code_type,code,description,gross_charge,discounted_cash,min_negotiated,max_negotiated,payer_entries APC,0717,"Instill adstiladrin, tx dose",,,,,0 APC,0763,"Inj, bupivacaine liposome",,,,,0 APC,0764,Ketorolac tromethamine inj,,,,,0 APC,0767,"Inj, nogapendekin pmln 1 mcg",,,,,0 APC,0790,"Inj, methylpred acetate 1 mg",,,,,0 APC,0792,"Inj, glycopyrrolate, 0.1 mg",,,,,0 APC,0801,"Inj, methylpred sod succ 5mg",,,,,0 APC,0822,"Inj, romiplostim 1 microgram",,,,,0 APC,0874,Synvisc or synvisc-one,,,,,0 APC,0875,Euflexxa inj per dose,,,,,0 APC,0902,"Injection,onabotulinumtoxinA",,,,,0 APC,1207,"Octreotide injection, depot",,,,,0 APC,1417,Gel-one,,,,,0 APC,1489,Inj vedolizumab iv 1 mg,,,,,0 APC,1490,Inj pembrolizumab,,,,,0 APC,1511,New Technology - Level 11 ($901 - $1000),,,,,0 APC,1521,New Technology - Level 21 ($1901-$2000),,,,,0 APC,1522,New Technology - Level 22 ($2001-$2500),,,,,0 APC,1563,New Technology - Level 26 ($4001-$4500),,,,,0 APC,1580,"New Technology - Level 43 ($40,001-$50,000)",,,,,0 APC,1694,Ziconotide injection,,,,,0 APC,1822,"Injection, zarxio",,,,,0 APC,2039,"Gen, neuro, imp led, ex cntr",,,,,0 APC,2050,Cath coronary drug-delivery,,,,,0 APC,2059,Cryo needle non-opioid dev,,,,,0 APC,2616,"Brachytx, non-str,Yttrium-90",,,,,0 APC,2638,"Brachytx, stranded, I-125",,,,,0 APC,2643,"Brachytx, non-stranded,C-131",,,,,0 APC,5012,Clinic Visits and Related Services,,,,,0 APC,5021,Level 1 Type A ED Visits,,,,,0 APC,5022,Level 2 Type A ED Visits,,,,,0 APC,5023,Level 3 Type A ED Visits,,,,,0 APC,5024,Level 4 Type A ED Visits,,,,,0 APC,5025,Level 5 Type A ED Visits,,,,,0 APC,5041,Critical Care,,,,,0 APC,5045,Trauma Response with Critical Care,,,,,0 APC,5051,Level 1 Skin Procedures,,,,,0 APC,5052,Level 2 Skin Procedures,,,,,0 APC,5053,Level 3 Skin Procedures,,,,,0 APC,5054,Level 4 Skin Procedures,,,,,0 APC,5055,Level 5 Skin Procedures,,,,,0 APC,5061,Hyperbaric Oxygen,,,,,0 APC,5071,Level 1 Excision/ Biopsy/ Incision and Drainage,,,,,0 APC,5072,Level 2 Excision/ Biopsy/ Incision and Drainage,,,,,0 APC,5073,Level 3 Excision/ Biopsy/ Incision and Drainage,,,,,0 APC,5091,Level 1 Breast/Lymphatic Surgery and Related Procedures,,,,,0 APC,5092,Level 2 Breast/Lymphatic Surgery and Related Procedures,,,,,0 APC,5093,Level 3 Breast/Lymphatic Surgery and Related Procedures,,,,,0 APC,5094,Level 4 Breast/Lymphatic Surgery and Related Procedures,,,,,0 APC,5101,Level 1 Strapping and Cast Application,,,,,0 APC,5102,Level 2 Strapping and Cast Application,,,,,0 APC,5111,Level 1 Musculoskeletal Procedures,,,,,0 APC,5112,Level 2 Musculoskeletal Procedures,,,,,0 APC,5113,Level 3 Musculoskeletal Procedures,,,,,0 APC,5114,Level 4 Musculoskeletal Procedures,,,,,0 APC,5115,Level 5 Musculoskeletal Procedures,,,,,0 APC,5116,Level 6 Musculoskeletal Procedures,,,,,0 APC,5151,Level 1 Airway Endoscopy,,,,,0 APC,5152,Level 2 Airway Endoscopy,,,,,0 APC,5153,Level 3 Airway Endoscopy,,,,,0 APC,5154,Level 4 Airway Endoscopy,,,,,0 APC,5155,Level 5 Airway Endoscopy,,,,,0 APC,5161,Level 1 ENT Procedures,,,,,0 APC,5162,Level 2 ENT Procedures,,,,,0 APC,5163,Level 3 ENT Procedures,,,,,0 APC,5164,Level 4 ENT Procedures,,,,,0 APC,5165,Level 5 ENT Procedures,,,,,0 APC,5166,Cochlear Implant Procedure,,,,,0 APC,5181,Level 1 Vascular Procedures,,,,,0 APC,5182,Level 2 Vascular Procedures,,,,,0 APC,5183,Level 3 Vascular Procedures,,,,,0 APC,5184,Level 4 Vascular Procedures,,,,,0 APC,5191,Level 1 Endovascular Procedures,,,,,0 APC,5192,Level 2 Endovascular Procedures,,,,,0 APC,5193,Level 3 Endovascular Procedures,,,,,0 APC,5194,Level 4 Endovascular Procedures,,,,,0 APC,5200,Implantation Wireless PA Pressure Monitor,,,,,0 APC,5212,Level 2 Electrophysiologic Procedures,,,,,0 APC,5213,Level 3 Electrophysiologic Procedures,,,,,0 APC,5221,Level 1 Pacemaker and Similar Procedures,,,,,0 APC,5222,Level 2 Pacemaker and Similar Procedures,,,,,0 APC,5223,Level 3 Pacemaker and Similar Procedures,,,,,0 APC,5224,Level 4 Pacemaker and Similar Procedures,,,,,0 APC,5231,Level 1 ICD and Similar Procedures,,,,,0 APC,5232,Level 2 ICD and Similar Procedures,,,,,0 APC,5241,Level 1 Blood Product Exchange and Related Services,,,,,0 APC,5242,Level 2 Blood Product Exchange and Related Services,,,,,0 APC,5243,Level 3 Blood Product Exchange and Related Services,,,,,0 APC,5244,Level 4 Blood Product Exchange and Related Services,,,,,0 APC,5301,Level 1 Upper GI Procedures,,,,,0 APC,5302,Level 2 Upper GI Procedures,,,,,0 APC,5303,Level 3 Upper GI Procedures,,,,,0 APC,5311,Level 1 Lower GI Procedures,,,,,0 APC,5312,Level 2 Lower GI Procedures,,,,,0 APC,5313,Level 3 Lower GI Procedures,,,,,0 APC,5331,Complex GI Procedures,,,,,0 APC,5341,Level 1 Abdominal/Peritoneal/Biliary and Related Procedures,,,,,0 APC,5342,Level 2 Abdominal/Peritoneal/Biliary and Related Procedures,,,,,0 APC,5361,Level 1 Laparoscopy and Related Services,,,,,0 APC,5362,Level 2 Laparoscopy and Related Services,,,,,0 APC,5371,Level 1 Urology and Related Services,,,,,0 APC,5372,Level 2 Urology and Related Services,,,,,0 APC,5373,Level 3 Urology and Related Services,,,,,0 APC,5374,Level 4 Urology and Related Services,,,,,0 APC,5375,Level 5 Urology and Related Services,,,,,0 APC,5376,Level 6 Urology and Related Services,,,,,0 APC,5377,Level 7 Urology and Related Services,,,,,0 APC,5378,Level 8 Urology and Related Services,,,,,0 APC,5401,Dialysis,,,,,0 APC,5411,Level 1 Gynecologic Procedures,,,,,0 APC,5412,Level 2 Gynecologic Procedures,,,,,0 APC,5413,Level 3 Gynecologic Procedures,,,,,0 APC,5414,Level 4 Gynecologic Procedures,,,,,0 APC,5415,Level 5 Gynecologic Procedures,,,,,0 APC,5416,Level 6 Gynecologic Procedures,,,,,0 APC,5431,Level 1 Nerve Procedures,,,,,0 APC,5432,Level 2 Nerve Procedures,,,,,0 APC,5441,Level 1 Nerve Injections,,,,,0 APC,5442,Level 2 Nerve Injections,,,,,0 APC,5443,Level 3 Nerve Injections,,,,,0 APC,5461,Level 1 Neurostimulator and Related Procedures,,,,,0 APC,5462,Level 2 Neurostimulator and Related Procedures,,,,,0 APC,5463,Level 3 Neurostimulator and Related Procedures,,,,,0 APC,5464,Level 4 Neurostimulator and Related Procedures,,,,,0 APC,5465,Level 5 Neurostimulator and Related Procedures,,,,,0 APC,5471,Implantation of Drug Infusion Device,,,,,0 APC,5481,Laser Eye Procedures,,,,,0 APC,5491,Level 1 Intraocular Procedures,,,,,0 APC,5492,Level 2 Intraocular Procedures,,,,,0 APC,5493,Level 3 Intraocular Procedures,,,,,0 APC,5501,"Level 1 Extraocular, Repair, and Plastic Eye Procedures",,,,,0 APC,5502,"Level 2 Extraocular, Repair, and Plastic Eye Procedures",,,,,0 APC,5503,"Level 3 Extraocular, Repair, and Plastic Eye Procedures",,,,,0 APC,5504,"Level 4 Extraocular, Repair, and Plastic Eye Procedures",,,,,0 APC,5521,Level 1 Imaging without Contrast,,,,,0 APC,5522,Level 2 Imaging without Contrast,,,,,0 APC,5523,Level 3 Imaging without Contrast,,,,,0 APC,5524,Level 4 Imaging without Contrast,,,,,0 APC,5571,Level 1 Imaging with Contrast,,,,,0 APC,5572,Level 2 Imaging with Contrast,,,,,0 APC,5573,Level 3 Imaging with Contrast,,,,,0 APC,5591,Level 1 Nuclear Medicine and Related Services,,,,,0 APC,5592,Level 2 Nuclear Medicine and Related Services,,,,,0 APC,5593,Level 3 Nuclear Medicine and Related Services,,,,,0 APC,5594,Level 4 Nuclear Medicine and Related Services,,,,,0 APC,5611,Level 1 Therapeutic Radiation Treatment Preparation,,,,,0 APC,5612,Level 2 Therapeutic Radiation Treatment Preparation,,,,,0 APC,5613,Level 3 Therapeutic Radiation Treatment Preparation,,,,,0 APC,5622,Level 2 Radiation Therapy,,,,,0 APC,5623,Level 3 Radiation Therapy,,,,,0 APC,5624,Level 4 Radiation Therapy,,,,,0 APC,5626,Level 6 Radiation Therapy,,,,,0 APC,5627,Level 7 Radiation Therapy,,,,,0 APC,5661,Therapeutic Nuclear Medicine,,,,,0 APC,5671,Level 1 Pathology,,,,,0 APC,5672,Level 2 Pathology,,,,,0 APC,5673,Level 3 Pathology,,,,,0 APC,5674,Level 4 Pathology,,,,,0 APC,5691,Level 1 Drug Administration,,,,,0 APC,5692,Level 2 Drug Administration,,,,,0 APC,5693,Level 3 Drug Administration,,,,,0 APC,5694,Level 4 Drug Administration,,,,,0 APC,5721,Level 1 Diagnostic Tests and Related Services,,,,,0 APC,5722,Level 2 Diagnostic Tests and Related Services,,,,,0 APC,5723,Level 3 Diagnostic Tests and Related Services,,,,,0 APC,5724,Level 4 Diagnostic Tests and Related Services,,,,,0 APC,5731,Level 1 Minor Procedures,,,,,0 APC,5732,Level 2 Minor Procedures,,,,,0 APC,5733,Level 3 Minor Procedures,,,,,0 APC,5734,Level 4 Minor Procedures,,,,,0 APC,5735,Level 5 Minor Procedures,,,,,0 APC,5741,Level 1 Electronic Analysis of Devices,,,,,0 APC,5742,Level 2 Electronic Analysis of Devices,,,,,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,5811,Manipulation Therapy,,,,,0 APC,5821,Level 1 Health and Behavior Services,,,,,0 APC,5822,Level 2 Health and Behavior Services,,,,,0 APC,5823,Level 3 Health and Behavior Services,,,,,0 APC,5871,Dental Procedures,,,,,0 APC,7048,Alteplase recombinant,,,,,0 APC,9011,Mmrv vaccine sc,,,,,0 APC,9067,Lutetium lu 177 dotatat ther,,,,,0 APC,9073,Buprenorph xr 100 mg or less,,,,,0 APC,9139,"Rabies vaccine, im",,,,,0 APC,9217,Leuprolide acetate suspnsion,,,,,0 APC,9278,Incobotulinumtoxin A,,,,,0 APC,9290,"Inj, bupivacaine, nos, 0.5mg",,,,,0 APC,9329,Inj mvasi 10 mg,,,,,0 APC,9364,Inj enfort vedo-ejfv 0.25mg,,,,,0 APC,9398,Covid-19 Vaccine Administration,,,,,0 APC,9400,"Inj, labetalol hcl, 5mg",,,,,0 APC,9404,"Inj, nitroglycerin, 5 mg",,,,,0 APC,9411,"Inj. riabni, 10 mg",,,,,0 APC,9463,"Inj., aprepitant, 1 mg",,,,,0 APC,9483,"Inj, atezolizumab,10 mg",,,,,0 APC,9501,Platelet pheres leukoreduced,,,,,0 APC,9512,RBC leukocytes reduced,,,,,0 APC,9522,RBC leukoreduced irradiated,,,,,0 APC,9525,"Platelets, hla-m, l/r, unit",,,,,0 APC,9530,Plate pheres leukoredu irrad,,,,,0 APC,N800,Clinical Diagnostic Lab Services,,,,,0 APC,N801,Therapy Services,,,,,0 APC,N804,Mammography Services,,,,,0 APC,N805,Durable Medical Equipment,,,,,0 APC,N809,Other Medicine,,,,,0 APC,N811,"Observation, Other",,,,,0 APC,N900,Non-covered Services,,,,,0 APC,N902,Packaged Services,,,,,0 APC,N905,Not Recognized by OPPS,,,,,0 APC,N907,Not Billable to FI,,,,,0 CDM,1120000001,Hc Private Room Daily,2245.95,898.38,,,0 CDM,1130000001,Hc Pediatrics Private Room Daily,2477.79,991.12,,,0 CDM,1140000001,Hc Psych Private Room Daily,3752.91,1501.16,,,0 CDM,1210000001,Hc Semi-Private Room Daily,2245.95,898.38,,,0 CDM,1220000001,Hc Ob Semi-Private Room Daily,2245.95,898.38,,,0 CDM,1220000002,Hc Ob Semi-Private Room Daily Labor And Delivery,3709.44,1483.78,,,0 CDM,1220000003,Hc Anteparte High Risk Bed Charge,3752.91,1501.16,,,0 CDM,1230000001,Hc Pediatrics Semi-Private Room Daily,2477.79,991.12,,,0 CDM,1240000001,Hc Psych Semi-Private Room Daily,3752.91,1501.16,,,0 CDM,1250000001,Hc Hospice Room Daily,2245.95,898.38,,,0 CDM,1270000001,Hc Oncology Routine Room Daily,2390.85,956.34,,,0 CDM,1640000001,Hc Isolation Room Daily,2898.0,1159.2,,,0 CDM,1700000001,Hc Nursery Room Daily,1397.71,559.08,,,0 CDM,1710000001,Hc Nursery 1 Room Daily To Hc Newborn I,1509.52,603.81,,,0 CDM,1720000001,Hc Nursery 2 Room Daily To Hc Newborn Ii,2571.16,1028.46,,,0 CDM,1730000001,Hc Nursery 3 Room Daily To Hc Newborn Iii,6369.85,2547.94,,,0 CDM,1740000001,Hc Nursery 4 Room Daily To Hc Newborn Iv,8899.54,3559.82,,,0 CDM,1790000001,Hc Antepartal Bed Charge,4006.2,1602.48,,,0 CDM,2010000001,Hc Icu Surgery Room Daily,8043.84,3217.54,,,0 CDM,2020000001,Hc Icu Room Daily,7900.2,3160.08,,,0 CDM,2020000002,Hc Complex Hematology-Oncology Icu,7900.2,3160.08,,,0 CDM,2030000001,Hc Icu Pediatrics Room Daily,8142.12,3256.85,,,0 CDM,2060000001,Hc Intermediate Icu Room Daily,5692.68,2277.07,,,0 CDM,2080000001,Hc Icu Trauma Room Daily,8353.8,3341.52,,,0 CDM,2100000001,Hc Icu Cardiology Room Daily,7892.64,3157.06,,,0 CDM,2140000001,Hc Telemetry Room Daily,3923.64,1569.46,,,0 CDM,2500000001,Hc Executive Health Hep A Vaccine,257.0,102.8,,,0 CDM,2500000002,Hc Executive Health Tet-Dip-Pert (Tdap),205.0,82.0,,,0 CDM,2500000004,Hc Rx 250 General Pharmacy With Hcpcs (Alt 636 For Op/Ed),630.35,252.14,,,0 CDM,2500000004_00002021301,"Humulin R: 1 Vial, Multi-Dose In 1 Carton (0002-0213-01) / 3 Ml In 1 Vial, Multi-Dose",0.83,0.33,,,0 CDM,2500000004_00002751001,Humalog: 1 Vial In 1 Carton (0002-7510-01) / 10 Ml In 1 Vial,1.11,0.44,,,0 CDM,2500000004_00002751017,Humalog: 1 Vial In 1 Carton (0002-7510-17) / 3 Ml In 1 Vial,0.87,0.35,,,0 CDM,2500000004_00002751601,NDC Description Not Available,1.45,0.58,,,0 CDM,2500000004_00002753301,Humalog: 1 Vial In 1 Carton (0002-7533-01) / 3 Ml In 1 Vial,0.85,0.34,,,0 CDM,2500000004_00002759701,Zyprexa Intramuscular: 1 Vial In 1 Carton (0002-7597-01) / 2 Ml In 1 Vial,37.12,14.85,,,0 CDM,2500000004_00002762301,Alimta: 1 Vial In 1 Carton (0002-7623-01) / 20 Ml In 1 Vial,348.49,139.4,,,0 CDM,2500000004_00002764001,Alimta: 1 Vial In 1 Carton (0002-7640-01) / 4 Ml In 1 Vial,348.49,139.4,,,0 CDM,2500000004_00002766901,"Cyramza: 1 Vial, Single-Dose In 1 Carton (0002-7669-01) / 10 Ml In 1 Vial, Single-Dose",321.99,128.8,,,0 CDM,2500000004_00002767801,"Cyramza: 1 Vial, Single-Dose In 1 Carton (0002-7678-01) / 50 Ml In 1 Vial, Single-Dose",321.6,128.64,,,0 CDM,2500000004_00002771227,Humalog Kwikpen: 2 Syringe In 1 Carton (0002-7712-27) / 3 Ml In 1 Syringe (0002-7712-01),7.78,3.11,,,0 CDM,2500000004_00002821501,"Humulin R: 1 Vial, Multi-Dose In 1 Carton (0002-8215-01) / 10 Ml In 1 Vial, Multi-Dose",0.31,0.12,,,0 CDM,2500000004_00002821517,"Humulin R: 1 Vial, Multi-Dose In 1 Carton (0002-8215-17) / 3 Ml In 1 Vial, Multi-Dose",0.39,0.16,,,0 CDM,2500000004_00002831501,"Humulin N: 1 Vial, Multi-Dose In 1 Carton (0002-8315-01) / 10 Ml In 1 Vial, Multi-Dose",0.79,0.32,,,0 CDM,2500000004_00002850101,"Humulin R U-500: 1 Vial, Multi-Dose In 1 Carton (0002-8501-01) / 20 Ml In 1 Vial, Multi-Dose",3.33,1.33,,,0 CDM,2500000004_00002871501,"Humulin 70/30: 1 Vial, Multi-Dose In 1 Carton (0002-8715-01) / 10 Ml In 1 Vial, Multi-Dose",0.93,0.37,,,0 CDM,2500000004_00002871517,"1 VIAL, MULTI-DOSE in 1 CARTON (0002-8715-17) / 3 mL in 1 VIAL, MULTI-DOSE",0.37,0.15,,,0 CDM,2500000004_00003029305,"Kenalog-40: 1 Vial, Single-Dose In 1 Carton (0003-0293-05) / 1 Ml In 1 Vial, Single-Dose",10.3,4.12,,,0 CDM,2500000004_00003029320,"Kenalog-40: 1 Vial, Multi-Dose In 1 Carton (0003-0293-20) / 5 Ml In 1 Vial, Multi-Dose",10.67,4.27,,,0 CDM,2500000004_00003029328,"Kenalog-40: 1 Vial, Multi-Dose In 1 Carton (0003-0293-28) / 10 Ml In 1 Vial, Multi-Dose",7.81,3.12,,,0 CDM,2500000004_00003037113,"Nulojix: 1 Vial, Single-Use In 1 Carton (0003-0371-13) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Use",17.21,6.88,,,0 CDM,2500000004_00003049420,"Kenalog-10: 1 Vial, Multi-Dose In 1 Carton (0003-0494-20) / 5 Ml In 1 Vial, Multi-Dose",10.6,4.24,,,0 CDM,2500000004_00003218713,"Orencia: 1 Vial, Single-Use In 1 Carton (0003-2187-13) / 15 Ml In 1 Vial, Single-Use",253.88,101.55,,,0 CDM,2500000004_00003229111,"Empliciti: 1 Vial, Single-Use In 1 Carton (0003-2291-11) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Use",33.21,13.28,,,0 CDM,2500000004_00003232711,"Yervoy: 1 Vial, Single-Use In 1 Carton (0003-2327-11) / 10 Ml In 1 Vial, Single-Use",780.86,312.34,,,0 CDM,2500000004_00003232822,"Yervoy: 1 Vial, Single-Use In 1 Carton (0003-2328-22) / 40 Ml In 1 Vial, Single-Use",780.01,312.0,,,0 CDM,2500000004_00003256016,"Azactam: 10 Vial, Single-Dose In 1 Carton (0003-2560-16) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose",12.81,5.12,,,0 CDM,2500000004_00003257016,"Azactam: 10 Vial, Single-Dose In 1 Carton (0003-2570-16) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose",13.32,5.33,,,0 CDM,2500000004_00003373413,"Opdivo: 1 Vial, Single-Dose In 1 Carton (0003-3734-13) / 24 Ml In 1 Vial, Single-Dose",141.84,56.74,,,0 CDM,2500000004_00003375614,"Opdivo: 1 Vial, Single-Dose In 1 Carton (0003-3756-14) / 12 Ml In 1 Vial, Single-Dose",141.13,56.45,,,0 CDM,2500000004_00003377211,"Opdivo: 1 Vial, Single-Dose In 1 Carton (0003-3772-11) / 4 Ml In 1 Vial, Single-Dose",142.21,56.88,,,0 CDM,2500000004_00003377412,"Opdivo: 1 Vial, Single-Dose In 1 Carton (0003-3774-12) / 10 Ml In 1 Vial, Single-Dose",141.82,56.73,,,0 CDM,2500000004_00003452211,"Empliciti: 1 Vial, Single-Use In 1 Carton (0003-4522-11) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Use",33.28,13.31,,,0 CDM,2500000004_00003712511,"Opdualag: 1 Vial, Single-Dose In 1 Carton (0003-7125-11) / 20 Ml In 1 Vial, Single-Dose",830.72,332.29,,,0 CDM,2500000004_00004110150,"Xeloda: 120 Tablet, Film Coated In 1 Bottle, Plastic (0004-1101-50)",194.06,77.62,,,0 CDM,2500000004_00005197102,Prevnar 13: 10 Syringe In 1 Carton (0005-1971-02) / .5 Ml In 1 Syringe (0005-1971-01),945.89,378.36,,,0 CDM,2500000004_00005200001,NDC Description Not Available,964.55,385.82,,,0 CDM,2500000004_00005200010,Prevnar 20: 10 Syringe In 1 Carton (0005-2000-10) / .5 Ml In 1 Syringe (0005-2000-01),1300.41,520.16,,,0 CDM,2500000004_00006302501,NDC Description Not Available,174.21,69.68,,,0 CDM,2500000004_00006302601,NDC Description Not Available,249.18,99.67,,,0 CDM,2500000004_00006302602,Keytruda: 1 Vial In 1 Carton (0006-3026-02) / 4 Ml In 1 Vial (0006-3026-01),265.98,106.39,,,0 CDM,2500000004_00006302604,Keytruda: 2 Vial In 1 Carton (0006-3026-04) / 4 Ml In 1 Vial (0006-3026-01),253.8,101.52,,,0 CDM,2500000004_00006385601,NDC Description Not Available,4.17,1.67,,,0 CDM,2500000004_00006385602,"Recarbrio: 25 Vial, Single-Dose In 1 Carton (0006-3856-02) / 20 Ml In 1 Vial, Single-Dose (0006-3856-01)",4.23,1.69,,,0 CDM,2500000004_00006411903,"Gardasil 9: 10 Vial, Single-Dose In 1 Carton (0006-4119-03) / .5 Ml In 1 Vial, Single-Dose (0006-4119-01)",759.71,303.88,,,0 CDM,2500000004_00006412101,NDC Description Not Available,1413.44,565.38,,,0 CDM,2500000004_00006412102,"Gardasil 9: 10 Syringe, Glass In 1 Carton (0006-4121-02) / .5 Ml In 1 Syringe, Glass (0006-4121-01)",1223.59,489.44,,,0 CDM,2500000004_00006417100,"Proquad: 10 Vial, Single-Dose In 1 Carton (0006-4171-00) / .5 Ml In 1 Vial, Single-Dose (0006-4171-01)",1094.88,437.95,,,0 CDM,2500000004_00006417101,NDC Description Not Available,1246.15,498.46,,,0 CDM,2500000004_00006468100,"M-M-R Ii: 10 Vial, Single-Dose In 1 Carton (0006-4681-00) / .5 Ml In 1 Vial, Single-Dose (0006-4681-01)",431.16,172.46,,,0 CDM,2500000004_00006482700,"Varivax: 10 Vial, Single-Dose In 1 Carton (0006-4827-00) / .5 Ml In 1 Vial, Single-Dose (0006-4827-01)",670.87,268.35,,,0 CDM,2500000004_00006482701,NDC Description Not Available,822.54,329.02,,,0 CDM,2500000004_00006483701,NDC Description Not Available,522.99,209.2,,,0 CDM,2500000004_00006483703,"Pneumovax 23: 10 Syringe, Glass In 1 Carton (0006-4837-03) / .5 Ml In 1 Syringe, Glass (0006-4837-01)",489.69,195.88,,,0 CDM,2500000004_00006489701,NDC Description Not Available,118.56,47.42,,,0 CDM,2500000004_00006499200,"Recombivax Hb: 1 Vial, Single-Dose In 1 Carton (0006-4992-00) / 1 Ml In 1 Vial, Single-Dose (0006-4992-01)",857.5,343.0,,,0 CDM,2500000004_00006499201,NDC Description Not Available,427.47,170.99,,,0 CDM,2500000004_00006500401,"Prevymis: 1 Vial, Single-Dose In 1 Carton (0006-5004-01) / 24 Ml In 1 Vial, Single-Dose (0006-5004-02)",1662.63,665.05,,,0 CDM,2500000004_00006500402,NDC Description Not Available,1579.23,631.69,,,0 CDM,2500000004_00006542302,NDC Description Not Available,425.47,170.19,,,0 CDM,2500000004_00006542312,"Bridion: 10 Vial, Single-Dose In 1 Carton (0006-5423-12) / 2 Ml In 1 Vial, Single-Dose (0006-5423-02)",384.74,153.9,,,0 CDM,2500000004_00006542505,NDC Description Not Available,215.37,86.15,,,0 CDM,2500000004_00006542515,"Bridion: 10 Vial, Single-Dose In 1 Carton (0006-5425-15) / 5 Ml In 1 Vial, Single-Dose (0006-5425-05)",282.97,113.19,,,0 CDM,2500000004_00008010001,"Besponsa: 1 Vial, Single-Dose In 1 Carton (0008-0100-01) / 4 Ml In 1 Vial, Single-Dose",11218.4,4487.36,,,0 CDM,2500000004_00008092351,Protonix I.V.: 1 Vial In 1 Carton (0008-0923-51) / 10 Ml In 1 Vial,19.81,7.92,,,0 CDM,2500000004_00008092355,Protonix I.V.: 10 Carton In 1 Package (0008-0923-55) / 1 Vial In 1 Carton / 10 Ml In 1 Vial,9.62,3.85,,,0 CDM,2500000004_00008103004,NDC Description Not Available,135.52,54.21,,,0 CDM,2500000004_00008451001,"Mylotarg: 1 Vial, Single-Dose In 1 Carton (0008-4510-01) / 5 Ml In 1 Vial, Single-Dose",974.98,389.99,,,0 CDM,2500000004_00009000302,Solu-Medrol: 1 Vial In 1 Carton (0009-0003-02) / 4 Ml In 1 Vial,2.15,0.86,,,0 CDM,2500000004_00009001103,"Solu-Cortef: 1 Vial, Single-Dose In 1 Carton (0009-0011-03) / 2 Ml In 1 Vial, Single-Dose",85.85,34.34,,,0 CDM,2500000004_00009001104,"Solu-Cortef: 25 Vial, Single-Dose In 1 Carton (0009-0011-04) / 2 Ml In 1 Vial, Single-Dose (0009-0011-03)",79.72,31.89,,,0 CDM,2500000004_00009001305,"Solu-Cortef: 1 Vial, Single-Dose In 1 Carton (0009-0013-05) / 2 Ml In 1 Vial, Single-Dose",67.9,27.16,,,0 CDM,2500000004_00009001820,Solu-Medrol: 1 Vial In 1 Carton (0009-0018-20) / 8 Ml In 1 Vial,1.55,0.62,,,0 CDM,2500000004_00009003928,Solu-Medrol: 25 Vial In 1 Carton (0009-0039-28) / 1 Ml In 1 Vial (0009-0039-30),5.8,2.32,,,0 CDM,2500000004_00009003930,NDC Description Not Available,4.82,1.93,,,0 CDM,2500000004_00009004722,Solu-Medrol: 25 Vial In 1 Carton (0009-0047-22) / 2 Ml In 1 Vial (0009-0047-25),1.53,0.61,,,0 CDM,2500000004_00009004725,NDC Description Not Available,2.13,0.85,,,0 CDM,2500000004_00009004727,NDC Description Not Available,1.74,0.7,,,0 CDM,2500000004_00009028002,"Depo-Medrol: 1 Vial, Multi-Dose In 1 Carton (0009-0280-02) / 5 Ml In 1 Vial, Multi-Dose",1.08,0.43,,,0 CDM,2500000004_00009028051,"Depo-Medrol: 25 Vial, Multi-Dose In 1 Package (0009-0280-51) / 5 Ml In 1 Vial, Multi-Dose",0.69,0.28,,,0 CDM,2500000004_00009030602,"Depo-Medrol: 5 Ml In 1 Vial, Multi-Dose (0009-0306-02)",0.27,0.11,,,0 CDM,2500000004_00009041701,Depo-Testosterone: 1 Vial In 1 Carton (0009-0417-01) / 1 Ml In 1 Vial,0.15,0.06,,,0 CDM,2500000004_00009069801,Solu-Medrol: 1 Vial In 1 Carton (0009-0698-01) / 16 Ml In 1 Vial,1.02,0.41,,,0 CDM,2500000004_00009075801,Solu-Medrol: 1 Vial In 1 Carton (0009-0758-01) / 8 Ml In 1 Vial,1.07,0.43,,,0 CDM,2500000004_00009082501,Solu-Cortef: 1 Vial In 1 Carton (0009-0825-01) / 2 Ml In 1 Vial,67.37,26.95,,,0 CDM,2500000004_00009087021,NDC Description Not Available,7.31,2.92,,,0 CDM,2500000004_00009090211,NDC Description Not Available,6.01,2.4,,,0 CDM,2500000004_00009090218,Cleocin Phosphate: 25 Vial In 1 Carton (0009-0902-18) / 6 Ml In 1 Vial (0009-0902-11),6.02,2.41,,,0 CDM,2500000004_00009307301,"Depo-Medrol: 1 Vial, Single-Dose In 1 Package (0009-3073-01) / 1 Ml In 1 Vial, Single-Dose",1.28,0.51,,,0 CDM,2500000004_00009307303,"Depo-Medrol: 25 Vial, Single-Dose In 1 Package (0009-3073-03) / 1 Ml In 1 Vial, Single-Dose",1.26,0.5,,,0 CDM,2500000004_00009307322,"Depo-Medrol: 1 Vial, Single-Dose In 1 Package (0009-3073-22) / 1 Ml In 1 Vial, Single-Dose",0.51,0.2,,,0 CDM,2500000004_00009316901,NDC Description Not Available,1.84,0.74,,,0 CDM,2500000004_00009316906,Prostin Vr Pediatric: 5 Ampule In 1 Package (0009-3169-06) / 1 Ml In 1 Ampule (0009-3169-01),1.4,0.56,,,0 CDM,2500000004_00009347501,"Depo-Medrol: 1 Vial, Single-Dose In 1 Package (0009-3475-01) / 1 Ml In 1 Vial, Single-Dose",1.08,0.43,,,0 CDM,2500000004_00009347503,"Depo-Medrol: 25 Vial, Single-Dose In 1 Package (0009-3475-03) / 1 Ml In 1 Vial, Single-Dose",0.46,0.18,,,0 CDM,2500000004_00009514001,NDC Description Not Available,31.2,12.48,,,0 CDM,2500000004_00009514004,Zyvox: 10 Bag In 1 Box (0009-5140-04) / 300 Ml In 1 Bag (0009-5140-01),31.74,12.7,,,0 CDM,2500000004_00009722401,NDC Description Not Available,20487.74,8195.1,,,0 CDM,2500000004_00009752903,"Camptosar: 1 Vial, Single-Dose In 1 Carton (0009-7529-03) / 5 Ml In 1 Vial, Single-Dose",17.56,7.02,,,0 CDM,2500000004_00013257605,"Idamycin Pfs: 1 Vial, Single-Dose In 1 Carton (0013-2576-05) / 5 Ml In 1 Vial, Single-Dose",157.3,62.92,,,0 CDM,2500000004_00013257691,"Idamycin Pfs: 1 Vial, Single-Dose In 1 Carton (0013-2576-91) / 5 Ml In 1 Vial, Single-Dose",101.58,40.63,,,0 CDM,2500000004_00013258691,"Idamycin Pfs: 1 Vial, Single-Dose In 1 Carton (0013-2586-91) / 10 Ml In 1 Vial, Single-Dose",181.58,72.63,,,0 CDM,2500000004_00013259620,"Idamycin Pfs: 1 Vial, Single-Dose In 1 Carton (0013-2596-20) / 20 Ml In 1 Vial, Single-Dose",210.96,84.38,,,0 CDM,2500000004_00013259691,"Idamycin Pfs: 1 Vial, Single-Dose In 1 Carton (0013-2596-91) / 20 Ml In 1 Vial, Single-Dose",198.06,79.22,,,0 CDM,2500000004_00023114501,"Botox: 1 Vial In 1 Carton (0023-1145-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",28.48,11.39,,,0 CDM,2500000004_00023114502,"Botox: 1 Vial In 1 Carton (0023-1145-02) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",27.37,10.95,,,0 CDM,2500000004_00023392102,"Botox: 1 Vial In 1 Carton (0023-3921-02) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",28.67,11.47,,,0 CDM,2500000004_00024065401,"Sarclisa: 1 Vial, Single-Dose In 1 Carton (0024-0654-01) / 5 Ml In 1 Vial, Single-Dose",359.86,143.94,,,0 CDM,2500000004_00024065601,"Sarclisa: 1 Vial, Single-Dose In 1 Carton (0024-0656-01) / 25 Ml In 1 Vial, Single-Dose",359.86,143.94,,,0 CDM,2500000004_00024279201,NDC Description Not Available,27.41,10.96,,,0 CDM,2500000004_00024279210,"Ferrlecit: 10 Vial, Single-Use In 1 Carton (0024-2792-10) / 5 Ml In 1 Vial, Single-Use (0024-2792-01)",27.41,10.96,,,0 CDM,2500000004_00024515010,"Elitek: 3 Kit In 1 Carton (0024-5150-10) / 1 Kit In 1 Kit * 1 Ml In 1 Vial, Single-Use (0024-5154-11) * 1 Ml In 1 Ampule (0024-5152-11)",1605.11,642.04,,,0 CDM,2500000004_00024515411,NDC Description Not Available,1448.82,579.53,,,0 CDM,2500000004_00024582411,"Jevtana: 1 Kit In 1 Carton (0024-5824-11) * 5.7 Ml In 1 Vial, Glass (0024-5823-15) * 5.7 Ml In 1 Vial, Glass (0024-5822-01)",1044.8,417.92,,,0 CDM,2500000004_00024592605,Admelog: 1 Vial In 1 Carton (0024-5926-05) / 3 Ml In 1 Vial,0.88,0.35,,,0 CDM,2500000004_00046074905,Premarin: 1 Vial In 1 Carton (0046-0749-05) / 5 Ml In 1 Vial,1654.48,661.79,,,0 CDM,2500000004_00049001481,NDC Description Not Available,31.67,12.67,,,0 CDM,2500000004_00049052083,"Pfizerpen: 10 Vial In 1 Carton (0049-0520-83) / 1 Powder, For Solution In 1 Vial (0049-0520-84)",2.33,0.93,,,0 CDM,2500000004_00049052084,NDC Description Not Available,2.33,0.93,,,0 CDM,2500000004_00049392020,NDC Description Not Available,123.45,49.38,,,0 CDM,2500000004_00052060202,Tice Bcg: 1 Vial In 1 Carton (0052-0602-02) / 50 Ml In 1 Vial (0052-0602-01),17.73,7.09,,,0 CDM,2500000004_00052433001,Nexplanon: 1 BLISTER PACK in 1 CARTON (0052-4330-01) / 1 IMPLANT in 1 BLISTER PACK,4515.18,1806.07,,,0 CDM,2500000004_00054001720,Prednisone: 10 Blister Pack In 1 Carton (0054-0017-20) / 10 Tablet In 1 Blister Pack,0.09,0.04,,,0 CDM,2500000004_00054001820,Prednisone: 10 Blister Pack In 1 Carton (0054-0018-20) / 10 Tablet In 1 Blister Pack,0.03,0.01,,,0 CDM,2500000004_00054001920,Prednisone: 10 Blister Pack In 1 Carton (0054-0019-20) / 10 Tablet In 1 Blister Pack,0.03,0.01,,,0 CDM,2500000004_00054001925,"Prednisone: 100 Tablet In 1 Bottle, Plastic (0054-0019-25)",0.03,0.01,,,0 CDM,2500000004_00054817525,Dexamethasone: 100 Blister Pack In 1 Carton (0054-8175-25) / 1 Tablet In 1 Blister Pack,0.19,0.08,,,0 CDM,2500000004_00054872425,Prednisone: 10 Blister Pack In 1 Carton (0054-8724-25) / 10 Tablet In 1 Blister Pack,0.12,0.05,,,0 CDM,2500000004_00054873925,Prednisone: 10 Blister Pack In 1 Carton (0054-8739-25) / 10 Tablet In 1 Blister Pack,0.96,0.38,,,0 CDM,2500000004_00054874025,Prednisone: 10 Blister Pack In 1 Carton (0054-8740-25) / 10 Tablet In 1 Blister Pack,0.25,0.1,,,0 CDM,2500000004_00054982825,Prednisone: 100 Tablet In 1 Bottle (0054-9828-25),0.11,0.04,,,0 CDM,2500000004_00065806401,Genteal Tears Severe: 1 Tube In 1 Carton (0065-8064-01) / 10 G In 1 Tube,41.73,16.69,,,0 CDM,2500000004_00069005902,NDC Description Not Available,1.05,0.42,,,0 CDM,2500000004_00069005903,Heparin Sodium: 25 Vial In 1 Container (0069-0059-03) / 1 Ml In 1 Vial (0069-0059-04),3.41,1.36,,,0 CDM,2500000004_00069005904,NDC Description Not Available,0.84,0.34,,,0 CDM,2500000004_00069020901,NDC Description Not Available,0.95,0.38,,,0 CDM,2500000004_00069020910,Propofol: 10 Vial In 1 Carton (0069-0209-10) / 20 Ml In 1 Vial (0069-0209-01),1.57,0.63,,,0 CDM,2500000004_00069023401,1 VIAL in 1 CARTON (0069-0234-01) / 50 mL in 1 VIAL,0.95,0.38,,,0 CDM,2500000004_00069023801,"Ruxience: 1 Vial, Single-Use In 1 Carton (0069-0238-01) / 10 Ml In 1 Vial, Single-Use",304.32,121.73,,,0 CDM,2500000004_00069024801,1 VIAL in 1 CARTON (0069-0248-01) / 100 mL in 1 VIAL,0.43,0.17,,,0 CDM,2500000004_00069024810,Propofol: 10 Vial In 1 Carton (0069-0248-10) / 100 Ml In 1 Vial,0.56,0.22,,,0 CDM,2500000004_00069024901,"Ruxience: 1 Vial, Single-Use In 1 Carton (0069-0249-01) / 50 Ml In 1 Vial, Single-Use",306.46,122.58,,,0 CDM,2500000004_00069030501,"Trazimera: 1 Kit In 1 Kit (0069-0305-01) * 20 Ml In 1 Vial, Multi-Dose (0069-0306-01) * 20 Ml In 1 Vial (0069-0307-01)",351.28,140.51,,,0 CDM,2500000004_00069030801,Trazimera: 1 Vial In 1 Carton (0069-0308-01) / 7.15 Ml In 1 Vial,341.23,136.49,,,0 CDM,2500000004_00069031501,"Zirabev: 1 Vial, Single-Use In 1 Carton (0069-0315-01) / 4 Ml In 1 Vial, Single-Use",260.96,104.38,,,0 CDM,2500000004_00069032401,Nyvepria: 1 Carton In 1 Carton (0069-0324-01) / 1 Syringe In 1 Carton / .6 Ml In 1 Syringe,1439.17,575.67,,,0 CDM,2500000004_00069034201,"Zirabev: 1 Vial, Single-Use In 1 Carton (0069-0342-01) / 16 Ml In 1 Vial, Single-Use",262.33,104.93,,,0 CDM,2500000004_00069034401,"Abrysvo: 1 Tray In 1 Carton (0069-0344-01) / 1 Kit In 1 Tray (0069-0344-21) * .5 Ml In 1 Vial, Glass (0069-0207-01) * .69 Ml In 1 Syringe, Glass (0069-0250-01)",1106.12,442.45,,,0 CDM,2500000004_00069034405,"Abrysvo: 5 Tray In 1 Carton (0069-0344-05) / 1 Kit In 1 Tray (0069-0344-21) * .5 Ml In 1 Vial, Glass (0069-0207-01) * .69 Ml In 1 Syringe, Glass (0069-0250-01)",1122.44,448.98,,,0 CDM,2500000004_00069080901,"Inflectra: 1 Vial, Single-Use In 1 Carton (0069-0809-01) / 10 Ml In 1 Vial, Single-Use",401.3,160.52,,,0 CDM,2500000004_00069130801,NDC Description Not Available,38.37,15.35,,,0 CDM,2500000004_00069130901,NDC Description Not Available,46.62,18.65,,,0 CDM,2500000004_00069130904,"Retacrit: 4 Vial, Single-Dose In 1 Carton (0069-1309-04) / 1 Ml In 1 Vial, Single-Dose (0069-1309-01)",40.5,16.2,,,0 CDM,2500000004_00069131101,NDC Description Not Available,45.35,18.14,,,0 CDM,2500000004_00069131110,"Retacrit: 10 Vial, Multi-Dose In 1 Carton (0069-1311-10) / 1 Ml In 1 Vial, Multi-Dose (0069-1311-01)",38.37,15.35,,,0 CDM,2500000004_00069154220,"Doxorubicin Hydrochloride: 1 Vial, Multi-Dose In 1 Carton (0069-1542-20) / 100 Ml In 1 Vial, Multi-Dose",12.08,4.83,,,0 CDM,2500000004_00069246510,Abrysvo: 10 Vial In 1 Carton (0069-2465-10) / .5 Ml In 1 Vial (0069-2465-19),1140.33,456.13,,,0 CDM,2500000004_00069303220,"Doxorubicin Hydrochloride: 1 Vial, Single-Dose In 1 Carton (0069-3032-20) / 25 Ml In 1 Vial, Single-Dose",19.6,7.84,,,0 CDM,2500000004_00069303420,"Doxorubicin Hydrochloride: 1 Vial, Multi-Dose In 1 Carton (0069-3034-20) / 100 Ml In 1 Vial, Multi-Dose",13.48,5.39,,,0 CDM,2500000004_00069449401,NDC Description Not Available,827.09,330.84,,,0 CDM,2500000004_00069449402,"Elrexfio: 1 Vial, Single-Dose In 1 Carton (0069-4494-02) / 1.9 Ml In 1 Vial, Single-Dose (0069-4494-01)",782.58,313.03,,,0 CDM,2500000004_00069600102,NDC Description Not Available,11.07,4.43,,,0 CDM,2500000004_00069600110,NDC Description Not Available,14.9,5.96,,,0 CDM,2500000004_00069600121,Cerebyx: 10 Vial In 1 Package (0069-6001-21) / 10 Ml In 1 Vial (0069-6001-10),5.62,2.25,,,0 CDM,2500000004_00069600125,Cerebyx: 25 Vial In 1 Carton (0069-6001-25) / 2 Ml In 1 Vial (0069-6001-02),4.3,1.72,,,0 CDM,2500000004_00074310832,Gengraf: 3 Blister Pack In 1 Carton (0074-3108-32) / 10 Capsule In 1 Blister Pack,5.52,2.21,,,0 CDM,2500000004_00074310932,Gengraf: 5 Blister Pack In 1 Carton (0074-3109-32) / 6 Capsule In 1 Blister Pack,21.44,8.58,,,0 CDM,2500000004_00074334603,Lupron Depot: 1 Kit In 1 Carton (0074-3346-03) * 1.5 Ml In 1 Syringe * 1 Swab In 1 Packet,9241.75,3696.7,,,0 CDM,2500000004_00074347303,Lupron Depot: 1 Kit In 1 Carton (0074-3473-03) * 1 Swab In 1 Packet * 1.5 Ml In 1 Syringe,9389.97,3755.99,,,0 CDM,2500000004_00074364103,Lupron Depot: 1 Kit In 1 Carton (0074-3641-03) * 1 Ml In 1 Syringe * 1 Ml In 1 Packet,7776.15,3110.46,,,0 CDM,2500000004_00074364203,Lupron Depot: 1 Kit In 1 Carton (0074-3642-03) * 1 Ml In 1 Syringe * 1 Swab In 1 Packet,9232.83,3693.13,,,0 CDM,2500000004_00074366303,Lupron Depot: 1 Kit In 1 Carton (0074-3663-03) * 1.5 Ml In 1 Syringe * 1 Ml In 1 Packet,6913.06,2765.22,,,0 CDM,2500000004_00074368303,Lupron Depot: 1 Kit In 1 Carton (0074-3683-03) * 1.5 Ml In 1 Syringe * 1 Swab In 1 Packet,9309.02,3723.61,,,0 CDM,2500000004_00074501501,"Skyrizi: 1 Vial, Single-Dose In 1 Carton (0074-5015-01) / 10 Ml In 1 Vial, Single-Dose",76.12,30.45,,,0 CDM,2500000004_00075062201,NDC Description Not Available,10.7,4.28,,,0 CDM,2500000004_00075062280,Lovenox: 10 Cello Pack In 1 Carton (0075-0622-80) / 1 Syringe In 1 Cello Pack (0075-0622-01) / .8 Ml In 1 Syringe,10.67,4.27,,,0 CDM,2500000004_00078010901,Sandimmune: 10 Ampule In 1 Box (0078-0109-01) / 5 Ml In 1 Ampule (0078-0109-61),77.7,31.08,,,0 CDM,2500000004_00078010961,NDC Description Not Available,87.54,35.02,,,0 CDM,2500000004_00078024661,NDC Description Not Available,9.7,3.88,,,0 CDM,2500000004_00078033184,"Simulect: 1 Vial, Single-Use In 1 Carton (0078-0331-84) / 5 Ml In 1 Vial, Single-Use",20547.63,8219.05,,,0 CDM,2500000004_00078068361,Arranon: 50 Ml In 1 Vial (0078-0683-61),626.93,250.77,,,0 CDM,2500000004_00078073461,"Ilaris: 1 Vial, Single-Use In 1 Carton (0078-0734-61) / 1 Ml In 1 Vial, Single-Use",145.81,58.32,,,0 CDM,2500000004_00078079761,NDC Description Not Available,965.49,386.2,,,0 CDM,2500000004_00078080461,NDC Description Not Available,921.93,368.77,,,0 CDM,2500000004_00078081881,Sandostatin Lar Depot: 1 Kit In 1 Kit (0078-0818-81) * 6 Ml In 1 Vial (0078-0797-61) * 2 Ml In 1 Syringe,704.51,281.8,,,0 CDM,2500000004_00078082581,Sandostatin Lar Depot: 1 Kit In 1 Kit (0078-0825-81) * 2 Ml In 1 Syringe * 6 Ml In 1 Vial (0078-0804-61),1007.75,403.1,,,0 CDM,2500000004_00078088361,"Adakveo: 10 Ml In 1 Vial, Glass (0078-0883-61)",539.65,215.86,,,0 CDM,2500000004_00078089778,"Triesence: 1 Blister Pack In 1 Carton (0078-0897-78) / 1 Vial, Glass In 1 Blister Pack / 1 Ml In 1 Vial, Glass",108.56,43.42,,,0 CDM,2500000004_00078100060,"Leqvio: 1 Syringe, Glass In 1 Carton (0078-1000-60) / 1.5 Ml In 1 Syringe, Glass",56.5,22.6,,,0 CDM,2500000004_00078116861,"Cosentyx: 5 Ml In 1 Vial, Glass (0078-1168-61)",77.63,31.05,,,0 CDM,2500000004_00085433101,"Noxafil: 1 Vial, Glass In 1 Carton (0085-4331-01) / 16.7 Ml In 1 Vial, Glass",2285.39,914.16,,,0 CDM,2500000004_00088222033,"Lantus: 1 Vial, Glass In 1 Carton (0088-2220-33) / 10 Ml In 1 Vial, Glass",1.38,0.55,,,0 CDM,2500000004_00093901819,NDC Description Not Available,3.34,1.34,,,0 CDM,2500000004_00093902019,NDC Description Not Available,12.69,5.08,,,0 CDM,2500000004_00093902065,"Cyclosporine Modified: 30 Blister Pack In 1 Carton (0093-9020-65) / 1 Capsule, Liquid Filled In 1 Blister Pack (0093-9020-19)",7.06,2.82,,,0 CDM,2500000004_00115169449,"Epinephrine: 2 Case In 1 Carton (0115-1694-49) / 1 Syringe, Glass In 1 Case / .3 Ml In 1 Syringe, Glass",175.39,70.16,,,0 CDM,2500000004_00121075908,Prednisolone Sodium Phosphate: 237 Ml In 1 Bottle (0121-0759-08),1.17,0.47,,,0 CDM,2500000004_00121092716,Promethazine Hydrochloride: 473 Ml In 1 Bottle (0121-0927-16),1.27,0.51,,,0 CDM,2500000004_00131181067,"Vimpat: 10 Vial, Glass In 1 Carton (0131-1810-67) / 20 Ml In 1 Vial, Glass",2.08,0.83,,,0 CDM,2500000004_00132020140,"Fleet: 133 Ml In 1 Bottle, With Applicator (0132-0201-40)",6.84,2.74,,,0 CDM,2500000004_00143900601,"Acetazolamide: 1 Vial In 1 Carton (0143-9006-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",145.2,58.08,,,0 CDM,2500000004_00143902201,NDC Description Not Available,15.03,6.01,,,0 CDM,2500000004_00143902202,"Fulvestrant: 2 Syringe, Glass In 1 Carton (0143-9022-02) / 5 Ml In 1 Syringe, Glass (0143-9022-01)",22.09,8.84,,,0 CDM,2500000004_00143909801,"Bortezomib: 1 Vial In 1 Carton (0143-9098-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",4.56,1.82,,,0 CDM,2500000004_00143914101,NDC Description Not Available,32.11,12.84,,,0 CDM,2500000004_00143916701,"Eribulin Mesylate: 1 Vial, Single-Dose In 1 Carton (0143-9167-01) / 2 Ml In 1 Vial, Single-Dose",569.01,227.6,,,0 CDM,2500000004_00143918001,NDC Description Not Available,0.57,0.23,,,0 CDM,2500000004_00143919201,Foscarnet Sodium: 10 Carton In 1 Case (0143-9192-01) / 1 Bottle In 1 Carton / 250 Ml In 1 Bottle,159.63,63.85,,,0 CDM,2500000004_00143921701,"Idarubicin Hydrochloride: 1 Vial, Glass In 1 Box (0143-9217-01) / 5 Ml In 1 Vial, Glass",328.57,131.43,,,0 CDM,2500000004_00143921801,"Idarubicin Hydrochloride: 1 Vial, Glass In 1 Box (0143-9218-01) / 10 Ml In 1 Vial, Glass",279.81,111.92,,,0 CDM,2500000004_00143921901,"Idarubicin Hydrochloride: 1 Vial, Glass In 1 Box (0143-9219-01) / 20 Ml In 1 Vial, Glass",113.1,45.24,,,0 CDM,2500000004_00143923305,Benztropine Mesylate: 5 Vial In 1 Box (0143-9233-05) / 2 Ml In 1 Vial (0143-9233-01),53.88,21.55,,,0 CDM,2500000004_00143924101,"Bleomycin: 1 Vial In 1 Box, Unit-Dose (0143-9241-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",84.34,33.74,,,0 CDM,2500000004_00143924501,NDC Description Not Available,32.0,12.8,,,0 CDM,2500000004_00143924510,"Dacarbazine: 10 Vial In 1 Carton (0143-9245-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (0143-9245-01)",20.8,8.32,,,0 CDM,2500000004_00143925001,NDC Description Not Available,32.78,13.11,,,0 CDM,2500000004_00143925010,Rocuronium Bromide: 10 Vial In 1 Box (0143-9250-10) / 5 Ml In 1 Vial (0143-9250-01),9.66,3.86,,,0 CDM,2500000004_00143925201,NDC Description Not Available,1.92,0.77,,,0 CDM,2500000004_00143926201,NDC Description Not Available,1.24,0.5,,,0 CDM,2500000004_00143926901,Clindamycin In 5 Percent Dextrose: 1 Vial In 1 Carton (0143-9269-01) / 50 Ml In 1 Vial,6.16,2.46,,,0 CDM,2500000004_00143927301,NDC Description Not Available,401.08,160.43,,,0 CDM,2500000004_00143927901,"Mitomycin: 1 Vial In 1 Box, Unit-Dose (0143-9279-01) / 40 Ml In 1 Vial",56.73,22.69,,,0 CDM,2500000004_00143928401,NDC Description Not Available,56.44,22.58,,,0 CDM,2500000004_00143928410,"Pantoprazole Sodium: 10 Vial In 1 Carton (0143-9284-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (0143-9284-01)",11.72,4.69,,,0 CDM,2500000004_00143929001,Estradiol Valerate: 1 Vial In 1 Carton (0143-9290-01) / 5 Ml In 1 Vial,23.89,9.56,,,0 CDM,2500000004_00143929201,"Thiotepa: 1 Vial In 1 Box, Unit-Dose (0143-9292-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",458.56,183.42,,,0 CDM,2500000004_00143931701,NDC Description Not Available,3.15,1.26,,,0 CDM,2500000004_00143931724,Levofloxacin: 24 Bag In 1 Carton (0143-9317-24) / 150 Ml In 1 Bag (0143-9317-01),2.99,1.2,,,0 CDM,2500000004_00143933001,NDC Description Not Available,0.2,0.08,,,0 CDM,2500000004_00143933101,NDC Description Not Available,0.16,0.06,,,0 CDM,2500000004_00143933301,NDC Description Not Available,0.19,0.08,,,0 CDM,2500000004_00143933801,NDC Description Not Available,7.01,2.8,,,0 CDM,2500000004_00143935501,NDC Description Not Available,18.8,7.52,,,0 CDM,2500000004_00143935510,"Vancomycin Hydrochloride: 10 Vial In 1 Carton (0143-9355-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (0143-9355-01)",18.8,7.52,,,0 CDM,2500000004_00143938001,NDC Description Not Available,0.91,0.36,,,0 CDM,2500000004_00143938010,Midazolam In Sodium Chloride: 10 Pouch In 1 Carton (0143-9380-10) / 1 Bag In 1 Pouch (0143-9380-01) / 100 Ml In 1 Bag,0.98,0.39,,,0 CDM,2500000004_00143938401,"Fosaprepitant Dimeglumine: 1 Vial, Single-Dose In 1 Carton (0143-9384-01) / 5 Ml In 1 Vial, Single-Dose",1.25,0.5,,,0 CDM,2500000004_00143938501,"Decitabine: 1 Vial, Single-Dose In 1 Carton (0143-9385-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",3.44,1.38,,,0 CDM,2500000004_00143938701,NDC Description Not Available,5.72,2.29,,,0 CDM,2500000004_00143938725,Triamcinolone Acetonide: 25 Vial In 1 Carton (0143-9387-25) / 1 Ml In 1 Vial (0143-9387-01),5.72,2.29,,,0 CDM,2500000004_00143943101,NDC Description Not Available,2.66,1.06,,,0 CDM,2500000004_00143943110,Meropenem: 10 Vial In 1 Carton (0143-9431-10) / 30 Ml In 1 Vial (0143-9431-01),2.68,1.07,,,0 CDM,2500000004_00143950301,"Acetazolamide: 1 Vial In 1 Box, Unit-Dose (0143-9503-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",195.28,78.11,,,0 CDM,2500000004_00143951001,"Etoposide: 1 Vial In 1 Box, Unit-Dose (0143-9510-01) / 5 Ml In 1 Vial",4.12,1.65,,,0 CDM,2500000004_00143951101,"Etoposide: 1 Vial In 1 Box, Unit-Dose (0143-9511-01) / 25 Ml In 1 Vial",3.03,1.21,,,0 CDM,2500000004_00143951201,"Etoposide: 1 Vial In 1 Box, Unit-Dose (0143-9512-01) / 50 Ml In 1 Vial",3.39,1.36,,,0 CDM,2500000004_00143951401,NDC Description Not Available,11.98,4.79,,,0 CDM,2500000004_00143951901,NDC Description Not Available,6.34,2.54,,,0 CDM,2500000004_00143951910,Methotrexate: 10 Vial In 1 Carton (0143-9519-10) / 2 Ml In 1 Vial,5.79,2.32,,,0 CDM,2500000004_00143953401,NDC Description Not Available,11.04,4.42,,,0 CDM,2500000004_00143955001,Daunorubicin Hydrochloride: 1 Vial In 1 Carton (0143-9550-01) / 10 Ml In 1 Vial,130.65,52.26,,,0 CDM,2500000004_00143955101,NDC Description Not Available,130.06,52.02,,,0 CDM,2500000004_00143955110,Daunorubicin Hydrochloride: 10 Vial In 1 Box (0143-9551-10) / 4 Ml In 1 Vial (0143-9551-01),192.89,77.16,,,0 CDM,2500000004_00143955201,"Leucovorin Calcium: 1 Vial In 1 Box, Unit-Dose (0143-9552-01) / 17.5 Ml In 1 Vial",15.99,6.4,,,0 CDM,2500000004_00143955301,"Leucovorin Calcium: 1 Vial In 1 Box, Unit-Dose (0143-9553-01) / 20 Ml In 1 Vial",24.88,9.95,,,0 CDM,2500000004_00143955401,Leucovorin Calcium: 1 Vial In 1 Box (0143-9554-01) / 10 Ml In 1 Vial,31.43,12.57,,,0 CDM,2500000004_00143956401,Phentolamine Mesylate: 1 Vial In 1 Box (0143-9564-01) / 1 Ml In 1 Vial,2190.52,876.21,,,0 CDM,2500000004_00143957701,NDC Description Not Available,0.03,0.01,,,0 CDM,2500000004_00143959501,NDC Description Not Available,0.12,0.05,,,0 CDM,2500000004_00143959525,"Lidocaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (0143-9595-25) / 5 Ml In 1 Vial, Single-Dose (0143-9595-01)",0.14,0.06,,,0 CDM,2500000004_00143960601,"Azacitidine: 1 Vial In 1 Carton (0143-9606-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",1.08,0.43,,,0 CDM,2500000004_00143962101,NDC Description Not Available,13.88,5.55,,,0 CDM,2500000004_00143962125,Cyanocobalamin: 25 Vial In 1 Box (0143-9621-25) / 1 Ml In 1 Vial (0143-9621-01),14.12,5.65,,,0 CDM,2500000004_00143963301,NDC Description Not Available,1.97,0.79,,,0 CDM,2500000004_00143963801,NDC Description Not Available,43.6,17.44,,,0 CDM,2500000004_00143963805,Sumatriptan: 5 Vial In 1 Carton (0143-9638-05) / .5 Ml In 1 Vial (0143-9638-01),25.87,10.35,,,0 CDM,2500000004_00143965901,Testosterone Cypionate: 1 Ml In 1 Vial (0143-9659-01),0.01,0.004,,,0 CDM,2500000004_00143967301,NDC Description Not Available,0.47,0.19,,,0 CDM,2500000004_00143967401,Argatroban: 2.5 Ml In 1 Vial (0143-9674-01),2.15,0.86,,,0 CDM,2500000004_00143968001,NDC Description Not Available,2.5,1.0,,,0 CDM,2500000004_00143968201,NDC Description Not Available,1.39,0.56,,,0 CDM,2500000004_00143968225,Glycopyrrolate: 25 Vial In 1 Carton (0143-9682-25) / 1 Ml In 1 Vial (0143-9682-01),0.03,0.01,,,0 CDM,2500000004_00143968901,NDC Description Not Available,0.89,0.36,,,0 CDM,2500000004_00143968910,Nicardipine Hydrochloride: 10 Vial In 1 Carton (0143-9689-10) / 10 Ml In 1 Vial (0143-9689-01),0.23,0.09,,,0 CDM,2500000004_00143970101,"Irinotecan Hydrochloride: 5 Ml In 1 Vial, Glass (0143-9701-01)",13.12,5.25,,,0 CDM,2500000004_00143970901,Milrinone Lactate: 20 Ml In 1 Box (0143-9709-01),6.0,2.4,,,0 CDM,2500000004_00143971001,NDC Description Not Available,8.17,3.27,,,0 CDM,2500000004_00143971901,NDC Description Not Available,23.99,9.6,,,0 CDM,2500000004_00143971910,Milrinone Lactate In Dextrose: 10 Container In 1 Package (0143-9719-10) / 100 Ml In 1 Container (0143-9719-01),16.9,6.76,,,0 CDM,2500000004_00143972001,NDC Description Not Available,5.2,2.08,,,0 CDM,2500000004_00143972024,Levofloxacin: 24 Bag In 1 Carton (0143-9720-24) / 150 Ml In 1 Bag (0143-9720-01),4.46,1.78,,,0 CDM,2500000004_00143972101,NDC Description Not Available,5.66,2.26,,,0 CDM,2500000004_00143972124,Levofloxacin: 24 Bag In 1 Carton (0143-9721-24) / 100 Ml In 1 Bag (0143-9721-01),5.62,2.25,,,0 CDM,2500000004_00143972201,NDC Description Not Available,9.4,3.76,,,0 CDM,2500000004_00143972224,Levofloxacin: 24 Bag In 1 Carton (0143-9722-24) / 50 Ml In 1 Bag (0143-9722-01),6.44,2.58,,,0 CDM,2500000004_00143972401,"Clonidine Hydrochloride: 10 Ml In 1 Vial, Single-Use (0143-9724-01)",171.95,68.78,,,0 CDM,2500000004_00143974401,NDC Description Not Available,5.03,2.01,,,0 CDM,2500000004_00143974410,"Granisetron Hydrochloride: 10 Vial, Single-Use In 1 Package (0143-9744-10) / 1 Ml In 1 Vial, Single-Use (0143-9744-01)",1.12,0.45,,,0 CDM,2500000004_00143974501,NDC Description Not Available,3.52,1.41,,,0 CDM,2500000004_00143974505,"Granisetron Hydrochloride: 5 Vial, Multi-Dose In 1 Carton (0143-9745-05) / 4 Ml In 1 Vial, Multi-Dose (0143-9745-01)",3.99,1.6,,,0 CDM,2500000004_00143974601,NDC Description Not Available,7.54,3.02,,,0 CDM,2500000004_00143974610,Terbutaline Sulfate: 10 Vial In 1 Carton (0143-9746-10) / 1 Ml In 1 Vial (0143-9746-01),1.36,0.54,,,0 CDM,2500000004_00143975301,NDC Description Not Available,2.23,0.89,,,0 CDM,2500000004_00143975401,NDC Description Not Available,1.43,0.57,,,0 CDM,2500000004_00143978610,Enalaprilat: 10 Vial In 1 Carton (0143-9786-10) / 2 Ml In 1 Vial (0143-9786-01),4.32,1.73,,,0 CDM,2500000004_00143985201,NDC Description Not Available,79.01,31.6,,,0 CDM,2500000004_00143985601,NDC Description Not Available,1.67,0.67,,,0 CDM,2500000004_00143985625,"Ceftriaxone: 25 Vial In 1 Box (0143-9856-25) / 1 Injection, Powder, For Solution In 1 Vial (0143-9856-01)",1.67,0.67,,,0 CDM,2500000004_00143987101,"Cladribine: 1 Vial In 1 Box, Unit-Dose (0143-9871-01) / 10 Ml In 1 Vial",49.35,19.74,,,0 CDM,2500000004_00143987501,NDC Description Not Available,1.69,0.68,,,0 CDM,2500000004_00143987510,Amiodarone Hydrochloride: 10 Vial In 1 Box (0143-9875-10) / 3 Ml In 1 Vial (0143-9875-01),0.84,0.34,,,0 CDM,2500000004_00143987525,Amiodarone Hydrochloride: 25 Vial In 1 Box (0143-9875-25) / 3 Ml In 1 Vial (0143-9875-01),1.12,0.45,,,0 CDM,2500000004_00143987701,NDC Description Not Available,11.5,4.6,,,0 CDM,2500000004_00143992490,Cefazolin: 3 Ml In 1 Vial (0143-9924-90),3.06,1.22,,,0 CDM,2500000004_00143997790,NDC Description Not Available,13.14,5.26,,,0 CDM,2500000004_00143997922,"Cefuroxime: 25 Vial In 1 Carton (0143-9979-22) / 1 Injection, Powder, For Solution In 1 Vial (0143-9979-90)",0.78,0.31,,,0 CDM,2500000004_00143997990,NDC Description Not Available,0.04,0.02,,,0 CDM,2500000004_00143998303,"Cefazolin: 10 Vial, Pharmacy Bulk Package In 1 Carton (0143-9983-03) / 1 Injection, Powder, For Solution In 1 Vial, Pharmacy Bulk Package (0143-9983-91)",0.67,0.27,,,0 CDM,2500000004_00143998391,NDC Description Not Available,2.0,0.8,,,0 CDM,2500000004_00169183311,Novolin R: 1 Vial In 1 Carton (0169-1833-11) / 10 Ml In 1 Vial,0.43,0.17,,,0 CDM,2500000004_00169183411,Novolin N: 1 Vial In 1 Carton (0169-1834-11) / 10 Ml In 1 Vial,0.91,0.36,,,0 CDM,2500000004_00169183711,Novolin 70/30: 1 Vial In 1 Carton (0169-1837-11) / 10 Ml In 1 Vial,0.59,0.24,,,0 CDM,2500000004_00169300715,"Novolin 70/30: 5 Syringe, Plastic In 1 Carton (0169-3007-15) / 3 Ml In 1 Syringe, Plastic (0169-3007-01)",1.31,0.52,,,0 CDM,2500000004_00169750111,"Novolog: 1 Vial, Glass In 1 Carton (0169-7501-11) / 10 Ml In 1 Vial, Glass",16.87,6.75,,,0 CDM,2500000004_00173088101,Nucala: 1 Vial In 1 Carton (0173-0881-01) / 1 Ml In 1 Vial,153.21,61.28,,,0 CDM,2500000004_00173089201,Nucala: 1 Syringe In 1 Carton (0173-0892-01) / 1 Ml In 1 Syringe,168.85,67.54,,,0 CDM,2500000004_00173089803,Jemperli: 1 Vial In 1 Carton (0173-0898-03) / 10 Ml In 1 Vial,1034.28,413.71,,,0 CDM,2500000004_00259160501,"Xeomin: 1 Vial, Single-Use In 1 Carton (0259-1605-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Use",27.09,10.84,,,0 CDM,2500000004_00259161001,"Xeomin: 1 Vial, Single-Use In 1 Carton (0259-1610-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Use",22.48,8.99,,,0 CDM,2500000004_00264100990,Levetiracetam: 24 Container In 1 Case (0264-1009-90) / 100 Ml In 1 Container,0.48,0.19,,,0 CDM,2500000004_00264150990,Levetiracetam: 24 Container In 1 Case (0264-1509-90) / 100 Ml In 1 Container,0.4,0.16,,,0 CDM,2500000004_00264180031,Sodium Chloride: 84 Container In 1 Case (0264-1800-31) / 50 Ml In 1 Container,24.65,9.86,,,0 CDM,2500000004_00264180032,Sodium Chloride: 64 Container In 1 Case (0264-1800-32) / 100 Ml In 1 Container,12.2,4.88,,,0 CDM,2500000004_00264194420,Potassium Chloride: 24 Container In 1 Case (0264-1944-20) / 250 Ml In 1 Container,0.41,0.16,,,0 CDM,2500000004_00264420452,Magnesium Sulfate In Water: 24 Container In 1 Case (0264-4204-52) / 50 Ml In 1 Container,5.34,2.14,,,0 CDM,2500000004_00264420654,Magnesium Sulfate In Water: 24 Container In 1 Case (0264-4206-54) / 100 Ml In 1 Container,1.97,0.79,,,0 CDM,2500000004_00264440054,Magnesium Sulfate In Dextrose: 24 Container In 1 Case (0264-4400-54) / 100 Ml In 1 Container,6.59,2.64,,,0 CDM,2500000004_00264580200,Sodium Chloride: 12 Container In 1 Case (0264-5802-00) / 1000 Ml In 1 Container,1.32,0.53,,,0 CDM,2500000004_00264580210,Sodium Chloride: 24 Container In 1 Case (0264-5802-10) / 500 Ml In 1 Container,13.32,5.33,,,0 CDM,2500000004_00264780020,Sodium Chloride: 24 Container In 1 Case (0264-7800-20) / 250 Ml In 1 Container,12.59,5.04,,,0 CDM,2500000004_00264958720,Heparin Sodium In Dextrose: 24 Container In 1 Case (0264-9587-20) / 250 Ml In 1 Container,2.77,1.11,,,0 CDM,2500000004_00264959820,Lidocaine Hydrochloride And Dextrose: 24 Container In 1 Case (0264-9598-20) / 250 Ml In 1 Container,0.01,0.004,,,0 CDM,2500000004_00270055615,Kinevac: 10 Vial In 1 Package (0270-0556-15) / 5 Ml In 1 Vial,574.88,229.95,,,0 CDM,2500000004_00310072010,"Faslodex: 2 Syringe, Glass In 1 Carton (0310-0720-10) / 5 Ml In 1 Syringe, Glass",417.84,167.14,,,0 CDM,2500000004_00310173030,"Fasenra: 1 Syringe, Glass In 1 Carton (0310-1730-30) / 1 Ml In 1 Syringe, Glass",843.88,337.55,,,0 CDM,2500000004_00310304000,"Saphnelo: 1 Vial, Glass In 1 Carton (0310-3040-00) / 2 Ml In 1 Vial, Glass",78.93,31.57,,,0 CDM,2500000004_00310450012,Imfinzi: 1 Vial In 1 Carton (0310-4500-12) / 2.4 Ml In 1 Vial,394.36,157.74,,,0 CDM,2500000004_00310453530,Imjudo: 1 Vial In 1 Carton (0310-4535-30) / 15 Ml In 1 Vial,590.58,236.23,,,0 CDM,2500000004_00310461150,Imfinzi: 1 Vial In 1 Carton (0310-4611-50) / 10 Ml In 1 Vial,370.72,148.29,,,0 CDM,2500000004_00338000402,"Sterile Water: 24 Bottle, Plastic In 1 Carton (0338-0004-02) / 250 Ml In 1 Bottle, Plastic",0.07,0.03,,,0 CDM,2500000004_00338004902,Sodium Chloride: 250 Ml In 1 Bag (0338-0049-02),11.47,4.59,,,0 CDM,2500000004_00338004903,Sodium Chloride: 500 Ml In 1 Bag (0338-0049-03),12.65,5.06,,,0 CDM,2500000004_00338004904,Sodium Chloride: 1000 Ml In 1 Bag (0338-0049-04),2.22,0.89,,,0 CDM,2500000004_00338004918,Sodium Chloride: 4 Bag In 1 Package (0338-0049-18) / 100 Ml In 1 Bag,7.82,3.13,,,0 CDM,2500000004_00338004941,Sodium Chloride: 1 Bag In 1 Package (0338-0049-41) / 50 Ml In 1 Bag,17.72,7.09,,,0 CDM,2500000004_00338004948,Sodium Chloride: 1 Bag In 1 Package (0338-0049-48) / 100 Ml In 1 Bag,9.65,3.86,,,0 CDM,2500000004_00338006301,"Doxil: 1 Vial, Single-Use In 1 Carton (0338-0063-01) / 10 Ml In 1 Vial, Single-Use",474.6,189.84,,,0 CDM,2500000004_00338006701,"Doxil: 1 Vial, Single-Use In 1 Carton (0338-0067-01) / 25 Ml In 1 Vial, Single-Use",233.14,93.26,,,0 CDM,2500000004_00338006910,Ketorolac Tromethamine: 10 Vial In 1 Carton (0338-0069-10) / 1 Ml In 1 Vial,3.1,1.24,,,0 CDM,2500000004_00338007225,Ketorolac Tromethamine: 25 Vial In 1 Carton (0338-0072-25) / 1 Ml In 1 Vial,2.42,0.97,,,0 CDM,2500000004_00338012612,Myxredlin: 12 Container In 1 Carton (0338-0126-12) / 100 Ml In 1 Container,4.52,1.81,,,0 CDM,2500000004_00338041102,Lidocaine Hydrochloride And Dextrose: 24 Bag In 1 Carton (0338-0411-02) / 250 Ml In 1 Bag,0.02,0.01,,,0 CDM,2500000004_00338050548,Gentamicin Sulfate In Sodium Chloride: 100 Ml In 1 Bag (0338-0505-48),14.67,5.87,,,0 CDM,2500000004_00338050741,Gentamicin Sulfate In Sodium Chloride: 50 Ml In 1 Bag (0338-0507-41),14.49,5.8,,,0 CDM,2500000004_00338050748,Gentamicin Sulfate In Sodium Chloride: 100 Ml In 1 Bag (0338-0507-48),8.61,3.44,,,0 CDM,2500000004_00338050941,Gentamicin Sulfate In Sodium Chloride: 50 Ml In 1 Bag (0338-0509-41),12.65,5.06,,,0 CDM,2500000004_00338055318,Sodium Chloride: 100 Ml In 1 Bag (0338-0553-18),14.69,5.88,,,0 CDM,2500000004_00338070341,Potassium Chloride: 24 Bag In 1 Carton (0338-0703-41) / 50 Ml In 1 Bag,1.58,0.63,,,0 CDM,2500000004_00338070948,Potassium Chloride: 24 Bag In 1 Carton (0338-0709-48) / 100 Ml In 1 Bag,3.29,1.32,,,0 CDM,2500000004_00338071906,Dextrose: 2000 Ml In 1 Bag (0338-0719-06),11.4,4.56,,,0 CDM,2500000004_00338100702,Dopamine Hydrochloride And Dextrose: 18 Bag In 1 Carton (0338-1007-02) / 250 Ml In 1 Bag,5.65,2.26,,,0 CDM,2500000004_00338100902,Dopamine Hydrochloride And Dextrose: 18 Bag In 1 Carton (0338-1009-02) / 250 Ml In 1 Bag,3.74,1.5,,,0 CDM,2500000004_00338102341,Penicillin G Potassium: 50 Ml In 1 Bag (0338-1023-41),12.93,5.17,,,0 CDM,2500000004_00338102541,Penicillin G Potassium: 50 Ml In 1 Bag (0338-1025-41),9.46,3.78,,,0 CDM,2500000004_00338104702,"Nitroglycerin In Dextrose: 12 Bottle, Glass In 1 Box (0338-1047-02) / 250 Ml In 1 Bottle, Glass",2.06,0.82,,,0 CDM,2500000004_00338104902,"Nitroglycerin In Dextrose: 12 Bottle, Glass In 1 Box (0338-1049-02) / 250 Ml In 1 Bottle, Glass",7.46,2.98,,,0 CDM,2500000004_00338105548,Metronidazole: 24 Bag In 1 Carton (0338-1055-48) / 100 Ml In 1 Bag,0.17,0.07,,,0 CDM,2500000004_00338107502,Dobutamine Hydrochloride In Dextrose: 18 Bag In 1 Carton (0338-1075-02) / 250 Ml In 1 Bag,82.56,33.02,,,0 CDM,2500000004_00338130501,"Mesnex: 1 Vial, Multi-Dose In 1 Box (0338-1305-01) / 10 Ml In 1 Vial, Multi-Dose",7.82,3.13,,,0 CDM,2500000004_00338170940,Magnesium Sulfate In Dextrose: 40 Bag In 1 Case (0338-1709-40) / 100 Ml In 1 Bag,14.36,5.74,,,0 CDM,2500000004_00338171540,Magnesium Sulfate: 40 Bag In 1 Carton (0338-1715-40) / 100 Ml In 1 Bag,2.11,0.84,,,0 CDM,2500000004_00338341050,NDC Description Not Available,30.45,12.18,,,0 CDM,2500000004_00338355248,Vancomycin Hydrochloride: 200 Ml In 1 Bag (0338-3552-48),16.21,6.48,,,0 CDM,2500000004_00338361224,Clindamycin Phosphate: 24 Bag In 1 Carton (0338-3612-24) / 50 Ml In 1 Bag (0338-3612-50),18.58,7.43,,,0 CDM,2500000004_00338361250,NDC Description Not Available,20.15,8.06,,,0 CDM,2500000004_00338381424,Clindamycin Phosphate: 24 Bag In 1 Carton (0338-3814-24) / 50 Ml In 1 Bag (0338-3814-50),16.02,6.41,,,0 CDM,2500000004_00338381450,NDC Description Not Available,16.1,6.44,,,0 CDM,2500000004_00338601048,Milrinone Lactate In Dextrose: 10 Bag In 1 Carton (0338-6010-48) / 100 Ml In 1 Bag,29.24,11.7,,,0 CDM,2500000004_00338604537,Fluconazole: 10 Bag In 1 Carton (0338-6045-37) / 200 Ml In 1 Bag,42.78,17.11,,,0 CDM,2500000004_00338604648,Fluconazole: 10 Bag In 1 Carton (0338-6046-48) / 100 Ml In 1 Bag,59.34,23.74,,,0 CDM,2500000004_00338954303,Sodium Chloride: 500 Ml In 1 Bag (0338-9543-03),5.86,2.34,,,0 CDM,2500000004_00409000701,NDC Description Not Available,0.05,0.02,,,0 CDM,2500000004_00409012201,"Daptomycin: 1 Vial, Single-Dose In 1 Carton (0409-0122-01) / 10 Ml In 1 Vial, Single-Dose",0.31,0.12,,,0 CDM,2500000004_00409015201,NDC Description Not Available,0.14,0.06,,,0 CDM,2500000004_00409015224,Metronidazole: 24 Pouch In 1 Carton (0409-0152-24) / 1 Bag In 1 Pouch (0409-0152-01) / 100 Ml In 1 Bag,0.14,0.06,,,0 CDM,2500000004_00409018201,"Gemcitabine: 1 Vial, Single-Dose In 1 Carton (0409-0182-01) / 52.6 Ml In 1 Vial, Single-Dose",23.2,9.28,,,0 CDM,2500000004_00409021211,NDC Description Not Available,4.83,1.93,,,0 CDM,2500000004_00409030201,"Topotecan: 1 Vial, Single-Dose In 1 Carton (0409-0302-01) / 4 Ml In 1 Vial, Single-Dose",14.65,5.86,,,0 CDM,2500000004_00409082901,"Aztreonam: 10 Vial, Single-Dose In 1 Carton (0409-0829-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose (0409-0829-11)",10.34,4.14,,,0 CDM,2500000004_00409082911,NDC Description Not Available,10.94,4.38,,,0 CDM,2500000004_00409083001,"Aztreonam: 10 Vial, Single-Dose In 1 Carton (0409-0830-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose (0409-0830-11)",10.56,4.22,,,0 CDM,2500000004_00409083011,NDC Description Not Available,14.61,5.84,,,0 CDM,2500000004_00409104130,"Carbocaine: 1 VIAL, SINGLE-DOSE in 1 CARTON (0409-1041-30) / 30 mL in 1 VIAL, SINGLE-DOSE",6.03,2.41,,,0 CDM,2500000004_00409114001,"Argatroban: 1 Vial, Single-Dose In 1 Carton (0409-1140-01) / 2.5 Ml In 1 Vial, Single-Dose",1.1,0.44,,,0 CDM,2500000004_00409115901,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-1159-01) / 10 Ml In 1 Vial, Single-Dose (0409-1159-18)",0.21,0.08,,,0 CDM,2500000004_00409115902,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-1159-02) / 30 Ml In 1 Vial, Single-Dose (0409-1159-19)",0.07,0.03,,,0 CDM,2500000004_00409115918,NDC Description Not Available,0.18,0.07,,,0 CDM,2500000004_00409115919,NDC Description Not Available,0.07,0.03,,,0 CDM,2500000004_00409116201,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-1162-01) / 10 Ml In 1 Vial, Single-Dose (0409-1162-18)",0.11,0.04,,,0 CDM,2500000004_00409116202,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-1162-02) / 30 Ml In 1 Vial, Single-Dose (0409-1162-19)",0.04,0.02,,,0 CDM,2500000004_00409116210,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-1162-10) / 30 Ml In 1 Vial, Single-Dose (0409-1162-09)",0.03,0.01,,,0 CDM,2500000004_00409116218,NDC Description Not Available,0.09,0.04,,,0 CDM,2500000004_00409116219,NDC Description Not Available,0.04,0.02,,,0 CDM,2500000004_00409116301,"Bupivacaine Hydrochloride: 25 Vial, Multi-Dose In 1 Tray (0409-1163-01) / 50 Ml In 1 Vial, Multi-Dose (0409-1163-18)",0.03,0.01,,,0 CDM,2500000004_00409116318,NDC Description Not Available,0.03,0.01,,,0 CDM,2500000004_00409116502,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-1165-02) / 30 Ml In 1 Vial, Single-Dose (0409-1165-19)",0.05,0.02,,,0 CDM,2500000004_00409116518,NDC Description Not Available,0.09,0.04,,,0 CDM,2500000004_00409116519,NDC Description Not Available,0.04,0.02,,,0 CDM,2500000004_00409117603,NDC Description Not Available,25.46,10.18,,,0 CDM,2500000004_00409120703,"Gentamicin Sulfate: 25 Vial, Single-Dose In 1 Tray (0409-1207-03) / 2 Ml In 1 Vial, Single-Dose (0409-1207-13)",12.65,5.06,,,0 CDM,2500000004_00409120713,NDC Description Not Available,12.23,4.89,,,0 CDM,2500000004_00409120715,NDC Description Not Available,3.62,1.45,,,0 CDM,2500000004_00409120901,Lidocaine Hydrochloride And Epinephrine: 10 Ampule In 1 Tray (0409-1209-01) / 5 Ml In 1 Ampule (0409-1209-10),0.2,0.08,,,0 CDM,2500000004_00409120910,NDC Description Not Available,0.19,0.08,,,0 CDM,2500000004_00409121501,"Naloxone Hydrochloride: 10 Vial, Single-Dose In 1 Carton (0409-1215-01) / 1 Ml In 1 Vial, Single-Dose (0409-1215-21)",14.97,5.99,,,0 CDM,2500000004_00409121521,NDC Description Not Available,102.54,41.02,,,0 CDM,2500000004_00409127303,NDC Description Not Available,61.25,24.5,,,0 CDM,2500000004_00409127332,Diazepam: 10 Cartridge In 1 Carton (0409-1273-32) / 2 Ml In 1 Cartridge (0409-1273-03),43.22,17.29,,,0 CDM,2500000004_00409128305,10 SYRINGE in 1 CARTON (0409-1283-05) / .5 mL in 1 SYRINGE (0409-1283-04),2.8,1.12,,,0 CDM,2500000004_00409128317,NDC Description Not Available,2.45,0.98,,,0 CDM,2500000004_00409131230,Hydromorphone Hydrochloride: 10 Cartridge In 1 Carton (0409-1312-30) / 1 Ml In 1 Cartridge (0409-1312-03),0.45,0.18,,,0 CDM,2500000004_00409131901,"Vancomycin Hydrochloride: 1 Vial, Pharmacy Bulk Package In 1 Carton (0409-1319-01) / 100 Ml In 1 Vial, Pharmacy Bulk Package",24.36,9.74,,,0 CDM,2500000004_00409132305,"Lidocaine Hydrochloride: 10 Carton In 1 Container (0409-1323-05) / 1 Syringe, Plastic In 1 Carton / 5 Ml In 1 Syringe, Plastic (0409-1323-15)",0.27,0.11,,,0 CDM,2500000004_00409132315,NDC Description Not Available,0.29,0.12,,,0 CDM,2500000004_00409139121,NDC Description Not Available,3.18,1.27,,,0 CDM,2500000004_00409139122,Meropenem: 10 Vial In 1 Carton (0409-1391-22) / 20 Ml In 1 Vial (0409-1391-21),1.89,0.76,,,0 CDM,2500000004_00409141204,Bumetanide: 10 VIAL in 1 BOX (0409-1412-04) / 4 mL in 1 VIAL (0409-1412-34),4.3,1.72,,,0 CDM,2500000004_00409146349,Nalbuphine Hydrochloride: 10 Ampule In 1 Tray (0409-1463-49) / 1 Ml In 1 Ampule (0409-1463-69),14.7,5.88,,,0 CDM,2500000004_00409146371,NDC Description Not Available,16.22,6.49,,,0 CDM,2500000004_00409155918,NDC Description Not Available,0.35,0.14,,,0 CDM,2500000004_00409155919,NDC Description Not Available,0.14,0.06,,,0 CDM,2500000004_00409155930,"Marcaine: 10 Vial, Single-Dose In 1 Carton (0409-1559-30) / 30 Ml In 1 Vial, Single-Dose (0409-1559-19)",0.14,0.06,,,0 CDM,2500000004_00409156010,"Marcaine: 10 Vial, Single-Dose In 1 Tray (0409-1560-10) / 10 Ml In 1 Vial, Single-Dose (0409-1560-18)",0.21,0.08,,,0 CDM,2500000004_00409156018,NDC Description Not Available,0.2,0.08,,,0 CDM,2500000004_00409156019,NDC Description Not Available,0.08,0.03,,,0 CDM,2500000004_00409156029,"Marcaine: 10 Vial, Single-Dose In 1 Carton (0409-1560-29) / 30 Ml In 1 Vial, Single-Dose (0409-1560-19)",0.08,0.03,,,0 CDM,2500000004_00409158210,"Marcaine: 10 Vial, Single-Dose In 1 Tray (0409-1582-10) / 10 Ml In 1 Vial, Single-Dose (0409-1582-18)",0.15,0.06,,,0 CDM,2500000004_00409161050,"Marcaine: 1 Vial, Multi-Dose In 1 Carton (0409-1610-50) / 50 Ml In 1 Vial, Multi-Dose",0.05,0.02,,,0 CDM,2500000004_00409162601,"Butorphanol Tartrate: 10 Vial, Single-Dose In 1 Carton (0409-1626-01) / 1 Ml In 1 Vial, Single-Dose (0409-1626-21)",28.86,11.54,,,0 CDM,2500000004_00409162621,NDC Description Not Available,25.1,10.04,,,0 CDM,2500000004_00409163015,NDC Description Not Available,0.41,0.16,,,0 CDM,2500000004_00409163140,NDC Description Not Available,0.11,0.04,,,0 CDM,2500000004_00409176118,NDC Description Not Available,1.31,0.52,,,0 CDM,2500000004_00409177815,NDC Description Not Available,0.48,0.19,,,0 CDM,2500000004_00409188602,"Levetiracetam: 25 Vial, Single-Dose In 1 Carton (0409-1886-02) / 5 Ml In 1 Vial, Single-Dose (0409-1886-22)",0.35,0.14,,,0 CDM,2500000004_00409188622,NDC Description Not Available,0.35,0.14,,,0 CDM,2500000004_00409189001,Morphine Sulfate: 10 Cartridge In 1 Carton (0409-1890-01) / 1 Ml In 1 Cartridge (0409-1890-03),3.1,1.24,,,0 CDM,2500000004_00409189013,NDC Description Not Available,8.19,3.28,,,0 CDM,2500000004_00409189201,Morphine Sulfate: 10 Cartridge In 1 Carton (0409-1892-01) / 1 Ml In 1 Cartridge (0409-1892-03),1.77,0.71,,,0 CDM,2500000004_00409189620,"Morphine Sulfate: 1 Vial, Single-Dose In 1 Carton (0409-1896-20) / 20 Ml In 1 Vial, Single-Dose",0.85,0.34,,,0 CDM,2500000004_00409190201,"Procainamide Hydrochloride: 25 Carton In 1 Case (0409-1902-01) / 1 Vial, Multi-Dose In 1 Carton (0409-1902-11) / 10 Ml In 1 Vial, Multi-Dose",1803.26,721.3,,,0 CDM,2500000004_00409190211,NDC Description Not Available,1662.8,665.12,,,0 CDM,2500000004_00409193201,"Adenosine: 1 VIAL, SINGLE-DOSE in 1 CARTON (0409-1932-01) / 20 mL in 1 VIAL, SINGLE-DOSE",2.41,0.96,,,0 CDM,2500000004_00409198503,NDC Description Not Available,10.91,4.36,,,0 CDM,2500000004_00409204501,NDC Description Not Available,17.53,7.01,,,0 CDM,2500000004_00409205001,NDC Description Not Available,0.69,0.28,,,0 CDM,2500000004_00409205020,Magnesium Sulfate In Water: 20 Pouch In 1 Case (0409-2050-20) / 1 Bag In 1 Pouch / 500 Ml In 1 Bag (0409-2050-01),0.69,0.28,,,0 CDM,2500000004_00409206605,"Lidocaine Hydrochloride: 10 Vial, Single-Dose In 1 Carton (0409-2066-05) / 5 Ml In 1 Vial, Single-Dose (0409-2066-10)",0.05,0.02,,,0 CDM,2500000004_00409206610,NDC Description Not Available,0.05,0.02,,,0 CDM,2500000004_00409216817,NDC Description Not Available,0.86,0.34,,,0 CDM,2500000004_00409222001,NDC Description Not Available,18.4,7.36,,,0 CDM,2500000004_00409222201,NDC Description Not Available,9.2,3.68,,,0 CDM,2500000004_00409230001,NDC Description Not Available,13.59,5.44,,,0 CDM,2500000004_00409230024,Ciprofloxacin In Dextrose: 24 Pouch In 1 Carton (0409-2300-24) / 1 Bag In 1 Pouch (0409-2300-01) / 100 Ml In 1 Bag,12.88,5.15,,,0 CDM,2500000004_00409230504,NDC Description Not Available,1.04,0.42,,,0 CDM,2500000004_00409230505,"Midazolam: 10 Vial, Single-Dose In 1 Carton (0409-2305-05) / 5 Ml In 1 Vial, Single-Dose (0409-2305-04)",1.03,0.41,,,0 CDM,2500000004_00409230516,NDC Description Not Available,2.57,1.03,,,0 CDM,2500000004_00409230517,"Midazolam: 25 Vial, Single-Dose In 1 Tray (0409-2305-17) / 2 Ml In 1 Vial, Single-Dose (0409-2305-16)",0.77,0.31,,,0 CDM,2500000004_00409230550,"Midazolam: 10 Vial, Single-Dose In 1 Carton (0409-2305-50) / 5 Ml In 1 Vial, Single-Dose (0409-2305-55)",0.79,0.32,,,0 CDM,2500000004_00409230802,"Midazolam: 10 Vial, Single-Dose In 1 Carton (0409-2308-02) / 2 Ml In 1 Vial, Single-Dose (0409-2308-22)",0.43,0.17,,,0 CDM,2500000004_00409230822,NDC Description Not Available,0.6,0.24,,,0 CDM,2500000004_00409233924,NDC Description Not Available,7.5,3.0,,,0 CDM,2500000004_00409233934,Labetalol Hydrochloride: 10 Carton In 1 Package (0409-2339-34) / 1 Cartridge In 1 Carton / 4 Ml In 1 Cartridge (0409-2339-24),9.96,3.98,,,0 CDM,2500000004_00409234402,"Dobutamine: 10 Vial, Single-Dose In 1 Tray (0409-2344-02) / 20 Ml In 1 Vial, Single-Dose (0409-2344-62)",22.74,9.1,,,0 CDM,2500000004_00409234462,NDC Description Not Available,19.08,7.63,,,0 CDM,2500000004_00409234731,NDC Description Not Available,86.4,34.56,,,0 CDM,2500000004_00409255201,Hydromorphone Hydrochloride: 10 Ampule In 1 Carton (0409-2552-01) / 1 Ml In 1 Ampule (0409-2552-11),1.39,0.56,,,0 CDM,2500000004_00409258705,"Midazolam: 10 Vial, Multi-Dose In 1 Carton (0409-2587-05) / 10 Ml In 1 Vial, Multi-Dose (0409-2587-04)",0.54,0.22,,,0 CDM,2500000004_00409263401,"Hydromorphone Hydrochloride: 10 Vial, Single-Dose In 1 Box (0409-2634-01) / 1 Ml In 1 Vial, Single-Dose (0409-2634-10)",0.1,0.04,,,0 CDM,2500000004_00409263405,"Hydromorphone Hydrochloride: 10 Vial, Single-Dose In 1 Box (0409-2634-05) / 5 Ml In 1 Vial, Single-Dose (0409-2634-25)",0.1,0.04,,,0 CDM,2500000004_00409263425,NDC Description Not Available,0.09,0.04,,,0 CDM,2500000004_00409263450,"Hydromorphone Hydrochloride: 1 Vial, Single-Dose In 1 Box (0409-2634-50) / 50 Ml In 1 Vial, Single-Dose",0.21,0.08,,,0 CDM,2500000004_00409272002,"Heparin Sodium: 25 Vial, Multi-Dose In 1 Tray (0409-2720-02) / 10 Ml In 1 Vial, Multi-Dose (0409-2720-31)",1.55,0.62,,,0 CDM,2500000004_00409272030,NDC Description Not Available,8.42,3.37,,,0 CDM,2500000004_00409272031,NDC Description Not Available,1.53,0.61,,,0 CDM,2500000004_00409272331,NDC Description Not Available,1.07,0.43,,,0 CDM,2500000004_00409316401,NDC Description Not Available,0.46,0.18,,,0 CDM,2500000004_00409317701,"Lidocaine Hydrochloride And Epinephrine: 25 Vial, Multi-Dose In 1 Tray (0409-3177-01) / 50 Ml In 1 Vial, Multi-Dose (0409-3177-16)",0.04,0.02,,,0 CDM,2500000004_00409317716,NDC Description Not Available,0.04,0.02,,,0 CDM,2500000004_00409317801,"Lidocaine Hydrochloride And Epinephrine: 25 Vial, Multi-Dose In 1 Tray (0409-3178-01) / 20 Ml In 1 Vial, Multi-Dose (0409-3178-16)",0.05,0.02,,,0 CDM,2500000004_00409317802,"Lidocaine Hydrochloride And Epinephrine: 25 Vial, Multi-Dose In 1 Tray (0409-3178-02) / 30 Ml In 1 Vial, Multi-Dose (0409-3178-17)",0.05,0.02,,,0 CDM,2500000004_00409317803,"Lidocaine Hydrochloride And Epinephrine: 25 Vial, Multi-Dose In 1 Tray (0409-3178-03) / 50 Ml In 1 Vial, Multi-Dose (0409-3178-18)",0.07,0.03,,,0 CDM,2500000004_00409317816,NDC Description Not Available,0.03,0.01,,,0 CDM,2500000004_00409317817,NDC Description Not Available,0.05,0.02,,,0 CDM,2500000004_00409318202,"Lidocaine Hydrochloride And Epinephrine: 25 Vial, Multi-Dose In 1 Tray (0409-3182-02) / 30 Ml In 1 Vial, Multi-Dose (0409-3182-21)",0.03,0.01,,,0 CDM,2500000004_00409318301,"Lidocaine Hydrochloride And Epinephrine: 5 Vial, Single-Dose In 1 Carton (0409-3183-01) / 20 Ml In 1 Vial, Single-Dose (0409-3183-11)",0.03,0.01,,,0 CDM,2500000004_00409329906,Sodium Acetate: 25 Vial In 1 Case (0409-3299-06) / 100 Ml In 1 Vial (0409-3299-16),0.69,0.28,,,0 CDM,2500000004_00409330001,NDC Description Not Available,9.08,3.63,,,0 CDM,2500000004_00409330024,Ciprofloxacin In Dextrose: 24 Pouch In 1 Carton (0409-3300-24) / 1 Bag In 1 Pouch (0409-3300-01) / 200 Ml In 1 Bag,8.18,3.27,,,0 CDM,2500000004_00409330803,Acetylcysteine: 3 Vial In 1 Carton (0409-3308-03) / 30 Ml In 1 Vial (0409-3308-11),11.1,4.44,,,0 CDM,2500000004_00409333001,NDC Description Not Available,16.39,6.56,,,0 CDM,2500000004_00409336511,NDC Description Not Available,0.25,0.1,,,0 CDM,2500000004_00409338302,"Piperacillin And Tazobactam: 10 Vial, Single-Use In 1 Carton (0409-3383-02) / 10 Ml In 1 Vial, Single-Use (0409-3383-11)",8.64,3.46,,,0 CDM,2500000004_00409338311,NDC Description Not Available,15.34,6.14,,,0 CDM,2500000004_00409339004,"Piperacillin And Tazobactam: 10 Vial, Single-Use In 1 Carton (0409-3390-04) / 20 Ml In 1 Vial, Single-Use (0409-3390-11)",10.3,4.12,,,0 CDM,2500000004_00409339011,NDC Description Not Available,14.52,5.81,,,0 CDM,2500000004_00409341401,"Metoclopramide: 25 Vial, Single-Dose In 1 Tray (0409-3414-01) / 2 Ml In 1 Vial, Single-Dose (0409-3414-18)",4.15,1.66,,,0 CDM,2500000004_00409341411,"Metoclopramide: 25 Vial, Single-Dose In 1 Tray (0409-3414-11) / 2 Ml In 1 Vial, Single-Dose (0409-3414-21)",4.88,1.95,,,0 CDM,2500000004_00409341418,NDC Description Not Available,4.31,1.72,,,0 CDM,2500000004_00409351021,NDC Description Not Available,71.12,28.45,,,0 CDM,2500000004_00409361301,Bupivacaine Spinal: 10 Ampule In 1 Carton (0409-3613-01) / 2 Ml In 1 Ampule (0409-3613-11),0.42,0.17,,,0 CDM,2500000004_00409379301,"Ketorolac Tromethamine: 25 Vial, Single-Dose In 1 Tray (0409-3793-01) / 1 Ml In 1 Vial, Single-Dose (0409-3793-19)",12.04,4.82,,,0 CDM,2500000004_00409379319,NDC Description Not Available,11.59,4.64,,,0 CDM,2500000004_00409379519,NDC Description Not Available,13.6,5.44,,,0 CDM,2500000004_00409381511,NDC Description Not Available,81.31,32.52,,,0 CDM,2500000004_00409381512,"Morphine Sulfate: 5 Vial, Glass In 1 Carton (0409-3815-12) / 10 Ml In 1 Vial, Glass (0409-3815-11)",85.11,34.04,,,0 CDM,2500000004_00409403101,"Mannitol: 25 Vial, Single-Dose In 1 Tray (0409-4031-01) / 50 Ml In 1 Vial, Single-Dose (0409-4031-16)",27.39,10.96,,,0 CDM,2500000004_00409403116,NDC Description Not Available,27.61,11.04,,,0 CDM,2500000004_00409426401,Hydromorphone Hydrochloride: 10 Syringe In 1 Cello Pack (0409-4264-01) / .5 Ml In 1 Syringe (0409-4264-11),2.83,1.13,,,0 CDM,2500000004_00409426411,NDC Description Not Available,2.85,1.14,,,0 CDM,2500000004_00409427601,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Tray (0409-4276-01) / 20 Ml In 1 Vial, Multi-Dose (0409-4276-16)",0.02,0.01,,,0 CDM,2500000004_00409427602,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Tray (0409-4276-02) / 50 Ml In 1 Vial, Multi-Dose (0409-4276-17)",0.04,0.02,,,0 CDM,2500000004_00409427616,NDC Description Not Available,0.02,0.01,,,0 CDM,2500000004_00409427617,NDC Description Not Available,0.03,0.01,,,0 CDM,2500000004_00409427701,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Tray (0409-4277-01) / 20 Ml In 1 Vial, Multi-Dose (0409-4277-16)",0.02,0.01,,,0 CDM,2500000004_00409427702,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Tray (0409-4277-02) / 50 Ml In 1 Vial, Multi-Dose (0409-4277-17)",0.02,0.01,,,0 CDM,2500000004_00409427716,NDC Description Not Available,0.02,0.01,,,0 CDM,2500000004_00409427717,NDC Description Not Available,0.02,0.01,,,0 CDM,2500000004_00409427902,"Lidocaine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-4279-02) / 30 Ml In 1 Vial, Single-Dose (0409-4279-16)",0.02,0.01,,,0 CDM,2500000004_00409427916,NDC Description Not Available,0.02,0.01,,,0 CDM,2500000004_00409428201,Lidocaine Hydrochloride: 5 Cello Pack In 1 Package (0409-4282-01) / 5 Ampule In 1 Cello Pack (0409-4282-25) / 2 Ml In 1 Ampule (0409-4282-11),0.1,0.04,,,0 CDM,2500000004_00409428202,Lidocaine Hydrochloride: 25 Ampule In 1 Carton (0409-4282-02) / 10 Ml In 1 Ampule (0409-4282-12),0.05,0.02,,,0 CDM,2500000004_00409428301,Lidocaine Hydrochloride: 5 Cello Pack In 1 Package (0409-4283-01) / 5 Ampule In 1 Cello Pack (0409-4283-25) / 5 Ml In 1 Ampule (0409-4283-11),0.07,0.03,,,0 CDM,2500000004_00409428311,NDC Description Not Available,0.06,0.02,,,0 CDM,2500000004_00409433201,"Vancomycin Hydrochloride: 10 Vial In 1 Tray (0409-4332-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (0409-4332-11)",32.99,13.2,,,0 CDM,2500000004_00409433211,NDC Description Not Available,0.73,0.29,,,0 CDM,2500000004_00409434616,NDC Description Not Available,6.16,2.46,,,0 CDM,2500000004_00409434673,"Aminocaproic Acid: 25 Vial, Single-Dose In 1 Tray (0409-4346-73) / 20 Ml In 1 Vial, Single-Dose (0409-4346-16)",7.02,2.81,,,0 CDM,2500000004_00409452002,NDC Description Not Available,1.9,0.76,,,0 CDM,2500000004_00409468816,NDC Description Not Available,15.89,6.36,,,0 CDM,2500000004_00409469924,Propofol: 10 Vial In 1 Tray (0409-4699-24) / 100 Ml In 1 Vial (0409-4699-54),0.95,0.38,,,0 CDM,2500000004_00409469930,Propofol: 5 Vial In 1 Carton (0409-4699-30) / 20 Ml In 1 Vial (0409-4699-50),0.37,0.15,,,0 CDM,2500000004_00409469933,Propofol: 20 Vial In 1 Tray (0409-4699-33) / 50 Ml In 1 Vial (0409-4699-53),0.98,0.39,,,0 CDM,2500000004_00409469950,NDC Description Not Available,0.39,0.16,,,0 CDM,2500000004_00409469953,NDC Description Not Available,0.71,0.28,,,0 CDM,2500000004_00409469954,NDC Description Not Available,0.99,0.4,,,0 CDM,2500000004_00409471375,NDC Description Not Available,0.08,0.03,,,0 CDM,2500000004_00409475518,NDC Description Not Available,1.67,0.67,,,0 CDM,2500000004_00409477601,Lidocaine Hydrochloride: 25 Ampule In 1 Carton (0409-4776-01) / 20 Ml In 1 Ampule (0409-4776-10),0.15,0.06,,,0 CDM,2500000004_00409477610,NDC Description Not Available,0.15,0.06,,,0 CDM,2500000004_00409490311,NDC Description Not Available,0.22,0.09,,,0 CDM,2500000004_00409490334,Lidocaine Hydrochloride: 10 Carton In 1 Container (0409-4903-34) / 1 Syringe In 1 Carton / 5 Ml In 1 Syringe (0409-4903-11),0.36,0.14,,,0 CDM,2500000004_00409493301,"Epinephrine: 10 Carton In 1 Package (0409-4933-01) / 1 Syringe, Glass In 1 Carton / 10 Ml In 1 Syringe, Glass (0409-4933-11)",3.68,1.47,,,0 CDM,2500000004_00409493310,Epinephrine: 10 Carton In 1 Package (0409-4933-10) / 1 Syringe In 1 Carton / 10 Ml In 1 Syringe (0409-4933-05),6.04,2.42,,,0 CDM,2500000004_00409493311,NDC Description Not Available,3.77,1.51,,,0 CDM,2500000004_00409508413,NDC Description Not Available,9.83,3.93,,,0 CDM,2500000004_00409582001,"Dopamine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-5820-01) / 5 Ml In 1 Vial, Single-Dose (0409-5820-11)",2.45,0.98,,,0 CDM,2500000004_00409582011,NDC Description Not Available,2.36,0.94,,,0 CDM,2500000004_00409592101,"Aminophylline: 25 Vial, Single-Dose In 1 Tray (0409-5921-01) / 10 Ml In 1 Vial, Single-Dose (0409-5921-16)",29.54,11.82,,,0 CDM,2500000004_00409592116,NDC Description Not Available,19.29,7.72,,,0 CDM,2500000004_00409592201,"Aminophylline: 25 Vial, Single-Dose In 1 Tray (0409-5922-01) / 20 Ml In 1 Vial, Single-Dose (0409-5922-16)",28.57,11.43,,,0 CDM,2500000004_00409592216,NDC Description Not Available,28.71,11.48,,,0 CDM,2500000004_00409610202,"Furosemide: 25 Vial, Single-Dose In 1 Tray (0409-6102-02) / 2 Ml In 1 Vial, Single-Dose (0409-6102-19)",4.3,1.72,,,0 CDM,2500000004_00409610204,"Furosemide: 25 Vial, Single-Dose In 1 Tray (0409-6102-04) / 4 Ml In 1 Vial, Single-Dose (0409-6102-18)",2.23,0.89,,,0 CDM,2500000004_00409610210,"Furosemide: 25 Vial, Single-Dose In 1 Tray (0409-6102-10) / 10 Ml In 1 Vial, Single-Dose (0409-6102-20)",0.88,0.35,,,0 CDM,2500000004_00409610218,NDC Description Not Available,2.54,1.02,,,0 CDM,2500000004_00409610219,NDC Description Not Available,16.59,6.64,,,0 CDM,2500000004_00409610220,NDC Description Not Available,3.32,1.33,,,0 CDM,2500000004_00409610226,"Furosemide: 25 Vial, Single-Dose In 1 Tray (0409-6102-26) / 4 Ml In 1 Vial, Single-Dose (0409-6102-36)",1.56,0.62,,,0 CDM,2500000004_00409610236,NDC Description Not Available,0.23,0.09,,,0 CDM,2500000004_00409648201,Erythrocin Lactobionate: 10 Vial In 1 Tray (0409-6482-01) / 10 Ml In 1 Vial (0409-6482-11),251.16,100.46,,,0 CDM,2500000004_00409648211,NDC Description Not Available,418.25,167.3,,,0 CDM,2500000004_00409653102,"Vancomycin Hydrochloride: 10 Vial In 1 Tray (0409-6531-02) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (0409-6531-12)",7.43,2.97,,,0 CDM,2500000004_00409653112,NDC Description Not Available,5.67,2.27,,,0 CDM,2500000004_00409653501,"Vancomycin Hydrochloride: 10 Vial, Single-Dose In 1 Tray (0409-6535-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose (0409-6535-11)",12.37,4.95,,,0 CDM,2500000004_00409665119,NDC Description Not Available,1.69,0.68,,,0 CDM,2500000004_00409665318,NDC Description Not Available,1.21,0.48,,,0 CDM,2500000004_00409707714,Potassium Chloride: 24 POUCH in 1 CASE (0409-7077-14) / 1 BAG in 1 POUCH / 50 mL in 1 BAG,0.09,0.04,,,0 CDM,2500000004_00409710102,Sodium Chloride: 24 Pouch In 1 Case (0409-7101-02) / 1 Bag In 1 Pouch / 250 Ml In 1 Bag (0409-7101-04),13.8,5.52,,,0 CDM,2500000004_00409710104,NDC Description Not Available,13.45,5.38,,,0 CDM,2500000004_00409710166,Sodium Chloride: 10 Pouch In 1 Case (0409-7101-66) / 5 Bag In 1 Pouch / 50 Ml In 1 Bag (0409-7101-68),19.32,7.73,,,0 CDM,2500000004_00409710168,NDC Description Not Available,20.04,8.02,,,0 CDM,2500000004_00409710169,NDC Description Not Available,9.66,3.86,,,0 CDM,2500000004_00409733201,"Ceftriaxone Sodium: 10 Vial, Single-Use In 1 Carton (0409-7332-01) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use (0409-7332-11)",1.67,0.67,,,0 CDM,2500000004_00409733211,NDC Description Not Available,1.83,0.73,,,0 CDM,2500000004_00409733220,"Ceftriaxone Sodium: 10 Vial, Single-Use In 1 Carton (0409-7332-20) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use (0409-7332-21)",0.8,0.32,,,0 CDM,2500000004_00409733503,"Ceftriaxone Sodium: 10 Vial, Single-Use In 1 Carton (0409-7335-03) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use (0409-7335-13)",1.3,0.52,,,0 CDM,2500000004_00409733513,NDC Description Not Available,1.6,0.64,,,0 CDM,2500000004_00409733711,NDC Description Not Available,2.67,1.07,,,0 CDM,2500000004_00409733801,"Ceftriaxone Sodium: 10 Vial, Single-Use In 1 Carton (0409-7338-01) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use (0409-7338-11)",1.99,0.8,,,0 CDM,2500000004_00409733811,NDC Description Not Available,1.68,0.67,,,0 CDM,2500000004_00409741813,NDC Description Not Available,255.41,102.16,,,0 CDM,2500000004_00409741914,NDC Description Not Available,133.4,53.36,,,0 CDM,2500000004_00409762013,NDC Description Not Available,24.2,9.68,,,0 CDM,2500000004_00409765005,NDC Description Not Available,2.62,1.05,,,0 CDM,2500000004_00409765030,Heparin Sodium: 30 Pouch In 1 Case (0409-7650-30) / 1 Bag In 1 Pouch / 250 Ml In 1 Bag (0409-7650-05),1.97,0.79,,,0 CDM,2500000004_00409765052,NDC Description Not Available,1.79,0.72,,,0 CDM,2500000004_00409780911,NDC Description Not Available,3.2,1.28,,,0 CDM,2500000004_00409780922,Dopamine Hydrochloride In Dextrose: 12 Bag In 1 Carton (0409-7809-22) / 250 Ml In 1 Bag (0409-7809-11),7.88,3.15,,,0 CDM,2500000004_00409781011,NDC Description Not Available,2.36,0.94,,,0 CDM,2500000004_00409909335,Fentanyl Citrate: 10 Ampule In 1 Cello Pack (0409-9093-35) / 5 Ml In 1 Ampule (0409-9093-45),4.19,1.68,,,0 CDM,2500000004_00409909412,NDC Description Not Available,5.06,2.02,,,0 CDM,2500000004_00409909416,NDC Description Not Available,2.73,1.09,,,0 CDM,2500000004_00409909418,NDC Description Not Available,2.6,1.04,,,0 CDM,2500000004_00409909422,"Fentanyl Citrate: 25 Vial, Single-Dose In 1 Tray (0409-9094-22) / 2 Ml In 1 Vial, Single-Dose (0409-9094-12)",3.54,1.42,,,0 CDM,2500000004_00409909441,NDC Description Not Available,4.22,1.69,,,0 CDM,2500000004_00409909461,"Fentanyl Citrate: 25 Carton In 1 Tray (0409-9094-61) / 1 Vial, Single-Dose In 1 Carton / 50 Ml In 1 Vial, Single-Dose (0409-9094-41)",1.67,0.67,,,0 CDM,2500000004_00409910421,NDC Description Not Available,0.93,0.37,,,0 CDM,2500000004_00409915731,NDC Description Not Available,20.9,8.36,,,0 CDM,2500000004_00409915801,Vitamin K1: 5 Tray In 1 Container (0409-9158-01) / 5 Ampule In 1 Tray (0409-9158-50) / 1 Ml In 1 Ampule (0409-9158-31),21.55,8.62,,,0 CDM,2500000004_00409930130,"Ropivacaine Hydrochloride: 10 VIAL, SINGLE-DOSE in 1 CARTON (0409-9301-30) / 30 mL in 1 VIAL, SINGLE-DOSE (0409-9301-31)",0.2,0.08,,,0 CDM,2500000004_00409956601,NDC Description Not Available,8.07,3.23,,,0 CDM,2500000004_00409973501,NDC Description Not Available,7.02,2.81,,,0 CDM,2500000004_00456040001,NDC Description Not Available,26.43,10.57,,,0 CDM,2500000004_00456040010,"Teflaro: 10 Vial, Single-Dose In 1 Carton (0456-0400-10) / 20 Ml In 1 Vial, Single-Dose (0456-0400-01)",24.57,9.83,,,0 CDM,2500000004_00456060001,NDC Description Not Available,17.79,7.12,,,0 CDM,2500000004_00456060010,"Teflaro: 10 Vial, Single-Dose In 1 Carton (0456-0600-10) / 20 Ml In 1 Vial, Single-Dose (0456-0600-01)",16.49,6.6,,,0 CDM,2500000004_00456270001,NDC Description Not Available,454.88,181.95,,,0 CDM,2500000004_00456270010,"Avycaz: 10 Vial, Single-Dose In 1 Carton (0456-2700-10) / 1 Powder, For Solution In 1 Vial, Single-Dose (0456-2700-01)",467.65,187.06,,,0 CDM,2500000004_00469042001,"Cresemba: 1 Vial, Single-Dose In 1 Carton (0469-0420-01) / 5 Ml In 1 Vial, Single-Dose",4.52,1.81,,,0 CDM,2500000004_00469042099,"Cresemba: 10 Carton In 1 Carton (0469-0420-99) / 1 Vial, Single-Dose In 1 Carton (0469-0420-01) / 5 Ml In 1 Vial, Single-Dose",4.43,1.77,,,0 CDM,2500000004_00469060773,"Prograf: 1 Bottle In 1 Carton (0469-0607-73) / 100 Capsule, Gelatin Coated In 1 Bottle",11.1,4.44,,,0 CDM,2500000004_00469061773,"Prograf: 1 Bottle In 1 Carton (0469-0617-73) / 100 Capsule, Gelatin Coated In 1 Bottle",22.16,8.86,,,0 CDM,2500000004_00469065773,"Prograf: 1 Bottle In 1 Carton (0469-0657-73) / 100 Capsule, Gelatin Coated In 1 Bottle",3.34,1.34,,,0 CDM,2500000004_00469301601,Prograf: 10 Ampule In 1 Box (0469-3016-01) / 1 Ml In 1 Ampule,1116.58,446.63,,,0 CDM,2500000004_00469305130,"Ambisome: 12.5 Ml In 1 Vial, Single-Dose (0469-3051-30)",275.78,110.31,,,0 CDM,2500000004_00469321110,"Mycamine: 10 Vial, Single-Dose In 1 Carton (0469-3211-10) / 10 Ml In 1 Vial, Single-Dose",8.06,3.22,,,0 CDM,2500000004_00469342510,Vyloy: 1 Vial In 1 Box (0469-3425-10) / 5 Ml In 1 Vial,126.91,50.76,,,0 CDM,2500000004_00469442530,Vyloy: 1 Vial In 1 Box (0469-4425-30) / 15 Ml In 1 Vial,140.8,56.32,,,0 CDM,2500000004_00469650189,"Lexiscan: 5 Ml In 1 Syringe, Plastic (0469-6501-89)",283.54,113.42,,,0 CDM,2500000004_00480432001,"Plerixafor: 1 Vial, Single-Dose In 1 Carton (0480-4320-01) / 1.2 Ml In 1 Vial, Single-Dose",233.87,93.55,,,0 CDM,2500000004_00517003101,NDC Description Not Available,31.19,12.48,,,0 CDM,2500000004_00517003125,"Cyanocobalamin: 25 Vial, Multi-Dose In 1 Tray (0517-0031-25) / 1 Ml In 1 Vial, Multi-Dose (0517-0031-01)",9.83,3.93,,,0 CDM,2500000004_00517003225,"Cyanocobalamin: 25 Vial, Multi-Dose In 1 Tray (0517-0032-25) / 10 Ml In 1 Vial, Multi-Dose (0517-0032-01)",4.32,1.73,,,0 CDM,2500000004_00517037401,NDC Description Not Available,43.1,17.24,,,0 CDM,2500000004_00517037405,Provayblue: 5 Ampule In 1 Carton (0517-0374-05) / 10 Ml In 1 Ampule (0517-0374-01),14.29,5.72,,,0 CDM,2500000004_00517038101,NDC Description Not Available,45.02,18.01,,,0 CDM,2500000004_00517038105,"Provayblue: 5 Vial, Single-Dose In 1 Carton (0517-0381-05) / 10 Ml In 1 Vial, Single-Dose (0517-0381-01)",12.47,4.99,,,0 CDM,2500000004_00517040125,"Atropine Sulfate: 25 VIAL, SINGLE-DOSE in 1 TRAY (0517-0401-25) / 1 mL in 1 VIAL, SINGLE-DOSE",0.46,0.18,,,0 CDM,2500000004_00517042001,"Estradiol Valerate: 1 Vial, Multi-Dose In 1 Carton (0517-0420-01) / 5 Ml In 1 Vial, Multi-Dose",6.3,2.52,,,0 CDM,2500000004_00517060201,"Injectafer: 1 Vial, Single-Dose In 1 Box (0517-0602-01) / 2 Ml In 1 Vial, Single-Dose",8.49,3.4,,,0 CDM,2500000004_00517065001,"Injectafer: 1 Vial, Single-Dose In 1 Box (0517-0650-01) / 15 Ml In 1 Vial, Single-Dose",7.92,3.17,,,0 CDM,2500000004_00517072001,"Betamethasone Sodium Phosphate And Betamethasone Acetate: 1 Vial, Multi-Dose In 1 Carton (0517-0720-01) / 5 Ml In 1 Vial, Multi-Dose",48.17,19.27,,,0 CDM,2500000004_00517074001,NDC Description Not Available,131.25,52.5,,,0 CDM,2500000004_00517074020,"Methylergonovine Maleate: 20 Vial, Single-Dose In 1 Carton (0517-0740-20) / 1 Ml In 1 Vial, Single-Dose (0517-0740-01)",135.36,54.14,,,0 CDM,2500000004_00517090101,NDC Description Not Available,38.12,15.25,,,0 CDM,2500000004_00517095501,"Olanzapine: 1 Vial, Glass In 1 Carton (0517-0955-01) / 2 Ml In 1 Vial, Glass",10.82,4.33,,,0 CDM,2500000004_00517100101,NDC Description Not Available,0.76,0.3,,,0 CDM,2500000004_00517100125,"Atropine Sulfate: 25 Vial, Glass In 1 Tray (0517-1001-25) / 1 Ml In 1 Vial, Glass (0517-1001-01)",0.76,0.3,,,0 CDM,2500000004_00517100401,NDC Description Not Available,0.48,0.19,,,0 CDM,2500000004_00517102001,NDC Description Not Available,12.61,5.04,,,0 CDM,2500000004_00517102025,"Vasopressin: 25 Vial, Single-Dose In 1 Carton (0517-1020-25) / 1 Ml In 1 Vial, Single-Dose (0517-1020-01)",4.55,1.82,,,0 CDM,2500000004_00517104501,NDC Description Not Available,33.36,13.34,,,0 CDM,2500000004_00517182001,Chlorothiazide Sodium: 1 Vial In 1 Carton (0517-1820-01) / 18 Ml In 1 Vial,552.43,220.97,,,0 CDM,2500000004_00517231001,NDC Description Not Available,1.43,0.57,,,0 CDM,2500000004_00517231005,"Venofer: 5 Vial, Single-Dose In 1 Box (0517-2310-05) / 10 Ml In 1 Vial, Single-Dose (0517-2310-01)",2.86,1.14,,,0 CDM,2500000004_00517232501,NDC Description Not Available,2.86,1.14,,,0 CDM,2500000004_00517232510,"Venofer: 10 Vial, Single-Dose In 1 Box (0517-2325-10) / 2.5 Ml In 1 Vial, Single-Dose (0517-2325-01)",2.83,1.13,,,0 CDM,2500000004_00517234010,"Venofer: 10 Vial, Single-Dose In 1 Box (0517-2340-10) / 5 Ml In 1 Vial, Single-Dose",2.9,1.16,,,0 CDM,2500000004_00517234025,"Venofer: 25 Vial, Single-Dose In 1 Tray (0517-2340-25) / 5 Ml In 1 Vial, Single-Dose",2.92,1.17,,,0 CDM,2500000004_00517400201,NDC Description Not Available,182.21,72.88,,,0 CDM,2500000004_00517400225,Papaverine Hydrochloride: 25 Vial In 1 Carton (0517-4002-25) / 2 Ml In 1 Vial (0517-4002-01),82.66,33.06,,,0 CDM,2500000004_00517420125,"Hydroxyzine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0517-4201-25) / 1 Ml In 1 Vial, Single-Dose (0517-4201-01)",124.97,49.99,,,0 CDM,2500000004_00517430001,Paclitaxel Protein Bound Particles Albumin Bound: 1 Vial In 1 Carton (0517-4300-01) / 20 Ml In 1 Vial,61.86,24.74,,,0 CDM,2500000004_00517560125,"Hydroxyzine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0517-5601-25) / 1 Ml In 1 Vial, Single-Dose (0517-5601-01)",74.17,29.67,,,0 CDM,2500000004_00517912001,NDC Description Not Available,4.03,1.61,,,0 CDM,2500000004_00517970201,NDC Description Not Available,34.33,13.73,,,0 CDM,2500000004_00517970225,"Droperidol: 25 Vial, Single-Dose In 1 Tray (0517-9702-25) / 2 Ml In 1 Vial, Single-Dose",13.68,5.47,,,0 CDM,2500000004_00548540000,"Medroxyprogesterone Acetate: 1 Vial, Single-Dose In 1 Carton (0548-5400-00) / 1 Ml In 1 Vial, Single-Dose",0.63,0.25,,,0 CDM,2500000004_00548560200,Enoxaparin Sodium: 10 Syringe In 1 Carton (0548-5602-00) / .4 Ml In 1 Syringe,6.6,2.64,,,0 CDM,2500000004_00548560400,Enoxaparin Sodium: 10 Syringe In 1 Carton (0548-5604-00) / .8 Ml In 1 Syringe,6.56,2.62,,,0 CDM,2500000004_00548560600,Enoxaparin Sodium: 10 Syringe In 1 Carton (0548-5606-00) / .8 Ml In 1 Syringe,7.03,2.81,,,0 CDM,2500000004_00548560800,Enoxaparin Sodium: 1 Vial In 1 Carton (0548-5608-00) / 3 Ml In 1 Vial,4.6,1.84,,,0 CDM,2500000004_00548570100,Medroxyprogesterone Acetate: 1 Syringe In 1 Carton (0548-5701-00) / 1 Ml In 1 Syringe,1.3,0.52,,,0 CDM,2500000004_00548585000,Glucagon: 1 Kit In 1 Kit (0548-5850-00) * 1 Ml In 1 Vial (0548-5905-00) * 1 Ml In 1 Syringe (0548-5831-00),1274.43,509.77,,,0 CDM,2500000004_00548590000,Cortrosyn: 10 Vial In 1 Carton (0548-5900-00) / 1 Ml In 1 Vial,450.53,180.21,,,0 CDM,2500000004_00548970100,Vasopressin: 1 Vial In 1 Carton (0548-9701-00) / 1 Ml In 1 Vial,6.21,2.48,,,0 CDM,2500000004_00574080530,Acetylcysteine: 4 Vial In 1 Carton (0574-0805-30) / 30 Ml In 1 Vial,2.92,1.17,,,0 CDM,2500000004_00574082001,"Testosterone Cypionate: 1 Vial, Glass In 1 Carton (0574-0820-01) / 1 Ml In 1 Vial, Glass",0.04,0.02,,,0 CDM,2500000004_00574082701,"Testosterone Cypionate: 1 Vial, Glass In 1 Carton (0574-0827-01) / 1 Ml In 1 Vial, Glass",0.02,0.01,,,0 CDM,2500000004_00574085005,Dihydroergotamine Mesylate: 5 Ampule In 1 Carton (0574-0850-05) / 1 Ml In 1 Ampule,566.09,226.44,,,0 CDM,2500000004_00591288830,"Hydroxocobalamin: 1 Vial, Multi-Dose In 1 Carton (0591-2888-30) / 30 Ml In 1 Vial, Multi-Dose",0.05,0.02,,,0 CDM,2500000004_00591544301,Prednisone: 100 Tablet In 1 Bottle (0591-5443-01),0.03,0.01,,,0 CDM,2500000004_00597005345,GlucaGen: 10 VIAL in 1 CARTON (0597-0053-45) / 1 mL in 1 VIAL,646.42,258.57,,,0 CDM,2500000004_00597019705,"Praxbind: 2 Vial, Single-Dose In 1 Carton (0597-0197-05) / 50 Ml In 1 Vial, Single-Dose",11849.72,4739.89,,,0 CDM,2500000004_00597026010,"GlucaGen: 1 KIT in 1 KIT (0597-0260-10) * 1 mL in 1 VIAL, GLASS (0597-0053-01) * 1 mL in 1 VIAL, GLASS (0597-0265-94)",524.91,209.96,,,0 CDM,2500000004_00603533621,"Prednisone: 100 Tablet In 1 Bottle, Plastic (0603-5336-21)",0.16,0.06,,,0 CDM,2500000004_00641036721,NDC Description Not Available,0.51,0.2,,,0 CDM,2500000004_00641036725,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (0641-0367-25) / 1 Ml In 1 Vial (0641-0367-21),0.63,0.25,,,0 CDM,2500000004_00641037621,NDC Description Not Available,6.28,2.51,,,0 CDM,2500000004_00641037625,Diphenhydramine Hydrochloride: 25 Vial In 1 Package (0641-0376-25) / 1 Ml In 1 Vial (0641-0376-21),5.25,2.1,,,0 CDM,2500000004_00641040037,NDC Description Not Available,6.71,2.68,,,0 CDM,2500000004_00641047621,NDC Description Not Available,108.76,43.5,,,0 CDM,2500000004_00641047625,Phenobarbital Sodium: 25 Vial In 1 Carton (0641-0476-25) / 1 Ml In 1 Vial (0641-0476-21),5.76,2.3,,,0 CDM,2500000004_00641047721,NDC Description Not Available,285.51,114.2,,,0 CDM,2500000004_00641047725,Phenobarbital Sodium: 25 Vial In 1 Carton (0641-0477-25) / 1 Ml In 1 Vial (0641-0477-21),232.64,93.06,,,0 CDM,2500000004_00641092821,NDC Description Not Available,6.17,2.47,,,0 CDM,2500000004_00641092825,"Promethazine Hydrochloride: 25 Vial, Single-Dose In 1 Package (0641-0928-25) / 1 Ml In 1 Vial, Single-Dose (0641-0928-21)",6.15,2.46,,,0 CDM,2500000004_00641139731,NDC Description Not Available,196.9,78.76,,,0 CDM,2500000004_00641139735,Chlorpromazine Hydrochloride: 25 Ampule In 1 Carton (0641-1397-35) / 1 Ml In 1 Ampule (0641-1397-31),213.78,85.51,,,0 CDM,2500000004_00641141031,NDC Description Not Available,24.53,9.81,,,0 CDM,2500000004_00641141035,Digoxin: 25 Ampule In 1 Carton (0641-1410-35) / 2 Ml In 1 Ampule (0641-1410-31),13.23,5.29,,,0 CDM,2500000004_00641600101,NDC Description Not Available,4.76,1.9,,,0 CDM,2500000004_00641600125,Ativan: 25 Vial In 1 Carton (0641-6001-25) / 1 Ml In 1 Vial (0641-6001-01),8.16,3.26,,,0 CDM,2500000004_00641600701,NDC Description Not Available,3.39,1.36,,,0 CDM,2500000004_00641600710,Bumetanide: 10 Vial In 1 Carton (0641-6007-10) / 10 Ml In 1 Vial (0641-6007-01),2.95,1.18,,,0 CDM,2500000004_00641600801,NDC Description Not Available,7.8,3.12,,,0 CDM,2500000004_00641600810,Bumetanide: 10 Vial In 1 Carton (0641-6008-10) / 4 Ml In 1 Vial (0641-6008-01),6.7,2.68,,,0 CDM,2500000004_00641601301,NDC Description Not Available,0.18,0.07,,,0 CDM,2500000004_00641602410,Fentanyl Citrate: 10 Ampule In 1 Carton (0641-6024-10) / 2 Ml In 1 Ampule (0641-6024-01),1.84,0.74,,,0 CDM,2500000004_00641602701,NDC Description Not Available,6.3,2.52,,,0 CDM,2500000004_00641602725,Fentanyl Citrate: 25 Vial In 1 Carton (0641-6027-25) / 2 Ml In 1 Vial (0641-6027-01),11.27,4.51,,,0 CDM,2500000004_00641602801,NDC Description Not Available,4.0,1.6,,,0 CDM,2500000004_00641603001,Fentanyl Citrate: 50 Ml In 1 Vial (0641-6030-01),4.17,1.67,,,0 CDM,2500000004_00641603901,Infumorph 200: 20 Ml In 1 Ampule (0641-6039-01),46.31,18.52,,,0 CDM,2500000004_00641604001,Infumorph 500: 20 Ml In 1 Ampule (0641-6040-01),31.3,12.52,,,0 CDM,2500000004_00641604401,NDC Description Not Available,5.46,2.18,,,0 CDM,2500000004_00641604425,Lorazepam: 25 Vial In 1 Carton (0641-6044-25) / 1 Ml In 1 Vial (0641-6044-01),6.96,2.78,,,0 CDM,2500000004_00641604801,NDC Description Not Available,2.08,0.83,,,0 CDM,2500000004_00641605201,NDC Description Not Available,7.69,3.08,,,0 CDM,2500000004_00641605225,Meperidine Hydrochloride: 25 Vial In 1 Carton (0641-6052-25) / 1 Ml In 1 Vial (0641-6052-01),4.9,1.96,,,0 CDM,2500000004_00641605701,NDC Description Not Available,2.79,1.12,,,0 CDM,2500000004_00641605901,NDC Description Not Available,1.12,0.45,,,0 CDM,2500000004_00641606001,NDC Description Not Available,0.65,0.26,,,0 CDM,2500000004_00641606010,Midazolam: 10 Vial In 1 Carton (0641-6060-10) / 10 Ml In 1 Vial (0641-6060-01),0.14,0.06,,,0 CDM,2500000004_00641606301,NDC Description Not Available,0.54,0.22,,,0 CDM,2500000004_00641607801,NDC Description Not Available,1.05,0.42,,,0 CDM,2500000004_00641607825,Ondansetron: 25 Vial In 1 Carton (0641-6078-25) / 2 Ml In 1 Vial (0641-6078-01),0.42,0.17,,,0 CDM,2500000004_00641607901,Ondansetron: 20 Ml In 1 Carton (0641-6079-01),0.88,0.35,,,0 CDM,2500000004_00641610301,NDC Description Not Available,30.52,12.21,,,0 CDM,2500000004_00641610310,Robaxin: 10 Vial In 1 Carton (0641-6103-10) / 10 Ml In 1 Vial (0641-6103-01),24.74,9.9,,,0 CDM,2500000004_00641611601,NDC Description Not Available,10.8,4.32,,,0 CDM,2500000004_00641611610,Ampicillin And Sulbactam: 10 Vial In 1 Carton (0641-6116-10) / 1.5 G In 1 Vial (0641-6116-01),19.21,7.68,,,0 CDM,2500000004_00641611701,NDC Description Not Available,20.42,8.17,,,0 CDM,2500000004_00641611710,Ampicillin And Sulbactam: 10 Vial In 1 Carton (0641-6117-10) / 3 G In 1 Vial (0641-6117-01),20.75,8.3,,,0 CDM,2500000004_00641612501,NDC Description Not Available,8.88,3.55,,,0 CDM,2500000004_00641612525,"Morphine Sulfate: 25 Vial, Single-Dose In 1 Package (0641-6125-25) / 1 Ml In 1 Vial, Single-Dose (0641-6125-01)",8.47,3.39,,,0 CDM,2500000004_00641612701,NDC Description Not Available,10.34,4.14,,,0 CDM,2500000004_00641612725,"Morphine Sulfate: 25 Vial, Single-Dose In 1 Package (0641-6127-25) / 1 Ml In 1 Vial, Single-Dose (0641-6127-01)",11.01,4.4,,,0 CDM,2500000004_00641613201,NDC Description Not Available,13.17,5.27,,,0 CDM,2500000004_00641613225,Naloxone Hydrochloride: 25 Vial In 1 Carton (0641-6132-25) / 1 Ml In 1 Vial (0641-6132-01),59.11,23.64,,,0 CDM,2500000004_00641613501,NDC Description Not Available,17.8,7.12,,,0 CDM,2500000004_00641613525,Prochlorperazine Edisylate: 25 Vial In 1 Carton (0641-6135-25) / 2 Ml In 1 Vial (0641-6135-01),9.6,3.84,,,0 CDM,2500000004_00641614501,NDC Description Not Available,1.07,0.43,,,0 CDM,2500000004_00641614525,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (0641-6145-25) / 1 Ml In 1 Vial (0641-6145-01),0.94,0.38,,,0 CDM,2500000004_00641615101,NDC Description Not Available,1.56,0.62,,,0 CDM,2500000004_00641616401,NDC Description Not Available,1.02,0.41,,,0 CDM,2500000004_00641616601,NDC Description Not Available,6.53,2.61,,,0 CDM,2500000004_00641616610,Amikacin Sulfate: 10 Vial In 1 Carton (0641-6166-10) / 4 Ml In 1 Vial (0641-6166-01),0.23,0.09,,,0 CDM,2500000004_00641616701,NDC Description Not Available,2.19,0.88,,,0 CDM,2500000004_00641616901,NDC Description Not Available,1.2,0.48,,,0 CDM,2500000004_00641616910,Hydromorphone Hydrochloride: 10 Syringe In 1 Carton (0641-6169-10) / 1 Ml In 1 Syringe (0641-6169-01),6.55,2.62,,,0 CDM,2500000004_00641617401,NDC Description Not Available,11.22,4.49,,,0 CDM,2500000004_00641617410,"Octreotide Acetate: 10 Vial, Single-Dose In 1 Carton (0641-6174-10) / 1 Ml In 1 Vial, Single-Dose (0641-6174-01)",9.98,3.99,,,0 CDM,2500000004_00641617610,"Octreotide Acetate: 10 Vial, Single-Dose In 1 Carton (0641-6176-10) / 1 Ml In 1 Vial, Single-Dose (0641-6176-01)",2.44,0.98,,,0 CDM,2500000004_00641617801,"Octreotide Acetate: 1 Vial, Multi-Dose In 1 Carton (0641-6178-01) / 5 Ml In 1 Vial, Multi-Dose",5.39,2.16,,,0 CDM,2500000004_00641618801,NDC Description Not Available,0.04,0.02,,,0 CDM,2500000004_00641618810,"Phenylephrine Hydrochloride: 10 Vial, Pharmacy Bulk Package In 1 Carton (0641-6188-10) / 5 Ml In 1 Vial, Pharmacy Bulk Package (0641-6188-01)",0.04,0.02,,,0 CDM,2500000004_00641620501,NDC Description Not Available,12.18,4.87,,,0 CDM,2500000004_00641620510,Naloxone Hydrochloride: 10 Syringe In 1 Carton (0641-6205-10) / 2 Ml In 1 Syringe (0641-6205-01),22.22,8.89,,,0 CDM,2500000004_00641620601,NDC Description Not Available,2.95,1.18,,,0 CDM,2500000004_00641620610,Hydromorphone Hydrochloride: 10 Syringe In 1 Carton (0641-6206-10) / .5 Ml In 1 Syringe (0641-6206-01),2.3,0.92,,,0 CDM,2500000004_00641622801,NDC Description Not Available,22.88,9.15,,,0 CDM,2500000004_00641622825,Thiamine Hydrochloride: 25 Vial In 1 Carton (0641-6228-25) / 2 Ml In 1 Vial (0641-6228-01),7.76,3.1,,,0 CDM,2500000004_00641623101,NDC Description Not Available,39.74,15.9,,,0 CDM,2500000004_00641623125,"Hydralazine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (0641-6231-25) / 20 Ml In 1 Vial, Single-Dose (0641-6231-01)",7.89,3.16,,,0 CDM,2500000004_00641624401,NDC Description Not Available,40.92,16.37,,,0 CDM,2500000004_00641624701,NDC Description Not Available,4.38,1.75,,,0 CDM,2500000004_00703001801,Hydromorphone Hydrochloride: 1 Vial In 1 Carton (0703-0018-01) / 50 Ml In 1 Vial,0.13,0.05,,,0 CDM,2500000004_00703011001,NDC Description Not Available,0.17,0.07,,,0 CDM,2500000004_00703011301,NDC Description Not Available,0.08,0.03,,,0 CDM,2500000004_00703011303,Hydromorphone Hydrochloride: 10 Vial In 1 Carton (0703-0113-03) / 5 Ml In 1 Vial (0703-0113-01),0.08,0.03,,,0 CDM,2500000004_00703024101,"Triamcinolone Acetonide: 1 Vial, Single-Dose In 1 Carton (0703-0241-01) / 1 Ml In 1 Vial, Single-Dose",12.8,5.12,,,0 CDM,2500000004_00703024301,"Triamcinolone Acetonide: 1 Vial, Multi-Dose In 1 Carton (0703-0243-01) / 5 Ml In 1 Vial, Multi-Dose",4.91,1.96,,,0 CDM,2500000004_00703024501,"Triamcinolone Acetonide: 1 Vial, Multi-Dose In 1 Carton (0703-0245-01) / 10 Ml In 1 Vial, Multi-Dose",3.25,1.3,,,0 CDM,2500000004_00703068601,"Treprostinil: 1 Vial, Multi-Dose In 1 Carton (0703-0686-01) / 20 Ml In 1 Vial, Multi-Dose",275.61,110.24,,,0 CDM,2500000004_00703321801,"Paclitaxel: 1 Vial, Multi-Dose In 1 Carton (0703-3218-01) / 50 Ml In 1 Vial, Multi-Dose",1.02,0.41,,,0 CDM,2500000004_00703367101,"Methotrexate: 1 Vial, Single-Dose In 1 Carton (0703-3671-01) / 2 Ml In 1 Vial, Single-Dose",12.25,4.9,,,0 CDM,2500000004_00703367501,"Methotrexate: 1 Vial, Single-Dose In 1 Carton (0703-3675-01) / 10 Ml In 1 Vial, Single-Dose",6.12,2.45,,,0 CDM,2500000004_00703367801,"Methotrexate: 1 Vial, Single-Dose In 1 Carton (0703-3678-01) / 40 Ml In 1 Vial, Single-Dose",5.13,2.05,,,0 CDM,2500000004_00703398601,"Oxaliplatin: 1 Vial, Single-Use In 1 Carton (0703-3986-01) / 20 Ml In 1 Vial, Single-Use",1.39,0.56,,,0 CDM,2500000004_00703423901,"Carboplatin: 1 Vial, Multi-Dose In 1 Carton (0703-4239-01) / 60 Ml In 1 Vial, Multi-Dose",23.91,9.56,,,0 CDM,2500000004_00703450201,NDC Description Not Available,9.12,3.65,,,0 CDM,2500000004_00703523313,"daunorubicin hydrochloride: 10 VIAL, SINGLE-DOSE in 1 CARTON (0703-5233-13) / 4 mL in 1 VIAL, SINGLE-DOSE (0703-5233-11)",289.06,115.62,,,0 CDM,2500000004_00703574811,"Cisplatin: 1 Vial, Multi-Dose In 1 Carton (0703-5748-11) / 100 Ml In 1 Vial, Multi-Dose",16.9,6.76,,,0 CDM,2500000004_00703903203,"Amikacin Sulfate: 10 VIAL, SINGLE-DOSE in 1 CARTON (0703-9032-03) / 2 mL in 1 VIAL, SINGLE-DOSE (0703-9032-01)",8.8,3.52,,,0 CDM,2500000004_00703951401,NDC Description Not Available,0.21,0.08,,,0 CDM,2500000004_00703952601,"Sulfamethoxazole And Trimethoprim: 1 Vial, Multi-Dose In 1 Carton (0703-9526-01) / 30 Ml In 1 Vial, Multi-Dose",0.35,0.14,,,0 CDM,2500000004_00713035102,NDC Description Not Available,10.26,4.1,,,0 CDM,2500000004_00713035125,Prochlorperazine Edisylate: 25 Vial In 1 Package (0713-0351-25) / 2 Ml In 1 Vial (0713-0351-02),11.08,4.43,,,0 CDM,2500000004_00781309894,NDC Description Not Available,5.83,2.33,,,0 CDM,2500000004_00781309895,Meropenem: 10 Vial In 1 Carton (0781-3098-95) / 30 Ml In 1 Vial (0781-3098-94),2.41,0.96,,,0 CDM,2500000004_00781311090,NDC Description Not Available,7.46,2.98,,,0 CDM,2500000004_00781311390,NDC Description Not Available,10.16,4.06,,,0 CDM,2500000004_00781311395,"Piperacillin And Tazobactam: 10 Vial, Single-Use In 1 Carton (0781-3113-95) / 15 Ml In 1 Vial, Single-Use (0781-3113-90)",5.48,2.19,,,0 CDM,2500000004_00781311491,NDC Description Not Available,4.61,1.84,,,0 CDM,2500000004_00781315606,NDC Description Not Available,0.31,0.12,,,0 CDM,2500000004_00781315695,"Acetaminophen: 10 Vial, Glass In 1 Carton (0781-3156-95) / 100 Ml In 1 Vial, Glass (0781-3156-06)",0.18,0.07,,,0 CDM,2500000004_00781315894,NDC Description Not Available,1.29,0.52,,,0 CDM,2500000004_00781315895,"Bivalirudin: 10 Vial, Single-Use In 1 Carton (0781-3158-95) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Use (0781-3158-94)",1.35,0.54,,,0 CDM,2500000004_00781315972,Olanzapine: 1 Vial In 1 Carton (0781-3159-72) / 2 Ml In 1 Vial,14.7,5.88,,,0 CDM,2500000004_00781320785,"Ceftriaxone Sodium: 1 Vial, Single-Use In 1 Carton (0781-3207-85) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use",4.4,1.76,,,0 CDM,2500000004_00781320795,"Ceftriaxone Sodium: 10 Vial, Single-Use In 1 Carton (0781-3207-95) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use",2.29,0.92,,,0 CDM,2500000004_00781320885,"Ceftriaxone Sodium: 1 Vial, Single-Use In 1 Carton (0781-3208-85) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use",3.76,1.5,,,0 CDM,2500000004_00781320895,"Ceftriaxone Sodium: 10 Vial, Single-Use In 1 Carton (0781-3208-95) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use",1.45,0.58,,,0 CDM,2500000004_00781320990,NDC Description Not Available,3.43,1.37,,,0 CDM,2500000004_00781320995,"Ceftriaxone Sodium: 10 Vial, Single-Use In 1 Carton (0781-3209-95) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use (0781-3209-90)",3.3,1.32,,,0 CDM,2500000004_00781321046,"Ceftriaxone Sodium: 1 Vial, Pharmacy Bulk Package In 1 Carton (0781-3210-46) / 100 Ml In 1 Vial, Pharmacy Bulk Package",3.1,1.24,,,0 CDM,2500000004_00781323294,NDC Description Not Available,27.21,10.88,,,0 CDM,2500000004_00781323295,Pantoprazole Sodium: 10 Vial In 1 Carton (0781-3232-95) / 10 Ml In 1 Vial (0781-3232-94),9.63,3.85,,,0 CDM,2500000004_00781324494,"Cyclophosphamide: 1 Vial, Single-Dose In 1 Carton (0781-3244-94) / 50 Ml In 1 Vial, Single-Dose",13.85,5.54,,,0 CDM,2500000004_00781324602,NDC Description Not Available,3.13,1.25,,,0 CDM,2500000004_00781324664,Enoxaparin Sodium: 10 Syringe In 1 Carton (0781-3246-64) / .4 Ml In 1 Syringe (0781-3246-02),3.26,1.3,,,0 CDM,2500000004_00781325603,NDC Description Not Available,3.47,1.39,,,0 CDM,2500000004_00781326805,NDC Description Not Available,2.99,1.2,,,0 CDM,2500000004_00781326869,Enoxaparin Sodium: 10 Syringe In 1 Carton (0781-3268-69) / 1 Ml In 1 Syringe (0781-3268-05),3.59,1.44,,,0 CDM,2500000004_00781328809,Clindamycin In 5 Percent Dextrose: 24 Bag In 1 Carton (0781-3288-09) / 50 Ml In 1 Bag (0781-3288-91),33.55,13.42,,,0 CDM,2500000004_00781328891,NDC Description Not Available,34.07,13.63,,,0 CDM,2500000004_00781328909,Clindamycin In 5 Percent Dextrose: 24 Bag In 1 Carton (0781-3289-09) / 50 Ml In 1 Bag (0781-3289-91),17.02,6.81,,,0 CDM,2500000004_00781328991,NDC Description Not Available,20.76,8.3,,,0 CDM,2500000004_00781329009,Clindamycin In 5 Percent Dextrose: 24 Bag In 1 Carton (0781-3290-09) / 50 Ml In 1 Bag (0781-3290-91),13.88,5.55,,,0 CDM,2500000004_00781329091,NDC Description Not Available,13.23,5.29,,,0 CDM,2500000004_00781329804,NDC Description Not Available,3.48,1.39,,,0 CDM,2500000004_00781329868,Enoxaparin Sodium: 10 Syringe In 1 Carton (0781-3298-68) / .8 Ml In 1 Syringe (0781-3298-04),3.59,1.44,,,0 CDM,2500000004_00781331275,"Palonosetron Hydrochloride: 1 Vial, Single-Dose In 1 Carton (0781-3312-75) / 5 Ml In 1 Vial, Single-Dose",4.22,1.69,,,0 CDM,2500000004_00781340278,NDC Description Not Available,11.96,4.78,,,0 CDM,2500000004_00781340295,"Ampicillin: 10 Vial, Glass In 1 Package (0781-3402-95) / 1 Injection, Powder, For Solution In 1 Vial, Glass (0781-3402-78)",11.94,4.78,,,0 CDM,2500000004_00781340485,NDC Description Not Available,13.78,5.51,,,0 CDM,2500000004_00781340880,NDC Description Not Available,14.85,5.94,,,0 CDM,2500000004_00781340895,"Ampicillin: 10 Vial, Glass In 1 Package (0781-3408-95) / 1 Injection, Powder, For Solution In 1 Vial, Glass (0781-3408-80)",2.78,1.11,,,0 CDM,2500000004_00781341170,NDC Description Not Available,2.02,0.81,,,0 CDM,2500000004_00781342780,"Treprostinil: 1 Vial, Multi-Dose In 1 Carton (0781-3427-80) / 20 Ml In 1 Vial, Multi-Dose",243.72,97.49,,,0 CDM,2500000004_00781344071,NDC Description Not Available,169.52,67.81,,,0 CDM,2500000004_00781344095,Cosyntropin: 10 Vial In 1 Carton (0781-3440-95) / 1 Ml In 1 Vial (0781-3440-71),352.88,141.15,,,0 CDM,2500000004_00781345895,"Phenylephrine Hydrochloride: 10 Vial, Pharmacy Bulk Package In 1 Carton (0781-3458-95) / 5 Ml In 1 Vial, Pharmacy Bulk Package (0781-3458-75)",0.01,0.004,,,0 CDM,2500000004_00781353191,"Paclitaxel: 1 Vial, Single-Dose In 1 Carton (0781-3531-91) / 20 Ml In 1 Vial, Single-Dose",78.18,31.27,,,0 CDM,2500000004_00781354010,NDC Description Not Available,0.37,0.15,,,0 CDM,2500000004_00781354510,NDC Description Not Available,1.31,0.52,,,0 CDM,2500000004_00781400332,"Leuprolide Acetate: 1 Kit In 1 Carton (0781-4003-32) * 1 Vial, Multi-Dose In 1 Carton (0781-3006-42) / 2.8 Ml In 1 Vial, Multi-Dose * 1 Ml In 1 Packet",3269.08,1307.63,,,0 CDM,2500000004_00781613594,NDC Description Not Available,5.33,2.13,,,0 CDM,2500000004_00781615394,NDC Description Not Available,146.44,58.58,,,0 CDM,2500000004_00904644161,"Hydralazine Hydrochloride: 100 Blister Pack In 1 Carton (0904-6441-61) / 1 Tablet, Film Coated In 1 Blister Pack",2.65,1.06,,,0 CDM,2500000004_00904646161,Promethazine Hydrochloride: 100 Blister Pack In 1 Carton (0904-6461-61) / 1 Tablet In 1 Blister Pack,0.25,0.1,,,0 CDM,2500000004_00904657261,Allopurinol: 100 Blister Pack In 1 Carton (0904-6572-61) / 1 Tablet In 1 Blister Pack,1.26,0.5,,,0 CDM,2500000004_00904662361,Tacrolimus: 100 Blister Pack In 1 Carton (0904-6623-61) / 1 Capsule In 1 Blister Pack,4.44,1.78,,,0 CDM,2500000004_00904662461,Tacrolimus: 100 Blister Pack In 1 Carton (0904-6624-61) / 1 Capsule In 1 Blister Pack,5.33,2.13,,,0 CDM,2500000004_00904674561,DRONABINOL: 100 BLISTER PACK in 1 CARTON (0904-6745-61) / 1 CAPSULE in 1 BLISTER PACK,14.41,5.76,,,0 CDM,2500000004_00904678504,"Mycophenolic Acid: 30 Blister Pack In 1 Carton (0904-6785-04) / 1 Tablet, Delayed Release In 1 Blister Pack",12.54,5.02,,,0 CDM,2500000004_00904691461,Methylprednisolone: 100 Blister Pack In 1 Carton (0904-6914-61) / 1 Tablet In 1 Blister Pack,4.01,1.6,,,0 CDM,2500000004_00904692361,Prednisone: 100 Blister Pack In 1 Carton (0904-6923-61) / 1 Tablet In 1 Blister Pack,0.05,0.02,,,0 CDM,2500000004_00904704661,"Hydroxychloroquine Sulfate: 100 Blister Pack In 1 Carton (0904-7046-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.54,0.22,,,0 CDM,2500000004_00904707461,Mycophenolate Mofetil: 100 Blister Pack In 1 Carton (0904-7074-61) / 1 Capsule In 1 Blister Pack,1.81,0.72,,,0 CDM,2500000004_00904709761,Tacrolimus: 100 Blister Pack In 1 Carton (0904-7097-61) / 1 Capsule In 1 Blister Pack,4.08,1.63,,,0 CDM,2500000004_00904712761,Prednisone: 100 Blister Pack In 1 Carton (0904-7127-61) / 1 Tablet In 1 Blister Pack,0.03,0.01,,,0 CDM,2500000004_00904714461,Dronabinol: 100 Blister Pack In 1 Carton (0904-7144-61) / 1 Capsule In 1 Blister Pack,19.02,7.61,,,0 CDM,2500000004_00904714504,Dronabinol: 30 Blister Pack In 1 Carton (0904-7145-04) / 1 Capsule In 1 Blister Pack,11.14,4.46,,,0 CDM,2500000004_00904724804,"Sirolimus: 30 Blister Pack In 1 Carton (0904-7248-04) / 1 Tablet, Film Coated In 1 Blister Pack",29.26,11.7,,,0 CDM,2500000004_00904726661,Dexamethasone: 100 Blister Pack In 1 Carton (0904-7266-61) / 1 Tablet In 1 Blister Pack,0.22,0.09,,,0 CDM,2500000004_00904730461,Promethazine Hydrochloride: 100 Blister Pack In 1 Carton (0904-7304-61) / 1 Tablet In 1 Blister Pack,0.23,0.09,,,0 CDM,2500000004_00904738106,Prochlorperazine Maleate: 50 Blister Pack In 1 Carton (0904-7381-06) / 1 Tablet In 1 Blister Pack,3.79,1.52,,,0 CDM,2500000004_00944049301,Flexbumin: 12 Bag In 1 Carton (0944-0493-01) / 50 Ml In 1 Bag (0944-0493-03),249.11,99.64,,,0 CDM,2500000004_00944049303,NDC Description Not Available,261.53,104.61,,,0 CDM,2500000004_00944049505,Flexbumin: 2 Bag In 1 Carton (0944-0495-05) / 250 Ml In 1 Bag (0944-0495-06),50.99,20.4,,,0 CDM,2500000004_00944049506,NDC Description Not Available,83.26,33.3,,,0 CDM,2500000004_00944270002,"Gammagard Liquid: 1 Bottle, Glass In 1 Carton (0944-2700-02) / 10 Ml In 1 Bottle, Glass (0944-2700-08)",172.32,68.93,,,0 CDM,2500000004_00944270004,"Gammagard Liquid: 1 Bottle, Glass In 1 Carton (0944-2700-04) / 50 Ml In 1 Bottle, Glass (0944-2700-10)",387.73,155.09,,,0 CDM,2500000004_00944270005,"Gammagard Liquid: 1 Bottle, Glass In 1 Carton (0944-2700-05) / 100 Ml In 1 Bottle, Glass (0944-2700-11)",388.18,155.27,,,0 CDM,2500000004_00944270006,"Gammagard Liquid: 1 Bottle, Glass In 1 Carton (0944-2700-06) / 200 Ml In 1 Bottle, Glass (0944-2700-12)",387.85,155.14,,,0 CDM,2500000004_00944270007,"Gammagard Liquid: 1 Bottle, Glass In 1 Carton (0944-2700-07) / 300 Ml In 1 Bottle, Glass (0944-2700-13)",384.14,153.66,,,0 CDM,2500000004_00944270008,NDC Description Not Available,384.04,153.62,,,0 CDM,2500000004_00944270010,NDC Description Not Available,384.7,153.88,,,0 CDM,2500000004_00944270011,NDC Description Not Available,386.23,154.49,,,0 CDM,2500000004_00944270012,NDC Description Not Available,387.6,155.04,,,0 CDM,2500000004_00944270013,NDC Description Not Available,384.21,153.68,,,0 CDM,2500000004_00955100401,NDC Description Not Available,9.13,3.65,,,0 CDM,2500000004_00955101001,NDC Description Not Available,9.14,3.66,,,0 CDM,2500000004_00955101201,NDC Description Not Available,9.14,3.66,,,0 CDM,2500000004_00955172901,"Insulin Glargine: 1 Vial, Glass In 1 Carton (0955-1729-01) / 10 Ml In 1 Vial, Glass",1.49,0.6,,,0 CDM,2500000004_00990707426,Potassium Chloride: 24 Pouch In 1 Case (0990-7074-26) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,4.48,1.79,,,0 CDM,2500000004_00990707714,Potassium Chloride: 24 Pouch In 1 Case (0990-7077-14) / 1 Bag In 1 Pouch / 50 Ml In 1 Bag,2.22,0.89,,,0 CDM,2500000004_00990793519,Dextrose: 12 Pouch In 1 Case (0990-7935-19) / 1 Bag In 1 Pouch / 500 Ml In 1 Bag,30.21,12.08,,,0 CDM,2500000004_00990798309,Sodium Chloride: 12 Pouch In 1 Case (0990-7983-09) / 1 Bag In 1 Pouch / 1000 Ml In 1 Bag,2.2,0.88,,,0 CDM,2500000004_08290 0,NDC Description Not Available,0.05,0.02,,,0 CDM,2500000004_09999001503,NDC Description Not Available,90.51,36.2,,,0 CDM,2500000004_09999001802,NDC Description Not Available,0.32,0.13,,,0 CDM,2500000004_09999200111,NDC Description Not Available,9.54,3.82,,,0 CDM,2500000004_09999409171,NDC Description Not Available,31.76,12.7,,,0 CDM,2500000004_09999409261,NDC Description Not Available,1.57,0.63,,,0 CDM,2500000004_09999505006,NDC Description Not Available,0.07,0.03,,,0 CDM,2500000004_09999700011,NDC Description Not Available,126.04,50.42,,,0 CDM,2500000004_09999727064,NDC Description Not Available,536.62,214.65,,,0 CDM,2500000004_10019007587,Brevibloc: 10 Bag In 1 Carton (10019-075-87) / 100 Ml In 1 Bag,11.31,4.52,,,0 CDM,2500000004_10019012039,NDC Description Not Available,5.36,2.14,,,0 CDM,2500000004_10019092602,"Ifosfamide: 1 Vial, Single-Dose In 1 Carton (10019-926-02) / 60 Ml In 1 Vial, Single-Dose (10019-926-16)",139.72,55.89,,,0 CDM,2500000004_10019092616,NDC Description Not Available,96.03,38.41,,,0 CDM,2500000004_10019095301,"Mesna: 1 Vial, Multi-Dose In 1 Box (10019-953-01) / 10 Ml In 1 Vial, Multi-Dose (10019-953-62)",22.29,8.92,,,0 CDM,2500000004_10019095362,NDC Description Not Available,22.29,8.92,,,0 CDM,2500000004_10019095601,"Cyclophosphamide: 1 Vial, Single-Dose In 1 Carton (10019-956-01) / 50 Ml In 1 Vial, Single-Dose (10019-956-16)",15.07,6.03,,,0 CDM,2500000004_10019095616,NDC Description Not Available,15.63,6.25,,,0 CDM,2500000004_10122032501,NDC Description Not Available,2.13,0.85,,,0 CDM,2500000004_10122032510,Cardene IV: 10 CARTON in 1 BOX (10122-325-10) / 1 BAG in 1 CARTON (10122-325-01) / 200 mL in 1 BAG,2.13,0.85,,,0 CDM,2500000004_10122061101,NDC Description Not Available,14.44,5.78,,,0 CDM,2500000004_10122062001,NDC Description Not Available,82.03,32.81,,,0 CDM,2500000004_10122062010,"Kengreal: 10 Vial, Single-Use In 1 Carton (10122-620-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Use (10122-620-01)",86.63,34.65,,,0 CDM,2500000004_10147092205,Haloperidol Decanoate: 5 Ampule In 1 Box (10147-0922-5) / 1 Ml In 1 Ampule,75.42,30.17,,,0 CDM,2500000004_10454071110,"Myobloc: 1 Vial, Single-Use In 1 Carton (10454-711-10) / 1 Ml In 1 Vial, Single-Use",55.52,22.21,,,0 CDM,2500000004_10454071210,"Myobloc: 1 Vial, Single-Use In 1 Carton (10454-712-10) / 2 Ml In 1 Vial, Single-Use",54.79,21.92,,,0 CDM,2500000004_11701008333,Critic-Aid Clear: 71 G In 1 Tube (11701-083-33),23.22,9.29,,,0 CDM,2500000004_11704037001,"Cyanokit: 1 VIAL, GLASS in 1 CARTON (11704-370-01) / 250 mL in 1 VIAL, GLASS",19.09,7.64,,,0 CDM,2500000004_12496030001,Sublocade: 1 Pouch In 1 Carton (12496-0300-1) / 1 Syringe In 1 Pouch (12496-0300-2) / 1 Solution In 1 Syringe (12496-0300-5),335.73,134.29,,,0 CDM,2500000004_13533031801,Hyperrab: 1 Vial In 1 Carton (13533-318-01) / 1 Ml In 1 Vial (13533-318-10),1878.61,751.44,,,0 CDM,2500000004_13533031805,Hyperrab: 1 Vial In 1 Carton (13533-318-05) / 5 Ml In 1 Vial (13533-318-50),1924.27,769.71,,,0 CDM,2500000004_13533031810,NDC Description Not Available,1682.02,672.81,,,0 CDM,2500000004_13533031850,NDC Description Not Available,1682.84,673.14,,,0 CDM,2500000004_13533063402,"Hypertet: 1 Syringe, Glass In 1 Box (13533-634-02) / 1 Ml In 1 Syringe, Glass (13533-634-20)",2856.35,1142.54,,,0 CDM,2500000004_13533063420,NDC Description Not Available,2773.12,1109.25,,,0 CDM,2500000004_13533080012,"Gamunex-C: 1 Vial, Glass In 1 Carton (13533-800-12) / 10 Ml In 1 Vial, Glass (13533-800-13)",311.19,124.48,,,0 CDM,2500000004_13533080013,NDC Description Not Available,316.63,126.65,,,0 CDM,2500000004_13533080020,"Gamunex-C: 1 Vial, Glass In 1 Carton (13533-800-20) / 50 Ml In 1 Vial, Glass (13533-800-21)",395.44,158.18,,,0 CDM,2500000004_13533080021,NDC Description Not Available,397.44,158.98,,,0 CDM,2500000004_13533080024,"Gamunex-C: 1 Vial, Glass In 1 Carton (13533-800-24) / 200 Ml In 1 Vial, Glass (13533-800-25)",395.55,158.22,,,0 CDM,2500000004_13533080025,NDC Description Not Available,372.34,148.94,,,0 CDM,2500000004_13533080040,"Gamunex-C: 1 Vial, Glass In 1 Carton (13533-800-40) / 400 Ml In 1 Vial, Glass (13533-800-41)",398.14,159.26,,,0 CDM,2500000004_13533080041,NDC Description Not Available,408.04,163.22,,,0 CDM,2500000004_13533080071,"Gamunex-C: 1 Vial, Glass In 1 Carton (13533-800-71) / 100 Ml In 1 Vial, Glass (13533-800-72)",398.06,159.22,,,0 CDM,2500000004_13533080072,NDC Description Not Available,392.89,157.16,,,0 CDM,2500000004_14789010910,Potassium Chloride: 24 Bag In 1 Box (14789-109-10) / 100 Ml In 1 Bag (14789-109-16),35.51,14.2,,,0 CDM,2500000004_14789010916,NDC Description Not Available,35.51,14.2,,,0 CDM,2500000004_14789011607,NDC Description Not Available,441.67,176.67,,,0 CDM,2500000004_14789012107,NDC Description Not Available,21.81,8.72,,,0 CDM,2500000004_14789012705,"Phenobarbital Sodium: 10 Vial, Glass In 1 Carton (14789-127-05) / 1 Ml In 1 Vial, Glass (14789-127-07)",86.05,34.42,,,0 CDM,2500000004_14789012707,NDC Description Not Available,44.68,17.87,,,0 CDM,2500000004_14789012807,NDC Description Not Available,100.53,40.21,,,0 CDM,2500000004_14789013607,NDC Description Not Available,7.13,2.85,,,0 CDM,2500000004_14789013705,"Potassium Chloride: 25 Vial, Glass In 1 Carton (14789-137-05) / 20 Ml In 1 Vial, Glass (14789-137-07)",4.71,1.88,,,0 CDM,2500000004_14789013707,NDC Description Not Available,4.62,1.85,,,0 CDM,2500000004_14789090107,NDC Description Not Available,1353.51,541.4,,,0 CDM,2500000004_15054004301,"Onivyde: 1 Vial, Single-Dose In 1 Carton (15054-0043-1) / 10 Ml In 1 Vial, Single-Dose",303.22,121.29,,,0 CDM,2500000004_15054050001,"Dysport: 1 Vial In 1 Carton (15054-0500-1) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",38.66,15.46,,,0 CDM,2500000004_15054053006,"Dysport: 1 Vial In 1 Carton (15054-0530-6) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",38.68,15.47,,,0 CDM,2500000004_15054112004,Somatuline Depot: 1 Pouch In 1 Carton (15054-1120-4) / 1 Syringe In 1 Pouch / .5 Ml In 1 Syringe,341.36,136.54,,,0 CDM,2500000004_16571081741,Temozolomide: 14 Capsule In 1 Bottle (16571-817-41),6.56,2.62,,,0 CDM,2500000004_16571081841,Temozolomide: 14 Capsule In 1 Bottle (16571-818-41),3.49,1.4,,,0 CDM,2500000004_16729009416,Mycophenolate Mofetil: 500 Capsule In 1 Bottle (16729-094-16),0.6,0.24,,,0 CDM,2500000004_16729010811,"Mitomycin: 1 Vial In 1 Box, Unit-Dose (16729-108-11) / 40 Ml In 1 Vial",154.83,61.93,,,0 CDM,2500000004_16729011408,"Etoposide: 1 Vial, Multi-Dose In 1 Box (16729-114-08) / 25 Ml In 1 Vial, Multi-Dose",3.75,1.5,,,0 CDM,2500000004_16729011411,"Etoposide: 1 Vial, Multi-Dose In 1 Box (16729-114-11) / 50 Ml In 1 Vial, Multi-Dose",5.48,2.19,,,0 CDM,2500000004_16729011431,"Etoposide: 1 Vial, Multi-Dose In 1 Box (16729-114-31) / 5 Ml In 1 Vial, Multi-Dose",4.41,1.76,,,0 CDM,2500000004_16729024231,Zoledronic Acid: 1 Vial In 1 Carton (16729-242-31) / 5 Ml In 1 Vial,15.31,6.12,,,0 CDM,2500000004_16729024331,"Topotecan: 1 Vial, Multi-Dose In 1 Carton (16729-243-31) / 4 Ml In 1 Vial, Multi-Dose",14.36,5.74,,,0 CDM,2500000004_16729027567,"Bivalirudin: 10 Vial, Single-Use In 1 Carton (16729-275-67) / 5 Ml In 1 Vial, Single-Use (16729-275-03)",0.76,0.3,,,0 CDM,2500000004_16729027668,Fluorouracil: 10 Vial In 1 Carton (16729-276-68) / 10 Ml In 1 Vial (16729-276-03),55.02,22.01,,,0 CDM,2500000004_16729027730,Methotrexate: 1 Vial In 1 Carton (16729-277-30) / 2 Ml In 1 Vial,6.47,2.59,,,0 CDM,2500000004_16729027735,Methotrexate: 1 Vial In 1 Carton (16729-277-35) / 40 Ml In 1 Vial,7.12,2.85,,,0 CDM,2500000004_16729028838,Cisplatin: 100 Ml In 1 Vial (16729-288-38),10.33,4.13,,,0 CDM,2500000004_16729029512,"Carboplatin: 1 Vial, Multi-Dose In 1 Carton (16729-295-12) / 60 Ml In 1 Vial, Multi-Dose",20.28,8.11,,,0 CDM,2500000004_16729049303,"Succinylcholine Chloride: 1 VIAL, MULTI-DOSE in 1 CARTON (16729-493-03) / 10 mL in 1 VIAL, MULTI-DOSE",2.47,0.99,,,0 CDM,2500000004_16729049345,"Succinylcholine Chloride: 10 VIAL, MULTI-DOSE in 1 CARTON (16729-493-45) / 10 mL in 1 VIAL, MULTI-DOSE",3.86,1.54,,,0 CDM,2500000004_16729052663,"Atropine Sulfate: 1 Vial, Single-Dose In 1 Carton (16729-526-63) / 1 Ml In 1 Vial, Single-Dose",0.91,0.36,,,0 CDM,2500000004_17478008130,"Ropivacaine Hydrochloride: 1 VIAL, SINGLE-DOSE in 1 CARTON (17478-081-30) / 30 mL in 1 VIAL, SINGLE-DOSE",0.17,0.07,,,0 CDM,2500000004_17478038020,"Methadone Hydrochloride: 20 mL in 1 VIAL, MULTI-DOSE (17478-380-20)",11.13,4.45,,,0 CDM,2500000004_17478093705,Diltiazem Hydrochloride: 10 VIAL in 1 CARTON (17478-937-05) / 5 mL in 1 VIAL,0.24,0.1,,,0 CDM,2500000004_18657011701,NDC Description Not Available,1.64,0.66,,,0 CDM,2500000004_18657011704,Hylenex Recombinant: 4 Box In 1 Carton (18657-117-04) / 1 Vial In 1 Box (18657-117-02) / 1 Ml In 1 Vial (18657-117-01),1.66,0.66,,,0 CDM,2500000004_18860072210,"Prialt: 1 VIAL, GLASS in 1 CARTON (18860-722-10) / 5 mL in 1 VIAL, GLASS",44.93,17.97,,,0 CDM,2500000004_19515081041,NDC Description Not Available,99.86,39.94,,,0 CDM,2500000004_19515081052,Flulaval 2024/2025: 10 Syringe In 1 Carton (19515-810-52) / .5 Ml In 1 Syringe (19515-810-41),67.9,27.16,,,0 CDM,2500000004_19515081441,NDC Description Not Available,74.27,29.71,,,0 CDM,2500000004_21586011002,NDC Description Not Available,38.7,15.48,,,0 CDM,2500000004_23155021631,"Cidofovir Dihydrate: 5 Ml In 1 Vial, Glass (23155-216-31)",2212.51,885.0,,,0 CDM,2500000004_23155024031,NDC Description Not Available,9.89,3.96,,,0 CDM,2500000004_23155024041,Metoclopramide: 25 Vial In 1 Carton (23155-240-41) / 2 Ml In 1 Vial (23155-240-31),9.49,3.8,,,0 CDM,2500000004_23155029032,NDC Description Not Available,7.13,2.85,,,0 CDM,2500000004_23155029431,NDC Description Not Available,26.21,10.48,,,0 CDM,2500000004_23155029441,Prochlorperazine Edisylate: 25 Vial In 1 Package (23155-294-41) / 2 Ml In 1 Vial (23155-294-31),13.35,5.34,,,0 CDM,2500000004_23155029442,Prochlorperazine Edisylate: 10 Vial In 1 Package (23155-294-42) / 2 Ml In 1 Vial (23155-294-31),31.8,12.72,,,0 CDM,2500000004_23155031331,"Acetazolamide: 5 Ml In 1 Vial, Glass (23155-313-31)",170.14,68.06,,,0 CDM,2500000004_23155034532,NDC Description Not Available,0.38,0.15,,,0 CDM,2500000004_23155047332,NDC Description Not Available,0.59,0.24,,,0 CDM,2500000004_23155051831,NDC Description Not Available,1.48,0.59,,,0 CDM,2500000004_23155054731,NDC Description Not Available,0.63,0.25,,,0 CDM,2500000004_23155054741,Ondansetron: 10 Vial In 1 Carton (23155-547-41) / 2 Ml In 1 Vial (23155-547-31),0.49,0.2,,,0 CDM,2500000004_23155054742,Ondansetron: 25 Vial In 1 Carton (23155-547-42) / 2 Ml In 1 Vial (23155-547-31),0.58,0.23,,,0 CDM,2500000004_23155054931,Ondansetron: 1 Vial In 1 Carton (23155-549-31) / 20 Ml In 1 Vial,0.94,0.38,,,0 CDM,2500000004_23155060031,NDC Description Not Available,1.1,0.44,,,0 CDM,2500000004_23155060041,"Midazolam Hydrochloride: 25 Vial, Single-Dose In 1 Carton (23155-600-41) / 2 Ml In 1 Vial, Single-Dose (23155-600-31)",1.15,0.46,,,0 CDM,2500000004_23155060132,NDC Description Not Available,0.54,0.22,,,0 CDM,2500000004_23155060142,"Midazolam Hydrochloride: 10 Vial, Multi-Dose In 1 Carton (23155-601-42) / 10 Ml In 1 Vial, Multi-Dose (23155-601-32)",0.5,0.2,,,0 CDM,2500000004_23155064941,"Carmustine: 1 Kit In 1 Carton (23155-649-41) * 3 Ml In 1 Vial (23155-648-31) * 30 Ml In 1 Vial, Single-Dose (23155-647-31)",1168.39,467.36,,,0 CDM,2500000004_23155068631,"Octreotide Acetate: 5 Ml In 1 Vial, Glass (23155-686-31)",4.63,1.85,,,0 CDM,2500000004_23155068741,"Octreotide Acetate: 10 Vial, Glass In 1 Carton (23155-687-41) / 1 Ml In 1 Vial, Glass (23155-687-31)",7.44,2.98,,,0 CDM,2500000004_23155068841,"Octreotide Acetate: 10 Vial, Glass In 1 Carton (23155-688-41) / 1 Ml In 1 Vial, Glass (23155-688-31)",2.39,0.96,,,0 CDM,2500000004_23155077131,"Foscarnet Sodium: 1 Bottle, Glass In 1 Carton (23155-771-31) / 250 Ml In 1 Bottle, Glass",126.32,50.53,,,0 CDM,2500000004_23155083711,NDC Description Not Available,2.65,1.06,,,0 CDM,2500000004_23155088431,"Paclitaxel Paclitaxel: 1 Vial, Multi-Dose In 1 Carton (23155-884-31) / 50 Ml In 1 Vial, Multi-Dose",0.79,0.32,,,0 CDM,2500000004_24201001020,Pentobarbital Sodium: 1 Vial In 1 Carton (24201-010-20) / 20 Ml In 1 Vial,144.33,57.73,,,0 CDM,2500000004_24201001050,Pentobarbital Sodium: 1 Vial In 1 Carton (24201-010-50) / 50 Ml In 1 Vial,202.15,80.86,,,0 CDM,2500000004_24201010001,NDC Description Not Available,0.48,0.19,,,0 CDM,2500000004_24201040002,"Calcitonin Salmon: 1 Vial, Multi-Dose In 1 Carton (24201-400-02) / 2 Ml In 1 Vial, Multi-Dose",4046.19,1618.48,,,0 CDM,2500000004_24338027001,"Vivimusta: 1 Vial, Multi-Dose In 1 Carton (24338-270-01) / 4 Ml In 1 Vial, Multi-Dose",144.04,57.62,,,0 CDM,2500000004_24643001179,NDC Description Not Available,0.02,0.01,,,0 CDM,2500000004_25021005301,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (25021-053-01) / 1 Ml In 1 Vial,0.55,0.22,,,0 CDM,2500000004_25021010610,"Ceftriaxone: 25 Vial In 1 Carton (25021-106-10) / 1 Injection, Powder, For Solution In 1 Vial",2.1,0.84,,,0 CDM,2500000004_25021010720,"Ceftriaxone: 25 Vial In 1 Carton (25021-107-20) / 1 Injection, Powder, For Solution In 1 Vial",2.45,0.98,,,0 CDM,2500000004_25021011020,"Cefoxitin: 10 Vial In 1 Carton (25021-110-20) / 1 Injection, Powder, For Solution In 1 Vial",22.0,8.8,,,0 CDM,2500000004_25021012120,"Cefepime: 10 Vial In 1 Carton (25021-121-20) / 1 Injection, Powder, For Solution In 1 Vial",9.42,3.77,,,0 CDM,2500000004_25021012999,Ceftazidime: 6 Bottle In 1 Carton (25021-129-99) / 30 Ml In 1 Bottle,1.68,0.67,,,0 CDM,2500000004_25021013182,Metronidazole: 24 Pouch In 1 Carton (25021-131-82) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,0.18,0.07,,,0 CDM,2500000004_25021013282,Levofloxacin: 24 Pouch In 1 Carton (25021-132-82) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,4.6,1.84,,,0 CDM,2500000004_25021013283,Levofloxacin: 24 Pouch In 1 Carton (25021-132-83) / 1 Bag In 1 Pouch / 150 Ml In 1 Bag,10.86,4.34,,,0 CDM,2500000004_25021013610,"Ampicillin: 10 Vial In 1 Carton (25021-136-10) / 1 Injection, Powder, For Solution In 1 Vial",4.82,1.93,,,0 CDM,2500000004_25021013720,"Ampicillin: 10 Vial In 1 Carton (25021-137-20) / 1 Injection, Powder, For Solution In 1 Vial",3.75,1.5,,,0 CDM,2500000004_25021014330,"Ampicillin And Sulbactam: 10 Vial In 1 Carton (25021-143-30) / 1 Injection, Powder, For Solution In 1 Vial",20.05,8.02,,,0 CDM,2500000004_25021017620,"Piperacillin, Tazobactam: 10 Vial In 1 Carton (25021-176-20) / 15 Ml In 1 Vial",2.66,1.06,,,0 CDM,2500000004_25021018467,Fluconazole: 10 Pouch In 1 Carton (25021-184-67) / 1 Bag In 1 Pouch / 200 Ml In 1 Bag,9.44,3.78,,,0 CDM,2500000004_25021018482,Fluconazole: 10 Pouch In 1 Carton (25021-184-82) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,39.6,15.84,,,0 CDM,2500000004_25021018487,Fluconazole: 10 Pouch In 1 Carton (25021-184-87) / 1 Bag In 1 Pouch / 200 Ml In 1 Bag,32.07,12.83,,,0 CDM,2500000004_25021019110,Micafungin: 1 Vial In 1 Carton (25021-191-10) / 5 Ml In 1 Vial,8.2,3.28,,,0 CDM,2500000004_25021019287,Ciprofloxacin: 24 Pouch In 1 Carton (25021-192-87) / 1 Bag In 1 Pouch / 200 Ml In 1 Bag,5.98,2.39,,,0 CDM,2500000004_25021020110,Mesna: 1 Vial In 1 Carton (25021-201-10) / 10 Ml In 1 Vial,17.56,7.02,,,0 CDM,2500000004_25021020405,Vinorelbine: 1 Vial In 1 Carton (25021-204-05) / 5 Ml In 1 Vial,87.0,34.8,,,0 CDM,2500000004_25021020751,Doxorubicin Hydrochloride: 1 Vial In 1 Carton (25021-207-51) / 100 Ml In 1 Vial,5.74,2.3,,,0 CDM,2500000004_25021021598,Fluorouracil: 1 Bottle In 1 Carton (25021-215-98) / 50 Ml In 1 Bottle,11.3,4.52,,,0 CDM,2500000004_25021021599,Fluorouracil: 1 Bottle In 1 Carton (25021-215-99) / 100 Ml In 1 Bottle,11.27,4.51,,,0 CDM,2500000004_25021021920,Decitabine: 1 Vial In 1 Carton (25021-219-20) / 20 Ml In 1 Vial,3.88,1.55,,,0 CDM,2500000004_25021022320,Cytarabine: 1 Vial In 1 Carton (25021-223-20) / 20 Ml In 1 Vial,2.26,0.9,,,0 CDM,2500000004_25021022610,Arsenic Trioxide: 10 Vial In 1 Carton (25021-226-10) / 10 Ml In 1 Vial,32.35,12.94,,,0 CDM,2500000004_25021024110,Busulfan: 8 Vial In 1 Carton (25021-241-10) / 10 Ml In 1 Vial,37.62,15.05,,,0 CDM,2500000004_25021024202,Fludarabine Phosphate: 1 Vial In 1 Carton (25021-242-02) / 2 Ml In 1 Vial,720.44,288.18,,,0 CDM,2500000004_25021024410,"Bortezomib: 1 Vial In 1 Carton (25021-244-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",3.33,1.33,,,0 CDM,2500000004_25021024851,Cyclophosphamide: 1 Vial In 1 Carton (25021-248-51) / 50 Ml In 1 Vial,5.58,2.23,,,0 CDM,2500000004_25021025150,Mitomycin: 1 Vial In 1 Carton (25021-251-50) / 40 Ml In 1 Vial,590.9,236.36,,,0 CDM,2500000004_25021025861,Melphalan Hydrochloride: 1 Kit In 1 Carton (25021-258-61) * 10 Ml In 1 Vial (25021-256-10) * 10 Ml In 1 Vial (25021-257-10),558.12,223.25,,,0 CDM,2500000004_25021025950,Nelarabine: 1 Vial In 1 Carton (25021-259-50) / 50 Ml In 1 Vial,215.69,86.28,,,0 CDM,2500000004_25021030520,Chlorothiazide Sodium: 1 Vial In 1 Carton (25021-305-20) / 18 Ml In 1 Vial,232.27,92.91,,,0 CDM,2500000004_25021030982,Esmolol Hydrochloride: 10 Bag In 1 Carton (25021-309-82) / 100 Ml In 1 Bag,3.4,1.36,,,0 CDM,2500000004_25021031102,Furosemide: 25 Vial In 1 Carton (25021-311-02) / 2 Ml In 1 Vial,3.23,1.29,,,0 CDM,2500000004_25021031104,Furosemide: 25 Vial In 1 Carton (25021-311-04) / 4 Ml In 1 Vial,2.19,0.88,,,0 CDM,2500000004_25021031110,Furosemide: 25 Vial In 1 Carton (25021-311-10) / 10 Ml In 1 Vial,1.32,0.53,,,0 CDM,2500000004_25021031382,Milrinone Lactate In Dextrose: 10 Bag In 1 Carton (25021-313-82) / 100 Ml In 1 Bag,11.1,4.44,,,0 CDM,2500000004_25021031802,Adenosine: 10 Vial In 1 Carton (25021-318-02) / 2 Ml In 1 Vial,4.5,1.8,,,0 CDM,2500000004_25021031905,Diltiazem Hydrochloride: 10 Vial In 1 Carton (25021-319-05) / 5 Ml In 1 Vial,0.23,0.09,,,0 CDM,2500000004_25021032104,Bumetanide: 10 Vial In 1 Carton (25021-321-04) / 4 Ml In 1 Vial,5.61,2.24,,,0 CDM,2500000004_25021032110,Bumetanide: 10 Vial In 1 Carton (25021-321-10) / 10 Ml In 1 Vial,1.64,0.66,,,0 CDM,2500000004_25021040010,Heparin Sodium: 25 Vial In 1 Carton (25021-400-10) / 10 Ml In 1 Vial,1.59,0.64,,,0 CDM,2500000004_25021040304,Heparin Sodium: 25 Vial In 1 Carton (25021-403-04) / 4 Ml In 1 Vial,0.84,0.34,,,0 CDM,2500000004_25021046301,Octreotide Acetate: 10 Vial In 1 Carton (25021-463-01) / 1 Ml In 1 Vial,5.23,2.09,,,0 CDM,2500000004_25021046705,Octreotide Acetate: 1 Vial In 1 Carton (25021-467-05) / 5 Ml In 1 Vial,7.54,3.02,,,0 CDM,2500000004_25021046810,Levothyroxine Sodium: 1 Vial In 1 Carton (25021-468-10) / 5 Ml In 1 Vial,40.57,16.23,,,0 CDM,2500000004_25021050002,Thiamine Hydrochloride: 25 Vial In 1 Carton (25021-500-02) / 2 Ml In 1 Vial,22.03,8.81,,,0 CDM,2500000004_25021060103,Caffeine Citrate: 1 Vial In 1 Carton (25021-601-03) / 3 Ml In 1 Vial,1.33,0.53,,,0 CDM,2500000004_25021060851,Propofol: 10 Vial In 1 Carton (25021-608-51) / 100 Ml In 1 Vial,1.28,0.51,,,0 CDM,2500000004_25021067182,Ropivacaine Hydrochloride: 10 Bag In 1 Carton (25021-671-82) / 100 Ml In 1 Bag,0.99,0.4,,,0 CDM,2500000004_25021067187,Ropivacaine Hydrochloride: 10 Bag In 1 Carton (25021-671-87) / 200 Ml In 1 Bag,0.45,0.18,,,0 CDM,2500000004_25021067620,Pentobarbital Sodium: 1 Vial In 1 Carton (25021-676-20) / 20 Ml In 1 Vial,154.27,61.71,,,0 CDM,2500000004_25021067650,Pentobarbital Sodium: 1 Vial In 1 Carton (25021-676-50) / 50 Ml In 1 Vial,188.52,75.41,,,0 CDM,2500000004_25021075110,Pantoprazole Sodium: 10 Vial In 1 Carton (25021-751-10) / 10 Ml In 1 Vial,8.81,3.52,,,0 CDM,2500000004_25021079002,Prochlorperazine Edisylate: 10 Vial In 1 Carton (25021-790-02) / 2 Ml In 1 Vial,14.24,5.7,,,0 CDM,2500000004_25021081230,Acetylcysteine: 4 Vial In 1 Carton (25021-812-30) / 30 Ml In 1 Vial,2.98,1.19,,,0 CDM,2500000004_25021081430,Leucovorin Calcium: 1 Vial In 1 Carton (25021-814-30) / 10 Ml In 1 Vial,20.07,8.03,,,0 CDM,2500000004_25021081530,Leucovorin Calcium: 1 Vial In 1 Carton (25021-815-30) / 20 Ml In 1 Vial,15.9,6.36,,,0 CDM,2500000004_25021081630,Leucovorin Calcium: 1 Vial In 1 Carton (25021-816-30) / 17.5 Ml In 1 Vial,44.05,17.62,,,0 CDM,2500000004_25021082005,Methylprednisolone Acetate: 1 Vial In 1 Carton (25021-820-05) / 5 Ml In 1 Vial,0.8,0.32,,,0 CDM,2500000004_25021082682,Zoledronic Acid: 1 Bag In 1 Carton (25021-826-82) / 100 Ml In 1 Bag,201.0,80.4,,,0 CDM,2500000004_25021083082,Zoledronic Acid: 1 Bag In 1 Carton (25021-830-82) / 100 Ml In 1 Bag,312.32,124.93,,,0 CDM,2500000004_25682000101,Soliris: 1 Vial In 1 Carton (25682-001-01) / 30 Ml In 1 Vial,506.49,202.6,,,0 CDM,2500000004_25682002501,"Ultomiris: 1 Vial, Glass In 1 Carton (25682-025-01) / 3 Ml In 1 Vial, Glass",949.72,379.89,,,0 CDM,2500000004_25682002801,"Ultomiris: 1 Vial, Glass In 1 Carton (25682-028-01) / 11 Ml In 1 Vial, Glass",950.35,380.14,,,0 CDM,2500000004_31722011620,NDC Description Not Available,0.07,0.03,,,0 CDM,2500000004_31722011634,"Lidocaine Hydrochloride: 10 Vial, Multi-Dose In 1 Carton (31722-116-34) / 50 Ml In 1 Vial, Multi-Dose (31722-116-50)",0.03,0.01,,,0 CDM,2500000004_31722020431,NDC Description Not Available,18.32,7.33,,,0 CDM,2500000004_31722030801,Olanzapine: 1 Vial In 1 Carton (31722-308-01) / 2 Ml In 1 Vial,5.49,2.2,,,0 CDM,2500000004_31722098110,NDC Description Not Available,0.94,0.38,,,0 CDM,2500000004_31722098131,"Succinylcholine Chloride: 25 Vial, Multi-Dose In 1 Carton (31722-981-31) / 10 Ml In 1 Vial, Multi-Dose (31722-981-10)",0.46,0.18,,,0 CDM,2500000004_31722099510,NDC Description Not Available,1.42,0.57,,,0 CDM,2500000004_31722099531,"Neostigmine Methylsulfate: 10 Vial, Multi-Dose In 1 Carton (31722-995-31) / 10 Ml In 1 Vial, Multi-Dose",1.25,0.5,,,0 CDM,2500000004_33332002403,"Afluria: 10 Syringe, Glass In 1 Carton (33332-024-03) / .5 Ml In 1 Syringe, Glass (33332-024-04)",83.11,33.24,,,0 CDM,2500000004_34324000607,NDC Description Not Available,6.18,2.47,,,0 CDM,2500000004_36000001225,"Ondansetron Hydrochloride: 25 Vial, Single-Dose In 1 Carton (36000-012-25) / 2 Ml In 1 Vial, Single-Dose",0.49,0.2,,,0 CDM,2500000004_36000003310,Metoprolol: 10 Vial In 1 Carton (36000-033-10) / 5 Ml In 1 Vial,0.62,0.25,,,0 CDM,2500000004_36000004624,Levofloxacin: 50 Ml In 1 Bag (36000-046-24),9.66,3.86,,,0 CDM,2500000004_36000024201,"Tobramycin: 1 Vial, Multi-Dose In 1 Carton (36000-242-01) / 30 Ml In 1 Vial, Multi-Dose",5.46,2.18,,,0 CDM,2500000004_36000028325,"Furosemide: 25 Vial, Single-Dose In 1 Box (36000-283-25) / 4 Ml In 1 Vial, Single-Dose",0.17,0.07,,,0 CDM,2500000004_36000028425,"Furosemide: 25 Vial, Single-Dose In 1 Box (36000-284-25) / 10 Ml In 1 Vial, Single-Dose",1.53,0.61,,,0 CDM,2500000004_36000032010,Labetalol Hydrochloride: 10 Vial In 1 Carton (36000-320-10) / 4 Ml In 1 Vial (36000-320-01),3.66,1.46,,,0 CDM,2500000004_36000032201,NDC Description Not Available,0.45,0.18,,,0 CDM,2500000004_36000032202,Labetalol Hydrochloride: 1 Vial In 1 Carton (36000-322-02) / 20 Ml In 1 Vial (36000-322-01),0.47,0.19,,,0 CDM,2500000004_36000032401,NDC Description Not Available,0.2,0.08,,,0 CDM,2500000004_38779036403,Beclomethasone Dipropionate: 5 G In 1 Jar (38779-0364-3),1.41,0.56,,,0 CDM,2500000004_38779051008,NDC Description Not Available,1.08,0.43,,,0 CDM,2500000004_38779061409,NDC Description Not Available,158.1,63.24,,,0 CDM,2500000004_38779247108,NDC Description Not Available,1572.42,628.97,,,0 CDM,2500000004_39822019001,"Acetazolamide: 1 Vial, Glass In 1 Carton (39822-0190-1) / 5 Ml In 1 Vial, Glass",139.62,55.85,,,0 CDM,2500000004_39822025501,"Cyclophosphamide: 1 Vial, Single-Dose In 1 Carton (39822-0255-1) / 50 Ml In 1 Vial, Single-Dose",4.05,1.62,,,0 CDM,2500000004_39822041201,Tobramycin: 1 Vial In 1 Carton (39822-0412-1) / 30 Ml In 1 Vial,23.33,9.33,,,0 CDM,2500000004_39822041206,Tobramycin: 6 Vial In 1 Carton (39822-0412-6) / 30 Ml In 1 Vial,20.41,8.16,,,0 CDM,2500000004_39822103001,NDC Description Not Available,510.07,204.03,,,0 CDM,2500000004_39822103002,Ibuprofen Lysine: 3 Vial In 1 Carton (39822-1030-2) / 2 Ml In 1 Vial (39822-1030-1),472.01,188.8,,,0 CDM,2500000004_39822105505,Amphotericin B: 10 Ml In 1 Vial (39822-1055-5),148.34,59.34,,,0 CDM,2500000004_39822110001,"Folic Acid: 1 Vial, Multi-Dose In 1 Carton (39822-1100-1) / 10 Ml In 1 Vial, Multi-Dose",0.26,0.1,,,0 CDM,2500000004_39822210002,"Dactinomycin: 1 Vial, Single-Dose In 1 Carton (39822-2100-2) / 1 Ml In 1 Vial, Single-Dose (39822-2100-1)",3306.88,1322.75,,,0 CDM,2500000004_39822420002,Rocuronium Bromide: 10 Vial In 1 Carton (39822-4200-2) / 5 Ml In 1 Vial (39822-4200-1),1.15,0.46,,,0 CDM,2500000004_42023011101,"Delestrogen: 5 Ml In 1 Vial, Multi-Dose (42023-111-01)",62.6,25.04,,,0 CDM,2500000004_42023015701,Ethacrynate Sodium: 1 Vial In 1 Carton (42023-157-01) / 50 Ml In 1 Vial,2400.51,960.2,,,0 CDM,2500000004_42023015901,NDC Description Not Available,6.67,2.67,,,0 CDM,2500000004_42023015925,Adrenalin: 25 Vial In 1 Carton (42023-159-25) / 1 Ml In 1 Vial (42023-159-01),6.67,2.67,,,0 CDM,2500000004_42023016401,NDC Description Not Available,10.03,4.01,,,0 CDM,2500000004_42023016425,Vasostrict: 25 Vial In 1 Carton (42023-164-25) / 1 Ml In 1 Vial (42023-164-01),9.03,3.61,,,0 CDM,2500000004_42023016801,Adrenalin: 1 Vial In 1 Carton (42023-168-01) / 30 Ml In 1 Vial,4.57,1.83,,,0 CDM,2500000004_42023017301,NDC Description Not Available,110.82,44.33,,,0 CDM,2500000004_42023017901,NDC Description Not Available,20.02,8.01,,,0 CDM,2500000004_42023017905,Buprenorphine Hydrochloride: 5 Vial In 1 Carton (42023-179-05) / 1 Ml In 1 Vial,18.61,7.44,,,0 CDM,2500000004_42023019001,Vasostrict: 1 Vial In 1 Carton (42023-190-01) / 10 Ml In 1 Vial,4.4,1.76,,,0 CDM,2500000004_42023019501,"Posaconazole: 1 Vial, Glass In 1 Carton (42023-195-01) / 16.7 Ml In 1 Vial, Glass",701.78,280.71,,,0 CDM,2500000004_42023020101,"Levothyroxine Sodium: 1 Vial, Single-Dose In 1 Carton (42023-201-01) / 5 Ml In 1 Vial, Single-Dose",28.28,11.31,,,0 CDM,2500000004_42023020501,"Calcitonin Salmon: 1 Vial, Multi-Dose In 1 Carton (42023-205-01) / 2 Ml In 1 Vial, Multi-Dose",4075.49,1630.2,,,0 CDM,2500000004_42023020801,Treprostinil: 1 Vial In 1 Carton (42023-208-01) / 20 Ml In 1 Vial,86.16,34.46,,,0 CDM,2500000004_42023021401,NDC Description Not Available,0.04,0.02,,,0 CDM,2500000004_42023022901,NDC Description Not Available,6.57,2.63,,,0 CDM,2500000004_42023022910,"Micafungin: 10 Vial, Single-Dose In 1 Carton (42023-229-10) / 10 Ml In 1 Vial, Single-Dose",7.11,2.84,,,0 CDM,2500000004_42023023001,NDC Description Not Available,6.58,2.63,,,0 CDM,2500000004_42023023010,"Micafungin: 10 Vial, Single-Dose In 1 Carton (42023-230-10) / 10 Ml In 1 Vial, Single-Dose",6.94,2.78,,,0 CDM,2500000004_42367054032,Ryanodex Dantrolene Sodium: 1 Vial In 1 Carton (42367-540-32) / 20 Ml In 1 Vial,11969.19,4787.68,,,0 CDM,2500000004_42494041501,NDC Description Not Available,44.69,17.88,,,0 CDM,2500000004_42494041601,NDC Description Not Available,130.49,52.2,,,0 CDM,2500000004_42494041625,"Phenobarbital Sodium: 25 Vial In 1 Box, Unit-Dose (42494-416-25) / 1 Ml In 1 Vial",87.81,35.12,,,0 CDM,2500000004_42658001001,"Cladribine: 1 Ml In 1 Vial, Single-Dose (42658-010-01)",37.9,15.16,,,0 CDM,2500000004_42658002101,Daunorubicin Hydrochloride: 1 Vial In 1 Box (42658-021-01) / 4 Ml In 1 Vial,104.71,41.88,,,0 CDM,2500000004_42658002102,Daunorubicin Hydrochloride: 10 Vial In 1 Carton (42658-021-02) / 4 Ml In 1 Vial,67.71,27.08,,,0 CDM,2500000004_42747010201,"Crysvita: 1 Ml In 1 Vial, Single-Use (42747-102-01)",2053.83,821.53,,,0 CDM,2500000004_42747020301,"Crysvita: 1 Ml In 1 Vial, Single-Use (42747-203-01)",1912.11,764.84,,,0 CDM,2500000004_42747030401,"Crysvita: 1 Ml In 1 Vial, Single-Use (42747-304-01)",1934.62,773.85,,,0 CDM,2500000004_42747076101,"Poteligeo: 1 Vial, Glass In 1 Carton (42747-761-01) / 5 Ml In 1 Vial, Glass",1052.13,420.85,,,0 CDM,2500000004_42858086806,Dronabinol: 60 Capsule In 1 Bottle (42858-868-06),4.48,1.79,,,0 CDM,2500000004_43066001501,NDC Description Not Available,0.57,0.23,,,0 CDM,2500000004_43066001510,Ropivacaine Hydrochloride: 10 Vial In 1 Carton (43066-015-10) / 20 Ml In 1 Vial (43066-015-01),0.56,0.22,,,0 CDM,2500000004_43066001610,Cardene Iv: 10 Bag In 1 Carton (43066-016-10) / 200 Ml In 1 Bag,0.68,0.27,,,0 CDM,2500000004_43066015010,Nexterone: 100 Ml In 1 Bag (43066-150-10),30.42,12.17,,,0 CDM,2500000004_43066036020,Nexterone: 200 Ml In 1 Bag (43066-360-20),16.83,6.73,,,0 CDM,2500000004_43528000301,NDC Description Not Available,671.4,268.56,,,0 CDM,2500000004_43528000305,Heplisav-B: 5 Syringe In 1 Carton (43528-003-05) / .5 Ml In 1 Syringe (43528-003-01),611.7,244.68,,,0 CDM,2500000004_43547063201,"Pemetrexed: 100 Injection, Powder, For Solution In 1 Vial (43547-632-01)",5.31,2.12,,,0 CDM,2500000004_43598005011,NDC Description Not Available,15.64,6.26,,,0 CDM,2500000004_43598005025,"Thiamine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (43598-050-25) / 2 Ml In 1 Vial, Multi-Dose (43598-050-11)",16.3,6.52,,,0 CDM,2500000004_43598005111,"Calcitonin Salmon: 1 Vial, Multi-Dose In 1 Carton (43598-051-11) / 2 Ml In 1 Vial, Multi-Dose",8392.14,3356.86,,,0 CDM,2500000004_43598005311,Desmopressin Acetate: 1 Vial In 1 Carton (43598-053-11) / 10 Ml In 1 Vial,19.58,7.83,,,0 CDM,2500000004_43598008711,NDC Description Not Available,0.89,0.36,,,0 CDM,2500000004_43598008758,"Lacosamide: 10 Vial, Single-Dose In 1 Carton (43598-087-58) / 20 Ml In 1 Vial, Single-Dose (43598-087-11)",0.3,0.12,,,0 CDM,2500000004_43598010610,"Diazepam: 10 Syringe, Glass In 1 Carton (43598-106-10) / 2 Ml In 1 Syringe, Glass (43598-106-11)",44.03,17.61,,,0 CDM,2500000004_43598010611,NDC Description Not Available,47.24,18.9,,,0 CDM,2500000004_43598012725,"Methylprednisolone Sodium Succinate: 25 Vial, Single-Dose In 1 Carton (43598-127-25) / 1 Ml In 1 Vial, Single-Dose (43598-127-45)",1.21,0.48,,,0 CDM,2500000004_43598012745,NDC Description Not Available,2.66,1.06,,,0 CDM,2500000004_43598012811,"Methylprednisolone Sodium Succinate: 1 Vial, Multi-Dose In 1 Carton (43598-128-11) / 8 Ml In 1 Vial, Multi-Dose",0.98,0.39,,,0 CDM,2500000004_43598012901,NDC Description Not Available,1.36,0.54,,,0 CDM,2500000004_43598012925,"Methylprednisolone Sodium Succinate: 25 Vial, Single-Dose In 1 Carton (43598-129-25) / 2 Ml In 1 Vial, Single-Dose (43598-129-01)",0.4,0.16,,,0 CDM,2500000004_43598013074,"Methylprednisolone Sodium Succinate: 1 Vial, Multi-Dose In 1 Carton (43598-130-74) / 16 Ml In 1 Vial, Multi-Dose",0.73,0.29,,,0 CDM,2500000004_43598014011,NDC Description Not Available,186.33,74.53,,,0 CDM,2500000004_43598014206,"Nelarabine: 6 Vial, Single-Dose In 1 Carton (43598-142-06) / 50 Ml In 1 Vial, Single-Dose",331.1,132.44,,,0 CDM,2500000004_43598014211,"Nelarabine: 1 Vial, Single-Dose In 1 Carton (43598-142-11) / 50 Ml In 1 Vial, Single-Dose",792.21,316.88,,,0 CDM,2500000004_43598017111,"Thiotepa: 1 Vial In 1 Carton (43598-171-11) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",1060.04,424.02,,,0 CDM,2500000004_43598026202,"Fulvestrant: 2 Syringe, Glass In 1 Carton (43598-262-02) / 5 Ml In 1 Syringe, Glass (43598-262-11)",23.54,9.42,,,0 CDM,2500000004_43598026211,NDC Description Not Available,23.54,9.42,,,0 CDM,2500000004_43598026223,"Fulvestrant: 2 Syringe, Glass In 1 Carton (43598-262-23) / 5 Ml In 1 Syringe, Glass (43598-262-11)",23.62,9.45,,,0 CDM,2500000004_43598028335,"Doxorubicin Hydrochloride: 1 Vial, Single-Dose In 1 Package (43598-283-35) / 10 Ml In 1 Vial, Single-Dose",376.49,150.6,,,0 CDM,2500000004_43598030562,"Azacitidine: 1 Injection, Powder, Lyophilized, For Solution In 1 Carton (43598-305-62)",8.8,3.52,,,0 CDM,2500000004_43598037074,"Pemetrexed Disodium: 1 Vial, Single-Dose In 1 Carton (43598-370-74) / 40 Ml In 1 Vial, Single-Dose",6.25,2.5,,,0 CDM,2500000004_43598038662,"Pemetrexed Disodium: 1 Vial, Single-Dose In 1 Carton (43598-386-62) / 4 Ml In 1 Vial, Single-Dose",6.18,2.47,,,0 CDM,2500000004_43598038711,"Pemetrexed Disodium: 1 Vial, Single-Dose In 1 Carton (43598-387-11) / 20 Ml In 1 Vial, Single-Dose",6.18,2.47,,,0 CDM,2500000004_43598040511,NDC Description Not Available,18.77,7.51,,,0 CDM,2500000004_43598040516,Phytonadione Phytonadione: 25 Ampule In 1 Carton (43598-405-16) / 1 Ml In 1 Ampule (43598-405-11),9.68,3.87,,,0 CDM,2500000004_43598041311,"Daptomycin: 1 Vial, Single-Dose In 1 Carton (43598-413-11) / 10 Ml In 1 Vial, Single-Dose",0.89,0.36,,,0 CDM,2500000004_43598042660,"Bortezomib: 1 Vial, Single-Dose In 1 Carton (43598-426-60) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",2.16,0.86,,,0 CDM,2500000004_43598052911,"Neostigmine: 1 Vial, Multi-Dose In 1 Carton (43598-529-11) / 10 Ml In 1 Vial, Multi-Dose",3.99,1.6,,,0 CDM,2500000004_43598054952,NDC Description Not Available,0.44,0.18,,,0 CDM,2500000004_43598063710,Levetiracetam: 10 Bag In 1 Carton (43598-637-10) / 100 Ml In 1 Bag (43598-637-52),0.42,0.17,,,0 CDM,2500000004_43598063752,NDC Description Not Available,0.46,0.18,,,0 CDM,2500000004_43598075011,Naloxone Hydrochloride: 1 Syringe In 1 Box (43598-750-11) / 2 Ml In 1 Syringe,67.9,27.16,,,0 CDM,2500000004_43598075058,Naloxone Hydrochloride: 10 Syringe In 1 Box (43598-750-58) / 2 Ml In 1 Syringe,68.97,27.59,,,0 CDM,2500000004_43598083911,NDC Description Not Available,44.94,17.98,,,0 CDM,2500000004_43598091406,Vasopressin: 25 Vial In 1 Carton (43598-914-06) / 1 Ml In 1 Vial (43598-914-11),2.37,0.95,,,0 CDM,2500000004_43598091411,NDC Description Not Available,2.27,0.91,,,0 CDM,2500000004_43598093111,NDC Description Not Available,29.0,11.6,,,0 CDM,2500000004_43825010201,"Ofirmev: 24 VIAL, GLASS in 1 CARTON (43825-102-01) / 100 mL in 1 VIAL, GLASS",0.34,0.14,,,0 CDM,2500000004_44087353501,"Bavencio: 1 Vial, Single-Dose In 1 Carton (44087-3535-1) / 10 Ml In 1 Vial, Single-Dose",436.83,174.73,,,0 CDM,2500000004_44206030001,"Rhophylac: 1 Syringe, Glass In 1 Carton (44206-300-01) / 2 Ml In 1 Syringe, Glass (44206-300-90)",50.97,20.39,,,0 CDM,2500000004_44206030010,"Rhophylac: 10 Syringe, Glass In 1 Carton (44206-300-10) / 2 Ml In 1 Syringe, Glass (44206-300-90)",22.27,8.91,,,0 CDM,2500000004_44206030090,NDC Description Not Available,48.92,19.57,,,0 CDM,2500000004_44206031025,"Alburx: 1 Vial, Glass In 1 Carton (44206-310-25) / 250 Ml In 1 Vial, Glass (44206-310-90)",195.74,78.3,,,0 CDM,2500000004_44206031090,NDC Description Not Available,30.41,12.16,,,0 CDM,2500000004_44206043710,"Privigen: 1 Vial, Glass In 1 Carton (44206-437-10) / 100 Ml In 1 Vial, Glass (44206-437-91)",399.33,159.73,,,0 CDM,2500000004_44206043791,NDC Description Not Available,403.82,161.53,,,0 CDM,2500000004_44206043820,"Privigen: 1 Vial, Glass In 1 Carton (44206-438-20) / 200 Ml In 1 Vial, Glass (44206-438-92)",402.19,160.88,,,0 CDM,2500000004_44206043892,NDC Description Not Available,231.95,92.78,,,0 CDM,2500000004_44567010010,"Ampicillin: 10 Vial In 1 Tray (44567-100-10) / 1 Injection, Powder, For Solution In 1 Vial",2.86,1.14,,,0 CDM,2500000004_44567010210,"Ampicillin: 10 Vial In 1 Tray (44567-102-10) / 1 Injection, Powder, For Solution In 1 Vial",13.66,5.46,,,0 CDM,2500000004_44567010310,"Ampicillin: 10 Vial In 1 Tray (44567-103-10) / 1 Injection, Powder, For Solution In 1 Vial",2.8,1.12,,,0 CDM,2500000004_44567021110,Ampicillin And Sulbactam: 10 Vial In 1 Carton (44567-211-10) / 20 Ml In 1 Vial,31.65,12.66,,,0 CDM,2500000004_44567022110,"Nafcillin: 10 Vial In 1 Carton (44567-221-10) / 1 Powder, For Solution In 1 Vial",1.27,0.51,,,0 CDM,2500000004_44567022301,"Nafcillin: 1 Vial, Pharmacy Bulk Package In 1 Carton (44567-223-01) / 100 Ml In 1 Vial, Pharmacy Bulk Package",1.87,0.75,,,0 CDM,2500000004_44567023525,"Ceftazidime: 25 Vial In 1 Carton (44567-235-25) / 1 Injection, Powder, For Solution In 1 Vial",9.99,4.0,,,0 CDM,2500000004_44567023610,"Ceftazidime: 10 Vial In 1 Carton (44567-236-10) / 1 Injection, Powder, For Solution In 1 Vial",10.98,4.39,,,0 CDM,2500000004_44567024010,Cefepime: 10 Vial In 1 Carton (44567-240-10) / 20 Ml In 1 Vial,6.25,2.5,,,0 CDM,2500000004_44567024110,Cefepime: 10 Vial In 1 Carton (44567-241-10) / 20 Ml In 1 Vial,8.6,3.44,,,0 CDM,2500000004_44567024625,"Cefoxitin: 25 Vial In 1 Carton (44567-246-25) / 1 Injection, Powder, For Solution In 1 Vial",41.41,16.56,,,0 CDM,2500000004_44567031110,"Penicillin G Potassium: 10 Vial In 1 Tray (44567-311-10) / 1 Injection, Powder, For Solution In 1 Vial",2.19,0.88,,,0 CDM,2500000004_44567040101,NDC Description Not Available,16.53,6.61,,,0 CDM,2500000004_44567040110,"Meropenem: 10 Vial In 1 Carton (44567-401-10) / 1 Injection, Powder, For Solution In 1 Vial (44567-401-01)",2.33,0.93,,,0 CDM,2500000004_44567041024,Magnesium Sulfate In Dextrose: 24 Bag In 1 Carton (44567-410-24) / 100 Ml In 1 Bag,5.93,2.37,,,0 CDM,2500000004_44567042024,Magnesium Sulfate In Water: 24 Pouch In 1 Carton (44567-420-24) / 1 Bag In 1 Pouch / 50 Ml In 1 Bag,7.48,2.99,,,0 CDM,2500000004_44567042124,Magnesium Sulfate In Water: 24 Pouch In 1 Carton (44567-421-24) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,2.01,0.8,,,0 CDM,2500000004_44567043624,Levofloxacin: 24 Pouch In 1 Carton (44567-436-24) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,5.38,2.15,,,0 CDM,2500000004_44567043724,Levofloxacin: 24 Pouch In 1 Carton (44567-437-24) / 1 Bag In 1 Pouch / 150 Ml In 1 Bag,4.52,1.81,,,0 CDM,2500000004_44567045101,NDC Description Not Available,2.35,0.94,,,0 CDM,2500000004_44567045110,Esmolol Hydrochloride: 10 Bag In 1 Carton (44567-451-10) / 100 Ml In 1 Bag (44567-451-01),1.91,0.76,,,0 CDM,2500000004_44567050201,NDC Description Not Available,0.48,0.19,,,0 CDM,2500000004_44567050210,Levetiracetam: 10 Bag In 1 Carton (44567-502-10) / 100 Ml In 1 Bag (44567-502-01),0.48,0.19,,,0 CDM,2500000004_44567050301,NDC Description Not Available,0.41,0.16,,,0 CDM,2500000004_44567061101,NDC Description Not Available,1.58,0.63,,,0 CDM,2500000004_44567061110,Midazolam In Sodium Chloride: 10 Bag In 1 Carton (44567-611-10) / 100 Ml In 1 Bag (44567-611-01),0.8,0.32,,,0 CDM,2500000004_44567070225,"Ceftriaxone: 25 Vial In 1 Carton (44567-702-25) / 1 Injection, Powder, For Solution In 1 Vial",3.62,1.45,,,0 CDM,2500000004_44567080110,"Piperacillin And Tazobactam: 10 Vial In 1 Box (44567-801-10) / 1 Injection, Powder, For Solution In 1 Vial",5.18,2.07,,,0 CDM,2500000004_44567080210,"Piperacillin And Tazobactam: 10 Vial In 1 Box (44567-802-10) / 1 Injection, Powder, For Solution In 1 Vial",9.82,3.93,,,0 CDM,2500000004_44567080310,"Piperacillin And Tazobactam: 10 Vial In 1 Box (44567-803-10) / 1 Injection, Powder, For Solution In 1 Vial",5.26,2.1,,,0 CDM,2500000004_44567080401,"Piperacillin And Tazobactam: 1 Bottle In 1 Box (44567-804-01) / 1 Injection, Powder, For Solution In 1 Bottle",3.01,1.2,,,0 CDM,2500000004_44567081110,Esmolol Hydrochloride In Water: 10 Bag In 1 Carton (44567-811-10) / 250 Ml In 1 Bag,2.09,0.84,,,0 CDM,2500000004_45963073360,"Doxorubicin Hydrochloride: 1 Vial, Multi-Dose In 1 Carton (45963-733-60) / 100 Ml In 1 Vial, Multi-Dose",14.81,5.92,,,0 CDM,2500000004_45963073368,"Doxorubicin Hydrochloride: 1 Vial, Single-Dose In 1 Carton (45963-733-68) / 25 Ml In 1 Vial, Single-Dose",18.91,7.56,,,0 CDM,2500000004_47335004940,"Doxorubicin Hydrochloride: 1 Vial, Single-Dose In 1 Package (47335-049-40) / 10 Ml In 1 Vial, Single-Dose",929.01,371.6,,,0 CDM,2500000004_47335005040,"Doxorubicin Hydrochloride: 1 Vial, Single-Dose In 1 Package (47335-050-40) / 25 Ml In 1 Vial, Single-Dose",1074.27,429.71,,,0 CDM,2500000004_47335089274,Temozolomide: 5 Blister Pack In 1 Carton (47335-892-74) / 1 Capsule In 1 Blister Pack,3.51,1.4,,,0 CDM,2500000004_47335099201,Magnesium Sulfate: 24 Pouch In 1 Case (47335-992-01) / 1 Bag In 1 Pouch / 50 Ml In 1 Bag,13.69,5.48,,,0 CDM,2500000004_47335099202,Magnesium Sulfate: 24 Pouch In 1 Case (47335-992-02) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,3.62,1.45,,,0 CDM,2500000004_47335099301,Metronidazole: 1 Bag In 1 Pouch (47335-993-01) / 100 Ml In 1 Bag,0.24,0.1,,,0 CDM,2500000004_47426020101,"Cinvanti: 1 Vial, Glass In 1 Carton (47426-201-01) / 18 Ml In 1 Vial, Glass",14.66,5.86,,,0 CDM,2500000004_49281012465,"Fluzone High Dose Northern Hemisphere: 5 Syringe, Glass In 1 Package (49281-124-65) / .5 Ml In 1 Syringe, Glass (49281-124-88)",303.5,121.4,,,0 CDM,2500000004_49281012488,NDC Description Not Available,302.79,121.12,,,0 CDM,2500000004_49281021588,NDC Description Not Available,202.77,81.11,,,0 CDM,2500000004_49281040010,Adacel Tdap: 10 Vial In 1 Package (49281-400-10) / .5 Ml In 1 Vial (49281-400-58),216.48,86.59,,,0 CDM,2500000004_49281042450,"Fluzone Trivalent Northern Hemisphere: 10 Syringe, Glass In 1 Package (49281-424-50) / .5 Ml In 1 Syringe, Glass (49281-424-88)",88.27,35.31,,,0 CDM,2500000004_49281057415,Beyfortus: 5 Syringe In 1 Carton (49281-574-15) / 1 Ml In 1 Syringe,2013.03,805.21,,,0 CDM,2500000004_49281057500,Beyfortus: 1 Syringe In 1 Carton (49281-575-00) / .5 Ml In 1 Syringe,2437.06,974.82,,,0 CDM,2500000004_49281057515,Beyfortus: 5 Syringe In 1 Carton (49281-575-15) / .5 Ml In 1 Syringe,2139.8,855.92,,,0 CDM,2500000004_49281059058,NDC Description Not Available,580.41,232.16,,,0 CDM,2500000004_49281072110,Flublok Quadrivalent Northern Hemisphere: 10 SYRINGE in 1 CARTON (49281-721-10) / .5 mL in 1 SYRINGE (49281-721-88),263.91,105.56,,,0 CDM,2500000004_49281075221,"Tubersol: 1 Vial, Multi-Dose In 1 Carton (49281-752-21) / 1 Ml In 1 Vial, Multi-Dose (49281-752-78)",53.93,21.57,,,0 CDM,2500000004_49281075222,"Tubersol: 1 Vial, Multi-Dose In 1 Carton (49281-752-22) / 5 Ml In 1 Vial, Multi-Dose (49281-752-98)",39.73,15.89,,,0 CDM,2500000004_49281075278,NDC Description Not Available,54.86,21.94,,,0 CDM,2500000004_49281075298,NDC Description Not Available,43.37,17.35,,,0 CDM,2500000004_49281079051,Typhim Vi: 1 Syringe In 1 Package (49281-790-51) / .5 Ml In 1 Syringe (49281-790-88),595.81,238.32,,,0 CDM,2500000004_49281079088,NDC Description Not Available,627.36,250.94,,,0 CDM,2500000004_49281086010,"Ipol: 1 Vial, Multi-Dose In 1 Package (49281-860-10) / 5 Ml In 1 Vial, Multi-Dose (49281-860-78)",186.7,74.68,,,0 CDM,2500000004_49281086078,NDC Description Not Available,171.04,68.42,,,0 CDM,2500000004_49401010101,Benlysta: 1 Vial In 1 Carton (49401-101-01) / 1.5 Ml In 1 Vial,235.0,94.0,,,0 CDM,2500000004_49401010201,Benlysta: 1 Vial In 1 Carton (49401-102-01) / 5 Ml In 1 Vial,232.35,92.94,,,0 CDM,2500000004_49502010101,NDC Description Not Available,195.71,78.28,,,0 CDM,2500000004_49502010102,"Epinephrine: 2 Container In 1 Carton (49502-101-02) / 1 Syringe, Glass In 1 Container (49502-101-01) / .3 Ml In 1 Syringe, Glass",334.7,133.88,,,0 CDM,2500000004_49502025080,"Semglee: 1 Vial, Multi-Dose In 1 Carton (49502-250-80) / 10 Ml In 1 Vial, Multi-Dose",5.41,2.16,,,0 CDM,2500000004_49502039380,"Insulin Glargine: 1 Vial, Multi-Dose In 1 Carton (49502-393-80) / 10 Ml In 1 Vial, Multi-Dose",1.33,0.53,,,0 CDM,2500000004_49502060530,Perforomist: 30 Pouch In 1 Carton (49502-605-30) / 1 Vial In 1 Pouch / 2 Ml In 1 Vial,21.27,8.51,,,0 CDM,2500000004_49502060595,NDC Description Not Available,13.94,5.58,,,0 CDM,2500000004_49591012611,NDC Description Not Available,10491.5,4196.6,,,0 CDM,2500000004_49591053250,NDC Description Not Available,7730.14,3092.06,,,0 CDM,2500000004_49702021301,NDC Description Not Available,5.98,2.39,,,0 CDM,2500000004_49702023803,NDC Description Not Available,28.8,11.52,,,0 CDM,2500000004_49702026423,Apretude: 1 Kit In 1 Carton (49702-264-23) * 3 Ml In 1 Vial (49702-238-03),29.37,11.75,,,0 CDM,2500000004_49884036401,Dantrolene Sodium: 100 Capsule In 1 Bottle (49884-364-01),2.94,1.18,,,0 CDM,2500000004_49884067314,Cabergoline: 8 TABLET in 1 BOTTLE (49884-673-14),48.06,19.22,,,0 CDM,2500000004_50016095711,NDC Description Not Available,4160.44,1664.18,,,0 CDM,2500000004_50090029501,"Kenalog-10: 1 Vial, Multi-Dose In 1 Carton (50090-0295-1) / 5 Ml In 1 Vial, Multi-Dose",9.95,3.98,,,0 CDM,2500000004_50242004110,Cathflo Activase: 10 Vial In 1 Carton (50242-041-10) / 2 Ml In 1 Vial,399.11,159.64,,,0 CDM,2500000004_50242004164,Cathflo Activase: 1 Vial In 1 Carton (50242-041-64) / 2 Ml In 1 Vial,397.8,159.12,,,0 CDM,2500000004_50242004413,"Activase: 1 Kit In 1 Carton (50242-044-13) * 50 Ml In 1 Vial, Single-Use * 50 Ml In 1 Vial, Single-Use",392.37,156.95,,,0 CDM,2500000004_50242005121,"Rituxan: 1 Vial, Single-Use In 1 Carton (50242-051-21) / 10 Ml In 1 Vial, Single-Use",389.32,155.73,,,0 CDM,2500000004_50242005306,"Rituxan: 1 Vial, Single-Use In 1 Carton (50242-053-06) / 50 Ml In 1 Vial, Single-Use",405.56,162.22,,,0 CDM,2500000004_50242006001,"Avastin: 1 Vial, Single-Use In 1 Carton (50242-060-01) / 4 Ml In 1 Vial, Single-Use",305.95,122.38,,,0 CDM,2500000004_50242006101,"Avastin: 1 Vial, Single-Use In 1 Carton (50242-061-01) / 16 Ml In 1 Vial, Single-Use",322.22,128.89,,,0 CDM,2500000004_50242007001,"Gazyva: 1 Vial, Single-Use In 1 Carton (50242-070-01) / 40 Ml In 1 Vial, Single-Use",374.22,149.69,,,0 CDM,2500000004_50242007701,"Herceptin Hylecta: 1 Vial, Single-Dose In 1 Carton (50242-077-01) / 5 Ml In 1 Vial, Single-Dose",344.21,137.68,,,0 CDM,2500000004_50242008527,"Activase: 1 Kit In 1 Carton (50242-085-27) * 100 Ml In 1 Vial, Single-Use * 100 Ml In 1 Vial, Single-Use",389.23,155.69,,,0 CDM,2500000004_50242008701,"Kadcyla: 1 Vial, Single-Use In 1 Carton (50242-087-01) / 8 Ml In 1 Vial, Single-Use",174.06,69.62,,,0 CDM,2500000004_50242008801,"Kadcyla: 1 Vial, Single-Use In 1 Carton (50242-088-01) / 5 Ml In 1 Vial, Single-Use",174.4,69.76,,,0 CDM,2500000004_50242010039,NDC Description Not Available,133.67,53.47,,,0 CDM,2500000004_50242010040,Pulmozyme: 5 Pouch In 1 Carton (50242-100-40) / 6 Ampule In 1 Pouch (50242-100-39) / 2.5 Ml In 1 Ampule,159.2,63.68,,,0 CDM,2500000004_50242010301,Polivy: 1 Vial In 1 Carton (50242-103-01) / 6 Ml In 1 Vial,524.82,209.93,,,0 CDM,2500000004_50242010501,"Polivy: 1 Vial, Single-Dose In 1 Carton (50242-105-01) / 20 Ml In 1 Vial, Single-Dose",571.64,228.66,,,0 CDM,2500000004_50242010801,"Rituxan Hycela: 1 Vial, Single-Dose In 1 Carton (50242-108-01) / 11.7 Ml In 1 Vial, Single-Dose",207.51,83.0,,,0 CDM,2500000004_50242010901,"Rituxan Hycela: 1 Vial, Single-Dose In 1 Carton (50242-109-01) / 13.4 Ml In 1 Vial, Single-Dose",216.09,86.44,,,0 CDM,2500000004_50242012047,"Tnkase: 1 Kit In 1 Carton (50242-120-47) * 1 Vial, Single-Use In 1 Carton (50242-037-06) / 10 Ml In 1 Vial, Single-Use * 1 Vial, Single-Use In 1 Carton (50242-901-09) / 10 Ml In 1 Vial, Single-Us",636.14,254.46,,,0 CDM,2500000004_50242012501,"Columvi: 1 Vial, Single-Dose In 1 Carton (50242-125-01) / 2.5 Ml In 1 Vial, Single-Dose",11303.04,4521.22,,,0 CDM,2500000004_50242012701,"Columvi: 1 Vial, Single-Dose In 1 Carton (50242-127-01) / 10 Ml In 1 Vial, Single-Dose",11609.22,4643.69,,,0 CDM,2500000004_50242013201,"Herceptin: 1 Vial, Single-Dose In 1 Carton (50242-132-01) / 15 Ml In 1 Vial, Single-Dose",475.11,190.04,,,0 CDM,2500000004_50242013501,"Actemra: 1 Vial, Single-Use In 1 Box (50242-135-01) / 4 Ml In 1 Vial, Single-Use",28.42,11.37,,,0 CDM,2500000004_50242013601,"Actemra: 1 Vial, Single-Use In 1 Box (50242-136-01) / 10 Ml In 1 Vial, Single-Use",28.43,11.37,,,0 CDM,2500000004_50242013701,"Actemra: 1 Vial, Single-Use In 1 Box (50242-137-01) / 20 Ml In 1 Vial, Single-Use",28.48,11.39,,,0 CDM,2500000004_50242014201,Lunsumio: 1 Vial In 1 Carton (50242-142-01) / 30 Ml In 1 Vial,2752.4,1100.96,,,0 CDM,2500000004_50242014501,"Perjeta: 1 Vial, Single-Use In 1 Carton (50242-145-01) / 14 Ml In 1 Vial, Single-Use",70.09,28.04,,,0 CDM,2500000004_50242015001,"Ocrevus: 1 Vial, Single-Use In 1 Carton (50242-150-01) / 10 Ml In 1 Vial, Single-Use",254.79,101.92,,,0 CDM,2500000004_50242015901,Lunsumio: 1 Vial In 1 Carton (50242-159-01) / 1 Ml In 1 Vial,2746.7,1098.68,,,0 CDM,2500000004_50242017601,"Tnkase: 1 Kit In 1 Carton (50242-176-01) * 1 Vial, Single-Use In 1 Carton (50242-037-06) / 10 Ml In 1 Vial, Single-Use * 1 Vial, Single-Use In 1 Carton (50242-901-09) / 10 Ml In 1 Vial, Single-Us",740.01,296.0,,,0 CDM,2500000004_50242021401,"Xolair Pfs: 1 Syringe, Glass In 1 Carton (50242-214-01) / .5 Ml In 1 Syringe, Glass",68.12,27.25,,,0 CDM,2500000004_50242021403,"Xolair Pfs: 1 Syringe, Glass In 1 Carton (50242-214-03) / .5 Ml In 1 Syringe, Glass",193.54,77.42,,,0 CDM,2500000004_50242021501,"Xolair Pfs: 1 Syringe, Glass In 1 Carton (50242-215-01) / 1 Ml In 1 Syringe, Glass",86.62,34.65,,,0 CDM,2500000004_50242021503,"Xolair Pfs: 1 Syringe, Glass In 1 Carton (50242-215-03) / 1 Ml In 1 Syringe, Glass",61.5,24.6,,,0 CDM,2500000004_50242024501,"Phesgo: 1 Vial, Single-Dose In 1 Carton (50242-245-01) / 15 Ml In 1 Vial, Single-Dose",324.31,129.72,,,0 CDM,2500000004_50242026001,"Phesgo: 1 Vial, Single-Dose In 1 Carton (50242-260-01) / 10 Ml In 1 Vial, Single-Dose",327.47,130.99,,,0 CDM,2500000004_50242091701,"Tecentriq: 1 Vial, Single-Use In 1 Carton (50242-917-01) / 20 Ml In 1 Vial, Single-Use",399.92,159.97,,,0 CDM,2500000004_50242091801,"Tecentriq: 1 Vial, Single-Use In 1 Carton (50242-918-01) / 14 Ml In 1 Vial, Single-Use",405.06,162.02,,,0 CDM,2500000004_50242093301,"Tecentriq Hybreza: 1 Vial, Single-Dose In 1 Box (50242-933-01) / 15 Ml In 1 Vial, Single-Dose",133.43,53.37,,,0 CDM,2500000004_50268055711,NDC Description Not Available,1.34,0.54,,,0 CDM,2500000004_50268055715,Mycophenolate Mofetil: 50 Blister Pack In 1 Box (50268-557-15) / 1 Capsule In 1 Blister Pack (50268-557-11),1.34,0.54,,,0 CDM,2500000004_50268068411,NDC Description Not Available,3.12,1.25,,,0 CDM,2500000004_50268068415,Prochlorperazine Maleate: 50 Blister Pack In 1 Box (50268-684-15) / 1 Tablet In 1 Blister Pack (50268-684-11),3.26,1.3,,,0 CDM,2500000004_50268068511,NDC Description Not Available,1.71,0.68,,,0 CDM,2500000004_50268068515,Prochlorperazine Maleate: 50 Blister Pack In 1 Box (50268-685-15) / 1 Tablet In 1 Blister Pack (50268-685-11),1.77,0.71,,,0 CDM,2500000004_50268071813,Sirolimus: 30 Blister Pack In 1 Box (50268-718-13) / 1 Tablet In 1 Blister Pack (50268-718-11),40.37,16.15,,,0 CDM,2500000004_50383080116,Promethazine Hydrochloride: 473 mL in 1 BOTTLE (50383-801-16),4.19,1.68,,,0 CDM,2500000004_50419032005,"Eovist: 5 Vial, Single-Dose In 1 Box (50419-320-05) / 10 Ml In 1 Vial, Single-Dose",88.39,35.36,,,0 CDM,2500000004_50419042201,Skyla: 1 Intrauterine Device In 1 Carton (50419-422-01),4395.13,1758.05,,,0 CDM,2500000004_50419042301,Mirena: 1 Intrauterine Device In 1 Carton (50419-423-01),5227.45,2090.98,,,0 CDM,2500000004_50419042401,Kyleena: 1 Intrauterine Device In 1 Carton (50419-424-01),5232.64,2093.06,,,0 CDM,2500000004_50458030711,Risperdal Consta: 1 Kit In 1 Box (50458-307-11) * 2 Ml In 1 Vial * 2 Ml In 1 Syringe (50458-307-01),51.91,20.76,,,0 CDM,2500000004_50458030801,NDC Description Not Available,54.42,21.77,,,0 CDM,2500000004_50458030811,Risperdal Consta: 1 Kit In 1 Box (50458-308-11) * 2 Ml In 1 Vial * 2 Ml In 1 Syringe (50458-308-01),51.92,20.77,,,0 CDM,2500000004_50458056301,Invega Sustenna: 1 Syringe In 1 Kit (50458-563-01) / 1 Ml In 1 Syringe,3.84,1.54,,,0 CDM,2500000004_50458056401,Invega Sustenna: 1 Syringe In 1 Kit (50458-564-01) / 1.5 Ml In 1 Syringe,4.3,1.72,,,0 CDM,2500000004_50474070062,"Cimzia: 2 Kit In 1 Carton (50474-700-62) / 1 Kit In 1 Kit * 1 Ml In 1 Vial, Glass * 1 Ml In 1 Vial, Glass",52.62,21.05,,,0 CDM,2500000004_50474071079,"Cimzia: 2 Syringe, Glass In 1 Carton (50474-710-79) / 1 Ml In 1 Syringe, Glass",62.07,24.83,,,0 CDM,2500000004_50474098284,"Rystiggo: 1 Vial, Glass In 1 Carton (50474-982-84) / 4 Ml In 1 Vial, Glass",100.64,40.26,,,0 CDM,2500000004_50474098386,"Rystiggo: 1 Vial, Glass In 1 Carton (50474-983-86) / 6 Ml In 1 Vial, Glass",96.94,38.78,,,0 CDM,2500000004_50632001001,"Rabavert: 1 Kit In 1 Carton (50632-010-01) * 1 Ml In 1 Syringe (50632-011-01) * 1 Ml In 1 Vial, Glass (50632-013-01)",1711.73,684.69,,,0 CDM,2500000004_50632001301,NDC Description Not Available,1402.42,560.97,,,0 CDM,2500000004_50633011011,NDC Description Not Available,12823.32,5129.33,,,0 CDM,2500000004_50633011012,"Crofab: 2 Vial, Glass In 1 Carton (50633-110-12) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Glass (50633-110-11)",10927.59,4371.04,,,0 CDM,2500000004_50633012011,"Digifab: 1 Vial, Glass In 1 Carton (50633-120-11) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Glass (50633-120-12)",20180.93,8072.37,,,0 CDM,2500000004_50633021011,"Voraxaze: 1 Vial In 1 Carton (50633-210-11) / 1 Injection, Powder, For Solution In 1 Vial",1894.0,757.6,,,0 CDM,2500000004_50633031011,"Cyanokit: 1 Vial, Glass In 1 Carton (50633-310-11) / 250 Ml In 1 Vial, Glass",23.13,9.25,,,0 CDM,2500000004_50742011808,Cabergoline: 8 Tablet In 1 Bottle (50742-118-08),4.18,1.67,,,0 CDM,2500000004_50742043001,"Decitabine: 1 Vial In 1 Carton (50742-430-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",9.89,3.96,,,0 CDM,2500000004_50881001303,Monjuvi: 1 Vial In 1 Carton (50881-013-03) / 5 Ml In 1 Vial,60.43,24.17,,,0 CDM,2500000004_51079067001,NDC Description Not Available,8.5,3.4,,,0 CDM,2500000004_51079067005,Methotrexate: 20 Blister Pack In 1 Carton (51079-670-05) / 1 Tablet In 1 Blister Pack (51079-670-01),11.45,4.58,,,0 CDM,2500000004_51079072101,NDC Description Not Available,2.18,0.87,,,0 CDM,2500000004_51079081701,NDC Description Not Available,5.21,2.08,,,0 CDM,2500000004_51079081801,NDC Description Not Available,3.23,1.29,,,0 CDM,2500000004_51144000301,Tivdak: 1 Vial In 1 Carton (51144-003-01) / 4 Ml In 1 Vial,780.52,312.21,,,0 CDM,2500000004_51144002001,"Padcev Ejfv: 1 Vial, Single-Dose In 1 Box (51144-020-01) / 2 Ml In 1 Vial, Single-Dose",155.22,62.09,,,0 CDM,2500000004_51144003001,"Padcev Ejfv: 1 Vial, Single-Dose In 1 Box (51144-030-01) / 3 Ml In 1 Vial, Single-Dose",155.24,62.1,,,0 CDM,2500000004_51144005001,"Adcetris: 1 Vial, Single-Dose In 1 Box (51144-050-01) / 10.5 Ml In 1 Vial, Single-Dose",1072.29,428.92,,,0 CDM,2500000004_51224001220,Phentolamine Mesylate: 1 Vial In 1 Carton (51224-012-20) / 1 Injection In 1 Vial,137.49,55.0,,,0 CDM,2500000004_51224001310,"Levetiracetam: 10 Vial, Single-Use In 1 Carton (51224-013-10) / 5 Ml In 1 Vial, Single-Use",0.23,0.09,,,0 CDM,2500000004_51224001325,"Levetiracetam: 25 Vial, Single-Use In 1 Carton (51224-013-25) / 5 Ml In 1 Vial, Single-Use",0.28,0.11,,,0 CDM,2500000004_51754050001,Caffeine Citrate: 1 Vial In 1 Carton (51754-0500-1) / 3 Ml In 1 Vial,3.8,1.52,,,0 CDM,2500000004_51754506001,"Betamethasone Sodium Phosphate And Betamethasone Acetate: 1 Vial, Multi-Dose In 1 Box (51754-5060-1) / 5 Ml In 1 Vial, Multi-Dose",32.16,12.86,,,0 CDM,2500000004_51862045801,NDC Description Not Available,2.2,0.88,,,0 CDM,2500000004_51862045847,"Cyclosporine: 30 Blister Pack In 1 Box (51862-458-47) / 1 Capsule, Liquid Filled In 1 Blister Pack (51862-458-01)",3.32,1.33,,,0 CDM,2500000004_51927100200,Chloral Hydrate: 1 Kg In 1 Container (51927-1002-0),8.12,3.25,,,0 CDM,2500000004_51927279000,NDC Description Not Available,2.07,0.83,,,0 CDM,2500000004_51991014417,Methylergonovine Maleate: 10 Ampule In 1 Box (51991-144-17) / 1 Ml In 1 Ampule,70.64,28.26,,,0 CDM,2500000004_52244002006,Edex: 6 Blister Pack In 1 Carton (52244-020-06) / 1 Cartridge In 1 Blister Pack / 1 Ml In 1 Cartridge,29.67,11.87,,,0 CDM,2500000004_52536062501,"Testosterone Cypionate: 1 Vial, Single-Dose In 1 Carton (52536-625-01) / 1 Ml In 1 Vial, Single-Dose",0.06,0.02,,,0 CDM,2500000004_54092070001,"Elaprase: 1 Vial, Glass In 1 Box (54092-700-01) / 3 Ml In 1 Vial, Glass",2313.0,925.2,,,0 CDM,2500000004_54288010001,Zoledronic Acid: 1 Vial In 1 Carton (54288-100-01) / 5 Ml In 1 Vial,24.24,9.7,,,0 CDM,2500000004_54288010301,NDC Description Not Available,4.84,1.94,,,0 CDM,2500000004_54288010310,Epinephrine: 10 Ampule In 1 Box (54288-103-10) / 1 Ml In 1 Ampule,4.9,1.96,,,0 CDM,2500000004_54288010902,"Melphalan Hydrochloride: 1 Kit In 1 Carton (54288-109-02) * 10 Ml In 1 Vial, Single-Dose (54288-106-01) * 10 Ml In 1 Vial, Single-Use (54288-107-01)",689.41,275.76,,,0 CDM,2500000004_54288012001,Epinephrine: 1 Vial In 1 Carton (54288-120-01) / 10 Ml In 1 Vial,2.16,0.86,,,0 CDM,2500000004_54288013601,NDC Description Not Available,111.61,44.64,,,0 CDM,2500000004_54288014101,NDC Description Not Available,2.64,1.06,,,0 CDM,2500000004_54288014201,NDC Description Not Available,54.08,21.63,,,0 CDM,2500000004_54288014210,Papaverine Hydrochloride: 10 Vial In 1 Carton (54288-142-10) / 2 Ml In 1 Vial (54288-142-01),32.36,12.94,,,0 CDM,2500000004_54288016701,"Carboplatin: 1 Vial, Multi-Dose In 1 Carton (54288-167-01) / 60 Ml In 1 Vial, Multi-Dose",22.66,9.06,,,0 CDM,2500000004_54482014701,Carnitor: 5 Vial In 1 Carton (54482-147-01) / 5 Ml In 1 Vial,13.65,5.46,,,0 CDM,2500000004_54643564901,Infuvite Adult: 1 Kit In 1 Carton (54643-5649-1) * 5 Ml In 1 Vial (54643-5657-1) * 5 Ml In 1 Vial (54643-5659-1),68.66,27.46,,,0 CDM,2500000004_55111052701,Tacrolimus: 1 Bottle In 1 Carton (55111-527-01) / 100 Capsule In 1 Bottle,1.92,0.77,,,0 CDM,2500000004_55111055610,"Decitabine: 1 Vial, Single-Use In 1 Carton (55111-556-10) / 10 Ml In 1 Vial, Single-Use",6.47,2.59,,,0 CDM,2500000004_55111065207,NDC Description Not Available,5.04,2.02,,,0 CDM,2500000004_55111067811,NDC Description Not Available,20.31,8.12,,,0 CDM,2500000004_55111067902,Fondaparinux Sodium: 2 Syringe In 1 Carton (55111-679-02) / .4 Ml In 1 Syringe (55111-679-11),8.57,3.43,,,0 CDM,2500000004_55111068002,Fondaparinux Sodium: 2 Syringe In 1 Carton (55111-680-02) / .6 Ml In 1 Syringe (55111-680-11),16.66,6.66,,,0 CDM,2500000004_55111068011,NDC Description Not Available,13.83,5.53,,,0 CDM,2500000004_55111068507,"Zoledronic Acid: 1 Vial, Glass In 1 Carton (55111-685-07) / 5 Ml In 1 Vial, Glass",57.16,22.86,,,0 CDM,2500000004_55111069407,"Palonosetron: 1 Vial, Single-Use In 1 Carton (55111-694-07) / 5 Ml In 1 Vial, Single-Use",7.92,3.17,,,0 CDM,2500000004_55135013201,"Trodelvy: 1 Vial In 1 Box (55135-132-01) / 1 Powder, For Solution In 1 Vial",152.27,60.91,,,0 CDM,2500000004_55150011310,"Ampicillin: 10 Vial In 1 Box (55150-113-10) / 1 Injection, Powder, For Solution In 1 Vial",11.16,4.46,,,0 CDM,2500000004_55150011420,"Ampicillin: 10 Vial In 1 Box (55150-114-20) / 1 Injection, Powder, For Solution In 1 Vial",9.12,3.65,,,0 CDM,2500000004_55150011720,"Ampicillin And Sulbactam: 10 Vial In 1 Carton (55150-117-20) / 1 Injection, Powder, For Solution In 1 Vial",11.79,4.72,,,0 CDM,2500000004_55150011930,"Piperacillin And Tazobactam: 10 Vial In 1 Box (55150-119-30) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",6.7,2.68,,,0 CDM,2500000004_55150012030,"Piperacillin And Tazobactam: 10 Vial In 1 Box (55150-120-30) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",10.9,4.36,,,0 CDM,2500000004_55150012150,"Piperacillin And Tazobactam: 10 Vial In 1 Box (55150-121-50) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",7.25,2.9,,,0 CDM,2500000004_55150012215,Nafcillin: 10 Vial In 1 Box (55150-122-15) / 4 Ml In 1 Vial,1.04,0.42,,,0 CDM,2500000004_55150012315,Nafcillin: 10 Vial In 1 Box (55150-123-15) / 8 Ml In 1 Vial,3.28,1.31,,,0 CDM,2500000004_55150012499,"Nafcillin: 1 Vial, Pharmacy Bulk Package In 1 Box (55150-124-99) / 100 Ml In 1 Vial, Pharmacy Bulk Package",0.3,0.12,,,0 CDM,2500000004_55150015410,"Acyclovir Sodium: 10 Vial, Single-Dose In 1 Carton (55150-154-10) / 10 Ml In 1 Vial, Single-Dose",0.56,0.22,,,0 CDM,2500000004_55150015520,"Acyclovir Sodium: 10 Vial, Single-Dose In 1 Carton (55150-155-20) / 20 Ml In 1 Vial, Single-Dose",0.57,0.23,,,0 CDM,2500000004_55150016102,"Lidocaine Hydrochloride: 10 Vial, Single-Dose In 1 Carton (55150-161-02) / 2 Ml In 1 Vial, Single-Dose",0.5,0.2,,,0 CDM,2500000004_55150016205,"Lidocaine Hydrochloride: 10 Vial, Single-Dose In 1 Carton (55150-162-05) / 5 Ml In 1 Vial, Single-Dose",0.1,0.04,,,0 CDM,2500000004_55150016505,"Lidocaine Hydrochloride: 10 Vial, Single-Dose In 1 Carton (55150-165-05) / 5 Ml In 1 Vial, Single-Dose",0.04,0.02,,,0 CDM,2500000004_55150016613,"Sildenafil: 1 Vial, Single-Dose In 1 Carton (55150-166-13) / 12.5 Ml In 1 Vial, Single-Dose",77.67,31.07,,,0 CDM,2500000004_55150016710,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-167-10) / 10 Ml In 1 Vial, Single-Dose",0.21,0.08,,,0 CDM,2500000004_55150016830,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-168-30) / 30 Ml In 1 Vial, Single-Dose",0.07,0.03,,,0 CDM,2500000004_55150016910,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-169-10) / 10 Ml In 1 Vial, Single-Dose",0.12,0.05,,,0 CDM,2500000004_55150017030,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-170-30) / 30 Ml In 1 Vial, Single-Dose",0.04,0.02,,,0 CDM,2500000004_55150017110,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-171-10) / 10 Ml In 1 Vial, Single-Dose",0.08,0.03,,,0 CDM,2500000004_55150017301,"Sumatriptan: 5 Vial, Single-Dose In 1 Carton (55150-173-01) / .5 Ml In 1 Vial, Single-Dose",48.98,19.59,,,0 CDM,2500000004_55150017705,"Levetiracetam: 10 Vial, Single-Dose In 1 Carton (55150-177-05) / 5 Ml In 1 Vial, Single-Dose",0.11,0.04,,,0 CDM,2500000004_55150019183,"Ibandronate Sodium: 1 Syringe, Glass In 1 Carton (55150-191-83) / 3 Ml In 1 Syringe, Glass",358.53,143.41,,,0 CDM,2500000004_55150019410,"Esmolol Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-194-10) / 10 Ml In 1 Vial, Single-Dose",1.9,0.76,,,0 CDM,2500000004_55150019520,"Ropivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-195-20) / 20 Ml In 1 Vial, Single-Dose",0.99,0.4,,,0 CDM,2500000004_55150019720,"Ropivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-197-20) / 20 Ml In 1 Vial, Single-Dose",0.1,0.04,,,0 CDM,2500000004_55150019830,"Ropivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-198-30) / 30 Ml In 1 Vial, Single-Dose",0.24,0.1,,,0 CDM,2500000004_55150020200,NDC Description Not Available,13.49,5.4,,,0 CDM,2500000004_55150020210,"Pantoprazole Sodium: 10 Vial, Single-Dose In 1 Carton (55150-202-10) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose (55150-202-00)",15.53,6.21,,,0 CDM,2500000004_55150020720,"Meropenem: 10 Vial In 1 Carton (55150-207-20) / 1 Injection, Powder, For Solution In 1 Vial",5.43,2.17,,,0 CDM,2500000004_55150020830,"Meropenem: 10 Vial In 1 Carton (55150-208-30) / 1 Injection, Powder, For Solution In 1 Vial",5.24,2.1,,,0 CDM,2500000004_55150021010,"Bivalirudin: 10 Vial, Single-Dose In 1 Carton (55150-210-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",0.79,0.32,,,0 CDM,2500000004_55150023805,"Dexamethasone Sodium Phosphate: 25 Vial, Multi-Dose In 1 Carton (55150-238-05) / 5 Ml In 1 Vial, Multi-Dose",0.12,0.05,,,0 CDM,2500000004_55150023930,"Dexamethasone Sodium Phosphate: 25 Vial, Multi-Dose In 1 Carton (55150-239-30) / 30 Ml In 1 Vial, Multi-Dose",0.2,0.08,,,0 CDM,2500000004_55150024251,Linezolid: 10 Pouch In 1 Carton (55150-242-51) / 1 Bag In 1 Pouch / 300 Ml In 1 Bag,24.48,9.79,,,0 CDM,2500000004_55150025050,"Bupivacaine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (55150-250-50) / 50 Ml In 1 Vial, Multi-Dose",0.02,0.01,,,0 CDM,2500000004_55150025110,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (55150-251-10) / 10 Ml In 1 Vial, Multi-Dose",0.05,0.02,,,0 CDM,2500000004_55150025220,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (55150-252-20) / 20 Ml In 1 Vial, Multi-Dose",0.02,0.01,,,0 CDM,2500000004_55150025350,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (55150-253-50) / 50 Ml In 1 Vial, Multi-Dose",0.05,0.02,,,0 CDM,2500000004_55150025410,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (55150-254-10) / 10 Ml In 1 Vial, Multi-Dose",0.02,0.01,,,0 CDM,2500000004_55150025520,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (55150-255-20) / 20 Ml In 1 Vial, Multi-Dose",0.01,0.004,,,0 CDM,2500000004_55150025930,"Acetylcysteine: 4 Vial, Single-Dose In 1 Carton (55150-259-30) / 30 Ml In 1 Vial, Single-Dose",2.27,0.91,,,0 CDM,2500000004_55150027301,NDC Description Not Available,8.68,3.47,,,0 CDM,2500000004_55150027325,"Thiamine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (55150-273-25) / 2 Ml In 1 Vial, Multi-Dose (55150-273-01)",8.36,3.34,,,0 CDM,2500000004_55150028220,"Ertapenem: 10 Vial, Single-Dose In 1 Carton (55150-282-20) / 1 Injection In 1 Vial, Single-Dose",133.44,53.38,,,0 CDM,2500000004_55150030401,NDC Description Not Available,2.18,0.87,,,0 CDM,2500000004_55150030701,NDC Description Not Available,0.78,0.31,,,0 CDM,2500000004_55150030724,"Acetaminophen: 24 Vial, Single-Dose In 1 Carton (55150-307-24) / 100 Ml In 1 Vial, Single-Dose (55150-307-01)",0.24,0.1,,,0 CDM,2500000004_55150030801,"Olanzapine: 1 Vial, Single-Dose In 1 Carton (55150-308-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",9.71,3.88,,,0 CDM,2500000004_55150032401,NDC Description Not Available,1.43,0.57,,,0 CDM,2500000004_55150033001,Medroxyprogesterone Acetate: 1 Syringe In 1 Carton (55150-330-01) / 1 Ml In 1 Syringe,1.8,0.72,,,0 CDM,2500000004_55150034510,Naloxone Hydrochloride: 10 Syringe In 1 Box (55150-345-10) / 2 Ml In 1 Syringe,9.95,3.98,,,0 CDM,2500000004_55150036501,"Amphotericin B: 1 Vial, Single-Dose In 1 Carton (55150-365-01) / 12.5 Ml In 1 Vial, Single-Dose",224.92,89.97,,,0 CDM,2500000004_55150037001,"Vasopressin: 1 Vial, Multi-Dose In 1 Carton (55150-370-01) / 1 Ml In 1 Vial, Multi-Dose",6.16,2.46,,,0 CDM,2500000004_55150038101,Pemetrexed: 1 Vial In 1 Carton (55150-381-01) / 4 Ml In 1 Vial,8.36,3.34,,,0 CDM,2500000004_55150038301,Pemetrexed: 1 Vial In 1 Carton (55150-383-01) / 40 Ml In 1 Vial,6.47,2.59,,,0 CDM,2500000004_55150038401,"Triamcinolone Acetonide: 1 Vial, Multi-Dose In 1 Carton (55150-384-01) / 5 Ml In 1 Vial, Multi-Dose",3.87,1.55,,,0 CDM,2500000004_55150038601,"Carboplatin: 1 Vial, Multi-Dose In 1 Carton (55150-386-01) / 60 Ml In 1 Vial, Multi-Dose",13.84,5.54,,,0 CDM,2500000004_55150038801,"Posaconazole: 1 Vial, Single-Dose In 1 Carton (55150-388-01) / 16.7 Ml In 1 Vial, Single-Dose",759.37,303.75,,,0 CDM,2500000004_55150040001,NDC Description Not Available,20.38,8.15,,,0 CDM,2500000004_55150042101,NDC Description Not Available,3.43,1.37,,,0 CDM,2500000004_55150043201,NDC Description Not Available,223.19,89.28,,,0 CDM,2500000004_55150043401,"Dexrazoxane: 1 Kit In 1 Package (55150-434-01) * 25 Ml In 1 Vial, Single-Dose (55150-432-01) * 25 Ml In 1 Vial (55150-433-01)",1225.27,490.11,,,0 CDM,2500000004_55150043501,NDC Description Not Available,176.16,70.46,,,0 CDM,2500000004_55150043701,"Dexrazoxane: 1 Kit In 1 Package (55150-437-01) * 50 Ml In 1 Vial, Single-Dose (55150-435-01) * 50 Ml In 1 Vial (55150-436-01)",1125.05,450.02,,,0 CDM,2500000004_55150049801,"Fluorouracil: 1 Vial, Pharmacy Bulk Package In 1 Carton (55150-498-01) / 100 Ml In 1 Vial, Pharmacy Bulk Package",7.36,2.94,,,0 CDM,2500000004_55292020111,Chemet: 100 Capsule In 1 Bottle (55292-201-11),101.36,40.54,,,0 CDM,2500000004_55292070255,Panhematin: 1 Vial In 1 Carton (55292-702-55) / 48 Ml In 1 Vial (55292-702-54),130.91,52.36,,,0 CDM,2500000004_55513002101,NDC Description Not Available,35.42,14.17,,,0 CDM,2500000004_55513002104,Aranesp: 1 Blister Pack In 1 Package (55513-021-04) / 4 Syringe In 1 Blister Pack / .4 Ml In 1 Syringe (55513-021-01),36.04,14.42,,,0 CDM,2500000004_55513002301,NDC Description Not Available,35.27,14.11,,,0 CDM,2500000004_55513002304,Aranesp: 1 Blister Pack In 1 Package (55513-023-04) / 4 Syringe In 1 Blister Pack / .3 Ml In 1 Syringe (55513-023-01),34.37,13.75,,,0 CDM,2500000004_55513002501,NDC Description Not Available,36.04,14.42,,,0 CDM,2500000004_55513002504,Aranesp: 1 Blister Pack In 1 Package (55513-025-04) / 4 Syringe In 1 Blister Pack / .5 Ml In 1 Syringe (55513-025-01),15.0,6.0,,,0 CDM,2500000004_55513002701,NDC Description Not Available,34.53,13.81,,,0 CDM,2500000004_55513003201,Aranesp: 1 Blister Pack In 1 Package (55513-032-01) / 1 Syringe In 1 Blister Pack / 1 Ml In 1 Syringe,15.0,6.0,,,0 CDM,2500000004_55513005701,NDC Description Not Available,35.11,14.04,,,0 CDM,2500000004_55513005704,Aranesp: 1 Blister Pack In 1 Package (55513-057-04) / 4 Syringe In 1 Blister Pack / .42 Ml In 1 Syringe (55513-057-01),36.0,14.4,,,0 CDM,2500000004_55513005901,Imdelltra (Amg757): 1 Kit In 1 Package (55513-059-01) * 1 Mg In 1 Vial (55513-103-01) * 7 Ml In 1 Vial (55513-068-01),6900.0,2760.0,,,0 CDM,2500000004_55513007701,Imdelltra (Amg757): 1 Kit In 1 Package (55513-077-01) * 10 Mg In 1 Vial (55513-069-01) * 7 Ml In 1 Vial (55513-068-01),6628.04,2651.22,,,0 CDM,2500000004_55513007801,Imlygic: 1 Vial In 1 Carton (55513-078-01) / 1 Ml In 1 Vial,209.61,83.84,,,0 CDM,2500000004_55513007901,Imlygic: 1 Vial In 1 Carton (55513-079-01) / 1 Ml In 1 Vial,203.52,81.41,,,0 CDM,2500000004_55513011101,Aranesp: 1 Blister Pack In 1 Package (55513-111-01) / 1 Syringe In 1 Blister Pack / .6 Ml In 1 Syringe,35.27,14.11,,,0 CDM,2500000004_55513013201,"Kanjinti: 1 Vial, Multi-Dose In 1 Carton (55513-132-01) / 20 Ml In 1 Vial, Multi-Dose",410.88,164.35,,,0 CDM,2500000004_55513014101,"Kanjinti: 1 Vial, Single-Dose In 1 Carton (55513-141-01) / 7.15 Ml In 1 Vial, Single-Dose",412.53,165.01,,,0 CDM,2500000004_55513016001,Blincyto: 1 Kit In 1 Package (55513-160-01) * 3.088 Ml In 1 Vial (55513-150-01) * 10.6 Ml In 1 Vial (55513-155-01),670.56,268.22,,,0 CDM,2500000004_55513019001,Neulasta: 1 Syringe In 1 Carton (55513-190-01) / .6 Ml In 1 Syringe,2169.38,867.75,,,0 CDM,2500000004_55513019201,Neulasta: 1 Kit In 1 Carton (55513-192-01) * .6 Ml In 1 Syringe,2204.23,881.69,,,0 CDM,2500000004_55513020601,Mvasi: 1 Vial In 1 Carton (55513-206-01) / 4 Ml In 1 Vial,295.75,118.3,,,0 CDM,2500000004_55513020701,Mvasi: 1 Vial In 1 Carton (55513-207-01) / 16 Ml In 1 Vial,295.79,118.32,,,0 CDM,2500000004_55513022101,Nplate: 1 Vial In 1 Carton (55513-221-01) / .5 Ml In 1 Vial,7.84,3.14,,,0 CDM,2500000004_55513022201,Nplate: 1 Vial In 1 Carton (55513-222-01) / 1 Ml In 1 Vial,64.76,25.9,,,0 CDM,2500000004_55513022301,"Nplate: 1 Vial, Single-Dose In 1 Carton (55513-223-01) / .25 Ml In 1 Vial, Single-Dose",62.36,24.94,,,0 CDM,2500000004_55513022401,"Riabni: 1 Vial, Single-Dose In 1 Carton (55513-224-01) / 10 Ml In 1 Vial, Single-Dose",349.92,139.97,,,0 CDM,2500000004_55513032601,"Riabni: 1 Vial, Single-Dose In 1 Carton (55513-326-01) / 50 Ml In 1 Vial, Single-Dose",349.35,139.74,,,0 CDM,2500000004_55513053001,NDC Description Not Available,4.48,1.79,,,0 CDM,2500000004_55513053010,Neupogen: 10 Vial In 1 Package (55513-530-10) / 1 Ml In 1 Vial (55513-530-01),4.52,1.81,,,0 CDM,2500000004_55513054601,NDC Description Not Available,4.6,1.84,,,0 CDM,2500000004_55513067001,"Avsola: 1 Vial, Single-Dose In 1 Carton (55513-670-01) / 10 Ml In 1 Vial, Single-Dose",211.86,84.74,,,0 CDM,2500000004_55513071001,Prolia: 1 Syringe In 1 Carton (55513-710-01) / 1 Ml In 1 Syringe,128.9,51.56,,,0 CDM,2500000004_55513071021,Prolia: 1 Syringe In 1 Carton (55513-710-21) / 1 Ml In 1 Syringe,135.74,54.3,,,0 CDM,2500000004_55513073001,"Xgeva: 1 Vial, Single-Use In 1 Carton (55513-730-01) / 1.7 Ml In 1 Vial, Single-Use",125.25,50.1,,,0 CDM,2500000004_55513088001,NDC Description Not Available,54.84,21.94,,,0 CDM,2500000004_55513088002,Evenity: 2 Syringe In 1 Carton (55513-880-02) / 1.17 Ml In 1 Syringe (55513-880-01),54.84,21.94,,,0 CDM,2500000004_55513095401,"Vectibix: 1 Vial, Single-Dose In 1 Carton (55513-954-01) / 5 Ml In 1 Vial, Single-Dose",754.55,301.82,,,0 CDM,2500000004_55513095601,"Vectibix: 1 Vial, Single-Dose In 1 Carton (55513-956-01) / 20 Ml In 1 Vial, Single-Dose",749.4,299.76,,,0 CDM,2500000004_55513099802,"Evenity: 2 Syringe, Glass In 1 Carton (55513-998-02) / 1.17 Ml In 1 Syringe, Glass (55513-998-01)",53.98,21.59,,,0 CDM,2500000004_55566105000,NDC Description Not Available,267290.1,106916.04,,,0 CDM,2500000004_55566105001,Adstiladrin: 4 Vial In 1 Carton (55566-1050-1) / 20 Ml In 1 Vial (55566-1050-0),267960.0,107184.0,,,0 CDM,2500000004_55566410001,NDC Description Not Available,5251.99,2100.8,,,0 CDM,2500000004_55566830301,"Firmagon: 1 Kit In 1 Carton (55566-8303-1) * 4 Ml In 1 Vial, Glass * 4.2 Ml In 1 Syringe",26.31,10.52,,,0 CDM,2500000004_55566840301,"Firmagon: 1 Kit In 1 Carton (55566-8403-1) * 3 Ml In 1 Syringe * 3 Ml In 1 Vial, Glass",13.68,5.47,,,0 CDM,2500000004_57664068331,NDC Description Not Available,56.26,22.5,,,0 CDM,2500000004_57664068357,Linezolid: 10 Bag In 1 Box (57664-683-57) / 300 Ml In 1 Bag (57664-683-31),38.98,15.59,,,0 CDM,2500000004_57894003001,"Remicade: 1 Vial, Single-Use In 1 Box (57894-030-01) / 10 Ml In 1 Vial, Single-Use",494.73,197.89,,,0 CDM,2500000004_57894005427,"Stelara: 1 Vial, Single-Use In 1 Box (57894-054-27) / 26 Ml In 1 Vial, Single-Use",69.79,27.92,,,0 CDM,2500000004_57894006002,"Stelara: 1 Vial, Single-Use In 1 Carton (57894-060-02) / .5 Ml In 1 Vial, Single-Use",989.39,395.76,,,0 CDM,2500000004_57894016001,"Infliximab: 1 Vial, Single-Use In 1 Box (57894-160-01) / 10 Ml In 1 Vial, Single-Use",200.83,80.33,,,0 CDM,2500000004_57894035001,"Simponi Aria: 1 Vial, Single-Dose In 1 Carton (57894-350-01) / 4 Ml In 1 Vial, Single-Dose",170.86,68.34,,,0 CDM,2500000004_57894044901,"Tecvayli: 1 Vial, Single-Dose In 1 Carton (57894-449-01) / 3 Ml In 1 Vial, Single-Dose",133.65,53.46,,,0 CDM,2500000004_57894045001,"Tecvayli: 1 Vial, Single-Dose In 1 Carton (57894-450-01) / 1.7 Ml In 1 Vial, Single-Dose",150.17,60.07,,,0 CDM,2500000004_57894046901,"Talvey: 1 Vial, Single-Dose In 1 Carton (57894-469-01) / 1.5 Ml In 1 Vial, Single-Dose",274.02,109.61,,,0 CDM,2500000004_57894047001,"Talvey: 1 Vial, Single-Dose In 1 Carton (57894-470-01) / 1 Ml In 1 Vial, Single-Dose",306.05,122.42,,,0 CDM,2500000004_57894050101,"Rybrevant: 1 Vial, Single-Use In 1 Carton (57894-501-01) / 1 Injection In 1 Vial, Single-Use (57894-501-00)",94.4,37.76,,,0 CDM,2500000004_57894050301,"Darzalex Faspro: 1 Vial, Single-Dose In 1 Box (57894-503-01) / 15 Ml In 1 Vial, Single-Dose",249.45,99.78,,,0 CDM,2500000004_57894050505,"Darzalex Iv: 1 Vial, Single-Dose In 1 Box (57894-505-05) / 5 Ml In 1 Vial, Single-Dose",327.41,130.96,,,0 CDM,2500000004_57894050520,"Darzalex Iv: 1 Vial, Single-Dose In 1 Box (57894-505-20) / 20 Ml In 1 Vial, Single-Dose",1089.68,435.87,,,0 CDM,2500000004_57894065002,"Tremfya: 1 Vial, Single-Dose In 1 Carton (57894-650-02) / 20 Ml In 1 Vial, Single-Dose (57894-650-01)",321.91,128.76,,,0 CDM,2500000004_57970010001,Dalvance: 1 Vial In 1 Package (57970-100-01) / 25 Ml In 1 Vial,79.67,31.87,,,0 CDM,2500000004_58160072303,NDC Description Not Available,1347.81,539.12,,,0 CDM,2500000004_58160072615,Hiberix: 1 Kit In 1 Carton (58160-726-15) * .85 Ml In 1 Syringe (58160-817-02) * .5 Ml In 1 Vial (58160-816-03),56.96,22.78,,,0 CDM,2500000004_58160074002,NDC Description Not Available,441.03,176.41,,,0 CDM,2500000004_58160074021,Rotarix: 10 Applicator In 1 Carton (58160-740-21) / 1.5 Ml In 1 Applicator (58160-740-02),426.72,170.69,,,0 CDM,2500000004_58160081011,NDC Description Not Available,109.19,43.68,,,0 CDM,2500000004_58160081043,NDC Description Not Available,128.67,51.47,,,0 CDM,2500000004_58160081052,Infanrix: 10 Syringe In 1 Carton (58160-810-52) / .5 Ml In 1 Syringe (58160-810-43),169.43,67.77,,,0 CDM,2500000004_58160081143,NDC Description Not Available,423.55,169.42,,,0 CDM,2500000004_58160081243,NDC Description Not Available,272.9,109.16,,,0 CDM,2500000004_58160081252,Kinrix: 10 Syringe In 1 Carton (58160-812-52) / .5 Ml In 1 Syringe (58160-812-43),257.23,102.89,,,0 CDM,2500000004_58160081543,NDC Description Not Available,566.16,226.46,,,0 CDM,2500000004_58160081552,Twinrix: 10 Syringe In 1 Carton (58160-815-52) / 1 Ml In 1 Syringe (58160-815-43),418.27,167.31,,,0 CDM,2500000004_58160081601,NDC Description Not Available,48.01,19.2,,,0 CDM,2500000004_58160081603,NDC Description Not Available,57.93,23.17,,,0 CDM,2500000004_58160081811,Hiberix: 1 Kit In 1 Carton (58160-818-11) * 10 Vial In 1 Carton (58160-816-05) / .5 Ml In 1 Vial (58160-816-01) * 10 Vial In 1 Package (58160-817-05) / .85 Ml In 1 Vial (58160-817-01),48.0,19.2,,,0 CDM,2500000004_58160082043,NDC Description Not Available,123.12,49.25,,,0 CDM,2500000004_58160082052,Engerix-B: 10 Syringe In 1 Carton (58160-820-52) / .5 Ml In 1 Syringe (58160-820-43),109.15,43.66,,,0 CDM,2500000004_58160082311,Shingrix: 1 Kit In 1 Carton (58160-823-11) * .5 Ml In 1 Vial (58160-828-03) * .5 Ml In 1 Vial (58160-829-03),683.08,273.23,,,0 CDM,2500000004_58160082415,Priorix: 1 Kit In 1 Carton (58160-824-15) * .5 Ml In 1 Vial (58160-831-03) * .5 Ml In 1 Syringe (58160-833-02),423.13,169.25,,,0 CDM,2500000004_58160082543,NDC Description Not Available,169.98,67.99,,,0 CDM,2500000004_58160082552,Havrix: 10 Syringe In 1 Carton (58160-825-52) / .5 Ml In 1 Syringe (58160-825-43),162.73,65.09,,,0 CDM,2500000004_58160082643,NDC Description Not Available,371.79,148.72,,,0 CDM,2500000004_58160082652,Havrix: 10 Syringe In 1 Carton (58160-826-52) / 1 Ml In 1 Syringe (58160-826-43),367.6,147.04,,,0 CDM,2500000004_58160082703,NDC Description Not Available,725.37,290.15,,,0 CDM,2500000004_58160082730,Menveo: 10 Vial In 1 Carton (58160-827-30) / .5 Ml In 1 Vial (58160-827-03),707.99,283.2,,,0 CDM,2500000004_58160082803,NDC Description Not Available,801.71,320.68,,,0 CDM,2500000004_58160082903,NDC Description Not Available,661.47,264.59,,,0 CDM,2500000004_58160083103,NDC Description Not Available,413.7,165.48,,,0 CDM,2500000004_58160084211,Boostrix: 10 Vial In 1 Carton (58160-842-11) / .5 Ml In 1 Vial (58160-842-01),166.2,66.48,,,0 CDM,2500000004_58160084243,NDC Description Not Available,211.98,84.79,,,0 CDM,2500000004_58160084252,Boostrix: 10 Syringe In 1 Carton (58160-842-52) / .5 Ml In 1 Syringe (58160-842-43),209.69,83.88,,,0 CDM,2500000004_58160084811,Arexvy: 1 Kit In 1 Carton (58160-848-11) * .5 Ml In 1 Vial (58160-723-03) * .5 Ml In 1 Vial (58160-744-03),1106.97,442.79,,,0 CDM,2500000004_58160088452,Fluarix 2024/2025: 10 Syringe In 1 Carton (58160-884-52) / .5 Ml In 1 Syringe (58160-884-41),69.23,27.69,,,0 CDM,2500000004_58160095509,"Menveo: 1 Kit In 1 Carton (58160-955-09) * .5 Ml In 1 Vial, Single-Dose (58160-958-01) * .5 Ml In 1 Vial, Single-Dose (58160-959-01)",462.96,185.18,,,0 CDM,2500000004_58160095801,NDC Description Not Available,463.18,185.27,,,0 CDM,2500000004_58160097602,NDC Description Not Available,1039.7,415.88,,,0 CDM,2500000004_58160097620,Bexsero: 10 Syringe In 1 Carton (58160-976-20) / .5 Ml In 1 Syringe (58160-976-02),724.24,289.7,,,0 CDM,2500000004_58284022401,"Brixadi: 1 Syringe, Glass In 1 Carton (58284-224-01) / .48 Ml In 1 Syringe, Glass",1885.28,754.11,,,0 CDM,2500000004_58284029601,"Brixadi: 1 Syringe, Glass In 1 Carton (58284-296-01) / .27 Ml In 1 Syringe, Glass",7556.75,3022.7,,,0 CDM,2500000004_58468003001,NDC Description Not Available,9100.81,3640.32,,,0 CDM,2500000004_58468003002,"Thyrogen: 2 Vial, Single-Dose In 1 Carton (58468-0030-2) / 1 Ml In 1 Vial, Single-Dose (58468-0030-1)",8702.53,3481.01,,,0 CDM,2500000004_58468008001,"Thymoglobulin: 1 Vial, Glass In 1 Carton (58468-0080-1) / 5 Ml In 1 Vial, Glass",4795.48,1918.19,,,0 CDM,2500000004_58468009001,NDC Description Not Available,199.6,79.84,,,0 CDM,2500000004_58468009003,NDC Description Not Available,168.87,67.55,,,0 CDM,2500000004_58468022501,"Cablivi: 1 Kit In 1 Carton (58468-0225-1) * 1 Ml In 1 Vial, Glass (58468-0227-1) * 1 Ml In 1 Syringe, Glass (58468-0229-1)",2855.36,1142.14,,,0 CDM,2500000004_58468035701,"Campath: 1 Vial, Single-Use In 1 Carton (58468-0357-1) / 1 Ml In 1 Vial, Single-Use",80.54,32.22,,,0 CDM,2500000004_58468042601,"Nexviazyme: 1 Vial, Single-Dose In 1 Carton (58468-0426-1) / 10 Ml In 1 Vial, Single-Dose",334.88,133.95,,,0 CDM,2500000004_58914008052,Bentyl: 5 Ampule In 1 Box (58914-080-52) / 2 Ml In 1 Ampule,362.27,144.91,,,0 CDM,2500000004_59338077501,"Feraheme: 1 Vial, Single-Use In 1 Carton (59338-775-01) / 17 Ml In 1 Vial, Single-Use",10.46,4.18,,,0 CDM,2500000004_59365512801,Paragard T 380A: 1 Pouch In 1 Carton (59365-5128-1) / 1 Intrauterine Device In 1 Pouch,4971.51,1988.6,,,0 CDM,2500000004_59365512901,Paragard T 380A: 1 Pouch In 1 Carton (59365-5129-1) / 1 Intrauterine Device In 1 Pouch,5011.6,2004.64,,,0 CDM,2500000004_59572071101,"Reblozyl: 1 Vial, Glass In 1 Carton (59572-711-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Glass",175.7,70.28,,,0 CDM,2500000004_59572077501,"Reblozyl: 1 Vial, Glass In 1 Carton (59572-775-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Glass",175.44,70.18,,,0 CDM,2500000004_59572098401,"Istodax: 1 Kit In 1 Carton (59572-984-01) * 2.2 Ml In 1 Vial, Glass (59572-962-10) * 2.4 Ml In 1 Vial, Glass (59572-973-02)",147.14,58.86,,,0 CDM,2500000004_59630026601,NDC Description Not Available,9.75,3.9,,,0 CDM,2500000004_59630026610,"Fetroja: 10 Vial, Single-Use In 1 Carton (59630-266-10) / 10 Ml In 1 Vial, Single-Use (59630-266-01)",9.47,3.79,,,0 CDM,2500000004_59651033201,Flucytosine: 100 Capsule In 1 Bottle (59651-332-01),205.37,82.15,,,0 CDM,2500000004_59651048401,Prednisone: 100 Tablet In 1 Bottle (59651-484-01),0.44,0.18,,,0 CDM,2500000004_59676061001,"Yondelis: 20 Ml In 1 Vial, Single-Use (59676-610-01)",1580.86,632.34,,,0 CDM,2500000004_59746000106,Methylprednisolone: 100 Tablet In 1 Bottle (59746-001-06),1.26,0.5,,,0 CDM,2500000004_59746011306,Prochlorperazine Maleate: 100 Tablet In 1 Bottle (59746-113-06),1.5,0.6,,,0 CDM,2500000004_59746017106,Prednisone: 100 Tablet In 1 Bottle (59746-171-06),0.44,0.18,,,0 CDM,2500000004_59746017306,Prednisone: 100 Tablet In 1 Bottle (59746-173-06),0.04,0.02,,,0 CDM,2500000004_59746017506,Prednisone: 100 Tablet In 1 Bottle (59746-175-06),0.03,0.01,,,0 CDM,2500000004_59762005001,Methylprednisolone: 50 Tablet In 1 Bottle (59762-0050-1),1.88,0.75,,,0 CDM,2500000004_59762005101,Methylprednisolone: 25 Tablet In 1 Bottle (59762-0051-1),1.6,0.64,,,0 CDM,2500000004_59762100101,"Sirolimus: 100 Tablet, Sugar Coated In 1 Bottle (59762-1001-1)",13.56,5.42,,,0 CDM,2500000004_60219107601,Azathioprine: 100 Tablet In 1 Bottle (60219-1076-1),1.93,0.77,,,0 CDM,2500000004_60267070550,"Sodium Thiosulfate: 50 Ml In 1 Vial, Single-Dose (60267-705-50)",3.44,1.38,,,0 CDM,2500000004_60505609700,"Ibandronate Sodium: 1 Syringe, Glass In 1 Carton (60505-6097-0) / 3 Ml In 1 Syringe, Glass",1084.88,433.95,,,0 CDM,2500000004_60505612801,"Irinotecan Hydrochloride: 1 Vial, Single-Use In 1 Carton (60505-6128-1) / 5 Ml In 1 Vial, Single-Use",13.4,5.36,,,0 CDM,2500000004_60505613000,NDC Description Not Available,0.5,0.2,,,0 CDM,2500000004_60505613005,"Ondansetron: 25 Vial, Single-Use In 1 Carton (60505-6130-5) / 2 Ml In 1 Vial, Single-Use (60505-6130-0)",0.48,0.19,,,0 CDM,2500000004_60505613207,Oxaliplatin: 1 Vial In 1 Carton (60505-6132-7) / 20 Ml In 1 Vial,0.89,0.36,,,0 CDM,2500000004_60505614200,NDC Description Not Available,2.89,1.16,,,0 CDM,2500000004_60505614600,"Cefepime: 1 Vial, Single-Dose In 1 Carton (60505-6146-0) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose",11.22,4.49,,,0 CDM,2500000004_60505614604,"Cefepime: 10 Vial, Single-Dose In 1 Carton (60505-6146-4) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose",11.28,4.51,,,0 CDM,2500000004_60505614700,"Cefepime: 1 Vial, Single-Dose In 1 Carton (60505-6147-0) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose",15.66,6.26,,,0 CDM,2500000004_60505614704,"Cefepime: 10 Vial, Single-Dose In 1 Carton (60505-6147-4) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose",15.77,6.31,,,0 CDM,2500000004_60505614800,"Ceftriaxone Sodium: 1 Vial, Single-Use In 1 Carton (60505-6148-0) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use",3.12,1.25,,,0 CDM,2500000004_60505614804,"Ceftriaxone Sodium: 10 Vial, Single-Use In 1 Carton (60505-6148-4) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use",1.63,0.65,,,0 CDM,2500000004_60505614900,NDC Description Not Available,1.51,0.6,,,0 CDM,2500000004_60505615204,"Ceftriaxone Sodium: 1 Vial, Single-Use In 1 Carton (60505-6152-4) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use",4.93,1.97,,,0 CDM,2500000004_60505615600,NDC Description Not Available,7.07,2.83,,,0 CDM,2500000004_60505615700,NDC Description Not Available,4.76,1.9,,,0 CDM,2500000004_60505615704,"Piperacillin And Tazobactam: 10 Vial, Single-Dose In 1 Carton (60505-6157-4) / 15 Ml In 1 Vial, Single-Dose (60505-6157-0)",6.29,2.52,,,0 CDM,2500000004_60505615900,NDC Description Not Available,13.46,5.38,,,0 CDM,2500000004_60505615904,"Piperacillin And Tazobactam: 10 Vial, Single-Dose In 1 Carton (60505-6159-4) / 20 Ml In 1 Vial, Single-Dose (60505-6159-0)",7.59,3.04,,,0 CDM,2500000004_60505619301,Palonosetron: 1 Vial In 1 Carton (60505-6193-1) / 5 Ml In 1 Vial,13.03,5.21,,,0 CDM,2500000004_60505619600,NDC Description Not Available,76.46,30.58,,,0 CDM,2500000004_60505619604,Ertapenem: 10 Vial In 1 Carton (60505-6196-4) / 20 Ml In 1 Vial (60505-6196-0),66.92,26.77,,,0 CDM,2500000004_60505619702,"Sirolimus: 1 Bottle, Glass In 1 Carton (60505-6197-2) / 60 Ml In 1 Bottle, Glass",58.1,23.24,,,0 CDM,2500000004_60505622904,"Daptomycin: 1 Vial, Single-Use In 1 Carton (60505-6229-4) / 10 Ml In 1 Vial, Single-Use",0.26,0.1,,,0 CDM,2500000004_60505623606,"Deferoxamine Mesylate: 4 Injection, Powder, Lyophilized, For Solution In 1 Carton (60505-6236-6)",35.59,14.24,,,0 CDM,2500000004_60505627101,"Azacitidine: 1 Injection, Powder, Lyophilized, For Solution In 1 Carton (60505-6271-1)",7.52,3.01,,,0 CDM,2500000004_60687012201,"Prednisone: 100 Blister Pack In 1 Box, Unit-Dose (60687-122-01) / 1 Tablet In 1 Blister Pack (60687-122-11)",0.14,0.06,,,0 CDM,2500000004_60687012211,NDC Description Not Available,0.1,0.04,,,0 CDM,2500000004_60687013401,"Prednisone: 100 Blister Pack In 1 Box, Unit-Dose (60687-134-01) / 1 Tablet In 1 Blister Pack (60687-134-11)",0.05,0.02,,,0 CDM,2500000004_60687013411,NDC Description Not Available,0.05,0.02,,,0 CDM,2500000004_60687014501,"Prednisone: 100 Blister Pack In 1 Box, Unit-Dose (60687-145-01) / 1 Tablet In 1 Blister Pack (60687-145-11)",0.03,0.01,,,0 CDM,2500000004_60687014511,NDC Description Not Available,0.03,0.01,,,0 CDM,2500000004_60687037501,"Dronabinol: 100 Blister Pack In 1 Box, Unit-Dose (60687-375-01) / 1 Capsule In 1 Blister Pack (60687-375-11)",30.5,12.2,,,0 CDM,2500000004_60687037511,NDC Description Not Available,19.66,7.86,,,0 CDM,2500000004_60687037521,Dronabinol: 30 Blister Pack In 1 Carton (60687-375-21) / 1 Capsule In 1 Blister Pack (60687-375-11),30.5,12.2,,,0 CDM,2500000004_60687038611,NDC Description Not Available,20.12,8.05,,,0 CDM,2500000004_60687038621,"Dronabinol: 30 Blister Pack In 1 Box, Unit-Dose (60687-386-21) / 1 Capsule In 1 Blister Pack (60687-386-11)",21.37,8.55,,,0 CDM,2500000004_60687038694,Dronabinol: 20 Blister Pack In 1 Carton (60687-386-94) / 1 Capsule In 1 Blister Pack (60687-386-11),20.12,8.05,,,0 CDM,2500000004_60687049401,"Mycophenolate Mofetil: 100 Blister Pack In 1 Box, Unit-Dose (60687-494-01) / 1 Capsule In 1 Blister Pack (60687-494-11)",1.81,0.72,,,0 CDM,2500000004_60687049411,NDC Description Not Available,2.05,0.82,,,0 CDM,2500000004_60687066001,Promethazine Hydrochloride: 100 Blister Pack In 1 Carton (60687-660-01) / 1 Tablet In 1 Blister Pack (60687-660-11),1.32,0.53,,,0 CDM,2500000004_60687066011,NDC Description Not Available,1.08,0.43,,,0 CDM,2500000004_60687066901,Methimazole: 100 Blister Pack In 1 Carton (60687-669-01) / 1 Tablet In 1 Blister Pack (60687-669-11),4.88,1.95,,,0 CDM,2500000004_60687081411,NDC Description Not Available,3.85,1.54,,,0 CDM,2500000004_60687088501,Mycophenolate Mofetil: 100 Blister Pack In 1 Carton (60687-885-01) / 1 Capsule In 1 Blister Pack (60687-885-11),2.16,0.86,,,0 CDM,2500000004_60793070001,NDC Description Not Available,113.62,45.45,,,0 CDM,2500000004_60793070010,Bicillin L-A: 10 Syringe In 1 Package (60793-700-10) / 1 Ml In 1 Syringe (60793-700-01),143.96,57.58,,,0 CDM,2500000004_60793070102,NDC Description Not Available,91.18,36.47,,,0 CDM,2500000004_60793070110,Bicillin L-A: 10 Syringe In 1 Package (60793-701-10) / 2 Ml In 1 Syringe (60793-701-02),119.54,47.82,,,0 CDM,2500000004_60793070204,NDC Description Not Available,103.44,41.38,,,0 CDM,2500000004_60793070210,Bicillin L-A: 10 Syringe In 1 Package (60793-702-10) / 4 Ml In 1 Syringe (60793-702-04),112.22,44.89,,,0 CDM,2500000004_61269041020,"Etopophos: 1 Vial, Single-Dose In 1 Carton (61269-410-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",68.4,27.36,,,0 CDM,2500000004_61314031801,Zarxio: 1 Blister Pack In 1 Carton (61314-318-01) / 1 Syringe In 1 Blister Pack / .5 Ml In 1 Syringe,4.02,1.61,,,0 CDM,2500000004_61314031805,NDC Description Not Available,3.91,1.56,,,0 CDM,2500000004_61314031810,Zarxio: 2 Blister Pack In 1 Carton (61314-318-10) / 5 Syringe In 1 Blister Pack (61314-318-05) / .5 Ml In 1 Syringe,1.68,0.67,,,0 CDM,2500000004_61314032601,Zarxio: 1 Blister Pack In 1 Carton (61314-326-01) / 1 Syringe In 1 Blister Pack / .8 Ml In 1 Syringe,4.01,1.6,,,0 CDM,2500000004_61314032605,NDC Description Not Available,4.03,1.61,,,0 CDM,2500000004_61314032610,Zarxio: 2 Blister Pack In 1 Carton (61314-326-10) / 5 Syringe In 1 Blister Pack (61314-326-05) / .8 Ml In 1 Syringe,1.85,0.74,,,0 CDM,2500000004_61703030906,"Vincristine Sulfate: 1 Vial, Single-Dose In 1 Carton (61703-309-06) / 1 Ml In 1 Vial, Single-Dose",78.85,31.54,,,0 CDM,2500000004_61703030916,"Vincristine Sulfate: 1 Vial, Single-Dose In 1 Carton (61703-309-16) / 2 Ml In 1 Vial, Single-Dose",30.87,12.35,,,0 CDM,2500000004_61703031922,"Cytarabine: 1 Vial, Single-Dose In 1 Carton (61703-319-22) / 20 Ml In 1 Vial, Single-Dose",4.75,1.9,,,0 CDM,2500000004_61703032418,"Pamidronate Disodium: 1 Vial, Single-Dose In 1 Carton (61703-324-18) / 10 Ml In 1 Vial, Single-Dose",64.45,25.78,,,0 CDM,2500000004_61703034250,"Paclitaxel: 1 Vial, Multi-Dose In 1 Carton (61703-342-50) / 50 Ml In 1 Vial, Multi-Dose",0.85,0.34,,,0 CDM,2500000004_61703034318,"Mitoxantrone: 1 Vial, Multi-Dose In 1 Carton (61703-343-18) / 10 Ml In 1 Vial, Multi-Dose",193.59,77.44,,,0 CDM,2500000004_61703034365,"Mitoxantrone: 1 Vial, Multi-Dose In 1 Carton (61703-343-65) / 12.5 Ml In 1 Vial, Multi-Dose",118.02,47.21,,,0 CDM,2500000004_61703036322,"Oxaliplatin: 1 Vial, Single-Dose In 1 Carton (61703-363-22) / 20 Ml In 1 Vial, Single-Dose",4.5,1.8,,,0 CDM,2500000004_61703040841,"Methotrexate: 1 Vial, Single-Dose In 1 Carton (61703-408-41) / 40 Ml In 1 Vial, Single-Dose",7.61,3.04,,,0 CDM,2500000004_61755000801,"Libtayo: 1 Vial, Single-Use In 1 Carton (61755-008-01) / 7 Ml In 1 Vial, Single-Use",133.6,53.44,,,0 CDM,2500000004_61958290102,"Veklury: 1 Vial, Single-Dose In 1 Carton (61958-2901-2) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",27.19,10.88,,,0 CDM,2500000004_62484002001,NDC Description Not Available,162.71,65.08,,,0 CDM,2500000004_62484002002,Purixan: 1 Bottle In 1 Carton (62484-0020-2) / 100 Ml In 1 Bottle (62484-0020-1),15.97,6.39,,,0 CDM,2500000004_62643007099,NDC Description Not Available,0.77,0.31,,,0 CDM,2500000004_62756005940,Epoprostenol: 1 Vial In 1 Carton (62756-059-40) / 10 Ml In 1 Vial,100.77,40.31,,,0 CDM,2500000004_62756006040,Epoprostenol: 1 Vial In 1 Carton (62756-060-40) / 10 Ml In 1 Vial,78.75,31.5,,,0 CDM,2500000004_62756023301,"Amphotericin B: 1 Vial, Single-Dose In 1 Carton (62756-233-01) / 1 Injectable, Liposomal In 1 Vial, Single-Dose",227.8,91.12,,,0 CDM,2500000004_62756030101,"Sezaby: 1 Injection In 1 Vial, Single-Dose (62756-301-01)",5.8,2.32,,,0 CDM,2500000004_62756035664,"Ondansetron: 3 Blister Pack In 1 Dose Pack (62756-356-64) / 10 Tablet, Orally Disintegrating In 1 Blister Pack",0.33,0.13,,,0 CDM,2500000004_62856021201,"Leqembi: 1 Vial, Single-Dose In 1 Carton (62856-212-01) / 2 Ml In 1 Vial, Single-Dose",5.68,2.27,,,0 CDM,2500000004_62856021501,"Leqembi: 1 Vial, Single-Dose In 1 Carton (62856-215-01) / 5 Ml In 1 Vial, Single-Dose",5.7,2.28,,,0 CDM,2500000004_62856038901,"Halaven: 1 Vial, Single-Dose In 1 Carton (62856-389-01) / 2 Ml In 1 Vial, Single-Dose",617.51,247.0,,,0 CDM,2500000004_62935016360,Fensolvi: 1 Syringe In 1 Carton (62935-163-60) / .375 Ml In 1 Syringe,82.93,33.17,,,0 CDM,2500000004_62935022710,Eligard: 1 Syringe In 1 Carton (62935-227-10) / .375 Ml In 1 Syringe,550.0,220.0,,,0 CDM,2500000004_62935046150,Eligard: 1 Syringe In 1 Carton (62935-461-50) / .375 Ml In 1 Syringe,550.0,220.0,,,0 CDM,2500000004_63323001001,NDC Description Not Available,14.18,5.67,,,0 CDM,2500000004_63323001002,Gentamicin: 25 Vial In 1 Tray (63323-010-02) / 2 Ml In 1 Vial (63323-010-01),22.51,9.0,,,0 CDM,2500000004_63323001003,NDC Description Not Available,9.63,3.85,,,0 CDM,2500000004_63323001020,Gentamicin: 25 Vial In 1 Tray (63323-010-20) / 20 Ml In 1 Vial (63323-010-03),12.87,5.15,,,0 CDM,2500000004_63323001094,"Gentamicin: 25 Vial, Multi-Dose In 1 Tray (63323-010-94) / 2 Ml In 1 Vial, Multi-Dose (63323-010-41)",5.06,2.02,,,0 CDM,2500000004_63323001203,NDC Description Not Available,15.34,6.14,,,0 CDM,2500000004_63323001207,Oxytocin: 25 Vial In 1 Tray (63323-012-07) / 1 Ml In 1 Vial (63323-012-17),6.09,2.44,,,0 CDM,2500000004_63323001211,Oxytocin: 25 Vial In 1 Tray (63323-012-11) / 1 Ml In 1 Vial (63323-012-03),4.19,1.68,,,0 CDM,2500000004_63323001212,Oxytocin: 25 Vial In 1 Tray (63323-012-12) / 1 Ml In 1 Vial (63323-012-21),2.68,1.07,,,0 CDM,2500000004_63323001302,"Thiamine: 25 Vial, Multi-Dose In 1 Tray (63323-013-02) / 2 Ml In 1 Vial, Multi-Dose (63323-013-01)",3.04,1.22,,,0 CDM,2500000004_63323002401,NDC Description Not Available,26.62,10.65,,,0 CDM,2500000004_63323002425,"Mannitol: 25 Vial, Single-Dose In 1 Tray (63323-024-25) / 50 Ml In 1 Vial, Single-Dose (63323-024-01)",23.74,9.5,,,0 CDM,2500000004_63323004400,NDC Description Not Available,15.21,6.08,,,0 CDM,2500000004_63323004401,"Cyanocobalamin: 25 Vial, Multi-Dose In 1 Tray (63323-044-01) / 1 Ml In 1 Vial, Multi-Dose (63323-044-00)",9.19,3.68,,,0 CDM,2500000004_63323004701,NDC Description Not Available,1.55,0.62,,,0 CDM,2500000004_63323004710,Heparin Sodium: 25 Vial In 1 Tray (63323-047-10) / 10 Ml In 1 Vial (63323-047-01),1.56,0.62,,,0 CDM,2500000004_63323006401,NDC Description Not Available,5.06,2.02,,,0 CDM,2500000004_63323006403,"Magnesium Sulfate: 25 Vial, Single-Dose In 1 Carton (63323-064-03) / 2 Ml In 1 Vial, Single-Dose (63323-064-01)",3.98,1.59,,,0 CDM,2500000004_63323006404,NDC Description Not Available,1.16,0.46,,,0 CDM,2500000004_63323006411,"Magnesium Sulfate: 25 Vial, Single-Dose In 1 Tray (63323-064-11) / 10 Ml In 1 Vial, Single-Dose (63323-064-04)",0.83,0.33,,,0 CDM,2500000004_63323010364,Cisplatin: 1 Vial In 1 Carton (63323-103-64) / 200 Ml In 1 Vial,18.37,7.35,,,0 CDM,2500000004_63323010365,Cisplatin: 1 Vial In 1 Carton (63323-103-65) / 100 Ml In 1 Vial,17.16,6.86,,,0 CDM,2500000004_63323010406,"Etoposide: 1 Vial, Multi-Dose In 1 Carton (63323-104-06) / 5 Ml In 1 Vial, Multi-Dose",5.22,2.09,,,0 CDM,2500000004_63323010425,"Etoposide: 1 Vial, Multi-Dose In 1 Carton (63323-104-25) / 25 Ml In 1 Vial, Multi-Dose",1.72,0.69,,,0 CDM,2500000004_63323010600,NDC Description Not Available,5.18,2.07,,,0 CDM,2500000004_63323010601,Magnesium Sulfate: 24 Bag In 1 Case (63323-106-01) / 100 Ml In 1 Bag (63323-106-00),5.18,2.07,,,0 CDM,2500000004_63323010602,NDC Description Not Available,14.39,5.76,,,0 CDM,2500000004_63323010605,Magnesium Sulfate: 24 Bag In 1 Case (63323-106-05) / 50 Ml In 1 Bag (63323-106-02),4.31,1.72,,,0 CDM,2500000004_63323010615,Magnesium Sulfate: 24 Bag In 1 Case (63323-106-15) / 500 Ml In 1 Bag,0.66,0.26,,,0 CDM,2500000004_63323010800,NDC Description Not Available,19.18,7.67,,,0 CDM,2500000004_63323011700,NDC Description Not Available,16.66,6.66,,,0 CDM,2500000004_63323011701,NDC Description Not Available,14.5,5.8,,,0 CDM,2500000004_63323011710,"Fluorouracil: 10 Vial, Single-Dose In 1 Tray (63323-117-10) / 10 Ml In 1 Vial, Single-Dose (63323-117-00)",15.28,6.11,,,0 CDM,2500000004_63323011720,"Fluorouracil: 10 Vial, Single-Dose In 1 Tray (63323-117-20) / 20 Ml In 1 Vial, Single-Dose (63323-117-01)",14.84,5.94,,,0 CDM,2500000004_63323011751,"Fluorouracil: 1 Vial, Pharmacy Bulk Package In 1 Carton (63323-117-51) / 50 Ml In 1 Vial, Pharmacy Bulk Package",12.61,5.04,,,0 CDM,2500000004_63323011761,"Fluorouracil: 1 Vial, Pharmacy Bulk Package In 1 Carton (63323-117-61) / 100 Ml In 1 Vial, Pharmacy Bulk Package",12.6,5.04,,,0 CDM,2500000004_63323012020,"Cytarabine: 1 Vial, Single-Dose In 1 Carton (63323-120-20) / 20 Ml In 1 Vial, Single-Dose",4.59,1.84,,,0 CDM,2500000004_63323012800,NDC Description Not Available,2.27,0.91,,,0 CDM,2500000004_63323012820,"Dacarbazine: 10 Vial, Single-Dose In 1 Tray (63323-128-20) / 20 Ml In 1 Vial, Single-Dose (63323-128-00)",24.94,9.98,,,0 CDM,2500000004_63323013011,Doxy 100: 10 Vial In 1 Tray (63323-130-11) / 10 Ml In 1 Vial (63323-130-02),0.71,0.28,,,0 CDM,2500000004_63323013410,"Pemetrexed: 1 Vial, Single-Use In 1 Carton (63323-134-10) / 4 Ml In 1 Vial, Single-Use",55.88,22.35,,,0 CDM,2500000004_63323013720,"Bleomycin: 1 Vial In 1 Carton (63323-137-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",134.34,53.74,,,0 CDM,2500000004_63323014010,"Cladribine: 1 Vial, Single-Dose In 1 Carton (63323-140-10) / 10 Ml In 1 Vial, Single-Dose",193.07,77.23,,,0 CDM,2500000004_63323016100,NDC Description Not Available,16.11,6.44,,,0 CDM,2500000004_63323016101,"Ketorolac Tromethamine: 25 Vial, Single-Use In 1 Tray (63323-161-01) / 1 Ml In 1 Vial, Single-Use (63323-161-00)",2.7,1.08,,,0 CDM,2500000004_63323016201,"Ketorolac Tromethamine: 25 Vial, Single-Use In 1 Tray (63323-162-01) / 1 Ml In 1 Vial, Single-Use (63323-162-00)",12.8,5.12,,,0 CDM,2500000004_63323016202,"Ketorolac Tromethamine: 25 Vial, Single-Use In 1 Tray (63323-162-02) / 2 Ml In 1 Vial, Single-Use (63323-162-03)",0.92,0.37,,,0 CDM,2500000004_63323016501,Dexamethasone Sodium Phosphate: 25 Vial In 1 Tray (63323-165-01) / 1 Ml In 1 Vial (63323-165-02),3.09,1.24,,,0 CDM,2500000004_63323016502,NDC Description Not Available,2.82,1.13,,,0 CDM,2500000004_63323016503,NDC Description Not Available,1.55,0.62,,,0 CDM,2500000004_63323016505,"Dexamethasone Sodium Phosphate: 25 Vial, Multi-Dose In 1 Tray (63323-165-05) / 5 Ml In 1 Vial, Multi-Dose (63323-165-03)",1.52,0.61,,,0 CDM,2500000004_63323016530,"Dexamethasone Sodium Phosphate: 1 Vial, Multi-Dose In 1 Box (63323-165-30) / 30 Ml In 1 Vial, Multi-Dose",1.72,0.69,,,0 CDM,2500000004_63323017260,Carboplatin: 1 Vial In 1 Box (63323-172-60) / 60 Ml In 1 Vial,18.1,7.24,,,0 CDM,2500000004_63323017302,Gentamicin: 25 Vial In 1 Tray (63323-173-02) / 2 Ml In 1 Vial (63323-173-01),23.35,9.34,,,0 CDM,2500000004_63323018000,NDC Description Not Available,65.59,26.24,,,0 CDM,2500000004_63323018001,Pyridoxine Hydrochloride: 25 Vial In 1 Tray (63323-180-01) / 1 Ml In 1 Vial (63323-180-00),26.1,10.44,,,0 CDM,2500000004_63323018410,"Folic Acid: 1 Vial, Multi-Dose In 1 Carton (63323-184-10) / 10 Ml In 1 Vial, Multi-Dose",0.48,0.19,,,0 CDM,2500000004_63323019202,Fludarabine: 1 Vial In 1 Box (63323-192-02) / 2 Ml In 1 Vial,118.92,47.57,,,0 CDM,2500000004_63323020101,NDC Description Not Available,0.06,0.02,,,0 CDM,2500000004_63323020102,Lidocaine: 25 Vial In 1 Tray (63323-201-02) / 2 Ml In 1 Vial (63323-201-01),0.58,0.23,,,0 CDM,2500000004_63323020103,NDC Description Not Available,0.06,0.02,,,0 CDM,2500000004_63323020110,Lidocaine: 25 Vial In 1 Tray (63323-201-10) / 10 Ml In 1 Vial (63323-201-03),0.06,0.02,,,0 CDM,2500000004_63323020201,NDC Description Not Available,0.26,0.1,,,0 CDM,2500000004_63323020202,Lidocaine: 25 Vial In 1 Tray (63323-202-02) / 2 Ml In 1 Vial (63323-202-01),0.26,0.1,,,0 CDM,2500000004_63323020320,Vancomycin Hydrochloride: 10 Vial In 1 Tray (63323-203-20) / 15 Ml In 1 Vial (63323-203-01),20.45,8.18,,,0 CDM,2500000004_63323020805,"Lidocaine: 25 Vial, Single-Dose In 1 Tray (63323-208-05) / 5 Ml In 1 Vial, Single-Dose (63323-208-01)",0.27,0.11,,,0 CDM,2500000004_63323022901,NDC Description Not Available,13.62,5.45,,,0 CDM,2500000004_63323022905,"Protamine Sulfate: 25 Vial, Single-Dose In 1 Tray (63323-229-05) / 5 Ml In 1 Vial, Single-Dose (63323-229-01)",13.84,5.54,,,0 CDM,2500000004_63323022930,"Protamine Sulfate: 1 Vial, Single-Dose In 1 Box (63323-229-30) / 25 Ml In 1 Vial, Single-Dose",9.45,3.78,,,0 CDM,2500000004_63323022935,"Protamine Sulfate: 1 Vial, Single-Dose In 1 Box (63323-229-35) / 25 Ml In 1 Vial, Single-Dose",5.64,2.26,,,0 CDM,2500000004_63323025501,NDC Description Not Available,3.36,1.34,,,0 CDM,2500000004_63323025503,"Methylprednisolone Sodium Succinate: 25 Vial, Single-Dose In 1 Tray (63323-255-03) / 1 Ml In 1 Vial, Single-Dose (63323-255-01)",4.1,1.64,,,0 CDM,2500000004_63323025803,"Methylprednisolone Sodium Succinate: 25 Vial, Single-Dose In 1 Tray (63323-258-03) / 2 Ml In 1 Vial, Single-Dose (63323-258-01)",2.24,0.9,,,0 CDM,2500000004_63323026201,Heparin Sodium: 25 Vial In 1 Tray (63323-262-01) / 1 Ml In 1 Vial,3.66,1.46,,,0 CDM,2500000004_63323026203,NDC Description Not Available,3.66,1.46,,,0 CDM,2500000004_63323026206,Heparin Sodium: 25 Vial In 1 Tray (63323-262-06) / 1 Ml In 1 Vial (63323-262-03),3.68,1.47,,,0 CDM,2500000004_63323026530,"Methylprednisolone Sodium Succinate: 1 Vial, Multi-Dose In 1 Carton (63323-265-30) / 16 Ml In 1 Vial, Multi-Dose",0.77,0.31,,,0 CDM,2500000004_63323026910,Diprivan: 10 Vial In 1 Box (63323-269-10) / 10 Ml In 1 Vial (63323-269-01),0.48,0.19,,,0 CDM,2500000004_63323026922,NDC Description Not Available,0.45,0.18,,,0 CDM,2500000004_63323026929,Diprivan: 10 Vial In 1 Box (63323-269-29) / 20 Ml In 1 Vial (63323-269-22),1.43,0.57,,,0 CDM,2500000004_63323026950,Diprivan: 20 Vial In 1 Box (63323-269-50) / 50 Ml In 1 Vial (63323-269-30),1.45,0.58,,,0 CDM,2500000004_63323026965,Diprivan: 10 Vial In 1 Box (63323-269-65) / 100 Ml In 1 Vial (63323-269-35),1.42,0.57,,,0 CDM,2500000004_63323026978,Diprivan: 10 Vial In 1 Box (63323-269-78) / 100 Ml In 1 Vial (63323-269-31),0.48,0.19,,,0 CDM,2500000004_63323027301,"Sumatriptan Succinate: 1 Vial, Single-Dose In 1 Carton (63323-273-01) / .5 Ml In 1 Vial, Single-Dose",25.9,10.36,,,0 CDM,2500000004_63323027810,"Vinblastine Sulfate: 1 Vial, Multi-Dose In 1 Box (63323-278-10) / 10 Ml In 1 Vial, Multi-Dose",23.9,9.56,,,0 CDM,2500000004_63323028001,NDC Description Not Available,6.29,2.52,,,0 CDM,2500000004_63323028002,Furosemide: 25 Vial In 1 Tray (63323-280-02) / 2 Ml In 1 Vial (63323-280-01),1.89,0.76,,,0 CDM,2500000004_63323028110,Fluphenazine Hydrochloride: 1 Vial In 1 Box (63323-281-10) / 10 Ml In 1 Vial,20.5,8.2,,,0 CDM,2500000004_63323028501,NDC Description Not Available,1.04,0.42,,,0 CDM,2500000004_63323028510,Naropin: 5 Ampule In 1 Box (63323-285-10) / 10 Ml In 1 Ampule (63323-285-01),1.0,0.4,,,0 CDM,2500000004_63323028513,"Naropin: 25 Vial, Single-Dose In 1 Carton (63323-285-13) / 10 Ml In 1 Vial, Single-Dose (63323-285-03)",1.23,0.49,,,0 CDM,2500000004_63323028563,Naropin: 24 Bag In 1 Case (63323-285-63) / 200 Ml In 1 Bag (63323-285-04),0.76,0.3,,,0 CDM,2500000004_63323028605,NDC Description Not Available,0.15,0.06,,,0 CDM,2500000004_63323028623,"Naropin: 25 Vial, Single-Dose In 1 Carton (63323-286-23) / 20 Ml In 1 Vial, Single-Dose (63323-286-05)",0.74,0.3,,,0 CDM,2500000004_63323028635,"Naropin: 25 Vial, Single-Dose In 1 Carton (63323-286-35) / 30 Ml In 1 Vial, Single-Dose (63323-286-11)",0.14,0.06,,,0 CDM,2500000004_63323028807,NDC Description Not Available,0.12,0.05,,,0 CDM,2500000004_63323029337,"Polocaine-Mpf: 25 Vial, Single-Dose In 1 Tray (63323-293-37) / 30 Ml In 1 Vial, Single-Dose (63323-293-01)",22.48,8.99,,,0 CDM,2500000004_63323030605,NDC Description Not Available,5.74,2.3,,,0 CDM,2500000004_63323030630,"Tobramycin: 10 Vial, Multi-Dose In 1 Tray (63323-306-30) / 30 Ml In 1 Vial, Multi-Dose (63323-306-05)",3.49,1.4,,,0 CDM,2500000004_63323031461,Vancomycin Hydrochloride: 1 Bottle In 1 Carton (63323-314-61) / 100 Ml In 1 Bottle,5.35,2.14,,,0 CDM,2500000004_63323031510,Ganciclovir: 25 Vial In 1 Tray (63323-315-10) / 10 Ml In 1 Vial (63323-315-01),375.87,150.35,,,0 CDM,2500000004_63323031801,"Granisetron: 1 Vial, Single-Use In 1 Box (63323-318-01) / 1 Ml In 1 Vial, Single-Use",8.8,3.52,,,0 CDM,2500000004_63323032201,NDC Description Not Available,67.38,26.95,,,0 CDM,2500000004_63323032221,NDC Description Not Available,22.92,9.17,,,0 CDM,2500000004_63323032503,NDC Description Not Available,0.65,0.26,,,0 CDM,2500000004_63323032509,NDC Description Not Available,0.83,0.33,,,0 CDM,2500000004_63323032510,"Acyclovir: 10 Vial, Single-Dose In 1 Tray (63323-325-10) / 10 Ml In 1 Vial, Single-Dose (63323-325-03)",0.13,0.05,,,0 CDM,2500000004_63323032520,"Acyclovir: 10 Vial, Single-Dose In 1 Tray (63323-325-20) / 20 Ml In 1 Vial, Single-Dose (63323-325-09)",0.1,0.04,,,0 CDM,2500000004_63323034610,"Ceftriaxone: 25 Vial In 1 Carton (63323-346-10) / 1 Injection, Powder, For Solution In 1 Vial (63323-346-01)",4.18,1.67,,,0 CDM,2500000004_63323035120,"Rifampin: 1 Vial In 1 Box (63323-351-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",1.1,0.44,,,0 CDM,2500000004_63323036001,NDC Description Not Available,0.48,0.19,,,0 CDM,2500000004_63323036003,NDC Description Not Available,0.26,0.1,,,0 CDM,2500000004_63323036005,NDC Description Not Available,0.17,0.07,,,0 CDM,2500000004_63323036019,"Calcium Gluconate: 25 Vial, Plastic In 1 Tray (63323-360-19) / 10 Ml In 1 Vial, Plastic (63323-360-01)",0.48,0.19,,,0 CDM,2500000004_63323036059,"Calcium Gluconate: 25 Vial, Plastic In 1 Tray (63323-360-59) / 50 Ml In 1 Vial, Plastic (63323-360-03)",0.27,0.11,,,0 CDM,2500000004_63323036061,"Calcium Gluconate: 20 Vial, Plastic In 1 Tray (63323-360-61) / 100 Ml In 1 Vial, Plastic (63323-360-05)",0.25,0.1,,,0 CDM,2500000004_63323037600,NDC Description Not Available,10.92,4.37,,,0 CDM,2500000004_63323037601,"Octreotide: 10 Vial, Single-Dose In 1 Tray (63323-376-01) / 1 Ml In 1 Vial, Single-Dose (63323-376-00)",2.7,1.08,,,0 CDM,2500000004_63323037700,NDC Description Not Available,10.96,4.38,,,0 CDM,2500000004_63323037905,"Octreotide: 1 Vial, Multi-Dose In 1 Carton (63323-379-05) / 5 Ml In 1 Vial, Multi-Dose",10.95,4.38,,,0 CDM,2500000004_63323039306,Colistimethate: 1 Vial In 1 Box (63323-393-06) / 2 Ml In 1 Vial,124.97,49.99,,,0 CDM,2500000004_63323040005,"Levetiracetam: 10 Vial, Single-Use In 1 Tray (63323-400-05) / 5 Ml In 1 Vial, Single-Use (63323-400-01)",0.31,0.12,,,0 CDM,2500000004_63323040101,NDC Description Not Available,17.39,6.96,,,0 CDM,2500000004_63323040120,"Aztreonam: 10 Vial In 1 Tray (63323-401-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (63323-401-01)",10.34,4.14,,,0 CDM,2500000004_63323040201,NDC Description Not Available,14.3,5.72,,,0 CDM,2500000004_63323040220,"Aztreonam: 10 Vial In 1 Tray (63323-402-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (63323-402-01)",13.44,5.38,,,0 CDM,2500000004_63323040703,Caffeine Citrate: 1 Vial In 1 Box (63323-407-03) / 3 Ml In 1 Vial,7.8,3.12,,,0 CDM,2500000004_63323041112,Midazolam: 25 Vial In 1 Tray (63323-411-12) / 2 Ml In 1 Vial (63323-411-15),2.66,1.06,,,0 CDM,2500000004_63323041115,NDC Description Not Available,1.48,0.59,,,0 CDM,2500000004_63323041202,Midazolam: 10 Vial In 1 Tray (63323-412-02) / 2 Ml In 1 Vial (63323-412-03),2.7,1.08,,,0 CDM,2500000004_63323041203,NDC Description Not Available,2.66,1.06,,,0 CDM,2500000004_63323045050,"Pemetrexed: 1 Vial, Single-Use In 1 Carton (63323-450-50) / 20 Ml In 1 Vial, Single-Use",53.0,21.2,,,0 CDM,2500000004_63323045100,NDC Description Not Available,6.97,2.79,,,0 CDM,2500000004_63323045101,"Morphine Sulfate: 25 Vial, Single-Dose In 1 Box (63323-451-01) / 1 Ml In 1 Vial, Single-Dose (63323-451-00)",8.45,3.38,,,0 CDM,2500000004_63323045200,NDC Description Not Available,4.18,1.67,,,0 CDM,2500000004_63323045201,"Morphine Sulfate: 25 Vial, Single-Dose In 1 Box (63323-452-01) / 1 Ml In 1 Vial, Single-Dose (63323-452-00)",3.15,1.26,,,0 CDM,2500000004_63323045400,NDC Description Not Available,6.58,2.63,,,0 CDM,2500000004_63323045401,"Morphine Sulfate: 25 Vial, Single-Dose In 1 Box (63323-454-01) / 1 Ml In 1 Vial, Single-Dose (63323-454-00)",5.88,2.35,,,0 CDM,2500000004_63323046401,NDC Description Not Available,0.56,0.22,,,0 CDM,2500000004_63323046417,"Sensorcaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-464-17) / 10 Ml In 1 Vial, Single-Dose (63323-464-01)",0.63,0.25,,,0 CDM,2500000004_63323046437,"Sensorcaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-464-37) / 30 Ml In 1 Vial, Single-Dose (63323-464-02)",0.21,0.08,,,0 CDM,2500000004_63323046601,NDC Description Not Available,0.11,0.04,,,0 CDM,2500000004_63323046617,"Sensorcaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-466-17) / 10 Ml In 1 Vial, Single-Dose (63323-466-03)",0.24,0.1,,,0 CDM,2500000004_63323046637,"Sensorcaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-466-37) / 30 Ml In 1 Vial, Single-Dose (63323-466-01)",0.1,0.04,,,0 CDM,2500000004_63323046701,NDC Description Not Available,0.09,0.04,,,0 CDM,2500000004_63323047203,NDC Description Not Available,0.14,0.06,,,0 CDM,2500000004_63323047237,"Sensorcaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-472-37) / 30 Ml In 1 Vial, Single-Dose (63323-472-01)",0.08,0.03,,,0 CDM,2500000004_63323047701,NDC Description Not Available,0.22,0.09,,,0 CDM,2500000004_63323047801,NDC Description Not Available,0.17,0.07,,,0 CDM,2500000004_63323047827,"Nesacaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-478-27) / 20 Ml In 1 Vial, Single-Dose (63323-478-01)",0.17,0.07,,,0 CDM,2500000004_63323048101,NDC Description Not Available,0.11,0.04,,,0 CDM,2500000004_63323048201,NDC Description Not Available,0.15,0.06,,,0 CDM,2500000004_63323048203,NDC Description Not Available,0.09,0.04,,,0 CDM,2500000004_63323048205,NDC Description Not Available,0.08,0.03,,,0 CDM,2500000004_63323048217,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-482-17) / 10 Ml In 1 Vial, Multi-Dose (63323-482-01)",0.15,0.06,,,0 CDM,2500000004_63323048226,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-482-26) / 20 Ml In 1 Vial, Multi-Dose (63323-482-41)",0.04,0.02,,,0 CDM,2500000004_63323048227,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-482-27) / 20 Ml In 1 Vial, Multi-Dose (63323-482-03)",0.09,0.04,,,0 CDM,2500000004_63323048457,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-484-57) / 50 Ml In 1 Vial, Multi-Dose",0.1,0.04,,,0 CDM,2500000004_63323048501,NDC Description Not Available,0.05,0.02,,,0 CDM,2500000004_63323048503,NDC Description Not Available,0.03,0.01,,,0 CDM,2500000004_63323048527,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-485-27) / 20 Ml In 1 Vial, Multi-Dose (63323-485-01)",0.04,0.02,,,0 CDM,2500000004_63323048601,NDC Description Not Available,0.04,0.02,,,0 CDM,2500000004_63323048602,NDC Description Not Available,0.02,0.01,,,0 CDM,2500000004_63323048605,NDC Description Not Available,0.02,0.01,,,0 CDM,2500000004_63323048617,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-486-17) / 10 Ml In 1 Vial, Multi-Dose (63323-486-01)",0.08,0.03,,,0 CDM,2500000004_63323048627,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-486-27) / 20 Ml In 1 Vial, Multi-Dose (63323-486-02)",0.04,0.02,,,0 CDM,2500000004_63323048657,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-486-57) / 50 Ml In 1 Vial, Multi-Dose (63323-486-05)",0.02,0.01,,,0 CDM,2500000004_63323048701,NDC Description Not Available,0.46,0.18,,,0 CDM,2500000004_63323048707,NDC Description Not Available,0.21,0.08,,,0 CDM,2500000004_63323048717,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-487-17) / 10 Ml In 1 Vial, Single-Dose (63323-487-01)",0.37,0.15,,,0 CDM,2500000004_63323048737,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-487-37) / 30 Ml In 1 Vial, Single-Dose (63323-487-07)",0.17,0.07,,,0 CDM,2500000004_63323048837,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-488-37) / 30 Ml In 1 Vial, Single-Dose (63323-488-07)",0.15,0.06,,,0 CDM,2500000004_63323048901,NDC Description Not Available,0.21,0.08,,,0 CDM,2500000004_63323048902,NDC Description Not Available,0.19,0.08,,,0 CDM,2500000004_63323048917,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-489-17) / 10 Ml In 1 Vial, Single-Dose (63323-489-01)",0.26,0.1,,,0 CDM,2500000004_63323048927,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-489-27) / 20 Ml In 1 Vial, Single-Dose (63323-489-02)",0.19,0.08,,,0 CDM,2500000004_63323049101,NDC Description Not Available,0.24,0.1,,,0 CDM,2500000004_63323049204,NDC Description Not Available,0.4,0.16,,,0 CDM,2500000004_63323049207,NDC Description Not Available,0.16,0.06,,,0 CDM,2500000004_63323049208,NDC Description Not Available,0.26,0.1,,,0 CDM,2500000004_63323049209,NDC Description Not Available,0.33,0.13,,,0 CDM,2500000004_63323049227,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Carton (63323-492-27) / 2 Ml In 1 Vial, Single-Dose (63323-492-04)",0.41,0.16,,,0 CDM,2500000004_63323049237,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-492-37) / 30 Ml In 1 Vial, Single-Dose (63323-492-07)",0.16,0.06,,,0 CDM,2500000004_63323049243,NDC Description Not Available,0.34,0.14,,,0 CDM,2500000004_63323049257,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Carton (63323-492-57) / 5 Ml In 1 Vial, Single-Dose (63323-492-09)",0.35,0.14,,,0 CDM,2500000004_63323049297,Xylocaine Mpf: 5 Ampule In 1 Box (63323-492-97) / 10 Ml In 1 Ampule (63323-492-08),0.25,0.1,,,0 CDM,2500000004_63323049504,NDC Description Not Available,0.16,0.06,,,0 CDM,2500000004_63323049507,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Carton (63323-495-07) / 5 Ml In 1 Vial, Single-Dose (63323-495-04)",0.09,0.04,,,0 CDM,2500000004_63323050600,NDC Description Not Available,3.35,1.34,,,0 CDM,2500000004_63323050601,Dexamethasone Sodium Phosphate: 25 Vial In 1 Tray (63323-506-01) / 1 Ml In 1 Vial (63323-506-00),0.59,0.24,,,0 CDM,2500000004_63323050720,Meropenem: 10 Vial In 1 Carton (63323-507-20) / 10 Ml In 1 Vial (63323-507-01),2.49,1.0,,,0 CDM,2500000004_63323050830,Meropenem: 10 Vial In 1 Carton (63323-508-30) / 20 Ml In 1 Vial (63323-508-01),2.58,1.03,,,0 CDM,2500000004_63323051701,NDC Description Not Available,1.89,0.76,,,0 CDM,2500000004_63323051774,Heparin Sodium: 24 Bag In 1 Case (63323-517-74) / 250 Ml In 1 Bag (63323-517-01),1.89,0.76,,,0 CDM,2500000004_63323052301,NDC Description Not Available,1.96,0.78,,,0 CDM,2500000004_63323054001,Heparin Sodium: 25 Vial In 1 Tray (63323-540-01) / 1 Ml In 1 Vial,6.73,2.69,,,0 CDM,2500000004_63323054011,Heparin Sodium: 25 Vial In 1 Tray (63323-540-11) / 10 Ml In 1 Vial,1.03,0.41,,,0 CDM,2500000004_63323054204,NDC Description Not Available,0.97,0.39,,,0 CDM,2500000004_63323054207,Heparin Sodium: 25 Vial In 1 Tray (63323-542-07) / 5 Ml In 1 Vial,0.97,0.39,,,0 CDM,2500000004_63323054505,NDC Description Not Available,0.14,0.06,,,0 CDM,2500000004_63323055921,NDC Description Not Available,4.04,1.62,,,0 CDM,2500000004_63323055993,Enoxaparin Sodium: 10 Blister Pack In 1 Carton (63323-559-93) / 1 Syringe In 1 Blister Pack (63323-559-21) / .3 Ml In 1 Syringe,4.13,1.65,,,0 CDM,2500000004_63323056210,"Bivalirudin: 10 Vial, Single-Use In 1 Carton (63323-562-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Use",0.86,0.34,,,0 CDM,2500000004_63323056421,NDC Description Not Available,3.68,1.47,,,0 CDM,2500000004_63323057901,NDC Description Not Available,336.43,134.57,,,0 CDM,2500000004_63323057905,Sincalide: 10 Vial In 1 Package (63323-579-05) / 5 Ml In 1 Vial (63323-579-01),202.92,81.17,,,0 CDM,2500000004_63323058421,NDC Description Not Available,4.19,1.68,,,0 CDM,2500000004_63323058499,Enoxaparin Sodium: 10 Blister Pack In 1 Carton (63323-584-99) / 1 Syringe In 1 Blister Pack (63323-584-21) / .8 Ml In 1 Syringe,3.63,1.45,,,0 CDM,2500000004_63323059303,"Glucagon: 1 Kit In 1 Carton (63323-593-03) * 1 Ml In 1 Vial, Single-Dose (63323-596-03) * 1 Ml In 1 Vial, Single-Dose (63323-185-03)",852.06,340.82,,,0 CDM,2500000004_63323059403,"Glucagon: 1 Kit In 1 Carton (63323-594-03) * 1 Ml In 1 Vial, Single-Dose (63323-596-06) * 1 Ml In 1 Vial, Single-Dose (63323-185-03)",508.88,203.55,,,0 CDM,2500000004_63323059603,NDC Description Not Available,1010.89,404.36,,,0 CDM,2500000004_63323059606,NDC Description Not Available,622.04,248.82,,,0 CDM,2500000004_63323059608,NDC Description Not Available,696.49,278.6,,,0 CDM,2500000004_63323059611,NDC Description Not Available,1058.15,423.26,,,0 CDM,2500000004_63323059710,Deferoxamine: 1 Vial In 1 Box (63323-597-10) / 5.3 Ml In 1 Vial,55.76,22.3,,,0 CDM,2500000004_63323060401,"Propranolol: 10 Vial, Single-Dose In 1 Tray (63323-604-01) / 1 Ml In 1 Vial, Single-Dose",11.57,4.63,,,0 CDM,2500000004_63323061400,NDC Description Not Available,50.49,20.2,,,0 CDM,2500000004_63323061401,"Hydralazine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (63323-614-01) / 1 Ml In 1 Vial, Single-Dose (63323-614-00)",58.84,23.54,,,0 CDM,2500000004_63323061710,"Milrinone Lactate: 10 Vial, Single-Dose In 1 Tray (63323-617-10) / 10 Ml In 1 Vial, Single-Dose (63323-617-01)",10.08,4.03,,,0 CDM,2500000004_63323062374,Sodium Chloride: 250 Ml In 1 Bag (63323-623-74),9.2,3.68,,,0 CDM,2500000004_63323063703,NDC Description Not Available,293.87,117.55,,,0 CDM,2500000004_63323063710,"Arsenic Trioxide: 10 Vial, Single-Dose In 1 Carton (63323-637-10) / 10 Ml In 1 Vial, Single-Dose (63323-637-03)",24.82,9.93,,,0 CDM,2500000004_63323064201,NDC Description Not Available,2.03,0.81,,,0 CDM,2500000004_63323064202,NDC Description Not Available,2.1,0.84,,,0 CDM,2500000004_63323064220,"Magnesium Sulfate: 25 Vial, Single-Dose In 1 Tray (63323-642-20) / 20 Ml In 1 Vial, Single-Dose (63323-642-01)",2.01,0.8,,,0 CDM,2500000004_63323064810,"Levothyroxine Sodium: 1 Vial, Single-Dose In 1 Carton (63323-648-10) / 5 Ml In 1 Vial, Single-Dose",47.07,18.83,,,0 CDM,2500000004_63323064907,"Levothyroxine Sodium: 1 Vial, Single-Dose In 1 Carton (63323-649-07) / 5 Ml In 1 Vial, Single-Dose",36.24,14.5,,,0 CDM,2500000004_63323065100,NDC Description Not Available,1.88,0.75,,,0 CDM,2500000004_63323065102,"Adenosine: 10 Vial, Single-Use In 1 Tray (63323-651-02) / 2 Ml In 1 Vial, Single-Use (63323-651-00)",2.2,0.88,,,0 CDM,2500000004_63323065820,Chlorothiazide: 1 Vial In 1 Box (63323-658-20) / 18 Ml In 1 Vial,183.18,73.27,,,0 CDM,2500000004_63323065903,Indomethacin: 1 Vial In 1 Carton (63323-659-03) / 1 Ml In 1 Vial,202.72,81.09,,,0 CDM,2500000004_63323066400,NDC Description Not Available,8.45,3.38,,,0 CDM,2500000004_63323066401,"Diphenhydramine: 25 Vial, Single-Dose In 1 Tray (63323-664-01) / 1 Ml In 1 Vial, Single-Dose (63323-664-00)",6.47,2.59,,,0 CDM,2500000004_63323066500,NDC Description Not Available,53.63,21.45,,,0 CDM,2500000004_63323066501,"Terbutaline Sulfate: 25 Vial, Single-Use In 1 Tray (63323-665-01) / 1 Ml In 1 Vial, Single-Use (63323-665-00)",6.81,2.72,,,0 CDM,2500000004_63323068517,"Posaconazole: 1 Vial, Single-Dose In 1 Carton (63323-685-17) / 16.7 Ml In 1 Vial, Single-Dose",1310.65,524.26,,,0 CDM,2500000004_63323069030,Acetylcysteine: 3 Vial In 1 Carton (63323-690-30) / 30 Ml In 1 Vial (63323-690-22),20.75,8.3,,,0 CDM,2500000004_63323069602,NDC Description Not Available,4.77,1.91,,,0 CDM,2500000004_63323071050,Leucovorin Calcium: 1 Vial In 1 Box (63323-710-50) / 20 Ml In 1 Vial,24.07,9.63,,,0 CDM,2500000004_63323071303,NDC Description Not Available,63.68,25.47,,,0 CDM,2500000004_63323071313,Linezolid: 10 Bag In 1 Case (63323-713-13) / 300 Ml In 1 Bag (63323-713-03),15.18,6.07,,,0 CDM,2500000004_63323072901,NDC Description Not Available,2.4,0.96,,,0 CDM,2500000004_63323072910,"Micafungin: 10 Carton In 1 Carton (63323-729-10) / 1 Vial, Single-Dose In 1 Carton (63323-729-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",1.46,0.58,,,0 CDM,2500000004_63323073806,NDC Description Not Available,0.05,0.02,,,0 CDM,2500000004_63323075100,NDC Description Not Available,0.01,0.004,,,0 CDM,2500000004_63323075101,"Phenylephrine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (63323-751-01) / 1 Ml In 1 Vial, Single-Dose (63323-751-00)",0.04,0.02,,,0 CDM,2500000004_63323076350,"Paclitaxel: 1 Vial, Multi-Dose In 1 Carton (63323-763-50) / 50 Ml In 1 Vial, Multi-Dose",1.32,0.53,,,0 CDM,2500000004_63323080612,NDC Description Not Available,8.42,3.37,,,0 CDM,2500000004_63323080613,NDC Description Not Available,4.28,1.71,,,0 CDM,2500000004_63323080650,"Fentanyl Citrate: 1 Vial, Single-Dose In 1 Carton (63323-806-50) / 50 Ml In 1 Vial, Single-Dose",2.91,1.16,,,0 CDM,2500000004_63323085103,NDC Description Not Available,0.23,0.09,,,0 CDM,2500000004_63323085150,"Hydromorphone Hydrochloride: 50 Ml In 1 Vial, Single-Dose (63323-851-50)",0.04,0.02,,,0 CDM,2500000004_63323085203,NDC Description Not Available,2.12,0.85,,,0 CDM,2500000004_63323085225,"Hydromorphone Hydrochloride: 25 Vial, Single-Dose In 1 Carton (63323-852-25) / 1 Ml In 1 Vial, Single-Dose (63323-852-03)",2.45,0.98,,,0 CDM,2500000004_63323085303,NDC Description Not Available,1.23,0.49,,,0 CDM,2500000004_63323085403,NDC Description Not Available,0.56,0.22,,,0 CDM,2500000004_63323085410,"Hydromorphone Hydrochloride: 25 Vial, Single-Dose In 1 Carton (63323-854-10) / 1 Ml In 1 Vial, Single-Dose (63323-854-03)",0.58,0.23,,,0 CDM,2500000004_63323087550,Foscarnet: 1 Bottle In 1 Carton (63323-875-50) / 250 Ml In 1 Bottle,277.31,110.92,,,0 CDM,2500000004_63323093000,NDC Description Not Available,4.02,1.61,,,0 CDM,2500000004_63323093001,"Vasopressin: 25 Vial, Single-Dose In 1 Tray (63323-930-01) / 1 Ml In 1 Vial, Single-Dose (63323-930-00)",3.99,1.6,,,0 CDM,2500000004_63323094310,"Succinylcholine Chloride: 25 Vial, Multi-Dose In 1 Carton (63323-943-10) / 10 Ml In 1 Vial, Multi-Dose (63323-943-21)",3.49,1.4,,,0 CDM,2500000004_63323096501,NDC Description Not Available,3.99,1.6,,,0 CDM,2500000004_63323096502,NDC Description Not Available,0.57,0.23,,,0 CDM,2500000004_63323096503,NDC Description Not Available,0.67,0.27,,,0 CDM,2500000004_63323096505,"Potassium Chloride: 25 Vial, Single-Dose In 1 Tray (63323-965-05) / 5 Ml In 1 Vial, Single-Dose (63323-965-01)",3.73,1.49,,,0 CDM,2500000004_63323096510,"Potassium Chloride: 25 Vial, Single-Dose In 1 Tray (63323-965-10) / 10 Ml In 1 Vial, Single-Dose (63323-965-03)",0.92,0.37,,,0 CDM,2500000004_63323096520,"Potassium Chloride: 25 Vial, Single-Dose In 1 Tray (63323-965-20) / 20 Ml In 1 Vial, Single-Dose (63323-965-02)",0.3,0.12,,,0 CDM,2500000004_63323096701,NDC Description Not Available,0.5,0.2,,,0 CDM,2500000004_63323098121,"Piperacillin And Tazobactam: 10 Vial, Single-Use In 1 Carton (63323-981-21) / 10 Ml In 1 Vial, Single-Use (63323-981-23)",5.14,2.06,,,0 CDM,2500000004_63323098323,NDC Description Not Available,6.19,2.48,,,0 CDM,2500000004_63361024315,Vaxelis: 10 Syringe In 1 Package (63361-243-15) / .5 Ml In 1 Syringe (63361-243-88),644.35,257.74,,,0 CDM,2500000004_63361024358,NDC Description Not Available,557.23,222.89,,,0 CDM,2500000004_63361024388,NDC Description Not Available,548.76,219.5,,,0 CDM,2500000004_63459010310,"Truxima: 1 Vial, Single-Use In 1 Carton (63459-103-10) / 10 Ml In 1 Vial, Single-Use",364.16,145.66,,,0 CDM,2500000004_63459010450,"Truxima: 1 Vial, Single-Use In 1 Carton (63459-104-50) / 50 Ml In 1 Vial, Single-Use",361.29,144.52,,,0 CDM,2500000004_63459034804,"Bendeka: 1 Vial, Multi-Dose In 1 Carton (63459-348-04) / 4 Ml In 1 Vial, Multi-Dose",93.75,37.5,,,0 CDM,2500000004_63739093114,NDC Description Not Available,1.66,0.66,,,0 CDM,2500000004_63739093128,"Heparin Sodium: 25 Vial, Multi-Dose In 1 Carton (63739-931-28) / 10 Ml In 1 Vial, Multi-Dose (63739-931-14)",1.65,0.66,,,0 CDM,2500000004_63739095311,NDC Description Not Available,1.68,0.67,,,0 CDM,2500000004_63833082502,Berinert: 1 Kit In 1 Carton (63833-825-02) * 10 Ml In 1 Vial (63833-835-01) * 10 Ml In 1 Vial (63833-765-15),374.03,149.61,,,0 CDM,2500000004_64253022230,NDC Description Not Available,0.72,0.29,,,0 CDM,2500000004_64253022235,NDC Description Not Available,0.43,0.17,,,0 CDM,2500000004_64253033330,NDC Description Not Available,0.05,0.02,,,0 CDM,2500000004_64253033335,NDC Description Not Available,0.05,0.02,,,0 CDM,2500000004_64253040030,NDC Description Not Available,0.37,0.15,,,0 CDM,2500000004_64253090030,NDC Description Not Available,0.07,0.03,,,0 CDM,2500000004_64253090036,"Calcium Chloride: 60 Syringe, Plastic In 1 Box (64253-900-36) / 10 Ml In 1 Syringe, Plastic (64253-900-30)",0.07,0.03,,,0 CDM,2500000004_64281011006,"Provocholine Inhalation Solution: 6 Package In 1 Package (64281-110-06) / 6 Carton In 1 Package (64281-110-05) / 1 Kit In 1 Carton * 1 Vial, Plastic In 1 Kit / 3 Ml In 1 Vial, Plastic (64281-113-00",18.69,7.48,,,0 CDM,2500000004_64380078206,"Prednisone: 100 Tablet In 1 Bottle, Plastic (64380-782-06)",0.22,0.09,,,0 CDM,2500000004_64380083506,"Prednisone: 100 Tablet In 1 Bottle, Plastic (64380-835-06)",0.15,0.06,,,0 CDM,2500000004_64380094906,Prednisone: 100 Tablet In 1 Bottle (64380-949-06),0.02,0.01,,,0 CDM,2500000004_64406000801,"Tysabri: 1 Vial, Single-Use In 1 Carton (64406-008-01) / 15 Ml In 1 Vial, Single-Use",86.74,34.7,,,0 CDM,2500000004_64406005801,"Spinraza: 1 Vial, Single-Use In 1 Box (64406-058-01) / 5 Ml In 1 Vial, Single-Use",4508.69,1803.48,,,0 CDM,2500000004_64406010901,"Qalsody: 1 Vial, Single-Use In 1 Carton (64406-109-01) / 15 Ml In 1 Vial, Single-Use",674.22,269.69,,,0 CDM,2500000004_64679001202,NDC Description Not Available,4.98,1.99,,,0 CDM,2500000004_64679005602,NDC Description Not Available,5.41,2.16,,,0 CDM,2500000004_64679067901,"Piperacillin And Tazobactam: 1 Vial, Pharmacy Bulk Package In 1 Carton (64679-679-01) / 180 Ml In 1 Vial, Pharmacy Bulk Package (64679-679-02)",2.39,0.96,,,0 CDM,2500000004_64679067902,NDC Description Not Available,1.31,0.52,,,0 CDM,2500000004_64764030020,"Entyvio: 1 Vial, Single-Dose In 1 Carton (64764-300-20) / 5 Ml In 1 Vial, Single-Dose",131.37,52.55,,,0 CDM,2500000004_65145011901,NDC Description Not Available,16.35,6.54,,,0 CDM,2500000004_65145012901,NDC Description Not Available,13.44,5.38,,,0 CDM,2500000004_65145014601,NDC Description Not Available,5.49,2.2,,,0 CDM,2500000004_65162080214,Temozolomide: 1 Bottle In 1 Carton (65162-802-14) / 14 Capsule In 1 Bottle,2.62,1.05,,,0 CDM,2500000004_65219001401,NDC Description Not Available,6.59,2.64,,,0 CDM,2500000004_65219001801,NDC Description Not Available,10.33,4.13,,,0 CDM,2500000004_65219002003,NDC Description Not Available,8.54,3.42,,,0 CDM,2500000004_65219002023,"Ampicillin: 10 Vial In 1 Carton (65219-020-23) / 1 Injection, Powder, For Solution In 1 Vial (65219-020-03)",8.91,3.56,,,0 CDM,2500000004_65219002920,"Thiotepa: 1 Vial In 1 Carton (65219-029-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",1207.8,483.12,,,0 CDM,2500000004_65219003900,NDC Description Not Available,4.89,1.96,,,0 CDM,2500000004_65219003901,"Vasopressin: 25 Vial, Single-Dose In 1 Tray (65219-039-01) / 1 Ml In 1 Vial, Single-Dose (65219-039-00)",4.94,1.98,,,0 CDM,2500000004_65219013120,"Cyclophosphamide: 1 Vial, Single-Dose In 1 Carton (65219-131-20) / 50 Ml In 1 Vial, Single-Dose",5.27,2.11,,,0 CDM,2500000004_65219028412,"Plerixafor: 1 Vial, Single-Use In 1 Carton (65219-284-12) / 1.2 Ml In 1 Vial, Single-Use",50.77,20.31,,,0 CDM,2500000004_65219029510,"Desmopressin Acetate: 1 Vial, Multi-Dose In 1 Carton (65219-295-10) / 10 Ml In 1 Vial, Multi-Dose",16.41,6.56,,,0 CDM,2500000004_65219036801,NDC Description Not Available,4.37,1.75,,,0 CDM,2500000004_65219043301,NDC Description Not Available,8.4,3.36,,,0 CDM,2500000004_65219055001,"Pralatrexate: 1 Vial, Single-Dose In 1 Carton (65219-550-01) / 1 Ml In 1 Vial, Single-Dose",1073.55,429.42,,,0 CDM,2500000004_65219056620,Mitomycin: 1 Vial In 1 Carton (65219-566-20) / 40 Ml In 1 Vial,669.3,267.72,,,0 CDM,2500000004_65219057001,NDC Description Not Available,7.61,3.04,,,0 CDM,2500000004_65219057201,NDC Description Not Available,3.7,1.48,,,0 CDM,2500000004_65219081810,"Nicardipine Hydrochloride: 1 Vial, Glass In 1 Carton (65219-818-10) / 10 Ml In 1 Vial, Glass",0.34,0.14,,,0 CDM,2500000004_65250026609,Exparel: 10 Vial In 1 Carton (65250-266-09) / 20 Ml In 1 Vial (65250-266-20),6.89,2.76,,,0 CDM,2500000004_65250026620,NDC Description Not Available,6.15,2.46,,,0 CDM,2500000004_65282160501,Lidocaine Hydrochloride: 25 Ampule In 1 Carton (65282-1605-1) / 5 Ml In 1 Ampule,0.32,0.13,,,0 CDM,2500000004_65597040601,"Enhertu: 1 Vial, Single-Dose In 1 Carton (65597-406-01) / 5 Ml In 1 Vial, Single-Dose",127.75,51.1,,,0 CDM,2500000004_65757030001,"Vivitrol: 1 Kit In 1 Carton (65757-300-01) * 4 Ml In 1 Vial, Glass (65757-302-02) * 4 Ml In 1 Vial, Glass (65757-304-03)",0.88,0.35,,,0 CDM,2500000004_65757040103,Aristada: 1 Syringe In 1 Carton (65757-401-03) / 1.6 Ml In 1 Syringe,15.74,6.3,,,0 CDM,2500000004_65757050003,Aristada Initio: 1 Syringe In 1 Carton (65757-500-03) / 2.4 Ml In 1 Syringe,15.1,6.04,,,0 CDM,2500000004_65862039110,"Ondansetron: 3 Blister Pack In 1 Carton (65862-391-10) / 10 Tablet, Orally Disintegrating In 1 Blister Pack",0.32,0.13,,,0 CDM,2500000004_66215040201,Veletri: 1 Vial In 1 Carton (66215-402-01) / 10 Ml In 1 Vial,214.25,85.7,,,0 CDM,2500000004_66288710001,"Vancomycin Hydrochloride: 1 Bag In 1 Bag (66288-7100-1) / 1 Injection, Powder, Lyophilized, For Solution In 1 Bag",8.58,3.43,,,0 CDM,2500000004_66658050101,"Gamifant: 1 Vial, Single-Use In 1 Carton (66658-501-01) / 2 Ml In 1 Vial, Single-Use",3072.71,1229.08,,,0 CDM,2500000004_66658050501,"Gamifant: 1 Vial, Single-Use In 1 Carton (66658-505-01) / 10 Ml In 1 Vial, Single-Use",1553.42,621.37,,,0 CDM,2500000004_66658051001,"Gamifant: 1 Vial, Single-Use In 1 Carton (66658-510-01) / 20 Ml In 1 Vial, Single-Use",1553.42,621.37,,,0 CDM,2500000004_66689030708,"Mycophenolate Mofetil: 1 Bottle, Plastic In 1 Carton (66689-307-08) / 250 Ml In 1 Bottle, Plastic",10.61,4.24,,,0 CDM,2500000004_66733094823,"Erbitux: 1 Vial, Single-Dose In 1 Carton (66733-948-23) / 50 Ml In 1 Vial, Single-Dose",368.06,147.22,,,0 CDM,2500000004_66733095823,"Erbitux: 1 Vial, Single-Dose In 1 Carton (66733-958-23) / 100 Ml In 1 Vial, Single-Dose",368.06,147.22,,,0 CDM,2500000004_66758005003,"Docetaxel: 1 Vial, Multi-Dose In 1 Carton (66758-050-03) / 16 Ml In 1 Vial, Multi-Dose",2.18,0.87,,,0 CDM,2500000004_66794015101,"Gablofen: 1 Ml In 1 Syringe, Glass (66794-151-01)",421.65,168.66,,,0 CDM,2500000004_66794015501,"Gablofen: 20 Ml In 1 Syringe, Glass (66794-155-01)",1180.42,472.17,,,0 CDM,2500000004_66794015601,"Gablofen: 20 Ml In 1 Syringe, Glass (66794-156-01)",1217.57,487.03,,,0 CDM,2500000004_66794015701,"Gablofen: 20 Ml In 1 Syringe, Glass (66794-157-01)",1218.58,487.43,,,0 CDM,2500000004_66794016202,"Mitigo: 1 Ml In 1 Vial, Single-Use (66794-162-02)",26.33,10.53,,,0 CDM,2500000004_66794020402,NDC Description Not Available,1.59,0.64,,,0 CDM,2500000004_66794020442,"Glycopyrrolate: 25 Vial, Glass In 1 Carton (66794-204-42) / 5 Ml In 1 Vial, Glass (66794-204-02)",1.72,0.69,,,0 CDM,2500000004_66794021002,NDC Description Not Available,10.64,4.26,,,0 CDM,2500000004_66794021943,Linezolid: 10 Bag In 1 Carton (66794-219-43) / 300 Ml In 1 Bag (66794-219-63),11.5,4.6,,,0 CDM,2500000004_66794021963,NDC Description Not Available,32.92,13.17,,,0 CDM,2500000004_66794022841,Rocuronium: 10 Vial In 1 Carton (66794-228-41) / 5 Ml In 1 Vial (66794-228-02),1.45,0.58,,,0 CDM,2500000004_66794023702,NDC Description Not Available,0.41,0.16,,,0 CDM,2500000004_66794023741,Doxycycline: 10 Vial In 1 Carton (66794-237-41) / 10 Ml In 1 Vial,0.6,0.24,,,0 CDM,2500000004_66794025802,NDC Description Not Available,19.27,7.71,,,0 CDM,2500000004_66887000301,"Xiaflex: 1 Kit In 1 Carton (66887-003-01) * 1 Injection, Powder, Lyophilized, For Solution In 1 Vial * 3 Ml In 1 Vial",323.09,129.24,,,0 CDM,2500000004_66993037083,Medroxyprogesterone Acetate: 1 Vial In 1 Carton (66993-370-83) / 1 Ml In 1 Vial,1.04,0.42,,,0 CDM,2500000004_66993037179,Medroxyprogesterone Acetate: 1 Syringe In 1 Carton (66993-371-79) / 1 Ml In 1 Syringe,1.61,0.64,,,0 CDM,2500000004_66993049084,NDC Description Not Available,296.48,118.59,,,0 CDM,2500000004_67066000501,"Chirhostim: 8 Ml In 1 Vial, Single-Use (67066-005-01)",176.43,70.57,,,0 CDM,2500000004_67386013051,"Vyepti: 1 Vial, Single-Dose In 1 Carton (67386-130-51) / 1 Ml In 1 Vial, Single-Dose",81.82,32.73,,,0 CDM,2500000004_67457017750,"Rimso-50: 1 Vial, Glass In 1 Carton (67457-177-50) / 50 Ml In 1 Vial, Glass",2995.29,1198.12,,,0 CDM,2500000004_67457018200,NDC Description Not Available,3.15,1.26,,,0 CDM,2500000004_67457018210,Esmolol Hydrochloride: 10 Vial In 1 Carton (67457-182-10) / 10 Ml In 1 Vial (67457-182-00),3.15,1.26,,,0 CDM,2500000004_67457019501,"Melphalan Hydrochloride: 1 Kit In 1 Carton (67457-195-01) * 10 Ml In 1 Vial, Glass (67457-193-50) * 10 Ml In 1 Vial, Glass (67457-194-10)",705.17,282.07,,,0 CDM,2500000004_67457019600,NDC Description Not Available,24.08,9.63,,,0 CDM,2500000004_67457019602,"Thiamine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (67457-196-02) / 2 Ml In 1 Vial, Multi-Dose (67457-196-00)",10.01,4.0,,,0 CDM,2500000004_67457021202,"Argatroban: 1 Vial, Glass In 1 Carton (67457-212-02) / 2.5 Ml In 1 Vial, Glass",9.11,3.64,,,0 CDM,2500000004_67457021720,"Methadone Hydrochloride: 1 Vial, Multi-Dose In 1 Carton (67457-217-20) / 20 Ml In 1 Vial, Multi-Dose",80.78,32.31,,,0 CDM,2500000004_67457021810,Duraclon: 1 Vial In 1 Carton (67457-218-10) / 10 Ml In 1 Vial,156.25,62.5,,,0 CDM,2500000004_67457022000,NDC Description Not Available,107.83,43.13,,,0 CDM,2500000004_67457022005,"Isosulfan Blue: 6 Vial, Glass In 1 Carton (67457-220-05) / 5 Ml In 1 Vial, Glass (67457-220-00)",108.33,43.33,,,0 CDM,2500000004_67457025600,NDC Description Not Available,1.01,0.4,,,0 CDM,2500000004_67457026600,NDC Description Not Available,0.69,0.28,,,0 CDM,2500000004_67457029200,NDC Description Not Available,11.49,4.6,,,0 CDM,2500000004_67457034000,NDC Description Not Available,5.2,2.08,,,0 CDM,2500000004_67457034001,Vancomycin Hydrochloride: 10 Vial In 1 Carton (67457-340-01) / 20 Ml In 1 Vial (67457-340-00),8.85,3.54,,,0 CDM,2500000004_67457034815,"ampicillin sodium and sulbactam sodium: 1 VIAL in 1 CARTON (67457-348-15) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL",12.29,4.92,,,0 CDM,2500000004_67457037412,NDC Description Not Available,2.58,1.03,,,0 CDM,2500000004_67457039054,Zoledronic Acid: 1 Vial In 1 Carton (67457-390-54) / 5 Ml In 1 Vial,31.77,12.71,,,0 CDM,2500000004_67457039910,NDC Description Not Available,1.26,0.5,,,0 CDM,2500000004_67457040913,Haloperidol Decanoate: 5 Vial In 1 Carton (67457-409-13) / 1 Ml In 1 Vial (67457-409-00),18.06,7.22,,,0 CDM,2500000004_67457041805,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (67457-418-05) / 5 Ml In 1 Vial (67457-418-00),0.11,0.04,,,0 CDM,2500000004_67457041900,NDC Description Not Available,0.86,0.34,,,0 CDM,2500000004_67457041901,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (67457-419-01) / 1 Ml In 1 Vial (67457-419-00),0.52,0.21,,,0 CDM,2500000004_67457042100,NDC Description Not Available,0.34,0.14,,,0 CDM,2500000004_67457042130,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (67457-421-30) / 30 Ml In 1 Vial (67457-421-00),0.19,0.08,,,0 CDM,2500000004_67457042200,NDC Description Not Available,0.44,0.18,,,0 CDM,2500000004_67457042254,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (67457-422-54) / 5 Ml In 1 Vial (67457-422-00),0.11,0.04,,,0 CDM,2500000004_67457042300,NDC Description Not Available,0.87,0.35,,,0 CDM,2500000004_67457042312,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (67457-423-12) / 1 Ml In 1 Vial (67457-423-00),0.86,0.34,,,0 CDM,2500000004_67457042600,NDC Description Not Available,3.94,1.58,,,0 CDM,2500000004_67457042612,Haloperidol Lactate: 25 Vial In 1 Carton (67457-426-12) / 1 Ml In 1 Vial (67457-426-00),3.94,1.58,,,0 CDM,2500000004_67457042800,NDC Description Not Available,5.89,2.36,,,0 CDM,2500000004_67457042830,Tobramycin: 10 Vial In 1 Carton (67457-428-30) / 30 Ml In 1 Vial (67457-428-00),6.09,2.44,,,0 CDM,2500000004_67457043010,Pamidronate Disodium: 1 Vial In 1 Carton (67457-430-10) / 10 Ml In 1 Vial,39.7,15.88,,,0 CDM,2500000004_67457043300,NDC Description Not Available,0.05,0.02,,,0 CDM,2500000004_67457043322,Famotidine: 25 Vial In 1 Carton (67457-433-22) / 2 Ml In 1 Vial (67457-433-00),0.05,0.02,,,0 CDM,2500000004_67457043700,NDC Description Not Available,0.72,0.29,,,0 CDM,2500000004_67457044220,Oxaliplatin: 1 Vial In 1 Carton (67457-442-20) / 20 Ml In 1 Vial,0.97,0.39,,,0 CDM,2500000004_67457044560,Rifampin: 1 Vial In 1 Carton (67457-445-60) / 10 Ml In 1 Vial,0.46,0.18,,,0 CDM,2500000004_67457044610,Pamidronate Disodium: 1 Vial In 1 Carton (67457-446-10) / 10 Ml In 1 Vial,171.8,68.72,,,0 CDM,2500000004_67457045220,Cytarabine: 1 VIAL in 1 CARTON (67457-452-20) / 20 mL in 1 VIAL,1.69,0.68,,,0 CDM,2500000004_67457045700,NDC Description Not Available,0.05,0.02,,,0 CDM,2500000004_67457047300,NDC Description Not Available,8.79,3.52,,,0 CDM,2500000004_67457047322,Tobramycin: 25 Vial In 1 Carton (67457-473-22) / 2 Ml In 1 Vial (67457-473-00),3.58,1.43,,,0 CDM,2500000004_67457051701,"Fosphenytoin Sodium: 10 VIAL, SINGLE-DOSE in 1 CARTON (67457-517-01) / 10 mL in 1 VIAL, SINGLE-DOSE (67457-517-00)",6.0,2.4,,,0 CDM,2500000004_67457052200,NDC Description Not Available,4.1,1.64,,,0 CDM,2500000004_67457052237,"piperacillin and tazobactam: 10 VIAL, SINGLE-USE in 1 CARTON (67457-522-37) / 15 mL in 1 VIAL, SINGLE-USE (67457-522-00)",4.57,1.83,,,0 CDM,2500000004_67457052433,"Ibandronate Sodium: 1 Syringe, Glass In 1 Carton (67457-524-33) / 3 Ml In 1 Syringe, Glass",332.58,133.03,,,0 CDM,2500000004_67457052810,"Leucovorin Calcium: 1 Vial, Single-Dose In 1 Carton (67457-528-10) / 10 Ml In 1 Vial, Single-Dose",19.22,7.69,,,0 CDM,2500000004_67457052920,"Leucovorin Calcium: 1 Vial, Single-Dose In 1 Carton (67457-529-20) / 20 Ml In 1 Vial, Single-Dose",42.56,17.02,,,0 CDM,2500000004_67457053035,"Leucovorin Calcium: 1 Vial, Single-Dose In 1 Carton (67457-530-35) / 17.5 Ml In 1 Vial, Single-Dose",11.73,4.69,,,0 CDM,2500000004_67457053316,"Docetaxel: 1 Vial, Multi-Dose In 1 Carton (67457-533-16) / 16 Ml In 1 Vial, Multi-Dose",13.06,5.22,,,0 CDM,2500000004_67457055300,Magnesium Sulfate: 1 Bag In 1 Pouch (67457-553-00) / 50 Ml In 1 Bag,3.68,1.47,,,0 CDM,2500000004_67457058200,NDC Description Not Available,8.63,3.45,,,0 CDM,2500000004_67457058300,NDC Description Not Available,13.2,5.28,,,0 CDM,2500000004_67457058810,Epoprostenol: 1 Vial In 1 Carton (67457-588-10) / 10 Ml In 1 Vial,55.01,22.0,,,0 CDM,2500000004_67457060305,NDC Description Not Available,0.98,0.39,,,0 CDM,2500000004_67457062205,"Triamcinolone Acetonide: 1 Vial, Multi-Dose In 1 Carton (67457-622-05) / 5 Ml In 1 Vial, Multi-Dose",9.93,3.97,,,0 CDM,2500000004_67457062910,Eptifibatide: 1 Vial In 1 Carton (67457-629-10) / 10 Ml In 1 Vial,33.75,13.5,,,0 CDM,2500000004_67457063110,Eptifibatide: 1 Vial In 1 Carton (67457-631-10) / 100 Ml In 1 Vial,31.09,12.44,,,0 CDM,2500000004_67457064000,NDC Description Not Available,23.61,9.44,,,0 CDM,2500000004_67457066520,"Posaconazole: 1 Vial, Glass In 1 Carton (67457-665-20) / 16.7 Ml In 1 Vial, Glass",2171.78,868.71,,,0 CDM,2500000004_67457079920,NDC Description Not Available,0.92,0.37,,,0 CDM,2500000004_67457079999,Ropivacaine Hydrochloride: 10 Pouch In 1 Carton (67457-799-99) / 1 Bag In 1 Pouch (67457-799-20) / 200 Ml In 1 Bag,0.37,0.15,,,0 CDM,2500000004_67457085350,Acetazolamide: 1 Vial In 1 Carton (67457-853-50) / 5 Ml In 1 Vial,178.61,71.44,,,0 CDM,2500000004_67457085500,NDC Description Not Available,4.87,1.95,,,0 CDM,2500000004_67457085502,"Adenosine: 10 Vial, Single-Dose In 1 Carton (67457-855-02) / 2 Ml In 1 Vial, Single-Dose (67457-855-00)",4.71,1.88,,,0 CDM,2500000004_67457085730,Adenosine: 1 Vial In 1 Carton (67457-857-30) / 30 Ml In 1 Vial,9.57,3.83,,,0 CDM,2500000004_67457086301,Granisetron Hydrochloride: 1 Vial In 1 Carton (67457-863-01) / 1 Ml In 1 Vial,4.39,1.76,,,0 CDM,2500000004_67457086404,Granisetron Hydrochloride: 1 Vial In 1 Carton (67457-864-04) / 1 Ml In 1 Vial,2.8,1.12,,,0 CDM,2500000004_67457088700,NDC Description Not Available,1.09,0.44,,,0 CDM,2500000004_67457088799,Medroxyprogesterone Acetate: 1 Vial In 1 Carton (67457-887-99) / 1 Ml In 1 Vial (67457-887-00),0.25,0.1,,,0 CDM,2500000004_67850002200,NDC Description Not Available,5.38,2.15,,,0 CDM,2500000004_67850015000,NDC Description Not Available,8.32,3.33,,,0 CDM,2500000004_67850015025,"Pantoprazole Sodium: 25 Vial, Glass In 1 Carton (67850-150-25) / 10 Ml In 1 Vial, Glass (67850-150-00)",8.99,3.6,,,0 CDM,2500000004_67871479006,NDC Description Not Available,1763.38,705.35,,,0 CDM,2500000004_67877023022,"Mycophenolate Mofetil: 1 Bottle, Plastic In 1 Carton (67877-230-22) / 225 Ml In 1 Bottle, Plastic",38.77,15.51,,,0 CDM,2500000004_67877026601,Mycophenolate Mofetil: 100 Capsule In 1 Bottle (67877-266-01),0.7,0.28,,,0 CDM,2500000004_67877045912,"Capecitabine: 120 Tablet, Film Coated In 1 Bottle (67877-459-12)",1.05,0.42,,,0 CDM,2500000004_67877071831,Everolimus: 6 Blister Pack In 1 Carton (67877-718-31) / 10 Tablet In 1 Blister Pack (67877-718-33),17.96,7.18,,,0 CDM,2500000004_67877071833,NDC Description Not Available,12.72,5.09,,,0 CDM,2500000004_67877071931,Everolimus: 6 Blister Pack In 1 Carton (67877-719-31) / 10 Tablet In 1 Blister Pack (67877-719-33),12.42,4.97,,,0 CDM,2500000004_67877071933,NDC Description Not Available,13.99,5.6,,,0 CDM,2500000004_67877075360,Dronabinol: 60 Capsule In 1 Bottle (67877-753-60),5.58,2.23,,,0 CDM,2500000004_67877075460,Dronabinol: 60 Capsule In 1 Bottle (67877-754-60),4.37,1.75,,,0 CDM,2500000004_67919003001,"Zerbaxa: 10 Vial, Single-Dose In 1 Carton (67919-030-01) / 10 Ml In 1 Vial, Single-Dose",36.3,14.52,,,0 CDM,2500000004_67979000201,"Supprelin La: 1 Vial, Glass In 1 Carton (67979-002-01) / 1 Implant In 1 Vial, Glass",146302.11,58520.84,,,0 CDM,2500000004_68084014901,"Methylprednisolone: 100 Blister Pack In 1 Box, Unit-Dose (68084-149-01) / 1 Tablet In 1 Blister Pack (68084-149-11)",6.76,2.7,,,0 CDM,2500000004_68084014911,NDC Description Not Available,7.15,2.86,,,0 CDM,2500000004_68084015511,NDC Description Not Available,0.64,0.26,,,0 CDM,2500000004_68084022901,Azathioprine: 100 Blister Pack In 1 Carton (68084-229-01) / 1 Tablet In 1 Blister Pack (68084-229-11),2.57,1.03,,,0 CDM,2500000004_68084022911,NDC Description Not Available,1.89,0.76,,,0 CDM,2500000004_68084044911,NDC Description Not Available,8.56,3.42,,,0 CDM,2500000004_68084045011,NDC Description Not Available,4.94,1.98,,,0 CDM,2500000004_68084045111,NDC Description Not Available,6.65,2.66,,,0 CDM,2500000004_68084090711,NDC Description Not Available,15.65,6.26,,,0 CDM,2500000004_68084090721,"Mycophenolic Acid: 30 Blister Pack In 1 Box, Unit-Dose (68084-907-21) / 1 Tablet, Delayed Release In 1 Blister Pack (68084-907-11)",15.21,6.08,,,0 CDM,2500000004_68084091595,NDC Description Not Available,39.87,15.95,,,0 CDM,2500000004_68094031310,"Levetiracetam: 10 Vial, Single-Use In 1 Carton (68094-313-10) / 5 Ml In 1 Vial, Single-Use",0.26,0.1,,,0 CDM,2500000004_68135002001,Naglazyme: 1 Vial In 1 Carton (68135-020-01) / 5 Ml In 1 Vial,2122.19,848.88,,,0 CDM,2500000004_68382004001,Promethazine Hydrochloride: 100 Tablet In 1 Bottle (68382-040-01),0.2,0.08,,,0 CDM,2500000004_68382039601,Sodium Phenylacetate And Sodium Benzoate: 1 Vial In 1 Carton (68382-396-01) / 50 Ml In 1 Vial,34569.0,13827.6,,,0 CDM,2500000004_68382086002,NDC Description Not Available,49.5,19.8,,,0 CDM,2500000004_68382091001,NDC Description Not Available,1.06,0.42,,,0 CDM,2500000004_68382099701,NDC Description Not Available,22.22,8.89,,,0 CDM,2500000004_68382099710,Arsenic Trioxide: 10 Vial In 1 Carton (68382-997-10) / 10 Ml In 1 Vial (68382-997-01),184.92,73.97,,,0 CDM,2500000004_68403110006,NDC Description Not Available,38918.78,15567.51,,,0 CDM,2500000004_68462015811,"Ondansetron: 10 Tablet, Orally Disintegrating In 1 Box, Unit-Dose (68462-158-11)",0.17,0.07,,,0 CDM,2500000004_68462015840,NDC Description Not Available,0.22,0.09,,,0 CDM,2500000004_68462046940,NDC Description Not Available,5.17,2.07,,,0 CDM,2500000004_68462046954,"Bumetanide: 10 Vial, Single-Dose In 1 Carton (68462-469-54) / 4 Ml In 1 Vial, Single-Dose (68462-469-40)",3.46,1.38,,,0 CDM,2500000004_68462047040,NDC Description Not Available,2.49,1.0,,,0 CDM,2500000004_68462062210,"Fosphenytoin Sodium: 10 Vial, Single-Dose In 1 Carton (68462-622-10) / 10 Ml In 1 Vial, Single-Dose (68462-622-64)",9.97,3.99,,,0 CDM,2500000004_68462062264,"Fosphenytoin Sodium: 10 Vial, Single-Dose In 1 Carton (68462-622-64) / 10 Ml In 1 Vial, Single-Dose (68462-622-10)",10.03,4.01,,,0 CDM,2500000004_68462075501,NDC Description Not Available,6.52,2.61,,,0 CDM,2500000004_68462075525,"Ketorolac Tromethamine: 25 Vial, Single-Dose In 1 Carton (68462-755-25) / 1 Ml In 1 Vial, Single-Dose (68462-755-01)",3.36,1.34,,,0 CDM,2500000004_68462090401,Posaconazole: 1 Vial In 1 Carton (68462-904-01) / 16.7 Ml In 1 Vial,2468.14,987.26,,,0 CDM,2500000004_68516521401,Albutein: 1 Vial In 1 Carton (68516-5214-1) / 250 Ml In 1 Vial (68516-5214-3),92.05,36.82,,,0 CDM,2500000004_68516521403,NDC Description Not Available,114.72,45.89,,,0 CDM,2500000004_68516521405,Albutein: 1 Vial In 1 Carton (68516-5214-5) / 50 Ml In 1 Vial (68516-5214-6),2.59,1.04,,,0 CDM,2500000004_68516521407,NDC Description Not Available,63.1,25.24,,,0 CDM,2500000004_68516521607,NDC Description Not Available,204.82,81.93,,,0 CDM,2500000004_68547011110,"Xacduro: 1 Kit In 1 Carton (68547-111-10) * 5 Ml In 1 Vial, Single-Dose (68547-211-20) * 2.5 Ml In 1 Vial, Single-Dose (68547-311-30)",2109.52,843.81,,,0 CDM,2500000004_68547021120,NDC Description Not Available,1092.5,437.0,,,0 CDM,2500000004_68547031130,NDC Description Not Available,1274.62,509.85,,,0 CDM,2500000004_68547050102,"Giapreza: 1 Vial, Single-Dose In 1 Carton (68547-501-02) / 1 Ml In 1 Vial, Single-Dose",7167.41,2866.96,,,0 CDM,2500000004_68727071201,"Zepzelca: 8 Ml In 1 Vial, Single-Dose (68727-712-01)",904.6,361.84,,,0 CDM,2500000004_68727074501,Vyxeos: 20 Ml In 1 Vial (68727-745-01),1107.54,443.02,,,0 CDM,2500000004_68727074502,Vyxeos: 40 Ml In 1 Carton (68727-745-02),1061.95,424.78,,,0 CDM,2500000004_68727080001,Defitelio: 2.5 Ml In 1 Vial (68727-800-01),4537.19,1814.88,,,0 CDM,2500000004_68727090001,NDC Description Not Available,227.46,90.98,,,0 CDM,2500000004_68727090003,"Rylaze: 3 Vial, Single-Dose In 1 Carton (68727-900-03) / .5 Ml In 1 Vial, Single-Dose (68727-900-01)",230.59,92.24,,,0 CDM,2500000004_68817013450,"Abraxane: 1 Vial, Single-Use In 1 Carton (68817-134-50) / 20 Ml In 1 Vial, Single-Use",66.81,26.72,,,0 CDM,2500000004_68982062302,"Albumin (Human): 250 Ml In 1 Bottle, Glass (68982-623-02)",222.43,88.97,,,0 CDM,2500000004_68992301001,"Envarsus Xr: 1 Pouch In 1 Carton (68992-3010-1) / 1 Bottle In 1 Pouch / 100 Tablet, Extended Release In 1 Bottle",5.15,2.06,,,0 CDM,2500000004_68992304001,"Envarsus Xr: 1 Pouch In 1 Carton (68992-3040-1) / 1 Bottle In 1 Pouch / 100 Tablet, Extended Release In 1 Bottle",5.18,2.07,,,0 CDM,2500000004_68992307501,"Envarsus Xr: 1 Pouch In 1 Carton (68992-3075-1) / 1 Bottle In 1 Pouch / 100 Tablet, Extended Release In 1 Bottle",5.16,2.06,,,0 CDM,2500000004_69097070831,NDC Description Not Available,18.78,7.51,,,0 CDM,2500000004_69097070996,Phytonadione: 10 Vial In 1 Carton (69097-709-96) / .5 Ml In 1 Vial,24.98,9.99,,,0 CDM,2500000004_69097087067,Lanreotide Acetate: 1 Syringe In 1 Carton (69097-870-67) / .5 Ml In 1 Syringe,219.08,87.63,,,0 CDM,2500000004_69315070150,"Ethacrynate Sodium: 1 Vial, Single-Dose In 1 Carton (69315-701-50) / 50 Ml In 1 Vial, Single-Dose",2327.28,930.91,,,0 CDM,2500000004_69374030210,NDC Description Not Available,0.32,0.13,,,0 CDM,2500000004_69374090305,NDC Description Not Available,7.59,3.04,,,0 CDM,2500000004_69374091910,NDC Description Not Available,5.29,2.12,,,0 CDM,2500000004_69374094905,NDC Description Not Available,0.37,0.15,,,0 CDM,2500000004_69374095710,NDC Description Not Available,0.52,0.21,,,0 CDM,2500000004_69452035092,"Granisetron Hydrochloride: 2 Blister Pack In 1 Carton (69452-350-92) / 10 Tablet, Film Coated In 1 Blister Pack",4.07,1.63,,,0 CDM,2500000004_69543045510,"Lacosamide: 10 Vial, Glass In 1 Carton (69543-455-10) / 20 Ml In 1 Vial, Glass (69543-455-20)",0.45,0.18,,,0 CDM,2500000004_69543045520,NDC Description Not Available,0.45,0.18,,,0 CDM,2500000004_69680011201,NDC Description Not Available,6.83,2.73,,,0 CDM,2500000004_69680011225,Cyanocobalamin: 25 Vial In 1 Box (69680-112-25) / 1 Ml In 1 Vial (69680-112-01),8.74,3.5,,,0 CDM,2500000004_69784000306,Fluconazole in Sodium Chloride: 6 BAG in 1 CARTON (69784-003-06) / 200 mL in 1 BAG,15.06,6.02,,,0 CDM,2500000004_69918089901,Desmopressin Acetate: 1 Ml In 1 Ampule (69918-899-01),41.88,16.75,,,0 CDM,2500000004_69918090110,"Desmopressin Acetate: 1 Vial, Multi-Dose In 1 Carton (69918-901-10) / 10 Ml In 1 Vial, Multi-Dose",44.35,17.74,,,0 CDM,2500000004_70069000501,NDC Description Not Available,5.53,2.21,,,0 CDM,2500000004_70069001301,NDC Description Not Available,2.12,0.85,,,0 CDM,2500000004_70069002101,NDC Description Not Available,2.7,1.08,,,0 CDM,2500000004_70069002125,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (70069-021-25) / 1 Ml In 1 Vial (70069-021-01),2.08,0.83,,,0 CDM,2500000004_70069003101,NDC Description Not Available,107.8,43.12,,,0 CDM,2500000004_70069006110,Ropivacaine Hydrochloride: 10 Vial In 1 Carton (70069-061-10) / 10 Ml In 1 Vial (70069-061-01),1.09,0.44,,,0 CDM,2500000004_70069006201,NDC Description Not Available,0.79,0.32,,,0 CDM,2500000004_70069006210,Ropivacaine Hydrochloride: 10 Vial In 1 Carton (70069-062-10) / 20 Ml In 1 Vial (70069-062-01),0.95,0.38,,,0 CDM,2500000004_70069006401,Ropivacaine Hydrochloride: 1 Vial In 1 Carton (70069-064-01) / 30 Ml In 1 Vial,0.28,0.11,,,0 CDM,2500000004_70069006425,Ropivacaine Hydrochloride: 25 Vial In 1 Carton (70069-064-25) / 30 Ml In 1 Vial,0.13,0.05,,,0 CDM,2500000004_70069007110,Naloxone Hydrochloride: 10 Vial In 1 Carton (70069-071-10) / 1 Ml In 1 Vial (70069-071-01),9.51,3.8,,,0 CDM,2500000004_70069010101,NDC Description Not Available,70.91,28.36,,,0 CDM,2500000004_70069036201,NDC Description Not Available,0.33,0.13,,,0 CDM,2500000004_70069036301,Sulfamethoxazole And Trimethoprim: 1 Vial In 1 Carton (70069-363-01) / 30 Ml In 1 Vial,0.16,0.06,,,0 CDM,2500000004_70069047101,NDC Description Not Available,0.91,0.36,,,0 CDM,2500000004_70069047110,"Lacosamide: 10 Vial, Single-Dose In 1 Carton (70069-471-10) / 20 Ml In 1 Vial, Single-Dose (70069-471-01)",0.93,0.37,,,0 CDM,2500000004_70069064101,NDC Description Not Available,0.73,0.29,,,0 CDM,2500000004_70069072801,NDC Description Not Available,0.14,0.06,,,0 CDM,2500000004_70069072810,"Calcium Gluconate: 10 Vial, Plastic In 1 Carton (70069-728-10) / 100 Ml In 1 Vial, Plastic",0.12,0.05,,,0 CDM,2500000004_70069072820,"Calcium Gluconate: 20 Vial, Plastic In 1 Carton (70069-728-20) / 100 Ml In 1 Vial, Plastic (70069-728-01)",0.24,0.1,,,0 CDM,2500000004_70069080201,NDC Description Not Available,0.01,0.004,,,0 CDM,2500000004_70069080210,"Phenylephrine Hydrochloride: 10 Vial, Pharmacy Bulk Package In 1 Carton (70069-802-10) / 5 Ml In 1 Vial, Pharmacy Bulk Package (70069-802-01)",0.01,0.004,,,0 CDM,2500000004_70069080701,NDC Description Not Available,9.26,3.7,,,0 CDM,2500000004_70069080710,Milrinone Lactate: 10 Vial In 1 Carton (70069-807-10) / 10 Ml In 1 Vial (70069-807-01),9.86,3.94,,,0 CDM,2500000004_70069081710,Midazolam: 10 Vial In 1 Carton (70069-817-10) / 5 Ml In 1 Vial,6.57,2.63,,,0 CDM,2500000004_70092100944,NDC Description Not Available,9.11,3.64,,,0 CDM,2500000004_70092104646,NDC Description Not Available,0.45,0.18,,,0 CDM,2500000004_70092111536,NDC Description Not Available,0.68,0.27,,,0 CDM,2500000004_70092138036,NDC Description Not Available,5.66,2.26,,,0 CDM,2500000004_70092141836,NDC Description Not Available,1.1,0.44,,,0 CDM,2500000004_70092152350,NDC Description Not Available,7.26,2.9,,,0 CDM,2500000004_70092168748,NDC Description Not Available,0.32,0.13,,,0 CDM,2500000004_70092200944,NDC Description Not Available,9.71,3.88,,,0 CDM,2500000004_70092208746,NDC Description Not Available,13.47,5.39,,,0 CDM,2500000004_70092905405,NDC Description Not Available,37.34,14.94,,,0 CDM,2500000004_70092905605,NDC Description Not Available,54.69,21.88,,,0 CDM,2500000004_70095002401,NDC Description Not Available,27.57,11.03,,,0 CDM,2500000004_70095002402,Pantoprazole Sodium: 10 Carton In 1 Package (70095-024-02) / 1 Vial In 1 Carton / 10 Ml In 1 Vial (70095-024-01),37.52,15.01,,,0 CDM,2500000004_70095002502,Azithromycin Monohydrate: 10 Vial In 1 Carton (70095-025-02) / 10 Ml In 1 Vial (70095-025-01),9.06,3.62,,,0 CDM,2500000004_70114010101,Udenyca: 1 Syringe In 1 Carton (70114-101-01) / .6 Ml In 1 Syringe,1488.36,595.34,,,0 CDM,2500000004_70114013001,Udenyca: 1 Syringe In 1 Carton (70114-130-01) / .6 Ml In 1 Syringe,1468.51,587.4,,,0 CDM,2500000004_70114034001,"Loqtorzi: 1 Vial, Glass In 1 Carton (70114-340-01) / 6 Ml In 1 Vial, Glass",171.96,68.78,,,0 CDM,2500000004_70121104901,NDC Description Not Available,17.87,7.15,,,0 CDM,2500000004_70121104902,Triamcinolone Acetonide: 1 Vial In 1 Carton (70121-1049-2) / 1 Ml In 1 Vial (70121-1049-1),12.43,4.97,,,0 CDM,2500000004_70121104905,Triamcinolone Acetonide: 25 Vial In 1 Carton (70121-1049-5) / 1 Ml In 1 Vial (70121-1049-1),17.36,6.94,,,0 CDM,2500000004_70121116801,"Triamcinolone Acetonide: 1 Vial, Multi-Dose In 1 Carton (70121-1168-1) / 5 Ml In 1 Vial, Multi-Dose",15.12,6.05,,,0 CDM,2500000004_70121116901,"Triamcinolone Acetonide: 1 Vial, Multi-Dose In 1 Carton (70121-1169-1) / 10 Ml In 1 Vial, Multi-Dose",12.63,5.05,,,0 CDM,2500000004_70121123901,"Cyclophosphamide: 1 Vial, Single-Dose In 1 Carton (70121-1239-1) / 50 Ml In 1 Vial, Single-Dose",5.45,2.18,,,0 CDM,2500000004_70121145301,NDC Description Not Available,9.32,3.73,,,0 CDM,2500000004_70121147901,NDC Description Not Available,0.82,0.33,,,0 CDM,2500000004_70121148202,"Carmustine: 1 Kit In 1 Carton (70121-1482-2) * 3 Ml In 1 Vial (70121-3639-1) * 30 Ml In 1 Vial, Single-Dose (70121-1668-1)",1385.19,554.08,,,0 CDM,2500000004_70121157301,"Methylprednisolone Acetate: 1 Vial, Single-Dose In 1 Carton (70121-1573-1) / 1 Ml In 1 Vial, Single-Dose",0.92,0.37,,,0 CDM,2500000004_70121157305,"Methylprednisolone Acetate: 25 Vial, Single-Dose In 1 Carton (70121-1573-5) / 1 Ml In 1 Vial, Single-Dose",0.86,0.34,,,0 CDM,2500000004_70121157401,"Methylprednisolone Acetate: 1 Vial, Single-Dose In 1 Carton (70121-1574-1) / 1 Ml In 1 Vial, Single-Dose",0.9,0.36,,,0 CDM,2500000004_70121157405,"Methylprednisolone Acetate: 25 Vial, Single-Dose In 1 Carton (70121-1574-5) / 1 Ml In 1 Vial, Single-Dose",0.91,0.36,,,0 CDM,2500000004_70121157801,NDC Description Not Available,0.08,0.03,,,0 CDM,2500000004_70121162701,Fylnetra: 1 Syringe In 1 Carton (70121-1627-1) / .6 Ml In 1 Syringe,790.12,316.05,,,0 CDM,2500000004_70121163101,"Tepadina: 1 Vial, Glass In 1 Box (70121-1631-1) / 1 Injection, Powder, For Solution In 1 Vial, Glass",1370.17,548.07,,,0 CDM,2500000004_70121164201,NDC Description Not Available,5.08,2.03,,,0 CDM,2500000004_70121164701,NDC Description Not Available,1.96,0.78,,,0 CDM,2500000004_70121165501,"Triamcinolone Acetonide: 1 Vial, Multi-Dose In 1 Carton (70121-1655-1) / 10 Ml In 1 Vial, Multi-Dose",2.64,1.06,,,0 CDM,2500000004_70121169402,"Plerixafor: 1 Vial, Single-Dose In 1 Carton (70121-1694-2) / 1.2 Ml In 1 Vial, Single-Dose",196.25,78.5,,,0 CDM,2500000004_70121171707,Esmolol Hydrochloride: 10 Pouch In 1 Carton (70121-1717-7) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,1.45,0.58,,,0 CDM,2500000004_70121171909,Magnesium Sulfate: 24 Pouch In 1 Carton (70121-1719-9) / 1 Bag In 1 Pouch / 50 Ml In 1 Bag,4.43,1.77,,,0 CDM,2500000004_70121172001,NDC Description Not Available,1.43,0.57,,,0 CDM,2500000004_70121172009,Magnesium Sulfate: 24 Pouch In 1 Carton (70121-1720-9) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,4.05,1.62,,,0 CDM,2500000004_70121173309,Ropivacaine Hydrochloride: 24 Pouch In 1 Carton (70121-1733-9) / 1 Bag In 1 Pouch / 200 Ml In 1 Bag,0.33,0.13,,,0 CDM,2500000004_70121174301,"Nelarabine: 1 Vial, Single-Dose In 1 Carton (70121-1743-1) / 50 Ml In 1 Vial, Single-Dose",217.58,87.03,,,0 CDM,2500000004_70121174304,"Nelarabine: 6 Vial, Single-Dose In 1 Carton (70121-1743-4) / 50 Ml In 1 Vial, Single-Dose (70121-1743-1)",209.75,83.9,,,0 CDM,2500000004_70121175401,Alymsys: 1 Vial In 1 Carton (70121-1754-1) / 4 Ml In 1 Vial,324.23,129.69,,,0 CDM,2500000004_70121175501,Alymsys: 1 Vial In 1 Carton (70121-1755-1) / 16 Ml In 1 Vial,324.3,129.72,,,0 CDM,2500000004_70121230804,"Calcium Chloride: 24 Carton In 1 Carton (70121-2308-4) / 1 Syringe, Glass In 1 Carton (70121-2308-1) / 10 Ml In 1 Syringe, Glass",0.09,0.04,,,0 CDM,2500000004_70199002611,"Aquasol A: 1 Vial, Single-Dose In 1 Carton (70199-026-11) / 2 Ml In 1 Vial, Single-Dose",206.1,82.44,,,0 CDM,2500000004_70257005105,NDC Description Not Available,241.38,96.55,,,0 CDM,2500000004_70257005151,"Hepagam B: 1 Vial, Glass In 1 Carton (70257-051-51) / 5 Ml In 1 Vial, Glass (70257-051-05)",242.46,96.98,,,0 CDM,2500000004_70257033051,"Winrho Sdf: 1 Vial, Single-Dose In 1 Carton (70257-330-51) / 1 Liquid In 1 Vial, Single-Dose (70257-330-11)",635.97,254.39,,,0 CDM,2500000004_70408014634,Promethazine Hydrochloride: 473 Ml In 1 Bottle (70408-146-34),2.4,0.96,,,0 CDM,2500000004_70436001982,Azithromycin: 10 Vial In 1 Box (70436-019-82) / 5 Ml In 1 Vial,16.85,6.74,,,0 CDM,2500000004_70436002082,"Vancomycin Hydrochloride: 10 Vial In 1 Carton (70436-020-82) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",3.27,1.31,,,0 CDM,2500000004_70436002182,"Vancomycin Hydrochloride: 10 Vial In 1 Carton (70436-021-82) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",5.25,2.1,,,0 CDM,2500000004_70436002382,"Vancomycin Hydrochloride: 1 Vial In 1 Carton (70436-023-82) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",5.14,2.06,,,0 CDM,2500000004_70436002580,"Bivalirudin: 1 Injection, Powder, Lyophilized, For Suspension In 1 Vial, Single-Dose (70436-025-80)",0.95,0.38,,,0 CDM,2500000004_70436002780,Eptifibatide: 100 Ml In 1 Vial (70436-027-80),16.84,6.74,,,0 CDM,2500000004_70436002980,"Voriconazole: 1 Injection, Powder, Lyophilized, For Solution In 1 Box (70436-029-80)",3.32,1.33,,,0 CDM,2500000004_70436008955,Ganciclovir: 25 Vial In 1 Carton (70436-089-55) / 10 Ml In 1 Vial,185.73,74.29,,,0 CDM,2500000004_70436020380,"Dobutamine: 1 Vial, Single-Dose In 1 Carton (70436-203-80) / 20 Ml In 1 Vial, Single-Dose",21.16,8.46,,,0 CDM,2500000004_70512084001,NDC Description Not Available,7.49,3.0,,,0 CDM,2500000004_70594003401,"Daptomycin: 1 Vial, Single-Use In 1 Carton (70594-034-01) / 10 Ml In 1 Vial, Single-Use",0.53,0.21,,,0 CDM,2500000004_70594004602,"Vancomycin Hydrochloride: 10 Vial, Glass In 1 Carton (70594-046-02) / 1 Injection, Powder, For Solution In 1 Vial, Glass (70594-046-01)",2.66,1.06,,,0 CDM,2500000004_70594004801,"Vancomycin Hydrochloride: 1 Vial, Glass In 1 Carton (70594-048-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Glass",5.92,2.37,,,0 CDM,2500000004_70594006701,"Voriconazole: 1 Vial, Single-Dose In 1 Carton (70594-067-01) / 20 Ml In 1 Vial, Single-Dose",8.8,3.52,,,0 CDM,2500000004_70594008701,NDC Description Not Available,7.76,3.1,,,0 CDM,2500000004_70594009001,NDC Description Not Available,10.62,4.25,,,0 CDM,2500000004_70594011101,NDC Description Not Available,4.96,1.98,,,0 CDM,2500000004_70594011102,Acetylcysteine: 4 Vial In 1 Carton (70594-111-02) / 30 Ml In 1 Vial (70594-111-01),5.11,2.04,,,0 CDM,2500000004_70594011401,NDC Description Not Available,0.11,0.04,,,0 CDM,2500000004_70594011701,NDC Description Not Available,0.06,0.02,,,0 CDM,2500000004_70700016722,NDC Description Not Available,7.47,2.99,,,0 CDM,2500000004_70700017022,"Irinotecan Hydrochloride: 1 Vial, Single-Dose In 1 Carton (70700-170-22) / 5 Ml In 1 Vial, Single-Dose",9.0,3.6,,,0 CDM,2500000004_70700018722,NDC Description Not Available,22.43,8.97,,,0 CDM,2500000004_70700018723,Fluorouracil: 10 Vial In 1 Carton (70700-187-23) / 20 Ml In 1 Vial (70700-187-22),27.32,10.93,,,0 CDM,2500000004_70700018822,"Fluorouracil: 1 Vial, Pharmacy Bulk Package In 1 Carton (70700-188-22) / 50 Ml In 1 Vial, Pharmacy Bulk Package",23.7,9.48,,,0 CDM,2500000004_70700018922,"Fluorouracil: 1 Vial, Pharmacy Bulk Package In 1 Carton (70700-189-22) / 100 Ml In 1 Vial, Pharmacy Bulk Package",25.34,10.14,,,0 CDM,2500000004_70700027422,"Estradiol Valerate: 5 Ml In 1 Vial, Multi-Dose (70700-274-22)",0.01,0.004,,,0 CDM,2500000004_70710135901,NDC Description Not Available,0.05,0.02,,,0 CDM,2500000004_70710141101,"Bortezomib: 1 Vial, Single-Dose In 1 Carton (70710-1411-1) / 3.5 Ml In 1 Vial, Single-Dose",3.38,1.35,,,0 CDM,2500000004_70710147801,Fomepizole: 1 Vial In 1 Carton (70710-1478-1) / 1.5 Ml In 1 Vial,71.93,28.77,,,0 CDM,2500000004_70710152509,"Carmustine: 1 Kit In 1 Carton (70710-1525-9) * 3 Ml In 1 Vial (70710-1523-1) * 30 Ml In 1 Vial, Single-Dose (70710-1524-1)",1288.6,515.44,,,0 CDM,2500000004_70710153001,"Doxorubicin Hydrochloride: 1 Vial, Single-Dose In 1 Carton (70710-1530-1) / 10 Ml In 1 Vial, Single-Dose",1752.84,701.14,,,0 CDM,2500000004_70710153101,"Doxorubicin Hydrochloride: 1 Vial, Single-Dose In 1 Carton (70710-1531-1) / 25 Ml In 1 Vial, Single-Dose",253.59,101.44,,,0 CDM,2500000004_70710166307,"Cyanocobalamin: 25 Vial, Multi-Dose In 1 Carton (70710-1663-7) / 1 Ml In 1 Vial, Multi-Dose (70710-1663-1)",12.05,4.82,,,0 CDM,2500000004_70710172601,"Nelarabine: 1 Vial, Single-Dose In 1 Carton (70710-1726-1) / 50 Ml In 1 Vial, Single-Dose",827.15,330.86,,,0 CDM,2500000004_70710183301,"Levothyroxine Sodium: 1 Vial, Single-Dose In 1 Carton (70710-1833-1) / 5 Ml In 1 Vial, Single-Dose",41.19,16.48,,,0 CDM,2500000004_70710183801,NDC Description Not Available,23.15,9.26,,,0 CDM,2500000004_70710183805,Methylene Blue: 5 Vial In 1 Carton (70710-1838-5) / 10 Ml In 1 Vial (70710-1838-1),899.65,359.86,,,0 CDM,2500000004_70710192601,Sodium Phenylacetate And Sodium Benzoate: 1 Vial In 1 Carton (70710-1926-1) / 20 Ml In 1 Vial,5919.62,2367.85,,,0 CDM,2500000004_70720072010,"Prialt: 1 Vial, Glass In 1 Carton (70720-720-10) / 1 Ml In 1 Vial, Glass",53.37,21.35,,,0 CDM,2500000004_70720072210,"Prialt: 1 Vial, Glass In 1 Carton (70720-722-10) / 5 Ml In 1 Vial, Glass",44.98,17.99,,,0 CDM,2500000004_70748032301,NDC Description Not Available,6.64,2.66,,,0 CDM,2500000004_70748033901,"Doxorubicin Hydrochloride: 1 Vial, Single-Use In 1 Carton (70748-339-01) / 10 Ml In 1 Vial, Single-Use",850.43,340.17,,,0 CDM,2500000004_70748034001,"Doxorubicin Hydrochloride: 1 Vial, Single-Use In 1 Carton (70748-340-01) / 25 Ml In 1 Vial, Single-Use",837.36,334.94,,,0 CDM,2500000004_70752013812,"Promethazine Hydrochloride: 473 Ml In 1 Bottle, Plastic (70752-138-12)",3.86,1.54,,,0 CDM,2500000004_70756062210,"Phenylephrine Hydrochloride: 10 Vial, Pharmacy Bulk Package In 1 Carton (70756-622-10) / 5 Ml In 1 Vial, Pharmacy Bulk Package (70756-622-85)",0.03,0.01,,,0 CDM,2500000004_70756062285,NDC Description Not Available,0.01,0.004,,,0 CDM,2500000004_70756064125,Lidocaine Hydrochloride: 25 Vial In 1 Carton (70756-641-25) / 5 Ml In 1 Vial,0.12,0.05,,,0 CDM,2500000004_70756064586,Lidocaine Hydrochloride: 1 Vial In 1 Carton (70756-645-86) / 10 Ml In 1 Vial,0.07,0.03,,,0 CDM,2500000004_70842012001,NDC Description Not Available,9.67,3.87,,,0 CDM,2500000004_70842012006,"Vabomere: 6 Vial, Single-Dose In 1 Carton (70842-120-06) / 2 G In 1 Vial, Single-Dose (70842-120-01)",8.38,3.35,,,0 CDM,2500000004_70842014001,NDC Description Not Available,117.53,47.01,,,0 CDM,2500000004_70842016001,NDC Description Not Available,10.42,4.17,,,0 CDM,2500000004_70842016010,Minocin: 10 Vial In 1 Carton (70842-160-10) / 1 Injection In 1 Vial (70842-160-01),10.8,4.32,,,0 CDM,2500000004_70860010010,"Azithromycin: 10 Vial, Single-Dose In 1 Carton (70860-100-10) / 5 Ml In 1 Vial, Single-Dose (70860-100-41)",22.0,8.8,,,0 CDM,2500000004_70860010041,NDC Description Not Available,22.0,8.8,,,0 CDM,2500000004_70860011415,"Ampicillin: 10 VIAL in 1 CARTON (70860-114-15) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL (70860-114-41)",16.5,6.6,,,0 CDM,2500000004_70860011999,Nafcillin: 1 Bottle In 1 Carton (70860-119-99) / 100 Ml In 1 Bottle,0.29,0.12,,,0 CDM,2500000004_70860012641,NDC Description Not Available,2.04,0.82,,,0 CDM,2500000004_70860030141,NDC Description Not Available,0.17,0.07,,,0 CDM,2500000004_70860030143,NDC Description Not Available,0.1,0.04,,,0 CDM,2500000004_70860030241,NDC Description Not Available,0.16,0.06,,,0 CDM,2500000004_70860040541,NDC Description Not Available,5.02,2.01,,,0 CDM,2500000004_70860045110,Levothyroxine Sodium: 1 VIAL in 1 CARTON (70860-451-10) / 5 mL in 1 VIAL,24.46,9.78,,,0 CDM,2500000004_70860060041,NDC Description Not Available,2.31,0.92,,,0 CDM,2500000004_70860060142,NDC Description Not Available,0.18,0.07,,,0 CDM,2500000004_70860070002,Ketorolac Tromethamine: 25 VIAL in 1 CARTON (70860-700-02) / 1 mL in 1 VIAL (70860-700-41),7.76,3.1,,,0 CDM,2500000004_70860070041,NDC Description Not Available,6.93,2.77,,,0 CDM,2500000004_70860070103,Ketorolac Tromethamine: 25 Vial In 1 Carton (70860-701-03) / 1 Ml In 1 Vial (70860-701-41),4.1,1.64,,,0 CDM,2500000004_70860070141,NDC Description Not Available,3.24,1.3,,,0 CDM,2500000004_70860077641,NDC Description Not Available,0.5,0.2,,,0 CDM,2500000004_70860077802,Prochlorperazine Edisylate: 10 Vial In 1 Carton (70860-778-02) / 2 Ml In 1 Vial (70860-778-41),7.96,3.18,,,0 CDM,2500000004_70860077841,NDC Description Not Available,8.57,3.43,,,0 CDM,2500000004_70954006010,Prednisone: 100 Tablet In 1 Bottle (70954-060-10),0.01,0.004,,,0 CDM,2500000004_70954006110,Prednisone: 100 Tablet In 1 Bottle (70954-061-10),0.02,0.01,,,0 CDM,2500000004_71225012001,"Vivimusta: 1 Vial, Multi-Dose In 1 Carton (71225-120-01) / 4 Ml In 1 Vial, Multi-Dose",144.0,57.6,,,0 CDM,2500000004_71266200102,NDC Description Not Available,4.09,1.64,,,0 CDM,2500000004_71266200108,NDC Description Not Available,6.22,2.49,,,0 CDM,2500000004_71266503001,NDC Description Not Available,0.92,0.37,,,0 CDM,2500000004_71266503501,NDC Description Not Available,0.61,0.24,,,0 CDM,2500000004_71266507201,NDC Description Not Available,39.19,15.68,,,0 CDM,2500000004_71266507301,NDC Description Not Available,27.5,11.0,,,0 CDM,2500000004_71266507501,NDC Description Not Available,30.01,12.0,,,0 CDM,2500000004_71266508201,NDC Description Not Available,1.78,0.71,,,0 CDM,2500000004_71266508301,NDC Description Not Available,6.3,2.52,,,0 CDM,2500000004_71266508501,NDC Description Not Available,5.27,2.11,,,0 CDM,2500000004_71266901101,NDC Description Not Available,0.43,0.17,,,0 CDM,2500000004_71266909001,NDC Description Not Available,0.23,0.09,,,0 CDM,2500000004_71266911501,NDC Description Not Available,0.42,0.17,,,0 CDM,2500000004_71288001615,"Daptomycin: 1 Vial, Single-Dose In 1 Carton (71288-016-15) / 10 Ml In 1 Vial, Single-Dose",0.13,0.05,,,0 CDM,2500000004_71288002420,NDC Description Not Available,10.38,4.15,,,0 CDM,2500000004_71288002421,"Vancomycin Hydrochloride: 10 Vial, Single-Dose In 1 Carton (71288-024-21) / 15 Ml In 1 Vial, Single-Dose (71288-024-20)",34.82,13.93,,,0 CDM,2500000004_71288002675,"Vancomycin Hydrochloride: 1 Vial, Pharmacy Bulk Package In 1 Carton (71288-026-75) / 95 Ml In 1 Vial, Pharmacy Bulk Package",46.78,18.71,,,0 CDM,2500000004_71288002730,"Voriconazole: 1 Vial, Single-Dose In 1 Carton (71288-027-30) / 20 Ml In 1 Vial, Single-Dose",7.7,3.08,,,0 CDM,2500000004_71288002810,NDC Description Not Available,3.64,1.46,,,0 CDM,2500000004_71288002811,"Micafungin: 10 Vial, Single-Dose In 1 Carton (71288-028-11) / 5 Ml In 1 Vial, Single-Dose (71288-028-10)",2.45,0.98,,,0 CDM,2500000004_71288002910,NDC Description Not Available,2.36,0.94,,,0 CDM,2500000004_71288002911,"Micafungin: 10 Vial, Single-Dose In 1 Carton (71288-029-11) / 5 Ml In 1 Vial, Single-Dose (71288-029-10)",2.34,0.94,,,0 CDM,2500000004_71288003020,NDC Description Not Available,0.43,0.17,,,0 CDM,2500000004_71288003120,NDC Description Not Available,22.9,9.16,,,0 CDM,2500000004_71288003121,"Ampicillin And Sulbactam: 10 Vial, Single-Dose In 1 Carton (71288-031-21) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose (71288-031-20)",9.37,3.75,,,0 CDM,2500000004_71288003220,NDC Description Not Available,18.29,7.32,,,0 CDM,2500000004_71288003221,"Ampicillin And Sulbactam: 10 Vial, Single-Dose In 1 Carton (71288-032-21) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose (71288-032-20)",7.65,3.06,,,0 CDM,2500000004_71288010120,"Oxaliplatin: 1 Vial, Single-Dose In 1 Carton (71288-101-20) / 20 Ml In 1 Vial, Single-Dose",0.26,0.1,,,0 CDM,2500000004_71288010720,"Bleomycin: 1 Vial, Single-Dose In 1 Carton (71288-107-20) / 30 Powder, For Solution In 1 Vial, Single-Dose",124.67,49.87,,,0 CDM,2500000004_71288010920,"Cytarabine: 1 Vial, Single-Dose In 1 Carton (71288-109-20) / 20 Ml In 1 Vial, Single-Dose",39.43,15.77,,,0 CDM,2500000004_71288011530,"Azacitidine: 1 Vial, Single-Dose In 1 Carton (71288-115-30) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",1.25,0.5,,,0 CDM,2500000004_71288011610,NDC Description Not Available,2.24,0.9,,,0 CDM,2500000004_71288011611,"Busulfan: 8 Vial, Single-Dose In 1 Carton (71288-116-11) / 10 Ml In 1 Vial, Single-Dose (71288-116-10)",2.24,0.9,,,0 CDM,2500000004_71288011754,"Gemcitabine: 1 Vial, Single-Dose In 1 Carton (71288-117-54) / 52.6 Ml In 1 Vial, Single-Dose",24.23,9.69,,,0 CDM,2500000004_71288011810,"Bortezomib: 1 Vial, Single-Dose In 1 Carton (71288-118-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",5.44,2.18,,,0 CDM,2500000004_71288011920,"Decitabine: 1 Vial, Single-Dose In 1 Carton (71288-119-20) / 20 Ml In 1 Vial, Single-Dose",4.66,1.86,,,0 CDM,2500000004_71288012690,"Carmustine: 1 Kit In 1 Carton (71288-126-90) * 30 Ml In 1 Vial, Single-Dose (71288-124-30) * 3 Ml In 1 Vial (71288-125-03)",2455.8,982.32,,,0 CDM,2500000004_71288013290,"Melphalan Hydrochloride: 1 Kit In 1 Carton (71288-132-90) * 15 Ml In 1 Vial, Single-Dose (71288-130-15) * 10 Ml In 1 Vial, Single-Use (71288-131-10)",367.46,146.98,,,0 CDM,2500000004_71288013850,"Mitomycin: 1 Vial, Single-Dose In 1 Carton (71288-138-50) / 40 Ml In 1 Vial, Single-Dose",494.99,198.0,,,0 CDM,2500000004_71288014750,"Pemetrexed: 1 Vial, Single-Dose In 1 Carton (71288-147-50) / 30 Ml In 1 Vial, Single-Dose",6.32,2.53,,,0 CDM,2500000004_71288014851,"Pemetrexed: 1 Vial, Single-Dose In 1 Carton (71288-148-51) / 40 Ml In 1 Vial, Single-Dose",6.12,2.45,,,0 CDM,2500000004_71288015476,"Fluorouracil: 1 Vial, Pharmacy Bulk Package In 1 Carton (71288-154-76) / 100 Ml In 1 Vial, Pharmacy Bulk Package",6.1,2.44,,,0 CDM,2500000004_71288015501,"Plerixafor: 1 Vial, Single-Dose In 1 Carton (71288-155-01) / 1.2 Ml In 1 Vial, Single-Dose",44.46,17.78,,,0 CDM,2500000004_71288015710,"Thiotepa: 1 Vial, Single-Dose In 1 Carton (71288-157-10) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose",1509.93,603.97,,,0 CDM,2500000004_71288016330,"Leucovorin Calcium: 1 Vial, Single-Dose In 1 Carton (71288-163-30) / 17.5 Ml In 1 Vial, Single-Dose",17.55,7.02,,,0 CDM,2500000004_71288016554,"Nelarabine: 1 Vial, Single-Dose In 1 Carton (71288-165-54) / 50 Ml In 1 Vial, Single-Dose (71288-165-52)",665.06,266.02,,,0 CDM,2500000004_71288016610,"Pemetrexed: 1 Vial, Single-Dose In 1 Carton (71288-166-10) / 10 Ml In 1 Vial, Single-Dose",4.9,1.96,,,0 CDM,2500000004_71288016750,"Pemetrexed: 1 Vial, Single-Dose In 1 Carton (71288-167-50) / 50 Ml In 1 Vial, Single-Dose",4.05,1.62,,,0 CDM,2500000004_71288017075,"Fluorouracil: 1 Vial, Pharmacy Bulk Package In 1 Carton (71288-170-75) / 50 Ml In 1 Vial, Pharmacy Bulk Package",6.54,2.62,,,0 CDM,2500000004_71288020010,NDC Description Not Available,5.8,2.32,,,0 CDM,2500000004_71288020020,NDC Description Not Available,8.37,3.35,,,0 CDM,2500000004_71288020021,"Milrinone Lactate: 10 Vial, Single-Dose In 1 Carton (71288-200-21) / 20 Ml In 1 Vial, Single-Dose (71288-200-20)",4.85,1.94,,,0 CDM,2500000004_71288020185,"Regadenoson: 1 Syringe, Plastic In 1 Carton (71288-201-85) / 5 Ml In 1 Syringe, Plastic",21.13,8.45,,,0 CDM,2500000004_71288020302,NDC Description Not Available,0.39,0.16,,,0 CDM,2500000004_71288020304,NDC Description Not Available,2.73,1.09,,,0 CDM,2500000004_71288020305,"Furosemide: 25 Vial, Single-Dose In 1 Carton (71288-203-05) / 4 Ml In 1 Vial, Single-Dose (71288-203-04)",4.23,1.69,,,0 CDM,2500000004_71288020310,NDC Description Not Available,0.17,0.07,,,0 CDM,2500000004_71288020311,"Furosemide: 25 Vial, Single-Dose In 1 Carton (71288-203-11) / 10 Ml In 1 Vial, Single-Dose (71288-203-10)",1.21,0.48,,,0 CDM,2500000004_71288030301,NDC Description Not Available,8.02,3.21,,,0 CDM,2500000004_71288040210,NDC Description Not Available,2.37,0.95,,,0 CDM,2500000004_71288040211,"Heparin Sodium: 25 Vial, Multi-Dose In 1 Carton (71288-402-11) / 10 Ml In 1 Vial, Multi-Dose (71288-402-10)",0.93,0.37,,,0 CDM,2500000004_71288040301,NDC Description Not Available,1.0,0.4,,,0 CDM,2500000004_71288040302,"Heparin Sodium: 25 Vial, Single-Dose In 1 Carton (71288-403-02) / 1 Ml In 1 Vial, Single-Dose (71288-403-01)",0.78,0.31,,,0 CDM,2500000004_71288040310,NDC Description Not Available,1.53,0.61,,,0 CDM,2500000004_71288040701,NDC Description Not Available,3.49,1.4,,,0 CDM,2500000004_71288040905,"Palonosetron Hydrochloride: 1 Vial, Single-Dose In 1 Carton (71288-409-05) / 5 Ml In 1 Vial, Single-Dose",5.92,2.37,,,0 CDM,2500000004_71288041080,NDC Description Not Available,3.53,1.41,,,0 CDM,2500000004_71288041082,NDC Description Not Available,6.6,2.64,,,0 CDM,2500000004_71288041084,NDC Description Not Available,3.23,1.29,,,0 CDM,2500000004_71288041086,NDC Description Not Available,3.33,1.33,,,0 CDM,2500000004_71288041088,NDC Description Not Available,3.34,1.34,,,0 CDM,2500000004_71288041180,NDC Description Not Available,6.6,2.64,,,0 CDM,2500000004_71288041182,NDC Description Not Available,2.42,0.97,,,0 CDM,2500000004_71288041183,Enoxaparin Sodium: 10 Syringe In 1 Carton (71288-411-83) / 1 Ml In 1 Syringe (71288-411-82),4.04,1.62,,,0 CDM,2500000004_71288041401,NDC Description Not Available,1.98,0.79,,,0 CDM,2500000004_71288041403,"Glycopyrrolate: 25 Vial, Single-Dose In 1 Carton (71288-414-03) / 1 Ml In 1 Vial, Single-Dose (71288-414-01)",1.97,0.79,,,0 CDM,2500000004_71288042603,"Enoxaparin Sodium: 1 Vial, Multi-Dose In 1 Carton (71288-426-03) / 3 Ml In 1 Vial, Multi-Dose",2.8,1.12,,,0 CDM,2500000004_71288042710,NDC Description Not Available,1.23,0.49,,,0 CDM,2500000004_71288043280,NDC Description Not Available,4.59,1.84,,,0 CDM,2500000004_71288043281,Enoxaparin Sodium: 10 Syringe In 1 Carton (71288-432-81) / .3 Ml In 1 Syringe (71288-432-80),2.63,1.05,,,0 CDM,2500000004_71288043382,NDC Description Not Available,4.17,1.67,,,0 CDM,2500000004_71288043383,Enoxaparin Sodium: 10 Syringe In 1 Carton (71288-433-83) / .4 Ml In 1 Syringe (71288-433-82),4.12,1.65,,,0 CDM,2500000004_71288043484,NDC Description Not Available,3.94,1.58,,,0 CDM,2500000004_71288043485,Enoxaparin Sodium: 10 Syringe In 1 Carton (71288-434-85) / .6 Ml In 1 Syringe (71288-434-84),3.99,1.6,,,0 CDM,2500000004_71288043586,NDC Description Not Available,4.08,1.63,,,0 CDM,2500000004_71288043587,Enoxaparin Sodium: 10 Syringe In 1 Carton (71288-435-87) / .8 Ml In 1 Syringe (71288-435-86),3.95,1.58,,,0 CDM,2500000004_71288043688,NDC Description Not Available,4.16,1.66,,,0 CDM,2500000004_71288043689,Enoxaparin Sodium: 10 Syringe In 1 Carton (71288-436-89) / 1 Ml In 1 Syringe (71288-436-88),4.17,1.67,,,0 CDM,2500000004_71288043791,NDC Description Not Available,4.11,1.64,,,0 CDM,2500000004_71288043792,Enoxaparin Sodium: 10 Syringe In 1 Carton (71288-437-92) / .8 Ml In 1 Syringe (71288-437-91),4.1,1.64,,,0 CDM,2500000004_71288043893,NDC Description Not Available,4.06,1.62,,,0 CDM,2500000004_71288043894,Enoxaparin Sodium: 10 Syringe In 1 Carton (71288-438-94) / 1 Ml In 1 Syringe (71288-438-93),2.44,0.98,,,0 CDM,2500000004_71288060010,NDC Description Not Available,18.21,7.28,,,0 CDM,2500000004_71288060011,"Pantoprazole Sodium: 10 Vial, Single-Dose In 1 Carton (71288-600-11) / 10 Ml In 1 Vial, Single-Dose (71288-600-10)",6.21,2.48,,,0 CDM,2500000004_71288070005,NDC Description Not Available,20.61,8.24,,,0 CDM,2500000004_71288071910,NDC Description Not Available,1.29,0.52,,,0 CDM,2500000004_71288071911,"Succinylcholine Chloride: 25 Vial, Multi-Dose In 1 Carton (71288-719-11) / 10 Ml In 1 Vial, Multi-Dose (71288-719-10)",1.44,0.58,,,0 CDM,2500000004_71288073211,"Ropivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (71288-732-11) / 10 Ml In 1 Vial, Single-Dose (71288-732-10)",0.54,0.22,,,0 CDM,2500000004_71288080320,NDC Description Not Available,8.44,3.38,,,0 CDM,2500000004_71288080321,"Mycophenolate Mofetil: 4 Vial, Single-Dose In 1 Carton (71288-803-21) / 20 Ml In 1 Vial, Single-Dose (71288-803-20)",6.46,2.58,,,0 CDM,2500000004_71336100301,"Amvuttra: 1 Syringe, Glass In 1 Carton (71336-1003-1) / .5 Ml In 1 Syringe, Glass",21005.78,8402.31,,,0 CDM,2500000004_71349007001,Ycanth: 1 Applicator In 1 Package (71349-070-01) / 1 Ampule In 1 Applicator / .45 Ml In 1 Ampule,1952.25,780.9,,,0 CDM,2500000004_71349007006,Ycanth: 6 Package In 1 Carton (71349-070-06) / 1 Applicator In 1 Package (71349-070-01) / 1 Ampule In 1 Applicator / .45 Ml In 1 Ampule,1952.25,780.9,,,0 CDM,2500000004_71351002105,NDC Description Not Available,0.16,0.06,,,0 CDM,2500000004_71351002110,Lidocaine Hydrochloride: 10 Vial In 1 Box (71351-021-10) / 5 Ml In 1 Vial (71351-021-05),0.18,0.07,,,0 CDM,2500000004_71506001558,NDC Description Not Available,27.98,11.19,,,0 CDM,2500000004_71506001858,NDC Description Not Available,84.19,33.68,,,0 CDM,2500000004_71506004645,NDC Description Not Available,7.61,3.04,,,0 CDM,2500000004_71715000101,NDC Description Not Available,19.05,7.62,,,0 CDM,2500000004_71773005012,"Xerava: 12 Vial, Glass In 1 Carton (71773-050-12) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Glass",5.66,2.26,,,0 CDM,2500000004_71837584301,NDC Description Not Available,205.56,82.22,,,0 CDM,2500000004_71839011010,Enoxaparin Sodium: 10 Syringe In 1 Carton (71839-110-10) / .4 Ml In 1 Syringe,2.89,1.16,,,0 CDM,2500000004_71894012002,Zolgensma: 1 Kit In 1 Carton (71894-120-02) * 1 Ml In 1 Pouch * 8.3 Ml In 1 Vial (71894-115-01),8707666.35,3483066.54,,,0 CDM,2500000004_71894012203,Zolgensma: 1 Kit In 1 Carton (71894-122-03) * 8.3 Ml In 1 Vial (71894-115-01) * 1 Ml In 1 Pouch * 5.5 Ml In 1 Vial (71894-110-01),8968896.34,3587558.54,,,0 CDM,2500000004_72078006550,NDC Description Not Available,25.14,10.06,,,0 CDM,2500000004_72078006599,"Vancomycin Hydrochloride: 10 Vial, Single-Dose In 1 Carton (72078-065-99) / 50 Ml In 1 Vial, Single-Dose",43.64,17.46,,,0 CDM,2500000004_72078006650,NDC Description Not Available,43.9,17.56,,,0 CDM,2500000004_72078006699,"Vancomycin Hydrochloride: 10 Vial, Single-Dose In 1 Carton (72078-066-99) / 50 Ml In 1 Vial, Single-Dose",49.41,19.76,,,0 CDM,2500000004_72205004501,"Thiotepa: 1 Vial, Glass In 1 Box (72205-045-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Glass",578.8,231.52,,,0 CDM,2500000004_72205004601,"Thiotepa: 1 Vial, Glass In 1 Box (72205-046-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Glass",133.38,53.35,,,0 CDM,2500000004_72205006301,"Paclitaxel: 1 Vial, Multi-Dose In 1 Carton (72205-063-01) / 50 Ml In 1 Vial, Multi-Dose",0.45,0.18,,,0 CDM,2500000004_72205010101,NDC Description Not Available,5.72,2.29,,,0 CDM,2500000004_72205010107,Bumetanide: 10 Vial In 1 Carton (72205-101-07) / 4 Ml In 1 Vial (72205-101-01),4.54,1.82,,,0 CDM,2500000004_72205010201,NDC Description Not Available,3.77,1.51,,,0 CDM,2500000004_72205015401,Nelarabine: 1 Vial In 1 Carton (72205-154-01) / 50 Ml In 1 Vial,647.17,258.87,,,0 CDM,2500000004_72205015404,Nelarabine: 6 Vial In 1 Carton (72205-154-04) / 50 Ml In 1 Vial,253.65,101.46,,,0 CDM,2500000004_72205017101,NDC Description Not Available,9.07,3.63,,,0 CDM,2500000004_72205017107,"Arsenic Trioxide: 10 Vial, Single-Dose In 1 Carton (72205-171-07) / 10 Ml In 1 Vial, Single-Dose (72205-171-01)",10.28,4.11,,,0 CDM,2500000004_72205019801,"Carmustine: 1 Kit In 1 Carton (72205-198-01) * 3 Ml In 1 Vial (72205-196-01) * 30 Ml In 1 Vial, Single-Dose (72205-197-01)",1057.54,423.02,,,0 CDM,2500000004_72266010201,"Labetalol Hydrochloride: 1 Vial, Multi-Dose In 1 Carton (72266-102-01) / 20 Ml In 1 Vial, Multi-Dose",0.54,0.22,,,0 CDM,2500000004_72266010301,"Labetalol Hydrochloride: 1 Vial, Multi-Dose In 1 Carton (72266-103-01) / 40 Ml In 1 Vial, Multi-Dose",0.59,0.24,,,0 CDM,2500000004_72266011801,NDC Description Not Available,7.57,3.03,,,0 CDM,2500000004_72266011825,Ketorolac Tromethamine: 25 Vial In 1 Carton (72266-118-25) / 1 Ml In 1 Vial (72266-118-01),7.81,3.12,,,0 CDM,2500000004_72266011901,NDC Description Not Available,3.9,1.56,,,0 CDM,2500000004_72266011925,Ketorolac Tromethamine: 25 Vial In 1 Carton (72266-119-25) / 2 Ml In 1 Vial (72266-119-01),0.55,0.22,,,0 CDM,2500000004_72266012301,NDC Description Not Available,0.54,0.22,,,0 CDM,2500000004_72266012401,Ondansetron: 1 Vial In 1 Carton (72266-124-01) / 20 Ml In 1 Vial,0.28,0.11,,,0 CDM,2500000004_72266012701,NDC Description Not Available,82.45,32.98,,,0 CDM,2500000004_72266012801,"Melphalan Hydrochloride: 1 Kit In 1 Carton (72266-128-01) * 10 Ml In 1 Vial, Single-Dose (72266-144-01) * 10 Ml In 1 Vial, Single-Use (72266-145-01)",1198.81,479.52,,,0 CDM,2500000004_72266016001,NDC Description Not Available,61.8,24.72,,,0 CDM,2500000004_72266016010,"Ziprasidone Mesylate: 10 Vial, Single-Dose In 1 Carton (72266-160-10) / 1 Ml In 1 Vial, Single-Dose (72266-160-01)",73.69,29.48,,,0 CDM,2500000004_72266020401,NDC Description Not Available,11.86,4.74,,,0 CDM,2500000004_72266023401,NDC Description Not Available,5.5,2.2,,,0 CDM,2500000004_72266023425,Ketorolac Tromethamine: 25 Vial In 1 Carton (72266-234-25) / 1 Ml In 1 Vial (72266-234-01),5.99,2.4,,,0 CDM,2500000004_72266023601,"Sodium Phenylacetate And Sodium Benzoate: 1 Vial, Single-Dose In 1 Carton (72266-236-01) / 20 Ml In 1 Vial, Single-Dose",6372.35,2548.94,,,0 CDM,2500000004_72266024801,NDC Description Not Available,229.97,91.99,,,0 CDM,2500000004_72266024805,Sincalide: 5 Vial In 1 Package (72266-248-05) / 5 Ml In 1 Vial (72266-248-01),138.37,55.35,,,0 CDM,2500000004_72266025110,Calcitriol: 10 Vial In 1 Carton (72266-251-10) / 1 Ml In 1 Vial (72266-251-01),2.63,1.05,,,0 CDM,2500000004_72485010101,NDC Description Not Available,2.58,1.03,,,0 CDM,2500000004_72485010125,"Diphenhydramine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (72485-101-25) / 1 Ml In 1 Vial, Single-Dose (72485-101-01)",8.01,3.2,,,0 CDM,2500000004_72485010401,"Caffeine Citrate: 1 Vial, Glass In 1 Carton (72485-104-01) / 3 Ml In 1 Vial, Glass",2.41,0.96,,,0 CDM,2500000004_72485010601,NDC Description Not Available,0.16,0.06,,,0 CDM,2500000004_72485010610,"Levetiracetam: 10 Vial, Single-Dose In 1 Carton (72485-106-10) / 5 Ml In 1 Vial, Single-Dose (72485-106-01)",0.18,0.07,,,0 CDM,2500000004_72485011601,NDC Description Not Available,0.24,0.1,,,0 CDM,2500000004_72485011610,Nicardipine Hydrochloride: 10 Vial In 1 Carton (72485-116-10) / 10 Ml In 1 Vial (72485-116-01),0.25,0.1,,,0 CDM,2500000004_72485020101,"Azacitidine: 1 Injection, Powder, Lyophilized, For Solution In 1 Carton (72485-201-01)",4.11,1.64,,,0 CDM,2500000004_72485040301,NDC Description Not Available,6.87,2.75,,,0 CDM,2500000004_72485040401,NDC Description Not Available,5.46,2.18,,,0 CDM,2500000004_72485041501,NDC Description Not Available,5.37,2.15,,,0 CDM,2500000004_72485041701,NDC Description Not Available,13.0,5.2,,,0 CDM,2500000004_72485041710,"Ampicillin Sodium And Sulbactam Sodium: 10 Vial In 1 Carton (72485-417-10) / 1 Injection, Powder, For Solution In 1 Vial (72485-417-01)",7.84,3.14,,,0 CDM,2500000004_72485042101,NDC Description Not Available,4.88,1.95,,,0 CDM,2500000004_72485042110,"Ampicillin: 10 Vial In 1 Carton (72485-421-10) / 1 Injection, Powder, For Solution In 1 Vial",2.04,0.82,,,0 CDM,2500000004_72485042201,NDC Description Not Available,5.71,2.28,,,0 CDM,2500000004_72611072201,NDC Description Not Available,1.83,0.73,,,0 CDM,2500000004_72611072225,"Ketorolac Tromethamine: 25 Vial, Single-Dose In 1 Carton (72611-722-25) / 1 Ml In 1 Vial, Single-Dose (72611-722-01)",1.79,0.72,,,0 CDM,2500000004_72611074001,NDC Description Not Available,0.58,0.23,,,0 CDM,2500000004_72611086004,"Acetylcysteine: 4 Vial, Single-Dose In 1 Carton (72611-860-04) / 30 Ml In 1 Vial, Single-Dose (72611-860-01)",2.84,1.14,,,0 CDM,2500000004_72694051501,"Asparlas: 1 Vial, Single-Use In 1 Carton (72694-515-01) / 5 Ml In 1 Vial, Single-Use",332.02,132.81,,,0 CDM,2500000004_72694095401,"Oncaspar: 1 Vial, Single-Use In 1 Carton (72694-954-01) / 5 Ml In 1 Vial, Single-Use",114693.12,45877.25,,,0 CDM,2500000004_72819015302,Mitomycin: 1 Vial In 1 Carton (72819-153-02) / 40 Ml In 1 Vial,152.54,61.02,,,0 CDM,2500000004_72888019201,Mycophenolate Mofetil: 100 Capsule In 1 Bottle (72888-192-01),0.6,0.24,,,0 CDM,2500000004_72888019205,Mycophenolate Mofetil: 500 Capsule In 1 Bottle (72888-192-05),0.56,0.22,,,0 CDM,2500000004_72893000301,Folotyn: 1 Vial In 1 Carton (72893-003-01) / 1 Ml In 1 Vial,1638.58,655.43,,,0 CDM,2500000004_72893000501,Folotyn: 1 Vial In 1 Carton (72893-005-01) / 2 Ml In 1 Vial,1638.23,655.29,,,0 CDM,2500000004_72903085301,"Elahere: 1 Vial, Single-Use In 1 Carton (72903-853-01) / 20 Ml In 1 Vial, Single-Use",292.03,116.81,,,0 CDM,2500000004_73150015006,"Briumvi: 1 Vial, Single-Dose In 1 Carton (73150-150-06) / 6 Ml In 1 Vial, Single-Dose",316.55,126.62,,,0 CDM,2500000004_73177010505,NDC Description Not Available,13.6,5.44,,,0 CDM,2500000004_73177014633,NDC Description Not Available,2.53,1.01,,,0 CDM,2500000004_73475304105,"Vyvgart: 1 Vial, Single-Dose In 1 Carton (73475-3041-5) / 20 Ml In 1 Vial, Single-Dose",136.18,54.47,,,0 CDM,2500000004_73475310203,"Vyvgart Hytrulo: 1 Vial, Single-Dose In 1 Carton (73475-3102-3) / 5.6 Ml In 1 Vial, Single-Dose",138.91,55.56,,,0 CDM,2500000004_73535020801,Monjuvi: 1 Vial In 1 Carton (73535-208-01) / 5 Ml In 1 Vial,61.88,24.75,,,0 CDM,2500000004_74676590201,"Trelstar: 1 Kit In 1 Carton (74676-5902-1) * 2 Ml In 1 Vial, Single-Dose (74676-5902-0) * 2 Ml In 1 Syringe",4071.89,1628.76,,,0 CDM,2500000004_74676590401,"Trelstar: 1 Kit In 1 Carton (74676-5904-1) * 2 Ml In 1 Vial, Single-Dose (74676-5904-0) * 2 Ml In 1 Syringe",3166.96,1266.78,,,0 CDM,2500000004_75834017119,Calcium Gluconate: 25 Vial In 1 Carton (75834-171-19) / 10 Ml In 1 Vial (75834-171-01),0.44,0.18,,,0 CDM,2500000004_75987008010,Krystexxa: 1 Vial In 1 Carton (75987-080-10) / 1 Ml In 1 Vial,16385.28,6554.11,,,0 CDM,2500000004_75987015003,"Uplizna: 3 Vial, Single-Dose In 1 Carton (75987-150-03) / 10 Ml In 1 Vial, Single-Dose (75987-150-01)",2047.18,818.87,,,0 CDM,2500000004_76014000430,NDC Description Not Available,0.03,0.01,,,0 CDM,2500000004_76045000401,NDC Description Not Available,4.09,1.64,,,0 CDM,2500000004_76045000411,"Morphine Sulfate: 10 Syringe, Glass In 1 Carton (76045-004-11) / 1 Ml In 1 Syringe, Glass (76045-004-01)",17.73,7.09,,,0 CDM,2500000004_76045000901,NDC Description Not Available,2.15,0.86,,,0 CDM,2500000004_76045000905,Dilaudid: 24 SYRINGE in 1 CARTON (76045-009-05) / .5 mL in 1 SYRINGE (76045-009-03),8.69,3.48,,,0 CDM,2500000004_76045000906,Dilaudid: 10 Syringe In 1 Carton (76045-009-06) / .5 Ml In 1 Syringe (76045-009-96),7.01,2.8,,,0 CDM,2500000004_76045000911,Dilaudid: 10 Syringe In 1 Carton (76045-009-11) / 1 Ml In 1 Syringe (76045-009-01),2.13,0.85,,,0 CDM,2500000004_76045000996,NDC Description Not Available,3.64,1.46,,,0 CDM,2500000004_76045010410,"Ketorolac Tromethamine: 24 Blister Pack In 1 Carton (76045-104-10) / 1 Syringe, Glass In 1 Blister Pack / 1 Ml In 1 Syringe, Glass",3.94,1.58,,,0 CDM,2500000004_76045010520,"Ketorolac Tromethamine: 24 Blister Pack In 1 Carton (76045-105-20) / 1 Syringe, Glass In 1 Blister Pack / 2 Ml In 1 Syringe, Glass",2.18,0.87,,,0 CDM,2500000004_76045020400,NDC Description Not Available,50.56,20.22,,,0 CDM,2500000004_76045020420,"Diazepam: 24 Syringe, Glass In 1 Carton (76045-204-20) / 2 Ml In 1 Syringe, Glass (76045-204-00)",49.1,19.64,,,0 CDM,2500000004_76045020910,"Ketorolac Tromethamine: 24 Blister Pack In 1 Carton (76045-209-10) / 1 Syringe, Glass In 1 Blister Pack (76045-209-00) / 1 Ml In 1 Syringe, Glass",5.14,2.06,,,0 CDM,2500000004_76075010101,"Kyprolis: 1 Vial, Single-Use In 1 Carton (76075-101-01) / 30 Ml In 1 Vial, Single-Use",253.17,101.27,,,0 CDM,2500000004_76075010201,"Kyprolis: 1 Vial, Single-Dose In 1 Carton (76075-102-01) / 15 Ml In 1 Vial, Single-Dose",248.05,99.22,,,0 CDM,2500000004_76075010301,"Kyprolis: 1 Vial, Single-Dose In 1 Carton (76075-103-01) / 10 Ml In 1 Vial, Single-Dose",247.86,99.14,,,0 CDM,2500000004_76125079025,Albuked: 1 Vial In 1 Carton (76125-790-25) / 250 Ml In 1 Vial (76125-790-26),37.68,15.07,,,0 CDM,2500000004_76125079026,NDC Description Not Available,32.53,13.01,,,0 CDM,2500000004_76125090010,"Gammaked: 1 Vial, Glass In 1 Carton (76125-900-10) / 100 Ml In 1 Vial, Glass (76125-900-11)",235.47,94.19,,,0 CDM,2500000004_76125090020,"Gammaked: 1 Vial, Glass In 1 Carton (76125-900-20) / 200 Ml In 1 Vial, Glass (76125-900-21)",235.47,94.19,,,0 CDM,2500000004_76204001011,NDC Description Not Available,3.76,1.5,,,0 CDM,2500000004_76204001155,Albuterol Sulfate Inhalation Solution: 25 Pouch In 1 Carton (76204-011-55) / 5 Vial In 1 Pouch (76204-011-05) / 3 Ml In 1 Vial,1.3,0.52,,,0 CDM,2500000004_76204090001,Levalbuterol: 30 Pouch In 1 Carton (76204-900-01) / 1 Ampule In 1 Pouch (76204-900-11) / 3 Ml In 1 Ampule,2.28,0.91,,,0 CDM,2500000004_76204090011,NDC Description Not Available,1.59,0.64,,,0 CDM,2500000004_76297000132,NDC Description Not Available,23.0,9.2,,,0 CDM,2500000004_76310002415,NDC Description Not Available,235.91,94.36,,,0 CDM,2500000004_76329124001,Phytonadione: 1 Syringe In 1 Carton (76329-1240-1) / .5 Ml In 1 Syringe,110.4,44.16,,,0 CDM,2500000004_76329330401,Calcium Chloride: 10 Syringe In 1 Package (76329-3304-1) / 10 Ml In 1 Syringe,0.08,0.03,,,0 CDM,2500000004_76329331601,Epinephrine: 10 VIAL in 1 PACKAGE (76329-3316-1) / 10 mL in 1 VIAL,3.54,1.42,,,0 CDM,2500000004_76329331801,Epinephrine: 10 Carton In 1 Package (76329-3318-1) / 1 Syringe In 1 Carton / 10 Ml In 1 Syringe,5.47,2.19,,,0 CDM,2500000004_76329332100,Regadenoson: 1 Syringe In 1 Carton (76329-3321-0) / 5 Ml In 1 Syringe,33.0,13.2,,,0 CDM,2500000004_76329333901,Atropine Sulfate: 10 SYRINGE in 1 CARTON (76329-3339-1) / 10 mL in 1 SYRINGE,0.37,0.15,,,0 CDM,2500000004_76329334001,Atropine Sulfate: 10 Carton In 1 Package (76329-3340-1) / 1 Syringe In 1 Carton / 10 Ml In 1 Syringe,0.51,0.2,,,0 CDM,2500000004_76329336901,Naloxone Hydrochloride: 10 Syringe In 1 Box (76329-3369-1) / 2 Ml In 1 Syringe,45.13,18.05,,,0 CDM,2500000004_76329339001,Lidocaine Hydrochloride: 10 Syringe In 1 Package (76329-3390-1) / 5 Ml In 1 Syringe,0.54,0.22,,,0 CDM,2500000004_78206011801,"Celestone Soluspan: 1 Vial, Multi-Dose In 1 Box (78206-118-01) / 5 Ml In 1 Vial, Multi-Dose",37.58,15.03,,,0 CDM,2500000004_78206014501,Nexplanon: 1 Blister Pack In 1 Carton (78206-145-01) / 1 Implant In 1 Blister Pack,5120.09,2048.04,,,0 CDM,2500000004_78206016201,"Renflexis: 1 Vial In 1 Carton (78206-162-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (78206-162-99)",332.71,133.08,,,0 CDM,2500000004_79672061304,NDC Description Not Available,13.19,5.28,,,0 CDM,2500000004_80446040101,"Kimmtrak: 1 Vial, Glass In 1 Carton (80446-401-01) / .5 Ml In 1 Vial, Glass",906.23,362.49,,,0 CDM,2500000004_80777010201,NDC Description Not Available,531.97,212.79,,,0 CDM,2500000004_80777011096,"Spikevax: 10 Syringe, Plastic In 1 Carton (80777-110-96) / .5 Ml In 1 Syringe, Plastic (80777-110-01)",417.6,167.04,,,0 CDM,2500000004_80777028792,"Moderna COVID-19 Vaccine: 10 VIAL, SINGLE-DOSE in 1 CARTON (80777-287-92) / .25 mL in 1 VIAL, SINGLE-DOSE (80777-287-07)",525.81,210.32,,,0 CDM,2500000004_80777029180,"Moderna Covid-19 Vaccine: 10 Syringe, Plastic In 1 Carton (80777-291-80) / .25 Ml In 1 Syringe, Plastic (80777-291-09)",386.14,154.46,,,0 CDM,2500000004_80803015350,"Fyarro: 1 Vial, Single-Use In 1 Carton (80803-153-50) / 20 Ml In 1 Vial, Single-Use",344.03,137.61,,,0 CDM,2500000004_81284015200,NDC Description Not Available,4.12,1.65,,,0 CDM,2500000004_81284015300,NDC Description Not Available,6.58,2.63,,,0 CDM,2500000004_81284015500,NDC Description Not Available,2.3,0.92,,,0 CDM,2500000004_81284015501,"Piperacillin And Tazobactam: 1 Vial, Pharmacy Bulk Package In 1 Carton (81284-155-01) / 180 Ml In 1 Vial, Pharmacy Bulk Package (81284-155-00)",1.34,0.54,,,0 CDM,2500000004_81284031500,NDC Description Not Available,43.1,17.24,,,0 CDM,2500000004_81298578303,"Triamcinolone Acetonide: 1 Vial, Multi-Dose In 1 Carton (81298-5783-3) / 10 Ml In 1 Vial, Multi-Dose",2.38,0.95,,,0 CDM,2500000004_81298811201,"Cyclophosphamide: 1 Vial, Single-Dose In 1 Carton (81298-8112-1) / 50 Ml In 1 Vial, Single-Dose",10.6,4.24,,,0 CDM,2500000004_81643927001,"Floxuridine: 1 Vial In 1 Box, Unit-Dose (81643-9270-1) / 5 Injection, Powder, Lyophilized, For Solution In 1 Vial",3796.06,1518.42,,,0 CDM,2500000004_81826000111,Sodium Chloride: 70 Bag In 1 Carton (81826-001-11) / 100 Ml In 1 Bag (81826-001-12),9.66,3.86,,,0 CDM,2500000004_81927011101,"Nelarabine: 1 Vial, Single-Dose In 1 Carton (81927-111-01) / 50 Ml In 1 Vial, Single-Dose",568.88,227.55,,,0 CDM,2500000004_81952011101,NDC Description Not Available,2.27,0.91,,,0 CDM,2500000004_82705000201,"Epkinly: 1 Vial, Glass In 1 Carton (82705-002-01) / .8 Ml In 1 Vial, Glass",235.35,94.14,,,0 CDM,2500000004_82705001001,"Epkinly: 1 Vial, Glass In 1 Carton (82705-010-01) / .8 Ml In 1 Vial, Glass",234.73,93.89,,,0 CDM,2500000004_82959011101,"Rytelo: 1 Vial, Single-Dose In 1 Carton (82959-111-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",237.63,95.05,,,0 CDM,2500000004_83090000701,NDC Description Not Available,0.2,0.08,,,0 CDM,2500000004_83090000710,Lidocaine Hydrochloride: 10 Ampule In 1 Carton (83090-007-10) / 5 Ml In 1 Ampule (83090-007-01),0.2,0.08,,,0 CDM,2500000004_83090001101,"Daptomycin: 1 Vial, Single-Dose In 1 Carton (83090-011-01) / 10 Ml In 1 Vial, Single-Dose",0.26,0.1,,,0 CDM,2500000004_83090001210,"Lacosamide: 10 Vial, Glass In 1 Carton (83090-012-10) / 20 Ml In 1 Vial, Glass",0.86,0.34,,,0 CDM,2500000004_83257000541,Fulphila: 1 Syringe In 1 Carton (83257-005-41) / .6 Ml In 1 Syringe,646.46,258.58,,,0 CDM,2500000004_83257001111,"Semglee: 1 Vial, Multi-Dose In 1 Carton (83257-011-11) / 10 Ml In 1 Vial, Multi-Dose",5.29,2.12,,,0 CDM,2500000004_83257001411,"Insulin Glargine: 1 Vial, Multi-Dose In 1 Carton (83257-014-11) / 10 Ml In 1 Vial, Multi-Dose",1.33,0.53,,,0 CDM,2500000004_83634020261,"Melphalan Hydrochloride: 1 Kit In 1 Carton (83634-202-61) * 15 Ml In 1 Vial, Single-Dose (83634-200-15) * 10 Ml In 1 Vial, Single-Use (83634-201-10)",1015.55,406.22,,,0 CDM,2500000004_83634040010,"Bivalirudin: 10 Vial, Single-Dose In 1 Carton (83634-400-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose (83634-400-41)",1.67,0.67,,,0 CDM,2500000004_83634050041,NDC Description Not Available,5.71,2.28,,,0 CDM,2500000004_83634050081,Magnesium Sulfate In Water: 24 Pouch In 1 Carton (83634-500-81) / 1 Bag In 1 Pouch (83634-500-41) / 50 Ml In 1 Bag,5.78,2.31,,,0 CDM,2500000004_83634077705,"Palonosetron Hydrochloride: 1 Vial, Single-Dose In 1 Carton (83634-777-05) / 5 Ml In 1 Vial, Single-Dose",6.03,2.41,,,0 CDM,2500000004_83634077802,Prochlorperazine Edisylate: 10 Vial In 1 Carton (83634-778-02) / 2 Ml In 1 Vial (83634-778-41),6.63,2.65,,,0 CDM,2500000004_87541030091,NDC Description Not Available,4800.51,1920.2,,,0 CDM,2500000004_89130202001,NDC Description Not Available,83.37,33.35,,,0 CDM,2500000004_99999999817,NDC Description Not Available,2.29,0.92,,,0 CDM,2500000004_99999999819,NDC Description Not Available,7.0,2.8,,,0 CDM,2500000004_99999999948,NDC Description Not Available,66.24,26.5,,,0 CDM,2500000004_J9226_278,"Supprelin La: 1 Vial, Glass In 1 Carton (67979-002-01) / 1 Implant In 1 Vial, Glass",235546.41,94218.56,,,0 CDM,2500000005_00002418230,"Olumiant: 30 Tablet, Film Coated In 1 Bottle (0002-4182-30)",370.86,148.34,,,0 CDM,2500000005_00002751017,Humalog: 1 Vial In 1 Carton (0002-7510-17) / 3 Ml In 1 Vial,55.64,22.26,,,0 CDM,2500000005_00002753301,Humalog: 1 Vial In 1 Carton (0002-7533-01) / 3 Ml In 1 Vial,1.55,0.62,,,0 CDM,2500000005_00002821501,"Humulin R: 1 Vial, Multi-Dose In 1 Carton (0002-8215-01) / 10 Ml In 1 Vial, Multi-Dose",16.3,6.52,,,0 CDM,2500000005_00002821517,"Humulin R: 1 Vial, Multi-Dose In 1 Carton (0002-8215-17) / 3 Ml In 1 Vial, Multi-Dose",9.17,3.67,,,0 CDM,2500000005_00006307502,"Prevymis: 4 Dose Pack In 1 Carton (0006-3075-02) / 7 Tablet, Film Coated In 1 Dose Pack (0006-3075-01)",1144.81,457.92,,,0 CDM,2500000005_00006307503,NDC Description Not Available,766.2,306.48,,,0 CDM,2500000005_00006307504,"Prevymis: 14 Blister Pack In 1 Carton (0006-3075-04) / 1 Tablet, Film Coated In 1 Blister Pack (0006-3075-03)",1202.08,480.83,,,0 CDM,2500000005_00006542302,NDC Description Not Available,561.75,224.7,,,0 CDM,2500000005_00006542312,"Bridion: 10 Vial, Single-Dose In 1 Carton (0006-5423-12) / 2 Ml In 1 Vial, Single-Dose (0006-5423-02)",597.97,239.19,,,0 CDM,2500000005_00006542505,NDC Description Not Available,784.98,313.99,,,0 CDM,2500000005_00006542515,"Bridion: 10 Vial, Single-Dose In 1 Carton (0006-5425-15) / 5 Ml In 1 Vial, Single-Dose (0006-5425-05)",370.63,148.25,,,0 CDM,2500000005_00009034201,NDC Description Not Available,136.63,54.65,,,0 CDM,2500000005_00009043601,R-Gene: 1 Container In 1 Carton (0009-0436-01) / 300 Ml In 1 Container,85.03,34.01,,,0 CDM,2500000005_00009085605,Hemabate: 1 Ml In 1 Ampule (0009-0856-05),564.83,225.93,,,0 CDM,2500000005_00013111401,NDC Description Not Available,5.35,2.14,,,0 CDM,2500000005_00013111420,NDC Description Not Available,55.67,22.27,,,0 CDM,2500000005_00024591400,NDC Description Not Available,8195.41,3278.16,,,0 CDM,2500000005_00024591401,"Dupixent: 2 Syringe, Glass In 1 Carton (0024-5914-01) / 2 Ml In 1 Syringe, Glass (0024-5914-00)",8785.4,3514.16,,,0 CDM,2500000005_00024591801,"Dupixent: 2 Syringe, Glass In 1 Carton (0024-5918-01) / 1.14 Ml In 1 Syringe, Glass (0024-5918-00)",8195.41,3278.16,,,0 CDM,2500000005_00024592605,Admelog: 1 Vial In 1 Carton (0024-5926-05) / 3 Ml In 1 Vial,173.46,69.38,,,0 CDM,2500000005_00045055320,NDC Description Not Available,0.69,0.28,,,0 CDM,2500000005_00054006405,NDC Description Not Available,36.67,14.67,,,0 CDM,2500000005_00054052863,Rufinamide: 1 Bottle In 1 Carton (0054-0528-63) / 460 Ml In 1 Bottle,231.47,92.59,,,0 CDM,2500000005_00054074287,"Albuterol Sulfate: 1 Canister In 1 Carton (0054-0742-87) / 200 Aerosol, Metered In 1 Canister",194.74,77.9,,,0 CDM,2500000005_00054350049,Lidocaine Viscous: 1 Bottle In 1 Carton (0054-3500-49) / 100 Ml In 1 Bottle,1.21,0.48,,,0 CDM,2500000005_00065079515,Bss: 15 Ml In 1 Bottle (0065-0795-15),51.41,20.56,,,0 CDM,2500000005_00065079550,Bss: 500 Ml In 1 Bottle (0065-0795-50),162.02,64.81,,,0 CDM,2500000005_00068059701,"Rifadin Iv: 1 Vial, Glass In 1 Carton (0068-0597-01) / 10 Ml In 1 Vial, Glass",238.36,95.34,,,0 CDM,2500000005_00074104328,"Rinvoq: 28 Tablet, Extended Release In 1 Bottle (0074-1043-28)",1273.09,509.24,,,0 CDM,2500000005_00078067515,"ZOFRAN: 30 TABLET, FILM COATED in 1 BOTTLE (0078-0675-15)",99.95,39.98,,,0 CDM,2500000005_00078086225,Durezol: 1 Bottle In 1 Carton (0078-0862-25) / 5 Ml In 1 Bottle,667.08,266.83,,,0 CDM,2500000005_00078092525,Maxidex: 5 Ml In 1 Bottle (0078-0925-25),35.68,14.27,,,0 CDM,2500000005_00093317431,"Albuterol Sulfate Hfa: 1 Inhaler In 1 Carton (0093-3174-31) / 200 Aerosol, Metered In 1 Inhaler",107.95,43.18,,,0 CDM,2500000005_00093598627,Epinephrine: 2 Container In 1 Carton (0093-5986-27) / 1 Syringe In 1 Container (0093-5986-19) / .3 Ml In 1 Syringe,689.98,275.99,,,0 CDM,2500000005_00093681519,NDC Description Not Available,24.67,9.87,,,0 CDM,2500000005_00093681555,"Budesonide: 30 Pouch In 1 Carton (0093-6815-55) / 1 Vial, Single-Dose In 1 Pouch / 2 Ml In 1 Vial, Single-Dose",26.87,10.75,,,0 CDM,2500000005_00093681619,NDC Description Not Available,26.65,10.66,,,0 CDM,2500000005_00093681655,"Budesonide: 30 Pouch In 1 Carton (0093-6816-55) / 1 Vial, Single-Dose In 1 Pouch / 2 Ml In 1 Vial, Single-Dose",26.59,10.64,,,0 CDM,2500000005_00115168774,Budesonide Inhalation: 6 Pouch In 1 Carton (0115-1687-74) / 5 Vial In 1 Pouch (0115-1687-76) / 2 Ml In 1 Vial,12.13,4.85,,,0 CDM,2500000005_00115168974,Budesonide Inhalation: 6 Pouch In 1 Carton (0115-1689-74) / 5 Vial In 1 Pouch (0115-1689-76) / 2 Ml In 1 Vial,3.57,1.43,,,0 CDM,2500000005_00115169449,"Epinephrine: 2 Case In 1 Carton (0115-1694-49) / 1 Syringe, Glass In 1 Case / .3 Ml In 1 Syringe, Glass",572.21,228.88,,,0 CDM,2500000005_00116400530,"Lactulose: 30 Ml In 1 Cup, Unit-Dose (0116-4005-30)",4.95,1.98,,,0 CDM,2500000005_00121065816,Trihexyphenidyl Hydrochloride: 473 Ml In 1 Bottle (0121-0658-16),2.74,1.1,,,0 CDM,2500000005_00121087332,Lactulose: 946 Ml In 1 Bottle (0121-0873-32),28.39,11.36,,,0 CDM,2500000005_00132008112,Pedia-Lax: 12 Suppository In 1 Jar (0132-0081-12),0.18,0.07,,,0 CDM,2500000005_00132020140,"Fleet: 133 Ml In 1 Bottle, With Applicator (0132-0201-40)",5.61,2.24,,,0 CDM,2500000005_00143925001,NDC Description Not Available,6.42,2.57,,,0 CDM,2500000005_00143925010,Rocuronium Bromide: 10 Vial In 1 Box (0143-9250-10) / 5 Ml In 1 Vial (0143-9250-01),7.59,3.04,,,0 CDM,2500000005_00143931801,NDC Description Not Available,66.1,26.44,,,0 CDM,2500000005_00143931810,Norepinephrine Bitartrate: 10 Vial In 1 Carton (0143-9318-10) / 4 Ml In 1 Vial (0143-9318-01),12.76,5.1,,,0 CDM,2500000005_00143939201,NDC Description Not Available,399.53,159.81,,,0 CDM,2500000005_00143939210,Remifentanil Hydrochloride: 10 Vial In 1 Carton (0143-9392-10) / 5 Ml In 1 Vial (0143-9392-01),356.66,142.66,,,0 CDM,2500000005_00143950601,NDC Description Not Available,29.02,11.61,,,0 CDM,2500000005_00143950610,"Etomidate: 10 Vial, Single-Dose In 1 Carton (0143-9506-10) / 10 Ml In 1 Vial, Single-Dose (0143-9506-01)",27.81,11.12,,,0 CDM,2500000005_00143950701,NDC Description Not Available,25.64,10.26,,,0 CDM,2500000005_00143950710,"Etomidate: 10 Vial, Single-Dose In 1 Carton (0143-9507-10) / 20 Ml In 1 Vial, Single-Dose (0143-9507-01)",13.5,5.4,,,0 CDM,2500000005_00143950801,NDC Description Not Available,10.72,4.29,,,0 CDM,2500000005_00143950810,Ketamine Hydrochloride: 10 Vial In 1 Box (0143-9508-10) / 10 Ml In 1 Vial (0143-9508-01),5.78,2.31,,,0 CDM,2500000005_00143950901,NDC Description Not Available,41.29,16.52,,,0 CDM,2500000005_00143950910,Ketamine Hydrochloride: 10 Vial In 1 Box (0143-9509-10) / 5 Ml In 1 Vial (0143-9509-01),89.23,35.69,,,0 CDM,2500000005_00143952501,NDC Description Not Available,140.8,56.32,,,0 CDM,2500000005_00143953201,NDC Description Not Available,9.04,3.62,,,0 CDM,2500000005_00143957710,"Lidocaine: 10 Vial, Multi-Dose In 1 Package (0143-9577-10) / 50 Ml In 1 Vial, Multi-Dose (0143-9577-01)",0.12,0.05,,,0 CDM,2500000005_00143959501,NDC Description Not Available,10.12,4.05,,,0 CDM,2500000005_00143959525,"Lidocaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (0143-9595-25) / 5 Ml In 1 Vial, Single-Dose (0143-9595-01)",11.29,4.52,,,0 CDM,2500000005_00143963701,NDC Description Not Available,7.61,3.04,,,0 CDM,2500000005_00143963710,"Valproate Sodium: 10 Vial, Single-Dose In 1 Tray (0143-9637-10) / 5 Ml In 1 Vial, Single-Dose (0143-9637-01)",9.95,3.98,,,0 CDM,2500000005_00143966001,NDC Description Not Available,8.9,3.56,,,0 CDM,2500000005_00143966010,Metoprolol Tartrate: 10 Vial In 1 Carton (0143-9660-10) / 5 Ml In 1 Vial (0143-9660-01),2.32,0.93,,,0 CDM,2500000005_00143968201,NDC Description Not Available,47.0,18.8,,,0 CDM,2500000005_00143978401,NDC Description Not Available,7.17,2.87,,,0 CDM,2500000005_00143978410,"Flumazenil: 10 Vial, Multi-Dose In 1 Box (0143-9784-10) / 5 Ml In 1 Vial, Multi-Dose (0143-9784-01)",19.12,7.65,,,0 CDM,2500000005_00143978501,NDC Description Not Available,27.18,10.87,,,0 CDM,2500000005_00143978510,"Valproate Sodium: 10 Vial, Single-Dose In 1 Carton (0143-9785-10) / 5 Ml In 1 Vial, Single-Dose (0143-9785-01)",27.62,11.05,,,0 CDM,2500000005_00143978601,NDC Description Not Available,7.58,3.03,,,0 CDM,2500000005_00169430713,3 BLISTER PACK in 1 CARTON (0169-4307-13) / 10 TABLET in 1 BLISTER PACK (0169-4307-01),59.45,23.78,,,0 CDM,2500000005_00173068220,"Ventolin Hfa: 1 Inhaler In 1 Carton (0173-0682-20) / 200 Aerosol, Metered In 1 Inhaler",174.73,69.89,,,0 CDM,2500000005_00173068224,"Ventolin Hfa: 1 Inhaler In 1 Carton (0173-0682-24) / 60 Aerosol, Metered In 1 Inhaler",69.49,27.8,,,0 CDM,2500000005_00173086906,Anoro Ellipta: 1 Tray In 1 Carton (0173-0869-06) / 1 Inhaler In 1 Tray / 7 Powder In 1 Inhaler,350.84,140.34,,,0 CDM,2500000005_00225052547,NDC Description Not Available,8.04,3.22,,,0 CDM,2500000005_00225080047,"Neo-Synephrine Mild: 15 Ml In 1 Bottle, Spray (0225-0800-47)",3.2,1.28,,,0 CDM,2500000005_00225080547,"Neo-Synephrine Regular: 15 Ml In 1 Bottle, Spray (0225-0805-47)",2.46,0.98,,,0 CDM,2500000005_00259050116,Cuvposa: 1 Bottle In 1 Carton (0259-0501-16) / 473 Ml In 1 Bottle,10.08,4.03,,,0 CDM,2500000005_00264193310,Trophamine: 12 Container In 1 Case (0264-1933-10) / 500 Ml In 1 Container,126.11,50.44,,,0 CDM,2500000005_00264450000,Plenamine: 8 Container In 1 Case (0264-4500-00) / 1000 Ml In 1 Container,112.89,45.16,,,0 CDM,2500000005_00264450005,Plenamine: 4 Container In 1 Case (0264-4500-05) / 2000 Ml In 1 Container,146.05,58.42,,,0 CDM,2500000005_00264738550,Sterile Water: 4 Container In 1 Case (0264-7385-50) / 2000 Ml In 1 Container,15.4,6.16,,,0 CDM,2500000005_00264738560,Sterile Water: 4 Container In 1 Case (0264-7385-60) / 3000 Ml In 1 Container,4.8,1.92,,,0 CDM,2500000005_00264738750,Dextrose: 4 Container In 1 Case (0264-7387-50) / 2000 Ml In 1 Container,3.17,1.27,,,0 CDM,2500000005_00264757810,Mannitol: 24 Container In 1 Case (0264-7578-10) / 500 Ml In 1 Container,64.34,25.74,,,0 CDM,2500000005_00264785000,Sterile Water: 12 Container In 1 Case (0264-7850-00) / 1000 Ml In 1 Container,9.63,3.85,,,0 CDM,2500000005_00264785010,Sterile Water: 24 Container In 1 Case (0264-7850-10) / 500 Ml In 1 Container,10.67,4.27,,,0 CDM,2500000005_00264785020,Sterile Water: 24 Container In 1 Case (0264-7850-20) / 250 Ml In 1 Container,7.27,2.91,,,0 CDM,2500000005_00264987210,Heparin Sodium In Sodium Chloride: 24 Container In 1 Case (0264-9872-10) / 500 Ml In 1 Container,1.98,0.79,,,0 CDM,2500000005_00268024901,NDC Description Not Available,35.38,14.15,,,0 CDM,2500000005_00316023125,Zeasorb: 71 G In 1 Bottle (0316-0231-25),15.09,6.04,,,0 CDM,2500000005_00316023225,Zeasorb: 71 G In 1 Bottle (0316-0232-25),14.71,5.88,,,0 CDM,2500000005_00338000402,"Sterile Water: 24 Bottle, Plastic In 1 Carton (0338-0004-02) / 250 Ml In 1 Bottle, Plastic",0.07,0.03,,,0 CDM,2500000005_00338001304,Sterile Water: 1000 Ml In 1 Bag (0338-0013-04),8.58,3.43,,,0 CDM,2500000005_00338001306,Sterile Water: 2000 Ml In 1 Bag (0338-0013-06),4.13,1.65,,,0 CDM,2500000005_00338001308,Sterile Water: 3000 Ml In 1 Bag (0338-0013-08),5.36,2.14,,,0 CDM,2500000005_00338001329,Sterile Water: 5000 Ml In 1 Bag (0338-0013-29),5.83,2.33,,,0 CDM,2500000005_00338001703,Dextrose: 500 Ml In 1 Bag (0338-0017-03),25.04,10.02,,,0 CDM,2500000005_00338010820,Norepinephrine Bitartrate: 20 Container In 1 Carton (0338-0108-20) / 250 Ml In 1 Container,146.72,58.69,,,0 CDM,2500000005_00338012612,Myxredlin: 12 Container In 1 Carton (0338-0126-12) / 100 Ml In 1 Container,169.14,67.66,,,0 CDM,2500000005_00338032201,Recothrom: 1 Kit In 1 Kit (0338-0322-01) * 5 Ml In 1 Vial (0338-0324-01) * 5 Ml In 1 Syringe,256.25,102.5,,,0 CDM,2500000005_00338032401,NDC Description Not Available,190.29,76.12,,,0 CDM,2500000005_00338035703,Osmitrol: 500 Ml In 1 Bag (0338-0357-03),161.19,64.48,,,0 CDM,2500000005_00338051909,Intralipid: 250 Ml In 1 Bag (0338-0519-09),11.48,4.59,,,0 CDM,2500000005_00338064406,Travasol: 2000 Ml In 1 Bag (0338-0644-06),120.91,48.36,,,0 CDM,2500000005_00338065604,"Acetic Acid: 1000 Ml In 1 Bottle, Plastic (0338-0656-04)",24.49,9.8,,,0 CDM,2500000005_00338071906,Dextrose: 2000 Ml In 1 Bag (0338-0719-06),8.4,3.36,,,0 CDM,2500000005_00338104702,"Nitroglycerin In Dextrose: 12 Bottle, Glass In 1 Box (0338-1047-02) / 250 Ml In 1 Bottle, Glass",0.46,0.18,,,0 CDM,2500000005_00338105548,Metronidazole: 24 Bag In 1 Carton (0338-1055-48) / 100 Ml In 1 Bag,3.66,1.46,,,0 CDM,2500000005_00338113004,Premasol - Sulfite-Free (Amino Acid): 1000 Ml In 1 Bag (0338-1130-04),24.74,9.9,,,0 CDM,2500000005_00338381424,Clindamycin Phosphate: 24 Bag In 1 Carton (0338-3814-24) / 50 Ml In 1 Bag (0338-3814-50),8.86,3.54,,,0 CDM,2500000005_00338381450,NDC Description Not Available,4.5,1.8,,,0 CDM,2500000005_00338954124,Metronidazole: 24 Bag In 1 Carton (0338-9541-24) / 100 Ml In 1 Bag,2.6,1.04,,,0 CDM,2500000005_00338955712,Dexmedetomidine Hydrochloride: 12 Bag In 1 Carton (0338-9557-12) / 100 Ml In 1 Bag,88.06,35.22,,,0 CDM,2500000005_00378698501,NDC Description Not Available,1.09,0.44,,,0 CDM,2500000005_00378699789,NDC Description Not Available,0.68,0.27,,,0 CDM,2500000005_00378773293,"Ondansetron: 30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE, PLASTIC (0378-7732-93)",1.72,0.69,,,0 CDM,2500000005_00378967130,Ipratropium Bromide And Albuterol Sulfate: 1 Pouch In 1 Carton (0378-9671-30) / 30 Ampule In 1 Pouch (0378-9671-64) / 3 Ml In 1 Ampule,2.17,0.87,,,0 CDM,2500000005_00378967131,NDC Description Not Available,1.45,0.58,,,0 CDM,2500000005_00378967193,Ipratropium Bromide And Albuterol Sulfate: 30 Pouch In 1 Carton (0378-9671-93) / 1 Ampule In 1 Pouch (0378-9671-31) / 3 Ml In 1 Ampule,1.43,0.57,,,0 CDM,2500000005_00395009416,NDC Description Not Available,0.7,0.28,,,0 CDM,2500000005_00395103116,NDC Description Not Available,9.04,3.62,,,0 CDM,2500000005_00395268594,"Humco Sodium Bicarbonate: 113 G In 1 Bottle, Plastic (0395-2685-94)",0.16,0.06,,,0 CDM,2500000005_00409006410,Carboprost Tromethamine: 10 Vial In 1 Carton (0409-0064-10) / 1 Ml In 1 Vial,255.19,102.08,,,0 CDM,2500000005_00409015201,NDC Description Not Available,4.64,1.86,,,0 CDM,2500000005_00409110311,NDC Description Not Available,294.12,117.65,,,0 CDM,2500000005_00409114402,Verapamil Hydrochloride: 5 Vial In 1 Carton (0409-1144-02) / 4 Ml In 1 Vial (0409-1144-62),145.8,58.32,,,0 CDM,2500000005_00409120703,"Gentamicin Sulfate: 25 Vial, Single-Dose In 1 Tray (0409-1207-03) / 2 Ml In 1 Vial, Single-Dose (0409-1207-13)",14.28,5.71,,,0 CDM,2500000005_00409120811,NDC Description Not Available,41.21,16.48,,,0 CDM,2500000005_00409120901,Lidocaine Hydrochloride And Epinephrine: 10 Ampule In 1 Tray (0409-1209-01) / 5 Ml In 1 Ampule (0409-1209-10),15.45,6.18,,,0 CDM,2500000005_00409163221,NDC Description Not Available,0.38,0.15,,,0 CDM,2500000005_00409163832,NDC Description Not Available,54.18,21.67,,,0 CDM,2500000005_00409166010,Precedex: 10 Bottle In 1 Tray (0409-1660-10) / 100 Ml In 1 Bottle (0409-1660-35),8.09,3.24,,,0 CDM,2500000005_00409166020,Precedex: 10 Vial In 1 Carton (0409-1660-20) / 20 Ml In 1 Vial (0409-1660-22),23.85,9.54,,,0 CDM,2500000005_00409166022,NDC Description Not Available,24.02,9.61,,,0 CDM,2500000005_00409166050,Precedex: 20 Bottle In 1 Tray (0409-1660-50) / 50 Ml In 1 Bottle (0409-1660-55),11.61,4.64,,,0 CDM,2500000005_00409166055,NDC Description Not Available,128.93,51.57,,,0 CDM,2500000005_00409174610,"Marcaine With Epinephrine: 10 Vial, Single-Dose In 1 Carton (0409-1746-10) / 10 Ml In 1 Vial, Single-Dose (0409-1746-70)",23.24,9.3,,,0 CDM,2500000005_00409174630,"Marcaine With Epinephrine: 10 Vial, Single-Dose In 1 Carton (0409-1746-30) / 30 Ml In 1 Vial, Single-Dose (0409-1746-71)",34.27,13.71,,,0 CDM,2500000005_00409174671,NDC Description Not Available,49.63,19.85,,,0 CDM,2500000005_00409174929,"Marcaine With Epinephrine: 10 Vial, Single-Dose In 1 Carton (0409-1749-29) / 30 Ml In 1 Vial, Single-Dose (0409-1749-71)",19.1,7.64,,,0 CDM,2500000005_00409174970,NDC Description Not Available,13.6,5.44,,,0 CDM,2500000005_00409175550,"Marcaine With Epinephrine: 1 Vial, Multi-Dose In 1 Carton (0409-1755-50) / 50 Ml In 1 Vial, Multi-Dose",23.03,9.21,,,0 CDM,2500000005_00409177510,"Dextrose: 10 Carton In 1 Package (0409-1775-10) / 1 Syringe, Plastic In 1 Carton / 10 Ml In 1 Syringe, Plastic (0409-1775-40)",90.6,36.24,,,0 CDM,2500000005_00409177540,NDC Description Not Available,70.03,28.01,,,0 CDM,2500000005_00409177805,"Metoprolol Tartrate: 10 Vial, Single-Dose In 1 Carton (0409-1778-05) / 5 Ml In 1 Vial, Single-Dose (0409-1778-15)",2.26,0.9,,,0 CDM,2500000005_00409177815,NDC Description Not Available,4.77,1.91,,,0 CDM,2500000005_00409196602,NDC Description Not Available,3.1,1.24,,,0 CDM,2500000005_00409205105,"Ketamine Hydrochloride: 10 Vial, Multi-Dose In 1 Box (0409-2051-05) / 5 Ml In 1 Vial, Multi-Dose (0409-2051-15)",16.33,6.53,,,0 CDM,2500000005_00409205115,NDC Description Not Available,26.47,10.59,,,0 CDM,2500000005_00409206610,NDC Description Not Available,4.73,1.89,,,0 CDM,2500000005_00409230802,"Midazolam: 10 Vial, Single-Dose In 1 Carton (0409-2308-02) / 2 Ml In 1 Vial, Single-Dose (0409-2308-22)",1.74,0.7,,,0 CDM,2500000005_00409317701,"Lidocaine Hydrochloride And Epinephrine: 25 Vial, Multi-Dose In 1 Tray (0409-3177-01) / 50 Ml In 1 Vial, Multi-Dose (0409-3177-16)",3.51,1.4,,,0 CDM,2500000005_00409317801,"Lidocaine Hydrochloride And Epinephrine: 25 Vial, Multi-Dose In 1 Tray (0409-3178-01) / 20 Ml In 1 Vial, Multi-Dose (0409-3178-16)",4.4,1.76,,,0 CDM,2500000005_00409317802,"Lidocaine Hydrochloride And Epinephrine: 25 Vial, Multi-Dose In 1 Tray (0409-3178-02) / 30 Ml In 1 Vial, Multi-Dose (0409-3178-17)",42.11,16.84,,,0 CDM,2500000005_00409318301,"Lidocaine Hydrochloride And Epinephrine: 5 Vial, Single-Dose In 1 Carton (0409-3183-01) / 20 Ml In 1 Vial, Single-Dose (0409-3183-11)",6.98,2.79,,,0 CDM,2500000005_00409329461,NDC Description Not Available,44.36,17.74,,,0 CDM,2500000005_00409329905,Sodium Acetate: 25 Vial In 1 Tray (0409-3299-05) / 50 Ml In 1 Vial (0409-3299-15),0.92,0.37,,,0 CDM,2500000005_00409329915,NDC Description Not Available,47.81,19.12,,,0 CDM,2500000005_00409329916,NDC Description Not Available,10.45,4.18,,,0 CDM,2500000005_00409330803,Acetylcysteine: 3 Vial In 1 Carton (0409-3308-03) / 30 Ml In 1 Vial (0409-3308-11),30.5,12.2,,,0 CDM,2500000005_00409330811,NDC Description Not Available,11.76,4.7,,,0 CDM,2500000005_00409337514,NDC Description Not Available,19.38,7.75,,,0 CDM,2500000005_00409338211,NDC Description Not Available,38.58,15.43,,,0 CDM,2500000005_00409338221,"Sufentanil Citrate: 10 Vial, Single-Dose In 1 Carton (0409-3382-21) / 1 Ml In 1 Vial, Single-Dose (0409-3382-11)",35.56,14.22,,,0 CDM,2500000005_00409409001,"Zinc: 25 Vial, Plastic In 1 Tray (0409-4090-01) / 10 Ml In 1 Vial, Plastic (0409-4090-11)",7.28,2.91,,,0 CDM,2500000005_00409409201,"Copper: 25 Vial, Single-Dose In 1 Tray (0409-4092-01) / 10 Ml In 1 Vial, Single-Dose (0409-4092-11)",1.27,0.51,,,0 CDM,2500000005_00409409211,NDC Description Not Available,77.2,30.88,,,0 CDM,2500000005_00409409310,"Chromium: 25 Vial, Single-Dose In 1 Tray (0409-4093-10) / 10 Ml In 1 Vial, Single-Dose (0409-4093-09)",0.08,0.03,,,0 CDM,2500000005_00409427601,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Tray (0409-4276-01) / 20 Ml In 1 Vial, Multi-Dose (0409-4276-16)",7.67,3.07,,,0 CDM,2500000005_00409427602,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Tray (0409-4276-02) / 50 Ml In 1 Vial, Multi-Dose (0409-4276-17)",0.71,0.28,,,0 CDM,2500000005_00409427616,NDC Description Not Available,13.26,5.3,,,0 CDM,2500000005_00409427617,NDC Description Not Available,0.36,0.14,,,0 CDM,2500000005_00409427701,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Tray (0409-4277-01) / 20 Ml In 1 Vial, Multi-Dose (0409-4277-16)",7.34,2.94,,,0 CDM,2500000005_00409427702,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Tray (0409-4277-02) / 50 Ml In 1 Vial, Multi-Dose (0409-4277-17)",15.46,6.18,,,0 CDM,2500000005_00409427716,NDC Description Not Available,7.83,3.13,,,0 CDM,2500000005_00409427816,NDC Description Not Available,0.4,0.16,,,0 CDM,2500000005_00409427902,"Lidocaine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-4279-02) / 30 Ml In 1 Vial, Single-Dose (0409-4279-16)",14.58,5.83,,,0 CDM,2500000005_00409427916,NDC Description Not Available,14.32,5.73,,,0 CDM,2500000005_00409428301,Lidocaine Hydrochloride: 5 Cello Pack In 1 Package (0409-4283-01) / 5 Ampule In 1 Cello Pack (0409-4283-25) / 5 Ml In 1 Ampule (0409-4283-11),11.76,4.7,,,0 CDM,2500000005_00409428311,NDC Description Not Available,17.06,6.82,,,0 CDM,2500000005_00409434616,NDC Description Not Available,34.65,13.86,,,0 CDM,2500000005_00409434673,"Aminocaproic Acid: 25 Vial, Single-Dose In 1 Tray (0409-4346-73) / 20 Ml In 1 Vial, Single-Dose (0409-4346-16)",34.87,13.95,,,0 CDM,2500000005_00409471201,Lidocaine Hydrochloride and Dextrose: 5 CELLO PACK in 1 PACKAGE (0409-4712-01) / 5 AMPULE in 1 CELLO PACK (0409-4712-25) / 2 mL in 1 AMPULE (0409-4712-11),27.06,10.82,,,0 CDM,2500000005_00409471375,NDC Description Not Available,3.3,1.32,,,0 CDM,2500000005_00409488710,"Sterile Water: 25 Vial, Plastic In 1 Tray (0409-4887-10) / 10 Ml In 1 Vial, Plastic (0409-4887-17)",9.53,3.81,,,0 CDM,2500000005_00409488717,NDC Description Not Available,9.19,3.68,,,0 CDM,2500000005_00409488720,"Sterile Water: 25 Vial, Plastic In 1 Tray (0409-4887-20) / 20 Ml In 1 Vial, Plastic (0409-4887-23)",20.89,8.36,,,0 CDM,2500000005_00409488723,NDC Description Not Available,9.96,3.98,,,0 CDM,2500000005_00409488724,NDC Description Not Available,13.49,5.4,,,0 CDM,2500000005_00409488725,NDC Description Not Available,11.28,4.51,,,0 CDM,2500000005_00409488750,"Sterile Water: 25 Vial, Plastic In 1 Tray (0409-4887-50) / 50 Ml In 1 Vial, Plastic (0409-4887-24)",0.9,0.36,,,0 CDM,2500000005_00409488799,"Sterile Water: 25 Vial, Glass In 1 Case (0409-4887-99) / 100 Ml In 1 Vial, Glass (0409-4887-25)",7.63,3.05,,,0 CDM,2500000005_00409490264,NDC Description Not Available,40.5,16.2,,,0 CDM,2500000005_00409493301,"Epinephrine: 10 Carton In 1 Package (0409-4933-01) / 1 Syringe, Glass In 1 Carton / 10 Ml In 1 Syringe, Glass (0409-4933-11)",0.14,0.06,,,0 CDM,2500000005_00409553424,NDC Description Not Available,37.43,14.97,,,0 CDM,2500000005_00409553434,NDC Description Not Available,42.53,17.01,,,0 CDM,2500000005_00409573801,NDC Description Not Available,15.88,6.35,,,0 CDM,2500000005_00409662502,Sodium Bicarbonate: 25 VIAL in 1 TRAY (0409-6625-02) / 50 mL in 1 VIAL,42.79,17.12,,,0 CDM,2500000005_00409662514,"Sodium Bicarbonate: 25 Vial, Single-Dose In 1 Tray (0409-6625-14) / 50 Ml In 1 Vial, Single-Dose (0409-6625-22)",7.49,3.0,,,0 CDM,2500000005_00409662522,NDC Description Not Available,38.99,15.6,,,0 CDM,2500000005_00409663714,Sodium Bicarbonate: 10 Carton In 1 Package (0409-6637-14) / 1 Syringe In 1 Carton / 50 Ml In 1 Syringe (0409-6637-24),69.46,27.78,,,0 CDM,2500000005_00409663724,NDC Description Not Available,59.87,23.95,,,0 CDM,2500000005_00409664802,"Dextrose: 25 Vial, Single-Dose In 1 Tray (0409-6648-02) / 50 Ml In 1 Vial, Single-Dose (0409-6648-16)",12.93,5.17,,,0 CDM,2500000005_00409664816,NDC Description Not Available,15.31,6.12,,,0 CDM,2500000005_00409669511,NDC Description Not Available,21.54,8.62,,,0 CDM,2500000005_00409724803,Hetastarch In Sodium Chloride: 12 Container In 1 Case (0409-7248-03) / 500 Ml In 1 Container (0409-7248-13),66.7,26.68,,,0 CDM,2500000005_00409729501,"Potassium Phosphates: 25 Vial, Single-Dose In 1 Tray (0409-7295-01) / 15 Ml In 1 Vial, Single-Dose (0409-7295-11)",31.76,12.7,,,0 CDM,2500000005_00409729511,NDC Description Not Available,29.55,11.82,,,0 CDM,2500000005_00409729973,"Sodium Acetate: 25 Vial, Single-Dose In 1 Tray (0409-7299-73) / 20 Ml In 1 Vial, Single-Dose (0409-7299-83)",6.41,2.56,,,0 CDM,2500000005_00409729983,NDC Description Not Available,24.81,9.92,,,0 CDM,2500000005_00409739172,"Sodium Phosphates: 25 Vial, Single-Dose In 1 Tray (0409-7391-72) / 15 Ml In 1 Vial, Single-Dose (0409-7391-82)",15.9,6.36,,,0 CDM,2500000005_00409739182,NDC Description Not Available,60.48,24.19,,,0 CDM,2500000005_00409751716,"Dextrose: 10 Carton In 1 Container (0409-7517-16) / 1 Syringe, Plastic In 1 Carton / 50 Ml In 1 Syringe, Plastic (0409-7517-66)",22.38,8.95,,,0 CDM,2500000005_00409751766,NDC Description Not Available,47.47,18.99,,,0 CDM,2500000005_00409762003,Heparin Sodium: 18 Pouch In 1 Case (0409-7620-03) / 1 Bag In 1 Pouch / 500 Ml In 1 Bag (0409-7620-13),2.47,0.99,,,0 CDM,2500000005_00409771513,NDC Description Not Available,35.66,14.26,,,0 CDM,2500000005_00409818311,NDC Description Not Available,18.24,7.3,,,0 CDM,2500000005_00409904516,NDC Description Not Available,6.46,2.58,,,0 CDM,2500000005_00409904517,"Bupivacaine Hydrochloride And Epinephrine: 25 Vial, Single-Dose In 1 Tray (0409-9045-17) / 30 Ml In 1 Vial, Single-Dose (0409-9045-16)",3.05,1.22,,,0 CDM,2500000005_00409909416,NDC Description Not Available,19.68,7.87,,,0 CDM,2500000005_00409909431,"Fentanyl Citrate: 25 Vial, Single-Dose In 1 Tray (0409-9094-31) / 20 Ml In 1 Vial, Single-Dose (0409-9094-16)",12.88,5.15,,,0 CDM,2500000005_00409955805,"Rocuronium Bromide: 10 Vial, Multi-Dose In 1 Box (0409-9558-05) / 5 Ml In 1 Vial, Multi-Dose (0409-9558-11)",8.29,3.32,,,0 CDM,2500000005_00409955811,NDC Description Not Available,17.09,6.84,,,0 CDM,2500000005_00409973501,NDC Description Not Available,6.68,2.67,,,0 CDM,2500000005_00456120330,"Linzess: 1 Bottle In 1 Carton (0456-1203-30) / 30 Capsule, Gelatin Coated In 1 Bottle",55.59,22.24,,,0 CDM,2500000005_00487020101,"Ipratropium Bromide And Albuterol Sulfate: 30 Pouch In 1 Carton (0487-0201-01) / 1 Vial, Single-Use In 1 Pouch / 3 Ml In 1 Vial, Single-Use",1.76,0.7,,,0 CDM,2500000005_00487900330,NDC Description Not Available,1.9,0.76,,,0 CDM,2500000005_00487900360,NDC Description Not Available,0.58,0.23,,,0 CDM,2500000005_00487900730,NDC Description Not Available,2.01,0.8,,,0 CDM,2500000005_00487900760,NDC Description Not Available,0.69,0.28,,,0 CDM,2500000005_00487930103,NDC Description Not Available,0.43,0.17,,,0 CDM,2500000005_00487950101,"Albuterol Sulfate: 30 Pouch In 1 Carton (0487-9501-01) / 1 Vial, Single-Dose In 1 Pouch / 3 Ml In 1 Vial, Single-Dose",0.82,0.33,,,0 CDM,2500000005_00487950102,NDC Description Not Available,0.9,0.36,,,0 CDM,2500000005_00487960101,Budesonide: 6 Pouch In 1 Carton (0487-9601-01) / 5 Ampule In 1 Pouch / 2 Ml In 1 Ampule,31.47,12.59,,,0 CDM,2500000005_00487970101,Budesonide: 6 Pouch In 1 Carton (0487-9701-01) / 5 Ampule In 1 Pouch / 2 Ml In 1 Ampule,43.55,17.42,,,0 CDM,2500000005_00487980101,"Ipratropium Bromide: 30 Pouch In 1 Carton (0487-9801-01) / 1 Vial, Single-Dose In 1 Pouch / 2.5 Ml In 1 Vial, Single-Dose",0.72,0.29,,,0 CDM,2500000005_00496088205,Lmx4: 5 G In 1 Tube (0496-0882-05),16.8,6.72,,,0 CDM,2500000005_00517037501,NDC Description Not Available,540.76,216.3,,,0 CDM,2500000005_00517102001,NDC Description Not Available,11.0,4.4,,,0 CDM,2500000005_00517210201,NDC Description Not Available,86.42,34.57,,,0 CDM,2500000005_00517250201,NDC Description Not Available,133.24,53.3,,,0 CDM,2500000005_00517250210,"Caffeine And Sodium Benzoate: 10 Vial, Single-Dose In 1 Box (0517-2502-10) / 2 Ml In 1 Vial, Single-Dose (0517-2502-01)",102.65,41.06,,,0 CDM,2500000005_00517481025,"Nitroglycerin: 25 Vial, Single-Dose In 1 Tray (0517-4810-25) / 10 Ml In 1 Vial, Single-Dose (0517-4810-01)",0.11,0.04,,,0 CDM,2500000005_00517656005,"Selenious Acid: 5 Vial, Pharmacy Bulk Package In 1 Box (0517-6560-05) / 10 Ml In 1 Vial, Pharmacy Bulk Package (0517-6560-01)",14.8,5.92,,,0 CDM,2500000005_00517671001,NDC Description Not Available,87.03,34.81,,,0 CDM,2500000005_00517731501,NDC Description Not Available,70.47,28.19,,,0 CDM,2500000005_00517731525,"Sodium Phosphates: 25 Vial, Single-Dose In 1 Tray (0517-7315-25) / 15 Ml In 1 Vial, Single-Dose (0517-7315-01)",3.61,1.44,,,0 CDM,2500000005_00517760401,NDC Description Not Available,13.58,5.43,,,0 CDM,2500000005_00517760425,"Acetylcysteine: 25 Vial, Glass In 1 Tray (0517-7604-25) / 4 Ml In 1 Vial, Glass",73.13,29.25,,,0 CDM,2500000005_00517912001,NDC Description Not Available,31.77,12.71,,,0 CDM,2500000005_00517930201,NDC Description Not Available,53.66,21.46,,,0 CDM,2500000005_00517930225,"Multrys: 25 Vial, Single-Dose In 1 Tray (0517-9302-25) / 1 Ml In 1 Vial, Single-Dose (0517-9302-01)",58.85,23.54,,,0 CDM,2500000005_00517930501,NDC Description Not Available,115.6,46.24,,,0 CDM,2500000005_00517930525,"Tralement: 25 Vial, Single-Dose In 1 Tray (0517-9305-25) / 1 Ml In 1 Vial, Single-Dose (0517-9305-01)",91.23,36.49,,,0 CDM,2500000005_00527132601,Ursodiol: 100 Capsule In 1 Bottle (0527-1326-01),0.68,0.27,,,0 CDM,2500000005_00536105224,Rugby Peg 3350: 238 G In 1 Bottle (0536-1052-24),1.21,0.48,,,0 CDM,2500000005_00536118612,Rugby Hemorrhoidal: 12 Blister Pack In 1 Carton (0536-1186-12) / 1 Suppository In 1 Blister Pack,0.6,0.24,,,0 CDM,2500000005_00536121195,Dibucaine Topical Anesthetic 1% Hemorrhoidal: 1 Tube In 1 Box (0536-1211-95) / 28 G In 1 Tube,5.77,2.31,,,0 CDM,2500000005_00536132926,"Rugby Tolnaftate 1% Powder: 24 Bottle, Plastic In 1 Case (0536-1329-26) / 45 G In 1 Bottle, Plastic",3.96,1.58,,,0 CDM,2500000005_00548950200,Isoproterenol Hydrochloride: 10 Vial In 1 Carton (0548-9502-00) / 5 Ml In 1 Vial,689.33,275.73,,,0 CDM,2500000005_00574030216,NDC Description Not Available,0.43,0.17,,,0 CDM,2500000005_00591379730,Albuterol Sulfate: 30 VIAL in 1 CARTON (0591-3797-30) / 3 mL in 1 VIAL,0.42,0.17,,,0 CDM,2500000005_00591406030,"Desvenlafaxine: 30 Tablet, Extended Release In 1 Bottle (0591-4060-30)",4.21,1.68,,,0 CDM,2500000005_00641601301,NDC Description Not Available,8.31,3.32,,,0 CDM,2500000005_00641601310,Diltiazem Hydrochloride: 10 Vial In 1 Carton (0641-6013-10) / 5 Ml In 1 Vial (0641-6013-01),7.22,2.89,,,0 CDM,2500000005_00641601501,NDC Description Not Available,37.08,14.83,,,0 CDM,2500000005_00641601510,Diltiazem Hydrochloride: 10 Vial In 1 Carton (0641-6015-10) / 25 Ml In 1 Vial (0641-6015-01),24.04,9.62,,,0 CDM,2500000005_00641602101,NDC Description Not Available,1.12,0.45,,,0 CDM,2500000005_00641602110,Famotidine: 10 Vial In 1 Carton (0641-6021-10) / 20 Ml In 1 Vial (0641-6021-01),0.26,0.1,,,0 CDM,2500000005_00641606301,NDC Description Not Available,0.6,0.24,,,0 CDM,2500000005_00641614701,NDC Description Not Available,1.93,0.77,,,0 CDM,2500000005_00641616610,Amikacin Sulfate: 10 Vial In 1 Carton (0641-6166-10) / 4 Ml In 1 Vial (0641-6166-01),0.54,0.22,,,0 CDM,2500000005_00641623601,NDC Description Not Available,30.34,12.14,,,0 CDM,2500000005_00641921701,NDC Description Not Available,4.76,1.9,,,0 CDM,2500000005_00703291401,NDC Description Not Available,21.55,8.62,,,0 CDM,2500000005_00703951401,NDC Description Not Available,26.55,10.62,,,0 CDM,2500000005_00703952601,"Sulfamethoxazole And Trimethoprim: 1 Vial, Multi-Dose In 1 Carton (0703-9526-01) / 30 Ml In 1 Vial, Multi-Dose",133.46,53.38,,,0 CDM,2500000005_00781315295,"Cisatracurium Besylate: 10 Vial, Multi-Dose In 1 Carton (0781-3152-95) / 10 Ml In 1 Vial, Multi-Dose (0781-3152-70)",16.48,6.59,,,0 CDM,2500000005_00781322075,NDC Description Not Available,8.67,3.47,,,0 CDM,2500000005_00781326971,NDC Description Not Available,32.88,13.15,,,0 CDM,2500000005_00781329091,NDC Description Not Available,13.27,5.31,,,0 CDM,2500000005_00781349380,NDC Description Not Available,8.27,3.31,,,0 CDM,2500000005_00781349491,NDC Description Not Available,132.0,52.8,,,0 CDM,2500000005_00781349546,NDC Description Not Available,211.2,84.48,,,0 CDM,2500000005_00781349595,Dexmedetomidine Hydrochloride In 0.9% Sodium Chloride: 10 Bottle In 1 Carton (0781-3495-95) / 100 Ml In 1 Bottle,283.16,113.26,,,0 CDM,2500000005_00781375575,NDC Description Not Available,15.04,6.02,,,0 CDM,2500000005_00781523864,"Ondansetron: 3 BLISTER PACK in 1 CARTON (0781-5238-64) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (0781-5238-06)",2.76,1.1,,,0 CDM,2500000005_00781600078,Difluprednate Ophthalmic: 1 Bottle In 1 Carton (0781-6000-78) / 5 Ml In 1 Bottle,371.94,148.78,,,0 CDM,2500000005_00781717156,Tobramycin: 56 AMPULE in 1 CARTON (0781-7171-56) / 5 mL in 1 AMPULE (0781-7171-75),281.25,112.5,,,0 CDM,2500000005_00781729685,"Albuterol Sulfate: 1 Canister In 1 Carton (0781-7296-85) / 200 Aerosol, Metered In 1 Canister",54.74,21.9,,,0 CDM,2500000005_00832051101,Bethanechol Chloride: 100 Blister Pack In 1 Carton (0832-0511-01) / 1 Tablet In 1 Blister Pack (0832-0511-89),0.19,0.08,,,0 CDM,2500000005_00904386575,NDC Description Not Available,2.47,0.99,,,0 CDM,2500000005_00904655161,"Ondansetron: 100 Blister Pack In 1 Carton (0904-6551-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.49,0.6,,,0 CDM,2500000005_00904655261,"Ondansetron: 100 Blister Pack In 1 Carton (0904-6552-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.68,0.67,,,0 CDM,2500000005_00904692761,"Spironolactone: 100 Blister Pack In 1 Carton (0904-6927-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.2,0.08,,,0 CDM,2500000005_00904693181,Polyethylene Glycol 3350: 100 Packet In 1 Carton (0904-6931-81) / 17 G In 1 Packet,2.21,0.88,,,0 CDM,2500000005_00904693961,Hydroxyurea: 100 Blister Pack In 1 Carton (0904-6939-61) / 1 Capsule In 1 Blister Pack,1.47,0.59,,,0 CDM,2500000005_00904707341,NDC Description Not Available,35.51,14.2,,,0 CDM,2500000005_00904707393,Ondansetron: 30 Cup In 1 Carton (0904-7073-93) / 5 Ml In 1 Cup (0904-7073-41),37.78,15.11,,,0 CDM,2500000005_00904772861,Clonazepam: 100 Blister Pack In 1 Carton (0904-7728-61) / 1 Tablet In 1 Blister Pack,0.89,0.36,,,0 CDM,2500000005_00942064104,Acd-A: 1000 Ml In 1 Bag (0942-0641-04),43.96,17.58,,,0 CDM,2500000005_00942950410,"Sodium Citrate Blood-Pack Units, (Pl 146 Plastic): 500 Ml In 1 Bag (0942-9504-10)",0.44,0.18,,,0 CDM,2500000005_00942950510,"Sodium Citrate Blood-Pack Units, (Pl 146 Plastic): 250 Ml In 1 Bag (0942-9505-10)",0.03,0.01,,,0 CDM,2500000005_00942950625,"Sodium Citrate Blood-Pack Units, (Pl 146 Plastic): 250 Ml In 1 Bag (0942-9506-25)",0.93,0.37,,,0 CDM,2500000005_00990711509,Potassium Chloride In Sodium Chloride: 12 Pouch In 1 Case (0990-7115-09) / 1 Bag In 1 Pouch / 1000 Ml In 1 Bag,32.2,12.88,,,0 CDM,2500000005_00990771503,Mannitol: 12 Pouch In 1 Case (0990-7715-03) / 1 Bag In 1 Pouch / 500 Ml In 1 Bag (0990-7715-13),55.06,22.02,,,0 CDM,2500000005_00990771513,NDC Description Not Available,56.46,22.58,,,0 CDM,2500000005_00990793519,Dextrose: 12 Pouch In 1 Case (0990-7935-19) / 1 Bag In 1 Pouch / 500 Ml In 1 Bag,32.03,12.81,,,0 CDM,2500000005_00990799009,Sterile Water: 12 Pouch In 1 Case (0990-7990-09) / 1 Bag In 1 Pouch / 1000 Ml In 1 Bag,12.98,5.19,,,0 CDM,2500000005_00998061505,"Maxidex: 5 mL in 1 BOTTLE, PLASTIC (0998-0615-05)",38.43,15.37,,,0 CDM,2500000005_08290 0,NDC Description Not Available,0.05,0.02,,,0 CDM,2500000005_09999200108,NDC Description Not Available,591.0,236.4,,,0 CDM,2500000005_09999200501,NDC Description Not Available,0.6,0.24,,,0 CDM,2500000005_09999400567,NDC Description Not Available,206.1,82.44,,,0 CDM,2500000005_09999408340,NDC Description Not Available,6.39,2.56,,,0 CDM,2500000005_09999409171,NDC Description Not Available,56.99,22.8,,,0 CDM,2500000005_09999409468,NDC Description Not Available,123.74,49.5,,,0 CDM,2500000005_09999505004,NDC Description Not Available,3.96,1.58,,,0 CDM,2500000005_09999505005,NDC Description Not Available,0.35,0.14,,,0 CDM,2500000005_09999505006,NDC Description Not Available,0.14,0.06,,,0 CDM,2500000005_09999505007,NDC Description Not Available,0.14,0.06,,,0 CDM,2500000005_09999555501,NDC Description Not Available,26.28,10.51,,,0 CDM,2500000005_10122051001,"Curosurf: 1.5 Ml In 1 Vial, Glass (10122-510-01)",2292.12,916.85,,,0 CDM,2500000005_10122061001,NDC Description Not Available,2.39,0.96,,,0 CDM,2500000005_10122061101,NDC Description Not Available,701.42,280.57,,,0 CDM,2500000005_10122061110,"Cleviprex: 10 Carton In 1 Carton (10122-611-10) / 1 Vial, Single-Use In 1 Carton (10122-611-01) / 100 Ml In 1 Vial, Single-Use",722.66,289.06,,,0 CDM,2500000005_11701008333,Critic-Aid Clear: 71 G In 1 Tube (11701-083-33),15.48,6.19,,,0 CDM,2500000005_11845071401,NDC Description Not Available,0.18,0.07,,,0 CDM,2500000005_13925051510,Pentamidine Isethionate: 10 Vial In 1 Tray (13925-515-10) / 300 Mg In 1 Vial,344.92,137.97,,,0 CDM,2500000005_13925052201,Pentamidine Isethionate: 1 Vial In 1 Carton (13925-522-01) / 300 Mg In 1 Vial,439.44,175.78,,,0 CDM,2500000005_14789001505,"Isoproterenol Hydrochloride: 10 Vial, Single-Dose In 1 Carton (14789-015-05) / 5 Ml In 1 Vial, Single-Dose",3769.81,1507.92,,,0 CDM,2500000005_14789001507,NDC Description Not Available,500.02,200.01,,,0 CDM,2500000005_14789012205,Fluorescein: 10 Vial In 1 Carton (14789-122-05) / 5 Ml In 1 Vial (14789-122-07),886.26,354.5,,,0 CDM,2500000005_14789025007,NDC Description Not Available,73.97,29.59,,,0 CDM,2500000005_14789025010,Emerphed: 10 Vial In 1 Carton (14789-250-10) / 10 Ml In 1 Vial (14789-250-07),18.6,7.44,,,0 CDM,2500000005_16729023930,NDC Description Not Available,4.55,1.82,,,0 CDM,2500000005_16729023993,Dexmedetomidine: 25 Vial In 1 Carton (16729-239-93) / 2 Ml In 1 Vial (16729-239-30),16.26,6.5,,,0 CDM,2500000005_17478025310,"AK-FLUOR: 12 VIAL, SINGLE-DOSE in 1 PACKAGE (17478-253-10) / 5 mL in 1 VIAL, SINGLE-DOSE",39.23,15.69,,,0 CDM,2500000005_17478051500,Ephedrine Sulfate: 10 AMPULE in 1 CARTON (17478-515-00) / 1 mL in 1 AMPULE,1.42,0.57,,,0 CDM,2500000005_17478093705,Diltiazem Hydrochloride: 10 VIAL in 1 CARTON (17478-937-05) / 5 mL in 1 VIAL,6.43,2.57,,,0 CDM,2500000005_17478093725,Diltiazem Hydrochloride: 1 VIAL in 1 CARTON (17478-937-25) / 25 mL in 1 VIAL,5.64,2.26,,,0 CDM,2500000005_17772013230,"Qelbree: 30 Capsule, Extended Release In 1 Bottle (17772-132-30)",36.38,14.55,,,0 CDM,2500000005_23155016631,NDC Description Not Available,13.0,5.2,,,0 CDM,2500000005_23155016641,"Tranexamic Acid: 10 Vial, Glass In 1 Carton (23155-166-41) / 10 Ml In 1 Vial, Glass (23155-166-31)",8.33,3.33,,,0 CDM,2500000005_23155019401,Nifedipine: 100 Capsule In 1 Bottle (23155-194-01),0.58,0.23,,,0 CDM,2500000005_23155066131,NDC Description Not Available,252.2,100.88,,,0 CDM,2500000005_23155074831,NDC Description Not Available,403.83,161.53,,,0 CDM,2500000005_23155074841,"Pentamidine Isethionate: 10 Vial, Single-Dose In 1 Carton (23155-748-41) / 300 Mg In 1 Vial, Single-Dose (23155-748-31)",393.3,157.32,,,0 CDM,2500000005_23731605305,NDC Description Not Available,1.11,0.44,,,0 CDM,2500000005_24208053920,Miochol E: 1 Kit In 1 Blister Pack (24208-539-20) * 2 Ml In 1 Vial * 2 Ml In 1 Ampule,543.75,217.5,,,0 CDM,2500000005_24357070105,NDC Description Not Available,48.4,19.36,,,0 CDM,2500000005_24357070106,Anecream: 5 Tube In 1 Carton (24357-701-06) / 5 G In 1 Tube (24357-701-05),74.53,29.81,,,0 CDM,2500000005_24357070107,Anecream: 5 Tube In 1 Carton (24357-701-07) / 5 G In 1 Tube (24357-701-05),74.66,29.86,,,0 CDM,2500000005_24357070115,Anecream: 1 Tube In 1 Carton (24357-701-15) / 15 G In 1 Tube,34.79,13.92,,,0 CDM,2500000005_24643001179,NDC Description Not Available,0.03,0.01,,,0 CDM,2500000005_24643002303,NDC Description Not Available,5.28,2.11,,,0 CDM,2500000005_24643006330,NDC Description Not Available,0.06,0.02,,,0 CDM,2500000005_24979053301,"Guanfacine Extended-Release: 100 Tablet, Extended Release In 1 Bottle (24979-533-01)",1.26,0.5,,,0 CDM,2500000005_25021013182,Metronidazole: 24 Pouch In 1 Carton (25021-131-82) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,0.19,0.08,,,0 CDM,2500000005_25021031905,Diltiazem Hydrochloride: 10 Vial In 1 Carton (25021-319-05) / 5 Ml In 1 Vial,10.09,4.04,,,0 CDM,2500000005_25021041510,Tranexamic Acid: 10 Vial In 1 Carton (25021-415-10) / 10 Ml In 1 Vial,9.51,3.8,,,0 CDM,2500000005_25021067376,Glydo: 10 Syringe In 1 Carton (25021-673-76) / 6 Ml In 1 Syringe,10.21,4.08,,,0 CDM,2500000005_25021067420,Etomidate: 10 Vial In 1 Carton (25021-674-20) / 20 Ml In 1 Vial,19.76,7.9,,,0 CDM,2500000005_25021068220,Ketamine Hydrochloride: 10 Vial In 1 Carton (25021-682-20) / 20 Ml In 1 Vial,10.98,4.39,,,0 CDM,2500000005_30103004100,NDC Description Not Available,10.38,4.15,,,0 CDM,2500000005_36000003310,Metoprolol: 10 Vial In 1 Carton (36000-033-10) / 5 Ml In 1 Vial,3.02,1.21,,,0 CDM,2500000005_36000014801,NDC Description Not Available,14.35,5.74,,,0 CDM,2500000005_36000016210,Norepinephrine Bitartrate: 10 Ampule In 1 Carton (36000-162-10) / 4 Ml In 1 Ampule (36000-162-01),5.22,2.09,,,0 CDM,2500000005_38779000904,Hydrocortisone: 25 G In 1 Jar (38779-0009-4),46.0,18.4,,,0 CDM,2500000005_38779010208,NDC Description Not Available,0.04,0.02,,,0 CDM,2500000005_38779050305,NDC Description Not Available,22.35,8.94,,,0 CDM,2500000005_38779052409,Bupivacaine Hydrochloride: 1000 G In 1 Jar (38779-0524-9),45.1,18.04,,,0 CDM,2500000005_38779055108,NDC Description Not Available,0.26,0.1,,,0 CDM,2500000005_38779056104,Clonidine Hydrochloride: 25 G In 1 Jar (38779-0561-4),264.26,105.7,,,0 CDM,2500000005_38779062908,NDC Description Not Available,0.06,0.02,,,0 CDM,2500000005_38779067303,"Morphine Sulfate: 5 G In 1 Bottle, Glass (38779-0673-3)",121.36,48.54,,,0 CDM,2500000005_38779067307,"Morphine Sulfate: 250 G In 1 Bottle, Glass (38779-0673-7)",158.46,63.38,,,0 CDM,2500000005_38779073105,Hydromorphone Hydrochloride: 100 G In 1 Vial (38779-0731-5),35.22,14.09,,,0 CDM,2500000005_38779083505,NDC Description Not Available,6.84,2.74,,,0 CDM,2500000005_38779175603,"Fentanyl Citrate: 5 G In 1 Vial, Glass (38779-1756-3)",500.94,200.38,,,0 CDM,2500000005_38779175604,"Fentanyl Citrate: 25 G In 1 Vial, Glass (38779-1756-4)",19.32,7.73,,,0 CDM,2500000005_38779193805,NDC Description Not Available,325.53,130.21,,,0 CDM,2500000005_38779247108,NDC Description Not Available,6.85,2.74,,,0 CDM,2500000005_39822100001,Tranexamic Acid: 10 Vial In 1 Carton (39822-1000-1) / 10 Ml In 1 Vial,19.83,7.93,,,0 CDM,2500000005_39822110001,"Folic Acid: 1 Vial, Multi-Dose In 1 Carton (39822-1100-1) / 10 Ml In 1 Vial, Multi-Dose",3.31,1.32,,,0 CDM,2500000005_39822420001,NDC Description Not Available,9.61,3.84,,,0 CDM,2500000005_39822420002,Rocuronium Bromide: 10 Vial In 1 Carton (39822-4200-2) / 5 Ml In 1 Vial (39822-4200-1),11.58,4.63,,,0 CDM,2500000005_39822930002,Dehydrated Alcohol: 10 Ampule In 1 Carton (39822-9300-2) / 5 Ml In 1 Ampule (39822-9300-1),2368.77,947.51,,,0 CDM,2500000005_40985027116,NDC Description Not Available,0.11,0.04,,,0 CDM,2500000005_42023010501,"Brevital Sodium: 1 Vial In 1 Carton (42023-105-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",31.17,12.47,,,0 CDM,2500000005_42023011310,Ketalar: 10 Vial In 1 Carton (42023-113-10) / 20 Ml In 1 Vial,5.59,2.24,,,0 CDM,2500000005_42023011410,Ketalar: 10 Vial In 1 Carton (42023-114-10) / 10 Ml In 1 Vial,2.88,1.15,,,0 CDM,2500000005_42023014625,Dexmedetomidine Hydrochloride: 25 Vial In 1 Carton (42023-146-25) / 2 Ml In 1 Vial,14.47,5.79,,,0 CDM,2500000005_42023016425,Vasostrict: 25 Vial In 1 Carton (42023-164-25) / 1 Ml In 1 Vial (42023-164-01),17.4,6.96,,,0 CDM,2500000005_42023018701,NDC Description Not Available,352.0,140.8,,,0 CDM,2500000005_42023020101,"Levothyroxine Sodium: 1 Vial, Single-Dose In 1 Carton (42023-201-01) / 5 Ml In 1 Vial, Single-Dose",47.06,18.82,,,0 CDM,2500000005_42023024301,"Ephedrine Sulfate: 10 Ml In 1 Vial, Single-Dose (42023-243-01)",43.68,17.47,,,0 CDM,2500000005_42023050001,NDC Description Not Available,352.26,140.9,,,0 CDM,2500000005_42023050010,Adrenalin (Epinephrine In Sodium Chloride): 10 Bag In 1 Carton (42023-500-10) / 250 Ml In 1 Bag (42023-500-01),357.42,142.97,,,0 CDM,2500000005_42494042301,"Ribavirin: 1 Vial, Glass In 1 Carton (42494-423-01) / 1 Powder, For Solution In 1 Vial, Glass",6878.98,2751.59,,,0 CDM,2500000005_43066000710,Rocuronium Bromide: 10 Vial In 1 Carton (43066-007-10) / 5 Ml In 1 Vial,4.35,1.74,,,0 CDM,2500000005_43066000801,NDC Description Not Available,7.31,2.92,,,0 CDM,2500000005_43066001610,Cardene Iv: 10 Bag In 1 Carton (43066-016-10) / 200 Ml In 1 Bag,355.51,142.2,,,0 CDM,2500000005_43066099701,NDC Description Not Available,32.61,13.04,,,0 CDM,2500000005_43066099710,"Norepinephrine Bitartrate: 10 Vial, Single-Dose In 1 Carton (43066-997-10) / 4 Ml In 1 Vial, Single-Dose (43066-997-01)",21.42,8.57,,,0 CDM,2500000005_43547060210,Lisdexamfetamine Dimesylate: 100 Capsule In 1 Bottle (43547-602-10),2.27,0.91,,,0 CDM,2500000005_43598058723,"Sodium Nitroprusside: 1 Vial, Single-Dose In 1 Carton (43598-587-23) / 2 Ml In 1 Vial, Single-Dose",73.69,29.48,,,0 CDM,2500000005_43598058811,Difluprednate Ophthalmic Emulsion: 1 Bottle In 1 Carton (43598-588-11) / 5 Ml In 1 Bottle,581.49,232.6,,,0 CDM,2500000005_43598069811,"Carboprost Tromethamine: 1 Vial, Single-Dose In 1 Carton (43598-698-11) / 1 Ml In 1 Vial, Single-Dose",250.84,100.34,,,0 CDM,2500000005_43598097511,NDC Description Not Available,58.88,23.55,,,0 CDM,2500000005_44567022210,"Nafcillin: 10 Vial In 1 Carton (44567-222-10) / 1 Powder, For Solution In 1 Vial",4.35,1.74,,,0 CDM,2500000005_44567060104,Dexmedetomidine: 4 Vial In 1 Carton (44567-601-04) / 10 Ml In 1 Vial,450.06,180.02,,,0 CDM,2500000005_44567064101,NDC Description Not Available,234.24,93.7,,,0 CDM,2500000005_44567064110,Norepinephrine Bitartrate In Sodium Chloride: 10 Bag In 1 Carton (44567-641-10) / 250 Ml In 1 Bag (44567-641-01),148.55,59.42,,,0 CDM,2500000005_44567064201,NDC Description Not Available,250.34,100.14,,,0 CDM,2500000005_44567064210,Norepinephrine Bitartrate In Sodium Chloride: 10 Bag In 1 Carton (44567-642-10) / 250 Ml In 1 Bag (44567-642-01),414.94,165.98,,,0 CDM,2500000005_46287050001,NDC Description Not Available,8.01,3.2,,,0 CDM,2500000005_46783022152,Asclera: 2 mL in 1 AMPULE (46783-221-52),92.0,36.8,,,0 CDM,2500000005_47335017148,NDC Description Not Available,27.68,11.07,,,0 CDM,2500000005_47335017149,Tobramycin: 14 Pouch In 1 Carton (47335-171-49) / 4 Ampule In 1 Pouch (47335-171-48) / 5 Ml In 1 Ampule,28.89,11.56,,,0 CDM,2500000005_47335093140,NDC Description Not Available,21.28,8.51,,,0 CDM,2500000005_47781056201,Lisdexamfetamine Dimesylate: 100 Capsule In 1 Bottle (47781-562-01),39.87,15.95,,,0 CDM,2500000005_48582000440,NDC Description Not Available,1.41,0.56,,,0 CDM,2500000005_48783011208,"Monsels Solution: 14 G In 1 Vial, Single-Dose (48783-112-08)",35.99,14.4,,,0 CDM,2500000005_49100040015,NDC Description Not Available,2.23,0.89,,,0 CDM,2500000005_49884046565,Cholestyramine: 60 Packet In 1 Carton (49884-465-65) / 9 G In 1 Packet (49884-465-64),33.49,13.4,,,0 CDM,2500000005_49884077052,NDC Description Not Available,359.44,143.78,,,0 CDM,2500000005_50190014123,NDC Description Not Available,1.9,0.76,,,0 CDM,2500000005_50190014263,NDC Description Not Available,1.57,0.63,,,0 CDM,2500000005_50268062111,NDC Description Not Available,1.25,0.5,,,0 CDM,2500000005_50268064711,NDC Description Not Available,29.72,11.89,,,0 CDM,2500000005_50268064714,"Ondansetron: 40 Cup, Unit-Dose In 1 Tray (50268-647-14) / 5 Ml In 1 Cup, Unit-Dose (50268-647-11)",36.49,14.6,,,0 CDM,2500000005_50268068411,NDC Description Not Available,4.13,1.65,,,0 CDM,2500000005_50289325001,Aer Pre-Moistened Witch Hazel Pad: 40 Applicator In 1 Jar (50289-3250-1) / 2.8 Ml In 1 Applicator,0.19,0.08,,,0 CDM,2500000005_50383077932,Lactulose: 946 mL in 1 BOTTLE (50383-779-32),44.71,17.88,,,0 CDM,2500000005_50474097063,NDC Description Not Available,826.9,330.76,,,0 CDM,2500000005_50474097075,"Briviact: 10 Vial, Glass In 1 Carton (50474-970-75) / 5 Ml In 1 Vial, Glass (50474-970-63)",21.22,8.49,,,0 CDM,2500000005_50474098183,"Rystiggo: 1 Vial, Glass In 1 Carton (50474-981-83) / 3 Ml In 1 Vial, Glass",239.93,95.97,,,0 CDM,2500000005_50474098284,"Rystiggo: 1 Vial, Glass In 1 Carton (50474-982-84) / 4 Ml In 1 Vial, Glass",54004.89,21601.96,,,0 CDM,2500000005_50580023201,"Childrens Benadryl Chewables: 2 Blister Pack In 1 Carton (50580-232-01) / 10 Tablet, Chewable In 1 Blister Pack",1.68,0.67,,,0 CDM,2500000005_51167033101,"Trikafta: 4 Blister Pack In 1 Carton (51167-331-01) / 1 Kit In 1 Blister Pack * 14 Tablet, Film Coated In 1 Blister Pack (51167-431-14) * 7 Tablet, Film Coated In 1 Blister Pack (51167-531-07)",33.81,13.52,,,0 CDM,2500000005_51552005506,Acetic Acid: 500 G In 1 Container (51552-0055-6),3.18,1.27,,,0 CDM,2500000005_51552006208,NDC Description Not Available,0.03,0.01,,,0 CDM,2500000005_51552045605,Bupivacaine Hcl: 100 G In 1 Container (51552-0456-5),180.34,72.14,,,0 CDM,2500000005_51552048005,Clonidine Hcl: 100 G In 1 Container (51552-0480-5),0.04,0.02,,,0 CDM,2500000005_51552061305,Baclofen: 100 G In 1 Container (51552-0613-5),0.02,0.01,,,0 CDM,2500000005_51552068206,Hydromorphone Hydrochloride: 500 G In 1 Container (51552-0682-6),0.11,0.04,,,0 CDM,2500000005_51552069702,Ketamine Hydrochloride: 5 G In 1 Container (51552-0697-2),178.09,71.24,,,0 CDM,2500000005_51672531609,Glycopyrrolate Oral Solution: 1 Bottle In 1 Carton (51672-5316-9) / 500 Ml In 1 Bottle,4.48,1.79,,,0 CDM,2500000005_51754010301,NDC Description Not Available,71.92,28.77,,,0 CDM,2500000005_51754010801,Tranexamic Acid In Sodium Chloride: 100 Ml In 1 Bag (51754-0108-1),91.17,36.47,,,0 CDM,2500000005_51754010803,Tranexamic Acid In Sodium Chloride: 1000 Ml In 1 Case (51754-0108-3),112.45,44.98,,,0 CDM,2500000005_51754100601,Nipride Rtu: 1 Vial In 1 Vial (51754-1006-1) / 100 Ml In 1 Vial,153.15,61.26,,,0 CDM,2500000005_51754100703,Elcys: 100 Ml In 1 Carton (51754-1007-3),183.55,73.42,,,0 CDM,2500000005_51754200104,"Potassium Acetate: 25 Vial, Single-Dose In 1 Carton (51754-2001-4) / 20 Ml In 1 Vial, Single-Dose",11.01,4.4,,,0 CDM,2500000005_51754425001,NDC Description Not Available,33.97,13.59,,,0 CDM,2500000005_51754500101,NDC Description Not Available,35.23,14.09,,,0 CDM,2500000005_51754500104,Sodium Bicarbonate: 25 Vial In 1 Carton (51754-5001-4) / 50 Ml In 1 Vial,20.33,8.13,,,0 CDM,2500000005_51754500105,Sodium Bicarbonate: 20 Vial In 1 Carton (51754-5001-5) / 50 Ml In 1 Vial,24.02,9.61,,,0 CDM,2500000005_51754501104,Sodium Bicarbonate: 25 Vial In 1 Carton (51754-5011-4) / 10 Ml In 1 Vial,26.08,10.43,,,0 CDM,2500000005_51754501201,NDC Description Not Available,15.5,6.2,,,0 CDM,2500000005_51754501204,Sodium Bicarbonate: 25 Vial In 1 Carton (51754-5012-4) / 10 Ml In 1 Vial,23.9,9.56,,,0 CDM,2500000005_51927100000,Morphine Sulfate: 1 G In 1 Container (51927-1000-0),161.17,64.47,,,0 CDM,2500000005_51927123400,NDC Description Not Available,5.35,2.14,,,0 CDM,2500000005_51927279000,NDC Description Not Available,2.97,1.19,,,0 CDM,2500000005_51991098399,NDC Description Not Available,57.63,23.05,,,0 CDM,2500000005_52276040001,Cystadane: 180 G In 1 Bottle (52276-400-01),3.29,1.32,,,0 CDM,2500000005_52536060011,Baclofen: 1 Bottle In 1 Carton (52536-600-11) / 120 Ml In 1 Bottle,26.17,10.47,,,0 CDM,2500000005_52652195001,"Thyquidity: 1 Bottle, Glass In 1 Carton (52652-1950-1) / 100 Ml In 1 Bottle, Glass",17.63,7.05,,,0 CDM,2500000005_52652195002,"Thyquidity: 2 Carton In 1 Carton (52652-1950-2) / 1 Bottle, Glass In 1 Carton / 100 Ml In 1 Bottle, Glass",34.73,13.89,,,0 CDM,2500000005_52652300101,Qbrelis: 150 Ml In 1 Bottle (52652-3001-1),86.25,34.5,,,0 CDM,2500000005_52652600102,Fleqsuvy: 1 Bottle In 1 Carton (52652-6001-2) / 300 Ml In 1 Bottle,34.96,13.98,,,0 CDM,2500000005_54092054601,"Motegrity: 30 Tablet, Film Coated In 1 Bottle (54092-546-01)",47.61,19.04,,,0 CDM,2500000005_54092054701,"Motegrity: 30 Tablet, Film Coated In 1 Bottle (54092-547-01)",47.97,19.19,,,0 CDM,2500000005_54288010502,NDC Description Not Available,4313.38,1725.35,,,0 CDM,2500000005_54288010515,Dehydrated Alcohol: 10 Ampule In 1 Carton (54288-105-15) / 5 Ml In 1 Ampule (54288-105-02),4472.04,1788.82,,,0 CDM,2500000005_54482014701,Carnitor: 5 Vial In 1 Carton (54482-147-01) / 5 Ml In 1 Vial,2.51,1.0,,,0 CDM,2500000005_54643564601,Infuvite Pediatric: 1 Kit In 1 Carton (54643-5646-1) * 4 Ml In 1 Vial (54643-5648-1) * 1 Ml In 1 Vial (54643-5651-1),66.83,26.73,,,0 CDM,2500000005_54643564700,Infuvite Pediatric: 1 Kit In 1 Carton (54643-5647-0) * 40 Ml In 1 Vial (54643-5653-0) * 10 Ml In 1 Vial (54643-5655-0),71.62,28.65,,,0 CDM,2500000005_54643564901,Infuvite Adult: 1 Kit In 1 Carton (54643-5649-1) * 5 Ml In 1 Vial (54643-5657-1) * 5 Ml In 1 Vial (54643-5659-1),43.51,17.4,,,0 CDM,2500000005_55111071830,"Lamotrigine: 30 Tablet, Extended Release In 1 Bottle (55111-718-30)",4.12,1.65,,,0 CDM,2500000005_55111072030,"Lamotrigine: 30 Tablet, Extended Release In 1 Bottle (55111-720-30)",5.24,2.1,,,0 CDM,2500000005_55150012315,Nafcillin: 10 Vial In 1 Box (55150-123-15) / 8 Ml In 1 Vial,0.79,0.32,,,0 CDM,2500000005_55150012499,"Nafcillin: 1 Vial, Pharmacy Bulk Package In 1 Box (55150-124-99) / 100 Ml In 1 Vial, Pharmacy Bulk Package",95.43,38.17,,,0 CDM,2500000005_55150016102,"Lidocaine Hydrochloride: 10 Vial, Single-Dose In 1 Carton (55150-161-02) / 2 Ml In 1 Vial, Single-Dose",5.15,2.06,,,0 CDM,2500000005_55150016205,"Lidocaine Hydrochloride: 10 Vial, Single-Dose In 1 Carton (55150-162-05) / 5 Ml In 1 Vial, Single-Dose",0.97,0.39,,,0 CDM,2500000005_55150016330,"Lidocaine Hydrochloride: 1 Vial, Single-Dose In 1 Carton (55150-163-30) / 30 Ml In 1 Vial, Single-Dose",4.72,1.89,,,0 CDM,2500000005_55150016505,"Lidocaine Hydrochloride: 10 Vial, Single-Dose In 1 Carton (55150-165-05) / 5 Ml In 1 Vial, Single-Dose",9.59,3.84,,,0 CDM,2500000005_55150016710,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-167-10) / 10 Ml In 1 Vial, Single-Dose",0.2,0.08,,,0 CDM,2500000005_55150018810,"Tranexamic Acid: 10 Vial, Single-Dose In 1 Carton (55150-188-10) / 10 Ml In 1 Vial, Single-Dose",14.13,5.65,,,0 CDM,2500000005_55150020902,Dexmedetomidine: 25 Vial In 1 Carton (55150-209-02) / 2 Ml In 1 Vial,7.59,3.04,,,0 CDM,2500000005_55150022110,"Etomidate: 10 Vial, Single-Dose In 1 Carton (55150-221-10) / 10 Ml In 1 Vial, Single-Dose",20.82,8.33,,,0 CDM,2500000005_55150023501,NDC Description Not Available,10.45,4.18,,,0 CDM,2500000005_55150023510,"Vecuronium Bromide: 10 Vial In 1 Carton (55150-235-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (55150-235-01)",13.58,5.43,,,0 CDM,2500000005_55150025110,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (55150-251-10) / 10 Ml In 1 Vial, Multi-Dose",4.51,1.8,,,0 CDM,2500000005_55150025220,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (55150-252-20) / 20 Ml In 1 Vial, Multi-Dose",11.38,4.55,,,0 CDM,2500000005_55150025410,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (55150-254-10) / 10 Ml In 1 Vial, Multi-Dose",8.48,3.39,,,0 CDM,2500000005_55150029701,NDC Description Not Available,63.8,25.52,,,0 CDM,2500000005_55150037001,"Vasopressin: 1 Vial, Multi-Dose In 1 Carton (55150-370-01) / 1 Ml In 1 Vial, Multi-Dose",4.58,1.83,,,0 CDM,2500000005_55150043801,NDC Description Not Available,4.52,1.81,,,0 CDM,2500000005_55150043901,NDC Description Not Available,11.17,4.47,,,0 CDM,2500000005_55150044001,NDC Description Not Available,27.14,10.86,,,0 CDM,2500000005_55150045901,NDC Description Not Available,231.6,92.64,,,0 CDM,2500000005_55513005901,Imdelltra (Amg757): 1 Kit In 1 Package (55513-059-01) * 1 Mg In 1 Vial (55513-103-01) * 7 Ml In 1 Vial (55513-068-01),6626.03,2650.41,,,0 CDM,2500000005_55513007701,Imdelltra (Amg757): 1 Kit In 1 Package (55513-077-01) * 10 Mg In 1 Vial (55513-069-01) * 7 Ml In 1 Vial (55513-068-01),69000.0,27600.0,,,0 CDM,2500000005_55513081301,NDC Description Not Available,10.13,4.05,,,0 CDM,2500000005_57237007710,"Ondansetron: 3 Blister Pack In 1 Carton (57237-077-10) / 10 Tablet, Orally Disintegrating In 1 Blister Pack",1.08,0.43,,,0 CDM,2500000005_57237032621,Glycerin Children: 2 Blister Pack In 1 Carton (57237-326-21) / 6 Suppository In 1 Blister Pack (57237-326-16),1.26,0.5,,,0 