEVETIRACETAM  750 MG ORAL TAB,8.0,5.6,,,0
NDC,0904-7126-61,METRONIDAZOLE 500 MG ORAL TAB,42.0,29.4,,,0
NDC,0904-7127-61,PREDNISONE 20 MG ORAL TAB,9.0,6.3,,,0
NDC,0904-7130-61,CHLORPROMAZINE  25 MG ORAL TAB,92.0,64.4,,,0
NDC,0904-7134-70,DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML SYRUP,20.0,14.0,,,0
NDC,0904-7137-61,NITROFURANTOIN (25% MACROCRYSTAL FORM) 100 MG CAP,69.0,48.300000000000004,,,0
NDC,0904-7139-61,METOLAZONE  5 MG ORAL TAB,36.0,25.200000000000003,,,0
NDC,0904-7141-10,METHOTREXATE SODIUM 2.5 MG ORAL TAB,88.0,61.6,,,0
NDC,0904-7153-61,BENZONATATE 100 MG ORAL CAP,50.0,35.0,,,0
NDC,0904-7154-04,BUPRENORPHINE 2 MG SL SUBL,24.0,16.8,,,0
NDC,0904-7156-61,METRONIDAZOLE 250 MG ORAL TAB,53.5,37.45,,,0
NDC,0904-7161-04,FENOFIBRATE NANOCRYSTALLIZED 145 MG ORAL TAB,10.0,7.0,,,0
NDC,0904-7162-61,METFORMIN  500 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-7168-06,URSODIOL 300 MG ORAL CAP,33.0,23.1,,,0
NDC,0904-7168-61,URSODIOL 300 MG ORAL CAP,41.0,28.7,,,0
NDC,0904-7172-07,EMTRICITABINE-TENOFOVIR 200 MG-300 MG TAB,26.0,18.2,,,0
NDC,0904-7177-61,FUROSEMIDE 20 MG ORAL TAB,4.0,2.8,,,0
NDC,0904-7178-61,FUROSEMIDE 40 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-7179-61,TRAMADOL  50 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-7182-61,DIVALPROEX 500 MG ORAL TB24,35.0,24.5,,,0
NDC,0904-7183-61,DOCUSATE SODIUM 100 MG ORAL CAP,5.5,3.85,,,0
NDC,0904-7184-61,AMITRIPTYLINE  25 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-7187-61,ATENOLOL  25 MG ORAL TAB,4.0,2.8,,,0
NDC,0904-7188-61,HYDROCORTISONE 10 MG ORAL TAB,15.0,10.5,,,0
NDC,0904-7189-04,NEBIVOLOL  5 MG ORAL TAB,38.0,26.6,,,0
NDC,0904-7193-06,FAMOTIDINE 20 MG ORAL TAB,9.0,6.3,,,0
NDC,0904-7193-61,FAMOTIDINE 20 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-7199-07,PHENYTOIN 50 MG ORAL CHEW,9.0,6.3,,,0
NDC,0904-7205-46,BISMUTH SUBSALICYLATE 262 MG ORAL CHEW,62.0,43.400000000000006,,,0
NDC,0904-7206-60,SIMETHICONE  80 MG ORAL CHEW,7.0,4.9,,,0
NDC,0904-7208-61,NIFEDIPINE 30 MG ORAL TO24,13.0,9.1,,,0
NDC,0904-7211-04,DANTROLENE  25 MG ORAL CAP,22.0,15.4,,,0
NDC,0904-7212-61,TRAZODONE 150 MG ORAL TAB,4.0,2.8,,,0
NDC,0904-7214-61,BUPROPION HCL 150 MG ORAL TBSR,7.5,5.25,,,0
NDC,0904-7217-61,DILTIAZEM SR 120 MG 24 HR CAP,7.0,4.9,,,0
NDC,0904-7218-61,DILTIAZEM SR 180 MG 24 HR CAP,5.5,3.85,,,0
NDC,0904-7224-61,FOLIC ACID  1 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-7227-61,CLONAZEPAM 0.5 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-7229-61,NIFEDIPINE 10 MG ORAL CAP,18.5,12.95,,,0
NDC,0904-7236-61,MEGESTROL 40 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-7237-60,DIPHENHYDRAMINE 25 MG CAP,5.5,3.85,,,0
NDC,0904-7237-61,DIPHENHYDRAMINE 25 MG CAP,5.5,3.85,,,0
NDC,0904-7243-61,CIPROFLOXACIN 500 MG ORAL TAB,17.0,11.9,,,0
NDC,0904-7244-68,LACOSAMIDE  50 MG ORAL TAB,29.0,20.3,,,0
NDC,0904-7247-68,LACOSAMIDE 200 MG ORAL TAB,17.0,11.9,,,0
NDC,0904-7252-60,SENNOSIDES  8.6 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-7252-61,SENNOSIDES  8.6 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-7257-61,CARBIDOPA-LEVODOPA 25 MG-100 MG TAB,5.5,3.85,,,0
NDC,0904-7261-61,SODIUM BICARBONATE 650 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-7263-61,OXCARBAZEPINE 300 MG ORAL TAB,10.5,7.35,,,0
NDC,0904-7266-61,DEXAMETHASONE 4 MG ORAL TAB,16.0,11.2,,,0
NDC,0904-7276-41,NYSTATIN 100000 UNIT/ML ORAL SUSP,7.5,5.25,,,0
NDC,0904-7278-41,ACETAMINOPHEN 160 MG/5 ML ORAL (PHS ERX MERGE),17.0,11.9,,,0
NDC,0904-7280-60,DOCUSATE SODIUM 100 MG ORAL CAP,7.0,4.9,,,0
NDC,0904-7288-61,BENZTROPINE 0.5 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-7289-61,BENZTROPINE 1 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-7292-61,POTASSIUM CHLORIDE  10 MEQ ORAL TBTQ,10.0,7.0,,,0
NDC,0904-7304-61,PROMETHAZINE 25 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-7305-61,CARVEDILOL  3.125 MG ORAL TAB,4.0,2.8,,,0
NDC,0904-7306-61,CARVEDILOL  6.25 MG ORAL TAB,4.0,2.8,,,0
NDC,0904-7307-61,CARVEDILOL 12.5 MG ORAL TAB,4.0,2.8,,,0
NDC,0904-7308-61,CARVEDILOL 25 MG ORAL TAB,4.0,2.8,,,0
NDC,0904-7319-41,ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SOLN,9.0,6.3,,,0
NDC,0904-7325-62,ALUM-MAG HYDROXIDE-SIMETH 200 MG-200 MG-20 MG/5 ML ORAL SUSP,35.5,24.85,,,0
NDC,0904-7326-62,ALUM-MAG HYDROXIDE-SIMETH 400 MG-400 MG-40 MG/5 ML ORAL SUSP,12.0,8.4,,,0
NDC,0904-7327-62,MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSP,8.0,5.6,,,0
NDC,0904-7336-61,CEPHALEXIN 250 MG ORAL CAP,7.0,4.9,,,0
NDC,0904-7337-35,CEPHALEXIN 500 MG ORAL CAP,25.0,17.5,,,0
NDC,0904-7345-61,FLUOXETINE 10 MG ORAL CAP,4.0,2.8,,,0
NDC,0904-7346-61,FLUOXETINE 20 MG ORAL CAP,3.0,2.1,,,0
NDC,0904-7350-06,AZITHROMYCIN 250 MG ORAL TAB,37.5,26.25,,,0
NDC,0904-7350-61,AZITHROMYCIN 250 MG ORAL TAB,28.0,19.6,,,0
NDC,0904-7351-04,AZITHROMYCIN 500 MG ORAL TAB,31.0,21.7,,,0
NDC,0904-7355-04,LURASIDONE 20 MG ORAL TAB,16.5,11.55,,,0
NDC,0904-7357-61,LURASIDONE  60 MG ORAL TAB,12.0,8.4,,,0
NDC,0904-7358-61,LURASIDONE  80 MG ORAL TAB,12.0,8.4,,,0
NDC,0904-7361-61,RISPERIDONE 0.5 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-7362-61,RISPERIDONE 1 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-7363-61,RISPERIDONE 2 MG ORAL TAB,5.0,3.5,,,0
NDC,0904-7364-61,RISPERIDONE 3 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-7366-04,ARIPIPRAZOLE  2 MG ORAL TAB,15.0,10.5,,,0
NDC,0904-7367-06,ARIPIPRAZOLE  5 MG ORAL TAB,20.0,14.0,,,0
NDC,0904-7368-06,ARIPIPRAZOLE 10 MG ORAL TAB,11.0,7.7,,,0
NDC,0904-7369-04,ARIPIPRAZOLE 15 MG ORAL TAB,14.0,9.8,,,0
NDC,0904-7376-61,MECLIZINE 25 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-7383-61,TAMSULOSIN 0.4 MG ORAL CP24,5.0,3.5,,,0
NDC,0904-7390-61,HALOPERIDOL  1 MG ORAL TAB,8.0,5.6,,,0
NDC,0904-7401-61,CYCLOBENZAPRINE 10 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-7402-67,BACITRACIN 500 UNIT/G TOP PACK,7.0,4.9,,,0
NDC,0904-7407-04,MOXIFLOXACIN 400 MG ORAL TAB,43.0,30.1,,,0
NDC,0904-7407-06,MOXIFLOXACIN 400 MG ORAL TAB,43.0,30.1,,,0
NDC,0904-7410-61,AMITRIPTYLINE  25 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-7411-61,AMITRIPTYLINE  50 MG ORAL TAB,7.5,5.25,,,0
NDC,0904-7427-30,OXYMETAZOLINE 0.05 % NASL SPRA,15.0,10.5,,,0
NDC,0904-7440-61,SENNOSIDES-DOCUSATE SODIUM 8.6 MG-50 MG TAB,5.5,3.85,,,0
NDC,0904-7442-61,CLONIDINE 0.1 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-7448-61,HYDRALAZINE  25 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-7449-61,HYDRALAZINE  50 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-7452-61,LABETALOL 200 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-7458-61,PANTOPRAZOLE 20 MG ORAL TBEC,4.5,3.1500000000000004,,,0
NDC,0904-7480-04,FENOFIBRATE NANOCRYSTALLIZED 145 MG ORAL TAB,9.0,6.3,,,0
NDC,0904-7496-61,TRAMADOL  50 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-7501-61,CARBIDOPA-LEVODOPA 25 MG-100 MG TAB,7.0,4.9,,,0
NDC,0904-7505-61,BUPROPION HCL 150 MG ORAL TB24,22.0,15.4,,,0
NDC,0904-7509-30,ASPIRIN 81 MG ORAL CHEW,4.0,2.8,,,0
NDC,0904-7510-61,CETIRIZINE 10 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-7511-61,LORATADINE 10 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-7728-61,CLONAZEPAM 1 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-7912-51,IBUPROFEN 200 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-7912-59,IBUPROFEN 200 MG ORAL TAB,7.0,4.9,,,0
NDC,0904-7914-61,IBUPROFEN 200 MG ORAL TAB,5.5,3.85,,,0
NDC,0904-8805-67,NEOMYCIN-BACITRACN ZN-POLYMYXIN 3.5 MG-400 U*,7.0,4.9,,,0
NDC,0942-9504-10,SODIUM CITRATE 4% (3 ML) SYRINGE (FOR DIALYSIS),16.0,11.2,,,0
NDC,0944-0493-02,"ALBUMIN, HUMAN 25 % IV SOLP (FOR DIALYSIS)",826.0,578.2,,,0
NDC,0944-0493-03,"ALBUMIN, HUMAN 25 % IV SOLN (MERGE)",504.0,352.8,,,0
NDC,0944-0493-04,"ALBUMIN, HUMAN 25 % IV SOLP",1501.0,1050.7,,,0
NDC,0944-0495-05,"ALBUMIN, HUMAN 5 % IV SOLP MERGE",826.0,578.2,,,0
NDC,0944-0495-06,"ALBUMIN, HUMAN 5 % IV SOLP MERGE",330.5,231.35,,,0
NDC,0944-2657-07,GAMMAGARD S/D  5 GRAM IV SOLR,2329.0,1630.3,,,0
NDC,0944-2658-04,GAMMAGARD S-D (IGA < 1 MCG/ML) 10 GRAM IV SOLR,9313.0,6519.099999999999,,,0
NDC,0944-2659-08,GAMMAGARD S-D (IGA < 1 MCG/ML) 10 GRAM IV SOLR,11641.0,8148.7,,,0
NDC,0944-2700-04,GAMMAGARD LIQUID 10 % IV SOLN,1803.0,1262.1,,,0
NDC,0944-2700-05,GAMMAGARD LIQUID 10 % IV SOLN,3606.0,2524.2,,,0
NDC,0944-2700-06,GAMMAGARD LIQUID 10 % IV SOLN,10816.5,7571.549999999999,,,0
NDC,0944-2700-07,GAMMAGARD LIQUID 10 % IV SOLN,21633.5,15143.45,,,0
NDC,0944-2700-10,GAMMAGARD LIQUID 10 % IV SOLN,7211.5,5048.05,,,0
NDC,0944-2700-11,GAMMAGARD LIQUID 10 % IV SOLN,1803.0,1262.1,,,0
NDC,0944-2700-12,GAMMAGARD LIQUID 10 % IV SOLN,9014.0,6309.799999999999,,,0
NDC,0944-2700-13,GAMMAGARD LIQUID 10 % IV SOLN,10817.0,7571.9,,,0
NDC,0944-3045-10,ADVATE: FACTOR VIII CONCENTRATE (MERGE RECORD),8372.0,5860.4,,,0
NDC,0944-3046-10,ADVATE: FACTOR VIII CONCENTRATE (MERGE RECORD),13312.5,9318.75,,,0
NDC,0944-3047-10,ADVATE: FACTOR VIII CONCENTRATE (MERGE RECORD),14651.0,10255.7,,,0
NDC,0944-3051-02,ADVATE: FACTOR VIII CONCENTRATE (MERGE RECORD),4027.0,2818.9,,,0
NDC,0944-3051-03,ADVATE: FACTOR VIII CONCENTRATE (MERGE RECORD),4027.0,2818.9,,,0
NDC,0944-3051-04,ADVATE: FACTOR VIII CONCENTRATE (MERGE RECORD),1343.0,940.1,,,0
NDC,0944-3052-02,ADVATE: FACTOR VIII CONCENTRATE (MERGE RECORD),4709.5,3296.6499999999996,,,0
NDC,0944-3052-03,ADVATE: FACTOR VIII CONCENTRATE (MERGE RECORD),4709.5,3296.6499999999996,,,0
NDC,0944-3052-04,ADVATE: FACTOR VIII CONCENTRATE (MERGE RECORD),3140.0,2198.0,,,0
NDC,0944-3053-02,ADVATE: FACTOR VIII CONCENTRATE (MERGE RECORD),8372.0,5860.4,,,0
NDC,0944-3053-03,ADVATE: FACTOR VIII CONCENTRATE (MERGE RECORD),13110.0,9177.0,,,0
NDC,0944-3053-04,ADVATE: FACTOR VIII CONCENTRATE (MERGE RECORD),10488.0,7341.6,,,0
NDC,0944-3054-02,ADVATE: FACTOR VIII CONCENTRATE (MERGE RECORD),8372.0,5860.4,,,0
NDC,0955-1003-01,ENOXAPARIN 30 MG/0.3 ML SUBQ SYRG,64.5,45.150000000000006,,,0
NDC,0955-1004-01,ENOXAPARIN 40 MG/0.4 ML SUBQ SYRG,44.5,31.150000000000002,,,0
NDC,0955-1008-01,ENOXAPARIN 80 MG/0.8 ML SUBQ SYRG,82.0,57.400000000000006,,,0
NDC,0955-1010-01,ENOXAPARIN 100 MG/1 ML SUBQ SYRG,113.0,79.1,,,0
NDC,0955-1012-01,ENOXAPARIN 120 MG/0.8 ML SUBQ SYRG,151.0,105.7,,,0
NDC,0955-1015-01,ENOXAPARIN 150 MG/1 ML SUBQ SYRG,179.5,125.65,,,0
NDC,0955-1040-90,IRBESARTAN  75 MG ORAL TAB,7.0,4.9,,,0
NDC,0955-1727-20,OXALIPLATIN 100 MG/20 ML IV SOLN,999.0,699.3,,,0
NDC,0990-7074-26,POTASSIUM CHLORIDE 10 MEQ/100 ML IV PGBK,81.0,56.7,,,0
NDC,0990-7075-14,POTASSIUM CHLORIDE 10 MEQ/50 ML IV PGBK,59.0,41.3,,,0
NDC,0990-7075-26,POTASSIUM CHLORIDE 20 MEQ/100 ML IV PGBK,50.5,35.35,,,0
NDC,0990-7111-09,D5-LR WITH POTASSIUM CHLORIDE 20 MEQ/L IV SOLP,54.0,37.8,,,0
NDC,0990-7715-13,MANNITOL 20% IV SOLP,71.0,49.7,,,0
NDC,0990-7922-02,DEXTROSE 5% IN WATER (D5W) IV,29.0,20.3,,,0
NDC,0990-7922-03,DEXTROSE 5% IN WATER (D5W) IV,28.0,19.6,,,0
NDC,0990-7923-23,DEXTROSE 5% IN WATER (D5W) IV,20.5,14.35,,,0
NDC,0990-7923-37,DEXTROSE 5% IN WATER (D5W) IV,16.0,11.2,,,0
NDC,0990-7926-09,DEXTROSE 5%-1/2 NORMAL SALINE IV,34.0,23.8,,,0
NDC,0990-7930-09,DEXTROSE 10% IN WATER (D10) IV SOLN,34.0,23.8,,,0
NDC,0990-7935-19,DEXTROSE 20% IN WATER (NEO) 500ML,75.5,52.849999999999994,,,0
NDC,0990-7953-09,LACTATED RINGERS IV,39.0,27.3,,,0
NDC,0990-7983-02,SODIUM CHLORIDE 0.9 % IV SOLP,29.0,20.3,,,0
NDC,0990-7983-03,SODIUM CHLORIDE 0.9 % IV SOLP,28.0,19.6,,,0
NDC,0990-7983-09,SODIUM CHLORIDE 0.9 % IV SOLP,34.0,23.8,,,0
NDC,0990-7983-61,SODIUM CHLORIDE 0.9 % IV SOLP,28.5,19.950000000000003,,,0
NDC,0990-7984-13,SODIUM CHLORIDE 0.9 % IV SOLP,16.5,11.55,,,0
NDC,0990-7984-23,SODIUM CHLORIDE 0.9 % IV SOLP,18.0,12.6,,,0
NDC,0990-7984-36,SODIUM CHLORIDE 0.9 % IV SOLP,17.0,11.899999999999999,,,0
NDC,0990-7984-37,SODIUM CHLORIDE 0.9 % IV SOLP,16.0,11.2,,,0
NDC,0990-7985-09,SODIUM CHLORIDE 0.45 % 0.45 % IV SOLP,32.0,22.4,,,0
NDC,0998-0630-06,"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",489.0,342.3,,,0
NDC,1000670020,NIACIN  250 MG ORAL CPSR,7.0,4.9,,,0
NDC,1000670028,MAGNESIUM OXIDE 400 MG ORAL TAB,7.0,4.9,,,0
NDC,1000670038,"CALCIUM CARBONATE-VITAMIN D3 500 MG(1,250MG) -200 UNIT ORAL TAB",7.0,4.9,,,0
NDC,1000673038,MAGNESIUM OXIDE 400 MG ORAL TAB,7.0,4.9,,,0
NDC,10019-016-39,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,17.0,11.899999999999999,,,0
NDC,10019-033-39,FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN,16.0,11.2,,,0
NDC,10019-055-61,"ESMOLOL IN SALINE (ISO-OSMOTIC) 2,500 MG/250 ML (10 MG/ML) IV",560.0,392.0,,,0
NDC,10019-075-87,"ESMOLOL IN SALINE (ISO-OSMOTIC) 2,000 MG/100 ML (20 MG/ML) IV",1391.0,973.7,,,0
NDC,10019-080-01,ERIBULIN 0.5 MG/ML IV SOLN,4692.0,3284.4,,,0
NDC,10019-506-10,BUMETANIDE 0.25 MG/ML INJ SOLN,107.0,74.9,,,0
NDC,10019-506-37,BUMETANIDE 0.25 MG/ML INJ SOLN,22.0,15.4,,,0
NDC,10019-553-90,SCOPOLAMINE TRANSDERMAL PATCH 1MG OVER 3 DAYS,125.0,87.5,,,0
NDC,10019-925-82,IFOSFAMIDE 1 GRAM IV SOLR,432.0,302.4,,,0
NDC,10019-926-16,IFOSFAMIDE 3 GRAM IV SOLR,930.0,651.0,,,0
NDC,10019-953-62,MESNA 100 MG/ML IV SOLN,118.0,82.6,,,0
NDC,10019-955-50,CYCLOPHOSPHAMIDE 500 MG IV SOLR,2593.5,1815.45,,,0
NDC,10019-956-16,CYCLOPHOSPHAMIDE 20 MG/ML IN NS,648.0,453.6,,,0
NDC,10019-957-11,CYCLOPHOSPHAMIDE 2 GRAM IV SOLUTION,3350.5,2345.3500000000004,,,0
NDC,10019-991-01,BORTEZOMIB 3.5 MG IV SOLR,129.0,90.3,,,0
NDC,1011902239,WHITE PETROLATUM-MINERAL OIL 80 %-20 % EYE OINTMENT,38.0,26.6,,,0
NDC,10122-313-01,NICARDIPINE IN NACL (ISO-OS) 20 MG/200 ML IV PGBK,68.0,47.6,,,0
NDC,10122-510-01,PORACTANT ALFA 240 MG/3 ML INTR SUSP,4017.5,2812.25,,,0
NDC,10122-510-03,PORACTANT ALFA 240 MG/3 ML INTR SUSP,6520.0,4564.0,,,0
NDC,10122-611-01,CLEVIDIPINE 50 MG/100 ML IV EMUL,1120.5,784.3499999999999,,,0
NDC,10122-620-01,CANGRELOR 50 MG IV SOLR,4016.5,2811.55,,,0
NDC,10135-111-01,DOCUSATE SODIUM 100 MG ORAL CAP,7.0,4.9,,,0
NDC,10135-123-01,ACETAMINOPHEN  325 MG ORAL TAB,5.0,3.5,,,0
NDC,10135-123-24,ACETAMINOPHEN  325 MG ORAL TAB,5.0,3.5,,,0
NDC,10135-123-50,ACETAMINOPHEN  325 MG ORAL TAB,5.0,3.5,,,0
NDC,10135-123-70,ACETAMINOPHEN  325 MG ORAL TAB,5.0,3.5,,,0
NDC,10135-143-01,IBUPROFEN 200 MG ORAL TAB,7.0,4.9,,,0
NDC,10135-144-01,ACETAMINOPHEN  500 MG ORAL TAB,5.0,3.5,,,0
NDC,10135-150-01,ASPIRIN  325 MG ORAL TAB,7.0,4.9,,,0
NDC,10135-162-13,IBUPROFEN 200 MG ORAL TAB,7.0,4.9,,,0
NDC,10135-163-13,ACETAMINOPHEN  325 MG ORAL TAB,5.0,3.5,,,0
NDC,10135-183-05,IBUPROFEN 200 MG ORAL TAB,7.0,4.9,,,0
NDC,10135-588-01,LOXAPINE 50 MG CAP,25.0,17.5,,,0
NDC,10135-669-01,SENNOSIDES-DOCUSATE SODIUM 8.6 MG-50 MG TAB,7.0,4.9,,,0
NDC,10135-676-01,ROPINIROLE  2 MG ORAL TAB,3.5,2.45,,,0
NDC,10135-678-01,ROPINIROLE  4 MG ORAL TAB,7.0,4.9,,,0
NDC,10135-679-01,ROPINIROLE  5 MG ORAL TAB,3.0,2.1,,,0
NDC,10135-681-01,GUAIFENESIN  200 MG ORAL TAB,7.0,4.9,,,0
NDC,10135-726-01,FLUPHENAZINE 2.5 MG TAB,43.0,30.1,,,0
NDC,10135-738-01,RIFABUTIN 150 MG ORAL CAP,85.5,59.849999999999994,,,0
NDC,10135-778-01,PREDNISONE 20 MG ORAL TAB,8.0,5.6,,,0
NDC,10135-779-01,PREDNISONE 50 MG ORAL TAB,7.5,5.25,,,0
NDC,10135-789-01,GUAIFENESIN  200 MG ORAL TAB,7.0,4.9,,,0
NDC,1013565201,CYANOCOBALAMIN 1000 MCG ORAL TAB,7.0,4.9,,,0
NDC,1013578301,SODIUM CHLORIDE 1000 MG MISC TBSO,7.0,4.9,,,0
NDC,10139-063-01,FLUOROURACIL 5 GRAM/100 ML IV SOLN,112.5,78.75,,,0
NDC,10139-235-10,ROCURONIUM 10 MG/ML IV SOLN,47.0,32.9,,,0
NDC,10147-0921-3,HALOPERIDOL DECANOATE  50 MG/ML IM SOLN,266.0,186.2,,,0
NDC,1031043028,BENZOCAINE-MENTHOL 20-0.26 % MM GEL,20.0,14.0,,,0
NDC,10481-0112-8,FERRIC SUBSULFATE 0.2 TO 0.22 GRAM/ML MISC SOLA,72.0,50.4,,,0
NDC,10481-3008-1,TRICHLOROACETIC ACID 80 % TOP SOLN,329.0,230.3,,,0
NDC,1054201010,B COMPLEX-VITAMIN C-FOLIC ACID 100-1 MG ORAL TAB,7.0,4.9,,,0
NDC,10702-003-01,PROMETHAZINE 25 MG ORAL TAB,7.0,4.9,,,0
NDC,10702-011-01,HYDROXYZINE 25 MG TAB,9.0,6.300000000000001,,,0
NDC,10702-018-01,OXYCODONE 5 MG ORAL TAB,9.0,6.3,,,0
NDC,10702-018-50,OXYCODONE 5 MG ORAL TAB,7.0,4.9,,,0
NDC,10702-036-15,SODIUM POLYSTYRENE SULFONATE ORAL POWDER,67.0,46.9,,,0
NDC,10702-253-01,BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TAB,14.5,10.15,,,0
NDC,10702-808-03,CYCLOSPORINE 0.05 % OPHT DPET,7.0,4.9,,,0
NDC,10742-0001-1,CAMPHOR 9% -MENTHOL 1.3% -BORIC ACID OINTMENT (PHS),10.0,7.0,,,0
NDC,10742-0001-2,MENTHOLATUM CAMPHOR 9% -MENTHOL 1.3% OINTMENT,26.0,18.2,,,0
NDC,1093-9955-30,DIPHENHYDRAMINE 25 MG CAP,7.0,4.9,,,0
NDC,1093911233,MAGNESIUM CITRATE ORAL SOLN,8.5,5.95,,,0
NDC,1093914833,CALAMINE-ZINC OXIDE 8 %-8 % TOPICAL SUSP,14.0,9.8,,,0
NDC,1093919344,NICOTINE (POLACRILEX) 2 MG MM LOZG,7.0,4.9,,,0
NDC,1093919444,NICOTINE (POLACRILEX) 4 MG MM LOZG,7.0,4.9,,,0
NDC,1093919844,DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,29.0,20.3,,,0
NDC,1093930833,IBUPROFEN 100 MG/5 ML ORAL SUSP,7.5,5.25,,,0
NDC,1093935033,IBUPROFEN 100 MG/5 ML ORAL SUSP,7.0,4.9,,,0
NDC,1093941033,OXYMETAZOLINE 0.05 % NASL SPRA,7.0,4.9,,,0
NDC,1093941433,OXYMETAZOLINE 0.05 % NASL SPRA,7.0,4.9,,,0
NDC,1093945944,PHENOL 1.4 % MM SPRA,27.0,18.9,,,0
NDC,1093956433,BACITRACIN 500 UNIT/G TOP OINT (MERGE),24.0,16.8,,,0
NDC,1093957233,HYDROCORTISONE  1 % TOP OINT,20.0,14.0,,,0
NDC,1093969133,NICOTINE (POLACRILEX) 2 MG BUCL GUM,7.0,4.9,,,0
NDC,1093977544,BISACODYL  5 MG ORAL TBEC,7.0,4.9,,,0
NDC,1093978844,POLYETHYLENE GLYCOL 3350 100 % ORAL POWD,49.0,34.3,,,0
NDC,1093979444,SIMETHICONE  80 MG ORAL CHEW,7.0,4.9,,,0
NDC,1093986244,NICOTINE 14 MG/24 HR TD PT24,24.0,16.8,,,0
NDC,1093990033,IBUPROFEN 100 MG/5 ML ORAL SUSP,7.0,4.9,,,0
NDC,1093990433,NICOTINE (POLACRILEX) 2 MG BUCL GUM,7.0,4.9,,,0
NDC,11523-1159-1,OXYMETAZOLINE 0.05 % NASAL MERGE,7.0,4.9,,,0
NDC,11523-4112-1,OXYMETAZOLINE 0.05 % NASL SPRA,34.0,23.8,,,0
NDC,11523-7234-1,POLYETHYLENE GLYCOL 3350 17 GRAM (100 %) ORAL PWPK,9.0,6.3,,,0
NDC,1152372688,POLYETHYLENE GLYCOL 3350 17 GRAM (100 %) ORAL PWPK,41.5,29.05,,,0
NDC,11534-166-15,SODIUM POLYSTYRENE SULFONATE ORAL POWDER,78.0,54.6,,,0
NDC,11534-166-16,SODIUM POLYSTYRENE SULFONATE ORAL POWDER,116.5,81.55,,,0
NDC,11673-130-26,ACETAMINOPHEN 160 MG/5 ML ORAL (PHS ERX MERGE),5.0,3.5,,,0
NDC,11673-660-26,IBUPROFEN 100 MG/5 ML ORAL SUSP,7.0,4.9,,,0
NDC,11822-2399-90,IBUPROFEN 100 MG/5 ML ORAL SUSP,7.0,4.9,,,0
NDC,11822-3324-70,ALUM-MAG HYDROXIDE-SIMETH 200 MG-200 MG-20 MG/5 ML ORAL SUSP,7.0,4.9,,,0
NDC,11822-3349-10,CARBAMIDE PEROXIDE 6.5 % OTIC DROP,39.0,27.3,,,0
NDC,11822-3615-30,ASPIRIN 81 MG ORAL CHEW,5.0,3.5,,,0
NDC,11822-5279-30,FAMOTIDINE 20 MG ORAL TAB,7.0,4.9,,,0
NDC,1191702059,ACETAMINOPHEN 160 MG/5 ML ORAL (PHS ERX MERGE),5.0,3.5,,,0
NDC,1191705095,NEOMYCIN-BACITRACIN ZN-POLYMYXIN 3.5 MG-400 UN*,28.0,19.6,,,0
NDC,1191706767,ACETAMINOPHEN  325 MG ORAL TAB,5.0,3.5,,,0
NDC,1191710788,CARBAMIDE PEROXIDE 6.5 % OTIC DROP,45.0,31.5,,,0
NDC,1191714663,MULTIVITAMIN WITH FOLIC ACID 400 MCG ORAL TAB,7.0,4.9,,,0
NDC,11980-174-05,PREDNISOLONE ACETATE 0.12 % OPHT DRPS,660.0,462.0,,,0
NDC,11980-174-10,PREDNISOLONE ACETATE 0.12 % OPHT DRPS,1082.0,757.4,,,0
NDC,11980-180-05,PREDNISOLONE ACETATE 1 % OPHT DROPS,693.0,485.1,,,0
NDC,11994-011-01,PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML IV SUSP,1029.0,720.3,,,0
NDC,11994-011-04,PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML IV SUSP,882.0,617.4000000000001,,,0
NDC,11994-011-16,PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML IV SUSP,735.0,514.5,,,0
NDC,11994-016-01,YTTRIUM-90 (Y-90 THERASPHERE) GLASS MICROSPHERES,44379.0,31065.3,,,0
NDC,121059530,SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLN,12.0,8.4,,,0
NDC,121067616,"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLN",8.0,5.6,,,0
NDC,121119030,SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLN,18.0,12.6,,,0
NDC,12165-100-03,SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,14.0,9.8,,,0
NDC,12496-0100-1,BUPRENORPHINE 100 MG/0.5 ML SUBQ SLSY,4418.0,3092.6,,,0
NDC,12496-0100-2,BUPRENORPHINE 100 MG/0.5 ML SUBQ SLSY,4418.0,3092.6,,,0
NDC,12496-0100-5,BUPRENORPHINE 100 MG/0.5 ML SUBQ SLSY,2319.0,1623.3,,,0
NDC,1254717167,DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,23.0,16.1,,,0
NDC,1284310120,ASPIRIN  325 MG ORAL TAB,7.0,4.9,,,0
NDC,1284355565,ASPIRIN  325 MG ORAL TBEC,5.0,3.5,,,0
NDC,12870-0001-1,SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,19.0,13.3,,,0
NDC,12870-0001-2,SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,22.0,15.4,,,0
NDC,13107-001-30,MIRTAZAPINE  7.5 MG ORAL TAB,37.0,25.9,,,0
NDC,13107-003-34,MIRTAZAPINE 30 MG ORAL TAB,16.0,11.2,,,0
NDC,13107-083-05,LORAZEPAM 0.5 MG ORAL TAB,7.0,4.9,,,0
NDC,13107-085-01,LORAZEPAM 2 MG ORAL TAB,9.5,6.65,,,0
NDC,13107-155-30,PAROXETINE 20 MG TAB,22.5,15.75,,,0
NDC,13107-319-01,CLORAZEPATE DIPOTASSIUM  3.75 MG ORAL TAB,23.0,16.1,,,0
NDC,132007924,GLYCERIN (ADULT) RECTAL SUPPOSITORY,7.0,4.9,,,0
NDC,132030140,MINERAL OIL ENEMA,21.0,14.7,,,0
NDC,13517-626-01,PHENOBARBITAL  32.4 MG ORAL TAB,8.0,5.6,,,0
NDC,13533-131-00,TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE,165.0,115.5,,,0
NDC,13533-318-05,RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML IM SOLN,7515.0,5260.5,,,0
NDC,13533-318-30,RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML IM SOLN,8452.5,5916.75,,,0
NDC,13533-318-50,RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML IM SOLN,8499.0,5949.299999999999,,,0
NDC,13533-603-20,ANTITHROMBIN III IV (PHS ERX MERGE),13397.5,9378.25,,,0
NDC,13533-605-21,ANTITHROMBIN III IV (PHS ERX MERGE),3355.0,2348.5,,,0
NDC,13533-606-12,ANTITHROMBIN III IV (PHS ERX MERGE),1880.0,1316.0,,,0
NDC,13533-631-03,RHO D IMMUNE GLOBULIN 300 MCG IM SYRG,422.0,295.4,,,0
NDC,13533-631-20,RHO(D) IMMUNE GLOBULIN IV (PHS ERX MERGE),405.0,283.5,,,0
NDC,13533-634-02,TETANUS IMMUNE GLOBULIN (PF) 250 UNIT IM SYRG,1262.0,883.4,,,0
NDC,13533-636-03,HEPATITIS B IMMUNE GLOBULIN 110 UNIT/0.5 ML IM SYRG,383.0,268.1,,,0
NDC,13533-636-05,HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML (5 ML) IM SOLN,2120.5,1484.35,,,0
NDC,13533-636-30,HEPATITIS B IMMUNE GLOBULIN 110 UNIT/0.5 ML IM SYRG,226.0,158.2,,,0
NDC,13533-636-50,HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML (5 ML) IM SOLN,1822.0,1275.3999999999999,,,0
NDC,13533-684-17,"ALBUMIN, HUMAN 25 % IV SOLN (MERGE)",78.0,54.6,,,0
NDC,13533-684-71,"ALBUMIN, HUMAN 25 % IV SOLP",427.0,298.9,,,0
NDC,13533-690-20,"ALBUMIN, HUMAN 5 % IV SOLP MERGE",103.5,72.45,,,0
NDC,13533-690-25,"ALBUMIN, HUMAN 5 % IV SOLP MERGE",868.0,607.6,,,0
NDC,13533-692-71,"ALBUMIN, HUMAN 25 % IV SOLN (MERGE)",427.0,298.9,,,0
NDC,13533-700-01,"ALPHA-1-PROTEINASE INHIBITOR (HUMAN) 1,000 MG IV SUSP (PROLASTIN-C)",5813.0,4069.1,,,0
NDC,13533-705-01,ALPHA-1 PROTEINASE INHIB.(HUM) 1000 MG (+/-)/20 ML IV SOLN,4856.0,3399.2,,,0
NDC,13533-705-11,ALPHA-1 PROTEINASE INHIB.(HUM) 1000 MG (+/-)/20 ML IV SOLN,7158.5,5010.95,,,0
NDC,13533-800-12,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 1 GRAM/10 ML (10 %) INJ SOLN",13283.0,9298.1,,,0
NDC,13533-800-13,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 1 GRAM/10 ML (10 %) INJ SOLN",886.0,620.2,,,0
NDC,13533-800-15,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 2.5 GRAM/25 ML (10 %) INJ SOLN",1361.5,953.05,,,0
NDC,13533-800-16,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 2.5 GRAM/25 ML (10 %) INJ SOLN",1361.5,953.05,,,0
NDC,13533-800-20,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 40 GRAM/400 ML (10 %) INJ SOLN",12023.0,8416.1,,,0
NDC,13533-800-21,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 5 GRAM/50 ML (10 %) INJ SOLN",11316.0,7921.2,,,0
NDC,13533-800-24,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 5 GRAM/50 ML (10 %) INJ SOLN",16973.0,11881.1,,,0
NDC,13533-800-25,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 20 GRAM/200 ML (10%) INJ SOLN",7779.5,5445.65,,,0
NDC,13533-800-40,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 40 GRAM/400 ML (10 %) INJ SOLN",22631.0,15841.7,,,0
NDC,13533-800-41,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 20 GRAM/200 ML (10%) INJ SOLN",12023.0,8416.1,,,0
NDC,13533-800-71,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 5 GRAM/50 ML (10 %) INJ SOLN (NEW TX NON-NEURO INDICATION)",11316.0,7921.2,,,0
NDC,13533-800-72,"IMMUNE GLOBULIN(HUM),CAPR(IGG) 10 GRAM/100 ML (10%) INJ SOLN",12730.0,8911.0,,,0
NDC,13668-009-01,CITALOPRAM 10 MG ORAL TAB,22.0,15.4,,,0
NDC,13668-010-01,CITALOPRAM 20 MG ORAL TAB,19.0,13.3,,,0
NDC,13668-011-01,CITALOPRAM 40 MG ORAL TAB,12.0,8.399999999999999,,,0
NDC,13668-086-30,OLANZAPINE  5 MG ORAL TBDL,137.0,95.9,,,0
NDC,13668-088-30,OLANZAPINE 10 MG ORAL TBDL,152.5,106.75,,,0
NDC,13668-091-90,PRAMIPEXOLE 0.125 MG ORAL TAB,33.0,23.1,,,0
NDC,13668-105-01,ISOSORBIDE MONONITRATE  60 MG ORAL TB24,43.5,30.450000000000003,,,0
NDC,13668-106-01,ISOSORBIDE MONONITRATE 120 MG ORAL TB24,49.0,34.3,,,0
NDC,13668-133-01,FELODIPINE  5 MG ORAL TB24,9.0,6.3,,,0
NDC,13668-134-01,FELODIPINE 10 MG ORAL TB24,16.0,11.2,,,0
NDC,13668-189-30,TOLTERODINE 2 MG ORAL CP24,94.0,65.8,,,0
NDC,13668-202-30,DARIFENACIN  7.5 MG ORAL TB24,55.0,38.5,,,0
NDC,13668-219-30,ARIPIPRAZOLE 15 MG ORAL TAB,184.0,128.8,,,0
NDC,13668-453-01,ANAGRELIDE 0.5 MG ORAL CAP,110.0,77.0,,,0
NDC,13668-484-50,MINOCYCLINE 100 MG ORAL CAP,19.0,13.3,,,0
NDC,13668-586-30,ERYTHROMYCIN 250 MG ORAL TBEC,83.0,58.1,,,0
NDC,1381156545,EMOLLIENT COMBINATION NO.10 TOPICAL EMULSION,156.0,109.2,,,0
NDC,13925-522-01,PENTAMIDINE 300 MG INHL SOLR,650.0,455.0,,,0
NDC,14362-0111-3,TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE,106.0,74.2,,,0
NDC,14789-109-16,POTASSIUM CHLORIDE 10 MEQ/100 ML IV PGBK,587.5,411.25,,,0
NDC,14789-115-08,"TRANEXAMIC ACID IN NACL,ISO-OS 1,000 MG/100 ML (10 MG/ML) IV PGBK",103.0,72.1,,,0
NDC,14789-121-07,PAPAVERINE 30 MG/ML INJ SOLN,221.0,154.7,,,0
NDC,14789-127-07,PHENOBARBITAL SODIUM  65 MG/ML INJ SOLN,53.5,37.45,,,0
NDC,14789-128-07,PHENOBARBITAL SODIUM 130 MG/ML INJ SOLN,336.0,235.20000000000002,,,0
NDC,14789-251-09,EPHEDRINE SULFATE  25 MG/5 ML (5 MG/ML) IV SYRG (MERGE),243.0,170.1,,,0
NDC,14789-901-07,PROCAINAMIDE 100 MG/ML INJECTION (MERGE),911.0,637.7,,,0
NDC,149003908,BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSP,7.0,4.9,,,0
NDC,149003916,BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSP,7.0,4.9,,,0
NDC,15054-0043-1,IRINOTECAN LIPOSOMAL 4.3 MG/ML IV DISP,8489.5,5942.65,,,0
NDC,15054-0500-1,ABOBOTULINUMTOXINA 500 UNITS IM SOLR,3629.5,2540.65,,,0
NDC,15054-0530-6,ABOBOTULINUMTOXINA 300 UNITS IM SOLR,4425.0,3097.5,,,0
NDC,15054-1060-4,LANREOTIDE 60 MG/0.2 ML SUBQ SYRG,16803.0,11762.1,,,0
NDC,15054-1090-4,LANREOTIDE 90 MG/0.3 ML SUBQ SYRG,22379.0,15665.3,,,0
NDC,15054-1120-4,LANREOTIDE 120 MG/0.5 ML SUBQ SYRG,19794.0,13855.800000000001,,,0
NDC,16252-539-01,ISRADIPINE  2.5 MG ORAL CAP,16.0,11.2,,,0
NDC,16477-738-01,HYOSCYAMINE SULFATE 0.375 MG ORAL TB12,9.0,6.3,,,0
NDC,1650053502,CALCIUM CITRATE-VITAMIN D3 200 MG CALCIUM -250 UNIT ORAL TAB,7.0,4.9,,,0
NDC,16571-109-01,AMITRIPTYLINE 100 MG ORAL TAB,15.0,10.5,,,0
NDC,16571-110-01,AMITRIPTYLINE 150 MG ORAL TAB,15.0,10.5,,,0
NDC,16571-201-06,"DICLOFENAC 75 MG TAB, DELAYED RELEASE",10.0,7.0,,,0
NDC,16571-202-06,"DICLOFENAC 50 MG TAB, DELAYED RELEASE",9.0,6.3,,,0
NDC,16571-202-10,"DICLOFENAC 50 MG TAB, DELAYED RELEASE",9.0,6.3,,,0
NDC,16571-203-10,"DICLOFENAC 25 MG TAB, DELAYED RELEASE",16.0,11.2,,,0
NDC,16571-401-10,CETIRIZINE  5 MG ORAL TAB,21.0,14.700000000000001,,,0
NDC,16571-665-01,METRONIDAZOLE 250 MG ORAL TAB,7.0,4.9,,,0
NDC,16571-668-01,PHENOBARBITAL  97.2 MG ORAL TAB,15.0,10.5,,,0
NDC,16571-673-01,PHENOBARBITAL  32.4 MG ORAL TAB,7.5,5.25,,,0
NDC,16571-681-01,CARBAMAZEPINE 200 MG ORAL TB12,18.0,12.6,,,0
NDC,16571-684-03,CLOMIPRAMINE 50 MG ORAL CAP,82.5,57.75,,,0
NDC,16571-685-03,CLOMIPRAMINE 75 MG ORAL CAP,110.0,77.0,,,0
NDC,16571-762-09,LEVOCARNITINE 330 MG ORAL TAB,19.0,13.3,,,0
NDC,1657187290,MELATONIN  3 MG ORAL TAB,5.5,3.85,,,0
NDC,16590-090-35,ERYTHROMYCIN 5 MG/G OPHT OINT,50.0,35.0,,,0
NDC,16714-006-01,ENOXAPARIN 30 MG/0.3 ML SUBQ SYRG,78.0,54.6,,,0
NDC,16714-006-10,ENOXAPARIN 30 MG/0.3 ML SUBQ SYRG,39.0,27.3,,,0
NDC,16714-014-02,AMOXICILLIN-POT CLAVULANATE 875 MG-125 MG TAB,28.0,19.6,,,0
NDC,16714-016-01,ENOXAPARIN 40 MG/0.4 ML SUBQ SYRG,66.0,46.2,,,0
NDC,16714-026-01,ENOXAPARIN 40 MG/0.4 ML SUBQ SYRG,47.0,32.9,,,0
NDC,16714-026-10,ENOXAPARIN 60 MG/0.6 ML SUBQ SYRG,70.0,49.0,,,0
NDC,16714-036-01,ENOXAPARIN 80 MG/0.8 ML SUBQ SYRG,47.5,33.25,,,0
NDC,16714-036-10,ENOXAPARIN 80 MG/0.8 ML SUBQ SYRG,94.0,65.8,,,0
NDC,16714-037-01,EPHEDRINE 50 MG/ML IV SOLN (MERGE),114.0,79.80000000000001,,,0
NDC,16714-037-10,EPHEDRINE 50 MG/ML IV SOLN (MERGE),88.5,61.95,,,0
NDC,16714-040-01,SUMATRIPTAN 6 MG/0.5 ML SUBQ PEN KIT,406.0,284.2,,,0
NDC,16714-041-04,ALLOPURINOL 20 MG/ML ORAL SUSPENSION (REPACK),7.5,5.25,,,0
NDC,16714-046-01,ENOXAPARIN 60 MG/0.6 ML SUBQ SYRG,103.0,72.1,,,0
NDC,16714-046-10,ENOXAPARIN 100 MG/1 ML SUBQ SYRG,115.0,80.5,,,0
NDC,16714-050-01,CHLORPROMAZINE 100 MG ORAL TAB,126.0,88.19999999999999,,,0
NDC,16714-052-03,CLOPIDOGREL  75 MG ORAL TAB,39.0,27.3,,,0
NDC,16714-052-10,CLOPIDOGREL  75 MG ORAL TAB,55.0,38.5,,,0
NDC,16714-056-01,ENOXAPARIN 120 MG/0.8 ML SUBQ SYRG,141.0,98.7,,,0
NDC,16714-056-10,ENOXAPARIN 120 MG/0.8 ML SUBQ SYRG,132.0,92.4,,,0
NDC,16714-063-01,CARBAMAZEPINE 100 MG ORAL TB12,7.0,4.9,,,0
NDC,16714-066-01,ENOXAPARIN 150 MG/1 ML SUBQ SYRG,156.0,109.2,,,0
NDC,16714-070-01,FULVESTRANT 250 MG/5 ML IM SYRG,4591.0,3213.7,,,0
NDC,16714-070-02,FULVESTRANT 250 MG/5 ML IM SYRG,3443.5,2410.45,,,0
NDC,16714-071-04,BACLOFEN 10 MG ORAL TAB,21.0,14.700000000000001,,,0
NDC,16714-072-04,BACLOFEN 20 MG ORAL TAB,29.0,20.3,,,0
NDC,16714-081-10,HYDROXYZINE 10 MG TAB,8.0,5.6,,,0
NDC,16714-082-10,HYDROXYZINE 25 MG TAB,11.0,7.7,,,0
NDC,16714-083-10,HYDROXYZINE 50 MG TAB,10.0,7.0,,,0
NDC,16714-101-02,GEMFIBROZIL 600 MG ORAL TAB,10.0,7.0,,,0
NDC,16714-112-02,FLUOXETINE 10 MG ORAL TAB,33.0,23.1,,,0
NDC,16714-130-01,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,16.0,11.2,,,0
NDC,16714-130-25,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,50.0,35.0,,,0
NDC,16714-131-01,IRINOTECAN 100 MG/5 ML IV SOLN,388.0,271.6,,,0
NDC,16714-140-01,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,47.0,32.9,,,0
NDC,16714-157-01,PROGESTERONE MICRONIZED 100 MG ORAL CAP,24.0,16.799999999999997,,,0
NDC,16714-161-01,CLINDAMYCIN 1 % TOPICAL GEL,361.0,252.7,,,0
NDC,16714-166-01,LIOTHYRONINE  5 MCG ORAL TAB,12.0,8.399999999999999,,,0
NDC,16714-167-01,LIOTHYRONINE 25 MCG ORAL TAB,11.0,7.7,,,0
NDC,16714-172-01,TIZANIDINE 4 MG ORAL TAB,9.0,6.3,,,0
NDC,16714-200-10,ONDANSETRON 4 MG ORAL TBDL,83.5,58.45,,,0
NDC,16714-227-01,CARVEDILOL PHOSPHATE 10 MG ORAL CM24,102.0,71.4,,,0
NDC,16714-234-01,PENICILLIN V POTASSIUM 250 MG ORAL TAB,10.0,7.0,,,0
NDC,16714-244-01,FAMOTIDINE 40 MG/5 ML ORAL SUSP,50.0,35.0,,,0
NDC,16714-293-01,AMOXICILLIN-POT CLAVULANATE 400 MG-57 MG/5 ML ORAL SUSP,25.0,17.5,,,0
NDC,16714-293-03,AMOXICILLIN-POT CLAVULANATE 400 MG-57 MG/5 ML ORAL SUSP,25.5,17.85,,,0
NDC,16714-294-01,AMOXICILLIN-POT CLAVULANATE 600 MG-42.9 MG/5 ML ORAL SUSP,24.0,16.8,,,0
NDC,16714-294-02,AMOXICILLIN-POT CLAVULANATE 600 MG-42.9 MG/5 ML ORAL SUSP,21.5,15.05,,,0
NDC,16714-296-01,AMOXICILLIN-POT CLAVULANATE 500 MG-125 MG TAB,130.5,91.35,,,0
NDC,16714-297-01,AMOXICILLIN-POT CLAVULANATE 875 MG-125 MG TAB,258.0,180.6,,,0
NDC,16714-297-02,AMOXICILLIN-POT CLAVULANATE 875 MG-125 MG TAB,169.0,118.3,,,0
NDC,16714-298-01,AMOXICILLIN 250 MG ORAL CAP,5.5,3.85,,,0
NDC,16714-298-02,AMOXICILLIN 250 MG ORAL CAP,7.0,4.9,,,0
NDC,16714-299-02,AMOXICILLIN 500 MG ORAL CAP,37.0,25.9,,,0
NDC,16714-299-03,AMOXICILLIN 500 MG ORAL CAP,22.0,15.4,,,0
NDC,16714-309-01,VANCOMYCIN 1000 MG IV SOLR,130.0,91.0,,,0
NDC,16714-314-01,VENLAFAXINE  75 MG ORAL TAB,13.0,9.1,,,0
NDC,16714-342-03,CLONIDINE 0.1MG/ML ORAL SOLUTION (HIGH CONC FOR PEDS),7.0,4.9,,,0
NDC,16714-355-01,LEVETIRACETAM  500 MG ORAL TAB,29.0,20.3,,,0
NDC,16714-358-01,LEVETIRACETAM 100 MG/ML ORAL SOLN,14.0,9.8,,,0
NDC,16714-365-01,NORGESTREL-ETHINYL ESTRADIOL 0.3 MG-30 MCG TAB,7.0,4.9,,,0
NDC,16714-365-04,NORGESTREL-ETHINYL ESTRADIOL 0.3 MG-30 MCG TAB,7.0,4.9,,,0
NDC,16714-372-02,LAMOTRIGINE 1MG/ML SUSPENSION (REPACK),13.0,9.1,,,0
NDC,16714-395-01,CEFPODOXIME 200 MG ORAL TAB,47.0,32.9,,,0
NDC,16714-400-01,CEFUROXIME AXETIL 250 MG ORAL TAB,39.5,27.65,,,0
NDC,16714-400-02,CEFUROXIME AXETIL 250 MG ORAL TAB,37.5,26.25,,,0
NDC,16714-439-01,NITROFURANTOIN (25% MACROCRYSTAL FORM) 100 MG CAP,20.0,14.0,,,0
NDC,16714-442-01,ENALAPRIL MALEATE  2.5 MG ORAL TAB,10.5,7.3500000000000005,,,0
NDC,16714-454-01,QUETIAPINE 10 MG/ML ORAL SUSPENSION,7.0,4.9,,,0
NDC,16714-456-01,QUETIAPINE 300 MG ORAL TAB,51.0,35.7,,,0
NDC,16714-476-01,AMOXICILLIN-POT CLAVULANATE 250 MG-125 MG TAB,45.5,31.85,,,0
NDC,16714-483-02,CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,35.0,24.5,,,0
NDC,16714-485-01,DIVALPROEX 500 MG ORAL TB24,46.0,32.2,,,0
NDC,16714-496-01,CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,184.0,128.8,,,0
NDC,16714-505-01,GABAPENTIN 400 MG ORAL CAP,18.0,12.6,,,0
NDC,16714-528-01,PROPOFOL 10 MG/ML 20ML BOLUS IV EMUL,11.0,7.7,,,0
NDC,16714-534-01,EMTRICITABINE-TENOFOVIR 200 MG-300 MG TAB,297.0,207.9,,,0
NDC,16714-536-01,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,38.0,26.6,,,0
NDC,16714-601-02,SERTRALINE 20 MG/ML ORAL CONC,20.0,14.0,,,0
NDC,16714-613-04,SERTRALINE 100 MG ORAL TAB,20.0,14.0,,,0
NDC,16714-621-01,ZOLPIDEM  5 MG ORAL TAB,39.0,27.3,,,0
NDC,16714-644-01,DOXYCYCLINE HYCLATE 100 MG IV SOLR,205.5,143.85000000000002,,,0
NDC,16714-653-01,CIPROFLOXACIN 750 MG ORAL TAB,282.0,197.4,,,0
NDC,16714-658-01,VENLAFAXINE  75 MG ORAL TAB,19.0,13.3,,,0
NDC,16714-661-01,GABAPENTIN 100 MG ORAL CAP,7.0,4.9,,,0
NDC,16714-662-01,GABAPENTIN 300 MG ORAL CAP,15.0,10.5,,,0
NDC,16714-663-01,GABAPENTIN 400 MG ORAL CAP,18.0,12.6,,,0
NDC,16714-671-02,ONDANSETRON HCL 4 MG/5 ML ORAL SOLN,54.0,37.8,,,0
NDC,16714-681-01,SIMVASTATIN  5 MG ORAL TAB,23.5,16.45,,,0
NDC,16714-681-02,SIMVASTATIN  5 MG ORAL TAB,19.0,13.3,,,0
NDC,16714-682-02,SIMVASTATIN 10 MG ORAL TAB,23.5,16.45,,,0
NDC,16714-683-02,SIMVASTATIN 20 MG ORAL TAB,40.0,28.0,,,0
NDC,16714-685-01,SIMVASTATIN 80 MG ORAL TAB,28.0,19.6,,,0
NDC,16714-685-02,SIMVASTATIN 80 MG ORAL TAB,20.5,14.35,,,0
NDC,16714-690-01,PROPOFOL 10 MG/ML 100ML INFUSION IV EMUL,26.0,18.2,,,0
NDC,16714-693-01,FLUCONAZOLE 200 MG ORAL TAB,106.0,74.2,,,0
NDC,16714-695-01,FLUCONAZOLE 10 MG/ML ORAL SUSR,173.0,121.1,,,0
NDC,16714-696-01,FLUCONAZOLE 40 MG/ML ORAL SUSR,52.0,36.4,,,0
NDC,16714-713-01,TAMSULOSIN 0.4 MG ORAL CP24,24.0,16.8,,,0
NDC,16714-720-02,FLUOXETINE 10 MG ORAL CAP,36.5,25.55,,,0
NDC,16714-728-01,OXALIPLATIN 100 MG/20 ML IV SOLN,1288.0,901.6,,,0
NDC,16714-732-01,CELECOXIB 100 MG ORAL CAP,39.0,27.299999999999997,,,0
NDC,16714-743-02,ITRACONAZOLE 100 MG ORAL CAP,183.0,128.1,,,0
NDC,16714-755-01,ATOMOXETINE  10 MG ORAL CAP,140.0,98.0,,,0
NDC,16714-766-01,CEFIXIME 100 MG/5 ML ORAL SUSR,378.0,264.6,,,0
NDC,16714-795-01,TERBINAFINE 250 MG ORAL TAB,611.0,427.7,,,0
NDC,16714-796-01,SUMATRIPTAN 25 MG TAB,181.5,127.05,,,0
NDC,16714-797-01,SUMATRIPTAN 50 MG TAB,123.0,86.1,,,0
NDC,16714-799-01,CETIRIZINE 10 MG ORAL TAB,7.0,4.9,,,0
NDC,16714-799-02,CETIRIZINE 10 MG ORAL TAB,14.0,9.8,,,0
NDC,16714-809-01,LEVONORGESTREL 1.5 MG ORAL TAB,165.0,115.5,,,0
NDC,16714-851-03,CLOMIPRAMINE 75 MG ORAL CAP,74.5,52.15,,,0
NDC,16714-877-01,ATORVASTATIN 80 MG ORAL TAB,32.0,22.4,,,0
NDC,16714-878-01,LIDOCAINE 5 % TOP OINT,803.0,562.1,,,0
NDC,16714-886-01,BLEOMYCIN 15 UNITS/5 ML INJ SOLR (WET SOLR VIAL),461.0,322.7,,,0
NDC,16714-889-01,ERTAPENEM 1 GRAM INJ SOLR,2100.0,1470.0,,,0
NDC,16714-894-01,GLIPIZIDE  2.5 MG ORAL TO24,7.0,4.9,,,0
NDC,16714-895-01,GLIPIZIDE  5 MG ORAL TO24,7.0,4.9,,,0
NDC,16714-928-01,DECITABINE 50 MG IV SOLR,1390.5,973.3499999999999,,,0
NDC,16714-930-01,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) BLADDER INSTILLATION,254.0,177.8,,,0
NDC,16714-950-01,AMPHETAMINE-DEXTROAMPHETAMINE 10 MG ORAL TAB,15.0,10.5,,,0
NDC,16714-988-01,ROSUVASTATIN  5 MG ORAL TAB,56.0,39.2,,,0
NDC,16714-989-01,ROSUVASTATIN 10 MG ORAL TAB,49.0,34.3,,,0
NDC,16714-990-01,ROSUVASTATIN 20 MG ORAL TAB,49.0,34.3,,,0
NDC,16714-997-01,ADENOSINE (DIAGNOSTIC) 3 MG/ML IV SOLN,1102.5,771.75,,,0
NDC,16729-023-10,BICALUTAMIDE 50 MG ORAL TAB,90.0,63.0,,,0
NDC,16729-035-10,ANASTROZOLE 1 MG ORAL TAB,66.0,46.2,,,0
NDC,16729-079-01,CARBIDOPA-LEVODOPA SR 50 MG-200 MG TAB,11.0,7.7,,,0
NDC,16729-108-11,MITOMYCIN 20 MG IV SOLR,1628.0,1139.6,,,0
NDC,16729-114-08,ETOPOSIDE 20 MG/ML IV SOLN,83.0,58.1,,,0
NDC,16729-114-31,ETOPOSIDE 20 MG/ML IV SOLN,61.5,43.05,,,0
NDC,16729-136-00,CLONAZEPAM 0.5 MG ORAL TAB,7.0,4.9,,,0
NDC,16729-137-00,CLONAZEPAM 1 MG ORAL TAB,10.0,7.0,,,0
NDC,16729-156-15,SIMVASTATIN  5 MG ORAL TAB,24.0,16.799999999999997,,,0
NDC,16729-175-01,AMITRIPTYLINE 100 MG ORAL TAB,15.0,10.5,,,0
NDC,16729-184-01,HYDROCHLOROTHIAZIDE  50 MG ORAL TAB,7.0,4.9,,,0
NDC,16729-216-15,SERTRALINE  50 MG ORAL TAB,24.0,16.8,,,0
NDC,16729-221-30,TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FINAL) IV SOLR,10988.0,7691.6,,,0
NDC,16729-226-01,SPIRONOLACTONE  50 MG ORAL TAB,7.0,4.9,,,0
NDC,16729-267-65,DOCETAXEL 20 MG/ML (1 ML) IV SOLN,9722.0,6805.4,,,0
NDC,16729-276-38,FLUOROURACIL 500 MG/10 ML IV SOLN,230.0,161.0,,,0
NDC,16729-277-03,METHOTREXATE NA (PRESERV FREE) 25 MG/ML INJ SOLN,2021.0,1414.7,,,0
NDC,16729-277-30,METHOTREXATE SODIUM 25 MG/ML INJ SOLN,55.0,38.5,,,0
NDC,16729-277-35,METHOTREXATE NA (PRESERV FREE) 25 MG/ML INJ SOLN,1776.0,1243.2,,,0
NDC,16729-278-01,ARIPIPRAZOLE  2 MG ORAL TAB,157.0,109.9,,,0
NDC,16729-288-11,CISPLATIN 1 MG/ML IV,272.0,190.4,,,0
NDC,16729-288-38,CISPLATIN 1 MG/ML IV,124.0,86.8,,,0
NDC,16729-295-12,CARBOPLATIN 10 MG/ML IV,191.0,133.7,,,0
NDC,16729-306-10,AZACITIDINE 100 MG INJ SOLR,1181.0,826.6999999999999,,,0
NDC,16729-321-10,OLMESARTAN 20 MG ORAL TAB,202.0,141.4,,,0
NDC,16729-322-15,OLMESARTAN 40 MG ORAL TAB,40.0,28.0,,,0
NDC,16729-415-01,DOXAZOSIN 8 MG ORAL TAB,9.0,6.3,,,0
NDC,16729-440-10,CINACALCET 30 MG ORAL TAB,260.0,182.0,,,0
NDC,16729-440-15,CINACALCET 30 MG ORAL TAB,260.0,182.0,,,0
NDC,16729-443-15,BUPROPION HCL 150 MG ORAL TB24,52.0,36.4,,,0
NDC,16729-443-16,BUPROPION HCL 150 MG ORAL TB24,29.0,20.3,,,0
NDC,16729-457-15,LEVOTHYROXINE 200 MCG ORAL TAB,6.0,4.2,,,0
NDC,16729-457-17,LEVOTHYROXINE 200 MCG ORAL TAB,7.0,4.9,,,0
NDC,16729-478-01,METHYLPHENIDATE  5 MG ORAL TAB,7.5,5.25,,,0
NDC,16729-484-03,ATROPINE 0.1 MG/ML INJ SYRG,92.5,64.75,,,0
NDC,16729-512-05,ATROPINE 0.4 MG/ML INJ SOLN,77.0,53.9,,,0
NDC,16729-526-63,ATROPINE 1 MG/ML IV SOLN,56.0,39.2,,,0
NDC,1678411613,BACITRACIN 500 UNIT/G TOP PACK,7.0,4.9,,,0
NDC,16837-855-25,FAMOTIDINE 20 MG ORAL TAB,7.0,4.9,,,0
NDC,16864-680-03,BENZOCAINE-MENTHOL 20 %-0.5 % TOPICAL AEROSOL,52.0,36.4,,,0
NDC,1698602080,"HYALURONATE SODIUM, STABILIZED 60 MG/3 ML IATC SYRG",989.0,692.3,,,0
NDC,17156-021-01,INDIUM IN-111 LABELED AUTOLOGOUS WHITE BLOOD CELLS,6136.0,4295.2,,,0
NDC,17156-210-01,IOFLUPANE I 123 5 MCI/2.5 ML (185 MBQ/2.5ML) IV SOLN,2080.0,1456.0,,,0
NDC,17156-235-01,"IOBENGUANE, I-123",8818.0,6172.6,,,0
NDC,17238-900-11,FLUORESCEIN 1 MG OPHT STRP,7.0,4.9,,,0
NDC,17238-900-30,FLUORESCEIN 1 MG OPHT STRP,7.0,4.9,,,0
NDC,17238-900-99,FLUORESCEIN 1 MG OPHT STRP,7.0,4.9,,,0
NDC,17271-701-02,SODIUM CHLORIDE 0.9 % IV SOLP,30.0,21.0,,,0
NDC,17271-701-05,SODIUM CHLORIDE 0.9 % IV SOLP,41.0,28.7,,,0
NDC,17271-701-06,SODIUM CHLORIDE 0.9 % IV SOLP,46.5,32.55,,,0
NDC,17271-701-07,SODIUM CHLORIDE 0.9 % IV SOLP,50.5,35.349999999999994,,,0
NDC,17271-710-06,LACTATED RINGERS IV (BOLUS),1631.0,1141.7,,,0
NDC,17271-710-07,LACTATED RINGERS IV (BOLUS),411.0,287.7,,,0
NDC,17478-015-02,DICYCLOMINE 10 MG/ML IM SOLN,385.0,269.5,,,0
NDC,17478-040-01,LORAZEPAM 2 MG/ML IV SOLN (PHS MERGE - ALL SITES),23.0,16.1,,,0
NDC,17478-045-32,LET TOP SOLN 5ML (COMPOUNDED),115.0,80.5,,,0
NDC,17478-050-05,SUFENTANIL CITRATE 50 MCG/ML IV SOLN,94.0,65.8,,,0
NDC,17478-070-35,ERYTHROMYCIN 5 MG/G OPHT OINT,92.0,64.4,,,0
NDC,17478-081-30,ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN,27.5,19.25,,,0
NDC,17478-215-05,ATROPINE 1 % OPHT DROP,248.0,173.6,,,0
NDC,17478-253-10,FLUORESCEIN 500 MG/5 ML (10 %) IV SOLN,550.0,385.0,,,0
NDC,17478-288-10,TIMOLOL MALEATE 0.5 % OPHT DROP,84.0,58.8,,,0
NDC,17478-380-20,METHADONE 10 MG/ML INJ SOLN,154.5,108.14999999999999,,,0
NDC,17478-419-40,CHLOROTHIAZIDE SODIUM 500 MG IV SOLR,225.0,157.5,,,0
NDC,17478-420-20,LABETALOL 5 MG/ML IV SOLN,23.0,16.1,,,0
NDC,17478-504-01,METHYLENE BLUE (ANTIDOTE) 1 % INJ SOLN,164.0,114.8,,,0
NDC,17478-504-10,METHYLENE BLUE (ANTIDOTE) 1 % INJ SOLN,544.0,380.8,,,0
NDC,17478-508-01,INDIGOTINDISULFONATE SODIUM 8 MG/ML INJ SOLN,66.0,46.2,,,0
NDC,17478-515-00,EPHEDRINE 5 MG/ML IN NS IV SYRINGE,54.0,37.8,,,0
NDC,17478-538-02,ORPHENADRINE CITRATE 30 MG/ML INJ SOLN,109.0,76.3,,,0
NDC,17478-542-02,ADENOSINE 3000 MCG/ML INJECTION,62.5,43.75,,,0
NDC,17478-711-10,LIDOCAINE 2 % MUCOSAL GEL,47.0,32.9,,,0
NDC,17478-711-30,LIDOCAINE 2 % MUCOSAL GEL,210.0,147.0,,,0
NDC,17478-711-31,LIDOCAINE 2 % MUCOSAL GEL,47.0,32.9,,,0
NDC,17478-840-05,LIDOCAINE 2 % MUCOSAL GEL,44.0,30.8,,,0
NDC,17478-931-01,CALCITRIOL 1 MCG/ML IV SOLN,52.0,36.4,,,0
NDC,17478-937-05,DILTIAZEM 5 MG/ML IV,20.0,14.0,,,0
NDC,17478-937-10,DILTIAZEM 5 MG/ML IV,16.0,11.2,,,0
NDC,17856-0039-04,MULTIVITAMIN W/IRON ORAL DROP 1 ML (PEDS/NEO),9.0,6.3,,,0
NDC,17856-0049-01,CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/ML ORAL DROP,50.0,35.0,,,0
NDC,17856-0055-1,"OMEGA-3 FATTY ACIDS-FISH OIL 360-1,200 MG ORAL CAP (ERX MERGE)",5.5,3.85,,,0
NDC,17856-0056-1,DEXTROMETHORPHAN-GUAIFENESIN SR 30 MG-600 MG 12 HR TAB,5.5,3.85,,,0
NDC,17856-0059-1,PROMETHAZINE  6.25 MG/5 ML ORAL SYRP,21.0,14.700000000000001,,,0
NDC,17856-0138-1,LIDOCAINE 2 % MUCOSAL SOLN (VISCOUS),28.0,19.6,,,0
NDC,17856-0306-1,SUCRALFATE 100 MG/ML ORAL SUSP,51.0,35.7,,,0
NDC,17856-0405-01,MULTIVITAMIN W/IRON ORAL DROP 0.5 ML (PEDS/NEO),8.0,5.6,,,0
NDC,17856-0555-1,ONDANSETRON HCL 4 MG/5 ML ORAL SOLN,33.0,23.1,,,0
NDC,17856-0555-5,ONDANSETRON HCL 4 MG/5 ML ORAL SOLN,50.0,35.0,,,0
NDC,17856-0574-1,LEVETIRACETAM 500 MG/5 ML ORAL SOLN,46.0,32.2,,,0
NDC,17856-0600-1,GABAPENTIN 250 MG/5 ML ORAL SOLN,21.5,15.05,,,0
NDC,17856-0630-1,ALUM-MAG HYDROXIDE-SIMETH 200 MG-200 MG-20 MG/5 ML ORAL SUSP,30.0,21.0,,,0
NDC,17856-0691-5,ONDANSETRON HCL 4 MG/5 ML ORAL SOLN,46.5,32.55,,,0
NDC,17856-0698-01,GABAPENTIN 250 MG/5 ML (5 ML) ORAL SOLN,21.0,14.7,,,0
NDC,17856-0732-1,BENZOCAINE-MENTHOL 15-2.6 MG MM LOZG,9.0,6.300000000000001,,,0
NDC,17856-0759-5,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (5 ML) ORAL SOLN,30.0,21.0,,,0
NDC,17856-0799-4,SIMETHICONE 40MG/0.6ML (0.6ML-UD) SYRINGE (REPACK),7.5,5.25,,,0
NDC,17856-0815-1,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (5 ML) ORAL SOLN,23.0,16.1,,,0
NDC,17856-0823-10,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,7.0,4.9,,,0
NDC,17856-1045-1,NYSTATIN 100000 UNIT/ML ORAL SUSP,35.0,24.5,,,0
NDC,17856-1141-4,SIMETHICONE 40MG/0.6ML (0.6ML-UD) SYRINGE (REPACK),13.0,9.1,,,0
NDC,17856-1162-01,DEXTROMETHORPHAN-GUAIFENESIN SR 30 MG-600 MG 12 HR TAB,5.5,3.85,,,0
NDC,17856-1303-4,SIMETHICONE 40 MG/0.6 ML ORAL DRPS,7.0,4.9,,,0
NDC,17856-2002-3,CHLORHEXIDINE GLUCONATE  0.12 % MM MWSH,7.0,4.9,,,0
NDC,17856-3086-1,ASPIRIN   81 MG ORAL TBEC,5.0,3.5,,,0
NDC,17856-5725-3,ALUM-MAG HYDROXIDE-SIMETH 400 MG-400 MG-40 MG/5 ML ORAL SUSP,14.0,9.8,,,0
NDC,17856-5894-02,SIMETHICONE 40MG/0.6ML (0.6ML-UD) SYRINGE (REPACK),7.0,4.9,,,0
NDC,17856-600-02,GABAPENTIN 300 MG/6 ML (6 ML) ORAL SOLN,10.0,7.0,,,0
NDC,17856-6836-1,LOPERAMIDE 1 MG/7.5 ML ORAL LIQD,16.0,11.2,,,0
NDC,17856-7014-7,ACETAMINOPHEN 650 MG/20.3 ML ORAL SOLN,5.0,3.5,,,0
NDC,17856-7482-02,FERROUS SULFATE 75 MG/ML (ELEMENTAL IRON 15 MG/ML) 0.2 ML ORAL SYRINGE (REPACK),10.0,7.0,,,0
NDC,17856-921-01,SEVELAMER CARBONATE 800 MG ORAL TAB,105.0,73.5,,,0
NDC,1785600021,SACCHAROMYCES BOULARDII 250 MG ORAL CAP,38.0,26.6,,,0
NDC,1785600102,MULTIVIT-MIN-FERROUS GLUCONATE 9 MG IRON/ 15 ML (15 ML) ORAL LIQD,9.0,6.3,,,0
NDC,17856002601,ACIDOPHILUS-PECTIN W CITRUS 25 MILLION-100 CELL MG TAB,5.5,3.85,,,0
NDC,1785600392,MULTIVITAMIN W/IRON ORAL DROP 0.5 ML (PEDS/NEO),8.0,5.6,,,0
NDC,1785600492,CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/ML ORAL DROP,7.0,4.9,,,0
NDC,1785608695,SACCHAROMYCES BOULARDII 250 MG ORAL CAP,9.5,6.65,,,0
NDC,1785614241,ACIDOPHILUS-PECTIN W CITRUS 25 MILLION-100 CELL MG TAB,18.0,12.6,,,0
NDC,18657-117-01,HYALURONIDASE 150 UNIT/ML INJ SOLN,568.0,397.6,,,0
NDC,18657-117-02,HYALURONIDASE 150 UNIT/ML INJ SOLN,256.0,179.2,,,0
NDC,18657-117-04,HYALURONIDASE 150 UNIT/ML INJ SOLN,29.0,20.3,,,0
NDC,19515-810-41,FLU VACCINE TS 2024-25 6MOS UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,116.0,81.2,,,0
NDC,19515-810-52,FLU VACCINE TS 2024-25 6MOS UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,116.0,81.2,,,0
NDC,19515-904-41,FLU VACCINE TS 2025-26 6 MO UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,120.0,84.0,,,0
NDC,19515-904-52,FLU VACCINE TS 2025-26 6 MO UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,120.0,84.0,,,0
NDC,2055500100,ASCORBIC ACID  250 MG ORAL TAB,7.0,4.9,,,0
NDC,2055501900,FERROUS GLUCONATE 324 MG (38 MG IRON) TAB,7.0,4.9,,,0
NDC,2055502101,FERROUS SULFATE 325 MG (65 MG IRON) TAB,7.0,4.9,,,0
NDC,2055502500,CALCIUM CARBONATE-VITAMIN D3 250 MG-125 UNIT TAB,5.5,3.85,,,0
NDC,2055503300,CHOLECALCIFEROL (VITAMIN D3)  1000 UNIT ORAL TAB,5.5,3.85,,,0
NDC,2055503600,MELATONIN  3 MG ORAL TAB,5.5,3.85,,,0
NDC,2055503601,MELATONIN  3 MG ORAL TAB,8.5,5.95,,,0