CDM,2500000005_57237032652,Glycerin Children: 5 Blister Pack In 1 Carton (57237-326-52) / 5 Suppository In 1 Blister Pack (57237-326-51),0.99,0.4,,,0 CDM,2500000005_57664004688,Lisdexamfetamine Dimesylate: 100 Capsule In 1 Bottle (57664-046-88),14.26,5.7,,,0 CDM,2500000005_57896019945,"Tolnaftate Antifungal: 45 G In 1 Bottle, Dispensing (57896-199-45)",9.18,3.67,,,0 CDM,2500000005_57896062912,Geri-Lanta Antacid Antigas: 355 Ml In 1 Bottle (57896-629-12),1.13,0.45,,,0 CDM,2500000005_58108060935,NDC Description Not Available,2.29,0.92,,,0 CDM,2500000005_58657032550,"Multi-Vitamin With Fluoride: 1 Bottle, Dropper In 1 Box (58657-325-50) / 50 Ml In 1 Bottle, Dropper",0.85,0.34,,,0 CDM,2500000005_58980040912,Stratuscare Glycerin Laxative Pediatric: 12 Suppository In 1 Jar (58980-409-12),0.32,0.13,,,0 CDM,2500000005_58980040925,Stratuscare Glycerin Laxative Pediatric: 25 Suppository In 1 Jar (58980-409-25),0.33,0.13,,,0 CDM,2500000005_59310057922,"PROAIR: 1 INHALER in 1 CARTON (59310-579-22) / 200 AEROSOL, METERED in 1 INHALER",335.29,134.12,,,0 CDM,2500000005_59385002501,NDC Description Not Available,48.69,19.48,,,0 CDM,2500000005_59385002560,"Belbuca: 60 Pouch In 1 Carton (59385-025-60) / 1 Film, Soluble In 1 Pouch (59385-025-01)",70.01,28.0,,,0 CDM,2500000005_59417010110,Vyvanse: 100 Capsule In 1 Bottle (59417-101-10),38.78,15.51,,,0 CDM,2500000005_59584013801,"Candin: 1 Ml In 1 Vial, Multi-Dose (59584-138-01)",141.68,56.67,,,0 CDM,2500000005_59746011306,Prochlorperazine Maleate: 100 Tablet In 1 Bottle (59746-113-06),1.5,0.6,,,0 CDM,2500000005_59762007401,Hydrocortisone: 100 Tablet In 1 Bottle (59762-0074-1),0.19,0.08,,,0 CDM,2500000005_60505392701,"Guanfacine Extended-Release: 100 Tablet, Extended Release In 1 Bottle (60505-3927-1)",0.74,0.3,,,0 CDM,2500000005_60505614700,"Cefepime: 1 Vial, Single-Dose In 1 Carton (60505-6147-0) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose",4.98,1.99,,,0 CDM,2500000005_60687012401,"Clonidine Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-124-01) / 1 Tablet In 1 Blister Pack (60687-124-11)",0.26,0.1,,,0 CDM,2500000005_60687025240,NDC Description Not Available,32.34,12.94,,,0 CDM,2500000005_60687025286,"Ondansetron: 3 Tray In 1 Case (60687-252-86) / 10 Cup, Unit-Dose In 1 Tray (60687-252-46) / 5 Ml In 1 Cup, Unit-Dose (60687-252-40)",37.67,15.07,,,0 CDM,2500000005_60687039479,NDC Description Not Available,0.61,0.24,,,0 CDM,2500000005_60687039579,NDC Description Not Available,0.73,0.29,,,0 CDM,2500000005_60687039583,Albuterol Sulfate: 30 Pouch In 1 Carton (60687-395-83) / 1 Ampule In 1 Pouch (60687-395-79) / 3 Ml In 1 Ampule,1.12,0.45,,,0 CDM,2500000005_60687040579,NDC Description Not Available,1.02,0.41,,,0 CDM,2500000005_60687040583,Ipratropium Bromide And Albuterol Sulfate: 30 Pouch In 1 Carton (60687-405-83) / 1 Ampule In 1 Pouch (60687-405-79) / 3 Ml In 1 Ampule,1.62,0.65,,,0 CDM,2500000005_61553039765,NDC Description Not Available,10.21,4.08,,,0 CDM,2500000005_61958090101,Cayston: 2 Carton In 1 Package (61958-0901-1) / 1 Kit In 1 Carton * 1 Ml In 1 Vial * 1 Ml In 1 Ampule,656.19,262.48,,,0 CDM,2500000005_61990061100,NDC Description Not Available,17.98,7.19,,,0 CDM,2500000005_61990061102,"tranexamic acid: 10 VIAL, SINGLE-DOSE in 1 CARTON (61990-0611-2) / 10 mL in 1 VIAL, SINGLE-DOSE (61990-0611-0)",95.22,38.09,,,0 CDM,2500000005_62205000020,NDC Description Not Available,362.55,145.02,,,0 CDM,2500000005_62327033303,NDC Description Not Available,772.2,308.88,,,0 CDM,2500000005_62327033343,"Steritalc 3G: 4 Vial, Glass In 1 Box (62327-333-43) / 10 Ml In 1 Vial, Glass (62327-333-03)",703.8,281.52,,,0 CDM,2500000005_62327044404,NDC Description Not Available,860.2,344.08,,,0 CDM,2500000005_62327044444,"Steritalc 4G: 4 Vial, Glass In 1 Box (62327-444-44) / 50 Ml In 1 Vial, Glass (62327-444-04)",782.0,312.8,,,0 CDM,2500000005_62584026701,"Metoprolol Tartrate: 100 Blister Pack In 1 Box, Unit-Dose (62584-267-01) / 1 Tablet, Film Coated In 1 Blister Pack (62584-267-11)",0.12,0.05,,,0 CDM,2500000005_62756024064,"Ondansetron: 3 Blister Pack In 1 Dose Pack (62756-240-64) / 10 Tablet, Orally Disintegrating In 1 Blister Pack",2.64,1.06,,,0 CDM,2500000005_62991101303,Baclofen: 100 G In 1 Jar (62991-1013-3),311.28,124.51,,,0 CDM,2500000005_62991140307,Morphine Sulfate: 500 G In 1 Jar (62991-1403-7),170.97,68.39,,,0 CDM,2500000005_62991140504,Fentanyl Citrate: 5 G In 1 Jar (62991-1405-4),987.39,394.96,,,0 CDM,2500000005_62991142202,Clonidine Hydrochloride: 5 G In 1 Jar (62991-1422-2),0.26,0.1,,,0 CDM,2500000005_62991201403,Bupivacaine Hydrochloride: 1000 G In 1 Jar (62991-2014-3),53.25,21.3,,,0 CDM,2500000005_62991309207,Hydromorphone Hydrochloride: 500 G In 1 Jar (62991-3092-7),291.86,116.74,,,0 CDM,2500000005_63020053530,"Iclusig: 30 Tablet, Film Coated In 1 Bottle (63020-535-30)",1923.32,769.33,,,0 CDM,2500000005_63090034030,"Nuplazid: 30 Capsule In 1 Bottle, Plastic (63090-340-30)",557.83,223.13,,,0 CDM,2500000005_63275110005,NDC Description Not Available,199.94,79.98,,,0 CDM,2500000005_63275210005,"Hydromorphone Hcl: 100 G In 1 Bottle, Plastic (63275-2100-5)",252.13,100.85,,,0 CDM,2500000005_63323008305,"Sodium Bicarbonate: 25 Vial, Single-Dose In 1 Tray (63323-083-05) / 5 Ml In 1 Vial, Single-Dose (63323-083-03)",104.4,41.76,,,0 CDM,2500000005_63323008861,"Sodium Chloride: 10 Vial, Pharmacy Bulk Package In 1 Tray (63323-088-61) / 100 Ml In 1 Vial, Pharmacy Bulk Package",8.02,3.21,,,0 CDM,2500000005_63323008863,"Sodium Chloride: 10 Vial, Pharmacy Bulk Package In 1 Tray (63323-088-63) / 200 Ml In 1 Vial, Pharmacy Bulk Package",5.52,2.21,,,0 CDM,2500000005_63323008950,"Sodium Bicarbonate: 25 Vial, Single-Dose In 1 Tray (63323-089-50) / 50 Ml In 1 Vial, Single-Dose (63323-089-25)",106.23,42.49,,,0 CDM,2500000005_63323009301,NDC Description Not Available,19.74,7.9,,,0 CDM,2500000005_63323009330,"Sodium Chloride: 25 Vial, Plastic In 1 Tray (63323-093-30) / 30 Ml In 1 Vial, Plastic (63323-093-01)",16.8,6.72,,,0 CDM,2500000005_63323009502,NDC Description Not Available,21.91,8.76,,,0 CDM,2500000005_63323009561,"Sodium Chloride: 20 Vial, Plastic In 1 Tray (63323-095-61) / 100 Ml In 1 Vial, Plastic (63323-095-02)",6.22,2.49,,,0 CDM,2500000005_63323009903,NDC Description Not Available,32.9,13.16,,,0 CDM,2500000005_63323009963,"Sodium Chloride: 10 Vial, Plastic In 1 Tray (63323-099-63) / 200 Ml In 1 Vial, Plastic (63323-099-03)",7.36,2.94,,,0 CDM,2500000005_63323011301,NDC Description Not Available,555.77,222.31,,,0 CDM,2500000005_63323011310,Pentam 300: 10 Vial In 1 Tray (63323-113-10) / 3 Ml In 1 Vial (63323-113-01),599.53,239.81,,,0 CDM,2500000005_63323013002,NDC Description Not Available,71.07,28.43,,,0 CDM,2500000005_63323013011,Doxy 100: 10 Vial In 1 Tray (63323-130-11) / 10 Ml In 1 Vial (63323-130-02),146.86,58.74,,,0 CDM,2500000005_63323017015,"Sodium Phosphates: 25 Vial, Single-Dose In 1 Tray (63323-170-15) / 15 Ml In 1 Vial, Single-Dose",13.13,5.25,,,0 CDM,2500000005_63323018410,"Folic Acid: 1 Vial, Multi-Dose In 1 Carton (63323-184-10) / 10 Ml In 1 Vial, Multi-Dose",5.64,2.26,,,0 CDM,2500000005_63323018507,NDC Description Not Available,12.67,5.07,,,0 CDM,2500000005_63323018508,NDC Description Not Available,14.03,5.61,,,0 CDM,2500000005_63323018509,NDC Description Not Available,13.92,5.57,,,0 CDM,2500000005_63323018510,Sterile Water: 25 Vial In 1 Tray (63323-185-10) / 10 Ml In 1 Vial (63323-185-07),19.07,7.63,,,0 CDM,2500000005_63323018520,Sterile Water: 25 Vial In 1 Tray (63323-185-20) / 20 Ml In 1 Vial (63323-185-08),26.64,10.66,,,0 CDM,2500000005_63323018730,"Sodium Chloride: 25 Vial, Single-Dose In 1 Tray (63323-187-30) / 30 Ml In 1 Vial, Single-Dose",12.43,4.97,,,0 CDM,2500000005_63323020101,NDC Description Not Available,1.13,0.45,,,0 CDM,2500000005_63323020102,Lidocaine: 25 Vial In 1 Tray (63323-201-02) / 2 Ml In 1 Vial (63323-201-01),7.6,3.04,,,0 CDM,2500000005_63323020103,NDC Description Not Available,7.4,2.96,,,0 CDM,2500000005_63323020110,Lidocaine: 25 Vial In 1 Tray (63323-201-10) / 10 Ml In 1 Vial (63323-201-03),52.82,21.13,,,0 CDM,2500000005_63323020201,NDC Description Not Available,9.35,3.74,,,0 CDM,2500000005_63323020202,Lidocaine: 25 Vial In 1 Tray (63323-202-02) / 2 Ml In 1 Vial (63323-202-01),13.04,5.22,,,0 CDM,2500000005_63323020521,NDC Description Not Available,188.9,75.56,,,0 CDM,2500000005_63323020805,"Lidocaine: 25 Vial, Single-Dose In 1 Tray (63323-208-05) / 5 Ml In 1 Vial, Single-Dose (63323-208-01)",1.53,0.61,,,0 CDM,2500000005_63323025410,NDC Description Not Available,54.99,22.0,,,0 CDM,2500000005_63323030630,"Tobramycin: 10 Vial, Multi-Dose In 1 Tray (63323-306-30) / 30 Ml In 1 Vial, Multi-Dose (63323-306-05)",2.25,0.9,,,0 CDM,2500000005_63323031461,Vancomycin Hydrochloride: 1 Bottle In 1 Carton (63323-314-61) / 100 Ml In 1 Bottle,16.95,6.78,,,0 CDM,2500000005_63323032820,Nafcillin: 10 Vial In 1 Carton (63323-328-20) / 8 Ml In 1 Vial (63323-328-21),2.06,0.82,,,0 CDM,2500000005_63323034021,NDC Description Not Available,10.63,4.25,,,0 CDM,2500000005_63323035120,"Rifampin: 1 Vial In 1 Box (63323-351-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",571.85,228.74,,,0 CDM,2500000005_63323041202,Midazolam: 10 Vial In 1 Tray (63323-412-02) / 2 Ml In 1 Vial (63323-412-03),28.5,11.4,,,0 CDM,2500000005_63323041203,NDC Description Not Available,6.74,2.7,,,0 CDM,2500000005_63323042101,NDC Description Not Available,151.28,60.51,,,0 CDM,2500000005_63323042102,Dexmedetomidine Hydrochloride: 25 Vial In 1 Tray (63323-421-02) / 2 Ml In 1 Vial (63323-421-01),12.93,5.17,,,0 CDM,2500000005_63323042405,"Flumazenil: 10 Vial, Multi-Dose In 1 Tray (63323-424-05) / 5 Ml In 1 Vial, Multi-Dose (63323-424-01)",26.12,10.45,,,0 CDM,2500000005_63323046201,NDC Description Not Available,46.19,18.48,,,0 CDM,2500000005_63323046204,NDC Description Not Available,32.65,13.06,,,0 CDM,2500000005_63323046237,"Sensorcaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-462-37) / 30 Ml In 1 Vial, Single-Dose (63323-462-01)",45.58,18.23,,,0 CDM,2500000005_63323046357,"Sensorcaine: 25 Vial, Multi-Dose In 1 Tray (63323-463-57) / 50 Ml In 1 Vial, Multi-Dose (63323-463-01)",37.28,14.91,,,0 CDM,2500000005_63323046801,NDC Description Not Available,27.29,10.92,,,0 CDM,2500000005_63323046802,NDC Description Not Available,32.22,12.89,,,0 CDM,2500000005_63323046817,"Sensorcaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-468-17) / 10 Ml In 1 Vial, Single-Dose (63323-468-01)",27.59,11.04,,,0 CDM,2500000005_63323046837,"Sensorcaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-468-37) / 30 Ml In 1 Vial, Single-Dose (63323-468-02)",46.73,18.69,,,0 CDM,2500000005_63323048101,NDC Description Not Available,4.58,1.83,,,0 CDM,2500000005_63323048201,NDC Description Not Available,13.87,5.55,,,0 CDM,2500000005_63323048203,NDC Description Not Available,7.09,2.84,,,0 CDM,2500000005_63323048217,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-482-17) / 10 Ml In 1 Vial, Multi-Dose (63323-482-01)",14.64,5.86,,,0 CDM,2500000005_63323048501,NDC Description Not Available,6.69,2.68,,,0 CDM,2500000005_63323048503,NDC Description Not Available,0.58,0.23,,,0 CDM,2500000005_63323048601,NDC Description Not Available,9.35,3.74,,,0 CDM,2500000005_63323048602,NDC Description Not Available,22.18,8.87,,,0 CDM,2500000005_63323048605,NDC Description Not Available,17.57,7.03,,,0 CDM,2500000005_63323048707,NDC Description Not Available,25.31,10.12,,,0 CDM,2500000005_63323048717,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-487-17) / 10 Ml In 1 Vial, Single-Dose (63323-487-01)",42.65,17.06,,,0 CDM,2500000005_63323048737,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-487-37) / 30 Ml In 1 Vial, Single-Dose (63323-487-07)",54.05,21.62,,,0 CDM,2500000005_63323048807,NDC Description Not Available,14.49,5.8,,,0 CDM,2500000005_63323048837,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-488-37) / 30 Ml In 1 Vial, Single-Dose (63323-488-07)",13.74,5.5,,,0 CDM,2500000005_63323048901,NDC Description Not Available,36.11,14.44,,,0 CDM,2500000005_63323048902,NDC Description Not Available,44.52,17.81,,,0 CDM,2500000005_63323049204,NDC Description Not Available,10.49,4.2,,,0 CDM,2500000005_63323049207,NDC Description Not Available,28.44,11.38,,,0 CDM,2500000005_63323049209,NDC Description Not Available,7.87,3.15,,,0 CDM,2500000005_63323049227,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Carton (63323-492-27) / 2 Ml In 1 Vial, Single-Dose (63323-492-04)",7.75,3.1,,,0 CDM,2500000005_63323049237,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-492-37) / 30 Ml In 1 Vial, Single-Dose (63323-492-07)",7.62,3.05,,,0 CDM,2500000005_63323049405,"Valproate Sodium: 10 Vial, Single-Dose In 1 Tray (63323-494-05) / 5 Ml In 1 Vial, Single-Dose (63323-494-01)",5.34,2.14,,,0 CDM,2500000005_63323049504,NDC Description Not Available,0.94,0.38,,,0 CDM,2500000005_63323049507,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Carton (63323-495-07) / 5 Ml In 1 Vial, Single-Dose (63323-495-04)",0.91,0.36,,,0 CDM,2500000005_63323050601,Dexamethasone Sodium Phosphate: 25 Vial In 1 Tray (63323-506-01) / 1 Ml In 1 Vial (63323-506-00),25.74,10.3,,,0 CDM,2500000005_63323054505,NDC Description Not Available,0.18,0.07,,,0 CDM,2500000005_63323064907,"Levothyroxine Sodium: 1 Vial, Single-Dose In 1 Carton (63323-649-07) / 5 Ml In 1 Vial, Single-Dose",36.11,14.44,,,0 CDM,2500000005_63323069404,Acetylcysteine: 25 Vial In 1 Carton (63323-694-04) / 4 Ml In 1 Vial (63323-694-22),46.43,18.57,,,0 CDM,2500000005_63323072405,"Remifentanil Hydrochloride: 10 Vial, Single-Dose In 1 Carton (63323-724-05) / 5 Ml In 1 Vial, Single-Dose (63323-724-01)",424.36,169.74,,,0 CDM,2500000005_63323073806,NDC Description Not Available,0.56,0.22,,,0 CDM,2500000005_63323087715,"Nebupent: 1 Vial, Single-Dose In 1 Carton (63323-877-15) / 6 Ml In 1 Vial, Single-Dose",506.0,202.4,,,0 CDM,2500000005_63323088101,NDC Description Not Available,62.63,25.05,,,0 CDM,2500000005_63323088116,"Sodium Phosphates: 25 Vial, Single-Dose In 1 Tray (63323-881-16) / 15 Ml In 1 Vial, Single-Dose (63323-881-01)",98.14,39.26,,,0 CDM,2500000005_63323088601,NDC Description Not Available,59.21,23.68,,,0 CDM,2500000005_63323092403,NDC Description Not Available,14.67,5.87,,,0 CDM,2500000005_63323093000,NDC Description Not Available,2.79,1.12,,,0 CDM,2500000005_63323093001,"Vasopressin: 25 Vial, Single-Dose In 1 Tray (63323-930-01) / 1 Ml In 1 Vial, Single-Dose (63323-930-00)",3.87,1.55,,,0 CDM,2500000005_63323094004,"Norepinephrine Bitartrate: 10 Vial, Single-Dose In 1 Carton (63323-940-04) / 4 Ml In 1 Vial, Single-Dose (63323-940-21)",25.88,10.35,,,0 CDM,2500000005_63323094021,NDC Description Not Available,21.62,8.65,,,0 CDM,2500000005_63807060005,NDC Description Not Available,0.12,0.05,,,0 CDM,2500000005_64067021601,"Uvadex: 12 Vial, Glass In 1 Carton (64067-216-01) / 10 Ml In 1 Vial, Glass",674.44,269.78,,,0 CDM,2500000005_64253033335,NDC Description Not Available,0.14,0.06,,,0 CDM,2500000005_64253090030,NDC Description Not Available,39.66,15.86,,,0 CDM,2500000005_64253090036,"Calcium Chloride: 60 Syringe, Plastic In 1 Box (64253-900-36) / 10 Ml In 1 Syringe, Plastic (64253-900-30)",33.12,13.25,,,0 CDM,2500000005_64370037501,"Hemangeol: 1 Bottle, Glass In 1 Carton (64370-375-01) / 120 Ml In 1 Bottle, Glass",30.97,12.39,,,0 CDM,2500000005_64850055001,Lisdexamfetamine Dimesylate: 100 Capsule In 1 Bottle (64850-550-01),15.07,6.03,,,0 CDM,2500000005_64980058805,NDC Description Not Available,21562.5,8625.0,,,0 CDM,2500000005_65162069179,Ondansetron: 50 Ml In 1 Bottle (65162-691-79),4.37,1.75,,,0 CDM,2500000005_65162089374,Aripiprazole: 1 Bottle In 1 Carton (65162-893-74) / 150 Ml In 1 Bottle,56.32,22.53,,,0 CDM,2500000005_65162091446,Tobramycin: 56 Ampule In 1 Carton (65162-914-46) / 5 Ml In 1 Ampule,50.9,20.36,,,0 CDM,2500000005_65219005209,NDC Description Not Available,25.48,10.19,,,0 CDM,2500000005_65219005229,"Potassium Phosphates: 25 Vial, Single-Dose In 1 Tray (65219-052-29) / 5 Ml In 1 Vial, Single-Dose (65219-052-09)",58.47,23.39,,,0 CDM,2500000005_65219005409,NDC Description Not Available,73.45,29.38,,,0 CDM,2500000005_65219005429,"Potassium Phosphates: 25 Vial, Single-Dose In 1 Tray (65219-054-29) / 15 Ml In 1 Vial, Single-Dose (65219-054-09)",149.64,59.86,,,0 CDM,2500000005_65219005609,NDC Description Not Available,70.96,28.38,,,0 CDM,2500000005_65219044501,NDC Description Not Available,20.5,8.2,,,0 CDM,2500000005_65219044510,"Etomidate: 10 Vial, Single-Dose In 1 Carton (65219-445-10) / 10 Ml In 1 Vial, Single-Dose (65219-445-01)",19.74,7.9,,,0 CDM,2500000005_65219053301,NDC Description Not Available,34.86,13.94,,,0 CDM,2500000005_65219053325,Intralipid: 10 Bag In 1 Case (65219-533-25) / 250 Ml In 1 Bag (65219-533-01),58.44,23.38,,,0 CDM,2500000005_65219057900,NDC Description Not Available,349.09,139.64,,,0 CDM,2500000005_65219057901,Carboprost Tromethamine: 10 Vial In 1 Carton (65219-579-01) / 1 Ml In 1 Vial (65219-579-00),347.9,139.16,,,0 CDM,2500000005_65282160501,Lidocaine Hydrochloride: 25 Ampule In 1 Carton (65282-1605-1) / 5 Ml In 1 Ampule,15.33,6.13,,,0 CDM,2500000005_65649055102,"Relistor: 1 Vial, Single-Dose In 1 Carton (65649-551-02) / .6 Ml In 1 Vial, Single-Dose",645.82,258.33,,,0 CDM,2500000005_65862018730,"Ondansetron Hydrochloride: 30 Tablet, Film Coated In 1 Bottle (65862-187-30)",0.38,0.15,,,0 CDM,2500000005_65862018830,"Ondansetron Hydrochloride: 30 Tablet, Film Coated In 1 Bottle (65862-188-30)",0.58,0.23,,,0 CDM,2500000005_65862039010,"Ondansetron: 3 Blister Pack In 1 Carton (65862-390-10) / 10 Tablet, Orally Disintegrating In 1 Blister Pack",2.68,1.07,,,0 CDM,2500000005_66215040301,Veletri: 1 Vial In 1 Carton (66215-403-01) / 10 Ml In 1 Vial,13.51,5.4,,,0 CDM,2500000005_66794022802,NDC Description Not Available,16.41,6.56,,,0 CDM,2500000005_66794022841,Rocuronium: 10 Vial In 1 Carton (66794-228-41) / 5 Ml In 1 Vial (66794-228-02),13.53,5.41,,,0 CDM,2500000005_66794023002,NDC Description Not Available,22.0,8.8,,,0 CDM,2500000005_66794023302,NDC Description Not Available,10.7,4.28,,,0 CDM,2500000005_66794023342,"Dexmedetomidine: 25 Vial, Glass In 1 Carton (66794-233-42) / 2 Ml In 1 Vial, Glass (66794-233-02)",9.46,3.78,,,0 CDM,2500000005_66794023502,NDC Description Not Available,164.01,65.6,,,0 CDM,2500000005_66794023702,NDC Description Not Available,110.45,44.18,,,0 CDM,2500000005_66794023741,Doxycycline: 10 Vial In 1 Carton (66794-237-41) / 10 Ml In 1 Vial,164.14,65.66,,,0 CDM,2500000005_66993001968,"Albuterol Sulfate Hfa: 1 Inhaler In 1 Carton (66993-019-68) / 200 Aerosol, Metered In 1 Inhaler",110.03,44.01,,,0 CDM,2500000005_67157010150,"Ascor: 1 Vial, Glass In 1 Carton (67157-101-50) / 50 Ml In 1 Vial, Glass",20.55,8.22,,,0 CDM,2500000005_67457016302,"Sotradecol: 5 Vial, Multi-Dose In 1 Carton (67457-163-02) / 2 Ml In 1 Vial, Multi-Dose (67457-163-00)",332.2,132.88,,,0 CDM,2500000005_67457018100,NDC Description Not Available,46.99,18.8,,,0 CDM,2500000005_67457019899,NDC Description Not Available,414.5,165.8,,,0 CDM,2500000005_67457022810,"Rocuronium Bromide: 10 Vial, Multi-Dose In 1 Carton (67457-228-10) / 10 Ml In 1 Vial, Multi-Dose (67457-228-99)",30.8,12.32,,,0 CDM,2500000005_67457025100,NDC Description Not Available,15.5,6.2,,,0 CDM,2500000005_67457043300,NDC Description Not Available,2.23,0.89,,,0 CDM,2500000005_67457043322,Famotidine: 25 Vial In 1 Carton (67457-433-22) / 2 Ml In 1 Vial (67457-433-00),1.83,0.73,,,0 CDM,2500000005_67457044560,Rifampin: 1 Vial In 1 Carton (67457-445-60) / 10 Ml In 1 Vial,687.93,275.17,,,0 CDM,2500000005_67457077930,"Sulfamethoxazole And Trimethoprim: 1 Vial, Multi-Dose In 1 Carton (67457-779-30) / 30 Ml In 1 Vial, Multi-Dose",64.73,25.89,,,0 CDM,2500000005_67457085200,NDC Description Not Available,2.6,1.04,,,0 CDM,2500000005_67457085204,"Norepinephrine Bitartrate: 10 Vial, Single-Dose In 1 Carton (67457-852-04) / 4 Ml In 1 Vial, Single-Dose (67457-852-00)",0.39,0.16,,,0 CDM,2500000005_67457090210,Etomidate: 10 Vial In 1 Carton (67457-902-10) / 10 Ml In 1 Vial (67457-902-00),10.72,4.29,,,0 CDM,2500000005_67457092400,NDC Description Not Available,201.49,80.6,,,0 CDM,2500000005_67457092500,NDC Description Not Available,126.96,50.78,,,0 CDM,2500000005_67684190102,Lipiodol: 1 Vial In 1 Carton (67684-1901-2) / 10 Ml In 1 Vial,5805.77,2322.31,,,0 CDM,2500000005_67850003200,NDC Description Not Available,8.86,3.54,,,0 CDM,2500000005_67850014100,NDC Description Not Available,99.44,39.78,,,0 CDM,2500000005_67850014105,Asclera: 2 Ml In 1 Ampule (67850-141-05),14.62,5.85,,,0 CDM,2500000005_67877067362,Rufinamide: 1 Bottle In 1 Carton (67877-673-62) / 460 Ml In 1 Bottle,44.23,17.69,,,0 CDM,2500000005_68084022011,NDC Description Not Available,1.53,0.61,,,0 CDM,2500000005_68094014720,Dexmedetomidine Hydrochloride In Sodium Chloride: 20 Bottle In 1 Carton (68094-147-20) / 50 Ml In 1 Bottle (68094-147-01),11.39,4.56,,,0 CDM,2500000005_68094024701,NDC Description Not Available,103.38,41.35,,,0 CDM,2500000005_68094076359,NDC Description Not Available,29.74,11.9,,,0 CDM,2500000005_68180096301,"Albuterol Sulfate: 1 Canister In 1 Carton (68180-963-01) / 200 Aerosol, Metered In 1 Canister",102.17,40.87,,,0 CDM,2500000005_68382039501,NDC Description Not Available,10672.83,4269.13,,,0 CDM,2500000005_68382039504,"Ribavirin: 4 Vial In 1 Carton (68382-395-04) / 1 Powder, For Solution In 1 Vial",20000.0,8000.0,,,0 CDM,2500000005_68382047001,"Indomethacin: 1 Vial In 1 Carton (68382-470-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",102.15,40.86,,,0 CDM,2500000005_68382052960,Cholestyramine: 60 Pouch In 1 Carton (68382-529-60) / 5.5 G In 1 Pouch,36.12,14.45,,,0 CDM,2500000005_68462010530,"Ondansetron: 30 Tablet, Film Coated In 1 Bottle (68462-105-30)",0.4,0.16,,,0 CDM,2500000005_68462015713,"Ondansetron: 30 Tablet, Orally Disintegrating In 1 Box, Unit-Dose (68462-157-13)",1.13,0.45,,,0 CDM,2500000005_68462015740,NDC Description Not Available,0.5,0.2,,,0 CDM,2500000005_68547050102,"Giapreza: 1 Vial, Single-Dose In 1 Carton (68547-501-02) / 1 Ml In 1 Vial, Single-Dose",7451.77,2980.71,,,0 CDM,2500000005_68803061210,"Visionblue: 10 Pouch In 1 Carton (68803-612-10) / 1 Syringe, Glass In 1 Pouch / .5 Ml In 1 Syringe, Glass",29.24,11.7,,,0 CDM,2500000005_68803072205,"Tissueblue: 10 Pouch In 1 Carton (68803-722-05) / 1 Syringe, Glass In 1 Pouch / .5 Ml In 1 Syringe, Glass",234.34,93.74,,,0 CDM,2500000005_68803072225,NDC Description Not Available,212.4,84.96,,,0 CDM,2500000005_69097014260,Albuterol Sulfate: 1 Canister In 1 Carton (69097-142-60) / 200 Inhalant In 1 Canister,78.53,31.41,,,0 CDM,2500000005_69097017364,Ipratropium Bromide And Albuterol Sulfate: 12 Pouch In 1 Carton (69097-173-64) / 5 Vial In 1 Pouch / 3 Ml In 1 Vial,1.13,0.45,,,0 CDM,2500000005_69097084064,Ipratropium Bromide And Albuterol Sulfate: 2 Pouch In 1 Carton (69097-840-64) / 30 Vial In 1 Pouch / 3 Ml In 1 Vial,1.01,0.4,,,0 CDM,2500000005_69097084087,Ipratropium Bromide And Albuterol Sulfate: 1 Pouch In 1 Carton (69097-840-87) / 30 Vial In 1 Pouch / 3 Ml In 1 Vial,1.3,0.52,,,0 CDM,2500000005_69238138003,Difluprednate: 1 Bottle In 1 Carton (69238-1380-3) / 5 Ml In 1 Bottle,753.71,301.48,,,0 CDM,2500000005_69238172907,Enalapril Maleate: 1 Bottle In 1 Carton (69238-1729-7) / 150 Ml In 1 Bottle,9.31,3.72,,,0 CDM,2500000005_69238214107,Enalapril Maleate: 1 Bottle In 1 Carton (69238-2141-7) / 150 Ml In 1 Bottle,11.01,4.4,,,0 CDM,2500000005_69367033360,"Levetiracetam Er: 60 Tablet, Film Coated, Extended Release In 1 Bottle, Plastic (69367-333-60)",1.72,0.69,,,0 CDM,2500000005_69374051550,NDC Description Not Available,230.0,92.0,,,0 CDM,2500000005_69374090105,NDC Description Not Available,39.74,15.9,,,0 CDM,2500000005_69374098255,NDC Description Not Available,26.45,10.58,,,0 CDM,2500000005_69374098810,NDC Description Not Available,880.0,352.0,,,0 CDM,2500000005_69452020913,"Nimodipine: 3 Blister Pack In 1 Carton (69452-209-13) / 10 Capsule, Liquid Filled In 1 Blister Pack",7.78,3.11,,,0 CDM,2500000005_69547035302,"Narcan: 2 Vial, Single-Dose In 1 Package (69547-353-02) / .1 Ml In 1 Vial, Single-Dose",269.36,107.74,,,0 CDM,2500000005_69547062702,"Narcan: 2 Vial, Single-Dose In 1 Carton (69547-627-02) / .1 Ml In 1 Vial, Single-Dose",103.5,41.4,,,0 CDM,2500000005_69784023010,"Sodium Acetate: 50 Ml In 1 Vial, Pharmacy Bulk Package (69784-230-10)",196.54,78.62,,,0 CDM,2500000005_69784023020,"Sodium Acetate: 50 Ml In 1 Vial, Pharmacy Bulk Package (69784-230-20)",2.51,1.0,,,0 CDM,2500000005_69784023110,"Sodium Acetate: 100 Ml In 1 Vial, Pharmacy Bulk Package (69784-231-10)",1.45,0.58,,,0 CDM,2500000005_69784023120,"Sodium Acetate: 100 Ml In 1 Vial, Pharmacy Bulk Package (69784-231-20)",76.15,30.46,,,0 CDM,2500000005_69918073110,"Isoproterenol Hydrochloride: 10 Vial, Single-Dose In 1 Carton (69918-731-10) / 1 Ml In 1 Vial, Single-Dose",322.17,128.87,,,0 CDM,2500000005_69918073501,NDC Description Not Available,616.0,246.4,,,0 CDM,2500000005_69918073510,"Isoproterenol Hydrochloride: 10 Vial, Single-Dose In 1 Carton (69918-735-10) / 5 Ml In 1 Vial, Single-Dose",531.81,212.72,,,0 CDM,2500000005_70000032301,"Miconazole Nitrate: 71 G In 1 Bottle, With Applicator (70000-0323-1)",11.29,4.52,,,0 CDM,2500000005_70000041503,Leader Clearlax: 510 G In 1 Bottle (70000-0415-3),0.71,0.28,,,0 CDM,2500000005_70000042901,Glycerin: 25 Suppository In 1 Jar (70000-0429-1),0.15,0.06,,,0 CDM,2500000005_70000067901,"Antifungal Powder: 71 G In 1 Bottle, Plastic (70000-0679-1)",11.29,4.52,,,0 CDM,2500000005_70069001301,NDC Description Not Available,1.52,0.61,,,0 CDM,2500000005_70069015101,Cisatracurium Besylate: 1 Vial In 1 Carton (70069-151-01) / 20 Ml In 1 Vial,434.83,173.93,,,0 CDM,2500000005_70069015110,Cisatracurium Besylate: 10 Vial In 1 Carton (70069-151-10) / 20 Ml In 1 Vial,486.96,194.78,,,0 CDM,2500000005_70069016110,"Cisatracurium Besylate: 10 Vial, Multi-Dose In 1 Carton (70069-161-10) / 10 Ml In 1 Vial, Multi-Dose",26.64,10.66,,,0 CDM,2500000005_70069026101,Sodium Nitroprusside: 1 Vial In 1 Carton (70069-261-01) / 2 Ml In 1 Vial,44.02,17.61,,,0 CDM,2500000005_70069027101,NDC Description Not Available,44.36,17.74,,,0 CDM,2500000005_70069027105,Verapamil Hydrochloride: 5 Vial In 1 Carton (70069-271-05) / 2 Ml In 1 Vial (70069-271-01),10.03,4.01,,,0 CDM,2500000005_70069036210,Sulfamethoxazole And Trimethoprim: 10 Vial In 1 Carton (70069-362-10) / 10 Ml In 1 Vial (70069-362-01),27.88,11.15,,,0 CDM,2500000005_70069036301,Sulfamethoxazole And Trimethoprim: 1 Vial In 1 Carton (70069-363-01) / 30 Ml In 1 Vial,52.42,20.97,,,0 CDM,2500000005_70092100944,NDC Description Not Available,8.47,3.39,,,0 CDM,2500000005_70092106807,NDC Description Not Available,96.8,38.72,,,0 CDM,2500000005_70092110336,NDC Description Not Available,102.52,41.01,,,0 CDM,2500000005_70092111536,NDC Description Not Available,0.44,0.18,,,0 CDM,2500000005_70092111944,NDC Description Not Available,15.54,6.22,,,0 CDM,2500000005_70092113243,NDC Description Not Available,2.9,1.16,,,0 CDM,2500000005_70092125575,NDC Description Not Available,219.03,87.61,,,0 CDM,2500000005_70092131046,NDC Description Not Available,95.7,38.28,,,0 CDM,2500000005_70092143350,NDC Description Not Available,229.38,91.75,,,0 CDM,2500000005_70092200944,NDC Description Not Available,8.61,3.44,,,0 CDM,2500000005_70092911944,NDC Description Not Available,13.51,5.4,,,0 CDM,2500000005_70095005001,NDC Description Not Available,149.59,59.84,,,0 CDM,2500000005_70100042401,NDC Description Not Available,70.84,28.34,,,0 CDM,2500000005_70100042402,"Indocyanine Green: 6 Package In 1 Carton (70100-424-02) / 1 Kit In 1 Package * 1 Injection, Powder, Lyophilized, For Solution In 1 Vial * 10 Ml In 1 Vial, Plastic (0409-4887-17)",767.11,306.84,,,0 CDM,2500000005_70121138801,NDC Description Not Available,40.48,16.19,,,0 CDM,2500000005_70121138901,NDC Description Not Available,365.24,146.1,,,0 CDM,2500000005_70121157601,NDC Description Not Available,14.53,5.81,,,0 CDM,2500000005_70121157607,Norepinephrine Bitartrate: 10 Vial In 1 Carton (70121-1576-7) / 4 Ml In 1 Vial (70121-1576-1),14.52,5.81,,,0 CDM,2500000005_70121163701,NDC Description Not Available,12.37,4.95,,,0 CDM,2500000005_70121163705,"Ephedrine Sulfate: 25 Vial, Single-Dose In 1 Carton (70121-1637-5) / 1 Ml In 1 Vial, Single-Dose (70121-1637-1)",6.89,2.76,,,0 CDM,2500000005_70121168001,Carboprost Tromethamine: 1 Vial In 1 Carton (70121-1680-1) / 1 Ml In 1 Vial,309.34,123.74,,,0 CDM,2500000005_70121168007,Carboprost Tromethamine: 10 Vial In 1 Carton (70121-1680-7) / 1 Ml In 1 Vial,309.34,123.74,,,0 CDM,2500000005_70121171203,Dexmedetomidine Hydrochloride: 12 Pouch In 1 Carton (70121-1712-3) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,86.02,34.41,,,0 CDM,2500000005_70436020780,"Sodium Nitroprusside In 0.9% Sodium Chloride: 1 Vial, Single-Dose In 1 Carton (70436-207-80) / 100 Ml In 1 Vial, Single-Dose",181.44,72.58,,,0 CDM,2500000005_70512085901,NDC Description Not Available,564.7,225.88,,,0 CDM,2500000005_70594009001,NDC Description Not Available,8.31,3.32,,,0 CDM,2500000005_70594011201,NDC Description Not Available,189.73,75.89,,,0 CDM,2500000005_70594011202,Carboprost Tromethamine: 10 Vial In 1 Carton (70594-112-02) / 1 Ml In 1 Vial (70594-112-01),190.63,76.25,,,0 CDM,2500000005_70710183801,NDC Description Not Available,1287.96,515.18,,,0 CDM,2500000005_70756064125,Lidocaine Hydrochloride: 25 Vial In 1 Carton (70756-641-25) / 5 Ml In 1 Vial,3.9,1.56,,,0 CDM,2500000005_70860011999,Nafcillin: 1 Bottle In 1 Carton (70860-119-99) / 100 Ml In 1 Bottle,86.42,34.57,,,0 CDM,2500000005_70860030105,Diltiazem Hydrochloride: 10 Vial In 1 Carton (70860-301-05) / 5 Ml In 1 Vial (70860-301-41),6.72,2.69,,,0 CDM,2500000005_70860030125,Diltiazem Hydrochloride: 10 Vial In 1 Carton (70860-301-25) / 25 Ml In 1 Vial (70860-301-43),34.86,13.94,,,0 CDM,2500000005_70860030141,NDC Description Not Available,9.52,3.81,,,0 CDM,2500000005_70860030143,NDC Description Not Available,40.04,16.02,,,0 CDM,2500000005_70860040010,Tranexamic Acid: 10 Vial In 1 Carton (70860-400-10) / 10 Ml In 1 Vial (70860-400-41),8.6,3.44,,,0 CDM,2500000005_70860045110,Levothyroxine Sodium: 1 VIAL in 1 CARTON (70860-451-10) / 5 mL in 1 VIAL,244.72,97.89,,,0 CDM,2500000005_71225013201,NDC Description Not Available,47.15,18.86,,,0 CDM,2500000005_71225013301,NDC Description Not Available,87.86,35.14,,,0 CDM,2500000005_71266503501,NDC Description Not Available,0.58,0.23,,,0 CDM,2500000005_71266507201,NDC Description Not Available,78.2,31.28,,,0 CDM,2500000005_71266508201,NDC Description Not Available,74.67,29.87,,,0 CDM,2500000005_71266510001,NDC Description Not Available,68.2,27.28,,,0 CDM,2500000005_71266510301,NDC Description Not Available,68.18,27.27,,,0 CDM,2500000005_71266513001,NDC Description Not Available,88.55,35.42,,,0 CDM,2500000005_71266523001,NDC Description Not Available,43.48,17.39,,,0 CDM,2500000005_71266650901,NDC Description Not Available,316.31,126.52,,,0 CDM,2500000005_71266651901,NDC Description Not Available,305.77,122.31,,,0 CDM,2500000005_71266664101,NDC Description Not Available,17.53,7.01,,,0 CDM,2500000005_71266802001,NDC Description Not Available,630.6,252.24,,,0 CDM,2500000005_71266861301,NDC Description Not Available,52.44,20.98,,,0 CDM,2500000005_71266901101,NDC Description Not Available,0.53,0.21,,,0 CDM,2500000005_71266908002,NDC Description Not Available,11.26,4.5,,,0 CDM,2500000005_71266908004,NDC Description Not Available,8.78,3.51,,,0 CDM,2500000005_71285020201,NDC Description Not Available,262.44,104.98,,,0 CDM,2500000005_71288003020,NDC Description Not Available,71.09,28.44,,,0 CDM,2500000005_71288041401,NDC Description Not Available,3.61,1.44,,,0 CDM,2500000005_71288041403,"Glycopyrrolate: 25 Vial, Single-Dose In 1 Carton (71288-414-03) / 1 Ml In 1 Vial, Single-Dose (71288-414-01)",11.69,4.68,,,0 CDM,2500000005_71288050502,NDC Description Not Available,24.17,9.67,,,0 CDM,2500000005_71288050503,"Dexmedetomidine: 25 Vial, Single-Dose In 1 Carton (71288-505-03) / 2 Ml In 1 Vial, Single-Dose (71288-505-02)",10.48,4.19,,,0 CDM,2500000005_71288070005,NDC Description Not Available,7.21,2.88,,,0 CDM,2500000005_71288070006,"Rocuronium Bromide: 10 Vial, Multi-Dose In 1 Carton (71288-700-06) / 5 Ml In 1 Vial, Multi-Dose (71288-700-05)",19.26,7.7,,,0 CDM,2500000005_71288071410,NDC Description Not Available,15.54,6.22,,,0 CDM,2500000005_71288071411,"Cisatracurium Besylate: 10 Vial, Multi-Dose In 1 Carton (71288-714-11) / 10 Ml In 1 Vial, Multi-Dose (71288-714-10)",37.62,15.05,,,0 CDM,2500000005_71351001099,NDC Description Not Available,0.1,0.04,,,0 CDM,2500000005_71351002105,NDC Description Not Available,4.29,1.72,,,0 CDM,2500000005_71506002859,NDC Description Not Available,63.31,25.32,,,0 CDM,2500000005_71506004645,NDC Description Not Available,7.96,3.18,,,0 CDM,2500000005_71506006058,NDC Description Not Available,292.64,117.06,,,0 CDM,2500000005_71656006620,Likmez: 200 Ml In 1 Bottle (71656-066-20),16.49,6.6,,,0 CDM,2500000005_71699005030,"Xcopri: 30 Tablet, Film Coated In 1 Bottle (71699-050-30)",112.43,44.97,,,0 CDM,2500000005_71699020030,"Xcopri: 30 Tablet, Film Coated In 1 Bottle (71699-200-30)",119.84,47.94,,,0 CDM,2500000005_71839013701,NDC Description Not Available,176.7,70.68,,,0 CDM,2500000005_71839014325,"Norepinephrine Bitartrate: 25 Vial, Single-Dose In 1 Carton (71839-143-25) / 4 Ml In 1 Vial, Single-Dose (71839-143-01)",23.92,9.57,,,0 CDM,2500000005_72078003401,"Ultiva: 10 Vial, Glass In 1 Carton (72078-034-01) / 3 Ml In 1 Vial, Glass (72078-034-00)",446.45,178.58,,,0 CDM,2500000005_72078003502,"Ultiva: 10 Vial, Glass In 1 Carton (72078-035-02) / 5 Ml In 1 Vial, Glass (72078-035-00)",400.37,160.15,,,0 CDM,2500000005_72266014601,NDC Description Not Available,16.15,6.46,,,0 CDM,2500000005_72266014610,Etomidate: 10 Vial In 1 Carton (72266-146-10) / 10 Ml In 1 Vial (72266-146-01),11.95,4.78,,,0 CDM,2500000005_72266014710,Etomidate: 10 Vial In 1 Carton (72266-147-10) / 20 Ml In 1 Vial (72266-147-01),8.56,3.42,,,0 CDM,2500000005_72485010805,Verapamil Hydrochloride: 5 Vial In 1 Carton (72485-108-05) / 2 Ml In 1 Vial (72485-108-01),16.84,6.74,,,0 CDM,2500000005_72485040601,NDC Description Not Available,0.18,0.07,,,0 CDM,2500000005_72485051001,NDC Description Not Available,8.33,3.33,,,0 CDM,2500000005_72572065001,NDC Description Not Available,8.22,3.29,,,0 CDM,2500000005_72611074001,NDC Description Not Available,3.49,1.4,,,0 CDM,2500000005_72611074010,"Metoprolol Tartrate: 10 Vial, Single-Dose In 1 Carton (72611-740-10) / 5 Ml In 1 Vial, Single-Dose (72611-740-01)",2.59,1.04,,,0 CDM,2500000005_72611075601,NDC Description Not Available,21.29,8.52,,,0 CDM,2500000005_72611075610,"Rocuronium Bromide: 10 Vial, Multi-Dose In 1 Carton (72611-756-10) / 5 Ml In 1 Vial, Multi-Dose (72611-756-01)",13.25,5.3,,,0 CDM,2500000005_72611075701,NDC Description Not Available,26.87,10.75,,,0 CDM,2500000005_72626270101,"Sofosbuvir And Velpatasvir: 2 Blister Pack In 1 Carton (72626-2701-1) / 14 Tablet, Film Coated In 1 Blister Pack",722.8,289.12,,,0 CDM,2500000005_72888017530,"Desvenlafaxine: 30 Tablet, Extended Release In 1 Package (72888-175-30)",1.72,0.69,,,0 CDM,2500000005_73177014633,NDC Description Not Available,163.78,65.51,,,0 CDM,2500000005_73177016333,NDC Description Not Available,147.56,59.02,,,0 CDM,2500000005_73302045601,Ella: 1 Blister Pack In 1 Carton (73302-456-01) / 1 Tablet In 1 Blister Pack,117.07,46.83,,,0 CDM,2500000005_74300000071,NDC Description Not Available,24.09,9.64,,,0 CDM,2500000005_74312000640,NDC Description Not Available,0.34,0.14,,,0 CDM,2500000005_75987005006,Ravicti: 1 Bottle In 1 Carton (75987-050-06) / 25 Ml In 1 Bottle,6311.43,2524.57,,,0 CDM,2500000005_76154047515,NDC Description Not Available,6.6,2.64,,,0 CDM,2500000005_76204002160,NDC Description Not Available,1.76,0.7,,,0 CDM,2500000005_76204002260,NDC Description Not Available,1.23,0.49,,,0 CDM,2500000005_76204010001,Ipratropium Bromide: 30 Pouch In 1 Carton (76204-100-01) / 1 Ampule In 1 Pouch / 2.5 Ml In 1 Ampule,0.5,0.2,,,0 CDM,2500000005_76204020001,Albuterol Sulfate: 30 Pouch In 1 Carton (76204-200-01) / 1 Ampule In 1 Pouch / 3 Ml In 1 Ampule,0.93,0.37,,,0 CDM,2500000005_76204060001,Ipratropium Bromide And Albuterol Sulfate: 30 Pouch In 1 Carton (76204-600-01) / 1 Ampule In 1 Pouch / 3 Ml In 1 Ampule,1.99,0.8,,,0 CDM,2500000005_76329301105,"Lidocaine Hydrochloride: 25 Vial, Single-Use In 1 Box (76329-3011-5) / 5 Ml In 1 Vial, Single-Use",17.07,6.83,,,0 CDM,2500000005_76329301205,"Lidocaine Hydrochloride: 25 Vial, Single-Use In 1 Box (76329-3012-5) / 5 Ml In 1 Vial, Single-Use",16.89,6.76,,,0 CDM,2500000005_76329330201,Dextrose Monohydrate: 1 Syringe In 1 Carton (76329-3302-1) / 50 Ml In 1 Syringe,56.8,22.72,,,0 CDM,2500000005_76329330401,Calcium Chloride: 10 Syringe In 1 Package (76329-3304-1) / 10 Ml In 1 Syringe,43.93,17.57,,,0 CDM,2500000005_76329335201,Sodium Bicarbonate: 1 Syringe In 1 Carton (76329-3352-1) / 50 Ml In 1 Syringe,72.81,29.12,,,0 CDM,2500000005_80681017200,NDC Description Not Available,2.17,0.87,,,0 CDM,2500000005_80830169101,NDC Description Not Available,247.64,99.06,,,0 CDM,2500000005_80830169102,"Potassium Phosphates: 10 Vial, Single-Dose In 1 Carton (80830-1691-2) / 15 Ml In 1 Vial, Single-Dose (80830-1691-1)",282.12,112.85,,,0 CDM,2500000005_80830232901,NDC Description Not Available,90.2,36.08,,,0 CDM,2500000005_81033006620,Likmez: 200 Ml In 1 Bottle (81033-066-20),32.31,12.92,,,0 CDM,2500000005_81284031500,NDC Description Not Available,2044.16,817.66,,,0 CDM,2500000005_81284061100,NDC Description Not Available,5.47,2.19,,,0 CDM,2500000005_81284061110,"Tranexamic Acid: 10 Vial, Single-Dose In 1 Carton (81284-611-10) / 10 Ml In 1 Vial, Single-Dose (81284-611-00)",20.84,8.34,,,0 CDM,2500000005_81298501001,NDC Description Not Available,653.7,261.48,,,0 CDM,2500000005_81298762001,NDC Description Not Available,46.28,18.51,,,0 CDM,2500000005_81298762003,Sodium Bicarbonate: 20 Vial In 1 Carton (81298-7620-3) / 50 Ml In 1 Vial (81298-7620-1),38.52,15.41,,,0 CDM,2500000005_81298866001,NDC Description Not Available,316.8,126.72,,,0 CDM,2500000005_81298866003,"Ak-Fluor: 12 Vial, Glass In 1 Carton (81298-8660-3) / 5 Ml In 1 Vial, Glass (81298-8660-1)",124.97,49.99,,,0 CDM,2500000005_81298965501,NDC Description Not Available,197.81,79.12,,,0 CDM,2500000005_81298965503,Norepinephrine: 10 Pouch In 1 Box (81298-9655-3) / 1 Bag In 1 Pouch (81298-9655-1) / 250 Ml In 1 Bag,138.0,55.2,,,0 CDM,2500000005_81298965801,NDC Description Not Available,257.6,103.04,,,0 CDM,2500000005_81665020025,Sodium Bicarbonate: 25 Vial In 1 Carton (81665-200-25) / 50 Ml In 1 Vial (81665-200-01),65.32,26.13,,,0 CDM,2500000005_82154044901,"Pegasys: 1 Vial, Single-Use In 1 Box (82154-0449-1) / 1 Ml In 1 Vial, Single-Use",4899.05,1959.62,,,0 CDM,2500000005_82667060005,"Maxidex: 1 Bottle, Plastic In 1 Carton (82667-600-05) / 5 Ml In 1 Bottle, Plastic",24.79,9.92,,,0 CDM,2500000005_83490020760,NDC Description Not Available,4.26,1.7,,,0 CDM,2500000005_83490030760,NDC Description Not Available,0.88,0.35,,,0 CDM,2500000005_83634030342,NDC Description Not Available,249.14,99.66,,,0 CDM,2500000005_83634040110,"Tranexamic Acid: 10 Vial, Single-Dose In 1 Carton (83634-401-10) / 10 Ml In 1 Vial, Single-Dose (83634-401-41)",0.62,0.25,,,0 CDM,2500000005_83634040141,NDC Description Not Available,9.85,3.94,,,0 CDM,2500000005_99999000564,NDC Description Not Available,118.68,47.47,,,0 CDM,2500000005_99999999910,NDC Description Not Available,10.49,4.2,,,0 CDM,2500000006_00264220100,Sodium Chloride: 16 Container In 1 Case (0264-2201-00) / 1000 Ml In 1 Container,12.0,4.8,,,0 CDM,2500000006_00338000404,"Sterile Water: 12 Bottle, Plastic In 1 Carton (0338-0004-04) / 1000 Ml In 1 Bottle, Plastic",1.85,0.74,,,0 CDM,2500000006_00338004804,"Sodium Chloride: 12 Bottle, Plastic In 1 Carton (0338-0048-04) / 1000 Ml In 1 Bottle, Plastic",4.23,1.69,,,0 CDM,2500000006_00338013727,Lactated Ringers: 3000 Ml In 1 Bag (0338-0137-27),2.51,1.0,,,0 CDM,2500000006_00338022104,Plasma-Lyte A: 1000 Ml In 1 Bag (0338-0221-04),25.39,10.16,,,0 CDM,2500000006_00409488802,NDC Description Not Available,2.93,1.17,,,0 CDM,2500000006_24571011606,Phoxillum Bk4/2.5: 2 Bag In 1 Case (24571-116-06) / 5 L In 1 Bag,132.0,52.8,,,0 CDM,2500000009,Hc Executive Health Flu Vaccine,120.0,48.0,,,0 CDM,2500000010,Hc Baclofen Powder,20.88,8.35,,,0 CDM,2500000011,Hc Bupivacaine 0.5%/1Ml (50Ml Mdv,0.2,0.08,,,0 CDM,2500000012,Hc Bupivacaine Pwd Comp/1Mg,0.14,0.06,,,0 CDM,2500000013,Hc Clonidine Pwd Comp/1Mg,0.87,0.35,,,0 CDM,2500000014,Hc Balofen Powder Comp/1Mcg,0.02,0.01,,,0 CDM,2500000015,Hc Clonidine Pwd Comp/1Mcg,0.02,0.01,,,0 CDM,2500000016,Hc Hydromorphone Compounding Powder 1 Mg,1.98,0.79,,,0 CDM,2500000017,Hc Morphine Compounding Powder 1 Mg,0.97,0.39,,,0 CDM,2500000018,Hc Executive Health Pneumovax Vaccine,248.0,99.2,,,0 CDM,2500000019,Hc Executive Health Prevnar Vaccine,422.0,168.8,,,0 CDM,2500000020,Hc Executive Health Tetanus (Td) Vaccine,215.0,86.0,,,0 CDM,25000000S1_120138,Hc Sup Shell 250 Revenue Code Without Hcpcs,3408.75,1363.5,,,0 CDM,25000000S1_120139,Hc Sup Shell 250 Revenue Code Without Hcpcs,2913.75,1165.5,,,0 CDM,25000000S1_137917,Hc Sup Shell 250 Revenue Code Without Hcpcs,1777.75,711.1,,,0 CDM,25000000S1_137959,Hc Sup Shell 250 Revenue Code Without Hcpcs,778.73,311.49,,,0 CDM,25000000S1_150419,Hc Sup Shell 250 Revenue Code Without Hcpcs,1046.14,418.46,,,0 CDM,25000000S1_150420,Hc Sup Shell 250 Revenue Code Without Hcpcs,2567.21,1026.88,,,0 CDM,25000000S1_164961,Hc Sup Shell 250 Revenue Code Without Hcpcs,140.55,56.22,,,0 CDM,2509066201_49281012488,NDC Description Not Available,322.8,129.12,,,0 CDM,2509068601_19515081041,NDC Description Not Available,67.9,27.16,,,0 CDM,2509068601_19515081841,NDC Description Not Available,69.7,27.88,,,0 CDM,2509071501_90715_250,Noncdm Charge Record Pharmacy,158.58,63.43,,,0 CDM,2509075001,Hc Zoster Hzv (Shingles) Vaccine Recombinant Adjuvanted Intramuscular Use,593.92,237.57,,,0 CDM,2509075001_50090514700,Shingrix: 1 KIT in 1 KIT (50090-5147-0) * .5 mL in 1 VIAL (58160-828-01) * .5 mL in 1 VIAL (58160-829-01),593.92,237.57,,,0 CDM,2509075001_58160082311,Shingrix: 1 Kit In 1 Carton (58160-823-11) * .5 Ml In 1 Vial (58160-828-03) * .5 Ml In 1 Vial (58160-829-03),593.92,237.57,,,0 CDM,2509075001_58160082803,NDC Description Not Available,578.46,231.38,,,0 CDM,2509075001_58160082903,NDC Description Not Available,593.92,237.57,,,0 CDM,250C9250S1_137883,Hc Sup Shell 250 Revenue Code C9250 Hcpcs,3249.38,1299.75,,,0 CDM,250C9250S1_137884,"Tisseel Fibrin Sealant: 1 Kit In 1 Carton (0338-4302-04) * 2 Ml In 1 Vial, Glass (0338-7332-02) * 2 Ml In 1 Vial, Glass (0338-7201-02) * 2 Ml In 1 Vial, Glass (0338-7401-02) * 2 Ml In 1 Vial, ",1451.81,580.72,,,0 CDM,250J047501,Hc Baclofen/10Mg (1Mg/Ml-20Ml),809.37,323.75,,,0 CDM,250J047502,Hc Baclofen 10Mg/0.5Mg/Ml 20Ml,821.1,328.44,,,0 CDM,250J047503,Hc Baclofen 10Mg/2Mg/Ml 20Ml,761.25,304.5,,,0 CDM,250J058501,Hc Botulinum Toxn A/1Un(100Un-Sdv,27.65,11.06,,,0 CDM,250J058502,Hc Botulinum Toxn A/1Un-Wastage,27.65,11.06,,,0 CDM,250J058601,Hc Abobotulunum/5 Units (300 Un),39.51,15.8,,,0 CDM,250J058701,Hc Rimabtlnmtxnb/100Un (5K/Ml-2Ml,48.88,19.55,,,0 CDM,250J058702,Hc Rimabtlnmtxnb/100U-Wastage,48.76,19.5,,,0 CDM,250J058801,Hc Incobotulinum/Unit (100 Units),22.17,8.87,,,0 CDM,250J058802,Hc Incobotulinum/Unit-Wastage,23.28,9.31,,,0 CDM,250J227801,Hc Ziconotide/Mcg (100Mcg/Ml),33.12,13.25,,,0 CDM,250Q4107S1_153353,Hc Sup Shell 250 Revenue Code Q4107 Hcpcs,9288.75,3715.5,,,0 CDM,254Q995701,Hc Definity Perflutren/Ml,215.81,86.32,,,0 CDM,2550000001_50419032005,"Eovist: 5 Vial, Single-Dose In 1 Box (50419-320-05) / 10 Ml In 1 Vial, Single-Dose",81.14,32.46,,,0 CDM,2550000002_00019086250,"Cysto-Conray Ii: 12 Bottle, Glass In 1 Box (0019-0862-50) / 250 Ml In 1 Bottle, Glass",0.66,0.26,,,0 CDM,2550000002_00270709916,Lumason: 5 Kit In 1 Box (0270-7099-16) / 1 Kit In 1 Kit * 25 Mg In 1 Vial * 5 Ml In 1 Syringe,154.05,61.62,,,0 CDM,2550000002_00407141110,"Omnipaque: 10 Vial, Glass In 1 Box (0407-1411-10) / 10 Ml In 1 Vial, Glass",20.33,8.13,,,0 CDM,2550000002_00407141120,"Omnipaque: 10 Vial, Glass In 1 Box (0407-1411-20) / 20 Ml In 1 Vial, Glass",10.53,4.21,,,0 CDM,2550000002_00407141230,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1412-30) / 50 Ml In 1 Bottle, Plastic",3.89,1.56,,,0 CDM,2550000002_00407141234,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1412-34) / 150 Ml In 1 Bottle, Plastic",0.37,0.15,,,0 CDM,2550000002_00407141310,"Omnipaque: 10 Vial, Glass In 1 Box (0407-1413-10) / 10 Ml In 1 Vial, Glass",15.8,6.32,,,0 CDM,2550000002_00407141359,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1413-59) / 30 Ml In 1 Bottle, Plastic",10.55,4.22,,,0 CDM,2550000002_00407141361,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1413-61) / 50 Ml In 1 Bottle, Plastic",6.14,2.46,,,0 CDM,2550000002_00407141363,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1413-63) / 100 Ml In 1 Bottle, Plastic",3.93,1.57,,,0 CDM,2550000002_00407141365,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1413-65) / 150 Ml In 1 Bottle, Plastic",4.01,1.6,,,0 CDM,2550000002_00407141489,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1414-89) / 50 Ml In 1 Bottle, Plastic",3.92,1.57,,,0 CDM,2550000002_00407141491,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1414-91) / 100 Ml In 1 Bottle, Plastic",4.67,1.87,,,0 CDM,2550000002_00407141494,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1414-94) / 200 Ml In 1 Bottle, Plastic",7.13,2.85,,,0 CDM,2550000002_00407222316,"Visipaque: 10 Bottle, Plastic In 1 Box (0407-2223-16) / 50 Ml In 1 Bottle, Plastic",6.33,2.53,,,0 CDM,2550000002_00407222317,"Visipaque: 10 Bottle, Plastic In 1 Box (0407-2223-17) / 100 Ml In 1 Bottle, Plastic",1.88,0.75,,,0 CDM,2550000002_00407222319,"Visipaque: 10 Bottle, Plastic In 1 Box (0407-2223-19) / 150 Ml In 1 Bottle, Plastic",3.92,1.57,,,0 CDM,2550000002_00407222321,"Visipaque: 10 Bottle, Plastic In 1 Box (0407-2223-21) / 200 Ml In 1 Bottle, Plastic",1.68,0.67,,,0 CDM,2550000002_00407294301,"Clariscan: 10 Vial, Glass In 1 Box (0407-2943-01) / 10 Ml In 1 Vial, Glass",1.08,0.43,,,0 CDM,2550000002_09999483022,NDC Description Not Available,0.48,0.19,,,0 CDM,2550000002_11994001104,"Definity: 4 Vial, Glass In 1 Carton (11994-011-04) / 1.5 Ml In 1 Vial, Glass",1132.19,452.88,,,0 CDM,2550000002_11994001116,"Definity: 16 Vial, Glass In 1 Carton (11994-011-16) / 1.5 Ml In 1 Vial, Glass",727.23,290.89,,,0 CDM,2550000002_50419032501,NDC Description Not Available,4.16,1.66,,,0 CDM,2550000002_50419032502,NDC Description Not Available,4.25,1.7,,,0 CDM,2550000002_50419032507,NDC Description Not Available,5.26,2.1,,,0 CDM,2550000002_50419032511,"Gadavist: 2 Carton In 1 Box (50419-325-11) / 10 Vial, Single-Dose In 1 Carton / 7.5 Ml In 1 Vial, Single-Dose",5.82,2.33,,,0 CDM,2550000002_50419032512,"Gadavist: 2 Carton In 1 Box (50419-325-12) / 10 Vial, Single-Dose In 1 Carton / 10 Ml In 1 Vial, Single-Dose",1.57,0.63,,,0 CDM,2550000002_50419032513,"Gadavist: 2 Carton In 1 Box (50419-325-13) / 10 Vial, Single-Dose In 1 Carton / 15 Ml In 1 Vial, Single-Dose",1.73,0.69,,,0 CDM,2550000002_50419032537,"Gadavist: 15 Carton In 1 Box (50419-325-37) / 3 Vial, Single-Dose In 1 Carton / 2 Ml In 1 Vial, Single-Dose",5.35,2.14,,,0 CDM,2550000002_65219038302,NDC Description Not Available,4.07,1.63,,,0 CDM,2550000002_65219038304,NDC Description Not Available,4.62,1.85,,,0 CDM,2550000002_65219038305,"Iodixanol: 10 Bottle, Plastic In 1 Box (65219-383-05) / 50 Ml In 1 Bottle, Plastic (65219-383-02)",1.29,0.52,,,0 CDM,2550000002_65219038306,NDC Description Not Available,2.29,0.92,,,0 CDM,2550000002_65219038310,"Iodixanol: 10 Bottle, Plastic In 1 Box (65219-383-10) / 100 Ml In 1 Bottle, Plastic (65219-383-04)",4.06,1.62,,,0 CDM,2550000002_65219038350,"Iodixanol: 10 Bottle, Plastic In 1 Box (65219-383-50) / 150 Ml In 1 Bottle, Plastic (65219-383-06)",3.73,1.49,,,0 CDM,2550000002_67684190102,Lipiodol: 1 Vial In 1 Carton (67684-1901-2) / 10 Ml In 1 Vial,4887.96,1955.18,,,0 CDM,2550000002_67684200101,Dotarem: 10 Vial In 1 Package (67684-2001-1) / 10 Ml In 1 Vial,1.47,0.59,,,0 CDM,2550000002_67684200102,Dotarem: 10 Vial In 1 Package (67684-2001-2) / 15 Ml In 1 Vial,1.25,0.5,,,0 CDM,2550000002_67684200103,Dotarem: 10 Vial In 1 Package (67684-2001-3) / 20 Ml In 1 Vial,0.68,0.27,,,0 CDM,2550000002_67684423002,Elucirem: 10 Vial In 1 Carton (67684-4230-2) / 3 Ml In 1 Vial,90.65,36.26,,,0 CDM,2550000002_67684423102,Elucirem: 10 Vial In 1 Carton (67684-4231-2) / 7.5 Ml In 1 Vial,72.54,29.02,,,0 CDM,2550000002_67684423202,Elucirem: 10 Vial In 1 Carton (67684-4232-2) / 10 Ml In 1 Vial,81.06,32.42,,,0 CDM,2580000001_00009043601,R-Gene: 1 Container In 1 Carton (0009-0436-01) / 300 Ml In 1 Container,180.78,72.31,,,0 CDM,2580000001_00264151031,Dextrose: 84 Container In 1 Case (0264-1510-31) / 50 Ml In 1 Container,1.2,0.48,,,0 CDM,2580000001_00264151032,Dextrose: 64 Container In 1 Case (0264-1510-32) / 100 Ml In 1 Container,4.35,1.74,,,0 CDM,2580000001_00264180031,Sodium Chloride: 84 Container In 1 Case (0264-1800-31) / 50 Ml In 1 Container,0.94,0.38,,,0 CDM,2580000001_00264180032,Sodium Chloride: 64 Container In 1 Case (0264-1800-32) / 100 Ml In 1 Container,3.2,1.28,,,0 CDM,2580000001_00264580200,Sodium Chloride: 12 Container In 1 Case (0264-5802-00) / 1000 Ml In 1 Container,12.25,4.9,,,0 CDM,2580000001_00264580210,Sodium Chloride: 24 Container In 1 Case (0264-5802-10) / 500 Ml In 1 Container,6.34,2.54,,,0 CDM,2580000001_00264580400,Sodium Chloride: 12 Container In 1 Case (0264-5804-00) / 1000 Ml In 1 Container,13.73,5.49,,,0 CDM,2580000001_00264751000,Dextrose: 12 Container In 1 Case (0264-7510-00) / 1000 Ml In 1 Container,18.53,7.41,,,0 CDM,2580000001_00264751010,Dextrose: 24 Container In 1 Case (0264-7510-10) / 500 Ml In 1 Container,1.24,0.5,,,0 CDM,2580000001_00264751020,Dextrose: 24 Container In 1 Case (0264-7510-20) / 250 Ml In 1 Container,1.7,0.68,,,0 CDM,2580000001_00264761000,Dextrose And Sodium Chloride: 12 Container In 1 Case (0264-7610-00) / 1000 Ml In 1 Container,8.8,3.52,,,0 CDM,2580000001_00264761200,Dextrose And Sodium Chloride: 12 Container In 1 Case (0264-7612-00) / 1000 Ml In 1 Container,3.36,1.34,,,0 CDM,2580000001_00264775100,Dextrose In Lactated Ringers: 12 Container In 1 Case (0264-7751-00) / 1000 Ml In 1 Container,10.81,4.32,,,0 CDM,2580000001_00264780000,Sodium Chloride: 12 Container In 1 Case (0264-7800-00) / 1000 Ml In 1 Container,11.83,4.73,,,0 CDM,2580000001_00264780009,Sodium Chloride: 12 Container In 1 Case (0264-7800-09) / 1000 Ml In 1 Container,13.2,5.28,,,0 CDM,2580000001_00264780010,Sodium Chloride: 24 Container In 1 Case (0264-7800-10) / 500 Ml In 1 Container,15.97,6.39,,,0 CDM,2580000001_00264780020,Sodium Chloride: 24 Container In 1 Case (0264-7800-20) / 250 Ml In 1 Container,5.34,2.14,,,0 CDM,2580000001_00264780200,Sodium Chloride: 12 Container In 1 Case (0264-7802-00) / 1000 Ml In 1 Container,13.54,5.42,,,0 CDM,2580000001_00264780510,Sodium Chloride: 24 Container In 1 Case (0264-7805-10) / 500 Ml In 1 Container,23.73,9.49,,,0 CDM,2580000001_00338001702,Dextrose: 250 Ml In 1 Bag (0338-0017-02),3.2,1.28,,,0 CDM,2580000001_00338001703,Dextrose: 500 Ml In 1 Bag (0338-0017-03),6.08,2.43,,,0 CDM,2580000001_00338001704,Dextrose: 1000 Ml In 1 Bag (0338-0017-04),20.77,8.31,,,0 CDM,2580000001_00338001711,Dextrose: 4 Bag In 1 Pouch (0338-0017-11) / 50 Ml In 1 Bag,5.65,2.26,,,0 CDM,2580000001_00338001718,Dextrose: 4 Bag In 1 Pouch (0338-0017-18) / 100 Ml In 1 Bag,7.46,2.98,,,0 CDM,2580000001_00338001731,Dextrose: 16 Bag In 1 Pouch (0338-0017-31) / 50 Ml In 1 Bag,7.59,3.04,,,0 CDM,2580000001_00338001741,Dextrose: 1 Bag In 1 Package (0338-0017-41) / 50 Ml In 1 Bag,2.42,0.97,,,0 CDM,2580000001_00338001748,Dextrose: 1 Bag In 1 Package (0338-0017-48) / 100 Ml In 1 Bag,4.1,1.64,,,0 CDM,2580000001_00338004303,Sodium Chloride: 500 Ml In 1 Bag (0338-0043-03),8.58,3.43,,,0 CDM,2580000001_00338004304,Sodium Chloride: 1000 Ml In 1 Bag (0338-0043-04),16.67,6.67,,,0 CDM,2580000001_00338004902,Sodium Chloride: 250 Ml In 1 Bag (0338-0049-02),12.65,5.06,,,0 CDM,2580000001_00338004903,Sodium Chloride: 500 Ml In 1 Bag (0338-0049-03),12.44,4.98,,,0 CDM,2580000001_00338004904,Sodium Chloride: 1000 Ml In 1 Bag (0338-0049-04),15.88,6.35,,,0 CDM,2580000001_00338004910,Sodium Chloride: 4 Bag In 1 Package (0338-0049-10) / 25 Ml In 1 Bag,9.2,3.68,,,0 CDM,2580000001_00338004911,Sodium Chloride: 4 Bag In 1 Package (0338-0049-11) / 50 Ml In 1 Bag,10.69,4.28,,,0 CDM,2580000001_00338004918,Sodium Chloride: 4 Bag In 1 Package (0338-0049-18) / 100 Ml In 1 Bag,8.52,3.41,,,0 CDM,2580000001_00338004938,Sodium Chloride: 16 Bag In 1 Package (0338-0049-38) / 100 Ml In 1 Bag,7.26,2.9,,,0 CDM,2580000001_00338004941,Sodium Chloride: 1 Bag In 1 Package (0338-0049-41) / 50 Ml In 1 Bag,9.77,3.91,,,0 CDM,2580000001_00338004948,Sodium Chloride: 1 Bag In 1 Package (0338-0049-48) / 100 Ml In 1 Bag,10.09,4.04,,,0 CDM,2580000001_00338005403,Sodium Chloride: 24 Bag In 1 Carton (0338-0054-03) / 500 Ml In 1 Bag,23.0,9.2,,,0 CDM,2580000001_00338008503,Dextrose And Sodium Chloride: 24 Bag In 1 Carton (0338-0085-03) / 500 Ml In 1 Bag,7.45,2.98,,,0 CDM,2580000001_00338008504,Dextrose And Sodium Chloride: 14 Bag In 1 Carton (0338-0085-04) / 1000 Ml In 1 Bag,13.8,5.52,,,0 CDM,2580000001_00338008904,Dextrose And Sodium Chloride: 14 Bag In 1 Carton (0338-0089-04) / 1000 Ml In 1 Bag,11.38,4.55,,,0 CDM,2580000001_00338012504,Lactated Ringers And Dextrose: 1000 Ml In 1 Bag (0338-0125-04),17.04,6.82,,,0 CDM,2580000001_00338055111,Dextrose: 50 Ml In 1 Bag (0338-0551-11),2.99,1.2,,,0 CDM,2580000001_00338055118,Dextrose: 100 Ml In 1 Bag (0338-0551-18),3.63,1.45,,,0 CDM,2580000001_00338055318,Sodium Chloride: 100 Ml In 1 Bag (0338-0553-18),6.04,2.42,,,0 CDM,2580000001_00338066304,Potassium Chloride In Dextrose And Sodium Chloride: 1000 Ml In 1 Bag (0338-0663-04),32.2,12.88,,,0 CDM,2580000001_00338954302,Sodium Chloride: 250 Ml In 1 Bag (0338-9543-02),12.65,5.06,,,0 CDM,2580000001_00338954303,Sodium Chloride: 500 Ml In 1 Bag (0338-9543-03),13.72,5.49,,,0 CDM,2580000001_00338954304,Sodium Chloride: 500 Ml In 1 Bag (0338-9543-04),18.4,7.36,,,0 CDM,2580000001_00338954306,Sodium Chloride: 1000 Ml In 1 Bag (0338-9543-06),30.03,12.01,,,0 CDM,2580000001_00378698501,NDC Description Not Available,1.3,0.52,,,0 CDM,2580000001_00409488803,NDC Description Not Available,3.91,1.56,,,0 CDM,2580000001_00409488820,"Sodium Chloride: 25 Vial, Single-Dose In 1 Tray (0409-4888-20) / 20 Ml In 1 Vial, Single-Dose (0409-4888-03)",8.08,3.23,,,0 CDM,2580000001_00409490234,Dextrose: 10 Carton In 1 Container (0409-4902-34) / 1 Syringe In 1 Carton / 50 Ml In 1 Syringe (0409-4902-64),16.06,6.42,,,0 CDM,2580000001_00409710066,Dextrose: 10 Pouch In 1 Case (0409-7100-66) / 5 Bag In 1 Pouch / 50 Ml In 1 Bag (0409-7100-68),9.66,3.86,,,0 CDM,2580000001_00409710068,NDC Description Not Available,7.87,3.15,,,0 CDM,2580000001_00409710102,Sodium Chloride: 24 Pouch In 1 Case (0409-7101-02) / 1 Bag In 1 Pouch / 250 Ml In 1 Bag (0409-7101-04),13.8,5.52,,,0 CDM,2580000001_00409710104,NDC Description Not Available,7.35,2.94,,,0 CDM,2580000001_00409710167,Sodium Chloride: 10 Pouch In 1 Case (0409-7101-67) / 5 Bag In 1 Pouch / 100 Ml In 1 Bag (0409-7101-69),9.56,3.82,,,0 CDM,2580000001_00409710168,NDC Description Not Available,55.07,22.03,,,0 CDM,2580000001_00409710169,NDC Description Not Available,7.84,3.14,,,0 CDM,2580000001_00409792320,Dextrose: 12 POUCH in 1 CASE (0409-7923-20) / 4 BAG in 1 POUCH / 25 mL in 1 BAG,2.07,0.83,,,0 CDM,2580000001_00409798309,Sodium Chloride: 12 POUCH in 1 CASE (0409-7983-09) / 1 BAG in 1 POUCH / 1000 mL in 1 BAG,16.5,6.6,,,0 CDM,2580000001_00990792203,Dextrose: 24 Pouch In 1 Case (0990-7922-03) / 1 Bag In 1 Pouch / 500 Ml In 1 Bag,1.11,0.44,,,0 CDM,2580000001_00990792209,Dextrose: 12 Pouch In 1 Case (0990-7922-09) / 1 Bag In 1 Pouch / 1000 Ml In 1 Bag,21.21,8.48,,,0 CDM,2580000001_00990798302,Sodium Chloride: 24 Pouch In 1 Case (0990-7983-02) / 1 Bag In 1 Pouch / 250 Ml In 1 Bag,24.15,9.66,,,0 CDM,2580000001_00990798303,Sodium Chloride: 24 Pouch In 1 Case (0990-7983-03) / 1 Bag In 1 Pouch / 500 Ml In 1 Bag,25.18,10.07,,,0 CDM,2580000001_00990798309,Sodium Chloride: 12 Pouch In 1 Case (0990-7983-09) / 1 Bag In 1 Pouch / 1000 Ml In 1 Bag,24.41,9.76,,,0 CDM,2580000001_00990798436,Sodium Chloride: 20 Pouch In 1 Case (0990-7984-36) / 4 Bag In 1 Pouch / 50 Ml In 1 Bag,6.0,2.4,,,0 CDM,2580000001_00990798509,Sodium Chloride: 12 Pouch In 1 Case (0990-7985-09) / 1 Bag In 1 Pouch / 1000 Ml In 1 Bag,22.0,8.8,,,0 CDM,2580000001_08290 0,NDC Description Not Available,2.75,1.1,,,0 CDM,2580000001_09999701350,NDC Description Not Available,27.6,11.04,,,0 CDM,2580000001_17271070105,Sodium Chloride: 250 Ml In 1 Bag (17271-701-05),17.25,6.9,,,0 CDM,2580000001_17271070106,Sodium Chloride: 500 Ml In 1 Bag (17271-701-06),20.7,8.28,,,0 CDM,2580000001_63323018601,NDC Description Not Available,10.3,4.12,,,0 CDM,2580000001_63323053021,NDC Description Not Available,12.39,4.96,,,0 CDM,2580000001_63323053075,Sodium Chloride: 20 Bag In 1 Case (63323-530-75) / 500 Ml In 1 Bag (63323-530-21),5.18,2.07,,,0 CDM,2580000001_63323062361,Sodium Chloride: 100 Ml In 1 Bag (63323-623-61),6.99,2.8,,,0 CDM,2580000001_63323062374,Sodium Chloride: 250 Ml In 1 Bag (63323-623-74),8.27,3.31,,,0 CDM,2580000001_63323062375,Sodium Chloride: 500 Ml In 1 Bag (63323-623-75),11.0,4.4,,,0 CDM,2580000001_63323082000,Smoflipid: 10 Bag In 1 Case (63323-820-00) / 100 Ml In 1 Bag (63323-820-01),9.41,3.76,,,0 CDM,2580000001_63323082001,NDC Description Not Available,31.37,12.55,,,0 CDM,2580000001_63323082004,NDC Description Not Available,70.81,28.32,,,0 CDM,2580000001_63323082074,Smoflipid: 10 Bag In 1 Case (63323-820-74) / 250 Ml In 1 Bag (63323-820-04),48.72,19.49,,,0 CDM,2580000001_63807010030,NDC Description Not Available,1.32,0.53,,,0 CDM,2580000001_63807010075,NDC Description Not Available,2.62,1.05,,,0 CDM,2580000001_64253011130,NDC Description Not Available,2.3,0.92,,,0 CDM,2580000001_65219022001,NDC Description Not Available,13.34,5.34,,,0 CDM,2580000001_65219022010,Sodium Chloride: 50 Bag In 1 Case (65219-220-10) / 100 Ml In 1 Bag (65219-220-01),13.34,5.34,,,0 CDM,2580000001_65219047005,NDC Description Not Available,8.3,3.32,,,0 CDM,2580000001_65219047205,NDC Description Not Available,8.7,3.48,,,0 CDM,2580000001_65219047405,NDC Description Not Available,13.8,5.52,,,0 CDM,2580000001_68883060010,NDC Description Not Available,1.72,0.69,,,0 CDM,2580000001_76297000132,NDC Description Not Available,6.39,2.56,,,0 CDM,2580000001_79672061301,NDC Description Not Available,6.44,2.58,,,0 CDM,2580000001_79672061303,NDC Description Not Available,12.36,4.94,,,0 CDM,2580000001_79672061304,NDC Description Not Available,137.59,55.04,,,0 CDM,2580000001_79672061305,NDC Description Not Available,32.2,12.88,,,0 CDM,2580000001_79672061330,Sodium Chloride: 28 Bag In 1 Carton (79672-613-30) / 250 Ml In 1 Bag (79672-613-03),13.56,5.42,,,0 CDM,2580000001_81298762003,Sodium Bicarbonate: 20 Vial In 1 Carton (81298-7620-3) / 50 Ml In 1 Vial (81298-7620-1),0.33,0.13,,,0 CDM,2580000001_81826000111,Sodium Chloride: 70 Bag In 1 Carton (81826-001-11) / 100 Ml In 1 Bag (81826-001-12),9.24,3.7,,,0 CDM,2580000001_81826000121,Sodium Chloride: 28 Bag In 1 Carton (81826-001-21) / 250 Ml In 1 Bag (81826-001-22),22.26,8.9,,,0 CDM,2580000002_00338002303,Dextrose: 500 Ml In 1 Bag (0338-0023-03),12.2,4.88,,,0 CDM,2580000002_00338002304,Dextrose: 1000 Ml In 1 Bag (0338-0023-04),4.56,1.82,,,0 CDM,2580000002_00338004303,Sodium Chloride: 500 Ml In 1 Bag (0338-0043-03),2.04,0.82,,,0 CDM,2580000002_00338004304,Sodium Chloride: 1000 Ml In 1 Bag (0338-0043-04),3.2,1.28,,,0 CDM,2580000002_00338004903,Sodium Chloride: 500 Ml In 1 Bag (0338-0049-03),3.54,1.42,,,0 CDM,2580000002_00338004904,Sodium Chloride: 1000 Ml In 1 Bag (0338-0049-04),13.11,5.24,,,0 CDM,2580000002_00338004910,Sodium Chloride: 4 Bag In 1 Package (0338-0049-10) / 25 Ml In 1 Bag,8.74,3.5,,,0 CDM,2580000002_00338007704,Dextrose And Sodium Chloride: 14 Bag In 1 Carton (0338-0077-04) / 1000 Ml In 1 Bag,5.28,2.11,,,0 CDM,2580000002_00338008504,Dextrose And Sodium Chloride: 14 Bag In 1 Carton (0338-0085-04) / 1000 Ml In 1 Bag,13.8,5.52,,,0 CDM,2580000002_00338008904,Dextrose And Sodium Chloride: 14 Bag In 1 Carton (0338-0089-04) / 1000 Ml In 1 Bag,6.9,2.76,,,0 CDM,2580000002_00338011703,Lactated Ringers: 500 Ml In 1 Bag (0338-0117-03),11.22,4.49,,,0 CDM,2580000002_00338011704,Lactated Ringers: 1000 Ml In 1 Bag (0338-0117-04),12.11,4.84,,,0 CDM,2580000002_00338012504,Lactated Ringers And Dextrose: 1000 Ml In 1 Bag (0338-0125-04),8.62,3.45,,,0 CDM,2580000002_00338067104,Potassium Chloride In Dextrose And Sodium Chloride: 1000 Ml In 1 Bag (0338-0671-04),14.08,5.63,,,0 CDM,2580000002_00338069104,Potassium Chloride In Sodium Chloride: 14 Bag In 1 Carton (0338-0691-04) / 1000 Ml In 1 Bag,3.14,1.26,,,0 CDM,2580000002_00990792403,Dextrose And Sodium Chloride: 24 Pouch In 1 Case (0990-7924-03) / 1 Bag In 1 Pouch / 500 Ml In 1 Bag,14.3,5.72,,,0 CDM,2609636001,"Hc Iv Infusion, Hydration, 31-60 Min",992.88,397.15,,,0 CDM,2609636101,"Hc Iv Infusion, Hydration, Each Additional Hour",409.63,163.85,,,0 CDM,2609636501,"Hc Iv Infusion, Therapy/Proph/Diagnostic,Initial,1St Hour",1336.05,534.42,,,0 CDM,2609636601,"Hc Iv Infusion, Therapy/Proph/Diagnostic,Initial,Each Additional Hour",575.11,230.04,,,0 CDM,2609636701,"Hc Iv Infusion, Therapy/Proph/Diagnostic,Additional Infusion,1St Hour",647.0,258.8,,,0 CDM,2609636801,"Hc Iv Infusion, Therapy/Proph/Diagnostic,Concurrent Infusion",610.38,244.15,,,0 CDM,2609636901,"Hc Subcut Infusion, Therap/Proph/Diagnost,Initial,1St Hour",1336.34,534.54,,,0 CDM,2609637401,"Hc Injection,Therapy/Proph/Diagnostic, Iv Push, Initial Drug",472.03,188.81,,,0 CDM,2609637501,"Hc Injection,Therapy/Proph/Diagnostic, Iv Push, Each Additional, New Drug",432.69,173.08,,,0 CDM,2609637601,"Hc Injection,Therapy/Proph/Diagnostic, Iv Push, Each Additional, Same Drug",409.63,163.85,,,0 CDM,2609637701,Hc Appl On-Body Injector For Timed Subq Injection,159.54,63.82,,,0 CDM,2609652101,"Hc Refill/Maint, Portable Pump",455.0,182.0,,,0 CDM,2700000002,Hc Aerosol Via Mask,34.74,13.9,,,0 CDM,2700000004,Hc Aerosol Via E-T Tube,34.74,13.9,,,0 CDM,2700000005,Hc Aerosol Via Trac Col,34.74,13.9,,,0 CDM,2700000026,"Hc Oxygen Hourly,No Sap Number",8.33,3.33,,,0 CDM,2700000026_270,"Hc Oxygen Hourly,No Sap Number",8.33,3.33,,,0 CDM,2700000047,Hc Donor Milk Sap#182969,241.5,96.6,,,0 CDM,2700000050,"Hc Prolact +4 Hmf (10Ml), Sap#216164",219.04,87.62,,,0 CDM,2700000050_270,"Hc Prolact +4 Hmf (10Ml), Sap#216164",219.04,87.62,,,0 CDM,2700000050_272,"Hc Prolact +4 Hmf (10Ml), Sap#216164",219.04,87.62,,,0 CDM,2700000052,"Hc Prolact +6 Hmf (15Ml), Sap#224943",328.54,131.42,,,0 CDM,2700000052_270,"Hc Prolact +6 Hmf (15Ml), Sap#224943",328.54,131.42,,,0 CDM,2700000052_272,"Hc Prolact +6 Hmf (15Ml), Sap#224943",328.54,131.42,,,0 CDM,2700000053,"Hc Prolact +4 Hmf (20Ml), Sap#216165",438.05,175.22,,,0 CDM,2700000054,"Hc Prolact +6 Hmf (30Ml), Sap#216166",657.09,262.84,,,0 CDM,2700000054_272,"Hc Prolact +6 Hmf (30Ml), Sap#216166",657.09,262.84,,,0 CDM,2700000055,"Hc Prolact +8 Hmf (40Ml), Sap#216167",876.1,350.44,,,0 CDM,2700000055_270,"Hc Prolact +8 Hmf (40Ml), Sap#216167",876.1,350.44,,,0 CDM,2700000055_272,"Hc Prolact +8 Hmf (40Ml), Sap#216167",876.1,350.44,,,0 CDM,2700000056,"Hc Prolact +10 Hmf (50Ml), Sap#216168",1095.14,438.06,,,0 CDM,2700000056_270,"Hc Prolact +10 Hmf (50Ml), Sap#216168",1095.14,438.06,,,0 CDM,2700000056_272,"Hc Prolact +10 Hmf (50Ml), Sap#216168",1095.14,438.06,,,0 CDM,2700000084,"Hc Charger Battery Universal Hm3, Sap#236950",24018.75,9607.5,,,0 CDM,2700000084_270,"Hc Charger Battery Universal Hm3, Sap#236950",24018.75,9607.5,,,0 CDM,2700000086,"Hc Bag Consolidated, Sap#173766",1181.25,472.5,,,0 CDM,2700000086_270,"Hc Bag Consolidated, Sap#173766",1181.25,472.5,,,0 CDM,2700000087,"Hc Solution Iv 0.9Nacl 1000Ml (1L) Inj, Sap#1135",10.01,4.0,,,0 CDM,2700000090,"Hc Solution Irrigation Btl Sterile 0.9Nacl Pf 1L, Sap#1194",13.54,5.42,,,0 CDM,2700000090_272,"Hc Solution Irrigation Btl Sterile 0.9Nacl Pf 1L, Sap#1194",13.54,5.42,,,0 CDM,2700000091,"Hc Solution Iv 0.9Nacl 250Ml, Sap#1133",7.8,3.12,,,0 CDM,2700000091_270,"Hc Solution Iv 0.9Nacl 250Ml, Sap#1133",7.8,3.12,,,0 CDM,27000000AM,"Hc Solution Iv 0.9Nacl 500Ml Inj, Sap#1134",8.82,3.53,,,0 CDM,27000000S1_119658,Hc Sup Shell 270 Revenue Code Without Hcpcs,200.5,80.2,,,0 CDM,27000000S1_133554,Hc Sup Shell 270 Revenue Code Without Hcpcs,25.08,10.03,,,0 CDM,27000000S1_134632,Hc Sup Shell 270 Revenue Code Without Hcpcs,207.74,83.1,,,0 CDM,27000000S1_163528,Hc Sup Shell 270 Revenue Code Without Hcpcs,17.41,6.96,,,0 CDM,27000000S1_163529,Hc Sup Shell 270 Revenue Code Without Hcpcs,17.41,6.96,,,0 CDM,27000000S1_163530,Hc Sup Shell 270 Revenue Code Without Hcpcs,17.38,6.95,,,0 CDM,27000000S1_163531,Hc Sup Shell 270 Revenue Code Without Hcpcs,17.42,6.97,,,0 CDM,27000000S1_163532,Hc Sup Shell 270 Revenue Code Without Hcpcs,17.43,6.97,,,0 CDM,27000000S1_163533,Hc Sup Shell 270 Revenue Code Without Hcpcs,17.41,6.96,,,0 CDM,27000000S1_163540,Hc Sup Shell 270 Revenue Code Without Hcpcs,244.42,97.77,,,0 CDM,27000000S1_171803,Hc Sup Shell 270 Revenue Code Without Hcpcs,456.3,182.52,,,0 CDM,27000000S1_181626,Hc Sup Shell 270 Revenue Code Without Hcpcs,198.45,79.38,,,0 CDM,27000000S1_182285,Hc Sup Shell 270 Revenue Code Without Hcpcs,116.59,46.64,,,0 CDM,27000000S1_182751,Hc Sup Shell 270 Revenue Code Without Hcpcs,116.58,46.63,,,0 CDM,27000000S1_183373,Hc Sup Shell 270 Revenue Code Without Hcpcs,116.86,46.74,,,0 CDM,27000000S1_188078,Hc Sup Shell 270 Revenue Code Without Hcpcs,116.58,46.63,,,0 CDM,27000000S1_195889,Hc Sup Shell 270 Revenue Code Without Hcpcs,11.7,4.68,,,0 CDM,27000000S1_197755,Hc Sup Shell 270 Revenue Code Without Hcpcs,11.22,4.49,,,0 CDM,27000000S1_198193,Hc Sup Shell 270 Revenue Code Without Hcpcs,9.81,3.92,,,0 CDM,27000000S1_198319,Hc Sup Shell 270 Revenue Code Without Hcpcs,9.81,3.92,,,0 CDM,27000000S1_83537,Hc Sup Shell 270 Revenue Code Without Hcpcs,25.75,10.3,,,0 CDM,27000000S1_83538,Hc Sup Shell 270 Revenue Code Without Hcpcs,25.46,10.18,,,0 CDM,27000000S1_83539,Hc Sup Shell 270 Revenue Code Without Hcpcs,26.11,10.44,,,0 CDM,27000000S1_83681,Hc Sup Shell 270 Revenue Code Without Hcpcs,10.17,4.07,,,0 CDM,27000000S1_83684,Hc Sup Shell 270 Revenue Code Without Hcpcs,7.29,2.92,,,0 CDM,27000000S1_83686,Hc Sup Shell 270 Revenue Code Without Hcpcs,8.91,3.56,,,0 CDM,27000000S1_83687,Hc Sup Shell 270 Revenue Code Without Hcpcs,10.88,4.35,,,0 CDM,27000000S1_83688,Hc Sup Shell 270 Revenue Code Without Hcpcs,11.19,4.48,,,0 CDM,27000000S1_83689,Hc Sup Shell 270 Revenue Code Without Hcpcs,14.12,5.65,,,0 CDM,27000000S1_83690,Hc Sup Shell 270 Revenue Code Without Hcpcs,13.06,5.22,,,0 CDM,27000000S1_83700,Hc Sup Shell 270 Revenue Code Without Hcpcs,13.78,5.51,,,0 CDM,27000000S1_83765,Hc Sup Shell 270 Revenue Code Without Hcpcs,18.01,7.2,,,0 CDM,27000000S1_83766,Hc Sup Shell 270 Revenue Code Without Hcpcs,16.43,6.57,,,0 CDM,27000000S1_83767,Hc Sup Shell 270 Revenue Code Without Hcpcs,17.12,6.85,,,0 CDM,27000000S1_83768,Hc Sup Shell 270 Revenue Code Without Hcpcs,16.44,6.58,,,0 CDM,27000000S1_83826,Hc Sup Shell 270 Revenue Code Without Hcpcs,302.33,120.93,,,0 CDM,27000000S1_84342,Hc Sup Shell 270 Revenue Code Without Hcpcs,136.13,54.45,,,0 CDM,27000000S1_84797,Hc Sup Shell 270 Revenue Code Without Hcpcs,397.08,158.83,,,0 CDM,27000000S1_84806,Hc Sup Shell 270 Revenue Code Without Hcpcs,17.81,7.12,,,0 CDM,27000000S1_84940,Hc Sup Shell 270 Revenue Code Without Hcpcs,83.1,33.24,,,0 CDM,270L8607S1_91102,Hc Sup Shell 270 Revenue Code L8607 Hcpcs,2842.2,1136.88,,,0 CDM,2710000050_271,Hc Custom Orthotics,212.86,85.14,,,0 CDM,2710000051_271,Hc Miscellaneous Supplies,20.63,8.25,,,0 CDM,2710000053_271,Hc Lymphademia Mat,39.79,15.92,,,0 CDM,2710000054_271,Hc Custom Lympedema Garment,258.68,103.47,,,0 CDM,2710000055_271,Hc Custom Garment,285.79,114.32,,,0 CDM,2710000057_271,Hc Miscellaneous Braces,57.62,23.05,,,0 CDM,27100000S1_116160,Hc Sup Shell 271 Revenue Code Without Hcpcs,4725.0,1890.0,,,0 CDM,27100000S1_137528,Hc Sup Shell 271 Revenue Code Without Hcpcs,58.43,23.37,,,0 CDM,27100000S1_163518,Hc Sup Shell 271 Revenue Code Without Hcpcs,250.01,100.0,,,0 CDM,27100000S1_163524,Hc Sup Shell 271 Revenue Code Without Hcpcs,249.77,99.91,,,0 CDM,27100000S1_163537,Hc Sup Shell 271 Revenue Code Without Hcpcs,288.41,115.36,,,0 CDM,27100000S1_163700,Hc Sup Shell 271 Revenue Code Without Hcpcs,88.0,35.2,,,0 CDM,27100000S1_163701,Hc Sup Shell 271 Revenue Code Without Hcpcs,85.72,34.29,,,0 CDM,27100000S1_163702,Hc Sup Shell 271 Revenue Code Without Hcpcs,88.0,35.2,,,0 CDM,27100000S1_163703,Hc Sup Shell 271 Revenue Code Without Hcpcs,88.0,35.2,,,0 CDM,27100000S1_163705,Hc Sup Shell 271 Revenue Code Without Hcpcs,116.16,46.46,,,0 CDM,27100000S1_163706,Hc Sup Shell 271 Revenue Code Without Hcpcs,116.16,46.46,,,0 CDM,27100000S1_163707,Hc Sup Shell 271 Revenue Code Without Hcpcs,116.16,46.46,,,0 CDM,27100000S1_181866,Hc Sup Shell 271 Revenue Code Without Hcpcs,260.31,104.12,,,0 CDM,27100000S1_186860,Hc Sup Shell 271 Revenue Code Without Hcpcs,2240.34,896.14,,,0 CDM,27100000S1_186861,Hc Sup Shell 271 Revenue Code Without Hcpcs,2222.67,889.07,,,0 CDM,27100000S1_186862,Hc Sup Shell 271 Revenue Code Without Hcpcs,2262.31,904.92,,,0 CDM,27100000S1_191159,Hc Sup Shell 271 Revenue Code Without Hcpcs,4427.72,1771.09,,,0 CDM,27100000S1_191621,Hc Sup Shell 271 Revenue Code Without Hcpcs,3614.62,1445.85,,,0 CDM,27100000S1_199219,Hc Sup Shell 271 Revenue Code Without Hcpcs,116.16,46.46,,,0 CDM,27100000S1_83804,Hc Sup Shell 271 Revenue Code Without Hcpcs,442.62,177.05,,,0 CDM,27100000S1_84381,Hc Sup Shell 271 Revenue Code Without Hcpcs,70.88,28.35,,,0 CDM,27100000S1_85876,Hc Sup Shell 271 Revenue Code Without Hcpcs,64.19,25.68,,,0 CDM,27100000S1_86283,Hc Sup Shell 271 Revenue Code Without Hcpcs,406.28,162.51,,,0 CDM,27100000S1_86284,Hc Sup Shell 271 Revenue Code Without Hcpcs,404.87,161.95,,,0 CDM,27100000S1_86496,Hc Sup Shell 271 Revenue Code Without Hcpcs,319.41,127.76,,,0 CDM,271A456201,"Hc Pessary Device (All Sizes), Mult Sap#260920, 261061-261105",236.25,94.5,,,0 CDM,271A456201_A4562_271,"Hc Pessary Device (All Sizes), Mult Sap#260920, 261061-261105",223.65,89.46,,,0 CDM,2720000001,Hc Vapotherm Set-Up,3400.57,1360.23,,,0 CDM,2720000001_188328,Hc Vapotherm Set-Up,10.83,4.33,,,0 CDM,2720000001_189016,Hc Vapotherm Set-Up,663.04,265.22,,,0 CDM,2720000001_189017,Hc Vapotherm Set-Up,72.22,28.89,,,0 CDM,2720000002,Hc Vapotherm Daily,693.25,277.3,,,0 CDM,2720000003,Hc Kit Disp Gyn Neblett 17G Sap#174180,4114.69,1645.88,,,0 CDM,2720000003_272,Hc Kit Disp Gyn Neblett 17G Sap#174180,4114.69,1645.88,,,0 CDM,2720000004,Hc Dermabond Mini Sap#18390,34.53,13.81,,,0 CDM,2720000004_272,Hc Dermabond Mini Sap#18390,34.53,13.81,,,0 CDM,2720000005,Hc Vap-Arrow Cath-Perph/Cntl/Midl,39.38,15.75,,,0 CDM,2720000005_272,Hc Vap-Arrow Cath-Perph/Cntl/Midl,39.38,15.75,,,0 CDM,2720000005_C1889_272,Hc Vap-Arrow Cath-Perph/Cntl/Midl,39.38,15.75,,,0 CDM,2720000006,"Hc Vap-Introduc,Ohr Than Guiding",126.0,50.4,,,0 CDM,2720000006_272,"Hc Vap-Introduc,Ohr Than Guiding",126.0,50.4,,,0 CDM,2720000007,Hc Flexi-Needle,157.5,63.0,,,0 CDM,2720000008,Hc Cannula 20Gx100Mm Sap#41502,75.39,30.16,,,0 CDM,2720000008_272,Hc Cannula 20Gx100Mm Sap#41502,75.39,30.16,,,0 CDM,2720000009,Hc Cannula 22Gx54Mm Sap#41504,72.85,29.14,,,0 CDM,2720000009_272,Hc Cannula 22Gx54Mm Sap#41504,72.85,29.14,,,0 CDM,2720000010,Hc Needle Stimuplex 20X6In Sap#140044,55.73,22.29,,,0 CDM,2720000010_272,Hc Needle Stimuplex 20X6In Sap#140044,55.73,22.29,,,0 CDM,2720000011,"Hc Pack Universal Split, Sap#76179",73.2,29.28,,,0 CDM,2720000011_272,"Hc Pack Universal Split, Sap#76179",73.2,29.28,,,0 CDM,2720000011_C1889_272,"Hc Pack Universal Split, Sap#76179",73.2,29.28,,,0 CDM,2720000012,Hc Tray Pain Proc #1 Sap#41497,41.74,16.7,,,0 CDM,2720000012_272,Hc Tray Pain Proc #1 Sap#41497,41.74,16.7,,,0 CDM,2720000013,Hc Tray Pain Proc #2 Sap#41498,40.95,16.38,,,0 CDM,2720000013_272,Hc Tray Pain Proc #2 Sap#41498,40.95,16.38,,,0 CDM,2720000014,Hc Suture 3-0 Gut Chromic 1X27 Sh G122H Sap#229,11.11,4.44,,,0 CDM,2720000019_272,Noncdm Charge Record Medical Supplies,76.03,30.41,,,0 CDM,2720000020,Hc Suture 3-0 Vicryl Und 1X27 Ps-2 J427H Sap#208,14.8,5.92,,,0 CDM,2720000021,"Hc Suture 5-0 Ethilon Black 1X18 P-3 1698G, Sap# 3650",13.78,5.51,,,0 CDM,2720000023,"Hc Biopsy Needle Inst 18Ga 22Mm 16Cm Monopty, Sap#1338",90.21,36.08,,,0 CDM,2720000024,"Hc Suture 6-0 Gut Plain 1X18 G-1 774G, Sap#1391",31.23,12.49,,,0 CDM,2720000024_272,"Hc Suture 6-0 Gut Plain 1X18 G-1 774G, Sap#1391",31.23,12.49,,,0 CDM,2720000025,"Hc Suture 5-0 Gut Plain Fast 18 Pc-1 1915G, Sap#3644",24.26,9.7,,,0 CDM,2720000026,"Hc Suture 4-0 Ethilon Blk 1X18 Fs-2 662G, Sap#9023",7.01,2.8,,,0 CDM,2720000027,Hc Suture Vicryl 3-0 36In Ct-1 Taper Undyed Sap#150363,6.14,2.46,,,0 CDM,2720000028_272,Noncdm Charge Record Medical Supplies,31.74,12.7,,,0 CDM,2720000033,Hc Bln Low Prof Mini One 14 Fr X 1.0 Sap#76794,425.25,170.1,,,0 CDM,2720000034,Hc Bln Low Prof Mini One 14 Fr X 1.2 Sap#76795,425.25,170.1,,,0 CDM,2720000035,Hc Bln Low Prof Mini One 14 Fr X 1.5 Sap#76796,425.25,170.1,,,0 CDM,2720000036,Hc Bln Low Prof Mini One 14 Fr X 1.7 Sap#76797,425.25,170.1,,,0 CDM,2720000037,Hc Bln Low Prof Mini One 16 Fr X 1.0 Sap 76798,385.88,154.35,,,0 CDM,2720000038,Hc Bln Low Prof Mini One 16Frx1.2 Sap#76799,466.71,186.68,,,0 CDM,2720000039,Hc Tube Gastrostomy 14 Fr Sap#30300,378.71,151.48,,,0 CDM,2720000040,Hc Tube Gastronomy 14 Fr X 1.2 Sap#30456,378.71,151.48,,,0 CDM,2720000041,Hc Tube Gastronomy 14 Fr X 1.5 Sap#30457,378.71,151.48,,,0 CDM,2720000042,"Hc Quadrox Oxygenator Silicone Membrane, Sap#10576",5185.69,2074.28,,,0 CDM,2720000043,Hc Tube Gastronomy 14 Fr X 2.0 Sap#30458,378.71,151.48,,,0 CDM,2720000044,Hc Needle Lng Injetk Adj Tip 70Cm 4.8Fr 23G Sap#241337,72.98,29.19,,,0 CDM,2720000044_272,Hc Needle Lng Injetk Adj Tip 70Cm 4.8Fr 23G Sap#241337,72.98,29.19,,,0 CDM,2720000045,"Hc Syringer Prefilled Water 10Ml, Sap#229552",5.71,2.28,,,0 CDM,2720000046,"Hc Suture 4-0 Ethilon Blk 1X18 Pc-3 1864G, Sap#220",20.99,8.4,,,0 CDM,2720000047,"Hc Solution Iv Lactated Ringers 1000Ml Inj, Sap#1148",8.15,3.26,,,0 CDM,2720000050,Hc Myringotomy Kit Sap #25309,19.4,7.76,,,0 CDM,2720000051,Hc Set Beq Hit 7050 Advanced 7.0 Cardio - Help Sap #199919,42131.25,16852.5,,,0 CDM,2720000051_272,Hc Set Beq Hit 7050 Advanced 7.0 Cardio - Help Sap #199919,40425.0,16170.0,,,0 CDM,2720000052,Hc Set Bo Hit 7050 Advanced 7.0 Cardio - Help Sap #199918,38587.5,15435.0,,,0 CDM,2720000053,Hc Endotracheal Tube,1238.74,495.5,,,0 CDM,2720000053_272,Hc Endotracheal Tube,1238.74,495.5,,,0 CDM,2720000054,"Hc Euroset (Amg)Oxygenator Pmp Adult, Sap#242062",4725.0,1890.0,,,0 CDM,2720000055,"Hc Pack Peds Vad Assest, Sap#18043",854.44,341.78,,,0 CDM,2720000055_272,"Hc Pack Peds Vad Assest, Sap#18043",854.44,341.78,,,0 CDM,2720000056,"Hc Medtronic Manifold, Sap#225478",208.69,83.48,,,0 CDM,2720000056_272,"Hc Medtronic Manifold, Sap#225478",208.69,83.48,,,0 CDM,2720000057,"Hc Kit Adult Vad Assist, Sap#10718",653.62,261.45,,,0 CDM,2720000057_272,"Hc Kit Adult Vad Assist, Sap#10718",653.62,261.45,,,0 CDM,2720000058,"Hc Set Cann 29Fr 50Cm Ven-Fem, Sap#7691",919.68,367.87,,,0 CDM,2720000059,Hc Set Cann 27Fr 50Cm Ven-Fem Sap#7689,919.68,367.87,,,0 CDM,2720000060,"Hc Set Cann 25Fr 50Cm Ven-Fem, Sap#7692",919.68,367.87,,,0 CDM,2720000061,"Hc Cannula Fem 19Fr Art, Sap#8843",919.68,367.87,,,0 CDM,2720000061_272,"Hc Cannula Fem 19Fr Art, Sap#8843",919.68,367.87,,,0 CDM,2720000062,"Hc Oxygenator Access Port Affinity, Sap#237231",1041.86,416.74,,,0 CDM,2720000063,"Hc Kit Blood Pump, Sap#241507",523.69,209.48,,,0 CDM,2720000063_272,"Hc Kit Blood Pump, Sap#241507",523.69,209.48,,,0 CDM,2720000064,"Hc Hls Cardio Help Oxygenator Perfusion 7050 Adv 7, Sap#199919",39375.0,15750.0,,,0 CDM,2720000065,"Hc Hemoconcentrator Peds W/Tubing, Sap#173237",525.78,210.31,,,0 CDM,2720000066,"Hc Rotoflow Pump Bioline, Sap#141052",1026.15,410.46,,,0 CDM,2720000066_272,"Hc Rotoflow Pump Bioline, Sap#141052",1026.15,410.46,,,0 CDM,2720000067,"Hc Kit Centrimag Blood Pump, Sap#218997",49612.5,19845.0,,,0 CDM,2720000067_272,"Hc Kit Centrimag Blood Pump, Sap#218997",49612.5,19845.0,,,0 CDM,2720000068,"Hc Catheter Foley Lf 22Fr 30Cc 3Way, Sap#537",39.65,15.86,,,0 CDM,2720000069,"Hc Catheter Foley 12Fr 5Cc Coude 2Way, Sap#550",33.43,13.37,,,0 CDM,2720000070,"Hc Foley Cath 14 Fr I&O Kit, Sap#275",10.2,4.08,,,0 CDM,2720000071,"Hc Suture 3-0 Chromic, Sap#229",11.11,4.44,,,0 CDM,2720000072,"Hc Catheter Foley 18Fr 5Cc 2Way Sil, Sap#454",12.72,5.09,,,0 CDM,2720000072_272,"Hc Catheter Foley 18Fr 5Cc 2Way Sil, Sap#454",12.72,5.09,,,0 CDM,2720000073,"Hc Catheter Foley 20Fr 5Cc 2Way Sil, Sap#455",12.72,5.09,,,0 CDM,2720000073_272,"Hc Catheter Foley 20Fr 5Cc 2Way Sil, Sap#455",12.72,5.09,,,0 CDM,2720000074,"Hc Catheter Foley 22Fr 5Cc 2Way Sil, Sap#456",12.72,5.09,,,0 CDM,2720000074_272,"Hc Catheter Foley 22Fr 5Cc 2Way Sil, Sap#456",12.72,5.09,,,0 CDM,2720000075,"Hc Catheter Foley 24Fr 5Cc 2Way Sil, Sap#457",12.72,5.09,,,0 CDM,2720000075_272,"Hc Catheter Foley 24Fr 5Cc 2Way Sil, Sap#457",12.72,5.09,,,0 CDM,2720000076,"Hc Catheter Ureth 14Fr Coude Tp Red, Sap#459",13.31,5.32,,,0 CDM,2720000077,"Hc Catheter Foley 14Fr 5Cc 2Way Sil, Sap#452",12.72,5.09,,,0 CDM,2720000077_272,"Hc Catheter Foley 14Fr 5Cc 2Way Sil, Sap#452",12.72,5.09,,,0 CDM,2720000078,"Hc Catheter Foley Lf 20Fr 30Cc 3Way, Sap#536",39.65,15.86,,,0 CDM,2720000078_272,"Hc Catheter Foley Lf 20Fr 30Cc 3Way, Sap#536",39.65,15.86,,,0 CDM,2720000079,"Hc Catheter Foley 14Fr 5Cc Coude 2Way, Sap#551",33.43,13.37,,,0 CDM,2720000080,"Hc Catheter Foley 16Fr 5Cc Coude 2Way, Sap#552",33.43,13.37,,,0 CDM,2720000081,"Hc Catheter Foley 18Fr 5Cc Coude 2Way, Sap#553",33.43,13.37,,,0 CDM,2720000082,Hc Catheter Foley 20Fr 5Cc Coude 2Way Sap 554,33.43,13.37,,,0 CDM,2720000083,"Hc Catheter Foley 22Fr 5Cc Coude 2Way, Sap#555",33.43,13.37,,,0 CDM,2720000084,"Hc Catheter Foley 12Fr 5Cc 2Way Sil, Sap#451",12.72,5.09,,,0 CDM,2720000084_272,"Hc Catheter Foley 12Fr 5Cc 2Way Sil, Sap#451",12.72,5.09,,,0 CDM,2720000085,"Hc Catheter Foley 16Fr 5Cc 2Way Sil, Sap#453",12.72,5.09,,,0 CDM,2720000085_272,"Hc Catheter Foley 16Fr 5Cc 2Way Sil, Sap#453",12.72,5.09,,,0 CDM,2720000086,"Hc Catheter 18Fr, Sap#140062",13.47,5.39,,,0 CDM,2720000086_272,"Hc Catheter 18Fr, Sap#140062",13.47,5.39,,,0 CDM,2720000087,"Hc Catheter Foley 16Fr 30Cc Lub, Sap#541",15.33,6.13,,,0 CDM,2720000087_272,"Hc Catheter Foley 16Fr 30Cc Lub, Sap#541",15.33,6.13,,,0 CDM,2720000088,"Hc Catheter Foley Lf 16Fr 30Cc 3Way, Sap#535",39.65,15.86,,,0 CDM,2720000089,"Hc Catheter Foley Lf 24Fr 30Cc 3Way, Sap#538",39.65,15.86,,,0 CDM,2720000090,Hc Nautilus Smart Ecmo Oxygenator Sap#260513,14805.0,5922.0,,,0 CDM,2720000090_272,Hc Nautilus Smart Ecmo Oxygenator Sap#260513,14805.0,5922.0,,,0 CDM,2720000091,"Hc Suture 2-0 Vicryl Und 1X36 Ct-1 J945H, Sap#218",5.94,2.38,,,0 CDM,2720000092,"Hc Suture 1 Gut Chromic 1X36 Ct-1 925H, Sap#233",12.21,4.88,,,0 CDM,2720000093,"Hc Suture 3-0 Vicryl Violet Br 27 Sh J316H, Sap#215",8.23,3.29,,,0 CDM,2720000094,Hc Tube Trach 4.0 Shiley Ped Flex Cuffless Sap#1237,178.45,71.38,,,0 CDM,2720000095,Hc Kit Gastrostomy Feeding Tube 16Fr 5.0Cm Sap#172079,362.41,144.96,,,0 CDM,2720000097,"Hc Catheter Foley Lubri Sil Ic Coude, Sap#263245",273.57,109.43,,,0 CDM,2720000097_272,"Hc Catheter Foley Lubri Sil Ic Coude, Sap#263245",273.57,109.43,,,0 CDM,2720000098,"Hc Catheter Foley 16Fr 2 Way 5Ml, Sap#261167",156.17,62.47,,,0 CDM,2720000098_272,"Hc Catheter Foley 16Fr 2 Way 5Ml, Sap#261167",156.17,62.47,,,0 CDM,2720000099,"Hc Set Mic-Key Cont Feed Enfit 2Port Y 30Cm, Sap#175245",33.66,13.46,,,0 CDM,2720000099_272,"Hc Set Mic-Key Cont Feed Enfit 2Port Y 30Cm, Sap#175245",33.66,13.46,,,0 CDM,27200000AA,"Hc Abdominal Binder 46 62 Inch Lg, Sap# 76335-76336",64.66,25.86,,,0 CDM,27200000AA_272,"Hc Abdominal Binder 46 62 Inch Lg, Sap# 76335-76336",64.66,25.86,,,0 CDM,27200000AB,"Hc Tip Smart 190 Gen2, Sap#263472-263474",1448.1,579.24,,,0 CDM,27200000AB_272,"Hc Tip Smart 190 Gen2, Sap#263472-263474",1439.64,575.86,,,0 CDM,27200000AC,"Hc Tube Feeding Jejunal, Mult Sap#89055,135440,138750-138753",567.43,226.97,,,0 CDM,27200000AC_272,"Hc Tube Feeding Jejunal, Mult Sap#89055,135440,138750-138753",538.65,215.46,,,0 CDM,27200000AD,"Hc Tube Feeding Mic Gastrostomy, Mult Sap #202302,220731,227014,251381,251819,254393",155.25,62.1,,,0 CDM,27200000AD_272,"Hc Tube Feeding Mic Gastrostomy, Mult Sap #202302,220731,227014,251381,251819,254393",128.1,51.24,,,0 CDM,27200000AE,"Hc Kit Jjnal Feed Tube-Mickey, Mult Sap#118540-118542",738.99,295.6,,,0 CDM,27200000AE_272,"Hc Kit Jjnal Feed Tube-Mickey, Mult Sap#118540-118542",713.93,285.57,,,0 CDM,27200000AF,"Hc Kit Gastrostomy Feeding Tube, Mult Sap#1066, 89054 -86035,118553 - 118570,86231,88785, 88954,8905",435.1,174.04,,,0 CDM,27200000AF_272,"Hc Kit Gastrostomy Feeding Tube, Mult Sap#1066, 89054 -86035,118553 - 118570,86231,88785, 88954,8905",412.26,164.9,,,0 CDM,27200000AG,"Hc Catheter Pezzar 12Fr Drn Propor Hd Ltx, Sap#4613",68.2,27.28,,,0 CDM,27200000AH,"Hc Suture 2-0 Silk Blk 1X18 Fs 685G, Sap#1460",5.88,2.35,,,0 CDM,27200000AI,"Hc Dressing Tegaderm Picc Cvc Securement 3.5In X 4.5In, Sap#229550",34.65,13.86,,,0 CDM,27200000AI_272,"Hc Dressing Tegaderm Picc Cvc Securement 3.5In X 4.5In, Sap#229550",34.65,13.86,,,0 CDM,27200000AJ,"Hc Suture 3-0 Vicryl Und 1X27 Sh J416H, Sap#7866",5.55,2.22,,,0 CDM,27200000AK,"Hc Cannula 20G Avanos Rf Crvd Shrp Radpaq 145/10Mm, Sap#259872",75.05,30.02,,,0 CDM,27200000AM,"Hc Vitalflow Set, Sap # 401084",35713.12,14285.25,,,0 CDM,27200000AM_272,"Hc Vitalflow Set, Sap # 401084",35713.12,14285.25,,,0 CDM,27200000AN,"Hc Valve Biopsy Endo Adj Uroseal, Sap#220884",97.45,38.98,,,0 CDM,27200000AN_272,"Hc Valve Biopsy Endo Adj Uroseal, Sap#220884",97.45,38.98,,,0 CDM,27200000AO,"Hc Suture 2-0 Ethilon Blk 1X18 Fs 664G, Sap#7989",7.24,2.9,,,0 CDM,27200000AP,"Hc Suture 4-0 Monocryl Und 1X18 Ps-2 Y496G, Sap#9050",21.07,8.43,,,0 CDM,27200000AQ,"Hc Curette Disp Ear Small Spoon 2M, Sap#265234",198.85,79.54,,,0 CDM,27200000AR,"Hc Kit Pleurx Cath Access, Sap#217264",228.38,91.35,,,0 CDM,27200000RS,"Initial Placement Kit Gast 18F (22F Dilator), Sap#2256",874.12,349.65,,,0 CDM,27200000S1_113429,Hc Sup Shell 272 Revenue Code Without Hcpcs,1.92,0.77,,,0 CDM,27200000S1_113446,Hc Sup Shell 272 Revenue Code Without Hcpcs,1993.19,797.28,,,0 CDM,27200000S1_113448,Hc Sup Shell 272 Revenue Code Without Hcpcs,378.74,151.5,,,0 CDM,27200000S1_113453,Hc Sup Shell 272 Revenue Code Without Hcpcs,97.17,38.87,,,0 CDM,27200000S1_113617,Hc Sup Shell 272 Revenue Code Without Hcpcs,15.65,6.26,,,0 CDM,27200000S1_113622,Hc Sup Shell 272 Revenue Code Without Hcpcs,152.34,60.94,,,0 CDM,27200000S1_113623,Hc Sup Shell 272 Revenue Code Without Hcpcs,66.83,26.73,,,0 CDM,27200000S1_113627,Hc Sup Shell 272 Revenue Code Without Hcpcs,142.65,57.06,,,0 CDM,27200000S1_113643,Hc Sup Shell 272 Revenue Code Without Hcpcs,183.76,73.5,,,0 CDM,27200000S1_113646,Hc Sup Shell 272 Revenue Code Without Hcpcs,414.5,165.8,,,0 CDM,27200000S1_113656,Hc Sup Shell 272 Revenue Code Without Hcpcs,142.65,57.06,,,0 CDM,27200000S1_113663,Hc Sup Shell 272 Revenue Code Without Hcpcs,7810.47,3124.19,,,0 CDM,27200000S1_113664,Hc Sup Shell 272 Revenue Code Without Hcpcs,456.58,182.63,,,0 CDM,27200000S1_113665,Hc Sup Shell 272 Revenue Code Without Hcpcs,458.43,183.37,,,0 CDM,27200000S1_113673,Hc Sup Shell 272 Revenue Code Without Hcpcs,54.81,21.92,,,0 CDM,27200000S1_113841,Hc Sup Shell 272 Revenue Code Without Hcpcs,1695.72,678.29,,,0 CDM,27200000S1_113842,Hc Sup Shell 272 Revenue Code Without Hcpcs,2118.04,847.22,,,0 CDM,27200000S1_113843,Hc Sup Shell 272 Revenue Code Without Hcpcs,2565.33,1026.13,,,0 CDM,27200000S1_113859,Hc Sup Shell 272 Revenue Code Without Hcpcs,535.5,214.2,,,0 CDM,27200000S1_113860,Hc Sup Shell 272 Revenue Code Without Hcpcs,399.5,159.8,,,0 CDM,27200000S1_113863,Hc Sup Shell 272 Revenue Code Without Hcpcs,469.74,187.9,,,0 CDM,27200000S1_113910,Hc Sup Shell 272 Revenue Code Without Hcpcs,98.44,39.38,,,0 CDM,27200000S1_113913,Hc Sup Shell 272 Revenue Code Without Hcpcs,36.23,14.49,,,0 CDM,27200000S1_113927,Hc Sup Shell 272 Revenue Code Without Hcpcs,575.61,230.24,,,0 CDM,27200000S1_113929,Hc Sup Shell 272 Revenue Code Without Hcpcs,699.13,279.65,,,0 CDM,27200000S1_113949,Hc Sup Shell 272 Revenue Code Without Hcpcs,5.78,2.31,,,0 CDM,27200000S1_114007,Hc Sup Shell 272 Revenue Code Without Hcpcs,349.98,139.99,,,0 CDM,27200000S1_114063,Hc Sup Shell 272 Revenue Code Without Hcpcs,390.91,156.36,,,0 CDM,27200000S1_114064,Hc Sup Shell 272 Revenue Code Without Hcpcs,583.56,233.42,,,0 CDM,27200000S1_114065,Hc Sup Shell 272 Revenue Code Without Hcpcs,741.73,296.69,,,0 CDM,27200000S1_114066,Hc Sup Shell 272 Revenue Code Without Hcpcs,602.02,240.81,,,0 CDM,27200000S1_114067,Hc Sup Shell 272 Revenue Code Without Hcpcs,753.0,301.2,,,0 CDM,27200000S1_114114,Hc Sup Shell 272 Revenue Code Without Hcpcs,314.47,125.79,,,0 CDM,27200000S1_114115,Hc Sup Shell 272 Revenue Code Without Hcpcs,317.4,126.96,,,0 CDM,27200000S1_114117,Hc Sup Shell 272 Revenue Code Without Hcpcs,1750.34,700.14,,,0 CDM,27200000S1_114121,Hc Sup Shell 272 Revenue Code Without Hcpcs,427.3,170.92,,,0 CDM,27200000S1_114216,Hc Sup Shell 272 Revenue Code Without Hcpcs,1575.0,630.0,,,0 CDM,27200000S1_114217,Hc Sup Shell 272 Revenue Code Without Hcpcs,1634.06,653.62,,,0 CDM,27200000S1_114218,Hc Sup Shell 272 Revenue Code Without Hcpcs,719.01,287.6,,,0 CDM,27200000S1_114219,Hc Sup Shell 272 Revenue Code Without Hcpcs,1014.86,405.94,,,0 CDM,27200000S1_114314,Hc Sup Shell 272 Revenue Code Without Hcpcs,709.31,283.72,,,0 CDM,27200000S1_114315,Hc Sup Shell 272 Revenue Code Without Hcpcs,997.76,399.1,,,0 CDM,27200000S1_114316,Hc Sup Shell 272 Revenue Code Without Hcpcs,991.11,396.44,,,0 CDM,27200000S1_114346,Hc Sup Shell 272 Revenue Code Without Hcpcs,409.24,163.7,,,0 CDM,27200000S1_114347,Hc Sup Shell 272 Revenue Code Without Hcpcs,399.82,159.93,,,0 CDM,27200000S1_114384,Hc Sup Shell 272 Revenue Code Without Hcpcs,299.25,119.7,,,0 CDM,27200000S1_114385,Hc Sup Shell 272 Revenue Code Without Hcpcs,336.66,134.66,,,0 CDM,27200000S1_114386,Hc Sup Shell 272 Revenue Code Without Hcpcs,339.12,135.65,,,0 CDM,27200000S1_114387,Hc Sup Shell 272 Revenue Code Without Hcpcs,334.69,133.88,,,0 CDM,27200000S1_114389,Hc Sup Shell 272 Revenue Code Without Hcpcs,334.69,133.88,,,0 CDM,27200000S1_114407,Hc Sup Shell 272 Revenue Code Without Hcpcs,1983.55,793.42,,,0 CDM,27200000S1_114558,Hc Sup Shell 272 Revenue Code Without Hcpcs,390.35,156.14,,,0 CDM,27200000S1_114603,Hc Sup Shell 272 Revenue Code Without Hcpcs,2309.21,923.68,,,0 CDM,27200000S1_114935,Hc Sup Shell 272 Revenue Code Without Hcpcs,167.24,66.9,,,0 CDM,27200000S1_114940,Hc Sup Shell 272 Revenue Code Without Hcpcs,161.4,64.56,,,0 CDM,27200000S1_114944,Hc Sup Shell 272 Revenue Code Without Hcpcs,96.43,38.57,,,0 CDM,27200000S1_114950,Hc Sup Shell 272 Revenue Code Without Hcpcs,184.19,73.68,,,0 CDM,27200000S1_114954,Hc Sup Shell 272 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Code Without Hcpcs,207.74,83.1,,,0 CDM,27200000S1_138209,Hc Sup Shell 272 Revenue Code Without Hcpcs,76.66,30.66,,,0 CDM,27200000S1_138210,Hc Sup Shell 272 Revenue Code Without Hcpcs,295.31,118.12,,,0 CDM,27200000S1_138211,Hc Sup Shell 272 Revenue Code Without Hcpcs,441.0,176.4,,,0 CDM,27200000S1_138212,Hc Sup Shell 272 Revenue Code Without Hcpcs,208.69,83.48,,,0 CDM,27200000S1_138214,Hc Sup Shell 272 Revenue Code Without Hcpcs,204.86,81.94,,,0 CDM,27200000S1_138215,Hc Sup Shell 272 Revenue Code Without Hcpcs,141.24,56.5,,,0 CDM,27200000S1_138258,Hc Sup Shell 272 Revenue Code Without Hcpcs,446.55,178.62,,,0 CDM,27200000S1_138317,Hc Sup Shell 272 Revenue Code Without Hcpcs,28330.31,11332.12,,,0 CDM,27200000S1_138318,Hc Sup Shell 272 Revenue Code Without Hcpcs,1437.19,574.88,,,0 CDM,27200000S1_138349,Hc Sup Shell 272 Revenue Code Without Hcpcs,329.96,131.98,,,0 CDM,27200000S1_138350,Hc Sup Shell 272 Revenue Code Without Hcpcs,314.21,125.68,,,0 CDM,27200000S1_138404,Hc Sup Shell 272 Revenue Code Without Hcpcs,2953.12,1181.25,,,0 CDM,27200000S1_138405,Hc Sup Shell 272 Revenue Code Without Hcpcs,1476.56,590.62,,,0 CDM,27200000S1_138445,Hc Sup Shell 272 Revenue Code Without Hcpcs,1535.62,614.25,,,0 CDM,27200000S1_138446,Hc Sup Shell 272 Revenue Code Without Hcpcs,1535.62,614.25,,,0 CDM,27200000S1_138449,Hc Sup Shell 272 Revenue Code Without Hcpcs,669.38,267.75,,,0 CDM,27200000S1_138474,Hc Sup Shell 272 Revenue Code Without Hcpcs,24.41,9.76,,,0 CDM,27200000S1_138475,Hc Sup Shell 272 Revenue Code Without Hcpcs,24.41,9.76,,,0 CDM,27200000S1_138476,Hc Sup Shell 272 Revenue Code Without Hcpcs,24.41,9.76,,,0 CDM,27200000S1_138477,Hc Sup Shell 272 Revenue Code Without Hcpcs,24.41,9.76,,,0 CDM,27200000S1_138478,Hc Sup Shell 272 Revenue Code Without Hcpcs,24.41,9.76,,,0 CDM,27200000S1_138479,Hc Sup Shell 272 Revenue Code Without Hcpcs,24.41,9.76,,,0 CDM,27200000S1_138480,Hc Sup Shell 272 Revenue Code Without Hcpcs,24.41,9.76,,,0 CDM,27200000S1_138481,Hc Sup Shell 272 Revenue 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Hcpcs,190.08,76.03,,,0 CDM,27200000S1_94181,Hc Sup Shell 272 Revenue Code Without Hcpcs,2277.6,911.04,,,0 CDM,27200000S1_94440,Hc Sup Shell 272 Revenue Code Without Hcpcs,5545.92,2218.37,,,0 CDM,27200000S1_94470,Hc Sup Shell 272 Revenue Code Without Hcpcs,181.31,72.52,,,0 CDM,27200000S1_94471,Hc Sup Shell 272 Revenue Code Without Hcpcs,230.78,92.31,,,0 CDM,27200000S1_94571,Hc Sup Shell 272 Revenue Code Without Hcpcs,295.16,118.06,,,0 CDM,27200000S1_94573,Hc Sup Shell 272 Revenue Code Without Hcpcs,86.0,34.4,,,0 CDM,27200000S1_94574,Hc Sup Shell 272 Revenue Code Without Hcpcs,87.6,35.04,,,0 CDM,27200000S1_94577,Hc Sup Shell 272 Revenue Code Without Hcpcs,129.91,51.96,,,0 CDM,27200000S1_94583,Hc Sup Shell 272 Revenue Code Without Hcpcs,334.96,133.98,,,0 CDM,27200000S1_94585,Hc Sup Shell 272 Revenue Code Without Hcpcs,109.58,43.83,,,0 CDM,27200000S1_94592,Hc Sup Shell 272 Revenue Code Without Hcpcs,574.2,229.68,,,0 CDM,27200000S1_94595,Hc Sup Shell 272 Revenue Code Without Hcpcs,54.36,21.74,,,0 CDM,27200000S1_94596,Hc Sup Shell 272 Revenue Code Without Hcpcs,66.94,26.78,,,0 CDM,27200000S1_94642,Hc Sup Shell 272 Revenue Code Without Hcpcs,804.94,321.98,,,0 CDM,27200000S1_94733,Hc Sup Shell 272 Revenue Code Without Hcpcs,703.5,281.4,,,0 CDM,27200000S1_94823,Hc Sup Shell 272 Revenue Code Without Hcpcs,2232.52,893.01,,,0 CDM,27200000S1_95352,Hc Sup Shell 272 Revenue Code Without Hcpcs,10.71,4.28,,,0 CDM,27200000S1_95391,Hc Sup Shell 272 Revenue Code Without Hcpcs,4.9,1.96,,,0 CDM,27200000S1_95398,Hc Sup Shell 272 Revenue Code Without Hcpcs,292.75,117.1,,,0 CDM,27200000S1_95413,Hc Sup Shell 272 Revenue Code Without Hcpcs,970.13,388.05,,,0 CDM,27200000S1_95464,Hc Sup Shell 272 Revenue Code Without Hcpcs,111.0,44.4,,,0 CDM,27200000S1_95532,Hc Sup Shell 272 Revenue Code Without Hcpcs,16.85,6.74,,,0 CDM,27200000S1_95603,Hc Sup Shell 272 Revenue Code Without Hcpcs,149.88,59.95,,,0 CDM,27200000S1_95612,Hc Sup Shell 272 Revenue Code Without Hcpcs,6.1,2.44,,,0 CDM,27200000S1_95613,Hc Sup Shell 272 Revenue Code Without Hcpcs,20.47,8.19,,,0 CDM,27200000S1_96059,Hc Sup Shell 272 Revenue Code Without Hcpcs,478.14,191.26,,,0 CDM,27200000S1_96062,Hc Sup Shell 272 Revenue Code Without Hcpcs,393.75,157.5,,,0 CDM,27200000S1_96083,Hc Sup Shell 272 Revenue Code Without Hcpcs,794.02,317.61,,,0 CDM,27200000S1_96096,Hc Sup Shell 272 Revenue Code Without Hcpcs,212.35,84.94,,,0 CDM,27200000S1_96098,Hc Sup Shell 272 Revenue Code Without Hcpcs,55.45,22.18,,,0 CDM,27200000S1_96111,Hc Sup Shell 272 Revenue Code Without Hcpcs,71.68,28.67,,,0 CDM,27200000S1_96112,Hc Sup Shell 272 Revenue Code Without Hcpcs,25.4,10.16,,,0 CDM,27200000S1_96129,Hc Sup Shell 272 Revenue Code Without Hcpcs,8.19,3.28,,,0 CDM,27200000S1_96130,Hc Sup Shell 272 Revenue Code Without Hcpcs,6.79,2.72,,,0 CDM,27200000S1_96132,Hc Sup Shell 272 Revenue Code Without Hcpcs,6.27,2.51,,,0 CDM,27200000S1_96133,Hc Sup Shell 272 Revenue Code Without Hcpcs,64.84,25.94,,,0 CDM,27200000S1_96136,Hc Sup Shell 272 Revenue Code Without Hcpcs,73.03,29.21,,,0 CDM,27200000S1_96147,Hc Sup Shell 272 Revenue Code Without Hcpcs,312.72,125.09,,,0 CDM,27200000S1_96149,Hc Sup Shell 272 Revenue Code Without Hcpcs,408.75,163.5,,,0 CDM,27200000S1_96160,Hc Sup Shell 272 Revenue Code Without Hcpcs,164.37,65.75,,,0 CDM,27200000S1_96164,Hc Sup Shell 272 Revenue Code Without Hcpcs,2173.5,869.4,,,0 CDM,27200000S1_96170,Hc Sup Shell 272 Revenue Code Without Hcpcs,64.19,25.68,,,0 CDM,27200000S1_96171,Hc Sup Shell 272 Revenue Code Without Hcpcs,64.6,25.84,,,0 CDM,27200000S1_96175,Hc Sup Shell 272 Revenue Code Without Hcpcs,377.58,151.03,,,0 CDM,27200000S1_96177,Hc Sup Shell 272 Revenue Code Without Hcpcs,258.92,103.57,,,0 CDM,27200000S1_96179,Hc Sup Shell 272 Revenue Code Without Hcpcs,165.64,66.26,,,0 CDM,27200000S1_96182,Hc Sup Shell 272 Revenue Code Without Hcpcs,193.61,77.44,,,0 CDM,27200000S1_96184,Hc Sup Shell 272 Revenue Code Without Hcpcs,77.06,30.82,,,0 CDM,27200000S1_96195,Hc Sup Shell 272 Revenue Code Without Hcpcs,586.69,234.68,,,0 CDM,27200000S1_96196,Hc Sup Shell 272 Revenue Code Without Hcpcs,586.69,234.68,,,0 CDM,27200000S1_96201,Hc Sup Shell 272 Revenue Code Without Hcpcs,964.67,385.87,,,0 CDM,27200000S1_96209,Hc Sup Shell 272 Revenue Code Without Hcpcs,13.66,5.46,,,0 CDM,27200000S1_96210,Hc Sup Shell 272 Revenue Code Without Hcpcs,22.57,9.03,,,0 CDM,27200000S1_96212,Hc Sup Shell 272 Revenue Code Without Hcpcs,16.51,6.6,,,0 CDM,27200000S1_96213,Hc Sup Shell 272 Revenue Code Without Hcpcs,5.79,2.32,,,0 CDM,27200000S1_96217,Hc Sup Shell 272 Revenue Code Without Hcpcs,264.48,105.79,,,0 CDM,27200000S1_96227,Hc Sup Shell 272 Revenue Code Without Hcpcs,165.13,66.05,,,0 CDM,27200000S1_96244,Hc Sup Shell 272 Revenue Code Without Hcpcs,13.33,5.33,,,0 CDM,27200000S1_96247,Hc Sup Shell 272 Revenue Code Without Hcpcs,34.38,13.75,,,0 CDM,27200000S1_96252,Hc Sup Shell 272 Revenue Code Without Hcpcs,46.16,18.46,,,0 CDM,27200000S1_96253,Hc Sup Shell 272 Revenue Code Without Hcpcs,65.05,26.02,,,0 CDM,27200000S1_96275,Hc Sup Shell 272 Revenue Code Without Hcpcs,60.16,24.06,,,0 CDM,27200000S1_96276,Hc Sup Shell 272 Revenue Code Without Hcpcs,5.71,2.28,,,0 CDM,27200000S1_96277,Hc Sup Shell 272 Revenue Code Without Hcpcs,35.98,14.39,,,0 CDM,27200000S1_96279,Hc Sup Shell 272 Revenue Code Without Hcpcs,1883.7,753.48,,,0 CDM,27200000S1_96284,Hc Sup Shell 272 Revenue Code Without Hcpcs,1255.82,502.33,,,0 CDM,27200000S1_96285,Hc Sup Shell 272 Revenue Code Without Hcpcs,425.25,170.1,,,0 CDM,27200000S1_96286,Hc Sup Shell 272 Revenue Code Without Hcpcs,425.25,170.1,,,0 CDM,27200000S1_96287,Hc Sup Shell 272 Revenue Code Without Hcpcs,427.89,171.16,,,0 CDM,27200000S1_96288,Hc Sup Shell 272 Revenue Code Without Hcpcs,427.67,171.07,,,0 CDM,27200000S1_96289,Hc Sup Shell 272 Revenue Code Without Hcpcs,430.27,172.11,,,0 CDM,27200000S1_96290,Hc Sup Shell 272 Revenue Code Without Hcpcs,425.25,170.1,,,0 CDM,2729907001,Hc Orthotic Finger Splint Material-Custom,26.25,10.5,,,0 CDM,2729907002,Hc Orthotic Hand Splint Material-Custom,196.88,78.75,,,0 CDM,2729907003,Hc Orthotic Forearm Splint Materials-Custom,393.75,157.5,,,0 CDM,2729907004,Hc Orthotic Elbow Split Materials-Custom,590.62,236.25,,,0 CDM,2729907005,Hc Dynamic Orthosis Splint Material-Custom,787.5,315.0,,,0 CDM,272A422301,"Hc Pump Tubing - Laborie Pump Tubing Infusion Line, Sap#219813",75.44,30.18,,,0 CDM,272A422301_A4223_272,"Hc Pump Tubing - Laborie Pump Tubing Infusion Line, Sap#219813",75.44,30.18,,,0 CDM,272A4270S1_130816,Hc Sup Shell 272 Revenue Code A4270 Hcpcs,196.6,78.64,,,0 CDM,272A4270S1_130818,Hc Sup Shell 272 Revenue Code A4270 Hcpcs,217.31,86.92,,,0 CDM,272A4270S1_130819,Hc Sup Shell 272 Revenue Code A4270 Hcpcs,217.31,86.92,,,0 CDM,272A430601,Hc Quickbloc Needle Set Sap#202783,136.08,54.43,,,0 CDM,272A431101,"Hc Foley Cath 14 Fr I&O Kit, Sap#275",10.2,4.08,,,0 CDM,272A431101_A4311_272,"Hc Foley Cath 14 Fr I&O Kit, Sap#275",10.2,4.08,,,0 CDM,272A4311S1_83418,Hc Sup Shell 272 Revenue Code A4311 Hcpcs,10.2,4.08,,,0 CDM,272A434001,"Hc Catheter Foley 2Way Sil, Mult Sap #451-457",49.35,19.74,,,0 CDM,272A434001_A4340_272,"Hc Catheter Foley 2Way Sil, Mult Sap #451-457",43.32,17.33,,,0 CDM,272A434002,"Hc Catheter Foley 5Cc 24Fr, Sap# 173221",13.03,5.21,,,0 CDM,272A434003,"Hc Foley Catheter 14 Fr 2W 5Ml, Sap#264196",117.46,46.98,,,0 CDM,272A4340S1_83470,Hc Sup Shell 272 Revenue Code A4340 Hcpcs,13.18,5.27,,,0 CDM,272A4340S1_83471,Hc Sup Shell 272 Revenue Code A4340 Hcpcs,13.16,5.26,,,0 CDM,272A4340S1_83472,Hc Sup Shell 272 Revenue Code A4340 Hcpcs,13.15,5.26,,,0 CDM,272A4340S1_83473,Hc Sup Shell 272 Revenue Code A4340 Hcpcs,13.15,5.26,,,0 CDM,272A4340S1_83474,Hc Sup Shell 272 Revenue Code A4340 Hcpcs,13.15,5.26,,,0 CDM,272A4340S1_83475,Hc Sup Shell 272 Revenue Code A4340 Hcpcs,13.07,5.23,,,0 CDM,272A434401,"Hc Catheter Foley Pediatric 2Way Sil, Mult Sap#1466-1467",13.65,5.46,,,0 CDM,272A4344S1_83752,Hc Sup Shell 272 Revenue Code A4344 Hcpcs,13.63,5.45,,,0 CDM,272A4344S1_83753,Hc Sup Shell 272 Revenue Code A4344 Hcpcs,13.76,5.5,,,0 CDM,272A435101,"Hc Catheter Urethra 14Fr Coude Tp Red, Sap#459",13.74,5.5,,,0 CDM,272A435101_A4351_272,"Hc Catheter Urethra 14Fr Coude Tp Red, Sap#459",13.74,5.5,,,0 CDM,272A435201,"Hc Catheter Foley Coude 2Way, Mult Sap#550-555",34.58,13.83,,,0 CDM,272A435201_A4352_272,"Hc Catheter Foley Coude 2Way, Mult Sap#550-555",34.58,13.83,,,0 CDM,272A455601,"Hc Eletrode Emg 22In Grounding, Sap#219815",14.57,5.83,,,0 CDM,272A455601_A4556_272,"Hc Eletrode Emg 22In Grounding, Sap#219815",14.57,5.83,,,0 CDM,272A464801,Hc Kit Procedure Pt Microseed Sap#237071,29137.5,11655.0,,,0 CDM,272A4648S1_182910,Hc Sup Shell 272 Revenue Code A4648 Hcpcs,297.0,118.8,,,0 CDM,272A619601_116652,Noncdm Charge Record Medical Supplies,17.64,7.06,,,0 CDM,272A620901,Hc Gel Therahoney Wound Sap#238108,39.69,15.88,,,0 CDM,272A621201,"Hc Dressing Wound Allevyn Life 6In X 6In, Sap#140009",11.18,4.47,,,0 CDM,272A621201_A6212_272,"Hc Dressing Wound Allevyn Life 6In X 6In, Sap#140009",11.18,4.47,,,0 CDM,272A6212S1_113452,Noncdm Charge Record Medical Supplies,251.11,100.44,,,0 CDM,272A6212S1_113619,Noncdm Charge Record Medical Supplies,9.51,3.8,,,0 CDM,272A6212S1_113621,Noncdm Charge Record Medical Supplies,11.16,4.46,,,0 CDM,272A6212S1_113674,Noncdm Charge Record Medical Supplies,10.21,4.08,,,0 CDM,272A6212S1_117683,Noncdm Charge Record Medical Supplies,21.58,8.63,,,0 CDM,272A6212S1_146190,Noncdm Charge Record Medical Supplies,28.47,11.39,,,0 CDM,272A6212S1_158804,Noncdm Charge Record Medical Supplies,28.66,11.46,,,0 CDM,272A6248S1_158810,Hc Sup Shell 272 Revenue Code A6248 Hcpcs,60.72,24.29,,,0 CDM,272A6250S1_198867,Hc Sup Shell 272 Revenue Code A6250 Hcpcs,17.68,7.07,,,0 CDM,272A750801,Hc Flexiderm Round Sap#36681,17.37,6.95,,,0 CDM,272A752101,"Hc Tube Trach Size 8.5 Shiley Flexible Cuffless Disposable Ic, Sap#829",152.42,60.97,,,0 CDM,272A752102,"Hc Tube Trach Size 7.5 Shiley Flexible Cuffless Disposable Ic, Sap#828",152.42,60.97,,,0 CDM,272A752103,Hc Tube Trach Size 7.5 Shiley Cuffed Disposable Ic Sap#826,166.52,66.61,,,0 CDM,272A7526S1_183332,Hc Sup Shell 272 Revenue Code A7526 Hcpcs,10.12,4.05,,,0 CDM,272C1713S1_128201,Hc Sup Shell 272 Revenue Code C1713 Hcpcs,171.16,68.46,,,0 CDM,272C1713S1_138215,Hc Sup Shell 272 Revenue Code C1713 Hcpcs,137.81,55.12,,,0 CDM,272C1713S1_191489,Hc Sup Shell 272 Revenue Code C1713 Hcpcs,452.81,181.12,,,0 CDM,272C1713S1_197563,Hc Sup Shell 272 Revenue Code C1713 Hcpcs,1767.94,707.18,,,0 CDM,272C1713S1_198317,Hc Sup Shell 272 Revenue Code C1713 Hcpcs,4311.56,1724.62,,,0 CDM,272C1725S1_184440,Hc Sup Shell 272 Revenue Code C1725 Hcpcs,13584.38,5433.75,,,0 CDM,272C1725S1_184443,Hc Sup Shell 272 Revenue Code C1725 Hcpcs,10828.12,4331.25,,,0 CDM,272C1725S1_184445,Hc Sup Shell 272 Revenue Code C1725 Hcpcs,13584.38,5433.75,,,0 CDM,272C1725S1_184446,Hc Sup Shell 272 Revenue Code C1725 Hcpcs,13584.38,5433.75,,,0 CDM,272C1725S1_184448,Hc Sup Shell 272 Revenue Code C1725 Hcpcs,13584.38,5433.75,,,0 CDM,272C1725S1_198418,Hc Sup Shell 272 Revenue Code C1725 Hcpcs,555.19,222.08,,,0 CDM,272C1725S1_198523,Hc Sup Shell 272 Revenue Code C1725 Hcpcs,555.19,222.08,,,0 CDM,272C1725S1_198693,Hc Sup Shell 272 Revenue Code C1725 Hcpcs,555.19,222.08,,,0 CDM,272C1725S1_198783,Hc Sup Shell 272 Revenue Code C1725 Hcpcs,555.19,222.08,,,0 CDM,272C1725S1_199358,Hc Sup Shell 272 Revenue Code C1725 Hcpcs,555.19,222.08,,,0 CDM,272C1726S1_175718,Hc Sup Shell 272 Revenue Code C1726 Hcpcs,13485.94,5394.38,,,0 CDM,272C1726S1_C1726_272,Hc Sup Shell 272 Revenue Code C1726 Hcpcs,13485.94,5394.38,,,0 CDM,272C174701,"Hc Forceps Grasping Flexcysto Single Use, Sap#252083",528.02,211.21,,,0 CDM,272C174701_C1747_272,"Hc Forceps Grasping Flexcysto Single Use, Sap#252083",528.02,211.21,,,0 CDM,272C174701_C2627_272,"Hc Forceps Grasping Flexcysto Single Use, Sap#252083",528.02,211.21,,,0 CDM,272C1747S1_178586,Hc Sup Shell 272 Revenue Code C1747 Hcpcs,276.02,110.41,,,0 CDM,272C1747S1_192523,Hc Sup Shell 272 Revenue Code C1747 Hcpcs,478.48,191.39,,,0 CDM,272C1748S1_182991,Hc Sup Shell 272 Revenue Code With C1748 Hcpcs,11536.88,4614.75,,,0 CDM,272C1761S1_198853,Hc Sup Shell 272 Revenue Code C1761 Hcpcs,18506.25,7402.5,,,0 CDM,272C1761S1_198854,Hc Sup Shell 272 Revenue Code C1761 Hcpcs,18506.25,7402.5,,,0 CDM,272C1769S1_198954,Hc Sup Shell 272 Revenue Code C1769 Hcpcs,1968.75,787.5,,,0 CDM,272C1787S1_132954,Hc Sup Shell 272 Revenue Code C1787 Hcpcs,3661.88,1464.75,,,0 CDM,272C1787S1_150623,Hc Sup Shell 272 Revenue Code C1787 Hcpcs,7331.62,2932.65,,,0 CDM,272C1787S1_191402,Hc Sup Shell 272 Revenue Code C1787 Hcpcs,5036.06,2014.42,,,0 CDM,272C1787S1_194456,Hc Sup Shell 272 Revenue Code C1787 Hcpcs,5036.06,2014.42,,,0 CDM,272C1787S1_197318,Hc Sup Shell 272 Revenue Code C1787 Hcpcs,3543.75,1417.5,,,0 CDM,272C1787S1_92564,Hc Sup Shell 272 Revenue Code C1787 Hcpcs,3327.19,1330.88,,,0 CDM,272C1787S1_95850,Hc Sup Shell 272 Revenue Code C1787 Hcpcs,1968.75,787.5,,,0 CDM,272C181901,"Hc Probe Ablation Rf 18G 70Mm 7Mm Star, Sap#265698",5866.88,2346.75,,,0 CDM,272C181902,"Hc Probe Ablation Rf 18G 70Mm 10Mm Star, Sap#265699",5866.88,2346.75,,,0 CDM,272C188301,"Hc Sprint Pns Repl Dual Lead Adapter Warranity, Sap#",0.01,0.004,,,0 CDM,272C188302,"Hc Sprint Pns Repl Lead Connector And Key, Ch 1, St, Warranity, Sap#",0.01,0.004,,,0 CDM,272C188303,"Hc Sprint Pns Repl Lead Connector And Key, Ch21, St Warranity, Sap#",0.01,0.004,,,0 CDM,272C1883S1_152551,Hc Sup Shell 272 Revenue Code C1883 Hcpcs,1968.75,787.5,,,0 CDM,272C1889S1_171460,Hc Sup Shell 272 Revenue Code C1889 Hcpcs,18852.75,7541.1,,,0 CDM,272C1889S1_95324,Hc Sup Shell 272 Revenue Code C1889 Hcpcs,2894.06,1157.62,,,0 CDM,272C2618S1_152573,Hc Sup Shell 272 Revenue Code C2618 Hcpcs,10040.62,4016.25,,,0 CDM,272C2618S1_152574,Hc Sup Shell 272 Revenue Code C2618 Hcpcs,10434.38,4173.75,,,0 CDM,272C2618S1_152614,Hc Sup Shell 272 Revenue Code C2618 Hcpcs,5886.56,2354.62,,,0 CDM,272C2618S1_170911,Hc Sup Shell 272 Revenue Code C2618 Hcpcs,5756.62,2302.65,,,0 CDM,272C2618S1_172536,Hc Sup Shell 272 Revenue Code C2618 Hcpcs,5709.38,2283.75,,,0 CDM,272C2618S1_185736,Hc Sup Shell 272 Revenue Code C2618 Hcpcs,1819.39,727.76,,,0 CDM,272C2618S1_185737,Hc Sup Shell 272 Revenue Code C2618 Hcpcs,1307.56,523.02,,,0 CDM,272C2618S1_185738,Hc Sup Shell 272 Revenue Code C2618 Hcpcs,1310.9,524.36,,,0 CDM,272C2618S1_197400,Hc Sup Shell 272 Revenue Code C2618 Hcpcs,1302.05,520.82,,,0 CDM,272C2627S1_84746,Hc Sup Shell 272 Revenue Code C2627 Hcpcs,630.44,252.18,,,0 CDM,272C9808S1_152573,Hc Sup Shell 272 Revenue Code C9808 Hcpcs,10040.62,4016.25,,,0 CDM,272C9808S1_152574,Hc Sup Shell 272 Revenue Code C9808 Hcpcs,10434.38,4173.75,,,0 CDM,272C980901,"Hc Cryoablation Needle For Non-Opioid Device, Sap#237077",6300.0,2520.0,,,0 CDM,272L850901,Hc Kit Repl 6Mm Insert Gel Cp Sap#36348,927.68,371.07,,,0 CDM,272L8681S1_156103,Hc Sup Shell 272 Revenue Code L8681 Hcpcs,75895.31,30358.12,,,0 CDM,272Q4101S1_158812,Hc Sup Shell 272 Revenue Code Q4101 Hcpcs,5020.31,2008.12,,,0 CDM,272Q4104S1_137761,Hc Sup Shell 272 Revenue Code Q4104 Hcpcs,12158.66,4863.46,,,0 CDM,272Q4104S1_137770,Hc Sup Shell 272 Revenue Code Q4104 Hcpcs,21498.75,8599.5,,,0 CDM,27400000S1_166579,Hc Sup Shell 274 Revenue Code Without Hcpcs,1098.56,439.42,,,0 CDM,274A456501,"Hc Sling Swathe, Sap# 76283",29.85,11.94,,,0 CDM,274A456501_A4565_274,"Hc Sling Swathe, Sap# 76283",29.85,11.94,,,0 CDM,274A4565S1_163505,Hc Sup Shell 274 Revenue Code A4565 Hcpcs,195.76,78.3,,,0 CDM,274A4565S1_163539,Hc Sup Shell 274 Revenue Code A4565 Hcpcs,195.9,78.36,,,0 CDM,274A4565S1_91888,Hc Sup Shell 274 Revenue Code A4565 Hcpcs,226.84,90.74,,,0 CDM,274A4565S1_91889,Hc Sup Shell 274 Revenue Code A4565 Hcpcs,226.84,90.74,,,0 CDM,274A7520S1_130650,Hc Sup Shell 274 Revenue Code A7520 Hcpcs,572.4,228.96,,,0 CDM,274A7520S1_91663,Hc Sup Shell 274 Revenue Code A7520 Hcpcs,615.35,246.14,,,0 CDM,274A7524S1_130555,Hc Sup Shell 274 Revenue Code A7524 Hcpcs,619.92,247.97,,,0 CDM,274L0174S1_118978,Hc Sup Shell 274 Revenue Code L0174 Hcpcs,570.94,228.38,,,0 CDM,274L1685S1_118994,Hc Sup Shell 274 Revenue Code L1685 Hcpcs,4843.12,1937.25,,,0 CDM,274L183001,Hc Imobilizer Knee,43.31,17.32,,,0 CDM,274L183001_L1830_274,Hc Imobilizer Knee,46.84,18.74,,,0 CDM,274L1830S1_163502,Hc Sup Shell 274 Revenue Code L1830 Hcpcs,48.52,19.41,,,0 CDM,274L1830S1_163599,Hc Sup Shell 274 Revenue Code L1830 Hcpcs,42.12,16.85,,,0 CDM,274L1830S1_163604,Hc Sup Shell 274 Revenue Code L1830 Hcpcs,48.95,19.58,,,0 CDM,274L1830S1_163605,Hc Sup Shell 274 Revenue Code L1830 Hcpcs,50.97,20.39,,,0 CDM,274L2624S1_118995,Hc Sup Shell 274 Revenue Code L2624 Hcpcs,2953.12,1181.25,,,0 CDM,274L367801,"Hc Hemi Shoulder Sling, Sap#259245",175.35,70.14,,,0 CDM,274L370201,Hc Eo Static,361.2,144.48,,,0 CDM,274L370201_L3702_274,Hc Eo Static,361.2,144.48,,,0 CDM,274L3740S1_165203,Hc Sup Shell 274 Revenue Code L3740 Hcpcs,339.1,135.64,,,0 CDM,274L3740S1_172564,Hc Sup Shell 274 Revenue Code L3740 Hcpcs,339.1,135.64,,,0 CDM,274L376001,Hc Innovator X Post Op Elbow Brace Unilateral,478.64,191.46,,,0 CDM,274L376001_L3760_274,Hc Innovator X Post Op Elbow Brace Unilateral,478.64,191.46,,,0 CDM,274L376002,Hc Mayo Clinic Elbow Brace Unilateral,1359.86,543.94,,,0 CDM,274L376201,Hc Elbow Stabilizer,177.3,70.92,,,0 CDM,274L376201_L3762_274,Hc Elbow Stabilizer,174.06,69.62,,,0 CDM,274L376301,Hc Ewho Static,1032.15,412.86,,,0 CDM,274L376301_L3763_274,Hc Ewho Static,1032.15,412.86,,,0 CDM,274L376401,Hc Ewho W/Joint(S) Cf,1029.0,411.6,,,0 CDM,274L376401_L3764_274,Hc Ewho W/Joint(S) Cf,1029.0,411.6,,,0 CDM,274L376501,Hc Ewhfo Static,1666.35,666.54,,,0 CDM,274L376501_L3765_274,Hc Ewhfo Static,1666.35,666.54,,,0 CDM,274L376601,Hc Ewhfo Dynamic,1764.0,705.6,,,0 CDM,274L380601,Hc Whfo Dynamic,590.1,236.04,,,0 CDM,274L380601_L3806_274,Hc Whfo Dynamic,590.1,236.04,,,0 CDM,274L380701,Hc Rolyan Fit Thumb Spica,116.91,46.76,,,0 CDM,274L380701_L3807_274,Hc Rolyan Fit Thumb Spica,109.76,43.9,,,0 CDM,274L380706,Hc Cool Comfort Thumb Cmc Splint,82.69,33.08,,,0 CDM,274L380706_L3807_274,Hc Cool Comfort Thumb Cmc Splint,78.41,31.36,,,0 CDM,274L380801,"Hc Whfo, Rigid W/O Joints, Sap# 259509",231.68,92.67,,,0 CDM,274L380801_L3808_274,"Hc Whfo, Rigid W/O Joints, Sap# 259509",231.68,92.67,,,0 CDM,274L390001,Hc Whfo Dynamic Flexor Hinge,2029.65,811.86,,,0 CDM,274L390501,Hc Who Dynamic,1288.35,515.34,,,0 CDM,274L390501_L3905_274,Hc Who Dynamic,1288.35,515.34,,,0 CDM,274L390601,Hc Who W/O Joints Cf,548.1,219.24,,,0 CDM,274L390601_L3906_274,Hc Who W/O Joints Cf,548.1,219.24,,,0 CDM,274L390801,Hc Rolyan D-Ring Wrist Black,61.38,24.55,,,0 CDM,274L390801_L3908_274,Hc Rolyan D-Ring Wrist Black,61.38,24.55,,,0 CDM,274L390802,Hc Wrist Widget,148.29,59.32,,,0 CDM,274L390802_L3908_274,Hc Wrist Widget,148.29,59.32,,,0 CDM,274L390803,"Hc Wristband Bullseye, Sap#263361-263364",153.56,61.42,,,0 CDM,274L390803_L3908_274,"Hc Wristband Bullseye, Sap#263361-263364",153.56,61.42,,,0 CDM,274L390804,"Hc Comfort Cool Ulnar Booster, Sap#",107.85,43.14,,,0 CDM,274L390805,"Hc Wristable Brace, Sap#",210.69,84.28,,,0 CDM,274L3908S1_116771,Hc Sup Shell 274 Revenue Code L3908 Hcpcs,39.53,15.81,,,0 CDM,274L391202,Hc Traction Glove Unilateral,50.01,20.0,,,0 CDM,274L391202_L3912_274,Hc Traction Glove Unilateral,49.53,19.81,,,0 CDM,274L391301,Hc Hfo W/O Joints Cf,351.75,140.7,,,0 CDM,274L391301_L3913_274,Hc Hfo W/O Joints Cf,351.75,140.7,,,0 CDM,274L391901,Hc Ho Static,351.75,140.7,,,0 CDM,274L391901_L3919_274,Hc Ho Static,351.75,140.7,,,0 CDM,274L392101,Hc Hfo Dynamic,416.85,166.74,,,0 CDM,274L392101_L3921_274,Hc Hfo Dynamic,416.85,166.74,,,0 CDM,274L392302,"Hc Push Metagrip Thumb Cmc Splint Unilateral, Sap# 245012",343.43,137.37,,,0 CDM,274L392302_L3923_274,"Hc Push Metagrip Thumb Cmc Splint Unilateral, Sap# 245012",343.43,137.37,,,0 CDM,274L392501,Hc Dynamic Digit Extension Tube,98.24,39.3,,,0 CDM,274L392501_L3925_274,Hc Dynamic Digit Extension Tube,78.48,31.39,,,0 CDM,274L392502,Hc Joint Jack Finger Splint,94.97,37.99,,,0 CDM,274L392504,Hc Rolyan Pip Ligament Repair,101.7,40.68,,,0 CDM,274L392504_L3925_274,Hc Rolyan Pip Ligament Repair,98.24,39.3,,,0 CDM,274L392505,Hc Sofstretch Short Extension Black,227.61,91.04,,,0 CDM,274L392505_L3925_274,Hc Sofstretch Short Extension Black,220.66,88.26,,,0 CDM,274L392506,"Hc Static Progressive Pip Extension, Sap# 245018",150.21,60.08,,,0 CDM,274L392506_L3925_274,"Hc Static Progressive Pip Extension, Sap# 245018",150.21,60.08,,,0 CDM,274L392701,Hc 3Pp Buddy Loop Black 1/2In,7.17,2.87,,,0 CDM,274L392701_L3927_274,Hc 3Pp Buddy Loop Black 1/2In,7.17,2.87,,,0 CDM,274L392702,"Hc 3Pp Final Flexion Wrap, Per Wrap",14.1,5.64,,,0 CDM,274L392702_L3927_274,"Hc 3Pp Final Flexion Wrap, Per Wrap",352.44,140.98,,,0 CDM,274L392703,Hc Oval 8 Splints,17.28,6.91,,,0 CDM,274L392703_L3927_274,Hc Oval 8 Splints,29.55,11.82,,,0 CDM,274L392704,"Hc Imak Finger Sleeve, Sap# 245009",39.3,15.72,,,0 CDM,274L392704_L3927_274,"Hc Imak Finger Sleeve, Sap# 245009",39.3,15.72,,,0 CDM,274L392706,"Hc Trigger Finger Solution, Sap# 156295",41.38,16.55,,,0 CDM,274L392706_L3927_274,"Hc Trigger Finger Solution, Sap# 156295",41.38,16.55,,,0 CDM,274L392901,Hc Knuckle Bender Splint,73.51,29.4,,,0 CDM,274L392901_L3929_274,Hc Knuckle Bender Splint,72.19,28.88,,,0 CDM,274L393101,Hc Splint Wrist,18.73,7.49,,,0 CDM,274L393102,Hc Splint Wrist 6In F Med Hk & Loop Close Left Sap#689,22.48,8.99,,,0 CDM,274L393103,Hc Splint Wrist 6In F Lg Hk & Loop Close Left Sap#688,22.2,8.88,,,0 CDM,274L393104,Hc Splint Wrist 6In Xl Hk & Loop Close Left Sap#695,22.2,8.88,,,0 CDM,274L393105,Hc Splint Wrist 6In F Sm Hk & Loop Close Left Sap#694,22.2,8.88,,,0 CDM,274L393106,Hc Splint Wrist 6In F Sm Hk & Loop Close Right Sap#692,22.48,8.99,,,0 CDM,274L393107,Hc Splint Wrist 6In-6.5In F Med Right Sap#691,22.48,8.99,,,0 CDM,274L393108,Hc Splint Wrist 6In F Rt Xl Hk & Loop Closure Sap#693,22.05,8.82,,,0 CDM,274L393109,"Hc Splint Wrist 6In F Rt Lg Hk & Loop Closure, Sap#690",54.6,21.84,,,0 CDM,274L393301,Hc Fo Static,277.2,110.88,,,0 CDM,274L393301_L3933_274,Hc Fo Static,277.2,110.88,,,0 CDM,274L393501,Hc Fo Dynamaic,286.65,114.66,,,0 CDM,274L393501_L3935_274,Hc Fo Dynamaic,286.65,114.66,,,0 CDM,274L398001,Hc Rolyan Aqua Humerus Fx,100.8,40.32,,,0 CDM,274L398001_L3980_274,Hc Rolyan Aqua Humerus Fx,100.8,40.32,,,0 CDM,274L3980S1_182460,Hc Sup Shell 274 Revenue Code L3980 Hcpcs,236.45,94.58,,,0 CDM,274L399901,"Hc Rolyan Gel/Air Universal Elbow Support Brace, Sap#259620",43.9,17.56,,,0 CDM,274L399901_L3999_274,"Hc Rolyan Gel/Air Universal Elbow Support Brace, Sap#259620",43.9,17.56,,,0 CDM,274L435001,Hc Brace Ankle Stirrup Universal Sap #140321,43.93,17.57,,,0 CDM,274L435001_L4350_274,Hc Brace Ankle Stirrup Universal Sap #140321,43.93,17.57,,,0 CDM,274L436001,Hc Moonboot Sap #139008,128.95,51.58,,,0 CDM,274L436002,"Hc Ankle Walker, Sap# 215476",598.11,239.24,,,0 CDM,274L4360S1_163610,Hc Sup Shell 274 Revenue Code L4360 Hcpcs,128.95,51.58,,,0 CDM,274L4360S1_175952,Hc Sup Shell 274 Revenue Code L4360 Hcpcs,128.95,51.58,,,0 CDM,274L4360S1_179062,Hc Sup Shell 274 Revenue Code L4360 Hcpcs,128.95,51.58,,,0 CDM,274L4360S1_182409,Hc Sup Shell 274 Revenue Code L4360 Hcpcs,125.57,50.23,,,0 CDM,274L4360S1_199359,Hc Sup Shell 274 Revenue Code L4360 Hcpcs,137.81,55.12,,,0 CDM,274L4370S1_188432,Hc Sup Shell 274 Revenue Code L4370 Hcpcs,15.05,6.02,,,0 CDM,274L850101,Hc Tracheostomy Speaking Valve Sap #4675,289.8,115.92,,,0 CDM,274L850901,"Hc Tracheoesophageal Voice Prosthesis Sap#36348, 36349, 36350",1004.06,401.62,,,0 CDM,274L851401,"Hc Trach Puncture Dilator, Sap# 202034",231.0,92.4,,,0 CDM,274L851401_L8514_274,"Hc Trach Puncture Dilator, Sap# 202034",231.0,92.4,,,0 CDM,274L851402,"Hc Puncture Dilator For Tep 18Fr, Sap#36357",448.88,179.55,,,0 CDM,274L867001,"Hc Heartware Graft Hvad Outlaw, Sap# 173753",7875.0,3150.0,,,0 CDM,274L8691S1_153200,Hc Sup Shell 274 Revenue Code L8691 Hcpcs,40963.07,16385.23,,,0 CDM,274L8691S1_L8691_274,Hc Sup Shell 274 Revenue Code L8691 Hcpcs,48628.12,19451.25,,,0 CDM,274L8694S1_180591,Hc Sup Shell 274 Revenue Code L8694 Hcpcs,48628.12,19451.25,,,0 CDM,274Q047801,Hc Heartware Ac Adapter Sap#263442,938.44,375.38,,,0 CDM,274Q047901,"Hc Heartmate Iii Mobile Cable Unit, Sap#234537",34020.0,13608.0,,,0 CDM,274Q047901_Q0479_274,"Hc Heartmate Iii Mobile Cable Unit, Sap#234537",34020.0,13608.0,,,0 CDM,274Q048101,"Hc Controller Heartmate 3 Lvad With Battery, Sap# 218193",23388.75,9355.5,,,0 CDM,274Q048101_Q0481_274,"Hc Controller Heartmate 3 Lvad With Battery, Sap# 218193",23388.75,9355.5,,,0 CDM,274Q048102,Hc Heartmate Ii Pocket Controller System Sap #173918,21656.25,8662.5,,,0 CDM,274Q0481S1_137271,Hc Sup Shell 274 Revenue Code Q0481 Hcpcs,23388.75,9355.5,,,0 CDM,274Q048201,Hc Adaptor Heartware Dc Sap #173762,7875.0,3150.0,,,0 CDM,274Q048202,Hc Heartware Controller Kit,28153.12,11261.25,,,0 CDM,274Q048601,Hc Heartware Cable Drive Ext,10237.5,4095.0,,,0 CDM,274Q048901,Hc Heartware Charger Battery,24018.75,9607.5,,,0 CDM,274Q048901_Q0489_274,Hc Heartware Charger Battery,24018.75,9607.5,,,0 CDM,274Q048901_Q0509_274,Hc Heartware Charger Battery,24018.75,9607.5,,,0 CDM,274Q049501,"Hc Charger Battery Universal Hm3, Sap#236950",30618.0,12247.2,,,0 CDM,274Q049501_Q0495_274,"Hc Charger Battery Universal Hm3, Sap#236950",30618.0,12247.2,,,0 CDM,274Q049601,"Hc Battery Lvad, Sap#173347",354.38,141.75,,,0 CDM,274Q049701,"Hc Heartmate Battery Clip Set 14V, Sap#246552",4677.75,1871.1,,,0 CDM,274Q049701_Q0497_274,"Hc Heartmate Battery Clip Set 14V, Sap#246552",4677.75,1871.1,,,0 CDM,274Q049801,"Hc Holster Battery, Sap#174712",1679.74,671.9,,,0 CDM,274Q049901,"Hc Bag Consolidated, Sap#174711",1382.06,552.82,,,0 CDM,274Q049901_Q0499_274,"Hc Bag Consolidated, Sap#174711",1382.06,552.82,,,0 CDM,274Q050101,Hc Heartware Bag Shower Sap #173766,1181.25,472.5,,,0 CDM,274Q050101_Q0501_274,Hc Heartware Bag Shower Sap #173766,1181.25,472.5,,,0 CDM,274Q050102,"Hc Bag Shower, Sap#174715",956.81,382.72,,,0 CDM,274Q050102_Q0501_274,"Hc Bag Shower, Sap#174715",956.81,382.72,,,0 CDM,274Q050601_Q0506_274,Hc Battery Lith Pocket Contrller,1968.75,787.5,,,0 CDM,274Q050602,Hc Heartware Battery Sap #173765,2953.12,1181.25,,,0 CDM,274Q050602_Q0506_274,Hc Heartware Battery Sap #173765,2953.12,1181.25,,,0 CDM,274Q050603,"Hc Battery Lith Pocket Controller, Sap# 173913",1968.75,787.5,,,0 CDM,274Q050603_Q0506_274,"Hc Battery Lith Pocket Controller, Sap# 173913",1968.75,787.5,,,0 CDM,274Q050604,"Hc Battery Lith 14V, Sap#254420",10631.25,4252.5,,,0 CDM,274Q050604_Q0506_274,"Hc Battery Lith 14V, Sap#254420",10631.25,4252.5,,,0 CDM,274Q050701,Hc Heartware Pack Patient,1673.44,669.38,,,0 CDM,274Q050801,Hc Kit Daily Driveline Management Sap #203124,64.98,25.99,,,0 CDM,274Q050801_Q0508_274,Hc Kit Daily Driveline Management Sap #203124,64.98,25.99,,,0 CDM,274Q050802,Hc Kit Extended Wear Sap #203125,74.57,29.83,,,0 CDM,274Q050802_Q0508_274,Hc Kit Extended Wear Sap #203125,74.57,29.83,,,0 CDM,274Q050803,"Hc Shoulder Pack Patient Magnetic F/Vent, Sap# 234313",1771.88,708.75,,,0 CDM,274Q050804,"Hc Case Travel, Sap#218897",630.0,252.0,,,0 CDM,274Q050804_Q0508_274,"Hc Case Travel, Sap#218897",630.0,252.0,,,0 CDM,274Q050805,"Hc Lvad Custom Dressing Kit, Sap#265922",189.91,75.96,,,0 CDM,275C1721S1_138105,Hc Sup Shell 275 Revenue Code C1721 Hcpcs,44296.88,17718.75,,,0 CDM,275C1721S1_138110,Hc Sup Shell 275 Revenue Code C1721 Hcpcs,68906.25,27562.5,,,0 CDM,275C1721S1_138297,Hc Sup Shell 275 Revenue Code C1721 Hcpcs,40930.31,16372.12,,,0 CDM,275C1721S1_161299,Hc Sup Shell 275 Revenue Code C1721 Hcpcs,51128.44,20451.38,,,0 CDM,275C1721S1_164598,Hc Sup Shell 275 Revenue Code C1721 Hcpcs,51277.5,20511.0,,,0 CDM,275C1721S1_186068,Hc Sup Shell 275 Revenue Code C1721 Hcpcs,42985.69,17194.28,,,0 CDM,275C1722S1_158754,Hc Sup Shell 275 Revenue Code C1722 Hcpcs,42918.75,17167.5,,,0 CDM,275C1722S1_161304,Hc Sup Shell 275 Revenue Code C1722 Hcpcs,40930.31,16372.12,,,0 CDM,275C1722S1_162719,Hc Sup Shell 275 Revenue Code C1722 Hcpcs,71579.81,28631.92,,,0 CDM,275C1722S1_162789,Hc Sup Shell 275 Revenue Code C1722 Hcpcs,46112.06,18444.82,,,0 CDM,275C1722S1_169581,Hc Sup Shell 275 Revenue Code C1722 Hcpcs,46831.64,18732.66,,,0 CDM,275C1722S1_169833,Hc Sup Shell 275 Revenue Code C1722 Hcpcs,71579.81,28631.92,,,0 CDM,275C1722S1_170823,Hc Sup Shell 275 Revenue Code C1722 Hcpcs,78750.0,31500.0,,,0 CDM,275C1764S1_134329,Hc Sup Shell 275 Revenue Code C1764 Hcpcs,20258.44,8103.38,,,0 CDM,275C1764S1_197525,Hc Sup Shell 275 Revenue Code C1764 Hcpcs,20258.44,8103.38,,,0 CDM,275C1764S1_199629,Hc Sup Shell 275 Revenue Code C1764 Hcpcs,20258.44,8103.38,,,0 CDM,275C1764S1_C1764_275,Hc Sup Shell 275 Revenue Code C1764 Hcpcs,19558.05,7823.22,,,0 CDM,275C1777S1_138043,Hc Sup Shell 275 Revenue Code C1777 Hcpcs,10434.38,4173.75,,,0 CDM,275C1777S1_138066,Hc Sup Shell 275 Revenue Code C1777 Hcpcs,12403.12,4961.25,,,0 CDM,275C1777S1_138072,Hc Sup 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Revenue Code V2632 Hcpcs,598.5,239.4,,,0 CDM,276V2632S1_184275,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,598.5,239.4,,,0 CDM,276V2632S1_184276,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,598.5,239.4,,,0 CDM,276V2632S1_184277,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,598.5,239.4,,,0 CDM,276V2632S1_184278,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,598.5,239.4,,,0 CDM,276V2632S1_184279,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,598.5,239.4,,,0 CDM,276V2632S1_184280,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,598.5,239.4,,,0 CDM,276V2632S1_184281,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,598.5,239.4,,,0 CDM,276V2632S1_184282,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,598.5,239.4,,,0 CDM,276V2632S1_184283,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,598.5,239.4,,,0 CDM,276V2632S1_184284,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,598.5,239.4,,,0 CDM,276V2632S1_184285,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,598.5,239.4,,,0 CDM,276V2632S1_184286,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,598.5,239.4,,,0 CDM,276V2632S1_184287,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,598.5,239.4,,,0 CDM,276V2632S1_184289,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,598.5,239.4,,,0 CDM,276V2632S1_184290,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,598.5,239.4,,,0 CDM,276V2632S1_184292,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,598.5,239.4,,,0 CDM,276V2632S1_185423,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,598.5,239.4,,,0 CDM,276V2632S1_187981,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,598.5,239.4,,,0 CDM,276V2632S1_189159,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,598.5,239.4,,,0 CDM,276V2632S1_194359,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,598.5,239.4,,,0 CDM,276V2632S1_197399,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,598.5,239.4,,,0 CDM,276V2632S1_87366,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,586.69,234.68,,,0 CDM,276V2632S1_92096,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,586.69,234.68,,,0 CDM,276V2632S1_92100,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,586.69,234.68,,,0 CDM,276V2632S1_92103,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,586.69,234.68,,,0 CDM,276V2632S1_92105,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,586.69,234.68,,,0 CDM,276V2632S1_V2632_276,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,1102.5,441.0,,,0 CDM,276V2787S1_186006,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 CDM,276V2787S1_186621,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 CDM,276V2787S1_192146,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 CDM,276V2787S1_192727,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 CDM,276V2787S1_193139,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 CDM,276V2787S1_193187,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 CDM,276V2787S1_193188,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 CDM,276V2787S1_193319,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 CDM,276V2787S1_194250,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 CDM,276V2787S1_194257,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 CDM,276V2787S1_194360,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 CDM,276V2787S1_195258,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 CDM,276V2787S1_196152,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 CDM,276V2787S1_196197,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 CDM,276V2787S1_196779,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 CDM,276V2787S1_197776,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 CDM,276V2787S1_198728,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 CDM,276V2787S1_198729,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 CDM,276V2787S1_199026,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 CDM,276V2787S1_199619,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 CDM,276V2787S1_199623,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 CDM,276V2787S1_199625,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 CDM,276V2787S1_V2632_276,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 CDM,276V2787S1_V2787_276,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 CDM,2780000003_09999700032,NDC Description Not Available,67481.25,26992.5,,,0 CDM,2780000003_C2616_278,NDC Description Not Available,70537.37,28214.95,,,0 CDM,2780000004,Hc Armstrong Ventilation Tube 1.14Mm Sap#10273,43.9,17.56,,,0 CDM,2780000004_278,Hc Armstrong Ventilation Tube 1.14Mm Sap#10273,43.9,17.56,,,0 CDM,2780000005,Hc Tube Suction Collar 1.27Mm Ventilator Button Sap#10244,37.84,15.14,,,0 CDM,2780000006,Hc Tube Suction Pediatric Ventilator Rock Plastic 1Mm Sap #10255,74.61,29.84,,,0 CDM,2780000007,Hc Trach Tube Ultrasil Modified,60.25,24.1,,,0 CDM,2780000008,Hc Triune Tympanostomy .5Mm Sap#140692,97.29,38.92,,,0 CDM,2780000008_278,Hc Triune Tympanostomy .5Mm Sap#140692,97.29,38.92,,,0 CDM,2780000009,"Hc Cannula Fem Flex Art 18, Sap#204064",827.39,330.96,,,0 CDM,2780000009_278,"Hc Cannula Fem Flex Art 18, Sap#204064",827.39,330.96,,,0 CDM,2780000010,"Hc Cannula Biomed Nextgen 25Fr, Sap#173149",1554.29,621.72,,,0 CDM,2780000010_278,"Hc Cannula Biomed Nextgen 25Fr, Sap#173149",1554.29,621.72,,,0 CDM,2780000011,"Hc Set Cann 21Fr 1In Fem Art Perc, Sap#8864",867.63,347.05,,,0 CDM,2780000011_278,"Hc Set Cann 21Fr 1In Fem Art Perc, Sap#8864",867.63,347.05,,,0 CDM,2780000012,"Hc Cannula Fem 17Fr Art, Sap#8862",867.63,347.05,,,0 CDM,2780000012_278,"Hc Cannula Fem 17Fr Art, Sap#8862",867.63,347.05,,,0 CDM,2780000013,"Hc Cannula, Art-Femoral (Carmeda) 15 Fr, Sap#8861",1231.26,492.5,,,0 CDM,2780000013_278,"Hc Cannula, Art-Femoral (Carmeda) 15 Fr, Sap#8861",1231.26,492.5,,,0 CDM,2780000014,"Hc Eartube Titanium ( 056101), Sap# 50360",104.31,41.72,,,0 CDM,2780000015,"Hc Cannula Fem Flex Art 20, Sap#204065",827.39,330.96,,,0 CDM,2780000015_278,"Hc Cannula Fem Flex Art 20, Sap#204065",827.39,330.96,,,0 CDM,2780000016,"Hc Catheter Bicaval Dual 20Fr, Sap#141822",9325.85,3730.34,,,0 CDM,2780000017,"Hc Catheter Bicaval Dual 23Fr, Sap#141823",9646.88,3858.75,,,0 CDM,2780000018,"Hc Catheter Bicaval Dual 27Fr, Sap#141824",9646.88,3858.75,,,0 CDM,2780000019,"Hc Catheter Bicaval Dual 31Fr, Sap#141825",9646.88,3858.75,,,0 CDM,2780000020,"Hc Cannula Mc3 Crescent 19Fr Ra, Sap#251602",10631.25,4252.5,,,0 CDM,2780000020_278,"Hc Cannula Mc3 Crescent 19Fr Ra, Sap#251602",10631.25,4252.5,,,0 CDM,2780000021,"Hc Kit Protekduo Dl29, Sap#211765",76781.25,30712.5,,,0 CDM,2780000022,"Hc Kit Protekduo Dl31, Sap#211766",76781.25,30712.5,,,0 CDM,2780000023,"Hc Cannula Fem Flex Art 16, Sap#204063",827.39,330.96,,,0 CDM,2780000023_278,"Hc Cannula Fem Flex Art 16, Sap#204063",827.39,330.96,,,0 CDM,2780000024,"Hc Catheter Bicaval Dual 19Fr, Sap#141821",9646.88,3858.75,,,0 CDM,2780000024_278,"Hc Catheter Bicaval Dual 19Fr, Sap#141821",9646.88,3858.75,,,0 CDM,2780000025,"Hc Cannula Fem 23Fr Art, Sap#7690",919.68,367.87,,,0 CDM,2780000098,Hc Kit Catheter Access Port,98.44,39.38,,,0 CDM,2780000098_278,Hc Kit Catheter Access Port,98.44,39.38,,,0 CDM,27800000S1_107025,Hc Sup Shell 278 Revenue Code Without Hcpcs,990.68,396.27,,,0 CDM,27800000S1_113443,Hc Sup Shell 278 Revenue Code Without Hcpcs,2394.0,957.6,,,0 CDM,27800000S1_113447,Hc Sup Shell 278 Revenue Code Without Hcpcs,273.82,109.53,,,0 CDM,27800000S1_114313,Hc Sup Shell 278 Revenue Code Without Hcpcs,284.68,113.87,,,0 CDM,27800000S1_115239,Hc Sup Shell 278 Revenue Code Without Hcpcs,8859.38,3543.75,,,0 CDM,27800000S1_115458,Hc Sup Shell 278 Revenue Code Without Hcpcs,8859.38,3543.75,,,0 CDM,27800000S1_117344,Hc Sup Shell 278 Revenue Code Without Hcpcs,1185.03,474.01,,,0 CDM,27800000S1_117434,Hc Sup Shell 278 Revenue Code Without Hcpcs,307.12,122.85,,,0 CDM,27800000S1_117435,Hc Sup Shell 278 Revenue Code Without Hcpcs,2681.44,1072.58,,,0 CDM,27800000S1_117436,Hc Sup Shell 278 Revenue Code Without Hcpcs,2681.44,1072.58,,,0 CDM,27800000S1_117438,Hc Sup Shell 278 Revenue Code Without Hcpcs,20173.79,8069.52,,,0 CDM,27800000S1_117668,Hc Sup Shell 278 Revenue Code Without Hcpcs,2754.79,1101.92,,,0 CDM,27800000S1_117912,Hc Sup Shell 278 Revenue Code Without Hcpcs,25347.66,10139.06,,,0 CDM,27800000S1_117916,Hc Sup Shell 278 Revenue Code Without Hcpcs,28726.04,11490.42,,,0 CDM,27800000S1_117917,Hc Sup Shell 278 Revenue Code Without Hcpcs,30419.16,12167.66,,,0 CDM,27800000S1_117918,Hc Sup Shell 278 Revenue Code Without Hcpcs,32104.41,12841.76,,,0 CDM,27800000S1_117919,Hc Sup Shell 278 Revenue Code Without Hcpcs,31259.81,12503.92,,,0 CDM,27800000S1_117920,Hc Sup Shell 278 Revenue Code Without Hcpcs,32779.69,13111.88,,,0 CDM,27800000S1_118963,Hc Sup Shell 278 Revenue Code Without Hcpcs,1575.0,630.0,,,0 CDM,27800000S1_119705,Hc Sup Shell 278 Revenue Code Without Hcpcs,20904.19,8361.68,,,0 CDM,27800000S1_119728,Hc Sup Shell 278 Revenue Code Without Hcpcs,7616.9,3046.76,,,0 CDM,27800000S1_119729,Hc Sup Shell 278 Revenue Code Without Hcpcs,7616.9,3046.76,,,0 CDM,27800000S1_132845,Hc Sup Shell 278 Revenue Code Without Hcpcs,66937.5,26775.0,,,0 CDM,27800000S1_132846,Hc Sup Shell 278 Revenue Code Without Hcpcs,3937.5,1575.0,,,0 CDM,27800000S1_135335,Hc Sup Shell 278 Revenue Code Without Hcpcs,3587.26,1434.9,,,0 CDM,27800000S1_135898,Hc Sup Shell 278 Revenue Code Without Hcpcs,80.32,32.13,,,0 CDM,27800000S1_135899,Hc Sup Shell 278 Revenue Code Without Hcpcs,80.32,32.13,,,0 CDM,27800000S1_135900,Hc Sup Shell 278 Revenue Code Without Hcpcs,80.32,32.13,,,0 CDM,27800000S1_146863,Hc Sup Shell 278 Revenue Code Without Hcpcs,19687.5,7875.0,,,0 CDM,27800000S1_146864,Hc Sup Shell 278 Revenue Code Without Hcpcs,19687.5,7875.0,,,0 CDM,27800000S1_146866,Hc Sup Shell 278 Revenue Code Without Hcpcs,984.38,393.75,,,0 CDM,27800000S1_147439,Hc Sup Shell 278 Revenue Code Without Hcpcs,393.75,157.5,,,0 CDM,27800000S1_147441,Hc Sup Shell 278 Revenue Code Without Hcpcs,393.75,157.5,,,0 CDM,27800000S1_152632,Hc Sup Shell 278 Revenue Code Without Hcpcs,1639.85,655.94,,,0 CDM,27800000S1_152633,Hc Sup Shell 278 Revenue Code Without Hcpcs,1639.85,655.94,,,0 CDM,27800000S1_152643,Hc Sup Shell 278 Revenue Code Without Hcpcs,1639.85,655.94,,,0 CDM,27800000S1_153732,Hc Sup Shell 278 Revenue Code Without Hcpcs,123.95,49.58,,,0 CDM,27800000S1_153989,Hc Sup Shell 278 Revenue Code Without Hcpcs,11812.5,4725.0,,,0 CDM,27800000S1_154004,Hc Sup Shell 278 Revenue Code Without Hcpcs,11812.5,4725.0,,,0 CDM,27800000S1_154008,Hc Sup Shell 278 Revenue Code Without Hcpcs,11812.5,4725.0,,,0 CDM,27800000S1_154233,Hc Sup Shell 278 Revenue Code Without Hcpcs,9765.0,3906.0,,,0 CDM,27800000S1_154250,Hc Sup Shell 278 Revenue Code Without Hcpcs,9765.0,3906.0,,,0 CDM,27800000S1_155693,Hc Sup Shell 278 Revenue Code Without Hcpcs,2264.06,905.62,,,0 CDM,27800000S1_155702,Hc Sup Shell 278 Revenue Code Without Hcpcs,2264.06,905.62,,,0 CDM,27800000S1_155720,Hc Sup Shell 278 Revenue Code Without Hcpcs,1968.75,787.5,,,0 CDM,27800000S1_155723,Hc Sup Shell 278 Revenue Code Without Hcpcs,787.5,315.0,,,0 CDM,27800000S1_155760,Hc Sup Shell 278 Revenue Code Without Hcpcs,1870.31,748.12,,,0 CDM,27800000S1_158947,Hc Sup Shell 278 Revenue Code Without Hcpcs,590.62,236.25,,,0 CDM,27800000S1_158948,Hc Sup Shell 278 Revenue Code Without Hcpcs,590.62,236.25,,,0 CDM,27800000S1_158949,Hc Sup Shell 278 Revenue Code Without Hcpcs,590.62,236.25,,,0 CDM,27800000S1_158951,Hc Sup Shell 278 Revenue Code Without Hcpcs,590.62,236.25,,,0 CDM,27800000S1_164393,Hc Sup Shell 278 Revenue Code Without Hcpcs,19687.5,7875.0,,,0 CDM,27800000S1_164420,Hc Sup Shell 278 Revenue Code Without Hcpcs,19687.5,7875.0,,,0 CDM,27800000S1_164464,Hc Sup Shell 278 Revenue Code Without Hcpcs,19687.5,7875.0,,,0 CDM,27800000S1_164476,Hc Sup Shell 278 Revenue Code Without Hcpcs,19687.5,7875.0,,,0 CDM,27800000S1_164503,Hc Sup Shell 278 Revenue Code Without Hcpcs,19687.5,7875.0,,,0 CDM,27800000S1_164505,Hc Sup Shell 278 Revenue Code Without Hcpcs,19687.5,7875.0,,,0 CDM,27800000S1_164532,Hc Sup Shell 278 Revenue Code Without Hcpcs,19687.5,7875.0,,,0 CDM,27800000S1_164534,Hc Sup Shell 278 Revenue Code Without Hcpcs,19687.5,7875.0,,,0 CDM,27800000S1_164535,Hc Sup Shell 278 Revenue Code Without Hcpcs,19687.5,7875.0,,,0 CDM,27800000S1_164538,Hc Sup Shell 278 Revenue Code Without Hcpcs,19687.5,7875.0,,,0 CDM,27800000S1_164553,Hc Sup Shell 278 Revenue Code Without Hcpcs,19687.5,7875.0,,,0 CDM,27800000S1_164554,Hc Sup Shell 278 Revenue Code Without Hcpcs,19687.5,7875.0,,,0 CDM,27800000S1_165880,Hc Sup Shell 278 Revenue Code Without Hcpcs,1222.44,488.98,,,0 CDM,27800000S1_174538,Hc Sup Shell 278 Revenue Code Without Hcpcs,984.38,393.75,,,0 CDM,27800000S1_177180,Hc Sup Shell 278 Revenue Code Without Hcpcs,4480.88,1792.35,,,0 CDM,27800000S1_177499,Hc Sup Shell 278 Revenue Code Without Hcpcs,1649.81,659.92,,,0 CDM,27800000S1_180203,Hc Sup Shell 278 Revenue Code Without Hcpcs,1893.94,757.58,,,0 CDM,27800000S1_180221,Hc Sup Shell 278 Revenue Code Without Hcpcs,5036.06,2014.42,,,0 CDM,27800000S1_182483,Hc Sup Shell 278 Revenue Code Without Hcpcs,17088.75,6835.5,,,0 CDM,27800000S1_191213,Hc Sup Shell 278 Revenue Code Without Hcpcs,1639.85,655.94,,,0 CDM,27800000S1_193691,Hc Sup Shell 278 Revenue Code Without Hcpcs,1639.85,655.94,,,0 CDM,27800000S1_278,Hc Sup Shell 278 Revenue Code Without Hcpcs,1943.16,777.26,,,0 CDM,27800000S1_88917,Hc Sup Shell 278 Revenue Code Without Hcpcs,854.44,341.78,,,0 CDM,27800000S1_92569,Hc Sup Shell 278 Revenue Code Without Hcpcs,563.06,225.22,,,0 CDM,27800000S1_93055,Hc Sup Shell 278 Revenue Code Without Hcpcs,492.19,196.88,,,0 CDM,27800000S1_93119,Hc Sup Shell 278 Revenue Code Without Hcpcs,393.75,157.5,,,0 CDM,27800000S1_93126,Hc Sup Shell 278 Revenue Code Without Hcpcs,1396.59,558.64,,,0 CDM,27800000S1_93136,Hc Sup Shell 278 Revenue Code Without Hcpcs,1771.88,708.75,,,0 CDM,27800000S1_95299,Hc Sup Shell 278 Revenue Code Without Hcpcs,787.5,315.0,,,0 CDM,27800000S1_95305,Hc Sup Shell 278 Revenue Code Without Hcpcs,787.5,315.0,,,0 CDM,27800000S1_95317,Hc Sup Shell 278 Revenue Code Without Hcpcs,1181.25,472.5,,,0 CDM,27800000S1_95319,Hc Sup Shell 278 Revenue Code Without Hcpcs,1181.25,472.5,,,0 CDM,27800000S1_95723,Hc Sup Shell 278 Revenue Code Without Hcpcs,1273.86,509.54,,,0 CDM,278A445301,"Hc Rectal Catheter - No Upp ( Fluid Catheter, Dual Lumen 9 Fr, Rectal), Sap #241351",105.92,42.37,,,0 CDM,278A445301_A4453_278,"Hc Rectal Catheter - No Upp ( Fluid Catheter, Dual Lumen 9 Fr, Rectal), Sap #241351",105.92,42.37,,,0 CDM,278A464801,Hc Tissue Marker Implantable,33.39,13.36,,,0 CDM,278A464801_A4648_278,Hc Tissue Marker Implantable,33.39,13.36,,,0 CDM,278A4648S1_115564,Hc Sup Shell 278 Revenue Code A4648 Hcpcs,343.93,137.57,,,0 CDM,278A4648S1_138411,Hc Sup Shell 278 Revenue Code A4648 Hcpcs,316.53,126.61,,,0 CDM,278A4648S1_153961,Hc Sup Shell 278 Revenue Code A4648 Hcpcs,307.52,123.01,,,0 CDM,278A4648S1_153964,Hc Sup Shell 278 Revenue Code A4648 Hcpcs,307.52,123.01,,,0 CDM,278A4648S1_172890,Hc Sup Shell 278 Revenue Code A4648 Hcpcs,297.06,118.82,,,0 CDM,278A4648S1_182910,Hc Sup Shell 278 Revenue Code A4648 Hcpcs,297.0,118.8,,,0 CDM,278A4648S1_183106,Hc Sup Shell 278 Revenue Code A4648 Hcpcs,1476.56,590.62,,,0 CDM,278A4648S1_183107,Hc Sup Shell 278 Revenue Code A4648 Hcpcs,1476.56,590.62,,,0 CDM,278A4648S1_183108,Hc Sup Shell 278 Revenue Code A4648 Hcpcs,1476.56,590.62,,,0 CDM,278A4648S1_183109,Hc Sup Shell 278 Revenue Code A4648 Hcpcs,1476.56,590.62,,,0 CDM,278A4648S1_183110,Hc Sup Shell 278 Revenue Code A4648 Hcpcs,1476.56,590.62,,,0 CDM,278A4648S1_183111,Hc Sup Shell 278 Revenue Code A4648 Hcpcs,1476.56,590.62,,,0 CDM,278A4648S1_183112,Hc Sup Shell 278 Revenue Code A4648 Hcpcs,1476.56,590.62,,,0 CDM,278A4648S1_183113,Hc Sup Shell 278 Revenue Code A4648 Hcpcs,1476.56,590.62,,,0 CDM,278A4648S1_183114,Hc Sup Shell 278 Revenue Code A4648 Hcpcs,1476.56,590.62,,,0 CDM,278A4648S1_190364,Hc Sup Shell 278 Revenue Code A4648 Hcpcs,767.81,307.12,,,0 CDM,278A4648S1_91868,Hc Sup Shell 278 Revenue Code A4648 Hcpcs,248.42,99.37,,,0 CDM,278A7520S1_92866,Hc Sup Shell 278 Revenue Code A7520 Hcpcs,854.44,341.78,,,0 CDM,278C171301,"Hc Pin Steinmann Threaded 4.8, Sap# 2680",46.94,18.78,,,0 CDM,278C1713S1_101633,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,176.48,70.59,,,0 CDM,278C1713S1_101635,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,174.53,69.81,,,0 CDM,278C1713S1_101636,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,174.71,69.88,,,0 CDM,278C1713S1_101639,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,175.3,70.12,,,0 CDM,278C1713S1_101641,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,174.67,69.87,,,0 CDM,278C1713S1_101644,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,175.54,70.22,,,0 CDM,278C1713S1_103152,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,363.24,145.3,,,0 CDM,278C1713S1_105962,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_105963,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_105964,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_109094,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,13373.72,5349.49,,,0 CDM,278C1713S1_109101,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,12299.18,4919.67,,,0 CDM,278C1713S1_110270,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1355.49,542.2,,,0 CDM,278C1713S1_112895,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1992.38,796.95,,,0 CDM,278C1713S1_112896,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1992.38,796.95,,,0 CDM,278C1713S1_112898,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1992.38,796.95,,,0 CDM,278C1713S1_112899,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1992.38,796.95,,,0 CDM,278C1713S1_112901,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1992.38,796.95,,,0 CDM,278C1713S1_112908,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1992.38,796.95,,,0 CDM,278C1713S1_112909,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1992.38,796.95,,,0 CDM,278C1713S1_112911,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1736.44,694.58,,,0 CDM,278C1713S1_112914,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,90.56,36.22,,,0 CDM,278C1713S1_112917,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,225.15,90.06,,,0 CDM,278C1713S1_112920,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,90.56,36.22,,,0 CDM,278C1713S1_112939,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,487.86,195.14,,,0 CDM,278C1713S1_112940,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,487.86,195.14,,,0 CDM,278C1713S1_112947,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,487.86,195.14,,,0 CDM,278C1713S1_112948,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,487.86,195.14,,,0 CDM,278C1713S1_112981,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,487.86,195.14,,,0 CDM,278C1713S1_112988,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,487.86,195.14,,,0 CDM,278C1713S1_113010,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_113017,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_113018,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_113019,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_113022,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_113045,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_113048,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_113049,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_113051,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_113052,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_113053,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_113553,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,154.43,61.77,,,0 CDM,278C1713S1_113554,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,154.43,61.77,,,0 CDM,278C1713S1_113555,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,154.43,61.77,,,0 CDM,278C1713S1_113559,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,154.43,61.77,,,0 CDM,278C1713S1_113560,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,154.43,61.77,,,0 CDM,278C1713S1_113870,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,470.14,188.06,,,0 CDM,278C1713S1_113871,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,464.0,185.6,,,0 CDM,278C1713S1_113872,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,472.5,189.0,,,0 CDM,278C1713S1_113873,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,468.85,187.54,,,0 CDM,278C1713S1_113878,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,270.9,108.36,,,0 CDM,278C1713S1_113887,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,469.56,187.82,,,0 CDM,278C1713S1_113908,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.52,209.41,,,0 CDM,278C1713S1_113957,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5617.71,2247.08,,,0 CDM,278C1713S1_113959,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5636.65,2254.66,,,0 CDM,278C1713S1_113961,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5874.12,2349.65,,,0 CDM,278C1713S1_113963,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6019.81,2407.92,,,0 CDM,278C1713S1_113981,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4190.13,1676.05,,,0 CDM,278C1713S1_113983,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4190.13,1676.05,,,0 CDM,278C1713S1_113984,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4190.13,1676.05,,,0 CDM,278C1713S1_113985,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4190.13,1676.05,,,0 CDM,278C1713S1_113986,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4190.13,1676.05,,,0 CDM,278C1713S1_113987,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4190.13,1676.05,,,0 CDM,278C1713S1_113988,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4190.13,1676.05,,,0 CDM,278C1713S1_113989,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2855.79,1142.32,,,0 CDM,278C1713S1_113994,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.08,205.63,,,0 CDM,278C1713S1_113995,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.08,205.63,,,0 CDM,278C1713S1_113996,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.08,205.63,,,0 CDM,278C1713S1_113997,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.08,205.63,,,0 CDM,278C1713S1_113998,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,325.08,130.03,,,0 CDM,278C1713S1_114056,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,763.88,305.55,,,0 CDM,278C1713S1_114058,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1221.76,488.7,,,0 CDM,278C1713S1_114062,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1328.36,531.34,,,0 CDM,278C1713S1_114072,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6287.24,2514.9,,,0 CDM,278C1713S1_114113,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114285,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,785.54,314.22,,,0 CDM,278C1713S1_114287,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,785.53,314.21,,,0 CDM,278C1713S1_114290,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,785.54,314.22,,,0 CDM,278C1713S1_114317,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,151.04,60.42,,,0 CDM,278C1713S1_114318,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,151.52,60.61,,,0 CDM,278C1713S1_114319,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,151.52,60.61,,,0 CDM,278C1713S1_114320,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,151.63,60.65,,,0 CDM,278C1713S1_114321,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,149.49,59.8,,,0 CDM,278C1713S1_114322,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,150.07,60.03,,,0 CDM,278C1713S1_114323,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,152.97,61.19,,,0 CDM,278C1713S1_114324,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,143.02,57.21,,,0 CDM,278C1713S1_114325,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,152.97,61.19,,,0 CDM,278C1713S1_114326,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,152.97,61.19,,,0 CDM,278C1713S1_114327,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,152.97,61.19,,,0 CDM,278C1713S1_114328,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,152.97,61.19,,,0 CDM,278C1713S1_114329,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,152.97,61.19,,,0 CDM,278C1713S1_114330,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,152.97,61.19,,,0 CDM,278C1713S1_114332,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,152.97,61.19,,,0 CDM,278C1713S1_114333,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,469.12,187.65,,,0 CDM,278C1713S1_114334,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,469.12,187.65,,,0 CDM,278C1713S1_114335,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,469.12,187.65,,,0 CDM,278C1713S1_114336,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,469.12,187.65,,,0 CDM,278C1713S1_114337,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,434.81,173.92,,,0 CDM,278C1713S1_114417,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1903.11,761.24,,,0 CDM,278C1713S1_114419,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1903.11,761.24,,,0 CDM,278C1713S1_114439,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4839.74,1935.9,,,0 CDM,278C1713S1_114443,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2979.9,1191.96,,,0 CDM,278C1713S1_114444,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2936.59,1174.64,,,0 CDM,278C1713S1_114485,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,448.72,179.49,,,0 CDM,278C1713S1_114486,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,448.72,179.49,,,0 CDM,278C1713S1_114487,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,448.72,179.49,,,0 CDM,278C1713S1_114488,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,448.72,179.49,,,0 CDM,278C1713S1_114489,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,448.72,179.49,,,0 CDM,278C1713S1_114491,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,448.72,179.49,,,0 CDM,278C1713S1_114492,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,448.72,179.49,,,0 CDM,278C1713S1_114493,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,448.72,179.49,,,0 CDM,278C1713S1_114504,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2680.65,1072.26,,,0 CDM,278C1713S1_114524,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,211.88,84.75,,,0 CDM,278C1713S1_114525,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,211.88,84.75,,,0 CDM,278C1713S1_114604,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114605,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114606,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114610,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114632,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,69.11,27.64,,,0 CDM,278C1713S1_114635,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,174.24,69.7,,,0 CDM,278C1713S1_114647,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114648,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,106.31,42.52,,,0 CDM,278C1713S1_114649,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,106.31,42.52,,,0 CDM,278C1713S1_114650,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114651,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114652,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114653,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114654,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114655,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114656,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114657,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114658,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114659,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114660,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114662,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114663,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114664,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114665,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114666,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114669,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114670,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114679,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_114705,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.89,23.96,,,0 CDM,278C1713S1_114706,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.89,23.96,,,0 CDM,278C1713S1_114707,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.89,23.96,,,0 CDM,278C1713S1_114708,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.89,23.96,,,0 CDM,278C1713S1_114710,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.89,23.96,,,0 CDM,278C1713S1_114711,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.89,23.96,,,0 CDM,278C1713S1_114715,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,175.07,70.03,,,0 CDM,278C1713S1_114721,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,175.07,70.03,,,0 CDM,278C1713S1_114725,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1766.32,706.53,,,0 CDM,278C1713S1_114726,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1945.24,778.1,,,0 CDM,278C1713S1_114727,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2146.45,858.58,,,0 CDM,278C1713S1_114737,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.89,23.96,,,0 CDM,278C1713S1_114738,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.89,23.96,,,0 CDM,278C1713S1_114739,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.89,23.96,,,0 CDM,278C1713S1_114741,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.89,23.96,,,0 CDM,278C1713S1_114742,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.89,23.96,,,0 CDM,278C1713S1_114743,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.89,23.96,,,0 CDM,278C1713S1_114745,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.89,23.96,,,0 CDM,278C1713S1_114746,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.89,23.96,,,0 CDM,278C1713S1_114752,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.89,23.96,,,0 CDM,278C1713S1_114753,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.89,23.96,,,0 CDM,278C1713S1_114754,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.89,23.96,,,0 CDM,278C1713S1_114755,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.89,23.96,,,0 CDM,278C1713S1_114756,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.89,23.96,,,0 CDM,278C1713S1_114758,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.89,23.96,,,0 CDM,278C1713S1_114759,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.89,23.96,,,0 CDM,278C1713S1_114760,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.89,23.96,,,0 CDM,278C1713S1_114761,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.89,23.96,,,0 CDM,278C1713S1_114771,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1766.32,706.53,,,0 CDM,278C1713S1_114772,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1945.24,778.1,,,0 CDM,278C1713S1_114773,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2146.45,858.58,,,0 CDM,278C1713S1_114774,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2349.0,939.6,,,0 CDM,278C1713S1_114775,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2504.21,1001.68,,,0 CDM,278C1713S1_114805,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3173.47,1269.39,,,0 CDM,278C1713S1_114824,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1087.97,435.19,,,0 CDM,278C1713S1_114835,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2828.03,1131.21,,,0 CDM,278C1713S1_114836,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2878.67,1151.47,,,0 CDM,278C1713S1_114839,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3191.85,1276.74,,,0 CDM,278C1713S1_114840,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3362.31,1344.92,,,0 CDM,278C1713S1_114841,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2828.03,1131.21,,,0 CDM,278C1713S1_114842,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2878.67,1151.47,,,0 CDM,278C1713S1_114844,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2998.41,1199.36,,,0 CDM,278C1713S1_114845,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3072.12,1228.85,,,0 CDM,278C1713S1_114846,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3362.31,1344.92,,,0 CDM,278C1713S1_114847,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2924.73,1169.89,,,0 CDM,278C1713S1_114932,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,651.58,260.63,,,0 CDM,278C1713S1_114979,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,201.05,80.42,,,0 CDM,278C1713S1_114980,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,201.05,80.42,,,0 CDM,278C1713S1_114984,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,201.05,80.42,,,0 CDM,278C1713S1_114985,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,201.05,80.42,,,0 CDM,278C1713S1_114992,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,201.05,80.42,,,0 CDM,278C1713S1_115119,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.76,45.5,,,0 CDM,278C1713S1_115193,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,620.59,248.24,,,0 CDM,278C1713S1_115194,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,613.74,245.5,,,0 CDM,278C1713S1_115195,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,623.72,249.49,,,0 CDM,278C1713S1_115196,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,615.8,246.32,,,0 CDM,278C1713S1_115198,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,619.92,247.97,,,0 CDM,278C1713S1_115199,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,620.59,248.24,,,0 CDM,278C1713S1_115200,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,620.59,248.24,,,0 CDM,278C1713S1_115201,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,616.83,246.73,,,0 CDM,278C1713S1_115202,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,620.59,248.24,,,0 CDM,278C1713S1_115203,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,613.74,245.5,,,0 CDM,278C1713S1_115204,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,613.74,245.5,,,0 CDM,278C1713S1_115205,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,620.59,248.24,,,0 CDM,278C1713S1_115206,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,613.74,245.5,,,0 CDM,278C1713S1_115207,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,613.74,245.5,,,0 CDM,278C1713S1_115208,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,620.59,248.24,,,0 CDM,278C1713S1_115209,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,625.29,250.12,,,0 CDM,278C1713S1_115210,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,620.59,248.24,,,0 CDM,278C1713S1_115291,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,574.36,229.74,,,0 CDM,278C1713S1_115313,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,574.36,229.74,,,0 CDM,278C1713S1_115390,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,897.75,359.1,,,0 CDM,278C1713S1_115392,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,897.75,359.1,,,0 CDM,278C1713S1_115419,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,918.58,367.43,,,0 CDM,278C1713S1_115421,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,918.58,367.43,,,0 CDM,278C1713S1_115588,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,765.45,306.18,,,0 CDM,278C1713S1_115589,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,765.45,306.18,,,0 CDM,278C1713S1_115590,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,765.45,306.18,,,0 CDM,278C1713S1_115591,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,765.45,306.18,,,0 CDM,278C1713S1_115593,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,747.02,298.81,,,0 CDM,278C1713S1_115624,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,765.45,306.18,,,0 CDM,278C1713S1_115882,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5241.66,2096.66,,,0 CDM,278C1713S1_115883,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9619.66,3847.86,,,0 CDM,278C1713S1_115884,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,13498.66,5399.46,,,0 CDM,278C1713S1_115934,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,154.43,61.77,,,0 CDM,278C1713S1_115941,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,456.0,182.4,,,0 CDM,278C1713S1_115942,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,456.0,182.4,,,0 CDM,278C1713S1_115943,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,456.0,182.4,,,0 CDM,278C1713S1_115944,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,291.53,116.61,,,0 CDM,278C1713S1_115945,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,291.53,116.61,,,0 CDM,278C1713S1_116030,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_116033,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_116036,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_116483,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7564.72,3025.89,,,0 CDM,278C1713S1_116485,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9783.43,3913.37,,,0 CDM,278C1713S1_116486,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,10148.98,4059.59,,,0 CDM,278C1713S1_116487,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9189.97,3675.99,,,0 CDM,278C1713S1_116488,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9994.87,3997.95,,,0 CDM,278C1713S1_116489,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,11224.87,4489.95,,,0 CDM,278C1713S1_116660,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1575.0,630.0,,,0 CDM,278C1713S1_116661,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1657.69,663.08,,,0 CDM,278C1713S1_116664,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5748.75,2299.5,,,0 CDM,278C1713S1_116903,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6464.83,2585.93,,,0 CDM,278C1713S1_116923,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,567.0,226.8,,,0 CDM,278C1713S1_116925,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,567.0,226.8,,,0 CDM,278C1713S1_116926,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,567.0,226.8,,,0 CDM,278C1713S1_116927,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,567.0,226.8,,,0 CDM,278C1713S1_116928,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,567.0,226.8,,,0 CDM,278C1713S1_116929,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,567.0,226.8,,,0 CDM,278C1713S1_116931,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,567.0,226.8,,,0 CDM,278C1713S1_116934,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,567.0,226.8,,,0 CDM,278C1713S1_116966,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9998.26,3999.3,,,0 CDM,278C1713S1_116976,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1738.48,695.39,,,0 CDM,278C1713S1_116977,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1328.56,531.42,,,0 CDM,278C1713S1_116978,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1328.62,531.45,,,0 CDM,278C1713S1_116980,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1525.3,610.12,,,0 CDM,278C1713S1_116981,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1525.61,610.24,,,0 CDM,278C1713S1_116982,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1741.91,696.76,,,0 CDM,278C1713S1_116987,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1981.76,792.7,,,0 CDM,278C1713S1_116995,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1642.89,657.16,,,0 CDM,278C1713S1_116996,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3063.81,1225.52,,,0 CDM,278C1713S1_116998,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3726.69,1490.68,,,0 CDM,278C1713S1_116999,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4134.62,1653.85,,,0 CDM,278C1713S1_117000,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3317.31,1326.92,,,0 CDM,278C1713S1_117077,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2844.33,1137.73,,,0 CDM,278C1713S1_117078,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2844.33,1137.73,,,0 CDM,278C1713S1_117084,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2698.8,1079.52,,,0 CDM,278C1713S1_117085,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2844.33,1137.73,,,0 CDM,278C1713S1_117086,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2844.33,1137.73,,,0 CDM,278C1713S1_117088,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2953.48,1181.39,,,0 CDM,278C1713S1_117093,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2848.23,1139.29,,,0 CDM,278C1713S1_117128,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,575.46,230.18,,,0 CDM,278C1713S1_117129,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,575.47,230.19,,,0 CDM,278C1713S1_117130,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,575.47,230.19,,,0 CDM,278C1713S1_117131,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,575.47,230.19,,,0 CDM,278C1713S1_117132,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,575.47,230.19,,,0 CDM,278C1713S1_117133,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,575.47,230.19,,,0 CDM,278C1713S1_117134,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,575.47,230.19,,,0 CDM,278C1713S1_117135,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,575.47,230.19,,,0 CDM,278C1713S1_117136,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,575.47,230.19,,,0 CDM,278C1713S1_117137,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,575.47,230.19,,,0 CDM,278C1713S1_117138,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,575.47,230.19,,,0 CDM,278C1713S1_117139,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,575.46,230.18,,,0 CDM,278C1713S1_117243,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_117244,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_117245,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_117246,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_117247,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_117252,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_117253,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_117254,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_117255,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_117256,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_117257,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_117258,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_117259,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_117260,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_117263,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_117337,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,87.67,35.07,,,0 CDM,278C1713S1_117338,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,73.32,29.33,,,0 CDM,278C1713S1_117351,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,267.75,107.1,,,0 CDM,278C1713S1_117353,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,374.14,149.66,,,0 CDM,278C1713S1_117424,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,933.11,373.24,,,0 CDM,278C1713S1_117425,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,933.11,373.24,,,0 CDM,278C1713S1_117426,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,933.11,373.24,,,0 CDM,278C1713S1_117439,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,13808.02,5523.21,,,0 CDM,278C1713S1_117462,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3451.64,1380.66,,,0 CDM,278C1713S1_117463,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3462.09,1384.84,,,0 CDM,278C1713S1_117464,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4419.45,1767.78,,,0 CDM,278C1713S1_117465,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3456.28,1382.51,,,0 CDM,278C1713S1_117503,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,28.19,11.28,,,0 CDM,278C1713S1_117505,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,79.74,31.9,,,0 CDM,278C1713S1_117510,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3863.26,1545.3,,,0 CDM,278C1713S1_117511,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3744.92,1497.97,,,0 CDM,278C1713S1_117513,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3955.06,1582.02,,,0 CDM,278C1713S1_117514,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4375.28,1750.11,,,0 CDM,278C1713S1_117516,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3463.67,1385.47,,,0 CDM,278C1713S1_117517,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4397.36,1758.94,,,0 CDM,278C1713S1_117518,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4878.48,1951.39,,,0 CDM,278C1713S1_117523,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4419.45,1767.78,,,0 CDM,278C1713S1_117525,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3981.6,1592.64,,,0 CDM,278C1713S1_117526,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3744.92,1497.97,,,0 CDM,278C1713S1_117528,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3744.92,1497.97,,,0 CDM,278C1713S1_117531,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3744.92,1497.97,,,0 CDM,278C1713S1_117535,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5392.8,2157.12,,,0 CDM,278C1713S1_117537,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4437.02,1774.81,,,0 CDM,278C1713S1_117538,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5728.39,2291.36,,,0 CDM,278C1713S1_117549,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4950.58,1980.23,,,0 CDM,278C1713S1_117550,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4950.58,1980.23,,,0 CDM,278C1713S1_117554,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4775.4,1910.16,,,0 CDM,278C1713S1_117808,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,169.51,67.8,,,0 CDM,278C1713S1_117809,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,169.61,67.84,,,0 CDM,278C1713S1_117810,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,169.51,67.8,,,0 CDM,278C1713S1_117811,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,169.51,67.8,,,0 CDM,278C1713S1_117812,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,169.51,67.8,,,0 CDM,278C1713S1_117813,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,169.51,67.8,,,0 CDM,278C1713S1_117814,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,169.51,67.8,,,0 CDM,278C1713S1_117815,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,169.51,67.8,,,0 CDM,278C1713S1_117816,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,243.77,97.51,,,0 CDM,278C1713S1_117817,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,243.77,97.51,,,0 CDM,278C1713S1_117818,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,243.77,97.51,,,0 CDM,278C1713S1_117819,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,243.77,97.51,,,0 CDM,278C1713S1_117820,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,243.77,97.51,,,0 CDM,278C1713S1_117821,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,243.77,97.51,,,0 CDM,278C1713S1_117822,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,243.77,97.51,,,0 CDM,278C1713S1_117823,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,243.77,97.51,,,0 CDM,278C1713S1_117825,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,264.76,105.9,,,0 CDM,278C1713S1_117826,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,264.76,105.9,,,0 CDM,278C1713S1_117827,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,264.76,105.9,,,0 CDM,278C1713S1_117828,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,264.76,105.9,,,0 CDM,278C1713S1_117829,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,264.76,105.9,,,0 CDM,278C1713S1_117830,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,264.76,105.9,,,0 CDM,278C1713S1_117831,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,264.76,105.9,,,0 CDM,278C1713S1_117833,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,339.02,135.61,,,0 CDM,278C1713S1_117834,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,316.42,126.57,,,0 CDM,278C1713S1_117835,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,316.42,126.57,,,0 CDM,278C1713S1_117836,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,316.42,126.57,,,0 CDM,278C1713S1_117837,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,316.42,126.57,,,0 CDM,278C1713S1_117838,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,316.42,126.57,,,0 CDM,278C1713S1_117840,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,390.68,156.27,,,0 CDM,278C1713S1_117841,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,390.68,156.27,,,0 CDM,278C1713S1_117842,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,397.81,159.12,,,0 CDM,278C1713S1_117843,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,390.68,156.27,,,0 CDM,278C1713S1_117844,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,390.68,156.27,,,0 CDM,278C1713S1_117845,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,390.68,156.27,,,0 CDM,278C1713S1_117846,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,447.18,178.87,,,0 CDM,278C1713S1_117847,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,447.18,178.87,,,0 CDM,278C1713S1_117848,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,447.18,178.87,,,0 CDM,278C1713S1_117849,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,447.18,178.87,,,0 CDM,278C1713S1_117850,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,447.18,178.87,,,0 CDM,278C1713S1_117856,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1638.59,655.44,,,0 CDM,278C1713S1_117858,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,720.02,288.01,,,0 CDM,278C1713S1_117860,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1409.35,563.74,,,0 CDM,278C1713S1_117861,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,889.52,355.81,,,0 CDM,278C1713S1_117862,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1181.72,472.69,,,0 CDM,278C1713S1_117865,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1314.11,525.64,,,0 CDM,278C1713S1_117866,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1772.59,709.04,,,0 CDM,278C1713S1_117867,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1772.59,709.04,,,0 CDM,278C1713S1_117868,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2027.66,811.06,,,0 CDM,278C1713S1_117872,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1580.47,632.19,,,0 CDM,278C1713S1_117873,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1672.49,669.0,,,0 CDM,278C1713S1_117875,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1850.08,740.03,,,0 CDM,278C1713S1_117876,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1720.93,688.37,,,0 CDM,278C1713S1_117877,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2323.08,929.23,,,0 CDM,278C1713S1_117878,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2931.7,1172.68,,,0 CDM,278C1713S1_117879,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2534.57,1013.83,,,0 CDM,278C1713S1_117880,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4843.12,1937.25,,,0 CDM,278C1713S1_117881,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4843.12,1937.25,,,0 CDM,278C1713S1_117885,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2502.29,1000.92,,,0 CDM,278C1713S1_117886,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3464.45,1385.78,,,0 CDM,278C1713S1_117887,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5214.44,2085.78,,,0 CDM,278C1713S1_117888,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5214.44,2085.78,,,0 CDM,278C1713S1_117890,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6371.94,2548.78,,,0 CDM,278C1713S1_117895,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2941.4,1176.56,,,0 CDM,278C1713S1_117897,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6386.47,2554.59,,,0 CDM,278C1713S1_117898,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6386.47,2554.59,,,0 CDM,278C1713S1_117901,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2084.16,833.66,,,0 CDM,278C1713S1_117902,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2084.16,833.66,,,0 CDM,278C1713S1_118011,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,443.95,177.58,,,0 CDM,278C1713S1_118013,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,484.31,193.72,,,0 CDM,278C1713S1_118014,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,484.31,193.72,,,0 CDM,278C1713S1_118038,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,330.75,132.3,,,0 CDM,278C1713S1_118039,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,330.75,132.3,,,0 CDM,278C1713S1_118041,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,330.75,132.3,,,0 CDM,278C1713S1_118051,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4488.75,1795.5,,,0 CDM,278C1713S1_118521,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1654.99,662.0,,,0 CDM,278C1713S1_118672,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,94.5,37.8,,,0 CDM,278C1713S1_118673,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,94.5,37.8,,,0 CDM,278C1713S1_118699,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,55.44,22.18,,,0 CDM,278C1713S1_118706,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,119.86,47.94,,,0 CDM,278C1713S1_118707,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,456.0,182.4,,,0 CDM,278C1713S1_118709,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,456.0,182.4,,,0 CDM,278C1713S1_118710,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,456.0,182.4,,,0 CDM,278C1713S1_118711,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,456.0,182.4,,,0 CDM,278C1713S1_118712,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,418.66,167.46,,,0 CDM,278C1713S1_118713,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,456.0,182.4,,,0 CDM,278C1713S1_118714,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,456.0,182.4,,,0 CDM,278C1713S1_118715,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,512.82,205.13,,,0 CDM,278C1713S1_118716,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,512.82,205.13,,,0 CDM,278C1713S1_118717,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,512.82,205.13,,,0 CDM,278C1713S1_118724,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,24.61,9.84,,,0 CDM,278C1713S1_118823,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1759.67,703.87,,,0 CDM,278C1713S1_119009,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,679.85,271.94,,,0 CDM,278C1713S1_119011,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,684.42,273.77,,,0 CDM,278C1713S1_119012,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,686.7,274.68,,,0 CDM,278C1713S1_119013,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,686.7,274.68,,,0 CDM,278C1713S1_119016,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,574.37,229.75,,,0 CDM,278C1713S1_119017,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,574.36,229.74,,,0 CDM,278C1713S1_119200,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,142.22,56.89,,,0 CDM,278C1713S1_119434,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4925.81,1970.32,,,0 CDM,278C1713S1_119715,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_119716,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_119733,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,374.06,149.62,,,0 CDM,278C1713S1_119737,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,374.06,149.62,,,0 CDM,278C1713S1_119756,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,846.56,338.62,,,0 CDM,278C1713S1_119856,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1755.54,702.22,,,0 CDM,278C1713S1_119858,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1571.06,628.42,,,0 CDM,278C1713S1_119920,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,138.4,55.36,,,0 CDM,278C1713S1_126749,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,246.52,98.61,,,0 CDM,278C1713S1_128864,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1909.61,763.84,,,0 CDM,278C1713S1_128996,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,968.15,387.26,,,0 CDM,278C1713S1_129006,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4035.94,1614.38,,,0 CDM,278C1713S1_129027,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,176.4,70.56,,,0 CDM,278C1713S1_129031,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,176.4,70.56,,,0 CDM,278C1713S1_129032,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,176.4,70.56,,,0 CDM,278C1713S1_129033,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,176.4,70.56,,,0 CDM,278C1713S1_129138,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,395.74,158.3,,,0 CDM,278C1713S1_129248,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1719.47,687.79,,,0 CDM,278C1713S1_129249,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1785.73,714.29,,,0 CDM,278C1713S1_129264,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,510.62,204.25,,,0 CDM,278C1713S1_129265,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,593.17,237.27,,,0 CDM,278C1713S1_129266,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,546.64,218.66,,,0 CDM,278C1713S1_129267,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,560.15,224.06,,,0 CDM,278C1713S1_129268,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,546.64,218.66,,,0 CDM,278C1713S1_129269,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,574.3,229.72,,,0 CDM,278C1713S1_129270,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,576.66,230.66,,,0 CDM,278C1713S1_129271,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,538.92,215.57,,,0 CDM,278C1713S1_129272,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,543.64,217.46,,,0 CDM,278C1713S1_129273,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,589.87,235.95,,,0 CDM,278C1713S1_129274,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,510.62,204.25,,,0 CDM,278C1713S1_129275,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,510.62,204.25,,,0 CDM,278C1713S1_129280,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,708.75,283.5,,,0 CDM,278C1713S1_129281,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,708.75,283.5,,,0 CDM,278C1713S1_129316,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6142.5,2457.0,,,0 CDM,278C1713S1_129317,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6142.5,2457.0,,,0 CDM,278C1713S1_129320,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5693.13,2277.25,,,0 CDM,278C1713S1_129321,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6142.5,2457.0,,,0 CDM,278C1713S1_129326,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5243.76,2097.5,,,0 CDM,278C1713S1_129335,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6142.5,2457.0,,,0 CDM,278C1713S1_129342,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6142.5,2457.0,,,0 CDM,278C1713S1_129346,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5243.76,2097.5,,,0 CDM,278C1713S1_129347,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5243.76,2097.5,,,0 CDM,278C1713S1_129348,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5243.76,2097.5,,,0 CDM,278C1713S1_129353,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5243.76,2097.5,,,0 CDM,278C1713S1_129354,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5243.76,2097.5,,,0 CDM,278C1713S1_129363,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5243.76,2097.5,,,0 CDM,278C1713S1_129383,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5489.86,2195.94,,,0 CDM,278C1713S1_129404,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5125.76,2050.3,,,0 CDM,278C1713S1_129408,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5216.79,2086.72,,,0 CDM,278C1713S1_129409,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5125.76,2050.3,,,0 CDM,278C1713S1_129410,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5398.84,2159.54,,,0 CDM,278C1713S1_129411,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5125.76,2050.3,,,0 CDM,278C1713S1_129412,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5125.76,2050.3,,,0 CDM,278C1713S1_129462,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5125.76,2050.3,,,0 CDM,278C1713S1_129645,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129646,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129648,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7275.53,2910.21,,,0 CDM,278C1713S1_129650,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7282.79,2913.12,,,0 CDM,278C1713S1_129651,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129652,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129670,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129672,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7217.44,2886.98,,,0 CDM,278C1713S1_129673,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129674,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129675,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129676,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7261.01,2904.4,,,0 CDM,278C1713S1_129733,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129737,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129738,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129739,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129740,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129741,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129753,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129755,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7217.44,2886.98,,,0 CDM,278C1713S1_129756,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129757,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129758,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129759,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7269.72,2907.89,,,0 CDM,278C1713S1_129760,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129761,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7287.15,2914.86,,,0 CDM,278C1713S1_129762,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129763,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129765,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129766,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129799,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129801,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129802,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129803,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129806,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7304.58,2921.83,,,0 CDM,278C1713S1_129813,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2335.8,934.32,,,0 CDM,278C1713S1_129814,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2335.8,934.32,,,0 CDM,278C1713S1_129815,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2333.12,933.25,,,0 CDM,278C1713S1_129816,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2332.56,933.02,,,0 CDM,278C1713S1_129817,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2334.22,933.69,,,0 CDM,278C1713S1_129818,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2328.3,931.32,,,0 CDM,278C1713S1_129819,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2339.55,935.82,,,0 CDM,278C1713S1_129971,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,468.56,187.42,,,0 CDM,278C1713S1_130006,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,611.89,244.76,,,0 CDM,278C1713S1_130090,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,203.96,81.58,,,0 CDM,278C1713S1_130091,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,203.96,81.58,,,0 CDM,278C1713S1_130092,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,203.96,81.58,,,0 CDM,278C1713S1_130093,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,203.96,81.58,,,0 CDM,278C1713S1_130204,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,873.74,349.5,,,0 CDM,278C1713S1_130205,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,873.74,349.5,,,0 CDM,278C1713S1_130206,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,873.73,349.49,,,0 CDM,278C1713S1_130207,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,873.74,349.5,,,0 CDM,278C1713S1_130208,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,873.74,349.5,,,0 CDM,278C1713S1_130209,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,873.74,349.5,,,0 CDM,278C1713S1_130210,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,873.74,349.5,,,0 CDM,278C1713S1_130211,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,873.74,349.5,,,0 CDM,278C1713S1_130212,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,873.73,349.49,,,0 CDM,278C1713S1_130213,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,873.74,349.5,,,0 CDM,278C1713S1_130214,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,873.74,349.5,,,0 CDM,278C1713S1_130215,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,873.74,349.5,,,0 CDM,278C1713S1_130219,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,873.74,349.5,,,0 CDM,278C1713S1_130252,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,435.49,174.2,,,0 CDM,278C1713S1_130253,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,435.49,174.2,,,0 CDM,278C1713S1_130254,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,435.49,174.2,,,0 CDM,278C1713S1_130257,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,435.49,174.2,,,0 CDM,278C1713S1_130258,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,435.49,174.2,,,0 CDM,278C1713S1_130259,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,435.49,174.2,,,0 CDM,278C1713S1_130261,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,435.49,174.2,,,0 CDM,278C1713S1_130262,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,435.49,174.2,,,0 CDM,278C1713S1_130267,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,435.49,174.2,,,0 CDM,278C1713S1_130294,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5495.96,2198.38,,,0 CDM,278C1713S1_130319,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,686.31,274.52,,,0 CDM,278C1713S1_130320,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,686.31,274.52,,,0 CDM,278C1713S1_130343,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,203.96,81.58,,,0 CDM,278C1713S1_130573,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2953.12,1181.25,,,0 CDM,278C1713S1_130574,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2953.12,1181.25,,,0 CDM,278C1713S1_130575,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2953.12,1181.25,,,0 CDM,278C1713S1_130576,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2953.12,1181.25,,,0 CDM,278C1713S1_130577,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2953.12,1181.25,,,0 CDM,278C1713S1_130654,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1162.21,464.88,,,0 CDM,278C1713S1_130732,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3063.81,1225.52,,,0 CDM,278C1713S1_131142,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,638.11,255.24,,,0 CDM,278C1713S1_131167,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3965.68,1586.27,,,0 CDM,278C1713S1_131168,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3951.75,1580.7,,,0 CDM,278C1713S1_131212,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,106.31,42.52,,,0 CDM,278C1713S1_131422,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3611.0,1444.4,,,0 CDM,278C1713S1_132064,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4841.19,1936.48,,,0 CDM,278C1713S1_132067,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4890.73,1956.29,,,0 CDM,278C1713S1_132129,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,718.4,287.36,,,0 CDM,278C1713S1_132130,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,718.4,287.36,,,0 CDM,278C1713S1_132131,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,313.19,125.28,,,0 CDM,278C1713S1_132132,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,313.19,125.28,,,0 CDM,278C1713S1_132166,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3680.07,1472.03,,,0 CDM,278C1713S1_132175,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2674.82,1069.93,,,0 CDM,278C1713S1_132182,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,230.19,92.08,,,0 CDM,278C1713S1_132183,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,230.19,92.08,,,0 CDM,278C1713S1_132184,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,230.19,92.08,,,0 CDM,278C1713S1_132186,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,230.19,92.08,,,0 CDM,278C1713S1_132187,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,230.19,92.08,,,0 CDM,278C1713S1_132189,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,230.19,92.08,,,0 CDM,278C1713S1_132191,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,230.19,92.08,,,0 CDM,278C1713S1_132219,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3591.2,1436.48,,,0 CDM,278C1713S1_132220,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3591.2,1436.48,,,0 CDM,278C1713S1_132223,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3032.39,1212.96,,,0 CDM,278C1713S1_132229,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4733.39,1893.36,,,0 CDM,278C1713S1_132244,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4465.32,1786.13,,,0 CDM,278C1713S1_132247,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4465.32,1786.13,,,0 CDM,278C1713S1_132250,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4465.32,1786.13,,,0 CDM,278C1713S1_132251,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4465.32,1786.13,,,0 CDM,278C1713S1_132252,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4465.32,1786.13,,,0 CDM,278C1713S1_132257,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4465.32,1786.13,,,0 CDM,278C1713S1_132258,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4465.32,1786.13,,,0 CDM,278C1713S1_132260,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4663.46,1865.38,,,0 CDM,278C1713S1_132262,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4465.32,1786.13,,,0 CDM,278C1713S1_132263,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4465.32,1786.13,,,0 CDM,278C1713S1_132264,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4465.32,1786.13,,,0 CDM,278C1713S1_132265,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4465.32,1786.13,,,0 CDM,278C1713S1_132266,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4663.46,1865.38,,,0 CDM,278C1713S1_132280,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4465.32,1786.13,,,0 CDM,278C1713S1_132281,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4218.06,1687.22,,,0 CDM,278C1713S1_132282,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4465.32,1786.13,,,0 CDM,278C1713S1_132287,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4465.32,1786.13,,,0 CDM,278C1713S1_132295,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,313.23,125.29,,,0 CDM,278C1713S1_132297,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,313.23,125.29,,,0 CDM,278C1713S1_132299,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,313.23,125.29,,,0 CDM,278C1713S1_132300,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,313.23,125.29,,,0 CDM,278C1713S1_132301,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,313.23,125.29,,,0 CDM,278C1713S1_132302,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,262.95,105.18,,,0 CDM,278C1713S1_132303,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,313.23,125.29,,,0 CDM,278C1713S1_132304,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,274.12,109.65,,,0 CDM,278C1713S1_132305,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,242.84,97.14,,,0 CDM,278C1713S1_132306,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,269.24,107.7,,,0 CDM,278C1713S1_132307,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,313.23,125.29,,,0 CDM,278C1713S1_132308,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,313.23,125.29,,,0 CDM,278C1713S1_132309,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,313.23,125.29,,,0 CDM,278C1713S1_132310,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,313.23,125.29,,,0 CDM,278C1713S1_132311,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,313.23,125.29,,,0 CDM,278C1713S1_132312,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,313.23,125.29,,,0 CDM,278C1713S1_132313,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,313.23,125.29,,,0 CDM,278C1713S1_132314,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,313.23,125.29,,,0 CDM,278C1713S1_132315,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,313.23,125.29,,,0 CDM,278C1713S1_132317,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,313.23,125.29,,,0 CDM,278C1713S1_132319,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,313.23,125.29,,,0 CDM,278C1713S1_132321,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,313.23,125.29,,,0 CDM,278C1713S1_132322,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,313.23,125.29,,,0 CDM,278C1713S1_132323,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,539.05,215.62,,,0 CDM,278C1713S1_132324,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,539.05,215.62,,,0 CDM,278C1713S1_132325,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,540.31,216.12,,,0 CDM,278C1713S1_132326,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,543.94,217.58,,,0 CDM,278C1713S1_132327,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,536.87,214.75,,,0 CDM,278C1713S1_132328,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,534.36,213.74,,,0 CDM,278C1713S1_132329,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,539.05,215.62,,,0 CDM,278C1713S1_132330,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,539.05,215.62,,,0 CDM,278C1713S1_132331,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,539.05,215.62,,,0 CDM,278C1713S1_132332,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,539.05,215.62,,,0 CDM,278C1713S1_132333,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,534.59,213.84,,,0 CDM,278C1713S1_132334,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,539.05,215.62,,,0 CDM,278C1713S1_132335,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,516.57,206.63,,,0 CDM,278C1713S1_132336,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,539.05,215.62,,,0 CDM,278C1713S1_132337,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,539.05,215.62,,,0 CDM,278C1713S1_132338,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,539.05,215.62,,,0 CDM,278C1713S1_132339,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,539.05,215.62,,,0 CDM,278C1713S1_132340,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,539.05,215.62,,,0 CDM,278C1713S1_132341,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,539.05,215.62,,,0 CDM,278C1713S1_132342,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,539.05,215.62,,,0 CDM,278C1713S1_132343,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,533.14,213.26,,,0 CDM,278C1713S1_132344,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,539.05,215.62,,,0 CDM,278C1713S1_132345,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,539.05,215.62,,,0 CDM,278C1713S1_132346,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,539.05,215.62,,,0 CDM,278C1713S1_132347,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,539.05,215.62,,,0 CDM,278C1713S1_132348,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,529.5,211.8,,,0 CDM,278C1713S1_132359,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3543.75,1417.5,,,0 CDM,278C1713S1_132362,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3543.75,1417.5,,,0 CDM,278C1713S1_132363,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3543.75,1417.5,,,0 CDM,278C1713S1_132364,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3543.75,1417.5,,,0 CDM,278C1713S1_132365,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3543.75,1417.5,,,0 CDM,278C1713S1_132366,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3543.75,1417.5,,,0 CDM,278C1713S1_132367,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3543.75,1417.5,,,0 CDM,278C1713S1_132369,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3543.75,1417.5,,,0 CDM,278C1713S1_132370,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3543.75,1417.5,,,0 CDM,278C1713S1_132371,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3543.75,1417.5,,,0 CDM,278C1713S1_132372,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3937.5,1575.0,,,0 CDM,278C1713S1_132373,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3937.5,1575.0,,,0 CDM,278C1713S1_132374,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3937.5,1575.0,,,0 CDM,278C1713S1_132375,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3937.5,1575.0,,,0 CDM,278C1713S1_132377,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3937.5,1575.0,,,0 CDM,278C1713S1_132378,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3937.5,1575.0,,,0 CDM,278C1713S1_132403,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4137.21,1654.88,,,0 CDM,278C1713S1_132408,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3977.82,1591.13,,,0 CDM,278C1713S1_132409,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3977.82,1591.13,,,0 CDM,278C1713S1_132410,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3706.82,1482.73,,,0 CDM,278C1713S1_132411,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3458.7,1383.48,,,0 CDM,278C1713S1_132420,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,180.65,72.26,,,0 CDM,278C1713S1_132421,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,180.65,72.26,,,0 CDM,278C1713S1_132422,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,180.65,72.26,,,0 CDM,278C1713S1_132423,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,180.65,72.26,,,0 CDM,278C1713S1_132424,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,180.65,72.26,,,0 CDM,278C1713S1_132430,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,180.65,72.26,,,0 CDM,278C1713S1_132432,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,710.32,284.13,,,0 CDM,278C1713S1_132443,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,710.32,284.13,,,0 CDM,278C1713S1_132454,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,710.32,284.13,,,0 CDM,278C1713S1_132462,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,180.65,72.26,,,0 CDM,278C1713S1_132477,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,180.65,72.26,,,0 CDM,278C1713S1_132478,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,180.65,72.26,,,0 CDM,278C1713S1_132511,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,179.19,71.68,,,0 CDM,278C1713S1_132512,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,179.19,71.68,,,0 CDM,278C1713S1_132513,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,179.19,71.68,,,0 CDM,278C1713S1_132515,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,179.19,71.68,,,0 CDM,278C1713S1_132519,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,179.19,71.68,,,0 CDM,278C1713S1_132520,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,179.19,71.68,,,0 CDM,278C1713S1_132521,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,179.19,71.68,,,0 CDM,278C1713S1_132522,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,179.19,71.68,,,0 CDM,278C1713S1_132525,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,179.19,71.68,,,0 CDM,278C1713S1_132528,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,179.19,71.68,,,0 CDM,278C1713S1_132531,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,179.19,71.68,,,0 CDM,278C1713S1_132532,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,154.23,61.69,,,0 CDM,278C1713S1_132533,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,179.19,71.68,,,0 CDM,278C1713S1_132535,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,179.19,71.68,,,0 CDM,278C1713S1_132536,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,179.19,71.68,,,0 CDM,278C1713S1_132537,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,179.19,71.68,,,0 CDM,278C1713S1_132538,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,171.71,68.68,,,0 CDM,278C1713S1_132539,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,169.83,67.93,,,0 CDM,278C1713S1_132540,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,172.96,69.18,,,0 CDM,278C1713S1_132541,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,179.2,71.68,,,0 CDM,278C1713S1_132571,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,176.28,70.51,,,0 CDM,278C1713S1_132589,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,591.49,236.6,,,0 CDM,278C1713S1_132590,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,591.5,236.6,,,0 CDM,278C1713S1_132591,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,591.5,236.6,,,0 CDM,278C1713S1_132831,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,873.73,349.49,,,0 CDM,278C1713S1_132832,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,873.73,349.49,,,0 CDM,278C1713S1_132841,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,569.68,227.87,,,0 CDM,278C1713S1_132902,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,90.56,36.22,,,0 CDM,278C1713S1_133280,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1638.83,655.53,,,0 CDM,278C1713S1_133335,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,354.38,141.75,,,0 CDM,278C1713S1_133336,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3346.88,1338.75,,,0 CDM,278C1713S1_133338,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3346.88,1338.75,,,0 CDM,278C1713S1_133339,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3346.88,1338.75,,,0 CDM,278C1713S1_133342,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3346.88,1338.75,,,0 CDM,278C1713S1_133343,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3346.88,1338.75,,,0 CDM,278C1713S1_133344,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3346.88,1338.75,,,0 CDM,278C1713S1_133345,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3346.88,1338.75,,,0 CDM,278C1713S1_133346,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3346.88,1338.75,,,0 CDM,278C1713S1_133351,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3346.88,1338.75,,,0 CDM,278C1713S1_133352,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3346.88,1338.75,,,0 CDM,278C1713S1_133353,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3346.88,1338.75,,,0 CDM,278C1713S1_133354,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3346.88,1338.75,,,0 CDM,278C1713S1_133378,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,562.82,225.13,,,0 CDM,278C1713S1_134769,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2953.12,1181.25,,,0 CDM,278C1713S1_134864,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4055.94,1622.38,,,0 CDM,278C1713S1_134866,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4055.94,1622.38,,,0 CDM,278C1713S1_135209,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,172.76,69.1,,,0 CDM,278C1713S1_135210,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,172.86,69.14,,,0 CDM,278C1713S1_135257,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,171.87,68.75,,,0 CDM,278C1713S1_135258,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,177.19,70.88,,,0 CDM,278C1713S1_135549,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_135592,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,351.9,140.76,,,0 CDM,278C1713S1_135639,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,479.79,191.92,,,0 CDM,278C1713S1_135644,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,474.55,189.82,,,0 CDM,278C1713S1_135645,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,477.74,191.1,,,0 CDM,278C1713S1_135646,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,477.74,191.1,,,0 CDM,278C1713S1_135647,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,474.55,189.82,,,0 CDM,278C1713S1_135648,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,439.04,175.62,,,0 CDM,278C1713S1_135649,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,477.74,191.1,,,0 CDM,278C1713S1_135650,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,477.74,191.1,,,0 CDM,278C1713S1_135656,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,412.06,164.82,,,0 CDM,278C1713S1_136183,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,391.26,156.5,,,0 CDM,278C1713S1_136203,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,685.12,274.05,,,0 CDM,278C1713S1_136205,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,685.12,274.05,,,0 CDM,278C1713S1_136207,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,685.12,274.05,,,0 CDM,278C1713S1_136209,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,685.12,274.05,,,0 CDM,278C1713S1_136211,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,685.12,274.05,,,0 CDM,278C1713S1_136213,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,685.12,274.05,,,0 CDM,278C1713S1_136217,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,685.12,274.05,,,0 CDM,278C1713S1_136229,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,685.12,274.05,,,0 CDM,278C1713S1_136471,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,164.0,65.6,,,0 CDM,278C1713S1_137246,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1349.06,539.62,,,0 CDM,278C1713S1_137251,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,969.18,387.67,,,0 CDM,278C1713S1_137279,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4725.0,1890.0,,,0 CDM,278C1713S1_137280,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9450.0,3780.0,,,0 CDM,278C1713S1_137282,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4725.0,1890.0,,,0 CDM,278C1713S1_137354,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3110.62,1244.25,,,0 CDM,278C1713S1_137355,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3110.62,1244.25,,,0 CDM,278C1713S1_137356,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3209.06,1283.62,,,0 CDM,278C1713S1_137357,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3209.06,1283.62,,,0 CDM,278C1713S1_137358,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3110.62,1244.25,,,0 CDM,278C1713S1_137359,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3110.62,1244.25,,,0 CDM,278C1713S1_137360,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3209.06,1283.62,,,0 CDM,278C1713S1_137361,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3209.06,1283.62,,,0 CDM,278C1713S1_137362,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3504.38,1401.75,,,0 CDM,278C1713S1_137363,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3504.38,1401.75,,,0 CDM,278C1713S1_137364,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3287.81,1315.12,,,0 CDM,278C1713S1_137365,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3287.81,1315.12,,,0 CDM,278C1713S1_137366,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3130.31,1252.12,,,0 CDM,278C1713S1_137367,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3129.82,1251.93,,,0 CDM,278C1713S1_137368,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3504.38,1401.75,,,0 CDM,278C1713S1_137372,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,350.44,140.18,,,0 CDM,278C1713S1_137374,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,350.44,140.18,,,0 CDM,278C1713S1_137378,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,350.44,140.18,,,0 CDM,278C1713S1_137392,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,374.06,149.62,,,0 CDM,278C1713S1_137394,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,374.06,149.62,,,0 CDM,278C1713S1_137398,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,362.25,144.9,,,0 CDM,278C1713S1_137399,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,362.25,144.9,,,0 CDM,278C1713S1_137400,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,362.25,144.9,,,0 CDM,278C1713S1_137401,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,362.25,144.9,,,0 CDM,278C1713S1_137402,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,362.25,144.9,,,0 CDM,278C1713S1_137403,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,362.25,144.9,,,0 CDM,278C1713S1_137404,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,362.25,144.9,,,0 CDM,278C1713S1_137405,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,362.25,144.9,,,0 CDM,278C1713S1_137406,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,362.25,144.9,,,0 CDM,278C1713S1_137407,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,362.25,144.9,,,0 CDM,278C1713S1_137409,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,362.25,144.9,,,0 CDM,278C1713S1_137410,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,362.25,144.9,,,0 CDM,278C1713S1_137414,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,350.44,140.18,,,0 CDM,278C1713S1_137415,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,350.44,140.18,,,0 CDM,278C1713S1_137416,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,350.44,140.18,,,0 CDM,278C1713S1_137417,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,350.44,140.18,,,0 CDM,278C1713S1_137419,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,350.44,140.18,,,0 CDM,278C1713S1_137420,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,350.44,140.18,,,0 CDM,278C1713S1_137423,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,350.44,140.18,,,0 CDM,278C1713S1_137430,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_137434,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,346.5,138.6,,,0 CDM,278C1713S1_137435,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,346.5,138.6,,,0 CDM,278C1713S1_137436,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,346.5,138.6,,,0 CDM,278C1713S1_137437,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,346.5,138.6,,,0 CDM,278C1713S1_137438,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,346.5,138.6,,,0 CDM,278C1713S1_137439,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,346.5,138.6,,,0 CDM,278C1713S1_137440,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,346.5,138.6,,,0 CDM,278C1713S1_137444,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,348.08,139.23,,,0 CDM,278C1713S1_137445,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,350.44,140.18,,,0 CDM,278C1713S1_137446,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,350.44,140.18,,,0 CDM,278C1713S1_137447,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,350.44,140.18,,,0 CDM,278C1713S1_137448,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,350.44,140.18,,,0 CDM,278C1713S1_137449,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,350.44,140.18,,,0 CDM,278C1713S1_137450,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,350.44,140.18,,,0 CDM,278C1713S1_137451,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,350.44,140.18,,,0 CDM,278C1713S1_137452,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,350.44,140.18,,,0 CDM,278C1713S1_137453,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,350.44,140.18,,,0 CDM,278C1713S1_137457,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,102.38,40.95,,,0 CDM,278C1713S1_137465,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,283.5,113.4,,,0 CDM,278C1713S1_137821,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3162.8,1265.12,,,0 CDM,278C1713S1_137852,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1755.99,702.4,,,0 CDM,278C1713S1_137885,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,439.26,175.7,,,0 CDM,278C1713S1_137886,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,893.57,357.43,,,0 CDM,278C1713S1_137890,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1391.91,556.76,,,0 CDM,278C1713S1_137891,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2480.62,992.25,,,0 CDM,278C1713S1_137892,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3923.05,1569.22,,,0 CDM,278C1713S1_137976,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3212.31,1284.92,,,0 CDM,278C1713S1_137978,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3210.24,1284.1,,,0 CDM,278C1713S1_137979,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3162.8,1265.12,,,0 CDM,278C1713S1_138426,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.88,78.75,,,0 CDM,278C1713S1_138427,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.88,78.75,,,0 CDM,278C1713S1_138430,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.88,78.75,,,0 CDM,278C1713S1_138438,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,456.75,182.7,,,0 CDM,278C1713S1_138970,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6496.88,2598.75,,,0 CDM,278C1713S1_138972,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4462.1,1784.84,,,0 CDM,278C1713S1_138979,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14836.5,5934.6,,,0 CDM,278C1713S1_139021,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4642.31,1856.92,,,0 CDM,278C1713S1_139029,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7465.5,2986.2,,,0 CDM,278C1713S1_139030,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1600.59,640.24,,,0 CDM,278C1713S1_139033,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6709.5,2683.8,,,0 CDM,278C1713S1_139038,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1476.56,590.62,,,0 CDM,278C1713S1_139039,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1476.56,590.62,,,0 CDM,278C1713S1_139166,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14041.12,5616.45,,,0 CDM,278C1713S1_139167,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,15112.12,6044.85,,,0 CDM,278C1713S1_139168,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9481.5,3792.6,,,0 CDM,278C1713S1_139196,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,723.64,289.46,,,0 CDM,278C1713S1_139817,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.88,78.75,,,0 CDM,278C1713S1_140114,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2001.24,800.5,,,0 CDM,278C1713S1_140181,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,787.5,315.0,,,0 CDM,278C1713S1_142564,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2972.81,1189.12,,,0 CDM,278C1713S1_142568,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2972.81,1189.12,,,0 CDM,278C1713S1_142580,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8111.25,3244.5,,,0 CDM,278C1713S1_142595,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,322.88,129.15,,,0 CDM,278C1713S1_142597,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,322.88,129.15,,,0 CDM,278C1713S1_142598,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,322.88,129.15,,,0 CDM,278C1713S1_142601,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,322.88,129.15,,,0 CDM,278C1713S1_142602,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,322.88,129.15,,,0 CDM,278C1713S1_142603,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,322.88,129.15,,,0 CDM,278C1713S1_142604,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,322.88,129.15,,,0 CDM,278C1713S1_142605,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,322.88,129.15,,,0 CDM,278C1713S1_142606,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,322.88,129.15,,,0 CDM,278C1713S1_142615,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,322.88,129.15,,,0 CDM,278C1713S1_142616,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,322.88,129.15,,,0 CDM,278C1713S1_142617,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,322.88,129.15,,,0 CDM,278C1713S1_142618,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,322.88,129.15,,,0 CDM,278C1713S1_142699,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,626.81,250.72,,,0 CDM,278C1713S1_142703,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7905.4,3162.16,,,0 CDM,278C1713S1_142705,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7985.25,3194.1,,,0 CDM,278C1713S1_142707,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7985.25,3194.1,,,0 CDM,278C1713S1_142713,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7905.4,3162.16,,,0 CDM,278C1713S1_142772,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3781.97,1512.79,,,0 CDM,278C1713S1_142780,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3833.95,1533.58,,,0 CDM,278C1713S1_142781,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3315.93,1326.37,,,0 CDM,278C1713S1_142782,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4564.35,1825.74,,,0 CDM,278C1713S1_142785,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3315.93,1326.37,,,0 CDM,278C1713S1_142788,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2953.6,1181.44,,,0 CDM,278C1713S1_142789,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2948.64,1179.46,,,0 CDM,278C1713S1_142792,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2948.64,1179.46,,,0 CDM,278C1713S1_142794,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3461.06,1384.42,,,0 CDM,278C1713S1_142795,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3469.8,1387.92,,,0 CDM,278C1713S1_142796,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3461.06,1384.42,,,0 CDM,278C1713S1_142888,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,208.33,83.33,,,0 CDM,278C1713S1_142889,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,208.33,83.33,,,0 CDM,278C1713S1_142890,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,208.33,83.33,,,0 CDM,278C1713S1_142902,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,463.29,185.32,,,0 CDM,278C1713S1_142903,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,463.29,185.32,,,0 CDM,278C1713S1_142906,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,463.29,185.32,,,0 CDM,278C1713S1_142910,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2023.6,809.44,,,0 CDM,278C1713S1_142919,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,555.07,222.03,,,0 CDM,278C1713S1_142920,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,555.07,222.03,,,0 CDM,278C1713S1_142921,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,555.07,222.03,,,0 CDM,278C1713S1_142922,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,555.07,222.03,,,0 CDM,278C1713S1_142924,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,555.07,222.03,,,0 CDM,278C1713S1_142927,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,555.07,222.03,,,0 CDM,278C1713S1_142934,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1976.98,790.79,,,0 CDM,278C1713S1_142939,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2167.83,867.13,,,0 CDM,278C1713S1_142946,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,553.61,221.44,,,0 CDM,278C1713S1_142947,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,553.61,221.44,,,0 CDM,278C1713S1_142948,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,553.61,221.44,,,0 CDM,278C1713S1_142949,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,553.61,221.44,,,0 CDM,278C1713S1_142950,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,553.61,221.44,,,0 CDM,278C1713S1_142951,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,553.61,221.44,,,0 CDM,278C1713S1_142952,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,553.61,221.44,,,0 CDM,278C1713S1_142953,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,553.61,221.44,,,0 CDM,278C1713S1_142954,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,553.61,221.44,,,0 CDM,278C1713S1_142955,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,553.61,221.44,,,0 CDM,278C1713S1_142956,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,553.61,221.44,,,0 CDM,278C1713S1_142960,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2122.67,849.07,,,0 CDM,278C1713S1_142962,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2278.55,911.42,,,0 CDM,278C1713S1_142966,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2498.54,999.42,,,0 CDM,278C1713S1_142973,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,256.41,102.56,,,0 CDM,278C1713S1_142974,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,256.41,102.56,,,0 CDM,278C1713S1_142975,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,256.41,102.56,,,0 CDM,278C1713S1_142977,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,256.41,102.56,,,0 CDM,278C1713S1_142978,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,256.41,102.56,,,0 CDM,278C1713S1_142979,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,256.41,102.56,,,0 CDM,278C1713S1_142980,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,256.41,102.56,,,0 CDM,278C1713S1_142981,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,256.41,102.56,,,0 CDM,278C1713S1_142982,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,256.41,102.56,,,0 CDM,278C1713S1_142987,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,254.95,101.98,,,0 CDM,278C1713S1_142988,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,254.95,101.98,,,0 CDM,278C1713S1_142989,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,254.95,101.98,,,0 CDM,278C1713S1_142990,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,254.95,101.98,,,0 CDM,278C1713S1_142991,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,254.95,101.98,,,0 CDM,278C1713S1_142993,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,254.95,101.98,,,0 CDM,278C1713S1_144280,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3155.36,1262.14,,,0 CDM,278C1713S1_144281,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3155.36,1262.14,,,0 CDM,278C1713S1_144282,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3396.06,1358.42,,,0 CDM,278C1713S1_144283,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3968.33,1587.33,,,0 CDM,278C1713S1_144284,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3701.03,1480.41,,,0 CDM,278C1713S1_144287,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3396.06,1358.42,,,0 CDM,278C1713S1_144288,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3981.6,1592.64,,,0 CDM,278C1713S1_144289,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3981.6,1592.64,,,0 CDM,278C1713S1_144291,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1075.81,430.32,,,0 CDM,278C1713S1_144293,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,210.66,84.26,,,0 CDM,278C1713S1_144294,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3513.17,1405.27,,,0 CDM,278C1713S1_144299,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,748.12,299.25,,,0 CDM,278C1713S1_144300,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,209.87,83.95,,,0 CDM,278C1713S1_144301,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,748.12,299.25,,,0 CDM,278C1713S1_144322,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5964.45,2385.78,,,0 CDM,278C1713S1_144329,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5964.45,2385.78,,,0 CDM,278C1713S1_144336,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6146.55,2458.62,,,0 CDM,278C1713S1_144387,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3189.38,1275.75,,,0 CDM,278C1713S1_144388,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3238.59,1295.44,,,0 CDM,278C1713S1_144395,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3200.31,1280.12,,,0 CDM,278C1713S1_144396,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3215.19,1286.08,,,0 CDM,278C1713S1_144397,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3212.29,1284.92,,,0 CDM,278C1713S1_144398,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3205.59,1282.24,,,0 CDM,278C1713S1_144399,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3227.48,1290.99,,,0 CDM,278C1713S1_144400,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3232.44,1292.98,,,0 CDM,278C1713S1_144406,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3205.78,1282.31,,,0 CDM,278C1713S1_144407,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3210.77,1284.31,,,0 CDM,278C1713S1_144408,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3208.56,1283.42,,,0 CDM,278C1713S1_144409,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3222.92,1289.17,,,0 CDM,278C1713S1_144410,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3222.32,1288.93,,,0 CDM,278C1713S1_144411,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3224.35,1289.74,,,0 CDM,278C1713S1_144417,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3287.81,1315.12,,,0 CDM,278C1713S1_144418,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3205.78,1282.31,,,0 CDM,278C1713S1_144419,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3218.54,1287.42,,,0 CDM,278C1713S1_144420,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3236.45,1294.58,,,0 CDM,278C1713S1_144421,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3219.63,1287.85,,,0 CDM,278C1713S1_144422,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3216.41,1286.56,,,0 CDM,278C1713S1_144423,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3189.38,1275.75,,,0 CDM,278C1713S1_144426,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3287.81,1315.12,,,0 CDM,278C1713S1_144430,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3189.38,1275.75,,,0 CDM,278C1713S1_144431,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3236.36,1294.54,,,0 CDM,278C1713S1_144432,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3228.75,1291.5,,,0 CDM,278C1713S1_144433,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3240.18,1296.07,,,0 CDM,278C1713S1_144434,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3189.38,1275.75,,,0 CDM,278C1713S1_144438,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3287.81,1315.12,,,0 CDM,278C1713S1_144440,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3287.81,1315.12,,,0 CDM,278C1713S1_144441,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3189.38,1275.75,,,0 CDM,278C1713S1_144442,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3205.78,1282.31,,,0 CDM,278C1713S1_144443,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3263.2,1305.28,,,0 CDM,278C1713S1_144444,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3205.78,1282.31,,,0 CDM,278C1713S1_144445,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3287.81,1315.12,,,0 CDM,278C1713S1_144454,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3740.62,1496.25,,,0 CDM,278C1713S1_144455,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3740.62,1496.25,,,0 CDM,278C1713S1_144459,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3740.62,1496.25,,,0 CDM,278C1713S1_144460,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3740.62,1496.25,,,0 CDM,278C1713S1_144461,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3740.62,1496.25,,,0 CDM,278C1713S1_144462,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3740.62,1496.25,,,0 CDM,278C1713S1_144463,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3740.62,1496.25,,,0 CDM,278C1713S1_144464,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3740.62,1496.25,,,0 CDM,278C1713S1_144466,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3740.62,1496.25,,,0 CDM,278C1713S1_144467,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3740.62,1496.25,,,0 CDM,278C1713S1_144468,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3740.62,1496.25,,,0 CDM,278C1713S1_144469,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3740.62,1496.25,,,0 CDM,278C1713S1_144470,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3740.62,1496.25,,,0 CDM,278C1713S1_144471,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3740.62,1496.25,,,0 CDM,278C1713S1_144472,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3740.62,1496.25,,,0 CDM,278C1713S1_144474,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3740.62,1496.25,,,0 CDM,278C1713S1_144475,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3740.62,1496.25,,,0 CDM,278C1713S1_144476,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3740.62,1496.25,,,0 CDM,278C1713S1_144477,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3740.62,1496.25,,,0 CDM,278C1713S1_144478,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3740.62,1496.25,,,0 CDM,278C1713S1_144479,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3740.62,1496.25,,,0 CDM,278C1713S1_144480,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4725.0,1890.0,,,0 CDM,278C1713S1_144481,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4725.0,1890.0,,,0 CDM,278C1713S1_144482,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4725.0,1890.0,,,0 CDM,278C1713S1_144505,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4725.0,1890.0,,,0 CDM,278C1713S1_144506,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4725.0,1890.0,,,0 CDM,278C1713S1_144507,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4725.0,1890.0,,,0 CDM,278C1713S1_144830,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1346.76,538.7,,,0 CDM,278C1713S1_144832,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1349.71,539.88,,,0 CDM,278C1713S1_144834,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1346.3,538.52,,,0 CDM,278C1713S1_144835,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,579.51,231.8,,,0 CDM,278C1713S1_144836,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,731.36,292.54,,,0 CDM,278C1713S1_144837,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,789.75,315.9,,,0 CDM,278C1713S1_144838,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,731.36,292.54,,,0 CDM,278C1713S1_144839,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,731.36,292.54,,,0 CDM,278C1713S1_144840,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,731.36,292.54,,,0 CDM,278C1713S1_144841,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,731.36,292.54,,,0 CDM,278C1713S1_144842,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,750.82,300.33,,,0 CDM,278C1713S1_144843,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,731.36,292.54,,,0 CDM,278C1713S1_144847,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3235.8,1294.32,,,0 CDM,278C1713S1_144848,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3243.24,1297.3,,,0 CDM,278C1713S1_144849,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1604.3,641.72,,,0 CDM,278C1713S1_144850,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1604.3,641.72,,,0 CDM,278C1713S1_144851,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1604.3,641.72,,,0 CDM,278C1713S1_144852,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1604.3,641.72,,,0 CDM,278C1713S1_144856,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1604.3,641.72,,,0 CDM,278C1713S1_144857,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1082.81,433.12,,,0 CDM,278C1713S1_144858,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1076.51,430.6,,,0 CDM,278C1713S1_144859,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1082.81,433.12,,,0 CDM,278C1713S1_144860,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1082.81,433.12,,,0 CDM,278C1713S1_144861,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1082.81,433.12,,,0 CDM,278C1713S1_144862,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1082.81,433.12,,,0 CDM,278C1713S1_144864,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1082.81,433.12,,,0 CDM,278C1713S1_144882,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1378.12,551.25,,,0 CDM,278C1713S1_144930,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1196.93,478.77,,,0 CDM,278C1713S1_145223,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,766.63,306.65,,,0 CDM,278C1713S1_145252,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,195.14,78.06,,,0 CDM,278C1713S1_145253,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,195.14,78.06,,,0 CDM,278C1713S1_145254,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,250.9,100.36,,,0 CDM,278C1713S1_145286,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,728.32,291.33,,,0 CDM,278C1713S1_145288,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,728.32,291.33,,,0 CDM,278C1713S1_145291,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,728.32,291.33,,,0 CDM,278C1713S1_145294,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,728.32,291.33,,,0 CDM,278C1713S1_145320,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,205.62,82.25,,,0 CDM,278C1713S1_145322,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,205.62,82.25,,,0 CDM,278C1713S1_145324,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,205.62,82.25,,,0 CDM,278C1713S1_145362,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,846.8,338.72,,,0 CDM,278C1713S1_145400,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4725.51,1890.2,,,0 CDM,278C1713S1_145401,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4725.51,1890.2,,,0 CDM,278C1713S1_145402,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4725.51,1890.2,,,0 CDM,278C1713S1_145428,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4847.97,1939.19,,,0 CDM,278C1713S1_145453,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,359.51,143.8,,,0 CDM,278C1713S1_145489,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5146.31,2058.52,,,0 CDM,278C1713S1_145513,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4286.79,1714.72,,,0 CDM,278C1713S1_145514,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4248.25,1699.3,,,0 CDM,278C1713S1_145515,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4452.9,1781.16,,,0 CDM,278C1713S1_145516,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5365.94,2146.38,,,0 CDM,278C1713S1_145517,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5478.28,2191.31,,,0 CDM,278C1713S1_145529,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5478.28,2191.31,,,0 CDM,278C1713S1_145574,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,463.71,185.48,,,0 CDM,278C1713S1_145575,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,443.05,177.22,,,0 CDM,278C1713S1_145576,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,443.05,177.22,,,0 CDM,278C1713S1_145577,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,412.06,164.82,,,0 CDM,278C1713S1_145578,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,567.0,226.8,,,0 CDM,278C1713S1_145579,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,412.06,164.82,,,0 CDM,278C1713S1_145636,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1247.21,498.88,,,0 CDM,278C1713S1_145939,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1673.44,669.38,,,0 CDM,278C1713S1_145940,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1673.44,669.38,,,0 CDM,278C1713S1_145945,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1673.44,669.38,,,0 CDM,278C1713S1_145947,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1673.44,669.38,,,0 CDM,278C1713S1_145948,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1673.44,669.38,,,0 CDM,278C1713S1_145949,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,121.58,48.63,,,0 CDM,278C1713S1_145950,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,121.48,48.59,,,0 CDM,278C1713S1_145951,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.12,47.25,,,0 CDM,278C1713S1_145952,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.12,47.25,,,0 CDM,278C1713S1_145953,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.12,47.25,,,0 CDM,278C1713S1_145954,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.12,47.25,,,0 CDM,278C1713S1_145955,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.12,47.25,,,0 CDM,278C1713S1_145957,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.12,47.25,,,0 CDM,278C1713S1_145958,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.12,47.25,,,0 CDM,278C1713S1_145973,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1402.74,561.1,,,0 CDM,278C1713S1_145974,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1402.74,561.1,,,0 CDM,278C1713S1_145980,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1515.94,606.38,,,0 CDM,278C1713S1_146005,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1515.94,606.38,,,0 CDM,278C1713S1_146008,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1189.72,475.89,,,0 CDM,278C1713S1_146009,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1352.83,541.13,,,0 CDM,278C1713S1_146010,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1189.71,475.88,,,0 CDM,278C1713S1_146011,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1195.72,478.29,,,0 CDM,278C1713S1_146012,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1201.72,480.69,,,0 CDM,278C1713S1_146027,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2687.35,1074.94,,,0 CDM,278C1713S1_146029,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2580.83,1032.33,,,0 CDM,278C1713S1_146030,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1920.99,768.4,,,0 CDM,278C1713S1_146031,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1927.46,770.98,,,0 CDM,278C1713S1_146033,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1927.46,770.98,,,0 CDM,278C1713S1_146034,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1985.33,794.13,,,0 CDM,278C1713S1_146045,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2687.35,1074.94,,,0 CDM,278C1713S1_146047,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1920.99,768.4,,,0 CDM,278C1713S1_146052,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2687.35,1074.94,,,0 CDM,278C1713S1_146053,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2687.35,1074.94,,,0 CDM,278C1713S1_146054,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2687.35,1074.94,,,0 CDM,278C1713S1_146071,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,117.11,46.84,,,0 CDM,278C1713S1_146072,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,115.91,46.36,,,0 CDM,278C1713S1_146139,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,119.31,47.72,,,0 CDM,278C1713S1_146141,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,119.9,47.96,,,0 CDM,278C1713S1_146142,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.17,47.27,,,0 CDM,278C1713S1_146144,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,119.23,47.69,,,0 CDM,278C1713S1_146145,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.17,47.27,,,0 CDM,278C1713S1_146146,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.71,47.48,,,0 CDM,278C1713S1_146147,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.71,47.48,,,0 CDM,278C1713S1_146148,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,119.42,47.77,,,0 CDM,278C1713S1_146149,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,119.17,47.67,,,0 CDM,278C1713S1_146150,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.55,47.42,,,0 CDM,278C1713S1_146151,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.46,47.38,,,0 CDM,278C1713S1_146152,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,119.63,47.85,,,0 CDM,278C1713S1_146153,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,119.03,47.61,,,0 CDM,278C1713S1_146154,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,168.21,67.28,,,0 CDM,278C1713S1_146155,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,119.05,47.62,,,0 CDM,278C1713S1_146156,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,159.18,63.67,,,0 CDM,278C1713S1_146157,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,119.01,47.6,,,0 CDM,278C1713S1_146158,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,131.1,52.44,,,0 CDM,278C1713S1_146159,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,119.01,47.6,,,0 CDM,278C1713S1_146160,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,119.25,47.7,,,0 CDM,278C1713S1_146161,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,119.31,47.72,,,0 CDM,278C1713S1_146180,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,123.16,49.26,,,0 CDM,278C1713S1_146182,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2724.21,1089.68,,,0 CDM,278C1713S1_146183,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3978.36,1591.34,,,0 CDM,278C1713S1_146191,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,123.16,49.26,,,0 CDM,278C1713S1_146192,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.17,47.27,,,0 CDM,278C1713S1_146198,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,548.81,219.52,,,0 CDM,278C1713S1_146201,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,548.81,219.52,,,0 CDM,278C1713S1_146202,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,533.42,213.37,,,0 CDM,278C1713S1_146204,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,533.41,213.36,,,0 CDM,278C1713S1_146205,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,533.41,213.36,,,0 CDM,278C1713S1_146206,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,533.42,213.37,,,0 CDM,278C1713S1_146207,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,533.41,213.36,,,0 CDM,278C1713S1_146208,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,528.32,211.33,,,0 CDM,278C1713S1_146209,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.22,209.29,,,0 CDM,278C1713S1_146210,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,507.94,203.18,,,0 CDM,278C1713S1_146211,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,507.94,203.18,,,0 CDM,278C1713S1_146212,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,507.94,203.18,,,0 CDM,278C1713S1_146213,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.31,205.72,,,0 CDM,278C1713S1_146219,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,117.93,47.17,,,0 CDM,278C1713S1_146220,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.27,45.31,,,0 CDM,278C1713S1_146221,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.34,45.34,,,0 CDM,278C1713S1_146222,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.16,45.26,,,0 CDM,278C1713S1_146223,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.25,45.3,,,0 CDM,278C1713S1_146224,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.27,45.31,,,0 CDM,278C1713S1_146225,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.32,45.33,,,0 CDM,278C1713S1_146226,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.4,45.36,,,0 CDM,278C1713S1_146227,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.38,45.35,,,0 CDM,278C1713S1_146228,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.37,45.35,,,0 CDM,278C1713S1_146229,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.36,45.34,,,0 CDM,278C1713S1_146230,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.43,45.37,,,0 CDM,278C1713S1_146231,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.46,45.38,,,0 CDM,278C1713S1_146232,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.26,45.3,,,0 CDM,278C1713S1_146233,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.31,45.32,,,0 CDM,278C1713S1_146234,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.4,45.36,,,0 CDM,278C1713S1_146235,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.31,45.32,,,0 CDM,278C1713S1_146236,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.46,45.38,,,0 CDM,278C1713S1_146237,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.22,45.29,,,0 CDM,278C1713S1_146238,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.44,45.38,,,0 CDM,278C1713S1_146239,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,117.82,47.13,,,0 CDM,278C1713S1_146240,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,117.79,47.12,,,0 CDM,278C1713S1_146241,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.37,45.35,,,0 CDM,278C1713S1_146242,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.54,45.42,,,0 CDM,278C1713S1_146243,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.92,45.57,,,0 CDM,278C1713S1_146244,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,112.97,45.19,,,0 CDM,278C1713S1_146245,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,956.02,382.41,,,0 CDM,278C1713S1_146255,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,227.59,91.04,,,0 CDM,278C1713S1_146256,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,145.37,58.15,,,0 CDM,278C1713S1_146257,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,143.91,57.56,,,0 CDM,278C1713S1_146258,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,143.91,57.56,,,0 CDM,278C1713S1_146259,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,144.64,57.86,,,0 CDM,278C1713S1_146260,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,144.41,57.76,,,0 CDM,278C1713S1_146261,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,144.02,57.61,,,0 CDM,278C1713S1_146262,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,144.17,57.67,,,0 CDM,278C1713S1_146263,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,144.01,57.6,,,0 CDM,278C1713S1_146264,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,143.93,57.57,,,0 CDM,278C1713S1_146265,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,144.32,57.73,,,0 CDM,278C1713S1_146266,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,143.44,57.38,,,0 CDM,278C1713S1_146267,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,143.44,57.38,,,0 CDM,278C1713S1_146277,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,144.9,57.96,,,0 CDM,278C1713S1_146298,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,579.8,231.92,,,0 CDM,278C1713S1_146301,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,579.33,231.73,,,0 CDM,278C1713S1_146305,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,579.33,231.73,,,0 CDM,278C1713S1_146313,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,579.33,231.73,,,0 CDM,278C1713S1_146314,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,579.33,231.73,,,0 CDM,278C1713S1_146315,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,579.32,231.73,,,0 CDM,278C1713S1_146316,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,579.33,231.73,,,0 CDM,278C1713S1_146317,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,579.33,231.73,,,0 CDM,278C1713S1_146331,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,128.86,51.54,,,0 CDM,278C1713S1_146332,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,129.0,51.6,,,0 CDM,278C1713S1_146333,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,129.1,51.64,,,0 CDM,278C1713S1_146334,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,128.92,51.57,,,0 CDM,278C1713S1_146335,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,127.52,51.01,,,0 CDM,278C1713S1_146336,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,127.73,51.09,,,0 CDM,278C1713S1_146337,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,127.5,51.0,,,0 CDM,278C1713S1_146338,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,127.64,51.06,,,0 CDM,278C1713S1_146339,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,127.65,51.06,,,0 CDM,278C1713S1_146340,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,127.76,51.1,,,0 CDM,278C1713S1_146341,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,127.79,51.12,,,0 CDM,278C1713S1_146342,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,127.71,51.08,,,0 CDM,278C1713S1_146343,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,127.74,51.1,,,0 CDM,278C1713S1_146344,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,127.3,50.92,,,0 CDM,278C1713S1_146345,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,128.68,51.47,,,0 CDM,278C1713S1_146346,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,127.52,51.01,,,0 CDM,278C1713S1_146347,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,152.42,60.97,,,0 CDM,278C1713S1_146348,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,152.93,61.17,,,0 CDM,278C1713S1_146349,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,152.42,60.97,,,0 CDM,278C1713S1_146353,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,129.98,51.99,,,0 CDM,278C1713S1_146406,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6516.88,2606.75,,,0 CDM,278C1713S1_146414,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6259.68,2503.87,,,0 CDM,278C1713S1_146426,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6961.5,2784.6,,,0 CDM,278C1713S1_146441,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2151.29,860.52,,,0 CDM,278C1713S1_146442,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2151.29,860.52,,,0 CDM,278C1713S1_146497,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7600.59,3040.24,,,0 CDM,278C1713S1_146498,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7759.16,3103.66,,,0 CDM,278C1713S1_146506,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7600.59,3040.24,,,0 CDM,278C1713S1_146699,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,326.81,130.72,,,0 CDM,278C1713S1_147138,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1854.68,741.87,,,0 CDM,278C1713S1_147198,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,90.56,36.22,,,0 CDM,278C1713S1_147340,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,787.5,315.0,,,0 CDM,278C1713S1_147452,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147456,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147460,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147468,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147486,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147510,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147512,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147520,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147522,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147532,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147540,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147550,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147558,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147578,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147580,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147582,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147586,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147589,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147594,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147598,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147600,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147615,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147616,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147618,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147621,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147622,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147627,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147629,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147637,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147638,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147642,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.88,330.75,,,0 CDM,278C1713S1_147652,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,937.12,374.85,,,0 CDM,278C1713S1_147668,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,937.12,374.85,,,0 CDM,278C1713S1_147673,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,937.12,374.85,,,0 CDM,278C1713S1_147677,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,937.12,374.85,,,0 CDM,278C1713S1_147681,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,937.12,374.85,,,0 CDM,278C1713S1_147682,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,937.12,374.85,,,0 CDM,278C1713S1_147684,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,937.12,374.85,,,0 CDM,278C1713S1_147689,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,937.12,374.85,,,0 CDM,278C1713S1_147691,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,937.12,374.85,,,0 CDM,278C1713S1_147692,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,937.12,374.85,,,0 CDM,278C1713S1_147693,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,937.12,374.85,,,0 CDM,278C1713S1_147695,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,937.12,374.85,,,0 CDM,278C1713S1_147696,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,937.12,374.85,,,0 CDM,278C1713S1_147698,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,937.12,374.85,,,0 CDM,278C1713S1_147699,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,937.12,374.85,,,0 CDM,278C1713S1_147751,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1063.12,425.25,,,0 CDM,278C1713S1_147754,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1063.12,425.25,,,0 CDM,278C1713S1_147757,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1063.12,425.25,,,0 CDM,278C1713S1_147760,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1063.12,425.25,,,0 CDM,278C1713S1_147808,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1417.5,567.0,,,0 CDM,278C1713S1_147809,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1417.5,567.0,,,0 CDM,278C1713S1_147821,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1417.5,567.0,,,0 CDM,278C1713S1_147824,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1417.5,567.0,,,0 CDM,278C1713S1_147826,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1417.5,567.0,,,0 CDM,278C1713S1_147829,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1417.5,567.0,,,0 CDM,278C1713S1_147838,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1417.5,567.0,,,0 CDM,278C1713S1_147839,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1417.5,567.0,,,0 CDM,278C1713S1_147851,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1653.75,661.5,,,0 CDM,278C1713S1_147859,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1653.75,661.5,,,0 CDM,278C1713S1_147864,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1653.75,661.5,,,0 CDM,278C1713S1_147868,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1653.75,661.5,,,0 CDM,278C1713S1_147870,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1653.75,661.5,,,0 CDM,278C1713S1_147876,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1653.75,661.5,,,0 CDM,278C1713S1_147880,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1653.75,661.5,,,0 CDM,278C1713S1_147892,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1653.75,661.5,,,0 CDM,278C1713S1_147894,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1653.75,661.5,,,0 CDM,278C1713S1_147896,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1653.75,661.5,,,0 CDM,278C1713S1_147898,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1653.75,661.5,,,0 CDM,278C1713S1_147908,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1653.75,661.5,,,0 CDM,278C1713S1_147911,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1653.75,661.5,,,0 CDM,278C1713S1_147912,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1653.75,661.5,,,0 CDM,278C1713S1_148118,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148120,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148121,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148122,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148124,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148125,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148127,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148128,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148130,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148132,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148157,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148158,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148161,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148163,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148164,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148165,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148166,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148167,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148169,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148175,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148177,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1968.75,787.5,,,0 CDM,278C1713S1_148193,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148197,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148199,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148200,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148201,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148203,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148205,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148214,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148215,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148216,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148217,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148218,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148219,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148220,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148221,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148222,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148223,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148224,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148225,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148226,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_148241,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1082.81,433.12,,,0 CDM,278C1713S1_148243,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1082.81,433.12,,,0 CDM,278C1713S1_148245,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1082.81,433.12,,,0 CDM,278C1713S1_148251,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1082.81,433.12,,,0 CDM,278C1713S1_148253,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1082.81,433.12,,,0 CDM,278C1713S1_148263,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1082.81,433.12,,,0 CDM,278C1713S1_148275,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1575.0,630.0,,,0 CDM,278C1713S1_148298,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1575.0,630.0,,,0 CDM,278C1713S1_148315,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2047.5,819.0,,,0 CDM,278C1713S1_148333,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2047.5,819.0,,,0 CDM,278C1713S1_148334,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2047.5,819.0,,,0 CDM,278C1713S1_148336,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2047.5,819.0,,,0 CDM,278C1713S1_148337,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2047.5,819.0,,,0 CDM,278C1713S1_148339,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2047.5,819.0,,,0 CDM,278C1713S1_148341,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2047.5,819.0,,,0 CDM,278C1713S1_148342,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2047.5,819.0,,,0 CDM,278C1713S1_148343,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2047.5,819.0,,,0 CDM,278C1713S1_148344,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2047.5,819.0,,,0 CDM,278C1713S1_148345,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2047.5,819.0,,,0 CDM,278C1713S1_148372,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2992.5,1197.0,,,0 CDM,278C1713S1_148376,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2992.5,1197.0,,,0 CDM,278C1713S1_148381,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2992.5,1197.0,,,0 CDM,278C1713S1_148383,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2992.5,1197.0,,,0 CDM,278C1713S1_148384,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2992.5,1197.0,,,0 CDM,278C1713S1_148393,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2992.5,1197.0,,,0 CDM,278C1713S1_148394,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2992.5,1197.0,,,0 CDM,278C1713S1_148396,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2992.5,1197.0,,,0 CDM,278C1713S1_148398,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2992.5,1197.0,,,0 CDM,278C1713S1_148399,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2992.5,1197.0,,,0 CDM,278C1713S1_148400,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2992.5,1197.0,,,0 CDM,278C1713S1_148402,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2992.5,1197.0,,,0 CDM,278C1713S1_148410,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2992.5,1197.0,,,0 CDM,278C1713S1_148491,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1004.06,401.62,,,0 CDM,278C1713S1_148493,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1004.06,401.62,,,0 CDM,278C1713S1_148494,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1004.06,401.62,,,0 CDM,278C1713S1_148495,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1004.06,401.62,,,0 CDM,278C1713S1_148497,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1004.06,401.62,,,0 CDM,278C1713S1_148549,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3053.54,1221.42,,,0 CDM,278C1713S1_148551,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3053.54,1221.42,,,0 CDM,278C1713S1_148558,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3053.54,1221.42,,,0 CDM,278C1713S1_148572,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3053.54,1221.42,,,0 CDM,278C1713S1_148579,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3053.54,1221.42,,,0 CDM,278C1713S1_148591,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3053.54,1221.42,,,0 CDM,278C1713S1_148610,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3053.54,1221.42,,,0 CDM,278C1713S1_148611,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3053.54,1221.42,,,0 CDM,278C1713S1_148632,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3053.54,1221.42,,,0 CDM,278C1713S1_148690,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4823.44,1929.38,,,0 CDM,278C1713S1_148769,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4823.44,1929.38,,,0 CDM,278C1713S1_148842,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5158.12,2063.25,,,0 CDM,278C1713S1_148846,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5158.12,2063.25,,,0 CDM,278C1713S1_149007,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4921.88,1968.75,,,0 CDM,278C1713S1_149011,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4921.88,1968.75,,,0 CDM,278C1713S1_149059,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149061,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149062,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149063,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149065,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149067,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149069,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149071,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149072,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149073,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149074,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149075,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149076,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149077,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149078,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149079,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149082,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149156,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149158,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149160,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149162,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149166,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149167,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149168,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149169,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149171,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149172,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149173,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149176,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149177,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149179,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149180,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149181,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149182,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149183,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149184,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149185,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149187,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149189,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149190,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149191,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149192,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149193,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149194,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149195,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149196,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149197,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149198,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149199,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149200,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149201,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149273,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.81,161.12,,,0 CDM,278C1713S1_149299,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149301,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149302,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149303,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149304,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149305,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149306,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149307,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149308,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149309,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149310,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149311,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149312,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149313,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149314,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149315,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149316,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149317,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149318,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149319,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149320,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149321,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149322,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149323,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149324,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149325,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149326,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149327,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149328,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149329,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149330,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149331,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149332,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149333,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149334,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149335,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149336,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149337,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149338,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149339,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149340,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149342,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149343,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149344,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149345,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149346,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149347,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149348,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149349,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149350,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149351,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149354,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149356,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149357,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149358,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149359,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149360,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_149369,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149371,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149372,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149373,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149374,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149375,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149376,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149377,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149378,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149379,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149381,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149382,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149383,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149384,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149385,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149386,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149387,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149388,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149389,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149390,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149391,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149392,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149393,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149394,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149395,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149396,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149397,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149398,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149399,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149400,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149401,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149402,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149403,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149404,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149405,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149406,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149407,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149408,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149409,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149410,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149411,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149412,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149414,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149415,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149416,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_149417,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149418,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149419,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149420,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149421,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149422,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149423,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149425,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149427,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149429,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149430,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149433,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149434,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149435,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149437,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_149468,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,846.56,338.62,,,0 CDM,278C1713S1_149471,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,846.56,338.62,,,0 CDM,278C1713S1_149473,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,846.56,338.62,,,0 CDM,278C1713S1_149475,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,846.56,338.62,,,0 CDM,278C1713S1_149476,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,846.56,338.62,,,0 CDM,278C1713S1_149508,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,669.38,267.75,,,0 CDM,278C1713S1_149509,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,669.38,267.75,,,0 CDM,278C1713S1_149510,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,669.38,267.75,,,0 CDM,278C1713S1_149513,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,669.38,267.75,,,0 CDM,278C1713S1_149517,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,669.38,267.75,,,0 CDM,278C1713S1_149518,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,669.38,267.75,,,0 CDM,278C1713S1_149519,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,669.38,267.75,,,0 CDM,278C1713S1_149689,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3002.15,1200.86,,,0 CDM,278C1713S1_149690,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3002.15,1200.86,,,0 CDM,278C1713S1_149691,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3002.15,1200.86,,,0 CDM,278C1713S1_149692,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3002.15,1200.86,,,0 CDM,278C1713S1_149695,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3878.44,1551.38,,,0 CDM,278C1713S1_149701,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3002.15,1200.86,,,0 CDM,278C1713S1_149705,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3002.15,1200.86,,,0 CDM,278C1713S1_149706,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3878.44,1551.38,,,0 CDM,278C1713S1_149711,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3878.44,1551.38,,,0 CDM,278C1713S1_149713,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3002.15,1200.86,,,0 CDM,278C1713S1_149714,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3878.44,1551.38,,,0 CDM,278C1713S1_149715,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3440.29,1376.12,,,0 CDM,278C1713S1_149716,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3002.15,1200.86,,,0 CDM,278C1713S1_149717,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3002.15,1200.86,,,0 CDM,278C1713S1_149719,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3002.15,1200.86,,,0 CDM,278C1713S1_149720,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3002.15,1200.86,,,0 CDM,278C1713S1_149722,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3002.15,1200.86,,,0 CDM,278C1713S1_149725,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3002.15,1200.86,,,0 CDM,278C1713S1_149726,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3294.25,1317.7,,,0 CDM,278C1713S1_149727,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3002.15,1200.86,,,0 CDM,278C1713S1_149728,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3002.15,1200.86,,,0 CDM,278C1713S1_149733,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3002.15,1200.86,,,0 CDM,278C1713S1_149737,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4390.31,1756.12,,,0 CDM,278C1713S1_149746,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4578.52,1831.41,,,0 CDM,278C1713S1_149752,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4921.88,1968.75,,,0 CDM,278C1713S1_149754,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5010.27,2004.11,,,0 CDM,278C1713S1_149760,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5743.73,2297.49,,,0 CDM,278C1713S1_149761,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5010.27,2004.11,,,0 CDM,278C1713S1_149811,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4367.67,1747.07,,,0 CDM,278C1713S1_149812,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4688.83,1875.53,,,0 CDM,278C1713S1_149813,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4367.67,1747.07,,,0 CDM,278C1713S1_149815,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5009.98,2003.99,,,0 CDM,278C1713S1_149817,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5009.98,2003.99,,,0 CDM,278C1713S1_149821,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4367.67,1747.07,,,0 CDM,278C1713S1_149822,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5009.98,2003.99,,,0 CDM,278C1713S1_149823,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4367.67,1747.07,,,0 CDM,278C1713S1_149827,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5009.98,2003.99,,,0 CDM,278C1713S1_149830,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4749.21,1899.68,,,0 CDM,278C1713S1_149831,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4872.32,1948.93,,,0 CDM,278C1713S1_149846,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4749.21,1899.68,,,0 CDM,278C1713S1_149847,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4856.93,1942.77,,,0 CDM,278C1713S1_149848,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5036.45,2014.58,,,0 CDM,278C1713S1_149879,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4638.77,1855.51,,,0 CDM,278C1713S1_149882,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4638.77,1855.51,,,0 CDM,278C1713S1_149884,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4919.91,1967.96,,,0 CDM,278C1713S1_149887,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5211.09,2084.44,,,0 CDM,278C1713S1_149888,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5166.5,2066.6,,,0 CDM,278C1713S1_149894,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4919.91,1967.96,,,0 CDM,278C1713S1_149898,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5029.5,2011.8,,,0 CDM,278C1713S1_149921,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6415.96,2566.38,,,0 CDM,278C1713S1_149922,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6415.96,2566.38,,,0 CDM,278C1713S1_149937,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6415.96,2566.38,,,0 CDM,278C1713S1_149938,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6415.96,2566.38,,,0 CDM,278C1713S1_149940,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8071.88,3228.75,,,0 CDM,278C1713S1_149942,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6415.96,2566.38,,,0 CDM,278C1713S1_149947,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6817.59,2727.04,,,0 CDM,278C1713S1_149951,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7018.4,2807.36,,,0 CDM,278C1713S1_149960,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4518.29,1807.32,,,0 CDM,278C1713S1_149961,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4518.29,1807.32,,,0 CDM,278C1713S1_149963,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4518.29,1807.32,,,0 CDM,278C1713S1_149965,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6104.7,2441.88,,,0 CDM,278C1713S1_149966,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7875.0,3150.0,,,0 CDM,278C1713S1_149969,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6104.7,2441.88,,,0 CDM,278C1713S1_149971,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6104.7,2441.88,,,0 CDM,278C1713S1_149973,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4518.29,1807.32,,,0 CDM,278C1713S1_149975,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4518.29,1807.32,,,0 CDM,278C1713S1_149976,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4518.29,1807.32,,,0 CDM,278C1713S1_149977,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4518.29,1807.32,,,0 CDM,278C1713S1_149978,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4518.29,1807.32,,,0 CDM,278C1713S1_149979,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4518.29,1807.32,,,0 CDM,278C1713S1_149980,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5315.62,2126.25,,,0 CDM,278C1713S1_149982,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6104.7,2441.88,,,0 CDM,278C1713S1_149984,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6104.7,2441.88,,,0 CDM,278C1713S1_149985,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6104.7,2441.88,,,0 CDM,278C1713S1_149988,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6104.7,2441.88,,,0 CDM,278C1713S1_149990,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4916.96,1966.78,,,0 CDM,278C1713S1_149999,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4006.21,1602.48,,,0 CDM,278C1713S1_150001,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4006.21,1602.48,,,0 CDM,278C1713S1_150013,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4006.21,1602.48,,,0 CDM,278C1713S1_150016,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4006.21,1602.48,,,0 CDM,278C1713S1_150021,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4677.62,1871.05,,,0 CDM,278C1713S1_150022,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4677.62,1871.05,,,0 CDM,278C1713S1_150024,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2510.16,1004.06,,,0 CDM,278C1713S1_150025,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2643.05,1057.22,,,0 CDM,278C1713S1_150027,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2620.9,1048.36,,,0 CDM,278C1713S1_150028,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2565.53,1026.21,,,0 CDM,278C1713S1_150029,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2562.27,1024.91,,,0 CDM,278C1713S1_150030,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2583.99,1033.6,,,0 CDM,278C1713S1_150031,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2590.7,1036.28,,,0 CDM,278C1713S1_150032,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2731.64,1092.66,,,0 CDM,278C1713S1_150033,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2510.16,1004.06,,,0 CDM,278C1713S1_150037,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5010.27,2004.11,,,0 CDM,278C1713S1_150039,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5010.27,2004.11,,,0 CDM,278C1713S1_150041,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5341.75,2136.7,,,0 CDM,278C1713S1_150047,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5436.45,2174.58,,,0 CDM,278C1713S1_150049,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5120.76,2048.3,,,0 CDM,278C1713S1_150051,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5673.22,2269.29,,,0 CDM,278C1713S1_150053,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5010.27,2004.11,,,0 CDM,278C1713S1_150063,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5211.09,2084.44,,,0 CDM,278C1713S1_150064,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5785.07,2314.03,,,0 CDM,278C1713S1_150066,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3996.17,1598.47,,,0 CDM,278C1713S1_150067,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3996.17,1598.47,,,0 CDM,278C1713S1_150068,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3996.17,1598.47,,,0 CDM,278C1713S1_150069,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3996.17,1598.47,,,0 CDM,278C1713S1_150070,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3996.17,1598.47,,,0 CDM,278C1713S1_150071,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4239.12,1695.65,,,0 CDM,278C1713S1_150072,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4141.94,1656.78,,,0 CDM,278C1713S1_150074,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5010.27,2004.11,,,0 CDM,278C1713S1_150078,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5010.27,2004.11,,,0 CDM,278C1713S1_150079,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5010.27,2004.11,,,0 CDM,278C1713S1_150081,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3996.17,1598.47,,,0 CDM,278C1713S1_150083,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3996.17,1598.47,,,0 CDM,278C1713S1_150084,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3996.17,1598.47,,,0 CDM,278C1713S1_150085,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5211.09,2084.44,,,0 CDM,278C1713S1_150088,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8780.62,3512.25,,,0 CDM,278C1713S1_150091,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7219.21,2887.68,,,0 CDM,278C1713S1_150092,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7219.21,2887.68,,,0 CDM,278C1713S1_150112,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4407.84,1763.14,,,0 CDM,278C1713S1_150113,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4407.84,1763.14,,,0 CDM,278C1713S1_150114,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5409.49,2163.8,,,0 CDM,278C1713S1_150115,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5740.15,2296.06,,,0 CDM,278C1713S1_150117,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5369.81,2147.92,,,0 CDM,278C1713S1_150119,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6004.69,2401.88,,,0 CDM,278C1713S1_150122,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4407.84,1763.14,,,0 CDM,278C1713S1_150283,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,86.62,34.65,,,0 CDM,278C1713S1_150285,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,532.74,213.1,,,0 CDM,278C1713S1_150312,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,86.62,34.65,,,0 CDM,278C1713S1_150313,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,86.62,34.65,,,0 CDM,278C1713S1_150314,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,86.62,34.65,,,0 CDM,278C1713S1_150316,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,86.62,34.65,,,0 CDM,278C1713S1_150318,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,86.62,34.65,,,0 CDM,278C1713S1_150319,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,86.62,34.65,,,0 CDM,278C1713S1_150321,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,86.62,34.65,,,0 CDM,278C1713S1_150322,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_150323,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,86.62,34.65,,,0 CDM,278C1713S1_150324,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,86.62,34.65,,,0 CDM,278C1713S1_150325,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,86.62,34.65,,,0 CDM,278C1713S1_150326,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,86.62,34.65,,,0 CDM,278C1713S1_150328,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,86.62,34.65,,,0 CDM,278C1713S1_150329,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,86.62,34.65,,,0 CDM,278C1713S1_150334,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,86.62,34.65,,,0 CDM,278C1713S1_150340,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_150344,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,389.81,155.92,,,0 CDM,278C1713S1_150345,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_150347,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_150348,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_150350,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_150352,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_150354,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_150363,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,86.62,34.65,,,0 CDM,278C1713S1_150366,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,433.12,173.25,,,0 CDM,278C1713S1_150368,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,433.12,173.25,,,0 CDM,278C1713S1_150397,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5723.16,2289.26,,,0 CDM,278C1713S1_150398,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5723.16,2289.26,,,0 CDM,278C1713S1_150399,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5723.16,2289.26,,,0 CDM,278C1713S1_150401,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5923.97,2369.59,,,0 CDM,278C1713S1_150403,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5923.97,2369.59,,,0 CDM,278C1713S1_150414,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9485.44,3794.18,,,0 CDM,278C1713S1_150415,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9485.44,3794.18,,,0 CDM,278C1713S1_150416,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9485.44,3794.18,,,0 CDM,278C1713S1_150537,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3581.16,1432.46,,,0 CDM,278C1713S1_150553,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1854.43,741.77,,,0 CDM,278C1713S1_150598,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2762.99,1105.2,,,0 CDM,278C1713S1_150605,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3146.85,1258.74,,,0 CDM,278C1713S1_150606,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3146.85,1258.74,,,0 CDM,278C1713S1_150708,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150717,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150718,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150719,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150720,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150721,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150722,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150728,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150729,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150730,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150731,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150732,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150733,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150740,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150741,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150742,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150743,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150744,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150745,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150751,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150752,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150753,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150754,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150755,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150756,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150757,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3583.12,1433.25,,,0 CDM,278C1713S1_150771,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2130.19,852.08,,,0 CDM,278C1713S1_151007,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,869.56,347.82,,,0 CDM,278C1713S1_151008,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,869.56,347.82,,,0 CDM,278C1713S1_151020,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1712.81,685.12,,,0 CDM,278C1713S1_151031,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1712.81,685.12,,,0 CDM,278C1713S1_151036,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1712.81,685.12,,,0 CDM,278C1713S1_151037,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,101.71,40.68,,,0 CDM,278C1713S1_151040,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.88,78.75,,,0 CDM,278C1713S1_151063,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1712.81,685.12,,,0 CDM,278C1713S1_151070,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1712.81,685.12,,,0 CDM,278C1713S1_152199,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,202.7,81.08,,,0 CDM,278C1713S1_152202,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,303.23,121.29,,,0 CDM,278C1713S1_152203,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,408.32,163.33,,,0 CDM,278C1713S1_152321,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,567.32,226.93,,,0 CDM,278C1713S1_152322,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,559.95,223.98,,,0 CDM,278C1713S1_152323,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,577.28,230.91,,,0 CDM,278C1713S1_152330,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,567.32,226.93,,,0 CDM,278C1713S1_152452,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,31.18,12.47,,,0 CDM,278C1713S1_152455,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,31.22,12.49,,,0 CDM,278C1713S1_152509,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2533.88,1013.55,,,0 CDM,278C1713S1_152510,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3282.97,1313.19,,,0 CDM,278C1713S1_152701,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1949.06,779.62,,,0 CDM,278C1713S1_153127,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,192.31,76.92,,,0 CDM,278C1713S1_153128,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,192.31,76.92,,,0 CDM,278C1713S1_153365,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,103.79,41.52,,,0 CDM,278C1713S1_153367,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,103.79,41.52,,,0 CDM,278C1713S1_153374,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,778.13,311.25,,,0 CDM,278C1713S1_153462,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,103.79,41.52,,,0 CDM,278C1713S1_153467,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,130.84,52.34,,,0 CDM,278C1713S1_153469,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,130.84,52.34,,,0 CDM,278C1713S1_153471,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,130.84,52.34,,,0 CDM,278C1713S1_153475,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,130.84,52.34,,,0 CDM,278C1713S1_153478,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,130.84,52.34,,,0 CDM,278C1713S1_153479,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,130.84,52.34,,,0 CDM,278C1713S1_153481,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,130.84,52.34,,,0 CDM,278C1713S1_153483,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,130.84,52.34,,,0 CDM,278C1713S1_153489,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,130.85,52.34,,,0 CDM,278C1713S1_153490,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.44,45.38,,,0 CDM,278C1713S1_153492,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.44,45.38,,,0 CDM,278C1713S1_153493,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.44,45.38,,,0 CDM,278C1713S1_153505,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,137.74,55.1,,,0 CDM,278C1713S1_153509,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,137.73,55.09,,,0 CDM,278C1713S1_153510,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,137.73,55.09,,,0 CDM,278C1713S1_153511,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,137.73,55.09,,,0 CDM,278C1713S1_153519,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,137.74,55.1,,,0 CDM,278C1713S1_153521,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,137.74,55.1,,,0 CDM,278C1713S1_153523,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.8,47.52,,,0 CDM,278C1713S1_153570,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,423.6,169.44,,,0 CDM,278C1713S1_153571,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,423.6,169.44,,,0 CDM,278C1713S1_153573,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,423.6,169.44,,,0 CDM,278C1713S1_153597,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,423.6,169.44,,,0 CDM,278C1713S1_153618,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,428.79,171.52,,,0 CDM,278C1713S1_153622,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,428.79,171.52,,,0 CDM,278C1713S1_153673,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,316.97,126.79,,,0 CDM,278C1713S1_153689,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,279.05,111.62,,,0 CDM,278C1713S1_153692,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,279.05,111.62,,,0 CDM,278C1713S1_153740,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1750.22,700.09,,,0 CDM,278C1713S1_153742,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1798.45,719.38,,,0 CDM,278C1713S1_153743,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1798.45,719.38,,,0 CDM,278C1713S1_153745,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1798.45,719.38,,,0 CDM,278C1713S1_153771,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1970.72,788.29,,,0 CDM,278C1713S1_154269,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1153.69,461.48,,,0 CDM,278C1713S1_154270,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,729.42,291.77,,,0 CDM,278C1713S1_154272,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,729.42,291.77,,,0 CDM,278C1713S1_154274,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,729.42,291.77,,,0 CDM,278C1713S1_154276,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,729.42,291.77,,,0 CDM,278C1713S1_154277,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,729.42,291.77,,,0 CDM,278C1713S1_154283,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5425.96,2170.38,,,0 CDM,278C1713S1_154385,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,591.63,236.65,,,0 CDM,278C1713S1_154386,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,591.54,236.62,,,0 CDM,278C1713S1_154387,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,591.0,236.4,,,0 CDM,278C1713S1_154530,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,255.39,102.16,,,0 CDM,278C1713S1_154531,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,592.08,236.83,,,0 CDM,278C1713S1_154532,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,591.95,236.78,,,0 CDM,278C1713S1_154533,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,592.64,237.06,,,0 CDM,278C1713S1_154534,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.14,237.66,,,0 CDM,278C1713S1_154535,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,592.74,237.1,,,0 CDM,278C1713S1_154536,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,593.03,237.21,,,0 CDM,278C1713S1_154537,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,591.8,236.72,,,0 CDM,278C1713S1_154538,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.0,237.6,,,0 CDM,278C1713S1_154539,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,256.31,102.52,,,0 CDM,278C1713S1_154540,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,591.23,236.49,,,0 CDM,278C1713S1_154541,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,604.67,241.87,,,0 CDM,278C1713S1_154542,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,256.53,102.61,,,0 CDM,278C1713S1_154543,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,589.25,235.7,,,0 CDM,278C1713S1_154544,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,602.64,241.06,,,0 CDM,278C1713S1_154545,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,592.22,236.89,,,0 CDM,278C1713S1_154546,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,605.69,242.28,,,0 CDM,278C1713S1_154547,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,606.52,242.61,,,0 CDM,278C1713S1_154548,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,606.7,242.68,,,0 CDM,278C1713S1_154549,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,592.22,236.89,,,0 CDM,278C1713S1_154550,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,608.74,243.5,,,0 CDM,278C1713S1_154551,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,608.74,243.5,,,0 CDM,278C1713S1_154553,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,254.48,101.79,,,0 CDM,278C1713S1_154554,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,261.66,104.66,,,0 CDM,278C1713S1_154555,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,261.97,104.79,,,0 CDM,278C1713S1_154556,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,261.79,104.72,,,0 CDM,278C1713S1_154557,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,261.72,104.69,,,0 CDM,278C1713S1_154558,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,255.61,102.24,,,0 CDM,278C1713S1_154559,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,255.6,102.24,,,0 CDM,278C1713S1_154560,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,255.67,102.27,,,0 CDM,278C1713S1_154561,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,256.04,102.42,,,0 CDM,278C1713S1_154562,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,255.72,102.29,,,0 CDM,278C1713S1_154563,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,261.53,104.61,,,0 CDM,278C1713S1_154564,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,255.76,102.3,,,0 CDM,278C1713S1_154565,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,261.5,104.6,,,0 CDM,278C1713S1_154566,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,256.19,102.48,,,0 CDM,278C1713S1_154567,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,255.33,102.13,,,0 CDM,278C1713S1_154568,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,255.12,102.05,,,0 CDM,278C1713S1_154569,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,254.8,101.92,,,0 CDM,278C1713S1_154570,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,254.76,101.9,,,0 CDM,278C1713S1_154571,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,255.58,102.23,,,0 CDM,278C1713S1_154572,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,254.99,102.0,,,0 CDM,278C1713S1_154573,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,255.38,102.15,,,0 CDM,278C1713S1_154574,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,255.03,102.01,,,0 CDM,278C1713S1_154575,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,261.15,104.46,,,0 CDM,278C1713S1_154576,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,254.48,101.79,,,0 CDM,278C1713S1_154577,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,256.47,102.59,,,0 CDM,278C1713S1_154580,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,593.21,237.28,,,0 CDM,278C1713S1_154581,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,591.23,236.49,,,0 CDM,278C1713S1_154582,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,589.25,235.7,,,0 CDM,278C1713S1_154583,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,590.44,236.18,,,0 CDM,278C1713S1_154584,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,603.65,241.46,,,0 CDM,278C1713S1_154585,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,602.64,241.06,,,0 CDM,278C1713S1_154586,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,605.69,242.28,,,0 CDM,278C1713S1_154587,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,605.69,242.28,,,0 CDM,278C1713S1_154588,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,602.64,241.06,,,0 CDM,278C1713S1_154589,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,605.69,242.28,,,0 CDM,278C1713S1_154590,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,602.64,241.06,,,0 CDM,278C1713S1_154591,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,605.69,242.28,,,0 CDM,278C1713S1_154592,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,602.63,241.05,,,0 CDM,278C1713S1_154593,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,602.64,241.06,,,0 CDM,278C1713S1_154594,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,603.65,241.46,,,0 CDM,278C1713S1_154595,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,605.69,242.28,,,0 CDM,278C1713S1_154597,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,606.7,242.68,,,0 CDM,278C1713S1_154598,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,606.7,242.68,,,0 CDM,278C1713S1_154599,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,602.64,241.06,,,0 CDM,278C1713S1_154600,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,602.64,241.06,,,0 CDM,278C1713S1_154601,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,602.64,241.06,,,0 CDM,278C1713S1_154606,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,255.85,102.34,,,0 CDM,278C1713S1_154607,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,256.44,102.58,,,0 CDM,278C1713S1_154608,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,262.6,105.04,,,0 CDM,278C1713S1_154609,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,259.63,103.85,,,0 CDM,278C1713S1_154610,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,262.38,104.95,,,0 CDM,278C1713S1_154611,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,260.62,104.25,,,0 CDM,278C1713S1_154612,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,255.5,102.2,,,0 CDM,278C1713S1_154613,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,260.62,104.25,,,0 CDM,278C1713S1_154614,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,260.62,104.25,,,0 CDM,278C1713S1_154615,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,262.38,104.95,,,0 CDM,278C1713S1_154616,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,256.19,102.48,,,0 CDM,278C1713S1_154617,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,255.33,102.13,,,0 CDM,278C1713S1_154618,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,255.18,102.07,,,0 CDM,278C1713S1_154619,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,327.68,131.07,,,0 CDM,278C1713S1_154620,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,328.63,131.45,,,0 CDM,278C1713S1_154621,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,257.04,102.82,,,0 CDM,278C1713S1_154622,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,255.33,102.13,,,0 CDM,278C1713S1_154623,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,328.79,131.52,,,0 CDM,278C1713S1_154624,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,255.76,102.3,,,0 CDM,278C1713S1_154625,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,257.04,102.82,,,0 CDM,278C1713S1_154626,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,330.99,132.4,,,0 CDM,278C1713S1_154627,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,254.48,101.79,,,0 CDM,278C1713S1_154628,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,327.68,131.07,,,0 CDM,278C1713S1_154629,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,327.68,131.07,,,0 CDM,278C1713S1_154631,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,544.67,217.87,,,0 CDM,278C1713S1_154632,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,518.04,207.22,,,0 CDM,278C1713S1_154633,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,542.41,216.96,,,0 CDM,278C1713S1_154634,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,544.0,217.6,,,0 CDM,278C1713S1_154635,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,546.41,218.56,,,0 CDM,278C1713S1_154636,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,459.15,183.66,,,0 CDM,278C1713S1_154637,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.72,216.69,,,0 CDM,278C1713S1_154638,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,544.85,217.94,,,0 CDM,278C1713S1_154639,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.73,216.69,,,0 CDM,278C1713S1_154640,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.72,216.69,,,0 CDM,278C1713S1_154641,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.73,216.69,,,0 CDM,278C1713S1_154642,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.73,216.69,,,0 CDM,278C1713S1_154643,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.73,216.69,,,0 CDM,278C1713S1_154644,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.73,216.69,,,0 CDM,278C1713S1_154645,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.73,216.69,,,0 CDM,278C1713S1_154648,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,316.78,126.71,,,0 CDM,278C1713S1_154649,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,253.44,101.38,,,0 CDM,278C1713S1_154650,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,252.39,100.96,,,0 CDM,278C1713S1_154651,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,253.5,101.4,,,0 CDM,278C1713S1_154652,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,252.73,101.09,,,0 CDM,278C1713S1_154653,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,316.88,126.75,,,0 CDM,278C1713S1_154654,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,317.21,126.88,,,0 CDM,278C1713S1_154655,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,317.74,127.1,,,0 CDM,278C1713S1_154656,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.14,127.26,,,0 CDM,278C1713S1_154657,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,317.56,127.02,,,0 CDM,278C1713S1_154658,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,252.73,101.09,,,0 CDM,278C1713S1_154659,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,316.14,126.46,,,0 CDM,278C1713S1_154660,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,316.94,126.78,,,0 CDM,278C1713S1_154661,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,317.74,127.1,,,0 CDM,278C1713S1_154662,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,317.06,126.82,,,0 CDM,278C1713S1_154664,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,543.09,217.24,,,0 CDM,278C1713S1_154665,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,512.38,204.95,,,0 CDM,278C1713S1_154666,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,531.99,212.8,,,0 CDM,278C1713S1_154667,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,512.43,204.97,,,0 CDM,278C1713S1_154668,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,512.25,204.9,,,0 CDM,278C1713S1_154669,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,531.68,212.67,,,0 CDM,278C1713S1_154670,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,530.87,212.35,,,0 CDM,278C1713S1_154671,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,511.52,204.61,,,0 CDM,278C1713S1_154672,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,511.94,204.78,,,0 CDM,278C1713S1_154673,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,511.88,204.75,,,0 CDM,278C1713S1_154674,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,511.95,204.78,,,0 CDM,278C1713S1_154675,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,510.66,204.26,,,0 CDM,278C1713S1_154678,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.73,216.69,,,0 CDM,278C1713S1_154682,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.73,216.69,,,0 CDM,278C1713S1_154683,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,316.14,126.46,,,0 CDM,278C1713S1_154684,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,252.09,100.84,,,0 CDM,278C1713S1_154685,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,252.26,100.9,,,0 CDM,278C1713S1_154686,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,252.32,100.93,,,0 CDM,278C1713S1_154687,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,252.07,100.83,,,0 CDM,278C1713S1_154688,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,252.53,101.01,,,0 CDM,278C1713S1_154689,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,252.73,101.09,,,0 CDM,278C1713S1_154690,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,252.38,100.95,,,0 CDM,278C1713S1_154691,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,251.88,100.75,,,0 CDM,278C1713S1_154692,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,252.55,101.02,,,0 CDM,278C1713S1_154693,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,252.98,101.19,,,0 CDM,278C1713S1_154694,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,252.09,100.84,,,0 CDM,278C1713S1_154695,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,253.16,101.26,,,0 CDM,278C1713S1_154696,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,253.58,101.43,,,0 CDM,278C1713S1_154697,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,316.14,126.46,,,0 CDM,278C1713S1_154698,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.06,127.22,,,0 CDM,278C1713S1_154699,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,316.78,126.71,,,0 CDM,278C1713S1_154701,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,317.74,127.1,,,0 CDM,278C1713S1_154723,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,319.14,127.66,,,0 CDM,278C1713S1_154770,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,406.51,162.6,,,0 CDM,278C1713S1_154772,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,406.51,162.6,,,0 CDM,278C1713S1_154773,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,406.51,162.6,,,0 CDM,278C1713S1_154909,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9715.03,3886.01,,,0 CDM,278C1713S1_155024,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,729.42,291.77,,,0 CDM,278C1713S1_155025,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,729.42,291.77,,,0 CDM,278C1713S1_155045,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5151.0,2060.4,,,0 CDM,278C1713S1_155046,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5207.54,2083.02,,,0 CDM,278C1713S1_155047,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4563.88,1825.55,,,0 CDM,278C1713S1_155048,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5043.51,2017.4,,,0 CDM,278C1713S1_155049,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5826.17,2330.47,,,0 CDM,278C1713S1_155050,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5826.17,2330.47,,,0 CDM,278C1713S1_155051,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5556.6,2222.64,,,0 CDM,278C1713S1_155052,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4706.81,1882.72,,,0 CDM,278C1713S1_155055,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1827.0,730.8,,,0 CDM,278C1713S1_155061,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_155110,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_155167,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4588.56,1835.42,,,0 CDM,278C1713S1_155168,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4588.56,1835.42,,,0 CDM,278C1713S1_155175,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5813.52,2325.41,,,0 CDM,278C1713S1_155179,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6004.3,2401.72,,,0 CDM,278C1713S1_155180,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6004.3,2401.72,,,0 CDM,278C1713S1_155181,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6004.3,2401.72,,,0 CDM,278C1713S1_155182,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6004.3,2401.72,,,0 CDM,278C1713S1_155183,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6004.3,2401.72,,,0 CDM,278C1713S1_155192,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6004.3,2401.72,,,0 CDM,278C1713S1_155193,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6004.3,2401.72,,,0 CDM,278C1713S1_155194,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6442.44,2576.98,,,0 CDM,278C1713S1_155217,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7219.21,2887.68,,,0 CDM,278C1713S1_155219,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7219.21,2887.68,,,0 CDM,278C1713S1_155344,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6714.74,2685.9,,,0 CDM,278C1713S1_155345,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6966.09,2786.44,,,0 CDM,278C1713S1_155346,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6212.04,2484.82,,,0 CDM,278C1713S1_155347,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6303.44,2521.38,,,0 CDM,278C1713S1_155424,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3130.31,1252.12,,,0 CDM,278C1713S1_155425,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3130.31,1252.12,,,0 CDM,278C1713S1_155625,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2264.06,905.62,,,0 CDM,278C1713S1_155626,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2264.06,905.62,,,0 CDM,278C1713S1_155704,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,216.56,86.62,,,0 CDM,278C1713S1_155705,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,216.56,86.62,,,0 CDM,278C1713S1_155785,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155786,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155787,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155788,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155789,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155790,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155791,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155792,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155793,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155794,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155795,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155796,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155797,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155798,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155799,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155803,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155804,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155805,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155806,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155807,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155808,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155846,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155847,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155848,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155849,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155850,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155851,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155852,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155853,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155854,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155855,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155856,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155878,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155879,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155880,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155881,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155882,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155883,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155884,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155885,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155886,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155887,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155901,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155902,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155903,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155904,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155905,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155906,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155907,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155908,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155909,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155910,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155913,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155914,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155920,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_155939,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,542.16,216.86,,,0 CDM,278C1713S1_155941,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,542.16,216.86,,,0 CDM,278C1713S1_155955,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,787.5,315.0,,,0 CDM,278C1713S1_155957,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,542.16,216.86,,,0 CDM,278C1713S1_155959,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,542.16,216.86,,,0 CDM,278C1713S1_155961,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,542.16,216.86,,,0 CDM,278C1713S1_155963,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,542.16,216.86,,,0 CDM,278C1713S1_155965,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,542.16,216.86,,,0 CDM,278C1713S1_155967,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,542.16,216.86,,,0 CDM,278C1713S1_155969,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,542.16,216.86,,,0 CDM,278C1713S1_155971,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,542.16,216.86,,,0 CDM,278C1713S1_155973,Hc Sup Shell 278 Revenue Code C1713 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CDM,278C1713S1_155993,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2460.94,984.38,,,0 CDM,278C1713S1_155994,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2460.94,984.38,,,0 CDM,278C1713S1_155997,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2460.94,984.38,,,0 CDM,278C1713S1_155998,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2460.94,984.38,,,0 CDM,278C1713S1_156006,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1771.88,708.75,,,0 CDM,278C1713S1_156008,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1771.88,708.75,,,0 CDM,278C1713S1_156022,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2460.94,984.38,,,0 CDM,278C1713S1_156030,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2460.94,984.38,,,0 CDM,278C1713S1_156055,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7087.5,2835.0,,,0 CDM,278C1713S1_156059,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7087.5,2835.0,,,0 CDM,278C1713S1_156060,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7087.5,2835.0,,,0 CDM,278C1713S1_156065,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,483.52,193.41,,,0 CDM,278C1713S1_156066,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,483.52,193.41,,,0 CDM,278C1713S1_156067,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,483.52,193.41,,,0 CDM,278C1713S1_156068,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,483.52,193.41,,,0 CDM,278C1713S1_156069,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,483.52,193.41,,,0 CDM,278C1713S1_156070,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,483.52,193.41,,,0 CDM,278C1713S1_156073,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,483.52,193.41,,,0 CDM,278C1713S1_156082,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,547.51,219.0,,,0 CDM,278C1713S1_156180,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6044.61,2417.84,,,0 CDM,278C1713S1_156181,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5941.12,2376.45,,,0 CDM,278C1713S1_156244,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,720.49,288.2,,,0 CDM,278C1713S1_156276,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,819.79,327.92,,,0 CDM,278C1713S1_156277,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,822.94,329.18,,,0 CDM,278C1713S1_156278,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,822.94,329.18,,,0 CDM,278C1713S1_156279,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,822.94,329.18,,,0 CDM,278C1713S1_156280,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,822.94,329.18,,,0 CDM,278C1713S1_156281,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,822.94,329.18,,,0 CDM,278C1713S1_156282,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,822.94,329.18,,,0 CDM,278C1713S1_156283,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,822.94,329.18,,,0 CDM,278C1713S1_156286,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8944.9,3577.96,,,0 CDM,278C1713S1_156287,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3361.76,1344.7,,,0 CDM,278C1713S1_156422,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6496.88,2598.75,,,0 CDM,278C1713S1_156424,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6496.88,2598.75,,,0 CDM,278C1713S1_156426,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,12993.75,5197.5,,,0 CDM,278C1713S1_156447,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1063.12,425.25,,,0 CDM,278C1713S1_156448,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1151.72,460.69,,,0 CDM,278C1713S1_156449,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1169.44,467.78,,,0 CDM,278C1713S1_156451,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1222.6,489.04,,,0 CDM,278C1713S1_156452,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1258.04,503.22,,,0 CDM,278C1713S1_156461,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1169.44,467.78,,,0 CDM,278C1713S1_156462,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1258.04,503.22,,,0 CDM,278C1713S1_156488,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,590.62,236.25,,,0 CDM,278C1713S1_156490,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,945.0,378.0,,,0 CDM,278C1713S1_156492,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.88,78.75,,,0 CDM,278C1713S1_156493,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.88,78.75,,,0 CDM,278C1713S1_156494,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.88,78.75,,,0 CDM,278C1713S1_156500,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2941.31,1176.52,,,0 CDM,278C1713S1_156914,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1464.2,585.68,,,0 CDM,278C1713S1_156925,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_156927,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_156929,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,326.81,130.72,,,0 CDM,278C1713S1_156930,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,326.81,130.72,,,0 CDM,278C1713S1_156932,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,326.81,130.72,,,0 CDM,278C1713S1_156963,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5492.81,2197.12,,,0 CDM,278C1713S1_156966,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2736.56,1094.62,,,0 CDM,278C1713S1_156971,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4469.06,1787.62,,,0 CDM,278C1713S1_156972,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4902.19,1960.88,,,0 CDM,278C1713S1_156976,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4469.06,1787.62,,,0 CDM,278C1713S1_156977,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4469.06,1787.62,,,0 CDM,278C1713S1_156981,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4469.06,1787.62,,,0 CDM,278C1713S1_156992,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,326.81,130.72,,,0 CDM,278C1713S1_156993,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,326.81,130.72,,,0 CDM,278C1713S1_156994,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,326.81,130.72,,,0 CDM,278C1713S1_156998,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_157001,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,326.81,130.72,,,0 CDM,278C1713S1_157003,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,326.81,130.72,,,0 CDM,278C1713S1_157004,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,326.81,130.72,,,0 CDM,278C1713S1_157005,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,326.81,130.72,,,0 CDM,278C1713S1_157006,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_157007,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_157008,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_157012,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_157014,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_157015,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_157016,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_157017,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_157018,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_157024,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,326.81,130.72,,,0 CDM,278C1713S1_157026,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,326.81,130.72,,,0 CDM,278C1713S1_157027,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,326.81,130.72,,,0 CDM,278C1713S1_157028,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,326.81,130.72,,,0 CDM,278C1713S1_157029,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,326.81,130.72,,,0 CDM,278C1713S1_157030,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,326.81,130.72,,,0 CDM,278C1713S1_157039,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_157060,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,63.0,25.2,,,0 CDM,278C1713S1_157072,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,315.0,126.0,,,0 CDM,278C1713S1_158759,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3248.44,1299.38,,,0 CDM,278C1713S1_158761,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_158768,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_158769,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_158770,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_158773,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_158775,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.06,23.62,,,0 CDM,278C1713S1_160525,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1102.15,440.86,,,0 CDM,278C1713S1_160526,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1114.0,445.6,,,0 CDM,278C1713S1_160527,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1084.39,433.76,,,0 CDM,278C1713S1_160559,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,655.28,262.11,,,0 CDM,278C1713S1_160565,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5346.97,2138.79,,,0 CDM,278C1713S1_160567,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5346.97,2138.79,,,0 CDM,278C1713S1_160578,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5346.97,2138.79,,,0 CDM,278C1713S1_160579,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5371.8,2148.72,,,0 CDM,278C1713S1_160580,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5386.22,2154.49,,,0 CDM,278C1713S1_160581,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5380.81,2152.32,,,0 CDM,278C1713S1_160582,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5389.82,2155.93,,,0 CDM,278C1713S1_160583,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5380.81,2152.32,,,0 CDM,278C1713S1_160584,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5346.97,2138.79,,,0 CDM,278C1713S1_160591,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5346.97,2138.79,,,0 CDM,278C1713S1_160592,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5380.81,2152.32,,,0 CDM,278C1713S1_160593,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5359.79,2143.92,,,0 CDM,278C1713S1_160594,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5376.04,2150.42,,,0 CDM,278C1713S1_160595,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5362.79,2145.12,,,0 CDM,278C1713S1_160596,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5371.8,2148.72,,,0 CDM,278C1713S1_160597,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5377.81,2151.12,,,0 CDM,278C1713S1_160598,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5353.78,2141.51,,,0 CDM,278C1713S1_160599,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5374.89,2149.96,,,0 CDM,278C1713S1_160604,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5346.97,2138.79,,,0 CDM,278C1713S1_160605,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5346.97,2138.79,,,0 CDM,278C1713S1_160606,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5407.85,2163.14,,,0 CDM,278C1713S1_160607,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5380.81,2152.32,,,0 CDM,278C1713S1_160608,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5362.79,2145.12,,,0 CDM,278C1713S1_160609,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5353.78,2141.51,,,0 CDM,278C1713S1_160611,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5380.81,2152.32,,,0 CDM,278C1713S1_160612,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5407.85,2163.14,,,0 CDM,278C1713S1_160619,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5545.97,2218.39,,,0 CDM,278C1713S1_160620,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5545.97,2218.39,,,0 CDM,278C1713S1_160621,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5407.85,2163.14,,,0 CDM,278C1713S1_160624,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5545.97,2218.39,,,0 CDM,278C1713S1_160633,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5545.97,2218.39,,,0 CDM,278C1713S1_160634,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5545.97,2218.39,,,0 CDM,278C1713S1_160635,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5407.85,2163.14,,,0 CDM,278C1713S1_160688,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6958.47,2783.39,,,0 CDM,278C1713S1_160697,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7019.5,2807.8,,,0 CDM,278C1713S1_160700,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7009.74,2803.9,,,0 CDM,278C1713S1_160701,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7080.53,2832.21,,,0 CDM,278C1713S1_160702,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7080.53,2832.21,,,0 CDM,278C1713S1_160727,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7214.84,2885.94,,,0 CDM,278C1713S1_160805,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7009.74,2803.9,,,0 CDM,278C1713S1_160806,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6958.47,2783.39,,,0 CDM,278C1713S1_160819,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6958.47,2783.39,,,0 CDM,278C1713S1_160909,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7003.48,2801.39,,,0 CDM,278C1713S1_160910,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7003.48,2801.39,,,0 CDM,278C1713S1_160925,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6950.52,2780.21,,,0 CDM,278C1713S1_160947,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7003.48,2801.39,,,0 CDM,278C1713S1_161014,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7017.63,2807.05,,,0 CDM,278C1713S1_161015,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7003.48,2801.39,,,0 CDM,278C1713S1_161028,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7074.23,2829.69,,,0 CDM,278C1713S1_161084,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,288.62,115.45,,,0 CDM,278C1713S1_161086,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,371.42,148.57,,,0 CDM,278C1713S1_161095,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,663.0,265.2,,,0 CDM,278C1713S1_161096,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.63,266.25,,,0 CDM,278C1713S1_161097,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,666.23,266.49,,,0 CDM,278C1713S1_161098,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,664.59,265.84,,,0 CDM,278C1713S1_161099,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,664.75,265.9,,,0 CDM,278C1713S1_161100,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,664.51,265.8,,,0 CDM,278C1713S1_161101,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,664.43,265.77,,,0 CDM,278C1713S1_161102,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,664.81,265.92,,,0 CDM,278C1713S1_161103,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,664.89,265.96,,,0 CDM,278C1713S1_161104,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,664.99,266.0,,,0 CDM,278C1713S1_161105,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,664.46,265.78,,,0 CDM,278C1713S1_161106,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.4,266.16,,,0 CDM,278C1713S1_161107,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.54,266.22,,,0 CDM,278C1713S1_161108,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,664.67,265.87,,,0 CDM,278C1713S1_161109,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.14,266.06,,,0 CDM,278C1713S1_161110,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.12,266.05,,,0 CDM,278C1713S1_161111,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.22,266.09,,,0 CDM,278C1713S1_161112,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,664.9,265.96,,,0 CDM,278C1713S1_161113,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,664.35,265.74,,,0 CDM,278C1713S1_161114,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,664.77,265.91,,,0 CDM,278C1713S1_161115,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,664.99,266.0,,,0 CDM,278C1713S1_161116,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,669.46,267.78,,,0 CDM,278C1713S1_161122,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,791.91,316.76,,,0 CDM,278C1713S1_161123,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,787.95,315.18,,,0 CDM,278C1713S1_161124,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,786.25,314.5,,,0 CDM,278C1713S1_161125,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,784.87,313.95,,,0 CDM,278C1713S1_161126,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,787.04,314.82,,,0 CDM,278C1713S1_161127,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,785.97,314.39,,,0 CDM,278C1713S1_161128,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,785.97,314.39,,,0 CDM,278C1713S1_161129,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,785.58,314.23,,,0 CDM,278C1713S1_161130,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,788.52,315.41,,,0 CDM,278C1713S1_161131,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,787.95,315.18,,,0 CDM,278C1713S1_161132,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,785.97,314.39,,,0 CDM,278C1713S1_161133,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,783.99,313.6,,,0 CDM,278C1713S1_161134,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,788.74,315.5,,,0 CDM,278C1713S1_161135,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,787.95,315.18,,,0 CDM,278C1713S1_161136,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,786.79,314.72,,,0 CDM,278C1713S1_161137,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,789.65,315.86,,,0 CDM,278C1713S1_161138,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,788.65,315.46,,,0 CDM,278C1713S1_161139,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,790.78,316.31,,,0 CDM,278C1713S1_161140,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,786.25,314.5,,,0 CDM,278C1713S1_161141,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,791.91,316.76,,,0 CDM,278C1713S1_161146,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,684.65,273.86,,,0 CDM,278C1713S1_161147,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,677.81,271.12,,,0 CDM,278C1713S1_161148,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,677.81,271.12,,,0 CDM,278C1713S1_161149,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,680.09,272.04,,,0 CDM,278C1713S1_161151,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,677.81,271.12,,,0 CDM,278C1713S1_161154,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,555.19,222.08,,,0 CDM,278C1713S1_161156,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,677.81,271.12,,,0 CDM,278C1713S1_161157,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,663.0,265.2,,,0 CDM,278C1713S1_161167,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,783.99,313.6,,,0 CDM,278C1713S1_161168,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,783.99,313.6,,,0 CDM,278C1713S1_161185,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,581.83,232.73,,,0 CDM,278C1713S1_161186,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,664.75,265.9,,,0 CDM,278C1713S1_161187,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,536.61,214.64,,,0 CDM,278C1713S1_161188,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,498.92,199.57,,,0 CDM,278C1713S1_161189,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,498.92,199.57,,,0 CDM,278C1713S1_161190,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,498.92,199.57,,,0 CDM,278C1713S1_161205,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,684.54,273.82,,,0 CDM,278C1713S1_161281,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1084.39,433.76,,,0 CDM,278C1713S1_161282,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1114.0,445.6,,,0 CDM,278C1713S1_161283,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,800.89,320.36,,,0 CDM,278C1713S1_161284,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,811.91,324.76,,,0 CDM,278C1713S1_161285,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,816.64,326.66,,,0 CDM,278C1713S1_161286,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1178.1,471.24,,,0 CDM,278C1713S1_162616,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,806.4,322.56,,,0 CDM,278C1713S1_162617,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,822.94,329.18,,,0 CDM,278C1713S1_162618,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,808.24,323.3,,,0 CDM,278C1713S1_162756,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,319.34,127.74,,,0 CDM,278C1713S1_162757,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,319.34,127.74,,,0 CDM,278C1713S1_162758,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,317.74,127.1,,,0 CDM,278C1713S1_162759,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.27,127.31,,,0 CDM,278C1713S1_162760,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,547.2,218.88,,,0 CDM,278C1713S1_162761,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,547.2,218.88,,,0 CDM,278C1713S1_162800,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,67295.81,26918.32,,,0 CDM,278C1713S1_162801,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,67295.81,26918.32,,,0 CDM,278C1713S1_162824,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,67295.81,26918.32,,,0 CDM,278C1713S1_162835,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,67295.81,26918.32,,,0 CDM,278C1713S1_162842,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,67295.81,26918.32,,,0 CDM,278C1713S1_162856,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,67295.81,26918.32,,,0 CDM,278C1713S1_162857,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,67295.81,26918.32,,,0 CDM,278C1713S1_162862,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,67295.81,26918.32,,,0 CDM,278C1713S1_162884,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,913.5,365.4,,,0 CDM,278C1713S1_162886,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,913.5,365.4,,,0 CDM,278C1713S1_162890,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,913.5,365.4,,,0 CDM,278C1713S1_162891,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,913.5,365.4,,,0 CDM,278C1713S1_162892,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,913.5,365.4,,,0 CDM,278C1713S1_162893,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,913.5,365.4,,,0 CDM,278C1713S1_162894,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,913.5,365.4,,,0 CDM,278C1713S1_162895,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,913.5,365.4,,,0 CDM,278C1713S1_162896,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,913.5,365.4,,,0 CDM,278C1713S1_162897,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,913.5,365.4,,,0 CDM,278C1713S1_162904,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,913.5,365.4,,,0 CDM,278C1713S1_162906,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,913.5,365.4,,,0 CDM,278C1713S1_162912,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,995.01,398.0,,,0 CDM,278C1713S1_162919,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,995.01,398.0,,,0 CDM,278C1713S1_162947,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,995.01,398.0,,,0 CDM,278C1713S1_162949,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,995.01,398.0,,,0 CDM,278C1713S1_162950,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,995.01,398.0,,,0 CDM,278C1713S1_162951,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,995.01,398.0,,,0 CDM,278C1713S1_162952,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,995.01,398.0,,,0 CDM,278C1713S1_162953,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,995.01,398.0,,,0 CDM,278C1713S1_162954,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,995.01,398.0,,,0 CDM,278C1713S1_162955,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,995.01,398.0,,,0 CDM,278C1713S1_162956,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,995.01,398.0,,,0 CDM,278C1713S1_162957,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,995.01,398.0,,,0 CDM,278C1713S1_162958,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,995.01,398.0,,,0 CDM,278C1713S1_162959,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,995.01,398.0,,,0 CDM,278C1713S1_162960,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,995.01,398.0,,,0 CDM,278C1713S1_162962,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,995.01,398.0,,,0 CDM,278C1713S1_162963,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,995.01,398.0,,,0 CDM,278C1713S1_163376,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,799.31,319.72,,,0 CDM,278C1713S1_163377,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,799.31,319.72,,,0 CDM,278C1713S1_163460,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4230.82,1692.33,,,0 CDM,278C1713S1_163467,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,820.34,328.14,,,0 CDM,278C1713S1_163468,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,809.71,323.88,,,0 CDM,278C1713S1_163774,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,805.3,322.12,,,0 CDM,278C1713S1_163775,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,809.71,323.88,,,0 CDM,278C1713S1_164727,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5814.0,2325.6,,,0 CDM,278C1713S1_164750,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,977.49,391.0,,,0 CDM,278C1713S1_164754,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,977.49,391.0,,,0 CDM,278C1713S1_164762,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1423.88,569.55,,,0 CDM,278C1713S1_164764,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,967.72,387.09,,,0 CDM,278C1713S1_164803,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,414.78,165.91,,,0 CDM,278C1713S1_164820,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,972.6,389.04,,,0 CDM,278C1713S1_164828,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,970.98,388.39,,,0 CDM,278C1713S1_164829,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,967.72,387.09,,,0 CDM,278C1713S1_164831,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,977.49,391.0,,,0 CDM,278C1713S1_164841,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,967.72,387.09,,,0 CDM,278C1713S1_164847,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,813.49,325.4,,,0 CDM,278C1713S1_164851,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,813.49,325.4,,,0 CDM,278C1713S1_164856,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,884.62,353.85,,,0 CDM,278C1713S1_164867,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,900.39,360.16,,,0 CDM,278C1713S1_164868,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,900.39,360.16,,,0 CDM,278C1713S1_164872,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,900.39,360.16,,,0 CDM,278C1713S1_164877,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2727.67,1091.07,,,0 CDM,278C1713S1_164879,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2727.67,1091.07,,,0 CDM,278C1713S1_164880,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2709.48,1083.79,,,0 CDM,278C1713S1_164881,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2700.38,1080.15,,,0 CDM,278C1713S1_164882,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2357.89,943.16,,,0 CDM,278C1713S1_164883,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2357.89,943.16,,,0 CDM,278C1713S1_164884,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2357.89,943.16,,,0 CDM,278C1713S1_164885,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2357.89,943.16,,,0 CDM,278C1713S1_164886,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2357.89,943.16,,,0 CDM,278C1713S1_164887,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2017.06,806.82,,,0 CDM,278C1713S1_164888,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2017.06,806.82,,,0 CDM,278C1713S1_164889,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2031.6,812.64,,,0 CDM,278C1713S1_164890,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2022.15,808.86,,,0 CDM,278C1713S1_164891,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2021.17,808.47,,,0 CDM,278C1713S1_164892,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2890.96,1156.38,,,0 CDM,278C1713S1_164893,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2886.13,1154.45,,,0 CDM,278C1713S1_164894,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2709.48,1083.79,,,0 CDM,278C1713S1_164895,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2716.75,1086.7,,,0 CDM,278C1713S1_164896,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2709.48,1083.79,,,0 CDM,278C1713S1_164898,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2714.02,1085.61,,,0 CDM,278C1713S1_164899,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2554.69,1021.88,,,0 CDM,278C1713S1_164900,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2554.69,1021.88,,,0 CDM,278C1713S1_164901,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2554.69,1021.88,,,0 CDM,278C1713S1_164905,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2357.89,943.16,,,0 CDM,278C1713S1_164906,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2357.89,943.16,,,0 CDM,278C1713S1_164908,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2381.72,952.69,,,0 CDM,278C1713S1_164909,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2188.3,875.32,,,0 CDM,278C1713S1_164910,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2193.83,877.53,,,0 CDM,278C1713S1_164911,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2210.4,884.16,,,0 CDM,278C1713S1_164918,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2700.38,1080.15,,,0 CDM,278C1713S1_164919,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2017.06,806.82,,,0 CDM,278C1713S1_164920,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2017.06,806.82,,,0 CDM,278C1713S1_164923,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2017.06,806.82,,,0 CDM,278C1713S1_164924,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1850.45,740.18,,,0 CDM,278C1713S1_164925,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1853.78,741.51,,,0 CDM,278C1713S1_164926,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1849.28,739.71,,,0 CDM,278C1713S1_164927,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1849.52,739.81,,,0 CDM,278C1713S1_164930,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1312.29,524.92,,,0 CDM,278C1713S1_164931,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1299.18,519.67,,,0 CDM,278C1713S1_164933,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,68.49,27.4,,,0 CDM,278C1713S1_164934,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,75.48,30.19,,,0 CDM,278C1713S1_164935,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,79.5,31.8,,,0 CDM,278C1713S1_165229,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1114.0,445.6,,,0 CDM,278C1713S1_165230,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,822.94,329.18,,,0 CDM,278C1713S1_165232,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8320.72,3328.29,,,0 CDM,278C1713S1_165409,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,983.21,393.28,,,0 CDM,278C1713S1_165410,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,973.99,389.6,,,0 CDM,278C1713S1_165415,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,966.57,386.63,,,0 CDM,278C1713S1_165416,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1043.97,417.59,,,0 CDM,278C1713S1_165417,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1055.42,422.17,,,0 CDM,278C1713S1_165418,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1119.95,447.98,,,0 CDM,278C1713S1_165419,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1080.34,432.14,,,0 CDM,278C1713S1_165420,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,978.06,391.22,,,0 CDM,278C1713S1_165422,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,889.88,355.95,,,0 CDM,278C1713S1_165423,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,957.82,383.13,,,0 CDM,278C1713S1_165424,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,921.01,368.4,,,0 CDM,278C1713S1_165426,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1019.76,407.9,,,0 CDM,278C1713S1_165427,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1232.52,493.01,,,0 CDM,278C1713S1_165428,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1020.66,408.26,,,0 CDM,278C1713S1_165429,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1106.35,442.54,,,0 CDM,278C1713S1_165430,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1055.22,422.09,,,0 CDM,278C1713S1_165431,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1099.54,439.82,,,0 CDM,278C1713S1_165432,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1106.35,442.54,,,0 CDM,278C1713S1_165433,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1009.4,403.76,,,0 CDM,278C1713S1_165883,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,18112.5,7245.0,,,0 CDM,278C1713S1_165885,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,18112.5,7245.0,,,0 CDM,278C1713S1_165889,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,18112.5,7245.0,,,0 CDM,278C1713S1_165890,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,18112.5,7245.0,,,0 CDM,278C1713S1_165935,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3346.88,1338.75,,,0 CDM,278C1713S1_165936,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3346.88,1338.75,,,0 CDM,278C1713S1_165937,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3346.88,1338.75,,,0 CDM,278C1713S1_165938,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3346.88,1338.75,,,0 CDM,278C1713S1_165939,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3346.88,1338.75,,,0 CDM,278C1713S1_165940,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3346.88,1338.75,,,0 CDM,278C1713S1_165970,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1161.56,464.62,,,0 CDM,278C1713S1_165971,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1161.56,464.62,,,0 CDM,278C1713S1_165972,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1161.56,464.62,,,0 CDM,278C1713S1_165973,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1161.56,464.62,,,0 CDM,278C1713S1_165974,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1161.56,464.62,,,0 CDM,278C1713S1_167636,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7613.67,3045.47,,,0 CDM,278C1713S1_167638,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7471.96,2988.78,,,0 CDM,278C1713S1_167647,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7613.67,3045.47,,,0 CDM,278C1713S1_167650,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7537.52,3015.01,,,0 CDM,278C1713S1_167651,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7537.52,3015.01,,,0 CDM,278C1713S1_167652,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7575.59,3030.24,,,0 CDM,278C1713S1_167653,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7566.07,3026.43,,,0 CDM,278C1713S1_167654,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7588.28,3035.31,,,0 CDM,278C1713S1_167655,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7570.15,3028.06,,,0 CDM,278C1713S1_167656,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7613.67,3045.47,,,0 CDM,278C1713S1_167662,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7471.96,2988.78,,,0 CDM,278C1713S1_167663,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7613.67,3045.47,,,0 CDM,278C1713S1_167664,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7556.56,3022.62,,,0 CDM,278C1713S1_167665,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7537.52,3015.01,,,0 CDM,278C1713S1_167667,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7537.52,3015.01,,,0 CDM,278C1713S1_167668,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7471.96,2988.78,,,0 CDM,278C1713S1_167677,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7613.67,3045.47,,,0 CDM,278C1713S1_167678,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7562.9,3025.16,,,0 CDM,278C1713S1_167679,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7562.9,3025.16,,,0 CDM,278C1713S1_167680,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7537.52,3015.01,,,0 CDM,278C1713S1_167689,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7537.52,3015.01,,,0 CDM,278C1713S1_167692,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7704.31,3081.72,,,0 CDM,278C1713S1_167693,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7537.52,3015.01,,,0 CDM,278C1713S1_167705,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7749.63,3099.85,,,0 CDM,278C1713S1_167706,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7613.67,3045.47,,,0 CDM,278C1713S1_167712,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7613.67,3045.47,,,0 CDM,278C1713S1_167713,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7613.67,3045.47,,,0 CDM,278C1713S1_167763,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,319.33,127.73,,,0 CDM,278C1713S1_167764,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,319.33,127.73,,,0 CDM,278C1713S1_167765,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,317.42,126.97,,,0 CDM,278C1713S1_167767,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,316.85,126.74,,,0 CDM,278C1713S1_167769,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,317.14,126.86,,,0 CDM,278C1713S1_167770,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,317.74,127.1,,,0 CDM,278C1713S1_167771,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,317.27,126.91,,,0 CDM,278C1713S1_167772,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,316.14,126.46,,,0 CDM,278C1713S1_167773,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,317.06,126.82,,,0 CDM,278C1713S1_167774,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,316.64,126.66,,,0 CDM,278C1713S1_167775,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,316.71,126.68,,,0 CDM,278C1713S1_167776,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,317.34,126.94,,,0 CDM,278C1713S1_167777,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,317.92,127.17,,,0 CDM,278C1713S1_167778,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.06,127.22,,,0 CDM,278C1713S1_167779,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,316.78,126.71,,,0 CDM,278C1713S1_167780,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,317.01,126.8,,,0 CDM,278C1713S1_167781,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,316.14,126.46,,,0 CDM,278C1713S1_167782,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,316.94,126.78,,,0 CDM,278C1713S1_167784,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,316.14,126.46,,,0 CDM,278C1713S1_167785,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,542.5,217.0,,,0 CDM,278C1713S1_167786,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.73,216.69,,,0 CDM,278C1713S1_167787,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.72,216.69,,,0 CDM,278C1713S1_167788,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.72,216.69,,,0 CDM,278C1713S1_167789,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,542.33,216.93,,,0 CDM,278C1713S1_167790,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.72,216.69,,,0 CDM,278C1713S1_167791,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,542.63,217.05,,,0 CDM,278C1713S1_167792,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.73,216.69,,,0 CDM,278C1713S1_167793,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,542.82,217.13,,,0 CDM,278C1713S1_167795,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,542.64,217.06,,,0 CDM,278C1713S1_167796,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,542.82,217.13,,,0 CDM,278C1713S1_167797,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,543.91,217.56,,,0 CDM,278C1713S1_167798,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,547.2,218.88,,,0 CDM,278C1713S1_167799,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,547.2,218.88,,,0 CDM,278C1713S1_167800,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,544.46,217.78,,,0 CDM,278C1713S1_167802,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.72,216.69,,,0 CDM,278C1713S1_167803,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.73,216.69,,,0 CDM,278C1713S1_167804,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.73,216.69,,,0 CDM,278C1713S1_167807,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,317.74,127.1,,,0 CDM,278C1713S1_167809,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,319.34,127.74,,,0 CDM,278C1713S1_167810,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,316.85,126.74,,,0 CDM,278C1713S1_167811,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,317.74,127.1,,,0 CDM,278C1713S1_167814,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.72,216.69,,,0 CDM,278C1713S1_167817,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.73,216.69,,,0 CDM,278C1713S1_167818,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.72,216.69,,,0 CDM,278C1713S1_167824,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,316.14,126.46,,,0 CDM,278C1713S1_167828,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.72,216.69,,,0 CDM,278C1713S1_167830,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.73,216.69,,,0 CDM,278C1713S1_167841,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3479.42,1391.77,,,0 CDM,278C1713S1_167842,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3910.34,1564.14,,,0 CDM,278C1713S1_167846,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4296.84,1718.74,,,0 CDM,278C1713S1_167847,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4249.51,1699.8,,,0 CDM,278C1713S1_167849,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3887.81,1555.12,,,0 CDM,278C1713S1_167856,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3826.62,1530.65,,,0 CDM,278C1713S1_167858,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3769.45,1507.78,,,0 CDM,278C1713S1_167863,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3910.34,1564.14,,,0 CDM,278C1713S1_167895,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3462.01,1384.8,,,0 CDM,278C1713S1_167906,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4002.82,1601.13,,,0 CDM,278C1713S1_167919,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3865.29,1546.12,,,0 CDM,278C1713S1_167920,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4249.51,1699.8,,,0 CDM,278C1713S1_167923,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3865.29,1546.12,,,0 CDM,278C1713S1_167932,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4234.17,1693.67,,,0 CDM,278C1713S1_167943,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2237.01,894.8,,,0 CDM,278C1713S1_167946,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3903.95,1561.58,,,0 CDM,278C1713S1_167949,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3282.97,1313.19,,,0 CDM,278C1713S1_167954,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2237.01,894.8,,,0 CDM,278C1713S1_167968,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3282.97,1313.19,,,0 CDM,278C1713S1_168012,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,885.11,354.04,,,0 CDM,278C1713S1_168019,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,885.11,354.04,,,0 CDM,278C1713S1_168054,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,107.5,43.0,,,0 CDM,278C1713S1_168217,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,817.06,326.82,,,0 CDM,278C1713S1_168225,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6398.44,2559.38,,,0 CDM,278C1713S1_168269,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,885.94,354.38,,,0 CDM,278C1713S1_168288,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4630.5,1852.2,,,0 CDM,278C1713S1_168294,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8489.25,3395.7,,,0 CDM,278C1713S1_168296,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,374.06,149.62,,,0 CDM,278C1713S1_168309,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2354.62,941.85,,,0 CDM,278C1713S1_168310,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2354.62,941.85,,,0 CDM,278C1713S1_168311,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2354.62,941.85,,,0 CDM,278C1713S1_168314,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2354.62,941.85,,,0 CDM,278C1713S1_168322,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2354.62,941.85,,,0 CDM,278C1713S1_168353,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1267.88,507.15,,,0 CDM,278C1713S1_168354,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1267.88,507.15,,,0 CDM,278C1713S1_168355,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1267.88,507.15,,,0 CDM,278C1713S1_168356,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1267.88,507.15,,,0 CDM,278C1713S1_168385,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5099.06,2039.62,,,0 CDM,278C1713S1_168390,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,716.62,286.65,,,0 CDM,278C1713S1_168391,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,716.62,286.65,,,0 CDM,278C1713S1_168392,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,626.06,250.42,,,0 CDM,278C1713S1_168394,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,671.34,268.54,,,0 CDM,278C1713S1_168395,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,626.06,250.42,,,0 CDM,278C1713S1_168401,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,716.62,286.65,,,0 CDM,278C1713S1_168414,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,433.12,173.25,,,0 CDM,278C1713S1_168415,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,433.12,173.25,,,0 CDM,278C1713S1_168416,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,433.12,173.25,,,0 CDM,278C1713S1_168418,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,433.12,173.25,,,0 CDM,278C1713S1_168420,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,685.12,274.05,,,0 CDM,278C1713S1_168423,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,685.12,274.05,,,0 CDM,278C1713S1_168425,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,685.12,274.05,,,0 CDM,278C1713S1_168426,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,685.12,274.05,,,0 CDM,278C1713S1_168446,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,576.84,230.74,,,0 CDM,278C1713S1_168447,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,573.89,229.56,,,0 CDM,278C1713S1_168448,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_168449,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_168450,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_168466,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,433.12,173.25,,,0 CDM,278C1713S1_168467,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,433.12,173.25,,,0 CDM,278C1713S1_168468,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,433.12,173.25,,,0 CDM,278C1713S1_168469,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,433.12,173.25,,,0 CDM,278C1713S1_168470,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,433.12,173.25,,,0 CDM,278C1713S1_168475,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,657.56,263.02,,,0 CDM,278C1713S1_168478,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,657.56,263.02,,,0 CDM,278C1713S1_168479,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,657.56,263.02,,,0 CDM,278C1713S1_168480,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,657.56,263.02,,,0 CDM,278C1713S1_168488,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,657.56,263.02,,,0 CDM,278C1713S1_168527,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,657.56,263.02,,,0 CDM,278C1713S1_168528,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.41,216.56,,,0 CDM,278C1713S1_168529,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,657.56,263.02,,,0 CDM,278C1713S1_168530,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,657.56,263.02,,,0 CDM,278C1713S1_168531,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,657.56,263.02,,,0 CDM,278C1713S1_168532,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,657.56,263.02,,,0 CDM,278C1713S1_168533,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,657.56,263.02,,,0 CDM,278C1713S1_168534,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,657.56,263.02,,,0 CDM,278C1713S1_168536,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,657.56,263.02,,,0 CDM,278C1713S1_168545,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_168547,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_168549,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_168581,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3642.19,1456.88,,,0 CDM,278C1713S1_168582,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3642.19,1456.88,,,0 CDM,278C1713S1_168590,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3642.19,1456.88,,,0 CDM,278C1713S1_168592,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5961.38,2384.55,,,0 CDM,278C1713S1_168599,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,11300.62,4520.25,,,0 CDM,278C1713S1_168601,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,350.44,140.18,,,0 CDM,278C1713S1_168602,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,350.44,140.18,,,0 CDM,278C1713S1_168603,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,350.44,140.18,,,0 CDM,278C1713S1_168605,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,350.44,140.18,,,0 CDM,278C1713S1_168620,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1295.44,518.18,,,0 CDM,278C1713S1_168622,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,968.62,387.45,,,0 CDM,278C1713S1_168626,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,649.69,259.88,,,0 CDM,278C1713S1_168627,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,649.69,259.88,,,0 CDM,278C1713S1_168633,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,401.62,160.65,,,0 CDM,278C1713S1_168634,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,401.62,160.65,,,0 CDM,278C1713S1_168635,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,401.62,160.65,,,0 CDM,278C1713S1_168636,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,342.56,137.02,,,0 CDM,278C1713S1_169205,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,800.89,320.36,,,0 CDM,278C1713S1_169483,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2964.31,1185.72,,,0 CDM,278C1713S1_169698,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2964.31,1185.72,,,0 CDM,278C1713S1_169760,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1378.12,551.25,,,0 CDM,278C1713S1_169761,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1250.7,500.28,,,0 CDM,278C1713S1_170324,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1173.38,469.35,,,0 CDM,278C1713S1_170598,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3094.01,1237.6,,,0 CDM,278C1713S1_170639,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3116.77,1246.71,,,0 CDM,278C1713S1_170641,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1178.1,471.24,,,0 CDM,278C1713S1_170690,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3110.26,1244.1,,,0 CDM,278C1713S1_170691,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3094.01,1237.6,,,0 CDM,278C1713S1_170692,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2964.31,1185.72,,,0 CDM,278C1713S1_171228,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2964.31,1185.72,,,0 CDM,278C1713S1_171355,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_171433,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2964.31,1185.72,,,0 CDM,278C1713S1_171564,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,25593.75,10237.5,,,0 CDM,278C1713S1_171565,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,25593.75,10237.5,,,0 CDM,278C1713S1_171566,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,25593.75,10237.5,,,0 CDM,278C1713S1_171567,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,25593.75,10237.5,,,0 CDM,278C1713S1_171568,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,25593.75,10237.5,,,0 CDM,278C1713S1_171569,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,25593.75,10237.5,,,0 CDM,278C1713S1_171570,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_171571,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_171573,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_171576,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_171579,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_171582,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.38,393.75,,,0 CDM,278C1713S1_171771,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4744.22,1897.69,,,0 CDM,278C1713S1_171792,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,11366.5,4546.6,,,0 CDM,278C1713S1_171793,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5964.45,2385.78,,,0 CDM,278C1713S1_171808,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8697.71,3479.08,,,0 CDM,278C1713S1_171809,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7828.7,3131.48,,,0 CDM,278C1713S1_171812,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3084.48,1233.79,,,0 CDM,278C1713S1_171813,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5931.02,2372.41,,,0 CDM,278C1713S1_171814,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5218.6,2087.44,,,0 CDM,278C1713S1_171970,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3937.5,1575.0,,,0 CDM,278C1713S1_171971,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3937.5,1575.0,,,0 CDM,278C1713S1_172134,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2067.19,826.88,,,0 CDM,278C1713S1_172180,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_172423,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3346.88,1338.75,,,0 CDM,278C1713S1_172424,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2953.12,1181.25,,,0 CDM,278C1713S1_172442,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2559.38,1023.75,,,0 CDM,278C1713S1_172465,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_172618,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2964.31,1185.72,,,0 CDM,278C1713S1_172619,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9944.55,3977.82,,,0 CDM,278C1713S1_172626,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5512.5,2205.0,,,0 CDM,278C1713S1_172627,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5512.5,2205.0,,,0 CDM,278C1713S1_172628,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5512.5,2205.0,,,0 CDM,278C1713S1_172629,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5512.5,2205.0,,,0 CDM,278C1713S1_172630,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5512.5,2205.0,,,0 CDM,278C1713S1_172631,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5512.5,2205.0,,,0 CDM,278C1713S1_172634,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5512.5,2205.0,,,0 CDM,278C1713S1_172635,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5512.5,2205.0,,,0 CDM,278C1713S1_172636,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5512.5,2205.0,,,0 CDM,278C1713S1_172637,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5512.5,2205.0,,,0 CDM,278C1713S1_172638,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5512.5,2205.0,,,0 CDM,278C1713S1_173171,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7638.59,3055.44,,,0 CDM,278C1713S1_173354,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,11224.87,4489.95,,,0 CDM,278C1713S1_173502,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9944.55,3977.82,,,0 CDM,278C1713S1_173513,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_173527,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_173528,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_173531,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_173539,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,767.81,307.12,,,0 CDM,278C1713S1_173551,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_173553,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_173554,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_173555,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_173557,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_173559,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_173561,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_173562,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_173564,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_173565,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_173566,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_173567,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_173568,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.25,220.5,,,0 CDM,278C1713S1_173569,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,570.94,228.38,,,0 CDM,278C1713S1_173590,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,86.62,34.65,,,0 CDM,278C1713S1_173596,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,86.62,34.65,,,0 CDM,278C1713S1_173597,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,86.62,34.65,,,0 CDM,278C1713S1_173652,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6501.48,2600.59,,,0 CDM,278C1713S1_174068,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8111.25,3244.5,,,0 CDM,278C1713S1_174164,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4528.12,1811.25,,,0 CDM,278C1713S1_174165,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.88,78.75,,,0 CDM,278C1713S1_174166,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.88,78.75,,,0 CDM,278C1713S1_174167,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.88,78.75,,,0 CDM,278C1713S1_174168,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.88,78.75,,,0 CDM,278C1713S1_174169,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.88,78.75,,,0 CDM,278C1713S1_174170,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.88,78.75,,,0 CDM,278C1713S1_174171,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.88,78.75,,,0 CDM,278C1713S1_174260,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3088.31,1235.32,,,0 CDM,278C1713S1_174327,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1114.0,445.6,,,0 CDM,278C1713S1_174398,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1594.69,637.88,,,0 CDM,278C1713S1_174534,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,295.31,118.12,,,0 CDM,278C1713S1_174547,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1968.75,787.5,,,0 CDM,278C1713S1_174548,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1968.75,787.5,,,0 CDM,278C1713S1_174549,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1968.75,787.5,,,0 CDM,278C1713S1_174550,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1968.75,787.5,,,0 CDM,278C1713S1_174551,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1968.75,787.5,,,0 CDM,278C1713S1_174678,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1181.25,472.5,,,0 CDM,278C1713S1_174763,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9944.55,3977.82,,,0 CDM,278C1713S1_174885,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1949.06,779.62,,,0 CDM,278C1713S1_174886,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1949.06,779.62,,,0 CDM,278C1713S1_174887,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2067.19,826.88,,,0 CDM,278C1713S1_174957,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7739.33,3095.73,,,0 CDM,278C1713S1_174960,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7719.19,3087.68,,,0 CDM,278C1713S1_174962,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7638.59,3055.44,,,0 CDM,278C1713S1_174967,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8041.56,3216.62,,,0 CDM,278C1713S1_174971,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7638.59,3055.44,,,0 CDM,278C1713S1_175071,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9944.55,3977.82,,,0 CDM,278C1713S1_175073,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9944.55,3977.82,,,0 CDM,278C1713S1_175075,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9944.55,3977.82,,,0 CDM,278C1713S1_175088,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9944.55,3977.82,,,0 CDM,278C1713S1_175166,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3116.77,1246.71,,,0 CDM,278C1713S1_175185,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6910.31,2764.12,,,0 CDM,278C1713S1_175193,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6910.31,2764.12,,,0 CDM,278C1713S1_175194,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6910.31,2764.12,,,0 CDM,278C1713S1_175195,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6949.69,2779.88,,,0 CDM,278C1713S1_175196,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6957.56,2783.02,,,0 CDM,278C1713S1_175197,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6930.0,2772.0,,,0 CDM,278C1713S1_175199,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6989.06,2795.62,,,0 CDM,278C1713S1_175201,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6910.31,2764.12,,,0 CDM,278C1713S1_175205,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6989.06,2795.62,,,0 CDM,278C1713S1_175206,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6936.56,2774.62,,,0 CDM,278C1713S1_175207,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6930.0,2772.0,,,0 CDM,278C1713S1_175209,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6910.31,2764.12,,,0 CDM,278C1713S1_175210,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6910.31,2764.12,,,0 CDM,278C1713S1_175211,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6910.31,2764.12,,,0 CDM,278C1713S1_175212,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6910.31,2764.12,,,0 CDM,278C1713S1_175213,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6989.06,2795.62,,,0 CDM,278C1713S1_175214,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6910.31,2764.12,,,0 CDM,278C1713S1_175215,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6989.06,2795.62,,,0 CDM,278C1713S1_175278,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2736.56,1094.62,,,0 CDM,278C1713S1_175279,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2736.56,1094.62,,,0 CDM,278C1713S1_175280,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2736.56,1094.62,,,0 CDM,278C1713S1_175310,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.06,23.62,,,0 CDM,278C1713S1_175311,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.06,23.62,,,0 CDM,278C1713S1_175312,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,59.06,23.62,,,0 CDM,278C1713S1_175315,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,334.69,133.88,,,0 CDM,278C1713S1_175316,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,334.69,133.88,,,0 CDM,278C1713S1_175317,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,334.69,133.88,,,0 CDM,278C1713S1_175318,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,334.69,133.88,,,0 CDM,278C1713S1_175382,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1094.26,437.7,,,0 CDM,278C1713S1_175470,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.88,78.75,,,0 CDM,278C1713S1_175476,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1208.81,483.52,,,0 CDM,278C1713S1_175479,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2559.38,1023.75,,,0 CDM,278C1713S1_175572,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1084.39,433.76,,,0 CDM,278C1713S1_175573,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1114.0,445.6,,,0 CDM,278C1713S1_175646,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1084.39,433.76,,,0 CDM,278C1713S1_175670,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,221.6,88.64,,,0 CDM,278C1713S1_175672,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,747.02,298.81,,,0 CDM,278C1713S1_175699,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,422.5,169.0,,,0 CDM,278C1713S1_175701,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,422.49,169.0,,,0 CDM,278C1713S1_175703,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,422.5,169.0,,,0 CDM,278C1713S1_175704,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,422.5,169.0,,,0 CDM,278C1713S1_175705,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,422.5,169.0,,,0 CDM,278C1713S1_175706,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,422.5,169.0,,,0 CDM,278C1713S1_175707,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,422.49,169.0,,,0 CDM,278C1713S1_175709,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,422.5,169.0,,,0 CDM,278C1713S1_175710,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,422.5,169.0,,,0 CDM,278C1713S1_175992,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,590.62,236.25,,,0 CDM,278C1713S1_176041,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5826.04,2330.42,,,0 CDM,278C1713S1_176057,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6796.6,2718.64,,,0 CDM,278C1713S1_176058,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7013.16,2805.26,,,0 CDM,278C1713S1_176061,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6508.69,2603.48,,,0 CDM,278C1713S1_176076,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1029.1,411.64,,,0 CDM,278C1713S1_176077,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1029.1,411.64,,,0 CDM,278C1713S1_176079,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1029.1,411.64,,,0 CDM,278C1713S1_176090,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,176.28,70.51,,,0 CDM,278C1713S1_176095,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3138.46,1255.38,,,0 CDM,278C1713S1_176099,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3277.03,1310.81,,,0 CDM,278C1713S1_176107,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4127.33,1650.93,,,0 CDM,278C1713S1_176109,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4127.33,1650.93,,,0 CDM,278C1713S1_176114,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,763.4,305.36,,,0 CDM,278C1713S1_176118,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,763.4,305.36,,,0 CDM,278C1713S1_176119,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,763.4,305.36,,,0 CDM,278C1713S1_176120,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,763.4,305.36,,,0 CDM,278C1713S1_176121,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,763.4,305.36,,,0 CDM,278C1713S1_176122,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,763.4,305.36,,,0 CDM,278C1713S1_176127,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,763.4,305.36,,,0 CDM,278C1713S1_176128,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,763.4,305.36,,,0 CDM,278C1713S1_176129,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,763.4,305.36,,,0 CDM,278C1713S1_176130,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,763.4,305.36,,,0 CDM,278C1713S1_176131,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,763.4,305.36,,,0 CDM,278C1713S1_176134,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5161.71,2064.68,,,0 CDM,278C1713S1_176135,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5161.71,2064.68,,,0 CDM,278C1713S1_176143,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6525.34,2610.14,,,0 CDM,278C1713S1_176144,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6525.34,2610.14,,,0 CDM,278C1713S1_176149,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,976.11,390.44,,,0 CDM,278C1713S1_176150,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2929.77,1171.91,,,0 CDM,278C1713S1_176151,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,230.19,92.08,,,0 CDM,278C1713S1_176152,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,230.19,92.08,,,0 CDM,278C1713S1_176153,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,230.19,92.08,,,0 CDM,278C1713S1_176154,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,230.19,92.08,,,0 CDM,278C1713S1_176155,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,230.19,92.08,,,0 CDM,278C1713S1_176157,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,230.19,92.08,,,0 CDM,278C1713S1_176160,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,976.11,390.44,,,0 CDM,278C1713S1_176161,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,933.86,373.54,,,0 CDM,278C1713S1_176163,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1646.27,658.51,,,0 CDM,278C1713S1_176166,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1490.38,596.15,,,0 CDM,278C1713S1_176167,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1490.39,596.16,,,0 CDM,278C1713S1_176168,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2736.02,1094.41,,,0 CDM,278C1713S1_176169,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1490.38,596.15,,,0 CDM,278C1713S1_176171,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1490.38,596.15,,,0 CDM,278C1713S1_176172,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2239.22,895.69,,,0 CDM,278C1713S1_176173,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1736.6,694.64,,,0 CDM,278C1713S1_176174,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1574.88,629.95,,,0 CDM,278C1713S1_176175,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1574.88,629.95,,,0 CDM,278C1713S1_176176,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1574.88,629.95,,,0 CDM,278C1713S1_176177,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1574.88,629.95,,,0 CDM,278C1713S1_176178,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1574.88,629.95,,,0 CDM,278C1713S1_176179,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1574.88,629.95,,,0 CDM,278C1713S1_176180,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2584.5,1033.8,,,0 CDM,278C1713S1_176182,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1494.76,597.9,,,0 CDM,278C1713S1_176263,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3444.05,1377.62,,,0 CDM,278C1713S1_176265,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3805.36,1522.14,,,0 CDM,278C1713S1_176267,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3627.62,1451.05,,,0 CDM,278C1713S1_176283,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7113.64,2845.46,,,0 CDM,278C1713S1_176290,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9800.75,3920.3,,,0 CDM,278C1713S1_176295,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,710.32,284.13,,,0 CDM,278C1713S1_176296,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,710.32,284.13,,,0 CDM,278C1713S1_176305,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5766.63,2306.65,,,0 CDM,278C1713S1_176313,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3919.86,1567.94,,,0 CDM,278C1713S1_176347,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,10223.37,4089.35,,,0 CDM,278C1713S1_176454,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,10223.37,4089.35,,,0 CDM,278C1713S1_176455,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,10223.37,4089.35,,,0 CDM,278C1713S1_176463,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,10223.37,4089.35,,,0 CDM,278C1713S1_176464,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,10223.37,4089.35,,,0 CDM,278C1713S1_176531,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,230.19,92.08,,,0 CDM,278C1713S1_176532,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,230.19,92.08,,,0 CDM,278C1713S1_176623,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,591.49,236.6,,,0 CDM,278C1713S1_176634,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5474.15,2189.66,,,0 CDM,278C1713S1_176635,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5474.15,2189.66,,,0 CDM,278C1713S1_176638,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6773.41,2709.36,,,0 CDM,278C1713S1_176690,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1656.27,662.51,,,0 CDM,278C1713S1_176693,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1656.27,662.51,,,0 CDM,278C1713S1_176715,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1656.27,662.51,,,0 CDM,278C1713S1_176731,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1656.27,662.51,,,0 CDM,278C1713S1_176740,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1656.27,662.51,,,0 CDM,278C1713S1_176783,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2791.06,1116.42,,,0 CDM,278C1713S1_176784,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2791.06,1116.42,,,0 CDM,278C1713S1_176791,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2791.06,1116.42,,,0 CDM,278C1713S1_176834,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1656.27,662.51,,,0 CDM,278C1713S1_176840,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1656.27,662.51,,,0 CDM,278C1713S1_176852,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1656.27,662.51,,,0 CDM,278C1713S1_176865,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1656.27,662.51,,,0 CDM,278C1713S1_176882,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1656.27,662.51,,,0 CDM,278C1713S1_176886,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1656.27,662.51,,,0 CDM,278C1713S1_176892,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.96,540.38,,,0 CDM,278C1713S1_177040,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4095.47,1638.19,,,0 CDM,278C1713S1_177079,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8268.75,3307.5,,,0 CDM,278C1713S1_177152,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6253.46,2501.38,,,0 CDM,278C1713S1_177153,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7133.42,2853.37,,,0 CDM,278C1713S1_177156,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8013.37,3205.35,,,0 CDM,278C1713S1_177181,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,317.21,126.88,,,0 CDM,278C1713S1_177184,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.54,127.42,,,0 CDM,278C1713S1_177185,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.54,127.42,,,0 CDM,278C1713S1_177186,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,319.34,127.74,,,0 CDM,278C1713S1_177187,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,319.34,127.74,,,0 CDM,278C1713S1_177189,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,319.33,127.73,,,0 CDM,278C1713S1_177190,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,317.51,127.0,,,0 CDM,278C1713S1_177191,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.27,127.31,,,0 CDM,278C1713S1_177200,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.73,216.69,,,0 CDM,278C1713S1_177204,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.73,216.69,,,0 CDM,278C1713S1_177207,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,319.33,127.73,,,0 CDM,278C1713S1_177208,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,317.74,127.1,,,0 CDM,278C1713S1_177209,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,319.34,127.74,,,0 CDM,278C1713S1_177211,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,319.34,127.74,,,0 CDM,278C1713S1_177212,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.72,216.69,,,0 CDM,278C1713S1_177216,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,547.2,218.88,,,0 CDM,278C1713S1_177218,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,541.72,216.69,,,0 CDM,278C1713S1_177226,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,301.64,120.66,,,0 CDM,278C1713S1_177282,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2672.4,1068.96,,,0 CDM,278C1713S1_177283,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2598.75,1039.5,,,0 CDM,278C1713S1_177284,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2715.43,1086.17,,,0 CDM,278C1713S1_177285,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2598.75,1039.5,,,0 CDM,278C1713S1_177286,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2598.75,1039.5,,,0 CDM,278C1713S1_177287,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3638.25,1455.3,,,0 CDM,278C1713S1_177288,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3638.25,1455.3,,,0 CDM,278C1713S1_177492,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2957.06,1182.82,,,0 CDM,278C1713S1_177493,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2957.06,1182.82,,,0 CDM,278C1713S1_178045,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1575.0,630.0,,,0 CDM,278C1713S1_178046,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1575.0,630.0,,,0 CDM,278C1713S1_178047,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1575.0,630.0,,,0 CDM,278C1713S1_178048,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1575.0,630.0,,,0 CDM,278C1713S1_178052,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1575.0,630.0,,,0 CDM,278C1713S1_178056,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,354.38,141.75,,,0 CDM,278C1713S1_178057,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,354.38,141.75,,,0 CDM,278C1713S1_178058,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,354.38,141.75,,,0 CDM,278C1713S1_178059,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,354.38,141.75,,,0 CDM,278C1713S1_178060,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,354.38,141.75,,,0 CDM,278C1713S1_178061,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,354.38,141.75,,,0 CDM,278C1713S1_178062,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,354.38,141.75,,,0 CDM,278C1713S1_178063,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,354.38,141.75,,,0 CDM,278C1713S1_178064,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,354.38,141.75,,,0 CDM,278C1713S1_178065,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,354.38,141.75,,,0 CDM,278C1713S1_178066,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,354.38,141.75,,,0 CDM,278C1713S1_179142,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1070.21,428.08,,,0 CDM,278C1713S1_179281,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1032.77,413.11,,,0 CDM,278C1713S1_179283,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1018.24,407.3,,,0 CDM,278C1713S1_179374,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,81.7,32.68,,,0 CDM,278C1713S1_179375,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,82.84,33.14,,,0 CDM,278C1713S1_179376,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,83.23,33.29,,,0 CDM,278C1713S1_179377,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,82.84,33.14,,,0 CDM,278C1713S1_179378,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,82.47,32.99,,,0 CDM,278C1713S1_179379,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,82.84,33.14,,,0 CDM,278C1713S1_179990,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,98.44,39.38,,,0 CDM,278C1713S1_180412,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8205.12,3282.05,,,0 CDM,278C1713S1_180414,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9028.06,3611.22,,,0 CDM,278C1713S1_180416,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8205.12,3282.05,,,0 CDM,278C1713S1_180420,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9028.06,3611.22,,,0 CDM,278C1713S1_180754,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2981.72,1192.69,,,0 CDM,278C1713S1_180762,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3138.82,1255.53,,,0 CDM,278C1713S1_181026,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,463.29,185.32,,,0 CDM,278C1713S1_181063,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6146.55,2458.62,,,0 CDM,278C1713S1_181211,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,327.89,131.16,,,0 CDM,278C1713S1_181214,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1673.44,669.38,,,0 CDM,278C1713S1_182168,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,385.84,154.34,,,0 CDM,278C1713S1_182186,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,669.57,267.83,,,0 CDM,278C1713S1_182459,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1698.79,679.52,,,0 CDM,278C1713S1_182854,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,765.45,306.18,,,0 CDM,278C1713S1_182880,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1555.31,622.12,,,0 CDM,278C1713S1_182888,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1181.25,472.5,,,0 CDM,278C1713S1_182889,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1181.25,472.5,,,0 CDM,278C1713S1_182898,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1825.03,730.01,,,0 CDM,278C1713S1_183264,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,885.94,354.38,,,0 CDM,278C1713S1_183460,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,642.06,256.82,,,0 CDM,278C1713S1_183461,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5556.6,2222.64,,,0 CDM,278C1713S1_184299,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,11099.02,4439.61,,,0 CDM,278C1713S1_184300,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1139.59,455.84,,,0 CDM,278C1713S1_184306,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,292.79,117.12,,,0 CDM,278C1713S1_184374,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,936.42,374.57,,,0 CDM,278C1713S1_184375,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,936.42,374.57,,,0 CDM,278C1713S1_184376,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,948.94,379.58,,,0 CDM,278C1713S1_184607,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,102.38,40.95,,,0 CDM,278C1713S1_184808,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,11099.02,4439.61,,,0 CDM,278C1713S1_184809,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,938.92,375.57,,,0 CDM,278C1713S1_184811,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1157.03,462.81,,,0 CDM,278C1713S1_184857,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_184913,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1535.62,614.25,,,0 CDM,278C1713S1_184914,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1535.62,614.25,,,0 CDM,278C1713S1_184915,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1535.62,614.25,,,0 CDM,278C1713S1_184917,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1941.19,776.48,,,0 CDM,278C1713S1_184918,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1738.41,695.36,,,0 CDM,278C1713S1_184922,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2346.75,938.7,,,0 CDM,278C1713S1_184923,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1992.38,796.95,,,0 CDM,278C1713S1_184925,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1535.62,614.25,,,0 CDM,278C1713S1_184927,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1535.62,614.25,,,0 CDM,278C1713S1_185262,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5577.67,2231.07,,,0 CDM,278C1713S1_185777,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1008.0,403.2,,,0 CDM,278C1713S1_185778,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,783.56,313.42,,,0 CDM,278C1713S1_185780,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,783.56,313.42,,,0 CDM,278C1713S1_185791,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,12.21,4.88,,,0 CDM,278C1713S1_185798,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,783.56,313.42,,,0 CDM,278C1713S1_185877,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1496.25,598.5,,,0 CDM,278C1713S1_185887,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5619.8,2247.92,,,0 CDM,278C1713S1_186088,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5569.24,2227.7,,,0 CDM,278C1713S1_186389,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2299.2,919.68,,,0 CDM,278C1713S1_186390,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1521.19,608.48,,,0 CDM,278C1713S1_186457,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5588.2,2235.28,,,0 CDM,278C1713S1_186657,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6268.5,2507.4,,,0 CDM,278C1713S1_187606,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,102.38,40.95,,,0 CDM,278C1713S1_187689,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5619.8,2247.92,,,0 CDM,278C1713S1_188243,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,936.42,374.57,,,0 CDM,278C1713S1_188244,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1183.18,473.27,,,0 CDM,278C1713S1_188245,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,11099.02,4439.61,,,0 CDM,278C1713S1_188266,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,25837.88,10335.15,,,0 CDM,278C1713S1_189081,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14320.69,5728.28,,,0 CDM,278C1713S1_189120,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5619.8,2247.92,,,0 CDM,278C1713S1_189192,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4407.84,1763.14,,,0 CDM,278C1713S1_189195,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8447.91,3379.16,,,0 CDM,278C1713S1_189196,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14980.22,5992.09,,,0 CDM,278C1713S1_189197,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,19390.22,7756.09,,,0 CDM,278C1713S1_189525,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7705.69,3082.28,,,0 CDM,278C1713S1_189526,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,381.94,152.78,,,0 CDM,278C1713S1_189527,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,397.85,159.14,,,0 CDM,278C1713S1_189528,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,389.43,155.77,,,0 CDM,278C1713S1_189529,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,381.94,152.78,,,0 CDM,278C1713S1_189530,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_189531,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_189587,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,15572.81,6229.12,,,0 CDM,278C1713S1_189588,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_189605,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14013.56,5605.42,,,0 CDM,278C1713S1_189606,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14497.88,5799.15,,,0 CDM,278C1713S1_189607,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_189608,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_189654,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6993.0,2797.2,,,0 CDM,278C1713S1_189655,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_189657,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_189658,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_189688,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,13312.69,5325.08,,,0 CDM,278C1713S1_189689,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_189691,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_189694,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,381.94,152.78,,,0 CDM,278C1713S1_189697,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_189698,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,13312.69,5325.08,,,0 CDM,278C1713S1_189767,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14013.56,5605.42,,,0 CDM,278C1713S1_189769,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_189770,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_189795,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_189796,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_189797,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_189798,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_189799,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_189800,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_189807,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6933.94,2773.58,,,0 CDM,278C1713S1_189808,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_189809,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_189810,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_189811,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_189812,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_189907,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,15659.44,6263.78,,,0 CDM,278C1713S1_189910,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1224.56,489.82,,,0 CDM,278C1713S1_189911,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1259.55,503.82,,,0 CDM,278C1713S1_189912,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1224.56,489.82,,,0 CDM,278C1713S1_189913,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1224.56,489.82,,,0 CDM,278C1713S1_189914,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1224.56,489.82,,,0 CDM,278C1713S1_189915,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1224.56,489.82,,,0 CDM,278C1713S1_189916,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1224.56,489.82,,,0 CDM,278C1713S1_189917,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_189918,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_189919,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_189920,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_189921,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_189922,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_189971,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3130.31,1252.12,,,0 CDM,278C1713S1_189972,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14793.19,5917.28,,,0 CDM,278C1713S1_189973,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5588.2,2235.28,,,0 CDM,278C1713S1_190030,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14013.56,5605.42,,,0 CDM,278C1713S1_190031,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3130.31,1252.12,,,0 CDM,278C1713S1_190033,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,15572.81,6229.12,,,0 CDM,278C1713S1_190034,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14793.19,5917.28,,,0 CDM,278C1713S1_190035,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4894.31,1957.72,,,0 CDM,278C1713S1_190054,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14486.06,5794.42,,,0 CDM,278C1713S1_190055,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_190057,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4209.19,1683.68,,,0 CDM,278C1713S1_190092,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,18683.44,7473.38,,,0 CDM,278C1713S1_190093,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_190102,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,13312.69,5325.08,,,0 CDM,278C1713S1_190103,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_190104,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,937.12,374.85,,,0 CDM,278C1713S1_190131,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,783.56,313.42,,,0 CDM,278C1713S1_190134,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,783.56,313.42,,,0 CDM,278C1713S1_190140,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,763.88,305.55,,,0 CDM,278C1713S1_190167,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,18683.44,7473.38,,,0 CDM,278C1713S1_190168,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,10557.42,4222.97,,,0 CDM,278C1713S1_190170,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,16348.5,6539.4,,,0 CDM,278C1713S1_190208,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1224.56,489.82,,,0 CDM,278C1713S1_190214,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,238.22,95.29,,,0 CDM,278C1713S1_190216,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,238.22,95.29,,,0 CDM,278C1713S1_190217,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,238.22,95.29,,,0 CDM,278C1713S1_190221,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,619.37,247.75,,,0 CDM,278C1713S1_190246,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3846.94,1538.78,,,0 CDM,278C1713S1_190247,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7749.0,3099.6,,,0 CDM,278C1713S1_190261,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7705.69,3082.28,,,0 CDM,278C1713S1_190262,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6933.94,2773.58,,,0 CDM,278C1713S1_190263,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6993.0,2797.2,,,0 CDM,278C1713S1_190264,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1224.56,489.82,,,0 CDM,278C1713S1_190265,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,381.94,152.78,,,0 CDM,278C1713S1_190266,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_190267,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_190274,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8158.5,3263.4,,,0 CDM,278C1713S1_190275,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1224.56,489.82,,,0 CDM,278C1713S1_190276,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,19463.06,7785.22,,,0 CDM,278C1713S1_190277,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,792.35,316.94,,,0 CDM,278C1713S1_190278,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,962.77,385.11,,,0 CDM,278C1713S1_190279,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,994.17,397.67,,,0 CDM,278C1713S1_190290,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,18683.44,7473.38,,,0 CDM,278C1713S1_190321,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7705.69,3082.28,,,0 CDM,278C1713S1_190376,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14403.38,5761.35,,,0 CDM,278C1713S1_190389,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,11030.51,4412.2,,,0 CDM,278C1713S1_190390,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,941.43,376.57,,,0 CDM,278C1713S1_190394,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1571.06,628.42,,,0 CDM,278C1713S1_190395,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1519.52,607.81,,,0 CDM,278C1713S1_190402,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7252.88,2901.15,,,0 CDM,278C1713S1_190403,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_190404,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,16348.5,6539.4,,,0 CDM,278C1713S1_190418,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,15572.81,6229.12,,,0 CDM,278C1713S1_190444,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8922.38,3568.95,,,0 CDM,278C1713S1_190485,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,12887.44,5154.98,,,0 CDM,278C1713S1_190502,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4209.19,1683.68,,,0 CDM,278C1713S1_190519,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,15572.81,6229.12,,,0 CDM,278C1713S1_190564,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,547.31,218.92,,,0 CDM,278C1713S1_190565,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,547.31,218.92,,,0 CDM,278C1713S1_190566,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,792.0,316.8,,,0 CDM,278C1713S1_190567,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,919.46,367.78,,,0 CDM,278C1713S1_190568,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1081.69,432.68,,,0 CDM,278C1713S1_190569,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1333.72,533.49,,,0 CDM,278C1713S1_190570,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3130.31,1252.12,,,0 CDM,278C1713S1_190577,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,15659.44,6263.78,,,0 CDM,278C1713S1_190594,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7201.69,2880.68,,,0 CDM,278C1713S1_190595,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1224.56,489.82,,,0 CDM,278C1713S1_190601,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5835.38,2334.15,,,0 CDM,278C1713S1_190620,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4209.19,1683.68,,,0 CDM,278C1713S1_190622,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14403.38,5761.35,,,0 CDM,278C1713S1_190659,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14013.56,5605.42,,,0 CDM,278C1713S1_190695,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6993.0,2797.2,,,0 CDM,278C1713S1_190696,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_190774,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1224.56,489.82,,,0 CDM,278C1713S1_190813,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14497.88,5799.15,,,0 CDM,278C1713S1_190848,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1046.92,418.77,,,0 CDM,278C1713S1_190849,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1233.9,493.56,,,0 CDM,278C1713S1_190851,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,783.56,313.42,,,0 CDM,278C1713S1_190866,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8158.5,3263.4,,,0 CDM,278C1713S1_190915,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5556.6,2222.64,,,0 CDM,278C1713S1_190931,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,19463.06,7785.22,,,0 CDM,278C1713S1_190936,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,16348.5,6539.4,,,0 CDM,278C1713S1_190962,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14875.88,5950.35,,,0 CDM,278C1713S1_190963,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_190966,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14096.25,5638.5,,,0 CDM,278C1713S1_190996,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.68,78.67,,,0 CDM,278C1713S1_191052,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,18994.5,7597.8,,,0 CDM,278C1713S1_191054,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1429.31,571.72,,,0 CDM,278C1713S1_191102,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.17,47.27,,,0 CDM,278C1713S1_191130,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,119.03,47.61,,,0 CDM,278C1713S1_191133,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.84,47.54,,,0 CDM,278C1713S1_191134,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,21924.0,8769.6,,,0 CDM,278C1713S1_191135,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1350.56,540.22,,,0 CDM,278C1713S1_191136,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1410.13,564.05,,,0 CDM,278C1713S1_191137,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,962.77,385.11,,,0 CDM,278C1713S1_191139,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,18683.44,7473.38,,,0 CDM,278C1713S1_191160,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,12903.19,5161.28,,,0 CDM,278C1713S1_191196,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8575.88,3430.35,,,0 CDM,278C1713S1_191197,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7252.88,2901.15,,,0 CDM,278C1713S1_191198,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7705.69,3082.28,,,0 CDM,278C1713S1_191199,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6933.94,2773.58,,,0 CDM,278C1713S1_191200,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9087.75,3635.1,,,0 CDM,278C1713S1_191223,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,955.94,382.38,,,0 CDM,278C1713S1_191271,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1932.52,773.01,,,0 CDM,278C1713S1_191280,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,555.19,222.08,,,0 CDM,278C1713S1_191333,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,783.56,313.42,,,0 CDM,278C1713S1_191371,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2937.38,1174.95,,,0 CDM,278C1713S1_191384,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14875.88,5950.35,,,0 CDM,278C1713S1_191385,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1244.25,497.7,,,0 CDM,278C1713S1_191410,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_191415,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,21022.31,8408.92,,,0 CDM,278C1713S1_191417,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1559.25,623.7,,,0 CDM,278C1713S1_191422,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7252.88,2901.15,,,0 CDM,278C1713S1_191431,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,15183.0,6073.2,,,0 CDM,278C1713S1_191557,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,20356.88,8142.75,,,0 CDM,278C1713S1_191592,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,13312.69,5325.08,,,0 CDM,278C1713S1_191668,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5556.6,2222.64,,,0 CDM,278C1713S1_191686,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,555.19,222.08,,,0 CDM,278C1713S1_191695,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,12903.19,5161.28,,,0 CDM,278C1713S1_191722,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14793.19,5917.28,,,0 CDM,278C1713S1_191723,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1429.31,571.72,,,0 CDM,278C1713S1_191724,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1174.39,469.76,,,0 CDM,278C1713S1_191785,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,238.22,95.29,,,0 CDM,278C1713S1_191786,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,238.22,95.29,,,0 CDM,278C1713S1_191787,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,238.22,95.29,,,0 CDM,278C1713S1_191796,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8390.81,3356.32,,,0 CDM,278C1713S1_191797,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_191883,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,12903.19,5161.28,,,0 CDM,278C1713S1_191960,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,13607.78,5443.11,,,0 CDM,278C1713S1_191962,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1146.3,458.52,,,0 CDM,278C1713S1_191963,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1046.92,418.77,,,0 CDM,278C1713S1_191964,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1307.66,523.06,,,0 CDM,278C1713S1_191965,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1559.25,623.7,,,0 CDM,278C1713S1_191984,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9546.51,3818.6,,,0 CDM,278C1713S1_191985,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,549.63,219.85,,,0 CDM,278C1713S1_192069,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,15183.0,6073.2,,,0 CDM,278C1713S1_192073,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1224.56,489.82,,,0 CDM,278C1713S1_192074,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7252.88,2901.15,,,0 CDM,278C1713S1_192101,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5556.6,2222.64,,,0 CDM,278C1713S1_192122,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,330.75,132.3,,,0 CDM,278C1713S1_192126,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9546.51,3818.6,,,0 CDM,278C1713S1_192135,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,114.98,45.99,,,0 CDM,278C1713S1_192136,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7815.94,3126.38,,,0 CDM,278C1713S1_192161,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,13233.94,5293.58,,,0 CDM,278C1713S1_192162,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,17931.38,7172.55,,,0 CDM,278C1713S1_192163,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1429.31,571.72,,,0 CDM,278C1713S1_192164,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1362.38,544.95,,,0 CDM,278C1713S1_192165,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,117.09,46.84,,,0 CDM,278C1713S1_192166,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7201.69,2880.68,,,0 CDM,278C1713S1_192167,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,20356.88,8142.75,,,0 CDM,278C1713S1_192189,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5556.6,2222.64,,,0 CDM,278C1713S1_192217,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,192.94,77.18,,,0 CDM,278C1713S1_192228,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,593.65,237.46,,,0 CDM,278C1713S1_192230,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,202.43,80.97,,,0 CDM,278C1713S1_192231,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,201.09,80.44,,,0 CDM,278C1713S1_192234,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2978.06,1191.22,,,0 CDM,278C1713S1_192295,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3274.42,1309.77,,,0 CDM,278C1713S1_192297,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5488.88,2195.55,,,0 CDM,278C1713S1_192300,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1082.81,433.12,,,0 CDM,278C1713S1_192301,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_192302,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,648.61,259.44,,,0 CDM,278C1713S1_192303,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192304,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192305,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6453.56,2581.42,,,0 CDM,278C1713S1_192307,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,200.81,80.32,,,0 CDM,278C1713S1_192309,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,240.19,96.08,,,0 CDM,278C1713S1_192326,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192327,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192328,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192331,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6276.38,2510.55,,,0 CDM,278C1713S1_192332,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14588.44,5835.38,,,0 CDM,278C1713S1_192333,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_192338,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192354,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,254.88,101.95,,,0 CDM,278C1713S1_192373,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,953.43,381.37,,,0 CDM,278C1713S1_192374,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,953.43,381.37,,,0 CDM,278C1713S1_192375,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1530.74,612.3,,,0 CDM,278C1713S1_192376,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,21014.4,8405.76,,,0 CDM,278C1713S1_192377,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6444.06,2577.62,,,0 CDM,278C1713S1_192380,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.67,30.67,,,0 CDM,278C1713S1_192381,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,89.26,35.7,,,0 CDM,278C1713S1_192382,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_192383,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_192384,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_192385,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_192388,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,11030.51,4412.2,,,0 CDM,278C1713S1_192389,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1186.08,474.43,,,0 CDM,278C1713S1_192390,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,938.51,375.4,,,0 CDM,278C1713S1_192399,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_192400,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_192401,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_192402,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192403,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,94.5,37.8,,,0 CDM,278C1713S1_192404,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5965.31,2386.12,,,0 CDM,278C1713S1_192428,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1606.5,642.6,,,0 CDM,278C1713S1_192430,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192431,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,338.62,135.45,,,0 CDM,278C1713S1_192432,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,338.62,135.45,,,0 CDM,278C1713S1_192433,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192436,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_192437,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,263.81,105.52,,,0 CDM,278C1713S1_192438,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_192439,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_192446,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9658.69,3863.48,,,0 CDM,278C1713S1_192447,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192448,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192449,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192450,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192451,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192452,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192453,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_192455,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2051.44,820.58,,,0 CDM,278C1713S1_192456,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_192457,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_192458,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_192459,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_192460,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_192461,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_192497,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,77.53,31.01,,,0 CDM,278C1713S1_192498,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,984.45,393.78,,,0 CDM,278C1713S1_192517,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192520,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_192521,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_192528,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_192534,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_192535,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_192536,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_192537,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,417.38,166.95,,,0 CDM,278C1713S1_192541,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,953.43,381.37,,,0 CDM,278C1713S1_192542,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.76,320.7,,,0 CDM,278C1713S1_192543,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.76,320.7,,,0 CDM,278C1713S1_192546,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.76,320.7,,,0 CDM,278C1713S1_192547,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.76,320.7,,,0 CDM,278C1713S1_192548,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.85,49.14,,,0 CDM,278C1713S1_192549,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.66,30.66,,,0 CDM,278C1713S1_192550,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.66,30.66,,,0 CDM,278C1713S1_192551,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1943.55,777.42,,,0 CDM,278C1713S1_192558,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,425.8,170.32,,,0 CDM,278C1713S1_192559,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.66,30.66,,,0 CDM,278C1713S1_192561,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.66,30.66,,,0 CDM,278C1713S1_192573,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14013.56,5605.42,,,0 CDM,278C1713S1_192574,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1046.92,418.77,,,0 CDM,278C1713S1_192575,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_192581,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_192584,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1953.0,781.2,,,0 CDM,278C1713S1_192585,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_192586,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_192587,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_192588,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192589,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192590,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1677.38,670.95,,,0 CDM,278C1713S1_192609,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_192610,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_192611,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_192640,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192641,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,338.62,135.45,,,0 CDM,278C1713S1_192642,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192643,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,338.62,135.45,,,0 CDM,278C1713S1_192644,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_192645,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_192646,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_192647,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1559.25,623.7,,,0 CDM,278C1713S1_192648,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_192649,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,338.62,135.45,,,0 CDM,278C1713S1_192659,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7426.12,2970.45,,,0 CDM,278C1713S1_192660,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7749.0,3099.6,,,0 CDM,278C1713S1_192664,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1693.12,677.25,,,0 CDM,278C1713S1_192688,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_192689,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_192690,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_192691,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_192692,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_192693,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_192694,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_192695,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_192696,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,534.6,213.84,,,0 CDM,278C1713S1_192697,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_192698,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_192699,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_192700,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_192701,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_192702,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9020.81,3608.32,,,0 CDM,278C1713S1_192703,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,39.38,15.75,,,0 CDM,278C1713S1_192707,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1685.25,674.1,,,0 CDM,278C1713S1_192708,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_192709,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192710,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_192712,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_192714,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_192715,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_192717,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4744.69,1897.88,,,0 CDM,278C1713S1_192725,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,358.31,143.32,,,0 CDM,278C1713S1_192734,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6327.56,2531.02,,,0 CDM,278C1713S1_192737,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1027.69,411.08,,,0 CDM,278C1713S1_192738,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4744.69,1897.88,,,0 CDM,278C1713S1_192739,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1027.69,411.08,,,0 CDM,278C1713S1_192740,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1027.69,411.08,,,0 CDM,278C1713S1_192744,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,338.62,135.45,,,0 CDM,278C1713S1_192745,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,338.62,135.45,,,0 CDM,278C1713S1_192746,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192747,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1614.38,645.75,,,0 CDM,278C1713S1_192754,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2388.45,955.38,,,0 CDM,278C1713S1_192755,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_192756,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_192757,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.66,30.66,,,0 CDM,278C1713S1_192758,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.66,30.66,,,0 CDM,278C1713S1_192761,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5209.08,2083.63,,,0 CDM,278C1713S1_192762,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,173.19,69.28,,,0 CDM,278C1713S1_192767,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,519.75,207.9,,,0 CDM,278C1713S1_192768,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,519.75,207.9,,,0 CDM,278C1713S1_192771,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_192772,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_192773,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_192774,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_192775,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5740.88,2296.35,,,0 CDM,278C1713S1_192776,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14364.0,5745.6,,,0 CDM,278C1713S1_192777,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_192778,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,351.58,140.63,,,0 CDM,278C1713S1_192779,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,351.58,140.63,,,0 CDM,278C1713S1_192781,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192782,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192783,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,169.31,67.72,,,0 CDM,278C1713S1_192801,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,811.12,324.45,,,0 CDM,278C1713S1_192802,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_192803,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_192804,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_192805,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_192806,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192807,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192808,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_192809,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_192810,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_192811,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_192813,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1082.81,433.12,,,0 CDM,278C1713S1_192814,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14588.44,5835.38,,,0 CDM,278C1713S1_192815,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6276.38,2510.55,,,0 CDM,278C1713S1_192816,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1559.25,623.7,,,0 CDM,278C1713S1_192818,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_192819,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_192820,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_192821,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_192825,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_192835,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3094.88,1237.95,,,0 CDM,278C1713S1_192836,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3094.88,1237.95,,,0 CDM,278C1713S1_192837,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192838,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,917.44,366.98,,,0 CDM,278C1713S1_192839,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192840,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_192844,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_192846,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192847,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192855,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1984.5,793.8,,,0 CDM,278C1713S1_192856,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5556.6,2222.64,,,0 CDM,278C1713S1_192880,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9546.51,3818.6,,,0 CDM,278C1713S1_192881,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9485.44,3794.18,,,0 CDM,278C1713S1_192894,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6327.56,2531.02,,,0 CDM,278C1713S1_192896,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.44,45.38,,,0 CDM,278C1713S1_192897,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.44,45.38,,,0 CDM,278C1713S1_192898,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,351.58,140.63,,,0 CDM,278C1713S1_192899,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,351.58,140.63,,,0 CDM,278C1713S1_192900,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,351.58,140.63,,,0 CDM,278C1713S1_192901,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,351.58,140.63,,,0 CDM,278C1713S1_192922,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1248.19,499.28,,,0 CDM,278C1713S1_192936,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_192941,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3630.38,1452.15,,,0 CDM,278C1713S1_192942,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_192943,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_192944,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192945,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192963,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,338.62,135.45,,,0 CDM,278C1713S1_192983,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8485.31,3394.12,,,0 CDM,278C1713S1_192984,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_192985,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_192986,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_192987,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_192988,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_192989,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_192990,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192991,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192992,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192993,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_192994,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14364.0,5745.6,,,0 CDM,278C1713S1_192995,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5689.69,2275.88,,,0 CDM,278C1713S1_192996,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5965.31,2386.12,,,0 CDM,278C1713S1_192997,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_192998,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_192999,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,94.5,37.8,,,0 CDM,278C1713S1_193000,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193001,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193035,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193036,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_193037,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193038,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193039,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193040,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_193041,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_193042,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_193049,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1874.25,749.7,,,0 CDM,278C1713S1_193050,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8619.19,3447.68,,,0 CDM,278C1713S1_193051,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,39.38,15.75,,,0 CDM,278C1713S1_193052,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_193053,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_193054,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,131.25,52.5,,,0 CDM,278C1713S1_193055,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_193068,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_193069,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193070,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_193071,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1606.5,642.6,,,0 CDM,278C1713S1_193072,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3295.73,1318.29,,,0 CDM,278C1713S1_193122,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,17907.75,7163.1,,,0 CDM,278C1713S1_193126,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,792.0,316.8,,,0 CDM,278C1713S1_193128,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,17907.75,7163.1,,,0 CDM,278C1713S1_193129,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,919.46,367.78,,,0 CDM,278C1713S1_193130,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1244.25,497.7,,,0 CDM,278C1713S1_193131,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1244.25,497.7,,,0 CDM,278C1713S1_193136,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,19577.25,7830.9,,,0 CDM,278C1713S1_193141,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,464.0,185.6,,,0 CDM,278C1713S1_193142,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,98.44,39.38,,,0 CDM,278C1713S1_193143,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_193144,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_193147,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_193148,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_193149,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193150,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193151,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8347.5,3339.0,,,0 CDM,278C1713S1_193154,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7103.25,2841.3,,,0 CDM,278C1713S1_193161,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4744.69,1897.88,,,0 CDM,278C1713S1_193162,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_193163,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8174.25,3269.7,,,0 CDM,278C1713S1_193164,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.44,266.18,,,0 CDM,278C1713S1_193166,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.44,266.18,,,0 CDM,278C1713S1_193167,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,992.25,396.9,,,0 CDM,278C1713S1_193175,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,613.46,245.38,,,0 CDM,278C1713S1_193176,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,613.46,245.38,,,0 CDM,278C1713S1_193177,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,613.46,245.38,,,0 CDM,278C1713S1_193178,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,613.46,245.38,,,0 CDM,278C1713S1_193182,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1667.61,667.04,,,0 CDM,278C1713S1_193183,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7256.38,2902.55,,,0 CDM,278C1713S1_193200,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.44,45.38,,,0 CDM,278C1713S1_193201,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.8,47.52,,,0 CDM,278C1713S1_193202,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.8,47.52,,,0 CDM,278C1713S1_193203,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.8,47.52,,,0 CDM,278C1713S1_193204,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.8,47.52,,,0 CDM,278C1713S1_193205,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.8,47.52,,,0 CDM,278C1713S1_193206,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.8,47.52,,,0 CDM,278C1713S1_193207,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.8,47.52,,,0 CDM,278C1713S1_193208,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.8,47.52,,,0 CDM,278C1713S1_193209,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.8,47.52,,,0 CDM,278C1713S1_193210,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.66,30.66,,,0 CDM,278C1713S1_193212,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.66,30.66,,,0 CDM,278C1713S1_193213,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2349.39,939.76,,,0 CDM,278C1713S1_193214,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2870.52,1148.21,,,0 CDM,278C1713S1_193215,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3399.95,1359.98,,,0 CDM,278C1713S1_193220,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7682.06,3072.82,,,0 CDM,278C1713S1_193224,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14929.04,5971.62,,,0 CDM,278C1713S1_193225,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3274.42,1309.77,,,0 CDM,278C1713S1_193226,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9546.51,3818.6,,,0 CDM,278C1713S1_193228,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_193229,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1248.19,499.28,,,0 CDM,278C1713S1_193230,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,89.26,35.7,,,0 CDM,278C1713S1_193231,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,89.26,35.7,,,0 CDM,278C1713S1_193232,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_193233,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_193234,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_193235,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_193236,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,218.69,87.48,,,0 CDM,278C1713S1_193237,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,218.69,87.48,,,0 CDM,278C1713S1_193238,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3702.47,1480.99,,,0 CDM,278C1713S1_193239,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5722.25,2288.9,,,0 CDM,278C1713S1_193244,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.44,266.18,,,0 CDM,278C1713S1_193264,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,114.19,45.68,,,0 CDM,278C1713S1_193265,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193266,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_193267,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_193270,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_193271,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_193272,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1685.25,674.1,,,0 CDM,278C1713S1_193273,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,338.62,135.45,,,0 CDM,278C1713S1_193274,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_193275,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_193279,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.79,47.52,,,0 CDM,278C1713S1_193280,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.8,47.52,,,0 CDM,278C1713S1_193281,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1148.57,459.43,,,0 CDM,278C1713S1_193282,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8886.94,3554.78,,,0 CDM,278C1713S1_193283,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193284,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193285,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_193287,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4744.69,1897.88,,,0 CDM,278C1713S1_193295,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1667.61,667.04,,,0 CDM,278C1713S1_193297,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7256.38,2902.55,,,0 CDM,278C1713S1_193303,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7256.38,2902.55,,,0 CDM,278C1713S1_193305,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1667.61,667.04,,,0 CDM,278C1713S1_193313,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1667.61,667.04,,,0 CDM,278C1713S1_193314,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6996.74,2798.7,,,0 CDM,278C1713S1_193317,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_193318,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_193326,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6996.74,2798.7,,,0 CDM,278C1713S1_193349,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,590.62,236.25,,,0 CDM,278C1713S1_193382,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3274.42,1309.77,,,0 CDM,278C1713S1_193383,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6996.74,2798.7,,,0 CDM,278C1713S1_193386,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193387,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193388,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193392,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9546.51,3818.6,,,0 CDM,278C1713S1_193395,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,15954.75,6381.9,,,0 CDM,278C1713S1_193413,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_193419,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193420,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4669.88,1867.95,,,0 CDM,278C1713S1_193421,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_193422,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_193423,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_193424,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_193425,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_193426,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193427,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,504.0,201.6,,,0 CDM,278C1713S1_193428,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,736.31,294.52,,,0 CDM,278C1713S1_193429,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,299.25,119.7,,,0 CDM,278C1713S1_193430,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,299.25,119.7,,,0 CDM,278C1713S1_193432,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,129.94,51.98,,,0 CDM,278C1713S1_193433,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_193434,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_193436,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_193437,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_193438,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_193442,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1667.61,667.04,,,0 CDM,278C1713S1_193443,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9546.51,3818.6,,,0 CDM,278C1713S1_193444,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_193445,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8485.31,3394.12,,,0 CDM,278C1713S1_193446,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,917.44,366.98,,,0 CDM,278C1713S1_193447,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,889.88,355.95,,,0 CDM,278C1713S1_193449,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1206.45,482.58,,,0 CDM,278C1713S1_193450,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2134.12,853.65,,,0 CDM,278C1713S1_193467,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_193468,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_193470,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4744.69,1897.88,,,0 CDM,278C1713S1_193471,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_193473,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_193476,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_193480,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_193481,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_193520,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8886.94,3554.78,,,0 CDM,278C1713S1_193521,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8571.94,3428.78,,,0 CDM,278C1713S1_193522,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_193523,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_193524,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_193525,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_193526,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_193528,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,567.0,226.8,,,0 CDM,278C1713S1_193531,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1319.06,527.62,,,0 CDM,278C1713S1_193532,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4705.31,1882.12,,,0 CDM,278C1713S1_193533,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.44,266.18,,,0 CDM,278C1713S1_193560,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_193561,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,452.81,181.12,,,0 CDM,278C1713S1_193562,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193563,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193564,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193566,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,452.81,181.12,,,0 CDM,278C1713S1_193567,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6933.94,2773.58,,,0 CDM,278C1713S1_193568,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1224.56,489.82,,,0 CDM,278C1713S1_193569,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6933.94,2773.58,,,0 CDM,278C1713S1_193570,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_193571,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6524.44,2609.78,,,0 CDM,278C1713S1_193572,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1874.25,749.7,,,0 CDM,278C1713S1_193573,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193574,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193575,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,811.12,324.45,,,0 CDM,278C1713S1_193576,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_193577,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8619.19,3447.68,,,0 CDM,278C1713S1_193578,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_193579,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.8,47.52,,,0 CDM,278C1713S1_193580,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.66,30.66,,,0 CDM,278C1713S1_193581,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.66,30.66,,,0 CDM,278C1713S1_193582,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.66,30.66,,,0 CDM,278C1713S1_193583,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_193584,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_193585,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_193586,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,218.69,87.48,,,0 CDM,278C1713S1_193595,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1174.39,469.76,,,0 CDM,278C1713S1_193601,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8485.31,3394.12,,,0 CDM,278C1713S1_193604,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_193605,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.25,44.1,,,0 CDM,278C1713S1_193608,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_193610,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,13623.75,5449.5,,,0 CDM,278C1713S1_193611,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1429.31,571.72,,,0 CDM,278C1713S1_193625,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,464.0,185.6,,,0 CDM,278C1713S1_193626,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6182.86,2473.14,,,0 CDM,278C1713S1_193639,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5425.88,2170.35,,,0 CDM,278C1713S1_193640,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193641,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193642,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193643,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193644,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1645.88,658.35,,,0 CDM,278C1713S1_193646,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,129.94,51.98,,,0 CDM,278C1713S1_193647,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,303.19,121.28,,,0 CDM,278C1713S1_193652,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_193655,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8154.56,3261.82,,,0 CDM,278C1713S1_193680,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1667.61,667.04,,,0 CDM,278C1713S1_193681,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7256.38,2902.55,,,0 CDM,278C1713S1_193683,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_193684,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,661.5,264.6,,,0 CDM,278C1713S1_193685,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,680.8,272.32,,,0 CDM,278C1713S1_193686,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,908.97,363.59,,,0 CDM,278C1713S1_193687,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,908.97,363.59,,,0 CDM,278C1713S1_193692,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1590.75,636.3,,,0 CDM,278C1713S1_193693,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1315.12,526.05,,,0 CDM,278C1713S1_193694,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193695,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193696,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193697,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193698,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193703,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_193708,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193709,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193710,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193711,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193712,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2016.0,806.4,,,0 CDM,278C1713S1_193713,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1027.69,411.08,,,0 CDM,278C1713S1_193714,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1027.69,411.08,,,0 CDM,278C1713S1_193715,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1027.69,411.08,,,0 CDM,278C1713S1_193716,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1027.69,411.08,,,0 CDM,278C1713S1_193724,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193725,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193726,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193727,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,889.88,355.95,,,0 CDM,278C1713S1_193740,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_193741,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_193742,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1559.25,623.7,,,0 CDM,278C1713S1_193743,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,103.79,41.52,,,0 CDM,278C1713S1_193744,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.44,45.38,,,0 CDM,278C1713S1_193745,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.44,45.38,,,0 CDM,278C1713S1_193746,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1069.31,427.72,,,0 CDM,278C1713S1_193747,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1110.57,444.23,,,0 CDM,278C1713S1_193750,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7225.31,2890.12,,,0 CDM,278C1713S1_193751,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_193752,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_193776,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8619.19,3447.68,,,0 CDM,278C1713S1_193777,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_193780,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,15572.81,6229.12,,,0 CDM,278C1713S1_193788,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,18525.94,7410.38,,,0 CDM,278C1713S1_193789,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3125.59,1250.24,,,0 CDM,278C1713S1_193790,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1362.38,544.95,,,0 CDM,278C1713S1_193791,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1311.19,524.48,,,0 CDM,278C1713S1_193792,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1102.5,441.0,,,0 CDM,278C1713S1_193798,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,18994.5,7597.8,,,0 CDM,278C1713S1_193799,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,888.21,355.28,,,0 CDM,278C1713S1_193800,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6996.74,2798.7,,,0 CDM,278C1713S1_193811,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3274.42,1309.77,,,0 CDM,278C1713S1_193812,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7256.38,2902.55,,,0 CDM,278C1713S1_193817,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9788.62,3915.45,,,0 CDM,278C1713S1_193834,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_193835,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8753.06,3501.22,,,0 CDM,278C1713S1_193836,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8438.06,3375.22,,,0 CDM,278C1713S1_193845,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9839.81,3935.92,,,0 CDM,278C1713S1_193846,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193847,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,94.5,37.8,,,0 CDM,278C1713S1_193848,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1082.81,433.12,,,0 CDM,278C1713S1_193856,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,567.0,226.8,,,0 CDM,278C1713S1_193858,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_193859,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_193860,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9292.5,3717.0,,,0 CDM,278C1713S1_193862,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_193863,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8304.19,3321.68,,,0 CDM,278C1713S1_193864,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_193865,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_193869,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193870,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193871,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193872,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_193873,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_193874,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_193885,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,468.56,187.42,,,0 CDM,278C1713S1_193886,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,468.56,187.42,,,0 CDM,278C1713S1_193887,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,468.56,187.42,,,0 CDM,278C1713S1_193888,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,468.56,187.42,,,0 CDM,278C1713S1_193889,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_193890,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193891,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_193892,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_193893,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_193894,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2291.62,916.65,,,0 CDM,278C1713S1_193927,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8575.88,3430.35,,,0 CDM,278C1713S1_193928,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,13863.94,5545.58,,,0 CDM,278C1713S1_193929,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1319.06,527.62,,,0 CDM,278C1713S1_193930,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4705.31,1882.12,,,0 CDM,278C1713S1_193931,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,315.0,126.0,,,0 CDM,278C1713S1_193962,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193963,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193964,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,653.62,261.45,,,0 CDM,278C1713S1_193965,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2023.88,809.55,,,0 CDM,278C1713S1_193966,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193967,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,15297.19,6118.88,,,0 CDM,278C1713S1_193968,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.85,49.14,,,0 CDM,278C1713S1_193969,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.85,49.14,,,0 CDM,278C1713S1_193970,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.85,49.14,,,0 CDM,278C1713S1_193971,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,19802.16,7920.86,,,0 CDM,278C1713S1_193972,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_193973,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_193974,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_193975,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14096.25,5638.5,,,0 CDM,278C1713S1_193976,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,16348.5,6539.4,,,0 CDM,278C1713S1_193984,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,338.62,135.45,,,0 CDM,278C1713S1_193985,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,338.62,135.45,,,0 CDM,278C1713S1_193986,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_193987,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1614.38,645.75,,,0 CDM,278C1713S1_193988,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193989,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193990,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193991,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193993,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_193995,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_193998,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5205.38,2082.15,,,0 CDM,278C1713S1_193999,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194000,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_194001,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1208.81,483.52,,,0 CDM,278C1713S1_194002,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1386.0,554.4,,,0 CDM,278C1713S1_194003,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_194004,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_194005,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_194006,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_194007,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194025,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5855.06,2342.02,,,0 CDM,278C1713S1_194026,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194027,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194028,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194029,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1386.0,554.4,,,0 CDM,278C1713S1_194030,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.06,48.82,,,0 CDM,278C1713S1_194031,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.06,48.82,,,0 CDM,278C1713S1_194033,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5685.75,2274.3,,,0 CDM,278C1713S1_194034,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_194035,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_194036,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_194038,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194039,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,94.5,37.8,,,0 CDM,278C1713S1_194041,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14812.88,5925.15,,,0 CDM,278C1713S1_194042,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6831.56,2732.62,,,0 CDM,278C1713S1_194043,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,114.19,45.68,,,0 CDM,278C1713S1_194044,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4744.69,1897.88,,,0 CDM,278C1713S1_194045,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4744.69,1897.88,,,0 CDM,278C1713S1_194046,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1027.69,411.08,,,0 CDM,278C1713S1_194047,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1027.69,411.08,,,0 CDM,278C1713S1_194048,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1027.69,411.08,,,0 CDM,278C1713S1_194049,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194050,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194051,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,417.38,166.95,,,0 CDM,278C1713S1_194052,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_194059,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.85,49.14,,,0 CDM,278C1713S1_194060,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.85,49.14,,,0 CDM,278C1713S1_194061,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.85,49.14,,,0 CDM,278C1713S1_194062,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.85,49.14,,,0 CDM,278C1713S1_194063,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.85,49.14,,,0 CDM,278C1713S1_194064,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1991.39,796.56,,,0 CDM,278C1713S1_194066,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.85,49.14,,,0 CDM,278C1713S1_194070,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,948.94,379.58,,,0 CDM,278C1713S1_194080,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194081,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_194084,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1429.31,571.72,,,0 CDM,278C1713S1_194088,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_194089,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_194090,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_194091,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4744.69,1897.88,,,0 CDM,278C1713S1_194092,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_194095,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1027.69,411.08,,,0 CDM,278C1713S1_194112,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_194113,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_194115,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7630.88,3052.35,,,0 CDM,278C1713S1_194116,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,149.62,59.85,,,0 CDM,278C1713S1_194129,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5723.16,2289.26,,,0 CDM,278C1713S1_194132,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9485.44,3794.18,,,0 CDM,278C1713S1_194133,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9485.44,3794.18,,,0 CDM,278C1713S1_194171,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,315.0,126.0,,,0 CDM,278C1713S1_194175,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14793.19,5917.28,,,0 CDM,278C1713S1_194176,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,567.0,226.8,,,0 CDM,278C1713S1_194179,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,417.38,166.95,,,0 CDM,278C1713S1_194180,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_194181,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_194182,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_194184,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8347.5,3339.0,,,0 CDM,278C1713S1_194185,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5685.75,2274.3,,,0 CDM,278C1713S1_194187,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.44,266.18,,,0 CDM,278C1713S1_194188,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.44,266.18,,,0 CDM,278C1713S1_194189,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.44,266.18,,,0 CDM,278C1713S1_194190,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.44,266.18,,,0 CDM,278C1713S1_194191,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.44,266.18,,,0 CDM,278C1713S1_194192,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.44,266.18,,,0 CDM,278C1713S1_194193,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194194,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194195,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194196,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1953.0,781.2,,,0 CDM,278C1713S1_194197,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14875.88,5950.35,,,0 CDM,278C1713S1_194215,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6800.06,2720.02,,,0 CDM,278C1713S1_194217,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6996.74,2798.7,,,0 CDM,278C1713S1_194238,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3274.42,1309.77,,,0 CDM,278C1713S1_194239,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_194240,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4744.69,1897.88,,,0 CDM,278C1713S1_194241,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_194242,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6996.74,2798.7,,,0 CDM,278C1713S1_194243,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,729.42,291.77,,,0 CDM,278C1713S1_194244,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,729.42,291.77,,,0 CDM,278C1713S1_194245,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,729.42,291.77,,,0 CDM,278C1713S1_194246,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6996.74,2798.7,,,0 CDM,278C1713S1_194248,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1027.69,411.08,,,0 CDM,278C1713S1_194259,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5382.56,2153.02,,,0 CDM,278C1713S1_194260,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_194261,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_194262,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,181.12,72.45,,,0 CDM,278C1713S1_194263,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,181.91,72.76,,,0 CDM,278C1713S1_194265,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,11792.81,4717.12,,,0 CDM,278C1713S1_194266,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_194268,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_194272,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,13623.75,5449.5,,,0 CDM,278C1713S1_194273,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,854.44,341.78,,,0 CDM,278C1713S1_194280,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194281,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194282,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194283,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2460.94,984.38,,,0 CDM,278C1713S1_194285,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_194286,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,78.75,31.5,,,0 CDM,278C1713S1_194287,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194288,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_194290,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7182.0,2872.8,,,0 CDM,278C1713S1_194292,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194293,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194294,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5382.56,2153.02,,,0 CDM,278C1713S1_194295,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1677.38,670.95,,,0 CDM,278C1713S1_194296,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2464.88,985.95,,,0 CDM,278C1713S1_194297,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_194298,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,940.59,376.24,,,0 CDM,278C1713S1_194310,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1177.31,470.92,,,0 CDM,278C1713S1_194335,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14812.88,5925.15,,,0 CDM,278C1713S1_194336,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194348,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9546.51,3818.6,,,0 CDM,278C1713S1_194355,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1027.69,411.08,,,0 CDM,278C1713S1_194356,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4744.69,1897.88,,,0 CDM,278C1713S1_194357,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1027.69,411.08,,,0 CDM,278C1713S1_194358,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_194374,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.66,30.66,,,0 CDM,278C1713S1_194375,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.66,30.66,,,0 CDM,278C1713S1_194376,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_194377,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,19802.16,7920.86,,,0 CDM,278C1713S1_194380,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.85,49.14,,,0 CDM,278C1713S1_194381,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1471.05,588.42,,,0 CDM,278C1713S1_194382,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.76,320.7,,,0 CDM,278C1713S1_194383,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,20092.52,8037.01,,,0 CDM,278C1713S1_194385,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,10542.66,4217.06,,,0 CDM,278C1713S1_194412,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,46.03,18.41,,,0 CDM,278C1713S1_194413,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2856.22,1142.49,,,0 CDM,278C1713S1_194414,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,163.01,65.2,,,0 CDM,278C1713S1_194415,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,163.01,65.2,,,0 CDM,278C1713S1_194416,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,163.01,65.2,,,0 CDM,278C1713S1_194417,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,341.62,136.65,,,0 CDM,278C1713S1_194418,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,341.62,136.65,,,0 CDM,278C1713S1_194419,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,341.62,136.65,,,0 CDM,278C1713S1_194421,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,519.75,207.9,,,0 CDM,278C1713S1_194422,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,519.75,207.9,,,0 CDM,278C1713S1_194430,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194439,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_194440,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1559.25,623.7,,,0 CDM,278C1713S1_194473,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9546.51,3818.6,,,0 CDM,278C1713S1_194475,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_194476,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_194477,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_194478,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_194479,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3500.44,1400.18,,,0 CDM,278C1713S1_194480,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_194481,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194511,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4602.94,1841.18,,,0 CDM,278C1713S1_194512,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_194513,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_194514,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_194515,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_194516,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_194517,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,504.0,201.6,,,0 CDM,278C1713S1_194538,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1786.59,714.64,,,0 CDM,278C1713S1_194561,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.06,48.82,,,0 CDM,278C1713S1_194564,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_194565,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194566,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.06,48.82,,,0 CDM,278C1713S1_194569,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3094.88,1237.95,,,0 CDM,278C1713S1_194571,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,315.0,126.0,,,0 CDM,278C1713S1_194579,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_194580,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.85,49.14,,,0 CDM,278C1713S1_194581,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,19981.51,7992.6,,,0 CDM,278C1713S1_194583,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.66,30.66,,,0 CDM,278C1713S1_194584,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_194585,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,16666.77,6666.71,,,0 CDM,278C1713S1_194587,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5351.06,2140.42,,,0 CDM,278C1713S1_194588,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_194589,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_194590,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_194591,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_194597,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,338.62,135.45,,,0 CDM,278C1713S1_194598,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_194599,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_194600,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2275.88,910.35,,,0 CDM,278C1713S1_194601,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_194602,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1386.0,554.4,,,0 CDM,278C1713S1_194603,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194604,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3702.47,1480.99,,,0 CDM,278C1713S1_194613,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4744.69,1897.88,,,0 CDM,278C1713S1_194618,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_194619,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194620,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_194623,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5685.75,2274.3,,,0 CDM,278C1713S1_194624,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,937.12,374.85,,,0 CDM,278C1713S1_194625,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,937.12,374.85,,,0 CDM,278C1713S1_194626,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4583.25,1833.3,,,0 CDM,278C1713S1_194673,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1870.31,748.12,,,0 CDM,278C1713S1_194676,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_194679,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5922.0,2368.8,,,0 CDM,278C1713S1_194680,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194681,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,17246.25,6898.5,,,0 CDM,278C1713S1_194682,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8174.25,3269.7,,,0 CDM,278C1713S1_194683,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,992.25,396.9,,,0 CDM,278C1713S1_194685,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,338.62,135.45,,,0 CDM,278C1713S1_194686,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_194687,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1685.25,674.1,,,0 CDM,278C1713S1_194690,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7749.0,3099.6,,,0 CDM,278C1713S1_194692,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_194700,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6996.74,2798.7,,,0 CDM,278C1713S1_194712,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.44,266.18,,,0 CDM,278C1713S1_194713,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5685.75,2274.3,,,0 CDM,278C1713S1_194714,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.44,266.18,,,0 CDM,278C1713S1_194715,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.44,266.18,,,0 CDM,278C1713S1_194741,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.8,47.52,,,0 CDM,278C1713S1_194743,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_194744,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_194745,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_194746,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.76,320.7,,,0 CDM,278C1713S1_194747,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,636.86,254.74,,,0 CDM,278C1713S1_194748,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.76,320.7,,,0 CDM,278C1713S1_194749,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,953.43,381.37,,,0 CDM,278C1713S1_194750,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,17250.62,6900.25,,,0 CDM,278C1713S1_194751,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,27172.49,10869.0,,,0 CDM,278C1713S1_194763,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3630.38,1452.15,,,0 CDM,278C1713S1_194790,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.85,49.14,,,0 CDM,278C1713S1_194791,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1471.05,588.42,,,0 CDM,278C1713S1_194792,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,19729.4,7891.76,,,0 CDM,278C1713S1_194793,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1685.25,674.1,,,0 CDM,278C1713S1_194802,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1224.56,489.82,,,0 CDM,278C1713S1_194812,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1319.06,527.62,,,0 CDM,278C1713S1_194813,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4165.88,1666.35,,,0 CDM,278C1713S1_194814,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.44,266.18,,,0 CDM,278C1713S1_194819,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1027.69,411.08,,,0 CDM,278C1713S1_194820,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1027.69,411.08,,,0 CDM,278C1713S1_194821,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1027.69,411.08,,,0 CDM,278C1713S1_194822,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1027.69,411.08,,,0 CDM,278C1713S1_194823,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_194824,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_194825,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194826,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,358.31,143.32,,,0 CDM,278C1713S1_194828,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,519.75,207.9,,,0 CDM,278C1713S1_194838,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,19463.06,7785.22,,,0 CDM,278C1713S1_194840,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.44,45.38,,,0 CDM,278C1713S1_194841,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.44,45.38,,,0 CDM,278C1713S1_194842,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,368.55,147.42,,,0 CDM,278C1713S1_194843,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,368.55,147.42,,,0 CDM,278C1713S1_194844,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2856.22,1142.49,,,0 CDM,278C1713S1_194845,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.44,45.38,,,0 CDM,278C1713S1_194846,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,368.55,147.42,,,0 CDM,278C1713S1_194847,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,368.55,147.42,,,0 CDM,278C1713S1_194848,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,610.67,244.27,,,0 CDM,278C1713S1_194849,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1685.25,674.1,,,0 CDM,278C1713S1_194850,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1032.77,413.11,,,0 CDM,278C1713S1_194851,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.44,45.38,,,0 CDM,278C1713S1_194870,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,937.12,374.85,,,0 CDM,278C1713S1_194871,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5685.75,2274.3,,,0 CDM,278C1713S1_194872,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4583.25,1833.3,,,0 CDM,278C1713S1_194873,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,937.12,374.85,,,0 CDM,278C1713S1_194874,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,937.12,374.85,,,0 CDM,278C1713S1_194878,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_194879,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194880,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3094.88,1237.95,,,0 CDM,278C1713S1_194881,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_194883,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194892,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.66,30.66,,,0 CDM,278C1713S1_194893,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_194894,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_194895,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,218.69,87.48,,,0 CDM,278C1713S1_194896,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5574.4,2229.76,,,0 CDM,278C1713S1_194897,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4657.79,1863.12,,,0 CDM,278C1713S1_194899,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_194900,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_194901,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5685.75,2274.3,,,0 CDM,278C1713S1_194903,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1614.38,645.75,,,0 CDM,278C1713S1_194905,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,618.19,247.28,,,0 CDM,278C1713S1_194930,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9839.81,3935.92,,,0 CDM,278C1713S1_194938,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1082.81,433.12,,,0 CDM,278C1713S1_194950,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1319.06,527.62,,,0 CDM,278C1713S1_194951,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4165.88,1666.35,,,0 CDM,278C1713S1_194952,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.44,266.18,,,0 CDM,278C1713S1_194953,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4197.38,1678.95,,,0 CDM,278C1713S1_194954,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2051.44,820.58,,,0 CDM,278C1713S1_194958,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.44,266.18,,,0 CDM,278C1713S1_194959,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5619.8,2247.92,,,0 CDM,278C1713S1_194962,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,664.53,265.81,,,0 CDM,278C1713S1_194963,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6453.56,2581.42,,,0 CDM,278C1713S1_194964,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6957.56,2783.02,,,0 CDM,278C1713S1_194969,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1712.81,685.12,,,0 CDM,278C1713S1_194970,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_194985,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1795.5,718.2,,,0 CDM,278C1713S1_194986,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1795.5,718.2,,,0 CDM,278C1713S1_194987,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1795.5,718.2,,,0 CDM,278C1713S1_194988,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1795.5,718.2,,,0 CDM,278C1713S1_194989,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9658.69,3863.48,,,0 CDM,278C1713S1_194990,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_194991,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_195001,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4744.69,1897.88,,,0 CDM,278C1713S1_195002,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3543.75,1417.5,,,0 CDM,278C1713S1_195014,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_195015,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_195016,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_195017,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_195018,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_195019,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_195021,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14793.19,5917.28,,,0 CDM,278C1713S1_195022,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,664.53,265.81,,,0 CDM,278C1713S1_195033,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6831.56,2732.62,,,0 CDM,278C1713S1_195034,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_195035,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_195036,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_195037,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_195038,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_195040,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,94.5,37.8,,,0 CDM,278C1713S1_195041,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14497.88,5799.15,,,0 CDM,278C1713S1_195042,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7749.0,3099.6,,,0 CDM,278C1713S1_195044,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14793.19,5917.28,,,0 CDM,278C1713S1_195045,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_195046,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,19463.06,7785.22,,,0 CDM,278C1713S1_195047,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,19463.06,7785.22,,,0 CDM,278C1713S1_195048,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.79,47.52,,,0 CDM,278C1713S1_195049,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,351.58,140.63,,,0 CDM,278C1713S1_195050,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2561.58,1024.63,,,0 CDM,278C1713S1_195053,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,94.5,37.8,,,0 CDM,278C1713S1_195054,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,94.5,37.8,,,0 CDM,278C1713S1_195059,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,11784.94,4713.98,,,0 CDM,278C1713S1_195082,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_195083,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_195101,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7052.06,2820.82,,,0 CDM,278C1713S1_195102,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_195108,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_195109,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_195110,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_195113,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,664.53,265.81,,,0 CDM,278C1713S1_195114,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,664.43,265.77,,,0 CDM,278C1713S1_195136,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1319.06,527.62,,,0 CDM,278C1713S1_195137,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4705.31,1882.12,,,0 CDM,278C1713S1_195139,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_195140,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_195141,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5685.75,2274.3,,,0 CDM,278C1713S1_195142,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,618.19,247.28,,,0 CDM,278C1713S1_195143,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,937.12,374.85,,,0 CDM,278C1713S1_195146,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3756.38,1502.55,,,0 CDM,278C1713S1_195147,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_195148,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_195149,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_195150,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_195151,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_195160,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_195171,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,11784.94,4713.98,,,0 CDM,278C1713S1_195172,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_195173,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.85,49.14,,,0 CDM,278C1713S1_195174,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.85,49.14,,,0 CDM,278C1713S1_195175,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1471.05,588.42,,,0 CDM,278C1713S1_195176,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.76,320.7,,,0 CDM,278C1713S1_195177,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1069.15,427.66,,,0 CDM,278C1713S1_195186,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5685.75,2274.3,,,0 CDM,278C1713S1_195190,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4583.25,1833.3,,,0 CDM,278C1713S1_195191,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.44,266.18,,,0 CDM,278C1713S1_195192,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.44,266.18,,,0 CDM,278C1713S1_195193,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_195194,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,937.12,374.85,,,0 CDM,278C1713S1_195201,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4583.25,1833.3,,,0 CDM,278C1713S1_195202,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5685.75,2274.3,,,0 CDM,278C1713S1_195203,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,181.12,72.45,,,0 CDM,278C1713S1_195224,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2551.5,1020.6,,,0 CDM,278C1713S1_195241,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1638.0,655.2,,,0 CDM,278C1713S1_195242,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_195250,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,936.42,374.57,,,0 CDM,278C1713S1_195251,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,936.42,374.57,,,0 CDM,278C1713S1_195252,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,11099.02,4439.61,,,0 CDM,278C1713S1_195259,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,117.17,46.87,,,0 CDM,278C1713S1_195267,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_195268,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2882.25,1152.9,,,0 CDM,278C1713S1_195269,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4744.69,1897.88,,,0 CDM,278C1713S1_195273,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.8,47.52,,,0 CDM,278C1713S1_195277,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_195330,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_195331,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_195332,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_195333,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,504.0,201.6,,,0 CDM,278C1713S1_195334,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8174.25,3269.7,,,0 CDM,278C1713S1_195335,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.44,266.18,,,0 CDM,278C1713S1_195402,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1638.0,655.2,,,0 CDM,278C1713S1_195403,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6276.38,2510.55,,,0 CDM,278C1713S1_195407,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,10107.56,4043.02,,,0 CDM,278C1713S1_195408,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14588.44,5835.38,,,0 CDM,278C1713S1_195409,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_195436,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_195444,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,819.59,327.84,,,0 CDM,278C1713S1_195449,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,94.5,37.8,,,0 CDM,278C1713S1_195450,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.76,320.7,,,0 CDM,278C1713S1_195451,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.76,320.7,,,0 CDM,278C1713S1_195452,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,23226.77,9290.71,,,0 CDM,278C1713S1_195453,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5685.75,2274.3,,,0 CDM,278C1713S1_195458,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4165.88,1666.35,,,0 CDM,278C1713S1_195460,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.85,49.14,,,0 CDM,278C1713S1_195461,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,611.5,244.6,,,0 CDM,278C1713S1_195469,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7103.25,2841.3,,,0 CDM,278C1713S1_195480,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1311.19,524.48,,,0 CDM,278C1713S1_195499,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,126.0,50.4,,,0 CDM,278C1713S1_195501,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_195549,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,17274.87,6909.95,,,0 CDM,278C1713S1_195558,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,854.44,341.78,,,0 CDM,278C1713S1_195562,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,21515.17,8606.07,,,0 CDM,278C1713S1_195563,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,78.71,31.48,,,0 CDM,278C1713S1_195564,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,277.6,111.04,,,0 CDM,278C1713S1_195565,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,277.59,111.04,,,0 CDM,278C1713S1_195571,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1524.01,609.6,,,0 CDM,278C1713S1_195572,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1381.23,552.49,,,0 CDM,278C1713S1_195574,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8776.61,3510.64,,,0 CDM,278C1713S1_195579,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,149.62,59.85,,,0 CDM,278C1713S1_195581,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1606.5,642.6,,,0 CDM,278C1713S1_195582,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_195583,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2354.62,941.85,,,0 CDM,278C1713S1_195585,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_195586,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_195587,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_195588,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5835.38,2334.15,,,0 CDM,278C1713S1_195603,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,13863.94,5545.58,,,0 CDM,278C1713S1_195604,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6800.06,2720.02,,,0 CDM,278C1713S1_195607,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8174.25,3269.7,,,0 CDM,278C1713S1_195608,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,992.25,396.9,,,0 CDM,278C1713S1_195609,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,992.25,396.9,,,0 CDM,278C1713S1_195611,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.44,266.18,,,0 CDM,278C1713S1_195613,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,664.53,265.81,,,0 CDM,278C1713S1_195614,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,919.46,367.78,,,0 CDM,278C1713S1_195615,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,18525.94,7410.38,,,0 CDM,278C1713S1_195616,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,17907.75,7163.1,,,0 CDM,278C1713S1_195622,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,889.88,355.95,,,0 CDM,278C1713S1_195629,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,749.97,299.99,,,0 CDM,278C1713S1_195638,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,78.71,31.48,,,0 CDM,278C1713S1_195645,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,138.4,55.36,,,0 CDM,278C1713S1_195659,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_195660,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_195662,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,338.62,135.45,,,0 CDM,278C1713S1_195664,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_195665,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_195666,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1712.81,685.12,,,0 CDM,278C1713S1_195672,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,992.25,396.9,,,0 CDM,278C1713S1_195673,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8174.25,3269.7,,,0 CDM,278C1713S1_195692,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4705.31,1882.12,,,0 CDM,278C1713S1_195693,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1319.06,527.62,,,0 CDM,278C1713S1_195695,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1539.56,615.82,,,0 CDM,278C1713S1_195701,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,11792.81,4717.12,,,0 CDM,278C1713S1_195702,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,263.81,105.52,,,0 CDM,278C1713S1_195703,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,882.0,352.8,,,0 CDM,278C1713S1_195706,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4705.31,1882.12,,,0 CDM,278C1713S1_195708,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.44,266.18,,,0 CDM,278C1713S1_195714,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6524.44,2609.78,,,0 CDM,278C1713S1_195733,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,11206.12,4482.45,,,0 CDM,278C1713S1_195734,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,11206.12,4482.45,,,0 CDM,278C1713S1_195741,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6095.25,2438.1,,,0 CDM,278C1713S1_195742,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,452.81,181.12,,,0 CDM,278C1713S1_195743,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_195744,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_195746,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5626.69,2250.68,,,0 CDM,278C1713S1_195747,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_195748,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_195749,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,468.56,187.42,,,0 CDM,278C1713S1_195750,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,468.56,187.42,,,0 CDM,278C1713S1_195751,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1862.44,744.98,,,0 CDM,278C1713S1_195752,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_195753,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_195754,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,417.38,166.95,,,0 CDM,278C1713S1_195764,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1685.25,674.1,,,0 CDM,278C1713S1_195765,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,33019.88,13207.95,,,0 CDM,278C1713S1_195766,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,664.53,265.81,,,0 CDM,278C1713S1_195767,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,664.53,265.81,,,0 CDM,278C1713S1_195768,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,15572.81,6229.12,,,0 CDM,278C1713S1_195769,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8347.5,3339.0,,,0 CDM,278C1713S1_195770,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5556.6,2222.64,,,0 CDM,278C1713S1_195775,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1255.9,502.36,,,0 CDM,278C1713S1_195776,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,10548.56,4219.42,,,0 CDM,278C1713S1_195779,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.85,49.14,,,0 CDM,278C1713S1_195780,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.85,49.14,,,0 CDM,278C1713S1_195783,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.85,49.14,,,0 CDM,278C1713S1_195784,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.51,56.6,,,0 CDM,278C1713S1_195785,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.76,320.7,,,0 CDM,278C1713S1_195786,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.76,320.7,,,0 CDM,278C1713S1_195787,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,24267.68,9707.07,,,0 CDM,278C1713S1_195819,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1386.0,554.4,,,0 CDM,278C1713S1_195820,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1590.75,636.3,,,0 CDM,278C1713S1_195821,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_195846,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,114.19,45.68,,,0 CDM,278C1713S1_195847,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,114.19,45.68,,,0 CDM,278C1713S1_195848,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4744.69,1897.88,,,0 CDM,278C1713S1_195849,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_195850,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_195935,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7256.38,2902.55,,,0 CDM,278C1713S1_195938,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9546.51,3818.6,,,0 CDM,278C1713S1_195946,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1000.12,400.05,,,0 CDM,278C1713S1_195951,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,121.99,48.8,,,0 CDM,278C1713S1_195961,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,114.19,45.68,,,0 CDM,278C1713S1_195962,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8532.56,3413.02,,,0 CDM,278C1713S1_195970,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7634.81,3053.92,,,0 CDM,278C1713S1_195993,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_195998,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,618.19,247.28,,,0 CDM,278C1713S1_195999,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,263.81,105.52,,,0 CDM,278C1713S1_196000,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_196001,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_196037,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,611.5,244.6,,,0 CDM,278C1713S1_196038,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.66,30.66,,,0 CDM,278C1713S1_196039,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.66,30.66,,,0 CDM,278C1713S1_196040,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_196041,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_196062,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,28995.75,11598.3,,,0 CDM,278C1713S1_196066,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9591.75,3836.7,,,0 CDM,278C1713S1_196083,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,452.81,181.12,,,0 CDM,278C1713S1_196086,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5685.75,2274.3,,,0 CDM,278C1713S1_196088,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,937.12,374.85,,,0 CDM,278C1713S1_196103,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6453.56,2581.42,,,0 CDM,278C1713S1_196104,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,94.5,37.8,,,0 CDM,278C1713S1_196129,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_196130,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_196146,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1712.81,685.12,,,0 CDM,278C1713S1_196147,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6453.56,2581.42,,,0 CDM,278C1713S1_196148,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_196149,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5685.75,2274.3,,,0 CDM,278C1713S1_196182,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14364.0,5745.6,,,0 CDM,278C1713S1_196183,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_196194,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8532.56,3413.02,,,0 CDM,278C1713S1_196203,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.76,320.7,,,0 CDM,278C1713S1_196204,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,22914.79,9165.92,,,0 CDM,278C1713S1_196207,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2598.75,1039.5,,,0 CDM,278C1713S1_196208,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4744.69,1897.88,,,0 CDM,278C1713S1_196209,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_196210,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_196215,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6996.74,2798.7,,,0 CDM,278C1713S1_196225,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5855.06,2342.02,,,0 CDM,278C1713S1_196226,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_196227,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_196228,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,94.5,37.8,,,0 CDM,278C1713S1_196232,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,149.62,59.85,,,0 CDM,278C1713S1_196235,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_196239,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5178.28,2071.31,,,0 CDM,278C1713S1_196264,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_196265,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_196268,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_196282,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.85,49.14,,,0 CDM,278C1713S1_196283,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.85,49.14,,,0 CDM,278C1713S1_196284,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.76,320.7,,,0 CDM,278C1713S1_196285,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.76,320.7,,,0 CDM,278C1713S1_196297,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4165.88,1666.35,,,0 CDM,278C1713S1_196300,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,519.75,207.9,,,0 CDM,278C1713S1_196301,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,519.75,207.9,,,0 CDM,278C1713S1_196302,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,519.75,207.9,,,0 CDM,278C1713S1_196303,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1224.56,489.82,,,0 CDM,278C1713S1_196304,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4882.5,1953.0,,,0 CDM,278C1713S1_196305,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,11206.12,4482.45,,,0 CDM,278C1713S1_196306,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7634.81,3053.92,,,0 CDM,278C1713S1_196307,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_196319,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9020.81,3608.32,,,0 CDM,278C1713S1_196320,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_196337,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6933.94,2773.58,,,0 CDM,278C1713S1_196338,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6996.74,2798.7,,,0 CDM,278C1713S1_196380,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4165.88,1666.35,,,0 CDM,278C1713S1_196399,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8977.5,3591.0,,,0 CDM,278C1713S1_196403,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.06,48.82,,,0 CDM,278C1713S1_196409,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2488.5,995.4,,,0 CDM,278C1713S1_196411,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2579.06,1031.62,,,0 CDM,278C1713S1_196416,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8174.25,3269.7,,,0 CDM,278C1713S1_196423,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4311.56,1724.62,,,0 CDM,278C1713S1_196428,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_196455,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1381.24,552.5,,,0 CDM,278C1713S1_196456,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1015.17,406.07,,,0 CDM,278C1713S1_196458,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6748.88,2699.55,,,0 CDM,278C1713S1_196461,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2116.6,846.64,,,0 CDM,278C1713S1_196462,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,80.84,32.34,,,0 CDM,278C1713S1_196481,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5685.75,2274.3,,,0 CDM,278C1713S1_196482,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1795.5,718.2,,,0 CDM,278C1713S1_196483,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1795.5,718.2,,,0 CDM,278C1713S1_196484,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.76,320.7,,,0 CDM,278C1713S1_196485,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.76,320.7,,,0 CDM,278C1713S1_196486,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.76,320.7,,,0 CDM,278C1713S1_196487,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,22676.42,9070.57,,,0 CDM,278C1713S1_196493,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_196494,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_196495,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_196496,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_196497,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_196498,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_196510,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_196528,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1638.0,655.2,,,0 CDM,278C1713S1_196529,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_196541,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_196557,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.88,78.75,,,0 CDM,278C1713S1_196560,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3346.88,1338.75,,,0 CDM,278C1713S1_196561,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3346.88,1338.75,,,0 CDM,278C1713S1_196562,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3346.88,1338.75,,,0 CDM,278C1713S1_196570,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3346.88,1338.75,,,0 CDM,278C1713S1_196571,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3346.88,1338.75,,,0 CDM,278C1713S1_196577,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_196578,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_196605,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4358.81,1743.52,,,0 CDM,278C1713S1_196606,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_196607,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_196608,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,468.56,187.42,,,0 CDM,278C1713S1_196609,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,468.56,187.42,,,0 CDM,278C1713S1_196610,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,468.56,187.42,,,0 CDM,278C1713S1_196615,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,664.53,265.81,,,0 CDM,278C1713S1_196616,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,664.53,265.81,,,0 CDM,278C1713S1_196617,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_196618,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_196619,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_196621,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_196622,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_196623,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8174.25,3269.7,,,0 CDM,278C1713S1_196624,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.76,320.7,,,0 CDM,278C1713S1_196625,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.75,320.7,,,0 CDM,278C1713S1_196627,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,448.33,179.33,,,0 CDM,278C1713S1_196628,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,448.32,179.33,,,0 CDM,278C1713S1_196632,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1638.0,655.2,,,0 CDM,278C1713S1_196633,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,15659.44,6263.78,,,0 CDM,278C1713S1_196694,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4744.69,1897.88,,,0 CDM,278C1713S1_196696,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,882.0,352.8,,,0 CDM,278C1713S1_196699,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_196702,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.44,266.18,,,0 CDM,278C1713S1_196703,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,665.44,266.18,,,0 CDM,278C1713S1_196704,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5965.31,2386.12,,,0 CDM,278C1713S1_196705,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_196707,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_196709,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_196710,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_196711,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8174.25,3269.7,,,0 CDM,278C1713S1_196712,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1401.75,560.7,,,0 CDM,278C1713S1_196713,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1842.75,737.1,,,0 CDM,278C1713S1_196714,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1862.44,744.98,,,0 CDM,278C1713S1_196715,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_196716,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_196717,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_196718,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_196719,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,468.56,187.42,,,0 CDM,278C1713S1_196720,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,468.56,187.42,,,0 CDM,278C1713S1_196721,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,468.56,187.42,,,0 CDM,278C1713S1_196740,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7363.12,2945.25,,,0 CDM,278C1713S1_196774,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,17242.31,6896.92,,,0 CDM,278C1713S1_196780,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1840.39,736.16,,,0 CDM,278C1713S1_196790,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,109.94,43.98,,,0 CDM,278C1713S1_196792,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,953.43,381.37,,,0 CDM,278C1713S1_196793,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,953.43,381.37,,,0 CDM,278C1713S1_196794,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,716.94,286.78,,,0 CDM,278C1713S1_196795,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7363.28,2945.31,,,0 CDM,278C1713S1_196798,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,171.72,68.69,,,0 CDM,278C1713S1_196800,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2059.31,823.72,,,0 CDM,278C1713S1_196801,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2858.62,1143.45,,,0 CDM,278C1713S1_196805,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4165.88,1666.35,,,0 CDM,278C1713S1_196806,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4165.88,1666.35,,,0 CDM,278C1713S1_196807,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1319.06,527.62,,,0 CDM,278C1713S1_196808,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4705.31,1882.12,,,0 CDM,278C1713S1_196810,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.85,49.14,,,0 CDM,278C1713S1_196811,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.76,320.7,,,0 CDM,278C1713S1_196812,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.66,30.66,,,0 CDM,278C1713S1_196813,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.51,56.6,,,0 CDM,278C1713S1_196814,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.85,49.14,,,0 CDM,278C1713S1_196815,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.76,320.7,,,0 CDM,278C1713S1_196831,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3870.56,1548.22,,,0 CDM,278C1713S1_196832,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_196845,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_196846,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_196847,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_196848,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,594.56,237.82,,,0 CDM,278C1713S1_196860,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_196861,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_196862,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5685.75,2274.3,,,0 CDM,278C1713S1_196870,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_196871,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2858.62,1143.45,,,0 CDM,278C1713S1_196872,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5556.6,2222.64,,,0 CDM,278C1713S1_196904,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,15659.44,6263.78,,,0 CDM,278C1713S1_196908,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6996.74,2798.7,,,0 CDM,278C1713S1_196910,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,664.53,265.81,,,0 CDM,278C1713S1_196914,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_196943,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,351.58,140.63,,,0 CDM,278C1713S1_196944,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,351.58,140.63,,,0 CDM,278C1713S1_196945,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4601.84,1840.74,,,0 CDM,278C1713S1_196947,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,114.19,45.68,,,0 CDM,278C1713S1_196948,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,114.19,45.68,,,0 CDM,278C1713S1_196971,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8174.25,3269.7,,,0 CDM,278C1713S1_196994,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1614.38,645.75,,,0 CDM,278C1713S1_196995,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_197031,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,15572.81,6229.12,,,0 CDM,278C1713S1_197032,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_197034,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_197045,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5685.75,2274.3,,,0 CDM,278C1713S1_197050,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6996.74,2798.7,,,0 CDM,278C1713S1_197053,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_197057,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6996.74,2798.7,,,0 CDM,278C1713S1_197058,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,23778.13,9511.25,,,0 CDM,278C1713S1_197060,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4197.38,1678.95,,,0 CDM,278C1713S1_197062,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_197063,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_197064,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_197073,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,653.62,261.45,,,0 CDM,278C1713S1_197078,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,11812.5,4725.0,,,0 CDM,278C1713S1_197079,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,11812.5,4725.0,,,0 CDM,278C1713S1_197097,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_197098,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6748.88,2699.55,,,0 CDM,278C1713S1_197099,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6398.44,2559.38,,,0 CDM,278C1713S1_197111,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_197134,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4744.69,1897.88,,,0 CDM,278C1713S1_197135,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_197138,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_197139,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_197140,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_197141,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_197145,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,919.96,367.98,,,0 CDM,278C1713S1_197146,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_197147,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_197148,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2819.25,1127.7,,,0 CDM,278C1713S1_197149,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_197150,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_197151,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_197326,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8174.25,3269.7,,,0 CDM,278C1713S1_197327,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,882.0,352.8,,,0 CDM,278C1713S1_197357,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8575.88,3430.35,,,0 CDM,278C1713S1_197359,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_197364,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.66,30.66,,,0 CDM,278C1713S1_197365,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.76,320.7,,,0 CDM,278C1713S1_197367,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,653.62,261.45,,,0 CDM,278C1713S1_197368,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,653.62,261.45,,,0 CDM,278C1713S1_197424,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2291.62,916.65,,,0 CDM,278C1713S1_197425,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_197426,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_197427,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_197428,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_197429,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,468.56,187.42,,,0 CDM,278C1713S1_197430,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3630.38,1452.15,,,0 CDM,278C1713S1_197431,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5685.75,2274.3,,,0 CDM,278C1713S1_197433,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8438.06,3375.22,,,0 CDM,278C1713S1_197434,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7225.31,2890.12,,,0 CDM,278C1713S1_197435,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_197438,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,417.38,166.95,,,0 CDM,278C1713S1_197441,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4744.69,1897.88,,,0 CDM,278C1713S1_197447,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.76,320.7,,,0 CDM,278C1713S1_197448,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,21515.17,8606.07,,,0 CDM,278C1713S1_197449,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,402.61,161.04,,,0 CDM,278C1713S1_197469,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4358.81,1743.52,,,0 CDM,278C1713S1_197470,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,468.56,187.42,,,0 CDM,278C1713S1_197471,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,468.56,187.42,,,0 CDM,278C1713S1_197472,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_197482,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4197.38,1678.95,,,0 CDM,278C1713S1_197483,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_197485,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6996.74,2798.7,,,0 CDM,278C1713S1_197518,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1100.54,440.22,,,0 CDM,278C1713S1_197521,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5178.28,2071.31,,,0 CDM,278C1713S1_197524,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8922.38,3568.95,,,0 CDM,278C1713S1_197532,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5685.75,2274.3,,,0 CDM,278C1713S1_197534,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.06,48.82,,,0 CDM,278C1713S1_197535,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,10107.56,4043.02,,,0 CDM,278C1713S1_197546,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_197547,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_197549,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6748.88,2699.55,,,0 CDM,278C1713S1_197558,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,17143.88,6857.55,,,0 CDM,278C1713S1_197577,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7091.44,2836.58,,,0 CDM,278C1713S1_197578,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_197587,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,783.56,313.42,,,0 CDM,278C1713S1_197616,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2807.44,1122.98,,,0 CDM,278C1713S1_197618,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1667.61,667.04,,,0 CDM,278C1713S1_197651,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,12859.88,5143.95,,,0 CDM,278C1713S1_197653,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8485.31,3394.12,,,0 CDM,278C1713S1_197656,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4602.94,1841.18,,,0 CDM,278C1713S1_197657,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_197658,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,736.31,294.52,,,0 CDM,278C1713S1_197668,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,209.48,83.79,,,0 CDM,278C1713S1_197670,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,16348.5,6539.4,,,0 CDM,278C1713S1_197672,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8922.38,3568.95,,,0 CDM,278C1713S1_197692,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_197693,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_197697,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,677.09,270.84,,,0 CDM,278C1713S1_197698,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,757.5,303.0,,,0 CDM,278C1713S1_197707,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7634.81,3053.92,,,0 CDM,278C1713S1_197708,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,114.19,45.68,,,0 CDM,278C1713S1_197711,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.85,49.14,,,0 CDM,278C1713S1_197712,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4978.42,1991.37,,,0 CDM,278C1713S1_197724,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,827.7,331.08,,,0 CDM,278C1713S1_197725,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1480.5,592.2,,,0 CDM,278C1713S1_197726,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1519.88,607.95,,,0 CDM,278C1713S1_197747,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_197781,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,94.5,37.8,,,0 CDM,278C1713S1_197786,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,17533.69,7013.48,,,0 CDM,278C1713S1_197800,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,882.0,352.8,,,0 CDM,278C1713S1_197801,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,882.0,352.8,,,0 CDM,278C1713S1_197802,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,882.0,352.8,,,0 CDM,278C1713S1_197803,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,882.0,352.8,,,0 CDM,278C1713S1_197804,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,882.0,352.8,,,0 CDM,278C1713S1_197812,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.76,45.5,,,0 CDM,278C1713S1_197814,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6996.74,2798.7,,,0 CDM,278C1713S1_197815,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6996.74,2798.7,,,0 CDM,278C1713S1_197820,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.44,45.38,,,0 CDM,278C1713S1_197821,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.44,45.38,,,0 CDM,278C1713S1_197822,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,368.55,147.42,,,0 CDM,278C1713S1_197823,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,368.55,147.42,,,0 CDM,278C1713S1_197824,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2349.39,939.76,,,0 CDM,278C1713S1_197828,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_197829,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_197848,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,94.5,37.8,,,0 CDM,278C1713S1_197849,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,94.5,37.8,,,0 CDM,278C1713S1_197857,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.8,47.52,,,0 CDM,278C1713S1_197858,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,351.58,140.63,,,0 CDM,278C1713S1_197859,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,351.58,140.63,,,0 CDM,278C1713S1_197860,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4356.22,1742.49,,,0 CDM,278C1713S1_197863,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,81.71,32.68,,,0 CDM,278C1713S1_197864,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,81.7,32.68,,,0 CDM,278C1713S1_197865,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,81.7,32.68,,,0 CDM,278C1713S1_197871,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8347.5,3339.0,,,0 CDM,278C1713S1_197875,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_197876,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_197900,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_197901,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_197902,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_197905,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_197907,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1209.33,483.73,,,0 CDM,278C1713S1_197908,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1209.33,483.73,,,0 CDM,278C1713S1_198023,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1284.14,513.66,,,0 CDM,278C1713S1_198024,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2977.34,1190.94,,,0 CDM,278C1713S1_198051,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1145.81,458.32,,,0 CDM,278C1713S1_198052,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1145.81,458.32,,,0 CDM,278C1713S1_198053,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1145.81,458.32,,,0 CDM,278C1713S1_198054,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1145.81,458.32,,,0 CDM,278C1713S1_198055,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1145.81,458.32,,,0 CDM,278C1713S1_198066,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1145.81,458.32,,,0 CDM,278C1713S1_198076,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_198100,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_198101,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,618.19,247.28,,,0 CDM,278C1713S1_198102,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2866.5,1146.6,,,0 CDM,278C1713S1_198103,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7497.0,2998.8,,,0 CDM,278C1713S1_198104,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_198105,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_198106,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_198107,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_198108,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_198109,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.69,209.48,,,0 CDM,278C1713S1_198112,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,567.0,226.8,,,0 CDM,278C1713S1_198113,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4705.31,1882.12,,,0 CDM,278C1713S1_198116,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4705.31,1882.12,,,0 CDM,278C1713S1_198117,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4705.31,1882.12,,,0 CDM,278C1713S1_198118,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,19852.88,7941.15,,,0 CDM,278C1713S1_198119,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5591.25,2236.5,,,0 CDM,278C1713S1_198132,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_198133,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,103.79,41.52,,,0 CDM,278C1713S1_198135,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,103.79,41.52,,,0 CDM,278C1713S1_198136,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,103.79,41.52,,,0 CDM,278C1713S1_198137,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.44,45.38,,,0 CDM,278C1713S1_198138,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.44,45.38,,,0 CDM,278C1713S1_198139,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.8,47.52,,,0 CDM,278C1713S1_198140,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,351.58,140.63,,,0 CDM,278C1713S1_198141,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1694.38,677.75,,,0 CDM,278C1713S1_198142,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.44,45.38,,,0 CDM,278C1713S1_198146,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2508.19,1003.28,,,0 CDM,278C1713S1_198147,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5685.75,2274.3,,,0 CDM,278C1713S1_198153,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_198160,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5619.8,2247.92,,,0 CDM,278C1713S1_198163,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1220.47,488.19,,,0 CDM,278C1713S1_198164,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_198179,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1606.5,642.6,,,0 CDM,278C1713S1_198197,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1992.38,796.95,,,0 CDM,278C1713S1_198198,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8422.31,3368.92,,,0 CDM,278C1713S1_198199,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,94.5,37.8,,,0 CDM,278C1713S1_198220,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5382.56,2153.02,,,0 CDM,278C1713S1_198221,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3051.56,1220.62,,,0 CDM,278C1713S1_198226,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5488.88,2195.55,,,0 CDM,278C1713S1_198228,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5689.69,2275.88,,,0 CDM,278C1713S1_198229,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_198230,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_198233,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,189.0,75.6,,,0 CDM,278C1713S1_198234,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,12560.62,5024.25,,,0 CDM,278C1713S1_198243,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4358.81,1743.52,,,0 CDM,278C1713S1_198244,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_198245,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_198261,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,94.5,37.8,,,0 CDM,278C1713S1_198263,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7256.38,2902.55,,,0 CDM,278C1713S1_198265,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1209.33,483.73,,,0 CDM,278C1713S1_198267,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_198268,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_198270,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1000.12,400.05,,,0 CDM,278C1713S1_198275,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,10962.0,4384.8,,,0 CDM,278C1713S1_198297,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,149.62,59.85,,,0 CDM,278C1713S1_198315,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9591.75,3836.7,,,0 CDM,278C1713S1_198316,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3256.31,1302.52,,,0 CDM,278C1713S1_198323,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.8,47.52,,,0 CDM,278C1713S1_198326,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4356.22,1742.49,,,0 CDM,278C1713S1_198329,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9591.75,3836.7,,,0 CDM,278C1713S1_198340,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7426.12,2970.45,,,0 CDM,278C1713S1_198343,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7225.31,2890.12,,,0 CDM,278C1713S1_198359,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14096.25,5638.5,,,0 CDM,278C1713S1_198378,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5362.88,2145.15,,,0 CDM,278C1713S1_198379,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_198380,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_198381,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_198382,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_198383,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,504.0,201.6,,,0 CDM,278C1713S1_198391,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,11099.02,4439.61,,,0 CDM,278C1713S1_198394,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_198407,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6933.94,2773.58,,,0 CDM,278C1713S1_198412,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.66,30.66,,,0 CDM,278C1713S1_198413,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2561.58,1024.63,,,0 CDM,278C1713S1_198414,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,103.79,41.52,,,0 CDM,278C1713S1_198432,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4524.19,1809.68,,,0 CDM,278C1713S1_198437,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5685.75,2274.3,,,0 CDM,278C1713S1_198439,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6996.74,2798.7,,,0 CDM,278C1713S1_198440,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5685.75,2274.3,,,0 CDM,278C1713S1_198441,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,19463.06,7785.22,,,0 CDM,278C1713S1_198446,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6996.74,2798.7,,,0 CDM,278C1713S1_198447,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7815.94,3126.38,,,0 CDM,278C1713S1_198494,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4862.81,1945.12,,,0 CDM,278C1713S1_198495,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7091.44,2836.58,,,0 CDM,278C1713S1_198497,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_198515,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.44,45.38,,,0 CDM,278C1713S1_198516,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.8,47.52,,,0 CDM,278C1713S1_198517,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4051.57,1620.63,,,0 CDM,278C1713S1_198537,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5478.28,2191.31,,,0 CDM,278C1713S1_198567,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6996.74,2798.7,,,0 CDM,278C1713S1_198569,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7256.38,2902.55,,,0 CDM,278C1713S1_198571,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,618.19,247.28,,,0 CDM,278C1713S1_198572,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,618.19,247.28,,,0 CDM,278C1713S1_198582,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,953.43,381.37,,,0 CDM,278C1713S1_198588,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5685.75,2274.3,,,0 CDM,278C1713S1_198626,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,936.42,374.57,,,0 CDM,278C1713S1_198627,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2488.5,995.4,,,0 CDM,278C1713S1_198628,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_198652,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8174.25,3269.7,,,0 CDM,278C1713S1_198653,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1236.38,494.55,,,0 CDM,278C1713S1_198655,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_198675,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_198676,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2858.62,1143.45,,,0 CDM,278C1713S1_198686,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_198687,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7091.44,2836.58,,,0 CDM,278C1713S1_198710,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4705.31,1882.12,,,0 CDM,278C1713S1_198711,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1795.5,718.2,,,0 CDM,278C1713S1_198712,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1795.5,718.2,,,0 CDM,278C1713S1_198713,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2799.56,1119.82,,,0 CDM,278C1713S1_198714,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,338.62,135.45,,,0 CDM,278C1713S1_198722,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,12694.5,5077.8,,,0 CDM,278C1713S1_198726,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,10367.44,4146.98,,,0 CDM,278C1713S1_198727,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3094.88,1237.95,,,0 CDM,278C1713S1_198731,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,628.38,251.35,,,0 CDM,278C1713S1_198744,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.8,47.52,,,0 CDM,278C1713S1_198745,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.66,30.66,,,0 CDM,278C1713S1_198746,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4601.84,1840.74,,,0 CDM,278C1713S1_198747,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2807.44,1122.98,,,0 CDM,278C1713S1_198748,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_198758,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,149.62,59.85,,,0 CDM,278C1713S1_198769,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_198770,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_198772,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1197.08,478.83,,,0 CDM,278C1713S1_198780,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1065.49,426.2,,,0 CDM,278C1713S1_198781,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1795.5,718.2,,,0 CDM,278C1713S1_198782,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1795.5,718.2,,,0 CDM,278C1713S1_198830,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1386.0,554.4,,,0 CDM,278C1713S1_198848,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1197.08,478.83,,,0 CDM,278C1713S1_198863,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4524.19,1809.68,,,0 CDM,278C1713S1_198891,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,259.92,103.97,,,0 CDM,278C1713S1_198893,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,98.44,39.38,,,0 CDM,278C1713S1_198903,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4358.81,1743.52,,,0 CDM,278C1713S1_198904,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_198905,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7256.38,2902.55,,,0 CDM,278C1713S1_198910,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,677.09,270.84,,,0 CDM,278C1713S1_198911,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,677.09,270.84,,,0 CDM,278C1713S1_198912,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,113.44,45.38,,,0 CDM,278C1713S1_198913,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2082.74,833.1,,,0 CDM,278C1713S1_198914,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5055.0,2022.0,,,0 CDM,278C1713S1_198934,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_198935,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_198936,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_198946,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,114.19,45.68,,,0 CDM,278C1713S1_198947,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_198956,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1968.75,787.5,,,0 CDM,278C1713S1_198957,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14486.06,5794.42,,,0 CDM,278C1713S1_198958,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6831.56,2732.62,,,0 CDM,278C1713S1_198959,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9776.81,3910.72,,,0 CDM,278C1713S1_198960,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,685.12,274.05,,,0 CDM,278C1713S1_198961,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,689.06,275.62,,,0 CDM,278C1713S1_198962,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,446.51,178.6,,,0 CDM,278C1713S1_198963,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,689.06,275.62,,,0 CDM,278C1713S1_198964,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,446.51,178.6,,,0 CDM,278C1713S1_198965,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,446.51,178.6,,,0 CDM,278C1713S1_198966,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,446.51,178.6,,,0 CDM,278C1713S1_198967,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4705.31,1882.12,,,0 CDM,278C1713S1_198977,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4882.5,1953.0,,,0 CDM,278C1713S1_198978,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,811.71,324.68,,,0 CDM,278C1713S1_198979,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,811.71,324.68,,,0 CDM,278C1713S1_198980,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_198981,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_198982,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_198983,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_198984,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_198985,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_198990,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8174.25,3269.7,,,0 CDM,278C1713S1_198991,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1224.56,489.82,,,0 CDM,278C1713S1_198992,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7252.88,2901.15,,,0 CDM,278C1713S1_198993,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1386.0,554.4,,,0 CDM,278C1713S1_198994,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1956.94,782.78,,,0 CDM,278C1713S1_198995,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_198996,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,318.94,127.58,,,0 CDM,278C1713S1_198997,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.06,48.82,,,0 CDM,278C1713S1_198998,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_198999,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2898.0,1159.2,,,0 CDM,278C1713S1_199000,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_199001,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_199002,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5685.75,2274.3,,,0 CDM,278C1713S1_199012,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4744.69,1897.88,,,0 CDM,278C1713S1_199014,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_199055,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,547.31,218.92,,,0 CDM,278C1713S1_199059,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1311.19,524.48,,,0 CDM,278C1713S1_199060,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4744.69,1897.88,,,0 CDM,278C1713S1_199061,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.06,225.22,,,0 CDM,278C1713S1_199063,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,10611.56,4244.62,,,0 CDM,278C1713S1_199064,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,10611.56,4244.62,,,0 CDM,278C1713S1_199065,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,10611.56,4244.62,,,0 CDM,278C1713S1_199079,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_199080,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1842.75,737.1,,,0 CDM,278C1713S1_199089,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14812.88,5925.15,,,0 CDM,278C1713S1_199090,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,141.75,56.7,,,0 CDM,278C1713S1_199104,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7256.38,2902.55,,,0 CDM,278C1713S1_199106,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4705.31,1882.12,,,0 CDM,278C1713S1_199125,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4165.88,1666.35,,,0 CDM,278C1713S1_199130,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,10611.56,4244.62,,,0 CDM,278C1713S1_199131,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,10611.56,4244.62,,,0 CDM,278C1713S1_199149,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,677.09,270.84,,,0 CDM,278C1713S1_199154,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,315.0,126.0,,,0 CDM,278C1713S1_199155,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,315.0,126.0,,,0 CDM,278C1713S1_199156,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4358.81,1743.52,,,0 CDM,278C1713S1_199183,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4996.69,1998.68,,,0 CDM,278C1713S1_199184,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5362.88,2145.15,,,0 CDM,278C1713S1_199187,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4705.31,1882.12,,,0 CDM,278C1713S1_199190,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,338.62,135.45,,,0 CDM,278C1713S1_199191,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1956.94,782.78,,,0 CDM,278C1713S1_199192,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,468.56,187.42,,,0 CDM,278C1713S1_199210,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,114.19,45.68,,,0 CDM,278C1713S1_199211,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8304.19,3321.68,,,0 CDM,278C1713S1_199212,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4705.31,1882.12,,,0 CDM,278C1713S1_199213,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_199215,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1255.9,502.36,,,0 CDM,278C1713S1_199216,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,811.12,324.45,,,0 CDM,278C1713S1_199217,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,889.88,355.95,,,0 CDM,278C1713S1_199228,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.8,47.52,,,0 CDM,278C1713S1_199229,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.8,47.52,,,0 CDM,278C1713S1_199230,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,164.08,65.63,,,0 CDM,278C1713S1_199231,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2133.22,853.29,,,0 CDM,278C1713S1_199247,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2583.0,1033.2,,,0 CDM,278C1713S1_199248,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_199249,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2468.81,987.52,,,0 CDM,278C1713S1_199250,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7225.31,2890.12,,,0 CDM,278C1713S1_199251,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,114.19,45.68,,,0 CDM,278C1713S1_199276,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2760.19,1104.08,,,0 CDM,278C1713S1_199277,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3768.19,1507.28,,,0 CDM,278C1713S1_199278,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.06,48.82,,,0 CDM,278C1713S1_199283,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_199284,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_199286,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.17,47.27,,,0 CDM,278C1713S1_199287,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9546.51,3818.6,,,0 CDM,278C1713S1_199288,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,94.5,37.8,,,0 CDM,278C1713S1_199332,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3740.62,1496.25,,,0 CDM,278C1713S1_199353,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_199354,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_199355,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,70.88,28.35,,,0 CDM,278C1713S1_199356,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4705.31,1882.12,,,0 CDM,278C1713S1_199374,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,801.76,320.7,,,0 CDM,278C1713S1_199375,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,22914.79,9165.92,,,0 CDM,278C1713S1_199377,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8174.25,3269.7,,,0 CDM,278C1713S1_199378,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,992.25,396.9,,,0 CDM,278C1713S1_199388,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8174.25,3269.7,,,0 CDM,278C1713S1_199389,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4705.31,1882.12,,,0 CDM,278C1713S1_199401,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5425.88,2170.35,,,0 CDM,278C1713S1_199402,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2488.5,995.4,,,0 CDM,278C1713S1_199403,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,732.38,292.95,,,0 CDM,278C1713S1_199405,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,519.75,207.9,,,0 CDM,278C1713S1_199407,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8174.25,3269.7,,,0 CDM,278C1713S1_199420,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4358.81,1743.52,,,0 CDM,278C1713S1_199421,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4705.31,1882.12,,,0 CDM,278C1713S1_199428,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,882.0,352.8,,,0 CDM,278C1713S1_199429,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9591.75,3836.7,,,0 CDM,278C1713S1_199439,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,618.19,247.28,,,0 CDM,278C1713S1_199448,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,14541.19,5816.48,,,0 CDM,278C1713S1_199449,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9788.62,3915.45,,,0 CDM,278C1713S1_199451,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,567.0,226.8,,,0 CDM,278C1713S1_199452,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_199453,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_199454,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2779.88,1111.95,,,0 CDM,278C1713S1_199455,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3756.38,1502.55,,,0 CDM,278C1713S1_199475,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_199476,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_199477,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,157.5,63.0,,,0 CDM,278C1713S1_199478,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,468.56,187.42,,,0 CDM,278C1713S1_199504,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,149.62,59.85,,,0 CDM,278C1713S1_199506,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_199507,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_199508,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_199509,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1405.69,562.28,,,0 CDM,278C1713S1_199516,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,8174.25,3269.7,,,0 CDM,278C1713S1_199520,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,149.62,59.85,,,0 CDM,278C1713S1_199543,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5382.56,2153.02,,,0 CDM,278C1713S1_199544,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,429.19,171.68,,,0 CDM,278C1713S1_199545,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5922.0,2368.8,,,0 CDM,278C1713S1_199577,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,94.5,37.8,,,0 CDM,278C1713S1_199617,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,218.69,87.48,,,0 CDM,278C1713S1_199618,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3867.1,1546.84,,,0 CDM,278C1713S1_199620,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5574.4,2229.76,,,0 CDM,278C1713S1_199621,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,89.26,35.7,,,0 CDM,278C1713S1_199622,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,218.69,87.48,,,0 CDM,278C1713S1_199624,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.67,30.67,,,0 CDM,278C1713S1_199670,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1886.06,754.42,,,0 CDM,278C1713S1_199671,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,945.0,378.0,,,0 CDM,278C1713S1_83850,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1134.9,453.96,,,0 CDM,278C1713S1_83854,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,563.81,225.52,,,0 CDM,278C1713S1_83856,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1322.84,529.14,,,0 CDM,278C1713S1_83857,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,667.25,266.9,,,0 CDM,278C1713S1_83860,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,651.22,260.49,,,0 CDM,278C1713S1_83861,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,667.25,266.9,,,0 CDM,278C1713S1_83916,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,180.65,72.26,,,0 CDM,278C1713S1_83917,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,145.64,58.26,,,0 CDM,278C1713S1_83918,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,137.92,55.17,,,0 CDM,278C1713S1_83919,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,116.55,46.62,,,0 CDM,278C1713S1_83929,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,180.65,72.26,,,0 CDM,278C1713S1_83930,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,180.65,72.26,,,0 CDM,278C1713S1_83936,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,180.65,72.26,,,0 CDM,278C1713S1_83947,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,451.64,180.66,,,0 CDM,278C1713S1_83951,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1134.9,453.96,,,0 CDM,278C1713S1_83956,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1848.78,739.51,,,0 CDM,278C1713S1_83960,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,34.05,13.62,,,0 CDM,278C1713S1_83961,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,34.03,13.61,,,0 CDM,278C1713S1_83962,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,34.37,13.75,,,0 CDM,278C1713S1_83963,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,34.14,13.66,,,0 CDM,278C1713S1_84021,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,449.19,179.68,,,0 CDM,278C1713S1_84049,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6590.43,2636.17,,,0 CDM,278C1713S1_84055,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,446.61,178.64,,,0 CDM,278C1713S1_84075,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,330.16,132.06,,,0 CDM,278C1713S1_84076,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,330.16,132.06,,,0 CDM,278C1713S1_84077,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,381.75,152.7,,,0 CDM,278C1713S1_84078,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,390.05,156.02,,,0 CDM,278C1713S1_84080,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,386.45,154.58,,,0 CDM,278C1713S1_84081,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,376.2,150.48,,,0 CDM,278C1713S1_84082,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,432.96,173.18,,,0 CDM,278C1713S1_84083,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,433.08,173.23,,,0 CDM,278C1713S1_84085,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,372.49,149.0,,,0 CDM,278C1713S1_84089,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,333.23,133.29,,,0 CDM,278C1713S1_84157,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1292.48,516.99,,,0 CDM,278C1713S1_84180,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,46.94,18.78,,,0 CDM,278C1713S1_84183,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,21.78,8.71,,,0 CDM,278C1713S1_84184,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,21.78,8.71,,,0 CDM,278C1713S1_84191,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,25.59,10.24,,,0 CDM,278C1713S1_84193,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,46.94,18.78,,,0 CDM,278C1713S1_84196,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,27.72,11.09,,,0 CDM,278C1713S1_84302,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,574.56,229.82,,,0 CDM,278C1713S1_84303,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,574.56,229.82,,,0 CDM,278C1713S1_84377,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3749.76,1499.9,,,0 CDM,278C1713S1_84459,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,669.38,267.75,,,0 CDM,278C1713S1_84607,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,935.55,374.22,,,0 CDM,278C1713S1_84608,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,935.55,374.22,,,0 CDM,278C1713S1_84609,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,909.76,363.9,,,0 CDM,278C1713S1_84610,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,955.4,382.16,,,0 CDM,278C1713S1_84611,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,935.55,374.22,,,0 CDM,278C1713S1_84612,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,935.55,374.22,,,0 CDM,278C1713S1_84613,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,935.55,374.22,,,0 CDM,278C1713S1_84615,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,935.55,374.22,,,0 CDM,278C1713S1_84617,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,935.55,374.22,,,0 CDM,278C1713S1_84618,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,935.55,374.22,,,0 CDM,278C1713S1_84619,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,935.55,374.22,,,0 CDM,278C1713S1_84699,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,211.25,84.5,,,0 CDM,278C1713S1_84700,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,211.25,84.5,,,0 CDM,278C1713S1_84707,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,765.45,306.18,,,0 CDM,278C1713S1_84709,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,765.45,306.18,,,0 CDM,278C1713S1_84710,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,765.45,306.18,,,0 CDM,278C1713S1_84936,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,340.91,136.36,,,0 CDM,278C1713S1_84974,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2648.99,1059.6,,,0 CDM,278C1713S1_84975,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2648.99,1059.6,,,0 CDM,278C1713S1_85162,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,537.84,215.14,,,0 CDM,278C1713S1_85164,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,537.08,214.83,,,0 CDM,278C1713S1_85210,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,164.63,65.85,,,0 CDM,278C1713S1_85225,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,55.21,22.08,,,0 CDM,278C1713S1_85300,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,391.9,156.76,,,0 CDM,278C1713S1_85359,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1743.88,697.55,,,0 CDM,278C1713S1_85362,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1917.25,766.9,,,0 CDM,278C1713S1_85367,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1574.88,629.95,,,0 CDM,278C1713S1_85476,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,708.75,283.5,,,0 CDM,278C1713S1_85504,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,47.13,18.85,,,0 CDM,278C1713S1_85551,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,516.64,206.66,,,0 CDM,278C1713S1_85552,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,670.48,268.19,,,0 CDM,278C1713S1_85562,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,670.48,268.19,,,0 CDM,278C1713S1_85577,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,693.16,277.26,,,0 CDM,278C1713S1_85587,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,708.75,283.5,,,0 CDM,278C1713S1_85589,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,708.75,283.5,,,0 CDM,278C1713S1_85590,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,708.75,283.5,,,0 CDM,278C1713S1_85594,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,708.75,283.5,,,0 CDM,278C1713S1_85605,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,708.75,283.5,,,0 CDM,278C1713S1_85609,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,708.75,283.5,,,0 CDM,278C1713S1_85610,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,708.75,283.5,,,0 CDM,278C1713S1_85611,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,708.75,283.5,,,0 CDM,278C1713S1_85612,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,708.75,283.5,,,0 CDM,278C1713S1_85637,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,747.02,298.81,,,0 CDM,278C1713S1_85640,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,747.02,298.81,,,0 CDM,278C1713S1_85641,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,747.02,298.81,,,0 CDM,278C1713S1_85649,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,565.9,226.36,,,0 CDM,278C1713S1_85650,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,747.02,298.81,,,0 CDM,278C1713S1_85651,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,210.82,84.33,,,0 CDM,278C1713S1_85652,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,765.45,306.18,,,0 CDM,278C1713S1_85653,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,765.45,306.18,,,0 CDM,278C1713S1_85654,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,765.45,306.18,,,0 CDM,278C1713S1_85655,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,765.45,306.18,,,0 CDM,278C1713S1_85660,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,269.52,107.81,,,0 CDM,278C1713S1_85696,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,722.61,289.04,,,0 CDM,278C1713S1_85697,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,722.61,289.04,,,0 CDM,278C1713S1_85698,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,754.67,301.87,,,0 CDM,278C1713S1_85710,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1574.84,629.94,,,0 CDM,278C1713S1_85717,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,204.44,81.78,,,0 CDM,278C1713S1_85731,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,435.92,174.37,,,0 CDM,278C1713S1_85762,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,24.61,9.84,,,0 CDM,278C1713S1_85763,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,24.61,9.84,,,0 CDM,278C1713S1_85839,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,968.62,387.45,,,0 CDM,278C1713S1_85840,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1034.78,413.91,,,0 CDM,278C1713S1_85841,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,955.4,382.16,,,0 CDM,278C1713S1_85842,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,935.55,374.22,,,0 CDM,278C1713S1_85843,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,952.09,380.84,,,0 CDM,278C1713S1_85844,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,935.55,374.22,,,0 CDM,278C1713S1_85845,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,935.55,374.22,,,0 CDM,278C1713S1_85855,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,810.34,324.14,,,0 CDM,278C1713S1_85856,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,810.34,324.14,,,0 CDM,278C1713S1_85893,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,911.92,364.77,,,0 CDM,278C1713S1_85950,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,645.39,258.16,,,0 CDM,278C1713S1_85952,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,694.93,277.97,,,0 CDM,278C1713S1_85954,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2648.99,1059.6,,,0 CDM,278C1713S1_85956,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2648.99,1059.6,,,0 CDM,278C1713S1_85969,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,201.62,80.65,,,0 CDM,278C1713S1_85991,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,765.45,306.18,,,0 CDM,278C1713S1_85992,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,765.45,306.18,,,0 CDM,278C1713S1_85993,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,765.45,306.18,,,0 CDM,278C1713S1_86148,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,84.87,33.95,,,0 CDM,278C1713S1_86372,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,859.56,343.82,,,0 CDM,278C1713S1_86373,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,826.75,330.7,,,0 CDM,278C1713S1_86715,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,752.51,301.0,,,0 CDM,278C1713S1_86815,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,356.94,142.78,,,0 CDM,278C1713S1_86901,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,755.53,302.21,,,0 CDM,278C1713S1_86975,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,505.41,202.16,,,0 CDM,278C1713S1_86990,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,649.69,259.88,,,0 CDM,278C1713S1_87001,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,470.16,188.06,,,0 CDM,278C1713S1_87031,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,204.1,81.64,,,0 CDM,278C1713S1_87032,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,216.29,86.52,,,0 CDM,278C1713S1_87033,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,218.54,87.42,,,0 CDM,278C1713S1_87034,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,218.54,87.42,,,0 CDM,278C1713S1_87035,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,218.53,87.41,,,0 CDM,278C1713S1_87036,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,218.53,87.41,,,0 CDM,278C1713S1_87037,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,218.54,87.42,,,0 CDM,278C1713S1_87040,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.68,78.67,,,0 CDM,278C1713S1_87041,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.68,78.67,,,0 CDM,278C1713S1_87042,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,195.26,78.1,,,0 CDM,278C1713S1_87043,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,191.67,76.67,,,0 CDM,278C1713S1_87044,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.68,78.67,,,0 CDM,278C1713S1_87045,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.68,78.67,,,0 CDM,278C1713S1_87046,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,147.46,58.98,,,0 CDM,278C1713S1_87047,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,154.43,61.77,,,0 CDM,278C1713S1_87048,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,154.43,61.77,,,0 CDM,278C1713S1_87049,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,154.43,61.77,,,0 CDM,278C1713S1_87050,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,154.43,61.77,,,0 CDM,278C1713S1_87051,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,154.43,61.77,,,0 CDM,278C1713S1_87052,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,154.43,61.77,,,0 CDM,278C1713S1_87053,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,180.65,72.26,,,0 CDM,278C1713S1_87060,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,180.65,72.26,,,0 CDM,278C1713S1_87066,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,396.25,158.5,,,0 CDM,278C1713S1_87378,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2304.82,921.93,,,0 CDM,278C1713S1_87391,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,154.43,61.77,,,0 CDM,278C1713S1_87498,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1574.88,629.95,,,0 CDM,278C1713S1_87499,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1574.88,629.95,,,0 CDM,278C1713S1_87500,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1595.19,638.08,,,0 CDM,278C1713S1_87524,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,456.0,182.4,,,0 CDM,278C1713S1_87525,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,456.0,182.4,,,0 CDM,278C1713S1_87527,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,374.9,149.96,,,0 CDM,278C1713S1_87569,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_87570,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_87571,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_87572,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_87573,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_87574,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_87578,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,529.59,211.84,,,0 CDM,278C1713S1_87587,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_87608,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_87609,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_87610,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_87611,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,76.35,30.54,,,0 CDM,278C1713S1_87841,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1047.45,418.98,,,0 CDM,278C1713S1_87947,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6404.42,2561.77,,,0 CDM,278C1713S1_87993,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.68,78.67,,,0 CDM,278C1713S1_87994,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.68,78.67,,,0 CDM,278C1713S1_87995,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.68,78.67,,,0 CDM,278C1713S1_87996,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.68,78.67,,,0 CDM,278C1713S1_87997,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.68,78.67,,,0 CDM,278C1713S1_87998,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.68,78.67,,,0 CDM,278C1713S1_87999,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.68,78.67,,,0 CDM,278C1713S1_88000,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.68,78.67,,,0 CDM,278C1713S1_88001,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.68,78.67,,,0 CDM,278C1713S1_88002,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.68,78.67,,,0 CDM,278C1713S1_88003,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.68,78.67,,,0 CDM,278C1713S1_88004,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.68,78.67,,,0 CDM,278C1713S1_88005,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,205.42,82.17,,,0 CDM,278C1713S1_88018,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,123.56,49.42,,,0 CDM,278C1713S1_88019,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,153.3,61.32,,,0 CDM,278C1713S1_88020,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,154.43,61.77,,,0 CDM,278C1713S1_88021,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.78,49.11,,,0 CDM,278C1713S1_88022,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,152.04,60.82,,,0 CDM,278C1713S1_88023,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,153.3,61.32,,,0 CDM,278C1713S1_88024,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,153.13,61.25,,,0 CDM,278C1713S1_88025,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,153.21,61.28,,,0 CDM,278C1713S1_88026,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,148.4,59.36,,,0 CDM,278C1713S1_88027,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,150.69,60.28,,,0 CDM,278C1713S1_88028,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,154.43,61.77,,,0 CDM,278C1713S1_88029,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,154.43,61.77,,,0 CDM,278C1713S1_88030,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,154.43,61.77,,,0 CDM,278C1713S1_88034,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,63.08,25.23,,,0 CDM,278C1713S1_88036,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1190.27,476.11,,,0 CDM,278C1713S1_88037,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1296.62,518.65,,,0 CDM,278C1713S1_88038,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1379.66,551.86,,,0 CDM,278C1713S1_88039,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1420.45,568.18,,,0 CDM,278C1713S1_88040,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1570.52,628.21,,,0 CDM,278C1713S1_88041,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2363.06,945.22,,,0 CDM,278C1713S1_88042,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1643.36,657.34,,,0 CDM,278C1713S1_88050,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1988.64,795.46,,,0 CDM,278C1713S1_88052,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1588.0,635.2,,,0 CDM,278C1713S1_88055,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1471.45,588.58,,,0 CDM,278C1713S1_88061,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,696.39,278.56,,,0 CDM,278C1713S1_88062,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,696.39,278.56,,,0 CDM,278C1713S1_88063,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,696.39,278.56,,,0 CDM,278C1713S1_88064,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,701.29,280.52,,,0 CDM,278C1713S1_88065,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,761.94,304.78,,,0 CDM,278C1713S1_88066,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,780.88,312.35,,,0 CDM,278C1713S1_88067,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_88068,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_88069,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,513.41,205.36,,,0 CDM,278C1713S1_88070,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_88071,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_88072,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_88073,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_88074,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_88075,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_88076,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,503.56,201.42,,,0 CDM,278C1713S1_88077,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_88078,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_88079,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_88080,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_88081,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_88082,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_88083,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_88084,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,499.82,199.93,,,0 CDM,278C1713S1_88085,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,511.38,204.55,,,0 CDM,278C1713S1_88086,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_88115,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5717.06,2286.82,,,0 CDM,278C1713S1_88116,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6123.37,2449.35,,,0 CDM,278C1713S1_88145,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,139.86,55.94,,,0 CDM,278C1713S1_88146,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,139.86,55.94,,,0 CDM,278C1713S1_88147,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,139.86,55.94,,,0 CDM,278C1713S1_88148,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,120.64,48.26,,,0 CDM,278C1713S1_88149,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,139.86,55.94,,,0 CDM,278C1713S1_88158,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,139.86,55.94,,,0 CDM,278C1713S1_88159,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,139.86,55.94,,,0 CDM,278C1713S1_88160,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,170.46,68.18,,,0 CDM,278C1713S1_88161,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,170.46,68.18,,,0 CDM,278C1713S1_88178,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,139.86,55.94,,,0 CDM,278C1713S1_88179,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,139.86,55.94,,,0 CDM,278C1713S1_88180,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,139.86,55.94,,,0 CDM,278C1713S1_88181,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,139.86,55.94,,,0 CDM,278C1713S1_88184,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,139.86,55.94,,,0 CDM,278C1713S1_88185,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,133.04,53.22,,,0 CDM,278C1713S1_88186,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,139.86,55.94,,,0 CDM,278C1713S1_88188,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,139.86,55.94,,,0 CDM,278C1713S1_88190,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,134.56,53.82,,,0 CDM,278C1713S1_88191,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,139.86,55.94,,,0 CDM,278C1713S1_88192,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,139.86,55.94,,,0 CDM,278C1713S1_88193,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,139.86,55.94,,,0 CDM,278C1713S1_88194,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,139.86,55.94,,,0 CDM,278C1713S1_88195,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,139.86,55.94,,,0 CDM,278C1713S1_88196,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,139.86,55.94,,,0 CDM,278C1713S1_88197,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,139.86,55.94,,,0 CDM,278C1713S1_88198,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,112.59,45.04,,,0 CDM,278C1713S1_88278,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,152.97,61.19,,,0 CDM,278C1713S1_88279,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,152.97,61.19,,,0 CDM,278C1713S1_88281,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,152.97,61.19,,,0 CDM,278C1713S1_88282,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,135.85,54.34,,,0 CDM,278C1713S1_88283,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,152.97,61.19,,,0 CDM,278C1713S1_88284,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,152.97,61.19,,,0 CDM,278C1713S1_88286,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,152.97,61.19,,,0 CDM,278C1713S1_88297,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,152.97,61.19,,,0 CDM,278C1713S1_88299,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,152.97,61.19,,,0 CDM,278C1713S1_88383,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,412.06,164.82,,,0 CDM,278C1713S1_88384,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,412.06,164.82,,,0 CDM,278C1713S1_88401,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5091.43,2036.57,,,0 CDM,278C1713S1_88402,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5091.43,2036.57,,,0 CDM,278C1713S1_88425,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6237.0,2494.8,,,0 CDM,278C1713S1_88435,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6237.0,2494.8,,,0 CDM,278C1713S1_88437,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5091.43,2036.57,,,0 CDM,278C1713S1_88473,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5551.9,2220.76,,,0 CDM,278C1713S1_88474,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6071.62,2428.65,,,0 CDM,278C1713S1_88484,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5551.9,2220.76,,,0 CDM,278C1713S1_88485,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5032.17,2012.87,,,0 CDM,278C1713S1_88495,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6071.62,2428.65,,,0 CDM,278C1713S1_88507,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5032.17,2012.87,,,0 CDM,278C1713S1_88517,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5032.17,2012.87,,,0 CDM,278C1713S1_88539,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,708.75,283.5,,,0 CDM,278C1713S1_88543,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,708.75,283.5,,,0 CDM,278C1713S1_88544,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,708.75,283.5,,,0 CDM,278C1713S1_88547,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,589.87,235.95,,,0 CDM,278C1713S1_88548,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,557.24,222.9,,,0 CDM,278C1713S1_88549,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,609.68,243.87,,,0 CDM,278C1713S1_88550,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,582.16,232.86,,,0 CDM,278C1713S1_88551,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,551.61,220.64,,,0 CDM,278C1713S1_88552,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,579.53,231.81,,,0 CDM,278C1713S1_88553,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,560.15,224.06,,,0 CDM,278C1713S1_88554,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,593.17,237.27,,,0 CDM,278C1713S1_88555,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,576.66,230.66,,,0 CDM,278C1713S1_88556,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,532.63,213.05,,,0 CDM,278C1713S1_88557,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,595.53,238.21,,,0 CDM,278C1713S1_88558,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,576.66,230.66,,,0 CDM,278C1713S1_88561,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,510.62,204.25,,,0 CDM,278C1713S1_88690,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,189.0,75.6,,,0 CDM,278C1713S1_88739,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2876.58,1150.63,,,0 CDM,278C1713S1_88757,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,649.69,259.88,,,0 CDM,278C1713S1_88758,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,649.69,259.88,,,0 CDM,278C1713S1_88804,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,218.53,87.41,,,0 CDM,278C1713S1_88811,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1243.3,497.32,,,0 CDM,278C1713S1_88814,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,626.23,250.49,,,0 CDM,278C1713S1_88839,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1054.78,421.91,,,0 CDM,278C1713S1_88840,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1136.36,454.54,,,0 CDM,278C1713S1_88841,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1199.01,479.6,,,0 CDM,278C1713S1_88842,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1271.85,508.74,,,0 CDM,278C1713S1_88843,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1362.18,544.87,,,0 CDM,278C1713S1_88918,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4488.75,1795.5,,,0 CDM,278C1713S1_88988,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1372.38,548.95,,,0 CDM,278C1713S1_88989,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1451.05,580.42,,,0 CDM,278C1713S1_88992,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1860.43,744.17,,,0 CDM,278C1713S1_88993,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2019.23,807.69,,,0 CDM,278C1713S1_88994,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2175.12,870.05,,,0 CDM,278C1713S1_88996,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2623.83,1049.53,,,0 CDM,278C1713S1_89002,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2341.2,936.48,,,0 CDM,278C1713S1_89003,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2492.71,997.08,,,0 CDM,278C1713S1_89008,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2572.85,1029.14,,,0 CDM,278C1713S1_89016,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.02,209.21,,,0 CDM,278C1713S1_89019,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.02,209.21,,,0 CDM,278C1713S1_89020,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.02,209.21,,,0 CDM,278C1713S1_89021,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.02,209.21,,,0 CDM,278C1713S1_89023,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.02,209.21,,,0 CDM,278C1713S1_89025,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.02,209.21,,,0 CDM,278C1713S1_89028,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.02,209.21,,,0 CDM,278C1713S1_89029,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.02,209.21,,,0 CDM,278C1713S1_89030,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.02,209.21,,,0 CDM,278C1713S1_89031,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.02,209.21,,,0 CDM,278C1713S1_89032,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.02,209.21,,,0 CDM,278C1713S1_89033,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.02,209.21,,,0 CDM,278C1713S1_89035,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,523.02,209.21,,,0 CDM,278C1713S1_89154,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,678.51,271.4,,,0 CDM,278C1713S1_89223,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,166.28,66.51,,,0 CDM,278C1713S1_89224,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,166.28,66.51,,,0 CDM,278C1713S1_89264,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89265,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89267,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89268,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89277,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89279,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1039.5,415.8,,,0 CDM,278C1713S1_89280,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89281,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89282,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89285,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89286,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89287,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89288,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89289,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89291,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89292,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89293,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89294,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89295,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89304,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89305,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89306,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89307,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89308,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89310,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89311,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89316,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89318,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,942.64,377.06,,,0 CDM,278C1713S1_89349,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,690.8,276.32,,,0 CDM,278C1713S1_89461,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,807.62,323.05,,,0 CDM,278C1713S1_89463,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,807.62,323.05,,,0 CDM,278C1713S1_89464,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,807.62,323.05,,,0 CDM,278C1713S1_89472,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1002.33,400.93,,,0 CDM,278C1713S1_89473,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1002.33,400.93,,,0 CDM,278C1713S1_89480,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1002.33,400.93,,,0 CDM,278C1713S1_89481,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1002.33,400.93,,,0 CDM,278C1713S1_89487,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,218.53,87.41,,,0 CDM,278C1713S1_90230,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2535.75,1014.3,,,0 CDM,278C1713S1_90606,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,356.94,142.78,,,0 CDM,278C1713S1_90607,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,356.94,142.78,,,0 CDM,278C1713S1_90715,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,218.54,87.42,,,0 CDM,278C1713S1_90824,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,480.77,192.31,,,0 CDM,278C1713S1_90825,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,480.77,192.31,,,0 CDM,278C1713S1_90826,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,480.77,192.31,,,0 CDM,278C1713S1_90827,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,480.77,192.31,,,0 CDM,278C1713S1_90828,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,480.77,192.31,,,0 CDM,278C1713S1_90829,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,480.77,192.31,,,0 CDM,278C1713S1_90836,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,249.12,99.65,,,0 CDM,278C1713S1_90837,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,249.13,99.65,,,0 CDM,278C1713S1_90838,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,249.12,99.65,,,0 CDM,278C1713S1_90839,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,249.12,99.65,,,0 CDM,278C1713S1_90840,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,249.13,99.65,,,0 CDM,278C1713S1_90841,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,249.12,99.65,,,0 CDM,278C1713S1_90842,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,249.12,99.65,,,0 CDM,278C1713S1_90843,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,249.12,99.65,,,0 CDM,278C1713S1_90844,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,249.13,99.65,,,0 CDM,278C1713S1_90845,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,208.9,83.56,,,0 CDM,278C1713S1_90847,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,180.65,72.26,,,0 CDM,278C1713S1_90848,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,180.65,72.26,,,0 CDM,278C1713S1_90849,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,179.31,71.72,,,0 CDM,278C1713S1_90850,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,176.48,70.59,,,0 CDM,278C1713S1_90851,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,177.64,71.06,,,0 CDM,278C1713S1_90852,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,180.65,72.26,,,0 CDM,278C1713S1_90853,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,180.65,72.26,,,0 CDM,278C1713S1_90854,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,180.65,72.26,,,0 CDM,278C1713S1_90855,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,180.65,72.26,,,0 CDM,278C1713S1_90856,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,180.65,72.26,,,0 CDM,278C1713S1_90857,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,180.65,72.26,,,0 CDM,278C1713S1_90883,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,973.35,389.34,,,0 CDM,278C1713S1_90911,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,878.85,351.54,,,0 CDM,278C1713S1_90937,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,288.97,115.59,,,0 CDM,278C1713S1_90938,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,288.97,115.59,,,0 CDM,278C1713S1_90944,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,232.47,92.99,,,0 CDM,278C1713S1_90945,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,232.47,92.99,,,0 CDM,278C1713S1_90949,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,232.47,92.99,,,0 CDM,278C1713S1_90950,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,232.47,92.99,,,0 CDM,278C1713S1_91121,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,149.62,59.85,,,0 CDM,278C1713S1_91122,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,134.66,53.86,,,0 CDM,278C1713S1_91123,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,134.66,53.86,,,0 CDM,278C1713S1_91157,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3020.06,1208.02,,,0 CDM,278C1713S1_91163,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,305.16,122.06,,,0 CDM,278C1713S1_91164,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,147.66,59.06,,,0 CDM,278C1713S1_91165,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,147.66,59.06,,,0 CDM,278C1713S1_91195,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1034.78,413.91,,,0 CDM,278C1713S1_91308,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1740.97,696.39,,,0 CDM,278C1713S1_91309,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1740.97,696.39,,,0 CDM,278C1713S1_91402,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6529.2,2611.68,,,0 CDM,278C1713S1_91466,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,448.72,179.49,,,0 CDM,278C1713S1_91467,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,448.72,179.49,,,0 CDM,278C1713S1_91580,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_91581,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_91582,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_91583,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_91584,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_91585,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_91586,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_91587,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_91588,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_91589,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_91590,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_91591,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_91593,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_91595,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_91596,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_91775,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,149.62,59.85,,,0 CDM,278C1713S1_91777,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,86.62,34.65,,,0 CDM,278C1713S1_91778,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,120.49,48.2,,,0 CDM,278C1713S1_91779,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,476.36,190.54,,,0 CDM,278C1713S1_91780,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,354.38,141.75,,,0 CDM,278C1713S1_91782,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,374.69,149.88,,,0 CDM,278C1713S1_91783,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,477.22,190.89,,,0 CDM,278C1713S1_91784,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,438.25,175.3,,,0 CDM,278C1713S1_91785,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,533.97,213.59,,,0 CDM,278C1713S1_91786,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1056.04,422.42,,,0 CDM,278C1713S1_91787,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,354.38,141.75,,,0 CDM,278C1713S1_91788,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,832.78,333.11,,,0 CDM,278C1713S1_91789,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1176.52,470.61,,,0 CDM,278C1713S1_91799,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,724.66,289.86,,,0 CDM,278C1713S1_91800,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,724.41,289.76,,,0 CDM,278C1713S1_91816,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,372.49,149.0,,,0 CDM,278C1713S1_91893,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,431.08,172.43,,,0 CDM,278C1713S1_91935,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4417.24,1766.9,,,0 CDM,278C1713S1_92021,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,168.21,67.28,,,0 CDM,278C1713S1_92022,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,168.21,67.28,,,0 CDM,278C1713S1_92023,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,168.21,67.28,,,0 CDM,278C1713S1_92025,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,149.31,59.72,,,0 CDM,278C1713S1_92026,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,149.31,59.72,,,0 CDM,278C1713S1_92342,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,210.78,84.31,,,0 CDM,278C1713S1_92343,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,669.38,267.75,,,0 CDM,278C1713S1_92357,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1284.81,513.92,,,0 CDM,278C1713S1_92358,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,515.35,206.14,,,0 CDM,278C1713S1_92359,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,412.06,164.82,,,0 CDM,278C1713S1_92360,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,489.53,195.81,,,0 CDM,278C1713S1_92361,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,446.49,178.6,,,0 CDM,278C1713S1_92365,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,567.0,226.8,,,0 CDM,278C1713S1_92383,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7203.74,2881.5,,,0 CDM,278C1713S1_92384,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7203.74,2881.5,,,0 CDM,278C1713S1_92387,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7441.09,2976.44,,,0 CDM,278C1713S1_92391,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,512.1,204.84,,,0 CDM,278C1713S1_92392,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,511.38,204.55,,,0 CDM,278C1713S1_92393,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_92394,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_92395,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_92413,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2334.15,933.66,,,0 CDM,278C1713S1_92414,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2358.72,943.49,,,0 CDM,278C1713S1_92417,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,161.44,64.58,,,0 CDM,278C1713S1_92419,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,161.44,64.58,,,0 CDM,278C1713S1_92420,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,161.44,64.58,,,0 CDM,278C1713S1_92632,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2703.29,1081.32,,,0 CDM,278C1713S1_92729,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3921.75,1568.7,,,0 CDM,278C1713S1_92731,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2294.46,917.78,,,0 CDM,278C1713S1_92732,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2294.46,917.78,,,0 CDM,278C1713S1_92733,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2177.28,870.91,,,0 CDM,278C1713S1_92734,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2402.19,960.88,,,0 CDM,278C1713S1_92737,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,491.4,196.56,,,0 CDM,278C1713S1_92738,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,491.4,196.56,,,0 CDM,278C1713S1_92739,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,506.07,202.43,,,0 CDM,278C1713S1_92740,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,491.4,196.56,,,0 CDM,278C1713S1_92795,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,322.88,129.15,,,0 CDM,278C1713S1_92796,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,322.88,129.15,,,0 CDM,278C1713S1_92798,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,322.88,129.15,,,0 CDM,278C1713S1_92799,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,322.88,129.15,,,0 CDM,278C1713S1_92848,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5210.73,2084.29,,,0 CDM,278C1713S1_92874,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3162.87,1265.15,,,0 CDM,278C1713S1_92887,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1733.69,693.48,,,0 CDM,278C1713S1_92888,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1915.79,766.32,,,0 CDM,278C1713S1_92889,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2007.57,803.03,,,0 CDM,278C1713S1_92890,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2093.53,837.41,,,0 CDM,278C1713S1_93015,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,275.62,110.25,,,0 CDM,278C1713S1_93016,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,275.62,110.25,,,0 CDM,278C1713S1_93019,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_93020,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_93022,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_93024,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_93026,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_93034,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_93072,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_93073,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_93074,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_93075,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_93076,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_93077,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_93078,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_93079,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,492.19,196.88,,,0 CDM,278C1713S1_93086,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_93087,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_93088,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_93089,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_93092,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_93098,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_93102,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_93103,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_93104,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_93114,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_93117,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_93120,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_93121,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,393.75,157.5,,,0 CDM,278C1713S1_93122,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,948.94,379.58,,,0 CDM,278C1713S1_93123,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,948.94,379.58,,,0 CDM,278C1713S1_93124,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,948.94,379.58,,,0 CDM,278C1713S1_93176,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2366.44,946.58,,,0 CDM,278C1713S1_93180,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1968.75,787.5,,,0 CDM,278C1713S1_93213,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93214,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93217,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93218,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93219,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93220,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93222,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93223,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93224,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93225,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93227,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93228,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93229,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93230,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93309,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93311,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93312,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93315,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93316,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93317,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93318,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93321,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93322,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93323,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93330,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93340,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_93364,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1575.0,630.0,,,0 CDM,278C1713S1_93366,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1575.0,630.0,,,0 CDM,278C1713S1_93367,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1575.0,630.0,,,0 CDM,278C1713S1_93377,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2292.02,916.81,,,0 CDM,278C1713S1_93379,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2292.02,916.81,,,0 CDM,278C1713S1_93380,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2292.02,916.81,,,0 CDM,278C1713S1_93383,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2292.02,916.81,,,0 CDM,278C1713S1_93384,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2292.02,916.81,,,0 CDM,278C1713S1_93385,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2292.02,916.81,,,0 CDM,278C1713S1_93386,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2292.02,916.81,,,0 CDM,278C1713S1_93389,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2559.38,1023.75,,,0 CDM,278C1713S1_93390,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2559.38,1023.75,,,0 CDM,278C1713S1_93391,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2559.38,1023.75,,,0 CDM,278C1713S1_93392,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2559.38,1023.75,,,0 CDM,278C1713S1_93393,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2559.38,1023.75,,,0 CDM,278C1713S1_93394,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2559.38,1023.75,,,0 CDM,278C1713S1_93396,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2559.38,1023.75,,,0 CDM,278C1713S1_93399,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2756.25,1102.5,,,0 CDM,278C1713S1_93400,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2756.25,1102.5,,,0 CDM,278C1713S1_93401,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2756.25,1102.5,,,0 CDM,278C1713S1_93402,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2756.25,1102.5,,,0 CDM,278C1713S1_93403,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2756.25,1102.5,,,0 CDM,278C1713S1_93408,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2992.5,1197.0,,,0 CDM,278C1713S1_93461,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4567.5,1827.0,,,0 CDM,278C1713S1_93462,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,4567.5,1827.0,,,0 CDM,278C1713S1_93482,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,501.56,200.62,,,0 CDM,278C1713S1_93731,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,322.88,129.15,,,0 CDM,278C1713S1_93732,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,322.88,129.15,,,0 CDM,278C1713S1_93735,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,322.88,129.15,,,0 CDM,278C1713S1_93737,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,322.88,129.15,,,0 CDM,278C1713S1_93739,Hc 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Hcpcs,747.89,299.16,,,0 CDM,278C1713S1_93788,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,762.55,305.02,,,0 CDM,278C1713S1_93789,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_93790,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_93791,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,765.59,306.24,,,0 CDM,278C1713S1_93792,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,749.02,299.61,,,0 CDM,278C1713S1_93793,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_93794,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_93795,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,725.34,290.14,,,0 CDM,278C1713S1_93796,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_93797,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_93799,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_93801,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_93804,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_93806,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_93810,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,878.38,351.35,,,0 CDM,278C1713S1_93811,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,878.38,351.35,,,0 CDM,278C1713S1_93812,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,878.38,351.35,,,0 CDM,278C1713S1_93813,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,878.38,351.35,,,0 CDM,278C1713S1_93814,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,878.38,351.35,,,0 CDM,278C1713S1_93815,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,878.38,351.35,,,0 CDM,278C1713S1_93830,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6843.38,2737.35,,,0 CDM,278C1713S1_93831,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6843.38,2737.35,,,0 CDM,278C1713S1_93842,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6843.38,2737.35,,,0 CDM,278C1713S1_93843,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6843.38,2737.35,,,0 CDM,278C1713S1_93846,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6843.38,2737.35,,,0 CDM,278C1713S1_93854,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6843.38,2737.35,,,0 CDM,278C1713S1_93855,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6517.71,2607.08,,,0 CDM,278C1713S1_93856,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6843.38,2737.35,,,0 CDM,278C1713S1_93857,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6843.38,2737.35,,,0 CDM,278C1713S1_93858,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6843.38,2737.35,,,0 CDM,278C1713S1_93860,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6843.38,2737.35,,,0 CDM,278C1713S1_93861,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6636.52,2654.61,,,0 CDM,278C1713S1_93869,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6843.38,2737.35,,,0 CDM,278C1713S1_93885,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6843.38,2737.35,,,0 CDM,278C1713S1_93987,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,999.65,399.86,,,0 CDM,278C1713S1_93988,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,999.65,399.86,,,0 CDM,278C1713S1_93989,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,999.65,399.86,,,0 CDM,278C1713S1_93990,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,999.65,399.86,,,0 CDM,278C1713S1_93991,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,999.65,399.86,,,0 CDM,278C1713S1_93992,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,999.65,399.86,,,0 CDM,278C1713S1_93993,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,999.65,399.86,,,0 CDM,278C1713S1_93994,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,981.16,392.46,,,0 CDM,278C1713S1_93995,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,968.84,387.54,,,0 CDM,278C1713S1_93996,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,999.65,399.86,,,0 CDM,278C1713S1_93997,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,981.16,392.46,,,0 CDM,278C1713S1_93998,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,999.65,399.86,,,0 CDM,278C1713S1_94000,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,999.65,399.86,,,0 CDM,278C1713S1_94001,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,999.65,399.86,,,0 CDM,278C1713S1_94003,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,999.65,399.86,,,0 CDM,278C1713S1_94004,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,999.65,399.86,,,0 CDM,278C1713S1_94009,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,999.65,399.86,,,0 CDM,278C1713S1_94011,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,999.65,399.86,,,0 CDM,278C1713S1_94019,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_94021,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_94022,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_94030,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7394.62,2957.85,,,0 CDM,278C1713S1_94042,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,772.7,309.08,,,0 CDM,278C1713S1_94059,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2397.78,959.11,,,0 CDM,278C1713S1_94078,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7394.62,2957.85,,,0 CDM,278C1713S1_94079,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7394.62,2957.85,,,0 CDM,278C1713S1_94094,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7394.62,2957.85,,,0 CDM,278C1713S1_94096,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7394.62,2957.85,,,0 CDM,278C1713S1_94109,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7394.62,2957.85,,,0 CDM,278C1713S1_94112,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7394.62,2957.85,,,0 CDM,278C1713S1_94113,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7394.62,2957.85,,,0 CDM,278C1713S1_94114,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7394.62,2957.85,,,0 CDM,278C1713S1_94154,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,7394.62,2957.85,,,0 CDM,278C1713S1_94475,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,215.46,86.18,,,0 CDM,278C1713S1_94485,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,207.9,83.16,,,0 CDM,278C1713S1_94488,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,215.46,86.18,,,0 CDM,278C1713S1_94489,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,215.46,86.18,,,0 CDM,278C1713S1_94490,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,215.46,86.18,,,0 CDM,278C1713S1_94491,Hc Sup Shell 278 Revenue Code C1713 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CDM,278C1713S1_94524,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,729.54,291.82,,,0 CDM,278C1713S1_94527,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,738.99,295.6,,,0 CDM,278C1713S1_94530,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,729.54,291.82,,,0 CDM,278C1713S1_94531,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1561.14,624.46,,,0 CDM,278C1713S1_94532,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1561.14,624.46,,,0 CDM,278C1713S1_94534,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,738.99,295.6,,,0 CDM,278C1713S1_94535,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,738.99,295.6,,,0 CDM,278C1713S1_94536,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,738.99,295.6,,,0 CDM,278C1713S1_94538,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,738.99,295.6,,,0 CDM,278C1713S1_94539,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,738.99,295.6,,,0 CDM,278C1713S1_94541,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,757.89,303.16,,,0 CDM,278C1713S1_94542,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,757.89,303.16,,,0 CDM,278C1713S1_94544,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,757.89,303.16,,,0 CDM,278C1713S1_94545,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,757.89,303.16,,,0 CDM,278C1713S1_94547,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,784.35,313.74,,,0 CDM,278C1713S1_94548,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,784.35,313.74,,,0 CDM,278C1713S1_94550,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,784.35,313.74,,,0 CDM,278C1713S1_94551,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,784.35,313.74,,,0 CDM,278C1713S1_94554,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,659.61,263.84,,,0 CDM,278C1713S1_94556,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,738.99,295.6,,,0 CDM,278C1713S1_94557,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,738.99,295.6,,,0 CDM,278C1713S1_94731,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1447.69,579.08,,,0 CDM,278C1713S1_94732,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1417.5,567.0,,,0 CDM,278C1713S1_94849,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,196.09,78.44,,,0 CDM,278C1713S1_94851,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,218.54,87.42,,,0 CDM,278C1713S1_94885,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6495.14,2598.06,,,0 CDM,278C1713S1_94886,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6872.83,2749.13,,,0 CDM,278C1713S1_94888,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6495.14,2598.06,,,0 CDM,278C1713S1_94889,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6872.83,2749.13,,,0 CDM,278C1713S1_94916,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5811.48,2324.59,,,0 CDM,278C1713S1_94918,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,5919.28,2367.71,,,0 CDM,278C1713S1_94945,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,218.54,87.42,,,0 CDM,278C1713S1_94946,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,218.54,87.42,,,0 CDM,278C1713S1_94951,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,218.54,87.42,,,0 CDM,278C1713S1_94952,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,218.54,87.42,,,0 CDM,278C1713S1_94954,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,218.54,87.42,,,0 CDM,278C1713S1_94956,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,218.53,87.41,,,0 CDM,278C1713S1_94964,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,199.59,79.84,,,0 CDM,278C1713S1_94972,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,199.59,79.84,,,0 CDM,278C1713S1_94975,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,152.95,61.18,,,0 CDM,278C1713S1_94976,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,154.43,61.77,,,0 CDM,278C1713S1_94977,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,148.5,59.4,,,0 CDM,278C1713S1_94978,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,152.28,60.91,,,0 CDM,278C1713S1_94984,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,148.61,59.44,,,0 CDM,278C1713S1_94986,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,148.61,59.44,,,0 CDM,278C1713S1_94987,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,148.6,59.44,,,0 CDM,278C1713S1_94990,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,148.61,59.44,,,0 CDM,278C1713S1_94991,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,148.6,59.44,,,0 CDM,278C1713S1_94992,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,148.61,59.44,,,0 CDM,278C1713S1_94993,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,148.61,59.44,,,0 CDM,278C1713S1_94994,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,148.61,59.44,,,0 CDM,278C1713S1_94995,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,148.61,59.44,,,0 CDM,278C1713S1_94996,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,148.61,59.44,,,0 CDM,278C1713S1_94997,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,148.61,59.44,,,0 CDM,278C1713S1_95001,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,262.24,104.9,,,0 CDM,278C1713S1_95010,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2374.71,949.88,,,0 CDM,278C1713S1_95011,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1917.25,766.9,,,0 CDM,278C1713S1_95019,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2648.6,1059.44,,,0 CDM,278C1713S1_95020,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1940.56,776.22,,,0 CDM,278C1713S1_95027,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,40.09,16.04,,,0 CDM,278C1713S1_95030,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,64.63,25.85,,,0 CDM,278C1713S1_95033,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,154.43,61.77,,,0 CDM,278C1713S1_95034,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,118.78,47.51,,,0 CDM,278C1713S1_95035,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,120.31,48.12,,,0 CDM,278C1713S1_95036,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,122.91,49.16,,,0 CDM,278C1713S1_95037,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,153.75,61.5,,,0 CDM,278C1713S1_95060,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,284.09,113.64,,,0 CDM,278C1713S1_95061,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,284.09,113.64,,,0 CDM,278C1713S1_95062,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,284.09,113.64,,,0 CDM,278C1713S1_95063,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,284.09,113.64,,,0 CDM,278C1713S1_95064,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,284.09,113.64,,,0 CDM,278C1713S1_95065,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,284.09,113.64,,,0 CDM,278C1713S1_95066,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,284.09,113.64,,,0 CDM,278C1713S1_95067,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,284.09,113.64,,,0 CDM,278C1713S1_95068,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,284.09,113.64,,,0 CDM,278C1713S1_95069,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,284.09,113.64,,,0 CDM,278C1713S1_95070,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,284.09,113.64,,,0 CDM,278C1713S1_95071,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,284.09,113.64,,,0 CDM,278C1713S1_95072,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,284.09,113.64,,,0 CDM,278C1713S1_95074,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,284.09,113.64,,,0 CDM,278C1713S1_95088,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_95089,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_95091,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_95094,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_95097,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2165.62,866.25,,,0 CDM,278C1713S1_95116,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2559.38,1023.75,,,0 CDM,278C1713S1_95207,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,110.56,44.22,,,0 CDM,278C1713S1_95249,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3191.85,1276.74,,,0 CDM,278C1713S1_95337,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,171.13,68.45,,,0 CDM,278C1713S1_95338,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,171.12,68.45,,,0 CDM,278C1713S1_95339,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,171.12,68.45,,,0 CDM,278C1713S1_95361,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,892.98,357.19,,,0 CDM,278C1713S1_95362,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,975.68,390.27,,,0 CDM,278C1713S1_95363,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,934.34,373.74,,,0 CDM,278C1713S1_95364,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,892.98,357.19,,,0 CDM,278C1713S1_95365,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,963.87,385.55,,,0 CDM,278C1713S1_95367,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,892.98,357.19,,,0 CDM,278C1713S1_95373,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,24.61,9.84,,,0 CDM,278C1713S1_95394,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9140.67,3656.27,,,0 CDM,278C1713S1_95395,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,9594.58,3837.83,,,0 CDM,278C1713S1_95396,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,10252.94,4101.18,,,0 CDM,278C1713S1_95431,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1324.3,529.72,,,0 CDM,278C1713S1_95438,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1324.3,529.72,,,0 CDM,278C1713S1_95440,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1324.3,529.72,,,0 CDM,278C1713S1_95441,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1324.3,529.72,,,0 CDM,278C1713S1_95442,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1324.3,529.72,,,0 CDM,278C1713S1_95444,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1324.3,529.72,,,0 CDM,278C1713S1_95450,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2648.99,1059.6,,,0 CDM,278C1713S1_95463,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,3594.11,1437.64,,,0 CDM,278C1713S1_95505,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1183.46,473.38,,,0 CDM,278C1713S1_95506,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1139.67,455.87,,,0 CDM,278C1713S1_95507,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1227.24,490.9,,,0 CDM,278C1713S1_95508,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1139.67,455.87,,,0 CDM,278C1713S1_95511,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1139.67,455.87,,,0 CDM,278C1713S1_95512,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1139.67,455.87,,,0 CDM,278C1713S1_95513,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1183.46,473.38,,,0 CDM,278C1713S1_95514,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1214.73,485.89,,,0 CDM,278C1713S1_95515,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1149.77,459.91,,,0 CDM,278C1713S1_95516,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1139.67,455.87,,,0 CDM,278C1713S1_95517,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1183.46,473.38,,,0 CDM,278C1713S1_95518,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1139.67,455.87,,,0 CDM,278C1713S1_95519,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1139.67,455.87,,,0 CDM,278C1713S1_95520,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1139.67,455.87,,,0 CDM,278C1713S1_95536,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6079.34,2431.74,,,0 CDM,278C1713S1_95537,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6282.04,2512.82,,,0 CDM,278C1713S1_95538,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6375.6,2550.24,,,0 CDM,278C1713S1_95539,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6760.22,2704.09,,,0 CDM,278C1713S1_95540,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,6079.34,2431.74,,,0 CDM,278C1713S1_95616,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_95617,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_95618,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,504.08,201.63,,,0 CDM,278C1713S1_95619,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_95620,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_95622,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_95623,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,514.28,205.71,,,0 CDM,278C1713S1_95713,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,765.45,306.18,,,0 CDM,278C1713S1_95952,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1134.0,453.6,,,0 CDM,278C1713S1_95960,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2450.09,980.04,,,0 CDM,278C1713S1_95962,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2573.79,1029.52,,,0 CDM,278C1713S1_96241,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2490.47,996.19,,,0 CDM,278C1713S1_96325,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1284.43,513.77,,,0 CDM,278C1713S1_C1713_278,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,2047.89,819.16,,,0 CDM,278C1715S1_187603,Hc Sup Shell 278 Revenue Code C1715 Hcpcs,307.79,123.12,,,0 CDM,278C1715S1_194150,Hc Sup Shell 278 Revenue Code C1715 Hcpcs,205.54,82.22,,,0 CDM,278C1724S1_147132,Hc Sup Shell 278 Revenue Code C1724 Hcpcs,11812.5,4725.0,,,0 CDM,278C1724S1_147133,Hc Sup Shell 278 Revenue Code C1724 Hcpcs,11812.5,4725.0,,,0 CDM,278C1724S1_157103,Hc Sup Shell 278 Revenue Code C1724 Hcpcs,7422.19,2968.88,,,0 CDM,278C1725S1_113631,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,787.5,315.0,,,0 CDM,278C1725S1_113922,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,787.5,315.0,,,0 CDM,278C1725S1_114466,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,787.5,315.0,,,0 CDM,278C1725S1_118889,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,387.09,154.84,,,0 CDM,278C1725S1_133430,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1260.0,504.0,,,0 CDM,278C1725S1_133439,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 CDM,278C1725S1_133441,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1575.0,630.0,,,0 CDM,278C1725S1_133443,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 CDM,278C1725S1_133444,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1141.88,456.75,,,0 CDM,278C1725S1_133445,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1240.31,496.12,,,0 CDM,278C1725S1_133446,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1240.31,496.12,,,0 CDM,278C1725S1_133447,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2756.25,1102.5,,,0 CDM,278C1725S1_133448,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2756.25,1102.5,,,0 CDM,278C1725S1_133449,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2756.25,1102.5,,,0 CDM,278C1725S1_133476,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2069.82,827.93,,,0 CDM,278C1725S1_133478,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2169.17,867.67,,,0 CDM,278C1725S1_133484,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2895.75,1158.3,,,0 CDM,278C1725S1_133485,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2895.75,1158.3,,,0 CDM,278C1725S1_133486,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,5679.04,2271.62,,,0 CDM,278C1725S1_133492,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,5598.23,2239.29,,,0 CDM,278C1725S1_133650,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2102.94,841.18,,,0 CDM,278C1725S1_133651,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2069.82,827.93,,,0 CDM,278C1725S1_133653,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2069.82,827.93,,,0 CDM,278C1725S1_133658,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2895.75,1158.3,,,0 CDM,278C1725S1_133659,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,3034.75,1213.9,,,0 CDM,278C1725S1_133673,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2069.82,827.93,,,0 CDM,278C1725S1_133855,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 CDM,278C1725S1_133856,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1456.88,582.75,,,0 CDM,278C1725S1_133858,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1456.88,582.75,,,0 CDM,278C1725S1_133859,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1496.25,598.5,,,0 CDM,278C1725S1_133860,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1575.0,630.0,,,0 CDM,278C1725S1_133948,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2050.89,820.36,,,0 CDM,278C1725S1_133952,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2069.82,827.93,,,0 CDM,278C1725S1_133953,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2119.5,847.8,,,0 CDM,278C1725S1_133955,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2069.82,827.93,,,0 CDM,278C1725S1_133957,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,3002.94,1201.18,,,0 CDM,278C1725S1_133969,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2895.75,1158.3,,,0 CDM,278C1725S1_133971,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,3000.0,1200.0,,,0 CDM,278C1725S1_133972,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2895.75,1158.3,,,0 CDM,278C1725S1_133976,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,3034.75,1213.9,,,0 CDM,278C1725S1_133993,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,787.5,315.0,,,0 CDM,278C1725S1_133995,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,787.5,315.0,,,0 CDM,278C1725S1_133998,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,787.5,315.0,,,0 CDM,278C1725S1_133999,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,787.5,315.0,,,0 CDM,278C1725S1_134000,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,787.5,315.0,,,0 CDM,278C1725S1_134002,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,787.5,315.0,,,0 CDM,278C1725S1_134005,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,787.5,315.0,,,0 CDM,278C1725S1_134006,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,787.5,315.0,,,0 CDM,278C1725S1_134009,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,787.5,315.0,,,0 CDM,278C1725S1_134010,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,787.5,315.0,,,0 CDM,278C1725S1_134011,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,787.5,315.0,,,0 CDM,278C1725S1_134012,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,787.5,315.0,,,0 CDM,278C1725S1_134014,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,787.5,315.0,,,0 CDM,278C1725S1_134017,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1141.88,456.75,,,0 CDM,278C1725S1_134018,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1141.88,456.75,,,0 CDM,278C1725S1_134019,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1141.88,456.75,,,0 CDM,278C1725S1_134020,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1141.88,456.75,,,0 CDM,278C1725S1_134021,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1141.88,456.75,,,0 CDM,278C1725S1_134022,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1319.06,527.62,,,0 CDM,278C1725S1_134059,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,433.12,173.25,,,0 CDM,278C1725S1_134060,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,433.12,173.25,,,0 CDM,278C1725S1_134061,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,433.12,173.25,,,0 CDM,278C1725S1_134063,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,433.12,173.25,,,0 CDM,278C1725S1_134077,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,433.12,173.25,,,0 CDM,278C1725S1_134086,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,433.12,173.25,,,0 CDM,278C1725S1_134089,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,433.12,173.25,,,0 CDM,278C1725S1_134106,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1575.0,630.0,,,0 CDM,278C1725S1_134108,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 CDM,278C1725S1_134109,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 CDM,278C1725S1_134110,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 CDM,278C1725S1_134112,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1476.56,590.62,,,0 CDM,278C1725S1_134113,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1476.56,590.62,,,0 CDM,278C1725S1_134114,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 CDM,278C1725S1_134115,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1575.0,630.0,,,0 CDM,278C1725S1_134117,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1575.0,630.0,,,0 CDM,278C1725S1_134118,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 CDM,278C1725S1_134307,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,702.52,281.01,,,0 CDM,278C1725S1_134316,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,698.56,279.42,,,0 CDM,278C1725S1_134391,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1063.12,425.25,,,0 CDM,278C1725S1_134392,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1027.89,411.16,,,0 CDM,278C1725S1_134395,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1009.24,403.7,,,0 CDM,278C1725S1_134396,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1004.62,401.85,,,0 CDM,278C1725S1_134397,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,984.38,393.75,,,0 CDM,278C1725S1_134398,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1102.5,441.0,,,0 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CDM,278C1725S1_134674,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,531.56,212.62,,,0 CDM,278C1725S1_134676,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,531.56,212.62,,,0 CDM,278C1725S1_134909,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2953.12,1181.25,,,0 CDM,278C1725S1_136601,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,3248.44,1299.38,,,0 CDM,278C1725S1_136649,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,393.75,157.5,,,0 CDM,278C1725S1_136676,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,393.75,157.5,,,0 CDM,278C1725S1_136678,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,393.75,157.5,,,0 CDM,278C1725S1_136679,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,393.75,157.5,,,0 CDM,278C1725S1_136680,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,393.75,157.5,,,0 CDM,278C1725S1_136682,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,393.75,157.5,,,0 CDM,278C1725S1_136683,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,393.75,157.5,,,0 CDM,278C1725S1_136684,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,393.75,157.5,,,0 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Shell 278 Revenue Code C1725 Hcpcs,393.75,157.5,,,0 CDM,278C1725S1_136790,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,393.75,157.5,,,0 CDM,278C1725S1_136791,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,393.75,157.5,,,0 CDM,278C1725S1_136793,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,393.75,157.5,,,0 CDM,278C1725S1_136795,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,393.75,157.5,,,0 CDM,278C1725S1_136796,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,393.75,157.5,,,0 CDM,278C1725S1_136797,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,393.75,157.5,,,0 CDM,278C1725S1_136799,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,393.75,157.5,,,0 CDM,278C1725S1_136801,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,393.75,157.5,,,0 CDM,278C1725S1_136803,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,393.75,157.5,,,0 CDM,278C1725S1_136805,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,393.75,157.5,,,0 CDM,278C1725S1_136815,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,393.75,157.5,,,0 CDM,278C1725S1_136816,Hc Sup Shell 278 Revenue Code C1725 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CDM,278C1725S1_137756,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,787.5,315.0,,,0 CDM,278C1725S1_137758,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,787.5,315.0,,,0 CDM,278C1725S1_137759,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,787.5,315.0,,,0 CDM,278C1725S1_137760,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,787.5,315.0,,,0 CDM,278C1725S1_137762,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1141.88,456.75,,,0 CDM,278C1725S1_137764,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1141.88,456.75,,,0 CDM,278C1725S1_138566,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1015.88,406.35,,,0 CDM,278C1725S1_138567,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1015.88,406.35,,,0 CDM,278C1725S1_138568,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1015.88,406.35,,,0 CDM,278C1725S1_138569,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1015.88,406.35,,,0 CDM,278C1725S1_138609,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,4123.35,1649.34,,,0 CDM,278C1725S1_138610,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,4123.35,1649.34,,,0 CDM,278C1725S1_138612,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,4228.05,1691.22,,,0 CDM,278C1725S1_138631,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,787.5,315.0,,,0 CDM,278C1725S1_138638,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,787.5,315.0,,,0 CDM,278C1725S1_138640,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,787.5,315.0,,,0 CDM,278C1725S1_138645,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1141.88,456.75,,,0 CDM,278C1725S1_138931,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1026.07,410.43,,,0 CDM,278C1725S1_138932,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1047.38,418.95,,,0 CDM,278C1725S1_138983,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,5517.42,2206.97,,,0 CDM,278C1725S1_138984,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,5517.42,2206.97,,,0 CDM,278C1725S1_138985,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2756.25,1102.5,,,0 CDM,278C1725S1_138986,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1141.88,456.75,,,0 CDM,278C1725S1_138987,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1141.88,456.75,,,0 CDM,278C1725S1_138988,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1240.31,496.12,,,0 CDM,278C1725S1_138998,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1141.88,456.75,,,0 CDM,278C1725S1_139169,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,3230.64,1292.26,,,0 CDM,278C1725S1_139170,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,3242.26,1296.9,,,0 CDM,278C1725S1_139171,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,3201.58,1280.63,,,0 CDM,278C1725S1_139172,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,3216.11,1286.44,,,0 CDM,278C1725S1_139173,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,3172.52,1269.01,,,0 CDM,278C1725S1_139174,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,3201.58,1280.63,,,0 CDM,278C1725S1_139175,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,3172.52,1269.01,,,0 CDM,278C1725S1_144309,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1575.0,630.0,,,0 CDM,278C1725S1_144312,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1673.44,669.38,,,0 CDM,278C1725S1_144314,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1673.44,669.38,,,0 CDM,278C1725S1_144316,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1935.94,774.38,,,0 CDM,278C1725S1_144828,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2069.82,827.93,,,0 CDM,278C1725S1_145776,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,431.71,172.68,,,0 CDM,278C1725S1_145778,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,431.71,172.68,,,0 CDM,278C1725S1_147153,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1319.06,527.62,,,0 CDM,278C1725S1_147161,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1019.12,407.65,,,0 CDM,278C1725S1_147162,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1055.25,422.1,,,0 CDM,278C1725S1_147163,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1023.75,409.5,,,0 CDM,278C1725S1_147164,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1082.81,433.12,,,0 CDM,278C1725S1_147165,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1212.75,485.1,,,0 CDM,278C1725S1_147169,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1443.75,577.5,,,0 CDM,278C1725S1_147170,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1434.37,573.75,,,0 CDM,278C1725S1_147171,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1046.25,418.5,,,0 CDM,278C1725S1_147172,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1001.25,400.5,,,0 CDM,278C1725S1_147173,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1063.12,425.25,,,0 CDM,278C1725S1_147174,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1092.66,437.06,,,0 CDM,278C1725S1_147175,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1191.09,476.44,,,0 CDM,278C1725S1_147176,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1023.75,409.5,,,0 CDM,278C1725S1_147177,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1008.0,403.2,,,0 CDM,278C1725S1_147179,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1299.38,519.75,,,0 CDM,278C1725S1_147180,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1001.25,400.5,,,0 CDM,278C1725S1_147181,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1023.75,409.5,,,0 CDM,278C1725S1_147182,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1086.75,434.7,,,0 CDM,278C1725S1_147183,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1147.78,459.11,,,0 CDM,278C1725S1_147184,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,984.38,393.75,,,0 CDM,278C1725S1_147185,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1018.12,407.25,,,0 CDM,278C1725S1_147186,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1095.94,438.38,,,0 CDM,278C1725S1_147188,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1008.0,403.2,,,0 CDM,278C1725S1_147189,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1013.91,405.56,,,0 CDM,278C1725S1_147190,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1082.81,433.12,,,0 CDM,278C1725S1_147292,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1673.44,669.38,,,0 CDM,278C1725S1_147293,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1476.56,590.62,,,0 CDM,278C1725S1_147296,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1490.62,596.25,,,0 CDM,278C1725S1_147297,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1476.56,590.62,,,0 CDM,278C1725S1_147298,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1575.0,630.0,,,0 CDM,278C1725S1_147299,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1141.88,456.75,,,0 CDM,278C1725S1_151005,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,4725.0,1890.0,,,0 CDM,278C1725S1_153946,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,13584.38,5433.75,,,0 CDM,278C1725S1_160480,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,452.81,181.12,,,0 CDM,278C1725S1_160520,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,472.5,189.0,,,0 CDM,278C1725S1_168190,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2756.25,1102.5,,,0 CDM,278C1725S1_169754,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,5517.42,2206.97,,,0 CDM,278C1725S1_170295,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1141.88,456.75,,,0 CDM,278C1725S1_171647,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2756.25,1102.5,,,0 CDM,278C1725S1_173892,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1443.75,577.5,,,0 CDM,278C1725S1_173893,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1509.38,603.75,,,0 CDM,278C1725S1_173914,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 CDM,278C1725S1_173916,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1575.0,630.0,,,0 CDM,278C1725S1_173919,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 CDM,278C1725S1_173923,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 CDM,278C1725S1_173924,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 CDM,278C1725S1_173925,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 CDM,278C1725S1_173926,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1575.0,630.0,,,0 CDM,278C1725S1_173928,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 CDM,278C1725S1_173930,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 CDM,278C1725S1_173932,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 CDM,278C1725S1_173935,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 CDM,278C1725S1_173936,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1420.31,568.12,,,0 CDM,278C1725S1_173937,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1410.94,564.38,,,0 CDM,278C1725S1_173938,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 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CDM,278C1725S1_173958,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 CDM,278C1725S1_173959,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 CDM,278C1725S1_173960,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 CDM,278C1725S1_173961,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 CDM,278C1725S1_173967,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 CDM,278C1725S1_173971,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 CDM,278C1725S1_173975,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1378.12,551.25,,,0 CDM,278C1725S1_173978,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1771.88,708.75,,,0 CDM,278C1725S1_173984,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1771.88,708.75,,,0 CDM,278C1725S1_173985,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1771.88,708.75,,,0 CDM,278C1725S1_173986,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1771.88,708.75,,,0 CDM,278C1725S1_173989,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1771.88,708.75,,,0 CDM,278C1725S1_183278,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2086.88,834.75,,,0 CDM,278C1725S1_183595,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1240.31,496.12,,,0 CDM,278C1725S1_184334,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2756.25,1102.5,,,0 CDM,278C1725S1_185344,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1141.88,456.75,,,0 CDM,278C1725S1_185843,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2756.25,1102.5,,,0 CDM,278C1725S1_188941,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,6081.98,2432.79,,,0 CDM,278C1725S1_192156,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,5558.92,2223.57,,,0 CDM,278C1725S1_193359,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,22246.88,8898.75,,,0 CDM,278C1725S1_193810,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,29767.5,11907.0,,,0 CDM,278C1725S1_196962,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,3851.86,1540.74,,,0 CDM,278C1725S1_198020,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1102.5,441.0,,,0 CDM,278C1725S1_199254,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,4123.35,1649.34,,,0 CDM,278C1725S1_92209,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,2525.79,1010.32,,,0 CDM,278C1725S1_94822,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,4123.35,1649.34,,,0 CDM,278C1725S1_C1725_272,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,52171.88,20868.75,,,0 CDM,278C172602,"Hc Valve Bronchial Loader Deploy Catheter, Sap#219067",3937.5,1575.0,,,0 CDM,278C172603,"Hc Balloon Spiration Catheter 2Mm, Sap#237168",441.47,176.59,,,0 CDM,278C172603_C1726_278,"Hc Balloon Spiration Catheter 2Mm, Sap#237168",441.47,176.59,,,0 CDM,278C172604,Hc Catheter Uromax Ultra Balloon Dilation 24Fr/8Cm Sap #251785,259.39,103.76,,,0 CDM,278C172604_C1726_278,Hc Catheter Uromax Ultra Balloon Dilation 24Fr/8Cm Sap #251785,995.01,398.0,,,0 CDM,278C1726S1_114077,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,10631.25,4252.5,,,0 CDM,278C1726S1_133593,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,10631.25,4252.5,,,0 CDM,278C1726S1_133594,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,10631.25,4252.5,,,0 CDM,278C1726S1_137514,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,759.78,303.91,,,0 CDM,278C1726S1_137515,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,759.78,303.91,,,0 CDM,278C1726S1_137593,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,676.42,270.57,,,0 CDM,278C1726S1_137594,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,759.78,303.91,,,0 CDM,278C1726S1_137595,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,759.78,303.91,,,0 CDM,278C1726S1_137767,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,759.78,303.91,,,0 CDM,278C1726S1_137942,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,3937.5,1575.0,,,0 CDM,278C1726S1_139098,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,865.74,346.3,,,0 CDM,278C1726S1_139099,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,865.74,346.3,,,0 CDM,278C1726S1_139100,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,865.74,346.3,,,0 CDM,278C1726S1_139101,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,865.74,346.3,,,0 CDM,278C1726S1_139189,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,865.74,346.3,,,0 CDM,278C1726S1_139190,Hc Sup Shell 278 Revenue 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Hcpcs,2262.1,904.84,,,0 CDM,278C1726S1_144893,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,2266.21,906.48,,,0 CDM,278C1726S1_145684,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,865.74,346.3,,,0 CDM,278C1726S1_145685,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,865.74,346.3,,,0 CDM,278C1726S1_145702,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,970.99,388.4,,,0 CDM,278C1726S1_145705,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,970.99,388.4,,,0 CDM,278C1726S1_145706,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,970.99,388.4,,,0 CDM,278C1726S1_145707,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,970.99,388.4,,,0 CDM,278C1726S1_145708,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,970.99,388.4,,,0 CDM,278C1726S1_145710,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,970.99,388.4,,,0 CDM,278C1726S1_145775,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,431.71,172.68,,,0 CDM,278C1726S1_145852,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,865.74,346.3,,,0 CDM,278C1726S1_145853,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,865.74,346.3,,,0 CDM,278C1726S1_146516,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,2494.21,997.68,,,0 CDM,278C1726S1_146517,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,865.74,346.3,,,0 CDM,278C1726S1_146518,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,865.74,346.3,,,0 CDM,278C1726S1_150511,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,1051.95,420.78,,,0 CDM,278C1726S1_152671,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,441.47,176.59,,,0 CDM,278C1726S1_152722,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,4626.56,1850.62,,,0 CDM,278C1726S1_170866,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,1008.57,403.43,,,0 CDM,278C1726S1_173957,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,1378.12,551.25,,,0 CDM,278C1726S1_173958,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,1575.0,630.0,,,0 CDM,278C1726S1_173961,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,1378.12,551.25,,,0 CDM,278C1726S1_173962,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,1378.12,551.25,,,0 CDM,278C1726S1_173983,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,1575.0,630.0,,,0 CDM,278C1726S1_173984,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,2008.12,803.25,,,0 CDM,278C1726S1_173985,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,2126.25,850.5,,,0 CDM,278C1726S1_175718,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,13120.31,5248.12,,,0 CDM,278C1726S1_195099,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,4263.1,1705.24,,,0 CDM,278C1726S1_84410,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,275.78,110.31,,,0 CDM,278C1726S1_84638,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,1034.14,413.66,,,0 CDM,278C1726S1_84759,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,1006.51,402.6,,,0 CDM,278C1726S1_86358,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,886.97,354.79,,,0 CDM,278C1726S1_88914,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,1196.3,478.52,,,0 CDM,278C1726S1_88915,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,1196.85,478.74,,,0 CDM,278C1726S1_88916,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,1196.3,478.52,,,0 CDM,278C1726S1_90052,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,3642.19,1456.88,,,0 CDM,278C1726S1_90899,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,822.39,328.96,,,0 CDM,278C1726S1_91982,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,1264.87,505.95,,,0 CDM,278C1726S1_95849,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,1196.3,478.52,,,0 CDM,278C1727S1_146821,Hc Sup Shell 278 Revenue Code C1727 Hcpcs,590.62,236.25,,,0 CDM,278C1727S1_95528,Hc Sup Shell 278 Revenue Code C1727 Hcpcs,885.67,354.27,,,0 CDM,278C172901,"Hc Chest Drain Kit, Sap#22191",436.26,174.5,,,0 CDM,278C172901_C1729_278,"Hc Chest Drain Kit, Sap#22191",436.26,174.5,,,0 CDM,278C172903,"Hc Denver Drain Kit, Sap#18195",216.56,86.62,,,0 CDM,278C172903_C1729_278,"Hc Denver Drain Kit, Sap#18195",216.56,86.62,,,0 CDM,278C1729S1_118910,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,756.0,302.4,,,0 CDM,278C1729S1_138460,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,305.57,122.23,,,0 CDM,278C1729S1_138462,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,299.53,119.81,,,0 CDM,278C1729S1_138463,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,298.56,119.42,,,0 CDM,278C1729S1_138469,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,300.96,120.38,,,0 CDM,278C1729S1_138471,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,293.52,117.41,,,0 CDM,278C1729S1_138615,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,81.11,32.44,,,0 CDM,278C1729S1_138759,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,274.17,109.67,,,0 CDM,278C1729S1_138820,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,244.12,97.65,,,0 CDM,278C1729S1_138839,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,304.53,121.81,,,0 CDM,278C1729S1_138923,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,606.38,242.55,,,0 CDM,278C1729S1_138924,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,645.75,258.3,,,0 CDM,278C1729S1_144384,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,298.9,119.56,,,0 CDM,278C1729S1_160528,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,81.11,32.44,,,0 CDM,278C1729S1_160529,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,81.11,32.44,,,0 CDM,278C1729S1_160530,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,244.12,97.65,,,0 CDM,278C1729S1_160531,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,307.12,122.85,,,0 CDM,278C1729S1_160532,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,244.12,97.65,,,0 CDM,278C1729S1_169793,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,673.31,269.32,,,0 CDM,278C1729S1_178675,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,244.12,97.65,,,0 CDM,278C1729S1_178676,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,244.12,97.65,,,0 CDM,278C1729S1_182997,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,72.85,29.14,,,0 CDM,278C1729S1_184167,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,452.42,180.97,,,0 CDM,278C1729S1_84246,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,574.88,229.95,,,0 CDM,278C1729S1_84539,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,96.23,38.49,,,0 CDM,278C1729S1_84540,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,96.95,38.78,,,0 CDM,278C1729S1_84541,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,96.23,38.49,,,0 CDM,278C1729S1_84542,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,96.23,38.49,,,0 CDM,278C1729S1_84543,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,96.23,38.49,,,0 CDM,278C1729S1_84544,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,96.23,38.49,,,0 CDM,278C1729S1_84545,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,201.84,80.74,,,0 CDM,278C1729S1_84546,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,98.36,39.34,,,0 CDM,278C1729S1_84548,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,96.95,38.78,,,0 CDM,278C1729S1_84550,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,96.95,38.78,,,0 CDM,278C1729S1_84551,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,96.95,38.78,,,0 CDM,278C1729S1_84562,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,96.95,38.78,,,0 CDM,278C1729S1_85870,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,791.44,316.58,,,0 CDM,278C1729S1_86024,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,437.89,175.16,,,0 CDM,278C1729S1_86230,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,2338.49,935.4,,,0 CDM,278C1729S1_86280,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,219.32,87.73,,,0 CDM,278C1729S1_86590,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,165.08,66.03,,,0 CDM,278C1729S1_87193,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,551.25,220.5,,,0 CDM,278C1729S1_88950,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,785.69,314.28,,,0 CDM,278C1729S1_92849,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,347.1,138.84,,,0 CDM,278C1729S1_92850,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,348.5,139.4,,,0 CDM,278C1729S1_95426,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,244.12,97.65,,,0 CDM,278C1729S1_95433,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,244.12,97.65,,,0 CDM,278C1730S1_133757,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,520.6,208.24,,,0 CDM,278C1730S1_133835,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,147.66,59.06,,,0 CDM,278C1730S1_134013,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,2854.69,1141.88,,,0 CDM,278C1730S1_134529,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,147.66,59.06,,,0 CDM,278C1730S1_134532,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,419.95,167.98,,,0 CDM,278C1730S1_135338,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,2053.35,821.34,,,0 CDM,278C1730S1_135339,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,2064.85,825.94,,,0 CDM,278C1730S1_136454,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,1870.31,748.12,,,0 CDM,278C1730S1_136585,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,1704.94,681.98,,,0 CDM,278C1730S1_137250,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,1031.62,412.65,,,0 CDM,278C1730S1_138060,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,3150.0,1260.0,,,0 CDM,278C1730S1_144874,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,1555.31,622.12,,,0 CDM,278C1730S1_163443,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,551.25,220.5,,,0 CDM,278C1730S1_185206,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,8624.44,3449.78,,,0 CDM,278C1730S1_185207,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,8657.1,3462.84,,,0 CDM,278C1730S1_189611,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,5819.62,2327.85,,,0 CDM,278C1730S1_192511,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,167.62,67.05,,,0 CDM,278C1730S1_195595,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,14923.12,5969.25,,,0 CDM,278C1730S1_195606,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,14923.12,5969.25,,,0 CDM,278C1730S1_195651,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,14923.12,5969.25,,,0 CDM,278C1730S1_195667,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,14923.12,5969.25,,,0 CDM,278C1730S1_196294,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,14923.12,5969.25,,,0 CDM,278C1730S1_196314,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,14923.12,5969.25,,,0 CDM,278C1730S1_196671,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,14923.12,5969.25,,,0 CDM,278C1730S1_198192,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,14923.12,5969.25,,,0 CDM,278C1731S1_134162,Hc Sup Shell 278 Revenue Code C1731 Hcpcs,4047.75,1619.1,,,0 CDM,278C1731S1_135337,Hc Sup Shell 278 Revenue Code C1731 Hcpcs,4413.94,1765.58,,,0 CDM,278C1731S1_145723,Hc Sup Shell 278 Revenue Code C1731 Hcpcs,5675.91,2270.36,,,0 CDM,278C1732S1_133830,Hc Sup Shell 278 Revenue Code C1732 Hcpcs,5315.62,2126.25,,,0 CDM,278C1732S1_133831,Hc Sup Shell 278 Revenue Code C1732 Hcpcs,5315.62,2126.25,,,0 CDM,278C1732S1_134134,Hc Sup Shell 278 Revenue Code C1732 Hcpcs,3248.44,1299.38,,,0 CDM,278C1732S1_134531,Hc Sup Shell 278 Revenue Code C1732 Hcpcs,4091.06,1636.42,,,0 CDM,278C1732S1_134536,Hc Sup Shell 278 Revenue Code C1732 Hcpcs,4030.39,1612.16,,,0 CDM,278C1732S1_135340,Hc Sup Shell 278 Revenue Code C1732 Hcpcs,12639.38,5055.75,,,0 CDM,278C1732S1_136452,Hc Sup Shell 278 Revenue Code C1732 Hcpcs,2526.56,1010.62,,,0 CDM,278C1732S1_136461,Hc Sup Shell 278 Revenue Code C1732 Hcpcs,8347.5,3339.0,,,0 CDM,278C1732S1_136462,Hc Sup Shell 278 Revenue Code C1732 Hcpcs,8347.5,3339.0,,,0 CDM,278C1732S1_136668,Hc Sup Shell 278 Revenue Code C1732 Hcpcs,12619.83,5047.93,,,0 CDM,278C1732S1_144521,Hc Sup Shell 278 Revenue Code C1732 Hcpcs,9355.5,3742.2,,,0 CDM,278C1732S1_169758,Hc Sup Shell 278 Revenue Code C1732 Hcpcs,2362.5,945.0,,,0 CDM,278C1732S1_185204,Hc Sup Shell 278 Revenue Code C1732 Hcpcs,8649.64,3459.86,,,0 CDM,278C1732S1_185205,Hc Sup Shell 278 Revenue Code C1732 Hcpcs,8638.88,3455.55,,,0 CDM,278C1732S1_197898,Hc Sup Shell 278 Revenue Code C1732 Hcpcs,569.64,227.86,,,0 CDM,278C1732S1_198213,Hc Sup Shell 278 Revenue Code C1732 Hcpcs,14761.69,5904.68,,,0 CDM,278C1732S1_198309,Hc Sup Shell 278 Revenue Code C1732 Hcpcs,14923.12,5969.25,,,0 CDM,278C173301,"Hc Catheter Safeline Coated Rf32, Sap#141051",6199.2,2479.68,,,0 CDM,278C1733S1_113928,Hc Sup Shell 278 Revenue Code C1733 Hcpcs,749.7,299.88,,,0 CDM,278C1733S1_138056,Hc Sup Shell 278 Revenue Code C1733 Hcpcs,17521.88,7008.75,,,0 CDM,278C1733S1_138057,Hc Sup Shell 278 Revenue Code C1733 Hcpcs,17521.88,7008.75,,,0 CDM,278C1733S1_194153,Hc Sup Shell 278 Revenue Code C1733 Hcpcs,33271.88,13308.75,,,0 CDM,278C1734S1_190341,Hc Sup Shell 278 Revenue Code C1734 Hcpcs,13347.44,5338.98,,,0 CDM,278C175001,"Hc Kit Lg Bore Multi-Lumen Cath, Sap# 1653",529.67,211.87,,,0 CDM,278C175001_C1750_278,"Hc Kit Lg Bore Multi-Lumen Cath, Sap# 1653",529.67,211.87,,,0 CDM,278C1750S1_130557,Hc Sup Shell 278 Revenue Code C1750 Hcpcs,1964.81,785.92,,,0 CDM,278C1750S1_134211,Hc Sup Shell 278 Revenue Code C1750 Hcpcs,1016.64,406.66,,,0 CDM,278C1750S1_134212,Hc Sup Shell 278 Revenue Code C1750 Hcpcs,1187.33,474.93,,,0 CDM,278C1750S1_134558,Hc Sup Shell 278 Revenue Code C1750 Hcpcs,1240.31,496.12,,,0 CDM,278C1750S1_138600,Hc Sup Shell 278 Revenue Code C1750 Hcpcs,1350.52,540.21,,,0 CDM,278C1750S1_138601,Hc Sup Shell 278 Revenue Code C1750 Hcpcs,1350.52,540.21,,,0 CDM,278C1750S1_138603,Hc Sup Shell 278 Revenue Code C1750 Hcpcs,1350.52,540.21,,,0 CDM,278C1750S1_156288,Hc Sup Shell 278 Revenue Code C1750 Hcpcs,1009.7,403.88,,,0 CDM,278C1750S1_156328,Hc Sup Shell 278 Revenue Code C1750 Hcpcs,1771.88,708.75,,,0 CDM,278C1750S1_156329,Hc Sup Shell 278 Revenue Code C1750 Hcpcs,1525.78,610.31,,,0 CDM,278C1750S1_158726,Hc Sup Shell 278 Revenue Code C1750 Hcpcs,1979.62,791.85,,,0 CDM,278C1750S1_158728,Hc Sup Shell 278 Revenue Code C1750 Hcpcs,410.09,164.04,,,0 CDM,278C1750S1_186432,Hc Sup Shell 278 Revenue Code C1750 Hcpcs,1488.87,595.55,,,0 CDM,278C1750S1_186433,Hc Sup Shell 278 Revenue Code C1750 Hcpcs,1279.69,511.88,,,0 CDM,278C1750S1_191893,Hc Sup Shell 278 Revenue Code C1750 Hcpcs,767.81,307.12,,,0 CDM,278C1750S1_83792,Hc Sup Shell 278 Revenue Code C1750 Hcpcs,504.79,201.92,,,0 CDM,278C1750S1_84202,Hc Sup Shell 278 Revenue Code C1750 Hcpcs,639.18,255.67,,,0 CDM,278C1750S1_86252,Hc Sup Shell 278 Revenue Code C1750 Hcpcs,686.82,274.73,,,0 CDM,278C1750S1_86718,Hc Sup Shell 278 Revenue Code C1750 Hcpcs,630.0,252.0,,,0 CDM,278C1750S1_87604,Hc Sup Shell 278 Revenue Code C1750 Hcpcs,1168.09,467.24,,,0 CDM,278C175101,Hc Catheter Kit,124.5,49.8,,,0 CDM,278C175101_C1751_278,Hc Catheter Kit,124.5,49.8,,,0 CDM,278C175102,Hc Catheter Kits Multilumen/Introducer,584.86,233.94,,,0 CDM,278C175102_C1751_278,Hc Catheter Kits Multilumen/Introducer,584.86,233.94,,,0 CDM,278C175103,Hc Kit Introducer Dual Lumen Mac Sap#207040,495.06,198.02,,,0 CDM,278C175104,"Hc Picc Solo 5Fr Dl, Sap#220464",1291.5,516.6,,,0 CDM,278C175104_C1751_278,"Hc Picc Solo 5Fr Dl, Sap#220464",1291.5,516.6,,,0 CDM,278C175105,Hc Kit Power Picc 6Fr Dual Lumen Sap#76540,956.81,382.72,,,0 CDM,278C175105_C1751_278,Hc Kit Power Picc 6Fr Dual Lumen Sap#76540,956.81,382.72,,,0 CDM,278C175106,Hc Cath Cvc Triple Lumen 7Fr Sap #208409,108.65,43.46,,,0 CDM,278C175106_C1751_278,Hc Cath Cvc Triple Lumen 7Fr Sap #208409,108.65,43.46,,,0 CDM,278C175107,Hc Picc Midline 4Fr Single Sap #203187,527.62,211.05,,,0 CDM,278C175107_C1751_278,Hc Picc Midline 4Fr Single Sap #203187,527.62,211.05,,,0 CDM,278C175109,Hc Kit Picc Max Solo 4Fr Sl Sap#72002,929.09,371.64,,,0 CDM,278C175109_C1751_278,Hc Kit Picc Max Solo 4Fr Sl Sap#72002,929.09,371.64,,,0 CDM,278C175110,Hc Set Cath 3Fr 8Cm 1Lumen Sap#645,142.18,56.87,,,0 CDM,278C175111,Hc Kit Cath 6Inx16Ga Adult Central Sap#412,107.42,42.97,,,0 CDM,278C175112,Hc Picc 3Fr Morpheus Sap#146193,426.39,170.56,,,0 CDM,278C175113,Hc Tray 3Fr Picc Sl Poly Cath Full Sap#72000,709.18,283.67,,,0 CDM,278C175113_C1751_278,Hc Tray 3Fr Picc Sl Poly Cath Full Sap#72000,709.18,283.67,,,0 CDM,278C175114,"Hc Picc 1.9Fr Sl W/Ez Flush, Sap#173196",125.41,50.16,,,0 CDM,278C175114_C1751_278,"Hc Picc 1.9Fr Sl W/Ez Flush, Sap#173196",125.41,50.16,,,0 CDM,278C175115,Hc Catheter Tray Picc Vygon Neonate Sap#37772,83.24,33.3,,,0 CDM,278C175115_C1751_278,Hc Catheter Tray Picc Vygon Neonate Sap#37772,83.24,33.3,,,0 CDM,278C175116,Hc Kit Silicone Picc Complete 1.9Fr Sap#234043,409.27,163.71,,,0 CDM,278C175116_C1751_278,Hc Kit Silicone Picc Complete 1.9Fr Sap#234043,409.27,163.71,,,0 CDM,278C175117,Hc Catheter Picc Sl 26Gx30Cm Sap#37773,283.97,113.59,,,0 CDM,278C175117_C1751_278,Hc Catheter Picc Sl 26Gx30Cm Sap#37773,283.97,113.59,,,0 CDM,278C175118,Hc Kit Silicone Picc Complete 1.9Fr Dl Sap#24203,409.23,163.69,,,0 CDM,278C175118_C1751_278,Hc Kit Silicone Picc Complete 1.9Fr Dl Sap#24203,409.23,163.69,,,0 CDM,278C175119,Hc Kit Poly Picc Complete 1.4Fr Sap#234041,438.05,175.22,,,0 CDM,278C175119_C1751_278,Hc Kit Poly Picc Complete 1.4Fr Sap#234041,438.05,175.22,,,0 CDM,278C175120,Hc Needle Intro 1.9Fr 26Ga Autogrd Sap#37774,166.59,66.64,,,0 CDM,278C175120_C1751_278,Hc Needle Intro 1.9Fr 26Ga Autogrd Sap#37774,166.59,66.64,,,0 CDM,278C175121,Hc Cannula Mc3 Crescent 26 Fr Sap #260402,9351.56,3740.62,,,0 CDM,278C175122,Hc Cannula Mc3 Crescent 28 Fr Sap #260403,9351.56,3740.62,,,0 CDM,278C175123,Hc Cannula Mc3 Crescent 30 Fr Sap #260404,9351.56,3740.62,,,0 CDM,278C175124,Hc Cannula Mc3 Crescent 24 Fr Sap #260401,9351.56,3740.62,,,0 CDM,278C175124_C1751_278,Hc Cannula Mc3 Crescent 24 Fr Sap #260401,9351.56,3740.62,,,0 CDM,278C175125,Hc Cannula Mc3 Crescent 32 Fr Sap #260405,9351.56,3740.62,,,0 CDM,278C175125_C1751_278,Hc Cannula Mc3 Crescent 32 Fr Sap #260405,9351.56,3740.62,,,0 CDM,278C175126,"Hc Picc Max Solo 4Fr Dual Lumen, Sap#69312",1077.73,431.09,,,0 CDM,278C175126_C1751_278,"Hc Picc Max Solo 4Fr Dual Lumen, Sap#69312",1077.73,431.09,,,0 CDM,278C175127,"Hc Kit Gold Marker 17Ga Etw 1.2X3Mm, Sap#263793",297.96,119.18,,,0 CDM,278C175127_C1751_278,"Hc Kit Gold Marker 17Ga Etw 1.2X3Mm, Sap#263793",297.96,119.18,,,0 CDM,278C1751S1_115918,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,409.62,163.85,,,0 CDM,278C1751S1_118819,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,76.79,30.72,,,0 CDM,278C1751S1_130842,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,547.68,219.07,,,0 CDM,278C1751S1_138575,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,1550.48,620.19,,,0 CDM,278C1751S1_138576,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,1552.01,620.8,,,0 CDM,278C1751S1_138577,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,1553.19,621.28,,,0 CDM,278C1751S1_138719,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,920.4,368.16,,,0 CDM,278C1751S1_138720,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,1252.35,500.94,,,0 CDM,278C1751S1_138721,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,1063.36,425.34,,,0 CDM,278C1751S1_138722,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,1181.25,472.5,,,0 CDM,278C1751S1_170404,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,10631.25,4252.5,,,0 CDM,278C1751S1_172854,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,1043.01,417.2,,,0 CDM,278C1751S1_182939,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,9351.56,3740.62,,,0 CDM,278C1751S1_182942,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,9351.56,3740.62,,,0 CDM,278C1751S1_182943,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,9351.56,3740.62,,,0 CDM,278C1751S1_190908,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,398.2,159.28,,,0 CDM,278C1751S1_194199,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,3273.6,1309.44,,,0 CDM,278C1751S1_196074,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,1094.01,437.6,,,0 CDM,278C1751S1_83721,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,311.06,124.42,,,0 CDM,278C1751S1_83788,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,504.56,201.82,,,0 CDM,278C1751S1_84215,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,555.49,222.2,,,0 CDM,278C1751S1_84216,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,532.88,213.15,,,0 CDM,278C1751S1_84598,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,138.05,55.22,,,0 CDM,278C1751S1_84599,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,219.8,87.92,,,0 CDM,278C1751S1_84768,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,433.12,173.25,,,0 CDM,278C1751S1_84799,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,767.81,307.12,,,0 CDM,278C1751S1_91226,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,341.26,136.5,,,0 CDM,278C1751S1_91227,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,365.36,146.14,,,0 CDM,278C1751S1_92370,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,789.87,315.95,,,0 CDM,278C1751S1_92442,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,663.46,265.38,,,0 CDM,278C1751S1_93917,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,1098.04,439.22,,,0 CDM,278C1751S1_94757,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,955.22,382.09,,,0 CDM,278C1751S1_96093,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,1099.39,439.76,,,0 CDM,278C1752S1_113374,Hc Sup Shell 278 Revenue Code C1752 Hcpcs,496.45,198.58,,,0 CDM,278C1752S1_118861,Hc Sup Shell 278 Revenue Code C1752 Hcpcs,338.55,135.42,,,0 CDM,278C1752S1_126734,Hc Sup Shell 278 Revenue Code C1752 Hcpcs,303.39,121.36,,,0 CDM,278C1752S1_130524,Hc Sup Shell 278 Revenue Code C1752 Hcpcs,666.66,266.66,,,0 CDM,278C1752S1_130526,Hc Sup Shell 278 Revenue Code C1752 Hcpcs,497.56,199.02,,,0 CDM,278C1752S1_171490,Hc Sup Shell 278 Revenue Code C1752 Hcpcs,666.66,266.66,,,0 CDM,278C1752S1_180500,Hc Sup Shell 278 Revenue Code C1752 Hcpcs,688.16,275.26,,,0 CDM,278C1753S1_136605,Hc Sup Shell 278 Revenue Code C1753 Hcpcs,2953.12,1181.25,,,0 CDM,278C1753S1_136606,Hc Sup Shell 278 Revenue Code C1753 Hcpcs,11792.81,4717.12,,,0 CDM,278C1753S1_137789,Hc Sup Shell 278 Revenue Code C1753 Hcpcs,2980.05,1192.02,,,0 CDM,278C1753S1_137790,Hc Sup Shell 278 Revenue Code C1753 Hcpcs,2775.94,1110.38,,,0 CDM,278C1753S1_137791,Hc Sup Shell 278 Revenue Code C1753 Hcpcs,3858.75,1543.5,,,0 CDM,278C1753S1_145679,Hc Sup Shell 278 Revenue Code C1753 Hcpcs,114.54,45.82,,,0 CDM,278C1753S1_155374,Hc Sup Shell 278 Revenue Code C1753 Hcpcs,433.12,173.25,,,0 CDM,278C1753S1_155375,Hc Sup Shell 278 Revenue Code C1753 Hcpcs,433.12,173.25,,,0 CDM,278C175501,Hc Kit Percutaneous Intraspinal C Sap #76313,290.06,116.02,,,0 CDM,278C1755S1_118523,Hc Sup Shell 278 Revenue Code C1755 Hcpcs,3917.81,1567.12,,,0 CDM,278C1755S1_118524,Hc Sup Shell 278 Revenue Code C1755 Hcpcs,3917.81,1567.12,,,0 CDM,278C1755S1_119772,Hc Sup Shell 278 Revenue Code C1755 Hcpcs,2165.62,866.25,,,0 CDM,278C1755S1_84807,Hc Sup Shell 278 Revenue Code C1755 Hcpcs,736.1,294.44,,,0 CDM,278C1757S1_113420,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,21636.56,8654.62,,,0 CDM,278C1757S1_113425,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,22221.56,8888.62,,,0 CDM,278C1757S1_113426,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,23684.06,9473.62,,,0 CDM,278C1757S1_114453,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,16478.44,6591.38,,,0 CDM,278C1757S1_133865,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,1575.0,630.0,,,0 CDM,278C1757S1_137517,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,1307.25,522.9,,,0 CDM,278C1757S1_137520,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,1307.25,522.9,,,0 CDM,278C1757S1_137521,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,1307.25,522.9,,,0 CDM,278C1757S1_137522,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,1307.25,522.9,,,0 CDM,278C1757S1_137523,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,1307.25,522.9,,,0 CDM,278C1757S1_137524,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,1307.25,522.9,,,0 CDM,278C1757S1_137525,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,1307.25,522.9,,,0 CDM,278C1757S1_137536,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,1307.25,522.9,,,0 CDM,278C1757S1_137537,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,1307.25,522.9,,,0 CDM,278C1757S1_137538,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,1307.25,522.9,,,0 CDM,278C1757S1_137564,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,1307.25,522.9,,,0 CDM,278C1757S1_137565,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,1307.25,522.9,,,0 CDM,278C1757S1_137787,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,10950.19,4380.08,,,0 CDM,278C1757S1_137971,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,4134.38,1653.75,,,0 CDM,278C1757S1_138644,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,468.56,187.42,,,0 CDM,278C1757S1_138735,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,23605.31,9442.12,,,0 CDM,278C1757S1_138737,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,23605.31,9442.12,,,0 CDM,278C1757S1_138847,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,9410.62,3764.25,,,0 CDM,278C1757S1_138897,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,772.76,309.1,,,0 CDM,278C1757S1_138900,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,9410.62,3764.25,,,0 CDM,278C1757S1_138916,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,25346.5,10138.6,,,0 CDM,278C1757S1_138917,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,25271.28,10108.51,,,0 CDM,278C1757S1_155041,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,10434.38,4173.75,,,0 CDM,278C1757S1_155285,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,7363.12,2945.25,,,0 CDM,278C1757S1_155286,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,3346.88,1338.75,,,0 CDM,278C1757S1_155287,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,12796.88,5118.75,,,0 CDM,278C1757S1_155288,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,12796.88,5118.75,,,0 CDM,278C1757S1_155289,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,12796.88,5118.75,,,0 CDM,278C1757S1_156175,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,9410.62,3764.25,,,0 CDM,278C1757S1_156239,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,8820.0,3528.0,,,0 CDM,278C1757S1_156240,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,4134.38,1653.75,,,0 CDM,278C1757S1_163435,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,10434.38,4173.75,,,0 CDM,278C1757S1_170381,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,7363.12,2945.25,,,0 CDM,278C1757S1_184453,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,38233.12,15293.25,,,0 CDM,278C1757S1_187743,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,23605.31,9442.12,,,0 CDM,278C1757S1_192538,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,26512.21,10604.88,,,0 CDM,278C1757S1_195976,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,25196.06,10078.42,,,0 CDM,278C1757S1_83770,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,356.01,142.4,,,0 CDM,278C1757S1_83771,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,211.45,84.58,,,0 CDM,278C1757S1_83772,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,210.86,84.34,,,0 CDM,278C1757S1_83773,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,210.75,84.3,,,0 CDM,278C1757S1_83774,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,212.01,84.8,,,0 CDM,278C1757S1_83775,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,209.87,83.95,,,0 CDM,278C1757S1_86214,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,345.67,138.27,,,0 CDM,278C1757S1_86215,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,347.83,139.13,,,0 CDM,278C1757S1_86216,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,349.13,139.65,,,0 CDM,278C1758S1_118828,Hc Sup Shell 278 Revenue Code C1758 Hcpcs,13.46,5.38,,,0 CDM,278C1758S1_195152,Hc Sup Shell 278 Revenue Code C1758 Hcpcs,83.49,33.4,,,0 CDM,278C1758S1_84748,Hc Sup Shell 278 Revenue Code C1758 Hcpcs,77.96,31.18,,,0 CDM,278C1758S1_84749,Hc Sup Shell 278 Revenue Code C1758 Hcpcs,77.96,31.18,,,0 CDM,278C1758S1_84918,Hc Sup Shell 278 Revenue Code C1758 Hcpcs,51.47,20.59,,,0 CDM,278C1758S1_84919,Hc Sup Shell 278 Revenue Code C1758 Hcpcs,44.72,17.89,,,0 CDM,278C1758S1_85819,Hc Sup Shell 278 Revenue Code C1758 Hcpcs,51.57,20.63,,,0 CDM,278C1758S1_86288,Hc Sup Shell 278 Revenue Code C1758 Hcpcs,52.02,20.81,,,0 CDM,278C1758S1_91137,Hc Sup Shell 278 Revenue Code C1758 Hcpcs,270.8,108.32,,,0 CDM,278C1759S1_134537,Hc Sup Shell 278 Revenue Code C1759 Hcpcs,9808.7,3923.48,,,0 CDM,278C1759S1_134538,Hc Sup Shell 278 Revenue Code C1759 Hcpcs,9637.96,3855.18,,,0 CDM,278C1759S1_136597,Hc Sup Shell 278 Revenue Code C1759 Hcpcs,3524.06,1409.62,,,0 CDM,278C1759S1_164051,Hc Sup Shell 278 Revenue Code C1759 Hcpcs,3524.06,1409.62,,,0 CDM,278C1759S1_182715,Hc Sup Shell 278 Revenue Code C1759 Hcpcs,13190.62,5276.25,,,0 CDM,278C1760S1_133847,Hc Sup Shell 278 Revenue Code C1760 Hcpcs,821.93,328.77,,,0 CDM,278C1760S1_133848,Hc Sup Shell 278 Revenue Code C1760 Hcpcs,841.27,336.51,,,0 CDM,278C1760S1_133864,Hc Sup Shell 278 Revenue Code C1760 Hcpcs,1019.81,407.92,,,0 CDM,278C1760S1_182124,Hc Sup Shell 278 Revenue Code C1760 Hcpcs,929.25,371.7,,,0 CDM,278C1760S1_86447,Hc Sup Shell 278 Revenue Code C1760 Hcpcs,1236.38,494.55,,,0 CDM,278C1761S1_175503,Hc Sup Shell 278 Revenue Code C1761 Hcpcs,18506.25,7402.5,,,0 CDM,278C1761S1_175504,Hc Sup Shell 278 Revenue Code C1761 Hcpcs,18506.25,7402.5,,,0 CDM,278C1761S1_175505,Hc Sup Shell 278 Revenue Code C1761 Hcpcs,18506.25,7402.5,,,0 CDM,278C1761S1_175506,Hc Sup Shell 278 Revenue Code C1761 Hcpcs,18506.25,7402.5,,,0 CDM,278C1761S1_191598,Hc Sup Shell 278 Revenue Code C1761 Hcpcs,18531.57,7412.63,,,0 CDM,278C1761S1_192627,Hc Sup Shell 278 Revenue Code C1761 Hcpcs,18512.59,7405.04,,,0 CDM,278C1762S1_133377,Hc Sup Shell 278 Revenue Code C1762 Hcpcs,8548.31,3419.32,,,0 CDM,278C1762S1_137850,Hc Sup Shell 278 Revenue Code C1762 Hcpcs,4019.2,1607.68,,,0 CDM,278C1762S1_137855,Hc Sup Shell 278 Revenue Code C1762 Hcpcs,1043.44,417.38,,,0 CDM,278C1762S1_137863,Hc Sup Shell 278 Revenue Code C1762 Hcpcs,5876.06,2350.42,,,0 CDM,278C1762S1_137864,Hc Sup Shell 278 Revenue Code C1762 Hcpcs,8062.89,3225.16,,,0 CDM,278C1762S1_150396,Hc Sup Shell 278 Revenue Code C1762 Hcpcs,5723.16,2289.26,,,0 CDM,278C1762S1_150399,Hc Sup Shell 278 Revenue Code C1762 Hcpcs,5723.16,2289.26,,,0 CDM,278C1762S1_156933,Hc Sup Shell 278 Revenue Code C1762 Hcpcs,4413.49,1765.4,,,0 CDM,278C1762S1_175560,Hc Sup Shell 278 Revenue Code C1762 Hcpcs,1988.05,795.22,,,0 CDM,278C1763S1_137634,Hc Sup Shell 278 Revenue Code C1763 Hcpcs,18112.5,7245.0,,,0 CDM,278C1763S1_137635,Hc Sup Shell 278 Revenue Code C1763 Hcpcs,22739.06,9095.62,,,0 CDM,278C1763S1_137918,Hc Sup Shell 278 Revenue Code C1763 Hcpcs,5650.31,2260.12,,,0 CDM,278C1763S1_137919,Hc Sup Shell 278 Revenue Code C1763 Hcpcs,1649.81,659.92,,,0 CDM,278C1763S1_146181,Hc Sup Shell 278 Revenue Code C1763 Hcpcs,8420.64,3368.26,,,0 CDM,278C1763S1_162714,Hc Sup Shell 278 Revenue Code C1763 Hcpcs,964.69,385.88,,,0 CDM,278C1763S1_162715,Hc Sup Shell 278 Revenue Code C1763 Hcpcs,1163.47,465.39,,,0 CDM,278C1763S1_170869,Hc Sup Shell 278 Revenue Code C1763 Hcpcs,17647.88,7059.15,,,0 CDM,278C1763S1_172857,Hc Sup Shell 278 Revenue Code C1763 Hcpcs,26901.0,10760.4,,,0 CDM,278C1763S1_179185,Hc Sup Shell 278 Revenue Code C1763 Hcpcs,1122.51,449.0,,,0 CDM,278C1763S1_179206,Hc Sup Shell 278 Revenue Code C1763 Hcpcs,23220.0,9288.0,,,0 CDM,278C176401,Hc Loop Recorder Receal Linq Sap#219760,19667.81,7867.12,,,0 CDM,278C176401_C1764_278,Hc Loop Recorder Receal Linq Sap#219760,19667.81,7867.12,,,0 CDM,278C176402,"Hc System Reveal Linq Ii Insertable Cardiac Monitor, Lnq22Sy, Sap#211254",20258.44,8103.38,,,0 CDM,278C176402_C1764_278,"Hc System Reveal Linq Ii Insertable Cardiac Monitor, Lnq22Sy, Sap#211254",20258.44,8103.38,,,0 CDM,278C176403,"Hc Kit Axonics Sacral Neurostim Pne Lead Implant, Sap#258825",1023.75,409.5,,,0 CDM,278C176403_C1764_278,"Hc Kit Axonics Sacral Neurostim Pne Lead Implant, Sap#258825",1023.75,409.5,,,0 CDM,278C1764S1_197910,Hc Sup Shell 278 Revenue Code C1764 Hcpcs,18112.5,7245.0,,,0 CDM,278C1764S1_C1764_278,Hc Sup Shell 278 Revenue Code C1764 Hcpcs,18112.5,7245.0,,,0 CDM,278C1765S1_113668,Hc Sup Shell 278 Revenue Code C1765 Hcpcs,1751.64,700.66,,,0 CDM,278C1765S1_86323,Hc Sup Shell 278 Revenue Code C1765 Hcpcs,1458.91,583.56,,,0 CDM,278C1766S1_134161,Hc Sup Shell 278 Revenue Code C1766 Hcpcs,3890.25,1556.1,,,0 CDM,278C1766S1_138014,Hc Sup Shell 278 Revenue Code C1766 Hcpcs,3933.56,1573.42,,,0 CDM,278C1766S1_138058,Hc Sup Shell 278 Revenue Code C1766 Hcpcs,4725.0,1890.0,,,0 CDM,278C1766S1_169983,Hc Sup Shell 278 Revenue Code C1766 Hcpcs,3709.12,1483.65,,,0 CDM,278C1766S1_169984,Hc Sup Shell 278 Revenue Code C1766 Hcpcs,3718.74,1487.5,,,0 CDM,278C1766S1_169985,Hc Sup Shell 278 Revenue Code C1766 Hcpcs,3717.74,1487.1,,,0 CDM,278C1766S1_194155,Hc Sup Shell 278 Revenue Code C1766 Hcpcs,5118.75,2047.5,,,0 CDM,278C1767S1_116811,Hc Sup Shell 278 Revenue Code C1767 Hcpcs,33862.5,13545.0,,,0 CDM,278C1767S1_116812,Hc Sup Shell 278 Revenue Code C1767 Hcpcs,33862.5,13545.0,,,0 CDM,278C1767S1_132959,Hc Sup Shell 278 Revenue Code C1767 Hcpcs,68906.25,27562.5,,,0 CDM,278C1767S1_132972,Hc Sup Shell 278 Revenue Code C1767 Hcpcs,64968.75,25987.5,,,0 CDM,278C1767S1_144247,Hc Sup Shell 278 Revenue Code C1767 Hcpcs,153444.2,61377.68,,,0 CDM,278C1767S1_158736,Hc Sup Shell 278 Revenue Code C1767 Hcpcs,78427.12,31370.85,,,0 CDM,278C1767S1_158737,Hc Sup Shell 278 Revenue Code C1767 Hcpcs,5036.06,2014.42,,,0 CDM,278C1767S1_171709,Hc Sup Shell 278 Revenue Code C1767 Hcpcs,136644.38,54657.75,,,0 CDM,278C1767S1_176995,Hc Sup Shell 278 Revenue Code C1767 Hcpcs,71760.94,28704.38,,,0 CDM,278C1767S1_178854,Hc Sup Shell 278 Revenue Code C1767 Hcpcs,3319.31,1327.72,,,0 CDM,278C1767S1_178855,Hc Sup Shell 278 Revenue Code C1767 Hcpcs,45875.81,18350.32,,,0 CDM,278C1767S1_182149,Hc Sup Shell 278 Revenue Code C1767 Hcpcs,68906.25,27562.5,,,0 CDM,278C1767S1_89538,Hc Sup Shell 278 Revenue Code C1767 Hcpcs,152766.24,61106.5,,,0 CDM,278C1767S1_91851,Hc Sup Shell 278 Revenue Code C1767 Hcpcs,44198.44,17679.38,,,0 CDM,278C1767S1_C1767_278,Hc Sup Shell 278 Revenue Code C1767 Hcpcs,70481.25,28192.5,,,0 CDM,278C176801,Hc Graft Felt Ptfe 1X6 Sap #5303,101.0,40.4,,,0 CDM,278C1768S1_115902,Hc Sup Shell 278 Revenue Code C1768 Hcpcs,1315.12,526.05,,,0 CDM,278C1768S1_115904,Hc Sup Shell 278 Revenue Code C1768 Hcpcs,5898.38,2359.35,,,0 CDM,278C1768S1_115905,Hc Sup Shell 278 Revenue Code C1768 Hcpcs,5122.69,2049.08,,,0 CDM,278C1768S1_116420,Hc Sup Shell 278 Revenue Code C1768 Hcpcs,2114.85,845.94,,,0 CDM,278C1768S1_134929,Hc Sup Shell 278 Revenue Code C1768 Hcpcs,2119.25,847.7,,,0 CDM,278C1768S1_134930,Hc Sup Shell 278 Revenue Code C1768 Hcpcs,2235.32,894.13,,,0 CDM,278C1768S1_134931,Hc Sup Shell 278 Revenue Code C1768 Hcpcs,2265.64,906.26,,,0 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CDM,278C1769S1_115323,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,403.99,161.6,,,0 CDM,278C1769S1_116802,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,95.76,38.3,,,0 CDM,278C1769S1_117339,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,163.01,65.2,,,0 CDM,278C1769S1_117455,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,72.69,29.08,,,0 CDM,278C1769S1_118400,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,428.87,171.55,,,0 CDM,278C1769S1_118401,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,500.93,200.37,,,0 CDM,278C1769S1_119007,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,245.53,98.21,,,0 CDM,278C1769S1_119719,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,115.92,46.37,,,0 CDM,278C1769S1_128867,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,146.36,58.54,,,0 CDM,278C1769S1_130983,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,331.4,132.56,,,0 CDM,278C1769S1_131286,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,463.03,185.21,,,0 CDM,278C1769S1_132797,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,371.31,148.52,,,0 CDM,278C1769S1_133292,Hc Sup 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Shell 278 Revenue Code C1769 Hcpcs,221.83,88.73,,,0 CDM,278C1769S1_137511,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,40.83,16.33,,,0 CDM,278C1769S1_137518,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,219.41,87.76,,,0 CDM,278C1769S1_137526,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,205.09,82.04,,,0 CDM,278C1769S1_137557,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,161.61,64.64,,,0 CDM,278C1769S1_137558,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,196.03,78.41,,,0 CDM,278C1769S1_137559,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,200.94,80.38,,,0 CDM,278C1769S1_137561,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,37.57,15.03,,,0 CDM,278C1769S1_137577,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,286.34,114.54,,,0 CDM,278C1769S1_137592,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,286.34,114.54,,,0 CDM,278C1769S1_137631,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,551.25,220.5,,,0 CDM,278C1769S1_137795,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,451.65,180.66,,,0 CDM,278C1769S1_137820,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,551.25,220.5,,,0 CDM,278C1769S1_137960,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,588.37,235.35,,,0 CDM,278C1769S1_138467,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,149.48,59.79,,,0 CDM,278C1769S1_138470,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,166.42,66.57,,,0 CDM,278C1769S1_138472,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,179.94,71.98,,,0 CDM,278C1769S1_138473,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,58.52,23.41,,,0 CDM,278C1769S1_138486,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,41.54,16.62,,,0 CDM,278C1769S1_138487,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,41.54,16.62,,,0 CDM,278C1769S1_138488,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,81.9,32.76,,,0 CDM,278C1769S1_138498,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,189.91,75.96,,,0 CDM,278C1769S1_138499,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,185.45,74.18,,,0 CDM,278C1769S1_138500,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,203.55,81.42,,,0 CDM,278C1769S1_138519,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,2732.48,1092.99,,,0 CDM,278C1769S1_138565,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,85.25,34.1,,,0 CDM,278C1769S1_138573,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,759.97,303.99,,,0 CDM,278C1769S1_138580,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,2182.4,872.96,,,0 CDM,278C1769S1_138652,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,110.56,44.22,,,0 CDM,278C1769S1_138656,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,2182.4,872.96,,,0 CDM,278C1769S1_138657,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,2186.3,874.52,,,0 CDM,278C1769S1_138658,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,2197.61,879.04,,,0 CDM,278C1769S1_138659,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,2140.11,856.04,,,0 CDM,278C1769S1_138848,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,1042.42,416.97,,,0 CDM,278C1769S1_138849,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,1019.16,407.66,,,0 CDM,278C1769S1_138976,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,453.4,181.36,,,0 CDM,278C1769S1_139134,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,492.58,197.03,,,0 CDM,278C1769S1_142646,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,2657.81,1063.12,,,0 CDM,278C1769S1_142647,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,2657.81,1063.12,,,0 CDM,278C1769S1_142697,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,411.63,164.65,,,0 CDM,278C1769S1_143345,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,157.5,63.0,,,0 CDM,278C1769S1_144516,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,657.59,263.04,,,0 CDM,278C1769S1_144517,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,635.47,254.19,,,0 CDM,278C1769S1_144899,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,1055.25,422.1,,,0 CDM,278C1769S1_144911,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,159.86,63.94,,,0 CDM,278C1769S1_145733,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,605.39,242.16,,,0 CDM,278C1769S1_145734,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,605.39,242.16,,,0 CDM,278C1769S1_145735,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,691.85,276.74,,,0 CDM,278C1769S1_145742,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,605.39,242.16,,,0 CDM,278C1769S1_145743,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,605.39,242.16,,,0 CDM,278C1769S1_145744,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,605.39,242.16,,,0 CDM,278C1769S1_145745,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,605.39,242.16,,,0 CDM,278C1769S1_145746,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,605.39,242.16,,,0 CDM,278C1769S1_145747,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,605.39,242.16,,,0 CDM,278C1769S1_145748,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,453.47,181.39,,,0 CDM,278C1769S1_145835,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,309.06,123.62,,,0 CDM,278C1769S1_145875,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,228.38,91.35,,,0 CDM,278C1769S1_145876,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,236.25,94.5,,,0 CDM,278C1769S1_145928,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,669.38,267.75,,,0 CDM,278C1769S1_146019,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,141.55,56.62,,,0 CDM,278C1769S1_146060,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,254.57,101.83,,,0 CDM,278C1769S1_146528,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,709.74,283.9,,,0 CDM,278C1769S1_147135,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,554.4,221.76,,,0 CDM,278C1769S1_152533,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,433.12,173.25,,,0 CDM,278C1769S1_152566,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,222.47,88.99,,,0 CDM,278C1769S1_156170,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,156.51,62.6,,,0 CDM,278C1769S1_156307,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,488.72,195.49,,,0 CDM,278C1769S1_156938,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,1299.38,519.75,,,0 CDM,278C1769S1_156939,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,1299.38,519.75,,,0 CDM,278C1769S1_158758,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,405.65,162.26,,,0 CDM,278C1769S1_162708,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,406.86,162.74,,,0 CDM,278C1769S1_162709,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,318.94,127.58,,,0 CDM,278C1769S1_162710,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,229.68,91.87,,,0 CDM,278C1769S1_165289,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,1886.46,754.58,,,0 CDM,278C1769S1_167736,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,774.47,309.79,,,0 CDM,278C1769S1_167739,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,645.39,258.16,,,0 CDM,278C1769S1_168698,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,1318.74,527.5,,,0 CDM,278C1769S1_168699,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,1309.65,523.86,,,0 CDM,278C1769S1_171356,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,84.19,33.68,,,0 CDM,278C1769S1_173787,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,515.82,206.33,,,0 CDM,278C1769S1_173793,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,433.12,173.25,,,0 CDM,278C1769S1_173990,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,946.58,378.63,,,0 CDM,278C1769S1_173991,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,1166.62,466.65,,,0 CDM,278C1769S1_173992,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,787.34,314.94,,,0 CDM,278C1769S1_174885,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,1949.06,779.62,,,0 CDM,278C1769S1_174886,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,1949.06,779.62,,,0 CDM,278C1769S1_174887,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,2067.19,826.88,,,0 CDM,278C1769S1_175278,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,2736.56,1094.62,,,0 CDM,278C1769S1_175279,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,2736.56,1094.62,,,0 CDM,278C1769S1_175280,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,2736.56,1094.62,,,0 CDM,278C1769S1_175851,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,1063.12,425.25,,,0 CDM,278C1769S1_175852,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,1063.12,425.25,,,0 CDM,278C1769S1_176649,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,246.02,98.41,,,0 CDM,278C1769S1_176650,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,273.74,109.5,,,0 CDM,278C1769S1_176651,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,317.05,126.82,,,0 CDM,278C1769S1_176652,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,343.04,137.22,,,0 CDM,278C1769S1_177677,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,196.88,78.75,,,0 CDM,278C1769S1_179237,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,399.87,159.95,,,0 CDM,278C1769S1_179238,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,357.94,143.18,,,0 CDM,278C1769S1_179734,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,493.37,197.35,,,0 CDM,278C1769S1_180104,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,492.59,197.04,,,0 CDM,278C1769S1_180250,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,2213.06,885.22,,,0 CDM,278C1769S1_181126,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,104.54,41.82,,,0 CDM,278C1769S1_183231,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,1931.31,772.52,,,0 CDM,278C1769S1_183528,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,21577.5,8631.0,,,0 CDM,278C1769S1_184304,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,595.61,238.24,,,0 CDM,278C1769S1_184897,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,82.69,33.08,,,0 CDM,278C1769S1_184898,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,66.94,26.78,,,0 CDM,278C1769S1_188657,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,433.12,173.25,,,0 CDM,278C1769S1_191219,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,1476.56,590.62,,,0 CDM,278C1769S1_191220,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,1476.56,590.62,,,0 CDM,278C1769S1_191939,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,177.19,70.88,,,0 CDM,278C1769S1_191969,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,150.37,60.15,,,0 CDM,278C1769S1_191993,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,177.19,70.88,,,0 CDM,278C1769S1_192724,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,472.5,189.0,,,0 CDM,278C1769S1_192748,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,181.12,72.45,,,0 CDM,278C1769S1_193067,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,157.5,63.0,,,0 CDM,278C1769S1_193135,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,766.63,306.65,,,0 CDM,278C1769S1_193145,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,200.81,80.32,,,0 CDM,278C1769S1_193171,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,358.31,143.32,,,0 CDM,278C1769S1_193172,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,358.31,143.32,,,0 CDM,278C1769S1_193173,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,358.31,143.32,,,0 CDM,278C1769S1_193227,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,200.81,80.32,,,0 CDM,278C1769S1_193301,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,3858.75,1543.5,,,0 CDM,278C1769S1_193316,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,354.38,141.75,,,0 CDM,278C1769S1_193506,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,3858.75,1543.5,,,0 CDM,278C1769S1_193554,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,2216.14,886.46,,,0 CDM,278C1769S1_193617,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,2216.14,886.46,,,0 CDM,278C1769S1_193650,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,354.38,141.75,,,0 CDM,278C1769S1_193844,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,228.38,91.35,,,0 CDM,278C1769S1_194498,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,69.3,27.72,,,0 CDM,278C1769S1_194621,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,358.31,143.32,,,0 CDM,278C1769S1_194627,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,688.59,275.44,,,0 CDM,278C1769S1_194971,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,582.75,233.1,,,0 CDM,278C1769S1_195698,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,110.25,44.1,,,0 CDM,278C1769S1_196004,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,441.0,176.4,,,0 CDM,278C1769S1_196080,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,3543.75,1417.5,,,0 CDM,278C1769S1_196089,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,606.38,242.55,,,0 CDM,278C1769S1_196156,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,504.0,201.6,,,0 CDM,278C1769S1_196700,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,358.31,143.32,,,0 CDM,278C1769S1_196973,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,181.12,72.45,,,0 CDM,278C1769S1_197106,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,74.81,29.92,,,0 CDM,278C1769S1_197634,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,2233.62,893.45,,,0 CDM,278C1769S1_198045,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,259.88,103.95,,,0 CDM,278C1769S1_198768,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,385.88,154.35,,,0 CDM,278C1769S1_199350,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,484.71,193.88,,,0 CDM,278C1769S1_83454,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,38.65,15.46,,,0 CDM,278C1769S1_83455,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,41.58,16.63,,,0 CDM,278C1769S1_83713,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,36.61,14.64,,,0 CDM,278C1769S1_84214,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,1500.19,600.08,,,0 CDM,278C1769S1_84755,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,141.16,56.46,,,0 CDM,278C1769S1_84933,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,126.4,50.56,,,0 CDM,278C1769S1_84934,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,111.98,44.79,,,0 CDM,278C1769S1_84935,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,187.94,75.18,,,0 CDM,278C1769S1_85730,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,172.68,69.07,,,0 CDM,278C1769S1_85762,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,24.61,9.84,,,0 CDM,278C1769S1_86064,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,122.0,48.8,,,0 CDM,278C1769S1_86090,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,71.86,28.74,,,0 CDM,278C1769S1_86143,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,108.29,43.32,,,0 CDM,278C1769S1_86156,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,207.97,83.19,,,0 CDM,278C1769S1_86382,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,145.42,58.17,,,0 CDM,278C1769S1_87081,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,157.34,62.94,,,0 CDM,278C1769S1_87387,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,35.82,14.33,,,0 CDM,278C1769S1_87537,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,151.67,60.67,,,0 CDM,278C1769S1_88630,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,314.52,125.81,,,0 CDM,278C1769S1_88913,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,484.71,193.88,,,0 CDM,278C1769S1_88955,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,354.38,141.75,,,0 CDM,278C1769S1_89037,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,145.78,58.31,,,0 CDM,278C1769S1_89341,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,87.35,34.94,,,0 CDM,278C1769S1_90116,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,393.11,157.24,,,0 CDM,278C1769S1_90903,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,42.42,16.97,,,0 CDM,278C1769S1_90904,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,41.58,16.63,,,0 CDM,278C1769S1_91098,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,293.42,117.37,,,0 CDM,278C1769S1_91242,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,145.14,58.06,,,0 CDM,278C1769S1_91314,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,145.6,58.24,,,0 CDM,278C1769S1_91869,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,732.38,292.95,,,0 CDM,278C1769S1_93049,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,354.38,141.75,,,0 CDM,278C1769S1_93935,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,427.93,171.17,,,0 CDM,278C1769S1_94186,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,436.71,174.68,,,0 CDM,278C1769S1_94896,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,691.42,276.57,,,0 CDM,278C1769S1_95273,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,50.96,20.38,,,0 CDM,278C1769S1_95354,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,1476.56,590.62,,,0 CDM,278C1769S1_95399,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,444.78,177.91,,,0 CDM,278C1769S1_95529,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,170.89,68.36,,,0 CDM,278C1769S1_95554,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,106.49,42.6,,,0 CDM,278C1769S1_95611,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,99.97,39.99,,,0 CDM,278C1769S1_96158,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,187.04,74.82,,,0 CDM,278C1769S1_C1769_278,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,318.94,127.58,,,0 CDM,278C1771S1_173515,Hc Sup Shell 278 Revenue Code C1771 Hcpcs,5225.46,2090.18,,,0 CDM,278C1771S1_181296,Hc Sup Shell 278 Revenue Code C1771 Hcpcs,4182.06,1672.82,,,0 CDM,278C1771S1_183308,Hc Sup Shell 278 Revenue Code C1771 Hcpcs,32674.95,13069.98,,,0 CDM,278C1771S1_92069,Hc Sup Shell 278 Revenue Code C1771 Hcpcs,4021.22,1608.49,,,0 CDM,278C1772S1_171804,Hc Sup Shell 278 Revenue Code C1772 Hcpcs,55986.87,22394.75,,,0 CDM,278C1772S1_91174,Hc Sup Shell 278 Revenue Code C1772 Hcpcs,43545.55,17418.22,,,0 CDM,278C1772S1_91175,Hc Sup Shell 278 Revenue Code C1772 Hcpcs,43107.19,17242.88,,,0 CDM,278C1773S1_133587,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,1078.88,431.55,,,0 CDM,278C1773S1_133588,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,1078.88,431.55,,,0 CDM,278C1773S1_133590,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,2275.88,910.35,,,0 CDM,278C1773S1_133591,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,2275.88,910.35,,,0 CDM,278C1773S1_133592,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,1078.88,431.55,,,0 CDM,278C1773S1_133661,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,6378.75,2551.5,,,0 CDM,278C1773S1_133779,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,3417.75,1367.1,,,0 CDM,278C1773S1_134097,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,2085.18,834.07,,,0 CDM,278C1773S1_134146,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,1152.11,460.84,,,0 CDM,278C1773S1_134483,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,8997.19,3598.88,,,0 CDM,278C1773S1_134484,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,8997.19,3598.88,,,0 CDM,278C1773S1_134494,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,2375.61,950.24,,,0 CDM,278C1773S1_134495,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,2348.18,939.27,,,0 CDM,278C1773S1_134539,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,7470.9,2988.36,,,0 CDM,278C1773S1_135060,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,1078.88,431.55,,,0 CDM,278C1773S1_138492,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,1078.88,431.55,,,0 CDM,278C1773S1_138851,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,1771.88,708.75,,,0 CDM,278C1773S1_146512,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,3417.75,1367.1,,,0 CDM,278C1773S1_152998,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,7067.81,2827.12,,,0 CDM,278C1773S1_152999,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,7067.81,2827.12,,,0 CDM,278C1773S1_153000,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,7067.81,2827.12,,,0 CDM,278C1773S1_187492,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,2501.69,1000.68,,,0 CDM,278C1773S1_196767,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,1893.94,757.58,,,0 CDM,278C1773S1_91136,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,825.91,330.36,,,0 CDM,278C1773S1_91398,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,1264.21,505.68,,,0 CDM,278C1773S1_91399,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,1264.21,505.68,,,0 CDM,278C1773S1_91400,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,1264.21,505.68,,,0 CDM,278C1776S1_100168,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,803.25,321.3,,,0 CDM,278C1776S1_100475,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,531.56,212.62,,,0 CDM,278C1776S1_100477,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,499.67,199.87,,,0 CDM,278C1776S1_100478,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,531.56,212.62,,,0 CDM,278C1776S1_100479,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,531.56,212.62,,,0 CDM,278C1776S1_100480,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,524.48,209.79,,,0 CDM,278C1776S1_100481,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,523.59,209.44,,,0 CDM,278C1776S1_100482,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,522.0,208.8,,,0 CDM,278C1776S1_100483,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,531.56,212.62,,,0 CDM,278C1776S1_100484,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,526.25,210.5,,,0 CDM,278C1776S1_100485,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,531.56,212.62,,,0 CDM,278C1776S1_100486,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,522.45,208.98,,,0 CDM,278C1776S1_100487,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,518.81,207.52,,,0 CDM,278C1776S1_100488,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,531.56,212.62,,,0 CDM,278C1776S1_100489,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,531.56,212.62,,,0 CDM,278C1776S1_100490,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,531.56,212.62,,,0 CDM,278C1776S1_100491,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,531.56,212.62,,,0 CDM,278C1776S1_100492,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,499.67,199.87,,,0 CDM,278C1776S1_101090,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2604.66,1041.86,,,0 CDM,278C1776S1_101091,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2657.81,1063.12,,,0 CDM,278C1776S1_101092,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2657.81,1063.12,,,0 CDM,278C1776S1_101093,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2657.81,1063.12,,,0 CDM,278C1776S1_101222,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7619.06,3047.62,,,0 CDM,278C1776S1_101224,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7619.06,3047.62,,,0 CDM,278C1776S1_101225,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7511.5,3004.6,,,0 CDM,278C1776S1_101226,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7484.61,2993.84,,,0 CDM,278C1776S1_101227,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7466.68,2986.67,,,0 CDM,278C1776S1_101228,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7619.06,3047.62,,,0 CDM,278C1776S1_101229,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7527.63,3011.05,,,0 CDM,278C1776S1_101230,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7619.06,3047.62,,,0 CDM,278C1776S1_101231,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7619.06,3047.62,,,0 CDM,278C1776S1_101234,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7619.06,3047.62,,,0 CDM,278C1776S1_101235,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7466.68,2986.67,,,0 CDM,278C1776S1_101236,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7390.49,2956.2,,,0 CDM,278C1776S1_101237,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7504.78,3001.91,,,0 CDM,278C1776S1_101238,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7619.06,3047.62,,,0 CDM,278C1776S1_101239,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7466.68,2986.67,,,0 CDM,278C1776S1_101240,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7619.06,3047.62,,,0 CDM,278C1776S1_101241,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7161.92,2864.77,,,0 CDM,278C1776S1_101242,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7619.06,3047.62,,,0 CDM,278C1776S1_101245,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7619.06,3047.62,,,0 CDM,278C1776S1_101293,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,10631.25,4252.5,,,0 CDM,278C1776S1_101296,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,10631.25,4252.5,,,0 CDM,278C1776S1_101346,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,177.19,70.88,,,0 CDM,278C1776S1_101347,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,177.19,70.88,,,0 CDM,278C1776S1_101348,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,177.19,70.88,,,0 CDM,278C1776S1_101349,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,170.1,68.04,,,0 CDM,278C1776S1_101350,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,174.53,69.81,,,0 CDM,278C1776S1_101351,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,177.19,70.88,,,0 CDM,278C1776S1_101352,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,170.81,68.32,,,0 CDM,278C1776S1_101353,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,166.56,66.62,,,0 CDM,278C1776S1_101368,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4497.02,1798.81,,,0 CDM,278C1776S1_101369,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4784.06,1913.62,,,0 CDM,278C1776S1_101370,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4784.06,1913.62,,,0 CDM,278C1776S1_101371,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4784.06,1913.62,,,0 CDM,278C1776S1_101372,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4640.54,1856.22,,,0 CDM,278C1776S1_101374,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4784.06,1913.62,,,0 CDM,278C1776S1_101375,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4784.06,1913.62,,,0 CDM,278C1776S1_101386,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4784.06,1913.62,,,0 CDM,278C1776S1_101387,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4784.06,1913.62,,,0 CDM,278C1776S1_101388,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4688.38,1875.35,,,0 CDM,278C1776S1_101389,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4784.06,1913.62,,,0 CDM,278C1776S1_101390,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4688.38,1875.35,,,0 CDM,278C1776S1_101391,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4592.7,1837.08,,,0 CDM,278C1776S1_101432,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1594.69,637.88,,,0 CDM,278C1776S1_101433,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1546.85,618.74,,,0 CDM,278C1776S1_101434,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1499.01,599.6,,,0 CDM,278C1776S1_101435,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1562.8,625.12,,,0 CDM,278C1776S1_101436,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1570.77,628.31,,,0 CDM,278C1776S1_101438,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1499.01,599.6,,,0 CDM,278C1776S1_101440,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1594.69,637.88,,,0 CDM,278C1776S1_101441,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1499.01,599.6,,,0 CDM,278C1776S1_101442,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1594.69,637.88,,,0 CDM,278C1776S1_101443,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1499.01,599.6,,,0 CDM,278C1776S1_101444,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1594.69,637.88,,,0 CDM,278C1776S1_101475,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,349.85,139.94,,,0 CDM,278C1776S1_101476,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,354.38,141.75,,,0 CDM,278C1776S1_101477,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,349.31,139.72,,,0 CDM,278C1776S1_101478,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,354.38,141.75,,,0 CDM,278C1776S1_101656,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2234.34,893.74,,,0 CDM,278C1776S1_101657,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2303.44,921.38,,,0 CDM,278C1776S1_101658,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2303.44,921.38,,,0 CDM,278C1776S1_101659,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2165.24,866.1,,,0 CDM,278C1776S1_101702,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2214.85,885.94,,,0 CDM,278C1776S1_101941,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3490.59,1396.24,,,0 CDM,278C1776S1_101942,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3472.88,1389.15,,,0 CDM,278C1776S1_101943,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3496.5,1398.6,,,0 CDM,278C1776S1_101944,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3485.56,1394.22,,,0 CDM,278C1776S1_101945,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3514.62,1405.85,,,0 CDM,278C1776S1_101946,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3505.89,1402.36,,,0 CDM,278C1776S1_101947,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3510.68,1404.27,,,0 CDM,278C1776S1_101948,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3480.75,1392.3,,,0 CDM,278C1776S1_101949,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3490.59,1396.24,,,0 CDM,278C1776S1_101951,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3543.75,1417.5,,,0 CDM,278C1776S1_101953,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2265.31,906.12,,,0 CDM,278C1776S1_101954,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2303.44,921.38,,,0 CDM,278C1776S1_102091,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2268.89,907.56,,,0 CDM,278C1776S1_102093,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2234.34,893.74,,,0 CDM,278C1776S1_102167,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2165.24,866.1,,,0 CDM,278C1776S1_102168,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2303.44,921.38,,,0 CDM,278C1776S1_102169,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2303.44,921.38,,,0 CDM,278C1776S1_102188,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4190.49,1676.2,,,0 CDM,278C1776S1_102189,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5699.25,2279.7,,,0 CDM,278C1776S1_102194,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4843.44,1937.38,,,0 CDM,278C1776S1_102195,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_102344,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2615.29,1046.12,,,0 CDM,278C1776S1_102345,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2591.37,1036.55,,,0 CDM,278C1776S1_102361,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2657.81,1063.12,,,0 CDM,278C1776S1_102370,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2625.03,1050.01,,,0 CDM,278C1776S1_102371,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2615.29,1046.12,,,0 CDM,278C1776S1_102372,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2618.6,1047.44,,,0 CDM,278C1776S1_102373,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2622.38,1048.95,,,0 CDM,278C1776S1_102389,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2570.83,1028.33,,,0 CDM,278C1776S1_102390,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2657.81,1063.12,,,0 CDM,278C1776S1_102391,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2657.81,1063.12,,,0 CDM,278C1776S1_102397,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2614.32,1045.73,,,0 CDM,278C1776S1_102398,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2617.95,1047.18,,,0 CDM,278C1776S1_102399,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2648.7,1059.48,,,0 CDM,278C1776S1_102400,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2657.81,1063.12,,,0 CDM,278C1776S1_102405,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3125.59,1250.24,,,0 CDM,278C1776S1_102433,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,19822.36,7928.94,,,0 CDM,278C1776S1_102438,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,19822.36,7928.94,,,0 CDM,278C1776S1_102440,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,19822.36,7928.94,,,0 CDM,278C1776S1_102500,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7161.92,2864.77,,,0 CDM,278C1776S1_102501,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7561.92,3024.77,,,0 CDM,278C1776S1_102502,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7527.63,3011.05,,,0 CDM,278C1776S1_102503,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7542.87,3017.15,,,0 CDM,278C1776S1_102504,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7559.44,3023.78,,,0 CDM,278C1776S1_102505,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7575.53,3030.21,,,0 CDM,278C1776S1_102506,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7521.1,3008.44,,,0 CDM,278C1776S1_102507,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7619.06,3047.62,,,0 CDM,278C1776S1_102508,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7390.49,2956.2,,,0 CDM,278C1776S1_102509,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7527.63,3011.05,,,0 CDM,278C1776S1_102510,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7161.92,2864.77,,,0 CDM,278C1776S1_102513,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7619.06,3047.62,,,0 CDM,278C1776S1_102514,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7488.45,2995.38,,,0 CDM,278C1776S1_102515,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7447.64,2979.06,,,0 CDM,278C1776S1_102516,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7535.95,3014.38,,,0 CDM,278C1776S1_102517,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7504.78,3001.91,,,0 CDM,278C1776S1_102518,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7452.83,2981.13,,,0 CDM,278C1776S1_102519,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7619.06,3047.62,,,0 CDM,278C1776S1_102520,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7561.92,3024.77,,,0 CDM,278C1776S1_102521,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7488.45,2995.38,,,0 CDM,278C1776S1_102522,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7436.21,2974.48,,,0 CDM,278C1776S1_102644,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3366.56,1346.62,,,0 CDM,278C1776S1_102645,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3319.95,1327.98,,,0 CDM,278C1776S1_102646,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3332.9,1333.16,,,0 CDM,278C1776S1_102647,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3331.74,1332.7,,,0 CDM,278C1776S1_102648,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3355.34,1342.14,,,0 CDM,278C1776S1_102649,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3339.02,1335.61,,,0 CDM,278C1776S1_102650,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3308.85,1323.54,,,0 CDM,278C1776S1_102652,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3366.56,1346.62,,,0 CDM,278C1776S1_102653,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3366.56,1346.62,,,0 CDM,278C1776S1_102654,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3331.94,1332.78,,,0 CDM,278C1776S1_102655,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3330.49,1332.2,,,0 CDM,278C1776S1_102656,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3366.56,1346.62,,,0 CDM,278C1776S1_102657,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3349.73,1339.89,,,0 CDM,278C1776S1_102695,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3366.56,1346.62,,,0 CDM,278C1776S1_102781,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3366.56,1346.62,,,0 CDM,278C1776S1_102823,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_102824,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_102825,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6187.39,2474.96,,,0 CDM,278C1776S1_102826,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_102827,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_102828,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6187.39,2474.96,,,0 CDM,278C1776S1_102831,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_102832,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5996.02,2398.41,,,0 CDM,278C1776S1_102833,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_102834,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_102835,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_102836,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_102837,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_102838,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_102840,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_102842,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_102844,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_102845,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5996.02,2398.41,,,0 CDM,278C1776S1_102850,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1398.6,559.44,,,0 CDM,278C1776S1_102851,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1407.19,562.88,,,0 CDM,278C1776S1_102852,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1405.35,562.14,,,0 CDM,278C1776S1_102859,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3331.12,1332.45,,,0 