NDC,2055504000,ZINC SULFATE 220 MG (50 MG) CAP,7.0,4.9,,,0
NDC,21922-004-04,DESONIDE 0.05 % TOP OINT,341.0,238.7,,,0
NDC,21922-021-07,PERMETHRIN 5 % TOP CREA,425.0,297.5,,,0
NDC,225052547,SODIUM CHLORIDE-ALOE VERA TOPICAL GEL,18.5,12.95,,,0
NDC,225052848,SODIUM CHLORIDE-ALOE VERA NASL SPRY,31.0,21.7,,,0
NDC,23066704,WHITE PETROLATUM-MINERAL OIL OPHT OINT (PDS MERGE),51.0,35.7,,,0
NDC,23155-001-01,HYDRALAZINE  10 MG ORAL TAB,7.0,4.9,,,0
NDC,23155-026-01,VERAPAMIL  80 MG ORAL TAB,7.0,4.9,,,0
NDC,23155-043-03,LEFLUNOMIDE  10 MG ORAL TAB,8.5,5.95,,,0
NDC,23155-049-01,FELODIPINE  5 MG ORAL TB24,9.0,6.3,,,0
NDC,23155-070-01,METHIMAZOLE  5 MG ORAL TAB,7.5,5.25,,,0
NDC,23155-071-01,METHIMAZOLE 10 MG ORAL TAB,8.0,5.6,,,0
NDC,23155-135-25,DOXYCYCLINE 100 MG TAB,246.0,172.2,,,0
NDC,23155-166-31,TRANEXAMIC ACID (FOR TOPICAL USE),49.5,34.650000000000006,,,0
NDC,23155-192-01,BUPROPION HCL 100 MG ORAL TAB,8.0,5.6,,,0
NDC,23155-194-01,NIFEDIPINE 10 MG ORAL CAP,7.5,5.25,,,0
NDC,23155-195-01,NIFEDIPINE 20 MG ORAL CAP,7.0,4.9,,,0
NDC,23155-240-31,METOCLOPRAMIDE  5 MG/ML INJ SOLN,23.0,16.1,,,0
NDC,23155-248-01,VENLAFAXINE  50 MG ORAL TAB,15.0,10.5,,,0
NDC,23155-258-32,ADENOSINE (DIAGNOSTIC) 3 MG/ML IV SOLN,719.0,503.3,,,0
NDC,23155-287-01,ACETAZOLAMIDE 125 MG ORAL TAB,7.0,4.9,,,0
NDC,23155-290-31,AMIKACIN 1000 MG/4 ML INJ SOLN,50.0,35.0,,,0
NDC,23155-290-32,AMIKACIN 1000 MG/4 ML INJ SOLN,101.0,70.7,,,0
NDC,23155-294-31,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN,30.0,21.0,,,0
NDC,23155-294-41,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN,32.0,22.4,,,0
NDC,23155-313-31,ACETAZOLAMIDE SODIUM 500 (100 MG/ML) INJ SOLR,117.0,81.9,,,0
NDC,23155-317-51,RISPERIDONE 1 MG/ML ORAL SOLN,100.0,70.0,,,0
NDC,23155-473-32,FUROSEMIDE 10 MG/ML INJ SOLN,47.0,32.9,,,0
NDC,23155-473-33,FUROSEMIDE 10 MG/ML INJ SOLN,43.0,30.1,,,0
NDC,23155-473-44,FUROSEMIDE 10 MG/ML INJ SOLN,21.5,15.049999999999999,,,0
NDC,23155-486-01,VERAPAMIL 120 MG ORAL TAB,7.0,4.9,,,0
NDC,23155-489-01,DESMOPRESSIN 0.1 MG ORAL TAB,52.0,36.4,,,0
NDC,23155-501-01,HYDROXYZINE 25 MG TAB,5.5,3.85,,,0
NDC,23155-512-11,NIMODIPINE 30 MG ORAL CAP,136.0,95.2,,,0
NDC,23155-512-30,NIMODIPINE 30 MG ORAL CAP,95.0,66.5,,,0
NDC,23155-547-31,ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN,12.0,8.399999999999999,,,0
NDC,23155-547-42,ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN,16.0,11.2,,,0
NDC,23155-548-31,ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN,16.0,11.2,,,0
NDC,23155-549-31,ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN,23.5,16.45,,,0
NDC,23155-594-31,AMPHOTERICIN B LIPOSOME 50 MG IV SUSR,5411.0,3787.7,,,0
NDC,23155-600-31,MIDAZOLAM 1 MG/ML INJ SOLN,19.5,13.649999999999999,,,0
NDC,23155-606-01,GLYCOPYRROLATE 1 MG ORAL TAB,8.0,5.6,,,0
NDC,23155-663-01,CALCITRIOL 0.5 MCG ORAL CAP,33.0,23.1,,,0
NDC,23155-687-31,OCTREOTIDE ACETATE   50 MCG/ML INJ SOLN,48.5,33.95,,,0
NDC,23155-688-31,OCTREOTIDE ACETATE  100 MCG/ML INJ SOLN,26.0,18.2,,,0
NDC,23155-723-01,LABETALOL 100 MG ORAL TAB,7.0,4.9,,,0
NDC,23155-724-01,LABETALOL 200 MG ORAL TAB,7.0,4.9,,,0
NDC,23155-748-31,PENTAMIDINE 300 MG INJ SOLR,132.5,92.75,,,0
NDC,23155-749-01,BENAZEPRIL  5 MG ORAL TAB,5.5,3.85,,,0
NDC,23155-767-01,TETRACYCLINE 500 MG ORAL CAP,78.0,54.6,,,0
NDC,23155-773-01,ENALAPRIL MALEATE 20 MG ORAL TAB,16.0,11.2,,,0
NDC,23155-787-01,ACETAZOLAMIDE 500 MG ORAL CPSR,7.0,4.9,,,0
NDC,23155-823-73,CABERGOLINE 0.5 MG ORAL TAB,180.0,126.0,,,0
NDC,23155-832-01,HYDRALAZINE  10 MG ORAL TAB,5.5,3.85,,,0
NDC,23155-833-01,HYDRALAZINE  25 MG ORAL TAB,10.5,7.35,,,0
NDC,23155-839-11,CYCLOSPORINE MODIFIED 100 MG ORAL CAP,31.0,21.7,,,0
NDC,23155-858-78,VANCOMYCIN  125 MG ORAL CAP,107.0,74.9,,,0
NDC,23155-869-31,ARSENIC TRIOXIDE 10 MG/10 ML IV SOLN,493.0,345.1,,,0
NDC,23155-902-01,BUMETANIDE 2 MG ORAL TAB,25.0,17.5,,,0
NDC,24201-100-01,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IVPB (PEDIATRICS/ADULT NON-FORM)",37.0,25.9,,,0
NDC,24201-201-01,SODIUM TETRADECYL SULFATE 3 % IV SOLN,392.0,274.4,,,0
NDC,24201-400-02,CALCITONIN (SALMON) 200 UNIT/ML INJ SOLN,1888.0,1321.6,,,0
NDC,24208-295-25,"TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE DROPS, SUSP",258.0,180.6,,,0
NDC,24208-315-10,"TRIMETHOPRIM-POLYMYXIN B 0.1 %-10,000 UNIT/ML EYE DROPS",66.0,46.2,,,0
NDC,24208-398-30,IPRATROPIUM BROMIDE 0.03 % NASL SPRA,224.0,156.8,,,0
NDC,24208-411-05,BRIMONIDINE 0.2 % OPHT DROP,89.0,62.3,,,0
NDC,24208-434-05,OFLOXACIN 0.3 % OPHT DROP,240.0,168.0,,,0
NDC,24208-457-05,DICLOFENAC 0.1 % EYE DROPS,86.0,60.2,,,0
NDC,24208-463-25,LATANOPROST 0.005 % OPHT DROP,120.0,84.0,,,0
NDC,24208-485-10,DORZOLAMIDE 2 % OPHT DROP,225.0,157.5,,,0
NDC,24208-486-10,DORZOLAMIDE-TIMOLOL 2 %-0.5 % EYE DROPS,287.0,200.9,,,0
NDC,24208-555-55,"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/G EYE OINTMENT",141.0,98.7,,,0
NDC,24208-580-60,GENTAMICIN 0.3 % OPHT DROP,210.0,147.0,,,0
NDC,24208-590-64,TROPICAMIDE 0.5 % OPHT DROP,123.0,86.1,,,0
NDC,24208-631-10,"NEOMYCIN-POLYMYXIN-HC 3.5 MG-10,000 UNIT/ML-1 % EAR SOLN",363.0,254.1,,,0
NDC,24208-635-62,"NEOMYCIN-POLYMYXIN-HC 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS, SUSP",363.0,254.1,,,0
NDC,24208-670-04,SULFACETAMIDE SODIUM 10 % OPHT DROP,259.0,181.3,,,0
NDC,24208-720-02,DEXAMETHASONE 0.1 % EYE DROPS,275.0,192.5,,,0
NDC,24208-730-06,PROPARACAINE 0.5 % OPHT DROP,206.0,144.2,,,0
NDC,24208-735-01,CYCLOPENTOLATE 1 % OPHT DROP,80.0,56.0,,,0
NDC,24208-780-55,"NEOMYCIN-BACITRACIN-POLYMYXIN 3.5 MG-400 UNIT-10,000 UNIT/G EYE OINT",242.0,169.4,,,0
NDC,24208-790-62,NEOMYCIN-POLYMYXIN-GRAMICIDIN 1.75-10K-0.025 MG-UNIT-MG/ML OPHT DROP,260.0,182.0,,,0
NDC,24208-795-35,"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG-10,000 UNIT/G-0.1 % EYE OINTMENT",98.0,68.6,,,0
NDC,24208-830-60,"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",98.0,68.6,,,0
NDC,24208-910-19,ERYTHROMYCIN 5 MG/G OPHT OINT,61.0,42.7,,,0
NDC,24208-910-55,ERYTHROMYCIN 5 MG/G OPHT OINT,93.0,65.1,,,0
NDC,24338-008-90,THYROID (PORK)  90 MG ORAL TAB,9.0,6.3,,,0
NDC,24338-134-02,ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL SUSR,111.0,77.7,,,0
NDC,24338-136-10,ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL SUSR,15.0,10.5,,,0
NDC,24338-230-15,NIMODIPINE 30 MG/5 ML ORAL SYRG,367.0,256.9,,,0
NDC,24338-260-10,NIMODIPINE 60 MG/10 ML ORAL SYRG,416.0,291.2,,,0
NDC,24338-530-25,SOTALOL 5 MG/ML ORAL SOLN,32.0,22.4,,,0
NDC,24357-011-13,EPINEPHRINE 1 MG/ML INJ KIT,10685.0,7479.5,,,0
NDC,24357-701-05,LIDOCAINE 4 % TOP CREA,24.0,16.8,,,0
NDC,24385-009-26,IBUPROFEN 100 MG/5 ML ORAL SUSP,7.0,4.9,,,0
NDC,24571-105-06,BICARBONATE DIALYSIS SOLN NO.9 K (4 MEQ/L)-CA (2.5)-MG (1.5) HEMO SOLN,172.0,120.4,,,0
NDC,24571-113-06,"BICARB DIAL SOLN13-NO CA,K,DEX MG 1.2 MEQ/L HEMO SOLN",412.0,288.4,,,0
NDC,24658-141-30,CITALOPRAM 20 MG ORAL TAB,7.0,4.9,,,0
NDC,24658-704-01,ESTRADIOL 2 MG ORAL TAB,32.5,22.75,,,0
NDC,24689-907-01,BUSPIRONE 10 MG ORAL TAB,12.0,8.4,,,0
NDC,24979-198-01,GUANFACINE 1 MG ORAL TAB,10.5,7.35,,,0
NDC,25021-053-01,DEXAMETHASONE SODIUM PHOS (PF) 10MG/ML INJ SOLN,2.0,1.4,,,0
NDC,25021-101-10,CEFAZOLIN   1 GRAM INJ SOLR,64.5,45.150000000000006,,,0
NDC,25021-105-10,CEFTRIAXONE 500 MG INJ SOLR,20.0,14.0,,,0
NDC,25021-106-10,CEFTRIAXONE 1 GRAM INJ SOLR,32.0,22.4,,,0
NDC,25021-107-20,CEFTRIAXONE   2 GRAM INJ SOLR,30.0,21.0,,,0
NDC,25021-107-68,CEFTRIAXONE   2 GRAM INJ SOLR,16.0,11.2,,,0
NDC,25021-113-82,FLUCONAZOLE PEDS SYRINGE (CDS MIXTURE),18.0,12.6,,,0
NDC,25021-114-87,CIPROFLOXACIN IN D5W 400 MG/200 ML IV PGBK,233.0,163.1,,,0
NDC,25021-115-06,CLINDAMYCIN 150 MG/ML INJECTION,34.5,24.15,,,0
NDC,25021-121-20,CEFEPIME 1 GRAM INJ SOLR,180.0,126.0,,,0
NDC,25021-122-50,CEFEPIME 2 GRAM INJ SOLR,44.5,31.15,,,0
NDC,25021-131-82,METRONIDAZOLE IN SODIUM CHLORIDE (ISO-OSM) 500 MG/100 ML IV PIGGY BACK,27.0,18.9,,,0
NDC,25021-132-82,LEVOFLOXACIN IN D5W 500 MG/100 ML IV PGBK,52.0,36.4,,,0
NDC,25021-132-83,LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK,65.0,45.5,,,0
NDC,25021-136-10,AMPICILLIN PEDS INFUSION (CDS MIXTURE),29.5,20.65,,,0
NDC,25021-137-20,AMPICILLIN SODIUM  2 GRAM INJ SOLR,44.0,30.8,,,0
NDC,25021-142-20,AMPICILLIN-SULBACTAM  1.5 GRAM INJ SOLR,37.0,25.9,,,0
NDC,25021-143-30,AMPICILLIN-SULBACTAM  3 GRAM INJ SOLR,53.0,37.1,,,0
NDC,25021-184-67,FLUCONAZOLE IN SALINE (ISO-OSM) 400 MG/200 ML IV PIGGY BACK,25.0,17.5,,,0
NDC,25021-184-82,FLUCONAZOLE 200 MG/100 ML IVPB (MERGE),106.0,74.2,,,0
NDC,25021-184-87,FLUCONAZOLE IN SALINE (ISO-OSM) 400 MG/200 ML IV PIGGY BACK,60.0,42.0,,,0
NDC,25021-185-10,GANCICLOVIR SODIUM 50 MG/ML IV SOLN,184.0,128.8,,,0
NDC,25021-191-10,MICAFUNGIN 100 MG IV SOLR,1212.0,848.4000000000001,,,0
NDC,25021-192-87,CIPROFLOXACIN IN D5W 400 MG/200 ML IV PGBK,47.0,32.9,,,0
NDC,25021-201-10,MESNA 100 MG/ML IV SOLN,411.0,287.7,,,0
NDC,25021-207-25,DOXORUBICIN 50 MG/25 ML IV SOLN,180.0,126.0,,,0
NDC,25021-207-51,DOXORUBICIN 2 MG/ML IV SOLN,150.0,105.0,,,0
NDC,25021-215-98,FLUOROURACIL 500 MG/10 ML IV SOLN,41.0,28.7,,,0
NDC,25021-215-99,FLUOROURACIL 5 GRAM/100 ML IV SOLN,211.5,148.05,,,0
NDC,25021-235-50,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) BLADDER INSTILLATION,127.0,88.9,,,0
NDC,25021-244-10,BORTEZOMIB 3.5 MG IV SOLR,191.0,133.7,,,0
NDC,25021-250-20,MITOMYCIN  5 MG IV SOLR,707.0,494.9,,,0
NDC,25021-301-02,ADENOSINE 3000 MCG/ML INJECTION,40.0,28.0,,,0
NDC,25021-301-67,ADENOSINE 3 MG/ML IV SYRG,282.0,197.4,,,0
NDC,25021-301-72,ADENOSINE 3 MG/ML IV SYRG,141.0,98.69999999999999,,,0
NDC,25021-305-20,CHLOROTHIAZIDE SODIUM 500 MG IV SOLR,37.0,25.9,,,0
NDC,25021-308-84,"ESMOLOL IN SALINE (ISO-OSMOTIC) 2,500 MG/250 ML (10 MG/ML) IV",428.0,299.6,,,0
NDC,25021-309-82,"ESMOLOL IN SALINE (ISO-OSMOTIC) 2,000 MG/100 ML (20 MG/ML) IV",648.0,453.6,,,0
NDC,25021-315-01,PHENYLEPHRINE 10 MG/ML INJECTION,16.0,11.2,,,0
NDC,25021-317-20,LABETALOL 5 MG/ML IV SOLN,20.0,14.0,,,0
NDC,25021-318-02,ADENOSINE 3000 MCG/ML INJECTION,28.0,19.6,,,0
NDC,25021-319-05,DILTIAZEM 5 MG/ML IV,19.5,13.65,,,0
NDC,25021-319-10,DILTIAZEM 5 MG/ML IV,18.5,12.95,,,0
NDC,25021-319-25,DILTIAZEM 5 MG/ML IV,16.0,11.2,,,0
NDC,25021-321-04,BUMETANIDE 0.25 MG/ML INJ SOLN,38.5,26.950000000000003,,,0
NDC,25021-321-10,BUMETANIDE 0.25 MG/ML INJ SOLN,146.0,102.2,,,0
NDC,25021-400-10,HEPARIN (PORCINE) 1000 UNITS/ML INJ SOL (FOR DIALYSIS ONLY),20.0,14.0,,,0
NDC,25021-402-01,HEPARIN (PORCINE)  5000 UNIT/ML INJ SOLN,18.0,12.6,,,0
NDC,25021-410-70,ENOXAPARIN 30 MG/0.3 ML SUBQ SYRG,17.5,12.25,,,0
NDC,25021-410-76,ENOXAPARIN 40 MG/0.4 ML SUBQ SYRG,25.0,17.5,,,0
NDC,25021-415-10,TRANEXAMIC ACID (FOR TOPICAL USE),38.5,26.950000000000003,,,0
NDC,25021-452-01,OCTREOTIDE ACETATE  100 MCG/ML INJ SOLN,260.0,182.0,,,0
NDC,25021-463-01,OCTREOTIDE ACETATE   50 MCG/ML INJ SOLN,42.0,29.4,,,0
NDC,25021-465-01,OCTREOTIDE ACETATE  500 MCG/ML INJ SOLN,206.0,144.2,,,0
NDC,25021-468-10,LEVOTHYROXINE 100 MCG IV SOLR,360.0,252.0,,,0
NDC,25021-470-10,LEVOTHYROXINE 500 MCG INJ SOLR,1838.5,1286.95,,,0
NDC,25021-481-01,DIPHENHYDRAMINE 50 MG/ML INJECTION,16.0,11.2,,,0
NDC,25021-500-02,THIAMINE 100 MG/ML INJECTION,73.0,51.1,,,0
NDC,25021-601-03,CAFFEINE CITRATE PEDS/NEO IV SYR (CDS MIX) LD,29.0,20.299999999999997,,,0
NDC,25021-602-03,CAFFEINE CITRATE 20 MG/ML ORAL SOLN,24.5,17.15,,,0
NDC,25021-608-20,PROPOFOL 10 MG/ML 20ML BOLUS IV EMUL,19.0,13.3,,,0
NDC,25021-608-51,PROPOFOL 10 MG/ML 100ML INFUSION IV EMUL,172.0,120.4,,,0
NDC,25021-612-81,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IV PGBK,99.0,69.3,,,0
NDC,25021-651-02,ORPHENADRINE CITRATE 30 MG/ML INJ SOLN,53.5,37.45,,,0
NDC,25021-662-05,ROCURONIUM 10 MG/ML (1ML-UD) OR SYRINGE,54.0,37.8,,,0
NDC,25021-662-10,ROCURONIUM 10 MG/ML IV SOLN,106.0,74.2,,,0
NDC,25021-671-82,ROPIVACAINE  2 MG/ML INJ SOLN,454.0,317.8,,,0
NDC,25021-673-76,LIDOCAINE HCL  2 % MM JELP,140.0,98.0,,,0
NDC,25021-673-77,LIDOCAINE HCL  2 % MM JELP,43.0,30.1,,,0
NDC,25021-674-20,ETOMIDATE 2 MG/ML IV SOLN,27.0,18.9,,,0
NDC,25021-676-20,PENTOBARBITAL 75 MG/1.5 ML SYRINGE (REPACK),116.0,81.19999999999999,,,0
NDC,25021-683-10,KETAMINE  50 MG/ML INJ SOLN,195.5,136.85000000000002,,,0
NDC,25021-701-01,KETOROLAC TROMETHAMINE 30 MG/ML INJ SOLN,17.0,11.9,,,0
NDC,25021-751-10,PANTOPRAZOLE 40 MG IV SOLR,24.0,16.8,,,0
NDC,25021-790-02,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN,21.5,15.05,,,0
NDC,25021-798-10,FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN,249.5,174.65,,,0
NDC,25021-806-01,HALOPERIDOL LACTATE 5 MG/ML INJECTION (MERGE),50.5,35.35,,,0
NDC,25021-812-30,ACETYLCYSTEINE 20 % (200 MG/ML) IV SOLN,864.0,604.8,,,0
NDC,25021-813-10,LEUCOVORIN CALCIUM  50 MG INJ SOLR,52.0,36.4,,,0
NDC,25021-814-30,LEUCOVORIN CALCIUM 100 MG INJ SOLR,103.5,72.44999999999999,,,0
NDC,25021-816-30,LEUCOVORIN CALCIUM 350 MG INJ SOLR,418.0,292.6,,,0
NDC,25021-826-82,ZOLEDRONIC ACID-MANNITOL-WATER 4 MG/100 ML IV PGBK,778.0,544.6,,,0
NDC,25021-830-82,ZOLEDRONIC ACID IN MANNITOL & WATER 5 MG/100 ML IV SOLN,486.0,340.2,,,0
NDC,25208-002-01,TIROFIBAN-0.9% SODIUM CHLORIDE 5 MG/100 ML (50 MCG/ML) IV SOLN,398.0,278.6,,,0
NDC,25208-002-03,TIROFIBAN-0.9% SODIUM CHLORIDE 5 MG/100 ML (50 MCG/ML) IV SOLN,102.5,71.75,,,0
NDC,25682-001-01,ECULIZUMAB 300 MG/30 ML IV SOLN,43181.0,30226.7,,,0
NDC,25682-025-01,RAVULIZUMAB-CWVZ 100 MG/ML IV SOLN,17676.0,12373.2,,,0
NDC,25682-028-01,RAVULIZUMAB-CWVZ 100 MG/ML IV SOLN,162021.5,113415.05,,,0
NDC,27241-001-06,RISPERIDONE 1 MG ORAL TAB,26.0,18.2,,,0
NDC,27241-049-10,ENTACAPONE 200 MG ORAL TAB,26.0,18.2,,,0
NDC,27241-063-03,VORICONAZOLE 200 MG ORAL TAB,338.0,236.6,,,0
NDC,27241-098-09,DULOXETINE 30 MG ORAL CPDR,77.0,53.9,,,0
NDC,27241-099-03,DULOXETINE 60 MG ORAL CPDR,61.0,42.7,,,0
NDC,27241-139-09,OSELTAMIVIR  6 MG/ML ORAL SUSR,67.0,46.9,,,0
NDC,27241-162-01,CAPTOPRIL  50 MG ORAL TAB,17.0,11.9,,,0
NDC,27808-002-01,RISPERIDONE 1 MG/ML ORAL SOLN,16.0,11.2,,,0
NDC,27808-051-02,PROMETHAZINE  6.25 MG/5 ML ORAL SYRP,7.0,4.9,,,0
NDC,27808-156-01,ROSUVASTATIN 10 MG ORAL TAB,50.0,35.0,,,0
NDC,27808-158-01,ROSUVASTATIN 40 MG ORAL TAB,50.0,35.0,,,0
NDC,27808-190-01,COLESEVELAM 625 MG ORAL TAB,22.0,15.4,,,0
NDC,28400-105-01,THROMBIN (RECOMBINANT) 5000 UNIT TOP SOLR,372.0,260.4,,,0
NDC,29033-003-01,SUCRALFATE 1 GRAM ORAL TAB,8.0,5.6,,,0
NDC,29033-030-01,ACETAZOLAMIDE 500 MG ORAL CPSR,48.0,33.6,,,0
NDC,29300-126-01,BISOPROLOL FUMARATE  5 MG ORAL TAB,8.0,5.6,,,0
NDC,29300-135-01,CLONIDINE 0.1 MG ORAL TAB,7.0,4.9,,,0
NDC,29300-136-01,CLONIDINE 0.2 MG ORAL TAB,7.5,5.25,,,0
NDC,29300-245-01,BUSPIRONE 10 MG ORAL TAB,8.0,5.6,,,0
NDC,29300-355-01,TRAMADOL  50 MG ORAL TAB,8.5,5.95,,,0
NDC,29300-423-01,AMITRIPTYLINE 100 MG ORAL TAB,15.0,10.5,,,0
NDC,29300-424-01,AMITRIPTYLINE 150 MG ORAL TAB,22.0,15.4,,,0
NDC,30698-477-01,METHENAMINE HIPPURATE 1 GRAM ORAL TAB,14.0,9.8,,,0
NDC,3160401281,THIAMINE MONONITRATE 100 MG ORAL TAB,7.0,4.9,,,0
NDC,31722-006-31,ITRACONAZOLE 10 MG/ML ORAL SOLN,61.0,42.7,,,0
NDC,31722-014-90,DROXIDOPA 100 MG ORAL CAP,398.0,278.6,,,0
NDC,31722-053-60,IVABRADINE 5 MG ORAL TAB,43.5,30.45,,,0
NDC,31722-103-30,CINACALCET 30 MG ORAL TAB,270.0,189.0,,,0
NDC,31722-129-01,POTASSIUM CITRATE  5 MEQ ORAL TBER,25.0,17.5,,,0
NDC,31722-130-01,POTASSIUM CITRATE 10 MEQ ORAL TBER,14.0,9.8,,,0
NDC,31722-131-30,DUTASTERIDE 0.5 MG ORAL CAP,34.0,23.8,,,0
NDC,31722-151-30,VALSARTAN  40 MG ORAL TAB,17.5,12.25,,,0
NDC,31722-152-90,VALSARTAN  80 MG ORAL TAB,54.0,37.8,,,0
NDC,31722-185-01,AMPHETAMINE-DEXTROAMPHETAMINE  5 MG ORAL CP24,105.0,73.5,,,0
NDC,31722-203-20,LACOSAMIDE 200 MG/20 ML IV SOLN,300.0,210.0,,,0
NDC,31722-526-30,FINASTERIDE 1 MG ORAL TAB,16.0,11.2,,,0
NDC,31722-529-01,TORSEMIDE   5 MG ORAL TAB,11.5,8.05,,,0
NDC,31722-542-01,INDOMETHACIN 25 MG ORAL CAP,5.5,3.85,,,0
NDC,31722-543-01,INDOMETHACIN 50 MG ORAL CAP,7.0,4.9,,,0
NDC,31722-574-47,LEVETIRACETAM 100 MG/ML ORAL SOLN,22.0,15.4,,,0
NDC,31722-585-30,NEBIVOLOL  2.5 MG ORAL TAB,56.0,39.2,,,0
NDC,31722-586-90,NEBIVOLOL  5 MG ORAL TAB,44.0,30.8,,,0
NDC,31722-630-31,OSELTAMIVIR PHOSPHATE 30 MG ORAL CAP,104.5,73.15,,,0
NDC,31722-632-31,OSELTAMIVIR PHOSPHATE 75 MG ORAL CAP,76.0,53.2,,,0
NDC,31722-681-47,ACYCLOVIR 200 MG/5 ML ORAL SUSP,34.0,23.8,,,0
NDC,31722-701-90,LOSARTAN  50 MG ORAL TAB,25.0,17.5,,,0
NDC,31722-711-30,SILDENAFIL 100 MG ORAL TAB,28.0,19.6,,,0
NDC,31722-713-90,PANTOPRAZOLE 40 MG ORAL TBEC,30.0,21.0,,,0
NDC,31722-714-30,ATOMOXETINE  10 MG ORAL CAP,140.0,98.0,,,0
NDC,31722-717-30,ATOMOXETINE  40 MG ORAL CAP,152.0,106.4,,,0
NDC,31722-726-30,MONTELUKAST 10 MG ORAL TAB,32.0,22.4,,,0
NDC,31722-727-30,MONTELUKAST  4 MG ORAL CHEW,32.0,22.4,,,0
NDC,31722-728-30,MONTELUKAST  5 MG ORAL CHEW,32.0,22.4,,,0
NDC,31722-729-30,IRBESARTAN  75 MG ORAL TAB,25.0,17.5,,,0
NDC,31722-730-30,IRBESARTAN 150 MG ORAL TAB,18.0,12.6,,,0
NDC,31722-730-90,IRBESARTAN 150 MG ORAL TAB,9.0,6.3,,,0
NDC,31722-731-30,IRBESARTAN 300 MG ORAL TAB,21.0,14.7,,,0
NDC,31722-820-30,ARIPIPRAZOLE  5 MG ORAL TAB,236.0,165.2,,,0
NDC,31722-828-30,ARIPIPRAZOLE 15 MG ORAL TAB,158.0,110.6,,,0
NDC,31722-842-30,ELTROMBOPAG 25 MG ORAL TAB,1064.0,744.8,,,0
NDC,31722-844-30,ELTROMBOPAG 75 MG ORAL TAB,3518.0,2462.6,,,0
NDC,31722-865-25,LINEZOLID 100 MG/5 ML ORAL SUSR,422.0,295.4,,,0
NDC,31722-953-01,METHYLPHENIDATE 27 MG ORAL TO24,100.0,70.0,,,0
NDC,31722-981-10,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ (MERGE),80.5,56.349999999999994,,,0
NDC,33342-024-07,FAMCICLOVIR 125 MG ORAL TAB,33.0,23.1,,,0
NDC,33342-048-07,IRBESARTAN 150 MG ORAL TAB,22.0,15.399999999999999,,,0
NDC,33342-049-07,IRBESARTAN 300 MG ORAL TAB,16.0,11.2,,,0
NDC,33342-054-10,PIOGLITAZONE 15 MG ORAL TAB,39.0,27.3,,,0
NDC,33342-055-07,PIOGLITAZONE 30 MG ORAL TAB,41.5,29.05,,,0
NDC,33342-056-07,PIOGLITAZONE 45 MG ORAL TAB,57.0,39.9,,,0
NDC,33342-063-10,VALSARTAN  80 MG ORAL TAB,22.0,15.4,,,0
NDC,33342-064-10,VALSARTAN 160 MG ORAL TAB,15.0,10.5,,,0
NDC,33342-083-07,OLANZAPINE  5 MG ORAL TBDL,103.0,72.1,,,0
NDC,33342-089-09,RIVASTIGMINE 1.5 MG ORAL CAP,45.0,31.5,,,0
NDC,33342-090-09,RIVASTIGMINE 3 MG ORAL CAP,34.0,23.8,,,0
NDC,33342-097-09,TOLTERODINE 1 MG ORAL TAB,28.0,19.6,,,0
NDC,33342-098-09,TOLTERODINE 2 MG ORAL TAB,28.5,19.950000000000003,,,0
NDC,33342-115-07,CANDESARTAN  8 MG ORAL TAB,17.0,11.9,,,0
NDC,33342-116-07,CANDESARTAN 16 MG ORAL TAB,17.0,11.9,,,0
NDC,33342-180-10,OLMESARTAN 40 MG ORAL TAB,49.0,34.3,,,0
NDC,33342-256-66,OSELTAMIVIR PHOSPHATE 30 MG ORAL CAP,70.0,49.0,,,0
NDC,33342-258-66,OSELTAMIVIR PHOSPHATE 75 MG ORAL CAP,473.5,331.45,,,0
NDC,33342-276-07,DARIFENACIN  7.5 MG ORAL TB24,82.0,57.4,,,0
NDC,33342-481-15,NYSTATIN  100000 UNIT/G TOP OINT,86.0,60.2,,,0
NDC,33342-570-09,SACUBITRIL-VALSARTAN 24-26 MG ORAL TAB,38.5,26.950000000000003,,,0
NDC,35573-428-51,PANTOPRAZOLE 40 MG ORAL TBEC,7.0,4.9,,,0
NDC,35573-433-30,KETOCONAZOLE 200 MG ORAL TAB,42.0,29.4,,,0
NDC,35573-445-25,LEVALBUTEROL 1.25 MG/3 ML NEB SOLUTION,36.0,25.2,,,0
NDC,36000-009-24,CIPROFLOXACIN IN D5W 400 MG/200 ML IV PGBK,24.0,16.8,,,0
NDC,36000-033-10,METOPROLOL TARTRATE 5 MG/5 ML IV,16.0,11.2,,,0
NDC,36000-048-24,LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK,115.0,80.5,,,0
NDC,36000-148-01,FLUMAZENIL 0.1 MG/ML IV SOLN,33.5,23.450000000000003,,,0
NDC,36000-283-25,FUROSEMIDE 10 MG/ML INJ SOLN,34.5,24.15,,,0
NDC,36000-308-01,NALOXONE 0.4 MG/ML INJ SOLN,53.0,37.1,,,0
NDC,36000-310-01,NALOXONE 0.4 MG/ML INJ SOLN,357.0,249.9,,,0
NDC,36000-310-02,NALOXONE 0.4 MG/ML INJ SOLN,357.0,249.9,,,0
NDC,36000-322-01,LABETALOL 5 MG/ML IV SOLN,16.0,11.2,,,0
NDC,36000-322-02,LABETALOL 5 MG/ML IV SOLN,16.0,11.2,,,0
NDC,36000-326-01,PALONOSETRON 0.25 MG/5 ML IV INJECTION (MERGE),40.0,28.0,,,0
NDC,36000-326-02,PALONOSETRON 0.25 MG/5 ML IV INJECTION (MERGE),40.0,28.0,,,0
NDC,36000-352-01,LEVETIRACETAM IN NACL (ISO-OS) 500 MG/100 ML IV PGBK,61.5,43.05,,,0
NDC,36000-354-01,LEVETIRACETAM IN NACL (ISO-OS) 1500 MG/100 ML IV PGBK,95.5,66.85,,,0
NDC,36000-356-01,LEVETIRACETAM IN NACL (ISO-OS) 1000 MG/100 ML IV PGBK,60.5,42.35,,,0
NDC,37000-023-10,PSYLLIUM HUSK (WITH SUGAR) 3.4 GRAM ORAL PWPK,7.0,4.9,,,0
NDC,37000-024-10,PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL PWPK,7.0,4.9,,,0
NDC,37000-024-44,PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL PWPK,7.0,4.9,,,0
NDC,3700025445,PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL PWPK,8.5,5.95,,,0
NDC,3786407039,ACETAMINOPHEN  325 MG ORAL TAB,5.0,3.5,,,0
NDC,378699789,SODIUM CHLORIDE  3 % INHL NEBU,7.0,4.9,,,0
NDC,386000102,ETHYL CHLORIDE 100 % TOP SPRA,157.0,109.9,,,0
NDC,386000103,ETHYL CHLORIDE 100 % TOP SPRA,180.0,126.0,,,0
NDC,386000104,ETHYL CHLORIDE 100 % TOP SPRA,194.0,135.8,,,0
NDC,39328-062-50,SODIUM HYPOCHLORITE 0.5 % MISC SOLN,91.0,63.7,,,0
NDC,39328-063-25,SODIUM HYPOCHLORITE 0.25 % MISC SOLN,79.5,55.650000000000006,,,0
NDC,3932805750,FERROUS SULFATE 75 MG/ML (ELEMENTAL IRON 15 MG/ML) 0.1 ML ORAL SYRINGE (REPACK),7.0,4.9,,,0
NDC,3932806412,SODIUM HYPOCHLORITE 0.125 % MISC SOLN,79.5,55.650000000000006,,,0
NDC,395266116,SIMPLE SYRUP,7.0,4.9,,,0
NDC,395266216,CHERRY SYRUP,7.0,4.9,,,0
NDC,39822-0151-1,LIOTHYRONINE 10 MCG/ML IV SOLN,1825.0,1277.5,,,0
NDC,39822-0190-1,ACETAZOLAMIDE SODIUM 500 (100 MG/ML) INJ SOLR,193.0,135.1,,,0
NDC,39822-0260-1,CYCLOPHOSPHAMIDE 2 GRAM IV SOLUTION,1259.0,881.3,,,0
NDC,39822-0310-5,NEOMYCIN 500 MG ORAL TAB,19.0,13.3,,,0
NDC,39822-0412-1,TOBRAMYCIN 1.2 G POWDER VIAL,27.0,18.9,,,0
NDC,39822-0412-6,TOBRAMYCIN 1.2 G POWDER VIAL,596.5,417.55,,,0
NDC,39822-1000-1,TRANEXAMIC ACID (FOR TOPICAL USE),84.0,58.8,,,0
NDC,39822-1100-1,FOLIC ACID  5 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,39822-1201-5,"NEOMYCIN-POLYMYXIN B GU 40 MG-200,000 UNIT/ML IRRIGATION SOLN",70.0,49.0,,,0
NDC,39822-2000-1,CLONIDINE (PF) 1000 MCG/10 ML EPID SOLN,16.0,11.2,,,0
NDC,39822-3030-1,PENTAMIDINE 300 MG INHL SOLR,405.0,283.5,,,0
NDC,39822-3030-2,PENTAMIDINE 300 MG INHL SOLR,405.0,283.5,,,0
NDC,39822-4200-1,ROCURONIUM 10 MG/ML IV SOLN,47.5,33.25,,,0
NDC,39822-5525-2,PROMETHAZINE 25 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,41100-81127,OXYMETAZOLINE 0.05 % NASL SPRA,7.0,4.9,,,0
NDC,4110081117,OXYMETAZOLINE 0.05 % NASL SPRA,25.0,17.5,,,0
NDC,4110081121,OXYMETAZOLINE 0.05 % NASAL MERGE,32.0,22.4,,,0
NDC,4110081123,OXYMETAZOLINE 0.05 % NASL SPRA,16.0,11.2,,,0
NDC,4110081125,OXYMETAZOLINE 0.05 % NASL SPRA,49.0,34.3,,,0
NDC,4110081163,VITAMINS A & D-WHITE PETROLATUM-LANOLIN OINTMENT,12.0,8.4,,,0
NDC,4110082073,POLYETHYLENE GLYCOL 3350 100 % ORAL POWDER 238 GRAMS,56.0,39.2,,,0
NDC,4116700607,DOXYLAMINE SUCCINATE 25 MG ORAL TAB,5.5,3.85,,,0
NDC,4116700609,DOXYLAMINE SUCCINATE 25 MG ORAL TAB,5.5,3.85,,,0
NDC,4116705840,LIDOCAINE 4% TOP PATCH,30.0,21.0,,,0
NDC,414200007,SACCHAROMYCES BOULARDII 250 MG ORAL CAP,7.0,4.9,,,0
NDC,41616-931-44,VECURONIUM 1 MG/ML IV SYRINGE (NEO),34.0,23.799999999999997,,,0
NDC,41616-936-40,LEUPROLIDE 1 MG/0.2 ML SUBQ KIT,79.0,55.3,,,0
NDC,4167936503,MEDIUM CHAIN TRIGLYCERIDES OIL ORAL,7.0,4.9,,,0
NDC,4167936513,MEDIUM CHAIN TRIGLYCERIDES OIL ORAL,7.0,4.9,,,0
NDC,42023-103-01,EPINEPHRINE 0.1 % NASAL SOLN,10818.0,7572.6,,,0
NDC,42023-114-10,KETAMINE  50 MG/ML INJ SOLN,47.0,32.9,,,0
NDC,42023-115-10,KETAMINE 100 MG/ML INJ SOLN,79.0,55.3,,,0
NDC,42023-116-25,OXYTOCIN 10 UNIT/ML INJ SOLN,84.0,58.8,,,0
NDC,42023-117-25,VASOPRESSIN 20 UNITS IN 100 ML NS,120.0,84.0,,,0
NDC,42023-129-01,FLUPHENAZINE DECANOATE 25 MG/ML INJ SOLN,120.0,84.0,,,0
NDC,42023-157-01,ETHACRYNATE SODIUM 50 MG IV SOLR,10488.0,7341.6,,,0
NDC,42023-159-01,EPINEPHRINE 1 MG/ML (1ML) INJ SOLN,264.0,184.8,,,0
NDC,42023-164-01,VASOPRESSIN 20 UNIT/ML IV SOLN,413.0,289.1,,,0
NDC,42023-164-25,VASOPRESSIN 20 UNIT/ML IV SOLN,265.5,185.85000000000002,,,0
NDC,42023-168-01,EPINEPHRINE 1 MG/ML INJ SOLN,888.0,621.6,,,0
NDC,42023-179-01,BUPRENORPHINE HCL 0.3 MG/ML INJ (MERGE),60.0,42.0,,,0
NDC,42023-186-01,DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) IV SOLN,79.5,55.65,,,0
NDC,42023-186-20,DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) IV SOLN,22.0,15.4,,,0
NDC,42023-189-01,NEOSTIGMINE METHYLSULFATE 1 MG/ML IV SOLN,23.0,16.1,,,0
NDC,42023-201-01,LEVOTHYROXINE 100 MCG IV SOLR,913.0,639.1,,,0
NDC,42023-203-01,LEVOTHYROXINE 500 MCG INJ SOLR,1458.0,1020.6,,,0
NDC,42023-205-01,CALCITONIN (SALMON) 200 UNIT/ML INJ SOLN,5380.0,3766.0,,,0
NDC,42023-216-01,EPHEDRINE 50 MG/ML IV SOLN (MERGE),256.0,179.2,,,0
NDC,42023-219-01,VASOPRESSIN  0.4 UNITS/ML IV SOLN,802.5,561.75,,,0
NDC,42023-221-01,ERTAPENEM 1 GRAM INJ SOLR,253.0,177.1,,,0
NDC,42023-230-01,MICAFUNGIN 100 MG IV SOLR,241.5,169.05,,,0
NDC,42023-315-01,EPINEPHRINE IN 0.9 % SOD CHLOR 4 MG/250 ML (16 MCG/ML) IV SOLN,389.0,272.3,,,0
NDC,42023-622-01,BIVALIRUDIN 250 MG/50 ML (5 MG/ML) IV SOLN,303.5,212.45,,,0
NDC,4203710478,CARBAMIDE PEROXIDE 6.5 % OTIC DROP,46.5,32.55,,,0
NDC,4203710479,CARBAMIDE PEROXIDE 6.5 % OTIC DROP,23.0,16.1,,,0
NDC,42043-221-00,SUMATRIPTAN 50 MG TAB,123.0,86.1,,,0
NDC,42043-221-09,SUMATRIPTAN 50 MG TAB,123.0,86.1,,,0
NDC,42192-327-01,THYROID (PORK) 15 MG ORAL TAB,6.0,4.2,,,0
NDC,42192-329-01,THYROID (PORK)  30 MG ORAL TAB,10.5,7.35,,,0
NDC,42192-330-01,THYROID (PORK)  60 MG ORAL TAB,10.0,7.0,,,0
NDC,42192-338-01,"HYOSCYAMINE 0.125 MG TAB, RAPID DISSOLVE",8.5,5.95,,,0
NDC,42192-339-01,HYOSCYAMINE 0.125 MG SUBLINGUAL TAB,7.0,4.9,,,0
NDC,42192-340-01,HYOSCYAMINE SULFATE 0.125 MG ORAL TAB,7.0,4.9,,,0
NDC,42192-608-05,GABAPENTIN 250 MG/5 ML (5 ML) ORAL SOLN,40.0,28.0,,,0
NDC,42192-608-16,GABAPENTIN 250 MG/5 ML ORAL SOLN,12.0,8.4,,,0
NDC,42291-082-30,AZITHROMYCIN 250 MG ORAL TAB,153.0,107.1,,,0
NDC,42291-083-30,AZITHROMYCIN 500 MG ORAL TAB,115.0,80.5,,,0
NDC,42291-412-60,DOFETILIDE 250 MCG ORAL CAP,66.0,46.2,,,0
NDC,42291-413-60,DOFETILIDE 500 MCG ORAL CAP,48.0,33.6,,,0
NDC,42291-415-30,FAMCICLOVIR 250 MG ORAL TAB,64.0,44.8,,,0
NDC,42291-416-30,FAMCICLOVIR 500 MG ORAL TAB,64.0,44.8,,,0
NDC,42291-454-30,EPLERENONE  25 MG ORAL TAB,29.5,20.65,,,0
NDC,42291-468-01,FUROSEMIDE 20 MG ORAL TAB,7.5,5.25,,,0
NDC,42291-471-01,CARBIDOPA-LEVODOPA 10 MG-100 MG TAB,8.0,5.6,,,0
NDC,42291-560-90,MIDODRINE  2.5 MG ORAL TAB,31.0,21.7,,,0
NDC,42291-567-60,OSELTAMIVIR  6 MG/ML ORAL SUSR,58.5,40.95,,,0
NDC,42291-664-10,OSELTAMIVIR PHOSPHATE 75 MG ORAL CAP,76.0,53.2,,,0
NDC,42291-748-01,SILDENAFIL 100 MG ORAL TAB,19.0,13.3,,,0
NDC,42291-800-30,TENOFOVIR DISOPROXIL FUMARATE 300 MG ORAL TAB,31.0,21.7,,,0
NDC,42291-809-15,TIZANIDINE 4 MG ORAL TAB,15.0,10.5,,,0
NDC,42291-855-01,VERAPAMIL 120 MG ORAL TAB,7.0,4.9,,,0
NDC,42291-899-30,VENLAFAXINE 150 MG ORAL CP24,29.0,20.3,,,0
NDC,42292-006-01,MEMANTINE 10 MG ORAL TAB,25.5,17.85,,,0
NDC,42292-038-01,LEVOTHYROXINE  88 MCG ORAL TAB,7.0,4.9,,,0
NDC,42292-038-20,LEVOTHYROXINE  88 MCG ORAL TAB,7.0,4.9,,,0
NDC,42292-039-01,LEVOTHYROXINE 112 MCG ORAL TAB,7.0,4.9,,,0
NDC,42292-040-01,LEVOTHYROXINE 175 MCG ORAL TAB,8.0,5.6,,,0
NDC,42292-043-01,IMATINIB 100 MG ORAL TAB,53.0,37.1,,,0
NDC,42292-054-01,COLCHICINE 0.6 MG ORAL TAB,82.5,57.75,,,0
NDC,42385-953-30,EMTRICITABINE-TENOFOVIR 200 MG-300 MG TAB,297.0,207.9,,,0
NDC,42494-340-01,FLUCYTOSINE 500 MG ORAL CAP,1462.0,1023.4,,,0
NDC,42494-341-12,HYDROCORTISONE ACETATE 25 MG RECT SUPP,155.5,108.85,,,0
NDC,42494-415-01,PHENOBARBITAL SODIUM  65 MG/ML INJ SOLN,225.0,157.5,,,0
NDC,42494-416-01,PHENOBARBITAL SODIUM 130 MG/ML INJ SOLN,433.0,303.1,,,0
NDC,42515-002-01,JAPANESE ENCEPHALITIS VACC(PF) 6 MCG/0.5 ML IM SYRG,862.0,603.4,,,0
NDC,42543-406-01,POTASSIUM CITRATE  5 MEQ ORAL TBER,34.5,24.15,,,0
NDC,42571-141-26,DORZOLAMIDE 2 % OPHT DROP,284.0,198.8,,,0
NDC,42571-147-26,DORZOLAMIDE-TIMOLOL 2 %-0.5 % EYE DROPS,440.0,308.0,,,0
NDC,42571-160-30,AMOXICILLIN-POT CLAVULANATE 250 MG-125 MG TAB,33.0,23.1,,,0
NDC,42571-161-01,AMOXICILLIN-POT CLAVULANATE 500 MG-125 MG TAB,21.0,14.7,,,0
NDC,42571-162-01,AMOXICILLIN-POT CLAVULANATE 875 MG-125 MG TAB,99.0,69.3,,,0
NDC,42571-162-42,AMOXICILLIN-POT CLAVULANATE 875 MG-125 MG TAB,215.0,150.5,,,0
NDC,42658-008-01,DACTINOMYCIN 0.5 MG IV SOLR,6900.0,4830.0,,,0
NDC,42658-021-01,DAUNORUBICIN 5 MG/ML IV INJ,1000.0,700.0,,,0
NDC,42794-012-08,GRISEOFULVIN MICROSIZE 500 MG ORAL TAB,115.0,80.5,,,0
NDC,42794-018-12,LIOTHYRONINE  5 MCG ORAL TAB,7.0,4.9,,,0
NDC,42794-019-12,LIOTHYRONINE 25 MCG ORAL TAB,8.5,5.95,,,0
NDC,42799-217-01,OPIUM TINCTURE 10 MG/ML ORAL TINC,35.0,24.5,,,0
NDC,42799-405-01,ETHACRYNIC ACID 25 MG ORAL TAB,118.0,82.6,,,0
NDC,42799-806-01,IVERMECTIN 3 MG ORAL TAB,134.0,93.80000000000001,,,0
NDC,42806-055-09,AMLODIPINE  2.5 MG ORAL TAB,10.0,7.0,,,0
NDC,42806-088-01,ESTRADIOL 1 MG ORAL TAB,8.0,5.6,,,0
NDC,42806-089-01,ESTRADIOL 2 MG ORAL TAB,9.5,6.65,,,0
NDC,42806-150-33,AZITHROMYCIN 200 MG/5 ML ORAL SUSR,39.5,27.65,,,0
NDC,42806-151-34,AZITHROMYCIN 200 MG/5 ML ORAL SUSR,40.0,28.0,,,0
NDC,42806-266-98,CHOLESTYRAMINE-SUCROSE 4 GRAM ORAL PACK,8.0,5.6,,,0
NDC,42806-270-98,CHOLESTYRAMINE-ASPARTAME 4 GRAM ORAL PACK,19.0,13.3,,,0
NDC,42806-274-01,CARBAMAZEPINE 100 MG ORAL TB12,10.0,7.0,,,0
NDC,42806-275-01,CARBAMAZEPINE 200 MG ORAL TB12,24.0,16.8,,,0
NDC,42806-312-50,DOXYCYCLINE HYCLATE 100 MG ORAL TAB,35.0,24.5,,,0
NDC,42806-341-01,AMPHETAMINE-DEXTROAMPHETAMINE 10 MG ORAL TAB,17.5,12.25,,,0
NDC,42806-359-25,LEUCOVORIN CALCIUM  25 MG ORAL TAB,55.0,38.5,,,0
NDC,42806-501-09,NICARDIPINE 20 MG ORAL CAP,76.0,53.2,,,0
NDC,42806-502-09,NICARDIPINE 30 MG ORAL CAP,109.0,76.3,,,0
NDC,42806-549-09,DUTASTERIDE 0.5 MG ORAL CAP,34.0,23.8,,,0
NDC,42806-714-01,BENZONATATE 100 MG ORAL CAP,21.0,14.700000000000001,,,0
NDC,42806-757-60,SULFADIAZINE 500 MG ORAL TAB,255.0,178.5,,,0
NDC,42858-001-01,OXYCODONE 5 MG ORAL TAB,7.0,4.9,,,0
NDC,42858-001-10,OXYCODONE 5 MG ORAL TAB,18.0,12.6,,,0
NDC,42858-003-01,OXYCODONE  15 MG ORAL TAB,5.5,3.85,,,0
NDC,42858-301-01,HYDROMORPHONE  2 MG ORAL TAB,4.0,2.8,,,0
NDC,42858-301-25,HYDROMORPHONE  2 MG ORAL TAB,4.5,3.1500000000000004,,,0
NDC,42858-302-01,HYDROMORPHONE  4 MG ORAL TAB,7.0,4.9,,,0
NDC,42858-302-25,HYDROMORPHONE  4 MG ORAL TAB,8.0,5.6,,,0
NDC,42858-502-03,BUPRENORPHINE 8 MG SL SUBL,7.0,4.9,,,0
NDC,42858-707-03,PAROXETINE SR 37.5 MG 24 HR TAB,8.5,5.95,,,0
NDC,42858-723-01,AMPHETAMINE-DEXTROAMPHETAMINE 10 MG ORAL TAB,7.0,4.9,,,0
NDC,42858-803-01,MORPHINE  60 MG ORAL TBSR,8.0,5.6,,,0
NDC,43066-006-01,DOCETAXEL 160 MG/16 ML (10 MG/ML) IV SOLN- NONSTANDARD DOSING,392.0,274.4,,,0
NDC,43066-007-10,ROCURONIUM 10 MG/ML IV SOLN,26.0,18.200000000000003,,,0
NDC,43066-008-01,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN",59.0,41.3,,,0
NDC,43066-009-10,NICARDIPINE IN NACL (ISO-OS) 20 MG/200 ML IV PGBK,382.0,267.4,,,0
NDC,43066-010-01,DOCETAXEL 160 MG/16 ML (10 MG/ML) IV SOLN- NONSTANDARD DOSING,278.5,194.95,,,0
NDC,43066-015-01,ROPIVACAINE  2 MG/ML INJ SOLN,34.0,23.8,,,0
NDC,43066-023-01,ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN,18.0,12.6,,,0
NDC,43066-026-10,NICARDIPINE INFUSION 100 MCG/ML 50ML (PEDIATRIC),86.0,60.2,,,0
NDC,43066-090-01,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN,27.0,18.9,,,0
NDC,43066-150-10,"AMIODARONE IN DEXTROSE,ISO-OSM 150 MG/100 ML (PREMIX)",611.0,427.7,,,0
NDC,43066-360-20,"AMIODARONE IN DEXTROSE,ISO-OSM 360 MG/200 ML (1.8 MG/ML) IV SOLN",181.0,126.7,,,0
NDC,43066-997-01,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,133.0,93.1,,,0
NDC,43199-040-05,LIDOCAINE 4 % TOP CREA,94.5,66.15,,,0
NDC,43199-040-50,LIDOCAINE 4 % TOP CREA,30.0,21.0,,,0
NDC,4329255740,NIACIN  250 MG ORAL TAB,7.0,4.9,,,0
NDC,43353-298-30,LISINOPRIL  5 MG ORAL TAB,7.0,4.9,,,0
NDC,43353-393-60,IBUPROFEN 600 MG ORAL TAB,7.0,4.9,,,0
NDC,43386-090-19,PEG 3350-ELECTROLYTES 236 G-22.74 G-6.74 G-5.86 G ORAL SOLUTION,196.0,137.2,,,0
NDC,43386-161-06,MISOPROSTOL 800 MCG (4 X 200 MCG TAB) PACKAGE,84.0,58.8,,,0
NDC,43386-194-90,POTASSIUM CHLORIDE  20 MEQ ORAL PACK,106.0,74.2,,,0
NDC,43386-312-08,POLYETHYLENE GLYCOL 3350 100 % ORAL POWDER 238 GRAMS,69.0,48.3,,,0
NDC,43386-480-24,ORPHENADRINE CITRATE 100 MG ORAL TBSR,13.0,9.1,,,0
NDC,43386-770-01,FLUCYTOSINE 500 MG ORAL CAP,1462.0,1023.4,,,0
NDC,43393-001-01,MIFEPRISTONE 200 MG ORAL TAB,285.0,199.5,,,0
NDC,43393-023-04,MISOPROSTOL 800 MCG (4 X 200 MCG TAB) PACKAGE,21.5,15.05,,,0
NDC,43547-275-03,DONEPEZIL  5 MG ORAL TAB,66.5,46.55,,,0
NDC,43547-276-03,DONEPEZIL 10 MG ORAL TAB,36.0,25.200000000000003,,,0
NDC,43547-281-10,ESCITALOPRAM 10 MG ORAL TAB,36.0,25.2,,,0
NDC,43547-282-10,ESCITALOPRAM 20 MG ORAL TAB,26.0,18.2,,,0
NDC,43547-284-03,TELMISARTAN 40 MG ORAL TAB,31.0,21.7,,,0
NDC,43547-288-10,BUPROPION HCL 100 MG ORAL TBSR,16.5,11.55,,,0
NDC,43547-335-10,BENAZEPRIL  5 MG ORAL TAB,9.5,6.65,,,0
NDC,43547-336-10,BENAZEPRIL 10 MG ORAL TAB,10.5,7.35,,,0
NDC,43547-339-06,RISPERIDONE 0.25 MG ORAL TAB,44.0,30.8,,,0
NDC,43547-351-10,LISINOPRIL  2.5 MG ORAL TAB,7.0,4.9,,,0
NDC,43547-352-10,LISINOPRIL  5 MG ORAL TAB,11.0,7.7,,,0
NDC,43547-354-10,LISINOPRIL 20 MG ORAL TAB,9.5,6.65,,,0
NDC,43547-361-09,LOSARTAN  50 MG ORAL TAB,26.0,18.2,,,0
NDC,43547-374-03,IRBESARTAN  75 MG ORAL TAB,33.0,23.1,,,0
NDC,43547-375-09,IRBESARTAN 150 MG ORAL TAB,18.0,12.6,,,0
NDC,43547-386-09,FOSINOPRIL 10 MG ORAL TAB,20.5,14.35,,,0
NDC,43547-387-09,FOSINOPRIL 20 MG ORAL TAB,10.5,7.3500000000000005,,,0
NDC,43547-400-10,CYCLOBENZAPRINE 10 MG ORAL TAB,7.0,4.9,,,0
NDC,43547-403-10,FUROSEMIDE 80 MG ORAL TAB,7.0,4.9,,,0
NDC,43547-405-10,METHOCARBAMOL 500 MG ORAL TAB,7.0,4.9,,,0
NDC,43547-415-10,LISINOPRIL  5 MG ORAL TAB,19.5,13.649999999999999,,,0
NDC,43547-543-01,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,28.0,19.6,,,0
NDC,43547-546-10,ENALAPRIL MALEATE  5 MG ORAL TAB,21.0,14.7,,,0
NDC,43547-548-10,ENALAPRIL MALEATE 20 MG ORAL TAB,23.5,16.45,,,0
NDC,43547-688-10,CIPROFLOXACIN 250 MG ORAL TAB,50.0,35.0,,,0
NDC,43598-004-51,AMOXICILLIN-POT CLAVULANATE 250 MG-62.5 MG/5 ML ORAL SUSP,240.0,168.0,,,0
NDC,43598-050-11,THIAMINE 100 MG/ML INJECTION,43.0,30.1,,,0
NDC,43598-051-11,CALCITONIN (SALMON) 200 UNIT/ML INJ SOLN,5748.5,4023.95,,,0
NDC,43598-053-11,DESMOPRESSIN 4 MCG/ML INJECTION SOLN,776.0,543.2,,,0
NDC,43598-078-11,ENALAPRILAT 1.25 MG/ML IV INJ,27.5,19.25,,,0
NDC,43598-106-11,DIAZEPAM 5 MG/ML INJ SYRG,289.0,202.3,,,0
NDC,43598-128-11,METHYLPREDNISOLONE 500 MG SOLUTION FOR INJECTION,130.0,91.0,,,0
NDC,43598-130-74,"METHYLPREDNISOLONE 1,000 MG SOLUTION FOR INJECTION",167.5,117.25,,,0
NDC,43598-140-11,CHLORPROMAZINE 25 MG/ML INJ SOLN,513.0,359.1,,,0
NDC,43598-141-11,CHLORPROMAZINE 25 MG/ML INJ SOLN,210.0,147.0,,,0
NDC,43598-142-11,NELARABINE 250 MG/50 ML IV SOLN (PEDS ONCOLOGY),1621.0,1134.7,,,0
NDC,43598-163-60,LUBIPROSTONE  8 MCG ORAL CAP,68.0,47.599999999999994,,,0
NDC,43598-165-30,OLANZAPINE  7.5 MG ORAL TAB,158.0,110.6,,,0
NDC,43598-168-60,LUBIPROSTONE 24 MCG ORAL CAP,38.0,26.6,,,0
NDC,43598-210-40,SILVER SULFADIAZINE 1 % TOP CREA,364.0,254.8,,,0
NDC,43598-210-50,SILVER SULFADIAZINE 1 % TOP CREA,73.0,51.1,,,0
NDC,43598-210-55,SILVER SULFADIAZINE 1 % TOP CREA,73.0,51.1,,,0
NDC,43598-262-02,FULVESTRANT 250 MG/5 ML IM SYRG,864.0,604.8,,,0
NDC,43598-262-23,FULVESTRANT 250 MG/5 ML IM SYRG,864.0,604.8,,,0
NDC,43598-305-62,AZACITIDINE 100 MG INJ SOLR,386.0,270.2,,,0
NDC,43598-326-75,"CIPROFLOXACIN-DEXAMETHASONE 0.3 %-0.1 % EAR DROPS, SUSP",794.0,555.8,,,0
NDC,43598-405-11,PHYTONADIONE 10 MG/ML INJ SOLN,218.0,152.6,,,0
NDC,43598-426-60,BORTEZOMIB 3.5 MG IV SOLR,544.0,380.8,,,0
NDC,43598-436-35,NITROGLYCERIN 0.4 MG SL SUBL,12.0,8.4,,,0
NDC,43598-446-71,NICOTINE  7 MG/24 HR TD PT24,18.0,12.600000000000001,,,0
NDC,43598-447-71,NICOTINE 14 MG/24 HR TD PT24,12.0,8.4,,,0
NDC,43598-448-71,NICOTINE 21 MG/24 HR TD PT24,28.0,19.6,,,0
NDC,43598-448-74,NICOTINE 21 MG/24 HR TD PT24,12.0,8.4,,,0
NDC,43598-549-10,PROPOFOL 10 MG/ML 100ML INFUSION IV EMUL,165.0,115.5,,,0
NDC,43598-549-52,PROPOFOL 10 MG/ML 100ML INFUSION IV EMUL,165.0,115.5,,,0
NDC,43598-587-23,NITROPRUSSIDE 25 MG/ML IV SOLN,71.0,49.699999999999996,,,0
NDC,43598-603-30,DASATINIB 100 MG ORAL TAB,1595.0,1116.5,,,0
NDC,43598-635-52,LEVETIRACETAM PEDS IVPB (FROM PREMIX),109.0,76.3,,,0
NDC,43598-636-52,LEVETIRACETAM IN NACL (ISO-OS) 1000 MG/100 ML IV PGBK,177.0,123.9,,,0
NDC,43598-637-52,LEVETIRACETAM IN NACL (ISO-OS) 1500 MG/100 ML IV PGBK,352.5,246.75,,,0
NDC,43598-655-30,BUPROPION HCL 150 MG ORAL TB24,40.0,28.0,,,0
NDC,43598-765-07,OLOPATADINE 0.1 % OPHT DROP,53.0,37.1,,,0
NDC,43598-848-11,ZIPRASIDONE 20 MG IM,120.0,84.0,,,0
NDC,43598-894-11,NITROGLYCERIN 0.4 MG/HR TD PT24,33.0,23.1,,,0
NDC,43598-901-11,ERTAPENEM 1 GRAM INJ SOLR,432.0,302.4,,,0
NDC,43598-914-06,VASOPRESSIN 20 UNIT/ML IV SOLN,21.5,15.049999999999999,,,0
NDC,43598-914-11,VASOPRESSIN 20 UNIT/ML IV SOLN,32.5,22.75,,,0
NDC,43598-914-25,VASOPRESSIN 20 UNIT/ML IV SOLN,41.0,28.7,,,0
NDC,43598-931-11,DESMOPRESSIN 4 MCG/ML INJECTION SOLN,89.5,62.650000000000006,,,0
NDC,43598-945-11,NEOSTIGMINE METHYLSULFATE 3 MG/3 ML (1 MG/ML) IV SYRG,59.5,41.65,,,0
NDC,43598-948-11,FOSAPREPITANT 150 MG IV SOLR,419.0,293.3,,,0
NDC,43598-977-10,DICLOFENAC 1 % TOPICAL GEL,71.0,49.7,,,0
NDC,43825-102-01,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN FOR PERI-OPERATIVE",103.0,72.1,,,0
NDC,43825-606-41,THROMBIN (RECOMBINANT) 5000 UNIT TOP SOLR,372.0,260.4,,,0
NDC,43975-322-03,TOLTERODINE 2 MG ORAL CP24,62.0,43.4,,,0
NDC,44087-3535-1,AVELUMAB 20 MG/ML IV SOLN,14907.0,10434.9,,,0
NDC,44206-251-10,"ALBUMIN, HUMAN 25 % IV SOLP",583.5,408.45000000000005,,,0
NDC,44206-251-91,"ALBUMIN, HUMAN 25 % IV SOLP",583.5,408.45000000000005,,,0
NDC,44206-300-01,"RHO(D) IMMUNE GLOBULIN (RHOPHYLAC) 1,500 UNIT (300 MCG)/2 ML INJ SYRG",693.0,485.1,,,0
NDC,44206-300-90,"RHO(D) IMMUNE GLOBULIN (RHOPHYLAC) 1,500 UNIT (300 MCG)/2 ML INJ SYRG",693.0,485.1,,,0
NDC,44206-310-25,"ALBUMIN, HUMAN 5 % IV SOLP MERGE",436.5,305.54999999999995,,,0
NDC,44206-310-50,"ALBUMIN, HUMAN 5 % IV SOLP MERGE",418.0,292.6,,,0
NDC,44206-310-91,"ALBUMIN, HUMAN 5 % IV SOLP MERGE",418.0,292.6,,,0
NDC,44206-437-10,PRIVIGEN 10 % IV SOLN,3588.0,2511.6,,,0
NDC,44206-437-91,PRIVIGEN 10 % IV SOLN,3588.0,2511.6,,,0
NDC,44206-438-20,PRIVIGEN 10 % IV SOLN,14352.0,10046.4,,,0
NDC,44206-438-92,PRIVIGEN 10 % IV SOLN,14352.0,10046.4,,,0
NDC,44206-439-40,PRIVIGEN 10 % IV SOLN,14352.0,10046.4,,,0
NDC,44206-439-93,PRIVIGEN 10 % IV SOLN,28704.0,20092.8,,,0
NDC,4422930760,SODIUM CHLORIDE  7 % INHL NEBU,7.0,4.9,,,0
NDC,44567-100-10,AMPICILLIN 250 MG SOLUTION FOR INJECTION,16.0,11.2,,,0
NDC,44567-210-10,AMPICILLIN-SULBACTAM  1.5 GRAM INJ SOLR,53.0,37.1,,,0
NDC,44567-211-10,AMPICILLIN-SULBACTAM  3 GRAM INJ SOLR,94.0,65.8,,,0
NDC,44567-221-10,NAFCILLIN  1 GRAM INJ SOLR,97.5,68.25,,,0
NDC,44567-240-10,CEFEPIME 1 GRAM INJ SOLR,28.5,19.950000000000003,,,0
NDC,44567-241-10,CEFEPIME 2 GRAM INJ SOLR,317.0,221.89999999999998,,,0
NDC,44567-311-10,PENICILLIN G POTASSIUM  5000000 UNIT INJ SOLR,26.5,18.55,,,0
NDC,44567-402-01,MEROPENEM 2000 MG IV SOLR,145.5,101.85000000000001,,,0
NDC,44567-410-24,MAGNESIUM SULFATE IN D5W 1 GRAM/100 ML IV PGBK,32.5,22.75,,,0
NDC,44567-420-00,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IV PGBK,46.0,32.2,,,0
NDC,44567-420-24,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IV PGBK,46.0,32.2,,,0
NDC,44567-421-00,MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IV PGBK,25.0,17.5,,,0
NDC,44567-436-24,LEVOFLOXACIN IN D5W 500 MG/100 ML IV PGBK,53.5,37.45,,,0
NDC,44567-437-24,LEVOFLOXACIN IN D5W 750 MG/150 ML IV PGBK,77.0,53.9,,,0
NDC,44567-450-01,"ESMOLOL IN SALINE (ISO-OSMOTIC) 2,500 MG/250 ML (10 MG/ML) IV",402.0,281.4,,,0
NDC,44567-451-01,"ESMOLOL IN SALINE (ISO-OSMOTIC) 2,000 MG/100 ML (20 MG/ML) IV",419.0,293.3,,,0
NDC,44567-501-01,LEVETIRACETAM NEO IV SYRINGE (PHS FROM PREMIX),26.0,18.2,,,0
NDC,44567-502-01,LEVETIRACETAM IN NACL (ISO-OS) 1000 MG/100 ML IV PGBK,163.5,114.44999999999999,,,0
NDC,44567-503-01,LEVETIRACETAM IN NACL (ISO-OS) 1500 MG/100 ML IV PGBK,178.0,124.6,,,0
NDC,44567-600-04,DEXMEDETOMIDINE 100 MCG/ML IV SOLN,412.0,288.4,,,0
NDC,44567-610-01,MIDAZOLAM (PF) IN 0.9 % NACL 1 MG/ML IV SOLN,130.0,91.0,,,0
NDC,44567-620-01,"CALCIUM GLUC IN NACL, ISO-OSM 1 GRAM/50 ML IV SOLN",464.0,324.8,,,0
NDC,44567-622-01,"CALCIUM GLUC IN NACL, ISO-OSM 1 G/100 ML IV SOLN",112.0,78.4,,,0
NDC,44567-640-01,NOREPINEPHRINE BITARTRATE-NACL 4 MG/250 ML (16 MCG/ML) IV SOLN (CENTRAL ONLY),327.0,228.89999999999998,,,0
NDC,44567-700-25,CEFTRIAXONE 500 MG INJ SOLR,16.0,11.2,,,0
NDC,44567-701-25,CEFTRIAXONE 1 GRAM INJ SOLR,22.5,15.75,,,0
NDC,44567-702-25,CEFTRIAXONE   2 GRAM INJ SOLR,24.0,16.8,,,0
NDC,44567-705-01,IMIPENEM-CILASTATIN 500 MG IV SOLR,241.0,168.7,,,0
NDC,44567-705-10,IMIPENEM-CILASTATIN 500 MG IV SOLR,161.0,112.7,,,0
NDC,44567-707-25,CEFAZOLIN   1 GRAM INJ SOLR,44.0,30.8,,,0
NDC,44567-802-10,PIPERACILLIN-TAZOBACTAM  3.375 GRAM IV SOLR,35.0,24.5,,,0
NDC,44567-803-10,PIPERACILLIN-TAZOBACTAM  4.5 GRAM IV SOLR,46.0,32.2,,,0
NDC,4467710202,LANOLIN OINTMENT (MODIFIED),14.0,9.8,,,0
NDC,45008002,LACTASE 3000 UNIT ORAL TAB,7.0,4.9,,,0
NDC,45029721,ACETAMINOPHEN  650 MG ORAL TBSR,7.0,4.9,,,0
NDC,45049660,ACETAMINOPHEN  325 MG ORAL TAB,5.0,3.5,,,0
NDC,45567-0030-1,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,110.0,77.0,,,0
NDC,45567-0060-1,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,255.0,178.5,,,0
NDC,45802-040-64,SELENIUM SULFIDE 2.5 % TOPICAL LOTN,97.0,67.9,,,0
NDC,45802-046-35,GENTAMICIN 0.1 % TOP OINT,242.0,169.4,,,0
NDC,45802-048-35,NYSTATIN  100000 UNIT/G TOP OINT,86.0,60.2,,,0
NDC,45802-049-35,TRIAMCINOLONE ACETONIDE 0.5 % TOP OINT,50.0,35.0,,,0
NDC,45802-054-35,TRIAMCINOLONE ACETONIDE 0.025 % TOP OINT,34.0,23.8,,,0
NDC,45802-055-05,TRIAMCINOLONE ACETONIDE 0.1 % TOP OINT,203.0,142.1,,,0
NDC,45802-055-35,TRIAMCINOLONE ACETONIDE 0.1 % TOP OINT,31.0,21.7,,,0
NDC,45802-056-35,GENTAMICIN 0.1 % TOP CREA,242.0,169.4,,,0
NDC,45802-059-35,NYSTATIN  100000 UNIT/G TOP CREA,86.0,60.2,,,0
NDC,45802-060-00,BACITRACIN 500 UNITS/1 GRAM PACKET (MERGE RECORD),8.0,5.6,,,0
NDC,45802-060-70,BACITRACIN 500 UNIT/G TOP PACK,8.0,5.6,,,0
NDC,45802-061-70,NEOMYCIN-BACITRACN ZN-POLYMYXIN 3.5 MG-400 U*,8.0,5.6,,,0
NDC,45802-064-35,TRIAMCINOLONE ACETONIDE 0.1 % TOP CREAM,44.0,30.8,,,0
NDC,45802-098-46,MESALAMINE 4 GRAM/60 ML RECT ENEM,119.0,83.3,,,0
NDC,45802-098-51,MESALAMINE 4 GRAM/60 ML RECT ENEM,119.0,83.3,,,0
NDC,45802-112-22,MUPIROCIN 2 % TOP OINT,55.0,38.5,,,0
NDC,45802-129-35,HALOBETASOL PROPIONATE 0.05 % TOP CREA,336.0,235.2,,,0
NDC,45802-139-70,METRONIDAZOLE 0.75 % VAGL GEL,551.0,385.7,,,0
NDC,45802-143-00,NEOMYCIN-BACITRACN ZN-POLYMYXIN 3.5 MG-400 U*,10.5,7.35,,,0
NDC,45802-143-01,NEOMYCIN-BACITRACIN ZN-POLYMYXIN 3.5 MG-400 UN*,24.0,16.8,,,0
NDC,45802-143-03,NEOMYCIN-BACITRACIN ZN-POLYMYXIN 3.5 MG-400 UN*,35.0,24.5,,,0
NDC,45802-143-70,NEOMYCIN-BACITRACN ZN-POLYMYXIN 3.5 MG-400 U*,7.0,4.9,,,0
NDC,45802-188-16,PHENYLEPH-MIN OIL-PETROLATUM 0.25-14-74.9 % RECT OINT,28.0,19.6,,,0
NDC,45802-269-37,PERMETHRIN 5 % TOP CREA,428.0,299.6,,,0
NDC,45802-276-03,HYDROCORTISONE  1 % TOP OINT,34.0,23.8,,,0
NDC,45802-344-03,NICOTINE (POLACRILEX) 2 MG MM LOZG,4.0,2.8,,,0
NDC,45802-344-05,NICOTINE (POLACRILEX) 2 MG MM LOZG,5.5,3.85,,,0
NDC,45802-357-58,SODIUM CHLORIDE  0.65 % NASL SPRA,23.0,16.1,,,0
NDC,45802-358-03,DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,34.0,23.8,,,0
NDC,45802-376-35,"BETAMETHASONE, AUGMENTED 0.05 % TOP CREA",26.0,18.2,,,0
NDC,45802-410-59,OXYMETAZOLINE 0.05 % NASAL MERGE,15.0,10.5,,,0
NDC,45802-419-54,AMMONIUM LACTATE 12 % TOP LOTN,291.5,204.05,,,0
NDC,45802-432-62,PSEUDOEPHEDRINE 30 MG TAB,7.0,4.9,,,0
NDC,45802-433-21,DEXTROMETHORPHAN POLY COMPLEX ER 30 MG/5 ML ORAL SU12,7.0,4.9,,,0
NDC,45802-434-11,CLOTRIMAZOLE 1 % TOP CREA,48.0,33.6,,,0
NDC,45802-438-03,HYDROCORTISONE  1 % TOP CREA,34.0,23.8,,,0
NDC,45802-465-64,KETOCONAZOLE 2 % TOP SHAM,148.0,103.6,,,0
NDC,45802-486-78,DOCUSATE SODIUM 100 MG ORAL CAP,7.0,4.9,,,0
NDC,45802-562-01,CLINDAMYCIN 1 % TOPICAL SOLN,142.0,99.4,,,0
NDC,45802-578-00,NALOXONE 4 MG/ACTUATION NASL SPRY,235.0,164.5,,,0
NDC,45802-580-01,SCOPOLAMINE TRANSDERMAL PATCH 1MG OVER 3 DAYS,113.0,79.1,,,0
NDC,45802-730-00,ACETAMINOPHEN  650 MG RECT SUPP,5.0,3.5,,,0
NDC,45802-730-30,ACETAMINOPHEN  650 MG RECT SUPP,5.0,3.5,,,0
NDC,45802-730-32,ACETAMINOPHEN  650 MG RECT SUPP,5.0,3.5,,,0
NDC,45802-732-00,ACETAMINOPHEN  120 MG RECT SUPP,6.0,4.2,,,0
NDC,45802-732-30,ACETAMINOPHEN  120 MG RECT SUPP,6.0,4.2,,,0
NDC,45802-758-00,PROMETHAZINE 12.5 MG RECT SUPP,130.5,91.35,,,0
NDC,45802-759-00,PROMETHAZINE 25 MG RECT SUPP,68.5,47.95,,,0
NDC,45802-868-00,POLYETHYLENE GLYCOL 3350 17 GRAM (100 %) ORAL PWPK,14.0,9.8,,,0
NDC,45802-868-02,POLYETHYLENE GLYCOL 3350 100 % ORAL POWDER 238 GRAMS,51.0,35.7,,,0
NDC,45802-873-03,NICOTINE (POLACRILEX) 4 MG MM LOZG,8.0,5.6,,,0
NDC,45802-873-05,NICOTINE (POLACRILEX) 4 MG MM LOZG,7.0,4.9,,,0
NDC,45802-900-94,CLINDAMYCIN 1 % TOPICAL GEL,118.0,82.6,,,0
NDC,45802-953-01,DICLOFENAC 1 % TOPICAL GEL,72.0,50.4,,,0
NDC,45963-439-65,LACTULOSE 10 GRAM/15 ML ORAL SOLN,12.0,8.4,,,0
NDC,45963-555-11,GABAPENTIN 100 MG ORAL CAP,7.0,4.9,,,0
NDC,45963-557-11,GABAPENTIN 400 MG ORAL CAP,18.0,12.6,,,0
NDC,45963-609-55,FLUDARABINE 50 MG IV SOLR,817.0,571.9,,,0
NDC,45963-613-59,PACLITAXEL 6 MG/ML IV CONC,245.5,171.85,,,0
NDC,45963-614-51,IRINOTECAN 100 MG/5 ML IV SOLN,232.0,162.4,,,0
NDC,45963-733-60,DOXORUBICIN 50 MG/25 ML IV SOLN,235.0,164.5,,,0
NDC,46028-114-11,"MENINGOCOCCAL B VACC,4-CMP(PF) 50-50-50-25 MCG/0.5 ML IM SYRG",694.0,485.8,,,0
NDC,46122-249-05,CARBAMIDE PEROXIDE 6.5 % OTIC DROP,41.0,28.7,,,0
NDC,46287-006-60,SODIUM POLYSTYRENE SULF-SORBTL 15-20 GRAM/60 ML ORAL SUSP,208.0,145.60000000000002,,,0
NDC,46287-009-01,ISONIAZID 50 MG/5 ML ORAL SYRP,106.0,74.2,,,0
NDC,46287-035-15,AMLODIPINE 1 MG/ML ORAL SOLN,20.5,14.350000000000001,,,0
NDC,4628750030,SORBITOL 70 % MISC SOLN,44.0,30.8,,,0
NDC,46581-830-01,LIDOCAINE 4% TOP PATCH,44.0,30.8,,,0
NDC,46581-830-06,LIDOCAINE 4% TOP PATCH,42.0,29.4,,,0
NDC,4687600030,MENTHOL-ZINC OXIDE 0.44-20.625 % TOP OINT,34.0,23.8,,,0
NDC,47335-049-40,DOXORUBICIN LIPOSOMAL 2 MG/ML IV INJ,2675.0,1872.5,,,0
NDC,47335-050-40,DOXORUBICIN LIPOSOMAL 2 MG/ML IV INJ,10030.0,7021.0,,,0
NDC,47335-154-40,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) BLADDER INSTILLATION,1108.0,775.6,,,0
NDC,47335-236-83,AMBRISENTAN  5 MG ORAL TAB,1286.0,900.2,,,0
NDC,47335-321-86,MEMANTINE  5 MG ORAL TAB,47.0,32.9,,,0
NDC,47335-485-83,BICALUTAMIDE 50 MG ORAL TAB,91.0,63.7,,,0
NDC,47335-631-48,BUDESONIDE 0.25 MG/2 ML INHL NBSP,19.0,13.3,,,0
NDC,47335-703-48,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) NEB SOLUTION,11.5,8.05,,,0
NDC,47335-703-52,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) NEB SOLUTION,8.0,5.6,,,0
NDC,47335-711-86,TOPIRAMATE 100 MG ORAL TAB,51.0,35.7,,,0
NDC,47335-756-48,IPRATROPIUM-ALBUTEROL 0.5 MG-2.5 MG/3 ML NEB SOLUTION,25.0,17.5,,,0
NDC,47335-756-49,IPRATROPIUM-ALBUTEROL 0.5 MG-2.5 MG/3 ML NEB SOLUTION,13.0,9.1,,,0
NDC,47335-931-40,VECURONIUM BROMIDE 10 MG IV SOLR,50.0,35.0,,,0
NDC,47335-932-40,VECURONIUM BROMIDE 20 MG IV SOLR,75.0,52.5,,,0
NDC,47335-992-01,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IV PGBK,116.5,81.55,,,0
NDC,47335-993-01,METRONIDAZOLE IN SODIUM CHLORIDE (ISO-OSM) 500 MG/100 ML IV PIGGY BACK,36.0,25.2,,,0
NDC,47426-201-01,APREPITANT 130 MG/18 ML (7.2 MG/ML) IV EMUL,1218.5,852.95,,,0
NDC,47682-145-99,ACETAMINOPHEN  325 MG ORAL TAB,5.0,3.5,,,0
NDC,47781-014-01,HYOSCYAMINE SULFATE 0.375 MG ORAL TB12,9.0,6.3,,,0
NDC,47781-176-01,AMPHETAMINE-DEXTROAMPHETAMINE 10 MG ORAL TAB,10.0,7.0,,,0
NDC,47781-204-04,ESTRADIOL 0.025 MG/24 HR TD PTWK,217.0,151.9,,,0
NDC,47781-307-01,NITROFURANTOIN MACROCRYSTAL  50 MG ORAL CAP,13.0,9.1,,,0
NDC,47781-332-01,CARBIDOPA 25 MG ORAL TAB,214.0,149.8,,,0
NDC,47781-335-30,PYRIDOSTIGMINE BROMIDE 180 MG ORAL TBSR,122.0,85.4,,,0
NDC,47781-423-11,FENTANYL  12 MCG/HR TD PT72,100.0,70.0,,,0
NDC,47781-424-11,FENTANYL  25 MCG/HR TD PT72,104.0,72.8,,,0
NDC,47781-424-47,FENTANYL  25 MCG/HR TD PT72,104.0,72.8,,,0
NDC,47781-426-11,FENTANYL  50 MCG/HR TD PT72,260.5,182.35,,,0
NDC,47781-427-11,FENTANYL  75 MCG/HR TD PT72,428.0,299.6,,,0
NDC,47781-428-11,FENTANYL 100 MCG/HR TD PT72,450.5,315.35,,,0
NDC,47781-468-13,OSELTAMIVIR PHOSPHATE 30 MG ORAL CAP,104.5,73.15,,,0
NDC,47781-470-13,OSELTAMIVIR PHOSPHATE 75 MG ORAL CAP,76.0,53.2,,,0
NDC,47781-584-93,KETOROLAC TROMETHAMINE 30 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,48102-057-11,ERYTHROMYCIN 5 MG/G OPHT OINT,87.0,60.900000000000006,,,0
NDC,48433-129-01,ASPIRIN 81 MG ORAL CHEW,5.0,3.5,,,0
NDC,48433-202-30,MINERAL OIL ORAL (REPACK),11.0,7.7,,,0
NDC,48433-230-15,IODINE STRONG (LUGOLS) 5 % ORAL SOLN,136.0,95.2,,,0
NDC,4843310801,THIAMINE MONONITRATE 100 MG ORAL TAB,7.0,4.9,,,0
NDC,4858200155,SALIVA STIMULANT AGENTS COMB.3 MM SPRY (BIOTENE) (REPACK),38.5,26.95,,,0
NDC,486112501,K PHOS DI & MONO-SOD PHOS MONO 250 MG ORAL TAB,10.0,7.0,,,0
NDC,48783-112-08,FERRIC SUBSULFATE 0.2 TO 0.22 GRAM/ML MISC SOLA,106.0,74.2,,,0
NDC,487900330,SODIUM CHLORIDE  3 % INHL NEBU,7.0,4.9,,,0
NDC,487900730,SODIUM CHLORIDE  7 % INHL NEBU,7.0,4.9,,,0
NDC,487930201,SODIUM CHLORIDE 0.9 % INHL NEBU,7.0,4.9,,,0
NDC,48815-1001-1,IODINE I-123 SODIUM IODINE CAPSULE,423.0,296.1,,,0
NDC,4898500150,NICOTINE 14 MG/24 HR TD PT24,36.0,25.2,,,0
NDC,4898500155,NICOTINE  7 MG/24 HR TD PT24,24.0,16.8,,,0
NDC,49230-645-51,SUCROFERRIC OXYHYDROXIDE 500 MG ORAL CHEW,50.0,35.0,,,0
NDC,49281-124-65,FLU VACCINE TS 2024-25 65 YR UP (PF) 180 MCG/0.5 ML IM SYRG,373.0,261.1,,,0
NDC,49281-124-88,FLU VACCINE TS 2024-25 65 YR UP (PF) 180 MCG/0.5 ML IM SYRG,373.0,261.1,,,0
NDC,49281-125-65,FLU VACCINE TS 2025-26 65 YR UP (PF) 180 MCG/0.5 ML IM SYRG,387.5,271.25,,,0
NDC,49281-125-88,FLU VACCINE TS 2025-26 65 YR UP (PF) 180 MCG/0.5 ML IM SYRG,387.5,271.25,,,0
NDC,49281-215-10,TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE,217.0,151.9,,,0
NDC,49281-215-15,TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE,236.0,165.2,,,0
NDC,49281-215-58,TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP,217.0,151.9,,,0
NDC,49281-215-88,TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE,225.0,157.5,,,0
NDC,49281-246-58,"RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT IM",1365.0,955.5,,,0
NDC,49281-252-51,"RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT IM",1222.0,855.4000000000001,,,0
NDC,49281-400-10,"DIPHTH,PERTUS(ACELL),TETANUS VIAL (ADACEL) 2 LF-(5-3-5MCG)-5 LF/0.5 ML IM SUSP",249.0,174.3,,,0
NDC,49281-424-50,FLU VACCINE TS 2024-25 6MOS UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,121.0,84.7,,,0
NDC,49281-424-88,FLU VACCINE TS 2024-25 6MOS UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,121.0,84.7,,,0
NDC,49281-425-50,FLU VACCINE TS 2025-26 6 MO UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,122.0,85.4,,,0
NDC,49281-425-88,FLU VACCINE TS 2025-26 6 MO UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,183.0,128.10000000000002,,,0
NDC,49281-511-05,DIP-PERT(A)-TET-POLIO-HIB (PF) 15LF-20MCG-5LF- 62 DU/0.5 ML IM KIT,504.5,353.15,,,0
NDC,49281-544-58,"HIB CONJ-TET,COMPNT 2 OF 2(PF) 10 MCG/0.5 ML IM SOLR",504.5,353.15,,,0
NDC,49281-545-03,HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX (PF) 10 MCG IM,77.0,53.900000000000006,,,0
NDC,49281-545-15,"HIB CONJ-TET,COMPNT 2 OF 2(PF) 10 MCG/0.5 ML IM SOLR",456.0,319.2,,,0
NDC,49281-547-58,HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX (PF) 10 MCG IM,76.0,53.2,,,0
NDC,49281-548-58,"HIB CONJ-TET,COMPNT 2 OF 2(PF) 10 MCG/0.5 ML IM SOLR",456.0,319.2,,,0
NDC,49281-561-01,"DIP,PER(A)TET-HEPB-POL-HIB(PF) 15 UNIT-5 UNIT- 10 MCG/0.5 ML IM SYRG",421.0,294.7,,,0
NDC,49281-574-15,NIRSEVIMAB-ALIP 100 MG/ML IM SYRG,1485.0,1039.5,,,0
NDC,49281-574-88,HC ADMIN RESPIRATORY SYNCYTIAL VIRUS MONOCLONAL ANTIBODY SEASONAL DOSE INTRAMUSCULAR INJECTION,1535.0,1074.5,,,0
NDC,49281-575-00,HC ADMIN RESPIRATORY SYNCYTIAL VIRUS MONOCLONAL ANTIBODY SEASONAL DOSE INTRAMUSCULAR INJECTION,2202.5,1541.75,,,0
NDC,49281-575-15,NIRSEVIMAB-ALIP 50 MG/0.5 ML IM SYRG,1535.0,1074.5,,,0
NDC,49281-589-05,"MENINGOC VAC A,C,Y,W-135 DIP (PF) 4 MCG/0.5 ML IM",612.0,428.4,,,0
NDC,49281-590-05,"MENING VAC A,C,Y,W135,TET (PF) 10 MCG/0.5 ML IM SOLN",721.0,504.7,,,0
NDC,49281-590-10,"MENING VAC A,C,Y,W135,TET (PF) 10 MCG/0.5 ML IM SOLN",732.0,512.4,,,0
NDC,49281-590-58,"MENING VAC A,C,Y,W135,TET (PF) 10 MCG/0.5 ML IM SOLN",732.0,512.4,,,0
NDC,49281-752-21,TUBERCULIN PPD 5 UNIT/0.1 ML IDRM SOLN,62.5,43.75,,,0
NDC,49281-752-78,TUBERCULIN PPD 5 UNIT/0.1 ML IDRM SOLN,65.0,45.5,,,0
NDC,49281-790-88,TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML IM SYRG,649.5,454.65,,,0
NDC,49281-860-10,POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML INJ SUSP,121.0,84.69999999999999,,,0
NDC,49281-860-78,POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML INJ SUSP,121.0,84.69999999999999,,,0
NDC,49281-915-58,YELLOW FEVER VACCINE (PF) 10 EXP4.74 UNIT/0.5 ML SUB-Q SUSP,1206.0,844.2,,,0
NDC,49348-154-72,BACITRACIN 500 UNIT/G TOP OINT (MERGE),18.0,12.6,,,0
NDC,49348-356-25,SODIUM CHLORIDE  0.65 % NASL SPRA,14.0,9.8,,,0
NDC,49348-441-72,HYDROCORTISONE-ALOE VERA 1 % TOP CREA,22.0,15.4,,,0
NDC,49348-498-07,ASPIRIN 81 MG ORAL CHEW,5.0,3.5,,,0
NDC,49348-522-72,HYDROCORTISONE  1 % TOP OINT,18.0,12.6,,,0
NDC,49348-572-36,NICOTINE (POLACRILEX) 4 MG BUCL GUM,7.0,4.9,,,0
NDC,49348-691-36,NICOTINE (POLACRILEX) 2 MG BUCL GUM,7.0,4.9,,,0
NDC,49401-101-01,BELIMUMAB 120 MG IV SOLR,3699.5,2589.6499999999996,,,0
NDC,49401-102-01,BELIMUMAB 400 MG IV SOLR,8471.0,5929.7,,,0
NDC,49502-101-01,EPINEPHRINE 0.15 MG/0.3 ML IM PNIJ,1462.5,1023.75,,,0
NDC,49502-102-01,EPINEPHRINE 0.3 MG/0.3 ML IM PNIJ,900.0,630.0,,,0
NDC,49502-393-80,INSULIN GLARGINE 100 UNIT/ML SUBQ SOLN,19.5,13.649999999999999,,,0
NDC,49502-500-01,EPINEPHRINE 0.3 MG/0.3 ML IM PNIJ,3232.0,2262.4,,,0
NDC,49502-500-02,EPINEPHRINE 0.3 MG/0.3 ML IM PNIJ,840.0,588.0,,,0
NDC,49591-126-51,VARICELLA-ZOSTER IG-MALTOSE 125 UNIT/1.2 ML IM SOLN,31475.0,22032.5,,,0
NDC,49591-532-50,CYTOMEGALOVIRUS IMMUNE GLOB 50 MG/ML IV SOLN,2475.0,1732.5,,,0
NDC,49702-228-13,DOLUTEGRAVIR 50 MG ORAL TAB,389.0,272.3,,,0
NDC,49702-231-13,ABACAVIR-DOLUTEGRAVIR-LAMIVUD 600-50-300 MG ORAL TAB,562.0,393.4,,,0
NDC,49702-238-03,CABOTEGRAVIR 600 MG/3 ML (200 MG/ML) IM SPER,11110.0,7777.0,,,0
NDC,49702-242-13,DOLUTEGRAVIR-RILPIVIRINE 50-25 MG ORAL TAB,516.0,361.2,,,0
NDC,49702-264-23,CABOTEGRAVIR 600 MG/3 ML (200 MG/ML) IM SPER,11110.0,7777.0,,,0
NDC,49884-065-01,GLYCOPYRROLATE 1 MG ORAL TAB,8.0,5.6,,,0
NDC,49884-117-01,AMILORIDE 5 MG ORAL TAB,15.0,10.5,,,0
NDC,49884-122-01,LABETALOL 100 MG ORAL TAB,7.0,4.9,,,0
NDC,49884-155-76,VARENICLINE 0.5 MG ORAL TAB,67.5,47.25,,,0
NDC,49884-161-11,CALCITONIN (SALMON) 200 UNIT/ACTUATION NASL SPRA,427.0,298.9,,,0
NDC,49884-311-52,RISPERIDONE 0.5 MG ORAL TBDL,41.5,29.05,,,0
NDC,49884-315-52,RISPERIDONE 1 MG ORAL TBDL,57.0,39.9,,,0
NDC,49884-465-64,CHOLESTYRAMINE-SUCROSE 4 GRAM ORAL PACK,14.5,10.15,,,0
NDC,49884-466-63,CHOLESTYRAMINE 4 G ORAL PWPK,28.5,19.950000000000003,,,0
NDC,49884-641-01,METHIMAZOLE 10 MG ORAL TAB,9.0,6.3,,,0
NDC,49884-724-01,HYDROXYUREA  500 MG ORAL CAP,22.0,15.4,,,0
NDC,49884-768-52,TOLVAPTAN 15 MG ORAL TAB,1293.0,905.1,,,0
NDC,49884-849-01,MIDODRINE  5 MG ORAL TAB,20.5,14.35,,,0
NDC,49938-101-30,DAPSONE 100 MG ORAL TAB,19.0,13.3,,,0
NDC,49999-059-06,DEXAMETHASONE 4 MG ORAL TAB,33.0,23.1,,,0
NDC,49999-185-25,SILVER SULFADIAZINE 1 % TOP CREA,129.0,90.3,,,0
NDC,49999-268-15,TETRACAINE 0.5 % EYE DROPS,159.0,111.3,,,0
NDC,49999-740-30,POTASSIUM CHLORIDE  20 MEQ ORAL TBTQ,7.0,4.9,,,0
NDC,5001695711,"HYALURONATE SOD, CROSS-LINKED 30 MG/3 ML IATC SYRG",3174.0,2221.8,,,0
NDC,5002443100,OXYMETAZOLINE 0.05 % NASAL MERGE,21.0,14.7,,,0
NDC,50090-0295-1,TRIAMCINOLONE ACETONIDE 10 MG/ML INJ SUSP,16.0,11.2,,,0
NDC,50090-0845-0,BACITRACIN 500 UNIT/G TOP PACK,7.0,4.9,,,0
NDC,50090-3372-0,VARICELLA-ZOSTER GE-AS01B (PF) 50 MCG/0.5 ML IM SUSR (CAM USE ONLY),855.0,598.5,,,0
NDC,50090-4811-0,PROMETHAZINE 25 MG ORAL TAB,7.0,4.9,,,0
NDC,50090-6180-0,"MENING VAC A,C,Y,W135,TET (PF) 10 MCG/0.5 ML IM SOLN",721.0,504.7,,,0
NDC,50102-400-01,LIDOCAINE 10 MG/ML (1 %) INJECTION,16.0,11.2,,,0
NDC,50111-327-01,HYDRALAZINE  25 MG ORAL TAB,9.0,6.3,,,0
NDC,50111-328-01,HYDRALAZINE  50 MG ORAL TAB,5.5,3.85,,,0
NDC,50111-334-01,METRONIDAZOLE 500 MG ORAL TAB,7.0,4.9,,,0
NDC,50111-398-01,HYDRALAZINE  10 MG ORAL TAB,5.5,3.85,,,0
NDC,50111-470-01,PROPRANOLOL  60 MG ORAL TAB,10.0,7.0,,,0
NDC,50111-560-01,TRAZODONE  50 MG ORAL TAB,8.0,5.6,,,0
NDC,50111-561-01,TRAZODONE 100 MG ORAL TAB,16.0,11.2,,,0
NDC,50111-647-01,FLUOXETINE 10 MG ORAL CAP,15.0,10.5,,,0
NDC,50111-648-01,FLUOXETINE 20 MG ORAL CAP,37.5,26.25,,,0
NDC,50111-787-10,AZITHROMYCIN 250 MG ORAL TAB,153.0,107.1,,,0
NDC,50111-787-66,AZITHROMYCIN 250 MG ORAL TAB,153.0,107.1,,,0
NDC,50111-788-67,AZITHROMYCIN 500 MG ORAL TAB,77.0,53.9,,,0
NDC,50111-789-10,AZITHROMYCIN 600 MG ORAL TAB,183.0,128.1,,,0
NDC,5021700106,TRICHLOROACETIC ACID 80 % TOP SOLN,329.0,230.3,,,0
NDC,50228-109-01,CARISOPRODOL 350 MG ORAL TAB,7.0,4.9,,,0
NDC,50228-175-01,BUPROPION HCL 150 MG ORAL TBSR,11.0,7.7,,,0
NDC,50228-420-01,FLUOXETINE 10 MG ORAL TAB,24.0,16.8,,,0
NDC,50228-458-01,CARBIDOPA-LEVODOPA 25 MG-100 MG TAB,10.0,7.0,,,0
NDC,50228-459-01,CARBIDOPA-LEVODOPA 25 MG-250 MG TAB,10.0,7.0,,,0
NDC,50228-461-01,CARBIDOPA-LEVODOPA SR 50 MG-200 MG TAB,10.0,7.0,,,0
NDC,50228-465-01,NABUMETONE 500 MG ORAL TAB,9.0,6.300000000000001,,,0
NDC,50228-482-01,DILTIAZEM 60 MG TAB,9.0,6.3,,,0
NDC,50228-483-01,DILTIAZEM 90 MG TAB,18.0,12.600000000000001,,,0
NDC,50242-009-01,TENECTEPLASE 25 MG IV SOLR,22901.0,16030.7,,,0
NDC,50242-037-06,TENECTEPLASE 50 MG IV (MERGE) (STROKE),6767.5,4737.25,,,0
NDC,50242-040-62,OMALIZUMAB 150 MG SUBQ SOLR,3914.0,2739.8,,,0
NDC,50242-041-10,ALTEPLASE 2 MG INJ SOLR,1400.0,980.0,,,0
NDC,50242-041-63,ALTEPLASE 2 MG INJ SOLR,1323.0,926.1,,,0
NDC,50242-041-64,ALTEPLASE 2 MG INJ SOLR,1752.5,1226.75,,,0
NDC,50242-044-06,ALTEPLASE IV BOLUS (STROKE) 100 MG (2 X 50 MG VIALS),12145.0,8501.5,,,0
NDC,50242-044-13,ALTEPLASE 1 MG/ML (1ML) SYRINGE (REPACK),1168.0,817.6,,,0
NDC,50242-051-21,RITUXIMAB 10 MG/ML IV CONC,5542.0,3879.4,,,0
NDC,50242-053-06,RITUXIMAB 10 MG/ML IV CONC,19059.5,13341.65,,,0
NDC,50242-060-01,BEVACIZUMAB 25 MG/ML IV SOLN,3004.0,2102.8,,,0
NDC,50242-061-01,BEVACIZUMAB 25 MG/ML IV SOLN,24030.0,16821.0,,,0
NDC,50242-070-01,OBINUTUZUMAB 900 MG IN NS 286 ML (STOCK DOSE),6046.0,4232.2,,,0
NDC,50242-077-01,"TRASTUZUMAB-HYALURONIDASE-OYSK 600 MG-10,000 UNIT/5 ML SUBQ SOLN",12904.0,9032.8,,,0
NDC,50242-085-25,ALTEPLASE 100 MG IV SOLR,1336.5,935.55,,,0
NDC,50242-085-27,ALTEPLASE 100 MG IV SOLR,1215.0,850.5,,,0
NDC,50242-087-01,TRASTUZUMAB EMTANSINE 160 MG IV SOLR,9250.0,6475.0,,,0
NDC,50242-088-01,TRASTUZUMAB EMTANSINE 100 MG IV SOLR,4147.0,2902.8999999999996,,,0
NDC,50242-100-39,DORNASE ALFA 1 MG/ML INHL SOLN,749.0,524.3,,,0
NDC,50242-103-01,POLATUZUMAB VEDOTIN-PIIQ 20 MG/ML IV WET SOLR VIAL (RECON 140 MG VIAL),26756.5,18729.55,,,0
NDC,50242-105-01,POLATUZUMAB VEDOTIN-PIIQ 20 MG/ML IV WET SOLR VIAL (RECON 140 MG VIAL),24249.0,16974.3,,,0
NDC,50242-108-01,"RITUXIMAB-HYALURONIDASE,HUMAN 1400 MG/11.7 ML (120 MG/ML) SUBQ SOLN",13985.0,9789.5,,,0
NDC,50242-120-47,TENECTEPLASE 50 MG IV (MERGE ERX) (STEMI),17176.0,12023.2,,,0
NDC,50242-127-01,GLOFITAMAB-GXBM 1 MG/ML IV SOLN (>10 MG DOSE 10 ML MIXTURE COMPONENT),84614.0,59229.8,,,0
NDC,50242-132-01,TRASTUZUMAB 150 MG IV SOLR,17205.0,12043.5,,,0
NDC,50242-135-01,TOCILIZUMAB 80 MG/4 ML (20 MG/ML) IV SOLN,5132.0,3592.4,,,0
NDC,50242-136-01,TOCILIZUMAB 80 MG/4 ML (20 MG/ML) IV SOLN,3666.0,2566.2,,,0
NDC,50242-137-01,TOCILIZUMAB 80 MG/4 ML (20 MG/ML) IV SOLN,5132.0,3592.4,,,0
NDC,50242-145-01,PERTUZUMAB 420 MG/14 ML (30 MG/ML) IV SOLN,9375.0,6562.5,,,0
NDC,50242-150-01,OCRELIZUMAB 30 MG/ML IV SOLN,67275.0,47092.5,,,0
NDC,50242-214-01,OMALIZUMAB 75 MG/0.5 ML SUBQ SYRG,1558.0,1090.6,,,0
NDC,50242-214-03,OMALIZUMAB 75 MG/0.5 ML SUBQ SYRG,1558.0,1090.6,,,0
NDC,50242-215-01,OMALIZUMAB 150 MG/ML SUBQ SYRG,4672.5,3270.75,,,0
NDC,50242-245-01,"PERTUZUMAB-TRASTUZUMAB-HY-ZZXF 1,200 MG-600MG- 30000 UNIT/15ML SUBQ SOLN",35072.0,24550.4,,,0
NDC,50242-260-01,PERTUZUMAB-TRASTUZUMAB-HY-ZZXF 600 MG-600 MG- 20000 UNIT/10ML SUBQ SOLN,23380.0,16366.0,,,0
NDC,50242-554-01,"OCRELIZUMAB-HYALURONIDASE-OCSQ 920 MG-23,000 UNIT/23 ML SUBQ SOLN",113939.0,79757.3,,,0
NDC,50242-901-09,"WATER FOR INJECTION, STERILE INJECTION",16.0,11.2,,,0
NDC,50242-917-01,"ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) IV SOLN",23792.0,16654.4,,,0
NDC,50242-918-01,ATEZOLIZUMAB 840 MG/14 ML (60 MG/ML) IV SOLN,26644.5,18651.15,,,0
NDC,50242-922-01,EMICIZUMAB-KXWH 105 MG/0.7 ML SUBQ SOLN,45550.0,31885.0,,,0
NDC,50242-923-01,EMICIZUMAB-KXWH 150 MG/ML SUBQ SOLN,67574.0,47301.8,,,0
NDC,50242-930-01,EMICIZUMAB-KXWH 300 MG/2 ML (150 MG/ML) SUBQ SOLN,100109.0,70076.3,,,0
NDC,50268-037-11,AMITRIPTYLINE  10 MG ORAL TAB,8.0,5.6,,,0
NDC,50268-040-11,AMITRIPTYLINE  75 MG ORAL TAB,7.5,5.25,,,0
NDC,50268-043-15,ARTIFICIAL TEAR(DXTRN-HPM-GLY) 0.1-0.3-0.2 % OPHT DROP,44.0,30.8,,,0
NDC,50268-054-11,ACETAZOLAMIDE 250 MG ORAL TAB,18.0,12.600000000000001,,,0
NDC,50268-060-11,ACYCLOVIR 200 MG ORAL CAP,22.0,15.4,,,0
NDC,50268-062-11,ACYCLOVIR 800 MG ORAL TAB,18.0,12.600000000000001,,,0
NDC,50268-074-11,AZITHROMYCIN 250 MG ORAL TAB,33.0,23.1,,,0
NDC,50268-075-11,ANASTROZOLE 1 MG ORAL TAB,12.0,8.4,,,0
NDC,50268-087-11,ARIPIPRAZOLE  2 MG ORAL TAB,150.0,105.0,,,0
NDC,50268-088-11,ARIPIPRAZOLE  5 MG ORAL TAB,237.0,165.9,,,0
NDC,50268-089-11,ARIPIPRAZOLE 10 MG ORAL TAB,201.5,141.05,,,0
NDC,50268-090-11,ARIPIPRAZOLE 15 MG ORAL TAB,112.5,78.75,,,0
NDC,50268-093-11,ATORVASTATIN 10 MG ORAL TAB,7.0,4.9,,,0
NDC,50268-097-11,AMIODARONE 100 MG ORAL TAB,73.0,51.1,,,0
NDC,50268-102-11,BALSALAZIDE 750 MG ORAL CAP,30.0,21.0,,,0
NDC,50268-110-11,BENAZEPRIL 10 MG ORAL TAB,13.5,9.45,,,0
NDC,50268-111-11,BENAZEPRIL 20 MG ORAL TAB,7.0,4.9,,,0
NDC,50268-127-11,BISOPROLOL FUMARATE  5 MG ORAL TAB,8.0,5.6,,,0
NDC,50268-130-11,BUMETANIDE 0.5 MG ORAL TAB,17.0,11.9,,,0
NDC,50268-131-11,BUMETANIDE 1 MG ORAL TAB,29.5,20.65,,,0
NDC,50268-132-11,BUMETANIDE 2 MG ORAL TAB,20.5,14.350000000000001,,,0
NDC,50268-144-11,BUPRENORPHINE-NALOXONE 2-0.5 MG SL SUBL,53.0,37.1,,,0
NDC,50268-145-11,BUPRENORPHINE-NALOXONE 8-2 MG SL SUBL,73.0,51.1,,,0
NDC,50268-152-11,CEPHALEXIN 500 MG ORAL CAP,84.0,58.8,,,0
NDC,50268-152-15,CEPHALEXIN 500 MG ORAL CAP,78.0,54.6,,,0
NDC,50268-162-11,CHLORPROMAZINE  10 MG ORAL TAB,76.0,53.2,,,0
NDC,50268-165-11,CHLORPROMAZINE 100 MG ORAL TAB,149.5,104.65,,,0
NDC,50268-167-11,CHLORTHALIDONE  25 MG ORAL TAB,26.0,18.2,,,0
NDC,50268-168-11,CELECOXIB 100 MG ORAL CAP,37.0,25.9,,,0
NDC,50268-169-11,CELECOXIB 200 MG ORAL CAP,20.5,14.35,,,0
NDC,50268-173-11,CLONAZEPAM 0.5 MG ORAL TAB,7.5,5.25,,,0
NDC,50268-174-11,CLONAZEPAM 1 MG ORAL TAB,7.5,5.25,,,0
NDC,50268-175-11,CLONAZEPAM 2 MG ORAL TAB,7.0,4.9,,,0
NDC,50268-177-11,CILOSTAZOL 100 MG ORAL TAB,10.0,7.0,,,0
NDC,50268-179-11,CLARITHROMYCIN 500 MG ORAL TAB,39.0,27.3,,,0
NDC,50268-184-11,CLOPIDOGREL 300 MG ORAL TAB,95.0,66.5,,,0
NDC,50268-187-11,COLCHICINE 0.6 MG ORAL TAB,55.5,38.85,,,0
NDC,50268-189-11,CYPROHEPTADINE 4 MG ORAL TAB,9.5,6.65,,,0
NDC,50268-190-11,CYCLOBENZAPRINE  5 MG ORAL TAB,24.0,16.8,,,0
NDC,50268-191-11,CYCLOBENZAPRINE 10 MG ORAL TAB,11.0,7.7,,,0
NDC,50268-192-11,CLONIDINE 0.1 MG ORAL TAB,5.5,3.85,,,0
NDC,50268-195-60,CAPSAICIN 0.025 % TOP CREA,56.0,39.2,,,0
NDC,50268-220-11,DESMOPRESSIN 0.1 MG ORAL TAB,17.0,11.9,,,0
NDC,50268-224-11,DOXAZOSIN 4 MG ORAL TAB,9.0,6.3,,,0
NDC,50268-225-11,DOXAZOSIN 8 MG ORAL TAB,9.5,6.65,,,0
NDC,50268-259-11,DIVALPROEX 250 MG ORAL TB24,14.0,9.8,,,0
NDC,50268-260-11,DIVALPROEX 500 MG ORAL TB24,19.0,13.3,,,0
NDC,50268-277-11,DOXYCYCLINE HYCLATE  50 MG ORAL CAP,23.5,16.45,,,0
NDC,50268-279-11,DOXYCYCLINE HYCLATE 100 MG ORAL TAB,295.0,206.5,,,0
NDC,50268-281-11,DOXYCYCLINE 100 MG CAP,7.0,4.9,,,0
NDC,50268-297-11,ERGOCALCIFEROL (VITAMIN D2) 50000 UNIT ORAL CAP,11.0,7.7,,,0
NDC,50268-298-11,EZETIMIBE 10 MG ORAL TAB,61.0,42.7,,,0
NDC,50268-299-11,FAMOTIDINE 20 MG ORAL TAB,5.5,3.85,,,0
NDC,50268-303-11,FAMOTIDINE 20 MG ORAL TAB,9.0,6.3,,,0
NDC,50268-314-11,FINASTERIDE 5 MG ORAL TAB,13.5,9.45,,,0
NDC,50268-321-11,FLECAINIDE 100 MG ORAL TAB,46.5,32.55,,,0
NDC,50268-330-11,FLUDROCORTISONE 0.1 MG ORAL TAB,13.5,9.45,,,0
NDC,50268-337-11,FLUCONAZOLE 100 MG ORAL TAB,70.0,49.0,,,0
NDC,50268-339-11,FLUCONAZOLE 200 MG ORAL TAB,140.0,98.0,,,0
NDC,50268-350-11,GEMFIBROZIL 600 MG ORAL TAB,7.0,4.9,,,0
NDC,50268-350-15,GEMFIBROZIL 600 MG ORAL TAB,7.0,4.9,,,0
NDC,50268-359-11,GLIMEPIRIDE 2 MG ORAL TAB,8.5,5.95,,,0
NDC,50268-362-11,GLIPIZIDE 10 MG ORAL TAB,8.0,5.6,,,0
NDC,50268-368-11,FLUPHENAZINE 5 MG TAB,94.5,66.15,,,0
NDC,50268-398-11,HYDROXYZINE PAMOATE  25 MG ORAL CAP,7.0,4.9,,,0
NDC,50268-399-11,HYDROXYZINE PAMOATE  50 MG ORAL CAP,5.5,3.85,,,0
NDC,50268-405-11,HYDROCORTISONE 5 MG ORAL TAB,17.0,11.9,,,0
NDC,50268-407-11,HYDROCORTISONE 20 MG ORAL TAB,18.5,12.95,,,0
NDC,50268-411-11,HYDROCORTISONE ACETATE 25 MG RECT SUPP,55.5,38.85,,,0
NDC,50268-411-24,HYDROCORTISONE ACETATE 25 MG RECT SUPP,106.0,74.2,,,0
NDC,50268-430-11,INDOMETHACIN 25 MG ORAL CAP,5.5,3.85,,,0
NDC,50268-431-11,INDOMETHACIN 50 MG ORAL CAP,7.0,4.9,,,0
NDC,50268-442-11,IRBESARTAN 300 MG ORAL TAB,16.0,11.2,,,0
NDC,50268-447-11,ISOSORBIDE DINITRATE  5 MG ORAL TAB,9.5,6.65,,,0
NDC,50268-448-11,ISOSORBIDE DINITRATE 10 MG ORAL TAB,12.0,8.4,,,0
NDC,50268-453-11,ISOSORBIDE MONONITRATE 120 MG ORAL TB24,13.0,9.1,,,0
NDC,50268-476-11,LETROZOLE 2.5 MG ORAL TAB,133.0,93.1,,,0
NDC,50268-477-11,LEFLUNOMIDE  10 MG ORAL TAB,46.5,32.55,,,0
NDC,50268-489-11,LORATADINE 10 MG ORAL TAB,7.0,4.9,,,0
NDC,50268-504-11,LOSARTAN  25 MG ORAL TAB,7.0,4.9,,,0
NDC,50268-505-11,LOSARTAN  50 MG ORAL TAB,7.0,4.9,,,0
NDC,50268-506-11,LOSARTAN 100 MG ORAL TAB,7.0,4.9,,,0
NDC,50268-520-11,METHOCARBAMOL 500 MG ORAL TAB,11.5,8.05,,,0
NDC,50268-522-11,MECLIZINE 12.5 MG ORAL TAB,7.5,5.25,,,0
NDC,50268-523-11,MECLIZINE 25 MG ORAL TAB,7.0,4.9,,,0
NDC,50268-525-11,MELOXICAM  7.5 MG ORAL TAB,18.0,12.6,,,0
NDC,50268-525-15,MELOXICAM  7.5 MG ORAL TAB,35.0,24.5,,,0
NDC,50268-527-11,METHOTREXATE SODIUM 2.5 MG ORAL TAB,80.0,56.0,,,0
NDC,50268-535-11,METRONIDAZOLE 500 MG ORAL TAB,29.5,20.65,,,0
NDC,50268-540-11,METOPROLOL SUCCINATE SR 25 MG 24 HR TAB,13.0,9.1,,,0
NDC,50268-541-11,METOPROLOL SUCCINATE SR 50 MG 24 HR TAB,16.0,11.2,,,0
NDC,50268-542-11,METOPROLOL SUCCINATE SR 100 MG 24 HR TAB,13.0,9.100000000000001,,,0
NDC,50268-549-11,METHENAMINE HIPPURATE 1 GRAM ORAL TAB,19.0,13.3,,,0
NDC,50268-551-11,METFORMIN  750 MG ORAL TB24,10.5,7.3500000000000005,,,0
NDC,50268-570-11,MODAFINIL 100 MG ORAL TAB,250.0,175.0,,,0
NDC,50268-573-11,MONTELUKAST  4 MG ORAL CHEW,31.0,21.7,,,0
NDC,50268-574-11,MONTELUKAST  5 MG ORAL CHEW,34.5,24.150000000000002,,,0
NDC,50268-576-11,MOXIFLOXACIN 400 MG ORAL TAB,131.0,91.7,,,0
NDC,50268-585-11,PANTOPRAZOLE 20 MG ORAL TBEC,34.0,23.8,,,0
NDC,50268-594-11,NAPROXEN 250 MG ORAL TAB,8.0,5.6,,,0
NDC,50268-594-15,NAPROXEN 250 MG ORAL TAB,7.0,4.9,,,0
NDC,50268-597-11,NIFEDIPINE 30 MG ORAL TO24,18.5,12.95,,,0
NDC,50268-598-11,NIFEDIPINE 60 MG ORAL TO24,16.0,11.2,,,0
NDC,50268-599-11,NIFEDIPINE 90 MG ORAL TO24,14.0,9.8,,,0
NDC,50268-603-11,NORTRIPTYLINE 10 MG ORAL CAP,8.5,5.95,,,0
NDC,50268-604-11,NORTRIPTYLINE 25 MG ORAL CAP,12.0,8.4,,,0
NDC,50268-605-11,NORTRIPTYLINE 50 MG ORAL CAP,4.0,2.8,,,0
NDC,50268-630-11,QUETIAPINE  25 MG ORAL TAB,31.5,22.049999999999997,,,0
NDC,50268-633-11,QUETIAPINE 200 MG ORAL TAB,60.0,42.0,,,0
NDC,50268-639-11,PANTOPRAZOLE 40 MG ORAL TBEC,23.0,16.1,,,0
NDC,50268-642-11,PAROXETINE 30 MG TAB,21.0,14.7,,,0
NDC,50268-662-11,PROPRANOLOL  10 MG ORAL TAB,7.0,4.9,,,0
NDC,50268-663-11,PROPRANOLOL  20 MG ORAL TAB,5.5,3.85,,,0
NDC,50268-671-11,POTASSIUM CHLORIDE  10 MEQ ORAL CPSR,52.0,36.4,,,0
NDC,50268-684-11,PROCHLORPERAZINE MALEATE  5 MG ORAL TAB,18.0,12.6,,,0
NDC,50268-685-11,PROCHLORPERAZINE MALEATE 10 MG ORAL TAB,8.5,5.95,,,0
NDC,50268-685-15,PROCHLORPERAZINE MALEATE 10 MG ORAL TAB,10.0,7.0,,,0
NDC,50268-686-11,PRIMIDONE  50 MG ORAL TAB,14.0,9.8,,,0
NDC,50268-687-11,PRIMIDONE 250 MG ORAL TAB,5.0,3.5,,,0
NDC,50268-694-11,RALOXIFENE 60 MG ORAL TAB,40.0,28.0,,,0
NDC,50268-709-11,ROSUVASTATIN 10 MG ORAL TAB,16.0,11.2,,,0
NDC,50268-710-11,ROSUVASTATIN 20 MG ORAL TAB,9.0,6.3,,,0
NDC,50268-711-11,ROSUVASTATIN 40 MG ORAL TAB,8.0,5.6,,,0
NDC,50268-717-11,SILDENAFIL  20 MG ORAL TAB,162.0,113.4,,,0
NDC,50268-718-11,SIROLIMUS 1 MG ORAL TAB,261.0,182.7,,,0
NDC,50268-720-11,SEVELAMER CARBONATE 800 MG ORAL TAB,131.0,91.7,,,0
NDC,50268-722-11,RANOLAZINE  500 MG ORAL TB12,16.0,11.2,,,0
NDC,50268-724-11,SOTALOL  80 MG ORAL TAB,13.0,9.1,,,0
NDC,50268-728-11,TRIMETHOPRIM-SULFAMETHOXAZOLE 80 MG-400 MG TAB,7.5,5.25,,,0
NDC,50268-740-11,TAMSULOSIN 0.4 MG ORAL CP24,7.0,4.9,,,0
NDC,50268-741-11,ROPINIROLE  0.25 MG ORAL TAB,7.0,4.9,,,0
NDC,50268-744-11,ROPINIROLE  2 MG ORAL TAB,7.0,4.9,,,0
NDC,50268-752-11,TOPIRAMATE 100 MG ORAL TAB,45.0,31.5,,,0
NDC,50268-754-11,TORSEMIDE   5 MG ORAL TAB,14.0,9.8,,,0
NDC,50268-756-11,TORSEMIDE  20 MG ORAL TAB,12.0,8.4,,,0
NDC,50268-760-11,TIZANIDINE 4 MG ORAL TAB,13.0,9.1,,,0
NDC,50268-764-11,TERAZOSIN  1 MG ORAL CAP,18.0,12.6,,,0
NDC,50268-765-11,TERAZOSIN  2 MG ORAL CAP,9.0,6.3,,,0
NDC,50268-766-11,TERAZOSIN  5 MG ORAL CAP,18.0,12.6,,,0
NDC,50268-779-11,TEMAZEPAM 15 MG ORAL CAP,7.0,4.9,,,0
NDC,50268-787-11,VALGANCICLOVIR 450 MG ORAL TAB,710.0,497.0,,,0
NDC,50268-796-11,URSODIOL 300 MG ORAL CAP,54.0,37.8,,,0
NDC,50268-797-11,URSODIOL 300 MG ORAL CAP,43.0,30.1,,,0
NDC,50268-812-11,ZIPRASIDONE 40 MG CAP,28.5,19.950000000000003,,,0
NDC,50268-874-11,VENLAFAXINE  75 MG ORAL CP24,27.0,18.9,,,0
NDC,5026834611,FOLIC ACID 400 MCG ORAL TAB,7.0,4.9,,,0
NDC,5026837511,GLUCOSAMINE SULFATE  500 MG ORAL CAP,7.0,4.9,,,0
NDC,5026852411,MELATONIN  3 MG ORAL TAB,7.0,4.9,,,0
NDC,5026885111,THIAMINE MONONITRATE 100 MG ORAL TAB,7.0,4.9,,,0
NDC,5026885211,CYANOCOBALAMIN  100 MCG ORAL TAB,7.0,4.9,,,0
NDC,5026885511,CYANOCOBALAMIN 1000 MCG ORAL TAB,7.0,4.9,,,0
NDC,5026885811,PYRIDOXINE  50 MG ORAL TAB,7.0,4.9,,,0
NDC,5026886011,ASCORBIC ACID  250 MG ORAL TAB,7.0,4.9,,,0
NDC,5026886311,CHOLECALCIFEROL (VITAMIN D3)   400 UNIT ORAL TAB,5.5,3.85,,,0
NDC,50289-3250-1,GLYCERIN-WITCH HAZEL 12.5 %-50 % TOPICAL PADS,18.0,12.6,,,0
NDC,50383-042-24,PREDNISOLONE 15 MG/5 ML ORAL SOLN,16.0,11.2,,,0
NDC,50383-063-10,GUAIFENESIN 100 MG/5 ML ORAL LIQD,55.0,38.5,,,0
NDC,50383-087-10,CODEINE-GUAIFENESIN 10-100 MG/5 ML ORAL LIQD (REPACK),7.0,4.9,,,0
NDC,50383-312-84,OXCARBAZEPINE 300 MG/5 ML ORAL SUSP,25.0,17.5,,,0
NDC,50383-363-15,LIDOCAINE 2 % MUCOSAL SOLN (VISCOUS),7.0,4.9,,,0
NDC,50383-584-05,IBUPROFEN 100 MG/5 ML ORAL SUSP,7.0,4.9,,,0
NDC,50383-700-16,FLUTICASONE  50 MCG/ACTUATION NASL SPSN,358.0,250.6,,,0
NDC,50383-775-15,LIDOCAINE 2 % MUCOSAL SOLN (VISCOUS),7.0,4.9,,,0
NDC,50383-775-17,LIDOCAINE 2 % MUCOSAL SOLN (VISCOUS),7.0,4.9,,,0
NDC,50383-779-30,LACTULOSE 10 GRAM/15 ML ORAL SOLN,17.0,11.9,,,0
NDC,50383-781-05,LIDOCAINE 2 % MUCOSAL GEL,77.0,53.9,,,0
NDC,50383-792-16,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML ORAL SYRP,7.0,4.9,,,0
NDC,50383-924-93,BUPRENORPHINE 2 MG SL SUBL,19.5,13.649999999999999,,,0
NDC,50383-930-93,BUPRENORPHINE 8 MG SL SUBL,47.0,32.9,,,0
NDC,50419-320-01,GADOXETATE 2.5 MMOL/10 ML IV SOLN,392.5,274.75,,,0
NDC,50419-422-01,LEVONORGESTREL 14 MCG/24 HOUR (3 YEARS) IU IUD,1973.0,1381.1,,,0
NDC,50419-423-01,LEVONORGESTREL 20 MCG/24 HR IU IUD,3553.5,2487.45,,,0
NDC,50419-424-01,LEVONORGESTREL 17.5 MCG/24 HR (5 YEARS) IU IUD,3763.5,2634.45,,,0
NDC,50419-424-08,LEVONORGESTREL 17.5 MCG/24 HR (5 YEARS) IU IUD,2509.0,1756.3,,,0
NDC,50419-451-01,ESTRADIOL 0.05 MG/24 HR TD PTWK,292.0,204.4,,,0
NDC,50419-451-04,ESTRADIOL 0.05 MG/24 HR TD PTWK,112.0,78.4,,,0
NDC,50419-754-01,CIPROFLOXACIN 500 MG ORAL TAB,39.0,27.3,,,0
NDC,50419-773-01,CIPROFLOXACIN 500 MG/5 ML ORAL SUMC,27.5,19.25,,,0
NDC,50458-028-02,ESKETAMINE 56 MG (28 MG X 2) NASL SPRY,1159.0,811.3,,,0
NDC,50458-028-03,ESKETAMINE 84 MG (28 MG X 3) NASL SPRY,5213.0,3649.1,,,0
NDC,50458-305-03,RISPERIDONE 1 MG/ML ORAL SOLN,710.0,497.0,,,0
NDC,50458-306-01,RISPERIDONE MICROSPHERES 25 MG/2 ML IM SYRG,1782.0,1247.4,,,0
NDC,50458-306-11,RISPERIDONE MICROSPHERES 25 MG/2 ML IM SYRG,1782.0,1247.4,,,0
NDC,50458-560-01,PALIPERIDONE PALMITATE 39 MG/0.25 ML IM SYRG,1642.0,1149.4,,,0
NDC,50458-561-01,PALIPERIDONE PALMITATE 78 MG/0.5 ML IM SYRG,3242.5,2269.75,,,0
NDC,50458-562-01,PALIPERIDONE PALMITATE 117 MG/0.75 ML IM SYRG,4926.0,3448.2,,,0
NDC,50458-563-01,PALIPERIDONE PALMITATE 156 MG/ML IM SYRG,6568.0,4597.6,,,0
NDC,50458-564-01,PALIPERIDONE PALMITATE 234 MG/1.5 ML IM SYRG,9726.5,6808.549999999999,,,0
NDC,50458-577-01,RIVAROXABAN  2.5 MG ORAL TAB,168.0,117.6,,,0
NDC,50458-578-01,RIVAROXABAN 15 MG ORAL TAB,314.5,220.14999999999998,,,0
NDC,50458-578-10,RIVAROXABAN 15 MG ORAL TAB,114.5,80.15,,,0
NDC,50458-578-90,RIVAROXABAN 15 MG ORAL TAB,117.0,81.9,,,0
NDC,50458-579-01,RIVAROXABAN 20 MG ORAL TAB,112.0,78.4,,,0
NDC,50458-579-90,RIVAROXABAN 20 MG ORAL TAB,211.0,147.7,,,0
NDC,50458-580-01,RIVAROXABAN 10 MG ORAL TAB,170.0,119.0,,,0
NDC,50458-585-01,METHYLPHENIDATE 18 MG ORAL TO24,114.0,79.80000000000001,,,0
NDC,50458-590-10,RISPERIDONE 0.25 MG ORAL TAB,23.0,16.1,,,0
NDC,50458-593-10,RISPERIDONE 2 MG ORAL TAB,33.0,23.1,,,0
NDC,50458-596-01,RISPERIDONE 1 MG/ML ORAL SOLN,527.0,368.9,,,0
NDC,50458-647-65,TOPIRAMATE  15 MG ORAL CPSP,41.0,28.7,,,0
NDC,50474-700-62,CERTOLIZUMAB PEGOL 400 MG (200 MG X 2) SUBQ KIT,3323.0,2326.1,,,0
NDC,50474-710-79,CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X 2) SUBQ SYKT,8280.0,5796.0,,,0
NDC,50474-870-15,BRIVARACETAM 10 MG/ML ORAL SOLN,373.5,261.45000000000005,,,0
NDC,50484-010-30,COLLAGENASE 250 UNIT/G TOP OINT,1097.5,768.25,,,0
NDC,50580-458-11,ACETAMINOPHEN  325 MG ORAL TAB,4.0,2.8,,,0
NDC,50580-501-30,ACETAMINOPHEN  325 MG ORAL TAB,5.0,3.5,,,0
NDC,50580-521-24,ACETAMINOPHEN  160 MG ORAL CHEW,7.0,4.9,,,0
NDC,50580-600-02,ACETAMINOPHEN  325 MG ORAL TAB,4.0,2.8,,,0
NDC,50632-010-01,"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM KIT",1333.0,933.1,,,0
NDC,50632-013-01,"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM KIT",1333.0,933.1,,,0
NDC,50632-016-02,"TYPHOID VACCINE 2 BILLION UNIT CAP, DELAYED RELEASE",173.0,121.1,,,0
NDC,50633-111-11,CROTALIDAE POLYVAL IMMUNE FAB SOLUTION FOR INJECTION,26479.5,18535.65,,,0
NDC,50633-210-11,GLUCARPIDASE 1000 UNIT IV SOLR,113217.0,79251.9,,,0
NDC,50633-310-11,HYDROXOCOBALAMIN 5 GRAM IV SOLR,2755.0,1928.5,,,0
NDC,50742-112-01,DESIPRAMINE  10 MG ORAL TAB,14.5,10.15,,,0
NDC,50742-113-01,DESIPRAMINE  25 MG ORAL TAB,39.5,27.65,,,0
NDC,50742-118-08,CABERGOLINE 0.5 MG ORAL TAB,180.0,126.0,,,0
NDC,50742-181-30,LEUCOVORIN CALCIUM   5 MG ORAL TAB,40.0,28.0,,,0
NDC,50742-190-01,CYPROHEPTADINE 4 MG ORAL TAB,7.0,4.9,,,0
NDC,50742-239-01,MEXILETINE 150 MG ORAL CAP,22.0,15.4,,,0
NDC,50742-240-01,MEXILETINE 200 MG ORAL CAP,17.0,11.9,,,0
NDC,50742-249-90,DILTIAZEM SR 180 MG 24 HR CAP,13.0,9.1,,,0
NDC,50742-251-30,DILTIAZEM SR 300 MG 24 HR CAP,15.0,10.5,,,0
NDC,50742-251-90,DILTIAZEM SR 300 MG 24 HR CAP,18.0,12.6,,,0
NDC,50742-267-50,NORETHINDRONE ACETATE 5 MG ORAL TAB,37.5,26.25,,,0
NDC,50742-351-01,METOLAZONE 10 MG ORAL TAB,10.0,7.0,,,0
NDC,50742-362-60,IVABRADINE 5 MG ORAL TAB,54.0,37.8,,,0
NDC,50742-363-60,IVABRADINE 7.5 MG ORAL TAB,81.0,56.699999999999996,,,0
NDC,50742-484-01,BORTEZOMIB 3.5 MG IV SOLR,341.0,238.7,,,0
NDC,50742-497-53,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) BLADDER INSTILLATION,386.0,270.2,,,0
NDC,50742-505-01,SCOPOLAMINE TRANSDERMAL PATCH 1MG OVER 3 DAYS,106.0,74.19999999999999,,,0
NDC,50742-615-01,METOPROLOL SUCCINATE SR 25 MG 24 HR TAB,15.0,10.5,,,0
NDC,50742-656-01,CARISOPRODOL 350 MG ORAL TAB,7.0,4.9,,,0
NDC,50881-013-03,TAFASITAMAB-CXIX 200 MG IV SOLR,5233.0,3663.1000000000004,,,0
NDC,50881-034-12,AXATILIMAB-CSFR 50 MG/ML IV SOLN,25286.0,17700.2,,,0
NDC,51079-023-01,METOLAZONE  2.5 MG ORAL TAB,28.0,19.6,,,0
NDC,51079-024-01,METOLAZONE  5 MG ORAL TAB,31.5,22.049999999999997,,,0
NDC,51079-028-01,TACROLIMUS 0.5 MG/ML ORAL SUSPENSION (REPACK),38.0,26.6,,,0
NDC,51079-051-01,PANTOPRAZOLE 40 MG ORAL TBEC,30.0,21.0,,,0
NDC,51079-051-20,PANTOPRAZOLE 40 MG ORAL TBEC,189.5,132.65,,,0
NDC,51079-058-01,CHLORTHALIDONE  25 MG ORAL TAB,32.5,22.75,,,0
NDC,51079-072-20,FUROSEMIDE 20 MG ORAL TAB,7.0,4.9,,,0
NDC,51079-074-01,HYDRALAZINE  10 MG ORAL TAB,7.0,4.9,,,0
NDC,51079-075-01,HYDRALAZINE  25 MG ORAL TAB,9.0,6.3,,,0
NDC,51079-076-01,HYDRALAZINE  50 MG ORAL TAB,5.5,3.85,,,0
NDC,51079-083-01,ISONIAZID 300 MG ORAL TAB,15.0,10.5,,,0
NDC,51079-086-01,MIRTAZAPINE 15 MG ORAL TAB,31.0,21.7,,,0
NDC,51079-087-01,MIRTAZAPINE 30 MG ORAL TAB,16.0,11.2,,,0
NDC,51079-103-01,SPIRONOLACTONE  25 MG ORAL TAB,8.0,5.6,,,0
NDC,51079-141-01,CHLORDIAZEPOXIDE 25 MG CAP,13.5,9.45,,,0
NDC,51079-149-01,SERTRALINE  25 MG ORAL TAB,16.0,11.2,,,0
NDC,51079-165-01,VORICONAZOLE 200 MG ORAL TAB,304.5,213.15,,,0
NDC,51079-169-01,METOPROLOL SUCCINATE SR 25 MG 24 HR TAB,20.0,14.0,,,0
NDC,51079-170-01,METOPROLOL SUCCINATE SR 50 MG 24 HR TAB,16.5,11.55,,,0
NDC,51079-171-01,METOPROLOL SUCCINATE SR 100 MG 24 HR TAB,10.0,7.0,,,0
NDC,51079-182-01,CIPROFLOXACIN 500 MG ORAL TAB,29.0,20.3,,,0
NDC,51079-205-01,ALLOPURINOL 100 MG ORAL TAB,5.0,3.5,,,0
NDC,51079-206-01,ALLOPURINOL 300 MG ORAL TAB,7.0,4.9,,,0
NDC,51079-208-01,ATORVASTATIN 10 MG ORAL TAB,7.0,4.9,,,0
NDC,51079-209-01,ATORVASTATIN 20 MG ORAL TAB,7.0,4.9,,,0
NDC,51079-210-01,ATORVASTATIN 40 MG ORAL TAB,5.5,3.85,,,0
NDC,51079-211-01,ATORVASTATIN 80 MG ORAL TAB,9.0,6.300000000000001,,,0
NDC,51079-246-01,LORATADINE 10 MG ORAL TAB,7.0,4.9,,,0
NDC,51079-255-01,METOPROLOL TARTRATE 25 MG TAB,7.0,4.9,,,0
NDC,51079-284-01,DIAZEPAM  2 MG ORAL TAB,5.5,3.85,,,0
NDC,51079-285-01,DIAZEPAM  5 MG ORAL TAB,11.5,8.05,,,0
NDC,51079-375-01,CHLORDIAZEPOXIDE 10 MG CAP,18.0,12.6,,,0
NDC,51079-379-01,MYCOPHENOLATE 500 MG TAB,78.0,54.6,,,0
NDC,51079-385-01,CARBAMAZEPINE 200 MG ORAL TAB,9.0,6.3,,,0
NDC,51079-436-01,DOXEPIN  10 MG ORAL CAP,8.0,5.6,,,0
NDC,51079-437-01,DOXEPIN  25 MG ORAL CAP,10.0,7.0,,,0
NDC,51079-438-01,DOXEPIN  50 MG ORAL CAP,16.5,11.55,,,0
NDC,51079-440-01,LEVOTHYROXINE  50 MCG ORAL TAB,6.5,4.550000000000001,,,0
NDC,51079-441-01,LEVOTHYROXINE  75 MCG ORAL TAB,7.0,4.9,,,0
NDC,51079-442-01,LEVOTHYROXINE 100 MCG ORAL TAB,9.0,6.300000000000001,,,0
NDC,51079-442-20,LEVOTHYROXINE 100 MCG ORAL TAB,7.0,4.9,,,0
NDC,51079-443-01,LEVOTHYROXINE 125 MCG ORAL TAB,7.5,5.25,,,0
NDC,51079-444-01,LEVOTHYROXINE 25 MCG ORAL TAB,9.5,6.65,,,0
NDC,51079-445-01,LEVOTHYROXINE 150 MCG ORAL TAB,6.0,4.2,,,0
NDC,51079-453-01,MIDODRINE  5 MG ORAL TAB,38.5,26.950000000000003,,,0
NDC,51079-456-01,SIMVASTATIN 40 MG ORAL TAB,28.0,19.6,,,0
NDC,51079-458-01,PRAVASTATIN 20 MG ORAL TAB,28.0,19.6,,,0
NDC,51079-543-01,ESCITALOPRAM 10 MG ORAL TAB,37.0,25.9,,,0
NDC,51079-544-01,ESCITALOPRAM 20 MG ORAL TAB,26.0,18.2,,,0
NDC,51079-566-01,THIORIDAZINE  25 MG ORAL TAB,7.0,4.9,,,0
NDC,51079-597-01,CETIRIZINE 10 MG ORAL TAB,28.0,19.6,,,0
NDC,51079-597-20,CETIRIZINE 10 MG ORAL TAB,14.0,9.8,,,0
NDC,51079-599-01,FENOFIBRATE NANOCRYSTALLIZED  48 MG ORAL TAB,27.0,18.9,,,0
NDC,51079-630-01,PRAZOSIN 1 MG ORAL CAP,41.0,28.7,,,0
NDC,51079-631-01,PRAZOSIN 2 MG ORAL CAP,28.0,19.6,,,0
NDC,51079-632-01,PRAZOSIN 5 MG ORAL CAP,56.0,39.2,,,0
NDC,51079-651-01,DOXEPIN 100 MG ORAL CAP,23.0,16.1,,,0
NDC,51079-670-01,METHOTREXATE SODIUM 2.5 MG ORAL TAB,183.0,128.1,,,0
NDC,51079-684-01,ATENOLOL  50 MG ORAL TAB,8.5,5.95,,,0
NDC,51079-685-01,ATENOLOL 100 MG ORAL TAB,9.0,6.3,,,0
NDC,51079-690-01,LOPERAMIDE 2 MG ORAL CAP,22.5,15.75,,,0
NDC,51079-721-01,MYCOPHENOLATE 250 MG CAP,51.5,36.05,,,0
NDC,51079-733-01,HALOPERIDOL  0.5 MG ORAL TAB,4.5,3.1500000000000004,,,0
NDC,51079-734-01,HALOPERIDOL  1 MG ORAL TAB,9.0,6.3,,,0
NDC,51079-735-01,HALOPERIDOL  2 MG ORAL TAB,8.5,5.95,,,0
NDC,51079-736-01,HALOPERIDOL  5 MG ORAL TAB,10.0,7.0,,,0
NDC,51079-753-01,SUCRALFATE 1 GRAM ORAL TAB,7.0,4.9,,,0
NDC,51079-759-01,ATENOLOL  25 MG ORAL TAB,9.0,6.3,,,0
NDC,51079-759-20,ATENOLOL  25 MG ORAL TAB,9.0,6.3,,,0
NDC,51079-766-01,DIVALPROEX 250 MG ORAL TB24,14.0,9.8,,,0
NDC,51079-801-01,METOPROLOL TARTRATE 50 MG TAB,7.0,4.9,,,0
NDC,51079-816-01,HYDROXYZINE 50 MG TAB,7.0,4.9,,,0
NDC,51079-817-01,TACROLIMUS 0.5 MG ORAL CAP,13.0,9.1,,,0
NDC,51079-818-01,TACROLIMUS 1 MG ORAL CAP,55.0,38.5,,,0
NDC,51079-818-20,TACROLIMUS 1 MG ORAL CAP,50.0,35.0,,,0
NDC,51079-821-01,LEVETIRACETAM  500 MG ORAL TAB,45.5,31.85,,,0
NDC,51079-882-01,CLONAZEPAM 0.1MG/ML SUSPENSION (REPACK),11.5,8.05,,,0
NDC,51079-886-01,METOCLOPRAMIDE  5 MG ORAL TAB,9.0,6.300000000000001,,,0
NDC,51079-886-20,METOCLOPRAMIDE  5 MG ORAL TAB,67.0,46.9,,,0
NDC,51079-888-01,METOCLOPRAMIDE 10 MG ORAL TAB,7.0,4.9,,,0
NDC,51079-893-01,BUMETANIDE 2 MG ORAL TAB,12.0,8.4,,,0
NDC,51079-921-01,CLOZAPINE  25 MG ORAL TAB,26.0,18.2,,,0
NDC,51079-922-01,CLOZAPINE 100 MG ORAL TAB,51.0,35.7,,,0
NDC,51079-923-01,CARBIDOPA-LEVODOPA SR 50 MG-200 MG TAB,15.0,10.5,,,0
NDC,51079-924-01,DILTIAZEM SR 60 MG 12 HR CAP,52.0,36.4,,,0
NDC,51079-925-01,DILTIAZEM SR 90 MG 12 HR CAP,52.0,36.4,,,0
NDC,51079-926-01,DILTIAZEM SR 120 MG 12 HR CAP,64.0,44.8,,,0
NDC,51079-931-01,CARVEDILOL 12.5 MG ORAL TAB,12.0,8.4,,,0
NDC,51079-932-01,CARVEDILOL 25 MG ORAL TAB,18.0,12.600000000000001,,,0
NDC,51079-937-01,TERAZOSIN  2 MG ORAL CAP,9.0,6.3,,,0
NDC,51079-943-01,BUPROPION HCL  75 MG ORAL TAB,9.0,6.3,,,0
NDC,51079-960-01,BUSPIRONE 15 MG ORAL TAB,9.5,6.65,,,0
NDC,51079-966-01,FAMOTIDINE 20 MG ORAL TAB,10.0,7.0,,,0
NDC,51079-978-01,CARBIDOPA-LEVODOPA SR 25 MG-100 MG TAB,9.0,6.300000000000001,,,0
NDC,51079-979-01,SPIRONOLACTONE  50 MG ORAL TAB,8.5,5.95,,,0
NDC,51079-980-01,SPIRONOLACTONE 100 MG ORAL TAB,8.5,5.949999999999999,,,0
NDC,51079-982-01,LISINOPRIL 10 MG ORAL TAB,27.0,18.9,,,0
NDC,51079-985-01,BUSPIRONE  5 MG ORAL TAB,8.0,5.6,,,0
NDC,51079-986-01,BUSPIRONE 10 MG ORAL TAB,19.0,13.3,,,0
NDC,51079-998-01,TIZANIDINE 4 MG ORAL TAB,15.0,10.5,,,0
NDC,51144-003-01,TISOTUMAB VEDOTIN-TFTV 40 MG IV SOLR,47249.0,33074.3,,,0
NDC,51144-020-01,ENFORTUMAB VEDOTIN-EJFV 20 MG IV SOLR,2476.0,1733.2,,,0
NDC,51144-030-01,ENFORTUMAB VEDOTIN-EJFV 30 MG IV SOLR,8517.5,5962.25,,,0
NDC,51144-050-01,BRENTUXIMAB VEDOTIN 50 MG IV SOLR,27071.5,18950.050000000003,,,0
NDC,51224-107-50,METFORMIN  750 MG ORAL TB24,12.5,8.75,,,0
NDC,51293-811-01,PHENAZOPYRIDINE 200 MG ORAL TAB,23.0,16.1,,,0
NDC,51407-153-90,ROSUVASTATIN  5 MG ORAL TAB,4.5,3.1500000000000004,,,0
NDC,51407-663-05,OLOPATADINE 0.1 % OPHT DROP,187.0,130.9,,,0
NDC,5140900722,BENZOCAINE-MENTHOL 20 %-0.5 % TOPICAL AEROSOL,39.5,27.65,,,0
NDC,51552-1345-1,LET TOPICAL SOLUTION 4ML (REPACK),92.0,64.4,,,0
NDC,5155200556,ACETIC ACID (VINEGAR) 5% IRRIGATION 12 ML (REPACK),56.0,39.2,,,0
NDC,5155210795,SYRSPEND SF (COMPOUND VEH.SUSP SUGAR-FREE 3) ORAL SUSP,7.0,4.9,,,0
NDC,51645-850-99,SENNOSIDES-DOCUSATE SODIUM 8.6 MG-50 MG TAB,7.0,4.9,,,0
NDC,5164582799,"CALCIUM CARBONATE 500 MG (1,250 MG) ORAL TAB",7.0,4.9,,,0
NDC,51660-200-30,EZETIMIBE 10 MG ORAL TAB,40.0,28.0,,,0
NDC,51660-204-21,PSEUDOEPHEDRINE SR 120 MG TAB,7.0,4.9,,,0
NDC,51660-204-69,PSEUDOEPHEDRINE SR 120 MG TAB,7.0,4.9,,,0
NDC,51672-1267-5,TRIAMCINOLONE ACETONIDE 0.1 % DENT PSTE,342.0,239.4,,,0
NDC,51672-1284-1,TRIAMCINOLONE ACETONIDE 0.1 % TOP OINT,33.0,23.1,,,0
NDC,51672-1289-1,NYSTATIN  100000 UNIT/G TOP CREA,172.0,120.4,,,0
NDC,51672-1298-1,KETOCONAZOLE 2 % TOP CREA,473.0,331.1,,,0
NDC,51672-1300-5,AMMONIUM LACTATE 12 % TOP LOTN,210.0,147.0,,,0
NDC,51672-1310-1,"BETAMETHASONE, AUGMENTED 0.05 % TOP CREA",186.0,130.2,,,0
NDC,51672-2002-2,CLOTRIMAZOLE 1 % TOP CREA,54.0,37.8,,,0
NDC,51672-2003-6,CLOTRIMAZOLE 1 % VAGL CREA,45.0,31.5,,,0
NDC,51672-2016-2,NEOMYCIN-BACITRACIN ZN-POLYMYXIN 3.5 MG-400 UN*,54.0,37.8,,,0
NDC,51672-2075-2,BACITRACIN 500 UNIT/G TOP OINT (MERGE),90.0,63.0,,,0
NDC,51672-2115-0,ACETAMINOPHEN  120 MG RECT SUPP,8.5,5.95,,,0
NDC,51672-2115-2,ACETAMINOPHEN  120 MG RECT SUPP,7.0,4.9,,,0
NDC,51672-2116-0,ACETAMINOPHEN  325 MG RECT SUPP,10.5,7.3500000000000005,,,0
NDC,51672-2116-2,ACETAMINOPHEN  325 MG RECT SUPP,14.0,9.8,,,0
NDC,51672-2131-8,LORATADINE 5 MG/5 ML ORAL SOLN,7.0,4.9,,,0
NDC,51672-3007-1,HYDROCORTISONE-ACETIC ACID 1 %-2 % EAR DROPS,813.0,569.1,,,0
NDC,51672-3020-9,LIDOCAINE 5 % TOP OINT,935.0,654.5,,,0
NDC,51672-4002-1,NORTRIPTYLINE 25 MG ORAL CAP,33.0,23.099999999999998,,,0
NDC,51672-4005-1,CARBAMAZEPINE 200 MG ORAL TAB,18.0,12.6,,,0
NDC,51672-4011-6,CLOMIPRAMINE 25 MG ORAL CAP,8.5,5.95,,,0
NDC,51672-4023-1,ACETAZOLAMIDE 25MG/ML SUSPENSION (REPACK),7.0,4.9,,,0
NDC,51672-4027-1,WARFARIN 1 MG ORAL TAB,11.5,8.05,,,0
NDC,51672-4029-1,WARFARIN  2.5 MG ORAL TAB,7.0,4.9,,,0
NDC,51672-4030-1,WARFARIN  3 MG ORAL TAB,7.5,5.25,,,0
NDC,51672-4031-1,WARFARIN  4 MG ORAL TAB,7.5,5.25,,,0
NDC,51672-4033-1,WARFARIN  6 MG ORAL TAB,7.5,5.25,,,0
NDC,51672-4034-1,WARFARIN  7.5 MG ORAL TAB,9.0,6.300000000000001,,,0
NDC,51672-4035-1,WARFARIN 10 MG ORAL TAB,6.0,4.2,,,0
NDC,51672-4037-1,ENALAPRIL MALEATE  2.5 MG ORAL TAB,13.0,9.1,,,0
NDC,51672-4038-1,ENALAPRIL MALEATE  5 MG ORAL TAB,16.0,11.2,,,0
NDC,51672-4042-1,CLORAZEPATE DIPOTASSIUM  3.75 MG ORAL TAB,20.0,14.0,,,0
NDC,51672-4047-9,CARBAMAZEPINE 100 MG/5 ML ORAL SUSP,14.0,9.8,,,0
NDC,51672-4069-1,PHENYTOIN 125 MG/5 ML ORAL SUSP,9.0,6.3,,,0
NDC,51672-4069-2,PHENYTOIN 125 MG/5 ML ORAL SUSP,17.5,12.25,,,0
NDC,51672-4081-3,CLINDAMYCIN 1 % TOPICAL SOLN,200.0,140.0,,,0
NDC,51672-4091-3,ONDANSETRON HCL 4 MG/5 ML ORAL SOLN,88.5,61.949999999999996,,,0
NDC,51672-4111-1,PHENYTOIN SODIUM EXTENDED 100 MG ORAL CAP,7.0,4.9,,,0
NDC,51672-4116-6,METRONIDAZOLE 0.75 % TOP GEL,943.0,660.1,,,0
NDC,51672-4123-1,CARBAMAZEPINE 100 MG ORAL TB12,16.5,11.55,,,0
NDC,51672-4146-1,PHENYTOIN 50 MG ORAL CHEW,10.5,7.35,,,0
NDC,51672-4245-1,ENALAPRIL MALEATE 10 MG ORAL TAB,7.0,4.9,,,0
NDC,51754-0103-1,CUPRIC CHLORIDE 0.4 MG/ML IV SOLN,154.0,107.8,,,0
NDC,51754-0108-1,"TRANEXAMIC ACID IN NACL,ISO-OS 1,000 MG/100 ML (10 MG/ML) IV PGBK",124.0,86.8,,,0
NDC,51754-0108-3,"TRANEXAMIC ACID IN NACL,ISO-OS 1,000 MG/100 ML (10 MG/ML) IV PGBK",247.0,172.9,,,0
NDC,51754-0500-1,CAFFEINE CITRATED 20 MG/ML IV SOLN,17.0,11.9,,,0
NDC,51754-2004-4,POTASSIUM ACETATE 2 MEQ/ML IV SOLN,16.0,11.2,,,0
NDC,51754-4250-1,EPHEDRINE SULFATE  25 MG/5 ML (5 MG/ML) IV SYRG (MERGE),102.0,71.4,,,0
NDC,51754-5001-1,SODIUM BICARBONATE 8.4 % IV (PHS ERX MERGE),79.0,55.3,,,0
NDC,51754-5001-5,SODIUM BICARBONATE 8.4 % IV (PHS ERX MERGE),103.0,72.1,,,0
NDC,51754-5011-1,SODIUM BICARBONATE 8.4 % IV (PHS ERX MERGE),135.0,94.5,,,0
NDC,51754-5012-1,SODIUM BICARBONATE   4.2 % IV SOLN,50.0,35.0,,,0
NDC,51754-5060-1,BETAMETHASONE ACET & SOD PHOS 6 MG/ML INJ SUSP,94.0,65.8,,,0
NDC,51801-009-01,FLUORESCEIN 1 MG OPHT STRP,7.0,4.9,,,0
NDC,51801-011-01,POTASSIUM BICARB-CITRIC ACID 20 MEQ ORAL TBEF,8.0,5.6,,,0
NDC,51801-011-30,POTASSIUM BICARB-CITRIC ACID 20 MEQ ORAL TBEF,11.5,8.05,,,0
NDC,51801-012-01,POTASSIUM BICARB-CITRIC ACID 20 MEQ ORAL TBEF,8.0,5.6,,,0
NDC,51803-001-01,POTASSIUM IODIDE 130 MG ORAL TAB,7.5,5.25,,,0
NDC,51862-458-01,CYCLOSPORINE MODIFIED  25 MG ORAL CAP,12.0,8.399999999999999,,,0
NDC,51862-460-01,CYCLOSPORINE MODIFIED 100 MG ORAL CAP,63.5,44.45,,,0
NDC,51862-540-01,BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TAB,10.0,7.0,,,0
NDC,51862-855-01,CARBIDOPA-LEVODOPA 10 MG-100 MG TAB,7.0,4.9,,,0
NDC,51991-144-99,METHYLERGONOVINE 0.2 MG/ML (1 ML) INJ SOLN,145.0,101.5,,,0
NDC,51991-735-99,GRANISETRON 1 MG ORAL TAB,251.0,175.7,,,0
NDC,51991-746-90,DULOXETINE 20 MG ORAL CPDR,82.5,57.75,,,0
NDC,51991-747-90,DULOXETINE 30 MG ORAL CPDR,74.0,51.8,,,0
NDC,51991-748-90,DULOXETINE 60 MG ORAL CPDR,56.0,39.2,,,0
NDC,51991-877-33,EPLERENONE  25 MG ORAL TAB,24.0,16.8,,,0
NDC,51991-897-99,RIVASTIGMINE 4.6 MG/24 HOUR TD PT24,83.0,58.1,,,0
NDC,51991-907-01,TETRACYCLINE 500 MG ORAL CAP,78.0,54.6,,,0
NDC,52015-080-01,FIDAXOMICIN 200 MG ORAL TAB,2750.0,1925.0,,,0
NDC,52061-00403,L. ACIDOPHILUS-B. LACTIS-FOS 5 BILLION CELL ORAL PWPK,7.5,5.25,,,0
NDC,5206100400,L. ACIDOPHILUS-B. LACTIS-FOS 5 BILLION CELL ORAL PWPK (NEONATAL),7.0,4.9,,,0
NDC,52244-100-10,THEOPHYLLINE 100 MG ORAL CP24,47.5,33.25,,,0
NDC,52268-100-01,PEG 3350-ELECTROLYTES 236 G-22.74 G-6.74 G-5.86 G ORAL SOLUTION,137.0,95.9,,,0
NDC,52380-0126-2,POVIDONE-IODINE 10 % TOP OINT,24.0,16.8,,,0
NDC,52427-430-90,ATENOLOL  50 MG ORAL TAB,79.0,55.3,,,0
NDC,52427-431-90,ATENOLOL 100 MG ORAL TAB,79.0,55.3,,,0
NDC,52536-168-01,PERPHENAZINE  8 MG ORAL TAB,33.0,23.1,,,0
NDC,52536-600-11,BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSP,64.5,45.15,,,0
NDC,52536-625-01,TESTOSTERONE CYPIONATE 200 MG/ML IM OIL,114.0,79.8,,,0
NDC,52544-931-07,IRON DEXTRAN 50 MG/ML INJ SOLN,78.0,54.6,,,0
NDC,52652-4001-1,ENALAPRIL MALEATE 1 MG/ML ORAL SOLN,46.0,32.2,,,0
NDC,52652-6001-1,BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSP,89.0,62.3,,,0
NDC,52817-180-10,CLONIDINE 0.1 MG ORAL TAB,7.0,4.9,,,0
NDC,52817-332-10,CYCLOBENZAPRINE 10 MG ORAL TAB,10.0,7.0,,,0
NDC,52817-364-10,TRIAMTERENE  50 MG ORAL CAP,117.0,81.9,,,0
NDC,52817-815-08,AMINOCAPROIC ACID 25 % ORAL SYRP,389.0,272.3,,,0
NDC,52817-816-15,ACETIC ACID  2 % OTIC SOLN,864.0,604.8,,,0
NDC,52817-830-04,LEVOCARNITINE (WITH SUCROSE) 100 MG/ML ORAL SOLN,17.5,12.25,,,0
NDC,52959-424-10,PHYTONADIONE 5 MG ORAL TAB,7.0,4.9,,,0
NDC,52959-478-10,AMOXICILLIN-POT CLAVULANATE 875 MG-125 MG TAB,44.0,30.8,,,0
NDC,53329-089-87,BACITRACIN ZINC 500 UNIT/G TOP PACK,7.0,4.9,,,0
NDC,53436-084-01,PATIROMER CALCIUM SORBITEX  8.4 G ORAL PWPK,355.0,248.5,,,0
NDC,53462-003-15,CHLORHEXIDINE GLUCONATE  0.12 % MM MWSH,7.0,4.9,,,0
NDC,53489-141-01,QUINIDINE SR 324 MG TAB,51.0,35.7,,,0
NDC,53489-143-01,SPIRONOLACTONE  25 MG ORAL TAB,7.5,5.25,,,0
NDC,53489-156-01,ALLOPURINOL 100 MG ORAL TAB,8.0,5.6,,,0
NDC,536115516,FERROUS SULFATE 220 MG (44 MG IRON)/5 ML ORAL SOLN,7.0,4.9,,,0
NDC,536134480,FERROUS SULFATE 75 MG/ML (ELEMENTAL IRON 15 MG/ML) ORAL DROP,7.0,4.9,,,0
NDC,536135807,COENZYME Q10  30 MG ORAL CAP,7.0,4.9,,,0
NDC,536142401,ACIDOPHILUS-PECTIN W CITRUS 25 MILLION-100 CELL MG TAB,5.5,3.85,,,0
NDC,536143607,COENZYME Q10  30 MG ORAL CAP,7.0,4.9,,,0
NDC,536322301,CALCIUM CITRATE-VITAMIN D3 200 MG CALCIUM -250 UNIT ORAL TAB,7.0,4.9,,,0
NDC,536354201,CYANOCOBALAMIN  100 MCG ORAL TAB,7.0,4.9,,,0
NDC,53746-188-01,NAPROXEN 250 MG ORAL TAB,8.0,5.6,,,0
NDC,53746-542-01,POTASSIUM CHLORIDE  10 MEQ ORAL CPSR,12.0,8.4,,,0
NDC,53746-542-05,POTASSIUM CHLORIDE  10 MEQ ORAL CPSR,12.0,8.4,,,0
NDC,53746-544-01,PRIMIDONE  50 MG ORAL TAB,7.0,4.9,,,0
NDC,53746-554-01,DEMECLOCYCLINE 150 MG ORAL TAB,92.0,64.4,,,0
NDC,53746-745-01,PROMETHAZINE 12.5 MG ORAL TAB,7.0,4.9,,,0
NDC,54092-189-81,MESALAMINE  250 MG ORAL CPSR,63.0,44.099999999999994,,,0
NDC,54092-252-45,LANTHANUM  500 MG ORAL CHEW,141.0,98.7,,,0
NDC,54092-252-90,LANTHANUM  500 MG ORAL CHEW,141.0,98.7,,,0
NDC,54092-702-02,ICATIBANT 30 MG/3 ML SUBQ SYRG,30768.0,21537.6,,,0
NDC,54162-007-08,SENNOSIDES 8.8 MG/5 ML ORAL SYRP,7.0,4.9,,,0
NDC,54162-190-16,MINERAL OIL ORAL (REPACK),7.0,4.9,,,0
NDC,54288-100-01,ZOLEDRONIC ACID 4 MG/5 ML IV SOLN,182.0,127.4,,,0