CDM,278C1776S1_102893,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2831.46,1132.58,,,0 CDM,278C1776S1_102895,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_102896,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_102910,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_102957,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_102958,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_102959,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_102960,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6187.39,2474.96,,,0 CDM,278C1776S1_102962,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_102987,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1407.37,562.95,,,0 CDM,278C1776S1_102988,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1403.2,561.28,,,0 CDM,278C1776S1_102989,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1400.29,560.12,,,0 CDM,278C1776S1_102990,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1399.99,560.0,,,0 CDM,278C1776S1_102991,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1383.48,553.39,,,0 CDM,278C1776S1_103009,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,17718.75,7087.5,,,0 CDM,278C1776S1_103010,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,17718.75,7087.5,,,0 CDM,278C1776S1_103011,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,17718.75,7087.5,,,0 CDM,278C1776S1_103012,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,17293.5,6917.4,,,0 CDM,278C1776S1_103013,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,17718.75,7087.5,,,0 CDM,278C1776S1_103014,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,17718.75,7087.5,,,0 CDM,278C1776S1_103017,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,16655.62,6662.25,,,0 CDM,278C1776S1_103018,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,17364.38,6945.75,,,0 CDM,278C1776S1_103019,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,17718.75,7087.5,,,0 CDM,278C1776S1_103020,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,17718.75,7087.5,,,0 CDM,278C1776S1_103021,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,16655.62,6662.25,,,0 CDM,278C1776S1_103023,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_103024,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6330.91,2532.36,,,0 CDM,278C1776S1_103025,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6336.22,2534.49,,,0 CDM,278C1776S1_103026,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6283.07,2513.23,,,0 CDM,278C1776S1_103027,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6251.18,2500.47,,,0 CDM,278C1776S1_103028,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6314.96,2525.98,,,0 CDM,278C1776S1_103030,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_103031,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_103032,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6251.18,2500.47,,,0 CDM,278C1776S1_103033,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6263.93,2505.57,,,0 CDM,278C1776S1_103034,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6257.89,2503.16,,,0 CDM,278C1776S1_103035,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_103037,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_103038,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6251.18,2500.47,,,0 CDM,278C1776S1_103039,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6290.43,2516.17,,,0 CDM,278C1776S1_103040,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6338.46,2535.38,,,0 CDM,278C1776S1_103041,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6302.2,2520.88,,,0 CDM,278C1776S1_103042,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_103044,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6251.18,2500.47,,,0 CDM,278C1776S1_103045,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6324.07,2529.63,,,0 CDM,278C1776S1_103046,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6306.99,2522.8,,,0 CDM,278C1776S1_103047,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6351.41,2540.56,,,0 CDM,278C1776S1_103048,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6225.66,2490.26,,,0 CDM,278C1776S1_103049,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5996.02,2398.41,,,0 CDM,278C1776S1_103052,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,11770.56,4708.22,,,0 CDM,278C1776S1_103074,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2628.8,1051.52,,,0 CDM,278C1776S1_103075,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2710.1,1084.04,,,0 CDM,278C1776S1_103076,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2628.8,1051.52,,,0 CDM,278C1776S1_103077,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2710.1,1084.04,,,0 CDM,278C1776S1_103078,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2710.1,1084.04,,,0 CDM,278C1776S1_103083,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_103086,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_103090,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2921.82,1168.73,,,0 CDM,278C1776S1_103091,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_103097,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2960.55,1184.22,,,0 CDM,278C1776S1_103098,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2921.82,1168.73,,,0 CDM,278C1776S1_103099,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_103104,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_103128,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2213.98,885.59,,,0 CDM,278C1776S1_103135,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4190.49,1676.2,,,0 CDM,278C1776S1_103136,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3939.08,1575.63,,,0 CDM,278C1776S1_103138,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4190.49,1676.2,,,0 CDM,278C1776S1_103142,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4190.49,1676.2,,,0 CDM,278C1776S1_103145,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4064.78,1625.91,,,0 CDM,278C1776S1_103146,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4190.49,1676.2,,,0 CDM,278C1776S1_103158,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6130.69,2452.28,,,0 CDM,278C1776S1_103162,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5762.85,2305.14,,,0 CDM,278C1776S1_103164,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6130.69,2452.28,,,0 CDM,278C1776S1_103168,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5762.85,2305.14,,,0 CDM,278C1776S1_103171,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6130.69,2452.28,,,0 CDM,278C1776S1_103173,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6130.69,2452.28,,,0 CDM,278C1776S1_103174,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6130.69,2452.28,,,0 CDM,278C1776S1_103176,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5920.5,2368.2,,,0 CDM,278C1776S1_103177,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6130.69,2452.28,,,0 CDM,278C1776S1_103180,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6130.69,2452.28,,,0 CDM,278C1776S1_103182,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6130.69,2452.28,,,0 CDM,278C1776S1_103189,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6008.08,2403.23,,,0 CDM,278C1776S1_103196,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3862.69,1545.08,,,0 CDM,278C1776S1_103197,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3862.69,1545.08,,,0 CDM,278C1776S1_103198,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3862.69,1545.08,,,0 CDM,278C1776S1_103202,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1103.88,441.55,,,0 CDM,278C1776S1_103240,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3293.68,1317.47,,,0 CDM,278C1776S1_103242,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3503.9,1401.56,,,0 CDM,278C1776S1_103243,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3503.9,1401.56,,,0 CDM,278C1776S1_103245,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3503.9,1401.56,,,0 CDM,278C1776S1_103468,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6251.18,2500.47,,,0 CDM,278C1776S1_103474,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_103475,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6187.39,2474.96,,,0 CDM,278C1776S1_103476,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5996.02,2398.41,,,0 CDM,278C1776S1_103483,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_103484,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_103487,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_103489,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_103490,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_103521,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5997.48,2398.99,,,0 CDM,278C1776S1_103522,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6182.98,2473.19,,,0 CDM,278C1776S1_103524,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6182.98,2473.19,,,0 CDM,278C1776S1_103525,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6182.98,2473.19,,,0 CDM,278C1776S1_103527,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_103533,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5885.3,2354.12,,,0 CDM,278C1776S1_103537,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5670.0,2268.0,,,0 CDM,278C1776S1_103538,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5670.0,2268.0,,,0 CDM,278C1776S1_103539,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5499.9,2199.96,,,0 CDM,278C1776S1_103540,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5499.9,2199.96,,,0 CDM,278C1776S1_103541,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5670.0,2268.0,,,0 CDM,278C1776S1_103542,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5670.0,2268.0,,,0 CDM,278C1776S1_103543,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5670.0,2268.0,,,0 CDM,278C1776S1_103545,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5329.8,2131.92,,,0 CDM,278C1776S1_103546,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5443.2,2177.28,,,0 CDM,278C1776S1_103547,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5584.95,2233.98,,,0 CDM,278C1776S1_103548,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5601.96,2240.78,,,0 CDM,278C1776S1_103549,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5670.0,2268.0,,,0 CDM,278C1776S1_103555,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3543.75,1417.5,,,0 CDM,278C1776S1_103568,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3402.0,1360.8,,,0 CDM,278C1776S1_103569,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3543.75,1417.5,,,0 CDM,278C1776S1_103570,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3543.75,1417.5,,,0 CDM,278C1776S1_103571,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3490.59,1396.24,,,0 CDM,278C1776S1_103572,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3543.75,1417.5,,,0 CDM,278C1776S1_103573,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3331.12,1332.45,,,0 CDM,278C1776S1_103574,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3543.75,1417.5,,,0 CDM,278C1776S1_103576,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3543.75,1417.5,,,0 CDM,278C1776S1_103577,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3543.75,1417.5,,,0 CDM,278C1776S1_103578,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3543.75,1417.5,,,0 CDM,278C1776S1_103583,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3543.75,1417.5,,,0 CDM,278C1776S1_103590,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3331.12,1332.45,,,0 CDM,278C1776S1_103612,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3449.25,1379.7,,,0 CDM,278C1776S1_103613,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3490.59,1396.24,,,0 CDM,278C1776S1_103614,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3437.44,1374.98,,,0 CDM,278C1776S1_103615,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3437.44,1374.98,,,0 CDM,278C1776S1_103616,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3543.75,1417.5,,,0 CDM,278C1776S1_103618,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3543.75,1417.5,,,0 CDM,278C1776S1_103619,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3437.44,1374.98,,,0 CDM,278C1776S1_103620,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3543.75,1417.5,,,0 CDM,278C1776S1_103623,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3543.75,1417.5,,,0 CDM,278C1776S1_103625,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3437.44,1374.98,,,0 CDM,278C1776S1_103626,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3425.62,1370.25,,,0 CDM,278C1776S1_103627,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3508.31,1403.32,,,0 CDM,278C1776S1_103651,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_103657,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2831.46,1132.58,,,0 CDM,278C1776S1_103659,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_103660,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_103661,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_103662,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_103664,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_103665,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2921.82,1168.73,,,0 CDM,278C1776S1_103670,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_103671,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2967.01,1186.8,,,0 CDM,278C1776S1_103672,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_103677,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2986.37,1194.55,,,0 CDM,278C1776S1_103678,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_103682,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_103683,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2976.04,1190.42,,,0 CDM,278C1776S1_103684,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2986.37,1194.55,,,0 CDM,278C1776S1_103685,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2995.76,1198.3,,,0 CDM,278C1776S1_103691,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_103693,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_104594,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3280.0,1312.0,,,0 CDM,278C1776S1_104595,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3284.5,1313.8,,,0 CDM,278C1776S1_104596,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3285.77,1314.31,,,0 CDM,278C1776S1_104597,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3299.23,1319.69,,,0 CDM,278C1776S1_104598,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3278.19,1311.28,,,0 CDM,278C1776S1_104599,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3304.41,1321.76,,,0 CDM,278C1776S1_104600,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3285.77,1314.31,,,0 CDM,278C1776S1_104601,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3164.57,1265.83,,,0 CDM,278C1776S1_104602,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3299.23,1319.69,,,0 CDM,278C1776S1_104603,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3312.18,1324.87,,,0 CDM,278C1776S1_104604,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3299.23,1319.69,,,0 CDM,278C1776S1_104605,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3219.66,1287.86,,,0 CDM,278C1776S1_104606,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3283.93,1313.57,,,0 CDM,278C1776S1_104607,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3332.9,1333.16,,,0 CDM,278C1776S1_104608,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3299.23,1319.69,,,0 CDM,278C1776S1_105258,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1927.41,770.96,,,0 CDM,278C1776S1_105981,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,16734.81,6693.92,,,0 CDM,278C1776S1_106013,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2953.12,1181.25,,,0 CDM,278C1776S1_106018,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1895.91,758.36,,,0 CDM,278C1776S1_106023,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8859.38,3543.75,,,0 CDM,278C1776S1_106026,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,11556.72,4622.69,,,0 CDM,278C1776S1_106029,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,14254.06,5701.62,,,0 CDM,278C1776S1_106030,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,14254.06,5701.62,,,0 CDM,278C1776S1_106036,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,14254.06,5701.62,,,0 CDM,278C1776S1_106280,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,196.88,78.75,,,0 CDM,278C1776S1_107031,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3041.32,1216.53,,,0 CDM,278C1776S1_107311,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7087.5,2835.0,,,0 CDM,278C1776S1_107390,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7481.25,2992.5,,,0 CDM,278C1776S1_107400,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7481.25,2992.5,,,0 CDM,278C1776S1_107403,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7481.25,2992.5,,,0 CDM,278C1776S1_107404,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7481.25,2992.5,,,0 CDM,278C1776S1_107405,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7481.25,2992.5,,,0 CDM,278C1776S1_107433,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5512.5,2205.0,,,0 CDM,278C1776S1_107569,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3346.88,1338.75,,,0 CDM,278C1776S1_107570,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3346.88,1338.75,,,0 CDM,278C1776S1_107571,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3346.88,1338.75,,,0 CDM,278C1776S1_107576,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3346.88,1338.75,,,0 CDM,278C1776S1_107681,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3346.88,1338.75,,,0 CDM,278C1776S1_107691,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3543.75,1417.5,,,0 CDM,278C1776S1_107792,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7568.86,3027.54,,,0 CDM,278C1776S1_107954,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1575.0,630.0,,,0 CDM,278C1776S1_108506,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5315.62,2126.25,,,0 CDM,278C1776S1_108877,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1771.88,708.75,,,0 CDM,278C1776S1_108879,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1771.88,708.75,,,0 CDM,278C1776S1_108886,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1771.88,708.75,,,0 CDM,278C1776S1_108895,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1968.75,787.5,,,0 CDM,278C1776S1_108973,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,236.25,94.5,,,0 CDM,278C1776S1_109357,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,9581.91,3832.76,,,0 CDM,278C1776S1_109920,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3291.75,1316.7,,,0 CDM,278C1776S1_110043,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8908.99,3563.6,,,0 CDM,278C1776S1_110045,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8908.99,3563.6,,,0 CDM,278C1776S1_110050,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3084.84,1233.94,,,0 CDM,278C1776S1_110054,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4867.34,1946.94,,,0 CDM,278C1776S1_110055,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,9956.16,3982.46,,,0 CDM,278C1776S1_110059,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3442.75,1377.1,,,0 CDM,278C1776S1_110123,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4567.9,1827.16,,,0 CDM,278C1776S1_110144,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8400.46,3360.18,,,0 CDM,278C1776S1_110151,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8400.46,3360.18,,,0 CDM,278C1776S1_110152,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8400.46,3360.18,,,0 CDM,278C1776S1_110153,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8400.46,3360.18,,,0 CDM,278C1776S1_110154,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8400.46,3360.18,,,0 CDM,278C1776S1_110275,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7875.99,3150.4,,,0 CDM,278C1776S1_110292,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,15052.08,6020.83,,,0 CDM,278C1776S1_110294,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,15052.08,6020.83,,,0 CDM,278C1776S1_110300,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,21494.61,8597.84,,,0 CDM,278C1776S1_110301,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,21494.61,8597.84,,,0 CDM,278C1776S1_110304,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3442.75,1377.1,,,0 CDM,278C1776S1_110311,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8900.13,3560.05,,,0 CDM,278C1776S1_110340,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12583.86,5033.54,,,0 CDM,278C1776S1_110343,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,9096.81,3638.72,,,0 CDM,278C1776S1_110344,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,9096.81,3638.72,,,0 CDM,278C1776S1_110345,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,9096.81,3638.72,,,0 CDM,278C1776S1_110347,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,9096.81,3638.72,,,0 CDM,278C1776S1_110348,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,9096.81,3638.72,,,0 CDM,278C1776S1_110350,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,9096.81,3638.72,,,0 CDM,278C1776S1_110353,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,9096.81,3638.72,,,0 CDM,278C1776S1_110466,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2953.12,1181.25,,,0 CDM,278C1776S1_110467,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2953.12,1181.25,,,0 CDM,278C1776S1_110470,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2953.12,1181.25,,,0 CDM,278C1776S1_111588,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,590.62,236.25,,,0 CDM,278C1776S1_111589,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,590.62,236.25,,,0 CDM,278C1776S1_111590,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,590.62,236.25,,,0 CDM,278C1776S1_111592,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,590.62,236.25,,,0 CDM,278C1776S1_111594,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,590.62,236.25,,,0 CDM,278C1776S1_111595,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,787.5,315.0,,,0 CDM,278C1776S1_111596,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,689.06,275.62,,,0 CDM,278C1776S1_111598,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,689.06,275.62,,,0 CDM,278C1776S1_111601,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,787.5,315.0,,,0 CDM,278C1776S1_111607,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,393.75,157.5,,,0 CDM,278C1776S1_111608,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,393.75,157.5,,,0 CDM,278C1776S1_111609,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,393.75,157.5,,,0 CDM,278C1776S1_111610,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,393.75,157.5,,,0 CDM,278C1776S1_111615,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,393.75,157.5,,,0 CDM,278C1776S1_112780,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3324.24,1329.7,,,0 CDM,278C1776S1_112789,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1378.12,551.25,,,0 CDM,278C1776S1_112816,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1771.88,708.75,,,0 CDM,278C1776S1_112824,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1378.12,551.25,,,0 CDM,278C1776S1_113107,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,9884.7,3953.88,,,0 CDM,278C1776S1_113153,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3191.74,1276.7,,,0 CDM,278C1776S1_113154,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1968.75,787.5,,,0 CDM,278C1776S1_113159,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,515.02,206.01,,,0 CDM,278C1776S1_113181,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,25766.01,10306.4,,,0 CDM,278C1776S1_113182,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,25766.01,10306.4,,,0 CDM,278C1776S1_113188,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4993.74,1997.5,,,0 CDM,278C1776S1_113222,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6626.81,2650.72,,,0 CDM,278C1776S1_113223,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6626.81,2650.72,,,0 CDM,278C1776S1_113225,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6626.81,2650.72,,,0 CDM,278C1776S1_113227,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5872.78,2349.11,,,0 CDM,278C1776S1_113228,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6626.81,2650.72,,,0 CDM,278C1776S1_113229,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6626.81,2650.72,,,0 CDM,278C1776S1_113234,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4819.5,1927.8,,,0 CDM,278C1776S1_113244,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4819.5,1927.8,,,0 CDM,278C1776S1_113249,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4819.5,1927.8,,,0 CDM,278C1776S1_113254,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4819.5,1927.8,,,0 CDM,278C1776S1_113255,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4819.5,1927.8,,,0 CDM,278C1776S1_113258,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4819.5,1927.8,,,0 CDM,278C1776S1_113259,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4819.5,1927.8,,,0 CDM,278C1776S1_114182,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7571.02,3028.41,,,0 CDM,278C1776S1_114183,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7571.02,3028.41,,,0 CDM,278C1776S1_114193,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7571.02,3028.41,,,0 CDM,278C1776S1_114194,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7571.02,3028.41,,,0 CDM,278C1776S1_114195,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6752.42,2700.97,,,0 CDM,278C1776S1_114196,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6752.42,2700.97,,,0 CDM,278C1776S1_114197,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6752.42,2700.97,,,0 CDM,278C1776S1_114198,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6752.42,2700.97,,,0 CDM,278C1776S1_114208,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12307.68,4923.07,,,0 CDM,278C1776S1_114209,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12307.68,4923.07,,,0 CDM,278C1776S1_114210,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12307.68,4923.07,,,0 CDM,278C1776S1_114211,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12307.68,4923.07,,,0 CDM,278C1776S1_114212,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12307.68,4923.07,,,0 CDM,278C1776S1_114213,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12307.68,4923.07,,,0 CDM,278C1776S1_115073,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2631.24,1052.5,,,0 CDM,278C1776S1_115074,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2610.91,1044.36,,,0 CDM,278C1776S1_115077,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,868.22,347.29,,,0 CDM,278C1776S1_115078,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,874.55,349.82,,,0 CDM,278C1776S1_115079,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,876.56,350.62,,,0 CDM,278C1776S1_115080,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,877.08,350.83,,,0 CDM,278C1776S1_115087,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_115088,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2951.95,1180.78,,,0 CDM,278C1776S1_115089,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_115090,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2983.65,1193.46,,,0 CDM,278C1776S1_115091,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_115092,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_115093,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_115094,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2939.9,1175.96,,,0 CDM,278C1776S1_115095,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2970.48,1188.19,,,0 CDM,278C1776S1_115096,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2983.65,1193.46,,,0 CDM,278C1776S1_115097,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2982.07,1192.83,,,0 CDM,278C1776S1_115098,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_115099,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_115100,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3003.15,1201.26,,,0 CDM,278C1776S1_115101,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2994.11,1197.64,,,0 CDM,278C1776S1_115102,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2967.01,1186.8,,,0 CDM,278C1776S1_115103,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2982.07,1192.83,,,0 CDM,278C1776S1_115104,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2891.7,1156.68,,,0 CDM,278C1776S1_115105,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2982.07,1192.83,,,0 CDM,278C1776S1_115106,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2831.46,1132.58,,,0 CDM,278C1776S1_115107,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_115562,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,19490.62,7796.25,,,0 CDM,278C1776S1_116056,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3543.75,1417.5,,,0 CDM,278C1776S1_116058,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3543.75,1417.5,,,0 CDM,278C1776S1_116070,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2257.37,902.95,,,0 CDM,278C1776S1_116071,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2275.8,910.32,,,0 CDM,278C1776S1_116072,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2303.44,921.38,,,0 CDM,278C1776S1_116077,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2268.89,907.56,,,0 CDM,278C1776S1_116078,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2289.62,915.85,,,0 CDM,278C1776S1_116104,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2303.44,921.38,,,0 CDM,278C1776S1_116121,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2165.24,866.1,,,0 CDM,278C1776S1_116312,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,9438.19,3775.28,,,0 CDM,278C1776S1_116313,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,9438.19,3775.28,,,0 CDM,278C1776S1_116314,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,9438.19,3775.28,,,0 CDM,278C1776S1_116329,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5020.31,2008.12,,,0 CDM,278C1776S1_116335,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,10120.59,4048.24,,,0 CDM,278C1776S1_118384,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,11594.01,4637.6,,,0 CDM,278C1776S1_118393,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4075.31,1630.12,,,0 CDM,278C1776S1_118394,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4075.31,1630.12,,,0 CDM,278C1776S1_118395,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2953.12,1181.25,,,0 CDM,278C1776S1_118398,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5032.12,2012.85,,,0 CDM,278C1776S1_118403,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,17010.0,6804.0,,,0 CDM,278C1776S1_118404,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,17718.75,7087.5,,,0 CDM,278C1776S1_118405,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,17718.75,7087.5,,,0 CDM,278C1776S1_118406,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,17187.19,6874.88,,,0 CDM,278C1776S1_118407,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,17718.75,7087.5,,,0 CDM,278C1776S1_118408,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2908.55,1163.42,,,0 CDM,278C1776S1_118409,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,11064.33,4425.73,,,0 CDM,278C1776S1_118410,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,11770.56,4708.22,,,0 CDM,278C1776S1_118411,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,11770.56,4708.22,,,0 CDM,278C1776S1_118416,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3923.25,1569.3,,,0 CDM,278C1776S1_118417,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4173.68,1669.47,,,0 CDM,278C1776S1_118418,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4173.68,1669.47,,,0 CDM,278C1776S1_118419,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4048.46,1619.38,,,0 CDM,278C1776S1_118420,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4173.68,1669.47,,,0 CDM,278C1776S1_118422,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4173.68,1669.47,,,0 CDM,278C1776S1_118423,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4090.2,1636.08,,,0 CDM,278C1776S1_118424,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4173.68,1669.47,,,0 CDM,278C1776S1_118425,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3923.25,1569.3,,,0 CDM,278C1776S1_118427,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4173.68,1669.47,,,0 CDM,278C1776S1_118428,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4048.46,1619.38,,,0 CDM,278C1776S1_118429,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4173.68,1669.47,,,0 CDM,278C1776S1_118431,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4173.68,1669.47,,,0 CDM,278C1776S1_118432,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4090.2,1636.08,,,0 CDM,278C1776S1_118437,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5997.48,2398.99,,,0 CDM,278C1776S1_118439,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5811.99,2324.8,,,0 CDM,278C1776S1_118446,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6182.98,2473.19,,,0 CDM,278C1776S1_118923,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_118924,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6187.39,2474.96,,,0 CDM,278C1776S1_118925,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6243.67,2497.47,,,0 CDM,278C1776S1_118926,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6314.96,2525.98,,,0 CDM,278C1776S1_118927,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_118928,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_118929,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6260.99,2504.4,,,0 CDM,278C1776S1_118930,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6187.39,2474.96,,,0 CDM,278C1776S1_118932,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6302.2,2520.88,,,0 CDM,278C1776S1_118933,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6319.87,2527.95,,,0 CDM,278C1776S1_118934,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6283.07,2513.23,,,0 CDM,278C1776S1_118935,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_118936,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_118937,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6296.74,2518.7,,,0 CDM,278C1776S1_118938,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6330.91,2532.36,,,0 CDM,278C1776S1_119947,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_119948,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_119949,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_119950,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_119954,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_119955,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6314.96,2525.98,,,0 CDM,278C1776S1_119956,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_119957,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_119958,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_120021,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2976.04,1190.42,,,0 CDM,278C1776S1_120023,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2976.04,1190.42,,,0 CDM,278C1776S1_120090,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2283.69,913.48,,,0 CDM,278C1776S1_120091,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2275.8,910.32,,,0 CDM,278C1776S1_120092,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2234.34,893.74,,,0 CDM,278C1776S1_120093,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2234.34,893.74,,,0 CDM,278C1776S1_120115,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7619.06,3047.62,,,0 CDM,278C1776S1_120116,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7573.35,3029.34,,,0 CDM,278C1776S1_120117,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7473.61,2989.44,,,0 CDM,278C1776S1_120118,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7533.35,3013.34,,,0 CDM,278C1776S1_120119,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7553.76,3021.5,,,0 CDM,278C1776S1_120120,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7565.28,3026.11,,,0 CDM,278C1776S1_120121,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7542.87,3017.15,,,0 CDM,278C1776S1_120122,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7619.06,3047.62,,,0 CDM,278C1776S1_120123,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7527.63,3011.05,,,0 CDM,278C1776S1_120126,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7436.21,2974.48,,,0 CDM,278C1776S1_120127,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7504.78,3001.91,,,0 CDM,278C1776S1_120128,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7553.76,3021.5,,,0 CDM,278C1776S1_120129,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7542.87,3017.15,,,0 CDM,278C1776S1_120130,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7619.06,3047.62,,,0 CDM,278C1776S1_120131,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7527.63,3011.05,,,0 CDM,278C1776S1_120132,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7504.78,3001.91,,,0 CDM,278C1776S1_120133,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7527.63,3011.05,,,0 CDM,278C1776S1_120180,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4211.55,1684.62,,,0 CDM,278C1776S1_120184,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,16731.27,6692.51,,,0 CDM,278C1776S1_120189,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5890.5,2356.2,,,0 CDM,278C1776S1_120191,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4921.88,1968.75,,,0 CDM,278C1776S1_120192,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4921.88,1968.75,,,0 CDM,278C1776S1_120197,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4921.88,1968.75,,,0 CDM,278C1776S1_122274,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5906.25,2362.5,,,0 CDM,278C1776S1_122275,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5906.25,2362.5,,,0 CDM,278C1776S1_122276,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5906.25,2362.5,,,0 CDM,278C1776S1_122508,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2756.25,1102.5,,,0 CDM,278C1776S1_122509,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2756.25,1102.5,,,0 CDM,278C1776S1_122833,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3937.5,1575.0,,,0 CDM,278C1776S1_122834,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3937.5,1575.0,,,0 CDM,278C1776S1_122836,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3937.5,1575.0,,,0 CDM,278C1776S1_124954,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8465.62,3386.25,,,0 CDM,278C1776S1_124955,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8465.62,3386.25,,,0 CDM,278C1776S1_124956,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8465.62,3386.25,,,0 CDM,278C1776S1_124957,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8465.62,3386.25,,,0 CDM,278C1776S1_124967,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8465.62,3386.25,,,0 CDM,278C1776S1_124969,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8465.62,3386.25,,,0 CDM,278C1776S1_126607,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4463.75,1785.5,,,0 CDM,278C1776S1_126899,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6995.36,2798.14,,,0 CDM,278C1776S1_126900,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6995.36,2798.14,,,0 CDM,278C1776S1_126901,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7441.88,2976.75,,,0 CDM,278C1776S1_126903,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6995.36,2798.14,,,0 CDM,278C1776S1_126905,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7441.88,2976.75,,,0 CDM,278C1776S1_127059,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,10418.62,4167.45,,,0 CDM,278C1776S1_127061,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,17718.75,7087.5,,,0 CDM,278C1776S1_127071,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3215.95,1286.38,,,0 CDM,278C1776S1_127091,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3836.11,1534.44,,,0 CDM,278C1776S1_127094,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3836.11,1534.44,,,0 CDM,278C1776S1_127907,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2831.46,1132.58,,,0 CDM,278C1776S1_127908,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2939.9,1175.96,,,0 CDM,278C1776S1_127909,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2891.7,1156.68,,,0 CDM,278C1776S1_127911,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2831.46,1132.58,,,0 CDM,278C1776S1_127912,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2831.46,1132.58,,,0 CDM,278C1776S1_127913,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2831.46,1132.58,,,0 CDM,278C1776S1_127915,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_127916,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2831.46,1132.58,,,0 CDM,278C1776S1_127917,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_128074,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_128221,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_128224,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_128228,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6314.96,2525.98,,,0 CDM,278C1776S1_128229,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6321.34,2528.54,,,0 CDM,278C1776S1_128230,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6266.18,2506.47,,,0 CDM,278C1776S1_128231,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6293.7,2517.48,,,0 CDM,278C1776S1_128232,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6283.07,2513.23,,,0 CDM,278C1776S1_128233,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6283.07,2513.23,,,0 CDM,278C1776S1_128234,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_128236,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5996.02,2398.41,,,0 CDM,278C1776S1_128237,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6314.96,2525.98,,,0 CDM,278C1776S1_128238,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6299.02,2519.61,,,0 CDM,278C1776S1_128239,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6302.2,2520.88,,,0 CDM,278C1776S1_128240,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6187.39,2474.96,,,0 CDM,278C1776S1_128241,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6283.07,2513.23,,,0 CDM,278C1776S1_128242,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6324.07,2529.63,,,0 CDM,278C1776S1_128337,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_128350,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_128357,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2831.46,1132.58,,,0 CDM,278C1776S1_128360,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2831.46,1132.58,,,0 CDM,278C1776S1_128363,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2831.46,1132.58,,,0 CDM,278C1776S1_128364,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_128365,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_128370,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2967.01,1186.8,,,0 CDM,278C1776S1_128371,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_128372,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_128377,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_128378,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_128379,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_128380,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2921.82,1168.73,,,0 CDM,278C1776S1_128384,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2967.01,1186.8,,,0 CDM,278C1776S1_128385,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2951.95,1180.78,,,0 CDM,278C1776S1_128386,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_128391,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2903.75,1161.5,,,0 CDM,278C1776S1_128393,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_128394,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_128395,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_128398,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2976.04,1190.42,,,0 CDM,278C1776S1_128399,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_128400,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2831.46,1132.58,,,0 CDM,278C1776S1_128406,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2967.01,1186.8,,,0 CDM,278C1776S1_128407,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2951.95,1180.78,,,0 CDM,278C1776S1_128408,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_128414,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_128416,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_128424,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_128431,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_128432,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_128433,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_128434,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_128435,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5996.02,2398.41,,,0 CDM,278C1776S1_128441,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6251.18,2500.47,,,0 CDM,278C1776S1_128442,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_128443,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6187.39,2474.96,,,0 CDM,278C1776S1_128450,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5996.02,2398.41,,,0 CDM,278C1776S1_128451,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_128458,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_128468,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_128471,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6378.75,2551.5,,,0 CDM,278C1776S1_128496,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7367.46,2946.98,,,0 CDM,278C1776S1_128497,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7314.3,2925.72,,,0 CDM,278C1776S1_128498,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7441.88,2976.75,,,0 CDM,278C1776S1_128499,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7441.88,2976.75,,,0 CDM,278C1776S1_128500,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7367.46,2946.98,,,0 CDM,278C1776S1_128501,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7218.62,2887.45,,,0 CDM,278C1776S1_128509,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7330.25,2932.1,,,0 CDM,278C1776S1_128598,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5329.8,2131.92,,,0 CDM,278C1776S1_128602,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5670.0,2268.0,,,0 CDM,278C1776S1_130897,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,19477.95,7791.18,,,0 CDM,278C1776S1_130903,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6758.84,2703.54,,,0 CDM,278C1776S1_132667,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_132668,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2921.82,1168.73,,,0 CDM,278C1776S1_132669,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_132671,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2967.01,1186.8,,,0 CDM,278C1776S1_132672,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_132673,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_132676,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_132677,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_132679,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_132681,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_133019,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7619.06,3047.62,,,0 CDM,278C1776S1_133022,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7619.06,3047.62,,,0 CDM,278C1776S1_133027,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7619.06,3047.62,,,0 CDM,278C1776S1_133029,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7619.06,3047.62,,,0 CDM,278C1776S1_133036,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7619.06,3047.62,,,0 CDM,278C1776S1_133037,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7344.78,2937.91,,,0 CDM,278C1776S1_133038,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7466.68,2986.67,,,0 CDM,278C1776S1_133039,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7619.06,3047.62,,,0 CDM,278C1776S1_133040,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7619.06,3047.62,,,0 CDM,278C1776S1_133041,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7504.78,3001.91,,,0 CDM,278C1776S1_135199,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,15717.02,6286.81,,,0 CDM,278C1776S1_135204,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,13473.65,5389.46,,,0 CDM,278C1776S1_135221,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5662.91,2265.16,,,0 CDM,278C1776S1_135301,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,14639.62,5855.85,,,0 CDM,278C1776S1_135310,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,14639.62,5855.85,,,0 CDM,278C1776S1_135324,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,21294.0,8517.6,,,0 CDM,278C1776S1_135334,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3477.01,1390.8,,,0 CDM,278C1776S1_135345,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5184.51,2073.8,,,0 CDM,278C1776S1_135346,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,9316.12,3726.45,,,0 CDM,278C1776S1_135348,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,9316.12,3726.45,,,0 CDM,278C1776S1_135349,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,9316.12,3726.45,,,0 CDM,278C1776S1_135379,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2831.46,1132.58,,,0 CDM,278C1776S1_135838,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,10276.88,4110.75,,,0 CDM,278C1776S1_135844,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12265.31,4906.12,,,0 CDM,278C1776S1_135845,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12265.31,4906.12,,,0 CDM,278C1776S1_136080,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,21262.5,8505.0,,,0 CDM,278C1776S1_136081,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,20837.25,8334.9,,,0 CDM,278C1776S1_136082,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,20624.62,8249.85,,,0 CDM,278C1776S1_136083,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,21262.5,8505.0,,,0 CDM,278C1776S1_136084,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,21262.5,8505.0,,,0 CDM,278C1776S1_136086,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,21262.5,8505.0,,,0 CDM,278C1776S1_136097,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,21262.5,8505.0,,,0 CDM,278C1776S1_136099,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,19986.75,7994.7,,,0 CDM,278C1776S1_136101,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,19986.75,7994.7,,,0 CDM,278C1776S1_136102,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,21262.5,8505.0,,,0 CDM,278C1776S1_136103,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,20837.25,8334.9,,,0 CDM,278C1776S1_136104,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,20465.16,8186.06,,,0 CDM,278C1776S1_136105,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,21262.5,8505.0,,,0 CDM,278C1776S1_136106,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,19986.75,7994.7,,,0 CDM,278C1776S1_136107,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,20624.62,8249.85,,,0 CDM,278C1776S1_136108,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,21262.5,8505.0,,,0 CDM,278C1776S1_136109,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,21262.5,8505.0,,,0 CDM,278C1776S1_136110,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,21262.5,8505.0,,,0 CDM,278C1776S1_136115,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,19986.75,7994.7,,,0 CDM,278C1776S1_136130,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,21262.5,8505.0,,,0 CDM,278C1776S1_136131,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,19986.75,7994.7,,,0 CDM,278C1776S1_136134,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,21262.5,8505.0,,,0 CDM,278C1776S1_136135,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,21007.35,8402.94,,,0 CDM,278C1776S1_136136,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,21262.5,8505.0,,,0 CDM,278C1776S1_136139,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,21262.5,8505.0,,,0 CDM,278C1776S1_136155,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,19986.75,7994.7,,,0 CDM,278C1776S1_136553,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6504.75,2601.9,,,0 CDM,278C1776S1_136554,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6504.75,2601.9,,,0 CDM,278C1776S1_136555,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6498.84,2599.54,,,0 CDM,278C1776S1_136558,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6300.0,2520.0,,,0 CDM,278C1776S1_136562,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6449.62,2579.85,,,0 CDM,278C1776S1_136567,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6449.62,2579.85,,,0 CDM,278C1776S1_136572,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6500.81,2600.32,,,0 CDM,278C1776S1_136573,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6449.62,2579.85,,,0 CDM,278C1776S1_137283,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12084.19,4833.68,,,0 CDM,278C1776S1_137284,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12403.12,4961.25,,,0 CDM,278C1776S1_137285,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12217.08,4886.83,,,0 CDM,278C1776S1_137286,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12403.12,4961.25,,,0 CDM,278C1776S1_137287,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12031.03,4812.41,,,0 CDM,278C1776S1_137290,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12403.12,4961.25,,,0 CDM,278C1776S1_137291,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12403.12,4961.25,,,0 CDM,278C1776S1_137293,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12403.12,4961.25,,,0 CDM,278C1776S1_137296,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12403.12,4961.25,,,0 CDM,278C1776S1_137874,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4084.76,1633.9,,,0 CDM,278C1776S1_138415,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3937.5,1575.0,,,0 CDM,278C1776S1_138417,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3937.5,1575.0,,,0 CDM,278C1776S1_138418,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3937.5,1575.0,,,0 CDM,278C1776S1_138421,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3937.5,1575.0,,,0 CDM,278C1776S1_139092,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1699.7,679.88,,,0 CDM,278C1776S1_140085,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,20853.99,8341.6,,,0 CDM,278C1776S1_140369,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,16731.27,6692.51,,,0 CDM,278C1776S1_140370,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,16731.27,6692.51,,,0 CDM,278C1776S1_142834,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5311.69,2124.68,,,0 CDM,278C1776S1_144849,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1604.3,641.72,,,0 CDM,278C1776S1_144850,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1589.28,635.71,,,0 CDM,278C1776S1_144851,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1604.3,641.72,,,0 CDM,278C1776S1_144852,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1604.3,641.72,,,0 CDM,278C1776S1_144853,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1604.3,641.72,,,0 CDM,278C1776S1_149008,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6969.38,2787.75,,,0 CDM,278C1776S1_150945,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5843.64,2337.46,,,0 CDM,278C1776S1_150988,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5903.89,2361.56,,,0 CDM,278C1776S1_150989,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5783.4,2313.36,,,0 CDM,278C1776S1_150990,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6024.38,2409.75,,,0 CDM,278C1776S1_150991,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5903.89,2361.56,,,0 CDM,278C1776S1_150992,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6024.38,2409.75,,,0 CDM,278C1776S1_150993,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5952.08,2380.83,,,0 CDM,278C1776S1_150994,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6024.38,2409.75,,,0 CDM,278C1776S1_150995,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5843.64,2337.46,,,0 CDM,278C1776S1_150997,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6024.38,2409.75,,,0 CDM,278C1776S1_150998,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5843.64,2337.46,,,0 CDM,278C1776S1_151001,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5662.91,2265.16,,,0 CDM,278C1776S1_152703,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7339.5,2935.8,,,0 CDM,278C1776S1_152897,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3665.81,1466.32,,,0 CDM,278C1776S1_152898,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3680.41,1472.16,,,0 CDM,278C1776S1_152899,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3679.41,1471.76,,,0 CDM,278C1776S1_152900,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3705.0,1482.0,,,0 CDM,278C1776S1_152901,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3702.58,1481.03,,,0 CDM,278C1776S1_152902,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3717.61,1487.04,,,0 CDM,278C1776S1_152903,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3671.57,1468.63,,,0 CDM,278C1776S1_152904,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3708.56,1483.42,,,0 CDM,278C1776S1_152914,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3740.62,1496.25,,,0 CDM,278C1776S1_152915,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2382.78,953.11,,,0 CDM,278C1776S1_152918,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2408.62,963.45,,,0 CDM,278C1776S1_152919,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2410.57,964.23,,,0 CDM,278C1776S1_152920,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2386.52,954.61,,,0 CDM,278C1776S1_152921,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2413.18,965.27,,,0 CDM,278C1776S1_152923,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2431.41,972.56,,,0 CDM,278C1776S1_152974,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2303.44,921.38,,,0 CDM,278C1776S1_153373,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6780.38,2712.15,,,0 CDM,278C1776S1_154818,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12211.09,4884.44,,,0 CDM,278C1776S1_154868,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,14665.34,5866.14,,,0 CDM,278C1776S1_154871,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,14665.34,5866.14,,,0 CDM,278C1776S1_154890,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,23887.4,9554.96,,,0 CDM,278C1776S1_154891,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7766.52,3106.61,,,0 CDM,278C1776S1_154892,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7541.42,3016.57,,,0 CDM,278C1776S1_154894,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7541.42,3016.57,,,0 CDM,278C1776S1_154898,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,10255.34,4102.14,,,0 CDM,278C1776S1_154900,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,17821.76,7128.7,,,0 CDM,278C1776S1_154912,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,22424.15,8969.66,,,0 CDM,278C1776S1_154915,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,21748.79,8699.52,,,0 CDM,278C1776S1_154921,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4872.54,1949.02,,,0 CDM,278C1776S1_154933,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4840.02,1936.01,,,0 CDM,278C1776S1_154938,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4840.02,1936.01,,,0 CDM,278C1776S1_154941,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4840.02,1936.01,,,0 CDM,278C1776S1_154945,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4840.02,1936.01,,,0 CDM,278C1776S1_156294,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2081.95,832.78,,,0 CDM,278C1776S1_156298,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2214.85,885.94,,,0 CDM,278C1776S1_164669,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1699.7,679.88,,,0 CDM,278C1776S1_165021,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6758.84,2703.54,,,0 CDM,278C1776S1_167434,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2559.38,1023.75,,,0 CDM,278C1776S1_167435,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2559.38,1023.75,,,0 CDM,278C1776S1_167504,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3937.5,1575.0,,,0 CDM,278C1776S1_167506,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3937.5,1575.0,,,0 CDM,278C1776S1_167509,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3937.5,1575.0,,,0 CDM,278C1776S1_169400,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5049.85,2019.94,,,0 CDM,278C1776S1_169401,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4974.1,1989.64,,,0 CDM,278C1776S1_169403,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5049.85,2019.94,,,0 CDM,278C1776S1_169404,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4898.35,1959.34,,,0 CDM,278C1776S1_169406,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4746.85,1898.74,,,0 CDM,278C1776S1_169407,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5049.85,2019.94,,,0 CDM,278C1776S1_170984,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3894.43,1557.77,,,0 CDM,278C1776S1_170988,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3894.43,1557.77,,,0 CDM,278C1776S1_171051,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4862.81,1945.12,,,0 CDM,278C1776S1_171052,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4862.81,1945.12,,,0 CDM,278C1776S1_171053,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4765.56,1906.22,,,0 CDM,278C1776S1_171054,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4862.81,1945.12,,,0 CDM,278C1776S1_171055,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4862.81,1945.12,,,0 CDM,278C1776S1_171056,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4862.81,1945.12,,,0 CDM,278C1776S1_171057,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4862.81,1945.12,,,0 CDM,278C1776S1_171060,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4571.05,1828.42,,,0 CDM,278C1776S1_171062,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4862.81,1945.12,,,0 CDM,278C1776S1_171063,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4765.56,1906.22,,,0 CDM,278C1776S1_171065,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4862.81,1945.12,,,0 CDM,278C1776S1_171066,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4716.93,1886.77,,,0 CDM,278C1776S1_171088,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5049.85,2019.94,,,0 CDM,278C1776S1_171089,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5049.85,2019.94,,,0 CDM,278C1776S1_171090,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4746.85,1898.74,,,0 CDM,278C1776S1_171091,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5049.85,2019.94,,,0 CDM,278C1776S1_171093,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5049.85,2019.94,,,0 CDM,278C1776S1_171097,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4746.85,1898.74,,,0 CDM,278C1776S1_171099,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5049.85,2019.94,,,0 CDM,278C1776S1_171100,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5049.85,2019.94,,,0 CDM,278C1776S1_171101,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4948.85,1979.54,,,0 CDM,278C1776S1_171103,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5049.85,2019.94,,,0 CDM,278C1776S1_171104,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4746.85,1898.74,,,0 CDM,278C1776S1_171105,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5049.85,2019.94,,,0 CDM,278C1776S1_171107,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2988.76,1195.5,,,0 CDM,278C1776S1_171113,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3179.54,1271.82,,,0 CDM,278C1776S1_171120,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3179.54,1271.82,,,0 CDM,278C1776S1_171121,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2988.76,1195.5,,,0 CDM,278C1776S1_171122,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3179.54,1271.82,,,0 CDM,278C1776S1_171127,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3179.54,1271.82,,,0 CDM,278C1776S1_171128,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3179.54,1271.82,,,0 CDM,278C1776S1_171134,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3179.54,1271.82,,,0 CDM,278C1776S1_171135,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2988.76,1195.5,,,0 CDM,278C1776S1_171281,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1343.2,537.28,,,0 CDM,278C1776S1_171282,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1478.25,591.3,,,0 CDM,278C1776S1_172626,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5512.5,2205.0,,,0 CDM,278C1776S1_172627,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5512.5,2205.0,,,0 CDM,278C1776S1_172630,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5512.5,2205.0,,,0 CDM,278C1776S1_172634,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5512.5,2205.0,,,0 CDM,278C1776S1_172636,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5512.5,2205.0,,,0 CDM,278C1776S1_172637,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5512.5,2205.0,,,0 CDM,278C1776S1_172638,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5181.75,2072.7,,,0 CDM,278C1776S1_172648,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172649,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172650,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172651,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172654,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172655,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2831.46,1132.58,,,0 CDM,278C1776S1_172656,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2951.95,1180.78,,,0 CDM,278C1776S1_172657,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172658,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172659,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172663,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172664,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172665,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172672,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2831.46,1132.58,,,0 CDM,278C1776S1_172678,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2867.61,1147.04,,,0 CDM,278C1776S1_172679,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172680,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2876.64,1150.66,,,0 CDM,278C1776S1_172681,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2921.82,1168.73,,,0 CDM,278C1776S1_172683,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172685,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172686,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172687,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2831.46,1132.58,,,0 CDM,278C1776S1_172688,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2921.82,1168.73,,,0 CDM,278C1776S1_172689,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172703,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172709,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2921.82,1168.73,,,0 CDM,278C1776S1_172710,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2831.46,1132.58,,,0 CDM,278C1776S1_172716,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2921.82,1168.73,,,0 CDM,278C1776S1_172717,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2891.7,1156.68,,,0 CDM,278C1776S1_172718,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172719,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172721,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172724,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2967.01,1186.8,,,0 CDM,278C1776S1_172725,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2967.01,1186.8,,,0 CDM,278C1776S1_172726,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2967.01,1186.8,,,0 CDM,278C1776S1_172727,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172732,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172733,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2921.82,1168.73,,,0 CDM,278C1776S1_172734,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172740,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2951.95,1180.78,,,0 CDM,278C1776S1_172741,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2967.01,1186.8,,,0 CDM,278C1776S1_172742,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172743,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2951.95,1180.78,,,0 CDM,278C1776S1_172748,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2921.82,1168.73,,,0 CDM,278C1776S1_172750,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172751,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2831.46,1132.58,,,0 CDM,278C1776S1_172752,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172756,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2951.95,1180.78,,,0 CDM,278C1776S1_172757,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2967.01,1186.8,,,0 CDM,278C1776S1_172758,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3012.19,1204.88,,,0 CDM,278C1776S1_172826,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2696.53,1078.61,,,0 CDM,278C1776S1_172827,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2698.37,1079.35,,,0 CDM,278C1776S1_172828,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2713.0,1085.2,,,0 CDM,278C1776S1_172829,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2726.72,1090.69,,,0 CDM,278C1776S1_172830,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2690.1,1076.04,,,0 CDM,278C1776S1_174092,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8071.88,3228.75,,,0 CDM,278C1776S1_174093,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8071.88,3228.75,,,0 CDM,278C1776S1_174099,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2756.25,1102.5,,,0 CDM,278C1776S1_174103,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2756.25,1102.5,,,0 CDM,278C1776S1_174104,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2756.25,1102.5,,,0 CDM,278C1776S1_174105,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2756.25,1102.5,,,0 CDM,278C1776S1_174107,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2756.25,1102.5,,,0 CDM,278C1776S1_174108,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2756.25,1102.5,,,0 CDM,278C1776S1_174109,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2756.25,1102.5,,,0 CDM,278C1776S1_174113,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2756.25,1102.5,,,0 CDM,278C1776S1_174120,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2953.12,1181.25,,,0 CDM,278C1776S1_174121,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2953.12,1181.25,,,0 CDM,278C1776S1_174122,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2953.12,1181.25,,,0 CDM,278C1776S1_174125,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2953.12,1181.25,,,0 CDM,278C1776S1_174126,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2953.12,1181.25,,,0 CDM,278C1776S1_174127,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2953.12,1181.25,,,0 CDM,278C1776S1_174134,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2953.12,1181.25,,,0 CDM,278C1776S1_174135,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2953.12,1181.25,,,0 CDM,278C1776S1_174136,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2953.12,1181.25,,,0 CDM,278C1776S1_174139,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2953.12,1181.25,,,0 CDM,278C1776S1_174140,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2953.12,1181.25,,,0 CDM,278C1776S1_174144,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2953.12,1181.25,,,0 CDM,278C1776S1_174157,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3740.62,1496.25,,,0 CDM,278C1776S1_174159,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3740.62,1496.25,,,0 CDM,278C1776S1_174160,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3740.62,1496.25,,,0 CDM,278C1776S1_174163,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3740.62,1496.25,,,0 CDM,278C1776S1_174164,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4528.12,1811.25,,,0 CDM,278C1776S1_174192,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,14635.69,5854.28,,,0 CDM,278C1776S1_174193,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,14635.69,5854.28,,,0 CDM,278C1776S1_174209,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,15750.0,6300.0,,,0 CDM,278C1776S1_174211,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,14635.69,5854.28,,,0 CDM,278C1776S1_174212,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,14635.69,5854.28,,,0 CDM,278C1776S1_174213,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,14635.69,5854.28,,,0 CDM,278C1776S1_174216,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,14635.69,5854.28,,,0 CDM,278C1776S1_174220,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,14635.69,5854.28,,,0 CDM,278C1776S1_174250,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2953.12,1181.25,,,0 CDM,278C1776S1_174257,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,16734.38,6693.75,,,0 CDM,278C1776S1_174258,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,16734.38,6693.75,,,0 CDM,278C1776S1_174259,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,16734.38,6693.75,,,0 CDM,278C1776S1_174532,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4705.31,1882.12,,,0 CDM,278C1776S1_175308,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4114.69,1645.88,,,0 CDM,278C1776S1_177089,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6856.17,2742.47,,,0 CDM,278C1776S1_177095,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6844.69,2737.88,,,0 CDM,278C1776S1_177098,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6890.62,2756.25,,,0 CDM,278C1776S1_177110,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5837.54,2335.02,,,0 CDM,278C1776S1_177112,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5808.21,2323.28,,,0 CDM,278C1776S1_177113,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5866.88,2346.75,,,0 CDM,278C1776S1_177454,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5906.25,2362.5,,,0 CDM,278C1776S1_177457,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5906.25,2362.5,,,0 CDM,278C1776S1_177458,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5906.25,2362.5,,,0 CDM,278C1776S1_177460,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5906.25,2362.5,,,0 CDM,278C1776S1_177480,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8583.75,3433.5,,,0 CDM,278C1776S1_177481,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8583.75,3433.5,,,0 CDM,278C1776S1_177482,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8583.75,3433.5,,,0 CDM,278C1776S1_177500,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12222.0,4888.8,,,0 CDM,278C1776S1_177501,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12222.0,4888.8,,,0 CDM,278C1776S1_177502,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12222.0,4888.8,,,0 CDM,278C1776S1_177503,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12222.0,4888.8,,,0 CDM,278C1776S1_177514,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12993.75,5197.5,,,0 CDM,278C1776S1_177515,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12993.75,5197.5,,,0 CDM,278C1776S1_177518,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,22699.69,9079.88,,,0 CDM,278C1776S1_177519,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,22699.69,9079.88,,,0 CDM,278C1776S1_177524,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,26062.31,10424.92,,,0 CDM,278C1776S1_177554,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,13092.19,5236.88,,,0 CDM,278C1776S1_177555,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,13092.19,5236.88,,,0 CDM,278C1776S1_177556,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,13092.19,5236.88,,,0 CDM,278C1776S1_177804,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4331.25,1732.5,,,0 CDM,278C1776S1_177807,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4331.25,1732.5,,,0 CDM,278C1776S1_177883,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3346.88,1338.75,,,0 CDM,278C1776S1_177895,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3346.88,1338.75,,,0 CDM,278C1776S1_177901,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3346.88,1338.75,,,0 CDM,278C1776S1_177913,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3346.88,1338.75,,,0 CDM,278C1776S1_177916,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3346.88,1338.75,,,0 CDM,278C1776S1_177925,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3346.88,1338.75,,,0 CDM,278C1776S1_177928,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3346.88,1338.75,,,0 CDM,278C1776S1_177929,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4921.88,1968.75,,,0 CDM,278C1776S1_177930,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4921.88,1968.75,,,0 CDM,278C1776S1_177932,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4921.88,1968.75,,,0 CDM,278C1776S1_177935,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4921.88,1968.75,,,0 CDM,278C1776S1_177936,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4921.88,1968.75,,,0 CDM,278C1776S1_177939,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,17718.75,7087.5,,,0 CDM,278C1776S1_177942,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,17718.75,7087.5,,,0 CDM,278C1776S1_177945,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,17718.75,7087.5,,,0 CDM,278C1776S1_177963,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,17718.75,7087.5,,,0 CDM,278C1776S1_177998,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4134.38,1653.75,,,0 CDM,278C1776S1_178005,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4134.38,1653.75,,,0 CDM,278C1776S1_178021,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,17718.75,7087.5,,,0 CDM,278C1776S1_178022,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,17718.75,7087.5,,,0 CDM,278C1776S1_178032,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1575.0,630.0,,,0 CDM,278C1776S1_178034,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4725.0,1890.0,,,0 CDM,278C1776S1_178035,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4725.0,1890.0,,,0 CDM,278C1776S1_178036,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4725.0,1890.0,,,0 CDM,278C1776S1_178037,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4725.0,1890.0,,,0 CDM,278C1776S1_178038,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4725.0,1890.0,,,0 CDM,278C1776S1_178039,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4725.0,1890.0,,,0 CDM,278C1776S1_178040,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4725.0,1890.0,,,0 CDM,278C1776S1_178041,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4725.0,1890.0,,,0 CDM,278C1776S1_178042,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4725.0,1890.0,,,0 CDM,278C1776S1_178067,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5020.31,2008.12,,,0 CDM,278C1776S1_178069,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8449.88,3379.95,,,0 CDM,278C1776S1_178071,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8894.81,3557.92,,,0 CDM,278C1776S1_178072,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8894.81,3557.92,,,0 CDM,278C1776S1_178076,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8894.81,3557.92,,,0 CDM,278C1776S1_178078,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7087.5,2835.0,,,0 CDM,278C1776S1_178084,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7087.5,2835.0,,,0 CDM,278C1776S1_178086,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7087.5,2835.0,,,0 CDM,278C1776S1_178106,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7040.25,2816.1,,,0 CDM,278C1776S1_178123,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7875.0,3150.0,,,0 CDM,278C1776S1_178124,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7875.0,3150.0,,,0 CDM,278C1776S1_178126,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7875.0,3150.0,,,0 CDM,278C1776S1_178127,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7875.0,3150.0,,,0 CDM,278C1776S1_178129,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7875.0,3150.0,,,0 CDM,278C1776S1_178132,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7875.0,3150.0,,,0 CDM,278C1776S1_178135,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7875.0,3150.0,,,0 CDM,278C1776S1_178142,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,9843.75,3937.5,,,0 CDM,278C1776S1_178230,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1232.44,492.98,,,0 CDM,278C1776S1_178278,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,21262.5,8505.0,,,0 CDM,278C1776S1_178279,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,18210.94,7284.38,,,0 CDM,278C1776S1_178280,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,18210.94,7284.38,,,0 CDM,278C1776S1_178281,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,21262.5,8505.0,,,0 CDM,278C1776S1_178282,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,18210.94,7284.38,,,0 CDM,278C1776S1_178283,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,18210.94,7284.38,,,0 CDM,278C1776S1_178285,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,21262.5,8505.0,,,0 CDM,278C1776S1_178286,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,18210.94,7284.38,,,0 CDM,278C1776S1_178287,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,18210.94,7284.38,,,0 CDM,278C1776S1_178294,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,815.06,326.02,,,0 CDM,278C1776S1_178442,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4528.12,1811.25,,,0 CDM,278C1776S1_178488,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3346.88,1338.75,,,0 CDM,278C1776S1_179973,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2303.44,921.38,,,0 CDM,278C1776S1_179975,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2211.3,884.52,,,0 CDM,278C1776S1_179976,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2277.29,910.92,,,0 CDM,278C1776S1_180163,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2389.73,955.89,,,0 CDM,278C1776S1_180164,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2391.62,956.65,,,0 CDM,278C1776S1_188295,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7619.06,3047.62,,,0 CDM,278C1776S1_190213,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8229.38,3291.75,,,0 CDM,278C1776S1_190220,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,18145.77,7258.31,,,0 CDM,278C1776S1_190222,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8662.5,3465.0,,,0 CDM,278C1776S1_190391,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6059.81,2423.92,,,0 CDM,278C1776S1_191604,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4427.72,1771.09,,,0 CDM,278C1776S1_191784,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7284.38,2913.75,,,0 CDM,278C1776S1_192009,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8467.63,3387.05,,,0 CDM,278C1776S1_194072,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2431.41,972.56,,,0 CDM,278C1776S1_194074,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2431.41,972.56,,,0 CDM,278C1776S1_194940,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6366.94,2546.78,,,0 CDM,278C1776S1_194941,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,16112.25,6444.9,,,0 CDM,278C1776S1_194942,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,17750.25,7100.1,,,0 CDM,278C1776S1_197170,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8272.3,3308.92,,,0 CDM,278C1776S1_197182,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8272.3,3308.92,,,0 CDM,278C1776S1_197195,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8272.3,3308.92,,,0 CDM,278C1776S1_197196,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8272.3,3308.92,,,0 CDM,278C1776S1_197197,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8272.3,3308.92,,,0 CDM,278C1776S1_197208,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8272.3,3308.92,,,0 CDM,278C1776S1_197210,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8272.3,3308.92,,,0 CDM,278C1776S1_197211,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,8272.3,3308.92,,,0 CDM,278C1776S1_197256,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2831.46,1132.58,,,0 CDM,278C1776S1_197257,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,5996.02,2398.41,,,0 CDM,278C1776S1_197487,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,21508.99,8603.6,,,0 CDM,278C1776S1_197488,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6890.62,2756.25,,,0 CDM,278C1776S1_197489,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,17060.8,6824.32,,,0 CDM,278C1776S1_197998,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,12181.64,4872.66,,,0 CDM,278C1776S1_199458,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,15049.12,6019.65,,,0 CDM,278C1776S1_199459,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,16580.81,6632.32,,,0 CDM,278C1776S1_84240,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4095.0,1638.0,,,0 CDM,278C1776S1_91927,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,21262.5,8505.0,,,0 CDM,278C1776S1_92709,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,3349.73,1339.89,,,0 CDM,278C1776S1_92953,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,6508.33,2603.33,,,0 CDM,278C1776S1_92964,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1317.29,526.92,,,0 CDM,278C1776S1_92965,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1840.59,736.24,,,0 CDM,278C1776S1_92966,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,1998.85,799.54,,,0 CDM,278C1776S1_92968,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4731.16,1892.46,,,0 CDM,278C1776S1_92969,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,10381.77,4152.71,,,0 CDM,278C1776S1_93754,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2535.75,1014.3,,,0 CDM,278C1776S1_94061,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,2397.78,959.11,,,0 CDM,278C1776S1_96330,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,18.9,7.56,,,0 CDM,278C1776S1_97054,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7875.0,3150.0,,,0 CDM,278C1776S1_97061,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,7875.0,3150.0,,,0 CDM,278C1776S1_C1776_278,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,18735.47,7494.19,,,0 CDM,278C1777S1_161253,Hc Sup Shell 278 Revenue Code C1777 Hcpcs,10434.38,4173.75,,,0 CDM,278C177802,Hc Lead Vectris Comp 1X8 90Cm Sap#177273,7658.44,3063.38,,,0 CDM,278C177803,"Hc Kit Conversion Sprint, Sap#263422",19293.75,7717.5,,,0 CDM,278C177804,"Hc Kit Procedure Dual Lead Sprint Pns, Sap#263421",31893.75,12757.5,,,0 CDM,278C177804_C1778_278,"Hc Kit Procedure Dual Lead Sprint Pns, Sap#263421",31585.6,12634.24,,,0 CDM,278C177806,"Hc Trial Lead Kit, Sap#177277",5473.12,2189.25,,,0 CDM,278C177806_C1778_278,"Hc Trial Lead Kit, Sap#177277",5473.12,2189.25,,,0 CDM,278C177807,"Hc Sprint Pns Repl Microlead 2.0 Lead Warranity, Sap#",0.01,0.004,,,0 CDM,278C177808,"Hc Kit Procedure Single Lead Sprint Pns, Sap#261717",19293.75,7717.5,,,0 CDM,278C1778S1_116577,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,5906.25,2362.5,,,0 CDM,278C1778S1_119847,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,7658.44,3063.38,,,0 CDM,278C1778S1_126641,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,17147.81,6859.12,,,0 CDM,278C1778S1_126646,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,18388.12,7355.25,,,0 CDM,278C1778S1_132969,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,5906.25,2362.5,,,0 CDM,278C1778S1_132970,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,4725.0,1890.0,,,0 CDM,278C1778S1_145900,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,3937.5,1575.0,,,0 CDM,278C1778S1_145901,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,3937.5,1575.0,,,0 CDM,278C1778S1_145906,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,9843.75,3937.5,,,0 CDM,278C1778S1_150977,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,11025.0,4410.0,,,0 CDM,278C1778S1_150978,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,11025.0,4410.0,,,0 CDM,278C1778S1_155334,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,15887.81,6355.12,,,0 CDM,278C1778S1_158922,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,44198.44,17679.38,,,0 CDM,278C1778S1_158923,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,14549.06,5819.62,,,0 CDM,278C1778S1_170322,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,20868.75,8347.5,,,0 CDM,278C1778S1_176994,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,13289.06,5315.62,,,0 CDM,278C1778S1_178809,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,13194.56,5277.82,,,0 CDM,278C1778S1_178810,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,1358.44,543.38,,,0 CDM,278C1778S1_181309,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,1023.75,409.5,,,0 CDM,278C1778S1_189104,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,27562.5,11025.0,,,0 CDM,278C1778S1_196116,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,25593.75,10237.5,,,0 CDM,278C1778S1_196117,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,25593.75,10237.5,,,0 CDM,278C1778S1_198773,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,18388.12,7355.25,,,0 CDM,278C1778S1_87539,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,35182.6,14073.04,,,0 CDM,278C1778S1_90544,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,196.88,78.75,,,0 CDM,278C1778S1_91850,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,14549.06,5819.62,,,0 CDM,278C1778S1_C1778_278,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,17860.5,7144.2,,,0 CDM,278C1781S1_114366,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,850.9,340.36,,,0 CDM,278C1781S1_114369,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,793.21,317.28,,,0 CDM,278C1781S1_114822,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,1339.6,535.84,,,0 CDM,278C1781S1_114886,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,3971.09,1588.44,,,0 CDM,278C1781S1_115060,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,1421.24,568.5,,,0 CDM,278C1781S1_115061,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,2253.21,901.28,,,0 CDM,278C1781S1_115062,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,2315.74,926.3,,,0 CDM,278C1781S1_115987,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,8825.91,3530.36,,,0 CDM,278C1781S1_115988,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,3705.49,1482.2,,,0 CDM,278C1781S1_115989,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,6216.05,2486.42,,,0 CDM,278C1781S1_118674,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,1374.19,549.68,,,0 CDM,278C1781S1_118898,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,1792.02,716.81,,,0 CDM,278C1781S1_119880,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,1949.06,779.62,,,0 CDM,278C1781S1_126795,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,4491.11,1796.44,,,0 CDM,278C1781S1_126796,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,8960.96,3584.38,,,0 CDM,278C1781S1_126797,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,14973.52,5989.41,,,0 CDM,278C1781S1_126798,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,23725.41,9490.16,,,0 CDM,278C1781S1_135150,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,5024.25,2009.7,,,0 CDM,278C1781S1_136469,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,29056.5,11622.6,,,0 CDM,278C1781S1_136470,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,52195.9,20878.36,,,0 CDM,278C1781S1_137503,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,9548.44,3819.38,,,0 CDM,278C1781S1_137504,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,15809.06,6323.62,,,0 CDM,278C1781S1_138185,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,4501.85,1800.74,,,0 CDM,278C1781S1_139186,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,4754.76,1901.9,,,0 CDM,278C1781S1_139187,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,12618.84,5047.54,,,0 CDM,278C1781S1_139188,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,19467.0,7786.8,,,0 CDM,278C1781S1_139226,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,34836.38,13934.55,,,0 CDM,278C1781S1_157089,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,5118.75,2047.5,,,0 CDM,278C1781S1_157090,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,2315.25,926.1,,,0 CDM,278C1781S1_157092,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,5705.44,2282.18,,,0 CDM,278C1781S1_163453,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,30712.5,12285.0,,,0 CDM,278C1781S1_163454,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,46068.75,18427.5,,,0 CDM,278C1781S1_164083,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,3031.09,1212.44,,,0 CDM,278C1781S1_187447,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,40506.01,16202.4,,,0 CDM,278C1781S1_187448,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,9308.25,3723.3,,,0 CDM,278C1781S1_187449,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,13041.0,5216.4,,,0 CDM,278C1781S1_187450,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,19656.0,7862.4,,,0 CDM,278C1781S1_188536,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,12481.88,4992.75,,,0 CDM,278C1781S1_188921,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,10139.06,4055.62,,,0 CDM,278C1781S1_189616,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,0.04,0.02,,,0 CDM,278C1781S1_189619,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,0.04,0.02,,,0 CDM,278C1781S1_189952,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,7855.31,3142.12,,,0 CDM,278C1781S1_189954,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,12363.75,4945.5,,,0 CDM,278C1781S1_198211,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,0.04,0.02,,,0 CDM,278C1781S1_198633,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,0.04,0.02,,,0 CDM,278C1781S1_198638,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,44709.96,17883.98,,,0 CDM,278C1781S1_198639,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,3780.0,1512.0,,,0 CDM,278C1781S1_199494,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,55888.88,22355.55,,,0 CDM,278C1781S1_84370,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,3121.2,1248.48,,,0 CDM,278C1781S1_84371,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,8495.71,3398.28,,,0 CDM,278C1781S1_84377,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,3749.76,1499.9,,,0 CDM,278C1781S1_84625,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,603.74,241.5,,,0 CDM,278C1781S1_90929,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,3895.29,1558.12,,,0 CDM,278C1781S1_90930,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,8380.26,3352.1,,,0 CDM,278C1781S1_91793,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,3728.02,1491.21,,,0 CDM,278C1781S1_91794,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,14504.57,5801.83,,,0 CDM,278C1781S1_92450,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,2621.43,1048.57,,,0 CDM,278C1781S1_93471,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,5124.66,2049.86,,,0 CDM,278C1781S1_94497,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,3539.81,1415.92,,,0 CDM,278C1781S1_94498,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,3539.81,1415.92,,,0 CDM,278C1781S1_95276,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,160.89,64.36,,,0 CDM,278C1781S1_95382,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,973.7,389.48,,,0 CDM,278C1781S1_95383,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,1210.85,484.34,,,0 CDM,278C1781S1_95386,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,941.44,376.58,,,0 CDM,278C1781S1_95387,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,1011.15,404.46,,,0 CDM,278C1781S1_95467,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,515.37,206.15,,,0 CDM,278C1781S1_95469,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,127.84,51.14,,,0 CDM,278C1781S1_95474,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,625.67,250.27,,,0 CDM,278C1781S1_C1781_278,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,4381.92,1752.77,,,0 CDM,278C1783S1_132566,Hc Sup Shell 278 Revenue Code C1783 Hcpcs,7579.69,3031.88,,,0 CDM,278C1783S1_85157,Hc Sup Shell 278 Revenue Code C1783 Hcpcs,4462.5,1785.0,,,0 CDM,278C1783S1_86290,Hc Sup Shell 278 Revenue Code C1783 Hcpcs,3937.5,1575.0,,,0 CDM,278C1783S1_86525,Hc Sup Shell 278 Revenue Code C1783 Hcpcs,2752.31,1100.92,,,0 CDM,278C178401,Hc Ocular Device Intraop Detach,177.19,70.88,,,0 CDM,278C178401_C1784_278,Hc Ocular Device Intraop Detach,177.19,70.88,,,0 CDM,278C1784S1_84176,Hc Sup Shell 278 Revenue Code C1784 Hcpcs,84.26,33.7,,,0 CDM,278C1784S1_C1784_278,Hc Sup Shell 278 Revenue Code C1784 Hcpcs,95.17,38.07,,,0 CDM,278C1786S1_139063,Hc Sup Shell 278 Revenue Code C1786 Hcpcs,47466.56,18986.62,,,0 CDM,278C1786S1_C1786_278,Hc Sup Shell 278 Revenue Code C1786 Hcpcs,54081.56,21632.62,,,0 CDM,278C1787S1_191390,Hc Sup Shell 278 Revenue Code C1787 Hcpcs,1181.25,472.5,,,0 CDM,278C1788S1_130814,Hc Sup Shell 278 Revenue Code C1788 Hcpcs,1785.0,714.0,,,0 CDM,278C1788S1_138852,Hc Sup Shell 278 Revenue Code C1788 Hcpcs,2201.91,880.76,,,0 CDM,278C1788S1_84906,Hc Sup Shell 278 Revenue Code C1788 Hcpcs,1204.88,481.95,,,0 CDM,278C1788S1_93593,Hc Sup Shell 278 Revenue Code C1788 Hcpcs,1042.21,416.88,,,0 CDM,278C1788S1_95083,Hc Sup Shell 278 Revenue Code C1788 Hcpcs,1024.08,409.63,,,0 CDM,278C1789S1_115548,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3484.69,1393.88,,,0 CDM,278C1789S1_143233,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,4725.0,1890.0,,,0 CDM,278C1789S1_158048,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3346.88,1338.75,,,0 CDM,278C1789S1_158050,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3248.44,1299.38,,,0 CDM,278C1789S1_158051,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3281.25,1312.5,,,0 CDM,278C1789S1_158052,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3268.12,1307.25,,,0 CDM,278C1789S1_158054,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3322.27,1328.91,,,0 CDM,278C1789S1_158055,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3346.88,1338.75,,,0 CDM,278C1789S1_158298,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,2500.31,1000.12,,,0 CDM,278C1789S1_158304,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,2500.31,1000.12,,,0 CDM,278C1789S1_158309,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,2500.31,1000.12,,,0 CDM,278C1789S1_158312,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,2500.31,1000.12,,,0 CDM,278C1789S1_158321,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,2500.31,1000.12,,,0 CDM,278C1789S1_158323,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,2362.5,945.0,,,0 CDM,278C1789S1_158324,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,2500.31,1000.12,,,0 CDM,278C1789S1_158328,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,2408.44,963.38,,,0 CDM,278C1789S1_158331,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,2500.31,1000.12,,,0 CDM,278C1789S1_158343,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,2362.5,945.0,,,0 CDM,278C1789S1_158379,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3346.88,1338.75,,,0 CDM,278C1789S1_158381,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3248.44,1299.38,,,0 CDM,278C1789S1_158382,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3346.88,1338.75,,,0 CDM,278C1789S1_158383,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3346.88,1338.75,,,0 CDM,278C1789S1_158385,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3248.44,1299.38,,,0 CDM,278C1789S1_158390,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3248.44,1299.38,,,0 CDM,278C1789S1_158391,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3248.44,1299.38,,,0 CDM,278C1789S1_158395,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3314.06,1325.62,,,0 CDM,278C1789S1_158396,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3346.88,1338.75,,,0 CDM,278C1789S1_158400,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3248.44,1299.38,,,0 CDM,278C1789S1_158401,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3314.06,1325.62,,,0 CDM,278C1789S1_158403,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3346.88,1338.75,,,0 CDM,278C1789S1_158404,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3248.44,1299.38,,,0 CDM,278C1789S1_158406,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3248.44,1299.38,,,0 CDM,278C1789S1_158407,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3248.44,1299.38,,,0 CDM,278C1789S1_158409,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3248.44,1299.38,,,0 CDM,278C1789S1_158410,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3327.19,1330.88,,,0 CDM,278C1789S1_158411,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3346.88,1338.75,,,0 CDM,278C1789S1_158412,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3297.66,1319.06,,,0 CDM,278C1789S1_158414,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3297.66,1319.06,,,0 CDM,278C1789S1_158415,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3314.06,1325.62,,,0 CDM,278C1789S1_158416,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3327.19,1330.88,,,0 CDM,278C1789S1_158417,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3346.88,1338.75,,,0 CDM,278C1789S1_158418,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3287.81,1315.12,,,0 CDM,278C1789S1_158419,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3281.25,1312.5,,,0 CDM,278C1789S1_158420,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3322.27,1328.91,,,0 CDM,278C1789S1_158421,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3288.97,1315.59,,,0 CDM,278C1789S1_158422,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3287.81,1315.12,,,0 CDM,278C1789S1_158423,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3248.44,1299.38,,,0 CDM,278C1789S1_158424,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3297.66,1319.06,,,0 CDM,278C1789S1_158425,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3346.88,1338.75,,,0 CDM,278C1789S1_158426,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3311.08,1324.43,,,0 CDM,278C1789S1_158427,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3297.66,1319.06,,,0 CDM,278C1789S1_158428,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3297.66,1319.06,,,0 CDM,278C1789S1_158429,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3301.44,1320.58,,,0 CDM,278C1789S1_158430,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3248.44,1299.38,,,0 CDM,278C1789S1_158431,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3318.75,1327.5,,,0 CDM,278C1789S1_158432,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3297.66,1319.06,,,0 CDM,278C1789S1_158433,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3281.25,1312.5,,,0 CDM,278C1789S1_158434,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3284.23,1313.69,,,0 CDM,278C1789S1_158435,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3314.06,1325.62,,,0 CDM,278C1789S1_158437,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3346.88,1338.75,,,0 CDM,278C1789S1_158438,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3346.88,1338.75,,,0 CDM,278C1789S1_158439,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3346.88,1338.75,,,0 CDM,278C1789S1_158440,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3307.5,1323.0,,,0 CDM,278C1789S1_158442,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3271.15,1308.46,,,0 CDM,278C1789S1_158445,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3346.88,1338.75,,,0 CDM,278C1789S1_158446,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3314.06,1325.62,,,0 CDM,278C1789S1_158916,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,6615.0,2646.0,,,0 CDM,278C1789S1_159587,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,6628.9,2651.56,,,0 CDM,278C1789S1_162608,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,6590.13,2636.05,,,0 CDM,278C1789S1_162631,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,6574.11,2629.64,,,0 CDM,278C1789S1_164818,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,48.24,19.3,,,0 CDM,278C1789S1_165074,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,6567.75,2627.1,,,0 CDM,278C1789S1_166187,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,6567.75,2627.1,,,0 CDM,278C1789S1_168673,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,6674.06,2669.62,,,0 CDM,278C1789S1_169830,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,6657.95,2663.18,,,0 CDM,278C1789S1_92650,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,1752.19,700.88,,,0 CDM,278C1813S1_118817,Hc Sup Shell 278 Revenue Code C1813 Hcpcs,11479.79,4591.92,,,0 CDM,278C1813S1_118818,Hc Sup Shell 278 Revenue Code C1813 Hcpcs,3729.8,1491.92,,,0 CDM,278C1813S1_119394,Hc Sup Shell 278 Revenue Code C1813 Hcpcs,46103.2,18441.28,,,0 CDM,278C1813S1_119397,Hc Sup Shell 278 Revenue Code C1813 Hcpcs,44735.64,17894.26,,,0 CDM,278C1813S1_119398,Hc Sup Shell 278 Revenue Code C1813 Hcpcs,44831.39,17932.56,,,0 CDM,278C1813S1_119400,Hc Sup Shell 278 Revenue Code C1813 Hcpcs,45605.7,18242.28,,,0 CDM,278C1813S1_130826,Hc Sup Shell 278 Revenue Code C1813 Hcpcs,44458.31,17783.32,,,0 CDM,278C1813S1_130828,Hc Sup Shell 278 Revenue Code C1813 Hcpcs,44458.31,17783.32,,,0 CDM,278C1813S1_130829,Hc Sup Shell 278 Revenue Code C1813 Hcpcs,9768.94,3907.58,,,0 CDM,278C1813S1_130830,Hc Sup Shell 278 Revenue Code C1813 Hcpcs,9768.94,3907.58,,,0 CDM,278C1813S1_186560,Hc Sup Shell 278 Revenue Code C1813 Hcpcs,44831.39,17932.56,,,0 CDM,278C1813S1_193632,Hc Sup Shell 278 Revenue Code C1813 Hcpcs,3071.25,1228.5,,,0 CDM,278C1813S1_96271,Hc Sup Shell 278 Revenue Code C1813 Hcpcs,11306.4,4522.56,,,0 CDM,278C1813S1_C1813_278,Hc Sup Shell 278 Revenue Code C1813 Hcpcs,15844.5,6337.8,,,0 CDM,278C1814S1_84472,Hc Sup Shell 278 Revenue Code C1814 Hcpcs,1655.09,662.04,,,0 CDM,278C1815S1_94441,Hc Sup Shell 278 Revenue Code C1815 Hcpcs,27512.1,11004.84,,,0 CDM,278C1815S1_94442,Hc Sup Shell 278 Revenue Code C1815 Hcpcs,27512.1,11004.84,,,0 CDM,278C1815S1_94443,Hc Sup Shell 278 Revenue Code C1815 Hcpcs,27373.5,10949.4,,,0 CDM,278C1815S1_94444,Hc Sup Shell 278 Revenue Code C1815 Hcpcs,27373.5,10949.4,,,0 CDM,278C1815S1_94445,Hc Sup Shell 278 Revenue Code C1815 Hcpcs,26459.63,10583.85,,,0 CDM,278C1815S1_94446,Hc Sup Shell 278 Revenue Code C1815 Hcpcs,12585.65,5034.26,,,0 CDM,278C1815S1_C1815_278,Hc Sup Shell 278 Revenue Code C1815 Hcpcs,28586.25,11434.5,,,0 CDM,278C1817S1_133452,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,5457.38,2182.95,,,0 CDM,278C1817S1_133453,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,5327.44,2130.98,,,0 CDM,278C1817S1_133454,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,5397.4,2158.96,,,0 CDM,278C1817S1_133455,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,5284.12,2113.65,,,0 CDM,278C1817S1_133725,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,29298.94,11719.58,,,0 CDM,278C1817S1_133727,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,29298.94,11719.58,,,0 CDM,278C1817S1_133772,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,19045.69,7618.28,,,0 CDM,278C1817S1_133773,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,19045.69,7618.28,,,0 CDM,278C1817S1_133840,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,29298.94,11719.58,,,0 CDM,278C1817S1_133926,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,35272.12,14108.85,,,0 CDM,278C1817S1_133927,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,35272.12,14108.85,,,0 CDM,278C1817S1_134679,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,29298.94,11719.58,,,0 CDM,278C1817S1_134682,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,29298.94,11719.58,,,0 CDM,278C1817S1_134683,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,29298.94,11719.58,,,0 CDM,278C1817S1_134684,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,29298.94,11719.58,,,0 CDM,278C1817S1_134686,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,29298.94,11719.58,,,0 CDM,278C1817S1_134696,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,29298.94,11719.58,,,0 CDM,278C1817S1_135026,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,19045.69,7618.28,,,0 CDM,278C1817S1_150479,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,37406.25,14962.5,,,0 CDM,278C1817S1_150482,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,37406.25,14962.5,,,0 CDM,278C1817S1_150483,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,37406.25,14962.5,,,0 CDM,278C1817S1_150486,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,37406.25,14962.5,,,0 CDM,278C1817S1_162706,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,32011.88,12804.75,,,0 CDM,278C1817S1_165462,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,32094.56,12837.82,,,0 CDM,278C1817S1_170825,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,32094.56,12837.82,,,0 CDM,278C1817S1_178769,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,39355.31,15742.12,,,0 CDM,278C1817S1_178770,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,39355.31,15742.12,,,0 CDM,278C1817S1_178771,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,39355.31,15742.12,,,0 CDM,278C1817S1_182418,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,31929.19,12771.68,,,0 CDM,278C1817S1_192139,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,31929.19,12771.68,,,0 CDM,278C1817S1_95424,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,34085.81,13634.32,,,0 CDM,278C1817S1_95425,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,33916.93,13566.77,,,0 CDM,278C1817S1_C1817_278,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,31149.56,12459.82,,,0 CDM,278C1820S1_116879,Hc Sup Shell 278 Revenue Code C1820 Hcpcs,62114.06,24845.62,,,0 CDM,278C1820S1_150976,Hc Sup Shell 278 Revenue Code C1820 Hcpcs,92925.0,37170.0,,,0 CDM,278C1820S1_150981,Hc Sup Shell 278 Revenue Code C1820 Hcpcs,67429.69,26971.88,,,0 CDM,278C1820S1_152537,Hc Sup Shell 278 Revenue Code C1820 Hcpcs,83750.62,33500.25,,,0 CDM,278C1820S1_178858,Hc Sup Shell 278 Revenue Code C1820 Hcpcs,42332.06,16932.82,,,0 CDM,278C1820S1_196115,Hc Sup Shell 278 Revenue Code C1820 Hcpcs,116156.25,46462.5,,,0 CDM,278C1820S1_C1820_278,Hc Sup Shell 278 Revenue Code C1820 Hcpcs,54849.38,21939.75,,,0 CDM,278C1822S1_C1822_278,Hc Sup Shell 278 Revenue Code C1822 Hcpcs,75895.31,30358.12,,,0 CDM,278C1825S1_189103,Hc Sup Shell 278 Revenue Code C1825 Hcpcs? Hb Chargeables,137812.5,55125.0,,,0 CDM,278C1827S1_196115,Hc Sup Shell 278 Revenue Code C1827 Hcpcs,116156.25,46462.5,,,0 CDM,278C1830S1_139092,Hc Sup Shell 278 Revenue Code C1830 Hcpcs,1699.7,679.88,,,0 CDM,278C1874S1_113935,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,10674.74,4269.9,,,0 CDM,278C1874S1_113936,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,10984.65,4393.86,,,0 CDM,278C1874S1_113937,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11360.09,4544.04,,,0 CDM,278C1874S1_113938,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11404.68,4561.87,,,0 CDM,278C1874S1_117457,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_117501,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_118687,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,14088.38,5635.35,,,0 CDM,278C1874S1_118690,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,14088.38,5635.35,,,0 CDM,278C1874S1_118691,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,14088.38,5635.35,,,0 CDM,278C1874S1_118694,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,14088.38,5635.35,,,0 CDM,278C1874S1_118695,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,14088.38,5635.35,,,0 CDM,278C1874S1_118696,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,14088.38,5635.35,,,0 CDM,278C1874S1_118734,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,42920.72,17168.29,,,0 CDM,278C1874S1_118746,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,15824.81,6329.92,,,0 CDM,278C1874S1_132867,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,62251.88,24900.75,,,0 CDM,278C1874S1_132878,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,62251.88,24900.75,,,0 CDM,278C1874S1_133470,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,27907.04,11162.82,,,0 CDM,278C1874S1_133472,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,33408.51,13363.4,,,0 CDM,278C1874S1_133473,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,33408.51,13363.4,,,0 CDM,278C1874S1_133887,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2362.5,945.0,,,0 CDM,278C1874S1_133893,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2362.5,945.0,,,0 CDM,278C1874S1_133896,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2362.5,945.0,,,0 CDM,278C1874S1_134208,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2362.5,945.0,,,0 CDM,278C1874S1_134215,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134216,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134217,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2745.06,1098.02,,,0 CDM,278C1874S1_134218,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134219,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134220,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134221,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134223,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134224,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134225,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134226,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134227,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134228,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134229,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134230,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134231,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134232,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134233,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134234,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134235,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134236,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134237,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134238,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134239,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134240,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134241,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134242,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134243,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134244,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134245,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2744.57,1097.83,,,0 CDM,278C1874S1_134246,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134247,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134248,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134249,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134250,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2675.71,1070.28,,,0 CDM,278C1874S1_134251,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134252,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2742.41,1096.96,,,0 CDM,278C1874S1_134253,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134282,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134323,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134324,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134325,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2741.72,1096.69,,,0 CDM,278C1874S1_134326,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134327,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134328,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134478,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_134649,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,20018.25,8007.3,,,0 CDM,278C1874S1_134669,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,20018.25,8007.3,,,0 CDM,278C1874S1_136637,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,19683.56,7873.42,,,0 CDM,278C1874S1_137582,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11863.69,4745.48,,,0 CDM,278C1874S1_137588,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11863.69,4745.48,,,0 CDM,278C1874S1_137615,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,9450.0,3780.0,,,0 CDM,278C1874S1_137616,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,9318.75,3727.5,,,0 CDM,278C1874S1_137617,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,9450.0,3780.0,,,0 CDM,278C1874S1_137618,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,9318.75,3727.5,,,0 CDM,278C1874S1_137619,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,9646.88,3858.75,,,0 CDM,278C1874S1_137624,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,9056.25,3622.5,,,0 CDM,278C1874S1_137625,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,9056.25,3622.5,,,0 CDM,278C1874S1_137629,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,15409.52,6163.81,,,0 CDM,278C1874S1_137630,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,15513.75,6205.5,,,0 CDM,278C1874S1_137765,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,13054.78,5221.91,,,0 CDM,278C1874S1_137769,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,14970.38,5988.15,,,0 CDM,278C1874S1_137774,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11568.21,4627.28,,,0 CDM,278C1874S1_137775,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12978.0,5191.2,,,0 CDM,278C1874S1_137776,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,15076.69,6030.68,,,0 CDM,278C1874S1_137777,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11595.01,4638.0,,,0 CDM,278C1874S1_137778,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,13083.82,5233.53,,,0 CDM,278C1874S1_137779,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11582.16,4632.86,,,0 CDM,278C1874S1_137783,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12289.34,4915.74,,,0 CDM,278C1874S1_137784,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12753.96,5101.58,,,0 CDM,278C1874S1_137785,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12289.34,4915.74,,,0 CDM,278C1874S1_137946,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11025.0,4410.0,,,0 CDM,278C1874S1_137947,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11025.0,4410.0,,,0 CDM,278C1874S1_137963,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,9778.12,3911.25,,,0 CDM,278C1874S1_138274,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11694.38,4677.75,,,0 CDM,278C1874S1_138344,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11358.01,4543.2,,,0 CDM,278C1874S1_138560,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,18672.19,7468.88,,,0 CDM,278C1874S1_138561,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,18500.69,7400.28,,,0 CDM,278C1874S1_138562,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,18981.88,7592.75,,,0 CDM,278C1874S1_144804,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12289.34,4915.74,,,0 CDM,278C1874S1_145725,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,9812.09,3924.84,,,0 CDM,278C1874S1_145726,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,9812.09,3924.84,,,0 CDM,278C1874S1_145730,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,9812.09,3924.84,,,0 CDM,278C1874S1_145761,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,8662.5,3465.0,,,0 CDM,278C1874S1_145762,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,8662.5,3465.0,,,0 CDM,278C1874S1_145763,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,8662.5,3465.0,,,0 CDM,278C1874S1_145764,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,8662.5,3465.0,,,0 CDM,278C1874S1_145765,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,8662.5,3465.0,,,0 CDM,278C1874S1_145766,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,8662.5,3465.0,,,0 CDM,278C1874S1_145819,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,8662.5,3465.0,,,0 CDM,278C1874S1_145824,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,10493.44,4197.38,,,0 CDM,278C1874S1_145825,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,10490.5,4196.2,,,0 CDM,278C1874S1_145826,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,10493.44,4197.38,,,0 CDM,278C1874S1_145844,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,8662.5,3465.0,,,0 CDM,278C1874S1_146531,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,8662.5,3465.0,,,0 CDM,278C1874S1_146532,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,17844.75,7137.9,,,0 CDM,278C1874S1_146533,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,17844.75,7137.9,,,0 CDM,278C1874S1_146534,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,20257.85,8103.14,,,0 CDM,278C1874S1_147320,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,40323.65,16129.46,,,0 CDM,278C1874S1_147321,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11344.92,4537.97,,,0 CDM,278C1874S1_147322,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11418.75,4567.5,,,0 CDM,278C1874S1_150435,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2953.12,1181.25,,,0 CDM,278C1874S1_150436,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2953.12,1181.25,,,0 CDM,278C1874S1_150438,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2953.12,1181.25,,,0 CDM,278C1874S1_150439,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2953.12,1181.25,,,0 CDM,278C1874S1_150441,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2953.12,1181.25,,,0 CDM,278C1874S1_150442,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_150443,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_150444,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_150445,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_150446,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_150447,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2756.25,1102.5,,,0 CDM,278C1874S1_150448,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2953.12,1181.25,,,0 CDM,278C1874S1_150449,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2953.12,1181.25,,,0 CDM,278C1874S1_150450,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2953.12,1181.25,,,0 CDM,278C1874S1_150451,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2953.12,1181.25,,,0 CDM,278C1874S1_150452,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2953.12,1181.25,,,0 CDM,278C1874S1_150453,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2953.12,1181.25,,,0 CDM,278C1874S1_150454,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2953.12,1181.25,,,0 CDM,278C1874S1_150457,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2953.12,1181.25,,,0 CDM,278C1874S1_150458,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2953.12,1181.25,,,0 CDM,278C1874S1_150459,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2953.12,1181.25,,,0 CDM,278C1874S1_150477,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,33610.66,13444.26,,,0 CDM,278C1874S1_150478,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,32912.58,13165.03,,,0 CDM,278C1874S1_150949,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,10217.81,4087.12,,,0 CDM,278C1874S1_150950,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,10217.81,4087.12,,,0 CDM,278C1874S1_150952,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,7855.31,3142.12,,,0 CDM,278C1874S1_150955,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,10217.81,4087.12,,,0 CDM,278C1874S1_151094,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,25096.64,10038.66,,,0 CDM,278C1874S1_153343,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,62251.88,24900.75,,,0 CDM,278C1874S1_153345,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,62251.88,24900.75,,,0 CDM,278C1874S1_153349,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,62251.88,24900.75,,,0 CDM,278C1874S1_153355,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,62251.88,24900.75,,,0 CDM,278C1874S1_153357,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,62251.88,24900.75,,,0 CDM,278C1874S1_153358,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,62251.88,24900.75,,,0 CDM,278C1874S1_153360,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,62251.88,24900.75,,,0 CDM,278C1874S1_156111,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11971.69,4788.68,,,0 CDM,278C1874S1_156112,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11749.06,4699.62,,,0 CDM,278C1874S1_156113,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11877.69,4751.08,,,0 CDM,278C1874S1_156114,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11928.15,4771.26,,,0 CDM,278C1874S1_156115,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11891.86,4756.74,,,0 CDM,278C1874S1_156116,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11836.76,4734.7,,,0 CDM,278C1874S1_156118,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12045.94,4818.38,,,0 CDM,278C1874S1_156119,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12042.19,4816.88,,,0 CDM,278C1874S1_156120,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11875.5,4750.2,,,0 CDM,278C1874S1_156121,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12044.81,4817.92,,,0 CDM,278C1874S1_156122,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12068.44,4827.38,,,0 CDM,278C1874S1_156124,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11915.08,4766.03,,,0 CDM,278C1874S1_156125,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12055.31,4822.12,,,0 CDM,278C1874S1_156126,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12068.44,4827.38,,,0 CDM,278C1874S1_156127,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12036.94,4814.78,,,0 CDM,278C1874S1_156128,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12029.06,4811.62,,,0 CDM,278C1874S1_156129,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11951.3,4780.52,,,0 CDM,278C1874S1_156130,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11868.94,4747.58,,,0 CDM,278C1874S1_156132,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11983.78,4793.51,,,0 CDM,278C1874S1_156133,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11932.99,4773.2,,,0 CDM,278C1874S1_156134,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12036.94,4814.78,,,0 CDM,278C1874S1_156135,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12029.06,4811.62,,,0 CDM,278C1874S1_156136,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11858.77,4743.51,,,0 CDM,278C1874S1_156137,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12055.31,4822.12,,,0 CDM,278C1874S1_156138,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11908.79,4763.52,,,0 CDM,278C1874S1_156139,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12029.06,4811.62,,,0 CDM,278C1874S1_156141,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12052.69,4821.08,,,0 CDM,278C1874S1_156143,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11981.32,4792.53,,,0 CDM,278C1874S1_156144,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11836.91,4734.76,,,0 CDM,278C1874S1_156145,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12048.75,4819.5,,,0 CDM,278C1874S1_156146,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12029.06,4811.62,,,0 CDM,278C1874S1_156147,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12034.69,4813.88,,,0 CDM,278C1874S1_156149,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12058.59,4823.44,,,0 CDM,278C1874S1_156150,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12055.31,4822.12,,,0 CDM,278C1874S1_156151,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11922.19,4768.88,,,0 CDM,278C1874S1_156152,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12040.31,4816.12,,,0 CDM,278C1874S1_156153,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12944.04,5177.62,,,0 CDM,278C1874S1_156154,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,13034.44,5213.78,,,0 CDM,278C1874S1_156155,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,13145.34,5258.14,,,0 CDM,278C1874S1_156156,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,13056.75,5222.7,,,0 CDM,278C1874S1_156157,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,13179.94,5271.98,,,0 CDM,278C1874S1_156158,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,13223.44,5289.38,,,0 CDM,278C1874S1_156159,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,13275.0,5310.0,,,0 CDM,278C1874S1_156161,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,13116.55,5246.62,,,0 CDM,278C1874S1_156163,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,13210.31,5284.12,,,0 CDM,278C1874S1_156164,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,13190.62,5276.25,,,0 CDM,278C1874S1_156165,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,13280.11,5312.04,,,0 CDM,278C1874S1_156166,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,13280.11,5312.04,,,0 CDM,278C1874S1_156167,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,13165.87,5266.35,,,0 CDM,278C1874S1_156168,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,13110.4,5244.16,,,0 CDM,278C1874S1_156342,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,62251.88,24900.75,,,0 CDM,278C1874S1_156343,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,62251.88,24900.75,,,0 CDM,278C1874S1_156344,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,62251.88,24900.75,,,0 CDM,278C1874S1_164670,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,48821.06,19528.42,,,0 CDM,278C1874S1_165802,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,40145.0,16058.0,,,0 CDM,278C1874S1_165817,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,10134.69,4053.88,,,0 CDM,278C1874S1_165850,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,10038.44,4015.38,,,0 CDM,278C1874S1_165852,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11891.81,4756.72,,,0 CDM,278C1874S1_168679,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11359.69,4543.88,,,0 CDM,278C1874S1_169796,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12047.24,4818.9,,,0 CDM,278C1874S1_169978,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,42920.72,17168.29,,,0 CDM,278C1874S1_170640,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,40262.91,16105.16,,,0 CDM,278C1874S1_170867,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,14088.38,5635.35,,,0 CDM,278C1874S1_170955,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,42920.72,17168.29,,,0 CDM,278C1874S1_172584,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,17699.06,7079.62,,,0 CDM,278C1874S1_172855,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,10208.73,4083.49,,,0 CDM,278C1874S1_173249,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,46378.41,18551.36,,,0 CDM,278C1874S1_173298,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,9607.82,3843.13,,,0 CDM,278C1874S1_173299,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,9607.82,3843.13,,,0 CDM,278C1874S1_173300,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,9607.82,3843.13,,,0 CDM,278C1874S1_173301,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,9607.82,3843.13,,,0 CDM,278C1874S1_173302,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,9607.82,3843.13,,,0 CDM,278C1874S1_173303,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,9666.72,3866.69,,,0 CDM,278C1874S1_173514,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,16340.62,6536.25,,,0 CDM,278C1874S1_173818,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2460.94,984.38,,,0 CDM,278C1874S1_173822,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2460.94,984.38,,,0 CDM,278C1874S1_173823,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2460.94,984.38,,,0 CDM,278C1874S1_173825,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2460.94,984.38,,,0 CDM,278C1874S1_173827,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2460.94,984.38,,,0 CDM,278C1874S1_173829,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2460.94,984.38,,,0 CDM,278C1874S1_173830,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2460.94,984.38,,,0 CDM,278C1874S1_173831,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2460.94,984.38,,,0 CDM,278C1874S1_173833,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2460.94,984.38,,,0 CDM,278C1874S1_173836,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2460.94,984.38,,,0 CDM,278C1874S1_173837,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2460.94,984.38,,,0 CDM,278C1874S1_173840,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2460.94,984.38,,,0 CDM,278C1874S1_173841,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2460.94,984.38,,,0 CDM,278C1874S1_173842,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2460.94,984.38,,,0 CDM,278C1874S1_173843,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2460.94,984.38,,,0 CDM,278C1874S1_173847,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2460.94,984.38,,,0 CDM,278C1874S1_173848,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2460.94,984.38,,,0 CDM,278C1874S1_173849,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2460.94,984.38,,,0 CDM,278C1874S1_173850,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2460.94,984.38,,,0 CDM,278C1874S1_173852,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2460.94,984.38,,,0 CDM,278C1874S1_173853,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2460.94,984.38,,,0 CDM,278C1874S1_173854,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2460.94,984.38,,,0 CDM,278C1874S1_173857,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2460.94,984.38,,,0 CDM,278C1874S1_173859,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,2460.94,984.38,,,0 CDM,278C1874S1_173894,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,16127.34,6450.94,,,0 CDM,278C1874S1_173895,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,16340.62,6536.25,,,0 CDM,278C1874S1_173897,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,16340.62,6536.25,,,0 CDM,278C1874S1_173898,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,16340.62,6536.25,,,0 CDM,278C1874S1_173899,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,45285.19,18114.08,,,0 CDM,278C1874S1_173900,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,46331.69,18532.68,,,0 CDM,278C1874S1_173901,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,46294.31,18517.72,,,0 CDM,278C1874S1_173902,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,46266.28,18506.51,,,0 CDM,278C1874S1_173903,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,46266.28,18506.51,,,0 CDM,278C1874S1_180026,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,62251.88,24900.75,,,0 CDM,278C1874S1_182153,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,9942.19,3976.88,,,0 CDM,278C1874S1_183063,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,10104.61,4041.84,,,0 CDM,278C1874S1_183349,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,79080.75,31632.3,,,0 CDM,278C1874S1_186242,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12054.66,4821.86,,,0 CDM,278C1874S1_186243,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11991.0,4796.4,,,0 CDM,278C1874S1_186246,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,13394.77,5357.91,,,0 CDM,278C1874S1_186247,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12245.62,4898.25,,,0 CDM,278C1874S1_186248,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12046.35,4818.54,,,0 CDM,278C1874S1_186249,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,13440.37,5376.15,,,0 CDM,278C1874S1_186250,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12150.14,4860.06,,,0 CDM,278C1874S1_186251,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12062.96,4825.18,,,0 CDM,278C1874S1_186252,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,13411.84,5364.74,,,0 CDM,278C1874S1_186253,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11590.25,4636.1,,,0 CDM,278C1874S1_186254,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,13170.94,5268.38,,,0 CDM,278C1874S1_186255,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12150.14,4860.06,,,0 CDM,278C1874S1_186256,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,11940.08,4776.03,,,0 CDM,278C1874S1_186459,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,9942.19,3976.88,,,0 CDM,278C1874S1_188482,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,14088.38,5635.35,,,0 CDM,278C1874S1_189014,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,10050.47,4020.19,,,0 CDM,278C1874S1_189781,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,15824.81,6329.92,,,0 CDM,278C1874S1_190336,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,10267.03,4106.81,,,0 CDM,278C1874S1_190337,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,10158.75,4063.5,,,0 CDM,278C1874S1_190338,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,9942.19,3976.88,,,0 CDM,278C1874S1_190339,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,10230.94,4092.38,,,0 CDM,278C1874S1_190340,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,10202.06,4080.82,,,0 CDM,278C1874S1_196555,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,15411.38,6164.55,,,0 CDM,278C1874S1_C1874_278,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,29267.56,11707.02,,,0 CDM,278C1876S1_133495,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,3678.61,1471.44,,,0 CDM,278C1876S1_133808,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,4921.88,1968.75,,,0 CDM,278C1876S1_133810,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,4921.88,1968.75,,,0 CDM,278C1876S1_133812,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,4921.88,1968.75,,,0 CDM,278C1876S1_133813,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5020.31,2008.12,,,0 CDM,278C1876S1_133814,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5020.31,2008.12,,,0 CDM,278C1876S1_134027,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5118.75,2047.5,,,0 CDM,278C1876S1_134028,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5118.75,2047.5,,,0 CDM,278C1876S1_134126,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,4921.88,1968.75,,,0 CDM,278C1876S1_134127,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,4921.88,1968.75,,,0 CDM,278C1876S1_134293,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5768.44,2307.38,,,0 CDM,278C1876S1_134294,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5826.71,2330.68,,,0 CDM,278C1876S1_134295,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5768.44,2307.38,,,0 CDM,278C1876S1_134296,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5768.44,2307.38,,,0 CDM,278C1876S1_134298,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5768.44,2307.38,,,0 CDM,278C1876S1_134314,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5768.44,2307.38,,,0 CDM,278C1876S1_134315,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,6059.81,2423.92,,,0 CDM,278C1876S1_134569,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5414.06,2165.62,,,0 CDM,278C1876S1_134577,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5414.06,2165.62,,,0 CDM,278C1876S1_134578,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5650.31,2260.12,,,0 CDM,278C1876S1_134579,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5414.06,2165.62,,,0 CDM,278C1876S1_134582,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,8367.19,3346.88,,,0 CDM,278C1876S1_134584,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5414.06,2165.62,,,0 CDM,278C1876S1_134585,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5532.19,2212.88,,,0 CDM,278C1876S1_134592,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5571.56,2228.62,,,0 CDM,278C1876S1_134593,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5591.25,2236.5,,,0 CDM,278C1876S1_137531,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5492.81,2197.12,,,0 CDM,278C1876S1_138351,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,27872.24,11148.9,,,0 CDM,278C1876S1_138352,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,27467.89,10987.16,,,0 CDM,278C1876S1_138353,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,27824.67,11129.87,,,0 CDM,278C1876S1_138399,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,28062.52,11225.01,,,0 CDM,278C1876S1_138400,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,27824.67,11129.87,,,0 CDM,278C1876S1_138401,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,28062.52,11225.01,,,0 CDM,278C1876S1_145799,Hc Sup 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CDM,278C1876S1_145923,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,9745.31,3898.12,,,0 CDM,278C1876S1_145924,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,9745.31,3898.12,,,0 CDM,278C1876S1_145925,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,9745.31,3898.12,,,0 CDM,278C1876S1_145926,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,9745.31,3898.12,,,0 CDM,278C1876S1_146535,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,9040.5,3616.2,,,0 CDM,278C1876S1_146537,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,9040.5,3616.2,,,0 CDM,278C1876S1_146538,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,9040.5,3616.2,,,0 CDM,278C1876S1_146539,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,9040.5,3616.2,,,0 CDM,278C1876S1_146540,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,9040.5,3616.2,,,0 CDM,278C1876S1_150557,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,2930.25,1172.1,,,0 CDM,278C1876S1_158731,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,4921.88,1968.75,,,0 CDM,278C1876S1_164084,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,6496.88,2598.75,,,0 CDM,278C1876S1_164085,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,6496.88,2598.75,,,0 CDM,278C1876S1_164086,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,6496.88,2598.75,,,0 CDM,278C1876S1_164087,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,6496.88,2598.75,,,0 CDM,278C1876S1_165043,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,7461.56,2984.62,,,0 CDM,278C1876S1_165044,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,6664.22,2665.69,,,0 CDM,278C1876S1_165839,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,7461.56,2984.62,,,0 CDM,278C1876S1_167557,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,7461.56,2984.62,,,0 CDM,278C1876S1_167558,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,7461.56,2984.62,,,0 CDM,278C1876S1_167560,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,7461.56,2984.62,,,0 CDM,278C1876S1_170400,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,7461.56,2984.62,,,0 CDM,278C1876S1_170401,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,7142.62,2857.05,,,0 CDM,278C1876S1_170781,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5866.88,2346.75,,,0 CDM,278C1876S1_171796,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,6930.0,2772.0,,,0 CDM,278C1876S1_171797,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,7461.56,2984.62,,,0 CDM,278C1876S1_171799,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,7461.56,2984.62,,,0 CDM,278C1876S1_171800,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,7461.56,2984.62,,,0 CDM,278C1876S1_173904,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,4429.69,1771.88,,,0 CDM,278C1876S1_173908,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,4429.69,1771.88,,,0 CDM,278C1876S1_173909,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,4429.69,1771.88,,,0 CDM,278C1876S1_178779,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,66913.88,26765.55,,,0 CDM,278C1876S1_190644,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,79080.75,31632.3,,,0 CDM,278C1876S1_191480,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,701.39,280.56,,,0 CDM,278C1876S1_197887,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,9745.31,3898.12,,,0 CDM,278C1876S1_197888,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,9745.31,3898.12,,,0 CDM,278C1876S1_197889,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,9745.31,3898.12,,,0 CDM,278C1876S1_91319,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,4954.69,1981.88,,,0 CDM,278C1876S1_91320,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,4921.88,1968.75,,,0 CDM,278C1876S1_91861,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,4823.44,1929.38,,,0 CDM,278C1876S1_91862,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5158.12,2063.25,,,0 CDM,278C1876S1_91863,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5158.12,2063.25,,,0 CDM,278C1876S1_91864,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5492.81,2197.12,,,0 CDM,278C1876S1_91865,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5492.81,2197.12,,,0 CDM,278C1876S1_C1876_278,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,48271.34,19308.54,,,0 CDM,278C1877S1_133684,Hc Sup Shell 278 Revenue Code C1877 Hcpcs,5187.62,2075.05,,,0 CDM,278C1877S1_133755,Hc Sup Shell 278 Revenue Code C1877 Hcpcs,5187.62,2075.05,,,0 CDM,278C1877S1_133941,Hc Sup Shell 278 Revenue Code C1877 Hcpcs,4921.88,1968.75,,,0 CDM,278C1877S1_133942,Hc Sup Shell 278 Revenue Code C1877 Hcpcs,4921.88,1968.75,,,0 CDM,278C1877S1_133943,Hc Sup Shell 278 Revenue Code C1877 Hcpcs,4921.88,1968.75,,,0 CDM,278C1877S1_133946,Hc Sup Shell 278 Revenue Code C1877 Hcpcs,4921.88,1968.75,,,0 CDM,278C1877S1_135052,Hc Sup Shell 278 Revenue Code C1877 Hcpcs,5187.62,2075.05,,,0 CDM,278C1880S1_134318,Hc Sup Shell 278 Revenue Code C1880 Hcpcs,6595.31,2638.12,,,0 CDM,278C1880S1_134319,Hc Sup Shell 278 Revenue Code C1880 Hcpcs,6595.31,2638.12,,,0 CDM,278C1883S1_114961,Hc Sup Shell 278 Revenue Code C1883 Hcpcs,0.04,0.02,,,0 CDM,278C1883S1_116605,Hc Sup Shell 278 Revenue Code C1883 Hcpcs,2255.4,902.16,,,0 CDM,278C1883S1_151559,Hc Sup Shell 278 Revenue Code C1883 Hcpcs,1968.75,787.5,,,0 CDM,278C1883S1_152551,Hc Sup Shell 278 Revenue Code C1883 Hcpcs,1968.75,787.5,,,0 CDM,278C1883S1_176996,Hc Sup Shell 278 Revenue Code C1883 Hcpcs,7678.12,3071.25,,,0 CDM,278C1883S1_183395,Hc Sup Shell 278 Revenue Code C1883 Hcpcs,7170.39,2868.16,,,0 CDM,278C1883S1_191529,Hc Sup Shell 278 Revenue Code C1883 Hcpcs,1968.75,787.5,,,0 CDM,278C1883S1_191572,Hc Sup Shell 278 Revenue Code C1883 Hcpcs,1673.44,669.38,,,0 CDM,278C1883S1_C1883_278,Hc Sup Shell 278 Revenue Code C1883 Hcpcs,5381.25,2152.5,,,0 CDM,278C1884S1_133771,Hc Sup Shell 278 Revenue Code C1884 Hcpcs,5522.76,2209.1,,,0 CDM,278C1884S1_138586,Hc Sup Shell 278 Revenue Code C1884 Hcpcs,9150.28,3660.11,,,0 CDM,278C1884S1_138587,Hc Sup Shell 278 Revenue Code C1884 Hcpcs,9302.34,3720.94,,,0 CDM,278C1884S1_150695,Hc Sup Shell 278 Revenue Code C1884 Hcpcs,3740.62,1496.25,,,0 CDM,278C1884S1_150762,Hc Sup Shell 278 Revenue Code C1884 Hcpcs,3740.62,1496.25,,,0 CDM,278C1884S1_150763,Hc Sup Shell 278 Revenue Code C1884 Hcpcs,3740.62,1496.25,,,0 CDM,278C1884S1_150764,Hc Sup Shell 278 Revenue Code C1884 Hcpcs,3740.62,1496.25,,,0 CDM,278C1884S1_152679,Hc Sup Shell 278 Revenue Code C1884 Hcpcs,58865.62,23546.25,,,0 CDM,278C1884S1_179181,Hc Sup Shell 278 Revenue Code C1884 Hcpcs,58865.62,23546.25,,,0 CDM,278C1884S1_179216,Hc Sup Shell 278 Revenue Code C1884 Hcpcs,58865.62,23546.25,,,0 CDM,278C1885S1_134501,Hc Sup Shell 278 Revenue Code C1885 Hcpcs,14450.62,5780.25,,,0 CDM,278C1885S1_134502,Hc Sup Shell 278 Revenue Code C1885 Hcpcs,14450.62,5780.25,,,0 CDM,278C1886S1_114357,Hc Sup Shell 278 Revenue Code C1886 Hcpcs,5969.25,2387.7,,,0 CDM,278C1886S1_145821,Hc Sup Shell 278 Revenue Code C1886 Hcpcs,6280.31,2512.12,,,0 CDM,278C1886S1_145822,Hc Sup Shell 278 Revenue Code C1886 Hcpcs,9195.85,3678.34,,,0 CDM,278C1886S1_145823,Hc Sup Shell 278 Revenue Code C1886 Hcpcs,5943.8,2377.52,,,0 CDM,278C1886S1_183257,Hc Sup Shell 278 Revenue Code C1886 Hcpcs,12029.06,4811.62,,,0 CDM,278C1886S1_183261,Hc Sup Shell 278 Revenue Code C1886 Hcpcs,15553.12,6221.25,,,0 CDM,278C1886S1_183279,Hc Sup Shell 278 Revenue Code C1886 Hcpcs,12029.06,4811.62,,,0 CDM,278C1886S1_185465,Hc Sup Shell 278 Revenue Code C1886 Hcpcs,16202.81,6481.12,,,0 CDM,278C1886S1_185466,Hc Sup Shell 278 Revenue Code C1886 Hcpcs,15392.67,6157.07,,,0 CDM,278C1886S1_188349,Hc Sup Shell 278 Revenue Code C1886 Hcpcs,12768.63,5107.45,,,0 CDM,278C1887S1_114147,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,885.94,354.38,,,0 CDM,278C1887S1_114904,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,417.38,166.95,,,0 CDM,278C1887S1_114905,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,370.12,148.05,,,0 CDM,278C1887S1_114906,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,368.37,147.35,,,0 CDM,278C1887S1_116797,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,359.22,143.69,,,0 CDM,278C1887S1_133586,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,215.94,86.38,,,0 CDM,278C1887S1_133630,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,34.44,13.78,,,0 CDM,278C1887S1_133654,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,217.03,86.81,,,0 CDM,278C1887S1_133688,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,65.79,26.32,,,0 CDM,278C1887S1_133690,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,56.65,22.66,,,0 CDM,278C1887S1_133691,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,565.27,226.11,,,0 CDM,278C1887S1_133708,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,49.93,19.97,,,0 CDM,278C1887S1_133824,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,34.02,13.61,,,0 CDM,278C1887S1_133825,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,33.62,13.45,,,0 CDM,278C1887S1_133826,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,34.18,13.67,,,0 CDM,278C1887S1_133827,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,34.11,13.64,,,0 CDM,278C1887S1_133974,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,217.35,86.94,,,0 CDM,278C1887S1_133975,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,217.24,86.9,,,0 CDM,278C1887S1_134153,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,148.86,59.54,,,0 CDM,278C1887S1_134301,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,1378.12,551.25,,,0 CDM,278C1887S1_134302,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,1378.12,551.25,,,0 CDM,278C1887S1_134330,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134331,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134332,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134333,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134334,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134335,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134336,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134337,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134338,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134339,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134340,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134342,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134344,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134345,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134347,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134353,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134354,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134355,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134357,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134360,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134361,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134364,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134365,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134366,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134368,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134371,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134372,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_134510,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2953.12,1181.25,,,0 CDM,278C1887S1_134711,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,945.0,378.0,,,0 CDM,278C1887S1_134718,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,972.56,389.02,,,0 CDM,278C1887S1_134906,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,217.41,86.96,,,0 CDM,278C1887S1_134955,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,1927.41,770.96,,,0 CDM,278C1887S1_135921,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2331.0,932.4,,,0 CDM,278C1887S1_136596,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,1890.0,756.0,,,0 CDM,278C1887S1_136619,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,217.24,86.9,,,0 CDM,278C1887S1_136659,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,846.56,338.62,,,0 CDM,278C1887S1_136660,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,846.56,338.62,,,0 CDM,278C1887S1_137534,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,157.59,63.04,,,0 CDM,278C1887S1_137535,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,56.44,22.58,,,0 CDM,278C1887S1_137539,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,54.89,21.96,,,0 CDM,278C1887S1_137554,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,49.93,19.97,,,0 CDM,278C1887S1_137555,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,56.53,22.61,,,0 CDM,278C1887S1_137556,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,57.51,23.0,,,0 CDM,278C1887S1_137562,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,214.49,85.8,,,0 CDM,278C1887S1_137563,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,56.15,22.46,,,0 CDM,278C1887S1_137653,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,565.67,226.27,,,0 CDM,278C1887S1_137950,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,357.24,142.9,,,0 CDM,278C1887S1_137951,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,417.38,166.95,,,0 CDM,278C1887S1_138122,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,945.0,378.0,,,0 CDM,278C1887S1_138455,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,59.2,23.68,,,0 CDM,278C1887S1_138456,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,54.89,21.96,,,0 CDM,278C1887S1_138459,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,213.14,85.26,,,0 CDM,278C1887S1_138464,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,217.94,87.18,,,0 CDM,278C1887S1_138465,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,216.78,86.71,,,0 CDM,278C1887S1_138482,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,1830.9,732.36,,,0 CDM,278C1887S1_138483,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,1340.68,536.27,,,0 CDM,278C1887S1_138513,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,54.89,21.96,,,0 CDM,278C1887S1_138514,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,3703.72,1481.49,,,0 CDM,278C1887S1_138532,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,1938.2,775.28,,,0 CDM,278C1887S1_138544,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,56.71,22.68,,,0 CDM,278C1887S1_138546,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,216.7,86.68,,,0 CDM,278C1887S1_138547,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,209.4,83.76,,,0 CDM,278C1887S1_138556,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2865.75,1146.3,,,0 CDM,278C1887S1_138570,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,322.88,129.15,,,0 CDM,278C1887S1_138571,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,322.88,129.15,,,0 CDM,278C1887S1_138572,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,417.38,166.95,,,0 CDM,278C1887S1_138574,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,1938.2,775.28,,,0 CDM,278C1887S1_138589,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2505.62,1002.25,,,0 CDM,278C1887S1_138590,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2797.46,1118.98,,,0 CDM,278C1887S1_138591,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2756.25,1102.5,,,0 CDM,278C1887S1_138592,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2460.94,984.38,,,0 CDM,278C1887S1_138646,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,376.29,150.52,,,0 CDM,278C1887S1_138663,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,1938.2,775.28,,,0 CDM,278C1887S1_138664,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,1938.2,775.28,,,0 CDM,278C1887S1_138723,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2294.42,917.77,,,0 CDM,278C1887S1_138757,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,4059.42,1623.77,,,0 CDM,278C1887S1_138817,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2811.38,1124.55,,,0 CDM,278C1887S1_138818,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,4437.56,1775.02,,,0 CDM,278C1887S1_138819,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,4556.49,1822.6,,,0 CDM,278C1887S1_138850,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,3220.58,1288.23,,,0 CDM,278C1887S1_138902,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,3402.12,1360.85,,,0 CDM,278C1887S1_138922,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,5891.6,2356.64,,,0 CDM,278C1887S1_139102,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,216.9,86.76,,,0 CDM,278C1887S1_139145,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,1929.38,771.75,,,0 CDM,278C1887S1_142682,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,1122.19,448.88,,,0 CDM,278C1887S1_143341,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,384.79,153.92,,,0 CDM,278C1887S1_144365,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,164.06,65.62,,,0 CDM,278C1887S1_144869,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2284.28,913.71,,,0 CDM,278C1887S1_150648,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,209.4,83.76,,,0 CDM,278C1887S1_152608,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2067.19,826.88,,,0 CDM,278C1887S1_152615,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,1555.31,622.12,,,0 CDM,278C1887S1_152616,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,1555.31,622.12,,,0 CDM,278C1887S1_152684,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,5315.62,2126.25,,,0 CDM,278C1887S1_152685,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,5368.41,2147.36,,,0 CDM,278C1887S1_152686,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,5354.0,2141.6,,,0 CDM,278C1887S1_152719,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2441.25,976.5,,,0 CDM,278C1887S1_152720,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2441.25,976.5,,,0 CDM,278C1887S1_152721,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2441.25,976.5,,,0 CDM,278C1887S1_152886,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_152888,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_152889,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_153903,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,3150.0,1260.0,,,0 CDM,278C1887S1_153947,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,3484.69,1393.88,,,0 CDM,278C1887S1_153948,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,3484.69,1393.88,,,0 CDM,278C1887S1_156174,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,4079.25,1631.7,,,0 CDM,278C1887S1_156309,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2256.88,902.75,,,0 CDM,278C1887S1_162626,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,698.75,279.5,,,0 CDM,278C1887S1_162627,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,696.94,278.78,,,0 CDM,278C1887S1_166134,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,1188.14,475.26,,,0 CDM,278C1887S1_169239,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,945.0,378.0,,,0 CDM,278C1887S1_170325,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,1378.12,551.25,,,0 CDM,278C1887S1_170459,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,3484.69,1393.88,,,0 CDM,278C1887S1_170460,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,3484.69,1393.88,,,0 CDM,278C1887S1_170482,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2268.0,907.2,,,0 CDM,278C1887S1_170483,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2275.27,910.11,,,0 CDM,278C1887S1_170485,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,3484.69,1393.88,,,0 CDM,278C1887S1_173161,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,217.72,87.09,,,0 CDM,278C1887S1_173297,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_174470,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,3701.08,1480.43,,,0 CDM,278C1887S1_174471,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,3739.56,1495.82,,,0 CDM,278C1887S1_175843,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,379.58,151.83,,,0 CDM,278C1887S1_175844,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,407.5,163.0,,,0 CDM,278C1887S1_175845,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,404.65,161.86,,,0 CDM,278C1887S1_175846,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,403.87,161.55,,,0 CDM,278C1887S1_175847,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,429.49,171.8,,,0 CDM,278C1887S1_177032,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,6890.62,2756.25,,,0 CDM,278C1887S1_177033,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,6890.62,2756.25,,,0 CDM,278C1887S1_179042,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,422.64,169.06,,,0 CDM,278C1887S1_179555,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,5492.81,2197.12,,,0 CDM,278C1887S1_180376,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,217.29,86.92,,,0 CDM,278C1887S1_180558,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,376.87,150.75,,,0 CDM,278C1887S1_182206,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,698.58,279.43,,,0 CDM,278C1887S1_182394,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,972.56,389.02,,,0 CDM,278C1887S1_182935,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,12186.56,4874.62,,,0 CDM,278C1887S1_182936,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,10178.44,4071.38,,,0 CDM,278C1887S1_182937,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,7028.44,2811.38,,,0 CDM,278C1887S1_182988,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,422.7,169.08,,,0 CDM,278C1887S1_183932,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,5310.14,2124.06,,,0 CDM,278C1887S1_183949,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,704.24,281.7,,,0 CDM,278C1887S1_184431,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2165.62,866.25,,,0 CDM,278C1887S1_184432,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2165.62,866.25,,,0 CDM,278C1887S1_184433,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2165.62,866.25,,,0 CDM,278C1887S1_184434,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2165.62,866.25,,,0 CDM,278C1887S1_184435,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2165.62,866.25,,,0 CDM,278C1887S1_184436,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2165.62,866.25,,,0 CDM,278C1887S1_184437,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2223.07,889.23,,,0 CDM,278C1887S1_184438,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2165.62,866.25,,,0 CDM,278C1887S1_186288,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,8685.5,3474.2,,,0 CDM,278C1887S1_187525,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2147.83,859.13,,,0 CDM,278C1887S1_188804,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,3150.0,1260.0,,,0 CDM,278C1887S1_190970,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_191289,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,449.66,179.86,,,0 CDM,278C1887S1_191364,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,118.12,47.25,,,0 CDM,278C1887S1_191575,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,118.12,47.25,,,0 CDM,278C1887S1_191588,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,118.12,47.25,,,0 CDM,278C1887S1_191980,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,52.21,20.88,,,0 CDM,278C1887S1_191988,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,84.19,33.68,,,0 CDM,278C1887S1_191990,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,80.96,32.38,,,0 CDM,278C1887S1_192019,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,80.96,32.38,,,0 CDM,278C1887S1_192086,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,152.78,61.11,,,0 CDM,278C1887S1_192115,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,152.78,61.11,,,0 CDM,278C1887S1_192262,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_192409,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,941.06,376.42,,,0 CDM,278C1887S1_192493,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,165.38,66.15,,,0 CDM,278C1887S1_193256,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,55.52,22.21,,,0 CDM,278C1887S1_193614,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,10178.44,4071.38,,,0 CDM,278C1887S1_193615,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,10178.44,4071.38,,,0 CDM,278C1887S1_193616,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,12186.56,4874.62,,,0 CDM,278C1887S1_193787,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,17718.75,7087.5,,,0 CDM,278C1887S1_193898,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,9410.62,3764.25,,,0 CDM,278C1887S1_193900,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,3484.69,1393.88,,,0 CDM,278C1887S1_193901,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,3484.69,1393.88,,,0 CDM,278C1887S1_193902,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,3484.69,1393.88,,,0 CDM,278C1887S1_194612,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,3484.69,1393.88,,,0 CDM,278C1887S1_194654,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,3484.69,1393.88,,,0 CDM,278C1887S1_194660,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,3484.69,1393.88,,,0 CDM,278C1887S1_195096,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2268.0,907.2,,,0 CDM,278C1887S1_195097,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2224.69,889.88,,,0 CDM,278C1887S1_195098,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2246.34,898.54,,,0 CDM,278C1887S1_196012,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,1949.06,779.62,,,0 CDM,278C1887S1_196418,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,10040.62,4016.25,,,0 CDM,278C1887S1_197323,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,2701.56,1080.62,,,0 CDM,278C1887S1_197415,Hc Sup Shell 278 Revenue Code C1887 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CDM,278C1889S1_113953,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1210.07,484.03,,,0 CDM,278C1889S1_113955,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1210.07,484.03,,,0 CDM,278C1889S1_113956,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1210.07,484.03,,,0 CDM,278C1889S1_114150,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7040.25,2816.1,,,0 CDM,278C1889S1_114313,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,280.55,112.22,,,0 CDM,278C1889S1_114373,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1575.0,630.0,,,0 CDM,278C1889S1_114375,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1575.0,630.0,,,0 CDM,278C1889S1_114378,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2362.5,945.0,,,0 CDM,278C1889S1_114410,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1208.81,483.52,,,0 CDM,278C1889S1_114885,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1571.06,628.42,,,0 CDM,278C1889S1_114914,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,209.59,83.84,,,0 CDM,278C1889S1_115057,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5132.57,2053.03,,,0 CDM,278C1889S1_115242,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,8859.38,3543.75,,,0 CDM,278C1889S1_115444,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,8859.38,3543.75,,,0 CDM,278C1889S1_115445,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,8859.38,3543.75,,,0 CDM,278C1889S1_115446,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,8859.38,3543.75,,,0 CDM,278C1889S1_115449,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,8859.38,3543.75,,,0 CDM,278C1889S1_115451,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,8859.38,3543.75,,,0 CDM,278C1889S1_115452,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,8859.38,3543.75,,,0 CDM,278C1889S1_115453,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,8859.38,3543.75,,,0 CDM,278C1889S1_115455,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,8859.38,3543.75,,,0 CDM,278C1889S1_115469,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,8859.38,3543.75,,,0 CDM,278C1889S1_115528,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3550.31,1420.12,,,0 CDM,278C1889S1_115529,Hc Sup Shell 278 Revenue Code C1889 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Hcpcs,20173.79,8069.52,,,0 CDM,278C1889S1_117721,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1968.75,787.5,,,0 CDM,278C1889S1_117726,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,125.61,50.24,,,0 CDM,278C1889S1_117732,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16340.62,6536.25,,,0 CDM,278C1889S1_117733,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16340.62,6536.25,,,0 CDM,278C1889S1_117734,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16222.5,6489.0,,,0 CDM,278C1889S1_117735,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16273.12,6509.25,,,0 CDM,278C1889S1_117736,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16340.62,6536.25,,,0 CDM,278C1889S1_117737,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16340.62,6536.25,,,0 CDM,278C1889S1_117852,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,916.96,366.78,,,0 CDM,278C1889S1_117853,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,916.96,366.78,,,0 CDM,278C1889S1_117854,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,997.69,399.08,,,0 CDM,278C1889S1_117892,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1146.21,458.48,,,0 CDM,278C1889S1_117893,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1188.18,475.27,,,0 CDM,278C1889S1_117894,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1238.22,495.29,,,0 CDM,278C1889S1_117899,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,981.54,392.62,,,0 CDM,278C1889S1_117900,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,981.54,392.62,,,0 CDM,278C1889S1_117917,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,30419.16,12167.66,,,0 CDM,278C1889S1_117919,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,31259.81,12503.92,,,0 CDM,278C1889S1_117920,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,32779.69,13111.88,,,0 CDM,278C1889S1_117923,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,34811.44,13924.58,,,0 CDM,278C1889S1_118066,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,708.75,283.5,,,0 CDM,278C1889S1_118773,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,8209.69,3283.88,,,0 CDM,278C1889S1_118774,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,8209.69,3283.88,,,0 CDM,278C1889S1_118775,Hc Sup Shell 278 Revenue 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Hcpcs,11284.88,4513.95,,,0 CDM,278C1889S1_119690,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,67449.38,26979.75,,,0 CDM,278C1889S1_119728,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7616.9,3046.76,,,0 CDM,278C1889S1_119729,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7616.9,3046.76,,,0 CDM,278C1889S1_119730,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7616.9,3046.76,,,0 CDM,278C1889S1_119923,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,127968.75,51187.5,,,0 CDM,278C1889S1_119924,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,127968.75,51187.5,,,0 CDM,278C1889S1_119925,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,127968.75,51187.5,,,0 CDM,278C1889S1_119926,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,127968.75,51187.5,,,0 CDM,278C1889S1_120138,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1610.45,644.18,,,0 CDM,278C1889S1_120139,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2752.31,1100.92,,,0 CDM,278C1889S1_126815,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1763.01,705.2,,,0 CDM,278C1889S1_129241,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1807.81,723.12,,,0 CDM,278C1889S1_129242,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1984.5,793.8,,,0 CDM,278C1889S1_129243,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1719.47,687.79,,,0 CDM,278C1889S1_129250,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1866.71,746.68,,,0 CDM,278C1889S1_129251,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1918.24,767.3,,,0 CDM,278C1889S1_129252,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1931.49,772.6,,,0 CDM,278C1889S1_129475,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,445.49,178.2,,,0 CDM,278C1889S1_129812,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2339.55,935.82,,,0 CDM,278C1889S1_130470,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3957.98,1583.19,,,0 CDM,278C1889S1_130473,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3957.98,1583.19,,,0 CDM,278C1889S1_130478,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3957.98,1583.19,,,0 CDM,278C1889S1_130488,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3957.98,1583.19,,,0 CDM,278C1889S1_130489,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3957.98,1583.19,,,0 CDM,278C1889S1_130511,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,93.99,37.6,,,0 CDM,278C1889S1_130512,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,106.04,42.42,,,0 CDM,278C1889S1_130570,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3543.75,1417.5,,,0 CDM,278C1889S1_130582,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,322.88,129.15,,,0 CDM,278C1889S1_130618,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,350.44,140.18,,,0 CDM,278C1889S1_130976,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,843.34,337.34,,,0 CDM,278C1889S1_130977,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,846.56,338.62,,,0 CDM,278C1889S1_130978,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,846.56,338.62,,,0 CDM,278C1889S1_131187,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1535.62,614.25,,,0 CDM,278C1889S1_131188,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1535.62,614.25,,,0 CDM,278C1889S1_132232,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4609.55,1843.82,,,0 CDM,278C1889S1_132238,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4609.55,1843.82,,,0 CDM,278C1889S1_132684,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1660.33,664.13,,,0 CDM,278C1889S1_132685,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1188.97,475.59,,,0 CDM,278C1889S1_132838,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,346.5,138.6,,,0 CDM,278C1889S1_132845,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,66937.5,26775.0,,,0 CDM,278C1889S1_132846,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3937.5,1575.0,,,0 CDM,278C1889S1_132936,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,146.52,58.61,,,0 CDM,278C1889S1_132942,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,275.31,110.12,,,0 CDM,278C1889S1_133286,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3031.88,1212.75,,,0 CDM,278C1889S1_133287,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2938.64,1175.46,,,0 CDM,278C1889S1_133289,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,14568.75,5827.5,,,0 CDM,278C1889S1_133290,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,14765.62,5906.25,,,0 CDM,278C1889S1_133422,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,649.69,259.88,,,0 CDM,278C1889S1_133432,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,657.56,263.02,,,0 CDM,278C1889S1_133493,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,233.97,93.59,,,0 CDM,278C1889S1_133494,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,231.57,92.63,,,0 CDM,278C1889S1_133510,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,349.58,139.83,,,0 CDM,278C1889S1_133511,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,360.16,144.06,,,0 CDM,278C1889S1_133517,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,349.58,139.83,,,0 CDM,278C1889S1_133518,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,360.16,144.06,,,0 CDM,278C1889S1_133537,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,649.69,259.88,,,0 CDM,278C1889S1_133539,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,649.69,259.88,,,0 CDM,278C1889S1_133628,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,78.75,31.5,,,0 CDM,278C1889S1_133631,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,34.21,13.68,,,0 CDM,278C1889S1_133632,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,34.14,13.66,,,0 CDM,278C1889S1_133693,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,34.11,13.64,,,0 CDM,278C1889S1_133694,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,34.18,13.67,,,0 CDM,278C1889S1_133695,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,34.36,13.74,,,0 CDM,278C1889S1_133696,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,33.98,13.59,,,0 CDM,278C1889S1_133697,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,34.13,13.65,,,0 CDM,278C1889S1_133698,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,34.19,13.68,,,0 CDM,278C1889S1_133699,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,34.26,13.7,,,0 CDM,278C1889S1_133700,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,34.16,13.66,,,0 CDM,278C1889S1_133701,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,103.18,41.27,,,0 CDM,278C1889S1_133702,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,34.2,13.68,,,0 CDM,278C1889S1_133703,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,33.73,13.49,,,0 CDM,278C1889S1_133704,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,34.29,13.72,,,0 CDM,278C1889S1_133705,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,34.31,13.72,,,0 CDM,278C1889S1_133706,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,34.51,13.8,,,0 CDM,278C1889S1_133707,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,34.24,13.7,,,0 CDM,278C1889S1_133731,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3417.75,1367.1,,,0 CDM,278C1889S1_133736,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1445.06,578.02,,,0 CDM,278C1889S1_133737,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1445.06,578.02,,,0 CDM,278C1889S1_133739,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,36.18,14.47,,,0 CDM,278C1889S1_133740,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,44.51,17.8,,,0 CDM,278C1889S1_133748,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,34.09,13.64,,,0 CDM,278C1889S1_133762,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,64.97,25.99,,,0 CDM,278C1889S1_133819,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,33.56,13.42,,,0 CDM,278C1889S1_133837,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1445.06,578.02,,,0 CDM,278C1889S1_133977,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,71.66,28.66,,,0 CDM,278C1889S1_133978,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,71.66,28.66,,,0 CDM,278C1889S1_133979,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,71.66,28.66,,,0 CDM,278C1889S1_134305,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,100864.3,40345.72,,,0 CDM,278C1889S1_134563,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,46856.25,18742.5,,,0 CDM,278C1889S1_134564,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,46856.25,18742.5,,,0 CDM,278C1889S1_134760,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,85.5,34.2,,,0 CDM,278C1889S1_134761,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,88.21,35.28,,,0 CDM,278C1889S1_134793,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,188.78,75.51,,,0 CDM,278C1889S1_134795,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1389.71,555.88,,,0 CDM,278C1889S1_134796,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1353.45,541.38,,,0 CDM,278C1889S1_134797,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1272.2,508.88,,,0 CDM,278C1889S1_134802,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,56.94,22.78,,,0 CDM,278C1889S1_134817,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,133.2,53.28,,,0 CDM,278C1889S1_134821,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,120.45,48.18,,,0 CDM,278C1889S1_134823,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,85.59,34.24,,,0 CDM,278C1889S1_134830,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,464.12,185.65,,,0 CDM,278C1889S1_134896,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,114.43,45.77,,,0 CDM,278C1889S1_134905,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,37.28,14.91,,,0 CDM,278C1889S1_134916,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,349.58,139.83,,,0 CDM,278C1889S1_134927,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,27.07,10.83,,,0 CDM,278C1889S1_134998,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,145.3,58.12,,,0 CDM,278C1889S1_135001,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,104.38,41.75,,,0 CDM,278C1889S1_135002,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,56.17,22.47,,,0 CDM,278C1889S1_135012,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1114.31,445.72,,,0 CDM,278C1889S1_135035,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4331.25,1732.5,,,0 CDM,278C1889S1_135036,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4547.81,1819.12,,,0 CDM,278C1889S1_135037,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4403.44,1761.38,,,0 CDM,278C1889S1_135038,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4417.88,1767.15,,,0 CDM,278C1889S1_135039,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4547.81,1819.12,,,0 CDM,278C1889S1_135040,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4475.62,1790.25,,,0 CDM,278C1889S1_135041,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4475.62,1790.25,,,0 CDM,278C1889S1_135042,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4331.25,1732.5,,,0 CDM,278C1889S1_135043,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4439.53,1775.81,,,0 CDM,278C1889S1_135068,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,248.06,99.22,,,0 CDM,278C1889S1_135132,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,17530.94,7012.38,,,0 CDM,278C1889S1_135133,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,17530.94,7012.38,,,0 CDM,278C1889S1_135134,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,21507.02,8602.81,,,0 CDM,278C1889S1_135135,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1169.44,467.78,,,0 CDM,278C1889S1_135136,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1169.44,467.78,,,0 CDM,278C1889S1_135137,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1169.44,467.78,,,0 CDM,278C1889S1_135138,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1169.44,467.78,,,0 CDM,278C1889S1_135140,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,757.62,303.05,,,0 CDM,278C1889S1_135170,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,266.62,106.65,,,0 CDM,278C1889S1_135171,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,58.38,23.35,,,0 CDM,278C1889S1_135172,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,58.42,23.37,,,0 CDM,278C1889S1_135173,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,53.82,21.53,,,0 CDM,278C1889S1_135181,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19963.12,7985.25,,,0 CDM,278C1889S1_135288,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,166.56,66.62,,,0 CDM,278C1889S1_135452,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2022.26,808.9,,,0 CDM,278C1889S1_135453,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2659.96,1063.98,,,0 CDM,278C1889S1_135597,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,455.89,182.36,,,0 CDM,278C1889S1_135657,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,417.97,167.19,,,0 CDM,278C1889S1_135675,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,315.0,126.0,,,0 CDM,278C1889S1_135804,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,315.0,126.0,,,0 CDM,278C1889S1_135805,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,295.31,118.12,,,0 CDM,278C1889S1_135806,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,315.0,126.0,,,0 CDM,278C1889S1_135834,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1771.88,708.75,,,0 CDM,278C1889S1_135899,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,80.32,32.13,,,0 CDM,278C1889S1_135900,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,80.32,32.13,,,0 CDM,278C1889S1_136192,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,587.95,235.18,,,0 CDM,278C1889S1_136305,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4725.0,1890.0,,,0 CDM,278C1889S1_136306,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5020.31,2008.12,,,0 CDM,278C1889S1_136307,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5315.62,2126.25,,,0 CDM,278C1889S1_136308,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4725.0,1890.0,,,0 CDM,278C1889S1_136599,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,912.51,365.0,,,0 CDM,278C1889S1_136600,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4985.03,1994.01,,,0 CDM,278C1889S1_136627,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,12568.5,5027.4,,,0 CDM,278C1889S1_136628,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15822.85,6329.14,,,0 CDM,278C1889S1_137247,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,170.34,68.14,,,0 CDM,278C1889S1_137464,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1590.75,636.3,,,0 CDM,278C1889S1_137501,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,17066.7,6826.68,,,0 CDM,278C1889S1_137510,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,360.16,144.06,,,0 CDM,278C1889S1_137541,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,40359.38,16143.75,,,0 CDM,278C1889S1_137544,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,40359.38,16143.75,,,0 CDM,278C1889S1_137545,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,40359.38,16143.75,,,0 CDM,278C1889S1_137546,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,40359.38,16143.75,,,0 CDM,278C1889S1_137547,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,40359.38,16143.75,,,0 CDM,278C1889S1_137548,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,40359.38,16143.75,,,0 CDM,278C1889S1_137551,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16290.0,6516.0,,,0 CDM,278C1889S1_137552,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16278.09,6511.24,,,0 CDM,278C1889S1_137571,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16234.31,6493.72,,,0 CDM,278C1889S1_137572,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16340.62,6536.25,,,0 CDM,278C1889S1_137573,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16269.75,6507.9,,,0 CDM,278C1889S1_137574,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16340.62,6536.25,,,0 CDM,278C1889S1_137575,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16340.62,6536.25,,,0 CDM,278C1889S1_137576,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16305.19,6522.08,,,0 CDM,278C1889S1_137604,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,360.16,144.06,,,0 CDM,278C1889S1_137632,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,17269.88,6907.95,,,0 CDM,278C1889S1_137654,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,17699.06,7079.62,,,0 CDM,278C1889S1_137656,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,17699.06,7079.62,,,0 CDM,278C1889S1_137658,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,17699.06,7079.62,,,0 CDM,278C1889S1_137674,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,12701.25,5080.5,,,0 CDM,278C1889S1_137675,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,12701.25,5080.5,,,0 CDM,278C1889S1_137676,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,12434.62,4973.85,,,0 CDM,278C1889S1_137677,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,12683.48,5073.39,,,0 CDM,278C1889S1_137705,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,349.58,139.83,,,0 CDM,278C1889S1_137706,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,360.16,144.06,,,0 CDM,278C1889S1_137707,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,360.16,144.06,,,0 CDM,278C1889S1_137731,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,396.2,158.48,,,0 CDM,278C1889S1_137732,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,396.2,158.48,,,0 CDM,278C1889S1_137733,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,396.2,158.48,,,0 CDM,278C1889S1_137812,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,10434.38,4173.75,,,0 CDM,278C1889S1_137813,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,10434.38,4173.75,,,0 CDM,278C1889S1_137814,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,10434.38,4173.75,,,0 CDM,278C1889S1_137822,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,22817.81,9127.12,,,0 CDM,278C1889S1_137824,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,22817.81,9127.12,,,0 CDM,278C1889S1_137833,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1683.19,673.28,,,0 CDM,278C1889S1_137834,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,17066.7,6826.68,,,0 CDM,278C1889S1_137835,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,17202.15,6880.86,,,0 CDM,278C1889S1_137836,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,17066.7,6826.68,,,0 CDM,278C1889S1_137837,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16734.38,6693.75,,,0 CDM,278C1889S1_137841,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16984.8,6793.92,,,0 CDM,278C1889S1_137842,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16978.5,6791.4,,,0 CDM,278C1889S1_137843,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16802.1,6720.84,,,0 CDM,278C1889S1_137844,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16868.25,6747.3,,,0 CDM,278C1889S1_137845,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16868.25,6747.3,,,0 CDM,278C1889S1_137851,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1710.73,684.29,,,0 CDM,278C1889S1_137858,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3342.23,1336.89,,,0 CDM,278C1889S1_137862,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,27365.62,10946.25,,,0 CDM,278C1889S1_137866,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19184.81,7673.92,,,0 CDM,278C1889S1_137867,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,18617.29,7446.92,,,0 CDM,278C1889S1_137868,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,18664.87,7465.95,,,0 CDM,278C1889S1_137869,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,18112.5,7245.0,,,0 CDM,278C1889S1_137870,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,61031.25,24412.5,,,0 CDM,278C1889S1_137872,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,59062.5,23625.0,,,0 CDM,278C1889S1_137875,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,88593.75,35437.5,,,0 CDM,278C1889S1_137876,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,88593.75,35437.5,,,0 CDM,278C1889S1_137883,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3232.03,1292.81,,,0 CDM,278C1889S1_137884,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1469.98,587.99,,,0 CDM,278C1889S1_137891,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2480.62,992.25,,,0 CDM,278C1889S1_137895,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3199.35,1279.74,,,0 CDM,278C1889S1_137896,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3204.3,1281.72,,,0 CDM,278C1889S1_137897,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3177.98,1271.19,,,0 CDM,278C1889S1_137898,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3194.43,1277.77,,,0 CDM,278C1889S1_137902,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5201.98,2080.79,,,0 CDM,278C1889S1_137903,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,24063.38,9625.35,,,0 CDM,278C1889S1_137904,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,23211.56,9284.62,,,0 CDM,278C1889S1_137905,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,23908.5,9563.4,,,0 CDM,278C1889S1_137917,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2029.49,811.8,,,0 CDM,278C1889S1_137920,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5949.78,2379.91,,,0 CDM,278C1889S1_137941,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,40359.38,16143.75,,,0 CDM,278C1889S1_137959,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,888.49,355.4,,,0 CDM,278C1889S1_137966,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1173.69,469.48,,,0 CDM,278C1889S1_137977,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3207.45,1282.98,,,0 CDM,278C1889S1_138228,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1219.84,487.94,,,0 CDM,278C1889S1_138260,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1731.56,692.62,,,0 CDM,278C1889S1_138261,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1992.1,796.84,,,0 CDM,278C1889S1_138319,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,20715.19,8286.08,,,0 CDM,278C1889S1_138320,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,20715.19,8286.08,,,0 CDM,278C1889S1_138324,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,586.69,234.68,,,0 CDM,278C1889S1_138325,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,680.4,272.16,,,0 CDM,278C1889S1_138378,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,100406.25,40162.5,,,0 CDM,278C1889S1_138380,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,25593.75,10237.5,,,0 CDM,278C1889S1_138407,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3917.81,1567.12,,,0 CDM,278C1889S1_138408,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3917.81,1567.12,,,0 CDM,278C1889S1_138439,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,118125.0,47250.0,,,0 CDM,278C1889S1_138440,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,118125.0,47250.0,,,0 CDM,278C1889S1_138441,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,118125.0,47250.0,,,0 CDM,278C1889S1_138443,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,8308.12,3323.25,,,0 CDM,278C1889S1_138444,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,8308.12,3323.25,,,0 CDM,278C1889S1_138489,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,74.81,29.92,,,0 CDM,278C1889S1_138491,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,396.2,158.48,,,0 CDM,278C1889S1_138511,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,285.75,114.3,,,0 CDM,278C1889S1_138524,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,360.16,144.06,,,0 CDM,278C1889S1_138525,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,396.2,158.48,,,0 CDM,278C1889S1_138527,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,66.61,26.64,,,0 CDM,278C1889S1_138537,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,32491.74,12996.7,,,0 CDM,278C1889S1_138563,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,450.45,180.18,,,0 CDM,278C1889S1_138564,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,500.06,200.02,,,0 CDM,278C1889S1_138582,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,360.16,144.06,,,0 CDM,278C1889S1_138605,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,26174.22,10469.69,,,0 CDM,278C1889S1_138606,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,25534.81,10213.92,,,0 CDM,278C1889S1_138607,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,25534.81,10213.92,,,0 CDM,278C1889S1_138608,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,26174.22,10469.69,,,0 CDM,278C1889S1_138618,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5654.25,2261.7,,,0 CDM,278C1889S1_138619,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,360.16,144.06,,,0 CDM,278C1889S1_138620,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,360.16,144.06,,,0 CDM,278C1889S1_138621,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,396.2,158.48,,,0 CDM,278C1889S1_138622,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,360.16,144.06,,,0 CDM,278C1889S1_138624,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,626.06,250.42,,,0 CDM,278C1889S1_138625,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,626.06,250.42,,,0 CDM,278C1889S1_138626,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,626.06,250.42,,,0 CDM,278C1889S1_138627,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,626.06,250.42,,,0 CDM,278C1889S1_138628,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,626.06,250.42,,,0 CDM,278C1889S1_138633,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,396.2,158.48,,,0 CDM,278C1889S1_138666,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,18614.61,7445.84,,,0 CDM,278C1889S1_138672,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,74.81,29.92,,,0 CDM,278C1889S1_138673,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,74.81,29.92,,,0 CDM,278C1889S1_138675,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,74.81,29.92,,,0 CDM,278C1889S1_138677,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7174.82,2869.93,,,0 CDM,278C1889S1_138678,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7349.78,2939.91,,,0 CDM,278C1889S1_138683,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7349.78,2939.91,,,0 CDM,278C1889S1_138684,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7349.78,2939.91,,,0 CDM,278C1889S1_138685,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7349.78,2939.91,,,0 CDM,278C1889S1_138687,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7203.98,2881.59,,,0 CDM,278C1889S1_138688,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7244.8,2897.92,,,0 CDM,278C1889S1_138689,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7284.17,2913.67,,,0 CDM,278C1889S1_138690,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7284.17,2913.67,,,0 CDM,278C1889S1_138691,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7254.35,2901.74,,,0 CDM,278C1889S1_138692,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7181.07,2872.43,,,0 CDM,278C1889S1_138693,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7196.69,2878.68,,,0 CDM,278C1889S1_138694,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7274.8,2909.92,,,0 CDM,278C1889S1_138695,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7211.65,2884.66,,,0 CDM,278C1889S1_138696,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7218.56,2887.42,,,0 CDM,278C1889S1_138697,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7278.21,2911.28,,,0 CDM,278C1889S1_138698,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7203.98,2881.59,,,0 CDM,278C1889S1_138699,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7262.3,2904.92,,,0 CDM,278C1889S1_138700,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7167.21,2866.88,,,0 CDM,278C1889S1_138701,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7142.37,2856.95,,,0 CDM,278C1889S1_138702,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7167.21,2866.88,,,0 CDM,278C1889S1_138703,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7189.4,2875.76,,,0 CDM,278C1889S1_138704,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7181.07,2872.43,,,0 CDM,278C1889S1_138705,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7174.82,2869.93,,,0 CDM,278C1889S1_138706,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7297.29,2918.92,,,0 CDM,278C1889S1_138707,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7143.58,2857.43,,,0 CDM,278C1889S1_138708,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7185.76,2874.3,,,0 CDM,278C1889S1_138715,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4599.94,1839.98,,,0 CDM,278C1889S1_138716,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,858.1,343.24,,,0 CDM,278C1889S1_138724,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7124.83,2849.93,,,0 CDM,278C1889S1_138725,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7205.44,2882.18,,,0 CDM,278C1889S1_138726,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7168.09,2867.24,,,0 CDM,278C1889S1_138727,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7139.83,2855.93,,,0 CDM,278C1889S1_138729,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4684.27,1873.71,,,0 CDM,278C1889S1_138730,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7349.78,2939.91,,,0 CDM,278C1889S1_138732,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,45.29,18.12,,,0 CDM,278C1889S1_138742,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4656.16,1862.46,,,0 CDM,278C1889S1_138743,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4656.16,1862.46,,,0 CDM,278C1889S1_138744,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7179.97,2871.99,,,0 CDM,278C1889S1_138745,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7174.82,2869.93,,,0 CDM,278C1889S1_138746,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7218.56,2887.42,,,0 CDM,278C1889S1_138747,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7131.08,2852.43,,,0 CDM,278C1889S1_138748,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7169.82,2867.93,,,0 CDM,278C1889S1_138821,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,46.7,18.68,,,0 CDM,278C1889S1_138840,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,249.8,99.92,,,0 CDM,278C1889S1_138841,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,970.18,388.07,,,0 CDM,278C1889S1_138842,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,969.41,387.76,,,0 CDM,278C1889S1_138853,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138854,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138855,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138856,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138857,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138858,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138859,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138860,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138861,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138862,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138863,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138864,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138865,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138866,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138867,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138868,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138869,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138871,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9877.67,3951.07,,,0 CDM,278C1889S1_138872,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9697.9,3879.16,,,0 CDM,278C1889S1_138874,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9817.75,3927.1,,,0 CDM,278C1889S1_138875,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,8564.06,3425.62,,,0 CDM,278C1889S1_138877,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9937.59,3975.04,,,0 CDM,278C1889S1_138878,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9937.59,3975.04,,,0 CDM,278C1889S1_138879,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9697.9,3879.16,,,0 CDM,278C1889S1_138880,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,10057.44,4022.98,,,0 CDM,278C1889S1_138881,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,10057.44,4022.98,,,0 CDM,278C1889S1_138882,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9827.34,3930.94,,,0 CDM,278C1889S1_138883,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9907.63,3963.05,,,0 CDM,278C1889S1_138884,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9777.8,3911.12,,,0 CDM,278C1889S1_138885,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9769.81,3907.92,,,0 CDM,278C1889S1_138886,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9913.62,3965.45,,,0 CDM,278C1889S1_138887,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9997.51,3999.0,,,0 CDM,278C1889S1_138888,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,10889.55,4355.82,,,0 CDM,278C1889S1_138889,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9841.72,3936.69,,,0 CDM,278C1889S1_138890,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9877.67,3951.07,,,0 CDM,278C1889S1_138893,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7349.78,2939.91,,,0 CDM,278C1889S1_138933,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,6300.0,2520.0,,,0 CDM,278C1889S1_138934,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,6300.0,2520.0,,,0 CDM,278C1889S1_138935,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,6300.0,2520.0,,,0 CDM,278C1889S1_138936,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,6300.0,2520.0,,,0 CDM,278C1889S1_138937,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138938,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138939,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138940,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138941,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138942,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138943,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138944,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138945,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138946,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138947,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138948,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138949,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138950,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138951,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138952,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138953,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138954,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_138973,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,118125.0,47250.0,,,0 CDM,278C1889S1_138982,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,13584.38,5433.75,,,0 CDM,278C1889S1_139044,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,117.89,47.16,,,0 CDM,278C1889S1_139045,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,117.89,47.16,,,0 CDM,278C1889S1_139162,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,159.47,63.79,,,0 CDM,278C1889S1_139176,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,214.99,86.0,,,0 CDM,278C1889S1_143129,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,588.62,235.45,,,0 CDM,278C1889S1_145646,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,149.62,59.85,,,0 CDM,278C1889S1_145654,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3162.8,1265.12,,,0 CDM,278C1889S1_145662,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,149.62,59.85,,,0 CDM,278C1889S1_145817,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,301.93,120.77,,,0 CDM,278C1889S1_145820,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,653.62,261.45,,,0 CDM,278C1889S1_145860,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,295.31,118.12,,,0 CDM,278C1889S1_146522,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9646.88,3858.75,,,0 CDM,278C1889S1_146523,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2287.69,915.08,,,0 CDM,278C1889S1_146524,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2223.9,889.56,,,0 CDM,278C1889S1_146525,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2454.9,981.96,,,0 CDM,278C1889S1_146526,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2527.88,1011.15,,,0 CDM,278C1889S1_146822,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2362.5,945.0,,,0 CDM,278C1889S1_146862,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19687.5,7875.0,,,0 CDM,278C1889S1_146863,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,22640.62,9056.25,,,0 CDM,278C1889S1_147441,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,393.75,157.5,,,0 CDM,278C1889S1_150419,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,889.01,355.6,,,0 CDM,278C1889S1_150420,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2326.51,930.6,,,0 CDM,278C1889S1_150427,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,41.38,16.55,,,0 CDM,278C1889S1_150509,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5654.25,2261.7,,,0 CDM,278C1889S1_150761,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,11269.69,4507.88,,,0 CDM,278C1889S1_150959,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1789.24,715.7,,,0 CDM,278C1889S1_150963,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1789.24,715.7,,,0 CDM,278C1889S1_150965,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1789.24,715.7,,,0 CDM,278C1889S1_150967,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1789.24,715.7,,,0 CDM,278C1889S1_152072,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1575.0,630.0,,,0 CDM,278C1889S1_152116,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,166.85,66.74,,,0 CDM,278C1889S1_152117,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,153.56,61.42,,,0 CDM,278C1889S1_152634,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1656.23,662.49,,,0 CDM,278C1889S1_152643,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1661.96,664.78,,,0 CDM,278C1889S1_152644,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1656.23,662.49,,,0 CDM,278C1889S1_152698,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,441.45,176.58,,,0 CDM,278C1889S1_152700,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,328.13,131.25,,,0 CDM,278C1889S1_152716,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,10710.0,4284.0,,,0 CDM,278C1889S1_152717,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,10710.0,4284.0,,,0 CDM,278C1889S1_152718,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,10710.0,4284.0,,,0 CDM,278C1889S1_152736,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1732.5,693.0,,,0 CDM,278C1889S1_152737,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1909.69,763.88,,,0 CDM,278C1889S1_152738,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_152739,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2362.5,945.0,,,0 CDM,278C1889S1_153324,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,324.33,129.73,,,0 CDM,278C1889S1_153906,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3150.0,1260.0,,,0 CDM,278C1889S1_153945,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_153974,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,11812.5,4725.0,,,0 CDM,278C1889S1_153990,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,11812.5,4725.0,,,0 CDM,278C1889S1_154004,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,11812.5,4725.0,,,0 CDM,278C1889S1_154005,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,11812.5,4725.0,,,0 CDM,278C1889S1_154141,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3937.5,1575.0,,,0 CDM,278C1889S1_154142,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3937.5,1575.0,,,0 CDM,278C1889S1_154143,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3937.5,1575.0,,,0 CDM,278C1889S1_154144,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3937.5,1575.0,,,0 CDM,278C1889S1_154145,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3937.5,1575.0,,,0 CDM,278C1889S1_154146,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3937.5,1575.0,,,0 CDM,278C1889S1_154148,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3937.5,1575.0,,,0 CDM,278C1889S1_154150,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3937.5,1575.0,,,0 CDM,278C1889S1_154191,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154192,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154193,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154194,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154196,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154197,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154198,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154199,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154201,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154202,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154204,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154207,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154231,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154232,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154233,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154238,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154239,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154240,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154242,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154244,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154246,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154247,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154248,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154250,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154252,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_154263,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2067.19,826.88,,,0 CDM,278C1889S1_154296,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,341.93,136.77,,,0 CDM,278C1889S1_155056,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,6599.42,2639.77,,,0 CDM,278C1889S1_155349,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,70875.0,28350.0,,,0 CDM,278C1889S1_155350,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,70875.0,28350.0,,,0 CDM,278C1889S1_155351,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,70875.0,28350.0,,,0 CDM,278C1889S1_155352,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,70875.0,28350.0,,,0 CDM,278C1889S1_155355,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,70481.25,28192.5,,,0 CDM,278C1889S1_155356,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,70166.25,28066.5,,,0 CDM,278C1889S1_155357,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,70284.38,28113.75,,,0 CDM,278C1889S1_155358,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,70875.0,28350.0,,,0 CDM,278C1889S1_155359,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,69693.75,27877.5,,,0 CDM,278C1889S1_155361,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,70875.0,28350.0,,,0 CDM,278C1889S1_155362,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,69300.0,27720.0,,,0 CDM,278C1889S1_155363,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,70284.38,28113.75,,,0 CDM,278C1889S1_155364,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,70481.25,28192.5,,,0 CDM,278C1889S1_155365,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,69300.0,27720.0,,,0 CDM,278C1889S1_155366,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,70087.5,28035.0,,,0 CDM,278C1889S1_155367,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,70284.38,28113.75,,,0 CDM,278C1889S1_155368,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,70875.0,28350.0,,,0 CDM,278C1889S1_155369,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,70875.0,28350.0,,,0 CDM,278C1889S1_155378,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,252.0,100.8,,,0 CDM,278C1889S1_155381,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,413.44,165.38,,,0 CDM,278C1889S1_155713,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1968.75,787.5,,,0 CDM,278C1889S1_155720,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1968.75,787.5,,,0 CDM,278C1889S1_155725,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,787.5,315.0,,,0 CDM,278C1889S1_155730,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,787.5,315.0,,,0 CDM,278C1889S1_155732,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,787.5,315.0,,,0 CDM,278C1889S1_155749,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1870.31,748.12,,,0 CDM,278C1889S1_155756,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1870.31,748.12,,,0 CDM,278C1889S1_155766,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,216.56,86.62,,,0 CDM,278C1889S1_155780,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_155781,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_155782,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2264.06,905.62,,,0 CDM,278C1889S1_156092,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,492.19,196.88,,,0 CDM,278C1889S1_156169,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5512.5,2205.0,,,0 CDM,278C1889S1_156219,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3346.88,1338.75,,,0 CDM,278C1889S1_156220,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3346.88,1338.75,,,0 CDM,278C1889S1_156221,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3346.88,1338.75,,,0 CDM,278C1889S1_156222,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3346.88,1338.75,,,0 CDM,278C1889S1_156223,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3346.88,1338.75,,,0 CDM,278C1889S1_156250,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2870.44,1148.18,,,0 CDM,278C1889S1_156251,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3327.19,1330.88,,,0 CDM,278C1889S1_156312,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,24510.94,9804.38,,,0 CDM,278C1889S1_156313,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,24871.1,9948.44,,,0 CDM,278C1889S1_156315,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,27927.9,11171.16,,,0 CDM,278C1889S1_156316,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7644.66,3057.86,,,0 CDM,278C1889S1_156317,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7622.21,3048.88,,,0 CDM,278C1889S1_156319,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,10053.22,4021.29,,,0 CDM,278C1889S1_156323,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,6611.06,2644.42,,,0 CDM,278C1889S1_156324,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,6229.12,2491.65,,,0 CDM,278C1889S1_156335,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9213.75,3685.5,,,0 CDM,278C1889S1_156336,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9213.75,3685.5,,,0 CDM,278C1889S1_156337,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9213.75,3685.5,,,0 CDM,278C1889S1_156338,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9213.75,3685.5,,,0 CDM,278C1889S1_156339,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9213.75,3685.5,,,0 CDM,278C1889S1_156340,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9213.75,3685.5,,,0 CDM,278C1889S1_156341,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9213.75,3685.5,,,0 CDM,278C1889S1_156355,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,30318.75,12127.5,,,0 CDM,278C1889S1_156356,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,30318.75,12127.5,,,0 CDM,278C1889S1_156357,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,30318.75,12127.5,,,0 CDM,278C1889S1_156358,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,30318.75,12127.5,,,0 CDM,278C1889S1_156359,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,30318.75,12127.5,,,0 CDM,278C1889S1_156360,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,670.55,268.22,,,0 CDM,278C1889S1_156432,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,21656.25,8662.5,,,0 CDM,278C1889S1_156511,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,40359.38,16143.75,,,0 CDM,278C1889S1_157101,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,37182.6,14873.04,,,0 CDM,278C1889S1_158722,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1673.91,669.56,,,0 CDM,278C1889S1_158740,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,166786.56,66714.62,,,0 CDM,278C1889S1_158755,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,507.15,202.86,,,0 CDM,278C1889S1_158756,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3524.06,1409.62,,,0 CDM,278C1889S1_158945,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,492.19,196.88,,,0 CDM,278C1889S1_158946,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,590.62,236.25,,,0 CDM,278C1889S1_158947,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,590.62,236.25,,,0 CDM,278C1889S1_158948,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,590.62,236.25,,,0 CDM,278C1889S1_158949,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,590.62,236.25,,,0 CDM,278C1889S1_158950,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,590.62,236.25,,,0 CDM,278C1889S1_158952,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,590.62,236.25,,,0 CDM,278C1889S1_158995,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1827.0,730.8,,,0 CDM,278C1889S1_158996,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,697.2,278.88,,,0 CDM,278C1889S1_162280,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,416.12,166.45,,,0 CDM,278C1889S1_162359,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,39575.81,15830.32,,,0 CDM,278C1889S1_162628,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52.92,21.17,,,0 CDM,278C1889S1_162646,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,10008.14,4003.26,,,0 CDM,278C1889S1_162751,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,666.66,266.66,,,0 CDM,278C1889S1_164375,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19687.5,7875.0,,,0 CDM,278C1889S1_164390,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19687.5,7875.0,,,0 CDM,278C1889S1_164405,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19687.5,7875.0,,,0 CDM,278C1889S1_164408,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19687.5,7875.0,,,0 CDM,278C1889S1_164472,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19687.5,7875.0,,,0 CDM,278C1889S1_164502,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19687.5,7875.0,,,0 CDM,278C1889S1_164505,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19687.5,7875.0,,,0 CDM,278C1889S1_164508,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19687.5,7875.0,,,0 CDM,278C1889S1_164520,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19687.5,7875.0,,,0 CDM,278C1889S1_164523,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19687.5,7875.0,,,0 CDM,278C1889S1_164533,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19687.5,7875.0,,,0 CDM,278C1889S1_164535,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19687.5,7875.0,,,0 CDM,278C1889S1_164536,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19687.5,7875.0,,,0 CDM,278C1889S1_164538,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19687.5,7875.0,,,0 CDM,278C1889S1_164539,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19687.5,7875.0,,,0 CDM,278C1889S1_164540,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19687.5,7875.0,,,0 CDM,278C1889S1_164551,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19687.5,7875.0,,,0 CDM,278C1889S1_164553,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19687.5,7875.0,,,0 CDM,278C1889S1_164554,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19687.5,7875.0,,,0 CDM,278C1889S1_164568,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19687.5,7875.0,,,0 CDM,278C1889S1_165821,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,68906.25,27562.5,,,0 CDM,278C1889S1_165880,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1222.44,488.98,,,0 CDM,278C1889S1_166190,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,35437.5,14175.0,,,0 CDM,278C1889S1_166191,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,21656.25,8662.5,,,0 CDM,278C1889S1_168360,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,23073.75,9229.5,,,0 CDM,278C1889S1_169323,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,35437.5,14175.0,,,0 CDM,278C1889S1_169527,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1575.0,630.0,,,0 CDM,278C1889S1_169645,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3917.81,1567.12,,,0 CDM,278C1889S1_169902,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,35437.5,14175.0,,,0 CDM,278C1889S1_169980,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1220.62,488.25,,,0 CDM,278C1889S1_170121,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_170244,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,92.02,36.81,,,0 CDM,278C1889S1_170453,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,35437.5,14175.0,,,0 CDM,278C1889S1_170454,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_170480,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_170607,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1043.44,417.38,,,0 CDM,278C1889S1_170783,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_170868,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5512.5,2205.0,,,0 CDM,278C1889S1_170872,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3543.75,1417.5,,,0 CDM,278C1889S1_170873,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3162.8,1265.12,,,0 CDM,278C1889S1_170874,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3177.68,1271.07,,,0 CDM,278C1889S1_170875,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3162.8,1265.12,,,0 CDM,278C1889S1_170877,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3178.84,1271.54,,,0 CDM,278C1889S1_171380,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,21656.25,8662.5,,,0 CDM,278C1889S1_171383,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,21656.25,8662.5,,,0 CDM,278C1889S1_171459,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_171526,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_171528,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_171531,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_171532,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_171534,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_171535,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_171537,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_171538,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_171539,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_171540,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,53943.75,21577.5,,,0 CDM,278C1889S1_171541,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_171542,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_171543,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_171545,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_171546,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_171547,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_171548,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_171551,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_171552,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_171554,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_171556,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,53943.75,21577.5,,,0 CDM,278C1889S1_171723,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,20904.19,8361.68,,,0 CDM,278C1889S1_171792,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,11366.5,4546.6,,,0 CDM,278C1889S1_171812,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3084.48,1233.79,,,0 CDM,278C1889S1_171813,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5931.02,2372.41,,,0 CDM,278C1889S1_171885,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2362.5,945.0,,,0 CDM,278C1889S1_171935,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,374.06,149.62,,,0 CDM,278C1889S1_171936,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,374.06,149.62,,,0 CDM,278C1889S1_171941,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5124.66,2049.86,,,0 CDM,278C1889S1_172054,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2362.5,945.0,,,0 CDM,278C1889S1_172055,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2362.5,945.0,,,0 CDM,278C1889S1_172056,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2362.5,945.0,,,0 CDM,278C1889S1_172058,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,492.19,196.88,,,0 CDM,278C1889S1_172059,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,492.19,196.88,,,0 CDM,278C1889S1_172060,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,492.19,196.88,,,0 CDM,278C1889S1_172070,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1771.88,708.75,,,0 CDM,278C1889S1_172080,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2362.5,945.0,,,0 CDM,278C1889S1_172081,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2362.5,945.0,,,0 CDM,278C1889S1_172091,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2362.5,945.0,,,0 CDM,278C1889S1_172092,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2362.5,945.0,,,0 CDM,278C1889S1_172093,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2362.5,945.0,,,0 CDM,278C1889S1_172429,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,787.5,315.0,,,0 CDM,278C1889S1_172581,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,129937.5,51975.0,,,0 CDM,278C1889S1_172884,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2862.56,1145.02,,,0 CDM,278C1889S1_174227,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,295.31,118.12,,,0 CDM,278C1889S1_174291,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,21656.25,8662.5,,,0 CDM,278C1889S1_174437,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3256.31,1302.52,,,0 CDM,278C1889S1_174446,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4421.81,1768.72,,,0 CDM,278C1889S1_174538,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,984.38,393.75,,,0 CDM,278C1889S1_174540,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,984.38,393.75,,,0 CDM,278C1889S1_174560,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_174565,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_174566,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_174567,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_174582,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_174587,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_174588,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_174591,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_174592,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_174602,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_174605,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_174609,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_174610,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_174619,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_174629,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_174630,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_174631,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_174643,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_174644,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_174828,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,396.2,158.48,,,0 CDM,278C1889S1_174858,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,35437.5,14175.0,,,0 CDM,278C1889S1_175273,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_175540,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_177180,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4318.12,1727.25,,,0 CDM,278C1889S1_177499,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1649.81,659.92,,,0 CDM,278C1889S1_178693,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3937.5,1575.0,,,0 CDM,278C1889S1_178946,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,578.34,231.34,,,0 CDM,278C1889S1_179021,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,21656.25,8662.5,,,0 CDM,278C1889S1_179183,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,64949.06,25979.62,,,0 CDM,278C1889S1_179226,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_179227,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_179735,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1789.24,715.7,,,0 CDM,278C1889S1_179853,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1877.33,750.93,,,0 CDM,278C1889S1_179854,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5704.96,2281.98,,,0 CDM,278C1889S1_180014,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1789.24,715.7,,,0 CDM,278C1889S1_180017,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1789.24,715.7,,,0 CDM,278C1889S1_180019,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1789.24,715.7,,,0 CDM,278C1889S1_180020,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1789.24,715.7,,,0 CDM,278C1889S1_180023,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1789.24,715.7,,,0 CDM,278C1889S1_180024,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1789.24,715.7,,,0 CDM,278C1889S1_180099,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3754.81,1501.92,,,0 CDM,278C1889S1_180102,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,649.69,259.88,,,0 CDM,278C1889S1_180200,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1673.44,669.38,,,0 CDM,278C1889S1_180201,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1893.94,757.58,,,0 CDM,278C1889S1_180202,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1673.44,669.38,,,0 CDM,278C1889S1_180203,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1673.44,669.38,,,0 CDM,278C1889S1_180220,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5036.06,2014.42,,,0 CDM,278C1889S1_180221,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5036.06,2014.42,,,0 CDM,278C1889S1_180306,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2075.06,830.02,,,0 CDM,278C1889S1_180394,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9450.0,3780.0,,,0 CDM,278C1889S1_180395,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9450.0,3780.0,,,0 CDM,278C1889S1_180396,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9450.0,3780.0,,,0 CDM,278C1889S1_180397,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9450.0,3780.0,,,0 CDM,278C1889S1_180502,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_180843,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,919.68,367.87,,,0 CDM,278C1889S1_182115,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4154.06,1661.62,,,0 CDM,278C1889S1_182118,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1870.31,748.12,,,0 CDM,278C1889S1_182120,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1870.31,748.12,,,0 CDM,278C1889S1_182251,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,21656.25,8662.5,,,0 CDM,278C1889S1_182252,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15750.0,6300.0,,,0 CDM,278C1889S1_182256,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,14829.61,5931.84,,,0 CDM,278C1889S1_182257,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15203.67,6081.47,,,0 CDM,278C1889S1_182258,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16325.86,6530.34,,,0 CDM,278C1889S1_182259,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16699.92,6679.97,,,0 CDM,278C1889S1_182261,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,35437.5,14175.0,,,0 CDM,278C1889S1_182262,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,35437.5,14175.0,,,0 CDM,278C1889S1_182351,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15494.06,6197.62,,,0 CDM,278C1889S1_182352,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15494.06,6197.62,,,0 CDM,278C1889S1_182353,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15494.06,6197.62,,,0 CDM,278C1889S1_182354,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15803.94,6321.58,,,0 CDM,278C1889S1_182362,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15663.38,6265.35,,,0 CDM,278C1889S1_182363,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15356.25,6142.5,,,0 CDM,278C1889S1_182364,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15356.25,6142.5,,,0 CDM,278C1889S1_182365,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15509.81,6203.92,,,0 CDM,278C1889S1_182366,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15356.25,6142.5,,,0 CDM,278C1889S1_182369,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16868.25,6747.3,,,0 CDM,278C1889S1_182483,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,20423.81,8169.52,,,0 CDM,278C1889S1_182898,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1818.79,727.52,,,0 CDM,278C1889S1_182944,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1519.88,607.95,,,0 CDM,278C1889S1_183350,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,126000.0,50400.0,,,0 CDM,278C1889S1_183351,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,30712.5,12285.0,,,0 CDM,278C1889S1_183481,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,253.22,101.29,,,0 CDM,278C1889S1_183683,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,126000.0,50400.0,,,0 CDM,278C1889S1_183800,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,33468.75,13387.5,,,0 CDM,278C1889S1_183943,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2362.5,945.0,,,0 CDM,278C1889S1_184000,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,126000.0,50400.0,,,0 CDM,278C1889S1_184001,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,30712.5,12285.0,,,0 CDM,278C1889S1_184138,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,126000.0,50400.0,,,0 CDM,278C1889S1_184204,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1256.06,502.42,,,0 CDM,278C1889S1_184205,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4091.06,1636.42,,,0 CDM,278C1889S1_184305,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,6141.99,2456.8,,,0 CDM,278C1889S1_184323,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,10828.12,4331.25,,,0 CDM,278C1889S1_184324,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,984.38,393.75,,,0 CDM,278C1889S1_184397,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,13564.69,5425.88,,,0 CDM,278C1889S1_184593,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,10828.12,4331.25,,,0 CDM,278C1889S1_184783,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1382.06,552.82,,,0 CDM,278C1889S1_184854,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,11812.5,4725.0,,,0 CDM,278C1889S1_184855,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,11812.5,4725.0,,,0 CDM,278C1889S1_184856,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,11812.5,4725.0,,,0 CDM,278C1889S1_185425,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,11812.5,4725.0,,,0 CDM,278C1889S1_185426,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,11812.5,4725.0,,,0 CDM,278C1889S1_185528,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,126000.0,50400.0,,,0 CDM,278C1889S1_185803,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,10828.12,4331.25,,,0 CDM,278C1889S1_185937,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2456.66,982.66,,,0 CDM,278C1889S1_186063,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,984.38,393.75,,,0 CDM,278C1889S1_186407,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,30712.5,12285.0,,,0 CDM,278C1889S1_186475,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,30712.5,12285.0,,,0 CDM,278C1889S1_186564,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,632.12,252.85,,,0 CDM,278C1889S1_186565,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,634.45,253.78,,,0 CDM,278C1889S1_186623,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,427.57,171.03,,,0 CDM,278C1889S1_186625,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,431.86,172.74,,,0 CDM,278C1889S1_187004,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_187088,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,8642.81,3457.12,,,0 CDM,278C1889S1_187097,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9788.62,3915.45,,,0 CDM,278C1889S1_187264,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9833.62,3933.45,,,0 CDM,278C1889S1_187265,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9824.06,3929.62,,,0 CDM,278C1889S1_187266,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9824.06,3929.62,,,0 CDM,278C1889S1_187267,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9824.06,3929.62,,,0 CDM,278C1889S1_187268,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9824.06,3929.62,,,0 CDM,278C1889S1_187367,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,673.31,269.32,,,0 CDM,278C1889S1_187441,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,984.38,393.75,,,0 CDM,278C1889S1_188017,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,126000.0,50400.0,,,0 CDM,278C1889S1_188018,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,30712.5,12285.0,,,0 CDM,278C1889S1_188228,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3090.94,1236.38,,,0 CDM,278C1889S1_188229,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,603.31,241.32,,,0 CDM,278C1889S1_188942,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19667.81,7867.12,,,0 CDM,278C1889S1_189021,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,11812.5,4725.0,,,0 CDM,278C1889S1_189198,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,397.69,159.08,,,0 CDM,278C1889S1_189199,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,984.38,393.75,,,0 CDM,278C1889S1_189200,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1984.5,793.8,,,0 CDM,278C1889S1_189201,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3963.75,1585.5,,,0 CDM,278C1889S1_189261,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,10828.12,4331.25,,,0 CDM,278C1889S1_189362,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_189450,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1701.0,680.4,,,0 CDM,278C1889S1_189451,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7071.7,2828.68,,,0 CDM,278C1889S1_189452,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,14403.38,5761.35,,,0 CDM,278C1889S1_189735,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1735.94,694.38,,,0 CDM,278C1889S1_189736,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7186.4,2874.56,,,0 CDM,278C1889S1_189737,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,14601.12,5840.45,,,0 CDM,278C1889S1_189738,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,20332.35,8132.94,,,0 CDM,278C1889S1_189976,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,6065.32,2426.13,,,0 CDM,278C1889S1_190235,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_190471,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,8401.8,3360.72,,,0 CDM,278C1889S1_190578,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1575.0,630.0,,,0 CDM,278C1889S1_191059,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,69.07,27.63,,,0 CDM,278C1889S1_191061,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,43.27,17.31,,,0 CDM,278C1889S1_191064,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,69.07,27.63,,,0 CDM,278C1889S1_191074,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5036.06,2014.42,,,0 CDM,278C1889S1_191082,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,43.24,17.3,,,0 CDM,278C1889S1_191153,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52.21,20.88,,,0 CDM,278C1889S1_191169,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52.21,20.88,,,0 CDM,278C1889S1_191170,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52.21,20.88,,,0 CDM,278C1889S1_191217,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5036.06,2014.42,,,0 CDM,278C1889S1_191470,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,674.57,269.83,,,0 CDM,278C1889S1_191515,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,18112.5,7245.0,,,0 CDM,278C1889S1_191537,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4213.12,1685.25,,,0 CDM,278C1889S1_191538,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4213.12,1685.25,,,0 CDM,278C1889S1_191615,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_191621,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3614.62,1445.85,,,0 CDM,278C1889S1_191622,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,104.18,41.67,,,0 CDM,278C1889S1_191652,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3858.75,1543.5,,,0 CDM,278C1889S1_191696,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4427.72,1771.09,,,0 CDM,278C1889S1_191728,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,6300.0,2520.0,,,0 CDM,278C1889S1_191851,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1893.94,757.58,,,0 CDM,278C1889S1_191955,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,118.12,47.25,,,0 CDM,278C1889S1_191961,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1271.81,508.72,,,0 CDM,278C1889S1_192141,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4578.8,1831.52,,,0 CDM,278C1889S1_192360,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,24659.13,9863.65,,,0 CDM,278C1889S1_192491,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,23227.31,9290.92,,,0 CDM,278C1889S1_192501,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,24211.69,9684.68,,,0 CDM,278C1889S1_192591,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2441.25,976.5,,,0 CDM,278C1889S1_192726,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_192833,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,8308.12,3323.25,,,0 CDM,278C1889S1_193006,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,52664.06,21065.62,,,0 CDM,278C1889S1_193077,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,6166.12,2466.45,,,0 CDM,278C1889S1_193192,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,44887.5,17955.0,,,0 CDM,278C1889S1_193505,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,114187.5,45675.0,,,0 CDM,278C1889S1_193612,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7904.54,3161.82,,,0 CDM,278C1889S1_193749,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,10828.12,4331.25,,,0 CDM,278C1889S1_193786,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,114187.5,45675.0,,,0 CDM,278C1889S1_193903,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5118.75,2047.5,,,0 CDM,278C1889S1_193994,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4427.72,1771.09,,,0 CDM,278C1889S1_194136,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,17277.75,6911.1,,,0 CDM,278C1889S1_194139,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,17277.75,6911.1,,,0 CDM,278C1889S1_194140,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,17277.75,6911.1,,,0 CDM,278C1889S1_194142,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,17277.75,6911.1,,,0 CDM,278C1889S1_194144,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3150.0,1260.0,,,0 CDM,278C1889S1_194145,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3150.0,1260.0,,,0 CDM,278C1889S1_194146,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3150.0,1260.0,,,0 CDM,278C1889S1_194147,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3150.0,1260.0,,,0 CDM,278C1889S1_194148,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,381.94,152.78,,,0 CDM,278C1889S1_194157,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19451.56,7780.62,,,0 CDM,278C1889S1_194258,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2012.06,804.82,,,0 CDM,278C1889S1_194317,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,23227.31,9290.92,,,0 CDM,278C1889S1_194328,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1425.92,570.37,,,0 CDM,278C1889S1_194431,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5630.62,2252.25,,,0 CDM,278C1889S1_194773,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,44887.5,17955.0,,,0 CDM,278C1889S1_194782,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4228.68,1691.47,,,0 CDM,278C1889S1_194811,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2559.38,1023.75,,,0 CDM,278C1889S1_195093,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_195094,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_195095,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9975.0,3990.0,,,0 CDM,278C1889S1_195100,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,9765.0,3906.0,,,0 CDM,278C1889S1_195217,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,6300.0,2520.0,,,0 CDM,278C1889S1_195254,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1893.94,757.58,,,0 CDM,278C1889S1_195489,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1425.92,570.37,,,0 CDM,278C1889S1_195524,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1495.35,598.14,,,0 CDM,278C1889S1_195525,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2553.39,1021.36,,,0 CDM,278C1889S1_195526,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3334.12,1333.65,,,0 CDM,278C1889S1_195527,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3937.5,1575.0,,,0 CDM,278C1889S1_195528,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,106312.5,42525.0,,,0 CDM,278C1889S1_195825,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,13545.0,5418.0,,,0 CDM,278C1889S1_196219,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5906.25,2362.5,,,0 CDM,278C1889S1_196591,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1156.13,462.45,,,0 CDM,278C1889S1_196722,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,44887.5,17955.0,,,0 CDM,278C1889S1_196830,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,7855.31,3142.12,,,0 CDM,278C1889S1_197081,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,17199.0,6879.6,,,0 CDM,278C1889S1_197124,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5906.25,2362.5,,,0 CDM,278C1889S1_197144,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,20904.19,8361.68,,,0 CDM,278C1889S1_197164,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,126000.0,50400.0,,,0 CDM,278C1889S1_197336,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3031.88,1212.75,,,0 CDM,278C1889S1_197337,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,6851.25,2740.5,,,0 CDM,278C1889S1_197338,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5059.69,2023.88,,,0 CDM,278C1889S1_197339,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5059.69,2023.88,,,0 CDM,278C1889S1_197340,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5059.69,2023.88,,,0 CDM,278C1889S1_197467,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,10434.38,4173.75,,,0 CDM,278C1889S1_197473,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,10434.38,4173.75,,,0 CDM,278C1889S1_197474,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5551.88,2220.75,,,0 CDM,278C1889S1_197498,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3819.38,1527.75,,,0 CDM,278C1889S1_197499,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3031.88,1212.75,,,0 CDM,278C1889S1_197500,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3031.88,1212.75,,,0 CDM,278C1889S1_197533,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1673.44,669.38,,,0 CDM,278C1889S1_197537,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3878.44,1551.38,,,0 CDM,278C1889S1_197608,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19687.5,7875.0,,,0 CDM,278C1889S1_197671,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,20904.19,8361.68,,,0 CDM,278C1889S1_197673,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3031.88,1212.75,,,0 CDM,278C1889S1_197674,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3819.38,1527.75,,,0 CDM,278C1889S1_197678,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1673.44,669.38,,,0 CDM,278C1889S1_197713,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3878.44,1551.38,,,0 CDM,278C1889S1_197714,Hc Sup Shell 278 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278 Revenue Code C1889 Hcpcs,5000.62,2000.25,,,0 CDM,278C1889S1_197925,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5000.62,2000.25,,,0 CDM,278C1889S1_197926,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5000.62,2000.25,,,0 CDM,278C1889S1_197927,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5000.62,2000.25,,,0 CDM,278C1889S1_197928,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5000.62,2000.25,,,0 CDM,278C1889S1_197929,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5000.62,2000.25,,,0 CDM,278C1889S1_197930,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3031.88,1212.75,,,0 CDM,278C1889S1_197933,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5000.62,2000.25,,,0 CDM,278C1889S1_197935,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5000.62,2000.25,,,0 CDM,278C1889S1_197936,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5000.62,2000.25,,,0 CDM,278C1889S1_197938,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3110.62,1244.25,,,0 CDM,278C1889S1_197939,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3110.62,1244.25,,,0 CDM,278C1889S1_197940,Hc 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CDM,278C1889S1_197955,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3878.44,1551.38,,,0 CDM,278C1889S1_197956,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3878.44,1551.38,,,0 CDM,278C1889S1_197957,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3878.44,1551.38,,,0 CDM,278C1889S1_197958,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5059.69,2023.88,,,0 CDM,278C1889S1_197967,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3819.38,1527.75,,,0 CDM,278C1889S1_197968,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5000.62,2000.25,,,0 CDM,278C1889S1_197969,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5000.62,2000.25,,,0 CDM,278C1889S1_198001,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2275.88,910.35,,,0 CDM,278C1889S1_198003,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1968.75,787.5,,,0 CDM,278C1889S1_198262,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1279.69,511.88,,,0 CDM,278C1889S1_198286,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1673.44,669.38,,,0 CDM,278C1889S1_198290,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,20904.19,8361.68,,,0 CDM,278C1889S1_198318,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1279.69,511.88,,,0 CDM,278C1889S1_198411,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1279.69,511.88,,,0 CDM,278C1889S1_198461,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,170.14,68.06,,,0 CDM,278C1889S1_198499,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1673.44,669.38,,,0 CDM,278C1889S1_198749,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1279.69,511.88,,,0 CDM,278C1889S1_198820,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,170.14,68.06,,,0 CDM,278C1889S1_199038,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1279.69,511.88,,,0 CDM,278C1889S1_199047,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4331.25,1732.5,,,0 CDM,278C1889S1_199078,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5906.25,2362.5,,,0 CDM,278C1889S1_199186,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5906.25,2362.5,,,0 CDM,278C1889S1_199196,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1279.69,511.88,,,0 CDM,278C1889S1_199220,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1968.75,787.5,,,0 CDM,278C1889S1_199232,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,98437.5,39375.0,,,0 CDM,278C1889S1_199233,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,5906.25,2362.5,,,0 CDM,278C1889S1_199257,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1968.75,787.5,,,0 CDM,278C1889S1_199303,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,771.75,308.7,,,0 CDM,278C1889S1_199305,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,771.75,308.7,,,0 CDM,278C1889S1_199306,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,771.75,308.7,,,0 CDM,278C1889S1_199390,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,8696.32,3478.53,,,0 CDM,278C1889S1_199404,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1279.69,511.88,,,0 CDM,278C1889S1_199471,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1673.44,669.38,,,0 CDM,278C1889S1_199576,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,8329.79,3331.92,,,0 CDM,278C1889S1_83315,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,225.44,90.18,,,0 CDM,278C1889S1_83329,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,61.2,24.48,,,0 CDM,278C1889S1_83489,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,395.34,158.14,,,0 CDM,278C1889S1_83602,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,220.82,88.33,,,0 CDM,278C1889S1_83603,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,80.59,32.24,,,0 CDM,278C1889S1_83642,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,78.53,31.41,,,0 CDM,278C1889S1_83844,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,58.42,23.37,,,0 CDM,278C1889S1_83845,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,58.42,23.37,,,0 CDM,278C1889S1_84015,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,107.3,42.92,,,0 CDM,278C1889S1_84067,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,950.55,380.22,,,0 CDM,278C1889S1_84068,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,950.55,380.22,,,0 CDM,278C1889S1_84069,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,959.76,383.9,,,0 CDM,278C1889S1_84070,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1025.09,410.04,,,0 CDM,278C1889S1_84071,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1024.05,409.62,,,0 CDM,278C1889S1_84073,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1124.18,449.67,,,0 CDM,278C1889S1_84136,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,268.54,107.42,,,0 CDM,278C1889S1_84139,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,249.48,99.79,,,0 CDM,278C1889S1_84140,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,274.52,109.81,,,0 CDM,278C1889S1_84156,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,237.55,95.02,,,0 CDM,278C1889S1_84158,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4161.25,1664.5,,,0 CDM,278C1889S1_84204,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,131.87,52.75,,,0 CDM,278C1889S1_84205,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,131.87,52.75,,,0 CDM,278C1889S1_84207,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2759.81,1103.92,,,0 CDM,278C1889S1_84211,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,889.45,355.78,,,0 CDM,278C1889S1_84441,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1648.4,659.36,,,0 CDM,278C1889S1_84443,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1648.4,659.36,,,0 CDM,278C1889S1_84772,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,137.11,54.84,,,0 CDM,278C1889S1_84822,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,248.49,99.4,,,0 CDM,278C1889S1_84823,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,243.34,97.34,,,0 CDM,278C1889S1_84824,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,237.29,94.92,,,0 CDM,278C1889S1_84866,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,71.81,28.72,,,0 CDM,278C1889S1_84868,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,44.71,17.88,,,0 CDM,278C1889S1_84884,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,97.97,39.19,,,0 CDM,278C1889S1_84885,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,413.44,165.38,,,0 CDM,278C1889S1_84887,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,108.99,43.6,,,0 CDM,278C1889S1_84889,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,104.82,41.93,,,0 CDM,278C1889S1_84890,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,100.37,40.15,,,0 CDM,278C1889S1_84891,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,113.22,45.29,,,0 CDM,278C1889S1_84893,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,104.38,41.75,,,0 CDM,278C1889S1_84894,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,102.55,41.02,,,0 CDM,278C1889S1_84895,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,104.38,41.75,,,0 CDM,278C1889S1_84896,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,104.38,41.75,,,0 CDM,278C1889S1_84897,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,104.38,41.75,,,0 CDM,278C1889S1_84898,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,104.38,41.75,,,0 CDM,278C1889S1_84920,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,53.72,21.49,,,0 CDM,278C1889S1_85136,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,928.9,371.56,,,0 CDM,278C1889S1_85160,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,734.56,293.82,,,0 CDM,278C1889S1_85173,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1712.81,685.12,,,0 CDM,278C1889S1_85316,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,919.68,367.87,,,0 CDM,278C1889S1_85330,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,867.63,347.05,,,0 CDM,278C1889S1_85474,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4474.84,1789.94,,,0 CDM,278C1889S1_85477,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,58.39,23.36,,,0 CDM,278C1889S1_85487,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,4980.82,1992.33,,,0 CDM,278C1889S1_85492,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3356.09,1342.44,,,0 CDM,278C1889S1_85493,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,15.56,6.22,,,0 CDM,278C1889S1_85495,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,22.09,8.84,,,0 CDM,278C1889S1_85497,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,506.52,202.61,,,0 CDM,278C1889S1_85498,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,605.27,242.11,,,0 CDM,278C1889S1_85499,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,711.19,284.48,,,0 CDM,278C1889S1_85500,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,822.13,328.85,,,0 CDM,278C1889S1_85661,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,100.64,40.26,,,0 CDM,278C1889S1_85662,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,94.7,37.88,,,0 CDM,278C1889S1_85727,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,31.78,12.71,,,0 CDM,278C1889S1_85761,Hc Sup Shell 278 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CDM,278C1889S1_86271,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1789.24,715.7,,,0 CDM,278C1889S1_86272,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1789.24,715.7,,,0 CDM,278C1889S1_86278,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1789.24,715.7,,,0 CDM,278C1889S1_86422,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2362.5,945.0,,,0 CDM,278C1889S1_86689,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,315.56,126.22,,,0 CDM,278C1889S1_86690,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,291.38,116.55,,,0 CDM,278C1889S1_86691,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,315.56,126.22,,,0 CDM,278C1889S1_87105,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,704.34,281.74,,,0 CDM,278C1889S1_87175,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1561.41,624.56,,,0 CDM,278C1889S1_87565,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1735.34,694.14,,,0 CDM,278C1889S1_88199,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,11293.05,4517.22,,,0 CDM,278C1889S1_88200,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,11143.12,4457.25,,,0 CDM,278C1889S1_88201,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,11187.42,4474.97,,,0 CDM,278C1889S1_88202,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,11320.31,4528.12,,,0 CDM,278C1889S1_88204,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,11284.88,4513.95,,,0 CDM,278C1889S1_88208,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1294.98,517.99,,,0 CDM,278C1889S1_88222,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16296.33,6518.53,,,0 CDM,278C1889S1_88223,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16274.18,6509.67,,,0 CDM,278C1889S1_88224,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16313.37,6525.35,,,0 CDM,278C1889S1_88225,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16276.19,6510.48,,,0 CDM,278C1889S1_88248,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1842.95,737.18,,,0 CDM,278C1889S1_88249,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1842.95,737.18,,,0 CDM,278C1889S1_88251,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1844.41,737.76,,,0 CDM,278C1889S1_88776,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1345.69,538.28,,,0 CDM,278C1889S1_88777,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1350.19,540.08,,,0 CDM,278C1889S1_88778,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1347.36,538.94,,,0 CDM,278C1889S1_88783,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,93.71,37.48,,,0 CDM,278C1889S1_88820,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,349.58,139.83,,,0 CDM,278C1889S1_88917,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,854.44,341.78,,,0 CDM,278C1889S1_89252,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,55.86,22.34,,,0 CDM,278C1889S1_89879,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16340.62,6536.25,,,0 CDM,278C1889S1_89880,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16340.62,6536.25,,,0 CDM,278C1889S1_89881,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16308.41,6523.36,,,0 CDM,278C1889S1_91023,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,40359.38,16143.75,,,0 CDM,278C1889S1_91026,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,39967.59,15987.04,,,0 CDM,278C1889S1_91027,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,40359.38,16143.75,,,0 CDM,278C1889S1_91150,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,11960.16,4784.06,,,0 CDM,278C1889S1_91151,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1521.85,608.74,,,0 CDM,278C1889S1_91152,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1521.85,608.74,,,0 CDM,278C1889S1_91154,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1521.85,608.74,,,0 CDM,278C1889S1_91205,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,41750.93,16700.37,,,0 CDM,278C1889S1_91300,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,672.53,269.01,,,0 CDM,278C1889S1_91790,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,442.97,177.19,,,0 CDM,278C1889S1_91791,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,442.97,177.19,,,0 CDM,278C1889S1_91792,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,442.97,177.19,,,0 CDM,278C1889S1_91810,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,711.11,284.44,,,0 CDM,278C1889S1_92035,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,401.62,160.65,,,0 CDM,278C1889S1_92037,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2872.6,1149.04,,,0 CDM,278C1889S1_92047,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,40228.78,16091.51,,,0 CDM,278C1889S1_92048,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,40359.38,16143.75,,,0 CDM,278C1889S1_92076,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1072.18,428.87,,,0 CDM,278C1889S1_92215,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,16.22,6.49,,,0 CDM,278C1889S1_92222,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,104.31,41.72,,,0 CDM,278C1889S1_92279,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,19435.9,7774.36,,,0 CDM,278C1889S1_92336,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,431.86,172.74,,,0 CDM,278C1889S1_92354,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1282.25,512.9,,,0 CDM,278C1889S1_92355,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,620.16,248.06,,,0 CDM,278C1889S1_92770,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,103.95,41.58,,,0 CDM,278C1889S1_92771,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,95.29,38.12,,,0 CDM,278C1889S1_92772,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2399.91,959.96,,,0 CDM,278C1889S1_92818,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,252.0,100.8,,,0 CDM,278C1889S1_92819,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,252.0,100.8,,,0 CDM,278C1889S1_92820,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,252.0,100.8,,,0 CDM,278C1889S1_92822,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,287.44,114.98,,,0 CDM,278C1889S1_92823,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,287.44,114.98,,,0 CDM,278C1889S1_92824,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,287.44,114.98,,,0 CDM,278C1889S1_92871,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,66.04,26.42,,,0 CDM,278C1889S1_93008,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,196.88,78.75,,,0 CDM,278C1889S1_93009,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,196.88,78.75,,,0 CDM,278C1889S1_93029,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,196.88,78.75,,,0 CDM,278C1889S1_93031,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,196.88,78.75,,,0 CDM,278C1889S1_93052,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,492.19,196.88,,,0 CDM,278C1889S1_93053,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,492.19,196.88,,,0 CDM,278C1889S1_93054,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,492.19,196.88,,,0 CDM,278C1889S1_93055,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,492.19,196.88,,,0 CDM,278C1889S1_93056,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,492.19,196.88,,,0 CDM,278C1889S1_93057,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,492.19,196.88,,,0 CDM,278C1889S1_93058,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,492.19,196.88,,,0 CDM,278C1889S1_93059,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,492.19,196.88,,,0 CDM,278C1889S1_93061,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,590.62,236.25,,,0 CDM,278C1889S1_93087,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,393.75,157.5,,,0 CDM,278C1889S1_93106,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,590.62,236.25,,,0 CDM,278C1889S1_93108,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,492.19,196.88,,,0 CDM,278C1889S1_93115,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,393.75,157.5,,,0 CDM,278C1889S1_93116,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,393.75,157.5,,,0 CDM,278C1889S1_93125,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,590.62,236.25,,,0 CDM,278C1889S1_93126,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1396.59,558.64,,,0 CDM,278C1889S1_93136,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1771.88,708.75,,,0 CDM,278C1889S1_93147,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1771.88,708.75,,,0 CDM,278C1889S1_93148,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1771.88,708.75,,,0 CDM,278C1889S1_93154,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1575.0,630.0,,,0 CDM,278C1889S1_93156,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1771.88,708.75,,,0 CDM,278C1889S1_93238,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1712.81,685.12,,,0 CDM,278C1889S1_93378,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2292.02,916.81,,,0 CDM,278C1889S1_93663,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3556.98,1422.79,,,0 CDM,278C1889S1_93766,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,774.43,309.77,,,0 CDM,278C1889S1_94054,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,867.98,347.19,,,0 CDM,278C1889S1_94474,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,215.46,86.18,,,0 CDM,278C1889S1_94476,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,221.3,88.52,,,0 CDM,278C1889S1_94477,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,215.46,86.18,,,0 CDM,278C1889S1_94483,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,207.9,83.16,,,0 CDM,278C1889S1_94484,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,207.9,83.16,,,0 CDM,278C1889S1_94749,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1575.0,630.0,,,0 CDM,278C1889S1_94752,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1575.0,630.0,,,0 CDM,278C1889S1_94899,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3592.01,1436.8,,,0 CDM,278C1889S1_94900,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,3497.01,1398.8,,,0 CDM,278C1889S1_95057,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1345.07,538.03,,,0 CDM,278C1889S1_95058,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,1345.47,538.19,,,0 CDM,278C1889S1_95076,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,196.88,78.75,,,0 CDM,278C1889S1_95290,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,787.5,315.0,,,0 CDM,278C1889S1_95291,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,787.5,315.0,,,0 CDM,278C1889S1_95292,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,787.5,315.0,,,0 CDM,278C1889S1_95293,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,787.5,315.0,,,0 CDM,278C1889S1_95294,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,787.5,315.0,,,0 CDM,278C1889S1_95295,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,787.5,315.0,,,0 CDM,278C1889S1_95296,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,787.5,315.0,,,0 CDM,278C1889S1_95297,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,787.5,315.0,,,0 CDM,278C1889S1_95298,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,787.5,315.0,,,0 CDM,278C1889S1_95299,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,787.5,315.0,,,0 CDM,278C1889S1_95301,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,787.5,315.0,,,0 CDM,278C1889S1_95302,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,787.5,315.0,,,0 CDM,278C1889S1_95304,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,787.5,315.0,,,0 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CDM,278C1894S1_175850,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,141.18,56.47,,,0 CDM,278C1894S1_175853,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,124.69,49.88,,,0 CDM,278C1894S1_175856,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,118.12,47.25,,,0 CDM,278C1894S1_178758,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,192.94,77.18,,,0 CDM,278C1894S1_183934,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,403.47,161.39,,,0 CDM,278C1894S1_187467,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,456.44,182.58,,,0 CDM,278C1894S1_188658,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,3059.44,1223.78,,,0 CDM,278C1894S1_188659,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,3835.12,1534.05,,,0 CDM,278C1894S1_188660,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,3835.12,1534.05,,,0 CDM,278C1894S1_196158,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,3835.12,1534.05,,,0 CDM,278C1894S1_84218,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,1279.69,511.88,,,0 CDM,278C1894S1_84219,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,322.71,129.08,,,0 CDM,278C1894S1_84220,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,1377.34,550.94,,,0 CDM,278C1894S1_86416,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,172.23,68.89,,,0 CDM,278C1894S1_90603,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,232.31,92.92,,,0 CDM,278C1894S1_92716,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,1030.29,412.12,,,0 CDM,278C1894S1_92717,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,1030.29,412.12,,,0 CDM,278C1894S1_93678,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,486.48,194.59,,,0 CDM,278C1894S1_93679,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,474.08,189.63,,,0 CDM,278C1894S1_94575,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,79.41,31.76,,,0 CDM,278C1894S1_94578,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,120.45,48.18,,,0 CDM,278C1894S1_95275,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,563.15,225.26,,,0 CDM,278C1894S1_95285,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,126.0,50.4,,,0 CDM,278C1894S1_95551,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,232.31,92.92,,,0 CDM,278C1894S1_95553,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,232.31,92.92,,,0 CDM,278C1894S1_96199,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,212.62,85.05,,,0 CDM,278C1894S1_C1894_278,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,223.45,89.38,,,0 CDM,278C1895S1_155027,Hc Sup Shell 278 Revenue Code C1895 Hcpcs,11812.5,4725.0,,,0 CDM,278C1895S1_155028,Hc Sup Shell 278 Revenue Code C1895 Hcpcs,11812.5,4725.0,,,0 CDM,278C1895S1_155029,Hc Sup Shell 278 Revenue Code C1895 Hcpcs,11812.5,4725.0,,,0 CDM,278C1895S1_155030,Hc Sup Shell 278 Revenue Code C1895 Hcpcs,11812.5,4725.0,,,0 CDM,278C1895S1_158753,Hc Sup Shell 278 Revenue Code C1895 Hcpcs,10434.38,4173.75,,,0 CDM,278C189701,Hc Lead Trial 50Cm Sap#229261,4725.0,1890.0,,,0 CDM,278C189701_C1897_278,Hc Lead Trial 50Cm Sap#229261,4725.0,1890.0,,,0 CDM,278C189703,"Hc Lead Perc Trial 8 El 60Cm, Sap#145086",2362.5,945.0,,,0 CDM,278C189703_C1897_278,"Hc Lead Perc Trial 8 El 60Cm, Sap#145086",2362.5,945.0,,,0 CDM,278C189704,"Hc Lead Implant Axonics Sacral Neurostim Pne, 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Hcpcs,401.62,160.65,,,0 CDM,278C2617S1_138507,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,378.0,151.2,,,0 CDM,278C2617S1_138508,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,370.12,148.05,,,0 CDM,278C2617S1_138509,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,378.72,151.49,,,0 CDM,278C2617S1_145794,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,244.12,97.65,,,0 CDM,278C2617S1_145795,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,217.89,87.16,,,0 CDM,278C2617S1_145796,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,236.25,94.5,,,0 CDM,278C2617S1_145804,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,244.12,97.65,,,0 CDM,278C2617S1_145805,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,244.12,97.65,,,0 CDM,278C2617S1_145806,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,236.25,94.5,,,0 CDM,278C2617S1_145807,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,244.12,97.65,,,0 CDM,278C2617S1_145808,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,244.12,97.65,,,0 CDM,278C2617S1_145811,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,244.12,97.65,,,0 CDM,278C2617S1_147221,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,244.12,97.65,,,0 CDM,278C2617S1_147222,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,244.12,97.65,,,0 CDM,278C2617S1_147224,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,244.12,97.65,,,0 CDM,278C2617S1_147228,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,244.12,97.65,,,0 CDM,278C2617S1_147229,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,244.12,97.65,,,0 CDM,278C2617S1_147230,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,244.12,97.65,,,0 CDM,278C2617S1_147231,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,244.12,97.65,,,0 CDM,278C2617S1_147232,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,244.12,97.65,,,0 CDM,278C2617S1_147234,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,244.12,97.65,,,0 CDM,278C2617S1_147235,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,244.12,97.65,,,0 CDM,278C2617S1_173791,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,128.28,51.31,,,0 CDM,278C2617S1_173792,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,129.82,51.93,,,0 CDM,278C2617S1_185648,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,836.34,334.54,,,0 CDM,278C2617S1_185649,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,853.59,341.44,,,0 CDM,278C2617S1_185650,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,850.99,340.4,,,0 CDM,278C2617S1_185651,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,870.26,348.1,,,0 CDM,278C2617S1_185652,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,783.56,313.42,,,0 CDM,278C2617S1_185653,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,832.77,333.11,,,0 CDM,278C2617S1_185654,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,819.26,327.7,,,0 CDM,278C2617S1_185655,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,808.85,323.54,,,0 CDM,278C2617S1_186211,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,295.63,118.25,,,0 CDM,278C2617S1_190236,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,295.63,118.25,,,0 CDM,278C2617S1_194523,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,783.56,313.42,,,0 CDM,278C2617S1_84758,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,332.55,133.02,,,0 CDM,278C2617S1_87213,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,492.19,196.88,,,0 CDM,278C2617S1_87214,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,480.73,192.29,,,0 CDM,278C2617S1_87215,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,480.73,192.29,,,0 CDM,278C2617S1_87394,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,492.19,196.88,,,0 CDM,278C2617S1_87395,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,492.19,196.88,,,0 CDM,278C2617S1_90890,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,321.29,128.52,,,0 CDM,278C2617S1_90891,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,324.34,129.74,,,0 CDM,278C2617S1_90892,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,337.65,135.06,,,0 CDM,278C2617S1_90893,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,318.65,127.46,,,0 CDM,278C2617S1_91241,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,318.65,127.46,,,0 CDM,278C2617S1_91731,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,492.19,196.88,,,0 CDM,278C2617S1_91975,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,426.63,170.65,,,0 CDM,278C2617S1_91976,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,426.63,170.65,,,0 CDM,278C2617S1_C2617_278,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,622.55,249.02,,,0 CDM,278C2618S1_119336,Hc Sup Shell 278 Revenue Code C2618 Hcpcs,9174.38,3669.75,,,0 CDM,278C2618S1_150508,Hc Sup Shell 278 Revenue Code C2618 Hcpcs,9154.69,3661.88,,,0 CDM,278C2618S1_172532,Hc Sup Shell 278 Revenue Code C2618 Hcpcs,5752.49,2301.0,,,0 CDM,278C2618S1_191178,Hc Sup Shell 278 Revenue Code C2618 Hcpcs,10040.62,4016.25,,,0 CDM,278C2621S1_C2621_278,Hc Sup Shell 278 Revenue Code Hcpcs C2621,22591.41,9036.56,,,0 CDM,278C2622S1_C2622_278,Hc Sup Shell 278 Revenue Code C2622 Hcpcs,45032.2,18012.88,,,0 CDM,278C2623S1_134384,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,5866.88,2346.75,,,0 CDM,278C2623S1_134385,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,6457.5,2583.0,,,0 CDM,278C2623S1_134387,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,5866.88,2346.75,,,0 CDM,278C2623S1_134388,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,6457.5,2583.0,,,0 CDM,278C2623S1_134390,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,5866.88,2346.75,,,0 CDM,278C2623S1_134869,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,7048.12,2819.25,,,0 CDM,278C2623S1_134870,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,7048.12,2819.25,,,0 CDM,278C2623S1_138168,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,5866.88,2346.75,,,0 CDM,278C2623S1_138169,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,5866.88,2346.75,,,0 CDM,278C2623S1_138170,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,5866.88,2346.75,,,0 CDM,278C2623S1_155309,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,6496.88,2598.75,,,0 CDM,278C2623S1_155310,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,6496.88,2598.75,,,0 CDM,278C2623S1_155316,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,6496.88,2598.75,,,0 CDM,278C2623S1_155317,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,6496.88,2598.75,,,0 CDM,278C2623S1_161254,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,7678.12,3071.25,,,0 CDM,278C2623S1_161255,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,7678.12,3071.25,,,0 CDM,278C2623S1_161256,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,7678.12,3071.25,,,0 CDM,278C2623S1_161257,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,6496.88,2598.75,,,0 CDM,278C2623S1_161258,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,6496.88,2598.75,,,0 CDM,278C2623S1_161259,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,7678.12,3071.25,,,0 CDM,278C2623S1_161260,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,7678.12,3071.25,,,0 CDM,278C2623S1_178691,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,6693.75,2677.5,,,0 CDM,278C2623S1_178774,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,9883.12,3953.25,,,0 CDM,278C2623S1_178775,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,9883.12,3953.25,,,0 CDM,278C2623S1_178887,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,6693.75,2677.5,,,0 CDM,278C2623S1_178888,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,6693.75,2677.5,,,0 CDM,278C2623S1_178889,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,6693.75,2677.5,,,0 CDM,278C2623S1_178890,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,6693.75,2677.5,,,0 CDM,278C2623S1_178891,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,7067.81,2827.12,,,0 CDM,278C2623S1_178893,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,8662.5,3465.0,,,0 CDM,278C2623S1_178895,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,6693.75,2677.5,,,0 CDM,278C2623S1_178896,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,6693.75,2677.5,,,0 CDM,278C2623S1_178897,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,7067.81,2827.12,,,0 CDM,278C2623S1_178899,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,8662.5,3465.0,,,0 CDM,278C2623S1_178900,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,6693.75,2677.5,,,0 CDM,278C2623S1_178901,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,6693.75,2677.5,,,0 CDM,278C2623S1_178902,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,6693.75,2677.5,,,0 CDM,278C2623S1_178903,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,6693.75,2677.5,,,0 CDM,278C2623S1_178906,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,8662.5,3465.0,,,0 CDM,278C2623S1_178907,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,6693.75,2677.5,,,0 CDM,278C2623S1_178908,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,6693.75,2677.5,,,0 CDM,278C2623S1_178913,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,8662.5,3465.0,,,0 CDM,278C2623S1_179066,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,5866.88,2346.75,,,0 CDM,278C2623S1_179067,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,5866.88,2346.75,,,0 CDM,278C2623S1_179069,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,8839.69,3535.88,,,0 CDM,278C2623S1_179070,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,9725.62,3890.25,,,0 CDM,278C2623S1_179071,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,8111.25,3244.5,,,0 CDM,278C2623S1_179072,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,9725.62,3890.25,,,0 CDM,278C2623S1_179073,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,8839.69,3535.88,,,0 CDM,278C2623S1_179074,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,9725.62,3890.25,,,0 CDM,278C2624S1_134457,Hc Sup Shell 278 Revenue Code C2624 Hcpcs,84384.56,33753.82,,,0 CDM,278C2625S1_130966,Hc Sup Shell 278 Revenue Code C2625 Hcpcs,3130.31,1252.12,,,0 CDM,278C2625S1_130967,Hc Sup Shell 278 Revenue Code C2625 Hcpcs,3130.31,1252.12,,,0 CDM,278C2625S1_144523,Hc Sup Shell 278 Revenue Code C2625 Hcpcs,3216.94,1286.78,,,0 CDM,278C2625S1_145797,Hc Sup Shell 278 Revenue Code C2625 Hcpcs,511.88,204.75,,,0 CDM,278C2625S1_145798,Hc Sup Shell 278 Revenue Code C2625 Hcpcs,511.88,204.75,,,0 CDM,278C2625S1_145815,Hc Sup Shell 278 Revenue Code C2625 Hcpcs,511.88,204.75,,,0 CDM,278C2625S1_147226,Hc Sup Shell 278 Revenue Code C2625 Hcpcs,507.94,203.18,,,0 CDM,278C2625S1_147227,Hc Sup Shell 278 Revenue Code C2625 Hcpcs,511.88,204.75,,,0 CDM,278C2625S1_84765,Hc Sup Shell 278 Revenue Code C2625 Hcpcs,862.31,344.92,,,0 CDM,278C2625S1_85376,Hc Sup Shell 278 Revenue Code C2625 Hcpcs,748.12,299.25,,,0 CDM,278C2625S1_91200,Hc Sup Shell 278 Revenue Code C2625 Hcpcs,266.52,106.61,,,0 CDM,278C2625S1_92845,Hc Sup Shell 278 Revenue Code C2625 Hcpcs,518.61,207.44,,,0 CDM,278C2625S1_93669,Hc Sup Shell 278 Revenue Code C2625 Hcpcs,4327.78,1731.11,,,0 CDM,278C2625S1_93670,Hc Sup Shell 278 Revenue Code C2625 Hcpcs,4327.78,1731.11,,,0 CDM,278C2628S1_134871,Hc Sup Shell 278 Revenue Code C2628 Hcpcs,3661.88,1464.75,,,0 CDM,278C2628S1_138629,Hc Sup Shell 278 Revenue Code C2628 Hcpcs,4921.88,1968.75,,,0 CDM,278C2628S1_138641,Hc Sup Shell 278 Revenue Code C2628 Hcpcs,4921.88,1968.75,,,0 CDM,278C2628S1_138738,Hc Sup Shell 278 Revenue Code C2628 Hcpcs,5138.63,2055.45,,,0 CDM,278C2628S1_138739,Hc Sup Shell 278 Revenue Code C2628 Hcpcs,4685.62,1874.25,,,0 CDM,278C2628S1_138740,Hc Sup Shell 278 Revenue Code C2628 Hcpcs,5266.4,2106.56,,,0 CDM,278C2628S1_138741,Hc Sup Shell 278 Revenue Code C2628 Hcpcs,6400.9,2560.36,,,0 CDM,278C2628S1_180248,Hc Sup Shell 278 Revenue Code C2628 Hcpcs,11927.18,4770.87,,,0 CDM,278C2628S1_183278,Hc Sup Shell 278 Revenue Code C2628 Hcpcs,2086.88,834.75,,,0 CDM,278C2628S1_84411,Hc Sup Shell 278 Revenue Code C2628 Hcpcs,376.3,150.52,,,0 CDM,278C2628S1_84412,Hc Sup Shell 278 Revenue Code C2628 Hcpcs,395.06,158.02,,,0 CDM,278C2628S1_91842,Hc Sup Shell 278 Revenue Code C2628 Hcpcs,1884.1,753.64,,,0 CDM,278C2629S1_134491,Hc Sup Shell 278 Revenue Code C2629 Hcpcs,12299.06,4919.62,,,0 CDM,278C2629S1_134492,Hc Sup Shell 278 Revenue Code C2629 Hcpcs,12317.43,4926.97,,,0 CDM,278C2629S1_134493,Hc Sup Shell 278 Revenue Code C2629 Hcpcs,12324.38,4929.75,,,0 CDM,278C2630S1_134516,Hc Sup Shell 278 Revenue Code C2630 Hcpcs,6087.38,2434.95,,,0 CDM,278C2630S1_136670,Hc Sup Shell 278 Revenue Code C2630 Hcpcs,12544.88,5017.95,,,0 CDM,278C2631S1_95279,Hc Sup Shell 278 Revenue Code C2631 Hcpcs,1755.46,702.18,,,0 CDM,278C263801,Hc Brachy Source Strand Iodin125,0.01,0.004,,,0 CDM,278C263801_C2638_278,Hc Brachy Source Strand Iodin125,442.53,177.01,,,0 CDM,278C264302,Hc Cesium 131 Non-Stranded,232.31,92.92,,,0 CDM,278C264302_C2643_278,Hc Cesium 131 Non-Stranded,363.68,145.47,,,0 CDM,278C9250S1_120138,Hc Sup Shell 278 Revenue Code C9250 Hcpcs,2753.9,1101.56,,,0 CDM,278C9250S1_120139,Hc Sup Shell 278 Revenue Code C9250 Hcpcs,2791.88,1116.75,,,0 CDM,278C9250S1_137883,Hc Sup Shell 278 Revenue Code C9250 Hcpcs,3411.85,1364.74,,,0 CDM,278C9250S1_137884,"Artiss Fibrin Sealant: 1 Syringe, Plastic In 1 Carton (0338-8503-10) / 10 Ml In 1 Syringe, Plastic (0338-8503-09)",1451.81,580.72,,,0 CDM,278C9250S1_137917,Hc Sup Shell 278 Revenue Code C9250 Hcpcs,1768.52,707.41,,,0 CDM,278C9250S1_137959,Hc Sup Shell 278 Revenue Code C9250 Hcpcs,812.15,324.86,,,0 CDM,278C9250S1_150419,Hc Sup Shell 278 Revenue Code C9250 Hcpcs,1098.45,439.38,,,0 CDM,278C9250S1_150420,"Artiss Fibrin Sealant: 2 Ml In 1 Syringe, Plastic (0338-9637-01)",2567.21,1026.88,,,0 CDM,278C9250S1_92035,Hc Sup Shell 278 Revenue Code C9250 Hcpcs,401.62,160.65,,,0 CDM,278C9610S1_196018,Hc Sup Shell 278 Revenue Code C9610 Hcpcs,24314.06,9725.62,,,0 CDM,278C9610S1_C9610_278,Hc Sup Shell 278 Revenue Code C9610 Hcpcs,24314.06,9725.62,,,0 CDM,278C9728S1_183115,Hc Sup Shell 278 Revenue Code C9728 Hcpcs,1673.44,669.38,,,0 CDM,278L8600S1_115546,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,3484.69,1393.88,,,0 CDM,278L8600S1_136322,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,3484.69,1393.88,,,0 CDM,278L8600S1_136323,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,3484.69,1393.88,,,0 CDM,278L8600S1_143232,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,4725.0,1890.0,,,0 CDM,278L8600S1_143234,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,4725.0,1890.0,,,0 CDM,278L8600S1_143235,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,4725.0,1890.0,,,0 CDM,278L8600S1_143236,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,4725.0,1890.0,,,0 CDM,278L8600S1_143237,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,4725.0,1890.0,,,0 CDM,278L8600S1_143238,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,4725.0,1890.0,,,0 CDM,278L8600S1_143239,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,4725.0,1890.0,,,0 CDM,278L8600S1_143339,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,4725.0,1890.0,,,0 CDM,278L8600S1_158582,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,4311.56,1724.62,,,0 CDM,278L8600S1_158584,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,4232.81,1693.12,,,0 CDM,278L8600S1_158588,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,4285.31,1714.12,,,0 CDM,278L8600S1_158594,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,4245.94,1698.38,,,0 CDM,278L8600S1_158596,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,4295.81,1718.32,,,0 CDM,278L8600S1_158598,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,4239.66,1695.86,,,0 CDM,278L8600S1_158600,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,4232.81,1693.12,,,0 CDM,278L8600S1_164298,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,4725.0,1890.0,,,0 CDM,278L8600S1_164299,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,4725.0,1890.0,,,0 CDM,278L8600S1_185731,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,761.25,304.5,,,0 CDM,278L8600S1_185732,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,767.81,307.12,,,0 CDM,278L8600S1_185869,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,787.5,315.0,,,0 CDM,278L8600S1_188898,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,2500.31,1000.12,,,0 CDM,278L8600S1_189031,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,787.5,315.0,,,0 CDM,278L8600S1_190372,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,787.5,315.0,,,0 CDM,278L8600S1_191558,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,3346.88,1338.75,,,0 CDM,278L8600S1_192629,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,3346.88,1338.75,,,0 CDM,278L8600S1_192631,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,787.5,315.0,,,0 CDM,278L8600S1_197311,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,787.5,315.0,,,0 CDM,278L8600S1_197312,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,787.5,315.0,,,0 CDM,278L8600S1_197313,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,787.5,315.0,,,0 CDM,278L8600S1_197314,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,787.5,315.0,,,0 CDM,278L8600S1_197893,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,787.5,315.0,,,0 CDM,278L8600S1_197894,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,787.5,315.0,,,0 CDM,278L8604S1_119694,Hc Sup Shell 278 Revenue Code L8604 Hcpcs,13013.44,5205.38,,,0 CDM,278L8606S1_175306,Hc Sup Shell 278 Revenue Code L8606 Hcpcs,4528.12,1811.25,,,0 CDM,278L8610S1_91202,Hc Sup Shell 278 Revenue Code L8610 Hcpcs,704.81,281.92,,,0 CDM,278L8610S1_L8610_278,Hc Sup Shell 278 Revenue Code L8610 Hcpcs,79852.5,31941.0,,,0 CDM,278L861305,Hc Triune Tympanostomy .76Mm Sap#177070,500.07,200.03,,,0 CDM,278L8613S1_119759,Hc Sup Shell 278 Revenue Code L8613 Hcpcs,1343.2,537.28,,,0 CDM,278L8613S1_119760,Hc Sup Shell 278 Revenue Code L8613 Hcpcs,1343.2,537.28,,,0 CDM,278L8613S1_119764,Hc Sup Shell 278 Revenue Code L8613 Hcpcs,1478.25,591.3,,,0 CDM,278L8613S1_119766,Hc Sup Shell 278 Revenue Code L8613 Hcpcs,1277.52,511.01,,,0 CDM,278L8613S1_119767,Hc Sup Shell 278 Revenue Code L8613 Hcpcs,1646.15,658.46,,,0 CDM,278L8613S1_119768,Hc Sup Shell 278 Revenue Code L8613 Hcpcs,492.74,197.1,,,0 CDM,278L8613S1_131018,Hc Sup Shell 278 Revenue Code L8613 Hcpcs,100.01,40.0,,,0 CDM,278L8613S1_171289,Hc Sup Shell 278 Revenue Code L8613 Hcpcs,2048.29,819.32,,,0 CDM,278L8613S1_182971,Hc Sup Shell 278 Revenue Code L8613 Hcpcs,1488.38,595.35,,,0 CDM,278L8613S1_182972,Hc Sup Shell 278 Revenue Code L8613 Hcpcs,1488.38,595.35,,,0 CDM,278L8613S1_88823,Hc Sup Shell 278 Revenue Code L8613 Hcpcs,1144.16,457.66,,,0 CDM,278L8613S1_88824,Hc Sup Shell 278 Revenue Code L8613 Hcpcs,1144.16,457.66,,,0 CDM,278L8613S1_88825,Hc Sup Shell 278 Revenue Code L8613 Hcpcs,1144.16,457.66,,,0 CDM,278L8614S1_118725,Hc Sup Shell 278 Revenue Code L8614 Hcpcs,73324.12,29329.65,,,0 CDM,278L8614S1_119679,Hc Sup Shell 278 Revenue Code L8614 Hcpcs,5230.58,2092.23,,,0 CDM,278L8614S1_119681,Hc Sup Shell 278 Revenue Code L8614 Hcpcs,597.32,238.93,,,0 CDM,278L8614S1_119686,Hc Sup Shell 278 Revenue Code L8614 Hcpcs,46659.38,18663.75,,,0 CDM,278L8614S1_119687,Hc Sup Shell 278 Revenue Code L8614 Hcpcs,46659.38,18663.75,,,0 CDM,278L8614S1_119688,Hc Sup Shell 278 Revenue Code L8614 Hcpcs,71121.09,28448.44,,,0 CDM,278L8614S1_119690,Hc Sup Shell 278 Revenue Code L8614 Hcpcs,67449.38,26979.75,,,0 CDM,278L8614S1_119745,Hc Sup Shell 278 Revenue Code L8614 Hcpcs,48628.96,19451.58,,,0 CDM,278L8614S1_180591,Hc Sup Shell 278 Revenue Code L8614 Hcpcs,48628.12,19451.25,,,0 CDM,278L8614S1_188230,Hc Sup Shell 278 Revenue Code L8614 Hcpcs,46659.38,18663.75,,,0 CDM,278L8614S1_193396,Hc Sup Shell 278 Revenue Code L8614 Hcpcs,60427.51,24171.0,,,0 CDM,278L8614S1_193397,Hc Sup Shell 278 Revenue Code L8614 Hcpcs,60134.17,24053.67,,,0 CDM,278L8630S1_193190,Hc Sup Shell 278 Revenue Code L8630 Hcpcs,4519.58,1807.83,,,0 CDM,278L8630S1_94835,Hc Sup Shell 278 Revenue Code L8630 Hcpcs,4463.75,1785.5,,,0 CDM,278L8630S1_94836,Hc Sup Shell 278 Revenue Code L8630 Hcpcs,4463.75,1785.5,,,0 CDM,278L8641S1_L8641_278,Hc Sup Shell 278 Revenue Code L8641 Hcpcs,68797.97,27519.19,,,0 CDM,278L8670S1_115650,Hc Sup Shell 278 Revenue Code L8670 Hcpcs,2110.64,844.26,,,0 CDM,278L8670S1_142658,Hc Sup Shell 278 Revenue Code L8670 Hcpcs,1937.05,774.82,,,0 CDM,278L8670S1_142734,Hc Sup Shell 278 Revenue Code L8670 Hcpcs,1958.91,783.56,,,0 CDM,278L8670S1_142753,Hc Sup Shell 278 Revenue Code L8670 Hcpcs,2265.64,906.26,,,0 CDM,278L8670S1_188791,Hc Sup Shell 278 Revenue Code L8670 Hcpcs,15789.38,6315.75,,,0 CDM,278L868001,Hc Kit Procedure Single Lead Sprint Pns Sap#261717,19293.75,7717.5,,,0 CDM,278L868001_C1778_278,Hc Kit Procedure Single Lead Sprint Pns Sap#261717,19293.75,7717.5,,,0 CDM,278L868001_L8680_278,Hc Kit Procedure Single Lead Sprint Pns Sap#261717,19293.75,7717.5,,,0 CDM,278L8690S1_119680,Hc Sup Shell 278 Revenue Code L8690 Hcpcs,5230.58,2092.23,,,0 CDM,278L8690S1_130995,Hc Sup Shell 278 Revenue Code L8690 Hcpcs,10784.02,4313.61,,,0 CDM,278L8690S1_130996,Hc Sup Shell 278 Revenue Code L8690 Hcpcs,10784.02,4313.61,,,0 CDM,278L8690S1_130997,Hc Sup Shell 278 Revenue Code L8690 Hcpcs,10784.02,4313.61,,,0 CDM,278L8690S1_155343,Hc Sup Shell 278 Revenue Code L8690 Hcpcs,21498.75,8599.5,,,0 CDM,278L8690S1_164621,Hc Sup Shell 278 Revenue Code L8690 Hcpcs,13657.61,5463.04,,,0 CDM,278L8690S1_164622,Hc Sup Shell 278 Revenue Code L8690 Hcpcs,13657.61,5463.04,,,0 CDM,278L8690S1_164623,Hc Sup Shell 278 Revenue Code L8690 Hcpcs,13657.61,5463.04,,,0 CDM,278L8690S1_164624,Hc Sup Shell 278 Revenue Code L8690 Hcpcs,13657.61,5463.04,,,0 CDM,278L8690S1_165347,Hc Sup Shell 278 Revenue Code L8690 Hcpcs,19707.19,7882.88,,,0 CDM,278L8690S1_189044,Hc Sup Shell 278 Revenue Code L8690 Hcpcs,18683.44,7473.38,,,0 CDM,278L8690S1_189045,Hc Sup Shell 278 Revenue Code L8690 Hcpcs,17462.81,6985.12,,,0 CDM,278L8691S1_165345,Hc Sup Shell 278 Revenue Code L8691 Hcpcs,29286.47,11714.59,,,0 CDM,278L8691S1_165346,Hc Sup Shell 278 Revenue Code L8691 Hcpcs,28463.11,11385.24,,,0 CDM,278L8691S1_165348,Hc Sup Shell 278 Revenue Code L8691 Hcpcs,19707.19,7882.88,,,0 CDM,278L8691S1_189045,Hc Sup Shell 278 Revenue Code L8691 Hcpcs,19957.5,7983.0,,,0 CDM,278L8699S1_142643,Hc Sup Shell 278 Revenue Code L8699 Hcpcs,9863.44,3945.38,,,0 CDM,278L8699S1_142644,Hc Sup Shell 278 Revenue Code L8699 Hcpcs,9863.44,3945.38,,,0 CDM,278L8699S1_145891,Hc Sup Shell 278 Revenue Code L8699 Hcpcs,492.19,196.88,,,0 CDM,278Q0481S1_137270,Hc Sup Shell 278 Revenue Code Q0481 Hcpcs,424931.06,169972.42,,,0 CDM,278Q050801,Hc Cable Heartmate 3 Lvad Mod Sap#218198,21049.88,8419.95,,,0 CDM,278Q050801_Q0508_278,Hc Cable Heartmate 3 Lvad Mod Sap#218198,21049.88,8419.95,,,0 CDM,278Q050802,"Hc Heartware Alarm Adapter, Sap#263443",1082.81,433.12,,,0 CDM,278Q4100S1_137849,Hc Sup Shell 278 Revenue Code Q4100 Hcpcs,1695.33,678.13,,,0 CDM,278Q4100S1_137901,Hc Sup Shell 278 Revenue Code Q4100 Hcpcs,3883.32,1553.33,,,0 CDM,278Q4100S1_Q4100_278,Hc Sup Shell 278 Revenue Code Q4100 Hcpcs,13840.31,5536.12,,,0 CDM,278Q4101S1_158812,NDC Description Not Available,4781.25,1912.5,,,0 CDM,278Q4101S1_Q4101_278,Hc Sup Shell 278 Revenue Code Q4101 Hcpcs,5020.31,2008.12,,,0 CDM,278Q4105S1_137887,Hc Sup Shell 278 Revenue Code Q4105 Hcpcs,21045.71,8418.28,,,0 CDM,278Q4105S1_137967,Hc Sup Shell 278 Revenue Code Q4105 Hcpcs,7412.04,2964.82,,,0 CDM,278Q4105S1_137968,Hc Sup Shell 278 Revenue Code Q4105 Hcpcs,13577.75,5431.1,,,0 CDM,278Q4122S1_150460,Hc Sup Shell 278 Revenue Code Q4122 Hcpcs,15034.25,6013.7,,,0 CDM,278Q4122S1_150704,Hc Sup Shell 278 Revenue Code Q4122 Hcpcs,15034.25,6013.7,,,0 CDM,278Q4122S1_169187,Hc Sup Shell 278 Revenue Code Q4122 Hcpcs,15034.25,6013.7,,,0 CDM,278Q4122S1_187451,Hc Sup Shell 278 Revenue Code Q4122 Hcpcs,0.04,0.02,,,0 CDM,278Q4122S1_187459,Hc Sup Shell 278 Revenue Code Q4122 Hcpcs,0.04,0.02,,,0 CDM,278Q4122S1_187465,Hc Sup Shell 278 Revenue Code Q4122 Hcpcs,0.04,0.02,,,0 CDM,278Q4128S1_Q4128_278,Hc Sup Shell 278 Revenue Code Q4128 Hcpcs,4921.88,1968.75,,,0 CDM,278Q4130S1_119438,Hc Sup Shell 278 Revenue Code Q4130 Hcpcs,94976.44,37990.58,,,0 CDM,278Q4130S1_137807,Hc Sup Shell 278 Revenue Code Q4130 Hcpcs,56987.44,22794.98,,,0 CDM,278Q4130S1_137880,Hc Sup Shell 278 Revenue Code Q4130 Hcpcs,15194.81,6077.92,,,0 CDM,278Q4130S1_137881,Hc Sup Shell 278 Revenue Code Q4130 Hcpcs,30393.56,12157.42,,,0 CDM,278Q4130S1_137882,Hc Sup Shell 278 Revenue Code Q4130 Hcpcs,37989.0,15195.6,,,0 CDM,278Q4130S1_137893,Hc Sup Shell 278 Revenue Code Q4130 Hcpcs,9497.25,3798.9,,,0 CDM,278Q4130S1_183589,Hc Sup Shell 278 Revenue Code Q4130 Hcpcs,85479.19,34191.68,,,0 CDM,278Q4196S1_158822,Hc Sup Shell 278 Revenue Code Q4196 Hcpcs,3543.75,1417.5,,,0 CDM,278Q4196S1_158823,Hc Sup Shell 278 Revenue Code Q4196 Hcpcs,10237.5,4095.0,,,0 CDM,278Q4196S1_158824,Hc Sup Shell 278 Revenue Code Q4196 Hcpcs,20199.38,8079.75,,,0 CDM,278Q4196S1_199662,Hc Sup Shell 278 Revenue Code Q4196 Hcpcs,3543.75,1417.5,,,0 CDM,278V2785S1_153201,Hc Sup Shell 278 Revenue Code V2785 Hcpcs,20415.94,8166.38,,,0 CDM,278V2785S1_198002,Hc Sup Shell 278 Revenue Code V2785 Hcpcs,14568.75,5827.5,,,0 CDM,278V2785S1_198007,Hc Sup Shell 278 Revenue Code V2785 Hcpcs,18250.31,7300.12,,,0 CDM,278V2785S1_86423,Hc Sup Shell 278 Revenue Code V2785 Hcpcs,14568.75,5827.5,,,0 CDM,278V2785S1_93687,Hc Sup Shell 278 Revenue Code V2785 Hcpcs,18250.31,7300.12,,,0 CDM,278V2788S1_V2788_278,Hc Sup Shell 278 Revenue Code V2788 Hcpcs,3839.06,1535.62,,,0 CDM,278V2790S1_138155,Hc Sup Shell 278 Revenue Code V2790 Hcpcs,2287.69,915.08,,,0 CDM,278V2790S1_138156,Hc Sup Shell 278 Revenue Code V2790 Hcpcs,2870.44,1148.18,,,0 CDM,278V2790S1_138158,Hc Sup Shell 278 Revenue Code V2790 Hcpcs,4343.06,1737.22,,,0 CDM,278V2790S1_198009,Hc Sup Shell 278 Revenue Code V2790 Hcpcs,2287.69,915.08,,,0 CDM,278V2790S1_198012,Hc Sup Shell 278 Revenue Code V2790 Hcpcs,3189.38,1275.75,,,0 CDM,3000000003,Hc Executive Health Psa,169.0,67.6,,,0 CDM,3000000004,Hc Bone Marrow Miscellaneous,21876.89,8750.76,,,0 CDM,3000000005,Hc Executive Health A1C,84.5,33.8,,,0 CDM,3000000006,Hc Executive Health Check,52.0,20.8,,,0 CDM,3000000008,Hc Head Only Outside Autopsy,747.5,299.0,,,0 CDM,3000000009,Hc Body Outside Autopsy,1121.25,448.5,,,0 CDM,3000000010,Hc Complete Outside Autopsy,1868.75,747.5,,,0 CDM,30000014BB,Hc 5 Pack Cryo Charge Panel,292.0,116.8,,,0 CDM,3000035U01,Hc Reflex Prion Markers Rt-Quic 3019868-So+,691.19,276.48,,,0 CDM,3000539T01,Hc Research Car-T Ip Storage & Administration,6597.55,2639.02,,,0 CDM,3000539T02,Hc Res-Car-T Rec&Prep,4005.66,1602.26,,,0 CDM,3003641501,"Hc Chg Collection Venous Blood,Venipuncture - Draw Charge",36.0,14.4,,,0 CDM,3003641502,"Hc Collection Venous Blood,Venipuncture - Bundled Charge",36.0,14.4,,,0 CDM,3003641601,Hc Collection Capillary Blood Specimen,27.0,10.8,,,0 CDM,3003641602,Hc Collection Capillary Blood Specimen - Bundled Charge,36.0,14.4,,,0 CDM,3003659101,Hc Chg Collect Blood From Implant Venous Access Device - Draw Charge,515.71,206.28,,,0 CDM,3003659201,Hc Chg Collect Blood From Catheter Venous Nos - Draw Charge,421.95,168.78,,,0 CDM,3007010901,Hc Testos F/T/Shbg Male-So+,11.0,4.4,,,0 CDM,3008004701,Hc Poct I-Stat Chem8+,195.0,78.0,,,0 CDM,3008004801,Hc Basic Metabolic Panel Calcium Total - Bundled Charge,193.0,77.2,,,0 CDM,3008005101,Hc Electrolyte Panel - Bundled Charge,114.0,45.6,,,0 CDM,3008005301,"Hc Metabolic Panel,Comprehensive - Bundled Charge",289.0,115.6,,,0 CDM,3008006901,Hc Renal Function Panel - Bundled Charge,203.0,81.2,,,0 CDM,3008007401,"Hc Hepatitis Panel,Acute - Bundled Charge",455.0,182.0,,,0 CDM,3008007601,Hc Hepatic Function Panel - Bundled Charge,204.0,81.6,,,0 CDM,3008105001,Hc Volume Measure Timed Collect,46.0,18.4,,,0 CDM,3008122002,Hc Cftr Gene Analysis Common Variants - Cystic Fibrosis Gene Test,1436.02,574.41,,,0 CDM,3008122005,"Hc Cystic Fibrosis, 97 Variants 481025-So+",667.92,267.17,,,0 CDM,3008126801,Hc Chimerism W/Comp To Baseline W/Cell Selection Each - Additional Chg,3067.51,1227.0,,,0 CDM,3008141901,Hc Epilepsy Ngs Panel,4395.3,1758.12,,,0 CDM,3008159901,Hc Predictrpk Ifx Maintenance 3400-So+,858.0,343.2,,,0 CDM,3008159902,Hc Predictrpk Ada Maintenance 3700-#2 So+,858.0,343.2,,,0 CDM,3008159903,Hc Predictrpk Ifx Induction 3500-So+,858.0,343.2,,,0 CDM,3008202402,Hc Acth,202.72,81.09,,,0 CDM,3008204001,Hc Albumin,64.7,25.88,,,0 CDM,3008208803,Hc 074 Aldosterone Serum-So+,146.54,58.62,,,0 CDM,3008224701,Hc Bilirubin Total,76.56,30.62,,,0 CDM,3008224801,Hc Bilirubin Direct (Conjugated),99.21,39.68,,,0 CDM,3008230802,Hc 826 Calcitonin Serum-So+,96.34,38.54,,,0 CDM,3008230803,Hc 908 Calcitonin Serum-So+,96.34,38.54,,,0 CDM,3008231001,"Hc Assay Of Calcium, Total - Calcium",57.15,22.86,,,0 CDM,3008233001,"Hc Assay Of Calcium, Ionized - Calcium Ionized",207.04,82.82,,,0 CDM,3008237401,Hc Assay Blood Carbon Dioxide - Co2 Total,64.7,25.88,,,0 CDM,3008238402,Hc 959 Catecholamin Fracture Urine-So+,30.0,12.0,,,0 CDM,3008243501,Hc Assay Of Blood Chloride - Chloride,78.72,31.49,,,0 CDM,3008246502,"Hc Assay, Blood/Serum Cholesterol - Cholesterol Total",85.19,34.08,,,0 CDM,3008253004,Hc 281 Cortisol Urine-So+,60.08,24.03,,,0 CDM,3008253301,Hc Cortisol Total,240.47,96.19,,,0 CDM,3008253305,Hc 771 Cortisol Total-So+,42.37,16.95,,,0 CDM,3008253306,Hc 148 Cortisol Total-So+,58.63,23.45,,,0 CDM,3008253307,"Hc Cortisol, Serum 70030-So+",19.56,7.82,,,0 CDM,3008253308,"Hc Cortisol By Lc-Ms/Ms, Salivary 3016866-So+",45.6,18.24,,,0 CDM,3008256501,Hc Assay Of Creatinine - Creatinine Serum,80.87,32.35,,,0 CDM,3008263401,"Hc 11-Deoxycortisol Quantitative By Hplc-Ms/Ms, Serum Or Plasma 92331-So+",33.54,13.42,,,0 CDM,3008263402,Hc 168 11 Deoxycortisol-So+,105.29,42.12,,,0 CDM,3008263403,Hc 771 Deoxycortisol 11-So+,48.74,19.5,,,0 CDM,3008267084,Hc Estradiol Assay,229.68,91.87,,,0 CDM,3008267086,Hc 742 Estradiol Ultra Sens-So+,37.38,14.95,,,0 CDM,3008294702,Hc Poc- Gem 5000 Glucose,56.07,22.43,,,0 CDM,3008300102,Hc Gonadotropin (Fsh) - Fsh,271.74,108.7,,,0 CDM,3008300106,Hc 238 Gonadotropin (Fsh)-So+,26.74,10.7,,,0 CDM,3008300107,Hc Testicular Function Group 1-So+,32.4,12.96,,,0 CDM,3008300205,Hc Gonadotropin (Lh) - Luteinizing Hormone,256.64,102.66,,,0 CDM,3008300206,Hc 743 Lh Peds Sensitive-So+,30.22,12.09,,,0 CDM,3008300207,Hc Testicular Function Group 1 #2-So+,32.4,12.96,,,0 CDM,3008300302,Hc 182 Human Growth Hormone-So+,142.0,56.8,,,0 CDM,3008349802,Hc 771 Hydroxyprog 17-D-So+,42.37,16.95,,,0 CDM,3008349803,Hc 716 17 Hydroxyprogesterone-So+,97.7,39.08,,,0 CDM,3008349804,Hc 180 Hydroxyprogesterone-So+,57.72,23.09,,,0 CDM,3008349812,Hc 242 Cah State-So+,37.75,15.1,,,0 CDM,3008349816,Hc Congenital Adrenal Hyperplasia (Cah) Pediatric Profile One 5015568 #4-So+,64.39,25.76,,,0 CDM,3008349817,"Hc 17-Hydroxyprogesterone Quantitative By Hplc-Ms/Ms, Serum Or Plasma 92332-So+",32.6,13.04,,,0 CDM,3008352502,Hc 345 Insulin,180.08,72.03,,,0 CDM,3008405601,Hc Testos F/T/Shbg Fm/Chd-So+,20.0,8.0,,,0 CDM,3008407501,Hc Assay Alkaline Phosphatase - Alkaline Phosphatase,89.5,35.8,,,0 CDM,3008410001,Hc Phosphorus,89.5,35.8,,,0 CDM,3008413201,Hc Assay Of Serum Potassium - Potassium,73.33,29.33,,,0 CDM,3008414301,Hc 771 17 Hydroxypregnenolone-So+,42.37,16.95,,,0 CDM,3008414302,Hc 099 17 Hydroxypregnenolone-So+,49.2,19.68,,,0 CDM,3008415509,Hc 839 Protein Total-So+,13.2,5.28,,,0 CDM,3008424402,Hc 341 Renin Plasma-Soq+,26.39,10.56,,,0 CDM,3008431109,Hc 806 Bromide-So+,43.86,17.54,,,0 CDM,3008431176,Hc Assay Of Thyroglobulin - Thyroglobulin,189.78,75.91,,,0 CDM,3008431188,"Hc Adenosine Deaminase,Peritoneal Fluid",44.1,17.64,,,0 CDM,3008440301,Hc 490 Testosterone Total-So+,92.84,37.14,,,0 CDM,3008440302,Hc 494 Testosterone Total-So+,92.84,37.14,,,0 CDM,3008440306,Hc Testicular Function Group 1 #3-So+,32.4,12.96,,,0 CDM,3008440366,Hc Congenital Adrenal Hyperplasia (Cah) Pediatric Profile One 501568 #5-So+,64.39,25.76,,,0 CDM,3008444306,Hc 242 Tsh-So+,23.34,9.34,,,0 CDM,3008445001,Hc Ast,71.17,28.47,,,0 CDM,3008446001,Hc Alt,71.17,28.47,,,0 CDM,3008447801,Hc Triglyceride,84.11,33.64,,,0 CDM,3008447803,Hc 782 Triglycerides-So+,20.68,8.27,,,0 CDM,3008452002,Hc Bun Pre,80.87,32.35,,,0 CDM,3008452003,Hc Bun,80.87,32.35,,,0 CDM,3008500401,Hc Wbc Differential Automated,75.0,30.0,,,0 CDM,3008500701,"Hc Blood Smear,Micro Exam,Manual Diff Wbc - Manual Differential",59.0,23.6,,,0 CDM,3008502501,Hc Complete Cbc & Auto Diff Wbc,185.0,74.0,,,0 CDM,3008502701,Hc Hemogram W/O Differential,110.0,44.0,,,0 CDM,3008561201,Hc Rvv Screen Undiluted,322.0,128.8,,,0 CDM,3008561202,Hc Rvv Confirm Undiluted,322.0,128.8,,,0 CDM,3008607801,Hc Transfusion Reaction Investiga,379.5,151.8,,,0 CDM,3008615701,Hc Cold Agglutinin Titer-Arup-So+,16.84,6.74,,,0 CDM,3008659208,Hc 309 Syphilis Test Non Treponemal Antibody Qual - Vdrl Csf-So+,42.0,16.8,,,0 CDM,3008670901,"Hc Hepatitis Antibody Haab Igm Antibody - Hepatitis A Antibody, Igm",215.05,86.02,,,0 CDM,3008676201,Hc Rubella - Rubella Antibody,17.27,6.91,,,0 CDM,3008679128,Hc 715 Kbc 339 Cell Separatn-So+,172.2,68.88,,,0 CDM,3008685077,Hc Atypical Antibody Screen,201.34,80.54,,,0 CDM,3008686001,Hc 709 Kbc 320 Ab Elution(Ea)-So+,172.2,68.88,,,0 CDM,3008686079,"Hc Rbc Antibody Elution - Elution & Antibody Identification, Rbc",275.32,110.13,,,0 CDM,3008687082,Hc Rbc Antibody Identification - Antibody Identification,367.5,147.0,,,0 CDM,3008688086,Hc Direct Coombs Test,128.56,51.42,,,0 CDM,3008688588,"Hc Antihuman Globulin Indir Qual Ea Reagent Cell - Coombs Test, Ind",211.04,84.42,,,0 CDM,3008688601,Hc 708 Kbc 319 Ab Titrat(Ea)-So+,172.2,68.88,,,0 CDM,3008688690,Hc Antihuman Globulin Indirect Ea Antibody Titer - Antibody Titer,306.86,122.74,,,0 CDM,3008689095,Hc Autologous Blood Procedure And Store,739.85,295.94,,,0 CDM,3008690001,Hc Blood Typing Serologic Abo - Blood Type And Screen,155.25,62.1,,,0 CDM,3008690105,Hc Blood Typing Serologic Rh (D) - Cord Blood Type,107.95,43.18,,,0 CDM,3008690201,Hc 714 Kbc 330 Ag Surchg(1Ag)-So+,340.09,136.04,,,0 CDM,3008690202,Hc Ag Typing Sur Kbc Ea Un-So+,340.09,136.04,,,0 CDM,3008690203,Hc Ag Typing/Unit Kbc 314-So+,340.09,136.04,,,0 CDM,3008690208,"Hc Blood Type Antigen Donor Reagent Serum Each - Blood Typing, Antigen",412.48,164.99,,,0 CDM,3008690512,"Hc Blood Typing Rbc Antigens Oth/Thn Abo/Rh D Each - Blood Typing, Rbc",399.03,159.61,,,0 CDM,3008692013,Hc Crossmatch-Immediate Spin,232.87,93.15,,,0 CDM,3008692201,Hc 713 Kbc 324 Compat(Ea)-So+,172.2,68.88,,,0 CDM,3008692214,Hc Crossmatch-Antiglobulin,257.13,102.85,,,0 CDM,3008692717,Hc Fresh Frozen Plasma Thawing,259.55,103.82,,,0 CDM,3008693001,Hc 720 Kbc 436 Freezing-So+,340.09,136.04,,,0 CDM,3008693002,Hc Kbc Freezing-So+,340.09,136.04,,,0 CDM,3008694522,Hc Blood Irradiation,275.32,110.13,,,0 CDM,3008694523,Hc Blood Irradiation #2-So+,272.0,108.8,,,0 CDM,3008696023,Hc Volume Reduced Platelets,311.71,124.68,,,0 CDM,3008696524,Hc Pooling Of Blood Products,265.62,106.25,,,0 CDM,3008697001,Hc 712 Kbc 322 Red Cell Treat-So+,120.0,48.0,,,0 CDM,3008697025,Hc Pretreatment Of Rbc,327.47,130.99,,,0 CDM,3008697701,Hc 711 Kbc 321 Ab Neutral(Ea)-So+,172.2,68.88,,,0 CDM,3008697832,Hc Auto Abdy Adsorption Cold Each,309.28,123.71,,,0 CDM,3008697833,Hc Auto Ab Adsorption Warm Each,309.28,123.71,,,0 CDM,3008698535,Hc Splitting Blood Product,211.04,84.42,,,0 CDM,3008699901,Hc Res Crsp-Onc-001 Phase 1,727.72,291.09,,,0 CDM,3008734001,Hc Hbsag,158.44,63.38,,,0 CDM,3008734003,Hc 058 Hbsag Cdvr-So+,37.14,14.86,,,0 CDM,3008734006,Hc Client Bill Only - Empath - Hbsag,12.43,4.97,,,0 CDM,3008734007,Hc Client Bill Only - Esh - Hbsag,12.43,4.97,,,0 CDM,3008734008,Hc Hepatitis B Virus Surface Antigen With Reflex To Confirmation 20089-So+,12.4,4.96,,,0 CDM,3008738901,Hc 418 Hiv-1 Ag W/Comb 1&2 Ab,49.39,19.76,,,0 CDM,3008738902,Hc Hiv Antigen/Antibody Screen Stat-So+,340.8,136.32,,,0 CDM,3008763601,Hc Covi D- Flu A - Flu B,208.47,83.39,,,0 CDM,3008763701,"Hc Poct Sars Cov2, Flu A/B, Rsv Pcr",141.92,56.77,,,0 CDM,30087637S1,Hc Flu A And B - Rsv And Covid,215.62,86.25,,,0 CDM,3008817701,Hc Cytp Fna Eval Each Additional,99.42,39.77,,,0 CDM,3008905001,"Hc Cell Count,Misc Body Fluids - Body Fluid Cell Count",110.4,44.16,,,0 CDM,3008905002,"Hc Cell Count,Misc Body Fluids - Additional Charge",123.65,49.46,,,0 CDM,3008905102,Hc Body Fluid Cell Count W Diff - Body Fluid Cell Count W/Diff,221.54,88.62,,,0 CDM,3008906001,"Hc Exam,Synovial Fluid Crystals - Synovial Fluid Crystal",168.73,67.49,,,0 CDM,3008923001,Hc Sweat Chloride Collection-Op,448.22,179.29,,,0 CDM,3008931001,"Hc Semen Analysis,Motil & Count W/O Huhner - Semen Analysis Motility",156.4,62.56,,,0 CDM,3008932101,"Hc Postvasectomy Sperm Evaluation, Qualitative 519020-So+",20.72,8.29,,,0 CDM,3009900101,Hc Ap Send Out Processing Per Specimen,57.0,22.8,,,0 CDM,3009900102,Hc Research Processing Per Specimen,7.0,2.8,,,0 CDM,3009900103,Hc Cp Send Out Processing Per Specimen,57.0,22.8,,,0 CDM,3009900104,Hc Flow Cytometry Send Out Processing Per Specimen,57.0,22.8,,,0 CDM,300C980301,Hc Covid-19 Test Specimen Collection,54.29,21.72,,,0 CDM,300G047201,Hc Hep C Secreen High Risk/Other,191.36,76.54,,,0 CDM,300P961201,Hc Cath Specimen Collection,133.0,53.2,,,0 CDM,3010000001,Hc Res Chemistry 23,109.51,43.8,,,0 CDM,3010000007,Hc Executive Health Ggt,153.4,61.36,,,0 CDM,3010000008,Hc Executive Health Uric Acid,127.4,50.96,,,0 CDM,3010140U01,Hc Bacterial Id Gram Positive Blood,483.0,193.2,,,0 CDM,3010443U01,Hc Motor Neuropathy Syndrome Panel Wusm #1-So+,73.97,29.59,,,0 CDM,3010445U01,Hc Ptau181/Ab42 Ratio,312.6,125.04,,,0 CDM,3010459U01,Hc Ttau/Ab42 Ratio,312.6,125.04,,,0 CDM,3018004701,Hc Basic Metabolic Panel Calcium Ionized - Bundled Charge,2915.0,1166.0,,,0 CDM,3018006101,Hc Lipid Panel - Bundled Charge,195.0,78.0,,,0 CDM,3018006103,Hc Lipofit By Nmr 2013716 #2-So+,17.4,6.96,,,0 CDM,3018014301,Hc Acetaminophen,354.32,141.73,,,0 CDM,3018014517,Hc Humira Activity-So+,198.87,79.55,,,0 CDM,3018014518,Hc Drug Assay Adalimumab-So+,390.0,156.0,,,0 CDM,3018014519,Hc Predictrpk Ada Maintenance 3700-So+,286.0,114.4,,,0 CDM,3018015001,Hc Assay Of Amikacin - Amikacin Random????????,174.8,69.92,,,0 CDM,3018015002,Hc Assay Of Amikacin - Amikacin Peak????????,174.8,69.92,,,0 CDM,3018015003,Hc Assay Of Amikacin - Amikacin Trough,174.8,69.92,,,0 CDM,3018015101,Hc Amiodarone And Metabolite 90161-So+,22.06,8.82,,,0 CDM,3018015601,Hc Assay Of Carbamazepine Total - Carbamazepine Total,246.01,98.4,,,0 CDM,3018015801,Hc Assay Of Cyclosporine - Cyclosporine,447.0,178.8,,,0 CDM,3018015902,Hc 124 Clozapin & Met Qnt S/P-So+,66.5,26.6,,,0 CDM,3018016201,Hc Drug Screen Quantitative Digoxin Total - Digoxin,128.8,51.52,,,0 CDM,3018016401,Hc Drug Screen Quant Valproic Acid Total,199.64,79.86,,,0 CDM,3018016403,Hc Drug Screen Quant Dipropylacetic Acid Total - Valproic Acid Free,178.25,71.3,,,0 CDM,3018016501,Hc Free Valproic Acid,52.9,21.16,,,0 CDM,3018016801,Hc 359 Ethosuximide S/P-So+,20.44,8.18,,,0 CDM,3018016901,Hc Drug Assay Everolimus,201.82,80.73,,,0 CDM,3018017001,Hc Assay Of Gentamicin - Gentamicin Trough,221.95,88.78,,,0 CDM,3018017002,Hc Assay Of Gentamicin - Gentamicin Random,221.95,88.78,,,0 CDM,3018017003,Hc Assay Of Gentamicin - Gentamicin Peak,248.58,99.43,,,0 CDM,3018017102,Hc Gabapentin Quant By Lcmsms,128.57,51.43,,,0 CDM,3018017301,Hc 719 Haloperidol Lev-So+,52.38,20.95,,,0 CDM,3018017511,Hc Lamotrigine Quant By Lcmsms,77.74,31.1,,,0 CDM,3018017604,Hc 331 Lidocaine-So+,107.64,43.06,,,0 CDM,3018017605,Hc Lidocaine 7000240-So+,124.0,49.6,,,0 CDM,3018017709,Hc Levetiracetam Quant By Lcmsms,94.18,37.67,,,0 CDM,3018017801,Hc Assay Of Lithium - Lithium,131.38,52.55,,,0 CDM,3018017901,Hc Salicylate,354.32,141.73,,,0 CDM,3018018001,Hc 407 Mycophenolic Acid&Met-So+,35.47,14.19,,,0 CDM,3018018101,Hc Flecainide 90003-So+,34.38,13.75,,,0 CDM,3018018301,Hc 088 Oxcarb/Eslicarb Metab-So+,27.94,11.18,,,0 CDM,3018018401,Hc Assay Of Phenobarbital - Phenobarbital,155.85,62.34,,,0 CDM,3018018404,Hc Assay Of Phenobarbital-So+,18.36,7.34,,,0 CDM,3018018501,"Hc Assay Of Phenytoin, Total - Phenytoin Total",203.5,81.4,,,0 CDM,3018018601,"Hc Assay Of Phenytoin, Free - Phenytoin Free",222.82,89.13,,,0 CDM,3018018722,Hc 405 Posaconazole Lcms-So+,155.38,62.15,,,0 CDM,3018018801,Hc Assay Of Primidone - Primidone Level 90202,19.91,7.96,,,0 CDM,3018018802,Hc 839 Primidone-So+,59.69,23.88,,,0 CDM,3018019202,Hc 974 Procainamide-So+,60.24,24.1,,,0 CDM,3018019204,"Hc Procainamide, Serum Or Plasma 007252-So+",19.36,7.74,,,0 CDM,3018019403,Hc Quinidine,22.85,9.14,,,0 CDM,3018019501,Hc Assay Of Sirolimus - Sirolimus,309.12,123.65,,,0 CDM,3018019701,Hc Assay Of Tacrolimus - Tacrolimus,431.48,172.59,,,0 CDM,3018019802,Hc 979 Theophylline-So+,50.87,20.35,,,0 CDM,3018019804,"Hc Theophylline, Serum Or Plasma3019010-So+",154.8,61.92,,,0 CDM,3018020002,Hc Assay Of Tobramycin - Tobramycin Random,258.75,103.5,,,0 CDM,3018020003,Hc Assay Of Tobramycin - Tobramycin Trough,258.75,103.5,,,0 CDM,3018020101,Hc Assay Of Topiramate - Topiramate Level,161.0,64.4,,,0 CDM,3018020201,Hc Assay Of Vancomycin - Vancomycin Trough,336.17,134.47,,,0 CDM,3018020202,Hc Assay Of Vancomycin - Vancomycin Random,336.17,134.47,,,0 CDM,3018020203,Hc Assay Of Vancomycin - Vancomycin Peak,336.17,134.47,,,0 CDM,3018020302,Hc 121 Zonisamide-So+,47.68,19.07,,,0 CDM,3018020401,Hc Methotrexate,409.63,163.85,,,0 CDM,3018022001,Hc Hydroxychloroquine (Arup->Nms 2362Sp),389.3,155.72,,,0 CDM,3018023001,Hc Predictrpk-So+,429.0,171.6,,,0 CDM,3018023002,Hc Drug Assay Infliximab-So+,390.0,156.0,,,0 CDM,3018023501,"Hc Lacosamide, Serum Or Plasma 2003182-So+",84.0,33.6,,,0 CDM,3018028001,Hc Drug Assay Vedolizumab-So+,390.0,156.0,,,0 CDM,3018028501,Hc Voriconazole-So+,155.28,62.11,,,0 CDM,3018029903,Hc Quantitation Drug Not Elsewhere Specified - Methotrexate Level,409.63,163.85,,,0 CDM,3018029912,Hc 282 Digitoxin-So+,49.26,19.7,,,0 CDM,3018029915,Hc 854 Qnt Adalimumab-So+,249.79,99.92,,,0 CDM,3018029919,"Ustekinumab Drug Measurement, So+",390.0,156.0,,,0 CDM,3018029923,Hc 403 Itraconozole Lcms-So+,155.4,62.16,,,0 CDM,3018029924,Hc 404 Vitraconazole Lcms-So+,144.0,57.6,,,0 CDM,3018029926,Hc 736 Ceftazime Drug Level-So+,139.87,55.95,,,0 CDM,3018029929,Hc 617 Qnt Vedolizumab-So+,133.08,53.23,,,0 CDM,3018029932,Hc 484 Aripiprozole Qnt Ser-So+,122.4,48.96,,,0 CDM,3018029938,"Hc Infliximab, Anser, Prometheus-So+",86.0,34.4,,,0 CDM,3018029939,"Hc Dexamethasone, Serum Or Plasma By Lc-Ms/Ms (Arup 2003248)",75.9,30.36,,,0 CDM,3018029940,"Hc Antifungal Level, 5-Fluorocytosine, 5-Fc 60846-So+",128.26,51.3,,,0 CDM,3018029941,Hc Busulfan Level-So+,108.0,43.2,,,0 CDM,3018029942,Hc Antibiotic Level-So+,140.4,56.16,,,0 CDM,3018029943,"Hc Piperacillin Level, Serum",193.63,77.45,,,0 CDM,3018029944,"Hc Meropenum Level, Serum",193.63,77.45,,,0 CDM,3018029945,"Hc Cefepime Level, Serum",188.6,75.44,,,0 CDM,3018029946,Hc Isavuconazole (Cresemba)4900-So+,196.56,78.62,,,0 CDM,3018029947,Hc Thiopurine Metabolites-So+,259.2,103.68,,,0 CDM,3018029963,"Hc Imatinib, Serum 3020479-So+",162.0,64.8,,,0 CDM,3018030505,Hc Drug Test Prsmv Dir Opt Obs - Toxicology Screen Urine,112.12,44.85,,,0 CDM,3018030704,Hc Drugs Of Abuse Urine,354.32,141.73,,,0 CDM,3018030714,Hc 283 Lab/Path Consult-So+,1704.0,681.6,,,0 CDM,3018030721,Hc Drug Test Prsmv Chem Anlyzr - Lsd Screen Urine,308.1,123.24,,,0 CDM,3018030723,Hc Hairstat 5,97.18,38.87,,,0 CDM,3018030724,"Hc Ethyl Glucuronide Screen With Reflex To Confirmation, Urine (Arup 2007912)",96.94,38.78,,,0 CDM,3018030725,Hc Hairstat 13 Childguard-So+,312.0,124.8,,,0 CDM,3018030726,Hc Hair Exposure Testing (Childguard) 19 Panel-So+,505.2,202.08,,,0 CDM,3018030727,"Hc Ethyl Glucuronide, Hair-So+",170.4,68.16,,,0 CDM,3018032006,"Hc Volatile Alcohol, Methanol",221.26,88.5,,,0 CDM,3018032007,Hc Quantitative Alcohols,426.08,170.43,,,0 CDM,3018032501,Hc Drug Screen Amphetamines 3 Or 4,195.0,78.0,,,0 CDM,3018033505,Hc Antidepressants Tricyclic Other Cyclicals 1 Or 2 - Imipramine Level,10870.14,4348.06,,,0 CDM,3018034501,Hc Drug Screening Barbiturates - Barbiturate Urine Quant,260.13,104.05,,,0 CDM,3018034604,Hc Drug Screening Benzodiazepines 1-12 Benzodiazepine - Bundled Charge,195.0,78.0,,,0 CDM,3018034801,Hc Drug Screening Buprenorphine,195.0,78.0,,,0 CDM,3018034901,Hc Drug Screening Cannabinoids Natural - Cannabinoid Confirmation Ur,195.0,78.0,,,0 CDM,3018035301,Hc Drug Screening Cocaine - Cocaine Urine Conf,195.0,78.0,,,0 CDM,3018035401,Hc Drug Screening Fentanyl - Fentanyl Urine,195.0,78.0,,,0 CDM,3018035801,Hc Drug Screening Methadone - Methadone & Metabolite Level,195.0,78.0,,,0 CDM,3018036102,Hc Drug Screening Opiates 1 Or More - Bundled Charge,195.0,78.0,,,0 CDM,3018037504,Hc Drug/Substance Definitive Qual/Quant Nos 1-3 Gold - Bundled Charge,168.94,67.58,,,0 CDM,3018037505,Hc Flucytosine By Mass Spec 3018708-So+,435.6,174.24,,,0 CDM,3018127901,Hc Jak2 Exon12,312.0,124.8,,,0 CDM,3018131502,Hc 096 Pml-Rara T(15;17)Qnt-So+,392.4,156.96,,,0 CDM,3018137702,Hc Riskimmune,468.83,187.53,,,0 CDM,30181479ND,Hc Res Change For Mcc Orien Return Of Results,110.5,44.2,,,0 CDM,3018201001,Hc Ketone Bodies Serum Quantitative - Ketones Blood,125.09,50.04,,,0 CDM,3018201002,Hc Ketone Bodies Serum Quantitative - Ketones Blood,125.09,50.04,,,0 CDM,3018201303,"Hc Acetylcholinesterase (Ache), Amniotic Fluid With Reflex To Fetal Hemoglobin (Hb F)-So+",95.42,38.17,,,0 CDM,3018201706,Hc 367 C4 Acylcarnitine Urine-So+,519.36,207.74,,,0 CDM,3018201710,Hc 044 Acylcarnit Pls Qnt May-So+,80.62,32.25,,,0 CDM,3018204001,Hc Assay Of Serum Albumin - Albumin,64.7,25.88,,,0 CDM,3018204003,Hc Predictrpk Ada 3700 #2-So+,286.0,114.4,,,0 CDM,3018204004,"Hc Testosterone, Free, Bioavailable And Total, Ms 14966 #1-So+",9.4,3.76,,,0 CDM,3018204005,Hc Albumin - Testosterone Free And Total,33.0,13.2,,,0 CDM,3018204006,Hc Oligoclonal Band Profile80440 #3-So+,14.4,5.76,,,0 CDM,3018204201,Hc Assay Of Urine Albumin - Albumin Body Fluid,83.03,33.21,,,0 CDM,3018204204,Hc 779 Albumin Body Fluid-So+,9.64,3.86,,,0 CDM,3018204210,Hc Oligoclonal Band Profile80440 #4-So+,14.4,5.76,,,0 CDM,3018204301,"Hc Microalbumin, Quantitative - Microalbumin 24Hr Urine",106.75,42.7,,,0 CDM,3018204302,"Hc Microalbumin, Quantitative - Microalbumin Random Urine",106.75,42.7,,,0 CDM,3018207501,Hc Poc Ch Ed Breath Alcohol,97.05,38.82,,,0 CDM,3018207701,Hc Etoh,255.56,102.22,,,0 CDM,3018208501,Hc 113 Aldolase Serum-So+,11.65,4.66,,,0 CDM,3018208801,"Hc Assay Of Aldosterone - Aldosterone,24Hr Urine",158.02,63.21,,,0 CDM,3018208802,Hc Assay Of Aldosterone - Aldosterone,181.16,72.46,,,0 CDM,3018208807,Hc Aldosterone,255.56,102.22,,,0 CDM,3018210303,Hc 154 Alpha1-Antitrypsin Tot-So+,48.31,19.32,,,0 CDM,3018210305,Hc 358 Alpha-1 Elisa Random Stool-So+,73.2,29.28,,,0 CDM,3018210306,Hc Alpha 1 Antitrypsin,76.8,30.72,,,0 CDM,3018210401,Hc 154 Alpha1-Antitrypsin Phen-So+,52.01,20.8,,,0 CDM,3018210501,"Hc Alpha-Fetoprotein, Serum - Alpha-Fetoprotein Marker",229.68,91.87,,,0 CDM,3018210502,Hc 991 Maternl Ser Scr Afp-So+,20.12,8.05,,,0 CDM,3018210602,Hc 423 Afp Only Amnio Fld-So+,17.74,7.1,,,0 CDM,3018210801,Hc 333 Aluminum Urine Arup-So+,30.58,12.23,,,0 CDM,3018212801,Hc 240 Amino Acids Mult Qlt-So+,49.87,19.95,,,0 CDM,3018213101,Hc 659 Urine Cystine Arup-So+,84.0,33.6,,,0 CDM,3018213501,Hc 816 Ala Quant-So+,59.16,23.66,,,0 CDM,3018213502,Hc 066 Delta Ala Randm Ur-So+,127.3,50.92,,,0 CDM,3018213601,"Hc Cobalamin, Methionine, And Methylmalonic Acid Pathways, Plasma Cmmpp #3-So+",336.48,134.59,,,0 CDM,3018213902,Hc 728 Amino Acids Rand Urine-So+,260.51,104.2,,,0 CDM,3018213903,Hc 043 Amino Acid Pls 6/> May-So+,194.33,77.73,,,0 CDM,3018213904,Hc 458 Amino Acids Csf-So+,192.0,76.8,,,0 CDM,3018213905,Hc 399 Amino Acids Qnt Csf-So+,126.0,50.4,,,0 CDM,3018213907,"Hc Amino Acids, Quantitative, Random, Urine Aapd-So+",194.33,77.73,,,0 CDM,3018214001,Hc Assay Of Ammonia - Ammonia,213.51,85.4,,,0 CDM,3018215002,Hc Assay Of Amylase - Amylase Body Fluid,150.96,60.38,,,0 CDM,3018215005,Hc Assay Of Amylase - Amylase,150.96,60.38,,,0 CDM,3018215006,Hc 478 Amylase Urine-So+,23.32,9.33,,,0 CDM,3018215007,Hc 781 Assay Of Amylase - Amylase Body Fluid-So+,23.32,9.33,,,0 CDM,3018215029,"Hc Amylase, Isoenzymes 20804-So+",10.84,4.34,,,0 CDM,3018215702,Hc 771 Assay Of Androstenedione - Androstenedione-So+,42.37,16.95,,,0 CDM,3018215703,Hc 485 Assay Of Androstenedione - Androstenedione-So+,44.28,17.71,,,0 CDM,3018215709,Hc Congenital Adrenal Hyperplasia (Cah) Pediatric Profile One 501568 #1-So+,64.39,25.76,,,0 CDM,3018216401,Hc 095 Angiotensin Convert Enzyme-So+,52.51,21.0,,,0 CDM,3018216402,Hc 160 Angiotensin Convert Enzyme-So+,17.52,7.01,,,0 CDM,3018216601,Hc Anti-Mullerian Hormone 2002656-So+,66.0,26.4,,,0 CDM,3018217206,"Hc Apolipoprotein, B 0050029-So+",25.31,10.12,,,0 CDM,3018217502,Hc 179 Arsenic-So+,22.76,9.1,,,0 CDM,3018217504,Hc 183 Arsenic Urine-So+,22.76,9.1,,,0 CDM,3018218001,Hc 810 Vit C (Ascorbc Ac)Plsm-So+,23.63,9.45,,,0 CDM,3018223201,Hc 981 Beta 2 Microglobulin-So+,58.86,23.54,,,0 CDM,3018223205,Hc 313 Beta 2 Microglobulin Serum-So+,108.0,43.2,,,0 CDM,3018223206,"Hc Beta-2-Microglobulin, Urine 80432-So+",17.26,6.9,,,0 CDM,3018223207,"Hc Beta-2 Microglobulin, Serum Or Plasma 80053-So+",19.42,7.77,,,0 CDM,3018223901,Hc 092 Bile Acids Total-So+,61.6,24.64,,,0 CDM,3018224702,Hc Bilirubin Total - Bilirubin Body Fluid,76.56,30.62,,,0 CDM,3018224703,Hc Bilirubin Total - Bilirubin Total,76.56,30.62,,,0 CDM,3018224708,"Hc Bilirubin, Total, Body Fluid 20510-So+",10.02,4.01,,,0 CDM,3018224801,Hc Bilirubin Direct - Bilirubin Direct,99.21,39.68,,,0 CDM,3018226103,Hc 686 Biotinidase-So+,60.0,24.0,,,0 CDM,3018226105,Hc 242 Biotinidase-So+,20.24,8.1,,,0 CDM,3018226107,Hc Biotinidase-So+,130.68,52.27,,,0 CDM,3018227001,"Hc Blood Occult,By Peroxid,Feces,Single, Colorectal Screen - Occult Bld",34.51,13.8,,,0 CDM,3018227002,"Hc Blood Occult,By Peroxid,Feces,Single, Colorectal Screen",34.51,13.8,,,0 CDM,3018227101,Hc Occult Blood Gastric Contents,34.51,13.8,,,0 CDM,3018227201,Hc Occult Blood Stool Dx,34.51,13.8,,,0 CDM,3018230001,Hc 723 Cadmium Blood-So+,83.21,33.28,,,0 CDM,3018230002,Hc 225 Cadmium Blood-So+,83.21,33.28,,,0 CDM,3018230601,"Hc Assay Of Vit D,Calcifediol W Fractions, If Performed - Vitamin D 25",250.17,100.07,,,0 CDM,3018230605,"Hc Vitamin D, 25-Hydroxy (Arup 82306)",63.2,25.28,,,0 CDM,3018230606,"Hc 25-Hydroxyvitamin D2 And D3, Serum 25Hdn-So+",35.52,14.21,,,0 CDM,3018231001,"Hc Assay Of Calcium, Total - Calcium",57.15,22.86,,,0 CDM,3018234001,Hc Assay Of Calcium In Urine - Calcium Random Urine,71.17,28.47,,,0 CDM,3018234003,Hc Assay Of Calcium In Urine - Calcium Timed Urine,71.17,28.47,,,0 CDM,3018236502,Hc 166 Kidney Stone Analysis-So+,46.36,18.54,,,0 CDM,3018237306,Hc Congential Disorders Of Glysylation,62.17,24.87,,,0 CDM,3018237401,Hc Assay Blood Carbon Dioxide - Co2 Total,64.7,25.88,,,0 CDM,3018237501,Hc Assay Blood Carbon Monoxide - Carboxyhemoglobin,184.39,73.76,,,0 CDM,3018237801,Hc Carcinoembryonic Antigen - Cea (Carcinoembryonic Antigen),266.34,106.54,,,0 CDM,3018237802,Hc 654 Carcinoembryonic Antigen - Cea (Carcinoembryonic Antigen)-So+,68.22,27.29,,,0 CDM,3018237901,Hc Assay Of Carnitine - Carnitine,37.06,14.82,,,0 CDM,3018237908,Hc 076 Carnitine Urine Mayo-So+,94.81,37.92,,,0 CDM,3018237909,Hc 039 Carnitine Mayo-So+,46.56,18.62,,,0 CDM,3018238001,"Hc Assay Of Carotene - Carotene, Serum",35.78,14.31,,,0 CDM,3018238402,"Hc Assay, Three Catecholamines - Catecholamines Fractionated Pl",33.6,13.44,,,0 CDM,3018239001,Hc Assay Of Ceruloplasmin - Ceruloplasmin,66.86,26.74,,,0 CDM,3018239002,Hc 335 Assay Of Ceruloplasmin - Ceruloplasmin-So+,62.0,24.8,,,0 CDM,3018239003,Hc Ceruloplasmin-So+-Arup 0050160,8.4,3.36,,,0 CDM,3018239702,Hc 870 Chemiluminescent Assay-So+,50.8,20.32,,,0 CDM,3018239703,Hc 280 Igfbp3-So+,16.94,6.78,,,0 CDM,3018239706,Hc 800 Humira Neutralizing Ab-So+,218.25,87.3,,,0 CDM,3018239709,Hc 601 Pth Related Peptide-So+,48.43,19.37,,,0 CDM,3018243501,Hc Assay Of Blood Chloride - Chloride,78.72,31.49,,,0 CDM,3018243601,Hc 217 Ur Chloride-So+,18.08,7.23,,,0 CDM,3018243602,Hc Assay Of Urine Chloride - Chloride Urine,87.34,34.94,,,0 CDM,3018243801,Hc Assay Other Fluid Chlorides - Chloride Body Fluid,120.77,48.31,,,0 CDM,3018243803,Hc 298 Assay Other Fluid Chlorides-Feces-So+,34.98,13.99,,,0 CDM,3018243805,Hc 102 Assay Other Fluid Chlorides - Chloride Body Fluid-So+,17.58,7.03,,,0 CDM,3018246502,"Hc Assay, Bld/Serum Cholesterol - Cholesterol Total",85.19,34.08,,,0 CDM,3018248001,Hc 633 Pseudocholinest Tot-So+,28.33,11.33,,,0 CDM,3018248002,Hc 176 Cholinesterase Serum-So+,28.33,11.33,,,0 CDM,3018248201,Hc 164 Cholinesterase Rbc-So+,28.98,11.59,,,0 CDM,3018249501,Hc 713 Chromium Serum-So+,24.34,9.74,,,0 CDM,3018249504,"Hc Chromium, Rbc 2014505-So+",118.8,47.52,,,0 CDM,3018250701,Hc 119 Citrate 24 Hr Urine-So+,33.36,13.34,,,0 CDM,3018252302,"Hc Assay For Collagen Cross Links - N-Telopeptide, Urine",130.48,52.19,,,0 CDM,3018252303,Hc 381 C-Telopeptide B-X-Link-So+,48.0,19.2,,,0 CDM,3018252304,Hc 221 Collagen Xlinks 24Hr-So+,75.6,30.24,,,0 CDM,3018252307,Hc 011 N-Telopeptide Serum-So+,72.0,28.8,,,0 CDM,3018252308,Hc 221 Collagen Xlinks 24Hr-So+,22.42,8.97,,,0 CDM,3018252501,Hc Assay Of Copper - Copper Liver Tissue,154.2,61.68,,,0 CDM,3018252502,Hc 303 Copper Liver Tissue-So+,69.48,27.79,,,0 CDM,3018252503,Hc 133 Copper Level Urine-So+,44.62,17.85,,,0 CDM,3018252504,Hc 109 Copper Serum-So+,44.62,17.85,,,0 CDM,3018252506,Hc 524 Copper Urine-So+,44.62,17.85,,,0 CDM,3018253301,Hc Total Cortisol - Cortisol,240.47,96.19,,,0 CDM,3018253315,Hc Congenital Adrenal Hyperplasia (Cah) Pediatric Profile One 501568 #2-So+,64.39,25.76,,,0 CDM,3018254043,Hc 040 Acylglycine Urine Mayo-So+,249.84,99.94,,,0 CDM,3018254063,Hc 969 Lsd Urine Confirm-So+,156.0,62.4,,,0 CDM,3018254201,Hc Col-Chr/Ms Nondrug Analyte Nes Qual/Quan Ea Spec - Mdma Ecstasy Ur,191.51,76.6,,,0 CDM,3018254203,Hc Column Chromotography Qual/Quan,462.6,185.04,,,0 CDM,3018254233,Hc 613 7 Dehydrocholesterol-So+,180.0,72.0,,,0 CDM,3018254239,Hc Pentobarbital,286.83,114.73,,,0 CDM,3018254240,Hc Ethylene Glycol,286.83,114.73,,,0 CDM,3018254241,Hc Confirmation - Drugs Of Abuse,286.83,114.73,,,0 CDM,3018254242,"Hc Leukotriene E4, 24 Hour, Urine (Mayo Tlte4)",433.56,173.42,,,0 CDM,3018254244,"Hc N-Methylhistamine, 24 Hr, Urine-Mayo Nmh24",83.42,33.37,,,0 CDM,3018254250,Hc Chromotography Quality/Quanitity-So+,390.0,156.0,,,0 CDM,3018254251,Hc Column Chromotography Qual/Quan #2-So+,276.96,110.78,,,0 CDM,3018254253,"Hc Purines And Pyrimidines Panel, U Mayo-So+",538.56,215.42,,,0 CDM,3018254255,Hc Predictrpk Ada 3700 #1-So+,286.0,114.4,,,0 CDM,3018254268,Hc Meropenem Level Arup-So+,139.86,55.94,,,0 CDM,3018254272,Hc 380 Thiopurine Metabl Hplc-So+,259.2,103.68,,,0 CDM,3018254284,Hc Busulfan Iv-So+,108.0,43.2,,,0 CDM,3018254291,Hc 283 Sertraline Arup-So+,83.16,33.26,,,0 CDM,3018254292,Hc Essential Fatty Acids,117.59,47.04,,,0 CDM,3018254293,Hc 5-Hydroxyindoleacetic Acid (5-Hiaa)3000202-So+,204.0,81.6,,,0 CDM,3018254294,Hc Coenzyme Q10 Tot-So+,73.16,29.26,,,0 CDM,30182542AA,Hc Col-Chr/Ms Nondrug Analyte Nes Qual/Quan Ea Spec-So+,390.0,156.0,,,0 CDM,30182542AB,"Ustekinumab Antibody Measurement, So+",390.0,156.0,,,0 CDM,30182542AC,Hc Col Chromotography Qual/Quan #2-So+,390.0,156.0,,,0 CDM,3018255088,Hc Assay Of Ck (Cpk) - Ck,86.27,34.51,,,0 CDM,3018255302,Hc 151 Creatine Kinase Mb-So+,23.68,9.47,,,0 CDM,3018256501,Hc Assay Of Creatinine - Creatinine Serum,80.87,32.35,,,0 CDM,3018256502,Hc Assay Of Creatinine - Creatinine Fluid,80.87,32.35,,,0 CDM,3018256504,Hc Poct Creatinine,80.87,32.35,,,0 CDM,3018257001,Hc Assay Of Urine Creatinine - Creatinine Urine,116.46,46.58,,,0 CDM,3018257004,Hc 290 Ur Creatinine-So+,60.39,24.16,,,0 CDM,3018257009,Hc 221 Ur Creatinine-So+,6.22,2.49,,,0 CDM,3018257023,Hc 591 Ur Creatinine-So+,18.61,7.44,,,0 CDM,3018257034,"Hc Creatinine Clearance Test - Creatinine Clearance, Urine, 24 Hour",157.43,62.97,,,0 CDM,3018257035,Hc Assay Of Urine Creatinine-So+,165.75,66.3,,,0 CDM,3018257534,"Hc Creatinine Clearance Test - Creatinine Clearance, Urine, 24 Hour",157.43,62.97,,,0 CDM,3018259501,Hc Assay Of Cryoglobulin - Cryoglobulin,134.79,53.92,,,0 CDM,3018259503,"Hc Cryoglobulin, S-Mayo Test Cry_S",34.5,13.8,,,0 CDM,3018260701,Hc Vitamin B-12 - Vitamin B12,181.16,72.46,,,0 CDM,3018260801,Hc 141 Vit B12 Binding Cap-So+,51.5,20.6,,,0 CDM,3018261001,Hc Cystatin C,95.97,38.39,,,0 CDM,3018261002,Hc 620 Cystatin C-So+,76.8,30.72,,,0 CDM,3018262602,Hc 771 Dhea-So+,42.37,16.95,,,0 CDM,3018262612,Hc Congenital Adrenal Hyperplasia (Cah) Pediatric Profile One 501568 #3-So+,30.32,12.13,,,0 CDM,3018262703,Hc 740 Dhea Sulfate-So+,79.97,31.99,,,0 CDM,3018262710,Hc Dehydroepiandrosterone-Sulfate - Dhea-Sulfate,155.28,62.11,,,0 CDM,3018262711,Hc 741 Dhea Sulfate Es-So+,93.6,37.44,,,0 CDM,3018263304,Hc 986 Deoxycorticosterone-So+,85.92,34.37,,,0 CDM,3018263305,Hc 771 Desoxycorticost 11-So+,48.74,19.5,,,0 CDM,3018263802,Hc 176 Dibucaine Number-So+,44.04,17.62,,,0 CDM,3018265202,Hc 108 Vit D 1 25-Dihydroxyh-So+,138.44,55.38,,,0 CDM,3018265204,"Hc 1,25 Dihydroxy Vitamin D",217.13,86.85,,,0 CDM,3018265301,Hc Pancreatic Elastase Fecal By Immunoassay 3002858-So+,120.0,48.0,,,0 CDM,3018265709,Hc 414 Disaccharide Tissue-So+,79.2,31.68,,,0 CDM,3018265710,Hc 883 Porphobilin Deamns Rbc-So+,74.76,29.9,,,0 CDM,3018265715,Hc 839 Enz Act Nonrad Nos Ea-So+,64.94,25.98,,,0 CDM,3018265719,Hc 920 L-Asparaginase Act-So+,165.0,66.0,,,0 CDM,3018265738,Hc 633 Thiopurine Met Enz Act-So+,326.88,130.75,,,0 CDM,3018265780,Hc 992 Chylomicron Scr Fld-So+,123.55,49.42,,,0 CDM,30182657AA,"Hc Gastric Pepsin A, Respiratory #3-So+",48.48,19.39,,,0 CDM,3018266402,Hc Chylomicron Electrophoresis (Reflex)-So+,73.8,29.52,,,0 CDM,3018266481,Hc Gal-1-Phos Urdyltr Pheno Galtp-So+,1142.88,457.15,,,0 CDM,3018266881,Hc Erythropoietin-So+,22.55,9.02,,,0 CDM,3018267189,Hc 963 Estrogen Fract-So+,38.76,15.5,,,0 CDM,3018267997,Hc 853 Estrone-So+,29.94,11.98,,,0 CDM,3018269302,Hc Ethylene Glycol Immunoassay,253.41,101.36,,,0 CDM,3018269303,"Hc Ethylene Glycol, Serum Or Plasma071654-So+",18.78,7.51,,,0 CDM,3018270599,Hc 962 Fat Fecal Qlt-So+,33.42,13.37,,,0 CDM,3018271001,"Hc Fats/Lipids, Feces, Quantitative - Fecal Fat Quantitative",122.0,48.8,,,0 CDM,3018271002,Hc 084 Fecal Fat Qnt-So+,63.96,25.58,,,0 CDM,3018272503,Hc Fatty Acids Free 0080120-Arup-So+,36.0,14.4,,,0 CDM,3018272504,"Hc Fatty Acid Profile, Essential, P Pfape-So+",191.38,76.55,,,0 CDM,3018272604,Hc 360 Very Long Chain Fat Acid-So+,127.99,51.2,,,0 CDM,3018272801,Hc Assay Of Ferritin - Ferritin,200.57,80.23,,,0 CDM,3018273101,Hc Assay Of Fetal Fibronectin - Fetal Fibronectin,791.49,316.6,,,0 CDM,3018273102,Hc Fetal Fibronectin,328.89,131.56,,,0 CDM,3018274601,Hc Blood Folic Acid Serum - Folate,211.35,84.54,,,0 CDM,3018274701,Hc 073 Folate Rbc-So+,62.28,24.91,,,0 CDM,3018277503,Hc 022 Galact-1-Phos Ur Galt-So+,245.74,98.3,,,0 CDM,3018277504,Hc 242 Galactosemia State-So+,29.28,11.71,,,0 CDM,3018277507,"Hc Galactose-1-Phosphate Uridyltransferase, Blood Galt-So+",122.04,48.82,,,0 CDM,3018278403,"Hc Assay Of Gammaglobulin Iga, Igd, Igg, Igm, Each - Igg",128.32,51.33,,,0 CDM,3018278404,"Hc Assay Of Gammaglobulin Iga, Igd, Igg, Igm, Each - Iga",128.32,51.33,,,0 CDM,3018278406,"Hc Assay Of Gammaglobulin Iga, Igd, Igg, Igm, Each - Igm",128.32,51.33,,,0 CDM,3018278409,Hc 240 Igg-So+,33.44,13.38,,,0 CDM,3018278434,"Hc Immunoglobulin D, Serum 3003486-So+",26.88,10.75,,,0 CDM,3018278435,"Hc Immunofixation, Daratumumab-Specific, Serum 123218-So+",24.0,9.6,,,0 CDM,3018278436,Hc Oligoclonal Band Profile080440 #2-So+,14.4,5.76,,,0 CDM,3018278528,Hc Immunoglob E-So+,19.75,7.9,,,0 CDM,3018278706,Hc 425 Igg Subclass 4-So+,27.48,10.99,,,0 CDM,3018278707,Hc 240 Subclass Igg1-So+,27.48,10.99,,,0 CDM,3018278708,Hc 240 Subclass Igg2-So+,27.48,10.99,,,0 CDM,3018278709,Hc 240 Subclass Igg3-So+,27.48,10.99,,,0 CDM,3018278710,Hc 240 Subclass Igg4-So+,27.48,10.99,,,0 CDM,3018278712,"Hc Immunoglobulin G Subclasses (1, 2, 3, 4)0050577-So+",12.3,4.92,,,0 CDM,3018280011,Hc Blood Ph - Ph Venous,84.11,33.64,,,0 CDM,3018280301,"Hc Blood Gases: Ph, Po2 & Pco2 - Blood Gas Arterial",340.75,136.3,,,0 CDM,3018280303,"Hc Blood Gases: Ph, Po2 & Pco2 - Blood Gas Capillary",340.75,136.3,,,0 CDM,3018280304,"Hc Blood Gases: Ph, Po2 & Pco2 - Blood Gas Venous",340.75,136.3,,,0 CDM,3018280306,"Hc Blood Gases: Ph, Po2 & Pco2 - Poct Arterial Blood Gas",340.75,136.3,,,0 CDM,3018280307,"Hc Blood Gases: Ph, Po2 & Pco2 - Poct Venous Blood Gas",340.75,136.3,,,0 CDM,3018280501,Hc Gases Blood O2 Direct,388.19,155.28,,,0 CDM,3018281001,"Hc Blood Gases, O2 Sat Only - Oxygen Saturation, Arterial",159.59,63.84,,,0 CDM,3018294101,Hc 128 Gastrin Level-So+,21.16,8.46,,,0 CDM,3018294302,Hc 383 Glucagon-So+,276.96,110.78,,,0 CDM,3018294501,"Hc Assay Glucose, Body Fluid - Glucose Csf",62.54,25.02,,,0 CDM,3018294502,"Hc Assay Glucose, Body Fluid - Glucose Body Fluid",62.54,25.02,,,0 CDM,3018294507,Hc Glucose Body Fluid 20503-So+,8.82,3.53,,,0 CDM,3018294701,"Hc Assay Quantitative,Blood Glucose - Poct Glucometer",56.07,22.43,,,0 CDM,3018294704,"Hc Assay Quantitative,Blood Glucose - Glucose Random",56.07,22.43,,,0 CDM,3018294705,"Hc Assay Quantitative,Blood Glucose - Gtt Fasting",56.07,22.43,,,0 CDM,3018294801,Hc Poc Blood Glucose By Reagent Strip,8.09,3.24,,,0 CDM,3018295001,Hc Glucose Test - Gtt 1 Hour,80.87,32.35,,,0 CDM,3018295003,Hc Glucose Test - Ltt 1 Hr,80.87,32.35,,,0 CDM,3018295004,Hc Glucose Test - Ltt 2 Hr,80.87,32.35,,,0 CDM,3018295101,Hc Glucose Tolerance Test (Gtt) - Gtt 2 Hour,166.06,66.42,,,0 CDM,3018295102,Hc Glucose Tolerance Test (Gtt) - Bundled Charge,166.06,66.42,,,0 CDM,3018295201,Hc Glucose Tolerance Ea Additional Specific,62.54,25.02,,,0 CDM,3018295204,Hc Gtt-Added Samples - Bundled Charge,62.54,25.02,,,0 CDM,3018295504,Hc 680 G6Pd Quant-So+,34.87,13.95,,,0 CDM,3018296202,Hc Glucose Blood Test Performed By Hand Held Device,57.0,22.8,,,0 CDM,3018297701,Hc Assay Of Ggt - Gamma Gt,120.77,48.31,,,0 CDM,3018297805,Hc Glutathione Total 2006328-So+,81.6,32.64,,,0 CDM,3018298503,Hc 994 Fructosamine-So+,20.11,8.04,,,0 CDM,3018300301,Hc 207 Growth Hormone-So+,59.98,23.99,,,0 CDM,3018300303,Hc Human Growth Hormone,170.0,68.0,,,0 CDM,3018301001,"Hc Assay Of Haptoglobin, Quant - Haptoglobin",198.41,79.36,,,0 CDM,3018301801,Hc 070 Iodine Urine-So+,78.98,31.59,,,0 CDM,3018301811,Hc 316 Strontium Quant-So+,95.66,38.26,,,0 CDM,3018301813,Hc 994 Iodine 24Hr Urine-So+,78.98,31.59,,,0 CDM,3018301821,"Hc Iodine, Serum 2007463-So+",48.0,19.2,,,0 CDM,3018302005,Hc 242 Hgb Electrophoresis-So+,17.97,7.19,,,0 CDM,3018302101,Hc Hemoglobin Chromotography - Hemoglobinopathy Eval,181.16,72.46,,,0 CDM,3018302110,Hc Hemoglobin Evaluation With Reflex To Electrophoresis And/Or Rbc Solubility 3017101-So+,24.0,9.6,,,0 CDM,3018303601,Hc Glycosylated Hemoglobin Test - Hemoglobin A1C,172.53,69.01,,,0 CDM,3018305001,"Hc Blood Methemoglobin, Quant - Methemoglobin",114.3,45.72,,,0 CDM,3018305101,Hc Assay Of Plasma Hemoglobin - Hemoglobin Plasma,141.26,56.5,,,0 CDM,3018305102,Hc Plasma Free Hemoglobin (Mayo Plhbb),87.81,35.12,,,0 CDM,3018308003,"Hc Hexosaminidase A And Total, S-So+",57.7,23.08,,,0 CDM,3018308004,"Hc Hexosaminidase A And Total Hexosaminidase, Leukocytes Nagw-So+",84.12,33.65,,,0 CDM,3018308806,Hc Histamine Plasma-Arup Test 0070036,35.46,14.18,,,0 CDM,3018308807,Hc Histamine Whole Blood,35.46,14.18,,,0 CDM,3018309001,Hc Assay Of Homocystine - Homocysteine Total,303.01,121.2,,,0 CDM,3018309002,Hc 727 Assay Of Homocystine - Homocysteine Total-So+,281.0,112.4,,,0 CDM,3018309003,Hc 370 Assay Of Homocystine - Homocysteine Total-So+,60.67,24.27,,,0 CDM,3018309006,"Hc Cobalamin, Methionine, And Methylmalonic Acid Pathways, Plasma Cmmpp #1-So+",336.48,134.59,,,0 CDM,3018309007,"Hc Homocysteine, Total, Plasma,Peds Hcysp-So+",31.61,12.64,,,0 CDM,3018315002,Hc 911 Homovanillic Acid-So+,26.89,10.76,,,0 CDM,3018315005,"Hc Homovanillic Acid (Hva), Random Urine3018862-So+",16.8,6.72,,,0 CDM,3018349103,Hc 071 17-Hydroxycorticoids-So+,60.9,24.36,,,0 CDM,3018349701,"Hc Assay Of 5-Hiaa - 5 Hiaa Quant,24Hr Urine",20.4,8.16,,,0 CDM,3018349702,Hc 160 5Hiaa Plasma-So+,462.0,184.8,,,0 CDM,3018349705,Hc 5-Hydroxyindoleacetic Acid (Hiaa) Plasma 3016920-So+,255.36,102.14,,,0 CDM,3018349706,"Hc 5-Hydroxyindoleacetic Acid (Hiaa) By Lc-Ms/Ms, Random Urine3018617-So+",20.4,8.16,,,0 CDM,3018350501,"Hc Assay, Total Hydroxyproline - Hydroxyproline, Total",94.28,37.71,,,0 CDM,3018351609,Hc 536 Mpo Pr3 Abs -> Anca-So+,78.0,31.2,,,0 CDM,3018351612,Hc 867 Trap 5B-So+,67.2,26.88,,,0 CDM,3018351616,Hc 439 Rna Polymer Iii Ab Igg-So+,59.51,23.8,,,0 CDM,3018351629,Hc 177 Acetyl Rec Mod Ab-So+,44.09,17.64,,,0 CDM,3018351630,Hc 145 Histone Ab Igg-So+,14.4,5.76,,,0 CDM,3018351632,Hc 689 Serine Protea 3Ab Arup-So+,39.16,15.66,,,0 CDM,3018351633,Hc 097 Acetycholine Block Ab-So+,39.16,15.66,,,0 CDM,3018351634,Hc 209 Sol Liver Ag Ab Igg-So+,39.16,15.66,,,0 CDM,3018351635,Hc 389 Myeloperoxid Ab-Arup-So+,39.16,15.66,,,0 CDM,3018351636,Hc 238 Gliadin Ab Iga-So+,39.16,15.66,,,0 CDM,3018351637,Hc 238 Gliadin Ab Igg-So+,39.16,15.66,,,0 CDM,3018351638,Hc 076 Tis Transglutamins Igg-So+,39.16,15.66,,,0 CDM,3018351639,Hc 577 Mitochondrial Ab Igg-So+,39.16,15.66,,,0 CDM,3018351640,Hc 104 F-Actin Ab Igg Rfx Asm-So+,39.16,15.66,,,0 CDM,3018351641,Hc 057 Tis Transglutamins Iga-So+,39.16,15.66,,,0 CDM,3018351650,Hc 501 Immun Assy Nos Mul Met-So+,39.16,15.66,,,0 CDM,3018351652,Hc 182 Myeloperox Ab Igg-So+,39.16,15.66,,,0 CDM,3018351653,Hc 182 Serine Protease 3 Igg-So+,39.16,15.66,,,0 CDM,3018351654,Hc 183 Myeloperox Ab Igg-So+,39.16,15.66,,,0 CDM,3018351655,Hc 183 Serine Protease 3 Igg-So+,39.16,15.66,,,0 CDM,3018351660,Hc 504 Immun Assy Nos Mul Met-So+,244.57,97.83,,,0 CDM,3018351665,Hc 281 Neuronal Nuc Ab Imublt-So+,198.67,79.47,,,0 CDM,3018351669,Hc 676 Hmcgr Ab Igg-So+,162.0,64.8,,,0 CDM,3018351678,Hc 147 Heat Shock Prot 70 Igg-So+,135.06,54.02,,,0 CDM,3018351690,Hc 320 Acetylchol Mod Ab-So+,49.59,19.84,,,0 CDM,3018351691,Hc Anti-Centromere,20.44,8.18,,,0 CDM,3018351692,Hc Anti-Th/To,78.0,31.2,,,0 CDM,3018351693,Hc 649 Extended Myositis Panel So+,139.29,55.72,,,0 CDM,3018351694,Hc Motor Neuropathy Syndrome Panel,877.32,350.93,,,0 CDM,3018351695,Hc Signal Recognition Particle (Srp) Ab-Arup Test 2002098,97.05,38.82,,,0 CDM,3018351696,Hc Gastric Pepsin A Assay-Arup,130.82,52.33,,,0 CDM,30183516AA,Noncdm Charge Record,22.84,9.14,,,0 CDM,30183516AB,Hc Antibody Analysis (Hoxworth),129.29,51.72,,,0 CDM,30183516AC,"Hc 21-Hydroxylase Autoantibodies, Serum 3001962-So+",55.48,22.19,,,0 CDM,30183516AD,"Hc Gastric Parietal Cell Antibody, Igg 50596-So+",23.74,9.5,,,0 CDM,30183516AE,"Hc Gbm Ab, Igg By Multiplex Bead Assay 51000-So+",32.1,12.84,,,0 CDM,30183516AF,"Hc Pepsin A, Respiratory 3016831 #3-So+",40.4,16.16,,,0 CDM,30183516AG,Hc Mpo-So+,13.92,5.57,,,0 CDM,30183516AH,Hc Pr3-So+,13.92,5.57,,,0 CDM,30183516AI,Hc Extended Myositis Panel Ext2 #1-So+,25.9,10.36,,,0 CDM,30183516AJ,"Hc Anti-Sp100 And Anti-Gp210 Antibodies, Igg 3002482-So+",103.49,41.4,,,0 CDM,3018351905,Hc 199 P/Q-Type Calcium Ch Ab-So+,77.54,31.02,,,0 CDM,3018351910,Hc 715 Igf Bp3 Endocrine Sci-So+,54.36,21.74,,,0 CDM,3018351912,Hc 094 Acetycholine Bind Ab-So+,48.58,19.43,,,0 CDM,3018351913,Hc 657 Tsh Receptor Ab-So+,48.58,19.43,,,0 CDM,3018351921,Hc 144 Pancreastatin-So+,240.0,96.0,,,0 CDM,3018351936,Hc 836 Immun Assay Qnt Rad-So+,287.0,114.8,,,0 CDM,3018351941,Hc 978 Human Pancreas Polypep-So+,104.56,41.82,,,0 CDM,3018351949,Hc 041 Neopterin Arup-So+,153.91,61.56,,,0 CDM,3018351954,Hc 375 21 Hydrolase Ab Quest-So+,124.5,49.8,,,0 CDM,3018351959,Hc 992 Igf Binding Protein-2-So+,116.4,46.56,,,0 CDM,3018351964,Hc 827 Inhibin B-So+,94.02,37.61,,,0 CDM,3018351970,Hc Ach Receptor Binding Ab-So+,228.0,91.2,,,0 CDM,3018351971,Hc Immunoassay Qn Ria,138.02,55.21,,,0 CDM,3018351972,"Hc Vgkc Complex Ab Ipa, Csf-So+",325.0,130.0,,,0 CDM,3018351973,"Hc Achr Ganglionic Neuronal Ab, S",43.43,17.37,,,0 CDM,3018351974,"Hc Paraneoplastic Autoantibody Eval, Serum",646.99,258.8,,,0 CDM,3018351988,Hc Muscle Spec Kinase Ab-So+,888.0,355.2,,,0 CDM,3018351991,"Hc Trypsin, Serum3016694-So+",54.0,21.6,,,0 CDM,3018351992,"Hc Voltage-Gated Potassium Channel (Vgkc) Antibody, Serum 2004890-So+",231.6,92.64,,,0 CDM,3018351993,Hc Mmp7-So+,308.4,123.36,,,0 CDM,3018352001,Hc 128 Il-7-So+,90.0,36.0,,,0 CDM,3018352002,Hc 128 Ang-1 & 2 (2)-So+,114.0,45.6,,,0 CDM,3018352022,Hc 072 Anti-Mulleriuan Hormn-So+,66.0,26.4,,,0 CDM,3018352028,Hc 059 Immun Assay Qnt Nos-So+,165.0,66.0,,,0 CDM,3018352041,Hc 361 Ige Ab-So+,46.55,18.62,,,0 CDM,3018352043,Hc 125 Tryptase-So+,46.55,18.62,,,0 CDM,3018352044,Hc 870 Immun Assay Qnt Nos Ea-So+,46.55,18.62,,,0 CDM,3018352050,Hc 722 Soluble Cd 25 Receptor-So+,100.0,40.0,,,0 CDM,3018352058,Hc 504 Immun Assay Qnt Nos-So+,57.6,23.04,,,0 CDM,3018352065,Hc 143 Interleukin 2-So+,102.0,40.8,,,0 CDM,3018352071,Hc 422 Adamts 13 Ab-So+,280.8,112.32,,,0 CDM,3018352076,Hc 874 Fibroblst Grwth Fac-23-So+,625.56,250.22,,,0 CDM,3018352080,Hc 249 Anti-Iga-So+,202.32,80.93,,,0 CDM,3018352087,Hc 964 Stelara Ab-So+,154.5,61.8,,,0 CDM,3018352093,Hc 242 Cystic Fibrosis State-So+,17.99,7.2,,,0 CDM,3018352094,Hc 399 Flucytosine Bioassay-So+,139.87,55.95,,,0 CDM,3018352096,Hc 365 Gq1B Ab Igg-So+,32.4,12.96,,,0 CDM,3018352098,Hc 838 Mannose Binding Lectin-So+,120.0,48.0,,,0 CDM,3018352099,Hc 122 Pancreatic Elast Fecal-So+,120.0,48.0,,,0 CDM,30183520AA,"Hc Prim Membranous Nephropathy Diagnosis, Serum (Mayo)",252.0,100.8,,,0 CDM,30183520AB,"Hc Phospholipase A2 Receptor, Monitoring, Serum (Mayo)",273.89,109.56,,,0 CDM,30183520AC,"Hc Neurofilament Light Chain, Serum-Labcorp 140455",257.5,103.0,,,0 CDM,30183520AD,Hc Cxcl9-So+,457.2,182.88,,,0 CDM,30183520AE,Hc Plasma Cytokine Panel,289.72,115.89,,,0 CDM,30183520AG,Hc Neopterin 140335-So+,85.66,34.26,,,0 CDM,30183520AH,Hc Mmp-7-So+,428.4,171.36,,,0 CDM,30183520AJ,Hc Beta Amyloid Csf,122.93,49.17,,,0 CDM,30183520AK,Hc Ptau Csf,122.93,49.17,,,0 CDM,30183520AL,Hc Ttau Csf,253.41,101.36,,,0 CDM,30183520AM,"Hc Ngal,U (Neutrophil Gelatinase-Associated Lipocalin)7570857-So+",219.96,87.98,,,0 CDM,30183520AN,Hc Motor Neuropathy Syndrome Panel Wusm #2-So+,73.97,29.59,,,0 CDM,30183520AO,Hc Demyelinating Neuropathy #1-So+,87.25,34.9,,,0 CDM,30183520BA,Hc Il-18 (Interleukin-18) 00541-So+,384.0,153.6,,,0 CDM,30183520BB,Hc Thyroid Stimulating Hormone Receptor Antibody (Trab)2002734-So+,37.2,14.88,,,0 CDM,30183520BC,Hc Vascular Endothelial Growth Factor 92660-So+,102.0,40.8,,,0 CDM,30183520ZZ,Hc Quantitative Immunoassay,40.72,16.29,,,0 CDM,3018352101,Hc 444 Vasc Endothel Grow Fac-So+,133.0,53.2,,,0 CDM,3018352102,Hc 122 Interleukin 1 Beta-So+,133.0,53.2,,,0 CDM,3018352103,Hc 683 Tnf Arup-So+,114.0,45.6,,,0 CDM,3018352107,Hc 304 Interleukin-6-So+,102.0,40.8,,,0 CDM,3018352110,"Hc Kappa/Lambda Quantitative Free Light Chains With Ratio, Serum-Arup 0055167",29.76,11.9,,,0 CDM,3018352111,"Hc Free Light Chains, Kappa/Lambda With Ratio, Serum",56.07,22.43,,,0 CDM,3018352503,"Hc Assay Of Insulin,Total - Insulin, Total",155.0,62.0,,,0 CDM,3018352901,Hc Interleukin-6,253.41,101.36,,,0 CDM,3018352902,"Hc Interleukin 6, Serum",90.58,36.23,,,0 CDM,3018354002,Hc Assay Of Iron - Iron,100.28,40.11,,,0 CDM,3018354003,Hc 995 Iron Liver Tissue-So+,68.45,27.38,,,0 CDM,3018355001,Hc Iron Binding Test - Iron And Iron Binding Capacity Panel - Sr Or Pl,131.55,52.62,,,0 CDM,3018355002,Hc Iron Binding Test - Iron + Transferrin + Tibc,131.55,52.62,,,0 CDM,3018358603,Hc 064 17-Ketosteroids 17Ks-So+,35.68,14.27,,,0 CDM,3018360501,Hc Poc- Gem 5000 Lactate,189.78,75.91,,,0 CDM,3018360503,Hc Assay Of Lactic Acid - Poct Lactic Acid (Lactate),189.78,75.91,,,0 CDM,3018360504,Hc Assay Of Lactic Acid - Lactic Acid Body Fluid,13.88,5.55,,,0 CDM,3018360599,Hc 489 D-Lactate Mayo-So+,134.4,53.76,,,0 CDM,3018361502,Hc Lactate (Ld) (Ldh) Enzyme - Lactate Dehydrogenase,91.66,36.66,,,0 CDM,3018361513,Hc Lactate (Ld) (Ldh) Enzyme - Lactate Dehydrogenase Fl,91.66,36.66,,,0 CDM,3018361515,Hc 396 Ldh Total Fluid-So+,21.7,8.68,,,0 CDM,3018361516,Hc Lactate (Ld) (Ldh) Enzyme-So+,11.61,4.64,,,0 CDM,3018362501,Hc 243 Ldh Isoenzymes-So+,46.02,18.41,,,0 CDM,3018362517,Hc Assay Of Ldh Enzymes-So+,15.35,6.14,,,0 CDM,3018363001,Hc Fecal Lactoferrin Qual,145.57,58.23,,,0 CDM,3018365505,Hc 058 Lead-So+,14.53,5.81,,,0 CDM,3018369001,Hc Assay Of Lipase - Lipase,184.39,73.76,,,0 CDM,3018369007,Hc 113 Lipase Peritoneal Fld-So+,43.2,17.28,,,0 CDM,3018369010,Hc 143 Lipase Fluid-So+,24.77,9.91,,,0 CDM,3018369512,Hc 207 Lipoprotein A-So+,46.55,18.62,,,0 CDM,3018370402,Hc Lipofit By Nmr 2013716 #1-So+,41.03,16.41,,,0 CDM,3018370416,Hc 250 Nmr Lipoprotein-So+,113.47,45.39,,,0 CDM,3018371801,"Hc Assay Of Blood Lipoprotein,Hdl Cholest - Hdl Cholesterol",120.77,48.31,,,0 CDM,3018372101,"Hc Assay Of Blood Lipoprotein,Ldl Cholest - Ldl Cholesterol Direct",85.19,34.08,,,0 CDM,3018372103,Hc 086 Ldl Cholesterol Direct-So+,43.47,17.39,,,0 CDM,3018373501,Hc Assay Of Magnesium - Magnesium,119.69,47.88,,,0 CDM,3018373502,Hc Assay Of Magnesium - Magnesium Urine,119.69,47.88,,,0 CDM,3018373503,Hc 627 Magnesium Rbc-So+,42.8,17.12,,,0 CDM,3018378510,Hc Manganese Wb-So+,31.98,12.79,,,0 CDM,3018378903,Hc 406 Dht Lcmsms-So+,98.56,39.42,,,0 CDM,3018378905,Hc 827 Bile Acids Urine-So+,1414.8,565.92,,,0 CDM,3018378907,Hc 485 Synth Stimulnt Qnt Ur-So+,92.72,37.09,,,0 CDM,3018378911,Hc 487 Olanzapine Zyprexa-So+,81.6,32.64,,,0 CDM,3018378929,Hc 242 Ms/Ms Qnt State-So+,25.09,10.04,,,0 CDM,3018378930,Hc 660 Lacosamide-So+,188.4,75.36,,,0 CDM,3018378933,Hc Everolimus By Lcmsms,200.57,80.23,,,0 CDM,3018378942,Hc 952 Buproprion+Metab-Soq+,118.8,47.52,,,0 CDM,3018378963,Hc 028 Myelin Basic Protein-So+,61.88,24.75,,,0 CDM,3018378974,"Hc Iodine, 24 Hour, Urine Uiod-So+",60.79,24.32,,,0 CDM,3018382547,Hc 179 Mercury-So+,19.51,7.8,,,0 CDM,3018383554,Hc Metanephrines Fract Ur-So+,20.33,8.13,,,0 CDM,3018383556,Hc 602 Metanephrine Free Frac-So+,48.61,19.44,,,0 CDM,3018388071,Hc Natriuretic Peptide - B-Type Natriuretic Peptide (Bnp),378.49,151.4,,,0 CDM,3018388302,Hc 861 Kappa Flc Serum,143.42,57.37,,,0 CDM,3018388317,Hc 321 Retinol Bnd Protein-So+,48.89,19.56,,,0 CDM,3018388373,"Hc Nephelometry, Not Specified - Kappa / Lambda Light Chains, Urine",143.42,57.37,,,0 CDM,3018391514,Hc 5 Nucleotidase-So+,14.4,5.76,,,0 CDM,3018391615,Hc 366 Oligoclonal Bands Only-So+,92.69,37.08,,,0 CDM,3018391616,Hc Oligoclonal Band Profile80440 #1-So+,32.87,13.15,,,0 CDM,3018391805,"Hc Cobalamin, Methionine, And Methylmalonic Acid Pathways, Plasma Cmmpp #2-So+",336.48,134.59,,,0 CDM,3018391902,Hc 042 Organ Acid Ur Qlt Mayo-So+,79.75,31.9,,,0 CDM,3018392101,"Hc Assay Single Organic Acid, Quantitative - Methylmalonic Acid, Serum",99.61,39.84,,,0 CDM,3018392102,Hc 649 Methylmalonic Acid Ur-So+,67.49,27.0,,,0 CDM,3018393001,Hc Assay Of Blood Osmolality - Osmolality,120.77,48.31,,,0 CDM,3018393501,Hc Assay Of Urine Osmolality - Osmolality Urine,136.95,54.78,,,0 CDM,3018393701,Hc 334 Osteocaicin-So+,44.4,17.76,,,0 CDM,3018394501,Hc 630 Oxalate Serum-So+,24.66,9.86,,,0 CDM,3018395104,Hc Des-Gamma Carboxy Prothrombin,106.16,42.46,,,0 CDM,3018397001,Hc Assay Of Parathormone - Pth Intact,332.12,132.85,,,0 CDM,3018397002,Hc Parathyroid Hormone Intact 70346-So+,49.54,19.82,,,0 CDM,3018397005,Hc 555 Assay Of Parathormone - Pth Intact-So+,148.45,59.38,,,0 CDM,3018397009,Hc 480 Assay Of Parathormone - Pth Intact-So+,26.86,10.74,,,0 CDM,3018397010,Hc Ph Body Fluid Nos - Ph Body Fluid,62.54,25.02,,,0 CDM,3018398602,Hc 266 Ph Body Fluid-Fecel-So+,12.89,5.16,,,0 CDM,3018398606,"Hc Pepsin A, Respiratory 3016831-So+",40.4,16.16,,,0 CDM,3018399301,Hc 107 Calprotectin Fecal-So+,90.0,36.0,,,0 CDM,3018403001,Hc Assay Of Blood Pku - Phenylalanine,74.4,29.76,,,0 CDM,3018403003,"Hc Biopterin, Pku Co-Factors-So+",130.68,52.27,,,0 CDM,3018406003,Hc Tartrate Resistant Acid Phosphatase (Trap) 415840-So+,162.96,65.18,,,0 CDM,3018406601,Hc Assay Phosphatase Acid Prostatic - Prostatic Acid Phosphatase,16.02,6.41,,,0 CDM,3018407501,Hc Assay Alkal Phosphatase - Alkaline Phosphatase,89.5,35.8,,,0 CDM,3018407505,"Hc Alkaline Phosphatase Isoenzy, Serpla 21020-So+",7.8,3.12,,,0 CDM,3018407506,"Hc Alkaline Phosphatase Isoenzymes, Serum Or Plasma 21020 #1-So+",7.8,3.12,,,0 CDM,3018408001,"Hc Assay Alkaline Phosphatase,Isoenzymes - Alkaline Phosphatase,Isoenzymes",17.74,7.1,,,0 CDM,3018408004,Hc Bone Specific Alkaline Phosphatase-Arup 0070053,38.82,15.53,,,0 CDM,3018408005,"Hc Alkaline Phosphatase Isoenzymes, Serum Or Plasma 21020 #2-So+",17.74,7.1,,,0 CDM,3018410501,Hc Assay Of Urine Phosphorus - Phosphorus Random Urine,95.97,38.39,,,0 CDM,3018410502,Hc 517 Assay Of Urine Phosphorus - Phosphorus Random Urine-So+,89.0,35.6,,,0 CDM,3018410601,Hc Assay Of Porphobilinogen Urine Qual - Porphobilinogen Screen,92.74,37.1,,,0 CDM,3018411004,"Hc Porphyrins And Porphobilinogen (Pbg), Urine 2002181(2)-So+",36.77,14.71,,,0 CDM,3018411201,Hc Amnisure Test,346.14,138.46,,,0 CDM,3018412006,"Hc Porphyrins And Porphobilinogen (Pbg), Urine 2002181(1)-So+",36.77,14.71,,,0 CDM,3018412601,Hc 910 Porphyrins Feces-So+,252.8,101.12,,,0 CDM,3018413201,Hc Assay Of Serum Potassium - Potassium,73.33,29.33,,,0 CDM,3018413303,Hc Assay Of Urine Potassium - Potassium Random Urine,80.87,32.35,,,0 CDM,3018413304,"Hc Assay Of Urine Potassium - Potassium,Timed Urine",80.87,32.35,,,0 CDM,3018413401,Hc Assay Of Prealbumin - Prealbumin,175.77,70.31,,,0 CDM,3018414401,Hc Assay Of Progesterone - Progesterone,198.41,79.36,,,0 CDM,3018414406,Hc 771 Progesterone-So+,48.74,19.5,,,0 CDM,3018414501,Hc Procalcitonin,295.46,118.18,,,0 CDM,3018414601,Hc Assay Of Prolactin - Prolactin,306.24,122.5,,,0 CDM,3018414602,Hc Macroprolactin-Arup Test 0020765,53.38,21.35,,,0 CDM,3018415007,"Hc 2,3-Dinor 11 Beta-Prostaglandin F2 Alpha, 24 Hour, Urine-Mayo 23Bpt",71.29,28.52,,,0 CDM,3018415301,"Hc Prostate Specific Antigen,Total - Psa",229.68,91.87,,,0 CDM,3018415302,"Hc 754 Prostate Specific Antigen,Total - Psa-So+",229.0,91.6,,,0 CDM,3018415303,"Hc 863 Prostate Specific Antigen,Total - Psa-So+",22.07,8.83,,,0 CDM,3018415402,Hc 191 Psa Free-So+,22.07,8.83,,,0 CDM,3018415501,Hc Protein Tot Xcpt Refractometry Serum - Protein Total,80.87,32.35,,,0 CDM,3018415602,Hc Protein Tot Xcpt Refractometry Urine - Protein Timed Urine,92.74,37.1,,,0 CDM,3018415611,Hc Protein Tot Xcpt Refractometry Urine - Protein Random Urine,92.74,37.1,,,0 CDM,3018415701,Hc 338 Galactosidase-Enz Wbc-So+,222.0,88.8,,,0 CDM,3018415707,Hc 778 Tot Protein Oth Source-So+,13.2,5.28,,,0 CDM,3018415710,"Hc Pepsin A, Respiratory 3016813 #2-So+",40.4,16.16,,,0 CDM,3018415712,Hc Protein Tot Xcpt Refractometry Oth Src - Protein Body Fluid,92.74,37.1,,,0 CDM,3018416501,"Hc Protein E-Phoresis, Serum - Protein Electrophoresis Serum",199.49,79.8,,,0 CDM,3018416601,Hc Protein E-Phoresis/Urine/Csf - Protein Electrophoresis Urine,214.59,85.84,,,0 CDM,3018418204,Hc 511 Paraneop Autoab Wb Cfm-So+,41.1,16.44,,,0 CDM,3018418205,Hc 063 14-3-3 Protein-So+,35.63,14.25,,,0 CDM,3018418216,Noncdm Charge Record,35.63,14.25,,,0 CDM,3018418217,Hc Agna-1 Immunoblot-So+,190.0,76.0,,,0 CDM,3018418218,Hc Amphiphysin Immunoblot-So+,190.0,76.0,,,0 CDM,3018418219,Hc Anna-1 Immunoblot-So+,190.0,76.0,,,0 CDM,3018418220,Hc Anna-2 Immunoblot-So+,190.0,76.0,,,0 CDM,3018418221,Hc Crmp-5-Igg Western Blot-So+,310.0,124.0,,,0 CDM,3018418222,Hc Pca-1 Immunoblot-So+,190.0,76.0,,,0 CDM,3018418223,Hc Pca-Tr Immunoblot-So+,190.0,76.0,,,0 CDM,3018418224,"Hc Neuronal Nuclear Ab Igg, Immunoblot, Ser 3002917-So+",35.64,14.26,,,0 CDM,3018418225,Hc 14-3-3 Protein Panel-So+,252.75,101.1,,,0 CDM,3018418226,Hc Ens2 Antibody Reflex Wb-So+,271.74,108.7,,,0 CDM,3018418227,Hc Ens2 Antibody Reflex Ib-So+,120.0,48.0,,,0 CDM,3018418228,"Hc Urine, Amylase 3016646-So+",13.44,5.38,,,0 CDM,3018418229,Hc Enc2 Antibody Western Blot-So+,330.0,132.0,,,0 CDM,3018418230,"Hc Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum Mds2 #4-So+",55.72,22.29,,,0 CDM,3018418231,"Hc Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid Mdc2 #2-So+",48.89,19.56,,,0 CDM,3018418232,Hc Extended Myositis Panel Ext2 #3-So+,35.05,14.02,,,0 CDM,3018418233,Hc Demyelinating Neuropathy #2-So+,87.25,34.9,,,0 CDM,3018420201,Hc Assay Rbc Protoporphyrin - Erythrocyte Porphyrin,90.0,36.0,,,0 CDM,3018420202,Hc 994 Porphyrin Rbc-So+,71.22,28.49,,,0 CDM,3018420204,Hc 127 Zinc Protoporphrn Inds-So+,51.59,20.64,,,0 CDM,3018420206,Hc 325 Zinc Protopor Indust-So+,90.0,36.0,,,0 CDM,3018420601,Hc 326 Proinsulin-So+,64.04,25.62,,,0 CDM,3018420702,Hc 085 Vitamin B6-So+,101.03,40.41,,,0 CDM,3018421002,Hc 859 Pyruvic Acid Csf-So+,39.05,15.62,,,0 CDM,3018421003,Hc 814 Pyruvic Acid-So+,39.05,15.62,,,0 CDM,3018422001,Hc 619 Pyruvate Kinase Qnt-So+,54.6,21.84,,,0 CDM,3018423401,Hc Progestrone Assay,561.8,224.72,,,0 CDM,3018425204,"Hc Vitamin B2, Riboflavin-So+",37.71,15.08,,,0 CDM,3018425502,Hc 130 Selenium-So+,30.64,12.26,,,0 CDM,3018426001,Hc 028 Serotonin-So+,39.28,15.71,,,0 CDM,3018426002,Hc 916 Serotonin Serum-So+,37.18,14.87,,,0 CDM,3018427001,Hc 269 Sex Hormone Bnd Glob-So+,78.17,31.27,,,0 CDM,3018427002,Hc 327 Sex Hormone Bnd Glob-So+,78.17,31.27,,,0 CDM,3018427011,Hc 490 Shbg-So+,78.17,31.27,,,0 CDM,3018427012,Hc 494 Shbg-So+,78.17,31.27,,,0 CDM,3018427013,"Hc Testosterone, Free, Bioavailable And Total, Ms 14966 #2-So+",26.08,10.43,,,0 CDM,3018429501,Hc Assay Of Serum Sodium - Sodium,73.33,29.33,,,0 CDM,3018429510,Hc Assay Of Serum Sodium - Sodium,73.33,29.33,,,0 CDM,3018430001,Hc Assay Of Urine Sodium - Sodium Random Urine,81.95,32.78,,,0 CDM,3018430003,Hc 217 Assay Of Urine Sodium - Sodium Random Urine-So+,17.51,7.0,,,0 CDM,3018430202,Hc 298 Sodium Feces-Soq+,34.8,13.92,,,0 CDM,3018430204,Hc 428 Sodium Stool-So+,31.2,12.48,,,0 CDM,3018430206,"Hc Sodium, Fluid-Arup 0020154-So+",10.24,4.1,,,0 CDM,3018430207,"Hc Sodium, Fecal 20379-So+",16.02,6.41,,,0 CDM,3018430502,Hc 714 Igf 1-So+,25.51,10.2,,,0 CDM,3018430701,Hc 323 Somatostatin-So+,232.8,93.12,,,0 CDM,3018431102,"Hc Adenosine Deaminase, Rbc 83001-So+",84.3,33.72,,,0 CDM,3018431106,Hc 298 Potassium Feces-So+,50.03,20.01,,,0 CDM,3018431118,Hc Porphyrin Blood Qnt-So+,25.13,10.05,,,0 CDM,3018431119,Hc Cholesterol Bdy Fld-So+,25.13,10.05,,,0 CDM,3018431127,Hc 457 Adenosn Deam Peri Fld-So+,132.0,52.8,,,0 CDM,3018431180,Hc Adenosine Deam Pleural-So+,38.81,15.52,,,0 CDM,3018437636,Hc Reducing Subst Fecal-So+,19.78,7.91,,,0 CDM,3018437844,Hc Galactose-1-Phos Rbc-So+,123.42,49.37,,,0 CDM,3018440202,Hc 494 Testosterone Free-So+,91.58,36.63,,,0 CDM,3018440248,Hc Assay Of Testosterone - Testosterone Total Free,217.82,87.13,,,0 CDM,3018440301,Hc Assay Of Total Testosterone - Testosterone,223.21,89.28,,,0 CDM,3018440302,"Hc Testosterone, Free, Bioavailable And Total, Ms 14966 #3-So+",30.97,12.39,,,0 CDM,3018442571,Hc Vit B1 Thiamine Plsm-So+,76.34,30.54,,,0 CDM,3018442572,Hc Vit B1 (Thiamine) Wb-So+,76.34,30.54,,,0 CDM,3018443203,Hc 794 Thyroglobulin Lcmsms-So+,238.08,95.23,,,0 CDM,3018443204,"Hc Thyroglobulin, Tumor Marker, Ia, S Htgt-So+",248.06,99.22,,,0 CDM,3018443276,Hc Assay Of Thyroglobulin - Thyroglobulin,189.78,75.91,,,0 CDM,3018443278,Hc Thyroglobulin Fna-So+,57.77,23.11,,,0 CDM,3018443301,Hc Tpmt Enzyme (Assay Thyipurine S-Methyltransferase),253.44,101.38,,,0 CDM,3018443701,Hc 242 T4 State-So+,9.0,3.6,,,0 CDM,3018443901,Hc Assay Of Free Thyroxine - T4 Free,174.69,69.88,,,0 CDM,3018443902,Hc 972 T4 Free By Dialys Mayo-So+,32.4,12.96,,,0 CDM,3018444201,Hc 559 Thyroxine Bind Protien-So+,64.74,25.9,,,0 CDM,3018444202,Hc 802 Thyroxine Bind Protien-So+,53.17,21.27,,,0 CDM,3018444301,Hc Assay Thyroid Stimulating Hormone - Thyroid Stimulating Hormone,243.7,97.48,,,0 CDM,3018444501,Hc 923 Thyroid Stim Immuglb-So+,61.03,24.41,,,0 CDM,3018444602,Hc 110 Vit E S/P-So+,40.24,16.1,,,0 CDM,3018445001,Hc Transferase Aspartate Amino (Ast) (Sgot) - Ast (Sgot),71.17,28.47,,,0 CDM,3018446001,Hc Transferase Alanine Amino (Alt) (Sgpt) - Alt (Sgpt),71.17,28.47,,,0 CDM,3018446601,Hc Assay Of Transferrin - Transferrin,177.92,71.17,,,0 CDM,3018447801,Hc Assay Of Triglycerides - Triglycerides,84.11,33.64,,,0 CDM,3018447805,Hc Chylo Rflxtriglycerides Body Fluid With Reflex To Chylomicron Electrophoresis-Arup 3005996,11.26,4.5,,,0 CDM,3018448001,"Hc Triiodothyronine Total Assay, Tt-3 - T3 (Thyroid Hormone)",224.29,89.72,,,0 CDM,3018448103,Hc 208 Free T3-So+,60.9,24.36,,,0 CDM,3018448401,"Hc Assay Of Troponin, Quant - Troponin T",273.89,109.56,,,0 CDM,3018448404,Hc Troponin I 90613-So+,29.64,11.86,,,0 CDM,3018451003,Hc Assay Of Tyrosine,12.75,5.1,,,0 CDM,3018452001,"Hc Assay Urea Nitrogen, Quan - Blood Urea Nitrogen",80.87,32.35,,,0 CDM,3018452005,"Hc Assay Urea Nitrogen, Quan - Urea Nitrogen, Body Fluid????????",9.63,3.85,,,0 CDM,3018454001,Hc 967 Urea Nitrogen Ur-So+,17.08,6.83,,,0 CDM,3018454002,Hc Assay Urine Urea Nitrogen,83.03,33.21,,,0 CDM,3018455001,"Hc Assay Of Uric Acid, Blood - Uric Acid",100.28,40.11,,,0 CDM,3018456012,"Hc 051 Assay Of Uric Acid, Blood, Other Source - Uric Acid Body Fluid-So+",21.12,8.45,,,0 CDM,3018456013,Hc 052 Uric Acid Body Fluid-So+,23.4,9.36,,,0 CDM,3018456014,Hc 112 Uric Acid Body Fluid-So+,29.58,11.83,,,0 CDM,3018458516,Hc 063 Vanillylmandel Acid Ur-So+,30.67,12.27,,,0 CDM,3018458517,"Hc Vanillylmandelic Acid (Vma), Random Urine3018861-So+",18.0,7.2,,,0 CDM,3018458602,Hc 628 Vip Mayo-So+,84.05,33.62,,,0 CDM,3018458803,Hc 872 Arginine Vasopressin-So+,122.08,48.83,,,0 CDM,3018458804,"Hc Copeptin Proavp, Plasma 3018705-So+",54.0,21.6,,,0 CDM,3018459001,Hc 114 Vitamin A-So+,25.66,10.26,,,0 CDM,3018459112,"Hc Vitamin B3, S/P 3016752-So+",117.6,47.04,,,0 CDM,3018459701,Hc Assay Of Vitamin K - Vitamin K,30.0,12.0,,,0 CDM,3018460010,Hc 631 D-Xylose Absor Ur 3Hr-So+,213.0,85.2,,,0 CDM,3018460011,Hc Assay Of Volatiles - Volatile Compounds,229.68,91.87,,,0 CDM,3018463001,Hc 071 Zinc Rbc-So+,86.4,34.56,,,0 CDM,3018463002,Hc 112 Zinc S/P-So+,40.94,16.38,,,0 CDM,3018468101,Hc Assay Of C-Peptide - C-Peptide,240.47,96.19,,,0 CDM,3018470201,"Hc Chorionic Gonadotropin, Quant - Hcg Quantitative Blood",283.6,113.44,,,0 CDM,3018470206,"Hc Beta-Human Chorionic