NDC,54288-103-01,EPINEPHRINE (PF) 1 MG/ML INJ SOLN,642.5,449.75,,,0
NDC,54288-103-10,EPINEPHRINE (PF) 1 MG/ML INJ SOLN,86.0,60.2,,,0
NDC,54288-105-02,ETHYL ALCOHOL  99 % IART SOLN,13793.5,9655.45,,,0
NDC,54288-111-01,HYOSCYAMINE 0.5 MG/ML INJECTION,350.5,245.35,,,0
NDC,54288-119-01,EPINEPHRINE 1 MG/ML (1ML) INJ SOLN,317.0,221.9,,,0
NDC,54288-119-25,EPINEPHRINE 1 MG/ML (1ML) INJ SOLN (FOR IRRIGATION ONLY),80.0,56.0,,,0
NDC,54288-135-01,TACROLIMUS 1 MG ORAL CAP,68.0,47.6,,,0
NDC,54288-136-01,PHENOBARBITAL SODIUM  65 MG/ML INJ SOLN,106.0,74.2,,,0
NDC,54288-137-01,PHENOBARBITAL SODIUM 130 MG/ML INJ SOLN,280.0,196.0,,,0
NDC,54288-141-01,MYCOPHENOLATE 500 MG IV SOLUTION,553.5,387.45000000000005,,,0
NDC,54288-142-01,PAPAVERINE 30 MG/ML INJ SOLN,191.0,133.7,,,0
NDC,54482-147-01,LEVOCARNITINE 200 MG/ML IV SOLN,451.5,316.04999999999995,,,0
NDC,54569-5877-1,PENICILLIN G BENZATHINE 1200000 UNIT/2 ML IM SYRG,281.0,196.7,,,0
NDC,54643-5649-1,"MVI, ADULT INJECTION (PHS)",65.0,45.5,,,0
NDC,54643-5650-2,"MVI, ADULT INJECTION (PHS)",41.0,28.7,,,0
NDC,54838-502-80,HYDROXYZINE 10 MG/5 ML SYRUP,31.0,21.7,,,0
NDC,54838-510-80,OXYBUTYNIN CHLORIDE 5 MG/5 ML ORAL SYRP,7.0,4.9,,,0
NDC,54838-512-40,DOXEPIN 10 MG/ML ORAL CONC,8.5,5.95,,,0
NDC,54838-558-40,LORATADINE 5 MG/5 ML ORAL SOLN,7.0,4.9,,,0
NDC,5483800180,FERROUS SULFATE 220 MG (44 MG IRON)/5 ML ORAL ELIX,7.0,4.9,,,0
NDC,5483800530,"VITAMIN E (DL, ACETATE) 22.5 MG (50 UNIT)/ML ORAL DROP",199.0,139.3,,,0
NDC,5483800650,CHOLECALCIFEROL 400 UNIT/ML ORAL DROP (REPACK),7.0,4.9,,,0
NDC,5483801150,FERROUS SULFATE 75 MG/ML (ELEMENTAL IRON 15 MG/ML) ORAL DROP,7.0,4.9,,,0
NDC,54868-5229-0,PEGFILGRASTIM (NEULASTA) 6 MG/0.6ML SUBQ SYRG,9784.0,6848.8,,,0
NDC,54868-5429-0,DARBEPOETIN ALFA IN POLYSORBAT 300 MCG/0.6 ML INJ SYRG,4592.0,3214.4,,,0
NDC,54879-001-01,ETHAMBUTOL 100 MG ORAL TAB,8.0,5.6,,,0
NDC,55111-150-01,FLUOXETINE 10 MG ORAL TAB,40.0,28.0,,,0
NDC,55111-153-30,ONDANSETRON HCL  4 MG ORAL TAB,122.0,85.4,,,0
NDC,55111-180-15,TIZANIDINE 4 MG ORAL TAB,9.0,6.3,,,0
NDC,55111-229-90,PRAVASTATIN 10 MG ORAL TAB,27.0,18.9,,,0
NDC,55111-262-79,OLANZAPINE  5 MG ORAL TBDL,20.5,14.350000000000001,,,0
NDC,55111-263-79,OLANZAPINE 10 MG ORAL TBDL,34.0,23.8,,,0
NDC,55111-263-81,OLANZAPINE 10 MG ORAL TBDL,25.5,17.85,,,0
NDC,55111-292-09,SUMATRIPTAN 50 MG TAB,123.0,86.1,,,0
NDC,55111-322-01,GLIMEPIRIDE 4 MG ORAL TAB,10.5,7.3500000000000005,,,0
NDC,55111-466-01,METOPROLOL SUCCINATE SR 25 MG 24 HR TAB,12.0,8.4,,,0
NDC,55111-467-01,METOPROLOL SUCCINATE SR 50 MG 24 HR TAB,7.0,4.9,,,0
NDC,55111-521-30,ATOMOXETINE  40 MG ORAL CAP,76.0,53.2,,,0
NDC,55111-532-01,DIVALPROEX 125 MG ORAL CPSP,19.0,13.3,,,0
NDC,55111-556-10,DECITABINE 50 MG IV SOLR,519.0,363.3,,,0
NDC,55111-626-60,ZAFIRLUKAST 20 MG ORAL TAB,12.0,8.4,,,0
NDC,55111-653-01,SIROLIMUS 1 MG ORAL TAB,84.0,58.8,,,0
NDC,55111-671-06,CLOPIDOGREL 300 MG ORAL TAB,187.0,130.9,,,0
NDC,55111-679-11,FONDAPARINUX 5 MG/0.4 ML SUBQ SYRG,489.0,342.3,,,0
NDC,55111-680-11,FONDAPARINUX 7.5 MG/0.6 ML SUBQ SYRG,476.0,333.20000000000005,,,0
NDC,55111-685-07,ZOLEDRONIC ACID 4 MG/5 ML IV SOLN,287.0,200.9,,,0
NDC,55111-688-52,ZOLEDRONIC ACID IN MANNITOL & WATER 5 MG/100 ML IV SOLN,1062.0,743.4,,,0
NDC,55111-693-05,SUMATRIPTAN 6 MG/0.5 ML SUBQ PEN KIT,379.0,265.3,,,0
NDC,55111-694-07,PALONOSETRON 0.25 MG/5 ML IV INJECTION (MERGE),180.5,126.35,,,0
NDC,55135-132-01,SACITUZUMAB GOVITECAN-HZIY 180 MG IV SOLR,13858.0,9700.6,,,0
NDC,55150-113-10,AMPICILLIN 1 GRAM SOLUTION FOR INJECTION,91.5,64.05000000000001,,,0
NDC,55150-114-20,AMPICILLIN SODIUM  2 GRAM INJ SOLR,117.0,81.9,,,0
NDC,55150-116-20,AMPICILLIN-SULBACTAM  1.5 GRAM INJ SOLR,43.0,30.1,,,0
NDC,55150-117-20,AMPICILLIN-SULBACTAM  3 GRAM INJ SOLR,72.0,50.4,,,0
NDC,55150-119-30,PIPERACILLIN-TAZOBACTAM  2.25 GRAM IV SOLR,30.0,21.0,,,0
NDC,55150-120-30,PIPERACILLIN-TAZOBACTAM  3.375 GRAM IV SOLR,55.5,38.849999999999994,,,0
NDC,55150-121-50,PIPERACILLIN-TAZOBACTAM  4.5 GRAM IV SOLR,89.5,62.65,,,0
NDC,55150-123-15,NAFCILLIN  2 GRAM INJ SOLR,74.0,51.8,,,0
NDC,55150-124-99,NAFCILLIN 10 GRAM INJ SOLR,447.5,313.25,,,0
NDC,55150-154-10,ACYCLOVIR SODIUM 50 MG/ML IV SOLN,83.0,58.1,,,0
NDC,55150-161-02,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,43.5,30.45,,,0
NDC,55150-162-05,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,30.5,21.35,,,0
NDC,55150-163-30,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,25.0,17.5,,,0
NDC,55150-164-02,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,37.5,26.25,,,0
NDC,55150-164-09,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,23.0,16.1,,,0
NDC,55150-165-05,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,70.0,49.0,,,0
NDC,55150-166-13,SILDENAFIL (PULM.HYPERTENSION) 10 MG/12.5 ML IV SOLN,270.0,189.0,,,0
NDC,55150-167-10,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN,17.0,11.899999999999999,,,0
NDC,55150-169-10,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN,16.0,11.2,,,0
NDC,55150-170-30,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN,7.0,4.9,,,0
NDC,55150-173-01,SUMATRIPTAN 6 MG/0.5 ML SUB-Q,49.0,34.3,,,0
NDC,55150-174-10,AZITHROMYCIN 500 MG IV SOLR,27.0,18.9,,,0
NDC,55150-177-05,LEVETIRACETAM 500 MG/5 ML IV SOLN,72.0,50.4,,,0
NDC,55150-183-01,NICARDIPINE 25 MG/10 ML IV SOLN,312.0,218.4,,,0
NDC,55150-188-10,TRANEXAMIC ACID (FOR TOPICAL USE),60.0,42.0,,,0
NDC,55150-193-01,ADENOSINE (DIAGNOSTIC) 3 MG/ML IV SOLN,1201.5,841.05,,,0
NDC,55150-194-10,ESMOLOL  100 MG/10 ML IV SOLN,49.0,34.3,,,0
NDC,55150-202-00,PANTOPRAZOLE 40 MG IV SOLR,32.0,22.4,,,0
NDC,55150-207-20,MEROPENEM 500 MG IV SOLR,40.0,28.0,,,0
NDC,55150-208-30,MEROPENEM 1 GRAM IV SOLR,97.5,68.25,,,0
NDC,55150-210-10,BIVALIRUDIN 250 MG IV SOLR,648.0,453.59999999999997,,,0
NDC,55150-221-10,ETOMIDATE 2 MG/ML IV SOLN,107.0,74.9,,,0
NDC,55150-222-20,ETOMIDATE 2 MG/ML IV SOLN,29.0,20.3,,,0
NDC,55150-223-10,METHOCARBAMOL 100 MG/ML INJ SOLN,45.0,31.5,,,0
NDC,55150-228-10,TIGECYCLINE 50 MG IV SOLR,562.0,393.4,,,0
NDC,55150-230-00,FONDAPARINUX 2.5 MG/0.5 ML SUBQ SYRG,177.0,123.9,,,0
NDC,55150-233-00,FONDAPARINUX 10 MG/0.8 ML SUBQ SYRG,370.0,259.0,,,0
NDC,55150-235-01,VECURONIUM BROMIDE 10 MG IV SOLR,37.0,25.9,,,0
NDC,55150-236-01,VECURONIUM BROMIDE 20 MG IV SOLR,50.5,35.35,,,0
NDC,55150-242-51,LINEZOLID 600 MG/300 ML IV SOLP,240.0,168.0,,,0
NDC,55150-247-47,LEVETIRACETAM IN NACL (ISO-OS) 1000 MG/100 ML IV PGBK,229.0,160.3,,,0
NDC,55150-248-47,LEVETIRACETAM IN NACL (ISO-OS) 1500 MG/100 ML IV PGBK,306.0,214.2,,,0
NDC,55150-249-50,BUPIVACAINE 0.25 % (2.5 MG/ML) INJ SOLN,16.5,11.55,,,0
NDC,55150-250-50,BUPIVACAINE 0.5 % (5 MG/ML) INJ SOLN,16.0,11.2,,,0
NDC,55150-252-20,LIDOCAINE 10 MG/ML (1 %) INJECTION,16.0,11.2,,,0
NDC,55150-253-50,LIDOCAINE 10 MG/ML (1 %) INJECTION,16.0,11.2,,,0
NDC,55150-254-10,LIDOCAINE 20 MG/ML (2 %) INJECTION,16.0,11.2,,,0
NDC,55150-255-20,LIDOCAINE 20 MG/ML (2 %) INJECTION,18.5,12.95,,,0
NDC,55150-255-24,LIDOCAINE 20 MG/ML (2 %) INJECTION,16.0,11.2,,,0
NDC,55150-259-30,ACETYLCYSTEINE 20 % (200 MG/ML) IV SOLN,813.0,569.1,,,0
NDC,55150-267-05,FLUPHENAZINE DECANOATE 25 MG/ML INJ SOLN,227.5,159.25,,,0
NDC,55150-277-01,TESTOSTERONE CYPIONATE 200 MG/ML IM OIL,56.0,39.2,,,0
NDC,55150-282-20,ERTAPENEM 1 GRAM INJ SOLR,305.5,213.85,,,0
NDC,55150-287-01,MILRINONE IN D5W 20 MG/100 ML (0.2 MG/ML) INFUSION,89.0,62.3,,,0
NDC,55150-297-01,DEXMEDETOMIDINE IN 0.9 % NACL 400 MCG/100 ML (4 MCG/ML) IV SOLN,1238.0,866.5999999999999,,,0
NDC,55150-304-01,DEXAMETHASONE SODIUM PHOS (PF) 10MG/ML INJ SOLN,44.5,31.15,,,0
NDC,55150-305-01,DEXAMETHASONE 10 MG/ML INJECTION,11.0,7.7,,,0
NDC,55150-305-10,DEXAMETHASONE 10 MG/ML FOR ORAL OR INJECTION (PEDS ONC),7.0,4.9,,,0
NDC,55150-306-10,PROGESTERONE 50 MG/ML IM OIL,118.0,82.6,,,0
NDC,55150-307-01,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IV SOLN FOR PERI-OPERATIVE",55.0,38.5,,,0
NDC,55150-308-01,OLANZAPINE 10 MG IM SOLR,68.0,47.599999999999994,,,0
NDC,55150-319-01,CHLORPROMAZINE 25 MG/ML INJ SOLN,171.5,120.05,,,0
NDC,55150-328-01,NALOXONE 0.4 MG/ML INJ SOLN,275.0,192.5,,,0
NDC,55150-329-01,MEDROXYPROGESTERONE (CONTRACEPTIVE) 150 MG/ML IM SUSP,215.5,150.85,,,0
NDC,55150-330-01,MEDROXYPROGESTERONE (CONTRACEPTIVE) 150 MG/ML IM (MERGE),357.0,249.9,,,0
NDC,55150-354-01,IRINOTECAN 100 MG/5 ML IV SOLN,428.0,299.6,,,0
NDC,55150-365-01,AMPHOTERICIN B LIPOSOME 50 MG IV SUSR,4960.5,3472.35,,,0
NDC,55150-370-01,VASOPRESSIN 20 UNIT/ML IV SOLN,39.0,27.3,,,0
NDC,55150-376-01,DECITABINE 50 MG IV SOLR,370.5,259.35,,,0
NDC,55150-400-01,HYDRALAZINE 20 MG/ML INJ SOLN,35.0,24.5,,,0
NDC,55150-402-01,GENTAMICIN 40 MG/ML INJ SOLN,23.5,16.450000000000003,,,0
NDC,55150-425-01,DILTIAZEM 5 MG/ML IV,20.0,14.0,,,0
NDC,55150-429-01,TIROFIBAN-0.9% SODIUM CHLORIDE 5 MG/100 ML (50 MCG/ML) IV SOLN,378.0,264.6,,,0
NDC,55150-431-01,DACTINOMYCIN 0.5 MG IV SOLR,8217.0,5751.9,,,0
NDC,55150-432-01,DEXRAZOXANE 250 MG IV SOLR,913.0,639.1,,,0
NDC,55150-435-01,DEXRAZOXANE 500 MG IV SOLR,1350.0,945.0,,,0
NDC,55154-0120-5,KETOROLAC TROMETHAMINE 30 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,55289-218-30,POTASSIUM CHLORIDE  10 MEQ ORAL CPSR,32.0,22.4,,,0
NDC,55289-330-05,PREDNISONE 50 MG ORAL TAB,18.0,12.6,,,0
NDC,55289-673-17,IBUPROFEN 200 MG ORAL TAB,9.0,6.3,,,0
NDC,55289-698-02,MISOPROSTOL 200 MCG ORAL TAB,101.0,70.7,,,0
NDC,55390-051-10,LEUCOVORIN CALCIUM  50 MG INJ SOLR,34.0,23.8,,,0
NDC,55390-077-10,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN,31.0,21.7,,,0
NDC,55390-110-10,DOXYCYCLINE HYCLATE 100 MG IV SOLR,70.0,49.0,,,0
NDC,55390-129-01,PAMIDRONATE 90 MG IV SOLR,519.0,363.3,,,0
NDC,55390-137-02,MIDAZOLAM 1 MG/ML INJ SOLN (PULMONARY USE),9.0,6.3,,,0
NDC,55390-137-05,MIDAZOLAM 1 MG/ML INJ SOLN (PULMONARY USE),8.5,5.95,,,0
NDC,55390-138-01,MIDAZOLAM (PF) 5 MG/ML INJ SOLN,2.0,1.4,,,0
NDC,55390-481-01,KETOROLAC TROMETHAMINE 30 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,55390-481-02,KETOROLAC TROMETHAMINE 60 MG/2 ML IM SOLN,8.5,5.949999999999999,,,0
NDC,55390-500-05,BUMETANIDE 0.25 MG/ML INJ SOLN,23.5,16.450000000000003,,,0
NDC,55513-002-01,DARBEPOETIN ALFA IN POLYSORBAT  25 MCG/ML INJ SOLN,1254.0,877.8000000000001,,,0
NDC,55513-021-01,DARBEPOETIN ALFA IN POLYSORBAT  40 MCG/0.4 ML INJ SYRG,1644.0,1150.8000000000002,,,0
NDC,55513-023-01,DARBEPOETIN ALFA IN POLYSORBAT  60 MCG/0.3 ML INJ SYRG,962.0,673.4,,,0
NDC,55513-023-04,DARBEPOETIN ALFA IN POLYSORBAT  60 MCG/0.3 ML INJ SYRG,1923.0,1346.1,,,0
NDC,55513-025-01,DARBEPOETIN ALFA IN POLYSORBAT 100 MCG/0.5 ML INJ SYRG,669.5,468.65,,,0
NDC,55513-025-04,DARBEPOETIN ALFA IN POLYSORBAT 100 MCG/0.5 ML INJ SYRG,748.0,523.6,,,0
NDC,55513-028-01,DARBEPOETIN ALFA IN POLYSORBAT 200 MCG/0.4 ML INJ SYRG,3205.0,2243.5,,,0
NDC,55513-032-01,DARBEPOETIN ALFA IN POLYSORBAT 500 MCG/ML INJ SYRG,8545.0,5981.5,,,0
NDC,55513-057-01,DARBEPOETIN ALFA IN POLYSORBAT 25 MCG/0.42 ML INJ SYRG,1421.5,995.0500000000001,,,0
NDC,55513-057-04,DARBEPOETIN ALFA IN POLYSORBAT 25 MCG/0.42 ML INJ SYRG,836.0,585.2,,,0
NDC,55513-059-01,TARLATAMAB-DLLE  1 MG IV SOLR,4140.0,2898.0,,,0
NDC,55513-069-01,TARLATAMAB-DLLE 10 MG IV SOLR,41381.0,28966.7,,,0
NDC,55513-098-01,DARBEPOETIN ALFA IN POLYSORBAT  10 MCG/0.4 ML INJ SYRG,788.0,551.6,,,0
NDC,55513-111-01,DARBEPOETIN ALFA IN POLYSORBAT 300 MCG/0.6 ML INJ SYRG,6409.0,4486.3,,,0
NDC,55513-112-01,TEZEPELUMAB-EKKO 210 MG/1.91 ML (110 MG/ML) SUBQ SYRG,10028.0,7019.6,,,0
NDC,55513-144-01,EPOETIN ALFA 10000 UNIT/ML INJ SOLN,574.0,401.8,,,0
NDC,55513-150-01,BLINATUMOMAB 12.5 MCG/ML IV SOLR,11056.0,7739.2,,,0
NDC,55513-160-01,BLINATUMOMAB 35 MCG IV KIT,9203.0,6442.1,,,0
NDC,55513-190-01,PEGFILGRASTIM (NEULASTA) 6 MG/0.6ML SUBQ SYRG,17714.0,12399.8,,,0
NDC,55513-192-01,PEGFILGRASTIM 6 MG/0.6 ML SUBQ W/ ON BODY INJECTOR,17714.0,12399.8,,,0
NDC,55513-206-01,BEVACIZUMAB-AWWB 25 MG/ML IV SOLN,5777.0,4043.9,,,0
NDC,55513-207-01,BEVACIZUMAB-AWWB 25 MG/ML IV SOLN,15406.0,10784.2,,,0
NDC,55513-221-01,ROMIPLOSTIM 250 MCG SUBQ SOLR,3073.0,2151.1,,,0
NDC,55513-222-01,ROMIPLOSTIM 500 MCG SUBQ SOLR,3512.0,2458.4,,,0
NDC,55513-223-01,ROMIPLOSTIM 125 MCG SUBQ SOLR,1385.5,969.8499999999999,,,0
NDC,55513-478-01,EPOETIN ALFA 20000 UNIT/ML INJ SOLN,880.5,616.3499999999999,,,0
NDC,55513-530-01,FILGRASTIM 300 (NEUPOGEN) MCG/ML INJ SOLN,636.0,445.2,,,0
NDC,55513-670-01,INFLIXIMAB-AXXQ 100 MG IV SOLR,8418.0,5892.6,,,0
NDC,55513-710-01,DENOSUMAB 60 MG/ML SUBQ SYRG,4930.0,3451.0,,,0
NDC,55513-710-21,DENOSUMAB 60 MG/ML SUBQ SYRG,5053.5,3537.45,,,0
NDC,55513-730-01,DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBQ SOLN,9295.0,6506.5,,,0
NDC,55513-810-60,IVABRADINE 7.5 MG ORAL TAB,89.5,62.650000000000006,,,0
NDC,55513-813-01,IVABRADINE 5 MG/5 ML ORAL SOLN,46.0,32.2,,,0
NDC,55513-880-02,ROMOSOZUMAB-AQQG 210MG/2.34ML ( 105MG/1.17MLX2) SUBQ SYRG,4420.5,3094.3500000000004,,,0
NDC,55513-954-01,PANITUMUMAB 400 MG/20 ML (20 MG/ML) IV SOLN,14286.5,10000.55,,,0
NDC,55513-956-01,PANITUMUMAB 400 MG/20 ML (20 MG/ML) IV SOLN,19048.5,13333.95,,,0
NDC,55513-998-01,ROMOSOZUMAB-AQQG 105 MG/1.17 ML SUBQ SYRG,4012.0,2808.4,,,0
NDC,55513-998-02,ROMOSOZUMAB-AQQG 210MG/2.34ML ( 105MG/1.17MLX2) SUBQ SYRG,5893.0,4125.1,,,0
NDC,55566-1050-0,NADOFARAGENE FIRADENOVEC-VNCG 3X10EXP11 VP/ML IVES SUSP,87000.0,60900.0,,,0
NDC,55566-1050-1,NADOFARAGENE FIRADENOVEC-VNCG 3X10EXP11 VP/ML IVES SUSP,87000.0,60900.0,,,0
NDC,55566-2200-0,DESMOPRESSIN 4 MCG/ML INJECTION SOLN,2065.0,1445.5,,,0
NDC,55566-8303-1,DEGARELIX 80 MG SUBQ SOLR,1348.5,943.95,,,0
NDC,55566-8402-0,DEGARELIX 120 MG SUBQ SOLR,3155.5,2208.85,,,0
NDC,55566-8403-1,DEGARELIX 120 MG SUBQ SOLR,3155.5,2208.85,,,0
NDC,5556641000,SODIUM HYALURONATE (VISCOSUP) 10 MG/ML(MW 2.4 -3.6 MILLION) IATC SYRG,1915.5,1340.85,,,0
NDC,5556641001,SODIUM HYALURONATE (VISCOSUP) 10 MG/ML(MW 2.4 -3.6 MILLION) IATC SYRG,1915.5,1340.85,,,0
NDC,5556641003,SODIUM HYALURONATE (VISCOSUP) 10 MG/ML(MW 2.4 -3.6 MILLION) IATC SYRG,1277.0,893.9,,,0
NDC,5556641004,SODIUM HYALURONATE (VISCOSUP) 10 MG/ML(MW 2.4 -3.6 MILLION) IATC SYRG,1277.0,893.9,,,0
NDC,5618412041,SIMETHICONE 40 MG/0.6 ML ORAL DRPS,7.0,4.9,,,0
NDC,57237-004-30,FLUCONAZOLE 100 MG ORAL TAB,86.0,60.2,,,0
NDC,57237-007-30,MIRTAZAPINE  7.5 MG ORAL TAB,22.5,15.75,,,0
NDC,57237-014-01,TAMSULOSIN 0.4 MG ORAL CP24,47.0,32.9,,,0
NDC,57237-019-30,DULOXETINE 60 MG ORAL CPDR,51.0,35.7,,,0
NDC,57237-019-90,DULOXETINE 60 MG ORAL CPDR,58.0,40.6,,,0
NDC,57237-040-01,PENICILLIN V POTASSIUM 250 MG ORAL TAB,19.0,13.3,,,0
NDC,57237-041-01,PENICILLIN V POTASSIUM 500 MG ORAL TAB,7.0,4.9,,,0
NDC,57237-049-60,GALANTAMINE  4 MG ORAL TAB,44.5,31.15,,,0
NDC,57237-077-10,ONDANSETRON 4 MG ORAL TBDL,402.0,281.4,,,0
NDC,57237-078-10,ONDANSETRON 8 MG ORAL TBDL,182.0,127.4,,,0
NDC,57237-078-30,ONDANSETRON 8 MG ORAL TBDL,91.0,63.7,,,0
NDC,57237-099-60,CEFDINIR 300 MG ORAL CAP,40.0,28.0,,,0
NDC,57237-120-01,WARFARIN  2 MG ORAL TAB,5.5,3.85,,,0
NDC,57237-126-01,WARFARIN  7.5 MG ORAL TAB,7.0,4.9,,,0
NDC,57237-150-35,FLUCONAZOLE 40 MG/ML ORAL SUSR,92.0,64.4,,,0
NDC,57237-184-90,PRAMIPEXOLE 1 MG ORAL TAB,13.0,9.1,,,0
NDC,57237-220-90,PIOGLITAZONE 30 MG ORAL TAB,66.0,46.2,,,0
NDC,57237-225-01,RAMIPRIL 10 MG ORAL CAP,13.0,9.1,,,0
NDC,57237-325-21,GLYCERIN (ADULT) RECTAL SUPPOSITORY,7.0,4.9,,,0
NDC,57237-326-21,GLYCERIN (CHILD) RECTAL SUPPOSITORY,7.0,4.9,,,0
NDC,57237-326-52,GLYCERIN (CHILD) RECTAL SUPPOSITORY,7.0,4.9,,,0
NDC,574006915,DEXTROSE 40 % ORAL GEL,44.0,30.8,,,0
NDC,574006930,DEXTROSE 40 % ORAL GEL,433.5,303.45,,,0
NDC,574007015,DEXTROSE 40 % ORAL GEL (NEONATAL/PEDIATRIC),22.0,15.4,,,0
NDC,574007030,DEXTROSE 40 % ORAL GEL,337.5,236.25,,,0
NDC,574030216,ORA-SWEET SF (COMPOUNDING VEHICLE SF NO.9 ORAL LIQD),7.0,4.9,,,0
NDC,574030316,ORAL PLUS ORAL VEHICLES ORAL LIQUID,7.0,4.9,,,0
NDC,574030416,COMPOUNDING VEHICLE SYRUP NO23 ORAL SYRP,7.0,4.9,,,0
NDC,574060801,FERROUS SULFATE 324 MG (65 MG IRON) ORAL TBEC,7.0,4.9,,,0
NDC,574195906,GLUCOSE (TOLERANCE TEST) 100 GRAM/180 ML ORAL LIQD,46.0,32.2,,,0
NDC,57664-167-52,METOPROLOL 10MG/1ML SUSPENSION (REPACK),7.0,4.9,,,0
NDC,57664-228-88,METHYLPHENIDATE  5 MG ORAL TAB,13.0,9.1,,,0
NDC,57664-347-88,CLOZAPINE 100 MG ORAL TAB,38.0,26.6,,,0
NDC,57664-377-08,TRAMADOL  50 MG ORAL TAB,7.0,4.9,,,0
NDC,57664-507-88,CITALOPRAM 10 MG ORAL TAB,14.0,9.8,,,0
NDC,57664-596-40,DEXMEDETOMIDINE 100 MCG/ML IV SOLN,981.0,686.7,,,0
NDC,57664-683-31,LINEZOLID 600 MG/300 ML IV SOLP,331.0,231.7,,,0
NDC,57664-692-88,AMITRIPTYLINE  75 MG ORAL TAB,12.0,8.4,,,0
NDC,57894-030-01,INFLIXIMAB 100 MG IV SOLR,14827.0,10378.9,,,0
NDC,57894-054-27,USTEKINUMAB 130 MG/26 ML IV SOLN,11040.0,7728.0,,,0
NDC,57894-160-01,INFLIXIMAB 100 MG IV SOLR,3802.0,2661.4,,,0
NDC,57894-350-01,GOLIMUMAB  12.5 MG/ML IV SOLN,13574.0,9501.8,,,0
NDC,57894-449-01,TECLISTAMAB-CQYV 10 MG/ML SUBQ SOLN,4886.0,3420.2,,,0
NDC,57894-450-01,TECLISTAMAB-CQYV 90 MG/ML SUBQ SOLN,24915.0,17440.5,,,0
NDC,57894-469-01,TALQUETAMAB-TGVS  2 MG/ML SUBQ SOLN,2145.0,1501.5,,,0
NDC,57894-470-01,TALQUETAMAB-TGVS 40 MG/ML SUBQ SOLN,10163.5,7114.45,,,0
NDC,57894-501-00,AMIVANTAMAB-VMJW 50 MG/ML IV SOLN,28823.5,20176.45,,,0
NDC,57894-502-05,DARATUMUMAB 20 MG/ML IV SOLN,11178.0,7824.6,,,0
NDC,57894-503-01,"DARATUMUMAB-HYALURONIDASE-FIHJ 1,800 MG-30,000 UNIT/15 ML SUBQ SOLN",20904.5,14633.15,,,0
NDC,57894-505-05,DARATUMUMAB 20 MG/ML IV SOLN,994.0,695.8,,,0
NDC,57894-505-20,DARATUMUMAB 20 MG/ML IV SOLN,7452.0,5216.4,,,0
NDC,57894-650-01,GUSELKUMAB 200 MG/20 ML (10 MG/ML) IV SOLN,38289.0,26802.3,,,0
NDC,57896-101-01,ACETAMINOPHEN  325 MG ORAL TAB,5.0,3.5,,,0
NDC,57896-102-01,ACETAMINOPHEN  325 MG ORAL TAB,5.0,3.5,,,0
NDC,57896-111-09,BACITRACIN 500 UNITS/1 GRAM PACKET (MERGE RECORD),7.0,4.9,,,0
NDC,57896-116-03,METHYL SALICYLATE-MENTHOL 15 %-10 % TOPICAL CREAM,27.0,18.9,,,0
NDC,57896-145-09,BACITRACIN 500 UNITS/1 GRAM PACKET (MERGE RECORD),7.0,4.9,,,0
NDC,57896-303-01,SENNOSIDES-DOCUSATE SODIUM 8.6 MG-50 MG TAB,5.5,3.85,,,0
NDC,57896-401-01,DOCUSATE SODIUM 100 MG ORAL CAP,7.0,4.9,,,0
NDC,57896-441-01,BISACODYL  5 MG ORAL TBEC,7.0,4.9,,,0
NDC,57896-444-12,BISACODYL 10 MG RECT SUPP,7.0,4.9,,,0
NDC,57896-489-14,POLYETHYLENE GLYCOL 3350 100 % ORAL POWDER 238 GRAMS,40.0,28.0,,,0
NDC,57896-901-01,ASPIRIN  325 MG ORAL TAB,7.0,4.9,,,0
NDC,57896-921-01,ASPIRIN  325 MG ORAL TBEC,5.0,3.5,,,0
NDC,57896-981-01,ASPIRIN   81 MG ORAL TBEC,5.0,3.5,,,0
NDC,57896-981-12,ASPIRIN   81 MG ORAL TBEC,4.0,2.8,,,0
NDC,5789683701,LACTOBACILLUS ACIDOPH-PECTIN 75 MILLION CELL -100 MG ORAL CAP,7.0,4.9,,,0
NDC,5789684101,ASCORBIC ACID  500 MG ORAL TAB,7.0,4.9,,,0
NDC,5789686406,MELATONIN  3 MG ORAL TAB,5.5,3.85,,,0
NDC,5789687503,COENZYME Q10 100 MG ORAL CAP,7.0,4.9,,,0
NDC,57970-100-01,DALBAVANCIN 500 MG IV SOLN,9821.5,6875.049999999999,,,0
NDC,58151-110-32,PHENYTOIN SODIUM EXTENDED 100 MG ORAL CAP,32.5,22.75,,,0
NDC,58151-118-01,PHENYTOIN SODIUM EXTENDED  30 MG ORAL CAP,15.0,10.5,,,0
NDC,58151-310-94,NITROGLYCERIN 0.4 MG SL SUBL,11.0,7.7,,,0
NDC,58160-740-02,"ROTAVIRUS VACCINE, LIVE, 89-12 10EXP6 CCID50 /1.5 ML ORAL SUSP",511.5,358.05,,,0
NDC,58160-740-21,"ROTAVIRUS VACCINE, LIVE, 89-12 10EXP6 CCID50 /1.5 ML ORAL SUSP",511.5,358.05,,,0
NDC,58160-810-43,"DIPHTH,PERTUS(ACELL),TETANUS SYRG (INFANRIX) 25 LF UNIT-58MCG-10 LF/0.5ML IM SYRINGE",334.0,233.8,,,0
NDC,58160-810-52,"DIPHTH,PERTUS(ACELL),TETANUS SYRG (INFANRIX) 25 LF UNIT-58MCG-10 LF/0.5ML IM SYRINGE",334.0,233.8,,,0
NDC,58160-811-43,HEP B-DP(ACELL)T-POLIO VACC-PF 10MCG-25LF-25MCG-10LF-40-8-32 IM SYRING,433.0,303.1,,,0
NDC,58160-811-52,HEP B-DP(ACELL)T-POLIO VACC-PF 10MCG-25LF-25MCG-10LF-40-8-32 IM SYRING,445.0,311.5,,,0
NDC,58160-812-43,"DIPH,PERTUS(ACEL),TET,POLIO(PF)(KINRIX) 25 LF-58 MCG-10 LF/0.5 ML IM SYRINGE",313.5,219.45,,,0
NDC,58160-812-52,"DIPH,PERTUS(ACEL),TET,POLIO(PF)(KINRIX) 25 LF-58 MCG-10 LF/0.5 ML IM SYRINGE",313.5,219.45,,,0
NDC,58160-815-43,HEPATITIS A & B VIRUS VACCINE (PF) 720 ELISA UNIT-20 MCG/ML IM SYRINGE,558.5,390.95,,,0
NDC,58160-815-52,HEPATITIS A & B VIRUS VACCINE (PF) 720 ELISA UNIT-20 MCG/ML IM SYRINGE,558.5,390.95,,,0
NDC,58160-816-01,HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX (PF) 10 MCG IM,75.0,52.5,,,0
NDC,58160-816-03,HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX (PF) 10 MCG IM,77.0,53.9,,,0
NDC,58160-819-12,VARICELLA-ZOSTER GE-AS01B (PF) 50 MCG/0.5 ML IM SUSR,655.0,458.5,,,0
NDC,58160-820-43,HC MCARE ADMIN HEPATITIS B VACC,252.0,176.4,,,0
NDC,58160-820-52,HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE,171.0,119.7,,,0
NDC,58160-821-01,HC MCARE ADMIN HEPATITIS B VACC,360.0,252.0,,,0
NDC,58160-821-11,HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML IM INJ MERGE (CAM USE ONLY),367.0,256.9,,,0
NDC,58160-821-43,HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML IM SYRINGE,360.0,252.0,,,0
NDC,58160-821-52,HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML IM SYRINGE,367.0,256.9,,,0
NDC,58160-823-11,VARICELLA-ZOSTER GE-AS01B (PF) 50 MCG/0.5 ML IM SUSR,809.0,566.3,,,0
NDC,58160-824-15,"MEASLES,MUMPS,RUBELLA VACC(PF) 10EXP3.4-4.2- 3.3CCID50/0.5ML SUBQ SUSR",398.0,278.6,,,0
NDC,58160-825-43,HEPATITIS A VIRUS VACCINE (PF) 720 EL UNIT/0.5 ML IM SYRG,229.0,160.3,,,0
NDC,58160-825-52,HEPATITIS A VIRUS VACCINE (PF) 720 EL UNIT/0.5 ML IM SYRG,226.0,158.2,,,0
NDC,58160-826-43,HEPATITIS A VIRUS VACCINE (PF) 1440 ELISA UNIT/ML IM SYRG,396.5,277.54999999999995,,,0
NDC,58160-826-52,HEPATITIS A VIRUS VACCINE (PF) 1440 ELISA UNIT/ML IM SYRG,396.5,277.54999999999995,,,0
NDC,58160-827-03,"MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM SOLN",700.0,490.0,,,0
NDC,58160-827-30,"MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM SOLN",700.0,490.0,,,0
NDC,58160-828-03,"VARICELLA-ZOSTER GE VAC,2 OF 2 50 MCG IM SUSR",809.0,566.3,,,0
NDC,58160-829-03,ADJUVANT AS01B (PF)VIAL 1 OF 2 IM SUSP,763.0,534.1,,,0
NDC,58160-831-03,"MEASLES,MUMPS,RUBELLA VACC(PF) 10EXP3.4-4.2- 3.3CCID50/0.5ML SUBQ SUSR",398.0,278.6,,,0
NDC,58160-842-01,"DIPHTH,PERTUS(ACELL),TETANUS VIAL (BOOSTRIX*) 2.5-8-5 LF-MCG-LF/0.5ML IM SUSP",240.0,168.0,,,0
NDC,58160-842-05,"DIPHTH,PERTUS(ACELL),TETANUS SYRG(BOOSTRIX) 2.5-8-5 LF-MCG-LF/0.5ML IM SYRG",233.0,163.1,,,0
NDC,58160-842-11,"DIPHTH,PERTUS(ACELL),TETANUS VIAL (BOOSTRIX*) 2.5-8-5 LF-MCG-LF/0.5ML IM SUSP",240.0,168.0,,,0
NDC,58160-842-43,"DIPHTH,PERTUS(ACELL),TETANUS SYRG(BOOSTRIX) 2.5-8-5 LF-MCG-LF/0.5ML IM SYRG",247.0,172.9,,,0
NDC,58160-842-52,"DIPHTH,PERTUS(ACELL),TETANUS SYRG(BOOSTRIX) 2.5-8-5 LF-MCG-LF/0.5ML IM SYRG",243.5,170.45,,,0
NDC,58160-851-01,"ROTAVIRUS VAC,LIVE ATT, 89-12 STRAIN G1P(8) 10EXP6 CCID50/ML ORAL SUSP",953.0,667.1,,,0
NDC,58160-854-52,"ROTAVIRUS VAC,LIVE ATT, 89-12 STRAIN G1P(8) 10EXP6 CCID50/ML ORAL SUSP",873.0,611.1,,,0
NDC,58160-884-41,FLU VACCINE TS 2024-25 6MOS UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,116.0,81.2,,,0
NDC,58160-884-52,FLU VACCINE TS 2024-25 6MOS UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,116.0,81.2,,,0
NDC,58160-912-41,FLU VACCINE TS 2025-26 6 MO UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,120.0,84.0,,,0
NDC,58160-912-52,FLU VACCINE TS 2025-26 6 MO UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,120.0,84.0,,,0
NDC,58160-955-09,"MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM KIT",680.0,476.0,,,0
NDC,58160-958-01,"MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM KIT (CAM USE ONLY)",680.0,476.0,,,0
NDC,58160-959-01,"MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM KIT (CAM USE ONLY)",680.0,476.0,,,0
NDC,58160-976-02,"MENINGOCOCCAL B VACC,4-CMP(PF) 50-50-50-25 MCG/0.5 ML IM SYRG",815.5,570.8499999999999,,,0
NDC,58160-976-20,"MENINGOCOCCAL B VACC,4-CMP(PF) 50-50-50-25 MCG/0.5 ML IM SYRG",815.5,570.8499999999999,,,0
NDC,58284-228-01,BUPRENORPHINE 128 MG/0.36 ML SUBQ SLSY,4047.0,2832.9,,,0
NDC,58284-264-01,BUPRENORPHINE 64 MG/0.18 ML SUBQ SLSY,4047.0,2832.9,,,0
NDC,58394-633-03,BENEFIX: FIX CONCENTRATE (MERGE RECORD),26004.5,18203.15,,,0
NDC,58394-637-03,BENEFIX: FIX CONCENTRATE (MERGE RECORD),45428.0,31799.6,,,0
NDC,5843800571,MELATONIN  1 MG/ML ORAL LIQD,9.5,6.65,,,0
NDC,58468-0030-1,THYROTROPIN ALFA 0.9 MG IM SOLR,8208.0,5745.6,,,0
NDC,58468-0030-2,THYROTROPIN ALFA 0.9 MG IM SOLR,8208.0,5745.6,,,0
NDC,58468-0040-1,AGALSIDASE BETA 35 MG IV SOLR,34859.0,24401.3,,,0
NDC,58468-0041-1,AGALSIDASE BETA  5 MG IV SOLR,4295.0,3006.5,,,0
NDC,58468-0080-1,ANTI-THYMOCYTE GLOB (RABBIT) 25 MG IV SOLR,9099.0,6369.3,,,0
NDC,58468-0160-1,ALGLUCOSIDASE ALFA 50 MG IV SOLR,47864.0,33504.8,,,0
NDC,5846800901,HYLAN G-F 20 48 MG/6 ML IATC SYRG,2521.0,1764.7,,,0
NDC,5846800902,HYLAN G-F 20 16 MG/2 ML IATC SYRG,1891.0,1323.7,,,0
NDC,5846800903,HYLAN G-F 20 16 MG/2 ML IATC SYRG,2521.0,1764.6999999999998,,,0
NDC,58602-006-40,OLOPATADINE 0.1 % OPHT DROP,51.0,35.7,,,0
NDC,58602-604-07,DICLOFENAC 1 % TOPICAL GEL,33.0,23.099999999999998,,,0
NDC,58657-528-16,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,7.0,4.9,,,0
NDC,58657-675-01,CIPROFLOXACIN 250 MG ORAL TAB,37.5,26.25,,,0
NDC,58657-676-01,CIPROFLOXACIN 500 MG ORAL TAB,21.0,14.700000000000001,,,0
NDC,58914-080-52,DICYCLOMINE 10 MG/ML IM SOLN,364.0,254.8,,,0
NDC,58914-501-01,MESALAMINE 1000 MG RECT SUPP,228.0,159.6,,,0
NDC,58914-501-56,MESALAMINE 1000 MG RECT SUPP,228.0,159.6,,,0
NDC,58980-011-10,BACITRACIN 500 UNIT/G TOP OINT (MERGE),41.5,29.05,,,0
NDC,58980-012-05,"BACITRACIN ZINC-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM OINTMENT",37.0,25.9,,,0
NDC,58980-409-12,GLYCERIN (CHILD) RECTAL SUPPOSITORY,7.0,4.9,,,0
NDC,58980-409-25,GLYCERIN (CHILD) RECTAL SUPPOSITORY,7.0,4.9,,,0
NDC,58980-415-04,BISACODYL 10 MG RECT SUPP,7.0,4.9,,,0
NDC,5898096012,EMOLLIENT COMBINATION NO.10 TOPICAL EMULSION,135.0,94.5,,,0
NDC,59011-410-20,OXYCODONE  10 MG ORAL TR12,83.0,58.1,,,0
NDC,59011-420-10,OXYCODONE  20 MG ORAL TR12,125.0,87.5,,,0
NDC,59011-420-20,OXYCODONE  20 MG ORAL TR12,154.0,107.8,,,0
NDC,59011-440-20,OXYCODONE  40 MG ORAL TR12,205.0,143.5,,,0
NDC,59267-4426-1,COVID VACCINE 24-25 (6M-4Y)(PFI)-PF 3 MCG/0.3 ML IM SUSP,249.0,174.3,,,0
NDC,59267-4426-2,COVID VACCINE 24-25 (6M-4Y)(PFI)-PF 3 MCG/0.3 ML IM SUSP,249.0,174.3,,,0
NDC,59267-4438-1,COVID VACCINE 24-25 (5-11Y)(PFI)-PF 10 MCG/0.3 ML IM SUSP,392.0,274.4,,,0
NDC,59267-4438-2,COVID VACCINE 24-25 (5-11Y)(PFI)-PF 10 MCG/0.3 ML IM SUSP,392.0,274.4,,,0
NDC,592800100,SOD CHLOR&BICARB-SQUEEZ BOTTLE NASL PKDV,1239.0,867.3,,,0
NDC,59310-302-40,BECLOMETHASONE DIPROPIONATE 40 MCG/ACTUATION INHL HFAB,14.0,9.8,,,0
NDC,59310-304-80,BECLOMETHASONE DIPROPIONATE 80 MCG/ACTUATION INHL HFAB,33.0,23.1,,,0
NDC,59310-579-20,ALBUTEROL SULFATE 90 MCG/ACTUATION INHL HFAA,15.0,10.5,,,0
NDC,59310-579-22,ALBUTEROL SULFATE 90 MCG/ACTUATION INHL HFAA,20.0,14.0,,,0
NDC,59338-775-01,FERUMOXYTOL 510 MG/17 ML (30 MG/ML) IV SOLN,3295.0,2306.5,,,0
NDC,59365-5128-1,COPPER 380 SQUARE MM IU IUD,3142.0,2199.4,,,0
NDC,59365-5129-1,COPPER 380 SQUARE MM IU IUD,3142.0,2199.4,,,0
NDC,59390-027-14,NEOMYCIN-BACITRACIN ZN-POLYMYXIN 3.5 MG-400 UN*,26.0,18.2,,,0
NDC,59390-181-13,TETRACAINE 0.5 % EYE DROPS,52.0,36.4,,,0
NDC,59572-711-01,LUSPATERCEPT-AAMT 25 MG SUBQ SOLR,4991.0,3493.7,,,0
NDC,59572-775-01,LUSPATERCEPT-AAMT 75 MG SUBQ SOLR,22747.5,15923.25,,,0
NDC,59630-266-01,CEFIDEROCOL 1 G IV SOLR,1649.0,1154.3,,,0
NDC,59651-026-75,AMOXICILLIN-POT CLAVULANATE 250 MG-62.5 MG/5 ML ORAL SUSP,27.0,18.9,,,0
NDC,59651-152-01,PROGESTERONE MICRONIZED 100 MG ORAL CAP,18.0,12.600000000000001,,,0
NDC,59651-256-01,PROPAFENONE 150 MG ORAL TAB,14.0,9.8,,,0
NDC,59651-257-01,PROPAFENONE 225 MG ORAL TAB,13.0,9.1,,,0
NDC,59651-299-60,TAMOXIFEN 10 MG ORAL TAB,16.0,11.2,,,0
NDC,59651-361-01,IBUPROFEN 600 MG ORAL TAB,7.0,4.9,,,0
NDC,59651-421-01,URSODIOL 300 MG ORAL CAP,72.0,50.4,,,0
NDC,59651-426-01,SPIRONOLACTONE  25 MG ORAL TAB,7.0,4.9,,,0
NDC,59651-455-01,COLCHICINE 0.6 MG ORAL TAB,38.0,26.6,,,0
NDC,59651-456-01,CARBIDOPA-LEVODOPA 10 MG-100 MG TAB,7.0,4.9,,,0
NDC,59651-457-01,CARBIDOPA-LEVODOPA 25 MG-100 MG TAB,8.0,5.6,,,0
NDC,59651-484-01,PREDNISONE  1 MG ORAL TAB,5.0,3.5,,,0
NDC,59651-485-01,PREDNISONE  2.5 MG ORAL TAB,32.5,22.75,,,0
NDC,59651-488-01,PREDNISONE 20 MG ORAL TAB,8.0,5.6,,,0
NDC,59651-489-01,PREDNISONE 50 MG ORAL TAB,4.5,3.15,,,0
NDC,59651-516-30,EXEMESTANE 25 MG ORAL TAB,99.0,69.3,,,0
NDC,59651-565-01,DICLOXACILLIN 250 MG ORAL CAP,48.5,33.95,,,0
NDC,59651-566-01,DICLOXACILLIN 500 MG ORAL CAP,14.0,9.8,,,0
NDC,59651-723-01,CLONAZEPAM 1 MG ORAL TAB,7.0,4.9,,,0
NDC,59651-782-01,GLIPIZIDE 10 MG ORAL TO24,7.0,4.9,,,0
NDC,59651-840-01,GUANFACINE 1 MG ORAL TAB,9.0,6.3,,,0
NDC,59651-873-50,CIPROFLOXACIN 750 MG ORAL TAB,32.0,22.4,,,0
NDC,59676-302-00,EPOETIN ALFA 2000 UNIT/ML IV SYRINGE (PED/NEO),115.0,80.5,,,0
NDC,59676-304-00,EPOETIN ALFA  4000 UNIT/ML INJ SOLN,693.0,485.09999999999997,,,0
NDC,59676-310-00,EPOETIN ALFA 10000 UNIT/ML INJ SOLN,947.0,662.9,,,0
NDC,59676-320-00,EPOETIN ALFA 20000 UNIT/ML INJ SOLN,1476.0,1033.2,,,0
NDC,59676-340-01,EPOETIN ALFA 40000 UNIT/ML INJ SOLN,2951.0,2065.7,,,0
NDC,59676-610-01,TRABECTEDIN 1 MG IV SOLR,7825.0,5477.5,,,0
NDC,59676-800-30,DARUNAVIR-COBI-EMTRI-TENOF ALA 800-150-200-10 MG ORAL TAB,6849.5,4794.65,,,0
NDC,5967636001,SODIUM HYALURONATE 30 MG/2 ML IATC SYRG,1320.0,924.0,,,0
NDC,5967682001,"HYALURONATE SODIUM, STABILIZED 88 MG/4 ML IATC SYRG",3105.0,2173.5,,,0
NDC,59746-010-32,RISPERIDONE 0.5 MG ORAL TBDL,41.5,29.05,,,0
NDC,59746-020-22,RISPERIDONE 1 MG ORAL TBDL,54.0,37.8,,,0
NDC,59746-113-06,PROCHLORPERAZINE MALEATE  5 MG ORAL TAB,17.0,11.899999999999999,,,0
NDC,59746-115-06,PROCHLORPERAZINE MALEATE 10 MG ORAL TAB,30.0,21.0,,,0
NDC,59746-171-06,PREDNISONE  1 MG ORAL TAB,9.0,6.3,,,0
NDC,59746-172-06,PREDNISONE  5 MG ORAL TAB,8.0,5.6,,,0
NDC,59746-173-06,PREDNISONE 10 MG ORAL TAB,6.0,4.2,,,0
NDC,59746-175-06,PREDNISONE 20 MG ORAL TAB,13.0,9.1,,,0
NDC,59746-175-09,PREDNISONE 20 MG ORAL TAB,16.0,11.2,,,0
NDC,59746-216-01,SPIRONOLACTONE  25 MG ORAL TAB,7.0,4.9,,,0
NDC,59746-218-01,SPIRONOLACTONE 100 MG ORAL TAB,7.5,5.25,,,0
NDC,59746-306-12,OLANZAPINE  5 MG ORAL TBDL,87.5,61.25,,,0
NDC,59746-383-06,TERAZOSIN  1 MG ORAL CAP,13.5,9.45,,,0
NDC,59746-384-06,TERAZOSIN  2 MG ORAL CAP,13.5,9.45,,,0
NDC,59746-385-06,TERAZOSIN  5 MG ORAL CAP,14.5,10.15,,,0
NDC,59746-762-01,NITROFURANTOIN (25% MACROCRYSTAL FORM) 100 MG CAP,18.0,12.6,,,0
NDC,59762-0050-1,METHYLPREDNISOLONE 16 MG ORAL TAB,35.0,24.5,,,0
NDC,59762-0058-1,MEDROXYPROGESTERONE  5 MG ORAL TAB,9.0,6.300000000000001,,,0
NDC,59762-0073-1,HYDROCORTISONE 5 MG ORAL TAB,7.5,5.25,,,0
NDC,59762-0074-1,HYDROCORTISONE 10 MG ORAL TAB,7.0,4.9,,,0
NDC,59762-0075-1,HYDROCORTISONE 20 MG ORAL TAB,13.0,9.1,,,0
NDC,59762-0104-1,SULFASALAZINE 500 MG ORAL TBEC,7.0,4.9,,,0
NDC,59762-0104-5,SULFASALAZINE 500 MG ORAL TBEC,7.0,4.9,,,0
NDC,59762-0180-3,VENLAFAXINE  37.5 MG ORAL CP24,35.5,24.85,,,0
NDC,59762-0333-2,LATANOPROST 0.005 % OPHT DROP,210.5,147.35,,,0
NDC,59762-0401-1,SUCRALFATE 1 GRAM ORAL TAB,7.0,4.9,,,0
NDC,59762-0541-1,GLIPIZIDE  5 MG ORAL TO24,7.0,4.9,,,0
NDC,59762-0800-2,TOLTERODINE 2 MG ORAL TAB,10.0,7.0,,,0
NDC,59762-1001-1,SIROLIMUS 0.5 MG ORAL TAB,47.0,32.9,,,0
NDC,59762-1206-1,LIOTHYRONINE  5 MCG ORAL TAB,10.0,7.0,,,0
NDC,59762-1207-1,LIOTHYRONINE 25 MCG ORAL TAB,10.0,7.0,,,0
NDC,59762-1308-4,LINEZOLID 100 MG/5 ML ORAL SUSR,406.0,284.2,,,0
NDC,59762-1342-1,PREGABALIN  25 MG ORAL CAP,103.5,72.45,,,0
NDC,59762-1516-1,CELECOXIB 100 MG ORAL CAP,26.0,18.2,,,0
NDC,59762-1710-2,EPLERENONE  25 MG ORAL TAB,35.5,24.85,,,0
NDC,59762-2198-7,AZITHROMYCIN 250 MG ORAL TAB,60.5,42.35,,,0
NDC,59762-3051-5,AZITHROMYCIN 1 GRAM ORAL PACK,143.0,100.1,,,0
NDC,59762-3060-1,AZITHROMYCIN 250 MG ORAL TAB,153.0,107.1,,,0
NDC,59762-3130-1,AZITHROMYCIN 200 MG/5 ML ORAL SUSR,29.0,20.3,,,0
NDC,59762-3140-1,AZITHROMYCIN 200 MG/5 ML ORAL SUSR,57.0,39.9,,,0
NDC,59762-3304-3,NITROGLYCERIN 0.4 MG SL SUBL,12.0,8.4,,,0
NDC,59762-3720-1,ALPRAZOLAM 0.5 MG ORAL TAB,9.0,6.3,,,0
NDC,59762-3740-1,MEDROXYPROGESTERONE  2.5 MG ORAL TAB,7.0,4.9,,,0
NDC,59762-3741-1,MEDROXYPROGESTERONE  5 MG ORAL TAB,42.0,29.4,,,0
NDC,59762-4537-1,MEDROXYPROGESTERONE (CONTRACEPTIVE) 150 MG/ML IM (MERGE),415.0,290.5,,,0
NDC,59762-4900-3,SERTRALINE  50 MG ORAL TAB,12.0,8.399999999999999,,,0
NDC,59762-4910-3,SERTRALINE 100 MG ORAL TAB,14.0,9.8,,,0
NDC,59762-4940-1,SERTRALINE 20 MG/ML ORAL CONC,285.0,199.5,,,0
NDC,59762-5000-5,SULFASALAZINE 500 MG ORAL TAB,7.0,4.9,,,0
NDC,59762-5007-1,MISOPROSTOL 25 MCG ORAL TAB,25.5,17.85,,,0
NDC,59762-5007-2,MISOPROSTOL 100 MCG ORAL TAB,28.0,19.6,,,0
NDC,59762-5008-1,MISOPROSTOL 200 MCG ORAL TAB,27.0,18.9,,,0
NDC,59762-5310-1,PRAZOSIN 1 MG ORAL CAP,8.5,5.95,,,0
NDC,59779-486-01,CARBAMIDE PEROXIDE 6.5 % OTIC DROP,39.0,27.3,,,0
NDC,60219-1573-1,METHYLPREDNISOLONE 40 MG/ML SUSP (DEPO-MEDROL) INJECTION,57.0,39.9,,,0
NDC,60219-1574-1,METHYLPREDNISOLONE 80 MG/ML SUSP FOR INJECTION,96.0,67.2,,,0
NDC,60219-1574-5,METHYLPREDNISOLONE 80 MG/ML SUSP FOR INJECTION,96.0,67.2,,,0
NDC,60219-1585-3,FLUOROMETHOLONE 0.1 % OPHT DRPS,395.0,276.5,,,0
NDC,60219-1708-1,PREDNISONE 20 MG ORAL TAB,11.5,8.05,,,0
NDC,60219-1748-2,ATROPINE 1 % OPHT DROP,235.0,164.5,,,0
NDC,60219-1749-3,ATROPINE 1 % OPHT DROP,248.0,173.6,,,0
NDC,6025800615,POTASSIUM & SODIUM PHOSPHATES 280-160-250 MG ORAL PWPK,15.0,10.5,,,0
NDC,6025817101,MAGNESIUM OXIDE 400 MG ORAL TAB,7.0,4.9,,,0
NDC,60267-705-50,SODIUM THIOSULFATE 25 % IV SOLN,413.0,289.1,,,0
NDC,60429-195-15,FLUTICASONE  50 MCG/ACTUATION NASL SPSN,413.0,289.1,,,0
NDC,60429-840-25,NITROGLYCERIN 0.4 MG SL SUBL,7.0,4.9,,,0
NDC,60432-065-75,AMOXICILLIN-POT CLAVULANATE 250 MG-62.5 MG/5 ML ORAL SUSP,32.0,22.4,,,0
NDC,60432-150-04,HYDROXYZINE 10 MG/5 ML SYRUP,12.0,8.4,,,0
NDC,60432-264-15,FLUTICASONE  50 MCG/ACTUATION NASL SPSN,362.0,253.4,,,0
NDC,60432-561-60,TRIAMCINOLONE ACETONIDE 0.1 % TOP LOTN,208.0,145.6,,,0
NDC,60505-0042-6,ACYCLOVIR 200 MG ORAL CAP,9.0,6.300000000000001,,,0
NDC,60505-0134-0,CYCLOSPORINE 100 MG ORAL CAP,81.5,57.05,,,0
NDC,60505-0165-1,FLUVOXAMINE  50 MG ORAL TAB,18.5,12.95,,,0
NDC,60505-0166-1,FLUVOXAMINE 100 MG ORAL TAB,15.0,10.5,,,0
NDC,60505-0252-2,TIZANIDINE 4 MG ORAL TAB,9.0,6.3,,,0
NDC,60505-0252-3,TIZANIDINE 4 MG ORAL TAB,11.0,7.699999999999999,,,0
NDC,60505-0257-1,DESMOPRESSIN 0.1 MG ORAL TAB,13.0,9.1,,,0
NDC,60505-0258-1,DESMOPRESSIN 0.2 MG ORAL TAB,46.0,32.2,,,0
NDC,60505-0363-2,OFLOXACIN 0.3 % OTIC DROP,911.0,637.7,,,0
NDC,60505-0560-0,OFLOXACIN 0.3 % OPHT DROP,103.0,72.1,,,0
NDC,60505-0750-4,CEFTRIAXONE 250 MG INJ SOLR,293.0,205.1,,,0
NDC,60505-0752-4,CEFTRIAXONE 1 GRAM INJ SOLR,225.0,157.5,,,0
NDC,60505-0753-4,CEFTRIAXONE   2 GRAM INJ SOLR,388.0,271.6,,,0
NDC,60505-0815-0,DESMOPRESSIN 10 MCG/SPRAY NASL SPRA,887.0,620.9,,,0
NDC,60505-0823-6,CALCITONIN (SALMON) 200 UNIT/ACTUATION NASL SPRA,427.0,298.9,,,0
NDC,60505-0826-1,IPRATROPIUM BROMIDE 0.03 % NASL SPRA,402.0,281.4,,,0
NDC,60505-0829-1,FLUTICASONE  50 MCG/ACTUATION NASL SPSN,362.0,253.4,,,0
NDC,60505-0834-0,CEFEPIME 40 MG/ML IV SYRINGE (CDS MIXTURE),54.5,38.15,,,0
NDC,60505-2575-7,BALSALAZIDE 750 MG ORAL CAP,22.5,15.75,,,0
NDC,60505-2653-1,TRAZODONE  50 MG ORAL TAB,9.5,6.65,,,0
NDC,60505-2806-7,CARBAMAZEPINE 200 MG ORAL CM12,16.5,11.55,,,0
NDC,60505-2833-3,ATOMOXETINE  40 MG ORAL CAP,152.0,106.4,,,0
NDC,60505-3110-0,OLANZAPINE  2.5 MG ORAL TAB,137.5,96.25,,,0
NDC,60505-3111-0,OLANZAPINE  5 MG ORAL TAB,113.5,79.45,,,0
NDC,60505-3113-0,OLANZAPINE 10 MG ORAL TAB,147.0,102.9,,,0
NDC,60505-3275-0,OLANZAPINE  5 MG ORAL TBDL,140.0,98.0,,,0
NDC,60505-3275-3,OLANZAPINE  5 MG ORAL TBDL,105.0,73.5,,,0
NDC,60505-3276-0,OLANZAPINE 10 MG ORAL TBDL,206.0,144.2,,,0
NDC,60505-3438-3,SELEGILINE 5 MG TAB,9.5,6.65,,,0
NDC,60505-3628-6,DASATINIB  20 MG ORAL TAB,1135.0,794.5,,,0
NDC,60505-3629-6,DASATINIB  50 MG ORAL TAB,1770.0,1239.0,,,0
NDC,60505-3631-3,DASATINIB 100 MG ORAL TAB,1914.0,1339.8,,,0
NDC,60505-3928-1,GUANFACINE 2 MG ORAL TB24,77.5,54.25,,,0
NDC,60505-4642-3,PRASUGREL 5 MG ORAL TAB,81.0,56.7,,,0
NDC,60505-5307-1,ACYCLOVIR 800 MG ORAL TAB,18.0,12.600000000000001,,,0
NDC,60505-6097-0,IBANDRONATE 3 MG/3 ML IV SYKT,1162.0,813.4,,,0
NDC,60505-6116-0,REGADENOSON 0.4 MG/5 ML IV SYRG,886.0,620.2,,,0
NDC,60505-6128-0,IRINOTECAN 100 MG/5 ML IV SOLN,92.0,64.4,,,0
NDC,60505-6128-1,IRINOTECAN 100 MG/5 ML IV SOLN,325.0,227.5,,,0
NDC,60505-6130-0,ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN,24.5,17.15,,,0
NDC,60505-6130-5,ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN,16.0,11.2,,,0
NDC,60505-6132-7,OXALIPLATIN 100 MG/20 ML IV SOLN,306.0,214.2,,,0
NDC,60505-6142-0,CEFAZOLIN   1 GRAM INJ SOLR,22.5,15.75,,,0
NDC,60505-6146-0,CEFEPIME 1 GRAM INJ SOLR,149.5,104.65,,,0
NDC,60505-6147-0,CEFEPIME 2 GRAM INJ SOLR,198.0,138.6,,,0
NDC,60505-6148-0,CEFTRIAXONE 1 GRAM INJ SOLR,193.5,135.45,,,0
NDC,60505-6148-4,CEFTRIAXONE 1 GRAM INJ SOLR,225.0,157.5,,,0
NDC,60505-6149-0,CEFTRIAXONE   2 GRAM INJ SOLR,775.0,542.5,,,0
NDC,60505-6151-4,CEFTRIAXONE 250 MG INJ SOLR,156.0,109.2,,,0
NDC,60505-6152-4,CEFTRIAXONE 500 MG INJ SOLR,81.0,56.7,,,0
NDC,60505-6156-0,PIPERACILLIN-TAZOBACTAM  2.25 GRAM IV SOLR,63.0,44.1,,,0
NDC,60505-6157-0,PIPERACILLIN-TAZOBACTAM  3.375 GRAM IV SOLR,84.0,58.8,,,0
NDC,60505-6159-0,PIPERACILLIN-TAZOBACTAM  4.5 GRAM IV SOLR,107.0,74.9,,,0
NDC,60505-6193-1,PALONOSETRON 0.25 MG/5 ML IV INJECTION (MERGE),605.0,423.5,,,0
NDC,60505-6196-0,ERTAPENEM 1 GRAM INJ SOLR,506.0,354.2,,,0
NDC,60505-6197-2,SIROLIMUS 1 MG/ML ORAL SOLN,124.0,86.8,,,0
NDC,60505-6202-1,CYCLOSPORINE 0.05 % OPHT DPET,33.5,23.45,,,0
NDC,60505-6230-4,PACLITAXEL-PROTEIN BOUND 100 MG IV SOLR,7416.0,5191.2,,,0
NDC,60505-6231-0,CEFAZOLIN   2 G INJ SOLR,47.5,33.25,,,0
NDC,60505-6236-0,DEFEROXAMINE 500 MG INJ SOLR,152.0,106.4,,,0
NDC,60505-6236-6,DEFEROXAMINE 500 MG INJ SOLR,152.0,106.4,,,0
NDC,60505-7006-0,FENTANYL  25 MCG/HR TD PT72,104.0,72.8,,,0
NDC,60505-7009-0,FENTANYL 100 MCG/HR TD PT72,334.0,233.8,,,0
NDC,60505-7061-0,NICOTINE  7 MG/24 HR TD PT24,11.0,7.7,,,0
NDC,60505-7062-0,NICOTINE 14 MG/24 HR TD PT24,19.5,13.649999999999999,,,0
NDC,60505-7081-0,FENTANYL  25 MCG/HR TD PT72,104.0,72.8,,,0
NDC,60687-100-11,URSODIOL 300 MG ORAL CAP,34.5,24.15,,,0
NDC,60687-105-11,MEDROXYPROGESTERONE 10 MG ORAL TAB,14.5,10.15,,,0
NDC,60687-112-11,ANASTROZOLE 1 MG ORAL TAB,12.0,8.4,,,0
NDC,60687-113-01,CLONIDINE 0.1 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-113-11,CLONIDINE 0.1 MG ORAL TAB,8.0,5.6,,,0
NDC,60687-121-95,ACAMPROSATE 333 MG ORAL TBEC,23.5,16.45,,,0
NDC,60687-122-11,PREDNISONE  5 MG ORAL TAB,11.5,8.05,,,0
NDC,60687-124-11,CLONIDINE 0.2 MG ORAL TAB,5.5,3.85,,,0
NDC,60687-129-11,DOCUSATE SODIUM 100 MG ORAL CAP,7.0,4.9,,,0
NDC,60687-134-11,PREDNISONE 10 MG ORAL TAB,5.5,3.85,,,0
NDC,60687-143-11,METFORMIN  850 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-145-01,PREDNISONE 20 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-145-11,PREDNISONE 20 MG ORAL TAB,5.5,3.85,,,0
NDC,60687-149-11,CAPECITABINE 500 MG ORAL TAB,74.0,51.8,,,0
NDC,60687-152-11,CEPHALEXIN 250 MG ORAL CAP,8.0,5.6,,,0
NDC,60687-155-11,METFORMIN  500 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-156-95,PHENYTOIN 50 MG ORAL CHEW,25.0,17.5,,,0
NDC,60687-157-11,ARIPIPRAZOLE  2 MG ORAL TAB,240.0,168.0,,,0
NDC,60687-161-01,HALOPERIDOL  5 MG ORAL TAB,10.0,7.0,,,0
NDC,60687-161-11,HALOPERIDOL  5 MG ORAL TAB,11.5,8.05,,,0
NDC,60687-163-11,CEPHALEXIN 500 MG ORAL CAP,15.0,10.5,,,0
NDC,60687-169-11,PRAVASTATIN 10 MG ORAL TAB,27.0,18.9,,,0
NDC,60687-173-11,MEMANTINE  5 MG ORAL TAB,9.0,6.3,,,0
NDC,60687-178-11,PRAVASTATIN 20 MG ORAL TAB,28.0,19.6,,,0
NDC,60687-179-11,ARIPIPRAZOLE 10 MG ORAL TAB,184.0,128.8,,,0
NDC,60687-188-11,ENTACAPONE 200 MG ORAL TAB,28.0,19.6,,,0
NDC,60687-190-11,PRAVASTATIN 40 MG ORAL TAB,27.0,18.9,,,0
NDC,60687-191-11,ARIPIPRAZOLE 15 MG ORAL TAB,114.0,79.80000000000001,,,0
NDC,60687-192-11,IMATINIB 100 MG ORAL TAB,110.0,77.0,,,0
NDC,60687-195-11,DILTIAZEM SR 120 MG 24 HR CAP,11.0,7.7,,,0
NDC,60687-206-11,DILTIAZEM SR 180 MG 24 HR CAP,7.0,4.9,,,0
NDC,60687-210-11,SIMVASTATIN 40 MG ORAL TAB,21.0,14.700000000000001,,,0
NDC,60687-211-11,DIVALPROEX 125 MG ORAL TBEC,7.0,4.9,,,0
NDC,60687-214-11,METHADONE  5 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-224-11,GEMFIBROZIL 600 MG ORAL TAB,10.0,7.0,,,0
NDC,60687-228-11,DILTIAZEM SR 300 MG 24 HR CAP,22.5,15.75,,,0
NDC,60687-229-11,LOPERAMIDE 2 MG ORAL CAP,17.0,11.9,,,0
NDC,60687-230-11,ZONISAMIDE 100 MG ORAL CAP,21.0,14.7,,,0
NDC,60687-231-11,SERTRALINE  25 MG ORAL TAB,7.5,5.25,,,0
NDC,60687-234-11,ROSUVASTATIN  5 MG ORAL TAB,46.5,32.55,,,0
NDC,60687-242-11,SERTRALINE  50 MG ORAL TAB,4.5,3.15,,,0
NDC,60687-245-11,ROSUVASTATIN 10 MG ORAL TAB,30.0,21.0,,,0
NDC,60687-252-40,ONDANSETRON HCL 4 MG/5 ML ORAL SOLN,40.0,28.0,,,0
NDC,60687-253-11,SERTRALINE 100 MG ORAL TAB,5.0,3.5,,,0
NDC,60687-256-11,ROSUVASTATIN 20 MG ORAL TAB,40.0,28.0,,,0
NDC,60687-265-33,NORTRIPTYLINE 50 MG ORAL CAP,15.0,10.5,,,0
NDC,60687-266-11,RALOXIFENE 60 MG ORAL TAB,41.0,28.7,,,0
NDC,60687-271-11,AZITHROMYCIN 500 MG ORAL TAB,68.0,47.6,,,0
NDC,60687-272-11,CEFUROXIME AXETIL 250 MG ORAL TAB,34.5,24.150000000000002,,,0
NDC,60687-275-62,PHENYTOIN 100 MG/4 ML ORAL SUSP,51.0,35.7,,,0
NDC,60687-281-11,NORTRIPTYLINE 10 MG ORAL CAP,7.0,4.9,,,0
NDC,60687-292-11,DONEPEZIL  5 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-293-11,NORTRIPTYLINE 25 MG ORAL CAP,7.0,4.9,,,0
NDC,60687-299-95,ITRACONAZOLE 100 MG ORAL CAP,34.0,23.8,,,0
NDC,60687-302-95,NADOLOL  20 MG ORAL TAB,47.5,33.25,,,0
NDC,60687-303-11,DONEPEZIL 10 MG ORAL TAB,8.0,5.6,,,0
NDC,60687-312-11,BUPROPION HCL 150 MG ORAL TB24,26.0,18.2,,,0
NDC,60687-317-95,CHLORTHALIDONE  25 MG ORAL TAB,10.0,7.0,,,0
NDC,60687-319-11,TOLTERODINE 2 MG ORAL CP24,88.5,61.949999999999996,,,0
NDC,60687-325-11,LISINOPRIL 10 MG ORAL TAB,5.5,3.85,,,0
NDC,60687-326-95,ATOMOXETINE  40 MG ORAL CAP,43.0,30.1,,,0
NDC,60687-327-11,QUETIAPINE  25 MG ORAL TAB,31.5,22.049999999999997,,,0
NDC,60687-328-11,SEVELAMER CARBONATE 800 MG ORAL TAB,79.0,55.3,,,0
NDC,60687-333-11,LISINOPRIL 20 MG ORAL TAB,4.0,2.8,,,0
NDC,60687-336-11,MINOCYCLINE 100 MG ORAL CAP,8.0,5.6,,,0
NDC,60687-344-95,DOXYCYCLINE 100 MG TAB,130.0,91.0,,,0
NDC,60687-345-11,CALCITRIOL 0.25 MCG ORAL CAP,10.5,7.35,,,0
NDC,60687-349-11,QUETIAPINE 100 MG ORAL TAB,55.0,38.5,,,0
NDC,60687-351-11,BUPROPION HCL 100 MG ORAL TAB,15.0,10.5,,,0
NDC,60687-360-11,QUETIAPINE 200 MG ORAL TAB,47.0,32.9,,,0
NDC,60687-368-11,BENZTROPINE 1 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-369-11,DICYCLOMINE 10 MG ORAL CAP,15.0,10.5,,,0
NDC,60687-373-11,EZETIMIBE 10 MG ORAL TAB,48.0,33.6,,,0
NDC,60687-375-11,DRONABINOL  2.5 MG ORAL CAP,84.0,58.8,,,0
NDC,60687-377-11,ALPRAZOLAM 0.25 MG ORAL TAB,8.0,5.6,,,0
NDC,60687-380-11,DICYCLOMINE 20 MG ORAL TAB,28.0,19.6,,,0
NDC,60687-381-11,PHYTONADIONE 5 MG ORAL TAB,270.5,189.35,,,0
NDC,60687-384-11,BUMETANIDE 1 MG ORAL TAB,8.0,5.6,,,0
NDC,60687-385-95,COLESEVELAM 625 MG ORAL TAB,41.0,28.7,,,0
NDC,60687-388-11,ALPRAZOLAM 0.5 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-390-11,METOPROLOL SUCCINATE SR 25 MG 24 HR TAB,22.0,15.4,,,0
NDC,60687-391-11,PIOGLITAZONE 15 MG ORAL TAB,10.5,7.3500000000000005,,,0
NDC,60687-394-79,IPRATROPIUM BROMIDE 0.02 % INHL SOLN,6.0,4.2,,,0
NDC,60687-395-79,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) NEB SOLUTION,7.5,5.25,,,0
NDC,60687-398-11,MIDODRINE  5 MG ORAL TAB,11.5,8.05,,,0
NDC,60687-402-11,METOPROLOL SUCCINATE SR 50 MG 24 HR TAB,14.5,10.149999999999999,,,0
NDC,60687-404-11,CLOZAPINE  25 MG ORAL TAB,19.0,13.3,,,0
NDC,60687-405-79,IPRATROPIUM-ALBUTEROL 0.5 MG-2.5 MG/3 ML NEB SOLUTION,8.0,5.6,,,0
NDC,60687-413-11,METOPROLOL SUCCINATE SR 100 MG 24 HR TAB,19.0,13.3,,,0
NDC,60687-415-11,CLOZAPINE 100 MG ORAL TAB,39.0,27.3,,,0
NDC,60687-416-11,SILDENAFIL  20 MG ORAL TAB,148.5,103.94999999999999,,,0
NDC,60687-419-11,CHLORPROMAZINE  10 MG ORAL TAB,46.0,32.2,,,0
NDC,60687-422-11,AMANTADINE 100 MG ORAL CAP,13.0,9.1,,,0
NDC,60687-423-11,CLOBAZAM 10 MG ORAL TAB,26.5,18.55,,,0
NDC,60687-428-11,FINASTERIDE 5 MG ORAL TAB,18.5,12.95,,,0
NDC,60687-429-45,MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSP,14.0,9.8,,,0
NDC,60687-432-11,TRAZODONE 150 MG ORAL TAB,14.0,9.8,,,0
NDC,60687-433-11,AMITRIPTYLINE  25 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-436-11,CELECOXIB 100 MG ORAL CAP,39.0,27.299999999999997,,,0
NDC,60687-437-11,AMIODARONE 200 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-438-11,MYCOPHENOLATE 500 MG TAB,18.0,12.6,,,0
NDC,60687-439-11,LABETALOL 100 MG ORAL TAB,10.0,7.0,,,0
NDC,60687-443-11,TRAZODONE  50 MG ORAL TAB,5.5,3.85,,,0
NDC,60687-444-11,AMITRIPTYLINE  50 MG ORAL TAB,7.5,5.25,,,0
NDC,60687-446-01,IBUPROFEN 400 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-446-11,IBUPROFEN 400 MG ORAL TAB,5.5,3.85,,,0
NDC,60687-447-11,CELECOXIB 200 MG ORAL CAP,20.5,14.35,,,0
NDC,60687-450-11,LABETALOL 200 MG ORAL TAB,9.0,6.3,,,0
NDC,60687-451-11,EPLERENONE  25 MG ORAL TAB,28.0,19.6,,,0
NDC,60687-453-11,LEVOTHYROXINE 25 MCG ORAL TAB,16.0,11.2,,,0
NDC,60687-454-11,TRAZODONE 100 MG ORAL TAB,4.0,2.8,,,0
NDC,60687-457-11,IBUPROFEN 600 MG ORAL TAB,13.0,9.1,,,0
NDC,60687-461-11,LABETALOL 300 MG ORAL TAB,10.5,7.35,,,0
NDC,60687-464-01,LEVOTHYROXINE  50 MCG ORAL TAB,7.0,4.9,,,0
NDC,60687-464-11,LEVOTHYROXINE  50 MCG ORAL TAB,9.5,6.65,,,0
NDC,60687-465-11,SPIRONOLACTONE  25 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-468-11,IBUPROFEN 800 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-473-11,PREGABALIN  25 MG ORAL CAP,49.5,34.65,,,0
NDC,60687-475-01,LEVOTHYROXINE  75 MCG ORAL TAB,17.5,12.25,,,0
NDC,60687-475-11,LEVOTHYROXINE  75 MCG ORAL TAB,9.0,6.3,,,0