Gonadotropin, Quantitative, Spinal Fluid Bhsf-So+",46.78,18.71,,,0 CDM,3018470301,Hc Chorionic (Hcg) Gonadotropin ? Qual,153.12,61.25,,,0 CDM,3018499902,Hc 162 Osmolality Stool-So+,35.7,14.28,,,0 CDM,3018499903,Hc 247 Amylase Isoenzymes-So+,3.63,1.45,,,0 CDM,3018499907,Hc Chitotriosidase,304.09,121.64,,,0 CDM,3018499908,Hc Chitotriosidase Assay 451822-So+,327.76,131.1,,,0 CDM,3018499909,"Hc Potassium, Fecal 20380-So+",16.02,6.41,,,0 CDM,3018499910,"Hc Osmolality, Fecal 98122-So+",27.24,10.9,,,0 CDM,3018513006,Hc Factorviii Chromofactor,114.0,45.6,,,0 CDM,3018539003,Hc Platelet Trans Em/Whole Blood,965.26,386.1,,,0 CDM,3018603601,Hc Anca Vasculitis Profile3003745-So+,13.92,5.57,,,0 CDM,3018633402,"Hc Multiple Myeloma,Daratumamab",276.0,110.4,,,0 CDM,3018633403,Hc Immunofixation Cryoglobulin-Reflex Test For Cry_S,92.92,37.17,,,0 CDM,3018633427,"Hc Immunofixation, Daratumumab-Specific, Serum (2) 123218-So+",24.0,9.6,,,0 CDM,3018635301,Hc Toll-Like Receptor Function,58.83,23.53,,,0 CDM,3018664412,Hc Cmv Avidity,125.49,50.2,,,0 CDM,3018677718,"Hc Toxoplasma Gondii Igg Antibody, Elisa (Csf) (So)",59.54,23.82,,,0 CDM,3018738901,"Hc Hiv-1,2 Combo Ag/Ab, W/Rflx 2013333-So+",25.2,10.08,,,0 CDM,3018759301,Hc Orthopoxvirus By Pcr-Arup 3005716,121.51,48.6,,,0 CDM,3018790005,"Hc Human Immunodeficiency Virus1,Drug Resistance Ngs",152.77,61.11,,,0 CDM,3018837201,Hc Prion (Tissue) Western Blot (Reflexfor Ap Samples),59.65,23.86,,,0 CDM,301G010301,Hc Psa Screen,189.78,75.91,,,0 CDM,301G048009,Hc Tetrahydrocannabinol (Thc),324.42,129.77,,,0 CDM,301G048010,Hc Alcohol Isopropyl,324.42,129.77,,,0 CDM,301G048011,Hc Drug Analysis-Pharm 1-7 Class,324.42,129.77,,,0 CDM,301G048012,Hc Alcohol Ethyl,324.42,129.77,,,0 CDM,301G048013,Hc Alcohols Urine Screen,324.42,129.77,,,0 CDM,301G048014,Hc Oxycodone + Metabolite Urine,405.14,162.06,,,0 CDM,301G048022,Hc 311 Phosphatidylethanol-So+,211.04,84.42,,,0 CDM,301G048030,Hc 446 Nortriptyline Hplc-So+,211.04,84.42,,,0 CDM,301G048031,Hc 375 Clonazepam-So+,137.32,54.93,,,0 CDM,301G048032,Hc 196 Amitriptyline Qnt-So+,137.42,54.97,,,0 CDM,301G048034,Hc 165 Olanzapine Level-So+,211.04,84.42,,,0 CDM,301G048035,Hc 149 Syn Cannabinoid Met Ur-So+,211.04,84.42,,,0 CDM,301G048036,Hc 102 Resperidon & Metab S/P-So+,211.04,84.42,,,0 CDM,301G048037,Hc 486 Synth Stimulnt Ur-Soq+,274.35,109.74,,,0 CDM,301G048039,Hc 157 Nicotine &Metab Ur Qnt,274.35,109.74,,,0 CDM,301G048040,Hc 060 Nicotine Serum/Plasma-So+,211.04,84.42,,,0 CDM,301G048045,Hc 369 Hypoglycem Sulfonl S/P-So+,211.04,84.42,,,0 CDM,301G048047,Hc 441 Hypoglycemia Pnl S/P-So+,153.6,61.44,,,0 CDM,301G048049,Hc 487 Ethyl Gluc&Sulf Ur Qnt-So+,211.04,84.42,,,0 CDM,301G048051,Hc 950 Clomipramn & Metb S/P-So+,137.32,54.93,,,0 CDM,301G048054,Hc 095 Xanax (Alprazolam)-So+,137.42,54.97,,,0 CDM,301G048055,Hc 373 Pcp Quant Urine Arup-So+,211.04,84.42,,,0 CDM,301G048078,Hc 801 Dextro/Levo Methrp S/P-So+,225.6,90.24,,,0 CDM,301G048085,Hc Clobazam,165.76,66.3,,,0 CDM,301G048086,"Hc Synth Cannabinoid, S/P",425.88,170.35,,,0 CDM,301G048090,"Hc Phosphatidylethanol (Peth), Whole Blood, Quant (So)",186.88,74.75,,,0 CDM,301G048091,"Hc Sulfonylurea Hypoglycemia Panel,Quant,Urine-So+",275.0,110.0,,,0 CDM,301G048095,"Hc Oxycodone Confirmation, Urine",337.87,135.15,,,0 CDM,301G0480AA,"Hc Sertraline, Serum Or Plasma-Arup 3005859",178.52,71.41,,,0 CDM,301G0480AB,Hc Diazepam And Nordiazepam 90076-So+,137.32,54.93,,,0 CDM,301G0480AC,"Hc Aripipazole And Metabolite, Serum/Plasma 2007945-So+",137.32,54.93,,,0 CDM,301G0480AD,"Hc Quetiapine, Serum Or Plasma-So+",137.32,54.93,,,0 CDM,301G0480AE,"Hc Pentobarbital, Serum Or Plasma 017194-So+",137.32,54.93,,,0 CDM,301G0480AF,"Hc Nicotine And Metabolite, Serum, Lcmsms",345.34,138.14,,,0 CDM,301G0480AG,"Hc Imipramine And Desipramine, Serum Or Plasma 90157-So+",153.6,61.44,,,0 CDM,301G0480AH,"Hc Digitoxin Quantitative, Serum Or Plasma 3002537-So+",137.32,54.93,,,0 CDM,301G0480AI,"Hc Doxepin And Metabolite, Serum Or Plasma 90102-So+",137.32,54.93,,,0 CDM,301G0480AJ,"Hc Lsd, Urine - Screen With Reflex To Confirmation/Quantitation91224- So+",137.32,54.93,,,0 CDM,301G0480AK,"Hc Brivaracetam Quantitative, Serum Or Plasma 3004978-So+",166.8,66.72,,,0 CDM,301G0480AL,Hc Pentobarbital-So+,137.32,54.93,,,0 CDM,301G0480AM,"Hc Drugs Of Abuse Confirmation, Lcmsms, Quantitative",282.1,112.84,,,0 CDM,301G0480AN,"Hc Flucytosine By Mass Spectrometry, Serum/Plasma3018708-So+",462.0,184.8,,,0 CDM,301G0480AO,"Hc Lsd Confirmation, Urine 91627-So+",181.2,72.48,,,0 CDM,301G048101,Hc Meconium Drug Scr 8-14,490.36,196.14,,,0 CDM,301G048201,Hc Abuse Drug Screning Lcmsms 15-21,662.28,264.91,,,0 CDM,301G048301,Hc Qual Toxicol >22 Drug Classes,858.13,343.25,,,0 CDM,3020000002,Hc Rpr Quant & Treponema Pallidum Abs (Labcorp 012005 Reflex-P),52.21,20.88,,,0 CDM,3020000003,Hc Metal Sensitivity (Arup->Orthopedic Analysis M8-P),145.08,58.03,,,0 CDM,3020035U01,"Hc Markers (Cjd), Csf 3001255-So+",649.19,259.68,,,0 CDM,3020432U01,"Hc Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Csf Mdc2 #4-So+",48.89,19.56,,,0 CDM,3020432U02,"Hc Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum Mds2 #5-So+",55.72,22.29,,,0 CDM,3028351901,"Hc Dysautonomia, Autoimm/Paraneo, S Dys2 #2=So+",90.58,36.23,,,0 CDM,3028351974,"Hc Neuronal (V-G) K+ Channel Ab, S",43.43,17.37,,,0 CDM,3028600004,Hc Reflex Francisella Tularensis Antibodies By Agglutination 3002915-So+,39.07,15.63,,,0 CDM,3028600135,"Hc Allergen Specific Igg, Each Food Allergen",21.59,8.64,,,0 CDM,3028600303,Hc Allergen Spec Ige - Allergen Almonds Ige,21.59,8.64,,,0 CDM,3028600313,Hc Allergen Spec Ige - Allergen Banana Ige,21.59,8.64,,,0 CDM,3028600314,Hc Allergen Spec Ige - Allergen Barley Ige,21.59,8.64,,,0 CDM,3028600317,"Hc Allergen Spec Ige - Allergen Bean, Green Ige",21.59,8.64,,,0 CDM,302860032D,Hc Allergen Spec Ige - Allergen Food: Rber E 1 Brazil Nut,21.59,8.64,,,0 CDM,302860032S,Hc Allergen Spec Ige - Allergen Tree: Chestnut,21.59,8.64,,,0 CDM,3028600340,Hc 832 Allergen Specific Ige Ea-So+,18.77,7.51,,,0 CDM,3028600341,Hc 329 Allergen Spinach Ige Ab-So+,18.77,7.51,,,0 CDM,3028600342,Hc 465 Allergen Oat Ige Ab-So+,18.77,7.51,,,0 CDM,3028600344,Hc 487 Allergen Chicken Ige Ab-So+,18.77,7.51,,,0 CDM,3028600346,Hc 489 Allergen Beef Ige Ab-So+,18.77,7.51,,,0 CDM,3028600347,Hc 749 Allergen Sesame-So+,18.77,7.51,,,0 CDM,3028600348,Hc 785 Allergen Mussels Blu Ige-So+,18.77,7.51,,,0 CDM,3028600349,Hc 787 Allergen Salmon Ige-So+,18.77,7.51,,,0 CDM,3028600351,Hc 326 Allergen Scallop Ige Ab-So+,18.77,7.51,,,0 CDM,3028600352,Hc 331 Allergen Tuna Ige Ab-So+,18.77,7.51,,,0 CDM,3028600353,Hc 484 Allergen Corn Ige Ab-So+,18.77,7.51,,,0 CDM,3028600354,Hc 485 Allergen Codfish Ige Ab-So+,18.77,7.51,,,0 CDM,3028600355,Hc 324 Allergen Pork Ige Ab-So+,18.77,7.51,,,0 CDM,3028600356,Hc 480 Allergen Egg Whol Ige Ab-So+,18.77,7.51,,,0 CDM,3028600357,Hc 788 Allergen Oyster Ige-So+,18.77,7.51,,,0 CDM,3028600358,Hc 842 Allergen Hazelnut-So+,18.77,7.51,,,0 CDM,3028600361,Hc 481 Allergen Dog Dander Ige Ab-So+,18.77,7.51,,,0 CDM,3028600362,Hc 598 Allergen Alpha-Gal Ige-So+,18.77,7.51,,,0 CDM,3028600363,Hc 598 Allergen Beef Ige-So+,18.77,7.51,,,0 CDM,3028600366,Hc 998 Allergen Latex Ige Ab-So+,18.77,7.51,,,0 CDM,3028600367,Hc 783 Allergen Crab Ige-So+,18.77,7.51,,,0 CDM,3028600368,Hc 784 Allergen Lobster Ige-So+,18.77,7.51,,,0 CDM,3028600369,Hc 789 Allergen Clam Ige-So+,18.77,7.51,,,0 CDM,3028600370,Hc 840 Allergen Brazil Nut Ige-So+,18.77,7.51,,,0 CDM,3028600371,Hc 327 Allergen Shrimp Ige Ab-So+,18.77,7.51,,,0 CDM,3028600372,Hc 747 Allergen Macadamia-So+,18.77,7.51,,,0 CDM,3028600373,Hc 479 Allergen Egg Whit Ige Ab-So+,18.77,7.51,,,0 CDM,3028600374,Hc 328 Allergen Soybean Ige Ab-So+,18.77,7.51,,,0 CDM,3028600375,Hc 745 Allergen Pistachio-So+,18.77,7.51,,,0 CDM,3028600376,Hc 746 Allergen Pecan-So+,18.77,7.51,,,0 CDM,3028600378,Hc 839 Allergen Cashew Ige-So+,18.77,7.51,,,0 CDM,3028600379,Hc 744 Allergen Walnut-So+,18.77,7.51,,,0 CDM,3028600380,Hc 748 Allergen Peanut-So+,18.77,7.51,,,0 CDM,3028600383,Hc 492 Allergen Almond Ige Ab-So+,18.77,7.51,,,0 CDM,3028600384,Hc 692 Allergen Spec Ige Ea-So+,18.77,7.51,,,0 CDM,3028600385,Hc 468 Allergen Milk Cow Ige Ab-So+,18.77,7.51,,,0 CDM,3028600389,Hc 296 Allergen Asperg Ful Ige-So+,18.77,7.51,,,0 CDM,3028600390,Hc 829 Allergen Spec Ige Ea-So+,18.77,7.51,,,0 CDM,3028600392,Hc 693 Allergen Spec Ige Ea-So+,18.77,7.51,,,0 CDM,3028600395,Hc 831 Allergen Walnut Black Food Ige-So+,18.77,7.51,,,0 CDM,30286003AE,Hc 841 Allergen Chestnut Ige-So+,44.4,17.76,,,0 CDM,30286003AH,Hc 321 Allergen Grn Pea Ige Ab-So+,18.77,7.51,,,0 CDM,30286003AL,Hc 466 Allergen Nutmeg Ige Ab-So+,18.77,7.51,,,0 CDM,30286003AO,Hc 638 Cat Dander Ige Ab Allg-So+,25.8,10.32,,,0 CDM,30286003AP,Hc 470 Allergen Horses Dander Ige Ab-So+,18.77,7.51,,,0 CDM,30286003AT,Hc 476 Allergen Ginger Ige Ab-So+,18.77,7.51,,,0 CDM,30286003AV,Hc 478 Allergen Egg Yolk Ige Ab-So+,18.77,7.51,,,0 CDM,30286003AX,Hc 483 Allergen Cow Dand Ige Ab-So+,18.77,7.51,,,0 CDM,30286003AY,Hc 786 Allergen Octopus Ige-So+,22.67,9.07,,,0 CDM,30286003B5,Hc Allergen Spec Ige - Allergen Food: Strawberry Ige,21.59,8.64,,,0 CDM,30286003BA,Hc 821 Allergen Tilapia Ige-So+,22.63,9.05,,,0 CDM,30286003BB,Hc 491 Allergen Apple Ige Ab-So+,18.77,7.51,,,0 CDM,30286003BC,Hc 688 Allergen-So+,18.77,7.51,,,0 CDM,30286003BD,Hc 634 Allergen Casein Ige Ab-So+,18.77,7.51,,,0 CDM,30286003BF,Hc 635 Allergen Whey Ige Ab-So+,18.77,7.51,,,0 CDM,30286003BM,Hc 322 Allergen Pcn Notat Ige Ab-So+,18.77,7.51,,,0 CDM,30286003BQ,Hc 325 Allergen Potato White Ige Ab-So+,18.77,7.51,,,0 CDM,30286003BU,Hc 332 Allergen Turkey Ige Ab-So+,18.77,7.51,,,0 CDM,30286003BV,Hc 750 Allergen Tomato-So+,18.77,7.51,,,0 CDM,30286003BW,Hc 334 Allergen Watermelon Ige Ab-So+,18.77,7.51,,,0 CDM,30286003CA,Hc 815 Allergen Rice Ige-So+,18.77,7.51,,,0 CDM,30286003CB,Hc 464 Allergen Orange Ige Ab-So+,18.77,7.51,,,0 CDM,30286003CC,Hc 817 Allergen Cabbage Ige-So+,18.77,7.51,,,0 CDM,30286003CD,Hc 475 Allergen Gluten Ige Ab-So+,18.77,7.51,,,0 CDM,30286003CE,Hc 477 Allergen Feath Mx Ige Ab-So+,18.77,7.51,,,0 CDM,30286003CN,Hc 482 Allergen Cranberry Ige Ab-So+,18.77,7.51,,,0 CDM,30286003CO,Hc 819 Allergen Mustard Ige-So+,18.77,7.51,,,0 CDM,30286003CP,Hc 486 Allergen Chocolate Ige Ab-So+,18.77,7.51,,,0 CDM,30286003CU,Hc 823 Allergen Onion Ige-So+,18.77,7.51,,,0 CDM,30286003CX,Hc 813 Allergen Celery Ige-So+,18.77,7.51,,,0 CDM,30286003CY,Hc 836 Allergen Lamb Ige-So+,18.77,7.51,,,0 CDM,30286003D,Hc 515 Allergen Spec Ige Ea-So+,18.77,7.51,,,0 CDM,30286003DE,Hc 831 Allergen Dust Cockroach Grm-So+,18.77,7.51,,,0 CDM,30286003DF,Hc Chickpea/Garbanzo Bean (Cicer Arietinus) Ige-So+,18.77,7.51,,,0 CDM,30286003DG,Hc Allergen Spec Ige Crude Allergen Extract-So+,20.57,8.23,,,0 CDM,30286003EE,"Hc Allergen, Level1",6.9,2.76,,,0 CDM,30286003EF,"Hc Allergen, Tree, Poplar White Ige So+-Arup 0098859",18.77,7.51,,,0 CDM,30286003FA,Hc Hypersensitivity Pneumonitis Ext Panel 3001561-So+,6.49,2.6,,,0 CDM,30286003H2,Hc Allergen Spec Ige - Allergen Mushroom Ige,21.59,8.64,,,0 CDM,30286003K4,Hc Allergen Spec Ige - Allergen Rye Ige,21.59,8.64,,,0 CDM,30286003N2,Hc Allergen Spec Ige - Allergen Oat Ige,21.59,8.64,,,0 CDM,30286003Q1,Hc Allergen Spec Ige - Allergen Macadamia Nut Ige,21.59,8.64,,,0 CDM,30286003Q3,Hc Allergen Spec Ige - Allergen Pineapple Ige,21.59,8.64,,,0 CDM,30286003R4,Hc Allergen Spec Ige - Allergen Sesame Seed Ige,21.59,8.64,,,0 CDM,30286003R5,Hc Allergen Spec Ige - Allergen Walnut Tree Ige,21.59,8.64,,,0 CDM,30286003U4,Hc Allergen Spec Ige - Allergen Shrimp Ige,21.59,8.64,,,0 CDM,30286003V5,Hc Allergen Spec Ige - Allergen Wheat Ige,21.59,8.64,,,0 CDM,30286003Y4,Hc Allergen Spec Ige - Allergen Soybean Ige,21.59,8.64,,,0 CDM,30286003ZA,"Hc Allergen, Locust Tree-Arup T004-Ige-So+",19.68,7.87,,,0 CDM,30286003ZB,"Hc Allergen, Gerbil Epithelium-Arup 83710A-So+",44.29,17.72,,,0 CDM,30286003ZC,"Hc Allergen, Lactobacillus Bulgaricus (Yogurt)-Arup 31510S-So+",25.84,10.34,,,0 CDM,30286003ZD,"Hc Allergen, Rhodoturula Mucilaginosa-Arup M027-So+",28.83,11.53,,,0 CDM,30286003ZE,"Hc Allergen, Rabbit Urine Protein-Arup-So+",69.0,27.6,,,0 CDM,3028600501,"Hc Allergen, Epidermals And Animal Proteins, Feather Mix-Arup 0055037",10.02,4.01,,,0 CDM,3028600502,Hc Hypersensitivity Pneumonitis Ext Panel 1-So+,6.49,2.6,,,0 CDM,3028600801,Hc Allergen Peanut Ige 2007211-So+,20.57,8.23,,,0 CDM,3028600818,Hc Allergen Components-So+,21.52,8.61,,,0 CDM,3028601501,"Hc F-Actin Ab, Igg Eia With Rflx To Asm Ifa 51174-So+",14.46,5.78,,,0 CDM,3028602110,Hc 596 Granulocyte Ab Serum-So+,75.43,30.17,,,0 CDM,3028602202,Hc 119 Hit Pf4 Igg W/Rfx->Sra-So+,66.05,26.42,,,0 CDM,3028602204,Hc 830 Platelet Ab Id (11)-So+,303.6,121.44,,,0 CDM,3028602207,Hc 120 Sra Unfract Hep-So+,258.0,103.2,,,0 CDM,3028602211,Hc 304 Plt Surf Glycoprotein-So+,56.0,22.4,,,0 CDM,3028602218,Hc Serotonin Release Assay,189.06,75.62,,,0 CDM,3028602219,Hc Heparin Dependent Ab With Reflex To Sra,189.06,75.62,,,0 CDM,3028602220,Hc Platelet Antibody Identification Panel,396.06,158.42,,,0 CDM,3028602221,"Hc-Heparin-Induced Thromobocytopenia Evaluation - Pea -Pf4,Igg-Versiti 5504-So+",190.8,76.32,,,0 CDM,3028603801,Hc 685 Centromere B Ab-So+,66.0,26.4,,,0 CDM,3028603803,Hc 925 Ana Ifa Pattern-Rfx-So+,43.48,17.39,,,0 CDM,3028603905,"Hc Antinuclear Antibody (Ana), Hep-2, Igg 3000082-So+",12.0,4.8,,,0 CDM,3028603906,Hc Extended Myositis Panel Ext2 #4-So+,25.9,10.36,,,0 CDM,3028604101,Hc Acetylcholine Receptor Binding Antibody 80009-So+,20.4,8.16,,,0 CDM,3028604201,Hc Acetylcholine Blocking Ab 99580-So+,33.6,13.44,,,0 CDM,3028604301,Hc Acetylcholine Receptor Modulating Ab 99521-So+,46.8,18.72,,,0 CDM,3028605301,"Hc Pediatric Autoimmune Encephalopathy/Cns Disorder Evaluation, Serum Pcdes #3-So+",138.46,55.38,,,0 CDM,3028605302,Hc Pcdes Facs Ab Titer-So+,104.4,41.76,,,0 CDM,3028605303,"Hc Pediatric Autoimmune Encephalopathy/Cns Disorder Evaluation, Spinal Fluid Pcdec #2 -So+",100.0,40.0,,,0 CDM,3028605304,Hc Neuromyelitis Optica (Nmo)/Aquaporin-4-Igg Nmofs-So+,354.0,141.6,,,0 CDM,3028606004,Hc 091 Aso Ab Qnt-So+,18.46,7.38,,,0 CDM,3028614001,Hc C-Reactive Protein - C-Reactive Protein,150.65,60.26,,,0 CDM,3028614004,Hc 870 C-Reactive Protein-So+,13.75,5.5,,,0 CDM,3028614101,"Hc C-Reactive Protein,High Sensitivity - High Sensitivity Crp",188.6,75.44,,,0 CDM,3028614601,"Hc Beta 2 Glycoprotein I Antibody,Ea - Beta-2 Glycoprotein Abs",131.1,52.44,,,0 CDM,3028614602,Hc Beta-2-Glycoprotein 1 Igm,131.1,52.44,,,0 CDM,3028614603,"Hc Beta-2 Glycoprotein 1 Antibody, Iga 50324-So+",30.54,12.22,,,0 CDM,3028614701,Hc 060 Cardiolipin Ab Igg-So+,245.0,98.0,,,0 CDM,3028614702,"Hc Cardiolipin Antibody - Cardiolipin Antibody, Iga - So+",30.54,12.22,,,0 CDM,3028614703,"Hc 793 Cardiolipin Antibody - Cardiolipin Antibody, Iga-So+",245.0,98.0,,,0 CDM,3028614705,Hc Cardiolipin Iga,281.75,112.7,,,0 CDM,3028614804,Hc 763 Phospholipid Ab Ea-So+,57.79,23.12,,,0 CDM,3028615601,Hc Cold Agglutinin Screen - Cold Agglutinin Screen,33.34,13.34,,,0 CDM,3028616001,"Hc Complement, Antigen - C4 Complement",205.85,82.34,,,0 CDM,3028616002,"Hc Complement, Antigen - C3 Complement",205.85,82.34,,,0 CDM,3028616021,Hc 146 C-1 Esterase Inhibitor-So+,43.16,17.26,,,0 CDM,3028616029,Hc 657 Factor I-So+,326.4,130.56,,,0 CDM,3028616033,Hc 356 Sc5B-9-So+,275.81,110.32,,,0 CDM,3028616034,Hc 653 Factor H-So+,252.49,101.0,,,0 CDM,3028616038,Hc 656 Factor B-So+,127.6,51.04,,,0 CDM,3028616042,Hc Soluble C5B-9 33335-So+,288.0,115.2,,,0 CDM,3028616102,Hc 137 C-1 Esteras Inhb Func-So+,43.16,17.26,,,0 CDM,3028616114,"Hc C-1-Esterase Inhibitor, Functional 50141-So+",25.2,10.08,,,0 CDM,3028616210,Hc Complement Act Tot Eia-So+,73.08,29.23,,,0 CDM,3028620001,Hc Cyclic Cirullinated Peptide Antibody - Cyclic Citrul Peptide Antibdy,143.75,57.5,,,0 CDM,3028621501,Hc 150 Dnase-B Ab-So+,15.9,6.36,,,0 CDM,3028622601,Hc 738 Dna Sng Strd Igg-So+,43.54,17.42,,,0 CDM,3028623101,"Hc Endomysial Antibody, Iga By Ifa 50736-So+",27.6,11.04,,,0 CDM,3028623501,Hc 649 Nuclear Antigen Ea Ab-So+,35.5,14.2,,,0 CDM,3028623502,Hc Nuclear Antigen Antibody - Sjogrens Syndrome-B Ext Nuc Ab,238.05,95.22,,,0 CDM,3028623504,Hc Nuclear Antigen Antibody - Scleroderma (Scl-70) Antibody,21.52,8.61,,,0 CDM,3028623506,Hc 080 Centromere B Ab-So+,21.48,8.59,,,0 CDM,3028623507,"Hc Nuclear Antigen Antibody - Ribonucleic Protein Antibody, Igg",238.05,95.22,,,0 CDM,3028623508,Hc 078 Jo-1 Ab Igg-So+,64.5,25.8,,,0 CDM,3028623509,Hc 394 Ribosom P Prot Ab Arup-So+,64.5,25.8,,,0 CDM,3028623522,"Hc Smith (Ena) Antibody, Igg (So)",37.09,14.84,,,0 CDM,3028623524,"Hc Ssa And Ssb Abs, Igg 50791-So+",21.52,8.61,,,0 CDM,3028623526,Hc Nuclear Antigen Antibody - Sjogrens Syndrome-A Ext Nu Ab,238.05,95.22,,,0 CDM,3028623527,"Hc Smith/Rnp (Ena) Antibody, Igg (So)",21.52,8.61,,,0 CDM,3028623530,Hc Extractable Nuclear Antigen Ea Antibody,94.3,37.72,,,0 CDM,3028623531,"Hc Fibrillarin (U3 Rnp) Antibody, Igg",109.71,43.88,,,0 CDM,3028623532,"Hc Pm/Scl-100 Antibody, Igg By Immunoblot",89.7,35.88,,,0 CDM,3028623533,Hc Extended Myositis Panel Ext2 #2-So+,25.9,10.36,,,0 CDM,3028625522,Hc 955 Myelin Olig Glycoprtn-So+,535.5,214.2,,,0 CDM,3028625533,Hc 924 Dna(Ds) Crithidia-Rfx-So+,42.44,16.98,,,0 CDM,3028625537,Hc 922 Parietal Cell Ab Igg-So+,34.94,13.98,,,0 CDM,3028625539,Hc 576 Endomysial Ab Iga-So+,30.0,12.0,,,0 CDM,3028625540,Hc 781 Nmo Igg Csf-So+,292.34,116.94,,,0 CDM,3028625542,Hc 074 Anti-Yo (Purkinje) Aru-So+,40.0,16.0,,,0 CDM,3028625543,Hc 175 Rfx-Nmo/Aqp4 Igg Facs-So+,274.38,109.75,,,0 CDM,3028625551,Hc 081 Striated Mus Abs Igg-So+,23.86,9.54,,,0 CDM,3028625552,Hc 182 Anca Igg-So+,23.86,9.54,,,0 CDM,3028625555,Hc 579 Phospholip A2 Ab Scr-So+,170.92,68.37,,,0 CDM,3028625557,Hc 009 Nmda Serum-So+,151.54,60.62,,,0 CDM,3028625571,Hc 533 Hu Ab Screen-So+,106.0,42.4,,,0 CDM,3028625572,Hc 533 Yo Ab Screen-So+,106.0,42.4,,,0 CDM,3028625573,Hc 533 Ri Ab Screen-So+,106.0,42.4,,,0 CDM,3028625578,Hc Ampa-R Ab Cba-So+,510.0,204.0,,,0 CDM,3028625579,Hc Caspr2-Igg Cba-So+,275.0,110.0,,,0 CDM,3028625580,Hc Dppx Ab Ifa-So+,210.0,84.0,,,0 CDM,3028625581,Hc Gaba-B-R Ab Cba-So+,510.0,204.0,,,0 CDM,3028625582,Hc Lgi-Igg Cba-So+,275.0,110.0,,,0 CDM,3028625583,Hc Mglur1 Ab Cba-So+,510.0,204.0,,,0 CDM,3028625584,Hc Mglur1 Ab Ifa-So+,210.0,84.0,,,0 CDM,3028625585,Hc Nmda-R Ab Cba-So+,510.0,204.0,,,0 CDM,3028625586,Hc Achr Modulating Flow Cytom-So+,185.0,74.0,,,0 CDM,3028625587,Hc Fluorescent Antibody Screen,115.0,46.0,,,0 CDM,3028625588,Hc Dppx Ab Cba-So+,510.0,204.0,,,0 CDM,3028625589,"Hc Amphyisphysin Ab, S",172.5,69.0,,,0 CDM,3028625590,"Hc Anti-Glial Nuclear Ab, Type 1",172.5,69.0,,,0 CDM,3028625591,"Hc Anti-Neuronal Nuclear Ab, Type 1",172.5,69.0,,,0 CDM,3028625592,"Hc Anti-Neuronal Nuclear Ab, Type 2",184.0,73.6,,,0 CDM,3028625593,"Hc Anti-Neuronal Nuclear Ab, Type 3",195.5,78.2,,,0 CDM,3028625594,"Hc Crmp 5 Igg, S",172.5,69.0,,,0 CDM,3028625595,Hc Purkinje Cell Cytoplasmic Ab Type 1,172.5,69.0,,,0 CDM,3028625596,Hc Purkinje Cell Cytoplasmic Ab Type 2,184.0,73.6,,,0 CDM,3028625597,Hc Purkinje Cell Cytoplasmic Ab Type 3,195.5,78.2,,,0 CDM,3028625599,Hc Ens2 Antibody Reflex Cba-So+,550.92,220.37,,,0 CDM,30286255AA,"Hc Phospholipase A2 Receptor, Immunofluorescence, Serum (Mayo)",354.0,141.6,,,0 CDM,30286255AB,Hc Thrombospondin Type-1 Domain -Containing 7A Antibodies (Mayo),354.0,141.6,,,0 CDM,30286255AG,"Hc Paraneoplas Autoantibody Eval,Csf",621.0,248.4,,,0 CDM,30286255AH,"Hc Muscle-Specific Kinase (Musk) Antibody, Igg By Cba-Ifa With Reflex To Titer, Serum (3006198)-So+",354.0,141.6,,,0 CDM,30286255AI,"Hc Encephalopathy, Autoimm/Paraneo, S Ens2 #2-So+",70.91,28.36,,,0 CDM,30286255AJ,Hc Enc2 Encephalopathy Autoimmuneparaneoplastic Evaluation Spinal Fluid Enc2-So+,60.0,24.0,,,0 CDM,30286255AK,"Hc Pediatric Autoimmune Encephalopathy/Cns Disorder Evaluation, Serum Pcdes #2-So+",138.46,55.38,,,0 CDM,30286255AL,"Hc Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum Mds2 #3-So+",55.72,22.29,,,0 CDM,30286255AM,"Hc Pediatric Autoimmune Encephalopathy/Cns Disorder Evaluation, Spinal Fluid Pcdec #1-So+",100.0,40.0,,,0 CDM,30286255AN,"Hc Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid Mdc2-So+",48.89,19.56,,,0 CDM,30286255AO,"Hc Encephalopathy, Autoimmune/Paraneoplastic Eval, Csf Cba Ab-So+",550.92,220.37,,,0 CDM,30286255AP,"Hc Encephalopathy, Autoimmune/Paraneoplastic , Csf Ifa Titer #2-So+",234.0,93.6,,,0 CDM,30286255AQ,Hc Stiff-Person Spectrum Disorders Evaluation Spps #2-So+,220.5,88.2,,,0 CDM,30286255AR,"Hc Reflex Ifa, Titer So+",36.96,14.78,,,0 CDM,30286255AS,"Hc Dysautonomia, Autoimm/Paraneo, S Dys2-So+",90.58,36.23,,,0 CDM,3028625608,Hc 955 Mogfs Rflx Ttr-So+,76.5,30.6,,,0 CDM,3028625634,Hc 511 Nmo/Aqp4-Igg Facs Ttr-So+,27.52,11.01,,,0 CDM,3028625636,Hc 579 Phospholip A2 Ab Ttr-So+,241.16,96.46,,,0 CDM,3028625637,Hc 916 Dna(Ds) Titer Rflx-So+,23.86,9.54,,,0 CDM,3028625658,"Hc Immunoassay, Tumor Antigen, Ca 19-9 - Cancer Antigen 19-9",255.3,102.12,,,0 CDM,3028625659,Hc 336 Ca 19-9-Soq+,24.97,9.99,,,0 CDM,3028625675,Hc 855 Neuron Spec Enolase-So+,74.84,29.94,,,0 CDM,3028625677,Hc 376 Angiotens-1-Recpt At1R-So+,352.8,141.12,,,0 CDM,3028625690,Hc 706 Tetanus Ab Igg-So+,17.99,7.2,,,0 CDM,3028625695,Hc Anca Titer Bill (Arup) (So),312.8,125.12,,,0 CDM,30286256AA,Hc Ampa-R Ab If Titer-So+,72.0,28.8,,,0 CDM,30286256AB,Hc Dppx Ab Ifa Titer-So+,75.0,30.0,,,0 CDM,30286256AC,Hc Gaba-B-R Ab If Titer-So+,75.0,30.0,,,0 CDM,30286256AD,Hc Mglur1 Ab Ifa Titer-So+,138.0,55.2,,,0 CDM,30286256AE,Hc Nmda-R Ab If Titer-So+,75.0,30.0,,,0 CDM,30286256AF,"Hc Muscle-Specific Kinase (Musk) Antibody, Igg Titer (3006251)-So+",362.4,144.96,,,0 CDM,30286256AG,Hc Ens2 Antibody Reflex Titer-So+,60.0,24.0,,,0 CDM,30286256AJ,Hc Ens2 Antibody Reflex Ifa #3-So+,114.0,45.6,,,0 CDM,30286256AK,Hc Mds2 Ifa Titer-So+,120.72,48.29,,,0 CDM,30286256AL,"Hc Double-Stranded Dna (Dsdna) Antibody, Igg 2002693-So+",26.4,10.56,,,0 CDM,30286256AM,Hc Reflex Titer-So+,128.4,51.36,,,0 CDM,3028625801,"Hc Gliadin Peptide Antibody, Iga 0051357-So+",14.46,5.78,,,0 CDM,3028625802,"Hc Gliadin Peptide Antibody, Igg 0051359-So+",14.46,5.78,,,0 CDM,3028627754,Hc Growth Hormone Ab-So+,92.4,36.96,,,0 CDM,3028629455,Hc Bladder Tumor Assc Ag-So+,78.55,31.42,,,0 CDM,3028630056,Hc Ca 27.29-Soq+,74.84,29.94,,,0 CDM,3028630057,Hc Ca 15-3-So+,74.84,29.94,,,0 CDM,3028630158,"Hc Immunoassay, Tumor Antigen, Ca 19-9 - Cancer Antigen 19-9",255.3,102.12,,,0 CDM,3028630464,Hc Ca-125,287.5,115.0,,,0 CDM,3028630801,Hc Ebv Igm Heterophilic Antibody,138.0,55.2,,,0 CDM,3028630866,"Hc Heterophile Antibodies,Screen - Mononucleosis Screen",138.0,55.2,,,0 CDM,3028631670,Hc Chromogranin A Mayo-So+,54.92,21.97,,,0 CDM,3028631675,Hc Neuron Spec Enolase-So+,38.92,15.57,,,0 CDM,3028631676,"Hc Alpha Fetoprotein, Csf (Tumor Marker) 20729-So+",24.97,9.99,,,0 CDM,3028631702,"Hc Immunoassay,Infect Agent,Quant - Tetanus Antibody, Igg",34.49,13.8,,,0 CDM,3028631784,Hc Haemophil Inf B Ab Aru-So+,53.9,21.56,,,0 CDM,3028631785,Hc Diphtheria Ab Igg-So+,17.99,7.2,,,0 CDM,3028631786,Hc 189 Pneumo Ab Igg Ea-Soq+,53.9,21.56,,,0 CDM,30286317AA,"Hc Streptococcus Pneumoniae Abs, Igg (23 Serotype)-So+",17.99,7.2,,,0 CDM,30286317AB,"Hc Prion Markers (Cjd), Csf 3001255-So+",17.99,7.2,,,0 CDM,30286317AC,Hc Reflex Prion Markers Bloody Total Tau 3019875-So+,80.65,32.26,,,0 CDM,30286317AD,Hc Reflex Prion Markers 14-3-3 3019874 -So+,38.65,15.46,,,0 CDM,30286317AE,Hc Reflex Prion Markers Total Tau-So+,38.65,15.46,,,0 CDM,3028632901,Hc Teichoic Acid Antibodies-So+,28.44,11.38,,,0 CDM,3028633101,Hc Immunodiffusion Ouchterlony - Hyper Pneumo Extended Panel,38.57,15.43,,,0 CDM,3028633116,Hc 767 Imm Comp Asy Raji Cell-So+,115.92,46.37,,,0 CDM,3028633117,Hc Fungal Antibodies By Immunodiffusion (So),56.43,22.57,,,0 CDM,3028633118,Hc Hypersensitivity Pneumonitis Ext Panel 2-So+,6.49,2.6,,,0 CDM,3028633119,Hc Hypersensitivity Pneumonitis 1 3006065 (1)-So+,22.86,9.14,,,0 CDM,3028633120,Hc Hypersensitivity Pneumonitis Panel 4-So+,14.38,5.75,,,0 CDM,3028633121,Hc Hypersensitivity Pneumonitis Avian Panel Favi-So+,99.6,39.84,,,0 CDM,3028633201,Hc 767 Imm Comp Asy C1Q-So+,115.92,46.37,,,0 CDM,3028633401,Hc Ife Serum,362.25,144.9,,,0 CDM,3028633501,Hc Immunfix E-Phorsis/Urine/Csf - Beta 2 Transferrin,372.6,149.04,,,0 CDM,3028633502,Hc 154 Tau Transferrin-Soq+,327.36,130.94,,,0 CDM,3028633503,Hc 587 Immunofixation Csf-So+,306.0,122.4,,,0 CDM,3028633504,Hc Beta-2 Transferrin-Arup 0050047-So+,93.6,37.44,,,0 CDM,3028633702,Hc 320 Insulin Ab-So+,76.98,30.79,,,0 CDM,3028634001,Hc 877 Intrinisic Fac Blk Abs-So+,54.23,21.69,,,0 CDM,3028634102,Hc Gad65 Ab-So+,240.0,96.0,,,0 CDM,30286341AD,Hc 511 Rfx-Gad65 Ab Csf-So+,94.62,37.85,,,0 CDM,30286341AJ,Hc 461 Gad Ab-So+,71.15,28.46,,,0 CDM,30286341AK,Hc 367 Islet Cl Cytopls Ab Igg-So,71.15,28.46,,,0 CDM,30286341AS,Hc 099 Zinc Transporter 8 Ab-So+,311.52,124.61,,,0 CDM,30286341AV,Hc 493 Islet Ag 2(Ia-2)Autoab-So+,113.82,45.53,,,0 CDM,30286341AX,"Hc Encephalopathy, Autoimm/Paraneo, S Ens2-So+",70.91,28.36,,,0 CDM,30286341AY,Hc Enc2 Encephalopathy Autoimmuneparaneoplastic Evaluation Spinal Fluid Enc2 #2-So+,60.0,24.0,,,0 CDM,30286341AZ,"Hc Pediatric Autoimmune Encephalopathy/Cns Disorder Evaluation, Serum Pcdes #1-So+",138.64,55.46,,,0 CDM,30286341BA,"Hc Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum Mds2 #2-So+",55.72,22.29,,,0 CDM,30286341BB,"Hc Pediatric Autoimmune Encephalopathy/Cns Disorder Evaluation, Spinal Fluid Pcdec-So+",100.0,40.0,,,0 CDM,30286341BC,"Hc Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid Mdc2 #3-So+",48.89,19.56,,,0 CDM,30286341BD,Hc Stiff-Person Spectrum Disorders Evaluation Spps #1-So+,220.5,88.2,,,0 CDM,30286352AA,Hc 229 Immune Cell Function-So+,255.0,102.0,,,0 CDM,30286352AB,Hc 512 Infliximab Activity-So+,669.6,267.84,,,0 CDM,30286352AD,Hc 048 Cell Function W/Stim-So+,540.06,216.02,,,0 CDM,30286352AE,Hc 328 Neutr Oxid Burst Dhr-So+,268.92,107.57,,,0 CDM,30286352AG,Hc 482 Functional Anti Fcer-So+,163.03,65.21,,,0 CDM,30286352AN,Hc Immuknow 9016-So+,239.54,95.82,,,0 CDM,3028635301,Hc 986 Lymph Trans Mit Or Ag-So+,406.8,162.72,,,0 CDM,3028635302,Hc 894 Lymph Trans Mit Or Ag-So+,394.8,157.92,,,0 CDM,3028635309,Noncdm Charge Record,140.11,56.04,,,0 CDM,3028635310,Hc Lymphocyte Antigen Proliferation-Arup 0096055-So+,185.25,74.1,,,0 CDM,3028635311,Hc Lymphocyte Mitogen Proliferation-Arup 0096043-So+,112.0,44.8,,,0 CDM,3028635312,Hc Pre/Post Procedure Metal Sensitivity Arup-Oa-So+,63.0,25.2,,,0 CDM,3028635313,Hc Lymphocyte Transformation Arup-So+,52.8,21.12,,,0 CDM,3028635501,"Hc B Cells, Total Count - B Cells, Total Count",238.05,95.22,,,0 CDM,3028635506,Hc B Cell Total Count,60.72,24.29,,,0 CDM,3028635507,Hc B Cell Total Count Arup-So+,52.8,21.12,,,0 CDM,3028635607,Hc 161 Kleinhauer Betke-So+,169.73,67.89,,,0 CDM,3028635608,Noncdm Charge Record,52.99,21.2,,,0 CDM,3028635609,"Hc Paroxysmal Nocturnal Hemoglobinuria (Pnh), High Sensitivity, Rbc And Wbc 2005006-So+",55.0,22.0,,,0 CDM,3028635701,"Hc Nk Cells, Total Count - Natural Killer Cell Count",231.15,92.46,,,0 CDM,3028635705,Noncdm Charge Record,74.66,29.86,,,0 CDM,3028635708,"Hc Natural Killer Cells, Total Count-So+",52.8,21.12,,,0 CDM,3028635901,"Hc T Cells, Total Count - T Cells, Total Count",350.75,140.3,,,0 CDM,3028635904,Noncdm Charge Record,74.66,29.86,,,0 CDM,3028636001,Hc T Cell Absolute Count/Ratio - T-Helper Cells Cd4/Cd8 %,400.2,160.08,,,0 CDM,3028636102,Hc Cd4 Percent And Absolute 0095885-So+,36.0,14.4,,,0 CDM,3028636601,"Hc Musk Igg Ab Cba, Serum, With Rflx 3006198-So+",354.0,141.6,,,0 CDM,3028636701,"Hc Stem Cells, Total Count - Stem Cells, Total Count",776.25,310.5,,,0 CDM,3028637601,Hc 111 Liv-Kid Microsm Ab Igg-So+,52.32,20.93,,,0 CDM,3028637602,Hc Microsomal Antibody - Thyroid Peroxidase Antibody,207.0,82.8,,,0 CDM,3028637609,Hc Thyroid Peroxidase (Tpo) Ab 50075-So+,17.46,6.98,,,0 CDM,3028638101,"Hc Mitochondrial M2 Antibody, Igg (Elisa) 50065-So+",30.54,12.22,,,0 CDM,3028638201,Hc 720 Rabies Abs (Rffit)-So+,78.0,31.2,,,0 CDM,3028638202,Hc 365 Rabies Abs (Rffit)-So+,78.0,31.2,,,0 CDM,3028640302,"Hc Particle Agglutination Test, Screen - Cryptococcal Antigen",151.8,60.72,,,0 CDM,3028640605,"Hc Particle Agglutination Test, Titer - Cryptococcal Antigen",131.0,52.4,,,0 CDM,3028643101,"Hc Rheumatoid Factor, Quant - Rheumatoid Factor",121.9,48.76,,,0 CDM,3028648001,"Hc Tb Test, Cell Mediated Antigen Response,Gamma Interfron - Tb Test",350.75,140.3,,,0 CDM,3028648101,Hc 348 T-Spot-So+,120.0,48.0,,,0 CDM,3028658001,Hc Tb Intradermal Test,63.25,25.3,,,0 CDM,3028658101,"Hc Streptococcus Pneumoniae Antibodies, Igg (14 Serotypes) 0050725-So+",42.95,17.18,,,0 CDM,3028658102,"Hc Streptococcus Pneumoniae Antibodies, Igg (23 Serotypes) 205779-So+",84.42,33.77,,,0 CDM,3028659201,Hc Syphilis Test Non Treponemal Antibody Qual - Vdrl Csf,98.9,39.56,,,0 CDM,3028659202,Hc Syphilis Test Non Treponemal Antibody Qual - Rapid Plasma Reagin-Syp,98.9,39.56,,,0 CDM,3028659204,Hc (Reflex) Rpr (Labcorp 082345-Reflex),62.1,24.84,,,0 CDM,3028659206,Hc Rapid Plasma Reagin (Rpr) W Reflex To Titer,62.1,24.84,,,0 CDM,3028659207,Hc Reflex-Rpr Titer,79.35,31.74,,,0 CDM,3028659301,"Hc Syphilis Test, Quantitative - Treponema Pallidum (Syphilis)",127.65,51.06,,,0 CDM,3028659303,Hc Reflex-Rpr Titer,79.35,31.74,,,0 CDM,3028659304,Hc Rpr Titer,127.65,51.06,,,0 CDM,3028659601,Hc P/Q Type Calcium Channel Ab,178.8,71.52,,,0 CDM,3028659602,"Hc Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum Mds2 #1-So+",55.72,22.29,,,0 CDM,3028660619,Hc Hypersensitivity Pneumonitis Ext Panel 3-So+,6.49,2.6,,,0 CDM,3028660620,Hc Hypersensitivity Pneumonitis 1 3006065 (2)-So+,15.24,6.1,,,0 CDM,3028660621,Hc Hypersensitivity Pneumonitis 1 Panel 4-So+,15.24,6.1,,,0 CDM,3028660622,Hc Fungal Antibodies Immunodiffusion 50164 #1-So+,18.06,7.22,,,0 CDM,3028660623,"Hc Fungal Antibodies With Reflex, Serum #1-So+",18.06,7.22,,,0 CDM,3028661112,Hc 566 Bartonella Igg Csf-So+,36.61,14.64,,,0 CDM,3028661113,Hc 566 Bartonella Igm Csf-So+,36.61,14.64,,,0 CDM,3028661201,Hc 457 Blastomyces Ab-So+,46.42,18.57,,,0 CDM,3028661220,Hc Fungal Antibodies With Reflex To?Blastomyces Dermatitidis?Abs By Immunodiffusion (So),53.38,21.35,,,0 CDM,3028661221,Hc Fungal Antibodies Immunodiffusion 50164 #2-So+,15.48,6.19,,,0 CDM,3028661222,"Hc Fungal Antibodies With Reflex, Serum #2-So+",14.31,5.72,,,0 CDM,3028661701,Hc 411 B Burgdorferi Igm Rflx-So+,18.59,7.44,,,0 CDM,3028661702,Hc 681 Lyme Ab Igg Ib -So+,18.57,7.43,,,0 CDM,3028661707,Hc 837 Borrelia Burg Igg-So+,22.2,8.88,,,0 CDM,3028661708,Hc 837 Borrelia Burg Igm-So+,22.2,8.88,,,0 CDM,3028661802,Hc 566 Lyme Ab Igm Ifa Csf-So+,61.25,24.5,,,0 CDM,3028661804,"Hc Arup B. Burgdorferi Vise1 /Pepc10 Antibodies, Total (So+)",66.16,26.46,,,0 CDM,3028661805,Hc Borrelia Burgdorferi Igg And Igm Elisa Reflex-So+,30.0,12.0,,,0 CDM,3028662201,Hc 252 Brucella Igg-So+,64.8,25.92,,,0 CDM,3028662202,Hc 252 Brucella Igm-So+,14.86,5.94,,,0 CDM,3028662501,Hc 261 Campy Jejuni Igg Ab-So+,70.62,28.25,,,0 CDM,3028663101,Hc 461 Chlamydia Ab Igg Ea-So+,86.8,34.72,,,0 CDM,3028663103,Hc 165 Chlamydia Ab Igg Ea-So+,14.18,5.67,,,0 CDM,3028663106,Hc Hypersensitivity Pneumonitis 1 So+-Arup 0055076,38.1,15.24,,,0 CDM,3028663107,"Hc Chlamydia Ab Differentiation (Lgv), Mif 98880 #1-So+",14.18,5.67,,,0 CDM,3028663203,Hc 165 Chlamydia Ab Igm Ea-So+,15.22,6.09,,,0 CDM,3028663205,Hc Chlamydia Igm Antibody-So+,15.22,6.09,,,0 CDM,3028663206,"Hc Chlamydia Ab Differentiation (Lgv), Mif 98880 #2-So+",15.22,6.09,,,0 CDM,3028663520,"Hc Fungal Antibodies With Reflex, Serum #3-So+",14.31,5.72,,,0 CDM,3028663521,Hc Fungal Antibodies Immunodiffusion 50164 #3-So+,13.76,5.5,,,0 CDM,3028663802,Hc 691 Q-Fever Phase I Igg-So+,18.0,7.2,,,0 CDM,3028663803,Hc 691 Q-Fever Phase Ii Igg-So+,18.0,7.2,,,0 CDM,3028663804,Hc 691 Q-Fever Phase I Igm-So+,18.0,7.2,,,0 CDM,3028663805,Hc 691 Q-Fever Phase Ii Igm-So+,18.0,7.2,,,0 CDM,3028663811,"Hc Reflex Coxiella Burnetii (Q-Fever) Antibody, Igg Phase I Titer 2012630-So+",39.6,15.84,,,0 CDM,3028663812,"Hc Reflex Coxiella Burnetii (Q-Fever) Antibody, Igg Phase Ii Titer 2012632-So+",39.6,15.84,,,0 CDM,3028663813,"Hc Reflex Coxiella Burnetii (Q-Fever) Antibody, Igm Phase I Titer 2012643-So+",86.4,34.56,,,0 CDM,3028663814,"Hc Reflex Coxiella Burnetii (Q-Fever) Antibody, Igm Phase Ii Titer 2012645-So+",86.4,34.56,,,0 CDM,3028664401,Hc 571 Cmv Igg Ab Csf-So+,17.27,6.91,,,0 CDM,3028664408,Hc 059 Cmv Ab (Kbc)-So+,51.77,20.71,,,0 CDM,3028664409,Hc Cmv Igg Avidity Elisa,192.05,76.82,,,0 CDM,3028664501,Hc 931 Cytomegalovirus Igm-So+,20.22,8.09,,,0 CDM,3028664512,"Hc Cmv Antibody, Igm - Cytomegalovirus Antibody, Igm",243.8,97.52,,,0 CDM,3028665101,Hc 120 Enceph Calif Igm-Soq+,50.54,20.22,,,0 CDM,3028665102,Hc 120 Enceph Calif Igg-Soq+,50.54,20.22,,,0 CDM,3028665103,Hc 471 Enceph Calif Igm-So+,23.08,9.23,,,0 CDM,3028665104,Hc 471 Enceph Calif Igg-So+,23.08,9.23,,,0 CDM,3028665114,Hc 924 Enceph Calif Igg-So+,47.44,18.98,,,0 CDM,3028665119,Hc 294 Enceph Calif Igg Csf-So+,23.08,9.23,,,0 CDM,3028665120,Hc 294 Enceph Calif Igm Csf-So+,23.08,9.23,,,0 CDM,3028665125,Hc 120 Enceph East Equin Igm-Soq+,23.08,9.23,,,0 CDM,3028665201,Hc 120 Enceph East Equin Igg-So+,50.54,20.22,,,0 CDM,3028665202,Hc 471 Enceph East Equin Igm-So+,23.08,9.23,,,0 CDM,3028665203,Hc 471 Enceph East Equin Igg-So+,23.08,9.23,,,0 CDM,3028665211,Hc 924 Enceph East Equin Igg-So+,23.08,9.23,,,0 CDM,3028665215,Hc 294 Enceph East Equin Igg-So+,47.44,18.98,,,0 CDM,3028665216,Hc 294 Enceph East Equin Igm-So+,47.44,18.98,,,0 CDM,3028665219,Hc 120 Enceph St Louis Igm-Soq+,23.08,9.23,,,0 CDM,3028665220,Hc 120 Enceph St Louis Igg-Soq+,23.08,9.23,,,0 CDM,3028665221,Hc 471 Enceph St Louis Igm-So+,23.08,9.23,,,0 CDM,3028665222,Hc 471 Enceph St Louis Igg-So+,23.08,9.23,,,0 CDM,3028665230,Hc 924 Enceph St Louis Igg-So+,47.44,18.98,,,0 CDM,3028665236,Hc 294 Encph St Louis Igg Csf-So+,47.44,18.98,,,0 CDM,3028665237,Hc 294 Encph St Louis Igm Csf-So+,47.44,18.98,,,0 CDM,3028665240,Hc 120 Enceph West Equin Igm-Soq+,23.08,9.23,,,0 CDM,3028665241,Hc 120 Enceph West Equin Igg-Soq+,23.08,9.23,,,0 CDM,3028665401,Hc 471 Enceph West Equin Igm-So+,23.08,9.23,,,0 CDM,3028665402,Hc 471 Enceph West Equin Igg-So+,23.08,9.23,,,0 CDM,3028665409,Hc 924 Enceph West Equin Igg-So+,47.44,18.98,,,0 CDM,3028665413,Hc 294 Enceph West Equin Igg-So+,47.44,18.98,,,0 CDM,3028665414,Hc 294 Enceph West Equin Igm-So+,47.44,18.98,,,0 CDM,3028665419,Hc 218 Coxsackie A9 Virus Abs-So+,46.86,18.74,,,0 CDM,3028665420,Hc 102 Enterovr B Diphther-So+,15.63,6.25,,,0 CDM,3028665802,Hc 699 Poliovirus Ab Type 3-So+,45.2,18.08,,,0 CDM,3028665803,Hc 103 Diphtheria Echo Ea-So+,46.86,18.74,,,0 CDM,3028665819,Hc Coxsackie A9 Virus Abs-So+,15.63,6.25,,,0 CDM,3028666302,Hc 161 Ebv Ab->Early D Ag Igg-So+,15.74,6.3,,,0 CDM,3028666403,Hc 170 Epstein Barr Ab Nuc Ag-So+,18.35,7.34,,,0 CDM,3028666502,"Hc Epstein-Barr Capsid Vca - Epstein-Barr Virus Vca, Igm",21.77,8.71,,,0 CDM,3028666508,"Hc 260 Epstein-Barr Capsid Vca - Epstein-Barr Virus Vca, Igg-So+",213.0,85.2,,,0 CDM,3028666519,"Hc Epstein-Barr Capsid Vca - Epstein-Barr Virus Vca, Igg",21.77,8.71,,,0 CDM,3028666520,Hc Epstein-Barr Virus Igm Antibodies,211.0,84.4,,,0 CDM,3028666603,Hc 431 Ehrl Chaffennsis Igg-So+,36.61,14.64,,,0 CDM,3028666802,Hc 424 Tularemia Ab Igg-So+,37.4,14.96,,,0 CDM,3028666803,Hc 424 Tularemia Ab Igm-So+,37.4,14.96,,,0 CDM,3028666804,"Hc Francisella Tularensis Antibodies, Igg And Igm 3018856-So+",24.0,9.6,,,0 CDM,3028667401,Hc 442 Giardia Lamblia Igg-So+,75.6,30.24,,,0 CDM,3028668203,Hc 477 Paragonimus Ab-So+,90.0,36.0,,,0 CDM,3028668204,Hc 693 Filaria Ab Igg4-Soq+,81.6,32.64,,,0 CDM,3028668205,Hc 593 Schistosomias Igg Ab-So+,108.0,43.2,,,0 CDM,3028668208,Hc 330 Toxocara Ab Serum-Soq+,56.1,22.44,,,0 CDM,3028668210,Hc 275 Cysticercosis Ab Igg-So+,25.68,10.27,,,0 CDM,3028668211,Hc 754 Echinococcosis Ab Igg-So+,46.78,18.71,,,0 CDM,3028668212,Hc 077 Strongyloides Ab Igg-So+,46.78,18.71,,,0 CDM,3028668224,Hc 053 Anti-Htlv-I (Kbc)-So+,30.18,12.07,,,0 CDM,3028668229,"Hc Toxocara Antibodies, Igg By Elisa-So+ Arup 3006066",108.0,43.2,,,0 CDM,3028668701,Hc Htlv I - Htlv-I Antibody,37.01,14.8,,,0 CDM,3028668904,Hc 084 Htlv 1/2 West Blt Arup-So+,109.2,43.68,,,0 CDM,3028669201,Hc 101 Hepatitis D Ab-So+,20.59,8.24,,,0 CDM,3028669401,Hc 241 Higmsf-So+,88.2,35.28,,,0 CDM,3028669402,Hc 063 Hsv 1/2 Ab Igg-So+,51.77,20.71,,,0 CDM,3028669403,Hc 284 Hsv 1/2 Ab Igm-So+,51.77,20.71,,,0 CDM,3028669505,Hc 825 Herpes Simplex Type 1-So+,15.83,6.33,,,0 CDM,3028669612,Hc 825 Herpes Simplex Type 2-So+,23.22,9.29,,,0 CDM,3028669808,Hc 201 Histoplasma Ab Serum-So+,44.93,17.97,,,0 CDM,3028669820,Hc Hiv-1 - Hiv 1 Antibody Eia,230.0,92.0,,,0 CDM,3028669821,"Hc Fungal Antibodies With Reflex, Serum300235 #4-So+",16.55,6.62,,,0 CDM,3028669822,Hc Fungal Antibodies Immunodiffusion 50164 #4-So+,16.55,6.62,,,0 CDM,3028669829,Hc 733 Hiv 1/2-So+,138.6,55.44,,,0 CDM,3028670101,"Hc Hiv-1/2 Ab Diff, Supplemental 2013107-So+",48.6,19.44,,,0 CDM,3028670120,Hc Hiv-1 - Hiv 1 Antibody Eia,230.0,92.0,,,0 CDM,3028670202,"Hc Hiv-1/2 Ab Diff, Supplemental 2013107 #2-So+",48.6,19.44,,,0 CDM,3028670203,Hc Hiv-2,16.22,6.49,,,0 CDM,3028670326,"Hc Hiv-1/Hiv-2, Single Assay - Rapid Hiv 1 And 2 Screen",241.5,96.6,,,0 CDM,3028670401,"Hc Hep B Core Ab Test, Total - Hepatitis B Core Antibody, Total",174.8,69.92,,,0 CDM,3028670404,"Hc 051-Hep B Core Ab Test, Total - Hepatitis B Core Antibody, Total-So+",43.32,17.33,,,0 CDM,3028670405,Hc Hepatitis B Virus Core Antibodies (Total) 20091-So+,14.46,5.78,,,0 CDM,3028670501,"Hc Hep B Core Ab Test, Igm - Hepatitis B Core Antibody, Igm",226.55,90.62,,,0 CDM,3028670503,"Hc Hepatitis B Virus Core Antibody, Igm 20092-So+",18.0,7.2,,,0 CDM,3028670601,Hc Hepatitis B Surface Ab Test - Hepatitis B Surface Antibody,200.1,80.04,,,0 CDM,3028670604,Hc Quant Hepatitis B Virus Surface Antibody 20090-So+,7.8,3.12,,,0 CDM,3028670605,Hc Hepatitis B Virus Core Antibodies (Total) 20090-So+,12.89,5.16,,,0 CDM,3028670701,Hc 116 Hepatitis Be Ab-So+,41.6,16.64,,,0 CDM,3028670802,Hc Hepatitis A Total Ab Igg,197.8,79.12,,,0 CDM,3028670901,"Hc Hepatitis Antibody Haab Igm Antibody - Hepatitis A Antibody, Igm",215.05,86.02,,,0 CDM,3028671312,Hc 649 Legionella 1-6 Ttr Igg-So+,55.04,22.02,,,0 CDM,3028671701,Hc 694 Leishmania Igg-So+,56.04,22.42,,,0 CDM,3028672001,Hc 489 Leptospirosis Ab-So+,64.8,25.92,,,0 CDM,3028673509,Hc Mumps - Mumps Igg Antibody,57.5,23.0,,,0 CDM,3028673511,Hc 065 Mumps Ab Igm Arup-So+,46.91,18.76,,,0 CDM,3028673806,Hc 100 M Pneumoniae Igg-So+,47.63,19.05,,,0 CDM,3028673807,Hc 100 M Pneumoniae Igm-So+,47.63,19.05,,,0 CDM,3028674712,Hc Parvovirus B19 Ab Igm-So+,54.07,21.63,,,0 CDM,3028674713,Hc Parvovirus B19 Ab Igg-So+,54.07,21.63,,,0 CDM,3028675301,Hc 692 Trypanosoma Cruzi Igm-So+,44.53,17.81,,,0 CDM,3028675302,Hc 569 E Histolyt Amebias Igg-So+,44.53,17.81,,,0 CDM,3028675303,Hc 691 Trypanosoma Cruzi Igg-So+,44.53,17.81,,,0 CDM,3028675304,Hc 227 Protozoa Ab Nes-So+,44.53,17.81,,,0 CDM,3028675701,Hc 470 Rocky Mountain Spotted Fever Igm Ttr-So+,45.0,18.0,,,0 CDM,3028675705,Hc 548 Typhus Fever Ab Igg-So+,69.61,27.84,,,0 CDM,3028675706,Hc 548 Typhus Fever Ab Igm-So+,69.61,27.84,,,0 CDM,3028676201,Hc Rubella-Rubella Ab,188.6,75.44,,,0 CDM,3028676501,Hc Rubeola - Rubeola Antibody Igg,56.35,22.54,,,0 CDM,3028676502,Hc 729 Rubeola - Rubeola Antibody Igm-So+,46.33,18.53,,,0 CDM,3028676901,Hc Sars Cov-2 Igg Antibody,58.65,23.46,,,0 CDM,3028676902,"Hc Covid-19 Igg(Spike),Semi Quant Cia-So+",50.56,20.22,,,0 CDM,3028676903,"Hc Covid-19 Igg, Qualitative By Cia-Arup 3002776-So+",50.56,20.22,,,0 CDM,3028677702,Hc 106 Toxoplasma Gondii Ab Igg-So+,51.77,20.71,,,0 CDM,3028677703,Hc 482 Toxoplasma Gondii Igg-So+,51.77,20.71,,,0 CDM,3028677715,Hc 184 Toxoplasma Igg Csf-So+,105.48,42.19,,,0 CDM,3028677720,"Hc Toxoplasma Gondii Igg Antibody, Elisa (Csf)-So+",94.48,37.79,,,0 CDM,3028677801,Hc 244 Toxoplasma Igm-So+,17.29,6.92,,,0 CDM,3028677816,Hc 578 Toxo Igm Csf-So+,99.6,39.84,,,0 CDM,3028678001,Hc Antibody Treponema Pallidum - T. Pallidum Confirmatory,190.9,76.36,,,0 CDM,3028678002,"Hc Antibody Treponema Pallidum - Fta Antibodies, Igg And Igm",190.9,76.36,,,0 CDM,3028678005,Hc 232 Antibody Treponema Pallidum - T. Pallidum Confirmatory-So+,27.32,10.93,,,0 CDM,3028678009,Hc Syphilis Antibody Igg/Igm,190.9,76.36,,,0 CDM,3028678011,Hc Treponema Pallidium Screen Casacade (Labcorp 082345),190.9,76.36,,,0 CDM,3028678012,Hc Treponema Pallidum Antibody By Tp-Pa 0050777-So+,15.6,6.24,,,0 CDM,3028678401,Hc 577 Trichinosis Ab-So+,89.77,35.91,,,0 CDM,3028678701,Hc Varicella-Zoster - Varicella Zoster Igg,185.15,74.06,,,0 CDM,3028678703,Hc 143 Varicella-Zoster - Varicella Zoster Igm-So+,46.33,18.53,,,0 CDM,3028678707,Hc 127 Varicella-Zoster - Varicella Zoster Igg-So+,18.0,7.2,,,0 CDM,3028678801,Hc 853 West Nile Ab Igm-So+,72.48,28.99,,,0 CDM,3028678803,Hc 471 West Nile Ab Igm-So+,23.08,9.23,,,0 CDM,3028678805,Hc 181 West Nile Ab Igm Csf-So+,60.59,24.24,,,0 CDM,3028678811,Hc 294 West Nile Virus Igm-So+,23.08,9.23,,,0 CDM,3028678813,Hc 471 West Nile Ab Igg-So+,23.08,9.23,,,0 CDM,3028678814,Hc 472 West Nile Ab Igg-So+,51.77,20.71,,,0 CDM,3028678910,Hc 924 West Nile Ab Igg-So+,23.08,9.23,,,0 CDM,3028678914,Hc 294 West Nile Virus Igg-So+,51.77,20.71,,,0 CDM,3028678915,Hc 181 West Nile Ab Igg Csf-So+,51.77,20.71,,,0 CDM,3028679004,Hc 220 Hepatitis E Igm-So+,67.08,26.83,,,0 CDM,3028679025,Hc 735 Htlv I/Ii-So+,112.2,44.88,,,0 CDM,3028679035,Hc Thyroglobulin Antibody - Anti-Thyroglobulin Ab,196.65,78.66,,,0 CDM,3028679040,Hc Hepatitis C Ab Test - Hepatitis C Antibody,235.75,94.3,,,0 CDM,3028679043,Hc 052 Anti Hcv (Kbc)-So+,51.32,20.53,,,0 CDM,3028679056,Hc 283 Mica Ab-So+,204.0,81.6,,,0 CDM,3028679063,Hc 399 C1Q Ab-Class I-So+,360.0,144.0,,,0 CDM,3028679070,Hc 401 C1Q Ab-Class Ii-So+,360.0,144.0,,,0 CDM,3028679099,Hc Htlv I/Ii Antibodies W/Reflex To Confirm 51164-So+,14.82,5.93,,,0 CDM,30286790AA,"Hc Herpesvirus 6 Antibodies (Igg, Igm)34282-So+",21.1,8.44,,,0 CDM,3028679434,Hc Zika Virus Igm Elisa-So+,89.76,35.9,,,0 CDM,3028680001,Hc Thyroglobulin Antibody 50105-So+,8.1,3.24,,,0 CDM,3028680002,Hc Thyroglobulin Reflex To Ms Or Ia Htgt-So+,256.75,102.7,,,0 CDM,3028680035,Hc Thyroglobulin Antibody - Anti-Thyroglobulin Ab,196.65,78.66,,,0 CDM,3028680303,Hc Res Hep C Ab Ed Gilead Protocol,4.13,1.65,,,0 CDM,3028680340,Hc Hepatitis C Ab Test - Hepatitis C Antibody,235.75,94.3,,,0 CDM,3028680346,Hc Client Bill Only - Esh - Hepatitis C Ab Test,4.13,1.65,,,0 CDM,3028680347,Hc Client Bill Only - Empath - Hepatitis C Ab Test,4.13,1.65,,,0 CDM,3028680701,Hc Mica Antibody #2-So+,171.0,68.4,,,0 CDM,3028681301,Hc Hla Type Unit #2-So+,937.2,374.88,,,0 CDM,3028681349,"Hc Hla Typing, A,B,Or C /Multi - Hla A And B Phenotype",898.15,359.26,,,0 CDM,3028682501,Hc Endothelial Cell Flow Cytometry Crossmatch-So+,522.0,208.8,,,0 CDM,3028682551,Hc Hla Flow Crossmatch 1St Serum,961.4,384.56,,,0 CDM,3028682553,Hc Xm One Crossmatch-So+,936.0,374.4,,,0 CDM,3028682652,Hc Hla Flow Crossmatch Addl Serum,325.45,130.18,,,0 CDM,3028682853,Hc Hla Antibody Screen,824.55,329.82,,,0 CDM,3028683157,Hc Mica Antibody #1-So+,171.0,68.4,,,0 CDM,3028683258,Hc Dsa Ci & Cii Test-Ci Part,993.6,397.44,,,0 CDM,3028683259,Hc Lsa Ci & Cii Test-Ci Part,993.6,397.44,,,0 CDM,3028683265,"Hc Single Antigen Antibody Id, Ci & Cii-So+",441.0,176.4,,,0 CDM,3028683365,Hc Dsa Ci & Cii Test-Cii Part,755.55,302.22,,,0 CDM,3028683366,Hc Lsa Ci & Cii Test-Cii Part,755.55,302.22,,,0 CDM,3028683371,"Hc Single Antigen Antibody Id, Ci & Cii #2-So+",441.0,176.4,,,0 CDM,3028684904,"Hc Natural Killer Function, Fresh",325.2,130.08,,,0 CDM,3028684905,Hc Client Bill Only - Cell Isolation-Immunology Procedure,1150.0,460.0,,,0 CDM,3028689198,Hc Haemon Cell Saver Procedure,2266.85,906.74,,,0 CDM,3028692316,Hc Crossmatch-Electronic,208.61,83.44,,,0 CDM,3028730505,Hc 654 Aspergillus Galact Eia-So+,142.43,56.97,,,0 CDM,3028730506,Hc 589 Aspergillus Galc Ag Sr-So+,142.43,56.97,,,0 CDM,3028730512,Hc 026 Entamoeba Ag-Soq+,54.69,21.88,,,0 CDM,3028732801,Hc Cryptosporidium Antigen By Eia60045-So+,18.0,7.2,,,0 CDM,3028734101,Hc Hepatitis B Surface Antigen Co,237.06,94.82,,,0 CDM,3028734103,"Hc Hepatitis B Virus Surface Antigen, Confirmation 20128-So+",41.88,16.75,,,0 CDM,3028744903,Hc 321 Beta-D Glucan-So+,142.43,56.97,,,0 CDM,3028744904,Hc 395 Blastomyces Ag Mirav-So+,129.6,51.84,,,0 CDM,3028744905,Hc 323 Coccidioides Ag-So+,129.6,51.84,,,0 CDM,3028744906,Hc Coccidioides Antigen Quantitative By Eia 2011075-So+,152.4,60.96,,,0 CDM,3028752301,Hc Hepatitis D By Quantitative Pcr 2013881-So+,270.0,108.0,,,0 CDM,302U000201,Hc 082 Covid-19 Rt Pcr Noncdc-So+,61.57,24.63,,,0 CDM,3058302001,Hc Hemoglobin Electrophoresis-Cap,196.25,78.5,,,0 CDM,3058302002,Hc Capillary Electrophoresis Reflex Testing 3017101-So+,38.5,15.4,,,0 CDM,3058500801,Hc Blood Smear Morphology Scan,33.0,13.2,,,0 CDM,3058501401,Hc Hematocrit - Hematocrit,43.0,17.2,,,0 CDM,3058501801,Hc Hemoglobin - Hemoglobin,38.0,15.2,,,0 CDM,3058501802,Hc Hemoglobin - Hemoglobin And Hematocrit,38.0,15.2,,,0 CDM,3058501803,Hc Hemoglobin - Poct Hemoglobin,38.0,15.2,,,0 CDM,3058504601,"Hc Reticulocyte Count, Auto, W Cell Param - Hemoglobin (Pg) In Retic",76.0,30.4,,,0 CDM,3058504801,Hc Leukocyte (Wbc) Count - White Blood Count And Differential,30.0,12.0,,,0 CDM,3058504802,Hc Leukocyte (Wbc) Count - Eosinophil Count,30.0,12.0,,,0 CDM,3058504902,Hc Platelet Count - Platelet Count,65.0,26.0,,,0 CDM,3058505501,Hc Immature Platelet Fraction,111.0,44.4,,,0 CDM,3058521001,Hc Clot Factor Ii Prothrom Spec - Factor 2 Activity,51.72,20.69,,,0 CDM,3058522001,Hc Blooc Clot Factor V Test - Factor 5 Activity,318.0,127.2,,,0 CDM,3058523001,Hc Clot Factor Vii Proconvertin - Factor 7 Activity,371.0,148.4,,,0 CDM,3058524001,Hc Clot Factor Viii Ahg 1 Stage - Factor 8 Activity,352.0,140.8,,,0 CDM,3058524502,Hc 941 Ristocetin Cofac (Act)-So+,31.2,12.48,,,0 CDM,3058524603,Hc Clot Factor Viii Vw Antigen - Von Willebrand Antigen,348.0,139.2,,,0 CDM,3058524702,Hc 621 Vwf Multimers-So+,243.6,97.44,,,0 CDM,3058525001,Hc Clot Factor Ix Ptc/Chrstmas - Factor 9 Activity,336.0,134.4,,,0 CDM,3058526001,Hc Clot Factor X Stuart-Power - Factor 10 Activity,33.66,13.46,,,0 CDM,3058527001,Hc Clot Factor Xi Pta - Factor 11 Activity,57.76,23.1,,,0 CDM,3058528001,Hc Clot Factor Xii Hageman - Factor 12 Activity,39.71,15.88,,,0 CDM,3058529002,Hc 745 Factor Xiii Activity-So+,222.0,88.8,,,0 CDM,3058530001,"Hc Antithrombin Iii Test,Activ - Antithrombin Iii",287.0,114.8,,,0 CDM,3058530301,"Hc Clot Inhib Protein C,Activ - Protein C Activity",389.0,155.6,,,0 CDM,3058530505,"Hc Protein S, Total Antigen (So)",21.6,8.64,,,0 CDM,3058530601,"Hc Clot Inhib Protein S,Free - Protein S Activity",308.0,123.2,,,0 CDM,3058530602,Hc 358 Protein S Free-So+,85.27,34.11,,,0 CDM,3058530608,"Hc Protein S, Free (So)",42.0,16.8,,,0 CDM,3058533501,Hc Factor Inhibitor Test - Bethesda Inhibitor,348.0,139.2,,,0 CDM,3058533503,Hc 421 Adamts 13 Inhibitor-So+,228.0,91.2,,,0 CDM,3058534701,"Hc Coagulation Time, Activated - Activated Clotting Time",120.0,48.0,,,0 CDM,3058534703,Hc Teg Coagulation Time; Activated,145.0,58.0,,,0 CDM,3058534704,"Hc Teg Coatulation Time With Lysis, Activated",255.0,102.0,,,0 CDM,3058537901,"Hc Fibrin Degradproducts,D-Dimer, Quant - D-Dimer,Quantitative",202.0,80.8,,,0 CDM,3058538401,"Hc Fibrinogen, Activity - Fibrinogen,Quantitative",160.0,64.0,,,0 CDM,3058538403,"Hc Teg Fibrinogen, Activity",156.0,62.4,,,0 CDM,3058538404,"Hc Teg Fibrinogen With Lysis, Activity",156.0,62.4,,,0 CDM,3058539001,Hc Teg Fibrinolysis/Coagulopathy Screen,955.0,382.0,,,0 CDM,3058539601,"Hc Clotting Assay, Whole Blood - Thromboelastograph Clotting Profile",538.0,215.2,,,0 CDM,3058539602,"Hc Coagulation/ Fibrinolysis Assay, Whole Blood",640.0,256.0,,,0 CDM,3058539701,Hc Vwf Gpibm Activity 1070-So+,175.2,70.08,,,0 CDM,3058539703,Hc 420 Adamts 13 Activity-So+,222.0,88.8,,,0 CDM,3058541006,"Hc Alpha-2 Antiplasmin, Activity 98727-So+",48.16,19.26,,,0 CDM,3058541501,"Hc Fibrinolytic Plasminogen,Activtr - Plasminogen Activator Inhibitor",67.06,26.82,,,0 CDM,3058541505,Hc Pai-1 Antigen-Mayo Pai-1,327.79,131.12,,,0 CDM,3058542003,Hc 761 Plasminogen Activity-So+,54.0,21.6,,,0 CDM,3058542101,"Hc Fibrinolytic Plasminogen,Antigen - Plasminogen Antigen",125.58,50.23,,,0 CDM,3058546101,"Hc Hemoglobin Fetal,Rosette - Fetal Bleed Screen",131.0,52.4,,,0 CDM,3058552001,Hc Heparin Assay - Low Molecular Wgt Heparin,298.0,119.2,,,0 CDM,3058552002,Hc Heparin Assay - Heparin Level,298.0,119.2,,,0 CDM,3058553001,Hc Heparin-Protamine Tolerance - Poct Heparin Dose Response,126.0,50.4,,,0 CDM,3058554001,Hc Wbc Alkaline Phosphatase - Leukocyte Alkaline Phosphatase,72.0,28.8,,,0 CDM,3058554901,"Hc Muramidase - Lysozyme, Serum",22.5,9.0,,,0 CDM,3058555504,"Hc Osmotic Fragility, Erythrocyte 2002257-So+",87.28,34.91,,,0 CDM,3058555707,Hc Blood Platelet Aggregation - Platelet Function Panel,258.0,103.2,,,0 CDM,3058557601,Hc Blood Platelet Aggregation - Platelet Function Panel,258.0,103.2,,,0 CDM,3058557602,Hc Blood Platelet Aggregation - P2Y12 Profile,258.0,103.2,,,0 CDM,3058557604,Hc Platelet Aggregation Panel 1 Performable,258.0,103.2,,,0 CDM,3058557605,Hc Collagen Platelet Aggretation In Vitro Each Agent,125.0,50.0,,,0 CDM,3058557606,Hc Ristocetin Platelet Aggregation,258.0,103.2,,,0 CDM,3058557608,"Hc Teg Platelet, Aggregation",186.83,74.73,,,0 CDM,3058557609,Hc Teg Platelet With Lysis Aggregation,282.0,112.8,,,0 CDM,3058557610,Hc Aa Platlett Aggregometer,224.0,89.6,,,0 CDM,3058557611,Hc Atp Platlett Aggregometer,284.0,113.6,,,0 CDM,3058557612,Hc Adp Platlett Aggregometer,234.0,93.6,,,0 CDM,3058559701,"Hc Phospholipid Neutralization,Platelet - Platelet Neutralization",132.0,52.8,,,0 CDM,3058559803,Hc Staclot La,212.0,84.8,,,0 CDM,3058561001,Hc Prothrombin Time - Protime-Inr,78.0,31.2,,,0 CDM,3058561005,Hc Prothrombin Time - Poct Inr,78.0,31.2,,,0 CDM,3058561101,"Hc Prothrombin Test,Substi,Fractn - Equal Mix,Pt/Inr",62.0,24.8,,,0 CDM,3058561301,"Hc Russell Viper Venom, Diluted - Drvvt (Dilute Russel Vv Time)",125.0,50.0,,,0 CDM,3058565201,"Hc Rbc Sed Rate, Auto - Sedimentation Rate, Automated",90.0,36.0,,,0 CDM,3058566001,Hc Rbc Sickle Cell Test - Sickle Cell Screen,119.0,47.6,,,0 CDM,3058566002,Hc Reflex Sickle Solubility 81271-So+,31.66,12.66,,,0 CDM,3058567001,"Hc Thrombin Time, Plasma - Thrombin Time",117.0,46.8,,,0 CDM,3058573002,Hc Thromboplas Time Partial - Ptt Crrt System,111.0,44.4,,,0 CDM,3058573201,"Hc Thromboplas Time Part Plasma Frac - Equal Mix,Aptt",131.0,52.4,,,0 CDM,3058581002,Hc 709 Viscosity-So+,82.8,33.12,,,0 CDM,3058581005,"Hc Viscosity, Serum-So+",66.0,26.4,,,0 CDM,3058599902,Hc Bronchial Lavage Differential,35.0,14.0,,,0 CDM,3058728502,Hc Rpr With Reflex To Quant Rpr And Confirmatory Treponema Pallidum Abs(So),156.05,62.42,,,0 CDM,305P910001,Hc Verax Platelet Pgd Test,242.57,97.03,,,0 CDM,3068227401,Hc Fecal Occult Blood By Immunoassay 2007190-So+,34.02,13.61,,,0 CDM,3068264201,Hc 5-A-Dihydrotestosterone By Lc-Ms/Ms 2002349-So+,35.14,14.06,,,0 CDM,3068701537,Hc Concentration For Infect Agent,89.34,35.74,,,0 CDM,3068704040,Hc Blood Culture,210.85,84.34,,,0 CDM,3068704601,"Hc Stool Culture, Addl Pathogens - Campylobacter Culture, Stool",126.27,50.51,,,0 CDM,3068707007,Hc Csf Culture,210.85,84.34,,,0 CDM,3068707008,Hc Wound Cultures,210.85,84.34,,,0 CDM,3068707009,Hc Routine Culture,210.85,84.34,,,0 CDM,3068707010,Hc Client Bill Only Ipac - Multi-Drug Resistance Test,210.85,84.34,,,0 CDM,3068707012,Hc Protected Bronch Brush Cult,236.16,94.46,,,0 CDM,3068707048,Hc Bronchial Culture,210.85,84.34,,,0 CDM,3068707049,Hc Rectal Scrn Fluoro Resistance,210.85,84.34,,,0 CDM,3068707050,Hc Genital Cultures,210.85,84.34,,,0 CDM,3068707051,Hc Respiratory Culture Cf*,210.85,84.34,,,0 CDM,3068707052,Hc Respiratory Cultures,210.85,84.34,,,0 CDM,3068707053,Hc Bone Marrow Culture And Gram Stain,210.85,84.34,,,0 CDM,3068707101,Hc Quantitative Duodenal Culture,263.27,105.31,,,0 CDM,3068707102,Hc Endoscope Surveillance Culture,263.27,105.31,,,0 CDM,3068707103,Hc Quant Bronch Brush Culture And Gram Stain,263.27,105.31,,,0 CDM,3068707104,Hc Quantitative Bal/Pal Bronch Wash Cult And Gs,263.27,105.31,,,0 CDM,3068707501,Hc Anaerobic Culture,264.46,105.78,,,0 CDM,3068707601,Hc Anaerobic Culture Isolate Id,148.91,59.56,,,0 CDM,3068707702,"Hc Bacteria Identification, Aerobic Isolate - Organism Id Culture",119.13,47.65,,,0 CDM,3068707706,Hc H. Pylori Reflex Test Mayo Gid-So+,53.76,21.5,,,0 CDM,3068707707,"Hc Client Bill Only Ipac - Bacteria Id, Aerobic Isolate-Organism Id Culture",93.23,37.29,,,0 CDM,3068707708,Hc Bacteria Id H.Pylori-So+,53.76,21.5,,,0 CDM,3068708101,Hc Culture Bacteria Screen,95.3,38.12,,,0 CDM,3068708105,Hc 347 Acanthamoeba Cult-So+,17.22,6.89,,,0 CDM,3068708108,Hc Urine Culture Qnt Cc,97.92,39.17,,,0 CDM,3068708109,Hc Client Bill Only Ipac - Culture Bacteria Screen 2,82.87,33.15,,,0 CDM,3068708110,Hc Helicobacter Pylori Culture-So+,82.2,32.88,,,0 CDM,3068708608,Hc Urine Culture Qnt Cc,114.36,45.74,,,0 CDM,3068708801,Hc Urine Bacteria Culture,131.04,52.42,,,0 CDM,3068710101,"Hc Culture Fungi-Skin Hair Nails - Fungal Culture, Cutaneous",212.04,84.82,,,0 CDM,3068710201,Hc Mycolog Culture Fluid/Tiss/Res,264.46,105.78,,,0 CDM,3068710202,Hc 586 Fungal Cx Isol-So+,30.23,12.09,,,0 CDM,3068710203,Hc Candida Panel Pcr 6351 #2-So+,29.14,11.66,,,0 CDM,3068710301,Hc Mycological Culture Blood,276.37,110.55,,,0 CDM,3068710601,Hc Fungus Exoantigen,167.97,67.19,,,0 CDM,3068710602,Hc 586 Yeast Def Id Ea Isolat-So+,32.26,12.9,,,0 CDM,3068710604,Hc Client Bill Only Ipac - Fungus Exoantigen 2,146.06,58.42,,,0 CDM,3068710605,Hc Candida Panel Pcr 6351 #3-So+,29.14,11.66,,,0 CDM,3068710701,"Hc Fungus Identification, Mold - Fungal Identification, Mold",157.25,62.9,,,0 CDM,3068710901,Hc Mycoplasma Culture - Mycoplasma / Ureaplasma Culture,45.99,18.4,,,0 CDM,3068710903,Hc 378 Ureoplasma Cx Arup-So+,55.33,22.13,,,0 CDM,3068711004,"Hc Culture, Chlamydia Trachomatis 60850 #1-So+",31.05,12.42,,,0 CDM,3068711601,Hc Tb Culture Acid Fast,263.27,105.31,,,0 CDM,3068711801,Hc Mycobacteria Identification - Mycobacteria Identification,341.89,136.76,,,0 CDM,3068714003,"Hc Culture, Chlamydia Trachomatis 60850 #2-So+",85.0,34.0,,,0 CDM,3068714004,Hc Reflex Herpes Simplex Virus (Hsv) Typing 2013897-So+,23.1,9.24,,,0 CDM,3068714701,Hc Cult Typing Immunologic,94.11,37.64,,,0 CDM,3068714702,Hc Client Bill Only Ipac - Cult Typing Immunologic,81.83,32.73,,,0 CDM,3068714901,Hc Gram-Negative Bld Cult Pcr,377.63,151.05,,,0 CDM,3068715010,Hc H. Pylori Reflex Test Mayo Hpcr1-So+,558.0,223.2,,,0 CDM,3068715011,Hc H.Pylori+Clarithro Resistance Pcr-So+,585.96,234.38,,,0 CDM,3068715303,Hc H. Pylori Reflex Test Mayo Isae-So+,414.85,165.94,,,0 CDM,3068715304,Hc Aerobe Id By Sequencing H.Pylori-So+,136.8,54.72,,,0 CDM,3068715305,Hc Bill Only Ut Tyler 87153 Identification Partial Sequencing Each-So+,360.0,144.0,,,0 CDM,3068716801,Hc Arthropod Id,95.3,38.12,,,0 CDM,3068716901,"Hc Macroscopic Exam, Parasite - Parasite Identification",35.74,14.3,,,0 CDM,3068717201,Hc Pinworm Exam - Pinworm Prep,72.67,29.07,,,0 CDM,3068717601,Hc Homogenization Of Tissue,90.54,36.22,,,0 CDM,3068717603,Hc H. Pylori Reflex Test Mayo Tissr-So+,16.8,6.72,,,0 CDM,3068717605,Hc Tissue Processing (H.Pylori)-So+,16.8,6.72,,,0 CDM,3068717701,Hc Ova And Parasites Smears - Ova And Parasite Examination,13.05,5.22,,,0 CDM,3068717702,"Hc Cryptosporidium And Coccidia Exam, Fecal 60046-So+",12.6,5.04,,,0 CDM,3068717703,"Hc Ova And Parasite, Fecal 301662 #1-So+",14.4,5.76,,,0 CDM,3068718101,Hc Susceptibility Manual,84.58,33.83,,,0 CDM,3068718103,Hc H. Pylori Reflex Test Mayo Sus-So+,82.2,32.88,,,0 CDM,3068718104,Hc Client Bill Only Ipac - Susceptibility Manual,73.55,29.42,,,0 CDM,3068718105,Hc Susceptibility (H.Pylori)-So+,40.32,16.13,,,0 CDM,3068718401,"Hc Antibiotic Sens,Disk,Each - Susceptibility Charge",120.32,48.13,,,0 CDM,3068718402,"Hc Client Bill Only Ipac - Antibiotic Sens, Disk, Each - Susceptibility",52.31,20.92,,,0 CDM,3068718501,Hc Beta-Lactamase Test,60.75,24.3,,,0 CDM,3068718502,Hc Client Bill Only Ipac - Beta-Lactamase Test,52.83,21.13,,,0 CDM,3068718503,Hc Mdrt - Carba-5 Carbapenemase Detection,52.83,21.13,,,0 CDM,3068718504,Hc Carba-5 Carbapenemase Detection,52.83,21.13,,,0 CDM,3068718601,"Hc Antibiotic Sens,Mic,Each - Susceptibility Charge",210.85,84.34,,,0 CDM,3068718604,Hc 586 Suscept Ea Agt/Plate-So+,31.1,12.44,,,0 CDM,3068718606,Hc H. Pylori Reflex Test Mayo Mic-So+,78.49,31.4,,,0 CDM,3068718607,"Hc Client Bill Only Ipac - Antibiotic Sens, Mic, Each; Susceptibility Charge",183.35,73.34,,,0 CDM,3068718608,Hc National Jewish 87186 Micsd-So+,120.0,48.0,,,0 CDM,3068718609,Hc Ut Tyler 87186 Special Mic Per Drug-So+,420.0,168.0,,,0 CDM,3068718610,Hc National Jewish 87186 Ntm13-So+,429.6,171.84,,,0 CDM,3068718611,Hc National Jewish 87186 Ntmp9-So+,120.0,48.0,,,0 CDM,3068718612,Hc National Jewish 87186 Ntmp5-So+,404.4,161.76,,,0 CDM,3068718613,Hc Texas Health San Antonio 87186-So+,78.0,31.2,,,0 CDM,3068718614,Hc National Jewish 87186 Ntmp6-So+,558.0,223.2,,,0 CDM,3068718615,Hc National Jewish 87186 Ntm9-So+,128.4,51.36,,,0 CDM,3068718616,Hc Ut Tyler 87186 Panel-So+,360.0,144.0,,,0 CDM,3068718617,Hc National Jewish 87186 Micsd1-So+,127.2,50.88,,,0 CDM,3068718618,Hc Candida Panel Pcr 6351 #4-So+,29.14,11.66,,,0 CDM,3068718619,Hc Susceptibility Mic (H.Pylori)-So+,78.49,31.4,,,0 CDM,3068718802,Hc 383 Mycobac Susc Each Jmc-So+,63.16,25.26,,,0 CDM,3068718804,Hc National Jewish 87188 Mictb6-So+,120.0,48.0,,,0 CDM,3068718805,Hc National Jewish 87188 Macsd-So+,42.0,16.8,,,0 CDM,3068718806,Hc Texas Health San Antonio 87188-So+,78.0,31.2,,,0 CDM,3068720501,Hc Gram Stain Smear,114.36,45.74,,,0 CDM,3068720601,"Hc Smear,Fluor Stain,Interp - Afb Stain",164.39,65.76,,,0 CDM,3068720602,"Hc Smear,Fluor Stain,Interp - Fungal Stain",164.39,65.76,,,0 CDM,3068720701,"Hc Smear,Inclusion Bodies/Parasites,Interp - Malaria Smear",210.85,84.34,,,0 CDM,3068720702,Hc 076 Microsporidia Ex-So+,12.6,5.04,,,0 CDM,3068720703,"Hc Cryptosporidium And Coccidia Exam, Fecal 60046 #2-So+",12.6,5.04,,,0 CDM,3068720901,"Hc Ova And Parasite, Fecal 3001662 #2-So+",21.58,8.63,,,0 CDM,3068721001,"Hc Smear,Stain,Wet Mnt,Interp",94.11,37.64,,,0 CDM,3068722001,Hc Tissue Exam By Koh - Koh Prep,100.07,40.03,,,0 CDM,3068725203,Hc Unknown Virus Evaluation,399.07,159.63,,,0 CDM,3068725204,"Hc Viral Culture, Respiratory2006499-So+",66.0,26.4,,,0 CDM,3068725205,"Hc Viral Culture, Non-Respiratory-So+",52.8,21.12,,,0 CDM,3068725310,"Hc Viral Culture, Reflex Id 2006696-So+",52.5,21.0,,,0 CDM,3068725401,Hc Shell Vial W/Immunofluor Stain,228.72,91.49,,,0 CDM,3068725502,Hc Herpes Simplex Virus Culture With Reflex To Hsv Typing 65065-So+,40.63,16.25,,,0 CDM,3068726002,"Hc Inf Agent, Fluor, Adenovirus - Respiratory Virus Antigens Panel",364.53,145.81,,,0 CDM,3068727201,Hc Cryptosporidium By Fa,200.13,80.05,,,0 CDM,3068728501,"Hc Trepon Pallidum Ag, Dfa - Treponema Pallidum (Syphilis)",156.05,62.42,,,0 CDM,3068732409,Hc Iaad Ia Clostridium Difficile Toxin - C. Difficile Toxins (By Eia),208.47,83.39,,,0 CDM,3068733801,Hc Iaad Ia Hpylori Stool - H Pylori Antigen Stool,240.63,96.25,,,0 CDM,3068734001,Hc Iaad Ia Hepatitis B Surface Antigen - Hepatitis B Surface Antigen,158.44,63.38,,,0 CDM,3068735001,Hc 115 Hepatitis Be Ag-So+,41.45,16.58,,,0 CDM,3068738001,"Hc Iaad Ia Hepatitis Delta Antigen - Hepatitis Delta Virus Antigen, Eia",100.21,40.08,,,0 CDM,3068738502,Hc 490 Histoplasma Urine Ag-So+,132.0,52.8,,,0 CDM,3068738503,Hc 371 Histoplasma Ag-So+,129.6,51.84,,,0 CDM,3068738508,Hc Histoplasma Galactomannan Eia-So+,108.0,43.2,,,0 CDM,3068744901,"Hc Iaad Ia Mult Step Method Nos Each Organism - Legionella Or Strep Pneumo Antigen, Ur",232.3,92.92,,,0 CDM,3068744903,"Hc 054 Iaad Ia Mult Step Method Nos Each Organism - Legionella Antigen, Ur-So+",195.0,78.0,,,0 CDM,3068746701,"Hc Hepatitis B Surface Antigen, Quantitative, Monitor 007130-So+",312.0,124.8,,,0 CDM,3068746801,Hc Anaplasma Phagocytophilum-So+,37.5,15.0,,,0 CDM,3068746901,Hc Babesia Species By Pcr 2008665-So+,87.0,34.8,,,0 CDM,3068747101,Hc 353 Bartonella Pcr Qlt-So+,156.0,62.4,,,0 CDM,3068747602,Hc Borrelia Species By Pcr (Lyme Disease) 55570-So+,82.8,33.12,,,0 CDM,3068748102,"Hc Client Bill Only Ipac - Canida Species, Amplified Probe Technique",51.79,20.72,,,0 CDM,3068748103,Hc Candida Panel Pcr 6351 #1-So+,42.11,16.84,,,0 CDM,3068748301,Hc Meningitis/Encph Pcr 12-25 Tgt,1072.13,428.85,,,0 CDM,3068748401,Hc Ehrlichia And Anaplasma Species By Pcr-So+,37.5,15.0,,,0 CDM,3068748601,"Hc Chylmd Pneum, Dna, Amp Probe - Chlamydia Pneumoniae Dna Probe, Amp",301.39,120.56,,,0 CDM,3068748604,"Hc 386 Chylmd Pneum, Dna, Amp Probe - Chlamydia Pneumoniae Dna Probe, Amp-So+",178.2,71.28,,,0 CDM,3068748605,Hc Ipac Np Respiratory Pcr Chlamydia Pneumo,301.39,120.56,,,0 CDM,3068749101,Hc 985 Chlamydia Trach Pcr-So+,228.0,91.2,,,0 CDM,3068749102,"Hc Chylmd Trach, Dna, Amp Probe",294.24,117.7,,,0 CDM,3068749113,Hc Chlamydia Trachomatis And Neisseria Gonorrhoeae (Ctng) By Transcription-Mediated Amplification (T,43.62,17.45,,,0 CDM,3068749114,Hc Reflex Chlamydia Trachomatis Confirmation By Tma 3000300-So+,42.11,16.84,,,0 CDM,3068749310,Hc Clostridium Difficile Pcr,333.55,133.42,,,0 CDM,3068749603,Hc 367 Cmv Dna Pcr Arup-So+,129.47,51.79,,,0 CDM,3068749604,"Hc Congenital Cytomegalovirus Pcr, Urine",355.31,142.12,,,0 CDM,3068749701,"Hc Cytomeg, Dna, Quant - Cmv Dna, Quantitative, Pcr",464.59,185.84,,,0 CDM,3068749702,Hc 919 Cmv Qnt Dna-So+,129.47,51.79,,,0 CDM,3068749704,Hc 588 Cmv Pcr Qnt-So+,129.47,51.79,,,0 CDM,3068749708,"Hc Cmv Pcr, Vitreous Fluid-So+",129.47,51.79,,,0 CDM,3068749709,"Hc Cmv Pcr, Aqueous Fluid-So+",129.47,51.79,,,0 CDM,3068749802,Hc 343 Enterovirus By Rt Pcr-So+,102.0,40.8,,,0 CDM,3068749803,Hc 501 Enterovirus Pcr-So+,150.0,60.0,,,0 CDM,3068749804,Hc 325 Enterovirus Pcr-So+,357.6,143.04,,,0 CDM,3068750201,Hc Influenza A/B,364.53,145.81,,,0 CDM,3068750202,"Hc Influenza A & B, Rapid By Naat 2012778-So+",144.0,57.6,,,0 CDM,3068750701,"Hc, Iadna-Dna/Rna Probe Tq 12-25 - Gastrointestinal Panel",1804.76,721.9,,,0 CDM,3068751101,Hc 587 Gardner Vag Amp Prb-So+,69.47,27.79,,,0 CDM,3068751202,Hc Bacterial Vaginosis & Aerobic Vaginitis Panel 7001 #4-So+,50.11,20.04,,,0 CDM,3068751603,"Hc Elite Hiv-1/2, Hcv, Hbv Nat Vira #1-So+",40.32,16.13,,,0 CDM,3068751701,"Hc Hepatitis B , Dna, Quant - Hepatitis B Dna, Ultraquantitative, Pcr",321.64,128.66,,,0 CDM,3068752101,Hc 670 Hcv Ngi Qual-So+,498.91,199.56,,,0 CDM,3068752105,"Hc Ultrio Elite Hiv-1/2, Hcv, Hbv Nat Vira #2-So+",51.79,20.72,,,0 CDM,3068752201,Hc Iadna Hepatitis C Quant & Reverse Transcription - Hcv Quant Pcr,721.9,288.76,,,0 CDM,3068752205,Hc Res Hepatitis C Quant Pcr-Ed Gilead Protocol,78.5,31.4,,,0 CDM,3068752206,Hc Client Bill Only - Esh - Hepatitis C Quant & Reverse Transcription,78.47,31.39,,,0 CDM,3068752901,"Hc Hsv, Dna, Amp Probe - Hsv Pcr",363.33,145.33,,,0 CDM,3068752906,Hc Herpes Simplex Virus 1 & 2 (Hsv-1 & Hsv-2) Quantitative Real-Time Pcr Conjunctival Swab 8527-So+,113.3,45.32,,,0 CDM,3068753002,Hc 829 Hsv 1/2 Qnt Pcr Bal-So+,214.42,85.77,,,0 CDM,3068753005,Hc 135 Hsv 1 Qnt Pcr Plasma-So+,113.3,45.32,,,0 CDM,3068753006,Hc 135 Hsv 2 Qnt Pcr Plasma-So+,113.3,45.32,,,0 CDM,3068753011,Hc 527 Hsv 1 Qnt Pcr Urn-So+,154.04,61.62,,,0 CDM,3068753012,Hc 527 Hsv 2 Qnt Pcr Urn-So+,154.04,61.62,,,0 CDM,3068753013,Hc Hsv-1 Vitreous Fluid-So+,113.3,45.32,,,0 CDM,3068753014,Hc Hsv-2 Vitreous Fluid-So+,113.3,45.32,,,0 CDM,3068753015,Hc Hsv-1 Aqueous Fluid-So+,113.3,45.32,,,0 CDM,3068753016,Hc Hsv-2 Aqueous Fluid-So+,113.3,45.32,,,0 CDM,3068753202,"Hc Hhv-6, Pcr Qual-So+",231.64,92.66,,,0 CDM,3068753301,Hc 304 Herpes Virus 6 Pcr-So+,418.8,167.52,,,0 CDM,3068753303,Hc 315 Hhv-6 Qnt Rtpcr (Csf)-So+,213.64,85.46,,,0 CDM,3068753306,Hc 103 Hum Herpesvirus 6 Pcr-So+,213.64,85.46,,,0 CDM,3068753310,"Hc Hhv6 Pcr, Csf 6503-So+",213.64,85.46,,,0 CDM,3068753502,"Hc Ultrio Elite Hiv-1/2, Hcv, Hbv Nat Vira #3-So+",51.79,20.72,,,0 CDM,3068753601,Hc Hiv-1 Quant&Revrse Trnscrpj - Hiv 1 Rna Quant By Pcr,863.66,345.46,,,0 CDM,3068753603,Hc 164 Hiv-1 Qnt Pcr-So+,306.02,122.41,,,0 CDM,3068753902,Hc Hiv 2 Rna Quantitation-So+,375.12,150.05,,,0 CDM,3068754101,Hc 339 Legion Pneumo Dna Pcr-So+,59.1,23.64,,,0 CDM,3068755001,"Hc Mycobacteria, Dna, Dir Probe - Mycobacteria Dna Probe, Direct",341.89,136.76,,,0 CDM,3068755103,"Hc Broad-Range Pcr, Afb #1-So+",379.54,151.82,,,0 CDM,3068755207,Hc Client Bill Only - Empath - Hepatitis C Quant & Reverse Transcription,78.47,31.39,,,0 CDM,3068755601,Hc M Tuberculosis Amplified Probe,421.71,168.68,,,0 CDM,3068755607,Hc 663 Tb Pcr Block-So+,63.6,25.44,,,0 CDM,3068755609,Hc 585 Mtb Complex Pcr Blood-Soq+,155.38,62.15,,,0 CDM,3068755610,"Hc Broad Range Pcr, Afb Tbcdna #2-So+",379.54,151.82,,,0 CDM,3068755615,"Hc M.Avium-Intra, Dna, Dir Prob - M. Avium-Intra Dna Probe, Direct",346.66,138.66,,,0 CDM,3068756302,Hc Ureaplasma And Mycoplasma Species By Pcr 2011172 #2-So+,58.16,23.26,,,0 CDM,3068758101,"Hc M.Pneumon, Dna, Amp Probe - Mycoplasma Pneumoniae Pcr",421.71,168.68,,,0 CDM,3068758102,Hc 356 Mycopls Pneumo Dna Pcr-So+,126.19,50.48,,,0 CDM,3068758103,Hc 0-Np Resp Pcr Mycoplsm Pnm,421.71,168.68,,,0 CDM,3068758104,Hc Ipac Nasopharyngeal Respiratory Panel,421.71,168.68,,,0 CDM,3068759101,"Hc N.Gonorrhoeae, Dna, Amp Prob - Gc Dna Pcr",289.48,115.79,,,0 CDM,3068759114,Hc Reflex Neisseria Gonorrhoeae Confirmation By Tma 3000302-So+,17.62,7.05,,,0 CDM,3068759115,Hc Chlamydia Trachomatis And Neisseria Gonorrhoeae (Ctng) By Transcription-Mediated Amplification (T,43.62,17.45,,,0 CDM,3068759401,Hc Pneumocystis Jirovecii By Pcr 2006254-So+,211.2,84.48,,,0 CDM,3068762404,"Hc Hpv High Risk Screen By Tma, With Reflex To Genotypes 16 And 18/45, Thinprep 3016945-So+",45.6,18.24,,,0 CDM,3068762405,Hc Hpv By Nucleic Acid Amplification 3003005-So+,57.6,23.04,,,0 CDM,3068762408,"Hc Iadna Human Papillomavirus High-Risk Types - Hpv Dna Probe, Amp",410.98,164.39,,,0 CDM,3068762503,"Hc Hpv Genotypes 16 And 18/45, By Transcription-Mediated Amplification (Tma), Thinprep3016944-So+",54.0,21.6,,,0 CDM,3068763101,Hc Influenza A/B Rsv,704.03,281.61,,,0 CDM,3068763201,Hc 848 Resp Virus 6-11 Targets,1191.26,476.5,,,0 CDM,3068763301,Hc Iadna Respiratry Probe & Rev Trnscr 12-25 Target - Additional Charge,1985.83,794.33,,,0 CDM,3068763303,Hc Ipac Resp Pnl 12-15 Targets,1985.83,794.33,,,0 CDM,3068763501,Hc Sars-2 Cov 19,107.21,42.88,,,0 CDM,3068763502,Hc Poct Sars-Cov-2 Cov 19,107.21,42.88,,,0 CDM,3068764001,Hc 587 Staph A Dna Amp Prb-So+,126.19,50.48,,,0 CDM,3068764003,Hc Bacterial Vaginosis & Aerobic Vaginitis Panel 7001 #2-So+,42.11,16.84,,,0 CDM,3068764102,"Hc Mrsa, Dna, Amp Probe - Mrsa Dna Probe",402.65,161.06,,,0 CDM,3068765101,"Hc Strep A, Dna, Amp Probe - Strep A Dna Probe, Amplification",227.53,91.01,,,0 CDM,3068765102,Hc Strep A Pcr,153.67,61.47,,,0 CDM,3068765301,"Hc Strep B, Dna, Amp Probe - Strep B Dna Probe, Amplification",345.47,138.19,,,0 CDM,3068765302,Hc Bacterial Vaginosis & Aerobic Vaginitis Panel 7001 #1-So+,42.11,16.84,,,0 CDM,3068766102,Hc 115 Trichom Vag Male Rna-So+,60.0,24.0,,,0 CDM,3068779701,"Hc Detect Agent Nos, Dna, Dir",256.12,102.45,,,0 CDM,3068779801,Hc 891 Ureaplasma/Myco Sp-So+,129.0,51.6,,,0 CDM,3068779810,Hc 494 Bk Virus Qlt Pcr Ur-Soq+,382.86,153.14,,,0 CDM,3068779812,Hc 351 Humn Metapneumovir Pcr-So+,358.8,143.52,,,0 CDM,3068779819,Hc 319 Coxiella Burnetti Pcr-So+,229.09,91.64,,,0 CDM,3068779820,Hc 320 Norovirus Pcr-So+,95.11,38.04,,,0 CDM,3068779823,Hc 943 Pneumocys Cari Amp Pcr-So+,264.0,105.6,,,0 CDM,3068779826,Hc 322 Babesia Micro Pcr Qlt-Soq+,90.12,36.05,,,0 CDM,3068779829,Hc 332 Aspergillus Sp Pcr-So+,124.08,49.63,,,0 CDM,3068779830,Hc 243 Acanthamoeba Pcr-So+,241.33,96.53,,,0 CDM,3068779835,Hc 358 Whipples Dna Pcr Qlt-Soq+,174.03,69.61,,,0 CDM,3068779836,Hc 408 Ehrlich & Anaplasm Pcr By 2007862-So+,37.5,15.0,,,0 CDM,3068779841,Hc 625 Malaria Pcr-So+,174.19,69.68,,,0 CDM,3068779849,Hc 461 Toxoplasma Pcr Qlt-Soq+,155.38,62.15,,,0 CDM,3068779863,Hc 089 Borde Pertus/Parap Pcr-So+,42.0,16.8,,,0 CDM,3068779864,Hc 100 Varicella-Zoster Pcr-So+,82.8,33.12,,,0 CDM,3068779865,Hc 587 Inf Agt Det Amp Pr Ea-So+,126.19,50.48,,,0 CDM,3068779884,"Hc Detect Agent Nos, Dna, Dir",234.73,93.89,,,0 CDM,3068779885,Hc Ehrlichia Pcr (Quest 11353),207.28,82.91,,,0 CDM,3068779888,"Hc Toxoplasma Gonfii Dna, Pcr",192.98,77.19,,,0 CDM,3068779889,Hc Monkey Pox So-Quest 12084,208.47,83.39,,,0 CDM,3068779890,"Hc Htlv I/Ii Dna, Qualitative Real-Time Pcr 2003075-So+",134.22,53.69,,,0 CDM,3068779891,"Hc Detect Agent Nos, Dna, Amp-So+",59.1,23.64,,,0 CDM,3068779892,Hc Ureaplasma And Mycoplasma Species By Pcr 2011172 #1-So+,54.1,21.64,,,0 CDM,3068779893,Hc National Jewish 87798 Ntmdr-So+,137.4,54.96,,,0 CDM,3068779894,Hc Bacterial Vaginosis & Aerobic Vaginitis Panel 7001 #3-So+,42.11,16.84,,,0 CDM,3068779895,Hc Bordetella Pertussis/Parapetussis,445.43,178.17,,,0 CDM,3068779896,"Hc Hhv-8 Pcr, Qualitative-So+",233.05,93.22,,,0 CDM,3068779901,Hc 849 Enterovirus Pcr Csf-So+,374.1,149.64,,,0 CDM,3068779902,"Hc Detect Agent Nos, Dna, Quant - Epstein-Barr Virus Dna, Quantitative",481.27,192.51,,,0 CDM,3068779904,Hc Bk Quantitative Pcr Blood,481.27,192.51,,,0 CDM,3068779916,Hc 316 Jcv Qnt Pcr (Csf)-So+,258.0,103.2,,,0 CDM,3068779917,Hc 283 Hepatitis D Pcr-So+,237.6,95.04,,,0 CDM,3068779919,Hc 362 Parvovirus Qnt Pcr Vir-So+,234.0,93.6,,,0 CDM,3068779921,Hc 317 V Zoster Qnt Pcr (Csf)-So+,233.05,93.22,,,0 CDM,3068779923,Hc 159 Adenovirus Qnt Pct-So+,227.04,90.82,,,0 CDM,3068779932,Hc 922 Herpes 7 Dna Qnt(Lavg)-So+,226.6,90.64,,,0 CDM,3068779934,Hc 925 Herpes 7 Dna Qnt(Fec)-So+,210.0,84.0,,,0 CDM,3068779935,Hc 926 Herpes 7 Dna Qnt(Tiss)-So+,226.6,90.64,,,0 CDM,3068779937,Hc 313 Adenovirus Rt Pcr(Csf)-So+,213.64,85.46,,,0 CDM,3068779940,Hc 935 Epstn Bar Dna Qnt(Csf)-So+,135.43,54.17,,,0 CDM,3068779941,Hc 331 Hhv 8 Qnt Pcr-So+,209.0,83.6,,,0 CDM,3068779942,Hc 397 Herpes Virus 7 Pcr-So+,144.36,57.74,,,0 CDM,3068779948,Hc 093 Parovirus B19 Qnt Pcr-So+,158.4,63.36,,,0 CDM,3068779949,Hc 354 Bk Virus Qnt Dna Pcr-So+,148.9,59.56,,,0 CDM,3068779951,Hc 536 Inf Agt Det Qnt Ea-So+,135.43,54.17,,,0 CDM,3068779953,Hc 314 Cmv Pcr (Csf)-So+,154.04,61.62,,,0 CDM,3068779960,"Hc Varicella Pcr, Vitreous, Fluid-So+",233.05,93.22,,,0 CDM,3068779961,"Hc Varicella Pcr, Aqueous, Fluid-So+",233.05,93.22,,,0 CDM,3068779962,Hc 374 Broad Range Pcr Fungi-So+,404.45,161.78,,,0 CDM,3068779963,Hc 179 Multi Bact Detect Pcr-So+,404.45,161.78,,,0 CDM,3068779966,"Hc Detect Agent,Immun,Dir Obs,Influenza - Rapid Flu",125.08,50.03,,,0 CDM,3068779969,Hc Trichomonas Assay W/Optic - Trichomonas Screen,119.13,47.65,,,0 CDM,3068779973,"Hc Hhv-8 Qpcr, Quantitative-So+",233.05,93.22,,,0 CDM,3068779975,Hc Parvovirus B19 Quant Pcr (Viracor 1504),293.97,117.59,,,0 CDM,3068779976,Hc Toxoplasma Gondii Quantitative Real-Time Pcr 2200-So+,381.97,152.79,,,0 CDM,3068779990,Hc Toxoplasma Gondii Quantitative Real-Time Pcr-Viracor 2200,455.03,182.01,,,0 CDM,3068779991,Hc Bacterial Vaginosis & Aerobic Vaginitis Panel 7001 #5-So+,51.41,20.56,,,0 CDM,3068780102,"Hc Broad Range Pcr, Bacteria-So+",411.9,164.76,,,0 CDM,3068780161,"Hc Detect Agent, Mult Orgs, Dna, Amp - Bordetella Pertuss/Parapertuss",511.76,204.7,,,0 CDM,3068780164,Hc Lyme Dna Pcr Bld-So+,282.0,112.8,,,0 CDM,3068780165,Hc Lyme Dna Pcr Csf/Fld-So+,252.43,100.97,,,0 CDM,3068780166,"Hc Broad-Range Pcr, Fungi-So+",672.08,268.83,,,0 CDM,3068780167,Hc Next Gen Seq Uwash-So+,1510.0,604.0,,,0 CDM,3068780401,"Hc Detect Agent,Immun,Dir Obs,Influenza - Rapid Flu",125.08,50.03,,,0 CDM,3068780701,"Hc Detect Agent,Immun,Dir Obs, Rsv - Poct Respiratory Syncytial Virus",136.99,54.8,,,0 CDM,3068780869,Hc Trichomonas Assay W/Optic - Trichomonas Screen,119.13,47.65,,,0 CDM,3068788070,Hc Strep A Assay W/Optic - Rapid Strep A Screen,156.05,62.42,,,0 CDM,3068789904,Hc Rapid Malaria Screen,256.12,102.45,,,0 CDM,3068789905,Hc Cryptcoccus Ag Lfa,166.78,66.71,,,0 CDM,3068789906,Hc S. Pneumoniae And L. Pneumophila Urinary Antigen,50.79,20.32,,,0 CDM,3068790006,Hc Phenosense Hiv Peredictor-So+,156.42,62.57,,,0 CDM,3068790007,Hc Phenotype Infectious Agent Drug-So+,156.42,62.57,,,0 CDM,3068790008,Hc Hcv Genosure Ns3 And Ns4A 3001234-So+,382.44,152.98,,,0 CDM,3068790009,"Hc Cmv Drug Resistance By Ngs, Ganciclovir, Foscarnet, Cidofovir, Maribavir, And Letermovir 3004615",512.76,205.1,,,0 CDM,3068790010,Hc Human Immunodeficiency Virus 1 (Hiv-1) Genosure Archive 551776 #1-So+,206.61,82.64,,,0 CDM,3068790102,Hc 511 Hiv 1 Rvrs Tran & Prot-So+,308.94,123.58,,,0 CDM,3068790105,"Hc Hiv 1 Phenotyp Analysis Dna/Rna, 1-10 Drugs-So+",295.73,118.29,,,0 CDM,3068790106,Hc Human Immunodeficiency Virus 1 (Hiv-1) Genosure Archive 551776 #2-So+,206.61,82.64,,,0 CDM,3068790201,Hc 379 Hepatits C Genotype Va-So+,925.82,370.33,,,0 CDM,3068790202,Hc 355 Hep C Vir Rna Ns5A Dr-So+,600.0,240.0,,,0 CDM,3068790203,Hc 617 Hep C Rna Gen 3 Ns5A-So+,624.0,249.6,,,0 CDM,3068790210,Hc Hepatitis C Genotype,1387.82,555.13,,,0 CDM,3068790215,Hc 360 Hiv 1 Intergrs Res Seq-So+,684.0,273.6,,,0 CDM,3068790217,Hc Hcv Genosure Ns3 And Ns4A 3001234 #2-So+,382.44,152.98,,,0 CDM,3068790218,"Hc Hepatitis C Virus (Hcv) Genotyping, Nonreflex-So+",308.94,123.58,,,0 CDM,3068790312,Hc Hiv Phenotype-So+,586.39,234.56,,,0 CDM,3068790401,Hc Phenoty Analysis Dna/Rna Each Additional Drug-So+,31.28,12.51,,,0 CDM,3068790514,Hc Bact Vag Enzym Actv Non Viral,91.73,36.69,,,0 CDM,3068790601,Hc 511 Hiv 1 Other Region-So+,462.92,185.17,,,0 CDM,3068790615,Hc 360 Hiv 1 Intervrs Res Seq - So+,147.48,58.99,,,0 CDM,3068790616,Hc Human Immunodeficiency Virus 1 (Hiv-1) Genosure Archive 551776 #3-So+,206.61,82.64,,,0 CDM,3068791002,Hc 925 Cmv Antiviral Resistnc-So+,2622.0,1048.8,,,0 CDM,3068791003,"Hc Cmv Drug Resistance By Ngs, Ganciclovir, Foscarnet, Cidofovir, Maribavir, And Letermovir 3004615",512.76,205.1,,,0 CDM,3068791201,Hc 403 Hbv Genotype-So+,308.94,123.58,,,0 CDM,3068799903,Hc Biofire Joint Infection Panel Pcr,1095.96,438.38,,,0 CDM,306G047201,Hc Hep C Screen High Risk/Other,93.15,37.26,,,0 CDM,306U000201,Hc Sars-2 Cov 19,72.69,29.08,,,0 CDM,306U000203,Hc Sars-2 Cov 19,72.69,29.08,,,0 CDM,306U000501,Hc Covid-19 Htp Comp 2Days Add-On,0.01,0.004,,,0 CDM,3078100101,"Hc Urinalysis, Auto, W/Scope - Urinalysis Microscopic",124.0,49.6,,,0 CDM,3078100102,"Hc Urinalysis, Auto, W/Scope - Bundled Charge",124.0,49.6,,,0 CDM,3078100301,"Hc Urinalysis, Auto, W/O Scope",62.0,24.8,,,0 CDM,3078100302,"Hc Urinalysis, Auto, W/O Scope - Poct Ketone, Urine",62.0,24.8,,,0 CDM,3078101501,Hc Urine Microscopic,62.0,24.8,,,0 CDM,3078102501,Hc Urine Pregnancy Test,109.0,43.6,,,0 CDM,3100000090,Hc Res Clariom S Assay Kit Only,2344.16,937.66,,,0 CDM,3100000092,Hc Res Picoclariom Assay Kit Only,3013.92,1205.57,,,0 CDM,3100000097,Hc Res Orien Return Of Results,109.2,43.68,,,0 CDM,31000000AG,Hc Research Processing Level I,34.8,13.92,,,0 CDM,31000000AH,Hc Research Processing Level Ii,56.25,22.5,,,0 CDM,31000000AI,Hc Research Processing Level Iii,100.23,40.09,,,0 CDM,31000000AJ,Hc Research Processing Level Iv,273.94,109.58,,,0 CDM,31000000BA,Hc Res Miscellaneous Cdm,6658.79,2663.52,,,0 CDM,31000000BB,Hc Res Bioanalysis Dna-1000,81.9,32.76,,,0 CDM,31000000BC,Hc Res Bioanalysis Dna-Hs,123.5,49.4,,,0 CDM,31000000BD,Hc Res Bioanalysis Nanodrop,6.7,2.68,,,0 CDM,31000000BE,Hc Res Bioanalysis Rna-Nano,80.6,32.24,,,0 CDM,31000000BF,Hc Res Bioanalysis Rna-Pico,78.0,31.2,,,0 CDM,31000000BG,Hc Res Nanostring Mi-Rna,201.5,80.6,,,0 CDM,31000000BH,Hc Res Nanostring Rna,110.5,44.2,,,0 CDM,31000000BI,Hc Res Extra Gene Array,292.5,117.0,,,0 CDM,31000000BJ,Hc Res Extra Ht Array,388.7,155.48,,,0 CDM,31000000BK,Hc Res Mirna Process & Array,487.5,195.0,,,0 CDM,31000000BL,Hc Res Mirna Process Only,248.25,99.3,,,0 CDM,31000000BM,Hc Res Dna Quant (Qubit),2.7,1.08,,,0 CDM,31000000BN,Hc Res Miseq Run 2X250 V2 Nano,1170.0,468.0,,,0 CDM,31000000BO,Hc Res Miseq Run 2X150 V2,1566.54,626.62,,,0 CDM,31000000BP,Hc Res Miseq Run 2X250 V2,1670.64,668.26,,,0 CDM,31000000BQ,Hc Res Miseq Run 2X300 V3,2164.12,865.65,,,0 CDM,31000000BR,Hc Res Nextera Xt Library Prep,332.8,133.12,,,0 CDM,31000000BS,Hc Res Q Pcr For Ngs Library,45.5,18.2,,,0 CDM,31000000BT,Hc Res Rna Quant By Qubit,5.55,2.22,,,0 CDM,31000000BU,Hc Res Sanger Sequencing Tier 1.1,4.42,1.77,,,0 CDM,31000000BV,Hc Res Sanger Sequencing Tier 1.2,65.0,26.0,,,0 CDM,31000000BW,Hc Res Sanger Sequencing Tier 2.1,5.49,2.2,,,0 CDM,31000000BX,Hc Res Sanger Sequencing Tier 2.3,71.5,28.6,,,0 CDM,31000000BY,Hc Res Sanger Sequencing Tier 3.1,12.92,5.17,,,0 CDM,31000000BZ,Hc Res Truseq Rna Library Prep,404.03,161.61,,,0 CDM,31000000CA,Hc Res Hiseq Rr Full Flwc Sr 50,2145.0,858.0,,,0 CDM,31000000CB,Hc Res Hiseq Rr Ful Flwc Sr 100,2990.0,1196.0,,,0 CDM,31000000CC,Hc Res Hiseq Rr Ful Flwc Sr200,3981.9,1592.76,,,0 CDM,31000000CD,Hc Res Hiseq Rr Full Flwcel Pe50,4049.5,1619.8,,,0 CDM,31000000CE,Hc Res Hiseq Rr Ful Flwcell Pe100,5211.7,2084.68,,,0 CDM,31000000CF,Hc Res Hiseq Rr Ful Flwcel Pe250,8273.59,3309.44,,,0 CDM,31000000CG,Hc Res Sanger Sequencing Tier 3.3,211.68,84.67,,,0 CDM,31000000CH,Hc Res Sanger Sequencing Tier 3.4,253.5,101.4,,,0 CDM,31000000CI,Hc Res Additional Primer,7.8,3.12,,,0 CDM,31000000CJ,Hc Res Sonication Single Sample,41.6,16.64,,,0 CDM,31000000CK,Hc Res Sonication Addl Sample,9.75,3.9,,,0 CDM,31000000CL,Hc Res Fragment Analysis Plate,111.81,44.72,,,0 CDM,31000000CM,Hc Res Enzymatic Pcr Purification,4.3,1.72,,,0 CDM,31000000CN,Hc Res Pcr Purification,2.07,0.83,,,0 CDM,31000000CO,Hc Res Tape Station Rna,23.19,9.28,,,0 CDM,31000000CP,Hc Res Tape Highsensitiv Dna 1000,21.24,8.5,,,0 CDM,31000000CQ,Hc Res Tapes High Sensitivity Rna,24.04,9.62,,,0 CDM,31000000CR,Hc Res Tapestation Genomic Dna,21.31,8.52,,,0 CDM,31000000CS,Hc Res Tap Station Dna 1000,19.54,7.82,,,0 CDM,31000000CT,Hc Res External Client Charge 10%,32.9,13.16,,,0 CDM,31000000CU,Hc Res Pcr Purification Wellplate,194.3,77.72,,,0 CDM,31000000CV,Hc Res Amplicon Dnaseq Nexter Ind,58.07,23.23,,,0 CDM,31000000CW,Hc Res Cancer Gene Panel,727.48,290.99,,,0 CDM,31000000CX,Hc Res Str Human Cell Line Athent,82.22,32.89,,,0 CDM,31000000CY,Hc Res Clariom D Array Only,747.5,299.0,,,0 CDM,31000000CZ,Hc Res Clariom S Processing,205.67,82.27,,,0 CDM,31000000DA,Hc Res Picoclariom S Processing,253.63,101.45,,,0 CDM,31000000DB,Hc Res Clariom S Array Only,373.75,149.5,,,0 CDM,31000000DC,Hc Res Agilent Cre Wes,727.48,290.99,,,0 CDM,31000000DD,Hc Res Dna Extraction Qia Symp,16.65,6.66,,,0 CDM,31000000DE,Hc Res 10X Chromium Single-Cell Lib Prep,3120.0,1248.0,,,0 CDM,31000000DF,Hc Res Nanostring Dsp Protein,305.5,122.2,,,0 CDM,31000000EJ,Hc Res Bbngs (Mes Version),390.0,156.0,,,0 CDM,31000000FA,Hc Res Sars-Covs Sequencing,494.0,197.6,,,0 CDM,31000000FB,Hc Res Peds Inherited Cancer,1016.6,406.64,,,0 CDM,31000000FC,Hc Res Nextseq P1 (300 Cycles),1873.3,749.32,,,0 CDM,31000000FD,Hc Res Nextseq P2 (100 Cycles),2152.8,861.12,,,0 CDM,31000000FE,Hc Res Nextseq P2 (200 Cycles),3893.5,1557.4,,,0 CDM,31000000FF,Hc Res Nextseq P2 (300 Cycles),5105.1,2042.04,,,0 CDM,31000000FG,Hc Res Nextseq P3 (50 Cycles),3308.5,1323.4,,,0 CDM,31000000FH,Hc Res Nextseq P3 (100 Cycles),4700.8,1880.32,,,0 CDM,31000000FI,Hc Res Nextseq P3 (200 Cycles),6441.5,2576.6,,,0 CDM,31000000FJ,Hc Res Nextseq P3 (300 Cycles),8530.6,3412.24,,,0 CDM,31000000FK,Hc Res Novaseq S1 (100 Cycles),6104.8,2441.92,,,0 CDM,31000000FL,Hc Res Novaseq S1 (200 Cycles),7637.5,3055.0,,,0 CDM,31000000FM,Hc Res Novaseq S1 (300 Cycles),8249.8,3299.92,,,0 CDM,31000000FN,Hc Res Novaseq S2 (100 Cycles),11315.2,4526.08,,,0 CDM,31000000FO,Hc Res Novaseq S2 (200 Cycles),13997.1,5598.84,,,0 CDM,31000000FP,Hc Res Novaseq S2 (300 Cycles),14916.2,5966.48,,,0 CDM,31000000FQ,Hc Res Novaseq S4 (35 Cycles),16305.9,6522.36,,,0 CDM,31000000FR,Hc Res Novaseq S4 (200 Cycles),20010.9,8004.36,,,0 CDM,31000000FS,Hc Res Novaseq S4 (300 Cycles),22271.6,8908.64,,,0 CDM,31000000FT,Hc Res Novaseq Sp (100 Cycles),3424.2,1369.68,,,0 CDM,31000000FU,Hc Res Novaseq Sp (200 Cycles),4420.0,1768.0,,,0 CDM,31000000FV,Hc Res Novaseq Sp (300 Cycles),4802.2,1920.88,,,0 CDM,31000000FW,Hc Res Novaseq Sp (500 Cycles),6641.7,2656.68,,,0 CDM,3100000BB1,Hc Res Addtl Ba Dna-1000,1.3,0.52,,,0 CDM,3100000BC1,Hc Res Addtl Ba Dna-Hs,1.3,0.52,,,0 CDM,3100000BE1,Hc Res Addtl Ba Rna-Nano,1.3,0.52,,,0 CDM,3100000BF1,Hc Res Addtl Ba Rna-Pico,1.3,0.52,,,0 CDM,3100029U02,"Hc Focused Pharmacogenomics Panel, V-So+",840.0,336.0,,,0 CDM,3100046U01,Hc Aml Flt3 Itd Mrd Testing By Ngs-So+,2790.0,1116.0,,,0 CDM,3100049U01,Hc Aml-Npm1 Mrd-So+,2790.0,1116.0,,,0 CDM,3100058U01,Hc Merkel Cell Carcinoma Antibodies 3005983-So+,483.6,193.44,,,0 CDM,3100059U01,Hr Reflex Merkel Polyomavirus Vp1 Capsid Antibody 3005991-So+,441.6,176.64,,,0 CDM,3100071U01,Hc Cyp2D6 Full Gene Sequence-So+,1470.48,588.19,,,0 CDM,3100072U02,Hc Cyp2D6 Gen Cyp2D6-2D7 Hybrid Reflex-So+,1470.48,588.19,,,0 CDM,3100073U01,Hc Cyp2D6 Gen Cyp2D7-2D6 Hybrid Reflex-So+,1470.48,588.19,,,0 CDM,3100074U01,Hc Cyp2D6 Nonduplicated Gene Reflex-So+,1470.48,588.19,,,0 CDM,3100075U01,Hc Cyp2D6 5' Gene Dup/Mlt Reflex-So+,1470.48,588.19,,,0 CDM,3100076U01,Hc Cyp2D6 3' Gene Dup/Mlt Reflex-So+,1470.48,588.19,,,0 CDM,3100088U02,Noncdm Charge Record,3762.52,1505.01,,,0 CDM,3100140U01,Hc Fungal Id Blood Pnl,431.25,172.5,,,0 CDM,3100141U01,Hc Bacterial Id Gram Pos Bld Pcr,431.25,172.5,,,0 CDM,3100142U01,Hc Bacterial Id Gram Negative Blood,431.25,172.5,,,0 CDM,3100152U01,Hc Microbial Cell-Free Dna By Sequencing (Karius Test)-So+,2436.0,974.4,,,0 CDM,3100275U01,Hc Reflex -Heparin-Induced Thromobocytopenia Evaluation - Pea-So+,514.8,205.92,,,0 CDM,3100431U01,Hc Stiff-Person Spectrum Disorders Evaluation Spps #3-So+,220.5,88.2,,,0 CDM,3103820804,Hc Frozen Blood Prep W/Thaw(Auto),2093.0,837.2,,,0 CDM,3103821201,Hc Red Blood Cell Removal,292.0,116.8,,,0 CDM,3103821402,Hc Transplant Prep Plasma Depletion,2820.72,1128.29,,,0 CDM,3103899901,Hc Amtagvi Receipt And Preparation,577.7,231.08,,,0 CDM,3108112001,Hc Idh1 Mutation Testing By Dpcr,763.94,305.58,,,0 CDM,3108112007,Hc Idh1 And Idh2 Mutation Detection-So+,1140.0,456.0,,,0 CDM,3108112008,"Hc Idh1 (R132) And Idh2 (R140 And R172) Quantitative Detection, Droplet Digital Pcr Idhq #2-So+",626.88,250.75,,,0 CDM,3108112101,Hc Idh2 Mutation Testing By Dpcr,897.0,358.8,,,0 CDM,3108112108,"Hc Idh1 (R132) And Idh2 (R140 And R172) Quantitative Detection, Droplet Digital Pcr Idhq #1-So+",626.88,250.75,,,0 CDM,3108117001,Hc Bcr-Abl1 Mutation Analysis By Ngs 2008420-So+,889.36,355.74,,,0 CDM,3108117401,Hc Familial Variant Ar,947.71,379.08,,,0 CDM,3108118601,Hc Familial Variant Cacna1A,947.71,379.08,,,0 CDM,3108118702,Hc Myotonic Dystrophy 2 (Znf9/Cnbp) Genetic Testing (Repeat Expansion)620087-So+,354.0,141.6,,,0 CDM,3108119001,Hc Familial Variant Cstb,947.71,379.08,,,0 CDM,3108120201,Hc Familial Variant Apc,1352.91,541.16,,,0 CDM,3108120602,Hc 753 Bcr/Abl Maj Bp Qlt-So+,240.0,96.0,,,0 CDM,3108120603,Hc 240 Bcr-Abl Qnt Major P210-So+,196.75,78.7,,,0 CDM,3108120604,Hc Diagnostic Qualitative Bcr-Abl1 Assay With Reflex To P190 Or P210 Quantitative Assays-Arup 300583,288.83,115.53,,,0 CDM,3108120605,"Hc Quantitative Detection Of Bcr-Abl1, Major Form (P210)-Arup 3005840",358.8,143.52,,,0 CDM,3108120702,Hc 362 Bcr/Abl Qnt Minor P190-So+,520.87,208.35,,,0 CDM,3108120703,Hc 753 Bcr/Abl Min Bp Qlt-So+,173.81,69.52,,,0 CDM,3108120704,"Hc Reflex Bcr-Abl1, Minor, Quant 2005025-So+",302.4,120.96,,,0 CDM,3108120801,Hc 395 Brc-Abl P230-So+,257.54,103.02,,,0 CDM,3108121001,Hc Braf Mutation Detection-So+,1080.0,432.0,,,0 CDM,3108121005,Hc 246 Braf-So+,472.51,189.0,,,0 CDM,3108121008,Hc Melanoma Mutation Panel So+,1800.0,720.0,,,0 CDM,3108121009,Hc Colorectal Cancer Mutation Panel-So+,1560.0,624.0,,,0 CDM,3108121501,Hc Familial Variant Brca1,1068.26,427.3,,,0 CDM,3108121701,Hc Familial Variant Brca2,1068.26,427.3,,,0 CDM,3108121904,Hc 189 Calr Exon 9-So+,240.0,96.0,,,0 CDM,3108122002,Hc 320 Cf Genzyme 97 Mutation-So+,960.55,384.22,,,0 CDM,3108122101,Hc Familial Variant Cftr,837.2,334.88,,,0 CDM,3108122201,Hc Metabolic Newborn Screen Panel #5,678.7,271.48,,,0 CDM,3108122204,Hc Comprehensive Renal Disease Panel #7,971.31,388.52,,,0 CDM,3108122205,Hc Primary Immunodeficiency Panel #7,1092.0,436.8,,,0 CDM,3108122301,Hc Metabolic Newborn Screen Panel #6,778.44,311.38,,,0 CDM,3108122313,Hc Renal Ciliopathy Panel #7,1161.0,464.4,,,0 CDM,3108122314,Hc Comprehensive Renal Disease Panel #8,971.31,388.52,,,0 CDM,3108122315,Hc Primary Immunodeficiency Panel #8,1092.0,436.8,,,0 CDM,3108122705,Hc 331 Cyp2C9 Gene Com Varian-So+,461.5,184.6,,,0 CDM,3108122707,Hc Warfarin Sensitivity Genotyping 3001541 #1-So+,70.4,28.16,,,0 CDM,3108122708,"Hc Cyp2C8, Cyp2C9, And Cyp2C Cluster3001501-So+",209.77,83.91,,,0 CDM,3108122901,Hc Familial Variant Pmp22,1786.59,714.64,,,0 CDM,3108122902,Hc Cma Microarray,6257.24,2502.9,,,0 CDM,3108123201,"Hc Dpyd Genotype, V Dpydq-So+",882.0,352.8,,,0 CDM,3108123401,Hc Myotonic Dystrophy 1 (Dmpk) Genetic Testing (Repeat Expansion)620084-So+,343.38,137.35,,,0 CDM,3108123503,Hc 296 Egfr Gene Alys-So+,869.9,347.96,,,0 CDM,3108124002,Hc F2 (Protrhombin) Mutation Test,1044.82,417.93,,,0 CDM,3108124108,Hc F5 Leiden Mutation Test,1158.69,463.48,,,0 CDM,3108124301,Hc Fragile X Screening By Pcr,614.51,245.8,,,0 CDM,3108124302,Hc 518 Fragile X-So+,486.0,194.4,,,0 CDM,3108124504,Hc Flt3-Itd,2166.67,866.67,,,0 CDM,3108124611,Hc Flt3-Tkd,1942.3,776.92,,,0 CDM,3108124801,Hc Familial Variant G6Pd,1068.26,427.3,,,0 CDM,3108124901,Hc Metabolic Newborn Screen Panel #7,936.0,374.4,,,0 CDM,3108124902,Hc Primary Immunodeficiency Panel #9,1092.0,436.8,,,0 CDM,3108125202,Hc 513 Connexin 26 Gjb2 Seq-So+,552.0,220.8,,,0 CDM,3108125301,Hc Familial Variant Gjb2,837.2,334.88,,,0 CDM,3108125602,Hc Hemochromatosis-H63D Mut,1573.94,629.58,,,0 CDM,3108125603,Hc Hemochromatosis-C282Y Mut,1573.94,629.58,,,0 CDM,3108125801,Hc Familial Variant Hba1/Hba2,1068.26,427.3,,,0 CDM,3108126102,Hc 275 B-Cell Igh Pcr-So+,240.0,96.0,,,0 CDM,3108126402,Hc 275 B-Cell Igk Pcr-So+,240.0,96.0,,,0 CDM,3108126509,Hc Str Pre-Transplant Evaluation,2677.36,1070.94,,,0 CDM,3108126510,Hc Specimen Id By Str,2677.36,1070.94,,,0 CDM,3108126712,Hc Chimerism Post Transplant Analyse,2970.38,1188.15,,,0 CDM,3108127003,Hc 647 Jak2 V617F Mut Qlt-So+,150.0,60.0,,,0 CDM,3108127101,Hc Huntington Disease Via The Htt Cag Repeat Expansion-So+,420.0,168.0,,,0 CDM,3108127102,Hc Huntington Disease Cag Repeat Expansion-So+,257.1,102.84,,,0 CDM,3108127201,Hc C-Kit Mutation Analysis 480940-So+,842.63,337.05,,,0 CDM,3108127204,Hc 333 Kit Mutations Aml-So+,869.9,347.96,,,0 CDM,3108127206,Hc Gastrointestinal Stromal Tumor Mutations 3004279-So+,588.6,235.44,,,0 CDM,3108127401,Hc 918 Huntington Diseas(Cag)-So+,300.0,120.0,,,0 CDM,3108127502,Hc 562 Kras Gene-So+,520.58,208.23,,,0 CDM,3108127602,Hc 562 Kras Add'l Variants-So+,238.28,95.31,,,0 CDM,3108127901,Hc Jak2 Exon 12-Mutation Analysis By Pcr 3020079-So+,240.0,96.0,,,0 CDM,3108128301,Hc Accutype? Il28B 90252-So+,136.37,54.55,,,0 CDM,3108128701,Hc Mgmt Promoter Methylation Detection By Ddpcr 3005956-So+,360.0,144.0,,,0 CDM,3108128703,Hc 712 Mgmt Gene Methylation-So+,360.0,144.0,,,0 CDM,3108128802,Hc 288 Mlh1 Promoter Methyltn-So+,421.45,168.58,,,0 CDM,3108128901,Hc Familial Variant Fxn,947.71,379.08,,,0 CDM,3108129101,Hc 164 Mthf Mutation-So+,156.97,62.79,,,0 CDM,3108129301,Hc Familial Variant Mlh1,947.71,379.08,,,0 CDM,3108129601,Hc Familial Variant Msh2,961.1,384.44,,,0 CDM,3108129802,Hc Primary Immunodeficiency Panel #10,1092.0,436.8,,,0 CDM,3108129901,Hc Familial Variant Msh6,947.71,379.08,,,0 CDM,3108130102,Hc Msi By Pcr,2156.62,862.65,,,0 CDM,3108130301,Hc Familial Variant Mecp2,837.2,334.88,,,0 CDM,3108130602,Hc Tpmt And Nudt15 Arup 3001535 #2-So+,279.7,111.88,,,0 CDM,3108130701,Hc Primary Immunodeficiency Panel #11,1092.0,436.8,,,0 CDM,3108130801,Hc Familial Variant Palb2,947.71,379.08,,,0 CDM,3108131003,Hc Npm1 Gene,1972.44,788.98,,,0 CDM,3108131004,"Hc Npm1, Mrd 3000066-So+",323.26,129.3,,,0 CDM,3108131102,Hc 286 Nras-So+,780.89,312.36,,,0 CDM,3108131401,Hc Gastrointestinal Stromal Tumor (Pdgfra)-So+,588.6,235.44,,,0 CDM,3108131701,Hc Primary Immunodeficiency Panel #12,1092.0,436.8,,,0 CDM,3108131801,Hc Familial Variant Pms2,947.71,379.08,,,0 CDM,3108132101,Hc Primary Immunodeficiency Panel #13,1092.0,436.8,,,0 CDM,3108132201,Hc Familial Variant Pten,947.71,379.08,,,0 CDM,3108133112,Hc 532 Prader-Willi Synd Dna-So+,600.0,240.0,,,0 CDM,3108133114,Hc Angelman Syndrome And Prader-Willi Syndrome By Methylation-Specific Mlpa 3006247-So+,360.0,144.0,,,0 CDM,3108133502,Hc 955 Tpmt Genotype-So+,510.0,204.0,,,0 CDM,3108133504,Hc Tpmt And Nudt15 3001535-So+,279.7,111.88,,,0 CDM,3108133701,Hc Familial Variant Smn1/Smn2,947.71,379.08,,,0 CDM,3108133801,Hc Mpl Mutation Detection 2005545-So+,404.4,161.76,,,0 CDM,3108134001,"Hc T-Cell Receptor V-Beta Repertoire Analysis, Spectratyping, Blood Tcrb-So+",2183.88,873.55,,,0 CDM,3108134203,Hc 569 T Cell Gene Rearran-So+,360.0,144.0,,,0 CDM,3108135005,Hc Ugt1A1 Genotyping,515.78,206.31,,,0 CDM,3108135101,Hc Primary Immunodeficiency Panel #14,1092.0,436.8,,,0 CDM,3108135301,Hc Familial Variant Tp53,947.71,379.08,,,0 CDM,3108135501,Hc Warfarin Sensitivity Genotyping 3001541 #2-So+,70.4,28.16,,,0 CDM,3108136201,Hc Familial Variant Hbb,1068.26,427.3,,,0 CDM,3108137002,Hc Hla-Ssp Typing Abcdrdqdp,5083.48,2033.39,,,0 CDM,3108137003,Hc Hla Complete Typing - Donor,5083.48,2033.39,,,0 CDM,3108137004,Hc Hla Complete Typing - Patient,5083.48,2033.39,,,0 CDM,3108137005,"Hc Hla Low Resolution Sso Typing, Donor",5083.48,2033.39,,,0 CDM,3108137006,"Hla Low Resolution Sso Typing, Patient",5083.48,2033.39,,,0 CDM,3108137202,Hc 649 Hla-Sso Abc Of Abcdrdq,2853.18,1141.27,,,0 CDM,3108137203,Hc Hla-Sso Abc-Loci Testing,2853.18,1141.27,,,0 CDM,3108137211,Hc Hla-Sso C-Locus Testing,2215.2,886.08,,,0 CDM,3108137302,Hc Hla-Sso A-Locus Testing,2107.95,843.18,,,0 CDM,3108137303,Hc Hla-Sso B-Locus Testing,2360.9,944.36,,,0 CDM,3108137402,Hc Hla-Sso B-27 Testing,1460.08,584.03,,,0 CDM,3108137403,Hc Hla-Sso B-Locus For Pharmaco,1460.08,584.03,,,0 CDM,3108137406,"Hc Hla-Ssp B-Locus Typing For B57, Patient",381.22,152.49,,,0 CDM,3108137502,Hc 649 Hla-Sso Drdq Of Abcdrdq,2751.03,1100.41,,,0 CDM,3108137601,"Hc Hla-Sso Single Loci Testing, Class Ii",2608.71,1043.48,,,0 CDM,3108137701,Hc Hla-Sso Dq Testing For Celiac,1647.61,659.04,,,0 CDM,3108137804,Hc 428 Hr Hla-A/B/C&Drb1 Typ,1684.8,673.92,,,0 CDM,3108137901,Hc Hr-Ngs Hla-A/B/C Typing,1001.65,400.66,,,0 CDM,3108138101,Hc Hla-B*57:01 For Abacavir Sensitivity2002429-So+,204.0,81.6,,,0 CDM,3108138106,"Hc Hla- B*58:01 Genotyping, Allopurinol Hyp 3001393-So+",288.0,115.2,,,0 CDM,3108138203,Hc 429 Hr Hla-Dqa1 Typ-So+,444.79,177.92,,,0 CDM,3108138204,Hc 430 Hr Hla-Dqb1 Typ-So+,444.79,177.92,,,0 CDM,3108138205,Hc 431 Hr Hla-Dpb1 Typ-So+,444.79,177.92,,,0 CDM,3108138210,Hc-Ngs Hla-Drb1 Typing,1979.38,791.75,,,0 CDM,3108138211,Hc Hr-Ngs Hla-Dpa1 Typing,1979.38,791.75,,,0 CDM,3108138212,Hc Hr-Ngs Hla-Dqa1 Typing,1979.38,791.75,,,0 CDM,3108138213,Hc Hr-Ngs Hla-Dpb1 Typing,1979.38,791.75,,,0 CDM,3108138214,Hc Hr-Ngs Hla-Drb3/4/5 Typing,1979.38,791.75,,,0 CDM,3108138215,Hc Hr-Ngs Hla-Dqb1 Typing,1979.38,791.75,,,0 CDM,3108140008,Hc 759 Plasminogen 1 Pai-1-So+,380.77,152.31,,,0 CDM,3108140108,Hc 347 Cbfb-Myh11 Inv(16)-So+,390.0,156.0,,,0 CDM,3108140111,Hc 893 Mopath Lev 2 Beck/Wied-So+,714.48,285.79,,,0 CDM,3108140125,Hc 438 Apoe Genotyp Card/Vasc-So+,160.77,64.31,,,0 CDM,3108140126,Hc 440 Apoe Genotyp Alzheimer-So+,160.77,64.31,,,0 CDM,3108140142,"Hc Runx1::Runx1T1 (Aml1::Eto) T(8;21) Detection, Quantitative2010138-So+",580.5,232.2,,,0 CDM,3108140238,Hc 181 Mpl Codon 515 Mut-So+,759.62,303.85,,,0 CDM,3108140301,Hc 478 Mp Lev 4 Kcnj11-So+,583.0,233.2,,,0 CDM,3108140310,Hc 790 Mopath Proc Lev 4-So+,819.75,327.9,,,0 CDM,3108140369,Hc Rhd Gene (Rhd) Copy Number51368-So+,292.2,116.88,,,0 CDM,3108140370,Hc Molecular Dna Test-Red Cell Genotyping So+,819.75,327.9,,,0 CDM,3108140371,Hc Kbc Rhd Genotyping So+,420.0,168.0,,,0 CDM,3108140401,Hc Fatty Acid Oxidation Panel #3,420.77,168.31,,,0 CDM,31081404AF,Hc Metabolic Newborn Screen Panel #3,428.74,171.5,,,0 CDM,31081404AG,Hc Nephrolithiasis And Calcinosis Panel #4,1040.43,416.17,,,0 CDM,31081404AH,Hc Comprehensive Renal Disease Panel #4,971.31,388.52,,,0 CDM,31081404AI,Hc Polyscystic Kidney Disease Panel #4,1145.73,458.29,,,0 CDM,31081404AJ,Hc Renal Tubulopathy Panel #4,987.42,394.97,,,0 CDM,31081404AK,Hc Renal Ciliopathy Panel #4,1161.0,464.4,,,0 CDM,31081404AL,Hc Primary Immunodeficiency Panel #4,1092.0,436.8,,,0 CDM,3108140573,Hc 009 Mp Lev 6 Tgfbr1,493.95,197.58,,,0 CDM,3108140574,Hc 009 Mp Lev 6 Tgfbr2,493.95,197.58,,,0 CDM,31081405AB,Hc Very Long Chain Fatty Acid Ngs #2,402.13,160.85,,,0 CDM,31081405AC,Hc Fatty Acid Oxidation Panel #2,420.77,168.31,,,0 CDM,31081405AD,Hc Metabolic Newborn Screen Panel #2,470.11,188.04,,,0 CDM,31081405AE,Hc Stat3 Snp-So+,361.62,144.65,,,0 CDM,31081405AG,Hc Comprehensive Renal Disease Panel #3,971.31,388.52,,,0 CDM,31081405AH,Hc Polyscystic Kidney Disease Panel #3,1145.73,458.29,,,0 CDM,31081405AI,Hc Nephrolithiasis And Calcinosis Panel #3,1040.43,416.17,,,0 CDM,31081405AJ,Hc Renal Ciliopathy Panel #3,1161.0,464.4,,,0 CDM,31081405AK,Hc Renal Tubulopathy Panel #3,987.42,394.97,,,0 CDM,31081405AM,Hc Nephrotic Syndrome & Fsgs Panel #3,1231.1,492.44,,,0 CDM,31081405AN,Hc Primary Immunodeficiency Panel #3,1092.0,436.8,,,0 CDM,31081406HF,Hc 305 Targeted Oncology-So+,3557.69,1423.08,,,0 CDM,31081406JC,Hc 014 Mp Lev 7 Ldlr,500.82,200.33,,,0 CDM,31081406JJ,Hc 014 Mp Lev-7 Pcsk9,500.82,200.33,,,0 CDM,31081406JK,Hc Metabolic Newborn Screen Panel #1,441.3,176.52,,,0 CDM,31081406JL,Hc Galactosemia Ngs Panel #1,359.78,143.91,,,0 CDM,31081406JM,Hc Fatty Acid Oxidation Panel #1,420.77,168.31,,,0 CDM,31081406JN,Hc Very Long Chain Fatty Acid Ngs #1,402.13,160.85,,,0 CDM,31081406JP,Hc Comprehensive Renal Disease Panel #2,971.31,388.52,,,0 CDM,31081406JQ,Hc Polyscystic Kidney Disease Panel #2,1145.73,458.29,,,0 CDM,31081406JR,Hc Nephrolithiasis And Calcinosis Panel #2,1040.43,416.17,,,0 CDM,31081406JS,Hc Renal Ciliopathy Panel #2,1161.0,464.4,,,0 CDM,31081406JT,Hc Renal Tubulopathy Panel #2,987.42,394.97,,,0 CDM,31081406JU,Hc Nephrotic Syndrome & Fsgs Panel #2,1231.1,492.44,,,0 CDM,31081406JV,Hc Primary Immunodeficiency Panel #2,1092.0,436.8,,,0 CDM,3108140701,Hc 014 Mp Lev 8 Tgfbr1,1166.1,466.44,,,0 CDM,3108140725,Hc Renal Ciliopathy Panel #1,1161.0,464.4,,,0 CDM,31081407AC,Hc Polyscystic Kidney Disease Panel #1,1145.73,458.29,,,0 CDM,31081407AD,Hc Nephrolithiasis And Calcinosis Panel #1,1040.43,416.17,,,0 CDM,31081407AE,Hc Renal Tubulopathy Panel #1,987.42,394.97,,,0 CDM,31081407AF,Hc Comprehensive Renal Disease Panel #1,1320.18,528.07,,,0 CDM,31081407AG,Hc Alport Syndrome Panel #1,1549.6,619.84,,,0 CDM,31081407AH,Hc Nephrotic Syndrome & Fsgs Panel #1,1231.1,492.44,,,0 CDM,31081407AI,Hc Primary Immunodeficiency Panel #1,1320.18,528.07,,,0 CDM,3108140802,Hc 223 Mopath 9 Fbn1-So+,1952.0,780.8,,,0 CDM,3108140834,Hc 001 Mp Lev-9 Col1A1/Col1A2,3806.27,1522.51,,,0 CDM,3108140842,Hc 009 Mp Lev-9 Fbn1,3268.43,1307.37,,,0 CDM,3108140867,Hc Renal Ciliopathy Panel #6,1161.0,464.4,,,0 CDM,3108140868,Hc Polyscystic Kidney Disease Panel #6,1145.73,458.29,,,0 CDM,3108140869,Hc Comprehensive Renal Disease Panel #6,3120.0,1248.0,,,0 CDM,3108140871,Hc Alport Syndrome Panel #2,1549.6,619.84,,,0 CDM,3108140872,Hc Nephrotic Syndrome & Fsgs Panel #5,1231.1,492.44,,,0 CDM,3108140873,Hc Primary Immunodeficiency Panel #6,3120.0,1248.0,,,0 CDM,3108141003,Hc Aortopathy Ngs,4323.31,1729.32,,,0 CDM,3108141305,Hc Arrhythmia Ngs,4360.14,1744.06,,,0 CDM,3108141501,Hc Exome Proband Sequencing,11524.89,4609.96,,,0 CDM,3108141601,Hc Exome Testing Familial Control,28933.63,11573.45,,,0 CDM,3108142003,Hc 495 Non-Invas Prenat Test-So+,2259.97,903.99,,,0 CDM,3108142004,Hc Fetal Aneuploidy Screening 3004764-So+,540.0,216.0,,,0 CDM,3108142005,Hc Non-Invasive Prenatal Aneuploidy By Ngs3003043-So+,910.86,364.34,,,0 CDM,3108143002,Hc Otoscope #1-So+,990.0,396.0,,,0 CDM,3108143102,Hc Otoscope #2-So+,990.0,396.0,,,0 CDM,3108143904,Hc Cardiomyopathy Ngs,4443.86,1777.54,,,0 CDM,3108144203,Hc Congenital Heart Ngs,4323.31,1729.32,,,0 CDM,3108144502,Hc Lung Cancer Mutation Panel-So+,2040.0,816.0,,,0 CDM,3108145003,"Hc Heme Malignancy Panel, 50 Gene",3767.4,1506.96,,,0 CDM,3108145501,Hc Solid Tumor 198 Gene Panel,7845.76,3138.3,,,0 CDM,3108145502,Hc Hematologic Malignancy Panel,8787.25,3514.9,,,0 CDM,3108145504,Hc Myeloid Malignancies Mutation Panel-Arup 201117,6285.3,2514.12,,,0 CDM,3108146001,Hc 647 Whole Mitochnd Genome-So+,2260.0,904.0,,,0 CDM,3108147901,Hc 014 Mp Unlisted,1011.34,404.54,,,0 CDM,3108147924,Hc 001 Mp Unlisted,137.31,54.92,,,0 CDM,3108147958,Hc 009 Mp Unlisted,105.48,42.19,,,0 CDM,31081479AD,Hc 331 Mp Unlst Cyp2C9-So+,150.0,60.0,,,0 CDM,31081479FK,Hc 363 Bcr/Abl Kinase Dom Mut-So+,1483.65,593.46,,,0 CDM,31081479KB,Hc 870 Mp Unlst Mult (4)-So+,132.08,52.83,,,0 CDM,31081479LO,Hc Renal Ciliopathy Panel #5,1161.0,464.4,,,0 CDM,31081479MM,Hc Clonoseq (Adaptive Branch),6279.0,2511.6,,,0 CDM,31081479MN,Hc Metabolic Newborn Screen Panel #4,285.53,114.21,,,0 CDM,31081479MO,Hc Galactosemia Ngs Panel #2,359.78,143.91,,,0 CDM,31081479MP,Hc Fatty Acid Oxidation Panel #4,420.77,168.31,,,0 CDM,31081479MQ,Hc Very Long Chain Fatty Acid Ngs #3,402.13,160.85,,,0 CDM,31081479MR,Hc Warfarin Sensitivity Genotyping 3001541 #3-So+,70.4,28.16,,,0 CDM,31081479MS,Hc Polyscystic Kidney Disease Panel #5,1145.73,458.29,,,0 CDM,31081479MT,Hc Nephrolithiasis And Calcinosis Panel #5,1040.43,416.17,,,0 CDM,31081479MU,Hc Renal Tubulopathy Panel #5,987.42,394.97,,,0 CDM,31081479MV,Hc Comprehensive Renal Disease Panel #5,971.31,388.52,,,0 CDM,31081479MW,Hc Oi Hae Panel #1,2166.84,866.74,,,0 CDM,31081479MX,Hc Nephrotic Syndrome & Fsgs Panel #4,1231.1,492.44,,,0 CDM,31081479MY,Hc Primary Immunodeficiency Panel #5,1092.0,436.8,,,0 CDM,31081479MZ,"Hc Karius Focus, Bal-So+",2640.0,1056.0,,,0 CDM,3108150302,Hc 878 Ova 1-Soq+,1291.68,516.67,,,0 CDM,3108150801,Hc 989 Maternl Ser 1St Trimes-So+,65.16,26.06,,,0 CDM,3108151102,Hc 990 Maternal Screen Quad-So+,184.2,73.68,,,0 CDM,3108151303,"Hc Bacterial Vaginosis Panel,Reflex To Lactobacillus Recovery -So+",171.16,68.46,,,0 CDM,3108151701,Hc Enhanced Liver Fibrosis (Elf)? Test 550659-So+,390.0,156.0,,,0 CDM,3108159501,Hc Allomap Molecular Expression (So),6113.98,2445.59,,,0 CDM,3108159502,Hc 395 Allomap Heart Txp-So+,5316.5,2126.6,,,0 CDM,3108159601,Hc 421 Hcv Fibrosure-So+,154.33,61.73,,,0 CDM,3108509701,Hc B Asp Interp 85097,712.0,284.8,,,0 CDM,3108636401,"Hc Tissue Transglutaminase Antibody, Igg 56009-So+",12.0,4.8,,,0 CDM,3108636402,"Hc Tissue Transglutaminase Antibody, Iga 0097709-So+",13.84,5.54,,,0 CDM,3108636403,"Hc Tissue Transglutaminase Antibody , Iga 3016860-So+",13.84,5.54,,,0 CDM,3108715401,Hc Fungal Id Blood Panel,446.72,178.69,,,0 CDM,3108715402,Hc Bacterial Id Gram Positive Blood,446.72,178.69,,,0 CDM,3108715403,Hc Bacterial Id Gram Negative Blood,446.72,178.69,,,0 CDM,3108715404,Hc Biofire Blood Culture Panel By Pcr,446.72,178.69,,,0 CDM,3108762601,"Hc Tp Hpv1618, 2011940-So+",84.24,33.7,,,0 CDM,3108803601,Hc Autopsy-Va,2632.16,1052.86,,,0 CDM,3108824101,Hc Res Client Bill Only Til Amtagvi Preparation,537.0,214.8,,,0 CDM,3108827501,"Hc Cytogenetics, 100-300 - Bcr/Abl1, Fish",275.0,110.0,,,0 CDM,3108836601,Hc Reflex Pathology Pancreatobiliary Fish Request2002453-So+,536.4,214.56,,,0 CDM,3118636301,"Hc Myelin Oligodendrocyte Glycoprotein (Mog-Igg1) Fluorescence-Activated Cell Sorting (Facs) Assay,",590.4,236.16,,,0 CDM,3118636302,"Hc Mog Facs Titer, S Mogts-So+",76.5,30.6,,,0 CDM,3118636303,"Hc Pediatric Autoimmune Encephalopathy/Cns Disorder Evaluation, Serum Pcdes #4-So+",138.46,55.38,,,0 CDM,3118636304,Hc Pcdes Ab Reflex Ib-So+,104.4,41.76,,,0 CDM,3118810801,"Hc Cytopath Concentrate Tech - Lab Cytopath Fluids,Concentratn,Interp",250.75,100.3,,,0 CDM,3118811201,"Hc Cytopath Cell Enhance Tech - Lab Cytopath, Cell Enhance Tech",277.26,110.9,,,0 CDM,3118814201,Hc Cytopath C/V Thin Layer - Lab Cytopath Cerv/Vag Thin Layer,32.03,12.81,,,0 CDM,3118816001,"Hc Cytopath Smear Other Source - Lab Cytopath,Othr Sourc,Screen,Interp",172.32,68.93,,,0 CDM,3118817201,"Hc Cytp Dx Eval Fna 1St Ea Site - Lab Evaluation Of Fna Smear, First",282.78,113.11,,,0 CDM,3118817301,Hc Cytopath Eval Fna Report - Lab Interpretation Of Fna Smear,387.72,155.09,,,0 CDM,3118817501,"Hc Cytopath C/V Auto Fluid Redo - Lab Cytopat,Cer/Vag,Thin Layer,Inter",187.79,75.12,,,0 CDM,3118817502,Hc Pap(So) Diagnostic-So+,170.0,68.0,,,0 CDM,3118817701,"Hc Cytp Fna Eval Ea Addl - Lab Evaluation Of Fna Smear, Ea Add Eval",99.42,39.77,,,0 CDM,3118818202,Hc Telomeres,660.0,264.0,,,0 CDM,3118818404,"Hc Flowcytometry/ Tech Component, 1 Marker - Lab Flowcytometry/Tech Cmp",455.11,182.04,,,0 CDM,3118818413,Hc 869 Flow Cytom 1St Mark-So+,324.98,129.99,,,0 CDM,3118818438,Hc Flow Cytometry 1St Marker,430.8,172.32,,,0 CDM,3118818456,Hc Alps Panel By Flow Cytometry,790.03,316.01,,,0 CDM,3118818460,Hc Tcr V-Beta Repertoire-Cinci Childrens 2900210,1259.27,503.71,,,0 CDM,3118818461,Hc Th17 Enumeration-Cinci Childrens 7372838,809.91,323.96,,,0 CDM,3118818462,Hc Flowcytometry Tc 1 Marker-So+,52.8,21.12,,,0 CDM,3118818463,Hc Flowcytometry Tc 1 Marker Arup-So+,52.8,21.12,,,0 CDM,3118818464,"Hc Minimal Residual Disease Detection(Aml, All T And B-Cell,Cll,Mds) #1-So+",75.0,30.0,,,0 CDM,3118818465,Hc B Cell Panel-So+,84.0,33.6,,,0 CDM,3118818466,Hc B-All Bm D29+(Cog) End Of Induction Mrd-So+,58.82,23.53,,,0 CDM,3118818467,Hc T-All Mrd-So+,58.42,23.37,,,0 CDM,3118818501,"Hc Flowcytometry/Tech Component, Add-On - Lab Flowcytometry/Tech Cmp",209.88,83.95,,,0 CDM,3118818517,Hc Flow Cytometry Ea Add Marker,198.83,79.53,,,0 CDM,3118818545,Hc 869 Flow Cytom Ea Add Mark-So+,15.0,6.0,,,0 CDM,3118818575,Hc Flowcytometry/Tc Add On-So+,52.8,21.12,,,0 CDM,3118818576,Hc Flowcytometry/Tc Add On Arup-So+,52.8,21.12,,,0 CDM,3118818577,"Hc Minimal Residual Disease Detection(Aml, All T And B-Cell,Cll,Mds) #2-So+",75.0,30.0,,,0 CDM,3118818578,Hc B Cell Panel #2-So+,84.0,33.6,,,0 CDM,3118818579,Hc B-All Bm D29+(Cog) End Of Induction Mrd #2-So+,58.82,23.53,,,0 CDM,3118818580,Hc T-All Mrd #2-So+,58.42,23.37,,,0 CDM,3118818901,Hc Flowcytometry/Read 16 & >-So+,52.8,21.12,,,0 CDM,3118818902,Hc Flowcytometry/Read 16 & > Arup-So+,52.8,21.12,,,0 CDM,3118823001,Hc Tissue Culture Lymphocytes C,1049.72,419.89,,,0 CDM,3118823037,"Hc Chromosome Analysis - Breakage, Fanconi Anemia, Whole Blood 0097688-#1-So+",247.8,99.12,,,0 CDM,3118823301,Hc Tissue Culture,1593.26,637.3,,,0 CDM,3118823304,Hc 839 Tissue Cx Skin/Bx-So+,506.09,202.44,,,0 CDM,3118823505,Hc Tis Culture Chorionic Villi,1302.17,520.87,,,0 CDM,3118823506,Hc Tissue Culture Amniotic Fluid,1302.17,520.87,,,0 CDM,3118823716,Hc Tiss Cult/Chromo Bone Marrow,1604.85,641.94,,,0 CDM,3118823722,Hc 218 Cryopres Fr&Stor-So+,50.66,20.26,,,0 CDM,3118823918,Hc Tissue Culture-Solid Tumor,1344.0,537.6,,,0 CDM,3118824001,Hc 839 Cryopres Fr&Stor-So+,36.32,14.53,,,0 CDM,3118824019,Hc Cryopresrvation Freezing & Sto,730.3,292.12,,,0 CDM,3118824903,"Hc Chromosome Analysis - Breakage, Fanconi Anemia, Whole Blood 0097688-#2-So+",247.8,99.12,,,0 CDM,3118826206,Hc Chromo Anal-D 15-20 Ce 2K,1369.14,547.66,,,0 CDM,3118826207,Hc Chromo Anal-A 15-20 Ce 2K,1369.14,547.66,,,0 CDM,3118826208,Hc Chromo Anal-C 15-20 Ce 2K,1369.14,547.66,,,0 CDM,3118826413,Hc Chromo Anal A 20-25,1469.61,587.84,,,0 CDM,3118826414,Hc Chromo Anal B 20-25,1469.61,587.84,,,0 CDM,3118826716,Hc Chrom Anal Cvs 15Ce,1593.26,637.3,,,0 CDM,3118826717,Hc Chrom Analysis -Amniotic Fluid,1593.26,637.3,,,0 CDM,3118827112,Hc 133 Mol Cyto Dna Prob-So+,68.7,27.48,,,0 CDM,3118827130,Hc 535 Mol Cyto Dna Prob-So+,52.06,20.82,,,0 CDM,3118827156,Hc Cytogenetics Dna Probe Ea,328.44,131.38,,,0 CDM,3118827171,Hc Myelodysplastic Syndrome (Mds) Panel By Fish 2002709-So+,108.0,43.2,,,0 CDM,3118827301,Hc 576 Chrom In Situ Hyb A10-30C,747.04,298.82,,,0 CDM,3118827550,Hc 535 Mol Cyt Insitu 100-300-So+,144.41,57.76,,,0 CDM,3118827567,Hc Inter In Situ Hybridization,985.32,394.13,,,0 CDM,3118828005,Hc Additional Karyotype,358.06,143.22,,,0 CDM,3118828012,Hc Additional Cells Counted,257.6,103.04,,,0 CDM,3118828512,Hc Additional Cells Counted,230.0,92.0,,,0 CDM,3118833301,Hc Cytology Touch Prep,518.07,207.23,,,0 CDM,311G012301,Hc Cytology Routine Thinprep Uhs,37.35,14.94,,,0 CDM,311G014501,Hc Routine Pap Imaging,149.41,59.76,,,0 CDM,311G014502,Hc Pap (So) Screening-So+,129.92,51.97,,,0 CDM,3120000001,Hc Res Processing Level I,38.97,15.59,,,0 CDM,3120000002,Hc Res Processing Level Ii,63.0,25.2,,,0 CDM,3120000003,Hc Res Processing Level Iv,306.81,122.72,,,0 CDM,3120000004,Hc Res 1 Slide Exist Blk Unstain,62.93,25.17,,,0 CDM,3120000005,Hc Res Stain Group 1,62.3,24.92,,,0 CDM,3128814104,Hc Insulinoma Associated Protein 1 (Insm1) Additional,511.44,204.58,,,0 CDM,3128827101,Hc Alk Pariffin Fish Each Probe,328.44,131.38,,,0 CDM,3128827102,Hc Ewsr1 Pariffin Fish Each Probe,328.44,131.38,,,0 CDM,3128827103,Hc Ss18 Pariffin Fish Probe Probe,293.25,117.3,,,0 CDM,3128827104,Hc 211-1P Paraffin Fish Each Probe,328.44,131.38,,,0 CDM,3128827105,Hc 211-19Q Paraffin Fish Each Probe,328.44,131.38,,,0 CDM,3128827106,Hc Ros1 Paraffin Fish Each Probe,328.44,131.38,,,0 CDM,3128827107,Hc Mdm2 Pariffin Fish Each Probe,328.44,131.38,,,0 CDM,3128827501,Hc Alk Pariffin Fish Each Additional Probe,985.32,394.13,,,0 CDM,3128827502,Hc Ewsr1 Pariffin Fish Each Additional Probe,985.32,394.13,,,0 CDM,3128827503,Hc Ss18 Pariffin Fish Probe Probe Each Additional Probe,985.32,394.13,,,0 CDM,3128827504,Hc 211-1P Paraffin Fish Each Additional Probe,985.32,394.13,,,0 CDM,3128827505,Hc 211-19Q Paraffin Fish Each Additional Probe,985.32,394.13,,,0 CDM,3128827506,Hc Ros1 Paraffin Fish Each Additional Probe,985.32,394.13,,,0 CDM,3128827507,Hc Mdm2 Pariffin Fish Each Additional Probe,985.32,394.13,,,0 CDM,3128827508,Hc Mds Panel By Fish 2002709 #2-So+,108.0,43.2,,,0 CDM,3128827509,Hc Myelodysplastic Syndrome (Mds) Panel By Fish 2002709 #2-So+,108.0,43.2,,,0 CDM,3128830015,"Hc Surg Path,Gross,Level I - Lab Surg Path,Gross,Level I",134.76,53.9,,,0 CDM,3128830216,"Hc Surg Path,Level Ii - Lab Surg Path,Level Ii",234.18,93.67,,,0 CDM,3128830401,"Hc Surg Path,Level Iii - Lab Surg Path,Level Iii",371.15,148.46,,,0 CDM,3128830501,"Hc Surg Path,Level Iv - Lab Surg Path,Level Iv",494.87,197.95,,,0 CDM,3128830502,Hc Histology Cell Block Prep,494.87,197.95,,,0 CDM,3128830503,Hc Comprehensive Muscle Biopsy Workup 2013260 #1-So+,102.56,41.02,,,0 CDM,3128830701,"Hc Surg Path,Level V - Lab Surg Path,Level V",803.06,321.22,,,0 CDM,3128830901,"Hc Surg Path,Level Vi - Lab Surg Path,Level Vi",957.71,383.08,,,0 CDM,3128831101,"Hc Decalcify Tissue - Lab Surg Path,Level Iii",102.73,41.09,,,0 CDM,3128831105,Hc Decalcify Tissue - Lab Decalcify Tissue,102.73,41.09,,,0 CDM,3128831201,"Hc Special Stains,Group I - Lab Special Stains,Group I",271.74,108.7,,,0 CDM,3128831301,"Hc Special Stains,Group Ii - Lab Special Stains,Group Ii",277.26,110.9,,,0 CDM,3128831305,Hc Comprehensive Muscle Biopsy Workup 2013260 #2-So+,102.56,41.02,,,0 CDM,3128831402,Hc Comprehensive Muscle Biopsy Workup 2013260 #4-So+,307.35,122.94,,,0 CDM,3128831901,Hc Enzyme Histochemistry - Lab Enzyme Histochemistry,585.45,234.18,,,0 CDM,3128831903,Hc Comprehensive Muscle Biopsy Workup 2013260 #3-So+,820.45,328.18,,,0 CDM,3128832301,Hc Microslide Consult W Slide Prep - Lab Microslide Consult W Sld Prep,226.45,90.58,,,0 CDM,3128832501,Hc Comprehensive Review Of Data Pro - Lab Comprehensive Review Of Data,408.71,163.48,,,0 CDM,3128833101,"Hc Path Consult In Surg,W Frz Sec - Bundled Charge",415.34,166.14,,,0 CDM,3128833201,"Hc Path Consult In Surg,W Addn Frz Sec - Block",186.68,74.67,,,0 CDM,3128833401,Hc Intraop Cyto Path Consult 2 - Lab Intraoperative Cyto Path Consult,166.8,66.72,,,0 CDM,3128834101,Hc Immunohisto Antb Addl Slide - Lab Imhistochem/Cytchm Ea Addl Ant Sld,511.44,204.58,,,0 CDM,3128834103,Hc Carbonic Anhydrase Ix Each Additional,197.96,79.18,,,0 CDM,3128834108,Hc Glutamine Synthetase Additional,511.44,204.58,,,0 CDM,3128834201,Hc Imhistochem/Cytchm Init Antibody Stain Procedure - Bundled Charge,537.95,215.18,,,0 CDM,3128834220,Hc 187 Immunohist 1St Ab Stn-So+,162.47,64.99,,,0 CDM,3128834233,Hc Glutamine Synthetase 1St,537.95,215.18,,,0 CDM,3128834247,Hc Insulinoma Associated Protein 1 (Insm1) 1St,537.95,215.18,,,0 CDM,3128834401,Hc Each Multiplex Ab Stain Procedure Ihc,740.1,296.04,,,0 CDM,3128834601,"Hc Immunofluorescent Study,Indirect - Anti Ribonucleic Acid",395.46,158.18,,,0 CDM,3128834610,Hc 151 Em Dx Cilia/Nasal-So+,753.84,301.54,,,0 CDM,3128834621,Hc 870 If Ab Per Spec 1St-So+,320.87,128.35,,,0 CDM,3128834801,Hc 159 Em Dx Muscle-So+,753.48,301.39,,,0 CDM,3128834816,Hc Em Dx Misc-So+,753.84,301.54,,,0 CDM,3128835003,Hc 870 If Ab Per Spec Ea Add-So+,54.02,21.61,,,0 CDM,3128835005,Hc Igg If Ea Add Antibody,376.68,150.67,,,0 CDM,3128835006,Hc Lambda If Each Additional Antibody,376.68,150.67,,,0 CDM,3128835007,Hc C3 If Each Add Anti,376.68,150.67,,,0 CDM,3128835008,Hc Iga If Ea Add Antib,376.68,150.67,,,0 CDM,3128835009,Hc Kappa If Each Additional Antibody,376.68,150.67,,,0 CDM,3128835010,Hc Igm If Ea Add Spec,376.68,150.67,,,0 CDM,3128835011,Hc Fibrinogen If Each Additional Antibody,376.68,150.67,,,0 CDM,3128835012,Hc C1Q If Ea Add Antib,376.68,150.67,,,0 CDM,3128835013,Hc Albumin If Each Additional Antibody,376.68,150.67,,,0 CDM,3128836001,Hc Imhc Pr-Progest Each Specimen,598.71,239.48,,,0 CDM,3128836017,Hc Eber In-Situ,598.71,239.48,,,0 CDM,3128836018,Hc 162 Hpv High Risk-So+,542.0,216.8,,,0 CDM,3128836023,Hc Pd-L1 Arup 3017615,542.0,216.8,,,0 CDM,3128836024,Hc Reflex Pd-L1 22C3 By Ihc With Tumor Proportion Score (Tps) Interpretation 3017680-So+,342.0,136.8,,,0 CDM,3128836025,"Hc Reflex Pd-L1 22C3 By Ihc With Combined Positive Score (Cps) Interpretation, 3017681 #2-So+",342.0,136.8,,,0 CDM,3128836517,Hc Eber In-Situ,1001.9,400.76,,,0 CDM,3128836519,Noncdm Charge Record,460.76,184.3,,,0 CDM,3128836520,Noncdm Charge Record,460.76,184.3,,,0 CDM,3128836805,Hc Ewsr1 Parrafin Fish Probe,967.65,387.06,,,0 CDM,3128836806,Hc Ss18 Parrafin Fish Probe,967.65,387.06,,,0 CDM,3128836809,Hc Ros1 Paraffin Fish Probe,967.65,387.06,,,0 CDM,3128836810,Hc Mdm2 Parrafin Fish Probe,967.65,387.06,,,0 CDM,3128836811,Hc Myc Pariffin Fish Each Probe Test,967.65,387.06,,,0 CDM,3128836812,Hc Bcl6 Paraffin Fish Each Probe,967.65,387.06,,,0 CDM,3128836813,Hc Bcl2 Paraffin Fish Each Probe,967.65,387.06,,,0 CDM,3128836814,Hc 260 Probe Her 2,967.65,387.06,,,0 CDM,3128836901,Hc Myc Pariffin Fish Each Additional Probe Test,497.08,198.83,,,0 CDM,3128836902,Hc Bcl6 Paraffin Fish Each Additional Probe,497.08,198.83,,,0 CDM,3128836903,Hc Bcl2 Paraffin Fish Each Additional Probe,497.08,198.83,,,0 CDM,3128837101,Hc Mds Panel By Fish 2002709-So+,108.0,43.2,,,0 CDM,3128838101,Hc 790 Microdissect Manual-So+,307.17,122.87,,,0 CDM,3128838107,Hc 286 Microdissect Manual-So+,293.35,117.34,,,0 CDM,3128838109,Hc 562 Microdissect Manual-So+,212.52,85.01,,,0 CDM,3128838111,Hc 246 Microdissect Manual-So+,212.52,85.01,,,0 CDM,3200000001,Hc Executive Health Ugi,1417.0,566.8,,,0 CDM,3200358T01,Hc Bia Whole Body Composition Assessment With Interpretation & Report,84.5,33.8,,,0 CDM,3200556T01,Hc Bone Strength & Fracture Risk Assessment,441.02,176.41,,,0 CDM,3207003001,Hc X-Ray Eye For Foreign Body - Unilateral,423.36,169.34,,,0 CDM,3207010001,Hc X-Ray Jaw <4 Views - Xr Mandible < 4 Views,620.15,248.06,,,0 CDM,3207011001,Hc X-Ray Jaw <4 Views - Xr Mandible < 4 Views,765.59,306.24,,,0 CDM,3207014001,Hc X-Ray Facial Bones <3 Views - Xr Facial Bones 1-2 Views,569.38,227.75,,,0 CDM,3207015001,Hc X-Ray Facial Bones 3+ Views - Xr Facial Bones 3+ Views,607.8,243.12,,,0 CDM,3207016001,Hc X-Ray Nasal Bones - Xr Nasal Bones,448.64,179.46,,,0 CDM,3207020001,Hc X-Ray Orbits - Xr Orbits Complete 4+ Views,824.58,329.83,,,0 CDM,3207022001,Hc X-Ray Sinuses 3+ View - Xr Paranasal Sinuses 3+ Views,749.12,299.65,,,0 CDM,3207025001,Hc X-Ray Skull <4 View - Xr Skull 1-3 Views,745.0,298.0,,,0 CDM,3207026001,Hc X-Ray Skull 4+ View - Xr Skull Complete 4+ Views,797.15,318.86,,,0 CDM,3207033001,Hc X-Ray Temporomandibular Joint Bilateral - Xr Temporomandibular Joint Open And Closed Bilateral,636.62,254.65,,,0 CDM,3207035501,Hc Panoramic X-Ray Of Jaws - Xr Panorex,624.27,249.71,,,0 CDM,3207036001,Hc X-Ray Neck Soft Tissue - Xr Neck Soft Tissue,477.12,190.85,,,0 CDM,3207110001,Hc X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Left,679.15,271.66,,,0 CDM,3207110002,Hc X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right,679.15,271.66,,,0 CDM,3207110101,"Hc X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws W/ Chest Anteroposterior",883.57,353.43,,,0 CDM,3207111001,Hc X-Ray Ribs 3 View Bilateral - Xr Ribs 3 Views Bilateral,972.75,389.1,,,0 CDM,3207111101,"Hc X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior",1052.34,420.94,,,0 CDM,3207112001,Hc X-Ray Sternum 2+ View - Xr Sternum 2+ Views,519.99,208.0,,,0 CDM,3207113001,Hc X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views,425.32,170.13,,,0 CDM,3207202001,Hc X-Ray Spine One View - Xr Spine,554.29,221.72,,,0 CDM,3207204001,Hc Radex Spine Cervical 2 Or 3 Views - Xr Cervical Spine 1 View,813.6,325.44,,,0 CDM,3207204002,Hc Radex Spine Cervical 2 Or 3 Views - Xr Cervical Spine 2-3 Views,813.6,325.44,,,0 CDM,3207205001,Hc Radex Spine Cervical 4 Or 5 Views - Xr Cervical Spine Comp 4-5 Views,1107.22,442.89,,,0 CDM,3207205201,Hc Radex Spine Cervical 6 Or More Views - Xr C-Spine Complete 6+ Views,1157.98,463.19,,,0 CDM,3207207001,Hc X-Ray Thoracic Spine 2 View - Xr Thoracic Spine 2 Views,749.12,299.65,,,0 CDM,3207207201,Hc X-Ray Thoracic Spine+Swim 3 View - Xr Thoracic Spine 3 Views,790.28,316.11,,,0 CDM,3207207401,Hc X-Ray Thoracic Spine 4 View - Xr Thoracic Spine Complete 4+ Views,806.74,322.7,,,0 CDM,3207208001,Hc Radex X-Ray Exam Thoracolmb 2+ Vw - Xr Thoracolumbar Spine 2 Views,795.77,318.31,,,0 CDM,3207208101,Hc Radex Entire Thrc Lumbar Cerival Sac Spine W/Skull 1 View - Xr Scoliosis 1 View,480.2,192.08,,,0 CDM,3207208102,Hc Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Entire Spine 1 V,480.2,192.08,,,0 CDM,3207208201,Hc Radex X-Ray Exam Entire Spine 2/3 Views - Xr Entire Spine 2 Or 3 Views,727.17,290.87,,,0 CDM,3207208202,Hc Radex X-Ray Exam Entire Spi 2/3 Vw - Xr Spine Survey Ap And Lateral,727.17,290.87,,,0 CDM,3207208301,Hc Radex X-Ray Exam Entire Spine 4/5 Views - Xr Entire Spine 4 Or 5 Views,865.74,346.3,,,0 CDM,3207208401,Hc Radex X-Ray Exam Entire Spine 6/> Views - Xr Entire Spine 6+ Views,1142.88,457.15,,,0 CDM,3207210001,Hc X-Ray Lumbar Spine 2/3 View - Xr Lumbar Spine 2-3 Views,901.42,360.57,,,0 CDM,3207211001,Hc X-Ray Lumbar Spine 4 View - Xr Lumbar Spine Complete 4+ Views,1274.6,509.84,,,0 CDM,3207211401,Hc X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending,1156.41,462.56,,,0 CDM,3207212001,Hc X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 2-3 Views W/ Flex Ext,901.42,360.57,,,0 CDM,3207217001,Hc X-Ray Pelvis 1/2 View - Xr Pelvis 1-2 Views,676.41,270.56,,,0 CDM,3207219001,Hc X-Ray Pelvis 3+ View - Xr Pelvis 3+ Views,765.59,306.24,,,0 CDM,3207220201,Hc X-Ray Sacroiliac Joints 3+ View - Xr Sacroiliac Joints 3+ Views,609.17,243.67,,,0 CDM,3207222001,Hc X-Ray Sacrum/Coccyx 2+ View - Xr Sacrum Coccyx 2+ Views,581.73,232.69,,,0 CDM,3207224001,Hc Myelography Cerv Spine - Fl Cervical Spine Myelogram,2964.98,1185.99,,,0 CDM,3207226501,Hc Myelography Lumbar Spine - Fl Lumbar Spine Myelogram,2964.98,1185.99,,,0 CDM,3207300001,Hc X-Ray Clavicle - Xr Clavicle,625.64,250.26,,,0 CDM,3207301001,Hc X-Ray Scapula - Xr Scapula,637.99,255.2,,,0 CDM,3207302002,Hc X-Ray Shoulder 1 Vw - Xr Shoulder 1 View,550.18,220.07,,,0 CDM,3207303002,Hc X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views,751.86,300.74,,,0 CDM,3207305001,Hc X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral,616.03,246.41,,,0 CDM,3207306001,Hc X-Ray Humerus - Xr Humerus,625.64,250.26,,,0 CDM,3207307002,Hc X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views,588.59,235.44,,,0 CDM,3207307003,Hc X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right,588.59,235.44,,,0 CDM,3207308002,Hc X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views,669.54,267.82,,,0 CDM,3207309001,Hc X-Ray Forearm 2 Vw - Xr Forearm 1-2 Views,640.73,256.29,,,0 CDM,3207309201,"Hc X-Ray Arm, Infant - Xr Upper Extremity 2+ Views Infant",519.99,208.0,,,0 CDM,3207310001,Hc X-Ray Wrist 2 View-Bilateral,563.9,225.56,,,0 CDM,3207310002,Hc X-Ray Wrist 2 View-Unilateral,281.95,112.78,,,0 CDM,3207311001,Hc X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views,717.56,287.02,,,0 CDM,3207312001,Hc X-Ray Hand 2 Vw - Xr Hand 1-2 Views,644.85,257.94,,,0 CDM,3207312003,Hc X-Ray Hand 2 Views - Xr Hand 1-2 Views Bilateral,644.85,257.94,,,0 CDM,3207312007,Hc Res Xr Hand 2 Views-Rt,579.42,231.77,,,0 CDM,3207312008,Hc Res Xr Hand 2 Views-Lt,579.42,231.77,,,0 CDM,3207313001,Hc X-Ray Hand 3+ Vw - Xr Hand 3+ Views,679.15,271.66,,,0 CDM,3207314001,Hc X-Ray Exam Of Finger(S) - Xr Fingers 2+ Views,507.64,203.06,,,0 CDM,3207350101,Hc X-Ray Exam Hip 1 View - Xr Hip 1 View,581.73,232.69,,,0 CDM,3207350201,Hc X-Ray Exam Hip 2-3 Views - Xr Hip 2 Or 3 Views,644.85,257.94,,,0 CDM,3207350301,Hc X-Ray Exam Hip 4+ Views - Xr Hip 4+ Views,710.71,284.28,,,0 CDM,3207352101,Hc X-Ray Exam Hips Bilateral 2 Views - Xr Hips Bilateral 2 Views W Wo Pelvis,873.98,349.59,,,0 CDM,3207352201,Hc X-Ray Exam Hips Bilateral 3-4 Views - Xr Hips Bilateral 3-4 Views W Wo Pelvis,937.08,374.83,,,0 CDM,3207352301,Hc X-Ray Exam Hips Bilateral 5+ Views - Xr Hips Bilateral 5+ Views W Wo Pelvis,1159.35,463.74,,,0 CDM,3207355101,Hc Radiologic Examination Femur 1 View - Xr Femur 1 View,592.71,237.08,,,0 CDM,3207355202,Hc Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Views,688.75,275.5,,,0 CDM,3207356001,Hc X-Ray Knee 1 Or 2 Views - Xr Knee 1-2 Views,669.54,267.82,,,0 CDM,3207356201,Hc X-Ray Knee 3 Views - Xr Knee 3 Views,808.12,323.25,,,0 CDM,3207356203,Hc X-Ray Knee 3 View - Xr Knee 3 Views Bilateral,1534.0,613.6,,,0 CDM,3207356401,Hc X-Ray Knee 4+ Views - Xr Knee 4+ Views,972.75,389.1,,,0 CDM,3207356501,Hc X-Ray Knee Bilateral Standing - Xr Knees Anteroposterior Standing Bilateral,668.17,267.27,,,0 CDM,3207359001,"Hc X-Ray Tibia Fibula, 2 Views - Xr Tibia Fibula 2 Views",720.3,288.12,,,0 CDM,3207359201,"Hc X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant",509.02,203.61,,,0 CDM,3207360001,Hc X-Ray Ankle 2 Views - Xr Ankle 2 Views,588.59,235.44,,,0 CDM,3207361001,Hc X-Ray Ankle 3+ Views- Xr Ankle 3+ Views,698.36,279.34,,,0 CDM,3207362001,Hc X-Ray Foot 2 Views - Xr Foot 1-2 Views,596.82,238.73,,,0 CDM,3207363001,Hc X-Ray Foot 3+ Views - Xr Foot 3+ Views,734.03,293.61,,,0 CDM,3207365001,Hc X-Ray Heel - Xr Calcaneus 2 Views,568.02,227.21,,,0 CDM,3207366001,Hc X-Ray Toe(S) - Xr Toes 2+ Views,466.49,186.6,,,0 CDM,3207401801,Hc Radiologic Exam Abdomen 1 View - Xr Colon Motility,527.52,211.01,,,0 CDM,3207401802,Hc Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View,527.52,211.01,,,0 CDM,3207401901,Hc Radiologic Exam Abdomen 2 Views - Xr Abdomen 2 View Poster W Decubitus,635.04,254.02,,,0 CDM,3207402101,Hc Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views,785.0,314.0,,,0 CDM,3207402201,"Hc X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Views With Chest 1 View",759.36,303.74,,,0 CDM,3207422001,Hc Esophagram - Fl Esophagus Barium Swallow,857.92,343.17,,,0 CDM,3207422101,Hc Barium Swallow (Barium & Air),868.0,347.2,,,0 CDM,3207423001,Hc Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech,882.56,353.02,,,0 CDM,3207424001,Hc X-Ray Upper Gi Delay W/O Kub - Fl Upper Gi Without Kub,1010.24,404.1,,,0 CDM,3207424101,Hc X-Ray Upper Gi Delay W/Kub - Fl Upper Gi With Kub,1303.68,521.47,,,0 CDM,3207424501,Hc X-Ray Upper Gi&Small Intest - Fl Upper Gi Single Cont W/ Small Bowel,1743.84,697.54,,,0 CDM,3207424601,Hc Contrst X-Ray Uppr Gi Tract - Fl Upper Gi With Double Cont W/O Kub,1554.56,621.82,,,0 CDM,3207424801,Hc X-Ray Upper Gi&Small Intest - Fl Upper Gi Single Cont W/ Small Bowel,1295.84,518.34,,,0 CDM,3207425001,Hc X-Ray Exam Of Small Bowel - Fl Small Bowel Series,990.08,396.03,,,0 CDM,3207427001,Hc X-Ray Colon Contrast - Fl Barium Enema Single Contrast Water Soluble,1304.8,521.92,,,0 CDM,3207428001,Hc X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast,1491.84,596.74,,,0 CDM,3207428301,Hc Xr Barium Enem Intussusception,1863.74,745.5,,,0 CDM,3207432801,Hc X-Ray For Bile Duct Endoscopy - Fl Ercp Biliary Duct,1453.76,581.5,,,0 CDM,3207432901,Hc X-Ray For Pancreas Endoscopy - Fl Ercp Pancreatic Duct,1301.44,520.58,,,0 CDM,3207433001,Hc X-Ray Bile/Pancreas Endoscopy - Fl Ercp Biliary And Pancreas,1809.92,723.97,,,0 CDM,3207434001,Hc X-Ray Guide For Gi Tube - Fl Feeding Tube Placement Long,900.48,360.19,,,0 CDM,3207434002,Hc X-Ray Guide For Gi Tube - Fl Feeding Tube Placement,900.48,360.19,,,0 CDM,3207436001,Hc X-Ray Guide Gi Dilation - Fl Guided Intraluminal Dilation Strictures,659.68,263.87,,,0 CDM,3207436302,Hc X-Ray Bile Duct Dilation - Ir Biliary Dilation Charge,1853.0,741.2,,,0 CDM,3207440001,Hc X-Ray Iv Pyelogram (Ivp) - Xr Urogram W/Wo Kub W/Wo Tomogram,1345.12,538.05,,,0 CDM,3207442001,Hc X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde W/ Disposable Scope,1506.0,602.4,,,0 CDM,3207442501,Hc X-Ray Antegrade Pyelogram Tube - Fl Guided Nephrostogram,1322.72,529.09,,,0 CDM,3207442502,Hc X-Ray Antegrade Pyelogram Tube - Fl Loopogram,1181.0,472.4,,,0 CDM,3207442503,Hc X-Ray Antegrade Pyelogram Tube - Ir Nephrostogram Charge,1181.0,472.4,,,0 CDM,3207443001,"Hc X-Ray Cystogram, Min 3 View - Fl Cystogram 3 View",1018.08,407.23,,,0 CDM,3207445001,Hc X-Ray Urethrocystogram - Xr Cystourethrogram,1011.36,404.54,,,0 CDM,3207445501,Hc X-Ray Urethrocystogram+Voiding - Fl Voiding Cystourethrogram,1247.68,499.07,,,0 CDM,3207474001,Hc X-Ray Hysterosalpingogram - Xr Hysterosalpingogram,1148.0,459.2,,,0 CDM,3207580301,Hc Lymphangiogram Extremity Bilateral - Ir Lymphangiogram Extremity Bilateral,2689.34,1075.74,,,0 CDM,3207580501,Hc Lymphangio Abdomen Pelvis - Ir Lymphangiogram Abdomen Pelvis-Unilateral,2557.97,1023.19,,,0 CDM,3207580702,Hc Lymphangiogram Abdomen/Pelvis Bilateral - Ir Lymphangiogram Abdomen Pelvis Bilateral,3420.93,1368.37,,,0 CDM,3207580901,Hc Nonvascular Shuntogram - Ir Nonvascular Shuntogram,672.0,268.8,,,0 CDM,3207582001,Hc Venogram Extrem- Ir Venogram Lower Extremity,2642.98,1057.19,,,0 CDM,3207582002,Hc Venogram Extrem Unilat - Ir Venogram Lower Extremity Left Chg,2642.98,1057.19,,,0 CDM,3207582005,Hc Venography Extremity S&I Left,2642.98,1057.19,,,0 CDM,3207582203,Hc Venogram Extremity Bilateral - Ir Venogram Upper Extremity Bilateral,3198.1,1279.24,,,0 CDM,3207582204,Hc Venogram Extrem Bilat - Ir Venogram Extremity Bilateral Charge,3198.1,1279.24,,,0 CDM,3207582501,Hc Venogram Infer Vena Cava - Ir Veno Caval Inferior W Serialography,6121.86,2448.74,,,0 CDM,3207582502,Hc Venogram Infer Vena Cava - Ir Veno Caval Inferior W Serialography Ch,6121.86,2448.74,,,0 CDM,3207582701,Hc Venogram Super Vena Cava - Ir Veno Caval Superior W Serialography,4593.01,1837.2,,,0 CDM,3207583102,Hc Venogram Renal- Ir Venogram Renal,5781.83,2312.73,,,0 CDM,3207583301,Hc Venogram Renal Bilat - Ir Venogram Renal Bilateral,6792.91,2717.16,,,0 CDM,3207586001,"Hc Venogram Sinus/Jugular - Ir Venogram Venous Sinus, Jugular",4443.6,1777.44,,,0 CDM,3207587001,Hc Venogram Super Sag Sinus - Ir Venogram Superior Sagittal Sinus,3298.57,1319.43,,,0 CDM,3207587002,Hc Venogram Super Sag Sinus - Ir Venogram Superior Sagittal Sinus Chg,3298.57,1319.43,,,0 CDM,3207588701,Hc Percutaneous Transhept Porto W/O Pres,3728.76,1491.5,,,0 CDM,3207588901,Hc Vein X-Ray Liver W/Hemodynam - Ir Veno Hepatic W Hemodynamic Evaluation,6625.47,2650.19,,,0 CDM,3207589301,Hc Venous Sampling By Catheter - Ir Venous Sampling Catheterization,5942.83,2377.13,,,0 CDM,3207589401,Hc X-Rays Transcath Therapy - Ir Transcatheter Therapy Embolization,5752.32,2300.93,,,0 CDM,3207597001,Hc Vascular Biopsy - Ir Transcatheter Biopsy,3748.64,1499.46,,,0 CDM,3207597002,Hc Vascular Biopsy - Ir Transcatheter Biopsy Charge,3748.64,1499.46,,,0 CDM,3207598901,Hc Abscess Drainage Under X-Ray - Ct Guidance For Abscess Drain,2058.56,823.42,,,0 CDM,3207600001,Hc Fluoroscopy <1 Hr Phys/Qhp - Ir Cvc Reposition W Fl Guidance,1275.12,510.05,,,0 CDM,3207600002,Hc Fluoroscopy <1 Hr Phys/Qhp - Ir Cvc Reposition W Fl Guidance Chg,1275.12,510.05,,,0 CDM,3207600003,Hc Fluoroscopy <1 Hr Phys/Qhp - Fl Sniff Test,1275.12,510.05,,,0 CDM,3207600004,Hc Fluoroscopy <1 Hr Phys/Qhp - Fl Less Than 1 Hour Intraoperative,1275.12,510.05,,,0 CDM,3207608001,"Hc X-Ray Fistula,Abscess,Sinus Tract - Ir Abscessogram W/ Contrast",1042.72,417.09,,,0 CDM,3207608004,"Hc X-Ray Fistula,Abscess,Sinus Tract - Ir Diagnostic Sinogram Chg",1042.72,417.09,,,0 CDM,3207609801,"Hc X-Ray Exam, Breast Specimen - Mammo Breast Specimen",594.0,237.6,,,0 CDM,3207612001,Hc Cineradiograpy/Videoradiography X-Rays,651.84,260.74,,,0 CDM,3207612501,Hc Cine/Videoradiography Add On,496.16,198.46,,,0 CDM,3207649602,Hc Hepatic Pressures Without Venogram,5185.0,2074.0,,,0 CDM,3207649903,Hc Res Whole Body Bmd,1138.96,455.58,,,0 CDM,3207700101,Hc Fluoroguide For Vein Device - Fl Guided Venous Access,1284.14,513.66,,,0 CDM,3207700201,Hc Fluoroguide Needle Placement-Biopsy/Aspiration/Injection,1297.02,518.81,,,0 CDM,3207700206,Hc Needle Localization By Xray - Fl Guided Aspir Or Inj Inter Joint Rt,1297.02,518.81,,,0 CDM,3207700226,Hc Needle Localization By Xray - Fl Guided Fine Needle Aspiration Chg,1297.02,518.81,,,0 CDM,3207700251,Hc Needle Localization By Xray - Fl Guided Aspiration Ankle Left,1297.02,518.81,,,0 CDM,3207700267,Hc Needle Localization By Xray - Fl Guided Aspiration Hip Left,1297.02,518.81,,,0 CDM,3207700288,Hc Needle Localization By Xray - Fl Guided Needle Placement,1297.02,518.81,,,0 CDM,3207700302,Hc Fluorscopic Guidance Spinal Injection - Ir Disc Aspiration Charge,1564.92,625.97,,,0 CDM,3207700303,Hc Fluorscopic Guidance Spinal Injection,1564.92,625.97,,,0 CDM,3207707101,Hc Manual Appl Stress Pfrmd Phys/Qhp Joint Films,267.54,107.02,,,0 CDM,3207707201,Hc X-Rays For Bone Age - Xr Bone Age Extended,627.01,250.8,,,0 CDM,3207707202,Hc X-Rays For Bone Age - Xr Bone Age Hand Wrist,627.01,250.8,,,0 CDM,3207707301,"Hc X-Rays, Bone Length Studies - Xr Lower Extremity Leg Length Eval",665.42,266.17,,,0 CDM,3207707401,"Hc X-Rays, Bone Survey, Limited - Xr Bone Survey Limited",1115.45,446.18,,,0 CDM,3207707501,"Hc X-Rays, Bone Survey Complete - Xr Bone Survey Complete",1372.01,548.8,,,0 CDM,3207707601,"Hc X-Rays, Bone Survey, Infant - Xr Bone Survey Infant",1299.3,519.72,,,0 CDM,3207707701,"Hc Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints",519.99,208.0,,,0 CDM,3207708002,Hc Dxa Bone Density Axial - Dexa Bone Density,996.08,398.43,,,0 CDM,3207708101,Hc Dxa Bone Density/Peripheral - Dexa Bone Density Extremity,850.65,340.26,,,0 CDM,3207708501,Hc Dxa Bone Density Study - Dexa Bone Density Axial Skeleton W Vfa,708.4,283.36,,,0 CDM,3207708601,Hc Fracture Assessment Via Dxa - Dexa Bone Density Spine Fracture,322.0,128.8,,,0 CDM,3207708901,Hc Tbs Dxa/Other Img Calculation W/I&R Fx Risk,125.0,50.0,,,0 CDM,3207709101,Hc Trabecular Bone Score (Tbs),95.0,38.0,,,0 CDM,3209358401,Hc Venography Chd Anomalous/Persistent Svc Nt Drg,2296.55,918.62,,,0 CDM,3209358501,Hc Venography Chd Azygos/Hemiazygos Venous System,2296.55,918.62,,,0 CDM,3209358601,Hc Venography Chd Coronary Sinus,2296.55,918.62,,,0 CDM,3209358701,Hc Venography Chd Venovenous Coltrl At/Above Heart,1322.5,529.0,,,0 CDM,3209358801,Hc Venography Chd Venovenous Collateral Below Heart,1322.5,529.0,,,0 CDM,321G041601,Hc Gross/Micro Prostate Biopsy,494.87,197.95,,,0 CDM,3227352502,Hc Arthrogram Of Hip - Xr Hip Arthrogram,1634.47,653.79,,,0 CDM,3237448504,"Hc X-Ray Guide, Gu Dilation - Ir Nephrostomy Dilation Charge",1800.0,720.0,,,0 CDM,3237560501,Hc Contrast Exam Thoracic Aorta - Ir Aortagram Thoracic Serialogram,7277.2,2910.88,,,0 CDM,3237560502,Hc Contrast Exam Thoracic Aorta - Ir Aortagram Thoracic Serialogram Chg,7277.2,2910.88,,,0 CDM,3237562501,Hc Contrast Exam Abdominal Aorta - Ir Aortagram Abdomnal Serialogram,6638.35,2655.34,,,0 CDM,3237562502,Hc Contrast Exam Abdominl Aorta - Ir Aortagram Abdomnl Serialogram Chg,6638.35,2655.34,,,0 CDM,3237563001,Hc X-Ray Aorta Leg Arteries - Ir Angio Abdom Aorta & Bi Iliofemoral Chg,6492.81,2597.12,,,0 CDM,3237570501,Hc Angio Spinal Selective - Ir Angiogram Spinal Selective,7402.14,2960.86,,,0 CDM,3237570502,Hc Angio Spinal Selectv - Ir Angiogram Spinal Selective Chg,7402.14,2960.86,,,0 CDM,3237571001,Hc Angio Extremity - Ir Angiogram Extremity,6440.0,2576.0,,,0 CDM,3237571002,Hc Angio Extremity Unilateral - Ir Angiogram Extremity Right,6440.0,2576.0,,,0 CDM,3237571003,Hc Angio Extremity Unilat - Ir Angiogram Extremity Left Charge,6440.0,2576.0,,,0 CDM,3237571004,Hc Angio/Ir Angiogram Extremity Unilateral,6440.0,2576.0,,,0 CDM,3237571601,Hc Angio Extermity Bilateral - Ir Angiogram Extremity Bilateral,7247.58,2899.03,,,0 CDM,3237571602,Hc Angio/Ir Angiogram Extremity Bilateral,7247.58,2899.03,,,0 CDM,3237572601,Hc Angio/Ir Angio Visceral Selective,8727.49,3491.0,,,0 CDM,3237572602,Hc Angio Visceral Selectv/Subselec - Ir Angio Visceral Selective Chg,8727.49,3491.0,,,0 CDM,3237573101,Hc Angio Adrenal Selective - Ir Angiogram Adrenal Selective-Unilateral,6022.69,2409.08,,,0 CDM,3237573601,Hc Angio Pelvis - Ir Angio Pelvic Selective Or Supraselective,7542.53,3017.01,,,0 CDM,3237573603,Hc Angio Pelvis - Ir Angio Pelvic Selective Or Supraselective Charge,7542.53,3017.01,,,0 CDM,3237573604,Hc Angio Pelvis - Ir Angiogram Pelvis Selective Or Supraselective Chg,7542.53,3017.01,,,0 CDM,3237574101,Hc Angio Pulmonary Selective - Ir Angiogram Pulmonary Selective,5842.37,2336.95,,,0 CDM,3237574301,Hc Angio/Ir Angiogram Pulmonary Selective Bilateral,7789.82,3115.93,,,0 CDM,3237574601,Hc Angio Pulmonary Venous Injection,3512.38,1404.95,,,0 CDM,3237575601,Hc Angio Internal Mammary - Ir Angiogram Internal Mammary,4274.87,1709.95,,,0 CDM,3237577401,Hc Angio Each Additional Selective Vessel - Ir Angio Selective Each Additional Vessel,4058.49,1623.4,,,0 CDM,3237577402,Hc Angio Ea Addnl Selectv Vessel - Ir Angio Selective Ea Addl Vessel Ch,4058.49,1623.4,,,0 CDM,3237582001,Hc Venogram Extrem Unilat - Ir Venogram Lower Extremity Left,2642.98,1057.19,,,0 CDM,3237582005,Hc Venogram Extrem Unilat - Ir Venogram Upper Extremity Left,2642.98,1057.19,,,0 CDM,3237582008,Hc Venogram Extrem Unilat - Ir Venogram Extremity Right Charge,2642.98,1057.19,,,0 CDM,3237582202,Hc Venogram Extrem Bilat - Ir Venogram Lower Extremity Bilateral Chg,3198.1,1279.24,,,0 CDM,3237583102,Hc Venogram Renal Unilat - Ir Venogram Renal Right,5781.83,2312.73,,,0 CDM,3237584201,Hc Venogram Adrenal Bilateral - Ir Venogram Adrenal Bilateral Selective,7628.82,3051.53,,,0 CDM,3237586001,"Hc Venogram Sinus/Jugular - Ir Venogram Venous Sinus, Jugular Left",4443.6,1777.44,,,0 CDM,3237586003,Hc Venogram Sinus/Jugular - Ir Venogram Sinus/Jugular Right,4443.6,1777.44,,,0 CDM,3237588501,Hc Vein X-Ray Liver W/Hemodynam - Ir Perc Transhep Porto W Hemo Evl Chg,5104.85,2041.94,,,0 CDM,3237588901,Hc Vein X-Ray Liver W/Hemodynam - Ir Veno Hepatic W Hemodynamic Eval,6625.47,2650.19,,,0 CDM,3237588902,Hc Vein X-Ray Liver W/Hemodynam - Ir Veno Hepatic W Hemodynamic Eval Ch,6625.47,2650.19,,,0 CDM,3237589101,Hc Vein X-Ray Liver - Ir Venogram Hepatic Wo Hemodynamic Evaluation,5826.91,2330.76,,,0 CDM,3237589301,Hc Venous Sampling By Catheter - Ir Venous Sampling Catheterization,5942.83,2377.13,,,0 CDM,3237589302,Hc Venous Sampling By Catheter - Ir Venous Sampling Catheterization Chg,5942.83,2377.13,,,0 CDM,3237589801,Hc Follow-Up Angiography - Ir Angio Thru Catheter Fu 4 Embolization,2251.42,900.57,,,0 CDM,3237598403,Hc Xray Control Catheter Change - Ir Gj Tube Change Charge,1342.88,537.15,,,0 CDM,3237598405,Hc Xray Control Catheter Change - Ir Nephrostomy Tube Change Charge,1342.88,537.15,,,0 CDM,3247104501,Hc Radiologic Exam Chest Single View - Xr Chest Lateral Decubitus,517.44,206.98,,,0 CDM,3247104502,Hc Radiologic Exam Chest Single View - Xr Chest 1 View,659.68,263.87,,,0 CDM,3247104601,Hc Radiologic Exam Chest 2 Views - Xr Chest 2 Views,531.0,212.4,,,0 CDM,3247104801,Hc Radiologic Exam Chest 4+ Views - Xr Chest 4+ Views,525.0,210.0,,,0 CDM,3319640101,Hc Chemotherapy Non-Hormone Anti-Neoplasma Subcutaneous/Intramuscular,427.79,171.12,,,0 CDM,3319640201,Hc Chemotherapy Hormone Antineoplasma Subcutaneous/Intramuscular,427.79,171.12,,,0 CDM,3319640501,"Hc Intralesional Chemo Admin,8+ Lesn",556.47,222.59,,,0 CDM,3319640502,"Hc Intralesional Chemo Admin, Up To 8 Lesions",251.57,100.63,,,0 CDM,3319640901,Hc Chemotherapy Iv Push Single Drug,591.26,236.5,,,0 CDM,3319641101,Hc Chemotherapy Iv Push Each Additional Drug,568.08,227.23,,,0 CDM,3319642001,"Hc Chemother,Ia Push Technique",960.0,384.0,,,0 CDM,3319645001,Hc Chemotherapy Spinal Tap With Lumbar Puncture,1581.33,632.53,,,0 CDM,3319654201,Hc Chemotherapy Injection Subarachnois/Intraventricular,687.48,274.99,,,0 CDM,3331929801,Hc Placement Of Brachytherapy Catheter For Breast Microseed,7146.26,2858.5,,,0 CDM,3335587501,"Hc Percut/Needle Insert,Prostate,Radioisot",13196.53,5278.61,,,0 CDM,3335715501,Hc Insert Tandem/Ovoid Device,3636.0,1454.4,,,0 CDM,3335715601,Hc Insert Vaginal Radiation Device,2289.0,915.6,,,0 CDM,3337696501,Hc Sono Guide Radioelemt Applic - Us Guide Interstitial Radioelmnt Appl,1649.23,659.69,,,0 CDM,3337728001,Hc Stimulated Treat Set-Up-Simple,1402.0,560.8,,,0 CDM,3337729001,Hc Grid Simulation Complex,2808.0,1123.2,,,0 CDM,3337729301,Hc Respiratory Motion Management,2528.04,1011.22,,,0 CDM,3337729501,Hc 3D Reconstruction Of Tumor,10280.0,4112.0,,,0 CDM,3337729502,Hc Gk 3-D Reconstruction Of Tumor,10280.0,4112.0,,,0 CDM,3337730001,Hc Radiation Therapy Dose Plan - Nm Therapy Sir Spheres,927.0,370.8,,,0 CDM,3337730101,Hc Imrt Plan,8503.0,3401.2,,,0 CDM,3337730601,Hc Teletx Isodose Smpl W/Calc,2721.0,1088.4,,,0 CDM,3337730701,Hc Teletx Isodose Cmplx W/Calc,4611.0,1844.4,,,0 CDM,3337731601,Hc Brachytherapy Isodose Simple W Calculations,1866.0,746.4,,,0 CDM,3337731701,Hc Brachytherapy Isodose Intermediate W Calculations,2330.0,932.0,,,0 CDM,3337731801,Hc Brachytherapy Isodose Complex W Calculations,2914.0,1165.6,,,0 CDM,3337732101,Hc Special Therapy Port Plan,1851.0,740.4,,,0 CDM,3337733101,Hc Special Dosimetry,851.0,340.4,,,0 CDM,3337733201,Hc Treatment Device Simple,901.0,360.4,,,0 CDM,3337733301,Hc Custom Fab Single Piece Unit,1173.0,469.2,,,0 CDM,3337733401,Hc Complx Treatment Devc,1949.0,779.6,,,0 CDM,3337733402,Hc Gk Complx Treatment Devc,1949.0,779.6,,,0 CDM,3337733601,Hc Continuing Physics Consult,1037.0,414.8,,,0 CDM,3337733801,Hc Mlc Device For Imrt,3657.0,1462.8,,,0 CDM,3337737001,Hc Special Med Physics Consult,1282.0,512.8,,,0 CDM,3337737101,Hc Msradiosurg Std Delivery,79422.0,31768.8,,,0 CDM,3337737201,"Hc Single Fx Srs, Cranial Lesion, Linear Accelerator Based",22400.0,8960.0,,,0 CDM,3337737301,Hc Stereotactic Body Tx Del,9659.0,3863.6,,,0 CDM,3337738501,Hc Imrt Breast/Prostat Simple,4028.0,1611.2,,,0 CDM,3337738502,Hc Halcyon Breast/Prostat Simple,4028.0,1611.2,,,0 CDM,3337738601,Hc Imrt All Other Sites,4198.0,1679.2,,,0 CDM,3337738602,Hc Halcyon All Other Sites,4198.0,1679.2,,,0 CDM,3337738701,Hc Guidance For Radiaj Tx Dlvr - Us Guidance Radiation Therapy Fields,818.0,327.2,,,0 CDM,3337740201,Hc Rad Tx Del >= 1 Mev Smpl,1500.0,600.0,,,0 CDM,3337740701,Hc Rad Tx Del >= 1 Mev Interm,1758.0,703.2,,,0 CDM,3337741201,Hc Rad Tx Del > 1 Mev Cmplx,2235.0,894.0,,,0 CDM,3337741202,Hc Grid Tx Del > 1 Mev Cmplx,2235.0,894.0,,,0 CDM,3337741701,Hc Radiographic Beam One Plane,551.0,220.4,,,0 CDM,3337747001,Hc Spec Tx Proc Imrt,4423.0,1769.2,,,0 CDM,3337747002,Hc Spec Tx Proc Tbi,4423.0,1769.2,,,0 CDM,3337776301,Hc Intracav Rad App-Complex,3064.0,1225.6,,,0 CDM,3337777001,Hc Hdr Brachytx 1 Channel W/Cadd,4523.0,1809.2,,,0 CDM,3337777101,Hc Hdr Brachytx 2-12 Chnl W/Cadd,8190.0,3276.0,,,0 CDM,3337777801,Hc Interstitial Application Compl,5642.0,2256.8,,,0 CDM,3337779001,Hc Supervise Loading Of Rad Elem,774.0,309.6,,,0 CDM,3337779901,Hc Unlist Interst App->10 Sources,1911.0,764.4,,,0 CDM,3359641301,Hc Chemotherapy Iv Infusion 1St Hour,1208.03,483.21,,,0 CDM,3359641501,Hc Chemotherapy Iv Infusion Each Additional Hour,579.67,231.87,,,0 CDM,3359641601,Hc Chemotherapy Prolong Infuse W/Pump,1194.11,477.64,,,0 CDM,3359641701,Hc Chemotherapy Iv Infusion Each Subsequent,585.47,234.19,,,0 CDM,3359642201,Hc Chemotheraphy Administration Intra-Arterial Infusion <1 Hour,440.0,176.0,,,0 CDM,3359652201,Hc Refill/Maint Systemic Pump/Resvr,628.36,251.34,,,0 CDM,335G049801,Hc Home Infus W/Pump,380.26,152.1,,,0 CDM,3407810301,"Hc Bone Marrow Imaging, Mult - Nm Bone Marrow Multiple Areas",1085.18,434.07,,,0 CDM,3407861001,Hc Brain Flow Imaging Only - Nm Brain Flow Only Brain Death,1487.36,594.94,,,0 CDM,3407865001,Hc Csf Leakage Imaging - Nm Brain Cerebrospinal Fluid Leak,2443.84,977.54,,,0 CDM,3417801201,Hc Thyroid Uptake Measurement - Nm Thyroid Uptake,1943.2,777.28,,,0 CDM,3417801301,Hc Thyroid Imaging W/Blood Flow - Nm Thyroid Scan,2318.4,927.36,,,0 CDM,3417801401,Hc Thyroid Imaging W/Blood Flow - Nm Thyroid Uptake Stimulation Suppres,3199.84,1279.94,,,0 CDM,3417801801,Hc Thyroid Met Imaging Body - Nm Thyroid Whole Body Tumor,3039.68,1215.87,,,0 CDM,3417807001,Hc Parathyroid Planar Imaging - Nm Parathyroid,2740.64,1096.26,,,0 CDM,3417807101,Hc Parathyroid Planar Imaging W/Wo Subtraction - Nm Parathyroid Spect,4564.0,1825.6,,,0 CDM,3417807201,Hc Parathyrd Planar W/Spect&Ct - Nm/Ct Parathyroid Spect,3479.84,1391.94,,,0 CDM,3417807501,Hc Nm Adrenal Nuclear Imaging,3928.96,1571.58,,,0 CDM,3417810201,Hc Nm Bone Marrow Limited,1683.36,673.34,,,0 CDM,3417810402,Hc Nm Bone Marrow Whole Body,2154.88,861.95,,,0 CDM,3417819502,Hc Lymphatics & Lymph Glands Imaging - Nm Lymphoscintigram,2595.04,1038.02,,,0 CDM,3417820101,Hc Liver Imaging - Nm Liver,2126.88,850.75,,,0 CDM,3417820201,Hc Liver Imaging With Flow - Nm Liver With Vascular Flow,1675.0,670.0,,,0 CDM,3417821501,Hc Liver And Spleen Imaging - Nm Liver Spleen,2136.96,854.78,,,0 CDM,3417821601,"Hc Liver & Spleen Image, Flow - Nm Liver Spleen With Vascular Flow",2367.68,947.07,,,0 CDM,3417822601,Hc Hepatobiliary Syst Imaging Including Gallbladder - Nm Liver Function,2783.2,1113.28,,,0 CDM,3417822702,Hc Hepatobil Syst Image W/Drug - Nm Hepatobiliary,2905.28,1162.11,,,0 CDM,3417826401,Hc Gastric Emptying Imaging Study - Nm Gastric Emptying Solid,2787.68,1115.07,,,0 CDM,3417826701,Hc Nm Urea Breath Test Acquirition For Analysis,1879.36,751.74,,,0 CDM,3417827801,Hc Nm Acute Gastrointestinal Blood Loss Imaging,2319.52,927.81,,,0 CDM,3417829001,Hc Nm Bowel Imaging Meckels Diverticulum,1805.44,722.18,,,0 CDM,3417829101,Hc Leveen/Shunt Patency - Nm Abdomen Peritoneal Venous Shunt Patency,1576.96,630.78,,,0 CDM,3417830001,"Hc Bone Imaging, Limited Area - Nm Bone Limited",1984.64,793.86,,,0 CDM,3417830501,Hc Nm Bone Imaging Multiple Areas,2027.2,810.88,,,0 CDM,3417830601,Hc Nm Bone Imaging Whole Body,3065.44,1226.18,,,0 CDM,3417831501,Hc Nm Bone Imaging Whole Body 3 Phase,3062.08,1224.83,,,0 CDM,3417843001,Hc Pet/Ct Myocard Perf Single Study,5330.0,2132.0,,,0 CDM,3417843101,Hc Pet/Ct Myocard Perf Rest And Stress Study,7403.5,2961.4,,,0 CDM,3417843301,Hc Pet/Ct Myocard Perf & Metabol Eval Dual Tracer,7282.0,2912.8,,,0 CDM,3417843401,"Hc Pet/Ct Add On Aqmbf, Absolute Quantitation Of Myocard Blood Flow",1028.47,411.39,,,0 CDM,3417845101,Hc Ht Muscle Image Spect Sing,5800.48,2320.19,,,0 CDM,3417845201,Hc Ht Muscle Image Spect Mult,7324.8,2929.92,,,0 CDM,3417847201,Hc Gated Heart Planar Single,2920.96,1168.38,,,0 CDM,3417847202,Hc Gated Heart Planar Single - Nm Heart Blood Pool Muga With Rvef,2920.96,1168.38,,,0 CDM,3417858001,Hc Lung Perfusion Imaging - Nm Lung Perfusion Particulate,1794.24,717.7,,,0 CDM,3417858201,Hc Lung Ventilation & Perfusion Imaging - Nm Lung Ventilation Perfusion,2803.36,1121.34,,,0 CDM,3417859701,Hc Lung Perfusion Differential - Nm Quant Differential Pulmonary Perfusion,2349.76,939.9,,,0 CDM,3417859801,Hc Lung Perfusion & Ventilation Differential - Nm Quant Differential Pulmonary Perfuse Ventilation,2864.96,1145.98,,,0 CDM,3417860001,Hc Brain Image < 4 Views - Nm Brain Limited,1324.96,529.98,,,0 CDM,3417860101,Hc Nm Brain Image With Flow Less Than 4 Views,2204.16,881.66,,,0 CDM,3417860601,Hc Nm Brain Image With Flow 4 Or More Views,2998.24,1199.3,,,0 CDM,3417866001,Hc Nuclear Exam Of Tear Flow - Nm Dacryocystogram,1146.88,458.75,,,0 CDM,3417870001,Hc Kidney Imaging Morphol - Nm Kidney Cortex,2007.04,802.82,,,0 CDM,3417870701,Hc Kidney Flow/Function Image Multiple - Nm Kidney Flow/Function W/Wo Pharmacol Initial,2683.52,1073.41,,,0 CDM,3417870801,Hc Kidney Flow/Function Image Multiple - Nm Kidney Flow/Function W/Wo Pharmacol Initial,2803.36,1121.34,,,0 CDM,3417870901,Hc Kidney Flow/Function Image Multiple - Nm Kidney Flow/Function W/Wo Pharmacol Initial,3128.16,1251.26,,,0 CDM,3417874001,Hc Ureteral Reflux Study - Nm Cystogram Reflux,1678.88,671.55,,,0 CDM,3417880001,"Hc Tumor Imaging, Limited Area - Nm Tumor Localization Limited",2082.08,832.83,,,0 CDM,3417880101,"Hc Tumor Imaging, Mult Areas - Nm Tumor Octreoscan",2620.0,1048.0,,,0 CDM,3417880201,Hc Tumor Imaging Whole Body - Nm Tumor Local Whole Body W Gallium,3897.6,1559.04,,,0 CDM,3417880304,Hc Radiopharmaceutical Localization Of Tumor Spect 1 Area/Acquisition 1 Day Imaging -Tumor,3381.28,1352.51,,,0 CDM,3417880401,Hc Tumor Imaging Whole Body - Nm Tumor Local Whole Body Multiple Days,4438.56,1775.42,,,0 CDM,3417880501,Hc Abscess Imaging Limited Area - Nm Inflammation Limited With Indium 111,2486.4,994.56,,,0 CDM,3417880601,Hc Abscess Imaging Whole Body - Nm Inflammation Whole Body With Inium,3228.96,1291.58,,,0 CDM,3417880801,Hc Nm Inj Proc Parathyroid,901.6,360.64,,,0 CDM,3417883001,Hc Nm Loc 1 Area/Day Spect/Ct,6229.44,2491.78,,,0 CDM,3417883101,Hc Nm Spect Multi Areas/Days,1736.29,694.52,,,0 CDM,3417883201,Hc Nm Spect Ct Multi Areas/Days,5536.16,2214.46,,,0 CDM,3417899901,Hc Nm Unlst Spect/Ct Fusion,2848.16,1139.26,,,0 CDM,3427779001,Hc Supervision Rad Source Hndlng,774.0,309.6,,,0 CDM,3427801501,Hc Thyroid Met Imaging - Nm Thyroid Tumor Metastases Limited,1680.0,672.0,,,0 CDM,3427900501,"Hc Nuclear Therapy, Oral - Nm Thyroid Therapy I 131",2238.88,895.55,,,0 CDM,3427910101,Hc Nuclear Rx Iv Admin - Nm Bone Treatment Therapy,1916.32,766.53,,,0 CDM,3430000001_00002120001,NDC Description Not Available,10789.01,4315.6,,,0 CDM,3430000001_11994000602,"Neurolite: 2 Kit In 1 Package, Combination (11994-006-02) / 1 Kit In 1 Kit * 1 Injection In 1 Vial (11994-002-01) * 1 Ml In 1 Vial (11994-004-01)",7283.44,2913.38,,,0 CDM,3430000001_11994009103,Technelite: 1 Vial In 1 Carton (11994-091-03) / 16 Ml In 1 Vial,2.0,0.8,,,0 CDM,3430000001_17156002205,Ceretec: 5 Vial In 1 Tray (17156-022-05) / 5 Ml In 1 Vial,9290.74,3716.3,,,0 CDM,3430000001_17156002305,Ceretec: 1 KIT in 1 CARTON (17156-023-05) * 5 VIAL in 1 TRAY / 1 mL in 1 VIAL * 5 VIAL in 1 TRAY / 4.5 mL in 1 VIAL * 5 VIAL in 1 TRAY (17156-022-05) / 5 mL in 1 VIAL,11362.58,4545.03,,,0 CDM,3430000001_17156002505,"Ceretec: 1 Kit In 1 Carton (17156-025-05) * 5 Ml In 1 Vial, Glass (17156-022-05) * 2.5 Ml In 1 Vial, Glass (17156-027-01)",7797.28,3118.91,,,0 CDM,3430000001_17156021001,"Datscan: 1 Vial, Glass In 1 Container (17156-210-01) / 2.5 Ml In 1 Vial, Glass",7722.98,3089.19,,,0 CDM,3430000001_17156023501,"Adreview: 1 Vial, Glass In 1 Container (17156-235-01) / 5 Ml In 1 Vial, Glass",18532.38,7412.95,,,0 CDM,3430000001_343,Noncdm Charge Record Radiopharmaceuticals,0.01,0.004,,,0 CDM,3430000001_45567003001,Kit For The Prepartion Of Technetium Tc99M Sulfur Colloid: 1 Kit In 1 Package (45567-0030-1) * 3 Ml In 1 Vial * 3 Ml In 1 Vial * 10 Ml In 1 Vial,347.35,138.94,,,0 CDM,3430000001_45567004001,"Kit For The Preparation Of Technetium Tc 99M Medronate: 5 Vial, Multi-Dose In 1 Kit (45567-0040-1) / 10 Ml In 1 Vial, Multi-Dose",199.92,79.97,,,0 CDM,3430000001_45567006001,"Kit For The Preparation Of Technetium Tc99M Pyrophosphate: 5 Vial, Multi-Dose In 1 Kit (45567-0060-1) / 10 Ml In 1 Vial, Multi-Dose",292.97,117.19,,,0 CDM,3430000001_45567045502,"Kit For The Preparation Of Technetium Tc 99M Mebrofenin: 30 Vial, Multi-Dose In 1 Kit (45567-0455-2) / 10 Ml In 1 Vial, Multi-Dose",198.89,79.56,,,0 CDM,3430000001_48815100101,"Sodium Iodide I 123: 1 Vial, Plastic In 1 Can (48815-1001-1) / 1 Capsule, Gelatin Coated In 1 Vial, Plastic",248.87,99.55,,,0 CDM,3430000001_49609010101,"Fludeoxyglucose F 18: 30 Ml In 1 Vial, Multi-Dose (49609-101-01)",511.39,204.56,,,0 CDM,3430000001_65174002110,"Ruby-Fill: 1 Injection, Solution In 1 Container (65174-021-10)",2943.75,1177.5,,,0 CDM,3430000001_65174027030,"Draximage Maa: 30 Injection, Powder, For Solution In 1 Kit (65174-270-30)",1066.65,426.66,,,0 CDM,3430000001_65174028830,"Draximage Dtpa: 30 Injection, Powder, Lyophilized, For Solution In 1 Kit (65174-288-30)",689.29,275.72,,,0 CDM,3430000001_65174046105,Sodium Iodide I 131 Diagnostic: 5 Capsule In 1 Vial (65174-461-05),3.89,1.56,,,0 CDM,3430000001_65174088000,Hicon: 1 Vial In 1 Kit (65174-880-00) / 1 Ml In 1 Vial,58.28,23.31,,,0 CDM,3430000001_65857010010,NDC Description Not Available,539.97,215.99,,,0 CDM,3430000001_65857015030,"Fludeoxyglucose F-18: 30 Ml In 1 Vial, Glass (65857-150-30)",546.67,218.67,,,0 CDM,3430000001_65857040001,NDC Description Not Available,1277.73,511.09,,,0 CDM,3430000001_65857042505,"Kit For The Preparation Of Lymphoseek (Technetium Tc 99M Tilmanocept): 1 Kit In 1 Carton (65857-425-05) / 1 Kit In 1 Kit * 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (65857-400-01)",1205.12,482.05,,,0 CDM,3430000001_65857050005,5 VIAL in 1 CARTON (65857-500-05) / 5 mL in 1 VIAL,157.58,63.03,,,0 CDM,3430000001_65857050020,Kit For The Preparation Of Technetium Tc99M Sestamibi: 20 Vial In 1 Carton (65857-500-20) / 5 Ml In 1 Vial,153.65,61.46,,,0 CDM,3430000001_65857050510,"Kit For The Preparation Of Technetium Tc 99M Medronate: 10 Injection, Powder, Lyophilized, For Solution In 1 Carton (65857-505-10)",219.41,87.76,,,0 CDM,3430000001_69208000115,"I3odine MAXTM: 1 VIAL, DISPENSING in 1 CANISTER (69208-001-15) / 1 mL in 1 VIAL, DISPENSING",60.23,24.09,,,0 CDM,3430000001_69208000315,NDC Description Not Available,64.65,25.86,,,0 CDM,3430000001_69488000140,"Netspot: 1 Kit In 1 Kit (69488-001-40) * 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",211.75,84.7,,,0 CDM,3430000001_69488001761,"Locametz: 1 Vial, Multi-Dose In 1 Carton (69488-017-61) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Multi-Dose",3806.73,1522.69,,,0 CDM,3430000001_69945006401,"Detectnet: 1 Vial, Single-Use In 1 Can (69945-064-01) / 4 Ml In 1 Vial, Single-Use",3719.03,1487.61,,,0 CDM,3430000001_69945006820,"Ultratag Rbc: 5 Cello Pack In 1 Box (69945-068-20) / 1 Kit In 1 Cello Pack (69945-068-10) * .6 Ml In 1 Syringe, Glass * 1 Ml In 1 Syringe, Glass * 9.5 Mg In 1 Vial, Glass",620.85,248.34,,,0 CDM,3430000001_69945009120,"Technescan Hdp: 5 Vial In 1 Cello Pack (69945-091-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (69945-091-01)",207.15,82.86,,,0 CDM,3430000001_69945009620,"Technescan Mag3: 5 Vial In 1 Cello Pack (69945-096-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",1304.46,521.78,,,0 CDM,3430000001_69945013940,"Pulmotech Maa: 30 Vial, Multi-Dose In 1 Carton (69945-139-40) / 15 Ml In 1 Vial, Multi-Dose (69945-139-10)",1154.12,461.65,,,0 CDM,3430000001_69945014013,"Ultra-Technekow V4: 1 Injection, Solution In 1 Carton (69945-140-13)",2.15,0.86,,,0 CDM,3430000001_69945018012,Gallium Citrate Ga-67: 1 Vial In 1 Can (69945-180-12) / 6.6 Ml In 1 Vial,297.58,119.03,,,0 CDM,3430000001_69945045001,Sodium Iodide I-131: 1 VIAL in 1 CAN (69945-450-01) / 1 mL in 1 VIAL,56.29,22.52,,,0 CDM,3430000001_69945045201,SODIUM IODIDE I 131: 1 CAPSULE in 1 CAN (69945-452-01) / 1 mL in 1 CAPSULE,68.39,27.36,,,0 CDM,3430000001_69945045205,SODIUM IODIDE I 131: 1 CAPSULE in 1 CAN (69945-452-05) / 5 mL in 1 CAPSULE,58.28,23.31,,,0 CDM,3430000001_71083002005,"Nephroscan: 5 Vial, Single-Dose In 1 Carton (71083-0020-5) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose (71083-0020-1)",5755.47,2302.19,,,0 CDM,3430000001_71258002200,NDC Description Not Available,2149.2,859.68,,,0 CDM,3430000001_72536092001,"Indium In 111 Oxyquinoline: 1 Ml In 1 Vial, Single-Dose (72536-0920-1)",4369.34,1747.74,,,0 CDM,3430000001_72874000101,"Cerianna: 50 Ml In 1 Vial, Multi-Dose (72874-001-01)",2880.25,1152.1,,,0 CDM,3430000001_74725010064,"Illuccix: 1 Kit In 1 Carton (74725-100-64) * 2.5 Ml In 1 Vial, Multi-Dose (74725-102-25) * 6.4 Ml In 1 Vial, Multi-Dose (74725-103-64) * 1 Injection, Powder, Lyophilized, For Solution In 1 Vial,",2647.28,1058.91,,,0 CDM,343A958801,Hc F-18 Fluciclovine/Mci,1800.0,720.0,,,0 CDM,343Q996901,Hc Tc-99M Radiopharmaceutical Add On,0.01,0.004,,,0 CDM,343Q996901_00065905095,NDC Description Not Available,0.01,0.004,,,0 CDM,343Q996901_00338850310,"Artiss Fibrin Sealant: 1 Syringe, Plastic In 1 Carton (0338-8503-10) / 10 Ml In 1 Syringe, Plastic (0338-8503-09)",0.01,0.004,,,0 CDM,343Q996901_17156002305,Ceretec: 1 KIT in 1 CARTON (17156-023-05) * 5 VIAL in 1 TRAY / 1 mL in 1 VIAL * 5 VIAL in 1 TRAY / 4.5 mL in 1 VIAL * 5 VIAL in 1 TRAY (17156-022-05) / 5 mL in 1 VIAL,0.01,0.004,,,0 CDM,343Q996901_45567003001,Kit For The Prepartion Of Technetium Tc99M Sulfur Colloid: 1 Kit In 1 Package (45567-0030-1) * 3 Ml In 1 Vial * 3 Ml In 1 Vial * 10 Ml In 1 Vial,0.01,0.004,,,0 CDM,343Q996901_45567045502,"Kit For The Preparation Of Technetium Tc 99M Mebrofenin: 30 Vial, Multi-Dose In 1 Kit (45567-0455-2) / 10 Ml In 1 Vial, Multi-Dose",0.01,0.004,,,0 CDM,343Q996901_65174027030,"Draximage Maa: 30 Injection, Powder, For Solution In 1 Kit (65174-270-30)",0.01,0.004,,,0 CDM,343Q996901_65174028830,"Draximage Dtpa: 30 Injection, Powder, Lyophilized, For Solution In 1 Kit (65174-288-30)",0.01,0.004,,,0 CDM,343Q996901_65857040001,NDC Description Not Available,0.01,0.004,,,0 CDM,343Q996901_65857042505,"Kit For The Preparation Of Lymphoseek (Technetium Tc 99M Tilmanocept): 1 Kit In 1 Carton (65857-425-05) / 1 Kit In 1 Kit * 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (65857-400-01)",0.01,0.004,,,0 CDM,343Q996901_65857050005,5 VIAL in 1 CARTON (65857-500-05) / 5 mL in 1 VIAL,0.01,0.004,,,0 CDM,343Q996901_65857050020,Kit For The Preparation Of Technetium Tc99M Sestamibi: 20 Vial In 1 Carton (65857-500-20) / 5 Ml In 1 Vial,0.01,0.004,,,0 CDM,343Q996901_65857050510,"Kit For The Preparation Of Technetium Tc 99M Medronate: 10 Injection, Powder, Lyophilized, For Solution In 1 Carton (65857-505-10)",0.01,0.004,,,0 CDM,343Q996901_69945009620,"Technescan Mag3: 5 Vial In 1 Cello Pack (69945-096-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",0.01,0.004,,,0 CDM,343Q996901_69945013940,"Pulmotech Maa: 30 Vial, Multi-Dose In 1 Carton (69945-139-40) / 15 Ml In 1 Vial, Multi-Dose (69945-139-10)",0.01,0.004,,,0 CDM,343Q996901_69945014013,"Ultra-Technekow V4: 1 Injection, Solution In 1 Carton (69945-140-13)",0.01,0.004,,,0 CDM,343Q996901_71083002005,"Nephroscan: 5 Vial, Single-Dose In 1 Carton (71083-0020-5) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose (71083-0020-1)",0.01,0.004,,,0 CDM,343Q996901_Q9969_343,Hc Tc-99M Radiopharmaceutical Add On,0.01,0.004,,,0 CDM,3440000001_09999700032,NDC Description Not Available,67481.25,26992.5,,,0 CDM,3440000001_09999700074,NDC Description Not Available,66562.5,26625.0,,,0 CDM,3440000001_50419020801,"Xofigo: 6 Ml In 1 Vial, Single-Dose (50419-208-01)",522.66,209.06,,,0 CDM,3440000001_69208000115,"I3odine MAXTM: 1 VIAL, DISPENSING in 1 CANISTER (69208-001-15) / 1 mL in 1 VIAL, DISPENSING",59.89,23.96,,,0 CDM,3440000001_69208000315,NDC Description Not Available,64.65,25.86,,,0 CDM,3440000001_69488000301,Lutathera: 1 Vial In 1 Package (69488-003-01) / 20.5 Ml In 1 Vial,963.19,385.28,,,0 CDM,3440000001_69488001061,"Pluvicto: 1 Vial, Glass In 1 Package (69488-010-61) / 7.5 Ml In 1 Vial, Glass",754.29,301.72,,,0 CDM,3440000001_69945045104,Sodium Iodide I-131: 1 VIAL in 1 CAN (69945-451-04) / 4 mL in 1 VIAL,58.28,23.31,,,0 CDM,3440000001_C2616_278,NDC Description Not Available,70533.75,28213.5,,,0 CDM,344A951301,Hc Lutetium Lu177 Dota Per 1 Mci,970.5,388.2,,,0 CDM,3507557102,Hc Ct Heart W/O Dye W/Ca Test - Ct Heart Calcium Scoring Wo Contrast-Non Research,107.98,43.19,,,0 CDM,3507557103,Hc Res Calcium Score,4799.2,1919.68,,,0 CDM,3507557201,Hc Ct Heart W/3D Image - Ct Heart Structure Morphology With Contrast,2038.29,815.32,,,0 CDM,3507557301,Hc Ct Heart W/3D Image Congen - Ct Heart Struct Morph Congen Heart Dis W/ Contrast,1511.75,604.7,,,0 CDM,3507557401,Hc Ct Angio Heart W/3D Image - Ct Heart Coronary Angiogram,1890.2,756.08,,,0 CDM,3507598401,Hc Xray Control Catheter Change - Ir Ureteral Stent Change,1342.88,537.15,,,0 CDM,3507637601,Hc 3D Rendering W/Interpretation & Postprocess Supervision - Ct 3D Reconstruction,1165.64,466.26,,,0 CDM,3507637701,Hc Ct 3D Rendering W/Interpretation And Postprocedure Diff Work Station,1201.7,480.68,,,0 CDM,3507637702,Hc 3D Render W/Intrp Postproces - 3D Rendering On An Indep Workstation,1201.7,480.68,,,0 CDM,3507637703,Hc 3D Rendering W/Interpretation And Postprocedure Diff Work Station - Echo 3D Reconstruction,1201.7,480.68,,,0 CDM,3507638001,"Hc Ct Scan,Limited/Localized F/U Study - Ct Limited Follow Up",939.96,375.98,,,0 CDM,3507701243,Hc Ct Guidance Needle Placement,2000.24,800.1,,,0 CDM,3507701301,Hc Ct Guidance Tissue Ablation,1899.45,759.78,,,0 CDM,3507701401,Hc Conebeam Ct Gde Therapy Plcm,1775.02,710.01,,,0 CDM,3510042T01,Hc Ct Cerebral Perfusion Analysis,2117.48,846.99,,,0 CDM,3517045001,"Hc Ct Scan,Head/Brain,W/O Contrast Matl - Ct Head Wo Contrast",2265.12,906.05,,,0 CDM,3517046001,Hc Ct Scan Head Contrast - Ct Head W Contrast,2552.27,1020.91,,,0 CDM,3517047001,Hc Ct Scan Head Combo - Ct Head W Wo Contrast,3081.28,1232.51,,,0 CDM,3517048001,Hc Ct Orbits Wo Iv Contrast,1833.3,733.32,,,0 CDM,3517048002,"Hc Ct Scan, Orbit Limited",1833.3,733.32,,,0 CDM,3517048004,"Hc Ct Scan, Temporal Bone Wo Iv Contrast",1833.3,733.32,,,0 CDM,3517048101,Hc Ct Temporal Bones W Iv Contrast,2135.91,854.36,,,0 CDM,3517048102,Hc Ct Orbits W Iv Contrast,2135.91,854.36,,,0 CDM,3517048201,Hc Ct Orbits W And Wo Iv Contrast,2567.73,1027.09,,,0 CDM,3517048601,Hc Ct Sinus Wo Contrast,2438.52,975.41,,,0 CDM,3517048602,Hc Ct Face Wo Iv Contrast,2438.52,975.41,,,0 CDM,3517048701,Hc Ct Sinus W Contrast,2662.71,1065.08,,,0 CDM,3517048702,Hc Ct Face W Iv Contrast,2662.71,1065.08,,,0 CDM,3517048801,Hc Ct Sinus W And Wo Contrast,2871.44,1148.58,,,0 CDM,3517048802,Hc Ct Face W And Wo Iv Contrast,2871.44,1148.58,,,0 CDM,3517049001,"Hc Ct Scan,Soft Tissue Neck,W/O Contrast - Ct Soft Tissue Neck Wo Contrast",2687.01,1074.8,,,0 CDM,3517049101,Hc Ct Neck Tissue Contrast - Ct Soft Tissue Neck W Contrast,3361.79,1344.72,,,0 CDM,3517049201,Hc Ct Neck Tissue Combo - Ct Soft Tissue Neck W Wo Contrast,3528.56,1411.42,,,0 CDM,3517049601,Hc Ct Angio Head,3901.85,1560.74,,,0 CDM,3517049602,Hc Ct Venogram Head,3901.85,1560.74,,,0 CDM,3517049801,"Hc Ct Angio,Neck Combo - Ct Neck Angio W And Wo Iv Contrast",4038.79,1615.52,,,0 CDM,3520625T01,Hc Ct Angio Data On Plaque In Heart Arteries (Add On),1265.0,506.0,,,0 CDM,3527125001,"Hc Ct Scan,Thorax,W/O Contrast - Ct Chest Wo Contrast",2341.67,936.67,,,0 CDM,3527125003,"Hc Ct Scan, Chest Lung Screening Follow Up",2341.67,936.67,,,0 CDM,3527126002,Hc Ct Scan Of Chest Contrast - Ct Chest W Contrast,3320.7,1328.28,,,0 CDM,3527127001,Hc Ct Scan Of Chest Combo - Ct Chest W Wo Contrast,3592.2,1436.88,,,0 CDM,3527127101,Hc Ct Low Dose Lung Cancer Screen,133.69,53.48,,,0 CDM,3527127501,"Hc Ct Angio, Chest, Combo, Including Image - Ct Chest Angio W And Wo Iv Contrast",3720.75,1488.3,,,0 CDM,3527127502,"Hc Ct Angio, Pulmonary Embolism",3720.75,1488.3,,,0 CDM,3527127503,Hc Ct Venogram Chest,3720.75,1488.3,,,0 CDM,3527212501,"Hc Ct Scan,Cervical Spine,W/O Contrast - Ct Cervical Spine Wo Contrast",3244.73,1297.89,,,0 CDM,3527212601,Hc Ct Scan Cervical Spine Contrast - Ct Cervical Spine W Contrast,3394.93,1357.97,,,0 CDM,3527212602,Hc Ct Scan Spine Myelogram,3394.93,1357.97,,,0 CDM,3527212701,Hc Ct Scan Cervical Spine Combo - Ct Cervical Spine W Wo Contrast,3780.36,1512.14,,,0 CDM,3527212801,"Hc Ct Scan,Thoracic Spine,W/O Contrast - Ct Thoracic Spine Wo Contrast",3130.45,1252.18,,,0 CDM,3527212901,Hc Ct Scan Dorsal Spine Contrast - Ct Thoracic Spine W Contrast,3226.09,1290.44,,,0 CDM,3527212902,Hc Ct Scan Thoracic Spine Myelogram,3226.09,1290.44,,,0 CDM,3527213001,Hc Ct Scan Dorsal Spine Combo - Ct Thoracic Spine W Wo Contrast,3309.39,1323.76,,,0 CDM,3527213101,"Hc Ct Scan,Lumbar Spine,W/O Contrast - Ct Lumbar Spine Wo Contrast",2947.39,1178.96,,,0 CDM,3527213103,"Hc Ct Scan,Lumbar Spine,W/O Contrast - Ct Lumbar Spine Wo Contrast",2947.39,1178.96,,,0 CDM,3527213201,Hc Ct Scan Lumbar Spine Contrast - Ct Lumbar Spine W Contrast,3170.56,1268.22,,,0 CDM,3527213202,Hc Ct Scan Lumbar Spine Myelogram,3170.56,1268.22,,,0 CDM,3527213301,Hc Ct Scan Lumbar Spine Combo - Ct Lumbar Spine W Wo Contrast,3309.39,1323.76,,,0 CDM,3527219101,"Hc Ct Angio, Pelvis, Combo, Including Image - Ct Pelvis Angio W And Wo Iv Contrast",3309.39,1323.76,,,0 CDM,3527219201,"Hc Ct Scan,Pelvis,W/O Contrast - Ct Pelvis Wo Contrast",2224.43,889.77,,,0 CDM,3527219202,"Hc Ct Scan, Bony Pelvis",2224.43,889.77,,,0 CDM,3527219203,"Hc Ct Scan, Cystogram",2224.43,889.77,,,0 CDM,3527219301,Hc Ct Scan Of Pelvis Contrast - Ct Pelvis W Contrast,2614.19,1045.68,,,0 CDM,3527219401,Hc Ct Scan Of Pelvis Combo - Ct Pelvis W Wo Contrast,3002.93,1201.17,,,0 CDM,3527320010,Hc Ct Scan Upper Extremity W/O Dye - Ct Upper Extremity W/O Iv Contrast,2364.29,945.72,,,0 CDM,3527320112,Hc Ct Scan Upper Extremity W Iv Contrast,2633.73,1053.49,,,0 CDM,3527320202,Hc Ct Up Extremity Wo/W Contrast,237.0,94.8,,,0 CDM,3527320601,Hc Ct Angio Upper Extremity-Unilateral,2760.23,1104.09,,,0 CDM,3527320602,Hc Ct Venogram Upper Extremity-Unilateral,2760.23,1104.09,,,0 CDM,3527370001,Hc Ct Lower Extremity W/O Contrast,2458.9,983.56,,,0 CDM,3527370101,Hc Ct Lower Extremity W Contrast,2647.1,1058.84,,,0 CDM,3527370201,Hc - Ct Foot Left W And Wo Iv Contrast-Bilateral,4186.62,1674.65,,,0 CDM,3527370202,Hc - Ct Lower Extremity W And Wo Iv Contrast,2791.08,1116.43,,,0 CDM,3527370601,Hc Ct Angio Lower Extremity-Unilateral,3110.91,1244.36,,,0 CDM,3527370602,Hc Ct Venogram Lower Extremity-Unilateral,3110.91,1244.36,,,0 CDM,3527415001,Hc Ct Abdomen W/O Dye - Ct Abdomen Wo Contrast,2527.81,1011.12,,,0 CDM,3527416001,Hc Ct Abdomen W/Dye - Ct Abdomen W Contrast,3094.46,1237.78,,,0 CDM,3527417001,Hc Ct Abdomen W/O & W/Dye - Ct Abdomen W Wo Contrast,3703.27,1481.31,,,0 CDM,3527417002,Hc Ct Adrenal W/O & W/Dye - Ct Adrenal W Wo Contrast,3703.27,1481.31,,,0 CDM,3527417003,Hc Ct Renal Mass W/O & W Dye,3703.27,1481.31,,,0 CDM,3527417401,Hc Ct Angio Abdomen/Pelvis,5969.86,2387.94,,,0 CDM,3527417402,Hc Ct Venogram Abdomen/Pelvis,5969.86,2387.94,,,0 CDM,3527417501,Hc Ct Angio Abdom W/O & W/Dye - Ct Angiogram Abdomen W Contrast,3855.47,1542.19,,,0 CDM,3527417601,Hc Ct Abdomen Pelvis Wo Iv Contrast,4297.68,1719.07,,,0 CDM,3527417602,Hc Ct Renal Stone Wo Iv Contrast,4297.68,1719.07,,,0 CDM,3527417701,Hc Ct Abd & Pelv W/Contrast - Ct Abdomen Pelvis W Contrast,5269.52,2107.81,,,0 CDM,3527417702,Hc Ct Enterography,5269.52,2107.81,,,0 CDM,3527417801,Hc Ct Abd & Pelv 1/> Regns - Ct Abdomen Pelvis W Wo Contrast,6426.47,2570.59,,,0 CDM,3527417802,Hc Ct Urogram,6426.47,2570.59,,,0 CDM,3527426101,Hc Ct Colonography Dx - Ct Colonography Diagnostic Wo Contrast,1254.0,501.6,,,0 CDM,3527426202,Hc Ct Colonography Dx W/Dye - Ct Colonography With Contrast Diagnostic,1175.0,470.0,,,0 CDM,3527426301,Hc Ct Colonography Screening - Ct Colonography Screening,600.0,240.0,,,0 CDM,3527563501,Hc Ct Angio Abdominal Arteries - Ct Angio Aorta & Bilateral Iliofemoral Run,3330.99,1332.4,,,0 CDM,3527598901,Hc Abscess Drainage Under X-Ray - Ct Guidance For Abscess Drain,2058.56,823.42,,,0 CDM,3527707801,Hc Ct Bmd 1 0R > Site Axial Skeleton,683.89,273.56,,,0 CDM,3600000001,Hc Auto Transfusion,4233.59,1693.44,,,0 CDM,3600000002,Hc Cardio Pulmonary Bypass Initial,1256.79,502.72,,,0 CDM,3600000003,Hc Cerclage,5812.19,2324.88,,,0 CDM,3600000004,Hc Or Hybrid Level 2 1St Hour,9877.35,3950.94,,,0 CDM,3600000005,Hc Or General Level 2 1St Hour,9254.05,3701.62,,,0 CDM,3600000006,Hc Or Orthopaedics Level 1 1St Hour,10667.4,4266.96,,,0 CDM,3600000007,Hc Nerve Block,1169.02,467.61,,,0 CDM,3600000008,Hc Or Card-Pulm Bp First Hour,11364.74,4545.9,,,0 CDM,3600000009,Hc Stereotactic Brain Biopsy,1054.44,421.78,,,0 CDM,3600000010,Hc Or Hybrid Level 1 1St Hour,7831.5,3132.6,,,0 CDM,3600000012,Hc Or General Level 1 1St Hour,7052.95,2821.18,,,0 CDM,3600000014,Hc Or-Cas Gen Level 4 1St 30 Minutes,5871.9,2348.76,,,0 CDM,3600000016,Hc Or Gynocology Level 4 1St Hour,69610.65,27844.26,,,0 CDM,3600000017,Hc Hysterectomy After Delivery,6408.28,2563.31,,,0 CDM,3600000018,Hc Or-Cas General Level 3 1St 30 Minutes,5554.5,2221.8,,,0 CDM,3600000019,Hc Or Urology/Pediatrics/Ent Level 4 1St Hour,65183.15,26073.26,,,0 CDM,3600000020,Hc Or-Cas General Level 2 1St 30 Minutes,4750.65,1900.26,,,0 CDM,3600000021,Hc Or Gynocology Level 4 Additional 15 Minutes,585.35,234.14,,,0 CDM,3600000022,Hc Or Urology/Pediatrics/Ent Level 4 Additional 15 Minutes,585.35,234.14,,,0 CDM,3600000023,Hc Or Ct Level 4 Additional 15 Minutes,585.35,234.14,,,0 CDM,3600000024,Hc Or Card-Pulm Bp Additional 15 Minutes,544.89,217.96,,,0 CDM,3600000025,Hc Or Ct Level 4 1St Hour,53419.8,21367.92,,,0 CDM,3600000027,Hc Postpartum Bridge Tied Load,4207.99,1683.2,,,0 CDM,3600000028,Hc Or-Cas General Level 1 1St 30 Minutes,3446.55,1378.62,,,0 CDM,3600000029,Hc Other Or Procedure Each Hour,3141.36,1256.54,,,0 CDM,3600000030,Hc Or Ortho Level 5 Each Additional 15 Minutes,2595.55,1038.22,,,0 CDM,3600000031,Hc Or General Level 5 Each Additional 15 Minutes,2233.3,893.32,,,0 CDM,3600000032,Hc Or Hybrid Level 5 Each Additional 15 Minutes,2211.45,884.58,,,0 CDM,3600000033,Hc Or Orthopaedics Level 4 Each Additional 15 Minutes,2082.65,833.06,,,0 CDM,3600000035,Hc Or Orthopaedics Level 5 1St Hour,19223.4,7689.36,,,0 CDM,3600000036,Hc Or General Level 4 Each Additional 15 Minutes,1820.45,728.18,,,0 CDM,3600000037,Hc Or Orthopaedics Level 3 Each Additional 15 Minutes,1922.8,769.12,,,0 CDM,3600000038,Hc Or Hybrid Level 5 1St Hour,15504.3,6201.72,,,0 CDM,3600000039,Hc Or General Level 5 1St Hour,14840.75,5936.3,,,0 CDM,3600000040,Hc Or Gen Level 4 - Ion Robot,26386.75,10554.7,,,0 CDM,3600000041,Hc Or Gen Level 6 1St Hour,17867.55,7147.02,,,0 CDM,3600000042,Hc Or Gen Level 6 Each Additional 15 Minutes,2622.0,1048.8,,,0 CDM,3600000043,Hc Or Gen Level 7 1St Hour,20839.15,8335.66,,,0 CDM,3600000044,Hc Or Gen Level 7 Each Additional 15 Minutes,3072.8,1229.12,,,0 CDM,3600000045,Hc Or Hybrid Level 6 1St Hour,18642.65,7457.06,,,0 CDM,3600000046,Hc Or Hybrid Level 6 Each Additional 15 Minutes,2580.6,1032.24,,,0 CDM,3600000047,Hc Or Hybrid Level 7 1St Hour,21762.6,8705.04,,,0 CDM,3600000048,Hc Or Hybrid Level 7 Each Additional 15 Minutes,3027.95,1211.18,,,0 CDM,3600000049,Hc Or Ortho Level 6 1St Hour,21675.2,8670.08,,,0 CDM,3600000051,Hc Or Ortho Level 6 Each Additional 15 Minutes,2850.85,1140.34,,,0 CDM,3600000052,Hc Or Ortho Level 7 1St Hour,23928.05,9571.22,,,0 CDM,3600000053,Hc Or Ortho Level 7 Each Additional 15 Minutes,3147.55,1259.02,,,0 CDM,3600000054,Hc Or Cas Level 1 Each Additional 15 Minutes,1499.6,599.84,,,0 CDM,3600000055,Hc Or Cas Level 2 Each Additional 15 Minutes,1612.3,644.92,,,0 CDM,3600000056,Hc Or Cas Level 3 Each Additional 15 Minutes,1805.5,722.2,,,0 CDM,3600000057,Hc Or Cas Level 4 Each Additional 15 Minutes,2071.15,828.46,,,0 CDM,3600000058,Hc Or-Cas Gen Level 5 1St 30 Minutes,8304.15,3321.66,,,0 CDM,3600000059,Hc Or Cas Level 5 Each Additional 15 Minutes,2540.35,1016.14,,,0 CDM,3600000060,Hc Or-Cas Gen Level 6 1St 30 Minutes,10231.55,4092.62,,,0 CDM,3600000061,Hc Or Cas Level 6 Each Additional 15 Minutes,2983.1,1193.24,,,0 CDM,3600000062,Hc Or-Cas Gen Level 7 1St 30 Minutes,11968.05,4787.22,,,0 CDM,3600000063,Hc Or Cas Level 7 Each Additional 15 Minutes,3496.0,1398.4,,,0 CDM,3600000064,Hc Or Level 4 - Ion Robot Each Additional 15 Minutes,4014.65,1605.86,,,0 CDM,3600000080,Hc Or General Level 3 Each Additional 15 Minutes,1587.0,634.8,,,0 CDM,3600000081,Hc Or Hybrid Level 3 Each Additional 15 Minutes,1612.3,644.92,,,0 CDM,3600000082,Hc Or Orthopaedics Level 2 Each Additional 15 Minutes,1689.35,675.74,,,0 CDM,3600000083,Hc Or Hybrid Level 4 Each Additional 15 Minutes,1807.8,723.12,,,0 CDM,3600000085,Hc Or Hybrid Level 2 Each Additional 15 Minutes,1370.8,548.32,,,0 CDM,3600000087,Hc Or Orthopaedics Level 4 1St Hour,14384.2,5753.68,,,0 CDM,3600000090,Hc Or Orthopaedics Level 1 Each Additional 15 Minutes,1605.4,642.16,,,0 CDM,3600000091,Hc Or General Level 2 Each Additional 15 Minutes,1417.95,567.18,,,0 CDM,3600000092,Hc Or General Level 4 1St Hour,12191.15,4876.46,,,0 CDM,3600000093,Hc Or Hybrid Level 4 1St Hour,12165.85,4866.34,,,0 CDM,3600000094,Hc Or General Level 1 Each Additional 15 Minutes,1317.9,527.16,,,0 CDM,3600000095,Hc Or Hybrid Level 1 Each Additional 15 Minutes,1325.95,530.38,,,0 CDM,3600000096,Hc Or Orthopaedics Level 3 1St Hour,12592.5,5037.0,,,0 CDM,3600000097,Hc Or Hybrid Level 3 1St Hour,10881.3,4352.52,,,0 CDM,3600000098,Hc Or General Level 3 1St Hour,10193.6,4077.44,,,0 CDM,3600000099,Hc Or Orthopaedics Level 2 1St Hour,11434.45,4573.78,,,0 CDM,36000000AA,Hc Dilation And Curetrage,5023.5,2009.4,,,0 CDM,3601142401,"Hc Removal Of Growth 3.1-4.0Cm Of The Scalp, Neck, Hands, Feet, Or Genitals",3040.83,1216.33,,,0 CDM,3601315301,Hc Repair Complex Eyelid/Nose/Ear/Lip Each Additional 5 Cm/<,1270.75,508.3,,,0 CDM,3601316001,Hc Complicated Repair Of Surface Wound Or Dehiscence,8671.0,3468.4,,,0 CDM,3601932801,Hc Removal Intact Breast Implant,9234.22,3693.69,,,0 CDM,3602524801,Hc Remove Forearm/Wrist Foreign Body,5471.7,2188.68,,,0 CDM,3603152601,Hc Laryngoscopy Direct Diagnostic Outpatient Microscopy,3342.36,1336.94,,,0 CDM,3603399912,Hc Oxygenator Pump Replacement,1573.2,629.28,,,0 CDM,3603646001,Hc Transfusion Intrauterine Fetal,2127.5,851.0,,,0 CDM,3604083101,Hc Repair Of Mouth Laceration,1794.0,717.6,,,0 CDM,3605172601,Hc Bladder Pressure Measurement During Filling,1547.32,618.93,,,0 CDM,3605713501,Hc Excision Vaginal Cyst/Tumor,3687.28,1474.91,,,0 CDM,3605741001,Hc Pelvic Examination Under Anesthesia,6532.5,2613.0,,,0 CDM,3605855501,Hc Hysteroscopy Diagnostic Separate Procedure,5263.0,2105.2,,,0 CDM,3606229001,Hc Injection Px Discography Each Level Lumbar,1403.0,561.2,,,0 CDM,3606238001,Hc Endoscopic Decompression Of Spinal Cord 1 Interspace Lumbar,9193.18,3677.27,,,0 CDM,3606699101,Hc Extracapsular Cataract Removal With Insertion Of Intracular Lens Prosthesis Stage 1,6105.56,2442.22,,,0 CDM,3609379902,Hc Or Perfusion 1St Hour,950.0,380.0,,,0 CDM,3609379903,Hc Or Perfusion Additional 15 Minutes,225.21,90.08,,,0 CDM,3609594001,Hc Ionm 1 On 1 In Or W/Attendance Each 15 Minutes,897.0,358.8,,,0 CDM,360C976401,Hc Shockwave And Pta Above The Knee,14300.0,5720.0,,,0 CDM,3610000001,Hc Percutaneous Trach Assist,1048.34,419.34,,,0 CDM,3610000003,Hc Incision And Drainage Service Pacu 1St Hour,7235.98,2894.39,,,0 CDM,3610000008,Hc Incision & Drainage,1047.12,418.85,,,0 CDM,3610000009,Hc Incision & Drainage-Obstretics,1431.11,572.44,,,0 CDM,3610000010,Hc Bronchoscopy Procedure With Ion Robot,21744.2,8697.68,,,0 CDM,3610000050,Hc Open Trach Assist,1429.89,571.96,,,0 CDM,3610075T01,Hc Carotid/Vert Stent Initial Artery,30114.08,12045.63,,,0 CDM,3610076T01,Hc Carotid/Vert Stent Each Additional Artery,20442.75,8177.1,,,0 CDM,3610268T01,Hc Barostim Generator Change,5462.5,2185.0,,,0 CDM,3610408T01,Hc Cardiac Contractility Modiulation System Pulse Generator With Transvenous Electodes,27191.75,10876.7,,,0 CDM,3610410T01,Hc Ccm Insert Atrial Lead Only,13512.5,5405.0,,,0 CDM,3610411T01,Hc Cardiac Contractility Modiulation System Insertion Venticular Electrode Only,13512.5,5405.0,,,0 CDM,3610412T01,Hc Cardiac Contractility Modiulation System Generator Only,7860.25,3144.1,,,0 CDM,3610413T01,Hc Cardiac Contractility Modiulation System Removal Transvenous Electrodes,8682.5,3473.0,,,0 CDM,3610414T01,Hc Cardiac Contractility Modiulation System Removal/Replacement Generator Only,28284.25,11313.7,,,0 CDM,3610415T01,Hc Ccm Reposition Lead (A Or V),2587.5,1035.0,,,0 CDM,3610416T01,Hc Cardiac Contractility Modiulation System Relocate Skin Pocket,5263.55,2105.42,,,0 CDM,3610483T01,Hc Transcatheter Miral Valve Implantation/Replacement With Prosthetic Valve Percutaneous Approach,20728.75,8291.5,,,0 CDM,3610507T01,Hc Repair Of Tricuspid Valve W/Prosthetic Valve- Additional Valve,46907.0,18762.8,,,0 CDM,3610569T01,Hc Repair Of Tricuspid Valve With Prosthetic Valve,33173.0,13269.2,,,0 CDM,3610570T01,Hc Repair Of Tricuspid Valve With Prosthetic Valve-Each Additional Valve,33173.0,13269.2,,,0 CDM,3610600T01,Hc Ire Ablation 1+Tumors Per Organ W/Img Gdn Perq,11795.44,4718.18,,,0 CDM,3610643T01,Hc Transcatheter Ventricular Restoration Implantation,3750.0,1500.0,,,0 CDM,3610644T01,Hc Transcath Removal Intracardiac Mass,8550.25,3420.1,,,0 CDM,3610644T02,Hc Angiovac Cardiac Thrombus,2686.4,1074.56,,,0 CDM,3610644T03,Hc Angiovac Valve Endocarditis,2557.6,1023.04,,,0 CDM,3610644T04,Hc Tricuspid Valve Rep Percut,1868.75,747.5,,,0 CDM,3610646T04,Hc Tricuspid Valve Rep Percut,1868.75,747.5,,,0 CDM,3610913T01,Hc Percutaneous Transcatheter Therapy For Delivering Therapeutic Agent Via Balloon Catheter In Major,20754.0,8301.6,,,0 CDM,3610914T01,Hc Percutaneous Transcatheter Therapy For Delivering Therapeutic Agent Via Balloon Catheter To A Sep,20754.0,8301.6,,,0 CDM,3611000501,Hc Fna Biopsy W/Us Image Guidance 1St Lesion,4328.32,1731.33,,,0 CDM,3611000601,Hc Fna Biopsy W/Us Image Guidance Each Additional,2074.58,829.83,,,0 CDM,3611000701,Hc Fna Bx W/Fluoroscopy Guidance 1St Les,3780.79,1512.32,,,0 CDM,3611000801,Hc Fna Bx W/Fluoroscopy Guidance Ea Additional,753.48,301.39,,,0 CDM,3611000901,Hc Fna Bx W/Ct Guidance 1St Les,5548.96,2219.58,,,0 CDM,3611003001,Hc Image-Guided Catheter Fluid Collection Drainage,6260.58,2504.23,,,0 CDM,3611003501,Hc Perq Sft Tiss Loc Device Plmt 1St Les W/Gdnce,1481.2,592.48,,,0 CDM,3611006001,Hc Drain Skin Abscess Simple,986.22,394.49,,,0 CDM,3611006101,Hc Drain Skin Abscess Complic,1369.65,547.86,,,0 CDM,3611012101,Hc Remove Foreign Body Complic,5232.5,2093.0,,,0 CDM,3611014001,Hc Drainage Of Hematoma/Fluid,6310.81,2524.32,,,0 CDM,3611016001,Hc Puncture Drainage Of Lesion,3186.38,1274.55,,,0 CDM,3611018001,"Hc Complex Drainage, Wound",6094.82,2437.93,,,0 CDM,3611104401,Hc Debride Bone 1St 20 Sqcm,4716.79,1886.72,,,0 CDM,3611140001,Hc Excision Of Benign Lesion <0.5,1594.03,637.61,,,0 CDM,3611144001,"Hc Exc Skin Benig <0.5 Cm Face,Facial",1530.88,612.35,,,0 CDM,3611144101,"Hc Exc Skin Benig 0.6-1 Cm Face,Facial",2392.0,956.8,,,0 CDM,3611144201,"Hc Exc Skin Benig 1.1-2 Cm Face,Facial",2526.55,1010.62,,,0 CDM,3611144301,"Hc Exc Skin Benig 2.1-3 Cm Face,Facial",3842.15,1536.86,,,0 CDM,3611144401,"Hc Exc Skin Benig 3.1- 4 Cm Face,Facial",2453.3,981.32,,,0 CDM,3611144601,"Hc Exc Skin Benig >4 Cm Face,Facial",5065.06,2026.02,,,0 CDM,3611164101,"Hc Exc Skin Malig 0.6-1Cm Face,Facial",2221.57,888.63,,,0 CDM,3611164201,"Hc Exc Skin Malig 1.1-2 Cm Face,Facial",4081.35,1632.54,,,0 CDM,3611200101,Hc Resuperf Wnd Body <2.5Cm,887.43,354.97,,,0 CDM,3611205101,Hc Resuperf Wnd Face <2.5 Cm,910.87,364.35,,,0 CDM,3611205201,"Hc Layr Clos Wnd Face,Facial 2.5-5 Cm",976.17,390.47,,,0 CDM,3611505001,Hc Pinch Graft Up To 2 Cm Diameter,1059.5,423.8,,,0 CDM,3611526001,"Hc Full Thick Grft Nos,Ear,Lid <20 Sqcm",3584.67,1433.87,,,0 CDM,3611582301,Hc Rev Upper Eyelid W Excess Skin,4784.0,1913.6,,,0 CDM,3611585101,Hc Removal Sutures/Staples Requiring Anesthesia,3835.0,1534.0,,,0 CDM,3611602001,Hc Dress/Debrid Small Burn No Anes,833.85,333.54,,,0 CDM,3611799901,Hc Skin Tissue Procedure Unlisted,704.0,281.6,,,0 CDM,3611900001,Hc Puncture/Aspiration Breast Cyst-Unilateral,2156.62,862.65,,,0 CDM,3611900101,"Hc Puncture/Aspiration Breast Cyst,Each Additional-Unilateral",994.59,397.84,,,0 CDM,3611908101,Hc Biopsy Breast W Device 1St Lesion Stereotactic Guide-Unilateral,11979.86,4791.94,,,0 CDM,3611908201,Hc Biopsy Breast With Device Additional Lesion Stereotactic Guide,7258.3,2903.32,,,0 CDM,3611908301,Hc Biopsy Breast W Device 1St Lesion Guide-Unilateral,10059.35,4023.74,,,0 CDM,3611908401,Hc Bx Breast W Device Addl Lesion Ultrasound Guide,6800.08,2720.03,,,0 CDM,3611908501,Hc Biopsy Breast W Device 1St Lesion Magnetic Resonance Guide,10810.61,4324.24,,,0 CDM,3611908601,Hc Biopsy Breast With Device Additional Lesion Magnetic Resonance Guide,6224.13,2489.65,,,0 CDM,3611928101,Hc Perq Device Placement Breast Loc 1St Lesion W Guidance-Unilateral,5553.26,2221.3,,,0 CDM,3611928201,Hc Perq Device Placemt Breast Loc Ea Les W Guidnce,3658.6,1463.44,,,0 CDM,3611928301,Hc Stereotactic Guided Breast Localization 1St Lesion-Unilateral,5553.92,2221.57,,,0 CDM,3611928303,Hc Stereotactic Guided Breast Localization 1St Lesion-Bilateral,6664.7,2665.88,,,0 CDM,3611928401,Hc Stereotactic Guided Breast Localization Additional Lesion,3659.12,1463.65,,,0 CDM,3611928501,Hc Perq Breast Loc Device Placement 1St Lesion Us Image-Unilateral,5808.94,2323.58,,,0 CDM,3611928601,Hc Perq Breast Loc Device Placement Each Lesion Us Image,2038.3,815.32,,,0 CDM,3611949902,Hc Ct Guided Cryoablation Breast-Unilateral,4384.0,1753.6,,,0 CDM,3611949904,Hc Us Breast Clip Placed W/O Biopsy-Unilateral,4464.43,1785.77,,,0 CDM,3612020601,"Hc Needle Biopsy,Muscle",3797.53,1519.01,,,0 CDM,3612022001,"Hc Bone Biopsy,Trocar/Needle Superficial",4172.61,1669.04,,,0 CDM,3612022501,"Hc Bone Biopsy,Trocar/Needle Deep",5701.33,2280.53,,,0 CDM,3612050001,Hc Inject Sinus Tract Theraputic,2737.34,1094.94,,,0 CDM,3612050101,Hc Inject Sinus Tract For Dx W Xray,947.71,379.08,,,0 CDM,3612052602,Hc Injection Carpal Tunnel,1049.85,419.94,,,0 CDM,3612055001,Hc Inject Tendon Sheath/Ligament,1369.65,547.86,,,0 CDM,3612055101,Hc Inject Tendon Origin/Insert,1091.71,436.68,,,0 CDM,3612055201,"Hc Inject Trigger Point, 1 Or 2",1525.38,610.15,,,0 CDM,3612055301,"Hc Inject Trigger Points, > 3",1741.38,696.55,,,0 CDM,3612060001,Hc Ct Guided Inj Asp Small Joint Or Bursa-Bilateral,2021.01,808.4,,,0 CDM,3612060002,Hc Ct Guided Inj Asp Small Joint Or Bursa-Unilateral,1347.89,539.16,,,0 CDM,3612060401,Hc Ct Guided Arthrocentesis Aspiration/Injection Small Joint/Bursa With Ultrasound-Bilateral,4060.42,1624.17,,,0 CDM,3612060501,Hc Ct Guided Arthorcentesis Aspiration/Injection Intermediate Joint/Bursa-Bilateral,2545.09,1018.04,,,0 CDM,3612060502,Hc Ct Guided Arthorcentesis Aspiration/Injection Intermediate Joint/Bursa-Unilateral,1697.84,679.14,,,0 CDM,3612060601,Hc Arthrocentesis Aspiration/Injection Intermediate Joint/Bursa With Ultrasound-Unilateral,3958.28,1583.31,,,0 CDM,3612060602,Hc Arthrocentesis Aspir&/Inj Interm Jt/Burs W/Us Right,5939.1,2375.64,,,0 CDM,3612061001,Hc Ct Guided Arthrocentesis Aspiration/Injection Major Joint/Bursa Without Us-Bilateral,2697.46,1078.98,,,0 CDM,3612061002,Hc Ct Guided Arthrocentesis Aspiration/Injection Major Joint/Bursa W/O Us-Unilateral,1796.63,718.65,,,0 CDM,3612061101,Hc Ct Guided Arthrocentesis Aspiration/Injection Major Joint/Bursa W Ultrasound-Bilateral,6041.23,2416.49,,,0 CDM,3612061102,Hc Arthrocentesis Aspiration/Injection Major Joint/Bursa W Us,4026.93,1610.77,,,0 CDM,3612061103,Hc Ct Guided Arthrocentesis Aspiration/Injection Major Joint/Bursa W Ultrasound-Unilateral,4026.93,1610.77,,,0 CDM,3612061201,Hc Aspiration/Injection Ganglion Cyst(S),1342.87,537.15,,,0 CDM,3612067001,Hc Removal Superficial Implant,4106.76,1642.7,,,0 CDM,3612068001,Hc Removal Deep Implant,8137.58,3255.03,,,0 CDM,3612098201,Hc Ablation Bone Tumor Rf Perq W/Img Gdn When Done,21814.08,8725.63,,,0 CDM,3612155001,Hc Biopsy Soft Tissue Neck/Chest,5865.42,2346.17,,,0 CDM,3612251001,Hc Perq Vertebroplasty Uni/Bi Injx Cervicothoracic,8131.25,3252.5,,,0 CDM,3612251101,Hc Perq Vertebroplasty Unilateral/Bilateral Injection Lumbosacral,10473.05,4189.22,,,0 CDM,3612251201,Hc Vertebroplasty Each Addl Cervicothor/Lumbosacral,5977.0,2390.8,,,0 CDM,3612251301,Hc Perq Vert Agmntj Cavity Crtj Uni/Bi Cannulation,18268.57,7307.43,,,0 CDM,3612251401,Hc Perq Vert Agmntj Cavity Crtj Uni/Bi Cannulj Lmbr,18268.57,7307.43,,,0 CDM,3612251501,Hc Perq Vert Agmntj Cavity Crtj Uni/Bi Cannulj Each,13459.39,5383.76,,,0 CDM,3612335001,Hc Injection Procedure Shoulder Arthrography/Ct/Mri,909.33,363.73,,,0 CDM,3612422001,Hc Injection Joint Upper Extremity,801.14,320.46,,,0 CDM,3612500001,Hc Incision Of Tendon Sheath Wrist,5070.0,2028.0,,,0 CDM,3612507501,Hc Excision Of Soft Tissue Tumor Forearm/Wrist <3Cm-Unilateral,4199.0,1679.6,,,0 CDM,3612511101,Hc Removal Of Ganglion Wrist Dorsal/Volar Primary,6552.0,2620.8,,,0 CDM,3612524601,Hc Injection For Wrist Arthrogram,951.83,380.73,,,0 CDM,3612604501,Hc Release Palm Contracture,6344.0,2537.6,,,0 CDM,3612605501,Hc Incise Finger Tendon Sheath,5005.0,2002.0,,,0 CDM,3612709301,Hc Injection Hip Arthrogram,945.39,378.16,,,0 CDM,3612730101,Hc I&D Thigh/Knee Lesion,7121.22,2848.49,,,0 CDM,3612732302,Hc Biopsy Soft Tissue Thigh/Knee,3690.38,1476.15,,,0 CDM,3612736901,Hc Injection Knee Arthography/Ct/Mri,979.52,391.81,,,0 CDM,3613123301,Hc Nasal/Sinus Endoscopy Diagnostic Maxilary Sinusoscopy-Unilateral,585.0,234.0,,,0 CDM,3613123302,Hc Nasal/Sinus Endoscopy Diagnostic Maxilary Sinusoscopy-Bilateral,878.0,351.2,,,0 CDM,3613150201,Hc Trach Tube Change,1143.61,457.44,,,0 CDM,3613157501,"Hc Laryngoscopy,Flex Fiber,Diagnostic",1826.38,730.55,,,0 CDM,3613162201,Hc Bronchoscopy Diagnostic,4478.38,1791.35,,,0 CDM,3613162301,Hc Bronchoscopy Diagnostic With Brush,4511.86,1804.74,,,0 CDM,3613162302,Noncdm Charge Record,21193.0,8477.2,,,0 CDM,3613162401,Hc Bronchoscopy Diagnostic With Lavage,4519.59,1807.84,,,0 CDM,3613162402,Noncdm Charge Record,21212.0,8484.8,,,0 CDM,3613162501,Hc Bronchoscopy Biopsy,4582.7,1833.08,,,0 CDM,3613162701,Hc Bronchoscopy Computer Assistant/Image-Guided Navigation,3697.85,1479.14,,,0 CDM,3613162702,Noncdm Charge Record,20390.0,8156.0,,,0 CDM,3613162801,Hc Bronchoscopy Transbronchial Biopsy,5331.03,2132.41,,,0 CDM,3613162802,Noncdm Charge Record,22023.0,8809.2,,,0 CDM,3613162901,Hc Bronchoscopy Transbronchial Aspiration Biopsy,5168.74,2067.5,,,0 CDM,3613163001,Hc Bronchoscopy With Tracheal/Bronchial Dilation,6025.26,2410.1,,,0 CDM,3613163101,Hc Bronchoscopy W/Placement Tracheal Stent,6250.0,2500.0,,,0 CDM,3613163201,Hc Bronchoscopy W/Transbronchial Lung Biopsy Each Lobe,3236.74,1294.7,,,0 CDM,3613163501,Hc Bronchoscopy Removal Foreign Body,4442.31,1776.92,,,0 CDM,3613163601,Hc Bronchoscopy Bronchial Stents,6035.57,2414.23,,,0 CDM,3613164001,Hc Bronchoscopy With Excision Of Tumor/Growth,5477.86,2191.14,,,0 CDM,3613164101,Hc Bronchoscopy Treatment Of Blockage,7304.25,2921.7,,,0 CDM,3613164301,"Hc Bronchoscopy,Rx W Place Catheter",1569.04,627.62,,,0 CDM,3613164501,Hc Bronchoscopy W/Therapy Aspiration Trachbrnchial Tree 1St,3891.05,1556.42,,,0 CDM,3613164801,Hc Bronchoscopy Removal Bronchial Valve Initial,4146.07,1658.43,,,0 CDM,3613164901,Hc Bronchoscopy Rigid/Flex Each Additional Lobe,2412.42,964.97,,,0 CDM,3613165201,Hc Bronchoscopy Ebus Guided Sample 1/2 Node Station/Strux,8050.0,3220.0,,,0 CDM,3613165301,Hc Bronchoscopy Ebus Guided Sample 3/> Node Station/Strux,8129.86,3251.94,,,0 CDM,3613165401,Hc Bronchoscopy With Ebus For Diagnostic/Therapeutic Intervention For Peripheral Lesions,5981.47,2392.59,,,0 CDM,3613166001,Hc Bronchial Thermoplasty 1 Lobe,8520.12,3408.05,,,0 CDM,3613166101,Hc Bronchoscopy Ridge Or Flexible,9710.23,3884.09,,,0 CDM,3613240001,Hc Needle Biopsy Pleura,1151.0,460.4,,,0 CDM,3613240501,"Hc Percut Bx, Lung/Mediastinum-Unilateral",3638.48,1455.39,,,0 CDM,3613240802,Hc Ct Lung/Med Biopsy Including Guidance Unilateral,7497.96,2999.18,,,0 CDM,3613255001,Hc Insertion Indwelling Tunneled Pleural Catheter,9827.05,3930.82,,,0 CDM,3613255101,Hc Tube Thoracostomy Includes Water Seal,3224.9,1289.96,,,0 CDM,3613255201,Hc Removal Of Indwelling Tunneled Pleural Catheter With Cuff,2849.83,1139.93,,,0 CDM,3613255501,Hc Thoracentesis Needle/Cath Pleura W/Imaging-Bilateral,6779.82,2711.93,,,0 CDM,3613255502,Hc Thoracentesis Needle/Cath Pleura W/Imaging-Unilateral,4519.2,1807.68,,,0 CDM,3613255601,Hc Perq Drainage Pleura Insert Cath W/O Imaging,3097.64,1239.06,,,0 CDM,3613255701,Hc Ct Guided Chest Tube-Bilateral,8998.22,3599.29,,,0 CDM,3613255702,Hc Percutaneous Drainage Pleura Insert Cath W/Imaging-Unilateral,5999.37,2399.75,,,0 CDM,3613299401,Hc Ct Cryoblation - Lung Unilateral,20584.62,8233.85,,,0 CDM,3613299801,"Hc Perq Radiofreq Ablation Tx, Pul Tumor",9423.81,3769.52,,,0 CDM,3613299902,Hc Pleural Drain Change,2022.5,809.0,,,0 CDM,3613301001,Hc Cath Drainage Of Heart Sac,2817.5,1127.0,,,0 CDM,3613301601,Hc Pericentesis W/Image-Guided,4428.65,1771.46,,,0 CDM,3613301701,Hc Prcrd Drg 6Yr+ W/O Cgen Car,11176.85,4470.74,,,0 CDM,3613301801,Hc Prcrd Drg 0-5Yr Or W/Anomly,11176.85,4470.74,,,0 CDM,3613320601,Hc Ep Insert Heart Pacer Xvenous Atrial,12719.0,5087.6,,,0 CDM,3613320701,Hc Ep Insert Heart Pacer Xvenous Venticular,13396.35,5358.54,,,0 CDM,3613320801,Hc Ep Insert Heart Pacer Xvenous Atrial/Venticular,18084.9,7233.96,,,0 CDM,3613321001,Hc Ep Insert Heart Temp Pacer One Chamber,13479.15,5391.66,,,0 CDM,3613321201,Hc Ep Insert Pulse Generate One Chamber,13058.25,5223.3,,,0 CDM,3613321301,Hc Ep Insert Pulse Generate Dual Chamber,14262.3,5704.92,,,0 CDM,3613321501,Hc Ep Rpsg Prev Implanted Pm/Dfb Atrial/Venticular Electrode,6276.7,2510.68,,,0 CDM,3613321601,Hc Ep Insj 1 Transvenous Electrode Perm Pacemaker/Implantable Dfb,9921.05,3968.42,,,0 CDM,3613321701,Hc Ep Insj 2 Transvenous Electrode Perm Pacemaker/Implantable Dfb,10858.3,4343.32,,,0 CDM,3613321801,Hc Ep Rpr 2 Transvneous Electrode Perm Pm/Pacing Implantable Dfb,7772.85,3109.14,,,0 CDM,3613322101,Hc Ep Ins Pacemaker Pulse General Only With Exist Multiple Leads,15598.6,6239.44,,,0 CDM,3613322201,Hc Ep Relocation Of Skin Pocket For Pacemaker,5162.35,2064.94,,,0 CDM,3613322301,Hc Ep Relocation Of Skin Pocket Implantable Defibrillator,5472.85,2189.14,,,0 CDM,3613322401,Hc Ep Insj Electrode Cardiac Venous System Tm Insj Dfb/Pm Pls General,14760.25,5904.1,,,0 CDM,3613322501,Hc Ep Insj Electrode Cardiac Venous System Attach Prev Perm/Dfb Pls General,11677.1,4670.84,,,0 CDM,3613322701,Hc Ep Removal Perm Pm Pulse General With/Replacement Pulse General Single Lead System,20214.7,8085.88,,,0 CDM,3613322801,Hc Ep Removal Perm Pm Pulse General With/Replacement Pulse General Multple Lead,23744.05,9497.62,,,0 CDM,3613322901,Hc Ep Removal Perm Pm Pulse General With/Replacement Pulse General Multi Lead,25646.15,10258.46,,,0 CDM,3613323001,Hc Ep Insj Implantable Defib Pulse General With/Exist Dual Leads,26926.1,10770.44,,,0 CDM,3613323101,Hc Insert Icd Pul Gen-Exist Multiple Lds,28771.85,11508.74,,,0 CDM,3613323301,Hc Ep Removal Perm Pacer Generator,9339.15,3735.66,,,0 CDM,3613323401,"Hc Ep Removal Transvenous Pacer Electrode,1 Lead",8694.0,3477.6,,,0 CDM,3613323501,"Hc Ep Removal Transvenous Pacer Electrode,2 Lead",9179.3,3671.72,,,0 CDM,3613324001,Hc Ep Insj Implantable Defib Pulse General With/1 Existing Lead,19352.2,7740.88,,,0 CDM,3613324101,Hc Ep Removal Implantable Defib Pulse Generator Only,7859.1,3143.64,,,0 CDM,3613324401,Hc Ep Removal 1/Dual Chamber Implantable Dfb Electrodes Transvenous Xtrj,9174.7,3669.88,,,0 CDM,3613324901,Hc Ep Insj/Replacement Perm Dfb With/Transvenous Leads 1/Dual Chamber,26575.35,10630.14,,,0 CDM,3613326201,Hc Ep Removal Implantable Dfb Pulse General With/Replacement Pulse General 1 Lead,27188.3,10875.32,,,0 CDM,3613326301,Hc Ep Removal Implantable Dfb Pulse General With/Replacement Pulse General 2 Lead,28281.95,11312.78,,,0 CDM,3613326401,Hc Ep Removal Implantable Dfb Pulse General With/Replacement Pulse General Mlt Ld,29634.35,11853.74,,,0 CDM,3613327001,Hc Ep Ins/Replacement Perm Subsequent Implantable Dfb With/Subsequent Electrode,29583.75,11833.5,,,0 CDM,3613327201,Hc Ep Rmvl Of Subq Implantable Defibrillator,6719.45,2687.78,,,0 CDM,3613327401,Hc Insert/Replacement Leadless Pacer Rv,29107.65,11643.06,,,0 CDM,3613327502,Hc Remove Leadless Pacemaker,7545.1,3018.04,,,0 CDM,3613328501,Hc Insert Cardiac Rhythm Monitor,12517.75,5007.1,,,0 CDM,3613328601,Hc Remove Cardiac Rhythm Monitor,3428.15,1371.26,,,0 CDM,3613334001,Hc Catheter Percutaneous Closure-Repair Of Left Upper Heart,16954.45,6781.78,,,0 CDM,3613336101,Hc Replacement Aortic Valve Percutaneous Femoral Artery Approach,33172.9,13269.16,,,0 CDM,3613341801,Hc Repair Of Mitral Valve With Prosthetic Valve Initial Prosthesis,28874.2,11549.68,,,0 CDM,3613341901,Hc Cath Tcat Mitral Valve Repair Additional Prosthesis,18033.15,7213.26,,,0 CDM,3613347701,Hc Implantation Of Heart Valve (Pulmonary) To Lungs,23667.0,9466.8,,,0 CDM,3613374101,Hc Transcath Atrial Septostomy,18419.55,7367.82,,,0 CDM,3613374501,Hc Tis Transc Intrcard Shunt Initial,20297.5,8119.0,,,0 CDM,3613374601,Hc Tis Trans Intracrd Shunt Additional,8797.5,3519.0,,,0 CDM,3613390001,Hc Percutaneous Pulmonary Artery Revascularization By Stent Placement-Unilateral,7403.47,2961.39,,,0 CDM,3613390101,Hc Percutaneous Pulmonary Artery Revascularization By Stent Placement-Bilateral,8398.05,3359.22,,,0 CDM,3613390201,Hc Placement Of Stent In Pulmonary Arteries With Abnormal Anatomical Connections-Unilateral,8665.25,3466.1,,,0 CDM,3613390301,Hc Placement Of Stent In Pulmonary Arteries With Abnormal Anatomical Connections-Bilateral,6614.8,2645.92,,,0 CDM,3613390401,Hc Placement Of Stent In Pulmonary Artery-Each Addtional,1969.95,787.98,,,0 CDM,3613395801,Hc Ecmo Reposition Cannula 6Yr+,1095.95,438.38,,,0 CDM,3613396701,Hc Catheter Insert Intra-Aortic Balloon Assist Device,8193.75,3277.5,,,0 CDM,3613397101,Hc Remove Iabp With/Femoral Artery Repair,5853.5,2341.4,,,0 CDM,3613399001,Hc Insj Perq Vad With/Imaging Artery Access Only,14861.45,5944.58,,,0 CDM,3613399201,Hc Removal Percutaneous Left Heart Vad Separate And Distinct Session,11283.8,4513.52,,,0 CDM,3613399301,Hc Reposition Vad With Imaging Different Session,7404.85,2961.94,,,0 CDM,3613399501,Hc Rvad Percut Insert Venous Only,8774.5,3509.8,,,0 CDM,3613399701,Hc Removal Rvad Percut,7334.7,2933.88,,,0 CDM,3613399901,Hc Pta Of Lvad Outflow Graft,1474.3,589.72,,,0 CDM,3613399904,Hc Lava Ecmo,3312.0,1324.8,,,0 CDM,3613399905,Hc Unlisted-Aneurym Rpr Stent Vein,3100.4,1240.16,,,0 CDM,3613399906,Hc Atrial Septostomy Noncongen,2274.7,909.88,,,0 CDM,3613399908,Hc Azygos Vein Icd Coil Insert,1063.75,425.5,,,0 CDM,3613399909,Hc Pta Of Lvad Outflow Graft,1831.95,732.78,,,0 CDM,3613399910,Hc Tricuspid Valve Rep Percut,1868.75,747.5,,,0 CDM,3613399913,Hc Iabp Reposition,1592.75,637.1,,,0 CDM,3613399914,Hc Reposition Loop Recorder,104.65,41.86,,,0 CDM,3613399915,Hc Laa Implant (Watchman) Leak Repair,21193.35,8477.34,,,0 CDM,3613600001,Hc Place Needle In Vein,560.05,224.02,,,0 CDM,3613600201,Hc Injection Rx Extremity Pseudoaneurysm,1106.3,442.52,,,0 CDM,3613600501,"Hc Injection Procedure,Extremity,Venography",1442.1,576.84,,,0 CDM,3613601001,"Hc Place Cath In Vein,Svc,Ivc",2885.12,1154.05,,,0 CDM,3613601101,"Hc Place Cath In Vein,Select",2717.45,1086.98,,,0 CDM,3613601102,Hc Sel Cath Ven 1St Or Branchial-Unilateral,2717.45,1086.98,,,0 CDM,3613601201,"Hc Place Cath In Vein,Subselect-Unilateral",2923.3,1169.32,,,0 CDM,3613601301,Hc Cath Place Cath In Main Pulmonary Artery-Bilateral,1810.1,724.04,,,0 CDM,3613601401,"Hc Place Cath In Left/Right Heart,Main Pulmonary Artery-Unilateral",2375.9,950.36,,,0 CDM,3613601501,Hc Place Cath In Subsegment Pulmonary Artery-Unilateral,1906.7,762.68,,,0 CDM,3613614001,Hc Place Cath Extremity Artery,2661.01,1064.4,,,0 CDM,3613620001,Hc Place Cath Aorta,3375.85,1350.34,,,0 CDM,3613621501,Hc Place Cath Selective Artery/Neck,3945.14,1578.06,,,0 CDM,3613621601,Hc Place Cath Subselective Artery/Neck 2 Ord,5669.78,2267.91,,,0 CDM,3613621701,Hc Place Cath Subsubselect Artery/Neck 3 Ord,5972.46,2388.98,,,0 CDM,3613621801,Hc Place Cath Additional Subselective Artery/Abdomen/Pelvis,4031.44,1612.58,,,0 CDM,3613622101,Hc Catheter Nonselective Thoracic Aorta Angio Internal/Extracranal Arterial,12722.86,5089.14,,,0 CDM,3613622201,Hc Slctv Cath Carotid/Innom Art Angio Xtrcranl Art Bilateral,21148.96,8459.58,,,0 CDM,3613622202,Hc Selective Cath Carotid/Innom Arterial Angio Extrcranial Arterial Unilateral,14099.74,5639.9,,,0 CDM,3613622301,Hc Selective Cath Carotid/Innom Artery Angio Intracranial Artery-Bilateral,24259.48,9703.79,,,0 CDM,3613622302,Hc Selective Cath Carotid/Innom Arterial Angio Intracranial Arterial,16172.13,6468.85,,,0 CDM,3613622401,Hc Selective Cath Intrnl Carotid Artery Angio Intracranial Artery-Bilateral,28110.6,11244.24,,,0 CDM,3613622402,Hc Selective Cath Intracarotid Arterial Angio,18741.69,7496.68,,,0 CDM,3613622501,Hc Slctv Cath Subclavian Art Angio Vertebral Artery - Bilateral,21303.52,8521.41,,,0 CDM,3613622502,Hc Selective Cath Subclavian Artery Angio Vertebral Artery-Unilateral,14201.49,5680.6,,,0 CDM,3613622601,Hc Slctv Cath Vertebral Art Angio Vertebral Artery,27854.29,11141.72,,,0 CDM,3613622602,Hc Selective Cath Vertebral Artery Angio Vertebral Artery,18569.1,7427.64,,,0 CDM,3613622701,Hc Selective Cath External Carotid Angio External Carotd Circ-Bilateral,17233.44,6893.38,,,0 CDM,3613622702,Hc Selective Cath Extracarotid Angio Circ-Unilateral,12867.12,5146.85,,,0 CDM,3613622802,Hc Selective Cath Intrcarotid Branch Angio Intracaroid,8092.5,3237.0,,,0 CDM,3613624501,Hc Place Cath Selective Artery/Abdomen/Pelvis,4061.06,1624.42,,,0 CDM,3613624601,Hc Place Cath Subselective Artery/Abdomen/Pelvis,5756.07,2302.43,,,0 CDM,3613624701,"Hc Place Cath Subsubselect Art,Abd/Pel",6123.15,2449.26,,,0 CDM,3613624702,"Hc Place Cath Subsubselect Artery, Abdomen/Pelvis",6123.15,2449.26,,,0 CDM,3613624801,Hc Place Cath Additional Subselective Artery/Abdomen/Pelvis,3594.81,1437.92,,,0 CDM,3613625101,Hc Selective Cath 1Stord W/Wo Art Punct/Fluor/S&I Unilateral,10883.6,4353.44,,,0 CDM,3613625201,Hc Selective Cath 1Stord W/Wo Art Punct/Fluor/S&I Bilateral,16320.25,6528.1,,,0 CDM,3613625301,Hc Supslctv Cath 2Nd+Ord Renl&Acces Artery/S&I Uni,13669.54,5467.82,,,0 CDM,3613625401,Hc Insertion Of Catheters Into Main/Accessory Arteries Of Both Kidneys For Imaging,15764.0,6305.6,,,0 CDM,3613629901,Hc Radi Of Renal Arteries,2584.05,1033.62,,,0 CDM,3613629902,Hc Jugular Injection,1366.2,546.48,,,0 CDM,3613647001,"Hc Injection Therapy Vein,One Vein-Unilateral",2268.81,907.52,,,0 CDM,3613647101,"Hc Injection Therapy Vein,Mult Veins Bilateral",1817.0,726.8,,,0 CDM,3613647102,Hc Multi Vein Sclerotherapy Unilateral,2362.1,944.84,,,0 CDM,3613647501,"Hc Endovenous Rf, 1St Vein",4223.37,1689.35,,,0 CDM,3613648101,Hc Percut Portal Vein Cath,2633.5,1053.4,,,0 CDM,3613650001,Hc Venous Select Sampling W Cath-Unilateral,2936.07,1174.43,,,0 CDM,3613650002,Hc Organ Vein Sampling Bilateral,4405.55,1762.22,,,0 CDM,3613655504,Hc Cvvhd Adult Daily Line Charge Inpatient,6225.41,2490.16,,,0 CDM,3613655552,Hc Insert Picc < 5 Yrs Old,6225.41,2490.16,,,0 CDM,3613655601,Hc Insert Non-Tunnel Cv Cath,6459.83,2583.93,,,0 CDM,3613655644,Hc Insert Deepline >5 Years,6459.83,2583.93,,,0 CDM,3613655801,Hc Insert Tunneled Cv Cath W/O Port Or Pump,10106.68,4042.67,,,0 CDM,3613656101,Hc Insert Tunneled Cv Cath With Port,13090.45,5236.18,,,0 CDM,3613656801,Hc Insert Picc W/O Sub-Q Port <5 Y/O,6488.3,2595.32,,,0 CDM,3613656901,Hc Insert Picc W/O Sub-Q Port,6545.23,2618.09,,,0 CDM,3613657101,Hc Insert Picc W/ Sub-Q Port,9805.29,3922.12,,,0 CDM,3613657201,Hc Insertion Picc W/Rs&I < 5 Yr,6320.86,2528.34,,,0 CDM,3613657301,Hc Insertion Picc W/Rs&I 5 Yr/>,7107.83,2843.13,,,0 CDM,3613657501,Hc Repair Cv Cath W/O Subq Port Or Pump,4842.3,1936.92,,,0 CDM,3613657601,Hc Repair Cv Cath W Subq Port Or Pump,4842.3,1936.92,,,0 CDM,3613657801,"Hc Replace Cv Cath, Catheter Only W Subq Pump Or Port",4695.8,1878.32,,,0 CDM,3613658001,"Hc Replace Cv Cath, Complete, Non-Tunneled, W/O Subq Port Or Pump",6188.58,2475.43,,,0 CDM,3613658101,"Hc Replace Cv Cath, Complete, Tunneled, W/O Subq Port Or Pump",9624.45,3849.78,,,0 CDM,3613658201,"Hc Replace Cv Cath, Complete, Non-Tunneled, W Subq Port Or Pump",11035.97,4414.39,,,0 CDM,3613658401,Hc Replace Picc W/O Port Or Pump,6329.23,2531.69,,,0 CDM,3613658501,Hc Replace Picc W Port Or Pump,5556.92,2222.77,,,0 CDM,3613658901,Hc Removal Tunneled Cv Cath W/O Subq Port Or Pump,4756.97,1902.79,,,0 CDM,3613659001,Hc Removal Tunneled Cv Cath W Subq Port Or Pump,5615.94,2246.38,,,0 CDM,3613659101,Noncdm Charge Record,396.7,158.68,,,0 CDM,3613659102,Hc Collect Blood From Implant Venous Access Device - Bundled Charge,515.71,206.28,,,0 CDM,3613659201,Hc Chg Collect Blood From Catheter Venous Nos - Draw Charge,421.95,168.78,,,0 CDM,3613659202,Hc Collect Blood From Catheter Venous Nos - Bundled Charge,421.95,168.78,,,0 CDM,3613659501,Hc Mech Remov Pericath Obstr Cv Dev Via Ven Access,8504.28,3401.71,,,0 CDM,3613659601,Hc Mech Remov Intralum Obstr Cv Dev Thru Lumen,1302.0,520.8,,,0 CDM,3613659701,Hc Reposition Venous Catheter,3675.31,1470.12,,,0 CDM,3613659801,"Hc Contrast Injection Central Venous Cath, Including Flouro",1233.9,493.56,,,0 CDM,3613660002,Hc Withdrawal Of Arterial Blood - Bundled Charge,271.26,108.5,,,0 CDM,3613660003,Hc Rt Arterial Puncture For Abg,242.19,96.88,,,0 CDM,3613662001,"Hc Insert Cath,Art,Percut,Shortterm",1452.45,580.98,,,0 CDM,3613690101,Hc Intro Cath Dialysis Circuit Dx Angrph Fluor S&I,4090.55,1636.22,,,0 CDM,3613690201,Hc Intro Cath Dialysis Circuit W/Trluml Balo Angiop,52636.65,21054.66,,,0 CDM,3613690301,Hc Intro Cath Dialysis Circuit W/Tcat Plmt Iv Stent,35160.1,14064.04,,,0 CDM,3613690501,Hc Percutaneous Transluminal Mechanical Thrombectomy And/Or Infusion With Balloon Angioplasty,28643.05,11457.22,,,0 CDM,3613690601,Hc Perq Thrmbc/Nfs Dial Circuit Tcat Plmt Iv Stent,1558.25,623.3,,,0 CDM,3613690701,Hc Trluml Baloon Angioplasty Ctr Dialysis Seg W/Img S&I,17484.6,6993.84,,,0 CDM,3613690801,Hc Tcat Plmt Iv Stent Ctr Dialysis Seg W/Img S&I,19599.45,7839.78,,,0 CDM,3613690901,Hc Dialyis Circuit Vasc Emboli Occls Evasc Img S&I,6259.45,2503.78,,,0 CDM,3613718201,Hc Insert Transven Intrahep Portosys Shunt,55216.69,22086.68,,,0 CDM,3613718301,Hc Revis Transven Intrahep Portosys Shunt,46987.02,18794.81,,,0 CDM,3613718501,Hc Prim Prq Trluml Mchnl Thrmbc N-Cor N-Icra Sbsq,8430.43,3372.17,,,0 CDM,3613719101,Hc Insert Intravascular Vc Filter W/Wo Vascular Access Vsl Selxn Rs&I,19364.58,7745.83,,,0 CDM,3613719301,Hc Rtrvl Intrvas Vc Filtr W/Wo Acs Vsl Selxn Rs&I,11505.75,4602.3,,,0 CDM,3613719701,Hc Prq Transcatheter Rtrvl Intrvas Fb With Imaging,11573.36,4629.34,,,0 CDM,3613720001,Hc Transcatheter Biopsy,8309.77,3323.91,,,0 CDM,3613721102,"Hc Cardiac Thrombolysis Therapy, Initial Bilateral",18311.19,7324.48,,,0 CDM,3613721201,Hc Thrombolysis Arterial Infusion Icra Rs&I Initial Treatment,8999.26,3599.7,,,0 CDM,3613721402,"Hc Cardiac Thrombolysis Therapy, Cessation",8729.02,3491.61,,,0 CDM,3613721501,Hc Tcat Iv Stent Crv Crtd Art Embolic Protecj,24814.41,9925.76,,,0 CDM,3613721601,Hc Tcat Iv Stent Crv Crtd Art W/O Embolic Protecj,19426.34,7770.54,,,0 CDM,3613721801,Hc Tcath Stent Placemt Antegrade Carotid/Innominate,18431.05,7372.42,,,0 CDM,3613722001,"Hc Revascularize Iliac Artery,Angioplasty, Initial Vessel",21656.8,8662.72,,,0 CDM,3613722002,"Hc Revascularize Iliac Artery,Angioplasty, Initial Vessel-Unilateral",21656.8,8662.72,,,0 CDM,3613722101,"Hc Revascularize Iliac Artery,Angioplasty/Stent, Initial Vessel",35091.1,14036.44,,,0 CDM,3613722301,"Hc Revascularize Iliac Artery,Angioplasty/Stent, Each Additional Vessel",29548.1,11819.24,,,0 CDM,3613722401,"Hc Revascularize Fem/Pop Artery,Angioplasty",22870.05,9148.02,,,0 CDM,3613722501,"Hc Revascularize Fem/Pop Artery,Angioplasty/Atherectomy",35807.55,14323.02,,,0 CDM,3613722601,"Hc Revascularize Fem/Pop Artery,Angioplasty/Stent",41610.45,16644.18,,,0 CDM,3613722701,"Hc Revascularize Fem/Pop Artery,Angioplasty/Stent/Atherectomy",61007.5,24403.0,,,0 CDM,3613722801,"Hc Revascularize Tibial/Peron Artery,Angioplasty Initial",23580.75,9432.3,,,0 CDM,3613723601,Hc Open/Perq Placement Intravascular Stent Initial-Unilateral,30432.45,12172.98,,,0 CDM,3613723701,Hc Open/Perq Placement Intravascular Stent Each Additional,19328.05,7731.22,,,0 CDM,3613723801,Hc Open/Perq Placement Intravascular Stent Same 1St,30545.15,12218.06,,,0 CDM,3613723901,Hc Open/Perq Placement Intravascular Stent Same Each Additional-Unilateral,19155.55,7662.22,,,0 CDM,3613724101,Hc Vascular Embolization Or Occlusion Venous Rs&I,39365.49,15746.2,,,0 CDM,3613724201,Hc Vascular Embolization Or Occlusion Arterial Rs&I,40925.46,16370.18,,,0 CDM,3613724301,Hc Vascular Embolize/Occlude Organ Tumor Infarct,38460.53,15384.21,,,0 CDM,3613724401,Hc Vascular Embolization Or Occlusion Hemorrhage,35408.11,14163.24,,,0 CDM,3613724601,Hc Trlml Baloon Angioplasty Open/Perq Image S&I 1St Artery,18626.55,7450.62,,,0 CDM,3613724801,Hc Trlml Baloon Angioplasty Open/Perq Image S&I 1St Vein,19236.05,7694.42,,,0 CDM,3613724901,Hc Trlml Baloon Angioplasty Open/Perq Image S&I Additional Vein,10879.74,4351.9,,,0 CDM,3613725201,Hc Intravascular Us Noncoronary Rs&I Intial Vessel,5492.23,2196.89,,,0 CDM,3613725401,"Hc Revascularize Iliac Artery,Angioplasty, Initial Vessel",21656.0,8662.4,,,0 CDM,3613725601,Hc Endovascular Revasularization Of Femoral/Popliteal/Tibial/Peroneal Artery With Transluminal Angio,14437.0,5774.8,,,0 CDM,3613725801,"Hc Endovascular Revasularization Transluminal Stent Placement In Iliac Artery, Inital",35091.1,14036.44,,,0 CDM,3613725901,"Hc Endovascular Revasularization Of Transluminal Stents Into Iliac Artery, Add On",29548.1,11819.24,,,0 CDM,3613726001,"Hc Endovascular Revasularization Stent Placement In Iliac Artery With Transluminal Angioplasty, Init",46788.0,18715.2,,,0 CDM,3613726101,"Hc Endovascular Revasularization Transluminal Stent Placement In Iliac Artery, Each Additional",39397.0,15758.8,,,0 CDM,3613779901,Hc Chg Vascular Surgery Procedure Unlist - Draw Charge,322.0,128.8,,,0 CDM,3613779902,Hc Direct Stick Face Therapy,1555.95,622.38,,,0 CDM,3613779903,Hc Stent Insert Lvad Graft,2475.95,990.38,,,0 CDM,3613779904,Hc Angiovac Cardiac Thrombus,2686.4,1074.56,,,0 CDM,3613779905,Hc Angiovac Valve Endocarditis,2557.6,1023.04,,,0 CDM,3613779907,Hc Insrt Cerebral Embol Protect,1817.0,726.8,,,0 CDM,3613779910,Hc Inout Cv Tunl Insrt 5+Yr,2565.65,1026.26,,,0 CDM,3613779911,Hc Inout Cv Tun W/Subqport Ins 5+,2626.6,1050.64,,,0 CDM,3613779912,Hc Inout Cv Non-Tunnel Insrt 5+,1288.0,515.2,,,0 CDM,3613779913,Hc Pta Of Fibrin Sheath,1121.25,448.5,,,0 CDM,3613822001,Hc Diagnostic Bone Marrow Aspirations,2722.58,1089.03,,,0 CDM,3613822101,Hc Bone Marrow Biopsy Needle/Trocar,3387.31,1354.92,,,0 CDM,3613822201,Hc Dx Bone Marrow Biopsy And Aspiration,4335.02,1734.01,,,0 CDM,3613850501,"Hc Needle Biopsy, Lymph Node(S)",3891.3,1556.52,,,0 CDM,3613879001,Hc Injection For Lymphatic Xray,2524.48,1009.79,,,0 CDM,3613879201,Hc Injection Of Radioactive Tracer For Id Of Sentinel Node,2396.97,958.79,,,0 CDM,3614240001,"Hc Biopsy Salivary Gland,Needle",2437.93,975.17,,,0 CDM,3614280601,Hc Bx Nasopharynx Unknown Primary Lesion,4290.0,1716.0,,,0 CDM,3614297501,Hc Drug Induced Sleep Endoscopy,661.77,264.71,,,0 CDM,3614320001,Hc Esophagoscopy Flexible Transoral Diagnostic - Esophagoscopy,2206.13,882.45,,,0 CDM,3614320201,Hc Esophagoscopy Flexible Transoral With Biopsy - Esophagoscopy,2449.79,979.92,,,0 CDM,3614321201,Hc Esophagoscopy Stent Place,5913.82,2365.53,,,0 CDM,3614321501,Hc Esophagoscopy Flexible Removal Foreign Body - Esophagoscopy,2424.58,969.83,,,0 CDM,3614322001,Hc Esophagoscopy Flexible Balloon Dilatation <30 Mm Diameter - Esophagoscopy,3706.5,1482.6,,,0 CDM,3614322901,Hc Esophagoscopy Flexible Transoral Lesion Ablation - Esophagoscopy,4633.11,1853.24,,,0 CDM,3614323102,Hc Esophagoscopy Flexible Transoral Ultrasound Exam - Esophagoscopy,3666.88,1466.75,,,0 CDM,3614323201,Hc Eus Endoscopic Ultrasound,3834.92,1533.97,,,0 CDM,3614323301,Hc Egd Esophagus Balloon Dilation 30 Mm Or Larger - Egd,3783.3,1513.32,,,0 CDM,3614323502,Hc Esophagogastroduodenoscopy Transoral Diagnostic - Egd,2100.51,840.2,,,0 CDM,3614323503,Hc Egd Transoral Diagnostic With Disposable Scope,2733.55,1093.42,,,0 CDM,3614323601,Hc Esophagogastroduodenoscopy Submucosal Injection - Egd,3314.0,1325.6,,,0 CDM,3614323701,Hc Esophagogastroduodenoscopy Us Scope W/Adj Strxrs - Egd,4120.59,1648.24,,,0 CDM,3614323801,Hc Egd Intrmural Us Needle Aspirate/Biopsy Esophags - Egd,3989.76,1595.9,,,0 CDM,3614323901,Hc Egd Transoral Biopsy Single/Multiple - Egd,3789.31,1515.72,,,0 CDM,3614324001,Hc Egd Transoral Transmural Drainage Pseudocyst - Endo Us (Upper),4311.44,1724.58,,,0 CDM,3614324101,Hc Edg Intraluminal Tube/Catheter Insertion,3684.89,1473.96,,,0 CDM,3614324201,Hc Egd Intrmural Needle Aspir/Biop Altered Anatomy - Egd,5047.21,2018.88,,,0 CDM,3614324301,Hc Egd Injection Sclerosis Esophgl/Gastric Varices - Egd,3946.55,1578.62,,,0 CDM,3614324401,Hc Egd Band Ligation Esophgeal/Gastric Varices - Egd,3947.75,1579.1,,,0 CDM,3614324501,Hc Egd Dilation Gastric/Duodenal Stricture - Egd,3844.52,1537.81,,,0 CDM,3614324601,Hc Egd Percutaneous Placement Gastrostomy Tube - Egd,3950.15,1580.06,,,0 CDM,3614324701,Hc Egd Flexible Foreign Body Removal,3600.87,1440.35,,,0 CDM,3614324801,Hc Egd Insert Guide Wire Dilator Passage Esophagus - Egd,3639.28,1455.71,,,0 CDM,3614324901,Hc Egd Balloon Dilation Esophagus <30 Mm Diam - Egd,3816.92,1526.77,,,0 CDM,3614325101,Hc Egd Removal Tumor Polyp/Other Lesion Snare Tech - Egd,4166.2,1666.48,,,0 CDM,3614325301,Hc Egd Us Guided Transmural Injxn/Fiducial Marker - Endo Us (Upper),3461.63,1384.65,,,0 CDM,3614325401,Hc Espgstrduodnscy Flx Trn W End,3514.45,1405.78,,,0 CDM,3614325501,Hc Egd Transoral Control Bleeding Any Method - Egd,3964.56,1585.82,,,0 CDM,3614325902,Hc Egd Us Exam Surgical Alter Stom Duodenum/Jejunum - Endo Us (Upper),4892.38,1956.95,,,0 CDM,3614326001,Hc Ercp Dx Collection Specimen Brushing/Washing - Ercp,6597.99,2639.2,,,0 CDM,3614326101,"Hc Ercp,Biopsy - Ercp",6197.09,2478.84,,,0 CDM,3614326201,"Hc Ercp,Sphincterotomy - Ercp",6876.45,2750.58,,,0 CDM,3614326301,Hc Ercp W/Pressure Measurement Sphincter Of Oddi - Ercp,6955.67,2782.27,,,0 CDM,3614326401,Hc Ercp Remove Calculi/Debris Biliary/Pancreas Duct - Ercp,6955.67,2782.27,,,0 CDM,3614326501,Hc Ercp Destruction/Lithotripsy Calculi Any Method - Ercp,7955.52,3182.21,,,0 CDM,3614326601,Hc Egd Endoscopic Stent Placement W/Wire& Dilation - Egd,8032.34,3212.94,,,0 CDM,3614327001,Hc Egd Ablate Tumor Polyp/Lesion W/Dilation& Wire - Egd,4845.56,1938.22,,,0 CDM,3614327301,Hc Ercp W/Cannulation Papilla +,5517.79,2207.12,,,0 CDM,3614327402,Hc Ercp Insrt Nasobil/Pan Drg Tub,8727.29,3490.92,,,0 CDM,3614327404,Hc Ercp Insrt Tb/Stnt->Bl/Pan Dct,8727.29,3490.92,,,0 CDM,3614327501,Hc Ercp Remove Foreign Body/Stent Biliary/Panc Duct - Ercp,7606.23,3042.49,,,0 CDM,3614327601,Hc Ercp Biliary/Panc Duct Stent Exchange W/Dil&Wire - Ercp,8402.02,3360.81,,,0 CDM,3614327701,Hc Ercp Balloon Dilate Biliary/Panc Duct/Ampulla Ea - Ercp,7521.01,3008.4,,,0 CDM,3614327801,Hc Ercp Tumor/Polyp/Lesion Ablation W/Dilation&Wire - Ercp,7643.44,3057.38,,,0 CDM,3614349901,Hc Unlisted Procedure Esophagus,1999.52,799.81,,,0 CDM,3614375201,Hc Placement Ng/Og Tube By Physician,1749.75,699.9,,,0 CDM,3614376101,"Hc Reposition Gastrostomy Tube - Gastrostomy Tube, Change / Reposition",3404.05,1361.62,,,0 CDM,3614376201,Hc Replacemet Gtube No Revj Trc,2015.98,806.39,,,0 CDM,3614399901,Hc Egd W/ Repair Of Fistula,1475.22,590.09,,,0 CDM,3614399902,Hc Ct Gastropexy,1723.72,689.49,,,0 CDM,3614436002,Hc Endoscopy Upper Small Intestine - Enteroscopy,4245.25,1698.1,,,0 CDM,3614436102,"Hc Small Bowel Endoscopy,Biopsy - Enteroscopy",4500.27,1800.11,,,0 CDM,3614436402,"Hc Sb Endoscopy,Rmvl Lesn,Snare - Enteroscopy",3584.0,1433.6,,,0 CDM,3614436602,"Hc Sb Endoscopy,W/Control,Bleeding - Enteroscopy",4783.63,1913.45,,,0 CDM,3614436902,"Hc Small Bowel Endoscopy,Ablate Lesn - Enteroscopy",1662.0,664.8,,,0 CDM,3614437202,"Hc Sb Scope,Place Percut Jejun Tube - Enteroscopy",4902.13,1960.85,,,0 CDM,3614437602,"Hc Sb Scope,To Ileum,Diagnostic - Enteroscopy",4891.82,1956.73,,,0 CDM,3614437702,"Hc Sb Scope,To Ileum,Biopsy - Enteroscopy",4574.98,1829.99,,,0 CDM,3614438001,Hc Ileoscopy Thru Stoma Dx W/Collj Spec When Prfmd - Enteroscopy,3531.7,1412.68,,,0 CDM,3614438201,"Hc Ileoscopy Thru Stoma,Biopsy - Enteroscopy",4023.71,1609.48,,,0 CDM,3614438501,Hc Ndsc Eval Intstinal Pouch Dx W/Collj Spec Spx - Enteroscopy,3563.9,1425.56,,,0 CDM,3614438601,Hc Ndsc Eval Intstinal Pouch W/Bx Single/Multiple - Enteroscopy,4151.22,1660.49,,,0 CDM,3614438801,Hc Colonoscopy Stm-Diag W/Wo Brush/Wash,3433.9,1373.56,,,0 CDM,3614438901,"Hc Colonoscopy Thru Stoma,Biopsy - Colonoscopy",3606.4,1442.56,,,0 CDM,3614439401,"Hc Colonoscopy Thru Stoma,Lession Remival W/Snare - Colonoscopy",3409.75,1363.9,,,0 CDM,3614440301,Hc Colonoscopy W/Resection,3544.3,1417.72,,,0 CDM,3614440401,Hc Colonoscopy Stoma W/Submucosal Injection - Colonoscopy,9416.2,3766.48,,,0 CDM,3614440501,Hc Colonoscopy Stoma W/Balloon Dilation - Colonoscopy,1639.9,655.96,,,0 CDM,3614450001,Hc Intro Long Gi Tube,2216.9,886.76,,,0 CDM,3614479901,Hc Unlisted Px Small Intest,2477.85,991.14,,,0 CDM,3614479902,Hc Unlisted Procedure Small Intestine,3717.49,1487.0,,,0 CDM,3614530001,"Hc Proctosigmoidoscopy,Rigid,Diagnos - Endoscopy Sigmoid",1805.5,722.2,,,0 CDM,3614533001,Hc Sigmoidoscopy Flex Diagnostic W/Collecting Spec Br/Wa If Pfrmd - Endoscopy Sigmoid,2665.7,1066.28,,,0 CDM,3614533101,"Hc Sigmoidoscopy,Biopsy - Endoscopy Sigmoid",2727.8,1091.12,,,0 CDM,3614533201,Hc Sigmoidoscopy Flex W/Rmvl Foreign Body - Endoscopy Sigmoid,2942.85,1177.14,,,0 CDM,3614533301,Hc Sigmoidoscopy Flx W/Rmvl Tumor By Hot Bx Forceps - Endoscopy Sigmoid,2671.45,1068.58,,,0 CDM,3614533401,Hc Sigmoidoscopy Flx Control Bleeding - Endoscopy Sigmoid,2845.0,1138.0,,,0 CDM,3614533501,"Hc Sigmoidoscopy,Flex,W/Dir Submuc Inject - Endoscopy Sigmoid",2647.3,1058.92,,,0 CDM,3614533701,Hc Peds-Sigmd Decomp Volvul,3490.25,1396.1,,,0 CDM,3614533801,"Hc Sigmoidoscopy,Removal Lesion,Snare - Endoscopy Sigmoid",3103.85,1241.54,,,0 CDM,3614534001,Hc Sigmoidoscopy Flex Tndsc Balo Dilat - Endoscopy Sigmoid,3458.05,1383.22,,,0 CDM,3614534101,Hc Sigmoidoscopy W/Endoscopic Us Exam - Endoscopy Sigmoid,3515.55,1406.22,,,0 CDM,3614534201,"Hc Sigmoidoscopy,Fine Needle Bioipsy,Us Guided - Endoscopy Sigmoid",3433.9,1373.56,,,0 CDM,3614534601,Hc Sigmoidoscopy Flx Ablation Tumor Polyp/Oth Les - Endoscopy Sigmoid,3161.35,1264.54,,,0 CDM,3614534701,Hc Sigmoidoscopy Flex Placement Of Endoscopic Stent - Endoscopy Sigmoid,4441.3,1776.52,,,0 CDM,3614534901,Hc Sigmd Flex W/Endo Mucosal Res,2819.0,1127.6,,,0 CDM,3614535001,Hc Sigmoid Flex W/ Band Ligation,2699.05,1079.62,,,0 CDM,3614537801,Hc Colonoscopy Flexible Diagnostic W/Collj Spec When Pfrmd - Colonoscopy,3635.15,1454.06,,,0 CDM,3614537902,Hc Colonoscopy Flexible W/Removal Of Foreign Body(S) - Colonoscopy,4099.75,1639.9,,,0 CDM,3614538001,Hc Colonoscopy W/Biopsy Single/Multiple - Colonoscopy,4146.9,1658.76,,,0 CDM,3614538101,Hc Colonoscopy Flexible With Directed Submucosal Njx Any Sbst - Colonoscopy,3689.2,1475.68,,,0 CDM,3614538201,Hc Colonoscopy Flexible W/Control Bleeding Any Method - Colonoscopy,3999.7,1599.88,,,0 CDM,3614538401,Hc Colposcopy Flexible W/Removal Lesion By Hot Biopsy Forceps - Colonoscopy,4319.4,1727.76,,,0 CDM,3614538501,Hc Colposcopy Flexible W/Rmvl Of Tumor Polyp Lesion Snare Tq - Colonoscopy,4246.95,1698.78,,,0 CDM,3614538601,Hc Colposcopy Flexible W/Transendoscopic Balloon Dilat - Colonoscopy,3636.3,1454.52,,,0 CDM,3614538801,Hc Colonoscopy Flexible Abl Tum/Pol/Ls Nt Sn,4318.25,1727.3,,,0 CDM,3614538901,Hc Colonoscopy Flexible With Endoscopic Stent Placement - Colonoscopy,5223.3,2089.32,,,0 CDM,3614539001,Hc Colonoscopy Flexible W/Endoscopic Mucosal Resection - Colonoscopy,4317.1,1726.84,,,0 CDM,3614539102,Hc Colonoscopy Flexible Endoscopy Us,3548.9,1419.56,,,0 CDM,3614539201,Hc Colonoscopy W/Endoscopic,4189.45,1675.78,,,0 CDM,3614539801,Hc Colonoscopy Flexible With Band Ligation(S) - Colonoscopy,4173.35,1669.34,,,0 CDM,3614605001,"Hc I&D Perianal Abscess,Superficial",3656.89,1462.76,,,0 CDM,3614622101,Hc Hemorrhoidectomy Internal Rubber Band Ligations,3486.11,1394.44,,,0 CDM,3614650501,Hc Chemodenervation Initial Sphincter,5747.18,2298.87,,,0 CDM,3614700001,Hc Needle Biopsy Liver,5768.31,2307.32,,,0 CDM,3614700101,Hc Bx Liver Not A Separate Procedure,3483.35,1393.34,,,0 CDM,3614738201,Hc Ct Guided Microwave Ablation Liver,14433.29,5773.32,,,0 CDM,3614738301,Hc Ablation 1/> Liver Tumor Perq Cryoablation,10873.63,4349.45,,,0 CDM,3614739901,Hc Ct Guided Alcohol Ablation Liver,2967.68,1187.07,,,0 CDM,3614749001,"Hc Cholecystostomy,Percutaneous, Complete",8622.91,3449.16,,,0 CDM,3614753101,Hc Njx Cholangio Prq W/Img Gid Rs&I Existing Access,4281.31,1712.52,,,0 CDM,3614753201,Hc Ptc Only,4974.26,1989.7,,,0 CDM,3614753301,Hc Palcement Of Drainage Catheter Of Biliary Duct With Image Guidance,11012.53,4405.01,,,0 CDM,3614753401,Hc Int/Ext Bili Drain,11094.58,4437.83,,,0 CDM,3614753501,Hc Convert Ext Bilateral Drg Cath To Int-Ext Bil Drg Cath,8706.23,3482.49,,,0 CDM,3614753601,Hc Exchange Biliary Drg Catheter Prq W/Img Gid Rs&I,9053.84,3621.54,,,0 CDM,3614753602,Hc Bili Drain Change,9053.84,3621.54,,,0 CDM,3614753701,Hc Removal Biliary Drg Catheter Req Fluor Gid Rs&I,4049.31,1619.72,,,0 CDM,3614753801,Hc Plmt Bile Duct Stent Prq Existing Access,17750.32,7100.13,,,0 CDM,3614753901,Hc Plmt Bile Duct Stent Prq New Access W/O Sep Cath,15227.64,6091.06,,,0 CDM,3614754201,Hc Balloon Dilation Biliary Duct/Ampulla Percutaneous Each Duct,2750.77,1100.31,,,0 CDM,3614754301,Hc Endoluminal Biopsy Of Biliary Tree,2156.0,862.4,,,0 CDM,3614754401,Hc Removal Biliary Duct &/Glbldr Calculi Perq Rs&I,5708.42,2283.37,,,0 CDM,3614799901,Hc Unlisted Procedure Biliary Tract,4234.6,1693.84,,,0 CDM,3614810201,Hc Needle Biopsy Of Pancreas,1686.25,674.5,,,0 CDM,3614899901,Hc Endo Necrosectomy Pancreas,1437.87,575.15,,,0 CDM,3614908201,Hc Abdominal Paracentesis Diagnosis/Therapy Without Imaging Guidance,2722.04,1088.82,,,0 CDM,3614908301,Hc Abdominal Paracentesis Diagnosis/Therapy W Imaging Guidance,4240.36,1696.14,,,0 CDM,3614908401,Hc Peritoneal Lavage W/Wo Imaging Guidance,2371.4,948.56,,,0 CDM,3614918001,"Hc Percut Biopsy, Abdominal Mass",4626.36,1850.54,,,0 CDM,3614918501,Hc Sclerotherapy Fluid Collection Prq W/Img Gid,2853.18,1141.27,,,0 CDM,3614940001,Hc Air/Contrast Inject Into Abdomen,1233.38,493.35,,,0 CDM,3614940201,Hc Remove Peritoneal Foreign Body,6733.29,2693.32,,,0 CDM,3614940501,Hc Image-Guide Fluid Collxn Drainage Cath Visc Perq,7694.98,3077.99,,,0 CDM,3614940601,Hc Img-Guide Fluid Collxn Drainag Cath Periton Perq,8180.49,3272.2,,,0 CDM,3614941801,Hc Insertion Tunnel Intraperitoneal Cath W Image Guidance,11968.61,4787.44,,,0 CDM,3614941901,Hc Insertion Tunnel Intraperitoneal Cath W Subq Port,9321.32,3728.53,,,0 CDM,3614942101,Hc Peritoneal Drain Placement,9430.45,3772.18,,,0 CDM,3614942201,Hc Removal Tunneled Intraperitoneal Catheter,7908.19,3163.28,,,0 CDM,3614942301,Hc Drainage Catheter Exchange,4756.04,1902.42,,,0 CDM,3614942401,"Hc Contrast Injection,Abscess/Cyst Via Cath Tube",924.0,369.6,,,0 CDM,3614944001,Hc Insert Gastrostomy Tube Percutaneous,6145.05,2458.02,,,0 CDM,3614944101,Hc Insert Duodenostomy/Jejunostomy Tube Percutaneous,6632.3,2652.92,,,0 CDM,3614944601,Hc Convert Gastrostomy-Gastro-Jejunostomy Tube Percutaneous,6630.62,2652.25,,,0 CDM,3614945001,Hc Replace Gastrostomy/Cecostomy Tube Percutaneous,3330.38,1332.15,,,0 CDM,3614945101,Hc Replace Duodenostomy/Jejunostomy Tube Percutaneous,3785.82,1514.33,,,0 CDM,3614945201,Hc Replacement Gastro-Jejunostomy Tube Percutaneous,3785.82,1514.33,,,0 CDM,3614946501,Hc Contrast Injection Percutaneouos Radiologic Eval Gi Tube,1736.36,694.54,,,0 CDM,3614999901,Hc Exchg Tunnel Abd Drain W/ Guid,1355.99,542.4,,,0 CDM,3614999904,Hc Ct Ablation Of Abdominal Wall,18262.83,7305.13,,,0 CDM,3615020001,Hc Biopsy Of Kidney Percutaneious-Unilateral,5768.31,2307.32,,,0 CDM,3615038203,"Hc Change Ureter Stent, Percutaneous",7816.09,3126.44,,,0 CDM,3615038401,"Hc Remove Ureter Stent, Percut",7265.22,2906.09,,,0 CDM,3615038601,Hc Remove Ureteral Stent Via Transureth,5564.9,2225.96,,,0 CDM,3615038701,Hc Removal & Replacement External Accessible Nephrourtrl Cath,5421.7,2168.68,,,0 CDM,3615038901,Hc Remove Renal Tube W/Fluoro-Unilateral,2512.32,1004.93,,,0 CDM,3615039001,Hc Ct Guided Asp Renal Cyst-Bilateral,6096.49,2438.6,,,0 CDM,3615039002,Hc Ct Guided Asp Renal Cyst-Unilateral,4063.77,1625.51,,,0 CDM,3615043001,Hc Injection Px Anteegrade Nfrosgrm &/Uretragram Existing Access-Unilateral,3088.62,1235.45,,,0 CDM,3615043101,Hc Injection Px Anteegrade Nfrosgrm &/Uretragram Existing Access-Unilateral,3088.62,1235.45,,,0 CDM,3615043201,Hc Plmt Nephrostomy Cath Prq New Access Rs&I-Bilateral,12156.54,4862.62,,,0 CDM,3615043202,Hc Guided Neph Tube Placement-Unilateral,8102.93,3241.17,,,0 CDM,3615043301,Hc Plmt Nephroureteral Cath Prq New Access Rs&I,8229.33,3291.73,,,0 CDM,3615043401,Hc Convert Nephrostomy Cath To Nephrourtrl Cath Prq,4271.95,1708.78,,,0 CDM,3615043501,Hc Exchange Nephrostomy Catheter Prq W/Img Gid Rs&I,8825.76,3530.3,,,0 CDM,3615043502,Hc Exchange Nephrostomy Catheter Prz W/Img Gid Rs&I-Bilateral,13239.49,5295.8,,,0 CDM,3615043601,Hc Dilat Xst Trc Ndurlgc Px,5761.54,2304.62,,,0 CDM,3615059201,Hc Ct Guided Microwave Ablation Renal-Bilateral,16378.99,6551.6,,,0 CDM,3615059202,Hc Ct Guided Microwave Ablation Renal-Unilateral,10920.44,4368.18,,,0 CDM,3615059301,Hc Ct Guided Cryoablation Renal- Bilateral,31934.16,12773.66,,,0 CDM,3615059302,Hc Ct Guided Cryoablation Renal-Unilateral,21288.32,8515.33,,,0 CDM,3615068801,Hc Rt Int To Ext Uert Via Il Cond,5106.92,2042.77,,,0 CDM,3615069001,Hc Injection Procedure Visual Ileal Conduit,1175.94,470.38,,,0 CDM,3615069301,Hc Plmt Urethral Stent Prq Pre-Existing Nfros Tract,10351.15,4140.46,,,0 CDM,3615070601,Hc Balloon Dilatation Ureteral Stricture W/Image Guidance Rs&I,2212.11,884.84,,,0 CDM,3615110201,Hc Aspiration Bladder Insert Suprapubic Catheter,3599.96,1439.98,,,0 CDM,3615160001,Hc Injection For Bladder X-Ray,1098.66,439.46,,,0 CDM,3615161001,Hc Inject For Retrograde Urethocysto W/ Disposable Scope,1463.95,585.58,,,0 CDM,3615179802,"Hc Meas, Post-Void Res, Us, Non-Imaging Poct",627.9,251.16,,,0 CDM,3615406001,Hc Excision Of Penis Lesion,5135.0,2054.0,,,0 CDM,3615570601,Hc Prostate Saturation Sampling,5720.0,2288.0,,,0 CDM,3615742001,"Hc Colposcopy,Entire Vagina",1389.75,555.9,,,0 CDM,3615815001,Hc Hysterectomy After Delivery,6214.14,2485.66,,,0 CDM,3615834001,Hc Cath/Inject Hysterosalpingogram,861.67,344.67,,,0 CDM,3615860501,Hc Postpartum Bridge Tied Load,4080.81,1632.32,,,0 CDM,3615890002,Hc Ct Biopsy Of Ovaries Unilateral,5153.8,2061.52,,,0 CDM,3615901501,Hc Chorion Villus Biopsy,1699.52,679.81,,,0 CDM,3615916001,Hc Dilation And Curetrage,4871.68,1948.67,,,0 CDM,3616010001,Hc Biopsy Of Thyroid Percutaneious,2253.74,901.5,,,0 CDM,3616030001,Hc Aspiration And/Or Injection Thyroid Cyst,1950.0,780.0,,,0 CDM,3616162301,"Hc Endovasc Temp Balloon Occlus,Head/Neck",20634.38,8253.75,,,0 CDM,3616162401,"Hc Perm Occlusion/Embolization,Percut,Cns",35824.8,14329.92,,,0 CDM,3616162601,Hc Percut Cath Occlusn Non Cns Lesn,30590.43,12236.17,,,0 CDM,3616163001,Hc Intracranial Balloon Angioplasty,19914.73,7965.89,,,0 CDM,3616163501,Hc Intracranial Balloon Angioplsty W/Stent,21795.02,8718.01,,,0 CDM,3616164001,Hc Intracranl Plasty Vasosp Init,17745.71,7098.28,,,0 CDM,3616164501,Hc Perq Art Trluml M-Thrombec &/Nfs Intracranial,17298.98,6919.59,,,0 CDM,3616164701,Hc Bronchoscopy Occulusion & Insert Bronch Valve Initial Lobe,9338.0,3735.2,,,0 CDM,3616165001,Hc Evasc Intracranial Prolng Admn Rx Agent Art 1St,10281.99,4112.8,,,0 CDM,3616165101,Hc Evasc Intracranial Prolng Admn Rx Agent Art Additional,10281.99,4112.8,,,0 CDM,3616178301,"Hc Stereotactic Comp Assist Proc,Spinal",6472.2,2588.88,,,0 CDM,3616179001,Hc Treat Trigeminal Nerve,3674.45,1469.78,,,0 CDM,3616179101,Hc Treat Trigeminal Tract,4732.54,1893.02,,,0 CDM,3616226701,Hc Percut Aspiration Vertebral Disc,3663.58,1465.43,,,0 CDM,3616227001,"Hc Spinal Puncture,Lumbar,Diagnostic",2722.58,1089.03,,,0 CDM,3616227201,"Hc Spinal Puncture,Therapeutic Drainage",2466.39,986.56,,,0 CDM,3616227301,"Hc Injection,Lumbar Epidur,Blood/Clot Patch",3358.85,1343.54,,,0 CDM,3616228201,Hc Inj/Inf Epid Lumb/Sacral,3566.66,1426.66,,,0 CDM,3616228401,Hc Injection Procedure Myelography/Ct Lumbar,1956.47,782.59,,,0 CDM,3616230201,Hc Myelography Via Lumbar Injection Rs&I Cervical,5793.42,2317.37,,,0 CDM,3616230301,Hc Myelography Via Lumbar Injection Rs&I Thoracic,5793.42,2317.37,,,0 CDM,3616230401,Hc Myelography Via Lumbar Injection Rs&I Lumbosacral,5793.42,2317.37,,,0 CDM,3616230501,Hc Myelography Via Lumbar Injection Rs&I 2+ Regions,6297.42,2518.97,,,0 CDM,3616232201,Hc Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn,4110.65,1644.26,,,0 CDM,3616232301,Hc Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn,6910.25,2764.1,,,0 CDM,3616232801,Hc Lp-Diagnostic W/Fluor Or Ct,4756.97,1902.79,,,0 CDM,3616232901,Hc Lp-Therapeutic W/Fluor Or Ct,4756.97,1902.79,,,0 CDM,3616443001,Hc Ct Guided Inj Anes Pudendal Nerve-Bilateral,3412.42,1364.97,,,0 CDM,3616443002,Hc Ct Guided Inj Anes Pudendal Nerve-Unilateral,2275.51,910.2,,,0 CDM,3616444501,"Hc Injection,Anesthesia Agent,Sciatic Nerve,Single, Including Imaging Guidance, When Performed",4542.1,1816.84,,,0 CDM,3616444701,"Hc Injection,Anesthesia Agent,Femoral Nerve,Single,Including Imaging Guidance, When Performed",3636.24,1454.5,,,0 CDM,3616445001,"Hc Injection Nerve Block,Othrr Peripheral Nerve",3260.06,1304.02,,,0 CDM,3616445002,"Hc Injection Nerve Block,Other Periph Nerve",2171.7,868.68,,,0 CDM,3616445501,Hc Injection Anesthesia/Steroid Plantar Common Digital Nerve-Unilateral,1028.08,411.23,,,0 CDM,3616445502,Hc Injection Anesthesia/Steroid Plantar Common Digital Nerve-Bilateral,1430.09,572.04,,,0 CDM,3616446102,Hc Hpvb Thoracic Single Injection Site W/Img Gid Unilateral,3146.2,1258.48,,,0 CDM,3616446202,Hc Pvb Thoracic Second & Addl Inj Site W/Img Gid Unilateral,4847.39,1938.96,,,0 CDM,3616446302,Hc Pvb Thoracic Cont Catheter Infusion W/Img Gid Unilateral,4847.39,1938.96,,,0 CDM,3616447902,Hc Ct Guided Inj Anes Epidural Transforminal Csp Tsp 1 Level-Unilateral,3646.84,1458.74,,,0 CDM,3616448002,Hc Ct Guided Inj Anes Epidural Transforminal Csp Tsp Each Additional Level-Unilateral,2551.78,1020.71,,,0 CDM,3616448301,Hc Ct Guided Inj Anes Epidural Transforminal Lsp Sac 1 Level-Bilateral,6096.49,2438.6,,,0 CDM,3616448302,Hc Ct Guided Inj Anes Epidural Transforminal Lsp Sac 1 Level-Unilateral,4063.77,1625.51,,,0 CDM,3616448402,"Hc Ct Injection Anesthesia/Steroid Foramen Lumbar/Sacral W Imagine Guidance ,Each Additional Level-U",2890.02,1156.01,,,0 CDM,3616448702,Hc Tap Block By Continuous Infusion(S)-Unilateral,1614.12,645.65,,,0 CDM,3616449001,Hc Ct Guided Inj Facet Csp Tsp 1 Level-Bilateral,6585.41,2634.16,,,0 CDM,3616449002,Hc Ct Guided Inj Facet Csp Tsp 1 Level-Unilateral,4390.28,1756.11,,,0 CDM,3616449102,Hc Ct Guided Inj Facet Csp Tsp 2Nd Level-Unilateral,3631.77,1452.71,,,0 CDM,3616449301,Hc Ct Guided Inj Facet Lsp Sacrum-Bilateral,6793.05,2717.22,,,0 CDM,3616449302,Hc Ct Guided Inj Facet Lsp Sacrum-Unilateral,4529.25,1811.7,,,0 CDM,3616449402,Hc Ct Guided Inj Facet Lsp Sacrum 2Nd Level-Unilateral,3469.36,1387.74,,,0 CDM,3616449502,Hc Ct Guided Inj Facet Lsp Sacrum 3 Or More Levels-Unilateral,3328.7,1331.48,,,0 CDM,3616453001,"Hc Inject Nerv Blck,Celiac Plexus",3176.21,1270.48,,,0 CDM,3616455301,Hc Perc Impl Neuroelectrds Cran,22451.0,8980.4,,,0 CDM,3616455501,Hc Percutaneous Implantation Of Neurostimulator Electrode Array,11702.86,4681.14,,,0 CDM,3616460001,Hc Destruction Of First Division Of Face Nerve Branch,3782.35,1512.94,,,0 CDM,3616460501,Hc Destruction Of Face Nerve Branch Under Xray Monitoring,5456.75,2182.7,,,0 CDM,3616463501,Hc Ct Guided Inj Destruct Facet Lsp Sac 1 Level-Bilateral,9121.36,3648.54,,,0 CDM,3616463502,Hc Ct Guided Inj Destruct Facet Lsp Sac 1 Level-Unilateral,6081.86,2432.74,,,0 CDM,3616468001,Hc Inject Rx Celiac Plexus Nerve,5451.85,2180.74,,,0 CDM,3616499901,Hc Nervous System Surgery Unlisted,1746.81,698.72,,,0 CDM,3616499902,Hc Rf Ablation Trigeminal Nerve,1746.81,698.72,,,0 CDM,3616521001,"Hc Removal Foreign Body,Eye,Embed Conjunction",964.28,385.71,,,0 CDM,3616543001,Hc Corneal Smear,1666.92,666.77,,,0 CDM,3616543501,Hc Curette/Treat Cornea,2167.75,867.1,,,0 CDM,3616577801,Hc Place Amniotic Membrane Ocular Surface W/O Sutures,4779.52,1911.81,,,0 CDM,3616580001,Hc Aspiration Of Eye Fluid,2190.18,876.07,,,0 CDM,3616585501,Hc Trabeculoplasty By Laser Surgery,2557.94,1023.18,,,0 CDM,3616602001,Hc Injection Treatment Of Eye-Air Or Liquid,1296.16,518.46,,,0 CDM,3616676101,"Hc Iridotomy/Iridectomy By Laser, Per Session",2586.35,1034.54,,,0 CDM,3616682101,"Hc Discission,2Nd Cataract,Laser",1868.75,747.5,,,0 CDM,3616701501,Hc Aspiration/Release Vitreous Subretinal/Choroidal,7893.6,3157.44,,,0 CDM,3616703101,"Hc Laser Surgery,Sever Vitreous Strands",2653.62,1061.45,,,0 CDM,3616710801,Hc Rpr Retinal Dtchmnt W/Vitrectomy Any Meth,18091.0,7236.4,,,0 CDM,3616711001,"Hc Repair Detacted Retina, Injection Air/Gas-Unilateral",6111.56,2444.62,,,0 CDM,3616714101,Hc Prophylaxis Retina Detachment Cryotherapy/Diathermy,2130.38,852.15,,,0 CDM,3616714501,"Hc Prophylaxis Retina Detachment, Photocoagulation",3570.06,1428.02,,,0 CDM,3616721001,"Hc Destruction Of Retinal Lesion,Photocoagulation",3501.29,1400.52,,,0 CDM,3616722001,"Hc Destruction,Choroid Lesion,Photocoagulation",2915.25,1166.1,,,0 CDM,3616722101,"Hc Destruction,Choroid Lesion,Photodynamic Therapy",1210.95,484.38,,,0 CDM,3616722801,Hc Treatment Extensive Retinopathy Photocoagulation,2645.55,1058.22,,,0 CDM,3616751501,"Hc Injection,Treatment Eye Socket",1457.62,583.05,,,0 CDM,3616770001,Hc Drainage Of Eyelid Abscess,1438.31,575.32,,,0 CDM,3616771001,Hc Incision Of Eyelid,1569.75,627.9,,,0 CDM,3616771501,Hc Incision Of Eyelid Fold,4218.89,1687.56,,,0 CDM,3616780001,"Hc Excision Chalazion,Single",1674.4,669.76,,,0 CDM,3616780501,"Hc Excision Chalazion,Multiple, Both Lids",1838.85,735.54,,,0 CDM,3616781001,Hc Incisional Biopsy Eyelid Skin & Lid Margin,1831.38,732.55,,,0 CDM,3616782001,"Hc Revise Eyelashes,Forceps",813.28,325.31,,,0 CDM,3616782501,Hc Revise Eyelashes,1405.3,562.12,,,0 CDM,3616784001,Hc Remove Eyelid Lesn (Not Chalazion),3471.39,1388.56,,,0 CDM,3616785001,"Hc Destruction Eyelid Lesion, <1 Cm",3649.3,1459.72,,,0 CDM,3616787501,Hc Temporary Closure Eyelid By Suture,4118.72,1647.49,,,0 CDM,3616793501,"Hc Suture Eyelid Wound,Full Thick",578.56,231.42,,,0 CDM,3616802001,Hc Incise/Drain Conjunctiva,3641.82,1456.73,,,0 CDM,3616820001,Hc Subconjunctival Injection,665.28,266.11,,,0 CDM,3616876101,"Hc Close Tear Duct Opening By Plug,Each",1681.88,672.75,,,0 CDM,3616881001,Hc Probe Nasolacrimal Duct,1068.92,427.57,,,0 CDM,3616881501,"Hc Probe Nasolac Duct,Insert Tube/Stent",197.34,78.94,,,0 CDM,3616943601,Hc Tympanostomy General Anesthesia Bilateral,6110.0,2444.0,,,0 CDM,3616943602,Hc Tympanostomy General Anesthesia Unilateral,5330.0,2132.0,,,0 CDM,3617880801,Hc Nm Inj Proc Parathyroid,901.6,360.64,,,0 CDM,3619297201,Hc Percutaneous Transluminal Coronary Lithotripsy,3864.0,1545.6,,,0 CDM,3619326101,Hc Interrogation Eval F2F Implant Subq Lead Defib,1350.0,540.0,,,0 CDM,3619356901,Hc Injection For Selective Imaging Of Pulmonary Artery During Heart Cath-Unilateral,1007.56,403.02,,,0 CDM,3619357301,Hc Injection For Selective Miaging Of Pulmonary Artery During Heart Catheterization-Bilateral,15991.87,6396.75,,,0 CDM,3619357401,Hc Injection For Selective Imaging Of Pulmonary Vein During Heart Cath,3437.19,1374.88,,,0 CDM,3619357501,Hc Injection Of Major Aortopulmonary Collatral Arteries During Heart Catheterization,2750.95,1100.38,,,0 CDM,3619359001,Hc Catheter Percutaneous Transcatheter Closure Paravalve Leak One Mitral Valve,27505.7,11002.28,,,0 CDM,3619359101,Hc Catheter Percutaneous Transcatheter Closure Paravalvular Leak One Aortic Valve,27505.7,11002.28,,,0 CDM,3619379901,Hc Procainamide Challenge,834.53,333.81,,,0 CDM,3619379902,Hc Cr Procainamide Challenge,834.53,333.81,,,0 CDM,3619379907,Hc Vein Of Marshall Ethanol Infusion For Persistent Atrial Fibrillation,1078.04,431.22,,,0 CDM,3619379908,Hc Ecmo Reposition Cannula 6Yr+,1089.47,435.79,,,0 CDM,3619379909,Hc Ecmo Inserton 6+,1081.47,432.59,,,0 CDM,3619379910,Hc Ifr W/Wo Cath Procedure,866.54,346.62,,,0 CDM,3619379911,Hc Cardiomems Recalibration,338.39,135.36,,,0 CDM,3619379912,Hc Lvad Ramp Study,970.57,388.23,,,0 CDM,3619379913,Hc Percutaneous Ao Valve Repair With Implant,1662.21,664.88,,,0 CDM,3619379914,Hc Vsd Closure Non-Congen Percut,2370.99,948.4,,,0 CDM,3619379915,Hc Ifr Of Coronary Artery,18620.4,7448.16,,,0 CDM,3619379917,Hc Icd Used For Arrhythmia (Nips),760.23,304.09,,,0 CDM,3619379918,Hc Aorto- Atrium Fistula Closure,12707.79,5083.12,,,0 CDM,3619379919,Hc Repair Of Residual Leak Around Patent Foramen Ovale,38157.65,15263.06,,,0 CDM,3619652301,Hc Irrig Implanted Drug Delivery Device,290.95,116.38,,,0 CDM,3619654901,Hc Intratumoral Injection Oncolytic Virus Asp9801,454.25,181.7,,,0 CDM,361C976501,Hc Revasc Intra Lithotrip-Stent,5462.5,2185.0,,,0 CDM,361C978001,Hc Inout Cv Tunl Insrt 5+Yr,20720.7,8288.28,,,0 CDM,361C979701,Hc Vasc Emb/Occ W/Prs Cath,27072.55,10829.02,,,0 CDM,361G010401,Hc Colorectal Cancer Screening-Flexible Sigmoidscope,1761.8,704.72,,,0 CDM,361G010501,Hc Colorectal Scrn; Hi Risk Ind,3141.8,1256.72,,,0 CDM,361G012101,Hc Colon Ca Scrn Not Hi Rsk Ind,3141.8,1256.72,,,0 CDM,361G026001,Hc Ct Guided In Anes Sacroiliac Joint-Bilateral,4666.56,1866.62,,,0 CDM,361G026002,Hc Ct Guided In Anes Sacroiliac Joint-Unilateral,3109.37,1243.75,,,0 CDM,361G026901,Hc Closure Device Placement,1917.19,766.88,,,0 CDM,361G045501,Hc Fecal Transplant Prep/Install,2042.17,816.87,,,0 CDM,3623824001,Hc Stem Cell Transplant Allogenic,13934.85,5573.94,,,0 CDM,3623824101,Hc Trnsplant Autologous Hematopoietic Cells Per Donor,10928.39,4371.36,,,0 CDM,3623824102,Hc Stem Cell Transplant Autologou,9661.46,3864.58,,,0 CDM,3623824201,Hc Allogeneic Lymphocyte Infusions,4706.35,1882.54,,,0 CDM,3700000001,Hc General Anesthesia Initial,3246.2,1298.48,,,0 CDM,3700000002,Hc General Ct Anesthesia Initial,5578.14,2231.26,,,0 CDM,3700000003,Hc General Trauma Anesthesia Time Initial,6166.92,2466.77,,,0 CDM,3700000004,Hc Anesthesia Cranial/Neurology Initial,12153.43,4861.37,,,0 CDM,3700000005,Hc General Neurology Anesthesia Initial,5739.05,2295.62,,,0 CDM,3700000007,Hc Non-Or/Safa/Mac Initial,2913.41,1165.36,,,0 CDM,3700000008,Hc Anesthesia General Safari Initial,2882.94,1153.18,,,0 CDM,3700000009,Hc Anesthesia Liver Each 1 Minute,21.48,8.59,,,0 CDM,3700000010,Hc Default Anesthesia Time - Each Incremental 1 Minute,18.1,7.24,,,0 CDM,3700000011,Hc Anesthesia Ct Each 1 Minute,17.19,6.88,,,0 CDM,3700000012,Hc Anesthesia General Each 1 Minute,12.01,4.8,,,0 CDM,3700000013,Hc Non-Or/Safa/Mac Each 1 Minute,8.59,3.44,,,0 CDM,3700000014,Hc Anesthesia Epidural Block Charge,1271.42,508.57,,,0 CDM,3700000015,Hc Anesthesia Trauma Each 1 Minute,17.19,6.88,,,0 CDM,3700000039,Hc Sedation For Surgery,3021.9,1208.76,,,0 CDM,3700000040,Hc Anesthesia General C-Section,3021.9,1208.76,,,0 CDM,3700000041,Hc C-Section Epidural & Spinal,2756.16,1102.46,,,0 CDM,3700000042,Hc Labor Epidural & Spinal,2601.35,1040.54,,,0 CDM,3700000043,Hc Spinal For Surgery,2462.38,984.95,,,0 CDM,3700000044,Hc C-Section Epidural,1431.11,572.44,,,0 CDM,3700000049,Hc Cas General Anesthesia Or 1St 30 Minutes,4192.14,1676.86,,,0 CDM,3700000078,Hc Anesthesia Cranial/Neurology Each Additional 1 Minute,17.19,6.88,,,0 CDM,3700000091,Hc Non-Or/Safa/Mac 1St 30 Minutes,2548.93,1019.57,,,0 CDM,3706444801,"Hc Inj,Anes Agent,Femoral Nerve,Cont Inf",2508.61,1003.44,,,0 CDM,3710000037,Hc Anesthesia Radiology Each 1 Minute,18.1,7.24,,,0 CDM,3710000077,Hc Anesthesia Radiology Initial,778.94,311.58,,,0 CDM,3719915101,Hc Moderate Sedation Same Physician/Qualified Health Professional Initial 15 Minutes <5 Years,110.51,44.2,,,0 CDM,3719915201,Hc Moderate Sedation Same Physician/Qualified Health Professional Initial 15 Minutes 5/> Years,110.51,44.2,,,0 CDM,3719915301,Hc Moderate Sedation Same Physician/Qualified Health Professional Each Additional 15 Minutes,53.59,21.44,,,0 CDM,3719915501,Hc Moderate Sedation Other Physician/Qualified Health Professional Initial 15 Minutes <5 Years,110.51,44.2,,,0 CDM,3719915601,Hc Moderate Sedation Other Physician/Qualified Health Professional Initial 15 Minutes 5/> Years,110.51,44.2,,,0 CDM,3719915701,Hc Moderate Sedation Other Physician/Qualified Health Professional Each Additional 15 Minutes,43.16,17.26,,,0 CDM,3720000038,Hc Anesthesia Diagnostic Each 1 Minute,18.1,7.24,,,0 CDM,3720000045,Hc Anesthesia Diagnostic Initial,778.94,311.58,,,0 CDM,3720199901,Hc Administration Of Nitrous Oxide,321.42,128.57,,,0 CDM,372G050001,Hc Moderate Sedation Endoscopy Service >5Yrs,110.51,44.2,,,0 CDM,3749781001,Hc Acupuncture W/O Electric Stimulation 15 Minutes,217.67,87.07,,,0 CDM,3749781101,Hc Acupuncture W/O Electric Stimulation Additional 15 Minutes,162.42,64.97,,,0 CDM,3749781301,Hc Acupuncture With Electric Stimulation First 15 Mins,217.67,87.07,,,0 CDM,3749781401,Hc Acupuncture W Stimulation Additional 15 Minutes,162.42,64.97,,,0 CDM,3900000001,Hc Research Chips Study Product Processing Fee,19.5,7.8,,,0 CDM,390P901001,Hc Whole Blood-Kbc,865.65,346.26,,,0 CDM,390P901101,Hc Pedi Pheresis Platelet,1080.06,432.02,,,0 CDM,390P901102,Hc Pedi-Rbc L/R 1/2 Unit,369.93,147.97,,,0 CDM,390P901103,Hc Pedi-Rbc L/R 1-30Ml,347.56,139.02,,,0 CDM,390P901105,Hc Pedi-Plasma 31-60Ml,278.96,111.58,,,0 CDM,390P901201,Hc Cryoprecipitate Ahf Ea,339.6,135.84,,,0 CDM,390P901202,Hc Cryoprecipitate-5 Pooled,1091.58,436.63,,,0 CDM,390P901204,Hc Cryoprecipitate-Single Unit,256.19,102.48,,,0 CDM,390P901601,Hc Red Blood Cells Leuko Red-Ckbc,1287.41,514.96,,,0 CDM,390P901602,Hc Rare Rbc L/R-Ckbc,1369.33,547.73,,,0 CDM,390P901703,Hc Fresh Frozen Plasma-Ckbc,266.83,106.73,,,0 CDM,390P901704,Hc Jumbo Fresh Frozen Plasma-Ckbc,470.59,188.24,,,0 CDM,390P902101,Hc Red Blood Cells-Ckbc,1287.41,514.96,,,0 CDM,390P902201,Hc Washed Red Cells-Ckbc,1342.44,536.98,,,0 CDM,390P903102,Hc Platelet-Pooled Lr Ea-Kbc,1080.06,432.02,,,0 CDM,390P903501,Hc Platelet Pheresis Leukored-Ckb,3702.26,1480.9,,,0 CDM,390P903503,Hc Research Chips Cold Stored Platelets,0.01,0.004,,,0 CDM,390P903504,Hc Research Chips Study Product Processing Fee,18.19,7.28,,,0 CDM,390P903505,Hc Platelet Pheresis Leukored-Ckbc #2-So+,3163.2,1265.28,,,0 CDM,390P903701,"Hc Platelet Pheresis Leukored Irr, Each Unit",2715.13,1086.05,,,0 CDM,390P903901,Hc Red Blood Cells Degly-Ckbc,1895.65,758.26,,,0 CDM,390P903902,Hc Rare Degly Rbc-Ckbc,2084.6,833.84,,,0 CDM,390P904002,Hc Red Blood Cells-Lr-Irr-Ckbc,1944.89,777.96,,,0 CDM,390P904401,Hc Plasma Cryo Reduced,266.83,106.73,,,0 CDM,390P905001,Hc Granulocyte Pheresis - Ckbc,2339.0,935.6,,,0 CDM,390P905201,"Hc Platelet, Hla-M, L/R, Irrad, Unit",2317.62,927.05,,,0 CDM,3910540T01,Hc Car-T Cell Adm-Inf Autologous,1566.0,626.4,,,0 CDM,3913643001,Hc Blood Transfusion Service,3938.19,1575.28,,,0 CDM,3913645001,Hc Exchange Transfus-Nbn,3378.5,1351.4,,,0 CDM,3913899901,Hc Cnty-101 Administration,1746.47,698.59,,,0 CDM,3913899902,Hc T-Cell Administration Of Amtagvi,1746.47,698.59,,,0 CDM,4017706101,Hc Mammogram Breast Diagnostic Tomosynthesis-Unilateral,128.0,51.2,,,0 CDM,4017706201,Hc Mammogram Breast Diagnostic Tomosynthesis-Bilateral,192.0,76.8,,,0 CDM,4017706501,"Hc Dx Mammogram Including Cad - Mammogram Diagnostic,Additional,Post Views",518.0,207.2,,,0 CDM,4017706503,Hc Dx Mammogram Including Cad- Mammogram Breast Post Biopsy Clip-Unilateral,518.0,207.2,,,0 CDM,4017706504,"Hc Dx Mammogram Including Cad - Mammogram Diagnostic,Additional,Post Views-Unilateral",518.0,207.2,,,0 CDM,4017706505,Hc Dx Mammogram Including Cad-Unilateral,518.0,207.2,,,0 CDM,4017706601,Hc Dx Mammogram Including Cad Bilateral - Mammogram Breast Bilateral Post Biopsy Clip,576.0,230.4,,,0 CDM,4017706602,Hc Dx Mammogram Including Cad Bilateral - Mammogram Breast Diagnostic Bilateral,576.0,230.4,,,0 CDM,401G027901,Hc Tomo Diagnostic,128.0,51.2,,,0 CDM,4025901201,Hc Pub/Cordocentesis,1594.03,637.61,,,0 CDM,4027598901,Hc Abscess Drainage Under X-Ray - Us Guided Abscess Drain,2058.56,823.42,,,0 CDM,4027637601,Hc Echo 3D Render W/Interpertation Postprocess Not On An Independent Workstation,1365.0,546.0,,,0 CDM,4027650602,"Hc Us, Head, Real Time - Us Head",1030.32,412.13,,,0 CDM,4027651205,"Hc Chg Us, Eye B-Scan - B Scan Ultrasound-Ou-Both Eyes Poct-Bilateral",345.44,138.18,,,0 CDM,4027651301,"Hc Us, Eye,Anterior - Us Eye Anterior",722.88,289.15,,,0 CDM,4027651401,"Hc Us, Eye, For Corneal Thickness - Us Exam Of Eye Thickness",73.89,29.56,,,0 CDM,4027651601,"Hc Us, Eye Biometry - Us Eye Biometry",423.02,169.21,,,0 CDM,4027651901,Hc Echo Exam Of Eye - Us Eye Biometry W Intraocular Lens Calculation,696.1,278.44,,,0 CDM,4027652901,"Hc Us, Eye F.B. Localization - Us Eye Foreign Body Localization",236.29,94.52,,,0 CDM,4027653601,"Hc Us, Head/Neck Tissues,Real Time - Us Thyroid",1119.08,447.63,,,0 CDM,4027653605,"Hc Us, Head/Neck Tissues,Real Time - Us Head Neck Soft Tissue",1119.08,447.63,,,0 CDM,4027653606,Hc Poct Us Soft Tissue Head/Neck,333.44,133.38,,,0 CDM,4027660401,"Hc Chg Us, Chest,Real Time",810.82,324.33,,,0 CDM,4027660402,"Hc Poct Us Charge Us, Chest,Real Time",242.29,96.92,,,0 CDM,4027664102,Hc Ultrasound Breast Complete - Unilateral,953.55,381.42,,,0 CDM,4027664201,Hc Ultrasound Breast Limited - Us Breast Limited,913.97,365.59,,,0 CDM,4027664202,Hc Ultrasound Breast Limited - Us Breast Right Limited,913.97,365.59,,,0 CDM,4027664203,Hc Ultrasound Breast Limited - Us Breast Bilateral Limited,1370.96,548.38,,,0 CDM,4027670001,"Hc Us, Abdomen,B-Scan &/Or Real Time,Complete - Us Abdomen",1787.16,714.86,,,0 CDM,4027670501,"Hc Chg Us, Abdomen Limited",1379.35,551.74,,,0 CDM,4027670502,Hc Poct Us Soft Tissue-Abd/Back,365.83,146.33,,,0 CDM,4027670503,"Hc Us, Abdomen Limited - Us Abdomen Limited Liver",1379.35,551.74,,,0 CDM,4027670504,"Hc Us, Abdomen Limited - Us Abdomen Limited Liver-Poct",1379.35,551.74,,,0 CDM,4027670505,"Hc Us, Abdomen Limited - Us Gallbladder",1379.35,551.74,,,0 CDM,4027670506,"Hc Us, Abdomen Limited - Us Abdomen Limited",1379.35,551.74,,,0 CDM,4027670601,Hc Us Abdl Aorta Screen Aaa - Us Abdomen Aortic Aneurysm Screening,454.59,181.84,,,0 CDM,4027670602,Hc Us Abdominal Aorta Aneurysm Screening Poct,454.59,181.84,,,0 CDM,4027677001,"Hc Us,Retroperit, B-Scan/Real Time,Complete - Us Renal Complete",1427.33,570.93,,,0 CDM,4027677002,"Hc Us,Retroperit, B-Scan/Real Time,Complete - Us Retroperitoneum",1427.33,570.93,,,0 CDM,4027677501,"Hc Chg Us, Retroperitional Abdominal, Limited",1163.45,465.38,,,0 CDM,4027677502,Hc Ultrasound Retroperitional Abdominal-Limited-Poct,363.43,145.37,,,0 CDM,4027677601,"Hc Us,Transplanted Kidney, Real Time/ Doppler - Us Kidney Transplant",1355.36,542.14,,,0 CDM,4027680001,"Hc Us, Spinal Canal & Contents - Us Spinal Canal And Contents",953.55,381.42,,,0 CDM,4027680101,Hc Ultrasound Ob < 14 Weeks-Single Fetus,929.56,371.82,,,0 CDM,4027680201,"Hc Chg Us, Ob < 14 Weeks, Additional Fetus",648.9,259.56,,,0 CDM,4027680501,Hc Ultrasound Ob >/= 14 Weeks-Single Fetus,1294.19,517.68,,,0 CDM,4027681001,Hc Ultrasound Ob >/= 14 Weeks-Additional Fetus,1095.09,438.04,,,0 CDM,4027681101,Hc Ob Us Detailed Sngle Fetus - Us Ob Detail Fetal Anat Single Or 1St Gestation,1411.74,564.7,,,0 CDM,4027681201,Hc Ob Us Detailed Additional Fetus - Us Ob Detail Fetal Anat Each Additional Gestation,874.39,349.76,,,0 CDM,4027681301,"Hc Us,Preg Uter,Nuchal Meas, 1St Trimest, Singleton",788.03,315.21,,,0 CDM,4027681303,"Hc Us,Preg Uter,Nuchal Meas, 1St Trimest, Singleton",788.03,315.21,,,0 CDM,4027681401,"Hc Us,Preg Uter,Nuchal Meas, 1St Tri,Addl Gest",484.57,193.83,,,0 CDM,4027681402,"Hc Us,Preg Uter,Nuchal Meas, 1St Tri,Addl Gest",484.57,193.83,,,0 CDM,4027681501,Hc Ultrasound Pregnant Uterus-Limited 1/> Fetuses,924.77,369.91,,,0 CDM,4027681502,Hc Poct Us Ed Pregnancy (Ta),284.27,113.71,,,0 CDM,4027681603,Hc Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach,916.37,366.55,,,0 CDM,4027681701,Hc Ultrasound Pregnant Uterus-Transvaginal,848.0,339.2,,,0 CDM,4027681702,"Hc Chg Us,Pregnant Uterus,Transvaginal-Poct",284.27,113.71,,,0 CDM,4027681801,Hc Fetal Biophysical Profile,1192.24,476.9,,,0 CDM,4027681901,Hc Fetal Biophysical Profile Wo Non-Stress Testing,1043.51,417.4,,,0 CDM,4027682001,Hc Doppler Fetal Umbilical Artery,618.7,247.48,,,0 CDM,4027682002,Hc Doppler Fetal Umbilical Artery,692.94,277.18,,,0 CDM,4027682101,Hc Doppler Fetal Mid Cerebral Artery,698.1,279.24,,,0 CDM,4027682103,Hc Doppler Fetal Mid Cerebral Artery,698.1,279.24,,,0 CDM,4027682501,Hc Sono Fetal Heart,1878.32,751.33,,,0 CDM,4027682601,Hc Sono Fetal Heart F/U,1163.45,465.38,,,0 CDM,4027682701,Hc Sono Fetal Heart Doppler,1030.32,412.13,,,0 CDM,4027682801,Hc Sono Fetal Hrt Doppl F/U,566.13,226.45,,,0 CDM,4027683001,Hc Echography Transvaginal,1174.25,469.7,,,0 CDM,4027683002,"Hc Chg Echography,Transvaginal-Poct",357.43,142.97,,,0 CDM,4027685601,"Hc Echo,Pelvic (Nonobstetric) - Us Pelvis",1459.72,583.89,,,0 CDM,4027685701,Hc Sono Pelvis Limited,1085.49,434.2,,,0 CDM,4027685702,Hc Sono Pelvis Limited - Us Pelvis Limited Follicles,365.83,146.33,,,0 CDM,4027685703,Hc Sono Pelvis Limited - Us Pelvis Limited,1085.49,434.2,,,0 CDM,4027687001,"Hc Chg Echo,Scrotum & Contents",1254.61,501.84,,,0 CDM,4027687002,"Hc Chg Echo, Scrotum & Contents Poct",1254.61,501.84,,,0 CDM,4027687201,"Hc Echo,Transrectal - Us Transrectal",960.75,384.3,,,0 CDM,4027687301,"Hc Echo,Transrectal,Prostate Vol - Us Prostate Transrectal Volume",1499.3,599.72,,,0 CDM,4027688102,Hc Us Extremity/Nonvascular Complete,1111.88,444.75,,,0 CDM,4027688201,Hc Ultrasound Extremity-Arm Or Leg,930.76,372.3,,,0 CDM,4027688202,"Hc Poct Us Extremity Limited,Joint,Focal",248.28,99.31,,,0 CDM,4027688301,Hc Us Length Of Nerves In Extremity,225.0,90.0,,,0 CDM,4027688501,Hc Us Exam Infant Hips Dynamic - Xr Infant Hips With Manipulation,1048.31,419.32,,,0 CDM,4027688504,Hc Us Exam Infant Hips Dynamic - Us Hip Pediatric Lmtd Bil Manipulation,1048.31,419.32,,,0 CDM,4027688601,Hc Us Exam Infant Hips Static - Xr Infant Hips Without Manipulation,755.65,302.26,,,0 CDM,4027693001,Hc Sono Guide Pericard Tap - Us Guided Pericardiocentesis,1125.07,450.03,,,0 CDM,4027693701,"Hc Chg Us Guide, Vascular Access",959.55,383.82,,,0 CDM,4027693702,"Hc Us Guide, Vascular Access",248.28,99.31,,,0 CDM,4027694002,"Hc Us Guide, Tissue Ablation - Us Guided Cryoablation Liver Chg",880.0,352.0,,,0 CDM,4027694101,Hc Sono Guide Intrauter Xfusn,693.28,277.31,,,0 CDM,4027694201,Hc Poct Us Guidance Needle Placement,333.44,133.38,,,0 CDM,4027694203,Hc Sono Guide Needle Biopsy,1428.53,571.41,,,0 CDM,4027694206,Hc Echo Guide For Biopsy - Us Guided Percutaneous Biopsy Renal Left,1428.53,571.41,,,0 CDM,4027694208,Hc Echo Guide For Biopsy - Us Guided Percutaneous Biopsy Renal Right,1428.53,571.41,,,0 CDM,4027694218,Hc Echo Guide For Biopsy - Us Guided Thyroid Biopsy,1428.53,571.41,,,0 CDM,4027694219,Hc Echo Guide For Biopsy - Us Guided Soft Tissue Biopsy,1428.53,571.41,,,0 CDM,4027694220,Hc Echo Guide For Biopsy - Us Guided Needle Liver Biopsy,1428.53,571.41,,,0 CDM,4027694221,"Hc Echo Guide For Biopsy - Us Guided Aspirat Of Abscess, Hematoma, Cyst",1428.53,571.41,,,0 CDM,4027694226,Hc Echo Guide For Biopsy - Us Guided Biopsy Lymph Node Superficial,1428.53,571.41,,,0 CDM,4027694232,Hc Echo Guide For Biopsy - Us Guidance Needle Placement,1958.0,783.2,,,0 CDM,4027694237,Hc Echo Guide For Biopsy - Fl Guided Needle Biopsy Bone,1428.53,571.41,,,0 CDM,4027694238,Hc Echo Guide For Biopsy - Fl Guided Needle Biopsy Bone Deep,1428.53,571.41,,,0 CDM,4027694241,Hc Echo Guide For Biopsy - Ir Paracentesis Charge,1428.53,571.41,,,0 CDM,4027694242,Hc Echo Guide For Biopsy - Ir Thoracentesis Charge,1428.53,571.41,,,0 CDM,4027694243,Hc Sono Guide Needle Biopsy,1428.53,571.41,,,0 CDM,4027694246,Hc Chg Sono Guide Needle Biopsy-Ir,1428.53,571.41,,,0 CDM,4027694501,Hc Sono Guide Chor Vill Sampling - Us Guidance Chorionic Villus Sample,503.76,201.5,,,0 CDM,4027694601,Hc Sono Guide Amniocentesis,567.33,226.93,,,0 CDM,4027697801,"Hc Us Of Growth Using Contrast, 1St Lesion",933.16,373.26,,,0 CDM,4027697901,"Hc Us Of Growth Using Contrast, Each Additional Lesion",473.78,189.51,,,0 CDM,4027698101,Hc Us Elastography Parenchyma,467.78,187.11,,,0 CDM,4027698301,Hc Ultrasound Elastography Ea Additional Target Lesion,133.87,53.55,,,0 CDM,4027699802,"Hc Ultrasonic Guidance, Intraoperative - Us Intraoperative",1529.28,611.71,,,0 CDM,4027699902,Hc Jugular/Sc Us,368.23,147.29,,,0 CDM,4027700201,Hc Needle Localization By Xray - Us Guided Perc Needle Biopsy Muscle,1297.02,518.81,,,0 CDM,4029397601,Hc Vascular Study - Us Abdomen Doppler Limited,1177.85,471.14,,,0 CDM,4029398501,Hc Vein Mapping Bilateral,1341.76,536.7,,,0 CDM,4029398601,Hc Vein Mapping Unilateral,1072.96,429.18,,,0 CDM,4029399801,Hc Spectral Doppler Vascular Malformations Duplex,818.78,327.51,,,0 CDM,4030000001,Hc Executive Health Screening Mammogram,741.0,296.4,,,0 CDM,4037706301,Hc Mammogram Breast Screening Tomosynthesis-Bilateral,122.0,48.8,,,0 CDM,4037706302,Hc Mammogram Breast Screening Tomosynthesis Limited,91.5,36.6,,,0 CDM,4037706303,Hc Mammogram Breast Screening Tomosynthesis Bilateral,122.0,48.8,,,0 CDM,4037706701,Hc Scr Mammo Bi Incl Cad - Mammo Breast Screening Bilateral,348.0,139.2,,,0 CDM,4037706702,Hc Screening Mammogram Including Cad - Mammogram Breast Screening,348.0,139.2,,,0 CDM,4037706703,Hc Screening Mammogram Including Cad Limited,261.0,104.4,,,0 CDM,4047845901,Hc Heart Muscle Imaging (Pet) - Nm Pet Myocardial Metabolic Evaluation,7142.24,2856.9,,,0 CDM,4047860801,Hc Brain Imaging (Pet) - Pet Brain,6810.72,2724.29,,,0 CDM,4047860802,Hc Research Pet Brain,5410.63,2164.25,,,0 CDM,4047881401,Hc Pet Imaging Ct For Attenuation Limited Area - Pt/Ct Lower Extremity,7468.16,2987.26,,,0 CDM,4047881402,Hc Research Pet/Ct Limited-Fdg,5410.63,2164.25,,,0 CDM,4047881501,Hc Pet Image W/Ct Skull-Thigh - Pt/Ct Bone Skull Base To Mid Thigh,8982.4,3592.96,,,0 CDM,4047881502,Hc Research Pet/Ct Eye-Thig Fdg,5410.63,2164.25,,,0 CDM,4047881601,Hc Pet Imaging For Ct Attenuation Whole Body - Pt/Ct Bone Whole Body,9509.92,3803.97,,,0 CDM,4047881602,Hc Research Pet/Ct Whole Body Fdg,9509.92,3803.97,,,0 CDM,4100000001,Hc Rt Pep Therapy,158.47,63.39,,,0 CDM,4100000003,Hc Rt Surfactant Administration,336.95,134.78,,,0 CDM,4103150001,Hc Insert Emergency Endotrach Airway,1794.1,717.64,,,0 CDM,4103394901,"Hc Ecmo/Ecls Daily Management Of Veno-Arterial, Each Day",625.0,250.0,,,0 CDM,4103660001,Hc Withdrawal Of Arterial Blood - Draw Charge,271.26,108.5,,,0 CDM,4108922001,Hc Sputum Specimen Collection,178.0,71.2,,,0 CDM,4109295001,Hc Rt Heart/Lung Resuscitation (Cpr),1469.7,587.88,,,0 CDM,4109400201,"Hc Rt Ventilator Management, Inpatient, Initial Day",3030.66,1212.26,,,0 CDM,4109400203,Hc Rt High Freq Oscillation Intital Day,3030.66,1212.26,,,0 CDM,4109400301,"Hc Rt Ventilator Management, Inpatient, Subsequent Day",2747.69,1099.08,,,0 CDM,4109400302,"Hc Rt Ventilator Mgmt, Subseq Day",2747.69,1099.08,,,0 CDM,4109400303,Hc Rt High Frequency Oscillation Subsequent Day,2747.69,1099.08,,,0 CDM,4109401001,Hc Rt Breathing Capacity Test,837.2,334.88,,,0 CDM,4109461001,Hc Rt Intrapulmonary Surfactant Administj Phys/Qhp,293.0,117.2,,,0 CDM,4109464001,Hc Pressurized/Nonpressurized Inhalation Treatment,403.53,161.41,,,0 CDM,4109464002,Hc Extended Nebulizer Treatement Subsequent,403.53,161.41,,,0 CDM,4109464003,Hc Rt Induced Sputum,403.53,161.41,,,0 CDM,4109464004,Hc Rt Hand Held Nebulizer,403.53,161.41,,,0 CDM,4109464201,Hc Pentamidine Treatment,812.08,324.83,,,0 CDM,4109464401,"Hc Rt Continuous Inhalation Tx, 1St Hour",671.26,268.5,,,0 CDM,4109464501,"Hc Rt Continuous Inhalation Tx, Each Additional Hour",438.04,175.22,,,0 CDM,4109466001,Hc Rt Continous Positive Airway Pressure Vent Non-Emergent,1940.63,776.25,,,0 CDM,4109466002,Hc Rt Cpap Non-Emergent Subseq Day,1940.63,776.25,,,0 CDM,4109466006,Hc Rt Bipap Non-Emergent,1940.63,776.25,,,0 CDM,4109466007,Hc Rt Bipap Non-Emergent Subseq Day,1940.63,776.25,,,0 CDM,4109466008,Hc Rt Bipap Emergent,1940.63,776.25,,,0 CDM,4109466401,"Hc Rt Demo &/Or Eval,Pt Use,Aerosol Device",323.15,129.26,,,0 CDM,4109466701,"Hc Rt Chest Wall Manipulation, Initial",534.13,213.65,,,0 CDM,4109466801,"Hc Rt Chest Wall Manipulation,Subsequent",316.46,126.58,,,0 CDM,4109466802,Hc Rt Cpt Subsequent,316.46,126.58,,,0 CDM,4109466901,Hc Rt Mechanical Chest Wall Oscillation Lung Function,390.13,156.05,,,0 CDM,4109468101,"Hc Rt Exhaled Air Analysis: O2, Co2",1352.98,541.19,,,0 CDM,4109476101,"Hc Rt Noninvasv Oxygen Satur,Multiple",158.47,63.39,,,0 CDM,4109479901,Hc Extensive Gas Delivery Initial 8Hrs,10891.4,4356.56,,,0 CDM,4109479902,Hc Ecmo Circuit Change,10085.27,4034.11,,,0 CDM,4109479903,Hc Ecmo Circuit Change,10085.27,4034.11,,,0 CDM,4109479904,Hc Extensive Gas Delivery To 4 Hr,5431.4,2172.56,,,0 CDM,4109479906,Hc Extensive Gas Delivry Init Day,32698.9,13079.56,,,0 CDM,4109479907,Hc Extensive Gas Delivery Daily,32581.9,13032.76,,,0 CDM,4109479908,Hc Peds Initial Ecmo Inclds Setup,34628.68,13851.47,,,0 CDM,4109479909,Hc Initial Ecmo W/Set-Up,34628.68,13851.47,,,0 CDM,4109479910,Hc N O Cath Lab Set Up To 30 Min,321.42,128.57,,,0 CDM,4109479911,Hc Apnea Test,293.02,117.21,,,0 CDM,4109479912,Hc Extensive Gas Delivery Inital 16Hrs,21781.5,8712.6,,,0 CDM,4109479913,Hc Peds Ecmo Daily Charge,23659.87,9463.95,,,0 CDM,4109479914,Hc Ecmo Daily Charge,23659.87,9463.95,,,0 CDM,4109946501,Hc Rt Delivery/Birthing Room Resuscitation,1141.0,456.4,,,0 CDM,410G023701,Hc Therapeutic Procedure Strength Endurance,301.39,120.56,,,0 CDM,410G023901,"Hc Rt Oth Resp Proc, Group",380.09,152.04,,,0 CDM,4139918301,Hc Rt Phys/Qhp Attn&Supvj Hyprbaric Oxygen Tx /Session,164.15,65.66,,,0 CDM,413G027701,Hc Hyperbaric Chamber 1/2Hr 2 Atm,1853.57,741.43,,,0 CDM,413G027702,Hc Hyperbaric Chamber 1/2Hr 3 Atm,1853.57,741.43,,,0 CDM,413G027703,Hc Hyperbaric Chamber-Add 1/2 Hr,1853.57,741.43,,,0 CDM,4200000001,Hc Pt Wellness Per Visit,86.25,34.5,,,0 CDM,4202056001,Hc Pt Dry Needle 1 Or 2 Muscles,110.51,44.2,,,0 CDM,4202056101,Hc Pt Dry Needle 3 Or More Muscles,115.53,46.21,,,0 CDM,4202924001,Hc Strapping Of Shoulder,379.6,151.84,,,0 CDM,4202926001,Hc Strapping Of Elbow Or Wrist,351.0,140.4,,,0 CDM,4202952001,Hc Strapping Of Hip,399.1,159.64,,,0 CDM,4209585201,Hc Rom Hand Pt,74.0,29.6,,,0 CDM,4209599201,"Hc Pt Canalith Repositioning Procedure, Per Day",156.0,62.4,,,0 CDM,4209701001,Hc Pt Hot Or Cold Packs Therapy,67.09,26.84,,,0 CDM,4209701201,Hc Pt Mechanical Traction Therapy,180.98,72.39,,,0 CDM,4209701601,Hc Pt Vasopneumatic Device Therapy,184.48,73.79,,,0 CDM,4209701801,Hc Pt Paraffin Bath Therapy,165.79,66.32,,,0 CDM,4209702201,Hc Whirlpool Therapy,240.52,96.21,,,0 CDM,4209703201,Hc Pt Electrical Stimulation,219.5,87.8,,,0 CDM,4209703301,Hc Pt Electric Current Therapy,218.34,87.34,,,0 CDM,4209703302,Hc Ionto W24Hr Patch(2) Ea 15,218.34,87.34,,,0 CDM,4209703501,Hc Pt Ultrasound Therapy,200.82,80.33,,,0 CDM,4209703901,Hc Pt Wellness Per Visit,86.25,34.5,,,0 CDM,4209711001,Hc Pt Therapeutic Exercises Each 15 Minutes,241.68,96.67,,,0 CDM,4209711003,Hc Ind Ex W Tape 15 Min,241.68,96.67,,,0 CDM,4209711201,"Hc Pt Neuromuscular Reeducation,1+ Areas, Each 15 Minutes",219.5,87.8,,,0 CDM,4209711301,Hc Pt Aquatic Therapy/Exercises,210.23,84.09,,,0 CDM,4209711601,Hc Pt Gait Training Therapy Each 15 Minutes,182.14,72.86,,,0 CDM,4209711602,Hc Pta Gait Training Tech/15 Minutes Each 15 Minutes,182.14,72.86,,,0 CDM,4209711603,Hc Pta Gait Training With Belt & Crutches Each 15 Minutes,182.14,72.86,,,0 CDM,4209711604,Hc Pta Gait Training With Belt Each 15 Minutes,182.14,72.86,,,0 CDM,4209711605,Hc Pta Gait Training With Crutches Each 15 Minutes,182.14,72.86,,,0 CDM,4209712401,Hc Pt Massage Therapy,182.14,72.86,,,0 CDM,4209714001,"Hc Pt Manual Therapy Tech,1+Regions,Eacg 15 Minutes",221.84,88.74,,,0 CDM,4209715001,Hc Pt Group Therapeutic Procedures,61.86,24.74,,,0 CDM,4209753001,Hc Pt Therapeutic Actvity Direct Patient Contact Each 15 Minutes,201.99,80.8,,,0 CDM,4209753002,Hc Pt Individual Activity 15 Minutes Stat,193.46,77.38,,,0 CDM,4209753301,Hc Pt Sensory Integrative Techniques Each 15 Minutes,158.79,63.52,,,0 CDM,4209753501,Hc Pt Self-Care/Home Mangement Training Each 15 Minutes,192.65,77.06,,,0 CDM,4209753502,Hc Pta Adl Tech/15 Minutes,192.65,77.06,,,0 CDM,4209754201,"Hc Pt Wheelchair Management Training, Each 15 Minutes",184.48,73.79,,,0 CDM,4209755001,Hc Pt Caregiver Training,65.0,26.0,,,0 CDM,4209755101,Hc Pt Caregiver Training Strategies & Tq Each Additional 15 Mins,30.0,12.0,,,0 CDM,4209755201,Hc Pt Group Caregiver Training,65.0,26.0,,,0 CDM,4209760201,"Hc Pt Wound Debridemnt, Non-Selective, Each",713.3,285.32,,,0 CDM,4209775001,Hc Pt Physical Performance Test,147.12,58.85,,,0 CDM,4209776001,"Hc Pt Orthotic Management And Training, Each 15 Minutes",235.85,94.34,,,0 CDM,4209776101,"Hc Pt Prosthetic Training, Each 15 Min",176.68,70.67,,,0 CDM,4209776301,Hc Pt Orthotics/Prosthetic Management & Training Subsquent Encounter 15 Minutes,217.18,86.87,,,0 CDM,4209776305,Hc Pta Splint Follow-Up Management-Training/15 Minutes,217.18,86.87,,,0 CDM,4209779901,Hc Garment Fitting Pt,230.01,92.0,,,0 CDM,4209896001,Hc Education And Training Self-Management Individual Each 30 Minutes,162.5,65.0,,,0 CDM,420G028301,Hc Pta Electrical Stimulation Unattended,363.35,145.34,,,0 CDM,420G045101,Hc Developmntl Test Pt,190.0,76.0,,,0 CDM,420G051501,Hc Pt Cognitive Skills Development,162.0,64.8,,,0 CDM,4239715001,Hc Pt Group Therapeutic Procedures,170.46,68.18,,,0 CDM,4239715002,Hc Pt Group Activity >2,170.46,68.18,,,0 CDM,4249716101,Hc Pt Physical Therapy Evaluation Low Complex 20 Minutes,413.33,165.33,,,0 CDM,4249716201,Hc Pt Physical Therapy Evaluation Mod Complex 30 Minutes,442.5,177.0,,,0 CDM,4249716301,Hc Pt Physical Therapy Evaluation High Complex 45 Minutes,471.69,188.68,,,0 CDM,4249716401,Hc Pt Physical Therapy Re-Eval Est Plan Care 20 Minutes,312.9,125.16,,,0 CDM,4249716501,Hc Pt Physical Therapy Eval Low Complex 30 Minutes,449.51,179.8,,,0 CDM,4249716601,Hc Pt Physical Therapy Eval Moderate Complex 45 Minutes,471.69,188.68,,,0 CDM,4249716701,Hc Pt Physical Therapy Eval High Complex 60 Minutes,500.89,200.36,,,0 CDM,4249716801,Hc Pt Physical Therapy Re-Eval Est Plan Care 30 Minutes,324.58,129.83,,,0 CDM,4249753001,Hc Therapeutic Actvity Direct Pt Contact Each 15 Minutes,201.99,80.8,,,0 CDM,4302056001,Hc Ot Dry Needle 1 Or 2 Muscles,110.51,44.2,,,0 CDM,4302056101,Hc Ot Dry Needle 3 Or More Muscles,115.53,46.21,,,0 CDM,4309585101,"Hc Ot Range Motion Measure,Each Extrem",124.0,49.6,,,0 CDM,4309585201,Hc Rom Hand Ot,74.0,29.6,,,0 CDM,4309701001,Hc Ot Hot Or Cold Packs Therapy,1454.83,581.93,,,0 CDM,4309701601,Hc Ot Vasopneumatic Device Therapy,184.48,73.79,,,0 CDM,4309701801,Hc Ot Paraffin Bath Therapy,165.79,66.32,,,0 CDM,4309703201,Hc Ot Electrical Stimulation,219.5,87.8,,,0 CDM,4309703301,Hc Ot Electric Current Therapy,218.34,87.34,,,0 CDM,4309703501,Hc Ot Ultrasound Therapy,200.82,80.33,,,0 CDM,4309711001,Hc Ot Therapeutic Exercises Each 15 Minutes,241.68,96.67,,,0 CDM,4309711201,"Hc Ot Neuromuscular Reeducation,1+ Areas, Each 15 Minutes",219.5,87.8,,,0 CDM,4309711301,Hc Ot Aquatic Therapy/Exercises,210.23,84.09,,,0 CDM,4309711601,Hc Ot Gait Training Therapy Each 15 Minutes,182.14,72.86,,,0 CDM,4309712401,Hc Ot Massage Therapy,182.14,72.86,,,0 CDM,4309712701,Hc Ot Therapeutic Ivntj W/Focus On Cognitive Function,189.15,75.66,,,0 CDM,4309712901,Hc Ota Cog Ther Ivntj 1St 15 Minutes,189.15,75.66,,,0 CDM,4309713001,Hc Ot Cog Therapy Ivn Each Additional 15 Minute Outpatient,189.15,75.66,,,0 CDM,4309714001,"Hc Ot Manual Therapy Tech,1+Regions,Each 15 Minutes",221.84,88.74,,,0 CDM,4309715001,Hc Ot Group Therapeutic Procedures,170.46,68.18,,,0 CDM,4309753001,Hc Ot Therapeutic Actvity Direct Patient Contact Each 15 Minutes,201.99,80.8,,,0 CDM,4309753301,Hc Ot Sensory Integrative Techniques Each 15 Minutes,165.79,66.32,,,0 CDM,4309753501,Hc Ot Self-Care/Home Mangement Training Each 15 Minutes,192.65,77.06,,,0 CDM,4309753502,Hc Ota Adl Tech/15 Minutes,192.65,77.06,,,0 CDM,4309754201,"Hc Ot Wheelchair Management Training, Each 15 Minute",184.48,73.79,,,0 CDM,4309754501,Hc Work Hardening 1St Two Hours,608.88,243.55,,,0 CDM,4309755001,Hc Ot Caregiver Training,50.0,20.0,,,0 CDM,4309755101,Hc Ot Caregiver Training Strategies & Tq Each Additional 15 Mins,30.0,12.0,,,0 CDM,4309755201,Hc Ot Group Caregiver Training,65.0,26.0,,,0 CDM,4309760201,"Hc Ot Wound Debridemnt, Non-Selective, Ea",713.3,285.32,,,0 CDM,4309775001,Hc Ot Physical Performance Test,147.12,58.85,,,0 CDM,4309776001,"Hc Ot Orthotics Mangement And Training, Each 15 Minutes",235.85,94.34,,,0 CDM,4309776101,"Hc Ot Prosthetic Training, Each 15 Min",176.68,70.67,,,0 CDM,4309776301,Hc Ot Orthotics/Prosthetic Mangement &/Training Subsquemt Encounter 15 Minutes,217.18,86.87,,,0 CDM,4309779901,Hc Garment Fitting Ot,230.01,92.0,,,0 CDM,430G028301,Hc Ot Electrical Stimulation Other Than Wound,363.35,145.34,,,0 CDM,430G051501,Hc Ot Cognitive Skills Development,162.0,64.8,,,0 CDM,4339715001,Hc Ot Group Therapeutic Procedures,170.46,68.18,,,0 CDM,4339715002,Hc Ot Group Activity >2,170.46,68.18,,,0 CDM,4349716101,Hc Pt Physical Therapy Evaluation Low Complex 20 Minutes,413.33,165.33,,,0 CDM,4349716201,Hc Ot Occupational Therapy Evaluation Mod Complex 30 Minutes,442.5,177.0,,,0 CDM,4349716301,Hc Ot Occupational Therapy Evaluation High Complex 45 Minutes,471.69,188.68,,,0 CDM,4349716401,Hc Ot Occupational Therapy Re-Eval Est Plan Care 20 Minutes,312.9,125.16,,,0 CDM,4349716501,Hc Ot Occupational Therapy Eval Low Complex 30 Minutes,449.51,179.8,,,0 CDM,4349716601,Hc Ot Occupational Therapy Eval Moderate Complex 45 Minutes,471.69,188.68,,,0 CDM,4349716701,Hc Ot Occupational Therapy Eval High Complex 60 Minutes,500.89,200.36,,,0 CDM,4349716801,Hc Ot Occupational Therapy Re-Eval Est Plan Care 30 Minutes,324.58,129.83,,,0 CDM,4349716802,Hc Iadl Partial Evaluation Van,437.83,175.13,,,0 CDM,4349716803,Hc Iadl Partial Evaluation Car,321.08,128.43,,,0 CDM,4409250701,"Hc Slp Speech/Hearing Therapy, Individual",480.02,192.01,,,0 CDM,4409250702,Hc Speech Lang Therapy Telehealth,480.02,192.01,,,0 CDM,4409250801,"Hc Slp Speech/Hearing Therapy, Group",230.24,92.1,,,0 CDM,4409251101,Hc Slp Nasopharyngoscopy,568.01,227.2,,,0 CDM,4409251201,Hc Nasal Function Studies,876.07,350.43,,,0 CDM,4409252001,Hc Slp Laryngeal Function Studies,989.69,395.88,,,0 CDM,4409252601,Hc Slp Oral Function Therapy,430.06,172.02,,,0 CDM,4409260601,"Hc Slp Ther Srvc(S),Non-Speech Gen Dev, W/Prog",398.57,159.43,,,0 CDM,4409260901,"Hc Slp Ther Srvc, Speech Gen Dev Use, W/Prog",409.43,163.77,,,0 CDM,4409610501,Hc Slp Assessment Of Aphasia,602.0,240.8,,,0 CDM,4409612501,Hc Slp Standardized Cognitive Performance Testing,423.55,169.42,,,0 CDM,4409703201,Hc Slp Electrical Stimulation,219.5,87.8,,,0 CDM,4409711001,Hc Slp Therapeutic Exercises Each 15 Minutes,241.68,96.67,,,0 CDM,4409712901,Hc Cog Ther Ivntj 1St 15 Min,189.15,75.66,,,0 CDM,4409713001,Hc Slp Coagulation Therapy Ivn Each Additional 15 Minute Outpatient,189.15,75.66,,,0 CDM,4409714001,"Hc Slp Manual Therapy Tech,1+Regions,Each 15 Minutes",221.84,88.74,,,0 CDM,4409753001,Hc Slp Therapeutic Actvity Direct Patient Contact Each 15 Minutes,201.99,80.8,,,0 CDM,4409755001,Hc Slp Caregiver Training,50.0,20.0,,,0 CDM,4409755101,Hc Caregiver Training Strategies & Tq Each Additional 15 Mins,30.0,12.0,,,0 CDM,4409755201,Hc Slp Group Caregiver Training,65.0,26.0,,,0 CDM,440G051501,Hc Slp Cognitive Skills Development,162.0,64.8,,,0 CDM,440G206101,Hc Spl Rehab 5-10 Minutes E Visit/7D,110.0,44.0,,,0 CDM,440G206201,Hc Spl Rehab 11-20 Minutes E Visit/7D,157.0,62.8,,,0 CDM,440G206301,Hc Spl Rehab 21 => Minutes E Visit/7D,209.0,83.6,,,0 CDM,4439715001,Hc Slp Group Therapeutic Procedures,170.46,68.18,,,0 CDM,4439715003,Hc Slp Group Activity >2,170.46,68.18,,,0 CDM,4443157501,"Hc Laryngoscopy,Flex Fiber,Diagnostic",1826.38,730.55,,,0 CDM,4443157502,"Hc Laryngoscopy,Flex Fiber,Diagnostic",1826.38,730.55,,,0 CDM,4449252101,Hc Slp Evaluation Of Speech Fluency (Stutter Clutter),662.47,264.99,,,0 CDM,4449252201,Hc Slp Evaluation Of Speech Sound Production Articulate,625.55,250.22,,,0 CDM,4449252301,Hc Slp Eval Speech Sound Product Language Comprehension,690.71,276.28,,,0 CDM,4449252302,Hc Speech Lang Eval Telehealth,690.71,276.28,,,0 CDM,4449252401,Hc Slp Behavioral & Qualit Analysis Voice And Resonance,655.95,262.38,,,0 CDM,4449259701,Hc Slp Eval Voice Prosth Device,499.57,199.83,,,0 CDM,4449260701,"Hc Slp Eval,Speech-Gen Aug/Alt Comm Dev,1St Hour",691.79,276.72,,,0 CDM,4449260801,"Hc Slp Eval,Speech-Gen Aug/Alt Comm Dev,Additional 30 Minutes",221.55,88.62,,,0 CDM,4449261001,"Hc Eval,Oral & Pharyngeal Swallow Function",687.45,274.98,,,0 CDM,4449261101,"Hc Slp Eval,Swallow Function,Cine/Video Record",860.12,344.05,,,0 CDM,4449261201,"Hc Slp Endoscopic Eval,Swallow Cine/Video/W/Disp Scope",799.31,319.72,,,0 CDM,4449716101,Hc Slp Speech Therapy Evaluation Low Complex 20 Minutes,413.33,165.33,,,0 CDM,4449716201,Hc Slp Speech Therapy Evaluation Mod Complex 30 Minutes,442.5,177.0,,,0 CDM,4449716301,Hc Slp Speech Therapy Evaluation High Complex 45 Minutes,470.77,188.31,,,0 CDM,4449716401,Hc Slp Speech Therapy Re-Eval Est Plan Care 20 Minutes,312.9,125.16,,,0 CDM,4449716501,Hc Slp Speech Therapy Eval Low Complex 30 Minutes,449.51,179.8,,,0 CDM,4449716601,Hc Slp Speech Therapy Eval Moderate Complex 45 Minutes,471.69,188.68,,,0 CDM,4449716701,Hc Slp Speech Therapy Eval High Complex 60 Minutes,500.89,200.36,,,0 CDM,4449716801,Hc Slp Speech Therapy Re-Eval Est Plan Care 30 Minutes,324.58,129.83,,,0 CDM,4500000016,Hc Decon 2 Stretcher Patient Emergent,9787.35,3914.94,,,0 CDM,4500000041,Hc Decon I Ambulatory Urgent,8557.38,3422.95,,,0 CDM,4500000090,Hc Adult Suture Repr-Simple,579.02,231.61,,,0 CDM,4500213T01,Hc Njx Dx/Ther Paraver Fct Jt W/Us Cer/Thor 1 Lvl,2051.14,820.46,,,0 CDM,4500216T01,Hc Njx Dx/Ther Paraver Fct Jt W/Us Lumb/Sac 1 Lvl,2051.14,820.46,,,0 CDM,4501176201,Hc Reconstruction Of Nail Bed W Graft,3256.71,1302.68,,,0 CDM,4501200601,Hc Simple Repair Scalp/Neck/Axillae/Genitalia/Trunk/Extremities 20.1-30.0Cm,795.34,318.14,,,0 CDM,4501201101,Hc Resuperficial Wound Face <2.5Cm,795.34,318.14,,,0 CDM,4501203701,"Hc Layer Close Wound Trunk, Arm, Leg >30Cm",3371.22,1348.49,,,0 CDM,4501204501,Hc Repair Intermediate N/H/F/Xtrnl Gent 12.6-20 Cm,910.87,364.35,,,0 CDM,4501312001,Hc Repair Complex Scalp/Arm/Leg 1.1-2.5 Cm,1198.87,479.55,,,0 CDM,4501313301,Hc Repair Complex F/C/C/M/N/Ax/G/H/F Ea Addl 5 Cm/<,1198.87,479.55,,,0 CDM,4501402101,"Hc Repair Of Wound To Scalp/Arms/Legs By Transfer Of Skin, 10.1-30.0 Sqcm",6674.74,2669.9,,,0 CDM,4501404001,"Hc Adjacent Tissue Transfer Head, Face, Hand <10Sqcm",6894.89,2757.96,,,0 CDM,4502010301,"Hc Explore Wound, Extremity",2300.62,920.25,,,0 CDM,4502060601,Hc Arthrocentesis Aspir&/Inj Interm Jt/Burs W/Us,3958.28,1583.31,,,0 CDM,4502061003,Hc Arthrocentesis Aspir&/Inj Major Jt/Bursa W/O Us Left,1794.96,717.98,,,0 CDM,4502082201,"Hc Replantation Digit Distal, Complicated",2090.01,836.0,,,0 CDM,4502111001,Hc Application And Removal Of Dental Fixation Device,3072.52,1229.01,,,0 CDM,4502131501,Hc Closed Tx Nasal Fracture W/O Stabilization,3253.35,1301.34,,,0 CDM,4502150101,Hc I&D Deep Absc/Hmtma Soft Tissue Neck/Thorax,7121.22,2848.49,,,0 CDM,4502303001,Hc I&D Shoulder Deep Abscess/Hematoma,7121.22,2848.49,,,0 CDM,4502350001,Hc Closed Treatment Clavicular Fracture With/Without Manipulation,1198.87,479.55,,,0 CDM,4502354501,Hc Closed Treatment Acromioclavicular Dislocation With Manipulation,957.76,383.1,,,0 CDM,4502360001,Hc Closed Treatment Of Proximal Humeral Unilateral,1374.1,549.64,,,0 CDM,4502360002,Hc Closed Treatment Of Proximal Humeral Bilateral,2061.8,824.72,,,0 CDM,4502367501,"Hc Closed Treatment Dislocated Shoulder, Broke Neck Upper Arm With Manipulation",3253.35,1301.34,,,0 CDM,4502393001,Hc I&D Upper Arm/Elbow Deep Abscess/Hematoma,7121.22,2848.49,,,0 CDM,4502450001,Hc Closed Treatment Mid Portion Of Humerus Shaft Fracture Without Manipulation,890.79,356.32,,,0 CDM,4502456001,Hc Humeral Epicondylar Fracture Medial/Lateral Wo Manipulation,1013.01,405.2,,,0 CDM,4502457601,Hc Closed Treatment Humerus Fracture Without Manipulation,1013.01,405.2,,,0 CDM,4502465001,Hc Closed Treatment Radial Head/Neck Fracture Without Manipulation,1198.87,479.55,,,0 CDM,4502467001,Hc Closed Treatment Ulnar Fracture Proximal End Without Manipulation,579.34,231.74,,,0 CDM,4502499901,Hc Upper Arm/Elbow Surgery,746.43,298.57,,,0 CDM,4502502801,Hc I&D Forearm&/Wrist Deep Abscess/Hematoma,7116.2,2846.48,,,0 CDM,4502503101,Hc Incision & Drainage Forearm&/Wrist Bursa,2790.99,1116.4,,,0 CDM,4502556001,Hc Closed Treatment Radial And Ulnar/Shaft Fracture Without Manipulation,838.88,335.55,,,0 CDM,4502562401,Hc Closed Treatment Wrist Bone Fracture With Manipulation,2977.08,1190.83,,,0 CDM,4502566001,Hc Closed Treatment Wrist Dislocation Unilateral,799.5,319.8,,,0 CDM,4502566002,Hc Closed Treatment Wrist Dislocation Bilateral,1004.9,401.96,,,0 CDM,4502569001,Hc Closed Treatment Wrist Dislocation,4003.49,1601.4,,,0 CDM,4502623601,Hc Partial Removal Finger Bone,5014.83,2005.93,,,0 CDM,4502632001,Hc Removal Implant From Finger/Hand,3662.75,1465.1,,,0 CDM,4502641801,Noncdm Charge Record,3857.56,1543.02,,,0 CDM,4502666501,Hc Open Tx Carpmetacarpal Fracture Dislocate Thumb Unilateral,11220.3,4488.12,,,0 CDM,4502666502,Hc Open Tx Carpmetacarpal Fracture Dislocate Thumb Bilateral,16831.1,6732.44,,,0 CDM,4502667001,Hc Cltx Carpo/Metacarpl Dislc Thmb Manj Ea W/O Anes,957.76,383.1,,,0 CDM,4502676501,Hc Open Treatment Distal Phalangeal Fracture Each,7116.2,2846.48,,,0 CDM,4502677501,Hc Treatment Finger Dislocation,1378.0,551.2,,,0 CDM,4502695201,Hc Amputation Of Finger/Thumb,7176.0,2870.4,,,0 CDM,4502699001,Hc I&D Pelvis/Hip Jt Area Deep Abscess/Hematoma,9334.78,3733.91,,,0 CDM,4502722201,Hc Closed Treatment Of Broken Hip Socket With Manipulation,3624.54,1449.82,,,0 CDM,4502722601,Hc Open Treatment Post/Ant Actblr Wall Fracture W/Int Fixj,9983.22,3993.29,,,0 CDM,4502723601,Hc Open Treatment Femoral Fracture Prox End Nck Int Fixj/Prostc Replacement,4302.12,1720.85,,,0 CDM,4502726601,Hc Closed Treatment Post Hip Arthroplasty Dislocation Requiring Anesthesia,5014.83,2005.93,,,0 CDM,4502731001,Hc Arthrocentesis Knee W/Expl Drg/Removal Fb,5924.02,2369.61,,,0 CDM,4502776601,Hc Open Treatment Medial Malleolus Fracture,11637.08,4654.83,,,0 CDM,4502776602,Hc Cltx Post Hip Arthrp Dislc Req Anes,5014.83,2005.93,,,0 CDM,4502776603,Hc Optx Pst/Ant Actblr Wall Fx W/Int Fixj,9983.22,3993.29,,,0 CDM,4502776701,Hc Closed Treatment Pst Malleolus Fracture Wo Manipulate,443.72,177.49,,,0 CDM,4502778101,Hc Closed Treatment Proximal Fibula/Shaft Fracture With Manipulation,3253.35,1301.34,,,0 CDM,4502782401,Hc Cltx Fx W8 Brg Artclr Prtn Dstl Tibia W/O Manj,1198.87,479.55,,,0 CDM,4502800101,Hc Incision & Drainage Bursa Foot,3231.98,1292.79,,,0 CDM,4502803901,Hc Excision Tumor Soft Tissue Foot/Toe Subq 1.5+Cm,6140.03,2456.01,,,0 CDM,4502812401,Hc Partial Removal Phalanx Of Toe,3596.66,1438.66,,,0 CDM,4502819201,Hc Removal Foreign Body Foot Deep,4095.58,1638.23,,,0 CDM,4502840001,Hc Closed Treatment Calcaneal Fracture Without Manipulation,1198.87,479.55,,,0 CDM,4502843001,Hc Closed Treatment Talus Fracture Wo Manipulation,527.44,210.98,,,0 CDM,4502845501,Hc Tx Tarsal Bone Fx Xcp Talus&Calcn W/Manj,3085.91,1234.36,,,0 CDM,4502847001,Hc Closed Treatment Metatarsal Fracture Without Manipulation,957.76,383.1,,,0 CDM,4502847501,Hc Closed Treatment Metatarsal Fracture With Manipulation,1043.15,417.26,,,0 CDM,4502881001,Hc Amputation Metatarsal W/Toe Single,6392.13,2556.85,,,0 CDM,4503002001,Hc Drainage Abscess/Hematoma Nasal Septum,1506.96,602.78,,,0 CDM,4503090101,"Hc Ctrl Nosebleed,Anter,Simple",872.36,348.94,,,0 CDM,4503099901,Hc Nasal Surgery Procedure Unlisted,1292.79,517.12,,,0 CDM,4503123801,Hc Nasal/Sinus Ndsc Surg W/Control Nasal Hemorrage,3670.8,1468.32,,,0 CDM,4503160301,"Hc Tracheostomy,Emergency,Xtrach",4646.87,1858.75,,,0 CDM,4503160501,"Hc Tracheostomy,Emergency,Cricothyroid Membrane",2063.2,825.28,,,0 CDM,4503162202,Hc Bronchoscopy Diagnostic-Emergency,4213.05,1685.22,,,0 CDM,4503216001,Hc Thoracotomy W/Cardiac Massage,13192.21,5276.88,,,0 CDM,4503520601,Hc Repair Blood Vessel Direct Upper Extremity,5660.76,2264.3,,,0 CDM,4503520701,Hc Repair Blood Vessel Direct Hand Or Finger,5635.0,2254.0,,,0 CDM,4503522601,Hc Rpr Blood Vessel Direct Lower Extremity,1964.2,785.68,,,0 CDM,4503641001,Hc Non-Routine Blood Draw 3/> Years,338.23,135.29,,,0 CDM,4503662501,Hc Insertion Catheter Artery,1255.8,502.32,,,0 CDM,4503760701,Hc Ligation Of Av Fistula,5512.64,2205.06,,,0 CDM,4503761801,Hc Ligation Major Artery Extremit,4025.0,1610.0,,,0 CDM,4504080101,Hc Drg Absc Cst Hmtma Vestibule Mouth Comp,3097.64,1239.06,,,0 CDM,4504083001,Hc Closure Laceration Vestibule Mouth 2.5 Cm/<,1054.87,421.95,,,0 CDM,4504100001,Hc Intraoral I&D Tongue/Floor Lingual,4227.86,1691.14,,,0 CDM,4504100801,Hc Intraoral I&D Tongue/Floor Submandble Space,6906.9,2762.76,,,0 CDM,4504180001,Hc Drainage Abscess Cyst Hematoma From Dentoalveolar Struxs,935.99,374.4,,,0 CDM,4504200001,Hc Drainage Abscess Palate Uvula,1438.31,575.32,,,0 CDM,4504231001,Hc Drainage Of Salivary Gland,1234.04,493.62,,,0 CDM,4504299901,Hc Throat Surgery Procedure,1419.76,567.9,,,0 CDM,4504500501,Hc I&D Submucosal Abscess Rectum,4663.2,1865.28,,,0 CDM,4504590001,Hc Reduction Of Rectal Prolapse With Anesthesia,3477.5,1391.0,,,0 CDM,4504591501,Hc Rmvl Fecal Impaction/Fb Spx Under Anes,2988.8,1195.52,,,0 CDM,4504900001,Hc Exploratory Laparotomy Celiotomy With Or Without Biopsy Separate Procedure,9563.22,3825.29,,,0 CDM,4504908201,Hc Abdominal Paracentesis Diagnosis/Therapy Without Guidance,2722.04,1088.82,,,0 CDM,4504908301,Hc Abdominal Paracentesis Diagnosis/Therapy W Imaging Guidance,4240.36,1696.14,,,0 CDM,4505104001,Hc Incision Of Bladder With Drainage,5594.91,2237.96,,,0 CDM,4505171001,Hc Change Of Bladder Tube Complicated,3097.64,1239.06,,,0 CDM,4505442001,Hc Corpora Cavernosa-Saphenous Vein Shunt Uni/Bi,5099.34,2039.74,,,0 CDM,4506227001,"Hc Spinal Puncture,Lumbar,Diagnostic",2466.39,986.56,,,0 CDM,4506440801,Hc Injection Aa&/Strd Vagus Nerve,879.06,351.62,,,0 CDM,4506440802,Hc Injection Aa&/Strd Vagus Nerve Unilateral,879.06,351.62,,,0 CDM,4506441801,Hc Injection Aa&/Strd Suprascapular Nerve,2046.12,818.45,,,0 CDM,4506442001,Hc Injection Aa&/Strd Intercostal Nrv Single Lvl,2290.57,916.23,,,0 CDM,4506522201,"Hc Removal Foreign Body,Eye,Cornea,Slit Lamp",790.32,316.13,,,0 CDM,4506523501,Hc Removal Fb Intraocular Ant Chamber Eye/Lens,7325.5,2930.2,,,0 CDM,4506528001,Hc Repair Of Perforating Laceration Of Cornea And/Or Sclera,13305.5,5322.2,,,0 CDM,4506581001,Hc Paracentsis Ant Chamber Removal Vitreous W/Wo Air Injx,4155.87,1662.35,,,0 CDM,4506793801,"Hc Removal Embedded Foreign Body, Eyelid",920.92,368.37,,,0 CDM,4506902001,Hc Drainage External Auditory Canal Abscess,1438.31,575.32,,,0 CDM,4509295001,Hc Heart/Lung Resuscitation (Cpr),531.0,212.4,,,0 CDM,4509297701,"Hc Thrombolysis,Coronary,Iv Infusion",1799.75,719.9,,,0 CDM,4509637301,"Hc Injection Into Artery For Therapy, Diagnosis, Or Prevention",786.92,314.77,,,0 CDM,4509928101,Hc Emergency Department Level 1 Visit Limited/Minor Prob,443.83,177.53,,,0 CDM,4509928201,Hc Emergency Department Level 2 Visit Low/Moderate Severity,704.71,281.88,,,0 CDM,4509928301,Hc Emergency Department Level 3 Visit Moderate Severity,1435.39,574.16,,,0 CDM,4509928401,Hc Emergency Department Level 4 Visit High/Urgent Severity,2265.46,906.18,,,0 CDM,4509928501,Hc Emergency Department Level 5 Visit High Severity&Threat Function,4230.52,1692.21,,,0 CDM,4509929101,"Hc Critical Care, E/M 30-74 Minutes",7015.48,2806.19,,,0 CDM,4509929201,"Hc Critical Care, Addl 30 Min",3297.68,1319.07,,,0 CDM,4509949901,Hc Unlisted E/M Service,377.31,150.92,,,0 CDM,4609401003,Hc Breathing Capacity Test,837.2,334.88,,,0 CDM,4609406001,Hc Eval Of Bronchospasm,1506.96,602.78,,,0 CDM,4609407001,"Hc Eval Of Bronchospasm,Prolonged - Bronchial Challenge W Methacholine",2139.34,855.74,,,0 CDM,4609415002,Hc Vital Capacity Test - Pr Vital Capacity Test,370.76,148.3,,,0 CDM,4609420001,Hc Lung Function Test (Mbc/Mvv) - Trans-Diaphragmatic Pressure,451.49,180.6,,,0 CDM,4609445001,Hc Hypoxia Response Curve,615.94,246.38,,,0 CDM,4609461801,Hc Pulm Stress Test Simple,944.84,377.94,,,0 CDM,4609461802,Hc Pulm Stress Simple (No Co2),944.84,377.94,,,0 CDM,4609461803,Hc Spirogram W/6 Min Walk,944.84,377.94,,,0 CDM,4609462101,"Hc Cardiopulmonary Exercise Testing - Complex Stress Test, Pulmonary",3024.38,1209.75,,,0 CDM,4609468001,Hc Exhaled Air Analysis: O2,1233.38,493.35,,,0 CDM,4609468101,"Hc Exhaled Air Analysis: O2, Co2",1352.98,541.19,,,0 CDM,4609472601,Hc Pulm Funct Tst Plethysmograp - Plethysmography,973.24,389.3,,,0 CDM,4609472701,Hc Pulm Function Test By Gas - Helium Dilution Lung Volumes,738.53,295.41,,,0 CDM,4609472801,Hc Airway Resistance By Oscillometry,560.62,224.25,,,0 CDM,4609472901,Hc Diffusing Capacity - Carbon Monoxide Diffusing Capacity,856.64,342.66,,,0 CDM,4609476001,Hc Noninvasv Oxygen Satur;Single,95.68,38.27,,,0 CDM,4609476101,"Hc Noninvasv Oxygen Satur,Multiple",158.47,63.39,,,0 CDM,4609477001,Hc End Tidal Co2 Monitor 1X/Day,436.28,174.51,,,0 CDM,4609477601,Hc Ped Home Apnea Monit/30 Day,681.72,272.69,,,0 CDM,4609478001,Hc Car Seat/Bed Airway Testing Of Infant 1 Year Or Less: 60 Minutes,60.0,24.0,,,0 CDM,4609479905,Hc Other Gas Delivery Initial,3424.2,1369.68,,,0 CDM,4609479906,Hc Other Gas Delivery Daily,3231.8,1292.72,,,0 CDM,4609501201,Hc Nitric Oxide Expired Gas Determination,70.26,28.1,,,0 CDM,4719251601,Hc Facial Nerve Function Test - Electroneuronography,609.96,243.98,,,0 CDM,4719251701,Hc Cervical Vemp Testing W/Interpratation And Report,313.95,125.58,,,0 CDM,4719253701,Hc Caloric Vestibular Test W/Rec Bi Bithermal,272.0,108.8,,,0 CDM,4719253801,Hc Caloric Vestibular Test W/Rec Bi Monothermal,242.0,96.8,,,0 CDM,4719254001,Hc Basic Vestibular Evaluation,246.68,98.67,,,0 CDM,4719255001,Hc Tympanometry And Reflex Threshold Measurements,284.05,113.62,,,0 CDM,4719255201,"Hc Pure Tone Audiometry, Air",227.24,90.9,,,0 CDM,4719255301,"Hc Audiometry, Air & Bone",306.48,122.59,,,0 CDM,4719255501,Hc Speech Threshold Audiometry,161.46,64.58,,,0 CDM,4719255601,"Hc Speech Audiometry, Complete",285.54,114.22,,,0 CDM,4719255701,Hc Comprehensive Hearing Test,390.2,156.08,,,0 CDM,4719256701,Hc Tympanometry,269.1,107.64,,,0 CDM,4719257001,Hc Acoustic Immit Test Tympanometry/Acoust Reflex/Decay,336.38,134.55,,,0 CDM,4719257901,Hc Visual Audiometry (Vra),373.75,149.5,,,0 CDM,4719258201,Hc Conditioning Play Audiometry,334.88,133.95,,,0 CDM,4719258301,Hc Select Picture Audiometry,313.95,125.58,,,0 CDM,4719258401,Hc Electrocochleography,454.48,181.79,,,0 CDM,4719258701,"Hc Evoked Auditory Test,Limited",402.16,160.86,,,0 CDM,4719258801,"Hc Evoked Auditory Test,Comprehsv",623.42,249.37,,,0 CDM,4719260101,"Hc Dx Analysis Of Cochlear Implant,Pt <7 Yrs,W/Programming",579.93,231.97,,,0 CDM,4719260201,"Hc Dx Analysis Of Cochlear Implant,Pt <7 Yrs,Reprogramming",579.93,231.97,,,0 CDM,4719260301,"Hc Dx Analysis Of Cochlear Implant,Pt >7 Yrs,W/Programming",696.14,278.46,,,0 CDM,4719260401,"Hc Dx Analysis Of Cochlear Implant,Pt >7 Yrs,Reprogramming",672.24,268.9,,,0 CDM,4719262001,"Hc Auditory Function, 60 Min",335.58,134.23,,,0 CDM,4719262101,"Hc Auditory Function, + 15 Min",56.47,22.59,,,0 CDM,4719262501,Hc Tinnitus Assessment,231.32,92.53,,,0 CDM,4719262601,"Hc Eval Auditory Rehab Status, 1St Hour",501.74,200.7,,,0 CDM,4719265001,Hc Aep Screen Auditory Potential W/Stimuli Auto Analysis,352.96,141.18,,,0 CDM,4719265101,Hc Auditory Evoked Potentials With Interpretation And Report,538.66,215.46,,,0 CDM,4800418T01,Hc Cardiac Contractility Modiulation System Interrogation,286.0,114.4,,,0 CDM,4803321401,Hc Ep Upgrade Of Pacemaker System,14411.8,5764.72,,,0 CDM,4803322001,Hc Ep Rpr 2 Transvns Electrodes Prm Pm/Implantable Dfb,7348.5,2939.4,,,0 CDM,4803322601,Hc Ep Reposit Prev Implanted Cardiac Electrode,5140.5,2056.2,,,0 CDM,4803327101,Hc Ep Insj Of Subq Implantable Defibrillator Electrode,11007.0,4402.8,,,0 CDM,4803327201,Hc Ep Rmvl Of Subq Implantable Defibrillator Electrode,6719.45,2687.78,,,0 CDM,4803327301,Hc Ep Repos Previously Implanted Subq Implantable Dfb,2397.0,958.8,,,0 CDM,4807558001,Hc Ffr Cta Data Analysis,1900.0,760.0,,,0 CDM,4809292001,Hc Ptca Single Vess Rms Initial,17216.65,6886.66,,,0 CDM,4809292002,Hc Ptca Single Vessel Circ,17216.65,6886.66,,,0 CDM,4809292003,Hc Ptca Single Vessel Left Anterior Desc,17216.65,6886.66,,,0 CDM,4809292004,Hc Ptca Single Vess Rt Coron,17216.65,6886.66,,,0 CDM,4809292005,Hc Ptca Single Vessel Left Main,17216.65,6886.66,,,0 CDM,4809292101,Hc Ptca Each Additonal Vessel Circ,13487.2,5394.88,,,0 CDM,4809292102,Hc Ptca Each Additonal Vessel Anter Des,13487.2,5394.88,,,0 CDM,4809292103,Hc Ptca Each Additonal Vessel Coron,13487.2,5394.88,,,0 CDM,4809292105,Hc Ptca Ea Addl Vess Rms Int,13487.2,5394.88,,,0 CDM,4809292404,Hc Artherec Single Vessel Main,26966.35,10786.54,,,0 CDM,4809292801,Hc Prq Trluml Coronary Stent W/Angio One Art/Brnch-Lc,23806.15,9522.46,,,0 CDM,4809292802,Hc Prq Trluml Coronary Stent W/Angio One Art/Brnch-Rc,23806.15,9522.46,,,0 CDM,4809292803,Hc Prq Trluml Coronary Stent W/Angio One Art/Brnch-Lm,23806.15,9522.46,,,0 CDM,4809292804,Hc Prq Trluml Coronary Stent W/Angio One Art/Brnch-Ld,23806.15,9522.46,,,0 CDM,4809292901,Hc Stent Plc Lc W/Ptca Ea Add Lc*,21179.55,8471.82,,,0 CDM,4809292902,Hc Stent Plc Ld W/Ptca Ea Add Ld*,21179.55,8471.82,,,0 CDM,4809292906,Hc Stent Plc Rc W/Ptca Ea Add Rc*,21179.55,8471.82,,,0 CDM,4809293301,Hc Stent Plc/Ptca/Art 1 Ves Ld*,25258.6,10103.44,,,0 CDM,4809293303,Hc Stent Plc/Ptca/Art 1 Ves Rc*,25258.6,10103.44,,,0 CDM,4809293401,Hc Stent Plc/Ptca/Art Ea Add Ld*,20762.1,8304.84,,,0 CDM,4809293704,Hc Prc Rvsc Byp Grf 1 Vl W/St Lm,25510.45,10204.18,,,0 CDM,4809294102,Hc Prq Trluml Coronry Tot Occlus Revasc Mi One Vsl-Lc,27447.05,10978.82,,,0 CDM,4809294103,Hc Prq Trluml Coronry Tot Occlus Revasc Mi One Vsl-Rc,27447.05,10978.82,,,0 CDM,4809294104,Hc Prq Trluml Coronry Tot Occlus Revasc Mi One Vsl-Ld,27447.05,10978.82,,,0 CDM,4809294303,Hc Prc Rvsc Chron 1 Vl W/St Rc,24591.6,9836.64,,,0 CDM,4809295001,Hc Heart/Lung Resuscitation (Cpr),1469.7,587.88,,,0 CDM,4809296001,Hc Cardioverson Electric External,2450.5,980.2,,,0 CDM,4809296006,"Hc Ep Cardioversion, Elective;Extern",3975.02,1590.01,,,0 CDM,4809297301,Hc Catheter Percutaneous Transluminal Coronary Mechanical Thrombectomy,8822.8,3529.12,,,0 CDM,4809297801,Hc Endoluminal Imaging Of Coronary Vessels- Initial Vessel,7266.28,2906.51,,,0 CDM,4809297901,Hc Endoluminal Imaging Of Coronary Vessels- Additional Vessel,4322.64,1729.06,,,0 CDM,4809298601,Hc Catheter Percutaneous Aortic Valvuloplasty,16742.85,6697.14,,,0 CDM,4809298701,Hc Catheter Percutaneous Mitral Valvuloplasty,19125.65,7650.26,,,0 CDM,4809299001,Hc Catheter Percutaneous Pulmonary Valvuloplasty,18856.55,7542.62,,,0 CDM,4809299201,"Hc Cath Atrial Septostomy,Xvenous,Balloon",18419.55,7367.82,,,0 CDM,4809299701,Hc Catheter Pulmonary Arterial Balloon Repair Percutaneous First Vessel,16428.9,6571.56,,,0 CDM,4809299801,Hc Catheter Pulmonary Arterial Balloon Repair Percutaneous Each Additional Vessel,9416.2,3766.48,,,0 CDM,4809327906,Hc Ep Program Eval Implantable In Prsn 1 Ld Pacemaker,349.82,139.93,,,0 CDM,4809328105,Hc Ep Program Eval Implantable In Prsn Multi Ld Pacer,473.28,189.31,,,0 CDM,4809328603,Hc Ep Peri-Px Eval&Program In Prsn Pacemaker System,515.78,206.31,,,0 CDM,4809329603,Hc Ep Interrogation Remote 2.0 Cm,691.6,276.64,,,0 CDM,5101130501,Hc Shave Lesion <0.5Cm Neck,545.86,218.34,,,0 CDM,5101130601,Hc Shave Skin Lesion 0.6-1.0 Cm Remainder Body,560.62,224.25,,,0 CDM,5101130701,"Hc Shave Skin Lesion 1.1-2.0 Cm-Scalp, Neck Hands, Feet, Genitalia",411.12,164.45,,,0 CDM,5101131001,"Hc Shav Skin Les <0.5 Cm Face,Facial",622.88,249.15,,,0 CDM,5101131101,Hc Shv Les 0.6-1.0Cm Face Exc Scl,730.04,292.02,,,0 CDM,5101131201,"Hc Shave Skin Lesion 1.1-2.0Cn-Face, Ears, Eyelids, Nose, Lips, Mucous Membrane",545.68,218.27,,,0 CDM,5101140101,"Hc Exc Skin Benig 0.6-1 Cm Trunk,Arm,Leg",2119.79,847.92,,,0 CDM,5101140201,"Hc Exc Skin Benig 1.1-2 Cm Trunk,Arm,Leg",2653.92,1061.57,,,0 CDM,5101140401,"Hc Exc Skin Benig 3.1-4 Cm Trunk,Arm,Leg",4219.49,1687.8,,,0 CDM,5101140601,"Hc Exc Skin Benig >4 Cm Trunk,Arm,Leg",4641.44,1856.58,,,0 CDM,5101142001,Hc Exc Skin Benig <0.5 Cm Remainder Body,2427.88,971.15,,,0 CDM,5101142101,Hc Exc Skin Benig 0.6-1 Cm Remaindr Body,2511.6,1004.64,,,0 CDM,5101142201,Hc Exc Skin Benig 1.1-2 Cm Remaindr Body,2906.76,1162.7,,,0 CDM,5101160401,Hc Excision Malignant Lesion 3.1-4Cm- Trunk/Arm/Leg,1868.75,747.5,,,0 CDM,5101162001,"Hc Removal Of Malignant Growth Of Scalp,Neck,Hand,Fee,Genital, 0.5 Cm Or <",3484.0,1393.6,,,0 CDM,5101164001,"Hc Exc Skin Malig <0.5 Cm Face,Facial",2223.6,889.44,,,0 CDM,5101171901,Hc Nail Trimming,641.29,256.52,,,0 CDM,5101172001,"Hc Debridement Of Nail(S), 1-5",572.65,229.06,,,0 CDM,5101173001,Hc Removal Of Nail Plate,1158.69,463.48,,,0 CDM,5101173201,Hc Remove Nail Plate Add-On,376.74,150.7,,,0 CDM,5101175001,Hc Removal Of Nail Bed,2317.37,926.95,,,0 CDM,5101190001,"Hc Injection Into Skin Lesions, Up To 7",642.97,257.19,,,0 CDM,5101190101,Hc Injection Skin Lesions >7,740.09,296.04,,,0 CDM,5101197601,Hc Removal Contraceptive Capsule,1396.45,558.58,,,0 CDM,5101198101,Hc Insrt Nonbio Drug Dlvr Imp,562.6,225.04,,,0 CDM,5101198201,Hc Removal Non-Biodegradable Drug Delivery Implant,1125.2,450.08,,,0 CDM,5101198301,Hc Remove/Insert Drug Implant,1312.73,525.09,,,0 CDM,5101200101,Hc Resuperf Wnd Body <2.5Cm,887.43,354.97,,,0 CDM,5101202101,Hc Wound Dehiscence- With Packing,1659.33,663.73,,,0 CDM,5101204501,Hc Repair Intermediate N/H/F/Xtrnl Gent 12.6-20 Cm,910.87,364.35,,,0 CDM,5101400001,"Hc Adjacent Tissue Repair,Trunk; 10 Sqcm Or Less",6240.0,2496.0,,,0 CDM,5101402001,"Hc Repair Of Wound 10 Sq Cm/<-Scalp, Arm, Leg",4769.05,1907.62,,,0 CDM,5101404101,"Hc Repair Of Wound 10.1-30.0 Sqcm-Forehead, Cheeks, Chin, Mouth, Neck, Hands, Feet, Genitalia",2885.69,1154.28,,,0 CDM,5101406101,"Hc Repair Of Wound 10.1-30 Sqcm-Eyelids, Nose, Ear, Or Lips",3482.07,1392.83,,,0 CDM,5101522001,"Hc Full Thick Graft Scalp, Arm, Leg <20Sqc",4452.05,1780.82,,,0 CDM,5101527101,Hc Grft 1St 25Sqcm <1Sc(Tal),1970.79,788.32,,,0 CDM,5101527201,Hc Graft Ea Ad 25Sqcm (Tal),949.49,379.8,,,0 CDM,5101527501,Hc Grft 1St 25Sqcm<1Sc(Oth),1970.79,788.32,,,0 CDM,5101527601,Hc Graft Each Additional (225 Cm) Other,949.49,379.8,,,0 CDM,5101600001,Hc Initial Rx Burn(S) 1St Degree,581.02,232.41,,,0 CDM,5101602001,Hc Drss/Debrid Small Burn No Anes,833.85,333.54,,,0 CDM,5101602501,Hc Dress/Debrid Med Burn No Anesth,1041.48,416.59,,,0 CDM,5101700001,"Hc Destruc Benign/Premal,First Lesion",468.83,187.53,,,0 CDM,5101700301,Hc Destruction Of Premalg 2-14Th Lesions Each,299.72,119.89,,,0 CDM,5101700401,"Hc Destruc Benign/Premal,15+ Lesions",1121.85,448.74,,,0 CDM,5101711001,Hc Destruction Benign Lesions Up To 14,485.58,194.23,,,0 CDM,5101711101,Hc Destruction Benign Lesions 15 Or More,635.38,254.15,,,0 CDM,5101725001,Hc Chemical Cauterization Of Granulation Tissue,731.72,292.69,,,0 CDM,5102052601,Hc Injection Carpal Tunnel Unilateral,1049.85,419.94,,,0 CDM,5102052602,Hc Inject Carpal Tunnel Bilateral,1573.94,629.58,,,0 CDM,5102052701,Hc Inj Enzyme Palmar Fascial Cord,1247.43,498.97,,,0 CDM,5102055001,Hc Injection Tendon Sheath/Ligament Bilateral,2052.82,821.13,,,0 CDM,5102055002,Hc Injection Tendon Sheath/Ligament Unilateral,1369.65,547.86,,,0 CDM,5102055101,Hc Inject Tendon Origin/Insert,1091.71,436.68,,,0 CDM,5102055201,"Hc Inject Trigger Point, 1 Or 2",1525.38,610.15,,,0 CDM,5102055301,"Hc Inject Trigger Points, > 3",1741.38,696.55,,,0 CDM,5102060001,Hc Arthrocentesis Aspiration/Injection Small Joint/Bursa Without Ultrasound-Bilateral,2021.01,808.4,,,0 CDM,5102060002,Hc Arthrocentesis Aspiration/Injection Small Joint/Bursa Without Ultrasound-Unilateral,1347.89,539.16,,,0 CDM,5102060401,Hc Arthrocentesis Aspiration/Injection Small Joint/Bursa With Ultrasound-Bilateral,4060.42,1624.17,,,0 CDM,5102060402,Hc Arthrocentesis Aspiration/Injection Small Joint/Bursa With Ultrasound-Unilateral,3516.24,1406.5,,,0 CDM,5102060501,Hc Arthorcentesis Aspiration/Injection Intermediate Joint/Bursa W/O Ultrasound-Bilateral,2545.09,1018.04,,,0 CDM,5102060502,Hc Arthorcentesis Aspiration/Injection Intermediate Joint/Bursa W/O Ultrasound-Unilateral,1697.84,679.14,,,0 CDM,5102060602,Hc Arthorcentesis Aspiration/Injection Intermediate Joint/Bursa W Ultrasound-Unilateral,3958.28,1583.31,,,0 CDM,5102060603,Hc Arthorcentesis Aspiration/Injection Intermediate Joint/Bursa W Ultrasound-Bilateral,5939.1,2375.64,,,0 CDM,5102061001,Hc Arthrocentesis Aspiration/Injection Major Joint/Bursa Without Us-Bilateral,2697.46,1078.98,,,0 CDM,5102061002,Hc Arthrocentesis Aspiration/Injection Major Joint/Bursa Without Us-Unilateral,1796.63,718.65,,,0 CDM,5102061003,Hc Pbb Arthrocentesis Aspir&/Inj Major Jt/Bursa W/O Us Left,2697.46,1078.98,,,0 CDM,5102061101,Hc Arthrocentesis Aspiration/Injection Major Joint/Bursa W Ultrasound-Bilateral,6041.23,2416.49,,,0 CDM,5102061102,Hc Arthrocentesis Aspiration/Injection Major Joint/Bursa W Ultrasound-Unilateral,4026.93,1610.77,,,0 CDM,5102065001,Hc Insert And Remove Of Wire Or Pin With Bone Traction,5358.08,2143.23,,,0 CDM,5102101201,Hc Excision Tumor Soft Tissue Face/Scalp Subq 2Cm Or More,5317.0,2126.8,,,0 CDM,5102604001,Hc Fasciotomy Palmar Percutaneous,4461.6,1784.64,,,0 CDM,5102634101,Hc Maniplatn Palar Fascial Crd Post Inj Single Cord,1659.33,663.73,,,0 CDM,5102752001,Hc Closed Treatment Of Broken Kneecap,1443.0,577.2,,,0 CDM,5102761801,Hc Excision Tumor Soft Tissue Leg/Ankle Subcutaneous <3Cm,4160.0,1664.0,,,0 CDM,5102801101,Hc Tenotomy Percutaneous Toe Multiple Tendon,2960.1,1184.04,,,0 CDM,5102849001,Hc Treatment Of Big Toe Fracture,336.38,134.55,,,0 CDM,5102853001,Hc Closed Treatment Sesamoid Fracture,336.38,134.55,,,0 CDM,5102882501,Hc Amputation Toe Interphalangeal Joint,7116.2,2846.48,,,0 CDM,5102944501,Hc Apply Rigid Leg Cast,1424.92,569.97,,,0 CDM,5102954001,Hc Strapping; Ankle &/Or Foot,994.59,397.84,,,0 CDM,5102955001,Hc Strapping Toes,240.5,96.2,,,0 CDM,5102958001,Hc Strapping Unna Boot - Unilateral,853.94,341.58,,,0 CDM,5102958002,Hc Strapping Unna Boot - Bilateral,1280.92,512.37,,,0 CDM,5102958101,Hc Appl Mlt-Layer Venous Wound Compress Below Knee -Bilateral,1265.85,506.34,,,0 CDM,5102958102,Hc Apply Multi-Layer Venous Wound Compression Below Knee-Unilateral,843.9,337.56,,,0 CDM,5103000001,Hc Drainage Abscess/Hematoma Nasal Internal Approach,144.0,57.6,,,0 CDM,5103011701,Hc Removal Of Intranasal Lesion,4212.91,1685.16,,,0 CDM,5103123701,"Hc Nasal/Sinus Endoscopy,Bx/Rmv Polyp/Debrid",2655.86,1062.34,,,0 CDM,5103157001,"Hc Laryngoscopy,Dirct,Inj Vocal Cord",3650.19,1460.08,,,0 CDM,5103157501,"Hc Laryngoscopy,Flex Fiber,Diagnostic",1826.38,730.55,,,0 CDM,5103157901,"Hc Laryngoscopy,Flex/Rigid+Stroboscopy",2524.48,1009.79,,,0 CDM,5103161501,Hc Scope Thru Tracheostomy,2860.65,1144.26,,,0 CDM,5103189902,Hc Biopsy Trachea Bronchi,410.82,164.33,,,0 CDM,5103647001,Noncdm Charge Record,1764.1,705.64,,,0 CDM,5103658901,Hc Removal Tunneled Cv Cath W/O Subq Port Or Pump,4756.97,1902.79,,,0 CDM,5103659001,Hc Removal Tunneled Cv Cath W Subq Port Or Pump,5615.94,2246.38,,,0 CDM,5103659201,Hc Collect Blood From Catheter Venous-Draw Charge,421.95,168.78,,,0 CDM,5103659301,Hc Declot By Thrombolytic Agent Implant Device/Cath,1635.89,654.36,,,0 CDM,5104049001,Hc Biopsy Of Lip,1146.96,458.78,,,0 CDM,5104080801,Hc Biopsy Of Mouth Lesion,1019.71,407.88,,,0 CDM,5104110001,"Hc Biopsy Tongue,Anter 2/3",1811.71,724.68,,,0 CDM,5104110801,Hc Biopsy Floor Of Mouth,1964.07,785.63,,,0 CDM,5104111001,Hc Excise Tongue Lesion W/O Closure,5408.31,2163.32,,,0 CDM,5104111501,Hc Excision Of Tongue Fold,2354.62,941.85,,,0 CDM,5104210001,Hc Biopsy Palate/Uvula,2354.21,941.68,,,0 CDM,5104218001,Hc Repair Palate Lacer <2 Cm,1590.68,636.27,,,0 CDM,5104240501,"Hc Biopsy Salivary Gland, Incisional",3894.48,1557.79,,,0 CDM,5104266001,Hc Dilation/Cath Of Salivary Duct,1068.92,427.57,,,0 CDM,5104280001,Hc Biopsy Oropharynx,4530.93,1812.37,,,0 CDM,5104361001,Hc Cryosurgery Anal Lesion(S),927.62,371.05,,,0 CDM,5104376201,Hc Replacement Gastro Tube Without Revision Of Gastrostomy Tract,2015.98,806.39,,,0 CDM,5104510001,Hc Biopsy Of Rectum,5831.93,2332.77,,,0 CDM,5104603001,Hc Seton Drain Removal,2756.06,1102.42,,,0 CDM,5104608301,Hc Incise External Hemorrhoid,1218.96,487.58,,,0 CDM,5104623001,Hc Excision Multiple External Papillae/Tags Anus,6268.95,2507.58,,,0 CDM,5104632001,"Hc Excision Thrombosed Hemorrhoid, External",4547.67,1819.07,,,0 CDM,5104660001,Hc Anoscopy Dx W/Collj Spec Br/Wa Spx When Prfrmd,1134.73,453.89,,,0 CDM,5104660601,"Hc Anoscopy And Biopsy - Endoscopy, Anus",2403.41,961.36,,,0 CDM,5104690001,Hc Destruction Anal Lesion(S),1146.66,458.66,,,0 CDM,5105039101,Hc Instillation Of Drug Into Kidney And/Or Ureter Unilateral,1147.87,459.15,,,0 CDM,5105170001,Hc Irrigation Of Bladder,890.79,356.32,,,0 CDM,5105170101,"Hc Insert,Non-Indwelling Bladder Catheter",547.53,219.01,,,0 CDM,5105170201,"Hc Insert,Temp Indwelling Blad Cath,Simple",676.46,270.58,,,0 CDM,5105172001,Hc Instill Anticancer Agent In Bladder,903.12,361.25,,,0 CDM,5105172501,Hc Simple Cystometrogram,1178.78,471.51,,,0 CDM,5105172801,Hc Complex Cystometrogram Voiding Pressure Studies,1964.07,785.63,,,0 CDM,5105173601,Hc Urine Flow Measurement,393.48,157.39,,,0 CDM,5105174101,Hc Complex Uroflowmetry,410.23,164.09,,,0 CDM,5105178401,Hc Anal/Urinary Muscle Study,800.36,320.14,,,0 CDM,5105179701,Hc Voiding Press Study Intra-Abdominal Void,631.25,252.5,,,0 CDM,5105179801,"Hc Meas,Post-Void Res,Us,Non-Imaging",627.9,251.16,,,0 CDM,5105200001,Hc Cystoscopy W/ Disposable Scope,1877.95,751.18,,,0 CDM,5105200101,Hc Cystoscopy Removal Of Clots W/ Disposable Scope,4206.7,1682.68,,,0 CDM,5105200501,"Hc Cystourethroscopy, Ureter Catheter W/ Disposable Scope",5005.95,2002.38,,,0 CDM,5105223401,"Hc Cystourethroscopy, Fulgur 0.5-2 Cm Lesn W/ Disposable Scope",5672.95,2269.18,,,0 CDM,5105228101,"Hc Cystoscopy,Dil Urethral Stricture W/ Disposable Scope",4453.95,1781.58,,,0 CDM,5105228701,Hc Cystourethroscopy Inj Chemodenervation Bladder W/ Disposable Scope,3545.45,1418.18,,,0 CDM,5105231001,"Hc Cystoscopy,Remv Calculus,Simple W/D Disposable Scope",4085.95,1634.38,,,0 CDM,5105235101,"Hc Cystoscopy/Uretero/Pyeloscopy, Dx W/ Disposable Scope",5299.2,2119.68,,,0 CDM,5105302001,Hc Incision Urethra Exclude Infant,3509.54,1403.82,,,0 CDM,5105360001,"Hc Dil Urethra Stric,Male,Initial W/ Disposable Scope",1469.58,587.83,,,0 CDM,5105405601,Hc Cryosurgery Penis Lesn(S) Simple,927.62,371.05,,,0 CDM,5105406501,Hc Destruction Penis Lesion(S)/Extensive,5441.8,2176.72,,,0 CDM,5105410001,Hc Excision Biopsy Of Penis,2362.1,944.84,,,0 CDM,5105415001,Hc Circumcision With Block/Clamp,3594.94,1437.98,,,0 CDM,5105416101,Hc Circumcision 28 Days Or Older,3631.77,1452.71,,,0 CDM,5105416201,Hc Lysis Of Penile Lesions,4278.09,1711.24,,,0 CDM,5105416301,Hc Repair Of Circumcision,3631.77,1452.71,,,0 CDM,5105423501,"Hc Penile Injection,Pharmacy Agent",795.34,318.14,,,0 CDM,5105445001,Hc Preputial Stretching,802.04,320.82,,,0 CDM,5105525001,Hc Removal Of Sperm Duct(S),4302.12,1720.85,,,0 CDM,5105570001,Hc Biopsy Needle/Punch Of Prostate,4994.73,1997.89,,,0 CDM,5105572001,Hc Drainage Of Prostate Abscess,5902.26,2360.9,,,0 CDM,5105587601,"Hc Place Radiother Device/Marker, Prostate",4129.75,1651.9,,,0 CDM,5105644101,Hc Lysis Of Labial Lesion(S),4263.02,1705.21,,,0 CDM,5105650101,"Hc Destruction,Lesion(S),Vulva,Simple",5701.33,2280.53,,,0 CDM,5105660501,"Hc Biopsy Vulva/Perineum,One Lesion",1860.26,744.1,,,0 CDM,5105660601,Hc Biopsy Vulva/Perineum Additional Lesion,745.11,298.04,,,0 CDM,5105682001,"Hc Colposcopy,Vulva",569.3,227.72,,,0 CDM,5105682101,"Hc Colposcopy,Vulva,W/Biopsy(S)",1105.1,442.04,,,0 CDM,5105710001,Hc Biopsy Of Vagina Simple,1799.98,719.99,,,0 CDM,5105716001,Hc Fit/Insert Intravag Support Device,599.43,239.77,,,0 CDM,5105742001,"Hc Colposcopy,Entire Vagina",1389.75,555.9,,,0 CDM,5105742101,"Hc Colposcopy,Entire Vagina,W/Biopsy(S)",1768.17,707.27,,,0 CDM,5105745201,"Hc Colposcopy,Cervix W/Adj Vagina",704.54,281.82,,,0 CDM,5105745401,"Hc Colposc,Cervix W/Adj Vag,W/Bx & Curretag",1152.76,461.1,,,0 CDM,5105745501,"Hc Colposcopy,Cervix W/Adj Vagina,W/Bx",1138.59,455.44,,,0 CDM,5105745601,"Hc Colposcopy,Cervix W/Adj Vagina, Curettag",982.74,393.1,,,0 CDM,5105746101,"Hc Colposcopy,Cervix W/Adj Vag,W/Loop Coniz",5149.42,2059.77,,,0 CDM,5105750001,"Hc Biopsy Cervix, 1 Or More, Or Excision Of Lesion",2176.72,870.69,,,0 CDM,5105750501,Hc Endocervical Curettage,1967.42,786.97,,,0 CDM,5105752201,"Hc Colposcopy,Cervix W/Adj Vag,W/O Loop Coniz",6736.11,2694.44,,,0 CDM,5105810001,Hc Biopsy Of Uterus Lining,954.41,381.76,,,0 CDM,5105811001,Hc Endomet Biopsy Done W/Colposcopy,828.83,331.53,,,0 CDM,5105830001,Hc Insert Intrauterine Device,838.88,335.55,,,0 CDM,5105830101,Hc Remove Intrauterine Device,947.71,379.08,,,0 CDM,5105900001,"Hc Amniocentesis,Diagnostic",1882.02,752.81,,,0 CDM,5106225201,"Hc Reporgramming, Programmable Csf Shunt",746.95,298.78,,,0 CDM,5106227001,"Hc Spinal Puncture,Lumbar,Diagnostic",2722.58,1089.03,,,0 CDM,5106232001,Hc Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/O Img Gdn,4018.56,1607.42,,,0 CDM,5106232101,Hc Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn,6876.77,2750.71,,,0 CDM,5106232501,Hc Pain Inj Epd Crv/Tho W/ Img Gd,5026.55,2010.62,,,0 CDM,5106236801,Hc Pump Interogation With Reprogram,1799.98,719.99,,,0 CDM,5106237001,Hc Pump Refill W/ Reprogramming,1693.55,677.42,,,0 CDM,5106365001,Hc Sc Implant Neuroelec,13996.62,5598.65,,,0 CDM,5106440001,Hc Sc Orbital Nerve Block,1639.24,655.7,,,0 CDM,5106440501,"Hc Injection Nerve Block,Great Occiptal Bilateral",3325.36,1330.14,,,0 CDM,5106440502,"Hc Injection Nerve Block,Great Occiptal Unilateral",2216.9,886.76,,,0 CDM,5106441502,"Hc Injection,Anes Agent,Brachial Plexus,Single",2210.21,884.08,,,0 CDM,5106441701,"Hc Injection Nerve Block,Axillary Nerve Including Imaging Guidance, When Performed",4361.38,1744.55,,,0 CDM,5106442101,"Hc Inject Nerv Blck,Intercost,Multpl",3514.56,1405.82,,,0 CDM,5106442501,"Hc Injection Nerve Block, Ilioinguinal, Iliohypogastric",1970.77,788.31,,,0 CDM,5106443001,"Hc Injection Nerve Block,Pudendal-Bilateral",3412.42,1364.97,,,0 CDM,5106443002,"Hc Injection Nerve Block,Pudendal-Unilateral",2275.51,910.2,,,0 CDM,5106445001,"Hc Injection Nerve Block,Other Periph Nerve-Bilateral",3260.06,1304.02,,,0 CDM,5106445002,"Hc Injection Nerve Block,Other Periph Nerve-Unilateral",2171.7,868.68,,,0 CDM,5106445101,Hc Injection Agent Somatic Nerve-Unilateral,1617.47,646.99,,,0 CDM,5106445102,Hc Injection Agent Somatic Nerve-Bilateral,2426.2,970.48,,,0 CDM,5106445401,Hc Inj Agt Geniculr Nrv W/Img-Bilateral,2426.2,970.48,,,0 CDM,5106445402,Hc Inj Agt Genicular Nrv W/Img-Unilateral,1617.47,646.99,,,0 CDM,5106447901,"Hc Inject Anes/Steroid Foramen Cerv/Thoracic W Img Guide ,1 Level-Bilateral",5471.93,2188.77,,,0 CDM,5106447902,"Hc Injection Anes/Steroid Foramen Cerv/Thoracic W Imagine Guidance ,1 Level",3646.84,1458.74,,,0 CDM,5106448302,"Hc Injection Anes/Steroid Foramen Lumbar/Sacral W Imagine Guidance ,1 Level",3125.98,1250.39,,,0 CDM,5106448401,"Hc Injection Anesthesia/Steroid Foramen Lumbar/Sacral W Imagine Guidance ,Each Additional Level",2890.02,1156.01,,,0 CDM,5106448402,"Hc Injection Anes/Steroid Foramen Lumbar/Sacral W Imagine Guidance ,Each Additional Level",2890.02,1156.01,,,0 CDM,5106448602,Hc Injection Tap Block W/Imagine-Unilateral,1759.8,703.92,,,0 CDM,5106448801,Hc Inj Tap Block Bilateral W/Img,2638.86,1055.54,,,0 CDM,5106449001,"Hc Injection Dx/Therapy Agent Paravert Facet Joint,Image Guidance,Cerv/Thorac, 1St Level- Bilateral",6585.41,2634.16,,,0 CDM,5106449002,"Hc Injection Dx/Therapy Agent Paravert Facet Joint,Image Guidance,Cerv/Thorac, 1St Level-Unilateral",4390.28,1756.11,,,0 CDM,5106449101,"Hc Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Cerv/Thorac, 2Nd Level - Bilateral",4865.81,1946.32,,,0 CDM,5106449102,"Hc Injection Dx/Therapy Agent Paravert Facet Joint,Imagine Guide,Cerv/Thorac, 2Nd Level",3631.77,1452.71,,,0 CDM,5106449201,"Hc Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Cerv/Thorac, Add Level - Bilateral",3555.18,1422.07,,,0 CDM,5106449202,"Hc Injection Dx/Therapy Agent Paravert Facet Joint,Imagine Guide,Cerv/Thorac, 2Nd Level - Unilateral",2653.1,1061.24,,,0 CDM,5106449301,"Hc Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Lumbar/Sac, 1St Level - Bilateral",6793.05,2717.22,,,0 CDM,5106449302,"Hc Pbb Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Lumbar/Sac, 1St Level Unilateral",4529.25,1811.7,,,0 CDM,5106449401,"Hc Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Lumbar/Sac, 2Nd Level - Bilateral",4646.46,1858.58,,,0 CDM,5106449402,"Hc Injection Dx/Therapy Agent Paravert Facet Joint,Imagine Guidance Lumbar/Sca, 2Nd Level",3469.36,1387.74,,,0 CDM,5106449501,"Hc Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Lumbar/Sac, Add Level - Bilateral",4458.92,1783.57,,,0 CDM,5106449502,"Hc Injection Dx/Therapy Agent Paravert Facet Joint,Imagine Guidance Lumbar/Sca, Additional",3328.7,1331.48,,,0 CDM,5106450501,Hc Inj Agt Sphenopalatine Gan Bilateral,2941.93,1176.77,,,0 CDM,5106451001,"Hc Inject Nerv Blck,Stellate Ganglion",3516.24,1406.5,,,0 CDM,5106451701,Hc Injection Agent Hypogastric Plexus,3715.49,1486.2,,,0 CDM,5106452001,"Hc Inject Nerv Blck,Paravert Sympath-Bilateral",6160.12,2464.05,,,0 CDM,5106452002,"Hc Injection Nerve Block,Paravert Sympath-Unilateral",4107.3,1642.92,,,0 CDM,5106453001,"Hc Inject Nerv Blck,Celiac Plexus",4129.07,1651.63,,,0 CDM,5106456601,"Hc Post Tibial Neurostimulation,Perc Needle Electrode",686.5,274.6,,,0 CDM,5106461101,Hc Chemodenervation Parotid/Submandibular Salivary Glands-Bilateral,943.74,377.5,,,0 CDM,5106461201,Hc Chemodenervation Muscle Innervated Facial Nerve-Biilateral,2869.92,1147.97,,,0 CDM,5106461202,Hc Chemodenervation Muscle Innervated Facial Nerve-Unilateral,1912.17,764.87,,,0 CDM,5106461501,Hc Chemodenervation Facial/Trigeminal/Cervical Spinal/Accessory Nerve Muscles- Migraine,1265.85,506.34,,,0 CDM,5106461601,Hc Chemodenervation Muscle Neck For Dystonia-Bilateral,2565.19,1026.08,,,0 CDM,5106461602,Hc Chemodenervation Muscle Neck For Dystonia-Unilateral,1709.56,683.82,,,0 CDM,5106461701,Hc Chemodenervation Muscle Larynx W/Emg-Bilateral,3365.54,1346.22,,,0 CDM,5106461702,Hc Chemodenervation Muscle Larynx W/Emg-Unilateral,2245.37,898.15,,,0 CDM,5106462401,Hc Destr Neuro Agt Genicu Nrv-Bilateral,8229.68,3291.87,,,0 CDM,5106462402,Hc Destruction Neurolytic Agt Genicular Nerve W/Img,3641.82,1456.73,,,0 CDM,5106462501,Hc Sc Rftc Sacroiliac W/Img-Bilateral,5562.36,2224.94,,,0 CDM,5106462502,Hc Sc Rftc Sacroiliac W/Img-Unilateral,3708.8,1483.52,,,0 CDM,5106463001,Hc Destruction By Neurolytic Agent Pudendal Nerve,2535.0,1014.0,,,0 CDM,5106463301,Hc Rftc Cer/Thoracic Sing Lev-Bilateral,9081.14,3632.46,,,0 CDM,5106463302,Hc Rftc Cervical/Thoracic Single Level-Unilateral,6054.57,2421.83,,,0 CDM,5106463401,Hc Cervical/Thoracic Additional Level-Bilateral,5764.41,2305.76,,,0 CDM,5106463402,Hc Cervical/Thoracic Additional Level-Unilateral,4303.56,1721.42,,,0 CDM,5106463501,Hc Destruction Nrolytc Agnt Parverteb Fct Single Lumbar/Sacral-Bilateral,9121.36,3648.54,,,0 CDM,5106463502,Hc Dstr Nrolytc Agent Parverteb Fct Single Lumbr/Sacral,6081.86,2432.74,,,0 CDM,5106463601,Hc Rftc Lumbar Add Lev-Bilateral,6173.79,2469.52,,,0 CDM,5106463602,Hc Rftc Lumbar Additonal Level - Unilateral,4609.52,1843.81,,,0 CDM,5106464001,Hc Destruct By Neuro Agent; Other Periph Nerve - Bilateral,6201.98,2480.79,,,0 CDM,5106464002,Hc Destruction By Neuro Agent; Other Periph Nerve,4135.77,1654.31,,,0 CDM,5106464201,Hc Chemodenervation One Extremity 1-4 Muscle,1828.45,731.38,,,0 CDM,5106464301,Hc Chemodenervation One Extremity 1-4 Muscle Each Additional Muscles,999.62,399.85,,,0 CDM,5106464401,Hc Chemodenervation One Extremity 5 Or More,1828.45,731.38,,,0 CDM,5106464501,Hc Chemodenervation One Extremity 5 Or More Each Additional Muscles,999.62,399.85,,,0 CDM,5106464601,Hc Chemodenervation Trunk 1-5 Muscles,2109.74,843.9,,,0 CDM,5106464701,Hc Cehmodenervation Of Trunk 6 Or More Muscles,2437.5,975.0,,,0 CDM,5106468001,Hc Inject Rx Celiac Plexus Nerve,5451.85,2180.74,,,0 CDM,5106520501,"Hc Removal Foreign Body,Eye,Superficial Conjunction",532.45,212.98,,,0 CDM,5106853001,Hc Removal Of Foreign Body/Stone In Tear Duct,1906.12,762.45,,,0 CDM,5106910001,Hc Biopsy Of External Ear,1483.52,593.41,,,0 CDM,5106920901,Hc Removal Impacted Cerumen Irrigation/Lvg Bilateral,604.46,241.78,,,0 CDM,5106920902,Hc Removal Impacted Cerumen Irrigation/Lvg Unilateral,401.86,160.74,,,0 CDM,5106921001,Hc Removal Impacted Cerumen Instrumentation Unilateral,423.62,169.45,,,0 CDM,5106921002,Hc Removal Impacted Cerumen Instrumentation Bilateral,637.95,255.18,,,0 CDM,5106922201,"Hc Debride Mastoid Cavity,Complex",1046.5,418.6,,,0 CDM,5106943301,Hc Tympanostomy W/Ins Tubes Bil Local Anesthesia,3872.05,1548.82,,,0 CDM,5106943302,Hc Tympanostomy W/Ins Tube Unilateral,3214.25,1285.7,,,0 CDM,5107616001,Hc Sensormotor Exam With Multiple Measurements Of Ocular Deviation,331.2,132.48,,,0 CDM,5108982701,Hc Osteo Manipulation 5-6 Body,105.48,42.19,,,0 CDM,5109091101,Hc Biofeedback Perineal/Urethral/Anorectal Sphincter,253.0,101.2,,,0 CDM,5109091201,Hc Bfb Training 1St 15 Minute,253.0,101.2,,,0 CDM,5109091301,Hc Bfb Training Each Additional 15 Minute,253.0,101.2,,,0 CDM,5109112001,Hc Balloon Expulsion Study,2069.56,827.82,,,0 CDM,5109112201,Hc Anorectal Manometry,3005.55,1202.22,,,0 CDM,5109120001,Hc Liver Elastography W/O Imag,692.94,277.18,,,0 CDM,5109207101,Hc Fitting Contact Lens Treatment Ocular Surface Disease,135.0,54.0,,,0 CDM,5109207201,Hc Fitting Contact Lens For Management Of Keratoconus,415.0,166.0,,,0 CDM,5109231001,"Hc Contact Lens Fitting, Bilateral",36.0,14.4,,,0 CDM,5109231101,"Hc Contact Lens Fit,Aphakia Unilateral",310.0,124.0,,,0 CDM,5109231201,"Hc Contact Lens Fit,Aphakia Bilateral",332.0,132.8,,,0 CDM,5109231301,"Hc Contact Lens Fit,Corneoscleral Lens",269.0,107.6,,,0 CDM,5109231401,"Hc Script Contact Lens,Bilateral",255.0,102.0,,,0 CDM,5109250401,Hc Binocular Microscopy,126.0,50.4,,,0 CDM,5109251101,Hc Nasopharyngoscopy,568.01,227.2,,,0 CDM,5109265201,Hc Auditory Brainstem Response Test,784.54,313.82,,,0 CDM,5109326001,Hc Programming Device Eval Of Heart Monitoring System,120.0,48.0,,,0 CDM,5109378601,Hc Ambulatory Blood Pressure Recording - 24 Hour Blood Pressure Monitor,798.33,319.33,,,0 CDM,5109501701,Hc Allergy Testing With Venoms Into Or Within Skin Each With Interpretation And Report,42.9,17.16,,,0 CDM,5109501801,Hc Allgergy Testing With Drugs/Biologicals Into The Skin With Interpretation And Report,136.04,54.42,,,0 CDM,5109501802,Hc Allergy Test (Misc Allergens)(So),136.04,54.42,,,0 CDM,5109507601,Hc Ingestion Challenge Test Initial 120 Minutes,973.24,389.3,,,0 CDM,5109507901,Hc Ingestion Challenge Test Each Additional 60 Minutes,337.87,135.15,,,0 CDM,5109511501,"Hc Immunotherapy, One Injection",56.0,22.4,,,0 CDM,5109511701,"Hc Immunotherapy, 2+ Injections",76.0,30.4,,,0 CDM,5109516501,Hc Prep&Allergen Imun 1/Mlt Antgn,85.0,34.0,,,0 CDM,5109518001,Hc Rapid Allergen Desensitization Procedure Each Hour,420.0,168.0,,,0 CDM,5109519901,"Hc Allergy Immunology Service,Unlisted",52.32,20.93,,,0 CDM,5109525001,Hc Continuous Glucose Monitor Phys/Qhp Eqp,386.4,154.56,,,0 CDM,5109586001,"Hc Emg, Needle, One Limb",1131.9,452.76,,,0 CDM,5109586101,"Hc Emg, Needle, Two Limbs",1252.45,500.98,,,0 CDM,5109586401,"Hc Emg, Needle, 4 Limbs",2463.04,985.22,,,0 CDM,5109586501,Hc Needle Emg Larynx,552.5,221.0,,,0 CDM,5109586601,Hc Needle Emg Hemidiaphragm,422.5,169.0,,,0 CDM,5109587001,"Hc Emg,1 Extrem,Nonparaspinal",838.88,335.55,,,0 CDM,5109587301,Hc E Stim Gde-Chemodenervation,231.84,92.74,,,0 CDM,5109587401,Hc Emg Guidance For Chemodenervat,919.24,367.7,,,0 CDM,5109597001,Hc Analysis Of Implanted Brain/Peripheral Neurostimulator Without Programming,747.5,299.0,,,0 CDM,5109597101,"Hc Analyze Neurostimulator,Simple/Progress",1330.55,532.22,,,0 CDM,5109597201,Hc Elec Alys Nstim Pls Gen Cplx Sc/Perph W/Prgrmg,1215.44,486.18,,,0 CDM,5109597601,Hc Electronic Analysis Implant Simple Cn Npgt Programming,167.44,66.98,,,0 CDM,5109597701,Hc Electronic Analysis Of Complex Cranial Nerve Stimulator Programming,240.5,96.2,,,0 CDM,5109598301,Hc Analysis Brain Stimulation Device/Programming First 15 Mins,541.19,216.48,,,0 CDM,5109598401,Hc Analysis Brain Stimulation Device/Programming Each Additional 15 Mins,358.8,143.52,,,0 CDM,5109599002,Hc Refl & Maintn Pump Implant,772.0,308.8,,,0 CDM,5109599101,Hc Reflex & Maintain Implant Pump Implant-Md,543.0,217.2,,,0 CDM,5109615601,Hc Health Behavorial Assessment/Re-Assessement,169.0,67.6,,,0 CDM,5109615801,Hc Health Behavorial Intervention 1St 30 Minutes,100.0,40.0,,,0 CDM,5109615901,"Hc Health Behavorial Intervention, Each Additional 15 Minutes",65.0,26.0,,,0 CDM,5109616701,Hc Health Behavior Intervention Family W/Pt F2F 1St 30 Min,125.0,50.0,,,0 CDM,5109616801,Hc Health Behavior Intervention Family W/Pt F2F Each Add 15 Min,80.0,32.0,,,0 CDM,5109637201,"Hc Injection,Therapy/Proph/Diagnostic, Im Or Subcut",275.35,110.14,,,0 CDM,5109637601,"Hc Injection,Therapy/Proph/Diagnostic, Iv Push, Each Additional, Same Drug",409.63,163.85,,,0 CDM,5109637701,Hc Application On-Body Injector For Timed Injection,196.68,78.67,,,0 CDM,5109640601,"Hc Intralesional Chemo Admin,8+ Lesn",552.0,220.8,,,0 CDM,5109642501,Hc Chemotherapy Infusion Intra-Arterial >8 Hours,938.95,375.58,,,0 CDM,5109652301,Hc Irrig Drug Delivery Device,325.86,130.34,,,0 CDM,5109759701,Hc Debridement Open Wound 20 Sq Cm<,904.18,361.67,,,0 CDM,5109759801,Hc Debridement Open Wound Ea Addl 20 Sq Cm,797.02,318.81,,,0 CDM,5109760201,"Hc Wound Debridemnt, Non-Selective, Ea",713.3,285.32,,,0 CDM,5109760501,Hc Negative Pressure Wound Therapy Dme 50 Sq Cm,925.94,370.38,,,0 CDM,5109760701,Hc Neg Pressure Wound Therapy Non Dme 100Sc(Tal,2531.7,1012.68,,,0 CDM,510C527501,Hc Lc Grft 1St 25Sqcm<100Sc(Oth),2297.28,918.91,,,0 CDM,510G010101,Hc Cervical/Vaginal Cancer Screening-Pelvic/Breast Exam,230.0,92.0,,,0 CDM,510G010201,Hc Prostate Cancer Screening-Digital Rectal Exam,63.0,25.2,,,0 CDM,510G011701,Hc Glaucoma Screening Hgh Risk Direct Opthalmologist,243.68,97.47,,,0 CDM,510G011801,Hc Glaucoma Screening Hgh Risk Direct Supervision,186.88,74.75,,,0 CDM,510G012701,Hc Trimming Of Dystrophic Nails,557.57,223.03,,,0 CDM,510G023801,"Hc Oth Resp Proc, Indiv",457.11,182.84,,,0 CDM,510G025901,Hc Injection For Sacroiliac Joint,1976.0,790.4,,,0 CDM,510G026001,Hc Sc Si Joint Inj Bilateral,4666.56,1866.62,,,0 CDM,510G026002,Hc Sc Si Joint Injection,3109.37,1243.75,,,0 CDM,510G029601,Hc Office Visit To Determine Lung Ca Screening Eligible,150.0,60.0,,,0 CDM,510G044301,Hc Brief Alcohol Misuse Counsel,125.0,50.0,,,0 CDM,510G044401,Hc Depression Screen Annual,65.0,26.0,,,0 CDM,510G044701,Hc Behavior Counsel Obesity Each 15 Minutes,123.0,49.2,,,0 CDM,510G046301,Hc Facility Visit-Pharmd Coumadin,175.0,70.0,,,0 CDM,510G046304,Hc Rn Nurse Visit Medicine Education,126.0,50.4,,,0 CDM,510G046305,Hc Pharmd Visit Fee,175.0,70.0,,,0 CDM,510G046306,Hc Facility Visit,253.0,101.2,,,0 CDM,510G046307,Noncdm Charge Record,251.05,100.42,,,0 CDM,510M101701,Hc New Pump Therapy,450.5,180.2,,,0 CDM,510M102201,Hc Sensor Upgrade,106.0,42.4,,,0 CDM,510M102301,Hc Client Bill Only - Additional Support,106.0,42.4,,,0 CDM,510M102401,Hc Therapy Review,106.0,42.4,,,0 CDM,510Q301401,Hc Telehealth Fee Peds Cardiology,55.16,22.06,,,0 CDM,510T101901,Hc Saline Start Only,371.0,148.4,,,0 CDM,540A042501,Hc Ground Transport Serv/Mile,26.48,10.59,,,0 CDM,540A042601,Hc Patient Transfer Level 1,1426.49,570.6,,,0 CDM,540A042701,Hc Ground Neo/Ped Transport,4765.99,1906.4,,,0 CDM,540A042702,Hc Ground Neo/Ped Return,2787.88,1115.15,,,0 CDM,540A042704,Hc Als Emergency Transprt Level 1,2098.36,839.34,,,0 CDM,540A042801,Hc Basic Life Support (Bls),2018.92,807.57,,,0 CDM,540A043301,Hc Advanced Life Support Level 2,3727.84,1491.14,,,0 CDM,540A043401,Hc Specialty Care-Transport,11859.8,4743.92,,,0 CDM,6107033601,"Hc Mri, Tmj - Mr Temporomandibular Joints Wo Iv Contrast",2815.24,1126.1,,,0 CDM,6107054001,"Hc Mri, Face, Neck - Mri Neck Soft Tissue Only Wo Contrast",3295.0,1318.0,,,0 CDM,6107054201,"Hc Mri, Face, Neck W/Contrast - Mri Neck Soft Tissue W Contrast",3436.0,1374.4,,,0 CDM,6107054301,"Hc Mri, Face, Neck, Combo - Mri Neck Soft Tissue Only W Wo Contrast",4777.0,1910.8,,,0 CDM,6107155001,"Hc Mri, Chest - Mri Chest Wo Contrast",3558.4,1423.36,,,0 CDM,6107155101,"Hc Mri, Chest, W/Contrast - Mri Chest W Contrast",3757.1,1502.84,,,0 CDM,6107155202,"Hc Mri, Chest, Combo - Mri Chest W Wo Contrast",4973.48,1989.39,,,0 CDM,6107219501,"Hc Mri, Pelvis, W/O Contrast - Mri Pelvis Wo Contrast",3127.67,1251.07,,,0 CDM,6107219601,"Hc Mri, Pelvis W/Contrast - Mri Pelvis W Contrast",4138.44,1655.38,,,0 CDM,6107219701,"Hc Mri, Pelvis, Combo - Mri Pelvis W Wo Contrast",5117.06,2046.82,,,0 CDM,6107321802,Hc Mri Upper Extremity No Joint W/O Contrast,3294.21,1317.68,,,0 CDM,6107321902,Hc Mri Upper Extremity No Joint W/Contrast,3546.91,1418.76,,,0 CDM,6107322002,Hc Mri Upper Extremity No Joint Wo/W Contrast,4599.04,1839.62,,,0 CDM,6107322101,Hc Mri Upper Extremity Joint W/O Contrast,4040.81,1616.32,,,0 CDM,6107322201,Hc Mri Upper Extremity Joint W/Contrast-Right,4040.81,1616.32,,,0 CDM,6107322214,Hc Mri Upper Extremity W Iv Contrast,4375.06,1750.02,,,0 CDM,6107322307,Hc Mri Upper Extremity Joint Wo/W Contrast,5184.83,2073.93,,,0 CDM,6107322507,Hc Mr Angio Upper Extrem - Mr Upper Extremity Angio Bil Wo Iv Contrast,2774.0,1109.6,,,0 CDM,6107371804,Hc Mri Lower Extremity No Joint W/O Contrast,4023.58,1609.43,,,0 CDM,6107371904,Hc Mri Lower Extremity No Joint W Contrast,4492.22,1796.89,,,0 CDM,6107372002,Hc Mri Lower Extremity No Joint Wo/W Contrast,4804.64,1921.86,,,0 CDM,6107372101,Hc Mri Lower Extremity W/O Iv Contrast,4023.58,1609.43,,,0 CDM,6107372202,Hc Mri Lower Extremity Joint W/Contrast,4518.63,1807.45,,,0 CDM,6107372302,"Hc Mri, Joint Of Leg Combo - W And Wo Iv Contrast",5182.53,2073.01,,,0 CDM,6107418101,"Hc Mri, Abdomen (Mri) - Mri Abdomen Wo Contrast Mrcp",4226.89,1690.76,,,0 CDM,6107418102,"Hc Mri, Abdomen (Mri) - Mri Abdomen Wo Contrast",4226.89,1690.76,,,0 CDM,6107418202,"Hc Mri, Abdomen W/Contrast - Mri Abdomen W Contrast",4390.0,1756.0,,,0 CDM,6107418301,"Hc Mri, Abdomen, Combo - Mri Abdomen W Wo Contrast Mrcp",5469.68,2187.87,,,0 CDM,6107418501,Hc Mr Angio Abdomen (Mra) - Mr Abdomen Angio W And Wo Iv Contrast,578.9,231.56,,,0 CDM,6107471201,Hc Mr Fetal Single Gestation,915.44,366.18,,,0 CDM,6107555701,Hc Cardiac Mri For Morph - Mri Cardiac Morph & Function Wo Iv Contrast,3347.05,1338.82,,,0 CDM,6107555901,Hc Cardiac Mri W/Stress - Mri Cardiac Morph & Function Wo Iv Contrast W Stress,3652.58,1461.03,,,0 CDM,6107556101,Hc Cardiac Mri Morph W/Dye - Mri Cardiac Morph & Function W & Wo Iv Contrast,4322.22,1728.89,,,0 CDM,6107556301,Hc Cardiac Mri W/Stress - Mri Cardiac Morph & Function W & Wo Iv Contrast W Stress,4875.85,1950.34,,,0 CDM,6107556501,Hc Cardiac Mri Velocity Flow Mapping - Mri Cardiac Velocity Flow Mapping,1616.09,646.44,,,0 CDM,6107601401,Hc Mr Safety Implant And/Or Foreign Body Assessment 1St 15 Minutes,34.29,13.72,,,0 CDM,6107601501,Hc Mr Safety Implant And/Or Foreign Body Assessment Each Additional 30 Minutes,34.29,13.72,,,0 CDM,6107601601,Hc Mr Safety Determination By A Physician Or Qualified Healthcare Professional,123.27,49.31,,,0 CDM,6107601701,Hc Mr Safety Medical Physics Exam Customization,338.41,135.36,,,0 CDM,6107601801,Hc Mr Safety Implant Electronics Preparation,128.51,51.4,,,0 CDM,6107601901,Hc Mr Safety Implant Positioning And/Or Immobilzation,83.16,33.26,,,0 CDM,6107639001,Hc Mri Spectroscopy - Mr Spectroscopy,1490.9,596.36,,,0 CDM,6107639101,Hc Mr Elastography,736.26,294.5,,,0 CDM,6107704601,Hc Mri Breast Without Contrast Unilateral,1784.0,713.6,,,0 CDM,6107704701,Hc Mri Breast Without Contrast Bilateral,2858.89,1143.56,,,0 CDM,6107704801,Hc Mri Breast With And Without Contrast Unilateral,2027.2,810.88,,,0 CDM,6107704802,Hc Mri Breast With Contrast Unilateral,2652.0,1060.8,,,0 CDM,6107704901,Hc Mri Breast With And Without Contrast Bilateral,3602.0,1440.8,,,0 CDM,6107704902,Hc Mri Breast With Contrast Bilateral,3118.0,1247.2,,,0 CDM,610C890601,Hc Mri Breast W/Contrast Bilateral,3118.48,1247.39,,,0 CDM,610C890801,Hc Mri Breast W And W/O Contrast Bilateral,3602.04,1440.82,,,0 CDM,610C890802,Hc Mri Breast Wo/W Contrast Right,3602.04,1440.82,,,0 CDM,610C893401,Hc Mra Upper Extremity W Contrast,2161.68,864.67,,,0 CDM,610C893601,Hc Mra Upper Extremity Wo And W Contrast,2773.89,1109.56,,,0 CDM,610C893701,Hc Cad W/Breast Mri,174.59,69.84,,,0 CDM,6117055102,Hc Mri Brain - Mri Brain Wo Contrast,3672.0,1468.8,,,0 CDM,6117055202,Hc Mri Brain Contrast - Mri Brain W Contrast,4019.0,1607.6,,,0 CDM,6117055302,Hc Mri Brain Combo - Mri Brain W Wo Contrast,4741.0,1896.4,,,0 CDM,6117055401,Hc Func Mri Brain - Mr Brain Neurofunctional Test W/O Physician Admin,2206.0,882.4,,,0 CDM,6117055501,Hc Func Mri Brain - Mr Brain Neurofunctional Test W/ Physician Admin,2295.0,918.0,,,0 CDM,6127214102,"Hc Mri, Cerv Spine - Mri Cervical Spine Wo Contrast",4063.0,1625.2,,,0 CDM,6127214201,"Hc Mri, Cerv Spine Contrast - Mri Cervical Spine W Contrast",4486.0,1794.4,,,0 CDM,6127214602,"Hc Mri, Dorsal Spine - Mri Thoracic Spine Wo Contrast",4401.48,1760.59,,,0 CDM,6127214701,"Hc Mri, Dorsal Spine Contrast - Mri Thoracic Spine W Contrast",4759.84,1903.94,,,0 CDM,6127214802,"Hc Mri, Lumbar Spine - Mri Lumbar Spine Wo Contrast",4535.86,1814.34,,,0 CDM,6127214901,"Hc Mri, Lumbar Spine Contrast - Mri Lumbar Spine W Contrast",4865.51,1946.2,,,0 CDM,6127215601,"Hc Mri, Cerv Spine Combo - Mri Cervical Spine W Wo Contrast",5392.0,2156.8,,,0 CDM,6127215701,"Hc Mri, Dorsal Spine Combo - Mri Thoracic Spine W Wo Contrast",5627.04,2250.82,,,0 CDM,6127215801,"Hc Mri, Lumbar Spine Combo - Mri Lumbar Spine W Wo Contrast",5684.47,2273.79,,,0 CDM,6140648T01,Hc Quantitative Magnetci Resonance Analysis For Tissue Compsition Without Diagnostic Mri Exam,1150.0,460.0,,,0 CDM,6140649T01,Hc Quantitative Magnetic Resonance Analysis Of Tissue Coposition With Diagnostic Mri Exam,1450.0,580.0,,,0 CDM,6147219501,"Hc Mri, Pelvis, W/O Contrast - Mri Pelvis Wo Contrast",3127.67,1251.07,,,0 CDM,6147219802,Hc Mr Angio Pelvis(Mra) - Mr Pelvis Angio W And Wo Iv Contrast,2808.35,1123.34,,,0 CDM,6147322002,Hc Mri Upper Extremity Combo - Mr Forearm Left W And Wo Iv Contrast,4599.04,1839.62,,,0 CDM,6147322101,"Hc Mri, Joint Upper Extrem - Mr Wrist Without Iv Contrast",4040.81,1616.32,,,0 CDM,6147322302,Hc Mri Joint Upr Extr W/O&W/Dye - Mr Elbow Rt W And Wo Iv Contrast,5184.83,2073.93,,,0 CDM,6147322305,Hc Mri Joint Upr Extr W/O&W/Dye - Mr Elbow Lt W And Wo Iv Contrast,5184.83,2073.93,,,0 CDM,6147418202,"Hc Mri, Abdomen With Contrast",4058.0,1623.2,,,0 CDM,6147418301,"Hc Mri, Abdomen, Combo - Mri Abdomen W Wo Contrast Mrcp",5469.68,2187.87,,,0 CDM,6157054001,"Hc Mri, Face, Neck - Mri Neck Soft Tissue Only Wo Contrast",3690.4,1476.16,,,0 CDM,6157054301,"Hc Mri, Face, Neck, Combo - Mri Neck Soft Tissue Only W Wo Contrast",4777.0,1910.8,,,0 CDM,6157054401,"Hc Mr Angio, Head - Mr Head Angio Wo Iv Contrast",3084.0,1233.6,,,0 CDM,6157054501,"Hc Mr Angio, Head W/Contrast - Mr Head Angio W Iv Contrast",3508.0,1403.2,,,0 CDM,6157054601,"Hc Mr Angio, Head, Combo - Mr Head Angio W And Wo Iv Contrast",3693.0,1477.2,,,0 CDM,6157054701,"Hc Mr Angio, Neck - Mr Neck Angio Wo Iv Contrast",3232.0,1292.8,,,0 CDM,6157054801,"Hc Mr Angio, Neck W/Contrast - Mr Neck Angio W Iv Contrast",3376.0,1350.4,,,0 CDM,6157054901,"Hc Mr Angio, Neck, Combo - Mr Neck Angio W And Wo Iv Contrast",3508.0,1403.2,,,0 CDM,6167372505,Hc Mr Angio Lower Extrem (Mra) - Mr Lower Ext Angio W Iv Cont Rt,1209.12,483.65,,,0 CDM,6167372507,Hc Mr Angio Lower Extrem (Mra) - Mr Lower Ext Angio W Iv Cont Lt,1209.12,483.65,,,0 CDM,6167372508,Hc Mr Angio Lower Extrem (Mra) - Mr Lower Ext Angio W And Wo Iv Cont Lt,3048.0,1219.2,,,0 CDM,6167372509,Hc Mra/Mrv Lower Extremity With And Without Contrast-Bilateral,3636.64,1454.66,,,0 CDM,6167372510,Hc Mra/Mrv Lower Extremity With Contrast -Unilateral,3220.0,1288.0,,,0 CDM,6167372511,Hc Mra/Mrv Lower Extremity Without Contrast - Unilateral,2972.0,1188.8,,,0 CDM,616C891201,Hc Mra Lower Extremity With Contrast-Unilateral,3047.92,1219.17,,,0 CDM,616C891202,Hc Mra Lower Extremity With Contrast - Bilateral,3396.61,1358.64,,,0 CDM,616C891302,Hc Mra Lower Extremity W/O Contast - Bilateral,3396.61,1358.64,,,0 CDM,616C891401,Hc Mra Lower Extremity Wo And W Contrast,3729.54,1491.82,,,0 CDM,6187155501,Hc Mra/Mrv Chest With Contrast,3170.72,1268.29,,,0 CDM,6187155503,Hc Mra/Mrv Chest Without Contrast,2670.08,1068.03,,,0 CDM,6187155504,Hc Mra/Mrv Chest With And Without Contrast,3551.52,1420.61,,,0 CDM,6187215901,Hc Mr Angio Spine (Mra) - Mr Spine Angio W And Wo Iv Contrast,1880.85,752.34,,,0 CDM,6187219801,Hc Mra/Mrv Pelvis With And Without Contrast,2738.4,1095.36,,,0 CDM,6187219802,Hc Mra/Mrv Pelvis With Contrast,2056.32,822.53,,,0 CDM,6187219803,Hc Mra/Mrv Pelvis Without Contrast,1923.04,769.22,,,0 CDM,6187322501,Hc Mra/Mrv Upper Extremity With Contrast-Unilateral,2860.0,1144.0,,,0 CDM,6187322502,Hc Mra/Mrv Upper Extremity Without Contrast-Unilateral,2012.0,804.8,,,0 CDM,6187322503,Hc Mra/Mrv Upper Extremity With And Without Contrast-Unilateral,3670.0,1468.0,,,0 CDM,6187418501,Hc Mra/Mrv Abdomen Without Contrast,2447.2,978.88,,,0 CDM,6187418502,Hc Mra/Mrv Abdomen With Contrast,2805.0,1122.0,,,0 CDM,6187418503,Hc Mra/Mrv Abdomen With And Without Contrast,3550.0,1420.0,,,0 CDM,618C890001,Hc Mra Abdomen W/Contrast,2804.91,1121.96,,,0 CDM,618C890101,Hc Mra Abdomen W/O Contrast,2509.71,1003.88,,,0 CDM,618C890201,Hc Mra Abdomen Wo/W Contrast,3460.76,1384.3,,,0 CDM,618C890901,Hc Mra Chest W/Contrast,3251.72,1300.69,,,0 CDM,618C891001,Hc Mra Chest W/O Contrast,2738.29,1095.32,,,0 CDM,618C891101,Hc Mra Chest Wo/W Contrast,3642.24,1456.9,,,0 CDM,618C891301,Hc Mra Lower Extremity Without Contrast - Unilateral,3047.92,1219.17,,,0 CDM,618C891801,Hc Mra Pelvis W/Contrast,2108.85,843.54,,,0 CDM,618C891901,Hc Mra Pelvis W/O Contrast,1972.16,788.86,,,0 CDM,618C892001,Hc Mra Pelvis Wo/W Contrast,2808.35,1123.34,,,0 CDM,6197649801,Hc Whole Body Mri-Unlist Proc,2655.59,1062.24,,,0 CDM,624C1757S1_186031,Hc Sup Shell 624 Revenue Code C1757 Hcpcs,26578.12,10631.25,,,0 CDM,624C1781S1_186031,Hc Sup Shell 624 Revenue Code C1781 Hcpcs,26578.12,10631.25,,,0 CDM,6340000001_00069130601,NDC Description Not Available,39.8,15.92,,,0 CDM,6340000001_00069130701,NDC Description Not Available,48.53,19.41,,,0 CDM,6340000001_00069130710,"Retacrit: 10 Vial, Single-Dose In 1 Carton (0069-1307-10) / 1 Ml In 1 Vial, Single-Dose (0069-1307-01)",40.5,16.2,,,0 CDM,6340000001_59676030200,NDC Description Not Available,114.84,45.94,,,0 CDM,6350000001_59676031000,NDC Description Not Available,113.25,45.3,,,0 CDM,6350000001_59676031001,"Procrit: 6 Vial, Single-Dose In 1 Carton (59676-310-01) / 1 Ml In 1 Vial, Single-Dose (59676-310-00)",62.2,24.88,,,0 CDM,6350000001_59676032000,NDC Description Not Available,32.75,13.1,,,0 CDM,6350000001_59676032004,"Procrit: 4 Vial, Multi-Dose In 1 Carton (59676-320-04) / 1 Ml In 1 Vial, Multi-Dose (59676-320-00)",62.15,24.86,,,0 CDM,6350000001_59676034000,NDC Description Not Available,114.43,45.77,,,0 CDM,6350000001_59676034001,"Procrit: 4 Vial, Single-Dose In 1 Carton (59676-340-01) / 1 Ml In 1 Vial, Single-Dose (59676-340-00)",117.59,47.04,,,0 CDM,6360000001_54092070104,"Vpriv: 1 Vial, Glass In 1 Box (54092-701-04) / 4 Ml In 1 Vial, Glass",1683.03,673.21,,,0 CDM,6360000002_00169720101,"Novoseven Rt: 1 Kit In 1 Kit (0169-7201-01) * 1 Ml In 1 Vial, Glass (0169-7211-11) * 1 Ml In 1 Syringe, Glass (0169-7011-98)",11.83,4.73,,,0 CDM,6360000002_00169720201,"Novoseven Rt: 1 Kit In 1 Kit (0169-7202-01) * 2 Ml In 1 Vial, Glass (0169-7212-11) * 2 Ml In 1 Syringe, Glass (0169-7012-98)",12.1,4.84,,,0 CDM,6360000002_00169720501,"Novoseven Rt: 1 Kit In 1 Kit (0169-7205-01) * 5 Ml In 1 Vial, Glass (0169-7215-11) * 5 Ml In 1 Syringe, Glass (0169-7015-98)",11.79,4.72,,,0 CDM,6360000002_00169721111,NDC Description Not Available,9.86,3.94,,,0 CDM,6360000002_13533060250,"Thrombate Iii: 1 Kit In 1 Carton (13533-602-50) * 10 Ml In 1 Vial, Glass (13533-605-21) * 10 Ml In 1 Vial, Glass (13533-200-10)",19.04,7.62,,,0 CDM,6360000002_13533060612,"Thrombate Iii: 1 Kit In 1 Carton (13533-606-12) * 10 Ml In 1 Vial, Glass (13533-605-21) * 10 Ml In 1 Vial, Glass (76297-002-12)",19.31,7.72,,,0 CDM,6360000002_58394001201,"Xyntha: 1 Kit In 1 Carton (58394-012-01) * 4 Ml In 1 Vial, Single-Use (58394-112-01) * 4 Ml In 1 Syringe (58394-018-01) * 1 Ml In 1 Packet",8.45,3.38,,,0 CDM,6360000002_58394001301,"Xyntha: 1 Kit In 1 Carton (58394-013-01) * 4 Ml In 1 Syringe (58394-018-01) * 1 Ml In 1 Packet * 4 Ml In 1 Vial, Single-Use (58394-113-01)",8.45,3.38,,,0 CDM,6360000002_58394001401,"Xyntha: 1 Kit In 1 Carton (58394-014-01) * 4 Ml In 1 Syringe (58394-018-01) * 1 Ml In 1 Packet * 4 Ml In 1 Vial, Single-Use (58394-114-01)",8.49,3.4,,,0 CDM,6360000002_58394001501,"Xyntha: 1 Kit In 1 Carton (58394-015-01) * 1 Ml In 1 Packet * 4 Ml In 1 Vial, Single-Use (58394-115-01) * 4 Ml In 1 Syringe (58394-018-01)",3.81,1.52,,,0 CDM,6360000002_58394002203,Xyntha: 1 Kit In 1 Carton (58394-022-03) * 4 Ml In 1 Syringe (58394-122-03) * 1 Ml In 1 Packet,3.81,1.52,,,0 CDM,6360000002_58394002303,Xyntha: 1 Kit In 1 Carton (58394-023-03) * 4 Ml In 1 Syringe (58394-123-03) * 1 Ml In 1 Packet,8.79,3.52,,,0 CDM,6360000002_58394002503,Xyntha: 1 Kit In 1 Carton (58394-025-03) * 4 Ml In 1 Syringe (58394-125-03) * 1 Ml In 1 Packet,8.79,3.52,,,0 CDM,6360000002_58394011401,NDC Description Not Available,8.4,3.36,,,0 CDM,6360000002_58394063503,"Benefix: 1 Kit In 1 Carton (58394-635-03) * 5 Ml In 1 Syringe (58394-041-11) * 1 Ml In 1 Packet (0069-1111-01) * 5 Ml In 1 Vial, Single-Use (58394-135-03)",7.66,3.06,,,0 CDM,6360000002_63833038602,"Kcentra: 1 Kit In 1 Carton (63833-386-02) * 20 Ml In 1 Vial, Single-Use (63833-396-01) * 20 Ml In 1 Vial, Single-Use (63833-761-20)",14.6,5.84,,,0 CDM,6360000002_63833038702,"Kcentra: 1 Kit In 1 Carton (63833-387-02) * 40 Ml In 1 Vial, Single-Use (63833-397-01) * 40 Ml In 1 Vial, Single-Use (63833-761-40)",10.28,4.11,,,0 CDM,6360000002_63833039601,NDC Description Not Available,9.18,3.67,,,0 CDM,6360000002_63833061502,"Humate-P: 1 Kit In 1 Carton (63833-615-02) * 5 Ml In 1 Vial (63833-625-01) * 5 Ml In 1 Vial, Single-Dose (63833-765-53)",6.17,2.47,,,0 CDM,6360000002_63833061602,"Humate-P: 1 Kit In 1 Carton (63833-616-02) * 10 Ml In 1 Vial (63833-626-01) * 10 Ml In 1 Vial, Single-Dose (63833-765-54)",4.73,1.89,,,0 CDM,6360000002_63833061702,"Humate-P: 1 Kit In 1 Carton (63833-617-02) * 15 Ml In 1 Vial (63833-627-01) * 15 Ml In 1 Vial, Single-Dose (63833-765-55)",6.77,2.71,,,0 CDM,6360000002_63833062501,NDC Description Not Available,4.21,1.68,,,0 CDM,6360000002_63833062601,NDC Description Not Available,4.38,1.75,,,0 CDM,6360000002_63833062701,NDC Description Not Available,4.28,1.71,,,0 CDM,6360000002_63833089151,"Riastap: 1 Vial, Single-Use In 1 Carton (63833-891-51) / 50 Ml In 1 Vial, Single-Use (63833-891-90)",5.12,2.05,,,0 CDM,6360000002_68982034701,"Fibryga: 1 Kit In 1 Carton (68982-347-01) * 50 Ml In 1 Bottle, Glass (68982-348-01)",4.77,1.91,,,0 CDM,6360000002_68982034801,NDC Description Not Available,5.07,2.03,,,0 CDM,636A960601,Hc Xofigo,533.7,213.48,,,0 CDM,636C1784S1_84472,"Artiss Fibrin Sealant: 1 Syringe, Plastic In 1 Carton (0338-8503-10) / 10 Ml In 1 Syringe, Plastic (0338-8503-09)",1576.28,630.51,,,0 CDM,636Q4104S1_137770,NDC Description Not Available,19735.52,7894.21,,,0 CDM,636Q4104S1_Q4104_636,Hc Sup Shell 636 Revenue Code Q4104 Hcpcs,13220.62,5288.25,,,0 CDM,636Q4160S1_158820,NDC Description Not Available,3562.5,1425.0,,,0 CDM,636Q4160S1_158821,NDC Description Not Available,7031.25,2812.5,,,0 CDM,636Q4160S1_Q4160_636,Hc Sup Shell 636 Revenue Code Q4160 Hcpcs Hb Chargeables,3318.75,1327.5,,,0 CDM,6370000001_00002021301,"Humulin R: 1 Vial, Multi-Dose In 1 Carton (0002-0213-01) / 3 Ml In 1 Vial, Multi-Dose",0.41,0.16,,,0 CDM,6370000001_00002751017,Humalog: 1 Vial In 1 Carton (0002-7510-17) / 3 Ml In 1 Vial,0.39,0.16,,,0 CDM,6370000001_00002753301,Humalog: 1 Vial In 1 Carton (0002-7533-01) / 3 Ml In 1 Vial,0.94,0.38,,,0 CDM,6370000001_00002821501,"Humulin R: 1 Vial, Multi-Dose In 1 Carton (0002-8215-01) / 10 Ml In 1 Vial, Multi-Dose",0.19,0.08,,,0 CDM,6370000001_00002821517,"Humulin R: 1 Vial, Multi-Dose In 1 Carton (0002-8215-17) / 3 Ml In 1 Vial, Multi-Dose",0.4,0.16,,,0 CDM,6370000001_00002831501,"Humulin N: 1 Vial, Multi-Dose In 1 Carton (0002-8315-01) / 10 Ml In 1 Vial, Multi-Dose",0.38,0.15,,,0 CDM,6370000001_00002871501,"Humulin 70/30: 1 Vial, Multi-Dose In 1 Carton (0002-8715-01) / 10 Ml In 1 Vial, Multi-Dose",0.44,0.18,,,0 CDM,6370000001_00003052411,Sprycel: 1 Bottle In 1 Carton (0003-0524-11) / 60 Tablet In 1 Bottle,1012.38,404.95,,,0 CDM,6370000001_00003052711,Sprycel: 1 Bottle In 1 Carton (0003-0527-11) / 60 Tablet In 1 Bottle,506.19,202.48,,,0 CDM,6370000001_00003085222,Sprycel: 1 Bottle In 1 Carton (0003-0852-22) / 30 Tablet In 1 Bottle,1824.64,729.86,,,0 CDM,6370000001_00003089331,"Eliquis: 10 Blister Pack In 1 Carton (0003-0893-31) / 10 Tablet, Film Coated In 1 Blister Pack",30.78,12.31,,,0 CDM,6370000001_00003089431,"Eliquis: 10 Blister Pack In 1 Carton (0003-0894-31) / 10 Tablet, Film Coated In 1 Blister Pack",30.76,12.3,,,0 CDM,6370000001_00003161412,Baraclude: 1 Bottle In 1 Carton (0003-1614-12) / 210 Ml In 1 Bottle,249.7,99.88,,,0 CDM,6370000001_00004080285,Tamiflu: 1 Blister Pack In 1 Carton (0004-0802-85) / 10 Capsule In 1 Blister Pack,60.06,24.02,,,0 CDM,6370000001_00005417758,NDC Description Not Available,0.44,0.18,,,0 CDM,6370000001_00005434415,NDC Description Not Available,0.71,0.28,,,0 CDM,6370000001_00005434462,NDC Description Not Available,1.2,0.48,,,0 CDM,6370000001_00006022101,NDC Description Not Available,47.7,19.08,,,0 CDM,6370000001_00006022128,"Januvia: 100 Blister Pack In 1 Carton (0006-0221-28) / 1 Tablet, Film Coated In 1 Blister Pack (0006-0221-01)",74.08,29.63,,,0 CDM,6370000001_00006022761,"Isentress: 60 Tablet, Film Coated In 1 Bottle (0006-0227-61)",95.94,38.38,,,0 CDM,6370000001_00006027701,NDC Description Not Available,41.3,16.52,,,0 CDM,6370000001_00006027728,"Januvia: 100 Blister Pack In 1 Carton (0006-0277-28) / 1 Tablet, Film Coated In 1 Blister Pack (0006-0277-01)",52.67,21.07,,,0 CDM,6370000001_00006033530,"Belsomra: 3 Case In 1 Carton (0006-0335-30) / 1 Blister Pack In 1 Case (0006-0335-10) / 10 Tablet, Film Coated In 1 Blister Pack",63.83,25.53,,,0 CDM,6370000001_00006047761,"Isentress: 60 Tablet, Chewable In 1 Bottle (0006-0477-61)",26.04,10.42,,,0 CDM,6370000001_00006306601,NDC Description Not Available,57.53,23.01,,,0 CDM,6370000001_00006306603,"Emend: 1 Pouch In 1 Carton (0006-3066-03) / 1 Powder, For Suspension In 1 Pouch (0006-3066-01)",40.71,16.28,,,0 CDM,6370000001_00006306901,"Pifeltro: 30 Tablet, Film Coated In 1 Bottle (0006-3069-01)",175.42,70.17,,,0 CDM,6370000001_00006307601,NDC Description Not Available,666.82,266.73,,,0 CDM,6370000001_00006307603,NDC Description Not Available,769.13,307.65,,,0 CDM,6370000001_00006307604,"Prevymis: 14 Blister Pack In 1 Carton (0006-3076-04) / 1 Tablet, Film Coated In 1 Blister Pack (0006-3076-03)",1202.08,480.83,,,0 CDM,6370000001_00006360301,NDC Description Not Available,11.66,4.66,,,0 CDM,6370000001_00006360361,"Isentress: 60 Packet In 1 Carton (0006-3603-61) / 1 Granule, For Suspension In 1 Packet (0006-3603-01)",21.16,8.46,,,0 CDM,6370000001_00006500701,"Delstrigo: 30 Tablet, Film Coated In 1 Bottle (0006-5007-01)",384.99,154.0,,,0 CDM,6370000001_00009006501,Provera: 100 Tablet In 1 Bottle (0009-0065-01),11.25,4.5,,,0 CDM,6370000001_00009513803,"Zyvox: 30 Blister Pack In 1 Box, Unit-Dose (0009-5138-03) / 1 Tablet, Film Coated In 1 Blister Pack",27.09,10.84,,,0 CDM,6370000001_00013010250,"Azulfidine En-Tabs: 1 Bottle In 1 Carton (0013-0102-50) / 100 Tablet, Delayed Release In 1 Bottle",6.44,2.58,,,0 CDM,6370000001_00023040330,"Refresh Plus: 30 Vial, Single-Use In 1 Carton (0023-0403-30) / .4 Ml In 1 Vial, Single-Use",0.91,0.36,,,0 CDM,6370000001_00023455430,"Refresh Celluvisc: 30 Vial, Single-Use In 1 Carton (0023-4554-30) / .4 Ml In 1 Vial, Single-Use",1.05,0.42,,,0 CDM,6370000001_00023599002,NDC Description Not Available,44.09,17.64,,,0 CDM,6370000001_00023916330,"Restasis: 30 Vial, Single-Use In 1 Tray (0023-9163-30) / .4 Ml In 1 Vial, Single-Use",31.21,12.48,,,0 CDM,6370000001_00023921105,"Combigan: 1 Bottle, Dropper In 1 Carton (0023-9211-05) / 5 Ml In 1 Bottle, Dropper",879.34,351.74,,,0 CDM,6370000001_00024159601,"Primaquine Phosphate: 100 Tablet, Film Coated In 1 Bottle (0024-1596-01)",6.24,2.5,,,0 CDM,6370000001_00024414260,"Multaq: 60 Tablet, Film Coated In 1 Bottle (0024-4142-60)",40.33,16.13,,,0 CDM,6370000001_00024592605,Admelog: 1 Vial In 1 Carton (0024-5926-05) / 3 Ml In 1 Vial,0.88,0.35,,,0 CDM,6370000001_00025100131,"Aldactone: 100 Tablet, Film Coated In 1 Bottle (0025-1001-31)",5.84,2.34,,,0 CDM,6370000001_00032004670,"Creon: 100 Capsule, Delayed Release Pellets In 1 Bottle (0032-0046-70)",6.39,2.56,,,0 CDM,6370000001_00032004770,"Creon: 100 Capsule, Delayed Release Pellets In 1 Bottle (0032-0047-70)",12.74,5.1,,,0 CDM,6370000001_00032120601,"Creon: 1 Bottle In 1 Carton (0032-1206-01) / 100 Capsule, Delayed Release Pellets In 1 Bottle",8.96,3.58,,,0 CDM,6370000001_00032121201,"Creon: 100 Capsule, Delayed Release Pellets In 1 Bottle (0032-1212-01)",17.9,7.16,,,0 CDM,6370000001_00032122401,"Creon: 100 Capsule, Delayed Release Pellets In 1 Bottle (0032-1224-01)",33.67,13.47,,,0 CDM,6370000001_00032263601,"Creon: 100 Capsule, Delayed Release Pellets In 1 Bottle (0032-2636-01)",25.31,10.12,,,0 CDM,6370000001_00032301613,"Creon: 100 Capsule, Delayed Release Pellets In 1 Bottle (0032-3016-13)",38.42,15.37,,,0 CDM,6370000001_00037682315,Proctofoam Ns: 1 Canister In 1 Carton (0037-6823-15) / 15 G In 1 Canister,283.09,113.24,,,0 CDM,6370000001_00037683015,Cortifoam: 1 Canister In 1 Carton (0037-6830-15) / 15 G In 1 Canister,1344.01,537.6,,,0 CDM,6370000001_00045008002,NDC Description Not Available,0.27,0.11,,,0 CDM,6370000001_00045012304,NDC Description Not Available,10.09,4.04,,,0 CDM,6370000001_00045013404,NDC Description Not Available,5.51,2.2,,,0 CDM,6370000001_00045016604,NDC Description Not Available,2.95,1.18,,,0 CDM,6370000001_00045018404,NDC Description Not Available,2.09,0.84,,,0 CDM,6370000001_00045019201,NDC Description Not Available,4.73,1.89,,,0 CDM,6370000001_00045019204,NDC Description Not Available,1.13,0.45,,,0 CDM,6370000001_00045090926,NDC Description Not Available,0.7,0.28,,,0 CDM,6370000001_00046087221,"Premarin Vaginal: 1 Tube, With Applicator In 1 Carton (0046-0872-21) / 30 G In 1 Tube, With Applicator",1379.87,551.95,,,0 CDM,6370000001_00046110081,"Premarin: 100 Tablet, Film Coated In 1 Bottle (0046-1100-81)",21.17,8.47,,,0 CDM,6370000001_00046110281,"Premarin: 100 Tablet, Film Coated In 1 Bottle (0046-1102-81)",29.77,11.91,,,0 CDM,6370000001_00046110481,"Premarin: 100 Tablet, Film Coated In 1 Bottle (0046-1104-81)",21.17,8.47,,,0 CDM,6370000001_00049234079,NDC Description Not Available,242.31,96.92,,,0 CDM,6370000001_00049316044,Vfend: 1 Bottle In 1 Carton (0049-3160-44) / 75 Ml In 1 Bottle,219.27,87.71,,,0 CDM,6370000001_00054001125,Flecainide Acetate: 100 Tablet In 1 Bottle (0054-0011-25),2.05,0.82,,,0 CDM,6370000001_00054004544,"Ipratropium Bromide: 1 Bottle, Spray In 1 Carton (0054-0045-44) / 345 Spray In 1 Bottle, Spray",108.0,43.2,,,0 CDM,6370000001_00054005746,Digoxin: 60 Ml In 1 Bottle (0054-0057-46),16.34,6.54,,,0 CDM,6370000001_00054017613,Buprenorphine: 30 Tablet In 1 Bottle (0054-0176-13),2.23,0.89,,,0 CDM,6370000001_00054017713,Buprenorphine: 30 Tablet In 1 Bottle (0054-0177-13),5.19,2.08,,,0 CDM,6370000001_00054023524,Morphine Sulfate: 100 Blister Pack In 1 Carton (0054-0235-24) / 1 Tablet In 1 Blister Pack,2.05,0.82,,,0 CDM,6370000001_00054023525,Morphine Sulfate: 100 Tablet In 1 Bottle (0054-0235-25),1.11,0.44,,,0 CDM,6370000001_00054023763,Morphine Sulfate: 500 Ml In 1 Bottle (0054-0237-63),0.06,0.02,,,0 CDM,6370000001_00054024324,Codeine Sulfate: 10 Blister Pack In 1 Box (0054-0243-24) / 10 Tablet In 1 Blister Pack,3.11,1.24,,,0 CDM,6370000001_00054024424,Codeine Sulfate: 10 Blister Pack In 1 Box (0054-0244-24) / 10 Tablet In 1 Blister Pack,2.52,1.01,,,0 CDM,6370000001_00054024425,Codeine Sulfate: 100 Tablet In 1 Bottle (0054-0244-25),2.22,0.89,,,0 CDM,6370000001_00054038225,Cyclophosphamide: 100 Capsule In 1 Bottle (0054-0382-25),24.04,9.62,,,0 CDM,6370000001_00054038325,Cyclophosphamide: 100 Capsule In 1 Bottle (0054-0383-25),13.13,5.25,,,0 CDM,6370000001_00054039168,Methadone Hydrochloride: 1000 Ml In 1 Bottle (0054-0391-68),1.14,0.46,,,0 CDM,6370000001_00054039268,Methadone Hydrochloride: 1000 Ml In 1 Bottle (0054-0392-68),0.55,0.22,,,0 CDM,6370000001_00054042523,"Rufinamide: 120 Tablet, Film Coated In 1 Bottle (0054-0425-23)",8.38,3.35,,,0 CDM,6370000001_00054042623,"Rufinamide: 120 Tablet, Film Coated In 1 Bottle (0054-0426-23)",18.13,7.25,,,0 CDM,6370000001_00054044949,"Posaconazole: 1 Bottle, Glass In 1 Carton (0054-0449-49) / 105 Ml In 1 Bottle, Glass",397.24,158.9,,,0 CDM,6370000001_00054051701,NDC Description Not Available,0.47,0.19,,,0 CDM,6370000001_00054051741,Morphine Sulfate: 15 Ml In 1 Bottle (0054-0517-41),1.47,0.59,,,0 CDM,6370000001_00054051744,Morphine Sulfate: 30 Ml In 1 Bottle (0054-0517-44),1.45,0.58,,,0 CDM,6370000001_00054071020,Methadone Hydrochloride: 1 Blister Pack In 1 Carton (0054-0710-20) / 100 Tablet In 1 Blister Pack,0.88,0.35,,,0 CDM,6370000001_00054312041,"Calcitriol: 1 Bottle, Glass In 1 Carton (0054-3120-41) / 15 Ml In 1 Bottle, Glass",11.56,4.62,,,0 CDM,6370000001_00054317763,"Dexamethasone: 500 Ml In 1 Bottle, Plastic (0054-3177-63)",0.18,0.07,,,0 CDM,6370000001_00054319446,Diphenoxylate Hydrochloride And Atropine Sulfate: 1 Bottle In 1 Carton (0054-3194-46) / 60 Ml In 1 Bottle,29.4,11.76,,,0 CDM,6370000001_00054327099,"Fluticasone Propionate: 1 Bottle, Glass In 1 Carton (0054-3270-99) / 120 Spray, Metered In 1 Bottle, Glass",40.95,16.38,,,0 CDM,6370000001_00054329450,Furosemide: 120 Ml In 1 Bottle (0054-3294-50),0.21,0.08,,,0 CDM,6370000001_00054350049,Lidocaine Viscous: 1 Bottle In 1 Carton (0054-3500-49) / 100 Ml In 1 Bottle,1.61,0.64,,,0 CDM,6370000001_00054350547,Lidocaine Hydrochloride: 50 Ml In 1 Bottle (0054-3505-47),174.8,69.92,,,0 CDM,6370000001_00054353244,Lorazepam: 1 Bottle In 1 Carton (0054-3532-44) / 30 Ml In 1 Bottle,2.48,0.99,,,0 CDM,6370000001_00054355344,Methadone Hydrochloride: 1 Bottle In 1 Carton (0054-3553-44) / 30 Ml In 1 Bottle,7.89,3.16,,,0 CDM,6370000001_00054355563,Methadone Hydrochloride: 500 Ml In 1 Bottle (0054-3555-63),0.21,0.08,,,0 CDM,6370000001_00054372763,"Propranolol Hydrochloride: 500 Ml In 1 Bottle, Plastic (0054-3727-63)",0.79,0.32,,,0 CDM,6370000001_00054414622,"Clotrimazole: 70 Lozenge In 1 Bottle, Plastic (0054-4146-22)",5.97,2.39,,,0 CDM,6370000001_00054417925,"Dexamethasone: 100 Tablet In 1 Bottle, Plastic (0054-4179-25)",0.17,0.07,,,0 CDM,6370000001_00054418225,"Dexamethasone: 100 Tablet In 1 Bottle, Plastic (0054-4182-25)",0.2,0.08,,,0 CDM,6370000001_00054449613,Leucovorin Calcium: 30 Tablet In 1 Bottle (0054-4496-13),4.78,1.91,,,0 CDM,6370000001_00054449625,Leucovorin Calcium: 100 Tablet In 1 Bottle (0054-4496-25),4.66,1.86,,,0 CDM,6370000001_00054458111,"Mercaptopurine: 25 Tablet In 1 Bottle, Plastic (0054-4581-11)",7.26,2.9,,,0 CDM,6370000001_00054814622,Clotrimazole: 70 Blister Pack In 1 Carton (0054-8146-22) / 1 Lozenge In 1 Blister Pack,5.02,2.01,,,0 CDM,6370000001_00054817525,Dexamethasone: 100 Blister Pack In 1 Carton (0054-8175-25) / 1 Tablet In 1 Blister Pack,0.27,0.11,,,0 CDM,6370000001_00054817925,Dexamethasone: 100 Blister Pack In 1 Carton (0054-8179-25) / 1 Tablet In 1 Blister Pack,0.26,0.1,,,0 CDM,6370000001_00054818125,Dexamethasone: 100 Blister Pack In 1 Carton (0054-8181-25) / 1 Tablet In 1 Blister Pack,0.23,0.09,,,0 CDM,6370000001_00054829725,Furosemide: 10 Blister Pack In 1 Carton (0054-8297-25) / 10 Tablet In 1 Blister Pack,0.5,0.2,,,0 CDM,6370000001_00054829925,Furosemide: 10 Blister Pack In 1 Carton (0054-8299-25) / 10 Tablet In 1 Blister Pack,0.56,0.22,,,0 CDM,6370000001_00054849619,Leucovorin Calcium: 5 Blister Pack In 1 Carton (0054-8496-19) / 10 Tablet In 1 Blister Pack,4.82,1.93,,,0 CDM,6370000001_00054852825,Lithium Carbonate: 10 Tablet In 1 Blister Pack (0054-8528-25),0.73,0.29,,,0 CDM,6370000001_00065002315,"Miostat: 12 Vial, Glass In 1 Carton (0065-0023-15) / 1.5 Ml In 1 Vial, Glass",69.81,27.92,,,0 CDM,6370000001_00065034905,"Phenylephrine Hydrochloride: 1 Bottle, Dropper In 1 Carton (0065-0349-05) / 2 Ml In 1 Bottle, Dropper",55.44,22.18,,,0 CDM,6370000001_00065035902,"Cyclomydril: 2 Ml In 1 Bottle, Plastic (0065-0359-02)",103.27,41.31,,,0 CDM,6370000001_00065039515,"Cyclogyl: 1 Bottle, Plastic In 1 Carton (0065-0395-15) / 15 Ml In 1 Bottle, Plastic",293.99,117.6,,,0 CDM,6370000001_00065039702,"Cyclogyl: 1 Bottle, Plastic In 1 Carton (0065-0397-02) / 2 Ml In 1 Bottle, Plastic",129.3,51.72,,,0 CDM,6370000001_00065041130,Betadine: 1 Bottle In 1 Carton (0065-0411-30) / 30 Ml In 1 Bottle,56.45,22.58,,,0 CDM,6370000001_00065050935,Systane Nighttime: 1 Tube In 1 Carton (0065-0509-35) / 3.5 G In 1 Tube,34.75,13.9,,,0 CDM,6370000001_00065051801,Genteal Tears Night-Time: 1 Tube In 1 Carton (0065-0518-01) / 3.5 G In 1 Tube,21.45,8.58,,,0 CDM,6370000001_00065064435,TOBREX: 3.5 g in 1 TUBE (0065-0644-35),601.86,240.74,,,0 CDM,6370000001_00065074114,"Tetracaine Hydrochloride: 12 Blister Pack In 1 Carton (0065-0741-14) / 1 Bottle, Dropper In 1 Blister Pack / 4 Ml In 1 Bottle, Dropper",38.77,15.51,,,0 CDM,6370000001_00065079515,Bss: 15 Ml In 1 Bottle (0065-0795-15),2.36,0.94,,,0 CDM,6370000001_00065081701,"Atropine Sulfate: 1 Bottle, Dropper In 1 Carton (0065-0817-01) / 5 Ml In 1 Bottle, Dropper",254.32,101.73,,,0 CDM,6370000001_00065401303,"VIGAMOX: 1 BOTTLE, PLASTIC in 1 CARTON (0065-4013-03) / 3 mL in 1 BOTTLE, PLASTIC",744.61,297.84,,,0 CDM,6370000001_00067000524,"EX-LAX: 2 PACKAGE in 1 BOX (0067-0005-24) / 12 TABLET, CHEWABLE in 1 PACKAGE",0.43,0.17,,,0 CDM,6370000001_00067000548,"EX-LAX: 4 PACKAGE in 1 BOX (0067-0005-48) / 12 TABLET, CHEWABLE in 1 PACKAGE",0.48,0.19,,,0 CDM,6370000001_00067022812,NDC Description Not Available,14.63,5.85,,,0 CDM,6370000001_00067815203,Voltaren Arthritis Pain: 1 Tube In 1 Carton (0067-8152-03) / 100 G In 1 Tube,83.26,33.3,,,0 CDM,6370000001_00069306030,"30 TABLET, FILM COATED in 1 BOTTLE (0069-3060-30)",4.56,1.82,,,0 CDM,6370000001_00069406189,"Zithromax: 50 Blister Pack In 1 Box, Unit-Dose (0069-4061-89) / 1 Tablet, Film Coated In 1 Blister Pack",14.88,5.95,,,0 CDM,6370000001_00069531702,NDC Description Not Available,299.53,119.81,,,0 CDM,6370000001_00069531720,"Paxlovid: 10 Blister Pack In 1 Carton (0069-5317-20) / 1 Kit In 1 Blister Pack (0069-5317-02) * 1 Tablet, Film Coated In 1 Blister Pack (0069-2085-11) * 1 Tablet, Film Coated In 1 Blister Pack (0",212.98,85.19,,,0 CDM,6370000001_00069532103,NDC Description Not Available,145.7,58.28,,,0 CDM,6370000001_00069532130,"Paxlovid: 10 Blister Pack In 1 Carton (0069-5321-30) / 1 Kit In 1 Blister Pack (0069-5321-03) * 2 Tablet, Film Coated In 1 Blister Pack (0069-2085-02) * 1 Tablet, Film Coated In 1 Blister Pack (0",149.6,59.84,,,0 CDM,6370000001_00071000740,"Dilantin Infatabs: 100 Blister Pack In 1 Box, Unit-Dose (0071-0007-40) / 1 Tablet, Chewable In 1 Blister Pack",6.71,2.68,,,0 CDM,6370000001_00071036940,Dilantin: 100 Blister Pack In 1 Carton (0071-0369-40) / 1 Capsule In 1 Blister Pack,5.74,2.3,,,0 CDM,6370000001_00071101341,Lyrica: 100 Blister Pack In 1 Carton (0071-1013-41) / 1 Capsule In 1 Blister Pack,47.89,19.16,,,0 CDM,6370000001_00071101441,Lyrica: 100 Blister Pack In 1 Carton (0071-1014-41) / 1 Capsule In 1 Blister Pack,47.97,19.19,,,0 CDM,6370000001_00071101541,Lyrica: 100 Blister Pack In 1 Carton (0071-1015-41) / 1 Capsule In 1 Blister Pack,33.4,13.36,,,0 CDM,6370000001_00074056111,"Venclexta: 1 Blister Pack In 1 Carton (0074-0561-11) / 2 Tablet, Film Coated In 1 Blister Pack",58.52,23.41,,,0 CDM,6370000001_00074056114,"Venclexta: 1 Blister Pack In 1 Carton (0074-0561-14) / 14 Tablet, Film Coated In 1 Blister Pack",38.17,15.27,,,0 CDM,6370000001_00074056607,"Venclexta: 1 Blister Pack In 1 Carton (0074-0566-07) / 7 Tablet, Film Coated In 1 Blister Pack",193.23,77.29,,,0 CDM,6370000001_00074056611,"Venclexta: 1 Blister Pack In 1 Carton (0074-0566-11) / 1 Tablet, Film Coated In 1 Blister Pack",292.61,117.04,,,0 CDM,6370000001_00074057622,"Venclexta: 120 Tablet, Film Coated In 1 Bottle (0074-0576-22)",585.26,234.1,,,0 CDM,6370000001_00074057630,"Venclexta: 1 Bottle In 1 Carton (0074-0576-30) / 28 Tablet, Film Coated In 1 Bottle",381.66,152.66,,,0 CDM,6370000001_00074230630,"Rinvoq: 30 Tablet, Extended Release In 1 Bottle (0074-2306-30)",621.51,248.6,,,0 CDM,6370000001_00074262528,"Mavyret: 4 Carton In 1 Carton (0074-2625-28) / 7 Dose Pack In 1 Carton / 3 Tablet, Film Coated In 1 Dose Pack",581.12,232.45,,,0 CDM,6370000001_00074434190,Synthroid: 90 Tablet In 1 Bottle (0074-4341-90),2.63,1.05,,,0 CDM,6370000001_00074455211,"Synthroid: 10 Blister Pack In 1 Box, Unit-Dose (0074-4552-11) / 10 Tablet In 1 Blister Pack",4.77,1.91,,,0 CDM,6370000001_00074455290,Synthroid: 90 Tablet In 1 Bottle (0074-4552-90),4.85,1.94,,,0 CDM,6370000001_00074518211,"Synthroid: 10 Blister Pack In 1 Box, Unit-Dose (0074-5182-11) / 10 Tablet In 1 Blister Pack",4.27,1.71,,,0 CDM,6370000001_00074518290,Synthroid: 90 Tablet In 1 Bottle (0074-5182-90),6.8,2.72,,,0 CDM,6370000001_00074662411,"Synthroid: 10 Blister Pack In 1 Box, Unit-Dose (0074-6624-11) / 10 Tablet In 1 Blister Pack",4.95,1.98,,,0 CDM,6370000001_00074662490,Synthroid: 90 Tablet In 1 Bottle (0074-6624-90),6.8,2.72,,,0 CDM,6370000001_00074709430,Qulipta: 30 Tablet In 1 Bottle (0074-7094-30),156.96,62.78,,,0 CDM,6370000001_00074714811,"Synthroid: 10 Blister Pack In 1 Box, Unit-Dose (0074-7148-11) / 10 Tablet In 1 Blister Pack",4.89,1.96,,,0 CDM,6370000001_00074929690,Synthroid: 90 Tablet In 1 Bottle (0074-9296-90),6.46,2.58,,,0 CDM,6370000001_00078034442,Vivelle-Dot: 8 Pouch In 1 Box (0078-0344-42) / 1 Patch In 1 Pouch (0078-0344-62) / 3.5 D In 1 Patch,82.9,33.16,,,0 CDM,6370000001_00078034462,NDC Description Not Available,79.91,31.96,,,0 CDM,6370000001_00078043005,"Focalin Xr: 100 Capsule, Extended Release In 1 Bottle (0078-0430-05)",21.19,8.48,,,0 CDM,6370000001_00078043105,"Focalin Xr: 100 Capsule, Extended Release In 1 Bottle (0078-0431-05)",14.98,5.99,,,0 CDM,6370000001_00078056845,Coartem: 24 Tablet In 1 Bottle (0078-0568-45),17.21,6.88,,,0 CDM,6370000001_00078065920,"Entresto: 60 Tablet, Film Coated In 1 Bottle (0078-0659-20)",35.22,14.09,,,0 CDM,6370000001_00078065967,"Entresto: 180 Tablet, Film Coated In 1 Bottle (0078-0659-67)",35.27,14.11,,,0 CDM,6370000001_00078068266,Tafinlar: 120 Capsule In 1 Bottle (0078-0682-66),433.3,173.32,,,0 CDM,6370000001_00078068415,"Promacta: 30 Tablet, Film Coated In 1 Bottle (0078-0684-15)",735.92,294.37,,,0 CDM,6370000001_00078068615,"Promacta: 30 Tablet, Film Coated In 1 Bottle (0078-0686-15)",1313.15,525.26,,,0 CDM,6370000001_00078069620,"Entresto: 60 Tablet, Film Coated In 1 Bottle (0078-0696-20)",35.19,14.08,,,0 CDM,6370000001_00078069802,NDC Description Not Available,500.48,200.19,,,0 CDM,6370000001_00078069851,NDC Description Not Available,575.41,230.16,,,0 CDM,6370000001_00078069899,"Rydapt: 2 Carton In 1 Carton (0078-0698-99) / 14 Blister Pack In 1 Carton (0078-0698-51) / 2 Capsule, Liquid Filled In 1 Blister Pack (0078-0698-02)",854.56,341.82,,,0 CDM,6370000001_00078077720,"Entresto: 60 Tablet, Film Coated In 1 Bottle (0078-0777-20)",33.7,13.48,,,0 CDM,6370000001_00078077767,"Entresto: 180 Tablet, Film Coated In 1 Bottle (0078-0777-67)",35.23,14.09,,,0 CDM,6370000001_00078081301,Tobrex: 3.5 G In 1 Tube (0078-0813-01),780.73,312.29,,,0 CDM,6370000001_00078086225,Durezol: 1 Bottle In 1 Carton (0078-0862-25) / 5 Ml In 1 Bottle,958.32,383.33,,,0 CDM,6370000001_00078087601,Tobradex: 3.5 G In 1 Tube (0078-0876-01),841.29,336.52,,,0 CDM,6370000001_00078092525,Maxidex: 5 Ml In 1 Bottle (0078-0925-25),228.24,91.3,,,0 CDM,6370000001_00078093926,Vigamox: 1 Bottle In 1 Carton (0078-0939-26) / 3 Ml In 1 Bottle,865.9,346.36,,,0 CDM,6370000001_00078116147,Mekinist: 90 Ml In 1 Bottle (0078-1161-47),166.23,66.49,,,0 CDM,6370000001_00081079888,NDC Description Not Available,15.09,6.04,,,0 CDM,6370000001_00085461005,Dulera: 1 CANISTER in 1 CARTON (0085-4610-05) / 60 AEROSOL in 1 CANISTER,248.09,99.24,,,0 CDM,6370000001_00085720607,Dulera: 1 CANISTER in 1 CARTON (0085-7206-07) / 60 AEROSOL in 1 CANISTER,151.36,60.54,,,0 CDM,6370000001_00087040203,NDC Description Not Available,0.27,0.11,,,0 CDM,6370000001_00087040255,NDC Description Not Available,0.32,0.13,,,0 CDM,6370000001_00087040265,NDC Description Not Available,0.23,0.09,,,0 CDM,6370000001_00087074002,NDC Description Not Available,0.2,0.08,,,0 CDM,6370000001_00087074054,NDC Description Not Available,0.28,0.11,,,0 CDM,6370000001_00087074081,NDC Description Not Available,0.08,0.03,,,0 CDM,6370000001_00087086644,NDC Description Not Available,0.33,0.13,,,0 CDM,6370000001_00088210201,NDC Description Not Available,21.33,8.53,,,0 CDM,6370000001_00088222033,"Lantus: 1 Vial, Glass In 1 Carton (0088-2220-33) / 10 Ml In 1 Vial, Glass",1.32,0.53,,,0 CDM,6370000001_00093005301,Buspirone Hydrochloride: 100 Tablet In 1 Bottle (0093-0053-01),0.17,0.07,,,0 CDM,6370000001_00093010901,Carbamazepine: 100 Tablet In 1 Bottle (0093-0109-01),2.88,1.15,,,0 CDM,6370000001_00093026230,Fluocinonide: 1 Tube In 1 Carton (0093-0262-30) / 30 G In 1 Tube,308.43,123.37,,,0 CDM,6370000001_00093031401,"Ketorolac Tromethamine: 100 Tablet, Film Coated In 1 Bottle (0093-0314-01)",3.25,1.3,,,0 CDM,6370000001_00093031801,"Diltiazem Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (0093-0318-01)",0.44,0.18,,,0 CDM,6370000001_00093031901,"Diltiazem Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (0093-0319-01)",0.65,0.26,,,0 CDM,6370000001_00093032001,"Diltiazem Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (0093-0320-01)",0.83,0.33,,,0 CDM,6370000001_00093081001,Nortriptyline Hydrochloride: 100 Capsule In 1 Bottle (0093-0810-01),0.79,0.32,,,0 CDM,6370000001_00093081101,Nortriptyline Hydrochloride: 100 Capsule In 1 Bottle (0093-0811-01),1.1,0.44,,,0 CDM,6370000001_00093083201,Clonazepam: 100 Tablet In 1 Bottle (0093-0832-01),0.14,0.06,,,0 CDM,6370000001_00093101042,Mupirocin: 1 Tube In 1 Carton (0093-1010-42) / 22 G In 1 Tube,140.17,56.07,,,0 CDM,6370000001_00093117701,Neomycin Sulfate: 100 Tablet In 1 Bottle (0093-1177-01),2.95,1.18,,,0 CDM,6370000001_00093202631,Azithromycin: 30 Ml In 1 Bottle (0093-2026-31),23.64,9.46,,,0 CDM,6370000001_00093206506,Cilostazol: 60 Tablet In 1 Bottle (0093-2065-06),1.37,0.55,,,0 CDM,6370000001_00093227434,"Amoxicillin And Clavulanate Potassium: 20 Tablet, Film Coated In 1 Bottle (0093-2274-34)",4.17,1.67,,,0 CDM,6370000001_00093310905,Amoxicillin: 500 Capsule In 1 Bottle (0093-3109-05),0.72,0.29,,,0 CDM,6370000001_00093312301,Dicloxacillin Sodium: 100 Capsule In 1 Bottle (0093-3123-01),1.97,0.79,,,0 CDM,6370000001_00093312701,Disopyramide Phosphate: 100 Capsule In 1 Bottle (0093-3127-01),8.59,3.44,,,0 CDM,6370000001_00093314705,Cephalexin: 500 Capsule In 1 Bottle (0093-3147-05),0.89,0.36,,,0 CDM,6370000001_00093342501,"Lorazepam: 100 Tablet In 1 Bottle, Plastic (0093-3425-01)",0.13,0.05,,,0 CDM,6370000001_00093342505,"Lorazepam: 500 Tablet In 1 Bottle, Plastic (0093-3425-05)",0.1,0.04,,,0 CDM,6370000001_00093342601,"Lorazepam: 100 Tablet In 1 Bottle, Plastic (0093-3426-01)",0.14,0.06,,,0 CDM,6370000001_00093342605,"Lorazepam: 500 Tablet In 1 Bottle, Plastic (0093-3426-05)",0.22,0.09,,,0 CDM,6370000001_00093365621,NDC Description Not Available,158.87,63.55,,,0 CDM,6370000001_00093365640,Buprenorphine: 4 Pouch In 1 Carton (0093-3656-40) / 1 Patch In 1 Pouch / 168 H In 1 Patch,160.83,64.33,,,0 CDM,6370000001_00093365721,NDC Description Not Available,238.3,95.32,,,0 CDM,6370000001_00093412774,Penicillin V Potassium: 200 Ml In 1 Bottle (0093-4127-74),0.68,0.27,,,0 CDM,6370000001_00093416173,Amoxicillin: 100 Ml In 1 Bottle (0093-4161-73),1.6,0.64,,,0 CDM,6370000001_00093417773,Cephalexin: 100 Ml In 1 Bottle (0093-4177-73),2.52,1.01,,,0 CDM,6370000001_00093417774,Cephalexin: 200 Ml In 1 Bottle (0093-4177-74),4.81,1.92,,,0 CDM,6370000001_00093503156,"Tiagabine Hydrochloride: 30 Tablet, Film Coated In 1 Bottle (0093-5031-56)",17.6,7.04,,,0 CDM,6370000001_00093555001,"Dexmethylphenidate Hydrochloride: 100 Capsule, Extended Release In 1 Bottle (0093-5550-01)",5.53,2.21,,,0 CDM,6370000001_00093716498,"Tolterodine Tartrate: 90 Capsule, Extended Release In 1 Bottle (0093-7164-98)",19.57,7.83,,,0 CDM,6370000001_00093729501,"Carvedilol: 100 Tablet, Film Coated In 1 Bottle (0093-7295-01)",0.18,0.07,,,0 CDM,6370000001_00093738598,"Venlafaxine Hydrochloride: 90 Capsule, Extended Release In 1 Bottle (0093-7385-98)",0.86,0.34,,,0 CDM,6370000001_00093762998,"Imatinib Mesylate: 90 Tablet, Film Coated In 1 Bottle (0093-7629-98)",3.72,1.49,,,0 CDM,6370000001_00093763056,"Imatinib Mesylate: 30 Tablet, Film Coated In 1 Bottle (0093-7630-56)",13.12,5.25,,,0 CDM,6370000001_00093873901,Mexiletine Hydrochloride: 100 Capsule In 1 Bottle (0093-8739-01),5.54,2.22,,,0 CDM,6370000001_00093874001,Mexiletine Hydrochloride: 100 Capsule In 1 Bottle (0093-8740-01),4.63,1.85,,,0 CDM,6370000001_00093970301,Carbidopa And Levodopa: 100 Tablet In 1 Bottle (0093-9703-01),0.86,0.34,,,0 CDM,6370000001_00096070735,NDC Description Not Available,28.0,11.2,,,0 CDM,6370000001_00115180401,"Hydroxyzine Pamoate: 100 Capsule In 1 Bottle, Plastic (0115-1804-01)",0.25,0.1,,,0 CDM,6370000001_00115262201,Terbutaline Sulfate: 100 Tablet In 1 Bottle (0115-2622-01),9.95,3.98,,,0 CDM,6370000001_00115443301,Dantrolene Sodium: 100 Capsule In 1 Bottle (0115-4433-01),1.98,0.79,,,0 CDM,6370000001_00115991901,"Dexmethylphenidate Hydrochloride: 100 Capsule, Extended Release In 1 Bottle, Plastic (0115-9919-01)",7.52,3.01,,,0 CDM,6370000001_00116200116,Chlorhexidine Gluconate: 473 Ml In 1 Bottle (0116-2001-16),3.38,1.35,,,0 CDM,6370000001_00116400511,"Lactulose: 100 Case In 1 Case (0116-4005-11) / 40 Tray In 1 Case (0116-4005-41) / 10 Cup, Unit-Dose In 1 Tray / 30 Ml In 1 Cup, Unit-Dose (0116-4005-30)",3.29,1.32,,,0 CDM,6370000001_00116400530,"Lactulose: 30 Ml In 1 Cup, Unit-Dose (0116-4005-30)",4.33,1.73,,,0 CDM,6370000001_00121043130,"Milk Of Magnesia: 10 Tray In 1 Case (0121-0431-30) / 10 Cup, Unit-Dose In 1 Tray / 30 Ml In 1 Cup, Unit-Dose",7.13,2.85,,,0 CDM,6370000001_00121048900,"Diphenhydramine Hydrochloride: 10 Tray In 1 Case (0121-0489-00) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (0121-0489-05)",9.59,3.84,,,0 CDM,6370000001_00121048905,NDC Description Not Available,9.39,3.76,,,0 CDM,6370000001_00121053005,NDC Description Not Available,10.36,4.14,,,0 CDM,6370000001_00121063800,"Guaifenesin Dm: 10 Tray In 1 Case (0121-0638-00) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (0121-0638-05)",3.3,1.32,,,0 CDM,6370000001_00121063805,NDC Description Not Available,6.81,2.72,,,0 CDM,6370000001_00121064616,Amantadine Hydrochloride: 473 Ml In 1 Bottle (0121-0646-16),1.48,0.59,,,0 CDM,6370000001_00121065705,NDC Description Not Available,1.36,0.54,,,0 CDM,6370000001_00121065916,NDC Description Not Available,0.12,0.05,,,0 CDM,6370000001_00121067016,Ethosuximide: 473 Ml In 1 Bottle (0121-0670-16),2.14,0.86,,,0 CDM,6370000001_00121067516,473 mL in 1 BOTTLE (0121-0675-16),0.72,0.29,,,0 CDM,6370000001_00121067585,Valproic Acid: 473 Ml In 1 Bottle (0121-0675-85),1.0,0.4,,,0 CDM,6370000001_00121067616,Potassium Citrate And Citric Acid: 473 Ml In 1 Bottle (0121-0676-16),1.94,0.78,,,0 CDM,6370000001_00121067716,Tricitrates: 473 Ml In 1 Bottle (0121-0677-16),0.63,0.25,,,0 CDM,6370000001_00121072104,Fluoxetine: 120 Ml In 1 Bottle (0121-0721-04),10.64,4.26,,,0 CDM,6370000001_00121076616,Calcium Carbonate: 12 Bottle In 1 Case (0121-0766-16) / 473 Ml In 1 Bottle,0.12,0.05,,,0 CDM,6370000001_00121077516,Guaifenesin And Codeine Phosphate: 473 Ml In 1 Bottle (0121-0775-16),1.06,0.42,,,0 CDM,6370000001_00121082016,Theophylline: 473 Ml In 1 Bottle (0121-0820-16),4.79,1.92,,,0 CDM,6370000001_00121082501,Morphine Sulfate: 30 Ml In 1 Bottle (0121-0825-01),0.92,0.37,,,0 CDM,6370000001_00121082601,Oxycodone Hydrochloride: 1 Bottle In 1 Carton (0121-0826-01) / 30 Ml In 1 Bottle,3.62,1.45,,,0 CDM,6370000001_00121085320,"Sulfamethoxazole And Trimethoprim: 10 Cup, Unit-Dose In 1 Tray (0121-0853-20) / 20 Ml In 1 Cup, Unit-Dose",13.53,5.41,,,0 CDM,6370000001_00121085416,Sulfatrim: 473 Ml In 1 Bottle (0121-0854-16),2.23,0.89,,,0 CDM,6370000001_00121086800,"Nystatin: 10 Tray In 1 Case (0121-0868-00) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (0121-0868-05)",4.59,1.84,,,0 CDM,6370000001_00121086805,NDC Description Not Available,2.1,0.84,,,0 CDM,6370000001_00121087332,Lactulose: 946 Ml In 1 Bottle (0121-0873-32),25.2,10.08,,,0 CDM,6370000001_00121089300,"Chlorhexidine Gluconate: 10 Tray In 1 Case (0121-0893-00) / 10 Cup, Unit-Dose In 1 Tray / 15 Ml In 1 Cup, Unit-Dose (0121-0893-15)",5.3,2.12,,,0 CDM,6370000001_00121089315,NDC Description Not Available,2.51,1.0,,,0 CDM,6370000001_00121090315,NDC Description Not Available,4.61,1.84,,,0 CDM,6370000001_00121090405,NDC Description Not Available,2.1,0.84,,,0 CDM,6370000001_00121090494,"Morphine Sulfate: 3 Tray In 1 Case (0121-0904-94) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (0121-0904-05)",2.41,0.96,,,0 CDM,6370000001_00121090505,NDC Description Not Available,2.1,0.84,,,0 CDM,6370000001_00121091400,"Childrens Ibuprofen Oral Suspension: 10 Tray In 1 Case (0121-0914-00) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (0121-0914-05)",1.93,0.77,,,0 CDM,6370000001_00121091405,NDC Description Not Available,1.92,0.77,,,0 CDM,6370000001_00121091805,NDC Description Not Available,1.86,0.74,,,0 CDM,6370000001_00121094205,NDC Description Not Available,6.01,2.4,,,0 CDM,6370000001_00121094289,NDC Description Not Available,4.39,1.76,,,0 CDM,6370000001_00121094816,Potassium Chloride: 473 Ml In 1 Bottle (0121-0948-16),0.54,0.22,,,0 CDM,6370000001_00121095003,Lidocaine Hydrochloride: 12 Bottle In 1 Case (0121-0950-03) / 100 Ml In 1 Bottle,3.48,1.39,,,0 CDM,6370000001_00121096605,NDC Description Not Available,3.21,1.28,,,0 CDM,6370000001_00121097251,"Lidocaine Hydrochloride: 1 Bottle, Glass In 1 Carton (0121-0972-51) / 50 Ml In 1 Bottle, Glass",59.0,23.6,,,0 CDM,6370000001_00121097410,NDC Description Not Available,16.75,6.7,,,0 CDM,6370000001_00121097800,"Diphenhydramine Hydrochloride: 10 Tray In 1 Case (0121-0978-00) / 10 Cup, Unit-Dose In 1 Tray / 10 Ml In 1 Cup, Unit-Dose (0121-0978-10)",16.2,6.48,,,0 CDM,6370000001_00121097810,NDC Description Not Available,11.66,4.66,,,0 CDM,6370000001_00121101605,NDC Description Not Available,85.71,34.28,,,0 CDM,6370000001_00121102205,"Dye Free Childrens Ibuprofen: 10 Cup, Unit-Dose In 1 Tray (0121-1022-05) / 5 Ml In 1 Cup, Unit-Dose",2.78,1.11,,,0 CDM,6370000001_00121115400,"Lactulose: 10 Tray In 1 Case (0121-1154-00) / 10 Cup, Unit-Dose In 1 Tray / 30 Ml In 1 Cup, Unit-Dose (0121-1154-30)",5.11,2.04,,,0 CDM,6370000001_00121115430,NDC Description Not Available,3.0,1.2,,,0 CDM,6370000001_00121115440,"Lactulose: 4 Tray In 1 Case (0121-1154-40) / 10 Cup, Unit-Dose In 1 Tray / 30 Ml In 1 Cup, Unit-Dose (0121-1154-30)",4.43,1.77,,,0 CDM,6370000001_00121119000,"Sodium Citrate And Citric Acid: 10 Tray In 1 Case (0121-1190-00) / 10 Cup, Unit-Dose In 1 Tray / 30 Ml In 1 Cup, Unit-Dose (0121-1190-30)",14.3,5.72,,,0 CDM,6370000001_00121119030,NDC Description Not Available,14.42,5.77,,,0 CDM,6370000001_00121127600,"Guaifenesin Dm: 10 Tray In 1 Case (0121-1276-00) / 10 Cup, Unit-Dose In 1 Tray / 10 Ml In 1 Cup, Unit-Dose (0121-1276-10)",7.61,3.04,,,0 CDM,6370000001_00121127610,NDC Description Not Available,7.35,2.94,,,0 CDM,6370000001_00121131411,NDC Description Not Available,3.58,1.43,,,0 CDM,6370000001_00121148800,"Guaifenesin: 10 Tray In 1 Case (0121-1488-00) / 10 Cup, Unit-Dose In 1 Tray / 10 Ml In 1 Cup, Unit-Dose (0121-1488-10)",3.74,1.5,,,0 CDM,6370000001_00121148810,NDC Description Not Available,3.16,1.26,,,0 CDM,6370000001_00121155000,"Guaifenesin And Codeine Phosphate: 10 Tray In 1 Case (0121-1550-00) / 10 Cup, Unit-Dose In 1 Tray / 10 Ml In 1 Cup, Unit-Dose (0121-1550-10)",2.34,0.94,,,0 CDM,6370000001_00121155010,NDC Description Not Available,2.54,1.02,,,0 CDM,6370000001_00121157610,"Metoclopramide: 10 Tray In 1 Case (0121-1576-10) / 10 Cup, Unit-Dose In 1 Tray / 10 Ml In 1 Cup, Unit-Dose",8.0,3.2,,,0 CDM,6370000001_00121174400,"Guaifenesin: 10 Tray In 1 Case (0121-1744-00) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (0121-1744-05)",3.26,1.3,,,0 CDM,6370000001_00121174405,NDC Description Not Available,4.05,1.62,,,0 CDM,6370000001_00121176130,"Mag-Al Plus: 10 Tray In 1 Case (0121-1761-30) / 10 Cup, Unit-Dose In 1 Tray / 30 Ml In 1 Cup, Unit-Dose",8.36,3.34,,,0 CDM,6370000001_00121176230,"Mag-Al Plus Xs: 10 Tray In 1 Case (0121-1762-30) / 10 Cup, Unit-Dose In 1 Tray / 30 Ml In 1 Cup, Unit-Dose",5.43,2.17,,,0 CDM,6370000001_00121178105,NDC Description Not Available,2.98,1.19,,,0 CDM,6370000001_00121182810,NDC Description Not Available,3.16,1.26,,,0 CDM,6370000001_00121183605,"Childrens Ibuprofen: 10 TRAY in 1 CASE (0121-1836-05) / 10 CUP, UNIT-DOSE in 1 TRAY / 5 mL in 1 CUP, UNIT-DOSE",1.36,0.54,,,0 CDM,6370000001_00121187000,"Docusate Sodium: 10 Tray In 1 Case (0121-1870-00) / 10 Cup, Unit-Dose In 1 Tray / 10 Ml In 1 Cup, Unit-Dose (0121-1870-10)",4.68,1.87,,,0 CDM,6370000001_00121187010,NDC Description Not Available,3.9,1.56,,,0 CDM,6370000001_00121188200,"Acetaminophen: 10 Tray In 1 Case (0121-1882-00) / 10 Cup, Unit-Dose In 1 Tray / 10.15 Ml In 1 Cup, Unit-Dose (0121-1882-11)",3.03,1.21,,,0 CDM,6370000001_00121188211,NDC Description Not Available,2.62,1.05,,,0 CDM,6370000001_00121223200,"Guaifenesin: 10 Tray In 1 Case (0121-2232-00) / 10 Cup, Unit-Dose In 1 Tray / 15 Ml In 1 Cup, Unit-Dose (0121-2232-15)",3.42,1.37,,,0 CDM,6370000001_00121223215,NDC Description Not Available,4.45,1.78,,,0 CDM,6370000001_00121231615,NDC Description Not Available,10.95,4.38,,,0 CDM,6370000001_00121467500,"Valproic Acid: 10 Tray In 1 Case (0121-4675-00) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (0121-4675-05)",3.51,1.4,,,0 CDM,6370000001_00121467505,NDC Description Not Available,2.57,1.03,,,0 CDM,6370000001_00121476605,"Calcium Carbonate: 4 Tray In 1 Case (0121-4766-05) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose",6.46,2.58,,,0 CDM,6370000001_00121479905,NDC Description Not Available,6.67,2.67,,,0 CDM,6370000001_00121479940,"Levetiracetam: 4 Tray In 1 Case (0121-4799-40) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (0121-4799-05)",11.62,4.65,,,0 CDM,6370000001_00121482705,NDC Description Not Available,11.67,4.67,,,0 CDM,6370000001_00121494800,"Potassium Chloride: 10 Tray In 1 Case (0121-4948-00) / 10 Cup, Unit-Dose In 1 Tray / 15 Ml In 1 Cup, Unit-Dose (0121-4948-15)",21.6,8.64,,,0 CDM,6370000001_00121494815,NDC Description Not Available,19.97,7.99,,,0 CDM,6370000001_00121495015,NDC Description Not Available,8.28,3.31,,,0 CDM,6370000001_00121495040,"Lidocaine Hydrochloride: 4 Tray In 1 Case (0121-4950-40) / 10 Cup, Unit-Dose In 1 Tray / 15 Ml In 1 Cup, Unit-Dose (0121-4950-15)",7.22,2.89,,,0 CDM,6370000001_00121496705,NDC Description Not Available,2.9,1.16,,,0 CDM,6370000001_00131247760,"Vimpat: 6 Blister Pack In 1 Carton (0131-2477-60) / 10 Tablet, Film Coated In 1 Blister Pack",53.93,21.57,,,0 CDM,6370000001_00131248060,"Vimpat: 6 Blister Pack In 1 Carton (0131-2480-60) / 10 Tablet, Film Coated In 1 Blister Pack",55.7,22.28,,,0 CDM,6370000001_00131541070,"465 mL in 1 BOTTLE, PLASTIC (0131-5410-70)",108.64,43.46,,,0 CDM,6370000001_00131541072,"Vimpat: 200 Ml In 1 Bottle, Glass (0131-5410-72)",83.62,33.45,,,0 CDM,6370000001_00132020140,"Fleet: 133 Ml In 1 Bottle, With Applicator (0132-0201-40)",2.66,1.06,,,0 CDM,6370000001_00132020142,"Fleet: 133 Ml In 1 Bottle, With Applicator (0132-0201-42)",3.6,1.44,,,0 CDM,6370000001_00132020220,"Pedia-Lax: 66 Ml In 1 Bottle, With Applicator (0132-0202-20)",4.06,1.62,,,0 CDM,6370000001_00132030140,"Fleet: 133 Ml In 1 Bottle, With Applicator (0132-0301-40)",5.97,2.39,,,0 CDM,6370000001_00143122701,"Dicyclomine: 100 Tablet In 1 Bottle, Plastic (0143-1227-01)",1.14,0.46,,,0 CDM,6370000001_00143177201,"Isosorbide Dinitrate: 100 Tablet In 1 Bottle, Plastic (0143-1772-01)",1.86,0.74,,,0 CDM,6370000001_00143988701,Amoxicillin: 100 Ml In 1 Bottle (0143-9887-01),0.62,0.25,,,0 CDM,6370000001_00143992801,"Ciprofloxacin: 100 Tablet, Film Coated In 1 Bottle (0143-9928-01)",0.9,0.36,,,0 CDM,6370000001_00143998201,Amoxicillin And Clavulanate Potassium: 100 Ml In 1 Bottle (0143-9982-01),4.45,1.78,,,0 CDM,6370000001_00168000315,Triamcinolone Acetonide: 1 Tube In 1 Carton (0168-0003-15) / 15 G In 1 Tube,11.16,4.46,,,0 CDM,6370000001_00168000415,Triamcinolone Acetonide: 1 Tube In 1 Carton (0168-0004-15) / 15 G In 1 Tube,11.6,4.64,,,0 CDM,6370000001_00168000615,Triamcinolone Acetonide: 15 G In 1 Tube (0168-0006-15),13.95,5.58,,,0 CDM,6370000001_00168000680,Triamcinolone Acetonide: 80 G In 1 Tube (0168-0006-80),29.81,11.92,,,0 CDM,6370000001_00168001516,Hydrocortisone: 453.6 G In 1 Jar (0168-0015-16),110.68,44.27,,,0 CDM,6370000001_00168001531,Hydrocortisone: 1 Tube In 1 Carton (0168-0015-31) / 28.35 G In 1 Tube,8.74,3.5,,,0 CDM,6370000001_00168004160,Betamethasone Valerate: 60 Ml In 1 Bottle (0168-0041-60),190.53,76.21,,,0 CDM,6370000001_00168005415,nystatin: 1 TUBE in 1 CARTON (0168-0054-15) / 15 g in 1 TUBE,60.17,24.07,,,0 CDM,6370000001_00168005546,Betamethasone Dipropionate: 1 Tube In 1 Carton (0168-0055-46) / 45 G In 1 Tube,279.18,111.67,,,0 CDM,6370000001_00168005615,Betamethasone Dipropionate: 1 Tube In 1 Carton (0168-0056-15) / 15 G In 1 Tube,152.8,61.12,,,0 CDM,6370000001_00168006231,ZINC OXIDE: 1 TUBE in 1 CARTON (0168-0062-31) / 28.35 g in 1 TUBE,7.74,3.1,,,0 CDM,6370000001_00168008031,Hydrocortisone: 30 G In 1 Tube (0168-0080-31),9.84,3.94,,,0 CDM,6370000001_00168009930,Ketoconazole: 1 Tube In 1 Carton (0168-0099-30) / 30 G In 1 Tube,94.41,37.76,,,0 CDM,6370000001_00168011109,Bacitracin Zinc: 144 PACKET in 1 CARTON (0168-0111-09) / .9 g in 1 PACKET,0.46,0.18,,,0 CDM,6370000001_00168014630,Hydrocortisone: 29 G In 1 Tube (0168-0146-30),10.07,4.03,,,0 CDM,6370000001_00168020437,Lidocaine: 1 Tube In 1 Carton (0168-0204-37) / 35.44 G In 1 Tube,28.12,11.25,,,0 CDM,6370000001_00168025846,Clotrimazole And Betamethasone Dipropionate: 45 G In 1 Tube (0168-0258-46),101.85,40.74,,,0 CDM,6370000001_00168035756,Lidocaine And Prilocaine: 1 Tube In 1 Carton (0168-0357-56) / 5 G In 1 Tube (0168-0357-05),123.96,49.58,,,0 CDM,6370000001_00169183311,Novolin R: 1 Vial In 1 Carton (0169-1833-11) / 10 Ml In 1 Vial,0.2,0.08,,,0 CDM,6370000001_00172208360,Hydrochlorothiazide: 100 Tablet In 1 Bottle (0172-2083-60),0.13,0.05,,,0 CDM,6370000001_00172392560,Diazepam: 100 Tablet In 1 Bottle (0172-3925-60),0.09,0.04,,,0 CDM,6370000001_00172409660,Baclofen: 100 Tablet In 1 Bottle (0172-4096-60),0.35,0.14,,,0 CDM,6370000001_00172731320,Cyclosporine: 1 Bottle In 1 Package (0172-7313-20) / 50 Ml In 1 Bottle,13.88,5.55,,,0 CDM,6370000001_00173038879,"Beconase Aq: 1 Bottle, Pump In 1 Carton (0173-0388-79) / 180 Spray, Suspension In 1 Bottle, Pump",1247.98,499.19,,,0 CDM,6370000001_00173052700,"Lamictal: 100 Tablet, For Suspension In 1 Bottle (0173-0527-00)",34.98,13.99,,,0 CDM,6370000001_00173071622,"Advair Hfa: 1 Inhaler In 1 Carton (0173-0716-22) / 60 Aerosol, Metered In 1 Inhaler",667.67,267.07,,,0 CDM,6370000001_00173071920,"Flovent Hfa: 1 Inhaler In 1 Carton (0173-0719-20) / 120 Aerosol, Metered In 1 Inhaler",692.54,277.02,,,0 CDM,6370000001_00178031430,"Potassium Iodide: 1 Bottle, Dropper In 1 Carton (0178-0314-30) / 30 Ml In 1 Bottle, Dropper",3.24,1.3,,,0 CDM,6370000001_00185067401,Hydroxyzine Pamoate: 100 Capsule In 1 Bottle (0185-0674-01),0.24,0.1,,,0 CDM,6370000001_00185560001,Metolazone: 100 Tablet In 1 Bottle (0185-5600-01),2.52,1.01,,,0 CDM,6370000001_00186077660,Brilinta: 60 Tablet In 1 Bottle (0186-0776-60),32.25,12.9,,,0 CDM,6370000001_00186077739,"Brilinta: 10 Blister Pack In 1 Box, Unit-Dose (0186-0777-39) / 10 Tablet In 1 Blister Pack",23.21,9.28,,,0 CDM,6370000001_00186402001,"Nexium: 30 Granule, Delayed Release In 1 Carton (0186-4020-01)",29.32,11.73,,,0 CDM,6370000001_00186404001,"Nexium: 30 Granule, Delayed Release In 1 Carton (0186-4040-01)",28.95,11.58,,,0 CDM,6370000001_00187074633,NDC Description Not Available,11.68,4.67,,,0 CDM,6370000001_00187301220,Mestinon: 473 Ml In 1 Bottle (0187-3012-20),55.75,22.3,,,0 CDM,6370000001_00187301330,"Mestinon: 30 Tablet, Extended Release In 1 Bottle (0187-3013-30)",160.03,64.01,,,0 CDM,6370000001_00187320447,Efudex: 1 Tube In 1 Carton (0187-3204-47) / 40 G In 1 Tube,180.0,72.0,,,0 CDM,6370000001_00223172001,NDC Description Not Available,0.16,0.06,,,0 CDM,6370000001_00228203110,Alprazolam: 100 Tablet In 1 Bottle (0228-2031-10),0.17,0.07,,,0 CDM,6370000001_00228206710,"Oxazepam: 100 Capsule, Gelatin Coated In 1 Bottle (0228-2067-10)",2.89,1.16,,,0 CDM,6370000001_00228207610,Temazepam: 100 Capsule In 1 Bottle (0228-2076-10),0.28,0.11,,,0 CDM,6370000001_00228212710,Clonidine Hydrochloride: 100 Tablet In 1 Bottle (0228-2127-10),0.12,0.05,,,0 CDM,6370000001_00228212810,Clonidine Hydrochloride: 100 Tablet In 1 Bottle (0228-2128-10),0.03,0.01,,,0 CDM,6370000001_00228253910,Carbidopa And Levodopa: 100 Tablet In 1 Bottle (0228-2539-10),0.17,0.07,,,0 CDM,6370000001_00228254010,Carbidopa And Levodopa: 100 Tablet In 1 Bottle (0228-2540-10),0.54,0.22,,,0 CDM,6370000001_00228262011,Isosorbide Mononitrate: 100 Tablet In 1 Bottle (0228-2620-11),1.08,0.43,,,0 CDM,6370000001_00245014701,Pacerone: 100 Blister Pack In 1 Carton (0245-0147-01) / 1 Tablet In 1 Blister Pack (0245-0147-89),0.92,0.37,,,0 CDM,6370000001_00245014789,NDC Description Not Available,1.02,0.41,,,0 CDM,6370000001_00245021201,Midodrine Hydrochloride: 100 Blister Pack In 1 Carton (0245-0212-01) / 1 Tablet In 1 Blister Pack (0245-0212-89),19.42,7.77,,,0 CDM,6370000001_00245021289,NDC Description Not Available,2.62,1.05,,,0 CDM,6370000001_00245036089,NDC Description Not Available,4.6,1.84,,,0 CDM,6370000001_00245531601,"Klor-Con: 100 Blister Pack In 1 Blister Pack (0245-5316-01) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack (0245-5316-89)",4.44,1.78,,,0 CDM,6370000001_00245531689,NDC Description Not Available,1.76,0.7,,,0 CDM,6370000001_00245531789,NDC Description Not Available,1.6,0.64,,,0 CDM,6370000001_00254101019,"Diazoxide: 1 Bottle, Dropper In 1 Carton (0254-1010-19) / 30 Ml In 1 Bottle, Dropper",26.41,10.56,,,0 CDM,6370000001_00254101636,"Posaconazole: 1 Bottle, Glass In 1 Carton (0254-1016-36) / 105 Ml In 1 Bottle, Glass",208.62,83.45,,,0 CDM,6370000001_00254301255,Alvimopan: 6 Blister Pack In 1 Carton (0254-3012-55) / 5 Capsule In 1 Blister Pack,478.03,191.21,,,0 CDM,6370000001_00254301278,NDC Description Not Available,471.33,188.53,,,0 CDM,6370000001_00254302802,"Lubiprostone: 60 Capsule, Gelatin Coated In 1 Bottle (0254-3028-02)",11.65,4.66,,,0 CDM,6370000001_00254302902,"Lubiprostone: 60 Capsule, Gelatin Coated In 1 Bottle (0254-3029-02)",5.36,2.14,,,0 CDM,6370000001_00281032608,Nitro-Bid: 48 Packet In 1 Box (0281-0326-08) / 1 G In 1 Packet,6.93,2.77,,,0 CDM,6370000001_00281032630,Nitro-Bid: 30 G In 1 Tube (0281-0326-30),104.45,41.78,,,0 CDM,6370000001_00283067902,Hurricaine Topical Anesthetic: 59.7 G In 1 Can (0283-0679-02),90.39,36.16,,,0 CDM,6370000001_00283067960,Hurricaine Topical Anesthetic: 1 Can In 1 Box (0283-0679-60) / 59.7 G In 1 Can (0283-0679-02),54.95,21.98,,,0 CDM,6370000001_00283091402,Hurricaine Topical Anesthetic: 59.7 G In 1 Can (0283-0914-02),54.95,21.98,,,0 CDM,6370000001_00310009530,"Daliresp: 30 Tablet In 1 Bottle, Plastic (0310-0095-30)",61.29,24.52,,,0 CDM,6370000001_00310110501,NDC Description Not Available,50.9,20.36,,,0 CDM,6370000001_00310110530,Lokelma: 30 Packet In 1 Box (0310-1105-30) / 5 G In 1 Packet (0310-1105-01),20.04,8.02,,,0 CDM,6370000001_00310110539,Lokelma: 11 Packet In 1 Box (0310-1105-39) / 5 G In 1 Packet (0310-1105-01),75.42,30.17,,,0 CDM,6370000001_00310111001,NDC Description Not Available,50.75,20.3,,,0 CDM,6370000001_00310111030,Lokelma: 30 Packet In 1 Box (0310-1110-30) / 10 G In 1 Packet (0310-1110-01),20.04,8.02,,,0 CDM,6370000001_00310111039,Lokelma: 11 Packet In 1 Box (0310-1110-39) / 10 G In 1 Packet (0310-1110-01),52.27,20.91,,,0 CDM,6370000001_00310621039,"Farxiga: 3 Blister Pack In 1 Carton (0310-6210-39) / 10 Tablet, Film Coated In 1 Blister Pack",68.18,27.27,,,0 CDM,6370000001_00316022130,Nystatin Cream: 1 Tube In 1 Carton (0316-0221-30) / 30 G In 1 Tube,59.94,23.98,,,0 CDM,6370000001_00338012612,Myxredlin: 12 Container In 1 Carton (0338-0126-12) / 100 Ml In 1 Container,4.25,1.7,,,0 CDM,6370000001_00378001801,"Metoprolol Tartrate: 100 Tablet, Film Coated In 1 Bottle, Plastic (0378-0018-01)",0.11,0.04,,,0 CDM,6370000001_00378013701,Allopurinol: 100 Tablet In 1 Bottle (0378-0137-01),1.22,0.49,,,0 CDM,6370000001_00378014491,Tamoxifen Citrate: 60 Tablet In 1 Bottle (0378-0144-91),0.58,0.23,,,0 CDM,6370000001_00378050301,"Bisoprolol Fumarate And Hydrochlorothiazide: 100 Tablet, Film Coated In 1 Bottle, Plastic (0378-0503-01)",1.12,0.45,,,0 CDM,6370000001_00378087116,NDC Description Not Available,26.58,10.63,,,0 CDM,6370000001_00378087199,Clonidine: 4 Pouch In 1 Carton (0378-0871-99) / 1 Patch In 1 Pouch (0378-0871-16) / 7 D In 1 Patch,31.12,12.45,,,0 CDM,6370000001_00378087216,NDC Description Not Available,47.69,19.08,,,0 CDM,6370000001_00378087299,Clonidine: 4 Pouch In 1 Carton (0378-0872-99) / 1 Patch In 1 Pouch (0378-0872-16) / 7 D In 1 Patch,53.06,21.22,,,0 CDM,6370000001_00378087316,NDC Description Not Available,74.44,29.78,,,0 CDM,6370000001_00378087399,Clonidine: 4 Pouch In 1 Carton (0378-0873-99) / 1 Patch In 1 Pouch (0378-0873-16) / 7 D In 1 Patch,69.64,27.86,,,0 CDM,6370000001_00378224693,"Imatinib Mesylate: 30 Tablet, Film Coated In 1 Bottle, Plastic (0378-2246-93)",34.34,13.74,,,0 CDM,6370000001_00378261001,"Amitriptyline Hydrochloride: 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-2610-01)",0.31,0.12,,,0 CDM,6370000001_00378392593,"Febuxostat: 30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3925-93)",10.82,4.33,,,0 CDM,6370000001_00378427193,"Ambrisentan: 30 Tablet, Film Coated In 1 Bottle, Plastic (0378-4271-93)",115.21,46.08,,,0 CDM,6370000001_00378464216,NDC Description Not Available,27.5,11.0,,,0 CDM,6370000001_00378561305,"Levetiracetam: 500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-5613-05)",1.24,0.5,,,0 CDM,6370000001_00378623201,"Citalopram: 100 Tablet, Film Coated In 1 Bottle, Plastic (0378-6232-01)",0.22,0.09,,,0 CDM,6370000001_00378633380,"Acamprosate Calcium: 180 Tablet, Delayed Release In 1 Bottle, Plastic (0378-6333-80)",2.48,0.99,,,0 CDM,6370000001_00378647016,NDC Description Not Available,69.58,27.83,,,0 CDM,6370000001_00378727253,Norethindrone: 3 Pouch In 1 Carton (0378-7272-53) / 1 Blister Pack In 1 Pouch (0378-7272-85) / 28 Tablet In 1 Blister Pack,0.58,0.23,,,0 CDM,6370000001_00378803005,"Lansoprazole: 500 Capsule, Delayed Release Pellets In 1 Bottle, Plastic (0378-8030-05)",4.32,1.73,,,0 CDM,6370000001_00378876616,NDC Description Not Available,9.65,3.86,,,0 CDM,6370000001_00378876693,Buprenorphine And Naloxone: 30 Pouch In 1 Carton (0378-8766-93) / 1 Film In 1 Pouch (0378-8766-16),17.07,6.83,,,0 CDM,6370000001_00378905593,Lidocaine: 30 Pouch In 1 Carton (0378-9055-93) / 1 Patch In 1 Pouch (0378-9055-16),24.66,9.86,,,0 CDM,6370000001_00378910216,NDC Description Not Available,1.81,0.72,,,0 CDM,6370000001_00378911916,NDC Description Not Available,29.16,11.66,,,0 CDM,6370000001_00378912116,NDC Description Not Available,21.39,8.56,,,0 CDM,6370000001_00378912216,NDC Description Not Available,38.01,15.2,,,0 CDM,6370000001_00378912298,Fentanyl: 5 Pouch In 1 Carton (0378-9122-98) / 1 Patch In 1 Pouch (0378-9122-16) / 72 H In 1 Patch,55.35,22.14,,,0 CDM,6370000001_00378912316,NDC Description Not Available,60.06,24.02,,,0 CDM,6370000001_00378912398,Fentanyl: 5 Pouch In 1 Carton (0378-9123-98) / 1 Patch In 1 Pouch (0378-9123-16) / 72 H In 1 Patch,87.5,35.0,,,0 CDM,6370000001_00378912416,NDC Description Not Available,82.68,33.07,,,0 CDM,6370000001_00378912498,Fentanyl: 5 Pouch In 1 Carton (0378-9124-98) / 1 Patch In 1 Pouch (0378-9124-16) / 72 H In 1 Patch,120.43,48.17,,,0 CDM,6370000001_00386000102,NDC Description Not Available,88.04,35.22,,,0 CDM,6370000001_00386000103,NDC Description Not Available,96.05,38.42,,,0 CDM,6370000001_00386000111,NDC Description Not Available,86.3,34.52,,,0 CDM,6370000001_00395100392,"Humco Gentian Violet 1%: 59 Ml In 1 Bottle, Plastic (0395-1003-92)",0.17,0.07,,,0 CDM,6370000001_00395103116,NDC Description Not Available,1.87,0.75,,,0 CDM,6370000001_00395140194,NDC Description Not Available,6.68,2.67,,,0 CDM,6370000001_00395266116,NDC Description Not Available,0.7,0.28,,,0 CDM,6370000001_00395266216,NDC Description Not Available,0.04,0.02,,,0 CDM,6370000001_00395268501,"Humco Sodium Bicarbonate: 454 G In 1 Bottle, Plastic (0395-2685-01)",0.08,0.03,,,0 CDM,6370000001_00395268594,"Humco Sodium Bicarbonate: 113 G In 1 Bottle, Plastic (0395-2685-94)",0.18,0.07,,,0 CDM,6370000001_00406012323,Hydrocodone Bitartrate And Acetaminophen: 1 Tablet In 1 Blister Pack (0406-0123-23),1.78,0.71,,,0 CDM,6370000001_00406012362,Hydrocodone Bitartrate And Acetaminophen: 100 Tablet In 1 Blister Pack (0406-0123-62),1.5,0.6,,,0 CDM,6370000001_00406052710,"Methadose: 1000 Ml In 1 Bottle, Plastic (0406-0527-10)",2.02,0.81,,,0 CDM,6370000001_00406055201,Oxycodone Hydrochloride: 100 Tablet In 1 Bottle (0406-0552-01),0.6,0.24,,,0 CDM,6370000001_00406055223,Oxycodone Hydrochloride: 1 Tablet In 1 Blister Pack (0406-0552-23),1.48,0.59,,,0 CDM,6370000001_00406055262,Oxycodone Hydrochloride: 100 Tablet In 1 Blister Pack (0406-0552-62),1.5,0.6,,,0 CDM,6370000001_00406123601,Diphenoxylate Hydrochloride And Atropine Sulfate: 100 Tablet In 1 Bottle (0406-1236-01),0.57,0.23,,,0 CDM,6370000001_00406324401,Hydromorphone Hydrochloride: 100 Tablet In 1 Bottle (0406-3244-01),0.44,0.18,,,0 CDM,6370000001_00406412303,"Methadone Hydrochloride: 1 Bottle, Dropper In 1 Carton (0406-4123-03) / 30 Ml In 1 Bottle, Dropper",6.97,2.79,,,0 CDM,6370000001_00406511862,Morphine Sulfate: 10 Blister Pack In 1 Carton (0406-5118-62) / 10 Tablet In 1 Blister Pack,2.79,1.12,,,0 CDM,6370000001_00406575523,Methadone Hydrochloride: 1 Tablet In 1 Blister Pack (0406-5755-23),1.16,0.46,,,0 CDM,6370000001_00406575562,Methadone Hydrochloride: 100 Tablet In 1 Blister Pack (0406-5755-62),0.85,0.34,,,0 CDM,6370000001_00406577123,Methadone Hydrochloride: 1 Tablet In 1 Blister Pack (0406-5771-23),0.73,0.29,,,0 CDM,6370000001_00406622501,NDC Description Not Available,0.12,0.05,,,0 CDM,6370000001_00406622505,Methadone Hydrochloride: 500 Ml In 1 Bottle (0406-6225-05),0.44,0.18,,,0 CDM,6370000001_00406800330,"Morphine Sulfate: 6 Carton In 1 Case (0406-8003-30) / 1 Bottle, Plastic In 1 Carton / 30 Ml In 1 Bottle, Plastic",2.24,0.9,,,0 CDM,6370000001_00406831523,"Morphine Sulfate: 1 Tablet, Extended Release In 1 Blister Pack (0406-8315-23)",3.59,1.44,,,0 CDM,6370000001_00406833023,"Morphine Sulfate: 1 Tablet, Extended Release In 1 Blister Pack (0406-8330-23)",3.39,1.36,,,0 CDM,6370000001_00406851023,Oxycodone Hydrochloride: 1 Tablet In 1 Blister Pack (0406-8510-23),1.73,0.69,,,0 CDM,6370000001_00406855730,"Oxycodone Hydrochloride: 1 Bottle, Plastic In 1 Carton (0406-8557-30) / 30 Ml In 1 Bottle, Plastic",4.96,1.98,,,0 CDM,6370000001_00406855755,NDC Description Not Available,1.99,0.8,,,0 CDM,6370000001_00406872510,"Methadose Sugar-Free: 1000 Ml In 1 Bottle, Plastic (0406-8725-10)",1.67,0.67,,,0 CDM,6370000001_00406889101,Dextroamphetamine Saccharate And Amphetamine Aspartate And Dextroamphetamine Sulfate And Amphetamine Sulfate: 100 Tablet In 1 Bottle (0406-8891-01),1.41,0.56,,,0 CDM,6370000001_00406895101,"Mixed Salts Of A Single Entity Amphetamine Product Xr: 100 Capsule, Extended Release In 1 Bottle (0406-8951-01)",3.36,1.34,,,0 CDM,6370000001_00436067216,Dakins Quarter: 473 Ml In 1 Bottle (0436-0672-16),53.93,21.57,,,0 CDM,6370000001_00440701001,NDC Description Not Available,0.08,0.03,,,0 CDM,6370000001_00440762620,NDC Description Not Available,0.56,0.22,,,0 CDM,6370000001_00456045801,Armour Thyroid: 100 Tablet In 1 Bottle (0456-0458-01),2.74,1.1,,,0 CDM,6370000001_00456045901,Armour Thyroid: 100 Tablet In 1 Bottle (0456-0459-01),3.3,1.32,,,0 CDM,6370000001_00456120130,"Linzess: 1 Bottle In 1 Carton (0456-1201-30) / 30 Capsule, Gelatin Coated In 1 Bottle",55.75,22.3,,,0 CDM,6370000001_00456120230,"Linzess: 1 Bottle In 1 Carton (0456-1202-30) / 30 Capsule, Gelatin Coated In 1 Bottle",55.54,22.22,,,0 CDM,6370000001_00456241060,Saphris: 6 Case In 1 Carton (0456-2410-60) / 1 Blister Pack In 1 Case (0456-2410-06) / 10 Tablet In 1 Blister Pack,86.21,34.48,,,0 CDM,6370000001_00456241063,10 BLISTER PACK in 1 CARTON (0456-2410-63) / 10 TABLET in 1 BLISTER PACK (0456-2410-11),85.74,34.3,,,0 CDM,6370000001_00456320511,NDC Description Not Available,31.91,12.76,,,0 CDM,6370000001_00469052002,Cresemba: 2 Blister Pack In 1 Carton (0469-0520-02) / 7 Capsule In 1 Blister Pack,345.89,138.36,,,0 CDM,6370000001_00469052014,Cresemba: 4 Carton In 1 Carton (0469-0520-14) / 14 Blister Pack In 1 Carton (0469-0520-02) / 1 Capsule In 1 Blister Pack,484.16,193.66,,,0 CDM,6370000001_00469260130,"Myrbetriq: 1 Bottle In 1 Carton (0469-2601-30) / 30 Tablet, Film Coated, Extended Release In 1 Bottle",46.73,18.69,,,0 CDM,6370000001_00469260230,"Myrbetriq: 1 Bottle In 1 Carton (0469-2602-30) / 30 Tablet, Film Coated, Extended Release In 1 Bottle",46.54,18.62,,,0 CDM,6370000001_00472008216,Acyclovir: 473 Ml In 1 Bottle (0472-0082-16),24.0,9.6,,,0 CDM,6370000001_00472017934,Triple Antibiotic: 1 TUBE in 1 CARTON (0472-0179-34) / 14 g in 1 TUBE,2.69,1.08,,,0 CDM,6370000001_00472032126,Hydrocortisone: 1 Tube In 1 Carton (0472-0321-26) / 28.4 G In 1 Tube,16.19,6.48,,,0 CDM,6370000001_00472037945,Clotrimazole And Betamethasone Dipropionate: 1 Tube In 1 Carton (0472-0379-45) / 45 G In 1 Tube,65.34,26.14,,,0 CDM,6370000001_00472110534,Bacitracin Zinc: 1 TUBE in 1 CARTON (0472-1105-34) / 14 g in 1 TUBE,2.69,1.08,,,0 CDM,6370000001_00472110556,Bacitracin Zinc: 1 TUBE in 1 CARTON (0472-1105-56) / 28 g in 1 TUBE,4.71,1.88,,,0 CDM,6370000001_00472173803,Miconazole Nitrate: 3 Suppository In 1 Carton (0472-1738-03),40.18,16.07,,,0 CDM,6370000001_00480372056,"Pyrimethamine: 30 Tablet In 1 Bottle, Plastic (0480-3720-56)",719.18,287.67,,,0 CDM,6370000001_00486112501,"K Phos Neutral: 100 Tablet, Coated In 1 Bottle (0486-1125-01)",3.19,1.28,,,0 CDM,6370000001_00487278401,"Asthmanefrin: 30 Pouch In 1 Carton (0487-2784-01) / 1 Vial, Single-Use In 1 Pouch / .5 Ml In 1 Vial, Single-Use",3.11,1.24,,,0 CDM,6370000001_00487590199,"S2: 30 Pouch In 1 Carton (0487-5901-99) / 1 Vial, Single-Use In 1 Pouch / .5 Ml In 1 Vial, Single-Use",3.28,1.31,,,0 CDM,6370000001_00521234500,NDC Description Not Available,16.56,6.62,,,0 CDM,6370000001_00527079137,"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate And Amphetamine Sulfate: 100 Capsule, Extended Release In 1 Bottle (0527-0791-37)",2.87,1.15,,,0 CDM,6370000001_00527131101,Terbutaline Sulfate: 100 Tablet In 1 Bottle (0527-1311-01),23.24,9.3,,,0 CDM,6370000001_00527132601,Ursodiol: 100 Capsule In 1 Bottle (0527-1326-01),4.14,1.66,,,0 CDM,6370000001_00527136801,Danazol: 100 Capsule In 1 Bottle (0527-1368-01),11.49,4.6,,,0 CDM,6370000001_00527169501,"Butalbital, Acetaminophen, And Caffeine: 100 Tablet In 1 Bottle, Plastic (0527-1695-01)",0.81,0.32,,,0 CDM,6370000001_00527178901,"Fluphenazine Hydrochloride: 100 Tablet, Film Coated In 1 Bottle, Plastic (0527-1789-01)",10.0,4.0,,,0 CDM,6370000001_00527194866,"Levofloxacin: 1 Bottle, Plastic In 1 Carton (0527-1948-66) / 100 Ml In 1 Bottle, Plastic",55.04,22.02,,,0 CDM,6370000001_00527194868,"Levofloxacin: 1 Bottle, Plastic In 1 Carton (0527-1948-68) / 200 Ml In 1 Bottle, Plastic",50.96,20.38,,,0 CDM,6370000001_00527194947,"Cyproheptadine Hydrochloride: 473 mL in 1 BOTTLE, PLASTIC (0527-1949-47)",1.42,0.57,,,0 CDM,6370000001_00527213335,"Posaconazole: 60 Tablet, Delayed Release In 1 Bottle (0527-2133-35)",27.2,10.88,,,0 CDM,6370000001_00527224432,Febuxostat: 30 Tablet In 1 Bottle (0527-2244-32),1.56,0.62,,,0 CDM,6370000001_00527411737,"Propranolol Hydrochloride: 100 Capsule, Extended Release In 1 Bottle (0527-4117-37)",0.68,0.27,,,0 CDM,6370000001_00527512578,Lactulose: 946 Ml In 1 Bottle (0527-5125-78),4.89,1.96,,,0 CDM,6370000001_00536009185,Aluminum Hydroxide: 473 Ml In 1 Bottle (0536-0091-85),0.29,0.12,,,0 CDM,6370000001_00536105224,Rugby Peg 3350: 238 G In 1 Bottle (0536-1052-24),0.37,0.15,,,0 CDM,6370000001_00536105429,"Aspirin: 1 Bottle, Plastic In 1 Carton (0536-1054-29) / 100 Tablet, Film Coated In 1 Bottle, Plastic",0.05,0.02,,,0 CDM,6370000001_00536110788,Nicotine Transdermal System Step 2: 14 Patch In 1 Carton (0536-1107-88) / 24 H In 1 Patch,3.43,1.37,,,0 CDM,6370000001_00536110888,Nicotine Transdermal System Step 1: 14 Patch In 1 Carton (0536-1108-88) / 24 H In 1 Patch,3.43,1.37,,,0 CDM,6370000001_00536111825,Rugby Arthritis Pain Relieving Topical Analgesic: 1 Tube In 1 Carton (0536-1118-25) / 57 G In 1 Tube,14.03,5.61,,,0 CDM,6370000001_00536114398,Rugby Petrolatum Hydrating Skin Protectant: 454 G In 1 Jar (0536-1143-98),20.49,8.2,,,0 CDM,6370000001_00536120610,"Calcium Carbonate 10 Gr (648 Mg) (Antacid): 1000 Tablet In 1 Bottle, Plastic (0536-1206-10)",0.03,0.01,,,0 CDM,6370000001_00536121794,"Rugby Tetrahydrozoline Ophthalmic Solution: 1 Bottle, Dropper In 1 Box (0536-1217-94) / 15 Ml In 1 Bottle, Dropper",2.94,1.18,,,0 CDM,6370000001_00536122497,"Rugby Eye Wash: 1 Bottle, Dropper In 1 Box (0536-1224-97) / 118 Ml In 1 Bottle, Dropper",9.21,3.68,,,0 CDM,6370000001_00536122858,"Rugby Cherry Flavor: 177 Ml In 1 Bottle, Spray (0536-1228-58)",0.61,0.24,,,0 CDM,6370000001_00536123927,"Nicotine Mini: 1 Bottle, Plastic In 1 Box (0536-1239-27) / 27 Lozenge In 1 Bottle, Plastic",1.05,0.42,,,0 CDM,6370000001_00536123981,"Nicotine Mini: 3 Bottle, Plastic In 1 Box (0536-1239-81) / 27 Lozenge In 1 Bottle, Plastic",1.27,0.51,,,0 CDM,6370000001_00536124181,"Mini Nicotine: 3 Bottle, Plastic In 1 Box (0536-1241-81) / 27 Lozenge In 1 Bottle, Plastic",1.34,0.54,,,0 CDM,6370000001_00536124701,"Senexon-S: 100 Tablet, Film Coated In 1 Bottle, Plastic (0536-1247-01)",0.13,0.05,,,0 CDM,6370000001_00536124710,"Senexon-S: 1000 Tablet, Film Coated In 1 Bottle, Plastic (0536-1247-10)",0.07,0.03,,,0 CDM,6370000001_00536124801,"Stimulant Laxative Plus Stool Softener: 100 Tablet, Film Coated In 1 Bottle, Plastic (0536-1248-01)",0.07,0.03,,,0 CDM,6370000001_00536125240,"Ketotifen Fumarate: 1 Bottle, Dropper In 1 Carton (0536-1252-40) / 5 Ml In 1 Bottle, Dropper",31.22,12.49,,,0 CDM,6370000001_00536125494,Sodium Chlorode Hypertonicity Ophthalmic Solution: 1 Bottle In 1 Carton (0536-1254-94) / 15 Ml In 1 Bottle,13.04,5.22,,,0 CDM,6370000001_00536125628,Bacitracin: 30 G In 1 Box (0536-1256-28),5.93,2.37,,,0 CDM,6370000001_00536126328,Bacitracin Zinc: 1 Tube In 1 Box (0536-1263-28) / 28 G In 1 Tube,7.48,2.99,,,0 CDM,6370000001_00536126595,Rugby Clotrimazole Antifungal Cream: 1 Tube In 1 Box (0536-1265-95) / 28 G In 1 Tube,0.41,0.16,,,0 CDM,6370000001_00536126659,Senna Liquid: 237 Ml In 1 Bottle (0536-1266-59),0.42,0.17,,,0 CDM,6370000001_00536126812,"Rugby Anti-Itch: 212 G In 1 Bottle, Pump (0536-1268-12)",16.07,6.43,,,0 CDM,6370000001_00536127222,Rugby Antifungal Clotrimazole: 1 Tube In 1 Carton (0536-1272-22) / 28 G In 1 Tube,6.05,2.42,,,0 CDM,6370000001_00536128806,Hemorrhoidal: 1 Tube In 1 Box (0536-1288-06) / 57 G In 1 Tube,7.36,2.94,,,0 CDM,6370000001_00536130353,NDC Description Not Available,0.06,0.02,,,0 CDM,6370000001_00536130375,"Infants: 1 Bottle, Dropper In 1 Carton (0536-1303-75) / 30 Ml In 1 Bottle, Dropper",0.21,0.08,,,0 CDM,6370000001_00536130485,Docusate Sodium Liquid: 473 Ml In 1 Bottle (0536-1304-85),0.29,0.12,,,0 CDM,6370000001_00536131625,Rugby Zinc Oxide 20%: 72 Tube In 1 Case (0536-1316-25) / 60 G In 1 Tube,8.77,3.51,,,0 CDM,6370000001_00536132601,"Acetaminophen, Aspirin, Caffeine: 1 Bottle In 1 Carton (0536-1326-01) / 100 Tablet, Film Coated In 1 Bottle",0.1,0.04,,,0 CDM,6370000001_00536134380,NDC Description Not Available,0.1,0.04,,,0 CDM,6370000001_00536134480,NDC Description Not Available,0.08,0.03,,,0 CDM,6370000001_00536134481,NDC Description Not Available,0.08,0.03,,,0 CDM,6370000001_00536135301,NDC Description Not Available,0.16,0.06,,,0 CDM,6370000001_00536136307,NDC Description Not Available,0.52,0.21,,,0 CDM,6370000001_00536137575,Miconazole Nitrate 2% Cream Antifungal: 1 Tube In 1 Box (0536-1375-75) / 28.3 G In 1 Tube,5.32,2.13,,,0 CDM,6370000001_00536137785,NDC Description Not Available,0.55,0.22,,,0 CDM,6370000001_00536138754,NDC Description Not Available,0.05,0.02,,,0 CDM,6370000001_00536138792,"Rugby Lubricant Eye Drops: 30 Vial, Single-Use In 1 Box (0536-1387-92) / .4 Ml In 1 Vial, Single-Use",0.71,0.28,,,0 CDM,6370000001_00536138793,"Rugby Lubricant Eye Drops: 50 Vial, Single-Use In 1 Box (0536-1387-93) / .4 Ml In 1 Vial, Single-Use",0.2,0.08,,,0 CDM,6370000001_00536252525,Capsaicin: 1 Tube In 1 Carton (0536-2525-25) / 60 G In 1 Tube,21.13,8.45,,,0 CDM,6370000001_00536311201,"Rugby Nicotine Polacrilex Gum, Coated Mint Flavor: 10 Blister Pack In 1 Carton (0536-3112-01) / 10 Gum, Chewing In 1 Blister Pack",0.89,0.36,,,0 CDM,6370000001_00536430611,"Fiber Lax: 90 Tablet, Film Coated In 1 Bottle (0536-4306-11)",0.19,0.08,,,0 CDM,6370000001_00536440601,NDC Description Not Available,0.07,0.03,,,0 CDM,6370000001_00536741551,Ready-To-Use: 1 Bottle In 1 Carton (0536-7415-51) / 133 Ml In 1 Bottle,4.39,1.76,,,0 CDM,6370000001_00555007102,Isoniazid: 100 Tablet In 1 Bottle (0555-0071-02),0.76,0.3,,,0 CDM,6370000001_00555015802,Chlordiazepoxide Hydrochloride: 100 Capsule In 1 Bottle (0555-0158-02),0.58,0.23,,,0 CDM,6370000001_00555015902,Chlordiazepoxide Hydrochloride: 100 Capsule In 1 Bottle (0555-0159-02),0.7,0.28,,,0 CDM,6370000001_00555060602,Megestrol Acetate: 100 Tablet In 1 Bottle (0555-0606-02),0.52,0.21,,,0 CDM,6370000001_00555063402,Danazol: 100 Capsule In 1 Bottle (0555-0634-02),16.65,6.66,,,0 CDM,6370000001_00555077902,Medroxyprogesterone Acetate: 100 Tablet In 1 Bottle (0555-0779-02),0.52,0.21,,,0 CDM,6370000001_00555087202,Medroxyprogesterone Acetate: 100 Tablet In 1 Bottle (0555-0872-02),0.32,0.13,,,0 CDM,6370000001_00555088602,Estradiol: 100 Tablet In 1 Bottle (0555-0886-02),0.85,0.34,,,0 CDM,6370000001_00555097202,"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate And Amphetamine Sulfate: 100 Tablet In 1 Bottle (0555-0972-02)",2.44,0.98,,,0 CDM,6370000001_00555901658,Sprintec: 6 Pouch In 1 Carton (0555-9016-58) / 1 Blister Pack In 1 Pouch / 1 Kit In 1 Blister Pack,2.35,0.94,,,0 CDM,6370000001_00555904979,NDC Description Not Available,2.27,0.91,,,0 CDM,6370000001_00573017920,"Junior Strength Advil: 1 Bottle In 1 Carton (0573-0179-20) / 24 Tablet, Chewable In 1 Bottle",0.47,0.19,,,0 CDM,6370000001_00573051330,NDC Description Not Available,1.3,0.52,,,0 CDM,6370000001_00574006915,Glutose: 37.5 g in 1 TUBE (0574-0069-15),7.91,3.16,,,0 CDM,6370000001_00574006930,Glutose: 3 TUBE in 1 CARTON (0574-0069-30) / 37.5 g in 1 TUBE,8.72,3.49,,,0 CDM,6370000001_00574007015,NDC Description Not Available,6.89,2.76,,,0 CDM,6370000001_00574007216,NDC Description Not Available,0.04,0.02,,,0 CDM,6370000001_00574010603,"Bromocriptine Mesylate: 30 Tablet In 1 Bottle, Plastic (0574-0106-03)",10.93,4.37,,,0 CDM,6370000001_00574010770,"Clotrimazole: 70 Lozenge In 1 Bottle, Plastic (0574-0107-70)",3.28,1.31,,,0 CDM,6370000001_00574015004,"Midazolam Hydrochloride: 1 Bottle, Glass In 1 Carton (0574-0150-04) / 118 Ml In 1 Bottle, Glass",12.34,4.94,,,0 CDM,6370000001_00574027500,NDC Description Not Available,0.74,0.3,,,0 CDM,6370000001_00574029201,Amiloride Hydrochloride: 100 Tablet In 1 Bottle (0574-0292-01),0.64,0.26,,,0 CDM,6370000001_00574030316,NDC Description Not Available,0.44,0.18,,,0 CDM,6370000001_00574030416,NDC Description Not Available,0.44,0.18,,,0 CDM,6370000001_00574031116,NDC Description Not Available,0.25,0.1,,,0 CDM,6370000001_00574050801,NDC Description Not Available,0.14,0.06,,,0 CDM,6370000001_00574050811,NDC Description Not Available,0.27,0.11,,,0 CDM,6370000001_00574052176,Actidose Aqua: 240 Ml In 1 Tube (0574-0521-76),52.91,21.16,,,0 CDM,6370000001_00574060801,NDC Description Not Available,0.09,0.04,,,0 CDM,6370000001_00574060811,NDC Description Not Available,0.27,0.11,,,0 CDM,6370000001_00574079101,"Methazolamide: 100 Tablet In 1 Bottle, Plastic (0574-0791-01)",19.68,7.87,,,0 CDM,6370000001_00574113316,Spironolactone: 473 Ml In 1 Bottle (0574-1133-16),18.45,7.38,,,0 CDM,6370000001_00574200815,"Nystop: 15 G In 1 Bottle, Plastic (0574-2008-15)",21.02,8.41,,,0 CDM,6370000001_00574200830,"Nystop: 30 G In 1 Bottle, Plastic (0574-2008-30)",166.02,66.41,,,0 CDM,6370000001_00574402411,NDC Description Not Available,27.43,10.97,,,0 CDM,6370000001_00574402435,Erythromycin: 1 Tube In 1 Carton (0574-4024-35) / 3.5 G In 1 Tube,42.67,17.07,,,0 CDM,6370000001_00574703412,Aspirin: 12 Packet In 1 Carton (0574-7034-12) / 1 Suppository In 1 Packet,2.85,1.14,,,0 CDM,6370000001_00574704512,Belladonna And Opium: 12 Packet In 1 Box (0574-7045-12) / 1 Suppository In 1 Packet,94.78,37.91,,,0 CDM,6370000001_00574705012,Bisacodyl: 12 Blister Pack In 1 Carton (0574-7050-12) / 1 Suppository In 1 Blister Pack,1.05,0.42,,,0 CDM,6370000001_00574705050,Bisacodyl: 50 Blister Pack In 1 Carton (0574-7050-50) / 1 Suppository In 1 Blister Pack,0.72,0.29,,,0 CDM,6370000001_00574722612,Compro: 12 Packet In 1 Carton (0574-7226-12) / 1 Suppository In 1 Packet,26.84,10.74,,,0 CDM,6370000001_00574985510,Budesonide: 1 Bottle In 1 Carton (0574-9855-10) / 100 Capsule In 1 Bottle,2.97,1.19,,,0 CDM,6370000001_00575620030,"Proglycem: 1 Bottle, Dropper In 1 Box (0575-6200-30) / 30 Ml In 1 Bottle, Dropper",15.61,6.24,,,0 CDM,6370000001_00591044401,"Guanfacine: 100 Tablet In 1 Bottle, Plastic (0591-0444-01)",0.59,0.24,,,0 CDM,6370000001_00591058201,"Propafenone Hcl: 100 Tablet, Film Coated In 1 Bottle, Plastic (0591-0582-01)",1.07,0.43,,,0 CDM,6370000001_00591231245,NDC Description Not Available,398.93,159.57,,,0 CDM,6370000001_00591257920,"Valganciclovir Hydrochloride For Oral: 100 Ml In 1 Bottle, Glass (0591-2579-20)",352.73,141.09,,,0 CDM,6370000001_00591292754,"Levalbuterol Tartrate Hfa Inhalation: 1 Inhaler In 1 Carton (0591-2927-54) / 200 Aerosol, Metered In 1 Inhaler",176.9,70.76,,,0 CDM,6370000001_00591333119,"Bupropion Hydrochloride Xl: 90 Tablet, Film Coated, Extended Release In 1 Bottle, Plastic (0591-3331-19)",5.71,2.28,,,0 CDM,6370000001_00591352511,NDC Description Not Available,9.73,3.89,,,0 CDM,6370000001_00591352530,Lidocaine: 30 Pouch In 1 Carton (0591-3525-30) / 1 G In 1 Pouch (0591-3525-11),6.51,2.6,,,0 CDM,6370000001_00591365930,"Desvenlafaxine: 30 Tablet, Extended Release In 1 Bottle (0591-3659-30)",4.21,1.68,,,0 CDM,6370000001_00591387044,"Memantine Hydrochloride: 10 Blister Pack In 1 Box, Unit-Dose (0591-3870-44) / 10 Tablet In 1 Blister Pack (0591-3870-45)",1.31,0.52,,,0 CDM,6370000001_00591387045,NDC Description Not Available,0.91,0.36,,,0 CDM,6370000001_00591387544,"Memantine Hydrochloride: 10 Blister Pack In 1 Box, Unit-Dose (0591-3875-44) / 10 Tablet In 1 Blister Pack (0591-3875-45)",0.9,0.36,,,0 CDM,6370000001_00591387545,NDC Description Not Available,0.82,0.33,,,0 CDM,6370000001_00591533501,"Trihexyphenidyl Hydrochloride: 100 Tablet In 1 Bottle, Plastic (0591-5335-01)",0.43,0.17,,,0 CDM,6370000001_00591533701,"Trihexyphenidyl Hydrochloride: 100 Tablet In 1 Bottle, Plastic (0591-5337-01)",0.81,0.32,,,0 CDM,6370000001_00591534701,"Probenecid: 100 Tablet, Film Coated In 1 Bottle, Plastic (0591-5347-01)",1.82,0.73,,,0 CDM,6370000001_00591569460,"Minocycline Hydrochloride: 60 Capsule In 1 Bottle, Plastic (0591-5694-60)",0.64,0.26,,,0 CDM,6370000001_00597008717,"Atrovent Hfa: 1 Canister In 1 Carton (0597-0087-17) / 200 Aerosol, Metered In 1 Canister",1270.45,508.18,,,0 CDM,6370000001_00597010051,"Spiriva Respimat: 1 Cartridge In 1 Carton (0597-0100-51) / 10 Spray, Metered In 1 Cartridge",228.23,91.29,,,0 CDM,6370000001_00597010061,"Spiriva Respimat: 1 Cartridge In 1 Carton (0597-0100-61) / 60 Spray, Metered In 1 Cartridge",1616.15,646.46,,,0 CDM,6370000001_00597015237,"Jardiance: 30 Blister Pack In 1 Carton (0597-0152-37) / 1 Tablet, Film Coated In 1 Blister Pack",62.6,25.04,,,0 CDM,6370000001_00597015337,"Jardiance: 30 Blister Pack In 1 Carton (0597-0153-37) / 1 Tablet, Film Coated In 1 Blister Pack",62.59,25.04,,,0 CDM,6370000001_00597035556,Pradaxa: 60 Blister Pack In 1 Carton (0597-0355-56) / 1 Capsule In 1 Blister Pack,13.54,5.42,,,0 CDM,6370000001_00597036082,Pradaxa: 60 Blister Pack In 1 Carton (0597-0360-82) / 1 Capsule In 1 Blister Pack,10.08,4.03,,,0 CDM,6370000001_00603116158,"Dicyclomine Hydrochloride: 473 Ml In 1 Bottle, Plastic (0603-1161-58)",5.76,2.3,,,0 CDM,6370000001_00603154258,"Potassium Chloride: 473 Ml In 1 Bottle, Plastic (0603-1542-58)",0.6,0.24,,,0 CDM,6370000001_00603155410,NDC Description Not Available,23.03,9.21,,,0 CDM,6370000001_00603188010,NDC Description Not Available,14.32,5.73,,,0 CDM,6370000001_00603188016,Lidocaine: 30 Pouch In 1 Carton (0603-1880-16) / .7 G In 1 Pouch (0603-1880-10),12.82,5.13,,,0 CDM,6370000001_00603516721,"Phenobarbital: 100 Tablet In 1 Bottle, Plastic (0603-5167-21)",1.91,0.76,,,0 CDM,6370000001_00603548421,Propranolol Hydrochloride: 100 Tablet In 1 Bottle (0603-5484-21),0.77,0.31,,,0 CDM,6370000001_00713013506,NDC Description Not Available,25.62,10.25,,,0 CDM,6370000001_00713022531,Triamcinolone Acetonide: 1 Tube In 1 Carton (0713-0225-31) / 30 G In 1 Tube,17.39,6.96,,,0 CDM,6370000001_00713022880,Triamcinolone Acetonide: 1 Tube In 1 Carton (0713-0228-80) / 80 G In 1 Tube,39.01,15.6,,,0 CDM,6370000001_00713026831,Triple Antibiotic: 1 Tube In 1 Carton (0713-0268-31) / 28.4 G In 1 Tube,9.28,3.71,,,0 CDM,6370000001_00713028031,Bacitracin: 28.4 G In 1 Tube (0713-0280-31),4.21,1.68,,,0 CDM,6370000001_00713050306,NDC Description Not Available,34.5,13.8,,,0 CDM,6370000001_00713050312,Anucort-Hc: 12 Suppository In 1 Carton (0713-0503-12),34.5,13.8,,,0 CDM,6370000001_00713052612,Promethegan: 12 Suppository In 1 Box (0713-0526-12),29.15,11.66,,,0 CDM,6370000001_00713053606,NDC Description Not Available,29.25,11.7,,,0 CDM,6370000001_00713055273,Terconazole: 3 Blister Pack In 1 Carton (0713-0552-73) / 1 Suppository In 1 Blister Pack,82.51,33.0,,,0 CDM,6370000001_00713068215,Gentamicin Sulfate: 1 Tube In 1 Carton (0713-0682-15) / 15 G In 1 Tube,52.24,20.9,,,0 CDM,6370000001_00713068315,Gentamicin Sulfate: 1 Tube In 1 Carton (0713-0683-15) / 15 G In 1 Tube,41.47,16.59,,,0 CDM,6370000001_00713068615,Nystatin: 1 Tube In 1 Carton (0713-0686-15) / 15 G In 1 Tube,42.27,16.91,,,0 CDM,6370000001_00781106101,Alprazolam: 100 Tablet In 1 Bottle (0781-1061-01),0.09,0.04,,,0 CDM,6370000001_00781152601,"Potassium Chloride: 100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0781-1526-01)",1.98,0.79,,,0 CDM,6370000001_00781165501,Penicillin V Potasium: 100 TABLET in 1 BOTTLE (0781-1655-01),4.02,1.61,,,0 CDM,6370000001_00781185220,"Amoxicillin And Clavulanate Potassium: 20 Tablet, Film Coated In 1 Bottle (0781-1852-20)",3.41,1.36,,,0 CDM,6370000001_00781194339,"Amoxicillin And Clavulanate Potassium: 40 Tablet, Multilayer, Extended Release In 1 Bottle (0781-1943-39)",17.51,7.0,,,0 CDM,6370000001_00781194382,"Amoxicillin And Clavulanate Potassium: 28 Tablet, Multilayer, Extended Release In 1 Bottle (0781-1943-82)",15.8,6.32,,,0 CDM,6370000001_00781202001,Amoxicillin: 100 Capsule In 1 Bottle (0781-2020-01),0.35,0.14,,,0 CDM,6370000001_00781214501,Ampicillin: 100 Capsule In 1 Bottle (0781-2145-01),1.56,0.62,,,0 CDM,6370000001_00781232106,Aprepitant: 1 Blister Pack In 1 Carton (0781-2321-06) / 1 Capsule In 1 Blister Pack,33.49,13.4,,,0 CDM,6370000001_00781232306,NDC Description Not Available,29.35,11.74,,,0 CDM,6370000001_00781232368,Aprepitant: 1 Blister Pack In 1 Carton (0781-2323-68) / 6 Capsule In 1 Blister Pack (0781-2323-06),37.05,14.82,,,0 CDM,6370000001_00781236101,"Methylphenidate: 100 Capsule, Extended Release In 1 Bottle (0781-2361-01)",24.37,9.75,,,0 CDM,6370000001_00781261301,Amoxicillin: 100 Capsule In 1 Bottle (0781-2613-01),0.54,0.22,,,0 CDM,6370000001_00781600078,Difluprednate Ophthalmic: 1 Bottle In 1 Carton (0781-6000-78) / 5 Ml In 1 Bottle,530.38,212.15,,,0 CDM,6370000001_00781602346,Clarithromycin: 100 Ml In 1 Bottle (0781-6023-46),54.5,21.8,,,0 CDM,6370000001_00781718675,Brimonidine Tartrate And Timolol Maleate: 1 Bottle In 1 Carton (0781-7186-75) / 5 Ml In 1 Bottle,341.76,136.7,,,0 CDM,6370000001_00781808931,"Azithromycin: 30 Tablet, Film Coated In 1 Bottle (0781-8089-31)",6.48,2.59,,,0 CDM,6370000001_00799000104,Calmoseptine: 113 G In 1 Tube (0799-0001-04),14.58,5.83,,,0 CDM,6370000001_00802392016,NDC Description Not Available,0.53,0.21,,,0 CDM,6370000001_00832003800,Oxybutynin Chloride: 100 Tablet In 1 Bottle (0832-0038-00),0.23,0.09,,,0 CDM,6370000001_00832003889,NDC Description Not Available,1.2,0.48,,,0 CDM,6370000001_00832046515,"Nyamyc: 1 Bottle, Plastic In 1 Carton (0832-0465-15) / 15 G In 1 Bottle, Plastic",20.87,8.35,,,0 CDM,6370000001_00832046530,"Nyamyc: 1 Bottle, Plastic In 1 Carton (0832-0465-30) / 30 G In 1 Bottle, Plastic",44.99,18.0,,,0 CDM,6370000001_00832051100,Bethanechol Chloride: 100 Tablet In 1 Bottle (0832-0511-00),0.06,0.02,,,0 CDM,6370000001_00832051101,Bethanechol Chloride: 100 Blister Pack In 1 Carton (0832-0511-01) / 1 Tablet In 1 Blister Pack (0832-0511-89),1.46,0.58,,,0 CDM,6370000001_00832051189,NDC Description Not Available,1.3,0.52,,,0 CDM,6370000001_00832051201,Bethanechol Chloride: 100 Blister Pack In 1 Carton (0832-0512-01) / 1 Tablet In 1 Blister Pack (0832-0512-89),2.22,0.89,,,0 CDM,6370000001_00832051289,NDC Description Not Available,2.8,1.12,,,0 CDM,6370000001_00832058011,Clobazam: 100 Tablet In 1 Bottle (0832-0580-11),0.91,0.36,,,0 CDM,6370000001_00832105511,Baclofen: 100 Tablet In 1 Bottle (0832-1055-11),0.96,0.38,,,0 CDM,6370000001_00832121101,Jantoven: 100 Blister Pack In 1 Carton (0832-1211-01) / 1 Tablet In 1 Blister Pack (0832-1211-89),1.14,0.46,,,0 CDM,6370000001_00832121189,NDC Description Not Available,0.93,0.37,,,0 CDM,6370000001_00832121201,Jantoven: 100 Blister Pack In 1 Carton (0832-1212-01) / 1 Tablet In 1 Blister Pack (0832-1212-89),1.22,0.49,,,0 CDM,6370000001_00832121289,NDC Description Not Available,1.18,0.47,,,0 CDM,6370000001_00832121301,Jantoven: 100 Blister Pack In 1 Carton (0832-1213-01) / 1 Tablet In 1 Blister Pack (0832-1213-89),0.73,0.29,,,0 CDM,6370000001_00832121389,NDC Description Not Available,1.14,0.46,,,0 CDM,6370000001_00832121401,Jantoven: 100 Blister Pack In 1 Carton (0832-1214-01) / 1 Tablet In 1 Blister Pack (0832-1214-89),1.19,0.48,,,0 CDM,6370000001_00832121489,NDC Description Not Available,1.18,0.47,,,0 CDM,6370000001_00832121501,Jantoven: 100 Blister Pack In 1 Carton (0832-1215-01) / 1 Tablet In 1 Blister Pack (0832-1215-89),1.05,0.42,,,0 CDM,6370000001_00832121589,NDC Description Not Available,1.09,0.44,,,0 CDM,6370000001_00832121601,Jantoven: 100 Blister Pack In 1 Carton (0832-1216-01) / 1 Tablet In 1 Blister Pack (0832-1216-89),1.12,0.45,,,0 CDM,6370000001_00832121689,NDC Description Not Available,1.14,0.46,,,0 CDM,6370000001_00832121701,Jantoven: 100 Blister Pack In 1 Carton (0832-1217-01) / 1 Tablet In 1 Blister Pack (0832-1217-89),1.73,0.69,,,0 CDM,6370000001_00832121789,NDC Description Not Available,0.73,0.29,,,0 CDM,6370000001_00832121800,Jantoven: 100 Tablet In 1 Bottle (0832-1218-00),1.74,0.7,,,0 CDM,6370000001_00832121801,Jantoven: 100 Blister Pack In 1 Carton (0832-1218-01) / 1 Tablet In 1 Blister Pack (0832-1218-89),1.03,0.41,,,0 CDM,6370000001_00832121889,NDC Description Not Available,1.6,0.64,,,0 CDM,6370000001_00832121900,Jantoven: 100 Tablet In 1 Bottle (0832-1219-00),0.76,0.3,,,0 CDM,6370000001_00832121901,Jantoven: 100 Blister Pack In 1 Carton (0832-1219-01) / 1 Tablet In 1 Blister Pack (0832-1219-89),1.82,0.73,,,0 CDM,6370000001_00832121989,NDC Description Not Available,1.78,0.71,,,0 CDM,6370000001_00832135911,Doxazosin: 100 Tablet In 1 Bottle (0832-1359-11),0.68,0.27,,,0 CDM,6370000001_00832152089,NDC Description Not Available,1.48,0.59,,,0 CDM,6370000001_00832532310,"Potassium Chloride: 1000 Tablet, Film Coated, Extended Release In 1 Bottle (0832-5323-10)",1.38,0.55,,,0 CDM,6370000001_00832602311,"Carbamazepin: 100 Tablet, Extended Release In 1 Bottle (0832-6023-11)",2.42,0.97,,,0 CDM,6370000001_00832712301,"Divalproex Sodium: 100 Blister Pack In 1 Carton (0832-7123-01) / 1 Tablet, Delayed Release In 1 Blister Pack (0832-7123-89)",0.67,0.27,,,0 CDM,6370000001_00832712389,NDC Description Not Available,0.76,0.3,,,0 CDM,6370000001_00832712401,"Divalproex Sodium: 100 Blister Pack In 1 Carton (0832-7124-01) / 1 Tablet, Delayed Release In 1 Blister Pack (0832-7124-89)",0.75,0.3,,,0 CDM,6370000001_00832712489,NDC Description Not Available,0.84,0.34,,,0 CDM,6370000001_00904001261,Allergy: 10 Blister Pack In 1 Carton (0904-0012-61) / 10 Tablet In 1 Blister Pack,0.12,0.05,,,0 CDM,6370000001_00904043004,"Doxycycline Hyclate: 30 Blister Pack In 1 Carton (0904-0430-04) / 1 Tablet, Coated In 1 Blister Pack",10.88,4.35,,,0 CDM,6370000001_00904043006,"Doxycycline Hyclate: 50 Blister Pack In 1 Carton (0904-0430-06) / 1 Tablet, Coated In 1 Blister Pack",6.55,2.62,,,0 CDM,6370000001_00904052361,NDC Description Not Available,0.11,0.04,,,0 CDM,6370000001_00904073431,Triple Antibiotic: 1 Tube In 1 Carton (0904-0734-31) / 28 G In 1 Tube,3.92,1.57,,,0 CDM,6370000001_00904188361,NDC Description Not Available,0.13,0.05,,,0 CDM,6370000001_00904253321,"Calamine: 177 Ml In 1 Bottle, Plastic (0904-2533-21)",4.25,1.7,,,0 CDM,6370000001_00904272561,Sulfamethoxazole And Trimethoprim: 100 Blister Pack In 1 Carton (0904-2725-61) / 1 Tablet In 1 Blister Pack,0.56,0.22,,,0 CDM,6370000001_00904385461,"Carbamazepine: 100 Blister Pack In 1 Carton (0904-3854-61) / 1 Tablet, Chewable In 1 Blister Pack",1.49,0.6,,,0 CDM,6370000001_00904386575,NDC Description Not Available,1.75,0.7,,,0 CDM,6370000001_00904429909,NDC Description Not Available,5.67,2.27,,,0 CDM,6370000001_00904505359,"Sudogest: 1 Bottle, Plastic In 1 Carton (0904-5053-59) / 100 Tablet, Film Coated In 1 Bottle, Plastic",0.06,0.02,,,0 CDM,6370000001_00904522452,NDC Description Not Available,0.23,0.09,,,0 CDM,6370000001_00904528261,RIFAMPIN: 100 BLISTER PACK in 1 CARTON (0904-5282-61) / 1 CAPSULE in 1 BLISTER PACK,2.56,1.02,,,0 CDM,6370000001_00904535431,Banophen: 1 Tube In 1 Carton (0904-5354-31) / 28 G In 1 Tube,5.38,2.15,,,0 CDM,6370000001_00904539561,NDC Description Not Available,0.39,0.16,,,0 CDM,6370000001_00904544861,"Pentoxifylline: 100 Blister Pack In 1 Carton (0904-5448-61) / 1 Tablet, Extended Release In 1 Blister Pack",0.86,0.34,,,0 CDM,6370000001_00904549261,NDC Description Not Available,0.09,0.04,,,0 CDM,6370000001_00904552361,Doxazosin: 100 Blister Pack In 1 Carton (0904-5523-61) / 1 Tablet In 1 Blister Pack,1.65,0.66,,,0 CDM,6370000001_00904552461,Doxazosin: 100 Blister Pack In 1 Carton (0904-5524-61) / 1 Tablet In 1 Blister Pack,2.59,1.04,,,0 CDM,6370000001_00904555159,"Banophen: 1 Bottle, Plastic In 1 Carton (0904-5551-59) / 100 Tablet, Film Coated In 1 Bottle, Plastic",0.03,0.01,,,0 CDM,6370000001_00904561061,ENALAPRIL MALEATE: 100 BLISTER PACK in 1 CARTON (0904-5610-61) / 1 TABLET in 1 BLISTER PACK,2.16,0.86,,,0 CDM,6370000001_00904567661,"Paroxetine: 100 Blister Pack In 1 Box, Unit-Dose (0904-5676-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.85,0.74,,,0 CDM,6370000001_00904567761,"Paroxetine: 100 Blister Pack In 1 Box, Unit-Dose (0904-5677-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.73,0.29,,,0 CDM,6370000001_00904573182,Petroleum Skin Protectant: 368 G In 1 Jar (0904-5731-82),9.94,3.98,,,0 CDM,6370000001_00904578461,Fluoxetine: 100 Blister Pack In 1 Carton (0904-5784-61) / 1 Capsule In 1 Blister Pack,0.25,0.1,,,0 CDM,6370000001_00904578561,Fluoxetine: 100 Blister Pack In 1 Carton (0904-5785-61) / 1 Capsule In 1 Blister Pack,0.27,0.11,,,0 CDM,6370000001_00904578961,Acyclovir: 100 Blister Pack In 1 Carton (0904-5789-61) / 1 Capsule In 1 Blister Pack,0.41,0.16,,,0 CDM,6370000001_00904579061,"Acyclovir: 100 Blister Pack In 1 Box, Unit-Dose (0904-5790-61) / 1 Tablet In 1 Blister Pack",1.21,0.48,,,0 CDM,6370000001_00904579146,"Childrens Mapap: 1 Bottle, Plastic In 1 Carton (0904-5791-46) / 30 Tablet, Chewable In 1 Bottle, Plastic",0.21,0.08,,,0 CDM,6370000001_00904585361,Ibuprofen: 100 Blister Pack In 1 Carton (0904-5853-61) / 1 Tablet In 1 Blister Pack,0.21,0.08,,,0 CDM,6370000001_00904585440,Ibuprofen: 500 Tablet In 1 Bottle (0904-5854-40),0.24,0.1,,,0 CDM,6370000001_00904585460,Ibuprofen: 100 Tablet In 1 Bottle (0904-5854-60),0.27,0.11,,,0 CDM,6370000001_00904585461,Ibuprofen: 100 Blister Pack In 1 Carton (0904-5854-61) / 1 Tablet In 1 Blister Pack,0.26,0.1,,,0 CDM,6370000001_00904585561,Ibuprofen: 100 Blister Pack In 1 Carton (0904-5855-61) / 1 Tablet In 1 Blister Pack,0.23,0.09,,,0 CDM,6370000001_00904588061,"Diazepam: 100 BLISTER PACK in 1 BOX, UNIT-DOSE (0904-5880-61) / 1 TABLET in 1 BLISTER PACK",0.19,0.08,,,0 CDM,6370000001_00904589161,"Pravastatin Sodium: 100 Blister Pack In 1 Box, Unit-Dose (0904-5891-61) / 1 Tablet In 1 Blister Pack",1.17,0.47,,,0 CDM,6370000001_00904589361,"Pravastatin Sodium: 100 Blister Pack In 1 Box, Unit-Dose (0904-5893-61) / 1 Tablet In 1 Blister Pack",2.04,0.82,,,0 CDM,6370000001_00904589430,"INFANTS GAS RELIEF: 1 BOTTLE, DROPPER in 1 CARTON (0904-5894-30) / 30 mL in 1 BOTTLE, DROPPER",0.14,0.06,,,0 CDM,6370000001_00904592161,Digoxin: 100 Blister Pack In 1 Carton (0904-5921-61) / 1 Tablet In 1 Blister Pack,3.83,1.53,,,0 CDM,6370000001_00904592261,Digoxin: 100 Blister Pack In 1 Carton (0904-5922-61) / 1 Tablet In 1 Blister Pack,3.81,1.52,,,0 CDM,6370000001_00904595961,Clindamycin Hydrochloride: 100 Blister Pack In 1 Carton (0904-5959-61) / 1 Capsule In 1 Blister Pack,1.0,0.4,,,0 CDM,6370000001_00904598426,NDC Description Not Available,11.53,4.61,,,0 CDM,6370000001_00904600761,Lorazepam: 100 Blister Pack In 1 Carton (0904-6007-61) / 1 Tablet In 1 Blister Pack,0.23,0.09,,,0 CDM,6370000001_00904600861,Lorazepam: 100 Blister Pack In 1 Carton (0904-6008-61) / 1 Tablet In 1 Blister Pack,0.26,0.1,,,0 CDM,6370000001_00904608261,Zolpidem Tartrate: 100 Blister Pack In 1 Carton (0904-6082-61) / 1 Tablet In 1 Blister Pack,0.23,0.09,,,0 CDM,6370000001_00904608561,"Citalopram: 100 Blister Pack In 1 Carton (0904-6085-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.17,0.07,,,0 CDM,6370000001_00904617261,Carbamazepine: 100 Blister Pack In 1 Carton (0904-6172-61) / 1 Tablet In 1 Blister Pack,2.52,1.01,,,0 CDM,6370000001_00904618761,Extended Phenytoin Sodium: 100 Blister Pack In 1 Carton (0904-6187-61) / 1 Capsule In 1 Blister Pack,1.87,0.75,,,0 CDM,6370000001_00904622106,Ursodiol: 50 Blister Pack In 1 Carton (0904-6221-06) / 1 Capsule In 1 Blister Pack,11.25,4.5,,,0 CDM,6370000001_00904622161,Ursodiol: 100 Blister Pack In 1 Carton (0904-6221-61) / 1 Capsule In 1 Blister Pack,8.82,3.53,,,0 CDM,6370000001_00904623861,Carbidopa And Levodopa: 100 Blister Pack In 1 Carton (0904-6238-61) / 1 Tablet In 1 Blister Pack,0.98,0.39,,,0 CDM,6370000001_00904626908,Ziprasidone: 40 Blister Pack In 1 Carton (0904-6269-08) / 1 Capsule In 1 Blister Pack,13.69,5.48,,,0 CDM,6370000001_00904627008,Ziprasidone: 40 Blister Pack In 1 Carton (0904-6270-08) / 1 Capsule In 1 Blister Pack,13.5,5.4,,,0 CDM,6370000001_00904627208,Ziprasidone: 40 Blister Pack In 1 Carton (0904-6272-08) / 1 Capsule In 1 Blister Pack,15.36,6.14,,,0 CDM,6370000001_00904628361,"Olanzapine: 100 Blister Pack In 1 Carton (0904-6283-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.03,0.41,,,0 CDM,6370000001_00904629061,"Atorvastatin Calcium: 100 Blister Pack In 1 Carton (0904-6290-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.74,0.3,,,0 CDM,6370000001_00904629206,"Atorvastatin Calcium: 50 Blister Pack In 1 Carton (0904-6292-06) / 1 Tablet, Film Coated In 1 Blister Pack",0.89,0.36,,,0 CDM,6370000001_00904629261,"Atorvastatin Calcium: 100 Blister Pack In 1 Carton (0904-6292-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.94,0.38,,,0 CDM,6370000001_00904629461,"Clopidogrel: 100 Blister Pack In 1 Carton (0904-6294-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.71,0.28,,,0 CDM,6370000001_00904630061,"Carvedilol: 100 Tablet, Film Coated In 1 Box, Unit-Dose (0904-6300-61)",0.25,0.1,,,0 CDM,6370000001_00904630161,"Carvedilol: 100 Tablet, Film Coated In 1 Box, Unit-Dose (0904-6301-61)",0.28,0.11,,,0 CDM,6370000001_00904630261,"Carvedilol: 100 Tablet, Film Coated In 1 Box, Unit-Dose (0904-6302-61)",0.36,0.14,,,0 CDM,6370000001_00904630361,"Carvedilol: 100 Tablet, Film Coated In 1 Box, Unit-Dose (0904-6303-61)",0.25,0.1,,,0 CDM,6370000001_00904630521,"Sore Throat Cherry: 177 Ml In 1 Bottle, Spray (0904-6305-21)",7.44,2.98,,,0 CDM,6370000001_00904631256,Cough Dm: 1 Bottle In 1 Carton (0904-6312-56) / 89 Ml In 1 Bottle,0.61,0.24,,,0 CDM,6370000001_00904632078,Saline Laxative: 133 Ml In 1 Bottle (0904-6320-78),2.66,1.06,,,0 CDM,6370000001_00904632206,"Metoprolol Succinate: 50 Blister Pack In 1 Carton (0904-6322-06) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack",1.49,0.6,,,0 CDM,6370000001_00904632261,"Metoprolol Succinate: 100 Blister Pack In 1 Carton (0904-6322-61) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack",2.4,0.96,,,0 CDM,6370000001_00904632361,"Metoprolol Succinate: 100 Blister Pack In 1 Carton (0904-6323-61) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack",2.74,1.1,,,0 CDM,6370000001_00904632946,"Lubricating Plus: 6 Pouch In 1 Carton (0904-6329-46) / 5 Vial, Single-Use In 1 Pouch / .4 Ml In 1 Vial, Single-Use",0.88,0.35,,,0 CDM,6370000001_00904634061,Metoprolol Tartrate: 100 BLISTER PACK in 1 CARTON (0904-6340-61) / 1 TABLET in 1 BLISTER PACK,0.23,0.09,,,0 CDM,6370000001_00904635161,"Levofloxacin: 100 Blister Pack In 1 Carton (0904-6351-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.63,0.25,,,0 CDM,6370000001_00904635261,"Levofloxacin: 100 Blister Pack In 1 Carton (0904-6352-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.72,0.29,,,0 CDM,6370000001_00904635361,"Levofloxacin: 100 Blister Pack In 1 Carton (0904-6353-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.31,0.52,,,0 CDM,6370000001_00904635861,"Risperidone: 100 Tablet In 1 Box, Unit-Dose (0904-6358-61)",0.74,0.3,,,0 CDM,6370000001_00904635961,"Risperidone: 100 Tablet In 1 Box, Unit-Dose (0904-6359-61)",0.6,0.24,,,0 CDM,6370000001_00904636061,"Risperidone: 100 Tablet In 1 Box, Unit-Dose (0904-6360-61)",0.74,0.3,,,0 CDM,6370000001_00904636161,"Risperidone: 100 Tablet In 1 Box, Unit-Dose (0904-6361-61)",0.79,0.32,,,0 CDM,6370000001_00904636361,"Divalproex Sodium: 100 Blister Pack In 1 Carton (0904-6363-61) / 1 Tablet, Extended Release In 1 Blister Pack",3.87,1.55,,,0 CDM,6370000001_00904636561,"TRAMADOL HYDROCHLORIDE: 100 BLISTER PACK in 1 CARTON (0904-6365-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK",0.22,0.09,,,0 CDM,6370000001_00904637061,Amlodipine Besylate: 100 Blister Pack In 1 Carton (0904-6370-61) / 1 Tablet In 1 Blister Pack,0.24,0.1,,,0 CDM,6370000001_00904637461,"Ropinirole: 100 Blister Pack In 1 Carton (0904-6374-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.62,0.65,,,0 CDM,6370000001_00904637661,"Olanzapine: 100 Blister Pack In 1 Carton (0904-6376-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.33,0.53,,,0 CDM,6370000001_00904637761,"Olanzapine: 100 Blister Pack In 1 Carton (0904-6377-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.47,0.19,,,0 CDM,6370000001_00904640161,100 BLISTER PACK in 1 CARTON (0904-6401-61) / 1 CAPSULE in 1 BLISTER PACK,0.9,0.36,,,0 CDM,6370000001_00904640761,"Bisacodyl: 10 Blister Pack In 1 Box (0904-6407-61) / 10 Tablet, Delayed Release In 1 Blister Pack",0.08,0.03,,,0 CDM,6370000001_00904641861,Tizanidine: 100 Blister Pack In 1 Carton (0904-6418-61) / 1 Tablet In 1 Blister Pack,1.37,0.55,,,0 CDM,6370000001_00904642285,PEG 3350: 14 PACKET in 1 CARTON (0904-6422-85) / 17 g in 1 PACKET,1.98,0.79,,,0 CDM,6370000001_00904642661,"Escitalopram: 100 Blister Pack In 1 Carton (0904-6426-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.47,0.19,,,0 CDM,6370000001_00904642761,"Escitalopram: 100 Blister Pack In 1 Carton (0904-6427-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.52,0.21,,,0 CDM,6370000001_00904643604,Temazepam: 30 Blister Pack In 1 Carton (0904-6436-04) / 1 Capsule In 1 Blister Pack,9.71,3.88,,,0 CDM,6370000001_00904644061,"Hydralazine Hydrochloride: 100 BLISTER PACK in 1 CARTON (0904-6440-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK",0.46,0.18,,,0 CDM,6370000001_00904644161,"Hydralazine Hydrochloride: 100 Blister Pack In 1 Carton (0904-6441-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.49,0.2,,,0 CDM,6370000001_00904644261,"Hydralazine Hydrochloride: 100 Blister Pack In 1 Carton (0904-6442-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.42,0.17,,,0 CDM,6370000001_00904644961,"Isosorbide Mononitrate: 100 Blister Pack In 1 Carton (0904-6449-61) / 1 Tablet, Extended Release In 1 Blister Pack",1.12,0.45,,,0 CDM,6370000001_00904645061,"Isosorbide Mononitrate: 100 Blister Pack In 1 Carton (0904-6450-61) / 1 Tablet, Extended Release In 1 Blister Pack",1.24,0.5,,,0 CDM,6370000001_00904647461,"Pantoprazole Sodium: 100 Blister Pack In 1 Carton (0904-6474-61) / 1 Tablet, Delayed Release In 1 Blister Pack",0.9,0.36,,,0 CDM,6370000001_00904647561,Baclofen: 100 Blister Pack In 1 Carton (0904-6475-61) / 1 Tablet In 1 Blister Pack,1.1,0.44,,,0 CDM,6370000001_00904647661,Baclofen: 100 Blister Pack In 1 Carton (0904-6476-61) / 1 Tablet In 1 Blister Pack,1.74,0.7,,,0 CDM,6370000001_00904647761,"Donepezil Hydrochloride: 100 Blister Pack In 1 Carton (0904-6477-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.41,0.16,,,0 CDM,6370000001_00904647861,"Donepezil Hydrochloride: 100 Blister Pack In 1 Carton (0904-6478-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.37,0.15,,,0 CDM,6370000001_00904648838,Major Lubrifresh Pm: 1 Tube In 1 Carton (0904-6488-38) / 3.5 G In 1 Tube,15.12,6.05,,,0 CDM,6370000001_00904650061,Fluconazole: 100 Blister Pack In 1 Carton (0904-6500-61) / 1 Tablet In 1 Blister Pack,4.2,1.68,,,0 CDM,6370000001_00904650106,Fluconazole: 50 Blister Pack In 1 Carton (0904-6501-06) / 1 Tablet In 1 Blister Pack,5.3,2.12,,,0 CDM,6370000001_00904650161,Fluconazole: 100 Blister Pack In 1 Carton (0904-6501-61) / 1 Tablet In 1 Blister Pack,6.12,2.45,,,0 CDM,6370000001_00904650261,Celecoxib: 100 Blister Pack In 1 Carton (0904-6502-61) / 1 Capsule In 1 Blister Pack,3.58,1.43,,,0 CDM,6370000001_00904650361,Celecoxib: 100 Blister Pack In 1 Carton (0904-6503-61) / 1 Capsule In 1 Blister Pack,5.98,2.39,,,0 CDM,6370000001_00904650561,"Memantine Hydrochloride: 100 Blister Pack In 1 Carton (0904-6505-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.3,0.52,,,0 CDM,6370000001_00904650606,"Memantine Hydrochloride: 50 Blister Pack In 1 Carton (0904-6506-06) / 1 Tablet, Film Coated In 1 Blister Pack",1.22,0.49,,,0 CDM,6370000001_00904650661,"Memantine Hydrochloride: 100 Blister Pack In 1 Carton (0904-6506-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.13,0.45,,,0 CDM,6370000001_00904650904,Aripiprazole: 30 Blister Pack In 1 Carton (0904-6509-04) / 1 Tablet In 1 Blister Pack,26.2,10.48,,,0 CDM,6370000001_00904651006,Aripiprazole: 50 Blister Pack In 1 Carton (0904-6510-06) / 1 Tablet In 1 Blister Pack,27.06,10.82,,,0 CDM,6370000001_00904651061,Aripiprazole: 100 Blister Pack In 1 Carton (0904-6510-61) / 1 Tablet In 1 Blister Pack,54.28,21.71,,,0 CDM,6370000001_00904651161,Aripiprazole: 100 Blister Pack In 1 Carton (0904-6511-61) / 1 Tablet In 1 Blister Pack,46.7,18.68,,,0 CDM,6370000001_00904651204,Aripiprazole: 30 Blister Pack In 1 Carton (0904-6512-04) / 1 Tablet In 1 Blister Pack,18.92,7.57,,,0 CDM,6370000001_00904651961,"Mirtazapine: 100 Blister Pack In 1 Carton (0904-6519-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.33,0.13,,,0 CDM,6370000001_00904652261,"Senna-Lax: 10 Blister Pack In 1 Box (0904-6522-61) / 10 Tablet, Film Coated In 1 Blister Pack",0.1,0.04,,,0 CDM,6370000001_00904653061,Methadone Hydrochloride: 100 Blister Pack In 1 Carton (0904-6530-61) / 1 Tablet In 1 Blister Pack,0.74,0.3,,,0 CDM,6370000001_00904655061,Propranolol Hydrochloride: 100 Blister Pack In 1 Carton (0904-6550-61) / 1 Tablet In 1 Blister Pack,0.68,0.27,,,0 CDM,6370000001_00904655304,"Linezolid: 30 Blister Pack In 1 Carton (0904-6553-04) / 1 Tablet, Film Coated In 1 Blister Pack",15.04,6.02,,,0 CDM,6370000001_00904655761,"Morphine Sulfate Extended Release: 100 Blister Pack In 1 Carton (0904-6557-61) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack",2.6,1.04,,,0 CDM,6370000001_00904655861,"Morphine Sulfate Extended Release: 100 Blister Pack In 1 Carton (0904-6558-61) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack",3.57,1.43,,,0 CDM,6370000001_00904655961,"Morphine Sulfate Extended Release: 100 Blister Pack In 1 Carton (0904-6559-61) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack",7.56,3.02,,,0 CDM,6370000001_00904656061,"Morphine Sulfate Extended Release: 100 Blister Pack In 1 Carton (0904-6560-61) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack",9.97,3.99,,,0 CDM,6370000001_00904656460,Benzonatate: 100 Capsule In 1 Bottle (0904-6564-60),1.51,0.6,,,0 CDM,6370000001_00904656461,100 BLISTER PACK in 1 CARTON (0904-6564-61) / 1 CAPSULE in 1 BLISTER PACK,0.96,0.38,,,0 CDM,6370000001_00904656561,"Valacyclovir Hydrochloride: 100 Blister Pack In 1 Carton (0904-6565-61) / 1 Tablet, Film Coated In 1 Blister Pack",5.83,2.33,,,0 CDM,6370000001_00904657006,"Oxybutynin Chloride: 50 Blister Pack In 1 Carton (0904-6570-06) / 1 Tablet, Extended Release In 1 Blister Pack",6.37,2.55,,,0 CDM,6370000001_00904657061,"Oxybutynin Chloride: 100 Blister Pack In 1 Carton (0904-6570-61) / 1 Tablet, Extended Release In 1 Blister Pack",6.88,2.75,,,0 CDM,6370000001_00904657261,Allopurinol: 100 Blister Pack In 1 Carton (0904-6572-61) / 1 Tablet In 1 Blister Pack,1.59,0.64,,,0 CDM,6370000001_00904657561,Phenobarbital: 100 Blister Pack In 1 Carton (0904-6575-61) / 1 Tablet In 1 Blister Pack,0.85,0.34,,,0 CDM,6370000001_00904659604,"Voriconazole: 30 Blister Pack In 1 Carton (0904-6596-04) / 1 Tablet, Film Coated In 1 Blister Pack",24.19,9.68,,,0 CDM,6370000001_00904661561,"Divalproex Sodium: 100 Blister Pack In 1 Carton (0904-6615-61) / 1 Capsule, Delayed Release In 1 Blister Pack",2.14,0.86,,,0 CDM,6370000001_00904661761,"Hydroxyzine Hydrochloride: 100 Blister Pack In 1 Carton (0904-6617-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.75,0.3,,,0 CDM,6370000001_00904661961,Isosorbide Dinitrate: 100 Blister Pack In 1 Carton (0904-6619-61) / 1 Tablet In 1 Blister Pack,1.54,0.62,,,0 CDM,6370000001_00904662061,Isosorbide Dinitrate: 100 Blister Pack In 1 Carton (0904-6620-61) / 1 Tablet In 1 Blister Pack,1.66,0.66,,,0 CDM,6370000001_00904662261,Pyridostigmine Bromide: 100 Blister Pack In 1 Carton (0904-6622-61) / 1 Tablet In 1 Blister Pack,3.42,1.37,,,0 CDM,6370000001_00904662735,Ear Drops Major: 1 Bottle In 1 Carton (0904-6627-35) / 15 Ml In 1 Bottle,5.67,2.27,,,0 CDM,6370000001_00904663061,amantadine hydrochloride: 100 BLISTER PACK in 1 CARTON (0904-6630-61) / 1 CAPSULE in 1 BLISTER PACK,4.54,1.82,,,0 CDM,6370000001_00904663561,"Bupropion Hydrochloride: 100 Blister Pack In 1 Carton (0904-6635-61) / 1 Tablet, Film Coated In 1 Blister Pack",3.92,1.57,,,0 CDM,6370000001_00904663661,"Bupropion Hydrochloride: 100 Blister Pack In 1 Carton (0904-6636-61) / 1 Tablet, Film Coated In 1 Blister Pack",4.03,1.61,,,0 CDM,6370000001_00904663761,Glipizide: 100 Blister Pack In 1 Carton (0904-6637-61) / 1 Tablet In 1 Blister Pack,1.03,0.41,,,0 CDM,6370000001_00904663861,"Quetiapine: 100 Blister Pack In 1 Carton (0904-6638-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.82,0.33,,,0 CDM,6370000001_00904664061,"Quetiapine: 100 Blister Pack In 1 Carton (0904-6640-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.29,0.52,,,0 CDM,6370000001_00904664161,"Quetiapine: 100 Blister Pack In 1 Carton (0904-6641-61) / 1 Tablet, Film Coated In 1 Blister Pack",2.78,1.11,,,0 CDM,6370000001_00904664524,"Childrens Mapap: 4 Blister Pack In 1 Carton (0904-6645-24) / 6 Tablet, Chewable In 1 Blister Pack",0.23,0.09,,,0 CDM,6370000001_00904666561,Gabapentin: 100 Blister Pack In 1 Carton (0904-6665-61) / 1 Capsule In 1 Blister Pack,0.34,0.14,,,0 CDM,6370000001_00904666661,Gabapentin: 100 Blister Pack In 1 Carton (0904-6666-61) / 1 Capsule In 1 Blister Pack,0.43,0.17,,,0 CDM,6370000001_00904666761,Gabapentin: 100 Blister Pack In 1 Carton (0904-6667-61) / 1 Capsule In 1 Blister Pack,0.5,0.2,,,0 CDM,6370000001_00904667104,"Sildenafil: 30 Blister Pack In 1 Carton (0904-6671-04) / 1 Tablet, Film Coated In 1 Blister Pack",2.55,1.02,,,0 CDM,6370000001_00904667106,"Sildenafil: 50 Blister Pack In 1 Carton (0904-6671-06) / 1 Tablet, Film Coated In 1 Blister Pack",2.32,0.93,,,0 CDM,6370000001_00904668108,Dofetilide: 40 Blister Pack In 1 Carton (0904-6681-08) / 1 Capsule In 1 Blister Pack,19.2,7.68,,,0 CDM,6370000001_00904668208,Dofetilide: 40 Blister Pack In 1 Carton (0904-6682-08) / 1 Capsule In 1 Blister Pack,19.42,7.77,,,0 CDM,6370000001_00904668961,Metformin hydrochloride: 100 BLISTER PACK in 1 CARTON (0904-6689-61) / 1 TABLET in 1 BLISTER PACK,0.23,0.09,,,0 CDM,6370000001_00904670310,Leucovorin Calcium: 20 Blister Pack In 1 Carton (0904-6703-10) / 1 Tablet In 1 Blister Pack,28.23,11.29,,,0 CDM,6370000001_00904670461,Pramipexole Dihydrochloride: 100 Blister Pack In 1 Carton (0904-6704-61) / 1 Tablet In 1 Blister Pack,0.87,0.35,,,0 CDM,6370000001_00904670506,Propranolol Hydrochloride: 50 Blister Pack In 1 Carton (0904-6705-06) / 1 Tablet In 1 Blister Pack,1.5,0.6,,,0 CDM,6370000001_00904670561,Propranolol Hydrochloride: 100 Blister Pack In 1 Carton (0904-6705-61) / 1 Tablet In 1 Blister Pack,1.33,0.53,,,0 CDM,6370000001_00904670706,"Sevelamer Carbonate: 50 Blister Pack In 1 Carton (0904-6707-06) / 1 Tablet, Film Coated In 1 Blister Pack",0.8,0.32,,,0 CDM,6370000001_00904670806,azithromycin monohydrate: 5 BLISTER PACK in 1 CARTON (0904-6708-06) / 10 TABLET in 1 BLISTER PACK,2.6,1.04,,,0 CDM,6370000001_00904670861,azithromycin monohydrate: 10 BLISTER PACK in 1 CARTON (0904-6708-61) / 10 TABLET in 1 BLISTER PACK,3.96,1.58,,,0 CDM,6370000001_00904670961,Glycopyrrolate: 100 Blister Pack In 1 Carton (0904-6709-61) / 1 Tablet In 1 Blister Pack,2.74,1.1,,,0 CDM,6370000001_00904671761,"Cetirizine: 100 Blister Pack In 1 Carton (0904-6717-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.36,0.14,,,0 CDM,6370000001_00904671839,"Mucus Relief Er: 100 Blister Pack In 1 Carton (0904-6718-39) / 1 Tablet, Extended Release In 1 Blister Pack",2.65,1.06,,,0 CDM,6370000001_00904672040,Acetaminophen: 500 Tablet In 1 Bottle (0904-6720-40),0.03,0.01,,,0 CDM,6370000001_00904672059,Acetaminophen: 1 Bottle In 1 Carton (0904-6720-59) / 100 Tablet In 1 Bottle,0.06,0.02,,,0 CDM,6370000001_00904672080,Acetaminophen: 1000 Tablet In 1 Bottle (0904-6720-80),0.06,0.02,,,0 CDM,6370000001_00904673060,Acetaminophen: 100 Tablet In 1 Bottle (0904-6730-60),0.08,0.03,,,0 CDM,6370000001_00904673061,"Acetaminophen: 10 Blister Pack In 1 Box, Unit-Dose (0904-6730-61) / 10 Tablet In 1 Blister Pack",0.12,0.05,,,0 CDM,6370000001_00904673080,Acetaminophen: 1000 Tablet In 1 Bottle (0904-6730-80),0.06,0.02,,,0 CDM,6370000001_00904676130,"Nasal Decongestant: 1 Bottle, Spray In 1 Carton (0904-6761-30) / 30 Ml In 1 Bottle, Spray",4.19,1.68,,,0 CDM,6370000001_00904676520,Childrens Cetirizine Hydrochloride: 1 Bottle In 1 Carton (0904-6765-20) / 118 Ml In 1 Bottle,0.33,0.13,,,0 CDM,6370000001_00904677361,"Acetaminophen: 10 Blister Pack In 1 Box, Unit-Dose (0904-6773-61) / 10 Tablet In 1 Blister Pack",0.16,0.06,,,0 CDM,6370000001_00904677861,"Rosuvastatin Calcium: 100 Blister Pack In 1 Carton (0904-6778-61) / 1 Tablet, Coated In 1 Blister Pack",3.01,1.2,,,0 CDM,6370000001_00904678061,"Rosuvastatin Calcium: 100 Blister Pack In 1 Carton (0904-6780-61) / 1 Tablet, Coated In 1 Blister Pack",4.11,1.64,,,0 CDM,6370000001_00904678261,Haloperidol: 100 Blister Pack In 1 Carton (0904-6782-61) / 1 Tablet In 1 Blister Pack,2.28,0.91,,,0 CDM,6370000001_00904678861,Benztropine Mesylate: 100 BLISTER PACK in 1 CARTON (0904-6788-61) / 1 TABLET in 1 BLISTER PACK,1.39,0.56,,,0 CDM,6370000001_00904679430,"Aspirin Low Dose Chewable Orange: 300 Blister Pack In 1 Carton (0904-6794-30) / 1 Tablet, Chewable In 1 Blister Pack",0.22,0.09,,,0 CDM,6370000001_00904679480,"Aspirin Low Dose Chewable Orange: 1000 Tablet, Chewable In 1 Package (0904-6794-80)",0.02,0.01,,,0 CDM,6370000001_00904679761,Lisinopril: 100 Blister Pack In 1 Carton (0904-6797-61) / 1 Tablet In 1 Blister Pack,0.17,0.07,,,0 CDM,6370000001_00904679861,Lisinopril: 100 Blister Pack In 1 Carton (0904-6798-61) / 1 Tablet In 1 Blister Pack,0.16,0.06,,,0 CDM,6370000001_00904679961,Lisinopril: 100 Blister Pack In 1 Carton (0904-6799-61) / 1 Tablet In 1 Blister Pack,0.21,0.08,,,0 CDM,6370000001_00904680161,"Quetiapine: 100 Blister Pack In 1 Carton (0904-6801-61) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack",2.26,0.9,,,0 CDM,6370000001_00904680361,"Quetiapine: 100 Blister Pack In 1 Carton (0904-6803-61) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack",3.3,1.32,,,0 CDM,6370000001_00904680461,"Quetiapine: 100 Blister Pack In 1 Carton (0904-6804-61) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack",3.25,1.3,,,0 CDM,6370000001_00904680806,"Montelukast Sodium: 50 Blister Pack In 1 Carton (0904-6808-06) / 1 Tablet, Film Coated In 1 Blister Pack",0.99,0.4,,,0 CDM,6370000001_00904680861,"Montelukast Sodium: 100 Blister Pack In 1 Carton (0904-6808-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.98,0.39,,,0 CDM,6370000001_00904681806,Midodrine Hydrochloride: 50 Blister Pack In 1 Carton (0904-6818-06) / 1 Tablet In 1 Blister Pack,1.77,0.71,,,0 CDM,6370000001_00904681861,Midodrine Hydrochloride: 100 Blister Pack In 1 Carton (0904-6818-61) / 1 Tablet In 1 Blister Pack,5.6,2.24,,,0 CDM,6370000001_00904682461,Hydrocodone Bitartrate And Acetaminophen: 100 Blister Pack In 1 Carton (0904-6824-61) / 1 Tablet In 1 Blister Pack,1.02,0.41,,,0 CDM,6370000001_00904682805,NDC Description Not Available,10.15,4.06,,,0 CDM,6370000001_00904682892,"Oxycodone Hydrochloride: 5 Tray In 1 Carton (0904-6828-92) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (0904-6828-05)",15.4,6.16,,,0 CDM,6370000001_00904683006,"Finasteride: 50 Blister Pack In 1 Carton (0904-6830-06) / 1 Tablet, Film Coated In 1 Blister Pack",2.02,0.81,,,0 CDM,6370000001_00904683620,Loperamide Hydrochloride: 120 Ml In 1 Bottle (0904-6836-20),3.72,1.49,,,0 CDM,6370000001_00904686061,"Divalproex Sodium: 100 Blister Pack In 1 Carton (0904-6860-61) / 1 Tablet, Delayed Release In 1 Blister Pack",0.6,0.24,,,0 CDM,6370000001_00904686161,"Divalproex Sodium: 100 Blister Pack In 1 Carton (0904-6861-61) / 1 Tablet, Delayed Release In 1 Blister Pack",0.58,0.23,,,0 CDM,6370000001_00904686190,"Divalproex Sodium: 90 Blister Pack In 1 Carton (0904-6861-90) / 1 Tablet, Delayed Release In 1 Blister Pack",0.95,0.38,,,0 CDM,6370000001_00904686704,Tretinoin: 30 Blister Pack In 1 Carton (0904-6867-04) / 1 Capsule In 1 Blister Pack,115.0,46.0,,,0 CDM,6370000001_00904686861,Trazodone Hydrochloride: 100 Blister Pack In 1 Carton (0904-6868-61) / 1 Tablet In 1 Blister Pack,0.35,0.14,,,0 CDM,6370000001_00904686961,Trazodone Hydrochloride: 100 Blister Pack In 1 Carton (0904-6869-61) / 1 Tablet In 1 Blister Pack,0.53,0.21,,,0 CDM,6370000001_00904687045,"Pantoprazole Sodium: 80 Blister Pack In 1 Carton (0904-6870-45) / 1 Tablet, Delayed Release In 1 Blister Pack",0.66,0.26,,,0 CDM,6370000001_00904687204,"Clarithromycin: 30 Blister Pack In 1 Carton (0904-6872-04) / 1 Tablet, Film Coated In 1 Blister Pack",9.73,3.89,,,0 CDM,6370000001_00904688806,Minocycline Hydrochloride: 50 Blister Pack In 1 Carton (0904-6888-06) / 1 Capsule In 1 Blister Pack,3.42,1.37,,,0 CDM,6370000001_00904689961,Buspirone Hydrochloride: 100 Blister Pack In 1 Carton (0904-6899-61) / 1 Tablet In 1 Blister Pack,1.47,0.59,,,0 CDM,6370000001_00904690061,Chlorthalidone: 100 Blister Pack In 1 Carton (0904-6900-61) / 1 Tablet In 1 Blister Pack,6.39,2.56,,,0 CDM,6370000001_00904690204,"Raloxifene Hydrochloride: 30 Blister Pack In 1 Carton (0904-6902-04) / 1 Tablet, Film Coated In 1 Blister Pack",22.1,8.84,,,0 CDM,6370000001_00904690706,Pseudoephedrine Hydrochloride: 5 Blister Pack In 1 Box (0904-6907-06) / 10 Tablet In 1 Blister Pack,0.17,0.07,,,0 CDM,6370000001_00904690804,Atomoxetine: 30 Blister Pack In 1 Carton (0904-6908-04) / 1 Capsule In 1 Blister Pack,18.84,7.54,,,0 CDM,6370000001_00904691761,"Omeprazole: 100 Blister Pack In 1 Carton (0904-6917-61) / 1 Capsule, Delayed Release In 1 Blister Pack",0.42,0.17,,,0 CDM,6370000001_00904692461,"Sertraline Hydrochloride: 100 Blister Pack In 1 Carton (0904-6924-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.98,0.39,,,0 CDM,6370000001_00904692561,"Sertraline Hydrochloride: 100 Blister Pack In 1 Carton (0904-6925-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.16,0.46,,,0 CDM,6370000001_00904692761,"Spironolactone: 100 Blister Pack In 1 Carton (0904-6927-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.46,0.18,,,0 CDM,6370000001_00904692861,"Topiramate: 100 Blister Pack In 1 Carton (0904-6928-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.83,0.33,,,0 CDM,6370000001_00904692961,"Topiramate: 100 Blister Pack In 1 Carton (0904-6929-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.48,0.59,,,0 CDM,6370000001_00904693061,"Potassium Chloride: 100 Blister Pack In 1 Carton (0904-6930-61) / 1 Capsule, Coated, Extended Release In 1 Blister Pack",2.76,1.1,,,0 CDM,6370000001_00904693181,Polyethylene Glycol 3350: 100 Packet In 1 Carton (0904-6931-81) / 17 G In 1 Packet,2.12,0.85,,,0 CDM,6370000001_00904693186,Polyethylene Glycol 3350: 17 G In 1 Packet (0904-6931-86),4.18,1.67,,,0 CDM,6370000001_00904693806,"Butalbital, Acetaminophen, And Caffeine: 50 Blister Pack In 1 Carton (0904-6938-06) / 1 Tablet In 1 Blister Pack",5.44,2.18,,,0 CDM,6370000001_00904693961,Hydroxyurea: 100 Blister Pack In 1 Carton (0904-6939-61) / 1 Capsule In 1 Blister Pack,3.28,1.31,,,0 CDM,6370000001_00904694961,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (0904-6949-61) / 1 Tablet In 1 Blister Pack,1.34,0.54,,,0 CDM,6370000001_00904695061,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (0904-6950-61) / 1 Tablet In 1 Blister Pack,1.35,0.54,,,0 CDM,6370000001_00904695161,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (0904-6951-61) / 1 Tablet In 1 Blister Pack,1.7,0.68,,,0 CDM,6370000001_00904695261,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (0904-6952-61) / 1 Tablet In 1 Blister Pack,1.75,0.7,,,0 CDM,6370000001_00904695361,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (0904-6953-61) / 1 Tablet In 1 Blister Pack,1.74,0.7,,,0 CDM,6370000001_00904695461,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (0904-6954-61) / 1 Tablet In 1 Blister Pack,2.04,0.82,,,0 CDM,6370000001_00904695561,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (0904-6955-61) / 1 Tablet In 1 Blister Pack,2.05,0.82,,,0 CDM,6370000001_00904695661,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (0904-6956-61) / 1 Tablet In 1 Blister Pack,2.11,0.84,,,0 CDM,6370000001_00904695761,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (0904-6957-61) / 1 Tablet In 1 Blister Pack,2.51,1.0,,,0 CDM,6370000001_00904696661,Oxycodone Hydrochloride: 100 Blister Pack In 1 Carton (0904-6966-61) / 1 Tablet In 1 Blister Pack,0.94,0.38,,,0 CDM,6370000001_00904698520,"Diphenhydramine Hcl: 118 Ml In 1 Bottle, Plastic (0904-6985-20)",0.25,0.1,,,0 CDM,6370000001_00904698761,Dicyclomine Hydrochloride: 100 Blister Pack In 1 Carton (0904-6987-61) / 1 Capsule In 1 Blister Pack,1.71,0.68,,,0 CDM,6370000001_00904698861,Dicyclomine Hydrochloride: 100 Blister Pack In 1 Carton (0904-6988-61) / 1 Tablet In 1 Blister Pack,1.48,0.59,,,0 CDM,6370000001_00904699061,"Pseudoephedrine Hcl: 10 Blister Pack In 1 Carton (0904-6990-61) / 10 Tablet, Film Coated In 1 Blister Pack",0.11,0.04,,,0 CDM,6370000001_00904699161,Pregabalin: 100 Blister Pack In 1 Carton (0904-6991-61) / 1 Capsule In 1 Blister Pack,2.31,0.92,,,0 CDM,6370000001_00904699261,Pregabalin: 100 Blister Pack In 1 Carton (0904-6992-61) / 1 Capsule In 1 Blister Pack,2.28,0.91,,,0 CDM,6370000001_00904699361,Amiodarone Hydrochloride: 100 Blister Pack In 1 Carton (0904-6993-61) / 1 Tablet In 1 Blister Pack,0.85,0.34,,,0 CDM,6370000001_00904700061,Pregabalin: 100 Blister Pack In 1 Carton (0904-7000-61) / 1 Capsule In 1 Blister Pack,2.31,0.92,,,0 CDM,6370000001_00904700161,Pregabalin: 100 Blister Pack In 1 Carton (0904-7001-61) / 1 Capsule In 1 Blister Pack,2.53,1.01,,,0 CDM,6370000001_00904700761,Lamotrigine: 100 Blister Pack In 1 Carton (0904-7007-61) / 1 Tablet In 1 Blister Pack,0.51,0.2,,,0 CDM,6370000001_00904700861,Lamotrigine: 100 Blister Pack In 1 Carton (0904-7008-61) / 1 Tablet In 1 Blister Pack,0.4,0.16,,,0 CDM,6370000001_00904701606,Bumetanide: 50 Blister Pack In 1 Carton (0904-7016-06) / 1 Tablet In 1 Blister Pack,3.05,1.22,,,0 CDM,6370000001_00904701661,Bumetanide: 100 Blister Pack In 1 Carton (0904-7016-61) / 1 Tablet In 1 Blister Pack,3.52,1.41,,,0 CDM,6370000001_00904702061,Prazosin Hydrochloride: 100 Blister Pack In 1 Carton (0904-7020-61) / 1 Capsule In 1 Blister Pack,4.06,1.62,,,0 CDM,6370000001_00904702161,Prazosin Hydrochloride: 100 Blister Pack In 1 Carton (0904-7021-61) / 1 Capsule In 1 Blister Pack,5.62,2.25,,,0 CDM,6370000001_00904702261,Prazosin Hydrochloride: 100 Blister Pack In 1 Carton (0904-7022-61) / 1 Capsule In 1 Blister Pack,13.36,5.34,,,0 CDM,6370000001_00904702761,Oxybutynin Chloride: 100 Blister Pack In 1 Carton (0904-7027-61) / 1 Tablet In 1 Blister Pack,1.65,0.66,,,0 CDM,6370000001_00904703580,Major Oral Rinse: 1500 Ml In 1 Package (0904-7035-80),5.55,2.22,,,0 CDM,6370000001_00904703588,"Major Oral Rinse: 15 Ml In 1 Cup, Unit-Dose (0904-7035-88)",3.74,1.5,,,0 CDM,6370000001_00904703604,"Naltrexone Hydrochloride: 30 Blister Pack In 1 Carton (0904-7036-04) / 1 Tablet, Film Coated In 1 Blister Pack",4.23,1.69,,,0 CDM,6370000001_00904704161,Allopurinol: 100 Blister Pack In 1 Carton (0904-7041-61) / 1 Tablet In 1 Blister Pack,0.95,0.38,,,0 CDM,6370000001_00904704206,Amantadine Hydrochloride: 50 Blister Pack In 1 Carton (0904-7042-06) / 1 Capsule In 1 Blister Pack,4.21,1.68,,,0 CDM,6370000001_00904704261,Amantadine Hydrochloride: 100 Blister Pack In 1 Carton (0904-7042-61) / 1 Capsule In 1 Blister Pack,3.87,1.55,,,0 CDM,6370000001_00904704304,"Duloxetine: 30 Blister Pack In 1 Carton (0904-7043-04) / 1 Capsule, Delayed Release In 1 Blister Pack",4.36,1.74,,,0 CDM,6370000001_00904704361,"Duloxetine: 100 Blister Pack In 1 Carton (0904-7043-61) / 1 Capsule, Delayed Release In 1 Blister Pack",4.83,1.93,,,0 CDM,6370000001_00904704461,"Duloxetine: 100 Blister Pack In 1 Carton (0904-7044-61) / 1 Capsule, Delayed Release In 1 Blister Pack",4.31,1.72,,,0 CDM,6370000001_00904704561,"Duloxetine: 100 Blister Pack In 1 Carton (0904-7045-61) / 1 Capsule, Delayed Release In 1 Blister Pack",4.3,1.72,,,0 CDM,6370000001_00904704661,"Hydroxychloroquine Sulfate: 100 Blister Pack In 1 Carton (0904-7046-61) / 1 Tablet, Film Coated In 1 Blister Pack",4.52,1.81,,,0 CDM,6370000001_00904704761,"Losartan Potassium: 100 Blister Pack In 1 Carton (0904-7047-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.63,0.65,,,0 CDM,6370000001_00904704861,"Losartan Potassium: 100 Blister Pack In 1 Carton (0904-7048-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.98,0.79,,,0 CDM,6370000001_00904705261,Doxepin Hydrochloride: 100 Blister Pack In 1 Carton (0904-7052-61) / 1 Capsule In 1 Blister Pack,1.81,0.72,,,0 CDM,6370000001_00904705361,Doxepin Hydrochloride: 100 Blister Pack In 1 Carton (0904-7053-61) / 1 Capsule In 1 Blister Pack,2.94,1.18,,,0 CDM,6370000001_00904705761,Methocarbamol: 100 Blister Pack In 1 Carton (0904-7057-61) / 1 Tablet In 1 Blister Pack,0.68,0.27,,,0 CDM,6370000001_00904705861,Methocarbamol: 100 Blister Pack In 1 Carton (0904-7058-61) / 1 Tablet In 1 Blister Pack,0.84,0.34,,,0 CDM,6370000001_00904706441,NDC Description Not Available,58.03,23.21,,,0 CDM,6370000001_00904706561,Hydroxyzine Pamoate: 100 Blister Pack In 1 Carton (0904-7065-61) / 1 Capsule In 1 Blister Pack,1.43,0.57,,,0 CDM,6370000001_00904706704,"Cinacalcet: 30 Blister Pack In 1 Carton (0904-7067-04) / 1 Tablet, Film Coated In 1 Blister Pack",103.63,41.45,,,0 CDM,6370000001_00904707007,Nadolol: 30 Blister Pack In 1 Carton (0904-7070-07) / 1 Tablet In 1 Blister Pack,8.87,3.55,,,0 CDM,6370000001_00904707107,Nadolol: 30 Blister Pack In 1 Carton (0904-7071-07) / 1 Tablet In 1 Blister Pack,10.84,4.34,,,0 CDM,6370000001_00904707561,"Venlafaxine Hydrochloride: 100 Blister Pack In 1 Carton (0904-7075-61) / 1 Capsule, Extended Release In 1 Blister Pack",1.43,0.57,,,0 CDM,6370000001_00904707761,"Venlafaxine Hydrochloride: 100 Blister Pack In 1 Carton (0904-7077-61) / 1 Capsule, Extended Release In 1 Blister Pack",1.57,0.63,,,0 CDM,6370000001_00904708161,"Nifedipine: 100 Blister Pack In 1 Carton (0904-7081-61) / 1 Tablet, Extended Release In 1 Blister Pack",8.79,3.52,,,0 CDM,6370000001_00904708206,"Nifedipine: 50 Blister Pack In 1 Carton (0904-7082-06) / 1 Tablet, Extended Release In 1 Blister Pack",2.62,1.05,,,0 CDM,6370000001_00904708361,"Ciprofloxacin: 100 Blister Pack In 1 Carton (0904-7083-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.83,0.33,,,0 CDM,6370000001_00904708461,"Bupropion Hydrochloride Xl: 100 Blister Pack In 1 Carton (0904-7084-61) / 1 Tablet, Extended Release In 1 Blister Pack",5.55,2.22,,,0 CDM,6370000001_00904708761,Clozapine: 100 Blister Pack In 1 Carton (0904-7087-61) / 1 Tablet In 1 Blister Pack,2.77,1.11,,,0 CDM,6370000001_00904708961,Clozapine: 100 Blister Pack In 1 Carton (0904-7089-61) / 1 Tablet In 1 Blister Pack,1.09,0.44,,,0 CDM,6370000001_00904710304,Ezetimibe: 30 Blister Pack In 1 Carton (0904-7103-04) / 1 Tablet In 1 Blister Pack,20.07,8.03,,,0 CDM,6370000001_00904710561,Captopril: 100 Blister Pack In 1 Carton (0904-7105-61) / 1 Tablet In 1 Blister Pack,1.36,0.54,,,0 CDM,6370000001_00904710661,Captopril: 100 Blister Pack In 1 Carton (0904-7106-61) / 1 Tablet In 1 Blister Pack,3.69,1.48,,,0 CDM,6370000001_00904710761,Rivastigmine Tartrate: 100 Blister Pack In 1 Carton (0904-7107-61) / 1 Capsule In 1 Blister Pack,9.89,3.96,,,0 CDM,6370000001_00904711341,NDC Description Not Available,25.19,10.08,,,0 CDM,6370000001_00904711741,NDC Description Not Available,4.06,1.62,,,0 CDM,6370000001_00904711793,"Diazepam: 30 Cup, Unit-Dose In 1 Case (0904-7117-93) / 5 Ml In 1 Cup, Unit-Dose (0904-7117-41)",10.63,4.25,,,0 CDM,6370000001_00904711861,Metoprolol Tartrate: 100 Blister Pack In 1 Carton (0904-7118-61) / 1 Tablet In 1 Blister Pack,0.33,0.13,,,0 CDM,6370000001_00904711906,Calcium Acetate: 50 Blister Pack In 1 Carton (0904-7119-06) / 1 Capsule In 1 Blister Pack,0.37,0.15,,,0 CDM,6370000001_00904711961,Calcium Acetate: 100 Blister Pack In 1 Carton (0904-7119-61) / 1 Capsule In 1 Blister Pack,1.66,0.66,,,0 CDM,6370000001_00904712161,Buspirone Hydrochloride: 100 Blister Pack In 1 Carton (0904-7121-61) / 1 Tablet In 1 Blister Pack,0.51,0.2,,,0 CDM,6370000001_00904712261,Buspirone Hydrochloride: 100 Blister Pack In 1 Carton (0904-7122-61) / 1 Tablet In 1 Blister Pack,0.38,0.15,,,0 CDM,6370000001_00904712361,"Levetiracetam: 100 Blister Pack In 1 Carton (0904-7123-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.5,0.2,,,0 CDM,6370000001_00904712461,"Levetiracetam: 100 Blister Pack In 1 Carton (0904-7124-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.52,0.21,,,0 CDM,6370000001_00904712661,Metronidazole: 100 Blister Pack In 1 Carton (0904-7126-61) / 1 Tablet In 1 Blister Pack,2.11,0.84,,,0 CDM,6370000001_00904713061,"Chlorpromazine Hydrochloride: 100 Blister Pack In 1 Carton (0904-7130-61) / 1 Tablet, Film Coated In 1 Blister Pack",15.53,6.21,,,0 CDM,6370000001_00904713261,"Chlorpromazine Hydrochloride: 100 Blister Pack In 1 Carton (0904-7132-61) / 1 Tablet, Film Coated In 1 Blister Pack",35.61,14.24,,,0 CDM,6370000001_00904713761,Nitrofurantoin Monohydrate/ Macrocrystalline: 100 Blister Pack In 1 Carton (0904-7137-61) / 1 Capsule In 1 Blister Pack,7.05,2.82,,,0 CDM,6370000001_00904713961,METOLAZONE: 100 BLISTER PACK in 1 CARTON (0904-7139-61) / 1 TABLET in 1 BLISTER PACK,11.18,4.47,,,0 CDM,6370000001_00904715404,Buprenorphine: 30 Blister Pack In 1 Carton (0904-7154-04) / 1 Tablet In 1 Blister Pack,4.26,1.7,,,0 CDM,6370000001_00904715504,Buprenorphine: 30 Blister Pack In 1 Carton (0904-7155-04) / 1 Tablet In 1 Blister Pack,9.57,3.83,,,0 CDM,6370000001_00904715661,Metronidazole: 100 Blister Pack In 1 Carton (0904-7156-61) / 1 Tablet In 1 Blister Pack,1.09,0.44,,,0 CDM,6370000001_00904716104,Fenofibrate: 30 Blister Pack In 1 Carton (0904-7161-04) / 1 Tablet In 1 Blister Pack,4.44,1.78,,,0 CDM,6370000001_00904716261,Metformin Hydrochloride: 100 Blister Pack In 1 Carton (0904-7162-61) / 1 Tablet In 1 Blister Pack,0.2,0.08,,,0 CDM,6370000001_00904716361,Metformin Hydrochloride: 100 Blister Pack In 1 Carton (0904-7163-61) / 1 Tablet In 1 Blister Pack,0.63,0.25,,,0 CDM,6370000001_00904716806,Ursodiol: 50 Blister Pack In 1 Carton (0904-7168-06) / 1 Capsule In 1 Blister Pack,6.96,2.78,,,0 CDM,6370000001_00904716861,Ursodiol: 100 Blister Pack In 1 Carton (0904-7168-61) / 1 Capsule In 1 Blister Pack,12.53,5.01,,,0 CDM,6370000001_00904717207,"Emtricitabine And Tenofovir Disoproxil Fumarate: 30 Blister Pack In 1 Carton (0904-7172-07) / 1 Tablet, Film Coated In 1 Blister Pack",5.86,2.34,,,0 CDM,6370000001_00904717761,Furosemide: 100 Blister Pack In 1 Carton (0904-7177-61) / 1 Tablet In 1 Blister Pack,0.22,0.09,,,0 CDM,6370000001_00904717861,Furosemide: 100 Blister Pack In 1 Carton (0904-7178-61) / 1 Tablet In 1 Blister Pack,0.21,0.08,,,0 CDM,6370000001_00904717961,Tramadol Hydrochloride: 100 Blister Pack In 1 Carton (0904-7179-61) / 1 Tablet In 1 Blister Pack,0.43,0.17,,,0 CDM,6370000001_00904718245,"Divalproex Sodium: 80 Blister Pack In 1 Carton (0904-7182-45) / 1 Tablet, Extended Release In 1 Blister Pack",7.29,2.92,,,0 CDM,6370000001_00904718261,"Divalproex Sodium: 100 Blister Pack In 1 Carton (0904-7182-61) / 1 Tablet, Extended Release In 1 Blister Pack",5.38,2.15,,,0 CDM,6370000001_00904718361,"Docusate Sodium - Stool Softener Laxative: 10 Blister Pack In 1 Carton (0904-7183-61) / 10 Capsule, Liquid Filled In 1 Blister Pack",0.15,0.06,,,0 CDM,6370000001_00904718461,"Amitriptyline Hydrochloride: 100 Blister Pack In 1 Carton (0904-7184-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.1,0.44,,,0 CDM,6370000001_00904718561,"Amitriptyline Hydrochloride: 100 Blister Pack In 1 Carton (0904-7185-61) / 10 Tablet, Film Coated In 1 Blister Pack",1.64,0.66,,,0 CDM,6370000001_00904718761,Atenolol: 100 Blister Pack In 1 Carton (0904-7187-61) / 1 Tablet In 1 Blister Pack,0.53,0.21,,,0 CDM,6370000001_00904718861,Hydrocortisone: 100 Blister Pack In 1 Carton (0904-7188-61) / 1 Tablet In 1 Blister Pack,4.36,1.74,,,0 CDM,6370000001_00904719106,NDC Description Not Available,0.43,0.17,,,0 CDM,6370000001_00904719306,"Famotidine: 50 Blister Pack In 1 Carton (0904-7193-06) / 1 Tablet, Film Coated In 1 Blister Pack",0.38,0.15,,,0 CDM,6370000001_00904719361,"Famotidine: 100 Blister Pack In 1 Carton (0904-7193-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.19,0.08,,,0 CDM,6370000001_00904720660,"Antiflatulent: 100 Tablet, Chewable In 1 Bottle (0904-7206-60)",0.05,0.02,,,0 CDM,6370000001_00904720806,"Nifedipine: 50 Blister Pack In 1 Carton (0904-7208-06) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack",3.29,1.32,,,0 CDM,6370000001_00904721104,Dantrolene Sodium: 30 Blister Pack In 1 Carton (0904-7211-04) / 1 Capsule In 1 Blister Pack,4.72,1.89,,,0 CDM,6370000001_00904721461,"Bupropion Hydrochloride Sr: 100 Blister Pack In 1 Carton (0904-7214-61) / 1 Tablet, Extended Release In 1 Blister Pack",1.95,0.78,,,0 CDM,6370000001_00904721661,"Potassium Chloride: 100 Blister Pack In 1 Carton (0904-7216-61) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack",0.81,0.32,,,0 CDM,6370000001_00904721761,"Diltiazem Hydrochloride: 100 Blister Pack In 1 Carton (0904-7217-61) / 1 Capsule, Extended Release In 1 Blister Pack",1.33,0.53,,,0 CDM,6370000001_00904721861,"Diltiazem Hydrochloride: 100 Blister Pack In 1 Carton (0904-7218-61) / 1 Capsule, Extended Release In 1 Blister Pack",1.17,0.47,,,0 CDM,6370000001_00904721961,"Diltiazem Hydrochloride: 100 Blister Pack In 1 Carton (0904-7219-61) / 1 Capsule, Extended Release In 1 Blister Pack",1.44,0.58,,,0 CDM,6370000001_00904722461,Folic Acid: 100 Blister Pack In 1 Carton (0904-7224-61) / 1 Tablet In 1 Blister Pack,0.51,0.2,,,0 CDM,6370000001_00904722761,Clonazepam: 100 Blister Pack In 1 Carton (0904-7227-61) / 1 Tablet In 1 Blister Pack,1.54,0.62,,,0 CDM,6370000001_00904723661,Megestrol Acetate: 100 Blister Pack In 1 Carton (0904-7236-61) / 1 Tablet In 1 Blister Pack,0.7,0.28,,,0 CDM,6370000001_00904723961,NDC Description Not Available,0.34,0.14,,,0 CDM,6370000001_00904724161,Haloperidol: 100 BLISTER PACK in 1 CARTON (0904-7241-61) / 1 TABLET in 1 BLISTER PACK,1.07,0.43,,,0 CDM,6370000001_00904724361,"Ciprofloxacin: 100 Blister Pack In 1 Carton (0904-7243-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.87,0.35,,,0 CDM,6370000001_00904724468,"Lacosamide: 60 Blister Pack In 1 Carton (0904-7244-68) / 1 Tablet, Film Coated In 1 Blister Pack",3.69,1.48,,,0 CDM,6370000001_00904724768,"Lacosamide: 60 Blister Pack In 1 Carton (0904-7247-68) / 1 Tablet, Film Coated In 1 Blister Pack",6.45,2.58,,,0 CDM,6370000001_00904725261,"Sennosides: 10 Blister Pack In 1 Box, Unit-Dose (0904-7252-61) / 10 Tablet, Film Coated In 1 Blister Pack",0.13,0.05,,,0 CDM,6370000001_00904725761,Carbidopa And Levodopa: 100 Blister Pack In 1 Carton (0904-7257-61) / 1 Tablet In 1 Blister Pack,0.65,0.26,,,0 CDM,6370000001_00904726161,"Sodium Bicarbonate: 10 Blister Pack In 1 Box, Unit-Dose (0904-7261-61) / 10 Tablet In 1 Blister Pack",0.23,0.09,,,0 CDM,6370000001_00904726261,"Oxcarbazepine: 100 Blister Pack In 1 Carton (0904-7262-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.71,0.68,,,0 CDM,6370000001_00904726361,"Oxcarbazepine: 100 Blister Pack In 1 Carton (0904-7263-61) / 1 Tablet, Film Coated In 1 Blister Pack",2.51,1.0,,,0 CDM,6370000001_00904726541,NDC Description Not Available,7.18,2.87,,,0 CDM,6370000001_00904726661,Dexamethasone: 100 Blister Pack In 1 Carton (0904-7266-61) / 1 Tablet In 1 Blister Pack,0.22,0.09,,,0 CDM,6370000001_00904726918,"Sucralfate: 4 Tray In 1 Case (0904-7269-18) / 10 Cup, Unit-Dose In 1 Tray / 10 Ml In 1 Cup, Unit-Dose (0904-7269-66)",21.51,8.6,,,0 CDM,6370000001_00904726966,NDC Description Not Available,21.34,8.54,,,0 CDM,6370000001_00904727061,"Bupropion Hydrochloride Sr: 100 Blister Pack In 1 Carton (0904-7270-61) / 1 Tablet, Extended Release In 1 Blister Pack",3.0,1.2,,,0 CDM,6370000001_00904727670,"Nystatin: 10 Tray In 1 Case (0904-7276-70) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (0904-7276-41)",2.04,0.82,,,0 CDM,6370000001_00904727770,NDC Description Not Available,3.26,1.3,,,0 CDM,6370000001_00904727966,NDC Description Not Available,3.26,1.3,,,0 CDM,6370000001_00904728060,"Stool Softener Laxative: 100 Capsule, Liquid Filled In 1 Bottle, Plastic (0904-7280-60)",0.07,0.03,,,0 CDM,6370000001_00904728361,Torsemide: 100 Blister Pack In 1 Carton (0904-7283-61) / 1 Tablet In 1 Blister Pack,1.14,0.46,,,0 CDM,6370000001_00904728454,NDC Description Not Available,9.46,3.78,,,0 CDM,6370000001_00904728861,Benztropine Mesylate: 100 Blister Pack In 1 Carton (0904-7288-61) / 1 Tablet In 1 Blister Pack,1.35,0.54,,,0 CDM,6370000001_00904728961,Benztropine Mesylate: 100 Blister Pack In 1 Carton (0904-7289-61) / 1 Tablet In 1 Blister Pack,1.25,0.5,,,0 CDM,6370000001_00904730561,"Carvedilol: 100 Blister Pack In 1 Carton (0904-7305-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.28,0.11,,,0 CDM,6370000001_00904730661,"Carvedilol: 100 Blister Pack In 1 Carton (0904-7306-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.32,0.13,,,0 CDM,6370000001_00904730761,"Carvedilol: 100 Blister Pack In 1 Carton (0904-7307-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.24,0.1,,,0 CDM,6370000001_00904730861,"Carvedilol: 100 Blister Pack In 1 Carton (0904-7308-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.28,0.11,,,0 CDM,6370000001_00904731761,Fludrocortisone Acetate: 100 Blister Pack In 1 Carton (0904-7317-61) / 1 Tablet In 1 Blister Pack,2.16,0.86,,,0 CDM,6370000001_00904732562,NDC Description Not Available,10.15,4.06,,,0 CDM,6370000001_00904732573,"Aluminum Hydroxide, Magnesium Hydroxide And Simethicone Suspension: 10 Tray In 1 Case (0904-7325-73) / 10 Cup, Unit-Dose In 1 Tray / 30 Ml In 1 Cup, Unit-Dose (0904-7325-62)",4.39,1.76,,,0 CDM,6370000001_00904732961,Metolazone: 100 Blister Pack In 1 Carton (0904-7329-61) / 1 Tablet In 1 Blister Pack,12.11,4.84,,,0 CDM,6370000001_00904733761,Cephalexin: 100 Blister Pack In 1 Carton (0904-7337-61) / 1 Capsule In 1 Blister Pack,1.38,0.55,,,0 CDM,6370000001_00904734661,Fluoxetine: 100 Blister Pack In 1 Carton (0904-7346-61) / 1 Capsule In 1 Blister Pack,0.29,0.12,,,0 CDM,6370000001_00904735006,"Azithromycin: 50 Blister Pack In 1 Carton (0904-7350-06) / 1 Tablet, Film Coated In 1 Blister Pack",3.72,1.49,,,0 CDM,6370000001_00904735504,"Lurasidone Hydrochloride: 30 Blister Pack In 1 Carton (0904-7355-04) / 1 Tablet, Film Coated In 1 Blister Pack",2.99,1.2,,,0 CDM,6370000001_00904736161,"Risperidone: 100 Blister Pack In 1 Carton (0904-7361-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.78,0.31,,,0 CDM,6370000001_00904736361,"Risperidone: 100 Blister Pack In 1 Carton (0904-7363-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.18,0.47,,,0 CDM,6370000001_00904736461,"Risperidone: 100 Blister Pack In 1 Carton (0904-7364-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.47,0.59,,,0 CDM,6370000001_00904736604,Aripiprazole: 30 Blister Pack In 1 Carton (0904-7366-04) / 1 Tablet In 1 Blister Pack,25.05,10.02,,,0 CDM,6370000001_00904736904,Aripiprazole: 30 Blister Pack In 1 Carton (0904-7369-04) / 1 Tablet In 1 Blister Pack,8.92,3.57,,,0 CDM,6370000001_00904738361,Tamsulosin Hydrochloride: 100 Blister Pack In 1 Carton (0904-7383-61) / 1 Capsule In 1 Blister Pack,1.3,0.52,,,0 CDM,6370000001_00904739061,Haloperidol: 100 Blister Pack In 1 Carton (0904-7390-61) / 1 Tablet In 1 Blister Pack,1.47,0.59,,,0 CDM,6370000001_00904740004,"Cyclobenzaprine Hydrochloride: 30 Blister Pack In 1 Carton (0904-7400-04) / 1 Tablet, Film Coated In 1 Blister Pack",1.57,0.63,,,0 CDM,6370000001_00904741061,Amitriptyline Hydrochloride: 100 Blister Pack In 1 Carton (0904-7410-61) / 1 Tablet In 1 Blister Pack,0.8,0.32,,,0 CDM,6370000001_00904741161,Amitriptyline Hydrochloride: 100 Blister Pack In 1 Carton (0904-7411-61) / 1 Tablet In 1 Blister Pack,1.75,0.7,,,0 CDM,6370000001_00904741761,Methadone Hydrochloride: 100 Blister Pack In 1 Carton (0904-7417-61) / 1 Tablet In 1 Blister Pack,0.66,0.26,,,0 CDM,6370000001_00904741844,"Magnesium Citrate: 296 Ml In 1 Bottle, Plastic (0904-7418-44)",8.67,3.47,,,0 CDM,6370000001_00904743535,"Major Nasal Decongestant: 1 Bottle, Spray In 1 Carton (0904-7435-35) / 15 Ml In 1 Bottle, Spray",7.64,3.06,,,0 CDM,6370000001_00904744061,"Sennosides, Docusate Sodium: 10 Blister Pack In 1 Box, Unit-Dose (0904-7440-61) / 10 Tablet, Film Coated In 1 Blister Pack",0.5,0.2,,,0 CDM,6370000001_00904744261,Clonidine Hydrochloride: 100 Blister Pack In 1 Carton (0904-7442-61) / 1 Tablet In 1 Blister Pack,1.05,0.42,,,0 CDM,6370000001_00904744761,Hydralazine Hydrochloride: 100 Blister Pack In 1 Carton (0904-7447-61) / 1 Tablet In 1 Blister Pack,0.02,0.01,,,0 CDM,6370000001_00904744861,Hydralazine Hydrochloride: 100 Blister Pack In 1 Carton (0904-7448-61) / 1 Tablet In 1 Blister Pack,0.72,0.29,,,0 CDM,6370000001_00904744961,Hydralazine Hydrochloride: 100 Blister Pack In 1 Carton (0904-7449-61) / 1 Tablet In 1 Blister Pack,0.9,0.36,,,0 CDM,6370000001_00904745161,"Labetalol Hydrochloride: 100 Blister Pack In 1 Carton (0904-7451-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.38,0.55,,,0 CDM,6370000001_00904745953,"Atovaquone: 7 Tray In 1 Case (0904-7459-53) / 6 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (0904-7459-41)",63.6,25.44,,,0 CDM,6370000001_00904746188,"Potassium Chloride: 15 Ml In 1 Cup, Unit-Dose (0904-7461-88)",8.0,3.2,,,0 CDM,6370000001_00904746806,Propranolol Hydrochloride: 50 Blister Pack In 1 Carton (0904-7468-06) / 1 Tablet In 1 Blister Pack,1.27,0.51,,,0 CDM,6370000001_00904747072,"Sucralfate: 100 Cup, Unit-Dose In 1 Case (0904-7470-72) / 10 Ml In 1 Cup, Unit-Dose (0904-7470-66)",23.42,9.37,,,0 CDM,6370000001_00904749661,"Tramadol Hydrochloride: 100 Blister Pack In 1 Carton (0904-7496-61) / 1 Tablet, Coated In 1 Blister Pack",0.44,0.18,,,0 CDM,6370000001_00904750161,Carbidopa And Levodopa: 100 Blister Pack In 1 Carton (0904-7501-61) / 1 Tablet In 1 Blister Pack,0.86,0.34,,,0 CDM,6370000001_00904772512,"Anti Diarrheal: 12 Blister Pack In 1 Carton (0904-7725-12) / 1 Tablet, Film Coated In 1 Blister Pack",0.29,0.12,,,0 CDM,6370000001_00904772524,"Anti Diarrheal: 24 Blister Pack In 1 Carton (0904-7725-24) / 1 Tablet, Film Coated In 1 Blister Pack",0.37,0.15,,,0 CDM,6370000001_00904772861,Clonazepam: 100 Blister Pack In 1 Carton (0904-7728-61) / 1 Tablet In 1 Blister Pack,1.22,0.49,,,0 CDM,6370000001_00904773445,"Miconazole 7: 1 Tube, With Applicator In 1 Carton (0904-7734-45) / 45 G In 1 Tube, With Applicator",9.45,3.78,,,0 CDM,6370000001_00904775127,NDC Description Not Available,9.82,3.93,,,0 CDM,6370000001_00904782231,Major Clotrimazole: 1 Tube In 1 Carton (0904-7822-31) / 28.35 G In 1 Tube,7.31,2.92,,,0 CDM,6370000001_00904791259,"Ibuprofen: 1 Bottle In 1 Carton (0904-7912-59) / 100 Tablet, Film Coated In 1 Bottle",0.03,0.01,,,0 CDM,6370000001_00904791459,"Ibuprofen: 1 Bottle, Plastic In 1 Carton (0904-7914-59) / 100 Tablet, Film Coated In 1 Bottle, Plastic",0.08,0.03,,,0 CDM,6370000001_00904791461,"Ibuprofen: 10 Blister Pack In 1 Carton (0904-7914-61) / 10 Tablet, Film Coated In 1 Blister Pack",0.2,0.08,,,0 CDM,6370000001_00904880567,Major Triple Antibiotic: 144 Packet In 1 Carton (0904-8805-67) / .9 G In 1 Packet,0.4,0.16,,,0 CDM,6370000001_00906990441,NDC Description Not Available,1.82,0.73,,,0 CDM,6370000001_00924540101,First Aid Only Ammonia Inhalants: 10 Ampule In 1 Carton (0924-5401-01) / .3 Ml In 1 Ampule,1.75,0.7,,,0 CDM,6370000001_00955105027,"Sevelamer Carbonate: 270 Tablet, Film Coated In 1 Bottle (0955-1050-27)",1.63,0.65,,,0 CDM,6370000001_01490003908,NDC Description Not Available,0.99,0.4,,,0 CDM,6370000001_01490003916,NDC Description Not Available,0.04,0.02,,,0 CDM,6370000001_05730051315,NDC Description Not Available,1.71,0.68,,,0 CDM,6370000001_08065 0,NDC Description Not Available,955.88,382.35,,,0 CDM,6370000001_09999000091,NDC Description Not Available,0.08,0.03,,,0 CDM,6370000001_09999172694,NDC Description Not Available,51.09,20.44,,,0 CDM,6370000001_09999210001,NDC Description Not Available,4.02,1.61,,,0 CDM,6370000001_09999408302,NDC Description Not Available,0.09,0.04,,,0 CDM,6370000001_09999408315,NDC Description Not Available,4.43,1.77,,,0 CDM,6370000001_09999708815,NDC Description Not Available,33.1,13.24,,,0 CDM,6370000001_10006070013,NDC Description Not Available,0.24,0.1,,,0 CDM,6370000001_10006070028,NDC Description Not Available,0.22,0.09,,,0 CDM,6370000001_10006070038,NDC Description Not Available,0.14,0.06,,,0 CDM,6370000001_10019055304,Transderm Scop: 24 Pouch In 1 Box (10019-553-04) / 1 Patch In 1 Pouch / 3 D In 1 Patch,63.89,25.56,,,0 CDM,6370000001_10019055390,Transderm Scop: 1 Patch In 1 Pouch (10019-553-90) / 3 D In 1 Patch,54.87,21.95,,,0 CDM,6370000001_10119000252,NDC Description Not Available,9.92,3.97,,,0 CDM,6370000001_10119002239,NDC Description Not Available,22.02,8.81,,,0 CDM,6370000001_10147015001,Itraconazole: 150 Ml In 1 Bottle (10147-0150-1),164.96,65.98,,,0 CDM,6370000001_10223020104,"Cetacaine Anesthetic: 1 Bottle, Glass In 1 Box (10223-0201-4) / 5 G In 1 Bottle, Glass",249.73,99.89,,,0 CDM,6370000001_10361079301,E-Z-Gas Ii: 50 Pouch In 1 Box (10361-793-01) / 4 G In 1 Pouch,8.41,3.36,,,0 CDM,6370000001_10702000601,"Cyclobenzaprine Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (10702-006-01)",0.21,0.08,,,0 CDM,6370000001_10702005601,Oxycodone Hydrochloride: 100 Tablet In 1 Bottle (10702-056-01),0.7,0.28,,,0 CDM,6370000001_10702005650,Oxycodone Hydrochloride: 500 Tablet In 1 Bottle (10702-056-50),0.73,0.29,,,0 CDM,6370000001_10702023701,Ursodiol: 100 Capsule In 1 Bottle (10702-237-01),3.41,1.36,,,0 CDM,6370000001_10956061801,"Pinworm: 30 mL in 1 BOTTLE, PLASTIC (10956-618-01)",2.16,0.86,,,0 CDM,6370000001_11523720401,A And D First Aid: 1 Tube In 1 Carton (11523-7204-1) / 42.5 G In 1 Tube,6.72,2.69,,,0 CDM,6370000001_11534016644,Sodium Polystyrene Sulfonate: 454 G In 1 Jar (11534-166-44),2.84,1.14,,,0 CDM,6370000001_11701004814,Baza Clear: 142 G In 1 Tube (11701-048-14),11.36,4.54,,,0 CDM,6370000001_11701006723,Critic Aid Clear Af: 57 G In 1 Tube (11701-067-23),24.0,9.6,,,0 CDM,6370000001_11845007791,NDC Description Not Available,0.19,0.08,,,0 CDM,6370000001_11845009151,NDC Description Not Available,0.11,0.04,,,0 CDM,6370000001_11980017410,"Pred Mild: 1 Bottle, Dropper In 1 Carton (11980-174-10) / 10 Ml In 1 Bottle, Dropper",983.11,393.24,,,0 CDM,6370000001_12165010001,Grafco Applicator 15 Cm: 100 Stick In 1 Tube (12165-100-01),1.04,0.42,,,0 CDM,6370000001_12547049380,NDC Description Not Available,12.6,5.04,,,0 CDM,6370000001_12870000101,Silver Nitrate Applicators: 10 Packet In 1 Box (12870-0001-1) / 10 Applicator In 1 Packet / 100 Mg In 1 Applicator,2.97,1.19,,,0 CDM,6370000001_12870000102,Silver Nitrate Applicators: 100 Applicator In 1 Vial (12870-0001-2) / 100 Mg In 1 Applicator,2.73,1.09,,,0 CDM,6370000001_13107003134,"Mirtazapine: 30 Tablet, Film Coated In 1 Bottle (13107-031-34)",0.22,0.09,,,0 CDM,6370000001_13107008401,Lorazepam: 100 Tablet In 1 Bottle (13107-084-01),0.15,0.06,,,0 CDM,6370000001_13107008405,Lorazepam: 500 Tablet In 1 Bottle (13107-084-05),0.22,0.09,,,0 CDM,6370000001_13107031901,Clorazepate Dipotassium: 100 Tablet In 1 Bottle (13107-319-01),3.63,1.45,,,0 CDM,6370000001_13517010716,"Phenobarbital: 473 Ml In 1 Bottle, Plastic (13517-107-16)",2.69,1.08,,,0 CDM,6370000001_13668000701,Zolpidem Tartrate: 100 Tablet In 1 Bottle (13668-007-01),0.27,0.11,,,0 CDM,6370000001_13668001001,"Citalopram: 100 Tablet, Film Coated In 1 Bottle (13668-010-01)",0.14,0.06,,,0 CDM,6370000001_13668009490,Pramipexole Dihydrochloride: 90 Tablet In 1 Bottle (13668-094-90),0.44,0.18,,,0 CDM,6370000001_13668010290,"Donepezil Hydrochloride: 90 Tablet, Film Coated In 1 Bottle (13668-102-90)",0.66,0.26,,,0 CDM,6370000001_13668013301,"Felodipine: 100 Tablet, Extended Release In 1 Bottle (13668-133-01)",1.16,0.46,,,0 CDM,6370000001_13668013401,"Felodipine: 100 Tablet, Extended Release In 1 Bottle (13668-134-01)",2.08,0.83,,,0 CDM,6370000001_13668013701,"Escitalopram: 100 Tablet, Film Coated In 1 Bottle (13668-137-01)",0.48,0.19,,,0 CDM,6370000001_13668018590,"Sildenafil: 90 Tablet, Film Coated In 1 Bottle (13668-185-90)",3.03,1.21,,,0 CDM,6370000001_13668033101,Trazodone Hydrochloride: 100 Tablet In 1 Bottle (13668-331-01),0.38,0.15,,,0 CDM,6370000001_13668044001,Fenofibrate: 100 Capsule In 1 Bottle (13668-440-01),0.67,0.27,,,0 CDM,6370000001_13668059180,NDC Description Not Available,20.02,8.01,,,0 CDM,6370000001_13668059283,NDC Description Not Available,28.02,11.21,,,0 CDM,6370000001_13668059380,NDC Description Not Available,39.86,15.94,,,0 CDM,6370000001_13668060630,"Erythromycin: 30 Tablet, Coated In 1 Bottle (13668-606-30)",14.37,5.75,,,0 CDM,6370000001_13811000710,NDC Description Not Available,0.65,0.26,,,0 CDM,6370000001_13811070610,"Methylphenidate Hydrochloride: 100 Tablet, Extended Release In 1 Bottle (13811-706-10)",2.21,0.88,,,0 CDM,6370000001_13811070710,"Methylphenidate Hydrochloride: 100 Tablet, Extended Release In 1 Bottle (13811-707-10)",2.27,0.91,,,0 CDM,6370000001_14428000944,NDC Description Not Available,3.63,1.45,,,0 CDM,6370000001_16500054605,NDC Description Not Available,0.11,0.04,,,0 CDM,6370000001_16500059918,NDC Description Not Available,0.32,0.13,,,0 CDM,6370000001_16571010501,Amitriptyline Hydrochloride: 100 Tablet In 1 Bottle (16571-105-01),0.2,0.08,,,0 CDM,6370000001_16571012706,"Tolterodine Tartrate: 60 Tablet, Film Coated In 1 Bottle (16571-127-06)",1.35,0.54,,,0 CDM,6370000001_16571012815,NDC Description Not Available,5.87,2.35,,,0 CDM,6370000001_16571012852,"Chlorhexidine Gluconate Oral Rinse: 100 Cup, Unit-Dose In 1 Box, Unit-Dose (16571-128-52) / 15 Ml In 1 Cup, Unit-Dose (16571-128-15)",5.74,2.3,,,0 CDM,6370000001_16571040210,Cetirizine Hydrochloride: 100 Tablet In 1 Bottle (16571-402-10),0.17,0.07,,,0 CDM,6370000001_16571067101,Phenobarbital: 100 Tablet In 1 Bottle (16571-671-01),0.25,0.1,,,0 CDM,6370000001_16571067301,Phenobarbital: 100 Tablet In 1 Bottle (16571-673-01),0.44,0.18,,,0 CDM,6370000001_16571067621,Hydrocortisone Acetate: 12 Suppository In 1 Carton (16571-676-21),5.07,2.03,,,0 CDM,6370000001_16571068309,Clomipramine Hydrochloride: 90 Capsule In 1 Bottle (16571-683-09),1.43,0.57,,,0 CDM,6370000001_16571072360,Sulfamylon: 1 Tube In 1 Carton (16571-723-60) / 56.7 G In 1 Tube,312.21,124.88,,,0 CDM,6370000001_16571073521,Methylergonovine Maleate: 12 Tablet In 1 Bottle (16571-735-21),47.09,18.84,,,0 CDM,6370000001_16571075453,Neomycin And Polymyxin B Sulfates And Bacitracin Zinc: 1 Tube In 1 Carton (16571-754-53) / 3.5 G In 1 Tube,74.16,29.66,,,0 CDM,6370000001_16571078101,Carisoprodol: 100 Tablet In 1 Bottle (16571-781-01),0.3,0.12,,,0 CDM,6370000001_16571078812,"Levetiracetam: 120 Tablet, Film Coated In 1 Bottle (16571-788-12)",0.64,0.26,,,0 CDM,6370000001_16571078850,"Levetiracetam: 500 Tablet, Film Coated In 1 Bottle (16571-788-50)",0.45,0.18,,,0 CDM,6370000001_16571086209,"Bupropion Hydrochloride: 90 Tablet, Extended Release In 1 Bottle (16571-862-09)",0.72,0.29,,,0 CDM,6370000001_16729013600,"Clonazepam: 100 Tablet In 1 Bottle, Plastic (16729-136-00)",0.17,0.07,,,0 CDM,6370000001_16729013700,"Clonazepam: 100 Tablet In 1 Bottle, Plastic (16729-137-00)",0.09,0.04,,,0 CDM,6370000001_16729021615,"Sertraline Hydrochloride: 90 Tablet, Film Coated In 1 Bottle (16729-216-15)",0.17,0.07,,,0 CDM,6370000001_16729022501,"Spironolactone: 100 Tablet, Film Coated In 1 Bottle (16729-225-01)",0.24,0.1,,,0 CDM,6370000001_16729044315,"Bupropion Hydrochloride: 90 Tablet, Extended Release In 1 Bottle (16729-443-15)",0.56,0.22,,,0 CDM,6370000001_16784011402,NDC Description Not Available,0.15,0.06,,,0 CDM,6370000001_16864004002,Triple Antifungal: 1 Tube In 1 Carton (16864-040-02) / 56.7 G In 1 Tube,60.68,24.27,,,0 CDM,6370000001_16864024001,"Domeboro: 12 Powder, For Solution In 1 Box (16864-240-01)",1.19,0.48,,,0 CDM,6370000001_16864068003,Dermoplast Pain Relieving: 85 G In 1 Can (16864-680-03),17.07,6.83,,,0 CDM,6370000001_17238090011,Bioglo: 100 Packet In 1 Box (17238-900-11) / 1 Mg In 1 Packet (17238-900-99),0.63,0.25,,,0 CDM,6370000001_17478021505,"Atropine: 1 BOTTLE, DROPPER in 1 CARTON (17478-215-05) / 5 mL in 1 BOTTLE, DROPPER",161.23,64.49,,,0 CDM,6370000001_17478023835,AK-POLY-BAC: 1 TUBE in 1 CARTON (17478-238-35) / 3.5 g in 1 TUBE,57.37,22.95,,,0 CDM,6370000001_17478040401,FUL-GLO: 100 APPLICATOR in 1 CARTON (17478-404-01) / 1 STRIP in 1 APPLICATOR,0.46,0.18,,,0 CDM,6370000001_17478076610,"Progesterone: 100 CAPSULE in 1 BOTTLE, PLASTIC (17478-766-10)",2.48,0.99,,,0 CDM,6370000001_17772012201,Oxtellar Xr: 100 Tablet In 1 Bottle (17772-122-01),38.84,15.54,,,0 CDM,6370000001_17856131301,Bismatrol: 15 mL in 1 CUP (17856-1313-1),4.42,1.77,,,0 CDM,6370000001_17856502301,NDC Description Not Available,0.34,0.14,,,0 CDM,6370000001_19903001020,NDC Description Not Available,0.37,0.15,,,0 CDM,6370000001_19903001023,NDC Description Not Available,0.6,0.24,,,0 CDM,6370000001_20555003300,NDC Description Not Available,0.08,0.03,,,0 CDM,6370000001_20555003600,NDC Description Not Available,0.43,0.17,,,0 CDM,6370000001_20555004000,NDC Description Not Available,0.56,0.22,,,0 CDM,6370000001_21922000301,"Fluocinolone Acetonide Topical Solution Usp, 0.01%: 1 Bottle In 1 Carton (21922-003-01) / 60 Ml In 1 Bottle",17.93,7.17,,,0 CDM,6370000001_21922001605,"Clobetasol Propionate Cream Usp, 0.05% Clobetasol Propionate Cream Usp, 0.05%: 30 G In 1 Tube (21922-016-05)",33.12,13.25,,,0 CDM,6370000001_21922002107,Permethrin: 1 Tube In 1 Carton (21922-021-07) / 60 G In 1 Tube,94.19,37.68,,,0 CDM,6370000001_21922002707,Clindamycin Phosphate: 1 Tube In 1 Carton (21922-027-07) / 60 G In 1 Tube,86.51,34.6,,,0 CDM,6370000001_21922002904,Mupirocin: 1 Tube In 1 Carton (21922-029-04) / 15 G In 1 Tube,76.8,30.72,,,0 CDM,6370000001_23155000101,"Hydralazine Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (23155-001-01)",0.16,0.06,,,0 CDM,6370000001_23155000301,"Hydralazine Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (23155-003-01)",0.2,0.08,,,0 CDM,6370000001_23155000901,Hydrochlorothiazide: 100 Tablet In 1 Bottle (23155-009-01),0.2,0.08,,,0 CDM,6370000001_23155002601,Verapamil Hydrochloride: 100 Tablet In 1 Bottle (23155-026-01),0.82,0.33,,,0 CDM,6370000001_23155004403,Leflunomide: 30 Tablet In 1 Bottle (23155-044-03),1.87,0.75,,,0 CDM,6370000001_23155005601,Glyburide: 100 Tablet In 1 Bottle (23155-056-01),0.15,0.06,,,0 CDM,6370000001_23155005801,Glyburide: 100 Tablet In 1 Bottle (23155-058-01),0.96,0.38,,,0 CDM,6370000001_23155019401,Nifedipine: 100 Capsule In 1 Bottle (23155-194-01),1.53,0.61,,,0 CDM,6370000001_23155019501,Nifedipine: 100 Capsule In 1 Bottle (23155-195-01),2.34,0.94,,,0 CDM,6370000001_23155022701,Acyclovir: 100 Tablet In 1 Bottle (23155-227-01),0.77,0.31,,,0 CDM,6370000001_23155028701,Acetazolamide: 100 Tablet In 1 Bottle (23155-287-01),0.73,0.29,,,0 CDM,6370000001_23155028801,Acetazolamide: 100 Tablet In 1 Bottle (23155-288-01),1.01,0.4,,,0 CDM,6370000001_23155048601,Verapamil Hydrochloride: 100 Tablet In 1 Bottle (23155-486-01),1.13,0.45,,,0 CDM,6370000001_23155049001,Desmopressin Acetate: 100 Tablet In 1 Bottle (23155-490-01),2.35,0.94,,,0 CDM,6370000001_23155050001,Hydroxyzine Hydrochloride: 100 Tablet In 1 Bottle (23155-500-01),0.13,0.05,,,0 CDM,6370000001_23155050101,Hydroxyzine Hydrochloride: 100 Tablet In 1 Bottle (23155-501-01),0.18,0.07,,,0 CDM,6370000001_23155051230,"Nimodipine: 3 Blister Pack In 1 Carton (23155-512-30) / 10 Capsule, Liquid Filled In 1 Blister Pack",1.53,0.61,,,0 CDM,6370000001_23155057901,Desipramine Hydrochloride: 100 Tablet In 1 Bottle (23155-579-01),3.29,1.32,,,0 CDM,6370000001_23155066201,Calcitriol: 100 Capsule In 1 Bottle (23155-662-01),0.59,0.24,,,0 CDM,6370000001_23155066301,Calcitriol: 100 Capsule In 1 Bottle (23155-663-01),1.27,0.51,,,0 CDM,6370000001_23155068631,"Octreotide Acetate: 5 Ml In 1 Vial, Glass (23155-686-31)",2.35,0.94,,,0 CDM,6370000001_23155070401,Enalapril Maleate: 100 Tablet In 1 Bottle (23155-704-01),0.39,0.16,,,0 CDM,6370000001_23155070501,Enalapril Maleate: 100 Tablet In 1 Bottle (23155-705-01),0.63,0.25,,,0 CDM,6370000001_23155076701,Tetracycline Hydrochloride: 100 Capsule In 1 Bottle (23155-767-01),5.08,2.03,,,0 CDM,6370000001_23155077201,Enalapril Maleate: 100 Tablet In 1 Bottle (23155-772-01),0.64,0.26,,,0 CDM,6370000001_23155077301,Enalapril Maleate: 100 Tablet In 1 Bottle (23155-773-01),0.44,0.18,,,0 CDM,6370000001_23155087201,Torsemide: 100 Tablet In 1 Bottle (23155-872-01),0.38,0.15,,,0 CDM,6370000001_23635052460,"Amitiza: 60 Capsule, Gelatin Coated In 1 Bottle (23635-524-60)",20.23,8.09,,,0 CDM,6370000001_24208027615,Muro 128: 1 Bottle In 1 Carton (24208-276-15) / 15 Ml In 1 Bottle,48.92,19.57,,,0 CDM,6370000001_24208029005,"Tobramycin: 1 Bottle, Dropper In 1 Carton (24208-290-05) / 5 Ml In 1 Bottle, Dropper",35.25,14.1,,,0 CDM,6370000001_24208029525,"Tobramycin And Dexamethasone: 1 Bottle, Dropper In 1 Carton (24208-295-25) / 2.5 Ml In 1 Bottle, Dropper",151.71,60.68,,,0 CDM,6370000001_24208031510,"Polymyxin B Sulfate And Trimethoprim: 1 Bottle, Dropper In 1 Carton (24208-315-10) / 10 Ml In 1 Bottle, Dropper",46.0,18.4,,,0 CDM,6370000001_24208031705,"Sulfacetamide Sodium And Prednisolone Sodium Phosphate: 1 Bottle, Dropper In 1 Carton (24208-317-05) / 5 Ml In 1 Bottle, Dropper",45.0,18.0,,,0 CDM,6370000001_24208039830,"Ipratropium Bromide: 1 Bottle, Spray In 1 Carton (24208-398-30) / 345 Spray, Metered In 1 Bottle, Spray",109.53,43.81,,,0 CDM,6370000001_24208041105,"Brimonidine Tartrate: 1 Bottle, Dropper In 1 Carton (24208-411-05) / 5 Ml In 1 Bottle, Dropper",63.39,25.36,,,0 CDM,6370000001_24208043410,"Ofloxacin: 1 Bottle, Dropper In 1 Carton (24208-434-10) / 10 Ml In 1 Bottle, Dropper",166.16,66.46,,,0 CDM,6370000001_24208046325,Latanoprost: 1 Bottle In 1 Carton (24208-463-25) / 2.5 Ml In 1 Bottle,78.66,31.46,,,0 CDM,6370000001_24208048510,"Dorzolamide Hcl: 1 Bottle, Dropper In 1 Carton (24208-485-10) / 10 Ml In 1 Bottle, Dropper",145.41,58.16,,,0 CDM,6370000001_24208048610,"Dorzolamide Hydrochloride And Timolol Maleate: 1 Bottle, Dropper In 1 Carton (24208-486-10) / 10 Ml In 1 Bottle, Dropper",151.06,60.42,,,0 CDM,6370000001_24208050912,NDC Description Not Available,0.49,0.2,,,0 CDM,6370000001_24208055555,Bacitracin Zinc And Polymyxin B Sulfate: 1 Tube In 1 Carton (24208-555-55) / 3.5 G In 1 Tube,68.93,27.57,,,0 CDM,6370000001_24208058060,"Gentamicin Sulfate: 1 Bottle, Dropper In 1 Carton (24208-580-60) / 5 Ml In 1 Bottle, Dropper",152.77,61.11,,,0 CDM,6370000001_24208063562,"Neomycin And Polymyxin B Sulfates And Hydrocortisone: 1 Bottle, Dropper In 1 Carton (24208-635-62) / 10 Ml In 1 Bottle, Dropper",250.51,100.2,,,0 CDM,6370000001_24208073501,"Cyclopentolate Hydrochloride: 1 Bottle, Dropper In 1 Carton (24208-735-01) / 2 Ml In 1 Bottle, Dropper",36.3,14.52,,,0 CDM,6370000001_24208078055,Neomycin And Polymyxin B Sulfates And Bacitracin Zinc: 1 Tube In 1 Carton (24208-780-55) / 3.5 G In 1 Tube,244.24,97.7,,,0 CDM,6370000001_24208078555,"Neomycin And Polymyxin B Sulfates, Bacitracin Zinc And Hydrocortisone: 1 Tube In 1 Carton (24208-785-55) / 3.5 G In 1 Tube",95.59,38.24,,,0 CDM,6370000001_24208079535,Neomycin And Polymyxin B Sulfates And Dexamethasone: 1 Tube In 1 Carton (24208-795-35) / 3.5 G In 1 Tube,47.75,19.1,,,0 CDM,6370000001_24208091019,Erythromycin: 50 Tube In 1 Box (24208-910-19) / 1 G In 1 Tube,28.36,11.34,,,0 CDM,6370000001_24208091055,Erythromycin: 1 Tube In 1 Carton (24208-910-55) / 3.5 G In 1 Tube,39.1,15.64,,,0 CDM,6370000001_24338013213,Ery-Ped: 100 Ml In 1 Bottle (24338-132-13),70.51,28.2,,,0 CDM,6370000001_24338053025,Sotylize: 250 Ml In 1 Bottle (24338-530-25),27.58,11.03,,,0 CDM,6370000001_24357030030,NDC Description Not Available,2801.4,1120.56,,,0 CDM,6370000001_24385006003,Good Neighbor Pharmacy Bacitracin Zinc: 1 Tube In 1 Carton (24385-060-03) / 28.4 G In 1 Tube,10.74,4.3,,,0 CDM,6370000001_24385019003,Good Neighbor Pharmacy Hydrocortisone With Aloe For Sensitive Skin: 1 Tube In 1 Carton (24385-190-03) / 28.4 G In 1 Tube,5.68,2.27,,,0 CDM,6370000001_24385035210,"Good Neighbor Pharmacy Nasal: 1 Bottle, Spray In 1 Carton (24385-352-10) / 30 Ml In 1 Bottle, Spray",4.14,1.66,,,0 CDM,6370000001_24385090530,NDC Description Not Available,3.59,1.44,,,0 CDM,6370000001_24979018646,"Sevelamer Carbonate: 270 Tablet, Film Coated In 1 Bottle (24979-186-46)",1.67,0.67,,,0 CDM,6370000001_25021046705,Octreotide Acetate: 1 Vial In 1 Carton (25021-467-05) / 5 Ml In 1 Vial,2.05,0.82,,,0 CDM,6370000001_25021060103,Caffeine Citrate: 1 Vial In 1 Carton (25021-601-03) / 3 Ml In 1 Vial,17.09,6.84,,,0 CDM,6370000001_25866059361,NDC Description Not Available,73.6,29.44,,,0 CDM,6370000001_27241006303,"Voriconazole: 30 Tablet, Film Coated In 1 Bottle (27241-063-03)",21.54,8.62,,,0 CDM,6370000001_27241015504,"Oxybutynin Chloride: 100 Tablet, Extended Release In 1 Bottle (27241-155-04)",0.85,0.34,,,0 CDM,6370000001_27241016201,Captopril: 100 Tablet In 1 Bottle (27241-162-01),0.35,0.14,,,0 CDM,6370000001_27241017356,"Varenicline: 56 Tablet, Film Coated In 1 Bottle (27241-173-56)",2.97,1.19,,,0 CDM,6370000001_27241017529,Sildenafil: 1 Pouch In 1 Carton (27241-175-29) / 1 Bottle In 1 Pouch / 112 Ml In 1 Bottle,6.54,2.62,,,0 CDM,6370000001_27241024949,Famotidine: 50 Ml In 1 Bottle (27241-249-49),2.95,1.18,,,0 CDM,6370000001_27808008202,"Morphine Sulfate: 1 Bottle, Unit-Dose In 1 Carton (27808-082-02) / 120 Ml In 1 Bottle, Unit-Dose",1.51,0.6,,,0 CDM,6370000001_27808009201,Dexmethylphenidate Hydrochloride: 100 Tablet In 1 Bottle (27808-092-01),1.19,0.48,,,0 CDM,6370000001_27808015501,"Rosuvastatin Calcium: 90 Tablet, Film Coated In 1 Bottle (27808-155-01)",0.49,0.2,,,0 CDM,6370000001_27808022301,"Paliperidone: 30 Tablet, Extended Release In 1 Bottle (27808-223-01)",9.31,3.72,,,0 CDM,6370000001_29300013601,"Clonidine Hydrochloride: 100 Tablet In 1 Bottle, Plastic (29300-136-01)",0.07,0.03,,,0 CDM,6370000001_29300014901,"Quetiapine Fumarate: 100 Tablet, Film Coated In 1 Bottle, Plastic (29300-149-01)",0.48,0.19,,,0 CDM,6370000001_29300035501,"Tramadol Hydrochloride: 100 Tablet, Film Coated In 1 Bottle, Plastic (29300-355-01)",0.14,0.06,,,0 CDM,6370000001_31722000631,"Itraconazole: 1 Bottle, Glass In 1 Carton (31722-006-31) / 150 Ml In 1 Bottle, Glass",126.6,50.64,,,0 CDM,6370000001_31722013747,NDC Description Not Available,3.64,1.46,,,0 CDM,6370000001_31722023001,"Dexmethylphenidate Hydrochloride: 100 Capsule, Extended Release In 1 Bottle (31722-230-01)",3.21,1.28,,,0 CDM,6370000001_31722051901,Hydralazine Hydrochloride: 100 Tablet In 1 Bottle (31722-519-01),0.68,0.27,,,0 CDM,6370000001_31722052001,Hydralazine Hydrochloride: 100 Tablet In 1 Bottle (31722-520-01),0.2,0.08,,,0 CDM,6370000001_31722052101,Hydralazine Hydrochloride: 100 Tablet In 1 Bottle (31722-521-01),0.75,0.3,,,0 CDM,6370000001_31722053530,"Tenofovir Disoproxil Fumarate: 30 Tablet, Film Coated In 1 Bottle (31722-535-30)",4.32,1.73,,,0 CDM,6370000001_31722053712,"Levetiracetam: 120 Tablet, Film Coated In 1 Bottle (31722-537-12)",0.74,0.3,,,0 CDM,6370000001_31722056224,Abacavir: 240 Ml In 1 Bottle (31722-562-24),2.29,0.92,,,0 CDM,6370000001_31722056560,"Indomethacin: 60 Capsule, Extended Release In 1 Bottle (31722-565-60)",3.8,1.52,,,0 CDM,6370000001_31722057447,Levetiracetam: 473 Ml In 1 Bottle (31722-574-47),4.77,1.91,,,0 CDM,6370000001_31722059730,Ritonavir: 30 Tablet In 1 Bottle (31722-597-30),11.66,4.66,,,0 CDM,6370000001_31722062705,NDC Description Not Available,11.99,4.8,,,0 CDM,6370000001_31722062726,Lacosamide: 1 Bottle In 1 Carton (31722-627-26) / 200 Ml In 1 Bottle,13.83,5.53,,,0 CDM,6370000001_31722062921,Atovaquone: 1 Bottle In 1 Carton (31722-629-21) / 210 Ml In 1 Bottle,34.66,13.86,,,0 CDM,6370000001_31722063630,Silodosin: 30 Capsule In 1 Bottle (31722-636-30),4.28,1.71,,,0 CDM,6370000001_31722064630,"Tadalafil: 30 Tablet, Film Coated In 1 Bottle (31722-646-30)",0.98,0.39,,,0 CDM,6370000001_31722066860,"Ranolazine: 60 Tablet, Film Coated, Extended Release In 1 Bottle (31722-668-60)",0.97,0.39,,,0 CDM,6370000001_31722066960,"Ranolazine: 60 Tablet, Film Coated, Extended Release In 1 Bottle (31722-669-60)",1.41,0.56,,,0 CDM,6370000001_31722081930,Aripiprazole: 30 Tablet In 1 Bottle (31722-819-30),1.12,0.45,,,0 CDM,6370000001_31722082111,"Tetrabenazine: 112 Tablet, Coated In 1 Bottle (31722-821-11)",11.46,4.58,,,0 CDM,6370000001_31722083260,"Valganciclovir: 60 Tablet, Film Coated In 1 Bottle (31722-832-60)",11.83,4.73,,,0 CDM,6370000001_31722083330,Entecavir: 30 Tablet In 1 Bottle (31722-833-30),3.98,1.59,,,0 CDM,6370000001_31722083430,Entecavir: 30 Tablet In 1 Bottle (31722-834-30),3.83,1.53,,,0 CDM,6370000001_31722086525,"Linezolid: 1 Bottle, Glass In 1 Carton (31722-865-25) / 150 Ml In 1 Bottle, Glass",199.79,79.92,,,0 CDM,6370000001_31722086831,NDC Description Not Available,144.78,57.91,,,0 CDM,6370000001_31722095201,"Methylphenidate Hydrochloride: 100 Tablet, Extended Release In 1 Bottle (31722-952-01)",2.18,0.87,,,0 CDM,6370000001_33342000109,"Lamivudine: 60 Tablet, Film Coated In 1 Bottle (33342-001-09)",2.49,1.0,,,0 CDM,6370000001_33342009607,"Tenofovir Disoproxil Fumarate: 30 Tablet, Film Coated In 1 Bottle (33342-096-07)",1.62,0.65,,,0 CDM,6370000001_33342009809,"Tolterodine Tartrate: 60 Tablet, Film Coated In 1 Bottle (33342-098-09)",0.82,0.33,,,0 CDM,6370000001_33342011607,Candesartan: 30 Tablet In 1 Container (33342-116-07),3.1,1.24,,,0 CDM,6370000001_33342021558,"Sevelamer Carbonate: 270 Tablet, Film Coated In 1 Bottle (33342-215-58)",0.56,0.22,,,0 CDM,6370000001_33342027407,Febuxostat: 30 Film In 1 Bottle (33342-274-07),1.6,0.64,,,0 CDM,6370000001_33342032980,Triamcinolone Acetonide: 1 Tube In 1 Carton (33342-329-80) / 80 G In 1 Tube,27.6,11.04,,,0 CDM,6370000001_33342033354,Triamcinolone Acetonide: 454 G In 1 Jar (33342-333-54),75.74,30.3,,,0 CDM,6370000001_35573043330,Ketoconazole: 30 Tablet In 1 Bottle (35573-433-30),3.16,1.26,,,0 CDM,6370000001_37000002404,Metamucil Therapy For Regularity: 30 Packet In 1 Carton (37000-024-04) / 5.8 G In 1 Packet,1.37,0.55,,,0 CDM,6370000001_37000002410,Metamucil Therapy For Regularity: 5.8 G In 1 Packet (37000-024-10),1.55,0.62,,,0 CDM,6370000001_38779000904,Hydrocortisone: 25 G In 1 Jar (38779-0009-4),3.51,1.4,,,0 CDM,6370000001_38779051008,NDC Description Not Available,0.04,0.02,,,0 CDM,6370000001_38779094908,NDC Description Not Available,4.01,1.6,,,0 CDM,6370000001_38779104605,NDC Description Not Available,164.19,65.68,,,0 CDM,6370000001_38779177908,NDC Description Not Available,8.59,3.44,,,0 CDM,6370000001_38779298501,NDC Description Not Available,0.5,0.2,,,0 CDM,6370000001_39328006250,NDC Description Not Available,35.48,14.19,,,0 CDM,6370000001_39328006325,NDC Description Not Available,35.91,14.36,,,0 CDM,6370000001_39328006412,NDC Description Not Available,23.65,9.46,,,0 CDM,6370000001_39328006712,NDC Description Not Available,76.86,30.74,,,0 CDM,6370000001_39328010710,NDC Description Not Available,0.97,0.39,,,0 CDM,6370000001_39328015705,NDC Description Not Available,6.09,2.44,,,0 CDM,6370000001_39328051150,"Levetiracetam: 5 Tray In 1 Case (39328-511-50) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose",12.21,4.88,,,0 CDM,6370000001_39328053016,"Amantadine Hydrochloride: 473 Ml In 1 Bottle, Plastic (39328-530-16)",1.43,0.57,,,0 CDM,6370000001_39328055750,NDC Description Not Available,0.13,0.05,,,0 CDM,6370000001_39822031005,"Neomycin Sulfate: 100 Blister Pack In 1 Box, Unit-Dose (39822-0310-5) / 1 Tablet In 1 Blister Pack (39822-0310-7)",4.15,1.66,,,0 CDM,6370000001_39822990001,Ammonia Inhalants: 10 AMPULE in 1 CARTON (39822-9900-1) / .3 mL in 1 AMPULE,1.62,0.65,,,0 CDM,6370000001_40093010116,NDC Description Not Available,0.12,0.05,,,0 CDM,6370000001_40565012249,NDC Description Not Available,256.56,102.62,,,0 CDM,6370000001_40565012255,NDC Description Not Available,70.52,28.21,,,0 CDM,6370000001_40565012256,NDC Description Not Available,70.52,28.21,,,0 CDM,6370000001_40985022368,NDC Description Not Available,0.11,0.04,,,0 CDM,6370000001_40985022928,NDC Description Not Available,0.13,0.05,,,0 CDM,6370000001_40985027435,NDC Description Not Available,0.6,0.24,,,0 CDM,6370000001_41100081122,NDC Description Not Available,3.16,1.26,,,0 CDM,6370000001_41100081123,NDC Description Not Available,18.3,7.32,,,0 CDM,6370000001_41100081125,NDC Description Not Available,23.46,9.38,,,0 CDM,6370000001_41167000362,NDC Description Not Available,11.2,4.48,,,0 CDM,6370000001_41167000623,NDC Description Not Available,0.42,0.17,,,0 CDM,6370000001_41167005723,NDC Description Not Available,14.28,5.71,,,0 CDM,6370000001_41167005743,NDC Description Not Available,36.6,14.64,,,0 CDM,6370000001_42037010479,NDC Description Not Available,19.4,7.76,,,0 CDM,6370000001_42192034001,Hyoscyamine Sulfate Tab: 100 Tablet In 1 Bottle (42192-340-01),1.35,0.54,,,0 CDM,6370000001_42192060816,Gabapentin: 470 Ml In 1 Bottle (42192-608-16),0.47,0.19,,,0 CDM,6370000001_42192061916,Naproxen: 473 Ml In 1 Bottle (42192-619-16),4.25,1.7,,,0 CDM,6370000001_42195012814,"Ciprofloxacin And Fluocinolone Acetonide: 1 Pouch In 1 Carton (42195-128-14) / 14 Vial, Single-Dose In 1 Pouch / .25 Ml In 1 Vial, Single-Dose",63.67,25.47,,,0 CDM,6370000001_42292003801,NDC Description Not Available,2.37,0.95,,,0 CDM,6370000001_42292003820,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (42292-038-20) / 1 Tablet In 1 Blister Pack (42292-038-01),2.19,0.88,,,0 CDM,6370000001_42292003901,NDC Description Not Available,2.8,1.12,,,0 CDM,6370000001_42292003920,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (42292-039-20) / 1 Tablet In 1 Blister Pack (42292-039-01),2.54,1.02,,,0 CDM,6370000001_42292004101,NDC Description Not Available,2.77,1.11,,,0 CDM,6370000001_42292004120,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (42292-041-20) / 1 Tablet In 1 Blister Pack (42292-041-01),1.79,0.72,,,0 CDM,6370000001_42385095330,"Emtricitabine And Tenofovir Disoproxil Fumarate: 30 Tablet, Film Coated In 1 Bottle (42385-953-30)",2.78,1.11,,,0 CDM,6370000001_42571016142,"Amoxicillin And Clavulanate Potassium: 20 Tablet, Film Coated In 1 Bottle (42571-161-42)",2.19,0.88,,,0 CDM,6370000001_42571024301,Acetazolamide Extended-Release: 100 Capsule In 1 Bottle (42571-243-01),2.25,0.9,,,0 CDM,6370000001_42571025930,Roflumilast: 30 Tablet In 1 Bottle (42571-259-30),4.3,1.72,,,0 CDM,6370000001_42571027560,"Dalfampridine: 60 Tablet, Extended Release In 1 Bottle (42571-275-60)",1.77,0.71,,,0 CDM,6370000001_42571034230,Clomipramine Hydrochloride: 30 Capsule In 1 Bottle (42571-342-30),1.43,0.57,,,0 CDM,6370000001_42571035707,Potassium Chloride: 473 Ml In 1 Bottle (42571-357-07),3.43,1.37,,,0 CDM,6370000001_42799011002,Albendazole: 2 Tablet In 1 Bottle (42799-110-02),417.29,166.92,,,0 CDM,6370000001_42799080601,Ivermectin: 2 Blister Pack In 1 Carton (42799-806-01) / 10 Tablet In 1 Blister Pack,10.96,4.38,,,0 CDM,6370000001_42806001101,Sulindac: 100 Tablet In 1 Bottle (42806-011-01),0.92,0.37,,,0 CDM,6370000001_42806015134,"Azithromycin: 30 Ml In 1 Bottle, Plastic (42806-151-34)",3.29,1.32,,,0 CDM,6370000001_42806031205,"Doxycycline Hyclate: 500 Tablet, Film Coated In 1 Bottle (42806-312-05)",0.87,0.35,,,0 CDM,6370000001_42806035801,Leucovorin Calcium: 100 Tablet In 1 Bottle (42806-358-01),3.65,1.46,,,0 CDM,6370000001_42806035830,Leucovorin Calcium: 30 Tablet In 1 Bottle (42806-358-30),3.95,1.58,,,0 CDM,6370000001_42806050109,Nicardipine Hydrochloride: 90 Capsule In 1 Bottle (42806-501-09),6.29,2.52,,,0 CDM,6370000001_42806050301,Ursodiol: 100 Capsule In 1 Bottle (42806-503-01),3.44,1.38,,,0 CDM,6370000001_42806051230,Quinidine Sulfate: 30 Tablet In 1 Bottle (42806-512-30),36.55,14.62,,,0 CDM,6370000001_42806051330,Quinidine Sulfate: 30 Tablet In 1 Bottle (42806-513-30),32.26,12.9,,,0 CDM,6370000001_42806065830,"Entecavir: 30 Tablet In 1 Bottle, Plastic (42806-658-30)",0.82,0.33,,,0 CDM,6370000001_42806065930,"Entecavir: 30 Tablet In 1 Bottle, Plastic (42806-659-30)",1.3,0.52,,,0 CDM,6370000001_42806075760,Sulfadiazine: 60 Tablet In 1 Bottle (42806-757-60),69.08,27.63,,,0 CDM,6370000001_42858000110,Oxycodone Hydrochloride: 10 Blister Pack In 1 Carton (42858-001-10) / 10 Tablet In 1 Blister Pack,1.33,0.53,,,0 CDM,6370000001_42858000210,Oxycodone Hydrochloride: 10 Blister Pack In 1 Carton (42858-002-10) / 10 Tablet In 1 Blister Pack,1.72,0.69,,,0 CDM,6370000001_42858030101,"Hydromorphone Hydrochloride: 100 Tablet In 1 Bottle, Plastic (42858-301-01)",0.64,0.26,,,0 CDM,6370000001_42858030125,Hydromorphone Hydrochloride: 4 Blister Pack In 1 Carton (42858-301-25) / 25 Tablet In 1 Blister Pack,0.44,0.18,,,0 CDM,6370000001_42858030201,"Hydromorphone Hydrochloride: 100 Tablet In 1 Bottle, Plastic (42858-302-01)",0.67,0.27,,,0 CDM,6370000001_42858030225,Hydromorphone Hydrochloride: 4 Blister Pack In 1 Carton (42858-302-25) / 25 Tablet In 1 Blister Pack,0.6,0.24,,,0 CDM,6370000001_42858051501,"Ms Contin: 100 Tablet In 1 Bottle, Plastic (42858-515-01)",14.72,5.89,,,0 CDM,6370000001_42858061001,"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, And Amphetamine Sulfate Extended-Release: 100 Capsule, Extended Release In 1 Bottle, Plastic (42858-610-01)",1.83,0.73,,,0 CDM,6370000001_42858080101,"Morphine Sulfate Extended Release: 100 Tablet, Film Coated, Extended Release In 1 Bottle, Plastic (42858-801-01)",0.7,0.28,,,0 CDM,6370000001_43386003860,Voriconazole: 1 Bottle In 1 Carton (43386-038-60) / 75 Ml In 1 Bottle,270.34,108.14,,,0 CDM,6370000001_43386005019,Gavilyte-N: 438.4 G In 1 Bottle (43386-050-19),38.48,15.39,,,0 CDM,6370000001_43386016101,Misoprostol: 100 Tablet In 1 Bottle (43386-161-01),4.13,1.65,,,0 CDM,6370000001_43386048024,"Orphenadrine Citrate: 100 Tablet, Extended Release In 1 Bottle (43386-480-24)",1.33,0.53,,,0 CDM,6370000001_43386077001,Flucytosine: 100 Capsule In 1 Bottle (43386-770-01),83.27,33.31,,,0 CDM,6370000001_43547005103,Tadalafil: 30 Tablet In 1 Bottle (43547-051-03),1.18,0.47,,,0 CDM,6370000001_43547026910,"Ropinirole Hydrochloride: 100 Tablet, Film Coated In 1 Bottle, Plastic (43547-269-10)",0.35,0.14,,,0 CDM,6370000001_43547027010,"Ropinirole Hydrochloride: 100 Tablet, Film Coated In 1 Bottle, Plastic (43547-270-10)",0.42,0.17,,,0 CDM,6370000001_43547028910,"Bupropion Hydrochloride Sr: 100 Tablet, Film Coated, Extended Release In 1 Bottle (43547-289-10)",0.75,0.3,,,0 CDM,6370000001_43547034506,"Levetiracetam: 60 Tablet, Film Coated, Extended Release In 1 Bottle (43547-345-06)",1.27,0.51,,,0 CDM,6370000001_43547034903,"Paroxetine: 30 Tablet, Film Coated In 1 Bottle (43547-349-03)",1.17,0.47,,,0 CDM,6370000001_43547038709,Fosinopril Sodium: 90 Tablet In 1 Bottle (43547-387-09),0.64,0.26,,,0 CDM,6370000001_43547039910,"Cyclobenzaprine Hydrochloride: 100 Tablet, Film Coated In 1 Bottle, Plastic (43547-399-10)",0.18,0.07,,,0 CDM,6370000001_43547040010,"Cyclobenzaprine Hydrochloride: 100 Tablet, Film Coated In 1 Bottle, Plastic (43547-400-10)",0.24,0.1,,,0 CDM,6370000001_43547040110,"Furosemide: 100 Tablet In 1 Bottle, Plastic (43547-401-10)",0.13,0.05,,,0 CDM,6370000001_43547040210,"Furosemide: 100 Tablet In 1 Bottle, Plastic (43547-402-10)",0.14,0.06,,,0 CDM,6370000001_43547040310,"Furosemide: 100 Tablet In 1 Bottle, Plastic (43547-403-10)",0.22,0.09,,,0 CDM,6370000001_43547040610,"Clonazepam: 100 Tablet In 1 Bottle, Plastic (43547-406-10)",0.17,0.07,,,0 CDM,6370000001_43547043506,"Clonidine Hydrochloride: 60 Tablet, Extended Release In 1 Bottle (43547-435-06)",9.75,3.9,,,0 CDM,6370000001_43547052503,Nebivolol: 30 Tablet In 1 Bottle (43547-525-03),0.66,0.26,,,0 CDM,6370000001_43547060510,Lisdexamfetamine Dimesylate: 100 Capsule In 1 Bottle (43547-605-10),3.18,1.27,,,0 CDM,6370000001_43598016360,"Lubiprostone: 60 Capsule, Gelatin Coated In 1 Bottle (43598-163-60)",7.43,2.97,,,0 CDM,6370000001_43598021050,Ssd Cream: 50 G In 1 Tube (43598-210-50),47.38,18.95,,,0 CDM,6370000001_43598035130,"Lurasidone Hydrochloride: 30 Tablet, Film Coated In 1 Bottle (43598-351-30)",2.53,1.01,,,0 CDM,6370000001_43598043635,NDC Description Not Available,36.98,14.79,,,0 CDM,6370000001_43598044674,Nicotine Transdermal System Step 3: 14 Patch In 1 Carton (43598-446-74) / 24 H In 1 Patch,5.41,2.16,,,0 CDM,6370000001_43598044774,Nicotine Transdermal System Step 2: 14 Patch In 1 Carton (43598-447-74) / 24 H In 1 Patch,5.41,2.16,,,0 CDM,6370000001_43598044870,Nicotine Transdermal System Step 1: 7 Patch In 1 Carton (43598-448-70) / 24 H In 1 Patch,6.39,2.56,,,0 CDM,6370000001_43598044874,Nicotine Transdermal System Step 1: 14 Patch In 1 Carton (43598-448-74) / 24 H In 1 Patch,5.41,2.16,,,0 CDM,6370000001_43598058201,NDC Description Not Available,15.08,6.03,,,0 CDM,6370000001_43598058230,"Buprenorphine And Naloxone: 30 Pouch In 1 Carton (43598-582-30) / 1 Film, Soluble In 1 Pouch (43598-582-01)",15.07,6.03,,,0 CDM,6370000001_43598067201,"Pyrimethamine: 100 Tablet In 1 Bottle, Plastic (43598-672-01)",1062.83,425.13,,,0 CDM,6370000001_43598074811,Timolol Maleate Ophthalmic Gel Forming Solution 0.5%: 1 Bottle In 1 Carton (43598-748-11) / 5 Ml In 1 Bottle,553.09,221.24,,,0 CDM,6370000001_43598089152,"Potassium Chloride: 50 Cup, Unit-Dose In 1 Package (43598-891-52) / 15 Ml In 1 Cup, Unit-Dose (43598-891-16)",12.01,4.8,,,0 CDM,6370000001_43900097647,NDC Description Not Available,1.52,0.61,,,0 CDM,6370000001_43975035003,"Paliperidone: 30 Tablet, Extended Release In 1 Bottle (43975-350-03)",9.34,3.74,,,0 CDM,6370000001_44677010202,NDC Description Not Available,6.64,2.66,,,0 CDM,6370000001_45802004064,Selenium Sulfide: 118 Ml In 1 Bottle (45802-040-64),22.61,9.04,,,0 CDM,6370000001_45802004611,Gentamicin Sulfate: 1 Tube In 1 Carton (45802-046-11) / 30 G In 1 Tube,345.28,138.11,,,0 CDM,6370000001_45802004635,Gentamicin Sulfate: 1 Tube In 1 Carton (45802-046-35) / 15 G In 1 Tube,118.49,47.4,,,0 CDM,6370000001_45802005535,Triamcinolone Acetonide: 1 Tube In 1 Carton (45802-055-35) / 15 G In 1 Tube,13.55,5.42,,,0 CDM,6370000001_45802005635,Gentamicin Sulfate: 1 Tube In 1 Carton (45802-056-35) / 15 G In 1 Tube,120.04,48.02,,,0 CDM,6370000001_45802005911,Nystatin: 1 Tube In 1 Carton (45802-059-11) / 30 G In 1 Tube,60.54,24.22,,,0 CDM,6370000001_45802006001,Bacitracin: 1 Tube In 1 Carton (45802-060-01) / 14 G In 1 Tube,3.03,1.21,,,0 CDM,6370000001_45802006003,Bacitracin: 1 Tube In 1 Carton (45802-060-03) / 28 G In 1 Tube,7.32,2.93,,,0 CDM,6370000001_45802006070,Bacitracin: 144 Packet In 1 Carton (45802-060-70) / .9 G In 1 Packet,0.4,0.16,,,0 CDM,6370000001_45802006435,Triamcinolone Acetonide: 1 Tube In 1 Carton (45802-064-35) / 15 G In 1 Tube,9.72,3.89,,,0 CDM,6370000001_45802006436,Triamcinolone Acetonide: 1 Tube In 1 Carton (45802-064-36) / 80 G In 1 Tube,33.86,13.54,,,0 CDM,6370000001_45802006535,Triamcinolone Acetonide: 1 Tube In 1 Carton (45802-065-35) / 15 G In 1 Tube,24.57,9.83,,,0 CDM,6370000001_45802009846,Mesalamine: 60 Ml In 1 Bottle (45802-098-46),22.32,8.93,,,0 CDM,6370000001_45802011222,Mupirocin: 1 Tube In 1 Carton (45802-112-22) / 22 G In 1 Tube,27.0,10.8,,,0 CDM,6370000001_45802014303,Triple Antibiotic: 1 Tube In 1 Carton (45802-143-03) / 28 G In 1 Tube,4.71,1.88,,,0 CDM,6370000001_45802016000,Diclofenac Sodium: 1 Tube In 1 Carton (45802-160-00) / 100 G In 1 Tube,189.06,75.62,,,0 CDM,6370000001_45802018816,Hemorrhoidal: 1 Tube In 1 Carton (45802-188-16) / 57 G In 1 Tube,4.68,1.87,,,0 CDM,6370000001_45802027603,Hydrocortisone: 1 Tube In 1 Carton (45802-276-03) / 28 G In 1 Tube,5.89,2.36,,,0 CDM,6370000001_45802036862,Imiquimod: 24 Packet In 1 Carton (45802-368-62) / .25 G In 1 Packet,0.71,0.28,,,0 CDM,6370000001_45802041059,"Oxymetazoline Hcl: 1 Bottle, Spray In 1 Carton (45802-410-59) / 30 Ml In 1 Bottle, Spray",5.88,2.35,,,0 CDM,6370000001_45802041954,"Ammonium Lactate: 225 G In 1 Bottle, Plastic (45802-419-54)",37.35,14.94,,,0 CDM,6370000001_45802043805,Hydrocortisone: 454 G In 1 Jar (45802-438-05),120.35,48.14,,,0 CDM,6370000001_45802046564,Ketoconazole: 120 Ml In 1 Bottle (45802-465-64),35.51,14.2,,,0 CDM,6370000001_45802071700,NDC Description Not Available,118.93,47.57,,,0 CDM,6370000001_45802071708,Terconazole: 3 Blister Pack In 1 Carton (45802-717-08) / 1 Suppository In 1 Blister Pack (45802-717-00),118.93,47.57,,,0 CDM,6370000001_45802073000,Acetaminophen Pain Reliever Fever Reducer: 1 Suppository In 1 Blister Pack (45802-730-00),0.64,0.26,,,0 CDM,6370000001_45802073030,Acetaminophen Pain Reliever Fever Reducer: 12 Blister Pack In 1 Carton (45802-730-30) / 1 Suppository In 1 Blister Pack,1.07,0.43,,,0 CDM,6370000001_45802073200,NDC Description Not Available,0.81,0.32,,,0 CDM,6370000001_45802073230,Acetaminophen For Children: 12 Blister Pack In 1 Carton (45802-732-30) / 1 Suppository In 1 Blister Pack,0.84,0.34,,,0 CDM,6370000001_45802091987,"Cetirizine Hydrochloride: 1 Bottle In 1 Carton (45802-919-87) / 300 Tablet, Film Coated In 1 Bottle",0.23,0.09,,,0 CDM,6370000001_45802093716,Hydrocortisone: 59 Ml In 1 Bottle (45802-937-16),96.26,38.5,,,0 CDM,6370000001_45802095243,Ibuprofen: 473 Ml In 1 Bottle (45802-952-43),3.91,1.56,,,0 CDM,6370000001_45802095301,Diclofenac Sodium: 1 Tube In 1 Carton (45802-953-01) / 100 G In 1 Tube,38.81,15.52,,,0 CDM,6370000001_45963041806,"Ranolazine: 60 Tablet, Film Coated, Extended Release In 1 Bottle (45963-418-06)",4.27,1.71,,,0 CDM,6370000001_45963041906,"Ranolazine: 60 Tablet, Film Coated, Extended Release In 1 Bottle (45963-419-06)",7.14,2.86,,,0 CDM,6370000001_45963043965,Constulose: 946 Ml In 1 Bottle (45963-439-65),20.7,8.28,,,0 CDM,6370000001_46122016510,"Good Neighbor Pharmacy Nasal: 1 Bottle, Spray In 1 Carton (46122-165-10) / 30 Ml In 1 Bottle, Spray",2.16,0.86,,,0 CDM,6370000001_46122027830,"Sore Throat Menthol: 177 Ml In 1 Bottle, Spray (46122-278-30)",3.54,1.42,,,0 CDM,6370000001_46122039516,"Mineral Oil: 473 Ml In 1 Bottle, Plastic (46122-395-16)",1.09,0.44,,,0 CDM,6370000001_46122046143,Epsom Salt: 454 G In 1 Pouch (46122-461-43),8.18,3.27,,,0 CDM,6370000001_46122074876,"Good Neighbor Sore Throat Cherry Flavor: 177 Ml In 1 Bottle, Spray (46122-748-76)",3.19,1.28,,,0 CDM,6370000001_46122075237,Arthritis Pain Reliever: 1 Tube In 1 Carton (46122-752-37) / 50 G In 1 Tube,20.01,8.0,,,0 CDM,6370000001_46287000601,Sodium Polystyrene Sulfonate: 473 Ml In 1 Bottle (46287-006-01),121.79,48.72,,,0 CDM,6370000001_46287000660,"Sodium Polystyrene Sulfonate: 10 Bottle, Unit-Dose In 1 Carton (46287-006-60) / 60 Ml In 1 Bottle, Unit-Dose",75.21,30.08,,,0 CDM,6370000001_46287000901,Isoniazid: 473 Ml In 1 Bottle (46287-009-01),176.74,70.7,,,0 CDM,6370000001_46287002001,Carospir: 473 Ml In 1 Bottle (46287-020-01),21.12,8.45,,,0 CDM,6370000001_46287050001,NDC Description Not Available,1.56,0.62,,,0 CDM,6370000001_46287050030,NDC Description Not Available,7.2,2.88,,,0 CDM,6370000001_47335023683,"Ambrisentan: 30 Tablet, Film Coated In 1 Bottle (47335-236-83)",137.56,55.02,,,0 CDM,6370000001_47335023783,"Ambrisentan: 30 Tablet, Film Coated In 1 Bottle (47335-237-83)",115.21,46.08,,,0 CDM,6370000001_47335047281,"Imatinib Mesylate: 90 Tablet, Film Coated In 1 Bottle (47335-472-81)",7.02,2.81,,,0 CDM,6370000001_47335048583,"Bicalutamide: 30 Tablet, Film Coated In 1 Bottle (47335-485-83)",1.27,0.51,,,0 CDM,6370000001_47335053981,"Niacin: 90 Tablet, Film Coated, Extended Release In 1 Bottle (47335-539-81)",1.2,0.48,,,0 CDM,6370000001_47335057883,Lurasidone Hydrochloride: 30 Tablet In 1 Bottle (47335-578-83),7.59,3.04,,,0 CDM,6370000001_47335076583,"Paliperidone: 30 Tablet, Extended Release In 1 Bottle (47335-765-83)",6.08,2.43,,,0 CDM,6370000001_47682022335,Triple Antibiotic: 144 Pouch In 1 Box (47682-223-35) / .5 G In 1 Pouch (47682-223-99),0.35,0.14,,,0 CDM,6370000001_47781017401,"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate Tablets,Cii: 100 Tablet In 1 Bottle (47781-174-01)",1.06,0.42,,,0 CDM,6370000001_47781017601,"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate Tablets,Cii: 100 Tablet In 1 Bottle (47781-176-01)",1.07,0.43,,,0 CDM,6370000001_47781035503,Buprenorphine And Naloxone Sublingual Film: 30 Pouch In 1 Carton (47781-355-03) / 1 Film In 1 Pouch (47781-355-11),6.77,2.71,,,0 CDM,6370000001_47781035511,NDC Description Not Available,6.33,2.53,,,0 CDM,6370000001_47781035603,Buprenorphine And Naloxone Sublingual Film: 30 Pouch In 1 Carton (47781-356-03) / 1 Film In 1 Pouch (47781-356-11),18.23,7.29,,,0 CDM,6370000001_47781035611,NDC Description Not Available,15.21,6.08,,,0 CDM,6370000001_47781035703,Buprenorphine And Naloxone Sublingual Film: 30 Pouch In 1 Carton (47781-357-03) / 1 Film In 1 Pouch (47781-357-11),19.11,7.64,,,0 CDM,6370000001_47781035711,NDC Description Not Available,10.59,4.24,,,0 CDM,6370000001_47781038426,"Oseltamivir Phosphate For Oral Suspension: 1 Bottle, Glass In 1 Carton (47781-384-26) / 60 Ml In 1 Bottle, Glass",65.77,26.31,,,0 CDM,6370000001_47781042411,NDC Description Not Available,21.39,8.56,,,0 CDM,6370000001_47781042447,Fentanyl System: 5 Pouch In 1 Carton (47781-424-47) / 1 Patch In 1 Pouch (47781-424-11),16.96,6.78,,,0 CDM,6370000001_47781042611,NDC Description Not Available,20.35,8.14,,,0 CDM,6370000001_47781042647,Fentanyl System: 5 Pouch In 1 Carton (47781-426-47) / 1 Patch In 1 Pouch (47781-426-11),38.0,15.2,,,0 CDM,6370000001_47781042711,NDC Description Not Available,57.61,23.04,,,0 CDM,6370000001_47781042747,Fentanyl System: 5 Pouch In 1 Carton (47781-427-47) / 1 Patch In 1 Pouch (47781-427-11),40.75,16.3,,,0 CDM,6370000001_47781042811,NDC Description Not Available,47.21,18.88,,,0 CDM,6370000001_48433010401,NDC Description Not Available,0.61,0.24,,,0 CDM,6370000001_48433010601,"Calcium Antacid: 100 Tablet, Chewable In 1 Box, Unit-Dose (48433-106-01)",0.48,0.19,,,0 CDM,6370000001_48433012801,NDC Description Not Available,0.58,0.23,,,0 CDM,6370000001_48433020016,NDC Description Not Available,0.79,0.32,,,0 CDM,6370000001_48433020230,"Mineral Oil: 30 Ml In 1 Cup, Unit-Dose (48433-202-30)",4.79,1.92,,,0 CDM,6370000001_48433021105,NDC Description Not Available,4.16,1.66,,,0 CDM,6370000001_48433021501,NDC Description Not Available,0.43,0.17,,,0 CDM,6370000001_48433021905,NDC Description Not Available,6.35,2.54,,,0 CDM,6370000001_48433021940,"Senna Syrup: 40 Cup, Unit-Dose In 1 Box (48433-219-40) / 5 Ml In 1 Cup, Unit-Dose (48433-219-05)",5.04,2.02,,,0 CDM,6370000001_48433023015,Strong Iodine Solution: 14 Ml In 1 Bottle (48433-230-15),74.49,29.8,,,0 CDM,6370000001_48582000440,NDC Description Not Available,1.29,0.52,,,0 CDM,6370000001_48582000592,NDC Description Not Available,2.66,1.06,,,0 CDM,6370000001_48648023000,NDC Description Not Available,1.16,0.46,,,0 CDM,6370000001_49100040008,NDC Description Not Available,2.12,0.85,,,0 CDM,6370000001_49100040053,NDC Description Not Available,1.9,0.76,,,0 CDM,6370000001_49452403503,NDC Description Not Available,0.05,0.02,,,0 CDM,6370000001_49483008001,"Senna Time: 100 Tablet, Coated In 1 Bottle, Plastic (49483-080-01)",0.04,0.02,,,0 CDM,6370000001_49483008010,"Senna Time: 1000 Tablet, Coated In 1 Bottle, Plastic (49483-080-10)",0.03,0.01,,,0 CDM,6370000001_49483034150,"Acetaminophen Extra Strength: 500 Tablet, Film Coated In 1 Bottle, Plastic (49483-341-50)",0.1,0.04,,,0 CDM,6370000001_49483060250,"Ibuprofen: 500 Tablet, Film Coated In 1 Bottle (49483-602-50)",0.14,0.06,,,0 CDM,6370000001_49483060350,"Ibuprofen: 500 Tablet, Film Coated In 1 Bottle (49483-603-50)",0.2,0.08,,,0 CDM,6370000001_49483060601,Gabapentin: 100 Capsule In 1 Bottle (49483-606-01),0.26,0.1,,,0 CDM,6370000001_49580033406,Mineral Oil: 473 Ml In 1 Bottle (49580-0334-6),0.72,0.29,,,0 CDM,6370000001_49702022248,Ziagen: 1 Bottle In 1 Carton (49702-222-48) / 240 Ml In 1 Bottle,2.64,1.06,,,0 CDM,6370000001_49702022813,"Tivicay: 30 Tablet, Film Coated In 1 Bottle (49702-228-13)",222.99,89.2,,,0 CDM,6370000001_49702023113,"Triumeq: 30 Tablet, Film Coated In 1 Bottle (49702-231-13)",367.43,146.97,,,0 CDM,6370000001_49702025018,"Rukobia: 1 Bottle In 1 Carton (49702-250-18) / 60 Tablet, Film Coated, Extended Release In 1 Bottle",647.18,258.87,,,0 CDM,6370000001_49884004801,"Dexmethylphenidate Hydrochloride: 100 Capsule, Extended Release In 1 Bottle (49884-048-01)",3.15,1.26,,,0 CDM,6370000001_49884005501,Imipramine Hydrochloride: 100 Tablet In 1 Bottle (49884-055-01),0.52,0.21,,,0 CDM,6370000001_49884015576,"Varenicline: 56 Tablet, Film Coated In 1 Bottle (49884-155-76)",19.15,7.66,,,0 CDM,6370000001_49884015676,"Varenicline: 56 Tablet, Film Coated In 1 Bottle (49884-156-76)",5.74,2.3,,,0 CDM,6370000001_49884023183,"Praziquantel: 6 Tablet, Film Coated In 1 Bottle (49884-231-83)",150.02,60.01,,,0 CDM,6370000001_49884030602,"Clonazepam: 60 Tablet, Orally Disintegrating In 1 Blister Pack (49884-306-02)",2.83,1.13,,,0 CDM,6370000001_49884030652,NDC Description Not Available,1.38,0.55,,,0 CDM,6370000001_49884031152,NDC Description Not Available,14.8,5.92,,,0 CDM,6370000001_49884031191,"Risperidone: 7 Blister Pack In 1 Carton (49884-311-91) / 4 Tablet, Orally Disintegrating In 1 Blister Pack (49884-311-52)",14.8,5.92,,,0 CDM,6370000001_49884031552,NDC Description Not Available,12.26,4.9,,,0 CDM,6370000001_49884031555,"Risperidone: 5 Blister Pack In 1 Carton (49884-315-55) / 6 Tablet, Orally Disintegrating In 1 Blister Pack",12.35,4.94,,,0 CDM,6370000001_49884031591,"Risperidone: 7 Blister Pack In 1 Carton (49884-315-91) / 4 Tablet, Orally Disintegrating In 1 Blister Pack (49884-315-52)",17.29,6.92,,,0 CDM,6370000001_49884034801,Pimozide: 100 Tablet In 1 Bottle (49884-348-01),7.19,2.88,,,0 CDM,6370000001_49884041301,"Ursodiol: 100 Tablet, Film Coated In 1 Bottle (49884-413-01)",7.71,3.08,,,0 CDM,6370000001_49938010230,Dapsone: 2 Blister Pack In 1 Carton (49938-102-30) / 15 Tablet In 1 Blister Pack,9.84,3.94,,,0 CDM,6370000001_49999018720,NDC Description Not Available,128.8,51.52,,,0 CDM,6370000001_50024043100,NDC Description Not Available,14.99,6.0,,,0 CDM,6370000001_50090084500,Bacitracin: 144 Packet In 1 Carton (50090-0845-0) / .9 G In 1 Packet,0.18,0.07,,,0 CDM,6370000001_50111039801,Hydralazine Hydrochloride: 100 Tablet In 1 Bottle (50111-398-01),0.52,0.21,,,0 CDM,6370000001_50111064802,Fluoxetine: 500 Capsule In 1 Bottle (50111-648-02),0.24,0.1,,,0 CDM,6370000001_50111078710,"Azithromycin: 30 Tablet, Film Coated In 1 Bottle (50111-787-10)",9.01,3.6,,,0 CDM,6370000001_50228017601,"Bupropion Hydrochloride Sr: 100 Tablet, Film Coated, Extended Release In 1 Bottle, Plastic (50228-176-01)",0.21,0.08,,,0 CDM,6370000001_50228037930,Ezetimibe: 30 Tablet In 1 Bottle (50228-379-30),0.26,0.1,,,0 CDM,6370000001_50228045701,Carbidopa And Levodopa: 100 Tablet In 1 Bottle (50228-457-01),0.39,0.16,,,0 CDM,6370000001_50228046501,Nabumetone: 100 Tablet In 1 Bottle (50228-465-01),0.26,0.1,,,0 CDM,6370000001_50242009002,"Zelboraf: 1 Bottle, Plastic In 1 Carton (50242-090-02) / 112 Tablet, Film Coated In 1 Bottle, Plastic",216.97,86.79,,,0 CDM,6370000001_50242086001,"Xofluza: 1 Blister Pack In 1 Carton (50242-860-01) / 1 Tablet, Film Coated In 1 Blister Pack",495.04,198.02,,,0 CDM,6370000001_50242087701,"Xofluza: 1 Blister Pack In 1 Carton (50242-877-01) / 1 Tablet, Film Coated In 1 Blister Pack",502.31,200.92,,,0 CDM,6370000001_50268005011,NDC Description Not Available,5.31,2.12,,,0 CDM,6370000001_50268005015,Acebutolol Hydrochloride: 50 Blister Pack In 1 Box (50268-050-15) / 1 Capsule In 1 Blister Pack (50268-050-11),5.65,2.26,,,0 CDM,6370000001_50268005411,NDC Description Not Available,6.97,2.79,,,0 CDM,6370000001_50268005711,NDC Description Not Available,10.98,4.39,,,0 CDM,6370000001_50268005811,NDC Description Not Available,14.25,5.7,,,0 CDM,6370000001_50268006111,NDC Description Not Available,0.86,0.34,,,0 CDM,6370000001_50268006211,NDC Description Not Available,3.41,1.36,,,0 CDM,6370000001_50268007411,NDC Description Not Available,2.52,1.01,,,0 CDM,6370000001_50268007415,"Azithromycin Dihydrate: 50 Blister Pack In 1 Box (50268-074-15) / 1 Tablet, Film Coated In 1 Blister Pack (50268-074-11)",2.69,1.08,,,0 CDM,6370000001_50268007511,NDC Description Not Available,2.98,1.19,,,0 CDM,6370000001_50268008711,NDC Description Not Available,3.02,1.21,,,0 CDM,6370000001_50268008712,"Aripiprazole: 20 Blister Pack In 1 Box, Unit-Dose (50268-087-12) / 1 Tablet In 1 Blister Pack (50268-087-11)",17.3,6.92,,,0 CDM,6370000001_50268008911,NDC Description Not Available,1.8,0.72,,,0 CDM,6370000001_50268008915,"Aripiprazole: 50 Blister Pack In 1 Box, Unit-Dose (50268-089-15) / 1 Tablet In 1 Blister Pack (50268-089-11)",1.71,0.68,,,0 CDM,6370000001_50268009511,NDC Description Not Available,1.33,0.53,,,0 CDM,6370000001_50268009515,"Atorvastatin Calcium: 50 Blister Pack In 1 Box, Unit-Dose (50268-095-15) / 1 Tablet, Film Coated In 1 Blister Pack (50268-095-11)",1.14,0.46,,,0 CDM,6370000001_50268010611,NDC Description Not Available,1.34,0.54,,,0 CDM,6370000001_50268011011,NDC Description Not Available,1.76,0.7,,,0 CDM,6370000001_50268011015,Benazepril Hydrochloride: 50 Blister Pack In 1 Box (50268-110-15) / 1 Tablet In 1 Blister Pack (50268-110-11),1.28,0.51,,,0 CDM,6370000001_50268011111,NDC Description Not Available,2.19,0.88,,,0 CDM,6370000001_50268011115,Benazepril Hydrochloride: 50 Blister Pack In 1 Box (50268-111-15) / 1 Tablet In 1 Blister Pack (50268-111-11),1.79,0.72,,,0 CDM,6370000001_50268013011,NDC Description Not Available,3.87,1.55,,,0 CDM,6370000001_50268013015,Bumetanide: 50 Blister Pack In 1 Box (50268-130-15) / 1 Tablet In 1 Blister Pack (50268-130-11),4.12,1.65,,,0 CDM,6370000001_50268013111,NDC Description Not Available,3.33,1.33,,,0 CDM,6370000001_50268013115,Bumetanide: 50 Blister Pack In 1 Box (50268-131-15) / 1 Tablet In 1 Blister Pack (50268-131-11),3.77,1.51,,,0 CDM,6370000001_50268013211,NDC Description Not Available,3.71,1.48,,,0 CDM,6370000001_50268013215,Bumetanide: 50 Blister Pack In 1 Box (50268-132-15) / 1 Tablet In 1 Blister Pack (50268-132-11),4.91,1.96,,,0 CDM,6370000001_50268014211,NDC Description Not Available,2.81,1.12,,,0 CDM,6370000001_50268014215,"Bupropion Hydrochloride: 50 Blister Pack In 1 Box, Unit-Dose (50268-142-15) / 1 Tablet, Film Coated In 1 Blister Pack (50268-142-11)",3.44,1.38,,,0 CDM,6370000001_50268015111,NDC Description Not Available,1.3,0.52,,,0 CDM,6370000001_50268015115,Cephalexin: 50 Blister Pack In 1 Box (50268-151-15) / 1 Capsule In 1 Blister Pack (50268-151-11),1.21,0.48,,,0 CDM,6370000001_50268015211,NDC Description Not Available,0.87,0.35,,,0 CDM,6370000001_50268015215,Cephalexin: 50 Blister Pack In 1 Box (50268-152-15) / 1 Capsule In 1 Blister Pack (50268-152-11),1.23,0.49,,,0 CDM,6370000001_50268016811,NDC Description Not Available,3.29,1.32,,,0 CDM,6370000001_50268017311,NDC Description Not Available,1.43,0.57,,,0 CDM,6370000001_50268017315,Clonazepam: 50 Blister Pack In 1 Box (50268-173-15) / 1 Tablet In 1 Blister Pack (50268-173-11),1.91,0.76,,,0 CDM,6370000001_50268017611,NDC Description Not Available,2.88,1.15,,,0 CDM,6370000001_50268017615,"Cilostazol: 50 Blister Pack In 1 Box, Unit-Dose (50268-176-15) / 1 Tablet In 1 Blister Pack (50268-176-11)",3.19,1.28,,,0 CDM,6370000001_50268027911,NDC Description Not Available,10.75,4.3,,,0 CDM,6370000001_50268029511,NDC Description Not Available,10.34,4.14,,,0 CDM,6370000001_50268029711,NDC Description Not Available,3.78,1.51,,,0 CDM,6370000001_50268029715,Vitamin D: 50 Blister Pack In 1 Box (50268-297-15) / 1 Capsule In 1 Blister Pack (50268-297-11),3.99,1.6,,,0 CDM,6370000001_50268029911,NDC Description Not Available,0.42,0.17,,,0 CDM,6370000001_50268029915,"Famotidine: 50 Blister Pack In 1 Box (50268-299-15) / 1 Tablet, Film Coated In 1 Blister Pack (50268-299-11)",0.47,0.19,,,0 CDM,6370000001_50268031411,NDC Description Not Available,1.81,0.72,,,0 CDM,6370000001_50268031415,"Finasteride: 50 Blister Pack In 1 Box (50268-314-15) / 1 Tablet, Film Coated In 1 Blister Pack (50268-314-11)",2.08,0.83,,,0 CDM,6370000001_50268032111,NDC Description Not Available,1.99,0.8,,,0 CDM,6370000001_50268032115,"Flecainide Acetate: 50 Blister Pack In 1 Box, Unit-Dose (50268-321-15) / 1 Tablet In 1 Blister Pack (50268-321-11)",1.76,0.7,,,0 CDM,6370000001_50268033011,NDC Description Not Available,1.96,0.78,,,0 CDM,6370000001_50268033015,"Fludrocortisone Acetate: 50 Blister Pack In 1 Box, Unit-Dose (50268-330-15) / 1 Tablet In 1 Blister Pack (50268-330-11)",2.05,0.82,,,0 CDM,6370000001_50268033911,NDC Description Not Available,7.88,3.15,,,0 CDM,6370000001_50268034611,NDC Description Not Available,4.06,1.62,,,0 CDM,6370000001_50268035011,NDC Description Not Available,0.93,0.37,,,0 CDM,6370000001_50268035911,NDC Description Not Available,1.14,0.46,,,0 CDM,6370000001_50268035915,Glimepiride: 50 Blister Pack In 1 Box (50268-359-15) / 1 Tablet In 1 Blister Pack (50268-359-11),1.41,0.56,,,0 CDM,6370000001_50268036211,NDC Description Not Available,1.77,0.71,,,0 CDM,6370000001_50268039811,NDC Description Not Available,1.31,0.52,,,0 CDM,6370000001_50268039850,Hydroxyzine Pamoate: 50 Blister Pack In 1 Box (50268-398-50) / 1 Capsule In 1 Blister Pack (50268-398-11),1.33,0.53,,,0 CDM,6370000001_50268039911,NDC Description Not Available,0.62,0.25,,,0 CDM,6370000001_50268039950,Hydroxyzine Pamoate: 50 Blister Pack In 1 Box (50268-399-50) / 1 Capsule In 1 Blister Pack (50268-399-11),0.62,0.25,,,0 CDM,6370000001_50268043011,NDC Description Not Available,1.07,0.43,,,0 CDM,6370000001_50268043015,"Indomethacin: 50 Blister Pack In 1 Box, Unit-Dose (50268-430-15) / 1 Capsule In 1 Blister Pack (50268-430-11)",1.08,0.43,,,0 CDM,6370000001_50268044711,NDC Description Not Available,2.82,1.13,,,0 CDM,6370000001_50268044715,"Isosorbide Dinitrate: 50 Blister Pack In 1 Box, Unit-Dose (50268-447-15) / 1 Tablet In 1 Blister Pack (50268-447-11)",2.61,1.04,,,0 CDM,6370000001_50268044811,NDC Description Not Available,2.29,0.92,,,0 CDM,6370000001_50268044911,NDC Description Not Available,2.78,1.11,,,0 CDM,6370000001_50268045011,NDC Description Not Available,9.0,3.6,,,0 CDM,6370000001_50268047011,NDC Description Not Available,18.15,7.26,,,0 CDM,6370000001_50268047611,NDC Description Not Available,1.16,0.46,,,0 CDM,6370000001_50268047615,Letrozole: 50 Blister Pack In 1 Box (50268-476-15) / 1 Tablet In 1 Blister Pack (50268-476-11),1.68,0.67,,,0 CDM,6370000001_50268048211,NDC Description Not Available,3.38,1.35,,,0 CDM,6370000001_50268050511,NDC Description Not Available,1.05,0.42,,,0 CDM,6370000001_50268050515,"Losortan Potassium: 50 Blister Pack In 1 Box (50268-505-15) / 1 Tablet, Film Coated In 1 Blister Pack (50268-505-11)",1.11,0.44,,,0 CDM,6370000001_50268052211,NDC Description Not Available,1.42,0.57,,,0 CDM,6370000001_50268052215,"Meclizine Hydrochloride: 50 Blister Pack In 1 Box, Unit-Dose (50268-522-15) / 1 Tablet In 1 Blister Pack (50268-522-11)",1.58,0.63,,,0 CDM,6370000001_50268052411,NDC Description Not Available,0.33,0.13,,,0 CDM,6370000001_50268052415,NDC Description Not Available,0.35,0.14,,,0 CDM,6370000001_50268052511,NDC Description Not Available,0.5,0.2,,,0 CDM,6370000001_50268052515,"Meloxicam: 50 Blister Pack In 1 Box, Unit-Dose (50268-525-15) / 1 Tablet In 1 Blister Pack (50268-525-11)",0.48,0.19,,,0 CDM,6370000001_50268053511,NDC Description Not Available,1.84,0.74,,,0 CDM,6370000001_50268053515,Metronidazole: 50 Blister Pack In 1 Box (50268-535-15) / 1 Tablet In 1 Blister Pack (50268-535-11),1.89,0.76,,,0 CDM,6370000001_50268054111,NDC Description Not Available,1.35,0.54,,,0 CDM,6370000001_50268054115,"Metoprolol Succinate: 50 Blister Pack In 1 Box, Unit-Dose (50268-541-15) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack (50268-541-11)",1.49,0.6,,,0 CDM,6370000001_50268054911,NDC Description Not Available,9.03,3.61,,,0 CDM,6370000001_50268055311,NDC Description Not Available,4.98,1.99,,,0 CDM,6370000001_50268056211,NDC Description Not Available,2.09,0.84,,,0 CDM,6370000001_50268056811,NDC Description Not Available,10.85,4.34,,,0 CDM,6370000001_50268056815,Mupirocin: 50 Tube In 1 Box (50268-568-15) / 50 G In 1 Tube (50268-568-11),11.62,4.65,,,0 CDM,6370000001_50268057260,mupirocin: 60 SYRINGE in 1 BOX (50268-572-60) / 1 g in 1 SYRINGE (50268-572-11),12.5,5.0,,,0 CDM,6370000001_50268057311,NDC Description Not Available,3.08,1.23,,,0 CDM,6370000001_50268057411,NDC Description Not Available,2.93,1.17,,,0 CDM,6370000001_50268057415,"Montelukast Sodium: 50 Blister Pack In 1 Box (50268-574-15) / 1 Tablet, Chewable In 1 Blister Pack (50268-574-11)",2.82,1.13,,,0 CDM,6370000001_50268059411,NDC Description Not Available,0.84,0.34,,,0 CDM,6370000001_50268059415,"Naproxen: 50 Blister Pack In 1 Box, Unit-Dose (50268-594-15) / 1 Tablet In 1 Blister Pack (50268-594-11)",0.78,0.31,,,0 CDM,6370000001_50268059711,NDC Description Not Available,3.58,1.43,,,0 CDM,6370000001_50268059715,"Nifedipine Er: 50 Blister Pack In 1 Box, Unit-Dose (50268-597-15) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack (50268-597-11)",3.71,1.48,,,0 CDM,6370000001_50268059911,NDC Description Not Available,8.25,3.3,,,0 CDM,6370000001_50268060411,NDC Description Not Available,1.93,0.77,,,0 CDM,6370000001_50268062511,NDC Description Not Available,6.11,2.44,,,0 CDM,6370000001_50268062515,"Nitrofurantoin (Monohydrate/Macrocrystals): 50 Blister Pack In 1 Box, Unit-Dose (50268-625-15) / 1 Capsule In 1 Blister Pack (50268-625-11)",8.53,3.41,,,0 CDM,6370000001_50268063211,NDC Description Not Available,0.54,0.22,,,0 CDM,6370000001_50268063911,NDC Description Not Available,0.52,0.21,,,0 CDM,6370000001_50268063915,"Pantoprazole Sodium: 50 Blister Pack In 1 Box (50268-639-15) / 1 Tablet, Delayed Release In 1 Blister Pack (50268-639-11)",0.57,0.23,,,0 CDM,6370000001_50268064211,NDC Description Not Available,1.37,0.55,,,0 CDM,6370000001_50268064215,"Paroxetine: 50 Blister Pack In 1 Box, Unit-Dose (50268-642-15) / 1 Tablet, Film Coated In 1 Blister Pack (50268-642-11)",1.38,0.55,,,0 CDM,6370000001_50268066215,Propranolol Hydrochloride: 50 Blister Pack In 1 Box (50268-662-15) / 1 Tablet In 1 Blister Pack (50268-662-11),0.91,0.36,,,0 CDM,6370000001_50268066311,NDC Description Not Available,1.24,0.5,,,0 CDM,6370000001_50268066315,Propranolol Hydrochloride: 50 Blister Pack In 1 Box (50268-663-15) / 1 Tablet In 1 Blister Pack (50268-663-11),1.1,0.44,,,0 CDM,6370000001_50268066511,NDC Description Not Available,1.07,0.43,,,0 CDM,6370000001_50268066515,Pravastatin Sodium: 50 Blister Pack In 1 Box (50268-665-15) / 1 Tablet In 1 Blister Pack (50268-665-11),1.49,0.6,,,0 CDM,6370000001_50268068611,NDC Description Not Available,1.48,0.59,,,0 CDM,6370000001_50268068711,NDC Description Not Available,1.7,0.68,,,0 CDM,6370000001_50268068715,"Primidone: 50 Blister Pack In 1 Box, Unit-Dose (50268-687-15) / 1 Tablet In 1 Blister Pack (50268-687-11)",2.17,0.87,,,0 CDM,6370000001_50268070115,"Propranolol Hydrochloride: 50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-701-15) / 1 TABLET in 1 BLISTER PACK (50268-701-11)",0.76,0.3,,,0 CDM,6370000001_50268071011,NDC Description Not Available,2.17,0.87,,,0 CDM,6370000001_50268071015,"Rosuvastatin: 50 Blister Pack In 1 Box (50268-710-15) / 1 Tablet, Film Coated In 1 Blister Pack (50268-710-11)",2.23,0.89,,,0 CDM,6370000001_50268071711,NDC Description Not Available,4.14,1.66,,,0 CDM,6370000001_50268072211,NDC Description Not Available,4.69,1.88,,,0 CDM,6370000001_50268072811,NDC Description Not Available,0.86,0.34,,,0 CDM,6370000001_50268072815,"Sulfamethoxazole And Trimethoprim: 50 Blister Pack In 1 Box, Unit-Dose (50268-728-15) / 1 Tablet In 1 Blister Pack (50268-728-11)",0.8,0.32,,,0 CDM,6370000001_50268073124,"Senna Syrup: 24 Cup, Unit-Dose In 1 Box (50268-731-24) / 5 Ml In 1 Cup, Unit-Dose (50268-731-11)",4.63,1.85,,,0 CDM,6370000001_50268074011,NDC Description Not Available,0.85,0.34,,,0 CDM,6370000001_50268074015,"Tamsulosin Hydrochloride: 50 Blister Pack In 1 Box, Unit-Dose (50268-740-15) / 1 Capsule In 1 Blister Pack (50268-740-11)",0.8,0.32,,,0 CDM,6370000001_50268074511,NDC Description Not Available,24.1,9.64,,,0 CDM,6370000001_50268075511,NDC Description Not Available,0.98,0.39,,,0 CDM,6370000001_50268075515,"Torsemide: 50 Blister Pack In 1 Box, Unit-Dose (50268-755-15) / 1 Tablet In 1 Blister Pack (50268-755-11)",1.01,0.4,,,0 CDM,6370000001_50268075711,NDC Description Not Available,1.3,0.52,,,0 CDM,6370000001_50268075811,NDC Description Not Available,7.07,2.83,,,0 CDM,6370000001_50268076411,NDC Description Not Available,2.41,0.96,,,0 CDM,6370000001_50268076415,Terazosin: 50 Blister Pack In 1 Box (50268-764-15) / 1 Capsule In 1 Blister Pack (50268-764-11),3.03,1.21,,,0 CDM,6370000001_50268076511,NDC Description Not Available,1.77,0.71,,,0 CDM,6370000001_50268076515,Terazosin: 50 Blister Pack In 1 Box (50268-765-15) / 1 Capsule In 1 Blister Pack (50268-765-11),2.74,1.1,,,0 CDM,6370000001_50268076611,NDC Description Not Available,2.51,1.0,,,0 CDM,6370000001_50268076615,Terazosin: 50 Blister Pack In 1 Box (50268-766-15) / 1 Capsule In 1 Blister Pack (50268-766-11),2.67,1.07,,,0 CDM,6370000001_50268076911,NDC Description Not Available,1.06,0.42,,,0 CDM,6370000001_50268076915,"Sertraline: 50 Blister Pack In 1 Box (50268-769-15) / 1 Tablet, Film Coated In 1 Blister Pack (50268-769-11)",1.61,0.64,,,0 CDM,6370000001_50268077911,NDC Description Not Available,2.46,0.98,,,0 CDM,6370000001_50268077915,Temazepam: 50 Blister Pack In 1 Box (50268-779-15) / 1 Capsule In 1 Blister Pack (50268-779-11),3.34,1.34,,,0 CDM,6370000001_50268079711,NDC Description Not Available,12.41,4.96,,,0 CDM,6370000001_50268081611,NDC Description Not Available,1.49,0.6,,,0 CDM,6370000001_50268081615,Zonisamide: 50 Blister Pack In 1 Box (50268-816-15) / 1 Capsule In 1 Blister Pack (50268-816-11),1.47,0.59,,,0 CDM,6370000001_50268081715,"Venlafaxine Hydrochloride: 50 BLISTER PACK in 1 BOX (50268-817-15) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (50268-817-11)",1.43,0.57,,,0 CDM,6370000001_50268085111,NDC Description Not Available,0.49,0.2,,,0 CDM,6370000001_50268085211,NDC Description Not Available,0.51,0.2,,,0 CDM,6370000001_50268085215,NDC Description Not Available,0.28,0.11,,,0 CDM,6370000001_50268085311,NDC Description Not Available,0.58,0.23,,,0 CDM,6370000001_50268085315,NDC Description Not Available,0.54,0.22,,,0 CDM,6370000001_50268085515,NDC Description Not Available,0.31,0.12,,,0 CDM,6370000001_50268085811,NDC Description Not Available,0.44,0.18,,,0 CDM,6370000001_50268086011,NDC Description Not Available,0.6,0.24,,,0 CDM,6370000001_50268086015,NDC Description Not Available,0.39,0.16,,,0 CDM,6370000001_50268086711,NDC Description Not Available,0.93,0.37,,,0 CDM,6370000001_50268086715,NDC Description Not Available,0.97,0.39,,,0 CDM,6370000001_50268087411,NDC Description Not Available,1.78,0.71,,,0 CDM,6370000001_50383031147,Gabapentin: 470 mL in 1 BOTTLE (50383-311-47),0.54,0.22,,,0 CDM,6370000001_50383062750,NDC Description Not Available,0.08,0.03,,,0 CDM,6370000001_50383062781,NDC Description Not Available,0.06,0.02,,,0 CDM,6370000001_50383077116,Docu Liquid: 473 mL in 1 BOTTLE (50383-771-16),0.06,0.02,,,0 CDM,6370000001_50383077515,NDC Description Not Available,0.71,0.28,,,0 CDM,6370000001_50383080716,Amantadine Hydrochloride: 473 mL in 1 BOTTLE (50383-807-16),0.53,0.21,,,0 CDM,6370000001_50383081016,Acyclovir: 473 mL in 1 BOTTLE (50383-810-16),7.99,3.2,,,0 CDM,6370000001_50383091750,NDC Description Not Available,0.19,0.08,,,0 CDM,6370000001_50419025191,"Adempas: 9 Tablet, Film Coated In 1 Bottle (50419-251-91)",470.34,188.14,,,0 CDM,6370000001_50419025401,"Adempas: 90 Tablet, Film Coated In 1 Bottle (50419-254-01)",470.34,188.14,,,0 CDM,6370000001_50419025491,"Adempas: 9 Tablet, Film Coated In 1 Bottle (50419-254-91)",470.34,188.14,,,0 CDM,6370000001_50419077301,"Cipro: 1 Kit In 1 Kit (50419-773-01) * 100 Ml In 1 Bottle, Glass * 100 Ml In 1 Bottle, Glass",22.03,8.81,,,0 CDM,6370000001_50419077501,NDC Description Not Available,20.91,8.36,,,0 CDM,6370000001_50458009801,"Elmiron: 100 Capsule, Gelatin Coated In 1 Bottle (50458-098-01)",34.63,13.85,,,0 CDM,6370000001_50458030001,"Risperdal: 10 Blister Pack In 1 Box, Unit-Dose (50458-300-01) / 10 Tablet In 1 Blister Pack",21.1,8.44,,,0 CDM,6370000001_50458057501,"Xarelto: 1 Bottle In 1 Carton (50458-575-01) / 1 Granule, For Suspension In 1 Bottle",60.08,24.03,,,0 CDM,6370000001_50458057701,NDC Description Not Available,1860.37,744.15,,,0 CDM,6370000001_50458057710,"Xarelto: 10 Blister Pack In 1 Box, Unit-Dose (50458-577-10) / 10 Tablet, Film Coated In 1 Blister Pack (50458-577-01)",29.91,11.96,,,0 CDM,6370000001_50458057801,NDC Description Not Available,59.8,23.92,,,0 CDM,6370000001_50458057810,"Xarelto: 10 Blister Pack In 1 Carton (50458-578-10) / 10 Tablet, Film Coated In 1 Blister Pack (50458-578-01)",59.81,23.92,,,0 CDM,6370000001_50458057901,NDC Description Not Available,0.03,0.01,,,0 CDM,6370000001_50458057910,"Xarelto: 10 Blister Pack In 1 Carton (50458-579-10) / 10 Tablet, Film Coated In 1 Blister Pack (50458-579-01)",59.78,23.91,,,0 CDM,6370000001_50458058001,NDC Description Not Available,59.43,23.77,,,0 CDM,6370000001_50458058010,"Xarelto: 10 Blister Pack In 1 Carton (50458-580-10) / 10 Tablet, Film Coated In 1 Blister Pack (50458-580-01)",58.04,23.22,,,0 CDM,6370000001_50458058501,"Concerta: 100 Tablet, Extended Release In 1 Bottle (50458-585-01)",55.6,22.24,,,0 CDM,6370000001_50458058801,"Concerta: 100 Tablet, Extended Release In 1 Bottle (50458-588-01)",40.06,16.02,,,0 CDM,6370000001_50458059601,Risperidone: 30 Ml In 1 Bottle (50458-596-01),12.61,5.04,,,0 CDM,6370000001_50474057009,"Briviact: 100 Blister Pack In 1 Carton (50474-570-09) / 1 Tablet, Film Coated In 1 Blister Pack",70.8,28.32,,,0 CDM,6370000001_50474087015,Briviact: 1 Bottle In 1 Carton (50474-870-15) / 300 Ml In 1 Bottle,156.98,62.79,,,0 CDM,6370000001_50484001030,Collagenase Santyl: 1 Tube In 1 Carton (50484-010-30) / 30 G In 1 Tube,923.74,369.5,,,0 CDM,6370000001_50486055032,Zilactin-B: 1 Tube In 1 Carton (50486-550-32) / 7 G In 1 Tube,16.05,6.42,,,0 CDM,6370000001_50580013404,Imodium A-D: 120 Ml In 1 Bottle (50580-134-04),3.17,1.27,,,0 CDM,6370000001_50580041202,"10 BLISTER PACK in 1 CARTON (50580-412-02) / 10 TABLET, FILM COATED in 1 BLISTER PACK",0.04,0.02,,,0 CDM,6370000001_50580045711,"Tylenol Extra Strength: 10 Blister Pack In 1 Carton (50580-457-11) / 10 Tablet, Film Coated In 1 Blister Pack",0.31,0.12,,,0 CDM,6370000001_50580045811,"Tylenol Regular Strength: 10 Blister Pack In 1 Carton (50580-458-11) / 10 Tablet, Film Coated In 1 Blister Pack",0.15,0.06,,,0 CDM,6370000001_50580053604,Childrens Sudafed Nasal Decongestant: 1 Bottle In 1 Carton (50580-536-04) / 118 Ml In 1 Bottle,2.75,1.1,,,0 CDM,6370000001_50580057902,Childrens Tylenol: 1 Bottle In 1 Carton (50580-579-02) / 120 Ml In 1 Bottle,0.36,0.14,,,0 CDM,6370000001_50580060002,"10 BLISTER PACK in 1 CARTON (50580-600-02) / 10 TABLET, FILM COATED in 1 BLISTER PACK",0.05,0.02,,,0 CDM,6370000001_50742018130,Leucovorin Calcium: 30 Tablet In 1 Bottle (50742-181-30),1.5,0.6,,,0 CDM,6370000001_50742023901,Mexiletine Hydrochloride: 100 Capsule In 1 Bottle (50742-239-01),1.06,0.42,,,0 CDM,6370000001_50742035401,"Mesna: 1 Blister Pack In 1 Carton (50742-354-01) / 10 Tablet, Film Coated In 1 Blister Pack",268.25,107.3,,,0 CDM,6370000001_50742037401,NDC Description Not Available,269.08,107.63,,,0 CDM,6370000001_50742050504,"Scopolamine: 4 Pouch In 1 Carton (50742-505-04) / 1 Patch, Extended Release In 1 Pouch",30.33,12.13,,,0 CDM,6370000001_50742050524,"Scopolamine: 24 Pouch In 1 Carton (50742-505-24) / 1 Patch, Extended Release In 1 Pouch",29.63,11.85,,,0 CDM,6370000001_50742064501,"Triazolam: 100 Tablet In 1 Bottle, Plastic (50742-645-01)",3.22,1.29,,,0 CDM,6370000001_50881000560,"Jakafi: 60 Tablet In 1 Bottle, Plastic (50881-005-60)",864.79,345.92,,,0 CDM,6370000001_51079002301,NDC Description Not Available,10.89,4.36,,,0 CDM,6370000001_51079002401,NDC Description Not Available,11.0,4.4,,,0 CDM,6370000001_51079005101,NDC Description Not Available,1.22,0.49,,,0 CDM,6370000001_51079005801,NDC Description Not Available,5.41,2.16,,,0 CDM,6370000001_51079005820,Chlorthalidone: 100 Blister Pack In 1 Carton (51079-058-20) / 1 Tablet In 1 Blister Pack (51079-058-01),7.84,3.14,,,0 CDM,6370000001_51079007201,NDC Description Not Available,0.29,0.12,,,0 CDM,6370000001_51079007301,NDC Description Not Available,0.29,0.12,,,0 CDM,6370000001_51079007401,NDC Description Not Available,0.64,0.26,,,0 CDM,6370000001_51079007420,Hydralazine Hydrochloride: 100 Blister Pack In 1 Carton (51079-074-20) / 1 Tablet In 1 Blister Pack (51079-074-01),0.61,0.24,,,0 CDM,6370000001_51079007501,NDC Description Not Available,0.82,0.33,,,0 CDM,6370000001_51079007520,Hydralazine Hydrochloride: 100 Blister Pack In 1 Carton (51079-075-20) / 1 Tablet In 1 Blister Pack (51079-075-01),0.83,0.33,,,0 CDM,6370000001_51079007601,NDC Description Not Available,0.85,0.34,,,0 CDM,6370000001_51079007620,Hydralazine Hydrochloride: 100 Blister Pack In 1 Carton (51079-076-20) / 1 Tablet In 1 Blister Pack (51079-076-01),1.04,0.42,,,0 CDM,6370000001_51079008301,NDC Description Not Available,2.83,1.13,,,0 CDM,6370000001_51079008320,Isoniazid: 100 Blister Pack In 1 Carton (51079-083-20) / 1 Tablet In 1 Blister Pack (51079-083-01),4.54,1.82,,,0 CDM,6370000001_51079008601,NDC Description Not Available,0.44,0.18,,,0 CDM,6370000001_51079008701,NDC Description Not Available,0.7,0.28,,,0 CDM,6370000001_51079008720,"Mirtazapine: 100 Blister Pack In 1 Carton (51079-087-20) / 1 Tablet, Film Coated In 1 Blister Pack (51079-087-01)",0.92,0.37,,,0 CDM,6370000001_51079010301,NDC Description Not Available,0.52,0.21,,,0 CDM,6370000001_51079010320,"Spironolactone: 100 Blister Pack In 1 Carton (51079-103-20) / 1 Tablet, Film Coated In 1 Blister Pack (51079-103-01)",0.69,0.28,,,0 CDM,6370000001_51079014101,NDC Description Not Available,5.29,2.12,,,0 CDM,6370000001_51079014120,Chlordiazepoxide Hydrochloride: 100 Blister Pack In 1 Carton (51079-141-20) / 1 Capsule In 1 Blister Pack (51079-141-01),2.29,0.92,,,0 CDM,6370000001_51079016901,NDC Description Not Available,2.74,1.1,,,0 CDM,6370000001_51079016920,"Metoprolol Succinate: 100 Blister Pack In 1 Carton (51079-169-20) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack (51079-169-01)",2.01,0.8,,,0 CDM,6370000001_51079017001,NDC Description Not Available,4.14,1.66,,,0 CDM,6370000001_51079020501,NDC Description Not Available,0.95,0.38,,,0 CDM,6370000001_51079020520,Allopurinol: 100 Blister Pack In 1 Carton (51079-205-20) / 1 Tablet In 1 Blister Pack (51079-205-01),1.36,0.54,,,0 CDM,6370000001_51079020601,NDC Description Not Available,1.91,0.76,,,0 CDM,6370000001_51079021001,NDC Description Not Available,1.73,0.69,,,0 CDM,6370000001_51079024106,"Acamprosate Calcium: 50 BLISTER PACK in 1 CARTON (51079-241-06) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (51079-241-01)",3.52,1.41,,,0 CDM,6370000001_51079025501,NDC Description Not Available,0.27,0.11,,,0 CDM,6370000001_51079025520,"Metoprolol Tartrate: 100 Blister Pack In 1 Carton (51079-255-20) / 1 Tablet, Film Coated In 1 Blister Pack (51079-255-01)",0.35,0.14,,,0 CDM,6370000001_51079028401,NDC Description Not Available,0.17,0.07,,,0 CDM,6370000001_51079028420,Diazepam: 100 Blister Pack In 1 Carton (51079-284-20) / 1 Tablet In 1 Blister Pack (51079-284-01),0.19,0.08,,,0 CDM,6370000001_51079028501,NDC Description Not Available,0.2,0.08,,,0 CDM,6370000001_51079028520,Diazepam: 100 Blister Pack In 1 Carton (51079-285-20) / 1 Tablet In 1 Blister Pack (51079-285-01),0.2,0.08,,,0 CDM,6370000001_51079037401,NDC Description Not Available,12.42,4.97,,,0 CDM,6370000001_51079043601,NDC Description Not Available,1.49,0.6,,,0 CDM,6370000001_51079043620,Doxepin Hydrochloride: 100 Blister Pack In 1 Carton (51079-436-20) / 1 Capsule In 1 Blister Pack (51079-436-01),2.3,0.92,,,0 CDM,6370000001_51079043701,NDC Description Not Available,1.98,0.79,,,0 CDM,6370000001_51079043720,Doxepin Hydrochloride: 100 Blister Pack In 1 Carton (51079-437-20) / 1 Capsule In 1 Blister Pack (51079-437-01),1.99,0.8,,,0 CDM,6370000001_51079044001,NDC Description Not Available,2.39,0.96,,,0 CDM,6370000001_51079044201,NDC Description Not Available,2.59,1.04,,,0 CDM,6370000001_51079044301,NDC Description Not Available,1.89,0.76,,,0 CDM,6370000001_51079044320,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (51079-443-20) / 1 Tablet In 1 Blister Pack (51079-443-01),2.86,1.14,,,0 CDM,6370000001_51079044401,NDC Description Not Available,2.1,0.84,,,0 CDM,6370000001_51079045301,NDC Description Not Available,3.46,1.38,,,0 CDM,6370000001_51079052701,NDC Description Not Available,0.52,0.21,,,0 CDM,6370000001_51079059701,NDC Description Not Available,0.41,0.16,,,0 CDM,6370000001_51079059720,"Cetirizine Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (51079-597-20) / 1 Tablet, Film Coated In 1 Blister Pack (51079-597-01)",0.23,0.09,,,0 CDM,6370000001_51079060801,NDC Description Not Available,11.91,4.76,,,0 CDM,6370000001_51079060820,"Fenofibrate: 100 Blister Pack In 1 Carton (51079-608-20) / 1 Tablet, Film Coated In 1 Blister Pack (51079-608-01)",11.94,4.78,,,0 CDM,6370000001_51079063001,NDC Description Not Available,4.6,1.84,,,0 CDM,6370000001_51079063020,Prazosin Hydrochloride: 100 Blister Pack In 1 Carton (51079-630-20) / 1 Capsule In 1 Blister Pack (51079-630-01),4.53,1.81,,,0 CDM,6370000001_51079063201,NDC Description Not Available,11.0,4.4,,,0 CDM,6370000001_51079068401,NDC Description Not Available,0.23,0.09,,,0 CDM,6370000001_51079068420,Atenolol: 100 Blister Pack In 1 Carton (51079-684-20) / 1 Tablet In 1 Blister Pack (51079-684-01),0.24,0.1,,,0 CDM,6370000001_51079068501,NDC Description Not Available,0.23,0.09,,,0 CDM,6370000001_51079068520,Atenolol: 100 Blister Pack In 1 Carton (51079-685-20) / 1 Tablet In 1 Blister Pack (51079-685-01),0.12,0.05,,,0 CDM,6370000001_51079073301,NDC Description Not Available,0.78,0.31,,,0 CDM,6370000001_51079073320,Haloperidol: 100 Blister Pack In 1 Carton (51079-733-20) / 1 Tablet In 1 Blister Pack (51079-733-01),0.79,0.32,,,0 CDM,6370000001_51079073401,NDC Description Not Available,1.11,0.44,,,0 CDM,6370000001_51079073420,Haloperidol: 100 Blister Pack In 1 Carton (51079-734-20) / 1 Tablet In 1 Blister Pack (51079-734-01),1.23,0.49,,,0 CDM,6370000001_51079073501,NDC Description Not Available,1.52,0.61,,,0 CDM,6370000001_51079073520,Haloperidol: 100 Blister Pack In 1 Carton (51079-735-20) / 1 Tablet In 1 Blister Pack (51079-735-01),1.47,0.59,,,0 CDM,6370000001_51079075301,NDC Description Not Available,0.93,0.37,,,0 CDM,6370000001_51079075320,Sucralfate: 100 Blister Pack In 1 Carton (51079-753-20) / 1 Tablet In 1 Blister Pack (51079-753-01),0.93,0.37,,,0 CDM,6370000001_51079075901,NDC Description Not Available,0.44,0.18,,,0 CDM,6370000001_51079075920,Atenolol: 100 Blister Pack In 1 Carton (51079-759-20) / 1 Tablet In 1 Blister Pack (51079-759-01),0.46,0.18,,,0 CDM,6370000001_51079080101,NDC Description Not Available,0.23,0.09,,,0 CDM,6370000001_51079080120,"Metoprolol Tartrate: 100 Blister Pack In 1 Carton (51079-801-20) / 1 Tablet, Film Coated In 1 Blister Pack (51079-801-01)",0.23,0.09,,,0 CDM,6370000001_51079082101,NDC Description Not Available,2.37,0.95,,,0 CDM,6370000001_51079086301,NDC Description Not Available,11.67,4.67,,,0 CDM,6370000001_51079088601,NDC Description Not Available,2.24,0.9,,,0 CDM,6370000001_51079092101,NDC Description Not Available,2.61,1.04,,,0 CDM,6370000001_51079092120,Clozapine: 100 Blister Pack In 1 Carton (51079-921-20) / 1 Tablet In 1 Blister Pack (51079-921-01),1.42,0.57,,,0 CDM,6370000001_51079092201,NDC Description Not Available,4.89,1.96,,,0 CDM,6370000001_51079092501,NDC Description Not Available,11.84,4.74,,,0 CDM,6370000001_51079093101,NDC Description Not Available,0.35,0.14,,,0 CDM,6370000001_51079093201,NDC Description Not Available,0.56,0.22,,,0 CDM,6370000001_51079096001,NDC Description Not Available,1.16,0.46,,,0 CDM,6370000001_51079096020,Buspirone Hydrochloride: 100 Blister Pack In 1 Carton (51079-960-20) / 1 Tablet In 1 Blister Pack (51079-960-01),1.13,0.45,,,0 CDM,6370000001_51079097801,NDC Description Not Available,1.08,0.43,,,0 CDM,6370000001_51079098501,NDC Description Not Available,0.28,0.11,,,0 CDM,6370000001_51079098520,Buspirone Hydrochloride: 100 Blister Pack In 1 Carton (51079-985-20) / 1 Tablet In 1 Blister Pack (51079-985-01),0.28,0.11,,,0 CDM,6370000001_51079098601,NDC Description Not Available,0.37,0.15,,,0 CDM,6370000001_51079098620,Buspirone Hydrochloride: 100 Blister Pack In 1 Carton (51079-986-20) / 1 Tablet In 1 Blister Pack (51079-986-01),0.35,0.14,,,0 CDM,6370000001_51552134501,Lets Kit: 1 Kit In 1 Box (51552-1345-1) * 180 Mg In 1 Container (51552-0454-9) * 500 Mg In 1 Container (51552-0269-9) * 4 G In 1 Container (51552-0106-9),8.37,3.35,,,0 CDM,6370000001_51660012312,Loperamide Hydrochloride: 2 Blister Pack In 1 Carton (51660-123-12) / 6 Tablet In 1 Blister Pack,0.18,0.07,,,0 CDM,6370000001_51660020030,Ezetimibe: 30 Tablet In 1 Bottle (51660-200-30),0.9,0.36,,,0 CDM,6370000001_51672125802,Clobetasol Propionate: 1 Tube In 1 Carton (51672-1258-2) / 30 G In 1 Tube,61.12,24.45,,,0 CDM,6370000001_51672126003,"Clotrimazole: 1 Bottle, Plastic In 1 Carton (51672-1260-3) / 30 Ml In 1 Bottle, Plastic",181.79,72.72,,,0 CDM,6370000001_51672126302,Nystatin And Triamcinolone Acetonide: 1 Tube In 1 Carton (51672-1263-2) / 30 G In 1 Tube,88.29,35.32,,,0 CDM,6370000001_51672127406,Betamethasone Dipropionate: 1 Tube In 1 Carton (51672-1274-6) / 45 G In 1 Tube,211.28,84.51,,,0 CDM,6370000001_51672128003,Desonide: 1 Tube In 1 Carton (51672-1280-3) / 60 G In 1 Tube,236.92,94.77,,,0 CDM,6370000001_51672128902,Nystatin: 1 Tube In 1 Carton (51672-1289-2) / 30 G In 1 Tube,36.45,14.58,,,0 CDM,6370000001_51672129802,Ketoconazole: 1 Tube In 1 Carton (51672-1298-2) / 30 G In 1 Tube,114.12,45.65,,,0 CDM,6370000001_51672130406,"Terconazole: 1 Tube, With Applicator In 1 Carton (51672-1304-6) / 45 G In 1 Tube, With Applicator",107.16,42.86,,,0 CDM,6370000001_51672131200,Mupirocin: 1 Tube In 1 Carton (51672-1312-0) / 22 G In 1 Tube,27.08,10.83,,,0 CDM,6370000001_51672131201,Mupirocin: 1 Tube In 1 Carton (51672-1312-1) / 15 G In 1 Tube,25.47,10.19,,,0 CDM,6370000001_51672136001,Acyclovir: 1 Tube In 1 Carton (51672-1360-1) / 15 G In 1 Tube,256.68,102.67,,,0 CDM,6370000001_51672138508,Ibuprofen: 1 Bottle In 1 Carton (51672-1385-8) / 118 Ml In 1 Bottle,5.94,2.38,,,0 CDM,6370000001_51672200102,Miconazole Nitrate: 1 Tube In 1 Carton (51672-2001-2) / 30 G In 1 Tube,14.37,5.75,,,0 CDM,6370000001_51672201002,Hydrocortisone: 1 Tube In 1 Carton (51672-2010-2) / 28.4 G In 1 Tube,9.89,3.96,,,0 CDM,6370000001_51672201302,Hydrocortisone With Aloe: 1 Tube In 1 Carton (51672-2013-2) / 28.4 G In 1 Tube,9.89,3.96,,,0 CDM,6370000001_51672202001,Tolnaftate Antifungal: 1 Tube In 1 Carton (51672-2020-1) / 15 G In 1 Tube,12.28,4.91,,,0 CDM,6370000001_51672203506,"Miconazole Nitrate: 1 Tube, With Applicator In 1 Carton (51672-2035-6) / 45 G In 1 Tube, With Applicator",25.71,10.28,,,0 CDM,6370000001_51672206302,Hydrocortisone Plus 12 Moisturizers: 1 Tube In 1 Carton (51672-2063-2) / 28.4 G In 1 Tube,8.47,3.39,,,0 CDM,6370000001_51672207502,Bacitracin Zinc: 1 Tube In 1 Carton (51672-2075-2) / 30 G In 1 Tube,13.88,5.55,,,0 CDM,6370000001_51672210208,Childrens Cetirizine Hydrochloride Sugar Free Grape: 1 Bottle In 1 Carton (51672-2102-8) / 120 Ml In 1 Bottle,0.39,0.16,,,0 CDM,6370000001_51672211400,NDC Description Not Available,2.0,0.8,,,0 CDM,6370000001_51672211402,Feverall Infants: 6 Blister Pack In 1 Carton (51672-2114-2) / 1 Suppository In 1 Blister Pack (51672-2114-0),1.87,0.75,,,0 CDM,6370000001_51672211500,NDC Description Not Available,2.42,0.97,,,0 CDM,6370000001_51672211502,Feverall Childrens: 6 Blister Pack In 1 Carton (51672-2115-2) / 1 Suppository In 1 Blister Pack (51672-2115-0),1.48,0.59,,,0 CDM,6370000001_51672211602,Feverall Jr. Strength: 6 Blister Pack In 1 Carton (51672-2116-2) / 1 Suppository In 1 Blister Pack (51672-2116-0),2.43,0.97,,,0 CDM,6370000001_51672211604,Feverall Jr. Strength: 50 Blister Pack In 1 Carton (51672-2116-4) / 1 Suppository In 1 Blister Pack (51672-2116-0),0.03,0.01,,,0 CDM,6370000001_51672300302,Hydrocortisone: 1 Tube In 1 Carton (51672-3003-2) / 28.35 G In 1 Tube,12.65,5.06,,,0 CDM,6370000001_51672302009,Lidocaine: 1 Tube In 1 Carton (51672-3020-9) / 35.44 G In 1 Tube,401.7,160.68,,,0 CDM,6370000001_51672402301,Acetazolamide: 100 Tablet In 1 Bottle (51672-4023-1),8.38,3.35,,,0 CDM,6370000001_51672403101,Warfarin Sodium: 100 Tablet In 1 Bottle (51672-4031-1),0.93,0.37,,,0 CDM,6370000001_51672403701,Enalapril Maleate: 100 Tablet In 1 Bottle (51672-4037-1),0.69,0.28,,,0 CDM,6370000001_51672404001,Enalapril Maleate: 100 Tablet In 1 Bottle (51672-4040-1),0.96,0.38,,,0 CDM,6370000001_51672404201,Clorazepate Dipotassium: 100 Tablet In 1 Bottle (51672-4042-1),9.9,3.96,,,0 CDM,6370000001_51672404709,Carbamazepine: 450 Ml In 1 Bottle (51672-4047-9),5.97,2.39,,,0 CDM,6370000001_51672404806,Clotrimazole And Betamethasone Dipropionate: 1 Tube In 1 Carton (51672-4048-6) / 45 G In 1 Tube,101.25,40.5,,,0 CDM,6370000001_51672406901,Phenytoin: 237 Ml In 1 Bottle (51672-4069-1),1.07,0.43,,,0 CDM,6370000001_51672411101,"Phenytoin Sodium: 100 Capsule, Extended Release In 1 Bottle (51672-4111-1)",0.74,0.3,,,0 CDM,6370000001_51672411806,Fluorouracil: 1 Tube In 1 Carton (51672-4118-6) / 40 G In 1 Tube,222.28,88.91,,,0 CDM,6370000001_51672412301,"Carbamazepine: 100 Tablet, Extended Release In 1 Bottle (51672-4123-1)",1.38,0.55,,,0 CDM,6370000001_51672422708,Clobazam: 120 Ml In 1 Bottle (51672-4227-8),6.14,2.46,,,0 CDM,6370000001_51672529701,Promethazine Hydrochloride: 12 Blister Pack In 1 Carton (51672-5297-1) / 1 Suppository In 1 Blister Pack,33.53,13.41,,,0 CDM,6370000001_51672533002,Hydrocortisone With Aloe: 1 Tube In 1 Carton (51672-5330-2) / 28.4 G In 1 Tube,9.89,3.96,,,0 CDM,6370000001_51801000130,"Effer-K Orange: 30 Pouch In 1 Carton (51801-001-30) / 1 Tablet, Effervescent In 1 Pouch",1.06,0.42,,,0 CDM,6370000001_51803000101,Iosat: 14 Tablet In 1 Package (51803-001-01),3.94,1.58,,,0 CDM,6370000001_51803000110,Iosat: 10 Package In 1 Bag (51803-001-10) / 14 Tablet In 1 Package (51803-001-01),1.43,0.57,,,0 CDM,6370000001_51862009501,Disopyramide Phosphate: 100 Capsule In 1 Bottle (51862-095-01),5.19,2.08,,,0 CDM,6370000001_51862032001,"Liothyronine Sodium: 100 Tablet In 1 Bottle, Plastic (51862-320-01)",3.13,1.25,,,0 CDM,6370000001_51862032101,"Liothyronine Sodium: 100 Tablet In 1 Bottle, Plastic (51862-321-01)",5.87,2.35,,,0 CDM,6370000001_51862048601,Trimethoprim: 100 Tablet In 1 Bottle (51862-486-01),5.09,2.04,,,0 CDM,6370000001_51862056401,NDC Description Not Available,3.58,1.43,,,0 CDM,6370000001_51862056406,Low-Ogestrel: 6 Blister Pack In 1 Carton (51862-564-06) / 1 Kit In 1 Blister Pack (51862-564-01),3.58,1.43,,,0 CDM,6370000001_51862061201,"Methylphenidate Hydrochloride (La): 100 Capsule, Extended Release In 1 Bottle, Plastic (51862-612-01)",7.48,2.99,,,0 CDM,6370000001_51927453900,NDC Description Not Available,0.1,0.04,,,0 CDM,6370000001_51927478200,NDC Description Not Available,24.14,9.66,,,0 CDM,6370000001_51927482500,NDC Description Not Available,59.72,23.89,,,0 CDM,6370000001_51991031133,"Desvenlafaxine: 30 Tablet, Extended Release In 1 Bottle (51991-311-33)",2.26,0.9,,,0 CDM,6370000001_51991036060,Asenapine: 6 Blister Pack In 1 Box (51991-360-60) / 10 Tablet In 1 Blister Pack,14.23,5.69,,,0 CDM,6370000001_51991065116,Levetiracetam: 473 Ml In 1 Bottle (51991-651-16),0.24,0.1,,,0 CDM,6370000001_51991090701,"Tetracycline Hydrochloride: 100 Capsule In 1 Bottle, Plastic (51991-907-01)",10.06,4.02,,,0 CDM,6370000001_52015008001,"Dificid: 1 Bottle In 1 Carton (52015-080-01) / 20 Tablet, Film Coated In 1 Bottle",768.23,307.29,,,0 CDM,6370000001_52244010010,"Theo-24: 100 Capsule, Extended Release In 1 Bottle (52244-100-10)",11.32,4.53,,,0 CDM,6370000001_52244020010,"Theo-24: 100 Capsule, Extended Release In 1 Bottle (52244-200-10)",16.71,6.68,,,0 CDM,6370000001_52276031205,"Carbaglu: 5 Tablet, For Suspension In 1 Bottle (52276-312-05)",661.71,264.68,,,0 CDM,6370000001_52276031260,"Carbaglu: 60 Tablet, For Suspension In 1 Bottle (52276-312-60)",642.94,257.18,,,0 CDM,6370000001_52536016401,"Perphenazine: 100 Tablet, Film Coated In 1 Bottle (52536-164-01)",1.36,0.54,,,0 CDM,6370000001_52536018603,"Erythromycin: 30 Tablet, Delayed Release In 1 Bottle (52536-186-03)",33.34,13.34,,,0 CDM,6370000001_52565000814,Lidocaine: 1 TUBE in 1 CARTON (52565-008-14) / 35.44 g in 1 TUBE,29.46,11.78,,,0 CDM,6370000001_52565001259,"Fluocinolone Acetonide: 1 BOTTLE, WITH APPLICATOR in 1 CARTON (52565-012-59) / 60 mL in 1 BOTTLE, WITH APPLICATOR",343.9,137.56,,,0 CDM,6370000001_52652500101,Katerzia: 1 Bottle In 1 Carton (52652-5001-1) / 150 Ml In 1 Bottle,27.94,11.18,,,0 CDM,6370000001_52652800101,Zonisade: 1 Bottle In 1 Carton (52652-8001-1) / 150 Ml In 1 Bottle,58.59,23.44,,,0 CDM,6370000001_52652900101,Eprontia: 473 Ml In 1 Bottle (52652-9001-1),15.62,6.25,,,0 CDM,6370000001_52817020110,"Acetazolamide: 100 Tablet In 1 Bottle, Plastic (52817-201-10)",0.37,0.15,,,0 CDM,6370000001_52817021010,"Cyproheptadine Hydrochloride: 100 Tablet In 1 Bottle, Plastic (52817-210-10)",0.3,0.12,,,0 CDM,6370000001_52817027010,"Bisoprolol: 100 Tablet, Film Coated In 1 Bottle (52817-270-10)",0.74,0.3,,,0 CDM,6370000001_52817027030,"Bisoprolol: 30 Tablet, Film Coated In 1 Bottle (52817-270-30)",2.48,0.99,,,0 CDM,6370000001_52817032010,Baclofen: 100 Tablet In 1 Bottle (52817-320-10),0.26,0.1,,,0 CDM,6370000001_52817032110,Baclofen: 100 Tablet In 1 Bottle (52817-321-10),0.32,0.13,,,0 CDM,6370000001_52817033010,"Cyclobenzaprine Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (52817-330-10)",0.12,0.05,,,0 CDM,6370000001_52817036210,"Metoprolol Tartrate: 100 Tablet, Film Coated In 1 Bottle (52817-362-10)",0.17,0.07,,,0 CDM,6370000001_52817081508,"Aminocaproic Acid: 236.5 Ml In 1 Bottle, Plastic (52817-815-08)",91.05,36.42,,,0 CDM,6370000001_52959014406,Sulfamethoxazole and Trimethoprim: 6 TABLET in 1 BOTTLE (52959-144-06),0.23,0.09,,,0 CDM,6370000001_53489014101,"Quinidine Gluconate: 100 Tablet, Extended Release In 1 Bottle, Plastic (53489-141-01)",23.29,9.32,,,0 CDM,6370000001_53489017601,Albuterol Sulfate: 100 Tablet In 1 Bottle (53489-176-01),1.74,0.7,,,0 CDM,6370000001_53746036101,Folic Acid: 100 Tablet In 1 Bottle (53746-361-01),0.22,0.09,,,0 CDM,6370000001_53746051101,Spironolactone: 100 Tablet In 1 Bottle (53746-511-01),0.27,0.11,,,0 CDM,6370000001_53746071101,Guanfacine Hydrochloride: 100 Tablet In 1 Bottle (53746-711-01),1.54,0.62,,,0 CDM,6370000001_53746073490,Felbamate: 90 Tablet In 1 Bottle (53746-734-90),10.35,4.14,,,0 CDM,6370000001_54022510001,NDC Description Not Available,0.19,0.08,,,0 CDM,6370000001_54092018981,Pentasa: 240 Capsule In 1 Bottle (54092-189-81),9.2,3.68,,,0 CDM,6370000001_54092038301,"Adderall Xr: 100 Capsule, Extended Release In 1 Bottle (54092-383-01)",30.7,12.28,,,0 CDM,6370000001_54288012510,Potassium Chloride For Oral Solution: 100 Pouch In 1 Carton (54288-125-10) / 1.58 G In 1 Pouch (54288-125-01),21.54,8.62,,,0 CDM,6370000001_54288012530,Potassium Chloride For Oral Solution: 30 Pouch In 1 Carton (54288-125-30) / 1.58 G In 1 Pouch (54288-125-01),14.96,5.98,,,0 CDM,6370000001_54482014801,"Carnitor Sf: 24 Bottle, Plastic In 1 Case (54482-148-01) / 118 Ml In 1 Bottle, Plastic",5.23,2.09,,,0 CDM,6370000001_54629011001,NDC Description Not Available,0.1,0.04,,,0 CDM,6370000001_54629020001,NDC Description Not Available,0.14,0.06,,,0 CDM,6370000001_54629084121,NDC Description Not Available,0.12,0.05,,,0 CDM,6370000001_54629398501,NDC Description Not Available,0.15,0.06,,,0 CDM,6370000001_54629409760,NDC Description Not Available,0.22,0.09,,,0 CDM,6370000001_54629797530,NDC Description Not Available,0.93,0.37,,,0 CDM,6370000001_54838000180,NDC Description Not Available,0.72,0.29,,,0 CDM,6370000001_54838000530,NDC Description Not Available,17.06,6.82,,,0 CDM,6370000001_54838000650,NDC Description Not Available,0.46,0.18,,,0 CDM,6370000001_54838000655,NDC Description Not Available,0.08,0.03,,,0 CDM,6370000001_54838001150,NDC Description Not Available,0.12,0.05,,,0 CDM,6370000001_54838001152,NDC Description Not Available,0.04,0.02,,,0 CDM,6370000001_54838001153,NDC Description Not Available,0.08,0.03,,,0 CDM,6370000001_54838001154,NDC Description Not Available,0.1,0.04,,,0 CDM,6370000001_54838011680,"Silace: 473 Ml In 1 Bottle, Plastic (54838-116-80)",0.06,0.02,,,0 CDM,6370000001_54838050140,"Haloperidol: 120 Ml In 1 Bottle, Dropper (54838-501-40)",0.42,0.17,,,0 CDM,6370000001_54838050280,"Hydroxyzine Hydrochloride: 473 Ml In 1 Bottle, Plastic (54838-502-80)",4.45,1.78,,,0 CDM,6370000001_54838050615,"Hyosyne: 15 Ml In 1 Bottle, Plastic (54838-506-15)",6.16,2.46,,,0 CDM,6370000001_54838051080,"Oxybutynin Chloride: 473 Ml In 1 Bottle, Plastic (54838-510-80)",0.4,0.16,,,0 CDM,6370000001_54838051240,"Doxepin Hydrochloride: 120 Ml In 1 Bottle, Plastic (54838-512-40)",9.33,3.73,,,0 CDM,6370000001_54859051608,NDC Description Not Available,0.71,0.28,,,0 CDM,6370000001_55111014630,Fluconazole: 30 Tablet In 1 Bottle (55111-146-30),8.83,3.53,,,0 CDM,6370000001_55111019630,"Clopidogrel Bisulfate: 30 Tablet, Film Coated In 1 Bottle (55111-196-30)",0.51,0.2,,,0 CDM,6370000001_55111026279,"Olanzapine: 10 Tablet, Orally Disintegrating In 1 Blister Pack (55111-262-79)",6.53,2.61,,,0 CDM,6370000001_55111026281,"Olanzapine: 3 Blister Pack In 1 Carton (55111-262-81) / 10 Tablet, Orally Disintegrating In 1 Blister Pack",6.34,2.54,,,0 CDM,6370000001_55111026379,"Olanzapine: 10 Tablet, Orally Disintegrating In 1 Blister Pack (55111-263-79)",5.91,2.36,,,0 CDM,6370000001_55111026381,"Olanzapine: 3 Blister Pack In 1 Carton (55111-263-81) / 10 Tablet, Orally Disintegrating In 1 Blister Pack",7.26,2.9,,,0 CDM,6370000001_55111029209,Sumatriptan Succinate: 9 Blister Pack In 1 Carton (55111-292-09) / 9 Tablet In 1 Blister Pack,7.6,3.04,,,0 CDM,6370000001_55111032001,Glimepiride: 100 Tablet In 1 Bottle (55111-320-01),0.13,0.05,,,0 CDM,6370000001_55111051930,Atomoxetine: 30 Capsule In 1 Bottle (55111-519-30),4.89,1.96,,,0 CDM,6370000001_55111052130,Atomoxetine: 30 Capsule In 1 Bottle (55111-521-30),7.49,3.0,,,0 CDM,6370000001_55111072030,"Lamotrigine: 30 Tablet, Extended Release In 1 Bottle (55111-720-30)",5.51,2.2,,,0 CDM,6370000001_55111072901,Allopurinol: 100 Tablet In 1 Bottle (55111-729-01),0.34,0.14,,,0 CDM,6370000001_55111073130,"Valsartan: 30 Tablet, Film Coated In 1 Bottle (55111-731-30)",0.44,0.18,,,0 CDM,6370000001_55292020111,Chemet: 100 Capsule In 1 Bottle (55292-201-11),101.37,40.55,,,0 CDM,6370000001_55513080060,"Corlanor: 60 Tablet, Film Coated In 1 Bottle (55513-800-60)",29.05,11.62,,,0 CDM,6370000001_55513081060,"Corlanor: 60 Tablet, Film Coated In 1 Bottle (55513-810-60)",42.76,17.1,,,0 CDM,6370000001_55566280001,Cervidil: 1 Pouch In 1 Carton (55566-2800-1) / 10 Mg In 1 Pouch (55566-2800-0),1633.44,653.38,,,0 CDM,6370000001_55566650001,NDC Description Not Available,44.22,17.69,,,0 CDM,6370000001_56151161111,NDC Description Not Available,0.28,0.11,,,0 CDM,6370000001_56184012041,NDC Description Not Available,0.33,0.13,,,0 CDM,6370000001_56184012053,NDC Description Not Available,0.16,0.06,,,0 CDM,6370000001_56184012062,NDC Description Not Available,0.16,0.06,,,0 CDM,6370000001_57237000330,Fluconazole: 30 Tablet In 1 Bottle (57237-003-30),1.0,0.4,,,0 CDM,6370000001_57237015035,Fluconazole: 1 Bottle In 1 Carton (57237-150-35) / 35 Ml In 1 Bottle,24.1,9.64,,,0 CDM,6370000001_57237017201,Venlafaxine: 100 Tablet In 1 Bottle (57237-172-01),0.44,0.18,,,0 CDM,6370000001_57237017501,Venlafaxine: 100 Tablet In 1 Bottle (57237-175-01),0.37,0.15,,,0 CDM,6370000001_57237018090,Pramipexole Dihydrochloride: 90 Tablet In 1 Bottle (57237-180-90),0.34,0.14,,,0 CDM,6370000001_57237027424,Lamivudine: 240 Ml In 1 Bottle (57237-274-24),7.98,3.19,,,0 CDM,6370000001_57237032521,Glycerin: 2 Blister Pack In 1 Carton (57237-325-21) / 6 Suppository In 1 Blister Pack (57237-325-16),1.11,0.44,,,0 CDM,6370000001_57237032552,Glycerin: 5 Blister Pack In 1 Carton (57237-325-52) / 5 Suppository In 1 Blister Pack (57237-325-51),0.78,0.31,,,0 CDM,6370000001_57664004988,Lisdexamfetamine Dimesylate: 100 Capsule In 1 Bottle (57664-049-88),13.85,5.54,,,0 CDM,6370000001_57664050389,Tizanidine: 150 Tablet In 1 Bottle (57664-503-89),0.28,0.11,,,0 CDM,6370000001_57771000702,NDC Description Not Available,2.74,1.1,,,0 CDM,6370000001_57896018105,Artificial Tears: 1 Bottle In 1 Carton (57896-181-05) / 15 Mg In 1 Bottle,4.56,1.82,,,0 CDM,6370000001_57896018405,Gericare Artificial Tears Lubricant Eye: 1 BOTTLE in 1 CARTON (57896-184-05) / 15 mg in 1 BOTTLE,3.83,1.53,,,0 CDM,6370000001_57896038124,NDC Description Not Available,0.06,0.02,,,0 CDM,6370000001_57896062101,NDC Description Not Available,0.12,0.05,,,0 CDM,6370000001_57896062912,Geri-Lanta Antacid Antigas: 355 Ml In 1 Bottle (57896-629-12),0.27,0.11,,,0 CDM,6370000001_57896064912,Milk Of Magnesia Original: 355 Ml In 1 Bottle (57896-649-12),0.21,0.08,,,0 CDM,6370000001_57896070916,NDC Description Not Available,0.13,0.05,,,0 CDM,6370000001_57896084401,NDC Description Not Available,0.55,0.22,,,0 CDM,6370000001_57896092101,"Regular Strength Enteric Coated Aspirin: 100 Tablet, Coated In 1 Bottle (57896-921-01)",0.06,0.02,,,0 CDM,6370000001_57962001428,"Imbruvica: 1 Blister Pack In 1 Carton (57962-014-28) / 28 Tablet, Film Coated In 1 Blister Pack",2692.91,1077.16,,,0 CDM,6370000001_58151031052,Nitrostat: 4 Bottle In 1 Carton (58151-310-52) / 25 Tablet In 1 Bottle (58151-310-94),40.42,16.17,,,0 CDM,6370000001_58151031094,NDC Description Not Available,121.28,48.51,,,0 CDM,6370000001_58204000409,NDC Description Not Available,1.64,0.66,,,0 CDM,6370000001_58204000413,NDC Description Not Available,1.64,0.66,,,0 CDM,6370000001_58468013202,"Renvela: 90 Packet In 1 Carton (58468-0132-2) / 1 Powder, For Suspension In 1 Packet (58468-0132-1)",76.93,30.77,,,0 CDM,6370000001_58657031016,Sodium Citrate-Citric Acid: 473 mL in 1 BOTTLE (58657-310-16),2.51,1.0,,,0 CDM,6370000001_58657050016,Codeine-Guaifenesin: 473 Ml In 1 Bottle (58657-500-16),2.17,0.87,,,0 CDM,6370000001_58657064801,Clonidine Hydrochloride: 100 Tablet In 1 Bottle (58657-648-01),0.24,0.1,,,0 CDM,6370000001_58914050156,Canasa: 30 Suppository In 1 Box (58914-501-56),118.68,47.47,,,0 CDM,6370000001_58980001205,Double Antibiotic: 1 Tube In 1 Box (58980-012-05) / 14.2 G In 1 Tube,20.45,8.18,,,0 CDM,6370000001_58980035050,White Petrolatum: 144 Packet In 1 Box (58980-350-50) / 5 G In 1 Packet,0.43,0.17,,,0 CDM,6370000001_58980041012,Stratuscare Adult Glycerin: 12 Suppository In 1 Jar (58980-410-12),0.27,0.11,,,0 CDM,6370000001_58980078021,NDC Description Not Available,90.85,36.34,,,0 CDM,6370000001_59011041020,"Oxycontin: 2 Blister Pack In 1 Carton (59011-410-20) / 10 Tablet, Film Coated, Extended Release In 1 Blister Pack",17.03,6.81,,,0 CDM,6370000001_59011042010,"Oxycontin: 100 Tablet, Film Coated, Extended Release In 1 Bottle (59011-420-10)",32.13,12.85,,,0 CDM,6370000001_59011042020,"Oxycontin: 2 Blister Pack In 1 Carton (59011-420-20) / 10 Tablet, Film Coated, Extended Release In 1 Blister Pack",31.31,12.52,,,0 CDM,6370000001_59011044020,"Oxycontin: 2 Blister Pack In 1 Carton (59011-440-20) / 10 Tablet, Film Coated, Extended Release In 1 Blister Pack",54.29,21.72,,,0 CDM,6370000001_59011048020,"Oxycontin: 2 Blister Pack In 1 Carton (59011-480-20) / 10 Tablet, Film Coated, Extended Release In 1 Blister Pack",97.16,38.86,,,0 CDM,6370000001_59011075004,Butrans: 4 Pouch In 1 Carton (59011-750-04) / 1 Patch In 1 Pouch / 168 H In 1 Patch,156.71,62.68,,,0 CDM,6370000001_59148003713,Rexulti: 1 Bottle In 1 Carton (59148-037-13) / 30 Tablet In 1 Bottle,139.48,55.79,,,0 CDM,6370000001_59385002101,NDC Description Not Available,30.75,12.3,,,0 CDM,6370000001_59385002201,NDC Description Not Available,21.37,8.55,,,0 CDM,6370000001_59385002260,"Belbuca: 60 Pouch In 1 Carton (59385-022-60) / 1 Film, Soluble In 1 Pouch (59385-022-01)",30.75,12.3,,,0 CDM,6370000001_59385002301,NDC Description Not Available,32.79,13.12,,,0 CDM,6370000001_59385002360,"Belbuca: 60 Pouch In 1 Carton (59385-023-60) / 1 Film, Soluble In 1 Pouch (59385-023-01)",48.29,19.32,,,0 CDM,6370000001_59390002601,NDC Description Not Available,0.25,0.1,,,0 CDM,6370000001_59390002662,NDC Description Not Available,37.48,14.99,,,0 CDM,6370000001_59390018213,Goniotaire: 1 Bottle In 1 Carton (59390-182-13) / 15 Ml In 1 Bottle,59.27,23.71,,,0 CDM,6370000001_59390021805,"Altafluor: 5 Ml In 1 Bottle, Dropper (59390-218-05)",61.62,24.65,,,0 CDM,6370000001_59417010410,Vyvanse: 100 Capsule In 1 Bottle (59417-104-10),38.19,15.28,,,0 CDM,6370000001_59651000830,Azithromycin: 1 Bottle In 1 Carton (59651-008-30) / 30 Ml In 1 Bottle,8.59,3.44,,,0 CDM,6370000001_59651003230,NDC Description Not Available,2.44,0.98,,,0 CDM,6370000001_59651003247,Ibuprofen: 1 Bottle In 1 Carton (59651-032-47) / 473 Ml In 1 Bottle,2.43,0.97,,,0 CDM,6370000001_59651013830,Nebivolol: 30 Tablet In 1 Bottle (59651-138-30),0.66,0.26,,,0 CDM,6370000001_59651015201,Progesterone: 100 Capsule In 1 Bottle (59651-152-01),0.87,0.35,,,0 CDM,6370000001_59651033101,Flucytosine: 100 Capsule In 1 Bottle (59651-331-01),31.62,12.65,,,0 CDM,6370000001_59651033201,Flucytosine: 100 Capsule In 1 Bottle (59651-332-01),81.08,32.43,,,0 CDM,6370000001_59651042011,Sildenafil Citrate: 1 Bottle In 1 Carton (59651-420-11) / 112 Ml In 1 Bottle,0.88,0.35,,,0 CDM,6370000001_59651044401,"Valganciclovir: 1 Bottle, Glass In 1 Carton (59651-444-01) / 100 Ml In 1 Bottle, Glass",158.7,63.48,,,0 CDM,6370000001_59651059001,Pyrimethamine: 100 Tablet In 1 Bottle (59651-590-01),1260.6,504.24,,,0 CDM,6370000001_59651078201,"Glipizide: 100 Tablet, Extended Release In 1 Bottle (59651-782-01)",0.77,0.31,,,0 CDM,6370000001_59651086705,"Ciprofloxacin: 500 Tablet, Film Coated In 1 Bottle (59651-867-05)",0.64,0.26,,,0 CDM,6370000001_59676027801,"Edurant: 30 Tablet, Film Coated In 1 Bottle (59676-278-01)",142.64,57.06,,,0 CDM,6370000001_59676056501,"Prezista: 1 Bottle, Glass In 1 Carton (59676-565-01) / 200 Ml In 1 Bottle, Glass",220.58,88.23,,,0 CDM,6370000001_59676056630,"Prezista: 30 Tablet, Film Coated In 1 Bottle, Plastic (59676-566-30)",310.04,124.02,,,0 CDM,6370000001_59676057530,"Prezcobix: 30 Tablet, Film Coated In 1 Bottle (59676-575-30)",239.72,95.89,,,0 CDM,6370000001_59676080030,"Symtuza: 30 Tablet, Film Coated In 1 Bottle (59676-800-30)",457.39,182.96,,,0 CDM,6370000001_59746001032,"Risperidone: 3 Blister Pack In 1 Carton (59746-010-32) / 10 Tablet, Orally Disintegrating In 1 Blister Pack",4.45,1.78,,,0 CDM,6370000001_59746002022,"Risperidone: 7 Blister Pack In 1 Carton (59746-020-22) / 4 Tablet, Orally Disintegrating In 1 Blister Pack",6.18,2.47,,,0 CDM,6370000001_59746003022,"Risperidone: 7 Blister Pack In 1 Carton (59746-030-22) / 4 Tablet, Orally Disintegrating In 1 Blister Pack",9.47,3.79,,,0 CDM,6370000001_59746021106,"Cyclobenzaprine Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (59746-211-06)",0.71,0.28,,,0 CDM,6370000001_59762006701,"Sertraline Hydrochloride: 1 Bottle, Dropper In 1 Carton (59762-0067-1) / 60 Ml In 1 Bottle, Dropper",6.36,2.54,,,0 CDM,6370000001_59762007301,Hydrocortisone: 50 Tablet In 1 Bottle (59762-0073-1),0.51,0.2,,,0 CDM,6370000001_59762007401,Hydrocortisone: 100 Tablet In 1 Bottle (59762-0074-1),0.83,0.33,,,0 CDM,6370000001_59762010405,"Sulfasalazine: 1 Bottle In 1 Carton (59762-0104-5) / 100 Tablet, Delayed Release In 1 Bottle",0.92,0.37,,,0 CDM,6370000001_59762011901,"Phenelzine Sulfate: 60 Tablet, Film Coated In 1 Bottle (59762-0119-1)",2.87,1.15,,,0 CDM,6370000001_59762080002,"Tolterodine Tartrate: 60 Tablet, Film Coated In 1 Bottle (59762-0800-2)",3.08,1.23,,,0 CDM,6370000001_59762100401,Nifedipine: 100 Capsule In 1 Bottle (59762-1004-1),3.02,1.21,,,0 CDM,6370000001_59762106101,Diphenoxylate Hydrochloride And Atropine Sulfate: 100 Tablet In 1 Bottle (59762-1061-1),1.77,0.71,,,0 CDM,6370000001_59762120601,Liothyronine Sodium: 100 Tablet In 1 Bottle (59762-1206-1),2.04,0.82,,,0 CDM,6370000001_59762130804,Linezolid: 150 Ml In 1 Bottle (59762-1308-4),246.86,98.74,,,0 CDM,6370000001_59762135001,Rifabutin: 100 Capsule In 1 Bottle (59762-1350-1),39.7,15.88,,,0 CDM,6370000001_59762171002,"Eplerenone: 30 Tablet, Film Coated In 1 Bottle (59762-1710-2)",5.86,2.34,,,0 CDM,6370000001_59762314001,Azithromycin: 1 Bottle In 1 Carton (59762-3140-1) / 30 Ml In 1 Bottle,1.77,0.71,,,0 CDM,6370000001_59762330403,"Nitroglycerin: 4 Bottle, Glass In 1 Carton (59762-3304-3) / 25 Tablet In 1 Bottle, Glass",20.86,8.34,,,0 CDM,6370000001_59762500005,Sulfasalazine: 1 Bottle In 1 Carton (59762-5000-5) / 100 Tablet In 1 Bottle,0.79,0.32,,,0 CDM,6370000001_59762500006,Sulfasalazine: 1 Bottle In 1 Carton (59762-5000-6) / 300 Tablet In 1 Bottle,0.61,0.24,,,0 CDM,6370000001_59762500701,Misoprostol: 60 Tablet In 1 Bottle (59762-5007-1),1.2,0.48,,,0 CDM,6370000001_59762505007,"Gabapentin: 1 Bottle, Plastic In 1 Carton (59762-5050-7) / 470 Ml In 1 Bottle, Plastic",2.35,0.94,,,0 CDM,6370000001_59767000401,"Pertzye: 100 Capsule, Delayed Release In 1 Bottle (59767-004-01)",5.56,2.22,,,0 CDM,6370000001_59767001601,"Pertzye: 100 Capsule, Delayed Release In 1 Bottle (59767-016-01)",16.65,6.66,,,0 CDM,6370000001_59767002401,"Pertzye: 80 Capsule, Delayed Release In 1 Bottle (59767-024-01)",24.8,9.92,,,0 CDM,6370000001_60219126601,Oseltamivir Phosphate: 1 Blister Pack In 1 Carton (60219-1266-1) / 10 Capsule In 1 Blister Pack,37.38,14.95,,,0 CDM,6370000001_60219150301,Erythromycin Ethylsuccinate: 100 Ml In 1 Bottle (60219-1503-1),10.64,4.26,,,0 CDM,6370000001_60219161701,NDC Description Not Available,4.84,1.94,,,0 CDM,6370000001_60219161708,Potassium Chloride: 100 Pouch In 1 Carton (60219-1617-8) / 1.58 G In 1 Pouch (60219-1617-1),6.56,2.62,,,0 CDM,6370000001_60219174802,"Atropine: 1 Bottle, Dropper In 1 Carton (60219-1748-2) / 2 Ml In 1 Bottle, Dropper",89.61,35.84,,,0 CDM,6370000001_60219174903,"Atropine: 1 Bottle, Dropper In 1 Carton (60219-1749-3) / 5 Ml In 1 Bottle, Dropper",112.55,45.02,,,0 CDM,6370000001_60258000116,"Cytra-2: 473 mL in 1 BOTTLE, PLASTIC (60258-001-16)",6.54,2.62,,,0 CDM,6370000001_60258000615,NDC Description Not Available,1.63,0.65,,,0 CDM,6370000001_60258016001,NDC Description Not Available,0.23,0.09,,,0 CDM,6370000001_60258016101,NDC Description Not Available,0.58,0.23,,,0 CDM,6370000001_60258017201,NDC Description Not Available,0.39,0.16,,,0 CDM,6370000001_60429011805,"Methocarbamol: 500 TABLET, FILM COATED in 1 BOTTLE (60429-118-05)",0.28,0.11,,,0 CDM,6370000001_60432003816,"Generlac: 473 mL in 1 BOTTLE, PLASTIC (60432-038-16)",0.95,0.38,,,0 CDM,6370000001_60432006500,"Amoxicillin And Clavulanate Potassium: 100 Ml In 1 Bottle, Plastic (60432-065-00)",2.11,0.84,,,0 CDM,6370000001_60432012616,"Megestrol Acetate: 480 mL in 1 BOTTLE, PLASTIC (60432-126-16)",8.08,3.23,,,0 CDM,6370000001_60432015016,"Hydroxyzine Hydrochloride: 473 mL in 1 BOTTLE, PLASTIC (60432-150-16)",2.16,0.86,,,0 CDM,6370000001_60505003901,Etodolac: 100 Capsule In 1 Bottle (60505-0039-1),3.24,1.3,,,0 CDM,6370000001_60505005501,Selegiline Hydrochloride: 60 Capsule In 1 Bottle (60505-0055-1),4.98,1.99,,,0 CDM,6370000001_60505008000,Sotalol Hydrochloride: 100 Tablet In 1 Bottle (60505-0080-0),0.24,0.1,,,0 CDM,6370000001_60505015900,Sotalol Hydrochloride: 100 Tablet In 1 Bottle (60505-0159-0),0.33,0.13,,,0 CDM,6370000001_60505018300,Carbamazepine: 100 Tablet In 1 Bottle (60505-0183-0),1.14,0.46,,,0 CDM,6370000001_60505058901,"Brimonidine Tartrate/Timolol Maleate Ophthalmic Solution: 1 Bottle, Dropper In 1 Carton (60505-0589-1) / 5 Ml In 1 Bottle, Dropper",494.67,197.87,,,0 CDM,6370000001_60505059304,Travoprost: 1 Bottle In 1 Carton (60505-0593-4) / 2.5 Ml In 1 Bottle,377.28,150.91,,,0 CDM,6370000001_60505081500,"Desmopressin Acetate: 1 Bottle, Spray In 1 Carton (60505-0815-0) / 50 Spray In 1 Bottle, Spray",246.89,98.76,,,0 CDM,6370000001_60505082306,"Calcitonin Salmon: 1 Bottle, Glass In 1 Carton (60505-0823-6) / 30 Spray, Metered In 1 Bottle, Glass",75.35,30.14,,,0 CDM,6370000001_60505082601,"Ipratropium Bromide: 1 Bottle, Spray In 1 Carton (60505-0826-1) / 345 Spray, Metered In 1 Bottle, Spray",154.01,61.6,,,0 CDM,6370000001_60505082901,"Fluticasone Propionate: 1 Bottle, Spray In 1 Carton (60505-0829-1) / 120 Spray, Metered In 1 Bottle, Spray",51.68,20.67,,,0 CDM,6370000001_60505265301,Trazodone Hydrochloride: 100 Tablet In 1 Bottle (60505-2653-1),0.2,0.08,,,0 CDM,6370000001_60505265701,Triamterene And Hydrochlorothiazide: 100 Tablet In 1 Bottle (60505-2657-1),0.86,0.34,,,0 CDM,6370000001_60505280507,"Carbamazepine: 120 Capsule, Extended Release In 1 Bottle (60505-2805-7)",4.91,1.96,,,0 CDM,6370000001_60505290103,"Imatinib Mesylate: 30 Tablet, Film Coated In 1 Bottle (60505-2901-3)",53.52,21.41,,,0 CDM,6370000001_60505311000,"Olanzapine: 10 Blister Pack In 1 Carton (60505-3110-0) / 10 Tablet, Film Coated In 1 Blister Pack",0.59,0.24,,,0 CDM,6370000001_60505311100,"Olanzapine: 10 Blister Pack In 1 Carton (60505-3111-0) / 10 Tablet, Film Coated In 1 Blister Pack",0.75,0.3,,,0 CDM,6370000001_60505311300,"Olanzapine: 10 Blister Pack In 1 Carton (60505-3113-0) / 10 Tablet, Film Coated In 1 Blister Pack",1.05,0.42,,,0 CDM,6370000001_60505327500,"Olanzapine: 10 Blister Pack In 1 Carton (60505-3275-0) / 10 Tablet, Orally Disintegrating In 1 Blister Pack",4.9,1.96,,,0 CDM,6370000001_60505327600,"Olanzapine: 10 Blister Pack In 1 Carton (60505-3276-0) / 10 Tablet, Orally Disintegrating In 1 Blister Pack",7.65,3.06,,,0 CDM,6370000001_60505412907,"Oxcarbazepine: 100 Tablet, Extended Release In 1 Bottle (60505-4129-7)",35.0,14.0,,,0 CDM,6370000001_60505464303,"Prasugrel: 30 Tablet, Film Coated In 1 Bottle (60505-4643-3)",2.39,0.96,,,0 CDM,6370000001_60505624901,Dexamethasone: 100 Tablet In 1 Bottle (60505-6249-1),0.17,0.07,,,0 CDM,6370000001_60505706200,NDC Description Not Available,3.45,1.38,,,0 CDM,6370000001_60505706400,Nicotine Transdermal System: 14 Pouch In 1 Carton (60505-7064-0) / 1 H In 1 Pouch,0.19,0.08,,,0 CDM,6370000001_60505708100,NDC Description Not Available,11.03,4.41,,,0 CDM,6370000001_60505708200,NDC Description Not Available,18.48,7.39,,,0 CDM,6370000001_60505708300,NDC Description Not Available,28.44,11.38,,,0 CDM,6370000001_60505708400,NDC Description Not Available,39.98,15.99,,,0 CDM,6370000001_60687010011,NDC Description Not Available,17.72,7.09,,,0 CDM,6370000001_60687010511,NDC Description Not Available,4.1,1.64,,,0 CDM,6370000001_60687010521,"Medroxyprogesterone Acetate: 30 Blister Pack In 1 Box, Unit-Dose (60687-105-21) / 1 Tablet In 1 Blister Pack (60687-105-11)",5.95,2.38,,,0 CDM,6370000001_60687011211,NDC Description Not Available,2.78,1.11,,,0 CDM,6370000001_60687011221,"Anastrozole: 30 Blister Pack In 1 Box, Unit-Dose (60687-112-21) / 1 Tablet, Coated In 1 Blister Pack (60687-112-11)",3.91,1.56,,,0 CDM,6370000001_60687011301,"Clonidine Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-113-01) / 1 Tablet In 1 Blister Pack (60687-113-11)",0.85,0.34,,,0 CDM,6370000001_60687011311,NDC Description Not Available,0.81,0.32,,,0 CDM,6370000001_60687011995,NDC Description Not Available,17.07,6.83,,,0 CDM,6370000001_60687012401,"Clonidine Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-124-01) / 1 Tablet In 1 Blister Pack (60687-124-11)",1.32,0.53,,,0 CDM,6370000001_60687012411,NDC Description Not Available,0.82,0.33,,,0 CDM,6370000001_60687012901,"Docusate Sodium: 100 Blister Pack In 1 Box, Unit-Dose (60687-129-01) / 1 Capsule, Liquid Filled In 1 Blister Pack (60687-129-11)",0.34,0.14,,,0 CDM,6370000001_60687012911,NDC Description Not Available,0.54,0.22,,,0 CDM,6370000001_60687015511,NDC Description Not Available,0.38,0.15,,,0 CDM,6370000001_60687015625,"Phenytoin: 30 Blister Pack In 1 Box, Unit-Dose (60687-156-25) / 1 Tablet, Chewable In 1 Blister Pack (60687-156-95)",5.23,2.09,,,0 CDM,6370000001_60687015695,NDC Description Not Available,4.44,1.78,,,0 CDM,6370000001_60687015711,NDC Description Not Available,37.62,15.05,,,0 CDM,6370000001_60687016301,"Cephalexin: 100 Blister Pack In 1 Box, Unit-Dose (60687-163-01) / 1 Capsule In 1 Blister Pack (60687-163-11)",1.52,0.61,,,0 CDM,6370000001_60687016311,NDC Description Not Available,0.92,0.37,,,0 CDM,6370000001_60687018811,NDC Description Not Available,12.66,5.06,,,0 CDM,6370000001_60687019501,"Diltiazem Hydrochloride Extended-Release: 100 Blister Pack In 1 Box, Unit-Dose (60687-195-01) / 1 Capsule, Coated, Extended Release In 1 Blister Pack (60687-195-11)",2.12,0.85,,,0 CDM,6370000001_60687019511,NDC Description Not Available,2.45,0.98,,,0 CDM,6370000001_60687019901,"Meloxicam: 100 Blister Pack In 1 Box, Unit-Dose (60687-199-01) / 1 Tablet In 1 Blister Pack (60687-199-11)",0.68,0.27,,,0 CDM,6370000001_60687019911,NDC Description Not Available,0.48,0.19,,,0 CDM,6370000001_60687020601,"Diltiazem Hydrochloride Extended-Release: 100 Blister Pack In 1 Box, Unit-Dose (60687-206-01) / 1 Capsule, Coated, Extended Release In 1 Blister Pack (60687-206-11)",1.5,0.6,,,0 CDM,6370000001_60687020611,NDC Description Not Available,2.34,0.94,,,0 CDM,6370000001_60687021111,NDC Description Not Available,2.33,0.93,,,0 CDM,6370000001_60687021121,"Divalproex Sodium: 30 Blister Pack In 1 Box, Unit-Dose (60687-211-21) / 1 Tablet, Delayed Release In 1 Blister Pack (60687-211-11)",2.82,1.13,,,0 CDM,6370000001_60687021501,"Propranolol Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-215-01) / 1 Capsule, Extended Release In 1 Blister Pack (60687-215-11)",8.24,3.3,,,0 CDM,6370000001_60687021511,NDC Description Not Available,5.2,2.08,,,0 CDM,6370000001_60687021711,NDC Description Not Available,2.37,0.95,,,0 CDM,6370000001_60687022401,"Gemfibrozil: 100 Blister Pack In 1 Box, Unit-Dose (60687-224-01) / 1 Tablet In 1 Blister Pack (60687-224-11)",0.99,0.4,,,0 CDM,6370000001_60687022411,NDC Description Not Available,0.75,0.3,,,0 CDM,6370000001_60687022611,NDC Description Not Available,9.89,3.96,,,0 CDM,6370000001_60687022801,"Diltiazem Hydrochloride Extended-Release: 100 Blister Pack In 1 Box, Unit-Dose (60687-228-01) / 1 Capsule, Coated, Extended Release In 1 Blister Pack (60687-228-11)",6.85,2.74,,,0 CDM,6370000001_60687022811,NDC Description Not Available,4.65,1.86,,,0 CDM,6370000001_60687023101,"Sertraline Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-231-01) / 1 Tablet In 1 Blister Pack (60687-231-11)",1.27,0.51,,,0 CDM,6370000001_60687023111,NDC Description Not Available,1.23,0.49,,,0 CDM,6370000001_60687023401,"Rosuvastatin Calcium: 100 Blister Pack In 1 Box, Unit-Dose (60687-234-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-234-11)",3.88,1.55,,,0 CDM,6370000001_60687023411,NDC Description Not Available,3.99,1.6,,,0 CDM,6370000001_60687024195,NDC Description Not Available,15.92,6.37,,,0 CDM,6370000001_60687024201,"Sertraline Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-242-01) / 1 Tablet In 1 Blister Pack (60687-242-11)",1.41,0.56,,,0 CDM,6370000001_60687024211,NDC Description Not Available,1.18,0.47,,,0 CDM,6370000001_60687024940,NDC Description Not Available,17.11,6.84,,,0 CDM,6370000001_60687024977,"Levetiracetam: 4 Tray In 1 Case (60687-249-77) / 10 Cup, Unit-Dose In 1 Tray (60687-249-46) / 5 Ml In 1 Cup, Unit-Dose (60687-249-40)",13.56,5.42,,,0 CDM,6370000001_60687025611,NDC Description Not Available,4.46,1.78,,,0 CDM,6370000001_60687026611,NDC Description Not Available,17.05,6.82,,,0 CDM,6370000001_60687027211,NDC Description Not Available,10.89,4.36,,,0 CDM,6370000001_60687027562,NDC Description Not Available,20.04,8.02,,,0 CDM,6370000001_60687028111,NDC Description Not Available,1.31,0.52,,,0 CDM,6370000001_60687029211,NDC Description Not Available,0.41,0.16,,,0 CDM,6370000001_60687029311,NDC Description Not Available,1.73,0.69,,,0 CDM,6370000001_60687029925,"Itraconazole: 30 Blister Pack In 1 Box, Unit-Dose (60687-299-25) / 1 Capsule In 1 Blister Pack (60687-299-95)",14.0,5.6,,,0 CDM,6370000001_60687029995,NDC Description Not Available,9.97,3.99,,,0 CDM,6370000001_60687030295,NDC Description Not Available,10.55,4.22,,,0 CDM,6370000001_60687030311,NDC Description Not Available,0.35,0.14,,,0 CDM,6370000001_60687030411,NDC Description Not Available,6.1,2.44,,,0 CDM,6370000001_60687030911,NDC Description Not Available,18.69,7.48,,,0 CDM,6370000001_60687030921,"Linezolid: 30 Blister Pack In 1 Box, Unit-Dose (60687-309-21) / 1 Tablet, Film Coated In 1 Blister Pack (60687-309-11)",15.11,6.04,,,0 CDM,6370000001_60687031395,NDC Description Not Available,10.39,4.16,,,0 CDM,6370000001_60687031711,NDC Description Not Available,5.22,2.09,,,0 CDM,6370000001_60687033301,"Lisinopril: 100 Blister Pack In 1 Box, Unit-Dose (60687-333-01) / 1 Tablet In 1 Blister Pack (60687-333-11)",0.53,0.21,,,0 CDM,6370000001_60687033311,NDC Description Not Available,0.39,0.16,,,0 CDM,6370000001_60687033611,NDC Description Not Available,3.27,1.31,,,0 CDM,6370000001_60687034011,NDC Description Not Available,3.31,1.32,,,0 CDM,6370000001_60687034501,"Calcitriol: 100 Blister Pack In 1 Box, Unit-Dose (60687-345-01) / 1 Capsule In 1 Blister Pack (60687-345-11)",2.37,0.95,,,0 CDM,6370000001_60687034511,NDC Description Not Available,2.32,0.93,,,0 CDM,6370000001_60687034901,"Quetiapine Fumarate: 100 Blister Pack In 1 Box, Unit-Dose (60687-349-01) / 1 Tablet In 1 Blister Pack (60687-349-11)",0.99,0.4,,,0 CDM,6370000001_60687036001,"Quetiapine Fumarate: 100 Blister Pack In 1 Box, Unit-Dose (60687-360-01) / 1 Tablet In 1 Blister Pack (60687-360-11)",1.63,0.65,,,0 CDM,6370000001_60687036011,NDC Description Not Available,1.61,0.64,,,0 CDM,6370000001_60687036801,"Benztropine Mesylate: 100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-368-01) / 1 TABLET in 1 BLISTER PACK (60687-368-11)",1.12,0.45,,,0 CDM,6370000001_60687036811,NDC Description Not Available,1.12,0.45,,,0 CDM,6370000001_60687036901,"Dicyclomine Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-369-01) / 1 Capsule In 1 Blister Pack (60687-369-11)",2.09,0.84,,,0 CDM,6370000001_60687036911,NDC Description Not Available,1.65,0.66,,,0 CDM,6370000001_60687038011,NDC Description Not Available,1.28,0.51,,,0 CDM,6370000001_60687038811,NDC Description Not Available,0.96,0.38,,,0 CDM,6370000001_60687038911,NDC Description Not Available,39.75,15.9,,,0 CDM,6370000001_60687039001,"Metoprolol Succinate: 100 Blister Pack In 1 Box, Unit-Dose (60687-390-01) / 1 Tablet, Extended Release In 1 Blister Pack (60687-390-11)",2.53,1.01,,,0 CDM,6370000001_60687039011,NDC Description Not Available,3.13,1.25,,,0 CDM,6370000001_60687039601,"Hydrocodone Bitartrate And Acetaminophen: 100 Blister Pack In 1 Box, Unit-Dose (60687-396-01) / 1 Tablet In 1 Blister Pack (60687-396-11)",1.68,0.67,,,0 CDM,6370000001_60687039801,"Midodrine Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-398-01) / 1 Tablet In 1 Blister Pack (60687-398-11)",3.24,1.3,,,0 CDM,6370000001_60687039811,NDC Description Not Available,2.29,0.92,,,0 CDM,6370000001_60687040201,"Metoprolol Succinate: 100 Blister Pack In 1 Box, Unit-Dose (60687-402-01) / 1 Tablet, Extended Release In 1 Blister Pack (60687-402-11)",2.57,1.03,,,0 CDM,6370000001_60687040211,NDC Description Not Available,3.22,1.29,,,0 CDM,6370000001_60687041744,NDC Description Not Available,8.48,3.39,,,0 CDM,6370000001_60687041771,"Hydrocodone Bitartrate And Acetaminophen: 5 Tray In 1 Case (60687-417-71) / 10 Cup, Unit-Dose In 1 Tray (60687-417-50) / 15 Ml In 1 Cup, Unit-Dose (60687-417-44)",9.64,3.86,,,0 CDM,6370000001_60687042095,NDC Description Not Available,27.66,11.06,,,0 CDM,6370000001_60687042201,"Amantadine: 100 Blister Pack In 1 Box, Unit-Dose (60687-422-01) / 1 Capsule In 1 Blister Pack (60687-422-11)",5.96,2.38,,,0 CDM,6370000001_60687042211,NDC Description Not Available,4.78,1.91,,,0 CDM,6370000001_60687042311,NDC Description Not Available,5.8,2.32,,,0 CDM,6370000001_60687042321,"Clobazam: 30 Blister Pack In 1 Box, Unit-Dose (60687-423-21) / 1 Tablet In 1 Blister Pack (60687-423-11)",5.75,2.3,,,0 CDM,6370000001_60687042811,NDC Description Not Available,2.62,1.05,,,0 CDM,6370000001_60687042945,NDC Description Not Available,8.28,3.31,,,0 CDM,6370000001_60687043001,"Chlorpromazine Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-430-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-430-11)",14.89,5.96,,,0 CDM,6370000001_60687043011,NDC Description Not Available,11.1,4.44,,,0 CDM,6370000001_60687043192,Polyethylene Glycol 3350: 100 Pouch In 1 Carton (60687-431-92) / 17 G In 1 Pouch (60687-431-99),2.95,1.18,,,0 CDM,6370000001_60687043199,NDC Description Not Available,4.43,1.77,,,0 CDM,6370000001_60687043301,"Amitriptyline Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-433-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-433-11)",1.38,0.55,,,0 CDM,6370000001_60687043311,NDC Description Not Available,1.55,0.62,,,0 CDM,6370000001_60687043611,NDC Description Not Available,4.35,1.74,,,0 CDM,6370000001_60687043701,"Amiodarone Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-437-01) / 1 Tablet In 1 Blister Pack (60687-437-11)",0.96,0.38,,,0 CDM,6370000001_60687043711,NDC Description Not Available,1.14,0.46,,,0 CDM,6370000001_60687043901,"Labetalol Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-439-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-439-11)",1.19,0.48,,,0 CDM,6370000001_60687043911,NDC Description Not Available,1.28,0.51,,,0 CDM,6370000001_60687044301,Trazodone Hydrochloride: 100 Blister Pack In 1 Carton (60687-443-01) / 1 Tablet In 1 Blister Pack (60687-443-11),0.5,0.2,,,0 CDM,6370000001_60687044311,NDC Description Not Available,0.38,0.15,,,0 CDM,6370000001_60687044411,NDC Description Not Available,1.86,0.74,,,0 CDM,6370000001_60687044611,NDC Description Not Available,0.38,0.15,,,0 CDM,6370000001_60687044711,NDC Description Not Available,6.39,2.56,,,0 CDM,6370000001_60687045111,NDC Description Not Available,11.77,4.71,,,0 CDM,6370000001_60687045121,"Eplerenone: 30 Blister Pack In 1 Box, Unit-Dose (60687-451-21) / 1 Tablet, Film Coated In 1 Blister Pack (60687-451-11)",12.51,5.0,,,0 CDM,6370000001_60687045211,NDC Description Not Available,35.23,14.09,,,0 CDM,6370000001_60687045311,NDC Description Not Available,1.39,0.56,,,0 CDM,6370000001_60687045401,Trazodone Hydrochloride: 100 Blister Pack In 1 Carton (60687-454-01) / 1 Tablet In 1 Blister Pack (60687-454-11),0.54,0.22,,,0 CDM,6370000001_60687045411,NDC Description Not Available,0.56,0.22,,,0 CDM,6370000001_60687045711,NDC Description Not Available,0.58,0.23,,,0 CDM,6370000001_60687046101,"Labetalol Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-461-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-461-11)",3.6,1.44,,,0 CDM,6370000001_60687046111,NDC Description Not Available,2.41,0.96,,,0 CDM,6370000001_60687046411,NDC Description Not Available,1.39,0.56,,,0 CDM,6370000001_60687046501,"Spironolactone: 100 Blister Pack In 1 Box, Unit-Dose (60687-465-01) / 1 Tablet In 1 Blister Pack (60687-465-11)",0.69,0.28,,,0 CDM,6370000001_60687046511,NDC Description Not Available,0.63,0.25,,,0 CDM,6370000001_60687047301,"Pregabalin: 100 Blister Pack In 1 Box, Unit-Dose (60687-473-01) / 1 Capsule In 1 Blister Pack (60687-473-11)",2.79,1.12,,,0 CDM,6370000001_60687047311,NDC Description Not Available,4.07,1.63,,,0 CDM,6370000001_60687048111,NDC Description Not Available,2.82,1.13,,,0 CDM,6370000001_60687048121,"Buprenorphine: 30 Blister Pack In 1 Box, Unit-Dose (60687-481-21) / 1 Tablet In 1 Blister Pack (60687-481-11)",4.4,1.76,,,0 CDM,6370000001_60687048401,"Pregabalin: 100 Blister Pack In 1 Box, Unit-Dose (60687-484-01) / 1 Capsule In 1 Blister Pack (60687-484-11)",2.57,1.03,,,0 CDM,6370000001_60687048411,NDC Description Not Available,36.21,14.48,,,0 CDM,6370000001_60687048611,NDC Description Not Available,2.17,0.87,,,0 CDM,6370000001_60687048701,"Spironolactone: 100 Blister Pack In 1 Box, Unit-Dose (60687-487-01) / 1 Tablet In 1 Blister Pack (60687-487-11)",2.13,0.85,,,0 CDM,6370000001_60687048711,NDC Description Not Available,2.05,0.82,,,0 CDM,6370000001_60687048801,"Amlodipine Besylate: 100 Blister Pack In 1 Box, Unit-Dose (60687-488-01) / 1 Tablet In 1 Blister Pack (60687-488-11)",0.65,0.26,,,0 CDM,6370000001_60687048811,NDC Description Not Available,0.5,0.2,,,0 CDM,6370000001_60687049211,NDC Description Not Available,9.67,3.87,,,0 CDM,6370000001_60687049221,"Buprenorphine: 30 Blister Pack In 1 Box, Unit-Dose (60687-492-21) / 1 Tablet In 1 Blister Pack (60687-492-11)",15.09,6.04,,,0 CDM,6370000001_60687049511,NDC Description Not Available,6.28,2.51,,,0 CDM,6370000001_60687049711,NDC Description Not Available,1.85,0.74,,,0 CDM,6370000001_60687050011,NDC Description Not Available,4.03,1.61,,,0 CDM,6370000001_60687050301,"Baclofen: 100 Blister Pack In 1 Box, Unit-Dose (60687-503-01) / 1 Tablet In 1 Blister Pack (60687-503-11)",1.71,0.68,,,0 CDM,6370000001_60687050311,NDC Description Not Available,1.48,0.59,,,0 CDM,6370000001_60687050601,"Pregabalin: 100 Blister Pack In 1 Box, Unit-Dose (60687-506-01) / 1 Capsule In 1 Blister Pack (60687-506-11)",2.57,1.03,,,0 CDM,6370000001_60687050611,NDC Description Not Available,9.56,3.82,,,0 CDM,6370000001_60687050811,NDC Description Not Available,2.69,1.08,,,0 CDM,6370000001_60687052511,NDC Description Not Available,77.13,30.85,,,0 CDM,6370000001_60687052611,NDC Description Not Available,1.01,0.4,,,0 CDM,6370000001_60687053436,"Atovaquone: 2 Tray In 1 Case (60687-534-36) / 10 Cup, Unit-Dose In 1 Tray (60687-534-46) / 5 Ml In 1 Cup, Unit-Dose (60687-534-40)",58.98,23.59,,,0 CDM,6370000001_60687053440,NDC Description Not Available,38.46,15.38,,,0 CDM,6370000001_60687054001,"Digoxin: 100 Blister Pack In 1 Box, Unit-Dose (60687-540-01) / 1 Tablet In 1 Blister Pack (60687-540-11)",4.23,1.69,,,0 CDM,6370000001_60687054011,NDC Description Not Available,4.54,1.82,,,0 CDM,6370000001_60687054111,NDC Description Not Available,2.57,1.03,,,0 CDM,6370000001_60687054401,"Clonazepam: 100 Blister Pack In 1 Box, Unit-Dose (60687-544-01) / 1 Tablet In 1 Blister Pack (60687-544-11)",1.76,0.7,,,0 CDM,6370000001_60687054411,NDC Description Not Available,1.11,0.44,,,0 CDM,6370000001_60687055001,"Metronidazole: 100 Blister Pack In 1 Box, Unit-Dose (60687-550-01) / 1 Tablet In 1 Blister Pack (60687-550-11)",2.42,0.97,,,0 CDM,6370000001_60687055011,NDC Description Not Available,2.24,0.9,,,0 CDM,6370000001_60687055201,"Levothyroxine Sodium: 100 Blister Pack In 1 Box, Unit-Dose (60687-552-01) / 1 Tablet In 1 Blister Pack (60687-552-11)",2.98,1.19,,,0 CDM,6370000001_60687055311,NDC Description Not Available,35.19,14.08,,,0 CDM,6370000001_60687055501,"Clonazepam: 100 Blister Pack In 1 Box, Unit-Dose (60687-555-01) / 1 Tablet In 1 Blister Pack (60687-555-11)",1.4,0.56,,,0 CDM,6370000001_60687055511,NDC Description Not Available,0.85,0.34,,,0 CDM,6370000001_60687055633,NDC Description Not Available,20.5,8.2,,,0 CDM,6370000001_60687055901,"Methocarbamol: 100 Blister Pack In 1 Box, Unit-Dose (60687-559-01) / 1 Tablet In 1 Blister Pack (60687-559-11)",0.71,0.28,,,0 CDM,6370000001_60687055911,NDC Description Not Available,0.73,0.29,,,0 CDM,6370000001_60687056311,NDC Description Not Available,2.14,0.86,,,0 CDM,6370000001_60687056801,"Methocarbamol: 100 Blister Pack In 1 Box, Unit-Dose (60687-568-01) / 1 Tablet In 1 Blister Pack (60687-568-11)",1.21,0.48,,,0 CDM,6370000001_60687056811,NDC Description Not Available,0.94,0.38,,,0 CDM,6370000001_60687057011,NDC Description Not Available,0.91,0.36,,,0 CDM,6370000001_60687057232,"Prazosin Hydrochloride: 20 Blister Pack In 1 Box, Unit-Dose (60687-572-32) / 1 Capsule In 1 Blister Pack (60687-572-33)",12.94,5.18,,,0 CDM,6370000001_60687057233,NDC Description Not Available,10.11,4.04,,,0 CDM,6370000001_60687057511,NDC Description Not Available,8.88,3.55,,,0 CDM,6370000001_60687057603,NDC Description Not Available,13.11,5.24,,,0 CDM,6370000001_60687057901,"Hydromorphone Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-579-01) / 1 Tablet In 1 Blister Pack (60687-579-11)",1.22,0.49,,,0 CDM,6370000001_60687057911,NDC Description Not Available,0.75,0.3,,,0 CDM,6370000001_60687058001,"Gabapentin: 100 Blister Pack In 1 Box, Unit-Dose (60687-580-01) / 1 Capsule In 1 Blister Pack (60687-580-11)",0.52,0.21,,,0 CDM,6370000001_60687058011,NDC Description Not Available,0.35,0.14,,,0 CDM,6370000001_60687058111,NDC Description Not Available,2.3,0.92,,,0 CDM,6370000001_60687058121,"Pramipexole Dihydrochloride: 30 Blister Pack In 1 Box, Unit-Dose (60687-581-21) / 1 Tablet In 1 Blister Pack (60687-581-11)",2.33,0.93,,,0 CDM,6370000001_60687058311,NDC Description Not Available,10.13,4.05,,,0 CDM,6370000001_60687058321,"Carbamazepine: 30 Blister Pack In 1 Box, Unit-Dose (60687-583-21) / 1 Tablet, Extended Release In 1 Blister Pack (60687-583-11)",14.49,5.8,,,0 CDM,6370000001_60687058601,"Rifampin: 100 Blister Pack In 1 Box, Unit-Dose (60687-586-01) / 1 Capsule In 1 Blister Pack (60687-586-11)",8.02,3.21,,,0 CDM,6370000001_60687058611,NDC Description Not Available,4.51,1.8,,,0 CDM,6370000001_60687058701,"Propranolol Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-587-01) / 1 Tablet In 1 Blister Pack (60687-587-11)",0.58,0.23,,,0 CDM,6370000001_60687058711,NDC Description Not Available,0.69,0.28,,,0 CDM,6370000001_60687058801,"Ropinirole Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-588-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-588-11)",1.83,0.73,,,0 CDM,6370000001_60687058811,NDC Description Not Available,1.74,0.7,,,0 CDM,6370000001_60687059001,"Hydromorphone Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-590-01) / 1 Tablet In 1 Blister Pack (60687-590-11)",1.23,0.49,,,0 CDM,6370000001_60687059011,NDC Description Not Available,0.95,0.38,,,0 CDM,6370000001_60687059101,"Gabapentin: 100 Blister Pack In 1 Box, Unit-Dose (60687-591-01) / 1 Capsule In 1 Blister Pack (60687-591-11)",0.54,0.22,,,0 CDM,6370000001_60687059111,NDC Description Not Available,0.39,0.16,,,0 CDM,6370000001_60687059211,NDC Description Not Available,2.62,1.05,,,0 CDM,6370000001_60687059221,"Pramipexole Dihydrochloride: 30 Blister Pack In 1 Box, Unit-Dose (60687-592-21) / 1 Tablet In 1 Blister Pack (60687-592-11)",4.1,1.64,,,0 CDM,6370000001_60687059301,"Hydrochlorothiazide: 100 Blister Pack In 1 Box, Unit-Dose (60687-593-01) / 1 Tablet In 1 Blister Pack (60687-593-11)",0.49,0.2,,,0 CDM,6370000001_60687059311,NDC Description Not Available,0.46,0.18,,,0 CDM,6370000001_60687059501,"Famotidine: 100 Blister Pack In 1 Box, Unit-Dose (60687-595-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-595-11)",0.86,0.34,,,0 CDM,6370000001_60687059511,NDC Description Not Available,0.59,0.24,,,0 CDM,6370000001_60687059801,"Propranolol Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-598-01) / 1 Tablet In 1 Blister Pack (60687-598-11)",1.74,0.7,,,0 CDM,6370000001_60687059811,NDC Description Not Available,1.4,0.56,,,0 CDM,6370000001_60687060211,NDC Description Not Available,0.6,0.24,,,0 CDM,6370000001_60687060311,NDC Description Not Available,0.92,0.37,,,0 CDM,6370000001_60687060711,NDC Description Not Available,6.44,2.58,,,0 CDM,6370000001_60687060721,"Desvenlafaxine: 30 Blister Pack In 1 Box, Unit-Dose (60687-607-21) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack (60687-607-11)",6.42,2.57,,,0 CDM,6370000001_60687060901,"Propranolol Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-609-01) / 1 Tablet In 1 Blister Pack (60687-609-11)",2.39,0.96,,,0 CDM,6370000001_60687060911,NDC Description Not Available,1.67,0.67,,,0 CDM,6370000001_60687061211,NDC Description Not Available,2.01,0.8,,,0 CDM,6370000001_60687061221,"Valsartan: 30 Blister Pack In 1 Box, Unit-Dose (60687-612-21) / 1 Tablet, Film Coated In 1 Blister Pack (60687-612-11)",3.5,1.4,,,0 CDM,6370000001_60687061811,NDC Description Not Available,3.03,1.21,,,0 CDM,6370000001_60687061821,"Fenofibrate: 30 Blister Pack In 1 Box, Unit-Dose (60687-618-21) / 1 Tablet In 1 Blister Pack (60687-618-11)",2.85,1.14,,,0 CDM,6370000001_60687062001,"Metoclopramide: 100 Blister Pack In 1 Box, Unit-Dose (60687-620-01) / 1 Tablet In 1 Blister Pack (60687-620-11)",1.73,0.69,,,0 CDM,6370000001_60687062011,NDC Description Not Available,1.74,0.7,,,0 CDM,6370000001_60687062201,"Sennosides And Docusate Sodium: 100 Blister Pack In 1 Box, Unit-Dose (60687-622-01) / 1 Tablet In 1 Blister Pack (60687-622-11)",0.46,0.18,,,0 CDM,6370000001_60687062211,NDC Description Not Available,0.44,0.18,,,0 CDM,6370000001_60687062301,"Valsartan: 100 Blister Pack In 1 Box, Unit-Dose (60687-623-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-623-11)",3.1,1.24,,,0 CDM,6370000001_60687062311,NDC Description Not Available,3.06,1.22,,,0 CDM,6370000001_60687062701,Lorazepam: 100 Blister Pack In 1 Carton (60687-627-01) / 1 Tablet In 1 Blister Pack (60687-627-11),0.58,0.23,,,0 CDM,6370000001_60687062711,NDC Description Not Available,0.38,0.15,,,0 CDM,6370000001_60687062911,NDC Description Not Available,5.29,2.12,,,0 CDM,6370000001_60687063011,NDC Description Not Available,3.34,1.34,,,0 CDM,6370000001_60687063101,"Metoclopramide: 100 Blister Pack In 1 Box, Unit-Dose (60687-631-01) / 1 Tablet In 1 Blister Pack (60687-631-11)",1.7,0.68,,,0 CDM,6370000001_60687063111,NDC Description Not Available,1.68,0.67,,,0 CDM,6370000001_60687063311,NDC Description Not Available,6.13,2.45,,,0 CDM,6370000001_60687063511,NDC Description Not Available,11.31,4.52,,,0 CDM,6370000001_60687063801,"Lorazepam: 100 Blister Pack In 1 Box, Unit-Dose (60687-638-01) / 1 Tablet In 1 Blister Pack (60687-638-11)",0.58,0.23,,,0 CDM,6370000001_60687063811,NDC Description Not Available,0.52,0.21,,,0 CDM,6370000001_60687064811,NDC Description Not Available,45.22,18.09,,,0 CDM,6370000001_60687065311,NDC Description Not Available,2.59,1.04,,,0 CDM,6370000001_60687065701,"Levetiracetam: 100 Blister Pack In 1 Carton (60687-657-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-657-11)",0.82,0.33,,,0 CDM,6370000001_60687065711,NDC Description Not Available,1.03,0.41,,,0 CDM,6370000001_60687065801,"Diclofenac Sodium: 100 Blister Pack In 1 Carton (60687-658-01) / 1 Tablet, Delayed Release In 1 Blister Pack (60687-658-11)",2.33,0.93,,,0 CDM,6370000001_60687065811,NDC Description Not Available,2.0,0.8,,,0 CDM,6370000001_60687066101,Carbidopa And Levodopa: 100 Blister Pack In 1 Carton (60687-661-01) / 1 Tablet In 1 Blister Pack (60687-661-11),0.85,0.34,,,0 CDM,6370000001_60687066111,NDC Description Not Available,1.05,0.42,,,0 CDM,6370000001_60687066401,"Hydroxyzine Hydrochloride: 100 Blister Pack In 1 Carton (60687-664-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-664-11)",0.75,0.3,,,0 CDM,6370000001_60687066411,NDC Description Not Available,0.71,0.28,,,0 CDM,6370000001_60687066711,NDC Description Not Available,0.49,0.2,,,0 CDM,6370000001_60687066901,Methimazole: 100 Blister Pack In 1 Carton (60687-669-01) / 1 Tablet In 1 Blister Pack (60687-669-11),2.32,0.93,,,0 CDM,6370000001_60687066911,NDC Description Not Available,1.6,0.64,,,0 CDM,6370000001_60687067011,NDC Description Not Available,1.29,0.52,,,0 CDM,6370000001_60687067140,NDC Description Not Available,4.96,1.98,,,0 CDM,6370000001_60687067167,"Phenobarbital: 5 Tray In 1 Case (60687-671-67) / 10 Cup, Unit-Dose In 1 Tray (60687-671-46) / 5 Ml In 1 Cup, Unit-Dose (60687-671-40)",3.78,1.51,,,0 CDM,6370000001_60687067211,NDC Description Not Available,4.88,1.95,,,0 CDM,6370000001_60687067265,"Butalbital, Acetaminophen And Caffeine: 50 Blister Pack In 1 Carton (60687-672-65) / 1 Tablet In 1 Blister Pack (60687-672-11)",5.67,2.27,,,0 CDM,6370000001_60687067501,"Hydroxyzine Hydrochloride: 100 Blister Pack In 1 Carton (60687-675-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-675-11)",0.86,0.34,,,0 CDM,6370000001_60687067511,NDC Description Not Available,0.91,0.36,,,0 CDM,6370000001_60687067611,NDC Description Not Available,8.44,3.38,,,0 CDM,6370000001_60687067711,NDC Description Not Available,1.19,0.48,,,0 CDM,6370000001_60687068011,NDC Description Not Available,2.47,0.99,,,0 CDM,6370000001_60687068101,Folic Acid: 100 Blister Pack In 1 Carton (60687-681-01) / 1 Tablet In 1 Blister Pack (60687-681-11),0.96,0.38,,,0 CDM,6370000001_60687068111,NDC Description Not Available,2.12,0.85,,,0 CDM,6370000001_60687068811,NDC Description Not Available,2.16,0.86,,,0 CDM,6370000001_60687069501,Sucralfate: 100 Blister Pack In 1 Carton (60687-695-01) / 1 Tablet In 1 Blister Pack (60687-695-11),1.5,0.6,,,0 CDM,6370000001_60687069511,NDC Description Not Available,0.91,0.36,,,0 CDM,6370000001_60687069611,NDC Description Not Available,1.45,0.58,,,0 CDM,6370000001_60687069711,NDC Description Not Available,1.16,0.46,,,0 CDM,6370000001_60687069811,NDC Description Not Available,6.77,2.71,,,0 CDM,6370000001_60687070101,Glipizide: 100 Blister Pack In 1 Carton (60687-701-01) / 1 Tablet In 1 Blister Pack (60687-701-11),2.07,0.83,,,0 CDM,6370000001_60687070111,NDC Description Not Available,2.07,0.83,,,0 CDM,6370000001_60687070711,NDC Description Not Available,0.83,0.33,,,0 CDM,6370000001_60687071711,NDC Description Not Available,1.31,0.52,,,0 CDM,6370000001_60687072201,"Oxcarbazepine: 100 Blister Pack In 1 Carton (60687-722-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-722-11)",2.63,1.05,,,0 CDM,6370000001_60687072211,NDC Description Not Available,2.47,0.99,,,0 CDM,6370000001_60687072311,NDC Description Not Available,7.76,3.1,,,0 CDM,6370000001_60687072321,"Duloxetine: 30 Blister Pack In 1 Carton (60687-723-21) / 1 Capsule, Delayed Release In 1 Blister Pack (60687-723-11)",5.31,2.12,,,0 CDM,6370000001_60687073001,Meclizine Hydrochloride: 100 Blister Pack In 1 Carton (60687-730-01) / 1 Tablet In 1 Blister Pack (60687-730-11),1.81,0.72,,,0 CDM,6370000001_60687073011,NDC Description Not Available,1.91,0.76,,,0 CDM,6370000001_60687073842,NDC Description Not Available,27.27,10.91,,,0 CDM,6370000001_60687073856,"Sucralfate: 10 Tray In 1 Case (60687-738-56) / 10 Cup, Unit-Dose In 1 Tray (60687-738-48) / 10 Ml In 1 Cup, Unit-Dose (60687-738-42)",30.82,12.33,,,0 CDM,6370000001_60687074211,NDC Description Not Available,2.33,0.93,,,0 CDM,6370000001_60687074317,"Childrens Ibuprofen: 10 Tray In 1 Case (60687-743-17) / 10 Cup, Unit-Dose In 1 Tray (60687-743-46) / 5 Ml In 1 Cup, Unit-Dose (60687-743-40)",2.19,0.88,,,0 CDM,6370000001_60687074340,NDC Description Not Available,1.94,0.78,,,0 CDM,6370000001_60687074501,"Duloxetine: 100 Blister Pack In 1 Carton (60687-745-01) / 1 Capsule, Delayed Release In 1 Blister Pack (60687-745-11)",4.12,1.65,,,0 CDM,6370000001_60687074511,NDC Description Not Available,5.18,2.07,,,0 CDM,6370000001_60687074611,NDC Description Not Available,7.91,3.16,,,0 CDM,6370000001_60687076040,NDC Description Not Available,1.9,0.76,,,0 CDM,6370000001_60687076086,"Morphine Sulfate: 3 Tray In 1 Case (60687-760-86) / 10 Cup, Unit-Dose In 1 Tray (60687-760-46) / 5 Ml In 1 Cup, Unit-Dose (60687-760-40)",2.95,1.18,,,0 CDM,6370000001_60687078811,NDC Description Not Available,3.51,1.4,,,0 CDM,6370000001_60687079511,NDC Description Not Available,0.42,0.17,,,0 CDM,6370000001_60687080017,"Nystatin: 10 Tray In 1 Case (60687-800-17) / 10 Cup, Unit-Dose In 1 Tray (60687-800-46) / 5 Ml In 1 Cup, Unit-Dose (60687-800-40)",6.95,2.78,,,0 CDM,6370000001_60687080040,NDC Description Not Available,5.03,2.01,,,0 CDM,6370000001_60687081009,"Potassium Chloride: 80 Blister Pack In 1 Carton (60687-810-09) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack (60687-810-11)",0.92,0.37,,,0 CDM,6370000001_60687081011,NDC Description Not Available,0.65,0.26,,,0 CDM,6370000001_60687081111,NDC Description Not Available,0.82,0.33,,,0 CDM,6370000001_60687081501,Baclofen: 100 Blister Pack In 1 Carton (60687-815-01) / 1 Tablet In 1 Blister Pack (60687-815-11),1.67,0.67,,,0 CDM,6370000001_60687081511,NDC Description Not Available,1.17,0.47,,,0 CDM,6370000001_60687081886,"Methadone Hydrochloride: 3 Tray In 1 Case (60687-818-86) / 10 Cup, Unit-Dose In 1 Tray (60687-818-46) / 5 Ml In 1 Cup, Unit-Dose (60687-818-40)",2.9,1.16,,,0 CDM,6370000001_60687082201,Hydralazine Hydrochloride: 100 Blister Pack In 1 Carton (60687-822-01) / 1 Tablet In 1 Blister Pack (60687-822-11),0.74,0.3,,,0 CDM,6370000001_60687082211,NDC Description Not Available,0.64,0.26,,,0 CDM,6370000001_60687082311,NDC Description Not Available,1.19,0.48,,,0 CDM,6370000001_60687082601,Baclofen: 100 Blister Pack In 1 Carton (60687-826-01) / 1 Tablet In 1 Blister Pack (60687-826-11),3.04,1.22,,,0 CDM,6370000001_60687082611,NDC Description Not Available,2.24,0.9,,,0 CDM,6370000001_60687083301,Hydralazine Hydrochloride: 100 Blister Pack In 1 Carton (60687-833-01) / 1 Tablet In 1 Blister Pack (60687-833-11),0.98,0.39,,,0 CDM,6370000001_60687083311,NDC Description Not Available,0.77,0.31,,,0 CDM,6370000001_60687083611,NDC Description Not Available,0.95,0.38,,,0 CDM,6370000001_60687083742,NDC Description Not Available,8.1,3.24,,,0 CDM,6370000001_60687083801,"Zolpidem Tartrate: 100 Blister Pack In 1 Carton (60687-838-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-838-11)",0.53,0.21,,,0 CDM,6370000001_60687084111,NDC Description Not Available,35.99,14.4,,,0 CDM,6370000001_60687085611,NDC Description Not Available,1.27,0.51,,,0 CDM,6370000001_60687086001,"Ciprofloxacin: 100 Blister Pack In 1 Carton (60687-860-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-860-11)",1.06,0.42,,,0 CDM,6370000001_60687086011,NDC Description Not Available,0.8,0.32,,,0 CDM,6370000001_60687086111,NDC Description Not Available,1.77,0.71,,,0 CDM,6370000001_60687088611,NDC Description Not Available,1.48,0.59,,,0 CDM,6370000001_60758011905,"Prednisolone Acetate: 1 Bottle, Dropper In 1 Carton (60758-119-05) / 5 Ml In 1 Bottle, Dropper",188.24,75.3,,,0 CDM,6370000001_60758080105,"Timolol Maleate: 1 Bottle, Dropper In 1 Carton (60758-801-05) / 5 Ml In 1 Bottle, Dropper",16.49,6.6,,,0 CDM,6370000001_60758090810,"Polymyxin B Sulfate And Trimethoprim Sulfate: 1 Bottle, Dropper In 1 Carton (60758-908-10) / 10 Ml In 1 Bottle, Dropper",30.54,12.22,,,0 CDM,6370000001_60793011501,Cytomel: 100 Tablet In 1 Bottle (60793-115-01),1.65,0.66,,,0 CDM,6370000001_61269073063,"Miconazole 7: 1 Tube, With Applicator In 1 Carton (61269-730-63) / 45 G In 1 Tube, With Applicator",11.88,4.75,,,0 CDM,6370000001_61269073607,Miconazole 7: 7 Suppository In 1 Box (61269-736-07),1.64,0.66,,,0 CDM,6370000001_61314001601,Proparacaine Hydrochloride: 1 Bottle In 1 Carton (61314-016-01) / 15 Ml In 1 Bottle,105.31,42.12,,,0 CDM,6370000001_61314001910,Dorzolamide Hydrochloride: 10 Ml In 1 Bottle (61314-019-10),37.95,15.18,,,0 CDM,6370000001_61314014305,Brimonidine Tartrate: 1 Bottle In 1 Carton (61314-143-05) / 5 Ml In 1 Bottle,26.36,10.54,,,0 CDM,6370000001_61314014310,Brimonidine Tartrate: 1 Bottle In 1 Carton (61314-143-10) / 10 Ml In 1 Bottle,43.8,17.52,,,0 CDM,6370000001_61314020315,Pilocarpine Hydrochloride: 1 Bottle In 1 Carton (61314-203-15) / 15 Ml In 1 Bottle,238.12,95.25,,,0 CDM,6370000001_61314022705,"Timolol Maleate: 5 Ml In 1 Bottle, Plastic (61314-227-05)",20.29,8.12,,,0 CDM,6370000001_61314024501,"Betaxolol Hydrochloride: 1 Bottle, Plastic In 1 Carton (61314-245-01) / 5 Ml In 1 Bottle, Plastic",152.91,61.16,,,0 CDM,6370000001_61314035401,"Tropicamide: 1 Bottle, Plastic In 1 Carton (61314-354-01) / 15 Ml In 1 Bottle, Plastic",65.59,26.24,,,0 CDM,6370000001_61314035501,"Tropicamide: 1 Bottle, Plastic In 1 Carton (61314-355-01) / 3 Ml In 1 Bottle, Plastic",29.98,11.99,,,0 CDM,6370000001_61314039601,Cyclopentolate Hydrochloride: 2 Ml In 1 Bottle (61314-396-01),32.21,12.88,,,0 CDM,6370000001_61314054701,Latanoprost: 1 Bottle In 1 Carton (61314-547-01) / 2.5 Ml In 1 Bottle,32.1,12.84,,,0 CDM,6370000001_61314054703,Latanoprost: 3 Bottle In 1 Carton (61314-547-03) / 2.5 Ml In 1 Bottle,17.4,6.96,,,0 CDM,6370000001_61314062810,"Polymyxin B Sulfate And Trimethoprim: 10 Ml In 1 Bottle, Plastic (61314-628-10)",30.95,12.38,,,0 CDM,6370000001_61314063136,Neomycin And Polymyxin B Sulfates And Dexamethasone: 3.5 G In 1 Tube (61314-631-36),77.01,30.8,,,0 CDM,6370000001_61314063305,"Gentamicin Sulfate: 1 Bottle, Dropper In 1 Carton (61314-633-05) / 5 Ml In 1 Bottle, Dropper",19.78,7.91,,,0 CDM,6370000001_61314063705,"Prednisolone Acetate: 1 Bottle, Plastic In 1 Carton (61314-637-05) / 5 Ml In 1 Bottle, Plastic",132.33,52.93,,,0 CDM,6370000001_61314063710,"Prednisolone Acetate: 1 Bottle, Plastic In 1 Carton (61314-637-10) / 10 Ml In 1 Bottle, Plastic",194.45,77.78,,,0 CDM,6370000001_61314064175,"Neomycin And Polymyxin B Sulfates And Hydrocortisone: 7.5 Ml In 1 Bottle, Plastic (61314-641-75)",586.95,234.78,,,0 CDM,6370000001_61314064511,"Neomycin And Polymyxin B Sulfates And Hydrocortisone: 10 Ml In 1 Bottle, Plastic (61314-645-11)",253.48,101.39,,,0 CDM,6370000001_61314065605,"Ciprofloxacin Hydrochloride: 1 Bottle, Plastic In 1 Carton (61314-656-05) / 5 Ml In 1 Bottle, Plastic",28.91,11.56,,,0 CDM,6370000001_61442011201,"Acyclovir: 24 Bottle, Plastic In 1 Box (61442-112-01) / 100 Tablet In 1 Bottle, Plastic",0.48,0.19,,,0 CDM,6370000001_61570013125,Silvadene: 1 Tube In 1 Carton (61570-131-25) / 25 G In 1 Tube,19.05,7.62,,,0 CDM,6370000001_61570013140,Silvadene: 400 G In 1 Jar (61570-131-40),214.75,85.9,,,0 CDM,6370000001_61570013150,Silvadene: 50 G In 1 Jar (61570-131-50),25.2,10.08,,,0 CDM,6370000001_61570013155,Silvadene: 1 Tube In 1 Carton (61570-131-55) / 50 G In 1 Tube,38.7,15.48,,,0 CDM,6370000001_61874011511,NDC Description Not Available,133.06,53.22,,,0 CDM,6370000001_61874011520,"Vraylar: 2 Blister Pack In 1 Carton (61874-115-20) / 10 Capsule, Gelatin Coated In 1 Blister Pack (61874-115-11)",207.71,83.08,,,0 CDM,6370000001_61874011530,"Vraylar: 30 Capsule, Gelatin Coated In 1 Bottle (61874-115-30)",207.71,83.08,,,0 CDM,6370000001_61958060101,"Emtriva: 30 Capsule In 1 Bottle, Plastic (61958-0601-1)",77.08,30.83,,,0 CDM,6370000001_61958060201,"Emtriva: 1 Bottle, Dispensing In 1 Carton (61958-0602-1) / 170 Ml In 1 Bottle, Dispensing",43.49,17.4,,,0 CDM,6370000001_61958190101,"Genvoya: 30 Tablet In 1 Bottle, Plastic (61958-1901-1)",393.15,157.26,,,0 CDM,6370000001_61958200201,"Descovy: 30 Tablet In 1 Bottle, Plastic (61958-2002-1)",215.0,86.0,,,0 CDM,6370000001_61958230101,"Vemlidy: 30 Tablet In 1 Bottle, Plastic (61958-2301-1)",149.89,59.96,,,0 CDM,6370000001_61958250101,"Biktarvy: 30 Tablet In 1 Bottle, Plastic (61958-2501-1)",394.26,157.7,,,0 CDM,6370000001_61959000101,NDC Description Not Available,7.72,3.09,,,0 CDM,6370000001_61959000130,Lidoderm: 30 Pouch In 1 Carton (61959-001-30) / 1 Patch In 1 Pouch (61959-001-01),114.24,45.7,,,0 CDM,6370000001_62135000294,Lactulose: 946 Ml In 1 Package (62135-002-94),409.86,163.94,,,0 CDM,6370000001_62135000394,"Lactulose: 946 Ml In 1 Bottle, Plastic (62135-003-94)",53.82,21.53,,,0 CDM,6370000001_62135001047,Amantadine Hydrochloride: 473 Ml In 1 Bottle (62135-010-47),50.39,20.16,,,0 CDM,6370000001_62135052047,Oxybutynin Chloride: 473 Ml In 1 Bottle (62135-520-47),6.38,2.55,,,0 CDM,6370000001_62135071242,Lidocaine Hydrochloride: 100 Ml In 1 Bottle (62135-712-42),16.48,6.59,,,0 CDM,6370000001_62135075047,Hydroxyzine Hydrochloride: 473 Ml In 1 Bottle (62135-750-47),36.07,14.43,,,0 CDM,6370000001_62332001131,Venlafaxine: 100 Tablet In 1 Bottle (62332-011-31),0.92,0.37,,,0 CDM,6370000001_62332002531,"Theophylline: 100 Tablet, Extended Release In 1 Bottle (62332-025-31)",7.68,3.07,,,0 CDM,6370000001_62332017160,"Lacosamide: 60 Tablet, Film Coated In 1 Bottle (62332-171-60)",1.27,0.51,,,0 CDM,6370000001_62332023230,"Vilazodone Hydrochloride: 30 Tablet, Film Coated In 1 Bottle (62332-232-30)",10.7,4.28,,,0 CDM,6370000001_62332023430,"Vilazodone Hydrochloride: 30 Tablet, Film Coated In 1 Bottle (62332-234-30)",10.33,4.13,,,0 CDM,6370000001_62332025330,"Azithromycin: 30 Tablet, Film Coated In 1 Bottle (62332-253-30)",13.8,5.52,,,0 CDM,6370000001_62332034290,Candesartan Cilexetil: 90 Tablet In 1 Bottle (62332-342-90),7.43,2.97,,,0 CDM,6370000001_62332034390,Candesartan Cilexetil: 90 Tablet In 1 Bottle (62332-343-90),3.42,1.37,,,0 CDM,6370000001_62332036406,"Clonazepam: 60 Blister Pack In 1 Carton (62332-364-06) / 6 Tablet, Orally Disintegrating In 1 Blister Pack",2.81,1.12,,,0 CDM,6370000001_62332041310,Oseltamivir: 1 Carton In 1 Blister Pack (62332-413-10) / 10 Capsule In 1 Carton,31.69,12.68,,,0 CDM,6370000001_62332051805,Tobramycin Ophthalmic Solution: 1 Bottle In 1 Carton (62332-518-05) / 5 Ml In 1 Bottle,33.58,13.43,,,0 CDM,6370000001_62332060630,Nystatin And Triamcinolone Acetonide: 1 Tube In 1 Carton (62332-606-30) / 30 G In 1 Tube,125.86,50.34,,,0 CDM,6370000001_62332061831,Cyclophosphamide: 100 Capsule In 1 Bottle (62332-618-31),4.74,1.9,,,0 CDM,6370000001_62332061931,Cyclophosphamide: 100 Capsule In 1 Bottle (62332-619-31),4.11,1.64,,,0 CDM,6370000001_62332067960,"Ivabradine: 60 Tablet, Film Coated In 1 Bottle (62332-679-60)",6.88,2.75,,,0 CDM,6370000001_62332070605,"Brimonidine Tartrate And Timolol Maleate: 1 Bottle, Dropper In 1 Carton (62332-706-05) / 5 Ml In 1 Bottle, Dropper",300.0,120.0,,,0 CDM,6370000001_62372063015,"Mylicon Infants Gas Relief Original: 1 Bottle, Dropper In 1 Carton (62372-630-15) / 15 Ml In 1 Bottle, Dropper",0.37,0.15,,,0 CDM,6370000001_62372063030,"Mylicon Infants Gas Relief Original: 1 Bottle, Dropper In 1 Carton (62372-630-30) / 30 Ml In 1 Bottle, Dropper",0.55,0.22,,,0 CDM,6370000001_62372063053,NDC Description Not Available,0.06,0.02,,,0 CDM,6370000001_62530000011,NDC Description Not Available,10.29,4.12,,,0 CDM,6370000001_62559013807,Hydrocortisone: 7 Bottle In 1 Box (62559-138-07) / 60 Ml In 1 Bottle (62559-138-11),64.26,25.7,,,0 CDM,6370000001_62559015116,Oxycodone Hydrochloride: 1 Bottle In 1 Carton (62559-151-16) / 473 Ml In 1 Bottle,3.09,1.24,,,0 CDM,6370000001_62559015717,NDC Description Not Available,5.21,2.08,,,0 CDM,6370000001_62559015901,"Fluvoxamine Maleate: 100 Tablet, Coated In 1 Bottle (62559-159-01)",1.57,0.63,,,0 CDM,6370000001_62559019016,"Metoclopramide: 473 Ml In 1 Bottle, Plastic (62559-190-16)",0.38,0.15,,,0 CDM,6370000001_62559026616,Valproic Acid: 473 Ml In 1 Bottle (62559-266-16),1.24,0.5,,,0 CDM,6370000001_62559035660,NDC Description Not Available,106.82,42.73,,,0 CDM,6370000001_62559043130,Hydrocortisone: 1 Tube In 1 Carton (62559-431-30) / 30 G In 1 Tube,212.28,84.91,,,0 CDM,6370000001_62559072101,Terbutaline Sulfate: 100 Tablet In 1 Bottle (62559-721-01),2.89,1.16,,,0 CDM,6370000001_62559073001,Felbamate: 100 Tablet In 1 Bottle (62559-730-01),2.35,0.94,,,0 CDM,6370000001_62584026501,"Metoprolol Tartrate: 100 Blister Pack In 1 Box, Unit-Dose (62584-265-01) / 1 Tablet, Film Coated In 1 Blister Pack (62584-265-11)",0.18,0.07,,,0 CDM,6370000001_62584026511,NDC Description Not Available,0.25,0.1,,,0 CDM,6370000001_62584026701,"Metoprolol Tartrate: 100 Blister Pack In 1 Box, Unit-Dose (62584-267-01) / 1 Tablet, Film Coated In 1 Blister Pack (62584-267-11)",0.64,0.26,,,0 CDM,6370000001_62584026711,NDC Description Not Available,0.61,0.24,,,0 CDM,6370000001_62584069311,NDC Description Not Available,12.16,4.86,,,0 CDM,6370000001_62584069321,"Doxycycline: 30 Blister Pack In 1 Box, Unit-Dose (62584-693-21) / 1 Tablet, Coated In 1 Blister Pack (62584-693-11)",10.9,4.36,,,0 CDM,6370000001_62584073301,"Hydralazine Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (62584-733-01) / 1 Tablet, Film Coated In 1 Blister Pack (62584-733-11)",0.74,0.3,,,0 CDM,6370000001_62584073311,NDC Description Not Available,0.74,0.3,,,0 CDM,6370000001_62584073411,NDC Description Not Available,1.12,0.45,,,0 CDM,6370000001_62584081311,NDC Description Not Available,7.43,2.97,,,0 CDM,6370000001_62584099411,NDC Description Not Available,0.95,0.38,,,0 CDM,6370000001_62756013802,Gabapentin: 100 Capsule In 1 Bottle (62756-138-02),0.36,0.14,,,0 CDM,6370000001_62756051788,Carbidopa And Levodopa: 100 Tablet In 1 Bottle (62756-517-88),1.13,0.45,,,0 CDM,6370000001_62756079688,"Divalproex Sodium: 100 Tablet, Delayed Release In 1 Bottle (62756-796-88)",0.19,0.08,,,0 CDM,6370000001_62756079888,"Divalproex Sodium: 100 Tablet, Delayed Release In 1 Bottle (62756-798-88)",0.76,0.3,,,0 CDM,6370000001_62756095501,Mexiletine Hydrochloride: 100 Capsule In 1 Bottle (62756-955-01),1.75,0.7,,,0 CDM,6370000001_62756095601,Mexiletine Hydrochloride: 100 Capsule In 1 Bottle (62756-956-01),5.05,2.02,,,0 CDM,6370000001_62856027230,Fycompa: 30 Tablet In 1 Bottle (62856-272-30),84.23,33.69,,,0 CDM,6370000001_62856027630,Fycompa: 30 Tablet In 1 Bottle (62856-276-30),165.76,66.3,,,0 CDM,6370000001_62856058252,"Banzel: 120 Tablet, Film Coated In 1 Bottle (62856-582-52)",42.67,17.07,,,0 CDM,6370000001_62856058352,"Banzel: 120 Tablet, Film Coated In 1 Bottle (62856-583-52)",94.82,37.93,,,0 CDM,6370000001_62991170105,NDC Description Not Available,0.45,0.18,,,0 CDM,6370000001_63304024159,Calcitriol: 15 Ml In 1 Bottle (63304-241-59),38.99,15.6,,,0 CDM,6370000001_63323003011,"Chorionic Gonadotropin: 1 Kit In 1 Carton (63323-030-11) * 10 Ml In 1 Vial, Multi-Dose * 10 Ml In 1 Vial, Multi-Dose",140.33,56.13,,,0 CDM,6370000001_63323025402,NDC Description Not Available,51.67,20.67,,,0 CDM,6370000001_63323025410,NDC Description Not Available,72.3,28.92,,,0 CDM,6370000001_63402020230,Aptiom: 30 Tablet In 1 Bottle (63402-202-30),126.78,50.71,,,0 CDM,6370000001_63402020430,Aptiom: 30 Tablet In 1 Bottle (63402-204-30),131.32,52.53,,,0 CDM,6370000001_63629877401,"Sertraline Hydrochloride: 1 Bottle, Dropper In 1 Carton (63629-8774-1) / 60 Ml In 1 Bottle, Dropper",1.48,0.59,,,0 CDM,6370000001_63736012002,NDC Description Not Available,26.73,10.69,,,0 CDM,6370000001_63739005110,Amiodarone Hydrochloride: 10 Blister Pack In 1 Box (63739-051-10) / 10 Tablet In 1 Blister Pack,0.85,0.34,,,0 CDM,6370000001_63739005269,Sky Oral Rinse: 1500 Ml In 1 Package (63739-052-69),4.97,1.99,,,0 CDM,6370000001_63739005802,NDC Description Not Available,0.27,0.11,,,0 CDM,6370000001_63739006010,"Clonidine Hydrochloride: 10 BLISTER PACK in 1 BOX, UNIT-DOSE (63739-060-10) / 10 TABLET in 1 BLISTER PACK",0.2,0.08,,,0 CDM,6370000001_63739007410,"Aripiprazole: 10 Blister Pack In 1 Box, Unit-Dose (63739-074-10) / 10 Tablet In 1 Blister Pack",22.17,8.87,,,0 CDM,6370000001_63739007833,"Aripiprazole: 3 Blister Pack In 1 Box, Unit-Dose (63739-078-33) / 10 Tablet In 1 Blister Pack",30.71,12.28,,,0 CDM,6370000001_63739009810,"Mirtazapine: 10 Blister Pack In 1 Box (63739-098-10) / 10 Tablet, Film Coated In 1 Blister Pack",0.35,0.14,,,0 CDM,6370000001_63739011510,"Fluconazole: 10 Blister Pack In 1 Box, Unit-Dose (63739-115-10) / 10 Tablet In 1 Blister Pack",5.87,2.35,,,0 CDM,6370000001_63739014310,"Tamoxifen Citrate: 10 Blister Pack In 1 Box, Unit-Dose (63739-143-10) / 10 Tablet, Film Coated In 1 Blister Pack",1.9,0.76,,,0 CDM,6370000001_63739014510,"Midodrine Hydrochloride: 10 Blister Pack In 1 Box, Unit-Dose (63739-145-10) / 10 Tablet In 1 Blister Pack",1.82,0.73,,,0 CDM,6370000001_63739019210,Phenobarbital: 10 Blister Pack In 1 Box (63739-192-10) / 10 Tablet In 1 Blister Pack,1.55,0.62,,,0 CDM,6370000001_63739019351,"Sucralfate: 2 Tray In 1 Case (63739-193-51) / 10 Cup, Unit-Dose In 1 Tray / 10 Ml In 1 Cup, Unit-Dose (63739-193-72)",25.98,10.39,,,0 CDM,6370000001_63739019372,NDC Description Not Available,25.35,10.14,,,0 CDM,6370000001_63739022502,"Gas Relief: 30 Blister Pack In 1 Box (63739-225-02) / 10 Tablet, Chewable In 1 Blister Pack",0.21,0.08,,,0 CDM,6370000001_63739026310,"Clonazepam: 10 BLISTER PACK in 1 BOX, UNIT-DOSE (63739-263-10) / 10 TABLET in 1 BLISTER PACK",0.22,0.09,,,0 CDM,6370000001_63739032710,Hydralazine Hydrochloride: 10 Blister Pack In 1 Case (63739-327-10) / 10 Tablet In 1 Blister Pack,0.36,0.14,,,0 CDM,6370000001_63739032810,Hydralazine Hydrochloride: 10 Blister Pack In 1 Case (63739-328-10) / 10 Tablet In 1 Blister Pack,0.41,0.16,,,0 CDM,6370000001_63739041010,"Allopurinol: 10 Blister Pack In 1 Box, Unit-Dose (63739-410-10) / 10 Tablet In 1 Blister Pack",1.13,0.45,,,0 CDM,6370000001_63739043401,"25 BLISTER PACK in 1 BOX, UNIT-DOSE (63739-434-01) / 30 TABLET in 1 BLISTER PACK",0.04,0.02,,,0 CDM,6370000001_63739043402,Aspirin Chewable: 30 Blister Pack In 1 Box (63739-434-02) / 10 Tablet In 1 Blister Pack,0.12,0.05,,,0 CDM,6370000001_63739047802,"Docusate Sodium: 30 Blister Pack In 1 Box, Unit-Dose (63739-478-02) / 10 Capsule, Liquid Filled In 1 Blister Pack",0.08,0.03,,,0 CDM,6370000001_63739047910,"Baclofen: 10 Blister Pack In 1 Box, Unit-Dose (63739-479-10) / 10 Tablet In 1 Blister Pack",1.72,0.69,,,0 CDM,6370000001_63739048310,"Hydroxyzine Hydrochloride: 10 Blister Pack In 1 Box, Unit-Dose (63739-483-10) / 10 Tablet In 1 Blister Pack",0.65,0.26,,,0 CDM,6370000001_63739048610,"Hydroxyzine Hydrochloride: 10 Blister Pack In 1 Box, Unit-Dose (63739-486-10) / 10 Tablet In 1 Blister Pack",0.78,0.31,,,0 CDM,6370000001_63739054410,"Spironolactone: 10 Blister Pack In 1 Box, Unit-Dose (63739-544-10) / 10 Tablet In 1 Blister Pack",0.64,0.26,,,0 CDM,6370000001_63739054833,"Oxybutynin Chloride Extended Release: 3 Blister Pack In 1 Box, Unit-Dose (63739-548-33) / 10 Tablet, Extended Release In 1 Blister Pack",11.27,4.51,,,0 CDM,6370000001_63739056710,"Tamsulosin Hydrochloride: 10 Blister Pack In 1 Box, Unit-Dose (63739-567-10) / 10 Capsule In 1 Blister Pack",1.49,0.6,,,0 CDM,6370000001_63739056910,"Isosorbide Dinitrate: 10 Blister Pack In 1 Box, Unit-Dose (63739-569-10) / 10 Tablet In 1 Blister Pack",2.06,0.82,,,0 CDM,6370000001_63739064510,"Famotidine: 10 Blister Pack In 1 Box, Unit-Dose (63739-645-10) / 10 Tablet In 1 Blister Pack",0.23,0.09,,,0 CDM,6370000001_63739067310,"Losortan Potassium: 10 Blister Pack In 1 Box, Unit-Dose (63739-673-10) / 10 Tablet, Film Coated In 1 Blister Pack",1.86,0.74,,,0 CDM,6370000001_63739068610,"Losartan Potassium: 10 Blister Pack In 1 Box, Unit-Dose (63739-686-10) / 10 Tablet, Film Coated In 1 Blister Pack",1.38,0.55,,,0 CDM,6370000001_63739072401,NDC Description Not Available,12.7,5.08,,,0 CDM,6370000001_63739072450,"Potassium Chloride: 5 Tray In 1 Case (63739-724-50) / 10 Cup, Unit-Dose In 1 Tray / 15 Ml In 1 Cup, Unit-Dose (63739-724-01)",12.7,5.08,,,0 CDM,6370000001_63739079510,"Levetiracetam: 10 Blister Pack In 1 Box, Unit-Dose (63739-795-10) / 10 Tablet, Film Coated In 1 Blister Pack",0.7,0.28,,,0 CDM,6370000001_63739090210,Gabapentin: 10 Blister Pack In 1 Carton (63739-902-10) / 10 Capsule In 1 Blister Pack,0.27,0.11,,,0 CDM,6370000001_63739090310,Gabapentin: 10 Blister Pack In 1 Carton (63739-903-10) / 10 Capsule In 1 Blister Pack,0.36,0.14,,,0 CDM,6370000001_63739090410,Gabapentin: 10 Blister Pack In 1 Carton (63739-904-10) / 10 Capsule In 1 Blister Pack,0.38,0.15,,,0 CDM,6370000001_63739099110,"Methocarbamol: 10 Blister Pack In 1 Box, Unit-Dose (63739-991-10) / 10 Tablet, Coated In 1 Blister Pack",0.93,0.37,,,0 CDM,6370000001_63739099210,"Methocarbamol: 10 Blister Pack In 1 Box, Unit-Dose (63739-992-10) / 10 Tablet, Coated In 1 Blister Pack",0.87,0.35,,,0 CDM,6370000001_63824017165,Delsym: 1 Bottle In 1 Carton (63824-171-65) / 148 Ml In 1 Bottle,1.57,0.63,,,0 CDM,6370000001_63824017563,Delsym: 1 Bottle In 1 Carton (63824-175-63) / 89 Ml In 1 Bottle,1.82,0.73,,,0 CDM,6370000001_63824017565,Delsym: 1 Bottle In 1 Carton (63824-175-65) / 148 Ml In 1 Bottle,0.87,0.35,,,0 CDM,6370000001_64380015801,Megestrol Acetate: 100 Tablet In 1 Bottle (64380-158-01),0.82,0.33,,,0 CDM,6370000001_64380015901,Megestrol Acetate: 100 Tablet In 1 Bottle (64380-159-01),0.96,0.38,,,0 CDM,6370000001_64380016002,"Megestrol Acetate: 480 Ml In 1 Bottle, Plastic (64380-160-02)",2.69,1.08,,,0 CDM,6370000001_64380016601,"Phenobarbital: 473 Ml In 1 Bottle, Plastic (64380-166-01)",0.78,0.31,,,0 CDM,6370000001_64380017101,"Imipramine Hydrochloride: 100 Tablet In 1 Bottle, Plastic (64380-171-01)",0.53,0.21,,,0 CDM,6370000001_64380017202,"Olanzapine: 3 Blister Pack In 1 Carton (64380-172-02) / 10 Tablet, Orally Disintegrating In 1 Blister Pack (64380-172-01)",4.11,1.64,,,0 CDM,6370000001_64380076921,"Polyethylene Glycol 3350, Sodium Chloride, Sodium Bicarbonate And Potassium Chloride With Lemon Flavor: 4 L In 1 Jug (64380-769-21)",140.7,56.28,,,0 CDM,6370000001_64380079701,Oseltamivir Phosphate: 10 Capsule In 1 Blister Pack (64380-797-01),3.6,1.44,,,0 CDM,6370000001_64380079901,Oseltamivir Phosphate: 10 Capsule In 1 Blister Pack (64380-799-01),5.54,2.22,,,0 CDM,6370000001_64380087806,Ethosuximide: 100 Capsule In 1 Bottle (64380-878-06),1.27,0.51,,,0 CDM,6370000001_64380088304,"Cinacalcet: 30 Tablet, Film Coated In 1 Bottle (64380-883-04)",2.06,0.82,,,0 CDM,6370000001_64380091906,Ursodiol: 100 Tablet In 1 Bottle (64380-919-06),2.66,1.06,,,0 CDM,6370000001_64597030160,"Nuedexta: 60 Capsule, Gelatin Coated In 1 Bottle (64597-301-60)",113.05,45.22,,,0 CDM,6370000001_64764073030,"Trintellix: 30 Tablet, Film Coated In 1 Bottle (64764-730-30)",47.68,19.07,,,0 CDM,6370000001_64764080028,"Livtencity: 1 Bottle In 1 Carton (64764-800-28) / 28 Tablet, Coated In 1 Bottle",670.65,268.26,,,0 CDM,6370000001_64764080056,"Livtencity: 1 Bottle In 1 Carton (64764-800-56) / 56 Tablet, Coated In 1 Bottle",1022.68,409.07,,,0 CDM,6370000001_64850050001,"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate And Amphetamine Sulfate: 100 Tablet In 1 Bottle (64850-500-01)",0.82,0.33,,,0 CDM,6370000001_64850050201,"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate And Amphetamine Sulfate: 100 Tablet In 1 Bottle (64850-502-01)",0.6,0.24,,,0 CDM,6370000001_64850051001,"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, And Amphetamine Sulfate: 100 Capsule, Extended Release In 1 Bottle (64850-510-01)",1.29,0.52,,,0 CDM,6370000001_64850051101,"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, And Amphetamine Sulfate: 100 Capsule, Extended Release In 1 Bottle (64850-511-01)",1.27,0.51,,,0 CDM,6370000001_64875000101,NDC Description Not Available,197.8,79.12,,,0 CDM,6370000001_64896066301,"Rytary: 100 Capsule, Extended Release In 1 Bottle (64896-663-01)",10.22,4.09,,,0 CDM,6370000001_64950034316,Hydrocodone Bitartrate And Acetaminophen: 473 Ml In 1 Bottle (64950-343-16),26.12,10.45,,,0 CDM,6370000001_64950035405,NDC Description Not Available,10.73,4.29,,,0 CDM,6370000001_64950035455,"Oxycodone Hydrochloride: 50 Cup, Unit-Dose In 1 Case (64950-354-55) / 5 Ml In 1 Cup, Unit-Dose (64950-354-05)",17.45,6.98,,,0 CDM,6370000001_64980010401,"Dibasic Sodium Phosphate, Monobasic Potassium Phosphate And Monobasic Sodium Phosphate: 100 Tablet In 1 Bottle (64980-104-01)",0.87,0.35,,,0 CDM,6370000001_64980012950,NDC Description Not Available,0.38,0.15,,,0 CDM,6370000001_64980014612,NDC Description Not Available,3.92,1.57,,,0 CDM,6370000001_64980014698,NDC Description Not Available,3.9,1.56,,,0 CDM,6370000001_64980028001,"Glipizide: 100 Tablet, Film Coated, Extended Release In 1 Bottle, Plastic (64980-280-01)",0.58,0.23,,,0 CDM,6370000001_64980028101,"Glipizide: 100 Tablet, Film Coated, Extended Release In 1 Bottle, Plastic (64980-281-01)",1.09,0.44,,,0 CDM,6370000001_64980029101,"Perphenazine: 100 Tablet, Film Coated In 1 Bottle (64980-291-01)",1.59,0.64,,,0 CDM,6370000001_64980032430,Proctozone-Hc: 1 Tube In 1 Carton (64980-324-30) / 30 G In 1 Tube,60.38,24.15,,,0 CDM,6370000001_64980040310,Cefpodoxime Proxetil: 1 Bottle In 1 Carton (64980-403-10) / 100 Ml In 1 Bottle,39.47,15.79,,,0 CDM,6370000001_64980040906,"Sertraline Hydrochloride: 1 Bottle, Plastic In 1 Carton (64980-409-06) / 60 Ml In 1 Bottle, Plastic",5.66,2.26,,,0 CDM,6370000001_64980044715,"Calcitriol: 1 Bottle, Glass In 1 Carton (64980-447-15) / 15 Ml In 1 Bottle, Glass",52.54,21.02,,,0 CDM,6370000001_64980050448,Cyproheptadine Hydrochloride: 473 Ml In 1 Bottle (64980-504-48),1.32,0.53,,,0 CDM,6370000001_64980051110,Clindamycin Palmitate Hydrochloride (Pediatric): 100 Ml In 1 Bottle (64980-511-10),6.75,2.7,,,0 CDM,6370000001_64980051501,"Ofloxacin: 1 Bottle, Plastic In 1 Carton (64980-515-01) / 10 Ml In 1 Bottle, Plastic",59.25,23.7,,,0 CDM,6370000001_64980051505,"Ofloxacin: 1 Bottle, Plastic In 1 Carton (64980-515-05) / 5 Ml In 1 Bottle, Plastic",27.56,11.02,,,0 CDM,6370000001_64980052660,"Nitazoxanide: 6 Tablet, Film Coated In 1 Bottle (64980-526-60)",382.67,153.07,,,0 CDM,6370000001_64980056201,Furosemide: 100 Tablet In 1 Bottle (64980-562-01),0.12,0.05,,,0 CDM,6370000001_64980056301,Furosemide: 100 Tablet In 1 Bottle (64980-563-01),0.23,0.09,,,0 CDM,6370000001_64980056401,Furosemide: 100 Tablet In 1 Bottle (64980-564-01),0.2,0.08,,,0 CDM,6370000001_64980059295,Lactulose Solution: 946 Ml In 1 Bottle (64980-592-95),0.87,0.35,,,0 CDM,6370000001_64980059324,Nitrofurantoin: 1 Bottle In 1 Carton (64980-593-24) / 230 Ml In 1 Bottle,313.83,125.53,,,0 CDM,6370000001_65162005827,"Sevelamer Carbonate: 270 Tablet, Film Coated In 1 Bottle (65162-058-27)",0.35,0.14,,,0 CDM,6370000001_65162006205,Sucralfate: 420 Ml In 1 Bottle (65162-062-05),5.09,2.04,,,0 CDM,6370000001_65162008774,"Itraconazole: 150 Ml In 1 Bottle, Glass (65162-087-74)",167.49,67.0,,,0 CDM,6370000001_65162028103,"Paliperidone: 30 Tablet, Extended Release In 1 Bottle (65162-281-03)",9.27,3.71,,,0 CDM,6370000001_65162032109,"Niacin: 90 Tablet, Extended Release In 1 Bottle (65162-321-09)",1.27,0.51,,,0 CDM,6370000001_65162037110,"Oxybutynin Chloride: 100 Tablet, Extended Release In 1 Bottle (65162-371-10)",0.69,0.28,,,0 CDM,6370000001_65162051210,Salsalate: 100 Tablet In 1 Bottle (65162-512-10),0.9,0.36,,,0 CDM,6370000001_65162064978,Oxcarbazepine: 1 Bottle In 1 Carton (65162-649-78) / 250 Ml In 1 Bottle,10.58,4.23,,,0 CDM,6370000001_65162067384,Risperidone: 30 Ml In 1 Bottle (65162-673-84),5.06,2.02,,,0 CDM,6370000001_65162068110,Phenazopyridine Hydrochloride: 100 Tablet In 1 Bottle (65162-681-10),0.97,0.39,,,0 CDM,6370000001_65162068210,Phenazopyridine Hydrochloride: 100 Tablet In 1 Bottle (65162-682-10),1.29,0.52,,,0 CDM,6370000001_65162068784,"Lorazepam: 30 Ml In 1 Bottle, Dropper (65162-687-84)",3.78,1.51,,,0 CDM,6370000001_65162069890,Gabapentin: 473 Ml In 1 Bottle (65162-698-90),2.02,0.81,,,0 CDM,6370000001_65162077810,"Budesonide: 100 Capsule, Delayed Release In 1 Bottle (65162-778-10)",6.71,2.68,,,0 CDM,6370000001_65162079104,NDC Description Not Available,7.53,3.01,,,0 CDM,6370000001_65162079108,Lidocaine: 30 Pouch In 1 Carton (65162-791-08) / 1 Patch In 1 Pouch (65162-791-04),8.67,3.47,,,0 CDM,6370000001_65162082534,Rivastigmine: 30 Patch In 1 Carton (65162-825-34) / 24 H In 1 Patch,7.6,3.04,,,0 CDM,6370000001_65162083366,Diclofenac Sodium: 1 Tube In 1 Carton (65162-833-66) / 100 G In 1 Tube,72.07,28.83,,,0 CDM,6370000001_65162083594,Acyclovir: 1 Tube In 1 Carton (65162-835-94) / 15 G In 1 Tube,53.43,21.37,,,0 CDM,6370000001_65162084106,Lubiprostone: 60 Capsule In 1 Bottle (65162-841-06),4.31,1.72,,,0 CDM,6370000001_65162089703,Aripiprazole: 30 Tablet In 1 Bottle (65162-897-03),0.9,0.36,,,0 CDM,6370000001_65162091322,Voriconazole: 75 Ml In 1 Bottle (65162-913-22),236.22,94.49,,,0 CDM,6370000001_65162099704,NDC Description Not Available,27.23,10.89,,,0 CDM,6370000001_65197040010,Ad First Aid Multipurpose: 1 Tube In 1 Box (65197-400-10) / 42.5 G In 1 Tube,10.07,4.03,,,0 CDM,6370000001_65628005001,"Diphenhydramine Hydrochloride And Lidocaine Hydrochloride And Aluminum Hydroxide And Magnesium Hydro: 1 Kit In 1 Container (65628-050-01) * 236 Ml In 1 Bottle, Plastic * .2 G In 1 Bottle, Glass * ",23.26,9.3,,,0 CDM,6370000001_65628005004,"Diphenhydramine Hydrochloride And Lidocaine Hydrochloride And Aluminum Hydroxide And Magnesium Hydro: 1 Kit In 1 Container (65628-050-04) * 118 Ml In 1 Bottle, Plastic * .1 G In 1 Bottle, Glass * ",47.91,19.16,,,0 CDM,6370000001_65628020810,Firvanq: 1 Kit In 1 Carton (65628-208-10) * 15 G In 1 Bottle * 289 Ml In 1 Bottle,10.02,4.01,,,0 CDM,6370000001_65628027010,NDC Description Not Available,26.75,10.7,,,0 CDM,6370000001_65628027203,Konvomep: 1 Kit In 1 Carton (65628-272-03) * 150 Ml In 1 Bottle (65628-270-05) * 300 Ml In 1 Bottle (65628-270-10) * 150 Ml In 1 Bottle (65628-271-05) * 300 Ml In 1 Bottle (65628-271-10) * 9,33.67,13.47,,,0 CDM,6370000001_65628027210,Konvomep: 1 Kit In 1 Carton (65628-272-10) * 150 Ml In 1 Bottle (65628-270-05) * 300 Ml In 1 Bottle (65628-270-10) * 150 Ml In 1 Bottle (65628-271-05) * 300 Ml In 1 Bottle (65628-271-10) * 9,28.82,11.53,,,0 CDM,6370000001_65649010302,"Apriso: 1 Bottle In 1 Carton (65649-103-02) / 120 Capsule, Extended Release In 1 Bottle",18.33,7.33,,,0 CDM,6370000001_65649030303,Xifaxan: 6 Blister Pack In 1 Carton (65649-303-03) / 10 Tablet In 1 Blister Pack,168.02,67.21,,,0 CDM,6370000001_65649031112,Diuril: 1 Bottle In 1 Carton (65649-311-12) / 237 Ml In 1 Bottle,1.02,0.41,,,0 CDM,6370000001_65862000601,"Citalopram: 100 Tablet, Film Coated In 1 Bottle (65862-006-01)",0.24,0.1,,,0 CDM,6370000001_65862001901,Cephalexin: 100 Capsule In 1 Bottle (65862-019-01),0.55,0.22,,,0 CDM,6370000001_65862002106,"Mirtazapine: 5 Blister Pack In 1 Carton (65862-021-06) / 6 Tablet, Orally Disintegrating In 1 Blister Pack",1.11,0.44,,,0 CDM,6370000001_65862004824,Zidovudine: 240 Ml In 1 Bottle (65862-048-24),0.97,0.39,,,0 CDM,6370000001_65862005724,Nevirapine: 240 Ml In 1 Bottle (65862-057-24),3.54,1.42,,,0 CDM,6370000001_65862006201,"Metoprolol Tartrate: 100 Tablet, Film Coated In 1 Bottle (65862-062-01)",0.03,0.01,,,0 CDM,6370000001_65862007101,Amoxicillin: 100 Ml In 1 Bottle (65862-071-01),1.77,0.71,,,0 CDM,6370000001_65862007930,Terbinafine: 30 Tablet In 1 Bottle (65862-079-30),0.75,0.3,,,0 CDM,6370000001_65862008401,Cefadroxil: 100 Ml In 1 Bottle (65862-084-01),6.87,2.75,,,0 CDM,6370000001_65862009620,"Cefpodoxime Proxetil: 20 Tablet, Film Coated In 1 Bottle (65862-096-20)",12.25,4.9,,,0 CDM,6370000001_65862014636,Sumatriptan: 1 Blister Pack In 1 Carton (65862-146-36) / 9 Tablet In 1 Blister Pack,0.93,0.37,,,0 CDM,6370000001_65862014736,Sumatriptan: 1 Blister Pack In 1 Carton (65862-147-36) / 9 Tablet In 1 Blister Pack,1.24,0.5,,,0 CDM,6370000001_65862014836,Sumatriptan: 1 Blister Pack In 1 Carton (65862-148-36) / 9 Tablet In 1 Blister Pack,1.98,0.79,,,0 CDM,6370000001_65862017501,"Penicillin V Potassium: 100 Tablet, Film Coated In 1 Bottle (65862-175-01)",0.45,0.18,,,0 CDM,6370000001_65862017601,"Penicillin V Potassium: 100 Tablet, Film Coated In 1 Bottle (65862-176-01)",0.73,0.29,,,0 CDM,6370000001_65862017760,Cefdinir: 60 Capsule In 1 Bottle (65862-177-60),2.47,0.99,,,0 CDM,6370000001_65862019201,Fluoxetine: 100 Capsule In 1 Bottle (65862-192-01),0.18,0.07,,,0 CDM,6370000001_65862019301,Fluoxetine: 100 Capsule In 1 Bottle (65862-193-01),0.12,0.05,,,0 CDM,6370000001_65862020768,"Ribavirin: 168 Tablet, Film Coated In 1 Bottle (65862-207-68)",1.83,0.73,,,0 CDM,6370000001_65862021150,Minocycline Hydrochloride: 50 Capsule In 1 Bottle (65862-211-50),2.41,0.96,,,0 CDM,6370000001_65862025047,"Levetiracetam: 473 Ml In 1 Bottle, Plastic (65862-250-47)",0.31,0.12,,,0 CDM,6370000001_65862029390,"Rosuvastatin Calcium: 90 Tablet, Film Coated In 1 Bottle (65862-293-90)",0.21,0.08,,,0 CDM,6370000001_65862030612,"Fluoxetine: 120 Ml In 1 Bottle, Glass (65862-306-12)",11.81,4.72,,,0 CDM,6370000001_65862037501,"Escitalopram: 100 Tablet, Film Coated In 1 Bottle (65862-375-01)",0.65,0.26,,,0 CDM,6370000001_65862041901,Sulfamethoxazole And Trimethoprim: 100 Tablet In 1 Bottle (65862-419-01),0.18,0.07,,,0 CDM,6370000001_65862047501,Ramipril: 100 Capsule In 1 Bottle (65862-475-01),0.17,0.07,,,0 CDM,6370000001_65862047601,Ramipril: 100 Capsule In 1 Bottle (65862-476-01),0.56,0.22,,,0 CDM,6370000001_65862049647,Sulfamethoxazole And Trimethoprim: 473 Ml In 1 Bottle (65862-496-47),4.12,1.65,,,0 CDM,6370000001_65862049730,"Efavirenz, Emtricitabine And Tenofovir Disoproxil Fumarate: 30 Tablet, Film Coated In 1 Bottle (65862-497-30)",11.71,4.68,,,0 CDM,6370000001_65862050220,"Amoxicillin And Clavulanate Potassium: 20 Tablet, Film Coated In 1 Bottle (65862-502-20)",1.33,0.53,,,0 CDM,6370000001_65862050301,"Amoxicillin And Clavulanate Potassium: 100 Tablet, Film Coated In 1 Bottle (65862-503-01)",1.44,0.58,,,0 CDM,6370000001_65862052890,"Venlafaxine Hydrochloride: 90 Capsule, Extended Release In 1 Bottle (65862-528-90)",0.7,0.28,,,0 CDM,6370000001_65862053401,Amoxicillin And Clavulanate Potassium: 100 Ml In 1 Bottle (65862-534-01),3.48,1.39,,,0 CDM,6370000001_65862053513,Amoxicillin And Clavulanate Potassium: 125 Ml In 1 Bottle (65862-535-13),2.43,0.97,,,0 CDM,6370000001_65862053575,Amoxicillin And Clavulanate Potassium: 75 Ml In 1 Bottle (65862-535-75),3.17,1.27,,,0 CDM,6370000001_65862060101,Modafinil: 100 Tablet In 1 Bottle (65862-601-01),1.18,0.47,,,0 CDM,6370000001_65862060130,Modafinil: 30 Tablet In 1 Bottle (65862-601-30),1.2,0.48,,,0 CDM,6370000001_65862060330,"Moxifloxacin Hydrochloride: 30 Tablet, Film Coated In 1 Bottle (65862-603-30)",5.77,2.31,,,0 CDM,6370000001_65862064860,Rivastigmine Tartrate: 60 Capsule In 1 Bottle (65862-648-60),1.07,0.43,,,0 CDM,6370000001_65862067605,Alprazolam: 500 Tablet In 1 Bottle (65862-676-05),0.12,0.05,,,0 CDM,6370000001_65862067799,Alprazolam: 1000 Tablet In 1 Bottle (65862-677-99),0.09,0.04,,,0 CDM,6370000001_65862067801,Alprazolam: 100 Tablet In 1 Bottle (65862-678-01),0.09,0.04,,,0 CDM,6370000001_65862069201,Extended Phenytoin Sodium: 100 Capsule In 1 Bottle (65862-692-01),1.02,0.41,,,0 CDM,6370000001_65862070020,Cefuroxime Axetil: 20 Tablet In 1 Bottle (65862-700-20),4.73,1.89,,,0 CDM,6370000001_65862078201,Methenamine Hippurate: 100 Tablet In 1 Bottle (65862-782-01),2.38,0.95,,,0 CDM,6370000001_65862089230,"Voriconazole: 30 Tablet, Film Coated In 1 Bottle (65862-892-30)",20.4,8.16,,,0 CDM,6370000001_65862092127,"Sevelamer Carbonate: 270 Tablet, Film Coated In 1 Bottle (65862-921-27)",0.11,0.04,,,0 CDM,6370000001_65862093008,NDC Description Not Available,1.22,0.49,,,0 CDM,6370000001_65862093090,"Sevelamer Carbonate: 90 Pouch In 1 Carton (65862-930-90) / 1 Powder, For Suspension In 1 Pouch (65862-930-08)",4.0,1.6,,,0 CDM,6370000001_65862096730,"Eszopiclone: 30 Tablet, Film Coated In 1 Bottle (65862-967-30)",0.69,0.28,,,0 CDM,6370000001_66215050115,"Opsumit: 1 Blister Pack In 1 Carton (66215-501-15) / 15 Tablet, Film Coated In 1 Blister Pack",1295.5,518.2,,,0 CDM,6370000001_66215060206,"Uptravi: 1 Bottle In 1 Carton (66215-602-06) / 60 Tablet, Coated In 1 Bottle",738.82,295.53,,,0 CDM,6370000001_66215060806,"Uptravi: 1 Bottle In 1 Carton (66215-608-06) / 60 Tablet, Coated In 1 Bottle",1098.53,439.41,,,0 CDM,6370000001_66215061606,"Uptravi: 1 Bottle In 1 Carton (66215-616-06) / 60 Tablet, Coated In 1 Bottle",1193.46,477.38,,,0 CDM,6370000001_66302031001,"Orenitram: 100 Tablet, Extended Release In 1 Bottle (66302-310-01)",260.68,104.27,,,0 CDM,6370000001_66302031002,"Orenitram: 1 Blister Pack In 1 Carton (66302-310-02) / 10 Tablet, Extended Release In 1 Blister Pack",178.15,71.26,,,0 CDM,6370000001_66302032501,"Orenitram: 100 Tablet, Extended Release In 1 Bottle (66302-325-01)",651.68,260.67,,,0 CDM,6370000001_66302032502,"Orenitram: 1 Blister Pack In 1 Carton (66302-325-02) / 10 Tablet, Extended Release In 1 Blister Pack",445.38,178.15,,,0 CDM,6370000001_66553000201,NDC Description Not Available,0.14,0.06,,,0 CDM,6370000001_66553000401,NDC Description Not Available,0.15,0.06,,,0 CDM,6370000001_66553000801,NDC Description Not Available,0.15,0.06,,,0 CDM,6370000001_66658023401,NDC Description Not Available,927.0,370.8,,,0 CDM,6370000001_66689002301,NDC Description Not Available,15.64,6.26,,,0 CDM,6370000001_66689003601,NDC Description Not Available,27.38,10.95,,,0 CDM,6370000001_66689003650,"Phenytoin: 5 Tray In 1 Case (66689-036-50) / 10 Cup, Unit-Dose In 1 Tray / 4 Ml In 1 Cup, Unit-Dose (66689-036-01)",27.38,10.95,,,0 CDM,6370000001_66689003801,NDC Description Not Available,2.99,1.2,,,0 CDM,6370000001_66689004701,NDC Description Not Available,25.88,10.35,,,0 CDM,6370000001_66689005804,"Clobazam: 1 Bottle, Plastic In 1 Carton (66689-058-04) / 120 Ml In 1 Bottle, Plastic",7.0,2.8,,,0 CDM,6370000001_66689020108,"Insta-Char Aqueous: 240 Ml In 1 Bottle, Plastic (66689-201-08)",54.93,21.97,,,0 CDM,6370000001_66689020208,"Insta-Char Aqueous Cherry: 240 Ml In 1 Bottle, Plastic (66689-202-08)",84.94,33.98,,,0 CDM,6370000001_66689020308,"Insta-Char Sorbitol: 240 Ml In 1 Bottle, Plastic (66689-203-08)",14.28,5.71,,,0 CDM,6370000001_66689069479,Methadone Hydrochloride: 1000 Ml In 1 Bottle (66689-694-79),1.81,0.72,,,0 CDM,6370000001_66689069579,Methadone Hydrochloride: 1000 Ml In 1 Bottle (66689-695-79),0.7,0.28,,,0 CDM,6370000001_66689082010,Methadone Hydrochloride: 100 Tablet In 1 Bottle (66689-820-10),0.69,0.28,,,0 CDM,6370000001_66992012814,"Otovel: 1 Pouch In 1 Carton (66992-128-14) / 14 Vial, Single-Dose In 1 Pouch / .25 Ml In 1 Vial, Single-Dose",83.26,33.3,,,0 CDM,6370000001_66993007896,"Fluticasone Propionate Hfa: 1 Inhaler In 1 Carton (66993-078-96) / 120 Aerosol, Metered In 1 Inhaler",400.56,160.22,,,0 CDM,6370000001_66993007996,"Fluticasone Propionate Hfa: 1 Inhaler In 1 Carton (66993-079-96) / 120 Aerosol, Metered In 1 Inhaler",535.19,214.08,,,0 CDM,6370000001_66993073051,NDC Description Not Available,0.25,0.1,,,0 CDM,6370000001_67457042130,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (67457-421-30) / 30 Ml In 1 Vial (67457-421-00),0.05,0.02,,,0 CDM,6370000001_67457042254,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (67457-422-54) / 5 Ml In 1 Vial (67457-422-00),0.03,0.01,,,0 CDM,6370000001_67457042312,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (67457-423-12) / 1 Ml In 1 Vial (67457-423-00),0.13,0.05,,,0 CDM,6370000001_67618011128,"Colace: 1 Bottle In 1 Carton (67618-111-28) / 28 Capsule, Liquid Filled In 1 Bottle",0.78,0.31,,,0 CDM,6370000001_67618030010,"Senokot: 1 Bottle, Plastic In 1 Carton (67618-300-10) / 100 Tablet In 1 Bottle, Plastic",0.33,0.13,,,0 CDM,6370000001_67777022007,Bacitracin Zinc: 425.3 g in 1 JAR (67777-220-07),51.0,20.4,,,0 CDM,6370000001_67777025101,NDC Description Not Available,1.03,0.41,,,0 CDM,6370000001_67877012440,Silver Sulfadiazine: 400 G In 1 Jar (67877-124-40),157.64,63.06,,,0 CDM,6370000001_67877012450,Silver Sulfadiazine: 50 G In 1 Jar (67877-124-50),27.89,11.16,,,0 CDM,6370000001_67877019890,Amlodipine Besylate: 90 Tablet In 1 Bottle (67877-198-90),0.09,0.04,,,0 CDM,6370000001_67877022301,Gabapentin: 100 Capsule In 1 Bottle (67877-223-01),0.2,0.08,,,0 CDM,6370000001_67877022401,Gabapentin: 100 Capsule In 1 Bottle (67877-224-01),0.19,0.08,,,0 CDM,6370000001_67877025115,Triamcinolone Acetonide: 15 G In 1 Tube (67877-251-15),7.8,3.12,,,0 CDM,6370000001_67877025145,Triamcinolone Acetonide: 454 G In 1 Jar (67877-251-45),68.01,27.2,,,0 CDM,6370000001_67877025180,Triamcinolone Acetonide: 80 G In 1 Tube (67877-251-80),14.36,5.74,,,0 CDM,6370000001_67877026030,Rasagiline: 30 Tablet In 1 Bottle (67877-260-30),28.46,11.38,,,0 CDM,6370000001_67877027690,Clopidogrel: 90 Tablet In 1 Bottle (67877-276-90),0.18,0.07,,,0 CDM,6370000001_67877031901,"Ibuprofen: 100 Tablet, Film Coated In 1 Bottle (67877-319-01)",0.22,0.09,,,0 CDM,6370000001_67877031905,"Ibuprofen: 500 Tablet, Film Coated In 1 Bottle (67877-319-05)",0.2,0.08,,,0 CDM,6370000001_67877032001,"Ibuprofen: 100 Tablet, Film Coated In 1 Bottle (67877-320-01)",0.27,0.11,,,0 CDM,6370000001_67877041920,"Linezolid: 20 Tablet, Film Coated In 1 Bottle (67877-419-20)",8.25,3.3,,,0 CDM,6370000001_67877041933,"Linezolid: 1 Blister Pack In 1 Carton (67877-419-33) / 10 Tablet, Film Coated In 1 Blister Pack",10.5,4.2,,,0 CDM,6370000001_67877043103,Aripiprazole: 30 Tablet In 1 Bottle (67877-431-03),0.65,0.26,,,0 CDM,6370000001_67877046390,Pregabalin: 90 Capsule In 1 Bottle (67877-463-90),0.33,0.13,,,0 CDM,6370000001_67877049030,Ezetimibe: 30 Tablet In 1 Bottle (67877-490-30),0.7,0.28,,,0 CDM,6370000001_67877049160,Ticagrelor: 60 Tablet In 1 Bottle (67877-491-60),2.38,0.95,,,0 CDM,6370000001_67877052560,"Ranolazine: 60 Tablet, Film Coated, Extended Release In 1 Bottle (67877-525-60)",0.88,0.35,,,0 CDM,6370000001_67877054568,Cephalexin: 200 Ml In 1 Bottle (67877-545-68),2.57,1.03,,,0 CDM,6370000001_67877054788,Cefdinir: 100 Ml In 1 Bottle (67877-547-88),2.71,1.08,,,0 CDM,6370000001_67877056105,Metformin Hcl: 500 Tablet In 1 Bottle (67877-561-05),0.12,0.05,,,0 CDM,6370000001_67877058901,Colchicine: 100 Tablet In 1 Bottle (67877-589-01),0.57,0.23,,,0 CDM,6370000001_67877063830,"Lurasidone Hydrochloride: 30 Tablet, Film Coated In 1 Bottle (67877-638-30)",1.13,0.45,,,0 CDM,6370000001_67877064130,"Lurasidone Hydrochloride: 30 Tablet, Film Coated In 1 Bottle (67877-641-30)",2.76,1.1,,,0 CDM,6370000001_67877065861,Clobazam: 1 Bottle In 1 Carton (67877-658-61) / 120 Ml In 1 Bottle,3.52,1.41,,,0 CDM,6370000001_67877067001,Morphine Sulfate: 100 Tablet In 1 Bottle (67877-670-01),0.91,0.36,,,0 CDM,6370000001_67877073295,Lacosamide Oral Solution: 200 Ml In 1 Bottle (67877-732-95),9.21,3.68,,,0 CDM,6370000001_67877073360,"Lacosamide: 60 Tablet, Film Coated In 1 Bottle (67877-733-60)",0.32,0.13,,,0 CDM,6370000001_67877074957,"Fosfomycin Tromethamine: 1 Packet In 1 Carton (67877-749-57) / 1 Granule, For Solution In 1 Packet",254.8,101.92,,,0 CDM,6370000001_67877084210,"Famotidine: 1000 Tablet, Film Coated In 1 Bottle (67877-842-10)",0.17,0.07,,,0 CDM,6370000001_67919004105,"Sivextro: 1 Blister Pack In 1 Carton (67919-041-05) / 6 Tablet, Film Coated In 1 Blister Pack",2000.95,800.38,,,0 CDM,6370000001_67919004199,NDC Description Not Available,1304.97,521.99,,,0 CDM,6370000001_68001043616,Cetirizine Hydrochloride (Allergy): 10 Tablet In 1 Blister Pack (68001-436-16),0.41,0.16,,,0 CDM,6370000001_68084002711,NDC Description Not Available,0.98,0.39,,,0 CDM,6370000001_68084004001,"Misoprostol: 100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-040-01) / 1 TABLET in 1 BLISTER PACK (68084-040-11)",4.39,1.76,,,0 CDM,6370000001_68084004011,NDC Description Not Available,2.02,0.81,,,0 CDM,6370000001_68084004411,NDC Description Not Available,2.61,1.04,,,0 CDM,6370000001_68084007001,"Ciprofloxacin: 100 Blister Pack In 1 Box, Unit-Dose (68084-070-01) / 1 Tablet, Film Coated In 1 Blister Pack (68084-070-11)",1.51,0.6,,,0 CDM,6370000001_68084007011,NDC Description Not Available,0.95,0.38,,,0 CDM,6370000001_68084008211,NDC Description Not Available,2.54,1.02,,,0 CDM,6370000001_68084008311,NDC Description Not Available,3.02,1.21,,,0 CDM,6370000001_68084009711,NDC Description Not Available,1.58,0.63,,,0 CDM,6370000001_68084009911,NDC Description Not Available,1.78,0.71,,,0 CDM,6370000001_68084010801,"Acyclovir: 100 Blister Pack In 1 Box, Unit-Dose (68084-108-01) / 1 Tablet In 1 Blister Pack (68084-108-11)",1.15,0.46,,,0 CDM,6370000001_68084010811,NDC Description Not Available,1.06,0.42,,,0 CDM,6370000001_68084010901,"Acyclovir: 100 Blister Pack In 1 Box, Unit-Dose (68084-109-01) / 1 Tablet In 1 Blister Pack (68084-109-11)",3.69,1.48,,,0 CDM,6370000001_68084010911,NDC Description Not Available,2.67,1.07,,,0 CDM,6370000001_68084011111,NDC Description Not Available,2.44,0.98,,,0 CDM,6370000001_68084012001,"Mirtazapine: 100 Blister Pack In 1 Box, Unit-Dose (68084-120-01) / 1 Tablet, Film Coated In 1 Blister Pack (68084-120-11)",1.0,0.4,,,0 CDM,6370000001_68084012011,NDC Description Not Available,1.27,0.51,,,0 CDM,6370000001_68084012801,"Omeprazole: 100 Blister Pack In 1 Box, Unit-Dose (68084-128-01) / 1 Capsule, Delayed Release In 1 Blister Pack (68084-128-11)",0.51,0.2,,,0 CDM,6370000001_68084012811,NDC Description Not Available,0.76,0.3,,,0 CDM,6370000001_68084018901,"Zolpidem Tartrate: 100 Blister Pack In 1 Box, Unit-Dose (68084-189-01) / 1 Tablet, Coated In 1 Blister Pack (68084-189-11)",0.52,0.21,,,0 CDM,6370000001_68084018911,NDC Description Not Available,0.5,0.2,,,0 CDM,6370000001_68084020201,"Primidone: 100 Blister Pack In 1 Box, Unit-Dose (68084-202-01) / 1 Tablet In 1 Blister Pack (68084-202-11)",3.4,1.36,,,0 CDM,6370000001_68084020211,NDC Description Not Available,2.39,0.96,,,0 CDM,6370000001_68084020411,NDC Description Not Available,1.5,0.6,,,0 CDM,6370000001_68084020501,"Minoxidil: 100 Blister Pack In 1 Box, Unit-Dose (68084-205-01) / 1 Tablet In 1 Blister Pack (68084-205-11)",2.37,0.95,,,0 CDM,6370000001_68084020511,NDC Description Not Available,1.97,0.79,,,0 CDM,6370000001_68084021401,Benzonatate: 10 Blister Pack In 1 Carton (68084-214-01) / 10 Capsule In 1 Blister Pack (68084-214-11),1.79,0.72,,,0 CDM,6370000001_68084021411,NDC Description Not Available,1.44,0.58,,,0 CDM,6370000001_68084021501,"Valacyclovir Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (68084-215-01) / 1 Tablet, Film Coated In 1 Blister Pack (68084-215-11)",6.51,2.6,,,0 CDM,6370000001_68084021511,NDC Description Not Available,10.75,4.3,,,0 CDM,6370000001_68084024311,NDC Description Not Available,1.33,0.53,,,0 CDM,6370000001_68084027301,"Risperidone: 100 Blister Pack In 1 Box, Unit-Dose (68084-273-01) / 1 Tablet, Film Coated In 1 Blister Pack (68084-273-11)",1.28,0.51,,,0 CDM,6370000001_68084027311,NDC Description Not Available,1.48,0.59,,,0 CDM,6370000001_68084028001,"Ethambutol Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (68084-280-01) / 1 Tablet In 1 Blister Pack (68084-280-11)",2.61,1.04,,,0 CDM,6370000001_68084028011,NDC Description Not Available,2.53,1.01,,,0 CDM,6370000001_68084028111,NDC Description Not Available,2.31,0.92,,,0 CDM,6370000001_68084028211,NDC Description Not Available,2.05,0.82,,,0 CDM,6370000001_68084028411,NDC Description Not Available,3.58,1.43,,,0 CDM,6370000001_68084028801,"Fludrocortisone Acetate: 100 Blister Pack In 1 Box, Unit-Dose (68084-288-01) / 1 Tablet In 1 Blister Pack (68084-288-11)",2.52,1.01,,,0 CDM,6370000001_68084028811,NDC Description Not Available,2.34,0.94,,,0 CDM,6370000001_68084029111,NDC Description Not Available,5.8,2.32,,,0 CDM,6370000001_68084029121,"Naltrexone Hydrochloride: 30 Blister Pack In 1 Box, Unit-Dose (68084-291-21) / 1 Tablet, Film Coated In 1 Blister Pack (68084-291-11)",5.11,2.04,,,0 CDM,6370000001_68084029911,NDC Description Not Available,1.07,0.43,,,0 CDM,6370000001_68084030011,NDC Description Not Available,5.98,2.39,,,0 CDM,6370000001_68084030021,"Dantrolene Sodium: 30 Blister Pack In 1 Box, Unit-Dose (68084-300-21) / 1 Capsule In 1 Blister Pack (68084-300-11)",6.61,2.64,,,0 CDM,6370000001_68084031001,"Divalproex Sodium: 100 Blister Pack In 1 Box, Unit-Dose (68084-310-01) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack (68084-310-11)",4.39,1.76,,,0 CDM,6370000001_68084031011,NDC Description Not Available,5.06,2.02,,,0 CDM,6370000001_68084031301,"Divalproex Sodium: 100 Blister Pack In 1 Box, Unit-Dose (68084-313-01) / 1 Capsule, Coated Pellets In 1 Blister Pack (68084-313-11)",3.4,1.36,,,0 CDM,6370000001_68084031311,NDC Description Not Available,2.27,0.91,,,0 CDM,6370000001_68084031801,"Lamotrigine: 100 Blister Pack In 1 Box, Unit-Dose (68084-318-01) / 1 Tablet In 1 Blister Pack (68084-318-11)",0.57,0.23,,,0 CDM,6370000001_68084031811,NDC Description Not Available,0.6,0.24,,,0 CDM,6370000001_68084031911,NDC Description Not Available,0.55,0.22,,,0 CDM,6370000001_68084032611,NDC Description Not Available,2.04,0.82,,,0 CDM,6370000001_68084034201,"Topiramate: 100 Blister Pack In 1 Box, Unit-Dose (68084-342-01) / 1 Tablet, Film Coated In 1 Blister Pack (68084-342-11)",0.92,0.37,,,0 CDM,6370000001_68084034211,NDC Description Not Available,0.91,0.36,,,0 CDM,6370000001_68084034401,"Topiramate: 100 Blister Pack In 1 Box, Unit-Dose (68084-344-01) / 1 Tablet, Film Coated In 1 Blister Pack (68084-344-11)",1.46,0.58,,,0 CDM,6370000001_68084034411,NDC Description Not Available,1.42,0.57,,,0 CDM,6370000001_68084034601,"Losartan Potassium: 100 Blister Pack In 1 Box, Unit-Dose (68084-346-01) / 1 Tablet, Film Coated In 1 Blister Pack (68084-346-11)",1.59,0.64,,,0 CDM,6370000001_68084034611,NDC Description Not Available,1.64,0.66,,,0 CDM,6370000001_68084034701,"Losartan Potassium: 100 Blister Pack In 1 Box, Unit-Dose (68084-347-01) / 1 Tablet, Film Coated In 1 Blister Pack (68084-347-11)",1.74,0.7,,,0 CDM,6370000001_68084034711,NDC Description Not Available,2.0,0.8,,,0 CDM,6370000001_68084035401,Oxycodone Hydrochloride: 100 Blister Pack In 1 Carton (68084-354-01) / 1 Tablet In 1 Blister Pack (68084-354-11),1.9,0.76,,,0 CDM,6370000001_68084035411,NDC Description Not Available,1.78,0.71,,,0 CDM,6370000001_68084037601,"Extended Phenytoin Sodium: 100 Blister Pack In 1 Box, Unit-Dose (68084-376-01) / 1 Capsule In 1 Blister Pack (68084-376-11)",2.2,0.88,,,0 CDM,6370000001_68084038101,"Benztropine Mesylate: 100 Blister Pack In 1 Box, Unit-Dose (68084-381-01) / 1 Tablet In 1 Blister Pack (68084-381-11)",1.39,0.56,,,0 CDM,6370000001_68084038111,NDC Description Not Available,1.48,0.59,,,0 CDM,6370000001_68084038801,"Benztropine Mesylate: 100 Blister Pack In 1 Box, Unit-Dose (68084-388-01) / 1 Tablet In 1 Blister Pack (68084-388-11)",1.45,0.58,,,0 CDM,6370000001_68084038811,NDC Description Not Available,1.34,0.54,,,0 CDM,6370000001_68084038911,NDC Description Not Available,1.63,0.65,,,0 CDM,6370000001_68084041501,"Divalproex Sodium: 100 Blister Pack In 1 Box, Unit-Dose (68084-415-01) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack (68084-415-11)",6.66,2.66,,,0 CDM,6370000001_68084041511,NDC Description Not Available,6.59,2.64,,,0 CDM,6370000001_68084044411,NDC Description Not Available,1.62,0.65,,,0 CDM,6370000001_68084044711,NDC Description Not Available,0.74,0.3,,,0 CDM,6370000001_68084047911,NDC Description Not Available,2.88,1.15,,,0 CDM,6370000001_68084048001,"Oxybutynin Chloride Extended Release: 100 Blister Pack In 1 Box, Unit-Dose (68084-480-01) / 1 Tablet, Extended Release In 1 Blister Pack (68084-480-11)",6.07,2.43,,,0 CDM,6370000001_68084048011,NDC Description Not Available,9.25,3.7,,,0 CDM,6370000001_68084049401,"Pyridostigmine Bromide: 100 Blister Pack In 1 Box, Unit-Dose (68084-494-01) / 1 Tablet In 1 Blister Pack (68084-494-11)",3.76,1.5,,,0 CDM,6370000001_68084053611,NDC Description Not Available,0.66,0.26,,,0 CDM,6370000001_68084053901,Torsemide: 100 Blister Pack In 1 Carton (68084-539-01) / 1 Tablet In 1 Blister Pack (68084-539-11),1.09,0.44,,,0 CDM,6370000001_68084053911,NDC Description Not Available,1.05,0.42,,,0 CDM,6370000001_68084057201,"Mucinex: 100 Blister Pack In 1 Box, Unit-Dose (68084-572-01) / 1 Tablet, Extended Release In 1 Blister Pack (68084-572-11)",2.51,1.0,,,0 CDM,6370000001_68084057211,NDC Description Not Available,2.59,1.04,,,0 CDM,6370000001_68084059711,NDC Description Not Available,3.42,1.37,,,0 CDM,6370000001_68084059801,"Nifedipine: 100 Blister Pack In 1 Box, Unit-Dose (68084-598-01) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack (68084-598-11)",7.52,3.01,,,0 CDM,6370000001_68084059811,NDC Description Not Available,7.55,3.02,,,0 CDM,6370000001_68084060311,NDC Description Not Available,9.44,3.78,,,0 CDM,6370000001_68084060421,"Desmopressin Acetate: 30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-604-21) / 1 TABLET in 1 BLISTER PACK (68084-604-11)",4.4,1.76,,,0 CDM,6370000001_68084061811,NDC Description Not Available,1.01,0.4,,,0 CDM,6370000001_68084064001,"Lithium Carbonate: 100 Blister Pack In 1 Box, Unit-Dose (68084-640-01) / 1 Tablet, Extended Release In 1 Blister Pack (68084-640-11)",1.44,0.58,,,0 CDM,6370000001_68084064011,NDC Description Not Available,1.09,0.44,,,0 CDM,6370000001_68084064501,"Tizanidine: 100 Blister Pack In 1 Box, Unit-Dose (68084-645-01) / 1 Tablet In 1 Blister Pack (68084-645-11)",1.56,0.62,,,0 CDM,6370000001_68084064511,NDC Description Not Available,1.79,0.72,,,0 CDM,6370000001_68084065501,"Lithium Carbonate: 100 Blister Pack In 1 Box, Unit-Dose (68084-655-01) / 1 Tablet, Extended Release In 1 Blister Pack (68084-655-11)",1.17,0.47,,,0 CDM,6370000001_68084065511,NDC Description Not Available,1.3,0.52,,,0 CDM,6370000001_68084069701,"Bupropion Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (68084-697-01) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack (68084-697-11)",2.48,0.99,,,0 CDM,6370000001_68084069711,NDC Description Not Available,2.38,0.95,,,0 CDM,6370000001_68084069801,"Venlafaxine Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (68084-698-01) / 1 Capsule, Extended Release In 1 Blister Pack (68084-698-11)",2.05,0.82,,,0 CDM,6370000001_68084069811,NDC Description Not Available,1.44,0.58,,,0 CDM,6370000001_68084070901,"Venlafaxine Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (68084-709-01) / 1 Capsule, Extended Release In 1 Blister Pack (68084-709-11)",1.66,0.66,,,0 CDM,6370000001_68084070911,NDC Description Not Available,1.66,0.66,,,0 CDM,6370000001_68084073501,"Fluconazole: 100 Blister Pack In 1 Box, Unit-Dose (68084-735-01) / 1 Tablet In 1 Blister Pack (68084-735-11)",8.22,3.29,,,0 CDM,6370000001_68084073511,NDC Description Not Available,8.77,3.51,,,0 CDM,6370000001_68084075025,"Triamterene And Hydrochlorothiazide: 30 Blister Pack In 1 Box, Unit-Dose (68084-750-25) / 1 Tablet In 1 Blister Pack (68084-750-95)",3.51,1.4,,,0 CDM,6370000001_68084075095,NDC Description Not Available,2.29,0.92,,,0 CDM,6370000001_68084075325,"Cyclobenzaprine Hydrochloride: 30 Blister Pack In 1 Box, Unit-Dose (68084-753-25) / 1 Tablet, Film Coated In 1 Blister Pack (68084-753-95)",2.07,0.83,,,0 CDM,6370000001_68084075395,NDC Description Not Available,1.43,0.57,,,0 CDM,6370000001_68084077601,"Divalproex Sodium: 100 Blister Pack In 1 Box, Unit-Dose (68084-776-01) / 1 Tablet, Delayed Release In 1 Blister Pack (68084-776-11)",0.67,0.27,,,0 CDM,6370000001_68084078211,NDC Description Not Available,0.9,0.36,,,0 CDM,6370000001_68084080511,NDC Description Not Available,5.52,2.21,,,0 CDM,6370000001_68084080521,"Methylphenidate Hydrochloride: 30 Blister Pack In 1 Box, Unit-Dose (68084-805-21) / 1 Tablet In 1 Blister Pack (68084-805-11)",4.38,1.75,,,0 CDM,6370000001_68084080801,"Tramadol Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (68084-808-01) / 1 Tablet, Coated In 1 Blister Pack (68084-808-11)",0.57,0.23,,,0 CDM,6370000001_68084080811,NDC Description Not Available,0.55,0.22,,,0 CDM,6370000001_68084082311,NDC Description Not Available,3.83,1.53,,,0 CDM,6370000001_68084082321,"Methylphenidate Hydrochloride: 30 Blister Pack In 1 Box, Unit-Dose (68084-823-21) / 1 Tablet In 1 Blister Pack (68084-823-11)",6.22,2.49,,,0 CDM,6370000001_68084083625,"Doxazosin: 30 Blister Pack In 1 Box, Unit-Dose (68084-836-25) / 1 Tablet In 1 Blister Pack (68084-836-95)",2.58,1.03,,,0 CDM,6370000001_68084083695,NDC Description Not Available,2.47,0.99,,,0 CDM,6370000001_68084084411,NDC Description Not Available,2.56,1.02,,,0 CDM,6370000001_68084084701,"Hydroxyzine Pamoate: 100 Blister Pack In 1 Box, Unit-Dose (68084-847-01) / 1 Capsule In 1 Blister Pack (68084-847-11)",1.58,0.63,,,0 CDM,6370000001_68084084711,NDC Description Not Available,2.14,0.86,,,0 CDM,6370000001_68084085311,NDC Description Not Available,2.88,1.15,,,0 CDM,6370000001_68084085401,"Carvedilol: 100 Blister Pack In 1 Box, Unit-Dose (68084-854-01) / 1 Tablet, Film Coated In 1 Blister Pack (68084-854-11)",0.36,0.14,,,0 CDM,6370000001_68084085411,NDC Description Not Available,0.28,0.11,,,0 CDM,6370000001_68084085601,"Venlafaxine: 100 Blister Pack In 1 Box, Unit-Dose (68084-856-01) / 1 Tablet In 1 Blister Pack (68084-856-11)",2.25,0.9,,,0 CDM,6370000001_68084085611,NDC Description Not Available,2.46,0.98,,,0 CDM,6370000001_68084085911,NDC Description Not Available,0.76,0.3,,,0 CDM,6370000001_68084086201,"Doxazosin: 100 Blister Pack In 1 Box, Unit-Dose (68084-862-01) / 1 Tablet In 1 Blister Pack (68084-862-11)",2.63,1.05,,,0 CDM,6370000001_68084086211,NDC Description Not Available,2.56,1.02,,,0 CDM,6370000001_68084089625,"Venlafaxine: 30 Blister Pack In 1 Box, Unit-Dose (68084-896-25) / 1 Tablet In 1 Blister Pack (68084-896-95)",3.6,1.44,,,0 CDM,6370000001_68084089695,NDC Description Not Available,2.66,1.06,,,0 CDM,6370000001_68084092825,"Pilocarpine Hydrochloride: 30 Blister Pack In 1 Box, Unit-Dose (68084-928-25) / 1 Tablet, Film Coated In 1 Blister Pack (68084-928-95)",9.81,3.92,,,0 CDM,6370000001_68084092895,NDC Description Not Available,6.56,2.62,,,0 CDM,6370000001_68084096495,NDC Description Not Available,8.09,3.24,,,0 CDM,6370000001_68084096595,NDC Description Not Available,68.7,27.48,,,0 CDM,6370000001_68084096801,Oxycodone Hydrochloride: 100 Blister Pack In 1 Carton (68084-968-01) / 1 Tablet In 1 Blister Pack (68084-968-11),1.99,0.8,,,0 CDM,6370000001_68084096811,NDC Description Not Available,1.9,0.76,,,0 CDM,6370000001_68084098832,"Antacid Peppermint Flavour Regular Strength: 20 Blister Pack In 1 Box, Unit-Dose (68084-988-32) / 1 Tablet, Chewable In 1 Blister Pack (68084-988-33)",1.33,0.53,,,0 CDM,6370000001_68084098833,NDC Description Not Available,2.2,0.88,,,0 CDM,6370000001_68084099611,NDC Description Not Available,4.53,1.81,,,0 CDM,6370000001_68094000159,NDC Description Not Available,2.16,0.86,,,0 CDM,6370000001_68094000162,"Morphine Sulfate: 3 Tray In 1 Case (68094-001-62) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (68094-001-59)",0.52,0.21,,,0 CDM,6370000001_68094000459,NDC Description Not Available,8.27,3.31,,,0 CDM,6370000001_68094000462,"Dye Free Childrens Cetirizine Hydrocholride: 3 Tray In 1 Case (68094-004-62) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (68094-004-59)",4.11,1.64,,,0 CDM,6370000001_68094001559,NDC Description Not Available,3.5,1.4,,,0 CDM,6370000001_68094001859,NDC Description Not Available,0.64,0.26,,,0 CDM,6370000001_68094001861,Diphenhydramine Hydrochloride: 10 Blister Pack In 1 Carton (68094-018-61) / 10 Tablet In 1 Blister Pack (68094-018-59),0.63,0.25,,,0 CDM,6370000001_68094002459,NDC Description Not Available,8.24,3.3,,,0 CDM,6370000001_68094003062,"Acetaminophen: 3 Tray In 1 Case (68094-030-62) / 10 Cup, Unit-Dose In 1 Tray / 20.3 Ml In 1 Cup, Unit-Dose (68094-030-59)",7.76,3.1,,,0 CDM,6370000001_68094003159,NDC Description Not Available,1.98,0.79,,,0 CDM,6370000001_68094003162,"Methadone Hydrochloride: 3 Tray In 1 Case (68094-031-62) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (68094-031-59)",2.25,0.9,,,0 CDM,6370000001_68094003464,"Sevelamer Carbonate: 9 Blister Pack In 1 Carton (68094-034-64) / 10 Tablet, Film Coated In 1 Blister Pack (68094-034-59)",8.2,3.28,,,0 CDM,6370000001_68094004159,NDC Description Not Available,16.17,6.47,,,0 CDM,6370000001_68094005459,NDC Description Not Available,0.41,0.16,,,0 CDM,6370000001_68094006159,NDC Description Not Available,3.88,1.55,,,0 CDM,6370000001_68094011259,NDC Description Not Available,0.48,0.19,,,0 CDM,6370000001_68094011359,NDC Description Not Available,0.55,0.22,,,0 CDM,6370000001_68094011659,NDC Description Not Available,0.5,0.2,,,0 CDM,6370000001_68094012959,NDC Description Not Available,9.01,3.6,,,0 CDM,6370000001_68094012962,"Loperamide Hydrochloride: 3 Tray In 1 Case (68094-129-62) / 10 Cup, Unit-Dose In 1 Tray / 15 Ml In 1 Cup, Unit-Dose (68094-129-59)",4.53,1.81,,,0 CDM,6370000001_68094019361,"Valproic Acid: 10 TRAY in 1 CASE (68094-193-61) / 10 CUP, UNIT-DOSE in 1 TRAY / 5 mL in 1 CUP, UNIT-DOSE (68094-193-59)",1.96,0.78,,,0 CDM,6370000001_68094023159,NDC Description Not Available,2.24,0.9,,,0 CDM,6370000001_68094023161,"Acetaminophen: 10 Tray In 1 Case (68094-231-61) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (68094-231-59)",1.52,0.61,,,0 CDM,6370000001_68094023162,"Acetaminophen: 3 Tray In 1 Case (68094-231-62) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (68094-231-59)",0.7,0.28,,,0 CDM,6370000001_68094033059,NDC Description Not Available,3.44,1.38,,,0 CDM,6370000001_68094035601,NDC Description Not Available,9.46,3.78,,,0 CDM,6370000001_68094035658,"Morphine Sulfate: 50 Bag In 1 Case (68094-356-58) / 1 Syringe, Plastic In 1 Bag / 1 Ml In 1 Syringe, Plastic (68094-356-01)",4.92,1.97,,,0 CDM,6370000001_68094049459,NDC Description Not Available,2.29,0.92,,,0 CDM,6370000001_68094050359,NDC Description Not Available,3.9,1.56,,,0 CDM,6370000001_68094050361,"Childrens Ibuprofen: 10 Tray In 1 Case (68094-503-61) / 10 Cup, Unit-Dose In 1 Tray / 10 Ml In 1 Cup, Unit-Dose (68094-503-59)",4.07,1.63,,,0 CDM,6370000001_68094058759,NDC Description Not Available,1.4,0.56,,,0 CDM,6370000001_68094059959,NDC Description Not Available,3.42,1.37,,,0 CDM,6370000001_68094060059,NDC Description Not Available,2.62,1.05,,,0 CDM,6370000001_68094060061,"Dye Free Childrens Ibuprofen: 10 Tray In 1 Case (68094-600-61) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (68094-600-59)",3.73,1.49,,,0 CDM,6370000001_68094075059,NDC Description Not Available,4.08,1.63,,,0 CDM,6370000001_68094075062,"Diazepam: 3 Tray In 1 Case (68094-750-62) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (68094-750-59)",4.72,1.89,,,0 CDM,6370000001_68094076259,NDC Description Not Available,12.81,5.12,,,0 CDM,6370000001_68094076262,"Midazolam Hydrochloride: 3 Tray In 1 Case (68094-762-62) / 10 Cup, Unit-Dose In 1 Tray / 2.5 Ml In 1 Cup, Unit-Dose (68094-762-59)",22.21,8.88,,,0 CDM,6370000001_68094076459,NDC Description Not Available,15.24,6.1,,,0 CDM,6370000001_68094076462,"Midazolam Hydrochloride: 3 Tray In 1 Case (68094-764-62) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (68094-764-59)",19.62,7.85,,,0 CDM,6370000001_68094085362,"Naltrexone Hydrochloride: 3 Blister Pack In 1 Carton (68094-853-62) / 10 Tablet, Film Coated In 1 Blister Pack (68094-853-59)",5.61,2.24,,,0 CDM,6370000001_68134020116,"Naproxen: 500 mL in 1 BOTTLE, PLASTIC (68134-201-16)",46.4,18.56,,,0 CDM,6370000001_68176000010,NDC Description Not Available,3.82,1.53,,,0 CDM,6370000001_68176000011,NDC Description Not Available,1.56,0.62,,,0 CDM,6370000001_68180012201,Cephalexin: 100 Capsule In 1 Bottle (68180-122-01),0.89,0.36,,,0 CDM,6370000001_68180015001,Famotidine: 50 Ml In 1 Bottle (68180-150-01),1.8,0.72,,,0 CDM,6370000001_68180015701,Clobazam: 1 Bottle In 1 Carton (68180-157-01) / 100 Tablet In 1 Bottle,1.59,0.64,,,0 CDM,6370000001_68180015901,Ethacrynic Acid: 100 Tablet In 1 Bottle (68180-159-01),5.82,2.33,,,0 CDM,6370000001_68180018001,Cefadroxil: 100 Capsule In 1 Bottle (68180-180-01),1.37,0.55,,,0 CDM,6370000001_68180018008,Cefadroxil: 50 Capsule In 1 Bottle (68180-180-08),1.44,0.58,,,0 CDM,6370000001_68180018203,Cefadroxil: 100 Ml In 1 Bottle (68180-182-03),6.91,2.76,,,0 CDM,6370000001_68180021430,"Cyclosporine: 30 Vial, Single-Use In 1 Tray (68180-214-30) / .4 Ml In 1 Vial, Single-Use",7.9,3.16,,,0 CDM,6370000001_68180028001,Ethambutol Hydrochloride: 100 Tablet In 1 Bottle (68180-280-01),1.24,0.5,,,0 CDM,6370000001_68180028101,Ethambutol Hydrochloride: 100 Tablet In 1 Bottle (68180-281-01),4.03,1.61,,,0 CDM,6370000001_68180029407,"Duloxetine: 60 Capsule, Delayed Release In 1 Bottle (68180-294-07)",1.87,0.75,,,0 CDM,6370000001_68180029509,"Duloxetine: 90 Capsule, Delayed Release In 1 Bottle (68180-295-09)",1.28,0.51,,,0 CDM,6370000001_68180029603,"Duloxetine: 1000 Capsule, Delayed Release In 1 Bottle (68180-296-03)",2.41,0.96,,,0 CDM,6370000001_68180029609,"Duloxetine: 90 Capsule, Delayed Release In 1 Bottle (68180-296-09)",0.9,0.36,,,0 CDM,6370000001_68180031906,"Bupropion Hydrochloride Xl: 30 Tablet, Extended Release In 1 Bottle (68180-319-06)",0.55,0.22,,,0 CDM,6370000001_68180039507,Celecoxib: 60 Capsule In 1 Bottle (68180-395-07),0.58,0.23,,,0 CDM,6370000001_68180044102,Cephalexin: 200 Ml In 1 Bottle (68180-441-02),8.01,3.2,,,0 CDM,6370000001_68180044701,Quetiapine Fumarate: 100 Tablet In 1 Bottle (68180-447-01),0.55,0.22,,,0 CDM,6370000001_68180052406,"Paliperidone: 30 Tablet, Extended Release In 1 Bottle (68180-524-06)",9.31,3.72,,,0 CDM,6370000001_68180065701,Doxycycline: 60 Ml In 1 Bottle (68180-657-01),8.39,3.36,,,0 CDM,6370000001_68180067006,Lurasidone Hydrochloride: 30 Tablet In 1 Bottle (68180-670-06),2.85,1.14,,,0 CDM,6370000001_68180067511,Oseltamivir Phosphate: 1 Blister Pack In 1 Carton (68180-675-11) / 10 Capsule In 1 Blister Pack,5.76,2.3,,,0 CDM,6370000001_68180067611,Oseltamivir Phosphate: 1 Blister Pack In 1 Carton (68180-676-11) / 10 Capsule In 1 Blister Pack,3.99,1.6,,,0 CDM,6370000001_68180067711,Oseltamivir Phosphate: 1 Blister Pack In 1 Carton (68180-677-11) / 10 Capsule In 1 Blister Pack,5.06,2.02,,,0 CDM,6370000001_68180067801,"Oseltamivir Phosphate: 1 Bottle, Glass In 1 Carton (68180-678-01) / 60 Ml In 1 Bottle, Glass",8.02,3.21,,,0 CDM,6370000001_68180072204,Cefdinir: 60 Ml In 1 Bottle (68180-722-04),21.26,8.5,,,0 CDM,6370000001_68180072205,Cefdinir: 100 Ml In 1 Bottle (68180-722-05),11.84,4.74,,,0 CDM,6370000001_68180085211,My Way: 1 Blister Pack In 1 Carton (68180-852-11) / 1 Tablet In 1 Blister Pack,40.65,16.26,,,0 CDM,6370000001_68180095602,Clobetasol Propionate: 1 Tube In 1 Carton (68180-956-02) / 30 G In 1 Tube,34.47,13.79,,,0 CDM,6370000001_68180096501,Levothyroxine Sodium: 100 Tablet In 1 Bottle (68180-965-01),0.3,0.12,,,0 CDM,6370000001_68180098101,Lisinopril: 100 Tablet In 1 Bottle (68180-981-01),0.12,0.05,,,0 CDM,6370000001_68308015230,"Nystatin: 30 G In 1 Bottle, Plastic (68308-152-30)",59.9,23.96,,,0 CDM,6370000001_68382000414,"Topiramate: 60 Capsule, Coated Pellets In 1 Bottle (68382-004-14)",2.81,1.12,,,0 CDM,6370000001_68382000514,"Topiramate: 60 Capsule, Coated Pellets In 1 Bottle (68382-005-14)",3.73,1.49,,,0 CDM,6370000001_68382001801,Venlafaxine: 100 Tablet In 1 Bottle (68382-018-01),0.9,0.36,,,0 CDM,6370000001_68382009301,"Carvedilol: 100 Tablet, Film Coated In 1 Bottle (68382-093-01)",0.09,0.04,,,0 CDM,6370000001_68382009401,"Carvedilol: 100 Tablet, Film Coated In 1 Bottle (68382-094-01)",0.11,0.04,,,0 CDM,6370000001_68382009405,"Carvedilol: 500 Tablet, Film Coated In 1 Bottle (68382-094-05)",0.12,0.05,,,0 CDM,6370000001_68382009501,"Carvedilol: 100 Tablet, Film Coated In 1 Bottle (68382-095-01)",0.12,0.05,,,0 CDM,6370000001_68382010601,"Divalproex Sodium: 100 Capsule, Coated Pellets In 1 Bottle (68382-106-01)",1.01,0.4,,,0 CDM,6370000001_68382011414,"Risperidone: 60 Tablet, Film Coated In 1 Bottle (68382-114-14)",0.36,0.14,,,0 CDM,6370000001_68382035306,"Bupropion: 30 Tablet, Extended Release In 1 Bottle (68382-353-06)",1.47,0.59,,,0 CDM,6370000001_68382037001,"Nystatin: 15 G In 1 Bottle, Plastic (68382-370-01)",21.02,8.41,,,0 CDM,6370000001_68382044405,"Famotidine: 50 Ml In 1 Bottle, Plastic (68382-444-05)",1.47,0.59,,,0 CDM,6370000001_68382052960,Cholestyramine: 60 Pouch In 1 Carton (68382-529-60) / 5.5 G In 1 Pouch,2.64,1.06,,,0 CDM,6370000001_68382058301,Liothyronine Sodium: 100 Tablet In 1 Bottle (68382-583-01),1.78,0.71,,,0 CDM,6370000001_68382080501,Trazodone Hydrochloride: 100 Tablet In 1 Bottle (68382-805-01),0.21,0.08,,,0 CDM,6370000001_68382080505,Trazodone Hydrochloride: 500 Tablet In 1 Bottle (68382-805-05),0.19,0.08,,,0 CDM,6370000001_68382084994,"Esomeprazole Magnesium: 30 Granule, Delayed Release In 1 Carton (68382-849-94)",23.35,9.34,,,0 CDM,6370000001_68382085701,Triamterene And Hydrochlorothiazide: 100 Tablet In 1 Bottle (68382-857-01),0.92,0.37,,,0 CDM,6370000001_68462010130,Fluconazole: 30 Tablet In 1 Bottle (68462-101-30),2.01,0.8,,,0 CDM,6370000001_68462012801,Zonisamide: 100 Capsule In 1 Bottle (68462-128-01),0.48,0.19,,,0 CDM,6370000001_68462013701,"Oxcarbazepine: 100 Tablet, Film Coated In 1 Bottle (68462-137-01)",1.28,0.51,,,0 CDM,6370000001_68462016201,"Carvedilol: 100 Tablet, Film Coated In 1 Bottle (68462-162-01)",0.18,0.07,,,0 CDM,6370000001_68462016401,"Carvedilol: 100 Tablet, Film Coated In 1 Bottle (68462-164-01)",0.18,0.07,,,0 CDM,6370000001_68462016501,"Carvedilol: 100 Tablet, Film Coated In 1 Bottle (68462-165-01)",0.26,0.1,,,0 CDM,6370000001_68462018022,Mupirocin: 22 G In 1 Tube (68462-180-22),39.37,15.75,,,0 CDM,6370000001_68462022801,"Lamotrigine: 100 Tablet, Chewable In 1 Bottle (68462-228-01)",1.25,0.5,,,0 CDM,6370000001_68462022901,"Lamotrigine: 100 Tablet, Chewable In 1 Bottle (68462-229-01)",1.27,0.51,,,0 CDM,6370000001_68462025501,"Ropinirole: 100 Tablet, Film Coated In 1 Bottle (68462-255-01)",0.36,0.14,,,0 CDM,6370000001_68462026001,"Verapamil Hydrochloride: 100 Tablet, Film Coated, Extended Release In 1 Bottle (68462-260-01)",0.93,0.37,,,0 CDM,6370000001_68462026190,"Rosuvastatin Calcium: 90 Tablet, Film Coated In 1 Bottle (68462-261-90)",0.57,0.23,,,0 CDM,6370000001_68462026630,Atomoxetine: 30 Capsule In 1 Bottle (68462-266-30),4.86,1.94,,,0 CDM,6370000001_68462028169,"Brimonidine Tartrate/Timolol Maleate: 1 Bottle, Dropper In 1 Carton (68462-281-69) / 5 Ml In 1 Bottle, Dropper",83.94,33.58,,,0 CDM,6370000001_68462029201,"Verapamil Hydrochloride: 100 Tablet, Film Coated, Extended Release In 1 Bottle (68462-292-01)",1.72,0.69,,,0 CDM,6370000001_68462029301,"Verapamil Hydrochloride: 100 Tablet, Film Coated, Extended Release In 1 Bottle (68462-293-01)",0.96,0.38,,,0 CDM,6370000001_68462030450,Norethindrone Acetate: 50 Tablet In 1 Bottle (68462-304-50),1.81,0.72,,,0 CDM,6370000001_68462033090,Pramipexole Dihydrochloride: 90 Tablet In 1 Bottle (68462-330-90),0.48,0.19,,,0 CDM,6370000001_68462033390,Pramipexole Dihydrochloride: 90 Tablet In 1 Bottle (68462-333-90),0.17,0.07,,,0 CDM,6370000001_68462039601,"Omeprazole: 100 Capsule, Delayed Release In 1 Bottle (68462-396-01)",0.32,0.13,,,0 CDM,6370000001_68462040601,Indomethacin: 100 Capsule In 1 Bottle (68462-406-01),0.33,0.13,,,0 CDM,6370000001_68462041820,Lidocaine: 1 Tube In 1 Carton (68462-418-20) / 35.44 G In 1 Tube,118.46,47.38,,,0 CDM,6370000001_68462043518,"Acamprosate Calcium: 180 Tablet, Delayed Release In 1 Bottle (68462-435-18)",3.29,1.32,,,0 CDM,6370000001_68462056417,Mupirocin: 15 G In 1 Tube (68462-564-17),845.25,338.1,,,0 CDM,6370000001_68462058340,Aprepitant: 1 Blister Pack In 1 Carton (68462-583-40) / 1 Capsule In 1 Blister Pack,32.98,13.19,,,0 CDM,6370000001_68462058385,Aprepitant: 5 Blister Pack In 1 Carton (68462-583-85) / 1 Capsule In 1 Blister Pack,48.04,19.22,,,0 CDM,6370000001_68462058440,NDC Description Not Available,30.26,12.1,,,0 CDM,6370000001_68462058476,Aprepitant: 1 Blister Pack In 1 Carton (68462-584-76) / 6 Capsule In 1 Blister Pack (68462-584-40),30.79,12.32,,,0 CDM,6370000001_68462079201,Tretinoin: 100 Capsule In 1 Bottle (68462-792-01),88.5,35.4,,,0 CDM,6370000001_68546017160,"Austedo: 60 Tablet, Coated In 1 Bottle (68546-171-60)",150.26,60.1,,,0 CDM,6370000001_68585000575,NDC Description Not Available,0.25,0.1,,,0 CDM,6370000001_68682030130,"Pyridostigmine Bromide: 30 Tablet, Extended Release In 1 Bottle (68682-301-30)",28.06,11.22,,,0 CDM,6370000001_68682042112,Tetrabenazine: 112 Tablet In 1 Bottle (68682-421-12),55.96,22.38,,,0 CDM,6370000001_69097042303,Celecoxib: 60 Capsule In 1 Bottle (69097-423-03),0.41,0.16,,,0 CDM,6370000001_69097051707,Cyclophosphamide: 100 Capsule In 1 Bottle (69097-517-07),12.45,4.98,,,0 CDM,6370000001_69097052444,Diclofenac Sodium: 1 Tube In 1 Carton (69097-524-44) / 100 G In 1 Tube,38.35,15.34,,,0 CDM,6370000001_69097052734,"Esomeprazole Magnesium: 30 Granule, For Suspension, Extended Release In 1 Carton (69097-527-34)",23.43,9.37,,,0 CDM,6370000001_69097052834,Esomeprazole Magnesium: 30 For Suspension In 1 Carton (69097-528-34),24.58,9.83,,,0 CDM,6370000001_69097052934,Esomeprazole Magnesium: 30 For Suspension In 1 Carton (69097-529-34),24.49,9.8,,,0 CDM,6370000001_69097057967,"Fosfomycin Tromethamine: 1 Dose Pack In 1 Carton (69097-579-67) / 1 Granule, For Solution In 1 Dose Pack",292.34,116.94,,,0 CDM,6370000001_69097067905,"Pregabalin Capsules, Cv: 90 Capsule In 1 Bottle (69097-679-05)",0.33,0.13,,,0 CDM,6370000001_69097083305,Sertraline Hydrochloride: 90 Tablet In 1 Bottle (69097-833-05),0.34,0.14,,,0 CDM,6370000001_69097085605,Fosinopril Sodium: 90 Tablet In 1 Bottle (69097-856-05),0.55,0.22,,,0 CDM,6370000001_69097085705,Fosinopril Sodium: 90 Tablet In 1 Bottle (69097-857-05),0.87,0.35,,,0 CDM,6370000001_69097096453,Vigabatrin: 50 Packet In 1 Carton (69097-964-53) / 10 Ml In 1 Packet,11.12,4.45,,,0 CDM,6370000001_69097096793,"Sevelamer Carbonate: 270 Tablet, Film Coated In 1 Bottle (69097-967-93)",0.15,0.06,,,0 CDM,6370000001_69097097902,"Vilazodone Hydrochloride: 30 Tablet, Film Coated In 1 Bottle (69097-979-02)",10.27,4.11,,,0 CDM,6370000001_69230031111,Ibuprofen Oral: 1 Bottle In 1 Carton (69230-311-11) / 118 Ml In 1 Bottle,3.76,1.5,,,0 CDM,6370000001_69238112601,Ethacrynic Acid: 100 Tablet In 1 Bottle (69238-1126-1),10.35,4.14,,,0 CDM,6370000001_69238115403,Ezetimibe: 30 Tablet In 1 Bottle (69238-1154-3),1.29,0.52,,,0 CDM,6370000001_69238120202,Buprenorphine: 4 Pouch In 1 Carton (69238-1202-2) / 1 Patch In 1 Pouch / 168 H In 1 Patch,226.55,90.62,,,0 CDM,6370000001_69238120302,Buprenorphine: 4 Pouch In 1 Carton (69238-1203-2) / 1 Patch In 1 Pouch / 168 H In 1 Patch,238.3,95.32,,,0 CDM,6370000001_69238131209,Pregabalin: 90 Capsule In 1 Bottle (69238-1312-9),0.27,0.11,,,0 CDM,6370000001_69238147303,"Erythromycin: 30 Tablet, Delayed Release In 1 Bottle (69238-1473-3)",31.22,12.49,,,0 CDM,6370000001_69238150301,Erythromycin Ethylsuccinate: 100 Ml In 1 Bottle (69238-1503-1),7.34,2.94,,,0 CDM,6370000001_69238153502,"Clobazam: 1 Bottle, Glass In 1 Carton (69238-1535-2) / 120 Ml In 1 Bottle, Glass",4.36,1.74,,,0 CDM,6370000001_69238157401,"Sildenafil: 1 Bottle, Glass In 1 Carton (69238-1574-1) / 112 Ml In 1 Bottle, Glass",1.2,0.48,,,0 CDM,6370000001_69238159608,"Aminocaproic Acid: 236.5 Ml In 1 Bottle, Plastic (69238-1596-8)",100.76,40.3,,,0 CDM,6370000001_69238161708,Potassium Chloride: 100 POUCH in 1 CARTON (69238-1617-8) / 1.58 g in 1 POUCH (69238-1617-1),6.4,2.56,,,0 CDM,6370000001_69238167901,"Fluphenazine Hydrochloride: 100 Tablet, Film Coated In 1 Bottle, Plastic (69238-1679-1)",4.58,1.83,,,0 CDM,6370000001_69238173002,Naproxen: 473 Ml In 1 Bottle (69238-1730-2),11.7,4.68,,,0 CDM,6370000001_69238201603,"Ipratropium Bromide: 1 Bottle, Spray In 1 Carton (69238-2016-3) / 345 Spray In 1 Bottle, Spray",102.96,41.18,,,0 CDM,6370000001_69238202905,Mupirocin: 1 Tube In 1 Carton (69238-2029-5) / 15 G In 1 Tube,129.31,51.72,,,0 CDM,6370000001_69238207701,Propranolol Hydrochloride: 100 Tablet In 1 Bottle (69238-2077-1),0.48,0.19,,,0 CDM,6370000001_69238207801,Propranolol Hydrochloride: 100 Tablet In 1 Bottle (69238-2078-1),0.44,0.18,,,0 CDM,6370000001_69292072225,"Flurbiprofen Sodium: 1 Bottle, Dropper In 1 Carton (69292-722-25) / 2.5 Ml In 1 Bottle, Dropper",109.59,43.84,,,0 CDM,6370000001_69315011601,Furosemide: 100 Tablet In 1 Bottle (69315-116-01),0.12,0.05,,,0 CDM,6370000001_69315011701,Furosemide: 100 Tablet In 1 Bottle (69315-117-01),0.18,0.07,,,0 CDM,6370000001_69315013401,"Imipramine Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (69315-134-01)",0.72,0.29,,,0 CDM,6370000001_69315030615,"Nystatin: 15 G In 1 Bottle, Plastic (69315-306-15)",125.83,50.33,,,0 CDM,6370000001_69315030805,"Ciprofloxacin: 1 Bottle, Plastic In 1 Carton (69315-308-05) / 5 Ml In 1 Bottle, Plastic",15.79,6.32,,,0 CDM,6370000001_69315031228,Procto-Med Hc: 1 Tube In 1 Carton (69315-312-28) / 28 G In 1 Tube,35.42,14.17,,,0 CDM,6370000001_69315090401,Lorazepam: 100 Tablet In 1 Bottle (69315-904-01),0.12,0.05,,,0 CDM,6370000001_69315090501,Lorazepam: 100 Tablet In 1 Bottle (69315-905-01),0.18,0.07,,,0 CDM,6370000001_69315090505,Lorazepam: 500 Tablet In 1 Bottle (69315-905-05),0.18,0.07,,,0 CDM,6370000001_69315091001,Diphenoxylate Hydrochloride And Atropine Sulfate: 100 Tablet In 1 Bottle (69315-910-01),1.4,0.56,,,0 CDM,6370000001_69339013815,"Dash Chlorhexidine Gluconate 0.12% Oral Rinse: 15 Ml In 1 Cup, Unit-Dose (69339-138-15)",5.72,2.29,,,0 CDM,6370000001_69339013819,Dash Chlorhexidine Gluconate 0.12% Oral Rinse: 1500 Ml In 1 Dose Pack (69339-138-19),6.46,2.58,,,0 CDM,6370000001_69339014801,NDC Description Not Available,32.07,12.83,,,0 CDM,6370000001_69339015705,NDC Description Not Available,12.17,4.87,,,0 CDM,6370000001_69339020901,NDC Description Not Available,30.98,12.39,,,0 CDM,6370000001_69344010233,Indocin: 30 Suppository In 1 Box (69344-102-33),1556.58,622.63,,,0 CDM,6370000001_69367028302,NDC Description Not Available,5.25,2.1,,,0 CDM,6370000001_69367029360,"Ranolazine: 60 Tablet, Film Coated, Extended Release In 1 Bottle (69367-293-60)",4.27,1.71,,,0 CDM,6370000001_69367029460,"Ranolazine: 60 Tablet, Film Coated, Extended Release In 1 Bottle (69367-294-60)",7.01,2.8,,,0 CDM,6370000001_69367032409,Pregabalin: 90 Capsule In 1 Bottle (69367-324-09),0.53,0.21,,,0 CDM,6370000001_69367033801,"Carbidopa And Levodopa: 100 Tablet In 1 Bottle, Plastic (69367-338-01)",0.27,0.11,,,0 CDM,6370000001_69367038801,"Amitriptyline Hydrochloride: 100 Tablet, Coated In 1 Bottle (69367-388-01)",0.2,0.08,,,0 CDM,6370000001_69367039001,"Amitriptyline Hydrochloride: 100 Tablet, Coated In 1 Bottle (69367-390-01)",0.55,0.22,,,0 CDM,6370000001_69367061101,Phenazopyridine Hydrochloride: 100 Tablet In 1 Bottle (69367-611-01),3.72,1.49,,,0 CDM,6370000001_69367061201,Phenazopyridine Hydrochloride: 100 Tablet In 1 Bottle (69367-612-01),5.25,2.1,,,0 CDM,6370000001_69396001420,Miconazole Nitrate 2% Cream Antifungal: 1 Tube In 1 Box (69396-014-20) / 30 G In 1 Tube,15.39,6.16,,,0 CDM,6370000001_69452011645,Clobazam: 1 Bottle In 1 Carton (69452-116-45) / 120 Ml In 1 Bottle,10.23,4.09,,,0 CDM,6370000001_69452013117,Dofetilide: 60 Capsule In 1 Bottle (69452-131-17),1.94,0.78,,,0 CDM,6370000001_69452013217,Dofetilide: 60 Capsule In 1 Bottle (69452-132-17),1.65,0.66,,,0 CDM,6370000001_69452013317,Dofetilide: 60 Capsule In 1 Bottle (69452-133-17),1.47,0.59,,,0 CDM,6370000001_69452014320,"Benzonatate: 100 Capsule In 1 Bottle, Plastic (69452-143-20)",1.32,0.53,,,0 CDM,6370000001_69452017313,"Azithromycin: 30 Tablet, Film Coated In 1 Bottle (69452-173-13)",7.26,2.9,,,0 CDM,6370000001_69452020820,"Calcitriol: 100 Capsule, Liquid Filled In 1 Bottle, Plastic (69452-208-20)",1.27,0.51,,,0 CDM,6370000001_69452020907,NDC Description Not Available,3.67,1.47,,,0 CDM,6370000001_69452020913,"Nimodipine: 3 Blister Pack In 1 Carton (69452-209-13) / 10 Capsule, Liquid Filled In 1 Blister Pack",4.47,1.79,,,0 CDM,6370000001_69452023320,Progesterone: 100 Capsule In 1 Bottle (69452-233-20),1.29,0.52,,,0 CDM,6370000001_69452024120,Trihexyphenidyl Hydrochloride: 100 Tablet In 1 Bottle (69452-241-20),0.6,0.24,,,0 CDM,6370000001_69452024220,Trihexyphenidyl Hydrochloride: 100 Tablet In 1 Bottle (69452-242-20),0.98,0.39,,,0 CDM,6370000001_69452035720,"Ropinirole: 100 Tablet, Film Coated In 1 Bottle, Plastic (69452-357-20)",0.42,0.17,,,0 CDM,6370000001_69452038998,"Magnesium Citrate: 296 Ml In 1 Bottle, Plastic (69452-389-98)",55.95,22.38,,,0 CDM,6370000001_69543035610,NDC Description Not Available,0.96,0.38,,,0 CDM,6370000001_69543041972,Sildenafil: 1 Bottle In 1 Carton (69543-419-72) / 112 Ml In 1 Bottle,2.72,1.09,,,0 CDM,6370000001_69543045101,NDC Description Not Available,9.8,3.92,,,0 CDM,6370000001_69543045110,Potassium Chloride: 100 Packet In 1 Carton (69543-451-10) / 1.77 G In 1 Packet (69543-451-01),12.02,4.81,,,0 CDM,6370000001_69584011110,Carisoprodol: 100 Tablet In 1 Bottle (69584-111-10),0.2,0.08,,,0 CDM,6370000001_69584042610,Imipramine Hydrochloride: 100 Tablet In 1 Bottle (69584-426-10),0.3,0.12,,,0 CDM,6370000001_69584061110,Methocarbamol: 100 Tablet In 1 Bottle (69584-611-10),0.26,0.1,,,0 CDM,6370000001_69616027230,Fycompa: 30 Tablet In 1 Bottle (69616-272-30),56.63,22.65,,,0 CDM,6370000001_69616027630,Fycompa: 30 Tablet In 1 Bottle (69616-276-30),121.59,48.64,,,0 CDM,6370000001_69618000506,NDC Description Not Available,0.19,0.08,,,0 CDM,6370000001_69618000815,NDC Description Not Available,1.07,0.43,,,0 CDM,6370000001_69618000858,NDC Description Not Available,0.71,0.28,,,0 CDM,6370000001_69618001959,NDC Description Not Available,0.14,0.06,,,0 CDM,6370000001_69724011210,Sotalol Hydrochloride: 1 Vial In 1 Carton (69724-112-10) / 10 Ml In 1 Vial,101.1,40.44,,,0 CDM,6370000001_69784018001,NDC Description Not Available,5.98,2.39,,,0 CDM,6370000001_69784063025,Tabloid: 1 Bottle In 1 Carton (69784-630-25) / 25 Tablet In 1 Bottle,54.28,21.71,,,0 CDM,6370000001_69918030130,Tranexamic Acid: 30 Tablet In 1 Bottle (69918-301-30),6.42,2.57,,,0 CDM,6370000001_70000002101,Epsom Salt: 454 G In 1 Pouch (70000-0021-1),5.45,2.18,,,0 CDM,6370000001_70000004402,"Stomach Relief Original Strength: 237 Ml In 1 Bottle, Plastic (70000-0044-2)",0.39,0.16,,,0 CDM,6370000001_70000005101,"Cardinal Health Infants Gas Relief: 1 Bottle, Dropper In 1 Carton (70000-0051-1) / 30 Ml In 1 Bottle, Dropper",0.09,0.04,,,0 CDM,6370000001_70000005162,NDC Description Not Available,0.39,0.16,,,0 CDM,6370000001_70000007901,Leader Baby Skin Protectant: 85 G In 1 Tube (70000-0079-1),10.82,4.33,,,0 CDM,6370000001_70000010901,Leader Ready To Use Mineral Oil Laxative: 1 Bottle In 1 Carton (70000-0109-1) / 133 Ml In 1 Bottle,3.99,1.6,,,0 CDM,6370000001_70000016901,Leader Maximum Strength Pain Relieving Analgesic: 1 Tube In 1 Carton (70000-0169-1) / 85 G In 1 Tube,8.9,3.56,,,0 CDM,6370000001_70000023901,"Leader Ibuprofen: 1 Bottle In 1 Carton (70000-0239-1) / 24 Tablet, Chewable In 1 Bottle",0.38,0.15,,,0 CDM,6370000001_70000034802,"Nicotine Polacrilex Coated Ice Mint: 100 Blister Pack In 1 Carton (70000-0348-2) / 1 Gum, Chewing In 1 Blister Pack",0.89,0.36,,,0 CDM,6370000001_70000038801,Leader Anti Itch: 1 Tube In 1 Carton (70000-0388-1) / 28 G In 1 Tube,3.62,1.45,,,0 CDM,6370000001_70000040001,Leader Calamine Plus: 177 Ml In 1 Container (70000-0400-1),7.44,2.98,,,0 CDM,6370000001_70000040901,Caffeine: 2 Blister Pack In 1 Carton (70000-0409-1) / 8 Tablet In 1 Blister Pack,0.22,0.09,,,0 CDM,6370000001_70000041503,Leader Clearlax: 510 G In 1 Bottle (70000-0415-3),8.1,3.24,,,0 CDM,6370000001_70000041701,Leader Anti Diarrheal: 120 Ml In 1 Bottle (70000-0417-1),1.97,0.79,,,0 CDM,6370000001_70000041715,NDC Description Not Available,0.78,0.31,,,0 CDM,6370000001_70000041801,Leader Anti Diarrheal: 120 Ml In 1 Bottle (70000-0418-1),0.3,0.12,,,0 CDM,6370000001_70000044801,"Leader Mineral Oil: 473 Ml In 1 Bottle, Plastic (70000-0448-1)",0.53,0.21,,,0 CDM,6370000001_70000045801,"Sore Throat Relief Cherry Flavor: 177 Ml In 1 Bottle, Spray (70000-0458-1)",5.31,2.12,,,0 CDM,6370000001_70000047401,Leader Childrens Allergy Relief: 1 Bottle In 1 Carton (70000-0474-1) / 118 Ml In 1 Bottle,0.18,0.07,,,0 CDM,6370000001_70000047701,Leader Regular Strength Chocolate Laxative Sennosides: 2 Pouch In 1 Carton (70000-0477-1) / 12 Tablet In 1 Pouch,0.16,0.06,,,0 CDM,6370000001_70000048501,Hydrocortisone: 72 Box In 1 Case (70000-0485-1) / 1 Tube In 1 Box / 28.4 G In 1 Tube,5.46,2.18,,,0 CDM,6370000001_70000049001,"Leader Earwax Removal Kit: 1 Bottle, Dropper In 1 Carton (70000-0490-1) / 15 Ml In 1 Bottle, Dropper",4.5,1.8,,,0 CDM,6370000001_70000050201,"Leader Dry Eye Relief Eye Drops: 1 Bottle, Plastic In 1 Carton (70000-0502-1) / 15 Ml In 1 Bottle, Plastic",7.62,3.05,,,0 CDM,6370000001_70000052601,"Stool Softener Plus Stimulant Laxative: 100 Tablet, Film Coated In 1 Bottle, Plastic (70000-0526-1)",0.03,0.01,,,0 CDM,6370000001_70000054202,Leader Athletes Foot Clotrimazole: 1 Tube In 1 Carton (70000-0542-2) / 28 G In 1 Tube,23.06,9.22,,,0 CDM,6370000001_70000054601,"Leader Anti-Itch: 212 G In 1 Bottle, Pump (70000-0546-1)",8.0,3.2,,,0 CDM,6370000001_70000054701,Leader Bacitracin Zinc: 1 Tube In 1 Box (70000-0547-1) / 28 G In 1 Tube,5.5,2.2,,,0 CDM,6370000001_70000055502,Diclofenac Sodium: 1 Tube In 1 Carton (70000-0555-2) / 100 G In 1 Tube,22.72,9.09,,,0 CDM,6370000001_70000056701,Sleep-Aid: 3 Blister Pack In 1 Carton (70000-0567-1) / 16 Tablet In 1 Blister Pack,0.26,0.1,,,0 CDM,6370000001_70000066301,"Mineral Oil: 473 Ml In 1 Bottle, Plastic (70000-0663-1)",0.45,0.18,,,0 CDM,6370000001_70010002901,"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate And Amphetamine Sulfate: 100 Capsule, Extended Release In 1 Bottle (70010-029-01)",1.82,0.73,,,0 CDM,6370000001_70010003001,"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate And Amphetamine Sulfate: 100 Capsule, Extended Release In 1 Bottle (70010-030-01)",1.84,0.74,,,0 CDM,6370000001_70010011101,"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate And Amphetamine Sulfate: 100 Tablet In 1 Bottle (70010-111-01)",1.01,0.4,,,0 CDM,6370000001_70010075401,"Methocarbamol: 100 Tablet, Coated In 1 Bottle (70010-754-01)",0.18,0.07,,,0 CDM,6370000001_70069005101,Dorzolamide Hydrochloride And Timolol Maleate: 1 Bottle In 1 Carton (70069-051-01) / 10 Ml In 1 Bottle,42.88,17.15,,,0 CDM,6370000001_70069012101,Tropicamide: 1 Bottle In 1 Carton (70069-121-01) / 15 Ml In 1 Bottle,25.89,10.36,,,0 CDM,6370000001_70069013101,Tobramycin: 1 Bottle In 1 Carton (70069-131-01) / 5 Ml In 1 Bottle,15.28,6.11,,,0 CDM,6370000001_70069023101,Brimonidine Tartrate: 1 Bottle In 1 Carton (70069-231-01) / 5 Ml In 1 Bottle,18.63,7.45,,,0 CDM,6370000001_70069042101,Latanoprost: 1 Bottle In 1 Carton (70069-421-01) / 2.5 Ml In 1 Bottle,19.55,7.82,,,0 CDM,6370000001_70069082301,Potassium Chloride For Oral Solution: 1.58 G In 1 Pouch (70069-823-01),4.53,1.81,,,0 CDM,6370000001_70127010001,NDC Description Not Available,123.95,49.58,,,0 CDM,6370000001_70127010010,"Epidiolex: 1 Bottle, Glass In 1 Carton (70127-100-10) / 100 Ml In 1 Bottle, Glass (70127-100-01)",121.23,48.49,,,0 CDM,6370000001_70156010401,Hyoscyamine Sulfate: 100 TABLET in 1 BOTTLE (70156-104-01),1.0,0.4,,,0 CDM,6370000001_70166028401,Methadone Hydrochloride: 30 BAG in 1 BOX (70166-284-01) / 1 SYRINGE in 1 BAG / 1 mL in 1 SYRINGE,0.1,0.04,,,0 CDM,6370000001_70370106001,Ingrezza: 30 Capsule In 1 Bottle (70370-1060-1),1265.77,506.31,,,0 CDM,6370000001_70377000612,"Rosuvastatin Calcium: 90 Tablet, Film Coated In 1 Bottle, Plastic (70377-006-12)",0.4,0.16,,,0 CDM,6370000001_70377011412,Liothyronine Sodium: 100 Tablet In 1 Bottle (70377-114-12),1.5,0.6,,,0 CDM,6370000001_70377011831,"Nitrofurantoin: 1 Bottle, Glass In 1 Carton (70377-118-31) / 230 Ml In 1 Bottle, Glass",101.0,40.4,,,0 CDM,6370000001_70408023932,"Nitrofurantoin: 240 Ml In 1 Bottle, Plastic (70408-239-32)",259.02,103.61,,,0 CDM,6370000001_70436002980,"Voriconazole: 1 Injection, Powder, Lyophilized, For Solution In 1 Box (70436-029-80)",53.79,21.52,,,0 CDM,6370000001_70436006001,"Bupropion Hydrochloride Sr: 100 Tablet, Extended Release In 1 Bottle (70436-060-01)",1.35,0.54,,,0 CDM,6370000001_70436023039,Voriconazole: 1 Bottle In 1 Carton (70436-230-39) / 75 Ml In 1 Bottle,132.75,53.1,,,0 CDM,6370000001_70515059415,Zanaflex: 150 Tablet In 1 Bottle (70515-594-15),13.38,5.35,,,0 CDM,6370000001_70700016201,Progesterone: 100 Capsule In 1 Bottle (70700-162-01),1.73,0.69,,,0 CDM,6370000001_70700026894,Fosfomycin Tromethamine: 1 Dose Pack In 1 Carton (70700-268-94) / 1 Powder In 1 Dose Pack,238.47,95.39,,,0 CDM,6370000001_70700026899,Fosfomycin Tromethamine: 1 Powder In 1 Packet (70700-268-99),240.96,96.38,,,0 CDM,6370000001_70710101401,Phytonadione: 1 Bottle In 1 Carton (70710-1014-1) / 100 Tablet In 1 Bottle,88.1,35.24,,,0 CDM,6370000001_70710113703,Fluconazole: 30 Tablet In 1 Bottle (70710-1137-3),0.99,0.4,,,0 CDM,6370000001_70710123304,Betamethasone Dipropionate: 1 Tube In 1 Carton (70710-1233-4) / 45 G In 1 Tube,181.33,72.53,,,0 CDM,6370000001_70710146002,Azithromycin: 1 Bottle In 1 Carton (70710-1460-2) / 30 Ml In 1 Bottle,5.65,2.26,,,0 CDM,6370000001_70710161306,"Varenicline: 56 Tablet, Film Coated In 1 Bottle (70710-1613-6)",18.09,7.24,,,0 CDM,6370000001_70710164206,Lubiprostone: 60 Capsule In 1 Bottle (70710-1642-6),3.18,1.27,,,0 CDM,6370000001_70710174503,Dasatinib: 30 Tablet In 1 Bottle (70710-1745-3),315.07,126.03,,,0 CDM,6370000001_70710185207,Indomethacin: 5 Blister Pack In 1 Carton (70710-1852-7) / 6 Suppository In 1 Blister Pack (70710-1852-6),1198.74,479.5,,,0 CDM,6370000001_70748012749,"Varenicline: 56 Tablet, Film Coated In 1 Bottle (70748-127-49)",7.29,2.92,,,0 CDM,6370000001_70748025807,"Posaconazole: 60 Tablet, Delayed Release In 1 Bottle (70748-258-07)",22.51,9.0,,,0 CDM,6370000001_70748033203,Prednisolone Acetate: 1 Bottle In 1 Carton (70748-332-03) / 10 Ml In 1 Bottle,245.52,98.21,,,0 CDM,6370000001_70752010406,"Cetirizine Hydrochloride: 1 Bottle, Plastic In 1 Carton (70752-104-06) / 118 Ml In 1 Bottle, Plastic",0.17,0.07,,,0 CDM,6370000001_70752011303,Lidocaine: 1 Tube In 1 Carton (70752-113-03) / 35.44 G In 1 Tube,29.34,11.74,,,0 CDM,6370000001_70756020111,"Amitriptyline Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (70756-201-11)",0.2,0.08,,,0 CDM,6370000001_70756020311,"Amitriptyline Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (70756-203-11)",0.55,0.22,,,0 CDM,6370000001_70756061430,"Phenylephrine Hydrochloride: 1 Bottle, Dropper In 1 Carton (70756-614-30) / 5 Ml In 1 Bottle, Dropper",187.46,74.98,,,0 CDM,6370000001_70756062925,"Phenylephrine Hydrochloride: 1 Bottle, Dropper In 1 Carton (70756-629-25) / 2 Ml In 1 Bottle, Dropper",118.77,47.51,,,0 CDM,6370000001_70756064935,"Phenylephrine Hydrochloride: 1 Bottle, Dropper In 1 Carton (70756-649-35) / 15 Ml In 1 Bottle, Dropper",386.27,154.51,,,0 CDM,6370000001_70954004110,Rifabutin: 100 Capsule In 1 Bottle (70954-041-10),54.28,21.71,,,0 CDM,6370000001_70954005110,Felbamate: 237 Ml In 1 Bottle (70954-051-10),14.37,5.75,,,0 CDM,6370000001_70954013510,Dapsone: 30 Tablet In 1 Bottle (70954-135-10),2.95,1.18,,,0 CDM,6370000001_70954013610,Dapsone: 30 Tablet In 1 Bottle (70954-136-10),3.6,1.44,,,0 CDM,6370000001_70954014010,Levocarnitine: 118 Ml In 1 Bottle (70954-140-10),5.98,2.39,,,0 CDM,6370000001_70954014810,Pyridostigmine: 473 Ml In 1 Bottle (70954-148-10),44.29,17.72,,,0 CDM,6370000001_70954016810,Sildenafil: 1 Bottle In 1 Carton (70954-168-10) / 112 Ml In 1 Bottle,1.25,0.5,,,0 CDM,6370000001_70954018810,Acyclovir: 473 Ml In 1 Bottle (70954-188-10),6.31,2.52,,,0 CDM,6370000001_70954021110,Trihexyphenidyl Hydrochloride: 100 Tablet In 1 Bottle (70954-211-10),0.67,0.27,,,0 CDM,6370000001_70954025810,Sulfamethoxazole And Trimethoprim: 473 Ml In 1 Bottle (70954-258-10),5.68,2.27,,,0 CDM,6370000001_70954027410,Fluphenazine Hydrochloride: 100 Tablet In 1 Bottle (70954-274-10),1.84,0.74,,,0 CDM,6370000001_70954031610,Famotidine: 50 Ml In 1 Bottle (70954-316-10),2.34,0.94,,,0 CDM,6370000001_70954031910,Paroxetine: 250 Ml In 1 Bottle (70954-319-10),62.63,25.05,,,0 CDM,6370000001_70954036510,Phenoxybenzamine Hydrochloride: 100 Capsule In 1 Bottle (70954-365-10),118.52,47.41,,,0 CDM,6370000001_70954041710,NDC Description Not Available,80.67,32.27,,,0 CDM,6370000001_70954041720,"L-Glutamine: 60 Packet In 1 Carton (70954-417-20) / 1 Powder, For Solution In 1 Packet (70954-417-10)",80.67,32.27,,,0 CDM,6370000001_70954044310,Misoprostol: 60 Tablet In 1 Bottle (70954-443-10),1.63,0.65,,,0 CDM,6370000001_70954044410,Misoprostol: 60 Tablet In 1 Bottle (70954-444-10),2.9,1.16,,,0 CDM,6370000001_70954048430,Pyrazinamide: 100 Tablet In 1 Bottle (70954-484-30),15.52,6.21,,,0 CDM,6370000001_70954048810,"Lacosamide: 200 Ml In 1 Bottle, Plastic (70954-488-10)",12.81,5.12,,,0 CDM,6370000001_70954049210,Levocarnitine: 90 Blister Pack In 1 Carton (70954-492-10) / 10 Tablet In 1 Blister Pack,2.48,0.99,,,0 CDM,6370000001_70954060010,"Fluoxetine Hydrochloride: 120 Ml In 1 Bottle, Plastic (70954-600-10)",7.39,2.96,,,0 CDM,6370000001_70954066210,"Ketoconazole: 120 Ml In 1 Bottle, Plastic (70954-662-10)",45.27,18.11,,,0 CDM,6370000001_70954089620,Megestrol Acetate: 480 Ml In 1 Bottle (70954-896-20),24.24,9.7,,,0 CDM,6370000001_71266629001,NDC Description Not Available,26.55,10.62,,,0 CDM,6370000001_71321080230,NDC Description Not Available,16.87,6.75,,,0 CDM,6370000001_71351001001,NDC Description Not Available,0.9,0.36,,,0 CDM,6370000001_71351001012,NDC Description Not Available,3.51,1.4,,,0 CDM,6370000001_71351001099,NDC Description Not Available,0.6,0.24,,,0 CDM,6370000001_71351001101,NDC Description Not Available,0.97,0.39,,,0 CDM,6370000001_71351001399,NDC Description Not Available,4.88,1.95,,,0 CDM,6370000001_71351001460,NDC Description Not Available,115.1,46.04,,,0 CDM,6370000001_71399003906,Onelax: 473 Ml In 1 Bottle (71399-0039-6),0.37,0.15,,,0 CDM,6370000001_71399005101,Onelax Saline Laxative: 296 Ml In 1 Bottle (71399-0051-1),8.81,3.52,,,0 CDM,6370000001_71399510101,Hydrophor: 454 G In 1 Jar (71399-5101-1),14.53,5.81,,,0 CDM,6370000001_71399748005,NDC Description Not Available,0.1,0.04,,,0 CDM,6370000001_71399788901,Magnesium Citrate Saline Laxative: 296 Ml In 1 Bottle (71399-7889-1),7.7,3.08,,,0 CDM,6370000001_71428000260,Fluocinolone Acetonide: 1 Bottle In 1 Carton (71428-002-60) / 60 Ml In 1 Bottle,2.4,0.96,,,0 CDM,6370000001_71656002150,"Potassium Chloride: 5 Tray In 1 Case (71656-021-50) / 10 Cup, Unit-Dose In 1 Tray / 15 Ml In 1 Cup, Unit-Dose (71656-021-15)",16.21,6.48,,,0 CDM,6370000001_71715000221,"Nuzyra: 1 Blister Pack In 1 Carton (71715-002-21) / 6 Tablet, Film Coated In 1 Blister Pack (71715-002-28)",812.61,325.04,,,0 CDM,6370000001_71776000515,"Natacyn: 1 Bottle, Glass In 1 Carton (71776-005-15) / 15 Ml In 1 Bottle, Glass",2178.75,871.5,,,0 CDM,6370000001_71930002330,Oxycodone Hydrochloride: 1 Bottle In 1 Carton (71930-023-30) / 30 Ml In 1 Bottle,8.2,3.28,,,0 CDM,6370000001_72060012140,Caplyta: 30 Capsule In 1 Bottle (72060-121-40),238.73,95.49,,,0 CDM,6370000001_72140000021,NDC Description Not Available,35.41,14.16,,,0 CDM,6370000001_72140001715,NDC Description Not Available,25.79,10.32,,,0 CDM,6370000001_72140001945,NDC Description Not Available,28.12,11.25,,,0 CDM,6370000001_72140003263,NDC Description Not Available,18.81,7.52,,,0 CDM,6370000001_72140011019,NDC Description Not Available,19.5,7.8,,,0 CDM,6370000001_72140063377,NDC Description Not Available,21.05,8.42,,,0 CDM,6370000001_72205000130,"Moxifloxacin Hydrochloride Tablets, 400 Mg: 30 Tablet, Film Coated In 1 Bottle (72205-001-30)",12.65,5.06,,,0 CDM,6370000001_72205001190,Pregabalin: 90 Capsule In 1 Bottle (72205-011-90),0.29,0.12,,,0 CDM,6370000001_72205001290,Pregabalin: 90 Capsule In 1 Bottle (72205-012-90),0.21,0.08,,,0 CDM,6370000001_72205001390,Pregabalin: 90 Capsule In 1 Bottle (72205-013-90),0.21,0.08,,,0 CDM,6370000001_72205001490,Pregabalin: 90 Capsule In 1 Bottle (72205-014-90),0.21,0.08,,,0 CDM,6370000001_72205001901,Valganciclovir Hydrochloride: 1 Bottle In 1 Carton (72205-019-01) / 100 Ml In 1 Bottle,299.53,119.81,,,0 CDM,6370000001_72205002830,"Febuxostat: 30 Tablet, Film Coated In 1 Bottle (72205-028-30)",1.5,0.6,,,0 CDM,6370000001_72205004211,Oseltamivir Phosphate: 1 Blister Pack In 1 Carton (72205-042-11) / 10 Capsule In 1 Blister Pack,7.07,2.83,,,0 CDM,6370000001_72205004411,Oseltamivir Phosphate: 1 Blister Pack In 1 Carton (72205-044-11) / 10 Capsule In 1 Blister Pack,7.92,3.17,,,0 CDM,6370000001_72205005108,Albendazole: 2 Tablet In 1 Bottle (72205-051-08),87.46,34.98,,,0 CDM,6370000001_72205008530,Tiagabine Hydrochloride: 30 Tablet In 1 Bottle (72205-085-30),8.94,3.58,,,0 CDM,6370000001_72205017072,Acyclovir Suspension: 473 Ml In 1 Bottle (72205-170-72),5.49,2.2,,,0 CDM,6370000001_72205018530,"Darunavir: 30 Tablet, Film Coated In 1 Bottle, Plastic (72205-185-30)",5.72,2.29,,,0 CDM,6370000001_72205020030,Roflumilast: 30 Tablet In 1 Bottle (72205-200-30),1.74,0.7,,,0 CDM,6370000001_72266015801,Moxifloxacin Ophthalmic Solution: 1 Bottle In 1 Carton (72266-158-01) / 3 Ml In 1 Bottle,39.93,15.97,,,0 CDM,6370000001_72266019701,Dorzolamide Hydrochloride: 1 Bottle In 1 Carton (72266-197-01) / 10 Ml In 1 Bottle,45.95,18.38,,,0 CDM,6370000001_72319002102,"Ranolazine: 60 Tablet, Film Coated, Extended Release In 1 Bottle, Plastic (72319-021-02)",0.88,0.35,,,0 CDM,6370000001_72485010401,"Caffeine Citrate: 1 Vial, Glass In 1 Carton (72485-104-01) / 3 Ml In 1 Vial, Glass",7.52,3.01,,,0 CDM,6370000001_72485067031,Erythromycin: 50 Tube In 1 Carton (72485-670-31) / 1 G In 1 Tube,30.6,12.24,,,0 CDM,6370000001_72578000201,Acyclovir: 100 Capsule In 1 Bottle (72578-002-01),0.36,0.14,,,0 CDM,6370000001_72578017001,Dexamethasone: 100 Tablet In 1 Bottle (72578-170-01),0.15,0.06,,,0 CDM,6370000001_72618300002,"Nurtec Odt: 1 Blister Pack In 1 Carton (72618-3000-2) / 8 Tablet, Orally Disintegrating In 1 Blister Pack",383.03,153.21,,,0 CDM,6370000001_72888001201,"Cyclobenzaprine Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (72888-012-01)",0.12,0.05,,,0 CDM,6370000001_72888002406,NDC Description Not Available,3.28,1.31,,,0 CDM,6370000001_72888002410,Potassium Chloride: 100 Pouch In 1 Carton (72888-024-10) / 1.58 G In 1 Pouch (72888-024-06),3.26,1.3,,,0 CDM,6370000001_72888003401,"Carvedilol: 100 Tablet, Film Coated In 1 Bottle (72888-034-01)",0.18,0.07,,,0 CDM,6370000001_72888003960,Amiodarone Hydrochloride: 60 Tablet In 1 Bottle (72888-039-60),0.58,0.23,,,0 CDM,6370000001_72888005201,Metolazone: 100 Tablet In 1 Bottle (72888-052-01),0.92,0.37,,,0 CDM,6370000001_72888005301,Metolazone: 100 Tablet In 1 Bottle (72888-053-01),0.88,0.35,,,0 CDM,6370000001_72888006701,"Amitriptyline Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (72888-067-01)",0.16,0.06,,,0 CDM,6370000001_72888006901,"Amitriptyline Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (72888-069-01)",0.45,0.18,,,0 CDM,6370000001_72888008001,"Tramadol Hydrochloride: 100 Tablet, Coated In 1 Bottle (72888-080-01)",0.08,0.03,,,0 CDM,6370000001_72888015201,Clonazepam: 100 Tablet In 1 Bottle (72888-152-01),0.08,0.03,,,0 CDM,6370000001_73562010410,Viokace: 1 Bottle In 1 Carton (73562-104-10) / 100 Tablet In 1 Bottle,12.77,5.11,,,0 CDM,6370000001_73562011001,"Zenpep: 100 Capsule, Delayed Release In 1 Bottle (73562-110-01)",12.58,5.03,,,0 CDM,6370000001_73562011201,"Zenpep: 100 Capsule, Delayed Release In 1 Bottle (73562-112-01)",24.59,9.84,,,0 CDM,6370000001_73562011301,"Zenpep: 100 Capsule, Delayed Release In 1 Bottle (73562-113-01)",6.64,2.66,,,0 CDM,6370000001_73562011401,"Zenpep: 100 Capsule, Delayed Release In 1 Bottle (73562-114-01)",48.58,19.43,,,0 CDM,6370000001_73562011501,"Zenpep: 100 Capsule, Delayed Release In 1 Bottle (73562-115-01)",5.85,2.34,,,0 CDM,6370000001_73562011601,"Zenpep: 100 Capsule, Delayed Release In 1 Bottle (73562-116-01)",30.42,12.17,,,0 CDM,6370000001_74300000065,NDC Description Not Available,5.26,2.1,,,0 CDM,6370000001_74300000071,NDC Description Not Available,14.88,5.95,,,0 CDM,6370000001_74312003201,NDC Description Not Available,0.08,0.03,,,0 CDM,6370000001_75826011410,"Phenazopyridine Hydrochloride: 100 Tablet In 1 Bottle, Plastic (75826-114-10)",1.16,0.46,,,0 CDM,6370000001_75826011510,"Phenazopyridine Hydrochloride: 100 Tablet In 1 Bottle, Plastic (75826-115-10)",1.11,0.44,,,0 CDM,6370000001_75834001060,NDC Description Not Available,3.81,1.52,,,0 CDM,6370000001_75907004301,Trimethoprim: 100 Tablet In 1 Bottle (75907-043-01),5.75,2.3,,,0 CDM,6370000001_75907005860,"Tamoxifen Citrate: 60 Tablet, Film Coated In 1 Bottle (75907-058-60)",0.57,0.23,,,0 CDM,6370000001_76329301105,"Lidocaine Hydrochloride: 25 Vial, Single-Use In 1 Box (76329-3011-5) / 5 Ml In 1 Vial, Single-Use",24.77,9.91,,,0 CDM,6370000001_76329301205,"Lidocaine Hydrochloride: 25 Vial, Single-Use In 1 Box (76329-3012-5) / 5 Ml In 1 Vial, Single-Use",24.77,9.91,,,0 CDM,6370000001_76329301305,"Lidocaine Hydrochloride: 25 Vial, Single-Use In 1 Box (76329-3013-5) / 10 Ml In 1 Vial, Single-Use",27.6,11.04,,,0 CDM,6370000001_76385010201,Primaquine Phosphate: 100 Tablet In 1 Bottle (76385-102-01),4.02,1.61,,,0 CDM,6370000001_76385012301,"Methocarbamol: 100 Tablet, Film Coated In 1 Bottle (76385-123-01)",0.34,0.14,,,0 CDM,6370000001_76385012401,"Methocarbamol: 100 Tablet, Film Coated In 1 Bottle (76385-124-01)",0.41,0.16,,,0 CDM,6370000001_76385013601,Metolazone: 100 Tablet In 1 Bottle (76385-136-01),1.95,0.78,,,0 CDM,6370000001_77333011010,NDC Description Not Available,0.33,0.13,,,0 CDM,6370000001_77333012025,NDC Description Not Available,1.26,0.5,,,0 CDM,6370000001_77333012050,Fiber Laxative Caplets: 50 Blister Pack In 1 Box (77333-120-50) / 1 Tablet In 1 Blister Pack (77333-120-25),0.86,0.34,,,0 CDM,6370000001_77333030810,NDC Description Not Available,0.48,0.19,,,0 CDM,6370000001_77333030825,NDC Description Not Available,4.54,1.82,,,0 CDM,6370000001_77333044110,NDC Description Not Available,0.64,0.26,,,0 CDM,6370000001_77333044125,NDC Description Not Available,0.6,0.24,,,0 CDM,6370000001_77333081210,"Simethicone 80Mg: 100 Blister Pack In 1 Box (77333-812-10) / 1 Tablet, Chewable In 1 Blister Pack (77333-812-25)",0.29,0.12,,,0 CDM,6370000001_77333081225,NDC Description Not Available,0.43,0.17,,,0 CDM,6370000001_77333083525,NDC Description Not Available,0.34,0.14,,,0 CDM,6370000001_77333084410,Sodium Chloride 1 Gram: 100 Blister Pack In 1 Box (77333-844-10) / 1 Tablet In 1 Blister Pack (77333-844-25),0.53,0.21,,,0 CDM,6370000001_77333084425,NDC Description Not Available,0.51,0.2,,,0 CDM,6370000001_77333093425,NDC Description Not Available,0.48,0.19,,,0 CDM,6370000001_77333093810,NDC Description Not Available,0.38,0.15,,,0 CDM,6370000001_77333093825,NDC Description Not Available,0.38,0.15,,,0 CDM,6370000001_77333094010,NDC Description Not Available,0.3,0.12,,,0 CDM,6370000001_77333094025,NDC Description Not Available,3.21,1.28,,,0 CDM,6370000001_77333098325,NDC Description Not Available,4.17,1.67,,,0 CDM,6370000001_78112001103,NDC Description Not Available,11.33,4.53,,,0 CDM,6370000001_78112001104,NDC Description Not Available,11.33,4.53,,,0 CDM,6370000001_78112001106,NDC Description Not Available,0.41,0.16,,,0 CDM,6370000001_78112001266,NDC Description Not Available,0.42,0.17,,,0 CDM,6370000001_78112073623,NDC Description Not Available,10.11,4.04,,,0 CDM,6370000001_78206012601,Dulera: 1 Canister In 1 Carton (78206-126-01) / 120 Aerosol In 1 Canister,1702.21,680.88,,,0 CDM,6370000001_78206012602,Dulera: 1 Canister In 1 Carton (78206-126-02) / 60 Aerosol In 1 Canister,900.46,360.18,,,0 CDM,6370000001_78206012701,Dulera: 1 Canister In 1 Carton (78206-127-01) / 120 Aerosol In 1 Canister,1700.68,680.27,,,0 CDM,6370000001_78206012702,Dulera: 1 Canister In 1 Carton (78206-127-02) / 60 Aerosol In 1 Canister,850.08,340.03,,,0 CDM,6370000001_78573000086,NDC Description Not Available,0.1,0.04,,,0 CDM,6370000001_78573000095,NDC Description Not Available,0.13,0.05,,,0 CDM,6370000001_79854005024,NDC Description Not Available,0.08,0.03,,,0 CDM,6370000001_79854007882,NDC Description Not Available,34.5,13.8,,,0 CDM,6370000001_79854011603,NDC Description Not Available,0.18,0.07,,,0 CDM,6370000001_80681007100,NDC Description Not Available,0.06,0.02,,,0 CDM,6370000001_80681009700,NDC Description Not Available,0.08,0.03,,,0 CDM,6370000001_80681009800,NDC Description Not Available,0.11,0.04,,,0 CDM,6370000001_80681009900,NDC Description Not Available,0.05,0.02,,,0 CDM,6370000001_80681016800,NDC Description Not Available,0.07,0.03,,,0 CDM,6370000001_80681016900,NDC Description Not Available,0.03,0.01,,,0 CDM,6370000001_80681017200,NDC Description Not Available,0.7,0.28,,,0 CDM,6370000001_80725063025,Tabloid: 1 Bottle In 1 Carton (80725-630-25) / 25 Tablet In 1 Bottle,986.25,394.5,,,0 CDM,6370000001_81033000205,NDC Description Not Available,1.4,0.56,,,0 CDM,6370000001_81033001105,NDC Description Not Available,7.76,3.1,,,0 CDM,6370000001_81033002001,NDC Description Not Available,7.51,3.0,,,0 CDM,6370000001_81033002050,Mupirocin: 50 Tube In 1 Package (81033-020-50) / 1 G In 1 Tube (81033-020-01),7.87,3.15,,,0 CDM,6370000001_81033002099,Mupirocin: 100 Tube In 1 Package (81033-020-99) / 1 G In 1 Tube (81033-020-01),10.76,4.3,,,0 CDM,6370000001_81033010210,NDC Description Not Available,4.93,1.97,,,0 CDM,6370000001_81033010252,"Guaifenesin: 50 Cup, Unit-Dose In 1 Carton (81033-102-52) / 10 Ml In 1 Cup, Unit-Dose (81033-102-10)",5.4,2.16,,,0 CDM,6370000001_81033010405,NDC Description Not Available,57.77,23.11,,,0 CDM,6370000001_81033051215,NDC Description Not Available,2.93,1.17,,,0 CDM,6370000001_81033051250,"Chlorhexidine Gluconate, 0.12% Oral Rinse Solution: 100 Cup, Unit-Dose In 1 Carton (81033-512-50) / 15 Ml In 1 Cup, Unit-Dose (81033-512-15)",2.83,1.13,,,0 CDM,6370000001_81421002002,NDC Description Not Available,0.67,0.27,,,0 CDM,6370000001_81421002102,NDC Description Not Available,2.38,0.95,,,0 CDM,6370000001_81520010030,"Voquezna: 30 Tablet In 1 Bottle, Plastic (81520-100-30)",93.38,37.35,,,0 CDM,6370000001_81665010310,Isosorbide Mononitrate: 100 Tablet In 1 Bottle (81665-103-10),7.09,2.84,,,0 CDM,6370000001_81665030102,"Cocaine Hydrochloride Nasal: 1 Bottle, Glass In 1 Carton (81665-301-02) / 4 Ml In 1 Bottle, Glass",1100.47,440.19,,,0 CDM,6370000001_82182045505,"Brimonidine Tartrate And Timolol Maleate: 5 Ml In 1 Bottle, Plastic (82182-455-05)",383.4,153.36,,,0 CDM,6370000001_82347050504,NDC Description Not Available,8.55,3.42,,,0 CDM,6370000001_82347050505,Lidocaine 5%: 30 Pouch In 1 Package (82347-0505-5) / 14 G In 1 Pouch (82347-0505-4),12.29,4.92,,,0 CDM,6370000001_82667060005,"Maxidex: 1 Bottle, Plastic In 1 Carton (82667-600-05) / 5 Ml In 1 Bottle, Plastic",178.01,71.2,,,0 CDM,6370000001_82667070003,Vigamox: 1 Bottle In 1 Carton (82667-700-03) / 3 Ml In 1 Bottle,438.94,175.58,,,0 CDM,6370000001_83257001411,"Insulin Glargine: 1 Vial, Multi-Dose In 1 Carton (83257-014-11) / 10 Ml In 1 Vial, Multi-Dose",1.23,0.49,,,0 CDM,6370000001_83851010001,NDC Description Not Available,0.66,0.26,,,0 CDM,6370000001_83851010030,C20H10Na2O5 Fluorescein Sodium Ophthalmic Strips: 300 Packet In 1 Box (83851-100-30) / 1 Mg In 1 Packet,0.71,0.28,,,0 CDM,6370000001_86067000000,NDC Description Not Available,0.1,0.04,,,0 CDM,6370000001_86067000004,NDC Description Not Available,0.07,0.03,,,0 CDM,6370000001_86067000006,NDC Description Not Available,0.07,0.03,,,0 CDM,6370000001_86067000008,NDC Description Not Available,0.01,0.004,,,0 CDM,6370000001_87701040065,NDC Description Not Available,2.91,1.16,,,0 CDM,6370000001_88395001540,NDC Description Not Available,1.45,0.58,,,0 CDM,6370000001_89476081780,NDC Description Not Available,15.93,6.37,,,0 CDM,6370000001_96974000002,NDC Description Not Available,0.2,0.08,,,0 CDM,6370000001_98115000250,NDC Description Not Available,0.65,0.26,,,0 CDM,6370000001_99999200301,NDC Description Not Available,0.78,0.31,,,0 CDM,6370000002_00002753301,Humalog: 1 Vial In 1 Carton (0002-7533-01) / 3 Ml In 1 Vial,0.79,0.32,,,0 CDM,6370000002_00002821501,"Humulin R: 1 Vial, Multi-Dose In 1 Carton (0002-8215-01) / 10 Ml In 1 Vial, Multi-Dose",0.33,0.13,,,0 CDM,6370000002_00003218713,"Orencia: 1 Vial, Single-Use In 1 Carton (0003-2187-13) / 15 Ml In 1 Vial, Single-Use",260.05,104.02,,,0 CDM,6370000002_00024592605,Admelog: 1 Vial In 1 Carton (0024-5926-05) / 3 Ml In 1 Vial,2.79,1.12,,,0 CDM,6370000002_00143963801,NDC Description Not Available,25.87,10.35,,,0 CDM,6370000002_00169183311,Novolin R: 1 Vial In 1 Carton (0169-1833-11) / 10 Ml In 1 Vial,0.16,0.06,,,0 CDM,6370000002_00169750111,"Novolog: 1 Vial, Glass In 1 Carton (0169-7501-11) / 10 Ml In 1 Vial, Glass",15.59,6.24,,,0 CDM,6370000002_00338012612,Myxredlin: 12 Container In 1 Carton (0338-0126-12) / 100 Ml In 1 Container,46.0,18.4,,,0 CDM,6370000002_23155068631,"Octreotide Acetate: 5 Ml In 1 Vial, Glass (23155-686-31)",2.35,0.94,,,0 CDM,6370000002_49401010201,Benlysta: 1 Vial In 1 Carton (49401-102-01) / 5 Ml In 1 Vial,243.31,97.32,,,0 CDM,6370000002_63323037600,NDC Description Not Available,2.69,1.08,,,0 CDM,6370000002_63323037905,"Octreotide: 1 Vial, Multi-Dose In 1 Carton (63323-379-05) / 5 Ml In 1 Vial, Multi-Dose",2.31,0.92,,,0 CDM,6370000002_83257001411,"Insulin Glargine: 1 Vial, Multi-Dose In 1 Carton (83257-014-11) / 10 Ml In 1 Vial, Multi-Dose",1.26,0.5,,,0 CDM,681G039001,Hc Trauma Response-Red Alert,21773.02,8709.21,,,0 CDM,681G039002,Hc Trauma Response-Alert,18415.49,7366.2,,,0 CDM,7002901001,"Hc Apply Body Cast,Risser Jacket",853.94,341.58,,,0 CDM,7002905501,"Hc Apply Shoulder Cast,Spica",85.45,34.18,,,0 CDM,7002906501,Hc Apply Long Arm Cast,1285.93,514.37,,,0 CDM,7002906501_29065_271,Hc Apply Long Arm Cast,1038.64,415.46,,,0 CDM,7002907501,Hc Apply Forearm Cast,1155.34,462.14,,,0 CDM,7002908501,Hc Gauntlet Cast,872.36,348.94,,,0 CDM,7002908601,Hc Thumb Spica Cast,815.44,326.18,,,0 CDM,7002910501,Hc Apply Long Arm Splint,838.88,335.55,,,0 CDM,7002910501_29105_271,Hc Apply Long Arm Splint,677.55,271.02,,,0 CDM,7002912501,Hc Apply Forearm Splint Static,795.34,318.14,,,0 CDM,7002912601,Hc Apply Forearm Splint Dynamic,709.94,283.98,,,0 CDM,7002912601_29126_271,Hc Apply Forearm Splint Dynamic,573.42,229.37,,,0 CDM,7002913001,Hc Apply Finger Splint Static,242.79,97.12,,,0 CDM,7002930501,"Hc Apply Of Hip Cast,One Leg",1466.78,586.71,,,0 CDM,7002932501,"Hc Apply Of Hip Casts,Two Legs",1466.78,586.71,,,0 CDM,7002934501,Hc Apply Long Leg Cast,1295.98,518.39,,,0 CDM,7002935501,Hc Apply Long Leg Cast Walker,1157.01,462.8,,,0 CDM,7002936501,"Hc Apply Long Leg Cast,Cylinder",1349.57,539.83,,,0 CDM,7002940501,Hc Apply Short Leg Cast,1165.38,466.15,,,0 CDM,7002942501,Hc Apply Short Leg Cast Walker,1039.8,415.92,,,0 CDM,7002943501,Hc Apply Patella Tendon Bearing Cast,1255.8,502.32,,,0 CDM,7002944501,Hc Apply Rigid Leg Cast,1157.01,462.8,,,0 CDM,7002945001,Hc Apply Of Clubfoot Cast,485.58,194.23,,,0 CDM,7002950501,Hc Apply Long Leg Splint,872.36,348.94,,,0 CDM,7002950501_29505_271,Hc Apply Long Leg Splint,704.6,281.84,,,0 CDM,7002951501,Hc Apply Lower Leg Splint,807.07,322.83,,,0 CDM,7002958001,Hc Strapping Unna Boot,853.94,341.58,,,0 CDM,7002970501,Hc Removal/Revision Full Arm/Leg Cast,904.18,361.67,,,0 CDM,7002972001,Hc Repair Spica/Body/Jacket Cast,1165.38,466.15,,,0 CDM,7002973001,Hc Windowing Of Cast,607.8,243.12,,,0 CDM,7002974001,Hc Wedging Of Cast,485.58,194.23,,,0 CDM,7100000001,Hc Phase 1 Recovery Room Time - Initial 30 Min,2501.39,1000.56,,,0 CDM,7100000002,Hc Phase 1 Recovery Room Time - Each Add 1 Min,32.1,12.84,,,0 CDM,7100000003,Hc Phase 1 Recovery Room Time - Initial 30 Min,2501.39,1000.56,,,0 CDM,7100000004,Hc Phase 1 Recovery Room Time - Each Add 1 Min,32.1,12.84,,,0 CDM,7100000005,Hc Phase 2 Recovery Room Time - Initial 30 Min,1589.58,635.83,,,0 CDM,7100000006,Hc Phase 2 Recovery Room Time - Each Add 1 Min,13.98,5.59,,,0 CDM,7100000007,Hc Phase 2 Recovery Room Time Each Additional 15 Minutes,209.67,83.87,,,0 CDM,7100000008,Hc Phase 2 Recovery Room Time - Each Add 1 Min,13.98,5.59,,,0 CDM,7100000009,Hc Phase 2 Recovery Room Time - Initial 30 Min,1589.58,635.83,,,0 CDM,7100000012,Hc Extended Recovery Per 1 Hour,93.59,37.44,,,0 CDM,7100000013,Hc Extended Recovery Carve-Out - Radiology,93.59,37.44,,,0 CDM,7100000014,Hc Extended Recovery Carve-Out - Gastrointestinal,93.59,37.44,,,0 CDM,7100000015,Hc Extended Recovery Carve-Out - Cardiology,93.59,37.44,,,0 CDM,7100000016,Hc Extended Recovery Carve-Out - Respiratory,93.59,37.44,,,0 CDM,7100000017,Hc Extended Recovery Carve-Out - Interventional Radiology,93.59,37.44,,,0 CDM,7100000018,Hc Endoscopy Phase 1 Recovery Initial 15 Minutes,242.65,97.06,,,0 CDM,7100000019,Hc Endoscopy Phase 1 Recovery Each Additional 1 Minute,4.6,1.84,,,0 CDM,7100000021,Hc Pacu Phase 1 Recovery Initial 30 Minutes,2501.39,1000.56,,,0 CDM,7100000025,Hc Endoscopy Recovery Initial 30 Minutes,258.75,103.5,,,0 CDM,7100000026,Hc Endoscopy Recovery Each Additional 15 Minutes,8.05,3.22,,,0 CDM,7100000027,Hc Recovery Initial 30 Minutes,2875.0,1150.0,,,0 CDM,7100000028,Hc Recovery Each Additional 15 Minute,28.75,11.5,,,0 CDM,7100000042,Hc Endoscopy Phase 2 Recovery Initial 30 Mins,154.2,61.68,,,0 CDM,7100000043,Hc Endoscopy Phase 2 Recovery Each Additional 1 Minute,2.92,1.17,,,0 CDM,7100000099,Hc Or Room Phase Recovery Each 1 Minute,57.78,23.11,,,0 CDM,7200000016,Hc Hemodynamic Monitoring,1009.7,403.88,,,0 CDM,7200000050,Hc Induction/Augmentation Of Labor,1245.45,498.18,,,0 CDM,7200000051,"Hc C-Section, Unsch Failed Vag",9145.95,3658.38,,,0 CDM,7202150001,Hc Labor And Delivery C-Section Unscheduled,11858.11,4743.24,,,0 CDM,7202200001,Hc C-Section Scheduled,9470.41,3788.16,,,0 CDM,7202300001,Hc High Risk Vaginal Delivery,8150.97,3260.39,,,0 CDM,7203050001,Hc Epidural Anes Monitor By Rn,644.64,257.86,,,0 CDM,7205900001,"Hc Amniocentesis,Diagnostic",1882.02,752.81,,,0 CDM,7205900101,"Hc Amniocentesis,Therapy Amniotic Fluid Reduction",1741.38,696.55,,,0 CDM,7205902001,Hc Fetal Contractn Stress Test,1465.1,586.04,,,0 CDM,7205902501,Hc Fetal Non-Stress Test,1349.57,539.83,,,0 CDM,7205930001,Hc Episiotomy Or Vaginal Repair,10335.0,4134.0,,,0 CDM,7205932001,Hc Revision Of Cervix,7983.53,3193.41,,,0 CDM,7205940001,Hc Labor And Delivery Induction/Augmentation,1207.81,483.12,,,0 CDM,7205940002,Hc High Risk Vaginal Delivery With Induction/Augmentation,7288.3,2915.32,,,0 CDM,7205940003,Hc High Risk Vaginal Delivery,6080.49,2432.2,,,0 CDM,7205940901,"Hc Obstetrical Care,Vaginal Delivery Only-Emergency Room",8413.2,3365.28,,,0 CDM,7205940902,"Hc Obstetrical Care,Vaginal Delivery Only-Labor And Delivery",5603.53,2241.41,,,0 CDM,7205940903,Hc Vaginal Delivery With Induction/Augmentation,6080.45,2432.18,,,0 CDM,7205941201,Hc External Cephalic Version; Ultrasound Not Included,4297.82,1719.13,,,0 CDM,7205951001,Hc Cesarean Section Scheduled,7064.76,2825.9,,,0 CDM,7205951501,Hc Labor And Delivery C Section Unscheduled,8845.94,3538.38,,,0 CDM,7205987101,Hc Remove Cerclage Suture,5072.54,2029.02,,,0 CDM,7209946501,Hc Delivery/Birthing Room Resuscitation,1141.0,456.4,,,0 CDM,7229946501,Hc Delivery/Birthing Room Resuscitation,1141.0,456.4,,,0 CDM,7230000001,Hc Circumcision-Neonate,3126.03,1250.41,,,0 CDM,7235415005,Hc Circumcision,1088.36,435.34,,,0 CDM,7309300501,"Hc Electrocardiogram, Tracing",428.7,171.48,,,0 CDM,7309300502,"Hc Electrocardiogram, Tracing - Ecg 12-Lead",428.7,171.48,,,0 CDM,7309322701,Hc Ecg < 48 Hours,434.42,173.77,,,0 CDM,7309322901,Hc External Mobile Cv Telemetry W/Technical Support,1354.69,541.88,,,0 CDM,7309324201,Hc Holter Hookup > 48Hrs-7 Days,414.98,165.99,,,0 CDM,7309324301,Hc Holter Analysis > 48Hrs-7 Day,585.32,234.13,,,0 CDM,7309324401,Hc Holter Analysis > 48Hrs <7 Day,497.29,198.92,,,0 CDM,7309324601,Hc Holter Hookup - 7-15 Days,414.98,165.99,,,0 CDM,7309324701,Hc Holter Analysis 7-15 Days,585.32,234.13,,,0 CDM,7309324801,Hc Ekg 8-15 Days Review And Interpretation,400.12,160.05,,,0 CDM,7309327801,Hc Single Averaged Ecg,258.36,103.34,,,0 CDM,730G040401,Hc Ekg Tracing Initial Preventive,142.9,57.16,,,0 CDM,7319322503,"Hc Ext Ecg Record Continuous 48 Hr, Record - Holter Monitor - 48 Hour",1119.19,447.68,,,0 CDM,7319322602,Hc Ecg Monit/Reprt Up To 48 Hrs - Holter Monitor - 48 Hour,1027.73,411.09,,,0 CDM,7319327001,Hc Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor,627.62,251.05,,,0 CDM,7319327101,Hc Ecg/Monitoring And Analysis - Cardiac Event Monitor,1047.17,418.87,,,0 CDM,7409570001,Hc Veeg Set Up Takedown Education,864.26,345.7,,,0 CDM,7409570501,Hc Unmonitored No Video 2-12 Tech,2336.7,934.68,,,0 CDM,7409570801,Hc Unmitrdnovideo 12-26 Tech Amb,4652.81,1861.12,,,0 CDM,7409571201,Hc Intrmntr 2-12Hr V/Eeg Tech,2900.29,1160.12,,,0 CDM,7409571301,Hc Cntmntr2-12Hveegtech 4Hr 6Hrop,3156.37,1262.55,,,0 CDM,7409571501,Hc Intrmntr12-26Hr Veeg Tech 24Hr,5800.59,2320.24,,,0 CDM,7409571601,Hc Continous 12-26 Hour W/Video Tech,6056.66,2422.66,,,0 CDM,7409578201,Hc Pediatric Poly <6 Yo,7087.99,2835.2,,,0 CDM,7409578202,Hc Reduced/Elimated Svcs Pediatric Poly <6 Yo,6163.47,2465.39,,,0 CDM,7409578301,Hc Pediatric Cpap <6 Yo,7146.78,2858.71,,,0 CDM,7409578302,Hc Reduced/Elimated Svcs Pediatric Cpap <6 Yo,6214.59,2485.84,,,0 CDM,7409580301,Hc Actigraphy Test Rec/Analy/I&R,485.21,194.08,,,0 CDM,7409580501,Hc Multiple Sleep Latency Test,5020.37,2008.15,,,0 CDM,7409580601,Hc Unattended Polysomnography,1175.56,470.22,,,0 CDM,7409580701,Hc Pap Nap Reduced Serv,865.55,346.22,,,0 CDM,7409580801,Hc Attended Hst,1265.0,506.0,,,0 CDM,7409581001,Hc Polysom 6/>Yrs Sleep 4/> Addl Param Attnd,6830.99,2732.4,,,0 CDM,7409581002,Hc Reduced/Elimated Svcs Polysom 6/>Yrs Sleep 4/> Addl Param Attnd,5939.99,2376.0,,,0 CDM,7409581101,Hc Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd,6819.45,2727.78,,,0 CDM,7409581102,Hc Reduced/Elimated Svcs Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd,5929.69,2371.88,,,0 CDM,7409581201,"Hc Eeg,Extended Monitoring,41-60 Minutes - Eeg",1961.73,784.69,,,0 CDM,7409581202,Hc Poct Ceribell Eeg 41-60 Minutes,3594.21,1437.68,,,0 CDM,7409581301,"Hc Eeg , Greater Than 1 Hr",2600.77,1040.31,,,0 CDM,7409581302,Hc Poct Ceribell Eeg 61-119 Minutes,3822.85,1529.14,,,0 CDM,7409581601,"Hc Eeg,W/Awake & Drowsy Record - Eeg Awake Or Drowsy Portable",1784.53,713.81,,,0 CDM,7409581602,Hc Poct Ceribell Eeg 20-40 Minutes,3422.73,1369.09,,,0 CDM,7409581901,"Hc Eeg,W/Awake & Asleep Record",1814.25,725.7,,,0 CDM,7409582201,"Hc Eeg,Coma/Sleep Record Only - Eeg In Coma",1710.22,684.09,,,0 CDM,7409582901,Hc Surgery Electrocorticogram - Electrocorticogram At Surgery,10347.79,4139.12,,,0 CDM,7409583601,Hc Electrocorticogram With Implanted Brain Neurostimulator,591.5,236.6,,,0 CDM,7409593301,Hc Blink Reflex Test,665.28,266.11,,,0 CDM,7409595502,Hc Eeg During Surgery - Eeg During Nonintracranial Surgery,4045.78,1618.31,,,0 CDM,7409595701,Hc Eeg Digital Analysis,1196.93,478.77,,,0 CDM,7409596101,Hc Cortical Map By Stim Init Hr,2657.4,1062.96,,,0 CDM,7409596201,Hc Cortical Map Stim Ea Ad Hr,1853.26,741.3,,,0 CDM,7504325901,Hc Egd Us Exam Surgical Alter Stom Duodenum/Jejunum - Egd,4892.38,1956.95,,,0 CDM,7504326401,Hc Ercp Remove Calculi/Debris Biliary/Pancreas Duct - Ercp,6955.67,2782.27,,,0 CDM,7504327401,Hc Ercp Stent Placement Biliary/Pancreatic Duct - Ercp,8727.29,3490.92,,,0 CDM,7504437301,"Hc Sb Scope,Convrt Gastro To Jejun - Endo, Small Bowel",3047.5,1219.0,,,0 CDM,7504440701,Hc Colonoscopy Stoma W/Us Gid Ndl Aspir/Bx - Endo Us (Lower),3279.8,1311.92,,,0 CDM,7504537801,Hc Colonoscopy Flexible Diagnostic W/Collj Spec When Pfrmd - Colonoscopy,3635.15,1454.06,,,0 CDM,7504700001,"Hc Needle Biopsy Liver - Needle Biopsy, Liver",5150.28,2060.11,,,0 CDM,7509101002,"Hc Esophageal Motility Study, Manometry - Manometry Esophageal",3549.13,1419.65,,,0 CDM,7509101301,Hc Esophageal Motility Study With Stimulaton Or Perfusion,2810.6,1124.24,,,0 CDM,7509102001,"Hc Gastric Motility Study - Manometry Study, Gastric",3209.76,1283.9,,,0 CDM,7509103401,Hc Esophageal Acid Prolong Infus,3404.05,1361.62,,,0 CDM,7509103701,Hc Esoph Function Test-Gstresop Reflx,2529.54,1011.82,,,0 CDM,7509103801,Hc Impedence Ph Testing >1Hr,2365.09,946.04,,,0 CDM,7509104001,Hc Esophageal Balloon Distension Provocation Study,2661.1,1064.44,,,0 CDM,7509111001,Hc Gi Tract Capsule Endoscopy - Small Bowel Capsule Enteroscopy,5504.91,2201.96,,,0 CDM,7509111101,Hc Gastrointestinal Tract Imaging With Interpretation And Report,5488.17,2195.27,,,0 CDM,7509111201,Hc Gastrointestinal Tran Pressure,2537.36,1014.94,,,0 CDM,7509129901,Hc Patency Capsule Test,679.9,271.96,,,0 CDM,760G037901,Hc Direct Admit To Observation,671.6,268.64,,,0 CDM,7610000044,Hc Peds Suture Repr-Intermed,663.14,265.26,,,0 CDM,7610000047,Hc Level 1 Uro 05371,415.68,166.27,,,0 CDM,7610000091,Hc Adult Suture Repr-Intermed,663.14,265.26,,,0 CDM,7610000092,Hc Peds Suture Repr-Simp,579.02,231.61,,,0 CDM,7610000094,Hc Adult Suture Repr-Complex,872.8,349.12,,,0 CDM,7610000095,Hc Peds Suture Repr-Complex,872.8,349.12,,,0 CDM,7610627T01,Hc Percutaneous Injection Of Allogeneic Cell Or Tissue Based Material Into Spinal Disc Of Lower Back,16728.66,6691.46,,,0 CDM,7610629T01,Hc Percutaneous Injection Of Cell Or Tissue-Based Material Into Spinal Disc Of Lower Back With Ct Im,18401.53,7360.61,,,0 CDM,7610720T01,Hc Percutaneous Electrical Nerve Field Stimulation Cranial Nerves Include Device,7528.3,3011.32,,,0 CDM,7610720T02,Hc Percutaneous Electrical Nerve Field Stimulation Cranial Nerves W/O Device,1703.0,681.2,,,0 CDM,7611004001,Hc Acne Surgery,364.0,145.6,,,0 CDM,7611008001,Hc Drain Pilonidal Cyst Simpl,1130.22,452.09,,,0 CDM,7611008101,Hc Drain Pilonidal Cyst Complic,1239.06,495.62,,,0 CDM,7611012001,Hc Remove Foreign Body Simple,1284.27,513.71,,,0 CDM,7611016001,Hc Puncture Drainage Of Lesion,165.76,66.3,,,0 CDM,7611018001,"Hc Complex Drainage, Wound",6094.82,2437.93,,,0 CDM,7611101001,Hc Debride Assoc Open Fx/Disloc Skin/Subq,2553.46,1021.38,,,0 CDM,7611101201,Hc Debride Assoc Open Fx/Dislo Skin/Mus/Bone,372.8,149.12,,,0 CDM,7611104201,"Hc Debridement, Skin, Sub-Q Tissue,=<20 Sq Cm",2096.35,838.54,,,0 CDM,7611120001,"Hc Removal Of Skin Tags, Up To 15",440.36,176.14,,,0 CDM,7611140301,"Hc Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg",3127.77,1251.11,,,0 CDM,7611142301,Hc Exc Skin Benig 2.1-3 Cm Remaindr Body,4507.42,1802.97,,,0 CDM,7611142601,Hc Exc Skin Benig >4 Cm Remaindr Body,5120.38,2048.15,,,0 CDM,7611145101,Hc Excision Hidradenitis Anillary Complex Repair,8086.0,3234.4,,,0 CDM,7611160001,Hc Excision Malignant Lesion Trunk/Arm/Lg 0.5 Cm/<,2008.5,803.4,,,0 CDM,7611160101,"Hc Exc Skin Malig 0.6-1 Cm Trunk,Arm,Leg",617.5,247.0,,,0 CDM,7611160201,"Hc Exc Skin Malig 1.1-2 Cm Trunk,Arm,Leg",804.31,321.72,,,0 CDM,7611160301,"Hc Exc Skin Malig 2.1-3 Cm Trunk,Arm,Leg",2557.94,1023.18,,,0 CDM,7611160601,"Hc Exc Skin Malig >4 Cm Trunk,Arm,Leg",606.14,242.46,,,0 CDM,7611162101,Hc Excision Of Scalp 0.6 -1.0 Cm,1907.62,763.05,,,0 CDM,7611162201,Hc Excision Malignant Lesion S/N/H/F/G 1.1-2.0 Cm,2548.98,1019.59,,,0 CDM,7611162301,Hc Exc Skin Malig 2.1-3 Cm Remaindr Body,4778.02,1911.21,,,0 CDM,7611162401,Hc Removal Of Cancer Skin Growth Of Scalp/Neck/Hands/Feet/Gentials 3.1-4.0 Cm,5128.5,2051.4,,,0 CDM,7611162601,Hc Exc Skin Malig >4 Cm Remaindr Body,4464.07,1785.63,,,0 CDM,7611164301,"Hc Exc Skin Malig 2.1-3 Cm Face,Facial",4091.82,1636.73,,,0 CDM,7611164401,"Hc Exc Skin Malig 3.1-4 Cm Face,Facial",2586.95,1034.78,,,0 CDM,7611164601,"Hc Exc Skin Malig >4 Cm Face,Facial",3716.57,1486.63,,,0 CDM,7611173001,Hc Removal Of Nail Plate,1158.69,463.48,,,0 CDM,7611174001,Hc Drain Blood From Under Nail,411.9,164.76,,,0 CDM,7611175001,Hc Removal Of Nail Bed,2317.37,926.95,,,0 CDM,7611175501,Hc Biopsy Nail/Finger/Toe,1572.74,629.1,,,0 CDM,7611176001,Hc Reconstruc Of Nail Bed,2327.42,930.97,,,0 CDM,7611176501,"Hc Excision Of Nail Fold, Toe",884.08,353.63,,,0 CDM,7611177001,Hc Remove Pilonidal Cyst Simple,5616.0,2246.4,,,0 CDM,7611192001,Hc Correct Skin Color Defect 6.0 Cm/<,1233.38,493.35,,,0 CDM,7611200101,Hc Application Dermabond,887.43,354.97,,,0 CDM,7611200201,Hc Resup Npterf Wnd Body 2.6-7.5 Cm,984.54,393.82,,,0 CDM,7611200401,Hc Resurerf Wnd Body 7.6-12.5 Cm,795.34,318.14,,,0 CDM,7611200501,Hc Resurperf Wnd Body 12.6-20 Cm,795.34,318.14,,,0 CDM,7611200601,Hc Resuperf Wnd Body 20.1-30 Cm,611.8,244.72,,,0 CDM,7611200701,Hc Resuperf Wnd Body >30 Cm,1716.26,686.5,,,0 CDM,7611201301,Hc Resuperf Wnd Face 2.6-5 Cm,795.34,318.14,,,0 CDM,7611201401,Hc Resuperf Wnd Face 5.2-7.5 Cm,795.34,318.14,,,0 CDM,7611201501,Hc Resuperf Wnd Face 7.6-12.5 Cm,487.5,195.0,,,0 CDM,7611201601,Hc Resuperf Wnd Face 12.6-20 Cm,795.34,318.14,,,0 CDM,7611202001,Hc Closure Superf Wnd Dehis Simple,1316.08,526.43,,,0 CDM,7611203101,"Hc Layr Clos Wnd Trunk,Arm,Leg < 2.5 Cm",910.87,364.35,,,0 CDM,7611203201,"Hc Layr Clos Wnd Trunk,Arm,Leg 2.6-7.5 Cm",1331.15,532.46,,,0 CDM,7611203401,"Hc Layr Clos Wnd Trunk,Arm,Leg 7.6-12.5 Cm",1625.06,650.02,,,0 CDM,7611203501,"Hc Repair Intermediate Scalp, Arm, Trunk, Leg 12.6-20.0Cm",2018.25,807.3,,,0 CDM,7611203601,"Hc Layr Clos Wnd Trunk,Arm,Leg 20.1-30 Cm",1868.75,747.5,,,0 CDM,7611204101,Hc Layr Clos Wnd Rest Body <2.5 Cm,910.87,364.35,,,0 CDM,7611204201,Hc Layr Clos Wnd Rest Body 2.6-7.5 Cm,910.87,364.35,,,0 CDM,7611204401,Hc Layr Clos Wnd Rest Body 7.6-12.5 Cm,5417.88,2167.15,,,0 CDM,7611205101,"Hc Layr Clos Wnd Face,Facial <2.5 Cm",910.87,364.35,,,0 CDM,7611205201,"Hc Layr Clos Wnd Face, Facial 2.5-5 Cm",976.17,390.47,,,0 CDM,7611205301,"Hc Layr Clos Wnd Face,Facial 5.1-7.5 Cm",632.92,253.17,,,0 CDM,7611205401,"Hc Layr Clos Wnd Face,Facial 7.6-12.5 Cm",1255.8,502.32,,,0 CDM,7611205501,"Hc Layr Clos Wnd Face, Facial 12.6-20 Cm",910.87,364.35,,,0 CDM,7611310001,Hc Repair Complex Trunk 1.1-2.5 Cm,3083.6,1233.44,,,0 CDM,7611310101,Hc Recmpl Wnd Trunk 2.6-7.5 Cm,1308.12,523.25,,,0 CDM,7611310201,"Hc Rep,Skin,Trunk,Cmplx,+5 Cm/<",1755.0,702.0,,,0 CDM,7611312101,"Hc Recmpl Wnd Scalp, Extr 2.6-7.5 Cm",1197.2,478.88,,,0 CDM,7611312201,"Hc Rep,Skin,Scalp/Extrem+5 Cm/<",514.05,205.62,,,0 CDM,7611313101,"Hc Recmpl Wnd Head,Fac,Hand 1.1-2.5 Cm",1068.92,427.57,,,0 CDM,7611313201,"Hc Recompl Wnd Head, Fac, Hand 2.6-7.5 Cm",1197.2,478.88,,,0 CDM,7611315101,"Hc Recmpl Wnd Lid,Nos,Ear 1.1-2.5 Cm",1383.63,553.45,,,0 CDM,7611315201,Hc Repair Complex Eyelid/Nose/Ear/Lip 2.6-7.5 Cm,2525.06,1010.02,,,0 CDM,7611400101,"Hc Repair Of Wound Of Trunk By Transferring Skin, 10.1-30.0 Sqcm",5799.27,2319.71,,,0 CDM,7611406001,"Hc Adj Tissue Xfer Lid,Nose, Ear 10 Sq Cm/<",3719.34,1487.74,,,0 CDM,7611430101,Hc Repair Of Wound By Transferring Skin-30.1-60 Sqcm,4491.42,1796.57,,,0 CDM,7611430201,"Hc Repair Of Wound By Transferring Skin, Each Additional 30.0 Sqcm",2141.83,856.73,,,0 CDM,7611510001,Hc Skin Graft At Trunk/Arm/Leg First 100Sqcm Or Less,3770.0,1508.0,,,0 CDM,7611512001,"Hc Partial Thickness Self Skin Graft To Face, Neck, Hands, Feet, Genitals-100 Sqcm",5386.63,2154.65,,,0 CDM,7611520001,"Hc Full Thickness Skin Graft To Trunk, 20.0 Sq Cm Or Less",3849.82,1539.93,,,0 CDM,7611520101,"Hc Full Thickness Skin Graft To Trunk, Each Additional 20.0 Sq Cm Or Less",2565.06,1026.02,,,0 CDM,7611522101,Hc Full Thickness Skin Graft To Scalp/Arms/Legs Each Additional 20.0 Sq Cm,3329.0,1331.6,,,0 CDM,7611524001,"Hc Full Thickness Skin Graft-Forehead, Cheeks, Chin, Mouth, Neck, Underarms, Hand, Feet Genitals-20.",3190.94,1276.38,,,0 CDM,7611524101,Hc Full Thickness Graft Forehead/Cheek/Chin/Mouth/Neck/Underarm/Gentials/Hands/Feet Each Additional,3234.21,1293.68,,,0 CDM,7611526101,Hc Full Thickness Skin Graft To Nose/Ears/Eyelids/Lips Each Additional 20.0 Sq Cm,2582.91,1033.16,,,0 CDM,7611527101,Hc Application Of Skin Substitute Wound Surface Up To 100 Sqcm To Trunk/Arms/Legs First <25 Sqcm,1970.79,788.32,,,0 CDM,7611527301,Hc App Skn Sub Grft T/A/L Area/>100Scm 1St 100Scm,347.0,138.8,,,0 CDM,7611527501,Hc Sub Grft F/S/N/H/F/G/M/D/ <100Scm/<1St 25 Scm,1970.79,788.32,,,0 CDM,7611557001,Hc Skin Pedicle Flap Trunk,3568.78,1427.51,,,0 CDM,7611557601,"Hc Creation Of Flap Graft To Eyelids, Nose, Ears, Lips, Mouth",2885.69,1154.28,,,0 CDM,7611562001,Hc Delay Of Flap To Forehead/Cheeks/Chin/Neck/Underarms/Genitals/Hands/Feet,7070.65,2828.26,,,0 CDM,7611563001,Hc Delay Flap Eye/Nose/Ear/Lip,3568.78,1427.51,,,0 CDM,7611573101,Hc Forehead Flap W Preservation Vascular Pedicle,7583.66,3033.46,,,0 CDM,7611573401,Hc Muscle/Skin Graft Trunk,7756.52,3102.61,,,0 CDM,7611574001,Hc Island Pedicle Flap Graft,3791.83,1516.73,,,0 CDM,7611585201,"Hc Dressing Change,Not For Burn",171.14,68.46,,,0 CDM,7611585301,Hc Removal Sutures Or Staples Not Requiring Anesthesia,358.8,143.52,,,0 CDM,7611585401,Hc Removal Sutures And Staples Not Requiring Anesthesia,240.5,96.2,,,0 CDM,7611600001,Hc Initial Rx Burn(S) 1St Degree,581.02,232.41,,,0 CDM,7611602001,Hc Dress/Debrid Small Burn No Anes,833.85,333.54,,,0 CDM,7611710601,Hc Destruction Cutaneous/Vascular Proliferative <10Cm,1472.58,589.03,,,0 CDM,7611725001,Hc Chem Cautery Granulatn Tissue,731.72,292.69,,,0 CDM,7611726101,"Hc Destruction Of Skin Lesions Trunk, Arm, Leg- 0.6-1.0 Cm",441.02,176.41,,,0 CDM,7611727001,"Hc Destruction Malignant Lesion Scalp, Neck, Hands, Feet, Or Genitals < 0.5Cm",650.32,260.13,,,0 CDM,7611727201,"Hc Destruction Of Skin Lesions-Scalp, Neck, Hands, Feet, Or Gentials-1.1-2.0 Cm",470.92,188.37,,,0 CDM,7611728201,"Hc Destruction Of Skin Lesions-Face, Ears, Eyelids, Nose, Lips, Or Mouth-1.1-2.0Cm",696.67,278.67,,,0 CDM,7611731101,"Hc Mohs Stage 1-Head, Neck, Hands, Feet, Genitals 1-5 Tissue Block",2840.5,1136.2,,,0 CDM,7611731201,"Hc Mohs Additional Stage-Head, Neck, Hands, Feet, Genitals-1-5 Tissue Block",946.34,378.54,,,0 CDM,7611731301,"Hc Mohs 1 Stage-Trunk, Are, Leg-1-5 Blocks",2740.34,1096.14,,,0 CDM,7611731401,"Hc Mohs Additional Stage-Trunk, Arms, Or Legs-1-5 Tissue Block",2302.3,920.92,,,0 CDM,7611731501,"Hc Mohs Additional Block-Trunk, Arm, Leg-After 5 Blocks",1861.28,744.51,,,0 CDM,7611902001,Hc Explo/Drain Breast Abscess,5902.26,2360.9,,,0 CDM,7611908401,Hc Biopsy Breast Ultrasound Guided With Device Each Additional Lesion,6800.08,2720.03,,,0 CDM,7611910101,Hc Biopsy Breast Open Incisional,6630.0,2652.0,,,0 CDM,7612024001,Hc Biopsy Open Superficial Procedure,5951.4,2380.56,,,0 CDM,7612052001,Hc Removal Of Foreign Body,1438.31,575.32,,,0 CDM,7612055201,"Hc Inject Trigger Point, 1 Or 2",1525.38,610.15,,,0 CDM,7612061101,Hc Arthrocentesis Aspir&/Inj Major Jt/Bursa W/Us,4026.93,1610.77,,,0 CDM,7612101101,Hc Excision Tumor Soft Tissue Face/Scalp Subq <2Cm,3767.4,1506.96,,,0 CDM,7612101401,Hc Exc Tumor Soft Tiss Face&Scalp Subfascial 2 Cm/>,4260.75,1704.3,,,0 CDM,7612123501,Hc Ear Cartilage Graft,9234.22,3693.69,,,0 CDM,7612131001,"Hc Closed Rx Nose Fracture, W/O Manipulation",1141.95,456.78,,,0 CDM,7612132001,Hc Closed Treatment Nose Fracture With Stabilization,3984.18,1593.67,,,0 CDM,7612145301,Hc Treat Lower Jaw Fracture,9792.25,3916.9,,,0 CDM,7612148001,Hc Reduce Temporomandibl Disloc,112.19,44.88,,,0 CDM,7612155201,Hc Exc Tumor Soft Tissue Neck/Ant Thorax Subq 3+Cm,6192.29,2476.92,,,0 CDM,7612155401,"Hc Excision Tumor, Soft Tissue Of Neck Or Anterior Thorax, Subfascial 5Cm/>",8598.53,3439.41,,,0 CDM,7612155501,"Hc Excision Tumor, Soft Tissue Of Neck Or Anterior Thorax, Subfascial <3Cm",7033.0,2813.2,,,0 CDM,7612155601,"Hc Excision Tumor, Soft Tissue Of Neck Or Anterior Thorax, Subfascial <5Cm",8988.2,3595.28,,,0 CDM,7612155701,"Hc Radical Resection Of Tumor, Soft Tissue Of Neck Or Anterior Thorax, Subfascial <5Cm",8993.33,3597.33,,,0 CDM,7612155801,"Hc Radical Resection Of Tumor, Soft Tissue Of Neck Or Anterior Thorax, Subfascial 5Cm/>",8078.83,3231.53,,,0 CDM,7612193001,Hc Excision Tumor Soft Tissue Back/Flan Subcutaneous <3Cm,3848.0,1539.2,,,0 CDM,7612193101,Hc Excision Tumor Soft Tissue Back/Flank Subcutaneous 3+Cm,7482.8,2993.12,,,0 CDM,7612193501,Hc Rad Resection Tumor Soft Tissue Back/Flank <5Cm,4795.55,1918.22,,,0 CDM,7612193601,Hc Resection Tumor Soft Tissue Back/Flank 5Cm/>,10901.51,4360.6,,,0 CDM,7612261201,Hc Arthrodesis Posterior/Posterolateral,28713.08,11485.23,,,0 CDM,7612286901,Hc Insertion Of Stabilizing Or Separating Device Into Lower Spine At Single Level,20806.0,8322.4,,,0 CDM,7612333001,Hc Remove Shoulder Foreign Body,2801.5,1120.6,,,0 CDM,7612350501,"Hc Closed Rx Clavicle Fx, Manipulatn",3253.35,1301.34,,,0 CDM,7612357001,Hc Closed Treatment Scapular Fracture Without Manipulation-Unilateral,639.6,255.84,,,0 CDM,7612357002,Hc Closed Treatment Scapular Fracture Without Manipulation-Bilateral,959.4,383.76,,,0 CDM,7612360501,Hc Closed Treatment Proximal Humerus Fracture With Manipulation,2553.46,1021.38,,,0 CDM,7612365001,Hc Closed Treatment Shoulder Dislocation With Fracture Of Humerus Without Manipulation,957.76,383.1,,,0 CDM,7612366501,Hc Closed Treatment Shoulder Dislocation With Fracture Of Humerus With Manipulation,1157.01,462.8,,,0 CDM,7612393101,Hc Incision&Drainage Upper Arm/Elbow Bursa,3231.98,1292.79,,,0 CDM,7612406501,Hc Biopsy Arm/Elbow Soft Tissue,3575.0,1430.0,,,0 CDM,7612407302,Hc Excision Upper Arm > 5Cm Bilateral,2935.71,1174.28,,,0 CDM,7612407501,Hc Exc Tumor Soft Tiss Upper Arm/Elbow Subq <3Cm,4903.6,1961.44,,,0 CDM,7612407701,Hc Radical Resection Of Tumor Soft Tissue Upper Arm/Elbow <5Cm-Unilateral,4628.26,1851.3,,,0 CDM,7612407702,Hc Radical Resection Of Tumor Soft Tissue Upper Arm/Elbow <5Cm-Bilateral,6942.39,2776.96,,,0 CDM,7612450501,Hc Closed Treatment Upper Humerus Fracture With Manipulation,2915.25,1166.1,,,0 CDM,7612453001,Hc Closed Treatment Humerus Supracondylar Fracture Without Manipulation,1198.87,479.55,,,0 CDM,7612453501,Hc Closed Treatment Humerus Supracondylar Fracture With Manipulation,3253.35,1301.34,,,0 CDM,7612456501,Hc Closed Treatment Of Broken Upper Arm At Shoulder With Manipulation,373.39,149.36,,,0 CDM,7612457701,Hc Closed Treatment Humerus Condylar Fracture With Manipulation,3253.35,1301.34,,,0 CDM,7612460001,Hc Closed Treatment Elbow Dislocation-Adult,957.76,383.1,,,0 CDM,7612462001,Hc Closed Treatment Monteggia Fracture/Dislocation Elbow With Manipulation,5014.83,2005.93,,,0 CDM,7612464001,Hc Closed Treatment Elbow Dislocation-Child,957.76,383.1,,,0 CDM,7612465501,Hc Closed Treatment Radius Head/Neck Fracture With Manipulation,3253.35,1301.34,,,0 CDM,7612467501,Hc Closed Treatment Ulnar Fracture Proximal End With Manipulation,1141.95,456.78,,,0 CDM,7612507502,Hc Excision Of Soft Tissue Tumor Forearm/Wrist <3Cm-Bilateral,6298.5,2519.4,,,0 CDM,7612507601,Hc Excision Of Tumor Soft Tissue Forearm/Wrist < 3Cm,5525.0,2210.0,,,0 CDM,7612511201,Hc Excision Recurrent Ganglion Wrist,3266.58,1306.63,,,0 CDM,7612550501,Hc Closed Treatment Radial Shaft Fracture With Manipulation,3253.35,1301.34,,,0 CDM,7612552001,Hc Closed Rx Radial Shaft Fx W/Dislocation,821.64,328.66,,,0 CDM,7612553001,Hc Closed Treatment Ulna Shaft Fracture Without Manipulation,652.6,261.04,,,0 CDM,7612553501,Hc Closed Treatment Ulna Shaft Fracture With Manipulation,1198.87,479.55,,,0 CDM,7612556501,Hc Closed Treatment Radius/Ulna Shaft Fracture With Manipulation,5014.83,2005.93,,,0 CDM,7612560001,Hc Closed Treatment Distal Radial/Ulna Fracture Without Manipulation,1198.87,479.55,,,0 CDM,7612560501,Hc Closed Treatment Distal Radial/Ulna Fracture With Manipulation Unilateral,3253.35,1301.34,,,0 CDM,7612560502,Hc Closed Treatment Distal Radial/Ulna Fracture With Manipulation Bilateral,5157.75,2063.1,,,0 CDM,7612562201,Hc Closed Treatment Of Broken Wrist Bone Without Manipulation,416.0,166.4,,,0 CDM,7612563001,Hc Closed Treatment Of Carpal Bone Fracture Bilateral,1384.5,553.8,,,0 CDM,7612563002,Hc Closed Treatment Of Carpal Bone Fracture Unilateral,923.0,369.2,,,0 CDM,7612565001,Hc Closed Treatment Ulna Styloid Fracture-Broken Forearm At Wrist Bone,841.68,336.67,,,0 CDM,7612601001,"Hc Drain Finger Abscess,Simple",1438.31,575.32,,,0 CDM,7612601101,"Hc Drain Finger Abscess,Complicated",3767.4,1506.96,,,0 CDM,7612606001,Hc Incision Of Finger Tendon,2808.0,1123.2,,,0 CDM,7612608001,"Hc Exploration, Drainage, Or Removal Of Foreign Body Of Hand Joint",3575.0,1430.0,,,0 CDM,7612611101,Hc Removal Tissue Beneath The Skin Growth Of Hand/Finger >/ 1.5 Cm,3770.0,1508.0,,,0 CDM,7612611601,Hc Removal Of < 1.5 Cm Muscle Growth Of Hand Or Finger,2801.5,1120.6,,,0 CDM,7612616001,"Hc Excision Tendon Sheath Lesion, Hand/Finger",5460.0,2184.0,,,0 CDM,7612637001,Hc Repair Of Finger/Tendon Each Tendon,5609.5,2243.8,,,0 CDM,7612641001,Hc Repair Hand Tendon Without Graft Each,4160.0,1664.0,,,0 CDM,7612660001,Hc Closed Treatment Metacarpal Fracture Without Manipulation,527.74,211.1,,,0 CDM,7612660501,Hc Closed Treatment Metacarpal Fracture With Manipulation,957.76,383.1,,,0 CDM,7612664101,Hc Closed Treatment Of Dislocated Thumb At Wrist With Manipulation,1352.0,540.8,,,0 CDM,7612664501,"Hc Treat Thumb Fx/Disloc,Manip",2205.12,882.05,,,0 CDM,7612670001,Hc Closed Treatment Knuckle Dislocation Without Anesthesia,299.72,119.89,,,0 CDM,7612672001,Hc Closed Treatment Proximal/Middle Phalanx Finger Fracture Without Manipulation,747.5,299.0,,,0 CDM,7612672501,Hc Closed Treatment Proximal/Middle Phalanx Finger Fracture With Manipulation,1198.87,479.55,,,0 CDM,7612674001,Hc Close Rx Fingr Articular Fx,1070.42,428.17,,,0 CDM,7612674201,Hc Closed Treatment Finger Articular Fracture With Manipulation,2531.04,1012.42,,,0 CDM,7612675001,Hc Close Rx Dist Fingr Fx,751.98,300.79,,,0 CDM,7612675501,Hc Closed Treatment Distal Finger Fracture With Manipulation,762.45,304.98,,,0 CDM,7612677001,Hc Closed Treatment Interphalangeal Joint Dislocation With Manipulation,957.76,383.1,,,0 CDM,7612695101,Hc Amputation Finger/Thumb,4651.48,1860.59,,,0 CDM,7612708601,Hc Removal Of Foreign Body From Pelvis/Hip,5330.0,2132.0,,,0 CDM,7612709601,"Hc Injection,Sacroiliac Joint Unilateral",2391.82,956.73,,,0 CDM,7612719701,Hc Closed Treatment Of Fracture And/Or Dislocation Of Pelvis And/Or Sacrum,624.0,249.6,,,0 CDM,7612724501,Hc Treatment Of Thigh Fracture,11311.92,4524.77,,,0 CDM,7612725001,Hc Closed Treatment Trauma Hip Dislocation Without Anesthesia,1820.0,728.0,,,0 CDM,7612725201,Hc Closed Treatment Trauma Hip Dislocation With Anesthesia,1558.27,623.31,,,0 CDM,7612726501,Hc Closed Treatment Hip Dislocation Without Anesthesia,357.3,142.92,,,0 CDM,7612727901,Hc Fusion Of Pelvic Joint Using Imaging Guidance,27277.76,10911.1,,,0 CDM,7612732701,Hc Excision Tumor Soft Tissue Thigh/Knee Subcutaneous <3Cm,5330.0,2132.0,,,0 CDM,7612736401,Hc Radical Resection Of Tumor Thigh/Knee 5Cm/> - Unilateral,4244.62,1697.85,,,0 CDM,7612736402,Hc Radical Resection Of Tumor Thigh/Knee 5Cm/> - Bilateral,6368.04,2547.22,,,0 CDM,7612750201,Hc Closed Treatment Femur Shaft Fracture With Manipulation,2489.39,995.76,,,0 CDM,7612750801,Hc Closed Treatment Of Thigh Fracture,1868.75,747.5,,,0 CDM,7612751001,"Hc Closed Rx Femur,Distal+Manip",1987.92,795.17,,,0 CDM,7612753001,Hc Closed Treatment Tibial Plateau Fracture Without Manipulation,1198.87,479.55,,,0 CDM,7612753201,Hc Closed Treatment Tibial Fracture Proximal With/Without Manipulation With Skeletal Traction,5441.8,2176.72,,,0 CDM,7612753801,Hc Treatment Knee Fracture(S) Unilateral,2671.56,1068.62,,,0 CDM,7612753802,Hc Treatment Knee Fracture(S) Bilateral,4008.1,1603.24,,,0 CDM,7612755001,Hc Closed Treatment Knee Dislocation Without Anesthesia,1423.24,569.3,,,0 CDM,7612755201,Hc Closed Treatment Knee Dislocation With Anesthesia,2128.54,851.42,,,0 CDM,7612756001,Hc Closed Treatment Kneecap Dislocation Without Anesthesia,957.76,383.1,,,0 CDM,7612756201,Hc Treatment Kneecap Dislocation Unilateral,1281.22,512.49,,,0 CDM,7612756202,Hc Treatment Kneecap Dislocation Bilateral,1922.57,769.03,,,0 CDM,7612760301,Hc Drain Lower Leg Deep Absc/Hematoma,7121.22,2848.49,,,0 CDM,7612761601,Hc Radical Resection Of Tumor Soft Tissue Leg/Ankle 5 Cm/>,4684.03,1873.61,,,0 CDM,7612761901,Hc Excision Tumor Soft Tissue Leg/Ankle Subfasical <3Cm,2877.88,1151.15,,,0 CDM,7612763401,Hc Excision Tumor Soft Tissue Of Leg/Ankle >/ 5Cm,7137.56,2855.02,,,0 CDM,7612768001,Hc Release Of Lower Leg Tendon-Unilateral,5603.0,2241.2,,,0 CDM,7612768002,Hc Release Of Lower Leg Tendon-Bilateral,8404.5,3361.8,,,0 CDM,7612775001,Hc Closed Treatment Tibia Shaft Fracture Without Manipulation,747.5,299.0,,,0 CDM,7612775201,Hc Closed Treatment Tibia Shaft Fracture With Manipulation,3253.35,1301.34,,,0 CDM,7612776001,Hc Closed Treatment Medial Malleolus Fracture Without Manipulation,687.7,275.08,,,0 CDM,7612776201,Hc Closed Treatment Medial Malleolus Fracture With Manipulation,3253.35,1301.34,,,0 CDM,7612778001,Hc Treatment Of Fibula Fracture-Unilateral,409.5,163.8,,,0 CDM,7612778002,Hc Treatment Of Fibula Fracture-Bilateral,614.9,245.96,,,0 CDM,7612778601,Hc Closed Treatment Distal Fibula Frature Without Manipulation,521.76,208.7,,,0 CDM,7612778801,Hc Closed Treatment Distal Fibula Frature With Manipulation,3253.35,1301.34,,,0 CDM,7612780801,Hc Closed Treatment Bimalleolar Ankle Fracture Without Manipulation,1141.95,456.78,,,0 CDM,7612781001,Hc Closed Treatment Bimalleolar Ankle Fracture With Manipulation,1141.95,456.78,,,0 CDM,7612781601,Hc Closed Rx Trimalleolar Fx,957.76,383.1,,,0 CDM,7612781801,Hc Closed Treatment Trimalleolar Fracture With Manipulation,5014.83,2005.93,,,0 CDM,7612782501,Hc Closed Treatment Lower Leg Fracture With Manipulation,5014.83,2005.93,,,0 CDM,7612784001,Hc Closed Treatment Ankle Dislocation,957.76,383.1,,,0 CDM,7612801001,Hc Incision Subcut Toe Tendon,3218.8,1287.52,,,0 CDM,7612819001,"Hc Remv Foot Foreign Body, Subcuteneous",1284.27,513.71,,,0 CDM,7612823001,Hc Incision Of Foot Tendon(S),4586.4,1834.56,,,0 CDM,7612823201,Hc Incision Of Toe Tendion,3670.22,1468.09,,,0 CDM,7612834501,Hc Repair Webbed Toe(S),1823.76,729.5,,,0 CDM,7612843501,Hc Closed Treatment Talus (Ankle) Fracture With Manipulation,3253.35,1301.34,,,0 CDM,7612845001,Hc Treatment Of Broken Foot Bone Without Manipulation,842.4,336.96,,,0 CDM,7612851001,Hc Closed Treatment Toe Fracture Without Manipulation,651.82,260.73,,,0 CDM,7612851501,Hc Closed Treatment Toe Fracture With Manipulation,1137.7,455.08,,,0 CDM,7612863001,Hc Closed Treatment Toe Dislocation,957.76,383.1,,,0 CDM,7612866001,"Hc Closed Rx I-P Jt,Toe Dislocation",957.76,383.1,,,0 CDM,7612913101,Hc Application Of Finger Splint-Unilateral,208.0,83.2,,,0 CDM,7612913102,Hc Application Of Finger Splint-Bilateral,312.0,124.8,,,0 CDM,7612953001,Hc Strapping Of Knee,430.3,172.12,,,0 CDM,7612958101,Hc Appl Mlt-Layer Venous Wound Compress Below Knee,1265.85,506.34,,,0 CDM,7612973001,Hc Removal Of Cast Only,527.44,210.98,,,0 CDM,7613010001,Hc Intranasal Biopsy,2586.35,1034.54,,,0 CDM,7613030001,Hc Remove Nasal Foreign Body,705.64,282.26,,,0 CDM,7613090301,"Hc Ctrl Nosebleed,Anter,Complex",1054.87,421.95,,,0 CDM,7613090501,"Hc Ctrl Nosebleed,Post,W/Packs &/Or Caut",1175.43,470.17,,,0 CDM,7613123101,"Hc Nasal Endoscopy,Dx",842.35,336.94,,,0 CDM,7613150501,"Hc Laryngoscopy,Indirect,Dx",1696.3,678.52,,,0 CDM,7613152501,"Hc Laryngoscopy,Direct,Diagnostic",2293.54,917.42,,,0 CDM,7613154101,Hc Removal Of Growth Of Tongue And/Or Stripping Of Vocal Cord Using An Endoscope With Opering Micros,10925.0,4370.0,,,0 CDM,7613157901,"Hc Laryngoscopy,Flex/Rigid+Stroboscopy",2524.48,1009.79,,,0 CDM,7613161301,Hc Trach Rev Smpl W/O Flp Rot,3762.92,1505.17,,,0 CDM,7613162301,Noncdm Charge Record,4511.86,1804.74,,,0 CDM,7613162401,"Hc Bronchoscopy,Diagnostic W Lavage",4519.59,1807.84,,,0 CDM,7613162501,"Hc Bronchoscopy,Biopsy",4582.7,1833.08,,,0 CDM,7613163501,"Hc Bronchoscopy,Remv For. Body",4442.31,1776.92,,,0 CDM,7613165101,Hc Bronchoscopy Occlusion & Insert Bronch Valve Additional Lobe,1966.5,786.6,,,0 CDM,7613182001,Hc Surg Clsr Tracheostomy/Fistula W/O Plastic Rpr,1823.9,729.56,,,0 CDM,7613211001,Hc Thoracotomy,13192.21,5276.88,,,0 CDM,7613255101,Hc Tube Thoracostomy Includes Water Seal,3224.9,1289.96,,,0 CDM,7613255401,Hc Thoracentesis Needle/Cath Pleura W/O Imaging,2831.41,1132.56,,,0 CDM,7613255501,Hc Thoracentesis Needle/Cath Pleura W/Imaging,4519.2,1807.68,,,0 CDM,7613320801,Hc Insert Heart Pacer Xvenous Atrial/Ventricular,9931.4,3972.56,,,0 CDM,7613478201,Hc Excision Hand/Foot Neuroma,4634.5,1853.8,,,0 CDM,7613641501,"Hc Chg Collection Venous Blood,Venipuncture",36.0,14.4,,,0 CDM,7613646801,Hc Injections Sclerosant For Spider Veins Lim/Trnk,635.38,254.15,,,0 CDM,7613651201,"Hc Ther Apheresis,Red Blood Cells",10230.58,4092.23,,,0 CDM,7613655501,Hc Insert Non-Tunnel Cv Cath < 5 Y/O,6225.41,2490.16,,,0 CDM,7613655601,Hc Insert Non-Tunnel Cv Cath,4556.04,1822.42,,,0 CDM,7613659101,Hc Collect Blood From Implant Venous Access Device - Draw Charge,460.46,184.18,,,0 CDM,7613659201,Hc Chg Collect Blood From Catheter Venous Nos,376.74,150.7,,,0 CDM,7613660001,Hc Withdrawal Of Arterial Blood,242.19,96.88,,,0 CDM,7613662001,"Hc Insert Cath,Art,Percut,Shortterm",1452.45,580.98,,,0 CDM,7613668001,"Hc Insert Needle,Intraosseous Infusn",1118.49,447.4,,,0 CDM,7613822201,Hc Diagnostic Bone Marrow Biopsies & Aspirations,4335.02,1734.01,,,0 CDM,7613824301,Hc Allo Hematopoietic Cell Boost,3412.97,1365.19,,,0 CDM,7613850001,"Hc Biopsy/Excision, Lymph Node(S)",6890.0,2756.0,,,0 CDM,7613851001,Hc Removal And Biopsy Of Lymph Nodes,8450.0,3380.0,,,0 CDM,7614050001,Hc Partial Excision Of Lip,5850.0,2340.0,,,0 CDM,7614065001,"Hc Repair Lip,Full Thick,Vermilion",2018.25,807.3,,,0 CDM,7614065201,"Hc Repair Lip,<1/2 Vert Height",1299.16,519.66,,,0 CDM,7614080001,"Hc Drain Mouth Absc/Cyst/Hematoma,Simpl",2553.46,1021.38,,,0 CDM,7614080401,Hc Removal Foreign Body Mouth,1471.08,588.43,,,0 CDM,7614081201,Hc Removal Of Growth Of Mouth,5831.8,2332.72,,,0 CDM,7614100501,Hc Intraoral I&D Tongue/Floor Sublngl Supfc,1438.31,575.32,,,0 CDM,7614100701,Hc Intraoral I&D Tongue/Floor Submental Space,3072.52,1229.01,,,0 CDM,7614100901,Hc Intraoral I&D Tongue/Floor Masticator Space,1716.26,686.5,,,0 CDM,7614110501,Hc Biopsy Of Tongue,7020.0,2808.0,,,0 CDM,7614125001,"Hc Repair Tongue Lacer, <2.6 Cm",343.85,137.54,,,0 CDM,7614125101,Hc Repair Tongue Laceration: 5Cm,6200.0,2480.0,,,0 CDM,7615228401,Hc Cystourethroscopy With Drug Coated Balloon For Male Treatment Of Urethral Stricture,6200.0,2480.0,,,0 CDM,7615231501,Hc Cystoscopy With Complex Removal Stone & Stent,4880.0,1952.0,,,0 CDM,7615233201,Hc Cystoscopy With Insert Ureteral Stent,6287.0,2514.8,,,0 CDM,7615235401,Hc Cystourethroscsopy With Biopsy-Unilateral,5580.0,2232.0,,,0 CDM,7615235402,Hc Cystourethroscsopy With Biopsy-Bilateral,8370.0,3348.0,,,0 CDM,7615344001,"Hc Sling Operation Correction, Male Incontience",19804.26,7921.7,,,0 CDM,7615385401,Hc Trurl Dstrj Prst8 Tiss Rf Wv Thermotherapy,6925.67,2770.27,,,0 CDM,7615405001,Hc Destruction Of Penis Lesion(S),691.6,276.64,,,0 CDM,7615416401,Hc Frenulotomy Of Penis,4550.0,1820.0,,,0 CDM,7615422001,"Hc Irrigat Corpus Cavern, Priapism",1130.22,452.09,,,0 CDM,7615452001,"Hc Removal Testis,Simple",5265.99,2106.4,,,0 CDM,7615464001,Hc Orchiopexy Inguinal Or Scrotal Approach,5484.3,2193.72,,,0 CDM,7615470001,"Hc Incis/Drain Scrotum/Testis,Epididym",5609.24,2243.7,,,0 CDM,7615500001,Hc Hydrocele Drainage,3214.25,1285.7,,,0 CDM,7615510001,Hc Drainage Scrotal Wall Abscess,4227.86,1691.14,,,0 CDM,7615570501,Hc Biopsy Of Prostate,4994.6,1997.84,,,0 CDM,7615570701,Hc Us Guided Biopsy Of Prostate Gland Through Rectum,5428.2,2171.28,,,0 CDM,7615587401,Hc Transperineal Placement Biodegradable Material 1/Mlt Njx,10550.1,4220.04,,,0 CDM,7615640501,Hc I&D Of Vulva/Perineum Abscess,1438.31,575.32,,,0 CDM,7615642001,Hc I&D Bartholin Gland Abscess,890.79,356.32,,,0 CDM,7615644001,Hc Marsupialization Bartholins Gland Cyst,5902.26,2360.9,,,0 CDM,7615715001,Hc Treatment Of Vagina Infection,323.7,129.48,,,0 CDM,7615717001,Hc Fitting Of Diaphragm,682.5,273.0,,,0 CDM,7615741501,Hc Removal Vaginal For.Body W Anesth,5353.17,2141.27,,,0 CDM,7615746001,Hc Colposcopy Of Cervix Using An Endoscope,4230.0,1692.0,,,0 CDM,7615902501,Hc Fetal Non-Stress Test,1349.57,539.83,,,0 CDM,7615941401,Hc Deliver Placenta,4942.68,1977.07,,,0 CDM,7615982101,"Hc Treatment Of Miscarriage, Second Trimester",4487.39,1794.96,,,0 CDM,7616066001,Hc Rfa Thyroid Ablation 1/+ Nodule,3033.46,1213.38,,,0 CDM,7616102001,Hc Remove Brain Cavity Fluid,3900.0,1560.0,,,0 CDM,7616107001,Hc Brain Canal Shunt Tube/Reservoir Aspiration/Injection Procedure,2396.07,958.43,,,0 CDM,7616226801,Hc Percutaneous Aspiration Of Fluid From Cyst Of Spinal Cord Or Fluid Filled Cavity,1320.45,528.18,,,0 CDM,7616227001,"Hc Spinal Puncture,Lumbar,Diagnostic",2722.58,1089.03,,,0 CDM,7616227301,"Hc Injection,Lumbar Epidur,Blood/Clot Patch",3358.85,1343.54,,,0 CDM,7616232601,Hc Insertion Of Indwelling Catheter And Administration Of Substance Into Spinal Canal Of Lower Back,3894.8,1557.92,,,0 CDM,7616232701,Hc Insertion Of Indwelling Catheter And Administration Of Substance Into Spinal Canal Of Lower Back,4557.8,1823.12,,,0 CDM,7616235001,Hc Implantation/Revision/Repositioning Of Spinal Canal Medication Catheter,11072.1,4428.84,,,0 CDM,7616235501,Hc Remove Spinal Canal Catheter,4349.45,1739.78,,,0 CDM,7616236201,Hc Implantation/Replacement Of Programmable Spinal Canal Drug Infusion Pump,30560.4,12224.16,,,0 CDM,7616236501,Hc Removal Of Spinal Canal Drug Infusion Pump/Device,9499.65,3799.86,,,0 CDM,7616236701,Hc Electronic Analysis Implant Intrathecal Or Epidural Pump Without Reprogramming Or Refill,1357.2,542.88,,,0 CDM,7616366101,Hc Insertion Of Spinal Neurostimulator Electrode Array Using Fluoroscopic Guidance,4014.88,1605.95,,,0 CDM,7616366201,Hc Removal Of Spinal Neurostimulator Electrode Plate Using Fluoroscopic Guidance,5102.24,2040.9,,,0 CDM,7616366301,Hc Revision/Replacement Of Spinal Neurostimulator Electrodes Percytabeiys Array(S) Using Fluoroscopy,9736.08,3894.43,,,0 CDM,7616366401,Hc Revision/Replacement Of Spinal Neurostimulator Electrodes Plates/Paddle Via Laminotomy/Laminectom,18496.32,7398.53,,,0 CDM,7616368501,Hc Insertion Or Replacement Of Spinal Nuerostimulator Generator/Receiver,49279.29,19711.72,,,0 CDM,7616368801,Hc Removal/Revision Of Neurostimulator Generator/Receiver,5102.24,2040.9,,,0 CDM,7616440501,"Hc Inject Nerv Blck,Great Occiptl",3325.36,1330.14,,,0 CDM,7616443501,Hc Injection Aa&/Strd Paracervical Nerve,1506.96,602.78,,,0 CDM,7616445001,"Hc Injection Nerve Block,Other Periph Nerve Bilateral",3260.06,1304.02,,,0 CDM,7616456101,Hc Percutaneous Nerve Evaluation W/ Imaging (If Performed) Unilateral,8698.9,3479.56,,,0 CDM,7616456102,Hc Percutaneous Implantation Neurostimulaotor Electored Sacral Nerve With Imaging If Performed Bilat,13940.55,5576.22,,,0 CDM,7616458501,Hc Revision/Removal Of Peripheral Neurostimulator Electrode Array,6275.1,2510.04,,,0 CDM,7616459001,Hc Insertion Of Peripheral Or Gastric Neurostimulator Generator,39028.6,15611.44,,,0 CDM,7616459601,Hc Insertion/Replacement Of Peripheral Neurostimulator,19469.93,7787.97,,,0 CDM,7616461001,"Hc Injection Destruction By Neurolytic Agent, 5Th N.