NDC,60687-476-11,SPIRONOLACTONE  50 MG ORAL TAB,10.0,7.0,,,0
NDC,60687-479-11,CARBAMAZEPINE 100 MG ORAL CHEW,10.0,7.0,,,0
NDC,60687-480-11,GLIPIZIDE  2.5 MG ORAL TO24,8.0,5.6,,,0
NDC,60687-480-21,GLIPIZIDE  2.5 MG ORAL TO24,27.0,18.9,,,0
NDC,60687-481-11,BUPRENORPHINE 2 MG SL SUBL,34.5,24.15,,,0
NDC,60687-483-01,NITROFURANTOIN MACROCRYSTAL 100 MG ORAL CAP,278.5,194.95,,,0
NDC,60687-484-11,PREGABALIN  50 MG ORAL CAP,27.0,18.9,,,0
NDC,60687-486-11,LEVOTHYROXINE  88 MCG ORAL TAB,7.5,5.25,,,0
NDC,60687-487-11,SPIRONOLACTONE 100 MG ORAL TAB,8.0,5.6,,,0
NDC,60687-488-11,AMLODIPINE  5 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-491-11,NAPROXEN 500 MG ORAL TAB,12.0,8.4,,,0
NDC,60687-492-11,BUPRENORPHINE 8 MG SL SUBL,35.0,24.5,,,0
NDC,60687-493-11,VERAPAMIL 120 MG ORAL TBSR,10.0,7.0,,,0
NDC,60687-495-01,PREGABALIN  75 MG ORAL CAP,9.0,6.3,,,0
NDC,60687-495-11,PREGABALIN  75 MG ORAL CAP,25.5,17.85,,,0
NDC,60687-497-11,LEVOTHYROXINE 100 MCG ORAL TAB,7.0,4.9,,,0
NDC,60687-503-11,BACLOFEN 10 MG ORAL TAB,10.0,7.0,,,0
NDC,60687-506-11,PREGABALIN 100 MG ORAL CAP,16.0,11.2,,,0
NDC,60687-508-11,LEVOTHYROXINE 112 MCG ORAL TAB,7.0,4.9,,,0
NDC,60687-519-11,LEVOTHYROXINE 125 MCG ORAL TAB,7.0,4.9,,,0
NDC,60687-524-79,BUDESONIDE 0.5 MG/2 ML INHL NBSP,55.0,38.5,,,0
NDC,60687-525-11,CINACALCET 30 MG ORAL TAB,329.0,230.3,,,0
NDC,60687-530-11,LEVOTHYROXINE 150 MCG ORAL TAB,6.0,4.2,,,0
NDC,60687-534-40,ATOVAQUONE 750 MG/5 ML ORAL SUSP,238.0,166.6,,,0
NDC,60687-538-11,FEBUXOSTAT 40 MG ORAL TAB,25.5,17.85,,,0
NDC,60687-541-11,LEVOTHYROXINE 175 MCG ORAL TAB,6.5,4.550000000000001,,,0
NDC,60687-544-11,CLONAZEPAM 0.5 MG ORAL TAB,7.5,5.25,,,0
NDC,60687-549-11,RANOLAZINE  500 MG ORAL TB12,14.5,10.15,,,0
NDC,60687-550-11,METRONIDAZOLE 500 MG ORAL TAB,11.0,7.7,,,0
NDC,60687-551-11,DIGOXIN 250 MCG ORAL TAB,8.0,5.6,,,0
NDC,60687-552-11,LEVOTHYROXINE 200 MCG ORAL TAB,10.5,7.3500000000000005,,,0
NDC,60687-553-11,ISONIAZID 300 MG ORAL TAB,8.0,5.6,,,0
NDC,60687-555-11,CLONAZEPAM 1 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-556-33,MESALAMINE 400 MG ORAL CAPSULE-WITH DR TABLETS (CDTI),123.0,86.1,,,0
NDC,60687-558-11,CYCLOBENZAPRINE 10 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-559-01,METHOCARBAMOL 500 MG ORAL TAB,17.0,11.9,,,0
NDC,60687-559-11,METHOCARBAMOL 500 MG ORAL TAB,5.5,3.85,,,0
NDC,60687-568-11,METHOCARBAMOL 750 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-569-11,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TAB,7.0,4.9,,,0
NDC,60687-570-11,PRAMIPEXOLE 0.25 MG ORAL TAB,4.5,3.1500000000000004,,,0
NDC,60687-571-24,ACETAMINOPHEN 160 MG/5 ML ORAL (PHS ERX MERGE),18.0,12.600000000000001,,,0
NDC,60687-572-33,PRAZOSIN 5 MG ORAL CAP,37.0,25.900000000000002,,,0
NDC,60687-573-11,DILTIAZEM 60 MG TAB,7.0,4.9,,,0
NDC,60687-575-11,RIFAMPIN 150 MG ORAL CAP,39.5,27.65,,,0
NDC,60687-576-40,MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRP (MERGE/REPACK),57.0,39.9,,,0
NDC,60687-577-11,ROPINIROLE  0.25 MG ORAL TAB,7.5,5.25,,,0
NDC,60687-578-11,ACETAZOLAMIDE 500 MG ORAL CPSR,44.0,30.8,,,0
NDC,60687-579-11,HYDROMORPHONE  2 MG ORAL TAB,8.0,5.6,,,0
NDC,60687-580-11,GABAPENTIN 100 MG ORAL CAP,26.0,18.2,,,0
NDC,60687-581-11,PRAMIPEXOLE 0.5 MG ORAL TAB,9.0,6.3,,,0
NDC,60687-582-11,HYDROCORTISONE 10 MG ORAL TAB,23.0,16.1,,,0
NDC,60687-583-11,CARBAMAZEPINE 200 MG ORAL TB12,45.0,31.5,,,0
NDC,60687-584-11,MIRTAZAPINE  7.5 MG ORAL TAB,38.0,26.6,,,0
NDC,60687-585-11,PANTOPRAZOLE 20 MG ORAL TBEC,22.0,15.4,,,0
NDC,60687-586-11,RIFAMPIN 300 MG ORAL CAP,16.0,11.2,,,0
NDC,60687-587-11,PROPRANOLOL  10 MG ORAL TAB,8.5,5.95,,,0
NDC,60687-588-11,ROPINIROLE  1 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-590-11,HYDROMORPHONE  4 MG ORAL TAB,8.0,5.6,,,0
NDC,60687-591-11,GABAPENTIN 300 MG ORAL CAP,23.0,16.1,,,0
NDC,60687-592-11,PRAMIPEXOLE 1 MG ORAL TAB,16.0,11.2,,,0
NDC,60687-593-11,HYDROCHLOROTHIAZIDE  25 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-595-11,FAMOTIDINE 20 MG ORAL TAB,5.5,3.85,,,0
NDC,60687-596-33,BUDESONIDE 3 MG ORAL CP24,238.0,166.6,,,0
NDC,60687-598-11,PROPRANOLOL  20 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-602-11,GABAPENTIN 400 MG ORAL CAP,11.5,8.05,,,0
NDC,60687-606-11,"DICLOFENAC 50 MG TAB, DELAYED RELEASE",7.0,4.9,,,0
NDC,60687-607-11,DESVENLAFAXINE  50 MG ORAL TB24,22.0,15.4,,,0
NDC,60687-609-11,PROPRANOLOL  40 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-612-11,VALSARTAN  40 MG ORAL TAB,12.0,8.4,,,0
NDC,60687-614-11,TRIMETHOPRIM-SULFAMETHOXAZOLE 160 MG-800 MG TAB,7.0,4.9,,,0
NDC,60687-620-11,METOCLOPRAMIDE  5 MG ORAL TAB,7.5,5.25,,,0
NDC,60687-622-01,SENNOSIDES-DOCUSATE SODIUM 8.6 MG-50 MG TAB,7.0,4.9,,,0
NDC,60687-622-11,SENNOSIDES-DOCUSATE SODIUM 8.6 MG-50 MG TAB,5.5,3.85,,,0
NDC,60687-623-11,VALSARTAN  80 MG ORAL TAB,15.0,10.5,,,0
NDC,60687-626-11,BUPRENORPHINE-NALOXONE 2-0.5 MG SL SUBL,25.5,17.85,,,0
NDC,60687-627-11,LORAZEPAM 0.5 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-629-11,FENOFIBRATE NANOCRYSTALLIZED 145 MG ORAL TAB,19.0,13.3,,,0
NDC,60687-630-11,NABUMETONE 500 MG ORAL TAB,10.0,7.0,,,0
NDC,60687-631-11,METOCLOPRAMIDE 10 MG ORAL TAB,8.0,5.6,,,0
NDC,60687-632-11,POTASSIUM CHLORIDE  10 MEQ ORAL TBTQ,7.0,4.9,,,0
NDC,60687-633-11,NITROFURANTOIN (25% MACROCRYSTAL FORM) 100 MG CAP,96.5,67.55,,,0
NDC,60687-634-11,VALSARTAN 160 MG ORAL TAB,11.0,7.699999999999999,,,0
NDC,60687-635-01,METOLAZONE  5 MG ORAL TAB,34.5,24.150000000000002,,,0
NDC,60687-635-11,METOLAZONE  5 MG ORAL TAB,34.5,24.150000000000002,,,0
NDC,60687-637-11,BUPRENORPHINE-NALOXONE 8-2 MG SL SUBL,40.0,28.0,,,0
NDC,60687-638-11,LORAZEPAM 1 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-640-11,METFORMIN  500 MG ORAL TB24,7.0,4.9,,,0
NDC,60687-641-11,NEBIVOLOL  5 MG ORAL TAB,45.5,31.85,,,0
NDC,60687-653-11,POTASSIUM CHLORIDE  10 MEQ ORAL CPSR,29.0,20.3,,,0
NDC,60687-656-11,LISINOPRIL  2.5 MG ORAL TAB,7.5,5.25,,,0
NDC,60687-657-11,LEVETIRACETAM  500 MG ORAL TAB,7.5,5.25,,,0
NDC,60687-658-11,"DICLOFENAC 75 MG TAB, DELAYED RELEASE",7.0,4.9,,,0
NDC,60687-660-11,PROMETHAZINE 12.5 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-661-11,CARBIDOPA-LEVODOPA 25 MG-100 MG TAB,8.5,5.95,,,0
NDC,60687-664-11,HYDROXYZINE 10 MG TAB,7.0,4.9,,,0
NDC,60687-669-11,METHIMAZOLE  5 MG ORAL TAB,8.0,5.6,,,0
NDC,60687-671-40,PHENOBARBITAL 20 MG/5 ML ORAL ELIX,30.0,21.0,,,0
NDC,60687-672-11,BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TAB,11.0,7.7,,,0
NDC,60687-675-11,HYDROXYZINE 25 MG TAB,5.0,3.5,,,0
NDC,60687-676-11,LACOSAMIDE  50 MG ORAL TAB,33.5,23.45,,,0
NDC,60687-677-11,ALLOPURINOL 100 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-679-11,BISOPROLOL FUMARATE  5 MG ORAL TAB,9.0,6.3,,,0
NDC,60687-680-11,METHIMAZOLE 10 MG ORAL TAB,10.5,7.35,,,0
NDC,60687-681-11,FOLIC ACID  1 MG ORAL TAB,5.5,3.85,,,0
NDC,60687-695-11,SUCRALFATE 1 GRAM ORAL TAB,7.0,4.9,,,0
NDC,60687-696-11,HYDROXYZINE PAMOATE  25 MG ORAL CAP,5.5,3.85,,,0
NDC,60687-698-11,LACOSAMIDE 200 MG ORAL TAB,22.0,15.4,,,0
NDC,60687-699-11,CEFDINIR 300 MG ORAL CAP,62.5,43.75,,,0
NDC,60687-701-11,GLIPIZIDE 10 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-709-11,PROPAFENONE 150 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-711-11,OXCARBAZEPINE 150 MG ORAL TAB,19.0,13.3,,,0
NDC,60687-717-11,DILTIAZEM 30 MG TAB,8.0,5.6,,,0
NDC,60687-718-11,DEXAMETHASONE 4 MG ORAL TAB,14.0,9.8,,,0
NDC,60687-719-95,EMTRICITABINE-TENOFOVIR 200 MG-300 MG TAB,26.0,18.2,,,0
NDC,60687-721-11,DESMOPRESSIN 0.1 MG ORAL TAB,29.5,20.65,,,0
NDC,60687-722-11,OXCARBAZEPINE 300 MG ORAL TAB,27.0,18.9,,,0
NDC,60687-723-11,DULOXETINE 20 MG ORAL CPDR,120.0,84.0,,,0
NDC,60687-725-11,PANTOPRAZOLE 20 MG ORAL TBEC,77.5,54.25,,,0
NDC,60687-727-11,COLCHICINE 0.6 MG ORAL TAB,82.5,57.75,,,0
NDC,60687-728-11,DILTIAZEM 60 MG TAB,4.5,3.1500000000000004,,,0
NDC,60687-730-11,MECLIZINE 25 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-734-11,DULOXETINE 30 MG ORAL CPDR,59.5,41.650000000000006,,,0
NDC,60687-735-01,MISOPROSTOL 50 MCG ORAL SPLIT TAB,154.0,107.8,,,0
NDC,60687-735-11,MISOPROSTOL 100 MCG ORAL TAB,55.0,38.5,,,0
NDC,60687-736-11,PANTOPRAZOLE 40 MG ORAL TBEC,7.0,4.9,,,0
NDC,60687-739-95,AMINOCAPROIC ACID  500 MG ORAL TAB,847.0,592.9,,,0
NDC,60687-742-11,AZITHROMYCIN 250 MG ORAL TAB,42.0,29.4,,,0
NDC,60687-743-40,IBUPROFEN 100 MG/5 ML ORAL SUSP,20.0,14.0,,,0
NDC,60687-745-11,DULOXETINE 60 MG ORAL CPDR,59.5,41.650000000000006,,,0
NDC,60687-746-01,MISOPROSTOL 200 MCG ORAL TAB,54.0,37.8,,,0
NDC,60687-746-11,MISOPROSTOL 200 MCG ORAL TAB,38.5,26.950000000000003,,,0
NDC,60687-747-11,LURASIDONE 20 MG ORAL TAB,75.0,52.5,,,0
NDC,60687-749-11,FLUPHENAZINE 5 MG TAB,41.0,28.7,,,0
NDC,60687-751-42,ACETAMINOPHEN 160 MG/5 ML ORAL (PHS ERX MERGE),9.0,6.3,,,0
NDC,60687-753-11,AZITHROMYCIN 500 MG ORAL TAB,39.0,27.3,,,0
NDC,60687-754-05,LINEZOLID 100 MG/5 ML ORAL SUSR,343.0,240.1,,,0
NDC,60687-755-40,DIAZEPAM 5 MG/5 ML (5 ML) ORAL SOLN,53.0,37.1,,,0
NDC,60687-760-40,MORPHINE  10 MG/5 ML ORAL SOLN,10.0,7.0,,,0
NDC,60687-768-11,GLIPIZIDE  2.5 MG ORAL TO24,16.5,11.55,,,0
NDC,60687-775-11,MECLIZINE 12.5 MG ORAL TAB,7.5,5.25,,,0
NDC,60687-776-11,AMOXICILLIN 250 MG ORAL CAP,44.0,30.8,,,0
NDC,60687-778-11,MEXILETINE 150 MG ORAL CAP,15.0,10.5,,,0
NDC,60687-781-11,AMOXICILLIN-POT CLAVULANATE 250 MG-125 MG TAB,54.0,37.8,,,0
NDC,60687-787-11,AMOXICILLIN 500 MG ORAL CAP,27.0,18.9,,,0
NDC,60687-789-11,PYRAZINAMIDE 500 MG ORAL TAB,86.0,60.199999999999996,,,0
NDC,60687-792-11,AMOXICILLIN-POT CLAVULANATE 500 MG-125 MG TAB,38.0,26.6,,,0
NDC,60687-793-11,BUPROPION HCL 300 MG ORAL TB24,17.0,11.9,,,0
NDC,60687-795-11,TRAMADOL  50 MG ORAL TAB,5.5,3.85,,,0
NDC,60687-797-42,AMANTADINE 50 MG/5 ML ORAL SYRP,14.0,9.8,,,0
NDC,60687-799-40,HALOPERIDOL 2 MG/ML ORAL CONCENTRATE,7.0,4.9,,,0
NDC,60687-800-40,NYSTATIN 100000 UNIT/ML ORAL SUSP,14.5,10.149999999999999,,,0
NDC,60687-803-01,AMOXICILLIN-POT CLAVULANATE 875 MG-125 MG TAB,43.0,30.1,,,0
NDC,60687-803-11,AMOXICILLIN-POT CLAVULANATE 875 MG-125 MG TAB,43.0,30.1,,,0
NDC,60687-807-11,CHLORDIAZEPOXIDE 25 MG CAP,27.0,18.9,,,0
NDC,60687-811-11,HYDRALAZINE  10 MG ORAL TAB,5.5,3.85,,,0
NDC,60687-813-11,METHYLERGONOVINE 0.2 MG ORAL TAB,280.0,196.0,,,0
NDC,60687-815-11,BACLOFEN 10 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-822-11,HYDRALAZINE  25 MG ORAL TAB,5.5,3.85,,,0
NDC,60687-825-11,PROCHLORPERAZINE MALEATE 10 MG ORAL TAB,10.0,7.0,,,0
NDC,60687-826-11,BACLOFEN 20 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-833-11,HYDRALAZINE  50 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-836-11,CARBIDOPA-LEVODOPA 25 MG-250 MG TAB,7.0,4.9,,,0
NDC,60687-838-11,ZOLPIDEM  5 MG ORAL TAB,5.5,3.85,,,0
NDC,60687-841-11,PHENYTOIN SODIUM EXTENDED 100 MG ORAL CAP,26.5,18.55,,,0
NDC,60687-854-11,PREDNISONE 50 MG ORAL TAB,5.0,3.5,,,0
NDC,60687-861-11,CLONAZEPAM 0.5 MG ORAL TAB,7.5,5.25,,,0
NDC,60687-863-42,GUAIFENESIN 100 MG/5 ML ORAL LIQD,19.0,13.3,,,0
NDC,60687-867-11,ACYCLOVIR 800 MG ORAL TAB,7.0,4.9,,,0
NDC,60687-868-11,DIVALPROEX 250 MG ORAL TBEC,4.5,3.1500000000000004,,,0
NDC,60687-885-11,MYCOPHENOLATE 250 MG CAP,9.0,6.3,,,0
NDC,60687-886-11,PRAVASTATIN 10 MG ORAL TAB,7.0,4.9,,,0
NDC,60758-119-05,PREDNISOLONE ACETATE 1 % OPHT DROPS,224.0,156.8,,,0
NDC,60758-188-05,GENTAMICIN 0.3 % OPHT DROP,94.0,65.8,,,0
NDC,60758-801-05,TIMOLOL MALEATE 0.5 % OPHT DROP,37.0,25.9,,,0
NDC,60758-880-05,FLUOROMETHOLONE 0.1 % OPHT DRPS,395.0,276.5,,,0
NDC,60760-002-21,PREDNISONE 20 MG ORAL TAB,7.0,4.9,,,0
NDC,60793-315-01,THROMBIN (BOVINE)  5000 UNIT TOP SOLR,386.0,270.2,,,0
NDC,60793-600-02,"PENICILLIN G BENZATHINE&PROCAIN 1,200,000 UNIT/2 ML IM SYRINGE",861.0,602.7,,,0
NDC,60793-601-02,"PENICILLIN G BENZATHINE&PROCAIN 1,200,000 UNIT/2 ML IM SYRINGE",861.0,602.7,,,0
NDC,60793-700-01,PENICILLIN G BENZATHINE 600000 UNIT/ML IM SYRG,1515.5,1060.85,,,0
NDC,60793-700-10,PENICILLIN G BENZATHINE 1200000 UNIT/2 ML IM SYRG,3043.0,2130.1,,,0
NDC,60793-701-02,PENICILLIN G BENZATHINE 600000 UNIT/ML IM SYRG,1188.0,831.6,,,0
NDC,60793-701-10,PENICILLIN G BENZATHINE 600000 UNIT/ML IM SYRG,1188.0,831.6,,,0
NDC,60793-702-04,PENICILLIN G BENZATHINE 2400000 UNIT/4 ML IM SYRG,1898.0,1328.6,,,0
NDC,60793-702-10,PENICILLIN G BENZATHINE 1200000 UNIT/2 ML IM SYRG,1993.0,1395.1,,,0
NDC,60793-850-01,LEVOXYL 25 MCG ORAL TAB (FOR NEONATAL PATIENTS),7.5,5.25,,,0
NDC,61269-220-41,CLOTRIMAZOLE 1 % VAGL CREA,27.0,18.9,,,0
NDC,61269-220-63,CLOTRIMAZOLE 1 % VAGL CREA,27.0,18.9,,,0
NDC,61269-518-12,BUDESONIDE 180 MCG/INHALATION INHL AEPB,937.0,655.9,,,0
NDC,61269-881-35,DOCOSANOL 10 % TOP CREAM,79.0,55.3,,,0
NDC,61269-981-35,DOCOSANOL 10 % TOP CREAM,118.0,82.6,,,0
NDC,61314-014-25,DICLOFENAC 0.1 % EYE DROPS,219.0,153.3,,,0
NDC,61314-016-01,PROPARACAINE 0.5 % OPHT DROP,215.0,150.5,,,0
NDC,61314-019-10,DORZOLAMIDE 2 % OPHT DROP,284.0,198.8,,,0
NDC,61314-126-05,KETOROLAC TROMETHAMINE 0.5 % OPHT DROP,380.0,266.0,,,0
NDC,61314-143-05,BRIMONIDINE 0.2 % OPHT DROP,160.0,112.0,,,0
NDC,61314-203-15,PILOCARPINE 1 % EYE DROPS,418.0,292.6,,,0
NDC,61314-204-15,PILOCARPINE 2 % EYE DROPS,363.0,254.1,,,0
NDC,61314-226-05,TIMOLOL MALEATE 0.25 % OPHT DROP,74.0,51.8,,,0
NDC,61314-226-10,TIMOLOL MALEATE 0.25 % OPHT DROP,136.0,95.2,,,0
NDC,61314-227-05,TIMOLOL MALEATE 0.5 % OPHT DROP,167.0,116.9,,,0
NDC,61314-228-94,DENOSUMAB-BBDZ 120 MG/1.7 ML (70 MG/ML) SUBQ SOLN,8855.0,6198.5,,,0
NDC,61314-237-10,CROMOLYN 4 % OPHT DROP,182.0,127.4,,,0
NDC,61314-240-63,DENOSUMAB-BBDZ 60 MG/ML SUBQ SYRG,4428.0,3099.6,,,0
NDC,61314-304-01,FILGRASTIM-SNDZ 300 MCG/0.5 ML INJ SYRG,976.0,683.2,,,0
NDC,61314-304-10,FILGRASTIM-SNDZ 300 MCG/0.5 ML INJ SYRG,976.0,683.2,,,0
NDC,61314-318-01,FILGRASTIM-SNDZ 300 MCG/0.5 ML INJ SYRG,972.0,680.4,,,0
NDC,61314-318-05,FILGRASTIM-SNDZ 300 MCG/0.5 ML INJ SYRG,1457.5,1020.25,,,0
NDC,61314-318-10,FILGRASTIM-SNDZ 300 MCG/0.5 ML INJ SYRG,972.0,680.4,,,0
NDC,61314-326-01,FILGRASTIM-SNDZ 480 MCG/0.8 ML INJ SYRG,1212.0,848.4,,,0
NDC,61314-326-05,FILGRASTIM-SNDZ 480 MCG/0.8 ML INJ SYRG,1212.0,848.4,,,0
NDC,61314-354-01,TROPICAMIDE 0.5 % OPHT DROP,131.0,91.7,,,0
NDC,61314-355-01,TROPICAMIDE 1 % OPHT DROP,69.0,48.3,,,0
NDC,61314-396-01,CYCLOPENTOLATE 1 % OPHT DROP,83.0,58.1,,,0
NDC,61314-547-01,LATANOPROST 0.005 % OPHT DROP,403.0,282.1,,,0
NDC,61314-547-03,LATANOPROST 0.005 % OPHT DROP,403.0,282.1,,,0
NDC,61314-628-10,"TRIMETHOPRIM-POLYMYXIN B 0.1 %-10,000 UNIT/ML EYE DROPS",46.5,32.550000000000004,,,0
NDC,61314-630-06,"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",216.0,151.2,,,0
NDC,61314-631-36,"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG-10,000 UNIT/G-0.1 % EYE OINTMENT",216.0,151.2,,,0
NDC,61314-633-05,GENTAMICIN 0.3 % OPHT DROP,213.0,149.1,,,0
NDC,61314-637-05,PREDNISOLONE ACETATE 1 % OPHT DROPS,399.0,279.3,,,0
NDC,61314-641-75,"NEOMYCIN-POLYMYXIN-HC 3.5 MG-10,000 UNIT-10 MG/ML EYE DROPS, SUSP",674.0,471.8,,,0
NDC,61314-643-05,TOBRAMYCIN 0.3 % EYE DROPS,167.0,116.9,,,0
NDC,61314-645-11,"NEOMYCIN-POLYMYXIN-HC 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS, SUSP",378.0,264.6,,,0
NDC,61314-646-10,"NEOMYCIN-POLYMYXIN-HC 3.5 MG-10,000 UNIT/ML-1 % EAR SOLN",378.0,264.6,,,0
NDC,61314-647-25,"TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE DROPS, SUSP",308.0,215.6,,,0
NDC,61314-656-05,CIPROFLOXACIN 0.3 % OPHT DROP,232.0,162.4,,,0
NDC,61314-656-25,CIPROFLOXACIN 0.3 % OPHT DROP,123.0,86.1,,,0
NDC,61442-121-10,FAMOTIDINE 20 MG ORAL TAB,18.0,12.600000000000001,,,0
NDC,61442-142-01,LOVASTATIN 20 MG ORAL TAB,24.0,16.799999999999997,,,0
NDC,61553-009-02,VANCOMYCIN IN 0.9% SODIUM CL 1.25 GRAM/250 ML IV SOLN,153.0,107.1,,,0
NDC,61553-0118-53,FENTANYL CITRATE (PF) 50 MCG/ML INJ (REPACK)(MERGE) (FOR PCA),80.0,56.0,,,0
NDC,61553-012-72,CEFAZOLIN SODIUM-STERILE WATER 1 GRAM/10 ML IV SYRG,60.0,42.0,,,0
NDC,61553-056-48,CALCIUM GLUCONATE IN 0.9% NACL 3 GRAM/100 ML IV SOLN,170.0,119.0,,,0
NDC,61553-149-61,PHENYLEPHRINE PEDS IV INFUSION (CDS MIXTURE),16.0,11.2,,,0
NDC,61553-227-02,ROPIVACAINE IN NACL(PF) 0.15 % EPID SOLN,514.0,359.8,,,0
NDC,61553-290-53,MIDAZOLAM 1 MG/ML IN NS (PREMIX),95.0,66.5,,,0
NDC,61553-320-70,KETAMINE 50 MG/5ML (10 MG/ML) SYRINGE (PHS MERGE),69.0,48.3,,,0
NDC,61553-331-65,KETAMINE IN 0.9 % SOD CHLORIDE 100 MG/10 ML (10 MG/ML) IV SYRG,191.0,133.7,,,0
NDC,61553-479-78,FENTANYL 5 MCG/ML INJECTION,25.0,17.5,,,0
NDC,61553-481-80,SODIUM CITRATE 4% (3 ML) SYRINGE (FOR DIALYSIS),16.0,11.2,,,0
NDC,61553-735-03,OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN,155.0,108.5,,,0
NDC,61553-820-41,MORPHINE 1 MG/ML PCA (PDS MERGE),122.0,85.4,,,0
NDC,61553-830-41,HYDROMORPHONE 10 MG/50 ML (0.2MG/ML) PCA IN NS (MERGE),94.5,66.15,,,0
NDC,61553-844-48,FENTANYL-ROPIVACAINE-NACL (PF) 2-0.2 MCG/ML-% INJ (MERGE ERX),588.0,411.6,,,0
NDC,61570-131-20,SILVER SULFADIAZINE 1 % TOP CREA,266.0,186.2,,,0
NDC,61570-131-50,SILVER SULFADIAZINE 1 % TOP CREA,85.0,59.5,,,0
NDC,61703-309-06,VINCRISTINE 2 MG/2 ML IV SOLN,157.0,109.9,,,0
NDC,61703-309-16,VINCRISTINE 2 MG/2 ML IV SOLN,46.0,32.2,,,0
NDC,61703-319-22,CYTARABINE 100 MG/ML INJ SOLN,298.5,208.95,,,0
NDC,61703-324-18,PAMIDRONATE 3 MG/ML IV SOLN,170.0,119.0,,,0
NDC,61703-326-18,PAMIDRONATE 9 MG/ML IV SOLN,217.0,151.9,,,0
NDC,61703-332-18,BLEOMYCIN 15 UNITS/5 ML INJ SOLR (WET SOLR VIAL),509.0,356.3,,,0
NDC,61703-339-22,CARBOPLATIN 10 MG/ML IV,137.0,95.9,,,0
NDC,61703-339-50,CARBOPLATIN 10 MG/ML IV,360.0,252.0,,,0
NDC,61703-339-56,CARBOPLATIN 10 MG/ML IV,451.5,316.04999999999995,,,0
NDC,61703-342-22,PACLITAXEL 6 MG/ML IV CONC,103.0,72.1,,,0
NDC,61703-342-50,PACLITAXEL 6 MG/ML IV CONC,265.0,185.5,,,0
NDC,61703-343-65,MITOXANTRONE 2 MG/ML IV CONC,183.0,128.1,,,0
NDC,61703-350-37,METHOTREXATE SODIUM 25 MG/ML INJ SOLN,92.5,64.75,,,0
NDC,61703-363-22,OXALIPLATIN 100 MG/20 ML IV SOLN,622.5,435.75,,,0
NDC,61703-408-41,METHOTREXATE NA (PRESERV FREE) 25 MG/ML INJ SOLN,1509.0,1056.3,,,0
NDC,61748-012-06,PYRAZINAMIDE 500 MG ORAL TAB,124.0,86.8,,,0
NDC,61748-044-16,AMINOCAPROIC ACID 25 % ORAL SYRP,158.0,110.6,,,0
NDC,61755-008-01,CEMIPLIMAB-RWLC 50 MG/ML IV SOLN,25491.0,17843.7,,,0
NDC,61755-010-01,EVINACUMAB-DGNB 150 MG/ML IV SOLN,93288.0,65301.6,,,0
NDC,61825-701-15,LIDOCAINE 4 % TOP CREA,54.0,37.8,,,0
NDC,61958-0701-1,EMTRICITABINE-TENOFOVIR 200 MG-300 MG TAB,313.0,219.1,,,0
NDC,61958-2002-1,EMTRICITABINE-TENOFOVIR ALAFEN 200-25 MG ORAL TAB,374.0,261.8,,,0
NDC,61958-2002-2,EMTRICITABINE-TENOFOVIR ALAFEN 200-25 MG ORAL TAB,374.0,261.8,,,0
NDC,61958-2501-1,BICTEGRAV-EMTRICIT-TENOFOV ALA 50-200-25 MG ORAL TAB,591.0,413.70000000000005,,,0
NDC,61958-2501-3,BICTEGRAV-EMTRICIT-TENOFOV ALA 50-200-25 MG ORAL TAB,608.0,425.6,,,0
NDC,61958-2901-1,REMDESIVIR 100 MG IV SOLR,1196.0,837.2,,,0
NDC,61958-2901-2,HC IV INFUSION HYDRAT 31-60 MIN,415.0,290.5,,,0
NDC,62037-560-01,POTASSIUM CHLORIDE  10 MEQ ORAL CPSR,9.5,6.65,,,0
NDC,6210333302,ZINC OXIDE 16 % TOP PSTE,32.0,22.4,,,0
NDC,6210333304,ZINC OXIDE 16 % TOP PSTE,52.0,36.4,,,0
NDC,62135-266-60,TETRACYCLINE 500 MG ORAL CAP,78.0,54.6,,,0
NDC,62135-340-62,SODIUM POLYSTYRENE SULFONATE ORAL POWDER,343.5,240.45,,,0
NDC,62135-417-46,DOXYCYCLINE 25 MG/5 ML ORAL SUSP,43.0,30.1,,,0
NDC,62135-579-12,HYDRALAZINE  10 MG ORAL TAB,17.0,11.9,,,0
NDC,62135-712-42,LIDOCAINE 2 % MUCOSAL SOLN (VISCOUS),13.0,9.1,,,0
NDC,62135-750-47,HYDROXYZINE 10 MG/5 ML SYRUP,45.0,31.5,,,0
NDC,62135-774-41,PROMETHAZINE  6.25 MG/5 ML ORAL SYRP,74.0,51.8,,,0
NDC,62135-813-47,NYSTATIN 100000 UNIT/ML ORAL SUSP,18.0,12.6,,,0
NDC,62135-829-84,ALBUTEROL SULFATE 2.5 MG/0.5 ML INHL NEBU,28.0,19.6,,,0
NDC,62135-842-60,SULFADIAZINE 500 MG ORAL TAB,255.0,178.5,,,0
NDC,62175-107-01,ISOSORBIDE MONONITRATE  20 MG ORAL TAB,7.0,4.9,,,0
NDC,62175-114-32,OMEPRAZOLE-SODIUM BICARBONATE 2-84 MG/ML ORAL SUSR,9.0,6.3,,,0
NDC,62175-270-37,OXYBUTYNIN CHLORIDE  5 MG ORAL TO24,43.5,30.45,,,0
NDC,62175-310-37,METHYLPHENIDATE 18 MG ORAL TO24,61.0,42.7,,,0
NDC,62175-470-32,PAROXETINE SR 12.5 MG 24 HR TAB,31.0,21.7,,,0
NDC,62175-471-32,PAROXETINE SR 25 MG 24 HR TAB,33.0,23.1,,,0
NDC,62175-472-32,PAROXETINE SR 37.5 MG 24 HR TAB,34.0,23.8,,,0
NDC,62295-5013-3,LET TOPICAL GEL 3 ML,56.0,39.2,,,0
NDC,62327-333-03,STERILE TALC 3 G INPL AERP,450.0,315.0,,,0
NDC,62327-444-04,STERILE TALC 4 G INPL SUSR,234.5,164.15,,,0
NDC,62332-023-31,FLUOXETINE 20 MG ORAL CAP,14.0,9.8,,,0
NDC,62332-033-31,ROPINIROLE  2 MG ORAL TAB,21.0,14.700000000000001,,,0
NDC,62332-037-31,LAMOTRIGINE  25 MG ORAL TAB,61.0,42.7,,,0
NDC,62332-062-30,LEFLUNOMIDE  20 MG ORAL TAB,63.5,44.45,,,0
NDC,62332-190-30,FEBUXOSTAT 40 MG ORAL TAB,91.5,64.05000000000001,,,0
NDC,62332-246-31,AMANTADINE 100 MG ORAL CAP,16.5,11.55,,,0
NDC,62332-253-30,AZITHROMYCIN 600 MG ORAL TAB,183.0,128.1,,,0
NDC,62332-413-10,OSELTAMIVIR PHOSPHATE 30 MG ORAL CAP,70.0,49.0,,,0
NDC,62332-518-05,TOBRAMYCIN 0.3 % EYE DROPS,167.0,116.9,,,0
NDC,62332-553-10,DORZOLAMIDE-TIMOLOL 2 %-0.5 % EYE DROPS,440.0,308.0,,,0
NDC,62332-582-04,LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,51.0,35.7,,,0
NDC,62332-599-01,KETOROLAC TROMETHAMINE 15 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,62332-600-01,KETOROLAC TROMETHAMINE 30 MG/ML INJ SOLN,26.0,18.2,,,0
NDC,62332-601-02,KETOROLAC TROMETHAMINE 60 MG/2 ML IM SOLN,9.0,6.3,,,0
NDC,62332-618-31,CYCLOPHOSPHAMIDE  25 MG ORAL CAP,50.0,35.0,,,0
NDC,62332-619-31,CYCLOPHOSPHAMIDE  50 MG ORAL CAP,477.5,334.25,,,0
NDC,62332-738-31,CHLORPROMAZINE 100 MG ORAL TAB,73.0,51.1,,,0
NDC,62332-745-31,GUANFACINE 1 MG ORAL TB24,128.5,89.94999999999999,,,0
NDC,62332-746-31,GUANFACINE 2 MG ORAL TB24,77.5,54.25,,,0
NDC,62332-751-50,FLUOROURACIL 500 MG/10 ML IV SOLN,146.5,102.55000000000001,,,0
NDC,62559-138-07,HYDROCORTISONE 100 MG/60 ML RECT ENEM,126.0,88.2,,,0
NDC,62559-157-17,POLYETHYLENE GLYCOL 3350 17 GRAM (100 %) ORAL PWPK,14.5,10.15,,,0
NDC,62559-190-16,METOCLOPRAMIDE HCL 5 MG/5 ML ORAL SOLN,7.0,4.9,,,0
NDC,62559-204-12,BACLOFEN 25 MG/5 ML (5 MG/ML) ORAL SUSP,63.0,44.099999999999994,,,0
NDC,62559-225-30,AMINOCAPROIC ACID  500 MG ORAL TAB,285.0,199.5,,,0
NDC,62559-251-01,ETODOLAC 300 MG ORAL CAP,9.0,6.3,,,0
NDC,62559-390-20,VANCOMYCIN  125 MG ORAL CAP,358.5,250.95,,,0
NDC,62559-390-50,VANCOMYCIN  125 MG ORAL CAP,266.0,186.2,,,0
NDC,62559-431-30,HYDROCORTISONE  2.5 % RECT CREA,353.0,247.1,,,0
NDC,62559-440-02,ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL SUSR,52.0,36.4,,,0
NDC,62559-490-01,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TAB,7.0,4.9,,,0
NDC,62559-511-01,INDAPAMIDE 2.5 MG ORAL TAB,8.0,5.6,,,0
NDC,62559-730-01,FELBAMATE 400 MG ORAL TAB,48.0,33.6,,,0
NDC,62559-741-01,THYROID (PORK)  30 MG ORAL TAB,12.0,8.4,,,0
NDC,62559-821-01,MEXILETINE 200 MG ORAL CAP,17.0,11.9,,,0
NDC,62559-822-01,MEXILETINE 250 MG ORAL CAP,20.0,14.0,,,0
NDC,62584-265-01,METOPROLOL TARTRATE 25 MG TAB,7.0,4.9,,,0
NDC,62584-265-11,METOPROLOL TARTRATE 25 MG TAB,5.5,3.85,,,0
NDC,62584-266-11,METOPROLOL TARTRATE 50 MG TAB,5.5,3.85,,,0
NDC,62584-267-11,METOPROLOL TARTRATE 100 MG TAB,5.5,3.85,,,0
NDC,62584-339-11,CLONIDINE 0.2 MG ORAL TAB,7.0,4.9,,,0
NDC,62584-693-11,DOXYCYCLINE HYCLATE 100 MG ORAL TAB,23.5,16.45,,,0
NDC,62584-733-11,HYDRALAZINE  25 MG ORAL TAB,7.0,4.9,,,0
NDC,62584-734-11,HYDRALAZINE  50 MG ORAL TAB,7.0,4.9,,,0
NDC,62584-813-11,OXAZEPAM 15 MG ORAL CAP,35.0,24.5,,,0
NDC,62584-984-11,WARFARIN  2 MG ORAL TAB,8.0,5.6,,,0
NDC,62584-994-11,WARFARIN  5 MG ORAL TAB,8.0,5.6,,,0
NDC,62756-233-01,AMPHOTERICIN B LIPOSOME 50 MG IV SUSR,2255.0,1578.5,,,0
NDC,62756-240-60,ONDANSETRON 4 MG ORAL TBDL,218.0,152.6,,,0
NDC,62756-240-64,ONDANSETRON 4 MG ORAL TBDL,163.5,114.44999999999999,,,0
NDC,62756-348-44,OCTREOTIDE ACETATE   50 MCG/ML INJ SOLN,55.0,38.5,,,0
NDC,62756-356-64,ONDANSETRON 8 MG ORAL TBDL,180.0,126.0,,,0
NDC,62756-427-90,"CIPROFLOXACIN-DEXAMETHASONE 0.3 %-0.1 % EAR DROPS, SUSP",434.5,304.15,,,0
NDC,62756-461-88,CARBIDOPA-LEVODOPA SR 25 MG-100 MG TAB,7.0,4.9,,,0
NDC,62756-589-88,LIOTHYRONINE  5 MCG ORAL TAB,9.0,6.3,,,0
NDC,62756-590-88,LIOTHYRONINE 25 MCG ORAL TAB,7.0,4.9,,,0
NDC,62756-711-86,TOPIRAMATE 100 MG ORAL TAB,68.0,47.6,,,0
NDC,62756-796-88,DIVALPROEX 125 MG ORAL TBEC,8.5,5.95,,,0
NDC,62756-797-88,DIVALPROEX 250 MG ORAL TBEC,17.5,12.25,,,0
NDC,62756-798-88,DIVALPROEX 500 MG ORAL TBEC,27.0,18.9,,,0
NDC,62856-212-01,LECANEMAB-IRMB 100 MG/ML IV SOLN,2747.0,1922.9,,,0
NDC,62856-215-01,LECANEMAB-IRMB 100 MG/ML IV SOLN,1341.5,939.0500000000001,,,0
NDC,62856-389-01,ERIBULIN 0.5 MG/ML IV SOLN,5708.0,3995.6,,,0
NDC,62856-600-01,DECITABINE 50 MG IV SOLR,2834.0,1983.8000000000002,,,0
NDC,62935-163-60,LEUPROLIDE (PEDIATRIC 6 MONTH) 45 MG SUBQ SYRG,75743.0,53020.1,,,0
NDC,62935-221-04,LEUPROLIDE 22.5 MG SUBQ SYRG,1176.0,823.2,,,0
NDC,62935-223-05,LEUPROLIDE 22.5 MG SUBQ SYRG,1176.0,823.2,,,0
NDC,62935-227-10,LEUPROLIDE 22.5 MG SUBQ SYRG,1175.5,822.85,,,0
NDC,62935-306-40,LEUPROLIDE (4-MONTH) 30 MG SUBQ SYRG,1176.0,823.2,,,0
NDC,62935-453-45,LEUPROLIDE (6 MONTH) 45 MG SUBCUTANOUS KIT,588.0,411.6,,,0
NDC,62935-454-44,LEUPROLIDE (6 MONTH) 45 MG SUBCUTANOUS KIT,1176.0,823.2,,,0
NDC,62935-461-50,LEUPROLIDE (6 MONTH) 45 MG SUBCUTANOUS KIT,1176.0,823.2,,,0
NDC,62935-753-75,LEUPROLIDE  7.5 MG SUBQ SYRG,1176.0,823.2,,,0
NDC,62935-754-74,LEUPROLIDE  7.5 MG SUBQ SYRG,1176.0,823.2,,,0
NDC,62935-756-80,LEUPROLIDE  7.5 MG SUBQ SYRG,1176.0,823.2,,,0
NDC,62991-2796-01,FERRIC SUBSULFATE 0.2 TO 0.22 GRAM/ML SOLN BULK,227.0,158.9,,,0
NDC,63020-049-01,BORTEZOMIB 3.5 MG IV SOLR,3350.5,2345.35,,,0
NDC,63029-322-01,CARBAMIDE PEROXIDE 6.5 % OTIC DROP,28.5,19.95,,,0
NDC,63037-119-05,DILTIAZEM IN D5W 125 MG/125 ML (1 MG/ML) IV SOLN (PREMIX),106.5,74.55000000000001,,,0
NDC,63037-136-25,KETAMINE 50 MG/5ML (10 MG/ML) SYRINGE (PHS MERGE),31.0,21.7,,,0
NDC,63037-155-25,ROCURONIUM 50 MG/5 ML (10 MG/ML) IV SYRG,50.5,35.35,,,0
NDC,63037-173-25,PHENYLEPHRINE IN 0.9% NS (PF) 1 MG/10 ML (100 MCG/ML) IV SYRG(PDS MERGE),47.0,32.9,,,0
NDC,63187-661-01,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,108.0,75.6,,,0
NDC,63304-205-18,MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRP (MERGE/REPACK),42.5,29.75,,,0
NDC,63304-352-60,LUBIPROSTONE 24 MCG ORAL CAP,38.0,26.6,,,0
NDC,63304-721-90,DILTIAZEM SR 300 MG 24 HR CAP,15.0,10.5,,,0
NDC,63304-758-01,MORPHINE  60 MG ORAL TBSR,35.0,24.5,,,0
NDC,63304-773-01,LORAZEPAM 1 MG ORAL TAB,3.0,2.0999999999999996,,,0
NDC,63304-774-01,LORAZEPAM 2 MG ORAL TAB,7.0,4.9,,,0
NDC,63323-010-01,GENTAMICIN 40 MG/ML INJ SOLN,83.0,58.1,,,0
NDC,63323-010-02,GENTAMICIN 40 MG/ML INJ SOLN,93.0,65.1,,,0
NDC,63323-010-03,GENTAMICIN 40 MG/ML INJ SOLN,78.5,54.95,,,0
NDC,63323-010-94,GENTAMICIN 40 MG/ML INJ SOLN,35.5,24.85,,,0
NDC,63323-012-03,OXYTOCIN 10 UNIT/ML INJ SOLN,46.0,32.2,,,0
NDC,63323-012-11,OXYTOCIN 10 UNIT/ML INJ SOLN,80.5,56.35,,,0
NDC,63323-013-01,THIAMINE 100 MG/ML INJECTION,88.0,61.6,,,0
NDC,63323-024-01,MANNITOL 25 % IV SOLN,177.0,123.9,,,0
NDC,63323-026-05,SODIUM BICARBONATE   4.2 % IV SOLN,17.0,11.9,,,0
NDC,63323-044-00,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,46.0,32.2,,,0
NDC,63323-044-01,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,34.5,24.150000000000002,,,0
NDC,63323-044-44,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,410.0,287.0,,,0
NDC,63323-047-10,HEPARIN (PORCINE)  5000 UNIT/ML INJ SOLN,21.0,14.7,,,0
NDC,63323-064-01,MAGNESIUM SULFATE 50 % (4 MEQ/ML) INJ SOLN,53.5,37.45,,,0
NDC,63323-064-02,MAGNESIUM SULFATE 50 % (4 MEQ/ML) INJ SOLN,22.0,15.4,,,0
NDC,63323-064-04,MAGNESIUM SULFATE 50 % (4 MEQ/ML) INJ SOLN,18.0,12.600000000000001,,,0
NDC,63323-083-05,SODIUM BICARBONATE   4.2 % IV SOLN,89.0,62.3,,,0
NDC,63323-086-05,POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML IV SOLP,87.0,60.9,,,0
NDC,63323-089-50,SODIUM BICARBONATE 8.4 % IV SOLN,365.0,255.5,,,0
NDC,63323-093-01,SODIUM CHLORIDE 4 MEQ/ML IV SOLP (COMPOUNDED 30ML),48.0,33.6,,,0
NDC,63323-093-30,23.4% SODIUM CHLORIDE (4 MEQ/ML) INJECTION,45.0,31.5,,,0
NDC,63323-095-02,23.4% SODIUM CHLORIDE (4 MEQ/ML) INJECTION,23.5,16.45,,,0
NDC,63323-099-03,NEO TPN SODIUM CHLORIDE 4 MEQ/ML IV SOLN,38.5,26.950000000000003,,,0
NDC,63323-103-64,CISPLATIN 1 MG/ML IV,248.0,173.6,,,0
NDC,63323-103-65,CISPLATIN 1 MG/ML IV,182.0,127.39999999999999,,,0
NDC,63323-104-01,ETOPOSIDE 20 MG/ML IV SOLN,54.0,37.8,,,0
NDC,63323-104-05,ETOPOSIDE 20 MG/ML IV SOLN,110.5,77.35,,,0
NDC,63323-104-06,ETOPOSIDE 20 MG/ML IV SOLN,92.0,64.4,,,0
NDC,63323-104-25,ETOPOSIDE 20 MG/ML IV SOLN,85.0,59.5,,,0
NDC,63323-106-00,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IV PGBK,53.5,37.45,,,0
NDC,63323-106-02,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IV PGBK,113.5,79.45,,,0
NDC,63323-106-15,MAGNESIUM SULFATE 20 GRAM/500 ML IV SOLP,42.0,29.4,,,0
NDC,63323-108-00,MAGNESIUM SULFATE IN D5W 1 GRAM/100 ML IV PGBK,104.5,73.15,,,0
NDC,63323-113-01,PENTAMIDINE 300 MG INJ SOLR,228.5,159.95,,,0
NDC,63323-117-00,FLUOROURACIL 1 GRAM/20 ML IV SOLN,34.5,24.150000000000002,,,0
NDC,63323-117-01,FLUOROURACIL 500 MG/10 ML IV SOLN,69.0,48.3,,,0
NDC,63323-117-10,FLUOROURACIL 500 MG/10 ML IV SOLN,46.0,32.2,,,0
NDC,63323-117-51,FLUOROURACIL 5 GRAM/100 ML IV SOLN,173.0,121.1,,,0
NDC,63323-117-61,FLUOROURACIL 500 MG/10 ML IV SOLN,258.5,180.95,,,0
NDC,63323-120-20,CYTARABINE 100 MG/ML INJ SOLN,123.0,86.1,,,0
NDC,63323-123-10,METHOTREXATE SODIUM 25 MG/ML INJ SOLN,71.0,49.7,,,0
NDC,63323-127-00,DACARBAZINE 100 MG IV SOLR,62.0,43.400000000000006,,,0
NDC,63323-128-00,DACARBAZINE 200 MG IV SOLR,231.0,161.7,,,0
NDC,63323-130-02,DOXYCYCLINE HYCLATE 100 MG IV SOLR,310.0,217.0,,,0
NDC,63323-137-20,BLEOMYCIN 30 UNITS/10 ML INJ SOLR (WET SOLR VIAL),389.0,272.3,,,0
NDC,63323-161-00,KETOROLAC TROMETHAMINE 15 MG/ML INJ SOLN,23.0,16.1,,,0
NDC,63323-162-00,KETOROLAC TROMETHAMINE 30 MG/ML INJ SOLN,22.5,15.75,,,0
NDC,63323-162-01,KETOROLAC TROMETHAMINE 30 MG/ML INJ SOLN,28.5,19.950000000000003,,,0
NDC,63323-162-02,KETOROLAC TROMETHAMINE 60 MG/2 ML IM SOLN,55.0,38.5,,,0
NDC,63323-162-03,KETOROLAC TROMETHAMINE 60 MG/2 ML IM SOLN,16.0,11.2,,,0
NDC,63323-162-12,KETOROLAC TROMETHAMINE 30 MG/ML INJ SOLN,34.0,23.8,,,0
NDC,63323-162-45,KETOROLAC TROMETHAMINE 60 MG/2 ML IM SOLN,16.0,11.2,,,0
NDC,63323-164-26,LACTATED RINGERS IV (CLINIC BOLUS),34.0,23.8,,,0
NDC,63323-165-01,DEXAMETHASONE 4 MG/ML INJECTION,34.0,23.8,,,0
NDC,63323-165-02,DEXAMETHASONE 20MG/55 ML IVPB IN NS (ONCOLOGY),80.5,56.35,,,0
NDC,63323-165-05,DEXAMETHASONE 4 MG/ML INJECTION,19.0,13.3,,,0
NDC,63323-165-16,DEXAMETHASONE 4 MG/ML INJECTION,16.0,11.2,,,0
NDC,63323-165-30,DEXAMETHASONE 4 MG/ML INJECTION,99.0,69.3,,,0
NDC,63323-170-05,SODIUM PHOSPHATE 3 MMOL/ML IV SOLN,95.0,66.5,,,0
NDC,63323-172-60,CARBOPLATIN 10 MG/ML IV,467.0,326.9,,,0
NDC,63323-173-01,GENTAMICIN (PF) 10 MG/ML INJECTION (NEONATAL IM USE),513.5,359.45,,,0
NDC,63323-173-02,GENTAMICIN (PF) 10 MG/ML INJECTION (NEONATAL IM USE),42.0,29.4,,,0
NDC,63323-180-00,PYRIDOXINE 100 MG/ML INJ SOLN,128.0,89.6,,,0
NDC,63323-184-10,FOLIC ACID 1 MG / 0.2 ML SYRINGE (CDS ADS REPACK),8.0,5.6,,,0
NDC,63323-185-05,"WATER FOR INJECTION, STERILE INJECTION",147.5,103.25,,,0
NDC,63323-185-07,"WATER FOR INJECTION, STERILE INJECTION",80.5,56.35,,,0
NDC,63323-185-08,"WATER FOR INJECTION, STERILE INJECTION",44.0,30.8,,,0
NDC,63323-185-09,"WATER FOR INJECTION, STERILE INJECTION",28.0,19.6,,,0
NDC,63323-185-10,"WATER FOR INJECTION, STERILE INJECTION",63.0,44.099999999999994,,,0
NDC,63323-185-50,"WATER FOR INJECTION, STERILE INJECTION",50.0,35.0,,,0
NDC,63323-186-00,SODIUM CHLORIDE 0.9 % INJ SOLN (VIAL),67.0,46.9,,,0
NDC,63323-186-01,SODIUM CHLORIDE 0.9 % INJ SOLN (VIAL),21.0,14.7,,,0
NDC,63323-186-03,SODIUM CHLORIDE 0.9 % INJ SOLN (VIAL),16.0,11.2,,,0
NDC,63323-186-10,SODIUM CHLORIDE 0.9 % INJ SOLN (VIAL),16.0,11.2,,,0
NDC,63323-186-20,SODIUM CHLORIDE 0.9 % INJ SOLN (VIAL),19.0,13.3,,,0
NDC,63323-187-30,23.4% SODIUM CHLORIDE (4 MEQ/ML) INJECTION,23.0,16.1,,,0
NDC,63323-192-02,FLUDARABINE 50 MG/2 ML IV SOLN,1925.0,1347.5,,,0
NDC,63323-194-10,IDARUBICIN 1 MG/ML IV SOLN,469.0,328.3,,,0
NDC,63323-194-20,IDARUBICIN 1 MG/ML IV SOLN,814.0,569.8,,,0
NDC,63323-201-01,LIDOCAINE 10 MG/ML (1 %) INJECTION,19.0,13.3,,,0
NDC,63323-201-02,LIDOCAINE 10 MG/ML (1 %) INJECTION,52.0,36.4,,,0
NDC,63323-201-03,LIDOCAINE 10 MG/ML (1 %) INJECTION,17.0,11.899999999999999,,,0
NDC,63323-201-10,LIDOCAINE 10 MG/ML (1 %) INJECTION,17.0,11.899999999999999,,,0
NDC,63323-202-02,LIDOCAINE 20 MG/ML (2 %) INJECTION,30.5,21.35,,,0
NDC,63323-203-01,VANCOMYCIN  750 MG IV SOLR,84.0,58.800000000000004,,,0
NDC,63323-208-01,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,92.0,64.4,,,0
NDC,63323-208-05,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,46.0,32.2,,,0
NDC,63323-221-01,VANCOMYCIN  500 MG IV SOLR,47.0,32.9,,,0
NDC,63323-229-01,PROTAMINE 10 MG/ML IV SOLN,73.0,51.1,,,0
NDC,63323-229-05,PROTAMINE 10 MG/ML IV SOLN,136.5,95.55000000000001,,,0
NDC,63323-229-30,PROTAMINE 10 MG/ML IV SOLN,302.0,211.4,,,0
NDC,63323-237-10,CEFAZOLIN   1 GRAM INJ SOLR,24.0,16.8,,,0
NDC,63323-255-03,METHYLPREDNISOLONE 40 MG SOLUTION FOR INJECTION,30.0,21.0,,,0
NDC,63323-258-03,METHYLPREDNISOLONE 125 MG INJECTION SOLR,69.0,48.3,,,0
NDC,63323-259-30,BACTERIOSTATIC SALINE 0.9 % INJ SOLN,17.0,11.899999999999999,,,0
NDC,63323-260-01,MEPIVACAINE (PF) 10 MG/ML (1 %) INJ SOLN,62.0,43.400000000000006,,,0
NDC,63323-265-30,"METHYLPREDNISOLONE 1,000 MG SOLUTION FOR INJECTION",301.5,211.04999999999998,,,0
NDC,63323-269-22,PROPOFOL 10 MG/ML 20ML BOLUS IV EMUL,71.0,49.7,,,0
NDC,63323-269-29,PROPOFOL IV BOLUS 10MG/ML (ANESTHESIA ONLY),74.0,51.8,,,0
NDC,63323-269-35,PROPOFOL 10 MG/ML 100ML INFUSION IV EMUL,177.0,123.9,,,0
NDC,63323-269-43,PROPOFOL 10 MG/ML 100ML INFUSION IV EMUL,32.0,22.4,,,0
NDC,63323-269-50,PROPOFOL 10 MG/ML 100ML INFUSION IV EMUL,84.0,58.8,,,0
NDC,63323-269-65,PROPOFOL 10 MG/ML 100ML INFUSION IV EMUL,150.0,105.0,,,0
NDC,63323-269-69,PROPOFOL 10 MG/ML 100ML INFUSION IV EMUL,82.0,57.4,,,0
NDC,63323-272-05,FLUPHENAZINE DECANOATE 25 MG/ML INJ SOLN,670.0,469.0,,,0
NDC,63323-278-10,VINBLASTINE 1 MG/ML IV SOLN,411.0,287.70000000000005,,,0
NDC,63323-280-01,FUROSEMIDE 10 MG/ML INJ SOLN,22.0,15.4,,,0
NDC,63323-280-02,FUROSEMIDE 10 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,63323-280-03,FUROSEMIDE 10 MG/ML INJ SOLN,33.0,23.1,,,0
NDC,63323-280-04,FUROSEMIDE 10 MG/ML INJ SOLN,38.0,26.6,,,0
NDC,63323-280-05,FUROSEMIDE 10 MG/ML INJ SOLN,22.0,15.4,,,0
NDC,63323-284-01,VANCOMYCIN 1000 MG IV SOLR,129.0,90.3,,,0
NDC,63323-284-26,VANCOMYCIN 1000 MG IV SOLR,72.0,50.400000000000006,,,0
NDC,63323-285-10,ROPIVACAINE  2 MG/ML INJ SOLN,97.0,67.9,,,0
NDC,63323-285-20,ROPIVACAINE  2 MG/ML INJ SOLN,142.5,99.75,,,0
NDC,63323-285-23,ROPIVACAINE  2 MG/ML INJ SOLN,130.0,91.0,,,0
NDC,63323-285-64,ROPIVACAINE (PF) 0.2 % 330 ML (RIGHT) (PHS CUSTOM PAIN BALL),580.0,406.0,,,0
NDC,63323-286-20,ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN,139.0,97.3,,,0
NDC,63323-286-30,ROPIVACAINE 0.5%/EPINEPHRINE 1:100K INJECTION,130.5,91.35,,,0
NDC,63323-288-03,ROPIVACAINE 10 MG/ML INJ SOLN,67.0,46.9,,,0
NDC,63323-288-07,ROPIVACAINE 10 MG/ML INJ SOLN,200.5,140.35,,,0
NDC,63323-288-11,ROPIVACAINE 10 MG/ML INJ SOLN,67.0,46.9,,,0
NDC,63323-294-01,MEPIVACAINE (PF) 20 MG/ML (2 %) INJ SOLN,50.5,35.349999999999994,,,0
NDC,63323-295-61,VANCOMYCIN  5 GRAM IV SOLR,142.0,99.4,,,0
NDC,63323-303-51,TOBRAMYCIN 1.2 G POWDER VIAL,361.0,252.7,,,0
NDC,63323-306-02,TOBRAMYCIN SULFATE 40 MG/ML INJ SOLN,68.0,47.6,,,0
NDC,63323-306-30,TOBRAMYCIN 150 MG/3.75 ML NEBULIZER SOLN (REPACK),21.0,14.7,,,0
NDC,63323-311-10,CALCIUM GLUCONATE 20MG/ML IV SYRINGE (PEDS/NEO),40.5,28.35,,,0
NDC,63323-311-19,CALCIUM GLUCONATE (FOR EMERGENCY) 100 MG/ML (10%) IV SOLN,47.0,32.9,,,0
NDC,63323-315-10,GANCICLOVIR NEO IV SYRINGE (CDS MIXTURE),9.5,6.65,,,0
NDC,63323-318-01,GRANISETRON (PF) 1 MG/ML (1 ML) IV SOLN,118.0,82.6,,,0
NDC,63323-322-01,IMIPENEM-CILASTATIN 500 MG IV SOLR,264.0,184.8,,,0
NDC,63323-325-03,ACYCLOVIR SODIUM 50 MG/ML IV SOLN,126.0,88.2,,,0
NDC,63323-325-09,ACYCLOVIR SODIUM 50 MG/ML IV SOLN,206.0,144.2,,,0
NDC,63323-325-10,ACYCLOVIR NEO/PEDS INFUSION (CDS FROM PREMIX),31.0,21.7,,,0
NDC,63323-325-14,ACYCLOVIR SODIUM 50 MG/ML IV SOLN,57.5,40.25,,,0
NDC,63323-325-20,ACYCLOVIR SODIUM 50 MG/ML IV SOLN,206.0,144.2,,,0
NDC,63323-327-10,NAFCILLIN NEO/PEDS (CDS MIXTURE),28.0,19.6,,,0
NDC,63323-328-21,NAFCILLIN  2 GRAM INJ SOLR,255.0,178.5,,,0
NDC,63323-330-60,NAFCILLIN 10 GRAM INJ SOLR,612.0,428.4,,,0
NDC,63323-346-01,CEFTRIAXONE 1 GRAM INJ SOLR,26.0,18.2,,,0
NDC,63323-347-20,CEFTRIAXONE   2 GRAM INJ SOLR,26.0,18.2,,,0
NDC,63323-351-20,RIFAMPIN 600 MG IV SOLR,269.5,188.64999999999998,,,0
NDC,63323-360-01,CALCIUM GLUCONATE (FOR EMERGENCY) 100 MG/ML (10%) IV SOLN,88.5,61.949999999999996,,,0
NDC,63323-360-03,CALCIUM GLUCONATE (FOR EMERGENCY) 100 MG/ML (10%) IV SOLN,317.0,221.9,,,0
NDC,63323-360-05,CALCIUM GLUCONATE (FOR EMERGENCY) 100 MG/ML (10%) IV SOLN,275.0,192.5,,,0
NDC,63323-360-19,CALCIUM GLUCONATE (FOR EMERGENCY) 100 MG/ML (10%) IV SOLN,118.0,82.6,,,0
NDC,63323-368-20,AMPICILLIN-SULBACTAM NEO/PEDS (CDS MIXTURE),28.0,19.6,,,0
NDC,63323-369-20,AMPICILLIN-SULBACTAM  3 GRAM INJ SOLR,52.0,36.4,,,0
NDC,63323-373-02,ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN,23.0,16.1,,,0
NDC,63323-376-00,OCTREOTIDE ACETATE  100 MCG/ML INJ SOLN,102.5,71.75,,,0
NDC,63323-376-01,OCTREOTIDE ACETATE  100 MCG/ML INJ SOLN,59.0,41.3,,,0
NDC,63323-377-00,OCTREOTIDE ACETATE  500 MCG/ML INJ SOLN,253.0,177.1,,,0
NDC,63323-377-01,OCTREOTIDE ACETATE  500 MCG/ML INJ SOLN,253.0,177.1,,,0
NDC,63323-383-10,NEOSTIGMINE 1MG/ML (UD) OR SYRINGE,48.0,33.6,,,0
NDC,63323-387-10,AMPICILLIN 250 MG SOLUTION FOR INJECTION,16.0,11.2,,,0
NDC,63323-398-01,AZITHROMYCIN 500 MG IV SOLR,50.0,35.0,,,0
NDC,63323-398-14,AZITHROMYCIN NEO/PEDS IV SYRINGE (CDS MIXTURE),36.0,25.2,,,0
NDC,63323-399-23,AMPICILLIN SODIUM  2 GRAM INJ SOLR,53.0,37.1,,,0
NDC,63323-400-01,LEVETIRACETAM 500 MG/5 ML IV SOLN,98.0,68.6,,,0
NDC,63323-401-01,AZTREONAM 1 GRAM INJ SOLR,159.0,111.30000000000001,,,0
NDC,63323-401-20,AZTREONAM 20 MG/ML IV SYRINGE (FOR NEO/PEDS),18.0,12.6,,,0
NDC,63323-402-01,AZTREONAM 2 GRAM INJ SOLR,166.5,116.55000000000001,,,0
NDC,63323-402-41,AZTREONAM 2 GRAM INJ SOLR,270.0,189.0,,,0
NDC,63323-403-01,FOSPHENYTOIN 100 MG PE/2 ML INJ SOLN,59.5,41.65,,,0
NDC,63323-406-03,CAFFEINE CITRATE 20 MG/ML ORAL SOLN,51.5,36.05,,,0
NDC,63323-411-15,MIDAZOLAM 1 MG/ML INJ SOLN,649.0,454.3,,,0
NDC,63323-411-18,MIDAZOLAM 1 MG/ML INJ SOLN,22.0,15.4,,,0
NDC,63323-412-03,MIDAZOLAM (PF) 5 MG/ML INJ SOLN,43.0,30.1,,,0
NDC,63323-415-10,NEOSTIGMINE 1MG/ML (UD) OR SYRINGE,493.0,345.1,,,0
NDC,63323-416-05,CISATRACURIUM  2 MG/ML IV SOLN,83.0,58.1,,,0
NDC,63323-424-05,FLUMAZENIL 0.1 MG/ML IV SOLN,99.0,69.3,,,0
NDC,63323-426-02,ROCURONIUM 10 MG/ML IV SOLN,46.0,32.2,,,0
NDC,63323-426-05,ROCURONIUM 10 MG/ML IV SOLN,46.0,32.2,,,0
NDC,63323-434-41,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) IVPB (PEDIATRICS/ADULT NON-FORM)",57.0,39.9,,,0
NDC,63323-452-00,MORPHINE 2 MG/ML IV SOLN (PHS/CDS MERGE),34.0,23.8,,,0
NDC,63323-454-00,MORPHINE 4 MG/ML IV SOLN (PHS/CDS MERGE),24.0,16.8,,,0
NDC,63323-461-01,"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJ SOLN",46.0,32.2,,,0
NDC,63323-462-01,"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN",106.0,74.2,,,0
NDC,63323-462-17,"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJ SOLN",92.0,64.4,,,0
NDC,63323-463-01,"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN",114.5,80.15,,,0
NDC,63323-464-01,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN,36.0,25.200000000000003,,,0
NDC,63323-464-02,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN,55.0,38.5,,,0
NDC,63323-464-17,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJ SOLN,34.0,23.8,,,0
NDC,63323-465-01,BUPIVACAINE 0.25 % (2.5 MG/ML) INJ SOLN,41.0,28.7,,,0
NDC,63323-465-57,BUPIVACAINE 0.25 % (2.5 MG/ML) INJ SOLN,34.0,23.8,,,0
NDC,63323-466-01,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN,34.5,24.15,,,0
NDC,63323-466-03,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN,19.0,13.3,,,0
NDC,63323-466-09,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN,16.0,11.2,,,0
NDC,63323-466-17,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN,54.0,37.8,,,0
NDC,63323-466-31,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN,33.0,23.1,,,0
NDC,63323-467-01,BUPIVACAINE 0.5 % (5 MG/ML) INJ SOLN,33.0,23.1,,,0
NDC,63323-467-57,BUPIVACAINE 0.5 % (5 MG/ML) INJ SOLN,16.0,11.2,,,0
NDC,63323-468-01,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN",51.0,35.7,,,0
NDC,63323-468-17,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN",48.0,33.6,,,0
NDC,63323-468-37,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJ SOLN",125.0,87.5,,,0
NDC,63323-473-02,BUPIVACAINE-DEXTROSE-WATER(PF) 7.5 MG/ML (0.75 %) INJ SOLN,40.0,28.0,,,0
NDC,63323-474-00,HALOPERIDOL LACTATE 5 MG/ML INJECTION (MERGE),36.0,25.2,,,0
NDC,63323-474-01,HALOPERIDOL LACTATE 5 MG/ML INJECTION (MERGE),40.0,28.0,,,0
NDC,63323-476-37,CHLOROPROCAINE 2 % INJ SOLN,109.0,76.3,,,0
NDC,63323-478-01,CHLOROPROCAINE 3 % INJ SOLN,31.0,21.7,,,0
NDC,63323-478-20,CHLOROPROCAINE 3 % INJ SOLN,25.0,17.5,,,0
NDC,63323-481-01,"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJ SOLN",27.5,19.25,,,0
NDC,63323-482-01,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN",23.0,16.1,,,0
NDC,63323-482-03,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN",26.0,18.2,,,0
NDC,63323-482-05,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN",23.0,16.1,,,0
NDC,63323-482-17,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN",48.5,33.95,,,0
NDC,63323-482-26,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN",16.0,11.2,,,0
NDC,63323-482-27,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN",35.5,24.85,,,0
NDC,63323-482-41,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN",27.0,18.9,,,0
NDC,63323-482-57,"LIDOCAINE-EPINEPHRINE 1 %-1:100,000 INJ SOLN",41.5,29.049999999999997,,,0
NDC,63323-485-01,LIDOCAINE 10 MG/ML (1 %) INJECTION,16.0,11.2,,,0
NDC,63323-485-03,LIDOCAINE 10 MG/ML (1 %) INJECTION,23.0,16.1,,,0
NDC,63323-485-26,LIDOCAINE 10 MG/ML (1 %) INJECTION,16.0,11.2,,,0
NDC,63323-485-27,LIDOCAINE 10 MG/ML (1 %) INJECTION,22.5,15.75,,,0
NDC,63323-485-41,LIDOCAINE 10 MG/ML (1 %) INJECTION,16.0,11.2,,,0
NDC,63323-485-57,LIDOCAINE 10 MG/ML (1 %) INJECTION,38.0,26.6,,,0
NDC,63323-486-01,LIDOCAINE 2% 20MG/ML (5ML-UD) OR SYRINGE,19.5,13.65,,,0
NDC,63323-486-02,LIDOCAINE 20 MG/ML (2 %) INJECTION,20.0,14.0,,,0
NDC,63323-486-05,LIDOCAINE 20 MG/ML (2 %) INJECTION,29.0,20.3,,,0
NDC,63323-486-17,LIDOCAINE 20 MG/ML (2 %) INJECTION,19.0,13.3,,,0
NDC,63323-486-20,LIDOCAINE 20 MG/ML (2 %) INJECTION,19.0,13.3,,,0
NDC,63323-486-26,LIDOCAINE 20 MG/ML (2 %) INJECTION,16.0,11.2,,,0
NDC,63323-486-27,LIDOCAINE 20 MG/ML (2 %) INJECTION,23.0,16.1,,,0
NDC,63323-486-41,LIDOCAINE 20 MG/ML (2 %) INJECTION,16.0,11.2,,,0
NDC,63323-486-57,LIDOCAINE 20 MG/ML (2 %) INJECTION,48.0,33.6,,,0
NDC,63323-487-01,"LIDOCAINE-EPINEPHRINE 1 %-1:200,000 INJ SOLN",114.0,79.8,,,0
NDC,63323-487-03,"LIDOCAINE-EPINEPHRINE 1 %-1:200,000 INJ SOLN",9.5,6.65,,,0
NDC,63323-487-07,"LIDOCAINE-EPINEPHRINE 1 %-1:200,000 INJ SOLN",85.5,59.85,,,0
NDC,63323-487-31,"LIDOCAINE-EPINEPHRINE 1 %-1:200,000 INJ SOLN",60.0,42.0,,,0
NDC,63323-487-37,"LIDOCAINE-EPINEPHRINE 1 %-1:200,000 INJ SOLN",91.0,63.7,,,0
NDC,63323-488-07,"LIDOCAINE-EPINEPHRINE 1.5 %-1:200,000 INJ SOLN",105.0,73.5,,,0
NDC,63323-489-01,"LIDOCAINE-EPINEPHRINE 2 %-1:200,000 INJ SOLN",103.5,72.44999999999999,,,0
NDC,63323-489-02,"LIDOCAINE-EPINEPHRINE 2 %-1:200,000 INJ SOLN",46.0,32.2,,,0
NDC,63323-489-03,"LIDOCAINE-EPINEPHRINE 2 %-1:200,000 INJ SOLN",16.0,11.2,,,0
NDC,63323-489-21,"LIDOCAINE-EPINEPHRINE 2 %-1:200,000 INJ SOLN",16.0,11.2,,,0
NDC,63323-489-27,"LIDOCAINE-EPINEPHRINE 2 %-1:200,000 INJ SOLN",138.0,96.6,,,0
NDC,63323-491-01,LIDOCAINE (PF) 5 MG/ML (0.5 %) INJ SOLN,26.5,18.55,,,0
NDC,63323-492-02,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,16.0,11.2,,,0
NDC,63323-492-04,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,87.0,60.9,,,0
NDC,63323-492-07,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,104.5,73.15,,,0
NDC,63323-492-08,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,18.0,12.6,,,0
NDC,63323-492-09,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,131.0,91.7,,,0
NDC,63323-492-16,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,18.5,12.95,,,0
NDC,63323-492-26,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,36.0,25.2,,,0
NDC,63323-492-27,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,165.0,115.5,,,0
NDC,63323-492-31,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,36.0,25.200000000000003,,,0
NDC,63323-492-37,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,70.0,49.0,,,0
NDC,63323-492-41,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,18.0,12.6,,,0
NDC,63323-492-43,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,16.0,11.2,,,0
NDC,63323-492-45,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,18.0,12.6,,,0
NDC,63323-492-57,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,50.5,35.35,,,0
NDC,63323-492-89,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,97.0,67.9,,,0
NDC,63323-492-97,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,40.0,28.0,,,0
NDC,63323-493-01,LIDOCAINE (PF) 15 MG/ML (1.5 %) INJ SOLN,19.0,13.3,,,0
NDC,63323-493-91,LIDOCAINE (PF) 15 MG/ML (1.5 %) INJ SOLN,81.0,56.7,,,0
NDC,63323-494-01,VALPROATE SODIUM 100 MG/ML IV SOLN,50.5,35.35,,,0
NDC,63323-495-04,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,96.0,67.2,,,0