-2.3 Division,Foramen Ovale, Xray",3089.27,1235.71,,,0 CDM,7616462001,Hc Injection Of Agent To Destroy Rib Nerve,3092.7,1237.08,,,0 CDM,7616463201,Hc Destruction Of Nerve Of Foot,1228.5,491.4,,,0 CDM,7616465001,Hc Chemodenervation Eccrine Glands Both Axillae,934.38,373.75,,,0 CDM,7616465301,Hc Chemodenervation Eccrine Glands Non-Axillary,934.38,373.75,,,0 CDM,7616477601,Hc Excision Digital Neuroma,9269.0,3707.6,,,0 CDM,7616477801,Hc Excision Neuroma Digital-Each Additional,883.54,353.42,,,0 CDM,7616478801,Hc Remove Skin Nerve Lesion,5070.0,2028.0,,,0 CDM,7616483101,Hc Repair Of Digit Nerve Foot/Hand,5005.0,2002.0,,,0 CDM,7616520501,"Hc Remv F.B.,Eye,Superf Conjunc",475.41,190.16,,,0 CDM,7616522001,"Hc Removal Foreign Body, Eye, Cornea, No Slit",1438.31,575.32,,,0 CDM,7616522201,"Hc Remv F.B.,Eye,Cornea,Slit Lamp",790.32,316.13,,,0 CDM,7616528601,"Hc Repair Cornea Laceration,Apply Glue",4724.2,1889.68,,,0 CDM,7616702801,Hc Inject Intravitreal Pharmcologic,753.48,301.39,,,0 CDM,7616810001,Hc Biopsy Of Eyelid Lining,4036.5,1614.6,,,0 CDM,7616900001,"Hc Drain Ext Ear Absc/Blood,Simple",1339.52,535.81,,,0 CDM,7616900501,"Hc Drain Ext Ear Absc/Blood,Complic",4227.86,1691.14,,,0 CDM,7616910501,Hc Biopsy Of External Auditory Canal,2988.5,1195.4,,,0 CDM,7616911001,"Hc Removal External Ear,Partial",4485.0,1794.0,,,0 CDM,7616920001,Hc Removal Ext Canal Foreign Body,728.36,291.34,,,0 CDM,7616920501,"Hc Remv Ext Canal F.B.,Gen Anesth",3513.25,1405.3,,,0 CDM,7616920901,Hc Removal Impacted Cerumen Irrigation/Lavage Bilateral,604.46,241.78,,,0 CDM,7616920902,Hc Removal Impacted Cerumen Irrigation/Lavage Unilateral,401.86,160.74,,,0 CDM,7616922001,"Hc Debride Mastoid Cavity,Simple",720.59,288.24,,,0 CDM,7616945001,"Hc Incision Eardrum,Aspiration",1264.77,505.91,,,0 CDM,7616980101,"Hc Labyrinthotomy W Perfusion Vestibuloactive Drugs,Transcranial",1955.86,782.34,,,0 CDM,7616999001,"Hc Microsurg Techniques,Req Oper Microscope",49.65,19.86,,,0 CDM,7617612001,"Hc Special Eye Evaluation,Gonioscopy",185.0,74.0,,,0 CDM,7619514701,Hc Preparation And Provision Of 3 Single Singing Insect Venom: Antigen Therapy,125.0,50.0,,,0 CDM,7619514801,Hc Antigen Therapy Of 4 Single Stinging Insect Venom,86.0,34.4,,,0 CDM,7619586801,Hc Needle Electromyography Cranial Nerve Muscle-Bilateral,942.5,377.0,,,0 CDM,7619586901,"Hc Needle Emg Thoracic Paraspinal Muscles, Excluding T1 Or T12)",646.1,258.44,,,0 CDM,7619587201,Hc Needle Emg W/1 Fiber Electrode With Quantitative Measurement Of Jitter,1120.6,448.24,,,0 CDM,7619600201,Hc Dynamic Surface Emg,538.2,215.28,,,0 CDM,7619692001,Hc Laser Treatment For Inflammatory Skin Disease <250Sq Cm,650.0,260.0,,,0 CDM,7619692101,Hc Laser Treatment For Inflammatory Skin Disease 250-500Sq Cm,975.0,390.0,,,0 CDM,7619692201,Hc Laser Treatment For Inflammatory Skin Disease > 500Sq Cm,1300.0,520.0,,,0 CDM,7619760701,Hc Neg Pressure Wound Therapy Non Dme 50 Sq Cm,838.88,335.55,,,0 CDM,761G051701,Hc Removal Of Drug Implant 4 Or More,729.3,291.72,,,0 CDM,761Q009101,Hc Obtaining Screen Pap Smear,105.3,42.12,,,0 CDM,7620000001,Hc Respost Chemo Mntr Each 30 Minutes,21.28,8.51,,,0 CDM,762G037801,Hc Observation Hourly,93.59,37.44,,,0 CDM,762G037802,Hc Observation Hourly With Telemetry,156.68,62.67,,,0 CDM,762G037803,Hc Observation Hourly Progressive,227.31,90.92,,,0 CDM,762G037804,Hc Peds Cardiology Routine Observation Per Hour,365.38,146.15,,,0 CDM,762G037805,Hc Observation Carve-Out - Respiratory,93.59,37.44,,,0 CDM,762G037806,Hc Observation Carve-Out - Surgical,93.59,37.44,,,0 CDM,762G037807,Hc Observation Carve-Out - Gastrointestinal,93.59,37.44,,,0 CDM,762G037808,Hc Observation Hourly Carve Out - Radiology,93.59,37.44,,,0 CDM,762G037809,Hc Observation Carve Out - Interventional Radiology,93.59,37.44,,,0 CDM,762G037812,Hc Cvicu/Sd Oncology Observation Per Hour,99.62,39.85,,,0 CDM,762G0378AT,Hc Cvicu/Sd Telemetry Observation Per Hour,156.68,62.67,,,0 CDM,762G0378AY,Hc Observation Carve-Out - Ambulance Transport,93.59,37.44,,,0 CDM,762G037901,Hc Direct Admit To Observation,671.6,268.64,,,0 CDM,770G040201,Hc Initial Preventive Exam,199.0,79.6,,,0 CDM,7710001A01,Hc Administration Pfizer Sarscov2 30Mcg/0.3Ml 1St Dose,67.82,27.13,,,0 CDM,7710002A01,Hc Administration Pfizer Sarscov2 30Mcg/0.3Ml 2Nd Dose,67.82,27.13,,,0 CDM,7710003A01,Hc Administration Pfizer Sarscov2 30Mcg/0.3Ml 3Rd Dose,50.0,20.0,,,0 CDM,7710004A01,Hc Administration Pfizer Sarscov2 30Mcg/0.3Ml Booster,50.0,20.0,,,0 CDM,7710011A01,Hc Administration Moderna Sarscov2 100Mcg/0.5Ml 1St Dose,67.82,27.13,,,0 CDM,7710012A01,Hc Administration Moderna Sarscov2 100Mcg/0.5Ml 2Nd Dose,67.82,27.13,,,0 CDM,7710013A01,Hc Administration Moderna Sarscov2 100Mcg/0.5Ml 3Rd Dose,50.0,20.0,,,0 CDM,7710021A01,Hc Administration Astrazeneca Sarscov2 5X10^10Vp/.5Ml 1St Dose,50.0,20.0,,,0 CDM,7710022A01,Hc Administration Astrazeneca Sarscov2 5X10^10Vp/.5Ml 2Nd Dose,50.0,20.0,,,0 CDM,7710031A01,Hc Administration Janssen Sarscov2 Vac Ad26 .5Ml,50.0,20.0,,,0 CDM,7710034A01,Hc Adminstration Janssen Sarscov2 Booster,50.0,20.0,,,0 CDM,7710041A01,Hc Administration Novavax Sarscov2 5Mcg/0.5Ml 1St Dose,50.0,20.0,,,0 CDM,7710042A01,Hc Administration Novavax Sarscov2 5Mcg/0.5Ml 2Nd Dose,50.0,20.0,,,0 CDM,7710051A01,Hc Administration Pfizer Sarscv2 30Mcg Trs-Sucr 1St Dose,50.0,20.0,,,0 CDM,7710052A01,Hc Administration Pfizer Sarscv2 30Mcg Trs-Sucr 2Nd Dose,50.0,20.0,,,0 CDM,7710053A01,Hc Administration Pfizer Sarscv2 30Mcg Trs-Sucr 3Rd Dose,50.0,20.0,,,0 CDM,7710054A01,Hc Administration Pfizer Sarscv2 30Mcg Trs-Sucr Booster,50.0,20.0,,,0 CDM,7710064A01,Hc Administration Moderna Sarscov2 50Mcg/0.25Ml Booster,50.0,20.0,,,0 CDM,7710071A01,Hc Imm Admn Sarscov2 10Mcg/0.2Ml Tris-Sucrose 1St,50.0,20.0,,,0 CDM,7710072A01,Hc Imm Admn Sarscov2 10Mcg/0.2Ml Tris-Sucrose 2Nd,50.0,20.0,,,0 CDM,7710081A01,Hc Imm Admn Sarscov2 3Mcg/0.2Ml Tris-Sucrose 1St,50.0,20.0,,,0 CDM,7710082A01,Hc Imm Admn Sarscov2 3Mcg/0.2Ml Tris-Sucrose 2Nd,50.0,20.0,,,0 CDM,7710112A01,Hc Administration Moderna Sarscov2 25 Mcg/0.25 Ml 2Nd Dose,74.75,29.9,,,0 CDM,7710124A01,Hc Administration Pfizer Sarscov2 Bival 30Mcg/0.3Ml Booster,67.82,27.13,,,0 CDM,7710134A01,Hc Administration Moderna Sarscov2 Bival 50Mcg/0.5Ml Booster,67.82,27.13,,,0 CDM,7710144A01,Hc Administration Moderna Sarscov2 Bival 25 Mcg/0.25Ml Booster,67.82,27.13,,,0 CDM,7710154A01,Hc Administration Pfizer Sarscov2 Bival 10Mcg/0.2Ml Booster,67.82,27.13,,,0 CDM,7719046001,"Hc Immuniz Admin, Thru Age 18, Any Route,W Counsel, 1St Vaccine/Toxoid",123.84,49.54,,,0 CDM,7719046101,"Hc Immuniz Admin, Thru Age 18, Any Route,W Counsel, Ea Add Vaccine/Toxoid",103.79,41.52,,,0 CDM,7719047101,"Hc Immuniz Admin,1 Single/Comb Vac/Toxoid",116.65,46.66,,,0 CDM,7719047201,"Hc Immuniz,Admin,Each Additional",96.3,38.52,,,0 CDM,7719047301,"Hc Immuniz Admin,Intranasal/Oral,1 Vac/Tox",109.87,43.95,,,0 CDM,7719047401,"Hc Immuniz Admin,Intranasal/Oral,Each Additional",89.52,35.81,,,0 CDM,7719048001,Hc Administration Sarscov2 Vaccine 1 Dose,116.18,46.47,,,0 CDM,7719638001,Hc Administration Of Respiratory Syncytial Virus With Counseling By Physician,116.65,46.66,,,0 CDM,7719638101,Hc Administration Of Rsv,116.65,46.66,,,0 CDM,771G000801,Hc Administration Influenza Virus Vaccine,109.87,43.95,,,0 CDM,771G000901,Hc Administration Pneumococcal Vaccine,109.87,43.95,,,0 CDM,771G001001,Hc Administration Hepatitis B Vaccine,137.0,54.8,,,0 CDM,771M022001,Hc Administration Tixagevimab And Cilgavimab Injection >12 Years Old,687.69,275.08,,,0 CDM,771M022101,Hc Administration Of Tixagevimab & Cilgavimab (Evusheld) Antibody >12 Years Old,339.1,135.64,,,0 CDM,771M022401,"Hc Intravenous Infusion, Pemgarda (Pemivibart)",1414.19,565.68,,,0 CDM,771M023901,Hc Bamlanivimab Infusion/Post Mon,1559.28,623.71,,,0 CDM,771M024302,Hc Admin Tixagevimab & Cilgavimab (Evusheld) Antibody,0.01,0.004,,,0 CDM,771M024303,Hc Punch Bx Skin Single Lesion,888.03,355.21,,,0 CDM,771M024501,Hc Bamlan & Etesev Infus/Post Mon,1413.36,565.34,,,0 CDM,780Q301401,Hc Telehealth Fee,66.19,26.48,,,0 CDM,7900000001,Hc Extracorporeal Shock Wave Lithotripsy Bil Initial,37957.22,15182.89,,,0 CDM,7900000002,Hc Extracorporeal Shock Wave Lithotripsy Bil Repeat,18977.39,7590.96,,,0 CDM,7900000003,Hc Extracorporeal Shock Wave Lithotripsy Uni Initial,25706.27,10282.51,,,0 CDM,7900000004,Hc Extracorporeal Shock Wave Lithotripsy Uni Repeat,13995.34,5598.14,,,0 CDM,8010000010,Hc Phase 1 Rec Initial 30 Minutes,2912.04,1164.82,,,0 CDM,8010000013,Hc Hemodialysis Emergent Call Inpatient,3291.87,1316.75,,,0 CDM,8010000019,Hc Cvvhd Pedatric Daily Line Charge Inpatient,3291.87,1316.75,,,0 CDM,8010000050,Hc Hemodialysis Adult Line Charge Inpatient,592.74,237.1,,,0 CDM,8013651401,Hc Charge Therapeutic Plasma Exchange,9952.63,3981.05,,,0 CDM,8020000001,Hc Dialysis - Peritoneal Dialysis Per Day,1438.31,575.32,,,0 CDM,8020000012,Hc Cvvhd Adult Daily Line Charge Inpatient,676.46,270.58,,,0 CDM,8020000014,Hc Cvvhd Pedatric Emergency Line Charge Inpatient,676.46,270.58,,,0 CDM,8020000055,Hc Manual Peritoneal Dialysis Daily Service Inpatient,1438.31,575.32,,,0 CDM,8020000056,Hc Peritoneal Line Charge Inpatient,676.46,270.58,,,0 CDM,8020000090,Hc Dialysis - Manual Peritoneal Dialysis Per Day,1751.42,700.57,,,0 CDM,8029094502,Hc Peritoneal Evaluation Inpatient,606.0,242.4,,,0 CDM,8120000002,Hc Double Lung Acquistion,243032.5,97213.0,,,0 CDM,8120000006,Hc Heart Acquisition,296110.4,118444.16,,,0 CDM,8120000007,Hc Kidney Acquisition,192462.89,76985.16,,,0 CDM,8120000008,Hc Liver Acquisition,337116.11,134846.44,,,0 CDM,8120000009,Hc Single Lung Acquisition,243032.5,97213.0,,,0 CDM,8120000010,Hc Pancrease Acquisition,166054.9,66421.96,,,0 CDM,8120000011,Hc Kidney Living Donor Acquisition,192462.89,76985.16,,,0 CDM,8120000013,Hc Heart Acquisition W/ Sherpapak Carrier,296110.4,118444.16,,,0 CDM,8153820501,Hc Pbsc Collect Allo,7569.0,3027.6,,,0 CDM,8153820702,Hc Frozen Blood Prep W/Freeze(Pbc),6776.0,2710.4,,,0 CDM,8153820901,Hc Wash Harvest Stem Cells,1850.0,740.0,,,0 CDM,8153822701,Hc Car-T Receipt And Preparation For Administration,6450.0,2580.0,,,0 CDM,8153823001,Hc Allo Bone Marrow Harvest,7747.0,3098.8,,,0 CDM,8193820601,Hc Pbsc Collect Auto,6443.0,2577.2,,,0 CDM,8193820612,Hc Pbsc Large Volume Auto,6443.0,2577.2,,,0 CDM,8219093501,Hc Hemodialysis Procedure W/ Phys/Qhp Evaluation,417.0,166.8,,,0 CDM,8219099901,Hc Dialysis Procedure - Hemodialysis Outpatient,2873.0,1149.2,,,0 CDM,829G025701,Hc Unscheduled Dialysis Esrd Pt Hos,5737.81,2295.12,,,0 CDM,829G025702,Hc Unscheduled Dialysis Esrd Pt Hos-Emergent,6426.34,2570.54,,,0 CDM,8310000050,Hc Peritoneal Dialysis Emergency Intial Outpatient,1014.69,405.88,,,0 CDM,8319094502,Hc Peritoneal Initation,606.0,242.4,,,0 CDM,8710537T01,Hc Car-T Therapy Hrvg Bld Drv T Lmphcyt Pr Day,5010.0,2004.0,,,0 CDM,8713822501,Hc Car-T Therapy-Harvesting Of Blood Derived T White Blood Cells For Chimeric Antigen Receptor Per D,7135.0,2854.0,,,0 CDM,8810000001,Hc Cvvh Adult Initation,3496.14,1398.46,,,0 CDM,8810000003,Hc Cvvh Adult Daily Line Charge,3494.48,1397.79,,,0 CDM,8810692T01,Hc Ultrafilitration Set Up/Change Incl Kit,4398.75,1759.5,,,0 CDM,8810692T02,Hc Ultrafilitration Daily,517.5,207.0,,,0 CDM,8913822601,Hc Car-T Therapy Preparation Of Blood Derviced T Lymphocytes From Bone Marrow,6753.0,2701.2,,,0 CDM,8913822801,Hc Car-T Therapy Adminstration Of Car-T Cells,1566.0,626.4,,,0 CDM,8913822801_38228_891,Hc Car-T Therapy Adminstration Of Car-T Cells,1566.0,626.4,,,0 CDM,891C939901,Hc Car-T Liso-Cel Breyanzi,2427638.0,971055.2,,,0 CDM,891C939901_C9399_891,Hc Car-T Liso-Cel Breyanzi,2427638.0,971055.2,,,0 CDM,891C939901_Q2054_891,Hc Car-T Liso-Cel Breyanzi,2427638.0,971055.2,,,0 CDM,891C939902,Hc Car-T Ide-Cel Abecma,2482072.0,992828.8,,,0 CDM,891C939902_C9399_891,Hc Car-T Ide-Cel Abecma,2482072.0,992828.8,,,0 CDM,891C939903,Hc T-Cell Amtagvi (Lifileucel),2798760.0,1119504.0,,,0 CDM,891J359001,Hc T-Cell Amtagvi (Lifileucel),2798760.0,1119504.0,,,0 CDM,891Q204101,Hc Yescarta,2722544.0,1089017.6,,,0 CDM,891Q204101_Q2041_891,Hc Yescarta,2722544.0,1089017.6,,,0 CDM,891Q204201,Hc Kymriah Car-T,2434856.01,973942.4,,,0 CDM,891Q204202,Hc Kymriah Car-T Ped And Young Adult W/ R/R All Age <25 Yrs,2955796.03,1182318.41,,,0 CDM,891Q205301,Hc Tecartus,2507470.0,1002988.0,,,0 CDM,891Q205301_Q2053_891,Hc Tecartus,2507470.0,1002988.0,,,0 CDM,891Q205401,Hc Car-T Liso-Cel Breyanzi,2778431.0,1111372.4,,,0 CDM,891Q205401_Q2054_891,Hc Car-T Liso-Cel Breyanzi,2778431.0,1111372.4,,,0 CDM,891Q205501,Hc Car-T Ide-Cel Abecma,2709926.0,1083970.4,,,0 CDM,891Q205501_Q2055_891,Hc Car-T Ide-Cel Abecma,2709926.0,1083970.4,,,0 CDM,891Q205601,Hc Car-T Cilta-Cel Carvykti,2665490.0,1066196.0,,,0 CDM,891Q205601_Q2056_891,Hc Car-T Cilta-Cel Carvykti,2665490.0,1066196.0,,,0 CDM,9009079101,Hc Psychiatric Diagnostic Evaluation,325.0,130.0,,,0 CDM,9009079201,Hc Psychiatric Diagnostic Eval W/Medical Services,350.0,140.0,,,0 CDM,9009086701,"Hc Transcranial Magnetic Stimulation Treatment,Initial",650.0,260.0,,,0 CDM,9009086801,"Hc Transcranial Magnetic Stimulation Treatment,Delivery/Management",450.0,180.0,,,0 CDM,9009086901,Hc Transcranial Magnetic Stimulation Treatment,765.0,306.0,,,0 CDM,9009088701,Hc Consultation With Family,150.0,60.0,,,0 CDM,9009715101,Hc Behavior Id Assessment By Physician/Other Qualified Professional 15 Min Each,162.5,65.0,,,0 CDM,9019087001,"Hc Electroconvulsive Therapy,1 Seiz",2523.82,1009.53,,,0 CDM,905S948001,"Hc Intensive Op Psychiatric Svc, Per Diem",718.0,287.2,,,0 CDM,9149078501,Hc Psychotherapy Complex Interactive,100.0,40.0,,,0 CDM,9149083201,Hc Psychotherapy Patient &/ Family 30 Minutes,250.0,100.0,,,0 CDM,9149083301,Hc Psychotherapy Patient & Family W/E&M Services 30 Minutes,75.0,30.0,,,0 CDM,9149083401,Hc Psychotherapy Patient &/ Family 45 Minutes,300.0,120.0,,,0 CDM,9149083601,Hc Psychotherapy Pt&/Family W/E&M Srvcs 45 Min,100.0,40.0,,,0 CDM,9149083701,Hc Psychotherapy Patient &/ Family 60 Minutes,350.0,140.0,,,0 CDM,9149083801,Hc Psychological Treatment With Patient With E/M 60 Minutes,125.0,50.0,,,0 CDM,9149083901,Hc Psychological Treatment Crisis Initial 60 Minutes,400.0,160.0,,,0 CDM,9149084001,Hc Psychotherapy Treatment Crisis Each Additional 30 Minutes,200.0,80.0,,,0 CDM,915G041001,Hc Group Psych Partial Hosp Or Intensive Op 45-50 Min,448.5,179.4,,,0 CDM,915G041101,Hc Inter Active Group Partial Hosp Or Intensive Op Psych Participation,379.73,151.89,,,0 CDM,9169084601,"Hc Family Psychotherapy,No Pt",225.0,90.0,,,0 CDM,9169084701,Hc Family Psychotherapy W Phys,250.0,100.0,,,0 CDM,9169085301,Hc Group Psychotherapy,125.0,50.0,,,0 CDM,9186913001,Hc Psychotherapy Test Eval Phys/Qhp 1St,485.88,194.35,,,0 CDM,9189611601,"Hc Neurobehavioral Status, First Hour",676.0,270.4,,,0 CDM,9189612101,Hc Neurobehavioral Status Each Additional Hour,364.0,145.6,,,0 CDM,9189612701,Hc Brief Emotional/Behavioral Assessment,125.58,50.23,,,0 CDM,9189613101,Hc Psychological Test Evaluation Phys/Qhp Initial,373.75,149.5,,,0 CDM,9189613201,Hc Neuropsyhchological Testing Evaluation Phys/Qhp 1 Hour,695.18,278.07,,,0 CDM,9189613301,Hc Neuropsychological Testing Evaluation Phys/Qhp Each Additional Hour,448.5,179.4,,,0 CDM,9189613601,Hc Neuropsy Testing-Md Initial 30 Minutes,296.01,118.4,,,0 CDM,9189613701,Hc Neuropsy Testing-Md Additional 30 Minutes,127.08,50.83,,,0 CDM,9189613801,Hc Neuropsy Test-Tech 1St 30M,548.66,219.46,,,0 CDM,9189613901,Hc Neuropsy Test-Tech Add 30 Min,224.25,89.7,,,0 CDM,9189616001,Hc Pateint Focused Health Risk Assessment/Std Instrumentation,56.0,22.4,,,0 CDM,9201000401,Hc Fine Needle Asp;W/O Imaging Guidance Additonal Lesion,703.25,281.3,,,0 CDM,9201002101,Hc Fine Needle Asp;W/O Imaging Guidance,890.79,356.32,,,0 CDM,9205902501,Hc Fetal Non-Stress Test,1349.57,539.83,,,0 CDM,9209103501,Hc Bravo Placement/Retrieval,5329.61,2131.84,,,0 CDM,9209202501,Hc Corneal Topography - Corneal Topography - Od - Unilateral,493.35,197.34,,,0 CDM,9209208101,"Hc Visual Field Exam,Limited - Auto Visual Field, Single Isopter Od- Unilateral",254.0,101.6,,,0 CDM,9209208201,"Hc Visual Field Exam,Intermediate - Auto Visual Field, Intermediate Od-Unilateral",394.0,157.6,,,0 CDM,9209208303,"Hc Visual Field Exam,Extended - Auto Visual Field, Extended Od-Unilateral",383.0,153.2,,,0 CDM,9209210001,Hc Serial Tonometry Exam(S),153.0,61.2,,,0 CDM,9209213201,"Hc Computerized Ophthalmic Diagnositc Imaging, Anterior Segment - Heidelberg Retina Tomography Ou- U",463.45,185.38,,,0 CDM,9209213202,"Hc Computerized Ophthalmic Diagnositc Imaging, Anterior Segment - Heidelberg Retina Tomography Ou- B",156.98,62.79,,,0 CDM,9209213301,Hc Computerized Ophthalmic Diagnositc Imaging Optic Nerve -Optic Nerve - Od - Unilateral,568.1,227.24,,,0 CDM,9209213401,Hc Computerized Ophthalmic Diagnositc Imaging Posterior Segment - Retina - Od - Unilateral,590.52,236.21,,,0 CDM,9209213402,Hc Computerized Ophthalmic Diagnositc Imaging Posterior Segment - Retina - Od - Bilateral,278.07,111.23,,,0 CDM,9209213601,Hc Ophthalmic Biometry - Iol Biometry - Os - Unilateral,449.79,179.92,,,0 CDM,9209213602,Hc Ophthalmic Biometry - Iol Biometry - Os - Bilateral,373.75,149.5,,,0 CDM,9209220101,Hc Ophthalmoscopy Extend Retina Drawing & Scleral Depression I&R Unilateral,430.56,172.22,,,0 CDM,9209220102,Hc Ophthalmoscopy Extend Retina Drawing & Scleral Depression I&R Bilateral,351.32,140.53,,,0 CDM,9209222901,Hc Imaging Retina Detection/Monitoring Of Eye Disease-Poct,485.88,194.35,,,0 CDM,9209223501,Hc Fluorescein Angiography - Fluorescein Angiography - Os - Unilateral,1423.0,569.2,,,0 CDM,9209223502,Hc Fluorescein Angiography - Fluorescein Angiography - Os - Bilateral,676.0,270.4,,,0 CDM,9209224001,Hc Indocyanine Green Angiography - Icg Angiography - Od - Unilateral,2145.32,858.13,,,0 CDM,9209224002,Hc Indocyanine Green Angiography - Icg Angiography - Od - Bilateral,874.58,349.83,,,0 CDM,9209224201,Hc Fluorescein Icg Angiography W/Multiframe I&R Unilateral,1988.35,795.34,,,0 CDM,9209224202,Hc Fluorescein Icg Angiography W/Multiframe I&R Bilateral,2317.25,926.9,,,0 CDM,9209225001,Hc Fundal Photography - Monochromatic Fundus Photography Os Unilateral,355.0,142.0,,,0 CDM,9209225009,Hc Fundal Photography - Monochromatic Fundus Photography Os Bilateral,255.0,102.0,,,0 CDM,9209227301,Hc Full Field Electoretinography W/I&R,825.0,330.0,,,0 CDM,9209227401,Hc Multifocal Electroretinography W/I&R,575.0,230.0,,,0 CDM,9209228301,Hc Color Vision Examination,235.0,94.0,,,0 CDM,9209228401,Hc Dark Adaptation Eye Exam - Dark Adaptation - Od - Unilateral,265.0,106.0,,,0 CDM,9209228402,Hc Dark Adaptation Eye Exam - Dark Adaptation - Od - Bilateral,352.0,140.8,,,0 CDM,9209228502,Hc Eye Photography - Gonio Photography - Os - Unilateral,295.0,118.0,,,0 CDM,9209228507,Hc Eye Photography - Gonio Photography - Os - Bilateral,249.0,99.6,,,0 CDM,9209228601,Hc Internal Eye Photography - Endothelial Photo And Cell Count Os- Unilateral,278.0,111.2,,,0 CDM,9209228606,Hc Internal Eye Photography - Endothelial Photo And Cell Count Os-Bilateral,440.0,176.0,,,0 CDM,9209378801,Hc Ambulatory Blood Pressure Monitor Scanning And Analysis,627.9,251.16,,,0 CDM,9209597101,Hc Analyze Neurostimulator Simple/Program Pump Refill,1957.86,783.14,,,0 CDM,9209602001,Hc Functional Brain Mapping - Mr Head Functional Motor,1167.6,467.04,,,0 CDM,9209611201,Hc Developmental Tst Admin Phys/Qhp 1St Hour,404.0,161.6,,,0 CDM,9209611301,Hc Devel Tst Phys/Qhp Ea 30 Min,121.0,48.4,,,0 CDM,9210338T01,Hc Vasc Transcatheter Renal Sympath Denervation Unilateral,18850.0,7540.0,,,0 CDM,9210339T01,Hc Vasc Transcatheter Renal Sympath Denervation Bilateral,21060.0,8424.0,,,0 CDM,9210650T01,Hc Remote Program Ilr,81.17,32.47,,,0 CDM,9213600201,Hc Vasc Injection Rx Extremity Pseudoaneurysm,1106.3,442.52,,,0 CDM,9213600501,"Hc Vasc Injection Proc,Extremity,Venography",1442.1,576.84,,,0 CDM,9213690401,Hc Vasc Perq Thrmbc/Nfs Dialysis Circuit Img Dx Angrph,15047.75,6019.1,,,0 CDM,9213690501,Hc Vasc Perq Thrmbc/Nfs Dial Circuit Trluml Balo Angiop,28643.05,11457.22,,,0 CDM,9213690701,Hc Vasc Trluml Balo Angiop Ctr Dialysis Seg W/Img S&I,17484.6,6993.84,,,0 CDM,9213690901,Hc Vasc Dialyis Circuit Vasc Emboli Occls Evasc Img S&I,6259.45,2503.78,,,0 CDM,9213718701,"Hc Vasc Percut Mech Thrombectomy, Venous",12802.94,5121.18,,,0 CDM,9213719101,Hc Vasc Ins Intrvas Vc Filtr W/Wo Vas Acs Vsl Selxn Rs&I,19364.58,7745.83,,,0 CDM,9213719301,Hc Vasc Rtrvl Intrvas Vc Filtr W/Wo Acs Vsl Selxn Rs&I,12886.44,5154.58,,,0 CDM,9213719701,Hc Vasc Prq Transcatheter Rtrvl Intrvas Fb With Imaging,11573.36,4629.34,,,0 CDM,9213721301,Hc Vasc Thrombolysis Art/Venous Infsn W/Image Subsq Tx,8335.62,3334.25,,,0 CDM,9213721601,Hc Vasc Tcat Iv Stent Crv Crtd Art W/O Embolic Protecj,19426.34,7770.54,,,0 CDM,9213724301,Hc Vasc Vascular Embolize/Occlude Organ Tumor Infarct,38460.53,15384.21,,,0 CDM,9213724401,Hc Vasc Vascular Embolization Or Occlusion Hemorrhage,35408.11,14163.24,,,0 CDM,9213724901,Hc Vasc Trlml Balo Angiop Open/Perq W/Img S&I Addl Vein,9714.05,3885.62,,,0 CDM,9213725201,Hc Vasc Intravascular Us Noncoronary Rs&I Intial Vessel,5492.23,2196.89,,,0 CDM,9215424001,Hc Penile Blood Pressure,749.0,299.6,,,0 CDM,9217698201,Hc Us Elastography First Target Lesion,443.36,177.34,,,0 CDM,9219327905,Hc Pm Device Program Eval Sngle - Card Device Inpatient Pacemaker W/ Programming,349.82,139.93,,,0 CDM,9219328004,Hc Pm Device Program Eval Dual - Card Device In Clinic Pacemaker Dual Chamber,405.84,162.34,,,0 CDM,9219328005,Hc Pm Device Program Eval Dual - Card Device Inpatient Pacemaker Dual Chamber,405.84,162.34,,,0 CDM,9219328103,Hc Pm Device Program Eval Multiple- Card Device In Clinic Pacemaker Bivalve Chamber,473.28,189.31,,,0 CDM,9219328204,Hc Programming Eval Implantable Dfb - Card Device In Clinic Icd Single Chamber,372.68,149.07,,,0 CDM,9219328205,Hc Programming Eval Implantable Dfb - Card Device Inpatient Icd Singlr Chamber,372.68,149.07,,,0 CDM,9219328304,Hc Programming Eval Implantable Dfb - Card Device In Clinic Icd Dual Chamber,418.41,167.36,,,0 CDM,9219328305,Hc Programming Eval Implantable Dfb - Card Device Inpatient Icd Dual Chamber,418.41,167.36,,,0 CDM,9219328402,Hc Programming Eval Implantable Dfb - Card Device Inpatient Icd Bivalve Chamber,523.58,209.43,,,0 CDM,9219328404,Hc Programming Eval Implantable Dfb - Cardiac Device Clinic Icd Bivalve Chamber,523.58,209.43,,,0 CDM,9219328503,Hc Ilr Device Eval Progr - Card Device In Clinic Loop Recorder (Ilr),349.82,139.93,,,0 CDM,9219328703,Hc Ep Peri-Px Dev Eval & Prog Sing/Dual/Multi Lead Dfb,515.78,206.31,,,0 CDM,9219328803,Hc Pm Device Eval In Person - Card Device In Clinic - Pacemaker,500.82,200.33,,,0 CDM,9219328804,Hc Pm Device Eval In Person - Card Device Inpatient - Pacemaker,500.82,200.33,,,0 CDM,9219328903,Hc Interrog Device Eval Heart - Card Device In Clinic - Icd,554.64,221.86,,,0 CDM,9219329001,Hc In Person Icm Interrogation,370.76,148.3,,,0 CDM,9219329105,Hc Ilr Device Interrogate - Card Device In Clinic - Loop Recorder (Ilr),500.82,200.33,,,0 CDM,9219329106,Hc Ilr Device Interrogate - Card Device Inpatient - Loop Recorder (Ilr),500.82,200.33,,,0 CDM,9219329602,Hc Pm/Icd Remote Tech Serv - Card Device Remote - Icd,457.47,182.99,,,0 CDM,9219329701,"Hc Ep Interrog Eval, Remote, Up To 30 Days, Cv Mon/Loop Rec,Tech Review",301.99,120.8,,,0 CDM,9219375001,Hc Interrogation Vad In Prson W/Phys/Qhp Analysis,414.98,165.99,,,0 CDM,9219388005,Hc Vascular Duplex Scan Extracranial,1792.37,716.95,,,0 CDM,9219388204,"Hc Vascular Duplex Scan Extracranial,Limited",1276.52,510.61,,,0 CDM,9219388601,Hc Transcran Doppler Intracran Art - Transcranial Doppler,1802.62,721.05,,,0 CDM,9219388801,Hc Intracranial Limited Study - Us Head Doppler Limited,1062.44,424.98,,,0 CDM,9219392201,Hc Upper/Lower Extremity Art 2 Levels - Cv Us Ankle Brachial Indices Extremity Cmp,1475.56,590.22,,,0 CDM,9219392301,Hc Vascular Non-Invasive Physiologic Study Extremity 3 Levels,1976.39,790.56,,,0 CDM,9219392401,"Hc Vascular Non-Invasive Lower Extremity Arterial Stress/Rest, Complete,Bilateral",2251.47,900.59,,,0 CDM,9219392502,Hc Duplex Lower Extremity Arterial Bilateral - Lower Extremity Arterial Duplex,1737.99,695.2,,,0 CDM,9219392506,Hc Vasc Duplex Lo Extrem Art Bilateral,1737.99,695.2,,,0 CDM,9219392603,Hc Vascular Duplex Lower Extremity Artery Unilateral/Limited,1295.39,518.16,,,0 CDM,9219393006,Hc Vascular Duplex Upper Extremity Artery Bilateral,1917.9,767.16,,,0 CDM,9219393103,Hc Vascular Duplex Upper Extremity Artery Unilateral/Limited,1429.73,571.89,,,0 CDM,9219397001,"Hc Duplex Extrem Venous,Bilat - Cv Us Doppler Venous Legs Bilateral",1956.28,782.51,,,0 CDM,9219397006,"Hc Vascular Duplex Extremity Venous,Bilateral",1956.28,782.51,,,0 CDM,9219397101,"Hc Duplex Extremity Venous,Unilateral Or Limited",1514.89,605.96,,,0 CDM,9219397102,Hc Poct Us Ed Extremity Study,327.45,130.98,,,0 CDM,9219397501,Hc Vascular Study - Us Renal Artery Stenosis Hypertension Complete,2013.86,805.54,,,0 CDM,9219397502,Hc Vascular Study - Renal Artery Duplex,2013.86,805.54,,,0 CDM,9219397504,"Hc Vascular Duplex Abdomen/Pelvid Vascular Study,Complete",2013.86,805.54,,,0 CDM,9219397601,"Hc Duplex Abdomen/Pelvis Vascular Study,Limited",1177.85,471.14,,,0 CDM,9219397801,Hc Vascular Study - Aortoiliac Duplex,1644.43,657.77,,,0 CDM,9219397804,"Hc Vascular Duplex Large Vessel(S),Complete Poct",3237.28,1294.91,,,0 CDM,9219398001,Hc Vascular Study - Penile Duplex,1282.2,512.88,,,0 CDM,9219399001,Hc Duplex Hemodialysis Access - Hemodialysis Access Duplex,905.0,362.0,,,0 CDM,921G027801,"Hc Vasc Iliac Art Angio,Cardiac Cath",3307.4,1322.96,,,0 CDM,9229586101,"Hc Emg, Needle, Two Limbs - Emg 2 Limbs",1252.45,500.98,,,0 CDM,9229586301,Hc Needle Emg 3 Extremities,304.2,121.68,,,0 CDM,9229586701,"Hc Emg,Needle,Cranial Nerve Supp Mus,Unilateral - Emg Head Or Neck Unilateral",1078.31,431.32,,,0 CDM,9229588501,Hc Needle Emg Ea Extremity W/Paraspinl Area Limited,962.78,385.11,,,0 CDM,9229588601,Hc Needle Emg Ea Extremty W/Paraspinl Area Complete,895.5,358.2,,,0 CDM,9229588701,Hc Needle Emg Nonextremty Mscles W/Nerve Conduction,831.22,332.49,,,0 CDM,9229590501,Hc Motor And/Or Sensesory Nerve Condition Each Limb,376.74,150.7,,,0 CDM,9229590701,Hc Motor &/Sens 1-2 Nrv Cndj Preconf Eltrode Limb,962.78,385.11,,,0 CDM,9229590801,Hc Motor &/Sens 3-4 Nerve Conduction Preconf Electrode Limb,1450.15,580.06,,,0 CDM,9229590901,Hc Motor &/Sens 5-6 Nerve Conduction Preconf Electrode Limb,1817.92,727.17,,,0 CDM,9229591001,Hc Motor &/Sens 7-8 Nerve Cnduction Preconf Electrode Limb,2167.75,867.1,,,0 CDM,9229591101,Hc Motor &/Sens 9-10 Nrv Cndj Preconf Eltrode Limb,2985.52,1194.21,,,0 CDM,9229591201,Hc Motor &/Sens 11-12 Nrv Cndj Preconf Eltrode Limb,3354.78,1341.91,,,0 CDM,9229591301,Hc Motor &/Sens 13/> Nrv Cndj Preconf Eltrode Limb,3549.13,1419.65,,,0 CDM,9229592301,Hc Autonomic Nervous System Function Testing,943.34,377.34,,,0 CDM,9229592501,Hc Somatosensory Evp Upper Limbs,1970.41,788.16,,,0 CDM,9229592601,"Hc Somatosensory Test,Lower Limbs - Somatosensory Test",2049.64,819.86,,,0 CDM,9229592801,Hc Upper Tcemep,2128.88,851.55,,,0 CDM,9229592901,Hc Lower Tcemep,2128.88,851.55,,,0 CDM,9229593001,Hc Visual Ep Testing Cns Except Glaucoma W/I&R,1577.22,630.89,,,0 CDM,9229593701,Hc Neuromuscular Junction Test,804.31,321.72,,,0 CDM,9229593801,Hc Upper And Lower Sep,3151.46,1260.58,,,0 CDM,9229593901,Hc Cmep Upper And Lower Limbs,3262.09,1304.84,,,0 CDM,9249500401,Hc Percutaneous Tests With Allergenic Extracts,31.4,12.56,,,0 CDM,9249502401,Hc Intracutaneous Test With Allergenic Extracts,119.6,47.84,,,0 CDM,9249504401,Hc Allergy Patch Testing,179.4,71.76,,,0 CDM,9401006001,Hc Drain Skin Abscess Simple,986.22,394.49,,,0 CDM,9401104501,"Hc Debridement, Skin, Sub-Q Tissue,Each Add 20 Sq Cm",1537.09,614.84,,,0 CDM,9401105501,"Hc Trim Hyperkeratotic Skin Lesion, One",599.43,239.77,,,0 CDM,9401105601,"Hc Trim Benign Hyperkeratotic Skin Lesion,2-4",721.67,288.67,,,0 CDM,9401105701,Hc Ip-Trim Skin Lesions > 4,971.15,388.46,,,0 CDM,9401172101,"Hc Debridement Of Nails, 6 Or More",832.18,332.87,,,0 CDM,9401602001,Hc Dress/Debrid Small Burn No Anes,833.85,333.54,,,0 CDM,9401602501,Hc Dress/Debrid Med Burn No Anesth,1041.48,416.59,,,0 CDM,9401603001,Hc Dress/Debrid Large Burn No Anesth,1237.38,494.95,,,0 CDM,9403651101,"Hc Ther Apheresis,White Blood Cells",9686.4,3874.56,,,0 CDM,9403651201,"Hc Ther Apheresis,Red Blood Cells",10230.58,4092.23,,,0 CDM,9403651301,"Hc Ther Apheresis,Platelets",9507.24,3802.9,,,0 CDM,9403651402,Hc Therapeutic Plasma Exchange,9952.63,3981.05,,,0 CDM,9403652203,Hc Photopheresis Extracorporeal,15514.93,6205.97,,,0 CDM,9409599201,"Hc Canalith Repositioning Procedure, Per Day",297.0,118.8,,,0 CDM,9409637301,Hc Ia Injection Therapeutic,702.61,281.04,,,0 CDM,9409919501,Hc Phlebotomy,848.93,339.57,,,0 CDM,940OM5ST01,Hc Client Bill Only - Omnipod 5 Start Training 1 Patient,632.5,253.0,,,0 CDM,940OM5ST02,Hc Omnipod 5 Start Training 2 Patients,690.0,276.0,,,0 CDM,940OM5ST03,Hc Client Bill Only - Omnipod 5 Start Training 3 Patients,747.5,299.0,,,0 CDM,940OM5ST04,Hc Client Bill Only - Omnipod 5 Start Training 1 Patient Upgrade,431.25,172.5,,,0 CDM,940OMDSH01,Hc Client Bill Only - Omnipod Dash Training 1 Patient,460.0,184.0,,,0 CDM,940OMDSH02,Hc Omnipod Dash Training 2 Patients,517.5,207.0,,,0 CDM,940OMDSH03,Hc Omnipod Dash Training 3 Patients,575.0,230.0,,,0 CDM,940OMDSH04,Hc Client Bill Only - Omnipod Dash Training 1 Patient Upgrade,258.75,103.5,,,0 CDM,9420000001,Hc Phase 3 Daily Fee,8.53,3.41,,,0 CDM,9420000002,Hc 3 D/Wk Optimal Health Prgm,69.0,27.6,,,0 CDM,9420000003,Hc Phase 3 Family Fee,54.86,21.94,,,0 CDM,9420000004,Hc 2 Day Per Week Optimal Health Program,46.0,18.4,,,0 CDM,9420000005,Hc Zcedc Caregiver Class,57.5,23.0,,,0 CDM,9420000006,Hc Zndmt Self Pay $50.00,57.5,23.0,,,0 CDM,9420000007,Hc Zpsme (Pre-Diabetes Education),57.5,23.0,,,0 CDM,9420000008,Hc Daily Wellness Prgr Cash Only,8.53,3.41,,,0 CDM,9420000009,Hc 3 Day Per Week Optimal Health Program,69.0,27.6,,,0 CDM,9420000010,Hc 2 Day/Week Wellness Program,48.76,19.5,,,0 CDM,9420000011,Hc Beta Bionics Training-Individual,460.0,184.0,,,0 CDM,9420000012,Hc Client Bill Only - Omdsh Omnipod Dash Training 1 Patient,460.0,184.0,,,0 CDM,9420000013,Hc Beta Bionics Training-Group,287.5,115.0,,,0 CDM,9420000014,Hc Client Bill Only - Omnipod Dash Training 3 Patients,575.0,230.0,,,0 CDM,9420000015,Hc Client Bill Only - Omdsh Omnipod Dash Training 1 Patient Upgrade,258.75,103.5,,,0 CDM,9420000016,Hc Client Bill Only - Upgrade Training From Non-Tandem Pump Or/Only A Saline Start,345.0,138.0,,,0 CDM,9420000017,Hc Client Bill Only - New Pump Therapy,488.75,195.5,,,0 CDM,9420000018,Hc Client Bill Only - Group Of 2 Pump Training: New Patient,747.5,299.0,,,0 CDM,9420000019,Hc Client Bill Only - Group Of 3 Pump Training: New Patient,977.5,391.0,,,0 CDM,9420000020,Hc Client Bill Only - Individual Pump & Cgm System: New Patient,747.5,299.0,,,0 CDM,9420000021,Hc Client Bill Only - Group Of 2 Pump & Cgm System: New Patient,1150.0,460.0,,,0 CDM,9420000022,Hc Client Bill Only - Group Of 3 Pump & Cgm System: New Patient,1466.25,586.5,,,0 CDM,9420000023,Hc Client Bill Only - Individual Pump & Cgm System: Experienced Patient,488.75,195.5,,,0 CDM,9420000024,Hc Client Bill Only - Group Of 2 Pump & Cgm System: Experienced Patient,747.5,299.0,,,0 CDM,9420000025,Hc Client Bill Only - Group Of 3 Pump & Cgm System: Experienced Patient,977.5,391.0,,,0 CDM,9420000026,Hc Client Bill Only - Individual Cgm Training: New/Upgrade,258.75,103.5,,,0 CDM,9420000027,Hc Client Bill Only - Group Of 2 Cgm Training: New/Upgrade,402.5,161.0,,,0 CDM,9420000028,Hc Client Bill Only - Group Of 3 Cgm Training: New/Upgrade,517.5,207.0,,,0 CDM,9420000029,Hc Client Bill Only - Individual Pump Training Upgrade: Experienced Patient,230.0,92.0,,,0 CDM,9420000031,Hc Client Bill Only - Group Of 3 Pump Training Upgrade: Experienced Patient,460.0,184.0,,,0 CDM,9420000032,Hc Client Bill Only - Auto Mode Education,172.5,69.0,,,0 CDM,9420000033,Hc Client Bill Only - Group Of 2 Smart Guard Training,287.5,115.0,,,0 CDM,9420000034,Hc Client Bill Only - Group Of 3 Smart Guard Training,345.0,138.0,,,0 CDM,9420000035,Hc Client Bill Only - Omnipod Dash Training 2 Patients,517.5,207.0,,,0 CDM,9420000036,Hc Client Bill Only - Om5St Omnipod 5 Start Training 1 Patient Upgrade,431.25,172.5,,,0 CDM,9420000037,Hc Client Bill Only - Om5St Omnipod 5 Start Training 3 Patients,747.5,299.0,,,0 CDM,9420000038,Hc Client Bill Only - Omnipod 5 Start Training 2 Patients,690.0,276.0,,,0 CDM,9420000039,Hc Client Bill Only - Om5St Omnipod 5 Start Training 1 Patient,632.5,253.0,,,0 CDM,9420000040,Hc Client Bill Only - Group Training (Max 3 Patients),287.5,115.0,,,0 CDM,9420000041,Hc Client Bill Only - Renewal Pump Training,201.25,80.5,,,0 CDM,9420000042,Hc Client Bill Only - Saline Start Training,345.0,138.0,,,0 CDM,9420000043,Hc Client Bill Only - Transition From Saline To Insulin,115.0,46.0,,,0 CDM,9420000044,Hc Client Bill Only - New To Pump Start Training,460.0,184.0,,,0 CDM,9420000045,Hc Client Billing Only-Ilet Group Training,287.5,115.0,,,0 CDM,9420000046,Hc Client Billing Only-Ilet Start Training,460.0,184.0,,,0 CDM,9420403001,Hc Ndpp Diabetes Prevent Prgm Enrollment Visit,63.25,25.3,,,0 CDM,9420403002,Hc Ndpp Diabetes Prevent Prgm Sessions 1-4,32.2,12.88,,,0 CDM,9420403003,Hc Ndpp Diabetes Prevent Prgm Sessions 5-9,57.5,23.0,,,0 CDM,9420403004,Hc Ndpp Diabetes Prevent Prgm Participant Progress Ind,184.0,73.6,,,0 CDM,9420403005,Hc Ndpp Diabetes Prevent Prgm Participant Progress Group,241.5,96.6,,,0 CDM,9420488001,Hc Ndpp Diabetes Prevent Prgm Online/Elec,60.95,24.38,,,0 CDM,9429379902,Hc 3 D/Wk Optimal Health Prgm,78.0,31.2,,,0 CDM,9429379904,Hc 2 D/Wk Optimal Health Prgm,46.0,18.4,,,0 CDM,9429780201,"Hc Med Nutr Ther, 1St, Indiv, Ea 15 Min",162.42,64.97,,,0 CDM,9429780301,"Hc Med Nutr Ther, Subsq, Indiv, Ea 15 Min",154.05,61.62,,,0 CDM,9429780401,"Hc Medical Nutritional Therapy, Group, Each 30 Minutes",130.6,52.24,,,0 CDM,9429940601,Hc Tobacco Use Cessation Intermediate 3-10 Minutes,51.0,20.4,,,0 CDM,9429940701,Hc Tobacco Use Cessation Intensive >10 Minutes,76.0,30.4,,,0 CDM,942G010801,Hc Diab Manage Trn Per Indiv,130.18,52.07,,,0 CDM,942G010901,Hc Diab Manage Trn Ind/Group,73.92,29.57,,,0 CDM,942G027001,Hc Mnt Reass/Inter 2Nd Ref Ind 15,60.0,24.0,,,0 CDM,942G027101,Hc Mnt Reass/Inter 2Nd Ref Group,55.0,22.0,,,0 CDM,942G987301,Hc Mdpp Diabetes Prevent Prgm Core First Session,30.89,12.36,,,0 CDM,942G987401,Hc Mdpp Diabetes Prevent Program Core Sessions - Attended A Total Of 4 Sessions,60.68,24.27,,,0 CDM,942G987501,Hc Mdpp Diabetes Prevent Program Core Sessions - Attended A Total Of 9 Sessions,105.91,42.36,,,0 CDM,942G987601,Hc Mdpp Attended 2-Diabetes Prevent Prgm Core Maint Sessions 7-9 Months Without Minimum Weight Loss,18.76,7.5,,,0 CDM,942G987701,Hc Mdpp Attended 2-Diabetes Prevent Prgm Core Maint Sessions 10-12 Months Without Minimum Wt Loss,70.61,28.24,,,0 CDM,942G987801,Hc Mdpp Attended 2-Diabetes Prevent Prgm Core Maint Sessions 7-9 Months W/ 5% Wt Loss Fr/Baseline,18.76,7.5,,,0 CDM,942G987901,Hc Mdpp Attended 2-Diabetes Prevent Prgm Core Maint Sessions 10-12 Months W/ 5% Wt Loss Fr/Baseline,70.61,28.24,,,0 CDM,942G988001,"Hc Mdpp Diabetes Prevent Prgm, Months 1-12, W/ 5% Wt Loss Fr/Baseline With In-Person Weight",19.86,7.94,,,0 CDM,942G988101,"Hc Mdpp Diabetes Prevent Prgm, Months 1-24, W/ 9% Wt Loss Fr/Baseline With In Person Weight",30.89,12.36,,,0 CDM,942G988201,"Hc Mdpp Attended 2-Diabetes Prevent Prgm Main Sessions Months 13-15, W/ 5% Wt Loss Fr/Baseline",60.68,24.27,,,0 CDM,942G988301,"Hc Mdpp Attended 2-Diabetes Prevent Prgm Main Sessions, Months 16-18, W/ 5% Wt Loss Fr/Baseline",60.68,24.27,,,0 CDM,942G988401,"Hc Mdpp Attended 2-Diabetes Prevent Prgm Main Sessions, Months 19-21, W/ 5% Wt Loss Fr/Baseline",60.68,24.27,,,0 CDM,942G988501,"Hc Mdpp Attended 2-Diabetes Prevent Prgm Main Sessions, Months 22-24, W/ 5% Wt Loss Fr/Baseline",60.68,24.27,,,0 CDM,942G988601,"Hc Behavorial Counseling For Diabetes Prevention, In Person/Group 60 Mins",63.25,25.3,,,0 CDM,942G988701,"Hc Behavorial Counseling For Diabetes Prevention, Distance Learning 60 Mins",63.25,25.3,,,0 CDM,942G988801,Hc Maintenance 5% Weight Loss From Baseline In Months 7-12,32.2,12.88,,,0 CDM,942G989001,"Hc Mdpp Diabetes Prevent Prgm Bridge Payment, Months 1-24",30.89,12.36,,,0 CDM,942G989101,Hc Mdpp Diabetes Prevent Prgm Session Reporting,0.01,0.004,,,0 CDM,942I102001,Hc Group Of 2 Patients Saline And/Or Insulin Start Training,713.12,285.25,,,0 CDM,942I102101,Hc Group Of 3 Patients Saline And/Or Insulin Start Training,792.35,316.94,,,0 CDM,942M101801,Hc Client Bill Only - New Platform Upgrade Pump Education,212.0,84.8,,,0 CDM,942M101901,Hc Client Bill Only - Same Platform Pump Upgrade Pump Education,106.0,42.4,,,0 CDM,942M102001,Hc Client Bill Only - Sensor Education,238.5,95.4,,,0 CDM,942M102501,Hc Non-Medtronic Pump Upgrade Education,318.0,127.2,,,0 CDM,942M102601,Hc Client Bill Only - Auto Mode Education,159.0,63.6,,,0 CDM,942T101701,Hc Client Bill Only - New Pump Training,424.0,169.6,,,0 CDM,942T101801,Hc Client Bill Only - Currently Pumping Training,371.0,148.4,,,0 CDM,942T102001,Hc Client Bill Only - Group Training,265.0,106.0,,,0 CDM,942T102101,Hc Client Bill Only - Upgrade Training From Non-Tandem Pump Or/Only A Saline Start,371.0,148.4,,,0 CDM,9439379701,Hc Phe-Th Card Rehab W/Ecg Monitoring,232.0,92.8,,,0 CDM,9439379801,Hc Outpatient Cardiac Rehab W/Cont Ecg Monitoring,268.0,107.2,,,0 CDM,9489366801,Hc Pad/Ic Rehab 30-60 Min Session,85.0,34.0,,,0 CDM,9489462501,Noncdm Charge Record,374.9,149.96,,,0 CDM,948G042401,Hc Pulmonary Rehab W Exer,326.0,130.4,,,0 CDM,9900000005,Hc Cash Only Performance Training,97.5,39.0,,,0 CDM,9900000006,Hc Performance Assessment,130.0,52.0,,,0 CDM,9900232T01,Hc Cash Only Stem Cell Procedure,910.0,364.0,,,0 CDM,9900232T02,Hc Harvest Perp Inject Prp With A2M-Cash Only,4225.0,1690.0,,,0 CDM,9900232T03,Hc Harvest Prep Inject Prp With Supershot-Cash Only,4225.0,1690.0,,,0 CDM,9990000002,Hc Miscellaneous Lab Test,264.74,105.9,,,0 CDM,9990000007,Hc Ap Miscellaneous Lab Charges,380.44,152.18,,,0 HCPCS,00000,Hc 3 D/Wk Optimal Health Prgm,78.0,31.2,,,0 HCPCS,0001A,Adm sarscov2 30mcg/0.3ml 1st,,,18.77,18.77,4 HCPCS,0001A,Hc Administration Pfizer Sarscov2 30Mcg/0.3Ml 1St Dose,67.82,27.13,,,0 HCPCS,0001U,Rbc dna hea 35 ag 11 bld grp,,,720.0,1800.0,12 HCPCS,0002A,Adm sarscov2 30mcg/0.3ml 2nd,,,18.77,18.77,4 HCPCS,0002A,Hc Administration Pfizer Sarscov2 30Mcg/0.3Ml 2Nd Dose,67.82,27.13,,,0 HCPCS,0002M,Liver dis 10 assays w/ash,,,503.4,1258.5,11 HCPCS,0002U,Onc clrct 3 ur metab alg plp,,,25.0,62.5,12 HCPCS,0003A,Fee covid-19 vac 1 booster,,,18.77,18.77,4 HCPCS,0003A,Hc Administration Pfizer Sarscov2 30Mcg/0.3Ml 3Rd Dose,50.0,20.0,,,0 HCPCS,0003M,Liver dis 10 assays w/nash,,,503.4,1258.5,11 HCPCS,0003U,Onc ovar 5 prtn ser alg scor,,,950.0,2375.0,12 HCPCS,0004A,Fee covid-19 vac 1 res,,,18.77,18.77,4 HCPCS,0004A,Hc Administration Pfizer Sarscov2 30Mcg/0.3Ml Booster,50.0,20.0,,,0 HCPCS,0004M,Scoliosis dna alys,,,79.0,197.5,11 HCPCS,0005U,Onco prst8 3 gene ur alg,,,760.0,1900.0,12 HCPCS,0006M,Onc hep gene risk classifier,,,150.0,375.0,11 HCPCS,0007M,Onc gastro 51 gene nomogram,,,375.0,937.5,11 HCPCS,0007U,Rx test prsmv ur w/def conf,,,114.43,286.08,12 HCPCS,0008U,Hpylori detcj abx rstnc dna,,,597.91,1494.78,12 HCPCS,0009U,Onc brst ca erbb2 amp/nonamp,,,107.0,267.5,12 HCPCS,0010U,Nfct ds strn typ whl gen seq,,,427.26,1068.15,12 HCPCS,0011A,Adm sarscov2 100mcg/0.5ml1st,,,18.77,18.77,4 HCPCS,0011A,Hc Administration Moderna Sarscov2 100Mcg/0.5Ml 1St Dose,67.82,27.13,,,0 HCPCS,0011M,Onc prst8 ca mrna 12 gen alg,,,760.0,1900.0,12 HCPCS,0011U,Rx mntr lc-ms/ms oral fluid,,,114.43,286.08,12 HCPCS,0012A,Adm sarscov2 100mcg/0.5ml2nd,,,18.77,18.77,4 HCPCS,0012A,Hc Administration Moderna Sarscov2 100Mcg/0.5Ml 2Nd Dose,67.82,27.13,,,0 HCPCS,0012M,Onc mrna 5 gen rsk urthl ca,,,760.0,1900.0,12 HCPCS,0013A,Fee covid-19 vac 2 booster,,,18.77,18.77,4 HCPCS,0013A,Hc Administration Moderna Sarscov2 100Mcg/0.5Ml 3Rd Dose,50.0,20.0,,,0 HCPCS,0013M,Onc mrna 5 gen recr urthl ca,,,760.0,1900.0,12 HCPCS,0014M,Liver ds alys 3 bmrk srm alg,,,176.19,201.36,11 HCPCS,0015M,Adrnl cortcl tum bchm asy 25,,,201.36,3263.42,16 HCPCS,0016M,Onc bladder mrna 209 gen alg,,,200.0,8724.08,16 HCPCS,0016U,Onc hmtlmf neo rna bcr/abl1,,,163.96,409.9,12 HCPCS,0017M,Onc dlbcl mrna 20 genes alg,,,304.0,6275.52,16 HCPCS,0017U,Onc hmtlmf neo jak2 mut dna,,,91.66,229.15,12 HCPCS,0018M,Trnsplj rnl meas cd154+cll,,,208.0,1601.82,16 HCPCS,0018U,Onc thyr 10 microrna seq alg,,,100.0,7505.22,16 HCPCS,0019M,Cv ds plasma alys prtn bmrk,,,45.77,1781.0,16 HCPCS,0019U,Onc rna tiss predict alg,,,12.28,9187.5,16 HCPCS,0020M,Onc cns alys 30000 dna loci,,,200.0,3000.0,5 HCPCS,0021A,Fee covid-19 vac 3 dose 1,,,18.77,18.77,4 HCPCS,0021A,Hc Administration Astrazeneca Sarscov2 5X10^10Vp/.5Ml 1St Dose,50.0,20.0,,,0 HCPCS,0021U,Onc prst8 detcj 8 autoantb,,,200.0,1900.0,16 HCPCS,0022A,Fee covid-19 vac 3 dose 2,,,18.77,18.77,4 HCPCS,0022A,Hc Administration Astrazeneca Sarscov2 5X10^10Vp/.5Ml 2Nd Dose,50.0,20.0,,,0 HCPCS,0022U,Trgt gen seq dna&rna 23 gene,,,239.16,4875.0,16 HCPCS,0023U,Onc aml dna detcj/nondetcj,,,66.2,621.28,16 HCPCS,0024U,Glyca nuc mr spectrsc quan,,,7.34,85.48,16 HCPCS,0025U,Tenofovir liq chrom ur quan,,,31.98,286.08,16 HCPCS,0026U,Onc thyr dna&mrna 112 genes,,,846.27,9000.0,16 HCPCS,0027U,Jak2 gene trgt seq alys,,,121.91,846.27,16 HCPCS,0028U,Cyp2d6 gene cpy nmr cmn vrnt,,,57.73,57.73,4 HCPCS,0029U,"Hc Focused Pharmacogenomics Panel, V-So+",840.0,336.0,,,0 HCPCS,0029U,Rx metab advrs trgt seq alys,,,699.2,890.72,12 HCPCS,0030U,Rx metab warf trgt seq alys,,,134.13,335.32,16 HCPCS,0031A,Fee covid-19 vac 4 dose 1,,,18.77,18.77,4 HCPCS,0031A,Hc Administration Janssen Sarscov2 Vac Ad26 .5Ml,50.0,20.0,,,0 HCPCS,0031U,Cyp1a2 gene,,,57.73,209.77,12 HCPCS,0032U,Comt gene,,,69.92,437.02,16 HCPCS,0033U,Htr2a htr2c genes,,,279.68,384.58,11 HCPCS,0034A,Fee covid-19 vac 4 res,,,18.77,18.77,4 HCPCS,0034A,Hc Adminstration Janssen Sarscov2 Booster,50.0,20.0,,,0 HCPCS,0034U,Tpmt nudt15 genes,,,279.68,1165.42,16 HCPCS,0035U,"Hc Markers (Cjd), Csf 3001255-So+",649.19,259.68,,,0 HCPCS,0035U,Hc Reflex Prion Markers Rt-Quic 3019868-So+,691.19,276.48,,,0 HCPCS,0035U,Neuro csf prion prtn qual,,,540.99,1352.48,12 HCPCS,0036U,Xome tum & nml spec seq alys,,,4780.0,11950.0,12 HCPCS,0037U,Trgt gen seq dna 324 genes,,,3500.0,8750.0,12 HCPCS,0038U,Vitamin d srm microsamp quan,,,29.6,74.0,12 HCPCS,0039U,Dna antb 2strand hi avidity,,,13.74,34.35,12 HCPCS,0040U,Bcr/abl1 gene major bp quan,,,409.9,1024.75,12 HCPCS,0041A,Fee covid-19 vac 5 dose 1,,,18.77,18.77,4 HCPCS,0041A,Hc Administration Novavax Sarscov2 5Mcg/0.5Ml 1St Dose,50.0,20.0,,,0 HCPCS,0041U,B brgdrferi antb 5 prtn igm,,,17.21,43.02,12 HCPCS,0042A,Fee covid-19 vac 5 dose 2,,,18.77,18.77,4 HCPCS,0042A,Hc Administration Novavax Sarscov2 5Mcg/0.5Ml 2Nd Dose,50.0,20.0,,,0 HCPCS,0042T,Hc Ct Cerebral Perfusion Analysis,2117.48,846.99,,,0 HCPCS,0042U,B brgdrferi antb 12 prtn igg,,,17.21,43.02,12 HCPCS,0043U,Tbrf b grp antb 4 prtn igm,,,14.86,37.15,12 HCPCS,0044A,Fee covid-19 vac 5 res,,,18.77,18.77,4 HCPCS,0044U,Tbrf b grp antb 4 prtn igg,,,14.86,37.15,12 HCPCS,0045U,Onc brst dux carc is 12 gene,,,3873.0,9682.5,12 HCPCS,0046U,Flt3 gene itd variants quan,,,198.61,1018.58,12 HCPCS,0046U,Hc Aml Flt3 Itd Mrd Testing By Ngs-So+,2790.0,1116.0,,,0 HCPCS,0047U,Onc prst8 mrna 17 gene alg,,,3873.0,9682.5,12 HCPCS,0048U,Onc sld org neo dna 468 gene,,,2919.6,7299.0,12 HCPCS,0049U,Hc Aml-Npm1 Mrd-So+,2790.0,1116.0,,,0 HCPCS,0049U,Npm1 gene analysis quan,,,295.82,1018.58,12 HCPCS,0050U,Trgt gen seq dna 194 genes,,,2916.6,7291.5,12 HCPCS,0051A,Fee covid-19 vac 6 dose 1,,,18.77,18.77,4 HCPCS,0051A,Hc Administration Pfizer Sarscv2 30Mcg Trs-Sucr 1St Dose,50.0,20.0,,,0 HCPCS,0051U,Rx mntr lc-ms/ms ur 31 pnl,,,246.76,617.3,12 HCPCS,0052A,Fee covid-19 vac 6 dose 2,,,18.77,18.77,4 HCPCS,0052A,Hc Administration Pfizer Sarscv2 30Mcg Trs-Sucr 2Nd Dose,50.0,20.0,,,0 HCPCS,0052U,Lpoprtn bld w/5 maj classes,,,33.86,84.65,12 HCPCS,0053A,Fee covid-19 vac 6 booster,,,18.77,18.77,4 HCPCS,0053A,Hc Administration Pfizer Sarscv2 30Mcg Trs-Sucr 3Rd Dose,50.0,20.0,,,0 HCPCS,0054A,Fee covid-19 vac 6 res,,,18.77,18.77,4 HCPCS,0054A,Hc Administration Pfizer Sarscv2 30Mcg Trs-Sucr Booster,50.0,20.0,,,0 HCPCS,0054U,Rx mntr 14+ drugs & sbsts,,,198.62,496.85,12 HCPCS,0055U,Card hrt trnspl 96 dna seq,,,3240.0,8100.0,12 HCPCS,0058U,Hc Merkel Cell Carcinoma Antibodies 3005983-So+,483.6,193.44,,,0 HCPCS,0058U,Onc merkel cll carc srm quan,,,322.96,807.4,12 HCPCS,0059U,Hr Reflex Merkel Polyomavirus Vp1 Capsid Antibody 3005991-So+,441.6,176.64,,,0 HCPCS,0059U,Onc merkel cll carc srm +/-,,,322.96,807.4,12 HCPCS,0060U,Twn zyg gen seq alys chrms2,,,759.05,1897.62,12 HCPCS,0061U,Tc meas 5 bmrk sfdi m-s alys,,,25.1,62.75,12 HCPCS,0062U,Ai sle igg&igm alys 80 bmrk,,,380.72,951.8,12 HCPCS,0063U,Neuro autism 32 amines alg,,,750.0,1875.0,12 HCPCS,0064A,Fee covid-19 vac 7 res,,,18.77,18.77,4 HCPCS,0064A,Hc Administration Moderna Sarscov2 50Mcg/0.25Ml Booster,50.0,20.0,,,0 HCPCS,0064U,Antb tp total&rpr ia qual,,,31.33,78.32,12 HCPCS,0065U,Syfls tst nontreponemal antb,,,18.09,45.22,12 HCPCS,0066U,Pamg-1 ia cervico-vag fluid,,,15.29,16.82,7 HCPCS,0067U,Onc brst imhchem prfl 4 bmrk,,,1897.0,4742.5,12 HCPCS,0068U,Candida species pnl amp prb,,,142.63,356.58,12 HCPCS,0069U,Onc clrct microrna mir-31-3p,,,380.0,950.0,12 HCPCS,0070U,Cyp2d6 gen com&slct rar vrnt,,,676.37,1690.92,12 HCPCS,0071A,Fee covid-19 vac 8 dose 1,,,18.77,18.77,4 HCPCS,0071A,Hc Imm Admn Sarscov2 10Mcg/0.2Ml Tris-Sucrose 1St,50.0,20.0,,,0 HCPCS,0071T,Us leiomyomata ablate <200,,,3161.39,7903.48,4 HCPCS,0071U,Cyp2d6 full gene sequence,,,361.62,1500.0,12 HCPCS,0071U,Hc Cyp2D6 Full Gene Sequence-So+,1470.48,588.19,,,0 HCPCS,0072A,Fee covid-19 vac 8 dose 2,,,18.77,18.77,4 HCPCS,0072A,Hc Imm Admn Sarscov2 10Mcg/0.2Ml Tris-Sucrose 2Nd,50.0,20.0,,,0 HCPCS,0072T,Us leiomyomata ablate >200,,,3161.39,7903.48,4 HCPCS,0072U,Cyp2d6 gen cyp2d6-2d7 hybrid,,,450.91,1127.28,12 HCPCS,0072U,Hc Cyp2D6 Gen Cyp2D6-2D7 Hybrid Reflex-So+,1470.48,588.19,,,0 HCPCS,0073A,Fee covid-19 vac 8 booster,,,18.77,18.77,4 HCPCS,0073U,Cyp2d6 gen cyp2d7-2d6 hybrid,,,450.91,1127.28,12 HCPCS,0073U,Hc Cyp2D6 Gen Cyp2D7-2D6 Hybrid Reflex-So+,1470.48,588.19,,,0 HCPCS,0074A,Fee covid-19 vac 8 res,,,18.77,18.77,4 HCPCS,0074U,Cyp2d6 nonduplicated gene,,,450.91,1127.28,12 HCPCS,0074U,Hc Cyp2D6 Nonduplicated Gene Reflex-So+,1470.48,588.19,,,0 HCPCS,0075T,Hc Carotid/Vert Stent Initial Artery,30114.08,12045.63,,,0 HCPCS,0075U,Cyp2d6 5' gene dup/mlt,,,450.91,1127.28,12 HCPCS,0075U,Hc Cyp2D6 5' Gene Dup/Mlt Reflex-So+,1470.48,588.19,,,0 HCPCS,0076T,Hc Carotid/Vert Stent Each Additional Artery,20442.75,8177.1,,,0 HCPCS,0076U,Cyp2d6 3' gene dup/mlt,,,450.91,1127.28,12 HCPCS,0076U,Hc Cyp2D6 3' Gene Dup/Mlt Reflex-So+,1470.48,588.19,,,0 HCPCS,0077U,Ig paraprotein qual bld/ur,,,4.59,108.58,16 HCPCS,0078U,Pain mgt opi use gnotyp pnl,,,450.91,496.0,7 HCPCS,0080U,Onc lng 5 clin rsk factr alg,,,2816.0,8800.0,16 HCPCS,0081A,Fee covid-19 vac 9 dose 1,,,18.77,18.77,4 HCPCS,0081A,Hc Imm Admn Sarscov2 3Mcg/0.2Ml Tris-Sucrose 1St,50.0,20.0,,,0 HCPCS,0082A,Fee covid-19 vac 9 dose 2,,,18.77,18.77,4 HCPCS,0082A,Hc Imm Admn Sarscov2 3Mcg/0.2Ml Tris-Sucrose 2Nd,50.0,20.0,,,0 HCPCS,0082U,Rx test def 90+ rx/sbsts ur,,,246.92,617.3,12 HCPCS,0083A,Fee covid-19 vac 9 booster,,,18.77,18.77,4 HCPCS,0083U,Onc rspse chemo cntrst tomog,,,167.35,418.38,12 HCPCS,0084U,Rbc dna gnotyp 10 bld groups,,,228.9,1800.0,16 HCPCS,0085U,Cdtb&vinculin igg antb ia,,,14.31,14.31,4 HCPCS,0086U,Nfct ds bact&fng org id 6+,,,13.28,500.0,16 HCPCS,0087U,Crd hrt trnspl mrna 1283 gen,,,1296.0,7898.55,16 HCPCS,0088U,Noncdm Charge Record,3762.52,1505.01,,,0 HCPCS,0088U,Trnsplj kdn algrft rej 1494,,,208.0,7898.55,16 HCPCS,0089U,Onc mlnma prame & linc00518,,,325.33,1900.0,16 HCPCS,0090U,Onc cutan mlnma mrna 23 gene,,,1560.0,4875.0,16 HCPCS,0091A,Fee covid-19 vac 10 dose 1,,,18.77,18.77,4 HCPCS,0091U,Onc clrct scr whl bld alg,,,203.55,203.55,4 HCPCS,0092A,Fee covid-19 vac 10 dose 2,,,18.77,18.77,4 HCPCS,0092U,Onc lng 3 prtn bmrk plsm alg,,,358.8,6220.0,16 HCPCS,0093A,Fee covid-19 vac 10 booster,,,18.77,18.77,4 HCPCS,0093U,Rx mntr 65 com drugs urine,,,45.77,155.35,16 HCPCS,0094A,Fee covid-19 vac 10 res,,,18.77,18.77,4 HCPCS,0094U,Genome rapid sequence alys,,,846.27,18955.5,16 HCPCS,0095U,Inflm ee elisa alys alg,,,771.98,1929.95,12 HCPCS,0096U,Hpv hi risk types male urine,,,19.1,87.72,16 HCPCS,0097U,Gi pathogen 22 targets,,,205.82,205.82,4 HCPCS,0098U,Respir pathogen 14 targets,,,205.82,205.82,4 HCPCS,0099U,Respir pathogen 20 targets,,,205.82,205.82,4 HCPCS,0100U,Respir pathogen 21 targets,,,205.82,205.82,4 HCPCS,0101T,Extracorp shockwv tx hi enrg,,,240.9,602.24,4 HCPCS,0101U,Hered colon ca do 15 genes,,,288.84,4359.88,16 HCPCS,0102T,Extracorp shockwv tx anesth,,,3195.45,7988.62,4 HCPCS,0102U,Hered brst ca rltd do 17 gen,,,288.84,3259.88,16 HCPCS,0103U,Hered ova ca pnl 24 genes,,,335.33,4359.88,16 HCPCS,0104U,Hered pan ca pnl 32 genes,,,335.33,335.33,4 HCPCS,0105U,Neph ckd mult eclia tum nec,,,950.0,2375.0,12 HCPCS,0106T,Touch Quant Sensory Test,,,36.48,91.19,4 HCPCS,0106U,Gstr emptg 7 timed brth spec,,,874.49,2186.22,12 HCPCS,0107T,Vibrate Quant Sensory Test,,,36.48,91.19,4 HCPCS,0107U,C diff tox ag detcj ia stool,,,16.0,40.0,12 HCPCS,0108T,Cool Quant Sensory Test,,,57.61,144.03,4 HCPCS,0108U,Gi barrett esoph 9 prtn bmrk,,,3015.9,12375.0,12 HCPCS,0109T,Heat Quant Sensory Test,,,36.48,91.19,4 HCPCS,0109U,Id aspergillus dna 4 species,,,142.63,356.58,12 HCPCS,0110T,Nos Quant Sensory Test,,,129.94,324.84,4 HCPCS,0110U,Rx mntr 1+oral onc rx&sbsts,,,27.11,67.78,12 HCPCS,0111A,Adm sarscov2 25mcg/0.25ml1st,,,18.77,18.77,4 HCPCS,0111U,Onc colon ca kras&nras alys,,,682.29,1705.72,12 HCPCS,0112A,Adm sarscov2 25mcg/0.25ml2nd,,,18.77,18.77,4 HCPCS,0112U,Iadi 16s&18s rrna genes,,,356.13,890.32,12 HCPCS,0113A,Adm sarscov2 25mcg/0.25ml3rd,,,18.77,18.77,4 HCPCS,0113U,Onc prst8 pca3&tmprss2-erg,,,760.0,1900.0,12 HCPCS,0114U,Gi barretts esoph vim&ccna1,,,1938.01,4845.02,12 HCPCS,0115U,Respir iadna 18 viral&2 bact,,,275.35,688.38,12 HCPCS,0116U,Rx mntr nzm ia 35+oral flu,,,246.92,617.3,12 HCPCS,0117U,Pain mgmt 11 endogenous anal,,,840.65,2101.62,12 HCPCS,0118U,Trnsplj don-drv cll-fr dna,,,2753.25,6883.12,12 HCPCS,0119U,Crd ceramides liq chrom plsm,,,83.76,209.4,12 HCPCS,0120U,Onc b cll lymphm mrna 58 gen,,,2510.21,6275.52,12 HCPCS,0121U,Sc dis vcam-1 whole blood,,,509.2,1273.0,12 HCPCS,0122U,Sc dis p-selectin whl blood,,,526.23,1315.58,12 HCPCS,0123U,Mchnl fragility rbc prflg,,,357.63,894.08,12 HCPCS,0124A,Adm sarscv2 bvl 30mcg/.3ml b,,,18.77,18.77,4 HCPCS,0124A,Hc Administration Pfizer Sarscov2 Bival 30Mcg/0.3Ml Booster,67.82,27.13,,,0 HCPCS,0129U,Hered brst ca rltd do panel,,,1303.95,3259.88,12 HCPCS,0130U,Hered colon ca do mrna pnl,,,584.9,1462.25,12 HCPCS,0131U,Hered brst ca rltd do pnl 13,,,710.0,781.0,7 HCPCS,0132U,Hered ova ca rltd do pnl 17,,,741.64,815.8,7 HCPCS,0133U,Hered prst8 ca rltd do 11,,,690.29,1725.72,12 HCPCS,0134A,Adm sarscv2 bvl 50mcg/.5ml b,,,18.77,18.77,4 HCPCS,0134A,Hc Administration Moderna Sarscov2 Bival 50Mcg/0.5Ml Booster,67.82,27.13,,,0 HCPCS,0134U,Hered pan ca mrna pnl 18 gen,,,748.39,1870.98,12 HCPCS,0135U,Hered gyn ca mrna pnl 12 gen,,,700.56,770.62,7 HCPCS,0136U,Atm mrna seq alys,,,407.43,1018.58,12 HCPCS,0137U,Palb2 mrna seq alys,,,282.88,707.2,12 HCPCS,0138U,Brca1 brca2 mrna seq alys,,,468.33,1170.82,12 HCPCS,0139U,Neuro austm meas 6 c metablt,,,336.26,336.26,4 HCPCS,0140U,Hc Bacterial Id Gram Positive Blood,483.0,193.2,,,0 HCPCS,0140U,Hc Fungal Id Blood Pnl,431.25,172.5,,,0 HCPCS,0140U,Nfct ds fungi dna 15 trgt,,,5.92,391.88,16 HCPCS,0141U,Hc Bacterial Id Gram Pos Bld Pcr,431.25,172.5,,,0 HCPCS,0141U,Nfct ds bact&fng gram pos,,,13.28,391.88,16 HCPCS,0142U,Hc Bacterial Id Gram Negative Blood,431.25,172.5,,,0 HCPCS,0142U,Nfct ds bact&fng gram neg,,,13.28,391.88,16 HCPCS,0143U,Drug assay 120+ rx/metablt,,,31.92,31.92,4 HCPCS,0144A,Adm srscv2 bvl 25mcg/.25ml b,,,18.77,18.77,4 HCPCS,0144A,Hc Administration Moderna Sarscov2 Bival 25 Mcg/0.25Ml Booster,67.82,27.13,,,0 HCPCS,0144U,Drug assay 160+ rx/metablt,,,31.92,31.92,4 HCPCS,0145U,Drug assay 65+ rx/metablt,,,31.92,31.92,4 HCPCS,0146U,Drug assay 80+ rx/metablt,,,31.92,31.92,4 HCPCS,0147U,Drug assay 85+ rx/metablt,,,31.92,31.92,4 HCPCS,0148U,Drug assay 100+ rx/metablt,,,31.92,31.92,4 HCPCS,0149U,Drug assay 60+ rx/metablt,,,31.92,31.92,4 HCPCS,0150U,Drug assay 120+ rx/metablt,,,31.92,31.92,4 HCPCS,0151U,Nfct bct/vir resp nfctj 33,,,13.28,13.28,4 HCPCS,0152U,Hc Microbial Cell-Free Dna By Sequencing (Karius Test)-So+,2436.0,974.4,,,0 HCPCS,0152U,Nfct bct fng prst dna >1000,,,13.28,5315.5,16 HCPCS,0153U,Onc breast mrna 101 genes,,,1239.61,7898.55,16 HCPCS,0154A,Adm sarscv2 bvl 10mcg/.2ml b,,,18.77,18.77,4 HCPCS,0154A,Hc Administration Pfizer Sarscov2 Bival 10Mcg/0.2Ml Booster,67.82,27.13,,,0 HCPCS,0154U,Fgfr3 gene analysis,,,109.93,1205.35,16 HCPCS,0155U,Pik3ca gene analysis,,,109.93,687.08,16 HCPCS,0156U,Copy number sequence alys,,,846.27,4350.0,16 HCPCS,0157U,Apc mrna seq alys,,,282.88,707.2,16 HCPCS,0158U,Mlh1 mrna seq alys,,,282.88,707.2,16 HCPCS,0159U,Msh2 mrna seq alys,,,282.88,707.2,16 HCPCS,0160U,Msh6 mrna seq alys,,,282.88,707.2,16 HCPCS,0161U,Pms2 mrna seq alys,,,282.88,707.2,16 HCPCS,0162U,Hered colon ca trgt mrna pnl,,,288.84,1216.35,16 HCPCS,0163U,Onc clrct scr 3 prtn alg,,,203.55,468.9,12 HCPCS,0164A,Adm srscv2 bvl 10mcg/0.2ml b,,,18.77,18.77,4 HCPCS,0164U,Gi ibs ia anti-cdtb&vinculin,,,13.82,280.05,16 HCPCS,0165U,Peanut allg spec asmt 64 epi,,,2.96,1159.4,16 HCPCS,0166U,Liver ds 10 biochem asy srm,,,28.88,1258.5,16 HCPCS,0167U,Chornc gonadotropin hcg ia,,,7.44,8.27,11 HCPCS,0168U,Ftl aneuploidy dna seq alys,,,645.0,645.0,4 HCPCS,0169U,Nudt15&tpmt gene com vrnt,,,279.68,1165.42,16 HCPCS,0170U,Neuro asd rna next gen seq,,,336.26,4875.0,16 HCPCS,0171U,Trgt gen seq alys pnl dna 23,,,239.16,3797.65,16 HCPCS,0172U,Onc sld tum alys brca1 brca2,,,1500.0,7575.0,16 HCPCS,0173A,Adm sarscv2 bvl 3mcg/0.2ml 3,,,18.77,18.77,4 HCPCS,0173U,Psyc gen alys panel 14 genes,,,423.14,1165.42,16 HCPCS,0174U,Onc solid tumor 30 prtn trgt,,,1148.4,3263.42,16 HCPCS,0175U,Psyc gen alys panel 15 genes,,,423.14,3340.22,16 HCPCS,0176T,Aqu canal dilat w/o retent,,,14697.0,17190.0,4 HCPCS,0176U,Cdtb&vinculin igg antb ia,,,6.91,160.48,16 HCPCS,0177T,Aqu canal dilat w retent,,,14697.0,17190.0,4 HCPCS,0177U,Onc brst ca dna pik3ca 11,,,109.93,687.08,16 HCPCS,0178U,Peanut allg asmt epi clin rx,,,2.58,1149.65,16 HCPCS,0179U,Onc nonsm cll lng ca alys 23,,,1148.4,4858.02,16 HCPCS,0180U,Abo gnotyp abo 7 exons,,,228.9,687.08,16 HCPCS,0181U,Co gnotyp aqp1 exon 1,,,185.2,463.0,16 HCPCS,0182U,Crom gnotyp cd55 exons 1-10,,,228.9,753.38,16 HCPCS,0183U,Di gnotyp slc4a1 exon 19,,,185.2,463.0,16 HCPCS,0184T,Exc rectal tumor endoscopic,,,5928.86,14822.16,4 HCPCS,0184U,Do gnotyp art4 exon 2,,,185.2,463.0,16 HCPCS,0185U,Fut1 gnotyp fut1 exon 4,,,185.2,463.0,16 HCPCS,0186U,Fut2 gnotyp fut2 exon 2,,,185.2,463.0,16 HCPCS,0187U,Fy gnotyp ackr1 exons 1-2,,,228.9,687.08,16 HCPCS,0188U,Ge gnotyp gypc exons 1-4,,,228.9,687.08,16 HCPCS,0189U,Gypa gnotyp ntrns 1 5 exon 2,,,228.9,687.08,16 HCPCS,0190U,Gypb gnotyp ntrns 1 5 seux 3,,,228.9,687.08,16 HCPCS,0191T,Insert ant segment drain int,,,7524.0,8800.0,4 HCPCS,0191U,In gnotyp cd44 exons 2 3 6,,,228.9,687.08,16 HCPCS,0192U,Jk gnotyp slc14a1 exon 9,,,228.9,687.08,16 HCPCS,0193U,Jr gnotyp abcg2 exons 2-26,,,228.9,707.2,16 HCPCS,0194U,Kel gnotyp kel exon 8,,,185.2,463.0,16 HCPCS,0195U,Klf1 targeted sequencing,,,131.8,938.12,16 HCPCS,0196U,Lu gnotyp bcam exon 3,,,185.2,463.0,16 HCPCS,0197U,Lw gnotyp icam4 exon 1,,,185.2,463.0,16 HCPCS,0198T,Ocular blood flow measure,,,129.94,324.84,4 HCPCS,0198U,Rhd&rhce gntyp rhd1-10&rhce5,,,228.9,707.2,16 HCPCS,01999,Hc Administration Of Nitrous Oxide,321.42,128.57,,,0 HCPCS,0199U,Sc gnotyp ermap exons 4 12,,,228.9,687.08,16 HCPCS,0200T,Perq sacral augmt unilat inj,,,7086.45,17716.12,4 HCPCS,0200U,Xk gnotyp xk exons 1-3,,,228.9,687.08,16 HCPCS,0201T,Perq sacral augmt bilat inj,,,7086.45,17716.12,4 HCPCS,0201U,Yt gnotyp ache exon 2,,,185.2,463.0,16 HCPCS,0202T,Post vert arthrplst 1 lumbar,,,12538.31,31345.78,4 HCPCS,0202U,Nfct ds 22 trgt sars-cov-2,,,166.71,1041.95,16 HCPCS,0203U,Ai ibd mrna xprsn prfl 17,,,336.26,1900.0,16 HCPCS,0204U,Onc thyr mrna xprsn alys 593,,,1440.0,1440.0,4 HCPCS,0205U,Oph amd alys 3 gene variants,,,47.0,117.5,16 HCPCS,0206U,Neuro alzheimer cell aggregj,,,336.26,5538.5,16 HCPCS,0207T,Clear eyelid gland w/heat,,,129.94,324.84,4 HCPCS,0207U,Neuro alzheimer quan imaging,,,168.13,613.44,12 HCPCS,0208T,Audiometry air only,,,36.48,91.19,4 HCPCS,0208U,Onc mtc mrna xprsn alys 108,,,1440.0,1440.0,4 HCPCS,0209T,Audiometry air & bone,,,36.48,91.19,4 HCPCS,0209U,Cytog const alys interrog,,,540.0,1967.88,16 HCPCS,0210T,Speech audiometry threshold,,,36.48,91.19,4 HCPCS,0210U,Syphilis tst antb ia quan,,,2.11,46.58,16 HCPCS,0211T,Speech audiom thresh & recog,,,36.48,91.19,4 HCPCS,0211U,Onc pan-tum dna&rna gnrj seq,,,208.0,21137.5,16 HCPCS,0212T,Compre audiometry evaluation,,,125.66,314.16,4 HCPCS,0212U,Rare ds gen dna alys proband,,,66.2,13688.0,16 HCPCS,0213T,Hc Njx Dx/Ther Paraver Fct Jt W/Us Cer/Thor 1 Lvl,2051.14,820.46,,,0 HCPCS,0213T,Njx paravert w/us cer/thor,,,863.78,2159.45,4 HCPCS,0213U,Rare ds gen dna alys ea comp,,,33.2,6774.88,16 HCPCS,0214U,Rare ds xom dna alys proband,,,1912.0,13061.5,16 HCPCS,0215U,Rare ds xom dna alys ea comp,,,2574.65,6436.62,16 HCPCS,0216T,Hc Njx Dx/Ther Paraver Fct Jt W/Us Lumb/Sac 1 Lvl,2051.14,820.46,,,0 HCPCS,0216T,Njx paravert w/us lumb/sac,,,863.78,2159.45,4 HCPCS,0216U,Neuro inh ataxia dna 12 com,,,514.8,3842.55,16 HCPCS,0217U,Neuro inh ataxia dna 51 gene,,,514.8,5495.88,16 HCPCS,0218U,Neuro musc dys dmd seq alys,,,800.0,5697.5,16 HCPCS,0219T,Plmt post facet implt cerv,,,12538.31,31345.78,4 HCPCS,0219U,Nfct agt hiv gnrj seq alys,,,255.08,1812.5,16 HCPCS,0220T,Plmt post facet implt thor,,,12538.31,31345.78,4 HCPCS,0220U,Onc brst ca ai assmt 12 feat,,,60.59,1765.62,16 HCPCS,0221T,Plmt post facet implt lumb,,,7086.45,17716.12,4 HCPCS,0221U,Abo gnotyp next gnrj seq abo,,,228.9,687.08,16 HCPCS,0222U,Rhd&rhce gntyp next gnrj seq,,,228.9,707.2,16 HCPCS,0223U,Nfct ds 22 trgt sars-cov-2,,,166.71,1041.95,16 HCPCS,0224U,Antibody sars-cov-2 titer(s),,,20.57,128.58,16 HCPCS,0225U,Nfct ds dna&rna 21 sarscov2,,,166.71,1041.95,16 HCPCS,0226U,Svnt sarscov2 elisa plsm srm,,,16.91,105.7,16 HCPCS,0227U,Rx asy prsmv 30+rx/metablt,,,31.92,155.35,16 HCPCS,0228U,Onc prst8 ma molec prfl alg,,,173.03,432.58,16 HCPCS,0229U,Bcat1 promoter mthyltn alys,,,33.47,960.0,16 HCPCS,0230U,Ar full sequence analysis,,,241.08,753.38,16 HCPCS,0231U,Cacna1a full gene analysis,,,677.02,2115.68,16 HCPCS,0232T,Hc Cash Only Stem Cell Procedure,910.0,364.0,,,0 HCPCS,0232T,Hc Harvest Perp Inject Prp With A2M-Cash Only,4225.0,1690.0,,,0 HCPCS,0232T,Hc Harvest Prep Inject Prp With Supershot-Cash Only,4225.0,1690.0,,,0 HCPCS,0232T,Njx platelet plasma,,,436.27,1090.68,4 HCPCS,0232U,Cstb full gene analysis,,,219.86,687.08,16 HCPCS,0233U,Fxn gene analysis,,,219.86,687.08,16 HCPCS,0234T,Trluml perip athrc renal art,,,11274.1,28185.26,4 HCPCS,0234U,Mecp2 full gene analysis,,,330.74,1319.68,16 HCPCS,0235U,Pten full gene analysis,,,600.0,1500.0,16 HCPCS,0236T,Trluml perip athrc abd aorta,,,11274.1,28185.26,4 HCPCS,0236U,Smn1&smn2 full gene analysis,,,241.08,1506.75,16 HCPCS,0237T,Trluml perip athrc brchiocph,,,11274.1,28185.26,4 HCPCS,0237U,Car ion chnlpthy gen seq pnl,,,100.0,1462.25,16 HCPCS,0238T,Trluml perip athrc iliac art,,,17902.75,44756.89,4 HCPCS,0238U,Onc lnch syn gen dna seq aly,,,100.0,1462.25,16 HCPCS,0239U,Trgt gen seq alys pnl 311+,,,239.16,8750.0,16 HCPCS,0240U,Nfct ds vir resp rna 3 trgt,,,57.05,156.89,11 HCPCS,0241U,Nfct ds vir resp rna 4 trgt,,,57.05,156.89,11 HCPCS,0242U,Trgt gen seq alys pnl 55-74,,,2000.0,12500.0,16 HCPCS,0243U,Ob pe biochem assay pgf alg,,,11.94,161.02,16 HCPCS,0244U,Onc solid orgn dna 257 genes,,,239.16,8750.0,16 HCPCS,0245U,Onc thyr mut alys 10 gen&37,,,1266.07,3165.18,16 HCPCS,0246U,Rbc dna gnotyp 16 bld groups,,,228.9,1800.0,16 HCPCS,0247U,Ob prtrm brth ibp4 shbg meas,,,10.73,1875.0,16 HCPCS,0248U,Onc brn sphrd cll 12 rx pnl,,,239.16,7584.65,16 HCPCS,0249U,Onc brst alys 32 phsprtn alg,,,1549.2,5547.82,16 HCPCS,0250U,Onc sld org neo dna 505 gene,,,1167.84,7299.0,16 HCPCS,0251U,Hepcidin-25 elisa serum/plsm,,,5.92,43.18,16 HCPCS,0252U,Ftl aneuploidy str alys dna,,,500.0,1897.62,16 HCPCS,0253T,Insert aqueous drain device,,,4036.72,10091.79,4 HCPCS,0253U,Rprdtve med rna gen prfl 238,,,500.0,7898.55,16 HCPCS,0254U,Reprdtve med alys 24 chrmsm,,,500.0,1897.62,16 HCPCS,0255U,Andrology infertility assmt,,,4.41,79.0,16 HCPCS,0256U,Tma/tmao prfl ms/ms ur alg,,,9.64,399.88,16 HCPCS,0257U,Vlcad leuk nzm actv whl bld,,,8.92,1781.18,16 HCPCS,0258U,Ai psor mrna 50-100 gen alg,,,1500.0,9187.5,16 HCPCS,0259U,Neph ckd nuc mrs meas gfr,,,4.97,131.78,16 HCPCS,0260U,Rare ds id opt genome mapg,,,66.38,3158.82,16 HCPCS,0261U,Onc clrct ca img alys w/ai,,,203.55,6283.12,16 HCPCS,0262U,Onc sld tum rt-pcr 7 gen,,,1148.4,8000.0,16 HCPCS,0263T,Im b1 mrw cel ther cmpl,,,4253.6,10634.01,4 HCPCS,0263U,Neuro asd meas 16 c metblt,,,336.26,1875.0,16 HCPCS,0264T,Im b1 mrw cel ther xcl hrvst,,,4253.6,10634.01,4 HCPCS,0264U,Rare ds id opt genome mapg,,,7.49,3158.82,16 HCPCS,0265T,Im b1 mrw cel ther hrvst onl,,,4253.6,10634.01,4 HCPCS,0265U,Rar do whl gn&mtcdrl dna als,,,1702.85,13689.5,16 HCPCS,0266U,Unxpl cnst hrtbl do gn xprsn,,,7.49,8000.0,16 HCPCS,0267U,Rare do id opt gen mapg&seq,,,426.88,16848.32,16 HCPCS,0268T,Hc Barostim Generator Change,5462.5,2185.0,,,0 HCPCS,0268U,Hem ahus gen seq alys 15 gen,,,113.15,1520.42,16 HCPCS,0269U,Hem aut dm cgen trmbctpna 14,,,109.93,1520.42,16 HCPCS,0270U,Hem cgen coagj do 20 genes,,,344.63,1520.42,16 HCPCS,0271U,Hem cgen neutropenia 23 gen,,,456.58,1520.42,16 HCPCS,0272U,Hem genetic bld do 51 genes,,,372.11,1520.42,16 HCPCS,0273U,Hem gen hyprfibrnlysis 8 gen,,,25.58,1520.42,16 HCPCS,0274T,Perq lamot/lam crv/thrc,,,7086.45,17716.12,4 HCPCS,0274U,Hem gen pltlt do 43 genes,,,111.54,1520.42,16 HCPCS,0275T,Hc Mild Procedure,17238.65,6895.46,,,0 HCPCS,0275U,Hc Reflex -Heparin-Induced Thromobocytopenia Evaluation - Pea-So+,514.8,205.92,,,0 HCPCS,0275U,Hem heprn nduc trmbctpna srm,,,9.07,45.92,16 HCPCS,0276U,Hem inh thrombocytopenia 23,,,9.07,6121.4,16 HCPCS,0277U,Hem gen pltlt funcj do 31,,,109.93,1520.42,16 HCPCS,0278T,Tempr,,,125.66,314.16,4 HCPCS,0278U,Hem gen thrombosis 12 genes,,,569.26,1520.42,16 HCPCS,0279U,Hem vw factor&clgn iii bndg,,,6.91,28.82,16 HCPCS,0280U,Hem vw factor&clgn iv bndg,,,6.91,43.18,16 HCPCS,0281U,Hem vwd propeptide ag lvl,,,6.91,43.18,16 HCPCS,0282U,Rbc dna gntyp 12 bld grp gen,,,228.9,1800.0,16 HCPCS,0283U,Vw factor type 2b eval plsm,,,9.35,46.0,16 HCPCS,0284U,Vw factor type 2n eval plsm,,,11.33,43.18,16 HCPCS,0285U,Onc rsps radj cll fr dna tox,,,11.33,1108.28,16 HCPCS,0286U,Cep72 nudt15&tpmt gene alys,,,134.13,335.32,16 HCPCS,0287U,Onc thyr dna&mrna 112 genes,,,1440.0,9000.0,16 HCPCS,0288U,Onc lung mrna quan pcr 11&3,,,1148.4,9682.5,16 HCPCS,0289U,Neuro alzheimer mrna 24 gen,,,168.13,1900.0,16 HCPCS,0290U,Pain mgmt mrna gen xprsn 36,,,760.0,1900.0,16 HCPCS,0291U,Psyc mood do mrna 144 genes,,,423.14,4387.5,16 HCPCS,0292U,Psyc strs do mrna 72 genes,,,423.14,4387.5,16 HCPCS,0293U,Psyc suicidal idea mrna 54,,,423.14,1900.0,16 HCPCS,0294U,Lngvty&mrtlty rsk mrna 18gen,,,760.0,1246.4,12 HCPCS,0295U,Onc brst dux carc 7 proteins,,,1549.2,13587.5,16 HCPCS,0296U,Onc orl&/orop ca 20 mlc feat,,,1440.0,4875.0,16 HCPCS,0297U,Onc pan tum whl gen seq dna,,,208.0,7299.0,16 HCPCS,0298U,Onc pan tum whl trns seq rna,,,208.0,7299.0,16 HCPCS,0299U,Onc pan tum whl gen opt mapg,,,208.0,4658.05,16 HCPCS,0300U,Onc pan tum whl gen seq&opt,,,208.0,10457.82,16 HCPCS,0301U,Iadna bartonella ddpcr,,,205.82,656.8,16 HCPCS,0302U,Iadna brtnla ddpcr flwg liq,,,205.82,903.42,16 HCPCS,0303U,Hem rbc ads whl bld hypoxic,,,12.34,5504.05,16 HCPCS,0304U,Hem rbc ads whl bld normoxic,,,12.34,5189.5,16 HCPCS,0305U,Hem rbc fnclty&dfrm shr strs,,,12.34,1656.45,16 HCPCS,0306U,Onc mrd nxt-gnrj alys 1st,,,239.16,9696.12,16 HCPCS,0307U,Onc mrd nxt-gnrj alys sbsq,,,239.16,1986.22,16 HCPCS,0308U,Crd cad alys 3 prtn plsm alg,,,45.77,976.88,16 HCPCS,0309U,Crd cv ds aly 4 prtn plm alg,,,45.77,976.88,16 HCPCS,0310U,Ped vsclts kd alys 3 bmrks,,,6.39,976.88,16 HCPCS,0311U,Nfct ds bct quan antmcrb sc,,,8.08,20.2,16 HCPCS,0312U,Ai ds sle alys 8 igg autoant,,,336.26,2101.62,16 HCPCS,0313U,Onc pncrs dna&mrna seq 74,,,1440.0,9000.0,16 HCPCS,0314U,Onc cutan mlnma mrna 35 gene,,,1549.2,4875.0,16 HCPCS,0315U,Onc cutan sq cll ca mrna 40,,,1549.2,21250.0,16 HCPCS,0316U,B brgdrferi lyme ds ospa evl,,,7.65,46.65,16 HCPCS,0317U,Onc lung ca 4-prb fish assay,,,304.0,5075.0,16 HCPCS,0318U,Ped whl gen mthyltn alys 50+,,,33.2,4426.2,16 HCPCS,0319U,Neph rna pretrnspl perph bld,,,208.0,6625.0,16 HCPCS,0320U,Neph rna psttrnspl perph bld,,,208.0,6625.0,16 HCPCS,0321U,Iadna gu pthgn 20bct&fng org,,,257.13,1587.1,16 HCPCS,0322U,Neuro asd meas 14 acyl carn,,,336.26,1875.0,16 HCPCS,0323U,Iadna cns pthgn next gen seq,,,21.15,5315.5,16 HCPCS,0324U,Onc ovar sphrd cell 4 rx pnl,,,239.16,239.16,4 HCPCS,0325U,Onc ovar sphrd cell parp,,,239.16,239.16,4 HCPCS,0326U,Trgt gen seq alys pnl 83+,,,2000.0,12500.0,16 HCPCS,0327U,Ftl aneuploidy trsmy dna seq,,,500.0,1987.5,16 HCPCS,0328U,Drug assay 120+ rx&metablt,,,31.92,286.08,16 HCPCS,0329U,Onc neo xome&trns seq alys,,,325.33,8594.95,16 HCPCS,0330T,Tear film img uni/bi w/i&r,,,36.48,91.19,4 HCPCS,0330U,Iadna vag pthgn panel 27 org,,,17.33,1041.95,16 HCPCS,0331T,Heart symp image plnr,,,1264.36,3160.9,4 HCPCS,0331U,Onc hl neo opt gen mapping,,,208.0,4658.05,16 HCPCS,0332T,Heart symp image plnr spect,,,1264.36,3160.9,4 HCPCS,0332U,Onc pan tum gen prflg 8 dna,,,1142.06,2855.15,16 HCPCS,0333U,Onc lvr surveilanc hcc cfdna,,,662.32,2000.0,16 HCPCS,0334U,Onc sld orgn tgsa dna 84/+,,,1167.8,8750.0,16 HCPCS,0335T,Extraosseous joint stblztion,,,7086.45,17716.12,8 HCPCS,0335U,Rare ds whl gen seq fetal,,,66.2,13061.5,16 HCPCS,0336T,Lap ablat uterine fibroids,,,8330.0,9743.0,4 HCPCS,0336U,Rare ds whl gen seq bld/slv,,,33.2,6436.62,16 HCPCS,0337U,Onc plsm cell do&myeloma id,,,121.34,6087.5,16 HCPCS,0338T,Hc Vasc Transcatheter Renal Sympath Denervation Unilateral,18850.0,7540.0,,,0 HCPCS,0338T,Trnscth renal symp denrv unl,,,5558.41,13896.01,4 HCPCS,0338U,Onc sld tum crcg tum cl slct,,,121.34,6087.5,16 HCPCS,0339T,Hc Vasc Transcatheter Renal Sympath Denervation Bilateral,21060.0,8424.0,,,0 HCPCS,0339T,Trnscth renal symp denrv bil,,,5558.41,13896.01,4 HCPCS,0339U,Onc prst8 mrna hoxc6 & dlx1,,,304.0,1900.0,16 HCPCS,0340U,Onc pan ca alys mrd plasma,,,3590.0,8975.0,16 HCPCS,0341U,Ftl aneup dna seq cmpr alys,,,500.0,4750.5,16 HCPCS,0342T,Thxp apheresis w/hdl delip,,,4253.6,10634.01,4 HCPCS,0342U,Onc pncrtc ca mult ia eclia,,,10.28,1076.4,12 HCPCS,0343U,Onc prst8 xom aly 442 sncrna,,,200.0,1900.0,16 HCPCS,0344U,Hep nafld semiq evl 28 lipid,,,201.36,1980.42,16 HCPCS,0345U,Psyc genom alys pnl 15 gen,,,423.14,3340.22,16 HCPCS,0346U,Beta amyl a?40&a?42 lc-ms/ms,,,45.77,102.59,11 HCPCS,0347T,Ins bone device for rsa,,,57.61,144.03,4 HCPCS,0347U,Rx metab/pcx dna 16 gen alys,,,699.2,3340.22,16 HCPCS,0348T,RSA spine exam,,,102.1,255.25,4 HCPCS,0348U,Rx metab/pcx dna 25 gen alys,,,699.2,1855.68,16 HCPCS,0349T,RSA upper extr exam,,,102.1,255.25,4 HCPCS,0349U,Rx metab/pcx dna 27gen rx ia,,,699.2,1855.68,16 HCPCS,0350T,RSA lower extr exam,,,84.99,212.47,4 HCPCS,0350U,Rx metab/pcx dna 27 gen alys,,,699.2,3340.22,16 HCPCS,0351U,Nfct ds bct/viral trail ip10,,,57.05,651.25,16 HCPCS,0352U,Nfct ds bv&vaginitis amp prb,,,57.05,156.89,11 HCPCS,0353U,Iadna chlmyd&gonorr amp prb,,,17.33,17.33,4 HCPCS,0354U,Hpv hi rsk qual mrna e6/e7,,,19.1,19.1,4 HCPCS,0355U,Apol1 risk variants,,,137.0,342.5,16 HCPCS,0356U,Onc orop 17 dna ddpcr alg,,,1440.0,4500.0,16 HCPCS,0357U,Onc mlnma ai quan alys 142,,,1500.0,1500.0,4 HCPCS,0358T,BIA whole body,,,28.25,70.62,4 HCPCS,0358T,Hc Bia Whole Body Composition Assessment With Interpretation & Report,84.5,33.8,,,0 HCPCS,0358U,Neuro alys b-amyl 1-42&1-40,,,168.13,651.25,16 HCPCS,0359U,Onc prst8 ca alys all psa,,,304.0,1900.0,16 HCPCS,0360U,Onc lung elisa 7 autoant alg,,,358.8,2101.62,16 HCPCS,0361U,Neurflmnt lt chn dig ia quan,,,6.91,127.85,11 HCPCS,0362T,Expose behav assessment,,,36.59,91.48,4 HCPCS,0362U,Onc pap thyr ca rna 82&10,,,82.92,9000.0,16 HCPCS,0363U,Onc urthl mrna 5 gen alg,,,200.0,1900.0,16 HCPCS,0364U,Onc hl neo gen seq alys alg,,,80.97,5018.12,16 HCPCS,0365U,Onc bldr 10 prb bldr ca,,,358.8,2242.5,16 HCPCS,0366U,Onc bldr 10 prb recr bldr ca,,,358.8,2242.5,16 HCPCS,0367U,Onc bldr 10 flwg trurl rescj,,,358.8,2255.45,16 HCPCS,0368U,Onc clrct ca mut&mthyltn mrk,,,416.78,1440.0,12 HCPCS,0369U,Iadna gi pthgn 31 org&21 arg,,,205.82,458.46,11 HCPCS,0370U,Iadna surg wnd pthgn 34&21,,,17.33,458.46,11 HCPCS,0371U,Iadna gu pthgn semiq dna16&1,,,17.33,1041.95,16 HCPCS,0372U,Nfct ds gu pthgn arg detcj,,,17.33,1041.95,16 HCPCS,0373T,Exposure behavior treatment,,,36.59,91.48,4 HCPCS,0373U,Iadna rsp tr nfct 17 8 13&16,,,17.33,458.46,11 HCPCS,0374U,Iadna gu pthgn 21 org&21arg,,,17.33,458.46,11 HCPCS,0375U,Onc ovrn bchm asy 7 prtn alg,,,358.8,2242.5,16 HCPCS,0376U,Onc prst8 ca img alys 128,,,200.0,1765.62,16 HCPCS,0377U,Cv ds quan advsrm/plsm lprtn,,,15.58,118.95,16 HCPCS,0378U,Rfc1 repeat xpnsj vrnt alys,,,45.77,342.5,16 HCPCS,0379T,Vis field assmnt tech suppt,,,36.48,91.19,4 HCPCS,0379U,Tgsap sl or neo dna523&rna55,,,303.81,8221.28,16 HCPCS,0380U,Rx metb advrs trgt sq aly 20,,,416.78,699.2,11 HCPCS,0381U,Maple syrup ur ds mntr quan,,,38.0,110.3,16 HCPCS,0382U,Hyprphenylalninmia mntr quan,,,45.77,129.1,16 HCPCS,0383U,Tyrosinemia typ i mntr quan,,,45.77,130.12,16 HCPCS,0384U,Neph ckd rsk hi stg kdn ds,,,4.97,1875.0,16 HCPCS,0385U,Neph ckd alg rsk dbtc kdn ds,,,4.97,976.88,16 HCPCS,0386U,Gi barrett esoph mthyltn aly,,,336.26,336.26,4 HCPCS,0387U,Onc mlnma ambra1&amlo,,,6.39,2371.25,16 HCPCS,0388U,Onc nonsm cll lng ca 37 gen,,,11.94,8750.0,16 HCPCS,0389U,Ped fbrl kd ifi27&mcemp1 rna,,,6.39,175.5,16 HCPCS,0390U,Ob pe kdr eng&rbp4 ia alg,,,11.94,161.02,16 HCPCS,0391U,Onc sld tum dna&rna 437 gen,,,239.16,9000.0,16 HCPCS,0392U,Rx metab genrx ia 16 genes,,,699.2,3340.22,16 HCPCS,0393U,Neu prksn msfl ?-syncln prtn,,,50.0,1352.48,16 HCPCS,0394U,Pfas 16 pfas compnd lc ms/ms,,,45.77,496.85,16 HCPCS,0395T,Hdr elctr ntrst/ntrcv brchtx,,,680.18,1700.45,4 HCPCS,0395U,Onc lng multiomics plsm alg,,,358.8,1993.62,16 HCPCS,0396U,Ob preimpltj tst 300000 dna,,,10.73,10.73,4 HCPCS,0397U,Onc nonsm cll lng ca 109,,,1148.4,1148.4,4 HCPCS,0398U,Gi baret esph dna mthyln aly,,,336.26,4387.5,16 HCPCS,0399U,Neuro cere folate defncy srm,,,168.13,750.0,16 HCPCS,0400U,Ob xpnd car scr 145 genes,,,10.73,1748.26,12 HCPCS,0401U,Crd c hrt ds 9 gen 12 vrnts,,,45.77,1224.2,16 HCPCS,0402T,Collagen crosslinking cornea,,,2321.86,5804.65,4 HCPCS,0402U,Nfct agt sti mult amp prb tq,,,17.33,356.58,16 HCPCS,0403T,Hc Ndpp Diabetes Prevent Prgm Sessions 5-9,57.5,23.0,,,0 HCPCS,0403T,Hc Ndpp Diabetes Prevent Prgm Enrollment Visit,63.25,25.3,,,0 HCPCS,0403T,Hc Ndpp Diabetes Prevent Prgm Participant Progress Group,241.5,96.6,,,0 HCPCS,0403T,Hc Ndpp Diabetes Prevent Prgm Participant Progress Ind,184.0,73.6,,,0 HCPCS,0403T,Hc Ndpp Diabetes Prevent Prgm Sessions 1-4,32.2,12.88,,,0 HCPCS,0403U,Onc prst8 mrna 18 gen dre ur,,,304.0,1900.0,16 HCPCS,0404U,Onc brst semiq meas thym kn,,,322.96,1549.2,16 HCPCS,0405U,Onc pncrtc 59 mthltn blk mrk,,,335.33,4426.2,16 HCPCS,0406U,Onc lung flow cytmtry 5 mrk,,,27.22,1900.0,16 HCPCS,0407U,Neph dbtc ckd mult eclia alg,,,336.26,2375.0,16 HCPCS,0408T,Hc Cardiac Contractility Modiulation System Pulse Generator With Transvenous Electodes,27191.75,10876.7,,,0 HCPCS,0408T,Insj/rplc cardiac modulj sys,,,30654.5,76636.25,4 HCPCS,0408U,Iaad blk ac wv bsnsr sarscv2,,,14.13,35.32,16 HCPCS,0409T,Insj/rplc car modulj pls gn,,,21723.17,54307.93,4 HCPCS,0409U,Onc sld tum dna 80 & rna 36,,,239.16,7299.0,16 HCPCS,0410T,Hc Ccm Insert Atrial Lead Only,13512.5,5405.0,,,0 HCPCS,0410T,Insj/rplc car modulj atr elt,,,8081.78,20204.45,4 HCPCS,0410U,Onc pncrtc dna whl gn seq 5-,,,208.0,2900.0,16 HCPCS,0411T,Hc Cardiac Contractility Modiulation System Insertion Venticular Electrode Only,13512.5,5405.0,,,0 HCPCS,0411T,Insj/rplc car modulj vnt elt,,,8081.78,20204.45,4 HCPCS,0411U,Psyc genom alys pnl 15 gen,,,423.14,3340.22,16 HCPCS,0412T,Hc Cardiac Contractility Modiulation System Generator Only,7860.25,3144.1,,,0 HCPCS,0412T,Rmvl cardiac modulj pls gen,,,3649.53,9123.83,4 HCPCS,0412U,Beta amyloid a?42/40 imprcip,,,45.77,1875.0,16 HCPCS,0413T,Hc Cardiac Contractility Modiulation System Removal Transvenous Electrodes,8682.5,3473.0,,,0 HCPCS,0413T,Rmvl car modulj tranvns elt,,,3649.53,9123.83,4 HCPCS,0413U,Onc hl neo opt gen mapg dna,,,208.0,3158.82,16 HCPCS,0414T,Hc Cardiac Contractility Modiulation System Removal/Replacement Generator Only,28284.25,11313.7,,,0 HCPCS,0414T,Rmvl & rpl car modulj pls gn,,,21723.17,54307.93,4 HCPCS,0414U,Onc lng aug alg aly whl sld8,,,706.25,1765.62,16 HCPCS,0415T,Hc Ccm Reposition Lead (A Or V),2587.5,1035.0,,,0 HCPCS,0415T,Repos car modulj tranvns elt,,,612.63,1531.57,4 HCPCS,0415U,Cv ds acs bld alg 5 yr score,,,45.77,976.88,16 HCPCS,0416T,Hc Cardiac Contractility Modiulation System Relocate Skin Pocket,5263.55,2105.42,,,0 HCPCS,0416T,Reloc skin pocket pls gen,,,2015.01,5037.52,4 HCPCS,0416U,Iadna gu pthgn 20bct&fng org,,,17.33,17.33,4 HCPCS,0417T,Prgrmg eval cardiac modulj,,,36.45,91.12,4 HCPCS,0417U,Rare ds alys 335 nuc genes,,,66.2,7106.32,16 HCPCS,0418T,Hc Cardiac Contractility Modiulation System Interrogation,286.0,114.4,,,0 HCPCS,0418T,Interro eval cardiac modulj,,,36.45,91.12,4 HCPCS,0418U,Onc brst aug alg aly whl sl8,,,706.25,1765.62,16 HCPCS,0419T,Dstrj neurofibroma xtnsv,,,721.78,1804.45,4 HCPCS,0419U,Nrpsyc gen seq vrnt aly 13,,,423.14,3340.22,16 HCPCS,0420T,Dstrj neurofibroma xtnsv,,,721.78,1804.45,4 HCPCS,0420U,Onc urthl mrna xprsn 6 snp,,,200.0,3320.8,9 HCPCS,0421U,Onc clrct scr sgl amp 8 rna,,,203.55,610.64,12 HCPCS,0422T,Tactile breast img uni/bi,,,84.99,212.47,4 HCPCS,0422U,Onc pan solid tum alys dna,,,11.33,4858.02,9 HCPCS,0423T,Assay secretory type ii pla2,,,20.0,20.0,4 HCPCS,0423U,Psyc genomic alys pnl 26 gen,,,416.78,500.14,12 HCPCS,0424U,Onc prst8 xom alys 53 sncrna,,,200.0,1900.0,16 HCPCS,0425U,Genom rpd seq alys ea cmprtr,,,846.27,10235.98,9 HCPCS,0426U,Genome ultra-rapid seq alys,,,846.27,18955.5,9 HCPCS,0427U,Monocyte dstrbj wdth whl bld,,,4.48,11.2,16 HCPCS,0428U,Onc brst ctdna alys 56/> gen,,,1239.61,1239.61,4 HCPCS,0429U,Hpv orop swab 14 hi-risk typ,,,19.1,87.72,16 HCPCS,0430U,Gi malabs aat calpro pncrtc,,,7.06,153.85,16 HCPCS,0431U,Gly rcptr alpha1 igg srm/csf,,,5.95,91.42,16 HCPCS,0431U,Hc Stiff-Person Spectrum Disorders Evaluation Spps #3-So+,220.5,88.2,,,0 HCPCS,0432U,"Hc Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Csf Mdc2 #4-So+",48.89,19.56,,,0 HCPCS,0432U,"Hc Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum Mds2 #5-So+",55.72,22.29,,,0 HCPCS,0432U,Klhl11 antb sr/csf asy qual,,,5.95,91.42,16 HCPCS,0433U,Onc prst8 5 dna reg mrk pcr,,,304.0,1900.0,16 HCPCS,0434U,Rx metab advrs vrnt alys 25,,,416.78,1041.95,16 HCPCS,0435U,Onc chemo rx cytox csc 14 rx,,,7.46,7584.65,16 HCPCS,0436U,Onc lng plsm alys 388 prtn,,,699.2,3760.6,9 HCPCS,0437U,Psyc anxiety do mrna 15 bmrk,,,423.14,1900.0,16 HCPCS,0438U,Rx metab advrs vrnt alys 33,,,416.78,1041.95,16 HCPCS,0439U,Crd chd dna alys 5 snp 3 dna,,,45.77,2135.0,9 HCPCS,0440T,Abltj perc uxtr/perph nrv,,,1907.04,4767.6,4 HCPCS,0440U,Crd chd dna alys 10 snp 6dna,,,45.77,2135.0,9 HCPCS,0441T,Abltj perc lxtr/perph nrv,,,1907.04,4767.6,4 HCPCS,0441U,Nfct ds bct fngl/viral semiq,,,13.28,1110.2,9 HCPCS,0442U,Nfct ds respir nfctj mxa&crp,,,41.38,166.71,16 HCPCS,0443U,Hc Motor Neuropathy Syndrome Panel Wusm #1-So+,73.97,29.59,,,0 HCPCS,0443U,Neurflmnt lt chn ultrsens ia,,,6.91,290.58,9 HCPCS,0444U,Onc sld orgn neo tgsap 361,,,1167.84,7299.0,16 HCPCS,0445U,Abeta42 & ptau181 eclia csf,,,45.77,651.25,16 HCPCS,0445U,Hc Ptau181/Ab42 Ratio,312.6,125.04,,,0 HCPCS,0446T,Insj impltbl glucose sensor,,,2546.0,10157.63,8 HCPCS,0446U,Ai ds sle alys 10 cytokine,,,336.26,2101.62,16 HCPCS,0447T,Rmvl impltbl glucose sensor,,,195.94,2978.0,8 HCPCS,0447U,Ai ds sle alys 11 cytokine,,,336.26,2101.62,16 HCPCS,0448T,Remvl insj impltbl gluc sens,,,2546.0,10157.63,8 HCPCS,0448U,Onc lng&cln ca dna qual ngs,,,1549.2,1549.2,4 HCPCS,0449T,Insj aqueous drain dev 1st,,,5196.81,12992.02,8 HCPCS,0449U,Car scr sev inh cond 5 genes,,,10.73,2189.86,12 HCPCS,0450U,Onc mm lc-ms/ms monoc p-prtn,,,43.43,325.33,11 HCPCS,0451U,Onc mm lc-ms/ms pep ion quan,,,43.43,325.33,11 HCPCS,0452U,Onc bldr mthyl penk lte-qmsp,,,192.0,480.0,16 HCPCS,0453T,Insj/rplcmt mech-elec ntrfce,,,7639.0,8934.0,4 HCPCS,0453U,Onc clrct ca cfdna qpcr asy,,,77.3,480.0,16 HCPCS,0454T,Insj/rplcmt subq electrode,,,7639.0,8934.0,4 HCPCS,0454U,U rare ds id opt genome mapg,,,426.88,3158.82,16 HCPCS,0455U,Nfct agt sti mult amp prb ur,,,57.05,356.58,16 HCPCS,0456U,Ai ra ngs 19 genes anti-ccp,,,336.26,336.26,4 HCPCS,0457T,Remvl mech-elec skin ntrfce,,,8330.0,9743.0,4 HCPCS,0457U,Pfas 9 cmpnd lcms/ms pls/sr,,,45.77,496.85,16 HCPCS,0458T,Remvl subq electrode,,,8330.0,9743.0,4 HCPCS,0458U,Onc brst ca s100 a8&a9 elisa,,,260.5,1549.2,16 HCPCS,0459U,Abeta42 & ttau eclia csf,,,45.77,651.25,16 HCPCS,0459U,Hc Ttau/Ab42 Ratio,312.6,125.04,,,0 HCPCS,0460T,Repos aortic ventr dev eltrd,,,8330.0,9743.0,4 HCPCS,0460U,Onc whl bld/bucc rtpcr 24gen,,,200.0,2292.7,9 HCPCS,0461U,Onc rxgenom alys rtpcr 24gen,,,699.2,2292.7,9 HCPCS,0462U,Melatonin lvl tst slp std7/9,,,6.91,43.18,16 HCPCS,0463U,Onc crvx mrna genxprsn 14bmk,,,45.77,1900.0,9 HCPCS,0464T,Visual ep test for glaucoma,,,125.66,314.16,4 HCPCS,0464U,Onc clrct scr qrtsa dna mrk,,,203.55,1479.8,16 HCPCS,0465T,Supchrdl njx rxw/o supply,,,2546.0,2978.0,4 HCPCS,0465U,Onc urthl carc dna qmsp 2gen,,,200.0,4845.02,16 HCPCS,0466U,Crd cad dna gwas 564856 snp,,,45.77,863.58,9 HCPCS,0467T,Revj/rplmnt ch respir eltrd,,,8330.0,9743.0,4 HCPCS,0467U,Onc bldr dna ngs 60gen&aneup,,,358.8,3797.65,16 HCPCS,0468T,Rmvl chwal respir eltrd/ra,,,8330.0,9743.0,4 HCPCS,0468U,Hep nash mir34a5p ?2m ykl40,,,201.36,629.25,16 HCPCS,0469U,Rare ds whl gen seq ftl samp,,,33.2,2994.85,16 HCPCS,0470U,Onc orop detcj mrd 8 dna hpv,,,597.91,1494.78,9 HCPCS,0471U,Onc clrc ca 35 vrn kras&nras,,,760.0,1900.0,16 HCPCS,0472T,Prgrmg io rta eltrd ra,,,299.95,749.88,4 HCPCS,0472U,Ca vi psp&sp1 antb sj?gren,,,4.59,69.75,9 HCPCS,0473T,Reprgrmg io rta eltrd ra,,,92.85,232.12,4 HCPCS,0473U,Onc sld tum bld/slv 648 gene,,,6.79,11250.0,16 HCPCS,0474U,Hered pan ca gsap 88gene ngs,,,1303.95,3259.88,16 HCPCS,0475U,Hered prst8 ca gsap 23 genes,,,335.33,3259.88,16 HCPCS,0476U,Rx metab psyc 14gen&cyp2d6,,,416.78,1041.95,16 HCPCS,0477U,Rx metab psy 14&cyp2d6 gn-rx,,,416.78,1041.95,16 HCPCS,0478U,Onc nsclc dna&rna dpcr 9 gen,,,552.99,1382.48,9 HCPCS,0479T,Fxjl abl lsr 1st 100 sq cm,,,721.78,1804.45,4 HCPCS,0479U,Tau phosphorylated ptau217,,,17.27,45.77,16 HCPCS,0480U,Nfct ds csf metag ngs alys,,,21.15,5315.5,16 HCPCS,0481T,Njx autol wbc concentrate,,,436.27,1090.68,4 HCPCS,0481U,Idh1 idh2&tert promoter ngs,,,77.3,1685.6,16 HCPCS,0482U,Ob pe biochem asy sfit1&pigf,,,11.94,322.05,16 HCPCS,0483T,Hc Transcatheter Miral Valve Implantation/Replacement With Prosthetic Valve Percutaneous Approach,20728.75,8291.5,,,0 HCPCS,0483U,Nfct ds ng gyra s91f pt mut,,,17.33,87.72,9 HCPCS,0484U,Nfct ds mgen 23s rrna pt mut,,,14.04,87.72,9 HCPCS,0485T,Oct mid ear i&r unilateral,,,36.48,91.19,4 HCPCS,0485U,Onc sol tum cfdna&rna ngs gm,,,239.16,9123.7,9 HCPCS,0486T,Oct mid ear i&r bilateral,,,36.48,91.19,4 HCPCS,0486U,Onc pan sol tum ngs cfctdna,,,11.33,4110.62,9 HCPCS,0487U,Onc sol tum cfcdna tgsap 84,,,239.16,7299.0,16 HCPCS,0488T,Hc Ndpp Diabetes Prevent Prgm Online/Elec,60.95,24.38,,,0 HCPCS,0488U,Ob fetal ag nipt cfdna alys,,,10.73,910.86,12 HCPCS,0489U,Ob sgnipt cfdna seq alys 1+,,,10.73,1384.34,5 HCPCS,0490U,Onc cutan/uveal mlnma cd146,,,325.33,6087.5,16 HCPCS,0491U,Onc sol tum ctc slct er prtn,,,974.0,6087.5,16 HCPCS,0492U,Onc sol tum ctc slctn pd-l1,,,974.0,6087.5,16 HCPCS,0493U,Trnspl med quan dd-cfdna ngs,,,208.0,6883.12,16 HCPCS,0494U,Rbc ag ftl rhd gene alys ngs,,,228.9,1897.62,16 HCPCS,0495U,Onc prst8 alys crcg plsm prt,,,304.0,1900.0,16 HCPCS,0496U,Onc clrct cfdna 8/7 genes,,,77.3,1214.65,9 HCPCS,0497U,Onc prst8 mrna rt-pcr 6 gene,,,573.2,9682.5,16 HCPCS,0498U,Onc clrct ngs mut detc 43gen,,,335.33,3363.28,9 HCPCS,0499U,Onc clrct&lng dna ngs 8gene,,,6.79,1494.78,16 HCPCS,0500T,Hpv 5+ hi risk hpv types,,,19.1,19.1,4 HCPCS,0500U,Autoinflam ds vexas synd dna,,,175.4,438.5,16 HCPCS,0501U,Onc clrc bld quan meas cfdna,,,77.3,230.4,5 HCPCS,0502U,Hpv e6/e7 mrk hi-rsk typ crv,,,35.09,87.72,16 HCPCS,0503U,Neuro alz ds ?amyl&tau prtn,,,45.77,1875.0,16 HCPCS,0504U,Nfct ds uti id 17 path orgs,,,17.33,1041.95,16 HCPCS,0505T,Ev fempop artl revsc,,,11274.1,28185.26,4 HCPCS,0505U,Nfct ds vag infctj id 32orgs,,,17.33,1699.42,16 HCPCS,0506T,Mac pgmt opt dns meas hfp,,,57.61,144.03,4 HCPCS,0506U,Gi barretts esophgl cell 89,,,33.47,4845.02,16 HCPCS,0507T,Hc Repair Of Tricuspid Valve W/Prosthetic Valve- Additional Valve,46907.0,18762.8,,,0 HCPCS,0507T,Near ifr 2img mibmn glnd i&r,,,57.61,144.03,4 HCPCS,0507U,Onc ovr dna whole gen w/5hmc,,,380.0,2900.0,16 HCPCS,0508U,Trnsplj med dd-cfdna 40 snps,,,208.0,208.0,4 HCPCS,0509T,Pattern erg w/i&r,,,210.87,527.18,4 HCPCS,0509U,Trnsplj med dd-cfdna<12 snps,,,208.0,208.0,4 HCPCS,0510T,Rmvl sinus tarsi implant,,,3195.45,7988.62,4 HCPCS,0510U,Onc pncrtc ca alg alys 16gen,,,10.28,1184.78,9 HCPCS,0511T,Rmvl&rinsj sinus tarsi implt,,,7086.45,17716.12,4 HCPCS,0511U,Onc sol tum 3dmicroenvir 36+,,,1500.0,7584.65,16 HCPCS,0512T,Esw integ wnd hlg 1st wnd,,,195.94,489.85,4 HCPCS,0512U,Onc prst8 alys dgtz img msi,,,706.25,1765.62,16 HCPCS,0513U,Onc prst8 alg alys msi&hrd,,,706.25,1765.62,16 HCPCS,0514U,Gi ibd ia quan deter adl lvl,,,6.91,96.42,16 HCPCS,0515T,Insj wcs lv compl sys,,,21723.17,54307.93,4 HCPCS,0515U,Gi ibd ia quan deter ifx lvl,,,6.91,96.42,16 HCPCS,0516T,Insj wcs lv eltrd only,,,10207.46,25518.66,4 HCPCS,0516U,Rx metab rxgenomic gnotyp 40,,,416.78,1041.95,16 HCPCS,0517T,Insj wcs lv pg compnt,,,10207.46,25518.66,4 HCPCS,0517U,Ther rx mntr 80+ psyactiv rx,,,45.77,617.3,16 HCPCS,0518T,Rmvl pg compnt wcs,,,3649.53,9123.83,4 HCPCS,0518U,Ther rx mntr 90+ pn&mtl hlth,,,45.77,617.3,16 HCPCS,0519T,Rmvl & rplcmt pg compnt wcs,,,10207.46,25518.66,4 HCPCS,0519U,Ther rx mntr meds p/d/a 110+,,,45.77,617.3,16 HCPCS,0520T,Rmvl&rplcmt pg wcs new eltrd,,,10207.46,25518.66,4 HCPCS,0520U,Ther rx mntr 200+ rx/sbsts,,,45.77,617.3,16 HCPCS,0521T,Interrog dev eval wcs ip,,,28.25,70.62,4 HCPCS,0521U,Rf iga&igm ccp antb sr-a ia,,,51.8,336.26,9 HCPCS,0522T,Prgrmg dev eval wcs ip,,,36.45,91.12,4 HCPCS,0522U,Ca vi psp&sp1 antb cl semiql,,,260.5,651.25,9 HCPCS,0523U,Onc soltum dna ngs snv 22gen,,,239.16,3380.22,9 HCPCS,0524T,Ev cath dir chem abltj w/img,,,3083.61,7709.02,4 HCPCS,0524U,Ob pe sflt-1/plgf ia srm/pls,,,11.94,322.05,9 HCPCS,0525T,Insj/rplcmt compl iims,,,18811.05,47027.63,4 HCPCS,0525U,Onc sphrd cell cul 11-rx pnl,,,239.16,7584.65,9 HCPCS,0526T,Insj/rplcmt iims eltrd only,,,8081.78,20204.45,4 HCPCS,0526U,Nefro rnl trnspl quan cxcl10,,,208.0,208.0,4 HCPCS,0527T,Insj/rplcmt iims implt mntr,,,8081.78,20204.45,4 HCPCS,0527U,Hsv 1&2 vzv amp prb tq pthgn,,,17.33,356.58,9 HCPCS,0528T,Prgrmg dev eval iims ip,,,36.45,91.12,4 HCPCS,0528U,Lrt iad 18bct/8vir&7arg rna,,,63.35,1587.1,9 HCPCS,0529T,Interrog dev eval iims ip,,,36.45,91.12,4 HCPCS,0529U,Hem vte snp f2&f5 gen leiden,,,25.58,25.58,4 HCPCS,0530T,Removal complete iims,,,3649.53,9123.83,4 HCPCS,0530U,Onc pan-sol tum ctdna 77 gen,,,208.0,7299.0,9 HCPCS,0531T,Removal iims electrode only,,,3649.53,9123.83,4 HCPCS,0531U,Nfct ds afb&inv fng 673orgs,,,13.28,13.28,4 HCPCS,0532T,Removal iims implt mntr only,,,3649.53,9123.83,4 HCPCS,0532U,Rare ds whlgen&mitochdrl dna,,,66.2,12578.0,9 HCPCS,0533U,Rx metab advrs gnotyp 16gens,,,416.78,1041.95,9 HCPCS,0534U,Onc prst8 mirna snp 32 vrnt,,,573.2,573.2,4 HCPCS,0535U,Pfas lc-ms/ms plsm/srm quan,,,45.77,155.35,9 HCPCS,0536U,Rbcag ftl rhd pcr alys exon4,,,192.0,480.0,9 HCPCS,0537T,Hc Car-T Therapy Hrvg Bld Drv T Lmphcyt Pr Day,5010.0,2004.0,,,0 HCPCS,0537U,Onc clrct ca cfdna >2500 dmr,,,598.0,3737.5,9 HCPCS,0538U,Onc sol tum ngts ffpe 600gen,,,6.79,7473.88,9 HCPCS,0539T,Hc Res-Car-T Rec&Prep,4005.66,1602.26,,,0 HCPCS,0539T,Hc Research Car-T Ip Storage & Administration,6597.55,2639.02,,,0 HCPCS,0539U,Onc sol tumor cfctdna 152gen,,,239.16,8221.28,9 HCPCS,0540T,Hc Car-T Cell Adm-Inf Autologous,1566.0,626.4,,,0 HCPCS,0540U,Trnsplj med quan dd-cfdna,,,208.0,6883.12,9 HCPCS,0541T,Myocardial imaging mcg,,,364.43,911.07,4 HCPCS,0541U,Cv ds hdl rct cec lc-ms/ms 5,,,15.58,15.58,4 HCPCS,0542U,Nefro renal trnspl ur nmr 84,,,208.0,208.0,4 HCPCS,0543U,Onc sol tum ngs dna 517 gens,,,6.79,7473.88,9 HCPCS,0544U,Nefro trnsp mntr 48vrnt dpcr,,,208.0,208.0,4 HCPCS,0545U,Achr antb id imfluor livecll,,,7.36,94.32,9 HCPCS,0546U,Ldns lrp4 antb imflr livecll,,,8.44,94.32,9 HCPCS,0547U,Neurflmnt lt chn cleia plsm,,,6.91,290.58,9 HCPCS,0548U,Gfap cleia plasma,,,6.97,290.58,9 HCPCS,0549U,Onc urthl dna mthyltd rt pcr,,,200.0,1900.0,9 HCPCS,0550U,Onc prst8 elisa tot&free psa,,,304.0,304.0,4 HCPCS,0551U,Tp ptau217 ult dgt prtn detj,,,45.77,45.77,4 HCPCS,0552U,Repr med pga gdo te bx locus,,,500.0,500.0,4 HCPCS,0553U,Repr med pga embry te strux,,,500.0,1897.62,9 HCPCS,0554U,Repr med pga 24chrm te bx qc,,,500.0,1897.62,9 HCPCS,0555T,B1 str&fx rsk transmis data,,,28.25,70.62,4 HCPCS,0555U,Repr med pga embryonic te qc,,,500.0,1897.62,9 HCPCS,0556T,B1 str & fx rsk assessment,,,233.02,582.55,4 HCPCS,0556T,Hc Bone Strength & Fracture Risk Assessment,441.02,176.41,,,0 HCPCS,0556U,Nfct ds p-s dna&rna 12 trgts,,,166.71,171.16,5 HCPCS,0557U,Nfct ds bv dna mrk vag fluid,,,105.2,315.59,5 HCPCS,0558T,Ct scan f/biomchn ct alys,,,84.99,212.47,4 HCPCS,0558U,Onc clrct elisa bf7 ag serum,,,20.81,203.55,9 HCPCS,0559T,Antmc mdl 3d print 1st cmpnt,,,129.94,324.84,4 HCPCS,0559U,Onc brs quan elisa bf9ag srm,,,20.81,1549.2,9 HCPCS,0560U,Onc mrd gsa cfdna baseline,,,239.16,9696.12,9 HCPCS,0561T,Antmc guide 3d print 1st gd,,,129.94,324.84,4 HCPCS,0561U,Onc mrd gsa cfdna subsequent,,,239.16,1986.22,9 HCPCS,0562U,Onc sol tum tgsa 33gens snvs,,,597.91,2000.0,9 HCPCS,0563T,Evac meibomian glnd heat bi,,,57.61,144.03,4 HCPCS,0563U,Nfct ds pthgn-sna 11vir&4bct,,,166.71,1041.95,9 HCPCS,0564T,Onc chemo rx cytotox csc 14,,,231.78,231.78,4 HCPCS,0564U,Nfct ds pthgn-sna 10vir&4bct,,,166.71,1041.95,9 HCPCS,0565U,Onc hcc ngs detc 6626epigalt,,,60.0,2900.0,9 HCPCS,0566U,Onc lng qpcr-bsd alys 13dmrs,,,416.78,1041.95,9 HCPCS,0567U,Rare ds whl gen seq srs&lrs,,,33.2,12578.0,9 HCPCS,0568U,Neurol dementia ?amyl ptau,,,45.77,2242.5,9 HCPCS,0569T,Hc Repair Of Tricuspid Valve With Prosthetic Valve,33173.0,13269.2,,,0 HCPCS,0569U,Onc sol tum ngs tmm>20000dmr,,,598.0,598.0,4 HCPCS,0570T,Hc Repair Of Tricuspid Valve With Prosthetic Valve-Each Additional Valve,33173.0,13269.2,,,0 HCPCS,0570U,Neurol tbi alys gfap&uch-l1,,,45.77,651.25,9 HCPCS,0571T,Insj/rplcmt icds ss eltrd,,,30654.5,76636.25,4 HCPCS,0571U,Onc sol tum dna80&rna10g ngs,,,2000.0,7299.0,9 HCPCS,0572T,Insertion ss dfb electrode,,,8081.78,20204.45,4 HCPCS,0572U,Onc prst8 httl qfish whl bld,,,304.0,304.0,4 HCPCS,0573T,Removal ss dfb electrode,,,3649.53,9123.83,4 HCPCS,0573U,Onc pancreas 3bmrk pclf alg,,,1440.0,1440.0,4 HCPCS,0574T,Repos prev ss impl dfb eltrd,,,3649.53,9123.83,4 HCPCS,0574U,Mtb cfp-10 serum/plsm lc-ms,,,30.71,30.71,4 HCPCS,0575T,Prgrmg dev eval icds ss ip,,,36.45,91.12,4 HCPCS,0575U,Trnsplj med lar rtpcr 4genes,,,380.0,950.0,5 HCPCS,0576T,Interrog dev eval icds ss ip,,,36.45,91.12,4 HCPCS,0576U,Trnsplj med lar quan ddcfdna,,,3240.0,8100.0,5 HCPCS,0577U,Onc ovr serum alys 39 gps,,,296.3,296.3,1 HCPCS,0578U,Onc cutan mln rna qpcr 10gen,,,3873.0,9682.5,5 HCPCS,0579T,Rem interrog dev icds tech,,,36.45,91.12,4 HCPCS,0579U,Nfro dbtc ckd elisa apoa4,,,390.75,976.88,5 HCPCS,0580T,Rmvl ss impl dfb pg only,,,3649.53,9123.83,4 HCPCS,0580U,Bbrgdrferi antb detc 24rprtn,,,17.21,43.02,5 HCPCS,0581T,Abltj mal brst tum perq crtx,,,3823.83,9559.57,4 HCPCS,0581U,Trnspl med antb nohla 39trgt,,,325.8,814.5,5 HCPCS,0582T,Trurl abltj mal prst8 tiss,,,12884.79,32211.97,4 HCPCS,0582U,Rare ds rpd whlgen dna vrnts,,,7582.2,18955.5,5 HCPCS,0583T,Tmpst auto tube dlvr sys,,,1515.28,3788.21,4 HCPCS,0583U,Rare ds rpd whlgen cmptr dna,,,3791.1,9477.75,5 HCPCS,0584U,Neuro csf prion prtn qual,,,540.99,1352.48,5 HCPCS,0585U,Tgsap so neo cfdna 521 genes,,,3503.52,3503.52,1 HCPCS,0586U,Onc mrna gen xprsn 216 genes,,,2919.6,7299.0,5 HCPCS,0587T,Perq impltj/rplcmt isdns ptn,,,6223.89,15559.73,4 HCPCS,0587U,Ther rx mntr 60-150rx&metabl,,,114.43,286.08,5 HCPCS,0588T,Revision/removal isdns ptn,,,3414.31,8535.78,4 HCPCS,0588U,Nfct ds bct/vir 32genes mrna,,,760.0,1900.0,5 HCPCS,0589T,Elec alys smpl prgrmg iins,,,92.85,232.12,4 HCPCS,0589U,Pfas24cmpnd hi-perf lc-ms/ms,,,198.74,496.85,5 HCPCS,0590T,Elec alys cplx prgrmg iins,,,92.85,232.12,4 HCPCS,0591U,Onc prst8 ca 3prtns plsm srm,,,760.0,1900.0,5 HCPCS,0592U,Onc hl neo dna tgs 417 genes,,,2919.6,7299.0,5 HCPCS,0593U,Nfct ds gu pthgn dna 46trgt,,,634.84,1587.1,5 HCPCS,0594T,Osteot hum xtrnl lngth dev,,,7086.45,17716.12,8 HCPCS,0595U,Nfct ds tfp vctrbrn&zoonotic,,,262.99,657.48,5 HCPCS,0596T,Temp fml iu vlv-pmp 1st insj,,,680.98,2978.0,8 HCPCS,0597T,Temp fml iu valve-pmp rplcmt,,,680.98,2978.0,8 HCPCS,0598T,Ncntc r-t fluor wnd img 1st,,,210.87,527.18,4 HCPCS,0598U,Gi ibs igg antb 18food items,,,300.0,750.0,5 HCPCS,0599U,Onc pncrtc ca mult ia serum,,,897.0,2242.5,5 HCPCS,0600T,Hc Ire Ablation 1+Tumors Per Organ W/Img Gdn Perq,11795.44,4718.18,,,0 HCPCS,0600T,Ire abltj 1+tum organ perq,,,10381.14,25952.85,4 HCPCS,0601T,Ire abltj 1+tumors open,,,10381.14,25952.85,4 HCPCS,0609T,Mrs disc pain acquisj data,,,233.02,582.55,4 HCPCS,0611T,Mrs disc pain alg alys data,,,233.02,582.55,4 HCPCS,0614T,Rmvl&rplcmt ss impl dfb pg,,,21723.17,54307.93,4 HCPCS,0615T,Eye mvmt alys w/o calbrj i&r,,,129.94,324.84,4 HCPCS,0619T,Cysto w/prst8 commissurotomy,,,8330.0,9743.0,4 HCPCS,0620T,Evasc ven artlz tibl/prnl vn,,,43015.98,107539.94,4 HCPCS,0621T,Trabeculostomy interno laser,,,4036.72,10091.79,4 HCPCS,0625T,Hc Ct Angio Data On Plaque In Heart Arteries (Add On),1265.0,506.0,,,0 HCPCS,0627T,Hc Percutaneous Injection Of Allogeneic Cell Or Tissue Based Material Into Spinal Disc Of Lower Back,16728.66,6691.46,,,0 HCPCS,0627T,Perq njx algc fluor lmbr 1st,,,12538.31,31345.78,4 HCPCS,0629T,Hc Percutaneous Injection Of Cell Or Tissue-Based Material Into Spinal Disc Of Lower Back With Ct Im,18401.53,7360.61,,,0 HCPCS,0629T,Perq njx algc ct lmbr 1st,,,12538.31,31345.78,4 HCPCS,0632T,Perq tcat us abltj nrv p-art,,,17902.75,44756.89,4 HCPCS,0633T,Ct breast w/3d uni c-,,,102.1,255.25,4 HCPCS,0634T,Ct breast w/3d uni c+,,,171.3,428.24,4 HCPCS,0635T,Ct breast w/3d uni c-/c+,,,171.3,428.24,4 HCPCS,0636T,Ct breast w/3d bi c-,,,233.02,582.55,4 HCPCS,0637T,Ct breast w/3d bi c+,,,340.71,851.78,4 HCPCS,0638T,Ct breast w/3d bi c-/c+,,,340.71,851.78,4 HCPCS,0640T,Ncntc nr ifr spctrsc wnd,,,36.48,91.19,4 HCPCS,0643T,Hc Transcatheter Ventricular Restoration Implantation,3750.0,1500.0,,,0 HCPCS,0644T,Hc Angiovac Cardiac Thrombus,2686.4,1074.56,,,0 HCPCS,0644T,Hc Angiovac Valve Endocarditis,2557.6,1023.04,,,0 HCPCS,0644T,Hc Transcath Removal Intracardiac Mass,8550.25,3420.1,,,0 HCPCS,0644T,Hc Tricuspid Valve Rep Percut,1868.75,747.5,,,0 HCPCS,0644T,Tcat rmvl/dblk icar mas perq,,,5558.41,13896.01,4 HCPCS,0645T,Tcat impltj c sins rdctj dev,,,17902.75,44756.89,4 HCPCS,0646T,Hc Tricuspid Valve Rep Percut,1868.75,747.5,,,0 HCPCS,0647T,Insj gtube perq mag gastrpxy,,,1874.01,4685.03,4 HCPCS,0648T,Hc Quantitative Magnetci Resonance Analysis For Tissue Compsition Without Diagnostic Mri Exam,1150.0,460.0,,,0 HCPCS,0648T,Quan mr alys tiss w/o mri,,,908.58,2271.46,4 HCPCS,0649T,Hc Quantitative Magnetic Resonance Analysis Of Tissue Coposition With Diagnostic Mri Exam,1450.0,580.0,,,0 HCPCS,0649T,Quan mr alys tiss w/mri,,,908.58,2271.46,4 HCPCS,0650T,Hc Remote Program Ilr,81.17,32.47,,,0 HCPCS,0650T,Prgrmg dev eval scrms remote,,,36.45,91.12,4 HCPCS,0651T,Mag ctrld capsule endoscopy,,,885.77,2214.41,4 HCPCS,0652T,Egd flx transnasal dx br/wa,,,1874.01,4685.03,4 HCPCS,0653T,Egd flx transnasal bx 1/ml,,,1874.01,4685.03,4 HCPCS,0654T,Egd flx transnasal tube/cath,,,3765.27,9413.18,4 HCPCS,0655T,Tprnl focal abltj mal prst8,,,5236.35,13090.88,4 HCPCS,0656T,Vrt bdy tethering ant,,,17123.6,42809.0,4 HCPCS,0657T,Vrt bdy tethering ant 8+ seg,,,17123.6,42809.0,4 HCPCS,0658T,Elec impd spectrsc 1+skn les,,,57.61,144.03,4 HCPCS,0660T,Implt ant sgm io nbio rx sys,,,4036.72,10091.79,4 HCPCS,0661T,Rmvl&Rimpltj ant sgm implt,,,4036.72,10091.79,4 HCPCS,0662T,Hc Scalp Cooling 1St Measurement & Cap Calibration,2587.5,1035.0,,,0 HCPCS,0663T,Hc Scalp Cooling Placement Montioring And Removal Of Device,143.75,57.5,,,0 HCPCS,0671T,Insj ant sgm aq drg dev 1+,,,5196.81,12992.02,4 HCPCS,0673T,Abltj b9 thyr ndul perq lasr,,,1612.96,4032.39,4 HCPCS,0674T,Laps insj nw/rpcmt prm isdss,,,30135.76,75339.4,4 HCPCS,0675T,Laps insj nw/rpcmt isdss 1ld,,,10882.0,27205.01,4 HCPCS,0677T,Laps repos lead isdss 1st ld,,,10381.14,25952.85,4 HCPCS,0679T,Laps rmvl lead isdss,,,10381.14,25952.85,4 HCPCS,0680T,Insj/rplcmt pg only isdss,,,18946.23,47365.59,4 HCPCS,0681T,Rlcj pulse gen only isdss,,,3414.31,8535.78,4 HCPCS,0682T,Removal pulse gen only isdss,,,3414.31,8535.78,4 HCPCS,0683T,Prgrmg dev eval isdss ip,,,36.45,91.12,4 HCPCS,0685T,Interrog dev eval isdss ip,,,36.45,91.12,4 HCPCS,0689T,Quan us tis charac w/o dx us,,,84.99,212.47,4 HCPCS,0692T,Hc Ultrafilitration Daily,517.5,207.0,,,0 HCPCS,0692T,Hc Ultrafilitration Set Up/Change Incl Kit,4398.75,1759.5,,,0 HCPCS,0692T,Therapeutic ultrafiltration,,,1520.99,3802.47,4 HCPCS,0696T,Bdy surf mapg pm/cvdfb f/up,,,36.45,91.12,4 HCPCS,0697T,Quan mr tis wo mri mlt orgn,,,908.58,2271.46,4 HCPCS,0698T,Quan mr tiss w/mri mlt orgn,,,908.58,2271.46,4 HCPCS,0699T,Njx pst chmbr eye medication,,,2253.83,5634.58,4 HCPCS,0707T,Njx b1 sub mtrl sbchdrl dfct,,,3195.45,7988.62,4 HCPCS,0712T,N-nvs artl plaq alys quan,,,210.87,527.18,4 HCPCS,0714T,Tprnl lsr ablt b9 prst8 hypr,,,5236.35,13090.88,4 HCPCS,0716T,Car acous wavfrm rec cad rsk,,,57.61,144.03,4 HCPCS,0717T,Adrc ther prtl rc tear,,,3460.82,8652.04,4 HCPCS,0718T,Adrc ther prtl rc tear njx,,,3460.82,8652.04,4 HCPCS,0720T,Hc Percutaneous Electrical Nerve Field Stimulation Cranial Nerves Include Device,7528.3,3011.32,,,0 HCPCS,0720T,Hc Percutaneous Electrical Nerve Field Stimulation Cranial Nerves W/O Device,1703.0,681.2,,,0 HCPCS,0723T,Qmrcp w/o dx mri sm anat ses,,,908.58,2271.46,4 HCPCS,0724T,Qmrcp w/dx mri same anatomy,,,908.58,2271.46,4 HCPCS,0730T,Trabeculotomy lsr w/oct gdn,,,5196.81,12992.02,4 HCPCS,0731T,Augmnt ai-based fcl phnt a/r,,,57.61,144.03,4 HCPCS,0736T,Colonic lavage 35+l water,,,125.66,314.16,4 HCPCS,0737T,Xenograft impltj artclr surf,,,12538.31,31345.78,4 HCPCS,0740T,Rem auton alg nsln cal setup,,,57.61,144.03,4 HCPCS,0741T,Rem auton alg nsln data coll,,,36.45,91.12,4 HCPCS,0743T,B1 str & fx rsk vrt fx assmt,,,233.02,582.55,4 HCPCS,0744T,Insj bioprostc vlv fem vn,,,5434.3,13585.75,4 HCPCS,0751T,Dgtz gls mcrscp sld level ii,,,3.77,3.77,4 HCPCS,0752T,Dgtz gls mcrscp sld lvl iii,,,4.9,4.9,4 HCPCS,0753T,Dgtz gls mcrscp sld level iv,,,8.26,8.26,4 HCPCS,0754T,Dgtz gls mcrscp sld level v,,,33.27,33.27,4 HCPCS,0755T,Dgtz gls mcrscp sld level vi,,,50.24,50.24,4 HCPCS,0756T,Dgtz gls mcrscp sld spc grpi,,,12.86,12.86,4 HCPCS,0757T,Dgtz gls mcrscp sl spc grpii,,,9.33,9.33,4 HCPCS,0758T,Dgtz gls mcrscp sl spc hchem,,,10.38,10.38,4 HCPCS,0759T,Dgtz gls mcrscp sl sp grpiii,,,15.49,15.49,4 HCPCS,0760T,Dgtz gls mcrscp sl imm 1st,,,11.51,11.51,4 HCPCS,0761T,Dgtz gls mcrscp sl imm ea 1,,,9.9,9.9,4 HCPCS,0762T,Dgtz gls mcrscp sl imm ea m,,,19.22,19.22,4 HCPCS,0763T,Dgtz gls mcrscp mphmtrc alys,,,13.6,13.6,4 HCPCS,0764T,Asstv alg ecg rsk asmt cncrt,,,129.94,324.84,4 HCPCS,0765T,Asstv alg ecg rsk asmt prev,,,129.94,324.84,4 HCPCS,0766T,Tc mag stimj pn 1st tx 1nrv,,,210.87,527.18,4 HCPCS,0778T,Smmg cncrnt appl imu snr,,,125.66,314.16,4 HCPCS,0779T,Gi myoelectrical actv study,,,364.43,911.07,4 HCPCS,0780T,Instlj fecal microbiota ssp,,,129.94,324.84,4 HCPCS,0783T,Tc auriculr neurostimulation,,,125.66,314.16,4 HCPCS,0784T,Ins/rplmt eltrd ra spi nstim,,,10882.0,27205.01,4 HCPCS,0785T,Revj/rmvl nea spi w/nstim,,,3414.31,8535.78,4 HCPCS,0786T,Insj/rplcmt prq ra sac nstim,,,10882.0,27205.01,4 HCPCS,0787T,Revj/rmvl nea sac w/nstim,,,3414.31,8535.78,4 HCPCS,0788T,Elec aly smp iins sp/sac nrv,,,92.85,232.12,4 HCPCS,0789T,Elec aly cpx iins sp/sac nrv,,,92.85,232.12,4 HCPCS,0790T,Revj rplcmt/rmvl vrt tethrg,,,17123.6,42809.0,4 HCPCS,0793T,Prq tcat thrm ablt nrv p-art,,,17902.75,44756.89,4 HCPCS,0794T,Pt spec alg rx-onc tx option,,,57.61,144.03,4 HCPCS,0795T,Tcat ins 2chmbr ldls pm cmpl,,,18811.05,47027.63,4 HCPCS,0796T,Tcat ins 2chmbr ldls pm ra,,,18811.05,47027.63,4 HCPCS,0797T,Tcat ins 2chmbr ldls pm rv,,,18811.05,47027.63,4 HCPCS,0798T,Tcat rmv 2chmbr ldls pm cmpl,,,3083.61,7709.02,4 HCPCS,0799T,Tcat rmvl 2chmbr ldls pm ra,,,3083.61,7709.02,4 HCPCS,0800T,Tcat rmvl 2chmbr ldls pm rv,,,3083.61,7709.02,4 HCPCS,0801T,Tcat rmv&rpl 2chmbr ldls pm,,,18811.05,47027.63,4 HCPCS,0802T,Tcat rmv&rpl2chmb ldls pm ra,,,18811.05,47027.63,4 HCPCS,0803T,Tcat rmv&rpl2chmb ldls pm rv,,,18811.05,47027.63,4 HCPCS,0804T,Prgrmg evl ldls pm 2chmbr ip,,,36.45,91.12,4 HCPCS,0807T,Pulm tiss vntj alys prev ct,,,210.87,527.18,4 HCPCS,0808T,Pulm tiss vntj alys w/ct,,,210.87,527.18,4 HCPCS,0810T,Subrta njx rx agt w/vtrc,,,4063.05,10157.63,4 HCPCS,0811T,Rem mlt day uroflow setup,,,130.02,325.05,4 HCPCS,0812T,Rem mlt day uroflow dev sply,,,125.66,314.16,4 HCPCS,0813T,Egd vol adjmt bariatric balo,,,885.77,2214.41,4 HCPCS,0816T,Opn insj/rplcmt ins ptn subq,,,18946.23,47365.59,4 HCPCS,0817T,Opn insj/rplcmt ins ptn subf,,,18946.23,47365.59,4 HCPCS,0818T,Revj/rmvl ins ptn subq,,,3414.31,8535.78,4 HCPCS,0819T,Revj/rmvl ins ptn subf,,,3414.31,8535.78,4 HCPCS,0823T,Tcat ins 1chmbr ldls pm ra,,,18811.05,47027.63,4 HCPCS,0824T,Tcat rmv 1chmbr ldls pm ra,,,3083.61,7709.02,4 HCPCS,0825T,Tcat rmv&rpl1chmb ldls pm ra,,,18811.05,47027.63,4 HCPCS,0826T,Prgrmg evl ldls pm 1chmbr ip,,,36.45,91.12,4 HCPCS,0827T,Dgtz gls mcrscp cytp smears,,,3.77,3.77,4 HCPCS,0828T,Dgtz gls mcrscp cytp smpl fl,,,3.77,3.77,4 HCPCS,0829T,Dgtz gls mcrscp cytp conctrj,,,3.77,3.77,4 HCPCS,0830T,Dgtz gls mcrscp cytp slctv,,,3.77,3.77,4 HCPCS,0831T,Dgtz gls mcrscp cytp c/v,,,3.77,3.77,4 HCPCS,0832T,Dgtz gls mcrscp cytp oth scr,,,3.77,3.77,4 HCPCS,0833T,Dgtz gls mcrscp cytp oth prp,,,3.77,3.77,4 HCPCS,0834T,Dgtz gls mcrscp cytp oth xtn,,,3.77,3.77,4 HCPCS,0835T,Dgtz gls mcrscp fna 1st ea,,,3.77,3.77,4 HCPCS,0836T,Dgtz gls mcrscp fna ea addl,,,3.77,3.77,4 HCPCS,0837T,Dgtz gls mcrscp fna i&r,,,3.77,3.77,4 HCPCS,0838T,Dgtz gls mcrscp cslt sld els,,,3.77,3.77,4 HCPCS,0839T,Dgtz gls mcrscp cslt mat prp,,,3.77,3.77,4 HCPCS,0840T,Dgtz gls mcrscp cslt compre,,,3.77,3.77,4 HCPCS,0841T,Dgtz gls mcrscp pth cslt 1st,,,3.77,3.77,4 HCPCS,0842T,Dgtz gls mcrscp pth cslt ea,,,3.77,3.77,4 HCPCS,0843T,Dgtz gls mcrscp cslt cyt 1st,,,3.77,3.77,4 HCPCS,0844T,Dgtz gls mcrscp cslt cyt ea,,,3.77,3.77,4 HCPCS,0845T,Dgtz gls mcrscp imfluor 1st,,,3.77,3.77,4 HCPCS,0846T,Dgtz gls mcrscp imfluor ea,,,3.77,3.77,4 HCPCS,0847T,Dgtz gls mcrscp xm arch tiss,,,3.77,3.77,4 HCPCS,0848T,Dgtz gls mcrscp ish 1st,,,3.77,3.77,4 HCPCS,0849T,Dgtz gls mcrscp ish ea adl 1,,,3.77,3.77,4 HCPCS,0850T,Dgtz gls mcrscp ish ea mult,,,3.77,3.77,4 HCPCS,0851T,Dgtz gls mcrscp mphmtrc 1st,,,3.77,3.77,4 HCPCS,0852T,Dgtz gls mcrscp mphmtrc ea 1,,,3.77,3.77,4 HCPCS,0853T,Dgtz gls mcrscp mphmtrc ea m,,,3.77,3.77,4 HCPCS,0854T,Dgtz gls mcrscp bld smr prph,,,3.77,3.77,4 HCPCS,0855T,Dgtz gls mcrscp b1 marow smr,,,3.77,3.77,4 HCPCS,0856T,Dgtz gls mcrscp electron mic,,,3.77,3.77,4 HCPCS,0857T,Opto-acoustic img breast uni,,,102.1,255.25,4 HCPCS,0858T,Ext trnscranl mag stimj meas,,,364.43,911.07,4 HCPCS,0861T,Rmvl pg wcs lv both compnt,,,3649.53,9123.83,4 HCPCS,0862T,Rlcj pg wcs lv battery only,,,2015.01,5037.52,4 HCPCS,0863T,Rlcj pg wcs lv trnsmtr only,,,2015.01,5037.52,4 HCPCS,0864T,Low ntsty eswt corpus cvrnsm,,,244.0,610.01,4 HCPCS,0865T,Quan mri alys brn w/o dx mri,,,233.02,582.55,4 HCPCS,0866T,Quan mri alys brn w/dx mri,,,233.02,582.55,4 HCPCS,0867T,Tpla b9 prst8 hyprplsa>=50ml,,,5236.35,13090.88,4 HCPCS,0868T,Hi-res gastric ep mapping,,,364.43,911.07,4 HCPCS,0869T,Njx b1 sub mtrl hw fixj aug,,,3195.45,7988.62,4 HCPCS,0870T,Imp subq prtl ascts pmp sys,,,43015.98,107539.94,4 HCPCS,0872T,Rplcmt ndwllg bldr&prtl cath,,,3496.63,8741.59,4 HCPCS,0873T,Revj subq prtl asct pmp sys,,,3496.63,8741.59,4 HCPCS,0874T,Rmvl pertl ascites pmp sys,,,3496.63,8741.59,4 HCPCS,0875T,Prgrm subq prtl asct pmp sys,,,36.45,91.12,4 HCPCS,0881T,Cryotherapy oral cavity,,,436.27,1090.68,4 HCPCS,0884T,Esphgsc flx 1st tndsc dilat,,,5928.86,14822.16,4 HCPCS,0885T,Colsc flx 1st tndsc dilat,,,5928.86,14822.16,4 HCPCS,0886T,Sgmdsc flx 1st tndsc dilat,,,5928.86,14822.16,4 HCPCS,0889T,Prsnlz trgt dvl arhfcmrigtbs,,,908.58,2271.46,4 HCPCS,0893T,N-invas assmt bld oxygnation,,,129.94,324.84,4 HCPCS,0897T,N-invas augmnt arrhyt alys,,,838.65,2096.62,4 HCPCS,0898T,N-invas prst8 cancer est map,,,838.65,2096.62,4 HCPCS,0902T,Qtc ntrvl augmnt alg aly ecg,,,129.94,324.84,4 HCPCS,0904T,Ecg alg 12 ld rdcd trcg only,,,57.61,144.03,4 HCPCS,0906T,Coms ther 1st appl<=50 sq cm,,,195.94,489.85,4 HCPCS,0908T,Opn imp int nstm sys vgs nrv,,,30135.76,75339.4,4 HCPCS,0909T,Rplcmt int nstim sys vgs nrv,,,30135.76,75339.4,4 HCPCS,0910T,Rmvl int nstim sys vagus nrv,,,3414.31,8535.78,4 HCPCS,0911T,Elec aly nstm sys vgs nrv wo,,,57.61,144.03,4 HCPCS,0912T,Elec alys nstim sys vgs smpl,,,92.85,232.12,4 HCPCS,0913T,Hc Percutaneous Transcatheter Therapy For Delivering Therapeutic Agent Via Balloon Catheter In Major,20754.0,8301.6,,,0 HCPCS,0913T,Prq tcat ther rx ntrac balo1,,,11274.1,28185.26,4 HCPCS,0914T,Hc Percutaneous Transcatheter Therapy For Delivering Therapeutic Agent Via Balloon Catheter To A Sep,20754.0,8301.6,,,0 HCPCS,0915T,Insj perm ccm-d sys pg&eltrd,,,30654.5,76636.25,4 HCPCS,0916T,Insj perm ccm-d sys pg only,,,21723.17,54307.93,4 HCPCS,0917T,Insj perm ccm-d sys 1 lead,,,8081.78,20204.45,4 HCPCS,0918T,Insj perm ccm-d sys dual ld,,,8081.78,20204.45,4 HCPCS,0919T,Rmvl perm ccm-d sys pg only,,,3649.53,9123.83,4 HCPCS,0920T,Rmvl perm ccm-d sys 1 pac ld,,,3649.53,9123.83,4 HCPCS,0921T,Rmvl perm ccm-d sys 1 dfb ld,,,3649.53,9123.83,4 HCPCS,0922T,Rmvl perm ccm-d sys dual ld,,,3649.53,9123.83,4 HCPCS,0923T,Rmvl&rplcmt perm ccm-d pg,,,21723.17,54307.93,4 HCPCS,0924T,Rpos prv ccm-d trnsvns eltrd,,,612.63,1531.57,4 HCPCS,0925T,Rlcj skin pocket ccm-d pg,,,2015.01,5037.52,4 HCPCS,0926T,Prgrmg dev eval ccm-d ip,,,36.45,91.12,4 HCPCS,0927T,Interrog dev eval ccm-d ip,,,36.45,91.12,4 HCPCS,0929T,Rem interrog dev ccm-d tech,,,36.45,91.12,4 HCPCS,0932T,N-invs det hrt fail aug echo,,,299.95,749.88,4 HCPCS,0933T,Tcat impl wrls l atr prs snr,,,3166.08,7915.21,4 HCPCS,0941T,Cysto flx ins&xpns urtl scaf,,,9244.99,23112.47,4 HCPCS,0942T,Cysto flx rmv&rplc urtl scaf,,,9244.99,23112.47,4 HCPCS,0943T,Cysto flx rmvl urtl scaffold,,,2041.48,5103.69,4 HCPCS,0944T,3d cntr simula trgt lvr les,,,233.02,582.55,4 HCPCS,0946T,Ortho impl mvmt alys pair ct,,,102.1,255.25,4 HCPCS,0949T,Rem interrog dev ccm tech,,,36.45,91.12,4 HCPCS,0950T,Abltj b9 prst8 tissue hifu,,,9244.99,23112.47,4 HCPCS,0957T,Rev s-sclp eltr ra rcvr&tlmt,,,1570.37,3925.93,4 HCPCS,0958T,Rmv s-sclp eltr ra rcvr&tlmt,,,3195.45,7988.62,4 HCPCS,0959T,Rmv/rplc magnet coil assem,,,1612.96,4032.39,4 HCPCS,0961T,Shortwave ifr radiation img,,,101.67,101.67,4 HCPCS,0962T,Asstv alg alys acous&ecg rec,,,129.94,324.84,4 HCPCS,0963T,Anosc sbmcsl njx bulking agt,,,1168.65,2921.61,4 HCPCS,0964T,I&cust prep jaw xpnsj 1arch,,,3237.89,8094.73,4 HCPCS,0965T,I&cst prp jw xpn dl arch non,,,3237.89,8094.73,4 HCPCS,0966T,I&cst prp jw xpn dl arch fxd,,,3237.89,8094.73,4 HCPCS,0967T,Tranal ins tmp clrc anst dev,,,1168.65,2921.61,4 HCPCS,0970T,Ablt b9 brst tum perq lsr ea,,,3823.83,9559.57,4 HCPCS,0971T,Ablt mal brst tum pq lsr uni,,,3823.83,9559.57,4 HCPCS,0973T,Slctv nzmtc dbrdmt t/a/l 1st,,,397.0,992.51,4 HCPCS,0975T,Slctv nzmtc dbrdmt s/n/hf 1,,,397.0,992.51,4 HCPCS,0977T,Upr gi bld detcj snr capsule,,,885.77,2214.41,4 HCPCS,0981T,Tcat impl wrls ivc snr,,,17902.75,44756.89,4 HCPCS,0982T,Rem mntr impl ivc snr set-up,,,130.02,325.05,4 HCPCS,0983T,Rem mntr impl ivc snr phys,,,36.45,91.12,4 HCPCS,0989T,Revj/rmvl ins ptn subq&subf,,,3414.31,8535.78,4 HCPCS,0991T,Cysto lo-nrg lithtrp&mcrsphr,,,9244.99,23112.47,4 HCPCS,0992T,N-invas assmt car rsk w/o ct,,,233.02,582.55,4 HCPCS,0993T,N-invas assmt car rsk w/ct,,,233.02,582.55,4 HCPCS,10004,Hc Fine Needle Asp;W/O Imaging Guidance Additonal Lesion,703.25,281.3,,,0 HCPCS,10004,Hc Fine Needle Aspiration;W/O Imaging Guidance Additonal Lesion,665.57,266.23,,,0 HCPCS,10005,Fna bx w/us gdn 1st les,,,691.56,1728.91,4 HCPCS,10005,Hc Fna Biopsy W/Us Image Guidance 1St Lesion,4328.32,1731.33,,,0 HCPCS,10006,Hc Fna Biopsy W/Us Image Guidance Each Additional,2074.58,829.83,,,0 HCPCS,10007,Fna bx w/fluor gdn 1st les,,,691.56,1728.91,4 HCPCS,10007,Hc Fna Bx W/Fluoroscopy Guidance 1St Les,3780.79,1512.32,,,0 HCPCS,10008,Hc Fna Bx W/Fluoroscopy Guidance Ea Additional,753.48,301.39,,,0 HCPCS,10009,Fna bx w/ct gdn 1st les,,,691.56,1728.91,4 HCPCS,10009,Hc Fna Bx W/Ct Guidance 1St Les,5548.96,2219.58,,,0 HCPCS,10011,Fna bx w/mr gdn 1st les,,,691.56,1728.91,4 HCPCS,10021,Fna w/o image,,,397.0,992.51,4 HCPCS,10021,Hc Fine Needle Asp;W/O Imaging Guidance,890.79,356.32,,,0 HCPCS,10022,Fna w/image,,,2546.0,2978.0,4 HCPCS,1002T,Air displacmnt plethysmograp,,,28.25,70.62,4 HCPCS,10030,Guide cathet fluid drainage,,,691.56,2978.0,8 HCPCS,10030,Hc Image-Guided Catheter Fluid Collection Drainage,6260.58,2504.23,,,0 HCPCS,10035,Hc Perq Sft Tiss Loc Device Plmt 1St Les W/Gdnce,1481.2,592.48,,,0 HCPCS,10035,Perq dev soft tiss 1st imag,,,691.56,1728.91,4 HCPCS,1003T,Arthrp 1st crp/mtcrpl prostc,,,12538.31,31345.78,4 HCPCS,10040,Acne surgery,,,195.94,489.85,4 HCPCS,10040,Hc Acne Surgery,364.0,145.6,,,0 HCPCS,1004T,Elec alys s-scl eeg wo prgrm,,,129.94,324.84,4 HCPCS,1005T,Elec alys s-scl eeg prgr 1st,,,92.85,232.12,4 HCPCS,10060,Drainage of skin abscess,,,195.94,2978.0,8 HCPCS,10060,Hc Drain Skin Abscess Simple,986.22,394.49,,,0 HCPCS,10061,Drainage of skin abscess,,,397.0,2978.0,8 HCPCS,10061,Hc Drain Skin Abscess Complic,1369.65,547.86,,,0 HCPCS,10080,Drainage of pilonidal cyst,,,691.56,2978.0,8 HCPCS,10080,Hc Drain Pilonidal Cyst Simpl,1130.22,452.09,,,0 HCPCS,10081,Drainage of pilonidal cyst,,,691.56,4059.0,8 HCPCS,10081,Hc Drain Pilonidal Cyst Complic,1239.06,495.62,,,0 HCPCS,1008T,Rem mntr s-scl eeg sys setup,,,130.02,325.05,4 HCPCS,1010T,Cptr oph alys monoc eye mvmt,,,129.94,324.84,4 HCPCS,1011T,Pbm therapy of oral cavity,,,436.27,1090.68,4 HCPCS,10120,Hc Remove Foreign Body Simple,1284.27,513.71,,,0 HCPCS,10120,Remove foreign body,,,397.0,2978.0,8 HCPCS,10121,Hc Remove Foreign Body Complic,5232.5,2093.0,,,0 HCPCS,10121,Remove foreign body,,,1612.96,4059.0,8 HCPCS,1012T,Mtrz ab ntrno trph scl/tr mw,,,4036.72,10091.79,4 HCPCS,10140,Drainage of hematoma/fluid,,,1612.96,8800.0,8 HCPCS,10140,Hc Drainage Of Hematoma/Fluid,6310.81,2524.32,,,0 HCPCS,10160,Hc Puncture Drainage Of Lesion,1676.0700000000002,670.425,,,0 HCPCS,10160,Puncture drainage of lesion,,,397.0,992.51,4 HCPCS,10180,Complex drainage wound,,,2836.76,7091.89,8 HCPCS,10180,"Hc Complex Drainage, Wound",6094.82,2437.93,,,0 HCPCS,1019T,Lymphovenous bypass per xtr,,,6484.82,16212.04,4 HCPCS,1020T,Raman spectroscopy 1+skn les,,,57.61,144.03,4 HCPCS,1021T,Active thrc irrigation spx,,,612.63,1531.57,4 HCPCS,1025T,Alt elec fld dos&dlv sim mdl,,,131.26,328.16,4 HCPCS,1030T,Crtj dig 3d mdl surf mesh 1,,,125.66,314.16,4 HCPCS,1032T,Crtj dig 3d mdl mesh&sim 1,,,125.66,314.16,4 HCPCS,1034T,Crt dig 3d mdl msh sim&aly 1,,,125.66,314.16,4 HCPCS,1041T,Augmnt alg alys enceph wvfrm,,,129.94,324.84,4 HCPCS,1054T,Fcsd nshckwv us prop resd st,,,2041.48,5103.69,4 HCPCS,1056T,Cochlear infusion rx agent,,,1515.28,3788.21,4 HCPCS,1062T,Artif insem trnscrv ntratubl,,,297.6,744.0,4 HCPCS,1069T,Mchnl xtr crycmprsn meas&edu,,,436.27,1090.68,4 HCPCS,1070T,Mchnl xtr crycmprsn plmt,,,36.48,91.19,4 HCPCS,1081T,Mvasc anast lymph nod&vn 1st,,,6484.82,16212.04,4 HCPCS,1084T,Impl scaf algrf sprchrdl spc,,,4036.72,10091.79,4 HCPCS,1085T,Asstv alg aly id les mets ca,,,838.65,2096.62,4 HCPCS,1086T,Ntrapx est c ff aug alg alys,,,838.65,2096.62,4 HCPCS,1087T,Est c ff drv aug alg alys,,,838.65,2096.62,4 HCPCS,1088T,Perq appl hi-frq neuromd sgl,,,125.66,314.16,4 HCPCS,1092T,Imp aclr scaf kne chndr open,,,7086.45,17716.12,4 HCPCS,1093T,Imp aclr scaf kne chndr arth,,,3195.45,7988.62,4 HCPCS,11000,Debride infected skin,,,397.0,992.51,4 HCPCS,11000,"Hc Debridement, Infected Skin, Up To 10% Bsa",1967.42,786.97,,,0 HCPCS,11005,Debride abdom wall,,,2546.0,2978.0,4 HCPCS,11010,Debride skin at fx site,,,691.56,4059.0,8 HCPCS,11010,Hc Debride Assoc Open Fx/Disloc Skin/Subq,2553.46,1021.38,,,0 HCPCS,11011,Debride skin musc at fx site,,,691.56,4059.0,8 HCPCS,11012,Deb skin bone at fx site,,,2836.76,7091.89,8 HCPCS,11012,Hc Debride Assoc Open Fx/Dislo Skin/Mus/Bone,372.8,149.12,,,0 HCPCS,11042,Deb subq tissue 20 sq cm/<,,,397.0,4059.0,8 HCPCS,11042,"Hc Debridement, Skin, Sub-Q Tissue,=<20 Sq Cm",2096.35,838.54,,,0 HCPCS,11043,Deb musc/fascia 20 sq cm/<,,,721.78,4059.0,8 HCPCS,11043,"Hc Debridement, Skin, Sub-Q Tissue,Muscle,=<20 Sq Cm",2456.35,982.54,,,0 HCPCS,11044,Deb bone 20 sq cm/<,,,1612.96,4059.0,8 HCPCS,11044,Hc Debride Bone 1St 20 Sqcm,4716.79,1886.72,,,0 HCPCS,11044,"Hc Debridement, Skin, Sub-Q Tissue,Muscle,Bone,=<20 Sq Cm",4716.79,1886.72,,,0 HCPCS,11045,"Hc Debridement, Skin, Sub-Q Tissue,Each Add 20 Sq Cm",1537.09,614.84,,,0 HCPCS,11046,"Hc Debridement, Skin, Sub-Q Tissue,Muscle,Each Add 20 Sq Cm",1932.26,772.9,,,0 HCPCS,11047,"Hc Debridement, Skin, Sub-Q Tissue,Muscle,Bone,Each Add 20 Sq Cm",3094.29,1237.72,,,0 HCPCS,1104T,N-invas cardpulm assmt cad,,,129.94,324.84,4 HCPCS,11055,"Hc Trim Hyperkeratotic Skin Lesion, One",599.43,239.77,,,0 HCPCS,11055,Trim skin lesion,,,195.94,489.85,4 HCPCS,11056,"Hc Trim Benign Hyperkeratotic Skin Lesion,2-4",721.67,288.67,,,0 HCPCS,11056,Trim skin lesions 2 to 4,,,195.94,489.85,4 HCPCS,11057,Hc Ip-Trim Skin Lesions > 4,971.15,388.46,,,0 HCPCS,11057,Trim skin lesions over 4,,,195.94,489.85,4 HCPCS,11102,Hc Tangential Biopsy Skin Single Lesion,984.54,393.82,,,0 HCPCS,11102,Tangntl bx skin single les,,,397.0,992.51,4 HCPCS,11103,Hc Tangntl Bx Skin Ea Separate Or Additional,485.88,194.35,,,0 HCPCS,11104,Hc Punch Bx Skin Single Lesion,941.31,376.525,,,0 HCPCS,11104,Punch bx skin single lesion,,,397.0,992.51,4 HCPCS,11105,Hc Punch Bx Skin Ea Sep/Addl,549.2,219.68,,,0 HCPCS,11106,Hc Incal Bx Skn Single Les (Wdge),1021.38,408.55,,,0 HCPCS,11106,Incal bx skn single les,,,721.78,2978.0,8 HCPCS,11107,Hc Incisional Biopsy Skin Each Separate/Addintional Lesion,485.88,194.35,,,0 HCPCS,11200,"Hc Removal Of Skin Tags, Up To 15",440.36,176.14,,,0 HCPCS,11200,Removal of skin tags 2.0 Cm,691.6,276.64,,,0 HCPCS,11303,Shave skin lesion >2.0 cm,,,397.0,992.51,4 HCPCS,11305,Hc Shave Lesion <0.5Cm Neck,545.86,218.34,,,0 HCPCS,11305,Shave skin lesion 0.5 cm/<,,,195.94,489.85,4 HCPCS,11306,Hc Shave Skin Lesion 0.6-1.0 Cm Remainder Body,560.62,224.25,,,0 HCPCS,11306,Shave skin lesion 0.6-1.0 cm,,,195.94,489.85,4 HCPCS,11307,"Hc Shave Skin Lesion 1.1-2.0 Cm-Scalp, Neck Hands, Feet, Genitalia",411.12,164.45,,,0 HCPCS,11307,Shave skin lesion 1.1-2.0 cm,,,195.94,489.85,4 HCPCS,11308,Shave skin lesion >2.0 cm,,,397.0,992.51,4 HCPCS,11310,"Hc Shav Skin Les <0.5 Cm Face,Facial",622.88,249.15,,,0 HCPCS,11310,Shave skin lesion 0.5 cm/<,,,195.94,489.85,4 HCPCS,11311,Hc Shv Les 0.6-1.0Cm Face Exc Scl,730.04,292.02,,,0 HCPCS,11311,Shave skin lesion 0.6-1.0 cm,,,195.94,489.85,4 HCPCS,11312,"Hc Shave Skin Lesion 1.1-2.0Cn-Face, Ears, Eyelids, Nose, Lips, Mucous Membrane",545.68,218.27,,,0 HCPCS,11312,Shave skin lesion 1.1-2.0 cm,,,397.0,992.51,4 HCPCS,11313,Shave skin lesion >2.0 cm,,,397.0,992.51,4 HCPCS,11400,Exc tr-ext b9+marg 0.5 cm<,,,691.56,2978.0,8 HCPCS,11400,Hc Excision Of Benign Lesion <0.5,1594.03,637.61,,,0 HCPCS,11401,Exc tr-ext b9+marg 0.6-1 cm,,,397.0,2978.0,8 HCPCS,11401,"Hc Exc Skin Benig 0.6-1 Cm Trunk,Arm,Leg",2119.79,847.92,,,0 HCPCS,11402,Exc tr-ext b9+marg 1.1-2 cm,,,691.56,2978.0,8 HCPCS,11402,"Hc Exc Skin Benig 1.1-2 Cm Trunk,Arm,Leg",2653.92,1061.57,,,0 HCPCS,11403,Exc tr-ext b9+marg 2.1-3cm/<,,,691.56,8800.0,8 HCPCS,11403,"Hc Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg",3127.77,1251.11,,,0 HCPCS,11404,Exc tr-ext b9+marg 3.1-4 cm,,,1612.96,4032.39,8 HCPCS,11404,"Hc Exc Skin Benig 3.1-4 Cm Trunk,Arm,Leg",4219.49,1687.8,,,0 HCPCS,11406,Exc tr-ext b9+marg >4.0 cm,,,1612.96,4059.0,8 HCPCS,11406,"Hc Exc Skin Benig >4 Cm Trunk,Arm,Leg",4641.44,1856.58,,,0 HCPCS,11420,Exc h-f-nk-sp b9+marg 0.5/<,,,1612.96,8800.0,8 HCPCS,11420,Hc Exc Skin Benig <0.5 Cm Remainder Body,2427.88,971.15,,,0 HCPCS,11421,Exc h-f-nk-sp b9+marg 0.6-1,,,691.56,8800.0,8 HCPCS,11421,Hc Exc Skin Benig 0.6-1 Cm Remaindr Body,2511.6,1004.64,,,0 HCPCS,11422,Exc h-f-nk-sp b9+marg 1.1-2,,,1612.96,8800.0,8 HCPCS,11422,Hc Exc Skin Benig 1.1-2 Cm Remaindr Body,2906.76,1162.7,,,0 HCPCS,11423,Exc h-f-nk-sp b9+marg 2.1-3,,,1612.96,8800.0,8 HCPCS,11423,Hc Exc Skin Benig 2.1-3 Cm Remaindr Body,4507.42,1802.97,,,0 HCPCS,11424,Exc h-f-nk-sp b9+marg 3.1-4,,,1612.96,4059.0,8 HCPCS,11424,"Hc Removal Of Growth 3.1-4.0Cm Of The Scalp, Neck, Hands, Feet, Or Genitals",3040.83,1216.33,,,0 HCPCS,11426,Exc h-f-nk-sp b9+marg >4 cm,,,2836.76,7091.89,8 HCPCS,11426,Hc Exc Skin Benig >4 Cm Remaindr Body,5120.38,2048.15,,,0 HCPCS,11440,Exc face-mm b9+marg 0.5 cm/<,,,691.56,2978.0,8 HCPCS,11440,"Hc Exc Skin Benig <0.5 Cm Face,Facial",1530.88,612.35,,,0 HCPCS,11441,Exc face-mm b9+marg 0.6-1 cm,,,691.56,2978.0,8 HCPCS,11441,"Hc Exc Skin Benig 0.6-1 Cm Face,Facial",2392.0,956.8,,,0 HCPCS,11442,Exc face-mm b9+marg 1.1-2 cm,,,691.56,8800.0,8 HCPCS,11442,"Hc Exc Skin Benig 1.1-2 Cm Face,Facial",2526.55,1010.62,,,0 HCPCS,11443,Exc face-mm b9+marg 2.1-3 cm,,,1612.96,4059.0,8 HCPCS,11443,"Hc Exc Skin Benig 2.1-3 Cm Face,Facial",3842.15,1536.86,,,0 HCPCS,11444,Exc face-mm b9+marg 3.1-4 cm,,,1612.96,4032.39,8 HCPCS,11444,"Hc Exc Skin Benig 3.1- 4 Cm Face,Facial",2453.3,981.32,,,0 HCPCS,11446,Exc face-mm b9+marg >4 cm,,,2836.76,7091.89,8 HCPCS,11446,"Hc Exc Skin Benig >4 Cm Face,Facial",5065.06,2026.02,,,0 HCPCS,11450,Removal sweat gland lesion,,,2836.76,7091.89,8 HCPCS,11451,Hc Excision Hidradenitis Anillary Complex Repair,8086.0,3234.4,,,0 HCPCS,11451,Removal sweat gland lesion,,,2836.76,7091.89,8 HCPCS,11462,Removal sweat gland lesion,,,2836.76,7091.89,8 HCPCS,11463,Removal sweat gland lesion,,,2836.76,7091.89,8 HCPCS,11470,Removal sweat gland lesion,,,2836.76,7091.89,8 HCPCS,11471,Removal sweat gland lesion,,,2836.76,7091.89,8 HCPCS,11600,Exc tr-ext mal+marg 0.5 cm/<,,,691.56,4059.0,8 HCPCS,11600,Hc Excision Malignant Lesion Trunk/Arm/Lg 0.5 Cm/<,2008.5,803.4,,,0 HCPCS,11601,Exc tr-ext mal+marg 0.6-1 cm,,,691.56,1728.91,4 HCPCS,11601,"Hc Exc Skin Malig 0.6-1 Cm Trunk,Arm,Leg",617.5,247.0,,,0 HCPCS,11602,Exc tr-ext mal+marg 1.1-2 cm,,,397.0,2978.0,8 HCPCS,11602,"Hc Exc Skin Malig 1.1-2 Cm Trunk,Arm,Leg",804.31,321.72,,,0 HCPCS,11603,Exc tr-ext mal+marg 2.1-3 cm,,,691.56,4059.0,8 HCPCS,11603,"Hc Exc Skin Malig 2.1-3 Cm Trunk,Arm,Leg",2557.94,1023.18,,,0 HCPCS,11604,Exc tr-ext mal+marg 3.1-4 cm,,,691.56,4059.0,8 HCPCS,11604,Hc Excision Malignant Lesion 3.1-4Cm- Trunk/Arm/Leg,1868.75,747.5,,,0 HCPCS,11606,Exc tr-ext mal+marg >4 cm,,,1612.96,4059.0,8 HCPCS,11606,"Hc Exc Skin Malig >4 Cm Trunk,Arm,Leg",606.14,242.46,,,0 HCPCS,11620,Exc h-f-nk-sp mal+marg 0.5/<,,,1612.96,4032.39,4 HCPCS,11620,"Hc Removal Of Malignant Growth Of Scalp,Neck,Hand,Fee,Genital, 0.5 Cm Or <",3484.0,1393.6,,,0 HCPCS,11621,Exc s/n/h/f/g mal+mrg 0.6-1,,,691.56,4059.0,8 HCPCS,11621,Hc Excision Of Scalp 0.6 -1.0 Cm,1907.62,763.05,,,0 HCPCS,11622,Exc s/n/h/f/g mal+mrg 1.1-2,,,691.56,4059.0,8 HCPCS,11622,Hc Excision Malignant Lesion S/N/H/F/G 1.1-2.0 Cm,2548.98,1019.59,,,0 HCPCS,11623,Exc s/n/h/f/g mal+mrg 2.1-3,,,1612.96,4059.0,8 HCPCS,11623,Hc Exc Skin Malig 2.1-3 Cm Remaindr Body,4778.02,1911.21,,,0 HCPCS,11624,Exc s/n/h/f/g mal+mrg 3.1-4,,,1612.96,4059.0,8 HCPCS,11624,Hc Removal Of Cancer Skin Growth Of Scalp/Neck/Hands/Feet/Gentials 3.1-4.0 Cm,5128.5,2051.4,,,0 HCPCS,11626,Exc s/n/h/f/g mal+mrg >4 cm,,,2836.76,7091.89,8 HCPCS,11626,Hc Exc Skin Malig >4 Cm Remaindr Body,4464.07,1785.63,,,0 HCPCS,11640,Exc f/e/e/n/l mal+mrg 0.5cm<,,,691.56,1728.91,4 HCPCS,11640,"Hc Exc Skin Malig <0.5 Cm Face,Facial",2223.6,889.44,,,0 HCPCS,11641,Exc f/e/e/n/l mal+mrg 0.6-1,,,691.56,1728.91,4 HCPCS,11641,"Hc Exc Skin Malig 0.6-1Cm Face,Facial",2221.57,888.63,,,0 HCPCS,11642,Exc f/e/e/n/l mal+mrg 1.1-2,,,691.56,1728.91,4 HCPCS,11642,"Hc Exc Skin Malig 1.1-2 Cm Face,Facial",4081.35,1632.54,,,0 HCPCS,11643,Exc f/e/e/n/l mal+mrg 2.1-3,,,1612.96,4059.0,8 HCPCS,11643,"Hc Exc Skin Malig 2.1-3 Cm Face,Facial",4091.82,1636.73,,,0 HCPCS,11644,Exc f/e/e/n/l mal+mrg 3.1-4,,,1612.96,4059.0,8 HCPCS,11644,"Hc Exc Skin Malig 3.1-4 Cm Face,Facial",2586.95,1034.78,,,0 HCPCS,11646,Exc f/e/e/n/l mal+mrg >4 cm,,,2836.76,7091.89,8 HCPCS,11646,"Hc Exc Skin Malig >4 Cm Face,Facial",3716.57,1486.63,,,0 HCPCS,11719,Hc Nail Trimming,641.29,256.52,,,0 HCPCS,11719,Trim nail(s) any number,,,57.61,144.03,4 HCPCS,11720,Debride nail 1-5,,,57.61,144.03,4 HCPCS,11720,"Hc Debridement Of Nail(S), 1-5",572.65,229.06,,,0 HCPCS,11721,Debride nail 6 or more,,,57.61,144.03,4 HCPCS,11721,"Hc Debridement Of Nails, 6 Or More",832.18,332.87,,,0 HCPCS,11730,Hc Removal Of Nail Plate,1158.69,463.48,,,0 HCPCS,11730,Removal of nail plate,,,195.94,2978.0,8 HCPCS,11732,Hc Remove Nail Plate Add-On,376.74,150.7,,,0 HCPCS,11740,Drain blood from under nail,,,129.94,324.84,4 HCPCS,11740,Hc Drain Blood From Under Nail,411.9,164.76,,,0 HCPCS,11750,Hc Removal Of Nail Bed,2317.37,926.95,,,0 HCPCS,11750,Removal of nail bed,,,397.0,2978.0,8 HCPCS,11755,Biopsy nail unit,,,691.56,2978.0,8 HCPCS,11755,Hc Biopsy Nail/Finger/Toe,1572.74,629.1,,,0 HCPCS,11760,Hc Reconstruc Of Nail Bed,2327.42,930.97,,,0 HCPCS,11760,Repair of nail bed,,,721.78,1804.45,4 HCPCS,11762,Hc Reconstruction Of Nail Bed W Graft,3256.71,1302.68,,,0 HCPCS,11762,Reconstruction of nail bed,,,2015.01,5037.52,8 HCPCS,11765,Excision of nail fold toe,,,397.0,2978.0,8 HCPCS,11765,"Hc Excision Of Nail Fold, Toe",884.08,353.63,,,0 HCPCS,11770,Hc Remove Pilonidal Cyst Simple,5616.0,2246.4,,,0 HCPCS,11770,Remove pilonidal cyst simple,,,2836.76,9743.0,8 HCPCS,11771,Remove pilonidal cyst exten,,,2836.76,9743.0,8 HCPCS,11772,Remove pilonidal cyst compl,,,2836.76,9743.0,8 HCPCS,11900,"Hc Injection Into Skin Lesions, Up To 7",642.97,257.19,,,0 HCPCS,11900,Inject skin lesions <=w 7,,,195.94,489.85,4 HCPCS,11901,Hc Injection Skin Lesions >7,740.09,296.04,,,0 HCPCS,11901,Inject skin lesions >7,,,195.94,489.85,4 HCPCS,11920,Correct skin color 6.0 cm/<,,,721.78,1804.45,4 HCPCS,11920,Hc Correct Skin Color Defect 6.0 Cm/<,1233.38,493.35,,,0 HCPCS,11921,Correct skn color 6.1-20.0cm,,,721.78,1804.45,4 HCPCS,11950,Tx contour defects 1 cc/<,,,195.94,489.85,4 HCPCS,11951,Tx contour defects 1.1-5.0cc,,,721.78,1804.45,4 HCPCS,11952,Tx contour defects 5.1-10cc,,,721.78,1804.45,4 HCPCS,11954,Tx contour defects >10.0 cc,,,721.78,1804.45,4 HCPCS,11960,Insert tissue expander(s),,,3460.82,8652.04,8 HCPCS,11970,Replace tissue expander,,,7086.45,17716.12,8 HCPCS,11971,Remove tissue expander(s),,,2546.0,7091.89,8 HCPCS,11976,Hc Removal Contraceptive Capsule,1396.45,558.58,,,0 HCPCS,11976,Remove contraceptive capsule,,,691.56,1728.91,4 HCPCS,11980,Implant hormone pellet(s),,,436.27,1090.68,4 HCPCS,11981,Hc Insrt Nonbio Drug Dlvr Imp,562.6,225.04,,,0 HCPCS,11981,Insert drug implant device,,,129.94,2978.0,8 HCPCS,11982,Hc Removal Non-Biodegradable Drug Delivery Implant,1125.2,450.08,,,0 HCPCS,11982,Remove drug implant device,,,436.27,2978.0,8 HCPCS,11983,Hc Remove/Insert Drug Implant,1312.73,525.09,,,0 HCPCS,11983,Remove/insert drug implant,,,436.27,2978.0,8 HCPCS,12001,Hc Application Dermabond,887.43,354.97,,,0 HCPCS,12001,Hc Resuperf Wnd Body <2.5Cm,887.43,354.97,,,0 HCPCS,12001,Rpr s/n/ax/gen/trnk 2.5cm/<,,,195.94,489.85,4 HCPCS,12002,Hc Resup Npterf Wnd Body 2.6-7.5 Cm,984.54,393.82,,,0 HCPCS,12002,Rpr s/n/ax/gen/trnk2.6-7.5cm,,,195.94,489.85,4 HCPCS,12004,Hc Resurerf Wnd Body 7.6-12.5 Cm,795.34,318.14,,,0 HCPCS,12004,Rpr s/n/ax/gen/trk7.6-12.5cm,,,195.94,489.85,4 HCPCS,12005,Hc Resurperf Wnd Body 12.6-20 Cm,795.34,318.14,,,0 HCPCS,12005,Rpr s/n/a/gen/trk12.6-20.0cm,,,397.0,4059.0,8 HCPCS,12006,Hc Resuperf Wnd Body 20.1-30 Cm,611.8,244.72,,,0 HCPCS,12006,Hc Simple Repair Scalp/Neck/Axillae/Genitalia/Trunk/Extremities 20.1-30.0Cm,795.34,318.14,,,0 HCPCS,12006,Rpr s/n/a/gen/trk20.1-30.0cm,,,397.0,4059.0,8 HCPCS,12007,Hc Resuperf Wnd Body >30 Cm,1716.26,686.5,,,0 HCPCS,12007,Rpr s/n/ax/gen/trnk >30.0 cm,,,195.94,4059.0,8 HCPCS,12011,Hc Resuperficial Wound Face <2.5Cm,795.34,318.14,,,0 HCPCS,12011,Rpr f/e/e/n/l/m 2.5 cm/<,,,195.94,489.85,4 HCPCS,12013,Hc Resuperf Wnd Face 2.6-5 Cm,795.34,318.14,,,0 HCPCS,12013,Rpr f/e/e/n/l/m 2.6-5.0 cm,,,195.94,489.85,4 HCPCS,12014,Hc Resuperf Wnd Face 5.2-7.5 Cm,795.34,318.14,,,0 HCPCS,12014,Rpr f/e/e/n/l/m 5.1-7.5 cm,,,195.94,489.85,4 HCPCS,12015,Hc Resuperf Wnd Face 7.6-12.5 Cm,487.5,195.0,,,0 HCPCS,12015,Rpr f/e/e/n/l/m 7.6-12.5 cm,,,195.94,489.85,4 HCPCS,12016,Hc Resuperf Wnd Face 12.6-20 Cm,795.34,318.14,,,0 HCPCS,12016,Rpr fe/e/en/l/m 12.6-20.0 cm,,,397.0,4059.0,8 HCPCS,12017,Rpr fe/e/en/l/m 20.1-30.0 cm,,,397.0,4059.0,8 HCPCS,12018,Rpr f/e/e/n/l/m >30.0 cm,,,195.94,4059.0,8 HCPCS,12020,Closure of split wound,,,721.78,2978.0,8 HCPCS,12020,Hc Closure Superf Wnd Dehis Simple,1316.08,526.43,,,0 HCPCS,12021,Closure of split wound,,,397.0,2978.0,8 HCPCS,12021,Hc Wound Dehiscence- With Packing,1659.33,663.73,,,0 HCPCS,12031,"Hc Layr Clos Wnd Trunk,Arm,Leg < 2.5 Cm",910.87,364.35,,,0 HCPCS,12031,Intmd rpr s/a/t/ext 2.5 cm/<,,,397.0,992.51,4 HCPCS,12032,"Hc Layr Clos Wnd Trunk,Arm,Leg 2.6-7.5 Cm",1331.15,532.46,,,0 HCPCS,12032,Intmd rpr s/a/t/ext 2.6-7.5,,,397.0,992.51,4 HCPCS,12034,"Hc Layr Clos Wnd Trunk,Arm,Leg 7.6-12.5 Cm",1625.06,650.02,,,0 HCPCS,12034,Intmd rpr s/tr/ext 7.6-12.5,,,397.0,4059.0,8 HCPCS,12035,"Hc Repair Intermediate Scalp, Arm, Trunk, Leg 12.6-20.0Cm",2018.25,807.3,,,0 HCPCS,12035,Intmd rpr s/a/t/ext 12.6-20,,,397.0,4059.0,8 HCPCS,12036,"Hc Layr Clos Wnd Trunk,Arm,Leg 20.1-30 Cm",1868.75,747.5,,,0 HCPCS,12036,Intmd rpr s/a/t/ext 20.1-30,,,721.78,4059.0,8 HCPCS,12037,"Hc Layer Close Wound Trunk, Arm, Leg >30Cm",3371.22,1348.49,,,0 HCPCS,12037,Intmd rpr s/tr/ext >30.0 cm,,,2015.01,5037.52,8 HCPCS,12041,Hc Layr Clos Wnd Rest Body <2.5 Cm,910.87,364.35,,,0 HCPCS,12041,Intmd rpr n-hf/genit 2.5cm/<,,,397.0,992.51,4 HCPCS,12042,Hc Layr Clos Wnd Rest Body 2.6-7.5 Cm,910.87,364.35,,,0 HCPCS,12042,Intmd rpr n-hf/genit2.6-7.5,,,397.0,992.51,4 HCPCS,12044,Hc Layr Clos Wnd Rest Body 7.6-12.5 Cm,5417.88,2167.15,,,0 HCPCS,12044,Intmd rpr n-hf/genit7.6-12.5,,,721.78,4059.0,8 HCPCS,12045,Hc Repair Intermediate N/H/F/Xtrnl Gent 12.6-20 Cm,910.87,364.35,,,0 HCPCS,12045,Intmd rpr n-hf/genit12.6-20,,,721.78,4059.0,8 HCPCS,12046,Intmd rpr n-hf/genit20.1-30,,,721.78,4059.0,8 HCPCS,12047,Intmd rpr n-hf/genit >30.0cm,,,2015.01,5037.52,8 HCPCS,12051,"Hc Layr Clos Wnd Face,Facial <2.5 Cm",910.87,364.35,,,0 HCPCS,12051,Hc Resuperf Wnd Face <2.5 Cm,910.87,364.35,,,0 HCPCS,12051,Intmd rpr face/mm 2.5 cm/<,,,397.0,9743.0,8 HCPCS,12052,"Hc Layr Clos Wnd Face, Facial 2.5-5 Cm",976.17,390.47,,,0 HCPCS,12052,"Hc Layr Clos Wnd Face,Facial 2.5-5 Cm",976.17,390.47,,,0 HCPCS,12052,Intmd rpr face/mm 2.6-5.0 cm,,,397.0,992.51,4 HCPCS,12053,"Hc Layr Clos Wnd Face,Facial 5.1-7.5 Cm",632.92,253.17,,,0 HCPCS,12053,Intmd rpr face/mm 5.1-7.5 cm,,,397.0,992.51,4 HCPCS,12054,"Hc Layr Clos Wnd Face,Facial 7.6-12.5 Cm",1255.8,502.32,,,0 HCPCS,12054,Intmd rpr face/mm 7.6-12.5cm,,,397.0,4059.0,8 HCPCS,12055,"Hc Layr Clos Wnd Face, Facial 12.6-20 Cm",910.87,364.35,,,0 HCPCS,12055,Intmd rpr face/mm 12.6-20 cm,,,397.0,4059.0,8 HCPCS,12056,Intmd rpr face/mm 20.1-30.0,,,397.0,4059.0,8 HCPCS,12057,Intmd rpr face/mm >30.0 cm,,,397.0,4059.0,8 HCPCS,13100,Cmplx rpr trunk 1.1-2.5 cm,,,721.78,4059.0,8 HCPCS,13100,Hc Repair Complex Trunk 1.1-2.5 Cm,3083.6,1233.44,,,0 HCPCS,13101,Cmplx rpr trunk 2.6-7.5 cm,,,721.78,9743.0,8 HCPCS,13101,Hc Recmpl Wnd Trunk 2.6-7.5 Cm,1308.12,523.25,,,0 HCPCS,13102,"Hc Rep,Skin,Trunk,Cmplx,+5 Cm/<",1755.0,702.0,,,0 HCPCS,13120,Cmplx rpr s/a/l 1.1-2.5 cm,,,397.0,4059.0,8 HCPCS,13120,Hc Repair Complex Scalp/Arm/Leg 1.1-2.5 Cm,1198.87,479.55,,,0 HCPCS,13121,Cmplx rpr s/a/l 2.6-7.5 cm,,,397.0,9743.0,8 HCPCS,13121,"Hc Recmpl Wnd Scalp, Extr 2.6-7.5 Cm",1197.2,478.88,,,0 HCPCS,13122,"Hc Rep,Skin,Scalp/Extrem+5 Cm/<",514.05,205.62,,,0 HCPCS,13131,Cmplx rpr f/c/c/m/n/ax/g/h/f,,,397.0,4059.0,8 HCPCS,13131,"Hc Recmpl Wnd Head,Fac,Hand 1.1-2.5 Cm",1068.92,427.57,,,0 HCPCS,13132,Cmplx rpr f/c/c/m/n/ax/g/h/f,,,397.0,9743.0,8 HCPCS,13132,"Hc Recompl Wnd Head, Fac, Hand 2.6-7.5 Cm",1197.2,478.88,,,0 HCPCS,13133,Hc Repair Complex F/C/C/M/N/Ax/G/H/F Ea Addl 5 Cm/<,1198.87,479.55,,,0 HCPCS,13151,Cmplx rpr e/n/e/l 1.1-2.5 cm,,,721.78,9743.0,8 HCPCS,13151,"Hc Recmpl Wnd Lid,Nos,Ear 1.1-2.5 Cm",1383.63,553.45,,,0 HCPCS,13152,Cmplx rpr e/n/e/l 2.6-7.5 cm,,,721.78,9743.0,8 HCPCS,13152,Hc Repair Complex Eyelid/Nose/Ear/Lip 2.6-7.5 Cm,2525.06,1010.02,,,0 HCPCS,13153,Hc Repair Complex Eyelid/Nose/Ear/Lip Each Additional 5 Cm/<,1270.75,508.3,,,0 HCPCS,13160,Hc Complicated Repair Of Surface Wound Or Dehiscence,8671.0,3468.4,,,0 HCPCS,13160,Late closure of wound,,,3460.82,8652.04,8 HCPCS,14000,"Hc Adjacent Tissue Repair,Trunk; 10 Sqcm Or Less",6240.0,2496.0,,,0 HCPCS,14000,Tis trnfr trunk 10 sq cm/<,,,2015.01,5037.52,8 HCPCS,14001,"Hc Repair Of Wound Of Trunk By Transferring Skin, 10.1-30.0 Sqcm",5799.27,2319.71,,,0 HCPCS,14001,Tis trnfr trunk 10.1-30sqcm,,,2015.01,9743.0,8 HCPCS,14020,"Hc Repair Of Wound 10 Sq Cm/<-Scalp, Arm, Leg",4769.05,1907.62,,,0 HCPCS,14020,Tis trnfr s/a/l 10 sq cm/<,,,2015.01,9743.0,8 HCPCS,14021,"Hc Repair Of Wound To Scalp/Arms/Legs By Transfer Of Skin, 10.1-30.0 Sqcm",6674.74,2669.9,,,0 HCPCS,14021,Tis trnfr s/a/l 10.1-30 sqcm,,,2015.01,9743.0,8 HCPCS,14040,"Hc Adjacent Tissue Transfer Head, Face, Hand <10Sqcm",6894.89,2757.96,,,0 HCPCS,14040,Tis trnfr f/c/c/m/n/a/g/h/f,,,2015.01,5037.52,8 HCPCS,14041,"Hc Repair Of Wound 10.1-30.0 Sqcm-Forehead, Cheeks, Chin, Mouth, Neck, Hands, Feet, Genitalia",2885.69,1154.28,,,0 HCPCS,14041,Tis trnfr f/c/c/m/n/a/g/h/f,,,2015.01,9743.0,8 HCPCS,14060,"Hc Adj Tissue Xfer Lid,Nose, Ear 10 Sq Cm/<",3719.34,1487.74,,,0 HCPCS,14060,Tis trnfr e/n/e/l 10 sq cm/<,,,2015.01,9743.0,8 HCPCS,14061,"Hc Repair Of Wound 10.1-30 Sqcm-Eyelids, Nose, Ear, Or Lips",3482.07,1392.83,,,0 HCPCS,14061,Tis trnfr e/n/e/l10.1-30sqcm,,,2015.01,9743.0,8 HCPCS,14300,Skin tissue rearrangement,,,7524.0,8800.0,4 HCPCS,14301,Hc Repair Of Wound By Transferring Skin-30.1-60 Sqcm,4491.42,1796.57,,,0 HCPCS,14301,Tis trnfr any 30.1-60 sq cm,,,3460.82,8800.0,8 HCPCS,14302,"Hc Repair Of Wound By Transferring Skin, Each Additional 30.0 Sqcm",2141.83,856.73,,,0 HCPCS,14302,Tis trnfr addl 30 sq cm/<,,,7524.0,8800.0,4 HCPCS,14350,Filleted finger/toe flap,,,2015.01,9743.0,8 HCPCS,15002,Wound prep trk/arm/leg,,,721.78,2978.0,8 HCPCS,15004,Wound prep f/n/hf/g,,,397.0,2978.0,8 HCPCS,15011,Hrv skn cll ssp agrft 1st 25,,,2015.01,5037.52,4 HCPCS,15015,App skn cl ssp agrft t/a/l 1,,,2015.01,5037.52,4 HCPCS,15017,App skn cll ssp f/n/g/hf 1st,,,2015.01,5037.52,4 HCPCS,15040,Harvest cultured skin graft,,,2015.01,5037.52,8 HCPCS,15050,Hc Pinch Graft Up To 2 Cm Diameter,1059.5,423.8,,,0 HCPCS,15050,Skin pinch graft,,,721.78,4059.0,8 HCPCS,15100,Hc Skin Graft At Trunk/Arm/Leg First 100Sqcm Or Less,3770.0,1508.0,,,0 HCPCS,15100,Skin splt grft trnk/arm/leg,,,2015.01,5037.52,8 HCPCS,15101,Skin splt grft t/a/l add-on,,,8330.0,9743.0,4 HCPCS,15110,Epidrm autogrft trnk/arm/leg,,,2015.01,5037.52,8 HCPCS,15111,Epidrm autogrft t/a/l add-on,,,2546.0,2978.0,4 HCPCS,15115,Epidrm a-grft face/nck/hf/g,,,2015.01,5037.52,8 HCPCS,15116,Epidrm a-grft f/n/hf/g addl,,,2546.0,2978.0,4 HCPCS,15120,"Hc Partial Thickness Self Skin Graft To Face, Neck, Hands, Feet, Genitals-100 Sqcm",5386.63,2154.65,,,0 HCPCS,15120,Skn splt a-grft fac/nck/hf/g,,,3460.82,8652.04,8 HCPCS,15121,Skn splt a-grft f/n/hf/g add,,,8330.0,9743.0,4 HCPCS,15130,Derm autograft trnk/arm/leg,,,2015.01,5037.52,8 HCPCS,15131,Derm autograft t/a/l add-on,,,2546.0,2978.0,4 HCPCS,15135,Derm autograft face/nck/hf/g,,,3460.82,8652.04,8 HCPCS,15136,Derm autograft f/n/hf/g add,,,2546.0,2978.0,4 HCPCS,15150,Cult skin grft t/arm/leg,,,2015.01,5037.52,8 HCPCS,15151,Cult skin grft t/a/l addl,,,2546.0,2978.0,4 HCPCS,15152,Cult skin graft t/a/l +%,,,2546.0,2978.0,4 HCPCS,15155,Cult skin graft f/n/hf/g,,,3460.82,8652.04,8 HCPCS,15156,Cult skin grft f/n/hfg add,,,2546.0,2978.0,4 HCPCS,15157,Cult epiderm grft f/n/hfg +%,,,2546.0,2978.0,4 HCPCS,15200,"Hc Full Thickness Skin Graft To Trunk, 20.0 Sq Cm Or Less",3849.82,1539.93,,,0 HCPCS,15200,Skin full graft trunk,,,2015.01,9743.0,8 HCPCS,15201,"Hc Full Thickness Skin Graft To Trunk, Each Additional 20.0 Sq Cm Or Less",2565.06,1026.02,,,0 HCPCS,15201,Skin full graft trunk add-on,,,3470.0,4059.0,4 HCPCS,15220,"Hc Full Thick Graft Scalp, Arm, Leg <20Sqc",4452.05,1780.82,,,0 HCPCS,15220,Skin full graft sclp/arm/leg,,,2015.01,5037.52,8 HCPCS,15221,Hc Full Thickness Skin Graft To Scalp/Arms/Legs Each Additional 20.0 Sq Cm,3329.0,1331.6,,,0 HCPCS,15221,Skin full graft add-on,,,3470.0,4059.0,4 HCPCS,15240,"Hc Full Thickness Skin Graft-Forehead, Cheeks, Chin, Mouth, Neck, Underarms, Hand, Feet Genitals-20.",3190.94,1276.38,,,0 HCPCS,15240,Skin full grft face/genit/hf,,,2015.01,9743.0,8 HCPCS,15241,Hc Full Thickness Graft Forehead/Cheek/Chin/Mouth/Neck/Underarm/Gentials/Hands/Feet Each Additional,3234.21,1293.68,,,0 HCPCS,15241,Skin full graft add-on,,,8330.0,9743.0,4 HCPCS,15260,"Hc Full Thick Grft Nos,Ear,Lid <20 Sqcm",3584.67,1433.87,,,0 HCPCS,15260,Skin full graft een & lips,,,2015.01,5037.52,8 HCPCS,15261,Hc Full Thickness Skin Graft To Nose/Ears/Eyelids/Lips Each Additional 20.0 Sq Cm,2582.91,1033.16,,,0 HCPCS,15261,Skin full graft add-on,,,3470.0,4059.0,4 HCPCS,15271,Hc Application Of Skin Substitute Wound Surface Up To 100 Sqcm To Trunk/Arms/Legs First <25 Sqcm,1970.79,788.32,,,0 HCPCS,15271,Hc Grft 1St 25Sqcm <1Sc(Tal),1970.79,788.32,,,0 HCPCS,15271,Skin sub graft trnk/arm/leg,,,721.78,4059.0,8 HCPCS,15272,Hc Graft Ea Ad 25Sqcm (Tal),949.49,379.8,,,0 HCPCS,15272,Skin sub graft t/a/l add-on,,,2546.0,2978.0,4 HCPCS,15273,Hc App Skn Sub Grft T/A/L Area/>100Scm 1St 100Scm,347.0,138.8,,,0 HCPCS,15273,Skin sub grft t/arm/lg child,,,2015.01,5037.52,8 HCPCS,15274,Skn sub grft t/a/l child add,,,2546.0,2978.0,4 HCPCS,15275,Hc Grft 1St 25Sqcm<1Sc(Oth),1970.79,788.32,,,0 HCPCS,15275,Hc Sub Grft F/S/N/H/F/G/M/D/ <100Scm/<1St 25 Scm,1970.79,788.32,,,0 HCPCS,15275,Skin sub graft face/nk/hf/g,,,721.78,4059.0,8 HCPCS,15276,Hc Graft Each Additional (225 Cm) Other,949.49,379.8,,,0 HCPCS,15276,Skin sub graft f/n/hf/g addl,,,2546.0,2978.0,4 HCPCS,15277,Skn sub grft f/n/hf/g child,,,2015.01,5037.52,8 HCPCS,15278,Skn sub grft f/n/hf/g ch add,,,2546.0,2978.0,4 HCPCS,15300,"Apply skinallogrft, t/arm",,,3470.0,4059.0,4 HCPCS,15301,Apply sknallogrft t/a/l a,,,2546.0,2978.0,4 HCPCS,15320,Apply skin allogrft f/n/h,,,3470.0,4059.0,4 HCPCS,15321,Aply sknallogrft f/n/hfg,,,2546.0,2978.0,4 HCPCS,15330,Aply acell alogrft t/arm/,,,3470.0,4059.0,4 HCPCS,15331,Aply acell grft t/a/l add,,,2546.0,2978.0,4 HCPCS,15335,"Apply acell graft, f/n/hf",,,3470.0,4059.0,4 HCPCS,15336,Aply acell grft f/n/hf/g,,,2546.0,2978.0,4 HCPCS,15400,Skin heterograft,,,3470.0,4059.0,4 HCPCS,15401,Skin heterograft add-on,,,3470.0,4059.0,4 HCPCS,15420,"Apply skin xgraft, f/n/hf",,,3470.0,4059.0,4 HCPCS,15421,Apply skn xgrft f/n/hf/g,,,2546.0,2978.0,4 HCPCS,15430,Apply acellular xenograft,,,3470.0,4059.0,4 HCPCS,15431,Apply acellular xgraft ad,,,2546.0,2978.0,4 HCPCS,15570,Hc Skin Pedicle Flap Trunk,3568.78,1427.51,,,0 HCPCS,15570,Skin pedicle flap trunk,,,2015.01,9743.0,8 HCPCS,15572,Skin pedicle flap arms/legs,,,3460.82,9743.0,8 HCPCS,15574,Pedcle fh/ch/ch/m/n/ax/g/h/f,,,2015.01,9743.0,8 HCPCS,15576,"Hc Creation Of Flap Graft To Eyelids, Nose, Ears, Lips, Mouth",2885.69,1154.28,,,0 HCPCS,15576,Pedicle e/n/e/l/ntroral,,,2015.01,9743.0,8 HCPCS,15600,Delay flap trunk,,,3460.82,9743.0,8 HCPCS,15610,Delay flap arms/legs,,,2015.01,9743.0,8 HCPCS,15620,Delay flap f/c/c/n/ax/g/h/f,,,2015.01,8800.0,8 HCPCS,15620,Hc Delay Of Flap To Forehead/Cheeks/Chin/Neck/Underarms/Genitals/Hands/Feet,7070.65,2828.26,,,0 HCPCS,15630,Delay flap eye/nos/ear/lip,,,2015.01,9743.0,8 HCPCS,15630,Hc Delay Flap Eye/Nose/Ear/Lip,3568.78,1427.51,,,0 HCPCS,15650,Transfer skin pedicle flap,,,2015.01,11433.0,8 HCPCS,15730,Mdfc flap w/prsrv vasc pedcl,,,3460.82,8652.04,4 HCPCS,15731,Forehead Flap w/Vasc Pedicle,,,3460.82,9743.0,8 HCPCS,15731,Hc Forehead Flap W Preservation Vascular Pedicle,7583.66,3033.46,,,0 HCPCS,15732,Muscle-skin graft head/neck,,,8330.0,9743.0,4 HCPCS,15733,Musc myoq/fscq flp h&n pedcl,,,3460.82,8652.04,4 HCPCS,15734,Hc Muscle/Skin Graft Trunk,7756.52,3102.61,,,0 HCPCS,15734,Muscle-skin graft trunk,,,3460.82,9743.0,8 HCPCS,15736,Muscle-skin graft arm,,,2015.01,9743.0,8 HCPCS,15738,Muscle-skin graft leg,,,3460.82,9743.0,8 HCPCS,15740,Hc Island Pedicle Flap Graft,3791.83,1516.73,,,0 HCPCS,15740,Island pedicle flap graft,,,2015.01,5037.52,8 HCPCS,15750,Neurovascular pedicle flap,,,3460.82,8652.04,8 HCPCS,15760,Composite skin graft,,,2015.01,5037.52,8 HCPCS,15769,Grfg autol soft tiss dir exc,,,3460.82,9743.0,8 HCPCS,15770,Derma-fat-fascia graft,,,3460.82,9743.0,8 HCPCS,15771,Grfg autol fat lipo 50 cc/<,,,3460.82,9743.0,8 HCPCS,15773,Grfg autol fat lipo 25 cc/<,,,2015.01,5037.52,8 HCPCS,15775,Hair trnspl 1-15 punch grfts,,,397.0,9743.0,8 HCPCS,15776,Hair trnspl >15 punch grafts,,,397.0,9743.0,8 HCPCS,15778,Impl absrb msh/prsth dly cls,,,7639.0,8934.0,4 HCPCS,15780,Dermabrasion total face,,,2836.76,7091.89,4 HCPCS,15781,Dermabrasion segmental face,,,691.56,1728.91,4 HCPCS,15782,Dermabrasion other than face,,,2836.76,7091.89,4 HCPCS,15783,Dermabrasion suprfl any site,,,397.0,992.51,4 HCPCS,15786,Abrasion lesion single,,,195.94,489.85,4 HCPCS,15788,Chemical peel face epiderm,,,397.0,992.51,4 HCPCS,15789,Chemical peel face dermal,,,721.78,1804.45,4 HCPCS,15792,Chemical peel nonfacial,,,721.78,1804.45,4 HCPCS,15793,Chemical peel nonfacial,,,397.0,992.51,4 HCPCS,15820,Revision of lower eyelid,,,2015.01,9743.0,8 HCPCS,15821,Revision of lower eyelid,,,2015.01,9743.0,8 HCPCS,15822,Revision of upper eyelid,,,2015.01,9743.0,8 HCPCS,15823,Hc Rev Upper Eyelid W Excess Skin,4784.0,1913.6,,,0 HCPCS,15823,Revision of upper eyelid,,,2015.01,11433.0,8 HCPCS,15824,Removal of forehead wrinkles,,,2015.01,9743.0,8 HCPCS,15825,Removal of neck wrinkles,,,3460.82,9743.0,8 HCPCS,15826,Removal of brow wrinkles,,,3460.82,9743.0,8 HCPCS,15828,Removal of face wrinkles,,,3460.82,9743.0,8 HCPCS,15829,Removal of skin wrinkles,,,3460.82,11433.0,8 HCPCS,15830,Exc Skin Abd,,,6484.82,16212.04,8 HCPCS,15832,Excise excessive skin thigh,,,2836.76,9743.0,8 HCPCS,15833,Excise excessive skin leg,,,2836.76,9743.0,8 HCPCS,15834,Excise excessive skin hip,,,2836.76,9743.0,8 HCPCS,15835,Excise excessive skin buttck,,,2836.76,9743.0,8 HCPCS,15836,Excise excessive skin arm,,,2836.76,9743.0,8 HCPCS,15837,Excise excess skin arm/hand,,,2836.76,7091.89,4 HCPCS,15838,Excise excess skin fat pad,,,2836.76,7091.89,4 HCPCS,15839,Excise excess skin & tissue,,,2836.76,9743.0,8 HCPCS,15840,Nerve palsy fascial graft,,,3460.82,8800.0,8 HCPCS,15841,Nerve palsy muscle graft,,,3460.82,8800.0,8 HCPCS,15842,Nerve palsy microsurg graft,,,2015.01,5037.52,4 HCPCS,15845,Skin and muscle repair face,,,3460.82,8800.0,8 HCPCS,15847,Exc Skin Abd Add-on,,,8330.0,9743.0,4 HCPCS,15851,Hc Removal Sutures/Staples Requiring Anesthesia,3835.0,1534.0,,,0 HCPCS,15851,Remove sutures diff surgeon,,,2015.01,5037.52,8 HCPCS,15852,Dressing change not for burn,,,721.78,1804.45,4 HCPCS,15852,"Hc Dressing Change,Not For Burn",171.14,68.46,,,0 HCPCS,15853,Hc Removal Sutures Or Staples Not Requiring Anesthesia,358.8,143.52,,,0 HCPCS,15854,Hc Removal Sutures And Staples Not Requiring Anesthesia,240.5,96.2,,,0 HCPCS,15860,Test for blood flow in graft,,,436.27,1090.68,4 HCPCS,15876,Suction lipectomy head&neck,,,3460.82,9743.0,8 HCPCS,15877,Suction lipectomy trunk,,,3460.82,9743.0,8 HCPCS,15878,Suction lipectomy upr extrem,,,2015.01,9743.0,8 HCPCS,15879,Suction lipectomy lwr extrem,,,3460.82,9743.0,8 HCPCS,15920,Removal of tail bone ulcer,,,2836.76,9743.0,8 HCPCS,15922,Removal of tail bone ulcer,,,3460.82,8800.0,8 HCPCS,15931,Remove sacrum pressure sore,,,2836.76,9743.0,8 HCPCS,15933,Remove sacrum pressure sore,,,2836.76,9743.0,8 HCPCS,15934,Remove sacrum pressure sore,,,3460.82,9743.0,8 HCPCS,15935,Remove sacrum pressure sore,,,3460.82,8800.0,8 HCPCS,15936,Remove sacrum pressure sore,,,2015.01,8800.0,8 HCPCS,15937,Remove sacrum pressure sore,,,2015.01,8800.0,8 HCPCS,15940,Remove hip pressure sore,,,2836.76,9743.0,8 HCPCS,15941,Remove hip pressure sore,,,2836.76,9743.0,8 HCPCS,15944,Remove hip pressure sore,,,3460.82,9743.0,8 HCPCS,15945,Remove hip pressure sore,,,2015.01,8800.0,8 HCPCS,15946,Remove hip pressure sore,,,2015.01,8800.0,8 HCPCS,15950,Remove thigh pressure sore,,,1612.96,9743.0,8 HCPCS,15951,Remove thigh pressure sore,,,2836.76,8800.0,8 HCPCS,15952,Remove thigh pressure sore,,,2015.01,9743.0,8 HCPCS,15953,Remove thigh pressure sore,,,3460.82,8800.0,8 HCPCS,15956,Remove thigh pressure sore,,,2015.01,9743.0,8 HCPCS,15958,Remove thigh pressure sore,,,3460.82,8800.0,8 HCPCS,15999,Removal of pressure sore,,,691.56,1728.91,4 HCPCS,16000,Hc Initial Rx Burn(S) 1St Degree,581.02,232.41,,,0 HCPCS,16000,Initial treatment of burn(s),,,195.94,489.85,4 HCPCS,16020,Dress/debrid p-thick burn s,,,195.94,489.85,4 HCPCS,16020,Hc Dress/Debrid Small Burn No Anes,833.85,333.54,,,0 HCPCS,16020,Hc Drss/Debrid Small Burn No Anes,833.85,333.54,,,0 HCPCS,16025,Dress/debrid p-thick burn m,,,195.94,4059.0,8 HCPCS,16025,Hc Dress/Debrid Med Burn No Anesth,1041.48,416.59,,,0 HCPCS,16030,Dress/debrid p-thick burn l,,,397.0,4059.0,8 HCPCS,16030,Hc Dress/Debrid Large Burn No Anesth,1237.38,494.95,,,0 HCPCS,16035,Incision of burn scab initi,,,397.0,2978.0,8 HCPCS,17000,Destruct premalg lesion,,,195.94,489.85,4 HCPCS,17000,"Hc Destruc Benign/Premal,First Lesion",468.83,187.53,,,0 HCPCS,17003,Hc Destruction Of Premalg 2-14Th Lesions Each,299.72,119.89,,,0 HCPCS,17004,Destroy premal lesions 15/>,,,397.0,2978.0,8 HCPCS,17004,"Hc Destruc Benign/Premal,15+ Lesions",1121.85,448.74,,,0 HCPCS,17106,Destruction of skin lesions,,,397.0,992.51,4 HCPCS,17106,Hc Destruction Cutaneous/Vascular Proliferative <10Cm,1472.58,589.03,,,0 HCPCS,17107,Destruction of skin lesions,,,721.78,1804.45,4 HCPCS,17108,Destruction of skin lesions,,,2015.01,5037.52,4 HCPCS,17110,Destruct b9 lesion 1-14,,,195.94,2978.0,8 HCPCS,17110,Hc Destruction Benign Lesions Up To 14,485.58,194.23,,,0 HCPCS,17111,Destruct lesion 15 or more,,,195.94,489.85,4 HCPCS,17111,Hc Destruction Benign Lesions 15 Or More,635.38,254.15,,,0 HCPCS,17250,Chemical cautery tissue,,,195.94,489.85,4 HCPCS,17250,Hc Chem Cautery Granulatn Tissue,731.72,292.69,,,0 HCPCS,17250,Hc Chemical Cauterization Of Granulation Tissue,731.72,292.69,,,0 HCPCS,17260,Destruction of skin lesions,,,195.94,489.85,4 HCPCS,17261,Destruction of skin lesions,,,195.94,489.85,4 HCPCS,17261,"Hc Destruction Of Skin Lesions Trunk, Arm, Leg- 0.6-1.0 Cm",441.02,176.41,,,0 HCPCS,17262,Destruction of skin lesions,,,195.94,489.85,4 HCPCS,17263,Destruction of skin lesions,,,195.94,489.85,4 HCPCS,17264,Destruction of skin lesions,,,397.0,992.51,4 HCPCS,17266,Destruction of skin lesions,,,397.0,992.51,4 HCPCS,17270,Destruction of skin lesions,,,195.94,489.85,4 HCPCS,17270,"Hc Destruction Malignant Lesion Scalp, Neck, Hands, Feet, Or Genitals < 0.5Cm",650.32,260.13,,,0 HCPCS,17271,Destruction of skin lesions,,,195.94,489.85,4 HCPCS,17272,Destruction of skin lesions,,,195.94,489.85,4 HCPCS,17272,"Hc Destruction Of Skin Lesions-Scalp, Neck, Hands, Feet, Or Gentials-1.1-2.0 Cm",470.92,188.37,,,0 HCPCS,17273,Destruction of skin lesions,,,397.0,992.51,4 HCPCS,17274,Destruction of skin lesions,,,397.0,992.51,4 HCPCS,17276,Destruction of skin lesions,,,397.0,992.51,4 HCPCS,17280,Destruction of skin lesions,,,195.94,489.85,4 HCPCS,17281,Destruction of skin lesions,,,195.94,489.85,4 HCPCS,17282,Destruction of skin lesions,,,195.94,489.85,4 HCPCS,17282,"Hc Destruction Of Skin Lesions-Face, Ears, Eyelids, Nose, Lips, Or Mouth-1.1-2.0Cm",696.67,278.67,,,0 HCPCS,17283,Destruction of skin lesions,,,397.0,992.51,4 HCPCS,17284,Destruction of skin lesions,,,721.78,1804.45,4 HCPCS,17286,Destruction of skin lesions,,,721.78,1804.45,4 HCPCS,17311,"Hc Mohs Stage 1-Head, Neck, Hands, Feet, Genitals 1-5 Tissue Block",2840.5,1136.2,,,0 HCPCS,17311,Mohs 1 stage h/n/hf/g,,,721.78,1804.45,4 HCPCS,17312,"Hc Mohs Additional Stage-Head, Neck, Hands, Feet, Genitals-1-5 Tissue Block",946.34,378.54,,,0 HCPCS,17313,"Hc Mohs 1 Stage-Trunk, Are, Leg-1-5 Blocks",2740.34,1096.14,,,0 HCPCS,17313,Mohs 1 stage t/a/l,,,721.78,1804.45,4 HCPCS,17314,"Hc Mohs Additional Stage-Trunk, Arms, Or Legs-1-5 Tissue Block",2302.3,920.92,,,0 HCPCS,17315,"Hc Mohs Additional Block-Trunk, Arm, Leg-After 5 Blocks",1861.28,744.51,,,0 HCPCS,17340,Cryotherapy of skin,,,57.61,144.03,4 HCPCS,17360,Skin peel therapy,,,195.94,489.85,4 HCPCS,17380,Hair removal by electrolysis,,,721.78,1804.45,4 HCPCS,17999,Hc Skin Tissue Procedure Unlisted,704.0,281.6,,,0 HCPCS,17999,Skin tissue procedure,,,195.94,489.85,4 HCPCS,19000,Drainage of breast lesion,,,691.56,2978.0,8 HCPCS,19000,Hc Puncture/Aspiration Breast Cyst-Unilateral,2156.62,862.65,,,0 HCPCS,19001,"Hc Puncture/Aspiration Breast Cyst,Each Additional-Unilateral",994.59,397.84,,,0 HCPCS,19020,Hc Explo/Drain Breast Abscess,5902.26,2360.9,,,0 HCPCS,19020,Incision of breast lesion,,,1612.96,4059.0,8 HCPCS,19081,Bx breast 1st lesion strtctc,,,1612.96,4059.0,8 HCPCS,19081,Hc Biopsy Breast W Device 1St Lesion Stereotactic Guide-Unilateral,11979.86,4791.94,,,0 HCPCS,19082,Hc Biopsy Breast With Device Additional Lesion Stereotactic Guide,7258.3,2903.32,,,0 HCPCS,19083,Bx breast 1st lesion us imag,,,1612.96,4059.0,8 HCPCS,19083,Hc Biopsy Breast W Device 1St Lesion Guide-Unilateral,10059.35,4023.74,,,0 HCPCS,19084,Hc Biopsy Breast Ultrasound Guided With Device Each Additional Lesion,6800.08,2720.03,,,0 HCPCS,19084,Hc Bx Breast W Device Addl Lesion Ultrasound Guide,6800.08,2720.03,,,0 HCPCS,19085,Bx breast 1st lesion mr imag,,,1612.96,4059.0,8 HCPCS,19085,Hc Biopsy Breast W Device 1St Lesion Magnetic Resonance Guide,10810.61,4324.24,,,0 HCPCS,19086,Hc Biopsy Breast With Device Additional Lesion Magnetic Resonance Guide,6224.13,2489.65,,,0 HCPCS,19100,Bx breast percut w/o image,,,1612.96,4032.39,8 HCPCS,19101,Biopsy of breast open,,,3470.0,9559.57,8 HCPCS,19101,Hc Biopsy Breast Open Incisional,6630.0,2652.0,,,0 HCPCS,19105,Cryosurg ablate fa each,,,3823.83,9559.57,4 HCPCS,19110,Nipple exploration,,,3470.0,9559.57,8 HCPCS,19112,Excise breast duct fistula,,,3823.83,9743.0,8 HCPCS,19120,Removal of breast lesion,,,3823.83,9743.0,8 HCPCS,19125,Excision breast lesion,,,3823.83,9743.0,8 HCPCS,19126,Excision addl breast lesion,,,8330.0,9743.0,4 HCPCS,19281,Hc Perq Device Placement Breast Loc 1St Lesion W Guidance-Unilateral,5553.26,2221.3,,,0 HCPCS,19281,Perq device breast 1st imag,,,1612.96,4032.39,8 HCPCS,19282,Hc Perq Device Placemt Breast Loc Ea Les W Guidnce,3658.6,1463.44,,,0 HCPCS,19283,Hc Stereotactic Guided Breast Localization 1St Lesion-Bilateral,6664.7,2665.88,,,0 HCPCS,19283,Hc Stereotactic Guided Breast Localization 1St Lesion-Unilateral,5553.92,2221.57,,,0 HCPCS,19283,Perq dev breast 1st strtctc,,,691.56,2978.0,8 HCPCS,19284,Hc Stereotactic Guided Breast Localization Additional Lesion,3659.12,1463.65,,,0 HCPCS,19285,Hc Perq Breast Loc Device Placement 1St Lesion Us Image-Unilateral,5808.94,2323.58,,,0 HCPCS,19285,Perq dev breast 1st us imag,,,691.56,2978.0,8 HCPCS,19286,Hc Perq Breast Loc Device Placement Each Lesion Us Image,2038.3,815.32,,,0 HCPCS,19287,Perq dev breast 1st mr guide,,,691.56,2978.0,8 HCPCS,19296,Place po breast cath for rad,,,7982.17,19955.42,8 HCPCS,19297,Place breast cath for rad,,,14697.0,17190.0,4 HCPCS,19298,Hc Placement Of Brachytherapy Catheter For Breast Microseed,7146.26,2858.5,,,0 HCPCS,19298,Place breast rad tube/caths,,,13458.54,33646.34,8 HCPCS,19300,Removal of Breast Tissue,,,3823.83,9559.57,8 HCPCS,19301,Partial Mastectomy,,,3823.83,9743.0,8 HCPCS,19302,P-Mastectomy w/LN Removal,,,6484.82,16212.04,8 HCPCS,19303,Mast simple complete,,,6484.82,16212.04,8 HCPCS,19304,Mast subq,,,7524.0,8800.0,4 HCPCS,19307,Mast mod rad,,,6484.82,17190.0,8 HCPCS,19316,Suspension of breast,,,6484.82,16212.04,8 HCPCS,19318,Reduction of large breast,,,6484.82,16212.04,8 HCPCS,19324,Enlarge breast,,,7524.0,8800.0,4 HCPCS,19325,Enlarge breast with implant,,,7982.17,19955.42,8 HCPCS,19328,Hc Removal Intact Breast Implant,9234.22,3693.69,,,0 HCPCS,19328,Removal of breast implant,,,2546.0,9559.57,8 HCPCS,19330,Removal of implant material,,,2546.0,9559.57,8 HCPCS,19340,Immediate breast prosthesis,,,3470.0,19955.42,8 HCPCS,19342,Delayed breast prosthesis,,,7982.17,19955.42,8 HCPCS,19350,Breast reconstruction,,,3823.83,9559.57,8 HCPCS,19355,Correct inverted nipple(s),,,3823.83,9559.57,8 HCPCS,19357,Breast reconstruction,,,9775.0,33646.34,8 HCPCS,19364,Breast reconstruction,,,7524.0,8800.0,4 HCPCS,19366,Breast reconstruction,,,9775.0,11433.0,4 HCPCS,19370,Surgery of breast capsule,,,3823.83,9559.57,8 HCPCS,19371,Removal of breast capsule,,,3823.83,9559.57,8 HCPCS,19380,Revise breast reconstruction,,,6484.82,16212.04,8 HCPCS,19396,Design custom breast implant,,,3823.83,9559.57,4 HCPCS,19499,Breast surgery procedure,,,3823.83,9559.57,4 HCPCS,19499,Hc Ct Guided Cryoablation Breast-Unilateral,4384.0,1753.6,,,0 HCPCS,19499,Hc Us Breast Clip Placed W/O Biopsy-Unilateral,4464.43,1785.77,,,0 HCPCS,20005,I&d abscess subfascial,,,3470.0,4059.0,4 HCPCS,20100,Explore wound neck,,,526.71,1316.78,4 HCPCS,20101,Explore wound chest,,,2015.01,5037.52,4 HCPCS,20102,Explore wound abdomen,,,2015.01,5037.52,4 HCPCS,20103,Explore wound extremity,,,1612.96,4059.0,8 HCPCS,20103,"Hc Explore Wound, Extremity",2300.62,920.25,,,0 HCPCS,20150,Excise epiphyseal bar,,,3195.45,7988.62,4 HCPCS,20200,Muscle biopsy,,,1612.96,4059.0,8 HCPCS,20205,Deep muscle biopsy,,,2836.76,9743.0,8 HCPCS,20206,"Hc Needle Biopsy,Muscle",3797.53,1519.01,,,0 HCPCS,20206,Needle biopsy muscle,,,1612.96,4032.39,8 HCPCS,20220,Bone biopsy trocar/needle,,,1612.96,4032.39,8 HCPCS,20220,"Hc Bone Biopsy,Trocar/Needle Superficial",4172.61,1669.04,,,0 HCPCS,20225,Bone biopsy trocar/needle,,,1612.96,4059.0,8 HCPCS,20225,"Hc Bone Biopsy,Trocar/Needle Deep",5701.33,2280.53,,,0 HCPCS,20240,Bone biopsy open superficial,,,2836.76,7091.89,8 HCPCS,20240,Hc Biopsy Open Superficial Procedure,5951.4,2380.56,,,0 HCPCS,20245,Bone biopsy open deep,,,2836.76,9743.0,8 HCPCS,20250,Open bone biopsy,,,3195.45,9743.0,8 HCPCS,20251,Open bone biopsy,,,7086.45,17716.12,8 HCPCS,20500,Hc Inject Sinus Tract Theraputic,2737.34,1094.94,,,0 HCPCS,20500,Injection of sinus tract,,,1515.28,3788.21,4 HCPCS,20501,Hc Inject Sinus Tract For Dx W Xray,947.71,379.08,,,0 HCPCS,20520,Hc Removal Of Foreign Body,1438.31,575.32,,,0 HCPCS,20520,Removal of foreign body,,,1612.96,4059.0,8 HCPCS,20525,Removal of foreign body,,,2836.76,9743.0,8 HCPCS,20526,Hc Inject Carpal Tunnel Bilateral,1573.94,629.58,,,0 HCPCS,20526,Hc Injection Carpal Tunnel,1049.85,419.94,,,0 HCPCS,20526,Hc Injection Carpal Tunnel Unilateral,1049.85,419.94,,,0 HCPCS,20526,Ther injection carp tunnel,,,299.77,749.43,4 HCPCS,20527,Hc Inj Enzyme Palmar Fascial Cord,1247.43,498.97,,,0 HCPCS,20527,Inj dupuytren cord w/enzyme,,,299.77,749.43,4 HCPCS,20550,Hc Inject Tendon Sheath/Ligament,1369.65,547.86,,,0 HCPCS,20550,Hc Injection Tendon Sheath/Ligament Bilateral,2052.82,821.13,,,0 HCPCS,20550,Hc Injection Tendon Sheath/Ligament Unilateral,1369.65,547.86,,,0 HCPCS,20550,Inj tendon sheath/ligament,,,299.77,749.43,4 HCPCS,20551,Hc Inject Tendon Origin/Insert,1091.71,436.68,,,0 HCPCS,20551,Inj tendon origin/insertion,,,299.77,749.43,4 HCPCS,20552,"Hc Inject Trigger Point, 1 Or 2",1525.38,610.15,,,0 HCPCS,20552,Inj trigger point 1/2 muscl,,,299.77,749.43,4 HCPCS,20553,"Hc Inject Trigger Points, > 3",1741.38,696.55,,,0 HCPCS,20553,Inject trigger points 3/>,,,299.77,749.43,4 HCPCS,20555,Place ndl musc/tis for rt,,,3195.45,7988.62,4 HCPCS,20560,Hc Ot Dry Needle 1 Or 2 Muscles,110.51,44.2,,,0 HCPCS,20560,Hc Pt Dry Needle 1 Or 2 Muscles,110.51,44.2,,,0 HCPCS,20560,Ndl insj w/o njx 1 or 2 musc,,,28.25,70.62,4 HCPCS,20561,Hc Ot Dry Needle 3 Or More Muscles,115.53,46.21,,,0 HCPCS,20561,Hc Pt Dry Needle 3 Or More Muscles,115.53,46.21,,,0 HCPCS,20561,Ndl insj w/o njx 3+ musc,,,28.25,70.62,4 HCPCS,20600,Drain/inj joint/bursa w/o us,,,299.77,749.43,4 HCPCS,20600,Hc Arthrocentesis Aspiration/Injection Small Joint/Bursa Without Ultrasound-Bilateral,2021.01,808.4,,,0 HCPCS,20600,Hc Arthrocentesis Aspiration/Injection Small Joint/Bursa Without Ultrasound-Unilateral,1347.89,539.16,,,0 HCPCS,20600,Hc Ct Guided Inj Asp Small Joint Or Bursa-Bilateral,2021.01,808.4,,,0 HCPCS,20600,Hc Ct Guided Inj Asp Small Joint Or Bursa-Unilateral,1347.89,539.16,,,0 HCPCS,20604,Drain/inj joint/bursa w/us,,,299.77,749.43,4 HCPCS,20604,Hc Arthrocentesis Aspiration/Injection Small Joint/Bursa With Ultrasound-Bilateral,4060.42,1624.17,,,0 HCPCS,20604,Hc Arthrocentesis Aspiration/Injection Small Joint/Bursa With Ultrasound-Unilateral,3516.24,1406.5,,,0 HCPCS,20604,Hc Ct Guided Arthrocentesis Aspiration/Injection Small Joint/Bursa With Ultrasound-Bilateral,4060.42,1624.17,,,0 HCPCS,20605,Drain/inj joint/bursa w/o us,,,299.77,749.43,4 HCPCS,20605,Hc Arthorcentesis Aspiration/Injection Intermediate Joint/Bursa W/O Ultrasound-Bilateral,2545.09,1018.04,,,0 HCPCS,20605,Hc Arthorcentesis Aspiration/Injection Intermediate Joint/Bursa W/O Ultrasound-Unilateral,1697.84,679.14,,,0 HCPCS,20605,Hc Ct Guided Arthorcentesis Aspiration/Injection Intermediate Joint/Bursa-Bilateral,2545.09,1018.04,,,0 HCPCS,20605,Hc Ct Guided Arthorcentesis Aspiration/Injection Intermediate Joint/Bursa-Unilateral,1697.84,679.14,,,0 HCPCS,20606,Drain/inj joint/bursa w/us,,,689.37,1723.42,4 HCPCS,20606,Hc Arthorcentesis Aspiration/Injection Intermediate Joint/Bursa W Ultrasound-Bilateral,5939.1,2375.64,,,0 HCPCS,20606,Hc Arthorcentesis Aspiration/Injection Intermediate Joint/Bursa W Ultrasound-Unilateral,3958.28,1583.31,,,0 HCPCS,20606,Hc Arthrocentesis Aspir&/Inj Interm Jt/Burs W/Us,3958.28,1583.31,,,0 HCPCS,20606,Hc Arthrocentesis Aspir&/Inj Interm Jt/Burs W/Us Right,5939.1,2375.64,,,0 HCPCS,20606,Hc Arthrocentesis Aspiration/Injection Intermediate Joint/Bursa With Ultrasound-Unilateral,3958.28,1583.31,,,0 HCPCS,20610,Drain/inj joint/bursa w/o us,,,299.77,2978.0,8 HCPCS,20610,Hc Arthrocentesis Aspir&/Inj Major Jt/Bursa W/O Us Left,1794.96,717.98,,,0 HCPCS,20610,Hc Arthrocentesis Aspiration/Injection Major Joint/Bursa Without Us-Bilateral,2697.46,1078.98,,,0 HCPCS,20610,Hc Arthrocentesis Aspiration/Injection Major Joint/Bursa Without Us-Unilateral,1796.63,718.65,,,0 HCPCS,20610,Hc Ct Guided Arthrocentesis Aspiration/Injection Major Joint/Bursa W/O Us-Unilateral,1796.63,718.65,,,0 HCPCS,20610,Hc Ct Guided Arthrocentesis Aspiration/Injection Major Joint/Bursa Without Us-Bilateral,2697.46,1078.98,,,0 HCPCS,20610,Hc Pbb Arthrocentesis Aspir&/Inj Major Jt/Bursa W/O Us Left,2697.46,1078.98,,,0 HCPCS,20611,Drain/inj joint/bursa w/us,,,299.77,749.43,4 HCPCS,20611,Hc Arthrocentesis Aspir&/Inj Major Jt/Bursa W/Us,4026.93,1610.77,,,0 HCPCS,20611,Hc Arthrocentesis Aspiration/Injection Major Joint/Bursa W Ultrasound-Bilateral,6041.23,2416.49,,,0 HCPCS,20611,Hc Arthrocentesis Aspiration/Injection Major Joint/Bursa W Ultrasound-Unilateral,4026.93,1610.77,,,0 HCPCS,20611,Hc Arthrocentesis Aspiration/Injection Major Joint/Bursa W Us,4026.93,1610.77,,,0 HCPCS,20611,Hc Ct Guided Arthrocentesis Aspiration/Injection Major Joint/Bursa W Ultrasound-Bilateral,6041.23,2416.49,,,0 HCPCS,20611,Hc Ct Guided Arthrocentesis Aspiration/Injection Major Joint/Bursa W Ultrasound-Unilateral,4026.93,1610.77,,,0 HCPCS,20612,Aspirate/inj ganglion cyst,,,299.77,749.43,4 HCPCS,20612,Hc Aspiration/Injection Ganglion Cyst(S),1342.87,537.15,,,0 HCPCS,20615,Treatment of bone cyst,,,691.56,1728.91,4 HCPCS,20650,Hc Insert And Remove Of Wire Or Pin With Bone Traction,5358.08,2143.23,,,0 HCPCS,20650,Insert and remove bone pin,,,3195.45,9743.0,8 HCPCS,20660,Apply rem fixation device,,,1570.37,3925.93,4 HCPCS,20661,Application of head brace,,,1570.37,3925.93,4 HCPCS,20662,Application of pelvis brace,,,1570.37,3925.93,4 HCPCS,20663,Application of thigh brace,,,3195.45,7988.62,4 HCPCS,20664,Application of halo,,,1570.37,3925.93,4 HCPCS,20665,Removal of fixation device,,,436.27,1090.68,4 HCPCS,20670,Hc Removal Superficial Implant,4106.76,1642.7,,,0 HCPCS,20670,Removal of support implant,,,1612.96,4032.39,8 HCPCS,20680,Hc Removal Deep Implant,8137.58,3255.03,,,0 HCPCS,20680,Removal of support implant,,,2836.76,9743.0,8 HCPCS,20690,Apply bone fixation device,,,3470.0,17716.12,8 HCPCS,20692,Apply bone fixation device,,,8330.0,31345.78,8 HCPCS,20693,Adjust bone fixation device,,,7086.45,17716.12,8 HCPCS,20694,Remove bone fixation device,,,1570.37,3925.93,8 HCPCS,20697,Comp ext fixate strut change,,,1570.37,3925.93,4 HCPCS,20802,Replantation arm complete,,,17123.6,42809.0,4 HCPCS,20805,Replant forearm complete,,,17123.6,42809.0,4 HCPCS,20808,Replantation hand complete,,,17123.6,42809.0,4 HCPCS,20816,Replantation digit complete,,,1570.37,3925.93,4 HCPCS,20822,"Hc Replantation Digit Distal, Complicated",2090.01,836.0,,,0 HCPCS,20822,Replantation digit complete,,,1570.37,3925.93,4 HCPCS,20824,Replantation thumb complete,,,1570.37,3925.93,4 HCPCS,20827,Replantation thumb complete,,,1570.37,3925.93,4 HCPCS,20838,Replantation foot complete,,,17123.6,42809.0,4 HCPCS,20900,Removal of bone for graft,,,7086.45,17716.12,8 HCPCS,20902,Removal of bone for graft,,,7086.45,17716.12,8 HCPCS,20910,Remove cartilage for graft,,,721.78,9743.0,8 HCPCS,20912,Remove cartilage for graft,,,3460.82,9743.0,8 HCPCS,20920,Removal of fascia for graft,,,2015.01,8800.0,8 HCPCS,20922,Removal of fascia for graft,,,2015.01,9743.0,8 HCPCS,20924,Removal of tendon for graft,,,7086.45,17716.12,8 HCPCS,20926,Removal of tissue for graft,,,7524.0,8800.0,4 HCPCS,20950,Fluid pressure muscle,,,691.56,1728.91,4 HCPCS,20955,Fibula bone graft microvasc,,,7086.45,17716.12,4 HCPCS,20956,Iliac bone graft microvasc,,,7086.45,17716.12,4 HCPCS,20957,Mt bone graft microvasc,,,7086.45,17716.12,4 HCPCS,20962,Other bone graft microvasc,,,7086.45,17716.12,4 HCPCS,20969,Bone/skin graft microvasc,,,7086.45,17716.12,4 HCPCS,20970,Bone/skin graft iliac crest,,,7086.45,17716.12,4 HCPCS,20972,Bone/skin graft metatarsal,,,7086.45,17716.12,4 HCPCS,20973,Bone/skin graft great toe,,,7086.45,17716.12,4 HCPCS,20974,Electrical bone stimulation,,,47.5,118.75,4 HCPCS,20975,Electrical bone stimulation,,,3470.0,4059.0,4 HCPCS,20979,Us bone stimulation,,,28.25,70.62,4 HCPCS,20982,Ablate bone tumor(s) perq,,,17123.6,42809.0,4 HCPCS,20982,Hc Ablation Bone Tumor Rf Perq W/Img Gdn When Done,21814.08,8725.63,,,0 HCPCS,20983,Ablate bone tumor(s) perq,,,7086.45,17716.12,4 HCPCS,20999,Musculoskeletal surgery,,,240.9,602.24,4 HCPCS,21010,Incision of jaw joint,,,3237.89,8094.73,8 HCPCS,21011,Exc face les sc <2 cm,,,1612.96,4059.0,8 HCPCS,21011,Hc Excision Tumor Soft Tissue Face/Scalp Subq <2Cm,3767.4,1506.96,,,0 HCPCS,21012,Exc face les sbq 2 cm/>,,,1612.96,4059.0,8 HCPCS,21012,Hc Excision Tumor Soft Tissue Face/Scalp Subq 2Cm Or More,5317.0,2126.8,,,0 HCPCS,21013,Exc face tum deep < 2 cm,,,1612.96,4059.0,8 HCPCS,21014,Exc face tum deep 2 cm/>,,,2836.76,7091.89,8 HCPCS,21014,Hc Exc Tumor Soft Tiss Face&Scalp Subfascial 2 Cm/>,4260.75,1704.3,,,0 HCPCS,21015,Resect face/scalp tum < 2 cm,,,2836.76,9743.0,8 HCPCS,21016,Resect face/scalp tum 2 cm/>,,,2836.76,7091.89,4 HCPCS,21025,Excision of bone lower jaw,,,3470.0,14453.33,8 HCPCS,21026,Excision of facial bone(s),,,3470.0,14453.33,8 HCPCS,21029,Contour of face bone lesion,,,3237.89,8094.73,8 HCPCS,21030,Excise max/zygoma b9 tumor,,,5781.33,14453.33,4 HCPCS,21031,Remove exostosis mandible,,,3237.89,9743.0,8 HCPCS,21032,Remove exostosis maxilla,,,3237.89,8094.73,4 HCPCS,21034,Excise max/zygoma mal tumor,,,5781.33,14453.33,8 HCPCS,21040,Excise mandible lesion,,,3237.89,8094.73,8 HCPCS,21044,Removal of jaw bone lesion,,,3470.0,14453.33,8 HCPCS,21045,Extensive jaw surgery,,,5781.33,14453.33,4 HCPCS,21046,Remove mandible cyst complex,,,3470.0,14453.33,8 HCPCS,21047,Excise lwr jaw cyst w/repair,,,3470.0,14453.33,8 HCPCS,21048,Remove maxilla cyst complex,,,5781.33,14453.33,8 HCPCS,21049,Excis uppr jaw cyst w/repair,,,5781.33,14453.33,4 HCPCS,21050,Removal of jaw joint,,,5781.33,14453.33,8 HCPCS,21060,Remove jaw joint cartilage,,,3470.0,14453.33,8 HCPCS,21070,Remove coronoid process,,,5781.33,14453.33,8 HCPCS,21073,Mnpj of tmj w/anesth,,,1515.28,9743.0,8 HCPCS,21076,Prepare face/oral prosthesis,,,1515.28,3788.21,4 HCPCS,21077,Prepare face/oral prosthesis,,,5781.33,14453.33,4 HCPCS,21079,Prepare face/oral prosthesis,,,3237.89,8094.73,4 HCPCS,21080,Prepare face/oral prosthesis,,,3237.89,8094.73,4 HCPCS,21081,Prepare face/oral prosthesis,,,5781.33,14453.33,4 HCPCS,21082,Prepare face/oral prosthesis,,,3237.89,8094.73,4 HCPCS,21083,Prepare face/oral prosthesis,,,3237.89,8094.73,4 HCPCS,21084,Prepare face/oral prosthesis,,,3237.89,8094.73,4 HCPCS,21085,Prepare face/oral prosthesis,,,231.31,578.27,4 HCPCS,21086,Prepare face/oral prosthesis,,,3237.89,8094.73,4 HCPCS,21087,Prepare face/oral prosthesis,,,5781.33,14453.33,4 HCPCS,21088,Prepare face/oral prosthesis,,,3237.89,8094.73,4 HCPCS,21089,Prepare face/oral prosthesis,,,231.31,578.27,4 HCPCS,21100,Maxillofacial fixation,,,3470.0,14453.33,8 HCPCS,21110,Hc Application And Removal Of Dental Fixation Device,3072.52,1229.01,,,0 HCPCS,21110,Interdental fixation,,,1515.28,3788.21,4 HCPCS,21120,Reconstruction of chin,,,5781.33,14453.33,8 HCPCS,21121,Reconstruction of chin,,,3237.89,12101.0,8 HCPCS,21122,Reconstruction of chin,,,5781.33,14453.33,8 HCPCS,21123,Reconstruction of chin,,,3237.89,12101.0,8 HCPCS,21125,Augmentation lower jaw bone,,,5781.33,14453.33,8 HCPCS,21127,Augmentation lower jaw bone,,,5781.33,17190.0,8 HCPCS,21137,Reduction of forehead,,,3237.89,8094.73,4 HCPCS,21138,Reduction of forehead,,,5781.33,14453.33,4 HCPCS,21139,Reduction of forehead,,,5781.33,14453.33,4 HCPCS,21141,Lefort i-1 piece w/o graft,,,5781.33,14453.33,4 HCPCS,21142,Lefort i-2 piece w/o graft,,,5781.33,14453.33,4 HCPCS,21143,Lefort i-3/> piece w/o graft,,,5781.33,14453.33,4 HCPCS,21145,Lefort i-1 piece w/ graft,,,5781.33,14453.33,4 HCPCS,21146,Lefort i-2 piece w/ graft,,,5781.33,14453.33,4 HCPCS,21147,Lefort i-3/> piece w/ graft,,,5781.33,14453.33,4 HCPCS,21150,Lefort ii anterior intrusion,,,5781.33,14453.33,4 HCPCS,21151,Lefort ii w/bone grafts,,,5781.33,14453.33,4 HCPCS,21154,Lefort iii w/o lefort i,,,5781.33,14453.33,4 HCPCS,21155,Lefort iii w/ lefort i,,,5781.33,14453.33,4 HCPCS,21159,Lefort iii w/fhdw/o lefort i,,,5781.33,14453.33,4 HCPCS,21160,Lefort iii w/fhd w/ lefort i,,,5781.33,14453.33,4 HCPCS,21172,Reconstruct orbit/forehead,,,5781.33,14453.33,4 HCPCS,21175,Reconstruct orbit/forehead,,,5781.33,14453.33,4 HCPCS,21179,Reconstruct entire forehead,,,5781.33,14453.33,4 HCPCS,21180,Reconstruct entire forehead,,,5781.33,14453.33,4 HCPCS,21181,Contour cranial bone lesion,,,5781.33,14453.33,8 HCPCS,21182,Reconstruct cranial bone,,,5781.33,14453.33,4 HCPCS,21183,Reconstruct cranial bone,,,5781.33,14453.33,4 HCPCS,21184,Reconstruct cranial bone,,,5781.33,14453.33,4 HCPCS,21188,Reconstruction of midface,,,5781.33,14453.33,4 HCPCS,21193,Reconst lwr jaw w/o graft,,,5781.33,14453.33,4 HCPCS,21194,Reconst lwr jaw w/graft,,,5781.33,14453.33,4 HCPCS,21195,Reconst lwr jaw w/o fixation,,,5781.33,14453.33,4 HCPCS,21196,Reconst lwr jaw w/fixation,,,5781.33,14453.33,4 HCPCS,21198,Reconstr lwr jaw segment,,,5781.33,14453.33,4 HCPCS,21199,Reconstr Lwr Jaw W/Advance,,,5781.33,14453.33,4 HCPCS,21206,Reconstruct upper jaw bone,,,5781.33,14453.33,8 HCPCS,21208,Augmentation of facial bones,,,5781.33,14453.33,8 HCPCS,21209,Reduction of facial bones,,,5781.33,14453.33,8 HCPCS,21210,Face bone graft,,,5781.33,14453.33,8 HCPCS,21215,Lower jaw bone graft,,,5781.33,14453.33,8 HCPCS,21230,Rib cartilage graft,,,5781.33,14453.33,8 HCPCS,21235,Ear cartilage graft,,,5781.33,14453.33,8 HCPCS,21235,Hc Ear Cartilage Graft,9234.22,3693.69,,,0 HCPCS,21240,Reconstruction of jaw joint,,,5781.33,14453.33,8 HCPCS,21242,Reconstruction of jaw joint,,,5781.33,14453.33,8 HCPCS,21243,Reconstruction of jaw joint,,,9775.0,66248.0,8 HCPCS,21244,Reconstruction of lower jaw,,,5781.33,14453.33,8 HCPCS,21245,Reconstruction of jaw,,,5781.33,14453.33,8 HCPCS,21246,Reconstruction of jaw,,,5781.33,14453.33,8 HCPCS,21247,Reconstruct lower jaw bone,,,5781.33,14453.33,4 HCPCS,21248,Reconstruction of jaw,,,5781.33,14453.33,8 HCPCS,21249,Reconstruction of jaw,,,5781.33,14453.33,8 HCPCS,21255,Reconstruct lower jaw bone,,,5781.33,14453.33,4 HCPCS,21256,Reconstruction of orbit,,,5781.33,14453.33,4 HCPCS,21260,Revise eye sockets,,,5781.33,14453.33,4 HCPCS,21261,Revise eye sockets,,,5781.33,14453.33,4 HCPCS,21263,Revise eye sockets,,,5781.33,14453.33,4 HCPCS,21267,Revise eye sockets,,,5781.33,14453.33,8 HCPCS,21268,Revise eye sockets,,,5781.33,14453.33,4 HCPCS,21270,Augmentation cheek bone,,,5781.33,14453.33,8 HCPCS,21275,Revision orbitofacial bones,,,5781.33,14453.33,8 HCPCS,21280,Revision of eyelid,,,3237.89,11433.0,8 HCPCS,21282,Revision of eyelid,,,3237.89,11433.0,8 HCPCS,21295,Revision of jaw muscle/bone,,,1515.28,3788.21,8 HCPCS,21296,Revision of jaw muscle/bone,,,2546.0,8094.73,8 HCPCS,21299,Cranio/maxillofacial surgery,,,231.31,578.27,4 HCPCS,21310,Closed tx nose fx w/o manj,,,3470.0,4059.0,4 HCPCS,21310,"Hc Closed Rx Nose Fracture, W/O Manipulation",1141.95,456.78,,,0 HCPCS,21315,Closed tx nose fx w/o stablj,,,1515.28,4059.0,8 HCPCS,21315,Hc Closed Tx Nasal Fracture W/O Stabilization,3253.35,1301.34,,,0 HCPCS,21320,Closed tx nose fx w/ stablj,,,3237.89,8094.73,8 HCPCS,21320,Hc Closed Treatment Nose Fracture With Stabilization,3984.18,1593.67,,,0 HCPCS,21325,Open tx nose fx uncomplicatd,,,3237.89,8800.0,8 HCPCS,21330,Open tx nose fx w/skele fixj,,,5781.33,14453.33,8 HCPCS,21335,Open tx nose & septal fx,,,3237.89,12101.0,8 HCPCS,21336,Open tx septal fx w/wo stabj,,,3195.45,8800.0,8 HCPCS,21337,Closed tx septal&nose fx,,,3237.89,8094.73,8 HCPCS,21338,Open nasoethmoid fx w/o fixj,,,5781.33,14453.33,8 HCPCS,21339,Open nasoethmoid fx w/ fixj,,,5781.33,14453.33,8 HCPCS,21340,Perq tx nasoethmoid fx,,,3237.89,8800.0,8 HCPCS,21343,Open tx dprsd front sinus fx,,,5781.33,14453.33,4 HCPCS,21344,Open tx compl front sinus fx,,,5781.33,14453.33,4 HCPCS,21345,Closed tx nose/jaw fx,,,1515.28,12101.0,8 HCPCS,21346,Opn tx nasomax fx w/fixj,,,5781.33,14453.33,4 HCPCS,21347,Opn tx nasomax fx multple,,,5781.33,14453.33,4 HCPCS,21348,Opn tx nasomax fx w/graft,,,5781.33,14453.33,4 HCPCS,21355,Perq tx malar fracture,,,3237.89,9743.0,8 HCPCS,21356,Opn tx dprsd zygomatic arch,,,5781.33,14453.33,8 HCPCS,21360,Opn tx dprsd malar fracture,,,5781.33,14453.33,4 HCPCS,21365,Opn tx complx malar fx,,,5781.33,14453.33,4 HCPCS,21366,Opn tx complx malar w/grft,,,5781.33,14453.33,4 HCPCS,21385,Opn tx orbit fx transantral,,,5781.33,14453.33,4 HCPCS,21386,Opn tx orbit fx periorbital,,,5781.33,14453.33,4 HCPCS,21387,Opn tx orbit fx combined,,,5781.33,14453.33,4 HCPCS,21390,Opn tx orbit periorbtl implt,,,5781.33,14453.33,4 HCPCS,21395,Opn tx orbit periorbt w/grft,,,5781.33,14453.33,4 HCPCS,21400,Closed tx orbit w/o manipulj,,,526.71,4059.0,8 HCPCS,21401,Closed tx orbit w/manipulj,,,1515.28,9743.0,8 HCPCS,21406,Opn tx orbit fx w/o implant,,,5781.33,14453.33,4 HCPCS,21407,Opn tx orbit fx w/implant,,,5781.33,14453.33,8 HCPCS,21408,Opn tx orbit fx w/bone grft,,,5781.33,14453.33,4 HCPCS,21421,Treat mouth roof fracture,,,3237.89,8800.0,8 HCPCS,21422,Treat mouth roof fracture,,,5781.33,14453.33,4 HCPCS,21423,Treat mouth roof fracture,,,5781.33,14453.33,4 HCPCS,21431,Treat craniofacial fracture,,,5781.33,14453.33,4 HCPCS,21432,Treat craniofacial fracture,,,5781.33,14453.33,4 HCPCS,21433,Treat craniofacial fracture,,,5781.33,14453.33,4 HCPCS,21435,Treat craniofacial fracture,,,5781.33,14453.33,4 HCPCS,21436,Treat craniofacial fracture,,,5781.33,14453.33,4 HCPCS,21440,Treat dental ridge fracture,,,3237.89,9743.0,8 HCPCS,21445,Treat dental ridge fracture,,,5781.33,14453.33,8 HCPCS,21450,Treat lower jaw fracture,,,526.71,9743.0,8 HCPCS,21451,Treat lower jaw fracture,,,1515.28,8800.0,8 HCPCS,21452,Treat lower jaw fracture,,,3470.0,14453.33,8 HCPCS,21453,Hc Treat Lower Jaw Fracture,9792.25,3916.9,,,0 HCPCS,21453,Treat lower jaw fracture,,,5781.33,14453.33,8 HCPCS,21454,Treat lower jaw fracture,,,5781.33,14453.33,8 HCPCS,21461,Treat lower jaw fracture,,,5781.33,14453.33,8 HCPCS,21462,Treat lower jaw fracture,,,5781.33,14453.33,8 HCPCS,21465,Treat lower jaw fracture,,,5781.33,14453.33,8 HCPCS,21470,Treat lower jaw fracture,,,5781.33,14453.33,4 HCPCS,21480,Hc Reduce Temporomandibl Disloc,112.19,44.88,,,0 HCPCS,21480,Reset dislocated jaw,,,240.9,2978.0,8 HCPCS,21485,Reset dislocated jaw,,,1515.28,4059.0,8 HCPCS,21490,Repair dislocated jaw,,,3237.89,9743.0,8 HCPCS,21497,Interdental wiring,,,1515.28,4059.0,8 HCPCS,21499,Head surgery procedure,,,231.31,578.27,4 HCPCS,21500,Hc Labor And Delivery C-Section Unscheduled,11858.11,4743.24,,,0 HCPCS,21501,Drain neck/chest lesion,,,2836.76,7091.89,8 HCPCS,21501,Hc I&D Deep Absc/Hmtma Soft Tissue Neck/Thorax,7121.22,2848.49,,,0 HCPCS,21502,Drain chest lesion,,,3195.45,7988.62,8 HCPCS,21510,Drainage of bone lesion,,,3195.45,7988.62,4 HCPCS,21550,Biopsy of neck/chest,,,1612.96,4032.39,4 HCPCS,21550,Hc Biopsy Soft Tissue Neck/Chest,5865.42,2346.17,,,0 HCPCS,21552,Exc neck les sc 3 cm/>,,,2836.76,7091.89,8 HCPCS,21552,Hc Exc Tumor Soft Tissue Neck/Ant Thorax Subq 3+Cm,6192.29,2476.92,,,0 HCPCS,21554,Exc neck tum deep 5 cm/>,,,2836.76,7091.89,8 HCPCS,21554,"Hc Excision Tumor, Soft Tissue Of Neck Or Anterior Thorax, Subfascial 5Cm/>",8598.53,3439.41,,,0 HCPCS,21555,Exc neck les sc < 3 cm,,,1612.96,4059.0,8 HCPCS,21555,"Hc Excision Tumor, Soft Tissue Of Neck Or Anterior Thorax, Subfascial <3Cm",7033.0,2813.2,,,0 HCPCS,21556,Exc neck tum deep < 5 cm,,,2836.76,7091.89,8 HCPCS,21556,"Hc Excision Tumor, Soft Tissue Of Neck Or Anterior Thorax, Subfascial <5Cm",8988.2,3595.28,,,0 HCPCS,21557,"Hc Radical Resection Of Tumor, Soft Tissue Of Neck Or Anterior Thorax, Subfascial <5Cm",8993.33,3597.33,,,0 HCPCS,21557,Resect neck thorax tumor<5cm,,,2836.76,7091.89,4 HCPCS,21558,"Hc Radical Resection Of Tumor, Soft Tissue Of Neck Or Anterior Thorax, Subfascial 5Cm/>",8078.83,3231.53,,,0 HCPCS,21558,Resect neck tumor 5 cm/>,,,2836.76,7091.89,4 HCPCS,21600,Partial removal of rib,,,3470.0,17716.12,8 HCPCS,21601,Exc chest wall tumor w/ribs,,,2836.76,7091.89,8 HCPCS,21602,Exc ch wal tum w/o lymphadec,,,7086.45,17716.12,4 HCPCS,21603,Exc ch wal tum w/lymphadec,,,7086.45,17716.12,4 HCPCS,21610,Partial removal of rib,,,3195.45,7988.62,8 HCPCS,21615,Removal of rib,,,7086.45,17716.12,4 HCPCS,21616,Removal of rib and nerves,,,7086.45,17716.12,4 HCPCS,21620,Partial removal of sternum,,,3195.45,7988.62,4 HCPCS,21627,Sternal debridement,,,3195.45,7988.62,4 HCPCS,21630,Extensive sternum surgery,,,7086.45,17716.12,4 HCPCS,21685,Hyoid myotomy & suspension,,,5781.33,14453.33,4 HCPCS,21700,Revision of neck muscle,,,3470.0,17716.12,8 HCPCS,21705,Revision of neck muscle/rib,,,7086.45,17716.12,4 HCPCS,21720,Revision of neck muscle,,,3195.45,9743.0,8 HCPCS,21725,Revision of neck muscle,,,691.56,9743.0,8 HCPCS,21740,Reconstruction of sternum,,,7086.45,17716.12,4 HCPCS,21742,Repair stern/nuss w/o scope,,,3195.45,7988.62,4 HCPCS,21743,Repair sternum/nuss w/scope,,,3195.45,7988.62,4 HCPCS,21750,Repair of sternum separation,,,7086.45,17716.12,4 HCPCS,21800,Treatment of rib fracture,,,2546.0,2978.0,4 HCPCS,21805,Treatment of rib fracture,,,3470.0,4059.0,4 HCPCS,21811,Optx of rib fx w/fixj scope,,,7086.45,17716.12,4 HCPCS,21812,Treatment of rib fracture,,,7086.45,17716.12,4 HCPCS,21813,Treatment of rib fracture,,,1570.37,3925.93,4 HCPCS,21820,Treat sternum fracture,,,240.9,2978.0,8 HCPCS,21825,Treat sternum fracture,,,7086.45,17716.12,4 HCPCS,21899,Neck/chest surgery procedure,,,231.31,578.27,4 HCPCS,21920,Biopsy soft tissue of back,,,1612.96,4032.39,4 HCPCS,21925,Biopsy soft tissue of back,,,1612.96,4059.0,8 HCPCS,21930,Exc back les sc < 3 cm,,,1612.96,4059.0,8 HCPCS,21930,Hc Excision Tumor Soft Tissue Back/Flan Subcutaneous <3Cm,3848.0,1539.2,,,0 HCPCS,21931,Exc back les sc 3 cm/>,,,1612.96,4059.0,8 HCPCS,21931,Hc Excision Tumor Soft Tissue Back/Flank Subcutaneous 3+Cm,7482.8,2993.12,,,0 HCPCS,21932,Exc back tum deep < 5 cm,,,2836.76,7091.89,8 HCPCS,21933,Exc back tum deep 5 cm/>,,,2836.76,7091.89,8 HCPCS,21935,Hc Rad Resection Tumor Soft Tissue Back/Flank <5Cm,4795.55,1918.22,,,0 HCPCS,21935,Resect back tum < 5 cm,,,2836.76,9743.0,8 HCPCS,21936,Hc Resection Tumor Soft Tissue Back/Flank 5Cm/>,10901.51,4360.6,,,0 HCPCS,21936,Resect back tum 5 cm/>,,,2836.76,7091.89,4 HCPCS,22000,Hc C-Section Scheduled,9470.41,3788.16,,,0 HCPCS,22010,I&d p-spine c/t/cerv-thor,,,7086.45,17716.12,4 HCPCS,22015,I&d abscess p-spine l/s/ls,,,7086.45,17716.12,4 HCPCS,22100,Remove part of neck vertebra,,,7086.45,17716.12,4 HCPCS,22101,Remove part thorax vertebra,,,7086.45,17716.12,4 HCPCS,22102,Remove part lumbar vertebra,,,7086.45,17716.12,4 HCPCS,22110,Remove part of neck vertebra,,,7086.45,17716.12,4 HCPCS,22112,Remove part thorax vertebra,,,7086.45,17716.12,4 HCPCS,22114,Remove part lumbar vertebra,,,7086.45,17716.12,4 HCPCS,22206,Incis spine 3 column thorac,,,7086.45,17716.12,4 HCPCS,22207,Incis spine 3 column lumbar,,,7086.45,17716.12,4 HCPCS,22210,Incis 1 vertebral seg cerv,,,7086.45,17716.12,4 HCPCS,22212,Incis 1 vertebral seg thorac,,,7086.45,17716.12,4 HCPCS,22214,Incis 1 vertebral seg lumbar,,,7086.45,17716.12,4 HCPCS,22220,Incis w/discectomy cervical,,,7086.45,17716.12,4 HCPCS,22222,Incis w/discectomy thoracic,,,7086.45,17716.12,4 HCPCS,22224,Incis w/discectomy lumbar,,,7086.45,17716.12,4 HCPCS,22305,Treat spine process fracture,,,2546.0,2978.0,4 HCPCS,22310,Closed tx vert fx w/o manj,,,240.9,2978.0,8 HCPCS,22315,Closed tx vert fx w/manj,,,3195.45,7988.62,8 HCPCS,22318,Treat odontoid fx w/o graft,,,12538.31,31345.78,4 HCPCS,22319,Treat odontoid fx w/graft,,,12538.31,31345.78,4 HCPCS,22325,Treat spine fracture,,,12538.31,31345.78,4 HCPCS,22326,Treat neck spine fracture,,,12538.31,31345.78,4 HCPCS,22327,Treat thorax spine fracture,,,12538.31,31345.78,4 HCPCS,22505,Manipulation of spine,,,1570.37,4059.0,8 HCPCS,22510,Hc Perq Vertebroplasty Uni/Bi Injx Cervicothoracic,8131.25,3252.5,,,0 HCPCS,22510,Perq cervicothoracic inject,,,3195.45,17190.0,8 HCPCS,22511,Hc Perq Vertebroplasty Unilateral/Bilateral Injection Lumbosacral,10473.05,4189.22,,,0 HCPCS,22511,Perq lumbosacral injection,,,3195.45,17190.0,8 HCPCS,22512,Hc Vertebroplasty Each Addl Cervicothor/Lumbosacral,5977.0,2390.8,,,0 HCPCS,22512,Vertebroplasty addl inject,,,14697.0,17190.0,4 HCPCS,22513,Hc Perq Vert Agmntj Cavity Crtj Uni/Bi Cannulation,18268.57,7307.43,,,0 HCPCS,22513,Perq vertebral augmentation,,,7086.45,17716.12,8 HCPCS,22514,Hc Perq Vert Agmntj Cavity Crtj Uni/Bi Cannulj Lmbr,18268.57,7307.43,,,0 HCPCS,22514,Perq vertebral augmentation,,,7086.45,17716.12,8 HCPCS,22515,Hc Perq Vert Agmntj Cavity Crtj Uni/Bi Cannulj Each,13459.39,5383.76,,,0 HCPCS,22515,Perq vertebral augmentation,,,14697.0,17190.0,4 HCPCS,22522,Percut Vertebroplasty Addl,,,14697.0,17190.0,4 HCPCS,22532,Lat thorax spine fusion,,,12538.31,31345.78,4 HCPCS,22533,Lat lumbar spine fusion,,,17123.6,42809.0,4 HCPCS,22548,Neck spine fusion,,,12538.31,31345.78,4 HCPCS,22551,Neck spine fuse&remov bel c2,,,12538.31,31345.78,4 HCPCS,22554,Neck spine fusion,,,12538.31,31345.78,4 HCPCS,22556,Thorax spine fusion,,,17123.6,42809.0,4 HCPCS,22586,Prescrl fuse w/ instr l5-s1,,,17123.6,42809.0,4 HCPCS,22590,Spine & skull spinal fusion,,,12538.31,31345.78,4 HCPCS,22595,Neck spinal fusion,,,12538.31,31345.78,4 HCPCS,22600,Neck spine fusion,,,17123.6,42809.0,4 HCPCS,22610,Thorax spine fusion,,,17123.6,42809.0,4 HCPCS,22612,Hc Arthrodesis Posterior/Posterolateral,28713.08,11485.23,,,0 HCPCS,22612,Lumbar spine fusion,,,17123.6,42809.0,4 HCPCS,22800,Post fusion <=6 vert seg,,,17123.6,42809.0,4 HCPCS,22802,Post fusion 7-12 vert seg,,,17123.6,42809.0,4 HCPCS,22804,Post fusion 13/> vert seg,,,17123.6,42809.0,4 HCPCS,22808,Ant fusion 2-3 vert seg,,,17123.6,42809.0,4 HCPCS,22810,Ant fusion 4-7 vert seg,,,17123.6,42809.0,4 HCPCS,22812,Ant fusion 8/> vert seg,,,17123.6,42809.0,4 HCPCS,22818,Kyphectomy 1-2 segments,,,17123.6,42809.0,4 HCPCS,22819,Kyphectomy 3 or more,,,17123.6,42809.0,4 HCPCS,22830,Exploration of spinal fusion,,,7086.45,17716.12,4 HCPCS,22836,Ant thrc vrt body tethrg <7,,,17123.6,42809.0,4 HCPCS,22837,Ant thrc vrt body tethrg 8+,,,17123.6,42809.0,4 HCPCS,22838,Rev rplc/rmv thrc vrt tethrg,,,17123.6,42809.0,4 HCPCS,22849,Reinsert spinal fixation,,,12538.31,31345.78,4 HCPCS,22850,Remove spine fixation device,,,7086.45,17716.12,4 HCPCS,22852,Remove spine fixation device,,,7086.45,17716.12,4 HCPCS,22855,Remove spine fixation device,,,7086.45,17716.12,4 HCPCS,22856,Cerv artific diskectomy,,,17123.6,42809.0,4 HCPCS,22857,Lumbar Artif Diskectomy,,,17123.6,42809.0,4 HCPCS,22861,Revise cerv artific disc,,,17123.6,42809.0,4 HCPCS,22862,Revise Lumbar Artif Disc,,,17123.6,42809.0,4 HCPCS,22864,Remove cerv artif disc,,,7086.45,17716.12,4 HCPCS,22865,Remove Lumb Artif Disc,,,7086.45,17716.12,4 HCPCS,22867,Insj stablj dev w/dcmprn,,,14697.0,42809.0,8 HCPCS,22869,Hc Insertion Of Stabilizing Or Separating Device Into Lower Spine At Single Level,20806.0,8322.4,,,0 HCPCS,22869,Insj stablj dev w/o dcmprn,,,12538.31,31345.78,8 HCPCS,22899,Spine surgery procedure,,,240.9,602.24,4 HCPCS,22900,Exc abdl tum deep < 5 cm,,,2836.76,8800.0,8 HCPCS,22901,Exc abdl tum deep 5 cm/>,,,2836.76,9743.0,8 HCPCS,22902,Exc abd les sc < 3 cm,,,1612.96,4059.0,8 HCPCS,22903,Exc abd les sc 3 cm/>,,,2836.76,7091.89,8 HCPCS,22904,Radical resect abd tumor<5cm,,,2836.76,7091.89,4 HCPCS,22905,Rad resect abd tumor 5 cm/>,,,2836.76,7091.89,4 HCPCS,22999,Abdomen surgery procedure,,,240.9,602.24,4 HCPCS,23000,Hc High Risk Vaginal Delivery,8150.97,3260.39,,,0 HCPCS,23000,Removal of calcium deposits,,,2836.76,7091.89,8 HCPCS,23020,Release shoulder joint,,,3195.45,7988.62,8 HCPCS,23030,Drain shoulder lesion,,,2546.0,7091.89,8 HCPCS,23030,Hc I&D Shoulder Deep Abscess/Hematoma,7121.22,2848.49,,,0 HCPCS,23031,Drain shoulder bursa,,,2836.76,9743.0,8 HCPCS,23035,Drain shoulder bone lesion,,,1570.37,9743.0,8 HCPCS,23040,Exploratory shoulder surgery,,,3195.45,9743.0,8 HCPCS,23044,Exploratory shoulder surgery,,,3195.45,8800.0,8 HCPCS,23065,Biopsy shoulder tissues,,,1612.96,4032.39,4 HCPCS,23066,Biopsy shoulder tissues,,,2836.76,7091.89,8 HCPCS,23071,Exc shoulder les sc 3 cm/>,,,1612.96,4059.0,8 HCPCS,23073,Exc shoulder tum deep 5 cm/>,,,2836.76,7091.89,8 HCPCS,23075,Exc shoulder les sc < 3 cm,,,1612.96,4059.0,8 HCPCS,23076,Exc shoulder tum deep < 5 cm,,,2836.76,7091.89,8 HCPCS,23077,Resect shoulder tumor < 5 cm,,,2836.76,9743.0,8 HCPCS,23078,Resect shoulder tumor 5 cm/>,,,2836.76,7091.89,4 HCPCS,23100,Biopsy of shoulder joint,,,3195.45,7988.62,8 HCPCS,23101,Shoulder joint surgery,,,3195.45,12101.0,8 HCPCS,23105,Remove shoulder joint lining,,,7086.45,17716.12,8 HCPCS,23106,Incision of collarbone joint,,,3195.45,8800.0,8 HCPCS,23107,Explore treat shoulder joint,,,7086.45,17716.12,8 HCPCS,23120,Partial removal collar bone,,,3195.45,11433.0,8 HCPCS,23125,Removal of collar bone,,,3195.45,11433.0,8 HCPCS,23130,Remove shoulder bone part,,,3195.45,11433.0,8 HCPCS,23140,Removal of bone lesion,,,3195.45,8800.0,8 HCPCS,23145,Removal of bone lesion,,,3195.45,11433.0,8 HCPCS,23146,Removal of bone lesion,,,7086.45,17716.12,8 HCPCS,23150,Removal of humerus lesion,,,3195.45,8800.0,8 HCPCS,23155,Removal of humerus lesion,,,7086.45,17716.12,8 HCPCS,23156,Removal of humerus lesion,,,7086.45,17716.12,8 HCPCS,23170,Remove collar bone lesion,,,3195.45,7988.62,8 HCPCS,23172,Remove shoulder blade lesion,,,3195.45,7988.62,8 HCPCS,23174,Remove humerus lesion,,,3470.0,17716.12,8 HCPCS,23180,Remove collar bone lesion,,,7086.45,17716.12,8 HCPCS,23182,Remove shoulder blade lesion,,,7086.45,17716.12,8 HCPCS,23184,Remove humerus lesion,,,7086.45,17716.12,8 HCPCS,23190,Partial removal of scapula,,,3195.45,8800.0,8 HCPCS,23195,Removal of head of humerus,,,7086.45,17716.12,8 HCPCS,23200,Resect clavicle tumor,,,7086.45,17716.12,4 HCPCS,23210,Resect scapula tumor,,,7086.45,17716.12,4 HCPCS,23220,Resect prox humerus tumor,,,7086.45,17716.12,4 HCPCS,23330,Hc Remove Shoulder Foreign Body,2801.5,1120.6,,,0 HCPCS,23330,Remove shoulder foreign body,,,1612.96,4032.39,8 HCPCS,23333,Remove shoulder fb deep,,,2546.0,7091.89,8 HCPCS,23334,Shoulder prosthesis removal,,,7086.45,17716.12,8 HCPCS,23335,Shoulder prosthesis removal,,,7086.45,17716.12,8 HCPCS,23350,Hc Injection Procedure Shoulder Arthrography/Ct/Mri,909.33,363.73,,,0 HCPCS,23395,Muscle transfer shoulder/arm,,,7086.45,17716.12,8 HCPCS,23397,Muscle transfers,,,7086.45,17716.12,8 HCPCS,23400,Fixation of shoulder blade,,,7086.45,17716.12,8 HCPCS,23405,Incision of tendon & muscle,,,3470.0,17716.12,8 HCPCS,23406,Incise tendon(s) & muscle(s),,,3470.0,17716.12,8 HCPCS,23410,Repair rotator cuff acute,,,7086.45,17716.12,8 HCPCS,23412,Repair rotator cuff chronic,,,7086.45,17716.12,8 HCPCS,23415,Release of shoulder ligament,,,7086.45,17716.12,8 HCPCS,23420,Repair of shoulder,,,7086.45,17716.12,8 HCPCS,23430,Repair biceps tendon,,,7086.45,17716.12,8 HCPCS,23440,Remove/transplant tendon,,,7086.45,17716.12,8 HCPCS,23450,Repair shoulder capsule,,,7086.45,17716.12,8 HCPCS,23455,Repair shoulder capsule,,,7086.45,17716.12,8 HCPCS,23460,Repair shoulder capsule,,,7086.45,17716.12,8 HCPCS,23462,Repair shoulder capsule,,,7086.45,17716.12,8 HCPCS,23465,Repair shoulder capsule,,,7086.45,17716.12,8 HCPCS,23466,Repair shoulder capsule,,,7086.45,17716.12,8 HCPCS,23470,Reconstruct shoulder joint,,,12538.31,31345.78,4 HCPCS,23472,Reconstruct shoulder joint,,,17123.6,42809.0,4 HCPCS,23473,Revis reconst shoulder joint,,,12538.31,31345.78,4 HCPCS,23474,Revis reconst shoulder joint,,,12538.31,31345.78,4 HCPCS,23480,Revision of collar bone,,,7086.45,17716.12,8 HCPCS,23485,Revision of collar bone,,,10346.0,31345.78,8 HCPCS,23490,Reinforce clavicle,,,7086.45,17716.12,8 HCPCS,23491,Reinforce shoulder bones,,,8330.0,31345.78,8 HCPCS,23500,Hc Closed Treatment Clavicular Fracture With/Without Manipulation,1198.87,479.55,,,0 HCPCS,23500,Treat clavicle fracture,,,240.9,2978.0,8 HCPCS,23505,"Hc Closed Rx Clavicle Fx, Manipulatn",3253.35,1301.34,,,0 HCPCS,23505,Treat clavicle fracture,,,1570.37,3925.93,8 HCPCS,23515,Treat clavicle fracture,,,7086.45,17716.12,8 HCPCS,23520,Treat clavicle dislocation,,,1570.37,3925.93,8 HCPCS,23525,Treat clavicle dislocation,,,240.9,2978.0,8 HCPCS,23530,Treat clavicle dislocation,,,7086.45,17716.12,8 HCPCS,23532,Treat clavicle dislocation,,,7086.45,17716.12,8 HCPCS,23540,Treat clavicle dislocation,,,240.9,2978.0,8 HCPCS,23545,Hc Closed Treatment Acromioclavicular Dislocation With Manipulation,957.76,383.1,,,0 HCPCS,23545,Treat clavicle dislocation,,,240.9,2978.0,8 HCPCS,23550,Treat clavicle dislocation,,,7086.45,17716.12,8 HCPCS,23552,Treat clavicle dislocation,,,7086.45,17716.12,8 HCPCS,23570,Hc Closed Treatment Scapular Fracture Without Manipulation-Bilateral,959.4,383.76,,,0 HCPCS,23570,Hc Closed Treatment Scapular Fracture Without Manipulation-Unilateral,639.6,255.84,,,0 HCPCS,23570,Treat shoulder blade fx,,,240.9,2978.0,8 HCPCS,23575,Treat shoulder blade fx,,,1570.37,3925.93,8 HCPCS,23585,Treat scapula fracture,,,7086.45,17716.12,8 HCPCS,23600,Hc Closed Treatment Of Proximal Humeral Bilateral,2061.8,824.72,,,0 HCPCS,23600,Hc Closed Treatment Of Proximal Humeral Unilateral,1374.1,549.64,,,0 HCPCS,23600,Treat humerus fracture,,,240.9,602.24,4 HCPCS,23605,Hc Closed Treatment Proximal Humerus Fracture With Manipulation,2553.46,1021.38,,,0 HCPCS,23605,Treat humerus fracture,,,1570.37,4059.0,8 HCPCS,23615,Treat humerus fracture,,,7524.0,31345.78,8 HCPCS,23616,Treat humerus fracture,,,7524.0,42809.0,8 HCPCS,23620,Treat humerus fracture,,,240.9,602.24,4 HCPCS,23625,Treat humerus fracture,,,1570.37,4059.0,8 HCPCS,23630,Treat humerus fracture,,,7086.45,17716.12,8 HCPCS,23650,Hc Closed Treatment Shoulder Dislocation With Fracture Of Humerus Without Manipulation,957.76,383.1,,,0 HCPCS,23650,Treat shoulder dislocation,,,240.9,2978.0,8 HCPCS,23655,Treat shoulder dislocation,,,1570.37,3925.93,8 HCPCS,23660,Treat shoulder dislocation,,,7086.45,17716.12,8 HCPCS,23665,Hc Closed Treatment Shoulder Dislocation With Fracture Of Humerus With Manipulation,1157.01,462.8,,,0 HCPCS,23665,Treat dislocation/fracture,,,1570.37,4059.0,8 HCPCS,23670,Treat dislocation/fracture,,,7086.45,17716.12,8 HCPCS,23675,"Hc Closed Treatment Dislocated Shoulder, Broke Neck Upper Arm With Manipulation",3253.35,1301.34,,,0 HCPCS,23675,Treat dislocation/fracture,,,1570.37,4059.0,8 HCPCS,23680,Treat dislocation/fracture,,,8330.0,31345.78,8 HCPCS,23700,Fixation of shoulder,,,1570.37,3925.93,8 HCPCS,23800,Fusion of shoulder joint,,,7086.45,17716.12,8 HCPCS,23802,Fusion of shoulder joint,,,10346.0,31345.78,8 HCPCS,23900,Amputation of arm & girdle,,,12538.31,31345.78,4 HCPCS,23920,Amputation at shoulder joint,,,12538.31,31345.78,4 HCPCS,23921,Amputation follow-up surgery,,,2015.01,9743.0,8 HCPCS,23929,Shoulder surgery procedure,,,240.9,2978.0,8 HCPCS,23930,Drainage of arm lesion,,,2546.0,7091.89,8 HCPCS,23930,Hc I&D Upper Arm/Elbow Deep Abscess/Hematoma,7121.22,2848.49,,,0 HCPCS,23931,Drainage of arm bursa,,,1612.96,4059.0,8 HCPCS,23931,Hc Incision&Drainage Upper Arm/Elbow Bursa,3231.98,1292.79,,,0 HCPCS,23935,Drain arm/elbow bone lesion,,,3195.45,7988.62,8 HCPCS,24000,Exploratory elbow surgery,,,3195.45,8800.0,8 HCPCS,24006,Release elbow joint,,,3195.45,8800.0,8 HCPCS,24065,Biopsy arm/elbow soft tissue,,,1612.96,4032.39,4 HCPCS,24065,Hc Biopsy Arm/Elbow Soft Tissue,3575.0,1430.0,,,0 HCPCS,24066,Biopsy arm/elbow soft tissue,,,2836.76,7091.89,8 HCPCS,24071,Exc arm/elbow les sc 3 cm/>,,,2836.76,7091.89,8 HCPCS,24073,Ex arm/elbow tum deep 5 cm/>,,,2836.76,7091.89,8 HCPCS,24073,Hc Excision Upper Arm > 5Cm Bilateral,2935.71,1174.28,,,0 HCPCS,24075,Exc arm/elbow les sc < 3 cm,,,1612.96,4059.0,8 HCPCS,24075,Hc Exc Tumor Soft Tiss Upper Arm/Elbow Subq <3Cm,4903.6,1961.44,,,0 HCPCS,24076,Ex arm/elbow tum deep < 5 cm,,,2836.76,7091.89,8 HCPCS,24077,Hc Radical Resection Of Tumor Soft Tissue Upper Arm/Elbow <5Cm-Bilateral,6942.39,2776.96,,,0 HCPCS,24077,Hc Radical Resection Of Tumor Soft Tissue Upper Arm/Elbow <5Cm-Unilateral,4628.26,1851.3,,,0 HCPCS,24077,Resect arm/elbow tum < 5 cm,,,2836.76,9743.0,8 HCPCS,24079,Resect arm/elbow tum 5 cm/>,,,2836.76,7091.89,4 HCPCS,24100,Biopsy elbow joint lining,,,2546.0,7988.62,8 HCPCS,24101,Explore/treat elbow joint,,,3195.45,8800.0,8 HCPCS,24102,Remove elbow joint lining,,,3195.45,8800.0,8 HCPCS,24105,Removal of elbow bursa,,,3195.45,9743.0,8 HCPCS,24110,Remove humerus lesion,,,3195.45,7988.62,8 HCPCS,24115,Remove/graft bone lesion,,,7086.45,17716.12,8 HCPCS,24116,Remove/graft bone lesion,,,7086.45,17716.12,8 HCPCS,24120,Remove elbow lesion,,,3195.45,9743.0,8 HCPCS,24125,Remove/graft bone lesion,,,3195.45,9743.0,8 HCPCS,24126,Remove/graft bone lesion,,,7086.45,17716.12,8 HCPCS,24130,Removal of head of radius,,,3195.45,9743.0,8 HCPCS,24134,Removal of arm bone lesion,,,3470.0,17716.12,8 HCPCS,24136,Remove radius bone lesion,,,3195.45,7988.62,8 HCPCS,24138,Remove elbow bone lesion,,,3470.0,17716.12,8 HCPCS,24140,Partial removal of arm bone,,,3195.45,9743.0,8 HCPCS,24145,Partial removal of radius,,,7086.45,17716.12,8 HCPCS,24147,Partial removal of elbow,,,3195.45,7988.62,8 HCPCS,24149,Radical resection of elbow,,,7086.45,17716.12,4 HCPCS,24150,Resect distal humerus tumor,,,7086.45,17716.12,4 HCPCS,24152,Resect radius tumor,,,7086.45,17716.12,8 HCPCS,24155,Removal of elbow joint,,,3195.45,9743.0,8 HCPCS,24160,Remove elbow joint implant,,,3195.45,7988.62,8 HCPCS,24164,Remove radius head implant,,,3195.45,9743.0,8 HCPCS,24200,Removal of arm foreign body,,,1612.96,4032.39,4 HCPCS,24201,Removal of arm foreign body,,,2836.76,7091.89,8 HCPCS,24220,Hc Injection Joint Upper Extremity,801.14,320.46,,,0 HCPCS,24300,Manipulate elbow w/anesth,,,1570.37,3925.93,4 HCPCS,24301,Muscle/tendon transfer,,,7086.45,17716.12,8 HCPCS,24305,Arm tendon lengthening,,,3195.45,8800.0,8 HCPCS,24310,Revision of arm tendon,,,3195.45,9743.0,8 HCPCS,24320,Repair of arm tendon,,,7086.45,17716.12,8 HCPCS,24330,Revision of arm muscles,,,7086.45,17716.12,8 HCPCS,24331,Revision of arm muscles,,,7086.45,17716.12,8 HCPCS,24332,Tenolysis triceps,,,3195.45,7988.62,4 HCPCS,24340,Repair of biceps tendon,,,7086.45,17716.12,8 HCPCS,24341,Repair arm tendon/muscle,,,7086.45,17716.12,8 HCPCS,24342,Repair of ruptured tendon,,,7086.45,17716.12,8 HCPCS,24343,Repr elbow lat ligmnt w/tiss,,,3195.45,7988.62,4 HCPCS,24344,Reconstruct elbow lat ligmnt,,,7086.45,17716.12,4 HCPCS,24345,Repr elbw med ligmnt w/tissu,,,3470.0,17716.12,8 HCPCS,24346,Reconstruct elbow med ligmnt,,,12538.31,31345.78,4 HCPCS,24350,Repair of tennis elbow,,,8330.0,9743.0,4 HCPCS,24351,Repair of tennis elbow,,,8330.0,9743.0,4 HCPCS,24352,Repair of tennis elbow,,,8330.0,9743.0,4 HCPCS,24354,Repair of tennis elbow,,,8330.0,9743.0,4 HCPCS,24356,Revision of tennis elbow,,,8330.0,9743.0,4 HCPCS,24357,Repair elbow perc,,,3195.45,9743.0,8 HCPCS,24358,Repair elbow w/deb open,,,3195.45,9743.0,8 HCPCS,24359,Repair elbow deb/attch open,,,3195.45,9743.0,8 HCPCS,24360,Reconstruct elbow joint,,,7086.45,17716.12,8 HCPCS,24361,Reconstruct elbow joint,,,9775.0,42809.0,8 HCPCS,24362,Reconstruct elbow joint,,,9775.0,31345.78,8 HCPCS,24363,Replace elbow joint,,,10346.0,42809.0,8 HCPCS,24365,Reconstruct head of radius,,,9775.0,31345.78,8 HCPCS,24366,Reconstruct head of radius,,,9775.0,31345.78,8 HCPCS,24370,Revise reconst elbow joint,,,12538.31,31345.78,4 HCPCS,24371,Revise reconst elbow joint,,,17123.6,42809.0,4 HCPCS,24400,Revision of humerus,,,7086.45,17716.12,8 HCPCS,24410,Revision of humerus,,,7524.0,31345.78,8 HCPCS,24420,Revision of humerus,,,7086.45,17716.12,8 HCPCS,24430,Repair of humerus,,,8330.0,31345.78,8 HCPCS,24435,Repair humerus with graft,,,7524.0,31345.78,8 HCPCS,24470,Revision of elbow joint,,,3195.45,9743.0,8 HCPCS,24495,Decompression of forearm,,,3470.0,17716.12,8 HCPCS,24498,Reinforce humerus,,,8330.0,31345.78,8 HCPCS,24500,Hc Closed Treatment Mid Portion Of Humerus Shaft Fracture Without Manipulation,890.79,356.32,,,0 HCPCS,24500,Treat humerus fracture,,,240.9,2978.0,8 HCPCS,24505,Hc Closed Treatment Upper Humerus Fracture With Manipulation,2915.25,1166.1,,,0 HCPCS,24505,Treat humerus fracture,,,1570.37,3925.93,8 HCPCS,24515,Treat humerus fracture,,,7524.0,31345.78,8 HCPCS,24516,Treat humerus fracture,,,7524.0,31345.78,8 HCPCS,24530,Hc Closed Treatment Humerus Supracondylar Fracture Without Manipulation,1198.87,479.55,,,0 HCPCS,24530,Treat humerus fracture,,,240.9,2978.0,8 HCPCS,24535,Hc Closed Treatment Humerus Supracondylar Fracture With Manipulation,3253.35,1301.34,,,0 HCPCS,24535,Treat humerus fracture,,,1570.37,3925.93,8 HCPCS,24538,Treat humerus fracture,,,3470.0,17716.12,8 HCPCS,24545,Treat humerus fracture,,,7524.0,31345.78,8 HCPCS,24546,Treat humerus fracture,,,9775.0,31345.78,8 HCPCS,24560,Hc Humeral Epicondylar Fracture Medial/Lateral Wo Manipulation,1013.01,405.2,,,0 HCPCS,24560,Treat humerus fracture,,,240.9,2978.0,8 HCPCS,24565,Hc Closed Treatment Of Broken Upper Arm At Shoulder With Manipulation,373.39,149.36,,,0 HCPCS,24565,Treat humerus fracture,,,1570.37,4059.0,8 HCPCS,24566,Treat humerus fracture,,,1570.37,4059.0,8 HCPCS,24575,Treat humerus fracture,,,8330.0,31345.78,8 HCPCS,24576,Hc Closed Treatment Humerus Fracture Without Manipulation,1013.01,405.2,,,0 HCPCS,24576,Treat humerus fracture,,,240.9,2978.0,8 HCPCS,24577,Hc Closed Treatment Humerus Condylar Fracture With Manipulation,3253.35,1301.34,,,0 HCPCS,24577,Treat humerus fracture,,,1570.37,3925.93,8 HCPCS,24579,Treat humerus fracture,,,8330.0,31345.78,8 HCPCS,24582,Treat humerus fracture,,,3470.0,17716.12,8 HCPCS,24586,Treat elbow fracture,,,7524.0,31345.78,8 HCPCS,24587,Treat elbow fracture,,,9775.0,31345.78,8 HCPCS,24600,Hc Closed Treatment Elbow Dislocation-Adult,957.76,383.1,,,0 HCPCS,24600,Treat elbow dislocation,,,240.9,2978.0,8 HCPCS,24605,Treat elbow dislocation,,,1570.37,4059.0,8 HCPCS,24615,Treat elbow dislocation,,,7086.45,17716.12,8 HCPCS,24620,Hc Closed Treatment Monteggia Fracture/Dislocation Elbow With Manipulation,5014.83,2005.93,,,0 HCPCS,24620,Treat elbow fracture,,,1570.37,4059.0,8 HCPCS,24635,Treat elbow fracture,,,7086.45,17716.12,8 HCPCS,24640,Hc Closed Treatment Elbow Dislocation-Child,957.76,383.1,,,0 HCPCS,24640,Treat elbow dislocation,,,240.9,602.24,4 HCPCS,24650,Hc Closed Treatment Radial Head/Neck Fracture Without Manipulation,1198.87,479.55,,,0 HCPCS,24650,Treat radius fracture,,,240.9,602.24,4 HCPCS,24655,Hc Closed Treatment Radius Head/Neck Fracture With Manipulation,3253.35,1301.34,,,0 HCPCS,24655,Treat radius fracture,,,1570.37,3925.93,8 HCPCS,24665,Treat radius fracture,,,7086.45,17716.12,8 HCPCS,24666,Treat radius fracture,,,7524.0,31345.78,8 HCPCS,24670,Hc Closed Treatment Ulnar Fracture Proximal End Without Manipulation,579.34,231.74,,,0 HCPCS,24670,Treat ulnar fracture,,,240.9,2978.0,8 HCPCS,24675,Hc Closed Treatment Ulnar Fracture Proximal End With Manipulation,1141.95,456.78,,,0 HCPCS,24675,Treat ulnar fracture,,,1570.37,3925.93,8 HCPCS,24685,Treat ulnar fracture,,,7086.45,17716.12,8 HCPCS,24800,Fusion of elbow joint,,,7086.45,17716.12,8 HCPCS,24802,Fusion/graft of elbow joint,,,9775.0,31345.78,8 HCPCS,24900,Amputation of upper arm,,,12538.31,31345.78,4 HCPCS,24920,Amputation of upper arm,,,12538.31,31345.78,4 HCPCS,24925,Amputation follow-up surgery,,,3195.45,9743.0,8 HCPCS,24930,Amputation follow-up surgery,,,7086.45,17716.12,4 HCPCS,24931,Amputate upper arm & implant,,,12538.31,31345.78,4 HCPCS,24935,Revision of amputation,,,7086.45,17716.12,4 HCPCS,24940,Revision of upper arm,,,12538.31,31345.78,4 HCPCS,24999,Hc Upper Arm/Elbow Surgery,746.43,298.57,,,0 HCPCS,24999,Upper arm/elbow surgery,,,240.9,602.24,4 HCPCS,25000,Hc Incision Of Tendon Sheath Wrist,5070.0,2028.0,,,0 HCPCS,25000,Incision of tendon sheath,,,1570.37,9743.0,8 HCPCS,25001,Incise flexor carpi radialis,,,3195.45,7988.62,4 HCPCS,25020,Decompress forearm 1 space,,,1570.37,9743.0,8 HCPCS,25023,Decompress forearm 1 space,,,3195.45,9743.0,8 HCPCS,25024,Decompress forearm 2 spaces,,,3195.45,9743.0,8 HCPCS,25025,Decompress forearm 2 spaces,,,1570.37,9743.0,8 HCPCS,25028,Drainage of forearm lesion,,,2546.0,7988.62,8 HCPCS,25028,Hc I&D Forearm&/Wrist Deep Abscess/Hematoma,7116.2,2846.48,,,0 HCPCS,25031,Drainage of forearm bursa,,,1570.37,4059.0,8 HCPCS,25031,Hc Incision & Drainage Forearm&/Wrist Bursa,2790.99,1116.4,,,0 HCPCS,25035,Treat forearm bone lesion,,,3470.0,17716.12,8 HCPCS,25040,Explore/treat wrist joint,,,3195.45,11433.0,8 HCPCS,25065,Biopsy forearm soft tissues,,,1612.96,4032.39,4 HCPCS,25066,Biopsy forearm soft tissues,,,2836.76,7091.89,8 HCPCS,25071,Exc forearm les sc 3 cm/>,,,1612.96,4059.0,8 HCPCS,25073,Exc forearm tum deep 3 cm/>,,,2836.76,9743.0,8 HCPCS,25075,Exc forearm les sc < 3 cm,,,1612.96,4059.0,8 HCPCS,25075,Hc Excision Of Soft Tissue Tumor Forearm/Wrist <3Cm-Bilateral,6298.5,2519.4,,,0 HCPCS,25075,Hc Excision Of Soft Tissue Tumor Forearm/Wrist <3Cm-Unilateral,4199.0,1679.6,,,0 HCPCS,25076,Exc forearm tum deep < 3 cm,,,1612.96,9743.0,8 HCPCS,25076,Hc Excision Of Tumor Soft Tissue Forearm/Wrist < 3Cm,5525.0,2210.0,,,0 HCPCS,25077,Resect forearm/wrist tum<3cm,,,2836.76,9743.0,8 HCPCS,25078,Resect forarm/wrist tum 3cm>,,,2836.76,9743.0,8 HCPCS,25085,Incision of wrist capsule,,,3195.45,9743.0,8 HCPCS,25100,Biopsy of wrist joint,,,3195.45,7988.62,8 HCPCS,25101,Explore/treat wrist joint,,,3195.45,9743.0,8 HCPCS,25105,Remove wrist joint lining,,,3195.45,8800.0,8 HCPCS,25107,Remove wrist joint cartilage,,,3195.45,9743.0,8 HCPCS,25109,Excise tendon forearm/wrist,,,3195.45,7988.62,4 HCPCS,25110,Remove wrist tendon lesion,,,1570.37,9743.0,8 HCPCS,25111,Hc Removal Of Ganglion Wrist Dorsal/Volar Primary,6552.0,2620.8,,,0 HCPCS,25111,Remove wrist tendon lesion,,,1570.37,9743.0,8 HCPCS,25112,Hc Excision Recurrent Ganglion Wrist,3266.58,1306.63,,,0 HCPCS,25112,Reremove wrist tendon lesion,,,1570.37,8800.0,8 HCPCS,25115,Remove wrist/forearm lesion,,,1570.37,8800.0,8 HCPCS,25116,Remove wrist/forearm lesion,,,3195.45,8800.0,8 HCPCS,25118,Excise wrist tendon sheath,,,1570.37,4059.0,8 HCPCS,25119,Partial removal of ulna,,,3195.45,9743.0,8 HCPCS,25120,Removal of forearm lesion,,,3195.45,9743.0,8 HCPCS,25125,Remove/graft forearm lesion,,,1570.37,9743.0,8 HCPCS,25126,Remove/graft forearm lesion,,,3195.45,9743.0,8 HCPCS,25130,Removal of wrist lesion,,,3195.45,9743.0,8 HCPCS,25135,Remove & graft wrist lesion,,,7086.45,17716.12,8 HCPCS,25136,Remove & graft wrist lesion,,,7086.45,17716.12,8 HCPCS,25145,Remove forearm bone lesion,,,3195.45,7988.62,8 HCPCS,25150,Partial removal of ulna,,,3195.45,7988.62,8 HCPCS,25151,Partial removal of radius,,,3195.45,7988.62,8 HCPCS,25170,Resect radius/ulnar tumor,,,7086.45,17716.12,4 HCPCS,25210,Removal of wrist bone,,,3195.45,9743.0,8 HCPCS,25215,Removal of wrist bones,,,3195.45,8800.0,8 HCPCS,25230,Partial removal of radius,,,3195.45,8800.0,8 HCPCS,25240,Partial removal of ulna,,,3195.45,8800.0,8 HCPCS,25246,Hc Injection For Wrist Arthrogram,951.83,380.73,,,0 HCPCS,25248,Hc Remove Forearm/Wrist Foreign Body,5471.7,2188.68,,,0 HCPCS,25248,Remove forearm foreign body,,,1570.37,4059.0,8 HCPCS,25250,Removal of wrist prosthesis,,,1570.37,3925.93,8 HCPCS,25251,Removal of wrist prosthesis,,,2546.0,7988.62,8 HCPCS,25259,Manipulate wrist w/anesthes,,,1570.37,3925.93,4 HCPCS,25260,Repair forearm tendon/muscle,,,3195.45,8800.0,8 HCPCS,25263,Repair forearm tendon/muscle,,,3470.0,17716.12,8 HCPCS,25265,Repair forearm tendon/muscle,,,3195.45,9743.0,8 HCPCS,25270,Repair forearm tendon/muscle,,,3195.45,8800.0,8 HCPCS,25272,Repair forearm tendon/muscle,,,3195.45,9743.0,8 HCPCS,25274,Repair forearm tendon/muscle,,,3195.45,8800.0,8 HCPCS,25275,Repair forearm tendon sheath,,,3195.45,8800.0,8 HCPCS,25280,Revise wrist/forearm tendon,,,3195.45,8800.0,8 HCPCS,25290,Incise wrist/forearm tendon,,,3195.45,9743.0,8 HCPCS,25295,Release wrist/forearm tendon,,,3195.45,9743.0,8 HCPCS,25300,Fusion of tendons at wrist,,,3195.45,9743.0,8 HCPCS,25301,Fusion of tendons at wrist,,,3195.45,9743.0,8 HCPCS,25310,Transplant forearm tendon,,,3195.45,9743.0,8 HCPCS,25312,Transplant forearm tendon,,,3195.45,8800.0,8 HCPCS,25315,Revise palsy hand tendon(s),,,7086.45,17716.12,8 HCPCS,25316,Revise palsy hand tendon(s),,,7086.45,17716.12,8 HCPCS,25320,Repair/revise wrist joint,,,7086.45,17716.12,8 HCPCS,25332,Revise wrist joint,,,3195.45,11433.0,8 HCPCS,25335,Realignment of hand,,,3195.45,9743.0,8 HCPCS,25337,Reconstruct ulna/radioulnar,,,7086.45,17716.12,8 HCPCS,25350,Revision of radius,,,7086.45,17716.12,8 HCPCS,25355,Revision of radius,,,3195.45,9743.0,8 HCPCS,25360,Revision of ulna,,,7086.45,17716.12,8 HCPCS,25365,Revise radius & ulna,,,8330.0,31345.78,8 HCPCS,25370,Revise radius or ulna,,,3195.45,9743.0,8 HCPCS,25375,Revise radius & ulna,,,3195.45,8800.0,8 HCPCS,25390,Shorten radius or ulna,,,7086.45,17716.12,8 HCPCS,25391,Lengthen radius or ulna,,,7524.0,31345.78,8 HCPCS,25392,Shorten radius & ulna,,,7086.45,17716.12,8 HCPCS,25393,Lengthen radius & ulna,,,7086.45,17716.12,8 HCPCS,25394,Repair carpal bone shorten,,,3195.45,7988.62,4 HCPCS,25400,Repair radius or ulna,,,7086.45,17716.12,8 HCPCS,25405,Repair/graft radius or ulna,,,7086.45,17716.12,8 HCPCS,25415,Repair radius & ulna,,,7086.45,17716.12,8 HCPCS,25420,Repair/graft radius & ulna,,,7086.45,17716.12,8 HCPCS,25425,Repair/graft radius or ulna,,,7086.45,17716.12,8 HCPCS,25426,Repair/graft radius & ulna,,,3195.45,8800.0,8 HCPCS,25430,Vasc graft into carpal bone,,,3195.45,7988.62,4 HCPCS,25431,Repair nonunion carpal bone,,,7086.45,17716.12,8 HCPCS,25440,Repair/graft wrist bone,,,7086.45,17716.12,8 HCPCS,25441,Reconstruct wrist joint,,,9775.0,31345.78,8 HCPCS,25442,Reconstruct wrist joint,,,9775.0,42809.0,8 HCPCS,25443,Reconstruct wrist joint,,,7086.45,17716.12,8 HCPCS,25444,Reconstruct wrist joint,,,9775.0,31345.78,8 HCPCS,25445,Reconstruct wrist joint,,,7086.45,17716.12,8 HCPCS,25446,Wrist replacement,,,10346.0,42809.0,8 HCPCS,25447,Repair wrist joints,,,3195.45,11433.0,8 HCPCS,25448,Arthrp ntrcrpl/crp/mtcrp ssp,,,3195.45,7988.62,4 HCPCS,25449,Remove wrist joint implant,,,7086.45,17716.12,8 HCPCS,25450,Revision of wrist joint,,,3195.45,9743.0,8 HCPCS,25455,Revision of wrist joint,,,3195.45,9743.0,8 HCPCS,25490,Reinforce radius,,,7086.45,17716.12,8 HCPCS,25491,Reinforce ulna,,,8330.0,31345.78,8 HCPCS,25492,Reinforce radius and ulna,,,3195.45,9743.0,8 HCPCS,25500,Treat fracture of radius,,,240.9,602.24,4 HCPCS,25505,Hc Closed Treatment Radial Shaft Fracture With Manipulation,3253.35,1301.34,,,0 HCPCS,25505,Treat fracture of radius,,,1570.37,3925.93,8 HCPCS,25515,Treat fracture of radius,,,7086.45,17716.12,8 HCPCS,25520,Hc Closed Rx Radial Shaft Fx W/Dislocation,821.64,328.66,,,0 HCPCS,25520,Treat fracture of radius,,,1570.37,3925.93,8 HCPCS,25525,Treat fracture of radius,,,7086.45,17716.12,8 HCPCS,25526,Treat fracture of radius,,,7086.45,17716.12,8 HCPCS,25530,Hc Closed Treatment Ulna Shaft Fracture Without Manipulation,652.6,261.04,,,0 HCPCS,25530,Treat fracture of ulna,,,240.9,602.24,4 HCPCS,25535,Hc Closed Treatment Ulna Shaft Fracture With Manipulation,1198.87,479.55,,,0 HCPCS,25535,Treat fracture of ulna,,,240.9,2978.0,8 HCPCS,25545,Treat fracture of ulna,,,7086.45,17716.12,8 HCPCS,25560,Hc Closed Treatment Radial And Ulnar/Shaft Fracture Without Manipulation,838.88,335.55,,,0 HCPCS,25560,Treat fracture radius & ulna,,,240.9,602.24,4 HCPCS,25565,Hc Closed Treatment Radius/Ulna Shaft Fracture With Manipulation,5014.83,2005.93,,,0 HCPCS,25565,Treat fracture radius & ulna,,,1570.37,4059.0,8 HCPCS,25574,Treat fracture radius & ulna,,,7086.45,17716.12,8 HCPCS,25575,Treat fracture radius/ulna,,,7086.45,17716.12,8 HCPCS,25600,Hc Closed Treatment Distal Radial/Ulna Fracture Without Manipulation,1198.87,479.55,,,0 HCPCS,25600,Treat fracture radius/ulna,,,240.9,602.24,4 HCPCS,25605,Hc Closed Treatment Distal Radial/Ulna Fracture With Manipulation Unilateral,3253.35,1301.34,,,0 HCPCS,25605,Hc Closed Treatment Distal Radial/Ulna Fracture With Manipulation Bilateral,5157.75,2063.1,,,0 HCPCS,25605,Treat fracture radius/ulna,,,1570.37,9743.0,8 HCPCS,25606,Treat Fx Distal Radial,,,3195.45,9743.0,8 HCPCS,25607,Treat Fx Rad Extra-Articul,,,7086.45,17716.12,8 HCPCS,25608,Treat Fx Rad Intra-Articul,,,7086.45,17716.12,8 HCPCS,25609,Treat Fx Radial 3+ Frag,,,7086.45,17716.12,8 HCPCS,25622,Hc Closed Treatment Of Broken Wrist Bone Without Manipulation,416.0,166.4,,,0 HCPCS,25622,Treat wrist bone fracture,,,240.9,602.24,4 HCPCS,25624,Hc Closed Treatment Wrist Bone Fracture With Manipulation,2977.08,1190.83,,,0 HCPCS,25624,Treat wrist bone fracture,,,1570.37,4059.0,8 HCPCS,25628,Treat wrist bone fracture,,,7086.45,17716.12,8 HCPCS,25630,Hc Closed Treatment Of Carpal Bone Fracture Bilateral,1384.5,553.8,,,0 HCPCS,25630,Hc Closed Treatment Of Carpal Bone Fracture Unilateral,923.0,369.2,,,0 HCPCS,25630,Treat wrist bone fracture,,,240.9,602.24,4 HCPCS,25635,Treat wrist bone fracture,,,1570.37,3925.93,8 HCPCS,25645,Treat wrist bone fracture,,,3195.45,9743.0,8 HCPCS,25650,Hc Closed Treatment Ulna Styloid Fracture-Broken Forearm At Wrist Bone,841.68,336.67,,,0 HCPCS,25650,Treat wrist bone fracture,,,240.9,602.24,4 HCPCS,25651,Pin ulnar styloid fracture,,,3195.45,7988.62,4 HCPCS,25652,Treat fracture ulnar styloid,,,7086.45,17716.12,4 HCPCS,25660,Hc Closed Treatment Wrist Dislocation Bilateral,1004.9,401.96,,,0 HCPCS,25660,Hc Closed Treatment Wrist Dislocation Unilateral,799.5,319.8,,,0 HCPCS,25660,Treat wrist dislocation,,,240.9,2978.0,8 HCPCS,25670,Treat wrist dislocation,,,7086.45,17716.12,8 HCPCS,25671,Pin radioulnar dislocation,,,2546.0,7988.62,8 HCPCS,25675,Treat wrist dislocation,,,240.9,2978.0,8 HCPCS,25676,Treat wrist dislocation,,,3470.0,17716.12,8 HCPCS,25680,Treat wrist fracture,,,240.9,4059.0,8 HCPCS,25685,Treat wrist fracture,,,7086.45,17716.12,8 HCPCS,25690,Hc Closed Treatment Wrist Dislocation,4003.49,1601.4,,,0 HCPCS,25690,Treat wrist dislocation,,,1570.37,3925.93,8 HCPCS,25695,Treat wrist dislocation,,,3470.0,17716.12,8 HCPCS,25800,Fusion of wrist joint,,,7086.45,17716.12,8 HCPCS,25805,Fusion/graft of wrist joint,,,7086.45,17716.12,8 HCPCS,25810,Fusion/graft of wrist joint,,,9775.0,31345.78,8 HCPCS,25820,Fusion of hand bones,,,7086.45,17716.12,8 HCPCS,25825,Fuse hand bones with graft,,,7086.45,17716.12,8 HCPCS,25830,Fusion radioulnar jnt/ulna,,,7086.45,17716.12,8 HCPCS,25900,Amputation of forearm,,,7086.45,17716.12,4 HCPCS,25905,Amputation of forearm,,,7086.45,17716.12,4 HCPCS,25907,Amputation follow-up surgery,,,3195.45,9743.0,8 HCPCS,25909,Amputation follow-up surgery,,,7086.45,17716.12,4 HCPCS,25915,Amputation of forearm,,,7086.45,17716.12,4 HCPCS,25920,Amputate hand at wrist,,,3195.45,7988.62,4 HCPCS,25922,Amputate hand at wrist,,,1570.37,9743.0,8 HCPCS,25924,Amputation follow-up surgery,,,3195.45,7988.62,4 HCPCS,25927,Amputation of hand,,,3195.45,7988.62,4 HCPCS,25929,Amputation follow-up surgery,,,2015.01,9743.0,8 HCPCS,25931,Amputation follow-up surgery,,,3195.45,7988.62,4 HCPCS,25999,Forearm or wrist surgery,,,240.9,602.24,4 HCPCS,26010,Drainage of finger abscess,,,195.94,2978.0,8 HCPCS,26010,"Hc Drain Finger Abscess,Simple",1438.31,575.32,,,0 HCPCS,26011,Drainage of finger abscess,,,1612.96,4032.39,8 HCPCS,26011,"Hc Drain Finger Abscess,Complicated",3767.4,1506.96,,,0 HCPCS,26020,Drain hand tendon sheath,,,3195.45,7988.62,8 HCPCS,26025,Drainage of palm bursa,,,2546.0,7988.62,8 HCPCS,26030,Drainage of palm bursas,,,3195.45,7988.62,8 HCPCS,26034,Treat hand bone lesion,,,1570.37,4059.0,8 HCPCS,26035,Decompress fingers/hand,,,3195.45,7988.62,4 HCPCS,26037,Decompress fingers/hand,,,3195.45,7988.62,4 HCPCS,26040,Hc Fasciotomy Palmar Percutaneous,4461.6,1784.64,,,0 HCPCS,26040,Release palm contracture,,,1570.37,8800.0,8 HCPCS,26045,Hc Release Palm Contracture,6344.0,2537.6,,,0 HCPCS,26045,Release palm contracture,,,3195.45,9743.0,8 HCPCS,26055,Hc Incise Finger Tendon Sheath,5005.0,2002.0,,,0 HCPCS,26055,Incise finger tendon sheath,,,1570.37,4059.0,8 HCPCS,26060,Hc Incision Of Finger Tendon,2808.0,1123.2,,,0 HCPCS,26060,Incision of finger tendon,,,1570.37,4059.0,8 HCPCS,26070,Explore/treat hand joint,,,1570.37,4059.0,8 HCPCS,26075,Explore/treat finger joint,,,3195.45,8800.0,8 HCPCS,26080,Explore/treat finger joint,,,1570.37,8800.0,8 HCPCS,26080,"Hc Exploration, Drainage, Or Removal Of Foreign Body Of Hand Joint",3575.0,1430.0,,,0 HCPCS,26100,Biopsy hand joint lining,,,3195.45,7988.62,8 HCPCS,26105,Biopsy finger joint lining,,,2546.0,7988.62,8 HCPCS,26110,Biopsy finger joint lining,,,1570.37,3925.93,8 HCPCS,26111,Exc hand les sc 1.5 cm/>,,,1612.96,4059.0,8 HCPCS,26111,Hc Removal Tissue Beneath The Skin Growth Of Hand/Finger >/ 1.5 Cm,3770.0,1508.0,,,0 HCPCS,26113,Exc hand tum deep 1.5 cm/>,,,1612.96,4059.0,8 HCPCS,26115,Exc hand les sc < 1.5 cm,,,1612.96,4059.0,8 HCPCS,26116,Exc hand tum deep < 1.5 cm,,,1612.96,4059.0,8 HCPCS,26116,Hc Removal Of < 1.5 Cm Muscle Growth Of Hand Or Finger,2801.5,1120.6,,,0 HCPCS,26117,Rad resect hand tumor < 3 cm,,,2836.76,9743.0,8 HCPCS,26118,Rad resect hand tumor 3 cm/>,,,2836.76,7091.89,4 HCPCS,26121,Release palm contracture,,,3195.45,8800.0,8 HCPCS,26123,Release palm contracture,,,3195.45,8800.0,8 HCPCS,26125,Release palm contracture,,,7524.0,8800.0,4 HCPCS,26130,Remove wrist joint lining,,,3195.45,9743.0,8 HCPCS,26135,Revise finger joint each,,,3195.45,8800.0,8 HCPCS,26140,Revise finger joint each,,,1570.37,4059.0,8 HCPCS,26145,Tendon excision palm/finger,,,1570.37,9743.0,8 HCPCS,26160,"Hc Excision Tendon Sheath Lesion, Hand/Finger",5460.0,2184.0,,,0 HCPCS,26160,Remove tendon sheath lesion,,,1570.37,9743.0,8 HCPCS,26170,Removal of palm tendon each,,,1570.37,9743.0,8 HCPCS,26180,Removal of finger tendon,,,1570.37,9743.0,8 HCPCS,26185,Remove finger bone,,,1570.37,8800.0,8 HCPCS,26200,Remove hand bone lesion,,,1570.37,4059.0,8 HCPCS,26205,Remove/graft bone lesion,,,7086.45,17716.12,8 HCPCS,26210,Removal of finger lesion,,,1570.37,4059.0,8 HCPCS,26215,Remove/graft finger lesion,,,3195.45,9743.0,8 HCPCS,26230,Partial removal of hand bone,,,3195.45,12101.0,8 HCPCS,26235,Partial removal finger bone,,,1570.37,9743.0,8 HCPCS,26236,Hc Partial Removal Finger Bone,5014.83,2005.93,,,0 HCPCS,26236,Partial removal finger bone,,,1570.37,9743.0,8 HCPCS,26250,Extensive hand surgery,,,3195.45,9743.0,8 HCPCS,26255,Extensive hand surgery,,,8330.0,9743.0,4 HCPCS,26260,Resect prox finger tumor,,,3195.45,9743.0,8 HCPCS,26261,Extensive finger surgery,,,8330.0,9743.0,4 HCPCS,26262,Resect distal finger tumor,,,1570.37,4059.0,8 HCPCS,26320,Hc Removal Implant From Finger/Hand,3662.75,1465.1,,,0 HCPCS,26320,Removal of implant from hand,,,1612.96,4059.0,8 HCPCS,26340,Manipulate finger w/anesth,,,1570.37,3925.93,4 HCPCS,26341,Hc Maniplatn Palar Fascial Crd Post Inj Single Cord,1659.33,663.73,,,0 HCPCS,26341,Manipulat palm cord post inj,,,240.9,602.24,4 HCPCS,26350,Repair finger/hand tendon,,,2546.0,7988.62,8 HCPCS,26352,Repair/graft hand tendon,,,7086.45,17716.12,8 HCPCS,26356,Repair finger/hand tendon,,,3195.45,8800.0,8 HCPCS,26357,Repair finger/hand tendon,,,3195.45,8800.0,8 HCPCS,26358,Repair/graft hand tendon,,,7086.45,17716.12,8 HCPCS,26370,Hc Repair Of Finger/Tendon Each Tendon,5609.5,2243.8,,,0 HCPCS,26370,Repair finger/hand tendon,,,3195.45,8800.0,8 HCPCS,26372,Repair/graft hand tendon,,,7086.45,17716.12,8 HCPCS,26373,Repair finger/hand tendon,,,3195.45,9743.0,8 HCPCS,26390,Revise hand/finger tendon,,,7086.45,17716.12,8 HCPCS,26392,Repair/graft hand tendon,,,7086.45,17716.12,8 HCPCS,26410,Hc Repair Hand Tendon Without Graft Each,4160.0,1664.0,,,0 HCPCS,26410,Repair hand tendon,,,1570.37,9743.0,8 HCPCS,26412,Repair/graft hand tendon,,,3195.45,9743.0,8 HCPCS,26415,Excision hand/finger tendon,,,3195.45,8800.0,8 HCPCS,26416,Graft hand or finger tendon,,,3195.45,9743.0,8 HCPCS,26418,Noncdm Charge Record,3857.56,1543.02,,,0 HCPCS,26418,Repair finger tendon,,,1570.37,8800.0,8 HCPCS,26420,Repair/graft finger tendon,,,3195.45,8800.0,8 HCPCS,26426,Repair finger/hand tendon,,,3195.45,9743.0,8 HCPCS,26428,Repair/graft finger tendon,,,3195.45,9743.0,8 HCPCS,26432,Repair finger tendon,,,1570.37,9743.0,8 HCPCS,26433,Repair finger tendon,,,3195.45,9743.0,8 HCPCS,26434,Repair/graft finger tendon,,,3195.45,9743.0,8 HCPCS,26437,Realignment of tendons,,,3195.45,9743.0,8 HCPCS,26440,Release palm/finger tendon,,,1570.37,9743.0,8 HCPCS,26442,Release palm & finger tendon,,,3195.45,9743.0,8 HCPCS,26445,Release hand/finger tendon,,,3195.45,9743.0,8 HCPCS,26449,Release forearm/hand tendon,,,3195.45,9743.0,8 HCPCS,26450,Incision of palm tendon,,,3195.45,9743.0,8 HCPCS,26455,Incision of finger tendon,,,1570.37,9743.0,8 HCPCS,26460,Incise hand/finger tendon,,,1570.37,9743.0,8 HCPCS,26471,Fusion of finger tendons,,,3195.45,7988.62,8 HCPCS,26474,Fusion of finger tendons,,,1570.37,4059.0,8 HCPCS,26476,Tendon lengthening,,,2546.0,7988.62,8 HCPCS,26477,Tendon shortening,,,2546.0,7988.62,8 HCPCS,26478,Lengthening of hand tendon,,,2546.0,7988.62,8 HCPCS,26479,Shortening of hand tendon,,,2546.0,7988.62,8 HCPCS,26480,Transplant hand tendon,,,3195.45,9743.0,8 HCPCS,26483,Transplant/graft hand tendon,,,3195.45,9743.0,8 HCPCS,26485,Transplant palm tendon,,,3195.45,7988.62,8 HCPCS,26489,Transplant/graft palm tendon,,,3195.45,9743.0,8 HCPCS,26490,Revise thumb tendon,,,3195.45,9743.0,8 HCPCS,26492,Tendon transfer with graft,,,3195.45,9743.0,8 HCPCS,26494,Hand tendon/muscle transfer,,,3195.45,9743.0,8 HCPCS,26496,Revise thumb tendon,,,3195.45,9743.0,8 HCPCS,26497,Finger tendon transfer,,,3195.45,9743.0,8 HCPCS,26498,Finger tendon transfer,,,3195.45,8800.0,8 HCPCS,26499,Revision of finger,,,3195.45,9743.0,8 HCPCS,26500,Hand tendon reconstruction,,,7086.45,17716.12,8 HCPCS,26502,Hand tendon reconstruction,,,3195.45,8800.0,8 HCPCS,26508,Release thumb contracture,,,3195.45,9743.0,8 HCPCS,26510,Thumb tendon transfer,,,3195.45,9743.0,8 HCPCS,26516,Fusion of knuckle joint,,,2546.0,7988.62,8 HCPCS,26517,Fusion of knuckle joints,,,3195.45,9743.0,8 HCPCS,26518,Fusion of knuckle joints,,,7086.45,17716.12,8 HCPCS,26520,Release knuckle contracture,,,3195.45,9743.0,8 HCPCS,26525,Release finger contracture,,,1570.37,9743.0,8 HCPCS,26530,Revise knuckle joint,,,7086.45,17716.12,8 HCPCS,26531,Revise knuckle with implant,,,7086.45,17716.12,8 HCPCS,26535,Revise finger joint,,,3195.45,11433.0,8 HCPCS,26536,Revise/implant finger joint,,,7086.45,17716.12,8 HCPCS,26540,Repair hand joint,,,3195.45,8800.0,8 HCPCS,26541,Repair hand joint with graft,,,3195.45,12101.0,8 HCPCS,26542,Repair hand joint with graft,,,3195.45,8800.0,8 HCPCS,26545,Reconstruct finger joint,,,3195.45,8800.0,8 HCPCS,26546,Repair nonunion hand,,,7086.45,17716.12,8 HCPCS,26548,Reconstruct finger joint,,,3195.45,8800.0,8 HCPCS,26550,Construct thumb replacement,,,3195.45,7988.62,8 HCPCS,26551,Great toe-hand transfer,,,7086.45,17716.12,4 HCPCS,26553,Single transfer toe-hand,,,7086.45,17716.12,4 HCPCS,26554,Double transfer toe-hand,,,7086.45,17716.12,4 HCPCS,26555,Positional change of finger,,,7086.45,17716.12,8 HCPCS,26556,Toe joint transfer,,,7086.45,17716.12,4 HCPCS,26560,Repair of web finger,,,1570.37,4059.0,8 HCPCS,26561,Repair of web finger,,,3195.45,9743.0,8 HCPCS,26562,Repair of web finger,,,3195.45,8800.0,8 HCPCS,26565,Correct metacarpal flaw,,,3195.45,11433.0,8 HCPCS,26567,Correct finger deformity,,,3195.45,11433.0,8 HCPCS,26568,Lengthen metacarpal/finger,,,7086.45,17716.12,8 HCPCS,26580,Repair hand deformity,,,3195.45,11433.0,8 HCPCS,26587,Reconstruct extra finger,,,3195.45,11433.0,8 HCPCS,26590,Repair finger deformity,,,1570.37,11433.0,8 HCPCS,26591,Repair muscles of hand,,,3195.45,9743.0,8 HCPCS,26593,Release muscles of hand,,,3195.45,9743.0,8 HCPCS,26596,Excision constricting tissue,,,3195.45,7988.62,8 HCPCS,26600,Hc Closed Treatment Metacarpal Fracture Without Manipulation,527.74,211.1,,,0 HCPCS,26600,Treat metacarpal fracture,,,240.9,602.24,4 HCPCS,26605,Hc Closed Treatment Metacarpal Fracture With Manipulation,957.76,383.1,,,0 HCPCS,26605,Treat metacarpal fracture,,,240.9,4059.0,8 HCPCS,26607,Treat metacarpal fracture,,,3195.45,7988.62,8 HCPCS,26608,Treat metacarpal fracture,,,3195.45,8800.0,8 HCPCS,26615,Treat metacarpal fracture,,,3195.45,8800.0,8 HCPCS,26641,Hc Closed Treatment Of Dislocated Thumb At Wrist With Manipulation,1352.0,540.8,,,0 HCPCS,26641,Treat thumb dislocation,,,240.9,602.24,4 HCPCS,26645,"Hc Treat Thumb Fx/Disloc,Manip",2205.12,882.05,,,0 HCPCS,26645,Treat thumb fracture,,,1570.37,3925.93,8 HCPCS,26650,Treat thumb fracture,,,3195.45,7988.62,8 HCPCS,26665,Hc Open Tx Carpmetacarpal Fracture Dislocate Thumb Bilateral,16831.1,6732.44,,,0 HCPCS,26665,Hc Open Tx Carpmetacarpal Fracture Dislocate Thumb Unilateral,11220.3,4488.12,,,0 HCPCS,26665,Treat thumb fracture,,,3195.45,8800.0,8 HCPCS,26670,Hc Cltx Carpo/Metacarpl Dislc Thmb Manj Ea W/O Anes,957.76,383.1,,,0 HCPCS,26670,Treat hand dislocation,,,240.9,602.24,4 HCPCS,26675,Treat hand dislocation,,,1570.37,4059.0,8 HCPCS,26676,Pin hand dislocation,,,3195.45,7988.62,8 HCPCS,26685,Treat hand dislocation,,,3195.45,9743.0,8 HCPCS,26686,Treat hand dislocation,,,3195.45,9743.0,8 HCPCS,26700,Hc Closed Treatment Knuckle Dislocation Without Anesthesia,299.72,119.89,,,0 HCPCS,26700,Treat knuckle dislocation,,,240.9,2978.0,8 HCPCS,26705,Treat knuckle dislocation,,,1570.37,4059.0,8 HCPCS,26706,Pin knuckle dislocation,,,3195.45,7988.62,8 HCPCS,26715,Treat knuckle dislocation,,,3195.45,8800.0,8 HCPCS,26720,Hc Closed Treatment Proximal/Middle Phalanx Finger Fracture Without Manipulation,747.5,299.0,,,0 HCPCS,26720,Treat finger fracture each,,,240.9,602.24,4 HCPCS,26725,Hc Closed Treatment Proximal/Middle Phalanx Finger Fracture With Manipulation,1198.87,479.55,,,0 HCPCS,26725,Treat finger fracture each,,,240.9,2978.0,8 HCPCS,26727,Treat finger fracture each,,,3195.45,12101.0,8 HCPCS,26735,Treat finger fracture each,,,3195.45,8800.0,8 HCPCS,26740,Hc Close Rx Fingr Articular Fx,1070.42,428.17,,,0 HCPCS,26740,Treat finger fracture each,,,240.9,602.24,4 HCPCS,26742,Hc Closed Treatment Finger Articular Fracture With Manipulation,2531.04,1012.42,,,0 HCPCS,26742,Treat finger fracture each,,,1570.37,4059.0,8 HCPCS,26746,Treat finger fracture each,,,3195.45,11433.0,8 HCPCS,26750,Hc Close Rx Dist Fingr Fx,751.98,300.79,,,0 HCPCS,26750,Treat finger fracture each,,,240.9,602.24,4 HCPCS,26755,Hc Closed Treatment Distal Finger Fracture With Manipulation,762.45,304.98,,,0 HCPCS,26755,Treat finger fracture each,,,240.9,602.24,4 HCPCS,26756,Pin finger fracture each,,,3195.45,7988.62,8 HCPCS,26765,Hc Open Treatment Distal Phalangeal Fracture Each,7116.2,2846.48,,,0 HCPCS,26765,Treat finger fracture each,,,3195.45,8800.0,8 HCPCS,26770,Hc Closed Treatment Interphalangeal Joint Dislocation With Manipulation,957.76,383.1,,,0 HCPCS,26770,Treat finger dislocation,,,240.9,602.24,4 HCPCS,26775,Hc Treatment Finger Dislocation,1378.0,551.2,,,0 HCPCS,26775,Treat finger dislocation,,,273.15,682.87,4 HCPCS,26776,Pin finger dislocation,,,3195.45,7988.62,8 HCPCS,26785,Treat finger dislocation,,,3195.45,7988.62,8 HCPCS,26820,Thumb fusion with graft,,,7086.45,17716.12,8 HCPCS,26841,Fusion of thumb,,,7086.45,17716.12,8 HCPCS,26842,Thumb fusion with graft,,,7086.45,17716.12,8 HCPCS,26843,Fusion of hand joint,,,7086.45,17716.12,8 HCPCS,26844,Fusion/graft of hand joint,,,7086.45,17716.12,8 HCPCS,26850,Fusion of knuckle,,,7086.45,17716.12,8 HCPCS,26852,Fusion of knuckle with graft,,,7086.45,17716.12,8 HCPCS,26860,Fusion of finger joint,,,3195.45,9743.0,8 HCPCS,26861,Fusion of finger jnt add-on,,,3470.0,4059.0,4 HCPCS,26862,Fusion/graft of finger joint,,,3195.45,8800.0,8 HCPCS,26863,Fuse/graft added joint,,,8330.0,9743.0,4 HCPCS,26910,Amputate metacarpal bone,,,3195.45,9743.0,8 HCPCS,26951,Amputation of finger/thumb,,,3195.45,7988.62,8 HCPCS,26951,Hc Amputation Finger/Thumb,4651.48,1860.59,,,0 HCPCS,26952,Amputation of finger/thumb,,,3195.45,8800.0,8 HCPCS,26952,Hc Amputation Of Finger/Thumb,7176.0,2870.4,,,0 HCPCS,26989,Hand/finger surgery,,,240.9,602.24,4 HCPCS,26990,Drainage of pelvis lesion,,,2546.0,7988.62,8 HCPCS,26990,Hc I&D Pelvis/Hip Jt Area Deep Abscess/Hematoma,9334.78,3733.91,,,0 HCPCS,26991,Drainage of pelvis bursa,,,1570.37,3925.93,8 HCPCS,26992,Drainage of bone lesion,,,3195.45,7988.62,4 HCPCS,27000,Incision of hip tendon,,,1570.37,4059.0,8 HCPCS,27001,Incision of hip tendon,,,3195.45,9743.0,8 HCPCS,27003,Incision of hip tendon,,,7086.45,17716.12,8 HCPCS,27005,Incision of hip tendon,,,3195.45,7988.62,4 HCPCS,27006,Incision of hip tendons,,,3195.45,7988.62,4 HCPCS,27025,Incision of hip/thigh fascia,,,3195.45,7988.62,4 HCPCS,27027,Buttock fasciotomy,,,7086.45,17716.12,4 HCPCS,27030,Drainage of hip joint,,,7086.45,17716.12,4 HCPCS,27033,Exploration of hip joint,,,7086.45,17716.12,8 HCPCS,27035,Denervation of hip joint,,,3195.45,8800.0,8 HCPCS,27036,Excision of hip joint/muscle,,,7086.45,17716.12,4 HCPCS,27040,Biopsy of soft tissues,,,1612.96,4032.39,8 HCPCS,27041,Biopsy of soft tissues,,,1612.96,4059.0,8 HCPCS,27043,Exc hip pelvis les sc 3 cm/>,,,2836.76,7091.89,8 HCPCS,27045,Exc hip/pelv tum deep 5 cm/>,,,2836.76,9743.0,8 HCPCS,27047,Exc hip/pelvis les sc < 3 cm,,,2836.76,7091.89,8 HCPCS,27048,Exc hip/pelv tum deep < 5 cm,,,2836.76,9743.0,8 HCPCS,27049,Resect hip/pelv tum < 5 cm,,,2836.76,9743.0,8 HCPCS,27050,Biopsy of sacroiliac joint,,,1570.37,9743.0,8 HCPCS,27052,Biopsy of hip joint,,,1570.37,9743.0,8 HCPCS,27054,Removal of hip joint lining,,,3195.45,7988.62,4 HCPCS,27057,Buttock fasciotomy w/dbrdmt,,,1570.37,3925.93,4 HCPCS,27059,Resect hip/pelv tum 5 cm/>,,,2836.76,7091.89,4 HCPCS,27060,Removal of ischial bursa,,,7086.45,17716.12,8 HCPCS,27062,Remove femur lesion/bursa,,,3195.45,11433.0,8 HCPCS,27065,Remove hip bone les super,,,7086.45,17716.12,8 HCPCS,27066,Remove hip bone les deep,,,3195.45,11433.0,8 HCPCS,27067,Remove/graft hip bone lesion,,,7086.45,17716.12,8 HCPCS,27070,Part remove hip bone super,,,3195.45,7988.62,4 HCPCS,27071,Part removal hip bone deep,,,3195.45,7988.62,4 HCPCS,27075,Resect hip tumor,,,7086.45,17716.12,4 HCPCS,27076,Resect hip tum incl acetabul,,,7086.45,17716.12,4 HCPCS,27077,Resect hip tum w/innom bone,,,7086.45,17716.12,4 HCPCS,27078,Rsect hip tum incl femur,,,7086.45,17716.12,4 HCPCS,27080,Removal of tail bone,,,3195.45,7988.62,8 HCPCS,27086,Hc Removal Of Foreign Body From Pelvis/Hip,5330.0,2132.0,,,0 HCPCS,27086,Remove hip foreign body,,,2546.0,7091.89,8 HCPCS,27087,Remove hip foreign body,,,3195.45,9743.0,8 HCPCS,27090,Removal of hip prosthesis,,,7086.45,17716.12,4 HCPCS,27091,Removal of hip prosthesis,,,12538.31,31345.78,4 HCPCS,27093,Hc Injection Hip Arthrogram,945.39,378.16,,,0 HCPCS,27096,"Hc Injection,Sacroiliac Joint Unilateral",2391.82,956.73,,,0 HCPCS,27097,Revision of hip tendon,,,3195.45,9743.0,8 HCPCS,27098,Transfer tendon to pelvis,,,3195.45,9743.0,8 HCPCS,27100,Transfer of abdominal muscle,,,7086.45,17716.12,8 HCPCS,27105,Transfer of spinal muscle,,,3195.45,8800.0,8 HCPCS,27110,Transfer of iliopsoas muscle,,,7086.45,17716.12,8 HCPCS,27111,Transfer of iliopsoas muscle,,,3195.45,8800.0,8 HCPCS,27120,Reconstruction of hip socket,,,12538.31,31345.78,4 HCPCS,27122,Reconstruction of hip socket,,,7086.45,17716.12,4 HCPCS,27125,Partial hip replacement,,,12538.31,31345.78,4 HCPCS,27130,Total hip arthroplasty,,,12538.31,31345.78,4 HCPCS,27132,Total hip arthroplasty,,,12538.31,31345.78,4 HCPCS,27134,Revise hip joint replacement,,,12538.31,31345.78,4 HCPCS,27137,Revise hip joint replacement,,,12538.31,31345.78,4 HCPCS,27138,Revise hip joint replacement,,,12538.31,31345.78,4 HCPCS,27140,Transplant femur ridge,,,7086.45,17716.12,4 HCPCS,27146,Incision of hip bone,,,7086.45,17716.12,4 HCPCS,27147,Revision of hip bone,,,7086.45,17716.12,4 HCPCS,27151,Incision of hip bones,,,7086.45,17716.12,4 HCPCS,27156,Revision of hip bones,,,7086.45,17716.12,4 HCPCS,27158,Revision of pelvis,,,7086.45,17716.12,4 HCPCS,27161,Incision of neck of femur,,,7086.45,17716.12,4 HCPCS,27165,Incision/fixation of femur,,,7086.45,17716.12,4 HCPCS,27170,Repair/graft femur head/neck,,,7086.45,17716.12,4 HCPCS,27175,Treat slipped epiphysis,,,3195.45,7988.62,4 HCPCS,27176,Treat slipped epiphysis,,,3195.45,7988.62,4 HCPCS,27177,Treat slipped epiphysis,,,3195.45,7988.62,4 HCPCS,27178,Treat slipped epiphysis,,,3195.45,7988.62,4 HCPCS,27179,Revise head/neck of femur,,,7086.45,17716.12,4 HCPCS,27181,Treat slipped epiphysis,,,7086.45,17716.12,4 HCPCS,27185,Revision of femur epiphysis,,,3195.45,7988.62,4 HCPCS,27187,Reinforce hip bones,,,7086.45,17716.12,4 HCPCS,27193,Treat pelvic ring fracture,,,2546.0,2978.0,4 HCPCS,27194,Treat pelvic ring fracture,,,3470.0,4059.0,4 HCPCS,27197,Clsd tx pelvic ring fx,,,240.9,2978.0,8 HCPCS,27197,Hc Closed Treatment Of Fracture And/Or Dislocation Of Pelvis And/Or Sacrum,624.0,249.6,,,0 HCPCS,27198,Clsd tx pelvic ring fx,,,240.9,4059.0,8 HCPCS,27200,Treat tail bone fracture,,,240.9,602.24,4 HCPCS,27202,Treat tail bone fracture,,,3195.45,7988.62,8 HCPCS,27220,Treat hip socket fracture,,,240.9,602.24,4 HCPCS,27222,Hc Closed Treatment Of Broken Hip Socket With Manipulation,3624.54,1449.82,,,0 HCPCS,27222,Treat hip socket fracture,,,240.9,602.24,4 HCPCS,27226,Hc Open Treatment Post/Ant Actblr Wall Fracture W/Int Fixj,9983.22,3993.29,,,0 HCPCS,27226,Hc Optx Pst/Ant Actblr Wall Fx W/Int Fixj,9983.22,3993.29,,,0 HCPCS,27226,Treat hip wall fracture,,,7086.45,17716.12,4 HCPCS,27227,Treat hip fracture(s),,,7086.45,17716.12,4 HCPCS,27228,Treat hip fracture(s),,,7086.45,17716.12,4 HCPCS,27230,Treat thigh fracture,,,240.9,2978.0,8 HCPCS,27232,Treat thigh fracture,,,1570.37,3925.93,4 HCPCS,27235,Treat thigh fracture,,,7086.45,17716.12,4 HCPCS,27236,Hc Open Treatment Femoral Fracture Prox End Nck Int Fixj/Prostc Replacement,4302.12,1720.85,,,0 HCPCS,27236,Treat thigh fracture,,,7086.45,17716.12,4 HCPCS,27238,Treat thigh fracture,,,1570.37,3925.93,8 HCPCS,27240,Treat thigh fracture,,,1570.37,3925.93,4 HCPCS,27244,Treat thigh fracture,,,7086.45,17716.12,4 HCPCS,27245,Hc Treatment Of Thigh Fracture,11311.92,4524.77,,,0 HCPCS,27245,Treat thigh fracture,,,7086.45,17716.12,4 HCPCS,27246,Treat thigh fracture,,,240.9,2978.0,8 HCPCS,27248,Treat thigh fracture,,,7086.45,17716.12,4 HCPCS,27250,Hc Closed Treatment Trauma Hip Dislocation Without Anesthesia,1820.0,728.0,,,0 HCPCS,27250,Treat hip dislocation,,,240.9,2978.0,8 HCPCS,27252,Hc Closed Treatment Trauma Hip Dislocation With Anesthesia,1558.27,623.31,,,0 HCPCS,27252,Treat hip dislocation,,,1570.37,4059.0,8 HCPCS,27253,Treat hip dislocation,,,3195.45,7988.62,4 HCPCS,27254,Treat hip dislocation,,,7086.45,17716.12,4 HCPCS,27256,Treat hip dislocation,,,240.9,602.24,4 HCPCS,27257,Treat hip dislocation,,,1570.37,9743.0,8 HCPCS,27258,Treat hip dislocation,,,3195.45,7988.62,4 HCPCS,27259,Treat hip dislocation,,,3195.45,7988.62,4 HCPCS,27265,Hc Closed Treatment Hip Dislocation Without Anesthesia,357.3,142.92,,,0 HCPCS,27265,Treat hip dislocation,,,240.9,2978.0,8 HCPCS,27266,Hc Closed Treatment Post Hip Arthroplasty Dislocation Requiring Anesthesia,5014.83,2005.93,,,0 HCPCS,27266,Hc Cltx Post Hip Arthrp Dislc Req Anes,5014.83,2005.93,,,0 HCPCS,27266,Treat hip dislocation,,,1570.37,4059.0,8 HCPCS,27267,Cltx thigh fx,,,3195.45,7988.62,4 HCPCS,27268,Cltx thigh fx w/mnpj,,,1570.37,3925.93,4 HCPCS,27269,Optx thigh fx,,,7086.45,17716.12,4 HCPCS,27275,Manipulation of hip joint,,,1570.37,4059.0,8 HCPCS,27278,Arthrd si jt prq wo tfxj dev,,,17123.6,42809.0,4 HCPCS,27279,Arthrodesis sacroiliac joint,,,17123.6,42809.0,4 HCPCS,27279,Hc Fusion Of Pelvic Joint Using Imaging Guidance,27277.76,10911.1,,,0 HCPCS,27280,Fusion of sacroiliac joint,,,17123.6,42809.0,4 HCPCS,27282,Fusion of pubic bones,,,3195.45,7988.62,4 HCPCS,27284,Fusion of hip joint,,,12538.31,31345.78,4 HCPCS,27286,Fusion of hip joint,,,12538.31,31345.78,4 HCPCS,27290,Amputation of leg at hip,,,17123.6,42809.0,4 HCPCS,27295,Amputation of leg at hip,,,17123.6,42809.0,4 HCPCS,27299,Pelvis/hip joint surgery,,,240.9,602.24,4 HCPCS,27301,Drain thigh/knee lesion,,,2836.76,9743.0,8 HCPCS,27301,Hc I&D Thigh/Knee Lesion,7121.22,2848.49,,,0 HCPCS,27303,Drainage of bone lesion,,,3195.45,7988.62,4 HCPCS,27305,Incise thigh tendon & fascia,,,3195.45,7988.62,8 HCPCS,27306,Incision of thigh tendon,,,3195.45,9743.0,8 HCPCS,27307,Incision of thigh tendons,,,3195.45,9743.0,8 HCPCS,27310,Exploration of knee joint,,,3195.45,8800.0,8 HCPCS,27310,Hc Arthrocentesis Knee W/Expl Drg/Removal Fb,5924.02,2369.61,,,0 HCPCS,27323,Biopsy thigh soft tissues,,,1612.96,4032.39,8 HCPCS,27323,Hc Biopsy Soft Tissue Thigh/Knee,3690.38,1476.15,,,0 HCPCS,27324,Biopsy thigh soft tissues,,,2546.0,7091.89,8 HCPCS,27325,Neurectomy hamstring,,,1907.04,4767.6,8 HCPCS,27326,Neurectomy popliteal,,,1907.04,4767.6,8 HCPCS,27327,Exc thigh/knee les sc < 3 cm,,,1612.96,4059.0,8 HCPCS,27327,Hc Excision Tumor Soft Tissue Thigh/Knee Subcutaneous <3Cm,5330.0,2132.0,,,0 HCPCS,27328,Exc thigh/knee tum deep <5cm,,,2836.76,9743.0,8 HCPCS,27329,Resect thigh/knee tum < 5 cm,,,2836.76,8800.0,8 HCPCS,27330,Biopsy knee joint lining,,,3195.45,8800.0,8 HCPCS,27331,Explore/treat knee joint,,,3195.45,8800.0,8 HCPCS,27332,Removal of knee cartilage,,,3195.45,8800.0,8 HCPCS,27333,Removal of knee cartilage,,,3195.45,8800.0,8 HCPCS,27334,Remove knee joint lining,,,3195.45,8800.0,8 HCPCS,27335,Remove knee joint lining,,,7086.45,17716.12,8 HCPCS,27337,Exc thigh/knee les sc 3 cm/>,,,2836.76,7091.89,8 HCPCS,27339,Exc thigh/knee tum dep 5cm/>,,,2836.76,9743.0,8 HCPCS,27340,Removal of kneecap bursa,,,3195.45,9743.0,8 HCPCS,27345,Removal of knee cyst,,,3195.45,8800.0,8 HCPCS,27347,Remove knee cyst,,,3195.45,8800.0,8 HCPCS,27350,Removal of kneecap,,,7086.45,17716.12,8 HCPCS,27355,Remove femur lesion,,,3195.45,9743.0,8 HCPCS,27356,Remove femur lesion/graft,,,7524.0,31345.78,8 HCPCS,27357,Remove femur lesion/graft,,,7086.45,17716.12,8 HCPCS,27358,Remove femur lesion/fixation,,,9775.0,11433.0,4 HCPCS,27360,Partial removal leg bone(s),,,3195.45,11433.0,8 HCPCS,27364,Hc Radical Resection Of Tumor Thigh/Knee 5Cm/> - Bilateral,6368.04,2547.22,,,0 HCPCS,27364,Hc Radical Resection Of Tumor Thigh/Knee 5Cm/> - Unilateral,4244.62,1697.85,,,0 HCPCS,27364,Resect thigh/knee tum 5 cm/>,,,2836.76,7091.89,4 HCPCS,27365,Resect femur/knee tumor,,,3195.45,7988.62,4 HCPCS,27369,Hc Injection Knee Arthography/Ct/Mri,979.52,391.81,,,0 HCPCS,27372,Removal of foreign body,,,2836.76,12101.0,8 HCPCS,27380,Repair of kneecap tendon,,,2546.0,17716.12,8 HCPCS,27381,Repair/graft kneecap tendon,,,7086.45,17716.12,8 HCPCS,27385,Repair of thigh muscle,,,7086.45,17716.12,8 HCPCS,27386,Repair/graft of thigh muscle,,,7086.45,17716.12,8 HCPCS,27390,Incision of thigh tendon,,,2546.0,7988.62,8 HCPCS,27391,Incision of thigh tendons,,,3195.45,7988.62,8 HCPCS,27392,Incision of thigh tendons,,,3195.45,9743.0,8 HCPCS,27393,Lengthening of thigh tendon,,,3470.0,17716.12,8 HCPCS,27394,Lengthening of thigh tendons,,,7086.45,17716.12,8 HCPCS,27395,Lengthening of thigh tendons,,,3195.45,9743.0,8 HCPCS,27396,Transplant of thigh tendon,,,7086.45,17716.12,8 HCPCS,27397,Transplants of thigh tendons,,,7086.45,17716.12,8 HCPCS,27400,Revise thigh muscles/tendons,,,7086.45,17716.12,8 HCPCS,27403,Repair of knee cartilage,,,7086.45,17716.12,8 HCPCS,27405,Repair of knee ligament,,,7086.45,17716.12,8 HCPCS,27407,Repair of knee ligament,,,7086.45,17716.12,8 HCPCS,27409,Repair of knee ligaments,,,7086.45,17716.12,8 HCPCS,27412,Autochondrocyte implant knee,,,7086.45,17716.12,4 HCPCS,27415,Osteochondral knee allograft,,,12538.31,31345.78,4 HCPCS,27416,Osteochondral knee autograft,,,7086.45,17716.12,4 HCPCS,27418,Repair degenerated kneecap,,,7086.45,17716.12,8 HCPCS,27420,Revision of unstable kneecap,,,7086.45,17716.12,8 HCPCS,27422,Revision of unstable kneecap,,,7086.45,17716.12,8 HCPCS,27424,Revision/removal of kneecap,,,7086.45,17716.12,8 HCPCS,27425,Lat retinacular release open,,,3195.45,12101.0,8 HCPCS,27427,Reconstruction knee,,,7086.45,17716.12,8 HCPCS,27428,Reconstruction knee,,,7524.0,31345.78,8 HCPCS,27429,Reconstruction knee,,,7524.0,31345.78,8 HCPCS,27430,Revision of thigh muscles,,,7086.45,17716.12,8 HCPCS,27435,Incision of knee joint,,,3195.45,8800.0,8 HCPCS,27437,Revise kneecap,,,7086.45,17716.12,8 HCPCS,27438,Revise kneecap with implant,,,9775.0,31345.78,8 HCPCS,27440,Revision of knee joint,,,12538.31,31345.78,4 HCPCS,27441,Revision of knee joint,,,9775.0,31345.78,8 HCPCS,27442,Revision of knee joint,,,9775.0,31345.78,8 HCPCS,27443,Revision of knee joint,,,9775.0,31345.78,8 HCPCS,27446,Revision of knee joint,,,12538.31,31345.78,4 HCPCS,27447,Total knee arthroplasty,,,12538.31,31345.78,4 HCPCS,27448,Incision of thigh,,,7086.45,17716.12,4 HCPCS,27450,Incision of thigh,,,7086.45,17716.12,4 HCPCS,27454,Realignment of thigh bone,,,7086.45,17716.12,4 HCPCS,27455,Realignment of knee,,,7086.45,17716.12,4 HCPCS,27457,Realignment of knee,,,7086.45,17716.12,4 HCPCS,27458,Osteot femur imed lngth dev,,,7086.45,17716.12,4 HCPCS,27465,Shortening of thigh bone,,,7086.45,17716.12,4 HCPCS,27466,Lengthening of thigh bone,,,7086.45,17716.12,4 HCPCS,27470,Repair of thigh,,,7086.45,17716.12,4 HCPCS,27472,Repair/graft of thigh,,,7086.45,17716.12,4 HCPCS,27475,Surgery to stop leg growth,,,7086.45,17716.12,4 HCPCS,27477,Surgery to stop leg growth,,,7086.45,17716.12,4 HCPCS,27479,Surgery to stop leg growth,,,7086.45,17716.12,4 HCPCS,27485,Surgery to stop leg growth,,,7086.45,17716.12,4 HCPCS,27486,Revise/replace knee joint,,,12538.31,31345.78,4 HCPCS,27487,Revise/replace knee joint,,,17123.6,42809.0,4 HCPCS,27488,Removal of knee prosthesis,,,12538.31,31345.78,4 HCPCS,27495,Reinforce thigh,,,7086.45,17716.12,4 HCPCS,27496,Decompression of thigh/knee,,,3195.45,11433.0,8 HCPCS,27497,Decompression of thigh/knee,,,3195.45,9743.0,8 HCPCS,27498,Decompression of thigh/knee,,,1570.37,9743.0,8 HCPCS,27499,Decompression of thigh/knee,,,7086.45,17716.12,8 HCPCS,27500,Treatment of thigh fracture,,,240.9,2978.0,8 HCPCS,27501,Treatment of thigh fracture,,,240.9,4059.0,8 HCPCS,27502,Hc Closed Treatment Femur Shaft Fracture With Manipulation,2489.39,995.76,,,0 HCPCS,27502,Treatment of thigh fracture,,,1570.37,4059.0,8 HCPCS,27503,Treatment of thigh fracture,,,1570.37,9743.0,8 HCPCS,27506,Treatment of thigh fracture,,,7086.45,17716.12,4 HCPCS,27507,Treatment of thigh fracture,,,7086.45,17716.12,4 HCPCS,27508,Hc Closed Treatment Of Thigh Fracture,1868.75,747.5,,,0 HCPCS,27508,Treatment of thigh fracture,,,240.9,2978.0,8 HCPCS,27509,Treatment of thigh fracture,,,7086.45,17716.12,8 HCPCS,27510,"Hc Closed Rx Femur,Distal+Manip",1987.92,795.17,,,0 HCPCS,27510,Treatment of thigh fracture,,,1570.37,3925.93,8 HCPCS,27511,Treatment of thigh fracture,,,12538.31,31345.78,4 HCPCS,27513,Treatment of thigh fracture,,,12538.31,31345.78,4 HCPCS,27514,Treatment of thigh fracture,,,12538.31,31345.78,4 HCPCS,27516,Treat thigh fx growth plate,,,240.9,2978.0,8 HCPCS,27517,Treat thigh fx growth plate,,,1570.37,3925.93,8 HCPCS,27519,Treat thigh fx growth plate,,,7086.45,17716.12,4 HCPCS,27520,Hc Closed Treatment Of Broken Kneecap,1443.0,577.2,,,0 HCPCS,27520,Treat kneecap fracture,,,240.9,2978.0,8 HCPCS,27524,Treat kneecap fracture,,,7086.45,17716.12,8 HCPCS,27530,Hc Closed Treatment Tibial Plateau Fracture Without Manipulation,1198.87,479.55,,,0 HCPCS,27530,Treat knee fracture,,,240.9,2978.0,8 HCPCS,27532,Hc Closed Treatment Tibial Fracture Proximal With/Without Manipulation With Skeletal Traction,5441.8,2176.72,,,0 HCPCS,27532,Treat knee fracture,,,2546.0,7988.62,8 HCPCS,27535,Treat knee fracture,,,7086.45,17716.12,4 HCPCS,27536,Treat knee fracture,,,7086.45,17716.12,4 HCPCS,27538,Hc Treatment Knee Fracture(S) Bilateral,4008.1,1603.24,,,0 HCPCS,27538,Hc Treatment Knee Fracture(S) Unilateral,2671.56,1068.62,,,0 HCPCS,27538,Treat knee fracture(s),,,240.9,2978.0,8 HCPCS,27540,Treat knee fracture,,,7086.45,17716.12,4 HCPCS,27550,Hc Closed Treatment Knee Dislocation Without Anesthesia,1423.24,569.3,,,0 HCPCS,27550,Treat knee dislocation,,,240.9,2978.0,8 HCPCS,27552,Hc Closed Treatment Knee Dislocation With Anesthesia,2128.54,851.42,,,0 HCPCS,27552,Treat knee dislocation,,,1570.37,3925.93,8 HCPCS,27556,Treat knee dislocation,,,7086.45,17716.12,4 HCPCS,27557,Treat knee dislocation,,,7086.45,17716.12,4 HCPCS,27558,Treat knee dislocation,,,7086.45,17716.12,4 HCPCS,27560,Hc Closed Treatment Kneecap Dislocation Without Anesthesia,957.76,383.1,,,0 HCPCS,27560,Treat kneecap dislocation,,,240.9,2978.0,8 HCPCS,27562,Hc Treatment Kneecap Dislocation Bilateral,1922.57,769.03,,,0 HCPCS,27562,Hc Treatment Kneecap Dislocation Unilateral,1281.22,512.49,,,0 HCPCS,27562,Treat kneecap dislocation,,,240.9,2978.0,8 HCPCS,27566,Treat kneecap dislocation,,,3470.0,17716.12,8 HCPCS,27570,Fixation of knee joint,,,1570.37,3925.93,8 HCPCS,27580,Fusion of knee,,,12538.31,31345.78,4 HCPCS,27590,Amputate leg at thigh,,,3195.45,7988.62,4 HCPCS,27591,Amputate leg at thigh,,,3195.45,7988.62,4 HCPCS,27592,Amputate leg at thigh,,,3195.45,7988.62,4 HCPCS,27594,Amputation follow-up surgery,,,3195.45,9743.0,8 HCPCS,27596,Amputation follow-up surgery,,,3195.45,7988.62,4 HCPCS,27598,Amputate lower leg at knee,,,3195.45,7988.62,4 HCPCS,27599,Leg surgery procedure,,,240.9,602.24,4 HCPCS,27600,Decompression of lower leg,,,3195.45,9743.0,8 HCPCS,27601,Decompression of lower leg,,,3195.45,9743.0,8 HCPCS,27602,Decompression of lower leg,,,3195.45,9743.0,8 HCPCS,27603,Drain lower leg lesion,,,2836.76,7091.89,8 HCPCS,27603,Hc Drain Lower Leg Deep Absc/Hematoma,7121.22,2848.49,,,0 HCPCS,27604,Drain lower leg bursa,,,3195.45,7988.62,8 HCPCS,27605,Incision of achilles tendon,,,1570.37,3925.93,8 HCPCS,27606,Incision of achilles tendon,,,2546.0,7988.62,8 HCPCS,27607,Treat lower leg bone lesion,,,3195.45,7988.62,8 HCPCS,27610,Explore/treat ankle joint,,,3195.45,7988.62,8 HCPCS,27612,Exploration of ankle joint,,,3195.45,9743.0,8 HCPCS,27613,Biopsy lower leg soft tissue,,,1612.96,4032.39,4 HCPCS,27614,Biopsy lower leg soft tissue,,,2836.76,7091.89,8 HCPCS,27615,Resect leg/ankle tum < 5 cm,,,2836.76,9743.0,8 HCPCS,27616,Hc Radical Resection Of Tumor Soft Tissue Leg/Ankle 5 Cm/>,4684.03,1873.61,,,0 HCPCS,27616,Resect leg/ankle tum 5 cm/>,,,2836.76,7091.89,4 HCPCS,27618,Exc leg/ankle tum < 3 cm,,,1612.96,4059.0,8 HCPCS,27618,Hc Excision Tumor Soft Tissue Leg/Ankle Subcutaneous <3Cm,4160.0,1664.0,,,0 HCPCS,27619,Exc leg/ankle tum deep <5 cm,,,2836.76,9743.0,8 HCPCS,27619,Hc Excision Tumor Soft Tissue Leg/Ankle Subfasical <3Cm,2877.88,1151.15,,,0 HCPCS,27620,Explore/treat ankle joint,,,3195.45,8800.0,8 HCPCS,27625,Remove ankle joint lining,,,3195.45,8800.0,8 HCPCS,27626,Remove ankle joint lining,,,3195.45,8800.0,8 HCPCS,27630,Removal of tendon lesion,,,3195.45,9743.0,8 HCPCS,27632,Exc leg/ankle les sc 3 cm/>,,,2836.76,9743.0,8 HCPCS,27634,Exc leg/ankle tum dep 5 cm/>,,,2836.76,7091.89,4 HCPCS,27634,Hc Excision Tumor Soft Tissue Of Leg/Ankle >/ 5Cm,7137.56,2855.02,,,0 HCPCS,27635,Remove lower leg bone lesion,,,3195.45,9743.0,8 HCPCS,27637,Remove/graft leg bone lesion,,,7086.45,17716.12,8 HCPCS,27638,Remove/graft leg bone lesion,,,7086.45,17716.12,8 HCPCS,27640,Partial removal of tibia,,,3195.45,7988.62,8 HCPCS,27641,Partial removal of fibula,,,3195.45,7988.62,8 HCPCS,27645,Resect tibia tumor,,,3195.45,7988.62,4 HCPCS,27646,Resect fibula tumor,,,3195.45,7988.62,4 HCPCS,27647,Resect talus/calcaneus tum,,,3195.45,9743.0,8 HCPCS,27650,Repair achilles tendon,,,7086.45,17716.12,8 HCPCS,27652,Repair/graft achilles tendon,,,7086.45,17716.12,8 HCPCS,27654,Repair of achilles tendon,,,7086.45,17716.12,8 HCPCS,27656,Repair leg fascia defect,,,3195.45,7988.62,8 HCPCS,27658,Repair of leg tendon each,,,2546.0,7988.62,8 HCPCS,27659,Repair of leg tendon each,,,3470.0,17716.12,8 HCPCS,27664,Repair of leg tendon each,,,3470.0,17716.12,8 HCPCS,27665,Repair of leg tendon each,,,3470.0,17716.12,8 HCPCS,27675,Repair lower leg tendons,,,3195.45,7988.62,8 HCPCS,27676,Repair lower leg tendons,,,7086.45,17716.12,8 HCPCS,27680,Hc Release Of Lower Leg Tendon-Bilateral,8404.5,3361.8,,,0 HCPCS,27680,Hc Release Of Lower Leg Tendon-Unilateral,5603.0,2241.2,,,0 HCPCS,27680,Release of lower leg tendon,,,3195.45,9743.0,8 HCPCS,27681,Release of lower leg tendons,,,3195.45,7988.62,8 HCPCS,27685,Revision of lower leg tendon,,,3195.45,9743.0,8 HCPCS,27686,Revise lower leg tendons,,,3195.45,9743.0,8 HCPCS,27687,Revision of calf tendon,,,3195.45,9743.0,8 HCPCS,27690,Revise lower leg tendon,,,7086.45,17716.12,8 HCPCS,27691,Revise lower leg tendon,,,7086.45,17716.12,8 HCPCS,27692,Revise additional leg tendon,,,8330.0,9743.0,4 HCPCS,27695,Repair of ankle ligament,,,3470.0,17716.12,8 HCPCS,27696,Repair of ankle ligaments,,,3470.0,17716.12,8 HCPCS,27698,Repair of ankle ligament,,,3470.0,17716.12,8 HCPCS,27700,Revision of ankle joint,,,7086.45,17716.12,8 HCPCS,27703,Reconstruction ankle joint,,,17123.6,42809.0,4 HCPCS,27704,Removal of ankle implant,,,3195.45,7988.62,8 HCPCS,27705,Incision of tibia,,,3470.0,17716.12,8 HCPCS,27707,Incision of fibula,,,3195.45,7988.62,8 HCPCS,27709,Incision of tibia & fibula,,,3470.0,31345.78,8 HCPCS,27712,Realignment of lower leg,,,12538.31,31345.78,4 HCPCS,27713,Osteot tibia imed lngth dev,,,7086.45,17716.12,4 HCPCS,27715,Revision of lower leg,,,12538.31,31345.78,4 HCPCS,27720,Repair of tibia,,,7086.45,17716.12,4 HCPCS,27722,Repair/graft of tibia,,,7086.45,17716.12,4 HCPCS,27724,Repair/graft of tibia,,,7086.45,17716.12,4 HCPCS,27725,Repair of lower leg,,,7086.45,17716.12,4 HCPCS,27726,Repair fibula nonunion,,,7086.45,17716.12,4 HCPCS,27727,Repair of lower leg,,,3195.45,7988.62,4 HCPCS,27730,Repair of tibia epiphysis,,,3195.45,7988.62,8 HCPCS,27732,Repair of fibula epiphysis,,,3195.45,7988.62,8 HCPCS,27734,Repair lower leg epiphyses,,,3195.45,7988.62,8 HCPCS,27740,Repair of leg epiphyses,,,3195.45,7988.62,8 HCPCS,27742,Repair of leg epiphyses,,,3195.45,7988.62,8 HCPCS,27745,Reinforce tibia,,,7086.45,17716.12,8 HCPCS,27750,Hc Closed Treatment Tibia Shaft Fracture Without Manipulation,747.5,299.0,,,0 HCPCS,27750,Treatment of tibia fracture,,,240.9,2978.0,8 HCPCS,27752,Hc Closed Treatment Tibia Shaft Fracture With Manipulation,3253.35,1301.34,,,0 HCPCS,27752,Treatment of tibia fracture,,,1570.37,3925.93,8 HCPCS,27756,Treatment of tibia fracture,,,7086.45,17716.12,8 HCPCS,27758,Treatment of tibia fracture,,,7524.0,31345.78,8 HCPCS,27759,Treatment of tibia fracture,,,7524.0,31345.78,8 HCPCS,27760,Cltx medial ankle fx,,,240.9,2978.0,8 HCPCS,27760,Hc Closed Treatment Medial Malleolus Fracture Without Manipulation,687.7,275.08,,,0 HCPCS,27762,Cltx med ankle fx w/mnpj,,,1570.37,3925.93,8 HCPCS,27762,Hc Closed Treatment Medial Malleolus Fracture With Manipulation,3253.35,1301.34,,,0 HCPCS,27766,Hc Open Treatment Medial Malleolus Fracture,11637.08,4654.83,,,0 HCPCS,27766,Optx medial ankle fx,,,7086.45,17716.12,8 HCPCS,27767,Cltx post ankle fx,,,240.9,602.24,4 HCPCS,27767,Hc Closed Treatment Pst Malleolus Fracture Wo Manipulate,443.72,177.49,,,0 HCPCS,27768,Cltx post ankle fx w/mnpj,,,1570.37,3925.93,8 HCPCS,27769,Optx post ankle fx,,,7086.45,17716.12,4 HCPCS,27780,Hc Treatment Of Fibula Fracture-Bilateral,614.9,245.96,,,0 HCPCS,27780,Hc Treatment Of Fibula Fracture-Unilateral,409.5,163.8,,,0 HCPCS,27780,Treatment of fibula fracture,,,240.9,2978.0,8 HCPCS,27781,Hc Closed Treatment Proximal Fibula/Shaft Fracture With Manipulation,3253.35,1301.34,,,0 HCPCS,27781,Treatment of fibula fracture,,,1570.37,3925.93,8 HCPCS,27784,Treatment of fibula fracture,,,7086.45,17716.12,8 HCPCS,27786,Hc Closed Treatment Distal Fibula Frature Without Manipulation,521.76,208.7,,,0 HCPCS,27786,Treatment of ankle fracture,,,240.9,2978.0,8 HCPCS,27788,Hc Closed Treatment Distal Fibula Frature With Manipulation,3253.35,1301.34,,,0 HCPCS,27788,Treatment of ankle fracture,,,240.9,2978.0,8 HCPCS,27792,Treatment of ankle fracture,,,7086.45,17716.12,8 HCPCS,27808,Hc Closed Treatment Bimalleolar Ankle Fracture Without Manipulation,1141.95,456.78,,,0 HCPCS,27808,Treatment of ankle fracture,,,240.9,2978.0,8 HCPCS,27810,Hc Closed Treatment Bimalleolar Ankle Fracture With Manipulation,1141.95,456.78,,,0 HCPCS,27810,Treatment of ankle fracture,,,1570.37,3925.93,8 HCPCS,27814,Treatment of ankle fracture,,,7086.45,17716.12,8 HCPCS,27816,Hc Closed Rx Trimalleolar Fx,957.76,383.1,,,0 HCPCS,27816,Treatment of ankle fracture,,,240.9,2978.0,8 HCPCS,27818,Hc Closed Treatment Trimalleolar Fracture With Manipulation,5014.83,2005.93,,,0 HCPCS,27818,Treatment of ankle fracture,,,1570.37,3925.93,8 HCPCS,27822,Treatment of ankle fracture,,,7086.45,17716.12,8 HCPCS,27823,Treatment of ankle fracture,,,7086.45,17716.12,8 HCPCS,27824,Hc Cltx Fx W8 Brg Artclr Prtn Dstl Tibia W/O Manj,1198.87,479.55,,,0 HCPCS,27824,Treat lower leg fracture,,,240.9,2978.0,8 HCPCS,27825,Hc Closed Treatment Lower Leg Fracture With Manipulation,5014.83,2005.93,,,0 HCPCS,27825,Treat lower leg fracture,,,1570.37,4059.0,8 HCPCS,27826,Treat lower leg fracture,,,7086.45,17716.12,8 HCPCS,27827,Treat lower leg fracture,,,8330.0,31345.78,8 HCPCS,27828,Treat lower leg fracture,,,7524.0,31345.78,8 HCPCS,27829,Treat lower leg joint,,,3470.0,17716.12,8 HCPCS,27830,Treat lower leg dislocation,,,240.9,2978.0,8 HCPCS,27831,Treat lower leg dislocation,,,2546.0,7988.62,8 HCPCS,27832,Treat lower leg dislocation,,,3470.0,17716.12,8 HCPCS,27840,Hc Closed Treatment Ankle Dislocation,957.76,383.1,,,0 HCPCS,27840,Treat ankle dislocation,,,240.9,2978.0,8 HCPCS,27842,Treat ankle dislocation,,,1570.37,3925.93,8 HCPCS,27846,Treat ankle dislocation,,,7086.45,17716.12,8 HCPCS,27848,Treat ankle dislocation,,,7086.45,17716.12,8 HCPCS,27860,Fixation of ankle joint,,,2546.0,7988.62,8 HCPCS,27870,Fusion of ankle joint open,,,7524.0,31345.78,8 HCPCS,27871,Fusion of tibiofibular joint,,,7524.0,31345.78,8 HCPCS,27880,Amputation of lower leg,,,7086.45,17716.12,4 HCPCS,27881,Amputation of lower leg,,,3195.45,7988.62,4 HCPCS,27882,Amputation of lower leg,,,3195.45,7988.62,4 HCPCS,27884,Amputation follow-up surgery,,,3195.45,9743.0,8 HCPCS,27886,Amputation follow-up surgery,,,3195.45,7988.62,4 HCPCS,27888,Amputation of foot at ankle,,,3195.45,7988.62,4 HCPCS,27889,Amputation of foot at ankle,,,7086.45,17716.12,8 HCPCS,27892,Decompression of leg,,,3195.45,9743.0,8 HCPCS,27893,Decompression of leg,,,7086.45,17716.12,8 HCPCS,27894,Decompression of leg,,,3195.45,9743.0,8 HCPCS,27899,Leg/ankle surgery procedure,,,240.9,602.24,4 HCPCS,28001,Drainage of bursa of foot,,,1612.96,4032.39,4 HCPCS,28001,Hc Incision & Drainage Bursa Foot,3231.98,1292.79,,,0 HCPCS,28002,Treatment of foot infection,,,1570.37,9743.0,8 HCPCS,28003,Treatment of foot infection,,,3195.45,9743.0,8 HCPCS,28005,Treat foot bone lesion,,,3195.45,9743.0,8 HCPCS,28008,Incision of foot fascia,,,3195.45,9743.0,8 HCPCS,28010,Hc Incision Subcut Toe Tendon,3218.8,1287.52,,,0 HCPCS,28010,Incision of toe tendon,,,1570.37,4059.0,8 HCPCS,28011,Hc Tenotomy Percutaneous Toe Multiple Tendon,2960.1,1184.04,,,0 HCPCS,28011,Incision of toe tendons,,,1570.37,9743.0,8 HCPCS,28020,Exploration of foot joint,,,3195.45,7988.62,8 HCPCS,28022,Exploration of foot joint,,,3195.45,7988.62,8 HCPCS,28024,Exploration of toe joint,,,1570.37,4059.0,8 HCPCS,28035,Decompression of tibia nerve,,,1907.04,8800.0,8 HCPCS,28039,Exc foot/toe tum sc 1.5 cm/>,,,2836.76,7091.89,8 HCPCS,28039,Hc Excision Tumor Soft Tissue Foot/Toe Subq 1.5+Cm,6140.03,2456.01,,,0 HCPCS,28041,Exc foot/toe tum dep 1.5cm/>,,,2836.76,7091.89,8 HCPCS,28043,Exc foot/toe tum sc < 1.5 cm,,,1612.96,4059.0,8 HCPCS,28045,Exc foot/toe tum deep <1.5cm,,,2836.76,9743.0,8 HCPCS,28046,Resect foot/toe tumor < 3 cm,,,2836.76,9743.0,8 HCPCS,28047,Resect foot/toe tumor 3 cm/>,,,2836.76,9743.0,8 HCPCS,28050,Biopsy of foot joint lining,,,3195.45,7988.62,8 HCPCS,28052,Biopsy of foot joint lining,,,3195.45,7988.62,8 HCPCS,28054,Biopsy of toe joint lining,,,3195.45,7988.62,8 HCPCS,28055,Neurectomy foot,,,1907.04,8800.0,8 HCPCS,28060,Partial removal foot fascia,,,3195.45,7988.62,8 HCPCS,28062,Removal of foot fascia,,,3195.45,9743.0,8 HCPCS,28070,Removal of foot joint lining,,,7086.45,17716.12,8 HCPCS,28072,Removal of foot joint lining,,,3195.45,9743.0,8 HCPCS,28080,Removal of foot lesion,,,1570.37,9743.0,8 HCPCS,28086,Excise foot tendon sheath,,,3195.45,7988.62,8 HCPCS,28088,Excise foot tendon sheath,,,3195.45,7988.62,8 HCPCS,28090,Removal of foot lesion,,,1570.37,9743.0,8 HCPCS,28092,Removal of toe lesions,,,1570.37,9743.0,8 HCPCS,28100,Removal of ankle/heel lesion,,,3195.45,7988.62,8 HCPCS,28102,Remove/graft foot lesion,,,7086.45,17716.12,8 HCPCS,28103,Remove/graft foot lesion,,,7086.45,17716.12,8 HCPCS,28104,Removal of foot lesion,,,3195.45,7988.62,8 HCPCS,28106,Remove/graft foot lesion,,,7086.45,17716.12,8 HCPCS,28107,Remove/graft foot lesion,,,7086.45,17716.12,8 HCPCS,28108,Removal of toe lesions,,,1570.37,4059.0,8 HCPCS,28110,Part removal of metatarsal,,,3195.45,9743.0,8 HCPCS,28111,Part removal of metatarsal,,,3195.45,9743.0,8 HCPCS,28112,Part removal of metatarsal,,,3195.45,9743.0,8 HCPCS,28113,Part removal of metatarsal,,,3195.45,9743.0,8 HCPCS,28114,Removal of metatarsal heads,,,3195.45,9743.0,8 HCPCS,28116,Revision of foot,,,3195.45,9743.0,8 HCPCS,28118,Removal of heel bone,,,3195.45,8800.0,8 HCPCS,28119,Removal of heel spur,,,3195.45,8800.0,8 HCPCS,28120,Part removal of ankle/heel,,,3195.45,12101.0,8 HCPCS,28122,Partial removal of foot bone,,,3195.45,9743.0,8 HCPCS,28124,Hc Partial Removal Phalanx Of Toe,3596.66,1438.66,,,0 HCPCS,28124,Partial removal of toe,,,3195.45,7988.62,8 HCPCS,28126,Partial removal of toe,,,3195.45,9743.0,8 HCPCS,28130,Removal of ankle bone,,,7086.45,17716.12,8 HCPCS,28140,Removal of metatarsal,,,3195.45,9743.0,8 HCPCS,28150,Removal of toe,,,3195.45,9743.0,8 HCPCS,28153,Partial removal of toe,,,3195.45,9743.0,8 HCPCS,28160,Partial removal of toe,,,3195.45,9743.0,8 HCPCS,28171,Resect tarsal tumor,,,3195.45,9743.0,8 HCPCS,28173,Resect metatarsal tumor,,,3195.45,9743.0,8 HCPCS,28175,Resect phalanx of toe tumor,,,1570.37,9743.0,8 HCPCS,28190,"Hc Remv Foot Foreign Body, Subcuteneous",1284.27,513.71,,,0 HCPCS,28190,Removal of foot foreign body,,,691.56,4059.0,8 HCPCS,28192,Hc Removal Foreign Body Foot Deep,4095.58,1638.23,,,0 HCPCS,28192,Removal of foot foreign body,,,1612.96,4059.0,8 HCPCS,28193,Removal of foot foreign body,,,1612.96,8800.0,8 HCPCS,28200,Repair of foot tendon,,,3195.45,9743.0,8 HCPCS,28202,Repair/graft of foot tendon,,,7086.45,17716.12,8 HCPCS,28208,Repair of foot tendon,,,3195.45,9743.0,8 HCPCS,28210,Repair/graft of foot tendon,,,7086.45,17716.12,8 HCPCS,28220,Release of foot tendon,,,1570.37,3925.93,4 HCPCS,28222,Release of foot tendons,,,2546.0,7988.62,8 HCPCS,28225,Release of foot tendon,,,2546.0,7988.62,8 HCPCS,28226,Release of foot tendons,,,2546.0,7988.62,8 HCPCS,28230,Hc Incision Of Foot Tendon(S),4586.4,1834.56,,,0 HCPCS,28230,Incision of foot tendon(s),,,1570.37,3925.93,4 HCPCS,28232,Hc Incision Of Toe Tendion,3670.22,1468.09,,,0 HCPCS,28232,Incision of toe tendon,,,1570.37,3925.93,4 HCPCS,28234,Incision of foot tendon,,,1570.37,4059.0,8 HCPCS,28238,Revision of foot tendon,,,7086.45,17716.12,8 HCPCS,28240,Release of big toe,,,3195.45,7988.62,8 HCPCS,28250,Revision of foot fascia,,,3195.45,9743.0,8 HCPCS,28260,Release of midfoot joint,,,3195.45,9743.0,8 HCPCS,28261,Revision of foot tendon,,,1570.37,9743.0,8 HCPCS,28262,Revision of foot and ankle,,,7086.45,17716.12,8 HCPCS,28264,Release of midfoot joint,,,1570.37,3925.93,8 HCPCS,28270,Release of foot contracture,,,3195.45,9743.0,8 HCPCS,28272,Release of toe joint each,,,1570.37,3925.93,4 HCPCS,28280,Fusion of toes,,,3195.45,7988.62,8 HCPCS,28285,Repair of hammertoe,,,3195.45,9743.0,8 HCPCS,28286,Repair of hammertoe,,,3195.45,8800.0,8 HCPCS,28288,Partial removal of foot bone,,,3195.45,9743.0,8 HCPCS,28289,Corrj halux rigdus w/o implt,,,3195.45,9743.0,8 HCPCS,28290,Correction of bunion,,,3470.0,4059.0,4 HCPCS,28291,Corrj halux rigdus w/implt,,,7086.45,17716.12,8 HCPCS,28292,Correction hallux valgus,,,3195.45,7988.62,8 HCPCS,28293,Correction of bunion,,,8330.0,9743.0,4 HCPCS,28294,Correction of bunion,,,8330.0,9743.0,4 HCPCS,28295,Correction hallux valgus,,,3195.45,9743.0,8 HCPCS,28296,Correction hallux valgus,,,3195.45,9743.0,8 HCPCS,28297,Correction hallux valgus,,,8330.0,31345.78,8 HCPCS,28298,Correction hallux valgus,,,7086.45,17716.12,8 HCPCS,28299,Correction hallux valgus,,,7086.45,17716.12,8 HCPCS,28300,Incision of heel bone,,,3470.0,17716.12,8 HCPCS,28302,Incision of ankle bone,,,3470.0,17716.12,8 HCPCS,28304,Incision of midfoot bones,,,3470.0,17716.12,8 HCPCS,28305,Incise/graft midfoot bones,,,7086.45,17716.12,8 HCPCS,28306,Incision of metatarsal,,,7086.45,17716.12,8 HCPCS,28307,Incision of metatarsal,,,7086.45,17716.12,8 HCPCS,28308,Incision of metatarsal,,,3195.45,7988.62,8 HCPCS,28309,Incision of metatarsals,,,7086.45,17716.12,8 HCPCS,28310,Revision of big toe,,,7086.45,17716.12,8 HCPCS,28312,Revision of toe,,,3195.45,9743.0,8 HCPCS,28313,Repair deformity of toe,,,3195.45,7988.62,8 HCPCS,28315,Removal of sesamoid bone,,,3195.45,8800.0,8 HCPCS,28320,Repair of foot bones,,,7524.0,31345.78,8 HCPCS,28322,Repair of metatarsals,,,7086.45,17716.12,8 HCPCS,28340,Resect enlarged toe tissue,,,3195.45,8800.0,8 HCPCS,28341,Resect enlarged toe,,,3195.45,8800.0,8 HCPCS,28344,Repair extra toe(s),,,3195.45,8800.0,8 HCPCS,28345,Hc Repair Webbed Toe(S),1823.76,729.5,,,0 HCPCS,28345,Repair webbed toe(s),,,1570.37,8800.0,8 HCPCS,28360,Reconstruct cleft foot,,,7086.45,17716.12,4 HCPCS,28400,Hc Closed Treatment Calcaneal Fracture Without Manipulation,1198.87,479.55,,,0 HCPCS,28400,Treatment of heel fracture,,,240.9,2978.0,8 HCPCS,28405,Treatment of heel fracture,,,240.9,4059.0,8 HCPCS,28406,Treatment of heel fracture,,,3470.0,17716.12,8 HCPCS,28415,Treat heel fracture,,,7086.45,17716.12,8 HCPCS,28420,Treat/graft heel fracture,,,7524.0,31345.78,8 HCPCS,28430,Hc Closed Treatment Talus Fracture Wo Manipulation,527.44,210.98,,,0 HCPCS,28430,Treatment of ankle fracture,,,240.9,602.24,4 HCPCS,28435,Hc Closed Treatment Talus (Ankle) Fracture With Manipulation,3253.35,1301.34,,,0 HCPCS,28435,Treatment of ankle fracture,,,1570.37,4059.0,8 HCPCS,28436,Treatment of ankle fracture,,,3470.0,17716.12,8 HCPCS,28445,Treat ankle fracture,,,7086.45,17716.12,8 HCPCS,28446,Osteochondral talus autogrft,,,7086.45,17716.12,4 HCPCS,28450,Hc Treatment Of Broken Foot Bone Without Manipulation,842.4,336.96,,,0 HCPCS,28450,Treat midfoot fracture each,,,240.9,602.24,4 HCPCS,28455,Hc Tx Tarsal Bone Fx Xcp Talus&Calcn W/Manj,3085.91,1234.36,,,0 HCPCS,28455,Treat midfoot fracture each,,,1570.37,3925.93,4 HCPCS,28456,Treat midfoot fracture,,,3470.0,17716.12,8 HCPCS,28465,Treat midfoot fracture each,,,7086.45,17716.12,8 HCPCS,28470,Hc Closed Treatment Metatarsal Fracture Without Manipulation,957.76,383.1,,,0 HCPCS,28470,Treat metatarsal fracture,,,240.9,602.24,4 HCPCS,28475,Hc Closed Treatment Metatarsal Fracture With Manipulation,1043.15,417.26,,,0 HCPCS,28475,Treat metatarsal fracture,,,240.9,602.24,4 HCPCS,28476,Treat metatarsal fracture,,,3195.45,7988.62,8 HCPCS,28485,Treat metatarsal fracture,,,7086.45,17716.12,8 HCPCS,28490,Hc Treatment Of Big Toe Fracture,336.38,134.55,,,0 HCPCS,28490,Treat big toe fracture,,,240.9,602.24,4 HCPCS,28495,Treat big toe fracture,,,240.9,2978.0,8 HCPCS,28496,Treat big toe fracture,,,3195.45,7988.62,8 HCPCS,28505,Treat big toe fracture,,,3195.45,9743.0,8 HCPCS,28510,Hc Closed Treatment Toe Fracture Without Manipulation,651.82,260.73,,,0 HCPCS,28510,Treatment of toe fracture,,,240.9,602.24,4 HCPCS,28515,Hc Closed Treatment Toe Fracture With Manipulation,1137.7,455.08,,,0 HCPCS,28515,Treatment of toe fracture,,,240.9,602.24,4 HCPCS,28525,Treat toe fracture,,,3195.45,9743.0,8 HCPCS,28530,Hc Closed Treatment Sesamoid Fracture,336.38,134.55,,,0 HCPCS,28530,Treat sesamoid bone fracture,,,240.9,602.24,4 HCPCS,28531,Treat sesamoid bone fracture,,,7086.45,17716.12,8 HCPCS,28540,Treat foot dislocation,,,240.9,602.24,4 HCPCS,28545,Treat foot dislocation,,,2546.0,7988.62,8 HCPCS,28546,Treat foot dislocation,,,1570.37,4059.0,8 HCPCS,28555,Repair foot dislocation,,,3470.0,17716.12,8 HCPCS,28570,Treat foot dislocation,,,240.9,602.24,4 HCPCS,28575,Treat foot dislocation,,,2546.0,7988.62,8 HCPCS,28576,Treat foot dislocation,,,7086.45,17716.12,8 HCPCS,28585,Repair foot dislocation,,,7086.45,17716.12,8 HCPCS,28600,Treat foot dislocation,,,240.9,602.24,4 HCPCS,28605,Treat foot dislocation,,,240.9,2978.0,8 HCPCS,28606,Treat foot dislocation,,,3195.45,7988.62,8 HCPCS,28615,Repair foot dislocation,,,7086.45,17716.12,8 HCPCS,28630,Hc Closed Treatment Toe Dislocation,957.76,383.1,,,0 HCPCS,28630,Treat toe dislocation,,,240.9,602.24,4 HCPCS,28635,Treat toe dislocation,,,1570.37,3925.93,8 HCPCS,28636,Treat toe dislocation,,,3195.45,9743.0,8 HCPCS,28645,Repair toe dislocation,,,3195.45,9743.0,8 HCPCS,28660,"Hc Closed Rx I-P Jt,Toe Dislocation",957.76,383.1,,,0 HCPCS,28660,Treat toe dislocation,,,240.9,602.24,4 HCPCS,28665,Treat toe dislocation,,,273.15,2978.0,8 HCPCS,28666,Treat toe dislocation,,,3195.45,9743.0,8 HCPCS,28675,Repair of toe dislocation,,,3195.45,9743.0,8 HCPCS,28705,Fusion of foot bones,,,7524.0,42809.0,8 HCPCS,28715,Fusion of foot bones,,,7524.0,31345.78,8 HCPCS,28725,Fusion of foot bones,,,7524.0,31345.78,8 HCPCS,28730,Fusion of foot bones,,,7524.0,31345.78,8 HCPCS,28735,Fusion of foot bones,,,7524.0,31345.78,8 HCPCS,28737,Revision of foot bones,,,9775.0,31345.78,8 HCPCS,28740,Fusion of foot bones,,,7086.45,17716.12,8 HCPCS,28750,Fusion of big toe joint,,,7086.45,17716.12,8 HCPCS,28755,Fusion of big toe joint,,,7086.45,17716.12,8 HCPCS,28760,Fusion of big toe joint,,,7086.45,17716.12,8 HCPCS,28800,Amputation of midfoot,,,3195.45,7988.62,4 HCPCS,28805,Amputation thru metatarsal,,,3195.45,7988.62,4 HCPCS,28810,Amputation toe & metatarsal,,,3195.45,7988.62,8 HCPCS,28810,Hc Amputation Metatarsal W/Toe Single,6392.13,2556.85,,,0 HCPCS,28820,Amputation of toe,,,3195.45,7988.62,8 HCPCS,28825,Hc Amputation Toe Interphalangeal Joint,7116.2,2846.48,,,0 HCPCS,28825,Partial amputation of toe,,,3195.45,7988.62,8 HCPCS,28890,Hi enrgy eswt plantar fascia,,,1570.37,3925.93,4 HCPCS,28899,Foot/toes surgery procedure,,,240.9,602.24,4 HCPCS,29000,Application of body cast,,,273.15,682.87,4 HCPCS,29010,Application of body cast,,,273.15,682.87,4 HCPCS,29010,"Hc Apply Body Cast,Risser Jacket",853.94,341.58,,,0 HCPCS,29015,Application of body cast,,,273.15,682.87,4 HCPCS,29035,Application of body cast,,,273.15,682.87,4 HCPCS,29040,Application of body cast,,,273.15,682.87,4 HCPCS,29044,Application of body cast,,,158.7,396.75,4 HCPCS,29046,Application of body cast,,,273.15,682.87,4 HCPCS,29049,Application of figure eight,,,273.15,682.87,4 HCPCS,29055,Application of shoulder cast,,,273.15,682.87,4 HCPCS,29055,"Hc Apply Shoulder Cast,Spica",85.45,34.18,,,0 HCPCS,29058,Application of shoulder cast,,,273.15,682.87,4 HCPCS,29065,Application of long arm cast,,,273.15,682.87,4 HCPCS,29065,Hc Apply Long Arm Cast,1162.285,464.91499999999996,,,0 HCPCS,29075,Application of forearm cast,,,273.15,682.87,4 HCPCS,29075,Hc Apply Forearm Cast,1155.34,462.14,,,0 HCPCS,29085,Apply hand/wrist cast,,,158.7,396.75,4 HCPCS,29085,Hc Gauntlet Cast,872.36,348.94,,,0 HCPCS,29086,Apply finger cast,,,158.7,396.75,4 HCPCS,29086,Hc Thumb Spica Cast,815.44,326.18,,,0 HCPCS,29105,Apply long arm splint,,,158.7,396.75,4 HCPCS,29105,Hc Apply Long Arm Splint,758.2149999999999,303.28499999999997,,,0 HCPCS,29125,Apply forearm splint,,,129.94,324.84,4 HCPCS,29125,Hc Apply Forearm Splint Static,795.34,318.14,,,0 HCPCS,29126,Apply forearm splint,,,129.94,324.84,4 HCPCS,29126,Hc Apply Forearm Splint Dynamic,641.6800000000001,256.675,,,0 HCPCS,29130,Application of finger splint,,,129.94,324.84,4 HCPCS,29130,Hc Apply Finger Splint Static,242.79,97.12,,,0 HCPCS,29131,Application of finger splint,,,57.61,144.03,4 HCPCS,29131,Hc Application Of Finger Splint-Bilateral,312.0,124.8,,,0 HCPCS,29131,Hc Application Of Finger Splint-Unilateral,208.0,83.2,,,0 HCPCS,29200,Strapping of chest,,,158.7,396.75,4 HCPCS,29240,Hc Strapping Of Shoulder,379.6,151.84,,,0 HCPCS,29240,Strapping of shoulder,,,129.94,2978.0,8 HCPCS,29260,Hc Strapping Of Elbow Or Wrist,351.0,140.4,,,0 HCPCS,29260,Strapping of elbow or wrist,,,57.61,144.03,4 HCPCS,29280,Strapping of hand or finger,,,57.61,144.03,4 HCPCS,29305,Application of hip cast,,,273.15,682.87,4 HCPCS,29305,"Hc Apply Of Hip Cast,One Leg",1466.78,586.71,,,0 HCPCS,29325,Application of hip casts,,,273.15,682.87,4 HCPCS,29325,"Hc Apply Of Hip Casts,Two Legs",1466.78,586.71,,,0 HCPCS,29345,Application of long leg cast,,,273.15,682.87,4 HCPCS,29345,Hc Apply Long Leg Cast,1295.98,518.39,,,0 HCPCS,29355,Application of long leg cast,,,273.15,682.87,4 HCPCS,29355,Hc Apply Long Leg Cast Walker,1157.01,462.8,,,0 HCPCS,29358,Apply long leg cast brace,,,273.15,682.87,4 HCPCS,29365,Application of long leg cast,,,273.15,682.87,4 HCPCS,29365,"Hc Apply Long Leg Cast,Cylinder",1349.57,539.83,,,0 HCPCS,29405,Apply short leg cast,,,273.15,682.87,4 HCPCS,29405,Hc Apply Short Leg Cast,1165.38,466.15,,,0 HCPCS,29425,Apply short leg cast,,,273.15,682.87,4 HCPCS,29425,Hc Apply Short Leg Cast Walker,1039.8,415.92,,,0 HCPCS,29435,Apply short leg cast,,,273.15,682.87,4 HCPCS,29435,Hc Apply Patella Tendon Bearing Cast,1255.8,502.32,,,0 HCPCS,29440,Addition of walker to cast,,,158.7,396.75,4 HCPCS,29445,Apply rigid leg cast,,,273.15,682.87,4 HCPCS,29445,Hc Apply Rigid Leg Cast,1290.9650000000001,516.385,,,0 HCPCS,29450,Application of leg cast,,,158.7,396.75,4 HCPCS,29450,Hc Apply Of Clubfoot Cast,485.58,194.23,,,0 HCPCS,29505,Application long leg splint,,,158.7,396.75,4 HCPCS,29505,Hc Apply Long Leg Splint,788.48,315.39,,,0 HCPCS,29515,Application lower leg splint,,,158.7,396.75,4 HCPCS,29515,Hc Apply Lower Leg Splint,807.07,322.83,,,0 HCPCS,29520,Hc Strapping Of Hip,399.1,159.64,,,0 HCPCS,29520,Strapping of hip,,,129.94,324.84,4 HCPCS,29530,Hc Strapping Of Knee,430.3,172.12,,,0 HCPCS,29530,Strapping of knee,,,129.94,324.84,4 HCPCS,29540,Hc Strapping; Ankle &/Or Foot,994.59,397.84,,,0 HCPCS,29540,Strapping of ankle and/or ft,,,158.7,396.75,4 HCPCS,29550,Hc Strapping Toes,240.5,96.2,,,0 HCPCS,29550,Strapping of toes,,,57.61,144.03,4 HCPCS,29580,Application of paste boot,,,158.7,396.75,4 HCPCS,29580,Hc Strapping Unna Boot,853.94,341.58,,,0 HCPCS,29580,Hc Strapping Unna Boot - Bilateral,1280.92,512.37,,,0 HCPCS,29580,Hc Strapping Unna Boot - Unilateral,853.94,341.58,,,0 HCPCS,29581,Apply multlay comprs lwr leg,,,158.7,396.75,4 HCPCS,29581,Hc Appl Mlt-Layer Venous Wound Compress Below Knee,1265.85,506.34,,,0 HCPCS,29581,Hc Appl Mlt-Layer Venous Wound Compress Below Knee -Bilateral,1265.85,506.34,,,0 HCPCS,29581,Hc Apply Multi-Layer Venous Wound Compression Below Knee-Unilateral,843.9,337.56,,,0 HCPCS,29584,Appl multlay comprs arm/hand,,,158.7,396.75,4 HCPCS,29700,Removal/revision of cast,,,273.15,682.87,4 HCPCS,29705,Hc Removal/Revision Full Arm/Leg Cast,904.18,361.67,,,0 HCPCS,29705,Removal/revision of cast,,,273.15,682.87,4 HCPCS,29710,Removal/revision of cast,,,273.15,682.87,4 HCPCS,29720,Hc Repair Spica/Body/Jacket Cast,1165.38,466.15,,,0 HCPCS,29720,Repair of body cast,,,158.7,396.75,4 HCPCS,29730,Hc Removal Of Cast Only,527.44,210.98,,,0 HCPCS,29730,Hc Windowing Of Cast,607.8,243.12,,,0 HCPCS,29730,Windowing of cast,,,158.7,396.75,4 HCPCS,29740,Hc Wedging Of Cast,485.58,194.23,,,0 HCPCS,29740,Wedging of cast,,,273.15,682.87,4 HCPCS,29750,Wedging of clubfoot cast,,,273.15,682.87,4 HCPCS,29799,Casting/strapping procedure,,,158.7,396.75,4 HCPCS,29800,Jaw arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29804,Jaw arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29805,Shoulder arthroscopy dx,,,3195.45,9743.0,8 HCPCS,29806,Shoulder arthroscopy/surgery,,,7086.45,17716.12,8 HCPCS,29807,Shoulder arthroscopy/surgery,,,7086.45,17716.12,8 HCPCS,29819,Shoulder arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29820,Shoulder arthroscopy/surgery,,,7086.45,17716.12,8 HCPCS,29821,Shoulder arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29822,Shoulder arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29823,Shoulder arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29824,Shoulder arthroscopy/surgery,,,3195.45,11433.0,8 HCPCS,29825,Shoulder arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29826,Shoulder arthroscopy/surgery,,,8330.0,9743.0,4 HCPCS,29827,Arthroscop rotator cuff repr,,,7086.45,17716.12,8 HCPCS,29828,Arthroscopy biceps tenodesis,,,7086.45,17716.12,8 HCPCS,29830,Elbow arthroscopy,,,3195.45,9743.0,8 HCPCS,29834,Elbow arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29835,Elbow arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29836,Elbow arthroscopy/surgery,,,7086.45,17716.12,8 HCPCS,29837,Elbow arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29838,Elbow arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29840,Wrist arthroscopy,,,3195.45,9743.0,8 HCPCS,29843,Wrist arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29844,Wrist arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29845,Wrist arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29846,Wrist arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29847,Wrist arthroscopy/surgery,,,7086.45,17716.12,8 HCPCS,29848,Wrist endoscopy/surgery,,,1570.37,17190.0,8 HCPCS,29850,Knee arthroscopy/surgery,,,1570.37,8800.0,8 HCPCS,29851,Knee arthroscopy/surgery,,,1570.37,8800.0,8 HCPCS,29855,Tibial arthroscopy/surgery,,,7086.45,17716.12,8 HCPCS,29856,Tibial arthroscopy/surgery,,,7524.0,31345.78,8 HCPCS,29860,Hip arthroscopy dx,,,7086.45,17716.12,8 HCPCS,29861,Hip arthro w/fb removal,,,7086.45,17716.12,8 HCPCS,29862,Hip arthr0 w/debridement,,,7086.45,17716.12,8 HCPCS,29863,Hip arthr0 w/synovectomy,,,3195.45,8800.0,8 HCPCS,29866,Autgrft implnt knee w/scope,,,7086.45,17716.12,4 HCPCS,29867,Allgrft implnt knee w/scope,,,12538.31,31345.78,4 HCPCS,29868,Meniscal trnspl knee w/scpe,,,7086.45,17716.12,4 HCPCS,29870,Knee arthroscopy dx,,,3195.45,9743.0,8 HCPCS,29871,Knee arthroscopy/drainage,,,3195.45,9743.0,8 HCPCS,29873,Knee arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29874,Knee arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29875,Knee arthroscopy/surgery,,,3195.45,8800.0,8 HCPCS,29876,Knee arthroscopy/surgery,,,3195.45,8800.0,8 HCPCS,29877,Knee arthroscopy/surgery,,,3195.45,8800.0,8 HCPCS,29879,Knee arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29880,Knee arthroscopy/surgery,,,3195.45,8800.0,8 HCPCS,29881,Knee arthroscopy/surgery,,,3195.45,8800.0,8 HCPCS,29882,Knee arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29883,Knee arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29884,Knee arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29885,Knee arthroscopy/surgery,,,7086.45,17716.12,8 HCPCS,29886,Knee arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29887,Knee arthroscopy/surgery,,,7086.45,17716.12,8 HCPCS,29888,Knee arthroscopy/surgery,,,7086.45,17716.12,8 HCPCS,29889,Knee arthroscopy/surgery,,,8330.0,31345.78,8 HCPCS,29891,Ankle arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29892,Ankle arthroscopy/surgery,,,7086.45,17716.12,8 HCPCS,29893,Scope plantar fasciotomy,,,3195.45,17190.0,8 HCPCS,29894,Ankle arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29895,Ankle arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29897,Ankle arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29898,Ankle arthroscopy/surgery,,,3195.45,9743.0,8 HCPCS,29899,Ankle arthroscopy/surgery,,,7086.45,17716.12,8 HCPCS,29900,Mcp joint arthroscopy dx,,,3195.45,9743.0,8 HCPCS,29901,Mcp joint arthroscopy surg,,,3195.45,9743.0,8 HCPCS,29902,Mcp joint arthroscopy surg,,,1570.37,9743.0,8 HCPCS,29904,Subtalar arthro w/fb rmvl,,,3195.45,7988.62,4 HCPCS,29905,Subtalar arthro w/exc,,,7086.45,17716.12,8 HCPCS,29906,Subtalar arthro w/deb,,,3195.45,7988.62,4 HCPCS,29907,Subtalar arthro w/fusion,,,12538.31,31345.78,4 HCPCS,29914,Hip arthro w/femoroplasty,,,7086.45,17716.12,8 HCPCS,29915,Hip arthro acetabuloplasty,,,7086.45,17716.12,8 HCPCS,29916,Hip arthro w/labral repair,,,7086.45,17716.12,8 HCPCS,29999,Arthroscopy of joint,,,240.9,602.24,4 HCPCS,30000,Drainage of nose lesion,,,231.31,578.27,4 HCPCS,30000,Hc Drainage Abscess/Hematoma Nasal Internal Approach,144.0,57.6,,,0 HCPCS,30020,Drainage of nose lesion,,,526.71,2978.0,8 HCPCS,30020,Hc Drainage Abscess/Hematoma Nasal Septum,1506.96,602.78,,,0 HCPCS,30100,Hc Intranasal Biopsy,2586.35,1034.54,,,0 HCPCS,30100,Intranasal biopsy,,,1515.28,3788.21,4 HCPCS,30110,Removal of nose polyp(s),,,1515.28,3788.21,4 HCPCS,30115,Removal of nose polyp(s),,,3237.89,8094.73,8 HCPCS,30117,Hc Removal Of Intranasal Lesion,4212.91,1685.16,,,0 HCPCS,30117,Removal of intranasal lesion,,,3237.89,9743.0,8 HCPCS,30118,Removal of intranasal lesion,,,3237.89,9743.0,8 HCPCS,30120,Revision of nose,,,2546.0,8094.73,8 HCPCS,30124,Removal of nose lesion,,,1515.28,3788.21,4 HCPCS,30125,Removal of nose lesion,,,3470.0,14453.33,8 HCPCS,30130,Excise inferior turbinate,,,3237.89,9743.0,8 HCPCS,30140,Resect inferior turbinate,,,3237.89,8094.73,8 HCPCS,30150,Partial removal of nose,,,5781.33,14453.33,8 HCPCS,30160,Removal of nose,,,5781.33,14453.33,8 HCPCS,30200,Injection treatment of nose,,,526.71,1316.78,4 HCPCS,30210,Nasal sinus therapy,,,1515.28,3788.21,4 HCPCS,30220,Insert nasal septal button,,,1515.28,9743.0,8 HCPCS,30300,Hc Remove Nasal Foreign Body,705.64,282.26,,,0 HCPCS,30300,Remove nasal foreign body,,,129.94,324.84,4 HCPCS,30310,Remove nasal foreign body,,,2546.0,8094.73,8 HCPCS,30320,Remove nasal foreign body,,,1515.28,4059.0,8 HCPCS,30400,Reconstruction of nose,,,5781.33,14453.33,8 HCPCS,30410,Reconstruction of nose,,,5781.33,14453.33,8 HCPCS,30420,Reconstruction of nose,,,5781.33,14453.33,8 HCPCS,30430,Revision of nose,,,5781.33,14453.33,8 HCPCS,30435,Revision of nose,,,5781.33,14453.33,8 HCPCS,30450,Revision of nose,,,5781.33,14453.33,8 HCPCS,30460,Revision of nose,,,5781.33,14453.33,8 HCPCS,30462,Revision of nose,,,5781.33,17190.0,8 HCPCS,30465,Repair Nasal Stenosis,,,5781.33,17190.0,8 HCPCS,30468,Rpr nsl vlv collapse w/implt,,,5781.33,14453.33,4 HCPCS,30469,Rpr nsl vlv collapse w/rmdlg,,,5781.33,14453.33,4 HCPCS,30500,Hc Epidural Anes Monitor By Rn,644.64,257.86,,,0 HCPCS,30520,Repair of nasal septum,,,3237.89,8800.0,8 HCPCS,30540,Repair nasal defect,,,5781.33,14453.33,8 HCPCS,30545,Repair nasal defect,,,5781.33,14453.33,8 HCPCS,30560,Release of nasal adhesions,,,526.71,4059.0,8 HCPCS,30580,Repair upper jaw fistula,,,5781.33,14453.33,8 HCPCS,30600,Repair mouth/nose fistula,,,5781.33,14453.33,8 HCPCS,30620,Intranasal reconstruction,,,5781.33,14453.33,8 HCPCS,30630,Repair nasal septum defect,,,3237.89,12101.0,8 HCPCS,30801,Ablate inf turbinate superf,,,1515.28,3788.21,8 HCPCS,30802,Ablate inf turbinate submuc,,,1515.28,3788.21,8 HCPCS,30901,Control of nosebleed,,,129.94,324.84,4 HCPCS,30901,"Hc Ctrl Nosebleed,Anter,Simple",872.36,348.94,,,0 HCPCS,30903,Control of nosebleed,,,129.94,2978.0,8 HCPCS,30903,"Hc Ctrl Nosebleed,Anter,Complex",1054.87,421.95,,,0 HCPCS,30905,Control of nosebleed,,,129.94,2978.0,8 HCPCS,30905,"Hc Ctrl Nosebleed,Post,W/Packs &/Or Caut",1175.43,470.17,,,0 HCPCS,30906,Repeat control of nosebleed,,,231.31,2978.0,8 HCPCS,30915,Ligation nasal sinus artery,,,3083.61,7709.02,8 HCPCS,30920,Ligation upper jaw artery,,,3083.61,9743.0,8 HCPCS,30930,Ther fx nasal inf turbinate,,,3237.89,8800.0,8 HCPCS,30999,Hc Nasal Surgery Procedure Unlisted,1292.79,517.12,,,0 HCPCS,30999,Nasal surgery procedure,,,231.31,578.27,4 HCPCS,31000,Irrigation maxillary sinus,,,231.31,578.27,4 HCPCS,31002,Irrigation sphenoid sinus,,,1515.28,3788.21,4 HCPCS,31020,Exploration maxillary sinus,,,3237.89,8094.73,8 HCPCS,31030,Exploration maxillary sinus,,,5781.33,14453.33,8 HCPCS,31032,Explore sinus remove polyps,,,5781.33,14453.33,8 HCPCS,31040,Exploration behind upper jaw,,,5781.33,14453.33,4 HCPCS,31050,Exploration sphenoid sinus,,,3470.0,14453.33,8 HCPCS,31051,Sphenoid sinus surgery,,,5781.33,14453.33,8 HCPCS,31070,Exploration of frontal sinus,,,3470.0,14453.33,8 HCPCS,31075,Exploration of frontal sinus,,,5781.33,14453.33,8 HCPCS,31080,Removal of frontal sinus,,,5781.33,14453.33,8 HCPCS,31081,Removal of frontal sinus,,,5781.33,14453.33,8 HCPCS,31084,Removal of frontal sinus,,,5781.33,14453.33,8 HCPCS,31085,Removal of frontal sinus,,,5781.33,14453.33,8 HCPCS,31086,Removal of frontal sinus,,,5781.33,14453.33,8 HCPCS,31087,Removal of frontal sinus,,,5781.33,14453.33,8 HCPCS,31090,Exploration of sinuses,,,5781.33,14453.33,8 HCPCS,31200,Removal of ethmoid sinus,,,3470.0,14453.33,8 HCPCS,31201,Removal of ethmoid sinus,,,1515.28,11433.0,8 HCPCS,31205,Removal of ethmoid sinus,,,3237.89,9743.0,8 HCPCS,31231,"Hc Nasal Endoscopy,Dx",842.35,336.94,,,0 HCPCS,31231,Nasal endoscopy dx,,,194.94,2978.0,8 HCPCS,31233,Hc Nasal/Sinus Endoscopy Diagnostic Maxilary Sinusoscopy-Bilateral,878.0,351.2,,,0 HCPCS,31233,Hc Nasal/Sinus Endoscopy Diagnostic Maxilary Sinusoscopy-Unilateral,585.0,234.0,,,0 HCPCS,31233,Nasal/sinus endoscopy dx,,,381.97,4059.0,8 HCPCS,31235,Nasal/sinus endoscopy dx,,,1738.26,4345.64,8 HCPCS,31237,"Hc Nasal/Sinus Endoscopy,Bx/Rmv Polyp/Debrid",2655.86,1062.34,,,0 HCPCS,31237,Nasal/sinus endoscopy surg,,,1738.26,4345.64,8 HCPCS,31238,Hc Nasal/Sinus Ndsc Surg W/Control Nasal Hemorrage,3670.8,1468.32,,,0 HCPCS,31238,Nasal/sinus endoscopy surg,,,1738.26,4345.64,8 HCPCS,31239,Nasal/sinus endoscopy surg,,,3641.12,9102.8,8 HCPCS,31240,Nasal/sinus endoscopy surg,,,1738.26,4345.64,8 HCPCS,31241,Nsl/sins ndsc w/artery lig,,,1738.26,4345.64,4 HCPCS,31242,Nsl/sinus ndsc rf abltj pnn,,,5781.33,14453.33,4 HCPCS,31243,Nsl/sinus ndsc cryoabltj pnn,,,5781.33,14453.33,4 HCPCS,31253,Nsl/sins ndsc total,,,6892.34,17230.86,4 HCPCS,31254,Revision of ethmoid sinus,,,6892.34,17230.86,8 HCPCS,31255,Removal of ethmoid sinus,,,6892.34,17230.86,8 HCPCS,31256,Exploration maxillary sinus,,,3641.12,9743.0,8 HCPCS,31257,Nsl/sins ndsc tot w/sphendt,,,6892.34,17230.86,8 HCPCS,31259,Nsl/sins ndsc sphn tiss rmvl,,,6892.34,17230.86,4 HCPCS,31267,Endoscopy maxillary sinus,,,6892.34,17230.86,8 HCPCS,31276,Sinus endoscopy surgical,,,6892.34,17230.86,8 HCPCS,31287,Nasal/sinus endoscopy surg,,,6892.34,17230.86,8 HCPCS,31288,Nasal/sinus endoscopy surg,,,6892.34,17230.86,8 HCPCS,31292,Nasal/sinus endoscopy surg,,,6892.34,17230.86,4 HCPCS,31293,Nasal/sinus endoscopy surg,,,6892.34,17230.86,4 HCPCS,31294,Nasal/sinus endoscopy surg,,,6892.34,17230.86,4 HCPCS,31295,Sinus endo w/balloon dil,,,6892.34,17230.86,4 HCPCS,31296,Sinus endo w/balloon dil,,,6892.34,17230.86,4 HCPCS,31297,Sinus endo w/balloon dil,,,6892.34,17230.86,4 HCPCS,31298,Nsl/sins ndsc w/sins dilat,,,6892.34,17230.86,4 HCPCS,31299,Sinus surgery procedure,,,231.31,578.27,4 HCPCS,31300,Removal of larynx lesion,,,3237.89,11433.0,8 HCPCS,31320,Diagnostic incision larynx,,,3470.0,4059.0,4 HCPCS,31400,Revision of larynx,,,3470.0,14453.33,8 HCPCS,31420,Removal of epiglottis,,,3470.0,14453.33,8 HCPCS,31500,Hc Insert Emergency Endotrach Airway,1794.1,717.64,,,0 HCPCS,31500,Insert emergency airway,,,231.31,2978.0,8 HCPCS,31502,Change of windpipe airway,,,231.31,578.27,4 HCPCS,31502,Hc Trach Tube Change,1143.61,457.44,,,0 HCPCS,31505,Diagnostic laryngoscopy,,,194.94,487.34,4 HCPCS,31505,"Hc Laryngoscopy,Indirect,Dx",1696.3,678.52,,,0 HCPCS,31510,Laryngoscopy with biopsy,,,3470.0,9102.8,8 HCPCS,31511,Remove foreign body larynx,,,194.94,4059.0,8 HCPCS,31512,Removal of larynx lesion,,,3470.0,9102.8,8 HCPCS,31513,Injection into vocal cord,,,381.97,4059.0,8 HCPCS,31515,Laryngoscopy for aspiration,,,381.97,2978.0,8 HCPCS,31520,Dx laryngoscopy newborn,,,381.97,954.92,4 HCPCS,31520,Hc Surg Clsr Tracheostomy/Fistula W/O Plastic Rpr,1823.9,729.56,,,0 HCPCS,31525,Dx laryngoscopy excl nb,,,1738.26,4345.64,8 HCPCS,31525,"Hc Laryngoscopy,Direct,Diagnostic",2293.54,917.42,,,0 HCPCS,31526,Dx laryngoscopy w/oper scope,,,1738.26,4345.64,8 HCPCS,31526,Hc Laryngoscopy Direct Diagnostic Outpatient Microscopy,3342.36,1336.94,,,0 HCPCS,31527,Laryngoscopy for treatment,,,2546.0,9102.8,8 HCPCS,31528,Laryngoscopy and dilation,,,3470.0,9102.8,8 HCPCS,31529,Laryngoscopy and dilation,,,3470.0,9102.8,8 HCPCS,31530,Laryngoscopy w/fb removal,,,1738.26,4345.64,8 HCPCS,31531,Laryngoscopy w/fb & op scope,,,3641.12,9743.0,8 HCPCS,31535,Laryngoscopy w/biopsy,,,3470.0,9102.8,8 HCPCS,31536,Laryngoscopy w/bx & op scope,,,3641.12,9743.0,8 HCPCS,31540,Laryngoscopy w/exc of tumor,,,3641.12,9743.0,8 HCPCS,31541,Hc Removal Of Growth Of Tongue And/Or Stripping Of Vocal Cord Using An Endoscope With Opering Micros,10925.0,4370.0,,,0 HCPCS,31541,Larynscop w/tumr exc + scope,,,3641.12,9102.8,8 HCPCS,31545,Remove vc lesion w/scope,,,3641.12,9102.8,8 HCPCS,31546,Remove vc lesion scope/graft,,,6892.34,17230.86,8 HCPCS,31551,Laryngoplasty laryngeal sten,,,5781.33,14453.33,8 HCPCS,31552,Laryngoplasty laryngeal sten,,,5781.33,14453.33,8 HCPCS,31553,Laryngoplasty laryngeal sten,,,5781.33,14453.33,8 HCPCS,31554,Laryngoplasty laryngeal sten,,,5781.33,14453.33,8 HCPCS,31560,Laryngoscop w/arytenoidectom,,,6892.34,17230.86,8 HCPCS,31561,Larynscop remve cart + scop,,,6892.34,17230.86,8 HCPCS,31570,"Hc Laryngoscopy,Dirct,Inj Vocal Cord",3650.19,1460.08,,,0 HCPCS,31570,Laryngoscope w/vc inj,,,3470.0,9102.8,8 HCPCS,31571,Laryngoscop w/vc inj + scope,,,3470.0,9102.8,8 HCPCS,31572,Largsc w/laser dstrj les,,,3641.12,9743.0,8 HCPCS,31573,Largsc w/ther injection,,,1738.26,4345.64,8 HCPCS,31574,Largsc w/njx augmentation,,,1738.26,4345.64,8 HCPCS,31575,Diagnostic laryngoscopy,,,194.94,487.34,4 HCPCS,31575,"Hc Laryngoscopy,Flex Fiber,Diagnostic",1826.38,730.55,,,0 HCPCS,31576,Laryngoscopy with biopsy,,,1738.26,4345.64,8 HCPCS,31577,Largsc w/rmvl foreign bdy(s),,,381.97,4059.0,8 HCPCS,31578,Largsc w/removal lesion,,,3470.0,9102.8,8 HCPCS,31579,"Hc Laryngoscopy,Flex/Rigid+Stroboscopy",2524.48,1009.79,,,0 HCPCS,31579,Laryngoscopy telescopic,,,381.97,954.92,4 HCPCS,31580,Laryngoplasty laryngeal web,,,5781.33,14453.33,8 HCPCS,31582,Revision of larynx,,,9775.0,11433.0,4 HCPCS,31584,Laryngoplasty fx rdctj fixj,,,5781.33,14453.33,4 HCPCS,31587,Laryngoplasty cricoid split,,,5781.33,14453.33,4 HCPCS,31588,Revision of larynx,,,9775.0,11433.0,4 HCPCS,31590,Reinnervate larynx,,,5781.33,14453.33,8 HCPCS,31591,Laryngoplasty medialization,,,5781.33,14453.33,8 HCPCS,31592,Cricotracheal resection,,,5781.33,14453.33,8 HCPCS,31595,Larynx nerve surgery,,,3470.0,4059.0,4 HCPCS,31599,Larynx surgery procedure,,,231.31,578.27,4 HCPCS,31600,Incision of windpipe,,,3237.89,8094.73,4 HCPCS,31601,Incision of windpipe,,,5781.33,14453.33,4 HCPCS,31603,"Hc Tracheostomy,Emergency,Xtrach",4646.87,1858.75,,,0 HCPCS,31603,Incision of windpipe,,,1515.28,3788.21,8 HCPCS,31605,"Hc Tracheostomy,Emergency,Cricothyroid Membrane",2063.2,825.28,,,0 HCPCS,31605,Incision of windpipe,,,231.31,578.27,4 HCPCS,31610,Incision of windpipe,,,5781.33,14453.33,4 HCPCS,31611,Surgery/speech prosthesis,,,3237.89,9743.0,8 HCPCS,31612,Puncture/clear windpipe,,,2546.0,8094.73,8 HCPCS,31613,Hc Trach Rev Smpl W/O Flp Rot,3762.92,1505.17,,,0 HCPCS,31613,Repair windpipe opening,,,3237.89,8094.73,8 HCPCS,31614,Repair windpipe opening,,,3470.0,14453.33,8 HCPCS,31615,Hc Scope Thru Tracheostomy,2860.65,1144.26,,,0 HCPCS,31615,Visualization of windpipe,,,526.71,2978.0,8 HCPCS,31620,Endobronchial ultrasound,,,2546.0,2978.0,4 HCPCS,31622,Dx bronchoscope/wash,,,1738.26,4345.64,8 HCPCS,31622,Hc Bronchoscopy Diagnostic,4478.38,1791.35,,,0 HCPCS,31622,Hc Bronchoscopy Diagnostic-Emergency,4213.05,1685.22,,,0 HCPCS,31623,Dx bronchoscope/brush,,,1738.26,4345.64,8 HCPCS,31623,Hc Bronchoscopy Diagnostic With Brush,4511.86,1804.74,,,0 HCPCS,31623,Noncdm Charge Record,12852.43,5140.97,,,0 HCPCS,31624,Dx bronchoscope/lavage,,,1738.26,4345.64,8 HCPCS,31624,Hc Bronchoscopy Diagnostic With Lavage,4519.59,1807.84,,,0 HCPCS,31624,"Hc Bronchoscopy,Diagnostic W Lavage",4519.59,1807.84,,,0 HCPCS,31624,Noncdm Charge Record,21212.0,8484.8,,,0 HCPCS,31625,Bronchoscopy w/biopsy(s),,,1738.26,4345.64,8 HCPCS,31625,Hc Bronchoscopy Biopsy,4582.7,1833.08,,,0 HCPCS,31625,"Hc Bronchoscopy,Biopsy",4582.7,1833.08,,,0 HCPCS,31626,Bronchoscopy w/markers,,,6892.34,17230.86,4 HCPCS,31627,Hc Bronchoscopy Computer Assistant/Image-Guided Navigation,3697.85,1479.14,,,0 HCPCS,31627,Noncdm Charge Record,20390.0,8156.0,,,0 HCPCS,31628,Bronchoscopy/lung bx each,,,3470.0,9102.8,8 HCPCS,31628,Hc Bronchoscopy Transbronchial Biopsy,5331.03,2132.41,,,0 HCPCS,31628,Noncdm Charge Record,22023.0,8809.2,,,0 HCPCS,31629,Bronchoscopy/needle bx each,,,3470.0,9102.8,8 HCPCS,31629,Hc Bronchoscopy Transbronchial Aspiration Biopsy,5168.74,2067.5,,,0 HCPCS,31630,Bronchoscopy dilate/fx repr,,,3470.0,9102.8,8 HCPCS,31630,Hc Bronchoscopy With Tracheal/Bronchial Dilation,6025.26,2410.1,,,0 HCPCS,31631,Bronchoscopy dilate w/stent,,,3470.0,17230.86,8 HCPCS,31631,Hc Bronchoscopy W/Placement Tracheal Stent,6250.0,2500.0,,,0 HCPCS,31632,Hc Bronchoscopy W/Transbronchial Lung Biopsy Each Lobe,3236.74,1294.7,,,0 HCPCS,31634,Bronch w/balloon occlusion,,,6892.34,17230.86,4 HCPCS,31635,Bronchoscopy w/fb removal,,,1738.26,4345.64,8 HCPCS,31635,Hc Bronchoscopy Removal Foreign Body,4442.31,1776.92,,,0 HCPCS,31635,"Hc Bronchoscopy,Remv For. Body",4442.31,1776.92,,,0 HCPCS,31636,Bronchoscopy bronch stents,,,3470.0,17230.86,8 HCPCS,31636,Hc Bronchoscopy Bronchial Stents,6035.57,2414.23,,,0 HCPCS,31637,Bronchoscopy stent add-on,,,2546.0,2978.0,4 HCPCS,31638,Bronchoscopy revise stent,,,3470.0,17230.86,8 HCPCS,31640,Bronchoscopy w/tumor excise,,,3470.0,9102.8,8 HCPCS,31640,Hc Bronchoscopy With Excision Of Tumor/Growth,5477.86,2191.14,,,0 HCPCS,31641,Bronchoscopy treat blockage,,,3470.0,9102.8,8 HCPCS,31641,Hc Bronchoscopy Treatment Of Blockage,7304.25,2921.7,,,0 HCPCS,31643,Diag bronchoscope/catheter,,,1738.26,4345.64,8 HCPCS,31643,"Hc Bronchoscopy,Rx W Place Catheter",1569.04,627.62,,,0 HCPCS,31645,Bronchoscopy clear airways,,,1738.26,4345.64,8 HCPCS,31645,Hc Bronchoscopy W/Therapy Aspiration Trachbrnchial Tree 1St,3891.05,1556.42,,,0 HCPCS,31646,Bronchoscopy reclear airway,,,381.97,2978.0,8 HCPCS,31647,Bronchial valve init insert,,,6892.34,17230.86,4 HCPCS,31647,Hc Bronchoscopy Occulusion & Insert Bronch Valve Initial Lobe,9338.0,3735.2,,,0 HCPCS,31648,Bronchial valve remov init,,,3641.12,9102.8,4 HCPCS,31648,Hc Bronchoscopy Removal Bronchial Valve Initial,4146.07,1658.43,,,0 HCPCS,31649,Bronchial valve remov addl,,,1738.26,4345.64,4 HCPCS,31649,Hc Bronchoscopy Rigid/Flex Each Additional Lobe,2412.42,964.97,,,0 HCPCS,31651,Hc Bronchoscopy Occlusion & Insert Bronch Valve Additional Lobe,1966.5,786.6,,,0 HCPCS,31652,Bronch ebus samplng 1/2 node,,,3641.12,9102.8,4 HCPCS,31652,Hc Bronchoscopy Ebus Guided Sample 1/2 Node Station/Strux,8050.0,3220.0,,,0 HCPCS,31653,Bronch ebus samplng 3/> node,,,3641.12,9102.8,4 HCPCS,31653,Hc Bronchoscopy Ebus Guided Sample 3/> Node Station/Strux,8129.86,3251.94,,,0 HCPCS,31654,Hc Bronchoscopy With Ebus For Diagnostic/Therapeutic Intervention For Peripheral Lesions,5981.47,2392.59,,,0 HCPCS,31656,"Bronchoscopy, inj for xray",,,2546.0,2978.0,4 HCPCS,31660,Bronch thermoplsty 1 lobe,,,6892.34,17230.86,4 HCPCS,31660,Hc Bronchial Thermoplasty 1 Lobe,8520.12,3408.05,,,0 HCPCS,31661,Bronch thermoplsty 2/> lobes,,,6892.34,17230.86,4 HCPCS,31661,Hc Bronchoscopy Ridge Or Flexible,9710.23,3884.09,,,0 HCPCS,31717,Bronchial brush biopsy,,,381.97,2978.0,8 HCPCS,31720,Clearance of airways,,,213.85,2978.0,8 HCPCS,31730,Intro windpipe wire/tube,,,1738.26,4345.64,8 HCPCS,31750,Repair of windpipe,,,5781.33,14453.33,8 HCPCS,31755,Repair of windpipe,,,3470.0,14453.33,8 HCPCS,31785,Remove windpipe lesion,,,5781.33,14453.33,4 HCPCS,31820,Closure of windpipe lesion,,,2546.0,8094.73,8 HCPCS,31825,Repair of windpipe defect,,,3237.89,8094.73,8 HCPCS,31830,Revise windpipe scar,,,3237.89,8094.73,8 HCPCS,31899,Airways surgical procedure,,,194.94,487.34,4 HCPCS,31899,Hc Biopsy Trachea Bronchi,410.82,164.33,,,0 HCPCS,32000,Drainage of chest,,,2546.0,2978.0,4 HCPCS,32110,Hc Thoracotomy,13192.21,5276.88,,,0 HCPCS,32160,Hc Thoracotomy W/Cardiac Massage,13192.21,5276.88,,,0 HCPCS,32400,Hc Needle Biopsy Pleura,1151.0,460.4,,,0 HCPCS,32400,Needle biopsy chest lining,,,1612.96,4032.39,8 HCPCS,32405,"Hc Percut Bx, Lung/Mediastinum-Unilateral",3638.48,1455.39,,,0 HCPCS,32405,Percut bx lung/mediastinum,,,2546.0,2978.0,4 HCPCS,32408,Core ndl bx lng/med perq,,,1612.96,9743.0,8 HCPCS,32408,Hc Ct Lung/Med Biopsy Including Guidance Unilateral,7497.96,2999.18,,,0 HCPCS,32420,Puncture/clear lung,,,2546.0,2978.0,4 HCPCS,32421,Thoracentesis for aspiration,,,2546.0,2978.0,4 HCPCS,32550,Hc Insertion Indwelling Tunneled Pleural Catheter,9827.05,3930.82,,,0 HCPCS,32550,Insert pleural cath,,,3496.63,9743.0,8 HCPCS,32551,Hc Tube Thoracostomy Includes Water Seal,3224.9,1289.96,,,0 HCPCS,32551,Insertion of chest tube,,,1537.33,3843.32,8 HCPCS,32552,Hc Removal Of Indwelling Tunneled Pleural Catheter With Cuff,2849.83,1139.93,,,0 HCPCS,32552,Remove lung catheter,,,612.63,2978.0,8 HCPCS,32553,Ins mark thor for rt perq,,,1351.75,3379.37,4 HCPCS,32554,Aspirate pleura w/o imaging,,,612.63,1531.57,4 HCPCS,32554,Hc Thoracentesis Needle/Cath Pleura W/O Imaging,2831.41,1132.56,,,0 HCPCS,32555,Aspirate pleura w/ imaging,,,612.63,2978.0,8 HCPCS,32555,Hc Thoracentesis Needle/Cath Pleura W/Imaging,4519.2,1807.68,,,0 HCPCS,32555,Hc Thoracentesis Needle/Cath Pleura W/Imaging-Bilateral,6779.82,2711.93,,,0 HCPCS,32555,Hc Thoracentesis Needle/Cath Pleura W/Imaging-Unilateral,4519.2,1807.68,,,0 HCPCS,32556,Hc Perq Drainage Pleura Insert Cath W/O Imaging,3097.64,1239.06,,,0 HCPCS,32556,Insert cath pleura w/o image,,,1874.01,4685.03,8 HCPCS,32557,Hc Ct Guided Chest Tube-Bilateral,8998.22,3599.29,,,0 HCPCS,32557,Hc Percutaneous Drainage Pleura Insert Cath W/Imaging-Unilateral,5999.37,2399.75,,,0 HCPCS,32557,Insert cath pleura w/ image,,,1537.33,3843.32,4 HCPCS,32560,Treat pleurodesis w/agent,,,612.63,1531.57,4 HCPCS,32561,Lyse chest fibrin init day,,,612.63,1531.57,4 HCPCS,32562,Lyse chest fibrin subq day,,,612.63,1531.57,4 HCPCS,32601,Thoracoscopy diagnostic,,,5904.09,14760.22,4 HCPCS,32604,Thoracoscopy wbx sac,,,10381.14,25952.85,4 HCPCS,32606,Thoracoscopy w/bx med space,,,5904.09,14760.22,4 HCPCS,32607,Thoracoscopy w/bx infiltrate,,,10381.14,25952.85,4 HCPCS,32608,Thoracoscopy w/bx nodule,,,10381.14,25952.85,4 HCPCS,32609,Thoracoscopy w/bx pleura,,,5904.09,14760.22,4 HCPCS,32960,Therapeutic pneumothorax,,,612.63,1531.57,4 HCPCS,32994,Ablate pulm tumor perq crybl,,,10381.14,25952.85,4 HCPCS,32994,Hc Ct Cryoblation - Lung Unilateral,20584.62,8233.85,,,0 HCPCS,32998,"Hc Perq Radiofreq Ablation Tx, Pul Tumor",9423.81,3769.52,,,0 HCPCS,32998,Perq rf ablate tx pul tumor,,,5904.09,14760.22,4 HCPCS,32999,Chest surgery procedure,,,612.63,1531.57,4 HCPCS,32999,Hc Pleural Drain Change,2022.5,809.0,,,0 HCPCS,33010,Drainage of heart sac,,,3470.0,4059.0,4 HCPCS,33010,Hc Cath Drainage Of Heart Sac,2817.5,1127.0,,,0 HCPCS,33011,Repeat drainage of heart sac,,,3470.0,4059.0,4 HCPCS,33016,Hc Pericentesis W/Image-Guided,4428.65,1771.46,,,0 HCPCS,33016,Pericardiocentesis w/imaging,,,1537.33,3843.32,4 HCPCS,33017,Hc Prcrd Drg 6Yr+ W/O Cgen Car,11176.85,4470.74,,,0 HCPCS,33018,Hc Prcrd Drg 0-5Yr Or W/Anomly,11176.85,4470.74,,,0 HCPCS,33206,Hc Ep Insert Heart Pacer Xvenous Atrial,12719.0,5087.6,,,0 HCPCS,33206,Insert heart pm atrial,,,10207.46,25518.66,4 HCPCS,33207,Hc Ep Insert Heart Pacer Xvenous Venticular,13396.35,5358.54,,,0 HCPCS,33207,Insert heart pm ventricular,,,10207.46,25518.66,4 HCPCS,33208,Hc Ep Insert Heart Pacer Xvenous Atrial/Venticular,18084.9,7233.96,,,0 HCPCS,33208,Hc Insert Heart Pacer Xvenous Atrial/Ventricular,9931.4,3972.56,,,0 HCPCS,33208,Insrt heart pm atrial & vent,,,10207.46,25518.66,4 HCPCS,33210,Hc Ep Insert Heart Temp Pacer One Chamber,13479.15,5391.66,,,0 HCPCS,33210,Insert electrd/pm cath sngl,,,8081.78,20204.45,4 HCPCS,33211,Insert card electrodes dual,,,8081.78,20204.45,4 HCPCS,33212,Hc Ep Insert Pulse Generate One Chamber,13058.25,5223.3,,,0 HCPCS,33212,Insert pulse gen sngl lead,,,8081.78,20204.45,8 HCPCS,33213,Hc Ep Insert Pulse Generate Dual Chamber,14262.3,5704.92,,,0 HCPCS,33213,Insert pulse gen dual leads,,,8330.0,25518.66,8 HCPCS,33214,Hc Ep Upgrade Of Pacemaker System,14411.8,5764.72,,,0 HCPCS,33214,Upgrade of pacemaker system,,,10207.46,25518.66,4 HCPCS,33215,Hc Ep Rpsg Prev Implanted Pm/Dfb Atrial/Venticular Electrode,6276.7,2510.68,,,0 HCPCS,33215,Reposition pacing-defib lead,,,3083.61,7709.02,4 HCPCS,33216,Hc Ep Insj 1 Transvenous Electrode Perm Pacemaker/Implantable Dfb,9921.05,3968.42,,,0 HCPCS,33216,Insert 1 electrode pm-defib,,,8081.78,20204.45,4 HCPCS,33217,Hc Ep Insj 2 Transvenous Electrode Perm Pacemaker/Implantable Dfb,10858.3,4343.32,,,0 HCPCS,33217,Insert 2 electrode pm-defib,,,8081.78,20204.45,4 HCPCS,33218,Hc Ep Rpr 2 Transvneous Electrode Perm Pm/Pacing Implantable Dfb,7772.85,3109.14,,,0 HCPCS,33218,Repair lead pace-defib one,,,3649.53,9123.83,4 HCPCS,33220,Hc Ep Rpr 2 Transvns Electrodes Prm Pm/Implantable Dfb,7348.5,2939.4,,,0 HCPCS,33220,Repair lead pace-defib dual,,,3649.53,9123.83,4 HCPCS,33221,Hc Ep Ins Pacemaker Pulse General Only With Exist Multiple Leads,15598.6,6239.44,,,0 HCPCS,33221,Insert pulse gen mult leads,,,18811.05,47027.63,4 HCPCS,33222,Hc Ep Relocation Of Skin Pocket For Pacemaker,5162.35,2064.94,,,0 HCPCS,33222,Relocation pocket pacemaker,,,2015.01,5037.52,8 HCPCS,33223,Hc Ep Relocation Of Skin Pocket Implantable Defibrillator,5472.85,2189.14,,,0 HCPCS,33223,Relocate pocket for defib,,,2015.01,5037.52,8 HCPCS,33224,Hc Ep Insj Electrode Cardiac Venous System Tm Insj Dfb/Pm Pls General,14760.25,5904.1,,,0 HCPCS,33224,Insert pacing lead & connect,,,10207.46,25518.66,4 HCPCS,33225,Hc Ep Insj Electrode Cardiac Venous System Attach Prev Perm/Dfb Pls General,11677.1,4670.84,,,0 HCPCS,33226,Hc Ep Reposit Prev Implanted Cardiac Electrode,5140.5,2056.2,,,0 HCPCS,33226,Reposition l ventric lead,,,3083.61,7709.02,4 HCPCS,33227,Hc Ep Removal Perm Pm Pulse General With/Replacement Pulse General Single Lead System,20214.7,8085.88,,,0 HCPCS,33227,Remove&replace pm gen singl,,,8081.78,20204.45,4 HCPCS,33228,Hc Ep Removal Perm Pm Pulse General With/Replacement Pulse General Multple Lead,23744.05,9497.62,,,0 HCPCS,33228,Remv&replc pm gen dual lead,,,10207.46,25518.66,4 HCPCS,33229,Hc Ep Removal Perm Pm Pulse General With/Replacement Pulse General Multi Lead,25646.15,10258.46,,,0 HCPCS,33229,Remv&replc pm gen mult leads,,,18811.05,47027.63,4 HCPCS,33230,Hc Ep Insj Implantable Defib Pulse General With/Exist Dual Leads,26926.1,10770.44,,,0 HCPCS,33230,Insrt pulse gen w/dual leads,,,21723.17,54307.93,4 HCPCS,33231,Hc Insert Icd Pul Gen-Exist Multiple Lds,28771.85,11508.74,,,0 HCPCS,33231,Insrt pulse gen w/mult leads,,,30654.5,76636.25,4 HCPCS,33233,Hc Ep Removal Perm Pacer Generator,9339.15,3735.66,,,0 HCPCS,33233,Removal of pm generator,,,3470.0,20204.45,8 HCPCS,33234,"Hc Ep Removal Transvenous Pacer Electrode,1 Lead",8694.0,3477.6,,,0 HCPCS,33234,Removal of pacemaker system,,,3649.53,9123.83,4 HCPCS,33235,"Hc Ep Removal Transvenous Pacer Electrode,2 Lead",9179.3,3671.72,,,0 HCPCS,33235,Removal pacemaker electrode,,,3649.53,9123.83,4 HCPCS,33240,Hc Ep Insj Implantable Defib Pulse General With/1 Existing Lead,19352.2,7740.88,,,0 HCPCS,33240,Insrt pulse gen w/singl lead,,,21723.17,54307.93,4 HCPCS,33241,Hc Ep Removal Implantable Defib Pulse Generator Only,7859.1,3143.64,,,0 HCPCS,33241,Remove pulse generator,,,3649.53,9123.83,4 HCPCS,33244,Hc Ep Removal 1/Dual Chamber Implantable Dfb Electrodes Transvenous Xtrj,9174.7,3669.88,,,0 HCPCS,33244,Remove elctrd transvenously,,,3649.53,9123.83,4 HCPCS,33249,Hc Ep Insj/Replacement Perm Dfb With/Transvenous Leads 1/Dual Chamber,26575.35,10630.14,,,0 HCPCS,33249,Insj/rplcmt defib w/lead(s),,,30654.5,76636.25,4 HCPCS,33262,Hc Ep Removal Implantable Dfb Pulse General With/Replacement Pulse General 1 Lead,27188.3,10875.32,,,0 HCPCS,33262,Rmvl& replc pulse gen 1 lead,,,21723.17,54307.93,4 HCPCS,33263,Hc Ep Removal Implantable Dfb Pulse General With/Replacement Pulse General 2 Lead,28281.95,11312.78,,,0 HCPCS,33263,Rmvl & rplcmt dfb gen 2 lead,,,21723.17,54307.93,4 HCPCS,33264,Hc Ep Removal Implantable Dfb Pulse General With/Replacement Pulse General Mlt Ld,29634.35,11853.74,,,0 HCPCS,33264,Rmvl & rplcmt dfb gen mlt ld,,,30654.5,76636.25,4 HCPCS,33270,Hc Ep Ins/Replacement Perm Subsequent Implantable Dfb With/Subsequent Electrode,29583.75,11833.5,,,0 HCPCS,33270,Ins/rep subq defibrillator,,,30654.5,76636.25,4 HCPCS,33271,Hc Ep Insj Of Subq Implantable Defibrillator Electrode,11007.0,4402.8,,,0 HCPCS,33271,Insj subq impltbl dfb elctrd,,,8081.78,20204.45,4 HCPCS,33272,Hc Ep Rmvl Of Subq Implantable Defibrillator,6719.45,2687.78,,,0 HCPCS,33272,Hc Ep Rmvl Of Subq Implantable Defibrillator Electrode,6719.45,2687.78,,,0 HCPCS,33272,Rmvl of subq defibrillator,,,3649.53,9123.83,4 HCPCS,33273,Hc Ep Repos Previously Implanted Subq Implantable Dfb,2397.0,958.8,,,0 HCPCS,33273,Repos prev impltbl subq dfb,,,3649.53,9123.83,4 HCPCS,33274,Hc Insert/Replacement Leadless Pacer Rv,29107.65,11643.06,,,0 HCPCS,33274,Tcat insj/rpl perm ldls pm,,,18811.05,47027.63,4 HCPCS,33275,Hc Remove Leadless Pacemaker,7545.1,3018.04,,,0 HCPCS,33275,Tcat rmvl perm ldls pm,,,3083.61,7709.02,4 HCPCS,33276,Insj phrnc nrv stim sys,,,43015.98,107539.94,4 HCPCS,33278,Rmvl phrnc nrv stim sys,,,3414.31,8535.78,4 HCPCS,33279,Rmvl phrnc nrv stim transvns,,,3414.31,8535.78,4 HCPCS,33280,Rmvl phrnc nrv stim pg only,,,3414.31,8535.78,4 HCPCS,33281,Reposg phrnc nrv stim trnsvn,,,3414.31,8535.78,4 HCPCS,33285,Hc Insert Cardiac Rhythm Monitor,12517.75,5007.1,,,0 HCPCS,33285,Insj subq car rhythm mntr,,,8081.78,20204.45,4 HCPCS,33286,Hc Remove Cardiac Rhythm Monitor,3428.15,1371.26,,,0 HCPCS,33286,Rmvl subq car rhythm mntr,,,691.56,1728.91,4 HCPCS,33287,Rmv&rplcmt phrnc nrv stim pg,,,30135.76,75339.4,4 HCPCS,33288,Rmv&rplcmt phrnc nrv stim ld,,,10882.0,27205.01,4 HCPCS,33289,Hc Tcat Impulse Wirerlesd P-Art Prs Snr,23778.55,9511.42,,,0 HCPCS,33289,Tcat impl wrls p-art prs snr,,,28012.29,70030.72,4 HCPCS,33340,Hc Catheter Percutaneous Closure-Repair Of Left Upper Heart,16954.45,6781.78,,,0 HCPCS,33361,Hc Replacement Aortic Valve Percutaneous Femoral Artery Approach,33172.9,13269.16,,,0 HCPCS,33370,Hc Tcat Placement & Removal Cepd Perq,1817.0,726.8,,,0 HCPCS,33418,Hc Repair Of Mitral Valve With Prosthetic Valve Initial Prosthesis,28874.2,11549.68,,,0 HCPCS,33419,Hc Cath Tcat Mitral Valve Repair Additional Prosthesis,18033.15,7213.26,,,0 HCPCS,33477,Hc Implantation Of Heart Valve (Pulmonary) To Lungs,23667.0,9466.8,,,0 HCPCS,33741,Hc Transcath Atrial Septostomy,18419.55,7367.82,,,0 HCPCS,33745,Hc Tis Transc Intrcard Shunt Initial,20297.5,8119.0,,,0 HCPCS,33746,Hc Tis Trans Intracrd Shunt Additional,8797.5,3519.0,,,0 HCPCS,33894,Hc Vascular St Repair Thoraic/Aa Acrs Brances,21453.25,8581.3,,,0 HCPCS,33895,Hc Vascular St Repair Thoraic/Aa X Crsg,18221.75,7288.7,,,0 HCPCS,33897,Hc Perq Trluml Angp Nt/Recr Coa,15536.5,6214.6,,,0 HCPCS,33900,Hc Percutaneous Pulmonary Artery Revascularization By Stent Placement-Unilateral,7403.47,2961.39,,,0 HCPCS,33900,Perq p-art revsc 1 nm nt uni,,,11274.1,28185.26,4 HCPCS,33901,Hc Percutaneous Pulmonary Artery Revascularization By Stent Placement-Bilateral,8398.05,3359.22,,,0 HCPCS,33901,Perq p-art revsc 1 nm nt bi,,,11274.1,28185.26,4 HCPCS,33902,Hc Placement Of Stent In Pulmonary Arteries With Abnormal Anatomical Connections-Unilateral,8665.25,3466.1,,,0 HCPCS,33902,Perq p-art revsc 1 abnor uni,,,17902.75,44756.89,4 HCPCS,33903,Hc Placement Of Stent In Pulmonary Arteries With Abnormal Anatomical Connections-Bilateral,6614.8,2645.92,,,0 HCPCS,33903,Perq p-art revsc 1 abnor bi,,,11274.1,28185.26,4 HCPCS,33904,Hc Placement Of Stent In Pulmonary Artery-Each Addtional,1969.95,787.98,,,0 HCPCS,33949,"Hc Ecmo/Ecls Daily Management Of Veno-Arterial, Each Day",625.0,250.0,,,0 HCPCS,33952,Hc Ecmo/Ecls Insertion Of Cannula For External Blood Circulation In Heart/Lungs Patients 6 Years And,1107.45,442.98,,,0 HCPCS,33958,Hc Ecmo Reposition Cannula 6Yr+,1095.95,438.38,,,0 HCPCS,33967,Hc Catheter Insert Intra-Aortic Balloon Assist Device,8193.75,3277.5,,,0 HCPCS,33968,Hc Removal Of Aortic Balloon Device,8068.93,3227.57,,,0 HCPCS,33971,Hc Remove Iabp With/Femoral Artery Repair,5853.5,2341.4,,,0 HCPCS,33990,Hc Insj Perq Vad With/Imaging Artery Access Only,14861.45,5944.58,,,0 HCPCS,33992,Hc Removal Percutaneous Left Heart Vad Separate And Distinct Session,11283.8,4513.52,,,0 HCPCS,33993,Hc Reposition Vad With Imaging Different Session,7404.85,2961.94,,,0 HCPCS,33995,Hc Rvad Percut Insert Venous Only,8774.5,3509.8,,,0 HCPCS,33997,Hc Removal Rvad Percut,7334.7,2933.88,,,0 HCPCS,33999,Cardiac surgery procedure,,,612.63,1531.57,4 HCPCS,33999,Hc Oxygenator Pump Replacement,1573.2,629.28,,,0 HCPCS,33999,Hc Atrial Septostomy Noncongen,2274.7,909.88,,,0 HCPCS,33999,Hc Azygos Vein Icd Coil Insert,1063.75,425.5,,,0 HCPCS,33999,Hc Iabp Reposition,1592.75,637.1,,,0 HCPCS,33999,Hc Laa Implant (Watchman) Leak Repair,21193.35,8477.34,,,0 HCPCS,33999,Hc Lava Ecmo,3312.0,1324.8,,,0 HCPCS,33999,Hc Pta Of Lvad Outflow Graft,1653.125,661.25,,,0 HCPCS,33999,Hc Reposition Loop Recorder,104.65,41.86,,,0 HCPCS,33999,Hc Temporary Pacer Repositioning,1868.75,747.5,,,0 HCPCS,33999,Hc Tricuspid Valve Rep Percut,1868.75,747.5,,,0 HCPCS,33999,Hc Unlisted-Aneurym Rpr Stent Vein,3100.4,1240.16,,,0 HCPCS,34101,Removal of artery clot,,,5434.3,13585.75,4 HCPCS,34111,Removal of arm artery clot,,,5434.3,13585.75,4 HCPCS,34201,Removal of artery clot,,,5434.3,13585.75,4 HCPCS,34203,Removal of leg artery clot,,,5434.3,13585.75,4 HCPCS,34421,Removal of vein clot,,,3083.61,7709.02,4 HCPCS,34471,Removal of vein clot,,,612.63,1531.57,4 HCPCS,34490,Removal of vein clot,,,3083.61,7709.02,4 HCPCS,34501,Repair valve femoral vein,,,5434.3,13585.75,4 HCPCS,34510,Transposition of vein valve,,,5434.3,13585.75,4 HCPCS,34520,Cross-over vein graft,,,5434.3,13585.75,4 HCPCS,34530,Leg vein fusion,,,3083.61,7709.02,4 HCPCS,35011,Repair defect of artery,,,5434.3,13585.75,4 HCPCS,35045,Repair defect of arm artery,,,5434.3,13585.75,4 HCPCS,35180,Repair blood vessel lesion,,,1537.33,3843.32,4 HCPCS,35184,Repair blood vessel lesion,,,3083.61,7709.02,4 HCPCS,35188,Repair blood vessel lesion,,,5434.3,13585.75,8 HCPCS,35190,Repair blood vessel lesion,,,5434.3,13585.75,8 HCPCS,35201,Repair blood vessel lesion,,,5434.3,13585.75,4 HCPCS,35206,Hc Repair Blood Vessel Direct Upper Extremity,5660.76,2264.3,,,0 HCPCS,35206,Repair blood vessel lesion,,,3083.61,7709.02,4 HCPCS,35207,Hc Repair Blood Vessel Direct Hand Or Finger,5635.0,2254.0,,,0 HCPCS,35207,Repair blood vessel lesion,,,3083.61,8800.0,8 HCPCS,35226,Hc Rpr Blood Vessel Direct Lower Extremity,1964.2,785.68,,,0 HCPCS,35226,Repair blood vessel lesion,,,691.56,1728.91,4 HCPCS,35231,Repair blood vessel lesion,,,3083.61,7709.02,4 HCPCS,35236,Repair blood vessel lesion,,,5434.3,13585.75,4 HCPCS,35256,Repair blood vessel lesion,,,5434.3,13585.75,4 HCPCS,35261,Repair blood vessel lesion,,,3083.61,7709.02,4 HCPCS,35266,Repair blood vessel lesion,,,5434.3,13585.75,4 HCPCS,35286,Repair blood vessel lesion,,,5434.3,13585.75,4 HCPCS,35321,Rechanneling of artery,,,5434.3,13585.75,4 HCPCS,35372,Rechanneling of artery,,,5434.3,13585.75,4 HCPCS,35800,Explore neck vessels,,,5434.3,13585.75,4 HCPCS,35860,Explore limb vessels,,,3083.61,7709.02,4 HCPCS,35875,Removal of clot in graft,,,5434.3,17190.0,8 HCPCS,35876,Removal of clot in graft,,,5434.3,17190.0,8 HCPCS,35879,Revise graft w/vein,,,5434.3,13585.75,4 HCPCS,35881,Revise graft w/vein,,,5434.3,13585.75,4 HCPCS,35883,Revise Graft w/Nonauto Graft,,,5434.3,13585.75,4 HCPCS,35884,Revise graft w/vein,,,5434.3,13585.75,4 HCPCS,35903,Excision graft extremity,,,3083.61,7709.02,4 HCPCS,36000,Hc Place Needle In Vein,560.05,224.02,,,0 HCPCS,36002,Hc Injection Rx Extremity Pseudoaneurysm,1106.3,442.52,,,0 HCPCS,36002,Hc Vasc Injection Rx Extremity Pseudoaneurysm,1106.3,442.52,,,0 HCPCS,36002,Pseudoaneurysm injection trt,,,612.63,2978.0,8 HCPCS,36005,"Hc Injection Procedure,Extremity,Venography",1442.1,576.84,,,0 HCPCS,36005,"Hc Vasc Injection Proc,Extremity,Venography",1442.1,576.84,,,0 HCPCS,36010,"Hc Place Cath In Vein,Svc,Ivc",2885.12,1154.05,,,0 HCPCS,36011,"Hc Place Cath In Vein,Select",2717.45,1086.98,,,0 HCPCS,36011,Hc Sel Cath Ven 1St Or Branchial-Unilateral,2717.45,1086.98,,,0 HCPCS,36012,"Hc Place Cath In Vein,Subselect-Unilateral",2923.3,1169.32,,,0 HCPCS,36013,Hc Cath Place Cath In Main Pulmonary Artery-Bilateral,1810.1,724.04,,,0 HCPCS,36014,"Hc Place Cath In Left/Right Heart,Main Pulmonary Artery-Unilateral",2375.9,950.36,,,0 HCPCS,36015,Hc Place Cath In Subsegment Pulmonary Artery-Unilateral,1906.7,762.68,,,0 HCPCS,36140,Hc Place Cath Extremity Artery,2661.01,1064.4,,,0 HCPCS,36147,Intro of needle/cath for dialysis,,,8330.0,9743.0,4 HCPCS,36200,Hc Place Cath Aorta,3375.85,1350.34,,,0 HCPCS,36215,Hc Place Cath Selective Artery/Neck,3945.14,1578.06,,,0 HCPCS,36216,Hc Place Cath Subselective Artery/Neck 2 Ord,5669.78,2267.91,,,0 HCPCS,36217,Hc Catheter Placement In Artery-Chest Or Arm-Third Order,5972.46,2388.98,,,0 HCPCS,36217,Hc Place Cath Subsubselect Artery/Neck 3 Ord,5972.46,2388.98,,,0 HCPCS,36218,Hc Catheter Placement In Artery-Chest Or Arm-Additional Second Order Or More,4031.44,1612.58,,,0 HCPCS,36218,Hc Place Cath Additional Subselective Artery/Abdomen/Pelvis,4031.44,1612.58,,,0 HCPCS,36221,Hc Catheter Nonselective Thoracic Aorta Angio Internal/Extracranal Arterial,12722.86,5089.14,,,0 HCPCS,36221,Place cath thoracic aorta,,,3083.61,7709.02,4 HCPCS,36222,Hc Selective Cath Carotid/Innom Arterial Angio Extrcranial Arterial Unilateral,14099.74,5639.9,,,0 HCPCS,36222,Hc Slctv Cath Carotid/Innom Art Angio Xtrcranl Art Bilateral,21148.96,8459.58,,,0 HCPCS,36222,Place cath carotid/inom art,,,3083.61,7709.02,4 HCPCS,36223,Hc Selective Cath Carotid/Innom Arterial Angio Intracranial Arterial,16172.13,6468.85,,,0 HCPCS,36223,Hc Selective Cath Carotid/Innom Artery Angio Intracranial Artery-Bilateral,24259.48,9703.79,,,0 HCPCS,36223,Place cath carotid/inom art,,,5434.3,13585.75,4 HCPCS,36224,Hc Selective Cath Intracarotid Arterial Angio,18741.69,7496.68,,,0 HCPCS,36224,Hc Selective Cath Intrnl Carotid Artery Angio Intracranial Artery-Bilateral,28110.6,11244.24,,,0 HCPCS,36224,Place cath carotd art,,,5434.3,17190.0,8 HCPCS,36225,Hc Selective Cath Subclavian Artery Angio Vertebral Artery-Unilateral,14201.49,5680.6,,,0 HCPCS,36225,Hc Slctv Cath Subclavian Art Angio Vertebral Artery - Bilateral,21303.52,8521.41,,,0 HCPCS,36225,Place cath subclavian art,,,3083.61,7709.02,4 HCPCS,36226,Hc Selective Cath Vertebral Artery Angio Vertebral Artery,18569.1,7427.64,,,0 HCPCS,36226,Hc Slctv Cath Vertebral Art Angio Vertebral Artery,27854.29,11141.72,,,0 HCPCS,36226,Place cath vertebral art,,,5434.3,17190.0,8 HCPCS,36227,Hc Cath Slctv Cath Xtrnl Carotid Angio Xtrnl Carotd Circ,11488.5,4595.4,,,0 HCPCS,36227,Hc Selective Cath External Carotid Angio External Carotd Circ-Bilateral,17233.44,6893.38,,,0 HCPCS,36227,Hc Selective Cath Extracarotid Angio Circ-Unilateral,12867.12,5146.85,,,0 HCPCS,36228,Hc Selective Cath Intrcarotid Branch Angio Intracaroid,8092.5,3237.0,,,0 HCPCS,36245,Hc Catheter Selective Placement Into Abdominal/Pelvic/Leg Artery-First Order,3625.95,1450.38,,,0 HCPCS,36245,Hc Place Cath Selective Artery/Abdomen/Pelvis,4061.06,1624.42,,,0 HCPCS,36246,Hc Place Cath Subselective Artery/Abdomen/Pelvis,5756.07,2302.43,,,0 HCPCS,36247,Hc Catheter Selective Placement Into Abdominal/Pelvic/Leg Artery-Third Order,5467.1,2186.84,,,0 HCPCS,36247,"Hc Place Cath Subsubselect Art,Abd/Pel",6123.15,2449.26,,,0 HCPCS,36247,"Hc Place Cath Subsubselect Artery, Abdomen/Pelvis",6123.15,2449.26,,,0 HCPCS,36248,Hc Place Cath Additional Subselective Artery/Abdomen/Pelvis,3594.81,1437.92,,,0 HCPCS,36251,Hc Selective Cath 1Stord W/Wo Art Punct/Fluor/S&I Unilateral,10883.6,4353.44,,,0 HCPCS,36251,Ins cath ren art 1st unilat,,,3083.61,7709.02,4 HCPCS,36252,Hc Selective Cath 1Stord W/Wo Art Punct/Fluor/S&I Bilateral,16320.25,6528.1,,,0 HCPCS,36252,Ins cath ren art 1st bilat,,,3083.61,7709.02,4 HCPCS,36253,Hc Supslctv Cath 2Nd+Ord Renl&Acces Artery/S&I Uni,13669.54,5467.82,,,0 HCPCS,36253,Ins cath ren art 2nd+ unilat,,,5434.3,13585.75,4 HCPCS,36254,Hc Insertion Of Catheters Into Main/Accessory Arteries Of Both Kidneys For Imaging,15764.0,6305.6,,,0 HCPCS,36254,Ins cath ren art 2nd+ bilat,,,3083.61,7709.02,4 HCPCS,36260,Insertion of infusion pump,,,5434.3,13585.75,8 HCPCS,36261,Revision of infusion pump,,,3470.0,9123.83,8 HCPCS,36262,Removal of infusion pump,,,2546.0,9123.83,8 HCPCS,36299,Hc Jugular Injection,1366.2,546.48,,,0 HCPCS,36299,Hc Radi Of Renal Arteries,2584.05,1033.62,,,0 HCPCS,36410,Hc Non-Routine Blood Draw 3/> Years,338.23,135.29,,,0 HCPCS,36415,"Hc Chg Collection Venous Blood,Venipuncture",36.0,14.4,,,0 HCPCS,36415,"Hc Chg Collection Venous Blood,Venipuncture - Draw Charge",36.0,14.4,,,0 HCPCS,36415,"Hc Collection Venous Blood,Venipuncture - Bundled Charge",36.0,14.4,,,0 HCPCS,36415,Routine venipuncture,,,3.6,23.35,16 HCPCS,36416,Capillary blood draw,,,3.44,5.0,5 HCPCS,36416,Hc Collection Capillary Blood Specimen,27.0,10.8,,,0 HCPCS,36416,Hc Collection Capillary Blood Specimen - Bundled Charge,36.0,14.4,,,0 HCPCS,36420,Vein access cutdown < 1 yr,,,129.94,324.84,4 HCPCS,36425,Vein access cutdown > 1 yr,,,436.27,1090.68,4 HCPCS,36430,Blood transfusion service,,,430.85,1077.13,4 HCPCS,36430,Hc Blood Transfusion Service,3938.19,1575.28,,,0 HCPCS,36440,Bl push transfuse 2 yr/<,,,430.85,1077.13,4 HCPCS,36450,Bl exchange/transfuse nb,,,430.85,1077.13,4 HCPCS,36450,Hc Exchange Transfus-Nbn,3378.5,1351.4,,,0 HCPCS,36455,Bl exchange/transfuse non-nb,,,430.85,1077.13,4 HCPCS,36456,Prtl exchange transfuse nb,,,430.85,2978.0,8 HCPCS,36460,Hc Transfusion Intrauterine Fetal,2127.5,851.0,,,0 HCPCS,36460,Transfusion service fetal,,,430.85,2978.0,8 HCPCS,36465,Njx noncmpnd sclrsnt 1 vein,,,2015.01,5037.52,8 HCPCS,36466,Njx noncmpnd sclrsnt mlt vn,,,2015.01,5037.52,4 HCPCS,36468,Hc Injections Sclerosant For Spider Veins Lim/Trnk,635.38,254.15,,,0 HCPCS,36468,Injection(s) spider veins,,,397.0,992.51,4 HCPCS,36470,"Hc Injection Therapy Vein,One Vein-Unilateral",2268.81,907.52,,,0 HCPCS,36470,Injection therapy of vein,,,397.0,2978.0,8 HCPCS,36471,"Hc Injection Therapy Vein,Mult Veins Bilateral",1817.0,726.8,,,0 HCPCS,36471,Hc Multi Vein Sclerotherapy Unilateral,2362.1,944.84,,,0 HCPCS,36471,Injection therapy of veins,,,397.0,2978.0,8 HCPCS,36471,Noncdm Charge Record,1764.1,705.64,,,0 HCPCS,36473,Endovenous mchnchem 1st vein,,,3083.61,9743.0,8 HCPCS,36475,Endovenous rf 1st vein,,,3083.61,17190.0,8 HCPCS,36475,"Hc Endovenous Rf, 1St Vein",4223.37,1689.35,,,0 HCPCS,36476,Endovenous rf vein add-on,,,14697.0,17190.0,4 HCPCS,36478,Endovenous laser 1st vein,,,3083.61,17190.0,8 HCPCS,36479,Endovenous laser vein addon,,,14697.0,17190.0,4 HCPCS,36481,Hc Percut Portal Vein Cath,2633.5,1053.4,,,0 HCPCS,36482,Endoven ther chem adhes 1st,,,5434.3,13585.75,4 HCPCS,36500,Hc Organ Vein Sampling Bilateral,4405.55,1762.22,,,0 HCPCS,36500,Hc Venous Select Sampling W Cath-Unilateral,2936.07,1174.43,,,0 HCPCS,36511,Apheresis wbc,,,1520.99,3802.47,4 HCPCS,36511,"Hc Ther Apheresis,White Blood Cells",9686.4,3874.56,,,0 HCPCS,36512,Apheresis rbc,,,1520.99,8800.0,8 HCPCS,36512,"Hc Ther Apheresis,Red Blood Cells",10230.58,4092.23,,,0 HCPCS,36513,Apheresis platelets,,,430.85,1077.13,4 HCPCS,36513,"Hc Ther Apheresis,Platelets",9507.24,3802.9,,,0 HCPCS,36514,Apheresis plasma,,,1520.99,3802.47,4 HCPCS,36514,Hc Charge Therapeutic Plasma Exchange,9952.63,3981.05,,,0 HCPCS,36514,Hc Therapeutic Plasma Exchange,9952.63,3981.05,,,0 HCPCS,36516,Apheresis selective,,,4253.6,10634.01,4 HCPCS,36522,Hc Photopheresis Extracorporeal,15514.93,6205.97,,,0 HCPCS,36522,Photopheresis,,,4253.6,17190.0,8 HCPCS,36555,Hc Cvvhd Adult Daily Line Charge Inpatient,6225.41,2490.16,,,0 HCPCS,36555,Hc Insert Non-Tunnel Cv Cath < 5 Y/O,6225.41,2490.16,,,0 HCPCS,36555,Hc Insert Picc < 5 Yrs Old,6225.41,2490.16,,,0 HCPCS,36555,Insert non-tunnel cv cath,,,2546.0,7709.02,8 HCPCS,36556,Hc Insert Deepline >5 Years,6459.83,2583.93,,,0 HCPCS,36556,Hc Insert Non-Tunnel Cv Cath,5507.9349999999995,2203.175,,,0 HCPCS,36556,Insert non-tunnel cv cath,,,2546.0,7709.02,8 HCPCS,36557,Insert tunneled cv cath,,,3470.0,13585.75,8 HCPCS,36558,Hc Insert Tunneled Cv Cath W/O Port Or Pump,10106.68,4042.67,,,0 HCPCS,36558,Insert tunneled cv cath,,,3083.61,7709.02,8 HCPCS,36560,Insert tunneled cv cath,,,3083.61,9743.0,8 HCPCS,36561,Hc Insert Tunneled Cv Cath With Port,13090.45,5236.18,,,0 HCPCS,36561,Insert tunneled cv cath,,,3083.61,9743.0,8 HCPCS,36563,Insert tunneled cv cath,,,5434.3,13585.75,8 HCPCS,36565,Insert tunneled cv cath,,,3083.61,9743.0,8 HCPCS,36566,Insert tunneled cv cath,,,5434.3,13585.75,8 HCPCS,36568,Hc Insert Picc W/O Sub-Q Port <5 Y/O,6488.3,2595.32,,,0 HCPCS,36568,Insert picc cath,,,1537.33,3843.32,8 HCPCS,36569,Hc Insert Picc W/O Sub-Q Port,6545.23,2618.09,,,0 HCPCS,36569,Insert picc cath,,,1537.33,3843.32,8 HCPCS,36570,Insert picvad cath,,,3083.61,9743.0,8 HCPCS,36571,Hc Insert Picc W/ Sub-Q Port,9805.29,3922.12,,,0 HCPCS,36571,Insert picvad cath,,,3083.61,9743.0,8 HCPCS,36572,Hc Insertion Picc W/Rs&I < 5 Yr,6320.86,2528.34,,,0 HCPCS,36572,Insj picc rs&i <5 yr,,,612.63,1531.57,4 HCPCS,36573,Hc Insertion Picc W/Rs&I 5 Yr/>,7107.83,2843.13,,,0 HCPCS,36573,Insj picc rs&i 5 yr+,,,1537.33,4059.0,8 HCPCS,36575,Hc Repair Cv Cath W/O Subq Port Or Pump,4842.3,1936.92,,,0 HCPCS,36575,Repair tunneled cv cath,,,612.63,4059.0,8 HCPCS,36576,Hc Repair Cv Cath W Subq Port Or Pump,4842.3,1936.92,,,0 HCPCS,36576,Repair tunneled cv cath,,,1537.33,4059.0,8 HCPCS,36578,"Hc Replace Cv Cath, Catheter Only W Subq Pump Or Port",4695.8,1878.32,,,0 HCPCS,36578,Replace tunneled cv cath,,,3083.61,7709.02,8 HCPCS,36580,"Hc Replace Cv Cath, Complete, Non-Tunneled, W/O Subq Port Or Pump",6188.58,2475.43,,,0 HCPCS,36580,Replace cvad cath,,,1537.33,3843.32,8 HCPCS,36581,"Hc Replace Cv Cath, Complete, Tunneled, W/O Subq Port Or Pump",9624.45,3849.78,,,0 HCPCS,36581,Replace tunneled cv cath,,,3083.61,7709.02,8 HCPCS,36582,"Hc Replace Cv Cath, Complete, Non-Tunneled, W Subq Port Or Pump",11035.97,4414.39,,,0 HCPCS,36582,Replace tunneled cv cath,,,3083.61,9743.0,8 HCPCS,36583,Replace tunneled cv cath,,,5434.3,13585.75,8 HCPCS,36584,Hc Replace Picc W/O Port Or Pump,6329.23,2531.69,,,0 HCPCS,36584,Replace picc cath,,,1537.33,3843.32,8 HCPCS,36585,Hc Replace Picc W Port Or Pump,5556.92,2222.77,,,0 HCPCS,36585,Replace picvad cath,,,3083.61,9743.0,8 HCPCS,36589,Hc Cath Removal Tunneled Cv Cath W/O Subq Port Or Pump,4247.3,1698.92,,,0 HCPCS,36589,Hc Removal Tunneled Cv Cath W/O Subq Port Or Pump,4756.97,1902.79,,,0 HCPCS,36589,Removal tunneled cv cath,,,612.63,2978.0,8 HCPCS,36590,Hc Cath Removal Tunneled Cv Cath W Subq Port Or Pump,5014.23,2005.69,,,0 HCPCS,36590,Hc Removal Tunneled Cv Cath W Subq Port Or Pump,5615.94,2246.38,,,0 HCPCS,36590,Removal tunneled cv cath,,,1537.33,3843.32,8 HCPCS,36591,Draw blood off venous device,,,5.0,324.84,8 HCPCS,36591,Hc Chg Collect Blood From Implant Venous Access Device - Draw Charge,515.71,206.28,,,0 HCPCS,36591,Hc Collect Blood From Implant Venous Access Device - Bundled Charge,515.71,206.28,,,0 HCPCS,36591,Hc Collect Blood From Implant Venous Access Device - Draw Charge,460.46,184.18,,,0 HCPCS,36591,Noncdm Charge Record,396.7,158.68,,,0 HCPCS,36592,Collect blood from picc,,,10.48,324.84,8 HCPCS,36592,Hc Chg Collect Blood From Catheter Venous Nos,376.74,150.7,,,0 HCPCS,36592,Hc Chg Collect Blood From Catheter Venous Nos - Draw Charge,421.95,168.78,,,0 HCPCS,36592,Hc Collect Blood From Catheter Venous Nos - Bundled Charge,421.95,168.78,,,0 HCPCS,36592,Hc Collect Blood From Catheter Venous-Draw Charge,421.95,168.78,,,0 HCPCS,36593,Declot vascular device,,,322.58,806.45,4 HCPCS,36593,Hc Declot By Thrombolytic Agent Implant Device/Cath,1635.89,654.36,,,0 HCPCS,36595,Hc Mech Remov Pericath Obstr Cv Dev Via Ven Access,8504.28,3401.71,,,0 HCPCS,36595,Mech remov tunneled cv cath,,,3083.61,7709.02,4 HCPCS,36596,Hc Mech Remov Intralum Obstr Cv Dev Thru Lumen,1302.0,520.8,,,0 HCPCS,36596,Mech remov tunneled cv cath,,,1537.33,3843.32,4 HCPCS,36597,Hc Reposition Venous Catheter,3675.31,1470.12,,,0 HCPCS,36597,Reposition venous catheter,,,1537.33,3843.32,4 HCPCS,36598,"Hc Contrast Injection Central Venous Cath, Including Flouro",1233.9,493.56,,,0 HCPCS,36598,Inj w/fluor eval cv device,,,207.73,519.32,4 HCPCS,36600,Hc Rt Arterial Puncture For Abg,242.19,96.88,,,0 HCPCS,36600,Hc Withdrawal Of Arterial Blood,242.19,96.88,,,0 HCPCS,36600,Hc Withdrawal Of Arterial Blood - Bundled Charge,271.26,108.5,,,0 HCPCS,36600,Hc Withdrawal Of Arterial Blood - Draw Charge,271.26,108.5,,,0 HCPCS,36600,Withdrawal of arterial blood,,,21.1,324.84,8 HCPCS,36620,"Hc Insert Cath,Art,Percut,Shortterm",1452.45,580.98,,,0 HCPCS,36625,Hc Insertion Catheter Artery,1255.8,502.32,,,0 HCPCS,36640,Insertion catheter artery,,,2546.0,7709.02,8 HCPCS,36680,"Hc Insert Needle,Intraosseous Infusn",1118.49,447.4,,,0 HCPCS,36680,Insert needle bone cavity,,,436.27,2978.0,8 HCPCS,36800,Insertion of cannula,,,5434.3,13585.75,8 HCPCS,36810,Insertion of cannula,,,3083.61,9743.0,8 HCPCS,36815,Insertion of cannula,,,5434.3,13585.75,8 HCPCS,36818,Av fuse uppr arm cephalic,,,5434.3,13585.75,8 HCPCS,36819,Av fuse uppr arm basilic,,,5434.3,13585.75,8 HCPCS,36820,Av fusion/forearm vein,,,5434.3,13585.75,8 HCPCS,36821,Av fusion direct any site,,,3083.61,9743.0,8 HCPCS,36825,Artery-vein autograft,,,5434.3,13585.75,8 HCPCS,36830,Artery-vein nonautograft,,,5434.3,13585.75,8 HCPCS,36831,Open thrombect av fistula,,,5434.3,17190.0,8 HCPCS,36832,Av fistula revision open,,,5434.3,13585.75,8 HCPCS,36833,Av fistula revision,,,5434.3,13585.75,8 HCPCS,36834,Repair A-V aneurysm,,,8330.0,9743.0,4 HCPCS,36835,Artery to vein shunt,,,3083.61,8800.0,8 HCPCS,36836,Prq av fstl crtj uxtr 1 acs,,,17902.75,44756.89,4 HCPCS,36837,Prq av fstl crt uxtr sep acs,,,7391.0,44756.89,8 HCPCS,36838,Dist revas ligation hemo,,,5434.3,13585.75,4 HCPCS,36860,External cannula declotting,,,1537.33,4059.0,8 HCPCS,36861,Cannula declotting,,,5434.3,13585.75,8 HCPCS,36870,"Av Fistula Revision, Open",,,14697.0,17190.0,4 HCPCS,36901,Hc Cath Intro Cath Dialysis Circuit Dx Angrph Fluor S&I,4090.55,1636.22,,,0 HCPCS,36901,Hc Intro Cath Dialysis Circuit Dx Angrph Fluor S&I,4090.55,1636.22,,,0 HCPCS,36901,Intro cath dialysis circuit,,,1537.33,4059.0,8 HCPCS,36902,Hc Cath Intro Cath Dialysis Circuit W/Trluml Balo Angiop,19942.15,7976.86,,,0 HCPCS,36902,Hc Intro Cath Dialysis Circuit W/Trluml Balo Angiop,52636.65,21054.66,,,0 HCPCS,36902,Intro cath dialysis circuit,,,5558.41,13896.01,8 HCPCS,36903,Hc Intro Cath Dialysis Circuit W/Tcat Plmt Iv Stent,35160.1,14064.04,,,0 HCPCS,36903,Intro cath dialysis circuit,,,7639.0,28185.26,8 HCPCS,36904,Hc Vasc Perq Thrmbc/Nfs Dialysis Circuit Img Dx Angrph,15047.75,6019.1,,,0 HCPCS,36904,Thrmbc/nfs dialysis circuit,,,5558.41,13896.01,8 HCPCS,36905,Hc Percutaneous Transluminal Mechanical Thrombectomy And/Or Infusion With Balloon Angioplasty,28643.05,11457.22,,,0 HCPCS,36905,Hc Vasc Perq Thrmbc/Nfs Dial Circuit Trluml Balo Angiop,28643.05,11457.22,,,0 HCPCS,36905,Thrmbc/nfs dialysis circuit,,,7639.0,28185.26,8 HCPCS,36906,Hc Cath Perq Thrmbc/Nfs Dial Circuit Tcat Plmt Iv Stent,41971.55,16788.62,,,0 HCPCS,36906,Hc Perq Thrmbc/Nfs Dial Circuit Tcat Plmt Iv Stent,1558.25,623.3,,,0 HCPCS,36906,Thrmbc/nfs dialysis circuit,,,14697.0,44756.89,8 HCPCS,36907,Hc Cath Trluml Balo Angiop Ctr Dialysis Seg W/Img S&I,17484.6,6993.84,,,0 HCPCS,36907,Hc Trluml Baloon Angioplasty Ctr Dialysis Seg W/Img S&I,17484.6,6993.84,,,0 HCPCS,36907,Hc Vasc Trluml Balo Angiop Ctr Dialysis Seg W/Img S&I,17484.6,6993.84,,,0 HCPCS,36908,Hc Tcat Plmt Iv Stent Ctr Dialysis Seg W/Img S&I,19599.45,7839.78,,,0 HCPCS,36909,Hc Dialyis Circuit Vasc Emboli Occls Evasc Img S&I,6259.45,2503.78,,,0 HCPCS,36909,Hc Vasc Dialyis Circuit Vasc Emboli Occls Evasc Img S&I,6259.45,2503.78,,,0 HCPCS,37182,Hc Insert Transven Intrahep Portosys Shunt,55216.69,22086.68,,,0 HCPCS,37182,Insert hepatic shunt (tips),,,17902.75,44756.89,4 HCPCS,37183,Hc Revis Transven Intrahep Portosys Shunt,46987.02,18794.81,,,0 HCPCS,37183,Remove hepatic shunt (tips),,,5558.41,13896.01,4 HCPCS,37184,Hc Removal Of Blood Clot And Injections To Dissolve Blood Clots From Artery Using Fluoroscopic Guida,16589.38,6635.75,,,0 HCPCS,37184,Prim art m-thrmbc 1st vsl,,,17902.75,44756.89,4 HCPCS,37185,Hc Prim Prq Trluml Mchnl Thrmbc N-Cor N-Icra Sbsq,8430.43,3372.17,,,0 HCPCS,37187,"Hc Vasc Percut Mech Thrombectomy, Venous",12802.94,5121.18,,,0 HCPCS,37187,Venous mech thrombectomy,,,11274.1,28185.26,4 HCPCS,37188,Venous m-thrombectomy add-on,,,3083.61,7709.02,4 HCPCS,37191,Hc Insert Intravascular Vc Filter W/Wo Vascular Access Vsl Selxn Rs&I,19364.58,7745.83,,,0 HCPCS,37191,Hc Vasc Ins Intrvas Vc Filtr W/Wo Vas Acs Vsl Selxn Rs&I,19364.58,7745.83,,,0 HCPCS,37191,Ins endovas vena cava filtr,,,5434.3,13585.75,4 HCPCS,37192,Redo endovas vena cava filtr,,,3083.61,7709.02,4 HCPCS,37193,Hc Rtrvl Intrvas Vc Filtr W/Wo Acs Vsl Selxn Rs&I,11505.75,4602.3,,,0 HCPCS,37193,Hc Vasc Rtrvl Intrvas Vc Filtr W/Wo Acs Vsl Selxn Rs&I,12886.44,5154.58,,,0 HCPCS,37193,Rem endovas vena cava filter,,,3083.61,7709.02,4 HCPCS,37195,Thrombolytic therapy stroke,,,322.58,2978.0,8 HCPCS,37197,Hc Prq Transcatheter Rtrvl Intrvas Fb With Imaging,11573.36,4629.34,,,0 HCPCS,37197,Hc Vasc Prq Transcatheter Rtrvl Intrvas Fb With Imaging,11573.36,4629.34,,,0 HCPCS,37197,Remove intrvas foreign body,,,3083.61,7709.02,4 HCPCS,37200,Hc Transcatheter Biopsy,8309.77,3323.91,,,0 HCPCS,37200,Transcatheter biopsy,,,5434.3,13585.75,4 HCPCS,37211,"Hc Cardiac Thrombolysis Therapy, Initial Bilateral",18311.19,7324.48,,,0 HCPCS,37211,Hc Catheter Insertion Into Artery For Thrombolysis Arterial Infusion Under Imaging,15259.24,6103.7,,,0 HCPCS,37211,Thrombolytic art therapy,,,5434.3,13585.75,4 HCPCS,37212,Hc Thrombolysis Arterial Infusion Icra Rs&I Initial Treatment,8999.26,3599.7,,,0 HCPCS,37212,Hc Thrombolysis Venous Infusion With Imaging Initial Treatment,8999.26,3599.7,,,0 HCPCS,37212,Thrombolytic venous therapy,,,3083.61,7709.02,4 HCPCS,37213,Hc Catheter Insertion Into Artery/Vein For Drug Infusion For Thrombolysis Under Imaging,8335.62,3334.25,,,0 HCPCS,37213,Hc Vasc Thrombolysis Art/Venous Infsn W/Image Subsq Tx,8335.62,3334.25,,,0 HCPCS,37213,Thromblytic art/ven therapy,,,3083.61,7709.02,4 HCPCS,37214,Cessj therapy cath removal,,,3083.61,7709.02,4 HCPCS,37214,"Hc Cardiac Thrombolysis Therapy, Cessation",8729.02,3491.61,,,0 HCPCS,37215,Hc Cath Tcat Iv Stent Crv Crtd Art Embolic Protecj,24814.41,9925.76,,,0 HCPCS,37215,Hc Tcat Iv Stent Crv Crtd Art Embolic Protecj,24814.41,9925.76,,,0 HCPCS,37216,Hc Cath Tcat Iv Stent Crv Crtd Art W/O Embolic Protecj,19426.34,7770.54,,,0 HCPCS,37216,Hc Tcat Iv Stent Crv Crtd Art W/O Embolic Protecj,19426.34,7770.54,,,0 HCPCS,37216,Hc Vasc Tcat Iv Stent Crv Crtd Art W/O Embolic Protecj,19426.34,7770.54,,,0 HCPCS,37218,Hc Tcath Stent Placemt Antegrade Carotid/Innominate,18431.05,7372.42,,,0 HCPCS,37220,"Hc Revascularize Iliac Artery,Angioplasty, Initial Vessel",21656.8,8662.72,,,0 HCPCS,37220,"Hc Revascularize Iliac Artery,Angioplasty, Initial Vessel-Unilateral",21656.8,8662.72,,,0 HCPCS,37221,"Hc Revascularize Iliac Artery,Angioplasty/Stent, Initial Vessel",35091.1,14036.44,,,0 HCPCS,37223,"Hc Revascularize Iliac Artery,Angioplasty/Stent, Each Additional Vessel",29548.1,11819.24,,,0 HCPCS,37224,"Hc Revascularize Fem/Pop Artery,Angioplasty",22870.05,9148.02,,,0 HCPCS,37225,"Hc Revascularize Fem/Pop Artery,Angioplasty/Atherectomy",35807.55,14323.02,,,0 HCPCS,37226,"Hc Revascularize Fem/Pop Artery,Angioplasty/Stent",41610.45,16644.18,,,0 HCPCS,37227,"Hc Revascularize Fem/Pop Artery,Angioplasty/Stent/Atherectomy",61007.5,24403.0,,,0 HCPCS,37228,"Hc Revascularize Tibial/Peron Artery,Angioplasty Initial",23580.75,9432.3,,,0 HCPCS,37236,Hc Open/Perq Placement Intravascular Stent Initial-Unilateral,30432.45,12172.98,,,0 HCPCS,37236,Open/perq place stent 1st,,,11274.1,28185.26,4 HCPCS,37237,Hc Open/Perq Placement Intravascular Stent Each Additional,19328.05,7731.22,,,0 HCPCS,37238,Hc Open/Perq Placement Intravascular Stent Same 1St,30545.15,12218.06,,,0 HCPCS,37238,Open/perq place stent same,,,11274.1,28185.26,4 HCPCS,37239,Hc Catheter Open/Percutaneous Placement Intravascular Stent Same Each Additional,21454.22,8581.69,,,0 HCPCS,37239,Hc Open/Perq Placement Intravascular Stent Same Each Additional-Unilateral,19155.55,7662.22,,,0 HCPCS,37241,Hc Vascular Embolization Or Occlusion Venous Rs&I,39365.49,15746.2,,,0 HCPCS,37241,Vasc embolize/occlude venous,,,11274.1,28185.26,4 HCPCS,37242,Hc Vascular Embolization Or Occlusion Arterial Rs&I,40925.46,16370.18,,,0 HCPCS,37242,Vasc embolize/occlude artery,,,17902.75,44756.89,4 HCPCS,37243,Hc Vasc Vascular Embolize/Occlude Organ Tumor Infarct,38460.53,15384.21,,,0 HCPCS,37243,Hc Vascular Embolize/Occlude Organ Tumor Infarct,38460.53,15384.21,,,0 HCPCS,37243,Vasc embolize/occlude organ,,,11274.1,28185.26,4 HCPCS,37244,Hc Vasc Vascular Embolization Or Occlusion Hemorrhage,35408.11,14163.24,,,0 HCPCS,37244,Hc Vascular Embolization Or Occlusion Hemorrhage,35408.11,14163.24,,,0 HCPCS,37244,Vasc embolize/occlude bleed,,,11274.1,28185.26,4 HCPCS,37246,Hc Cath Trlml Balo Angiop Open/Perq Img S&I 1St Art,20861.74,8344.7,,,0 HCPCS,37246,Hc Trlml Baloon Angioplasty Open/Perq Image S&I 1St Artery,18626.55,7450.62,,,0 HCPCS,37246,Trluml balo angiop 1st art,,,5558.41,13896.01,8 HCPCS,37247,Hc Cath Trlml Balo Angiop Open/Perq Img S&I Ea Addl Art,10317.8,4127.12,,,0 HCPCS,37248,Hc Transluminal Balloon Angioplasty Including Imaging Inital Vein,21544.38,8617.75,,,0 HCPCS,37248,Hc Trlml Baloon Angioplasty Open/Perq Image S&I 1St Vein,19236.05,7694.42,,,0 HCPCS,37248,Trluml balo angiop 1st vein,,,5558.41,13896.01,8 HCPCS,37249,Hc Transluminal Balloon Angioplasty Including Imaging Each Additional Vein,10879.74,4351.9,,,0 HCPCS,37249,Hc Trlml Baloon Angioplasty Open/Perq Image S&I Additional Vein,10879.74,4351.9,,,0 HCPCS,37249,Hc Vasc Trlml Balo Angiop Open/Perq W/Img S&I Addl Vein,9714.05,3885.62,,,0 HCPCS,37252,Hc Intravascular Us Noncoronary Rs&I Intial Vessel,5492.23,2196.89,,,0 HCPCS,37252,Hc Vasc Intravascular Us Noncoronary Rs&I Intial Vessel,5492.23,2196.89,,,0 HCPCS,37254,"Hc Revascularize Iliac Artery,Angioplasty, Initial Vessel",21656.0,8662.4,,,0 HCPCS,37254,Revsc evasc ivt angio sf 1st,,,5558.41,13896.01,4 HCPCS,37256,Hc Endovascular Revasularization Of Femoral/Popliteal/Tibial/Peroneal Artery With Transluminal Angio,14437.0,5774.8,,,0 HCPCS,37256,Revsc evasc ivt angio cplx 1,,,5558.41,13896.01,4 HCPCS,37258,"Hc Endovascular Revasularization Transluminal Stent Placement In Iliac Artery, Inital",35091.1,14036.44,,,0 HCPCS,37258,Revsc evasc ivt stent sf 1st,,,11274.1,28185.26,4 HCPCS,37259,"Hc Endovascular Revasularization Of Transluminal Stents Into Iliac Artery, Add On",29548.1,11819.24,,,0 HCPCS,37260,"Hc Endovascular Revasularization Stent Placement In Iliac Artery With Transluminal Angioplasty, Init",46788.0,18715.2,,,0 HCPCS,37260,Revsc evasc ivt st cplx 1st,,,11274.1,28185.26,4 HCPCS,37261,"Hc Endovascular Revasularization Transluminal Stent Placement In Iliac Artery, Each Additional",39397.0,15758.8,,,0 HCPCS,37263,Revsc evasc fpvt angio sf 1,,,5558.41,13896.01,4 HCPCS,37265,Revsc evsc fpvt angio cplx 1,,,5558.41,13896.01,4 HCPCS,37267,Revsc evsc fpvt stent sf 1st,,,11274.1,28185.26,4 HCPCS,37269,Revsc evasc fpvt st cplx 1st,,,11274.1,28185.26,4 HCPCS,37271,Revsc evsc fpvt athrc sf 1st,,,17902.75,44756.89,4 HCPCS,37273,Revsc evsc fpvt athrc cplx 1,,,17902.75,44756.89,4 HCPCS,37275,Rvsc evsc fpvt st athrc sf 1,,,17902.75,44756.89,4 HCPCS,37277,Rvsc evsc fpvt st athr cpx 1,,,17902.75,44756.89,4 HCPCS,37280,Revsc evsc tpvt angio sf 1st,,,11274.1,28185.26,4 HCPCS,37282,Rvsc evsc tpvt angio cplx 1,,,11274.1,28185.26,4 HCPCS,37284,Revsc evasc tpvt st sf 1st,,,17902.75,44756.89,4 HCPCS,37286,Revsc evasc tpvt st cplx 1st,,,17902.75,44756.89,4 HCPCS,37288,Revsc evsc tpvt athrc sf 1st,,,17902.75,44756.89,4 HCPCS,37290,Revsc evsc tpvt athrc cplx 1,,,17902.75,44756.89,4 HCPCS,37292,Rvsc evsc tpvt st athrc sf 1,,,17902.75,44756.89,4 HCPCS,37294,Rvsc evsc tpvt st athr cpx 1,,,17902.75,44756.89,4 HCPCS,37296,Revsc evasc imvt angio sf 1,,,11274.1,28185.26,4 HCPCS,37298,Revsc evsc imvt angio cplx 1,,,11274.1,28185.26,4 HCPCS,37500,Endoscopy ligate perf veins,,,8330.0,9743.0,4 HCPCS,37501,Vascular endoscopy procedure,,,612.63,1531.57,4 HCPCS,37565,Ligation of neck vein,,,3083.61,7709.02,4 HCPCS,37600,Ligation of neck artery,,,3083.61,7709.02,4 HCPCS,37605,Ligation of neck artery,,,3083.61,7709.02,4 HCPCS,37606,Ligation of neck artery,,,3083.61,7709.02,4 HCPCS,37607,Hc Ligation Of Av Fistula,5512.64,2205.06,,,0 HCPCS,37607,Ligation of a-v fistula,,,3083.61,9743.0,8 HCPCS,37609,Temporal artery procedure,,,1612.96,4059.0,8 HCPCS,37615,Ligation of neck artery,,,3083.61,7709.02,4 HCPCS,37617,Ligation of abdomen artery,,,5434.3,13585.75,4 HCPCS,37618,Hc Ligation Major Artery Extremit,4025.0,1610.0,,,0 HCPCS,37619,Ligation of inf vena cava,,,5434.3,13585.75,4 HCPCS,37650,Revision of major vein,,,3083.61,7709.02,8 HCPCS,37700,Revise leg vein,,,3083.61,7709.02,8 HCPCS,37718,Ligate/strip short leg vein,,,3083.61,9743.0,8 HCPCS,37722,Ligate/strip long leg vein,,,3083.61,9743.0,8 HCPCS,37735,Removal of leg veins/lesion,,,3083.61,9743.0,8 HCPCS,37760,Ligate leg veins radical,,,3083.61,9743.0,8 HCPCS,37761,Ligate leg veins open,,,3083.61,9743.0,8 HCPCS,37765,Stab phleb veins xtr 10-20,,,3083.61,7709.02,4 HCPCS,37766,Phleb veins - extrem 20+,,,3083.61,12101.0,8 HCPCS,37780,Revision of leg vein,,,3083.61,9743.0,8 HCPCS,37785,Ligate/divide/excise vein,,,3083.61,9743.0,8 HCPCS,37790,Penile venous occlusion,,,3442.51,9743.0,8 HCPCS,37799,Hc Angiovac Valve Endocarditis,2557.6,1023.04,,,0 HCPCS,37799,Hc Chg Vascular Surgery Procedure Unlist - Draw Charge,322.0,128.8,,,0 HCPCS,37799,Hc Direct Stick Face Therapy,1555.95,622.38,,,0 HCPCS,37799,Hc Inout Cv Non-Tunnel Insrt 5+,1288.0,515.2,,,0 HCPCS,37799,Hc Inout Cv Tun W/Subqport Ins 5+,2626.6,1050.64,,,0 HCPCS,37799,Hc Inout Cv Tunl Insrt 5+Yr,2565.65,1026.26,,,0 HCPCS,37799,Hc Insrt Cerebral Embol Protect,1817.0,726.8,,,0 HCPCS,37799,Hc Pta Of Fibrin Sheath,1121.25,448.5,,,0 HCPCS,37799,Hc Stent Insert Lvad Graft,2475.95,990.38,,,0 HCPCS,37799,Vascular surgery procedure,,,612.63,1531.57,4 HCPCS,38120,Laparoscopy splenectomy,,,10381.14,25952.85,8 HCPCS,38129,Laparoscope proc spleen,,,5904.09,14760.22,8 HCPCS,38205,Hc Pbsc Collect Allo,7569.0,3027.6,,,0 HCPCS,38206,Harvest auto stem cells,,,1520.99,3802.47,4 HCPCS,38206,Hc Pbsc Collect Auto,6443.0,2577.2,,,0 HCPCS,38206,Hc Pbsc Large Volume Auto,6443.0,2577.2,,,0 HCPCS,38207,Cryopreserve stem cells,,,430.85,1077.13,4 HCPCS,38207,Hc Frozen Blood Prep W/Freeze(Pbc),6776.0,2710.4,,,0 HCPCS,38208,Hc Frozen Blood Prep W/Thaw(Auto),2093.0,837.2,,,0 HCPCS,38208,Thaw preserved stem cells,,,430.85,1077.13,4 HCPCS,38209,Hc Wash Harvest Stem Cells,1850.0,740.0,,,0 HCPCS,38209,Wash harvest stem cells,,,430.85,1077.13,4 HCPCS,38210,T-cell depletion of harvest,,,430.85,1077.13,4 HCPCS,38211,Tumor cell deplete of harvst,,,430.85,1077.13,4 HCPCS,38212,Hc Red Blood Cell Removal,292.0,116.8,,,0 HCPCS,38212,Rbc depletion of harvest,,,430.85,1077.13,4 HCPCS,38213,Platelet deplete of harvest,,,430.85,1077.13,4 HCPCS,38214,Hc Transplant Prep Plasma Depletion,2820.72,1128.29,,,0 HCPCS,38214,Volume deplete of harvest,,,430.85,1077.13,4 HCPCS,38215,Harvest stem cell concentrte,,,430.85,1077.13,4 HCPCS,38220,Bone marrow aspiration,,,1612.96,8800.0,8 HCPCS,38220,Hc Diagnostic Bone Marrow Aspirations,2722.58,1089.03,,,0 HCPCS,38221,Bone marrow biopsy,,,1612.96,12101.0,8 HCPCS,38221,Hc Bone Marrow Biopsy Needle/Trocar,3387.31,1354.92,,,0 HCPCS,38222,Dx bone marrow bx & aspir,,,2836.76,7091.89,8 HCPCS,38222,Hc Diagnostic Bone Marrow Biopsies & Aspirations,4335.02,1734.01,,,0 HCPCS,38222,Hc Dx Bone Marrow Biopsy And Aspiration,4335.02,1734.01,,,0 HCPCS,38225,Hc Car-T Therapy-Harvesting Of Blood Derived T White Blood Cells For Chimeric Antigen Receptor Per D,7135.0,2854.0,,,0 HCPCS,38226,Hc Car-T Therapy Preparation Of Blood Derviced T Lymphocytes From Bone Marrow,6753.0,2701.2,,,0 HCPCS,38227,Hc Car-T Receipt And Preparation For Administration,6450.0,2580.0,,,0 HCPCS,38228,Car-t admn autologous,,,322.58,806.45,4 HCPCS,38228,Hc Car-T Therapy Adminstration Of Car-T Cells,1566.0,626.4,,,0 HCPCS,38230,Bone marrow harvest allogen,,,1520.99,3802.47,4 HCPCS,38230,Hc Allo Bone Marrow Harvest,7747.0,3098.8,,,0 HCPCS,38232,Bone marrow harvest autolog,,,4253.6,10634.01,4 HCPCS,38240,Hc Stem Cell Transplant Allogenic,13934.85,5573.94,,,0 HCPCS,38240,Transplt allo hct/donor,,,61429.5,153573.75,4 HCPCS,38241,Hc Stem Cell Transplant Autologou,9661.46,3864.58,,,0 HCPCS,38241,Hc Trnsplant Autologous Hematopoietic Cells Per Donor,10928.39,4371.36,,,0 HCPCS,38241,Transplt autol hct/donor,,,1520.99,3802.47,4 HCPCS,38242,Hc Allogeneic Lymphocyte Infusions,4706.35,1882.54,,,0 HCPCS,38242,Transplt allo lymphocytes,,,1520.99,3802.47,4 HCPCS,38243,Hc Allo Hematopoietic Cell Boost,3412.97,1365.19,,,0 HCPCS,38243,Transplj hematopoietic boost,,,1520.99,3802.47,4 HCPCS,38300,Drainage lymph node lesion,,,2546.0,7091.89,8 HCPCS,38305,Drainage lymph node lesion,,,2836.76,7091.89,8 HCPCS,38308,Incision of lymph channels,,,3470.0,9559.57,8 HCPCS,38500,Biopsy/removal lymph nodes,,,3470.0,9559.57,8 HCPCS,38500,"Hc Biopsy/Excision, Lymph Node(S)",6890.0,2756.0,,,0 HCPCS,38505,"Hc Needle Biopsy, Lymph Node(S)",3891.3,1556.52,,,0 HCPCS,38505,Needle biopsy lymph nodes,,,1612.96,4032.39,8 HCPCS,38510,Biopsy/removal lymph nodes,,,3470.0,9559.57,8 HCPCS,38510,Hc Removal And Biopsy Of Lymph Nodes,8450.0,3380.0,,,0 HCPCS,38520,Biopsy/removal lymph nodes,,,3470.0,9559.57,8 HCPCS,38525,Biopsy/removal lymph nodes,,,3470.0,9559.57,8 HCPCS,38530,Biopsy/removal lymph nodes,,,3470.0,9559.57,8 HCPCS,38531,Open bx/exc inguinofem nodes,,,3823.83,9559.57,4 HCPCS,38542,Explore deep node(s) neck,,,3470.0,14760.22,8 HCPCS,38550,Removal neck/armpit lesion,,,3823.83,9743.0,8 HCPCS,38555,Removal neck/armpit lesion,,,6484.82,16212.04,8 HCPCS,38562,Removal pelvic lymph nodes,,,7982.17,19955.42,4 HCPCS,38570,Laparoscopy lymph node biop,,,5904.09,17190.0,8 HCPCS,38571,Laparoscopy lymphadenectomy,,,10381.14,25952.85,8 HCPCS,38572,Laparoscopy lymphadenectomy,,,10381.14,25952.85,8 HCPCS,38573,Laps pelvic lymphadec,,,10381.14,25952.85,4 HCPCS,38589,Laparoscope proc lymphatic,,,5904.09,14760.22,8 HCPCS,38700,Removal of lymph nodes neck,,,6484.82,16212.04,4 HCPCS,38720,Removal of lymph nodes neck,,,6484.82,16212.04,4 HCPCS,38740,Remove armpit lymph nodes,,,3470.0,14760.22,8 HCPCS,38745,Remove armpit lymph nodes,,,5904.09,14760.22,8 HCPCS,38760,Remove groin lymph nodes,,,3470.0,16212.04,8 HCPCS,38790,Hc Injection For Lymphatic Xray,2524.48,1009.79,,,0 HCPCS,38792,Hc Injection Of Radioactive Tracer For Id Of Sentinel Node,2396.97,958.79,,,0 HCPCS,38792,Ra tracer id of sentinl node,,,390.42,976.05,4 HCPCS,38999,Blood/lymph system procedure,,,430.85,1077.13,4 HCPCS,38999,Hc Amtagvi Receipt And Preparation,577.7,231.08,,,0 HCPCS,38999,Hc Cnty-101 Administration,1746.47,698.59,,,0 HCPCS,38999,Hc T-Cell Administration Of Amtagvi,1746.47,698.59,,,0 HCPCS,39401,Mediastinoscpy w/medstnl bx,,,5904.09,14760.22,4 HCPCS,39402,Mediastinoscpy w/lmph nod bx,,,5904.09,14760.22,4 HCPCS,40490,Biopsy of lip,,,231.31,578.27,4 HCPCS,40490,Hc Biopsy Of Lip,1146.96,458.78,,,0 HCPCS,40500,Hc Partial Excision Of Lip,5850.0,2340.0,,,0 HCPCS,40500,Partial excision of lip,,,3237.89,8094.73,8 HCPCS,40510,Partial excision of lip,,,3237.89,8094.73,8 HCPCS,40520,Partial excision of lip,,,3237.89,8094.73,8 HCPCS,40525,Reconstruct lip with flap,,,3237.89,8094.73,8 HCPCS,40527,Reconstruct lip with flap,,,3470.0,14453.33,8 HCPCS,40530,Partial removal of lip,,,3237.89,8094.73,8 HCPCS,40650,"Hc Repair Lip,Full Thick,Vermilion",2018.25,807.3,,,0 HCPCS,40650,Repair lip,,,526.71,9743.0,8 HCPCS,40652,"Hc Repair Lip,<1/2 Vert Height",1299.16,519.66,,,0 HCPCS,40652,Repair lip,,,526.71,9743.0,8 HCPCS,40654,Repair lip,,,1515.28,9743.0,8 HCPCS,40700,Repair cleft lip/nasal,,,5781.33,14453.33,8 HCPCS,40701,Repair cleft lip/nasal,,,5781.33,14453.33,8 HCPCS,40702,Repair cleft lip/nasal,,,5781.33,14453.33,4 HCPCS,40720,Repair cleft lip/nasal,,,3237.89,12101.0,8 HCPCS,40761,Repair cleft lip/nasal,,,5781.33,14453.33,8 HCPCS,40799,Lip surgery procedure,,,231.31,578.27,4 HCPCS,40800,Drainage of mouth lesion,,,691.56,2978.0,8 HCPCS,40800,"Hc Drain Mouth Absc/Cyst/Hematoma,Simpl",2553.46,1021.38,,,0 HCPCS,40801,Drainage of mouth lesion,,,526.71,4059.0,8 HCPCS,40801,Hc Drg Absc Cst Hmtma Vestibule Mouth Comp,3097.64,1239.06,,,0 HCPCS,40804,Hc Removal Foreign Body Mouth,1471.08,588.43,,,0 HCPCS,40804,Removal foreign body mouth,,,885.77,2214.41,4 HCPCS,40805,Removal foreign body mouth,,,526.71,1316.78,4 HCPCS,40806,Incision of lip fold,,,526.71,1316.78,4 HCPCS,40808,Biopsy of mouth lesion,,,526.71,2978.0,8 HCPCS,40808,Hc Biopsy Of Mouth Lesion,1019.71,407.88,,,0 HCPCS,40810,Excision of mouth lesion,,,3237.89,8094.73,4 HCPCS,40812,Excise/repair mouth lesion,,,1515.28,4059.0,8 HCPCS,40812,Hc Removal Of Growth Of Mouth,5831.8,2332.72,,,0 HCPCS,40814,Excise/repair mouth lesion,,,3237.89,8094.73,8 HCPCS,40816,Excision of mouth lesion,,,3237.89,8094.73,8 HCPCS,40818,Excise oral mucosa for graft,,,526.71,2978.0,8 HCPCS,40819,Excise lip or cheek fold,,,1515.28,3788.21,8 HCPCS,40820,Treatment of mouth lesion,,,3237.89,8094.73,4 HCPCS,40830,Hc Closure Laceration Vestibule Mouth 2.5 Cm/<,1054.87,421.95,,,0 HCPCS,40830,Repair mouth laceration,,,231.31,578.27,4 HCPCS,40831,Hc Repair Of Mouth Laceration,1794.0,717.6,,,0 HCPCS,40831,Repair mouth laceration,,,526.71,2978.0,8 HCPCS,40840,Reconstruction of mouth,,,3470.0,14453.33,8 HCPCS,40842,Reconstruction of mouth,,,5781.33,14453.33,8 HCPCS,40843,Reconstruction of mouth,,,5781.33,14453.33,8 HCPCS,40844,Reconstruction of mouth,,,5781.33,14453.33,8 HCPCS,40845,Reconstruction of mouth,,,5781.33,14453.33,8 HCPCS,40899,Mouth surgery procedure,,,231.31,578.27,4 HCPCS,41000,Drainage of mouth lesion,,,526.71,1316.78,4 HCPCS,41000,Hc Intraoral I&D Tongue/Floor Lingual,4227.86,1691.14,,,0 HCPCS,41005,Drainage of mouth lesion,,,231.31,2978.0,8 HCPCS,41005,Hc Intraoral I&D Tongue/Floor Sublngl Supfc,1438.31,575.32,,,0 HCPCS,41006,Drainage of mouth lesion,,,1515.28,3788.21,8 HCPCS,41007,Drainage of mouth lesion,,,1515.28,3788.21,8 HCPCS,41007,Hc Intraoral I&D Tongue/Floor Submental Space,3072.52,1229.01,,,0 HCPCS,41008,Drainage of mouth lesion,,,2546.0,8094.73,8 HCPCS,41008,Hc Intraoral I&D Tongue/Floor Submandble Space,6906.9,2762.76,,,0 HCPCS,41009,Drainage of mouth lesion,,,526.71,2978.0,8 HCPCS,41009,Hc Intraoral I&D Tongue/Floor Masticator Space,1716.26,686.5,,,0 HCPCS,41010,Incision of tongue fold,,,1515.28,3788.21,8 HCPCS,41015,Drainage of mouth lesion,,,526.71,2978.0,8 HCPCS,41016,Drainage of mouth lesion,,,2546.0,14453.33,8 HCPCS,41017,Drainage of mouth lesion,,,2546.0,8094.73,8 HCPCS,41018,Drainage of mouth lesion,,,1515.28,3788.21,8 HCPCS,41019,Place needles h&n for rt,,,5781.33,14453.33,8 HCPCS,41100,Biopsy of tongue,,,526.71,2978.0,8 HCPCS,41100,"Hc Biopsy Tongue,Anter 2/3",1811.71,724.68,,,0 HCPCS,41105,Biopsy of tongue,,,3237.89,8094.73,4 HCPCS,41105,Hc Biopsy Of Tongue,7020.0,2808.0,,,0 HCPCS,41108,Biopsy of floor of mouth,,,1612.96,4032.39,4 HCPCS,41108,Hc Biopsy Floor Of Mouth,1964.07,785.63,,,0 HCPCS,41110,Excision of tongue lesion,,,3237.89,8094.73,4 HCPCS,41110,Hc Excise Tongue Lesion W/O Closure,5408.31,2163.32,,,0 HCPCS,41112,Excision of tongue lesion,,,3237.89,8094.73,8 HCPCS,41113,Excision of tongue lesion,,,3237.89,8094.73,8 HCPCS,41114,Excision of tongue lesion,,,3237.89,8094.73,8 HCPCS,41115,Excision of tongue fold,,,1515.28,3788.21,8 HCPCS,41115,Hc Excision Of Tongue Fold,2354.62,941.85,,,0 HCPCS,41116,Excision of mouth lesion,,,2546.0,8094.73,8 HCPCS,41120,Partial removal of tongue,,,5781.33,14453.33,8 HCPCS,41250,"Hc Repair Tongue Lacer, <2.6 Cm",343.85,137.54,,,0 HCPCS,41250,Repair tongue laceration,,,436.27,4059.0,8 HCPCS,41251,Hc Repair Tongue Laceration: ,,,1874.01,9743.0,8 HCPCS,43233,Hc Egd Esophagus Balloon Dilation 30 Mm Or Larger - Egd,3783.3,1513.32,,,0 HCPCS,43234,"Upper GI endoscopy, exam",,,2546.0,2978.0,4 HCPCS,43235,Egd diagnostic brush wash,,,885.77,2978.0,8 HCPCS,43235,Hc Egd Transoral Diagnostic With Disposable Scope,2733.55,1093.42,,,0 HCPCS,43235,Hc Esophagogastroduodenoscopy Transoral Diagnostic - Egd,2100.51,840.2,,,0 HCPCS,43236,Hc Esophagogastroduodenoscopy Submucosal Injection - Egd,3314.0,1325.6,,,0 HCPCS,43236,Uppr gi scope w/submuc inj,,,885.77,4059.0,8 HCPCS,43237,Endoscopic us exam esoph,,,1874.01,4685.03,8 HCPCS,43237,Hc Esophagogastroduodenoscopy Us Scope W/Adj Strxrs - Egd,4120.59,1648.24,,,0 HCPCS,43238,Egd us fine needle bx/aspir,,,1874.01,4685.03,8 HCPCS,43238,Hc Egd Intrmural Us Needle Aspirate/Biopsy Esophags - Egd,3989.76,1595.9,,,0 HCPCS,43239,Egd biopsy single/multiple,,,885.77,4059.0,8 HCPCS,43239,Hc Egd Transoral Biopsy Single/Multiple - Egd,3789.31,1515.72,,,0 HCPCS,43240,Egd w/transmural drain cyst,,,3470.0,14822.16,8 HCPCS,43240,Hc Egd Transoral Transmural Drainage Pseudocyst - Endo Us (Upper),4311.44,1724.58,,,0 HCPCS,43241,Egd tube/cath insertion,,,1874.01,4685.03,8 HCPCS,43241,Hc Edg Intraluminal Tube/Catheter Insertion,3684.89,1473.96,,,0 HCPCS,43242,Egd us fine needle bx/aspir,,,1874.01,4685.03,8 HCPCS,43242,Hc Egd Intrmural Needle Aspir/Biop Altered Anatomy - Egd,5047.21,2018.88,,,0 HCPCS,43243,Egd injection varices,,,1874.01,4685.03,8 HCPCS,43243,Hc Egd Injection Sclerosis Esophgl/Gastric Varices - Egd,3946.55,1578.62,,,0 HCPCS,43244,Egd varices ligation,,,1874.01,4685.03,8 HCPCS,43244,Hc Egd Band Ligation Esophgeal/Gastric Varices - Egd,3947.75,1579.1,,,0 HCPCS,43245,Egd dilate stricture,,,1874.01,4685.03,8 HCPCS,43245,Hc Egd Dilation Gastric/Duodenal Stricture - Egd,3844.52,1537.81,,,0 HCPCS,43246,Egd place gastrostomy tube,,,1874.01,4685.03,8 HCPCS,43246,Hc Egd Percutaneous Placement Gastrostomy Tube - Egd,3950.15,1580.06,,,0 HCPCS,43247,Egd remove foreign body,,,885.77,4059.0,8 HCPCS,43247,Hc Egd Flexible Foreign Body Removal,3600.87,1440.35,,,0 HCPCS,43248,Egd guide wire insertion,,,885.77,4059.0,8 HCPCS,43248,Hc Egd Insert Guide Wire Dilator Passage Esophagus - Egd,3639.28,1455.71,,,0 HCPCS,43249,Esoph egd dilation <30 mm,,,1874.01,4685.03,8 HCPCS,43249,Hc Egd Balloon Dilation Esophagus <30 Mm Diam - Egd,3816.92,1526.77,,,0 HCPCS,43250,Egd cautery tumor polyp,,,1874.01,4685.03,8 HCPCS,43251,Egd remove lesion snare,,,1874.01,4685.03,8 HCPCS,43251,Hc Egd Removal Tumor Polyp/Other Lesion Snare Tech - Egd,4166.2,1666.48,,,0 HCPCS,43252,Egd optical endomicroscopy,,,1874.01,4685.03,4 HCPCS,43253,Egd us transmural injxn/mark,,,1874.01,4685.03,4 HCPCS,43253,Hc Egd Us Guided Transmural Injxn/Fiducial Marker - Endo Us (Upper),3461.63,1384.65,,,0 HCPCS,43254,Egd endo mucosal resection,,,1874.01,4685.03,8 HCPCS,43254,Hc Espgstrduodnscy Flx Trn W End,3514.45,1405.78,,,0 HCPCS,43255,Egd control bleeding any,,,1874.01,4685.03,8 HCPCS,43255,Hc Egd Transoral Control Bleeding Any Method - Egd,3964.56,1585.82,,,0 HCPCS,43257,Egd w/thrml txmnt gerd,,,3765.27,9743.0,8 HCPCS,43259,Egd us exam duodenum/jejunum,,,1874.01,9743.0,8 HCPCS,43259,Hc Egd Us Exam Surgical Alter Stom Duodenum/Jejunum - Egd,4892.38,1956.95,,,0 HCPCS,43259,Hc Egd Us Exam Surgical Alter Stom Duodenum/Jejunum - Endo Us (Upper),4892.38,1956.95,,,0 HCPCS,43260,Ercp w/specimen collection,,,3470.0,9413.18,8 HCPCS,43260,Hc Ercp Dx Collection Specimen Brushing/Washing - Ercp,6597.99,2639.2,,,0 HCPCS,43261,Endo cholangiopancreatograph,,,3470.0,9413.18,8 HCPCS,43261,"Hc Ercp,Biopsy - Ercp",6197.09,2478.84,,,0 HCPCS,43262,Endo cholangiopancreatograph,,,3470.0,9413.18,8 HCPCS,43262,"Hc Ercp,Sphincterotomy - Ercp",6876.45,2750.58,,,0 HCPCS,43263,Ercp sphincter pressure meas,,,1874.01,4685.03,8 HCPCS,43263,Hc Ercp W/Pressure Measurement Sphincter Of Oddi - Ercp,6955.67,2782.27,,,0 HCPCS,43264,Ercp remove duct calculi,,,3470.0,9413.18,8 HCPCS,43264,Hc Ercp Remove Calculi/Debris Biliary/Pancreas Duct - Ercp,6955.67,2782.27,,,0 HCPCS,43265,Ercp lithotripsy calculi,,,3470.0,14822.16,8 HCPCS,43265,Hc Ercp Destruction/Lithotripsy Calculi Any Method - Ercp,7955.52,3182.21,,,0 HCPCS,43266,Egd endoscopic stent place,,,5928.86,14822.16,8 HCPCS,43266,Hc Egd Endoscopic Stent Placement W/Wire& Dilation - Egd,8032.34,3212.94,,,0 HCPCS,43270,Egd lesion ablation,,,1874.01,9743.0,8 HCPCS,43270,Hc Egd Ablate Tumor Polyp/Lesion W/Dilation& Wire - Egd,4845.56,1938.22,,,0 HCPCS,43273,Hc Ercp W/Cannulation Papilla +,5517.79,2207.12,,,0 HCPCS,43274,Ercp duct stent placement,,,3470.0,14822.16,8 HCPCS,43274,Hc Ercp Insrt Nasobil/Pan Drg Tub,8727.29,3490.92,,,0 HCPCS,43274,Hc Ercp Insrt Tb/Stnt->Bl/Pan Dct,8727.29,3490.92,,,0 HCPCS,43274,Hc Ercp Stent Placement Biliary/Pancreatic Duct - Ercp,8727.29,3490.92,,,0 HCPCS,43275,Ercp remove forgn body duct,,,1874.01,4685.03,8 HCPCS,43275,Hc Ercp Remove Foreign Body/Stent Biliary/Panc Duct - Ercp,7606.23,3042.49,,,0 HCPCS,43276,Ercp stent exchange w/dilate,,,3470.0,14822.16,8 HCPCS,43276,Hc Ercp Biliary/Panc Duct Stent Exchange W/Dil&Wire - Ercp,8402.02,3360.81,,,0 HCPCS,43277,Ercp ea duct/ampulla dilate,,,3470.0,9413.18,8 HCPCS,43277,Hc Ercp Balloon Dilate Biliary/Panc Duct/Ampulla Ea - Ercp,7521.01,3008.4,,,0 HCPCS,43278,Ercp lesion ablate w/dilate,,,3470.0,9413.18,8 HCPCS,43278,Hc Ercp Tumor/Polyp/Lesion Ablation W/Dilation&Wire - Ercp,7643.44,3057.38,,,0 HCPCS,43280,Laparoscopy fundoplasty,,,10381.14,25952.85,8 HCPCS,43281,Lap paraesophag hern repair,,,10381.14,25952.85,8 HCPCS,43282,Lap paraesoph her rpr w/mesh,,,10381.14,25952.85,8 HCPCS,43284,Laps esophgl sphnctr agmntj,,,7639.0,25952.85,8 HCPCS,43285,Rmvl esophgl sphnctr dev,,,5904.09,14760.22,8 HCPCS,43289,Laparoscope proc esoph,,,5904.09,14760.22,8 HCPCS,43290,Egd flx trnsorl dplmnt balo,,,1874.01,4685.03,8 HCPCS,43291,Egd flx trnsorl rmvl balo,,,885.77,2214.41,4 HCPCS,43420,Repair esophagus opening,,,3237.89,8094.73,4 HCPCS,43450,Dilate esophagus 1/mult pass,,,885.77,2978.0,8 HCPCS,43453,Dilate esophagus,,,1874.01,4685.03,8 HCPCS,43497,Transorl lwr esophgl myotomy,,,5928.86,14822.16,8 HCPCS,43499,Esophagus surgery procedure,,,885.77,2214.41,4 HCPCS,43499,Hc Unlisted Procedure Esophagus,1999.52,799.81,,,0 HCPCS,43510,Surgical opening of stomach,,,885.77,2214.41,4 HCPCS,43600,Biopsy of stomach,,,2546.0,2978.0,4 HCPCS,43647,Lap impl electrode antrum,,,10882.0,27205.01,4 HCPCS,43648,Lap revise/remv eltrd antrum,,,7524.0,25952.85,8 HCPCS,43651,Laparoscopy vagus nerve,,,5904.09,17190.0,8 HCPCS,43652,Laparoscopy vagus nerve,,,5904.09,17190.0,8 HCPCS,43653,Laparoscopy gastrostomy,,,5904.09,17190.0,8 HCPCS,43659,Laparoscope proc stom,,,5904.09,14760.22,8 HCPCS,43750,Place gastrostomy tube,,,3470.0,4059.0,4 HCPCS,43752,Hc Placement Ng/Og Tube By Physician,1749.75,699.9,,,0 HCPCS,43752,Nasal/orogastric w/tube plmt,,,436.27,1090.68,4 HCPCS,43753,Tx gastro intub w/asp,,,210.87,527.18,4 HCPCS,43754,Dx gastr intub w/asp spec,,,210.87,527.18,4 HCPCS,43755,Dx gastr intub w/asp specs,,,125.66,314.16,4 HCPCS,43756,Dx duod intub w/asp spec,,,885.77,2214.41,4 HCPCS,43757,Dx duod intub w/asp specs,,,885.77,2214.41,4 HCPCS,43760,Change gastrostomy tube,,,2546.0,2978.0,4 HCPCS,43761,"Hc Reposition Gastrostomy Tube - Gastrostomy Tube, Change / Reposition",3404.05,1361.62,,,0 HCPCS,43761,Reposition gastrostomy tube,,,244.0,2978.0,8 HCPCS,43762,Hc Replacement Gastro Tube Without Revision Of Gastrostomy Tract,2015.98,806.39,,,0 HCPCS,43762,Hc Replacemet Gtube No Revj Trc,2015.98,806.39,,,0 HCPCS,43762,Rplc gtube no revj trc,,,244.0,610.01,4 HCPCS,43763,Rplc gtube revj gstrst trc,,,244.0,610.01,4 HCPCS,43770,Lap place gastr adj device,,,10346.0,25952.85,8 HCPCS,43772,Lap rmvl gastr adj device,,,3765.27,9413.18,4 HCPCS,43773,Lap replace gastr adj device,,,5904.09,14760.22,4 HCPCS,43774,Lap rmvl gastr adj all parts,,,3765.27,9413.18,4 HCPCS,43830,Place gastrostomy tube,,,1874.01,4685.03,4 HCPCS,43831,Place gastrostomy tube,,,885.77,2214.41,4 HCPCS,43840,Repair of stomach lesion,,,3765.27,9413.18,4 HCPCS,43870,Repair stomach opening,,,2546.0,9413.18,8 HCPCS,43886,Revise gastric port open,,,3460.82,9743.0,8 HCPCS,43887,Remove gastric port open,,,2015.01,5037.52,4 HCPCS,43888,Change gastric port open,,,3460.82,8652.04,4 HCPCS,43889,Gstr rstcv px trnsorl esg,,,10381.14,25952.85,4 HCPCS,43999,Hc Ct Gastropexy,1723.72,689.49,,,0 HCPCS,43999,Hc Egd W/ Repair Of Fistula,1475.22,590.09,,,0 HCPCS,43999,Stomach surgery procedure,,,885.77,2214.41,4 HCPCS,44100,Biopsy of bowel,,,885.77,2978.0,8 HCPCS,44180,Lap enterolysis,,,5904.09,14760.22,8 HCPCS,44186,Lap jejunostomy,,,5904.09,17190.0,8 HCPCS,44206,Lap part colectomy w/stoma,,,14697.0,17190.0,4 HCPCS,44207,L colectomy/coloproctostomy,,,14697.0,17190.0,4 HCPCS,44208,L colectomy/coloproctostomy,,,14697.0,17190.0,4 HCPCS,44213,Lap mobil splenic fl add-on,,,7524.0,8800.0,4 HCPCS,44238,Laparoscope proc intestine,,,5904.09,14760.22,8 HCPCS,44300,Open bowel to skin,,,1874.01,4685.03,4 HCPCS,44312,Revision of ileostomy,,,2546.0,8652.04,8 HCPCS,44314,Revision of ileostomy,,,3460.82,8652.04,4 HCPCS,44340,Revision of colostomy,,,3460.82,9743.0,8 HCPCS,44345,Revision of colostomy,,,3460.82,8652.04,4 HCPCS,44346,Revision of colostomy,,,3460.82,8652.04,4 HCPCS,44360,Hc Endoscopy Upper Small Intestine - Enteroscopy,4245.25,1698.1,,,0 HCPCS,44360,Small bowel endoscopy,,,1874.01,4685.03,8 HCPCS,44361,"Hc Small Bowel Endoscopy,Biopsy - Enteroscopy",4500.27,1800.11,,,0 HCPCS,44361,Small bowel endoscopy/biopsy,,,1874.01,4685.03,8 HCPCS,44363,Small bowel endoscopy,,,1874.01,4685.03,8 HCPCS,44364,"Hc Sb Endoscopy,Rmvl Lesn,Snare - Enteroscopy",3584.0,1433.6,,,0 HCPCS,44364,Small bowel endoscopy,,,1874.01,4685.03,8 HCPCS,44365,Small bowel endoscopy,,,1874.01,4685.03,8 HCPCS,44366,"Hc Sb Endoscopy,W/Control,Bleeding - Enteroscopy",4783.63,1913.45,,,0 HCPCS,44366,Small bowel endoscopy,,,1874.01,4685.03,8 HCPCS,44369,"Hc Small Bowel Endoscopy,Ablate Lesn - Enteroscopy",1662.0,664.8,,,0 HCPCS,44369,Small bowel endoscopy,,,1874.01,4685.03,8 HCPCS,44370,Small Bowel Endoscopy/Stent,,,5928.86,17190.0,8 HCPCS,44372,"Hc Sb Scope,Place Percut Jejun Tube - Enteroscopy",4902.13,1960.85,,,0 HCPCS,44372,Small bowel endoscopy,,,1874.01,4685.03,8 HCPCS,44373,"Hc Sb Scope,Convrt Gastro To Jejun - Endo, Small Bowel",3047.5,1219.0,,,0 HCPCS,44373,Small bowel endoscopy,,,1874.01,4685.03,8 HCPCS,44376,"Hc Sb Scope,To Ileum,Diagnostic - Enteroscopy",4891.82,1956.73,,,0 HCPCS,44376,Small bowel endoscopy,,,1874.01,4685.03,8 HCPCS,44377,"Hc Sb Scope,To Ileum,Biopsy - Enteroscopy",4574.98,1829.99,,,0 HCPCS,44377,Small bowel endoscopy/biopsy,,,1874.01,4685.03,8 HCPCS,44378,Small bowel endoscopy,,,1874.01,4685.03,8 HCPCS,44379,S Bowel Endoscope W/Stent,,,5928.86,17190.0,8 HCPCS,44380,Hc Ileoscopy Thru Stoma Dx W/Collj Spec When Prfmd - Enteroscopy,3531.7,1412.68,,,0 HCPCS,44380,Small bowel endoscopy br/wa,,,885.77,2978.0,8 HCPCS,44381,Small bowel endoscopy br/wa,,,1874.01,4685.03,8 HCPCS,44382,"Hc Ileoscopy Thru Stoma,Biopsy - Enteroscopy",4023.71,1609.48,,,0 HCPCS,44382,Small bowel endoscopy,,,885.77,2978.0,8 HCPCS,44384,Small bowel endoscopy,,,1874.01,17190.0,8 HCPCS,44385,Endoscopy of bowel pouch,,,908.2,2978.0,8 HCPCS,44385,Hc Ndsc Eval Intstinal Pouch Dx W/Collj Spec Spx - Enteroscopy,3563.9,1425.56,,,0 HCPCS,44386,Endoscopy bowel pouch/biop,,,908.2,2978.0,8 HCPCS,44386,Hc Ndsc Eval Intstinal Pouch W/Bx Single/Multiple - Enteroscopy,4151.22,1660.49,,,0 HCPCS,44388,Colonoscopy thru stoma spx,,,908.2,2978.0,8 HCPCS,44388,Hc Colonoscopy Stm-Diag W/Wo Brush/Wash,3433.9,1373.56,,,0 HCPCS,44389,Colonoscopy with biopsy,,,1168.65,2978.0,8 HCPCS,44389,"Hc Colonoscopy Thru Stoma,Biopsy - Colonoscopy",3606.4,1442.56,,,0 HCPCS,44390,Colonoscopy for foreign body,,,908.2,2978.0,8 HCPCS,44391,Colonoscopy for bleeding,,,1168.65,2978.0,8 HCPCS,44392,Colonoscopy & polypectomy,,,1168.65,2978.0,8 HCPCS,44394,Colonoscopy w/snare,,,1168.65,2978.0,8 HCPCS,44394,"Hc Colonoscopy Thru Stoma,Lession Remival W/Snare - Colonoscopy",3409.75,1363.9,,,0 HCPCS,44401,Colonoscopy with ablation,,,1168.65,2978.0,8 HCPCS,44402,Colonoscopy w/stent plcmt,,,2546.0,14822.16,8 HCPCS,44403,Colonoscopy w/resection,,,1168.65,2921.61,4 HCPCS,44403,Hc Colonoscopy W/Resection,3544.3,1417.72,,,0 HCPCS,44404,Colonoscopy w/injection,,,1168.65,2921.61,4 HCPCS,44404,Hc Colonoscopy Stoma W/Submucosal Injection - Colonoscopy,9416.2,3766.48,,,0 HCPCS,44405,Colonoscopy w/dilation,,,1168.65,4059.0,8 HCPCS,44405,Hc Colonoscopy Stoma W/Balloon Dilation - Colonoscopy,1639.9,655.96,,,0 HCPCS,44406,Colonoscopy w/ultrasound,,,1168.65,2921.61,4 HCPCS,44407,Colonoscopy w/ndl aspir/bx,,,1168.65,2921.61,4 HCPCS,44407,Hc Colonoscopy Stoma W/Us Gid Ndl Aspir/Bx - Endo Us (Lower),3279.8,1311.92,,,0 HCPCS,44408,Colonoscopy w/decompression,,,908.2,2270.5,4 HCPCS,44500,Hc Intro Long Gi Tube,2216.9,886.76,,,0 HCPCS,44500,Intro gastrointestinal tube,,,885.77,2214.41,4 HCPCS,44602,Suture small intestine,,,3765.27,9413.18,4 HCPCS,44799,Hc Unlisted Procedure Small Intestine,3717.49,1487.0,,,0 HCPCS,44799,Hc Unlisted Px Small Intest,2477.85,991.14,,,0 HCPCS,44799,Unlisted px small intestine,,,885.77,2214.41,4 HCPCS,44950,Appendectomy,,,6322.36,17190.0,8 HCPCS,44970,Laparoscopy appendectomy,,,5904.09,14760.22,8 HCPCS,44979,Laparoscope proc app,,,5904.09,14760.22,8 HCPCS,45000,Drainage of pelvic abscess,,,1168.65,2978.0,8 HCPCS,45005,Drainage of rectal abscess,,,1168.65,4059.0,8 HCPCS,45005,Hc I&D Submucosal Abscess Rectum,4663.2,1865.28,,,0 HCPCS,45020,Drainage of rectal abscess,,,2710.72,6776.81,8 HCPCS,45100,Biopsy of rectum,,,2546.0,6776.81,8 HCPCS,45100,Hc Biopsy Of Rectum,5831.93,2332.77,,,0 HCPCS,45108,Removal of anorectal lesion,,,2710.72,6776.81,8 HCPCS,45150,Excision of rectal stricture,,,1168.65,4059.0,8 HCPCS,45160,Excision of rectal lesion,,,2710.72,6776.81,8 HCPCS,45170,Excision of rectal lesion,,,3470.0,4059.0,4 HCPCS,45171,Exc rect tum transanal part,,,2710.72,6776.81,8 HCPCS,45172,Exc rect tum transanal full,,,2710.72,6776.81,8 HCPCS,45190,Destruction rectal tumor,,,2710.72,17190.0,8 HCPCS,45300,"Hc Proctosigmoidoscopy,Rigid,Diagnos - Endoscopy Sigmoid",1805.5,722.2,,,0 HCPCS,45300,Proctosigmoidoscopy dx,,,908.2,2978.0,8 HCPCS,45303,Proctosigmoidoscopy dilate,,,1168.65,4059.0,8 HCPCS,45305,Proctosigmoidoscopy w/bx,,,1168.65,2978.0,8 HCPCS,45307,Proctosigmoidoscopy fb,,,2546.0,6776.81,8 HCPCS,45308,Proctosigmoidoscopy removal,,,2546.0,6776.81,8 HCPCS,45309,Proctosigmoidoscopy removal,,,1168.65,2978.0,8 HCPCS,45315,Proctosigmoidoscopy removal,,,1168.65,2978.0,8 HCPCS,45317,Proctosigmoidoscopy bleed,,,1168.65,2978.0,8 HCPCS,45320,Proctosigmoidoscopy ablate,,,2546.0,6776.81,8 HCPCS,45321,Proctosigmoidoscopy volvul,,,2546.0,6776.81,8 HCPCS,45327,Proctosigmoidoscopy W/Stent,,,2546.0,14822.16,8 HCPCS,45330,Diagnostic sigmoidoscopy,,,908.2,2978.0,8 HCPCS,45330,Hc Sigmoidoscopy Flex Diagnostic W/Collecting Spec Br/Wa If Pfrmd - Endoscopy Sigmoid,2665.7,1066.28,,,0 HCPCS,45331,"Hc Sigmoidoscopy,Biopsy - Endoscopy Sigmoid",2727.8,1091.12,,,0 HCPCS,45331,Sigmoidoscopy and biopsy,,,908.2,2978.0,8 HCPCS,45332,Hc Sigmoidoscopy Flex W/Rmvl Foreign Body - Endoscopy Sigmoid,2942.85,1177.14,,,0 HCPCS,45332,Sigmoidoscopy w/fb removal,,,1168.65,2978.0,8 HCPCS,45333,Hc Sigmoidoscopy Flx W/Rmvl Tumor By Hot Bx Forceps - Endoscopy Sigmoid,2671.45,1068.58,,,0 HCPCS,45333,Sigmoidoscopy & polypectomy,,,908.2,2978.0,8 HCPCS,45334,Hc Sigmoidoscopy Flx Control Bleeding - Endoscopy Sigmoid,2845.0,1138.0,,,0 HCPCS,45334,Sigmoidoscopy for bleeding,,,1168.65,2978.0,8 HCPCS,45335,"Hc Sigmoidoscopy,Flex,W/Dir Submuc Inject - Endoscopy