NDC,63323-495-07,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,36.0,25.200000000000003,,,0
NDC,63323-495-09,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,29.5,20.65,,,0
NDC,63323-495-26,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,20.0,14.0,,,0
NDC,63323-495-27,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,78.0,54.6,,,0
NDC,63323-496-97,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,47.0,32.9,,,0
NDC,63323-506-00,DEXAMETHASONE SODIUM PHOS (PF) 10MG/ML INJ SOLN,25.0,17.5,,,0
NDC,63323-506-01,DEXAMETHASONE SODIUM PHOS (PF) 10MG/ML INJ SOLN,55.0,38.5,,,0
NDC,63323-506-41,DEXAMETHASONE SODIUM PHOS (PF) 10MG/ML INJ SOLN,9.0,6.3,,,0
NDC,63323-507-01,MEROPENEM 500 MG IV SOLR,20.0,14.0,,,0
NDC,63323-507-20,MEROPENEM 500 MG IV SOLR,20.0,14.0,,,0
NDC,63323-508-01,MEROPENEM 1 GRAM IV SOLR,275.0,192.5,,,0
NDC,63323-513-02,GENTAMICIN (PF) NEO IV SYRINGE (CDS MIXTURE),14.5,10.15,,,0
NDC,63323-516-10,DEXAMETHASONE 10 MG/ML INJECTION,53.5,37.45,,,0
NDC,63323-523-01,HEPARIN (PORCINE) IN D5W 25000 UNIT/250 ML (ANTI-XA MONITORING),63.0,44.1,,,0
NDC,63323-544-01,HEPARIN LOCK FLUSH (PORCINE)  10 UNIT/ML IV SOLN,262.5,183.75,,,0
NDC,63323-545-01,HEPARIN LOCK FLUSH 100 UNIT/ML IV SOLN,22.0,15.4,,,0
NDC,63323-545-05,HEPARIN LOCK FLUSH 100 UNIT/ML IV SOLN,16.0,11.2,,,0
NDC,63323-562-10,BIVALIRUDIN 250 MG IV SOLR,940.0,658.0,,,0
NDC,63323-563-97,TRANEXAMIC ACID (FOR TOPICAL USE),448.5,313.95000000000005,,,0
NDC,63323-564-21,ENOXAPARIN 40 MG/0.4 ML SUBQ SYRG,25.0,17.5,,,0
NDC,63323-565-86,ENOXAPARIN 20 MG/ML IN NS NEONATAL INJECTION (REPACK),72.0,50.4,,,0
NDC,63323-574-86,ICATIBANT 30 MG/3 ML SUBQ SYRG,3588.0,2511.6,,,0
NDC,63323-578-03,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,66.5,46.55,,,0
NDC,63323-582-82,GLUCAGON 1 MG/ML INJ (MERGE),1981.0,1386.7,,,0
NDC,63323-583-13,GLUCAGON 1 MG/ML INJ (MERGE),991.0,693.7,,,0
NDC,63323-586-21,ENOXAPARIN 100 MG/1 ML SUBQ SYRG,52.5,36.75,,,0
NDC,63323-593-03,GLUCAGON 1 MG/ML INJ (MERGE),1118.5,782.95,,,0
NDC,63323-596-03,GLUCAGON 1 MG/ML INJ (MERGE),1118.5,782.95,,,0
NDC,63323-596-11,GLUCAGON 1 MG/ML INJ (MERGE),3131.0,2191.7,,,0
NDC,63323-597-10,DEFEROXAMINE 500 MG INJ SOLR,152.0,106.4,,,0
NDC,63323-599-30,DEFEROXAMINE 2 GRAM INJ SOLR,242.0,169.4,,,0
NDC,63323-604-00,PROPRANOLOL  1 MG/ML IV SOLN,135.0,94.5,,,0
NDC,63323-604-01,PROPRANOLOL  1 MG/ML IV SOLN,135.0,94.5,,,0
NDC,63323-614-00,HYDRALAZINE 20 MG/ML INJ SOLN,134.5,94.15,,,0
NDC,63323-616-02,AMIODARONE 50 MG/ML IV SOLN,33.5,23.45,,,0
NDC,63323-616-03,AMIODARONE 50 MG/ML IV SOLN,27.0,18.9,,,0
NDC,63323-616-09,AMIODARONE 50 MG/ML IV SOLN,37.0,25.9,,,0
NDC,63323-617-10,MILRINONE 1 MG/ML IV SOLN,235.0,164.5,,,0
NDC,63323-623-10,SODIUM CHLORIDE 0.9 % IV (CLINIC BOLUS),79.0,55.3,,,0
NDC,63323-623-61,SODIUM CHLORIDE 0.9 % IV SOLP,20.0,14.0,,,0
NDC,63323-623-76,SODIUM CHLORIDE 0.9 % IV (CLINIC BOLUS),28.0,19.6,,,0
NDC,63323-624-06,DEXTROSE 5% IN WATER (D5W) IV,16.0,11.2,,,0
NDC,63323-642-50,MAGNESIUM SULFATE 50 % (4 MEQ/ML) INJ SOLN,2077.0,1453.8999999999999,,,0
NDC,63323-647-10,LEVOTHYROXINE 200 MCG INJ SOLR,934.0,653.8,,,0
NDC,63323-648-10,LEVOTHYROXINE 500 MCG INJ SOLR,1458.0,1020.6,,,0
NDC,63323-649-07,LEVOTHYROXINE 100 MCG IV SOLR,976.5,683.55,,,0
NDC,63323-649-94,LEVOTHYROXINE 20 MCG/ML IV SYRINGE (PEDIATRIC),80.0,56.0,,,0
NDC,63323-651-00,ADENOSINE 3000 MCG/ML INJECTION,161.0,112.69999999999999,,,0
NDC,63323-651-21,ADENOSINE 3 MG/ML IV SYRG,94.0,65.8,,,0
NDC,63323-652-10,ESMOLOL  100 MG/10 ML IV SOLN,145.5,101.85,,,0
NDC,63323-658-20,CHLOROTHIAZIDE SODIUM 500 MG IV SOLR,1054.0,737.8,,,0
NDC,63323-658-94,CHLOROTHIAZIDE SODIUM 500 MG IV SOLR,229.0,160.3,,,0
NDC,63323-660-01,METOPROLOL TARTRATE 5 MG/5 ML IV,30.0,21.0,,,0
NDC,63323-660-05,METOPROLOL TARTRATE 5 MG/5 ML IV,25.0,17.5,,,0
NDC,63323-664-00,DIPHENHYDRAMINE 50 MG/ML INJECTION,51.0,35.7,,,0
NDC,63323-664-01,DIPHENHYDRAMINE 50 MG/ML INJECTION,21.0,14.7,,,0
NDC,63323-665-00,TERBUTALINE 1 MG/ML SUBQ SOLN,2948.0,2063.6,,,0
NDC,63323-665-01,TERBUTALINE 1 MG/ML SUBQ SOLN,2948.0,2063.6,,,0
NDC,63323-671-50,DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) IV SOLN,219.0,153.3,,,0
NDC,63323-673-05,PALONOSETRON 0.25 MG/5 ML IV INJECTION (MERGE),235.0,164.5,,,0
NDC,63323-694-04,ACETYLCYSTEINE 20 % (200 MG/ML) MISC SOLN,54.0,37.8,,,0
NDC,63323-694-22,ACETYLCYSTEINE 20 % (200 MG/ML) MISC SOLN,94.0,65.8,,,0
NDC,63323-694-41,ACETYLCYSTEINE 20 % (200 MG/ML) MISC SOLN,29.0,20.3,,,0
NDC,63323-695-04,ACETYLCYSTEINE 10 % (100 MG/ML) MISC SOLN,80.5,56.35,,,0
NDC,63323-695-22,ACETYLCYSTEINE 10 % (100 MG/ML) MISC SOLN,62.0,43.4,,,0
NDC,63323-696-02,EPINEPHRINE 1 MG/ML (1ML) INJ SOLN,33.5,23.45,,,0
NDC,63323-710-50,LEUCOVORIN CALCIUM 200 MG INJ SOLR,127.0,88.9,,,0
NDC,63323-713-03,LINEZOLID 600 MG/300 ML IV SOLP,233.5,163.45,,,0
NDC,63323-715-05,FULVESTRANT 250 MG/5 ML IM SYRG,2760.0,1932.0,,,0
NDC,63323-724-01,REMIFENTANIL 2 MG IV SOLR,556.0,389.2,,,0
NDC,63323-729-01,MICAFUNGIN 100 MG IV SOLR,306.0,214.2,,,0
NDC,63323-739-11,FAMOTIDINE (PF) 20 MG/2 ML IV SOLN,16.0,11.2,,,0
NDC,63323-739-12,FAMOTIDINE (PF) 20 MG/2 ML IV SOLN,16.0,11.2,,,0
NDC,63323-739-41,FAMOTIDINE (PF) 20 MG/2 ML IV SOLN,20.0,14.0,,,0
NDC,63323-762-10,TOPOTECAN 4 MG IV SOLR,832.0,582.4,,,0
NDC,63323-778-21,METHOCARBAMOL 100 MG/ML INJ SOLN,59.0,41.3,,,0
NDC,63323-806-02,FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN,16.0,11.2,,,0
NDC,63323-806-12,FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN,31.0,21.7,,,0
NDC,63323-806-13,FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN,52.0,36.4,,,0
NDC,63323-806-14,FENTANYL CITRATE (PF) 50 MCG/ML INJ SOLN,75.0,52.5,,,0
NDC,63323-806-50,FENTANYL CITRATE (PF) 50 MCG/ML IV SOLN,147.0,102.9,,,0
NDC,63323-820-00,FAT EMUL-SOY-MCT-OLIV-FISH OIL 20 % IV EMUL (NEO/PEDS),24.0,16.8,,,0
NDC,63323-820-01,FAT EMUL-SOY-MCT-OLIV-FISH OIL 20 % IV EMUL,36.0,25.2,,,0
NDC,63323-820-04,FAT EMUL-SOY-MCT-OLIV-FISH OIL 20 % IV EMUL,160.5,112.35,,,0
NDC,63323-850-74,MOXIFLOXACIN 400 MG/250 ML IVPB PREMIX (MERGE),235.0,164.5,,,0
NDC,63323-851-03,HYDROMORPHONE (PF) 10 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,63323-852-03,HYDROMORPHONE (PF) 1 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,63323-865-02,CALCITONIN (SALMON) 200 UNIT/ML INJ SOLN,1750.5,1225.35,,,0
NDC,63323-875-50,FOSCARNET 24 MG/ML IV SOLN,1305.0,913.5,,,0
NDC,63323-877-15,PENTAMIDINE 300 MG INHL SOLR,721.0,504.7,,,0
NDC,63323-881-01,SODIUM PHOSPHATE 3 MMOL/ML IV SOLN,81.0,56.7,,,0
NDC,63323-883-30,DOXORUBICIN 50 MG/25 ML IV SOLN,294.0,205.79999999999998,,,0
NDC,63323-884-01,SODIUM PHOSPHATE 3 MMOL/ML IV SOLN,133.0,93.1,,,0
NDC,63323-924-10,BACTERIOSTATIC SALINE 0.9 % INJ SOLN,16.0,11.2,,,0
NDC,63323-924-30,BACTERIOSTATIC SALINE 0.9 % INJ SOLN,16.0,11.2,,,0
NDC,63323-930-01,VASOPRESSIN 20 UNIT/ML IV SOLN,47.5,33.25,,,0
NDC,63323-963-21,ACETYLCYSTEINE 20 % (200 MG/ML) IV SOLN,1188.5,831.95,,,0
NDC,63323-965-01,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLP,33.5,23.450000000000003,,,0
NDC,63323-965-02,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLP,18.0,12.6,,,0
NDC,63323-965-03,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLP,16.0,11.2,,,0
NDC,63323-965-05,POTASSIUM CHLORIDE 2 MEQ/ML ORAL SOLUTION (FOR PEDIATRIC USE),18.5,12.95,,,0
NDC,63323-965-10,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLP,23.5,16.45,,,0
NDC,63323-972-10,FOSAPREPITANT 150 MG IV SOLR,540.0,378.0,,,0
NDC,63323-983-23,PIPERACILLIN-TAZOBACTAM  3.375 GRAM IV SOLR,82.0,57.4,,,0
NDC,6332325402,MINERAL OIL,116.5,81.55,,,0
NDC,6332325410,MINERAL OIL,31.0,21.7,,,0
NDC,63361-243-15,"DIP,PER(A)TET-HEPB-POL-HIB(PF) 15 UNIT-5 UNIT- 10 MCG/0.5 ML IM INJ MERGE (CAM USE ONLY)",652.5,456.75,,,0
NDC,63361-243-58,"DIP,PER(A)TET-HEPB-POL-HIB(PF) 15 UNIT-5 UNIT- 10 MCG/0.5 ML IM INJ MERGE (CAM USE ONLY)",674.0,471.8,,,0
NDC,63361-243-88,"DIP,PER(A)TET-HEPB-POL-HIB(PF) 15 UNIT-5 UNIT- 10 MCG/0.5 ML IM INJ MERGE (CAM USE ONLY)",652.5,456.75,,,0
NDC,63395-201-13,CEVIMELINE 30 MG ORAL CAP,52.0,36.4,,,0
NDC,63402-308-30,LURASIDONE  80 MG ORAL TAB,325.0,227.5,,,0
NDC,63459-103-10,RITUXIMAB-ABBS 10 MG/ML IV SOLN,23338.0,16336.6,,,0
NDC,63459-104-50,RITUXIMAB-ABBS 10 MG/ML IV SOLN,17503.5,12252.45,,,0
NDC,63459-348-04,BENDAMUSTINE 25 MG/ML IV SOLN,9252.0,6476.4,,,0
NDC,63629-1030-1,"HYOSCYAMINE 0.125 MG TAB, RAPID DISSOLVE",7.0,4.9,,,0
NDC,63629-1061-1,SPIRONOLACTONE  25 MG ORAL TAB,7.0,4.9,,,0
NDC,63629-1064-3,SPIRONOLACTONE  25 MG ORAL TAB,7.0,4.9,,,0
NDC,63629-1266-2,MECLIZINE 25 MG ORAL TAB,7.0,4.9,,,0
NDC,63629-1579-2,PREDNISONE 10 MG ORAL TAB,2.0,1.4,,,0
NDC,63629-1587-1,PREDNISONE 20 MG ORAL TAB,7.0,4.9,,,0
NDC,63629-2072-1,PROPRANOLOL  80 MG ORAL CS24,20.5,14.35,,,0
NDC,6373612002,PERMETHRIN 1 % TOP LIQD (REPACK),54.0,37.8,,,0
NDC,6373612003,PERMETHRIN 1 % TOP LIQD (REPACK),62.0,43.4,,,0
NDC,63739-003-33,TEMAZEPAM  7.5 MG ORAL CAP,85.5,59.849999999999994,,,0
NDC,63739-051-10,AMIODARONE 200 MG ORAL TAB,4.5,3.1500000000000004,,,0
NDC,63739-060-10,CLONIDINE 20 MCG/ML ORAL SYRUP (LOW CONC NEONATAL ONLY),7.0,4.9,,,0
NDC,63739-069-33,ARIPIPRAZOLE  2 MG ORAL TAB,50.0,35.0,,,0
NDC,63739-070-10,ARIPIPRAZOLE  5 MG ORAL TAB,52.5,36.75,,,0
NDC,63739-072-33,SILDENAFIL  20 MG ORAL TAB,9.0,6.300000000000001,,,0
NDC,63739-074-10,ARIPIPRAZOLE 10 MG ORAL TAB,46.0,32.2,,,0
NDC,63739-077-10,VALACYCLOVIR 500 MG ORAL TAB,19.0,13.3,,,0
NDC,63739-078-33,ARIPIPRAZOLE 15 MG ORAL TAB,57.0,39.9,,,0
NDC,63739-086-10,VALPROIC ACID 250 MG ORAL CAP,10.5,7.35,,,0
NDC,63739-087-02,ACETAMINOPHEN  325 MG ORAL TAB,8.0,5.6,,,0
NDC,63739-098-10,MIRTAZAPINE 15 MG ORAL TAB,2.0,1.4,,,0
NDC,63739-132-33,BUPROPION HCL 300 MG ORAL TB24,20.0,14.0,,,0
NDC,63739-134-01,IBUPROFEN 200 MG ORAL TAB,8.0,5.6,,,0
NDC,63739-145-10,MIDODRINE  5 MG ORAL TAB,8.0,5.6,,,0
NDC,63739-159-10,ALUM-MAG HYDROXIDE-SIMETH 200 MG-200 MG-20 MG/5 ML ORAL SUSP,13.0,9.1,,,0
NDC,63739-159-77,ALUM-MAG HYDROXIDE-SIMETH 200 MG-200 MG-20 MG/5 ML ORAL SUSP,10.0,7.0,,,0
NDC,63739-160-70,NYSTATIN 100000 UNIT/ML ORAL SUSP,54.0,37.8,,,0
NDC,63739-170-13,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,16.0,11.2,,,0
NDC,63739-196-01,MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSP,13.0,9.1,,,0
NDC,63739-212-02,ASPIRIN   81 MG ORAL TBEC,5.0,3.5,,,0
NDC,63739-236-10,GABAPENTIN 300 MG ORAL CAP,7.0,4.9,,,0
NDC,63739-264-10,CLONAZEPAM 1 MG ORAL TAB,9.0,6.300000000000001,,,0
NDC,63739-283-10,DILTIAZEM SR 120 MG 24 HR CAP,13.0,9.1,,,0
NDC,63739-327-10,HYDRALAZINE  25 MG ORAL TAB,5.5,3.85,,,0
NDC,63739-328-10,HYDRALAZINE  50 MG ORAL TAB,5.5,3.85,,,0
NDC,63739-367-10,ISOSORBIDE DINITRATE 20 MG ORAL TAB,7.5,5.25,,,0
NDC,63739-369-10,NICOTINE (POLACRILEX) 4 MG BUCL GUM,7.0,4.9,,,0
NDC,63739-403-10,NAPROXEN 500 MG ORAL TAB,7.0,4.9,,,0
NDC,63739-411-10,LEVETIRACETAM  500 MG ORAL TAB,13.0,9.1,,,0
NDC,63739-432-02,SENNOSIDES-DOCUSATE SODIUM 8.6 MG-50 MG TAB,5.5,3.85,,,0
NDC,63739-434-02,ASPIRIN 81 MG ORAL CHEW,5.0,3.5,,,0
NDC,63739-468-05,LIDOCAINE 1%/EPINEPHRINE 1:200K INJECTION (PF),31.5,22.049999999999997,,,0
NDC,63739-479-10,BACLOFEN 10 MG ORAL TAB,7.0,4.9,,,0
NDC,63739-480-10,BACLOFEN 20 MG ORAL TAB,8.5,5.95,,,0
NDC,63739-483-10,HYDROXYZINE 10 MG TAB,5.5,3.85,,,0
NDC,63739-486-10,HYDROXYZINE 25 MG TAB,7.0,4.9,,,0
NDC,63739-499-10,LORAZEPAM 0.5 MG ORAL TAB,7.0,4.9,,,0
NDC,63739-531-10,CYCLOBENZAPRINE 10 MG ORAL TAB,7.0,4.9,,,0
NDC,63739-532-10,HYDROCODONE-ACETAMINOPHEN 5 MG-325 MG TAB,7.0,4.9,,,0
NDC,63739-544-10,SPIRONOLACTONE  25 MG ORAL TAB,8.0,5.6,,,0
NDC,63739-545-10,SPIRONOLACTONE  50 MG ORAL TAB,9.0,6.3,,,0
NDC,63739-564-10,PANTOPRAZOLE 40 MG ORAL TBEC,7.0,4.9,,,0
NDC,63739-569-10,ISOSORBIDE DINITRATE 10 MG ORAL TAB,6.0,4.2,,,0
NDC,63739-570-10,SIMVASTATIN  5 MG ORAL TAB,7.0,4.9,,,0
NDC,63739-571-10,SIMVASTATIN 10 MG ORAL TAB,4.5,3.1500000000000004,,,0
NDC,63739-572-10,SIMVASTATIN 20 MG ORAL TAB,4.5,3.1500000000000004,,,0
NDC,63739-573-10,SIMVASTATIN 40 MG ORAL TAB,7.0,4.9,,,0
NDC,63739-645-10,FAMOTIDINE 20 MG ORAL TAB,7.0,4.9,,,0
NDC,63739-645-41,FAMOTIDINE 20 MG ORAL TAB,7.0,4.9,,,0
NDC,63739-649-10,PRAVASTATIN 20 MG ORAL TAB,8.0,5.6,,,0
NDC,63739-673-10,LOSARTAN  25 MG ORAL TAB,8.5,5.95,,,0
NDC,63739-686-10,LOSARTAN  50 MG ORAL TAB,7.0,4.9,,,0
NDC,63739-691-10,IBUPROFEN 800 MG ORAL TAB,7.0,4.9,,,0
NDC,63739-777-10,HYDROXYCHLOROQUINE 200 MG ORAL TAB,25.0,17.5,,,0
NDC,63739-903-10,GABAPENTIN 300 MG ORAL CAP,3.5,2.45,,,0
NDC,63739-931-14,HEPARIN (PORCINE)  1000 UNIT/ML INJ SOLN,18.0,12.6,,,0
NDC,63739-931-28,HEPARIN (PORCINE)  1000 UNIT/ML INJ SOLN,24.0,16.8,,,0
NDC,63739-963-10,PAROXETINE 20 MG TAB,4.5,3.1500000000000004,,,0
NDC,63739-995-10,DIVALPROEX 125 MG ORAL CPSP,8.5,5.95,,,0
NDC,6380710001,SODIUM CHLORIDE 0.9 % INJ SYRG,16.0,11.2,,,0
NDC,6380710005,SODIUM CHLORIDE 0.9 % INJ SOLN (VIAL),19.0,13.3,,,0
NDC,6380710010,SODIUM CHLORIDE 0.9 % INJ SYRG,40.0,28.0,,,0
NDC,6380710011,SODIUM CHLORIDE 0.9 % INJ SOLN (VIAL),20.0,14.0,,,0
NDC,6380760055,"HEPARIN, PORCINE (PF)  100 UNIT/ML IV SYRG",16.0,11.2,,,0
NDC,63824-008-15,GUAIFENESIN 600 MG ORAL TP12,7.0,4.9,,,0
NDC,63824-056-01,DEXTROMETHORPHAN-GUAIFENESIN SR 30 MG-600 MG 12 HR TAB,7.0,4.9,,,0
NDC,63824-056-34,DEXTROMETHORPHAN-GUAIFENESIN SR 30 MG-600 MG 12 HR TAB,9.5,6.65,,,0
NDC,63824-171-63,DEXTROMETHORPHAN POLY COMPLEX ER 30 MG/5 ML ORAL SU12,7.0,4.9,,,0
NDC,63824-173-63,DEXTROMETHORPHAN POLY COMPLEX ER 30 MG/5 ML ORAL SU12,7.0,4.9,,,0
NDC,63824-272-63,DEXTROMETHORPHAN POLY COMPLEX ER 30 MG/5 ML ORAL SU12,48.0,33.6,,,0
NDC,63824-713-16,BENZOCAINE-MENTHOL 15-3.6 MG MM LOZG,5.0,3.5,,,0
NDC,63824-732-16,BENZOCAINE-MENTHOL 15-2.6 MG MM LOZG,5.0,3.5,,,0
NDC,6382400840,GUAIFENESIN 600 MG ORAL TP12,5.5,3.85,,,0
NDC,6382405620,DEXTROMETHORPHAN-GUAIFENESIN SR 30 MG-600 MG 12 HR TAB,25.0,17.5,,,0
NDC,6382405640,DEXTROMETHORPHAN-GUAIFENESIN SR 30 MG-600 MG 12 HR TAB,7.0,4.9,,,0
NDC,6382471016,BENZOCAINE-MENTHOL 15-3.6 MG MM LOZG,10.0,7.0,,,0
NDC,63833-386-02,HUMAN PROTHROMBIN COMPLEX 500 UNIT IV SOLR,7274.0,5091.8,,,0
NDC,63833-396-01,HUMAN PROTHROMBIN COMPLEX 500 UNIT IV SOLR,7565.0,5295.5,,,0
NDC,63833-615-02,HUMATE-P: VWF CONCENTRATE (MERGE RECORD),6195.0,4336.5,,,0
NDC,63833-616-02,HUMATE-P: VWF CONCENTRATE (MERGE RECORD),3220.0,2254.0,,,0
NDC,63833-617-02,"ANTIHEMOPHILIC FACTOR-VWF 1,000-2,400 UNIT IV KIT",3019.0,2113.3,,,0
NDC,63833-626-01,HUMATE-P: VWF CONCENTRATE (MERGE RECORD),1610.0,1127.0,,,0
NDC,63833-627-01,HUMATE-P: VWF CONCENTRATE (MERGE RECORD),2997.5,2098.25,,,0
NDC,63868-176-26,ACETAMINOPHEN 160 MG/5 ML ORAL (PHS ERX MERGE),5.0,3.5,,,0
NDC,64067-216-01,METHOXSALEN 20 MCG/ML INJ SOLN,403.0,282.1,,,0
NDC,64193-324-01,ANTI-INHIBITOR COAGULANT CMPLX (PHS MERGE),17423.0,12196.1,,,0
NDC,64193-325-01,ANTI-INHIBITOR COAGULANT CMPLX (PHS MERGE),27275.0,19092.5,,,0
NDC,64193-326-01,ANTI-INHIBITOR COAGULANT CMPLX (PHS MERGE),4153.0,2907.1,,,0
NDC,64193-423-02,ANTI-INHIBITOR COAGULANT CMPLX 350-650 UNIT IV SOLR,873.5,611.4499999999999,,,0
NDC,64193-424-02,ANTI-INHIBITOR COAGULANT CMPLX (PHS MERGE),3426.0,2398.2,,,0
NDC,64193-425-02,"ANTI-INHIBITOR COAGULANT CMPLX 1,750-3,250 UNIT IV SOLR",11055.5,7738.85,,,0
NDC,64193-426-02,ANTI-INHIBITOR COAGULANT CMPLX (PHS MERGE),2817.0,1971.9,,,0
NDC,64208-2510-1,"ALBUMIN, HUMAN 5 % IV SOLP MERGE",238.0,166.6,,,0
NDC,64208-2510-2,"ALBUMIN, HUMAN 5 % IV SOLP MERGE",187.5,131.25,,,0
NDC,64208-2510-5,"ALBUMIN, HUMAN 5 % IV SOLP MERGE",909.0,636.3,,,0
NDC,64208-2512-3,"ALBUMIN, HUMAN 25 % IV SOLN (MERGE)",274.0,191.8,,,0
NDC,64208-2512-4,"ALBUMIN, HUMAN 25 % IV SOLN (MERGE)",205.5,143.85000000000002,,,0
NDC,64208-2512-7,"ALBUMIN, HUMAN 25 % IV SOLN (MERGE)",238.0,166.6,,,0
NDC,64208-2512-8,"ALBUMIN, HUMAN 25 % IV SOLN (MERGE)",594.0,415.8,,,0
NDC,64253-400-30,ATROPINE 0.1 MG/ML INJ SYRG,59.0,41.3,,,0
NDC,64253-900-30,CALCIUM CHLORIDE (FOR CODE) 10% (100 MG/ML) IV SYRINGE,29.5,20.65,,,0
NDC,6425311125,SODIUM CHLORIDE 0.9 % INJ SOLN (VIAL),18.0,12.6,,,0
NDC,6425311130,SODIUM CHLORIDE 0.9 % INJ SYRG,51.0,35.7,,,0
NDC,6425322223,"HEPARIN, PORCINE (PF)   10 UNIT/ML IV SYRG",16.5,11.55,,,0
NDC,6425322233,"HEPARIN, PORCINE (PF)   10 UNIT/ML IV SYRG",17.5,12.25,,,0
NDC,6425322235,"HEPARIN, PORCINE (PF)   10 UNIT/ML IV SYRG",16.0,11.2,,,0
NDC,6425333335,HEPARIN LOCK FLUSH 100 UNIT/ML IV SOLN,62.0,43.4,,,0
NDC,6425344425,"HEPARIN, PORCINE (PF) 1 UNIT/ML IV SYRG NEONATE",63.0,44.1,,,0
NDC,6425344430,"HEPARIN, PORCINE (PF) 1 UNIT/ML IV SYRG NEONATE",51.0,35.7,,,0
NDC,64281-110-05,METHACHOLINE CHLORIDE STERILE INHALATION SOLUTION (PF) KIT,3494.0,2445.8,,,0
NDC,64380-158-01,MEGESTROL 20 MG ORAL TAB,7.0,4.9,,,0
NDC,64380-169-01,IMIPRAMINE 10 MG TAB,7.0,4.9,,,0
NDC,64380-170-01,IMIPRAMINE 25 MG TAB,4.0,2.8,,,0
NDC,64380-710-03,LAMIVUDINE 150 MG ORAL TAB,70.0,49.0,,,0
NDC,64380-724-06,CALCITRIOL 0.5 MCG ORAL CAP,16.5,11.55,,,0
NDC,64380-737-06,ERGOCALCIFEROL (VITAMIN D2) 50000 UNIT ORAL CAP,11.0,7.7,,,0
NDC,64380-759-06,ACARBOSE  50 MG ORAL TAB,7.0,4.9,,,0
NDC,64380-782-06,PREDNISONE  1 MG ORAL TAB,36.0,25.2,,,0
NDC,64380-797-01,OSELTAMIVIR PHOSPHATE 30 MG ORAL CAP,409.0,286.3,,,0
NDC,64380-799-01,OSELTAMIVIR PHOSPHATE 75 MG ORAL CAP,394.0,275.8,,,0
NDC,64380-834-06,ACETAZOLAMIDE 250 MG ORAL TAB,16.0,11.2,,,0
NDC,64380-878-06,ETHOSUXIMIDE 250 MG ORAL CAP,39.0,27.299999999999997,,,0
NDC,64380-883-04,CINACALCET 30 MG ORAL TAB,242.5,169.75,,,0
NDC,64380-972-06,HYDROCORTISONE 20 MG ORAL TAB,19.0,13.3,,,0
NDC,64406-008-01,NATALIZUMAB 300 MG/15 ML IV SOLN,16000.0,11200.0,,,0
NDC,64455-192-01,ISOSORBIDE DINITRATE 40 MG ORAL TAB,16.0,11.2,,,0
NDC,64455-993-95,ACYCLOVIR 5 % TOP OINT,1363.0,954.1,,,0
NDC,64679-012-02,PIPERACILLIN-TAZOBACTAM  4.5 GRAM IV SOLR,135.0,94.5,,,0
NDC,64679-056-02,PIPERACILLIN-TAZOBACTAM  3.375 GRAM IV SOLR,107.0,74.9,,,0
NDC,64679-631-02,NICARDIPINE 25 MG/10 ML IV SOLN,232.0,162.4,,,0
NDC,64679-961-01,AZITHROMYCIN 250 MG ORAL TAB,153.0,107.1,,,0
NDC,64679-983-01,CEFTRIAXONE 1 GRAM INJ SOLR,218.0,152.6,,,0
NDC,64679-990-01,ZONISAMIDE 10 MG/ML ORAL SYRUP (REPACK),27.0,18.9,,,0
NDC,64764-300-20,VEDOLIZUMAB 300 MG IV SOLR,11084.0,7758.8,,,0
NDC,64764-451-25,PIOGLITAZONE 45 MG ORAL TAB,123.0,86.1,,,0
NDC,64764-543-30,LANSOPRAZOLE 15 MG ORAL TBLD,82.0,57.4,,,0
NDC,64764-544-30,LANSOPRAZOLE 30 MG ORAL TBLD,82.0,57.4,,,0
NDC,64850-502-01,AMPHETAMINE-DEXTROAMPHETAMINE 10 MG ORAL TAB,15.0,10.5,,,0
NDC,64850-510-01,AMPHETAMINE-DEXTROAMPHETAMINE  5 MG ORAL CP24,33.5,23.450000000000003,,,0
NDC,64950-362-04,COCAINE  4 % TOP SOLN (MERGE),868.0,607.6,,,0
NDC,64950-373-16,HYDROCODONE-ACETAMINOPHEN 7.5 MG-325 MG/15 ML ORAL SOLN (REPACK),42.0,29.4,,,0
NDC,64980-220-03,PYRIDOSTIGMINE BROMIDE 180 MG ORAL TBSR,122.0,85.4,,,0
NDC,64980-281-01,GLIPIZIDE 10 MG ORAL TO24,12.5,8.75,,,0
NDC,64980-282-03,MESALAMINE 1000 MG RECT SUPP,187.0,130.9,,,0
NDC,64980-320-05,TRIAMCINOLONE ACETONIDE 0.1 % DENT PSTE,342.0,239.4,,,0
NDC,64980-324-30,HYDROCORTISONE  2.5 % RECT CREA,371.0,259.7,,,0
NDC,64980-376-03,ATOMOXETINE  40 MG ORAL CAP,114.0,79.80000000000001,,,0
NDC,64980-411-09,PREGABALIN  50 MG ORAL CAP,103.5,72.45,,,0
NDC,64980-447-15,CALCITRIOL 1 MCG/ML ORAL SOLN,35.5,24.85,,,0
NDC,64980-503-12,LEVOCARNITINE (WITH SUCROSE) 100 MG/ML ORAL SOLN,22.0,15.4,,,0
NDC,64980-504-48,CYPROHEPTADINE 2 MG/5 ML ORAL SYRP,8.0,5.6,,,0
NDC,64980-511-10,CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,41.0,28.7,,,0
NDC,64980-514-05,TIMOLOL MALEATE 0.5 % OPHT DROP,84.0,58.8,,,0
NDC,64980-515-05,OFLOXACIN 0.3 % OPHT DROP,299.0,209.3,,,0
NDC,64980-526-60,NITAZOXANIDE 500 MG ORAL TAB,595.0,416.5,,,0
NDC,64980-562-01,FUROSEMIDE 20 MG ORAL TAB,7.5,5.25,,,0
NDC,64980-567-03,DAPSONE  25 MG ORAL TAB,21.0,14.700000000000001,,,0
NDC,64980-592-95,LACTULOSE 10 GRAM/15 ML ORAL SOLN,108.0,75.6,,,0
NDC,6498010401,K PHOS DI & MONO-SOD PHOS MONO 250 MG ORAL TAB,9.5,6.65,,,0
NDC,6498033990,MAGNESIUM OXIDE 400 MG ORAL TAB,7.5,5.25,,,0
NDC,65145-146-01,KETOROLAC TROMETHAMINE 15 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,65162-058-27,SEVELAMER CARBONATE 800 MG ORAL TAB,60.0,42.0,,,0
NDC,65162-247-09,CHLORTHALIDONE  25 MG ORAL TAB,10.5,7.3500000000000005,,,0
NDC,65162-271-10,TRIMETHOPRIM-SULFAMETHOXAZOLE 80 MG-400 MG TAB,7.0,4.9,,,0
NDC,65162-302-09,VENLAFAXINE  37.5 MG ORAL TAB,12.0,8.4,,,0
NDC,65162-351-09,SILDENAFIL  20 MG ORAL TAB,98.0,68.6,,,0
NDC,65162-361-10,FOLIC ACID  1 MG ORAL TAB,7.0,4.9,,,0
NDC,65162-441-10,MECLIZINE 12.5 MG ORAL TAB,7.0,4.9,,,0
NDC,65162-464-10,IBUPROFEN 400 MG ORAL TAB,10.5,7.3500000000000005,,,0
NDC,65162-465-10,IBUPROFEN 600 MG ORAL TAB,7.0,4.9,,,0
NDC,65162-475-05,NORETHINDRONE ACETATE 5 MG ORAL TAB,15.0,10.5,,,0
NDC,65162-511-10,SPIRONOLACTONE 5MG/ML SUSPENSION (REPACK),7.0,4.9,,,0
NDC,65162-596-06,DIPYRIDAMOLE-ASPIRIN SR 200 MG-25 MG MULTIPHASE 12 HR CAP,47.0,32.9,,,0
NDC,65162-649-78,OXCARBAZEPINE 300 MG/5 ML ORAL SUSP,28.0,19.6,,,0
NDC,65162-673-84,RISPERIDONE 1 MG/ML ORAL SOLN,15.0,10.5,,,0
NDC,65162-681-10,PHENAZOPYRIDINE 100 MG ORAL TAB,22.5,15.75,,,0
NDC,65162-682-10,PHENAZOPYRIDINE 200 MG ORAL TAB,23.0,16.1,,,0
NDC,65162-686-88,FELBAMATE 600 MG/5 ML ORAL SUSP,50.0,35.0,,,0
NDC,65162-691-79,ONDANSETRON HCL 4 MG/5 ML ORAL SOLN,48.0,33.6,,,0
NDC,65162-698-90,GABAPENTIN 250 MG/5 ML (5 ML) ORAL SOLN,9.0,6.3,,,0
NDC,65162-710-09,COLCHICINE 0.6 MG ORAL TAB,66.0,46.2,,,0
NDC,65162-735-09,FELBAMATE 600 MG ORAL TAB,59.0,41.3,,,0
NDC,65162-778-10,BUDESONIDE 3 MG ORAL CP24,244.0,170.8,,,0
NDC,65162-807-10,PROGESTERONE MICRONIZED 100 MG ORAL CAP,40.0,28.0,,,0
NDC,65162-879-03,LURASIDONE 20 MG ORAL TAB,229.0,160.3,,,0
NDC,65162-896-09,ARIPIPRAZOLE  2 MG ORAL TAB,248.5,173.95,,,0
NDC,65162-897-09,ARIPIPRAZOLE  5 MG ORAL TAB,272.0,190.4,,,0
NDC,65162-898-09,ARIPIPRAZOLE 10 MG ORAL TAB,157.0,109.9,,,0
NDC,65162-918-38,LIDOCAINE 5 % TOP OINT,885.0,619.5,,,0
NDC,65174-270-30,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,642.0,449.4,,,0
NDC,65174-288-30,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,133.0,93.1,,,0
NDC,65174-461-05,IODINE (I-131) CAPSULE FOR UPTAKE DIAGNOSTIC,191.0,133.7,,,0
NDC,65174-660-30,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,628.0,439.6,,,0
NDC,65174-880-00,IODINE (I-131) CAPSULE FOR THYROID THERAPY,5304.0,3712.8,,,0
NDC,65197-400-10,VITAMINS A & D-WHITE PETROLATUM-LANOLIN OINTMENT,25.5,17.85,,,0
NDC,65219-014-01,AMPICILLIN 250 MG SOLUTION FOR INJECTION,16.0,11.2,,,0
NDC,65219-020-03,AMPICILLIN SODIUM  2 GRAM INJ SOLR,53.0,37.1,,,0
NDC,65219-039-00,VASOPRESSIN 20 UNIT/ML IV SOLN,51.5,36.05,,,0
NDC,65219-131-20,CYCLOPHOSPHAMIDE 20 MG/ML IN NS,765.5,535.85,,,0
NDC,65219-135-20,CYCLOPHOSPHAMIDE 500 MG IV SOLR,517.0,361.9,,,0
NDC,65219-186-01,KETAMINE 100 MG/ML INJ SOLN,20.5,14.35,,,0
NDC,65219-187-01,"WATER FOR INJECTION, STERILE INJECTION",16.0,11.2,,,0
NDC,65219-205-05,TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FINAL) IV SOLR,9771.0,6839.7,,,0
NDC,65219-238-01,DEXTROSE 5% IN WATER (D5W) IV,24.0,16.8,,,0
NDC,65219-259-05,PIPERACILLIN-TAZOBACTAM  4.5 GRAM IV SOLR,63.0,44.1,,,0
NDC,65219-259-45,PIPERACILLIN-TAZOBACTAM  4.5 GRAM IV SOLR,63.0,44.1,,,0
NDC,65219-293-00,DESMOPRESSIN 4 MCG/ML INJECTION SOLN,306.0,214.2,,,0
NDC,65219-368-01,LORAZEPAM 2 MG/ML IV SOLN (PHS MERGE - ALL SITES),19.0,13.3,,,0
NDC,65219-380-30,ALLOPURINOL SODIUM 500 MG IV SOLR,1601.0,1120.7,,,0
NDC,65219-436-02,PIPERACILLIN-TAZOBACTAM  3.375 GRAM IV SOLR,27.0,18.9,,,0
NDC,65219-445-01,ETOMIDATE 2 MG/ML IV SOLN,28.0,19.6,,,0
NDC,65219-472-05,SODIUM CHLORIDE 0.9 % IV (BOLUS),42.0,29.400000000000002,,,0
NDC,65219-533-01,FAT EMULSION 20 % IV EMUL,129.0,90.3,,,0
NDC,65219-534-01,"TRANEXAMIC ACID IN NACL,ISO-OS 1,000 MG/100 ML (10 MG/ML) IV PGBK",98.0,68.6,,,0
NDC,65219-570-01,BUMETANIDE 0.25 MG/ML INJ SOLN,116.0,81.19999999999999,,,0
NDC,65219-572-01,BUMETANIDE 0.25 MG/ML INJ SOLN,85.5,59.849999999999994,,,0
NDC,65219-590-04,TOCILIZUMAB-AAZG 80 MG/4 ML (20 MG/ML) IV SOLN,4160.0,2912.0,,,0
NDC,65219-592-10,TOCILIZUMAB-AAZG 80 MG/4 ML (20 MG/ML) IV SOLN,2703.0,1892.1,,,0
NDC,65219-594-20,TOCILIZUMAB-AAZG 80 MG/4 ML (20 MG/ML) IV SOLN,4865.0,3405.5,,,0
NDC,65219-622-02,ACYCLOVIR SODIUM 50 MG/ML IV SOLN,100.5,70.35,,,0
NDC,65219-635-00,PHYTONADIONE 10 MG/ML INJ SOLN,130.0,91.0,,,0
NDC,65219-635-01,PHYTONADIONE 10 MG/ML INJ SOLN,65.0,45.5,,,0
NDC,65219-650-05,MIDAZOLAM (PF) IN 0.9 % NACL 1 MG/ML IV SOLN,110.0,77.0,,,0
NDC,65219-658-01,POTASSIUM PHOS IN 0.9 % NACL 15 MMOL/250 ML IVPB PREMIX,233.0,163.1,,,0
NDC,65219-800-01,PROPOFOL 10 MG/ML 20ML BOLUS IV EMUL,9.0,6.3,,,0
NDC,65250-266-09,BUPIVACAINE LIPOSOME (PF) 266 MG/20 ML (13.3 MG/ML) LINF SUSP,1116.0,781.2,,,0
NDC,65250-266-20,BUPIVACAINE LIPOSOME (PF) 266 MG/20 ML (13.3 MG/ML) LINF SUSP,1116.0,781.2,,,0
NDC,65282-1605-1,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,53.0,37.1,,,0
NDC,65302-503-04,LABETALOL (5 MG/ML) IV SYRG (CONTAINS PRESERVATIVE),67.0,46.9,,,0
NDC,65302-506-10,PHENYLEPHRINE IN 0.9% NS (PF) 1 MG/10 ML (100 MCG/ML) IV SYRG(PDS MERGE),24.5,17.15,,,0
NDC,65302-507-10,EPINEPHRINE 0.1 MG/ML SYRINGE (ERX MERGE),335.0,234.5,,,0
NDC,65302-528-15,ALBUTEROL SULFATE 5 MG/ML INHL NEB CONTINUOUS,7.0,4.9,,,0
NDC,65483-116-07,"ALDESLEUKIN 360,000 UNITS/ ML SOLUTION",5121.0,3584.7,,,0
NDC,65597-103-30,OLMESARTAN 20 MG ORAL TAB,52.0,36.4,,,0
NDC,65597-104-90,OLMESARTAN 40 MG ORAL TAB,57.0,39.9,,,0
NDC,65597-406-01,FAM-TRASTUZUMAB DERUXTECAN-NXKI 100 MG IV SOLR,17110.5,11977.349999999999,,,0
NDC,65597-801-01,DATOPOTAMAB DERUXTECAN-DLNK 100 MG IV SOLR,38209.5,26746.65,,,0
NDC,65628-050-01,LIDOCAINE-DIPHENHYD-AL-MAG-SIM 200-25-400-40 MG/30 ML MM MWSH,36.0,25.2,,,0
NDC,65628-080-05,LANSOPRAZOLE 3 MG/ML ORAL SUSR,14.5,10.15,,,0
NDC,65628-270-03,OMEPRAZOLE-SODIUM BICARBONATE 2-84 MG/ML ORAL SUSR,26.0,18.2,,,0
NDC,65628-270-05,OMEPRAZOLE-SODIUM BICARBONATE 2-84 MG/ML ORAL SUSR,28.0,19.6,,,0
NDC,65649-211-24,FAMOTIDINE 40 MG/5 ML ORAL SUSP,33.0,23.1,,,0
NDC,65649-303-02,RIFAXIMIN 550 MG ORAL TAB,294.0,205.8,,,0
NDC,65649-303-03,RIFAXIMIN 550 MG ORAL TAB,286.0,200.2,,,0
NDC,65649-311-12,CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSP,9.0,6.3,,,0
NDC,65649-551-02,METHYLNALTREXONE 12 MG/0.6 ML SUBQ SOLN,714.0,499.8,,,0
NDC,65649-551-03,METHYLNALTREXONE 12 MG/0.6 ML SUBQ SYRG,577.5,404.25,,,0
NDC,65649-551-07,METHYLNALTREXONE 12 MG/0.6 ML SUBQ SYRG,591.5,414.05,,,0
NDC,65649-552-04,METHYLNALTREXONE 12 MG/0.6 ML SUBQ SYRG,606.5,424.55,,,0
NDC,65757-300-01,NALTREXONE MICROSPHERES 380 MG IM SERR,4530.0,3171.0,,,0
NDC,65757-302-02,NALTREXONE MICROSPHERES 380 MG IM SERR,4598.0,3218.6,,,0
NDC,65757-401-03,ARIPIPRAZOLE LAUROXIL 441 MG/1.6 ML IM SERS,3788.0,2651.6,,,0
NDC,65757-402-03,ARIPIPRAZOLE LAUROXIL 662 MG/2.4 ML IM SERS,6592.0,4614.4,,,0
NDC,65757-403-03,ARIPIPRAZOLE LAUROXIL 882 MG/3.2 ML IM SERS,7575.0,5302.5,,,0
NDC,65857-100-30,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,2641.5,1849.05,,,0
NDC,65857-400-01,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,1770.0,1239.0,,,0
NDC,65857-500-20,TECHNETIUM TC 99M SESTAMIBI - CARDIOLITE,214.0,149.8,,,0
NDC,65862-006-01,CITALOPRAM 20 MG ORAL TAB,15.0,10.5,,,0
NDC,65862-008-01,METFORMIN  500 MG ORAL TAB,7.5,5.25,,,0
NDC,65862-013-01,SERTRALINE 100 MG ORAL TAB,20.0,14.0,,,0
NDC,65862-019-01,CEPHALEXIN 500 MG ORAL CAP,11.5,8.05,,,0
NDC,65862-036-60,LAMIVUDINE-ZIDOVUDINE 150 MG-300 MG TAB,72.0,50.4,,,0
NDC,65862-055-24,LAMIVUDINE 10 MG/ML ORAL SOLN,58.0,40.6,,,0
NDC,65862-064-01,METOPROLOL TARTRATE 100 MG TAB,7.0,4.9,,,0
NDC,65862-071-01,AMOXICILLIN 400 MG/5 ML ORAL SUSR,7.0,4.9,,,0
NDC,65862-076-01,CIPROFLOXACIN 250 MG ORAL TAB,459.0,321.3,,,0
NDC,65862-116-01,BENAZEPRIL 10 MG ORAL TAB,12.0,8.4,,,0
NDC,65862-146-36,SUMATRIPTAN 25 MG TAB,230.0,161.0,,,0
NDC,65862-187-03,ONDANSETRON HCL  4 MG ORAL TAB,119.0,83.3,,,0
NDC,65862-187-30,ONDANSETRON HCL  4 MG ORAL TAB,523.0,366.1,,,0
NDC,65862-192-01,FLUOXETINE 10 MG ORAL CAP,47.5,33.25,,,0
NDC,65862-219-60,CEFDINIR 250 MG/5 ML ORAL SUSR,22.0,15.4,,,0
NDC,65862-226-60,CLARITHROMYCIN 500 MG ORAL TAB,34.0,23.8,,,0
NDC,65862-246-08,LEVETIRACETAM  500 MG ORAL TAB,30.0,21.0,,,0
NDC,65862-247-08,LEVETIRACETAM  750 MG ORAL TAB,58.0,40.6,,,0
NDC,65862-290-84,RIBAVIRIN 200 MG ORAL CAP,53.0,37.1,,,0
NDC,65862-296-30,ROSUVASTATIN 40 MG ORAL TAB,50.0,35.0,,,0
NDC,65862-306-12,FLUOXETINE 20 MG/5 ML ORAL SOLN,41.5,29.05,,,0
NDC,65862-354-30,EMTRICITABINE-TENOFOVIR 200 MG-300 MG TAB,527.0,368.9,,,0
NDC,65862-357-30,CLOPIDOGREL  75 MG ORAL TAB,39.0,27.3,,,0
NDC,65862-357-90,CLOPIDOGREL  75 MG ORAL TAB,39.0,27.3,,,0
NDC,65862-390-10,ONDANSETRON 4 MG ORAL TBDL,110.0,77.0,,,0
NDC,65862-391-10,ONDANSETRON 8 MG ORAL TBDL,182.0,127.4,,,0
NDC,65862-419-01,TRIMETHOPRIM-SULFAMETHOXAZOLE 80 MG-400 MG TAB,7.0,4.9,,,0
NDC,65862-420-01,TRIMETHOPRIM-SULFAMETHOXAZOLE 160 MG-800 MG TAB,20.0,14.0,,,0
NDC,65862-458-60,GALANTAMINE  4 MG ORAL TAB,18.0,12.6,,,0
NDC,65862-474-01,RAMIPRIL  1.25 MG ORAL CAP,17.0,11.9,,,0
NDC,65862-477-01,RAMIPRIL 10 MG ORAL CAP,19.0,13.3,,,0
NDC,65862-496-47,TRIMETHOPRIM-SULFAMETHOXAZOLE 40 MG-200 MG/5 ML ORAL SUSP,28.5,19.95,,,0
NDC,65862-502-20,AMOXICILLIN-POT CLAVULANATE 500 MG-125 MG TAB,21.0,14.7,,,0
NDC,65862-503-01,AMOXICILLIN-POT CLAVULANATE 875 MG-125 MG TAB,243.0,170.1,,,0
NDC,65862-503-20,AMOXICILLIN-POT CLAVULANATE 875 MG-125 MG TAB,29.0,20.3,,,0
NDC,65862-512-30,PIOGLITAZONE 15 MG ORAL TAB,69.0,48.3,,,0
NDC,65862-512-90,PIOGLITAZONE 15 MG ORAL TAB,54.0,37.8,,,0
NDC,65862-513-30,PIOGLITAZONE 30 MG ORAL TAB,66.0,46.2,,,0
NDC,65862-527-90,VENLAFAXINE  37.5 MG ORAL CP24,47.0,32.9,,,0
NDC,65862-528-90,VENLAFAXINE  75 MG ORAL CP24,60.5,42.349999999999994,,,0
NDC,65862-570-30,VALSARTAN  40 MG ORAL TAB,96.0,67.2,,,0
NDC,65862-595-01,DIVALPROEX 500 MG ORAL TB24,46.0,32.2,,,0
NDC,65862-598-01,TAMSULOSIN 0.4 MG ORAL CP24,35.5,24.85,,,0
NDC,65862-601-30,MODAFINIL 100 MG ORAL TAB,224.0,156.8,,,0
NDC,65862-603-30,MOXIFLOXACIN 400 MG ORAL TAB,134.0,93.8,,,0
NDC,65862-625-03,RIZATRIPTAN  5 MG ORAL TBDL,222.5,155.75,,,0
NDC,65862-642-30,AZITHROMYCIN 500 MG ORAL TAB,191.0,133.7,,,0
NDC,65862-672-01,REPAGLINIDE 2 MG ORAL TAB,11.0,7.7,,,0
NDC,65862-687-30,RITONAVIR 100 MG ORAL TAB,52.0,36.4,,,0
NDC,65862-692-01,PHENYTOIN SODIUM EXTENDED 100 MG ORAL CAP,16.5,11.55,,,0
NDC,65862-697-90,VENLAFAXINE 150 MG ORAL CP24,43.0,30.1,,,0
NDC,65862-699-20,CEFUROXIME AXETIL 250 MG ORAL TAB,111.0,77.69999999999999,,,0
NDC,65862-700-20,CEFUROXIME AXETIL 500 MG ORAL TAB,45.0,31.5,,,0
NDC,65862-703-60,ZIPRASIDONE 40 MG CAP,69.0,48.3,,,0
NDC,65862-707-01,AMOXICILLIN 250 MG/5 ML ORAL SUSR,7.0,4.9,,,0
NDC,65862-707-55,AMOXICILLIN 250 MG/5 ML ORAL SUSR,7.0,4.9,,,0
NDC,65862-707-80,AMOXICILLIN 250 MG/5 ML ORAL SUSR,9.0,6.3,,,0
NDC,65862-846-01,CLOZAPINE 100 MG ORAL TAB,19.0,13.3,,,0
NDC,65862-859-01,FAMOTIDINE 20 MG ORAL TAB,14.0,9.8,,,0
NDC,65862-891-30,VORICONAZOLE  50 MG ORAL TAB,195.0,136.5,,,0
NDC,65862-896-10,LANSOPRAZOLE 30 MG ORAL TBLD,78.0,54.6,,,0
NDC,65862-910-60,CELECOXIB 400 MG ORAL CAP,56.0,39.2,,,0
NDC,65862-927-30,FINASTERIDE 1 MG ORAL TAB,16.0,11.2,,,0
NDC,65862-930-08,SEVELAMER CARBONATE 0.8 GRAM ORAL PWPK,179.0,125.3,,,0
NDC,65862-946-01,DORZOLAMIDE-TIMOLOL 2 %-0.5 % EYE DROPS,440.0,308.0,,,0
NDC,66019-112-00,FLU VACC TV LIVE 2025(2-49YRS) 10EXP6.5-7.5 FF UNIT/0.2 ML NASL NSSY,153.0,107.1,,,0
NDC,66215-101-03,BOSENTAN 62.5 MG ORAL TAB,413.0,289.1,,,0
NDC,66220-207-30,ACETYLCYSTEINE 20 % (200 MG/ML) IV SOLN,305.0,213.5,,,0
NDC,66267-976-15,CARBAMIDE PEROXIDE 6.5 % OTIC DROP,48.0,33.6,,,0
NDC,66479-583-05,OXYCODONE 5 MG/5 ML ORAL SOLN,19.5,13.649999999999999,,,0
NDC,66490-650-20,DIAZEPAM 2.5 MG RECT KIT,2156.0,1509.2,,,0
NDC,66553-001-01,ASPIRIN  325 MG ORAL TAB,7.0,4.9,,,0
NDC,66553-002-01,ASPIRIN 81 MG ORAL CHEW,4.0,2.8,,,0
NDC,66553-004-01,CALCIUM CARBONATE 500 MG (200 MG ELEMENTAL) CHEW TAB,5.5,3.85,,,0
NDC,66553-008-01,SODIUM BICARBONATE 650 MG ORAL TAB,5.5,3.85,,,0
NDC,66621-0790-1,ANTIVENIN CROTALIDAE (EQUINE) INJ SOLR,21860.0,15302.0,,,0
NDC,66621-0790-2,ANTIVENIN CROTALIDAE (EQUINE) INJ SOLR,36432.0,25502.4,,,0
NDC,66647-6156-33,NOREPINEPHRINE BITARTRATE-D5W 4 MG/250 ML (16 MCG/ML) IV SOLN,52.0,36.4,,,0
NDC,66658-234-01,ANAKINRA 100 MG/0.67 ML SUBQ SYRG,562.0,393.4,,,0
NDC,66658-234-07,ANAKINRA 100 MG/0.67 ML SUBQ SYRG,562.0,393.4,,,0
NDC,66689-020-01,MEGESTROL 400 MG/10 ML (10 ML) ORAL SUSP,24.0,16.8,,,0
NDC,66689-023-01,HYDROCODONE-ACETAMINOPHEN 7.5 MG-325 MG/15 ML ORAL SOLN (REPACK),18.0,12.6,,,0
NDC,66689-025-30,OXYCODONE 20MG/ML (1ML-UD) SYRINGE (REPACK),16.0,11.2,,,0
NDC,66689-031-01,METOCLOPRAMIDE HCL 5 MG/5 ML ORAL SOLN,38.0,26.6,,,0
NDC,66689-036-01,PHENYTOIN 100 MG/4 ML ORAL SUSP,50.5,35.35,,,0
NDC,66689-038-01,LACTULOSE 10 GRAM/15 ML ORAL SOLN,19.0,13.3,,,0
NDC,66689-053-01,MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSP,15.0,10.5,,,0
NDC,66689-053-99,MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSP,15.0,10.5,,,0
NDC,66689-056-01,ACETAMINOPHEN 160 MG/5 ML ORAL (PHS ERX MERGE),24.0,16.799999999999997,,,0
NDC,66689-062-01,ATOVAQUONE 750 MG/5 ML ORAL SUSP,288.5,201.95,,,0
NDC,66689-201-08,ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSP,133.5,93.45,,,0
NDC,66689-307-08,MYCOPHENOLATE 200 MG/ML ORAL SUSP,82.5,57.75,,,0
NDC,66689-775-08,PHENYTOIN 125 MG/5 ML ORAL SUSP,9.0,6.3,,,0
NDC,66733-948-23,CETUXIMAB 200 MG/100 ML IV SOLN,1267.0,886.9,,,0
NDC,66733-958-23,CETUXIMAB 100 MG/50 ML IV SOLN,15582.0,10907.400000000001,,,0
NDC,66758-016-03,PHENYLEPHRINE 10 MG/ML INJECTION,199.0,139.3,,,0
NDC,66758-035-01,GRANISETRON 1 MG/ML (1 ML) IV SOLN,245.0,171.5,,,0
NDC,66758-087-70,"CIPROFLOXACIN-HYDROCORTISONE 0.2 %-1 % EAR DROPS, SUSP",752.5,526.75,,,0
NDC,66780-212-01,EXENATIDE 10 MCG/0.04 ML SUBQ PNIJ,1179.0,825.3,,,0
NDC,66794-207-02,AMPICILLIN-SULBACTAM  3 GRAM INJ SOLR,42.0,29.4,,,0
NDC,66794-219-63,LINEZOLID 600 MG/300 ML IV SOLP,65.0,45.5,,,0
NDC,66794-228-02,ROCURONIUM 10 MG/ML IV SOLN,90.0,63.0,,,0
NDC,66794-229-02,ROCURONIUM 10 MG/ML IV SOLN,53.5,37.45,,,0
NDC,66794-229-41,ROCURONIUM 10 MG/ML IV SOLN,38.5,26.95,,,0
NDC,66794-234-02,DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) IV SOLN,153.0,107.1,,,0
NDC,66794-237-02,DOXYCYCLINE HYCLATE 100 MG IV SOLR,148.0,103.6,,,0
NDC,66887-004-01,TESTOSTERONE  75 MG IMPL PLLT,15773.5,11041.45,,,0
NDC,66887-004-10,TESTOSTERONE  75 MG IMPL PLLT,10143.0,7100.1,,,0
NDC,66993-019-68,ALBUTEROL SULFATE 90 MCG/ACTUATION INHL HFAA,13.0,9.1,,,0
NDC,66993-066-02,PHENOXYBENZAMINE 10 MG ORAL CAP,955.0,668.5,,,0
NDC,66993-078-96,FLUTICASONE 44 MCG/ACTUATION INHL AERO,16.5,11.55,,,0
NDC,66993-079-96,FLUTICASONE 110 MCG/ACTUATION INHL AERO,22.5,15.75,,,0
NDC,66993-080-96,FLUTICASONE 220 MCG/ACTUATION INHL AERO,35.0,24.5,,,0
NDC,66993-081-69,SUMATRIPTAN  5 MG/ACTUATION NASL SPRY,443.0,310.1,,,0
NDC,66993-370-83,MEDROXYPROGESTERONE (CONTRACEPTIVE) 150 MG/ML IM (MERGE),415.0,290.5,,,0
NDC,66993-371-79,MEDROXYPROGESTERONE (CONTRACEPTIVE) 150 MG/ML IM (MERGE),415.0,290.5,,,0
NDC,66993-409-32,CARBAMAZEPINE 300 MG ORAL CM12,11.0,7.7,,,0
NDC,66993-456-30,DAPAGLIFLOZIN PROPANEDIOL  5 MG ORAL TAB,109.0,76.3,,,0
NDC,66993-457-30,DAPAGLIFLOZIN PROPANEDIOL 10 MG ORAL TAB,82.0,57.4,,,0
NDC,66993-490-36,IBUPROFEN LYSINE (PF) 20 MG/2 ML IV SOLN,1087.0,760.9,,,0
NDC,66993-490-84,IBUPROFEN LYSINE (PF) 20 MG/2 ML IV SOLN,794.0,555.8,,,0
NDC,66993-585-97,FLUTICASONE-SALMETEROL 250 MCG-50 MCG/DOSE DISK DEVICE FOR INHALATION,1311.0,917.7,,,0
NDC,66993-586-97,FLUTICASONE-SALMETEROL 500 MCG-50 MCG/DOSE DISK DEVICE FOR INHALATION,1345.0,941.5,,,0
NDC,66993-727-57,TRIMETHOPRIM-SULFAMETHOXAZOLE 40 MG-200 MG/5 ML ORAL SUSP,48.0,33.6,,,0
NDC,66993-791-97,FLUTICASONE  100 MCG/ACTUATION INHL DSDV,840.0,588.0,,,0
NDC,66993-792-97,FLUTICASONE  250 MCG/ACTUATION INHL DSDV,921.0,644.7,,,0
NDC,66993-897-15,"BETAMETHASONE, AUGMENTED 0.05 % TOP OINT",270.0,189.0,,,0
NDC,67120176,DICLOFENAC 1 % TOPICAL GEL,123.0,86.1,,,0
NDC,67157-101-50,ASCORBIC ACID 500 MG/ML INJ SOLN,29.5,20.65,,,0
NDC,67253-651-10,PROPYLTHIOURACIL 50 MG ORAL TAB,10.0,7.0,,,0
NDC,67386-122-52,IBUPROFEN LYSINE (PF) 20 MG/2 ML IV SOLN,1569.0,1098.3,,,0
NDC,67386-130-51,EPTINEZUMAB-JJMR 100 MG/ML IV SOLN,8253.0,5777.099999999999,,,0
NDC,67386-421-01,TETRABENAZINE 12.5 MG ORAL TAB,304.5,213.14999999999998,,,0
NDC,67386-422-01,TETRABENAZINE 25 MG ORAL TAB,386.0,270.2,,,0
NDC,67386-820-19,DROXIDOPA 100 MG ORAL CAP,423.0,296.1,,,0
NDC,67457-108-00,KETAMINE 100 MG/ML INJ SOLN,19.0,13.3,,,0
NDC,67457-153-00,AMIODARONE 50 MG/ML IV SOLN,30.0,21.0,,,0
NDC,67457-153-03,AMIODARONE 50 MG/ML IV SOLN,38.5,26.950000000000003,,,0
NDC,67457-153-09,AMIODARONE 50 MG/ML IV SOLN,52.0,36.4,,,0
NDC,67457-153-99,AMIODARONE 50 MG/ML IV SOLN,18.0,12.6,,,0
NDC,67457-163-00,SODIUM TETRADECYL SULFATE 3 % IV SOLN,796.0,557.2,,,0
NDC,67457-163-02,SODIUM TETRADECYL SULFATE 3 % IV SOLN,1193.0,835.0999999999999,,,0
NDC,67457-182-00,ESMOLOL  100 MG/10 ML IV SOLN,49.0,34.3,,,0
NDC,67457-187-50,ALLOPURINOL SODIUM 500 MG IV SOLR,11005.0,7703.5,,,0
NDC,67457-196-00,THIAMINE 100 MG/ML INJECTION,53.0,37.1,,,0
NDC,67457-197-00,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN",552.0,386.40000000000003,,,0
NDC,67457-197-10,TRANEXAMIC ACID (FOR TOPICAL USE),552.0,386.40000000000003,,,0
NDC,67457-198-03,REMIFENTANIL 1 MG IV SOLR,468.0,327.6,,,0
NDC,67457-211-02,FOMEPIZOLE 1 GRAM/ML IV SOLN,2834.0,1983.8,,,0
NDC,67457-212-02,ARGATROBAN 100 MG/ML IV SOLN,1408.0,985.6,,,0
NDC,67457-217-20,METHADONE 10 MG/ML INJ SOLN,31.5,22.05,,,0
NDC,67457-218-10,CLONIDINE (PF) 1000 MCG/10 ML EPID SOLN,224.0,156.8,,,0
NDC,67457-220-00,ISOSULFAN BLUE 1 % INJ SOLN,1370.0,959.0,,,0
NDC,67457-220-05,ISOSULFAN BLUE 1 % INJ SOLN,1166.0,816.2,,,0
NDC,67457-227-00,COSYNTROPIN 0.25 MG INJ SOLR,381.0,266.7,,,0
NDC,67457-228-00,ROCURONIUM 10 MG/ML IV SOLN,68.0,47.6,,,0
NDC,67457-255-00,LEVETIRACETAM IN NACL (ISO-OS) 500 MG/100 ML IV PGBK,157.5,110.25,,,0
NDC,67457-265-00,LEVETIRACETAM IN NACL (ISO-OS) 1000 MG/100 ML IV PGBK,190.0,133.0,,,0
NDC,67457-266-00,LEVETIRACETAM IN NACL (ISO-OS) 1500 MG/100 ML IV PGBK,168.0,117.6,,,0
NDC,67457-292-00,NALOXONE 0.4 MG/ML INJ SOLN,175.0,122.5,,,0
NDC,67457-299-00,NALOXONE 0.4 MG/ML INJ SOLN,90.5,63.349999999999994,,,0
NDC,67457-299-10,NALOXONE 0.4 MG/ML INJ SOLN,257.0,179.9,,,0
NDC,67457-323-25,MOXIFLOXACIN 400 MG/250 ML IVPB PREMIX (MERGE),700.0,490.0,,,0
NDC,67457-339-00,VANCOMYCIN ENEMA 500MG IN 100ML NS,48.0,33.599999999999994,,,0
NDC,67457-339-50,VANCOMYCIN  500 MG IV SOLR,54.0,37.8,,,0
NDC,67457-340-00,VANCOMYCIN 125 MG/5 ML (25MG/ML) ORAL SYRINGE (REPACK),71.0,49.7,,,0
NDC,67457-340-01,VANCOMYCIN 1000 MG IV SOLR,236.0,165.2,,,0
NDC,67457-341-05,VANCOMYCIN  5 GRAM IV SOLR,135.0,94.5,,,0
NDC,67457-348-15,AMPICILLIN-SULBACTAM  1.5 GRAM INJ SOLR,46.0,32.2,,,0
NDC,67457-359-59,FLUPHENAZINE DECANOATE 25 MG/ML INJ SOLN,134.0,93.8,,,0
NDC,67457-366-10,IBUTILIDE FUMARATE 0.1 MG/ML IV SOLN,1100.0,770.0,,,0
NDC,67457-384-31,HEPARIN (PORCINE)  1000 UNIT/ML INJ SOLN,7457.0,5219.9,,,0
NDC,67457-385-10,HEPARIN (PORCINE)  1000 UNIT/ML INJ SOLN,22.0,15.4,,,0
NDC,67457-390-54,ZOLEDRONIC ACID 4 MG/5 ML IV SOLN,224.0,156.8,,,0
NDC,67457-420-00,DEXAMETHASONE 10 MG/ML INJECTION,6.5,4.55,,,0
NDC,67457-420-10,DEXAMETHASONE 10 MG/ML INJECTION,10.5,7.35,,,0
NDC,67457-421-00,DEXAMETHASONE 4 MG/ML INJECTION,18.5,12.95,,,0
NDC,67457-423-00,DEXAMETHASONE 4 MG/ML INJECTION,6.0,4.2,,,0
NDC,67457-423-12,DEXAMETHASONE 4 MG/ML INJECTION,16.0,11.2,,,0
NDC,67457-426-00,HALOPERIDOL LACTATE 5 MG/ML INJECTION (MERGE),12.0,8.399999999999999,,,0
NDC,67457-426-12,HALOPERIDOL LACTATE 5 MG/ML INJECTION (MERGE),16.0,11.2,,,0
NDC,67457-430-10,PAMIDRONATE 3 MG/ML IV SOLN,238.0,166.6,,,0
NDC,67457-433-00,FAMOTIDINE (PF) 20 MG/2 ML IV SOLN,12.0,8.399999999999999,,,0
NDC,67457-437-00,DOXYCYCLINE HYCLATE 100 MG IV SOLR,98.0,68.6,,,0
NDC,67457-438-00,VECURONIUM BROMIDE 10 MG IV SOLR,38.0,26.6,,,0
NDC,67457-445-60,RIFAMPIN 600 MG IV SOLR,520.5,364.35,,,0
NDC,67457-446-10,PAMIDRONATE 9 MG/ML IV SOLN,405.0,283.5,,,0
NDC,67457-469-10,OXALIPLATIN 100 MG/20 ML IV SOLN,104.0,72.8,,,0
NDC,67457-473-00,TOBRAMYCIN SULFATE 40 MG/ML INJ SOLN,65.5,45.85,,,0
NDC,67457-473-22,TOBRAMYCIN SULFATE 40 MG/ML INJ SOLN,59.5,41.65,,,0
NDC,67457-475-00,VECURONIUM BROMIDE 20 MG IV SOLR,67.0,46.9,,,0
NDC,67457-517-00,FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN,489.0,342.3,,,0
NDC,67457-519-20,MITOMYCIN 20 MG IV SOLR,1424.5,997.15,,,0
NDC,67457-528-10,LEUCOVORIN CALCIUM 100 MG INJ SOLR,147.5,103.25,,,0
NDC,67457-530-35,LEUCOVORIN CALCIUM 350 MG INJ SOLR,306.0,214.2,,,0
NDC,67457-532-08,DOCETAXEL 160 MG/16 ML (10 MG/ML) IV SOLN- NONSTANDARD DOSING,457.0,319.9,,,0
NDC,67457-533-16,DOCETAXEL 160 MG/16 ML (10 MG/ML) IV SOLN,977.5,684.25,,,0
NDC,67457-582-00,FONDAPARINUX 2.5 MG/0.5 ML SUBQ SYRG,232.0,162.4,,,0
NDC,67457-588-10,EPOPROSTENOL (ARGNININE) (VELETRI) CONTINUOUS NEB 1.5 MG IN NS 50 ML,243.0,170.1,,,0
NDC,67457-599-00,NALOXONE 0.4 MG/ML INJ SOLN,117.0,81.9,,,0
NDC,67457-617-30,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) IV SOLN,495.0,346.5,,,0
NDC,67457-618-10,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) IV SOLN,409.0,286.3,,,0
NDC,67457-619-10,ZOLEDRONIC ACID IN MANNITOL & WATER 5 MG/100 ML IV SOLN,1571.5,1100.05,,,0
NDC,67457-621-02,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,27.0,18.9,,,0
NDC,67457-622-05,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,46.0,32.2,,,0
NDC,67457-623-10,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,52.0,36.4,,,0
NDC,67457-640-00,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJ SOLN,109.0,76.3,,,0
NDC,67457-657-25,"ESMOLOL IN SALINE (ISO-OSMOTIC) 2,500 MG/250 ML (10 MG/ML) IV",1161.0,812.7,,,0
NDC,67457-658-10,"ESMOLOL IN SALINE (ISO-OSMOTIC) 2,000 MG/100 ML (20 MG/ML) IV",1251.0,875.7,,,0
NDC,67457-675-02,CALCITONIN (SALMON) 200 UNIT/ML INJ SOLN,2788.0,1951.6,,,0
NDC,67457-705-00,VANCOMYCIN  750 MG IV SOLR,57.0,39.9,,,0
NDC,67457-823-12,VANCOMYCIN   1.25 G IV SOLR,130.0,91.0,,,0
NDC,67457-823-99,VANCOMYCIN   1.25 G IV SOLR,118.0,82.6,,,0
NDC,67457-824-15,VANCOMYCIN   1.5 G IV SOLR,142.0,99.4,,,0
NDC,67457-824-99,VANCOMYCIN   1.5 G IV SOLR,142.0,99.4,,,0
NDC,67457-833-06,PEGFILGRASTIM-JMDB (FULPHILA) 6 MG/0.6 ML SUBQ SYRG,11523.0,8066.1,,,0
NDC,67457-853-50,ACETAZOLAMIDE SODIUM 500 (100 MG/ML) INJ SOLR,118.0,82.6,,,0
NDC,67457-855-00,ADENOSINE 3000 MCG/ML INJECTION,125.0,87.5,,,0
NDC,67457-855-02,ADENOSINE 3000 MCG/ML INJECTION,42.0,29.4,,,0
NDC,67457-887-00,MEDROXYPROGESTERONE (CONTRACEPTIVE) 150 MG/ML IM (MERGE),202.0,141.4,,,0
NDC,67457-953-00,HEPARIN (PORCINE) 1000 UNITS/ML INJ SOL (FOR DIALYSIS ONLY),16.0,11.2,,,0
NDC,67457-994-05,REGADENOSON 0.4 MG/5 ML IV SYRG,177.0,123.9,,,0
NDC,67684-1901-1,ETHIODIZED OIL 48 % INJ SOLN,4954.0,3467.8,,,0
NDC,67777-116-10,BACITRACIN 500 UNIT/G TOP PACK,7.0,4.9,,,0
NDC,67777-116-11,BACITRACIN 500 UNIT/G TOP PACK,7.0,4.9,,,0
NDC,67850-041-00,TRANEXAMIC ACID (FOR TOPICAL USE),172.0,120.4,,,0
NDC,67877-124-05,SILVER SULFADIAZINE 1 % TOP CREA,88.0,61.6,,,0
NDC,67877-124-20,SILVER SULFADIAZINE 1 % TOP CREA,116.5,81.55000000000001,,,0
NDC,67877-124-50,SILVER SULFADIAZINE 1 % TOP CREA,102.0,71.4,,,0
NDC,67877-146-01,TEMAZEPAM 15 MG ORAL CAP,8.5,5.95,,,0
NDC,67877-215-60,CEFUROXIME AXETIL 250 MG ORAL TAB,44.0,30.8,,,0
NDC,67877-216-20,CEFUROXIME AXETIL 500 MG ORAL TAB,55.0,38.5,,,0
NDC,67877-246-01,QUETIAPINE 200 MG ORAL TAB,79.5,55.65,,,0
NDC,67877-251-15,TRIAMCINOLONE ACETONIDE 0.1 % TOP CREAM,33.0,23.1,,,0
NDC,67877-288-90,FINASTERIDE 5 MG ORAL TAB,18.0,12.6,,,0
NDC,67877-319-01,IBUPROFEN 400 MG ORAL TAB,7.0,4.9,,,0
NDC,67877-320-01,IBUPROFEN 600 MG ORAL TAB,5.5,3.85,,,0
NDC,67877-414-01,METFORMIN  750 MG ORAL TB24,7.0,4.9,,,0
NDC,67877-419-20,LINEZOLID 600 MG ORAL TAB,526.0,368.2,,,0
NDC,67877-419-33,LINEZOLID 600 MG ORAL TAB,2112.5,1478.75,,,0
NDC,67877-422-57,CHOLESTYRAMINE-ASPARTAME 4 GRAM ORAL PACK,14.5,10.15,,,0
NDC,67877-432-03,ARIPIPRAZOLE 10 MG ORAL TAB,196.0,137.2,,,0
NDC,67877-433-03,ARIPIPRAZOLE 15 MG ORAL TAB,157.0,109.9,,,0
NDC,67877-445-30,OLMESARTAN  5 MG ORAL TAB,40.0,28.0,,,0
NDC,67877-473-79,LIDOCAINE 5 % TOP OINT,890.0,623.0,,,0
NDC,67877-493-01,AZATHIOPRINE  50 MG ORAL TAB,9.5,6.65,,,0
NDC,67877-543-60,CEFDINIR 300 MG ORAL CAP,39.5,27.65,,,0
NDC,67877-545-68,CEPHALEXIN 250 MG/5 ML ORAL SUSR,9.0,6.3,,,0
NDC,67877-545-88,CEPHALEXIN 250 MG/5 ML ORAL SUSR,11.0,7.7,,,0
NDC,67877-548-88,CEFDINIR 250 MG/5 ML ORAL SUSR,33.5,23.450000000000003,,,0
NDC,67877-590-01,METOPROLOL SUCCINATE SR 25 MG 24 HR TAB,14.0,9.8,,,0
NDC,67877-592-01,METOPROLOL SUCCINATE SR 100 MG 24 HR TAB,16.0,11.2,,,0
NDC,67877-638-30,LURASIDONE 20 MG ORAL TAB,460.0,322.0,,,0
NDC,67877-658-61,CLOBAZAM 2.5 MG/ML ORAL SUSP,169.0,118.3,,,0
NDC,67877-670-01,MORPHINE  15 MG ORAL TAB,13.5,9.45,,,0
NDC,67877-719-33,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG ORAL TAB,197.0,137.9,,,0
NDC,67919-012-01,DAPTOMYCIN 500 MG IV SOLR,1845.0,1291.5,,,0
NDC,67919-012-02,DAPTOMYCIN 500 MG IV SOLR,984.0,688.8,,,0
NDC,67919-030-01,CEFTOLOZANE-TAZOBACTAM 1.5 G IV SOLR,891.5,624.05,,,0
NDC,67979-002-01,HISTRELIN 50 MG (65 MCG/DAY) IMPL KIT,74263.0,51984.1,,,0
NDC,68001-477-45,BACITRACIN 500 UNIT/G TOP PACK,7.0,4.9,,,0
NDC,68084-021-11,ABACAVIR 300 MG ORAL TAB,99.0,69.3,,,0
NDC,68084-027-11,WARFARIN  2.5 MG ORAL TAB,8.0,5.6,,,0
NDC,68084-041-01,MISOPROSTOL 200 MCG ORAL TAB,54.0,37.8,,,0
NDC,68084-045-11,PAROXETINE 20 MG TAB,31.0,21.7,,,0
NDC,68084-046-11,PAROXETINE 30 MG TAB,16.0,11.2,,,0
NDC,68084-059-11,ZAFIRLUKAST 20 MG ORAL TAB,20.0,14.0,,,0
NDC,68084-070-01,CIPROFLOXACIN 500 MG ORAL TAB,18.0,12.6,,,0
NDC,68084-070-11,CIPROFLOXACIN 500 MG ORAL TAB,18.0,12.6,,,0
NDC,68084-075-11,TRETINOIN (CHEMOTHERAPY) 10 MG ORAL CAP,546.0,382.2,,,0
NDC,68084-083-11,ISOSORBIDE DINITRATE 20 MG ORAL TAB,10.0,7.0,,,0
NDC,68084-094-11,CARBIDOPA-LEVODOPA 25 MG-250 MG TAB,7.0,4.9,,,0
NDC,68084-097-01,ATORVASTATIN 10 MG ORAL TAB,17.5,12.25,,,0
NDC,68084-097-11,ATORVASTATIN 10 MG ORAL TAB,11.0,7.7,,,0
NDC,68084-098-11,ATORVASTATIN 20 MG ORAL TAB,7.0,4.9,,,0
NDC,68084-099-11,ATORVASTATIN 40 MG ORAL TAB,10.0,7.0,,,0
NDC,68084-104-09,ZIPRASIDONE 40 MG CAP,86.0,60.2,,,0
NDC,68084-104-11,ZIPRASIDONE 40 MG CAP,83.0,58.1,,,0
NDC,68084-109-11,ACYCLOVIR 800 MG ORAL TAB,19.5,13.649999999999999,,,0
NDC,68084-111-11,GLIPIZIDE  5 MG ORAL TO24,8.0,5.6,,,0
NDC,68084-119-11,MIRTAZAPINE 15 MG ORAL TAB,9.0,6.3,,,0
NDC,68084-120-11,MIRTAZAPINE 30 MG ORAL TAB,8.0,5.6,,,0
NDC,68084-149-11,METHYLPREDNISOLONE  4 MG ORAL TAB,18.0,12.600000000000001,,,0
NDC,68084-154-01,PROMETHAZINE 12.5 MG ORAL TAB,7.0,4.9,,,0
NDC,68084-155-11,PROMETHAZINE 25 MG ORAL TAB,7.0,4.9,,,0
NDC,68084-157-11,MORPHINE  15 MG ORAL TBSR,21.0,14.7,,,0
NDC,68084-180-11,SERTRALINE  25 MG ORAL TAB,7.0,4.9,,,0
NDC,68084-184-01,OXYCODONE  15 MG ORAL TAB,11.0,7.7,,,0
NDC,68084-189-11,ZOLPIDEM  5 MG ORAL TAB,15.0,10.5,,,0
NDC,68084-202-11,PRIMIDONE  50 MG ORAL TAB,11.0,7.7,,,0
NDC,68084-203-11,PRIMIDONE 250 MG ORAL TAB,6.5,4.550000000000001,,,0
NDC,68084-204-11,MINOXIDIL  2.5 MG ORAL TAB,29.0,20.3,,,0
NDC,68084-214-11,BENZONATATE 100 MG ORAL CAP,7.0,4.9,,,0
NDC,68084-215-11,VALACYCLOVIR 500 MG ORAL TAB,61.5,43.05,,,0
NDC,68084-220-11,ONDANSETRON HCL  4 MG ORAL TAB,7.0,4.9,,,0
NDC,68084-229-11,AZATHIOPRINE  50 MG ORAL TAB,9.0,6.3,,,0
NDC,68084-230-11,TRIMETHOPRIM-SULFAMETHOXAZOLE 160 MG-800 MG TAB,23.0,16.1,,,0
NDC,68084-243-11,CLINDAMYCIN 150 MG CAP,11.0,7.7,,,0
NDC,68084-244-11,CLINDAMYCIN 300 MG CAP,11.5,8.05,,,0
NDC,68084-248-11,LORATADINE 10 MG ORAL TAB,7.0,4.9,,,0
NDC,68084-249-11,HALOPERIDOL 10 MG ORAL TAB,9.0,6.300000000000001,,,0
NDC,68084-252-11,BUPROPION HCL 300 MG ORAL TB24,27.0,18.9,,,0
NDC,68084-254-11,HYDROXYZINE 25 MG TAB,7.0,4.9,,,0
NDC,68084-255-11,HYDROXYZINE 50 MG TAB,7.5,5.25,,,0
NDC,68084-258-11,AMLODIPINE  2.5 MG ORAL TAB,11.0,7.7,,,0
NDC,68084-259-01,AMLODIPINE (NORVASC) 1MG/ML SUSPENSION (REPACK),7.0,4.9,,,0
NDC,68084-269-11,HYDROXYCHLOROQUINE 200 MG ORAL TAB,49.0,34.3,,,0
NDC,68084-270-11,RISPERIDONE 0.25 MG ORAL TAB,58.0,40.6,,,0
NDC,68084-272-11,RISPERIDONE 1 MG ORAL TAB,38.0,26.6,,,0
NDC,68084-280-11,ETHAMBUTOL 400 MG ORAL TAB,19.5,13.65,,,0
NDC,68084-281-11,CARBIDOPA-LEVODOPA SR 25 MG-100 MG TAB,8.5,5.95,,,0
NDC,68084-282-11,CARBIDOPA-LEVODOPA SR 50 MG-200 MG TAB,13.5,9.45,,,0
NDC,68084-284-11,HYDROXYUREA  500 MG ORAL CAP,25.0,17.5,,,0
NDC,68084-288-11,FLUDROCORTISONE 0.1 MG ORAL TAB,9.5,6.65,,,0
NDC,68084-291-11,NALTREXONE 50 MG ORAL TAB,36.0,25.200000000000003,,,0
NDC,68084-299-11,TAMSULOSIN 0.4 MG ORAL CP24,35.5,24.85,,,0
NDC,68084-300-11,DANTROLENE  25 MG ORAL CAP,16.5,11.55,,,0
NDC,68084-313-11,DIVALPROEX 125 MG ORAL CPSP,32.0,22.4,,,0
NDC,68084-318-11,LAMOTRIGINE  25 MG ORAL TAB,7.0,4.9,,,0
NDC,68084-319-11,LAMOTRIGINE 100 MG ORAL TAB,5.5,3.85,,,0
NDC,68084-326-11,GLIMEPIRIDE 2 MG ORAL TAB,10.0,7.0,,,0
NDC,68084-327-11,GLIMEPIRIDE 4 MG ORAL TAB,10.5,7.3500000000000005,,,0
NDC,68084-342-11,TOPIRAMATE  25 MG ORAL TAB,41.0,28.7,,,0
NDC,68084-344-11,TOPIRAMATE 100 MG ORAL TAB,47.5,33.25,,,0
NDC,68084-345-11,TOPIRAMATE 200 MG ORAL TAB,10.0,7.0,,,0
NDC,68084-346-11,LOSARTAN  25 MG ORAL TAB,16.5,11.55,,,0
NDC,68084-347-11,LOSARTAN  50 MG ORAL TAB,19.0,13.3,,,0
NDC,68084-354-11,OXYCODONE 5 MG ORAL TAB,8.0,5.6,,,0
NDC,68084-376-11,PHENYTOIN SODIUM EXTENDED 100 MG ORAL CAP,8.0,5.6,,,0
NDC,68084-388-11,BENZTROPINE 1 MG ORAL TAB,5.5,3.85,,,0
NDC,68084-389-11,BENZTROPINE 2 MG ORAL TAB,7.0,4.9,,,0
NDC,68084-396-11,BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TAB,16.5,11.55,,,0
NDC,68084-415-11,DIVALPROEX 500 MG ORAL TB24,54.0,37.8,,,0
NDC,68084-423-11,HYDROMORPHONE  2 MG ORAL TAB,7.0,4.9,,,0
NDC,68084-444-11,CARBAMAZEPINE 200 MG ORAL TAB,7.0,4.9,,,0
NDC,68084-447-11,HYDRALAZINE  10 MG ORAL TAB,7.0,4.9,,,0
NDC,68084-449-11,TACROLIMUS 0.5 MG ORAL CAP,31.5,22.05,,,0
NDC,68084-450-11,TACROLIMUS 1 MG ORAL CAP,66.0,46.2,,,0
NDC,68084-473-11,GEMFIBROZIL 600 MG ORAL TAB,19.0,13.3,,,0
NDC,68084-479-11,CALCIUM ACETATE 667 MG ORAL CAP,23.5,16.450000000000003,,,0
NDC,68084-480-11,OXYBUTYNIN CHLORIDE  5 MG ORAL TO24,43.5,30.450000000000003,,,0
NDC,68084-491-11,MECLIZINE 25 MG ORAL TAB,7.0,4.9,,,0
NDC,68084-511-11,SIMVASTATIN 10 MG ORAL TAB,16.0,11.2,,,0
NDC,68084-512-11,SIMVASTATIN 20 MG ORAL TAB,34.5,24.15,,,0
NDC,68084-536-11,CLOPIDOGREL  75 MG ORAL TAB,67.0,46.9,,,0
NDC,68084-539-11,TORSEMIDE  20 MG ORAL TAB,13.0,9.100000000000001,,,0
NDC,68084-549-11,TEMAZEPAM  7.5 MG ORAL CAP,102.5,71.75,,,0
NDC,68084-572-11,GUAIFENESIN 600 MG ORAL TP12,7.0,4.9,,,0
NDC,68084-590-95,ATORVASTATIN 80 MG ORAL TAB,9.0,6.300000000000001,,,0
NDC,68084-597-11,NIFEDIPINE 30 MG ORAL TO24,19.5,13.65,,,0
NDC,68084-598-01,NIFEDIPINE 60 MG ORAL TO24,17.0,11.9,,,0
NDC,68084-598-11,NIFEDIPINE 60 MG ORAL TO24,21.0,14.7,,,0
NDC,68084-602-11,PERPHENAZINE  4 MG ORAL TAB,12.0,8.4,,,0
NDC,68084-603-11,NIFEDIPINE 90 MG ORAL TO24,15.0,10.5,,,0
NDC,68084-617-11,ESCITALOPRAM 10 MG ORAL TAB,24.0,16.8,,,0
NDC,68084-618-11,ESCITALOPRAM 20 MG ORAL TAB,19.5,13.649999999999999,,,0
NDC,68084-621-11,MODAFINIL 100 MG ORAL TAB,176.5,123.55000000000001,,,0
NDC,68084-640-11,LITHIUM CARBONATE 300 MG ORAL TBSR,7.5,5.25,,,0
NDC,68084-645-11,TIZANIDINE 4 MG ORAL TAB,11.0,7.699999999999999,,,0
NDC,68084-647-11,ALPRAZOLAM 0.25 MG ORAL TAB,7.5,5.25,,,0
NDC,68084-654-11,SOTALOL  80 MG ORAL TAB,16.5,11.55,,,0
NDC,68084-655-11,LITHIUM CARBONATE 450 MG ORAL TBSR,8.0,5.6,,,0
NDC,68084-658-11,IBUPROFEN 400 MG ORAL TAB,7.0,4.9,,,0
NDC,68084-666-11,METOPROLOL SUCCINATE SR 50 MG 24 HR TAB,19.0,13.3,,,0
NDC,68084-697-11,BUPROPION HCL 100 MG ORAL TBSR,19.0,13.3,,,0
NDC,68084-698-11,VENLAFAXINE  37.5 MG ORAL CP24,55.0,38.5,,,0
NDC,68084-708-95,BUPROPION HCL 150 MG ORAL TBSR,8.0,5.6,,,0
NDC,68084-709-01,VENLAFAXINE  75 MG ORAL CP24,43.0,30.1,,,0
NDC,68084-709-11,VENLAFAXINE  75 MG ORAL CP24,47.0,32.9,,,0
NDC,68084-713-11,VENLAFAXINE 150 MG ORAL CP24,35.0,24.5,,,0
NDC,68084-722-11,MOXIFLOXACIN 400 MG ORAL TAB,132.0,92.4,,,0
NDC,68084-723-11,OLANZAPINE  5 MG ORAL TAB,80.0,56.0,,,0
NDC,68084-728-11,FLUCONAZOLE 100 MG ORAL TAB,177.0,123.9,,,0
NDC,68084-729-11,GALANTAMINE  4 MG ORAL TAB,37.0,25.9,,,0
NDC,68084-735-11,FLUCONAZOLE 200 MG ORAL TAB,374.0,261.8,,,0
NDC,68084-744-11,CITALOPRAM 20 MG ORAL TAB,15.0,10.5,,,0
NDC,68084-750-95,TRIAMTERENE-HYDROCHLOROTHIAZIDE 37.5 MG-25 MG TAB,9.0,6.300000000000001,,,0
NDC,68084-752-95,CLOPIDOGREL 300 MG ORAL TAB,131.0,91.7,,,0
NDC,68084-753-95,CYCLOBENZAPRINE  5 MG ORAL TAB,7.0,4.9,,,0
NDC,68084-776-11,DIVALPROEX 250 MG ORAL TBEC,20.0,14.0,,,0
NDC,68084-782-11,DIVALPROEX 500 MG ORAL TBEC,18.0,12.6,,,0
NDC,68084-788-95,GLIMEPIRIDE 1 MG ORAL TAB,6.5,4.550000000000001,,,0
NDC,68084-795-11,MYCOPHENOLATE 250 MG CAP,7.0,4.9,,,0
NDC,68084-805-11,METHYLPHENIDATE  5 MG ORAL TAB,48.0,33.6,,,0
NDC,68084-808-11,TRAMADOL  50 MG ORAL TAB,8.5,5.95,,,0
NDC,68084-813-11,PANTOPRAZOLE 40 MG ORAL TBEC,7.0,4.9,,,0
NDC,68084-836-95,DOXAZOSIN 1 MG ORAL TAB,9.5,6.65,,,0
NDC,68084-844-11,VENLAFAXINE  37.5 MG ORAL TAB,17.5,12.25,,,0
NDC,68084-847-01,HYDROXYZINE PAMOATE  25 MG ORAL CAP,7.0,4.9,,,0
NDC,68084-847-11,HYDROXYZINE PAMOATE  25 MG ORAL CAP,7.0,4.9,,,0
NDC,68084-850-33,POTASSIUM CITRATE 10 MEQ ORAL TBER,41.0,28.7,,,0
NDC,68084-851-95,DOXAZOSIN 2 MG ORAL TAB,9.5,6.65,,,0
NDC,68084-854-11,CARVEDILOL  6.25 MG ORAL TAB,27.5,19.25,,,0
NDC,68084-856-11,VENLAFAXINE  75 MG ORAL TAB,19.0,13.3,,,0
NDC,68084-862-95,DOXAZOSIN 4 MG ORAL TAB,8.0,5.6,,,0
NDC,68084-863-11,HYDROCODONE-ACETAMINOPHEN 7.5 MG-325 MG TAB,7.0,4.9,,,0
NDC,68084-875-11,MONTELUKAST 10 MG ORAL TAB,23.5,16.45,,,0
NDC,68084-879-95,CYCLOSPORINE  25 MG ORAL CAP,53.5,37.45,,,0
NDC,68084-882-11,LEVETIRACETAM  750 MG ORAL TAB,8.5,5.95,,,0
NDC,68084-895-11,HYDROCODONE-ACETAMINOPHEN 5 MG-325 MG TAB,7.0,4.9,,,0
NDC,68084-896-95,VENLAFAXINE  25 MG ORAL TAB,12.0,8.4,,,0
NDC,68084-907-11,"MYCOPHENOLATE 180 MG TAB, DELAYED RELEASE",51.0,35.7,,,0
NDC,68084-918-95,MYCOPHENOLATE SODIUM 360 MG ORAL TBEC,98.0,68.6,,,0
NDC,68084-921-95,CYCLOSPORINE 100 MG ORAL CAP,85.0,59.5,,,0
NDC,68084-928-95,PILOCARPINE 5 MG TAB,17.0,11.9,,,0
NDC,68084-964-95,PROPYLTHIOURACIL 50 MG ORAL TAB,44.0,30.8,,,0
NDC,68084-965-95,VALGANCICLOVIR 450 MG ORAL TAB,141.0,98.69999999999999,,,0
NDC,68084-975-11,OXYCODONE  15 MG ORAL TAB,18.0,12.6,,,0
NDC,68084-988-33,CALCIUM CARBONATE 500 MG (200 MG ELEMENTAL) CHEW TAB,15.0,10.5,,,0
NDC,68084-996-11,PRAZOSIN 1 MG ORAL CAP,15.0,10.5,,,0
NDC,68094-001-59,MORPHINE  10 MG/5 ML ORAL SOLN,10.0,7.0,,,0
NDC,68094-004-59,CETIRIZINE 5 MG/5 ML ORAL SOLN,32.0,22.4,,,0
NDC,68094-005-59,OXYCODONE  15 MG ORAL TAB,8.0,5.6,,,0
NDC,68094-015-59,ACETAMINOPHEN 160 MG/5 ML ORAL (PHS ERX MERGE),40.0,28.0,,,0
NDC,68094-019-59,GUANFACINE 1 MG ORAL TAB,10.0,7.0,,,0
NDC,68094-024-59,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,13.0,9.1,,,0
NDC,68094-029-59,LOPERAMIDE 1 MG/7.5 ML ORAL LIQD,35.0,24.5,,,0
NDC,68094-031-59,METHADONE 1 MG/1 ML ORAL SOLN,14.0,9.8,,,0
NDC,68094-043-59,SUCRALFATE 100 MG/ML ORAL SUSP,79.5,55.650000000000006,,,0
NDC,68094-045-01,MORPHINE CONCENTRATE 10 MG/ 0.5 ML ORAL SYRINGE (0.5ML UD MERGE),17.5,12.25,,,0
NDC,68094-061-59,ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSP,14.0,9.8,,,0
NDC,68094-063-59,MEGESTROL 400 MG/10 ML (10 ML) ORAL SUSP,19.5,13.649999999999999,,,0
NDC,68094-147-01,DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) IV SOLN,6422.5,4495.75,,,0
NDC,68094-147-20,DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) IV SOLN,99.0,69.3,,,0
NDC,68094-193-59,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLN,11.0,7.7,,,0
NDC,68094-231-59,ACETAMINOPHEN 160 MG/5 ML ORAL (PHS ERX MERGE),26.0,18.2,,,0
NDC,68094-330-59,ACETAMINOPHEN 160 MG/5 ML ORAL (PHS ERX MERGE),8.5,5.949999999999999,,,0
NDC,68094-494-58,IBUPROFEN 100 MG/5 ML ORAL SUSP,31.0,21.7,,,0
NDC,68094-494-59,IBUPROFEN 100 MG/5 ML ORAL SUSP,15.5,10.850000000000001,,,0
NDC,68094-503-59,IBUPROFEN 100 MG/5 ML ORAL SUSP,12.0,8.4,,,0
NDC,68094-503-61,IBUPROFEN 100 MG/5 ML ORAL SUSP,27.0,18.9,,,0
NDC,68094-600-59,IBUPROFEN 100 MG/5 ML ORAL SUSP,22.0,15.4,,,0
NDC,68094-676-59,METOCLOPRAMIDE HCL 5 MG/5 ML ORAL SOLN,7.0,4.9,,,0
NDC,68094-750-59,DIAZEPAM 5 MG/5 ML (5 ML) ORAL SOLN,8.0,5.6,,,0
NDC,68094-756-59,FUROSEMIDE 40 MG/4 ML ORAL SOLN,10.5,7.3500000000000005,,,0
NDC,68094-763-59,ONDANSETRON HCL 4 MG/5 ML ORAL SOLN,112.5,78.75,,,0
NDC,68094-764-59,MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRP (MERGE/REPACK),34.0,23.8,,,0
NDC,68094-799-30,AZITHROMYCIN 500 MG ORAL TAB,7.0,4.9,,,0
NDC,68094-853-62,NALTREXONE 50 MG ORAL TAB,16.0,11.2,,,0
NDC,68094-900-30,AZITHROMYCIN 250 MG ORAL TAB,13.0,9.1,,,0
NDC,6809411059,MELATONIN  3 MG ORAL TAB,5.5,3.85,,,0
NDC,6809411659,THIAMINE MONONITRATE 100 MG ORAL TAB,7.0,4.9,,,0
NDC,6809412059,MULTIVIT-MIN-FERROUS GLUCONATE 9 MG IRON/ 15 ML (15 ML) ORAL LIQD,16.0,11.2,,,0
NDC,6817600010,PEDI MULTIVIT NO.128-VITAMIN K 500 MCG/ML ORAL LIQD,7.0,4.9,,,0
NDC,68180-113-16,LEVETIRACETAM  500 MG ORAL TAB,30.0,21.0,,,0
NDC,68180-150-01,FAMOTIDINE 40 MG/5 ML ORAL SUSP,41.0,28.7,,,0
NDC,68180-166-11,VANCOMYCIN  125 MG ORAL CAP,154.0,107.8,,,0
NDC,68180-214-30,CYCLOSPORINE 0.05 % OPHT DPET,33.5,23.45,,,0
NDC,68180-214-60,CYCLOSPORINE 0.05 % OPHT DPET,33.5,23.45,,,0
NDC,68180-280-01,ETHAMBUTOL 100 MG ORAL TAB,8.5,5.95,,,0
NDC,68180-294-07,DULOXETINE 20 MG ORAL CPDR,86.0,60.2,,,0
NDC,68180-295-09,DULOXETINE 30 MG ORAL CPDR,77.0,53.9,,,0
NDC,68180-296-06,DULOXETINE 60 MG ORAL CPDR,44.0,30.8,,,0
NDC,68180-296-09,DULOXETINE 60 MG ORAL CPDR,55.0,38.5,,,0
NDC,68180-315-06,IMIPRAMINE PAMOATE 100 MG ORAL CAP,83.0,58.1,,,0
NDC,68180-319-09,BUPROPION HCL 150 MG ORAL TB24,53.0,37.1,,,0
NDC,68180-320-06,BUPROPION HCL 300 MG ORAL TB24,27.0,18.9,,,0
NDC,68180-405-01,CEFIXIME 100 MG/5 ML ORAL SUSR,98.0,68.6,,,0
NDC,68180-422-01,MOXIFLOXACIN 0.5 % OPHT DROP,603.0,422.1,,,0
NDC,68180-441-01,CEPHALEXIN 250 MG/5 ML ORAL SUSR,10.5,7.35,,,0
NDC,68180-441-02,CEPHALEXIN 250 MG/5 ML ORAL SUSR,18.0,12.6,,,0
NDC,68180-445-01,QUETIAPINE  25 MG ORAL TAB,45.0,31.5,,,0
NDC,68180-465-09,SIMVASTATIN 80 MG ORAL TAB,28.0,19.6,,,0
NDC,68180-467-01,LOVASTATIN 10 MG ORAL TAB,8.0,5.6,,,0
NDC,68180-468-01,LOVASTATIN 20 MG ORAL TAB,20.0,14.0,,,0
NDC,68180-468-07,LOVASTATIN 20 MG ORAL TAB,20.5,14.35,,,0
NDC,68180-513-01,LISINOPRIL  5 MG ORAL TAB,11.0,7.7,,,0
NDC,68180-592-06,DESVENLAFAXINE  50 MG ORAL TB24,113.0,79.1,,,0
NDC,68180-644-01,CEFTRIAXONE   2 GRAM INJ SOLR,388.0,271.6,,,0
NDC,68180-657-01,DOXYCYCLINE 25 MG/5 ML ORAL SUSP,22.0,15.4,,,0
NDC,68180-659-06,RIFAMPIN 300 MG ORAL CAP,26.0,18.2,,,0
NDC,68180-675-11,OSELTAMIVIR PHOSPHATE 30 MG ORAL CAP,122.0,85.4,,,0
NDC,68180-677-11,OSELTAMIVIR PHOSPHATE 75 MG ORAL CAP,76.0,53.2,,,0
NDC,68180-678-01,OSELTAMIVIR  6 MG/ML ORAL SUSR,58.0,40.6,,,0
NDC,68180-711-60,CEFDINIR 300 MG ORAL CAP,29.0,20.3,,,0
NDC,68180-723-04,CEFDINIR 250 MG/5 ML ORAL SUSR,22.5,15.75,,,0
NDC,68180-723-05,CEFDINIR 250 MG/5 ML ORAL SUSR,33.0,23.1,,,0
NDC,68180-819-42,LANTHANUM  500 MG ORAL CHEW,159.0,111.3,,,0
NDC,68180-819-52,LANTHANUM  500 MG ORAL CHEW,127.0,88.9,,,0
NDC,68180-947-01,"BETAMETHASONE, AUGMENTED 0.05 % TOP OINT",270.0,189.0,,,0
NDC,68180-963-01,ALBUTEROL SULFATE 90 MCG/ACTUATION INHL HFAA,12.0,8.4,,,0
NDC,68180-966-01,LEVOTHYROXINE  50 MCG ORAL TAB,5.5,3.85,,,0
NDC,68180-969-01,LEVOTHYROXINE 100 MCG ORAL TAB,7.0,4.9,,,0
NDC,68180-976-09,LEVOTHYROXINE 300 MCG ORAL TAB,5.5,3.85,,,0
NDC,68180-980-01,LISINOPRIL 10 MG ORAL TAB,9.5,6.65,,,0
NDC,68180-981-01,LISINOPRIL 20 MG ORAL TAB,7.0,4.9,,,0
NDC,68180-984-05,BUDESONIDE 0.5 MG/2 ML INHL NBSP,55.0,38.5,,,0
NDC,68180-984-30,BUDESONIDE 0.5 MG/2 ML INHL NBSP,55.0,38.5,,,0
NDC,68180-998-01,FLUOXETINE 10 MG ORAL TAB,44.5,31.15,,,0
NDC,68220-112-10,HYOSCYAMINE SULFATE 0.125 MG ORAL TAB,17.0,11.9,,,0
NDC,68308-152-15,NYSTATIN  100000 UNIT/G TOP POWD,161.5,113.05,,,0
NDC,68382-004-14,TOPIRAMATE  15 MG ORAL CPSP,60.0,42.0,,,0
NDC,68382-005-14,TOPIRAMATE  25 MG ORAL CPSP,66.0,46.2,,,0
NDC,68382-022-10,ATENOLOL  25 MG ORAL TAB,7.0,4.9,,,0
NDC,68382-050-01,MELOXICAM  7.5 MG ORAL TAB,44.5,31.15,,,0
NDC,68382-079-01,HALOPERIDOL  5 MG ORAL TAB,9.5,6.65,,,0
NDC,68382-092-01,CARVEDILOL  3.125 MG ORAL TAB,12.0,8.4,,,0
NDC,68382-094-01,CARVEDILOL 12.5 MG ORAL TAB,21.0,14.7,,,0
NDC,68382-112-14,RISPERIDONE 0.25 MG ORAL TAB,33.0,23.1,,,0
NDC,68382-123-16,AMLODIPINE 10 MG ORAL TAB,14.0,9.8,,,0
NDC,68382-132-01,TAMSULOSIN 0.4 MG ORAL CP24,35.5,24.85,,,0
NDC,68382-144-06,RAMIPRIL  1.25 MG ORAL CAP,13.0,9.1,,,0
NDC,68382-146-01,RAMIPRIL  5 MG ORAL CAP,16.0,11.2,,,0
NDC,68382-181-01,BUSPIRONE 10 MG ORAL TAB,12.0,8.4,,,0
NDC,68382-370-01,NYSTATIN  100000 UNIT/G TOP POWD,137.0,95.9,,,0
NDC,68382-444-05,FAMOTIDINE 40 MG/5 ML ORAL SUSP,30.0,21.0,,,0
NDC,68382-472-30,TELMISARTAN 40 MG ORAL TAB,31.0,21.7,,,0
NDC,68382-520-01,SIROLIMUS 0.5 MG ORAL TAB,48.0,33.6,,,0
NDC,68382-528-60,CHOLESTYRAMINE-SUCROSE 4 GRAM ORAL PACK,14.5,10.15,,,0
NDC,68382-536-01,POTASSIUM CITRATE  5 MEQ ORAL TBER,15.0,10.5,,,0
NDC,68382-537-01,POTASSIUM CITRATE 10 MEQ ORAL TBER,14.0,9.8,,,0
NDC,68382-582-01,LIOTHYRONINE  5 MCG ORAL TAB,9.0,6.3,,,0
NDC,68382-591-01,PERPHENAZINE  2 MG ORAL TAB,45.5,31.85,,,0
NDC,68382-771-30,LANSOPRAZOLE 15 MG ORAL TBLD,61.0,42.7,,,0
NDC,68382-772-30,LANSOPRAZOLE 30 MG ORAL TBLD,78.0,54.6,,,0
NDC,68382-773-06,EZETIMIBE 10 MG ORAL TAB,56.0,39.2,,,0
NDC,68382-783-01,DOXAZOSIN 1 MG ORAL TAB,11.5,8.05,,,0
NDC,68382-786-01,DOXAZOSIN 8 MG ORAL TAB,8.0,5.6,,,0
NDC,68382-805-01,TRAZODONE  50 MG ORAL TAB,10.5,7.35,,,0
NDC,68382-806-01,TRAZODONE 100 MG ORAL TAB,20.0,14.0,,,0
NDC,68382-857-01,TRIAMTERENE-HYDROCHLOROTHIAZIDE 75 MG-50 MG TAB,7.0,4.9,,,0
NDC,68382-860-02,BENZTROPINE 1 MG/ML INJ SOLN,125.0,87.5,,,0
NDC,68382-910-01,DOXYCYCLINE HYCLATE 100 MG IV SOLR,148.0,103.6,,,0
NDC,68382-918-18,METHYLPREDNISOLONE 16 MG ORAL TAB,32.5,22.75,,,0
NDC,68462-157-13,ONDANSETRON 4 MG ORAL TBDL,170.5,119.35,,,0
NDC,68462-157-40,ONDANSETRON 4 MG ORAL TBDL,294.0,205.8,,,0
NDC,68462-158-11,ONDANSETRON 8 MG ORAL TBDL,142.0,99.4,,,0
NDC,68462-158-40,ONDANSETRON 8 MG ORAL TBDL,142.0,99.4,,,0
NDC,68462-163-01,CARVEDILOL  6.25 MG ORAL TAB,12.0,8.4,,,0
NDC,68462-164-01,CARVEDILOL 12.5 MG ORAL TAB,12.0,8.4,,,0
NDC,68462-180-22,MUPIROCIN 2 % TOP OINT,210.0,147.0,,,0
NDC,68462-181-35,CLOTRIMAZOLE 1 % TOP CREA,171.0,119.7,,,0
NDC,68462-190-01,NAPROXEN 500 MG ORAL TAB,7.5,5.25,,,0
NDC,68462-223-01,LITHIUM CARBONATE 300 MG ORAL TBSR,7.0,4.9,,,0
NDC,68462-224-01,LITHIUM CARBONATE 450 MG ORAL TBSR,7.0,4.9,,,0
NDC,68462-233-01,FELODIPINE  2.5 MG ORAL TB24,13.5,9.45,,,0
NDC,68462-234-01,FELODIPINE  5 MG ORAL TB24,13.5,9.45,,,0
NDC,68462-235-01,FELODIPINE 10 MG ORAL TB24,16.0,11.2,,,0
NDC,68462-255-01,ROPINIROLE  1 MG ORAL TAB,14.0,9.8,,,0
NDC,68462-265-30,ATOMOXETINE  10 MG ORAL CAP,209.0,146.3,,,0
NDC,68462-292-01,VERAPAMIL 120 MG ORAL TBSR,7.0,4.9,,,0
NDC,68462-298-17,CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,239.0,167.3,,,0
NDC,68462-302-01,INDOMETHACIN 50 MG ORAL CAP,7.0,4.9,,,0
NDC,68462-304-50,NORETHINDRONE ACETATE 5 MG ORAL TAB,30.0,21.0,,,0
NDC,68462-330-90,PRAMIPEXOLE 0.125 MG ORAL TAB,50.0,35.0,,,0
NDC,68462-333-90,PRAMIPEXOLE 1 MG ORAL TAB,28.5,19.950000000000003,,,0
NDC,68462-394-84,NORETHINDRONE-ETHINYL ESTRADIOL 1 MG-35 MCG TAB,10.0,7.0,,,0
NDC,68462-395-30,OMEPRAZOLE 10 MG ORAL CPDR,43.0,30.1,,,0
NDC,68462-418-20,LIDOCAINE 5 % TOP OINT,935.0,654.5,,,0
NDC,68462-435-18,ACAMPROSATE 333 MG ORAL TBEC,15.0,10.5,,,0
NDC,68462-436-30,OLMESARTAN  5 MG ORAL TAB,56.0,39.2,,,0
NDC,68462-437-30,OLMESARTAN 20 MG ORAL TAB,39.0,27.3,,,0
NDC,68462-437-90,OLMESARTAN 20 MG ORAL TAB,53.5,37.45,,,0
NDC,68462-438-30,OLMESARTAN 40 MG ORAL TAB,40.5,28.349999999999998,,,0
NDC,68462-469-40,BUMETANIDE 0.25 MG/ML INJ SOLN,42.0,29.400000000000002,,,0
NDC,68462-469-54,BUMETANIDE 0.25 MG/ML INJ SOLN,31.0,21.7,,,0
NDC,68462-470-40,BUMETANIDE 0.25 MG/ML INJ SOLN,50.0,35.0,,,0
NDC,68462-534-35,TACROLIMUS 0.1 % TOP OINT,769.0,538.3,,,0
NDC,68462-562-01,DILTIAZEM SR 120 MG 12 HR CAP,29.0,20.3,,,0
NDC,68462-583-40,APREPITANT  40 MG ORAL CAP,396.0,277.2,,,0
NDC,68462-584-40,APREPITANT  80 MG ORAL CAP,550.5,385.34999999999997,,,0
NDC,68462-585-40,APREPITANT 125 MG ORAL CAP,940.0,658.0,,,0
NDC,68462-621-02,FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN,141.5,99.05000000000001,,,0
NDC,68462-622-10,FOSPHENYTOIN 500 MG PE/10 ML INJ SOLN,91.0,63.7,,,0
NDC,68462-639-25,NITROGLYCERIN 0.4 MG SL SUBL,12.0,8.4,,,0
NDC,68462-685-01,TACROLIMUS 0.5 MG ORAL CAP,31.5,22.05,,,0
NDC,68462-721-01,THEOPHYLLINE 300 MG ORAL TB12,24.0,16.8,,,0
NDC,68462-746-35,ACYCLOVIR 5 % TOP OINT,1835.0,1284.5,,,0
NDC,68462-755-01,KETOROLAC TROMETHAMINE 15 MG/ML INJ SOLN,21.0,14.7,,,0
NDC,68462-756-01,KETOROLAC TROMETHAMINE 30 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,68462-758-01,PHYTONADIONE 10 MG/ML INJ SOLN,109.0,76.3,,,0
NDC,68462-758-05,PHYTONADIONE 10 MG/ML INJ SOLN,109.0,76.3,,,0
NDC,68462-798-17,TRIAMCINOLONE ACETONIDE 0.5 % TOP OINT,50.0,35.0,,,0
NDC,68462-893-56,VARENICLINE 0.5 MG ORAL TAB,71.5,50.05,,,0
NDC,68462-896-01,OCTREOTIDE ACETATE  100 MCG/ML INJ SOLN,57.0,39.900000000000006,,,0
NDC,68462-896-10,OCTREOTIDE ACETATE  100 MCG/ML INJ SOLN,91.0,63.7,,,0
NDC,68462-897-01,OCTREOTIDE ACETATE  500 MCG/ML INJ SOLN,214.0,149.8,,,0
NDC,68462-933-01,EPINEPHRINE (PF) 1 MG/ML INJ SOLN,86.0,60.2,,,0
NDC,68516-5214-1,"ALBUMIN, HUMAN 5 % IV SOLP MERGE",781.5,547.05,,,0
NDC,68516-5214-2,"ALBUMIN, HUMAN 5 % IV SOLP MERGE",1426.0,998.2,,,0
NDC,68516-5214-3,"ALBUMIN, HUMAN 5 % IV SOLP MERGE",447.0,312.9,,,0
NDC,68516-5214-4,"ALBUMIN, HUMAN 5 % IV SOLP MERGE",1445.0,1011.5,,,0
NDC,68516-5214-6,"ALBUMIN, HUMAN 5 % IV SOLP MERGE",121.5,85.05000000000001,,,0
NDC,68516-5214-8,"ALBUMIN, HUMAN 5 % IV SOLP MERGE",3050.0,2135.0,,,0
NDC,68516-5216-2,"ALBUMIN, HUMAN 25 % IV SOLN (MERGE)",640.0,448.0,,,0
NDC,68516-5216-3,"ALBUMIN, HUMAN 25 % IV SOLN (MERGE)",502.0,351.4,,,0
NDC,68516-5216-4,"ALBUMIN, HUMAN 25 % IV SOLN (MERGE)",640.0,448.0,,,0
NDC,68516-5216-8,"ALBUMIN, HUMAN 25 % IV SOLP",1210.5,847.3499999999999,,,0
NDC,68516-5218-0,"ALBUMIN, HUMAN 5 % IV SOLP MERGE",803.0,562.1,,,0
NDC,68516-5219-0,"ALBUMIN, HUMAN 5 % IV SOLP MERGE",2796.0,1957.2,,,0
NDC,68682-200-25,CARBIDOPA 25 MG ORAL TAB,15.0,10.5,,,0
NDC,68682-372-90,DILTIAZEM SR 420 MG CAP,10.0,7.0,,,0
NDC,68682-650-20,DIAZEPAM 2.5 MG RECT KIT,553.0,387.1,,,0
NDC,68682-652-20,DIAZEPAM 5-7.5-10 MG RECT KIT,1074.0,751.8,,,0
NDC,68682-813-05,TIMOLOL MALEATE 0.5 % OPHT DROP,65.0,45.5,,,0
NDC,68682-920-05,TETRACAINE 0.5 % EYE DROPS,177.0,123.9,,,0
NDC,68727-712-01,LURBINECTEDIN 4 MG IV SOLR,36615.0,25630.5,,,0
NDC,68727-800-01,DEFIBROTIDE 80 MG/ML IV SOLN,2450.0,1715.0,,,0
NDC,68817-134-50,PACLITAXEL-PROTEIN BOUND 100 MG IV SOLR,7981.0,5586.7,,,0
NDC,68850-012-02,ETHAMBUTOL 400 MG ORAL TAB,22.0,15.4,,,0
NDC,68982-623-02,"ALBUMIN, HUMAN 5 % IV SOLP MERGE",4.5,3.1500000000000004,,,0
NDC,68982-643-02,"ALBUMIN, HUMAN 25 % IV SOLN (MERGE)",745.0,521.5,,,0
NDC,68982-850-04,OCTAGAM 10 % IV SOLN,11021.5,7715.05,,,0
NDC,68992-3010-3,TACROLIMUS 1 MG (ENVARSUS XR) 24-HOUR EXTENDED-RELEASE TABLET,99.0,69.3,,,0
NDC,68992-3040-3,TACROLIMUS 4 MG (ENVARSUS XR) 24-HOUR EXTENDED-RELEASE TABLET,141.0,98.7,,,0
NDC,68992-3075-3,TACROLIMUS 0.75 MG (ENVARSUS XR) 24-HOUR EXTENDED-RELEASE TABLET,48.0,33.6,,,0
NDC,69051-300-01,MILTEFOSINE 50 MG ORAL CAP,1368.0,957.6,,,0
NDC,69076-146-01,ACYCLOVIR 200 MG ORAL CAP,9.0,6.300000000000001,,,0
NDC,69097-007-45,NICARDIPINE IN NACL (ISO-OS) 20 MG/200 ML IV PGBK,255.0,178.5,,,0
NDC,69097-098-43,AMOXICILLIN-POT CLAVULANATE 250 MG-62.5 MG/5 ML ORAL SUSP,48.0,33.6,,,0
NDC,69097-125-03,TOPIRAMATE 200 MG ORAL TAB,36.5,25.55,,,0
NDC,69097-316-02,EXEMESTANE 25 MG ORAL TAB,64.0,44.8,,,0
NDC,69097-321-32,BUDESONIDE 1 MG/2 ML INHL NBSP,59.0,41.3,,,0
NDC,69097-321-86,BUDESONIDE 1 MG/2 ML INHL NBSP,85.0,59.5,,,0
NDC,69097-410-02,CINACALCET 30 MG ORAL TAB,260.0,182.0,,,0
NDC,69097-664-34,ICATIBANT 30 MG/3 ML SUBQ SYRG,29229.0,20460.3,,,0
NDC,69097-664-68,ICATIBANT 30 MG/3 ML SUBQ SYRG,29229.0,20460.3,,,0
NDC,69097-708-31,PHYTONADIONE 10 MG/ML INJ SOLN,55.0,38.5,,,0
NDC,69097-708-96,PHYTONADIONE 10 MG/ML INJ SOLN,82.0,57.4,,,0
NDC,69097-802-32,TESTOSTERONE CYPIONATE 200 MG/ML IM OIL,45.5,31.85,,,0
NDC,69097-815-07,GABAPENTIN 400 MG ORAL CAP,18.0,12.6,,,0
NDC,69097-833-02,SERTRALINE  25 MG ORAL TAB,32.0,22.4,,,0
NDC,69097-840-87,IPRATROPIUM-ALBUTEROL 0.5 MG-2.5 MG/3 ML NEB SOLUTION,13.0,9.1,,,0
NDC,69097-846-07,CYCLOBENZAPRINE 10 MG ORAL TAB,7.0,4.9,,,0
NDC,69097-861-07,ZONISAMIDE 100 MG ORAL CAP,37.0,25.9,,,0
NDC,69097-862-83,CALCIUM ACETATE 667 MG ORAL CAP,15.0,10.5,,,0
NDC,69097-870-67,LANREOTIDE 120 MG/0.5 ML SUBQ SYRG,24544.0,17180.8,,,0
NDC,69238-1056-1,CHLORPROMAZINE  25 MG ORAL TAB,66.0,46.2,,,0
NDC,69238-1109-9,CLOMIPRAMINE 50 MG ORAL CAP,55.0,38.5,,,0
NDC,69238-1124-9,NADOLOL  40 MG ORAL TAB,23.5,16.45,,,0
NDC,69238-1126-1,ETHACRYNIC ACID 25 MG ORAL TAB,237.0,165.9,,,0
NDC,69238-1154-3,EZETIMIBE 10 MG ORAL TAB,56.0,39.2,,,0
NDC,69238-1310-9,PREGABALIN  25 MG ORAL CAP,165.0,115.5,,,0
NDC,69238-1312-9,PREGABALIN  75 MG ORAL CAP,103.5,72.45,,,0
NDC,69238-1314-9,PREGABALIN 150 MG ORAL CAP,65.0,45.5,,,0
NDC,69238-1342-1,ETODOLAC 400 MG ORAL TAB,8.0,5.6,,,0
NDC,69238-1490-1,BUMETANIDE 1 MG ORAL TAB,30.0,21.0,,,0
NDC,69238-1491-1,BUMETANIDE 2 MG ORAL TAB,25.0,17.5,,,0
NDC,69238-1503-1,ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL SUSR,60.0,42.0,,,0
NDC,69238-1544-1,HYDROXYCHLOROQUINE 200 MG ORAL TAB,49.0,34.3,,,0
NDC,69238-1605-2,METHYLERGONOVINE 0.2 MG ORAL TAB,506.5,354.54999999999995,,,0
NDC,69238-1605-8,METHYLERGONOVINE 0.2 MG ORAL TAB,285.0,199.5,,,0
NDC,69238-1615-3,OFLOXACIN 0.3 % OTIC DROP,567.0,396.9,,,0
NDC,69238-1729-7,ENALAPRIL MALEATE 1 MG/ML ORAL SOLN,28.0,19.6,,,0
NDC,69238-1731-2,PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRP,40.0,28.0,,,0
NDC,69238-2078-1,PROPRANOLOL  20 MG ORAL TAB,7.0,4.9,,,0
NDC,69238-2080-1,PROPRANOLOL  60 MG ORAL TAB,10.0,7.0,,,0
NDC,69238-2141-7,ENALAPRIL MALEATE 1 MG/ML ORAL SOLN,10.0,7.0,,,0
NDC,69292-208-50,METRONIDAZOLE 500 MG ORAL TAB,7.0,4.9,,,0
NDC,69292-536-01,PROPRANOLOL  60 MG ORAL TAB,8.5,5.95,,,0
NDC,69292-562-01,METOLAZONE  2.5 MG ORAL TAB,43.0,30.1,,,0
NDC,69315-117-01,FUROSEMIDE 40 MG ORAL TAB,4.0,2.8000000000000003,,,0
NDC,69315-133-01,IMIPRAMINE 10 MG TAB,8.5,5.95,,,0
NDC,69315-135-01,IMIPRAMINE 50 MG TAB,11.5,8.05,,,0
NDC,69315-136-01,BENZTROPINE 0.5 MG ORAL TAB,5.5,3.85,,,0
NDC,69315-308-02,CIPROFLOXACIN 0.3 % OPHT DROP,62.0,43.4,,,0
NDC,69315-312-28,HYDROCORTISONE  2.5 % RECT CREA,357.0,249.9,,,0
NDC,69315-504-60,NYSTATIN 100000 UNIT/ML ORAL SUSP,7.0,4.9,,,0
NDC,69315-904-01,LORAZEPAM 0.5 MG ORAL TAB,11.0,7.7,,,0
NDC,69315-905-01,LORAZEPAM 1 MG ORAL TAB,10.0,7.0,,,0
NDC,69315-905-05,LORAZEPAM 1 MG ORAL TAB,7.0,4.9,,,0
NDC,69339-136-03,DIAZEPAM 5 MG/ML INJ SYRG,289.0,202.3,,,0
NDC,69339-138-15,CHLORHEXIDINE GLUCONATE  0.12 % MM MWSH,13.0,9.1,,,0
NDC,69339-150-01,DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML SYRUP,16.0,11.2,,,0
NDC,69339-152-01,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID,30.0,21.0,,,0
NDC,69344-102-33,INDOMETHACIN 50 MG RECT SUPP,1998.0,1398.6,,,0
NDC,69367-339-05,CARBIDOPA-LEVODOPA 25 MG-100 MG TAB,9.0,6.3,,,0
NDC,69367-388-01,AMITRIPTYLINE  10 MG ORAL TAB,7.0,4.9,,,0
NDC,69367-388-10,AMITRIPTYLINE  10 MG ORAL TAB,7.0,4.9,,,0
NDC,69367-611-01,PHENAZOPYRIDINE 100 MG ORAL TAB,22.5,15.75,,,0
NDC,69374-309-20,ALBUTEROL SULFATE 5 MG/ML INHL NEB CONTINUOUS,7.0,4.9,,,0
NDC,69374-330-05,ALBUTEROL SULFATE 5 MG/ML INHL NEB CONTINUOUS,98.0,68.6,,,0
NDC,69374-542-06,METHACHOLINE CHLORIDE STERILE INHALATION SOLUTION (PF) KIT,797.0,557.9,,,0
NDC,69374-544-10,EPINEPHRINE HCL IN 0.9% NS 100 MCG/10 ML (10 MCG/ML) NON-CARDIAC LOW-DOSE (PEDS/NEO),25.0,17.5,,,0
NDC,69374-919-10,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ (MERGE),53.5,37.45,,,0
NDC,69374-924-05,ROCURONIUM 50 MG/5 ML (10 MG/ML) IV SYRG,63.0,44.099999999999994,,,0
NDC,69374-932-03,NEOSTIGMINE METHYLSULFATE 3 MG/3 ML (1 MG/ML) IV SYRG,143.5,100.44999999999999,,,0
NDC,69374-946-04,LABETALOL (5 MG/ML) IV SYRG PF,37.0,25.9,,,0
NDC,69374-957-10,PHENYLEPHRINE IN 0.9% NS (PF) 1 MG/10 ML (100 MCG/ML) IV SYRG(PDS MERGE),17.5,12.25,,,0
NDC,69374-965-02,DIAZEPAM 5 MG/ML INJ SYRG,81.0,56.7,,,0
NDC,69374-984-10,CARDIOPLEGIC SOLUTION NO.25 29 MMOL/L (POTASSIUM) PERF SOLN,1260.0,882.0,,,0
NDC,69401-000-02,"TYPHOID VACCINE 2 BILLION UNIT CAP, DELAYED RELEASE",157.0,109.9,,,0
NDC,69452-125-50,OXCARBAZEPINE 300 MG/5 ML ORAL SUSP,51.0,35.7,,,0
NDC,69452-132-17,DOFETILIDE 250 MCG ORAL CAP,54.0,37.8,,,0
NDC,69452-133-17,DOFETILIDE 500 MCG ORAL CAP,54.0,37.8,,,0
NDC,69452-150-20,VALPROIC ACID 250 MG ORAL CAP,8.5,5.95,,,0
NDC,69452-151-20,ERGOCALCIFEROL (VITAMIN D2) 50000 UNIT ORAL CAP,7.0,4.9,,,0
NDC,69452-156-74,RIZATRIPTAN  5 MG ORAL TBDL,222.5,155.75,,,0
NDC,69452-207-20,CALCITRIOL 0.25 MCG ORAL CAP,7.0,4.9,,,0
NDC,69452-208-20,CALCITRIOL 0.5 MCG ORAL CAP,16.5,11.55,,,0
NDC,69452-209-07,NIMODIPINE 30 MG ORAL CAP,189.0,132.3,,,0
NDC,69452-233-20,PROGESTERONE MICRONIZED 100 MG ORAL CAP,17.5,12.25,,,0
NDC,69452-345-60,SUMATRIPTAN 50 MG TAB,123.0,86.1,,,0
NDC,69452-350-60,GRANISETRON 1 MG ORAL TAB,251.0,175.7,,,0
NDC,69452-389-98,MAGNESIUM CITRATE ORAL SOLN,9.0,6.3,,,0
NDC,69452-390-98,MAGNESIUM CITRATE ORAL SOLN,8.0,5.6,,,0
NDC,69452-455-20,FLUVOXAMINE 100 MG ORAL TAB,26.0,18.2,,,0
NDC,69488-001-40,KIT FOR PREP OF GA 68-DOTATATE 40 MCG IV SOLR,13212.5,9248.75,,,0
NDC,69536-050-15,PHENYLEPHRINE 0.5% NASAL DROPS (REPACK),15.5,10.85,,,0
NDC,69536-162-88,LEVONORGESTREL 1.5 MG ORAL TAB,191.0,133.7,,,0
NDC,69543-386-30,KETOROLAC TROMETHAMINE 30 MG/ML INJ SOLN,34.0,23.8,,,0
NDC,69543-451-01,POTASSIUM CHLORIDE  20 MEQ ORAL PACK,76.5,53.55,,,0
NDC,6954326810,K PHOS DI & MONO-SOD PHOS MONO 250 MG ORAL TAB,7.0,4.9,,,0
NDC,69547-353-02,NALOXONE 4 MG/ACTUATION NASL SPRY,270.0,189.0,,,0
NDC,69547-627-02,NALOXONE 4 MG/ACTUATION NASL SPRY,172.0,120.4,,,0
NDC,69584-111-10,CARISOPRODOL 350 MG ORAL TAB,7.0,4.9,,,0
NDC,69618-010-01,ACETAMINOPHEN  325 MG ORAL TAB,5.0,3.5,,,0
NDC,69618-015-01,ASPIRIN  325 MG ORAL TBEC,5.0,3.5,,,0
NDC,69618-024-01,DIPHENHYDRAMINE 25 MG CAP,7.0,4.9,,,0
NDC,69618-033-01,SIMETHICONE  80 MG ORAL CHEW,7.0,4.9,,,0
NDC,69618-050-51,OXYMETAZOLINE 0.05 % NASL SPRAY (BLUE DYE FOR OR),14.0,9.8,,,0
NDC,69618-064-01,SENNOSIDES  8.6 MG ORAL TAB,5.5,3.85,,,0
NDC,69618-066-02,ASPIRIN   81 MG ORAL TBEC,5.0,3.5,,,0
NDC,6961807059,FERROUS SULFATE 75 MG/ML (ELEMENTAL IRON 15 MG/ML) ORAL DROP,7.0,4.9,,,0
NDC,69623-232-39,SODIUM BICARBONATE 8.4 % IV (PHS ERX MERGE),140.0,98.0,,,0
NDC,69623-801-14,LET TOPICAL GEL 3 ML,55.0,38.5,,,0
NDC,69680-112-01,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,26.0,18.2,,,0
NDC,69724-112-10,SOTALOL 150 MG/10 ML (15 MG/ML) IV SOLN,3900.0,2730.0,,,0
NDC,69784-002-06,FLUCONAZOLE 200 MG/100 ML IVPB (MERGE),40.0,28.0,,,0
NDC,69784-230-10,SODIUM ACETATE 2 MEQ/ML IV SOLN,9.0,6.3,,,0
NDC,69784-231-20,SODIUM ACETATE 0.45% IV INFUSION (PEDIATRIC),81.0,56.7,,,0
NDC,69800-4202-1,HEPATITIS B IMMUNE GLOBULIN >312 UNIT/ML IM SOLN,721.0,504.7,,,0
NDC,69918-301-30,TRANEXAMIC ACID 650 MG ORAL TAB,51.0,35.7,,,0
NDC,69918-720-01,ARSENIC TRIOXIDE 10 MG/10 ML IV SOLN,372.0,260.4,,,0
NDC,69918-731-01,ISOPROTERENOL 0.2 MG/ML INJECTION,540.0,378.0,,,0
NDC,69918-899-01,DESMOPRESSIN 4 MCG/ML INJECTION SOLN,150.0,105.0,,,0
NDC,69918-901-10,DESMOPRESSIN 4 MCG/ML INJECTION SOLN,1074.0,751.8,,,0
NDC,69932-001-01,FLUCICLOVINE F18 10 MCI (370 MBQ) IV SOLN,12529.0,8770.3,,,0
NDC,69945-0050-40,INDIUM IN-111 PENTETATE,13053.0,9137.1,,,0
NDC,69945-068-20,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,664.5,465.15000000000003,,,0
NDC,69945-091-20,KIT PREP TC-99M-SOD OXIDRONATE 3.15 MG IV SOLR,274.5,192.15,,,0
NDC,69945-110-12,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,76.0,53.2,,,0
NDC,69945-180-06,GALLIUM-67 CITRATE 74 MBQ/ML (2 MCI/ML) IV SOLN,338.0,236.6,,,0
NDC,69968-0063-1,NAPHAZOLINE-PHENIRAMINE 0.025 %-0.3 % EYE DROPS,26.0,18.2,,,0
NDC,70000-0409-1,CAFFEINE 200 MG ORAL TAB,14.5,10.15,,,0
NDC,70004-085-44,OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN,114.0,79.80000000000001,,,0
NDC,70004-211-30,FENTANYL CITRATE (PF) 50 MCG/ML INJ (REPACK)(MERGE) (FOR PCA),217.0,151.9,,,0
NDC,70004-430-09,KETAMINE 50 MG/5ML (10 MG/ML) SYRINGE (PHS MERGE),2125.0,1487.5,,,0
NDC,70004-430-12,KETAMINE IN 0.9 % SOD CHLORIDE 100 MG/10 ML (10 MG/ML) IV SYRG,52.0,36.4,,,0
NDC,70004-540-35,DILTIAZEM IN D5W 125 MG/125 ML (1 MG/ML) IV SOLN (PREMIX),79.5,55.650000000000006,,,0
NDC,70004-600-09,EPHEDRINE SULFATE  25 MG/5 ML (5 MG/ML) IV SYRG (MERGE),66.5,46.55,,,0
NDC,70004-613-40,EPINEPHRINE IN 0.9 % NACL 4 MG/250 ML (16 MCG/ML) IV SOLN (MERGE),616.5,431.54999999999995,,,0
NDC,70004-811-40,PHENYLEPHRINE HCL IN NS 10 MG/250 ML (0.04 MG/ML) IV SOLN (PDS MERGE),509.5,356.65,,,0
NDC,70004-841-40,POTASSIUM PHOS IN 0.9 % NACL 15 MMOL/250 ML IVPB PREMIX,211.0,147.7,,,0
NDC,70004-900-25,SODIUM CITRATE 4 % (3 ML) MISC SYRG,33.0,23.1,,,0
NDC,70004-923-59,VANCOMYCIN IN 0.9% SODIUM CL 1.25 GRAM/250 ML IV SOLN,189.0,132.3,,,0
NDC,70004-924-44,VANCOMYCIN IN 0.9 % SODIUM CHL 1.5 GRAM/500 ML IV SOLN,105.5,73.85,,,0
NDC,70010-002-01,COLCHICINE 0.6 MG ORAL TAB,61.0,42.7,,,0
NDC,70010-029-01,AMPHETAMINE-DEXTROAMPHETAMINE  5 MG ORAL CP24,141.0,98.7,,,0
NDC,70010-138-01,NAPROXEN 375 MG ORAL TAB,7.0,4.9,,,0
NDC,70010-491-01,METFORMIN  500 MG ORAL TB24,10.0,7.0,,,0
NDC,70010-492-01,METFORMIN  750 MG ORAL TB24,10.5,7.3500000000000005,,,0
NDC,70010-754-01,METHOCARBAMOL 500 MG ORAL TAB,5.5,3.85,,,0
NDC,70010-786-12,METHYLERGONOVINE 0.2 MG ORAL TAB,301.0,210.7,,,0
NDC,70069-005-01,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,25.0,17.5,,,0
NDC,70069-005-10,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,25.0,17.5,,,0
NDC,70069-011-01,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,38.0,26.6,,,0
NDC,70069-013-25,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,34.0,23.8,,,0
NDC,70069-017-01,OLOPATADINE 0.1 % OPHT DROP,53.0,37.1,,,0
NDC,70069-021-01,DEXAMETHASONE SODIUM PHOS (PF) 10MG/ML INJ SOLN,32.0,22.4,,,0
NDC,70069-025-10,DEXAMETHASONE 10 MG/ML INJECTION,16.0,11.2,,,0
NDC,70069-027-01,BUPRENORPHINE HCL 0.3 MG/ML INJ (MERGE),134.5,94.15,,,0
NDC,70069-030-01,HALOPERIDOL DECANOATE  50 MG/ML IM SOLN,336.5,235.54999999999998,,,0
NDC,70069-030-03,HALOPERIDOL DECANOATE  50 MG/ML IM SOLN,421.0,294.70000000000005,,,0
NDC,70069-051-01,DORZOLAMIDE-TIMOLOL 2 %-0.5 % EYE DROPS,123.0,86.1,,,0
NDC,70069-062-01,ROPIVACAINE  2 MG/ML INJ SOLN,73.5,51.45,,,0
NDC,70069-064-01,ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN,39.0,27.299999999999997,,,0
NDC,70069-064-25,ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJ SOLN,19.5,13.649999999999999,,,0
NDC,70069-072-01,NALOXONE 0.4 MG/ML INJ SOLN,424.0,296.8,,,0
NDC,70069-072-10,NALOXONE 0.4 MG/ML INJ SOLN,212.0,148.4,,,0
NDC,70069-101-01,METHOCARBAMOL 100 MG/ML INJ SOLN,42.0,29.4,,,0
NDC,70069-131-01,TOBRAMYCIN 0.3 % EYE DROPS,35.0,24.5,,,0
NDC,70069-151-01,CISATRACURIUM 10 MG/ML IV SOLN,1916.0,1341.2,,,0
NDC,70069-161-01,CISATRACURIUM  2 MG/ML IV SOLN,102.0,71.4,,,0
NDC,70069-172-01,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,17.0,11.899999999999999,,,0
NDC,70069-231-01,BRIMONIDINE 0.2 % OPHT DROP,62.0,43.4,,,0
NDC,70069-261-01,NITROPRUSSIDE 25 MG/ML IV SOLN,49.0,34.3,,,0
NDC,70069-362-01,TRIMETHOPRIM-SULFAMETHOXAZOLE 80 MG-400 MG/5 ML IV,233.0,163.1,,,0
NDC,70069-363-01,TRIMETHOPRIM-SULFAMETHOXAZOLE 80 MG-400 MG/5 ML IV,151.0,105.7,,,0
NDC,70069-383-01,HALOPERIDOL DECANOATE 100 MG/ML IM SOLN,326.5,228.55,,,0
NDC,70069-383-10,HALOPERIDOL DECANOATE 100 MG/ML IM SOLN,297.0,207.89999999999998,,,0
NDC,70069-421-01,LATANOPROST 0.005 % OPHT DROP,403.0,282.1,,,0
NDC,70069-506-01,CUPRIC CHLORIDE 0.4 MG/ML IV SOLN,80.0,56.0,,,0
NDC,70069-582-01,ATROPINE 1 % OPHT DROP,221.0,154.7,,,0
NDC,70069-596-01,TETRACAINE 0.5 % EYE DROPS,177.0,123.9,,,0
NDC,70069-601-01,PROPARACAINE 0.5 % OPHT DROP,214.0,149.8,,,0
NDC,70069-727-01,CALCIUM GLUCONATE (FOR EMERGENCY) 100 MG/ML (10%) IV SOLN,343.0,240.1,,,0
NDC,70069-747-01,POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML IV SOLP,106.0,74.2,,,0
NDC,70069-788-01,ACETYLCYSTEINE 20 % (200 MG/ML) IV SOLN,283.0,198.1,,,0
NDC,70069-806-01,NEOSTIGMINE METHYLSULFATE 1 MG/ML IV SOLN,21.0,14.7,,,0
NDC,70069-810-01,VALGANCICLOVIR 50 MG/ML ORAL SOLR,366.0,256.2,,,0
NDC,70069-817-01,MIDAZOLAM (PF) 1 MG/ML INJ (MERGE),10.0,7.0,,,0
NDC,7007411133,ORAL ELECTROLYTES ORAL SOLN,18.5,12.950000000000001,,,0
NDC,7007467398,BIFIDO ANIM-B.INF-S.THERMOPHL 1 BILLION CELL ORAL PWPK,7.0,4.9,,,0
NDC,7007480336,ORAL ELECTROLYTES ORAL SOLN,147.0,102.9,,,0
NDC,70092-1007-36,DILTIAZEM IN D5W 125 MG/125 ML (1 MG/ML) IV SOLN (PREMIX),67.0,46.9,,,0
NDC,70092-1009-44,LABETALOL (5 MG/ML) IV SYRG (CONTAINS PRESERVATIVE),39.0,27.299999999999997,,,0
NDC,70092-1015-50,SODIUM BICARBONATE 8.4 % (1 MEQ/ML) IV 50 ML EMERGENCY SYRINGE,155.0,108.5,,,0
NDC,70092-1017-46,CEFAZOLIN SODIUM-STERILE WATER 1 GRAM/10 ML IV SYRG,53.5,37.45,,,0
NDC,70092-1046-46,PHENYLEPHRINE IN 0.9% NS (PF) 1 MG/10 ML (100 MCG/ML) IV SYRG(PDS MERGE),84.0,58.8,,,0
NDC,70092-1068-07,OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN,89.0,62.3,,,0
NDC,70092-1119-44,KETAMINE 50 MG/5ML (10 MG/ML) SYRINGE (PHS MERGE),67.0,46.9,,,0
NDC,70092-1135-44,LET TOPICAL GEL 3 ML,54.0,37.8,,,0
NDC,70092-1148-43,SODIUM CITRATE 4 % (3 ML) MISC SYRG,52.0,36.4,,,0
NDC,70092-1175-46,LIDOCAINE 1% (BUFFERED W/NAHCO3 8.4%) 10 ML SYRINGE (MERGE),233.0,163.1,,,0
NDC,70092-1177-35,MIDAZOLAM (PF) IN 0.9 % NACL 1 MG/ML IV SOLN,105.0,73.5,,,0
NDC,70092-1217-47,HEPARIN 1 UNIT/ML IN NS 20 ML SYRINGE (CDS ADS MIXTURE),46.0,32.2,,,0
NDC,70092-1238-47,CEFAZOLIN IN STERILE WATER 2 GRAM/20 ML IV SYRG,53.0,37.1,,,0
NDC,70092-1259-75,FENTANYL-ROPIVACAINE-NACL (PF) 2-0.2 MCG/ML-% INJ (MERGE ERX),435.0,304.5,,,0
NDC,70092-1286-74,HYDROMORPHONE 10 MG/50 ML (0.2MG/ML) PCA IN NS (MERGE),429.0,300.3,,,0
NDC,70092-1287-35,HYDROMORPHONE (PF)-0.9 % NACL 0.2 MG/ML IV SOLN BAG (FOR VENT),72.0,50.4,,,0
NDC,70092-1312-75,MIDAZOLAM 1 MG/ML IN NS (PREMIX),16.0,11.2,,,0
NDC,70092-1433-50,ROPIVACAINE-EPI-CLONID-KETOROL 2.46-0.005- 0.0008-0.3MG/ML PATC SYRG,637.0,445.9,,,0
NDC,70092-1475-50,DEXTROSE 50% IN WATER (MERGE RECORD),110.5,77.35,,,0
NDC,70092-1478-44,EPHEDRINE SULFATE  25 MG/5 ML (5 MG/ML) IV SYRG (MERGE),211.0,147.7,,,0
NDC,70092-1509-35,FENTANYL CITRATE (PF) 50 MCG/ML IV (MERGE) (FOR VENT),104.0,72.8,,,0
NDC,70092-1521-74,MORPHINE 1 MG/ML PCA (PDS MERGE),154.0,107.8,,,0
NDC,70092-1522-35,MORPHINE (PF) IN 0.9 % NACL 1 MG/ML VENT INFUSION,87.0,60.9,,,0
NDC,70092-1552-07,OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN,186.0,130.2,,,0
NDC,70092-1575-36,DILTIAZEM IN D5W 125 MG/125 ML (1 MG/ML) IV SOLN (PREMIX),67.0,46.9,,,0
NDC,70092-1604-47,CEFAZOLIN IN STERILE WATER 2 GRAM/20 ML IV SYRG,261.0,182.7,,,0
NDC,70092-1611-44,LET TOPICAL GEL 3 ML,108.0,75.6,,,0
NDC,70092-1617-46,EPINEPHRINE HCL IN 5% DEXTROSE 100 MCG/10 ML (10 MCG/ML) IV SYRG,37.0,25.9,,,0
NDC,70092-1664-74,FENTANYL CITRATE (PF) 50 MCG/ML INJ (REPACK)(MERGE) (FOR PCA),324.0,226.8,,,0
NDC,70092-1688-46,EPINEPHRINE HCL IN 5% DEXTROSE 100 MCG/10 ML (10 MCG/ML) IV SYRG,42.0,29.4,,,0
NDC,70092-1691-44,"LIDO-EPI WITH 8.4% SOD BICARB 1 %- 1:100,000 (3 ML) INJ SYRG",72.0,50.400000000000006,,,0
NDC,70092-9054-05,VANCOMYCIN IN 0.9% SODIUM CL 1.25 GRAM/250 ML IV SOLN,112.0,78.4,,,0
NDC,70092-9119-44,KETAMINE 50 MG/5ML (10 MG/ML) SYRINGE (PHS MERGE),67.0,46.9,,,0
NDC,70092-9259-75,FENTANYL-ROPIVACAINE-NACL (PF) 2-0.2 MCG/ML-% INJ (MERGE ERX),760.5,532.3499999999999,,,0
NDC,70092-9286-74,HYDROMORPHONE 10 MG/50 ML (0.2MG/ML) PCA IN NS (MERGE),131.0,91.7,,,0
NDC,70092-9338-07,VANCOMYCIN IN 0.9 % SODIUM CHL 2 GRAM/500 ML IV SOLN,129.0,90.3,,,0
NDC,70092-9664-74,FENTANYL CITRATE (PF) 50 MCG/ML INJ (REPACK)(MERGE) (FOR PCA),104.0,72.8,,,0
NDC,70095-025-01,AZITHROMYCIN 500 MG IV SOLR,20.0,14.0,,,0
NDC,70095-026-01,DESMOPRESSIN 4 MCG/ML INJECTION SOLN,60.0,42.0,,,0
NDC,70095-031-01,DESMOPRESSIN 4 MCG/ML INJECTION SOLN,970.0,679.0,,,0
NDC,70100-424-01,INDOCYANINE GREEN 25 MG INJ,6093.5,4265.45,,,0
NDC,70100-725-01,INDOCYANINE GREEN 25 MG INJ,450.5,315.35,,,0
NDC,70114-101-01,PEGFILGRASTIM-CBQV 6 MG/0.6 ML SUBQ SYRG,11523.0,8066.1,,,0
NDC,70114-340-01,TORIPALIMAB-TPZI 240 MG/6 ML (40 MG/ML) IV SOLN,25650.0,17955.0,,,0
NDC,70121-1049-1,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,31.5,22.05,,,0
NDC,70121-1049-2,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,25.0,17.5,,,0
NDC,70121-1049-5,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,25.0,17.5,,,0
NDC,70121-1168-1,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,45.0,31.5,,,0
NDC,70121-1169-1,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,33.0,23.1,,,0
NDC,70121-1238-1,CYCLOPHOSPHAMIDE 500 MG IV SOLR,230.0,161.0,,,0
NDC,70121-1239-1,CYCLOPHOSPHAMIDE 20 MG/ML IN NS,622.0,435.4,,,0
NDC,70121-1388-1,DEXMEDETOMIDINE IN 0.9 % NACL 200 MCG/50 ML (4 MCG/ML) IV SOLN,569.5,398.65000000000003,,,0
NDC,70121-1399-1,DEXAMETHASONE SODIUM PHOS (PF) 10MG/ML INJ SOLN,38.0,26.6,,,0
NDC,70121-1454-1,MEROPENEM 500 MG IV SOLR,40.0,28.0,,,0
NDC,70121-1454-7,MEROPENEM 500 MG IV SOLR,40.0,28.0,,,0
NDC,70121-1463-2,FULVESTRANT 250 MG/5 ML IM SYRG,2655.0,1858.5,,,0
NDC,70121-1467-2,MEDROXYPROGESTERONE (CONTRACEPTIVE) 150 MG/ML IM SUSP,415.0,290.5,,,0
NDC,70121-1573-1,METHYLPREDNISOLONE 40 MG/ML SUSP (DEPO-MEDROL) INJECTION,22.5,15.75,,,0
NDC,70121-1573-5,METHYLPREDNISOLONE 40 MG/ML SUSP (DEPO-MEDROL) INJECTION,85.5,59.849999999999994,,,0
NDC,70121-1574-1,METHYLPREDNISOLONE 80 MG/ML SUSP FOR INJECTION,36.0,25.200000000000003,,,0
NDC,70121-1605-1,ISOPROTERENOL 0.2 MG/ML INJECTION,3121.5,2185.05,,,0
NDC,70121-1627-1,PEGFILGRASTIM-PBBK 6 MG/0.6 ML SUBQ SYRG,6900.0,4830.0,,,0
NDC,70121-1642-1,VASOPRESSIN 20 UNIT/ML IV SOLN,455.0,318.5,,,0
NDC,70121-1647-1,TIGECYCLINE 50 MG IV SOLR,420.0,294.0,,,0
NDC,70121-1651-1,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,33.0,23.1,,,0
NDC,70121-1651-5,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,50.0,35.0,,,0
NDC,70121-1652-1,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,45.0,31.5,,,0
NDC,70121-1653-1,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,33.0,23.1,,,0
NDC,70121-1654-1,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,45.0,31.5,,,0
NDC,70121-1655-1,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,33.0,23.1,,,0
NDC,70121-1657-1,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,50.0,35.0,,,0
NDC,70121-1716-1,"ESMOLOL IN SALINE (ISO-OSMOTIC) 2,500 MG/250 ML (10 MG/ML) IV",648.0,453.6,,,0
NDC,70121-1722-1,POTASSIUM PHOSPHATE 0.06 MMOL/ML IVPB (FOR PEDIATRICS),352.0,246.4,,,0
NDC,70121-1754-1,BEVACIZUMAB-MALY 25 MG/ML IV SOLN,3967.0,2776.9,,,0
NDC,70121-1755-1,BEVACIZUMAB-MALY 25 MG/ML IV SOLN,11900.5,8330.35,,,0
NDC,70121-2308-1,CALCIUM CHLORIDE (FOR CODE) 10% (100 MG/ML) IV SYRINGE,154.5,108.15,,,0
NDC,70257-126-11,VARICELLA-ZOSTER IG-MALTOSE 125 UNIT/1.2 ML IM SOLN,25935.0,18154.5,,,0
NDC,70257-126-51,VARICELLA-ZOSTER IG-MALTOSE 125 UNIT/1.2 ML IM SOLN,4980.0,3486.0,,,0
NDC,7027562901,SALIVA SUBSTITUTE COMB NO.11 351 MG MM PWPK,44.0,30.8,,,0
NDC,7027562904,SALIVA SUBSTITUTE COMB NO.11 351 MG MM PWPK,60.5,42.35,,,0
NDC,7027562912,SALIVA SUBSTITUTE COMB NO.11 351 MG MM PWPK,44.0,30.8,,,0
NDC,7031246129,BENZOCAINE-MENTHOL 15-3.6 MG MM LOZG,5.0,3.5,,,0
NDC,70324-227-01,EPINEPHRINE HCL IN 0.9 % NACL 4 MG/250 ML (16 MCG/ML) IV SOLN,147.0,102.9,,,0
NDC,70377-008-12,ROSUVASTATIN 20 MG ORAL TAB,69.0,48.3,,,0
NDC,70377-009-11,ROSUVASTATIN 40 MG ORAL TAB,50.0,35.0,,,0
NDC,70377-081-11,DORZOLAMIDE 2 % OPHT DROP,284.0,198.8,,,0
NDC,70377-138-12,TRIAMTERENE  50 MG ORAL CAP,59.0,41.3,,,0
NDC,70436-019-82,AZITHROMYCIN 500 MG IV SOLR,38.0,26.6,,,0
NDC,70436-020-82,VANCOMYCIN  500 MG IV SOLR,34.0,23.8,,,0
NDC,70436-021-82,VANCOMYCIN 1000 MG IV SOLR,30.0,21.0,,,0
NDC,70436-023-82,VANCOMYCIN 10 GRAM IV SOLR,46.0,32.2,,,0
NDC,70436-028-80,NITROPRUSSIDE 25 MG/ML IV SOLN,184.0,128.8,,,0
NDC,70436-029-80,VORICONAZOLE 200 MG IV SOLN,824.0,576.8,,,0
NDC,70436-030-82,ACYCLOVIR SODIUM 50 MG/ML IV SOLN,91.5,64.05,,,0
NDC,70436-032-35,DOXYCYCLINE HYCLATE 100 MG IV SOLR,296.0,207.2,,,0
NDC,70436-089-55,GANCICLOVIR 500 MG IV SOLUTION,101.0,70.7,,,0
NDC,70436-116-82,LEUCOVORIN CALCIUM  50 MG INJ SOLR,36.0,25.2,,,0
NDC,70436-147-80,DICYCLOMINE 10 MG/ML IM SOLN,229.0,160.3,,,0
NDC,70436-157-06,CILOSTAZOL 100 MG ORAL TAB,11.0,7.7,,,0
NDC,70436-203-80,DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) IV,87.0,60.9,,,0
NDC,70436-211-37,IOPAMIDOL 41 % INJ SOLN,3.0,2.1,,,0
NDC,70436-227-48,FLUCONAZOLE 40 MG/ML ORAL SUSR,57.0,39.9,,,0
NDC,70436-232-72,AMIODARONE 50 MG/ML IV SOLN,30.0,21.0,,,0
NDC,70461-024-04,FLU VACCINE 2024-25 65YR UP ADJMF59C (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,373.0,261.1,,,0
NDC,70461-654-04,FLU VACCINE TS 2024-25 6MOS UP (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG,190.0,133.0,,,0
NDC,70512-812-01,LIDOCAINE 4% TOP PATCH,18.5,12.95,,,0
NDC,70594-034-01,DAPTOMYCIN 500 MG IV SOLR,367.0,256.9,,,0
NDC,70594-057-01,VANCOMYCIN-DILUENT COMBO NO.1 1.25 GRAM/250 ML IV PGBK,112.0,78.4,,,0
NDC,70594-063-01,PHENYLEPHRINE 10 MG/ML INJECTION,19.0,13.3,,,0
NDC,70594-084-01,AMPICILLIN 250 MG SOLUTION FOR INJECTION,26.0,18.2,,,0
NDC,70594-089-01,CEFEPIME 1 GRAM INJ SOLR,39.0,27.3,,,0
NDC,70594-111-01,ACETYLCYSTEINE 20 % (200 MG/ML) IV SOLN,509.0,356.3,,,0
NDC,70594-117-01,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN,52.5,36.75,,,0
NDC,70594-118-01,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN,17.0,11.9,,,0
NDC,70677-0068-1,DOXYLAMINE SUCCINATE 25 MG ORAL TAB,7.0,4.9,,,0
NDC,70677-1037-1,OXYMETAZOLINE 0.05 % NASAL MERGE,10.0,7.0,,,0
NDC,70677-1063-1,ALUM-MAG HYDROXIDE-SIMETH 200 MG-200 MG-20 MG/5 ML ORAL SUSP,7.0,4.9,,,0
NDC,70677-1068-1,POLYETHYLENE GLYCOL 3350 100 % ORAL POWDER 238 GRAMS,44.0,30.8,,,0
NDC,70677-1078-1,SIMETHICONE 40 MG/0.6 ML ORAL DRPS,7.0,4.9,,,0
NDC,70677-1087-1,DIMENHYDRINATE 50 MG ORAL TAB,7.0,4.9,,,0
NDC,70677-1107-1,LOPERAMIDE 1 MG/7.5 ML ORAL LIQD,18.0,12.6,,,0
NDC,70677-1108-1,PHENYLEPH-MIN OIL-PETROLATUM 0.25-14-74.9 % RECT OINT,49.0,34.3,,,0
NDC,70677-1111-1,MAGNESIUM CITRATE ORAL SOLN,10.5,7.3500000000000005,,,0
NDC,70677-1112-1,MAGNESIUM CITRATE ORAL SOLN,10.5,7.3500000000000005,,,0
NDC,70677-1133-1,ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TAB,5.0,3.5,,,0
NDC,70677-1153-1,CARBAMIDE PEROXIDE 6.5 % OTIC DROP,23.0,16.1,,,0
NDC,70677-1154-1,CARBAMIDE PEROXIDE 6.5 % OTIC DROP,12.5,8.75,,,0
NDC,70677-1166-1,NICOTINE (POLACRILEX) 2 MG BUCL GUM,7.0,4.9,,,0
NDC,70677-1166-2,NICOTINE (POLACRILEX) 2 MG BUCL GUM,7.0,4.9,,,0
NDC,70677-1167-1,NICOTINE (POLACRILEX) 4 MG BUCL GUM,18.0,12.600000000000001,,,0
NDC,70677-1171-1,NICOTINE (POLACRILEX) 4 MG BUCL GUM,7.0,4.9,,,0
NDC,70677-1214-1,HYDROCORTISONE  1 % TOP OINT,13.0,9.1,,,0
NDC,70677-1218-1,"NEOMYCIN-POLYMYXIN-PRAMOXINE 3.5 MG-10,000 UNIT-10 MG/G TOPICAL CREAM",15.0,10.5,,,0
NDC,70677-1228-1,CLOTRIMAZOLE 1 % VAGL CREA,31.0,21.7,,,0
NDC,70700-165-22,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,51.0,35.7,,,0
NDC,70700-188-22,FLUOROURACIL 500 MG/10 ML IV SOLN,43.0,30.1,,,0
NDC,70700-189-22,FLUOROURACIL 5 GRAM/100 ML IV SOLN,254.0,177.8,,,0
NDC,70700-274-22,ESTRADIOL VALERATE 20 MG/ML IM OIL,73.0,51.1,,,0
NDC,70700-289-22,TESTOSTERONE CYPIONATE 200 MG/ML IM OIL,57.0,39.9,,,0
NDC,70710-1179-3,AMBRISENTAN  5 MG ORAL TAB,982.0,687.4,,,0
NDC,70710-1196-1,RIVASTIGMINE 4.6 MG/24 HOUR TD PT24,83.0,58.1,,,0
NDC,70710-1225-1,AMITRIPTYLINE  10 MG ORAL TAB,7.0,4.9,,,0
NDC,70710-1272-6,SACUBITRIL-VALSARTAN 24-26 MG ORAL TAB,63.0,44.1,,,0
NDC,70710-1359-1,LACOSAMIDE 200 MG/20 ML IV SOLN,500.5,350.35,,,0
NDC,70710-1411-1,BORTEZOMIB 3.5 MG IV SOLR,142.0,99.4,,,0
NDC,70710-1461-1,HALOPERIDOL DECANOATE  50 MG/ML IM SOLN,131.0,91.7,,,0
NDC,70710-1478-1,FOMEPIZOLE 1 GRAM/ML IV SOLN,6210.0,4347.0,,,0
NDC,70710-1530-1,DOXORUBICIN LIPOSOMAL 2 MG/ML IV INJ,2996.0,2097.2,,,0
NDC,70710-1531-1,DOXORUBICIN LIPOSOMAL 2 MG/ML IV INJ,7021.0,4914.7,,,0
NDC,70710-1641-6,LUBIPROSTONE  8 MCG ORAL CAP,68.0,47.599999999999994,,,0
NDC,70710-1643-1,VERAPAMIL 2.5 MG/ML IV SOLN,62.0,43.4,,,0
NDC,70710-1726-1,NELARABINE 250 MG/50 ML IV SOLN (PEDS ONCOLOGY),7092.0,4964.4,,,0
NDC,70710-1833-1,LEVOTHYROXINE 100 MCG IV SOLR,384.5,269.15,,,0
NDC,70710-1838-1,METHYLENE BLUE (ANTIDOTE) 5 MG/ML (0.5 %) IV SOLN,255.0,178.5,,,0
NDC,70710-1850-1,CHLORPROMAZINE 25 MG/ML INJ SOLN,210.0,147.0,,,0
NDC,70720-950-36,GOSERELIN  3.6 MG SUBQ IMPL,1670.0,1169.0,,,0
NDC,70720-951-30,GOSERELIN 10.8 MG SUBQ IMPL,5010.0,3507.0,,,0
NDC,70748-130-06,LEFLUNOMIDE  20 MG ORAL TAB,63.5,44.45,,,0
NDC,70748-217-16,"MYCOPHENOLATE 180 MG TAB, DELAYED RELEASE",26.0,18.2,,,0
NDC,70748-258-07,POSACONAZOLE 100 MG ORAL TBEC,533.0,373.1,,,0
NDC,70748-323-01,BUMETANIDE 0.25 MG/ML INJ SOLN,61.0,42.7,,,0
NDC,70752-138-12,PROMETHAZINE  6.25 MG/5 ML ORAL SYRP,9.5,6.65,,,0
NDC,70756-201-11,AMITRIPTYLINE  10 MG ORAL TAB,5.5,3.85,,,0
NDC,70756-204-11,AMITRIPTYLINE  75 MG ORAL TAB,11.0,7.7,,,0
NDC,70756-405-11,CLOMIPRAMINE 25 MG ORAL CAP,82.5,57.75,,,0
NDC,70756-604-44,TOBRAMYCIN 300 MG/5 ML INHL NEBU (REPACK),396.0,277.2,,,0
NDC,70756-604-56,TOBRAMYCIN 300 MG/5 ML INHL NEBU (REPACK),396.0,277.2,,,0
NDC,70756-607-30,OFLOXACIN 0.3 % OPHT DROP,299.0,209.3,,,0
NDC,70756-609-15,OFLOXACIN 0.3 % OTIC DROP,567.0,396.9,,,0
NDC,70756-611-82,EPHEDRINE 50 MG/ML IV SOLN (MERGE),74.0,51.8,,,0
NDC,70756-615-10,HALOPERIDOL DECANOATE  50 MG/ML IM SOLN,419.0,293.3,,,0
NDC,70756-616-10,HALOPERIDOL DECANOATE 100 MG/ML IM SOLN,198.5,138.95,,,0
NDC,70756-616-81,HALOPERIDOL DECANOATE 100 MG/ML IM SOLN,277.5,194.25,,,0
NDC,70756-622-85,PHENYLEPHRINE 10 MG/ML INJECTION,104.0,72.8,,,0
NDC,70756-629-25,PHENYLEPHRINE 2.5 % EYE DROPS,199.0,139.3,,,0
NDC,70756-635-81,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,47.0,32.9,,,0
NDC,70756-640-82,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,32.0,22.4,,,0
NDC,70756-641-25,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,16.0,11.2,,,0
NDC,70756-641-85,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,16.0,11.2,,,0
NDC,70756-643-85,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,16.0,11.2,,,0
NDC,70756-644-82,LIDOCAINE 10 MG/ML (1 %) INJECTION,36.0,25.2,,,0
NDC,70756-645-86,LIDOCAINE 10 MG/ML (1 %) INJECTION,16.0,11.2,,,0
NDC,70756-649-35,PHENYLEPHRINE 2.5 % EYE DROPS,405.0,283.5,,,0
NDC,70839-362-04,COCAINE  4 % TOP SOLN (MERGE),1041.0,728.7,,,0
NDC,70860-100-41,AZITHROMYCIN 500 MG IV SOLR,34.0,23.8,,,0
NDC,70860-105-20,VANCOMYCIN 1000 MG IV SOLR,50.0,35.0,,,0
NDC,70860-115-26,AMPICILLIN SODIUM  2 GRAM INJ SOLR,80.0,56.0,,,0
NDC,70860-117-41,NAFCILLIN  2 GRAM INJ SOLR,765.0,535.5,,,0
NDC,70860-119-99,NAFCILLIN 10 GRAM INJ SOLR,432.0,302.4,,,0
NDC,70860-126-41,PENICILLIN G POTASSIUM  5000000 UNIT INJ SOLR,76.0,53.2,,,0
NDC,70860-127-51,PENICILLIN G POTASSIUM 20000000 UNIT INJ SOLR,217.0,151.9,,,0
NDC,70860-301-41,DILTIAZEM 5 MG/ML IV,21.5,15.05,,,0
NDC,70860-301-43,DILTIAZEM 5 MG/ML IV,37.0,25.9,,,0
NDC,70860-400-41,TRANEXAMIC ACID (FOR TOPICAL USE),49.0,34.3,,,0
NDC,70860-405-04,BUMETANIDE 0.25 MG/ML INJ SOLN,28.0,19.6,,,0
NDC,70860-405-41,BUMETANIDE 0.25 MG/ML INJ SOLN,37.0,25.9,,,0
NDC,70860-406-41,BUMETANIDE 0.25 MG/ML INJ SOLN,67.0,46.9,,,0
NDC,70860-602-41,LEVETIRACETAM IN NACL (ISO-OS) 500 MG/100 ML IV PGBK,499.5,349.65,,,0
NDC,70860-700-41,KETOROLAC TROMETHAMINE 15 MG/ML INJ SOLN,20.0,14.0,,,0
NDC,70860-701-04,KETOROLAC TROMETHAMINE 60 MG/2 ML IM SOLN,9.0,6.3,,,0
NDC,70860-751-02,FAMOTIDINE (PF) 20 MG/2 ML IV SOLN,16.0,11.2,,,0
NDC,70860-776-41,ONDANSETRON HCL (PF) 4 MG/2 ML INJ SOLN,25.5,17.85,,,0
NDC,70860-784-41,VALPROATE SODIUM 100 MG/ML IV SOLN,34.0,23.8,,,0
NDC,70954-005-10,OXYBUTYNIN CHLORIDE  5 MG ORAL TAB,8.0,5.6,,,0
NDC,70954-021-10,PRAZOSIN 5 MG ORAL CAP,25.0,17.5,,,0
NDC,70954-059-10,PREDNISONE 10 MG ORAL TAB,7.0,4.9,,,0
NDC,70954-135-10,DAPSONE  25 MG ORAL TAB,28.0,19.6,,,0
NDC,70954-136-10,DAPSONE 100 MG ORAL TAB,13.0,9.1,,,0
NDC,70954-136-20,DAPSONE 100 MG ORAL TAB,15.0,10.5,,,0
NDC,70954-148-10,PYRIDOSTIGMINE BROMIDE 60 MG/5 ML ORAL SYRP,70.0,49.0,,,0
NDC,70954-159-30,CLORAZEPATE DIPOTASSIUM  3.75 MG ORAL TAB,34.0,23.8,,,0
NDC,70954-188-10,ACYCLOVIR 200 MG/5 ML ORAL SUSP,29.0,20.299999999999997,,,0
NDC,70954-211-10,TRIHEXYPHENIDYL 5 MG ORAL TAB,7.0,4.9,,,0
NDC,70954-212-10,TRIHEXYPHENIDYL 2 MG ORAL TAB,7.0,4.9,,,0
NDC,70954-240-10,CARBAMAZEPINE 100 MG/5 ML ORAL SUSP,14.0,9.8,,,0
NDC,70954-261-10,DICYCLOMINE 10 MG/5 ML ORAL SOLN,9.0,6.3,,,0
NDC,70954-273-10,FLUPHENAZINE 1 MG TAB,37.0,25.9,,,0
NDC,70954-274-10,FLUPHENAZINE 2.5 MG TAB,134.0,93.8,,,0
NDC,70954-316-10,FAMOTIDINE 40 MG/5 ML ORAL SUSP,34.0,23.8,,,0
NDC,70954-319-10,PAROXETINE 10 MG/5 ML ORAL SUSP,97.0,67.9,,,0
NDC,70954-455-20,BISOPROLOL FUMARATE  5 MG ORAL TAB,13.0,9.1,,,0
NDC,70954-484-10,PYRAZINAMIDE 500 MG ORAL TAB,93.0,65.1,,,0
NDC,70954-492-10,LEVOCARNITINE 330 MG ORAL TAB,19.0,13.3,,,0
NDC,70954-518-10,LIDOCAINE 4 % MUCOSAL TOPICAL SOLN,32.5,22.75,,,0
NDC,70954-566-10,ESTRADIOL 2 MG ORAL TAB,7.0,4.9,,,0
NDC,70954-600-10,FLUOXETINE 20 MG/5 ML ORAL SOLN,28.0,19.6,,,0
NDC,70954-852-30,LEVOFLOXACIN 250 MG/10 ML ORAL SOLN,213.0,149.1,,,0
NDC,71019-263-20,PHENYLEPHRINE IN 0.9% NS (PF) 1 MG/10 ML (100 MCG/ML) IV SYRG(PDS MERGE),47.0,32.9,,,0
NDC,71093-143-11,SERTRALINE 20 MG/ML ORAL CONC,16.0,11.2,,,0
NDC,71205-109-50,ONDANSETRON HCL 4 MG/5 ML ORAL SOLN,116.0,81.2,,,0
NDC,71205-909-30,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TAB,7.0,4.9,,,0
NDC,71247-130-01,LABETALOL 300 MG ORAL TAB,10.0,7.0,,,0
NDC,71266-2001-2,SUCCINYLCHOLINE CHLORIDE 200 MG/10 ML (20 MG/ML) IV SYRG,50.0,35.0,,,0
NDC,71266-2002-1,ROCURONIUM 50 MG/5 ML (10 MG/ML) IV SYRG,85.0,59.5,,,0
NDC,71266-5073-1,VANCOMYCIN IN 0.9% SODIUM CL 1.25 GRAM/250 ML IV SOLN,86.0,60.2,,,0
NDC,71266-5082-1,VANCOMYCIN IN 0.9% SODIUM CL 1 GRAM/250 ML IV SOLN,80.0,56.0,,,0
NDC,71266-5083-1,VANCOMYCIN IN 0.9% SODIUM CL 1.25 GRAM/250 ML IV SOLN,16.0,11.2,,,0
NDC,71266-5100-1,OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN,81.0,56.699999999999996,,,0
NDC,71266-5102-1,OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN,83.5,58.45,,,0
NDC,71266-5103-1,OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN,103.0,72.1,,,0
NDC,71266-6290-1,LIDOCAINE-EPINEPHR-TETRACAINE 4-0.18-0.5 % TOPICAL GEL,45.0,31.5,,,0
NDC,71266-9005-5,ROCURONIUM 50 MG/5 ML (10 MG/ML) IV SYRG,75.0,52.5,,,0
NDC,71266-9011-1,PHENYLEPHRINE IN 0.9% NS (PF) 1 MG/10 ML (100 MCG/ML) IV SYRG(PDS MERGE),12.5,8.75,,,0
NDC,71266-9080-2,KETAMINE 50 MG/5ML (10 MG/ML) SYRINGE (PHS MERGE),68.5,47.95,,,0
NDC,71266-9080-4,KETAMINE 50 MG/5ML (10 MG/ML) SYRINGE (PHS MERGE),59.0,41.3,,,0
NDC,71266-9081-1,"KETAMINE IN NACL, 10 MG/ML IV SOLN (PHS MERGE RECORD)",147.0,102.9,,,0
NDC,71285-0202-1,"CARDIOPLEGIC SOLUTION NO.16 26 MEQ/1,052.8 ML (POTASSIUM) PERF SOLN",535.0,374.5,,,0
NDC,71285-6044-1,OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN,50.0,35.0,,,0
NDC,71285-6056-1,NOREPINEPHRINE BITARTRATE-D5W 4 MG/250 ML (16 MCG/ML) IV SOLN,68.0,47.6,,,0
NDC,71285-6058-1,PHENYLEPHRINE HCL IN NS 10 MG/250 ML (0.04 MG/ML) IV SOLN (PDS MERGE),51.0,35.7,,,0
NDC,71285-6060-1,POTASSIUM PHOSPHATE 0.06 MMOL/ML IVPB (FOR PEDIATRICS),16.0,11.2,,,0
NDC,71285-6074-1,VANCOMYCIN IN 0.9% SODIUM CL 1.25 GRAM/250 ML IV SOLN,153.0,107.1,,,0
NDC,71285-8000-1,"HEPARIN (PORCINE) IN 0.9% NACL 2,500 UNIT/250 ML (10 UNIT/ML) IV SOLP",16.0,11.2,,,0
NDC,71286-3022-1,KETAMINE 50MG/5ML (10MG/ML) ORAL SOLUTION (REPACK),27.0,18.9,,,0
NDC,71288-005-21,AMPICILLIN-SULBACTAM  1.5 GRAM INJ SOLR,35.0,24.5,,,0
NDC,71288-006-31,AMPICILLIN-SULBACTAM  3 GRAM INJ SOLR,55.0,38.5,,,0
NDC,71288-009-21,CEFEPIME 2 GRAM INJ SOLR,57.0,39.9,,,0
NDC,71288-016-15,DAPTOMYCIN 500 MG IV SOLR,150.5,105.35,,,0
NDC,71288-030-20,DOXYCYCLINE HYCLATE 100 MG IV SOLR,141.0,98.69999999999999,,,0
NDC,71288-101-10,OXALIPLATIN 100 MG/20 ML IV SOLN,52.5,36.75,,,0
NDC,71288-101-20,OXALIPLATIN 100 MG/20 ML IV SOLN,117.5,82.25,,,0
NDC,71288-107-20,BLEOMYCIN 30 UNIT INJ SOLR,224.0,156.8,,,0
NDC,71288-118-10,BORTEZOMIB 3.5 MG IV SOLR,121.0,84.7,,,0
NDC,71288-119-20,DECITABINE 50 MG IV SOLR,177.0,123.9,,,0
NDC,71288-129-02,DACTINOMYCIN 0.5 MG IV SOLR,2335.0,1634.5,,,0
NDC,71288-138-50,MITOMYCIN 20 MG IV SOLR,1037.5,726.25,,,0
NDC,71288-160-10,LEUCOVORIN 1 MG/ML INJECTION (PEDS ONCOLOGY),37.0,25.9,,,0
NDC,71288-161-20,LEUCOVORIN CALCIUM 100 MG INJ SOLR,124.5,87.15,,,0
NDC,71288-163-30,LEUCOVORIN CALCIUM 350 MG INJ SOLR,266.0,186.2,,,0
NDC,71288-165-52,NELARABINE 250 MG/50 ML IV SOLN (PEDS ONCOLOGY),5360.0,3752.0,,,0
NDC,71288-166-10,PEMETREXED 100 MG IV SOLR,330.5,231.35,,,0
NDC,71288-167-50,PEMETREXED 500 MG IV SOLR,558.0,390.6,,,0
NDC,71288-171-11,OXALIPLATIN 100 MG/20 ML IV SOLN,22.0,15.4,,,0
NDC,71288-172-21,OXALIPLATIN 100 MG/20 ML IV SOLN,118.0,82.6,,,0
NDC,71288-201-85,REGADENOSON 0.4 MG/5 ML IV SYRG,118.0,82.6,,,0
NDC,71288-203-10,FUROSEMIDE 10 MG/ML INJ SOLN (NEO),21.0,14.7,,,0
NDC,71288-303-01,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,16.0,11.2,,,0
NDC,71288-402-01,HEPARIN (PORCINE)  1000 UNIT/ML INJ SOLN,48.0,33.6,,,0
NDC,71288-402-10,HEPARIN (PORCINE)  1000 UNIT/ML INJ SOLN,26.0,18.2,,,0
NDC,71288-402-30,HEPARIN (PORCINE)  1000 UNIT/ML INJ SOLN,47.0,32.9,,,0
NDC,71288-403-01,HEPARIN (PORCINE)  5000 UNIT/ML INJ SOLN,16.0,11.2,,,0
NDC,71288-414-01,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,42.0,29.4,,,0
NDC,71288-422-95,HEPARIN (PORCINE)  5000 UNIT/ML INJ SOLN,16.0,11.2,,,0
NDC,71288-426-03,ENOXAPARIN 300 MG/3 ML SUBQ SOLN,23.0,16.1,,,0
NDC,71288-427-10,BIVALIRUDIN 250 MG IV SOLR,535.0,374.5,,,0
NDC,71288-433-82,ENOXAPARIN 40 MG/0.4 ML SUBQ SYRG,19.0,13.3,,,0
NDC,71288-505-02,DEXMEDETOMIDINE 100 MCG/ML IV SOLN,26.5,18.55,,,0
NDC,71288-701-06,ATRACURIUM 10 MG/ML IV SOLN,165.5,115.85,,,0
NDC,71288-716-10,METHOCARBAMOL 100 MG/ML INJ SOLN,53.0,37.1,,,0
NDC,71288-716-11,METHOCARBAMOL 100 MG/ML INJ SOLN,53.0,37.1,,,0
NDC,71288-719-10,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ (MERGE),16.0,11.2,,,0
NDC,71288-802-02,DOXERCALCIFEROL 4 MCG/2 ML IV SOLN,20.0,14.0,,,0
NDC,71288-803-20,MYCOPHENOLATE 500 MG IV SOLUTION,369.5,258.65,,,0
NDC,71288-811-10,METHYLENE BLUE (ANTIDOTE) 5 MG/ML (0.5 %) IV SOLN,237.5,166.25,,,0
NDC,7132180230,"VITAMIN E (DL, ACETATE) 22.5 MG (50 UNIT)/ML ORAL DROP",41.5,29.05,,,0
NDC,71336-1003-1,VUTRISIRAN 25 MG/0.5 ML SUBQ SYRG,329409.0,230586.3,,,0
NDC,71351-022-10,BUPIVACAINE-DEXTROSE-WATER(PF) 7.5 MG/ML (0.75 %) INJ SOLN,25.5,17.85,,,0
NDC,7135101001,POTASSIUM & SODIUM PHOSPHATES 280-160-250 MG ORAL PWPK,7.0,4.9,,,0
NDC,7135101099,POTASSIUM & SODIUM PHOSPHATES 280-160-250 MG ORAL PWPK,13.0,9.1,,,0
NDC,71399-0027-8,SENNOSIDES 8.8 MG/5 ML ORAL SYRP,7.0,4.9,,,0
NDC,71399-0051-1,MAGNESIUM CITRATE ORAL SOLN,20.0,14.0,,,0
NDC,71399-1017-3,SENNOSIDES  8.6 MG ORAL TAB,5.5,3.85,,,0
NDC,71399-1025-3,ACETAMINOPHEN  325 MG ORAL TAB,6.0,4.2,,,0
NDC,71399-1027-1,DIPHENHYDRAMINE 25 MG CAP,7.0,4.9,,,0
NDC,71399-2829-1,DIBUCAINE 1 % TOP OINT,33.0,23.1,,,0
NDC,71399-8014-1,ACETAMINOPHEN  325 MG ORAL TAB,5.0,3.5,,,0
NDC,71399-8237-8,SENNOSIDES 8.8 MG/5 ML ORAL SYRP,7.0,4.9,,,0
NDC,7139974015,CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/ML ORAL DROP,7.5,5.25,,,0
NDC,71449-001-15,PHENYLEPHRINE IN 0.9% NS (PF) 1 MG/10 ML (100 MCG/ML) IV SYRG(PDS MERGE),16.0,11.2,,,0
NDC,71449-004-11,ROCURONIUM 50 MG/5 ML (10 MG/ML) IV SYRG,66.0,46.2,,,0
NDC,71449-068-11,KETAMINE 50 MG/5ML (10 MG/ML) SYRINGE (PHS MERGE),69.0,48.3,,,0
NDC,71449-069-11,KETAMINE 50 MG/5ML (10 MG/ML) SYRINGE (PHS MERGE),69.0,48.3,,,0
NDC,71449-079-51,ROPIVACAINE(PF)0.2 % ELASTOMERIC PUMP (ONQ) 545ML (PREFILLED),2341.5,1639.0500000000002,,,0
NDC,71449-079-57,ROPIVACAINE(PF)-0.9 % SODCHLOR 0.2 % 745 ML LINF ELPH,681.5,477.05,,,0
NDC,71449-126-15,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ (MERGE),49.0,34.3,,,0
NDC,71456-001-01,SODIUM BICARBONATE 8.4 % IV (PHS ERX MERGE),617.0,431.9,,,0
NDC,71506-010-58,PHENYLEPHRINE HCL IN NS 10 MG/250 ML (0.04 MG/ML) IV SOLN (PDS MERGE),146.0,102.2,,,0
NDC,71506-015-58,VANCOMYCIN IN 0.9% SODIUM CL 1.25 GRAM/250 ML IV SOLN,82.0,57.4,,,0
NDC,71506-016-59,VANCOMYCIN IN 0.9 % SODIUM CHL 1.5 GRAM/500 ML IV SOLN,91.0,63.7,,,0
NDC,71506-019-59,VANCOMYCIN IN 0.9 % SODIUM CHL 2 GRAM/500 ML IV SOLN,148.0,103.6,,,0
NDC,71506-029-58,PHENYLEPHRINE HCL IN NS 10 MG/250 ML (0.04 MG/ML) IV SOLN (PDS MERGE),146.0,102.2,,,0
NDC,71506-046-45,LABETALOL (5 MG/ML) IV SYRG PF,31.5,22.049999999999997,,,0
NDC,71506-079-56,THIAMINE IN 0.9 % SOD CHLORIDE 500 MG/100 ML IV SOLN,161.0,112.7,,,0
NDC,71699-050-30,CENOBAMATE  50 MG ORAL TAB,238.0,166.6,,,0
NDC,71699-200-30,CENOBAMATE 200 MG ORAL TAB,238.0,166.6,,,0
NDC,71740-112-30,POTASSIUM IODIDE 1 GRAM/ML ORAL SOLN,39.0,27.3,,,0
NDC,71839-104-01,FOSAPREPITANT 150 MG IV SOLR,1065.0,745.5,,,0
NDC,71921-226-10,DORZOLAMIDE-TIMOLOL 2 %-0.5 % EYE DROPS,442.0,309.4,,,0
NDC,72060-142-40,LUMATEPERONE 42 MG ORAL CAP,291.0,203.7,,,0
NDC,72078-033-00,ADENOSINE 3000 MCG/ML INJECTION,60.0,42.0,,,0
NDC,72078-081-00,MEROPENEM 2000 MG IV SOLR,189.0,132.3,,,0
NDC,7214003147,HYDROPHILLIC OINTMENT (AQUAPHOR),64.5,45.15,,,0
NDC,7214003868,WHITE PETROLATUM-MINERAL OIL TOPICAL CREAM (MERGE),66.0,46.2,,,0
NDC,7214045231,HYDROPHILLIC OINTMENT (AQUAPHOR),202.5,141.75,,,0
NDC,7214063608,HYDROPHILLIC OINTMENT (AQUAPHOR),62.0,43.4,,,0
NDC,72162-1329-8,PHENOBARBITAL SODIUM  65 MG/ML INJ SOLN,167.5,117.25,,,0
NDC,72162-1330-6,PHENOBARBITAL SODIUM 130 MG/ML INJ SOLN,551.0,385.7,,,0
NDC,72162-2280-2,BACITRACIN 500 UNIT/G TOP PACK,7.0,4.9,,,0
NDC,72162-2280-4,BACITRACIN 500 UNIT/G TOP PACK,7.0,4.9,,,0
NDC,72162-2425-5,CIPROFLOXACIN 500 MG ORAL TAB,28.0,19.6,,,0
NDC,72196-6044-1,OXYTOCIN IN 0.9 % SOD CHLORIDE 30 UNIT/500 ML IV SOLN,50.0,35.0,,,0
NDC,72196-6054-1,DILTIAZEM IN D5W 125 MG/125 ML (1 MG/ML) IV SOLN (PREMIX),53.0,37.1,,,0
NDC,72196-6056-1,NOREPINEPHRINE BITARTRATE-D5W 4 MG/250 ML (16 MCG/ML) IV SOLN,289.5,202.65,,,0
NDC,72196-6058-1,PHENYLEPHRINE HCL IN NS 10 MG/250 ML (0.04 MG/ML) IV SOLN (PDS MERGE),51.0,35.7,,,0
NDC,72196-6060-1,POTASSIUM PHOS IN 0.9 % NACL 15 MMOL/250 ML IVPB PREMIX,41.0,28.7,,,0
NDC,72196-6074-1,VANCOMYCIN IN 0.9% SODIUM CL 1.25 GRAM/250 ML IV SOLN,168.5,117.95,,,0
NDC,72196-6176-1,VANCOMYCIN IN 0.9 % SODIUM CHL 1.5 GRAM/500 ML IV SOLN,91.0,63.7,,,0
NDC,72196-7018-1,EPINEPHRINE HCL IN D5W 4 MG/250 ML (16 MCG/ML) IV SOLN,631.0,441.7,,,0
NDC,72205-003-90,ROSUVASTATIN 10 MG ORAL TAB,50.0,35.0,,,0
NDC,72205-012-90,PREGABALIN  50 MG ORAL CAP,124.0,86.8,,,0
NDC,72205-014-90,PREGABALIN 100 MG ORAL CAP,83.0,58.1,,,0
NDC,72205-039-60,DOFETILIDE 125 MCG ORAL CAP,75.0,52.5,,,0
NDC,72205-042-11,OSELTAMIVIR PHOSPHATE 30 MG ORAL CAP,104.5,73.15,,,0
NDC,72205-044-11,OSELTAMIVIR PHOSPHATE 75 MG ORAL CAP,55.5,38.85,,,0
NDC,72205-049-30,AMINOCAPROIC ACID  500 MG ORAL TAB,565.0,395.5,,,0
NDC,72205-051-08,ALBENDAZOLE 200 MG ORAL TAB,1351.0,945.7,,,0
NDC,72205-054-01,FOSAPREPITANT 150 MG IV SOLR,948.0,663.6,,,0
NDC,72205-099-78,SIROLIMUS 1 MG/ML ORAL SOLN,62.0,43.4,,,0
NDC,72205-101-01,BUMETANIDE 0.25 MG/ML INJ SOLN,35.0,24.5,,,0
NDC,72205-102-01,BUMETANIDE 0.25 MG/ML INJ SOLN,70.0,49.0,,,0
NDC,72205-120-01,LEVETIRACETAM 500 MG/5 ML IV SOLN,100.0,70.0,,,0
NDC,72205-142-90,LOSARTAN  50 MG ORAL TAB,13.0,9.1,,,0
NDC,72205-205-01,ZIPRASIDONE 20 MG IM,96.0,67.2,,,0
NDC,72205-220-01,LACOSAMIDE 200 MG/20 ML IV SOLN,147.5,103.25,,,0
NDC,72205-368-91,TICAGRELOR 90 MG ORAL TAB,93.0,65.1,,,0
NDC,72241-030-22,PAROXETINE SR 25 MG 24 HR TAB,45.0,31.5,,,0
NDC,72266-103-01,LABETALOL 5 MG/ML IV SOLN,200.0,140.0,,,0
NDC,72266-118-01,KETOROLAC TROMETHAMINE 30 MG/ML INJ SOLN,12.0,8.4,,,0
NDC,72266-118-25,KETOROLAC TROMETHAMINE 30 MG/ML INJ SOLN,9.0,6.3,,,0
NDC,72266-119-01,KETOROLAC TROMETHAMINE 60 MG/2 ML IM SOLN,2.0,1.4,,,0
NDC,72266-119-25,KETOROLAC TROMETHAMINE 60 MG/2 ML IM SOLN,9.0,6.3,,,0
NDC,72266-127-01,DICYCLOMINE 10 MG/ML IM SOLN,145.0,101.5,,,0
NDC,72266-146-01,ETOMIDATE 2 MG/ML IV SOLN,60.0,42.0,,,0
NDC,72266-147-01,ETOMIDATE 2 MG/ML IV SOLN,17.0,11.9,,,0
NDC,72266-158-01,MOXIFLOXACIN 0.5 % OPHT DROP,69.0,48.3,,,0
NDC,72266-197-01,DORZOLAMIDE 2 % OPHT DROP,89.0,62.3,,,0
NDC,72266-234-01,KETOROLAC TROMETHAMINE 15 MG/ML INJ SOLN,16.0,11.2,,,0
NDC,72266-248-01,SINCALIDE 5 MCG INJ SOLR,591.0,413.7,,,0
NDC,72266-248-05,SINCALIDE 5 MCG INJ SOLR,213.0,149.1,,,0
NDC,72266-251-01,CALCITRIOL 1 MCG/ML IV SOLN,38.5,26.95,,,0
NDC,72485-101-01,DIPHENHYDRAMINE 50 MG/ML INJECTION,16.0,11.2,,,0
NDC,72485-104-01,CAFFEINE CITRATE PEDS/NEO IV SYR (CDS MIX) LD,29.5,20.65,,,0
NDC,72485-106-01,LEVETIRACETAM 500 MG/5 ML IV SOLN,46.0,32.2,,,0
NDC,72485-107-01,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) IV SOLN",68.0,47.6,,,0
NDC,72485-108-01,VERAPAMIL 2.5 MG/ML IV SOLN,62.0,43.4,,,0
NDC,72485-116-01,NICARDIPINE 25 MG/10 ML IV SOLN,205.5,143.85000000000002,,,0
NDC,72485-201-01,AZACITIDINE 100 MG INJ SOLR,1009.0,706.3,,,0
NDC,72485-417-01,AMPICILLIN-SULBACTAM  3 GRAM INJ SOLR,30.0,21.0,,,0
NDC,72485-422-01,AMPICILLIN SODIUM  2 GRAM INJ SOLR,35.5,24.85,,,0
NDC,72485-501-01,MILRINONE 1 MG/ML IV SOLN,21.5,15.049999999999999,,,0
NDC,72485-507-01,THIAMINE 100 MG/ML INJECTION,62.5,43.75,,,0
NDC,72485-510-01,TRANEXAMIC ACID (FOR TOPICAL USE),203.0,142.1,,,0
NDC,72485-613-10,OFLOXACIN 0.3 % OPHT DROP,89.0,62.3,,,0
NDC,72485-670-31,ERYTHROMYCIN 5 MG/G OPHT OINT,225.5,157.85,,,0
NDC,72578-002-01,ACYCLOVIR 200 MG ORAL CAP,4.5,3.1500000000000004,,,0
NDC,72578-093-01,BETAMETHASONE DIPROPIONATE 0.05 % TOP OINT,261.0,182.7,,,0
NDC,72578-136-06,FEBUXOSTAT 40 MG ORAL TAB,74.5,52.15,,,0
NDC,72578-166-01,DEXAMETHASONE 1 MG ORAL TAB,6.0,4.2,,,0
NDC,72579-121-01,TISLELIZUMAB-JSGR 10 MG/ML IV SOLN,13211.0,9247.7,,,0
NDC,72603-103-01,DOXORUBICIN LIPOSOMAL 2 MG/ML IV INJ,2675.0,1872.5,,,0
NDC,72603-115-01,TAMSULOSIN 0.4 MG ORAL CP24,35.5,24.85,,,0
NDC,72603-131-01,DOFETILIDE 250 MCG ORAL CAP,86.0,60.2,,,0
NDC,72603-139-01,THIAMINE 100 MG/ML INJECTION,69.5,48.650000000000006,,,0
NDC,72603-139-25,THIAMINE 100 MG/ML INJECTION,42.0,29.400000000000002,,,0
NDC,72603-141-01,SUMATRIPTAN 6 MG/0.5 ML SUBQ PEN KIT,322.5,225.75,,,0
NDC,72603-141-02,SUMATRIPTAN 6 MG/0.5 ML SUBQ PEN KIT,406.0,284.2,,,0
NDC,72603-152-01,DAPTOMYCIN 500 MG IV SOLR,1609.0,1126.3,,,0
NDC,72603-161-01,KETOROLAC TROMETHAMINE 30 MG/ML INJ SOLN,19.0,13.3,,,0
NDC,72603-170-01,FLUDROCORTISONE 0.1 MG ORAL TAB,7.0,4.9,,,0
NDC,72603-179-01,HEPARIN (PORCINE)  1000 UNIT/ML INJ SOLN,24.5,17.15,,,0
NDC,72603-180-01,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,80.0,56.0,,,0
NDC,72603-181-01,OLANZAPINE 10 MG IM SOLR,104.0,72.8,,,0
NDC,72603-206-01,GEMFIBROZIL 600 MG ORAL TAB,14.0,9.8,,,0
NDC,72603-209-01,SODIUM BICARBONATE 8.4 % IV (PHS ERX MERGE),93.0,65.1,,,0
NDC,72603-210-01,PENICILLIN G POTASSIUM  5000000 UNIT INJ SOLR,70.5,49.35,,,0
NDC,72603-212-01,DEXAMETHASONE 0.5 MG ORAL TAB,3.0,2.1,,,0
NDC,72603-224-01,HEPARIN (PORCINE) 20000 UNIT/ML INJ SOLN,33.0,23.1,,,0
NDC,72603-251-01,FUROSEMIDE 10 MG/ML INJ SOLN,40.0,28.0,,,0
NDC,72603-270-01,BORTEZOMIB 3.5 MG IV SOLR,284.0,198.8,,,0
NDC,72603-286-01,TESTOSTERONE CYPIONATE 200 MG/ML IM OIL,114.0,79.8,,,0
NDC,72603-350-01,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,39.5,27.650000000000002,,,0
NDC,72603-387-01,TRANEXAMIC ACID (FOR TOPICAL USE),42.0,29.4,,,0
NDC,72603-505-01,LIDOCAINE (PF) 20 MG/ML (2 %) INJ SOLN,40.0,28.0,,,0
NDC,72603-506-01,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJ SOLN,21.0,14.7,,,0
NDC,72603-567-01,NAFCILLIN 10 GRAM INJ SOLR,538.0,376.6,,,0
NDC,72603-650-01,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,25.0,17.5,,,0
NDC,72603-825-01,LIDOCAINE 20 MG/ML (2 %) INJECTION,16.0,11.2,,,0
NDC,72611-722-25,KETOROLAC TROMETHAMINE 30 MG/ML INJ SOLN,9.0,6.3,,,0
NDC,72611-761-01,VANCOMYCIN  500 MG IV SOLR,20.0,14.0,,,0
NDC,72611-780-01,TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FINAL) IV SOLR,10681.0,7476.7,,,0
NDC,72611-860-01,ACETYLCYSTEINE 20 % (200 MG/ML) IV SOLN,543.5,380.45,,,0
NDC,72694-515-01,CALASPARGASE PEGOL-MKNL 750 UNITS/ML IV SOLN,75551.0,52885.7,,,0
NDC,72694-954-01,PEGASPARGASE 750 UNIT/ML INJ SOLN,64175.5,44922.85,,,0
NDC,72789-057-01,POTASSIUM CHLORIDE  10 MEQ ORAL CPSR,4.5,3.15,,,0
NDC,72789-062-01,HYDROCORTISONE 20 MG ORAL TAB,6.0,4.2,,,0
NDC,72789-325-90,TIZANIDINE 4 MG ORAL TAB,4.0,2.8000000000000003,,,0
NDC,72789-355-30,LORAZEPAM 0.5 MG ORAL TAB,7.0,4.9,,,0
NDC,72888-019-01,BUMETANIDE 0.5 MG ORAL TAB,54.0,37.8,,,0
NDC,72888-024-06,POTASSIUM CHLORIDE  20 MEQ ORAL PACK,115.5,80.85,,,0
NDC,72888-037-01,CARVEDILOL 25 MG ORAL TAB,12.0,8.4,,,0
NDC,72888-039-60,AMIODARONE 200 MG ORAL TAB,19.0,13.3,,,0
NDC,72888-053-01,METOLAZONE  5 MG ORAL TAB,33.5,23.45,,,0
NDC,72888-060-30,AMIODARONE 100 MG ORAL TAB,57.5,40.25,,,0
NDC,72888-074-14,OXCARBAZEPINE 300 MG/5 ML ORAL SUSP,16.0,11.2,,,0
NDC,72888-080-01,TRAMADOL  50 MG ORAL TAB,8.5,5.95,,,0
NDC,72888-125-26,LIDOCAINE 2 % MUCOSAL SOLN (VISCOUS),7.0,4.9,,,0
NDC,72888-141-35,FLUTICASONE  50 MCG/ACTUATION NASL SPSN,396.0,277.2,,,0
NDC,72888-200-12,MYCOPHENOLATE SODIUM 360 MG ORAL TBEC,90.0,63.0,,,0
NDC,72903-853-01,MIRVETUXIMAB SORAVTANSINE-GYNX 5 MG/ML IV SOLN,17324.5,12127.15,,,0
NDC,73013-1030-1,HYDROMORPHONE 10 MG/50 ML (0.2MG/ML) PCA IN NS (MERGE),223.0,156.1,,,0
NDC,73013-1048-01,FENTANYL-ROPIVACAINE-NACL (PF) 2-0.2 MCG/ML-% INJ (MERGE ERX),540.0,378.0,,,0
NDC,73013-2002-2,KETAMINE 50 MG/5ML (10 MG/ML) SYRINGE (PHS MERGE),42.5,29.75,,,0
NDC,73070-200-11,INSULIN ASP PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBQ SOLN,23.0,16.1,,,0
NDC,73070-400-11,INSULIN DEGLUDEC 100 UNITS/ML SUBQ SOLN,26.0,18.2,,,0
NDC,73150-150-06,UBLITUXIMAB-XIIY 25 MG/ML IV SOLN,57809.0,40466.3,,,0
NDC,73177-108-03,PHENYLEPHRINE HCL IN 0.9% NACL 1 MG/10 ML (100 MCG/ML) IV SYRG,35.0,24.5,,,0
NDC,73177-109-14,ROPIVACAINE(PF)-0.9 % SODCHLOR 0.2 % 745 ML LINF ELPH,2415.0,1690.5,,,0
NDC,73177-123-02,DEXMEDETOMIDINE IN NS 20 MCG/5 ML (4 MCG/ML) IV POST OP SHIVERING,59.0,41.3,,,0
NDC,73177-146-33,ALBUTEROL SULFATE 5 MG/ML INHL NEB CONTINUOUS,340.0,238.0,,,0
NDC,73177-163-33,ALBUTEROL SULFATE 5 MG/ML INHL NEB CONTINUOUS,245.0,171.5,,,0
NDC,73293-0001-1,LIDOCAINE (PF) 10 MG/ML (1 %) INJ SOLN,25.0,17.5,,,0
NDC,73475-3041-5,EFGARTIGIMOD ALFA-FCAB 20 MG/ML IV SOLN,30791.5,21554.05,,,0
NDC,73475-3102-3,"EFGARTIGIMOD-HYALURONIDAS-QVFC 1,008 MG-11,200 UNIT/5.6 ML SUBQ SOLN",43534.0,30473.8,,,0
NDC,73535-208-01,TAFASITAMAB-CXIX 200 MG IV SOLR,14854.5,10398.150000000001,,,0
NDC,73536-500-01,ROPEGINTERFERON ALFA-2B-NJFT 500 MCG/ML SUBQ SYRG,23234.0,16263.8,,,0
NDC,73562-115-01,"LIPASE-PROTEASE-AMYLASE 5,000-17,000- 24,000 UNIT ORAL CPDR",28.0,19.6,,,0
NDC,73594-9310-1,FERRIC DERISOMALTOSE 100 MG IRON/ML IV SOLN,8962.0,6273.4,,,0
NDC,73650-316-01,TEPLIZUMAB-MZWV 2 MG/20 ML IV SOLN,7987.5,5591.25,,,0
NDC,73702-104-65,DEXTROSE 50% IN WATER (MERGE RECORD),91.0,63.7,,,0
NDC,73702-132-23,CEFAZOLIN IN STERILE WATER 2 GRAM/20 ML IV SYRG,184.0,128.8,,,0
NDC,73702-140-71,INDOMETHACIN 100 MG RECT SUPP,677.0,473.90000000000003,,,0
NDC,73702-301-15,KETAMINE 50 MG/5ML (10 MG/ML) SYRINGE (PHS MERGE),18.0,12.6,,,0
NDC,74024001,ORAL ELECTROLYTES ORAL SOLN,39.0,27.3,,,0
NDC,7431200640,RIBOFLAVIN 100 MG ORAL TAB,7.0,4.9,,,0
NDC,74725-100-64,KIT PREP OF GA-68-GOZETOTIDE 25 MCG IV SOLR,10591.0,7413.7,,,0
NDC,7513785045,BENZOCAINE-MENTHOL 20 %-0.5 % TOPICAL AEROSOL,29.0,20.3,,,0
NDC,75826-114-10,PHENAZOPYRIDINE 100 MG ORAL TAB,7.0,4.9,,,0
NDC,75826-115-10,PHENAZOPYRIDINE 200 MG ORAL TAB,7.0,4.9,,,0
NDC,75826-142-10,PHENOBARBITAL  97.2 MG ORAL TAB,3.5,2.45,,,0
NDC,75834-147-06,HYDROCORTISONE ACETATE 25 MG RECT SUPP,111.0,77.7,,,0
NDC,75834-147-12,HYDROCORTISONE ACETATE 25 MG RECT SUPP,111.0,77.7,,,0
NDC,75834-158-01,VERAPAMIL 180 MG ORAL TBSR,13.0,9.100000000000001,,,0
NDC,75834-159-01,VERAPAMIL 240 MG ORAL TBSR,10.0,7.0,,,0
NDC,75834-170-01,ZINC OXIDE 20 % TOP OINT (REPACK),37.0,25.9,,,0
NDC,75834-171-01,CALCIUM GLUCONATE (FOR EMERGENCY) 100 MG/ML (10%) IV SOLN,88.5,61.949999999999996,,,0
NDC,75834-221-01,CARBAMAZEPINE 200 MG ORAL TAB,18.0,12.6,,,0
NDC,75834-280-30,POTASSIUM IODIDE 1 GRAM/ML ORAL SOLN,32.0,22.4,,,0
NDC,75834-312-01,THYROID (PORK)  60 MG ORAL TAB,13.0,9.1,,,0
NDC,75834-320-01,VERAPAMIL 120 MG ORAL TBSR,9.5,6.65,,,0
NDC,75907-058-60,TAMOXIFEN 10 MG ORAL TAB,21.0,14.7,,,0
NDC,75907-060-44,NYSTATIN  100000 UNIT/G TOP POWD,108.0,75.6,,,0
NDC,75907-069-01,NORTRIPTYLINE 10 MG ORAL CAP,7.0,4.9,,,0
NDC,75987-080-10,PEGLOTICASE 8 MG/ML IV SOLN,51290.0,35903.0,,,0
NDC,75987-130-15,TEPROTUMUMAB-TRBW 500 MG IV SOLR,70458.0,49320.6,,,0
NDC,75987-150-01,INEBILIZUMAB-CDON 10 MG/ML IV SOLN,540888.5,378621.95,,,0
NDC,76014-003-33,NEOSTIGMINE 1MG/ML (UD) OR SYRINGE,213.0,149.10000000000002,,,0
NDC,76045-004-01,MORPHINE 2 MG/ML IV SOLN (PHS/CDS MERGE),51.0,35.7,,,0
NDC,76045-004-10,MORPHINE  2 MG/ML INJ SYRG,51.0,35.7,,,0
NDC,76045-004-11,MORPHINE 2 MG/ML IV SOLN (PHS/CDS MERGE),16.0,11.2,,,0
NDC,76045-005-01,MORPHINE  4 MG/ML INJ SYRG,169.0,118.3,,,0
NDC,76045-009-01,HYDROMORPHONE (PF) 1 MG/ML IV SOLN (PHS ERX MERGE),56.0,39.2,,,0
NDC,76045-009-05,HYDROMORPHONE 0.5 MG/0.5 ML INJ SYRG (PHS ERX MERGE),20.0,14.0,,,0
NDC,76045-009-10,HYDROMORPHONE (PF) 1 MG/ML IV SOLN (PHS ERX MERGE),32.0,22.4,,,0
NDC,76045-009-96,HYDROMORPHONE (PF) 1 MG/ML IV SOLN (PHS ERX MERGE),34.0,23.8,,,0
NDC,76045-204-00,DIAZEPAM 5 MG/ML INJ SYRG,109.0,76.3,,,0
NDC,76045-737-01,HALOPERIDOL LACTATE 5 MG/ML INJECTION (MERGE),40.5,28.349999999999998,,,0
NDC,76075-101-01,CARFILZOMIB 60 MG IV SOLR,4531.0,3171.7,,,0
NDC,76075-102-01,CARFILZOMIB 30 MG IV SOLR,2186.0,1530.2,,,0
NDC,76075-103-01,CARFILZOMIB 10 MG IV SOLR,1027.5,719.25,,,0
NDC,761003220,RIBOFLAVIN 100 MG ORAL TAB,7.0,4.9,,,0
NDC,76125-792-10,"ALBUMIN, HUMAN 25 % IV SOLN (MERGE)",415.0,290.5,,,0
NDC,76125-792-11,"ALBUMIN, HUMAN 25 % IV SOLN (MERGE)",208.0,145.6,,,0
NDC,76125-792-26,"ALBUMIN, HUMAN 25 % IV SOLP",172.0,120.4,,,0
NDC,76204-011-05,ALBUTEROL SULFATE 1.25 MG/3 ML INHL NEBU,8.5,5.95,,,0
NDC,76204-100-01,IPRATROPIUM BROMIDE 0.02 % INHL SOLN,21.0,14.7,,,0
NDC,76204-200-01,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) NEB SOLUTION,8.0,5.6,,,0
NDC,76204-200-30,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) NEB SOLUTION,8.0,5.6,,,0
NDC,76204-600-01,IPRATROPIUM-ALBUTEROL 0.5 MG-2.5 MG/3 ML NEB SOLUTION,13.0,9.1,,,0
NDC,76204-600-30,IPRATROPIUM-ALBUTEROL 0.5 MG-2.5 MG/3 ML NEB SOLUTION,13.0,9.1,,,0
NDC,7620430003,SODIUM CHLORIDE 0.9 % INHL NEBU,7.0,4.9,,,0
NDC,76282-208-90,CITALOPRAM 40 MG ORAL TAB,10.0,7.0,,,0
NDC,76282-212-60,SERTRALINE  25 MG ORAL TAB,23.5,16.45,,,0
NDC,76282-476-45,LANTHANUM  500 MG ORAL CHEW,51.5,36.05,,,0
NDC,76282-663-39,DICLOFENAC 1 % TOPICAL GEL,24.0,16.8,,,0
NDC,76282-740-30,PHYTONADIONE 5 MG ORAL TAB,48.0,33.6,,,0
NDC,76297-001-32,SODIUM CHLORIDE 0.9 % IV SOLP,23.5,16.450000000000003,,,0
NDC,76297-001-42,SODIUM CHLORIDE 0.9 % IV (CLINIC BOLUS),39.0,27.3,,,0
NDC,76310-024-15,FOSCARNET 24 MG/ML IV SOLN,1325.0,927.5,,,0
NDC,76329-1240-1,PHYTONADIONE 1 MG/0.5 ML INJ SYRG,146.0,102.2,,,0
NDC,76329-3011-5,LIDOCAINE HCL  2 % MM JELP,55.5,38.85,,,0
NDC,76329-3012-5,LIDOCAINE HCL  2 % MM JELP,55.5,38.85,,,0
NDC,76329-3013-5,LIDOCAINE HCL  2 % MM JELP,76.0,53.2,,,0
NDC,76329-3015-5,LIDOCAINE HCL  2 % MM JELP,34.0,23.8,,,0
NDC,76329-3302-1,DEXTROSE 50% IN WATER (MERGE RECORD),109.0,76.3,,,0
NDC,76329-3304-1,CALCIUM CHLORIDE (FOR CODE) 10% (100 MG/ML) IV SYRINGE,124.0,86.8,,,0
NDC,76329-3318-1,EPINEPHRINE 0.1 MG/ML SYRINGE (ERX MERGE),514.0,359.8,,,0
NDC,76329-3340-1,ATROPINE 0.1 MG/ML INJ SYRG,38.0,26.6,,,0
NDC,76329-3352-1,SODIUM BICARBONATE 8.4 % IV (PHS ERX MERGE),526.0,368.2,,,0
NDC,76329-3369-1,NALOXONE 1 MG/ML NEEDLELESS SYRG,194.0,135.8,,,0
NDC,76329-3390-1,LIDOCAINE (PF) 20 MG/ML (2 %) IV SYRG,133.5,93.44999999999999,,,0
NDC,76329-3399-5,PROCAINAMIDE 100 MG/ML IV SYRG,368.0,257.6,,,0
NDC,76329-6300-5,LIDOCAINE 4 % TOPICAL SOLN,749.0,524.3,,,0
NDC,76329-8261-0,LORAZEPAM 2 MG/ML IV SOLN (PHS MERGE - ALL SITES),88.5,61.95,,,0
NDC,76329-9060-0,EPINEPHRINE 1 MG/ML INJ SOLN,144.0,100.8,,,0
NDC,76329-9061-0,EPINEPHRINE 1 MG/ML INJ SOLN,162.5,113.75,,,0
NDC,76385-102-01,PRIMAQUINE 26.3 MG ORAL TAB,15.0,10.5,,,0
NDC,76385-114-01,SOTALOL  80 MG ORAL TAB,18.5,12.95,,,0
NDC,76385-133-01,NADOLOL  20 MG ORAL TAB,19.0,13.3,,,0
NDC,76385-134-01,NADOLOL  40 MG ORAL TAB,22.0,15.4,,,0
NDC,76385-138-01,METOLAZONE 10 MG ORAL TAB,18.0,12.6,,,0
NDC,76420-081-01,METHYLPREDNISOLONE 80 MG/ML SUSP FOR INJECTION,116.0,81.2,,,0
NDC,76420-085-01,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,623.0,436.1,,,0
NDC,7651805050,CHOLECALCIFEROL (VITAMIN D3) 400 UNIT/ML ORAL DROP,17.5,12.25,,,0
NDC,77333-031-25,ASPIRIN   81 MG ORAL TBEC,5.0,3.5,,,0
NDC,77333-049-25,ASPIRIN 81 MG ORAL CHEW,5.0,3.5,,,0
NDC,77333-812-25,SIMETHICONE  80 MG ORAL CHEW,11.0,7.7,,,0
NDC,77333-827-25,SODIUM BICARBONATE 650 MG ORAL TAB,5.5,3.85,,,0
NDC,77333-844-25,SODIUM CHLORIDE 1000 MG MISC TBSO,5.5,3.85,,,0
NDC,7733300415,LACTOBACILLUS ACIDOPHILUS 500 MILLION CELLS ORAL CAP,5.5,3.85,,,0
NDC,7733343025,LACTASE 3000 UNIT ORAL TAB,7.0,4.9,,,0
NDC,7733351625,MELATONIN  3 MG ORAL TAB,7.5,5.25,,,0
NDC,7733371525,PRENATAL VIT NO.130-IRON-FOLIC 27 MG IRON- 800 MCG ORAL TAB,7.0,4.9,,,0
NDC,7733380025,SACCHAROMYCES BOULARDII 250 MG ORAL CAP,7.0,4.9,,,0
NDC,7733380050,SACCHAROMYCES BOULARDII 250 MG ORAL CAP,32.0,22.4,,,0
NDC,7733386125,MULTIVIT-IRON-FA-CALCIUM &MINS 9 MG IRON-400 MCG ORAL TAB,7.0,4.9,,,0
NDC,7733393425,THIAMINE MONONITRATE 100 MG ORAL TAB,5.5,3.85,,,0
NDC,7733393825,CYANOCOBALAMIN 1000 MCG ORAL TAB,7.0,4.9,,,0
NDC,7733394025,PYRIDOXINE  50 MG ORAL TAB,7.0,4.9,,,0
NDC,7733394825,CHOLECALCIFEROL (VITAMIN D3)   400 UNIT ORAL TAB,11.5,8.05,,,0
NDC,7733398325,ZINC SULFATE 220 MG (50 MG) CAP,7.0,4.9,,,0
NDC,7811201103,PHENOL 1.4 % MM SPRA,25.0,17.5,,,0
NDC,7811201106,BENZOCAINE-MENTHOL 6-10 MG MM LOZG,10.5,7.35,,,0
NDC,7811201266,BENZOCAINE-MENTHOL 6-10 MG MM LOZG,5.0,3.5,,,0
NDC,7811225419,NAPHAZOLINE-GLYCERIN 0.012-0.25 % OPHT DROP,25.0,17.5,,,0
NDC,7811273623,CARBAMIDE PEROXIDE 6.5 % OTIC DROP,181.0,126.7,,,0
NDC,78206-114-03,MOMETASONE 220 MCG (14 DOSES) INHL AEPB,228.0,159.6,,,0
NDC,78206-115-01,MOMETASONE 110 MCG (30 DOSES) INHL AEPB,402.0,281.4,,,0
NDC,78206-118-01,BETAMETHASONE ACET & SOD PHOS 6 MG/ML INJ SUSP,89.0,62.3,,,0
NDC,78206-121-01,LOSARTAN  25 MG ORAL TAB,23.0,16.1,,,0
NDC,78206-122-01,LOSARTAN  50 MG ORAL TAB,40.5,28.35,,,0
NDC,78206-145-01,ETONOGESTREL 68 MG SDRM IMPL,2258.0,1580.6,,,0
NDC,78206-162-01,INFLIXIMAB-ABDA 100 MG IV SOLR,6808.5,4765.95,,,0
NDC,78206-162-99,INFLIXIMAB-ABDA 100 MG IV SOLR,9773.5,6841.45,,,0
NDC,7985420062,CYANOCOBALAMIN 1000 MCG ORAL TAB,7.0,4.9,,,0
NDC,7985420140,NIACIN  250 MG ORAL TAB,7.0,4.9,,,0
NDC,7985440050,MULTIVIT-MIN-IRON FUM-FOLIC AC 7.5 MG IRON-400 MCG ORAL TAB,7.0,4.9,,,0
NDC,7985450021,"CALCIUM CARBONATE 500 MG (1,250 MG) ORAL TAB",7.0,4.9,,,0
NDC,7985450032,FERROUS GLUCONATE 324 MG (37.5 MG IRON) ORAL TAB,7.0,4.9,,,0
NDC,79952-110-01,LONCASTUXIMAB TESIRINE-LPYL 10 MG IV SOLR,46505.5,32553.85,,,0
NDC,8068102600,ACIDOPHILUS-PECTIN W CITRUS 25 MILLION-100 CELL MG TAB,7.0,4.9,,,0
NDC,8068104900,PEDIATRIC MULTIVITAMIN NO.42 ORAL CHEW,7.0,4.9,,,0
NDC,8068105500,"OMEGA-3 FATTY ACIDS-FISH OIL 360-1,200 MG ORAL CAP (ERX MERGE)",5.5,3.85,,,0
NDC,8068107100,CYANOCOBALAMIN  100 MCG ORAL TAB,7.0,4.9,,,0
NDC,8068108600,MELATONIN  3 MG ORAL TAB,5.5,3.85,,,0
NDC,8068109900,FOLIC ACID 400 MCG ORAL TAB,7.0,4.9,,,0
NDC,8068116900,CHOLECALCIFEROL (VITAMIN D3)  1000 UNIT ORAL TAB,5.5,3.85,,,0
NDC,80725-140-20,CARVEDILOL  6.25 MG ORAL TAB,82.0,57.4,,,0
NDC,80725-250-01,PAROMOMYCIN 250 MG ORAL CAP,761.0,532.7,,,0
NDC,80777-110-01,COVID VACCINE 24-25 (12UP)(MOD)(PF) 50 MCG/0.5 ML IM SYRG,613.0,429.1,,,0
NDC,80777-110-93,COVID VACCINE 24-25 (12UP)(MOD)(PF) 50 MCG/0.5 ML IM SYRG,613.0,429.1,,,0
NDC,80777-112-01,COVID VAC 25-26(12UP)(MOD)(PF) 50 MCG/0.5 ML IM SYRG,613.0,429.1,,,0
NDC,80777-113-09,COVID VAC 25-26(6M-11Y)(MOD)PF 25 MCG/0.25 ML IM SYRG,558.0,390.6,,,0
NDC,80777-291-09,COVID VACCINE 24-25 (6M-11Y)(MOD)PF 25 MCG/0.25 ML IM SYRG,836.5,585.55,,,0
NDC,80777-291-80,COVID VACCINE 24-25 (6M-11Y)(MOD)PF 25 MCG/0.25 ML IM SYRG,558.0,390.6,,,0
NDC,80777-291-81,COVID VACCINE 24-25 (6M-11Y)(MOD)PF 25 MCG/0.25 ML IM SYRG,558.0,390.6,,,0
NDC,80803-153-50,SIROLIMUS-PROTEIN BOUND 100 MG IV SUSR (WET SUSR VIAL),10843.5,7590.45,,,0
NDC,80830-1691-2,POTASSIUM PHOSPHATE DIBASIC 3 MMOLE/ML IV SOLP,77.0,53.9,,,0
NDC,80830-1693-1,POTASSIUM PHOSPHATE 4.4 MEQ/ML ORAL SOLUTION (CDS),14.0,9.8,,,0
NDC,80830-2329-1,"TRANEXAMIC ACID IN NACL,ISO-OS 1,000 MG/100 ML (10 MG/ML) IV PGBK",121.0,84.7,,,0
NDC,81033-002-05,ACETAMINOPHEN 160 MG/5 ML ORAL (PHS ERX MERGE),12.5,8.75,,,0
NDC,81033-002-10,ACETAMINOPHEN 160 MG/5 ML ORAL (PHS ERX MERGE),7.5,5.25,,,0
NDC,81033-002-20,ACETAMINOPHEN 160 MG/5 ML ORAL (PHS ERX MERGE),22.0,15.399999999999999,,,0
NDC,81033-002-30,ACETAMINOPHEN 160 MG/5 ML ORAL (PHS ERX MERGE),42.0,29.4,,,0
NDC,81033-016-05,PROMETHAZINE  6.25 MG/5 ML ORAL SYRP,43.0,30.1,,,0
NDC,81033-104-05,ATOVAQUONE 750 MG/5 ML ORAL SUSP,223.0,156.1,,,0
NDC,8103350115,MULTIVIT-MIN-FERROUS GLUCONATE 9 MG IRON/ 15 ML (15 ML) ORAL LIQD,15.0,10.5,,,0
NDC,81073794,"NEOMYCIN-POLYMYXIN-PRAMOXINE 3.5 MG-10,000 UNIT-10 MG/G TOPICAL CREAM",38.5,26.950000000000003,,,0
NDC,81284-153-00,PIPERACILLIN-TAZOBACTAM  4.5 GRAM IV SOLR,40.0,28.0,,,0
NDC,81284-315-00,INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) IV SOLN,1296.0,907.1999999999999,,,0
NDC,81284-315-05,INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) IV SOLN,470.0,329.0,,,0
NDC,81284-411-00,DIHYDROERGOTAMINE 1 MG/ML INJ SOLN,397.0,277.9,,,0
NDC,81284-411-05,DIHYDROERGOTAMINE 1 MG/ML INJ SOLN,397.0,277.9,,,0
NDC,81284-611-00,TRANEXAMIC ACID (FOR TOPICAL USE),92.0,64.4,,,0
NDC,81298-5010-1,CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN,306.0,214.2,,,0
NDC,81298-5781-1,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,31.0,21.7,,,0
NDC,81298-5781-5,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,35.0,24.5,,,0
NDC,81298-5783-3,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,32.0,22.4,,,0
NDC,81298-5785-3,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,37.0,25.9,,,0
NDC,81298-8554-1,VASOPRESSIN IN 0.9 % NS 40 UNIT/100 ML (0.4 UNIT/ML) IV SOLN,843.0,590.0999999999999,,,0
NDC,8142102103,BISACODYL 10 MG RECT SUPP,7.0,4.9,,,0
NDC,81665-103-10,ISOSORBIDE MONONITRATE  20 MG ORAL TAB,12.0,8.4,,,0
NDC,81665-108-30,ISONIAZID 300 MG ORAL TAB,26.0,18.2,,,0
NDC,81665-301-02,COCAINE  4 % TOP SOLN (MERGE),1271.0,889.7,,,0
NDC,81952-111-01,HEPARIN (PORCINE)  5000 UNIT/ML INJ SOLN,18.0,12.6,,,0
NDC,81960-031-03,HC IV INFUSION PEMIVIBART,15939.0,11157.3,,,0
NDC,81964-221-14,AMOXICILLIN-POT CLAVULANATE 875 MG-125 MG TAB,29.0,20.3,,,0
NDC,82154-0449-1,PEGINTERFERON ALFA-2A 180 MCG/ML SUBQ SOLN,769.0,538.3,,,0
NDC,82260-813-05,TIMOLOL MALEATE 0.5 % OPHT DROP,65.0,45.5,,,0
NDC,82293-004-10,MIDODRINE  5 MG ORAL TAB,31.5,22.049999999999997,,,0
NDC,82705-002-01,EPCORITAMAB-BYSP  4 MG/0.8 ML SUBQ SOLN,1031.0,721.7,,,0
NDC,82705-010-01,EPCORITAMAB-BYSP 48 MG/0.8 ML SUBQ SOLN,44594.0,31215.8,,,0
NDC,8290033010,SODIUM CHLORIDE 0.9 % INJ SYRG,16.0,11.2,,,0
NDC,8290306413,"HEPARIN, PORCINE (PF)   10 UNIT/ML IV SYRG",16.0,11.2,,,0
NDC,8290306424,"HEPARIN, PORCINE (PF)  100 UNIT/ML IV SYRG",16.0,11.2,,,0
NDC,8290306499,SODIUM CHLORIDE 0.9 % INJ SYRG,16.0,11.2,,,0
NDC,8290306500,SODIUM CHLORIDE 0.9 % INJ SYRG,194.0,135.79999999999998,,,0
NDC,8290306504,SODIUM CHLORIDE 0.9 % INJ SYRG,17.0,11.899999999999999,,,0
NDC,8290306513,"HEPARIN, PORCINE (PF)  100 UNIT/ML IV SYRG",16.0,11.2,,,0
NDC,8290306544,SODIUM CHLORIDE 0.9 % INJ SOLN (VIAL),19.0,13.3,,,0
NDC,8290306545,SODIUM CHLORIDE 0.9 % INJ SOLN (VIAL),16.0,11.2,,,0
NDC,8290306546,SODIUM CHLORIDE 0.9 % INJ SYRG,12.0,8.399999999999999,,,0
NDC,8290306547,SODIUM CHLORIDE 0.9 % INJ SYRG,16.5,11.55,,,0
NDC,8290306553,SODIUM CHLORIDE 0.9 % INJ SYRG,16.0,11.2,,,0
NDC,82959-111-01,IMETELSTAT 188 MG IV SOLR,51468.5,36027.95,,,0
NDC,82959-112-01,IMETELSTAT  47 MG IV SOLR,8729.5,6110.65,,,0
NDC,83257-005-41,PEGFILGRASTIM-JMDB (FULPHILA) 6 MG/0.6 ML SUBQ SYRG,5762.0,4033.4,,,0
NDC,83257-011-11,INSULIN GLARGINE 100 UNIT/ML SUBQ SOLN,20.0,14.0,,,0
NDC,83257-014-11,INSULIN GLARGINE 100 UNIT/ML SUBQ SOLN (LANTUS/SEMGLEE) (MERGE),22.0,15.4,,,0
NDC,83257-026-11,USTEKINUMAB-KFCE 130 MG/26 ML IV SOLN,4248.0,2973.6,,,0
NDC,8349020760,SODIUM CHLORIDE  7 % INHL NEBU,7.0,4.9,,,0
NDC,8349030760,SODIUM CHLORIDE  7 % INHL NEBU,7.0,4.9,,,0
NDC,83634-401-41,TRANEXAMIC ACID 1000 MG/10 ML FOR NEBULIZATION,116.0,81.2,,,0
NDC,83851-100-30,FLUORESCEIN 1 MG OPHT STRP,7.0,4.9,,,0
NDC,8385110001,FLUORESCEIN 1 MG OPHT STRP,7.0,4.9,,,0
NDC,83980-006-01,PROPRANOLOL  20 MG ORAL TAB,8.0,5.6,,,0
NDC,83980-007-01,PROPRANOLOL  40 MG ORAL TAB,7.5,5.25,,,0
NDC,8438912178,2-OCTYL CYANOACRYLATE TOPICAL LIQD,117.0,81.9,,,0
NDC,8452100686,WHITE PETROLATUM TOP OIPK,7.0,4.9,,,0
NDC,87040203,PEDIATRIC MULTIVITAMIN NO.192 250 MCG-50 MG- 10 MCG/ML ORAL DROP,10.5,7.3500000000000005,,,0
NDC,87040501,PEDI MV NO.189-FERROUS SULFATE 11 MG IRON/ML ORAL DROP,7.0,4.9,,,0
NDC,87074002,FERROUS SULFATE 75 MG/ML (ELEMENTAL IRON 15 MG/ML) ORAL DROP,7.0,4.9,,,0
NDC,87086644,CHOLECALCIFEROL 400 UNIT/ML ORAL DROP (REPACK),20.0,14.0,,,0
NDC,8754130091,"HYALURONATE SOD, CROSS-LINKED 30 MG/3 ML IATC SYRG",4240.0,2968.0,,,0
NDC,8770143151,CARBAMIDE PEROXIDE 6.5 % OTIC DROP,54.0,37.8,,,0
NDC,8770143152,CARBAMIDE PEROXIDE 6.5 % OTIC DROP,43.0,30.1,,,0
NDC,8770179215,ASPIRIN 81 MG ORAL CHEW,5.0,3.5,,,0
NDC,8913020201,"HYALURONATE SODIUM, STABILIZED 60 MG/3 ML IATC SYRG",3022.5,2115.75,,,0
NDC,8913044441,SODIUM HYALURONATE (VISCOSUP) 10 MG/ML IATC SYRG,672.0,470.4,,,0
NDC,904052361,ASCORBIC ACID  500 MG ORAL TAB,7.0,4.9,,,0
NDC,904053061,MULTIVITAMIN WITH FOLIC ACID 400 MCG ORAL TAB,7.0,4.9,,,0
NDC,904053961,MULTIVITAMIN WITH FOLIC ACID 400 MCG ORAL TAB,7.0,4.9,,,0
NDC,904188260,CALCIUM CARBONATE-VITAMIN D3 250 MG-125 UNIT TAB,5.5,3.85,,,0
NDC,904188361,"CALCIUM CARBONATE 500 MG (1,250 MG) ORAL TAB",7.0,4.9,,,0
NDC,904208560,VITAMIN A 10000 UNIT ORAL CAP,7.0,4.9,,,0
NDC,904518206,MELATONIN  3 MG ORAL TAB,7.0,4.9,,,0
NDC,904522452,LACTASE 3000 UNIT ORAL TAB,7.0,4.9,,,0
NDC,904531360,PRENATAL VIT NO.130-IRON-FOLIC 27 MG IRON- 800 MCG ORAL TAB,7.0,4.9,,,0
NDC,904549280,MULTIVIT-IRON-FA-CALCIUM &MINS 9 MG IRON-400 MCG ORAL TAB,7.0,4.9,,,0
NDC,904598426,AMMONIUM LACTATE 12 % TOP LOTN,187.0,130.9,,,0
NDC,904661161,ACIDOPHILUS-PECTIN W CITRUS 25 MILLION-100 CELL MG TAB,7.0,4.9,,,0
NDC,904719106,THIAMINE 100 MG TAB,7.0,4.9,,,0
NDC,904723006,SACCHAROMYCES BOULARDII 250 MG ORAL CAP,8.5,5.95,,,0
NDC,904723961,SODIUM CHLORIDE 1000 MG MISC TBSO,7.5,5.25,,,0
NDC,904726006,LACTOBACILLUS ACIDOPHILUS 500 MILLION CELLS ORAL CAP,5.5,3.85,,,0
NDC,904740361,CYANOCOBALAMIN 1000 MCG ORAL TAB,5.5,3.85,,,0
NDC,904759060,FERROUS SULFATE 325 MG (65 MG IRON) TAB,7.0,4.9,,,0
NDC,904759160,FERROUS SULFATE 325 MG (65 MG IRON) TAB,7.0,4.9,,,0
NDC,904759161,FERROUS SULFATE 325 MG (65 MG IRON) TAB,7.0,4.9,,,0
NDC,904759182,FERROUS SULFATE 325 MG (65 MG IRON) TAB,7.0,4.9,,,0
NDC,9629511419,FAMOTIDINE 20 MG ORAL TAB,7.0,4.9,,,0
NDC,995803360,HONEY 100 % TOP PSTE,59.0,41.3,,,0
NDC,99999-0400-16,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,522.0,365.4,,,0
NDC,99999-0401-04,MAGNESIUM SULFATE 20 GRAM/500 ML IV SOLP,37.0,25.9,,,0
NDC,99999-0402-06,DEXTROSE 25% IN WATER (NEO),150.0,105.0,,,0
NDC,99999-0402-55,ALTEPLASE IV INFUSION (PULMONARY EMBOLISM) 100 MG (2 X 50 MG VIALS),36433.5,25503.449999999997,,,0
NDC,99999-0402-85,BICARB FOR OR,95.5,66.85,,,0
NDC,99999-0403-03,METRONIDAZOLE 50 MG/ML SUSPENSION (10ML REPACK),8.0,5.6,,,0
NDC,99999-0403-06,0.2 MICRON FILTER ATTACHMENT MISC MISC,105.0,73.5,,,0
NDC,99999-0403-36,ALTEPLASE 1MG/ML SYRINGE (FOR IR USE ONLY),950.5,665.35,,,0
NDC,99999-0403-50,HEPARIN 0.5 UNITS/ML IN 0.45% SODIUM CHLORIDE (REPACK REC),16.0,11.2,,,0
NDC,99999-0403-51,HEPARIN 0.5 UNITS/ML IN DEXTROSE 10% FOR TRANSPORT (REPACK REC),13.0,9.1,,,0
NDC,99999-0403-63,ADENOSINE 300 MCG/ML BOLUS (NEO),16.0,11.2,,,0
NDC,99999-0403-82,AMPHOTERICIN B 5 MCG/0.1 ML INTRAVITREAL INJECTION,55886.0,39120.200000000004,,,0
NDC,99999-0403-91,GENTAMICIN 10 MG/1 ML SUBCONJUNCTIVAL INJECTION,21.0,14.7,,,0
NDC,99999-0404-03,CLOBAZAM 2.5 MG/ML ORAL SUSP,119.0,83.3,,,0
NDC,99999-0404-10,PENICILLIN GK 2.5 MU IN NS 100ML IVPB (PDS ADS MIXTURE),159.0,111.3,,,0
NDC,99999-0404-16,YTTRIUM-90 (SIR-SPHERES) MICROSPHERES,42831.0,29981.699999999997,,,0
NDC,99999-0404-59,CHLOROTHIAZIDE SODIUM 28 MG/ML IV (PEDS) REPACK,38.0,26.6,,,0
NDC,99999-0404-65,METOLAZONE 1MG/ML SUSPENSION (REPACK),7.0,4.9,,,0
NDC,99999-0404-75,SILDENAFIL 2.5 MG/ML SUSPENSION,17.0,11.9,,,0
NDC,99999-0405-41,LACTULOSE ENEMA 200G IN SW (1000 ML TOTAL VOLUME),48.0,33.6,,,0
NDC,99999-0405-70,AMIODARONE BOLUS PEDS/NEO IV SYRINGE (1.5MG/ML FROM PREMIX),204.0,142.8,,,0
NDC,99999-0405-74,DEXAMETHASONE 0.1 MG/ML IV SYRINGE (NEO/INFANT),27.5,19.25,,,0
NDC,99999-0405-84,UREA 15 GRAM PACKET,28.0,19.6,,,0
NDC,99999-0405-85,METHYLPREDNISOLONE SOD SUC(PF) 10 MG/ML INJ (REPACK),16.0,11.2,,,0
NDC,99999-0406-15,CEFAZOLIN 1000 MG IN NS 500 ML IRRIGATION (REPACK),69.0,48.300000000000004,,,0
NDC,99999-0406-16,VANCOMYCIN 1000 MG IN NS 500 ML IRRIGATION (REPACK),97.0,67.9,,,0
NDC,99999-0406-25,MILRINONE INFUSION PED/NEO IV SYRINGE (CDS MIXTURE),139.0,97.3,,,0
NDC,99999-0406-26,MILRINONE INFUSION PED/NEO IV SYRINGE (CDS MIXTURE),346.5,242.54999999999998,,,0
NDC,99999-0406-81,SODIUM CHLORIDE 4 MEQ/ML ORAL SOLUTION (CDS),30.0,21.0,,,0
NDC,99999-0407-05,HC TC-99 FROM NON-HIGHLY ENRICHED URANIUM SOURCE FULL COST ADD ON PER STUDY DOSE,5381.0,3766.7,,,0
NDC,99999-0407-66,IODINE I-123 CAPSULE FOR WHOLE BODY SCAN,1681.0,1176.7,,,0
NDC,99999-0408-26,BUPRENORPHINE 0.5 MG SL (1/4 TAB) SUBL,10.0,7.0,,,0
NDC,99999-402-98,IODINE (I-131) CAPSULE FOR UPTAKE DIAGNOSTIC,191.0,133.7,,,0
NDC,99999-403-39,DOPAMINE INFUSION PEDS IV SYRINGE (FROM PREMIX),19.0,13.3,,,0
NDC,99999-407-39,TOBRAMYCIN (FORTIFIED) 15MG/ML OPHTHALMIC DROP (15ML),42.0,29.4,,,0
NDC,99999-407-40,VANCOMYCIN (FORTIFIED) 50MG/ML OPHTHALMIC DROP (15ML),326.0,228.2,,,0
NDC,99999-407-47,CLONIDINE 0.1MG/ML ORAL SOLUTION (HIGH CONC FOR PEDS),7.0,4.9,,,0
NDC,99999-407-59,PSYLLIUM HUSK (ASPARTAME) 3.4 GRAM ORAL PWPK,7.0,4.9,,,0
NDC,99999-408-60,SODIUM CHLORIDE 0.9 % IV SOLN 400ML (PHS REPACK),20.0,14.0,,,0
NDC,99999-408-63,AMPICILLIN PEDS INFUSION (CDS MIXTURE),38.0,26.6,,,0
NDC,99999-408-72,VASOPRESSIN INFUSION PEDS IV SYRINGE IN D5W (FROM PREMIX),752.0,526.4,,,0
NDC,99999-420-10,HYDRALAZINE 1MG/ML IV SYRINGE (PEDS/NEO),18.0,12.6,,,0
NDC,99999-420-20,PHENYLEPHRINE PEDS IV INFUSION (CDS MIXTURE),16.0,11.2,,,0
NDC,99999-444-01,DOPAMINE INFUSION NEO IV SYRINGE (FROM PREMIX) 3200 MIG/ML,16.0,11.2,,,0
NDC,99999-444-03,DOPAMINE INFUSION NEO IV SYRINGE (FROM PREMIX) 3200 MIG/ML,16.0,11.2,,,0
NDC,99999-444-05,DOPAMINE INFUSION NEO IV SYRINGE (FROM PREMIX) 3200 MIG/ML,26.0,18.2,,,0
NDC,99999-444-26,CISATRACURIUM IN NS 400 MG/200 ML (2 MG/ML) IV SOLN,1503.0,1052.1,,,0
NDC,99999-444-41,NOREPINEPHRINE BITARTRATE-D5W 16 MG/250 ML (64 MCG/ML) IV SOLN (CENTRAL ONLY),227.0,158.9,,,0
NDC,99999-500-04,CEFAZOLIN 1000 MG IN NS 1000 ML IRRIGATION (REPACK),57.5,40.25,,,0
NDC,99999-500-20,EPOPROSTENOL (ARGNININE) (VELETRI) CONTINUOUS NEB 1.5 MG IN NS 50 ML,243.0,170.1,,,0
NDC,99999-500-26,MIDAZOLAM 50 MG/50 ML (1 MG/ML) IN D5W (INFUSION),53.0,37.1,,,0
NDC,99999-500-91,MAGIC MOUTHWASH REPACK (BMX 1:1:1),27.0,18.9,,,0
NDC,99999-500-93,DAY 1 NEO SOLUTION (D12.5W/AA 2%/HEPARIN 0.5 UNITS/ML),167.0,116.9,,,0
NDC,99999-501-19,MERCAPTOPURINE 25 MG SPLIT TABLET,46.0,32.2,,,0
NDC,99999-502-02,VANCOMYCIN IN 0.9 % SODIUM CHL 1.5 GRAM/500 ML IV SOLN,91.0,63.7,,,0
NDC,99999-555-57,MIDAZOLAM 250 MG/50 ML CONCENTRATED DRIP (RSE),203.0,142.1,,,0
NDC,99999-805-02,CEPHALEXIN 250 MG/5 ML SUSPENSION KIT (REPACK),7.0,4.9,,,0
NDC,99999-999-99,INSULIN INFUSION PEDS IV SYRINGE (FROM PREMIX),103.0,72.1,,,0