Sigmoid",2647.3,1058.92,,,0 HCPCS,45335,Sigmoidoscopy w/submuc inj,,,908.2,2978.0,8 HCPCS,45337,Hc Peds-Sigmd Decomp Volvul,3490.25,1396.1,,,0 HCPCS,45337,Sigmoidoscopy & decompress,,,908.2,2978.0,8 HCPCS,45338,"Hc Sigmoidoscopy,Removal Lesion,Snare - Endoscopy Sigmoid",3103.85,1241.54,,,0 HCPCS,45338,Sigmoidoscopy w/tumr remove,,,1168.65,2978.0,8 HCPCS,45340,Hc Sigmoidoscopy Flex Tndsc Balo Dilat - Endoscopy Sigmoid,3458.05,1383.22,,,0 HCPCS,45340,Sig w/tndsc balloon dilation,,,1168.65,2978.0,8 HCPCS,45341,Hc Sigmoidoscopy W/Endoscopic Us Exam - Endoscopy Sigmoid,3515.55,1406.22,,,0 HCPCS,45341,Sigmoidoscopy W/Ultrasound,,,908.2,2978.0,8 HCPCS,45342,"Hc Sigmoidoscopy,Fine Needle Bioipsy,Us Guided - Endoscopy Sigmoid",3433.9,1373.56,,,0 HCPCS,45342,Sigmoidoscopy W/Us Guide Bx,,,1168.65,2978.0,8 HCPCS,45346,Hc Sigmoidoscopy Flx Ablation Tumor Polyp/Oth Les - Endoscopy Sigmoid,3161.35,1264.54,,,0 HCPCS,45346,Sigmoidoscopy w/ablation,,,1168.65,2978.0,8 HCPCS,45347,Hc Sigmoidoscopy Flex Placement Of Endoscopic Stent - Endoscopy Sigmoid,4441.3,1776.52,,,0 HCPCS,45347,Sigmoidoscopy w/plcmt stent,,,2546.0,14822.16,8 HCPCS,45349,Hc Sigmd Flex W/Endo Mucosal Res,2819.0,1127.6,,,0 HCPCS,45349,Sigmoidoscopy w/resection,,,2710.72,6776.81,4 HCPCS,45350,Hc Sigmoid Flex W/ Band Ligation,2699.05,1079.62,,,0 HCPCS,45350,Sgmdsc w/band ligation,,,1168.65,4059.0,8 HCPCS,45378,Diagnostic colonoscopy,,,908.2,4059.0,8 HCPCS,45378,Hc Colonoscopy Flexible Diagnostic W/Collj Spec When Pfrmd - Colonoscopy,3635.15,1454.06,,,0 HCPCS,45379,Colonoscopy w/fb removal,,,1168.65,4059.0,8 HCPCS,45379,Hc Colonoscopy Flexible W/Removal Of Foreign Body(S) - Colonoscopy,4099.75,1639.9,,,0 HCPCS,45380,Colonoscopy and biopsy,,,1168.65,4059.0,8 HCPCS,45380,Hc Colonoscopy W/Biopsy Single/Multiple - Colonoscopy,4146.9,1658.76,,,0 HCPCS,45381,Colonoscopy submucous njx,,,1168.65,4059.0,8 HCPCS,45381,Hc Colonoscopy Flexible With Directed Submucosal Njx Any Sbst - Colonoscopy,3689.2,1475.68,,,0 HCPCS,45382,Colonoscopy w/control bleed,,,1168.65,4059.0,8 HCPCS,45382,Hc Colonoscopy Flexible W/Control Bleeding Any Method - Colonoscopy,3999.7,1599.88,,,0 HCPCS,45384,Colonoscopy w/lesion removal,,,1168.65,4059.0,8 HCPCS,45384,Hc Colposcopy Flexible W/Removal Lesion By Hot Biopsy Forceps - Colonoscopy,4319.4,1727.76,,,0 HCPCS,45385,Colonoscopy w/lesion removal,,,1168.65,4059.0,8 HCPCS,45385,Hc Colposcopy Flexible W/Rmvl Of Tumor Polyp Lesion Snare Tq - Colonoscopy,4246.95,1698.78,,,0 HCPCS,45386,Colonoscopy w/balloon dilat,,,1168.65,4059.0,8 HCPCS,45386,Hc Colposcopy Flexible W/Transendoscopic Balloon Dilat - Colonoscopy,3636.3,1454.52,,,0 HCPCS,45388,Colonoscopy w/ablation,,,1168.65,4059.0,8 HCPCS,45388,Hc Colonoscopy Flexible Abl Tum/Pol/Ls Nt Sn,4318.25,1727.3,,,0 HCPCS,45389,Colonoscopy w/stent plcmt,,,2546.0,14822.16,8 HCPCS,45389,Hc Colonoscopy Flexible With Endoscopic Stent Placement - Colonoscopy,5223.3,2089.32,,,0 HCPCS,45390,Colonoscopy w/resection,,,2710.72,6776.81,8 HCPCS,45390,Hc Colonoscopy Flexible W/Endoscopic Mucosal Resection - Colonoscopy,4317.1,1726.84,,,0 HCPCS,45391,Colonoscopy w/endoscope us,,,1168.65,4059.0,8 HCPCS,45391,Hc Colonoscopy Flexible Endoscopy Us,3548.9,1419.56,,,0 HCPCS,45392,Colonoscopy w/endoscopic fnb,,,1168.65,4059.0,8 HCPCS,45392,Hc Colonoscopy W/Endoscopic,4189.45,1675.78,,,0 HCPCS,45393,Colonoscopy w/decompression,,,1168.65,2921.61,4 HCPCS,45398,Colonoscopy w/band ligation,,,1168.65,4059.0,8 HCPCS,45398,Hc Colonoscopy Flexible With Band Ligation(S) - Colonoscopy,4173.35,1669.34,,,0 HCPCS,45399,Unlisted procedure colon,,,908.2,2270.5,4 HCPCS,45499,Laparoscope proc rectum,,,5904.09,14760.22,4 HCPCS,45500,Repair of rectum,,,2710.72,6776.81,8 HCPCS,45505,Repair of rectum,,,2710.72,6776.81,8 HCPCS,45520,Treatment of rectal prolapse,,,908.2,2270.5,4 HCPCS,45541,Correct rectal prolapse,,,2710.72,6776.81,4 HCPCS,45560,Repair of rectocele,,,2710.72,6776.81,8 HCPCS,45900,Hc Reduction Of Rectal Prolapse With Anesthesia,3477.5,1391.0,,,0 HCPCS,45900,Reduction of rectal prolapse,,,908.2,2978.0,8 HCPCS,45905,Dilation of anal sphincter,,,1168.65,2978.0,8 HCPCS,45910,Dilation of rectal narrowing,,,1168.65,2978.0,8 HCPCS,45915,Hc Rmvl Fecal Impaction/Fb Spx Under Anes,2988.8,1195.52,,,0 HCPCS,45915,Remove rectal obstruction,,,1168.65,2978.0,8 HCPCS,45990,Surg dx exam anorectal,,,2710.72,6776.81,8 HCPCS,45999,Rectum surgery procedure,,,908.2,2270.5,4 HCPCS,46020,Placement of seton,,,2710.72,9743.0,8 HCPCS,46030,Hc Seton Drain Removal,2756.06,1102.42,,,0 HCPCS,46030,Removal of rectal marker,,,1168.65,2978.0,8 HCPCS,46040,Hc I&D Perirectal Abscess,3656.89,1462.76,,,0 HCPCS,46040,Incision of rectal abscess,,,1168.65,9743.0,8 HCPCS,46045,Incision of rectal abscess,,,2710.72,6776.81,8 HCPCS,46050,"Hc I&D Perianal Abscess,Superficial",3656.89,1462.76,,,0 HCPCS,46050,Incision of anal abscess,,,908.2,2978.0,8 HCPCS,46060,Incision of rectal abscess,,,2710.72,6776.81,8 HCPCS,46070,Incision of anal septum,,,2710.72,6776.81,4 HCPCS,46080,Incision of anal sphincter,,,2710.72,9743.0,8 HCPCS,46083,Hc Incise External Hemorrhoid,1218.96,487.58,,,0 HCPCS,46083,Incise external hemorrhoid,,,244.0,610.01,4 HCPCS,46200,Removal of anal fissure,,,2710.72,6776.81,8 HCPCS,46210,Removal of anal crypt,,,3470.0,4059.0,4 HCPCS,46211,Removal of anal crypts,,,3470.0,4059.0,4 HCPCS,46220,Excise anal ext tag/papilla,,,1168.65,2978.0,8 HCPCS,46220,Hc Excision Single External Anal Papilla Or Tag,4160.0,1664.0,,,0 HCPCS,46221,Hc Hemorrhoidectomy Internal Rubber Band Ligations,3486.11,1394.44,,,0 HCPCS,46221,Ligation of hemorrhoid(s),,,908.2,2978.0,8 HCPCS,46230,Hc Excision Multiple External Papillae/Tags Anus,6268.95,2507.58,,,0 HCPCS,46230,Removal of anal tags,,,2546.0,6776.81,8 HCPCS,46250,Remove ext hem groups 2+,,,2710.72,9743.0,8 HCPCS,46255,Hc Hemorrhoidectomy,7774.0,3109.6,,,0 HCPCS,46255,Remove int/ext hem 1 group,,,2710.72,9743.0,8 HCPCS,46257,Remove in/ex hem grp & fiss,,,2710.72,9743.0,8 HCPCS,46258,Remove in/ex hem grp w/fistu,,,2710.72,9743.0,8 HCPCS,46260,Remove in/ex hem groups 2+,,,2710.72,9743.0,8 HCPCS,46261,Remove in/ex hem grps & fiss,,,2710.72,8800.0,8 HCPCS,46262,Remove in/ex hem grps w/fist,,,2710.72,8800.0,8 HCPCS,46270,Remove anal fist subq,,,2710.72,9743.0,8 HCPCS,46275,Remove anal fist inter,,,2710.72,9743.0,8 HCPCS,46280,Remove anal fist complex,,,2710.72,8800.0,8 HCPCS,46285,Remove anal fist 2 stage,,,2546.0,6776.81,8 HCPCS,46288,Repair anal fistula,,,2710.72,8800.0,8 HCPCS,46320,"Hc Excision Thrombosed Hemorrhoid, External",4547.67,1819.07,,,0 HCPCS,46320,Removal of hemorrhoid clot,,,1168.65,4059.0,8 HCPCS,46500,Injection into hemorrhoid(s),,,908.2,2270.5,4 HCPCS,46505,Chemodenervation anal musc,,,1168.65,4059.0,8 HCPCS,46505,Hc Chemodenervation Initial Sphincter,5747.18,2298.87,,,0 HCPCS,46600,Diagnostic anoscopy spx,,,129.94,324.84,4 HCPCS,46600,Hc Anoscopy Dx W/Collj Spec Br/Wa Spx When Prfrmd,1134.73,453.89,,,0 HCPCS,46601,Diagnostic anoscopy,,,436.27,1090.68,4 HCPCS,46604,Anoscopy and dilation,,,1168.65,4059.0,8 HCPCS,46606,Anoscopy and biopsy,,,1168.65,4059.0,8 HCPCS,46606,"Hc Anoscopy And Biopsy - Endoscopy, Anus",2403.41,961.36,,,0 HCPCS,46607,Diagnostic anoscopy & biopsy,,,1168.65,4059.0,8 HCPCS,46608,Anoscopy remove for body,,,908.2,2978.0,8 HCPCS,46610,Anoscopy remove lesion,,,2546.0,6776.81,8 HCPCS,46611,Anoscopy,,,908.2,2978.0,8 HCPCS,46612,Anoscopy remove lesions,,,2546.0,6776.81,8 HCPCS,46614,Anoscopy control bleeding,,,1168.65,2921.61,4 HCPCS,46615,Anoscopy,,,2710.72,6776.81,8 HCPCS,46700,Repair of anal stricture,,,2710.72,9743.0,8 HCPCS,46706,Repr of anal fistula w/glue,,,2546.0,6776.81,8 HCPCS,46707,Repair anorectal fist w/plug,,,2710.72,6776.81,4 HCPCS,46750,Repair of anal sphincter,,,2710.72,9743.0,8 HCPCS,46753,Reconstruction of anus,,,2710.72,9743.0,8 HCPCS,46754,Removal of suture from anus,,,2710.72,6776.81,8 HCPCS,46760,Repair of anal sphincter,,,2710.72,6776.81,8 HCPCS,46761,Repair of anal sphincter,,,2710.72,9743.0,8 HCPCS,46762,Implant artificial sphincter,,,10346.0,12101.0,4 HCPCS,46900,Destruction anal lesion(s),,,397.0,992.51,4 HCPCS,46900,Hc Destruction Anal Lesion(S),1146.66,458.66,,,0 HCPCS,46910,Destruction anal lesion(s),,,2015.01,5037.52,8 HCPCS,46916,Cryosurgery anal lesion(s),,,195.94,489.85,4 HCPCS,46916,Hc Cryosurgery Anal Lesion(S),927.62,371.05,,,0 HCPCS,46917,Laser surgery anal lesions,,,2546.0,6776.81,8 HCPCS,46922,Excision of anal lesion(s),,,2546.0,6776.81,8 HCPCS,46922,Hc Exision Of Anal Lesion(S),6779.5,2711.8,,,0 HCPCS,46924,Destruction anal lesion(s),,,2546.0,6776.81,8 HCPCS,46930,Destroy internal hemorrhoids,,,1168.65,2978.0,8 HCPCS,46937,Cryotherapy of rectal lesion,,,3470.0,4059.0,4 HCPCS,46938,Cryotherapy of rectal lesion,,,3470.0,4059.0,4 HCPCS,46940,Treatment of anal fissure,,,2710.72,6776.81,4 HCPCS,46942,Treatment of anal fissure,,,908.2,2270.5,4 HCPCS,46945,Remove by ligat int hem grp,,,2710.72,9743.0,8 HCPCS,46946,Remove by ligat int hem grps,,,2546.0,6776.81,8 HCPCS,46947,Hemorrhoidopexy by stapling,,,2710.72,12101.0,8 HCPCS,46948,Int hrhc tranal dartlzj 2+,,,2710.72,6776.81,4 HCPCS,46999,Anus surgery procedure,,,908.2,2270.5,4 HCPCS,47000,Hc Needle Biopsy Liver,5768.31,2307.32,,,0 HCPCS,47000,"Hc Needle Biopsy Liver - Needle Biopsy, Liver",5150.28,2060.11,,,0 HCPCS,47000,Needle biopsy of liver,,,1612.96,4032.39,8 HCPCS,47001,Hc Bx Liver Not A Separate Procedure,3483.35,1393.34,,,0 HCPCS,47370,Laparo ablate liver tumor rf,,,10381.14,25952.85,4 HCPCS,47371,Laparo ablate liver cryosurg,,,10381.14,25952.85,4 HCPCS,47379,Laparoscope procedure liver,,,5904.09,14760.22,8 HCPCS,47382,Hc Ct Guided Microwave Ablation Liver,14433.29,5773.32,,,0 HCPCS,47382,Percut ablate liver rf,,,5904.09,14760.22,4 HCPCS,47383,Hc Ablation 1/> Liver Tumor Perq Cryoablation,10873.63,4349.45,,,0 HCPCS,47383,Perq abltj lvr cryoablation,,,10381.14,25952.85,4 HCPCS,47384,Abltj ire liver 1+ tum perq,,,10381.14,25952.85,4 HCPCS,47399,Hc Ct Guided Alcohol Ablation Liver,2967.68,1187.07,,,0 HCPCS,47399,Liver surgery procedure,,,691.56,1728.91,4 HCPCS,47490,"Hc Cholecystostomy,Percutaneous, Complete",8622.91,3449.16,,,0 HCPCS,47490,Incision of gallbladder,,,3496.63,8741.59,4 HCPCS,47510,"Insert catheter, bile duct",,,3470.0,4059.0,4 HCPCS,47511,Insert bile duct drain,,,14697.0,17190.0,4 HCPCS,47525,Change bile duct catheter,,,2546.0,2978.0,4 HCPCS,47530,Revise/reinsert bile tube,,,2546.0,2978.0,4 HCPCS,47531,Hc Njx Cholangio Prq W/Img Gid Rs&I Existing Access,4281.31,1712.52,,,0 HCPCS,47531,Injection for cholangiogram,,,3496.63,8741.59,4 HCPCS,47532,Hc Ptc Only,4974.26,1989.7,,,0 HCPCS,47532,Injection for cholangiogram,,,3496.63,8741.59,4 HCPCS,47533,Hc Palcement Of Drainage Catheter Of Biliary Duct With Image Guidance,11012.53,4405.01,,,0 HCPCS,47533,Plmt biliary drainage cath,,,3496.63,9743.0,8 HCPCS,47534,Hc Int/Ext Bili Drain,11094.58,4437.83,,,0 HCPCS,47534,Plmt biliary drainage cath,,,3496.63,8741.59,4 HCPCS,47535,Conversion ext bil drg cath,,,3496.63,8741.59,4 HCPCS,47535,Hc Convert Ext Bilateral Drg Cath To Int-Ext Bil Drg Cath,8706.23,3482.49,,,0 HCPCS,47536,Exchange biliary drg cath,,,3496.63,8741.59,4 HCPCS,47536,Hc Bili Drain Change,9053.84,3621.54,,,0 HCPCS,47536,Hc Exchange Biliary Drg Catheter Prq W/Img Gid Rs&I,9053.84,3621.54,,,0 HCPCS,47537,Hc Removal Biliary Drg Catheter Req Fluor Gid Rs&I,4049.31,1619.72,,,0 HCPCS,47537,Removal biliary drg cath,,,885.77,2978.0,8 HCPCS,47538,Hc Plmt Bile Duct Stent Prq Existing Access,17750.32,7100.13,,,0 HCPCS,47538,Perq plmt bile duct stent,,,5904.09,14760.22,4 HCPCS,47539,Hc Plmt Bile Duct Stent Prq New Access W/O Sep Cath,15227.64,6091.06,,,0 HCPCS,47539,Perq plmt bile duct stent,,,5904.09,14760.22,4 HCPCS,47540,Perq plmt bile duct stent,,,5904.09,14760.22,4 HCPCS,47541,Plmt access bil tree sm bwl,,,6322.36,15805.9,4 HCPCS,47542,Hc Balloon Dilation Biliary Duct/Ampulla Percutaneous Each Duct,2750.77,1100.31,,,0 HCPCS,47543,Hc Endoluminal Biopsy Of Biliary Tree,2156.0,862.4,,,0 HCPCS,47544,Hc Removal Biliary Duct &/Glbldr Calculi Perq Rs&I,5708.42,2283.37,,,0 HCPCS,47552,Biliary endo perq dx w/speci,,,3470.0,15805.9,8 HCPCS,47553,Biliary endoscopy thru skin,,,6322.36,15805.9,8 HCPCS,47554,Biliary endoscopy thru skin,,,8330.0,25952.85,8 HCPCS,47555,Biliary endoscopy thru skin,,,6322.36,15805.9,8 HCPCS,47556,Biliary endoscopy thru skin,,,10381.14,25952.85,8 HCPCS,47560,Laparoscopy w/cholangio,,,8330.0,9743.0,4 HCPCS,47561,Laparo w/cholangio/biopsy,,,8330.0,9743.0,4 HCPCS,47562,Laparoscopic cholecystectomy,,,5904.09,14760.22,8 HCPCS,47563,Laparo cholecystectomy/graph,,,5904.09,14760.22,8 HCPCS,47564,Laparo cholecystectomy/explr,,,10346.0,25952.85,8 HCPCS,47579,Laparoscope proc biliary,,,5904.09,14760.22,8 HCPCS,47630,Remove bile duct stone,,,8330.0,9743.0,4 HCPCS,47999,Bile tract surgery procedure,,,885.77,2214.41,4 HCPCS,47999,Hc Unlisted Procedure Biliary Tract,4234.6,1693.84,,,0 HCPCS,48102,Hc Needle Biopsy Of Pancreas,1686.25,674.5,,,0 HCPCS,48102,Needle biopsy pancreas,,,1612.96,4032.39,8 HCPCS,48999,Hc Endo Necrosectomy Pancreas,1437.87,575.15,,,0 HCPCS,48999,Pancreas surgery procedure,,,691.56,1728.91,4 HCPCS,49000,Hc Exploratory Laparotomy Celiotomy With Or Without Biopsy Separate Procedure,9563.22,3825.29,,,0 HCPCS,49010,Exploration behind abdomen,,,6322.36,15805.9,4 HCPCS,49080,"Puncture, peritoneal cavity",,,3470.0,4059.0,4 HCPCS,49081,Removal of abdominal fluid,,,3470.0,4059.0,4 HCPCS,49082,Abd paracentesis,,,885.77,2978.0,8 HCPCS,49082,Hc Abdominal Paracentesis Diagnosis/Therapy Without Guidance,2722.04,1088.82,,,0 HCPCS,49082,Hc Abdominal Paracentesis Diagnosis/Therapy Without Imaging Guidance,2722.04,1088.82,,,0 HCPCS,49083,Abd paracentesis w/imaging,,,885.77,2978.0,8 HCPCS,49083,Hc Abdominal Paracentesis Diagnosis/Therapy W Imaging Guidance,4240.36,1696.14,,,0 HCPCS,49084,Hc Peritoneal Lavage W/Wo Imaging Guidance,2371.4,948.56,,,0 HCPCS,49084,Peritoneal lavage,,,885.77,2214.41,4 HCPCS,49180,Biopsy abdominal mass,,,1612.96,4032.39,8 HCPCS,49180,"Hc Percut Biopsy, Abdominal Mass",4626.36,1850.54,,,0 HCPCS,49185,Hc Sclerotherapy Fluid Collection Prq W/Img Gid,2853.18,1141.27,,,0 HCPCS,49185,Sclerotx fluid collection,,,1612.96,4032.39,4 HCPCS,49204,Exc abd tum over 5 cm,,,8330.0,9743.0,4 HCPCS,49250,Excision of umbilicus,,,3496.63,8800.0,8 HCPCS,49255,Removal of omentum,,,6322.36,15805.9,4 HCPCS,49320,Diag laparo separate proc,,,5904.09,14760.22,8 HCPCS,49321,Laparoscopy biopsy,,,5904.09,14760.22,8 HCPCS,49322,Laparoscopy aspiration,,,5904.09,14760.22,8 HCPCS,49323,Laparo drain lymphocele,,,5904.09,14760.22,8 HCPCS,49324,Lap insert tunnel ip cath,,,5904.09,14760.22,8 HCPCS,49325,Lap Revision Perm IP Cath,,,5904.09,14760.22,8 HCPCS,49326,Lap w/Omentopexy Add-on,,,8330.0,9743.0,4 HCPCS,49327,Lap ins device for rt,,,7524.0,8800.0,4 HCPCS,49329,Laparo proc abdm/per/oment,,,5904.09,14760.22,8 HCPCS,49400,Hc Air/Contrast Inject Into Abdomen,1233.38,493.35,,,0 HCPCS,49402,Hc Remove Peritoneal Foreign Body,6733.29,2693.32,,,0 HCPCS,49402,Remove foreign body adbomen,,,3470.0,8741.59,8 HCPCS,49405,Hc Image-Guide Fluid Collxn Drainage Cath Visc Perq,7694.98,3077.99,,,0 HCPCS,49405,Image cath fluid colxn visc,,,1612.96,4059.0,8 HCPCS,49406,Hc Img-Guide Fluid Collxn Drainag Cath Periton Perq,8180.49,3272.2,,,0 HCPCS,49406,Image cath fluid peri/retro,,,1612.96,4032.39,4 HCPCS,49407,Image cath fluid trns/vgnl,,,1612.96,4032.39,4 HCPCS,49411,Ins mark abd/pel for rt perq,,,1351.75,3379.37,4 HCPCS,49418,Hc Insertion Tunnel Intraperitoneal Cath W Image Guidance,11968.61,4787.44,,,0 HCPCS,49418,Insert tun ip cath perc,,,3496.63,9743.0,8 HCPCS,49419,Hc Insertion Tunnel Intraperitoneal Cath W Subq Port,9321.32,3728.53,,,0 HCPCS,49419,Insert tun ip cath w/port,,,2546.0,13585.75,8 HCPCS,49420,Insert abdominal drain,,,2546.0,2978.0,4 HCPCS,49421,Hc Peritoneal Drain Placement,9430.45,3772.18,,,0 HCPCS,49421,Ins tun ip cath for dial opn,,,2546.0,8741.59,8 HCPCS,49422,Hc Removal Tunneled Intraperitoneal Catheter,7908.19,3163.28,,,0 HCPCS,49422,Remove tunneled ip cath,,,2546.0,7709.02,8 HCPCS,49423,Exchange drainage catheter,,,1874.01,4685.03,8 HCPCS,49423,Hc Drainage Catheter Exchange,4756.04,1902.42,,,0 HCPCS,49424,"Hc Contrast Injection,Abscess/Cyst Via Cath Tube",924.0,369.6,,,0 HCPCS,49426,Revise abdomen-venous shunt,,,3470.0,8741.59,8 HCPCS,49429,Removal of shunt,,,3083.61,7709.02,4 HCPCS,49436,Embedded IP Cath Exit-Site,,,1874.01,4685.03,4 HCPCS,49440,Hc Insert Gastrostomy Tube Percutaneous,6145.05,2458.02,,,0 HCPCS,49440,Place gastrostomy tube perc,,,1874.01,4685.03,8 HCPCS,49441,Hc Insert Duodenostomy/Jejunostomy Tube Percutaneous,6632.3,2652.92,,,0 HCPCS,49441,Place duod/jej tube perc,,,1874.01,4685.03,8 HCPCS,49442,Place cecostomy tube perc,,,1168.65,2921.61,4 HCPCS,49446,Change g-tube to g-j perc,,,1874.01,4685.03,8 HCPCS,49446,Hc Convert Gastrostomy-Gastro-Jejunostomy Tube Percutaneous,6630.62,2652.25,,,0 HCPCS,49450,Hc Replace Gastrostomy/Cecostomy Tube Percutaneous,3330.38,1332.15,,,0 HCPCS,49450,Replace g/c tube perc,,,885.77,2978.0,8 HCPCS,49451,Hc Replace Duodenostomy/Jejunostomy Tube Percutaneous,3785.82,1514.33,,,0 HCPCS,49451,Replace duod/jej tube perc,,,885.77,2978.0,8 HCPCS,49452,Hc Replacement Gastro-Jejunostomy Tube Percutaneous,3785.82,1514.33,,,0 HCPCS,49452,Replace g-j tube perc,,,885.77,2978.0,8 HCPCS,49460,Fix g/colon tube w/device,,,885.77,2214.41,4 HCPCS,49465,Fluoro exam of g/colon tube,,,233.02,582.55,4 HCPCS,49465,Hc Contrast Injection Percutaneouos Radiologic Eval Gi Tube,1736.36,694.54,,,0 HCPCS,49491,Rpr hern preemie reduc,,,5904.09,14760.22,4 HCPCS,49492,Rpr ing hern premie blocked,,,3496.63,8741.59,4 HCPCS,49495,Rpr ing hernia baby reduc,,,3496.63,8800.0,8 HCPCS,49496,Rpr ing hernia baby blocked,,,3496.63,8800.0,8 HCPCS,49500,Rpr ing hernia init reduce,,,6322.36,15805.9,8 HCPCS,49501,Rpr ing hernia init blocked,,,3496.63,17190.0,8 HCPCS,49505,Prp i/hern init reduc >5 yr,,,3496.63,8800.0,8 HCPCS,49507,Prp i/hern init block >5 yr,,,3496.63,17190.0,8 HCPCS,49520,Rerepair ing hernia reduce,,,3496.63,12101.0,8 HCPCS,49521,Rerepair ing hernia blocked,,,6322.36,17190.0,8 HCPCS,49525,Repair ing hernia sliding,,,3496.63,8800.0,8 HCPCS,49540,Repair lumbar hernia,,,3470.0,14760.22,8 HCPCS,49550,Rpr rem hernia init reduce,,,3496.63,11433.0,8 HCPCS,49553,Rpr fem hernia init blocked,,,3496.63,17190.0,8 HCPCS,49555,Rerepair fem hernia reduce,,,3496.63,11433.0,8 HCPCS,49557,Rerepair fem hernia blocked,,,3496.63,17190.0,8 HCPCS,49560,Rpr ventral hern init reduc,,,7524.0,8800.0,4 HCPCS,49561,Rpr ventral hern init block,,,14697.0,17190.0,4 HCPCS,49565,"Hc Pbb Repair Recurr Incis Hernia,Reduc",137.9,55.16,,,0 HCPCS,49565,Rerepair ventrl hern reduce,,,7524.0,8800.0,4 HCPCS,49566,"Hc Pbb Repair Recurr Incis Hernia,Strang",104.86,41.94,,,0 HCPCS,49566,Rerepair ventrl hern block,,,14697.0,17190.0,4 HCPCS,49568,Hernia repair w/mesh,,,10346.0,12101.0,4 HCPCS,49570,Rpr epigastric hern reduce,,,7524.0,8800.0,4 HCPCS,49572,Rpr epigastric hern blocked,,,14697.0,17190.0,4 HCPCS,49580,Rpr umbil hern reduc < 5 yr,,,7524.0,8800.0,4 HCPCS,49582,Rpr umbil hern block < 5 yr,,,14697.0,17190.0,4 HCPCS,49585,Rpr umbil hern reduc > 5 yr,,,7524.0,8800.0,4 HCPCS,49587,Rpr umbil hern block > 5 yr,,,14697.0,17190.0,4 HCPCS,49590,Repair spigelian hernia,,,8330.0,9743.0,4 HCPCS,49591,Rpr aa hrn 1st < 3 cm rdc,,,3496.63,8800.0,8 HCPCS,49592,Rpr aa hrn 1st < 3 ncr/strn,,,5904.09,17190.0,8 HCPCS,49593,Rpr aa hrn 1st 3-10 rdc,,,6322.36,15805.9,8 HCPCS,49594,Rpr aa hrn 1st 3-10 ncr/strn,,,5904.09,17190.0,8 HCPCS,49595,Rpr aa hrn 1st > 10 rdc,,,6322.36,15805.9,8 HCPCS,49596,Rpr aa hrn 1st > 10 ncr/strn,,,14697.0,17190.0,4 HCPCS,49600,Repair umbilical lesion,,,3496.63,8800.0,8 HCPCS,49613,Rpr aa hrn rcr < 3 rdc,,,3496.63,8800.0,8 HCPCS,49614,Rpr aa hrn rcr < 3 ncr/strn,,,5904.09,17190.0,8 HCPCS,49615,Rpr aa hrn rcr 3-10 rdc,,,6322.36,15805.9,8 HCPCS,49616,Rpr aa hrn rcr 3-10 ncr/strn,,,14697.0,17190.0,4 HCPCS,49617,Rpr aa hrn rcr > 10 rdc,,,7524.0,8800.0,4 HCPCS,49621,Rpr parastomal hernia rdc,,,7524.0,8800.0,4 HCPCS,49650,Lap ing hernia repair init,,,5904.09,14760.22,8 HCPCS,49651,Lap ing hernia repair recur,,,5904.09,14760.22,8 HCPCS,49652,Lap vent/abd hernia repair,,,10346.0,12101.0,4 HCPCS,49653,Lap vent/abd hern proc comp,,,14697.0,17190.0,4 HCPCS,49654,Lap inc hernia repair,,,10346.0,12101.0,4 HCPCS,49655,Lap inc hern repair comp,,,14697.0,17190.0,4 HCPCS,49656,Lap inc hernia repair recur,,,10346.0,12101.0,4 HCPCS,49657,Lap inc hern recur comp,,,14697.0,17190.0,4 HCPCS,49659,Laparo proc hernia repair,,,5904.09,14760.22,8 HCPCS,49900,Repair of abdominal wall,,,8330.0,9743.0,4 HCPCS,49999,Abdomen surgery procedure,,,885.77,2214.41,4 HCPCS,49999,Hc Ct Ablation Of Abdominal Wall,18262.83,7305.13,,,0 HCPCS,49999,Hc Exchg Tunnel Abd Drain W/ Guid,1355.99,542.4,,,0 HCPCS,50020,Renal abscess open drain,,,2041.48,5103.69,4 HCPCS,50080,Removal of kidney stone,,,9244.99,23112.47,4 HCPCS,50081,Removal of kidney stone,,,9244.99,23112.47,4 HCPCS,50200,Hc Biopsy Of Kidney Percutaneious-Unilateral,5768.31,2307.32,,,0 HCPCS,50200,Renal biopsy perq,,,1612.96,4032.39,8 HCPCS,50382,Change ureter stent percut,,,2041.48,5103.69,4 HCPCS,50382,"Hc Change Ureter Stent, Percutaneous",7816.09,3126.44,,,0 HCPCS,50384,"Hc Remove Ureter Stent, Percut",7265.22,2906.09,,,0 HCPCS,50384,Remove ureter stent percut,,,2041.48,5103.69,4 HCPCS,50385,Change stent via transureth,,,2041.48,9743.0,8 HCPCS,50386,Hc Remove Ureteral Stent Via Transureth,5564.9,2225.96,,,0 HCPCS,50386,Remove stent via transureth,,,2041.48,5103.69,4 HCPCS,50387,Change nephroureteral cath,,,2041.48,5103.69,4 HCPCS,50387,Hc Removal & Replacement External Accessible Nephrourtrl Cath,5421.7,2168.68,,,0 HCPCS,50389,Hc Remove Renal Tube W/Fluoro-Unilateral,2512.32,1004.93,,,0 HCPCS,50389,Remove renal tube w/fluoro,,,680.98,1702.46,4 HCPCS,50390,Drainage of kidney lesion,,,691.56,2978.0,8 HCPCS,50390,Hc Ct Guided Asp Renal Cyst-Bilateral,6096.49,2438.6,,,0 HCPCS,50390,Hc Ct Guided Asp Renal Cyst-Unilateral,4063.77,1625.51,,,0 HCPCS,50391,Hc Instillation Of Drug Into Kidney And/Or Ureter Unilateral,1147.87,459.15,,,0 HCPCS,50391,Instll rx agnt into rnal tub,,,244.0,610.01,4 HCPCS,50392,Insert kidney drain,,,2546.0,2978.0,4 HCPCS,50393,Insert ureteral tube,,,2546.0,2978.0,4 HCPCS,50395,Create passage to kidney,,,2546.0,2978.0,4 HCPCS,50396,Measure kidney pressure,,,680.98,2978.0,8 HCPCS,50398,Change kidney tube,,,2546.0,2978.0,4 HCPCS,50430,Hc Injection Px Anteegrade Nfrosgrm &/Uretragram Existing Access-Unilateral,3088.62,1235.45,,,0 HCPCS,50430,Njx px nfrosgrm &/urtrgrm,,,680.98,1702.46,4 HCPCS,50431,Hc Injection Px Anteegrade Nfrosgrm &/Uretragram Existing Access-Unilateral,3088.62,1235.45,,,0 HCPCS,50431,Njx px nfrosgrm &/urtrgrm,,,680.98,1702.46,4 HCPCS,50432,Hc Guided Neph Tube Placement-Unilateral,8102.93,3241.17,,,0 HCPCS,50432,Hc Plmt Nephrostomy Cath Prq New Access Rs&I-Bilateral,12156.54,4862.62,,,0 HCPCS,50432,Plmt nephrostomy catheter,,,2041.48,5103.69,4 HCPCS,50433,Hc Plmt Nephroureteral Cath Prq New Access Rs&I,8229.33,3291.73,,,0 HCPCS,50433,Plmt nephroureteral catheter,,,3442.51,8606.28,4 HCPCS,50434,Convert nephrostomy catheter,,,2041.48,5103.69,4 HCPCS,50434,Hc Convert Nephrostomy Cath To Nephrourtrl Cath Prq,4271.95,1708.78,,,0 HCPCS,50435,Exchange nephrostomy cath,,,2041.48,5103.69,8 HCPCS,50435,Hc Exchange Nephrostomy Catheter Prq W/Img Gid Rs&I,8825.76,3530.3,,,0 HCPCS,50435,Hc Exchange Nephrostomy Catheter Prz W/Img Gid Rs&I-Bilateral,13239.49,5295.8,,,0 HCPCS,50436,Dilat xst trc ndurlgc px,,,3442.51,8606.28,4 HCPCS,50436,Hc Dilat Xst Trc Ndurlgc Px,5761.54,2304.62,,,0 HCPCS,50437,Dilat xst trc new access rcs,,,3442.51,8606.28,4 HCPCS,50541,Laparo ablate renal cyst,,,7524.0,25952.85,8 HCPCS,50542,Laparo ablate renal mass,,,10381.14,25952.85,4 HCPCS,50543,Laparo partial nephrectomy,,,10381.14,25952.85,8 HCPCS,50544,Laparoscopy pyeloplasty,,,10346.0,25952.85,8 HCPCS,50549,Laparoscope proc renal,,,5904.09,14760.22,8 HCPCS,50551,Kidney endoscopy,,,2546.0,13090.88,8 HCPCS,50553,Kidney endoscopy,,,2546.0,13090.88,8 HCPCS,50555,Kidney endoscopy & biopsy,,,2546.0,23112.47,8 HCPCS,50557,Kidney endoscopy & treatment,,,2546.0,23112.47,8 HCPCS,50561,Kidney endoscopy & treatment,,,2546.0,13090.88,8 HCPCS,50562,Renal scope w/tumor resect,,,9244.99,23112.47,4 HCPCS,50570,Kidney endoscopy,,,3442.51,8606.28,4 HCPCS,50572,Kidney endoscopy,,,680.98,1702.46,4 HCPCS,50574,Kidney endoscopy & biopsy,,,3442.51,8606.28,4 HCPCS,50575,Kidney endoscopy,,,5236.35,13090.88,4 HCPCS,50576,Kidney endoscopy & treatment,,,9244.99,23112.47,4 HCPCS,50580,Kidney endoscopy & treatment,,,5236.35,13090.88,4 HCPCS,50590,Fragmenting of kidney stone,,,3442.51,8800.0,8 HCPCS,50592,Hc Ct Guided Microwave Ablation Renal-Bilateral,16378.99,6551.6,,,0 HCPCS,50592,Hc Ct Guided Microwave Ablation Renal-Unilateral,10920.44,4368.18,,,0 HCPCS,50592,Perc rf ablate renal tumor,,,5904.09,14760.22,4 HCPCS,50593,Hc Ct Guided Cryoablation Renal- Bilateral,31934.16,12773.66,,,0 HCPCS,50593,Hc Ct Guided Cryoablation Renal-Unilateral,21288.32,8515.33,,,0 HCPCS,50593,Perc cryo ablate renal tum,,,10381.14,25952.85,4 HCPCS,50686,Measure ureter pressure,,,125.66,314.16,4 HCPCS,50688,Change of ureter tube/stent,,,2041.48,5103.69,8 HCPCS,50688,Hc Rt Int To Ext Uert Via Il Cond,5106.92,2042.77,,,0 HCPCS,50690,Hc Injection Procedure Visual Ileal Conduit,1175.94,470.38,,,0 HCPCS,50693,Hc Plmt Urethral Stent Prq Pre-Existing Nfros Tract,10351.15,4140.46,,,0 HCPCS,50693,Plmt ureteral stent prq,,,3442.51,8606.28,4 HCPCS,50694,Plmt ureteral stent prq,,,3442.51,8606.28,4 HCPCS,50695,Plmt ureteral stent prq,,,3442.51,8606.28,4 HCPCS,50706,Hc Balloon Dilatation Ureteral Stricture W/Image Guidance Rs&I,2212.11,884.84,,,0 HCPCS,50727,Revise ureter,,,3442.51,8606.28,4 HCPCS,50945,Laparoscopy ureterolithotomy,,,5904.09,14760.22,8 HCPCS,50947,Laparo New Ureter/Bladder,,,10381.14,25952.85,8 HCPCS,50948,Laparo New Ureter/Bladder,,,10381.14,25952.85,8 HCPCS,50949,Laparoscope proc ureter,,,5904.09,14760.22,8 HCPCS,50951,Endoscopy of ureter,,,2546.0,8606.28,8 HCPCS,50953,Endoscopy of ureter,,,2546.0,8606.28,8 HCPCS,50955,Ureter endoscopy & biopsy,,,2546.0,13090.88,8 HCPCS,50957,Ureter endoscopy & treatment,,,2546.0,13090.88,8 HCPCS,50961,Ureter endoscopy & treatment,,,2546.0,13090.88,8 HCPCS,50970,Ureter endoscopy,,,2546.0,8606.28,8 HCPCS,50972,Ureter endoscopy & catheter,,,2546.0,8606.28,8 HCPCS,50974,Ureter endoscopy & biopsy,,,2546.0,13090.88,8 HCPCS,50976,Ureter endoscopy & treatment,,,2546.0,13090.88,8 HCPCS,50980,Ureter endoscopy & treatment,,,2546.0,13090.88,8 HCPCS,51010,Drainage of bladder,,,2546.0,2978.0,4 HCPCS,51020,Incise & treat bladder,,,3442.51,8800.0,8 HCPCS,51030,Incise & treat bladder,,,7524.0,8800.0,4 HCPCS,51040,Hc Incision Of Bladder With Drainage,5594.91,2237.96,,,0 HCPCS,51040,Incise & drain bladder,,,2041.48,8800.0,8 HCPCS,51045,Incise bladder/drain ureter,,,2041.48,8800.0,8 HCPCS,51050,Removal of bladder stone,,,5236.35,13090.88,8 HCPCS,51060,Removal of ureter stone,,,2041.48,5103.69,4 HCPCS,51065,Remove ureter calculus,,,3442.51,8800.0,8 HCPCS,51080,Drainage of bladder abscess,,,2546.0,7091.89,8 HCPCS,51100,Drain bladder by needle,,,244.0,610.01,4 HCPCS,51101,Drain bladder by trocar/cath,,,838.65,2096.62,4 HCPCS,51102,Drain bl w/cath insertion,,,2041.48,5103.69,8 HCPCS,51102,Hc Aspiration Bladder Insert Suprapubic Catheter,3599.96,1439.98,,,0 HCPCS,51500,Removal of bladder cyst,,,5904.09,14760.22,8 HCPCS,51520,Removal of bladder lesion,,,3442.51,8800.0,8 HCPCS,51535,Repair of ureter lesion,,,3442.51,8606.28,4 HCPCS,51600,Hc Injection For Bladder X-Ray,1098.66,439.46,,,0 HCPCS,51610,Hc Inject For Retrograde Urethocysto W/ Disposable Scope,1463.95,585.58,,,0 HCPCS,51700,Hc Irrigation Of Bladder,890.79,356.32,,,0 HCPCS,51700,Irrigation of bladder,,,244.0,610.01,4 HCPCS,51701,"Hc Insert,Non-Indwelling Bladder Catheter",547.53,219.01,,,0 HCPCS,51701,Insert bladder catheter,,,129.94,2978.0,8 HCPCS,51702,"Hc Insert,Temp Indwelling Blad Cath,Simple",676.46,270.58,,,0 HCPCS,51702,Insert temp bladder cath,,,129.94,324.84,4 HCPCS,51703,"Hc Insert, Temp Indwelling Blad Cath, Comp",815.44,326.18,,,0 HCPCS,51703,Insert bladder cath complex,,,125.66,2978.0,8 HCPCS,51705,Change of bladder tube,,,244.0,610.01,4 HCPCS,51705,Hc Change Of Bladder Tube Simple,879.06,351.62,,,0 HCPCS,51710,Change of bladder tube,,,680.98,2978.0,8 HCPCS,51710,Hc Change Of Bladder Tube Complicated,3097.64,1239.06,,,0 HCPCS,51715,Endoscopic injection/implant,,,3442.51,9743.0,8 HCPCS,51720,Hc Instill Anticancer Agent In Bladder,903.12,361.25,,,0 HCPCS,51720,Treatment of bladder lesion,,,680.98,1702.46,4 HCPCS,51725,Hc Simple Cystometrogram,1178.78,471.51,,,0 HCPCS,51725,Simple cystometrogram,,,244.0,610.01,4 HCPCS,51726,Complex cystometrogram,,,244.0,2978.0,8 HCPCS,51726,Hc Bladder Pressure Measurement During Filling,1547.32,618.93,,,0 HCPCS,51727,Cystometrogram w/up,,,680.98,2978.0,8 HCPCS,51727,Hc Complex Cystometrogram Urethral Pressure Profile,1170.0,468.0,,,0 HCPCS,51728,Cystometrogram w/vp,,,680.98,4059.0,8 HCPCS,51728,Hc Complex Cystometrogram Voiding Pressure Studies,1964.07,785.63,,,0 HCPCS,51729,Cystometrogram w/vp&up,,,680.98,2978.0,8 HCPCS,51729,Hc Complex Cystometrogram With Void Pressure And Urethral Profile,1625.0,650.0,,,0 HCPCS,51736,Hc Urine Flow Measurement,393.48,157.39,,,0 HCPCS,51736,Urine flow measurement,,,129.94,324.84,4 HCPCS,51741,Electro-uroflowmetry first,,,210.87,527.18,4 HCPCS,51741,Hc Complex Uroflowmetry,410.23,164.09,,,0 HCPCS,51772,Urethra pressure profile,,,2546.0,2978.0,4 HCPCS,51784,Anal/urinary muscle study,,,125.66,314.16,4 HCPCS,51784,Hc Anal/Urinary Muscle Study,800.36,320.14,,,0 HCPCS,51785,Anal/urinary muscle study,,,244.0,2978.0,8 HCPCS,51792,Urinary reflex study,,,57.61,144.03,4 HCPCS,51797,Hc Voiding Press Study Intra-Abdominal Void,631.25,252.5,,,0 HCPCS,51798,"Hc Meas, Post-Void Res, Us, Non-Imaging Poct",627.9,251.16,,,0 HCPCS,51798,"Hc Meas,Post-Void Res,Us,Non-Imaging",627.9,251.16,,,0 HCPCS,51798,Us urine capacity measure,,,57.61,144.03,4 HCPCS,51840,Attach bladder/urethra,,,4885.41,12213.53,4 HCPCS,51845,Repair bladder neck,,,4885.41,12213.53,4 HCPCS,51860,Repair of bladder wound,,,8330.0,23112.47,8 HCPCS,51880,Repair of bladder opening,,,2546.0,8606.28,8 HCPCS,51990,Laparo urethral suspension,,,5904.09,14760.22,8 HCPCS,51992,Laparo sling operation,,,5904.09,14760.22,8 HCPCS,51999,Laparoscope proc bla,,,5904.09,14760.22,8 HCPCS,52000,Cystoscopy,,,680.98,2978.0,8 HCPCS,52000,Hc Cystoscopy W/ Disposable Scope,1877.95,751.18,,,0 HCPCS,52001,Cystoscopy removal of clots,,,3442.51,8606.28,8 HCPCS,52001,Hc Cystoscopy Removal Of Clots W/ Disposable Scope,4206.7,1682.68,,,0 HCPCS,52005,Cystoscopy & ureter catheter,,,2041.48,5103.69,8 HCPCS,52005,"Hc Cystourethroscopy, Ureter Catheter W/ Disposable Scope",5005.95,2002.38,,,0 HCPCS,52007,Cystoscopy and biopsy,,,3442.51,8606.28,8 HCPCS,52010,Cystoscopy & duct catheter,,,680.98,4059.0,8 HCPCS,52204,Cystoscopy w/biopsy(s),,,2041.48,5103.69,8 HCPCS,52204,"Hc Cystourethroscopy With Biopsy, Inlcuding Fulguration",6833.0,2733.2,,,0 HCPCS,52214,Cystoscopy and treatment,,,3442.51,8606.28,8 HCPCS,52214,Hc Cystourethroscopy With Destruction Of Lesions,3800.0,1520.0,,,0 HCPCS,52224,Cystoscopy and treatment,,,3442.51,8606.28,8 HCPCS,52224,Hc Cystoscopy With Removal Of Lesions Small<0.5 Cm Lesion,5447.0,2178.8,,,0 HCPCS,52234,Cystoscopy and treatment,,,3442.51,8606.28,8 HCPCS,52234,"Hc Cystourethroscopy, Fulgur 0.5-2 Cm Lesn W/ Disposable Scope",5672.95,2269.18,,,0 HCPCS,52235,Cystoscopy and treatment,,,3442.51,9743.0,8 HCPCS,52235,Hc Cystourethroscopy With Destruction Of Lesions 2-5Cm,4775.0,1910.0,,,0 HCPCS,52240,Cystoscopy and treatment,,,5236.35,13090.88,8 HCPCS,52240,Hc Cystourethroscopy With Destruction Of Lesions >5Cm,6200.0,2480.0,,,0 HCPCS,52250,Cystoscopy and radiotracer,,,3442.51,8800.0,8 HCPCS,52260,Cystoscopy and treatment,,,2041.48,5103.69,8 HCPCS,52265,Cystoscopy and treatment,,,2041.48,5103.69,8 HCPCS,52270,Cystoscopy & revise urethra,,,2041.48,5103.69,8 HCPCS,52275,Cystoscopy & revise urethra,,,2041.48,5103.69,8 HCPCS,52276,Cystoscopy and treatment,,,2041.48,9743.0,8 HCPCS,52277,Cystoscopy and treatment,,,3442.51,8606.28,8 HCPCS,52281,Cystoscopy and treatment,,,2041.48,5103.69,8 HCPCS,52281,"Hc Cystoscopy,Dil Urethral Stricture W/ Disposable Scope",4453.95,1781.58,,,0 HCPCS,52282,Cystoscopy implant stent,,,3442.51,17190.0,8 HCPCS,52283,Cystoscopy and treatment,,,2041.48,5103.69,8 HCPCS,52284,Cysto rx balo cath urtl strx,,,5236.35,13090.88,4 HCPCS,52284,Hc Cystourethroscopy With Drug Coated Balloon For Male Treatment Of Urethral Stricture,6200.0,2480.0,,,0 HCPCS,52285,Cystoscopy and treatment,,,680.98,4059.0,8 HCPCS,52287,Cystoscopy chemodenervation,,,2041.48,5103.69,8 HCPCS,52287,Hc Cystourethroscopy Inj Chemodenervation Bladder W/ Disposable Scope,3545.45,1418.18,,,0 HCPCS,52290,Cystoscopy and treatment,,,2041.48,5103.69,8 HCPCS,52300,Cystoscopy and treatment,,,3442.51,8606.28,8 HCPCS,52301,Cystoscopy and treatment,,,3442.51,9743.0,8 HCPCS,52305,Cystoscopy and treatment,,,3470.0,13090.88,8 HCPCS,52310,Cystoscopy and treatment,,,2041.48,5103.69,8 HCPCS,52310,"Hc Cystoscopy,Remv Calculus,Simple W/D Disposable Scope",4085.95,1634.38,,,0 HCPCS,52315,Cystoscopy and treatment,,,2041.48,5103.69,8 HCPCS,52315,Hc Cystoscopy With Complex Removal Stone & Stent,4880.0,1952.0,,,0 HCPCS,52317,Remove bladder stone,,,2546.0,8606.28,8 HCPCS,52318,Remove bladder stone,,,3442.51,8606.28,8 HCPCS,52320,Cystoscopy and treatment,,,3442.51,11433.0,8 HCPCS,52325,Cystoscopy stone removal,,,5236.35,13090.88,8 HCPCS,52327,Cystoscopy inject material,,,3470.0,13090.88,8 HCPCS,52330,Cystoscopy and treatment,,,3442.51,8606.28,8 HCPCS,52332,Cystoscopy and treatment,,,3442.51,8606.28,8 HCPCS,52332,Hc Cystoscopy With Insert Ureteral Stent,6287.0,2514.8,,,0 HCPCS,52334,Create passage to kidney,,,3442.51,9743.0,8 HCPCS,52341,Cysto W/Ureter Stricture Tx,,,3442.51,9743.0,8 HCPCS,52342,Cysto W/Up Stricture Tx,,,3442.51,9743.0,8 HCPCS,52343,Cysto W/Renal Stricture Tx,,,3442.51,9743.0,8 HCPCS,52344,Cysto/uretero stricture tx,,,3442.51,9743.0,8 HCPCS,52345,Cysto/Uretero W/Up Stricture,,,3442.51,9743.0,8 HCPCS,52346,Cystouretero W/Renal Strict,,,5236.35,13090.88,8 HCPCS,52351,Cystouretero & or pyeloscope,,,3442.51,9743.0,8 HCPCS,52351,"Hc Cystoscopy/Uretero/Pyeloscopy, Dx W/ Disposable Scope",5299.2,2119.68,,,0 HCPCS,52352,Cystouretero w/stone remove,,,3442.51,8800.0,8 HCPCS,52353,Cystouretero W/Lithotripsy,,,5236.35,13090.88,8 HCPCS,52354,Cystouretero W/Biopsy,,,5236.35,13090.88,8 HCPCS,52354,Hc Cystourethroscsopy With Biopsy-Bilateral,8370.0,3348.0,,,0 HCPCS,52354,Hc Cystourethroscsopy With Biopsy-Unilateral,5580.0,2232.0,,,0 HCPCS,52355,Cystouretero W/Excise Tumor,,,5236.35,13090.88,8 HCPCS,52356,Cysto/uretero w/lithotripsy,,,5236.35,13090.88,8 HCPCS,52400,Cystouretero W/Congen Repr,,,3442.51,9743.0,8 HCPCS,52402,Cystourethro cut ejacul duct,,,3442.51,9743.0,8 HCPCS,52443,Cysto 1st trurl prst8 comis,,,9244.99,23112.47,4 HCPCS,52450,Incision of prostate,,,3442.51,9743.0,8 HCPCS,52500,Revision of bladder neck,,,3442.51,9743.0,8 HCPCS,52510,Dilation prostatic urethra,,,8330.0,9743.0,4 HCPCS,52597,Trurl rbtc wtrjt rescj prst8,,,9244.99,23112.47,4 HCPCS,52601,Prostatectomy (TURP),,,5236.35,13090.88,8 HCPCS,52606,Control postop bleeding,,,2546.0,2978.0,4 HCPCS,52612,"Prostatectomy, first stage",,,3470.0,4059.0,4 HCPCS,52614,"Prostatectomy, second stage",,,2546.0,2978.0,4 HCPCS,52620,Remove residual prostate,,,2546.0,2978.0,4 HCPCS,52630,Remove prostate regrowth,,,3470.0,13090.88,8 HCPCS,52640,Relieve bladder contracture,,,3442.51,8606.28,8 HCPCS,52647,Laser surgery of prostate,,,14697.0,17190.0,4 HCPCS,52648,Laser surgery of prostate,,,5236.35,17190.0,8 HCPCS,52649,Prostate laser enucleation,,,5236.35,13090.88,4 HCPCS,52700,Drainage of prostate abscess,,,3442.51,8606.28,8 HCPCS,53000,Incision of urethra,,,2041.48,5103.69,8 HCPCS,53010,Incision of urethra,,,2546.0,13090.88,8 HCPCS,53020,Hc Incision Urethra Exclude Infant,3509.54,1403.82,,,0 HCPCS,53020,Incision of urethra,,,2041.48,5103.69,8 HCPCS,53025,Incision of urethra,,,2041.48,5103.69,4 HCPCS,53040,Drainage of urethra abscess,,,3442.51,8606.28,8 HCPCS,53060,Drainage of urethra abscess,,,2041.48,5103.69,4 HCPCS,53080,Drainage of urinary leakage,,,680.98,9743.0,8 HCPCS,53085,Drainage of urinary leakage,,,2041.48,5103.69,4 HCPCS,53200,Biopsy of urethra,,,2041.48,5103.69,8 HCPCS,53210,Removal of urethra,,,3442.51,11433.0,8 HCPCS,53215,Removal of urethra,,,5236.35,13090.88,8 HCPCS,53220,Treatment of urethra lesion,,,3442.51,8606.28,8 HCPCS,53230,Removal of urethra lesion,,,3470.0,13090.88,8 HCPCS,53235,Removal of urethra lesion,,,5236.35,13090.88,8 HCPCS,53240,Surgery for urethra pouch,,,3442.51,8606.28,8 HCPCS,53250,Removal of urethra gland,,,3442.51,8606.28,8 HCPCS,53260,Treatment of urethra lesion,,,3442.51,8606.28,8 HCPCS,53265,Treatment of urethra lesion,,,2041.48,5103.69,8 HCPCS,53270,Removal of urethra gland,,,3442.51,8606.28,8 HCPCS,53275,Repair of urethra defect,,,3442.51,8606.28,8 HCPCS,53400,Revise urethra stage 1,,,5236.35,13090.88,8 HCPCS,53405,Revise urethra stage 2,,,3470.0,13090.88,8 HCPCS,53410,Reconstruction of urethra,,,3470.0,13090.88,8 HCPCS,53420,Reconstruct urethra stage 1,,,5236.35,13090.88,8 HCPCS,53425,Reconstruct urethra stage 2,,,3470.0,13090.88,8 HCPCS,53430,Reconstruction of urethra,,,3470.0,13090.88,8 HCPCS,53431,Reconstruct urethra/bladder,,,3470.0,13090.88,8 HCPCS,53440,"Hc Sling Operation Correction, Male Incontience",19804.26,7921.7,,,0 HCPCS,53440,Male sling procedure,,,3470.0,32211.97,8 HCPCS,53442,Remove/revise male sling,,,2546.0,13090.88,8 HCPCS,53444,Insert tandem cuff,,,3470.0,50603.05,8 HCPCS,53445,Insert uro/ves nck sphincter,,,2546.0,50603.05,8 HCPCS,53446,Remove uro sphincter,,,2546.0,13090.88,8 HCPCS,53447,Remove/replace ur sphincter,,,2546.0,50603.05,8 HCPCS,53449,Repair uro sphincter,,,2546.0,23112.47,8 HCPCS,53450,Revision of urethra,,,2546.0,8606.28,8 HCPCS,53451,Tprnl balo cntnc dev bi,,,12884.79,32211.97,4 HCPCS,53452,Tprnl balo cntnc dev uni,,,9244.99,23112.47,4 HCPCS,53453,Tprnl balo cntnc dev rmvl ea,,,3442.51,8606.28,4 HCPCS,53454,Tprnl balo cntnc dev adjmt,,,244.0,610.01,4 HCPCS,53460,Revision of urethra,,,2546.0,8606.28,8 HCPCS,53500,Urethrlys transvag w/ scope,,,3442.51,8606.28,4 HCPCS,53502,Repair of urethra injury,,,3442.51,8606.28,8 HCPCS,53505,Repair of urethra injury,,,3470.0,13090.88,8 HCPCS,53510,Repair of urethra injury,,,3470.0,13090.88,8 HCPCS,53515,Repair of urethra injury,,,3470.0,13090.88,8 HCPCS,53520,Repair of urethra defect,,,3470.0,13090.88,8 HCPCS,53600,Dilate urethra stricture,,,244.0,610.01,4 HCPCS,53600,"Hc Dil Urethra Stric,Male,Initial W/ Disposable Scope",1469.58,587.83,,,0 HCPCS,53601,Dilate urethra stricture,,,129.94,324.84,4 HCPCS,53605,Dilate urethra stricture,,,3442.51,8606.28,8 HCPCS,53620,Dilate urethra stricture,,,680.98,1702.46,4 HCPCS,53621,Dilate urethra stricture,,,244.0,610.01,4 HCPCS,53660,Dilation of urethra,,,125.66,314.16,4 HCPCS,53661,Dilation of urethra,,,129.94,324.84,4 HCPCS,53665,Dilation of urethra,,,2041.48,5103.69,8 HCPCS,53850,Prostatic microwave thermotx,,,3442.51,8606.28,4 HCPCS,53852,Prostatic rf thermotx,,,3442.51,8606.28,4 HCPCS,53854,Hc Trurl Dstrj Prst8 Tiss Rf Wv Thermotherapy,6925.67,2770.27,,,0 HCPCS,53854,Trurl dstrj prst8 tiss rf wv,,,3442.51,8606.28,4 HCPCS,53855,Insert prost urethral stent,,,2041.48,5103.69,4 HCPCS,53860,Transurethral rf treatment,,,2041.48,5103.69,4 HCPCS,53865,Cysto insj dev ischmc rmdlg,,,9244.99,23112.47,4 HCPCS,53866,Cathj rmvl dev ischmc rmdlg,,,244.0,610.01,4 HCPCS,53899,Urology surgery procedure,,,244.0,610.01,4 HCPCS,54000,Slitting of prepuce,,,3442.51,8606.28,8 HCPCS,54001,Slitting of prepuce,,,2041.48,5103.69,8 HCPCS,54015,Drain penis lesion,,,1612.96,8800.0,8 HCPCS,54050,Destruction penis lesion(s),,,397.0,992.51,4 HCPCS,54050,Hc Destruction Of Penis Lesion(S),691.6,276.64,,,0 HCPCS,54055,Destruction penis lesion(s),,,2015.01,5037.52,8 HCPCS,54056,Cryosurgery penis lesion(s),,,195.94,489.85,4 HCPCS,54056,Hc Cryosurgery Penis Lesn(S) Simple,927.62,371.05,,,0 HCPCS,54057,Laser surg penis lesion(s),,,2015.01,5037.52,8 HCPCS,54060,Excision of penis lesion(s),,,2015.01,5037.52,8 HCPCS,54060,Hc Excision Of Penis Lesion,5135.0,2054.0,,,0 HCPCS,54065,Destruction penis lesion(s),,,2015.01,5037.52,8 HCPCS,54065,Hc Destruction Penis Lesion(S)/Extensive,5441.8,2176.72,,,0 HCPCS,54100,Biopsy of penis,,,1612.96,4032.39,8 HCPCS,54100,Hc Excision Biopsy Of Penis,2362.1,944.84,,,0 HCPCS,54105,Biopsy of penis,,,2546.0,7091.89,8 HCPCS,54110,Treatment of penis lesion,,,3442.51,8606.28,8 HCPCS,54111,Treat penis lesion graft,,,3470.0,13090.88,8 HCPCS,54112,Treat penis lesion graft,,,3470.0,23112.47,8 HCPCS,54115,Treatment of penis lesion,,,2546.0,7091.89,8 HCPCS,54120,Partial removal of penis,,,3442.51,8606.28,8 HCPCS,54150,Circumcision w/regionl block,,,2041.48,5103.69,8 HCPCS,54150,Hc Circumcision,1088.36,435.34,,,0 HCPCS,54150,Hc Circumcision With Block/Clamp,3594.94,1437.98,,,0 HCPCS,54150,Hc Circumcision-Neonate,3126.03,1250.41,,,0 HCPCS,54160,Circumcision neonate,,,680.98,4059.0,8 HCPCS,54161,Circum 28 days or older,,,2041.48,5103.69,8 HCPCS,54161,Hc Circumcision 28 Days Or Older,3631.77,1452.71,,,0 HCPCS,54162,Hc Lysis Of Penile Lesions,4278.09,1711.24,,,0 HCPCS,54162,Lysis penil circumic lesion,,,2041.48,5103.69,8 HCPCS,54163,Hc Repair Of Circumcision,3631.77,1452.71,,,0 HCPCS,54163,Repair of circumcision,,,2041.48,5103.69,8 HCPCS,54164,Frenulotomy of penis,,,2041.48,5103.69,8 HCPCS,54164,Hc Frenulotomy Of Penis,4550.0,1820.0,,,0 HCPCS,54200,Treatment of penis lesion,,,244.0,610.01,4 HCPCS,54205,Treatment of penis lesion,,,5236.35,13090.88,8 HCPCS,54220,"Hc Irrigat Corpus Cavern, Priapism",1130.22,452.09,,,0 HCPCS,54220,Treatment of penis lesion,,,244.0,2978.0,8 HCPCS,54231,Dynamic cavernosometry,,,244.0,610.01,4 HCPCS,54235,"Hc Penile Injection,Pharmacy Agent",795.34,318.14,,,0 HCPCS,54235,Penile injection,,,244.0,610.01,4 HCPCS,54240,Hc Penile Blood Pressure,749.0,299.6,,,0 HCPCS,54240,Penis study,,,210.87,527.18,4 HCPCS,54250,Penis study,,,244.0,610.01,4 HCPCS,54300,Revision of penis,,,3442.51,9743.0,8 HCPCS,54304,Revision of penis,,,3442.51,9743.0,8 HCPCS,54308,Reconstruction of urethra,,,5236.35,13090.88,8 HCPCS,54312,Reconstruction of urethra,,,3442.51,9743.0,8 HCPCS,54316,Reconstruction of urethra,,,8330.0,23112.47,8 HCPCS,54318,Reconstruction of urethra,,,3442.51,9743.0,8 HCPCS,54322,Reconstruction of urethra,,,3442.51,9743.0,8 HCPCS,54324,Reconstruction of urethra,,,3442.51,9743.0,8 HCPCS,54326,Reconstruction of urethra,,,3442.51,9743.0,8 HCPCS,54328,Revise penis/urethra,,,3442.51,9743.0,8 HCPCS,54332,Revise penis/urethra,,,3442.51,9743.0,8 HCPCS,54336,Revise penis/urethra,,,3442.51,8606.28,4 HCPCS,54340,Secondary urethral surgery,,,3442.51,9743.0,8 HCPCS,54344,Secondary urethral surgery,,,8330.0,23112.47,8 HCPCS,54348,Secondary urethral surgery,,,5236.35,13090.88,8 HCPCS,54352,Reconstruct urethra/penis,,,5236.35,13090.88,8 HCPCS,54360,Penis plastic surgery,,,3442.51,9743.0,8 HCPCS,54380,Repair penis,,,2041.48,9743.0,8 HCPCS,54385,Repair penis,,,2041.48,9743.0,8 HCPCS,54400,Insert semi-rigid prosthesis,,,8330.0,32211.97,8 HCPCS,54401,Insert self-contd prosthesis,,,8330.0,50603.05,8 HCPCS,54405,Insert multi-comp penis pros,,,8330.0,50603.05,8 HCPCS,54406,Remove muti-comp penis pros,,,3442.51,9743.0,8 HCPCS,54408,Repair multi-comp penis pros,,,5236.35,13090.88,8 HCPCS,54410,Remove/replace penis prosth,,,8330.0,50603.05,8 HCPCS,54411,Remov/replc penis pros comp,,,20241.22,50603.05,4 HCPCS,54415,Remove self-contd penis pros,,,3442.51,9743.0,8 HCPCS,54416,Remv/repl penis contain pros,,,8330.0,50603.05,8 HCPCS,54417,Remv/replc penis pros compl,,,20241.22,50603.05,4 HCPCS,54420,Hc Corpora Cavernosa-Saphenous Vein Shunt Uni/Bi,5099.34,2039.74,,,0 HCPCS,54420,Revision of penis,,,3442.51,8800.0,8 HCPCS,54435,Revision of penis,,,3442.51,8800.0,8 HCPCS,54437,Repair corporeal tear,,,3442.51,8606.28,4 HCPCS,54440,Repair of penis,,,3442.51,8800.0,8 HCPCS,54450,Hc Preputial Stretching,802.04,320.82,,,0 HCPCS,54450,Preputial stretching,,,244.0,2978.0,8 HCPCS,54500,Biopsy of testis,,,2546.0,7091.89,8 HCPCS,54505,Biopsy of testis,,,2546.0,8606.28,8 HCPCS,54512,Excise Lesion Testis,,,3442.51,8606.28,8 HCPCS,54520,"Hc Removal Testis,Simple",5265.99,2106.4,,,0 HCPCS,54520,Removal of testis,,,3442.51,9743.0,8 HCPCS,54522,Orchiectomy partial,,,3442.51,9743.0,8 HCPCS,54530,Removal of testis,,,3496.63,8800.0,8 HCPCS,54535,Extensive testis surgery,,,3442.51,8606.28,4 HCPCS,54550,Exploration for testis,,,3496.63,8800.0,8 HCPCS,54560,Exploration for testis,,,2041.48,5103.69,4 HCPCS,54600,Reduce testis torsion,,,3442.51,8800.0,8 HCPCS,54620,Suspension of testis,,,3442.51,9743.0,8 HCPCS,54640,Hc Orchiopexy Inguinal Or Scrotal Approach,5484.3,2193.72,,,0 HCPCS,54640,Suspension of testis,,,3496.63,8800.0,8 HCPCS,54650,Orchiopexy (Fowler-Stephens),,,3496.63,8741.59,4 HCPCS,54660,Revision of testis,,,3470.0,13090.88,8 HCPCS,54670,Repair testis injury,,,3442.51,9743.0,8 HCPCS,54680,Relocation of testis(es),,,3442.51,9743.0,8 HCPCS,54690,Laparoscopy orchiectomy,,,5904.09,17190.0,8 HCPCS,54692,Laparoscopy orchiopexy,,,5904.09,14760.22,8 HCPCS,54699,Laparoscope proc testis,,,5904.09,14760.22,8 HCPCS,54700,Drainage of scrotum,,,2041.48,5103.69,8 HCPCS,54700,"Hc Incis/Drain Scrotum/Testis,Epididym",5609.24,2243.7,,,0 HCPCS,54800,Biopsy of epididymis,,,1612.96,4032.39,8 HCPCS,54830,Remove epididymis lesion,,,3442.51,9743.0,8 HCPCS,54840,Remove epididymis lesion,,,2041.48,8800.0,8 HCPCS,54860,Removal of epididymis,,,3442.51,9743.0,8 HCPCS,54861,Removal of epididymis,,,3442.51,8800.0,8 HCPCS,54865,Explore Epididymis,,,2546.0,8606.28,8 HCPCS,54900,Fusion of spermatic ducts,,,2041.48,8800.0,8 HCPCS,54901,Fusion of spermatic ducts,,,3442.51,8800.0,8 HCPCS,55000,Drainage of hydrocele,,,691.56,1728.91,4 HCPCS,55000,Hc Hydrocele Drainage,3214.25,1285.7,,,0 HCPCS,55040,Removal of hydrocele,,,3496.63,9743.0,8 HCPCS,55041,Removal of hydroceles,,,3496.63,11433.0,8 HCPCS,55060,Repair of hydrocele,,,3442.51,8800.0,8 HCPCS,55100,Drainage of scrotum abscess,,,1612.96,4032.39,8 HCPCS,55100,Hc Drainage Scrotal Wall Abscess,4227.86,1691.14,,,0 HCPCS,55110,Explore scrotum,,,3442.51,8606.28,8 HCPCS,55120,Removal of scrotum lesion,,,2041.48,5103.69,8 HCPCS,55150,Removal of scrotum,,,2546.0,8606.28,8 HCPCS,55175,Revision of scrotum,,,2546.0,8606.28,8 HCPCS,55180,Revision of scrotum,,,3470.0,13090.88,8 HCPCS,55200,Incision of sperm duct,,,3442.51,8606.28,8 HCPCS,55250,Hc Removal Of Sperm Duct(S),4302.12,1720.85,,,0 HCPCS,55250,Removal of sperm duct(s),,,2041.48,5103.69,8 HCPCS,55400,Repair of sperm duct,,,2546.0,8606.28,8 HCPCS,55500,Removal of hydrocele,,,3442.51,9743.0,8 HCPCS,55520,Removal of sperm cord lesion,,,3442.51,8800.0,8 HCPCS,55530,Revise spermatic cord veins,,,3442.51,8800.0,8 HCPCS,55535,Revise spermatic cord veins,,,6322.36,15805.9,8 HCPCS,55540,Revise hernia & sperm veins,,,3496.63,11433.0,8 HCPCS,55550,Laparo ligate spermatic vein,,,5904.09,17190.0,8 HCPCS,55559,Laparo proc spermatic cord,,,5904.09,14760.22,8 HCPCS,55600,Incise sperm duct pouch,,,2041.48,5103.69,4 HCPCS,55680,Remove sperm pouch lesion,,,2546.0,8606.28,8 HCPCS,55700,Biopsy of prostate,,,3470.0,4059.0,4 HCPCS,55700,Hc Biopsy Needle/Punch Of Prostate,4994.73,1997.89,,,0 HCPCS,55705,Biopsy of prostate,,,3442.51,8606.28,8 HCPCS,55705,Hc Biopsy Of Prostate,4994.6,1997.84,,,0 HCPCS,55706,Hc Prostate Saturation Sampling,5720.0,2288.0,,,0 HCPCS,55706,Prostate saturation sampling,,,3442.51,8606.28,4 HCPCS,55707,Bx prst8 trct us guided,,,3442.51,8606.28,4 HCPCS,55707,Hc Us Guided Biopsy Of Prostate Gland Through Rectum,5428.2,2171.28,,,0 HCPCS,55708,Bx prst8 trct us w/mri fus 1,,,3442.51,8606.28,4 HCPCS,55709,Bx prst8 tprnl us guided,,,3442.51,8606.28,4 HCPCS,55710,Bx prst8 tprn us w/mri fus 1,,,3442.51,8606.28,4 HCPCS,55711,Bx prst8 trct mri-us 1st,,,3442.51,8606.28,4 HCPCS,55712,Bx prst8 tprnl mri-us 1st,,,3442.51,8606.28,4 HCPCS,55713,Bx prst8 in-bore ct/mri bx 1,,,5236.35,13090.88,4 HCPCS,55714,Bx prst8 in-bore ct/mri 1,,,5236.35,13090.88,4 HCPCS,55720,Drainage of prostate abscess,,,2546.0,8606.28,8 HCPCS,55720,Hc Drainage Of Prostate Abscess,5902.26,2360.9,,,0 HCPCS,55725,Drainage of prostate abscess,,,3442.51,8606.28,8 HCPCS,55860,Surgical exposure prostate,,,5236.35,13090.88,4 HCPCS,55866,Laparo radical prostatectomy,,,10381.14,25952.85,4 HCPCS,55867,Laps surg prst8ect smpl stot,,,10381.14,25952.85,8 HCPCS,55868,Lap srg prst8ct lymph nod bx,,,10381.14,25952.85,4 HCPCS,55869,Lap srg prst8ct bi pl lmphad,,,10381.14,25952.85,4 HCPCS,55870,Electroejaculation,,,899.5,2248.75,4 HCPCS,55873,Cryoablate Prostate,,,9244.99,23112.47,8 HCPCS,55874,Hc Transperineal Placement Biodegradable Material 1/Mlt Njx,10550.1,4220.04,,,0 HCPCS,55874,Tprnl plmt biodegrdabl matrl,,,5236.35,13090.88,4 HCPCS,55875,"Hc Percut/Needle Insert,Prostate,Radioisot",13196.53,5278.61,,,0 HCPCS,55875,Transperi needle place pros,,,5236.35,17190.0,8 HCPCS,55876,"Hc Place Radiother Device/Marker, Prostate",4129.75,1651.9,,,0 HCPCS,55876,Place rt device/marker pros,,,1351.75,4059.0,8 HCPCS,55877,Abltj ire prst8 1+ tum perq,,,10381.14,25952.85,4 HCPCS,55880,Abltj mal prst8 tiss hifu,,,9244.99,23112.47,4 HCPCS,55882,Ablt trurl prst8 tis trnsdcr,,,12884.79,32211.97,4 HCPCS,55899,Genital surgery procedure,,,244.0,610.01,4 HCPCS,55920,Place needles pelvic for rt,,,4885.41,12213.53,4 HCPCS,55970,Sex transformation m to f,,,4885.41,12213.53,4 HCPCS,55980,Sex transformation f to m,,,3442.51,8606.28,4 HCPCS,56405,Hc I&D Of Vulva/Perineum Abscess,1438.31,575.32,,,0 HCPCS,56405,I & D of vulva/perineum,,,297.6,2978.0,8 HCPCS,56420,Drainage of gland abscess,,,197.44,493.6,4 HCPCS,56420,Hc I&D Bartholin Gland Abscess,890.79,356.32,,,0 HCPCS,56440,Hc Marsupialization Bartholins Gland Cyst,5902.26,2360.9,,,0 HCPCS,56440,Surgery for vulva lesion,,,3161.39,7903.48,8 HCPCS,56441,Hc Lysis Of Labial Lesion(S),4263.02,1705.21,,,0 HCPCS,56441,Lysis of labial lesion(s),,,2546.0,7903.48,8 HCPCS,56442,Hymenotomy,,,2546.0,7903.48,8 HCPCS,56501,Destroy vulva lesions sim,,,2015.01,5037.52,8 HCPCS,56501,"Hc Destruction,Lesion(S),Vulva,Simple",5701.33,2280.53,,,0 HCPCS,56515,Destroy vulva lesion/s compl,,,2015.01,9743.0,8 HCPCS,56605,Biopsy of vulva/perineum,,,899.5,2978.0,8 HCPCS,56605,"Hc Biopsy Vulva/Perineum,One Lesion",1860.26,744.1,,,0 HCPCS,56606,Hc Biopsy Vulva/Perineum Additional Lesion,745.11,298.04,,,0 HCPCS,56620,Partial removal of vulva,,,3161.39,11433.0,8 HCPCS,56625,Complete removal of vulva,,,3161.39,12101.0,8 HCPCS,56630,Extensive vulva surgery,,,4885.41,12213.53,4 HCPCS,56700,Partial removal of hymen,,,2546.0,7903.48,8 HCPCS,56740,Remove vagina gland lesion,,,3161.39,9743.0,8 HCPCS,56800,Repair of vagina,,,3161.39,9743.0,8 HCPCS,56805,Repair clitoris,,,3161.39,7903.48,4 HCPCS,56810,Repair of perineum,,,3161.39,11433.0,8 HCPCS,56820,Exam of vulva w/scope,,,197.44,493.6,4 HCPCS,56820,"Hc Colposcopy,Vulva",569.3,227.72,,,0 HCPCS,56821,Exam/biopsy of vulva w/scope,,,297.6,2978.0,8 HCPCS,56821,"Hc Colposcopy,Vulva,W/Biopsy(S)",1105.1,442.04,,,0 HCPCS,57000,Exploration of vagina,,,2546.0,7903.48,8 HCPCS,57010,Drainage of pelvic abscess,,,3161.39,7903.48,8 HCPCS,57020,Drainage of pelvic fluid,,,3470.0,12213.53,8 HCPCS,57022,I & d vaginal hematoma pp,,,2836.76,7091.89,8 HCPCS,57023,I & d vag hematoma non-ob,,,2546.0,7091.89,8 HCPCS,57061,Destroy vag lesions simple,,,3161.39,7903.48,8 HCPCS,57065,Destroy vag lesions complex,,,2546.0,7903.48,8 HCPCS,57100,Biopsy of vagina,,,899.5,2978.0,8 HCPCS,57100,Hc Biopsy Of Vagina Simple,1799.98,719.99,,,0 HCPCS,57105,Biopsy of vagina,,,3161.39,7903.48,8 HCPCS,57106,Remove vagina wall partial,,,3161.39,7903.48,4 HCPCS,57107,Remove vagina tissue part,,,3161.39,7903.48,4 HCPCS,57109,Vaginectomy partial w/nodes,,,3161.39,7903.48,4 HCPCS,57120,Closure of vagina,,,4885.41,12213.53,4 HCPCS,57130,Remove vagina lesion,,,3161.39,7903.48,8 HCPCS,57135,Hc Excision Vaginal Cyst/Tumor,3687.28,1474.91,,,0 HCPCS,57135,Remove vagina lesion,,,3161.39,7903.48,8 HCPCS,57150,Hc Treatment Of Vagina Infection,323.7,129.48,,,0 HCPCS,57150,Treat vagina infection,,,57.61,144.03,4 HCPCS,57155,Hc Insert Tandem/Ovoid Device,3636.0,1454.4,,,0 HCPCS,57155,Insert uteri tandem/ovoids,,,3470.0,12213.53,8 HCPCS,57156,Hc Insert Vaginal Radiation Device,2289.0,915.6,,,0 HCPCS,57156,Ins vag brachytx device,,,297.6,744.0,4 HCPCS,57160,Hc Fit/Insert Intravag Support Device,599.43,239.77,,,0 HCPCS,57160,Insert pessary/other device,,,197.44,493.6,4 HCPCS,57170,Fitting of diaphragm/cap,,,197.44,493.6,4 HCPCS,57170,Hc Fitting Of Diaphragm,682.5,273.0,,,0 HCPCS,57180,Treat vaginal bleeding,,,197.44,2978.0,8 HCPCS,57200,Repair of vagina,,,2546.0,7903.48,8 HCPCS,57210,Repair vagina/perineum,,,3161.39,7903.48,8 HCPCS,57220,Revision of urethra,,,4885.41,12213.53,8 HCPCS,57230,Repair of urethral lesion,,,3161.39,9743.0,8 HCPCS,57240,Repair bladder & vagina,,,4885.41,12213.53,8 HCPCS,57250,Repair rectum & vagina,,,4885.41,12213.53,8 HCPCS,57260,Repair of vagina,,,4885.41,12213.53,8 HCPCS,57265,Extensive repair of vagina,,,4885.41,12213.53,8 HCPCS,57267,Insert mesh/pelvic flr addon,,,10346.0,12101.0,4 HCPCS,57268,Repair of bowel bulge,,,4885.41,12213.53,8 HCPCS,57282,Colpopexy extraperitoneal,,,7241.95,18104.87,4 HCPCS,57283,Colpopexy intraperitoneal,,,7241.95,18104.87,4 HCPCS,57284,Repair paravag defect open,,,4885.41,12213.53,4 HCPCS,57285,Repair paravag defect vag,,,7241.95,18104.87,4 HCPCS,57287,Revise/Remove Sling Repair,,,3161.39,7903.48,4 HCPCS,57288,Repair bladder defect,,,4885.41,12213.53,8 HCPCS,57289,Repair bladder & vagina,,,7241.95,18104.87,8 HCPCS,57291,Construction of vagina,,,4885.41,12213.53,8 HCPCS,57292,Construct vagina with graft,,,4885.41,12213.53,4 HCPCS,57295,Revise vag graft via vagina,,,3161.39,9743.0,8 HCPCS,57300,Repair rectum-vagina fistula,,,3161.39,9743.0,8 HCPCS,57310,Repair urethrovaginal lesion,,,7241.95,18104.87,4 HCPCS,57320,Repair bladder-vagina lesion,,,4885.41,12213.53,4 HCPCS,57330,Repair bladder-vagina lesion,,,7241.95,18104.87,4 HCPCS,57335,Repair vagina,,,4885.41,12213.53,4 HCPCS,57400,Dilation of vagina,,,3161.39,7903.48,8 HCPCS,57410,Hc Pelvic Examination Under Anesthesia,6532.5,2613.0,,,0 HCPCS,57410,Pelvic examination,,,3161.39,7903.48,8 HCPCS,57415,Hc Removal Vaginal For.Body W Anesth,5353.17,2141.27,,,0 HCPCS,57415,Remove vaginal foreign body,,,3161.39,7903.48,8 HCPCS,57420,Exam of vagina w/scope,,,297.6,744.0,4 HCPCS,57420,"Hc Colposcopy,Entire Vagina",1389.75,555.9,,,0 HCPCS,57421,Exam/biopsy of vag w/scope,,,899.5,2978.0,8 HCPCS,57421,"Hc Colposcopy,Entire Vagina,W/Biopsy(S)",1768.17,707.27,,,0 HCPCS,57423,Repair paravag defect lap,,,10381.14,25952.85,4 HCPCS,57425,Laparoscopy surg colpopexy,,,9775.0,25952.85,8 HCPCS,57426,Revise prosth vag graft lap,,,7241.95,18104.87,4 HCPCS,57452,Exam of cervix w/scope,,,197.44,493.6,4 HCPCS,57452,"Hc Colposcopy,Cervix W/Adj Vagina",704.54,281.82,,,0 HCPCS,57454,Bx/curett of cervix w/scope,,,297.6,2978.0,8 HCPCS,57454,"Hc Colposc,Cervix W/Adj Vag,W/Bx & Curretag",1152.76,461.1,,,0 HCPCS,57455,Biopsy of cervix w/scope,,,297.6,2978.0,8 HCPCS,57455,"Hc Colposcopy,Cervix W/Adj Vagina,W/Bx",1138.59,455.44,,,0 HCPCS,57456,Endocerv curettage w/scope,,,297.6,744.0,4 HCPCS,57456,"Hc Colposcopy,Cervix W/Adj Vagina, Curettag",982.74,393.1,,,0 HCPCS,57460,Bx of cervix w/scope leep,,,3161.39,7903.48,8 HCPCS,57460,Hc Colposcopy Of Cervix Using An Endoscope,4230.0,1692.0,,,0 HCPCS,57461,Conz of cervix w/scope leep,,,3161.39,7903.48,8 HCPCS,57461,"Hc Colposcopy,Cervix W/Adj Vag,W/Loop Coniz",5149.42,2059.77,,,0 HCPCS,57500,Biopsy of cervix,,,899.5,2978.0,8 HCPCS,57500,"Hc Biopsy Cervix, 1 Or More, Or Excision Of Lesion",2176.72,870.69,,,0 HCPCS,57505,Endocervical curettage,,,899.5,2978.0,8 HCPCS,57505,Hc Endocervical Curettage,1967.42,786.97,,,0 HCPCS,57510,Cauterization of cervix,,,3161.39,7903.48,4 HCPCS,57511,Cryocautery of cervix,,,297.6,744.0,4 HCPCS,57513,Laser surgery of cervix,,,3161.39,7903.48,8 HCPCS,57520,Conization of cervix,,,3161.39,7903.48,8 HCPCS,57522,Conization of cervix,,,3161.39,7903.48,8 HCPCS,57522,"Hc Colposcopy,Cervix W/Adj Vag,W/O Loop Coniz",6736.11,2694.44,,,0 HCPCS,57530,Removal of cervix,,,4885.41,12213.53,8 HCPCS,57550,Removal of residual cervix,,,4885.41,12213.53,8 HCPCS,57555,Remove cervix/repair vagina,,,4885.41,12213.53,4 HCPCS,57556,Remove cervix repair bowel,,,4885.41,12213.53,8 HCPCS,57558,D&C oF Cervical Stump,,,3161.39,9743.0,8 HCPCS,57700,Revision of cervix,,,2546.0,7903.48,8 HCPCS,57720,Revision of cervix,,,3161.39,9743.0,8 HCPCS,57800,Dilation of cervical canal,,,3161.39,7903.48,8 HCPCS,58100,Biopsy of uterus lining,,,197.44,493.6,4 HCPCS,58100,Hc Biopsy Of Uterus Lining,954.41,381.76,,,0 HCPCS,58110,Hc Endomet Biopsy Done W/Colposcopy,828.83,331.53,,,0 HCPCS,58120,Dilation and curettage,,,3161.39,7903.48,8 HCPCS,58145,Myomectomy vag method,,,3161.39,11433.0,8 HCPCS,58150,Hc Hysterectomy After Delivery,6214.14,2485.66,,,0 HCPCS,58260,Vaginal hysterectomy,,,4885.41,17190.0,8 HCPCS,58262,Vag hyst including t/o,,,4885.41,17190.0,8 HCPCS,58263,Vag hyst w/t/o & vag repair,,,4885.41,12213.53,4 HCPCS,58270,Vag hyst w/enterocele repair,,,4885.41,12213.53,4 HCPCS,58290,Vag hyst complex,,,7241.95,18104.87,4 HCPCS,58291,Vag hyst incl t/o complex,,,4885.41,12213.53,4 HCPCS,58292,Vag hyst t/o & repair compl,,,7241.95,18104.87,4 HCPCS,58294,Vag hyst w/enterocele compl,,,4885.41,12213.53,4 HCPCS,58300,Hc Insert Intrauterine Device,838.88,335.55,,,0 HCPCS,58300,Insert intrauterine device,,,2546.0,2978.0,4 HCPCS,58301,Hc Remove Intrauterine Device,947.71,379.08,,,0 HCPCS,58301,Remove intrauterine device,,,297.6,2978.0,8 HCPCS,58321,Artificial insemination,,,297.6,744.0,4 HCPCS,58322,Artificial insemination,,,197.44,493.6,4 HCPCS,58323,Sperm washing,,,197.44,493.6,4 HCPCS,58340,Hc Cath/Inject Hysterosalpingogram,861.67,344.67,,,0 HCPCS,58345,Reopen fallopian tube,,,3161.39,7903.48,4 HCPCS,58346,Insert heyman uteri capsule,,,3470.0,12213.53,8 HCPCS,58350,Reopen fallopian tube,,,4885.41,12213.53,8 HCPCS,58353,Endometr ablate thermal,,,4885.41,12213.53,8 HCPCS,58356,Endometrial cryoablation,,,4885.41,12213.53,4 HCPCS,58541,Lsh uterus 250 g or less,,,10381.14,25952.85,8 HCPCS,58542,Lsh w/t/o ut 250 g or less,,,10381.14,25952.85,8 HCPCS,58543,LSH Uterus Above 250 g,,,10381.14,25952.85,8 HCPCS,58544,LSH w/t/o Uterus Above 250 g,,,10381.14,25952.85,8 HCPCS,58545,Laparoscopic myomectomy,,,5904.09,17190.0,8 HCPCS,58546,Laparo-myomectomy complex,,,10381.14,25952.85,8 HCPCS,58550,Laparo-asst vag hysterectomy,,,5904.09,17190.0,8 HCPCS,58552,Laparo-vag hyst incl t/o,,,10381.14,25952.85,8 HCPCS,58553,Laparo-vag hyst complex,,,10381.14,25952.85,8 HCPCS,58554,Laparo-vag hyst w/t/o compl,,,10381.14,25952.85,8 HCPCS,58555,Hc Hysteroscopy Diagnostic Separate Procedure,5263.0,2105.2,,,0 HCPCS,58555,Hysteroscopy dx sep proc,,,2546.0,7903.48,8 HCPCS,58558,Hysteroscopy biopsy,,,3161.39,9743.0,8 HCPCS,58559,Hysteroscopy lysis,,,3470.0,12213.53,8 HCPCS,58560,Hysteroscopy resect septum,,,4885.41,12213.53,8 HCPCS,58561,Hysteroscopy remove myoma,,,4885.41,12213.53,8 HCPCS,58562,Hysteroscopy remove fb,,,3161.39,9743.0,8 HCPCS,58563,Hysteroscopy ablation,,,4885.41,17190.0,8 HCPCS,58565,Hysteroscopy sterilization,,,4885.41,17190.0,8 HCPCS,58570,Tlh uterus 250 g or less,,,10381.14,25952.85,8 HCPCS,58571,Tlh w/t/o 250 g or less,,,10381.14,25952.85,8 HCPCS,58572,Tlh uterus over 250 g,,,10381.14,25952.85,8 HCPCS,58573,Tlh w/t/o uterus over 250 g,,,10381.14,25952.85,8 HCPCS,58578,Laparo proc uterus,,,5904.09,14760.22,8 HCPCS,58579,Hysteroscope procedure,,,197.44,9743.0,8 HCPCS,58580,Transcrv abltj utrn fibrd rf,,,7241.95,18104.87,4 HCPCS,58600,Division of fallopian tube,,,3161.39,7903.48,4 HCPCS,58605,Hc Postpartum Bridge Tied Load,4080.81,1632.32,,,0 HCPCS,58615,Occlude fallopian tube(s),,,3161.39,7903.48,4 HCPCS,58660,Laparoscopy lysis,,,5904.09,14760.22,8 HCPCS,58661,Laparoscopy remove adnexa,,,5904.09,14760.22,8 HCPCS,58662,Laparoscopy excise lesions,,,5904.09,14760.22,8 HCPCS,58670,Laparoscopy tubal cautery,,,5904.09,14760.22,8 HCPCS,58671,Laparoscopy tubal block,,,5904.09,14760.22,8 HCPCS,58672,Laparoscopy fimbrioplasty,,,5904.09,14760.22,8 HCPCS,58673,Laparoscopy salpingostomy,,,9775.0,25952.85,8 HCPCS,58674,Laps abltj uterine fibroids,,,7639.0,25952.85,8 HCPCS,58679,Laparo proc oviduct-ovary,,,5904.09,14760.22,8 HCPCS,58770,Create new tubal opening,,,3161.39,7903.48,4 HCPCS,58800,Drainage of ovarian cyst(s),,,3161.39,9743.0,8 HCPCS,58805,Drainage of ovarian cyst(s),,,3161.39,7903.48,4 HCPCS,58820,Drain ovary abscess open,,,3161.39,9743.0,8 HCPCS,58900,Biopsy of ovary(s),,,3161.39,9743.0,8 HCPCS,58900,Hc Ct Biopsy Of Ovaries Unilateral,5153.8,2061.52,,,0 HCPCS,58920,Partial removal of ovary(s),,,7241.95,18104.87,4 HCPCS,58925,Removal of ovarian cyst(s),,,4885.41,12213.53,4 HCPCS,58970,Retrieval of oocyte,,,899.5,2978.0,8 HCPCS,58974,Transfer of embryo,,,899.5,2978.0,8 HCPCS,58976,Transfer of embryo,,,297.6,2978.0,8 HCPCS,58999,Genital surgery procedure,,,197.44,493.6,4 HCPCS,59000,Amniocentesis diagnostic,,,899.5,2248.75,4 HCPCS,59000,"Hc Amniocentesis,Diagnostic",1882.02,752.81,,,0 HCPCS,59001,Amniocentesis therapeutic,,,297.6,744.0,4 HCPCS,59001,"Hc Amniocentesis,Therapy Amniotic Fluid Reduction",1741.38,696.55,,,0 HCPCS,59012,Fetal cord puncture prenatal,,,297.6,744.0,4 HCPCS,59012,Hc Pub/Cordocentesis,1594.03,637.61,,,0 HCPCS,59015,Chorion biopsy,,,899.5,2248.75,4 HCPCS,59015,Hc Chorion Villus Biopsy,1699.52,679.81,,,0 HCPCS,59020,Fetal contract stress test,,,197.44,493.6,4 HCPCS,59020,Hc Fetal Contractn Stress Test,1465.1,586.04,,,0 HCPCS,59025,Fetal non-stress test,,,197.44,493.6,4 HCPCS,59025,Hc Fetal Non-Stress Test,1349.57,539.83,,,0 HCPCS,59030,Fetal scalp blood sample,,,297.6,744.0,4 HCPCS,59070,Transabdom amnioinfus w/us,,,297.6,744.0,4 HCPCS,59072,Umbilical cord occlud w/us,,,297.6,744.0,4 HCPCS,59074,Fetal fluid drainage w/us,,,297.6,744.0,4 HCPCS,59076,Fetal shunt placement w/us,,,297.6,744.0,4 HCPCS,59100,Remove uterus lesion,,,4885.41,12213.53,4 HCPCS,59150,Treat ectopic pregnancy,,,5904.09,14760.22,8 HCPCS,59151,Treat ectopic pregnancy,,,5904.09,14760.22,8 HCPCS,59160,D & c after delivery,,,3161.39,9743.0,8 HCPCS,59160,Hc Dilation And Curetrage,4871.68,1948.67,,,0 HCPCS,59200,Insert cervical dilator,,,297.6,744.0,4 HCPCS,59300,Episiotomy or vaginal repair,,,3161.39,7903.48,4 HCPCS,59300,Hc Episiotomy Or Vaginal Repair,10335.0,4134.0,,,0 HCPCS,59320,Hc Revision Of Cervix,7983.53,3193.41,,,0 HCPCS,59320,Revision of cervix,,,2546.0,7903.48,8 HCPCS,59400,Hc High Risk Vaginal Delivery,6080.49,2432.2,,,0 HCPCS,59400,Hc High Risk Vaginal Delivery With Induction/Augmentation,7288.3,2915.32,,,0 HCPCS,59400,Hc Labor And Delivery Induction/Augmentation,1207.81,483.12,,,0 HCPCS,59409,"Hc Obstetrical Care,Vaginal Delivery Only-Emergency Room",8413.2,3365.28,,,0 HCPCS,59409,"Hc Obstetrical Care,Vaginal Delivery Only-Labor And Delivery",5603.53,2241.41,,,0 HCPCS,59409,Hc Vaginal Delivery With Induction/Augmentation,6080.45,2432.18,,,0 HCPCS,59409,Obstetrical care,,,3161.39,7903.48,8 HCPCS,59412,Antepartum manipulation,,,3161.39,7903.48,4 HCPCS,59412,Hc External Cephalic Version; Ultrasound Not Included,4297.82,1719.13,,,0 HCPCS,59414,Deliver placenta,,,3161.39,7903.48,4 HCPCS,59414,Hc Deliver Placenta,4942.68,1977.07,,,0 HCPCS,59510,Hc Cesarean Section Scheduled,7064.76,2825.9,,,0 HCPCS,59515,Hc Labor And Delivery C Section Unscheduled,8845.94,3538.38,,,0 HCPCS,59612,Vbac delivery only,,,3161.39,7903.48,4 HCPCS,59812,Treatment of miscarriage,,,3161.39,11433.0,8 HCPCS,59820,Care of miscarriage,,,3161.39,11433.0,8 HCPCS,59821,"Hc Treatment Of Miscarriage, Second Trimester",4487.39,1794.96,,,0 HCPCS,59821,Treatment of miscarriage,,,3161.39,11433.0,8 HCPCS,59840,Abortion,,,3161.39,11433.0,8 HCPCS,59841,Abortion,,,3161.39,11433.0,8 HCPCS,59866,Abortion (mpr),,,297.6,744.0,4 HCPCS,59870,Evacuate mole of uterus,,,3161.39,11433.0,8 HCPCS,59871,Hc Remove Cerclage Suture,5072.54,2029.02,,,0 HCPCS,59871,Remove cerclage suture,,,3161.39,11433.0,8 HCPCS,59897,Fetal invas px w/us,,,197.44,493.6,4 HCPCS,59898,Laparo proc ob care/deliver,,,5904.09,14760.22,8 HCPCS,59899,Maternity care procedure,,,197.44,493.6,4 HCPCS,60000,Drain thyroid/tongue cyst,,,1515.28,3788.21,8 HCPCS,60100,Biopsy of thyroid,,,691.56,1728.91,4 HCPCS,60100,Hc Biopsy Of Thyroid Percutaneious,2253.74,901.5,,,0 HCPCS,60200,Remove thyroid lesion,,,3470.0,14760.22,8 HCPCS,60210,Partial thyroid excision,,,5904.09,17190.0,8 HCPCS,60212,Partial thyroid excision,,,5904.09,14760.22,4 HCPCS,60220,Partial removal of thyroid,,,5904.09,17190.0,8 HCPCS,60225,Partial removal of thyroid,,,5904.09,14760.22,4 HCPCS,60240,Removal of thyroid,,,5904.09,17190.0,8 HCPCS,60252,Removal of thyroid,,,5781.33,17190.0,8 HCPCS,60260,Repeat thyroid surgery,,,5781.33,17190.0,8 HCPCS,60271,Removal of thyroid,,,5781.33,14453.33,4 HCPCS,60280,Remove thyroid duct lesion,,,5904.09,14760.22,8 HCPCS,60281,Remove thyroid duct lesion,,,5904.09,14760.22,8 HCPCS,60300,Aspir/inj thyroid cyst,,,691.56,1728.91,4 HCPCS,60300,Hc Aspiration And/Or Injection Thyroid Cyst,1950.0,780.0,,,0 HCPCS,60500,Explore parathyroid glands,,,5781.33,17190.0,8 HCPCS,60502,Re-explore parathyroids,,,5781.33,14453.33,4 HCPCS,60520,Removal of thymus gland,,,5781.33,14453.33,4 HCPCS,60659,Laparo proc endocrine,,,5904.09,14760.22,8 HCPCS,60660,Abltj 1/+thyr ndul 1lobe prq,,,1612.96,4032.39,4 HCPCS,60660,Hc Rfa Thyroid Ablation 1/+ Nodule,3033.46,1213.38,,,0 HCPCS,60699,Endocrine surgery procedure,,,5904.09,14760.22,4 HCPCS,61000,Remove cranial cavity fluid,,,689.37,1723.42,4 HCPCS,61001,Remove cranial cavity fluid,,,689.37,1723.42,4 HCPCS,61020,Hc Remove Brain Cavity Fluid,3900.0,1560.0,,,0 HCPCS,61020,Remove brain cavity fluid,,,863.78,2978.0,8 HCPCS,61026,Injection into brain canal,,,689.37,2978.0,8 HCPCS,61050,Remove brain canal fluid,,,299.77,2978.0,8 HCPCS,61055,Injection into brain canal,,,299.77,2978.0,8 HCPCS,61070,Brain canal shunt procedure,,,689.37,2978.0,8 HCPCS,61070,Hc Brain Canal Shunt Tube/Reservoir Aspiration/Injection Procedure,2396.07,958.43,,,0 HCPCS,61215,Insert brain-fluid device,,,8330.0,21426.33,8 HCPCS,61330,Decompress eye socket,,,3237.89,8094.73,4 HCPCS,61500,Removal of skull lesion,,,7639.0,8934.0,4 HCPCS,61623,Endovasc tempory vessel occl,,,11274.1,28185.26,4 HCPCS,61623,"Hc Endovasc Temp Balloon Occlus,Head/Neck",20634.38,8253.75,,,0 HCPCS,61624,"Hc Perm Occlusion/Embolization,Percut,Cns",35824.8,14329.92,,,0 HCPCS,61624,Transcath occlusion cns,,,17902.75,44756.89,4 HCPCS,61626,Hc Percut Cath Occlusn Non Cns Lesn,30590.43,12236.17,,,0 HCPCS,61626,Transcath occlusion non-cns,,,11274.1,28185.26,4 HCPCS,61630,Hc Intracranial Balloon Angioplasty,19914.73,7965.89,,,0 HCPCS,61635,Hc Intracranial Balloon Angioplsty W/Stent,21795.02,8718.01,,,0 HCPCS,61640,Hc Intracranl Plasty Vasosp Init,17745.71,7098.28,,,0 HCPCS,61645,Hc Perq Art Trluml M-Thrombec &/Nfs Intracranial,17298.98,6919.59,,,0 HCPCS,61650,Hc Evasc Intracranial Prolng Admn Rx Agent Art 1St,10281.99,4112.8,,,0 HCPCS,61651,Hc Evasc Intracranial Prolng Admn Rx Agent Art Additional,10281.99,4112.8,,,0 HCPCS,61715,Mrgfus strtctc ablt trgt icr,,,10882.0,27205.01,4 HCPCS,61770,Incise skull for treatment,,,3336.22,8340.56,4 HCPCS,61783,"Hc Stereotactic Comp Assist Proc,Spinal",6472.2,2588.88,,,0 HCPCS,61790,Hc Treat Trigeminal Nerve,3674.45,1469.78,,,0 HCPCS,61790,Treat trigeminal nerve,,,1907.04,9743.0,8 HCPCS,61791,Hc Treat Trigeminal Tract,4732.54,1893.02,,,0 HCPCS,61791,Treat trigeminal tract,,,1907.04,9743.0,8 HCPCS,61880,Revise/remove neuroelectrode,,,3414.31,8535.78,4 HCPCS,61885,Insrt/redo neurostim 1 array,,,3470.0,75339.4,8 HCPCS,61886,Implant neurostim arrays,,,8330.0,75339.4,8 HCPCS,61888,Revise/remove neuroreceiver,,,2546.0,27205.01,8 HCPCS,61891,Rev/rplcmt sk-mnt crnl nstm,,,30135.76,75339.4,4 HCPCS,61892,Rmv sk-mnt crnl nstm pg/rcvr,,,3195.45,7988.62,4 HCPCS,62000,Treat skull fracture,,,3237.89,8094.73,4 HCPCS,62140,Repair of skull defect,,,9775.0,11433.0,4 HCPCS,62194,Replace/irrigate catheter,,,1907.04,4767.6,8 HCPCS,62225,Replace/irrigate catheter,,,2546.0,8340.56,8 HCPCS,62230,Replace/revise brain shunt,,,3470.0,21426.33,8 HCPCS,62252,Csf Shunt Reprogram,,,299.95,749.88,4 HCPCS,62252,"Hc Reporgramming, Programmable Csf Shunt",746.95,298.78,,,0 HCPCS,62263,Epidural lysis mult sessions,,,863.78,2978.0,8 HCPCS,62264,Epidural lysis on single day,,,863.78,2978.0,8 HCPCS,62267,Hc Percut Aspiration Vertebral Disc,3663.58,1465.43,,,0 HCPCS,62267,Interdiscal perq aspir dx,,,691.56,1728.91,4 HCPCS,62268,Drain spinal cord cyst,,,863.78,2978.0,8 HCPCS,62268,Hc Percutaneous Aspiration Of Fluid From Cyst Of Spinal Cord Or Fluid Filled Cavity,1320.45,528.18,,,0 HCPCS,62269,Needle biopsy spinal cord,,,1612.96,4032.39,8 HCPCS,62270,"Hc Spinal Puncture,Lumbar,Diagnostic",2722.58,1089.03,,,0 HCPCS,62270,Spinal fluid tap diagnostic,,,689.37,2978.0,8 HCPCS,62272,Drain cerebro spinal fluid,,,689.37,2978.0,8 HCPCS,62272,"Hc Spinal Puncture,Lumbar,Diagnostic",2466.39,986.56,,,0 HCPCS,62272,"Hc Spinal Puncture,Therapeutic Drainage",2466.39,986.56,,,0 HCPCS,62273,"Hc Injection,Lumbar Epidur,Blood/Clot Patch",3358.85,1343.54,,,0 HCPCS,62273,Inject epidural patch,,,689.37,2978.0,8 HCPCS,62280,Treat spinal cord lesion,,,863.78,2978.0,8 HCPCS,62281,Treat spinal cord lesion,,,863.78,2978.0,8 HCPCS,62282,Hc Inj/Inf Epid Lumb/Sacral,3566.66,1426.66,,,0 HCPCS,62282,Treat spinal canal lesion,,,863.78,2978.0,8 HCPCS,62284,Hc Injection Procedure Myelography/Ct Lumbar,1956.47,782.59,,,0 HCPCS,62287,Percutaneous diskectomy,,,1907.04,17190.0,8 HCPCS,62290,Hc Injection Px Discography Each Level Lumbar,1403.0,561.2,,,0 HCPCS,62292,Injection into disk lesion,,,1907.04,4767.6,4 HCPCS,62294,Injection into spinal artery,,,863.78,9743.0,8 HCPCS,62302,Hc Myelography Via Lumbar Injection Rs&I Cervical,5793.42,2317.37,,,0 HCPCS,62302,Myelography lumbar injection,,,765.58,2978.0,8 HCPCS,62303,Hc Myelography Via Lumbar Injection Rs&I Thoracic,5793.42,2317.37,,,0 HCPCS,62303,Myelography lumbar injection,,,765.58,2978.0,8 HCPCS,62304,Hc Myelography Via Lumbar Injection Rs&I Lumbosacral,5793.42,2317.37,,,0 HCPCS,62304,Myelography lumbar injection,,,765.58,9743.0,8 HCPCS,62305,Hc Myelography Via Lumbar Injection Rs&I 2+ Regions,6297.42,2518.97,,,0 HCPCS,62305,Myelography lumbar injection,,,765.58,2978.0,8 HCPCS,62310,Inject spine c/t,,,2546.0,2978.0,4 HCPCS,62311,Inject spine l/s (cd),,,2546.0,2978.0,4 HCPCS,62318,"Inject spine w/cath, c/t",,,2546.0,2978.0,4 HCPCS,62319,Inject spine w/cath l/s (cd),,,2546.0,2978.0,4 HCPCS,62320,Hc Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/O Img Gdn,4018.56,1607.42,,,0 HCPCS,62320,Njx interlaminar crv/thrc,,,689.37,2978.0,8 HCPCS,62321,Hc Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn,6876.77,2750.71,,,0 HCPCS,62321,Njx interlaminar crv/thrc,,,689.37,2978.0,8 HCPCS,62322,Hc Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn,4110.65,1644.26,,,0 HCPCS,62322,Njx interlaminar lmbr/sac,,,863.78,2978.0,8 HCPCS,62323,Hc Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn,6910.25,2764.1,,,0 HCPCS,62323,Njx interlaminar lmbr/sac,,,689.37,2978.0,8 HCPCS,62324,Njx interlaminar crv/thrc,,,863.78,2978.0,8 HCPCS,62325,Hc Pain Inj Epd Crv/Tho W/ Img Gd,5026.55,2010.62,,,0 HCPCS,62325,Njx interlaminar crv/thrc,,,863.78,2978.0,8 HCPCS,62326,Hc Insertion Of Indwelling Catheter And Administration Of Substance Into Spinal Canal Of Lower Back,3894.8,1557.92,,,0 HCPCS,62326,Njx interlaminar lmbr/sac,,,863.78,2978.0,8 HCPCS,62327,Hc Insertion Of Indwelling Catheter And Administration Of Substance Into Spinal Canal Of Lower Back,4557.8,1823.12,,,0 HCPCS,62327,Njx interlaminar lmbr/sac,,,863.78,2978.0,8 HCPCS,62328,Dx lmbr spi pnxr w/fluor/ct,,,689.37,2978.0,8 HCPCS,62328,Hc Lp-Diagnostic W/Fluor Or Ct,4756.97,1902.79,,,0 HCPCS,62329,Hc Lp-Therapeutic W/Fluor Or Ct,4756.97,1902.79,,,0 HCPCS,62329,Ther spi pnxr csf fluor/ct,,,689.37,2978.0,8 HCPCS,62330,Dcmprn prq rmv lig flv 1lmbr,,,7086.45,17716.12,4 HCPCS,62350,Hc Implantation/Revision/Repositioning Of Spinal Canal Medication Catheter,11072.1,4428.84,,,0 HCPCS,62350,Implant spinal canal cath,,,3470.0,21426.33,8 HCPCS,62351,Implant spinal canal cath,,,7086.45,17716.12,4 HCPCS,62355,Hc Remove Spinal Canal Catheter,4349.45,1739.78,,,0 HCPCS,62355,Remove spinal canal catheter,,,1907.04,4767.6,8 HCPCS,62360,Insert spine infusion device,,,3470.0,44005.43,8 HCPCS,62361,Implant spine infusion pump,,,3470.0,44005.43,8 HCPCS,62362,Hc Implantation/Replacement Of Programmable Spinal Canal Drug Infusion Pump,30560.4,12224.16,,,0 HCPCS,62362,Implant spine infusion pump,,,3470.0,44005.43,8 HCPCS,62365,Hc Removal Of Spinal Canal Drug Infusion Pump/Device,9499.65,3799.86,,,0 HCPCS,62365,Remove spine infusion device,,,3336.22,8340.56,8 HCPCS,62367,Analyze spine infus pump,,,299.95,749.88,4 HCPCS,62367,Hc Electronic Analysis Implant Intrathecal Or Epidural Pump Without Reprogramming Or Refill,1357.2,542.88,,,0 HCPCS,62368,Analyze sp inf pump w/reprog,,,299.95,749.88,4 HCPCS,62368,Hc Pump Interogation With Reprogram,1799.98,719.99,,,0 HCPCS,62369,Anal sp inf pmp w/reprg&fill,,,299.95,749.88,4 HCPCS,62369,Hc Analyze Neurostimulator Simple/Program Pump Refill,1957.86,783.14,,,0 HCPCS,62370,Anl sp inf pmp w/mdreprg&fil,,,299.95,749.88,4 HCPCS,62370,Hc Pump Refill W/ Reprogramming,1693.55,677.42,,,0 HCPCS,62380,Hc Endoscopic Decompression Of Spinal Cord 1 Interspace Lumbar,9193.18,3677.27,,,0 HCPCS,62380,Ndsc dcmprn 1 ntrspc lumbar,,,7086.45,17716.12,8 HCPCS,63001,Remove spine lamina 1/2 crvl,,,7086.45,17716.12,4 HCPCS,63003,Remove spine lamina 1/2 thrc,,,7086.45,17716.12,4 HCPCS,63005,Remove spine lamina 1/2 lmbr,,,7086.45,17716.12,4 HCPCS,63011,Remove spine lamina 1/2 scrl,,,7086.45,17716.12,4 HCPCS,63012,Remove lamina/facets lumbar,,,7086.45,17716.12,4 HCPCS,63015,Remove spine lamina >2 crvcl,,,7086.45,17716.12,4 HCPCS,63016,Remove spine lamina >2 thrc,,,7086.45,17716.12,4 HCPCS,63017,Remove spine lamina >2 lmbr,,,7086.45,17716.12,4 HCPCS,63020,Neck spine disk surgery,,,7086.45,17716.12,4 HCPCS,63030,Low back disk surgery,,,7086.45,17716.12,4 HCPCS,63040,Laminotomy single cervical,,,7086.45,17716.12,4 HCPCS,63042,Laminotomy single lumbar,,,7086.45,17716.12,4 HCPCS,63045,Remove spine lamina 1 crvl,,,7086.45,17716.12,4 HCPCS,63046,Remove spine lamina 1 thrc,,,7086.45,17716.12,4 HCPCS,63047,Remove spine lamina 1 lmbr,,,7086.45,17716.12,4 HCPCS,63055,Decompress spinal cord thrc,,,7086.45,17716.12,4 HCPCS,63056,Decompress spinal cord lmbr,,,7086.45,17716.12,4 HCPCS,63064,Decompress spinal cord thrc,,,7086.45,17716.12,4 HCPCS,63075,Neck spine disk surgery,,,7086.45,17716.12,4 HCPCS,63265,Excise intraspinl lesion crv,,,7086.45,17716.12,4 HCPCS,63266,Excise intrspinl lesion thrc,,,7086.45,17716.12,4 HCPCS,63267,Excise intrspinl lesion lmbr,,,7086.45,17716.12,4 HCPCS,63268,Excise intrspinl lesion scrl,,,7086.45,17716.12,4 HCPCS,63600,Remove spinal cord lesion,,,1907.04,4767.6,8 HCPCS,63610,Stimulation of spinal cord,,,1907.04,4767.6,8 HCPCS,63650,Hc Sc Implant Neuroelec,13996.62,5598.65,,,0 HCPCS,63650,Implant neuroelectrodes,,,3470.0,15559.73,8 HCPCS,63655,Implant neuroelectrodes,,,18946.23,47365.59,4 HCPCS,63660,Revise/remove neuroelectrode,,,2546.0,2978.0,4 HCPCS,63661,Hc Insertion Of Spinal Neurostimulator Electrode Array Using Fluoroscopic Guidance,4014.88,1605.95,,,0 HCPCS,63661,Remove spine eltrd perq aray,,,1907.04,4767.6,8 HCPCS,63662,Hc Removal Of Spinal Neurostimulator Electrode Plate Using Fluoroscopic Guidance,5102.24,2040.9,,,0 HCPCS,63662,Remove spine eltrd plate,,,3414.31,8535.78,4 HCPCS,63663,Hc Revision/Replacement Of Spinal Neurostimulator Electrodes Percytabeiys Array(S) Using Fluoroscopy,9736.08,3894.43,,,0 HCPCS,63663,Revise spine eltrd perq aray,,,6223.89,15559.73,4 HCPCS,63664,Hc Revision/Replacement Of Spinal Neurostimulator Electrodes Plates/Paddle Via Laminotomy/Laminectom,18496.32,7398.53,,,0 HCPCS,63664,Revise spine eltrd plate,,,10882.0,27205.01,4 HCPCS,63685,Hc Insertion Or Replacement Of Spinal Nuerostimulator Generator/Receiver,49279.29,19711.72,,,0 HCPCS,63685,Insrt/redo spine n generator,,,3470.0,75339.4,8 HCPCS,63688,Hc Removal/Revision Of Neurostimulator Generator/Receiver,5102.24,2040.9,,,0 HCPCS,63688,Revise/remove neuroreceiver,,,2546.0,8535.78,8 HCPCS,63744,Revision of spinal shunt,,,3336.22,9743.0,8 HCPCS,63746,Removal of spinal shunt,,,1907.04,4767.6,8 HCPCS,64400,Hc Sc Orbital Nerve Block,1639.24,655.7,,,0 HCPCS,64400,N block inj trigeminal,,,299.77,749.43,4 HCPCS,64405,"Hc Inject Nerv Blck,Great Occiptl",3325.36,1330.14,,,0 HCPCS,64405,"Hc Injection Nerve Block,Great Occiptal Bilateral",3325.36,1330.14,,,0 HCPCS,64405,"Hc Injection Nerve Block,Great Occiptal Unilateral",2216.9,886.76,,,0 HCPCS,64405,N block inj occipital,,,299.77,749.43,4 HCPCS,64408,Hc Injection Aa&/Strd Vagus Nerve,879.06,351.62,,,0 HCPCS,64408,Hc Injection Aa&/Strd Vagus Nerve Unilateral,879.06,351.62,,,0 HCPCS,64408,N block inj vagus,,,299.77,749.43,4 HCPCS,64410,N block inj phrenic,,,2546.0,2978.0,4 HCPCS,64415,"Hc Injection,Anes Agent,Brachial Plexus,Single",2210.21,884.08,,,0 HCPCS,64415,N block inj brachial plexus,,,863.78,2978.0,8 HCPCS,64416,N block cont infuse b plex,,,863.78,2159.45,4 HCPCS,64417,"Hc Injection Nerve Block,Axillary Nerve Including Imaging Guidance, When Performed",4361.38,1744.55,,,0 HCPCS,64417,N block inj axillary,,,863.78,2978.0,8 HCPCS,64418,Hc Injection Aa&/Strd Suprascapular Nerve,2046.12,818.45,,,0 HCPCS,64418,N block inj suprascapular,,,689.37,1723.42,4 HCPCS,64420,Hc Injection Aa&/Strd Intercostal Nrv Single Lvl,2290.57,916.23,,,0 HCPCS,64420,N block inj intercost sng,,,689.37,2978.0,8 HCPCS,64421,"Hc Inject Nerv Blck,Intercost,Multpl",3514.56,1405.82,,,0 HCPCS,64421,N block inj intercost mlt,,,863.78,2978.0,8 HCPCS,64425,"Hc Injection Nerve Block, Ilioinguinal, Iliohypogastric",1970.77,788.31,,,0 HCPCS,64425,N block inj ilio-ing/hypogi,,,689.37,1723.42,4 HCPCS,64430,Hc Ct Guided Inj Anes Pudendal Nerve-Bilateral,3412.42,1364.97,,,0 HCPCS,64430,Hc Ct Guided Inj Anes Pudendal Nerve-Unilateral,2275.51,910.2,,,0 HCPCS,64430,"Hc Injection Nerve Block,Pudendal-Bilateral",3412.42,1364.97,,,0 HCPCS,64430,"Hc Injection Nerve Block,Pudendal-Unilateral",2275.51,910.2,,,0 HCPCS,64430,N block inj pudendal,,,863.78,2978.0,8 HCPCS,64435,Hc Injection Aa&/Strd Paracervical Nerve,1506.96,602.78,,,0 HCPCS,64435,N block inj paracervical,,,689.37,1723.42,4 HCPCS,64445,"Hc Injection,Anesthesia Agent,Sciatic Nerve,Single, Including Imaging Guidance, When Performed",4542.1,1816.84,,,0 HCPCS,64445,N block inj sciatic sng,,,689.37,4059.0,8 HCPCS,64446,N blk inj sciatic cont inf,,,863.78,2159.45,4 HCPCS,64447,"Hc Injection,Anesthesia Agent,Femoral Nerve,Single,Including Imaging Guidance, When Performed",3636.24,1454.5,,,0 HCPCS,64447,N block inj fem single,,,689.37,1723.42,4 HCPCS,64448,"Hc Inj,Anes Agent,Femoral Nerve,Cont Inf",2508.61,1003.44,,,0 HCPCS,64448,N block inj fem cont inf,,,863.78,2159.45,4 HCPCS,64449,N block inj lumbar plexus,,,863.78,2159.45,4 HCPCS,64450,"Hc Injection Nerve Block,Other Periph Nerve",2171.7,868.68,,,0 HCPCS,64450,"Hc Injection Nerve Block,Other Periph Nerve Bilateral",3260.06,1304.02,,,0 HCPCS,64450,"Hc Injection Nerve Block,Other Periph Nerve-Bilateral",3260.06,1304.02,,,0 HCPCS,64450,"Hc Injection Nerve Block,Other Periph Nerve-Unilateral",2171.7,868.68,,,0 HCPCS,64450,"Hc Injection Nerve Block,Othrr Peripheral Nerve",3260.06,1304.02,,,0 HCPCS,64450,N block other peripheral,,,689.37,1723.42,4 HCPCS,64451,Hc Injection Agent Somatic Nerve-Bilateral,2426.2,970.48,,,0 HCPCS,64451,Hc Injection Agent Somatic Nerve-Unilateral,1617.47,646.99,,,0 HCPCS,64451,Njx aa&/strd nrv nrvtg si jt,,,689.37,1723.42,4 HCPCS,64454,Hc Inj Agt Genicular Nrv W/Img-Unilateral,1617.47,646.99,,,0 HCPCS,64454,Hc Inj Agt Geniculr Nrv W/Img-Bilateral,2426.2,970.48,,,0 HCPCS,64454,Njx aa&/strd gnclr nrv brnch,,,689.37,1723.42,4 HCPCS,64455,Hc Injection Anesthesia/Steroid Plantar Common Digital Nerve-Bilateral,1430.09,572.04,,,0 HCPCS,64455,Hc Injection Anesthesia/Steroid Plantar Common Digital Nerve-Unilateral,1028.08,411.23,,,0 HCPCS,64455,N block inj plantar digit,,,299.77,749.43,4 HCPCS,64461,Hc Hpvb Thoracic Single Injection Site W/Img Gid Unilateral,3146.2,1258.48,,,0 HCPCS,64461,Pvb thoracic single inj site,,,689.37,1723.42,4 HCPCS,64462,Hc Pvb Thoracic Second & Addl Inj Site W/Img Gid Unilateral,4847.39,1938.96,,,0 HCPCS,64463,Hc Pvb Thoracic Cont Catheter Infusion W/Img Gid Unilateral,4847.39,1938.96,,,0 HCPCS,64463,Pvb thoracic cont infusion,,,689.37,1723.42,4 HCPCS,64470,Inj paravertebral c/t,,,2546.0,2978.0,4 HCPCS,64472,Inj paravertebral c/t add-on,,,2546.0,2978.0,4 HCPCS,64475,Inj paravertebral l/s,,,2546.0,2978.0,4 HCPCS,64476,Inj paravertebral l/s add-on,,,2546.0,2978.0,4 HCPCS,64479,Hc Ct Guided Inj Anes Epidural Transforminal Csp Tsp 1 Level-Unilateral,3646.84,1458.74,,,0 HCPCS,64479,"Hc Inject Anes/Steroid Foramen Cerv/Thoracic W Img Guide ,1 Level-Bilateral",5471.93,2188.77,,,0 HCPCS,64479,"Hc Injection Anes/Steroid Foramen Cerv/Thoracic W Imagine Guidance ,1 Level",3646.84,1458.74,,,0 HCPCS,64479,Inj foramen epidural c/t,,,863.78,2978.0,8 HCPCS,64480,Hc Ct Guided Inj Anes Epidural Transforminal Csp Tsp Each Additional Level-Unilateral,2551.78,1020.71,,,0 HCPCS,64480,Inj foramen epidural add-on,,,2546.0,2978.0,4 HCPCS,64483,Hc Ct Guided Inj Anes Epidural Transforminal Lsp Sac 1 Level-Bilateral,6096.49,2438.6,,,0 HCPCS,64483,Hc Ct Guided Inj Anes Epidural Transforminal Lsp Sac 1 Level-Unilateral,4063.77,1625.51,,,0 HCPCS,64483,"Hc Injection Anes/Steroid Foramen Lumbar/Sacral W Imagine Guidance ,1 Level",3125.98,1250.39,,,0 HCPCS,64483,Inj foramen epidural l/s,,,863.78,2978.0,8 HCPCS,64484,"Hc Ct Injection Anesthesia/Steroid Foramen Lumbar/Sacral W Imagine Guidance ,Each Additional Level-U",2890.02,1156.01,,,0 HCPCS,64484,"Hc Injection Anes/Steroid Foramen Lumbar/Sacral W Imagine Guidance ,Each Additional Level",2890.02,1156.01,,,0 HCPCS,64484,"Hc Injection Anesthesia/Steroid Foramen Lumbar/Sacral W Imagine Guidance ,Each Additional Level",2890.02,1156.01,,,0 HCPCS,64484,Inj foramen epidural add-on,,,2546.0,2978.0,4 HCPCS,64486,Hc Injection Tap Block W/Imagine-Unilateral,1759.8,703.92,,,0 HCPCS,64487,Hc Tap Block By Continuous Infusion(S)-Unilateral,1614.12,645.65,,,0 HCPCS,64488,Hc Inj Tap Block Bilateral W/Img,2638.86,1055.54,,,0 HCPCS,64490,Hc Ct Guided Inj Facet Csp Tsp 1 Level-Bilateral,6585.41,2634.16,,,0 HCPCS,64490,Hc Ct Guided Inj Facet Csp Tsp 1 Level-Unilateral,4390.28,1756.11,,,0 HCPCS,64490,"Hc Injection Dx/Therapy Agent Paravert Facet Joint,Image Guidance,Cerv/Thorac, 1St Level- Bilateral",6585.41,2634.16,,,0 HCPCS,64490,"Hc Injection Dx/Therapy Agent Paravert Facet Joint,Image Guidance,Cerv/Thorac, 1St Level-Unilateral",4390.28,1756.11,,,0 HCPCS,64490,Inj paravert f jnt c/t 1 lev,,,863.78,2978.0,8 HCPCS,64491,Hc Ct Guided Inj Facet Csp Tsp 2Nd Level-Unilateral,3631.77,1452.71,,,0 HCPCS,64491,"Hc Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Cerv/Thorac, 2Nd Level - Bilateral",4865.81,1946.32,,,0 HCPCS,64491,"Hc Injection Dx/Therapy Agent Paravert Facet Joint,Imagine Guide,Cerv/Thorac, 2Nd Level",3631.77,1452.71,,,0 HCPCS,64491,Inj paravert f jnt c/t 2 lev,,,2546.0,2978.0,4 HCPCS,64492,"Hc Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Cerv/Thorac, Add Level - Bilateral",3555.18,1422.07,,,0 HCPCS,64492,"Hc Injection Dx/Therapy Agent Paravert Facet Joint,Imagine Guide,Cerv/Thorac, 2Nd Level - Unilateral",2653.1,1061.24,,,0 HCPCS,64492,Inj paravert f jnt c/t 3 lev,,,2546.0,2978.0,4 HCPCS,64493,Hc Ct Guided Inj Facet Lsp Sacrum-Bilateral,6793.05,2717.22,,,0 HCPCS,64493,Hc Ct Guided Inj Facet Lsp Sacrum-Unilateral,4529.25,1811.7,,,0 HCPCS,64493,"Hc Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Lumbar/Sac, 1St Level - Bilateral",6793.05,2717.22,,,0 HCPCS,64493,"Hc Pbb Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Lumbar/Sac, 1St Level Unilateral",4529.25,1811.7,,,0 HCPCS,64493,Inj paravert f jnt l/s 1 lev,,,863.78,2978.0,8 HCPCS,64494,Hc Ct Guided Inj Facet Lsp Sacrum 2Nd Level-Unilateral,3469.36,1387.74,,,0 HCPCS,64494,"Hc Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Lumbar/Sac, 2Nd Level - Bilateral",4646.46,1858.58,,,0 HCPCS,64494,"Hc Injection Dx/Therapy Agent Paravert Facet Joint,Imagine Guidance Lumbar/Sca, 2Nd Level",3469.36,1387.74,,,0 HCPCS,64494,Inj paravert f jnt l/s 2 lev,,,2546.0,2978.0,4 HCPCS,64495,Hc Ct Guided Inj Facet Lsp Sacrum 3 Or More Levels-Unilateral,3328.7,1331.48,,,0 HCPCS,64495,"Hc Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Lumbar/Sac, Add Level - Bilateral",4458.92,1783.57,,,0 HCPCS,64495,"Hc Injection Dx/Therapy Agent Paravert Facet Joint,Imagine Guidance Lumbar/Sca, Additional",3328.7,1331.48,,,0 HCPCS,64495,Inj paravert f jnt l/s 3 lev,,,2546.0,2978.0,4 HCPCS,64505,Hc Inj Agt Sphenopalatine Gan Bilateral,2941.93,1176.77,,,0 HCPCS,64505,N block spenopalatine gangl,,,299.77,749.43,4 HCPCS,64510,"Hc Inject Nerv Blck,Stellate Ganglion",3516.24,1406.5,,,0 HCPCS,64510,N block stellate ganglion,,,863.78,2978.0,8 HCPCS,64517,Hc Injection Agent Hypogastric Plexus,3715.49,1486.2,,,0 HCPCS,64517,N block inj hypogas plxs,,,863.78,4059.0,8 HCPCS,64520,"Hc Inject Nerv Blck,Paravert Sympath-Bilateral",6160.12,2464.05,,,0 HCPCS,64520,"Hc Injection Nerve Block,Paravert Sympath-Unilateral",4107.3,1642.92,,,0 HCPCS,64520,N block lumbar/thoracic,,,863.78,2978.0,8 HCPCS,64530,"Hc Inject Nerv Blck,Celiac Plexus",3652.64,1461.055,,,0 HCPCS,64530,N block inj celiac pelus,,,863.78,2978.0,8 HCPCS,64553,Hc Perc Impl Neuroelectrds Cran,22451.0,8980.4,,,0 HCPCS,64553,Implant neuroelectrodes,,,2546.0,27205.01,8 HCPCS,64555,Hc Percutaneous Implantation Of Neurostimulator Electrode Array,11702.86,4681.14,,,0 HCPCS,64555,Implant neuroelectrodes,,,6223.89,15559.73,4 HCPCS,64561,Hc Percutaneous Implantation Neurostimulaotor Electored Sacral Nerve With Imaging If Performed Bilat,13940.55,5576.22,,,0 HCPCS,64561,Hc Percutaneous Nerve Evaluation W/ Imaging (If Performed) Unilateral,8698.9,3479.56,,,0 HCPCS,64561,Implant neuroelectrodes,,,6223.89,15559.73,8 HCPCS,64566,"Hc Post Tibial Neurostimulation,Perc Needle Electrode",686.5,274.6,,,0 HCPCS,64566,Neuroeltrd stim post tibial,,,299.77,749.43,4 HCPCS,64567,Perq elec nrv field stimj cn,,,885.77,2214.41,4 HCPCS,64568,Inc for vagus n elect impl,,,2546.0,107539.94,8 HCPCS,64569,Revise/repl vagus n eltrd,,,10882.0,27205.01,4 HCPCS,64570,Remove vagus n eltrd,,,3336.22,8340.56,4 HCPCS,64573,Implant neuroelectrodes,,,2546.0,2978.0,4 HCPCS,64575,Implant neuroelectrodes,,,2546.0,27205.01,8 HCPCS,64577,Implant neuroelectrodes,,,2546.0,2978.0,4 HCPCS,64580,Implant neuroelectrodes,,,2546.0,47365.59,8 HCPCS,64581,Implant neuroelectrodes,,,6223.89,15559.73,8 HCPCS,64582,Opn mpltj hpglsl nstm ary pg,,,30135.76,75339.4,4 HCPCS,64583,Rev/rplct hpglsl nstm ary pg,,,10882.0,27205.01,4 HCPCS,64584,Rmvl hpglsl nstim ary pg,,,3336.22,8340.56,4 HCPCS,64585,Hc Revision/Removal Of Peripheral Neurostimulator Electrode Array,6275.1,2510.04,,,0 HCPCS,64585,Revise/remove neuroelectrode,,,2546.0,8535.78,8 HCPCS,64590,Hc Insertion Of Peripheral Or Gastric Neurostimulator Generator,39028.6,15611.44,,,0 HCPCS,64590,Insrt/redo pn/gastr stimul,,,3470.0,47365.59,8 HCPCS,64595,Revise/rmv pn/gastr stimul,,,2546.0,8535.78,8 HCPCS,64596,Hc Insertion/Replacement Of Peripheral Neurostimulator,19469.93,7787.97,,,0 HCPCS,64596,Ins/rplcmt prq eltrd ra pn 1,,,10882.0,27205.01,4 HCPCS,64598,Revj/rmvl nea pn w/int nstim,,,3414.31,8535.78,4 HCPCS,64600,Hc Destruction Of First Division Of Face Nerve Branch,3782.35,1512.94,,,0 HCPCS,64600,Injection treatment of nerve,,,863.78,2978.0,8 HCPCS,64605,Hc Destruction Of Face Nerve Branch Under Xray Monitoring,5456.75,2182.7,,,0 HCPCS,64605,Injection treatment of nerve,,,1907.04,4767.6,8 HCPCS,64610,"Hc Injection Destruction By Neurolytic Agent, 5Th N.-2.3 Division,Foramen Ovale, Xray",3089.27,1235.71,,,0 HCPCS,64610,Injection treatment of nerve,,,1907.04,4767.6,8 HCPCS,64611,Chemodenerv saliv glands,,,299.77,749.43,4 HCPCS,64611,Hc Chemodenervation Parotid/Submandibular Salivary Glands-Bilateral,943.74,377.5,,,0 HCPCS,64612,Destroy nerve face muscle,,,299.77,2978.0,8 HCPCS,64612,Hc Chemodenervation Muscle Innervated Facial Nerve-Biilateral,2869.92,1147.97,,,0 HCPCS,64612,Hc Chemodenervation Muscle Innervated Facial Nerve-Unilateral,1912.17,764.87,,,0 HCPCS,64615,Chemodenerv musc migraine,,,299.77,749.43,4 HCPCS,64615,Hc Chemodenervation Facial/Trigeminal/Cervical Spinal/Accessory Nerve Muscles- Migraine,1265.85,506.34,,,0 HCPCS,64616,Chemodenerv musc neck dyston,,,299.77,749.43,4 HCPCS,64616,Hc Chemodenervation Muscle Neck For Dystonia-Bilateral,2565.19,1026.08,,,0 HCPCS,64616,Hc Chemodenervation Muscle Neck For Dystonia-Unilateral,1709.56,683.82,,,0 HCPCS,64617,Chemodener muscle larynx emg,,,689.37,1723.42,4 HCPCS,64617,Hc Chemodenervation Muscle Larynx W/Emg-Bilateral,3365.54,1346.22,,,0 HCPCS,64617,Hc Chemodenervation Muscle Larynx W/Emg-Unilateral,2245.37,898.15,,,0 HCPCS,64620,Hc Injection Of Agent To Destroy Rib Nerve,3092.7,1237.08,,,0 HCPCS,64620,Injection treatment of nerve,,,863.78,2978.0,8 HCPCS,64622,Destr paravertebrl nerve l/s,,,2546.0,2978.0,4 HCPCS,64623,Destr paravertebral n add-on,,,2546.0,2978.0,4 HCPCS,64624,Dstrj nulyt agt gnclr nrv,,,1907.04,4767.6,4 HCPCS,64624,Hc Destr Neuro Agt Genicu Nrv-Bilateral,8229.68,3291.87,,,0 HCPCS,64624,Hc Destruction Neurolytic Agt Genicular Nerve W/Img,3641.82,1456.73,,,0 HCPCS,64625,Hc Sc Rftc Sacroiliac W/Img-Bilateral,5562.36,2224.94,,,0 HCPCS,64625,Hc Sc Rftc Sacroiliac W/Img-Unilateral,3708.8,1483.52,,,0 HCPCS,64625,Rf abltj nrv nrvtg si jt,,,1907.04,4767.6,4 HCPCS,64626,Destr paravertebrl nerve c/t,,,2546.0,2978.0,4 HCPCS,64627,Destr paravertebral n add-on,,,2546.0,2978.0,4 HCPCS,64628,Trml dstrj ios bvn 1st 2 l/s,,,12538.31,31345.78,4 HCPCS,64630,Hc Destruction By Neurolytic Agent Pudendal Nerve,2535.0,1014.0,,,0 HCPCS,64630,Injection treatment of nerve,,,863.78,4059.0,8 HCPCS,64632,Hc Destruction Of Nerve Of Foot,1228.5,491.4,,,0 HCPCS,64632,N block inj common digit,,,299.77,749.43,4 HCPCS,64633,Destroy cerv/thor facet jnt,,,1907.04,4767.6,8 HCPCS,64633,Hc Rftc Cer/Thoracic Sing Lev-Bilateral,9081.14,3632.46,,,0 HCPCS,64633,Hc Rftc Cervical/Thoracic Single Level-Unilateral,6054.57,2421.83,,,0 HCPCS,64634,Destroy c/th facet jnt addl,,,2546.0,2978.0,4 HCPCS,64634,Hc Cervical/Thoracic Additional Level-Bilateral,5764.41,2305.76,,,0 HCPCS,64634,Hc Cervical/Thoracic Additional Level-Unilateral,4303.56,1721.42,,,0 HCPCS,64635,Destroy lumb/sac facet jnt,,,1907.04,4767.6,8 HCPCS,64635,Hc Ct Guided Inj Destruct Facet Lsp Sac 1 Level-Bilateral,9121.36,3648.54,,,0 HCPCS,64635,Hc Ct Guided Inj Destruct Facet Lsp Sac 1 Level-Unilateral,6081.86,2432.74,,,0 HCPCS,64635,Hc Destruction Nrolytc Agnt Parverteb Fct Single Lumbar/Sacral-Bilateral,9121.36,3648.54,,,0 HCPCS,64635,Hc Dstr Nrolytc Agent Parverteb Fct Single Lumbr/Sacral,6081.86,2432.74,,,0 HCPCS,64636,Destroy l/s facet jnt addl,,,2546.0,2978.0,4 HCPCS,64636,Hc Rftc Lumbar Add Lev-Bilateral,6173.79,2469.52,,,0 HCPCS,64636,Hc Rftc Lumbar Additonal Level - Unilateral,4609.52,1843.81,,,0 HCPCS,64640,Hc Destruct By Neuro Agent; Other Periph Nerve - Bilateral,6201.98,2480.79,,,0 HCPCS,64640,Hc Destruction By Neuro Agent; Other Periph Nerve,4135.77,1654.31,,,0 HCPCS,64640,Injection treatment of nerve,,,863.78,4059.0,8 HCPCS,64642,Chemodenerv 1 extremity 1-4,,,689.37,4059.0,8 HCPCS,64642,Hc Chemodenervation One Extremity 1-4 Muscle,1828.45,731.38,,,0 HCPCS,64643,Hc Chemodenervation One Extremity 1-4 Muscle Each Additional Muscles,999.62,399.85,,,0 HCPCS,64644,Chemodenerv 1 extrem 5/> mus,,,689.37,2978.0,8 HCPCS,64644,Hc Chemodenervation One Extremity 5 Or More,1828.45,731.38,,,0 HCPCS,64645,Hc Chemodenervation One Extremity 5 Or More Each Additional Muscles,999.62,399.85,,,0 HCPCS,64646,Chemodenerv trunk musc 1-5,,,689.37,1723.42,4 HCPCS,64646,Hc Chemodenervation Trunk 1-5 Muscles,2109.74,843.9,,,0 HCPCS,64647,Chemodenerv trunk musc 6/>,,,689.37,1723.42,4 HCPCS,64647,Hc Cehmodenervation Of Trunk 6 Or More Muscles,2437.5,975.0,,,0 HCPCS,64650,Chemodenerv eccrine glands,,,299.77,749.43,4 HCPCS,64650,Hc Chemodenervation Eccrine Glands Both Axillae,934.38,373.75,,,0 HCPCS,64653,Chemodenerv eccrine glands,,,299.77,749.43,4 HCPCS,64653,Hc Chemodenervation Eccrine Glands Non-Axillary,934.38,373.75,,,0 HCPCS,64654,1st opn implt bat modulj sys,,,43015.98,107539.94,4 HCPCS,64655,Revj/rplcmt bat mod sys lead,,,3414.31,8535.78,4 HCPCS,64656,Revj/rplcmt bat mod sys pg,,,30135.76,75339.4,4 HCPCS,64657,Rmvl bat modulj sys tot sys,,,3336.22,8340.56,4 HCPCS,64658,Rmvl bat modul sys lead only,,,3414.31,8535.78,4 HCPCS,64659,Rmvl bat modulj sys pg only,,,3414.31,8535.78,4 HCPCS,64680,Hc Inject Rx Celiac Plexus Nerve,5451.85,2180.74,,,0 HCPCS,64680,Injection treatment of nerve,,,863.78,4059.0,8 HCPCS,64681,Injection treatment of nerve,,,863.78,4059.0,8 HCPCS,64702,Revise finger/toe nerve,,,1907.04,4767.6,8 HCPCS,64704,Revise hand/foot nerve,,,1907.04,4767.6,8 HCPCS,64708,Revise arm/leg nerve,,,1907.04,4767.6,8 HCPCS,64712,Revision of sciatic nerve,,,1907.04,4767.6,8 HCPCS,64713,Revision of arm nerve(s),,,1907.04,4767.6,8 HCPCS,64714,Revise low back nerve(s),,,1907.04,4767.6,8 HCPCS,64716,Revision of cranial nerve,,,1907.04,9743.0,8 HCPCS,64718,Revise ulnar nerve at elbow,,,1907.04,4767.6,8 HCPCS,64719,Revise ulnar nerve at wrist,,,1907.04,4767.6,8 HCPCS,64721,Carpal tunnel surgery,,,1907.04,4767.6,8 HCPCS,64722,Relieve pressure on nerve(s),,,1907.04,4767.6,8 HCPCS,64726,Release foot/toe nerve,,,1907.04,4767.6,8 HCPCS,64727,Internal nerve revision,,,2546.0,2978.0,4 HCPCS,64728,Dcmprn median nrv carpl tunl,,,1907.04,4767.6,4 HCPCS,64732,Incision of brow nerve,,,1907.04,4767.6,8 HCPCS,64734,Incision of cheek nerve,,,1907.04,4767.6,8 HCPCS,64736,Incision of chin nerve,,,1907.04,4767.6,8 HCPCS,64738,Incision of jaw nerve,,,1907.04,4767.6,8 HCPCS,64740,Incision of tongue nerve,,,1907.04,4767.6,8 HCPCS,64742,Incision of facial nerve,,,1907.04,4767.6,8 HCPCS,64744,Incise nerve back of head,,,1907.04,4767.6,8 HCPCS,64746,Incise diaphragm nerve,,,1907.04,4767.6,8 HCPCS,64763,Incise hip/thigh nerve,,,1907.04,4767.6,4 HCPCS,64766,Incise hip/thigh nerve,,,1907.04,4767.6,4 HCPCS,64771,Sever cranial nerve,,,1907.04,4767.6,8 HCPCS,64772,Incision of spinal nerve,,,1907.04,4767.6,8 HCPCS,64774,Remove skin nerve lesion,,,1907.04,4767.6,8 HCPCS,64776,Hc Excision Digital Neuroma,9269.0,3707.6,,,0 HCPCS,64776,Remove digit nerve lesion,,,1907.04,9743.0,8 HCPCS,64778,Digit nerve surgery add-on,,,3470.0,4059.0,4 HCPCS,64778,Hc Excision Neuroma Digital-Each Additional,883.54,353.42,,,0 HCPCS,64782,Hc Excision Hand/Foot Neuroma,4634.5,1853.8,,,0 HCPCS,64782,Remove limb nerve lesion,,,1907.04,9743.0,8 HCPCS,64783,Limb nerve surgery add-on,,,3470.0,4059.0,4 HCPCS,64784,Remove nerve lesion,,,1907.04,9743.0,8 HCPCS,64786,Remove sciatic nerve lesion,,,3336.22,9743.0,8 HCPCS,64787,Implant nerve end,,,3470.0,4059.0,4 HCPCS,64788,Hc Remove Skin Nerve Lesion,5070.0,2028.0,,,0 HCPCS,64788,Remove skin nerve lesion,,,1907.04,9743.0,8 HCPCS,64790,Removal of nerve lesion,,,1907.04,9743.0,8 HCPCS,64792,Removal of nerve lesion,,,3336.22,9743.0,8 HCPCS,64795,Biopsy of nerve,,,1907.04,4767.6,8 HCPCS,64802,Sympathectomy cervical,,,1907.04,4767.6,8 HCPCS,64804,Remove sympathetic nerves,,,1907.04,4767.6,4 HCPCS,64820,Sympathectomy digital artery,,,1907.04,4767.6,4 HCPCS,64821,Remove sympathetic nerves,,,3195.45,8800.0,8 HCPCS,64822,Remove sympathetic nerves,,,3195.45,7988.62,4 HCPCS,64823,Sympathectomy supfc palmar,,,3195.45,7988.62,4 HCPCS,64831,Hc Repair Of Digit Nerve Foot/Hand,5005.0,2002.0,,,0 HCPCS,64831,Repair of digit nerve,,,1907.04,8800.0,8 HCPCS,64832,Repair nerve add-on,,,2546.0,2978.0,4 HCPCS,64834,Repair of hand or foot nerve,,,3336.22,8340.56,8 HCPCS,64835,Repair of hand or foot nerve,,,3336.22,9743.0,8 HCPCS,64836,Repair of hand or foot nerve,,,3336.22,9743.0,8 HCPCS,64837,Repair nerve add-on,,,2546.0,2978.0,4 HCPCS,64840,Repair of leg nerve,,,3470.0,21426.33,8 HCPCS,64856,Repair/transpose nerve,,,3470.0,21426.33,8 HCPCS,64857,Repair arm/leg nerve,,,3336.22,8340.56,8 HCPCS,64858,Repair sciatic nerve,,,1907.04,4767.6,8 HCPCS,64859,Nerve surgery,,,2546.0,2978.0,4 HCPCS,64861,Repair of arm nerves,,,1907.04,9743.0,8 HCPCS,64862,Repair of low back nerves,,,3336.22,9743.0,8 HCPCS,64864,Repair of facial nerve,,,8330.0,21426.33,8 HCPCS,64865,Repair of facial nerve,,,3336.22,8800.0,8 HCPCS,64870,Fusion of facial/other nerve,,,7524.0,8800.0,4 HCPCS,64872,Subsequent repair of nerve,,,3470.0,4059.0,4 HCPCS,64874,Repair & revise nerve add-on,,,8330.0,9743.0,4 HCPCS,64876,Repair nerve/shorten bone,,,8330.0,9743.0,4 HCPCS,64885,Nerve graft head/neck <=4 cm,,,3470.0,21426.33,8 HCPCS,64886,Nerve graft head/neck >4 cm,,,3470.0,21426.33,8 HCPCS,64890,Nerve graft hand/foot <=4 cm,,,3470.0,21426.33,8 HCPCS,64891,Nerve graft hand/foot >4 cm,,,3470.0,21426.33,8 HCPCS,64892,Nerve graft arm/leg <4 cm,,,3470.0,21426.33,8 HCPCS,64893,Nerve graft arm/leg >4 cm,,,3336.22,8340.56,8 HCPCS,64895,Nerve graft hand/foot <=4 cm,,,8330.0,21426.33,8 HCPCS,64896,Nerve graft hand/foot >4 cm,,,8330.0,21426.33,8 HCPCS,64897,Nerve graft arm/leg <=4 cm,,,8330.0,21426.33,8 HCPCS,64898,Nerve graft arm/leg >4 cm,,,8330.0,21426.33,8 HCPCS,64901,Nerve graft add-on,,,3470.0,4059.0,4 HCPCS,64902,Nerve graft add-on,,,3470.0,4059.0,4 HCPCS,64905,Nerve pedicle transfer,,,3470.0,21426.33,8 HCPCS,64907,Nerve pedicle transfer,,,2546.0,21426.33,8 HCPCS,64999,Hc Nervous System Surgery Unlisted,1746.81,698.72,,,0 HCPCS,64999,Hc Rf Ablation Trigeminal Nerve,1746.81,698.72,,,0 HCPCS,64999,Nervous system surgery,,,299.77,749.43,4 HCPCS,65091,Revise eye,,,3839.42,9743.0,8 HCPCS,65093,Revise eye with implant,,,3839.42,9743.0,8 HCPCS,65101,Removal of eye,,,3839.42,9743.0,8 HCPCS,65103,Remove eye/insert implant,,,3839.42,9743.0,8 HCPCS,65105,Remove eye/attach implant,,,3839.42,9598.55,8 HCPCS,65110,Removal of eye,,,3839.42,11433.0,8 HCPCS,65112,Remove eye/revise socket,,,3839.42,12101.0,8 HCPCS,65114,Remove eye/revise socket,,,3839.42,12101.0,8 HCPCS,65125,Revise ocular implant,,,2321.86,5804.65,4 HCPCS,65130,Insert ocular implant,,,3839.42,9743.0,8 HCPCS,65135,Insert ocular implant,,,3470.0,9598.55,8 HCPCS,65140,Attach ocular implant,,,3839.42,9743.0,8 HCPCS,65150,Revise ocular implant,,,3470.0,9598.55,8 HCPCS,65155,Reinsert ocular implant,,,3839.42,9743.0,8 HCPCS,65175,Removal of ocular implant,,,2546.0,9598.55,8 HCPCS,65205,"Hc Removal Foreign Body,Eye,Superficial Conjunction",532.45,212.98,,,0 HCPCS,65205,"Hc Remv F.B.,Eye,Superf Conjunc",475.41,190.16,,,0 HCPCS,65205,Remove foreign body from eye,,,129.94,324.84,4 HCPCS,65210,"Hc Removal Foreign Body,Eye,Embed Conjunction",964.28,385.71,,,0 HCPCS,65210,Remove foreign body from eye,,,436.27,1090.68,4 HCPCS,65220,"Hc Removal Foreign Body, Eye, Cornea, No Slit",1438.31,575.32,,,0 HCPCS,65220,Remove foreign body from eye,,,436.27,1090.68,4 HCPCS,65222,"Hc Removal Foreign Body,Eye,Cornea,Slit Lamp",790.32,316.13,,,0 HCPCS,65222,"Hc Remv F.B.,Eye,Cornea,Slit Lamp",790.32,316.13,,,0 HCPCS,65222,Remove foreign body from eye,,,129.94,324.84,4 HCPCS,65235,Hc Removal Fb Intraocular Ant Chamber Eye/Lens,7325.5,2930.2,,,0 HCPCS,65235,Remove foreign body from eye,,,2253.83,5634.58,8 HCPCS,65260,Remove foreign body from eye,,,2253.83,9743.0,8 HCPCS,65265,Remove foreign body from eye,,,2253.83,8800.0,8 HCPCS,65270,Repair of eye wound,,,2321.86,5804.65,8 HCPCS,65272,Repair of eye wound,,,2321.86,5804.65,8 HCPCS,65275,Repair of eye wound,,,3839.42,9598.55,8 HCPCS,65280,Hc Repair Of Perforating Laceration Of Cornea And/Or Sclera,13305.5,5322.2,,,0 HCPCS,65280,Repair of eye wound,,,5196.81,12992.02,8 HCPCS,65285,Repair of eye wound,,,5196.81,12992.02,8 HCPCS,65286,"Hc Repair Cornea Laceration,Apply Glue",4724.2,1889.68,,,0 HCPCS,65286,Repair of eye wound,,,2253.83,5634.58,4 HCPCS,65290,Repair of eye socket wound,,,3839.42,9743.0,8 HCPCS,65400,Removal of eye lesion,,,973.56,2978.0,8 HCPCS,65410,Biopsy of cornea,,,2321.86,5804.65,8 HCPCS,65420,Removal of eye lesion,,,2321.86,5804.65,8 HCPCS,65426,Removal of eye lesion,,,2321.86,11433.0,8 HCPCS,65430,Corneal smear,,,436.27,1090.68,4 HCPCS,65430,Hc Corneal Smear,1666.92,666.77,,,0 HCPCS,65435,Curette/treat cornea,,,973.56,2433.89,4 HCPCS,65435,Hc Curette/Treat Cornea,2167.75,867.1,,,0 HCPCS,65436,Curette/treat cornea,,,2321.86,5804.65,4 HCPCS,65450,Treatment of corneal lesion,,,309.98,774.95,4 HCPCS,65600,Revision of cornea,,,2321.86,5804.65,4 HCPCS,65710,Corneal transplant,,,5196.81,12992.02,8 HCPCS,65730,Corneal transplant,,,4036.72,12101.0,8 HCPCS,65750,Corneal transplant,,,5196.81,12992.02,8 HCPCS,65755,Corneal transplant,,,4036.72,12101.0,8 HCPCS,65756,Corneal trnspl endothelial,,,3470.0,10091.79,8 HCPCS,65770,Revise cornea with implant,,,10346.0,35416.81,8 HCPCS,65772,Correction of astigmatism,,,973.56,8800.0,8 HCPCS,65775,Correction of astigmatism,,,2321.86,8800.0,8 HCPCS,65778,Cover eye w/membrane,,,973.56,2433.89,4 HCPCS,65778,Hc Place Amniotic Membrane Ocular Surface W/O Sutures,4779.52,1911.81,,,0 HCPCS,65779,Cover eye w/membrane suture,,,3839.42,9598.55,4 HCPCS,65780,Ocular reconst transplant,,,3839.42,11433.0,8 HCPCS,65781,Ocular reconst transplant,,,5196.81,12992.02,8 HCPCS,65782,Ocular reconst transplant,,,3839.42,11433.0,8 HCPCS,65785,Impltj ntrstrml crnl rng seg,,,4036.72,10091.79,4 HCPCS,65800,Drainage of eye,,,2253.83,5634.58,8 HCPCS,65800,Hc Aspiration Of Eye Fluid,2190.18,876.07,,,0 HCPCS,65805,Drainage of eye,,,2546.0,2978.0,4 HCPCS,65810,Drainage of eye,,,2253.83,9743.0,8 HCPCS,65810,Hc Paracentsis Ant Chamber Removal Vitreous W/Wo Air Injx,4155.87,1662.35,,,0 HCPCS,65815,Drainage of eye,,,2253.83,5634.58,8 HCPCS,65820,Relieve inner eye pressure,,,2546.0,10091.79,8 HCPCS,65850,Incision of eye,,,2253.83,8800.0,8 HCPCS,65855,Hc Trabeculoplasty By Laser Surgery,2557.94,1023.18,,,0 HCPCS,65855,Trabeculoplasty laser surg,,,537.13,1342.82,4 HCPCS,65860,Incise inner eye adhesions,,,537.13,1342.82,4 HCPCS,65865,Incise inner eye adhesions,,,2253.83,5634.58,8 HCPCS,65870,Incise inner eye adhesions,,,2253.83,8800.0,8 HCPCS,65875,Incise inner eye adhesions,,,2253.83,8800.0,8 HCPCS,65880,Incise inner eye adhesions,,,4036.72,10091.79,8 HCPCS,65900,Remove eye lesion,,,2253.83,11433.0,8 HCPCS,65920,Remove implant of eye,,,2253.83,12101.0,8 HCPCS,65930,Remove blood clot from eye,,,2253.83,11433.0,8 HCPCS,66020,Hc Injection Treatment Of Eye-Air Or Liquid,1296.16,518.46,,,0 HCPCS,66020,Injection treatment of eye,,,2253.83,5634.58,8 HCPCS,66030,Injection treatment of eye,,,2253.83,5634.58,8 HCPCS,66130,Remove eye lesion,,,2321.86,12101.0,8 HCPCS,66150,Glaucoma surgery,,,4036.72,10091.79,8 HCPCS,66155,Glaucoma surgery,,,4036.72,10091.79,8 HCPCS,66160,Glaucoma surgery,,,2253.83,5634.58,8 HCPCS,66165,Glaucoma surgery,,,7524.0,8800.0,4 HCPCS,66170,Glaucoma surgery,,,2253.83,8800.0,8 HCPCS,66172,Incision of eye,,,2253.83,8800.0,8 HCPCS,66174,Translum dil eye canal,,,4036.72,17190.0,8 HCPCS,66175,Trnslum dil eye canal w/stnt,,,5196.81,17190.0,8 HCPCS,66179,Aqueous shunt eye w/o graft,,,5196.81,12992.02,8 HCPCS,66180,Aqueous shunt eye w/graft,,,5196.81,12992.02,8 HCPCS,66183,Insert ant drainage device,,,4036.72,10091.79,4 HCPCS,66184,Revision of aqueous shunt,,,2253.83,11433.0,8 HCPCS,66185,Revise aqueous shunt eye,,,2253.83,5634.58,8 HCPCS,66220,Repair eye lesion,,,8330.0,9743.0,4 HCPCS,66225,Repair/graft eye lesion,,,5196.81,12992.02,8 HCPCS,66250,Follow-up surgery of eye,,,2321.86,5804.65,8 HCPCS,66500,Incision of iris,,,2253.83,5634.58,8 HCPCS,66505,Incision of iris,,,2253.83,5634.58,8 HCPCS,66600,Remove iris and lesion,,,4036.72,10091.79,8 HCPCS,66605,Removal of iris,,,2253.83,9743.0,8 HCPCS,66625,Removal of iris,,,2253.83,9743.0,8 HCPCS,66630,Removal of iris,,,2253.83,9743.0,8 HCPCS,66635,Removal of iris,,,2253.83,9743.0,8 HCPCS,66680,Repair iris & ciliary body,,,2253.83,9743.0,8 HCPCS,66682,Repair iris & ciliary body,,,2253.83,5634.58,8 HCPCS,66700,Destruction ciliary body,,,2253.83,5634.58,8 HCPCS,66710,Ciliary transsleral therapy,,,2321.86,5804.65,8 HCPCS,66711,Ciliary endoscopic ablation,,,2253.83,5634.58,8 HCPCS,66720,Destruction ciliary body,,,2321.86,5804.65,8 HCPCS,66740,Destruction ciliary body,,,2321.86,5804.65,8 HCPCS,66761,"Hc Iridotomy/Iridectomy By Laser, Per Session",2586.35,1034.54,,,0 HCPCS,66761,Revision of iris,,,537.13,1342.82,4 HCPCS,66762,Revision of iris,,,537.13,1342.82,4 HCPCS,66770,Removal of inner eye lesion,,,537.13,1342.82,4 HCPCS,66820,Incision secondary cataract,,,2253.83,5634.58,4 HCPCS,66821,After cataract laser surgery,,,537.13,4059.0,8 HCPCS,66821,"Hc Discission,2Nd Cataract,Laser",1868.75,747.5,,,0 HCPCS,66825,Reposition intraocular lens,,,2253.83,8800.0,8 HCPCS,66830,Removal of lens lesion,,,2253.83,8800.0,8 HCPCS,66840,Removal of lens material,,,2253.83,8800.0,8 HCPCS,66850,Removal of lens material,,,2253.83,12101.0,8 HCPCS,66852,Removal of lens material,,,4036.72,10091.79,8 HCPCS,66920,Extraction of lens,,,2253.83,8800.0,8 HCPCS,66930,Extraction of lens,,,4036.72,11433.0,8 HCPCS,66940,Extraction of lens,,,2253.83,11433.0,8 HCPCS,66982,Cataract surgery complex,,,2253.83,8934.0,8 HCPCS,66983,Cataract surg w/iol 1 stage,,,2253.83,8934.0,8 HCPCS,66984,Cataract surg w/iol 1 stage,,,2253.83,8934.0,8 HCPCS,66985,Insert lens prosthesis,,,2253.83,8644.0,8 HCPCS,66986,Exchange lens prosthesis,,,2253.83,8644.0,8 HCPCS,66987,Xcapsl ctrc rmvl cplx w/ecp,,,4036.72,10091.79,8 HCPCS,66988,Xcapsl ctrc rmvl w/ecp,,,4036.72,10091.79,8 HCPCS,66989,Xcpsl ctrc rmvl cplx insj 1+,,,5196.81,12992.02,8 HCPCS,66991,Hc Extracapsular Cataract Removal With Insertion Of Intracular Lens Prosthesis Stage 1,6105.56,2442.22,,,0 HCPCS,66991,Xcapsl ctrc rmvl insj 1+,,,5196.81,12992.02,8 HCPCS,66999,Eye surgery procedure,,,2253.83,5634.58,4 HCPCS,67005,Partial removal of eye fluid,,,2253.83,8800.0,8 HCPCS,67010,Partial removal of eye fluid,,,2253.83,8800.0,8 HCPCS,67015,Hc Aspiration/Release Vitreous Subretinal/Choroidal,7893.6,3157.44,,,0 HCPCS,67015,Release of eye fluid,,,2253.83,5634.58,8 HCPCS,67025,Replace eye fluid,,,2253.83,5634.58,8 HCPCS,67027,Implant eye drug system,,,7524.0,34066.29,8 HCPCS,67028,Hc Inject Intravitreal Pharmcologic,753.48,301.39,,,0 HCPCS,67028,Injection eye drug,,,322.58,2978.0,8 HCPCS,67030,Incise inner eye strands,,,2253.83,5634.58,8 HCPCS,67031,"Hc Laser Surgery,Sever Vitreous Strands",2653.62,1061.45,,,0 HCPCS,67031,Laser surgery eye strands,,,537.13,4059.0,8 HCPCS,67036,Removal of inner eye fluid,,,4036.72,10091.79,8 HCPCS,67038,Strip retinal membrane,,,9775.0,11433.0,4 HCPCS,67039,Laser treatment of retina,,,4036.72,12101.0,8 HCPCS,67040,Laser treatment of retina,,,4036.72,12101.0,8 HCPCS,67041,Vit for macular pucker,,,4036.72,11433.0,8 HCPCS,67042,Vit for macular hole,,,4036.72,11433.0,8 HCPCS,67043,Vit for membrane dissect,,,4036.72,11433.0,8 HCPCS,67101,Repair detached retina crtx,,,2253.83,11433.0,8 HCPCS,67105,Repair detached retina pc,,,537.13,1342.82,4 HCPCS,67107,Repair detached retina,,,4036.72,11433.0,8 HCPCS,67108,Hc Rpr Retinal Dtchmnt W/Vitrectomy Any Meth,18091.0,7236.4,,,0 HCPCS,67108,Repair detached retina,,,4036.72,12101.0,8 HCPCS,67110,"Hc Repair Detacted Retina, Injection Air/Gas-Unilateral",6111.56,2444.62,,,0 HCPCS,67110,Repair detached retina,,,2253.83,5634.58,4 HCPCS,67112,Rerepair detached retina,,,10346.0,12101.0,4 HCPCS,67113,Repair retinal detach cplx,,,5196.81,12992.02,8 HCPCS,67115,Release encircling material,,,3470.0,10091.79,8 HCPCS,67120,Remove eye implant material,,,2253.83,5634.58,8 HCPCS,67121,Remove eye implant material,,,2253.83,5634.58,8 HCPCS,67141,Hc Prophylaxis Retina Detachment Cryotherapy/Diathermy,2130.38,852.15,,,0 HCPCS,67141,Treatment of retina,,,309.98,4059.0,8 HCPCS,67145,"Hc Prophylaxis Retina Detachment, Photocoagulation",3570.06,1428.02,,,0 HCPCS,67145,Treatment of retina,,,537.13,1342.82,4 HCPCS,67208,Treatment of retinal lesion,,,309.98,774.95,4 HCPCS,67210,"Hc Destruction Of Retinal Lesion,Photocoagulation",3501.29,1400.52,,,0 HCPCS,67210,Treatment of retinal lesion,,,537.13,2978.0,8 HCPCS,67218,Treatment of retinal lesion,,,3839.42,11433.0,8 HCPCS,67220,"Hc Destruction,Choroid Lesion,Photocoagulation",2915.25,1166.1,,,0 HCPCS,67220,Treatment of choroid lesion,,,537.13,1342.82,4 HCPCS,67221,"Hc Destruction,Choroid Lesion,Photodynamic Therapy",1210.95,484.38,,,0 HCPCS,67221,Ocular Photodynamic Ther,,,537.13,1342.82,4 HCPCS,67227,Dstrj extensive retinopathy,,,2546.0,9598.55,8 HCPCS,67228,Hc Treatment Extensive Retinopathy Photocoagulation,2645.55,1058.22,,,0 HCPCS,67228,Treatment x10sv retinopathy,,,537.13,2978.0,8 HCPCS,67229,Tr retinal les preterm inf,,,537.13,1342.82,4 HCPCS,67250,Reinforce eye wall,,,2321.86,9743.0,8 HCPCS,67255,Reinforce/graft eye wall,,,4036.72,10091.79,8 HCPCS,67299,Eye surgery procedure,,,2253.83,5634.58,4 HCPCS,67311,Revise eye muscle,,,2321.86,9743.0,8 HCPCS,67312,Revise two eye muscles,,,3839.42,9598.55,8 HCPCS,67314,Revise eye muscle,,,2321.86,8800.0,8 HCPCS,67316,Revise two eye muscles,,,2321.86,8800.0,8 HCPCS,67318,Revise eye muscle(s),,,2321.86,8800.0,8 HCPCS,67320,Revise eye muscle(s) add-on,,,7524.0,8800.0,4 HCPCS,67331,Eye surgery follow-up add-on,,,7524.0,8800.0,4 HCPCS,67332,Rerevise eye muscles add-on,,,7524.0,8800.0,4 HCPCS,67334,Revise eye muscle w/suture,,,7524.0,8800.0,4 HCPCS,67335,Eye suture during surgery,,,7524.0,8800.0,4 HCPCS,67340,Revise eye muscle add-on,,,7524.0,8800.0,4 HCPCS,67343,Release eye tissue,,,2321.86,12101.0,8 HCPCS,67345,Destroy nerve of eye muscle,,,309.98,774.95,4 HCPCS,67346,Biopsy eye muscle,,,2546.0,9598.55,8 HCPCS,67399,Unlisted px extraocular musc,,,309.98,774.95,4 HCPCS,67400,Explore/biopsy eye socket,,,3839.42,9743.0,8 HCPCS,67405,Explore/drain eye socket,,,2321.86,8800.0,8 HCPCS,67412,Explore/treat eye socket,,,2321.86,11433.0,8 HCPCS,67413,Explore/treat eye socket,,,2321.86,11433.0,8 HCPCS,67414,Explr/decompress eye socket,,,3839.42,9598.55,4 HCPCS,67415,Aspiration orbital contents,,,2321.86,5804.65,8 HCPCS,67420,Explore/treat eye socket,,,3839.42,11433.0,8 HCPCS,67430,Explore/treat eye socket,,,3839.42,11433.0,8 HCPCS,67440,Explore/drain eye socket,,,3839.42,11433.0,8 HCPCS,67445,Explr/decompress eye socket,,,3839.42,11433.0,8 HCPCS,67450,Explore/biopsy eye socket,,,3839.42,11433.0,8 HCPCS,67500,Inject/treat eye socket,,,309.98,774.95,4 HCPCS,67505,Inject/treat eye socket,,,309.98,774.95,4 HCPCS,67515,"Hc Injection,Treatment Eye Socket",1457.62,583.05,,,0 HCPCS,67515,Inject/treat eye socket,,,309.98,774.95,4 HCPCS,67516,Sprchoroidal spc njx rx agt,,,322.58,806.45,4 HCPCS,67550,Insert eye socket implant,,,3839.42,9598.55,8 HCPCS,67560,Revise eye socket implant,,,3470.0,9598.55,8 HCPCS,67570,Decompress optic nerve,,,3839.42,9598.55,8 HCPCS,67599,Orbit surgery procedure,,,309.98,774.95,4 HCPCS,67700,Drainage of eyelid abscess,,,309.98,2978.0,8 HCPCS,67700,Hc Drainage Of Eyelid Abscess,1438.31,575.32,,,0 HCPCS,67710,Hc Incision Of Eyelid,1569.75,627.9,,,0 HCPCS,67710,Incision of eyelid,,,973.56,4059.0,8 HCPCS,67715,Hc Incision Of Eyelid Fold,4218.89,1687.56,,,0 HCPCS,67715,Incision of eyelid fold,,,2321.86,5804.65,8 HCPCS,67800,"Hc Excision Chalazion,Single",1674.4,669.76,,,0 HCPCS,67800,Remove eyelid lesion,,,309.98,2978.0,8 HCPCS,67801,Remove eyelid lesions,,,973.56,2433.89,4 HCPCS,67805,"Hc Excision Chalazion,Multiple, Both Lids",1838.85,735.54,,,0 HCPCS,67805,Remove eyelid lesions,,,309.98,774.95,4 HCPCS,67808,Remove eyelid lesion(s),,,2321.86,5804.65,8 HCPCS,67810,Biopsy eyelid & lid margin,,,309.98,774.95,4 HCPCS,67810,Hc Incisional Biopsy Eyelid Skin & Lid Margin,1831.38,732.55,,,0 HCPCS,67820,"Hc Revise Eyelashes,Forceps",813.28,325.31,,,0 HCPCS,67820,Revise eyelashes,,,129.94,324.84,4 HCPCS,67825,Hc Revise Eyelashes,1405.3,562.12,,,0 HCPCS,67825,Revise eyelashes,,,309.98,774.95,4 HCPCS,67830,Revise eyelashes,,,973.56,4059.0,8 HCPCS,67835,Revise eyelashes,,,2321.86,5804.65,8 HCPCS,67840,Hc Remove Eyelid Lesn (Not Chalazion),3471.39,1388.56,,,0 HCPCS,67840,Remove eyelid lesion,,,973.56,4059.0,8 HCPCS,67850,"Hc Destruction Eyelid Lesion, <1 Cm",3649.3,1459.72,,,0 HCPCS,67850,Treat eyelid lesion,,,973.56,2433.89,4 HCPCS,67875,Closure of eyelid by suture,,,973.56,4059.0,8 HCPCS,67875,Hc Temporary Closure Eyelid By Suture,4118.72,1647.49,,,0 HCPCS,67880,Revision of eyelid,,,2321.86,9743.0,8 HCPCS,67882,Revision of eyelid,,,2321.86,9743.0,8 HCPCS,67900,Repair brow defect,,,2321.86,8800.0,8 HCPCS,67901,Repair eyelid defect,,,2321.86,11433.0,8 HCPCS,67902,Repair eyelid defect,,,3839.42,11433.0,8 HCPCS,67903,Repair eyelid defect,,,2321.86,8800.0,8 HCPCS,67904,Repair eyelid defect,,,2321.86,8800.0,8 HCPCS,67906,Repair eyelid defect,,,3839.42,11433.0,8 HCPCS,67908,Repair eyelid defect,,,2321.86,8800.0,8 HCPCS,67909,Revise eyelid defect,,,2321.86,8800.0,8 HCPCS,67911,Revise eyelid defect,,,2321.86,9743.0,8 HCPCS,67912,Correction eyelid w/implant,,,2321.86,9743.0,8 HCPCS,67914,Repair eyelid defect,,,2321.86,9743.0,8 HCPCS,67915,Repair eyelid defect,,,2321.86,5804.65,4 HCPCS,67916,Repair eyelid defect,,,2321.86,8800.0,8 HCPCS,67917,Repair eyelid defect,,,2321.86,8800.0,8 HCPCS,67921,Repair eyelid defect,,,2321.86,9743.0,8 HCPCS,67922,Repair eyelid defect,,,2321.86,5804.65,4 HCPCS,67923,Repair eyelid defect,,,2321.86,8800.0,8 HCPCS,67924,Repair eyelid defect,,,2321.86,8800.0,8 HCPCS,67930,Repair eyelid wound,,,2321.86,5804.65,4 HCPCS,67935,"Hc Suture Eyelid Wound,Full Thick",578.56,231.42,,,0 HCPCS,67935,Repair eyelid wound,,,2321.86,5804.65,8 HCPCS,67938,"Hc Removal Embedded Foreign Body, Eyelid",920.92,368.37,,,0 HCPCS,67938,Remove eyelid foreign body,,,309.98,774.95,4 HCPCS,67950,Revision of eyelid,,,2321.86,5804.65,8 HCPCS,67961,Revision of eyelid,,,2321.86,9743.0,8 HCPCS,67966,Revision of eyelid,,,2321.86,9743.0,8 HCPCS,67971,Reconstruction of eyelid,,,2321.86,9743.0,8 HCPCS,67973,Reconstruction of eyelid,,,2321.86,9743.0,8 HCPCS,67974,Reconstruction of eyelid,,,3839.42,9743.0,8 HCPCS,67975,Reconstruction of eyelid,,,2321.86,9743.0,8 HCPCS,67999,Revision of eyelid,,,309.98,774.95,4 HCPCS,68020,Hc Incise/Drain Conjunctiva,3641.82,1456.73,,,0 HCPCS,68020,Incise/drain eyelid lining,,,973.56,2433.89,4 HCPCS,68040,Treatment of eyelid lesions,,,309.98,774.95,4 HCPCS,68100,Biopsy of eyelid lining,,,2321.86,5804.65,4 HCPCS,68100,Hc Biopsy Of Eyelid Lining,4036.5,1614.6,,,0 HCPCS,68110,Remove eyelid lining lesion,,,2321.86,5804.65,8 HCPCS,68115,Remove eyelid lining lesion,,,2321.86,5804.65,8 HCPCS,68130,Remove eyelid lining lesion,,,2321.86,5804.65,8 HCPCS,68135,Remove eyelid lining lesion,,,2321.86,5804.65,4 HCPCS,68200,Hc Subconjunctival Injection,665.28,266.11,,,0 HCPCS,68200,Treat eyelid by injection,,,436.27,1090.68,4 HCPCS,68320,Revise/graft eyelid lining,,,2321.86,8800.0,8 HCPCS,68325,Revise/graft eyelid lining,,,3839.42,9598.55,8 HCPCS,68326,Revise/graft eyelid lining,,,3839.42,9598.55,8 HCPCS,68328,Revise/graft eyelid lining,,,2321.86,8800.0,8 HCPCS,68330,Revise eyelid lining,,,2253.83,8800.0,8 HCPCS,68335,Revise/graft eyelid lining,,,3839.42,9598.55,8 HCPCS,68340,Separate eyelid adhesions,,,2321.86,8800.0,8 HCPCS,68360,Revise eyelid lining,,,3470.0,9598.55,8 HCPCS,68362,Revise eyelid lining,,,2321.86,5804.65,8 HCPCS,68371,Harvest eye tissue alograft,,,2321.86,5804.65,8 HCPCS,68399,Eyelid lining surgery,,,309.98,774.95,4 HCPCS,68400,Incise/drain tear gland,,,973.56,2433.89,4 HCPCS,68420,Incise/drain tear sac,,,2321.86,5804.65,4 HCPCS,68440,Incise tear duct opening,,,309.98,774.95,4 HCPCS,68500,Removal of tear gland,,,3839.42,9743.0,8 HCPCS,68505,Partial removal tear gland,,,3839.42,9743.0,8 HCPCS,68510,Biopsy of tear gland,,,2321.86,5804.65,8 HCPCS,68520,Removal of tear sac,,,3839.42,9743.0,8 HCPCS,68525,Biopsy of tear sac,,,2321.86,5804.65,8 HCPCS,68530,Clearance of tear duct,,,309.98,2978.0,8 HCPCS,68530,Hc Removal Of Foreign Body/Stone In Tear Duct,1906.12,762.45,,,0 HCPCS,68540,Remove tear gland lesion,,,2321.86,9743.0,8 HCPCS,68550,Remove tear gland lesion,,,3839.42,9743.0,8 HCPCS,68700,Repair tear ducts,,,2321.86,5804.65,8 HCPCS,68705,Revise tear duct opening,,,309.98,774.95,4 HCPCS,68720,Create tear sac drain,,,3839.42,9598.55,8 HCPCS,68745,Create tear duct drain,,,3839.42,9598.55,8 HCPCS,68750,Create tear duct drain,,,3839.42,9598.55,8 HCPCS,68760,Close tear duct opening,,,309.98,774.95,4 HCPCS,68761,Close tear duct opening,,,309.98,774.95,4 HCPCS,68761,"Hc Close Tear Duct Opening By Plug,Each",1681.88,672.75,,,0 HCPCS,68770,Close tear system fistula,,,2321.86,8800.0,8 HCPCS,68801,Dilate tear duct opening,,,436.27,1090.68,4 HCPCS,68810,Hc Probe Nasolacrimal Duct,1068.92,427.57,,,0 HCPCS,68810,Probe nasolacrimal duct,,,309.98,2978.0,8 HCPCS,68811,Probe nasolacrimal duct,,,2321.86,5804.65,8 HCPCS,68815,"Hc Probe Nasolac Duct,Insert Tube/Stent",197.34,78.94,,,0 HCPCS,68815,Probe nasolacrimal duct,,,2321.86,5804.65,8 HCPCS,68816,Probe nl duct w/balloon,,,2321.86,5804.65,8 HCPCS,68840,Explore/irrigate tear ducts,,,309.98,2978.0,8 HCPCS,68841,Insj rx elut implt lac canal,,,2321.86,5804.65,4 HCPCS,68899,Tear duct system surgery,,,309.98,774.95,4 HCPCS,69000,Drain external ear lesion,,,691.56,1728.91,4 HCPCS,69000,"Hc Drain Ext Ear Absc/Blood,Simple",1339.52,535.81,,,0 HCPCS,69005,Drain external ear lesion,,,1612.96,4032.39,4 HCPCS,69005,"Hc Drain Ext Ear Absc/Blood,Complic",4227.86,1691.14,,,0 HCPCS,69020,Drain outer ear canal lesion,,,691.56,1728.91,4 HCPCS,69020,Hc Drainage External Auditory Canal Abscess,1438.31,575.32,,,0 HCPCS,69100,Biopsy of external ear,,,231.31,578.27,4 HCPCS,69100,Hc Biopsy Of External Ear,1483.52,593.41,,,0 HCPCS,69105,Biopsy of external ear canal,,,1515.28,3788.21,4 HCPCS,69105,Hc Biopsy Of External Auditory Canal,2988.5,1195.4,,,0 HCPCS,69110,"Hc Removal External Ear,Partial",4485.0,1794.0,,,0 HCPCS,69110,Remove external ear partial,,,2546.0,7091.89,8 HCPCS,69120,Removal of external ear,,,3470.0,14453.33,8 HCPCS,69140,Remove ear canal lesion(s),,,3470.0,14453.33,8 HCPCS,69145,Remove ear canal lesion(s),,,2836.76,7091.89,8 HCPCS,69150,Extensive ear canal surgery,,,5781.33,14453.33,8 HCPCS,69200,Clear outer ear canal,,,129.94,324.84,4 HCPCS,69200,Hc Removal Ext Canal Foreign Body,728.36,291.34,,,0 HCPCS,69205,Clear outer ear canal,,,1612.96,4032.39,8 HCPCS,69205,"Hc Remv Ext Canal F.B.,Gen Anesth",3513.25,1405.3,,,0 HCPCS,69209,Hc Removal Impacted Cerumen Irrigation/Lavage Bilateral,604.46,241.78,,,0 HCPCS,69209,Hc Removal Impacted Cerumen Irrigation/Lavage Unilateral,401.86,160.74,,,0 HCPCS,69209,Hc Removal Impacted Cerumen Irrigation/Lvg Bilateral,604.46,241.78,,,0 HCPCS,69209,Hc Removal Impacted Cerumen Irrigation/Lvg Unilateral,401.86,160.74,,,0 HCPCS,69209,Remove impacted ear wax uni,,,57.61,144.03,4 HCPCS,69210,Hc Removal Impacted Cerumen Instrumentation Bilateral,637.95,255.18,,,0 HCPCS,69210,Hc Removal Impacted Cerumen Instrumentation Unilateral,423.62,169.45,,,0 HCPCS,69210,Remove impacted ear wax uni,,,57.61,2978.0,8 HCPCS,69220,Clean out mastoid cavity,,,195.94,489.85,4 HCPCS,69220,"Hc Debride Mastoid Cavity,Simple",720.59,288.24,,,0 HCPCS,69222,Clean out mastoid cavity,,,526.71,1316.78,4 HCPCS,69222,"Hc Debride Mastoid Cavity,Complex",1046.5,418.6,,,0 HCPCS,69300,Revise external ear,,,3237.89,9743.0,8 HCPCS,69310,Rebuild outer ear canal,,,5781.33,14453.33,8 HCPCS,69320,Rebuild outer ear canal,,,5781.33,14453.33,8 HCPCS,69399,Outer ear surgery procedure,,,231.31,578.27,4 HCPCS,69420,"Hc Incision Eardrum,Aspiration",1264.77,505.91,,,0 HCPCS,69420,Incision of eardrum,,,231.31,2978.0,8 HCPCS,69421,Incision of eardrum,,,3237.89,9743.0,8 HCPCS,69424,Remove ventilating tube,,,3237.89,8094.73,8 HCPCS,69433,Create eardrum opening,,,526.71,1316.78,4 HCPCS,69433,Hc Tympanostomy W/Ins Tube Unilateral,3214.25,1285.7,,,0 HCPCS,69433,Hc Tympanostomy W/Ins Tubes Bil Local Anesthesia,3872.05,1548.82,,,0 HCPCS,69436,Create eardrum opening,,,1515.28,9743.0,8 HCPCS,69436,Hc Tympanostomy General Anesthesia Bilateral,6110.0,2444.0,,,0 HCPCS,69436,Hc Tympanostomy General Anesthesia Unilateral,5330.0,2132.0,,,0 HCPCS,69440,Exploration of middle ear,,,3237.89,9743.0,8 HCPCS,69450,Eardrum revision,,,2546.0,8094.73,8 HCPCS,69501,Mastoidectomy,,,5781.33,14453.33,8 HCPCS,69502,Mastoidectomy,,,5781.33,14453.33,8 HCPCS,69505,Remove mastoid structures,,,5781.33,14453.33,8 HCPCS,69511,Extensive mastoid surgery,,,5781.33,14453.33,8 HCPCS,69530,Extensive mastoid surgery,,,5781.33,14453.33,8 HCPCS,69540,Remove ear lesion,,,1515.28,4059.0,8 HCPCS,69550,Remove ear lesion,,,5781.33,14453.33,8 HCPCS,69552,Remove ear lesion,,,5781.33,14453.33,8 HCPCS,69601,Mastoid surgery revision,,,5781.33,14453.33,8 HCPCS,69602,Mastoid surgery revision,,,5781.33,14453.33,8 HCPCS,69603,Mastoid surgery revision,,,5781.33,14453.33,8 HCPCS,69604,Mastoid surgery revision,,,5781.33,14453.33,8 HCPCS,69605,Mastoid surgery revision,,,10346.0,12101.0,4 HCPCS,69610,Repair of eardrum,,,1515.28,8934.0,8 HCPCS,69620,Repair of eardrum,,,3237.89,8094.73,8 HCPCS,69631,Repair eardrum structures,,,5781.33,14453.33,8 HCPCS,69632,Rebuild eardrum structures,,,5781.33,14453.33,8 HCPCS,69633,Rebuild eardrum structures,,,5781.33,14453.33,8 HCPCS,69635,Repair eardrum structures,,,5781.33,14453.33,8 HCPCS,69636,Rebuild eardrum structures,,,5781.33,14453.33,8 HCPCS,69637,Rebuild eardrum structures,,,5781.33,14453.33,8 HCPCS,69641,Revise middle ear & mastoid,,,5781.33,14453.33,8 HCPCS,69642,Revise middle ear & mastoid,,,5781.33,14453.33,8 HCPCS,69643,Revise middle ear & mastoid,,,5781.33,14453.33,8 HCPCS,69644,Revise middle ear & mastoid,,,5781.33,14453.33,8 HCPCS,69645,Revise middle ear & mastoid,,,5781.33,14453.33,8 HCPCS,69646,Revise middle ear & mastoid,,,5781.33,14453.33,8 HCPCS,69650,Release middle ear bone,,,3237.89,12101.0,8 HCPCS,69660,Revise middle ear bone,,,5781.33,14453.33,8 HCPCS,69661,Revise middle ear bone,,,5781.33,14453.33,8 HCPCS,69662,Revise middle ear bone,,,5781.33,14453.33,8 HCPCS,69666,Repair middle ear structures,,,3237.89,8800.0,8 HCPCS,69667,Repair middle ear structures,,,3237.89,8800.0,8 HCPCS,69670,Remove mastoid air cells,,,5781.33,14453.33,8 HCPCS,69676,Remove middle ear nerve,,,3237.89,9743.0,8 HCPCS,69700,Close mastoid fistula,,,1515.28,9743.0,8 HCPCS,69705,Nps surg dilat eust tube uni,,,5781.33,14453.33,8 HCPCS,69706,Nps surg dilat eust tube bi,,,5781.33,14453.33,8 HCPCS,69711,Remove/repair hearing aid,,,2546.0,8094.73,8 HCPCS,69714,Implant Temple Bone W/Stimul,,,12538.31,31345.78,8 HCPCS,69715,Temple Bne Implnt W/Stimulat,,,14697.0,17190.0,4 HCPCS,69716,Impltj oi implt skl tc esp,,,12538.31,31345.78,4 HCPCS,69717,Temple Bone Implant Revision,,,7086.45,17716.12,8 HCPCS,69718,Revise Temple Bone Implant,,,14697.0,17190.0,4 HCPCS,69719,Revj/rplcmt oi implt tc esp,,,12538.31,31345.78,4 HCPCS,69720,Release facial nerve,,,5781.33,14453.33,8 HCPCS,69725,Release facial nerve,,,5781.33,14453.33,4 HCPCS,69726,Rmvl oi implt skl perq esp,,,3195.45,7988.62,4 HCPCS,69727,Rmvl oi implt skl tc esp,,,3195.45,7988.62,4 HCPCS,69728,Rmv ntr oi imp sktc esp>=100,,,3195.45,7988.62,4 HCPCS,69729,Impl oi implt sk tc esp>=100,,,12538.31,31345.78,4 HCPCS,69730,Rplc oi implt sk tc esp>=100,,,12538.31,31345.78,4 HCPCS,69740,Repair facial nerve,,,5781.33,14453.33,8 HCPCS,69745,Repair facial nerve,,,5781.33,14453.33,8 HCPCS,69799,Middle ear surgery procedure,,,231.31,578.27,4 HCPCS,69801,"Hc Labyrinthotomy W Perfusion Vestibuloactive Drugs,Transcranial",1955.86,782.34,,,0 HCPCS,69801,Incise inner ear,,,1515.28,11433.0,8 HCPCS,69802,Incise inner ear,,,10346.0,12101.0,4 HCPCS,69805,Explore inner ear,,,5781.33,14453.33,8 HCPCS,69806,Explore inner ear,,,5781.33,14453.33,8 HCPCS,69820,Establish inner ear window,,,9775.0,11433.0,4 HCPCS,69840,Revise inner ear window,,,9775.0,11433.0,4 HCPCS,69905,Remove inner ear,,,5781.33,14453.33,8 HCPCS,69910,Remove inner ear & mastoid,,,5781.33,14453.33,8 HCPCS,69915,Incise inner ear nerve,,,3237.89,12101.0,8 HCPCS,69930,Implant cochlear device,,,10346.0,80501.79,8 HCPCS,69949,Inner ear surgery procedure,,,231.31,578.27,4 HCPCS,69955,Release facial nerve,,,5781.33,14453.33,4 HCPCS,69960,Release inner ear canal,,,5781.33,14453.33,4 HCPCS,69970,Remove inner ear lesion,,,5781.33,14453.33,4 HCPCS,69979,Temporal bone surgery,,,231.31,578.27,4 HCPCS,69990,"Hc Microsurg Techniques,Req Oper Microscope",49.65,19.86,,,0 HCPCS,70010,Contrast x-ray of brain,,,340.71,851.78,4 HCPCS,70015,Contrast x-ray of brain,,,765.58,1913.95,4 HCPCS,70030,Hc X-Ray Eye For Foreign Body - Unilateral,423.36,169.34,,,0 HCPCS,70030,X-ray eye for foreign body,,,84.99,212.47,4 HCPCS,70100,Hc X-Ray Jaw <4 Views - Xr Mandible < 4 Views,620.15,248.06,,,0 HCPCS,70100,X-ray exam of jaw <4views,,,84.99,212.47,4 HCPCS,70109,Hc Testos F/T/Shbg Male-So+,11.0,4.4,,,0 HCPCS,70110,Hc X-Ray Jaw <4 Views - Xr Mandible < 4 Views,765.59,306.24,,,0 HCPCS,70110,X-ray exam of jaw 4/> views,,,102.1,255.25,4 HCPCS,70120,X-ray exam of mastoids,,,102.1,255.25,4 HCPCS,70130,X-ray exam of mastoids,,,102.1,255.25,4 HCPCS,70134,X-ray exam of middle ear,,,533.63,1334.08,4 HCPCS,70140,Hc X-Ray Facial Bones <3 Views - Xr Facial Bones 1-2 Views,569.38,227.75,,,0 HCPCS,70140,X-ray exam of facial bones,,,84.99,212.47,4 HCPCS,70150,Hc X-Ray Facial Bones 3+ Views - Xr Facial Bones 3+ Views,607.8,243.12,,,0 HCPCS,70150,X-ray exam of facial bones,,,102.1,255.25,4 HCPCS,70160,Hc X-Ray Nasal Bones - Xr Nasal Bones,448.64,179.46,,,0 HCPCS,70160,X-ray exam of nasal bones,,,84.99,212.47,4 HCPCS,70170,X-ray exam of tear duct,,,233.02,582.55,4 HCPCS,70190,X-ray exam of eye sockets,,,84.99,212.47,4 HCPCS,70200,Hc X-Ray Orbits - Xr Orbits Complete 4+ Views,824.58,329.83,,,0 HCPCS,70200,X-ray exam of eye sockets,,,102.1,255.25,4 HCPCS,70210,X-ray exam of sinuses,,,84.99,212.47,4 HCPCS,70220,Hc X-Ray Sinuses 3+ View - Xr Paranasal Sinuses 3+ Views,749.12,299.65,,,0 HCPCS,70220,X-ray exam of sinuses,,,84.99,212.47,4 HCPCS,70240,X-ray exam pituitary saddle,,,84.99,212.47,4 HCPCS,70250,Hc X-Ray Skull <4 View - Xr Skull 1-3 Views,745.0,298.0,,,0 HCPCS,70250,X-ray exam of skull,,,102.1,255.25,4 HCPCS,70260,Hc X-Ray Skull 4+ View - Xr Skull Complete 4+ Views,797.15,318.86,,,0 HCPCS,70260,X-ray exam of skull,,,102.1,255.25,4 HCPCS,70300,X-ray exam of teeth,,,84.99,212.47,4 HCPCS,70310,X-ray exam of teeth,,,233.02,582.55,4 HCPCS,70320,Full mouth x-ray of teeth,,,233.02,582.55,4 HCPCS,70328,X-ray exam of jaw joint,,,84.99,212.47,4 HCPCS,70330,Hc X-Ray Temporomandibular Joint Bilateral - Xr Temporomandibular Joint Open And Closed Bilateral,636.62,254.65,,,0 HCPCS,70330,X-ray exam of jaw joints,,,84.99,212.47,4 HCPCS,70332,X-ray exam of jaw joint,,,233.02,582.55,4 HCPCS,70336,"Hc Mri, Tmj - Mr Temporomandibular Joints Wo Iv Contrast",2815.24,1126.1,,,0 HCPCS,70336,Magnetic image jaw joint,,,233.02,582.55,4 HCPCS,70350,X-ray head for orthodontia,,,84.99,212.47,4 HCPCS,70355,Hc Panoramic X-Ray Of Jaws - Xr Panorex,624.27,249.71,,,0 HCPCS,70355,Panoramic x-ray of jaws,,,84.99,212.47,4 HCPCS,70360,Hc X-Ray Neck Soft Tissue - Xr Neck Soft Tissue,477.12,190.85,,,0 HCPCS,70360,X-ray exam of neck,,,84.99,212.47,4 HCPCS,70370,Throat x-ray & fluoroscopy,,,84.99,212.47,4 HCPCS,70371,Speech evaluation complex,,,233.02,582.55,4 HCPCS,70380,X-ray exam of salivary gland,,,84.99,212.47,4 HCPCS,70390,X-ray exam of salivary duct,,,233.02,582.55,4 HCPCS,70450,Ct head/brain w/o dye,,,102.1,255.25,4 HCPCS,70450,"Hc Ct Scan,Head/Brain,W/O Contrast Matl - Ct Head Wo Contrast",2265.12,906.05,,,0 HCPCS,70460,Ct head/brain w/dye,,,171.3,428.24,4 HCPCS,70460,Hc Ct Scan Head Contrast - Ct Head W Contrast,2552.27,1020.91,,,0 HCPCS,70470,Ct head/brain w/o & w/dye,,,171.3,428.24,4 HCPCS,70470,Hc Ct Scan Head Combo - Ct Head W Wo Contrast,3081.28,1232.51,,,0 HCPCS,70471,Cta h&n c+ w/noncontrast img,,,340.71,851.78,4 HCPCS,70473,Ct cere prfu aly c+wo ct/cta,,,171.3,428.24,4 HCPCS,70480,Ct orbit/ear/fossa w/o dye,,,102.1,255.25,4 HCPCS,70480,Hc Ct Orbits Wo Iv Contrast,1833.3,733.32,,,0 HCPCS,70480,"Hc Ct Scan, Orbit Limited",1833.3,733.32,,,0 HCPCS,70480,"Hc Ct Scan, Temporal Bone Wo Iv Contrast",1833.3,733.32,,,0 HCPCS,70481,Ct orbit/ear/fossa w/dye,,,171.3,428.24,4 HCPCS,70481,Hc Ct Orbits W Iv Contrast,2135.91,854.36,,,0 HCPCS,70481,Hc Ct Temporal Bones W Iv Contrast,2135.91,854.36,,,0 HCPCS,70482,Ct orbit/ear/fossa w/o&w/dye,,,171.3,428.24,4 HCPCS,70482,Hc Ct Orbits W And Wo Iv Contrast,2567.73,1027.09,,,0 HCPCS,70486,Ct maxillofacial w/o dye,,,102.1,255.25,4 HCPCS,70486,Hc Ct Face Wo Iv Contrast,2438.52,975.41,,,0 HCPCS,70486,Hc Ct Sinus Wo Contrast,2438.52,975.41,,,0 HCPCS,70487,Ct maxillofacial w/dye,,,171.3,428.24,4 HCPCS,70487,Hc Ct Face W Iv Contrast,2662.71,1065.08,,,0 HCPCS,70487,Hc Ct Sinus W Contrast,2662.71,1065.08,,,0 HCPCS,70488,Ct maxillofacial w/o & w/dye,,,171.3,428.24,4 HCPCS,70488,Hc Ct Face W And Wo Iv Contrast,2871.44,1148.58,,,0 HCPCS,70488,Hc Ct Sinus W And Wo Contrast,2871.44,1148.58,,,0 HCPCS,70490,Ct soft tissue neck w/o dye,,,102.1,255.25,4 HCPCS,70490,"Hc Ct Scan,Soft Tissue Neck,W/O Contrast - Ct Soft Tissue Neck Wo Contrast",2687.01,1074.8,,,0 HCPCS,70491,Ct soft tissue neck w/dye,,,171.3,428.24,4 HCPCS,70491,Hc Ct Neck Tissue Contrast - Ct Soft Tissue Neck W Contrast,3361.79,1344.72,,,0 HCPCS,70492,Ct sft tsue nck w/o & w/dye,,,171.3,428.24,4 HCPCS,70492,Hc Ct Neck Tissue Combo - Ct Soft Tissue Neck W Wo Contrast,3528.56,1411.42,,,0 HCPCS,70496,Ct angiography head,,,171.3,428.24,4 HCPCS,70496,Hc Ct Angio Head,3901.85,1560.74,,,0 HCPCS,70496,Hc Ct Venogram Head,3901.85,1560.74,,,0 HCPCS,70498,Ct angiography neck,,,171.3,428.24,4 HCPCS,70498,"Hc Ct Angio,Neck Combo - Ct Neck Angio W And Wo Iv Contrast",4038.79,1615.52,,,0 HCPCS,70540,"Hc Mri, Face, Neck - Mri Neck Soft Tissue Only Wo Contrast",3492.7,1397.08,,,0 HCPCS,70540,Mri orbit/face/neck w/o dye,,,233.02,582.55,4 HCPCS,70542,"Hc Mri, Face, Neck W/Contrast - Mri Neck Soft Tissue W Contrast",3436.0,1374.4,,,0 HCPCS,70542,Mri Orbit/Face/Neck W/Dye,,,340.71,851.78,4 HCPCS,70543,"Hc Mri, Face, Neck, Combo - Mri Neck Soft Tissue Only W Wo Contrast",4777.0,1910.8,,,0 HCPCS,70543,Mri orbt/fac/nck w/o &w/dye,,,340.71,851.78,4 HCPCS,70544,"Hc Mr Angio, Head - Mr Head Angio Wo Iv Contrast",3084.0,1233.6,,,0 HCPCS,70544,Mr Angiography Head W/O Dye,,,233.02,582.55,4 HCPCS,70545,"Hc Mr Angio, Head W/Contrast - Mr Head Angio W Iv Contrast",3508.0,1403.2,,,0 HCPCS,70545,Mr Angiography Head W/Dye,,,340.71,851.78,4 HCPCS,70546,"Hc Mr Angio, Head, Combo - Mr Head Angio W And Wo Iv Contrast",3693.0,1477.2,,,0 HCPCS,70546,Mr angiograph head w/o&w/dye,,,340.71,851.78,4 HCPCS,70547,"Hc Mr Angio, Neck - Mr Neck Angio Wo Iv Contrast",3232.0,1292.8,,,0 HCPCS,70547,Mr Angiography Neck W/O Dye,,,233.02,582.55,4 HCPCS,70548,"Hc Mr Angio, Neck W/Contrast - Mr Neck Angio W Iv Contrast",3376.0,1350.4,,,0 HCPCS,70548,Mr Angiography Neck W/Dye,,,340.71,851.78,4 HCPCS,70549,"Hc Mr Angio, Neck, Combo - Mr Neck Angio W And Wo Iv Contrast",3508.0,1403.2,,,0 HCPCS,70549,Mr angiograph neck w/o&w/dye,,,340.71,851.78,4 HCPCS,70551,Hc Mri Brain - Mri Brain Wo Contrast,3672.0,1468.8,,,0 HCPCS,70551,Mri brain stem w/o dye,,,233.02,582.55,4 HCPCS,70552,Hc Mri Brain Contrast - Mri Brain W Contrast,4019.0,1607.6,,,0 HCPCS,70552,Mri brain stem w/dye,,,340.71,851.78,4 HCPCS,70553,Hc Mri Brain Combo - Mri Brain W Wo Contrast,4741.0,1896.4,,,0 HCPCS,70553,Mri brain stem w/o & w/dye,,,340.71,851.78,4 HCPCS,70554,Fmri brain by tech,,,233.02,582.55,4 HCPCS,70554,Hc Func Mri Brain - Mr Brain Neurofunctional Test W/O Physician Admin,2206.0,882.4,,,0 HCPCS,70555,Fmri brain by phys/psych,,,233.02,582.55,4 HCPCS,70555,Hc Func Mri Brain - Mr Brain Neurofunctional Test W/ Physician Admin,2295.0,918.0,,,0 HCPCS,70557,Mri brain w/o dye,,,533.63,1334.08,4 HCPCS,70558,Mri brain w/dye,,,171.3,428.24,4 HCPCS,70559,Mri brain w/o & w/dye,,,171.3,428.24,4 HCPCS,71045,Hc Radiologic Exam Chest Single View - Xr Chest 1 View,659.68,263.87,,,0 HCPCS,71045,Hc Radiologic Exam Chest Single View - Xr Chest Lateral Decubitus,517.44,206.98,,,0 HCPCS,71045,X-ray exam chest 1 view,,,84.99,212.47,4 HCPCS,71046,Hc Radiologic Exam Chest 2 Views - Xr Chest 2 Views,531.0,212.4,,,0 HCPCS,71046,X-ray exam chest 2 views,,,84.99,212.47,4 HCPCS,71047,X-ray exam chest 3 views,,,84.99,212.47,4 HCPCS,71048,Hc Radiologic Exam Chest 4+ Views - Xr Chest 4+ Views,525.0,210.0,,,0 HCPCS,71048,X-ray exam chest 4+ views,,,102.1,255.25,4 HCPCS,71100,Hc X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Left,679.15,271.66,,,0 HCPCS,71100,Hc X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right,679.15,271.66,,,0 HCPCS,71100,X-ray exam ribs uni 2 views,,,84.99,212.47,4 HCPCS,71101,"Hc X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws W/ Chest Anteroposterior",883.57,353.43,,,0 HCPCS,71101,X-ray exam unilat ribs/chest,,,102.1,255.25,4 HCPCS,71110,Hc X-Ray Ribs 3 View Bilateral - Xr Ribs 3 Views Bilateral,972.75,389.1,,,0 HCPCS,71110,X-ray exam ribs bil 3 views,,,102.1,255.25,4 HCPCS,71111,"Hc X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior",1052.34,420.94,,,0 HCPCS,71111,X-ray exam ribs/chest4/> vws,,,102.1,255.25,4 HCPCS,71120,Hc X-Ray Sternum 2+ View - Xr Sternum 2+ Views,519.99,208.0,,,0 HCPCS,71120,X-ray exam breastbone 2/>vws,,,84.99,212.47,4 HCPCS,71130,Hc X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views,425.32,170.13,,,0 HCPCS,71130,X-ray strenoclavic jt 3/>vws,,,84.99,212.47,4 HCPCS,71250,Ct thorax w/o dye,,,102.1,255.25,4 HCPCS,71250,"Hc Ct Scan, Chest Lung Screening Follow Up",2341.67,936.67,,,0 HCPCS,71250,"Hc Ct Scan,Thorax,W/O Contrast - Ct Chest Wo Contrast",2341.67,936.67,,,0 HCPCS,71260,Ct thorax w/dye,,,171.3,428.24,4 HCPCS,71260,Hc Ct Scan Of Chest Contrast - Ct Chest W Contrast,3320.7,1328.28,,,0 HCPCS,71270,Ct thorax w/o & w/dye,,,171.3,428.24,4 HCPCS,71270,Hc Ct Scan Of Chest Combo - Ct Chest W Wo Contrast,3592.2,1436.88,,,0 HCPCS,71271,Ct thorax lung cancer scr c-,,,102.1,255.25,4 HCPCS,71271,Hc Ct Low Dose Lung Cancer Screen,133.69,53.48,,,0 HCPCS,71275,Ct angiography chest,,,171.3,428.24,4 HCPCS,71275,"Hc Ct Angio, Chest, Combo, Including Image - Ct Chest Angio W And Wo Iv Contrast",3720.75,1488.3,,,0 HCPCS,71275,"Hc Ct Angio, Pulmonary Embolism",3720.75,1488.3,,,0 HCPCS,71275,Hc Ct Venogram Chest,3720.75,1488.3,,,0 HCPCS,71550,"Hc Mri, Chest - Mri Chest Wo Contrast",3558.4,1423.36,,,0 HCPCS,71550,Mri chest w/o dye,,,233.02,582.55,4 HCPCS,71551,"Hc Mri, Chest, W/Contrast - Mri Chest W Contrast",3757.1,1502.84,,,0 HCPCS,71551,Mri Chest W/Dye,,,765.58,1913.95,4 HCPCS,71552,"Hc Mri, Chest, Combo - Mri Chest W Wo Contrast",4973.48,1989.39,,,0 HCPCS,71552,Mri chest w/o & w/dye,,,340.71,851.78,4 HCPCS,71555,Hc Mra/Mrv Chest With And Without Contrast,3551.52,1420.61,,,0 HCPCS,71555,Hc Mra/Mrv Chest With Contrast,3170.72,1268.29,,,0 HCPCS,71555,Hc Mra/Mrv Chest Without Contrast,2670.08,1068.03,,,0 HCPCS,72020,Hc X-Ray Spine One View - Xr Spine,554.29,221.72,,,0 HCPCS,72020,X-ray exam of spine 1 view,,,84.99,212.47,4 HCPCS,72040,Hc Radex Spine Cervical 2 Or 3 Views - Xr Cervical Spine 1 View,813.6,325.44,,,0 HCPCS,72040,Hc Radex Spine Cervical 2 Or 3 Views - Xr Cervical Spine 2-3 Views,813.6,325.44,,,0 HCPCS,72040,X-ray exam neck spine 2-3 vw,,,84.99,212.47,4 HCPCS,72050,Hc Radex Spine Cervical 4 Or 5 Views - Xr Cervical Spine Comp 4-5 Views,1107.22,442.89,,,0 HCPCS,72050,X-ray exam neck spine 4/5vws,,,102.1,255.25,4 HCPCS,72052,Hc Radex Spine Cervical 6 Or More Views - Xr C-Spine Complete 6+ Views,1157.98,463.19,,,0 HCPCS,72052,X-ray exam neck spine 6/>vws,,,102.1,255.25,4 HCPCS,72070,Hc X-Ray Thoracic Spine 2 View - Xr Thoracic Spine 2 Views,749.12,299.65,,,0 HCPCS,72070,X-ray exam thorac spine 2vws,,,102.1,255.25,4 HCPCS,72072,Hc X-Ray Thoracic Spine+Swim 3 View - Xr Thoracic Spine 3 Views,790.28,316.11,,,0 HCPCS,72072,X-ray exam thorac spine 3vws,,,102.1,255.25,4 HCPCS,72074,Hc X-Ray Thoracic Spine 4 View - Xr Thoracic Spine Complete 4+ Views,806.74,322.7,,,0 HCPCS,72074,X-ray exam thorac spine4/>vw,,,102.1,255.25,4 HCPCS,72080,Hc Radex X-Ray Exam Thoracolmb 2+ Vw - Xr Thoracolumbar Spine 2 Views,795.77,318.31,,,0 HCPCS,72080,X-ray exam thoracolmb 2/> vw,,,84.99,212.47,4 HCPCS,72081,Hc Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Entire Spine 1 V,480.2,192.08,,,0 HCPCS,72081,Hc Radex Entire Thrc Lumbar Cerival Sac Spine W/Skull 1 View - Xr Scoliosis 1 View,480.2,192.08,,,0 HCPCS,72081,X-ray exam entire spi 1 vw,,,84.99,212.47,4 HCPCS,72082,Hc Radex X-Ray Exam Entire Spi 2/3 Vw - Xr Spine Survey Ap And Lateral,727.17,290.87,,,0 HCPCS,72082,Hc Radex X-Ray Exam Entire Spine 2/3 Views - Xr Entire Spine 2 Or 3 Views,727.17,290.87,,,0 HCPCS,72082,X-ray exam entire spi 2/3 vw,,,102.1,255.25,4 HCPCS,72083,Hc Radex X-Ray Exam Entire Spine 4/5 Views - Xr Entire Spine 4 Or 5 Views,865.74,346.3,,,0 HCPCS,72083,X-ray exam entire spi 4/5 vw,,,102.1,255.25,4 HCPCS,72084,Hc Radex X-Ray Exam Entire Spine 6/> Views - Xr Entire Spine 6+ Views,1142.88,457.15,,,0 HCPCS,72084,X-ray exam entire spi 6/> vw,,,102.1,255.25,4 HCPCS,72100,Hc X-Ray Lumbar Spine 2/3 View - Xr Lumbar Spine 2-3 Views,901.42,360.57,,,0 HCPCS,72100,X-ray exam l-s spine 2/3 vws,,,102.1,255.25,4 HCPCS,72110,Hc X-Ray Lumbar Spine 4 View - Xr Lumbar Spine Complete 4+ Views,1274.6,509.84,,,0 HCPCS,72110,X-ray exam l-2 spine 4/>vws,,,102.1,255.25,4 HCPCS,72114,Hc X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending,1156.41,462.56,,,0 HCPCS,72114,X-ray exam l-s spine bending,,,102.1,255.25,4 HCPCS,72120,Hc X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 2-3 Views W/ Flex Ext,901.42,360.57,,,0 HCPCS,72120,X-ray bend only l-s spine,,,102.1,255.25,4 HCPCS,72125,Ct neck spine w/o dye,,,102.1,255.25,4 HCPCS,72125,"Hc Ct Scan,Cervical Spine,W/O Contrast - Ct Cervical Spine Wo Contrast",3244.73,1297.89,,,0 HCPCS,72126,Ct neck spine w/dye,,,340.71,851.78,4 HCPCS,72126,Hc Ct Scan Cervical Spine Contrast - Ct Cervical Spine W Contrast,3394.93,1357.97,,,0 HCPCS,72126,Hc Ct Scan Spine Myelogram,3394.93,1357.97,,,0 HCPCS,72127,Ct neck spine w/o & w/dye,,,171.3,428.24,4 HCPCS,72127,Hc Ct Scan Cervical Spine Combo - Ct Cervical Spine W Wo Contrast,3780.36,1512.14,,,0 HCPCS,72128,Ct chest spine w/o dye,,,102.1,255.25,4 HCPCS,72128,"Hc Ct Scan,Thoracic Spine,W/O Contrast - Ct Thoracic Spine Wo Contrast",3130.45,1252.18,,,0 HCPCS,72129,Ct chest spine w/dye,,,171.3,428.24,4 HCPCS,72129,Hc Ct Scan Dorsal Spine Contrast - Ct Thoracic Spine W Contrast,3226.09,1290.44,,,0 HCPCS,72129,Hc Ct Scan Thoracic Spine Myelogram,3226.09,1290.44,,,0 HCPCS,72130,Ct chest spine w/o & w/dye,,,171.3,428.24,4 HCPCS,72130,Hc Ct Scan Dorsal Spine Combo - Ct Thoracic Spine W Wo Contrast,3309.39,1323.76,,,0 HCPCS,72131,Ct lumbar spine w/o dye,,,102.1,255.25,4 HCPCS,72131,"Hc Ct Scan,Lumbar Spine,W/O Contrast - Ct Lumbar Spine Wo Contrast",2947.39,1178.96,,,0 HCPCS,72132,Ct lumbar spine w/dye,,,340.71,851.78,4 HCPCS,72132,Hc Ct Scan Lumbar Spine Contrast - Ct Lumbar Spine W Contrast,3170.56,1268.22,,,0 HCPCS,72132,Hc Ct Scan Lumbar Spine Myelogram,3170.56,1268.22,,,0 HCPCS,72133,Ct lumbar spine w/o & w/dye,,,171.3,428.24,4 HCPCS,72133,Hc Ct Scan Lumbar Spine Combo - Ct Lumbar Spine W Wo Contrast,3309.39,1323.76,,,0 HCPCS,72141,"Hc Mri, Cerv Spine - Mri Cervical Spine Wo Contrast",4063.0,1625.2,,,0 HCPCS,72141,Mri neck spine w/o dye,,,233.02,582.55,4 HCPCS,72142,"Hc Mri, Cerv Spine Contrast - Mri Cervical Spine W Contrast",4486.0,1794.4,,,0 HCPCS,72142,Mri neck spine w/dye,,,340.71,851.78,4 HCPCS,72146,"Hc Mri, Dorsal Spine - Mri Thoracic Spine Wo Contrast",4401.48,1760.59,,,0 HCPCS,72146,Mri chest spine w/o dye,,,233.02,582.55,4 HCPCS,72147,"Hc Mri, Dorsal Spine Contrast - Mri Thoracic Spine W Contrast",4759.84,1903.94,,,0 HCPCS,72147,Mri chest spine w/dye,,,340.71,851.78,4 HCPCS,72148,"Hc Mri, Lumbar Spine - Mri Lumbar Spine Wo Contrast",4535.86,1814.34,,,0 HCPCS,72148,Mri lumbar spine w/o dye,,,233.02,582.55,4 HCPCS,72149,"Hc Mri, Lumbar Spine Contrast - Mri Lumbar Spine W Contrast",4865.51,1946.2,,,0 HCPCS,72149,Mri lumbar spine w/dye,,,340.71,851.78,4 HCPCS,72156,"Hc Mri, Cerv Spine Combo - Mri Cervical Spine W Wo Contrast",5392.0,2156.8,,,0 HCPCS,72156,Mri neck spine w/o & w/dye,,,340.71,851.78,4 HCPCS,72157,"Hc Mri, Dorsal Spine Combo - Mri Thoracic Spine W Wo Contrast",5627.04,2250.82,,,0 HCPCS,72157,Mri chest spine w/o & w/dye,,,340.71,851.78,4 HCPCS,72158,"Hc Mri, Lumbar Spine Combo - Mri Lumbar Spine W Wo Contrast",5684.47,2273.79,,,0 HCPCS,72158,Mri lumbar spine w/o & w/dye,,,340.71,851.78,4 HCPCS,72159,Hc Mr Angio Spine (Mra) - Mr Spine Angio W And Wo Iv Contrast,1880.85,752.34,,,0 HCPCS,72170,Hc X-Ray Pelvis 1/2 View - Xr Pelvis 1-2 Views,676.41,270.56,,,0 HCPCS,72170,X-ray exam of pelvis,,,102.1,255.25,4 HCPCS,72190,Hc X-Ray Pelvis 3+ View - Xr Pelvis 3+ Views,765.59,306.24,,,0 HCPCS,72190,X-ray exam of pelvis,,,102.1,255.25,4 HCPCS,72191,Ct angiograph pelv w/o&w/dye,,,171.3,428.24,4 HCPCS,72191,"Hc Ct Angio, Pelvis, Combo, Including Image - Ct Pelvis Angio W And Wo Iv Contrast",3309.39,1323.76,,,0 HCPCS,72192,Ct pelvis w/o dye,,,102.1,255.25,4 HCPCS,72192,"Hc Ct Scan, Bony Pelvis",2224.43,889.77,,,0 HCPCS,72192,"Hc Ct Scan, Cystogram",2224.43,889.77,,,0 HCPCS,72192,"Hc Ct Scan,Pelvis,W/O Contrast - Ct Pelvis Wo Contrast",2224.43,889.77,,,0 HCPCS,72193,Ct pelvis w/dye,,,171.3,428.24,4 HCPCS,72193,Hc Ct Scan Of Pelvis Contrast - Ct Pelvis W Contrast,2614.19,1045.68,,,0 HCPCS,72194,Ct pelvis w/o & w/dye,,,171.3,428.24,4 HCPCS,72194,Hc Ct Scan Of Pelvis Combo - Ct Pelvis W Wo Contrast,3002.93,1201.17,,,0 HCPCS,72195,"Hc Mri, Pelvis, W/O Contrast - Mri Pelvis Wo Contrast",3127.67,1251.07,,,0 HCPCS,72195,Mri Pelvis W/O Dye,,,233.02,582.55,4 HCPCS,72196,"Hc Mri, Pelvis W/Contrast - Mri Pelvis W Contrast",4138.44,1655.38,,,0 HCPCS,72196,Mri pelvis w/dye,,,340.71,851.78,4 HCPCS,72197,"Hc Mri, Pelvis, Combo - Mri Pelvis W Wo Contrast",5117.06,2046.82,,,0 HCPCS,72197,Mri pelvis w/o & w/dye,,,340.71,851.78,4 HCPCS,72198,Hc Mr Angio Pelvis(Mra) - Mr Pelvis Angio W And Wo Iv Contrast,2808.35,1123.34,,,0 HCPCS,72198,Hc Mra/Mrv Pelvis With And Without Contrast,2738.4,1095.36,,,0 HCPCS,72198,Hc Mra/Mrv Pelvis With Contrast,2056.32,822.53,,,0 HCPCS,72198,Hc Mra/Mrv Pelvis Without Contrast,1923.04,769.22,,,0 HCPCS,72200,X-ray exam si joints,,,102.1,255.25,4 HCPCS,72202,Hc X-Ray Sacroiliac Joints 3+ View - Xr Sacroiliac Joints 3+ Views,609.17,243.67,,,0 HCPCS,72202,X-ray exam si joints 3/> vws,,,102.1,255.25,4 HCPCS,72220,Hc X-Ray Sacrum/Coccyx 2+ View - Xr Sacrum Coccyx 2+ Views,581.73,232.69,,,0 HCPCS,72220,X-ray exam sacrum tailbone,,,84.99,212.47,4 HCPCS,72240,Hc Myelography Cerv Spine - Fl Cervical Spine Myelogram,2964.98,1185.99,,,0 HCPCS,72240,Myelography neck spine,,,765.58,1913.95,4 HCPCS,72255,Myelography thoracic spine,,,765.58,1913.95,4 HCPCS,72265,Hc Myelography Lumbar Spine - Fl Lumbar Spine Myelogram,2964.98,1185.99,,,0 HCPCS,72265,Myelography l-s spine,,,765.58,1913.95,4 HCPCS,72270,Myelogphy 2/> spine regions,,,765.58,1913.95,4 HCPCS,72285,Discography cerv/thor spine,,,1907.04,4767.6,4 HCPCS,72295,X-ray of lower spine disk,,,1907.04,4767.6,4 HCPCS,73000,Hc X-Ray Clavicle - Xr Clavicle,625.64,250.26,,,0 HCPCS,73000,X-ray exam of collar bone,,,84.99,212.47,4 HCPCS,73010,Hc X-Ray Scapula - Xr Scapula,637.99,255.2,,,0 HCPCS,73010,X-ray exam of shoulder blade,,,102.1,255.25,4 HCPCS,73020,Hc X-Ray Shoulder 1 Vw - Xr Shoulder 1 View,550.18,220.07,,,0 HCPCS,73020,X-ray exam of shoulder,,,84.99,212.47,4 HCPCS,73030,Hc X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views,751.86,300.74,,,0 HCPCS,73030,X-ray exam of shoulder,,,84.99,212.47,4 HCPCS,73040,Contrast x-ray of shoulder,,,340.71,851.78,4 HCPCS,73050,Hc X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral,616.03,246.41,,,0 HCPCS,73050,X-ray exam of shoulders,,,84.99,212.47,4 HCPCS,73060,Hc X-Ray Humerus - Xr Humerus,625.64,250.26,,,0 HCPCS,73060,X-ray exam of humerus,,,84.99,212.47,4 HCPCS,73070,Hc X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views,588.59,235.44,,,0 HCPCS,73070,Hc X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right,588.59,235.44,,,0 HCPCS,73070,X-ray exam of elbow,,,84.99,212.47,4 HCPCS,73080,Hc X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views,669.54,267.82,,,0 HCPCS,73080,X-ray exam of elbow,,,84.99,212.47,4 HCPCS,73085,Contrast x-ray of elbow,,,340.71,851.78,4 HCPCS,73090,Hc X-Ray Forearm 2 Vw - Xr Forearm 1-2 Views,640.73,256.29,,,0 HCPCS,73090,X-ray exam of forearm,,,84.99,212.47,4 HCPCS,73092,"Hc X-Ray Arm, Infant - Xr Upper Extremity 2+ Views Infant",519.99,208.0,,,0 HCPCS,73092,X-ray exam of arm infant,,,102.1,255.25,4 HCPCS,73100,Hc X-Ray Wrist 2 View-Bilateral,563.9,225.56,,,0 HCPCS,73100,Hc X-Ray Wrist 2 View-Unilateral,281.95,112.78,,,0 HCPCS,73100,X-ray exam of wrist,,,84.99,212.47,4 HCPCS,73110,Hc X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views,717.56,287.02,,,0 HCPCS,73110,X-ray exam of wrist,,,84.99,212.47,4 HCPCS,73115,Contrast x-ray of wrist,,,340.71,851.78,4 HCPCS,73120,Hc Res Xr Hand 2 Views-Lt,579.42,231.77,,,0 HCPCS,73120,Hc Res Xr Hand 2 Views-Rt,579.42,231.77,,,0 HCPCS,73120,Hc X-Ray Hand 2 Views - Xr Hand 1-2 Views Bilateral,644.85,257.94,,,0 HCPCS,73120,Hc X-Ray Hand 2 Vw - Xr Hand 1-2 Views,644.85,257.94,,,0 HCPCS,73120,X-ray exam of hand,,,102.1,255.25,4 HCPCS,73130,Hc X-Ray Hand 3+ Vw - Xr Hand 3+ Views,679.15,271.66,,,0 HCPCS,73130,X-ray exam of hand,,,84.99,212.47,4 HCPCS,73140,Hc X-Ray Exam Of Finger(S) - Xr Fingers 2+ Views,507.64,203.06,,,0 HCPCS,73140,X-ray exam of finger(s),,,84.99,212.47,4 HCPCS,73200,Ct upper extremity w/o dye,,,102.1,255.25,4 HCPCS,73200,Hc Ct Scan Upper Extremity W/O Dye - Ct Upper Extremity W/O Iv Contrast,2364.29,945.72,,,0 HCPCS,73201,Ct upper extremity w/dye,,,340.71,851.78,4 HCPCS,73201,Hc Ct Scan Upper Extremity W Iv Contrast,2633.73,1053.49,,,0 HCPCS,73202,Ct uppr extremity w/o&w/dye,,,171.3,428.24,4 HCPCS,73202,Hc Ct Up Extremity Wo/W Contrast,237.0,94.8,,,0 HCPCS,73206,Ct angio upr extrm w/o&w/dye,,,171.3,428.24,4 HCPCS,73206,Hc Ct Angio Upper Extremity-Unilateral,2760.23,1104.09,,,0 HCPCS,73206,Hc Ct Venogram Upper Extremity-Unilateral,2760.23,1104.09,,,0 HCPCS,73218,Hc Mri Upper Extremity No Joint W/O Contrast,3294.21,1317.68,,,0 HCPCS,73218,Mri Upper Extremity W/O Dye,,,233.02,582.55,4 HCPCS,73219,Hc Mri Upper Extremity No Joint W/Contrast,3546.91,1418.76,,,0 HCPCS,73219,Mri Upper Extremity W/Dye,,,340.71,851.78,4 HCPCS,73220,Hc Mri Upper Extremity Combo - Mr Forearm Left W And Wo Iv Contrast,4599.04,1839.62,,,0 HCPCS,73220,Hc Mri Upper Extremity No Joint Wo/W Contrast,4599.04,1839.62,,,0 HCPCS,73220,Mri uppr extremity w/o&w/dye,,,340.71,851.78,4 HCPCS,73221,Hc Mri Upper Extremity Joint W/O Contrast,4040.81,1616.32,,,0 HCPCS,73221,"Hc Mri, Joint Upper Extrem - Mr Wrist Without Iv Contrast",4040.81,1616.32,,,0 HCPCS,73221,Mri joint upr extrem w/o dye,,,233.02,582.55,4 HCPCS,73222,Hc Mri Upper Extremity Joint W/Contrast-Right,4040.81,1616.32,,,0 HCPCS,73222,Hc Mri Upper Extremity W Iv Contrast,4375.06,1750.02,,,0 HCPCS,73222,Mri joint upr extrem w/dye,,,765.58,1913.95,4 HCPCS,73223,Hc Mri Joint Upr Extr W/O&W/Dye - Mr Elbow Lt W And Wo Iv Contrast,5184.83,2073.93,,,0 HCPCS,73223,Hc Mri Joint Upr Extr W/O&W/Dye - Mr Elbow Rt W And Wo Iv Contrast,5184.83,2073.93,,,0 HCPCS,73223,Hc Mri Upper Extremity Joint Wo/W Contrast,5184.83,2073.93,,,0 HCPCS,73223,Mri joint upr extr w/o&w/dye,,,340.71,851.78,4 HCPCS,73225,Hc Mr Angio Upper Extrem - Mr Upper Extremity Angio Bil Wo Iv Contrast,2774.0,1109.6,,,0 HCPCS,73225,Hc Mra/Mrv Upper Extremity With And Without Contrast-Unilateral,3670.0,1468.0,,,0 HCPCS,73225,Hc Mra/Mrv Upper Extremity With Contrast-Unilateral,2860.0,1144.0,,,0 HCPCS,73225,Hc Mra/Mrv Upper Extremity Without Contrast-Unilateral,2012.0,804.8,,,0 HCPCS,73501,Hc X-Ray Exam Hip 1 View - Xr Hip 1 View,581.73,232.69,,,0 HCPCS,73501,X-ray exam hip uni 1 view,,,84.99,212.47,4 HCPCS,73502,Hc X-Ray Exam Hip 2-3 Views - Xr Hip 2 Or 3 Views,644.85,257.94,,,0 HCPCS,73502,X-ray exam hip uni 2-3 views,,,84.99,212.47,4 HCPCS,73503,Hc X-Ray Exam Hip 4+ Views - Xr Hip 4+ Views,710.71,284.28,,,0 HCPCS,73503,X-ray exam hip uni 4/> views,,,102.1,255.25,4 HCPCS,73521,Hc X-Ray Exam Hips Bilateral 2 Views - Xr Hips Bilateral 2 Views W Wo Pelvis,873.98,349.59,,,0 HCPCS,73521,X-ray exam hips bi 2 views,,,102.1,255.25,4 HCPCS,73522,Hc X-Ray Exam Hips Bilateral 3-4 Views - Xr Hips Bilateral 3-4 Views W Wo Pelvis,937.08,374.83,,,0 HCPCS,73522,X-ray exam hips bi 3-4 views,,,102.1,255.25,4 HCPCS,73523,Hc X-Ray Exam Hips Bilateral 5+ Views - Xr Hips Bilateral 5+ Views W Wo Pelvis,1159.35,463.74,,,0 HCPCS,73523,X-ray exam hips bi 5/> views,,,102.1,255.25,4 HCPCS,73525,Contrast x-ray of hip,,,340.71,851.78,4 HCPCS,73525,Hc Arthrogram Of Hip - Xr Hip Arthrogram,1634.47,653.79,,,0 HCPCS,73551,Hc Radiologic Examination Femur 1 View - Xr Femur 1 View,592.71,237.08,,,0 HCPCS,73551,X-ray exam of femur 1,,,84.99,212.47,4 HCPCS,73552,Hc Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Views,688.75,275.5,,,0 HCPCS,73552,X-ray exam of femur 2/>,,,84.99,212.47,4 HCPCS,73560,Hc X-Ray Knee 1 Or 2 Views - Xr Knee 1-2 Views,669.54,267.82,,,0 HCPCS,73560,X-ray exam of knee 1 or 2,,,84.99,212.47,4 HCPCS,73562,Hc X-Ray Knee 3 View - Xr Knee 3 Views Bilateral,1534.0,613.6,,,0 HCPCS,73562,Hc X-Ray Knee 3 Views - Xr Knee 3 Views,808.12,323.25,,,0 HCPCS,73562,X-ray exam of knee 3,,,84.99,212.47,4 HCPCS,73564,Hc X-Ray Knee 4+ Views - Xr Knee 4+ Views,972.75,389.1,,,0 HCPCS,73564,X-ray exam knee 4 or more,,,102.1,255.25,4 HCPCS,73565,Hc X-Ray Knee Bilateral Standing - Xr Knees Anteroposterior Standing Bilateral,668.17,267.27,,,0 HCPCS,73565,X-ray exam of knees,,,84.99,212.47,4 HCPCS,73580,Contrast x-ray of knee joint,,,340.71,851.78,4 HCPCS,73590,"Hc X-Ray Tibia Fibula, 2 Views - Xr Tibia Fibula 2 Views",720.3,288.12,,,0 HCPCS,73590,X-ray exam of lower leg,,,84.99,212.47,4 HCPCS,73592,"Hc X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant",509.02,203.61,,,0 HCPCS,73592,X-ray exam of leg infant,,,84.99,212.47,4 HCPCS,73600,Hc X-Ray Ankle 2 Views - Xr Ankle 2 Views,588.59,235.44,,,0 HCPCS,73600,X-ray exam of ankle,,,84.99,212.47,4 HCPCS,73610,Hc X-Ray Ankle 3+ Views- Xr Ankle 3+ Views,698.36,279.34,,,0 HCPCS,73610,X-ray exam of ankle,,,84.99,212.47,4 HCPCS,73615,Contrast x-ray of ankle,,,340.71,851.78,4 HCPCS,73620,Hc X-Ray Foot 2 Views - Xr Foot 1-2 Views,596.82,238.73,,,0 HCPCS,73620,X-ray exam of foot,,,84.99,212.47,4 HCPCS,73630,Hc X-Ray Foot 3+ Views - Xr Foot 3+ Views,734.03,293.61,,,0 HCPCS,73630,X-ray exam of foot,,,84.99,212.47,4 HCPCS,73650,Hc X-Ray Heel - Xr Calcaneus 2 Views,568.02,227.21,,,0 HCPCS,73650,X-ray exam of heel,,,84.99,212.47,4 HCPCS,73660,Hc X-Ray Toe(S) - Xr Toes 2+ Views,466.49,186.6,,,0 HCPCS,73660,X-ray exam of toe(s),,,84.99,212.47,4 HCPCS,73676,Hc Echo 3D Render W/Interpertation Postprocess Not On An Independent Workstation,1365.0,546.0,,,0 HCPCS,73700,Ct lower extremity w/o dye,,,102.1,255.25,4 HCPCS,73700,Hc Ct Lower Extremity W/O Contrast,2458.9,983.56,,,0 HCPCS,73701,Ct lower extremity w/dye,,,171.3,428.24,4 HCPCS,73701,Hc Ct Lower Extremity W Contrast,2647.1,1058.84,,,0 HCPCS,73702,Ct lwr extremity w/o&w/dye,,,171.3,428.24,4 HCPCS,73702,Hc - Ct Foot Left W And Wo Iv Contrast-Bilateral,4186.62,1674.65,,,0 HCPCS,73702,Hc - Ct Lower Extremity W And Wo Iv Contrast,2791.08,1116.43,,,0 HCPCS,73706,Ct angio lwr extr w/o&w/dye,,,171.3,428.24,4 HCPCS,73706,Hc Ct Angio Lower Extremity-Unilateral,3110.91,1244.36,,,0 HCPCS,73706,Hc Ct Venogram Lower Extremity-Unilateral,3110.91,1244.36,,,0 HCPCS,73718,Hc Mri Lower Extremity No Joint W/O Contrast,4023.58,1609.43,,,0 HCPCS,73718,Mri Lower Extremity W/O Dye,,,233.02,582.55,4 HCPCS,73719,Hc Mri Lower Extremity No Joint W Contrast,4492.22,1796.89,,,0 HCPCS,73719,Mri Lower Extremity W/Dye,,,340.71,851.78,4 HCPCS,73720,Hc Mri Lower Extremity No Joint Wo/W Contrast,4804.64,1921.86,,,0 HCPCS,73720,Mri lwr extremity w/o&w/dye,,,340.71,851.78,4 HCPCS,73721,Hc Mri Lower Extremity W/O Iv Contrast,4023.58,1609.43,,,0 HCPCS,73721,Mri jnt of lwr extre w/o dye,,,233.02,582.55,4 HCPCS,73722,Hc Mri Lower Extremity Joint W/Contrast,4518.63,1807.45,,,0 HCPCS,73722,Mri Joint Of Lwr Extr W/Dye,,,765.58,1913.95,4 HCPCS,73723,"Hc Mri, Joint Of Leg Combo - W And Wo Iv Contrast",5182.53,2073.01,,,0 HCPCS,73723,Mri joint lwr extr w/o&w/dye,,,340.71,851.78,4 HCPCS,73725,Hc Mr Angio Lower Extrem (Mra) - Mr Lower Ext Angio W And Wo Iv Cont Lt,3048.0,1219.2,,,0 HCPCS,73725,Hc Mr Angio Lower Extrem (Mra) - Mr Lower Ext Angio W Iv Cont Lt,1209.12,483.65,,,0 HCPCS,73725,Hc Mr Angio Lower Extrem (Mra) - Mr Lower Ext Angio W Iv Cont Rt,1209.12,483.65,,,0 HCPCS,73725,Hc Mra/Mrv Lower Extremity With And Without Contrast-Bilateral,3636.64,1454.66,,,0 HCPCS,73725,Hc Mra/Mrv Lower Extremity With Contrast -Unilateral,3220.0,1288.0,,,0 HCPCS,73725,Hc Mra/Mrv Lower Extremity Without Contrast - Unilateral,2972.0,1188.8,,,0 HCPCS,74018,Hc Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View,527.52,211.01,,,0 HCPCS,74018,Hc Radiologic Exam Abdomen 1 View - Xr Colon Motility,527.52,211.01,,,0 HCPCS,74018,X-ray exam abdomen 1 view,,,84.99,212.47,4 HCPCS,74019,Hc Radiologic Exam Abdomen 2 Views - Xr Abdomen 2 View Poster W Decubitus,635.04,254.02,,,0 HCPCS,74019,X-ray exam abdomen 2 views,,,102.1,255.25,4 HCPCS,74021,Hc Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views,785.0,314.0,,,0 HCPCS,74021,X-ray exam abdomen 3+ views,,,102.1,255.25,4 HCPCS,74022,"Hc X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Views With Chest 1 View",759.36,303.74,,,0 HCPCS,74022,X-ray exam series abdomen,,,102.1,255.25,4 HCPCS,74150,Ct abdomen w/o dye,,,102.1,255.25,4 HCPCS,74150,Hc Ct Abdomen W/O Dye - Ct Abdomen Wo Contrast,2527.81,1011.12,,,0 HCPCS,74160,Ct abdomen w/dye,,,171.3,428.24,4 HCPCS,74160,Hc Ct Abdomen W/Dye - Ct Abdomen W Contrast,3094.46,1237.78,,,0 HCPCS,74170,Ct abdomen w/o & w/dye,,,171.3,428.24,4 HCPCS,74170,Hc Ct Abdomen W/O & W/Dye - Ct Abdomen W Wo Contrast,3703.27,1481.31,,,0 HCPCS,74170,Hc Ct Adrenal W/O & W/Dye - Ct Adrenal W Wo Contrast,3703.27,1481.31,,,0 HCPCS,74170,Hc Ct Renal Mass W/O & W Dye,3703.27,1481.31,,,0 HCPCS,74174,Ct angio abd&pelv w/o&w/dye,,,340.71,851.78,4 HCPCS,74174,Hc Ct Angio Abdomen/Pelvis,5969.86,2387.94,,,0 HCPCS,74174,Hc Ct Venogram Abdomen/Pelvis,5969.86,2387.94,,,0 HCPCS,74175,Ct angio abdom w/o & w/dye,,,171.3,428.24,4 HCPCS,74175,Hc Ct Angio Abdom W/O & W/Dye - Ct Angiogram Abdomen W Contrast,3855.47,1542.19,,,0 HCPCS,74176,Ct abd & pelvis w/o contrast,,,233.02,582.55,4 HCPCS,74176,Hc Ct Abdomen Pelvis Wo Iv Contrast,4297.68,1719.07,,,0 HCPCS,74176,Hc Ct Renal Stone Wo Iv Contrast,4297.68,1719.07,,,0 HCPCS,74177,Ct abd & pelv w/contrast,,,340.71,851.78,4 HCPCS,74177,Hc Ct Abd & Pelv W/Contrast - Ct Abdomen Pelvis W Contrast,5269.52,2107.81,,,0 HCPCS,74177,Hc Ct Enterography,5269.52,2107.81,,,0 HCPCS,74178,Ct abd & pelv 1/> regns,,,340.71,851.78,4 HCPCS,74178,Hc Ct Abd & Pelv 1/> Regns - Ct Abdomen Pelvis W Wo Contrast,6426.47,2570.59,,,0 HCPCS,74178,Hc Ct Urogram,6426.47,2570.59,,,0 HCPCS,74181,"Hc Mri, Abdomen (Mri) - Mri Abdomen Wo Contrast",4226.89,1690.76,,,0 HCPCS,74181,"Hc Mri, Abdomen (Mri) - Mri Abdomen Wo Contrast Mrcp",4226.89,1690.76,,,0 HCPCS,74181,Mri abdomen w/o dye,,,233.02,582.55,4 HCPCS,74182,"Hc Mri, Abdomen W/Contrast - Mri Abdomen W Contrast",4390.0,1756.0,,,0 HCPCS,74182,"Hc Mri, Abdomen With Contrast",4058.0,1623.2,,,0 HCPCS,74182,Mri Abdomen W/Dye,,,340.71,851.78,4 HCPCS,74183,"Hc Mri, Abdomen, Combo - Mri Abdomen W Wo Contrast Mrcp",5469.68,2187.87,,,0 HCPCS,74183,Mri abdomen w/o & w/dye,,,340.71,851.78,4 HCPCS,74185,Hc Mr Angio Abdomen (Mra) - Mr Abdomen Angio W And Wo Iv Contrast,578.9,231.56,,,0 HCPCS,74185,Hc Mra/Mrv Abdomen With And Without Contrast,3550.0,1420.0,,,0 HCPCS,74185,Hc Mra/Mrv Abdomen With Contrast,2805.0,1122.0,,,0 HCPCS,74185,Hc Mra/Mrv Abdomen Without Contrast,2447.2,978.88,,,0 HCPCS,74190,X-ray exam of peritoneum,,,533.63,1334.08,4 HCPCS,74210,Contrst x-ray exam of throat,,,171.3,428.24,4 HCPCS,74220,Contrast x-ray esophagus,,,171.3,428.24,4 HCPCS,74220,Hc Esophagram - Fl Esophagus Barium Swallow,857.92,343.17,,,0 HCPCS,74221,Hc Barium Swallow (Barium & Air),868.0,347.2,,,0 HCPCS,74221,X-ray xm esophagus 2cntrst,,,171.3,428.24,4 HCPCS,74230,Cine/vid x-ray throat/esoph,,,171.3,428.24,4 HCPCS,74230,Hc Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech,882.56,353.02,,,0 HCPCS,74240,Hc X-Ray Upper Gi Delay W/O Kub - Fl Upper Gi Without Kub,1010.24,404.1,,,0 HCPCS,74240,X-ray upper gi delay w/o kub,,,171.3,428.24,4 HCPCS,74241,Hc X-Ray Upper Gi Delay W/Kub - Fl Upper Gi With Kub,1303.68,521.47,,,0 HCPCS,74245,Hc X-Ray Upper Gi&Small Intest - Fl Upper Gi Single Cont W/ Small Bowel,1743.84,697.54,,,0 HCPCS,74246,Contrst x-ray uppr gi tract,,,171.3,428.24,4 HCPCS,74246,Hc Contrst X-Ray Uppr Gi Tract - Fl Upper Gi With Double Cont W/O Kub,1554.56,621.82,,,0 HCPCS,74248,Hc X-Ray Upper Gi&Small Intest - Fl Upper Gi Single Cont W/ Small Bowel,1295.84,518.34,,,0 HCPCS,74250,Hc X-Ray Exam Of Small Bowel - Fl Small Bowel Series,990.08,396.03,,,0 HCPCS,74250,X-ray exam of small bowel,,,171.3,428.24,4 HCPCS,74251,X-ray exam of small bowel,,,171.3,428.24,4 HCPCS,74261,Ct colonography dx,,,102.1,255.25,4 HCPCS,74261,Hc Ct Colonography Dx - Ct Colonography Diagnostic Wo Contrast,1254.0,501.6,,,0 HCPCS,74262,Ct colonography dx w/dye,,,171.3,428.24,4 HCPCS,74262,Hc Ct Colonography Dx W/Dye - Ct Colonography With Contrast Diagnostic,1175.0,470.0,,,0 HCPCS,74263,Ct colonography screening,,,233.02,582.55,4 HCPCS,74263,Hc Ct Colonography Screening - Ct Colonography Screening,600.0,240.0,,,0 HCPCS,74270,Contrast x-ray exam of colon,,,171.3,428.24,4 HCPCS,74270,Hc X-Ray Colon Contrast - Fl Barium Enema Single Contrast Water Soluble,1304.8,521.92,,,0 HCPCS,74280,Contrast x-ray exam of colon,,,171.3,428.24,4 HCPCS,74280,Hc X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast,1491.84,596.74,,,0 HCPCS,74283,Contrast x-ray exam of colon,,,171.3,428.24,4 HCPCS,74283,Hc Xr Barium Enem Intussusception,1863.74,745.5,,,0 HCPCS,74290,Contrast x-ray gallbladder,,,171.3,428.24,4 HCPCS,74328,Hc X-Ray For Bile Duct Endoscopy - Fl Ercp Biliary Duct,1453.76,581.5,,,0 HCPCS,74329,Hc X-Ray For Pancreas Endoscopy - Fl Ercp Pancreatic Duct,1301.44,520.58,,,0 HCPCS,74330,Hc X-Ray Bile/Pancreas Endoscopy - Fl Ercp Biliary And Pancreas,1809.92,723.97,,,0 HCPCS,74340,Hc X-Ray Guide For Gi Tube - Fl Feeding Tube Placement,900.48,360.19,,,0 HCPCS,74340,Hc X-Ray Guide For Gi Tube - Fl Feeding Tube Placement Long,900.48,360.19,,,0 HCPCS,74360,Hc X-Ray Guide Gi Dilation - Fl Guided Intraluminal Dilation Strictures,659.68,263.87,,,0 HCPCS,74363,Hc X-Ray Bile Duct Dilation - Ir Biliary Dilation Charge,1853.0,741.2,,,0 HCPCS,74400,Contrst x-ray urinary tract,,,171.3,428.24,4 HCPCS,74400,Hc X-Ray Iv Pyelogram (Ivp) - Xr Urogram W/Wo Kub W/Wo Tomogram,1345.12,538.05,,,0 HCPCS,74410,Contrst x-ray urinary tract,,,171.3,428.24,4 HCPCS,74415,Contrst x-ray urinary tract,,,171.3,428.24,4 HCPCS,74420,Contrst x-ray urinary tract,,,340.71,851.78,4 HCPCS,74420,Hc X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde W/ Disposable Scope,1506.0,602.4,,,0 HCPCS,74425,Contrst x-ray urinary tract,,,340.71,851.78,4 HCPCS,74425,Hc X-Ray Antegrade Pyelogram Tube - Fl Guided Nephrostogram,1322.72,529.09,,,0 HCPCS,74425,Hc X-Ray Antegrade Pyelogram Tube - Fl Loopogram,1181.0,472.4,,,0 HCPCS,74425,Hc X-Ray Antegrade Pyelogram Tube - Ir Nephrostogram Charge,1181.0,472.4,,,0 HCPCS,74430,Contrast x-ray bladder,,,340.71,851.78,4 HCPCS,74430,"Hc X-Ray Cystogram, Min 3 View - Fl Cystogram 3 View",1018.08,407.23,,,0 HCPCS,74440,X-ray male genital tract,,,233.02,582.55,4 HCPCS,74445,X-ray exam of penis,,,102.1,255.25,4 HCPCS,74450,Hc X-Ray Urethrocystogram - Xr Cystourethrogram,1011.36,404.54,,,0 HCPCS,74450,X-ray urethra/bladder,,,233.02,582.55,4 HCPCS,74455,Hc X-Ray Urethrocystogram+Voiding - Fl Voiding Cystourethrogram,1247.68,499.07,,,0 HCPCS,74455,X-ray urethra/bladder,,,233.02,582.55,4 HCPCS,74470,X-ray exam of kidney lesion,,,533.63,1334.08,4 HCPCS,74485,"Hc X-Ray Guide, Gu Dilation - Ir Nephrostomy Dilation Charge",1800.0,720.0,,,0 HCPCS,74485,X-ray guide gu dilation,,,2041.48,5103.69,4 HCPCS,74712,Hc Mr Fetal Single Gestation,915.44,366.18,,,0 HCPCS,74712,Mri fetal sngl/1st gestation,,,233.02,582.55,4 HCPCS,74740,Hc X-Ray Hysterosalpingogram - Xr Hysterosalpingogram,1148.0,459.2,,,0 HCPCS,74740,X-ray female genital tract,,,233.02,582.55,4 HCPCS,74775,X-ray exam of perineum,,,233.02,582.55,4 HCPCS,75557,Cardiac mri for morph,,,233.02,582.55,4 HCPCS,75557,Hc Cardiac Mri For Morph - Mri Cardiac Morph & Function Wo Iv Contrast,3347.05,1338.82,,,0 HCPCS,75559,Cardiac mri w/stress img,,,533.63,1334.08,4 HCPCS,75559,Hc Cardiac Mri W/Stress - Mri Cardiac Morph & Function Wo Iv Contrast W Stress,3652.58,1461.03,,,0 HCPCS,75561,Cardiac mri for morph w/dye,,,340.71,851.78,4 HCPCS,75561,Hc Cardiac Mri Morph W/Dye - Mri Cardiac Morph & Function W & Wo Iv Contrast,4322.22,1728.89,,,0 HCPCS,75563,Card mri w/stress img & dye,,,765.58,1913.95,4 HCPCS,75563,Hc Cardiac Mri W/Stress - Mri Cardiac Morph & Function W & Wo Iv Contrast W Stress,4875.85,1950.34,,,0 HCPCS,75565,Hc Cardiac Mri Velocity Flow Mapping - Mri Cardiac Velocity Flow Mapping,1616.09,646.44,,,0 HCPCS,75571,Ct hrt w/o dye w/ca test,,,84.99,212.47,4 HCPCS,75571,Hc Ct Heart W/O Dye W/Ca Test - Ct Heart Calcium Scoring Wo Contrast-Non Research,107.98,43.19,,,0 HCPCS,75571,Hc Res Calcium Score,4799.2,1919.68,,,0 HCPCS,75572,Ct hrt w/3d image,,,340.71,851.78,4 HCPCS,75572,Hc Ct Heart W/3D Image - Ct Heart Structure Morphology With Contrast,2038.29,815.32,,,0 HCPCS,75573,Ct hrt w/3d image congen,,,340.71,851.78,4 HCPCS,75573,Hc Ct Heart W/3D Image Congen - Ct Heart Struct Morph Congen Heart Dis W/ Contrast,1511.75,604.7,,,0 HCPCS,75574,Ct angio hrt w/3d image,,,340.71,851.78,4 HCPCS,75574,Hc Ct Angio Heart W/3D Image - Ct Heart Coronary Angiogram,1890.2,756.08,,,0 HCPCS,75577,Quan&char c athrosclrtc plaq,,,908.58,2271.46,4 HCPCS,75580,Hc Ffr Cta Data Analysis,1900.0,760.0,,,0 HCPCS,75580,N-invas est c ffr sw aly cta,,,838.65,2096.62,4 HCPCS,75600,Contrast exam thoracic aorta,,,3083.61,7709.02,4 HCPCS,75605,Contrast exam thoracic aorta,,,5434.3,13585.75,4 HCPCS,75605,Hc Contrast Exam Thoracic Aorta - Ir Aortagram Thoracic Serialogram,7277.2,2910.88,,,0 HCPCS,75605,Hc Contrast Exam Thoracic Aorta - Ir Aortagram Thoracic Serialogram Chg,7277.2,2910.88,,,0 HCPCS,75625,Contrast exam abdominl aorta,,,3083.61,7709.02,4 HCPCS,75625,Hc Contrast Exam Abdominal Aorta - Ir Aortagram Abdomnal Serialogram,6638.35,2655.34,,,0 HCPCS,75625,Hc Contrast Exam Abdominl Aorta - Ir Aortagram Abdomnl Serialogram Chg,6638.35,2655.34,,,0 HCPCS,75630,Hc X-Ray Aorta Leg Arteries - Ir Angio Abdom Aorta & Bi Iliofemoral Chg,6492.81,2597.12,,,0 HCPCS,75630,X-ray aorta leg arteries,,,3083.61,7709.02,4 HCPCS,75635,Ct Angio Abdominal Arteries,,,171.3,428.24,4 HCPCS,75635,Hc Ct Angio Abdominal Arteries - Ct Angio Aorta & Bilateral Iliofemoral Run,3330.99,1332.4,,,0 HCPCS,75705,Artery x-rays spine,,,5434.3,13585.75,4 HCPCS,75705,Hc Angio Spinal Selective - Ir Angiogram Spinal Selective,7402.14,2960.86,,,0 HCPCS,75705,Hc Angio Spinal Selectv - Ir Angiogram Spinal Selective Chg,7402.14,2960.86,,,0 HCPCS,75710,Artery x-rays arm/leg,,,3083.61,7709.02,4 HCPCS,75710,Hc Angio Extremity - Ir Angiogram Extremity,6440.0,2576.0,,,0 HCPCS,75710,Hc Angio Extremity Unilat - Ir Angiogram Extremity Left Charge,6440.0,2576.0,,,0 HCPCS,75710,Hc Angio Extremity Unilateral - Ir Angiogram Extremity Right,6440.0,2576.0,,,0 HCPCS,75710,Hc Angio/Ir Angiogram Extremity Unilateral,6440.0,2576.0,,,0 HCPCS,75716,Artery x-rays arms/legs,,,3083.61,7709.02,4 HCPCS,75716,Hc Angio Extermity Bilateral - Ir Angiogram Extremity Bilateral,7247.58,2899.03,,,0 HCPCS,75716,Hc Angio/Ir Angiogram Extremity Bilateral,7247.58,2899.03,,,0 HCPCS,75726,Artery x-rays abdomen,,,5434.3,13585.75,4 HCPCS,75726,Hc Angio Visceral Selectv/Subselec - Ir Angio Visceral Selective Chg,8727.49,3491.0,,,0 HCPCS,75726,Hc Angio/Ir Angio Visceral Selective,8727.49,3491.0,,,0 HCPCS,75731,Artery x-rays adrenal gland,,,3083.61,7709.02,4 HCPCS,75731,Hc Angio Adrenal Selective - Ir Angiogram Adrenal Selective-Unilateral,6022.69,2409.08,,,0 HCPCS,75733,Artery x-rays adrenals,,,3083.61,7709.02,4 HCPCS,75736,Artery x-rays pelvis,,,5434.3,13585.75,4 HCPCS,75736,Hc Angio Pelvis - Ir Angio Pelvic Selective Or Supraselective,7542.53,3017.01,,,0 HCPCS,75736,Hc Angio Pelvis - Ir Angio Pelvic Selective Or Supraselective Charge,7542.53,3017.01,,,0 HCPCS,75736,Hc Angio Pelvis - Ir Angiogram Pelvis Selective Or Supraselective Chg,7542.53,3017.01,,,0 HCPCS,75741,Artery x-rays lung,,,3083.61,7709.02,4 HCPCS,75741,Hc Angio Pulmonary Selective - Ir Angiogram Pulmonary Selective,5842.37,2336.95,,,0 HCPCS,75743,Artery x-rays lungs,,,3083.61,7709.02,4 HCPCS,75743,Hc Angio/Ir Angiogram Pulmonary Selective Bilateral,7789.82,3115.93,,,0 HCPCS,75746,Artery x-rays lung,,,3083.61,7709.02,4 HCPCS,75746,Hc Angio Pulmonary Venous Injection,3512.38,1404.95,,,0 HCPCS,75756,Artery x-rays chest,,,3083.61,7709.02,4 HCPCS,75756,Hc Angio Internal Mammary - Ir Angiogram Internal Mammary,4274.87,1709.95,,,0 HCPCS,75774,Hc Angio Ea Addnl Selectv Vessel - Ir Angio Selective Ea Addl Vessel Ch,4058.49,1623.4,,,0 HCPCS,75774,Hc Angio Each Additional Selective Vessel - Ir Angio Selective Each Additional Vessel,4058.49,1623.4,,,0 HCPCS,75801,Lymph vessel x-ray arm/leg,,,612.63,1531.57,4 HCPCS,75803,Hc Lymphangiogram Extremity Bilateral - Ir Lymphangiogram Extremity Bilateral,2689.34,1075.74,,,0 HCPCS,75803,Lymph vessel x-ray arms/legs,,,1537.33,3843.32,4 HCPCS,75805,Hc Lymphangio Abdomen Pelvis - Ir Lymphangiogram Abdomen Pelvis-Unilateral,2557.97,1023.19,,,0 HCPCS,75805,Lymph vessel x-ray trunk,,,3083.61,7709.02,4 HCPCS,75807,Hc Lymphangiogram Abdomen/Pelvis Bilateral - Ir Lymphangiogram Abdomen Pelvis Bilateral,3420.93,1368.37,,,0 HCPCS,75807,Lymph vessel x-ray trunk,,,3083.61,7709.02,4 HCPCS,75809,Hc Nonvascular Shuntogram - Ir Nonvascular Shuntogram,672.0,268.8,,,0 HCPCS,75809,Nonvascular shunt x-ray,,,102.1,255.25,4 HCPCS,75810,Vein x-ray spleen/liver,,,3083.61,7709.02,4 HCPCS,75820,Hc Venogram Extrem Unilat - Ir Venogram Extremity Right Charge,2642.98,1057.19,,,0 HCPCS,75820,Hc Venogram Extrem Unilat - Ir Venogram Lower Extremity Left,2642.98,1057.19,,,0 HCPCS,75820,Hc Venogram Extrem Unilat - Ir Venogram Lower Extremity Left Chg,2642.98,1057.19,,,0 HCPCS,75820,Hc Venogram Extrem Unilat - Ir Venogram Upper Extremity Left,2642.98,1057.19,,,0 HCPCS,75820,Hc Venogram Extrem- Ir Venogram Lower Extremity,2642.98,1057.19,,,0 HCPCS,75820,Hc Venography Extremity S&I Left,2642.98,1057.19,,,0 HCPCS,75820,Vein x-ray arm/leg,,,1537.33,3843.32,4 HCPCS,75822,Hc Venogram Extrem Bilat - Ir Venogram Extremity Bilateral Charge,3198.1,1279.24,,,0 HCPCS,75822,Hc Venogram Extrem Bilat - Ir Venogram Lower Extremity Bilateral Chg,3198.1,1279.24,,,0 HCPCS,75822,Hc Venogram Extremity Bilateral - Ir Venogram Upper Extremity Bilateral,3198.1,1279.24,,,0 HCPCS,75822,Vein x-ray arms/legs,,,1537.33,3843.32,4 HCPCS,75825,Hc Venogram Infer Vena Cava - Ir Veno Caval Inferior W Serialography,6121.86,2448.74,,,0 HCPCS,75825,Hc Venogram Infer Vena Cava - Ir Veno Caval Inferior W Serialography Ch,6121.86,2448.74,,,0 HCPCS,75825,Vein x-ray trunk,,,3083.61,7709.02,4 HCPCS,75827,Hc Venogram Super Vena Cava - Ir Veno Caval Superior W Serialography,4593.01,1837.2,,,0 HCPCS,75827,Vein x-ray chest,,,1537.33,3843.32,4 HCPCS,75831,Hc Venogram Renal Unilat - Ir Venogram Renal Right,5781.83,2312.73,,,0 HCPCS,75831,Hc Venogram Renal- Ir Venogram Renal,5781.83,2312.73,,,0 HCPCS,75831,Vein x-ray kidney,,,3083.61,7709.02,4 HCPCS,75833,Hc Venogram Renal Bilat - Ir Venogram Renal Bilateral,6792.91,2717.16,,,0 HCPCS,75833,Vein x-ray kidneys,,,3083.61,7709.02,4 HCPCS,75840,Vein x-ray adrenal gland,,,3083.61,7709.02,4 HCPCS,75842,Hc Venogram Adrenal Bilateral - Ir Venogram Adrenal Bilateral Selective,7628.82,3051.53,,,0 HCPCS,75860,Hc Venogram Sinus/Jugular - Ir Venogram Sinus/Jugular Right,4443.6,1777.44,,,0 HCPCS,75860,"Hc Venogram Sinus/Jugular - Ir Venogram Venous Sinus, Jugular",4443.6,1777.44,,,0 HCPCS,75860,"Hc Venogram Sinus/Jugular - Ir Venogram Venous Sinus, Jugular Left",4443.6,1777.44,,,0 HCPCS,75860,Vein x-ray neck,,,3083.61,7709.02,4 HCPCS,75870,Hc Venogram Super Sag Sinus - Ir Venogram Superior Sagittal Sinus,3298.57,1319.43,,,0 HCPCS,75870,Hc Venogram Super Sag Sinus - Ir Venogram Superior Sagittal Sinus Chg,3298.57,1319.43,,,0 HCPCS,75870,Vein x-ray skull,,,3083.61,7709.02,4 HCPCS,75872,Vein x-ray skull epidural,,,612.63,1531.57,4 HCPCS,75880,Vein x-ray eye socket,,,612.63,1531.57,4 HCPCS,75885,Hc Vein X-Ray Liver W/Hemodynam - Ir Perc Transhep Porto W Hemo Evl Chg,5104.85,2041.94,,,0 HCPCS,75885,Vein x-ray liver w/hemodynam,,,3083.61,7709.02,4 HCPCS,75887,Hc Percutaneous Transhept Porto W/O Pres,3728.76,1491.5,,,0 HCPCS,75887,Vein x-ray liver w/o hemodyn,,,3083.61,7709.02,4 HCPCS,75889,Hc Vein X-Ray Liver W/Hemodynam - Ir Veno Hepatic W Hemodynamic Eval,6625.47,2650.19,,,0 HCPCS,75889,Hc Vein X-Ray Liver W/Hemodynam - Ir Veno Hepatic W Hemodynamic Eval Ch,6625.47,2650.19,,,0 HCPCS,75889,Hc Vein X-Ray Liver W/Hemodynam - Ir Veno Hepatic W Hemodynamic Evaluation,6625.47,2650.19,,,0 HCPCS,75889,Vein x-ray liver w/hemodynam,,,3083.61,7709.02,4 HCPCS,75891,Hc Vein X-Ray Liver - Ir Venogram Hepatic Wo Hemodynamic Evaluation,5826.91,2330.76,,,0 HCPCS,75891,Vein x-ray liver,,,3083.61,7709.02,4 HCPCS,75893,Hc Venous Sampling By Catheter - Ir Venous Sampling Catheterization,5942.83,2377.13,,,0 HCPCS,75893,Hc Venous Sampling By Catheter - Ir Venous Sampling Catheterization Chg,5942.83,2377.13,,,0 HCPCS,75893,Venous sampling by catheter,,,5434.3,13585.75,4 HCPCS,75894,Hc X-Rays Transcath Therapy - Ir Transcatheter Therapy Embolization,5752.32,2300.93,,,0 HCPCS,75898,Follow-up angiography,,,3083.61,7709.02,4 HCPCS,75898,Hc Follow-Up Angiography - Ir Angio Thru Catheter Fu 4 Embolization,2251.42,900.57,,,0 HCPCS,75970,Hc Vascular Biopsy - Ir Transcatheter Biopsy,3748.64,1499.46,,,0 HCPCS,75970,Hc Vascular Biopsy - Ir Transcatheter Biopsy Charge,3748.64,1499.46,,,0 HCPCS,75984,Hc Xray Control Catheter Change - Ir Gj Tube Change Charge,1342.88,537.15,,,0 HCPCS,75984,Hc Xray Control Catheter Change - Ir Nephrostomy Tube Change Charge,1342.88,537.15,,,0 HCPCS,75984,Hc Xray Control Catheter Change - Ir Ureteral Stent Change,1342.88,537.15,,,0 HCPCS,75989,Hc Abscess Drainage Under X-Ray - Ct Guidance For Abscess Drain,2058.56,823.42,,,0 HCPCS,75989,Hc Abscess Drainage Under X-Ray - Us Guided Abscess Drain,2058.56,823.42,,,0 HCPCS,76000,Fluoroscope examination,,,233.02,582.55,4 HCPCS,76000,Hc Fluoroscopy <1 Hr Phys/Qhp - Fl Less Than 1 Hour Intraoperative,1275.12,510.05,,,0 HCPCS,76000,Hc Fluoroscopy <1 Hr Phys/Qhp - Fl Sniff Test,1275.12,510.05,,,0 HCPCS,76000,Hc Fluoroscopy <1 Hr Phys/Qhp - Ir Cvc Reposition W Fl Guidance,1275.12,510.05,,,0 HCPCS,76000,Hc Fluoroscopy <1 Hr Phys/Qhp - Ir Cvc Reposition W Fl Guidance Chg,1275.12,510.05,,,0 HCPCS,76010,X-ray nose to rectum,,,84.99,212.47,4 HCPCS,76014,Hc Mr Safety Implant And/Or Foreign Body Assessment 1St 15 Minutes,34.29,13.72,,,0 HCPCS,76014,Mr sfty implt&/fb asmt stf 1,,,28.25,70.62,4 HCPCS,76015,Hc Mr Safety Implant And/Or Foreign Body Assessment Each Additional 30 Minutes,34.29,13.72,,,0 HCPCS,76016,Hc Mr Safety Determination By A Physician Or Qualified Healthcare Professional,123.27,49.31,,,0 HCPCS,76016,Mr safety deter phys/qhp,,,84.99,212.47,4 HCPCS,76017,Hc Mr Safety Medical Physics Exam Customization,338.41,135.36,,,0 HCPCS,76017,Mr sfty med physics xm cstmz,,,233.02,582.55,4 HCPCS,76018,Hc Mr Safety Implant Electronics Preparation,128.51,51.4,,,0 HCPCS,76018,Mr safety implant elec prepj,,,92.85,232.12,4 HCPCS,76019,Hc Mr Safety Implant Positioning And/Or Immobilzation,83.16,33.26,,,0 HCPCS,76019,Mr safety implt pos&/immoblj,,,57.61,144.03,4 HCPCS,76080,"Hc X-Ray Fistula,Abscess,Sinus Tract - Ir Abscessogram W/ Contrast",1042.72,417.09,,,0 HCPCS,76080,"Hc X-Ray Fistula,Abscess,Sinus Tract - Ir Diagnostic Sinogram Chg",1042.72,417.09,,,0 HCPCS,76080,X-ray exam of fistula,,,533.63,1334.08,4 HCPCS,76098,"Hc X-Ray Exam, Breast Specimen - Mammo Breast Specimen",594.0,237.6,,,0 HCPCS,76098,X-ray exam breast specimen,,,533.63,1334.08,4 HCPCS,76100,X-ray exam of body section,,,102.1,255.25,4 HCPCS,76120,Cine/video x-rays,,,102.1,255.25,4 HCPCS,76120,Hc Cineradiograpy/Videoradiography X-Rays,651.84,260.74,,,0 HCPCS,76125,Hc Cine/Videoradiography Add On,496.16,198.46,,,0 HCPCS,76145,Med physic dos eval rad exps,,,364.43,911.07,4 HCPCS,76376,Hc 3D Rendering W/Interpretation & Postprocess Supervision - Ct 3D Reconstruction,1165.64,466.26,,,0 HCPCS,76377,Hc 3D Render W/Intrp Postproces - 3D Rendering On An Indep Workstation,1201.7,480.68,,,0 HCPCS,76377,Hc 3D Rendering W/Interpretation And Postprocedure Diff Work Station - Echo 3D Reconstruction,1201.7,480.68,,,0 HCPCS,76377,Hc Ct 3D Rendering W/Interpretation And Postprocedure Diff Work Station,1201.7,480.68,,,0 HCPCS,76380,CAT scan follow-up study,,,84.99,212.47,4 HCPCS,76380,"Hc Ct Scan,Limited/Localized F/U Study - Ct Limited Follow Up",939.96,375.98,,,0 HCPCS,76390,Hc Mri Spectroscopy - Mr Spectroscopy,1490.9,596.36,,,0 HCPCS,76390,Mr spectroscopy,,,84.99,212.47,4 HCPCS,76391,Hc Mr Elastography,736.26,294.5,,,0 HCPCS,76391,Mr elastography,,,233.02,582.55,4 HCPCS,76496,Fluoroscopic procedure,,,84.99,212.47,4 HCPCS,76496,Hc Hepatic Pressures Without Venogram,5185.0,2074.0,,,0 HCPCS,76497,Ct procedure,,,84.99,212.47,4 HCPCS,76498,Hc Whole Body Mri-Unlist Proc,2655.59,1062.24,,,0 HCPCS,76498,Mri procedure,,,84.99,212.47,4 HCPCS,76499,Hc Res Whole Body Bmd,1138.96,455.58,,,0 HCPCS,76499,Radiographic procedure,,,84.99,212.47,4 HCPCS,76506,Echo exam of head,,,102.1,255.25,4 HCPCS,76506,"Hc Us, Head, Real Time - Us Head",1030.32,412.13,,,0 HCPCS,76510,Ophth us b & quant a,,,129.94,324.84,4 HCPCS,76511,Ophth us quant a only,,,102.1,255.25,4 HCPCS,76512,"Hc Chg Us, Eye B-Scan - B Scan Ultrasound-Ou-Both Eyes Poct-Bilateral",345.44,138.18,,,0 HCPCS,76512,Ophth us b w/non-quant a,,,102.1,255.25,4 HCPCS,76513,Echo exam of eye water bath,,,102.1,255.25,4 HCPCS,76513,"Hc Us, Eye,Anterior - Us Eye Anterior",722.88,289.15,,,0 HCPCS,76514,Echo exam of eye thickness,,,28.25,70.62,4 HCPCS,76514,"Hc Us, Eye, For Corneal Thickness - Us Exam Of Eye Thickness",73.89,29.56,,,0 HCPCS,76516,Echo exam of eye,,,102.1,255.25,4 HCPCS,76516,"Hc Us, Eye Biometry - Us Eye Biometry",423.02,169.21,,,0 HCPCS,76519,Echo exam of eye,,,102.1,255.25,4 HCPCS,76519,Hc Echo Exam Of Eye - Us Eye Biometry W Intraocular Lens Calculation,696.1,278.44,,,0 HCPCS,76529,Echo exam of eye,,,84.99,212.47,4 HCPCS,76529,"Hc Us, Eye F.B. Localization - Us Eye Foreign Body Localization",236.29,94.52,,,0 HCPCS,76536,Hc Poct Us Soft Tissue Head/Neck,333.44,133.38,,,0 HCPCS,76536,"Hc Us, Head/Neck Tissues,Real Time - Us Head Neck Soft Tissue",1119.08,447.63,,,0 HCPCS,76536,"Hc Us, Head/Neck Tissues,Real Time - Us Thyroid",1119.08,447.63,,,0 HCPCS,76536,Us exam of head and neck,,,102.1,255.25,4 HCPCS,76604,"Hc Chg Us, Chest,Real Time",810.82,324.33,,,0 HCPCS,76604,"Hc Poct Us Charge Us, Chest,Real Time",242.29,96.92,,,0 HCPCS,76604,Us exam chest,,,102.1,255.25,4 HCPCS,76641,Hc Ultrasound Breast Complete - Unilateral,953.55,381.42,,,0 HCPCS,76641,Ultrasound breast complete,,,102.1,255.25,4 HCPCS,76642,Hc Ultrasound Breast Limited - Us Breast Bilateral Limited,1370.96,548.38,,,0 HCPCS,76642,Hc Ultrasound Breast Limited - Us Breast Limited,913.97,365.59,,,0 HCPCS,76642,Hc Ultrasound Breast Limited - Us Breast Right Limited,913.97,365.59,,,0 HCPCS,76642,Ultrasound breast limited,,,84.99,212.47,4 HCPCS,76700,"Hc Us, Abdomen,B-Scan &/Or Real Time,Complete - Us Abdomen",1787.16,714.86,,,0 HCPCS,76700,Us exam abdom complete,,,102.1,255.25,4 HCPCS,76705,Echo exam of abdomen,,,102.1,255.25,4 HCPCS,76705,"Hc Chg Us, Abdomen Limited",1379.35,551.74,,,0 HCPCS,76705,Hc Poct Us Soft Tissue-Abd/Back,365.83,146.33,,,0 HCPCS,76705,"Hc Us, Abdomen Limited - Us Abdomen Limited",1379.35,551.74,,,0 HCPCS,76705,"Hc Us, Abdomen Limited - Us Abdomen Limited Liver",1379.35,551.74,,,0 HCPCS,76705,"Hc Us, Abdomen Limited - Us Abdomen Limited Liver-Poct",1379.35,551.74,,,0 HCPCS,76705,"Hc Us, Abdomen Limited - Us Gallbladder",1379.35,551.74,,,0 HCPCS,76706,Hc Us Abdl Aorta Screen Aaa - Us Abdomen Aortic Aneurysm Screening,454.59,181.84,,,0 HCPCS,76706,Hc Us Abdominal Aorta Aneurysm Screening Poct,454.59,181.84,,,0 HCPCS,76706,Us abdl aorta screen aaa,,,102.1,255.25,4 HCPCS,76770,"Hc Us,Retroperit, B-Scan/Real Time,Complete - Us Renal Complete",1427.33,570.93,,,0 HCPCS,76770,"Hc Us,Retroperit, B-Scan/Real Time,Complete - Us Retroperitoneum",1427.33,570.93,,,0 HCPCS,76770,Us exam abdo back wall comp,,,102.1,255.25,4 HCPCS,76775,"Hc Chg Us, Retroperitional Abdominal, Limited",1163.45,465.38,,,0 HCPCS,76775,Hc Ultrasound Retroperitional Abdominal-Limited-Poct,363.43,145.37,,,0 HCPCS,76775,Us exam abdo back wall lim,,,102.1,255.25,4 HCPCS,76776,"Hc Us,Transplanted Kidney, Real Time/ Doppler - Us Kidney Transplant",1355.36,542.14,,,0 HCPCS,76776,Us exam k transpl w/doppler,,,102.1,255.25,4 HCPCS,76800,"Hc Us, Spinal Canal & Contents - Us Spinal Canal And Contents",953.55,381.42,,,0 HCPCS,76800,Us exam spinal canal,,,102.1,255.25,4 HCPCS,76801,Hc Ultrasound Ob < 14 Weeks-Single Fetus,929.56,371.82,,,0 HCPCS,76801,Ob us < 14 wks single fetus,,,102.1,255.25,4 HCPCS,76802,"Hc Chg Us, Ob < 14 Weeks, Additional Fetus",648.9,259.56,,,0 HCPCS,76805,Hc Ultrasound Ob >/= 14 Weeks-Single Fetus,1294.19,517.68,,,0 HCPCS,76805,Ob us >/= 14 wks sngl fetus,,,102.1,255.25,4 HCPCS,76810,Hc Ultrasound Ob >/= 14 Weeks-Additional Fetus,1095.09,438.04,,,0 HCPCS,76811,Hc Ob Us Detailed Sngle Fetus - Us Ob Detail Fetal Anat Single Or 1St Gestation,1411.74,564.7,,,0 HCPCS,76811,Ob us detailed sngl fetus,,,233.02,582.55,4 HCPCS,76812,Hc Ob Us Detailed Additional Fetus - Us Ob Detail Fetal Anat Each Additional Gestation,874.39,349.76,,,0 HCPCS,76813,"Hc Us,Preg Uter,Nuchal Meas, 1St Trimest, Singleton",788.03,315.21,,,0 HCPCS,76813,Ob us nuchal meas 1 gest,,,102.1,255.25,4 HCPCS,76814,"Hc Us,Preg Uter,Nuchal Meas, 1St Tri,Addl Gest",484.57,193.83,,,0 HCPCS,76815,Hc Poct Us Ed Pregnancy (Ta),284.27,113.71,,,0 HCPCS,76815,Hc Ultrasound Pregnant Uterus-Limited 1/> Fetuses,924.77,369.91,,,0 HCPCS,76815,Ob us limited fetus(s),,,102.1,255.25,4 HCPCS,76816,Hc Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach,916.37,366.55,,,0 HCPCS,76816,Ob us follow-up per fetus,,,102.1,255.25,4 HCPCS,76817,"Hc Chg Us,Pregnant Uterus,Transvaginal-Poct",284.27,113.71,,,0 HCPCS,76817,Hc Ultrasound Pregnant Uterus-Transvaginal,848.0,339.2,,,0 HCPCS,76817,Transvaginal us obstetric,,,102.1,255.25,4 HCPCS,76818,Fetal biophys profile w/nst,,,102.1,255.25,4 HCPCS,76818,Hc Fetal Biophysical Profile,1192.24,476.9,,,0 HCPCS,76819,Fetal biophys profil w/o nst,,,102.1,255.25,4 HCPCS,76819,Hc Fetal Biophysical Profile Wo Non-Stress Testing,1043.51,417.4,,,0 HCPCS,76820,Hc Doppler Fetal Umbilical Artery,655.82,262.33,,,0 HCPCS,76820,Umbilical artery echo,,,102.1,255.25,4 HCPCS,76821,Hc Doppler Fetal Mid Cerebral Artery,698.1,279.24,,,0 HCPCS,76821,Middle cerebral artery echo,,,102.1,255.25,4 HCPCS,76825,Echo exam of fetal heart,,,533.63,2978.0,8 HCPCS,76825,Hc Sono Fetal Heart,1878.32,751.33,,,0 HCPCS,76826,Echo exam of fetal heart,,,233.02,2978.0,8 HCPCS,76826,Hc Sono Fetal Heart F/U,1163.45,465.38,,,0 HCPCS,76827,Echo exam of fetal heart,,,102.1,255.25,4 HCPCS,76827,Hc Sono Fetal Heart Doppler,1030.32,412.13,,,0 HCPCS,76828,Echo exam of fetal heart,,,102.1,255.25,4 HCPCS,76828,Hc Sono Fetal Hrt Doppl F/U,566.13,226.45,,,0 HCPCS,76830,"Hc Chg Echography,Transvaginal-Poct",357.43,142.97,,,0 HCPCS,76830,Hc Echography Transvaginal,1174.25,469.7,,,0 HCPCS,76830,Transvaginal us non-ob,,,102.1,255.25,4 HCPCS,76831,Echo exam uterus,,,233.02,582.55,4 HCPCS,76856,"Hc Echo,Pelvic (Nonobstetric) - Us Pelvis",1459.72,583.89,,,0 HCPCS,76856,Us exam pelvic complete,,,102.1,255.25,4 HCPCS,76857,Hc Sono Pelvis Limited,1085.49,434.2,,,0 HCPCS,76857,Hc Sono Pelvis Limited - Us Pelvis Limited,1085.49,434.2,,,0 HCPCS,76857,Hc Sono Pelvis Limited - Us Pelvis Limited Follicles,365.83,146.33,,,0 HCPCS,76857,Us exam pelvic limited,,,102.1,255.25,4 HCPCS,76870,"Hc Chg Echo, Scrotum & Contents Poct",1254.61,501.84,,,0 HCPCS,76870,"Hc Chg Echo,Scrotum & Contents",1254.61,501.84,,,0 HCPCS,76870,Us exam scrotum,,,102.1,255.25,4 HCPCS,76872,"Hc Echo,Transrectal - Us Transrectal",960.75,384.3,,,0 HCPCS,76872,Us transrectal,,,102.1,255.25,4 HCPCS,76873,Echograp trans r pros study,,,102.1,255.25,4 HCPCS,76873,"Hc Echo,Transrectal,Prostate Vol - Us Prostate Transrectal Volume",1499.3,599.72,,,0 HCPCS,76881,Hc Us Extremity/Nonvascular Complete,1111.88,444.75,,,0 HCPCS,76881,Us xtr non-vasc complete,,,102.1,255.25,4 HCPCS,76882,"Hc Poct Us Extremity Limited,Joint,Focal",248.28,99.31,,,0 HCPCS,76882,Hc Ultrasound Extremity-Arm Or Leg,930.76,372.3,,,0 HCPCS,76882,Us xtr non-vasc lmtd,,,102.1,255.25,4 HCPCS,76883,Hc Us Length Of Nerves In Extremity,225.0,90.0,,,0 HCPCS,76883,Us nrv&acc strux 1xtr compre,,,102.1,255.25,4 HCPCS,76885,Hc Us Exam Infant Hips Dynamic - Us Hip Pediatric Lmtd Bil Manipulation,1048.31,419.32,,,0 HCPCS,76885,Hc Us Exam Infant Hips Dynamic - Xr Infant Hips With Manipulation,1048.31,419.32,,,0 HCPCS,76885,Us exam infant hips dynamic,,,84.99,212.47,4 HCPCS,76886,Hc Us Exam Infant Hips Static - Xr Infant Hips Without Manipulation,755.65,302.26,,,0 HCPCS,76886,Us exam infant hips static,,,84.99,212.47,4 HCPCS,76930,Hc Sono Guide Pericard Tap - Us Guided Pericardiocentesis,1125.07,450.03,,,0 HCPCS,76936,Echo guide for artery repair,,,210.87,527.18,4 HCPCS,76937,"Hc Chg Us Guide, Vascular Access",959.55,383.82,,,0 HCPCS,76937,"Hc Us Guide, Vascular Access",248.28,99.31,,,0 HCPCS,76940,"Hc Us Guide, Tissue Ablation - Us Guided Cryoablation Liver Chg",880.0,352.0,,,0 HCPCS,76941,Hc Sono Guide Intrauter Xfusn,693.28,277.31,,,0 HCPCS,76942,Hc Chg Sono Guide Needle Biopsy-Ir,1428.53,571.41,,,0 HCPCS,76942,Hc Echo Guide For Biopsy - Fl Guided Needle Biopsy Bone,1428.53,571.41,,,0 HCPCS,76942,Hc Echo Guide For Biopsy - Fl Guided Needle Biopsy Bone Deep,1428.53,571.41,,,0 HCPCS,76942,Hc Echo Guide For Biopsy - Ir Paracentesis Charge,1428.53,571.41,,,0 HCPCS,76942,Hc Echo Guide For Biopsy - Ir Thoracentesis Charge,1428.53,571.41,,,0 HCPCS,76942,Hc Echo Guide For Biopsy - Us Guidance Needle Placement,1958.0,783.2,,,0 HCPCS,76942,"Hc Echo Guide For Biopsy - Us Guided Aspirat Of Abscess, Hematoma, Cyst",1428.53,571.41,,,0 HCPCS,76942,Hc Echo Guide For Biopsy - Us Guided Biopsy Lymph Node Superficial,1428.53,571.41,,,0 HCPCS,76942,Hc Echo Guide For Biopsy - Us Guided Needle Liver Biopsy,1428.53,571.41,,,0 HCPCS,76942,Hc Echo Guide For Biopsy - Us Guided Percutaneous Biopsy Renal Left,1428.53,571.41,,,0 HCPCS,76942,Hc Echo Guide For Biopsy - Us Guided Percutaneous Biopsy Renal Right,1428.53,571.41,,,0 HCPCS,76942,Hc Echo Guide For Biopsy - Us Guided Soft Tissue Biopsy,1428.53,571.41,,,0 HCPCS,76942,Hc Echo Guide For Biopsy - Us Guided Thyroid Biopsy,1428.53,571.41,,,0 HCPCS,76942,Hc Poct Us Guidance Needle Placement,333.44,133.38,,,0 HCPCS,76942,Hc Sono Guide Needle Biopsy,1428.53,571.41,,,0 HCPCS,76945,Hc Sono Guide Chor Vill Sampling - Us Guidance Chorionic Villus Sample,503.76,201.5,,,0 HCPCS,76946,Hc Sono Guide Amniocentesis,567.33,226.93,,,0 HCPCS,76965,Hc Sono Guide Radioelemt Applic - Us Guide Interstitial Radioelmnt Appl,1649.23,659.69,,,0 HCPCS,76975,GI endoscopic ultrasound,,,233.02,582.55,4 HCPCS,76977,Us bone density measure,,,102.1,255.25,4 HCPCS,76978,"Hc Us Of Growth Using Contrast, 1St Lesion",933.16,373.26,,,0 HCPCS,76978,Us trgt dyn mbubb 1st les,,,340.71,851.78,4 HCPCS,76979,"Hc Us Of Growth Using Contrast, Each Additional Lesion",473.78,189.51,,,0 HCPCS,76981,Hc Us Elastography Parenchyma,467.78,187.11,,,0 HCPCS,76981,Use parenchyma,,,102.1,255.25,4 HCPCS,76982,Hc Us Elastography First Target Lesion,443.36,177.34,,,0 HCPCS,76982,Use 1st target lesion,,,102.1,255.25,4 HCPCS,76983,Hc Ultrasound Elastography Ea Additional Target Lesion,133.87,53.55,,,0 HCPCS,76998,"Hc Ultrasonic Guidance, Intraoperative - Us Intraoperative",1529.28,611.71,,,0 HCPCS,76999,Echo examination procedure,,,84.99,212.47,4 HCPCS,76999,Hc Jugular/Sc Us,368.23,147.29,,,0 HCPCS,77001,Hc Fluoroguide For Vein Device - Fl Guided Venous Access,1284.14,513.66,,,0 HCPCS,77002,Hc Fluoroguide Needle Placement-Biopsy/Aspiration/Injection,1297.02,518.81,,,0 HCPCS,77002,Hc Needle Localization By Xray - Fl Guided Aspir Or Inj Inter Joint Rt,1297.02,518.81,,,0 HCPCS,77002,Hc Needle Localization By Xray - Fl Guided Aspiration Ankle Left,1297.02,518.81,,,0 HCPCS,77002,Hc Needle Localization By Xray - Fl Guided Aspiration Hip Left,1297.02,518.81,,,0 HCPCS,77002,Hc Needle Localization By Xray - Fl Guided Fine Needle Aspiration Chg,1297.02,518.81,,,0 HCPCS,77002,Hc Needle Localization By Xray - Fl Guided Needle Placement,1297.02,518.81,,,0 HCPCS,77002,Hc Needle Localization By Xray - Us Guided Perc Needle Biopsy Muscle,1297.02,518.81,,,0 HCPCS,77003,Hc Fluorscopic Guidance Spinal Injection,1564.92,625.97,,,0 HCPCS,77003,Hc Fluorscopic Guidance Spinal Injection - Ir Disc Aspiration Charge,1564.92,625.97,,,0 HCPCS,77012,Hc Ct Guidance Needle Placement,2000.24,800.1,,,0 HCPCS,77013,Hc Ct Guidance Tissue Ablation,1899.45,759.78,,,0 HCPCS,77014,Hc Conebeam Ct Gde Therapy Plcm,1775.02,710.01,,,0 HCPCS,77046,Hc Mri Breast Without Contrast Unilateral,1784.0,713.6,,,0 HCPCS,77046,Mri breast c- unilateral,,,233.02,582.55,4 HCPCS,77047,Hc Mri Breast Without Contrast Bilateral,2858.89,1143.56,,,0 HCPCS,77047,Mri breast c- bilateral,,,233.02,582.55,4 HCPCS,77048,Hc Mri Breast With Contrast Unilateral,2652.0,1060.8,,,0 HCPCS,77048,Hc Mri Breast With And Without Contrast Unilateral,2027.2,810.88,,,0 HCPCS,77049,Hc Mri Breast With And Without Contrast Bilateral,3602.0,1440.8,,,0 HCPCS,77049,Hc Mri Breast With Contrast Bilateral,3118.0,1247.2,,,0 HCPCS,77053,X-Ray of Mammary Duct,,,233.02,582.55,4 HCPCS,77054,X-ray of mammary ducts,,,233.02,582.55,4 HCPCS,77061,Hc Mammogram Breast Diagnostic Tomosynthesis-Unilateral,128.0,51.2,,,0 HCPCS,77062,Hc Mammogram Breast Diagnostic Tomosynthesis-Bilateral,192.0,76.8,,,0 HCPCS,77063,Breast tomosynthesis bi,,,20.79,51.98,4 HCPCS,77063,Hc Mammogram Breast Screening Tomosynthesis Bilateral,122.0,48.8,,,0 HCPCS,77063,Hc Mammogram Breast Screening Tomosynthesis Limited,91.5,36.6,,,0 HCPCS,77063,Hc Mammogram Breast Screening Tomosynthesis-Bilateral,122.0,48.8,,,0 HCPCS,77065,Dx mammo incl cad uni,,,76.62,191.55,4 HCPCS,77065,"Hc Dx Mammogram Including Cad - Mammogram Diagnostic,Additional,Post Views",518.0,207.2,,,0 HCPCS,77065,"Hc Dx Mammogram Including Cad - Mammogram Diagnostic,Additional,Post Views-Unilateral",518.0,207.2,,,0 HCPCS,77065,Hc Dx Mammogram Including Cad- Mammogram Breast Post Biopsy Clip-Unilateral,518.0,207.2,,,0 HCPCS,77065,Hc Dx Mammogram Including Cad-Unilateral,518.0,207.2,,,0 HCPCS,77066,Dx mammo incl cad bi,,,98.3,245.75,4 HCPCS,77066,Hc Dx Mammogram Including Cad Bilateral - Mammogram Breast Bilateral Post Biopsy Clip,576.0,230.4,,,0 HCPCS,77066,Hc Dx Mammogram Including Cad Bilateral - Mammogram Breast Diagnostic Bilateral,576.0,230.4,,,0 HCPCS,77067,Hc Scr Mammo Bi Incl Cad - Mammo Breast Screening Bilateral,348.0,139.2,,,0 HCPCS,77067,Hc Screening Mammogram Including Cad - Mammogram Breast Screening,348.0,139.2,,,0 HCPCS,77067,Hc Screening Mammogram Including Cad Limited,261.0,104.4,,,0 HCPCS,77067,Scr mammo bi incl cad,,,81.07,202.68,4 HCPCS,77071,Hc Manual Appl Stress Pfrmd Phys/Qhp Joint Films,267.54,107.02,,,0 HCPCS,77071,X-Ray Stress View,,,84.99,212.47,4 HCPCS,77072,Hc X-Rays For Bone Age - Xr Bone Age Extended,627.01,250.8,,,0 HCPCS,77072,Hc X-Rays For Bone Age - Xr Bone Age Hand Wrist,627.01,250.8,,,0 HCPCS,77072,X-Rays for Bone Age,,,102.1,255.25,4 HCPCS,77073,"Hc X-Rays, Bone Length Studies - Xr Lower Extremity Leg Length Eval",665.42,266.17,,,0 HCPCS,77073,X-rays bone length studies,,,102.1,255.25,4 HCPCS,77074,"Hc X-Rays, Bone Survey, Limited - Xr Bone Survey Limited",1115.45,446.18,,,0 HCPCS,77074,X-rays bone survey limited,,,102.1,255.25,4 HCPCS,77075,"Hc X-Rays, Bone Survey Complete - Xr Bone Survey Complete",1372.01,548.8,,,0 HCPCS,77075,X-rays bone survey complete,,,102.1,255.25,4 HCPCS,77076,"Hc X-Rays, Bone Survey, Infant - Xr Bone Survey Infant",1299.3,519.72,,,0 HCPCS,77076,X-rays bone survey infant,,,102.1,255.25,4 HCPCS,77077,"Hc Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints",519.99,208.0,,,0 HCPCS,77077,Joint survey single view,,,102.1,255.25,4 HCPCS,77078,Ct bone density axial,,,84.99,212.47,4 HCPCS,77078,Hc Ct Bmd 1 0R > Site Axial Skeleton,683.89,273.56,,,0 HCPCS,77080,Dxa bone density axial,,,102.1,255.25,4 HCPCS,77080,Hc Dxa Bone Density Axial - Dexa Bone Density,996.08,398.43,,,0 HCPCS,77081,Dxa bone density/peripheral,,,84.99,212.47,4 HCPCS,77081,Hc Dxa Bone Density/Peripheral - Dexa Bone Density Extremity,850.65,340.26,,,0 HCPCS,77084,Magnetic image bone marrow,,,233.02,582.55,4 HCPCS,77085,Dxa bone density study,,,102.1,255.25,4 HCPCS,77085,Hc Dxa Bone Density Study - Dexa Bone Density Axial Skeleton W Vfa,708.4,283.36,,,0 HCPCS,77086,Fracture assessment via dxa,,,84.99,212.47,4 HCPCS,77086,Hc Fracture Assessment Via Dxa - Dexa Bone Density Spine Fracture,322.0,128.8,,,0 HCPCS,77089,Hc Tbs Dxa/Other Img Calculation W/I&R Fx Risk,125.0,50.0,,,0 HCPCS,77090,Tbs techl prep&transmis data,,,84.99,212.47,4 HCPCS,77091,Hc Trabecular Bone Score (Tbs),95.0,38.0,,,0 HCPCS,77091,Tbs techl calculation only,,,84.99,212.47,4 HCPCS,77280,Hc Stimulated Treat Set-Up-Simple,1402.0,560.8,,,0 HCPCS,77280,Set radiation therapy field,,,131.26,328.16,4 HCPCS,77285,Set radiation therapy field,,,365.67,914.17,4 HCPCS,77290,Hc Grid Simulation Complex,2808.0,1123.2,,,0 HCPCS,77290,Set radiation therapy field,,,365.67,914.17,4 HCPCS,77293,Hc Respiratory Motion Management,2528.04,1011.22,,,0 HCPCS,77295,3-d radiotherapy plan,,,1351.75,3379.37,4 HCPCS,77295,Hc 3D Reconstruction Of Tumor,10280.0,4112.0,,,0 HCPCS,77295,Hc Gk 3-D Reconstruction Of Tumor,10280.0,4112.0,,,0 HCPCS,77299,Radiation therapy planning,,,131.26,328.16,4 HCPCS,77300,Hc Radiation Therapy Dose Plan - Nm Therapy Sir Spheres,927.0,370.8,,,0 HCPCS,77300,Radiation therapy dose plan,,,131.26,328.16,4 HCPCS,77301,Hc Imrt Plan,8503.0,3401.2,,,0 HCPCS,77301,Radiotherapy dose plan imrt,,,1351.75,3379.37,4 HCPCS,77306,Hc Teletx Isodose Smpl W/Calc,2721.0,1088.4,,,0 HCPCS,77306,Telethx isodose plan simple,,,365.67,914.17,4 HCPCS,77307,Hc Teletx Isodose Cmplx W/Calc,4611.0,1844.4,,,0 HCPCS,77307,Telethx isodose plan cplx,,,365.67,914.17,4 HCPCS,77316,Brachytx isodose plan simple,,,365.67,914.17,4 HCPCS,77316,Hc Brachytherapy Isodose Simple W Calculations,1866.0,746.4,,,0 HCPCS,77317,Brachytx isodose intermed,,,365.67,914.17,4 HCPCS,77317,Hc Brachytherapy Isodose Intermediate W Calculations,2330.0,932.0,,,0 HCPCS,77318,Brachytx isodose complex,,,365.67,914.17,4 HCPCS,77318,Hc Brachytherapy Isodose Complex W Calculations,2914.0,1165.6,,,0 HCPCS,77321,Hc Special Therapy Port Plan,1851.0,740.4,,,0 HCPCS,77321,Special teletx port plan,,,365.67,914.17,4 HCPCS,77331,Hc Special Dosimetry,851.0,340.4,,,0 HCPCS,77331,Special radiation dosimetry,,,131.26,328.16,4 HCPCS,77332,Hc Treatment Device Simple,901.0,360.4,,,0 HCPCS,77332,Radiation treatment aid(s),,,131.26,328.16,4 HCPCS,77333,Hc Custom Fab Single Piece Unit,1173.0,469.2,,,0 HCPCS,77333,Radiation treatment aid(s),,,131.26,328.16,4 HCPCS,77334,Hc Complx Treatment Devc,1949.0,779.6,,,0 HCPCS,77334,Hc Gk Complx Treatment Devc,1949.0,779.6,,,0 HCPCS,77334,Radiation treatment aid(s),,,365.67,914.17,4 HCPCS,77336,Hc Continuing Physics Consult,1037.0,414.8,,,0 HCPCS,77336,Radiation physics consult,,,131.26,328.16,4 HCPCS,77338,Design mlc device for imrt,,,365.67,914.17,4 HCPCS,77338,Hc Mlc Device For Imrt,3657.0,1462.8,,,0 HCPCS,77370,Hc Special Med Physics Consult,1282.0,512.8,,,0 HCPCS,77370,Radiation physics consult,,,131.26,328.16,4 HCPCS,77371,Hc Msradiosurg Std Delivery,79422.0,31768.8,,,0 HCPCS,77371,Srs multisource,,,7192.98,17982.44,4 HCPCS,77372,"Hc Single Fx Srs, Cranial Lesion, Linear Accelerator Based",22400.0,8960.0,,,0 HCPCS,77372,Srs linear based,,,7192.98,17982.44,4 HCPCS,77373,Hc Stereotactic Body Tx Del,9659.0,3863.6,,,0 HCPCS,77373,SBRT Delivery,,,1746.22,4365.55,4 HCPCS,77385,Hc Halcyon Breast/Prostat Simple,4028.0,1611.2,,,0 HCPCS,77385,Hc Imrt Breast/Prostat Simple,4028.0,1611.2,,,0 HCPCS,77386,Hc Halcyon All Other Sites,4198.0,1679.2,,,0 HCPCS,77386,Hc Imrt All Other Sites,4198.0,1679.2,,,0 HCPCS,77387,Hc Guidance For Radiaj Tx Dlvr - Us Guidance Radiation Therapy Fields,818.0,327.2,,,0 HCPCS,77399,External radiation dosimetry,,,131.26,328.16,4 HCPCS,77402,Hc Rad Tx Del >= 1 Mev Smpl,1500.0,600.0,,,0 HCPCS,77407,Hc Rad Tx Del >= 1 Mev Interm,1758.0,703.2,,,0 HCPCS,77407,Radiation treatment delivery,,,376.67,941.68,4 HCPCS,77412,Hc Grid Tx Del > 1 Mev Cmplx,2235.0,894.0,,,0 HCPCS,77412,Hc Rad Tx Del > 1 Mev Cmplx,2235.0,894.0,,,0 HCPCS,77412,Radiation treatment delivery,,,539.62,1349.04,4 HCPCS,77417,Hc Radiographic Beam One Plane,551.0,220.4,,,0 HCPCS,77423,Neutron beam tx complex,,,539.62,1349.04,4 HCPCS,77424,Io rad tx delivery by x-ray,,,7192.98,17982.44,4 HCPCS,77425,Io rad tx deliver by elctrns,,,7192.98,17982.44,4 HCPCS,77436,Surf radj ther tx planning,,,36.48,91.19,4 HCPCS,77470,Hc Spec Tx Proc Imrt,4423.0,1769.2,,,0 HCPCS,77470,Hc Spec Tx Proc Tbi,4423.0,1769.2,,,0 HCPCS,77470,Special radiation treatment,,,539.62,1349.04,4 HCPCS,77520,Proton trmt simple w/o comp,,,539.62,1349.04,4 HCPCS,77600,Hyperthermia treatment,,,376.67,941.68,4 HCPCS,77605,Hyperthermia treatment,,,680.18,1700.45,4 HCPCS,77610,Hyperthermia treatment,,,539.62,1349.04,4 HCPCS,77615,Hyperthermia treatment,,,539.62,1349.04,4 HCPCS,77620,Hyperthermia treatment,,,539.62,1349.04,4 HCPCS,77750,Infuse radioactive materials,,,376.67,941.68,4 HCPCS,77761,Apply intrcav radiat simple,,,539.62,1349.04,4 HCPCS,77762,Apply intrcav radiat interm,,,539.62,1349.04,4 HCPCS,77763,Apply intrcav radiat compl,,,680.18,1700.45,4 HCPCS,77763,Hc Intracav Rad App-Complex,3064.0,1225.6,,,0 HCPCS,77767,Hdr rdncl skn surf brachytx,,,376.67,941.68,4 HCPCS,77768,Hdr rdncl skn surf brachytx,,,376.67,941.68,4 HCPCS,77770,Hc Hdr Brachytx 1 Channel W/Cadd,4523.0,1809.2,,,0 HCPCS,77770,Hdr rdncl ntrstl/icav brchtx,,,680.18,1700.45,4 HCPCS,77771,Hc Hdr Brachytx 2-12 Chnl W/Cadd,8190.0,3276.0,,,0 HCPCS,77771,Hdr rdncl ntrstl/icav brchtx,,,680.18,1700.45,4 HCPCS,77772,Hdr rdncl ntrstl/icav brchtx,,,680.18,1700.45,4 HCPCS,77778,Apply interstit radiat compl,,,680.18,1700.45,4 HCPCS,77778,Hc Interstitial Application Compl,5642.0,2256.8,,,0 HCPCS,77790,Hc Supervise Loading Of Rad Elem,774.0,309.6,,,0 HCPCS,77790,Hc Supervision Rad Source Hndlng,774.0,309.6,,,0 HCPCS,77799,Hc Unlist Interst App->10 Sources,1911.0,764.4,,,0 HCPCS,78012,Hc Thyroid Uptake Measurement - Nm Thyroid Uptake,1943.2,777.28,,,0 HCPCS,78012,Thyroid uptake measurement,,,390.42,976.05,4 HCPCS,78013,Hc Thyroid Imaging W/Blood Flow - Nm Thyroid Scan,2318.4,927.36,,,0 HCPCS,78013,Thyroid imaging w/blood flow,,,390.42,976.05,4 HCPCS,78014,Hc Thyroid Imaging W/Blood Flow - Nm Thyroid Uptake Stimulation Suppres,3199.84,1279.94,,,0 HCPCS,78014,Thyroid imaging w/blood flow,,,390.42,976.05,4 HCPCS,78015,Hc Thyroid Met Imaging - Nm Thyroid Tumor Metastases Limited,1680.0,672.0,,,0 HCPCS,78015,Thyroid met imaging,,,390.42,976.05,4 HCPCS,78016,Thyroid met imaging/studies,,,390.42,976.05,4 HCPCS,78018,Hc Thyroid Met Imaging Body - Nm Thyroid Whole Body Tumor,3039.68,1215.87,,,0 HCPCS,78018,Thyroid met imaging body,,,530.27,1325.67,4 HCPCS,78070,Hc Parathyroid Planar Imaging - Nm Parathyroid,2740.64,1096.26,,,0 HCPCS,78070,Parathyroid planar imaging,,,390.42,976.05,4 HCPCS,78071,Hc Parathyroid Planar Imaging W/Wo Subtraction - Nm Parathyroid Spect,4564.0,1825.6,,,0 HCPCS,78071,Parathyrd planar w/wo subtrj,,,390.42,976.05,4 HCPCS,78072,Hc Parathyrd Planar W/Spect&Ct - Nm/Ct Parathyroid Spect,3479.84,1391.94,,,0 HCPCS,78072,Parathyrd planar w/spect&ct,,,530.27,1325.67,4 HCPCS,78075,Adrenal cortex & medulla img,,,1264.36,3160.9,4 HCPCS,78075,Hc Nm Adrenal Nuclear Imaging,3928.96,1571.58,,,0 HCPCS,78099,Endocrine nuclear procedure,,,390.42,976.05,4 HCPCS,78102,Bone marrow imaging ltd,,,390.42,976.05,4 HCPCS,78102,Hc Nm Bone Marrow Limited,1683.36,673.34,,,0 HCPCS,78103,Bone marrow imaging mult,,,390.42,976.05,4 HCPCS,78103,"Hc Bone Marrow Imaging, Mult - Nm Bone Marrow Multiple Areas",1085.18,434.07,,,0 HCPCS,78104,Bone marrow imaging body,,,390.42,976.05,4 HCPCS,78104,Hc Nm Bone Marrow Whole Body,2154.88,861.95,,,0 HCPCS,78110,Plasma volume single,,,1264.36,3160.9,4 HCPCS,78111,Plasma volume multiple,,,1264.36,3160.9,4 HCPCS,78120,Red cell mass single,,,390.42,976.05,4 HCPCS,78121,Red cell mass multiple,,,530.27,1325.67,4 HCPCS,78122,Blood volume,,,530.27,1325.67,4 HCPCS,78130,Red cell survival study,,,390.42,976.05,4 HCPCS,78140,Red cell sequestration,,,390.42,976.05,4 HCPCS,78185,Spleen imaging,,,390.42,976.05,4 HCPCS,78191,Platelet survival,,,390.42,976.05,4 HCPCS,78195,Hc Lymphatics & Lymph Glands Imaging - Nm Lymphoscintigram,2595.04,1038.02,,,0 HCPCS,78195,Lymph system imaging,,,530.27,1325.67,4 HCPCS,78199,Blood/lymph nuclear exam,,,390.42,976.05,4 HCPCS,78201,Hc Liver Imaging - Nm Liver,2126.88,850.75,,,0 HCPCS,78201,Liver imaging,,,530.27,1325.67,4 HCPCS,78202,Hc Liver Imaging With Flow - Nm Liver With Vascular Flow,1675.0,670.0,,,0 HCPCS,78202,Liver imaging with flow,,,530.27,1325.67,4 HCPCS,78215,Hc Liver And Spleen Imaging - Nm Liver Spleen,2136.96,854.78,,,0 HCPCS,78215,Liver and spleen imaging,,,390.42,976.05,4 HCPCS,78216,"Hc Liver & Spleen Image, Flow - Nm Liver Spleen With Vascular Flow",2367.68,947.07,,,0 HCPCS,78216,Liver & spleen image/flow,,,390.42,976.05,4 HCPCS,78226,Hc Hepatobiliary Syst Imaging Including Gallbladder - Nm Liver Function,2783.2,1113.28,,,0 HCPCS,78226,Hepatobiliary system imaging,,,390.42,976.05,4 HCPCS,78227,Hc Hepatobil Syst Image W/Drug - Nm Hepatobiliary,2905.28,1162.11,,,0 HCPCS,78227,Hepatobil syst image w/drug,,,530.27,1325.67,4 HCPCS,78230,Salivary gland imaging,,,390.42,976.05,4 HCPCS,78231,Serial salivary imaging,,,390.42,976.05,4 HCPCS,78232,Salivary gland function exam,,,390.42,976.05,4 HCPCS,78258,Esophageal motility study,,,390.42,976.05,4 HCPCS,78261,Gastric mucosa imaging,,,390.42,976.05,4 HCPCS,78262,Gastroesophageal reflux exam,,,390.42,976.05,4 HCPCS,78264,Gastric emptying imag study,,,390.42,976.05,4 HCPCS,78264,Hc Gastric Emptying Imaging Study - Nm Gastric Emptying Solid,2787.68,1115.07,,,0 HCPCS,78265,Gastric emptying imag study,,,390.42,976.05,4 HCPCS,78266,Gastric emptying imag study,,,530.27,1325.67,4 HCPCS,78267,Breath tst attain/anal c-14,,,11.06,27.65,11 HCPCS,78267,Hc Nm Urea Breath Test Acquirition For Analysis,1879.36,751.74,,,0 HCPCS,78268,Breath test analysis c-14,,,94.41,236.02,11 HCPCS,78278,Acute GI blood loss imaging,,,390.42,976.05,4 HCPCS,78278,Hc Nm Acute Gastrointestinal Blood Loss Imaging,2319.52,927.81,,,0 HCPCS,78282,GI protein loss exam,,,390.42,976.05,4 HCPCS,78290,Hc Nm Bowel Imaging Meckels Diverticulum,1805.44,722.18,,,0 HCPCS,78290,Meckels divert exam,,,390.42,976.05,4 HCPCS,78291,Hc Leveen/Shunt Patency - Nm Abdomen Peritoneal Venous Shunt Patency,1576.96,630.78,,,0 HCPCS,78291,Leveen/shunt patency exam,,,390.42,976.05,4 HCPCS,78299,GI nuclear procedure,,,390.42,976.05,4 HCPCS,78300,Bone imaging limited area,,,390.42,976.05,4 HCPCS,78300,"Hc Bone Imaging, Limited Area - Nm Bone Limited",1984.64,793.86,,,0 HCPCS,78305,Bone imaging multiple areas,,,390.42,976.05,4 HCPCS,78305,Hc Nm Bone Imaging Multiple Areas,2027.2,810.88,,,0 HCPCS,78306,Bone imaging whole body,,,390.42,976.05,4 HCPCS,78306,Hc Nm Bone Imaging Whole Body,3065.44,1226.18,,,0 HCPCS,78315,Bone imaging 3 phase,,,390.42,976.05,4 HCPCS,78315,Hc Nm Bone Imaging Whole Body 3 Phase,3062.08,1224.83,,,0 HCPCS,78399,Musculoskeletal nuclear exam,,,390.42,976.05,4 HCPCS,78414,Non-imaging heart function,,,530.27,2978.0,8 HCPCS,78428,Cardiac shunt imaging,,,390.42,2978.0,8 HCPCS,78429,Myocrd img pet 1 std w/ct,,,1396.49,3491.23,4 HCPCS,78430,Hc Pet/Ct Myocard Perf Single Study,5330.0,2132.0,,,0 HCPCS,78430,Myocrd img pet rst/strs w/ct,,,1396.49,3491.23,4 HCPCS,78431,Hc Pet/Ct Myocard Perf Rest And Stress Study,7403.5,2961.4,,,0 HCPCS,78431,Myocrd img pet rst&strs ct,,,2151.25,5378.13,4 HCPCS,78433,Hc Pet/Ct Myocard Perf & Metabol Eval Dual Tracer,7282.0,2912.8,,,0 HCPCS,78433,Myocrd img pet 2rtracer ct,,,2151.25,5378.13,4 HCPCS,78434,"Hc Pet/Ct Add On Aqmbf, Absolute Quantitation Of Myocard Blood Flow",1028.47,411.39,,,0 HCPCS,78445,Vascular flow imaging,,,390.42,976.05,4 HCPCS,78451,Hc Ht Muscle Image Spect Sing,5800.48,2320.19,,,0 HCPCS,78451,Ht muscle image spect sing,,,1264.36,3160.9,8 HCPCS,78452,Hc Ht Muscle Image Spect Mult,7324.8,2929.92,,,0 HCPCS,78452,Ht muscle image spect mult,,,1264.36,3160.9,8 HCPCS,78453,Ht muscle image planar sing,,,1264.36,3160.9,8 HCPCS,78454,Ht musc image planar mult,,,1264.36,3160.9,8 HCPCS,78456,Acute venous thrombus image,,,1264.36,3160.9,4 HCPCS,78457,Venous thrombosis imaging,,,530.27,1325.67,4 HCPCS,78458,Ven thrombosis images bilat,,,390.42,976.05,4 HCPCS,78459,Hc Heart Muscle Imaging (Pet) - Nm Pet Myocardial Metabolic Evaluation,7142.24,2856.9,,,0 HCPCS,78459,Heart muscle imaging (PET),,,1264.36,3160.9,4 HCPCS,78466,Heart infarct image,,,390.42,2978.0,8 HCPCS,78468,Heart infarct image (ef),,,530.27,2978.0,8 HCPCS,78469,Heart infarct image (3D),,,530.27,2978.0,8 HCPCS,78472,Gated heart planar single,,,390.42,2978.0,8 HCPCS,78472,Hc Gated Heart Planar Single,2920.96,1168.38,,,0 HCPCS,78472,Hc Gated Heart Planar Single - Nm Heart Blood Pool Muga With Rvef,2920.96,1168.38,,,0 HCPCS,78473,Gated heart multiple,,,390.42,2978.0,8 HCPCS,78481,Heart first pass single,,,530.27,2978.0,8 HCPCS,78483,Heart first pass multiple,,,530.27,2978.0,8 HCPCS,78491,Heart image (pet) single,,,1396.49,3491.23,4 HCPCS,78492,Heart image (pet) multiple,,,1396.49,3491.23,4 HCPCS,78494,Heart image spect,,,390.42,2978.0,8 HCPCS,78499,Cardiovascular nuclear exam,,,390.42,2978.0,8 HCPCS,78579,Lung ventilation imaging,,,390.42,976.05,4 HCPCS,78580,Hc Lung Perfusion Imaging - Nm Lung Perfusion Particulate,1794.24,717.7,,,0 HCPCS,78580,Lung perfusion imaging,,,390.42,976.05,4 HCPCS,78582,Hc Lung Ventilation & Perfusion Imaging - Nm Lung Ventilation Perfusion,2803.36,1121.34,,,0 HCPCS,78582,Lung ventilat&perfus imaging,,,530.27,1325.67,4 HCPCS,78597,Hc Lung Perfusion Differential - Nm Quant Differential Pulmonary Perfusion,2349.76,939.9,,,0 HCPCS,78597,Lung perfusion differential,,,390.42,976.05,4 HCPCS,78598,Hc Lung Perfusion & Ventilation Differential - Nm Quant Differential Pulmonary Perfuse Ventilation,2864.96,1145.98,,,0 HCPCS,78598,Lung perf&ventilat diferentl,,,530.27,1325.67,4 HCPCS,78599,Respiratory nuclear exam,,,390.42,976.05,4 HCPCS,78600,Brain image < 4 views,,,390.42,976.05,4 HCPCS,78600,Hc Brain Image < 4 Views - Nm Brain Limited,1324.96,529.98,,,0 HCPCS,78601,Brain image w/flow < 4 views,,,390.42,976.05,4 HCPCS,78601,Hc Nm Brain Image With Flow Less Than 4 Views,2204.16,881.66,,,0 HCPCS,78605,Brain image 4+ views,,,530.27,1325.67,4 HCPCS,78606,Brain image w/flow 4 + views,,,530.27,1325.67,4 HCPCS,78606,Hc Nm Brain Image With Flow 4 Or More Views,2998.24,1199.3,,,0 HCPCS,78608,Brain imaging (PET),,,1396.49,3491.23,4 HCPCS,78608,Hc Brain Imaging (Pet) - Pet Brain,6810.72,2724.29,,,0 HCPCS,78608,Hc Research Pet Brain,5410.63,2164.25,,,0 HCPCS,78610,Brain flow imaging only,,,530.27,1325.67,4 HCPCS,78610,Hc Brain Flow Imaging Only - Nm Brain Flow Only Brain Death,1487.36,594.94,,,0 HCPCS,78630,Cerebrospinal fluid scan,,,530.27,1325.67,4 HCPCS,78635,CSF ventriculography,,,530.27,1325.67,4 HCPCS,78645,CSF shunt evaluation,,,530.27,1325.67,4 HCPCS,78650,CSF leakage imaging,,,1264.36,3160.9,4 HCPCS,78650,Hc Csf Leakage Imaging - Nm Brain Cerebrospinal Fluid Leak,2443.84,977.54,,,0 HCPCS,78660,Hc Nuclear Exam Of Tear Flow - Nm Dacryocystogram,1146.88,458.75,,,0 HCPCS,78660,Nuclear exam of tear flow,,,390.42,976.05,4 HCPCS,78699,Nervous system nuclear exam,,,390.42,976.05,4 HCPCS,78700,Hc Kidney Imaging Morphol - Nm Kidney Cortex,2007.04,802.82,,,0 HCPCS,78700,Kidney imaging morphol,,,390.42,976.05,4 HCPCS,78701,Kidney imaging with flow,,,390.42,976.05,4 HCPCS,78707,Hc Kidney Flow/Function Image Multiple - Nm Kidney Flow/Function W/Wo Pharmacol Initial,2683.52,1073.41,,,0 HCPCS,78707,K flow/funct image w/o drug,,,530.27,1325.67,4 HCPCS,78708,Hc Kidney Flow/Function Image Multiple - Nm Kidney Flow/Function W/Wo Pharmacol Initial,2803.36,1121.34,,,0 HCPCS,78708,K flow/funct image w/drug,,,530.27,1325.67,4 HCPCS,78709,Hc Kidney Flow/Function Image Multiple - Nm Kidney Flow/Function W/Wo Pharmacol Initial,3128.16,1251.26,,,0 HCPCS,78709,K flow/funct image multiple,,,530.27,1325.67,4 HCPCS,78725,Kidney function study,,,390.42,976.05,4 HCPCS,78740,Hc Ureteral Reflux Study - Nm Cystogram Reflux,1678.88,671.55,,,0 HCPCS,78740,Ureteral reflux study,,,390.42,976.05,4 HCPCS,78761,Testicular imaging w/flow,,,390.42,976.05,4 HCPCS,78799,Genitourinary nuclear exam,,,390.42,976.05,4 HCPCS,78800,"Hc Tumor Imaging, Limited Area - Nm Tumor Localization Limited",2082.08,832.83,,,0 HCPCS,78800,Tumor imaging limited area,,,390.42,976.05,4 HCPCS,78801,"Hc Tumor Imaging, Mult Areas - Nm Tumor Octreoscan",2620.0,1048.0,,,0 HCPCS,78801,Tumor imaging mult areas,,,390.42,976.05,4 HCPCS,78802,Hc Tumor Imaging Whole Body - Nm Tumor Local Whole Body W Gallium,3897.6,1559.04,,,0 HCPCS,78802,Tumor imaging whole body,,,530.27,1325.67,4 HCPCS,78803,Hc Radiopharmaceutical Localization Of Tumor Spect 1 Area/Acquisition 1 Day Imaging -Tumor,3381.28,1352.51,,,0 HCPCS,78803,Tumor imaging (3D),,,530.27,1325.67,4 HCPCS,78804,Hc Tumor Imaging Whole Body - Nm Tumor Local Whole Body Multiple Days,4438.56,1775.42,,,0 HCPCS,78804,Tumor imaging whole body,,,530.27,1325.67,4 HCPCS,78805,Hc Abscess Imaging Limited Area - Nm Inflammation Limited With Indium 111,2486.4,994.56,,,0 HCPCS,78806,Hc Abscess Imaging Whole Body - Nm Inflammation Whole Body With Inium,3228.96,1291.58,,,0 HCPCS,78808,Hc Nm Inj Proc Parathyroid,901.6,360.64,,,0 HCPCS,78808,Iv inj ra drug dx study,,,390.42,976.05,4 HCPCS,78811,Pet image ltd area,,,1264.36,3160.9,4 HCPCS,78812,Pet image skull-thigh,,,1396.49,3491.23,4 HCPCS,78813,Pet image full body,,,1396.49,3491.23,4 HCPCS,78814,Hc Pet Imaging Ct For Attenuation Limited Area - Pt/Ct Lower Extremity,7468.16,2987.26,,,0 HCPCS,78814,Hc Research Pet/Ct Limited-Fdg,5410.63,2164.25,,,0 HCPCS,78814,Pet image w/ct lmtd,,,1396.49,3491.23,4 HCPCS,78815,Hc Pet Image W/Ct Skull-Thigh - Pt/Ct Bone Skull Base To Mid Thigh,8982.4,3592.96,,,0 HCPCS,78815,Hc Research Pet/Ct Eye-Thig Fdg,5410.63,2164.25,,,0 HCPCS,78815,Pet image w/ct skull-thigh,,,1396.49,3491.23,4 HCPCS,78816,Hc Pet Imaging For Ct Attenuation Whole Body - Pt/Ct Bone Whole Body,9509.92,3803.97,,,0 HCPCS,78816,Hc Research Pet/Ct Whole Body Fdg,9509.92,3803.97,,,0 HCPCS,78816,Pet image w/ct full body,,,1396.49,3491.23,4 HCPCS,78830,Hc Nm Loc 1 Area/Day Spect/Ct,6229.44,2491.78,,,0 HCPCS,78830,Rp loclzj tum spect w/ct 1,,,1264.36,3160.9,4 HCPCS,78831,Hc Nm Spect Multi Areas/Days,1736.29,694.52,,,0 HCPCS,78831,Rp loclzj tum spect 2 areas,,,1264.36,3160.9,4 HCPCS,78832,Hc Nm Spect Ct Multi Areas/Days,5536.16,2214.46,,,0 HCPCS,78832,Rp loclzj tum spect w/ct 2,,,1396.49,3491.23,4 HCPCS,78999,Hc Nm Unlst Spect/Ct Fusion,2848.16,1139.26,,,0 HCPCS,78999,Nuclear diagnostic exam,,,390.42,976.05,4 HCPCS,79005,"Hc Nuclear Therapy, Oral - Nm Thyroid Therapy I 131",2238.88,895.55,,,0 HCPCS,79005,Nuclear rx oral admin,,,227.88,569.69,4 HCPCS,79101,Hc Nuclear Rx Iv Admin - Nm Bone Treatment Therapy,1916.32,766.53,,,0 HCPCS,79101,Nuclear rx iv admin,,,227.88,569.69,4 HCPCS,79200,Nuclear rx intracav admin,,,227.88,569.69,4 HCPCS,79300,Nuclr rx interstit colloid,,,227.88,569.69,4 HCPCS,79403,Hematopoietic nuclear tx,,,227.88,569.69,4 HCPCS,79440,Nuclear rx intra-articular,,,227.88,569.69,4 HCPCS,79445,Nuclear rx intra-arterial,,,227.88,569.69,4 HCPCS,79999,Nuclear medicine therapy,,,227.88,569.69,4 HCPCS,80047,Hc Basic Metabolic Panel Calcium Ionized - Bundled Charge,2915.0,1166.0,,,0 HCPCS,80047,Hc Poct I-Stat Chem8+,195.0,78.0,,,0 HCPCS,80047,Metabolic panel ionized ca,,,5.69,34.32,16 HCPCS,80048,Hc Basic Metabolic Panel Calcium Total - Bundled Charge,193.0,77.2,,,0 HCPCS,80048,Metabolic panel total ca,,,5.69,21.15,16 HCPCS,80050,General health panel,,,10.26,49.42,12 HCPCS,80051,Electrolyte panel,,,4.75,17.52,16 HCPCS,80051,Hc Electrolyte Panel - Bundled Charge,114.0,45.6,,,0 HCPCS,80053,Comprehen metabolic panel,,,7.15,26.4,16 HCPCS,80053,"Hc Metabolic Panel,Comprehensive - Bundled Charge",289.0,115.6,,,0 HCPCS,80055,Obstetric panel,,,47.81,119.52,16 HCPCS,80061,Hc Lipid Panel - Bundled Charge,195.0,78.0,,,0 HCPCS,80061,Hc Lipofit By Nmr 2013716 #2-So+,17.4,6.96,,,0 HCPCS,80061,Lipid panel,,,9.68,33.48,16 HCPCS,80069,Hc Renal Function Panel - Bundled Charge,203.0,81.2,,,0 HCPCS,80069,Renal function panel,,,5.69,21.7,16 HCPCS,80074,Acute hepatitis panel,,,46.17,119.08,16 HCPCS,80074,"Hc Hepatitis Panel,Acute - Bundled Charge",455.0,182.0,,,0 HCPCS,80076,Hc Hepatic Function Panel - Bundled Charge,204.0,81.6,,,0 HCPCS,80076,Hepatic function panel,,,5.69,20.42,16 HCPCS,80081,Obstetric panel,,,61.18,187.15,16 HCPCS,80143,Drug assay acetaminophen,,,7.46,46.6,16 HCPCS,80143,Hc Acetaminophen,354.32,141.73,,,0 HCPCS,80145,Drug assay adalimumab,,,15.43,96.42,16 HCPCS,80145,Hc Humira Activity-So+,198.87,79.55,,,0 HCPCS,80145,Hc Drug Assay Adalimumab-So+,390.0,156.0,,,0 HCPCS,80145,Hc Predictrpk Ada Maintenance 3700-So+,286.0,114.4,,,0 HCPCS,80150,Assay of amikacin,,,12.81,37.7,16 HCPCS,80150,Hc Assay Of Amikacin - Amikacin Peak????????,174.8,69.92,,,0 HCPCS,80150,Hc Assay Of Amikacin - Amikacin Random????????,174.8,69.92,,,0 HCPCS,80150,Hc Assay Of Amikacin - Amikacin Trough,174.8,69.92,,,0 HCPCS,80151,Drug assay amiodarone,,,7.46,46.6,16 HCPCS,80151,Hc Amiodarone And Metabolite 90161-So+,22.06,8.82,,,0 HCPCS,80155,Drug assay caffeine,,,19.3,96.42,16 HCPCS,80156,Assay carbamazepine total,,,12.37,36.42,16 HCPCS,80156,Hc Assay Of Carbamazepine Total - Carbamazepine Total,246.01,98.4,,,0 HCPCS,80157,Assay carbamazepine free,,,11.26,33.12,16 HCPCS,80158,Drug assay cyclosporine,,,15.34,45.12,16 HCPCS,80158,Hc Assay Of Cyclosporine - Cyclosporine,447.0,178.8,,,0 HCPCS,80159,Drug assay clozapine,,,20.15,50.38,16 HCPCS,80159,Hc 124 Clozapin & Met Qnt S/P-So+,66.5,26.6,,,0 HCPCS,80161,"Asy carbamazepin 10,11-epxid",,,7.46,46.6,16 HCPCS,80162,Assay of digoxin total,,,11.28,33.2,16 HCPCS,80162,Hc Drug Screen Quantitative Digoxin Total - Digoxin,128.8,51.52,,,0 HCPCS,80163,Assay of digoxin free,,,11.28,33.2,16 HCPCS,80164,Assay dipropylacetic acd tot,,,11.51,33.85,16 HCPCS,80164,Hc Drug Screen Quant Dipropylacetic Acid Total - Valproic Acid Free,178.25,71.3,,,0 HCPCS,80164,Hc Drug Screen Quant Valproic Acid Total,199.64,79.86,,,0 HCPCS,80165,Dipropylacetic acid free,,,11.51,33.85,16 HCPCS,80165,Hc Free Valproic Acid,52.9,21.16,,,0 HCPCS,80167,Drug assay felbamate,,,7.46,46.6,16 HCPCS,80168,Assay of ethosuximide,,,13.89,40.85,16 HCPCS,80168,Hc 359 Ethosuximide S/P-So+,20.44,8.18,,,0 HCPCS,80169,Drug assay everolimus,,,13.73,34.32,16 HCPCS,80169,Hc Drug Assay Everolimus,201.82,80.73,,,0 HCPCS,80170,Assay of gentamicin,,,13.93,40.95,16 HCPCS,80170,Hc Assay Of Gentamicin - Gentamicin Peak,248.58,99.43,,,0 HCPCS,80170,Hc Assay Of Gentamicin - Gentamicin Random,221.95,88.78,,,0 HCPCS,80170,Hc Assay Of Gentamicin - Gentamicin Trough,221.95,88.78,,,0 HCPCS,80171,Drug screen quant gabapentin,,,18.09,54.18,16 HCPCS,80171,Hc Gabapentin Quant By Lcmsms,128.57,51.43,,,0 HCPCS,80173,Assay Of Haloperidol,,,12.37,39.45,16 HCPCS,80173,Hc 719 Haloperidol Lev-So+,52.38,20.95,,,0 HCPCS,80175,Drug screen quan lamotrigine,,,13.25,33.12,16 HCPCS,80175,Hc Lamotrigine Quant By Lcmsms,77.74,31.1,,,0 HCPCS,80176,Assay of lidocaine,,,12.48,36.72,16 HCPCS,80176,Hc 331 Lidocaine-So+,107.64,43.06,,,0 HCPCS,80176,Hc Lidocaine 7000240-So+,124.0,49.6,,,0 HCPCS,80177,Drug scrn quan levetiracetam,,,13.25,33.12,16 HCPCS,80177,Hc Levetiracetam Quant By Lcmsms,94.18,37.67,,,0 HCPCS,80178,Assay of lithium,,,5.62,16.52,16 HCPCS,80178,Hc Assay Of Lithium - Lithium,131.38,52.55,,,0 HCPCS,80179,Drug assay salicylate,,,7.46,46.6,16 HCPCS,80179,Hc Salicylate,354.32,141.73,,,0 HCPCS,80180,Drug scrn quan mycophenolate,,,18.05,45.12,16 HCPCS,80180,Hc 407 Mycophenolic Acid&Met-So+,35.47,14.19,,,0 HCPCS,80181,Drug assay flecainide,,,7.46,46.6,16 HCPCS,80181,Hc Flecainide 90003-So+,34.38,13.75,,,0 HCPCS,80183,Drug scrn quant oxcarbazepin,,,13.25,33.12,16 HCPCS,80183,Hc 088 Oxcarb/Eslicarb Metab-So+,27.94,11.18,,,0 HCPCS,80184,Assay of phenobarbital,,,9.73,38.25,16 HCPCS,80184,Hc Assay Of Phenobarbital - Phenobarbital,155.85,62.34,,,0 HCPCS,80184,Hc Assay Of Phenobarbital-So+,18.36,7.34,,,0 HCPCS,80185,Assay of phenytoin total,,,11.26,33.12,16 HCPCS,80185,"Hc Assay Of Phenytoin, Total - Phenytoin Total",203.5,81.4,,,0 HCPCS,80186,Assay of phenytoin free,,,11.7,34.4,16 HCPCS,80186,"Hc Assay Of Phenytoin, Free - Phenytoin Free",222.82,89.13,,,0 HCPCS,80187,Drug assay posaconazole,,,10.84,67.78,16 HCPCS,80187,Hc 405 Posaconazole Lcms-So+,155.38,62.15,,,0 HCPCS,80188,Assay of primidone,,,14.11,41.48,16 HCPCS,80188,Hc 839 Primidone-So+,59.69,23.88,,,0 HCPCS,80188,Hc Assay Of Primidone - Primidone Level 90202,19.91,7.96,,,0 HCPCS,80189,Drug assay itraconzaole,,,10.84,67.78,16 HCPCS,80190,Assay of procainamide,,,14.23,150.0,16 HCPCS,80192,Assay of procainamide,,,14.23,41.88,16 HCPCS,80192,Hc 974 Procainamide-So+,60.24,24.1,,,0 HCPCS,80192,"Hc Procainamide, Serum Or Plasma 007252-So+",19.36,7.74,,,0 HCPCS,80193,Drug assay leflunomide,,,15.43,96.42,16 HCPCS,80194,Assay of quinidine,,,12.41,36.5,16 HCPCS,80194,Hc Quinidine,22.85,9.14,,,0 HCPCS,80195,Assay of sirolimus,,,11.67,34.32,16 HCPCS,80195,Hc Assay Of Sirolimus - Sirolimus,309.12,123.65,,,0 HCPCS,80197,Assay of tacrolimus,,,11.67,34.32,16 HCPCS,80197,Hc Assay Of Tacrolimus - Tacrolimus,431.48,172.59,,,0 HCPCS,80198,Assay of theophylline,,,12.02,35.35,16 HCPCS,80198,Hc 979 Theophylline-So+,50.87,20.35,,,0 HCPCS,80198,"Hc Theophylline, Serum Or Plasma3019010-So+",154.8,61.92,,,0 HCPCS,80199,Drug screen quant tiagabine,,,24.63,67.78,16 HCPCS,80200,Assay of tobramycin,,,13.7,40.32,16 HCPCS,80200,Hc Assay Of Tobramycin - Tobramycin Random,258.75,103.5,,,0 HCPCS,80200,Hc Assay Of Tobramycin - Tobramycin Trough,258.75,103.5,,,0 HCPCS,80201,Assay of topiramate,,,10.13,29.8,16 HCPCS,80201,Hc Assay Of Topiramate - Topiramate Level,161.0,64.4,,,0 HCPCS,80202,Assay of vancomycin,,,11.51,33.85,16 HCPCS,80202,Hc Assay Of Vancomycin - Vancomycin Peak,336.17,134.47,,,0 HCPCS,80202,Hc Assay Of Vancomycin - Vancomycin Random,336.17,134.47,,,0 HCPCS,80202,Hc Assay Of Vancomycin - Vancomycin Trough,336.17,134.47,,,0 HCPCS,80203,Drug screen quant zonisamide,,,13.25,33.12,16 HCPCS,80203,Hc 121 Zonisamide-So+,47.68,19.07,,,0 HCPCS,80204,Drug assay methotrexate,,,15.43,96.42,16 HCPCS,80204,Hc Methotrexate,409.63,163.85,,,0 HCPCS,80204,Hc Quantitation Drug Not Elsewhere Specified - Methotrexate Level,409.63,163.85,,,0 HCPCS,80210,Drug assay rufinamide,,,10.84,67.78,16 HCPCS,80220,Drug asy hydroxychloroquine,,,7.46,46.6,16 HCPCS,80220,Hc Hydroxychloroquine (Arup->Nms 2362Sp),389.3,155.72,,,0 HCPCS,80230,Drug assay infliximab,,,15.43,96.42,16 HCPCS,80230,Hc Drug Assay Infliximab-So+,390.0,156.0,,,0 HCPCS,80230,Hc Predictrpk-So+,429.0,171.6,,,0 HCPCS,80235,Drug assay lacosamide,,,10.84,67.78,16 HCPCS,80235,"Hc Lacosamide, Serum Or Plasma 2003182-So+",84.0,33.6,,,0 HCPCS,80280,Drug assay vedolizumab,,,15.43,96.42,16 HCPCS,80280,Hc Drug Assay Vedolizumab-So+,390.0,156.0,,,0 HCPCS,80285,Drug assay voriconazole,,,10.84,67.78,16 HCPCS,80285,Hc Voriconazole-So+,155.28,62.11,,,0 HCPCS,80299,Hc 282 Digitoxin-So+,49.26,19.7,,,0 HCPCS,80299,Hc 403 Itraconozole Lcms-So+,155.4,62.16,,,0 HCPCS,80299,Hc 404 Vitraconazole Lcms-So+,144.0,57.6,,,0 HCPCS,80299,Hc 484 Aripiprozole Qnt Ser-So+,122.4,48.96,,,0 HCPCS,80299,Hc 617 Qnt Vedolizumab-So+,133.08,53.23,,,0 HCPCS,80299,Hc 736 Ceftazime Drug Level-So+,139.87,55.95,,,0 HCPCS,80299,Hc 854 Qnt Adalimumab-So+,249.79,99.92,,,0 HCPCS,80299,Hc Antibiotic Level-So+,140.4,56.16,,,0 HCPCS,80299,"Hc Antifungal Level, 5-Fluorocytosine, 5-Fc 60846-So+",128.26,51.3,,,0 HCPCS,80299,Hc Busulfan Level-So+,108.0,43.2,,,0 HCPCS,80299,"Hc Cefepime Level, Serum",188.6,75.44,,,0 HCPCS,80299,"Hc Dexamethasone, Serum Or Plasma By Lc-Ms/Ms (Arup 2003248)",75.9,30.36,,,0 HCPCS,80299,"Hc Imatinib, Serum 3020479-So+",162.0,64.8,,,0 HCPCS,80299,"Hc Infliximab, Anser, Prometheus-So+",86.0,34.4,,,0 HCPCS,80299,Hc Isavuconazole (Cresemba)4900-So+,196.56,78.62,,,0 HCPCS,80299,"Hc Meropenum Level, Serum",193.63,77.45,,,0 HCPCS,80299,"Hc Piperacillin Level, Serum",193.63,77.45,,,0 HCPCS,80299,Hc Thiopurine Metabolites-So+,259.2,103.68,,,0 HCPCS,80299,Quantitative assay drug,,,11.64,46.6,16 HCPCS,80299,"Ustekinumab Drug Measurement, So+",390.0,156.0,,,0 HCPCS,80305,Drug test prsmv dir opt obs,,,6.43,31.5,16 HCPCS,80305,Hc Drug Test Prsmv Dir Opt Obs - Toxicology Screen Urine,112.12,44.85,,,0 HCPCS,80306,Drug test prsmv instrmnt,,,8.57,42.85,16 HCPCS,80307,Drug test prsmv chem anlyzr,,,34.27,155.35,16 HCPCS,80307,Hc Drug Test Prsmv Chem Anlyzr - Lsd Screen Urine,308.1,123.24,,,0 HCPCS,80307,Hc Drugs Of Abuse Urine,354.32,141.73,,,0 HCPCS,80307,"Hc Ethyl Glucuronide Screen With Reflex To Confirmation, Urine (Arup 2007912)",96.94,38.78,,,0 HCPCS,80307,"Hc Ethyl Glucuronide, Hair-So+",170.4,68.16,,,0 HCPCS,80307,Hc Hair Exposure Testing (Childguard) 19 Panel-So+,505.2,202.08,,,0 HCPCS,80307,Hc Hairstat 13 Childguard-So+,312.0,124.8,,,0 HCPCS,80307,Hc Hairstat 5,97.18,38.87,,,0 HCPCS,80320,Drug screen quantalcohols,,,0.01,28.22,5 HCPCS,80320,Hc Quantitative Alcohols,426.08,170.43,,,0 HCPCS,80320,"Hc Volatile Alcohol, Methanol",221.26,88.5,,,0 HCPCS,80321,Alcohols biomarkers 1or 2,,,0.01,17.64,5 HCPCS,80322,Alcohols biomarkers 3/more,,,0.01,17.64,5 HCPCS,80323,Alkaloids nos,,,0.01,49.02,5 HCPCS,80324,Drug screen amphetamines 1/2,,,0.01,25.38,5 HCPCS,80325,Amphetamines 3or 4,,,0.01,25.38,5 HCPCS,80325,Hc Drug Screen Amphetamines 3 Or 4,195.0,78.0,,,0 HCPCS,80326,Amphetamines 5 or more,,,0.01,25.38,5 HCPCS,80327,Anabolic steroid 1 or 2,,,0.01,42.16,5 HCPCS,80328,Anabolic steroid 3 or more,,,0.01,42.16,5 HCPCS,80329,Analgesics non-opioid 1 or 2,,,0.01,33.05,5 HCPCS,80330,Analgesics non-opioid 3-5,,,0.01,33.05,5 HCPCS,80331,Analgesics non-opioid 6/more,,,0.01,33.05,5 HCPCS,80332,Antidepressants class 1 or 2,,,0.01,29.32,5 HCPCS,80333,Antidepressants class 3-5,,,0.01,17.71,5 HCPCS,80334,Antidepressants class 6/more,,,0.01,11.66,5 HCPCS,80335,Antidepressant tricyclic 1/2,,,0.01,29.23,5 HCPCS,80335,Hc Antidepressants Tricyclic Other Cyclicals 1 Or 2 - Imipramine Level,10870.14,4348.06,,,0 HCPCS,80336,Antidepressant tricyclic 3-5,,,0.01,29.23,5 HCPCS,80337,Tricyclic & cyclicals 6/more,,,0.01,29.23,5 HCPCS,80338,Antidepressant not specified,,,0.01,15.12,5 HCPCS,80339,Antiepileptics nos 1-3,,,0.01,24.19,5 HCPCS,80340,Antiepileptics nos 4-6,,,0.01,24.19,5 HCPCS,80341,Antiepileptics nos 7/more,,,0.01,24.19,5 HCPCS,80342,Antipsychotics nos 1-3,,,0.01,25.43,5 HCPCS,80343,Antipsychotics nos 4-6,,,0.01,25.43,5 HCPCS,80344,Antipsychotics nos 7/more,,,0.01,25.43,5 HCPCS,80345,Drug screening barbiturates,,,0.01,18.7,5 HCPCS,80345,Hc Drug Screening Barbiturates - Barbiturate Urine Quant,260.13,104.05,,,0 HCPCS,80346,Benzodiazepines1-12,,,0.01,32.33,5 HCPCS,80346,Hc Drug Screening Benzodiazepines 1-12 Benzodiazepine - Bundled Charge,195.0,78.0,,,0 HCPCS,80347,Benzodiazepines 13 or more,,,0.01,32.33,5 HCPCS,80348,Drug screening buprenorphine,,,0.01,19.44,5 HCPCS,80348,Hc Drug Screening Buprenorphine,195.0,78.0,,,0 HCPCS,80349,Cannabinoids natural,,,0.01,29.32,5 HCPCS,80349,Hc Drug Screening Cannabinoids Natural - Cannabinoid Confirmation Ur,195.0,78.0,,,0 HCPCS,80350,Cannabinoids synthetic 1-3,,,0.01,29.32,5 HCPCS,80351,Cannabinoids synthetic 4-6,,,0.01,19.87,5 HCPCS,80352,Cannabinoid synthetic 7/more,,,0.01,19.44,5 HCPCS,80353,Drug screening cocaine,,,0.01,24.74,5 HCPCS,80353,Hc Drug Screening Cocaine - Cocaine Urine Conf,195.0,78.0,,,0 HCPCS,80354,Drug screening fentanyl,,,0.01,29.32,5 HCPCS,80354,Hc Drug Screening Fentanyl - Fentanyl Urine,195.0,78.0,,,0 HCPCS,80355,Gabapentin non-blood,,,0.01,21.56,5 HCPCS,80356,Heroin metabolite,,,0.01,31.91,5 HCPCS,80357,Ketamine and norketamine,,,0.01,25.87,5 HCPCS,80358,Drug screening methadone,,,0.01,26.66,5 HCPCS,80358,Hc Drug Screening Methadone - Methadone & Metabolite Level,195.0,78.0,,,0 HCPCS,80359,Methylenedioxyamphetamines,,,0.01,25.44,5 HCPCS,80360,Methylphenidate,,,0.01,25.87,5 HCPCS,80361,Hc Drug Screening Opiates 1 Or More - Bundled Charge,195.0,78.0,,,0 HCPCS,80361,Opiates 1 or more,,,0.01,41.98,5 HCPCS,80362,Opioids & opiate analogs 1/2,,,0.01,35.78,5 HCPCS,80363,Opioids & opiate analogs 3/4,,,0.01,25.49,5 HCPCS,80364,Opioid &opiate analog 5/more,,,0.01,19.01,5 HCPCS,80365,Drug screening oxycodone,,,0.01,31.91,5 HCPCS,80366,Drug screening pregabalin,,,0.01,25.87,5 HCPCS,80367,Drug screening propoxyphene,,,0.01,29.32,5 HCPCS,80368,Sedative hypnotics,,,0.01,28.03,5 HCPCS,80369,Skeletal muscle relaxant 1/2,,,0.01,28.78,5 HCPCS,80370,Skel musc relaxant 3 or more,,,0.01,28.78,5 HCPCS,80371,Stimulants synthetic,,,0.01,29.32,5 HCPCS,80372,Drug screening tapentadol,,,0.01,25.87,5 HCPCS,80373,Drug screening tramadol,,,0.01,25.87,5 HCPCS,80374,Stereoisomer analysis,,,0.01,25.44,5 HCPCS,80375,Drug/substance nos 1-3,,,0.01,26.59,5 HCPCS,80375,Hc Drug/Substance Definitive Qual/Quant Nos 1-3 Gold - Bundled Charge,168.94,67.58,,,0 HCPCS,80375,Hc Flucytosine By Mass Spec 3018708-So+,435.6,174.24,,,0 HCPCS,80376,Drug/substance nos 4-6,,,0.01,29.66,5 HCPCS,80377,Drug/substance nos 7/more,,,0.01,29.66,5 HCPCS,80400,Acth stimulation panel,,,27.72,81.55,16 HCPCS,80402,Acth stimulation panel,,,73.9,217.4,16 HCPCS,80406,Acth stimulation panel,,,66.5,195.65,16 HCPCS,80408,Aldosterone suppression eval,,,106.64,313.75,16 HCPCS,80410,Calcitonin stimul panel,,,68.27,200.92,16 HCPCS,80412,CRH stimulation panel,,,251.32,2004.05,16 HCPCS,80414,Testosterone response,,,43.88,129.1,16 HCPCS,80415,Estradiol response panel,,,47.5,139.72,16 HCPCS,80416,Renin stimulation panel,,,112.14,523.3,16 HCPCS,80417,Renin stimulation panel,,,37.38,109.98,16 HCPCS,80418,Pituitary evaluation panel,,,473.35,1448.7,16 HCPCS,80420,Dexamethasone panel,,,60.94,404.7,16 HCPCS,80422,Glucagon tolerance panel,,,39.15,115.18,16 HCPCS,80424,Glucagon tolerance panel,,,42.91,126.25,16 HCPCS,80426,Gonadotropin hormone panel,,,126.12,371.02,16 HCPCS,80428,Growth hormone panel,,,56.69,166.75,16 HCPCS,80430,Growth hormone panel,,,66.7,323.32,16 HCPCS,80432,Insulin suppression panel,,,107.96,414.02,16 HCPCS,80434,Insulin tolerance panel,,,85.98,712.58,16 HCPCS,80435,Insulin tolerance panel,,,87.54,257.5,16 HCPCS,80436,Metyrapone panel,,,77.47,227.9,16 HCPCS,80438,TRH stimulation panel,,,42.84,126.02,16 HCPCS,80439,TRH stimulation panel,,,57.12,168.02,16 HCPCS,80500,Lab pathology consultation,,,11.22,11.22,4 HCPCS,80502,Hc 283 Lab/Path Consult-So+,1704.0,681.6,,,0 HCPCS,80502,Lab pathology consultation,,,36.24,36.24,4 HCPCS,80503,Path clin consltj sf 5-20,,,10.66,127.23,9 HCPCS,80504,Path clin consltj mod 21-40,,,21.32,415.96,9 HCPCS,80505,Path clin consltj high 41-60,,,38.62,415.96,9 HCPCS,80506,Path clin consltj prolng svc,,,17.3,51.91,5 HCPCS,81000,Urinalysis nonauto w/scope,,,2.69,10.05,16 HCPCS,81001,"Hc Urinalysis, Auto, W/Scope - Bundled Charge",124.0,49.6,,,0 HCPCS,81001,"Hc Urinalysis, Auto, W/Scope - Urinalysis Microscopic",124.0,49.6,,,0 HCPCS,81001,Urinalysis auto w/scope,,,2.69,7.92,16 HCPCS,81002,Urinalysis nonauto w/o scope,,,2.05,8.7,16 HCPCS,81003,"Hc Urinalysis, Auto, W/O Scope",62.0,24.8,,,0 HCPCS,81003,"Hc Urinalysis, Auto, W/O Scope - Poct Ketone, Urine",62.0,24.8,,,0 HCPCS,81003,Urinalysis auto w/o scope,,,1.91,5.62,16 HCPCS,81005,Urinalysis,,,1.84,5.42,16 HCPCS,81007,Urine screen for bacteria,,,2.18,74.95,16 HCPCS,81015,Hc Urine Microscopic,62.0,24.8,,,0 HCPCS,81015,Microscopic exam of urine,,,2.59,7.62,16 HCPCS,81020,Urinalysis glass test,,,3.13,11.75,16 HCPCS,81025,Hc Urine Pregnancy Test,109.0,43.6,,,0 HCPCS,81025,Urine pregnancy test,,,1.02,21.52,16 HCPCS,81050,Hc Volume Measure Timed Collect,46.0,18.4,,,0 HCPCS,81050,Urinalysis volume measure,,,2.41,9.1,16 HCPCS,81099,Urinalysis test procedure,,,0.01,0.01,4 HCPCS,81105,Hpa-1 genotyping,,,60.36,305.55,16 HCPCS,81106,Hpa-2 genotyping,,,60.36,305.55,16 HCPCS,81107,Hpa-3 genotyping,,,60.36,305.55,16 HCPCS,81108,Hpa-4 genotyping,,,60.36,305.55,16 HCPCS,81109,Hpa-5 genotyping,,,60.36,305.55,16 HCPCS,81110,Hpa-6 genotyping,,,60.36,305.55,16 HCPCS,81111,Hpa-9 genotyping,,,60.36,305.55,16 HCPCS,81112,Hpa-15 genotyping,,,60.36,305.55,16 HCPCS,81120,"Hc Idh1 (R132) And Idh2 (R140 And R172) Quantitative Detection, Droplet Digital Pcr Idhq #2-So+",626.88,250.75,,,0 HCPCS,81120,Hc Idh1 And Idh2 Mutation Detection-So+,1140.0,456.0,,,0 HCPCS,81120,Hc Idh1 Mutation Testing By Dpcr,763.94,305.58,,,0 HCPCS,81120,Idh1 common variants,,,77.3,483.12,16 HCPCS,81121,"Hc Idh1 (R132) And Idh2 (R140 And R172) Quantitative Detection, Droplet Digital Pcr Idhq #1-So+",626.88,250.75,,,0 HCPCS,81121,Hc Idh2 Mutation Testing By Dpcr,897.0,358.8,,,0 HCPCS,81121,Idh2 common variants,,,118.32,739.48,16 HCPCS,81161,DMD dup/delet analysis,,,107.98,697.5,16 HCPCS,81162,Brca1&2 seq & full dup/del,,,1103.72,4562.2,16 HCPCS,81163,Brca1&2 gene full seq alys,,,187.2,1170.0,16 HCPCS,81164,Brca1&2 gen ful dup/del alys,,,233.69,1460.58,16 HCPCS,81165,Brca1 gene full seq alys,,,113.15,707.2,16 HCPCS,81166,Brca1 gene full dup/del alys,,,120.54,753.38,16 HCPCS,81167,Brca2 gene full dup/del alys,,,113.15,707.2,16 HCPCS,81168,Ccnd1/igh translocation alys,,,82.92,518.28,16 HCPCS,81170,Abl1 gene,,,69.13,750.0,16 HCPCS,81170,Hc Bcr-Abl1 Mutation Analysis By Ngs 2008420-So+,889.36,355.74,,,0 HCPCS,81171,Aff2 gene detc abnor alleles,,,54.8,342.5,16 HCPCS,81172,Aff2 gene charac alleles,,,109.93,687.08,16 HCPCS,81173,Ar gene full gene sequence,,,120.54,753.38,16 HCPCS,81174,Ar gene known famil variant,,,74.08,463.0,16 HCPCS,81174,Hc Familial Variant Ar,947.71,379.08,,,0 HCPCS,81175,Asxl1 full gene sequence,,,282.81,1691.25,16 HCPCS,81176,Asxl1 gene target seq alys,,,119.46,604.75,16 HCPCS,81177,Atn1 gene detc abnor alleles,,,54.8,342.5,16 HCPCS,81178,Atxn1 gene detc abnor allele,,,54.8,342.5,16 HCPCS,81179,Atxn2 gene detc abnor allele,,,54.8,342.5,16 HCPCS,81180,Atxn3 gene detc abnor allele,,,54.8,342.5,16 HCPCS,81181,Atxn7 gene detc abnor allele,,,54.8,342.5,16 HCPCS,81182,Atxn8os gen detc abnor allel,,,54.8,342.5,16 HCPCS,81183,Atxn10 gene detc abnor allel,,,54.8,342.5,16 HCPCS,81184,Cacna1a gen detc abnor allel,,,54.8,342.5,16 HCPCS,81185,Cacna1a gene full gene seq,,,338.51,2115.68,16 HCPCS,81186,Cacna1a gen known famil vrnt,,,74.08,463.0,16 HCPCS,81186,Hc Familial Variant Cacna1A,947.71,379.08,,,0 HCPCS,81187,Cnbp gene detc abnor allele,,,54.8,342.5,16 HCPCS,81187,Hc Myotonic Dystrophy 2 (Znf9/Cnbp) Genetic Testing (Repeat Expansion)620087-So+,354.0,141.6,,,0 HCPCS,81188,Cstb gene detc abnor allele,,,54.8,342.5,16 HCPCS,81189,Cstb gene full gene sequence,,,109.93,687.08,16 HCPCS,81190,Cstb gene known famil vrnt,,,74.08,463.0,16 HCPCS,81190,Hc Familial Variant Cstb,947.71,379.08,,,0 HCPCS,81191,Ntrk1 translocation analysis,,,82.92,518.28,16 HCPCS,81192,Ntrk2 translocation analysis,,,82.92,518.28,16 HCPCS,81193,Ntrk3 translocation analysis,,,82.92,518.28,16 HCPCS,81194,Ntrk translocation analysis,,,207.31,1295.7,16 HCPCS,81195,Cytog genom-wid alys hem mal,,,505.41,4658.05,16 HCPCS,81200,Aspa gene,,,47.25,118.12,16 HCPCS,81201,Apc gene full sequence,,,780.0,1950.0,16 HCPCS,81202,Apc gene known fam variants,,,280.0,700.0,16 HCPCS,81202,Hc Familial Variant Apc,1352.91,541.16,,,0 HCPCS,81203,Apc gene dup/delet variants,,,200.0,500.0,16 HCPCS,81204,Ar gene charac alleles,,,54.8,342.5,16 HCPCS,81205,Bckdhb gene,,,61.43,237.48,16 HCPCS,81206,Bcr/abl1 gene major bp,,,36.53,409.9,16 HCPCS,81206,Hc 240 Bcr-Abl Qnt Major P210-So+,196.75,78.7,,,0 HCPCS,81206,Hc 753 Bcr/Abl Maj Bp Qlt-So+,240.0,96.0,,,0 HCPCS,81206,Hc Diagnostic Qualitative Bcr-Abl1 Assay With Reflex To P190 Or P210 Quantitative Assays-Arup 300583,288.83,115.53,,,0 HCPCS,81206,"Hc Quantitative Detection Of Bcr-Abl1, Major Form (P210)-Arup 3005840",358.8,143.52,,,0 HCPCS,81207,Bcr/abl1 gene minor bp,,,36.53,362.1,16 HCPCS,81207,Hc 362 Bcr/Abl Qnt Minor P190-So+,520.87,208.35,,,0 HCPCS,81207,Hc 753 Bcr/Abl Min Bp Qlt-So+,173.81,69.52,,,0 HCPCS,81207,"Hc Reflex Bcr-Abl1, Minor, Quant 2005025-So+",302.4,120.96,,,0 HCPCS,81208,Bcr/abl1 gene other bp,,,95.15,536.55,16 HCPCS,81208,Hc 395 Brc-Abl P230-So+,257.54,103.02,,,0 HCPCS,81209,Blm gene,,,26.3,98.28,16 HCPCS,81210,Braf gene,,,45.89,438.5,16 HCPCS,81210,Hc 246 Braf-So+,472.51,189.0,,,0 HCPCS,81210,Hc Braf Mutation Detection-So+,1080.0,432.0,,,0 HCPCS,81210,Hc Colorectal Cancer Mutation Panel-So+,1560.0,624.0,,,0 HCPCS,81210,Hc Melanoma Mutation Panel So+,1800.0,720.0,,,0 HCPCS,81211,Brca1&2 seq & com dup/del,,,1903.8,1903.8,4 HCPCS,81212,Brca1&2 185&5385&6174 var,,,212.04,1100.0,16 HCPCS,81213,Brca1&2 uncom dup/del var,,,270.75,270.75,4 HCPCS,81214,Brca1 full seq & com dup/del,,,997.5,997.5,4 HCPCS,81215,Brca1 gene known fam variant,,,111.89,938.12,16 HCPCS,81215,Hc Familial Variant Brca1,1068.26,427.3,,,0 HCPCS,81216,Brca2 gene full sequence,,,185.12,1191.3,16 HCPCS,81217,Brca2 gene known fam variant,,,111.89,938.12,16 HCPCS,81217,Hc Familial Variant Brca2,1068.26,427.3,,,0 HCPCS,81218,Cebpa gene full sequence,,,69.13,604.75,16 HCPCS,81219,Calr gene com variants,,,66.59,304.08,16 HCPCS,81219,Hc 189 Calr Exon 9-So+,240.0,96.0,,,0 HCPCS,81220,Cftr gene com variants,,,332.71,1391.5,16 HCPCS,81220,Hc 320 Cf Genzyme 97 Mutation-So+,960.55,384.22,,,0 HCPCS,81220,Hc Cftr Gene Analysis Common Variants - Cystic Fibrosis Gene Test,1436.02,574.41,,,0 HCPCS,81220,"Hc Cystic Fibrosis, 97 Variants 481025-So+",667.92,267.17,,,0 HCPCS,81221,Cftr gene known fam variants,,,42.97,243.05,16 HCPCS,81221,Hc Familial Variant Cftr,837.2,334.88,,,0 HCPCS,81222,Cftr gene dup/delet variants,,,59.01,1087.68,16 HCPCS,81222,Hc Comprehensive Renal Disease Panel #7,971.31,388.52,,,0 HCPCS,81222,Hc Metabolic Newborn Screen Panel #5,678.7,271.48,,,0 HCPCS,81222,Hc Primary Immunodeficiency Panel #7,1092.0,436.8,,,0 HCPCS,81223,Cftr gene full sequence,,,499.0,1247.5,16 HCPCS,81223,Hc Comprehensive Renal Disease Panel #8,971.31,388.52,,,0 HCPCS,81223,Hc Metabolic Newborn Screen Panel #6,778.44,311.38,,,0 HCPCS,81223,Hc Primary Immunodeficiency Panel #8,1092.0,436.8,,,0 HCPCS,81223,Hc Renal Ciliopathy Panel #7,1161.0,464.4,,,0 HCPCS,81224,Cftr gene intron poly t,,,33.32,421.88,16 HCPCS,81225,Cyp2c19 gene com variants,,,67.07,728.4,16 HCPCS,81226,Cyp2d6 gene com variants,,,86.62,1127.28,16 HCPCS,81227,Cyp2c9 gene com variants,,,35.72,437.02,16 HCPCS,81227,Hc 331 Cyp2C9 Gene Com Varian-So+,461.5,184.6,,,0 HCPCS,81227,"Hc Cyp2C8, Cyp2C9, And Cyp2C Cluster3001501-So+",209.77,83.91,,,0 HCPCS,81227,Hc Warfarin Sensitivity Genotyping 3001541 #1-So+,70.4,28.16,,,0 HCPCS,81228,Cytogen micrarray copy nmbr,,,19.66,2250.0,16 HCPCS,81229,Cytogen m array copy no&snp,,,9.64,2900.0,16 HCPCS,81229,Hc Cma Microarray,6257.24,2502.9,,,0 HCPCS,81230,Cyp3a4 gene common variants,,,69.92,437.02,16 HCPCS,81231,Cyp3a5 gene common variants,,,69.92,437.02,16 HCPCS,81232,Dpyd gene common variants,,,69.92,437.02,16 HCPCS,81232,"Hc Dpyd Genotype, V Dpydq-So+",882.0,352.8,,,0 HCPCS,81233,Btk gene common variants,,,70.16,438.5,16 HCPCS,81234,Dmpk gene detc abnor allele,,,54.8,342.5,16 HCPCS,81234,Hc Myotonic Dystrophy 1 (Dmpk) Genetic Testing (Repeat Expansion)620084-So+,343.38,137.35,,,0 HCPCS,81235,Egfr gene com variants,,,217.95,811.45,16 HCPCS,81235,Hc 296 Egfr Gene Alys-So+,869.9,347.96,,,0 HCPCS,81236,Ezh2 gene full gene sequence,,,113.15,707.2,16 HCPCS,81237,Ezh2 gene common variants,,,70.16,438.5,16 HCPCS,81238,F9 full gene sequence,,,240.0,1500.0,16 HCPCS,81239,Dmpk gene charac alleles,,,109.93,687.08,16 HCPCS,81240,F2 gene,,,26.02,164.22,16 HCPCS,81240,Hc F2 (Protrhombin) Mutation Test,1044.82,417.93,,,0 HCPCS,81241,F5 gene,,,26.74,183.42,16 HCPCS,81241,Hc F5 Leiden Mutation Test,1158.69,463.48,,,0 HCPCS,81242,Fancc gene,,,26.3,91.55,16 HCPCS,81243,Fmr1 gene detection,,,42.14,142.6,16 HCPCS,81243,Hc 518 Fragile X-So+,486.0,194.4,,,0 HCPCS,81243,Hc Fragile X Screening By Pcr,614.51,245.8,,,0 HCPCS,81244,Fmr1 gene characterization,,,16.07,112.22,16 HCPCS,81245,Flt3 gene,,,53.47,413.78,16 HCPCS,81245,Hc Flt3-Itd,2166.67,866.67,,,0 HCPCS,81246,Flt3 gene analysis,,,53.47,207.5,16 HCPCS,81246,Hc Flt3-Tkd,1942.3,776.92,,,0 HCPCS,81247,G6pd gene alys cmn variant,,,69.92,437.02,16 HCPCS,81248,G6pd known familial variant,,,150.1,938.12,16 HCPCS,81248,Hc Familial Variant G6Pd,1068.26,427.3,,,0 HCPCS,81249,G6pd full gene sequence,,,240.0,1500.0,16 HCPCS,81249,Hc Metabolic Newborn Screen Panel #7,936.0,374.4,,,0 HCPCS,81249,Hc Primary Immunodeficiency Panel #9,1092.0,436.8,,,0 HCPCS,81250,G6pc gene,,,36.53,146.22,16 HCPCS,81251,Gba gene,,,47.25,118.12,16 HCPCS,81252,Gjb2 gene full sequence,,,101.12,299.46,16 HCPCS,81252,Hc 513 Connexin 26 Gjb2 Seq-So+,552.0,220.8,,,0 HCPCS,81253,Gjb2 gene known fam variants,,,61.52,153.8,16 HCPCS,81253,Hc Familial Variant Gjb2,837.2,334.88,,,0 HCPCS,81254,Gjb6 gene com variants,,,35.0,87.5,16 HCPCS,81255,Hexa gene,,,51.45,128.62,16 HCPCS,81256,Hc Hemochromatosis-C282Y Mut,1573.94,629.58,,,0 HCPCS,81256,Hc Hemochromatosis-H63D Mut,1573.94,629.58,,,0 HCPCS,81256,Hfe gene,,,31.01,163.4,16 HCPCS,81257,Hba1/hba2 gene,,,58.73,255.65,16 HCPCS,81258,Hba1/hba2 gene fam vrnt,,,150.1,938.12,16 HCPCS,81258,Hc Familial Variant Hba1/Hba2,1068.26,427.3,,,0 HCPCS,81259,Hba1/hba2 full gene sequence,,,240.0,1500.0,16 HCPCS,81260,Ikbkap gene,,,36.53,98.28,16 HCPCS,81261,Hc 275 B-Cell Igh Pcr-So+,240.0,96.0,,,0 HCPCS,81261,Igh gene rearrange amp meth,,,71.68,494.98,16 HCPCS,81262,Igh gene rearrang dir probe,,,46.53,171.38,16 HCPCS,81263,Igh vari regional mutation,,,70.28,736.3,16 HCPCS,81264,Hc 275 B-Cell Igk Pcr-So+,240.0,96.0,,,0 HCPCS,81264,Igk rearrangeabn clonal pop,,,172.73,431.82,16 HCPCS,81265,Hc Specimen Id By Str,2677.36,1070.94,,,0 HCPCS,81265,Hc Str Pre-Transplant Evaluation,2677.36,1070.94,,,0 HCPCS,81265,Str markers specimen anal,,,182.89,582.68,16 HCPCS,81266,Str markers spec anal addl,,,182.89,762.02,16 HCPCS,81267,Chimerism anal no cell selec,,,207.46,518.65,16 HCPCS,81267,Hc Chimerism Post Transplant Analyse,2970.38,1188.15,,,0 HCPCS,81268,Chimerism anal w/cell select,,,260.79,651.98,16 HCPCS,81268,Hc Chimerism W/Comp To Baseline W/Cell Selection Each - Additional Chg,3067.51,1227.0,,,0 HCPCS,81269,Hba1/hba2 gene dup/del vrnts,,,80.96,506.0,16 HCPCS,81270,Hc 647 Jak2 V617F Mut Qlt-So+,150.0,60.0,,,0 HCPCS,81270,Jak2 gene,,,26.3,229.15,16 HCPCS,81271,Hc Huntington Disease Cag Repeat Expansion-So+,257.1,102.84,,,0 HCPCS,81271,Hc Huntington Disease Via The Htt Cag Repeat Expansion-So+,420.0,168.0,,,0 HCPCS,81271,Htt gene detc abnor alleles,,,54.8,342.5,16 HCPCS,81272,Hc 333 Kit Mutations Aml-So+,869.9,347.96,,,0 HCPCS,81272,Hc C-Kit Mutation Analysis 480940-So+,842.63,337.05,,,0 HCPCS,81272,Hc Gastrointestinal Stromal Tumor Mutations 3004279-So+,588.6,235.44,,,0 HCPCS,81272,Kit gene targeted seq analys,,,69.13,823.78,16 HCPCS,81273,Kit gene analys d816 variant,,,43.29,312.18,16 HCPCS,81274,Hc 918 Huntington Diseas(Cag)-So+,300.0,120.0,,,0 HCPCS,81274,Htt gene charac alleles,,,109.93,687.08,16 HCPCS,81275,Hc 562 Kras Gene-So+,520.58,208.23,,,0 HCPCS,81275,Kras gene variants exon 2,,,90.56,483.12,16 HCPCS,81276,Hc 562 Kras Add'l Variants-So+,238.28,95.31,,,0 HCPCS,81276,Kras gene addl variants,,,87.55,483.12,16 HCPCS,81277,Cytogenomic neo microra alys,,,464.0,2900.0,16 HCPCS,81278,Igh@/bcl2 translocation alys,,,82.92,518.28,16 HCPCS,81279,Hc Jak2 Exon 12-Mutation Analysis By Pcr 3020079-So+,240.0,96.0,,,0 HCPCS,81279,Hc Jak2 Exon12,312.0,124.8,,,0 HCPCS,81279,Jak2 gene trgt sequence alys,,,74.08,463.0,16 HCPCS,81283,Hc Accutype? Il28B 90252-So+,136.37,54.55,,,0 HCPCS,81283,Ifnl3 gene,,,30.18,183.42,16 HCPCS,81284,Fxn gene detc abnor alleles,,,54.8,342.5,16 HCPCS,81285,Fxn gene charac alleles,,,109.93,687.08,16 HCPCS,81286,Fxn gene full gene sequence,,,109.93,687.08,16 HCPCS,81287,Hc 712 Mgmt Gene Methylation-So+,360.0,144.0,,,0 HCPCS,81287,Hc Mgmt Promoter Methylation Detection By Ddpcr 3005956-So+,360.0,144.0,,,0 HCPCS,81287,Mgmt gene methylation anal,,,99.61,311.6,16 HCPCS,81288,Hc 288 Mlh1 Promoter Methyltn-So+,421.45,168.58,,,0 HCPCS,81288,Mlh1 gene,,,173.26,480.8,16 HCPCS,81289,Fxn gene known famil variant,,,74.08,463.0,16 HCPCS,81289,Hc Familial Variant Fxn,947.71,379.08,,,0 HCPCS,81290,Mcoln1 gene,,,36.53,98.28,16 HCPCS,81291,Hc 164 Mthf Mutation-So+,156.97,62.79,,,0 HCPCS,81291,Mthfr gene,,,26.3,163.35,16 HCPCS,81292,Mlh1 gene full seq,,,517.96,1688.5,16 HCPCS,81293,Hc Familial Variant Mlh1,947.71,379.08,,,0 HCPCS,81293,Mlh1 gene known variants,,,42.13,827.5,16 HCPCS,81294,Mlh1 gene dup/delete variant,,,173.26,506.0,16 HCPCS,81295,Msh2 gene full seq,,,182.05,954.25,16 HCPCS,81296,Hc Familial Variant Msh2,961.1,384.44,,,0 HCPCS,81296,Msh2 gene known variants,,,42.13,844.32,16 HCPCS,81297,Msh2 gene dup/delete variant,,,153.65,533.25,16 HCPCS,81298,Hc Primary Immunodeficiency Panel #10,1092.0,436.8,,,0 HCPCS,81298,Msh6 gene full seq,,,345.4,1604.62,16 HCPCS,81299,Hc Familial Variant Msh6,947.71,379.08,,,0 HCPCS,81299,Msh6 gene known variants,,,42.13,770.0,16 HCPCS,81300,Msh6 gene dup/delete variant,,,148.36,595.0,16 HCPCS,81301,Hc Msi By Pcr,2156.62,862.65,,,0 HCPCS,81301,Microsatellite instability,,,97.76,871.4,16 HCPCS,81302,Mecp2 gene full seq,,,198.44,1319.68,16 HCPCS,81303,Hc Familial Variant Mecp2,837.2,334.88,,,0 HCPCS,81303,Mecp2 gene known variant,,,5.35,300.0,16 HCPCS,81304,Mecp2 gene dup/delet variant,,,46.53,375.0,16 HCPCS,81305,Myd88 gene p.leu265pro vrnt,,,70.16,438.5,16 HCPCS,81306,Hc Tpmt And Nudt15 Arup 3001535 #2-So+,279.7,111.88,,,0 HCPCS,81306,Nudt15 gene common variants,,,116.54,728.4,16 HCPCS,81307,Hc Primary Immunodeficiency Panel #11,1092.0,436.8,,,0 HCPCS,81307,Palb2 gene full gene seq,,,113.15,1691.25,16 HCPCS,81308,Hc Familial Variant Palb2,947.71,379.08,,,0 HCPCS,81308,Palb2 gene known famil vrnt,,,120.54,753.38,16 HCPCS,81309,Pik3ca gene trgt seq alys,,,109.93,687.08,16 HCPCS,81310,Hc Npm1 Gene,1972.44,788.98,,,0 HCPCS,81310,"Hc Npm1, Mrd 3000066-So+",323.26,129.3,,,0 HCPCS,81310,Npm1 gene,,,26.83,616.3,16 HCPCS,81311,Hc 286 Nras-So+,780.89,312.36,,,0 HCPCS,81311,Nras gene variants exon 2&3,,,131.33,739.48,16 HCPCS,81312,Pabpn1 gene detc abnor allel,,,54.8,342.5,16 HCPCS,81313,Pca3/klk3 antigen,,,200.0,637.62,16 HCPCS,81314,Hc Gastrointestinal Stromal Tumor (Pdgfra)-So+,588.6,235.44,,,0 HCPCS,81314,Pdgfra gene,,,69.13,823.78,16 HCPCS,81315,Hc 096 Pml-Rara T(15;17)Qnt-So+,392.4,156.96,,,0 HCPCS,81315,Pml/raralpha com breakpoints,,,37.53,518.28,16 HCPCS,81316,Pml/raralpha 1 breakpoint,,,49.94,518.28,16 HCPCS,81317,Hc Primary Immunodeficiency Panel #12,1092.0,436.8,,,0 HCPCS,81317,Pms2 gene full seq analysis,,,387.07,1691.25,16 HCPCS,81318,Hc Familial Variant Pms2,947.71,379.08,,,0 HCPCS,81318,Pms2 known familial variants,,,39.37,827.5,16 HCPCS,81319,Pms2 gene dup/delet variants,,,203.5,508.75,16 HCPCS,81320,Plcg2 gene common variants,,,116.54,728.4,16 HCPCS,81321,Hc Primary Immunodeficiency Panel #13,1092.0,436.8,,,0 HCPCS,81321,Pten gene full sequence,,,600.0,1500.0,16 HCPCS,81322,Hc Familial Variant Pten,947.71,379.08,,,0 HCPCS,81322,Pten gene known fam variant,,,46.6,269.72,16 HCPCS,81323,Pten gene dup/delet variant,,,105.12,1000.22,16 HCPCS,81324,Pmp22 gene dup/delet,,,627.82,1895.9,16 HCPCS,81325,Pmp22 gene full sequence,,,175.64,1923.95,16 HCPCS,81326,Hc Familial Variant Pmp22,1786.59,714.64,,,0 HCPCS,81326,Pmp22 gene known fam variant,,,46.6,627.82,16 HCPCS,81327,Sept9 methylation analysis,,,100.4,480.0,16 HCPCS,81328,Slco1b1 gene com variants,,,69.92,437.02,16 HCPCS,81329,Smn1 gene dos/deletion alys,,,54.8,342.5,16 HCPCS,81330,Smpd1 gene common variants,,,47.0,117.5,16 HCPCS,81331,Hc 532 Prader-Willi Synd Dna-So+,600.0,240.0,,,0 HCPCS,81331,Hc Angelman Syndrome And Prader-Willi Syndrome By Methylation-Specific Mlpa 3006247-So+,360.0,144.0,,,0 HCPCS,81331,Snrpn/ube3a gene,,,24.61,127.68,16 HCPCS,81332,Serpina1 gene,,,31.01,109.12,16 HCPCS,81333,Tgfbi gene common variants,,,54.8,342.5,16 HCPCS,81334,Runx1 gene targeted seq alys,,,131.8,823.78,16 HCPCS,81335,Hc 955 Tpmt Genotype-So+,510.0,204.0,,,0 HCPCS,81335,Hc Tpmt And Nudt15 3001535-So+,279.7,111.88,,,0 HCPCS,81335,Tpmt gene com variants,,,69.92,437.02,16 HCPCS,81336,Smn1 gene full gene sequence,,,120.54,753.38,16 HCPCS,81337,Hc Familial Variant Smn1/Smn2,947.71,379.08,,,0 HCPCS,81337,Smn1 gen nown famil seq vrnt,,,74.08,463.0,16 HCPCS,81338,Hc Mpl Mutation Detection 2005545-So+,404.4,161.76,,,0 HCPCS,81338,Mpl gene common variants,,,60.13,375.82,16 HCPCS,81339,Mpl gene seq alys exon 10,,,74.08,463.0,16 HCPCS,81340,"Hc T-Cell Receptor V-Beta Repertoire Analysis, Spectratyping, Blood Tcrb-So+",2183.88,873.55,,,0 HCPCS,81340,Trb@ gene rearrange amplify,,,90.58,522.3,16 HCPCS,81341,Trb@ gene rearrange dirprobe,,,46.53,123.98,16 HCPCS,81342,Hc 569 T Cell Gene Rearran-So+,360.0,144.0,,,0 HCPCS,81342,Trg gene rearrangement anal,,,58.89,503.75,16 HCPCS,81343,Ppp2r2b gen detc abnor allel,,,54.8,342.5,16 HCPCS,81344,Tbp gene detc abnor alleles,,,54.8,342.5,16 HCPCS,81345,Tert gene targeted seq alys,,,74.08,463.0,16 HCPCS,81346,Tyms gene com variants,,,69.92,437.02,16 HCPCS,81347,Sf3b1 gene common variants,,,77.3,483.12,16 HCPCS,81348,Srsf2 gene common variants,,,70.16,438.5,16 HCPCS,81349,Cytog alys chrml abnr lw-ps,,,360.0,2994.85,16 HCPCS,81350,Hc Ugt1A1 Genotyping,515.78,206.31,,,0 HCPCS,81350,Ugt1a1 gene,,,31.67,585.0,16 HCPCS,81351,Hc Primary Immunodeficiency Panel #14,1092.0,436.8,,,0 HCPCS,81351,Tp53 gene full gene sequence,,,256.74,1604.62,16 HCPCS,81352,Tp53 gene trgt sequence alys,,,131.8,823.78,16 HCPCS,81353,Hc Familial Variant Tp53,947.71,379.08,,,0 HCPCS,81353,Tp53 gene known famil vrnt,,,123.2,770.0,16 HCPCS,81354,Cytog alys chrml abnor ogm,,,1263.53,3158.82,5 HCPCS,81355,Hc Warfarin Sensitivity Genotyping 3001541 #2-So+,70.4,28.16,,,0 HCPCS,81355,Vkorc1 gene,,,35.72,220.5,16 HCPCS,81357,U2af1 gene common variants,,,77.3,483.12,16 HCPCS,81360,Zrsr2 gene common variants,,,77.3,483.12,16 HCPCS,81361,Hbb gene com variants,,,69.92,437.02,16 HCPCS,81362,Hbb gene known fam variant,,,150.1,938.12,16 HCPCS,81362,Hc Familial Variant Hbb,1068.26,427.3,,,0 HCPCS,81363,Hbb gene dup/del variants,,,80.96,506.0,16 HCPCS,81364,Hbb full gene sequence,,,129.83,811.45,16 HCPCS,81370,Hc Hla Complete Typing - Donor,5083.48,2033.39,,,0 HCPCS,81370,Hc Hla Complete Typing - Patient,5083.48,2033.39,,,0 HCPCS,81370,"Hc Hla Low Resolution Sso Typing, Donor",5083.48,2033.39,,,0 HCPCS,81370,Hc Hla-Ssp Typing Abcdrdqdp,5083.48,2033.39,,,0 HCPCS,81370,"Hla Low Resolution Sso Typing, Patient",5083.48,2033.39,,,0 HCPCS,81370,Hla i & ii typing lr,,,129.8,1005.3,16 HCPCS,81371,Hla i & ii type verify lr,,,129.8,1011.3,16 HCPCS,81372,Hc 649 Hla-Sso Abc Of Abcdrdq,2853.18,1141.27,,,0 HCPCS,81372,Hc Hla-Sso Abc-Loci Testing,2853.18,1141.27,,,0 HCPCS,81372,Hla i typing complete lr,,,346.9,1008.98,16 HCPCS,81373,Hc Hla-Sso A-Locus Testing,2107.95,843.18,,,0 HCPCS,81373,Hc Hla-Sso B-Locus Testing,2360.9,944.36,,,0 HCPCS,81373,Hc Hla-Sso C-Locus Testing,2215.2,886.08,,,0 HCPCS,81373,Hla i typing 1 locus lr,,,116.8,318.58,16 HCPCS,81374,Hc Hla-Sso B-27 Testing,1460.08,584.03,,,0 HCPCS,81374,Hc Hla-Sso B-Locus For Pharmaco,1460.08,584.03,,,0 HCPCS,81374,"Hc Hla-Ssp B-Locus Typing For B57, Patient",381.22,152.49,,,0 HCPCS,81374,Hla i typing 1 antigen lr,,,74.33,185.82,16 HCPCS,81375,Hc 649 Hla-Sso Drdq Of Abcdrdq,2751.03,1100.41,,,0 HCPCS,81375,Hla ii typing ag equiv lr,,,131.51,551.85,16 HCPCS,81376,"Hc Hla-Sso Single Loci Testing, Class Ii",2608.71,1043.48,,,0 HCPCS,81376,Hla ii typing 1 locus lr,,,72.11,305.55,16 HCPCS,81377,Hc Hla-Sso Dq Testing For Celiac,1647.61,659.04,,,0 HCPCS,81377,Hc Riskimmune,468.83,187.53,,,0 HCPCS,81377,Hla ii type 1 ag equiv lr,,,64.3,236.85,16 HCPCS,81378,Hc 428 Hr Hla-A/B/C&Drb1 Typ,1684.8,673.92,,,0 HCPCS,81378,Hla i & ii typing hr,,,64.3,863.92,16 HCPCS,81379,Hc Hr-Ngs Hla-A/B/C Typing,1001.65,400.66,,,0 HCPCS,81379,Hla i typing complete hr,,,64.3,838.45,16 HCPCS,81380,Hla i typing 1 locus hr,,,71.08,443.12,16 HCPCS,81381,"Hc Hla- B*58:01 Genotyping, Allopurinol Hyp 3001393-So+",288.0,115.2,,,0 HCPCS,81381,Hc Hla-B*57:01 For Abacavir Sensitivity2002429-So+,204.0,81.6,,,0 HCPCS,81381,Hla i typing 1 allele hr,,,116.8,424.75,16 HCPCS,81382,Hc 429 Hr Hla-Dqa1 Typ-So+,444.79,177.92,,,0 HCPCS,81382,Hc 430 Hr Hla-Dqb1 Typ-So+,444.79,177.92,,,0 HCPCS,81382,Hc 431 Hr Hla-Dpb1 Typ-So+,444.79,177.92,,,0 HCPCS,81382,Hc Hr-Ngs Hla-Dpa1 Typing,1979.38,791.75,,,0 HCPCS,81382,Hc Hr-Ngs Hla-Dpb1 Typing,1979.38,791.75,,,0 HCPCS,81382,Hc Hr-Ngs Hla-Dqa1 Typing,1979.38,791.75,,,0 HCPCS,81382,Hc Hr-Ngs Hla-Dqb1 Typing,1979.38,791.75,,,0 HCPCS,81382,Hc Hr-Ngs Hla-Drb3/4/5 Typing,1979.38,791.75,,,0 HCPCS,81382,Hc-Ngs Hla-Drb1 Typing,1979.38,791.75,,,0 HCPCS,81382,Hla ii typing 1 loc hr,,,58.38,309.2,16 HCPCS,81383,Hla ii typing 1 allele hr,,,45.66,272.82,16 HCPCS,81400,Hc 759 Plasminogen 1 Pai-1-So+,380.77,152.31,,,0 HCPCS,81400,Mopath procedure level 1,,,32.16,159.9,16 HCPCS,81401,Hc 347 Cbfb-Myh11 Inv(16)-So+,390.0,156.0,,,0 HCPCS,81401,Hc 438 Apoe Genotyp Card/Vasc-So+,160.77,64.31,,,0 HCPCS,81401,Hc 440 Apoe Genotyp Alzheimer-So+,160.77,64.31,,,0 HCPCS,81401,Hc 893 Mopath Lev 2 Beck/Wied-So+,714.48,285.79,,,0 HCPCS,81401,"Hc Runx1::Runx1T1 (Aml1::Eto) T(8;21) Detection, Quantitative2010138-So+",580.5,232.2,,,0 HCPCS,81401,Mopath procedure level 2,,,32.16,342.5,16 HCPCS,81402,Hc 181 Mpl Codon 515 Mut-So+,759.62,303.85,,,0 HCPCS,81402,Mopath procedure level 3,,,61.84,375.82,16 HCPCS,81403,Hc 478 Mp Lev 4 Kcnj11-So+,583.0,233.2,,,0 HCPCS,81403,Hc 790 Mopath Proc Lev 4-So+,819.75,327.9,,,0 HCPCS,81403,Hc Kbc Rhd Genotyping So+,420.0,168.0,,,0 HCPCS,81403,Hc Molecular Dna Test-Red Cell Genotyping So+,819.75,327.9,,,0 HCPCS,81403,Hc Rhd Gene (Rhd) Copy Number51368-So+,292.2,116.88,,,0 HCPCS,81403,Mopath procedure level 4,,,60.26,463.0,16 HCPCS,81404,Hc Comprehensive Renal Disease Panel #4,971.31,388.52,,,0 HCPCS,81404,Hc Fatty Acid Oxidation Panel #3,420.77,168.31,,,0 HCPCS,81404,Hc Metabolic Newborn Screen Panel #3,428.74,171.5,,,0 HCPCS,81404,Hc Nephrolithiasis And Calcinosis Panel #4,1040.43,416.17,,,0 HCPCS,81404,Hc Polyscystic Kidney Disease Panel #4,1145.73,458.29,,,0 HCPCS,81404,Hc Primary Immunodeficiency Panel #4,1092.0,436.8,,,0 HCPCS,81404,Hc Renal Ciliopathy Panel #4,1161.0,464.4,,,0 HCPCS,81404,Hc Renal Tubulopathy Panel #4,987.42,394.97,,,0 HCPCS,81404,Mopath procedure level 5,,,133.97,687.08,16 HCPCS,81405,Hc 009 Mp Lev 6 Tgfbr1,493.95,197.58,,,0 HCPCS,81405,Hc 009 Mp Lev 6 Tgfbr2,493.95,197.58,,,0 HCPCS,81405,Hc Comprehensive Renal Disease Panel #3,971.31,388.52,,,0 HCPCS,81405,Hc Fatty Acid Oxidation Panel #2,420.77,168.31,,,0 HCPCS,81405,Hc Metabolic Newborn Screen Panel #2,470.11,188.04,,,0 HCPCS,81405,Hc Nephrolithiasis And Calcinosis Panel #3,1040.43,416.17,,,0 HCPCS,81405,Hc Nephrotic Syndrome & Fsgs Panel #3,1231.1,492.44,,,0 HCPCS,81405,Hc Polyscystic Kidney Disease Panel #3,1145.73,458.29,,,0 HCPCS,81405,Hc Primary Immunodeficiency Panel #3,1092.0,436.8,,,0 HCPCS,81405,Hc Renal Ciliopathy Panel #3,1161.0,464.4,,,0 HCPCS,81405,Hc Renal Tubulopathy Panel #3,987.42,394.97,,,0 HCPCS,81405,Hc Stat3 Snp-So+,361.62,144.65,,,0 HCPCS,81405,Hc Very Long Chain Fatty Acid Ngs #2,402.13,160.85,,,0 HCPCS,81405,Mopath procedure level 6,,,159.69,753.38,16 HCPCS,81406,Hc 014 Mp Lev 7 Ldlr,500.82,200.33,,,0 HCPCS,81406,Hc 014 Mp Lev-7 Pcsk9,500.82,200.33,,,0 HCPCS,81406,Hc 305 Targeted Oncology-So+,3557.69,1423.08,,,0 HCPCS,81406,Hc Comprehensive Renal Disease Panel #2,971.31,388.52,,,0 HCPCS,81406,Hc Fatty Acid Oxidation Panel #1,420.77,168.31,,,0 HCPCS,81406,Hc Galactosemia Ngs Panel #1,359.78,143.91,,,0 HCPCS,81406,Hc Metabolic Newborn Screen Panel #1,441.3,176.52,,,0 HCPCS,81406,Hc Nephrolithiasis And Calcinosis Panel #2,1040.43,416.17,,,0 HCPCS,81406,Hc Nephrotic Syndrome & Fsgs Panel #2,1231.1,492.44,,,0 HCPCS,81406,Hc Polyscystic Kidney Disease Panel #2,1145.73,458.29,,,0 HCPCS,81406,Hc Primary Immunodeficiency Panel #2,1092.0,436.8,,,0 HCPCS,81406,Hc Renal Ciliopathy Panel #2,1161.0,464.4,,,0 HCPCS,81406,Hc Renal Tubulopathy Panel #2,987.42,394.97,,,0 HCPCS,81406,Hc Very Long Chain Fatty Acid Ngs #1,402.13,160.85,,,0 HCPCS,81406,Mopath procedure level 7,,,28.14,707.2,16 HCPCS,81407,Hc 014 Mp Lev 8 Tgfbr1,1166.1,466.44,,,0 HCPCS,81407,Hc Alport Syndrome Panel #1,1549.6,619.84,,,0 HCPCS,81407,Hc Comprehensive Renal Disease Panel #1,1320.18,528.07,,,0 HCPCS,81407,Hc Nephrolithiasis And Calcinosis Panel #1,1040.43,416.17,,,0 HCPCS,81407,Hc Nephrotic Syndrome & Fsgs Panel #1,1231.1,492.44,,,0 HCPCS,81407,Hc Polyscystic Kidney Disease Panel #1,1145.73,458.29,,,0 HCPCS,81407,Hc Primary Immunodeficiency Panel #1,1320.18,528.07,,,0 HCPCS,81407,Hc Renal Ciliopathy Panel #1,1161.0,464.4,,,0 HCPCS,81407,Hc Renal Tubulopathy Panel #1,987.42,394.97,,,0 HCPCS,81407,Mopath procedure level 8,,,846.27,2115.68,16 HCPCS,81408,Hc 001 Mp Lev-9 Col1A1/Col1A2,3806.27,1522.51,,,0 HCPCS,81408,Hc 009 Mp Lev-9 Fbn1,3268.43,1307.37,,,0 HCPCS,81408,Hc 223 Mopath 9 Fbn1-So+,1952.0,780.8,,,0 HCPCS,81408,Hc Alport Syndrome Panel #2,1549.6,619.84,,,0 HCPCS,81408,Hc Comprehensive Renal Disease Panel #6,3120.0,1248.0,,,0 HCPCS,81408,Hc Nephrotic Syndrome & Fsgs Panel #5,1231.1,492.44,,,0 HCPCS,81408,Hc Polyscystic Kidney Disease Panel #6,1145.73,458.29,,,0 HCPCS,81408,Hc Primary Immunodeficiency Panel #6,3120.0,1248.0,,,0 HCPCS,81408,Hc Renal Ciliopathy Panel #6,1161.0,464.4,,,0 HCPCS,81408,Mopath procedure level 9,,,2000.0,5000.0,16 HCPCS,81410,Aortic dysfunction/dilation,,,504.0,1883.31,16 HCPCS,81410,Hc Aortopathy Ngs,4323.31,1729.32,,,0 HCPCS,81411,Aortic dysfunction/dilation,,,1350.19,3375.48,16 HCPCS,81412,Ashkenazi jewish assoc dis,,,722.52,6121.4,16 HCPCS,81413,Car ion chnnlpath inc 10 gns,,,584.9,1462.25,16 HCPCS,81413,Hc Arrhythmia Ngs,4360.14,1744.06,,,0 HCPCS,81414,Car ion chnnlpath inc 2 gns,,,584.9,1462.25,16 HCPCS,81415,Exome sequence analysis,,,1883.31,11950.0,16 HCPCS,81415,Hc Exome Proband Sequencing,11524.89,4609.96,,,0 HCPCS,81416,Exome sequence analysis,,,1883.31,30000.0,16 HCPCS,81416,Hc Exome Testing Familial Control,28933.63,11573.45,,,0 HCPCS,81417,Exome re-evaluation,,,320.0,941.66,16 HCPCS,81418,Rx metab gen seq alys pnl 6,,,699.2,2292.7,16 HCPCS,81419,Epilepsy gen seq alys panel,,,979.42,6121.4,16 HCPCS,81419,Hc Epilepsy Ngs Panel,4395.3,1758.12,,,0 HCPCS,81420,Fetal chrmoml aneuploidy,,,759.05,1897.62,16 HCPCS,81420,Hc 495 Non-Invas Prenat Test-So+,2259.97,903.99,,,0 HCPCS,81420,Hc Fetal Aneuploidy Screening 3004764-So+,540.0,216.0,,,0 HCPCS,81420,Hc Non-Invasive Prenatal Aneuploidy By Ngs3003043-So+,910.86,364.34,,,0 HCPCS,81422,Fetal chrmoml microdeltj,,,759.05,1897.62,16 HCPCS,81425,Genome sequence analysis,,,1883.31,12578.0,16 HCPCS,81426,Genome sequence analysis,,,1883.31,6774.88,16 HCPCS,81427,Genome re-evaluation,,,941.66,5844.12,16 HCPCS,81430,Hc Otoscope #1-So+,990.0,396.0,,,0 HCPCS,81430,Hearing loss sequence analys,,,1625.0,4062.5,16 HCPCS,81431,Hc Otoscope #2-So+,990.0,396.0,,,0 HCPCS,81431,Hearing loss dup/del analys,,,679.57,1883.31,16 HCPCS,81432,Hrdtry brst ca-rlatd dsordrs,,,800.0,3259.88,16 HCPCS,81433,Hrdtry brst ca-rlatd dsordrs,,,438.93,800.0,11 HCPCS,81434,Hereditary retinal disorders,,,597.91,1494.78,16 HCPCS,81435,Hereditary colon ca dsordrs,,,955.12,3259.88,16 HCPCS,81436,Hereditary colon ca dsordrs,,,584.9,1883.31,11 HCPCS,81437,Heredtry nurondcrn tum dsrdr,,,722.52,3259.88,16 HCPCS,81438,Heredtry nurondcrn tum dsrdr,,,438.93,800.0,11 HCPCS,81439,Hc Cardiomyopathy Ngs,4443.86,1777.54,,,0 HCPCS,81439,Inherited cardmypthy 5 gns,,,584.9,1462.25,16 HCPCS,81440,Mitochondrial gene,,,1883.31,8310.0,16 HCPCS,81441,Ibmfs seq alys pnl 30 genes,,,979.42,6121.4,16 HCPCS,81442,Hc Congenital Heart Ngs,4323.31,1729.32,,,0 HCPCS,81442,Noonan spectrum disorders,,,722.52,5359.0,16 HCPCS,81443,Genetic tstg severe inh cond,,,979.42,6121.4,16 HCPCS,81445,Hc Lung Cancer Mutation Panel-So+,2040.0,816.0,,,0 HCPCS,81445,Targeted genomic seq analys,,,107.8,1883.31,16 HCPCS,81448,Hrdtry perph neurphy panel,,,288.84,1462.25,16 HCPCS,81449,Tgsap so neo 5-50 rna alys,,,239.16,1494.78,16 HCPCS,81450,"Hc Heme Malignancy Panel, 50 Gene",3767.4,1506.96,,,0 HCPCS,81450,Targeted genomic seq analys,,,107.8,1898.82,16 HCPCS,81451,Tgsap hl neo 5-50 rna alys,,,303.81,1898.82,16 HCPCS,81455,Hc Hematologic Malignancy Panel,8787.25,3514.9,,,0 HCPCS,81455,Hc Myeloid Malignancies Mutation Panel-Arup 201117,6285.3,2514.12,,,0 HCPCS,81455,Hc Solid Tumor 198 Gene Panel,7845.76,3138.3,,,0 HCPCS,81455,Targeted genomic seq analys,,,1883.31,7299.0,16 HCPCS,81456,Tgsap so/hl 51/< rna alys,,,1167.84,7299.0,16 HCPCS,81457,So neo gsap dna mcrstl ins,,,239.16,2242.18,16 HCPCS,81458,So gsap dna cpy nmbr&mcrstl,,,239.16,2615.88,16 HCPCS,81459,So neo gsap dna/dna&rna,,,239.16,7473.88,16 HCPCS,81460,Hc 647 Whole Mitochnd Genome-So+,2260.0,904.0,,,0 HCPCS,81460,Whole mitochondrial genome,,,1287.0,3217.5,16 HCPCS,81462,So gsap cll fr dna/dna&rna,,,239.16,2989.58,16 HCPCS,81463,So gsap cl fr cpy nmbr&mcrst,,,239.16,3363.28,16 HCPCS,81464,So gsap cll fr mcrstl ins,,,239.16,8221.28,16 HCPCS,81465,Whole mitochondrial genome,,,936.0,2340.0,16 HCPCS,81470,X-linked intellectual dblt,,,914.0,2285.0,16 HCPCS,81471,X-linked intellectual dblt,,,914.0,2285.0,16 HCPCS,81479,Hc 001 Mp Unlisted,137.31,54.92,,,0 HCPCS,81479,Hc 009 Mp Unlisted,105.48,42.19,,,0 HCPCS,81479,Hc 014 Mp Unlisted,1011.34,404.54,,,0 HCPCS,81479,Hc 331 Mp Unlst Cyp2C9-So+,150.0,60.0,,,0 HCPCS,81479,Hc 363 Bcr/Abl Kinase Dom Mut-So+,1483.65,593.46,,,0 HCPCS,81479,Hc 870 Mp Unlst Mult (4)-So+,132.08,52.83,,,0 HCPCS,81479,Hc Clonoseq (Adaptive Branch),6279.0,2511.6,,,0 HCPCS,81479,Hc Comprehensive Renal Disease Panel #5,971.31,388.52,,,0 HCPCS,81479,Hc Fatty Acid Oxidation Panel #4,420.77,168.31,,,0 HCPCS,81479,Hc Galactosemia Ngs Panel #2,359.78,143.91,,,0 HCPCS,81479,"Hc Karius Focus, Bal-So+",2640.0,1056.0,,,0 HCPCS,81479,Hc Metabolic Newborn Screen Panel #4,285.53,114.21,,,0 HCPCS,81479,Hc Nephrolithiasis And Calcinosis Panel #5,1040.43,416.17,,,0 HCPCS,81479,Hc Nephrotic Syndrome & Fsgs Panel #4,1231.1,492.44,,,0 HCPCS,81479,Hc Oi Hae Panel #1,2166.84,866.74,,,0 HCPCS,81479,Hc Polyscystic Kidney Disease Panel #5,1145.73,458.29,,,0 HCPCS,81479,Hc Primary Immunodeficiency Panel #5,1092.0,436.8,,,0 HCPCS,81479,Hc Renal Ciliopathy Panel #5,1161.0,464.4,,,0 HCPCS,81479,Hc Renal Tubulopathy Panel #5,987.42,394.97,,,0 HCPCS,81479,Hc Res 10X Chromium Single-Cell Lib Prep,3120.0,1248.0,,,0 HCPCS,81479,Hc Res Additional Primer,7.8,3.12,,,0 HCPCS,81479,Hc Res Addtl Ba Dna-1000,1.3,0.52,,,0 HCPCS,81479,Hc Res Addtl Ba Dna-Hs,1.3,0.52,,,0 HCPCS,81479,Hc Res Addtl Ba Rna-Nano,1.3,0.52,,,0 HCPCS,81479,Hc Res Addtl Ba Rna-Pico,1.3,0.52,,,0 HCPCS,81479,Hc Res Agilent Cre Wes,727.48,290.99,,,0 HCPCS,81479,Hc Res Amplicon Dnaseq Nexter Ind,58.07,23.23,,,0 HCPCS,81479,Hc Res Bioanalysis Dna-1000,81.9,32.76,,,0 HCPCS,81479,Hc Res Bioanalysis Dna-Hs,123.5,49.4,,,0 HCPCS,81479,Hc Res Bioanalysis Nanodrop,6.7,2.68,,,0 HCPCS,81479,Hc Res Bioanalysis Rna-Nano,80.6,32.24,,,0 HCPCS,81479,Hc Res Bioanalysis Rna-Pico,78.0,31.2,,,0 HCPCS,81479,Hc Res Cancer Gene Panel,727.48,290.99,,,0 HCPCS,81479,Hc Res Change For Mcc Orien Return Of Results,110.5,44.2,,,0 HCPCS,81479,Hc Res Clariom D Array Only,747.5,299.0,,,0 HCPCS,81479,Hc Res Clariom S Array Only,373.75,149.5,,,0 HCPCS,81479,Hc Res Clariom S Processing,205.67,82.27,,,0 HCPCS,81479,Hc Res Dna Extraction Qia Symp,16.65,6.66,,,0 HCPCS,81479,Hc Res Dna Quant (Qubit),2.7,1.08,,,0 HCPCS,81479,Hc Res Enzymatic Pcr Purification,4.3,1.72,,,0 HCPCS,81479,Hc Res Extra Gene Array,292.5,117.0,,,0 HCPCS,81479,Hc Res Extra Ht Array,388.7,155.48,,,0 HCPCS,81479,Hc Res Fragment Analysis Plate,111.81,44.72,,,0 HCPCS,81479,Hc Res Mirna Process & Array,487.5,195.0,,,0 HCPCS,81479,Hc Res Mirna Process Only,248.25,99.3,,,0 HCPCS,81479,Hc Res Miscellaneous Cdm,6658.79,2663.52,,,0 HCPCS,81479,Hc Res Miseq Run 2X150 V2,1566.54,626.62,,,0 HCPCS,81479,Hc Res Miseq Run 2X250 V2,1670.64,668.26,,,0 HCPCS,81479,Hc Res Miseq Run 2X250 V2 Nano,1170.0,468.0,,,0 HCPCS,81479,Hc Res Miseq Run 2X300 V3,2164.12,865.65,,,0 HCPCS,81479,Hc Res Nanostring Dsp Protein,305.5,122.2,,,0 HCPCS,81479,Hc Res Nanostring Mi-Rna,201.5,80.6,,,0 HCPCS,81479,Hc Res Nanostring Rna,110.5,44.2,,,0 HCPCS,81479,Hc Res Nextera Xt Library Prep,332.8,133.12,,,0 HCPCS,81479,Hc Res Pcr Purification,2.07,0.83,,,0 HCPCS,81479,Hc Res Pcr Purification Wellplate,194.3,77.72,,,0 HCPCS,81479,Hc Res Picoclariom S Processing,253.63,101.45,,,0 HCPCS,81479,Hc Res Q Pcr For Ngs Library,45.5,18.2,,,0 HCPCS,81479,Hc Res Rna Quant By Qubit,5.55,2.22,,,0 HCPCS,81479,Hc Res Sanger Sequencing Tier 1.1,4.42,1.77,,,0 HCPCS,81479,Hc Res Sanger Sequencing Tier 1.2,65.0,26.0,,,0 HCPCS,81479,Hc Res Sanger Sequencing Tier 2.1,5.49,2.2,,,0 HCPCS,81479,Hc Res Sanger Sequencing Tier 2.3,71.5,28.6,,,0 HCPCS,81479,Hc Res Sanger Sequencing Tier 3.1,12.92,5.17,,,0 HCPCS,81479,Hc Res Sanger Sequencing Tier 3.3,211.68,84.67,,,0 HCPCS,81479,Hc Res Sanger Sequencing Tier 3.4,253.5,101.4,,,0 HCPCS,81479,Hc Res Sonication Addl Sample,9.75,3.9,,,0 HCPCS,81479,Hc Res Sonication Single Sample,41.6,16.64,,,0 HCPCS,81479,Hc Res Str Human Cell Line Athent,82.22,32.89,,,0 HCPCS,81479,Hc Res Tap Station Dna 1000,19.54,7.82,,,0 HCPCS,81479,Hc Res Tape Highsensitiv Dna 1000,21.24,8.5,,,0 HCPCS,81479,Hc Res Tape Station Rna,23.19,9.28,,,0 HCPCS,81479,Hc Res Tapes High Sensitivity Rna,24.04,9.62,,,0 HCPCS,81479,Hc Res Tapestation Genomic Dna,21.31,8.52,,,0 HCPCS,81479,Hc Res Truseq Rna Library Prep,404.03,161.61,,,0 HCPCS,81479,Hc Very Long Chain Fatty Acid Ngs #3,402.13,160.85,,,0 HCPCS,81479,Hc Warfarin Sensitivity Genotyping 3001541 #3-So+,70.4,28.16,,,0 HCPCS,81479,Unlisted molecular pathology,,,0.01,0.01,4 HCPCS,81490,Autoimmune rheumatoid arthr,,,98.04,2101.62,16 HCPCS,81493,Cor artery disease mrna,,,800.0,2625.0,16 HCPCS,81500,Onco (ovar) two proteins,,,13.28,651.25,16 HCPCS,81503,Hc 878 Ova 1-Soq+,1291.68,516.67,,,0 HCPCS,81503,Onco (ovar) five proteins,,,49.15,2242.5,16 HCPCS,81504,Oncology tissue of origin,,,13.28,1300.0,16 HCPCS,81506,Endo assay seven anal,,,38.23,172.3,16 HCPCS,81507,Fetal aneuploidy trisom risk,,,13.28,1987.5,16 HCPCS,81508,Ftl cgen abnor two proteins,,,14.24,135.75,16 HCPCS,81508,Hc 989 Maternl Ser 1St Trimes-So+,65.16,26.06,,,0 HCPCS,81509,Ftl cgen abnor 3 proteins,,,34.22,3718.42,16 HCPCS,81510,Ftl cgen abnor three anal,,,26.5,138.85,16 HCPCS,81511,Ftl cgen abnor four anal,,,46.48,383.75,16 HCPCS,81511,Hc 990 Maternal Screen Quad-So+,184.2,73.68,,,0 HCPCS,81512,Ftl cgen abnor five anal,,,53.6,173.8,16 HCPCS,81513,"Hc Bacterial Vaginosis Panel,Reflex To Lactobacillus Recovery -So+",171.16,68.46,,,0 HCPCS,81513,Nfct ds bv rna vag flu alg,,,57.05,356.58,16 HCPCS,81514,Nfct ds bv&vaginitis dna alg,,,105.2,657.48,16 HCPCS,81515,Nfct ds bv&vaginitis dna alg,,,105.2,657.48,16 HCPCS,81517,Hc Enhanced Liver Fibrosis (Elf)? Test 550659-So+,390.0,156.0,,,0 HCPCS,81517,Liver ds alys 3 bmrk srm alg,,,70.48,440.48,16 HCPCS,81518,Onc brst mrna 11 genes,,,1549.2,9682.5,16 HCPCS,81519,Oncology breast mrna,,,1883.31,9682.5,16 HCPCS,81520,Onc breast mrna 58 genes,,,1239.61,6275.52,16 HCPCS,81521,Onc breast mrna 70 genes,,,1549.2,9682.5,16 HCPCS,81522,Onc breast mrna 12 genes,,,1549.2,9682.5,16 HCPCS,81523,Onc brst mrna 70 cnt 31 gene,,,1549.2,9682.5,16 HCPCS,81525,Oncology colon mrna,,,800.0,7790.0,16 HCPCS,81528,Oncology colorectal scr,,,159.38,1272.18,16 HCPCS,81529,Onc cutan mlnma mrna 31 gene,,,2877.2,17982.5,16 HCPCS,81535,Oncology gynecologic,,,347.68,1448.65,16 HCPCS,81536,Oncology gynecologic,,,106.54,443.9,16 HCPCS,81538,Oncology lung,,,87.76,7177.5,16 HCPCS,81539,Oncology prostate prob score,,,200.0,1900.0,16 HCPCS,81540,Oncology tum unknown origin,,,100.0,9375.0,16 HCPCS,81541,Onc prostate mrna 46 genes,,,1549.2,9682.5,16 HCPCS,81542,Onc prostate mrna 22 cnt gen,,,573.2,9682.5,16 HCPCS,81545,Oncology thyroid,,,100.0,100.0,4 HCPCS,81546,"Onc thyr mrna 10,196 gen alg",,,1440.0,9000.0,16 HCPCS,81551,Onc prostate 3 genes,,,200.0,5075.0,16 HCPCS,81552,Onc uveal mlnma mrna 15 gene,,,309.84,19440.0,16 HCPCS,81554,Pulm ds ipf mrna 190 gen alg,,,2200.0,13524.0,16 HCPCS,81558,Trnspl rej kdn mrna qpcr 139,,,1296.0,8100.0,16 HCPCS,81560,Trnsplj pd lvr&bwl cd154+cll,,,208.0,1601.82,16 HCPCS,81595,Cardiology hrt trnspl mrna,,,100.0,8100.0,16 HCPCS,81595,Hc 395 Allomap Heart Txp-So+,5316.5,2126.6,,,0 HCPCS,81595,Hc Allomap Molecular Expression (So),6113.98,2445.59,,,0 HCPCS,81596,Hc 421 Hcv Fibrosure-So+,154.33,61.73,,,0 HCPCS,81596,Nfct ds chrnc hcv 6 assays,,,28.88,180.48,16 HCPCS,81599,Hc Predictrpk Ada Maintenance 3700-#2 So+,858.0,343.2,,,0 HCPCS,81599,Hc Predictrpk Ifx Induction 3500-So+,858.0,343.2,,,0 HCPCS,81599,Hc Predictrpk Ifx Maintenance 3400-So+,858.0,343.2,,,0 HCPCS,81599,Unlisted maaa,,,0.01,0.01,4 HCPCS,82009,Test for acetone/ketones,,,3.84,11.3,16 HCPCS,82010,Acetone assay,,,6.94,20.42,16 HCPCS,82010,Hc Ketone Bodies Serum Quantitative - Ketones Blood,125.09,50.04,,,0 HCPCS,82013,Acetylcholinesterase assay,,,9.49,30.72,16 HCPCS,82013,"Hc Acetylcholinesterase (Ache), Amniotic Fluid With Reflex To Fetal Hemoglobin (Hb F)-So+",95.42,38.17,,,0 HCPCS,82016,Acylcarnitines qual,,,11.78,41.22,16 HCPCS,82017,Acylcarnitines quant,,,1.73,42.18,16 HCPCS,82017,Hc 044 Acylcarnit Pls Qnt May-So+,80.62,32.25,,,0 HCPCS,82017,Hc 367 C4 Acylcarnitine Urine-So+,519.36,207.74,,,0 HCPCS,82024,Assay of acth,,,28.03,96.55,16 HCPCS,82024,Hc Acth,202.72,81.09,,,0 HCPCS,82030,Assay of adp & amp,,,21.92,64.5,16 HCPCS,82040,Assay of serum albumin,,,4.2,12.38,16 HCPCS,82040,Hc Albumin,64.7,25.88,,,0 HCPCS,82040,Hc Albumin - Testosterone Free And Total,33.0,13.2,,,0 HCPCS,82040,Hc Assay Of Serum Albumin - Albumin,64.7,25.88,,,0 HCPCS,82040,Hc Oligoclonal Band Profile80440 #3-So+,14.4,5.76,,,0 HCPCS,82040,Hc Predictrpk Ada 3700 #2-So+,286.0,114.4,,,0 HCPCS,82040,"Hc Testosterone, Free, Bioavailable And Total, Ms 14966 #1-So+",9.4,3.76,,,0 HCPCS,82042,Assay of urine albumin,,,4.4,19.45,16 HCPCS,82042,Hc 779 Albumin Body Fluid-So+,9.64,3.86,,,0 HCPCS,82042,Hc Assay Of Urine Albumin - Albumin Body Fluid,83.03,33.21,,,0 HCPCS,82042,Hc Oligoclonal Band Profile80440 #4-So+,14.4,5.76,,,0 HCPCS,82043,"Hc Microalbumin, Quantitative - Microalbumin 24Hr Urine",106.75,42.7,,,0 HCPCS,82043,"Hc Microalbumin, Quantitative - Microalbumin Random Urine",106.75,42.7,,,0 HCPCS,82043,Microalbumin quantitative,,,4.91,14.45,16 HCPCS,82044,Microalbumin semiquant,,,3.89,15.58,16 HCPCS,82045,Albumin ischemia modified,,,28.85,84.85,16 HCPCS,82075,Assay of breath ethanol,,,9.88,75.0,16 HCPCS,82075,Hc Poc Ch Ed Breath Alcohol,97.05,38.82,,,0 HCPCS,82077,Assay spec xcp ur&breath ia,,,6.91,43.18,16 HCPCS,82077,Hc Etoh,255.56,102.22,,,0 HCPCS,82085,Assay of aldolase,,,8.25,24.28,16 HCPCS,82085,Hc 113 Aldolase Serum-So+,11.65,4.66,,,0 HCPCS,82088,Assay of aldosterone,,,34.63,101.88,16 HCPCS,82088,Hc 074 Aldosterone Serum-So+,146.54,58.62,,,0 HCPCS,82088,Hc Aldosterone,255.56,102.22,,,0 HCPCS,82088,Hc Assay Of Aldosterone - Aldosterone,181.16,72.46,,,0 HCPCS,82088,"Hc Assay Of Aldosterone - Aldosterone,24Hr Urine",158.02,63.21,,,0 HCPCS,82103,Alpha-1-antitrypsin total,,,11.42,33.6,16 HCPCS,82103,Hc 154 Alpha1-Antitrypsin Tot-So+,48.31,19.32,,,0 HCPCS,82103,Hc 358 Alpha-1 Elisa Random Stool-So+,73.2,29.28,,,0 HCPCS,82103,Hc Alpha 1 Antitrypsin,76.8,30.72,,,0 HCPCS,82104,Alpha-1-antitrypsin pheno,,,12.29,36.15,16 HCPCS,82104,Hc 154 Alpha1-Antitrypsin Phen-So+,52.01,20.8,,,0 HCPCS,82105,Alpha-fetoprotein serum,,,14.26,41.92,16 HCPCS,82105,Hc 991 Maternl Ser Scr Afp-So+,20.12,8.05,,,0 HCPCS,82105,"Hc Alpha-Fetoprotein, Serum - Alpha-Fetoprotein Marker",229.68,91.87,,,0 HCPCS,82106,Alpha-fetoprotein amniotic,,,14.26,42.5,16 HCPCS,82106,Hc 423 Afp Only Amnio Fld-So+,17.74,7.1,,,0 HCPCS,82107,Alpha-Fetoprotein L3,,,54.74,161.02,16 HCPCS,82108,Assay of aluminum,,,21.65,63.7,16 HCPCS,82108,Hc 333 Aluminum Urine Arup-So+,30.58,12.23,,,0 HCPCS,82120,Amines vaginal fluid qual,,,3.2,14.98,16 HCPCS,82127,Amino acid single qual,,,11.78,35.45,16 HCPCS,82128,Amino acids mult qual,,,11.78,34.68,16 HCPCS,82128,Hc 240 Amino Acids Mult Qlt-So+,49.87,19.95,,,0 HCPCS,82131,Amino acids single quant,,,14.33,57.45,16 HCPCS,82131,Hc 659 Urine Cystine Arup-So+,84.0,33.6,,,0 HCPCS,82135,Assay aminolevulinic acid,,,13.99,41.12,16 HCPCS,82135,Hc 066 Delta Ala Randm Ur-So+,127.3,50.92,,,0 HCPCS,82135,Hc 816 Ala Quant-So+,59.16,23.66,,,0 HCPCS,82136,Amino acids quant 2-5,,,1.73,49.02,16 HCPCS,82136,"Hc Cobalamin, Methionine, And Methylmalonic Acid Pathways, Plasma Cmmpp #3-So+",336.48,134.59,,,0 HCPCS,82139,Amino acids quan 6 or more,,,1.73,42.18,16 HCPCS,82139,Hc 043 Amino Acid Pls 6/> May-So+,194.33,77.73,,,0 HCPCS,82139,Hc 399 Amino Acids Qnt Csf-So+,126.0,50.4,,,0 HCPCS,82139,Hc 458 Amino Acids Csf-So+,192.0,76.8,,,0 HCPCS,82139,Hc 728 Amino Acids Rand Urine-So+,260.51,104.2,,,0 HCPCS,82139,"Hc Amino Acids, Quantitative, Random, Urine Aapd-So+",194.33,77.73,,,0 HCPCS,82140,Assay of ammonia,,,12.38,36.42,16 HCPCS,82140,Hc Assay Of Ammonia - Ammonia,213.51,85.4,,,0 HCPCS,82143,Amniotic fluid scan,,,5.84,23.38,16 HCPCS,82150,Assay of amylase,,,5.51,16.2,16 HCPCS,82150,Hc 478 Amylase Urine-So+,23.32,9.33,,,0 HCPCS,82150,Hc 781 Assay Of Amylase - Amylase Body Fluid-So+,23.32,9.33,,,0 HCPCS,82150,"Hc Amylase, Isoenzymes 20804-So+",10.84,4.34,,,0 HCPCS,82150,Hc Assay Of Amylase - Amylase,150.96,60.38,,,0 HCPCS,82150,Hc Assay Of Amylase - Amylase Body Fluid,150.96,60.38,,,0 HCPCS,82150,"Hc Urine, Amylase 3016646-So+",13.44,5.38,,,0 HCPCS,82154,Androstanediol glucuronide,,,24.5,72.08,16 HCPCS,82157,Assay of androstenedione,,,24.88,73.2,16 HCPCS,82157,Hc 485 Assay Of Androstenedione - Androstenedione-So+,44.28,17.71,,,0 HCPCS,82157,Hc 771 Assay Of Androstenedione - Androstenedione-So+,42.37,16.95,,,0 HCPCS,82157,Hc Congenital Adrenal Hyperplasia (Cah) Pediatric Profile One 501568 #1-So+,64.39,25.76,,,0 HCPCS,82160,Assay of androsterone,,,21.25,63.88,16 HCPCS,82163,Assay of angiotensin II,,,14.83,51.3,16 HCPCS,82164,Angiotensin I enzyme test,,,12.41,36.5,16 HCPCS,82164,Hc 095 Angiotensin Convert Enzyme-So+,52.51,21.0,,,0 HCPCS,82164,Hc 160 Angiotensin Convert Enzyme-So+,17.52,7.01,,,0 HCPCS,82166,Assay anti-mullerian horm,,,15.45,96.55,16 HCPCS,82166,Hc Anti-Mullerian Hormone 2002656-So+,66.0,26.4,,,0 HCPCS,82172,Assay of apolipoprotein,,,12.04,52.72,16 HCPCS,82172,"Hc Apolipoprotein, B 0050029-So+",25.31,10.12,,,0 HCPCS,82175,Assay of arsenic,,,16.12,47.42,16 HCPCS,82175,Hc 179 Arsenic-So+,22.76,9.1,,,0 HCPCS,82175,Hc 183 Arsenic Urine-So+,22.76,9.1,,,0 HCPCS,82180,Assay of ascorbic acid,,,4.94,24.72,16 HCPCS,82180,Hc 810 Vit C (Ascorbc Ac)Plsm-So+,23.63,9.45,,,0 HCPCS,82190,Atomic absorption,,,12.67,39.75,16 HCPCS,82232,Assay of beta-2 protein,,,13.75,40.45,16 HCPCS,82232,Hc 313 Beta 2 Microglobulin Serum-So+,108.0,43.2,,,0 HCPCS,82232,Hc 981 Beta 2 Microglobulin-So+,58.86,23.54,,,0 HCPCS,82232,"Hc Beta-2 Microglobulin, Serum Or Plasma 80053-So+",19.42,7.77,,,0 HCPCS,82232,"Hc Beta-2-Microglobulin, Urine 80432-So+",17.26,6.9,,,0 HCPCS,82233,Beta-amyloid 1-40 (abeta 40),,,45.77,322.3,9 HCPCS,82234,Beta-amyloid 1-42 (abeta 42),,,45.77,322.3,9 HCPCS,82239,Bile acids total,,,14.56,42.8,16 HCPCS,82239,Hc 092 Bile Acids Total-So+,61.6,24.64,,,0 HCPCS,82240,Bile acids cholylglycine,,,18.61,66.45,16 HCPCS,82247,Bilirubin total,,,4.26,12.55,16 HCPCS,82247,Hc Bilirubin Total,76.56,30.62,,,0 HCPCS,82247,Hc Bilirubin Total - Bilirubin Body Fluid,76.56,30.62,,,0 HCPCS,82247,Hc Bilirubin Total - Bilirubin Total,76.56,30.62,,,0 HCPCS,82247,"Hc Bilirubin, Total, Body Fluid 20510-So+",10.02,4.01,,,0 HCPCS,82248,Bilirubin direct,,,4.26,12.55,16 HCPCS,82248,Hc Bilirubin Direct (Conjugated),99.21,39.68,,,0 HCPCS,82248,Hc Bilirubin Direct - Bilirubin Direct,99.21,39.68,,,0 HCPCS,82252,Fecal bilirubin test,,,3.87,11.4,16 HCPCS,82261,Assay of biotinidase,,,1.73,42.18,16 HCPCS,82261,Hc 242 Biotinidase-So+,20.24,8.1,,,0 HCPCS,82261,Hc 686 Biotinidase-So+,60.0,24.0,,,0 HCPCS,82261,Hc Biotinidase-So+,130.68,52.27,,,0 HCPCS,82270,"Hc Blood Occult,By Peroxid,Feces,Single, Colorectal Screen",34.51,13.8,,,0 HCPCS,82270,"Hc Blood Occult,By Peroxid,Feces,Single, Colorectal Screen - Occult Bld",34.51,13.8,,,0 HCPCS,82270,Occult blood feces,,,2.77,10.95,16 HCPCS,82271,Hc Occult Blood Gastric Contents,34.51,13.8,,,0 HCPCS,82271,Occult blood other sources,,,2.77,13.3,16 HCPCS,82272,Hc Occult Blood Stool Dx,34.51,13.8,,,0 HCPCS,82272,Occult bld feces 1-3 tests,,,2.77,10.58,16 HCPCS,82274,Assay test for blood fecal,,,13.52,39.8,16 HCPCS,82274,Hc Fecal Occult Blood By Immunoassay 2007190-So+,34.02,13.61,,,0 HCPCS,82286,Assay of bradykinin,,,5.16,12.9,16 HCPCS,82300,Assay of cadmium,,,19.67,59.1,16 HCPCS,82300,Hc 225 Cadmium Blood-So+,83.21,33.28,,,0 HCPCS,82300,Hc 723 Cadmium Blood-So+,83.21,33.28,,,0 HCPCS,82306,"Hc 25-Hydroxyvitamin D2 And D3, Serum 25Hdn-So+",35.52,14.21,,,0 HCPCS,82306,"Hc Assay Of Vit D,Calcifediol W Fractions, If Performed - Vitamin D 25",250.17,100.07,,,0 HCPCS,82306,"Hc Vitamin D, 25-Hydroxy (Arup 82306)",63.2,25.28,,,0 HCPCS,82306,Vitamin d 25 hydroxy,,,23.22,74.0,16 HCPCS,82308,Assay of calcitonin,,,22.76,66.98,16 HCPCS,82308,Hc 826 Calcitonin Serum-So+,96.34,38.54,,,0 HCPCS,82308,Hc 908 Calcitonin Serum-So+,96.34,38.54,,,0 HCPCS,82310,Assay of calcium,,,4.38,12.9,16 HCPCS,82310,"Hc Assay Of Calcium, Total - Calcium",57.15,22.86,,,0 HCPCS,82330,Assay of calcium,,,11.62,34.2,16 HCPCS,82330,"Hc Assay Of Calcium, Ionized - Calcium Ionized",207.04,82.82,,,0 HCPCS,82331,Calcium infusion test,,,4.4,33.35,16 HCPCS,82340,Assay of calcium in urine,,,3.34,15.08,16 HCPCS,82340,Hc Assay Of Calcium In Urine - Calcium Random Urine,71.17,28.47,,,0 HCPCS,82340,Hc Assay Of Calcium In Urine - Calcium Timed Urine,71.17,28.47,,,0 HCPCS,82355,Calculus analysis qual,,,9.83,28.95,16 HCPCS,82360,Calculus assay quant,,,10.94,32.18,16 HCPCS,82365,Calculus spectroscopy,,,10.96,32.25,16 HCPCS,82365,Hc 166 Kidney Stone Analysis-So+,46.36,18.54,,,0 HCPCS,82370,X-ray assay calculus,,,10.65,31.3,16 HCPCS,82373,Assay c-d transfer measure,,,15.34,45.15,16 HCPCS,82373,Hc Congential Disorders Of Glysylation,62.17,24.87,,,0 HCPCS,82374,Assay blood carbon dioxide,,,4.16,12.2,16 HCPCS,82374,Hc Assay Blood Carbon Dioxide - Co2 Total,64.7,25.88,,,0 HCPCS,82375,Assay carboxyhb quant,,,10.48,30.8,16 HCPCS,82375,Hc Assay Blood Carbon Monoxide - Carboxyhemoglobin,184.39,73.76,,,0 HCPCS,82376,Assay carboxyhb qual,,,5.09,35.18,16 HCPCS,82378,Carcinoembryonic antigen,,,16.12,47.4,16 HCPCS,82378,Hc 654 Carcinoembryonic Antigen - Cea (Carcinoembryonic Antigen)-So+,68.22,27.29,,,0 HCPCS,82378,Hc Carcinoembryonic Antigen - Cea (Carcinoembryonic Antigen),266.34,106.54,,,0 HCPCS,82379,Assay of carnitine,,,1.73,42.18,16 HCPCS,82379,Hc 039 Carnitine Mayo-So+,46.56,18.62,,,0 HCPCS,82379,Hc 076 Carnitine Urine Mayo-So+,94.81,37.92,,,0 HCPCS,82379,Hc Assay Of Carnitine - Carnitine,37.06,14.82,,,0 HCPCS,82380,Assay of carotene,,,7.84,23.05,16 HCPCS,82380,"Hc Assay Of Carotene - Carotene, Serum",35.78,14.31,,,0 HCPCS,82382,Assay urine catecholamines,,,14.61,68.25,16 HCPCS,82383,Assay blood catecholamines,,,21.29,72.7,16 HCPCS,82384,Assay three catecholamines,,,21.46,63.12,16 HCPCS,82384,Hc 959 Catecholamin Fracture Urine-So+,30.0,12.0,,,0 HCPCS,82384,"Hc Assay, Three Catecholamines - Catecholamines Fractionated Pl",33.6,13.44,,,0 HCPCS,82387,Assay of cathepsin-d,,,17.68,45.15,16 HCPCS,82390,Assay of ceruloplasmin,,,9.13,26.85,16 HCPCS,82390,Hc 335 Assay Of Ceruloplasmin - Ceruloplasmin-So+,62.0,24.8,,,0 HCPCS,82390,Hc Assay Of Ceruloplasmin - Ceruloplasmin,66.86,26.74,,,0 HCPCS,82390,Hc Ceruloplasmin-So+-Arup 0050160,8.4,3.36,,,0 HCPCS,82397,Chemiluminescent assay,,,12.01,35.3,16 HCPCS,82397,Hc 280 Igfbp3-So+,16.94,6.78,,,0 HCPCS,82397,Hc 601 Pth Related Peptide-So+,48.43,19.37,,,0 HCPCS,82397,Hc 800 Humira Neutralizing Ab-So+,218.25,87.3,,,0 HCPCS,82397,Hc 870 Chemiluminescent Assay-So+,50.8,20.32,,,0 HCPCS,82415,Assay of chloramphenicol,,,10.77,31.68,16 HCPCS,82435,Assay of blood chloride,,,3.91,11.5,16 HCPCS,82435,Hc Assay Of Blood Chloride - Chloride,78.72,31.49,,,0 HCPCS,82436,Assay of urine chloride,,,4.27,14.38,16 HCPCS,82436,Hc 217 Ur Chloride-So+,18.08,7.23,,,0 HCPCS,82436,Hc Assay Of Urine Chloride - Chloride Urine,87.34,34.94,,,0 HCPCS,82438,Assay other fluid chlorides,,,4.16,12.5,16 HCPCS,82438,Hc 102 Assay Other Fluid Chlorides - Chloride Body Fluid-So+,17.58,7.03,,,0 HCPCS,82438,Hc 298 Assay Other Fluid Chlorides-Feces-So+,34.98,13.99,,,0 HCPCS,82438,Hc Assay Other Fluid Chlorides - Chloride Body Fluid,120.77,48.31,,,0 HCPCS,82441,Test for chlorohydrocarbons,,,4.45,15.02,16 HCPCS,82465,Assay bld/serum cholesterol,,,3.7,10.88,16 HCPCS,82465,"Hc Assay, Bld/Serum Cholesterol - Cholesterol Total",85.19,34.08,,,0 HCPCS,82465,"Hc Assay, Blood/Serum Cholesterol - Cholesterol Total",85.19,34.08,,,0 HCPCS,82480,Assay serum cholinesterase,,,6.7,19.68,16 HCPCS,82480,Hc 176 Cholinesterase Serum-So+,28.33,11.33,,,0 HCPCS,82480,Hc 633 Pseudocholinest Tot-So+,28.33,11.33,,,0 HCPCS,82482,Assay rbc cholinesterase,,,6.53,24.52,16 HCPCS,82482,Hc 164 Cholinesterase Rbc-So+,28.98,11.59,,,0 HCPCS,82485,Assay chondroitin sulfate,,,17.55,51.62,16 HCPCS,82486,Gas/liquid chromatography,,,15.34,15.34,4 HCPCS,82487,Paper chromatography,,,13.57,13.57,4 HCPCS,82488,Paper chromatography,,,18.16,18.16,4 HCPCS,82489,Thin layer chromatography,,,15.72,15.72,4 HCPCS,82491,"Chromotography, quant, sing",,,15.34,15.34,4 HCPCS,82492,"Chromotography, quant, mult",,,15.34,15.34,4 HCPCS,82495,Assay of chromium,,,17.24,50.7,16 HCPCS,82495,Hc 713 Chromium Serum-So+,24.34,9.74,,,0 HCPCS,82495,"Hc Chromium, Rbc 2014505-So+",118.8,47.52,,,0 HCPCS,82507,Assay of citrate,,,23.63,69.5,16 HCPCS,82507,Hc 119 Citrate 24 Hr Urine-So+,33.36,13.34,,,0 HCPCS,82523,Collagen crosslinks,,,15.89,46.7,16 HCPCS,82523,Hc 011 N-Telopeptide Serum-So+,72.0,28.8,,,0 HCPCS,82523,Hc 221 Collagen Xlinks 24Hr-So+,49.01,19.605,,,0 HCPCS,82523,Hc 381 C-Telopeptide B-X-Link-So+,48.0,19.2,,,0 HCPCS,82523,"Hc Assay For Collagen Cross Links - N-Telopeptide, Urine",130.48,52.19,,,0 HCPCS,82525,Assay of copper,,,10.55,31.02,16 HCPCS,82525,Hc 109 Copper Serum-So+,44.62,17.85,,,0 HCPCS,82525,Hc 133 Copper Level Urine-So+,44.62,17.85,,,0 HCPCS,82525,Hc 303 Copper Liver Tissue-So+,69.48,27.79,,,0 HCPCS,82525,Hc 524 Copper Urine-So+,44.62,17.85,,,0 HCPCS,82525,Hc Assay Of Copper - Copper Liver Tissue,154.2,61.68,,,0 HCPCS,82528,Assay of corticosterone,,,19.13,56.3,16 HCPCS,82530,Cortisol free,,,14.2,41.78,16 HCPCS,82530,Hc 281 Cortisol Urine-So+,60.08,24.03,,,0 HCPCS,82533,Hc 148 Cortisol Total-So+,58.63,23.45,,,0 HCPCS,82533,Hc 771 Cortisol Total-So+,42.37,16.95,,,0 HCPCS,82533,Hc Congenital Adrenal Hyperplasia (Cah) Pediatric Profile One 501568 #2-So+,64.39,25.76,,,0 HCPCS,82533,"Hc Cortisol By Lc-Ms/Ms, Salivary 3016866-So+",45.6,18.24,,,0 HCPCS,82533,Hc Cortisol Total,240.47,96.19,,,0 HCPCS,82533,"Hc Cortisol, Serum 70030-So+",19.56,7.82,,,0 HCPCS,82533,Hc Total Cortisol - Cortisol,240.47,96.19,,,0 HCPCS,82533,Total cortisol,,,13.86,40.75,16 HCPCS,82540,Assay of creatine,,,3.94,11.6,16 HCPCS,82541,"Column chromotography, qual",,,15.34,15.34,4 HCPCS,82542,Col chromotography qual/quan,,,8.5,60.22,16 HCPCS,82542,Hc Busulfan Iv-So+,108.0,43.2,,,0 HCPCS,82542,Hc Coenzyme Q10 Tot-So+,73.16,29.26,,,0 HCPCS,82542,Hc Meropenem Level Arup-So+,139.86,55.94,,,0 HCPCS,82542,Hc 040 Acylglycine Urine Mayo-So+,249.84,99.94,,,0 HCPCS,82542,Hc 283 Sertraline Arup-So+,83.16,33.26,,,0 HCPCS,82542,Hc 380 Thiopurine Metabl Hplc-So+,259.2,103.68,,,0 HCPCS,82542,Hc 5-Hydroxyindoleacetic Acid (5-Hiaa)3000202-So+,204.0,81.6,,,0 HCPCS,82542,Hc 613 7 Dehydrocholesterol-So+,180.0,72.0,,,0 HCPCS,82542,Hc 969 Lsd Urine Confirm-So+,156.0,62.4,,,0 HCPCS,82542,Hc Chromotography Quality/Quanitity-So+,390.0,156.0,,,0 HCPCS,82542,Hc Col Chromotography Qual/Quan #2-So+,390.0,156.0,,,0 HCPCS,82542,Hc Col-Chr/Ms Nondrug Analyte Nes Qual/Quan Ea Spec - Mdma Ecstasy Ur,191.51,76.6,,,0 HCPCS,82542,Hc Col-Chr/Ms Nondrug Analyte Nes Qual/Quan Ea Spec-So+,390.0,156.0,,,0 HCPCS,82542,Hc Column Chromotography Qual/Quan,462.6,185.04,,,0 HCPCS,82542,Hc Column Chromotography Qual/Quan #2-So+,276.96,110.78,,,0 HCPCS,82542,Hc Confirmation - Drugs Of Abuse,286.83,114.73,,,0 HCPCS,82542,Hc Essential Fatty Acids,117.59,47.04,,,0 HCPCS,82542,Hc Ethylene Glycol,286.83,114.73,,,0 HCPCS,82542,"Hc Leukotriene E4, 24 Hour, Urine (Mayo Tlte4)",433.56,173.42,,,0 HCPCS,82542,"Hc N-Methylhistamine, 24 Hr, Urine-Mayo Nmh24",83.42,33.37,,,0 HCPCS,82542,Hc Pentobarbital,286.83,114.73,,,0 HCPCS,82542,Hc Predictrpk Ada 3700 #1-So+,286.0,114.4,,,0 HCPCS,82542,"Hc Purines And Pyrimidines Panel, U Mayo-So+",538.56,215.42,,,0 HCPCS,82542,"Ustekinumab Antibody Measurement, So+",390.0,156.0,,,0 HCPCS,82543,Column chromotograph/isotope,,,15.34,15.34,4 HCPCS,82544,Column chromotograph/isotope,,,15.34,15.34,4 HCPCS,82550,Assay of ck (cpk),,,5.3,16.28,16 HCPCS,82550,Hc Assay Of Ck (Cpk) - Ck,86.27,34.51,,,0 HCPCS,82552,Assay of cpk in blood,,,11.39,33.48,16 HCPCS,82553,Creatine mb fraction,,,5.59,28.88,16 HCPCS,82553,Hc 151 Creatine Kinase Mb-So+,23.68,9.47,,,0 HCPCS,82554,Creatine isoforms,,,10.09,29.68,16 HCPCS,82565,Assay of creatinine,,,4.36,12.8,16 HCPCS,82565,Hc Assay Of Creatinine - Creatinine Fluid,80.87,32.35,,,0 HCPCS,82565,Hc Assay Of Creatinine - Creatinine Serum,80.87,32.35,,,0 HCPCS,82565,Hc Poct Creatinine,80.87,32.35,,,0 HCPCS,82570,Assay of urine creatinine,,,4.4,12.95,16 HCPCS,82570,Hc 221 Ur Creatinine-So+,6.22,2.49,,,0 HCPCS,82570,Hc 290 Ur Creatinine-So+,60.39,24.16,,,0 HCPCS,82570,Hc 591 Ur Creatinine-So+,18.61,7.44,,,0 HCPCS,82570,Hc Assay Of Urine Creatinine - Creatinine Urine,116.46,46.58,,,0 HCPCS,82570,Hc Assay Of Urine Creatinine-So+,165.75,66.3,,,0 HCPCS,82575,Creatinine clearance test,,,7.27,23.65,16 HCPCS,82575,"Hc Creatinine Clearance Test - Creatinine Clearance, Urine, 24 Hour",157.43,62.97,,,0 HCPCS,82585,Assay of cryofibrinogen,,,7.29,35.35,16 HCPCS,82595,Assay of cryoglobulin,,,5.06,16.18,16 HCPCS,82595,Hc Assay Of Cryoglobulin - Cryoglobulin,134.79,53.92,,,0 HCPCS,82595,"Hc Cryoglobulin, S-Mayo Test Cry_S",34.5,13.8,,,0 HCPCS,82600,Assay of cyanide,,,16.49,48.5,16 HCPCS,82607,Hc Vitamin B-12 - Vitamin B12,181.16,72.46,,,0 HCPCS,82607,Vitamin B-12,,,12.81,37.7,16 HCPCS,82608,B-12 binding capacity,,,12.17,35.8,16 HCPCS,82608,Hc 141 Vit B12 Binding Cap-So+,51.5,20.6,,,0 HCPCS,82610,Cystatin c,,,11.55,46.3,16 HCPCS,82610,Hc 620 Cystatin C-So+,76.8,30.72,,,0 HCPCS,82610,Hc Cystatin C,95.97,38.39,,,0 HCPCS,82615,Test for urine cystines,,,6.94,23.88,16 HCPCS,82626,Dehydroepiandrosterone,,,21.47,63.18,16 HCPCS,82626,Hc 771 Dhea-So+,42.37,16.95,,,0 HCPCS,82626,Hc Congenital Adrenal Hyperplasia (Cah) Pediatric Profile One 501568 #3-So+,30.32,12.13,,,0 HCPCS,82627,Dehydroepiandrosterone,,,18.89,55.58,16 HCPCS,82627,Hc 740 Dhea Sulfate-So+,79.97,31.99,,,0 HCPCS,82627,Hc 741 Dhea Sulfate Es-So+,93.6,37.44,,,0 HCPCS,82627,Hc Dehydroepiandrosterone-Sulfate - Dhea-Sulfate,155.28,62.11,,,0 HCPCS,82633,Desoxycorticosterone,,,26.32,77.45,16 HCPCS,82633,Hc 771 Desoxycorticost 11-So+,48.74,19.5,,,0 HCPCS,82633,Hc 986 Deoxycorticosterone-So+,85.92,34.37,,,0 HCPCS,82634,Deoxycortisol,,,24.88,73.2,16 HCPCS,82634,"Hc 11-Deoxycortisol Quantitative By Hplc-Ms/Ms, Serum Or Plasma 92331-So+",33.54,13.42,,,0 HCPCS,82634,Hc 168 11 Deoxycortisol-So+,105.29,42.12,,,0 HCPCS,82634,Hc 771 Deoxycortisol 11-So+,48.74,19.5,,,0 HCPCS,82638,Assay of dibucaine number,,,10.41,30.62,16 HCPCS,82638,Hc 176 Dibucaine Number-So+,44.04,17.62,,,0 HCPCS,82642,Dihydrotestosterone,,,13.01,73.2,16 HCPCS,82642,Hc 5-A-Dihydrotestosterone By Lc-Ms/Ms 2002349-So+,35.14,14.06,,,0 HCPCS,82652,"Hc 1,25 Dihydroxy Vitamin D",217.13,86.85,,,0 HCPCS,82652,Hc 108 Vit D 1 25-Dihydroxyh-So+,138.44,55.38,,,0 HCPCS,82652,Vit d 1 25-dihydroxy,,,32.72,96.25,16 HCPCS,82653,El-1 fecal quantitative,,,9.19,57.42,16 HCPCS,82653,Hc Pancreatic Elastase Fecal By Immunoassay 3002858-So+,120.0,48.0,,,0 HCPCS,82656,Pancreatic elastase fecal,,,9.26,28.82,16 HCPCS,82657,Enzyme cell activity,,,15.34,55.42,16 HCPCS,82657,Hc 414 Disaccharide Tissue-So+,79.2,31.68,,,0 HCPCS,82657,Hc 633 Thiopurine Met Enz Act-So+,326.88,130.75,,,0 HCPCS,82657,Hc 839 Enz Act Nonrad Nos Ea-So+,64.94,25.98,,,0 HCPCS,82657,Hc 883 Porphobilin Deamns Rbc-So+,74.76,29.9,,,0 HCPCS,82657,Hc 920 L-Asparaginase Act-So+,165.0,66.0,,,0 HCPCS,82657,"Hc Gastric Pepsin A, Respiratory #3-So+",48.48,19.39,,,0 HCPCS,82658,Enzyme cell activity ra,,,15.34,110.08,16 HCPCS,82664,Electrophoretic test,,,29.2,153.75,16 HCPCS,82664,Hc 992 Chylomicron Scr Fld-So+,123.55,49.42,,,0 HCPCS,82664,Hc Chylomicron Electrophoresis (Reflex)-So+,73.8,29.52,,,0 HCPCS,82664,Hc Gal-1-Phos Urdyltr Pheno Galtp-So+,1142.88,457.15,,,0 HCPCS,82668,Assay of erythropoietin,,,15.98,46.98,16 HCPCS,82668,Hc Erythropoietin-So+,22.55,9.02,,,0 HCPCS,82670,Assay of estradiol,,,23.75,69.85,16 HCPCS,82670,Hc 742 Estradiol Ultra Sens-So+,37.38,14.95,,,0 HCPCS,82670,Hc Estradiol Assay,229.68,91.87,,,0 HCPCS,82671,Assay of estrogens,,,27.45,80.75,16 HCPCS,82671,Hc 963 Estrogen Fract-So+,38.76,15.5,,,0 HCPCS,82672,Assay of estrogen,,,18.43,54.25,16 HCPCS,82677,Assay of estriol,,,20.55,60.45,16 HCPCS,82679,Assay of estrone,,,21.21,62.38,16 HCPCS,82679,Hc 853 Estrone-So+,29.94,11.98,,,0 HCPCS,82681,Assay dir meas fr estradiol,,,11.18,69.85,16 HCPCS,82693,Assay of ethylene glycol,,,12.66,37.25,16 HCPCS,82693,Hc Ethylene Glycol Immunoassay,253.41,101.36,,,0 HCPCS,82693,"Hc Ethylene Glycol, Serum Or Plasma071654-So+",18.78,7.51,,,0 HCPCS,82696,Assay of etiocholanolone,,,20.04,65.6,16 HCPCS,82705,Fats/lipids feces qual,,,0.98,12.75,16 HCPCS,82705,Hc 962 Fat Fecal Qlt-So+,33.42,13.37,,,0 HCPCS,82710,Fats/lipids feces quant,,,14.28,42.0,16 HCPCS,82710,Hc 084 Fecal Fat Qnt-So+,63.96,25.58,,,0 HCPCS,82710,"Hc Fats/Lipids, Feces, Quantitative - Fecal Fat Quantitative",122.0,48.8,,,0 HCPCS,82715,Assay of fecal fat,,,2.83,57.42,16 HCPCS,82725,Assay of blood fatty acids,,,11.32,46.92,16 HCPCS,82725,"Hc Fatty Acid Profile, Essential, P Pfape-So+",191.38,76.55,,,0 HCPCS,82725,Hc Fatty Acids Free 0080120-Arup-So+,36.0,14.4,,,0 HCPCS,82726,Hc 360 Very Long Chain Fat Acid-So+,127.99,51.2,,,0 HCPCS,82726,Long chain fatty acids,,,15.34,49.38,16 HCPCS,82728,Assay of ferritin,,,11.58,34.08,16 HCPCS,82728,Hc Assay Of Ferritin - Ferritin,200.57,80.23,,,0 HCPCS,82731,Assay of fetal fibronectin,,,54.74,161.02,16 HCPCS,82731,Hc Assay Of Fetal Fibronectin - Fetal Fibronectin,791.49,316.6,,,0 HCPCS,82731,Hc Fetal Fibronectin,328.89,131.56,,,0 HCPCS,82735,Assay of fluoride,,,15.76,46.35,16 HCPCS,82746,Assay of folic acid serum,,,12.49,36.75,16 HCPCS,82746,Hc Blood Folic Acid Serum - Folate,211.35,84.54,,,0 HCPCS,82747,Assay of folic acid rbc,,,14.72,44.12,16 HCPCS,82747,Hc 073 Folate Rbc-So+,62.28,24.91,,,0 HCPCS,82757,Assay of semen fructose,,,14.74,43.35,16 HCPCS,82759,Assay of rbc galactokinase,,,18.26,53.7,16 HCPCS,82760,Assay of galactose,,,9.52,28.0,16 HCPCS,82775,Assay galactose transferase,,,17.9,52.68,16 HCPCS,82775,Hc 022 Galact-1-Phos Ur Galt-So+,245.74,98.3,,,0 HCPCS,82775,Hc 242 Galactosemia State-So+,29.28,11.71,,,0 HCPCS,82775,"Hc Galactose-1-Phosphate Uridyltransferase, Blood Galt-So+",122.04,48.82,,,0 HCPCS,82776,Galactose transferase test,,,7.13,29.35,16 HCPCS,82777,Galectin-3,,,17.8,110.62,16 HCPCS,82784,Assay iga/igd/igg/igm each,,,7.9,23.25,16 HCPCS,82784,Hc 240 Igg-So+,33.44,13.38,,,0 HCPCS,82784,"Hc Assay Of Gammaglobulin Iga, Igd, Igg, Igm, Each - Iga",128.32,51.33,,,0 HCPCS,82784,"Hc Assay Of Gammaglobulin Iga, Igd, Igg, Igm, Each - Igg",128.32,51.33,,,0 HCPCS,82784,"Hc Assay Of Gammaglobulin Iga, Igd, Igg, Igm, Each - Igm",128.32,51.33,,,0 HCPCS,82784,"Hc Immunofixation, Daratumumab-Specific, Serum 123218-So+",24.0,9.6,,,0 HCPCS,82784,"Hc Immunoglobulin D, Serum 3003486-So+",26.88,10.75,,,0 HCPCS,82784,Hc Oligoclonal Band Profile080440 #2-So+,14.4,5.76,,,0 HCPCS,82785,Assay of ige,,,13.99,41.15,16 HCPCS,82785,Hc Immunoglob E-So+,19.75,7.9,,,0 HCPCS,82787,Hc 240 Subclass Igg1-So+,27.48,10.99,,,0 HCPCS,82787,Hc 240 Subclass Igg2-So+,27.48,10.99,,,0 HCPCS,82787,Hc 240 Subclass Igg3-So+,27.48,10.99,,,0 HCPCS,82787,Hc 240 Subclass Igg4-So+,27.48,10.99,,,0 HCPCS,82787,Hc 425 Igg Subclass 4-So+,27.48,10.99,,,0 HCPCS,82787,"Hc Immunoglobulin G Subclasses (1, 2, 3, 4)0050577-So+",12.3,4.92,,,0 HCPCS,82787,Igg 1 2 3 or 4 each,,,6.5,20.05,16 HCPCS,82800,Blood pH,,,6.11,27.5,16 HCPCS,82800,Hc Blood Ph - Ph Venous,84.11,33.64,,,0 HCPCS,82803,Blood gases any combination,,,13.34,65.18,16 HCPCS,82803,"Hc Blood Gases: Ph, Po2 & Pco2 - Blood Gas Arterial",340.75,136.3,,,0 HCPCS,82803,"Hc Blood Gases: Ph, Po2 & Pco2 - Blood Gas Capillary",340.75,136.3,,,0 HCPCS,82803,"Hc Blood Gases: Ph, Po2 & Pco2 - Blood Gas Venous",340.75,136.3,,,0 HCPCS,82803,"Hc Blood Gases: Ph, Po2 & Pco2 - Poct Arterial Blood Gas",340.75,136.3,,,0 HCPCS,82803,"Hc Blood Gases: Ph, Po2 & Pco2 - Poct Venous Blood Gas",340.75,136.3,,,0 HCPCS,82805,Blood gases w/o2 saturation,,,19.15,196.92,16 HCPCS,82805,Hc Gases Blood O2 Direct,388.19,155.28,,,0 HCPCS,82810,Blood gases o2 sat only,,,5.8,24.42,16 HCPCS,82810,"Hc Blood Gases, O2 Sat Only - Oxygen Saturation, Arterial",159.59,63.84,,,0 HCPCS,82820,Hemoglobin-oxygen affinity,,,8.5,33.35,16 HCPCS,82930,Gastric analy w/ph ea spec,,,4.64,16.78,16 HCPCS,82938,Gastrin test,,,15.04,44.22,16 HCPCS,82941,Assay of gastrin,,,14.99,44.08,16 HCPCS,82941,Hc 128 Gastrin Level-So+,21.16,8.46,,,0 HCPCS,82943,Assay of glucagon,,,4.94,35.72,16 HCPCS,82943,Hc 383 Glucagon-So+,276.96,110.78,,,0 HCPCS,82945,Glucose Other Fluid,,,3.34,9.82,16 HCPCS,82945,"Hc Assay Glucose, Body Fluid - Glucose Body Fluid",62.54,25.02,,,0 HCPCS,82945,"Hc Assay Glucose, Body Fluid - Glucose Csf",62.54,25.02,,,0 HCPCS,82945,Hc Glucose Body Fluid 20503-So+,8.82,3.53,,,0 HCPCS,82946,Glucagon tolerance test,,,12.81,44.42,16 HCPCS,82947,Assay glucose blood quant,,,3.34,9.82,16 HCPCS,82947,"Hc Assay Quantitative,Blood Glucose - Glucose Random",56.07,22.43,,,0 HCPCS,82947,"Hc Assay Quantitative,Blood Glucose - Gtt Fasting",56.07,22.43,,,0 HCPCS,82947,"Hc Assay Quantitative,Blood Glucose - Poct Glucometer",56.07,22.43,,,0 HCPCS,82947,Hc Poc- Gem 5000 Glucose,56.07,22.43,,,0 HCPCS,82948,Hc Poc Blood Glucose By Reagent Strip,8.09,3.24,,,0 HCPCS,82948,Reagent strip/blood glucose,,,2.69,12.6,16 HCPCS,82950,Glucose test,,,4.04,11.88,16 HCPCS,82950,Hc Glucose Test - Gtt 1 Hour,80.87,32.35,,,0 HCPCS,82950,Hc Glucose Test - Ltt 1 Hr,80.87,32.35,,,0 HCPCS,82950,Hc Glucose Test - Ltt 2 Hr,80.87,32.35,,,0 HCPCS,82951,Glucose tolerance test (GTT),,,10.94,32.18,16 HCPCS,82951,Hc Glucose Tolerance Test (Gtt) - Bundled Charge,166.06,66.42,,,0 HCPCS,82951,Hc Glucose Tolerance Test (Gtt) - Gtt 2 Hour,166.06,66.42,,,0 HCPCS,82952,GTT-added samples,,,3.33,9.8,16 HCPCS,82952,Hc Glucose Tolerance Ea Additional Specific,62.54,25.02,,,0 HCPCS,82952,Hc Gtt-Added Samples - Bundled Charge,62.54,25.02,,,0 HCPCS,82955,Assay of g6pd enzyme,,,8.24,24.25,16 HCPCS,82955,Hc 680 G6Pd Quant-So+,34.87,13.95,,,0 HCPCS,82960,Test for G6PD enzyme,,,5.14,15.12,16 HCPCS,82962,Glucose blood test,,,1.99,8.2,16 HCPCS,82962,Hc Glucose Blood Test Performed By Hand Held Device,57.0,22.8,,,0 HCPCS,82963,Assay of glucosidase,,,18.26,53.7,16 HCPCS,82965,Assay of gdh enzyme,,,6.07,32.88,16 HCPCS,82977,Assay of GGT,,,6.12,18.0,16 HCPCS,82977,Hc Assay Of Ggt - Gamma Gt,120.77,48.31,,,0 HCPCS,82978,Assay of glutathione,,,12.11,38.62,16 HCPCS,82978,Hc Glutathione Total 2006328-So+,81.6,32.64,,,0 HCPCS,82979,Assay rbc glutathione,,,5.86,23.6,16 HCPCS,82985,Assay of glycated protein,,,12.81,41.9,16 HCPCS,82985,Hc 994 Fructosamine-So+,20.11,8.04,,,0 HCPCS,83001,Assay of gonadotropin (fsh),,,15.79,46.45,16 HCPCS,83001,Hc 238 Gonadotropin (Fsh)-So+,26.74,10.7,,,0 HCPCS,83001,Hc Gonadotropin (Fsh) - Fsh,271.74,108.7,,,0 HCPCS,83001,Hc Testicular Function Group 1-So+,32.4,12.96,,,0 HCPCS,83002,Assay of gonadotropin (lh),,,15.74,46.3,16 HCPCS,83002,Hc 743 Lh Peds Sensitive-So+,30.22,12.09,,,0 HCPCS,83002,Hc Gonadotropin (Lh) - Luteinizing Hormone,256.64,102.66,,,0 HCPCS,83002,Hc Testicular Function Group 1 #2-So+,32.4,12.96,,,0 HCPCS,83003,Assay growth hormone (hgh),,,14.17,41.68,16 HCPCS,83003,Hc 182 Human Growth Hormone-So+,142.0,56.8,,,0 HCPCS,83003,Hc 207 Growth Hormone-So+,59.98,23.99,,,0 HCPCS,83003,Hc Human Growth Hormone,170.0,68.0,,,0 HCPCS,83006,Growth stimulation gene 2,,,17.8,189.0,16 HCPCS,83009,H pylori (c-13) blood,,,57.24,168.4,16 HCPCS,83010,Assay of haptoglobin quant,,,10.69,31.45,16 HCPCS,83010,"Hc Assay Of Haptoglobin, Quant - Haptoglobin",198.41,79.36,,,0 HCPCS,83012,Assay of haptoglobins,,,14.61,67.22,16 HCPCS,83013,H pylori (c-13) breath,,,57.24,168.4,16 HCPCS,83014,H pylori drug admin,,,6.68,19.65,16 HCPCS,83015,Heavy metal qual any anal,,,16.0,52.35,16 HCPCS,83018,Hc 070 Iodine Urine-So+,78.98,31.59,,,0 HCPCS,83018,Hc 316 Strontium Quant-So+,95.66,38.26,,,0 HCPCS,83018,Hc 994 Iodine 24Hr Urine-So+,78.98,31.59,,,0 HCPCS,83018,"Hc Iodine, Serum 2007463-So+",48.0,19.2,,,0 HCPCS,83018,Heavy metal quant each nes,,,18.67,54.9,16 HCPCS,83020,Hc 242 Hgb Electrophoresis-So+,17.97,7.19,,,0 HCPCS,83020,Hc Capillary Electrophoresis Reflex Testing 3017101-So+,38.5,15.4,,,0 HCPCS,83020,Hc Hemoglobin Electrophoresis-Cap,196.25,78.5,,,0 HCPCS,83020,Hemoglobin electrophoresis,,,10.94,32.18,16 HCPCS,83021,Hc Hemoglobin Chromotography - Hemoglobinopathy Eval,181.16,72.46,,,0 HCPCS,83021,Hc Hemoglobin Evaluation With Reflex To Electrophoresis And/Or Rbc Solubility 3017101-So+,24.0,9.6,,,0 HCPCS,83021,Hemoglobin chromotography,,,15.34,45.15,16 HCPCS,83026,Hemoglobin copper sulfate,,,2.0,10.02,16 HCPCS,83030,Fetal hemoglobin chemical,,,7.03,26.85,16 HCPCS,83033,Fetal hemoglobin assay qual,,,5.06,20.0,16 HCPCS,83036,Glycosylated hemoglobin test,,,8.25,24.28,16 HCPCS,83036,Hc Glycosylated Hemoglobin Test - Hemoglobin A1C,172.53,69.01,,,0 HCPCS,83037,Glycosylated hb home device,,,8.25,24.28,16 HCPCS,83045,Blood methemoglobin test,,,4.21,16.22,16 HCPCS,83050,Blood methemoglobin assay,,,4.94,20.5,16 HCPCS,83050,"Hc Blood Methemoglobin, Quant - Methemoglobin",114.3,45.72,,,0 HCPCS,83051,Assay of plasma hemoglobin,,,6.21,18.28,16 HCPCS,83051,Hc Assay Of Plasma Hemoglobin - Hemoglobin Plasma,141.26,56.5,,,0 HCPCS,83051,Hc Plasma Free Hemoglobin (Mayo Plhbb),87.81,35.12,,,0 HCPCS,83060,Blood sulfhemoglobin assay,,,4.94,22.0,16 HCPCS,83065,Assay of hemoglobin heat,,,4.94,22.5,16 HCPCS,83068,Hemoglobin stability screen,,,7.19,23.68,16 HCPCS,83069,Assay of urine hemoglobin,,,3.35,9.88,16 HCPCS,83070,Assay of hemosiderin qual,,,4.04,11.88,16 HCPCS,83080,Assay of b hexosaminidase,,,1.73,42.18,16 HCPCS,83080,"Hc Hexosaminidase A And Total Hexosaminidase, Leukocytes Nagw-So+",84.12,33.65,,,0 HCPCS,83080,"Hc Hexosaminidase A And Total, S-So+",57.7,23.08,,,0 HCPCS,83088,Assay of histamine,,,25.1,73.82,16 HCPCS,83088,Hc Histamine Plasma-Arup Test 0070036,35.46,14.18,,,0 HCPCS,83088,Hc Histamine Whole Blood,35.46,14.18,,,0 HCPCS,83090,Assay Of Homocystine,,,14.33,44.8,16 HCPCS,83090,Hc 370 Assay Of Homocystine - Homocysteine Total-So+,60.67,24.27,,,0 HCPCS,83090,Hc 727 Assay Of Homocystine - Homocysteine Total-So+,281.0,112.4,,,0 HCPCS,83090,Hc Assay Of Homocystine - Homocysteine Total,303.01,121.2,,,0 HCPCS,83090,"Hc Cobalamin, Methionine, And Methylmalonic Acid Pathways, Plasma Cmmpp #1-So+",336.48,134.59,,,0 HCPCS,83090,"Hc Homocysteine, Total, Plasma,Peds Hcysp-So+",31.61,12.64,,,0 HCPCS,83150,Assay of homovanillic acid,,,16.44,56.02,16 HCPCS,83150,Hc 911 Homovanillic Acid-So+,26.89,10.76,,,0 HCPCS,83150,"Hc Homovanillic Acid (Hva), Random Urine3018862-So+",16.8,6.72,,,0 HCPCS,83491,Assay of corticosteroids 17,,,14.89,44.75,16 HCPCS,83491,Hc 071 17-Hydroxycorticoids-So+,60.9,24.36,,,0 HCPCS,83497,Assay of 5-hiaa,,,10.37,32.25,16 HCPCS,83497,Hc 160 5Hiaa Plasma-So+,462.0,184.8,,,0 HCPCS,83497,"Hc 5-Hydroxyindoleacetic Acid (Hiaa) By Lc-Ms/Ms, Random Urine3018617-So+",20.4,8.16,,,0 HCPCS,83497,Hc 5-Hydroxyindoleacetic Acid (Hiaa) Plasma 3016920-So+,255.36,102.14,,,0 HCPCS,83497,"Hc Assay Of 5-Hiaa - 5 Hiaa Quant,24Hr Urine",20.4,8.16,,,0 HCPCS,83498,Assay of progesterone 17-d,,,23.09,67.92,16 HCPCS,83498,"Hc 17-Hydroxyprogesterone Quantitative By Hplc-Ms/Ms, Serum Or Plasma 92332-So+",32.6,13.04,,,0 HCPCS,83498,Hc 180 Hydroxyprogesterone-So+,57.72,23.09,,,0 HCPCS,83498,Hc 242 Cah State-So+,37.75,15.1,,,0 HCPCS,83498,Hc 716 17 Hydroxyprogesterone-So+,97.7,39.08,,,0 HCPCS,83498,Hc 771 Hydroxyprog 17-D-So+,42.37,16.95,,,0 HCPCS,83498,Hc Congenital Adrenal Hyperplasia (Cah) Pediatric Profile One 5015568 #4-So+,64.39,25.76,,,0 HCPCS,83500,Assay free hydroxyproline,,,19.25,56.62,16 HCPCS,83505,Assay total hydroxyproline,,,20.66,60.75,16 HCPCS,83505,"Hc Assay, Total Hydroxyproline - Hydroxyproline, Total",94.28,37.71,,,0 HCPCS,83516,Hc 057 Tis Transglutamins Iga-So+,39.16,15.66,,,0 HCPCS,83516,Hc 076 Tis Transglutamins Igg-So+,39.16,15.66,,,0 HCPCS,83516,Hc 097 Acetycholine Block Ab-So+,39.16,15.66,,,0 HCPCS,83516,Hc 104 F-Actin Ab Igg Rfx Asm-So+,39.16,15.66,,,0 HCPCS,83516,Hc 145 Histone Ab Igg-So+,14.4,5.76,,,0 HCPCS,83516,Hc 147 Heat Shock Prot 70 Igg-So+,135.06,54.02,,,0 HCPCS,83516,Hc 177 Acetyl Rec Mod Ab-So+,44.09,17.64,,,0 HCPCS,83516,Hc 182 Myeloperox Ab Igg-So+,39.16,15.66,,,0 HCPCS,83516,Hc 182 Serine Protease 3 Igg-So+,39.16,15.66,,,0 HCPCS,83516,Hc 183 Myeloperox Ab Igg-So+,39.16,15.66,,,0 HCPCS,83516,Hc 183 Serine Protease 3 Igg-So+,39.16,15.66,,,0 HCPCS,83516,Hc 209 Sol Liver Ag Ab Igg-So+,39.16,15.66,,,0 HCPCS,83516,"Hc 21-Hydroxylase Autoantibodies, Serum 3001962-So+",55.48,22.19,,,0 HCPCS,83516,Hc 238 Gliadin Ab Iga-So+,39.16,15.66,,,0 HCPCS,83516,Hc 238 Gliadin Ab Igg-So+,39.16,15.66,,,0 HCPCS,83516,Hc 281 Neuronal Nuc Ab Imublt-So+,198.67,79.47,,,0 HCPCS,83516,Hc 389 Myeloperoxid Ab-Arup-So+,39.16,15.66,,,0 HCPCS,83516,Hc 439 Rna Polymer Iii Ab Igg-So+,59.51,23.8,,,0 HCPCS,83516,Hc 501 Immun Assy Nos Mul Met-So+,39.16,15.66,,,0 HCPCS,83516,Hc 504 Immun Assy Nos Mul Met-So+,244.57,97.83,,,0 HCPCS,83516,Hc 536 Mpo Pr3 Abs -> Anca-So+,78.0,31.2,,,0 HCPCS,83516,Hc 577 Mitochondrial Ab Igg-So+,39.16,15.66,,,0 HCPCS,83516,Hc 649 Extended Myositis Panel So+,139.29,55.72,,,0 HCPCS,83516,Hc 676 Hmcgr Ab Igg-So+,162.0,64.8,,,0 HCPCS,83516,Hc 689 Serine Protea 3Ab Arup-So+,39.16,15.66,,,0 HCPCS,83516,Hc 867 Trap 5B-So+,67.2,26.88,,,0 HCPCS,83516,Hc Anti-Centromere,20.44,8.18,,,0 HCPCS,83516,"Hc Anti-Sp100 And Anti-Gp210 Antibodies, Igg 3002482-So+",103.49,41.4,,,0 HCPCS,83516,Hc Anti-Th/To,78.0,31.2,,,0 HCPCS,83516,Hc Antibody Analysis (Hoxworth),129.29,51.72,,,0 HCPCS,83516,Hc Extended Myositis Panel Ext2 #1-So+,25.9,10.36,,,0 HCPCS,83516,"Hc Gastric Parietal Cell Antibody, Igg 50596-So+",23.74,9.5,,,0 HCPCS,83516,Hc Gastric Pepsin A Assay-Arup,130.82,52.33,,,0 HCPCS,83516,"Hc Gbm Ab, Igg By Multiplex Bead Assay 51000-So+",32.1,12.84,,,0 HCPCS,83516,Hc Motor Neuropathy Syndrome Panel,877.32,350.93,,,0 HCPCS,83516,Hc Mpo-So+,13.92,5.57,,,0 HCPCS,83516,"Hc Pepsin A, Respiratory 3016831 #3-So+",40.4,16.16,,,0 HCPCS,83516,Hc Pr3-So+,13.92,5.57,,,0 HCPCS,83516,Hc Signal Recognition Particle (Srp) Ab-Arup Test 2002098,97.05,38.82,,,0 HCPCS,83516,Immunoassay nonantibody,,,9.26,28.82,16 HCPCS,83516,Noncdm Charge Record,22.84,9.14,,,0 HCPCS,83518,Immunoassay dipstick,,,6.28,24.1,16 HCPCS,83519,Hc Muscle Spec Kinase Ab-So+,888.0,355.2,,,0 HCPCS,83519,Hc 041 Neopterin Arup-So+,153.91,61.56,,,0 HCPCS,83519,Hc 094 Acetycholine Bind Ab-So+,48.58,19.43,,,0 HCPCS,83519,Hc 144 Pancreastatin-So+,240.0,96.0,,,0 HCPCS,83519,Hc 199 P/Q-Type Calcium Ch Ab-So+,77.54,31.02,,,0 HCPCS,83519,Hc 320 Acetylchol Mod Ab-So+,49.59,19.84,,,0 HCPCS,83519,Hc 375 21 Hydrolase Ab Quest-So+,124.5,49.8,,,0 HCPCS,83519,Hc 657 Tsh Receptor Ab-So+,48.58,19.43,,,0 HCPCS,83519,Hc 715 Igf Bp3 Endocrine Sci-So+,54.36,21.74,,,0 HCPCS,83519,Hc 836 Immun Assay Qnt Rad-So+,287.0,114.8,,,0 HCPCS,83519,Hc 978 Human Pancreas Polypep-So+,104.56,41.82,,,0 HCPCS,83519,Hc 992 Igf Binding Protein-2-So+,116.4,46.56,,,0 HCPCS,83519,Hc Ach Receptor Binding Ab-So+,228.0,91.2,,,0 HCPCS,83519,"Hc Achr Ganglionic Neuronal Ab, S",43.43,17.37,,,0 HCPCS,83519,"Hc Dysautonomia, Autoimm/Paraneo, S Dys2 #2=So+",90.58,36.23,,,0 HCPCS,83519,Hc Immunoassay Qn Ria,138.02,55.21,,,0 HCPCS,83519,Hc Mmp7-So+,308.4,123.36,,,0 HCPCS,83519,"Hc Neuronal (V-G) K+ Channel Ab, S",43.43,17.37,,,0 HCPCS,83519,"Hc Paraneoplastic Autoantibody Eval, Serum",646.99,258.8,,,0 HCPCS,83519,"Hc Trypsin, Serum3016694-So+",54.0,21.6,,,0 HCPCS,83519,"Hc Vgkc Complex Ab Ipa, Csf-So+",325.0,130.0,,,0 HCPCS,83519,"Hc Voltage-Gated Potassium Channel (Vgkc) Antibody, Serum 2004890-So+",231.6,92.64,,,0 HCPCS,83519,Ria nonantibody,,,11.48,46.0,16 HCPCS,83520,Hc 059 Immun Assay Qnt Nos-So+,165.0,66.0,,,0 HCPCS,83520,Hc 072 Anti-Mulleriuan Hormn-So+,66.0,26.4,,,0 HCPCS,83520,Hc 122 Pancreatic Elast Fecal-So+,120.0,48.0,,,0 HCPCS,83520,Hc 125 Tryptase-So+,46.55,18.62,,,0 HCPCS,83520,Hc 128 Ang-1 & 2 (2)-So+,114.0,45.6,,,0 HCPCS,83520,Hc 128 Il-7-So+,90.0,36.0,,,0 HCPCS,83520,Hc 143 Interleukin 2-So+,102.0,40.8,,,0 HCPCS,83520,Hc 242 Cystic Fibrosis State-So+,17.99,7.2,,,0 HCPCS,83520,Hc 249 Anti-Iga-So+,202.32,80.93,,,0 HCPCS,83520,Hc 304 Interleukin-6-So+,102.0,40.8,,,0 HCPCS,83520,Hc 361 Ige Ab-So+,46.55,18.62,,,0 HCPCS,83520,Hc 365 Gq1B Ab Igg-So+,32.4,12.96,,,0 HCPCS,83520,Hc 399 Flucytosine Bioassay-So+,139.87,55.95,,,0 HCPCS,83520,Hc 422 Adamts 13 Ab-So+,280.8,112.32,,,0 HCPCS,83520,Hc 504 Immun Assay Qnt Nos-So+,57.6,23.04,,,0 HCPCS,83520,Hc 683 Tnf Arup-So+,114.0,45.6,,,0 HCPCS,83520,Hc 722 Soluble Cd 25 Receptor-So+,100.0,40.0,,,0 HCPCS,83520,Hc 827 Inhibin B-So+,94.02,37.61,,,0 HCPCS,83520,Hc 838 Mannose Binding Lectin-So+,120.0,48.0,,,0 HCPCS,83520,Hc 870 Immun Assay Qnt Nos Ea-So+,46.55,18.62,,,0 HCPCS,83520,Hc 874 Fibroblst Grwth Fac-23-So+,625.56,250.22,,,0 HCPCS,83520,Hc 964 Stelara Ab-So+,154.5,61.8,,,0 HCPCS,83520,Hc Beta Amyloid Csf,122.93,49.17,,,0 HCPCS,83520,Hc Cxcl9-So+,457.2,182.88,,,0 HCPCS,83520,Hc Demyelinating Neuropathy #1-So+,87.25,34.9,,,0 HCPCS,83520,Hc Il-18 (Interleukin-18) 00541-So+,384.0,153.6,,,0 HCPCS,83520,Hc Mmp-7-So+,428.4,171.36,,,0 HCPCS,83520,Hc Motor Neuropathy Syndrome Panel Wusm #2-So+,73.97,29.59,,,0 HCPCS,83520,Hc Neopterin 140335-So+,85.66,34.26,,,0 HCPCS,83520,"Hc Neurofilament Light Chain, Serum-Labcorp 140455",257.5,103.0,,,0 HCPCS,83520,"Hc Ngal,U (Neutrophil Gelatinase-Associated Lipocalin)7570857-So+",219.96,87.98,,,0 HCPCS,83520,"Hc Phospholipase A2 Receptor, Monitoring, Serum (Mayo)",273.89,109.56,,,0 HCPCS,83520,Hc Plasma Cytokine Panel,289.72,115.89,,,0 HCPCS,83520,"Hc Prim Membranous Nephropathy Diagnosis, Serum (Mayo)",252.0,100.8,,,0 HCPCS,83520,Hc Ptau Csf,122.93,49.17,,,0 HCPCS,83520,Hc Quantitative Immunoassay,40.72,16.29,,,0 HCPCS,83520,Hc Thyroid Stimulating Hormone Receptor Antibody (Trab)2002734-So+,37.2,14.88,,,0 HCPCS,83520,Hc Ttau Csf,253.41,101.36,,,0 HCPCS,83520,Hc Vascular Endothelial Growth Factor 92660-So+,102.0,40.8,,,0 HCPCS,83520,Immunoassay quant nos nonab,,,11.0,43.18,16 HCPCS,83521,Hc 122 Interleukin 1 Beta-So+,133.0,53.2,,,0 HCPCS,83521,Hc 444 Vasc Endothel Grow Fac-So+,133.0,53.2,,,0 HCPCS,83521,"Hc Free Light Chains, Kappa/Lambda With Ratio, Serum",56.07,22.43,,,0 HCPCS,83521,"Hc Kappa/Lambda Quantitative Free Light Chains With Ratio, Serum-Arup 0055167",29.76,11.9,,,0 HCPCS,83521,Ig light chains free each,,,6.91,43.18,16 HCPCS,83525,Assay of insulin,,,9.71,28.58,16 HCPCS,83525,Hc 345 Insulin,180.08,72.03,,,0 HCPCS,83525,"Hc Assay Of Insulin,Total - Insulin, Total",155.0,62.0,,,0 HCPCS,83527,Assay of insulin,,,11.0,32.38,16 HCPCS,83528,Assay of intrinsic factor,,,13.52,49.55,16 HCPCS,83529,Asay of interleukin-6 (il-6),,,6.91,43.18,16 HCPCS,83529,"Hc Interleukin 6, Serum",90.58,36.23,,,0 HCPCS,83529,Hc Interleukin-6,253.41,101.36,,,0 HCPCS,83540,Assay of iron,,,5.51,16.18,16 HCPCS,83540,Hc 995 Iron Liver Tissue-So+,68.45,27.38,,,0 HCPCS,83540,Hc Assay Of Iron - Iron,100.28,40.11,,,0 HCPCS,83550,Hc Iron Binding Test - Iron + Transferrin + Tibc,131.55,52.62,,,0 HCPCS,83550,Hc Iron Binding Test - Iron And Iron Binding Capacity Panel - Sr Or Pl,131.55,52.62,,,0 HCPCS,83550,Iron binding test,,,7.43,21.85,16 HCPCS,83570,Assay of idh enzyme,,,7.17,22.12,16 HCPCS,83582,Assay of ketogenic steroids,,,12.05,38.68,16 HCPCS,83586,Assay 17- ketosteroids,,,10.88,32.0,16 HCPCS,83586,Hc 064 17-Ketosteroids 17Ks-So+,35.68,14.27,,,0 HCPCS,83593,Fractionation ketosteroids,,,22.35,71.25,16 HCPCS,83605,Assay of lactic acid,,,9.08,28.92,16 HCPCS,83605,Hc 489 D-Lactate Mayo-So+,134.4,53.76,,,0 HCPCS,83605,Hc Assay Of Lactic Acid - Lactic Acid Body Fluid,13.88,5.55,,,0 HCPCS,83605,Hc Assay Of Lactic Acid - Poct Lactic Acid (Lactate),189.78,75.91,,,0 HCPCS,83605,Hc Poc- Gem 5000 Lactate,189.78,75.91,,,0 HCPCS,83615,Hc 396 Ldh Total Fluid-So+,21.7,8.68,,,0 HCPCS,83615,Hc Lactate (Ld) (Ldh) Enzyme - Lactate Dehydrogenase,91.66,36.66,,,0 HCPCS,83615,Hc Lactate (Ld) (Ldh) Enzyme - Lactate Dehydrogenase Fl,91.66,36.66,,,0 HCPCS,83615,Hc Lactate (Ld) (Ldh) Enzyme-So+,11.61,4.64,,,0 HCPCS,83615,Lactate (LD) (LDH) enzyme,,,5.13,15.1,16 HCPCS,83625,Assay of ldh enzymes,,,10.88,31.98,16 HCPCS,83625,Hc 243 Ldh Isoenzymes-So+,46.02,18.41,,,0 HCPCS,83625,Hc Assay Of Ldh Enzymes-So+,15.35,6.14,,,0 HCPCS,83630,Hc Fecal Lactoferrin Qual,145.57,58.23,,,0 HCPCS,83630,Lactoferrin fecal (qual),,,16.68,49.25,16 HCPCS,83631,Lactoferrin fecal (quant),,,16.68,49.08,16 HCPCS,83632,Placental lactogen,,,17.18,50.55,16 HCPCS,83633,Test urine for lactose,,,4.67,28.12,16 HCPCS,83655,Assay of lead,,,10.29,30.28,16 HCPCS,83655,Hc 058 Lead-So+,14.53,5.81,,,0 HCPCS,83661,L/s ratio fetal lung,,,18.68,54.98,16 HCPCS,83662,Foam stability fetal lung,,,16.08,47.28,16 HCPCS,83663,Fluoro polarize fetal lung,,,16.08,47.28,16 HCPCS,83664,Lamellar bdy fetal lung,,,16.08,48.3,16 HCPCS,83670,Assay of lap enzyme,,,7.79,24.52,16 HCPCS,83690,Assay of lipase,,,5.86,17.22,16 HCPCS,83690,Hc 113 Lipase Peritoneal Fld-So+,43.2,17.28,,,0 HCPCS,83690,Hc 143 Lipase Fluid-So+,24.77,9.91,,,0 HCPCS,83690,Hc Assay Of Lipase - Lipase,184.39,73.76,,,0 HCPCS,83695,Assay of lipoprotein(a),,,11.0,35.8,16 HCPCS,83695,Hc 207 Lipoprotein A-So+,46.55,18.62,,,0 HCPCS,83698,Assay Lipoprotein Pla2,,,28.85,115.78,16 HCPCS,83700,Lipopro bld electrophoretic,,,8.89,28.15,16 HCPCS,83701,Lipoprotein bld hr fraction,,,21.1,84.65,16 HCPCS,83704,Hc 250 Nmr Lipoprotein-So+,113.47,45.39,,,0 HCPCS,83704,Hc Lipofit By Nmr 2013716 #1-So+,41.03,16.41,,,0 HCPCS,83704,Lipoprotein bld quan part,,,26.81,85.48,16 HCPCS,83718,Assay of lipoprotein,,,6.96,20.48,16 HCPCS,83718,"Hc Assay Of Blood Lipoprotein,Hdl Cholest - Hdl Cholesterol",120.77,48.31,,,0 HCPCS,83719,Assay of blood lipoprotein,,,7.91,31.88,16 HCPCS,83721,Assay of blood lipoprotein,,,8.11,26.25,16 HCPCS,83721,Hc 086 Ldl Cholesterol Direct-So+,43.47,17.39,,,0 HCPCS,83721,"Hc Assay Of Blood Lipoprotein,Ldl Cholest - Ldl Cholesterol Direct",85.19,34.08,,,0 HCPCS,83722,Lipoprtn dir meas sd ldl chl,,,14.02,85.48,16 HCPCS,83727,Assay of lrh hormone,,,13.75,42.98,16 HCPCS,83735,Assay of magnesium,,,5.69,16.75,16 HCPCS,83735,Hc 627 Magnesium Rbc-So+,42.8,17.12,,,0 HCPCS,83735,Hc Assay Of Magnesium - Magnesium,119.69,47.88,,,0 HCPCS,83735,Hc Assay Of Magnesium - Magnesium Urine,119.69,47.88,,,0 HCPCS,83775,Assay malate dehydrogenase,,,6.26,18.42,16 HCPCS,83785,Assay of manganese,,,20.9,66.62,16 HCPCS,83785,Hc Manganese Wb-So+,31.98,12.79,,,0 HCPCS,83788,Mass spectrometry qual,,,15.34,15.34,4 HCPCS,83789,Hc 242 Ms/Ms Qnt State-So+,25.09,10.04,,,0 HCPCS,83789,Hc 406 Dht Lcmsms-So+,98.56,39.42,,,0 HCPCS,83789,Hc 485 Synth Stimulnt Qnt Ur-So+,92.72,37.09,,,0 HCPCS,83789,Hc 487 Olanzapine Zyprexa-So+,81.6,32.64,,,0 HCPCS,83789,Hc 660 Lacosamide-So+,188.4,75.36,,,0 HCPCS,83789,Hc 827 Bile Acids Urine-So+,1414.8,565.92,,,0 HCPCS,83789,Hc 952 Buproprion+Metab-Soq+,118.8,47.52,,,0 HCPCS,83789,Hc Everolimus By Lcmsms,200.57,80.23,,,0 HCPCS,83789,"Hc Iodine, 24 Hour, Urine Uiod-So+",60.79,24.32,,,0 HCPCS,83789,Mass spectrometry qual/quan,,,15.34,60.28,16 HCPCS,83825,Assay of mercury,,,13.82,40.65,16 HCPCS,83825,Hc 179 Mercury-So+,19.51,7.8,,,0 HCPCS,83835,Assay of metanephrines,,,14.4,42.35,16 HCPCS,83835,Hc Metanephrines Fract Ur-So+,20.33,8.13,,,0 HCPCS,83835,Hc 602 Metanephrine Free Frac-So+,48.61,19.44,,,0 HCPCS,83857,Assay of methemalbumin,,,9.13,26.85,16 HCPCS,83861,Microfluid analy tears,,,14.04,56.2,16 HCPCS,83864,Mucopolysaccharides,,,16.92,71.25,16 HCPCS,83872,Assay synovial fluid mucin,,,3.85,14.65,16 HCPCS,83873,Assay of csf protein,,,14.62,43.0,16 HCPCS,83873,Hc 028 Myelin Basic Protein-So+,61.88,24.75,,,0 HCPCS,83874,Assay of myoglobin,,,10.97,32.3,16 HCPCS,83876,Assay myeloperoxidase,,,28.85,127.15,16 HCPCS,83880,Assay of natriuretic peptide,,,28.85,98.15,16 HCPCS,83880,Hc Natriuretic Peptide - B-Type Natriuretic Peptide (Bnp),378.49,151.4,,,0 HCPCS,83883,Assay nephelometry not spec,,,11.55,34.0,16 HCPCS,83883,Hc 321 Retinol Bnd Protein-So+,48.89,19.56,,,0 HCPCS,83883,Hc 861 Kappa Flc Serum,143.42,57.37,,,0 HCPCS,83883,"Hc Nephelometry, Not Specified - Kappa / Lambda Light Chains, Urine",143.42,57.37,,,0 HCPCS,83884,Assay neurflmnt light chain,,,6.91,290.58,9 HCPCS,83885,Assay of nickel,,,20.82,61.28,16 HCPCS,83915,Assay of nucleotidase,,,7.66,27.88,16 HCPCS,83915,Hc 5 Nucleotidase-So+,14.4,5.76,,,0 HCPCS,83916,Hc 366 Oligoclonal Bands Only-So+,92.69,37.08,,,0 HCPCS,83916,Hc Oligoclonal Band Profile80440 #1-So+,32.87,13.15,,,0 HCPCS,83916,Oligoclonal bands,,,17.09,68.48,16 HCPCS,83918,"Hc Cobalamin, Methionine, And Methylmalonic Acid Pathways, Plasma Cmmpp #2-So+",336.48,134.59,,,0 HCPCS,83918,Organic acids total quant,,,13.99,59.0,16 HCPCS,83919,Hc 042 Organ Acid Ur Qlt Mayo-So+,79.75,31.9,,,0 HCPCS,83919,Organic acids qual each,,,13.99,41.12,16 HCPCS,83921,Hc 649 Methylmalonic Acid Ur-So+,67.49,27.0,,,0 HCPCS,83921,"Hc Assay Single Organic Acid, Quantitative - Methylmalonic Acid, Serum",99.61,39.84,,,0 HCPCS,83921,Organic acid single quant,,,13.99,53.02,16 HCPCS,83930,Assay of blood osmolality,,,5.62,16.52,16 HCPCS,83930,Hc Assay Of Blood Osmolality - Osmolality,120.77,48.31,,,0 HCPCS,83935,Assay of urine osmolality,,,5.79,17.05,16 HCPCS,83935,Hc Assay Of Urine Osmolality - Osmolality Urine,136.95,54.78,,,0 HCPCS,83937,Assay of osteocalcin,,,24.2,74.62,16 HCPCS,83937,Hc 334 Osteocaicin-So+,44.4,17.76,,,0 HCPCS,83945,Assay of oxalate,,,10.94,36.12,16 HCPCS,83945,Hc 630 Oxalate Serum-So+,24.66,9.86,,,0 HCPCS,83950,Oncoprotein her-2/neu,,,54.74,161.02,16 HCPCS,83951,Hc Des-Gamma Carboxy Prothrombin,106.16,42.46,,,0 HCPCS,83951,Oncoprotein dcp,,,54.74,161.02,16 HCPCS,83970,Assay of parathormone,,,35.08,103.2,16 HCPCS,83970,Hc 480 Assay Of Parathormone - Pth Intact-So+,26.86,10.74,,,0 HCPCS,83970,Hc 555 Assay Of Parathormone - Pth Intact-So+,148.45,59.38,,,0 HCPCS,83970,Hc Assay Of Parathormone - Pth Intact,332.12,132.85,,,0 HCPCS,83970,Hc Parathyroid Hormone Intact 70346-So+,49.54,19.82,,,0 HCPCS,83986,Assay ph body fluid nos,,,3.04,8.95,16 HCPCS,83986,Hc 266 Ph Body Fluid-Fecel-So+,12.89,5.16,,,0 HCPCS,83986,"Hc Pepsin A, Respiratory 3016831-So+",40.4,16.16,,,0 HCPCS,83986,Hc Ph Body Fluid Nos - Ph Body Fluid,62.54,25.02,,,0 HCPCS,83987,Exhaled breath condensate,,,3.58,26.2,16 HCPCS,83992,Assay for phencyclidine,,,12.49,24.24,12 HCPCS,83993,Assay for calprotectin fecal,,,16.68,49.08,16 HCPCS,83993,Hc 107 Calprotectin Fecal-So+,90.0,36.0,,,0 HCPCS,84030,Assay of blood pku,,,4.67,13.75,16 HCPCS,84030,Hc Assay Of Blood Pku - Phenylalanine,74.4,29.76,,,0 HCPCS,84030,"Hc Biopterin, Pku Co-Factors-So+",130.68,52.27,,,0 HCPCS,84035,Assay of phenylketones,,,3.11,9.95,16 HCPCS,84056,Hc Testos F/T/Shbg Fm/Chd-So+,20.0,8.0,,,0 HCPCS,84060,Assay acid phosphatase,,,6.28,19.1,16 HCPCS,84060,Hc Tartrate Resistant Acid Phosphatase (Trap) 415840-So+,162.96,65.18,,,0 HCPCS,84066,Assay prostate phosphatase,,,8.21,24.15,16 HCPCS,84066,Hc Assay Phosphatase Acid Prostatic - Prostatic Acid Phosphatase,16.02,6.41,,,0 HCPCS,84075,Assay alkaline phosphatase,,,4.4,12.95,16 HCPCS,84075,"Hc Alkaline Phosphatase Isoenzy, Serpla 21020-So+",7.8,3.12,,,0 HCPCS,84075,"Hc Alkaline Phosphatase Isoenzymes, Serum Or Plasma 21020 #1-So+",7.8,3.12,,,0 HCPCS,84075,Hc Assay Alkal Phosphatase - Alkaline Phosphatase,89.5,35.8,,,0 HCPCS,84075,Hc Assay Alkaline Phosphatase - Alkaline Phosphatase,89.5,35.8,,,0 HCPCS,84078,Assay alkaline phosphatase,,,5.93,20.65,16 HCPCS,84080,Assay alkaline phosphatases,,,12.57,36.95,16 HCPCS,84080,"Hc Alkaline Phosphatase Isoenzymes, Serum Or Plasma 21020 #2-So+",17.74,7.1,,,0 HCPCS,84080,"Hc Assay Alkaline Phosphatase,Isoenzymes - Alkaline Phosphatase,Isoenzymes",17.74,7.1,,,0 HCPCS,84080,Hc Bone Specific Alkaline Phosphatase-Arup 0070053,38.82,15.53,,,0 HCPCS,84081,Assay phosphatidylglycerol,,,14.04,41.3,16 HCPCS,84085,Assay of rbc pg6d enzyme,,,5.73,23.6,16 HCPCS,84087,Assay phosphohexose enzymes,,,8.77,26.82,16 HCPCS,84100,Assay of phosphorus,,,4.03,11.85,16 HCPCS,84100,Hc Phosphorus,89.5,35.8,,,0 HCPCS,84105,Assay of urine phosphorus,,,4.4,14.45,16 HCPCS,84105,Hc 517 Assay Of Urine Phosphorus - Phosphorus Random Urine-So+,89.0,35.6,,,0 HCPCS,84105,Hc Assay Of Urine Phosphorus - Phosphorus Random Urine,95.97,38.39,,,0 HCPCS,84106,Hc Assay Of Porphobilinogen Urine Qual - Porphobilinogen Screen,92.74,37.1,,,0 HCPCS,84106,Test for porphobilinogen,,,3.64,14.55,16 HCPCS,84110,Assay of porphobilinogen,,,7.18,21.1,16 HCPCS,84110,"Hc Porphyrins And Porphobilinogen (Pbg), Urine 2002181(2)-So+",36.77,14.71,,,0 HCPCS,84112,Eval amniotic fluid protein,,,54.74,245.28,16 HCPCS,84112,Hc Amnisure Test,346.14,138.46,,,0 HCPCS,84119,Test urine for porphyrins,,,7.32,33.4,16 HCPCS,84120,Assay of urine porphyrins,,,12.5,36.78,16 HCPCS,84120,"Hc Porphyrins And Porphobilinogen (Pbg), Urine 2002181(1)-So+",36.77,14.71,,,0 HCPCS,84126,Assay of feces porphyrins,,,21.65,97.78,16 HCPCS,84126,Hc 910 Porphyrins Feces-So+,252.8,101.12,,,0 HCPCS,84132,Assay of serum potassium,,,3.91,11.9,16 HCPCS,84132,Hc Assay Of Serum Potassium - Potassium,73.33,29.33,,,0 HCPCS,84133,Assay of urine potassium,,,3.65,11.82,16 HCPCS,84133,Hc Assay Of Urine Potassium - Potassium Random Urine,80.87,32.35,,,0 HCPCS,84133,"Hc Assay Of Urine Potassium - Potassium,Timed Urine",80.87,32.35,,,0 HCPCS,84134,Assay of prealbumin,,,12.39,36.48,16 HCPCS,84134,Hc Assay Of Prealbumin - Prealbumin,175.77,70.31,,,0 HCPCS,84135,Assay of pregnanediol,,,16.26,53.18,16 HCPCS,84138,Assay of pregnanetriol,,,16.09,52.62,16 HCPCS,84140,Assay of pregnenolone,,,17.57,51.68,16 HCPCS,84143,Assay of 17-hydroxypregneno,,,19.39,57.02,16 HCPCS,84143,Hc 099 17 Hydroxypregnenolone-So+,49.2,19.68,,,0 HCPCS,84143,Hc 771 17 Hydroxypregnenolone-So+,42.37,16.95,,,0 HCPCS,84144,Assay of progesterone,,,17.73,52.15,16 HCPCS,84144,Hc 771 Progesterone-So+,48.74,19.5,,,0 HCPCS,84144,Hc Assay Of Progesterone - Progesterone,198.41,79.36,,,0 HCPCS,84145,Hc Procalcitonin,295.46,118.18,,,0 HCPCS,84145,Procalcitonin (PCT),,,22.76,68.05,16 HCPCS,84146,Assay of prolactin,,,16.47,48.45,16 HCPCS,84146,Hc Assay Of Prolactin - Prolactin,306.24,122.5,,,0 HCPCS,84146,Hc Macroprolactin-Arup Test 0020765,53.38,21.35,,,0 HCPCS,84150,Assay of prostaglandin,,,21.21,104.42,16 HCPCS,84150,"Hc 2,3-Dinor 11 Beta-Prostaglandin F2 Alpha, 24 Hour, Urine-Mayo 23Bpt",71.29,28.52,,,0 HCPCS,84152,Assay of psa complexed,,,15.64,45.98,16 HCPCS,84153,Assay of psa total,,,15.64,45.98,16 HCPCS,84153,"Hc 754 Prostate Specific Antigen,Total - Psa-So+",229.0,91.6,,,0 HCPCS,84153,"Hc 863 Prostate Specific Antigen,Total - Psa-So+",22.07,8.83,,,0 HCPCS,84153,"Hc Prostate Specific Antigen,Total - Psa",229.68,91.87,,,0 HCPCS,84154,Assay of psa free,,,15.64,45.98,16 HCPCS,84154,Hc 191 Psa Free-So+,22.07,8.83,,,0 HCPCS,84155,Assay of protein serum,,,3.11,9.18,16 HCPCS,84155,Hc 839 Protein Total-So+,13.2,5.28,,,0 HCPCS,84155,Hc Protein Tot Xcpt Refractometry Serum - Protein Total,80.87,32.35,,,0 HCPCS,84156,Assay of protein urine,,,3.11,9.18,16 HCPCS,84156,Hc Protein Tot Xcpt Refractometry Urine - Protein Random Urine,92.74,37.1,,,0 HCPCS,84156,Hc Protein Tot Xcpt Refractometry Urine - Protein Timed Urine,92.74,37.1,,,0 HCPCS,84157,Assay of protein other,,,3.11,10.0,16 HCPCS,84157,Hc 338 Galactosidase-Enz Wbc-So+,222.0,88.8,,,0 HCPCS,84157,Hc 778 Tot Protein Oth Source-So+,13.2,5.28,,,0 HCPCS,84157,"Hc Pepsin A, Respiratory 3016813 #2-So+",40.4,16.16,,,0 HCPCS,84157,Hc Protein Tot Xcpt Refractometry Oth Src - Protein Body Fluid,92.74,37.1,,,0 HCPCS,84160,Assay of protein any source,,,4.4,14.02,16 HCPCS,84163,Pappa serum,,,12.8,37.62,16 HCPCS,84165,"Hc Protein E-Phoresis, Serum - Protein Electrophoresis Serum",199.49,79.8,,,0 HCPCS,84165,Protein e-phoresis serum,,,9.13,26.85,16 HCPCS,84166,Hc Protein E-Phoresis/Urine/Csf - Protein Electrophoresis Urine,214.59,85.84,,,0 HCPCS,84166,Protein e-phoresis/urine/csf,,,14.74,44.58,16 HCPCS,84181,Western blot test,,,14.47,42.58,16 HCPCS,84182,Hc 063 14-3-3 Protein-So+,35.63,14.25,,,0 HCPCS,84182,Hc 14-3-3 Protein Panel-So+,252.75,101.1,,,0 HCPCS,84182,Hc 511 Paraneop Autoab Wb Cfm-So+,41.1,16.44,,,0 HCPCS,84182,Hc Agna-1 Immunoblot-So+,190.0,76.0,,,0 HCPCS,84182,Hc Amphiphysin Immunoblot-So+,190.0,76.0,,,0 HCPCS,84182,Hc Anna-1 Immunoblot-So+,190.0,76.0,,,0 HCPCS,84182,Hc Anna-2 Immunoblot-So+,190.0,76.0,,,0 HCPCS,84182,Hc Crmp-5-Igg Western Blot-So+,310.0,124.0,,,0 HCPCS,84182,Hc Demyelinating Neuropathy #2-So+,87.25,34.9,,,0 HCPCS,84182,Hc Enc2 Antibody Western Blot-So+,330.0,132.0,,,0 HCPCS,84182,Hc Ens2 Antibody Reflex Ib-So+,120.0,48.0,,,0 HCPCS,84182,Hc Ens2 Antibody Reflex Wb-So+,271.74,108.7,,,0 HCPCS,84182,Hc Extended Myositis Panel Ext2 #3-So+,35.05,14.02,,,0 HCPCS,84182,"Hc Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum Mds2 #4-So+",55.72,22.29,,,0 HCPCS,84182,"Hc Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid Mdc2 #2-So+",48.89,19.56,,,0 HCPCS,84182,"Hc Neuronal Nuclear Ab Igg, Immunoblot, Ser 3002917-So+",35.64,14.26,,,0 HCPCS,84182,Hc Pca-1 Immunoblot-So+,190.0,76.0,,,0 HCPCS,84182,Hc Pca-Tr Immunoblot-So+,190.0,76.0,,,0 HCPCS,84182,Noncdm Charge Record,35.63,14.25,,,0 HCPCS,84182,Protein western blot test,,,15.29,73.02,16 HCPCS,84202,Assay RBC protoporphyrin,,,12.19,35.88,16 HCPCS,84202,Hc 127 Zinc Protoporphrn Inds-So+,51.59,20.64,,,0 HCPCS,84202,Hc 325 Zinc Protopor Indust-So+,90.0,36.0,,,0 HCPCS,84202,Hc 994 Porphyrin Rbc-So+,71.22,28.49,,,0 HCPCS,84202,Hc Assay Rbc Protoporphyrin - Erythrocyte Porphyrin,90.0,36.0,,,0 HCPCS,84203,Test RBC protoporphyrin,,,7.32,24.35,16 HCPCS,84206,Assay of proinsulin,,,15.14,66.72,16 HCPCS,84206,Hc 326 Proinsulin-So+,64.04,25.62,,,0 HCPCS,84207,Assay of vitamin b-6,,,23.88,70.25,16 HCPCS,84207,Hc 085 Vitamin B6-So+,101.03,40.41,,,0 HCPCS,84210,Assay of pyruvate,,,9.22,36.2,16 HCPCS,84210,Hc 814 Pyruvic Acid-So+,39.05,15.62,,,0 HCPCS,84210,Hc 859 Pyruvic Acid Csf-So+,39.05,15.62,,,0 HCPCS,84220,Assay of pyruvate kinase,,,8.02,23.6,16 HCPCS,84220,Hc 619 Pyruvate Kinase Qnt-So+,54.6,21.84,,,0 HCPCS,84228,Assay of quinine,,,9.89,29.08,16 HCPCS,84233,Assay of estrogen,,,54.74,219.7,16 HCPCS,84234,Assay of progesterone,,,55.13,162.2,16 HCPCS,84234,Hc Progestrone Assay,561.8,224.72,,,0 HCPCS,84235,Assay of endocrine hormone,,,44.48,178.08,16 HCPCS,84238,Assay nonendocrine receptor,,,31.07,91.42,16 HCPCS,84244,Assay of renin,,,18.69,54.98,16 HCPCS,84244,Hc 341 Renin Plasma-Soq+,26.39,10.56,,,0 HCPCS,84252,Assay of vitamin b-2,,,17.2,50.6,16 HCPCS,84252,"Hc Vitamin B2, Riboflavin-So+",37.71,15.08,,,0 HCPCS,84255,Assay of selenium,,,21.7,63.82,16 HCPCS,84255,Hc 130 Selenium-So+,30.64,12.26,,,0 HCPCS,84260,Assay of serotonin,,,26.32,77.45,16 HCPCS,84260,Hc 028 Serotonin-So+,39.28,15.71,,,0 HCPCS,84260,Hc 916 Serotonin Serum-So+,37.18,14.87,,,0 HCPCS,84270,Assay of sex hormone globul,,,18.47,54.32,16 HCPCS,84270,Hc 269 Sex Hormone Bnd Glob-So+,78.17,31.27,,,0 HCPCS,84270,Hc 327 Sex Hormone Bnd Glob-So+,78.17,31.27,,,0 HCPCS,84270,Hc 490 Shbg-So+,78.17,31.27,,,0 HCPCS,84270,Hc 494 Shbg-So+,78.17,31.27,,,0 HCPCS,84270,"Hc Testosterone, Free, Bioavailable And Total, Ms 14966 #2-So+",26.08,10.43,,,0 HCPCS,84275,Assay of sialic acid,,,11.42,33.6,16 HCPCS,84285,Assay of silica,,,20.01,63.02,16 HCPCS,84295,Assay of serum sodium,,,4.09,12.02,16 HCPCS,84295,Hc Assay Of Serum Sodium - Sodium,73.33,29.33,,,0 HCPCS,84300,Assay of urine sodium,,,4.13,12.65,16 HCPCS,84300,Hc 217 Assay Of Urine Sodium - Sodium Random Urine-So+,17.51,7.0,,,0 HCPCS,84300,Hc Assay Of Urine Sodium - Sodium Random Urine,81.95,32.78,,,0 HCPCS,84302,Assay of sweat sodium,,,4.13,12.15,16 HCPCS,84302,Hc 298 Sodium Feces-Soq+,34.8,13.92,,,0 HCPCS,84302,Hc 428 Sodium Stool-So+,31.2,12.48,,,0 HCPCS,84302,"Hc Sodium, Fecal 20379-So+",16.02,6.41,,,0 HCPCS,84302,"Hc Sodium, Fluid-Arup 0020154-So+",10.24,4.1,,,0 HCPCS,84305,Assay of somatomedin,,,18.07,53.15,16 HCPCS,84305,Hc 714 Igf 1-So+,25.51,10.2,,,0 HCPCS,84307,Assay of somatostatin,,,15.54,45.7,16 HCPCS,84307,Hc 323 Somatostatin-So+,232.8,93.12,,,0 HCPCS,84311,Hc Adenosine Deam Pleural-So+,38.81,15.52,,,0 HCPCS,84311,Hc Cholesterol Bdy Fld-So+,25.13,10.05,,,0 HCPCS,84311,Hc Porphyrin Blood Qnt-So+,25.13,10.05,,,0 HCPCS,84311,Hc 298 Potassium Feces-So+,50.03,20.01,,,0 HCPCS,84311,Hc 457 Adenosn Deam Peri Fld-So+,132.0,52.8,,,0 HCPCS,84311,Hc 806 Bromide-So+,43.86,17.54,,,0 HCPCS,84311,"Hc Adenosine Deaminase, Rbc 83001-So+",84.3,33.72,,,0 HCPCS,84311,"Hc Adenosine Deaminase,Peritoneal Fluid",44.1,17.64,,,0 HCPCS,84311,Spectrophotometry,,,5.94,20.25,16 HCPCS,84315,Body fluid specific gravity,,,2.13,8.2,16 HCPCS,84375,Chromatogram assay sugars,,,16.66,97.5,16 HCPCS,84376,Hc Reducing Subst Fecal-So+,19.78,7.91,,,0 HCPCS,84376,Sugars single qual,,,4.67,13.75,16 HCPCS,84377,Sugars multiple qual,,,4.67,13.75,16 HCPCS,84378,Hc Galactose-1-Phos Rbc-So+,123.42,49.37,,,0 HCPCS,84378,Sugars single quant,,,9.79,28.82,16 HCPCS,84379,Sugars multiple quant,,,9.79,28.82,16 HCPCS,84392,Assay of urine sulfate,,,4.04,13.72,16 HCPCS,84393,Tau phosphorylated ea,,,45.77,322.3,9 HCPCS,84394,Total tau,,,45.77,322.3,9 HCPCS,84402,Assay of free testosterone,,,21.64,63.68,16 HCPCS,84402,Hc 494 Testosterone Free-So+,91.58,36.63,,,0 HCPCS,84402,Hc Assay Of Testosterone - Testosterone Total Free,217.82,87.13,,,0 HCPCS,84403,Assay of total testosterone,,,21.94,64.52,16 HCPCS,84403,Hc 490 Testosterone Total-So+,92.84,37.14,,,0 HCPCS,84403,Hc 494 Testosterone Total-So+,92.84,37.14,,,0 HCPCS,84403,Hc Assay Of Total Testosterone - Testosterone,223.21,89.28,,,0 HCPCS,84403,Hc Congenital Adrenal Hyperplasia (Cah) Pediatric Profile One 501568 #5-So+,64.39,25.76,,,0 HCPCS,84403,Hc Testicular Function Group 1 #3-So+,32.4,12.96,,,0 HCPCS,84403,"Hc Testosterone, Free, Bioavailable And Total, Ms 14966 #3-So+",30.97,12.39,,,0 HCPCS,84410,Testosterone bioavailable,,,31.44,128.2,16 HCPCS,84425,Assay of vitamin b-1,,,18.04,53.08,16 HCPCS,84425,Hc Vit B1 (Thiamine) Wb-So+,76.34,30.54,,,0 HCPCS,84425,Hc Vit B1 Thiamine Plsm-So+,76.34,30.54,,,0 HCPCS,84430,Assay of thiocyanate,,,9.89,29.08,16 HCPCS,84431,Thromboxane urine,,,14.28,87.78,16 HCPCS,84432,Assay of thyroglobulin,,,13.66,40.15,16 HCPCS,84432,Hc Thyroglobulin Fna-So+,57.77,23.11,,,0 HCPCS,84432,Hc 794 Thyroglobulin Lcmsms-So+,238.08,95.23,,,0 HCPCS,84432,Hc Assay Of Thyroglobulin - Thyroglobulin,189.78,75.91,,,0 HCPCS,84432,"Hc Thyroglobulin, Tumor Marker, Ia, S Htgt-So+",248.06,99.22,,,0 HCPCS,84433,Asy thiopurin s-mthyltrnsfrs,,,8.87,55.42,16 HCPCS,84433,Hc Tpmt Enzyme (Assay Thyipurine S-Methyltransferase),253.44,101.38,,,0 HCPCS,84436,Assay of total thyroxine,,,5.84,17.18,16 HCPCS,84437,Assay of neonatal thyroxine,,,5.5,16.18,16 HCPCS,84437,Hc 242 T4 State-So+,9.0,3.6,,,0 HCPCS,84439,Assay of free thyroxine,,,7.66,22.55,16 HCPCS,84439,Hc 972 T4 Free By Dialys Mayo-So+,32.4,12.96,,,0 HCPCS,84439,Hc Assay Of Free Thyroxine - T4 Free,174.69,69.88,,,0 HCPCS,84442,Assay of thyroid activity,,,12.57,36.95,16 HCPCS,84442,Hc 559 Thyroxine Bind Protien-So+,64.74,25.9,,,0 HCPCS,84442,Hc 802 Thyroxine Bind Protien-So+,53.17,21.27,,,0 HCPCS,84443,Assay thyroid stim hormone,,,14.28,42.0,16 HCPCS,84443,Hc 242 Tsh-So+,23.34,9.34,,,0 HCPCS,84443,Hc Assay Thyroid Stimulating Hormone - Thyroid Stimulating Hormone,243.7,97.48,,,0 HCPCS,84445,Assay of tsi globulin,,,43.21,127.15,16 HCPCS,84445,Hc 923 Thyroid Stim Immuglb-So+,61.03,24.41,,,0 HCPCS,84446,Assay of vitamin e,,,9.51,35.45,16 HCPCS,84446,Hc 110 Vit E S/P-So+,40.24,16.1,,,0 HCPCS,84449,Assay of transcortin,,,15.29,45.0,16 HCPCS,84450,Hc Ast,71.17,28.47,,,0 HCPCS,84450,Hc Transferase Aspartate Amino (Ast) (Sgot) - Ast (Sgot),71.17,28.47,,,0 HCPCS,84450,Transferase (AST) (SGOT),,,4.4,12.95,16 HCPCS,84460,Alanine amino (ALT) (SGPT),,,4.5,13.25,16 HCPCS,84460,Hc Alt,71.17,28.47,,,0 HCPCS,84460,Hc Transferase Alanine Amino (Alt) (Sgpt) - Alt (Sgpt),71.17,28.47,,,0 HCPCS,84466,Assay of transferrin,,,10.85,31.9,16 HCPCS,84466,Hc Assay Of Transferrin - Transferrin,177.92,71.17,,,0 HCPCS,84478,Assay of triglycerides,,,4.89,14.35,16 HCPCS,84478,Hc 782 Triglycerides-So+,20.68,8.27,,,0 HCPCS,84478,Hc Assay Of Triglycerides - Triglycerides,84.11,33.64,,,0 HCPCS,84478,Hc Chylo Rflxtriglycerides Body Fluid With Reflex To Chylomicron Electrophoresis-Arup 3005996,11.26,4.5,,,0 HCPCS,84478,Hc Triglyceride,84.11,33.64,,,0 HCPCS,84479,Assay of thyroid (t3 or t4),,,5.5,16.18,16 HCPCS,84480,Assay triiodothyronine (t3),,,12.05,35.45,16 HCPCS,84480,"Hc Triiodothyronine Total Assay, Tt-3 - T3 (Thyroid Hormone)",224.29,89.72,,,0 HCPCS,84481,Free assay (FT-3),,,14.4,42.35,16 HCPCS,84481,Hc 208 Free T3-So+,60.9,24.36,,,0 HCPCS,84482,T3 reverse,,,13.4,39.4,16 HCPCS,84484,Assay of troponin quant,,,8.36,31.18,16 HCPCS,84484,"Hc Assay Of Troponin, Quant - Troponin T",273.89,109.56,,,0 HCPCS,84484,Hc Troponin I 90613-So+,29.64,11.86,,,0 HCPCS,84485,Assay duodenal fluid trypsin,,,6.38,18.0,16 HCPCS,84488,Test feces for trypsin,,,6.2,18.25,16 HCPCS,84490,Assay of feces for trypsin,,,6.46,24.82,16 HCPCS,84510,Assay of tyrosine,,,8.84,26.58,16 HCPCS,84510,Hc Assay Of Tyrosine,12.75,5.1,,,0 HCPCS,84512,Assay of troponin qual,,,5.27,25.22,16 HCPCS,84520,Assay of urea nitrogen,,,3.35,9.88,16 HCPCS,84520,"Hc Assay Urea Nitrogen, Quan - Blood Urea Nitrogen",80.87,32.35,,,0 HCPCS,84520,"Hc Assay Urea Nitrogen, Quan - Urea Nitrogen, Body Fluid????????",9.63,3.85,,,0 HCPCS,84520,Hc Bun,80.87,32.35,,,0 HCPCS,84520,Hc Bun Pre,80.87,32.35,,,0 HCPCS,84525,Urea nitrogen semi-quant,,,3.2,12.82,16 HCPCS,84540,Assay of urine/urea-n,,,4.04,13.9,16 HCPCS,84540,Hc 967 Urea Nitrogen Ur-So+,17.08,6.83,,,0 HCPCS,84540,Hc Assay Urine Urea Nitrogen,83.03,33.21,,,0 HCPCS,84545,Urea-N clearance test,,,4.94,18.0,16 HCPCS,84550,Assay of blood/uric acid,,,3.84,11.3,16 HCPCS,84550,"Hc Assay Of Uric Acid, Blood - Uric Acid",100.28,40.11,,,0 HCPCS,84560,Assay of urine/uric acid,,,4.04,12.7,16 HCPCS,84560,"Hc 051 Assay Of Uric Acid, Blood, Other Source - Uric Acid Body Fluid-So+",21.12,8.45,,,0 HCPCS,84560,Hc 052 Uric Acid Body Fluid-So+,23.4,9.36,,,0 HCPCS,84560,Hc 112 Uric Acid Body Fluid-So+,29.58,11.83,,,0 HCPCS,84577,Assay of feces/urobilinogen,,,9.64,42.0,16 HCPCS,84578,Test urine urobilinogen,,,2.56,11.18,16 HCPCS,84580,Assay of urine urobilinogen,,,6.03,23.88,16 HCPCS,84583,Assay of urine urobilinogen,,,4.27,15.12,16 HCPCS,84585,Assay of urine vma,,,3.46,38.75,16 HCPCS,84585,Hc 063 Vanillylmandel Acid Ur-So+,30.67,12.27,,,0 HCPCS,84585,"Hc Vanillylmandelic Acid (Vma), Random Urine3018861-So+",18.0,7.2,,,0 HCPCS,84586,Assay of vip,,,13.58,88.32,16 HCPCS,84586,Hc 628 Vip Mayo-So+,84.05,33.62,,,0 HCPCS,84588,Assay of vasopressin,,,28.85,84.85,16 HCPCS,84588,Hc 872 Arginine Vasopressin-So+,122.08,48.83,,,0 HCPCS,84588,"Hc Copeptin Proavp, Plasma 3018705-So+",54.0,21.6,,,0 HCPCS,84590,Assay of vitamin a,,,6.06,29.02,16 HCPCS,84590,Hc 114 Vitamin A-So+,25.66,10.26,,,0 HCPCS,84591,Assay Of Nos Vitamin,,,6.06,42.65,16 HCPCS,84591,"Hc Vitamin B3, S/P 3016752-So+",117.6,47.04,,,0 HCPCS,84597,Assay of vitamin k,,,11.65,34.3,16 HCPCS,84597,Hc Assay Of Vitamin K - Vitamin K,30.0,12.0,,,0 HCPCS,84600,Assay of volatiles,,,9.97,42.78,16 HCPCS,84600,Hc 631 D-Xylose Absor Ur 3Hr-So+,213.0,85.2,,,0 HCPCS,84600,Hc Assay Of Volatiles - Volatile Compounds,229.68,91.87,,,0 HCPCS,84620,Xylose tolerance test,,,7.42,32.28,16 HCPCS,84630,Assay of zinc,,,9.67,28.48,16 HCPCS,84630,Hc 071 Zinc Rbc-So+,86.4,34.56,,,0 HCPCS,84630,Hc 112 Zinc S/P-So+,40.94,16.38,,,0 HCPCS,84681,Assay of c-peptide,,,16.31,52.02,16 HCPCS,84681,Hc Assay Of C-Peptide - C-Peptide,240.47,96.19,,,0 HCPCS,84702,Chorionic gonadotropin test,,,12.8,37.62,16 HCPCS,84702,"Hc Beta-Human Chorionic Gonadotropin, Quantitative, Spinal Fluid Bhsf-So+",46.78,18.71,,,0 HCPCS,84702,"Hc Chorionic Gonadotropin, Quant - Hcg Quantitative Blood",283.6,113.44,,,0 HCPCS,84703,Chorionic gonadotropin assay,,,6.38,18.8,16 HCPCS,84703,Hc Chorionic (Hcg) Gonadotropin ? Qual,153.12,61.25,,,0 HCPCS,84704,Hcg free betachain test,,,12.8,38.22,16 HCPCS,84830,Ovulation tests,,,8.53,31.75,16 HCPCS,84999,Clinical chemistry test,,,0.01,0.01,4 HCPCS,84999,Hc 162 Osmolality Stool-So+,35.7,14.28,,,0 HCPCS,84999,Hc 247 Amylase Isoenzymes-So+,3.63,1.45,,,0 HCPCS,84999,Hc Chitotriosidase,304.09,121.64,,,0 HCPCS,84999,Hc Chitotriosidase Assay 451822-So+,327.76,131.1,,,0 HCPCS,84999,"Hc Osmolality, Fecal 98122-So+",27.24,10.9,,,0 HCPCS,84999,"Hc Potassium, Fecal 20380-So+",16.02,6.41,,,0 HCPCS,85002,Bleeding time test,,,3.83,12.05,16 HCPCS,85004,Automated diff wbc count,,,5.5,16.18,16 HCPCS,85004,Hc Wbc Differential Automated,75.0,30.0,,,0 HCPCS,85007,Bl smear w/diff wbc count,,,1.99,9.5,16 HCPCS,85007,"Hc Blood Smear,Micro Exam,Manual Diff Wbc - Manual Differential",59.0,23.6,,,0 HCPCS,85008,Bl smear w/o diff wbc count,,,2.92,8.58,16 HCPCS,85008,Hc Blood Smear Morphology Scan,33.0,13.2,,,0 HCPCS,85009,Manual diff wbc count b-coat,,,1.99,12.68,16 HCPCS,85013,Spun microhematocrit,,,1.81,17.5,16 HCPCS,85014,Hc Hematocrit - Hematocrit,43.0,17.2,,,0 HCPCS,85014,Hematocrit,,,1.81,5.92,16 HCPCS,85018,Hc Hemoglobin - Hemoglobin,38.0,15.2,,,0 HCPCS,85018,Hc Hemoglobin - Hemoglobin And Hematocrit,38.0,15.2,,,0 HCPCS,85018,Hc Hemoglobin - Poct Hemoglobin,38.0,15.2,,,0 HCPCS,85018,Hemoglobin,,,1.81,5.92,16 HCPCS,85025,Complete cbc w/auto diff wbc,,,6.61,19.42,16 HCPCS,85025,Hc Complete Cbc & Auto Diff Wbc,185.0,74.0,,,0 HCPCS,85027,Complete cbc automated,,,5.5,16.18,16 HCPCS,85027,Hc Hemogram W/O Differential,110.0,44.0,,,0 HCPCS,85032,Manual cell count each,,,3.65,10.78,16 HCPCS,85041,Automated rbc count,,,2.47,7.55,16 HCPCS,85044,Manual reticulocyte count,,,3.56,10.78,16 HCPCS,85045,Automated reticulocyte count,,,3.4,9.98,16 HCPCS,85046,"Hc Reticulocyte Count, Auto, W Cell Param - Hemoglobin (Pg) In Retic",76.0,30.4,,,0 HCPCS,85046,Reticyte/hgb concentrate,,,4.74,13.92,16 HCPCS,85048,Automated leukocyte count,,,2.03,6.35,16 HCPCS,85048,Hc Leukocyte (Wbc) Count - Eosinophil Count,30.0,12.0,,,0 HCPCS,85048,Hc Leukocyte (Wbc) Count - White Blood Count And Differential,30.0,12.0,,,0 HCPCS,85049,Automated platelet count,,,3.8,11.2,16 HCPCS,85049,Hc Platelet Count - Platelet Count,65.0,26.0,,,0 HCPCS,85055,Hc Immature Platelet Fraction,111.0,44.4,,,0 HCPCS,85055,Reticulated platelet assay,,,22.75,89.35,16 HCPCS,85060,Blood smear interpretation,,,13.21,28.99,12 HCPCS,85097,Bone marrow interpretation,,,45.72,1967.07,16 HCPCS,85097,Hc B Asp Interp 85097,712.0,284.8,,,0 HCPCS,85130,Chromogenic substrate assay,,,10.11,29.72,16 HCPCS,85130,Hc Factorviii Chromofactor,114.0,45.6,,,0 HCPCS,85170,Blood clot retraction,,,2.47,40.75,16 HCPCS,85175,Blood clot lysis time,,,3.87,50.92,16 HCPCS,85210,Clot factor ii prothrom spec,,,11.03,32.45,16 HCPCS,85210,Hc Clot Factor Ii Prothrom Spec - Factor 2 Activity,51.72,20.69,,,0 HCPCS,85220,Blooc clot factor v test,,,15.0,44.12,16 HCPCS,85220,Hc Blooc Clot Factor V Test - Factor 5 Activity,318.0,127.2,,,0 HCPCS,85230,Clot factor vii proconvertin,,,15.22,44.75,16 HCPCS,85230,Hc Clot Factor Vii Proconvertin - Factor 7 Activity,371.0,148.4,,,0 HCPCS,85240,Clot factor viii ahg 1 stage,,,15.22,44.75,16 HCPCS,85240,Hc Clot Factor Viii Ahg 1 Stage - Factor 8 Activity,352.0,140.8,,,0 HCPCS,85244,Clot factor viii reltd antgn,,,17.35,51.05,16 HCPCS,85245,Clot factor viii vw ristoctn,,,19.5,57.35,16 HCPCS,85245,Hc 941 Ristocetin Cofac (Act)-So+,31.2,12.48,,,0 HCPCS,85246,Clot factor viii vw antigen,,,19.5,57.35,16 HCPCS,85246,Hc Clot Factor Viii Vw Antigen - Von Willebrand Antigen,348.0,139.2,,,0 HCPCS,85247,Clot factor viii multimetric,,,19.5,57.35,16 HCPCS,85247,Hc 621 Vwf Multimers-So+,243.6,97.44,,,0 HCPCS,85250,Clot factor ix ptc/chrstmas,,,16.18,47.6,16 HCPCS,85250,Hc Clot Factor Ix Ptc/Chrstmas - Factor 9 Activity,336.0,134.4,,,0 HCPCS,85260,Clot factor x stuart-power,,,15.22,44.75,16 HCPCS,85260,Hc Clot Factor X Stuart-Power - Factor 10 Activity,33.66,13.46,,,0 HCPCS,85270,Clot factor xi pta,,,15.22,44.75,16 HCPCS,85270,Hc Clot Factor Xi Pta - Factor 11 Activity,57.76,23.1,,,0 HCPCS,85280,Clot factor xii hageman,,,16.44,48.38,16 HCPCS,85280,Hc Clot Factor Xii Hageman - Factor 12 Activity,39.71,15.88,,,0 HCPCS,85290,Clot factor xiii fibrin stab,,,13.89,40.85,16 HCPCS,85290,Hc 745 Factor Xiii Activity-So+,222.0,88.8,,,0 HCPCS,85291,Clot factor xiii fibrin scrn,,,7.55,22.78,16 HCPCS,85292,Clot factor fletcher fact,,,16.1,47.32,16 HCPCS,85293,Clot factor wght kininogen,,,16.1,47.32,16 HCPCS,85300,Antithrombin iii activity,,,10.07,29.62,16 HCPCS,85300,"Hc Antithrombin Iii Test,Activ - Antithrombin Iii",287.0,114.8,,,0 HCPCS,85301,Antithrombin iii antigen,,,9.19,27.02,16 HCPCS,85302,Clot inhibit prot c antigen,,,10.22,30.02,16 HCPCS,85303,Clot inhibit prot c activity,,,11.75,34.6,16 HCPCS,85303,"Hc Clot Inhib Protein C,Activ - Protein C Activity",389.0,155.6,,,0 HCPCS,85305,Clot inhibit prot s total,,,9.86,29.02,16 HCPCS,85305,"Hc Protein S, Total Antigen (So)",21.6,8.64,,,0 HCPCS,85306,Clot inhibit prot s free,,,13.02,38.3,16 HCPCS,85306,Hc 358 Protein S Free-So+,85.27,34.11,,,0 HCPCS,85306,"Hc Clot Inhib Protein S,Free - Protein S Activity",308.0,123.2,,,0 HCPCS,85306,"Hc Protein S, Free (So)",42.0,16.8,,,0 HCPCS,85307,Assay Activated Protein C,,,13.02,38.3,16 HCPCS,85335,Factor inhibitor test,,,10.94,32.18,16 HCPCS,85335,Hc 421 Adamts 13 Inhibitor-So+,228.0,91.2,,,0 HCPCS,85335,Hc Factor Inhibitor Test - Bethesda Inhibitor,348.0,139.2,,,0 HCPCS,85337,Thrombomodulin,,,8.86,43.18,16 HCPCS,85345,Coagulation time lee & white,,,3.65,11.72,16 HCPCS,85347,Coagulation time activated,,,3.62,10.7,16 HCPCS,85347,"Hc Coagulation Time, Activated - Activated Clotting Time",120.0,48.0,,,0 HCPCS,85347,Hc Teg Coagulation Time; Activated,145.0,58.0,,,0 HCPCS,85347,"Hc Teg Coatulation Time With Lysis, Activated",255.0,102.0,,,0 HCPCS,85348,Coagulation time otr method,,,2.58,11.22,16 HCPCS,85360,Euglobulin lysis,,,7.14,21.02,16 HCPCS,85362,Fibrin degradation products,,,5.86,17.22,16 HCPCS,85366,Fibrinogen test,,,7.32,201.15,16 HCPCS,85370,Fibrinogen test,,,9.65,31.08,16 HCPCS,85378,Fibrin degrade semiquant,,,6.06,24.3,16 HCPCS,85379,Fibrin degradation quant,,,8.65,25.45,16 HCPCS,85379,"Hc Fibrin Degradproducts,D-Dimer, Quant - D-Dimer,Quantitative",202.0,80.8,,,0 HCPCS,85380,Fibrin degradj d-dimer,,,8.65,25.45,16 HCPCS,85384,Fibrinogen activity,,,7.22,24.3,16 HCPCS,85384,"Hc Fibrinogen, Activity - Fibrinogen,Quantitative",160.0,64.0,,,0 HCPCS,85384,"Hc Teg Fibrinogen With Lysis, Activity",156.0,62.4,,,0 HCPCS,85384,"Hc Teg Fibrinogen, Activity",156.0,62.4,,,0 HCPCS,85385,Fibrinogen antigen,,,7.22,36.15,16 HCPCS,85390,Fibrinolysins screen i&r,,,4.39,38.7,16 HCPCS,85390,Hc Platelet Trans Em/Whole Blood,965.26,386.1,,,0 HCPCS,85390,Hc Teg Fibrinolysis/Coagulopathy Screen,955.0,382.0,,,0 HCPCS,85396,Clotting assay whole blood,,,10.87,24.5,5 HCPCS,85396,"Hc Clotting Assay, Whole Blood - Thromboelastograph Clotting Profile",538.0,215.2,,,0 HCPCS,85396,"Hc Coagulation/ Fibrinolysis Assay, Whole Blood",640.0,256.0,,,0 HCPCS,85397,Clotting funct activity,,,19.5,77.15,16 HCPCS,85397,Hc 420 Adamts 13 Activity-So+,222.0,88.8,,,0 HCPCS,85397,Hc Vwf Gpibm Activity 1070-So+,175.2,70.08,,,0 HCPCS,85400,Fibrinolytic plasmin,,,7.52,19.28,16 HCPCS,85410,Fibrinolytic antiplasmin,,,6.56,19.28,16 HCPCS,85410,"Hc Alpha-2 Antiplasmin, Activity 98727-So+",48.16,19.26,,,0 HCPCS,85415,Fibrinolytic plasminogen,,,14.61,42.98,16 HCPCS,85415,"Hc Fibrinolytic Plasminogen,Activtr - Plasminogen Activator Inhibitor",67.06,26.82,,,0 HCPCS,85415,Hc Pai-1 Antigen-Mayo Pai-1,327.79,131.12,,,0 HCPCS,85420,Fibrinolytic plasminogen,,,5.56,16.32,16 HCPCS,85420,Hc 761 Plasminogen Activity-So+,54.0,21.6,,,0 HCPCS,85421,Fibrinolytic plasminogen,,,8.66,25.45,16 HCPCS,85421,"Hc Fibrinolytic Plasminogen,Antigen - Plasminogen Antigen",125.58,50.23,,,0 HCPCS,85441,Heinz bodies direct,,,3.58,10.5,16 HCPCS,85445,Heinz bodies induced,,,5.79,17.05,16 HCPCS,85460,Hemoglobin fetal,,,6.58,19.32,16 HCPCS,85461,"Hc Hemoglobin Fetal,Rosette - Fetal Bleed Screen",131.0,52.4,,,0 HCPCS,85461,Hemoglobin fetal,,,5.64,23.4,16 HCPCS,85475,Hemolysin acid,,,7.54,22.18,16 HCPCS,85520,Hc Heparin Assay - Heparin Level,298.0,119.2,,,0 HCPCS,85520,Hc Heparin Assay - Low Molecular Wgt Heparin,298.0,119.2,,,0 HCPCS,85520,Heparin assay,,,11.12,32.72,16 HCPCS,85525,Heparin neutralization,,,10.07,29.6,16 HCPCS,85530,Hc Heparin-Protamine Tolerance - Poct Heparin Dose Response,126.0,50.4,,,0 HCPCS,85530,Heparin-protamine tolerance,,,12.05,32.72,16 HCPCS,85536,Iron Stain Peripheral Blood,,,5.5,17.2,16 HCPCS,85540,Hc Wbc Alkaline Phosphatase - Leukocyte Alkaline Phosphatase,72.0,28.8,,,0 HCPCS,85540,Wbc alkaline phosphatase,,,7.31,21.5,16 HCPCS,85547,RBC mechanical fragility,,,5.93,21.5,16 HCPCS,85549,"Hc Muramidase - Lysozyme, Serum",22.5,9.0,,,0 HCPCS,85549,Muramidase,,,15.94,46.88,16 HCPCS,85555,"Hc Osmotic Fragility, Erythrocyte 2002257-So+",87.28,34.91,,,0 HCPCS,85555,RBC osmotic fragility,,,5.68,18.68,16 HCPCS,85557,RBC osmotic fragility,,,11.35,33.4,16 HCPCS,85576,Blood platelet aggregation,,,18.26,62.28,16 HCPCS,85576,Hc Aa Platlett Aggregometer,224.0,89.6,,,0 HCPCS,85576,Hc Adp Platlett Aggregometer,234.0,93.6,,,0 HCPCS,85576,Hc Atp Platlett Aggregometer,284.0,113.6,,,0 HCPCS,85576,Hc Blood Platelet Aggregation - P2Y12 Profile,258.0,103.2,,,0 HCPCS,85576,Hc Blood Platelet Aggregation - Platelet Function Panel,258.0,103.2,,,0 HCPCS,85576,Hc Collagen Platelet Aggretation In Vitro Each Agent,125.0,50.0,,,0 HCPCS,85576,Hc Platelet Aggregation Panel 1 Performable,258.0,103.2,,,0 HCPCS,85576,Hc Ristocetin Platelet Aggregation,258.0,103.2,,,0 HCPCS,85576,Hc Teg Platelet With Lysis Aggregation,282.0,112.8,,,0 HCPCS,85576,"Hc Teg Platelet, Aggregation",186.83,74.73,,,0 HCPCS,85597,"Hc Phospholipid Neutralization,Platelet - Platelet Neutralization",132.0,52.8,,,0 HCPCS,85597,Phospholipid pltlt neutraliz,,,15.28,44.95,16 HCPCS,85598,Hc Staclot La,212.0,84.8,,,0 HCPCS,85598,Hexagnal phosph pltlt neutrl,,,15.28,44.95,16 HCPCS,85610,Hc Prothrombin Time - Poct Inr,78.0,31.2,,,0 HCPCS,85610,Hc Prothrombin Time - Protime-Inr,78.0,31.2,,,0 HCPCS,85610,Prothrombin time,,,3.34,10.72,16 HCPCS,85611,"Hc Prothrombin Test,Substi,Fractn - Equal Mix,Pt/Inr",62.0,24.8,,,0 HCPCS,85611,Prothrombin test,,,3.35,9.85,16 HCPCS,85612,Hc Rvv Confirm Undiluted,322.0,128.8,,,0 HCPCS,85612,Hc Rvv Screen Undiluted,322.0,128.8,,,0 HCPCS,85612,Viper venom prothrombin time,,,8.14,43.72,16 HCPCS,85613,"Hc Russell Viper Venom, Diluted - Drvvt (Dilute Russel Vv Time)",125.0,50.0,,,0 HCPCS,85613,Russell viper venom diluted,,,8.14,23.95,16 HCPCS,85635,Reptilase test,,,8.37,24.62,16 HCPCS,85651,Rbc sed rate nonautomated,,,3.01,10.68,16 HCPCS,85652,"Hc Rbc Sed Rate, Auto - Sedimentation Rate, Automated",90.0,36.0,,,0 HCPCS,85652,Rbc sed rate automated,,,2.3,6.75,16 HCPCS,85660,Hc Rbc Sickle Cell Test - Sickle Cell Screen,119.0,47.6,,,0 HCPCS,85660,Hc Reflex Sickle Solubility 81271-So+,31.66,12.66,,,0 HCPCS,85660,RBC sickle cell test,,,4.69,13.78,16 HCPCS,85670,"Hc Thrombin Time, Plasma - Thrombin Time",117.0,46.8,,,0 HCPCS,85670,Thrombin time plasma,,,4.91,14.42,16 HCPCS,85675,Thrombin time titer,,,5.82,17.12,16 HCPCS,85705,Thromboplastin inhibition,,,8.18,24.08,16 HCPCS,85730,Hc Thromboplas Time Partial - Ptt Crrt System,111.0,44.4,,,0 HCPCS,85730,Thromboplastin time partial,,,5.1,15.02,16 HCPCS,85732,"Hc Thromboplas Time Part Plasma Frac - Equal Mix,Aptt",131.0,52.4,,,0 HCPCS,85732,Thromboplastin time partial,,,5.5,16.18,16 HCPCS,85810,Blood viscosity examination,,,9.92,29.18,16 HCPCS,85810,Hc 709 Viscosity-So+,82.8,33.12,,,0 HCPCS,85810,"Hc Viscosity, Serum-So+",66.0,26.4,,,0 HCPCS,85999,Hc Bronchial Lavage Differential,35.0,14.0,,,0 HCPCS,85999,Hematology procedure,,,0.01,0.01,4 HCPCS,86000,Agglutinins febrile antigen,,,5.93,17.45,16 HCPCS,86000,Hc Reflex Francisella Tularensis Antibodies By Agglutination 3002915-So+,39.07,15.63,,,0 HCPCS,86001,Allergen Specific Igg,,,4.43,19.55,16 HCPCS,86001,"Hc Allergen Specific Igg, Each Food Allergen",21.59,8.64,,,0 HCPCS,86003,Allergen specific IgE,,,4.43,13.05,16 HCPCS,86003,Hc 296 Allergen Asperg Ful Ige-So+,18.77,7.51,,,0 HCPCS,86003,Hc 321 Allergen Grn Pea Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 322 Allergen Pcn Notat Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 324 Allergen Pork Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 325 Allergen Potato White Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 326 Allergen Scallop Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 327 Allergen Shrimp Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 328 Allergen Soybean Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 329 Allergen Spinach Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 331 Allergen Tuna Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 332 Allergen Turkey Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 334 Allergen Watermelon Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 464 Allergen Orange Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 465 Allergen Oat Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 466 Allergen Nutmeg Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 468 Allergen Milk Cow Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 470 Allergen Horses Dander Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 475 Allergen Gluten Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 476 Allergen Ginger Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 477 Allergen Feath Mx Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 478 Allergen Egg Yolk Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 479 Allergen Egg Whit Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 480 Allergen Egg Whol Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 481 Allergen Dog Dander Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 482 Allergen Cranberry Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 483 Allergen Cow Dand Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 484 Allergen Corn Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 485 Allergen Codfish Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 486 Allergen Chocolate Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 487 Allergen Chicken Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 489 Allergen Beef Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 491 Allergen Apple Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 492 Allergen Almond Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 515 Allergen Spec Ige Ea-So+,18.77,7.51,,,0 HCPCS,86003,Hc 598 Allergen Alpha-Gal Ige-So+,18.77,7.51,,,0 HCPCS,86003,Hc 598 Allergen Beef Ige-So+,18.77,7.51,,,0 HCPCS,86003,Hc 634 Allergen Casein Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 635 Allergen Whey Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc 638 Cat Dander Ige Ab Allg-So+,25.8,10.32,,,0 HCPCS,86003,Hc 688 Allergen-So+,18.77,7.51,,,0 HCPCS,86003,Hc 692 Allergen Spec Ige Ea-So+,18.77,7.51,,,0 HCPCS,86003,Hc 693 Allergen Spec Ige Ea-So+,18.77,7.51,,,0 HCPCS,86003,Hc 744 Allergen Walnut-So+,18.77,7.51,,,0 HCPCS,86003,Hc 745 Allergen Pistachio-So+,18.77,7.51,,,0 HCPCS,86003,Hc 746 Allergen Pecan-So+,18.77,7.51,,,0 HCPCS,86003,Hc 747 Allergen Macadamia-So+,18.77,7.51,,,0 HCPCS,86003,Hc 748 Allergen Peanut-So+,18.77,7.51,,,0 HCPCS,86003,Hc 749 Allergen Sesame-So+,18.77,7.51,,,0 HCPCS,86003,Hc 750 Allergen Tomato-So+,18.77,7.51,,,0 HCPCS,86003,Hc 783 Allergen Crab Ige-So+,18.77,7.51,,,0 HCPCS,86003,Hc 784 Allergen Lobster Ige-So+,18.77,7.51,,,0 HCPCS,86003,Hc 785 Allergen Mussels Blu Ige-So+,18.77,7.51,,,0 HCPCS,86003,Hc 786 Allergen Octopus Ige-So+,22.67,9.07,,,0 HCPCS,86003,Hc 787 Allergen Salmon Ige-So+,18.77,7.51,,,0 HCPCS,86003,Hc 788 Allergen Oyster Ige-So+,18.77,7.51,,,0 HCPCS,86003,Hc 789 Allergen Clam Ige-So+,18.77,7.51,,,0 HCPCS,86003,Hc 813 Allergen Celery Ige-So+,18.77,7.51,,,0 HCPCS,86003,Hc 815 Allergen Rice Ige-So+,18.77,7.51,,,0 HCPCS,86003,Hc 817 Allergen Cabbage Ige-So+,18.77,7.51,,,0 HCPCS,86003,Hc 819 Allergen Mustard Ige-So+,18.77,7.51,,,0 HCPCS,86003,Hc 821 Allergen Tilapia Ige-So+,22.63,9.05,,,0 HCPCS,86003,Hc 823 Allergen Onion Ige-So+,18.77,7.51,,,0 HCPCS,86003,Hc 829 Allergen Spec Ige Ea-So+,18.77,7.51,,,0 HCPCS,86003,Hc 831 Allergen Dust Cockroach Grm-So+,18.77,7.51,,,0 HCPCS,86003,Hc 831 Allergen Walnut Black Food Ige-So+,18.77,7.51,,,0 HCPCS,86003,Hc 832 Allergen Specific Ige Ea-So+,18.77,7.51,,,0 HCPCS,86003,Hc 836 Allergen Lamb Ige-So+,18.77,7.51,,,0 HCPCS,86003,Hc 839 Allergen Cashew Ige-So+,18.77,7.51,,,0 HCPCS,86003,Hc 840 Allergen Brazil Nut Ige-So+,18.77,7.51,,,0 HCPCS,86003,Hc 841 Allergen Chestnut Ige-So+,44.4,17.76,,,0 HCPCS,86003,Hc 842 Allergen Hazelnut-So+,18.77,7.51,,,0 HCPCS,86003,Hc 998 Allergen Latex Ige Ab-So+,18.77,7.51,,,0 HCPCS,86003,Hc Allergen Spec Ige - Allergen Almonds Ige,21.59,8.64,,,0 HCPCS,86003,Hc Allergen Spec Ige - Allergen Banana Ige,21.59,8.64,,,0 HCPCS,86003,Hc Allergen Spec Ige - Allergen Barley Ige,21.59,8.64,,,0 HCPCS,86003,"Hc Allergen Spec Ige - Allergen Bean, Green Ige",21.59,8.64,,,0 HCPCS,86003,Hc Allergen Spec Ige - Allergen Food: Rber E 1 Brazil Nut,21.59,8.64,,,0 HCPCS,86003,Hc Allergen Spec Ige - Allergen Food: Strawberry Ige,21.59,8.64,,,0 HCPCS,86003,Hc Allergen Spec Ige - Allergen Macadamia Nut Ige,21.59,8.64,,,0 HCPCS,86003,Hc Allergen Spec Ige - Allergen Mushroom Ige,21.59,8.64,,,0 HCPCS,86003,Hc Allergen Spec Ige - Allergen Oat Ige,21.59,8.64,,,0 HCPCS,86003,Hc Allergen Spec Ige - Allergen Pineapple Ige,21.59,8.64,,,0 HCPCS,86003,Hc Allergen Spec Ige - Allergen Rye Ige,21.59,8.64,,,0 HCPCS,86003,Hc Allergen Spec Ige - Allergen Sesame Seed Ige,21.59,8.64,,,0 HCPCS,86003,Hc Allergen Spec Ige - Allergen Shrimp Ige,21.59,8.64,,,0 HCPCS,86003,Hc Allergen Spec Ige - Allergen Soybean Ige,21.59,8.64,,,0 HCPCS,86003,Hc Allergen Spec Ige - Allergen Tree: Chestnut,21.59,8.64,,,0 HCPCS,86003,Hc Allergen Spec Ige - Allergen Walnut Tree Ige,21.59,8.64,,,0 HCPCS,86003,Hc Allergen Spec Ige - Allergen Wheat Ige,21.59,8.64,,,0 HCPCS,86003,Hc Allergen Spec Ige Crude Allergen Extract-So+,20.57,8.23,,,0 HCPCS,86003,"Hc Allergen, Gerbil Epithelium-Arup 83710A-So+",44.29,17.72,,,0 HCPCS,86003,"Hc Allergen, Lactobacillus Bulgaricus (Yogurt)-Arup 31510S-So+",25.84,10.34,,,0 HCPCS,86003,"Hc Allergen, Level1",6.9,2.76,,,0 HCPCS,86003,"Hc Allergen, Locust Tree-Arup T004-Ige-So+",19.68,7.87,,,0 HCPCS,86003,"Hc Allergen, Rabbit Urine Protein-Arup-So+",69.0,27.6,,,0 HCPCS,86003,"Hc Allergen, Rhodoturula Mucilaginosa-Arup M027-So+",28.83,11.53,,,0 HCPCS,86003,"Hc Allergen, Tree, Poplar White Ige So+-Arup 0098859",18.77,7.51,,,0 HCPCS,86003,Hc Chickpea/Garbanzo Bean (Cicer Arietinus) Ige-So+,18.77,7.51,,,0 HCPCS,86003,Hc Hypersensitivity Pneumonitis Ext Panel 3001561-So+,6.49,2.6,,,0 HCPCS,86005,Allergen specific IgE,,,6.77,19.92,16 HCPCS,86005,"Hc Allergen, Epidermals And Animal Proteins, Feather Mix-Arup 0055037",10.02,4.01,,,0 HCPCS,86005,Hc Hypersensitivity Pneumonitis Ext Panel 1-So+,6.49,2.6,,,0 HCPCS,86008,Allg spec ige recomb ea,,,8.86,44.82,16 HCPCS,86008,Hc Allergen Components-So+,21.52,8.61,,,0 HCPCS,86008,Hc Allergen Peanut Ige 2007211-So+,20.57,8.23,,,0 HCPCS,86015,Actin antibody each,,,4.61,30.12,16 HCPCS,86015,"Hc F-Actin Ab, Igg Eia With Rflx To Asm Ifa 51174-So+",14.46,5.78,,,0 HCPCS,86021,Hc 596 Granulocyte Ab Serum-So+,75.43,30.17,,,0 HCPCS,86021,WBC antibody identification,,,12.8,37.62,16 HCPCS,86022,Hc 119 Hit Pf4 Igg W/Rfx->Sra-So+,66.05,26.42,,,0 HCPCS,86022,Hc 120 Sra Unfract Hep-So+,258.0,103.2,,,0 HCPCS,86022,Hc 304 Plt Surf Glycoprotein-So+,56.0,22.4,,,0 HCPCS,86022,Hc 830 Platelet Ab Id (11)-So+,303.6,121.44,,,0 HCPCS,86022,Hc Heparin Dependent Ab With Reflex To Sra,189.06,75.62,,,0 HCPCS,86022,Hc Platelet Antibody Identification Panel,396.06,158.42,,,0 HCPCS,86022,Hc Serotonin Release Assay,189.06,75.62,,,0 HCPCS,86022,"Hc-Heparin-Induced Thromobocytopenia Evaluation - Pea -Pf4,Igg-Versiti 5504-So+",190.8,76.32,,,0 HCPCS,86022,Platelet antibodies,,,15.61,45.92,16 HCPCS,86023,Immunoglobulin assay,,,10.58,31.15,16 HCPCS,86036,Anca screen each antibody,,,4.82,30.12,16 HCPCS,86036,Hc Anca Vasculitis Profile3003745-So+,13.92,5.57,,,0 HCPCS,86037,Anca titer each antibody,,,4.82,30.12,16 HCPCS,86038,Antinuclear antibodies,,,10.27,30.22,16 HCPCS,86038,Hc 685 Centromere B Ab-So+,66.0,26.4,,,0 HCPCS,86038,Hc 925 Ana Ifa Pattern-Rfx-So+,43.48,17.39,,,0 HCPCS,86039,Antinuclear antibodies (ANA),,,9.49,27.9,16 HCPCS,86039,"Hc Antinuclear Antibody (Ana), Hep-2, Igg 3000082-So+",12.0,4.8,,,0 HCPCS,86039,Hc Extended Myositis Panel Ext2 #4-So+,25.9,10.36,,,0 HCPCS,86041,Acetylcholn rcptr bndng antb,,,7.36,46.0,16 HCPCS,86041,Hc Acetylcholine Receptor Binding Antibody 80009-So+,20.4,8.16,,,0 HCPCS,86042,Acetylcholn rcptr blckg antb,,,7.36,46.0,16 HCPCS,86042,Hc Acetylcholine Blocking Ab 99580-So+,33.6,13.44,,,0 HCPCS,86043,Acetylcholn rcptr modlg antb,,,4.82,30.12,16 HCPCS,86043,Hc Acetylcholine Receptor Modulating Ab 99521-So+,46.8,18.72,,,0 HCPCS,86051,Aquaporin-4 antb elisa,,,4.61,28.82,16 HCPCS,86052,Aquaporin-4 antb cba each,,,4.82,30.12,16 HCPCS,86053,Aqaprn-4 antb flo cytmtry ea,,,4.82,94.32,16 HCPCS,86053,Hc Neuromyelitis Optica (Nmo)/Aquaporin-4-Igg Nmofs-So+,354.0,141.6,,,0 HCPCS,86053,Hc Pcdes Facs Ab Titer-So+,104.4,41.76,,,0 HCPCS,86053,"Hc Pediatric Autoimmune Encephalopathy/Cns Disorder Evaluation, Serum Pcdes #3-So+",138.46,55.38,,,0 HCPCS,86053,"Hc Pediatric Autoimmune Encephalopathy/Cns Disorder Evaluation, Spinal Fluid Pcdec #2 -So+",100.0,40.0,,,0 HCPCS,86060,Antistreptolysin o titer,,,4.36,18.25,16 HCPCS,86060,Hc 091 Aso Ab Qnt-So+,18.46,7.38,,,0 HCPCS,86063,Antistreptolysin o screen,,,4.36,14.42,16 HCPCS,86077,Phys blood bank serv xmatch,,,15.25,70.62,16 HCPCS,86078,Hc Transfusion Reaction Investiga,379.5,151.8,,,0 HCPCS,86078,Phys blood bank serv reactj,,,28.12,415.96,16 HCPCS,86079,Phys blood bank serv authrj,,,22.9,127.23,16 HCPCS,86140,C-reactive protein,,,3.25,12.95,16 HCPCS,86140,Hc 870 C-Reactive Protein-So+,13.75,5.5,,,0 HCPCS,86140,Hc C-Reactive Protein - C-Reactive Protein,150.65,60.26,,,0 HCPCS,86141,C-reactive protein hs,,,11.0,32.38,16 HCPCS,86141,"Hc C-Reactive Protein,High Sensitivity - High Sensitivity Crp",188.6,75.44,,,0 HCPCS,86146,Beta-2 glycoprotein antibody,,,21.62,63.62,16 HCPCS,86146,"Hc Beta 2 Glycoprotein I Antibody,Ea - Beta-2 Glycoprotein Abs",131.1,52.44,,,0 HCPCS,86146,"Hc Beta-2 Glycoprotein 1 Antibody, Iga 50324-So+",30.54,12.22,,,0 HCPCS,86146,Hc Beta-2-Glycoprotein 1 Igm,131.1,52.44,,,0 HCPCS,86147,Cardiolipin antibody ea ig,,,21.62,63.62,16 HCPCS,86147,Hc 060 Cardiolipin Ab Igg-So+,245.0,98.0,,,0 HCPCS,86147,"Hc 793 Cardiolipin Antibody - Cardiolipin Antibody, Iga-So+",245.0,98.0,,,0 HCPCS,86147,"Hc Cardiolipin Antibody - Cardiolipin Antibody, Iga - So+",30.54,12.22,,,0 HCPCS,86147,Hc Cardiolipin Iga,281.75,112.7,,,0 HCPCS,86148,Anti-phospholipid antibody,,,13.66,40.18,16 HCPCS,86148,Hc 763 Phospholipid Ab Ea-So+,57.79,23.12,,,0 HCPCS,86152,Cell enumeration & id,,,15.25,626.95,16 HCPCS,86153,Cell enumeration phys interp,,,15.25,33.7,5 HCPCS,86155,Chemotaxis assay,,,13.58,39.98,16 HCPCS,86156,Cold agglutinin screen,,,5.69,20.18,16 HCPCS,86156,Hc Cold Agglutinin Screen - Cold Agglutinin Screen,33.34,13.34,,,0 HCPCS,86157,Cold agglutinin titer,,,6.86,20.15,16 HCPCS,86157,Hc Cold Agglutinin Titer-Arup-So+,16.84,6.74,,,0 HCPCS,86160,Complement antigen,,,10.21,30.0,16 HCPCS,86160,Hc 146 C-1 Esterase Inhibitor-So+,43.16,17.26,,,0 HCPCS,86160,Hc 356 Sc5B-9-So+,275.81,110.32,,,0 HCPCS,86160,Hc 653 Factor H-So+,252.49,101.0,,,0 HCPCS,86160,Hc 656 Factor B-So+,127.6,51.04,,,0 HCPCS,86160,Hc 657 Factor I-So+,326.4,130.56,,,0 HCPCS,86160,"Hc Complement, Antigen - C3 Complement",205.85,82.34,,,0 HCPCS,86160,"Hc Complement, Antigen - C4 Complement",205.85,82.34,,,0 HCPCS,86160,Hc Soluble C5B-9 33335-So+,288.0,115.2,,,0 HCPCS,86161,Complement/function activity,,,10.21,30.0,16 HCPCS,86161,Hc 137 C-1 Esteras Inhb Func-So+,43.16,17.26,,,0 HCPCS,86161,"Hc C-1-Esterase Inhibitor, Functional 50141-So+",25.2,10.08,,,0 HCPCS,86162,Complement total (ch50),,,17.27,50.8,16 HCPCS,86162,Hc Complement Act Tot Eia-So+,73.08,29.23,,,0 HCPCS,86171,Complement fixation each,,,8.51,25.02,16 HCPCS,86200,Ccp antibody,,,11.0,32.38,16 HCPCS,86200,Hc Cyclic Cirullinated Peptide Antibody - Cyclic Citrul Peptide Antibdy,143.75,57.5,,,0 HCPCS,86215,Deoxyribonuclease antibody,,,11.26,33.12,16 HCPCS,86215,Hc 150 Dnase-B Ab-So+,15.9,6.36,,,0 HCPCS,86225,Dna antibody native,,,10.07,34.35,16 HCPCS,86226,Dna antibody single strand,,,10.29,30.28,16 HCPCS,86226,Hc 738 Dna Sng Strd Igg-So+,43.54,17.42,,,0 HCPCS,86231,Ema each ig class,,,4.84,30.22,16 HCPCS,86231,"Hc Endomysial Antibody, Iga By Ifa 50736-So+",27.6,11.04,,,0 HCPCS,86235,Hc 078 Jo-1 Ab Igg-So+,64.5,25.8,,,0 HCPCS,86235,Hc 080 Centromere B Ab-So+,21.48,8.59,,,0 HCPCS,86235,Hc 394 Ribosom P Prot Ab Arup-So+,64.5,25.8,,,0 HCPCS,86235,Hc 649 Nuclear Antigen Ea Ab-So+,35.5,14.2,,,0 HCPCS,86235,Hc Extended Myositis Panel Ext2 #2-So+,25.9,10.36,,,0 HCPCS,86235,Hc Extractable Nuclear Antigen Ea Antibody,94.3,37.72,,,0 HCPCS,86235,"Hc Fibrillarin (U3 Rnp) Antibody, Igg",109.71,43.88,,,0 HCPCS,86235,"Hc Nuclear Antigen Antibody - Ribonucleic Protein Antibody, Igg",238.05,95.22,,,0 HCPCS,86235,Hc Nuclear Antigen Antibody - Scleroderma (Scl-70) Antibody,21.52,8.61,,,0 HCPCS,86235,Hc Nuclear Antigen Antibody - Sjogrens Syndrome-A Ext Nu Ab,238.05,95.22,,,0 HCPCS,86235,Hc Nuclear Antigen Antibody - Sjogrens Syndrome-B Ext Nuc Ab,238.05,95.22,,,0 HCPCS,86235,"Hc Pm/Scl-100 Antibody, Igg By Immunoblot",89.7,35.88,,,0 HCPCS,86235,"Hc Smith (Ena) Antibody, Igg (So)",37.09,14.84,,,0 HCPCS,86235,"Hc Smith/Rnp (Ena) Antibody, Igg (So)",21.52,8.61,,,0 HCPCS,86235,"Hc Ssa And Ssb Abs, Igg 50791-So+",21.52,8.61,,,0 HCPCS,86235,Nuclear antigen antibody,,,15.24,44.82,16 HCPCS,86255,Fluorescent antibody screen,,,4.45,30.12,16 HCPCS,86255,Hc 009 Nmda Serum-So+,151.54,60.62,,,0 HCPCS,86255,Hc 074 Anti-Yo (Purkinje) Aru-So+,40.0,16.0,,,0 HCPCS,86255,Hc 081 Striated Mus Abs Igg-So+,23.86,9.54,,,0 HCPCS,86255,Hc 175 Rfx-Nmo/Aqp4 Igg Facs-So+,274.38,109.75,,,0 HCPCS,86255,Hc 182 Anca Igg-So+,23.86,9.54,,,0 HCPCS,86255,Hc 533 Hu Ab Screen-So+,106.0,42.4,,,0 HCPCS,86255,Hc 533 Ri Ab Screen-So+,106.0,42.4,,,0 HCPCS,86255,Hc 533 Yo Ab Screen-So+,106.0,42.4,,,0 HCPCS,86255,Hc 576 Endomysial Ab Iga-So+,30.0,12.0,,,0 HCPCS,86255,Hc 579 Phospholip A2 Ab Scr-So+,170.92,68.37,,,0 HCPCS,86255,Hc 781 Nmo Igg Csf-So+,292.34,116.94,,,0 HCPCS,86255,Hc 922 Parietal Cell Ab Igg-So+,34.94,13.98,,,0 HCPCS,86255,Hc 924 Dna(Ds) Crithidia-Rfx-So+,42.44,16.98,,,0 HCPCS,86255,Hc 955 Myelin Olig Glycoprtn-So+,535.5,214.2,,,0 HCPCS,86255,Hc Achr Modulating Flow Cytom-So+,185.0,74.0,,,0 HCPCS,86255,Hc Ampa-R Ab Cba-So+,510.0,204.0,,,0 HCPCS,86255,"Hc Amphyisphysin Ab, S",172.5,69.0,,,0 HCPCS,86255,"Hc Anti-Glial Nuclear Ab, Type 1",172.5,69.0,,,0 HCPCS,86255,"Hc Anti-Neuronal Nuclear Ab, Type 1",172.5,69.0,,,0 HCPCS,86255,"Hc Anti-Neuronal Nuclear Ab, Type 2",184.0,73.6,,,0 HCPCS,86255,"Hc Anti-Neuronal Nuclear Ab, Type 3",195.5,78.2,,,0 HCPCS,86255,Hc Caspr2-Igg Cba-So+,275.0,110.0,,,0 HCPCS,86255,"Hc Crmp 5 Igg, S",172.5,69.0,,,0 HCPCS,86255,Hc Dppx Ab Cba-So+,510.0,204.0,,,0 HCPCS,86255,Hc Dppx Ab Ifa-So+,210.0,84.0,,,0 HCPCS,86255,"Hc Dysautonomia, Autoimm/Paraneo, S Dys2-So+",90.58,36.23,,,0 HCPCS,86255,Hc Enc2 Encephalopathy Autoimmuneparaneoplastic Evaluation Spinal Fluid Enc2-So+,60.0,24.0,,,0 HCPCS,86255,"Hc Encephalopathy, Autoimm/Paraneo, S Ens2 #2-So+",70.91,28.36,,,0 HCPCS,86255,"Hc Encephalopathy, Autoimmune/Paraneoplastic , Csf Ifa Titer #2-So+",234.0,93.6,,,0 HCPCS,86255,"Hc Encephalopathy, Autoimmune/Paraneoplastic Eval, Csf Cba Ab-So+",550.92,220.37,,,0 HCPCS,86255,Hc Ens2 Antibody Reflex Cba-So+,550.92,220.37,,,0 HCPCS,86255,Hc Fluorescent Antibody Screen,115.0,46.0,,,0 HCPCS,86255,Hc Gaba-B-R Ab Cba-So+,510.0,204.0,,,0 HCPCS,86255,Hc Lgi-Igg Cba-So+,275.0,110.0,,,0 HCPCS,86255,Hc Mglur1 Ab Cba-So+,510.0,204.0,,,0 HCPCS,86255,Hc Mglur1 Ab Ifa-So+,210.0,84.0,,,0 HCPCS,86255,"Hc Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum Mds2 #3-So+",55.72,22.29,,,0 HCPCS,86255,"Hc Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid Mdc2-So+",48.89,19.56,,,0 HCPCS,86255,"Hc Muscle-Specific Kinase (Musk) Antibody, Igg By Cba-Ifa With Reflex To Titer, Serum (3006198)-So+",354.0,141.6,,,0 HCPCS,86255,Hc Nmda-R Ab Cba-So+,510.0,204.0,,,0 HCPCS,86255,"Hc Paraneoplas Autoantibody Eval,Csf",621.0,248.4,,,0 HCPCS,86255,"Hc Pediatric Autoimmune Encephalopathy/Cns Disorder Evaluation, Serum Pcdes #2-So+",138.46,55.38,,,0 HCPCS,86255,"Hc Pediatric Autoimmune Encephalopathy/Cns Disorder Evaluation, Spinal Fluid Pcdec #1-So+",100.0,40.0,,,0 HCPCS,86255,"Hc Phospholipase A2 Receptor, Immunofluorescence, Serum (Mayo)",354.0,141.6,,,0 HCPCS,86255,Hc Purkinje Cell Cytoplasmic Ab Type 1,172.5,69.0,,,0 HCPCS,86255,Hc Purkinje Cell Cytoplasmic Ab Type 2,184.0,73.6,,,0 HCPCS,86255,Hc Purkinje Cell Cytoplasmic Ab Type 3,195.5,78.2,,,0 HCPCS,86255,"Hc Reflex Ifa, Titer So+",36.96,14.78,,,0 HCPCS,86255,Hc Stiff-Person Spectrum Disorders Evaluation Spps #2-So+,220.5,88.2,,,0 HCPCS,86255,Hc Thrombospondin Type-1 Domain -Containing 7A Antibodies (Mayo),354.0,141.6,,,0 HCPCS,86256,Fluorescent antibody titer,,,9.14,30.12,16 HCPCS,86256,Hc 511 Nmo/Aqp4-Igg Facs Ttr-So+,27.52,11.01,,,0 HCPCS,86256,Hc 579 Phospholip A2 Ab Ttr-So+,241.16,96.46,,,0 HCPCS,86256,Hc 916 Dna(Ds) Titer Rflx-So+,23.86,9.54,,,0 HCPCS,86256,Hc 955 Mogfs Rflx Ttr-So+,76.5,30.6,,,0 HCPCS,86256,Hc Ampa-R Ab If Titer-So+,72.0,28.8,,,0 HCPCS,86256,Hc Anca Titer Bill (Arup) (So),312.8,125.12,,,0 HCPCS,86256,"Hc Double-Stranded Dna (Dsdna) Antibody, Igg 2002693-So+",26.4,10.56,,,0 HCPCS,86256,Hc Dppx Ab Ifa Titer-So+,75.0,30.0,,,0 HCPCS,86256,Hc Ens2 Antibody Reflex Ifa #3-So+,114.0,45.6,,,0 HCPCS,86256,Hc Ens2 Antibody Reflex Titer-So+,60.0,24.0,,,0 HCPCS,86256,Hc Gaba-B-R Ab If Titer-So+,75.0,30.0,,,0 HCPCS,86256,Hc Mds2 Ifa Titer-So+,120.72,48.29,,,0 HCPCS,86256,Hc Mglur1 Ab Ifa Titer-So+,138.0,55.2,,,0 HCPCS,86256,"Hc Muscle-Specific Kinase (Musk) Antibody, Igg Titer (3006251)-So+",362.4,144.96,,,0 HCPCS,86256,Hc Nmda-R Ab If Titer-So+,75.0,30.0,,,0 HCPCS,86256,Hc Reflex Titer-So+,128.4,51.36,,,0 HCPCS,86258,Dgp antibody each ig class,,,4.61,30.12,16 HCPCS,86258,"Hc Gliadin Peptide Antibody, Iga 0051357-So+",14.46,5.78,,,0 HCPCS,86258,"Hc Gliadin Peptide Antibody, Igg 0051359-So+",14.46,5.78,,,0 HCPCS,86277,Growth hormone antibody,,,13.37,39.35,16 HCPCS,86277,Hc Growth Hormone Ab-So+,92.4,36.96,,,0 HCPCS,86280,Hemagglutination inhibition,,,6.07,20.48,16 HCPCS,86294,Hc Bladder Tumor Assc Ag-So+,78.55,31.42,,,0 HCPCS,86294,Immunoassay tumor qual,,,15.74,63.92,16 HCPCS,86300,Hc Ca 15-3-So+,74.84,29.94,,,0 HCPCS,86300,Hc Ca 27.29-Soq+,74.84,29.94,,,0 HCPCS,86300,Immunoassay tumor ca 15-3,,,17.69,52.02,16 HCPCS,86301,Hc 336 Ca 19-9-Soq+,24.97,9.99,,,0 HCPCS,86301,"Hc Immunoassay, Tumor Antigen, Ca 19-9 - Cancer Antigen 19-9",255.3,102.12,,,0 HCPCS,86301,Immunoassay tumor ca 19-9,,,17.69,52.02,16 HCPCS,86304,Hc Ca-125,287.5,115.0,,,0 HCPCS,86304,Immunoassay tumor ca 125,,,17.69,52.02,16 HCPCS,86305,Human epididymis protein 4,,,17.69,52.02,16 HCPCS,86308,Hc Ebv Igm Heterophilic Antibody,138.0,55.2,,,0 HCPCS,86308,"Hc Heterophile Antibodies,Screen - Mononucleosis Screen",138.0,55.2,,,0 HCPCS,86308,Heterophile antibody screen,,,4.4,12.95,16 HCPCS,86309,Heterophile antibody titer,,,4.94,16.18,16 HCPCS,86310,Heterophile antibody absrbj,,,6.26,18.42,16 HCPCS,86316,Hc Chromogranin A Mayo-So+,54.92,21.97,,,0 HCPCS,86316,Hc Neuron Spec Enolase-So+,38.92,15.57,,,0 HCPCS,86316,Hc 376 Angiotens-1-Recpt At1R-So+,352.8,141.12,,,0 HCPCS,86316,Hc 855 Neuron Spec Enolase-So+,74.84,29.94,,,0 HCPCS,86316,"Hc Alpha Fetoprotein, Csf (Tumor Marker) 20729-So+",24.97,9.99,,,0 HCPCS,86316,Immunoassay tumor other,,,17.69,52.02,16 HCPCS,86317,Hc Diphtheria Ab Igg-So+,17.99,7.2,,,0 HCPCS,86317,Hc Haemophil Inf B Ab Aru-So+,53.9,21.56,,,0 HCPCS,86317,Hc 189 Pneumo Ab Igg Ea-Soq+,53.9,21.56,,,0 HCPCS,86317,Hc 706 Tetanus Ab Igg-So+,17.99,7.2,,,0 HCPCS,86317,"Hc Immunoassay,Infect Agent,Quant - Tetanus Antibody, Igg",34.49,13.8,,,0 HCPCS,86317,"Hc Prion Markers (Cjd), Csf 3001255-So+",17.99,7.2,,,0 HCPCS,86317,Hc Reflex Prion Markers 14-3-3 3019874 -So+,38.65,15.46,,,0 HCPCS,86317,Hc Reflex Prion Markers Bloody Total Tau 3019875-So+,80.65,32.26,,,0 HCPCS,86317,Hc Reflex Prion Markers Total Tau-So+,38.65,15.46,,,0 HCPCS,86317,"Hc Streptococcus Pneumoniae Abs, Igg (23 Serotype)-So+",17.99,7.2,,,0 HCPCS,86317,Immunoassay infectious agent,,,12.74,37.48,16 HCPCS,86318,Immunoassay infectious agent,,,11.0,45.22,16 HCPCS,86320,Serum immunoelectrophoresis,,,15.25,74.8,16 HCPCS,86325,Other immunoelectrophoresis,,,19.0,57.82,16 HCPCS,86327,Immunoelectrophoresis assay,,,19.28,32.91,11 HCPCS,86328,Ia nfct ab sarscov2 covid19,,,18.11,113.2,16 HCPCS,86329,Hc Teichoic Acid Antibodies-So+,28.44,11.38,,,0 HCPCS,86329,Immunodiffusion nes,,,8.89,35.12,16 HCPCS,86331,Hc Fungal Antibodies By Immunodiffusion (So),56.43,22.57,,,0 HCPCS,86331,Hc Hypersensitivity Pneumonitis 1 3006065 (1)-So+,22.86,9.14,,,0 HCPCS,86331,Hc Hypersensitivity Pneumonitis Avian Panel Favi-So+,99.6,39.84,,,0 HCPCS,86331,Hc Hypersensitivity Pneumonitis Ext Panel 2-So+,6.49,2.6,,,0 HCPCS,86331,Hc Hypersensitivity Pneumonitis Panel 4-So+,14.38,5.75,,,0 HCPCS,86331,Hc Immunodiffusion Ouchterlony - Hyper Pneumo Extended Panel,38.57,15.43,,,0 HCPCS,86331,Immunodiffusion ouchterlony,,,9.88,29.95,16 HCPCS,86332,Hc 767 Imm Comp Asy C1Q-So+,115.92,46.37,,,0 HCPCS,86332,Hc 767 Imm Comp Asy Raji Cell-So+,115.92,46.37,,,0 HCPCS,86332,Immune complex assay,,,20.71,60.92,16 HCPCS,86334,Hc Ife Serum,362.25,144.9,,,0 HCPCS,86334,Hc Immunofixation Cryoglobulin-Reflex Test For Cry_S,92.92,37.17,,,0 HCPCS,86334,"Hc Immunofixation, Daratumumab-Specific, Serum (2) 123218-So+",24.0,9.6,,,0 HCPCS,86334,"Hc Multiple Myeloma,Daratumamab",276.0,110.4,,,0 HCPCS,86334,Immunofix e-phoresis serum,,,18.98,55.85,16 HCPCS,86335,Hc 154 Tau Transferrin-Soq+,327.36,130.94,,,0 HCPCS,86335,Hc 587 Immunofixation Csf-So+,306.0,122.4,,,0 HCPCS,86335,Hc Beta-2 Transferrin-Arup 0050047-So+,93.6,37.44,,,0 HCPCS,86335,Hc Immunfix E-Phorsis/Urine/Csf - Beta 2 Transferrin,372.6,149.04,,,0 HCPCS,86335,Immunfix e-phorsis/urine/csf,,,24.94,73.38,16 HCPCS,86336,Inhibin A,,,12.74,38.98,16 HCPCS,86337,Hc 320 Insulin Ab-So+,76.98,30.79,,,0 HCPCS,86337,Insulin antibodies,,,18.2,53.52,16 HCPCS,86340,Hc 877 Intrinisic Fac Blk Abs-So+,54.23,21.69,,,0 HCPCS,86340,Intrinsic factor antibody,,,12.81,37.7,16 HCPCS,86341,Hc 099 Zinc Transporter 8 Ab-So+,311.52,124.61,,,0 HCPCS,86341,Hc 367 Islet Cl Cytopls Ab Igg-So,71.15,28.46,,,0 HCPCS,86341,Hc 461 Gad Ab-So+,71.15,28.46,,,0 HCPCS,86341,Hc 493 Islet Ag 2(Ia-2)Autoab-So+,113.82,45.53,,,0 HCPCS,86341,Hc 511 Rfx-Gad65 Ab Csf-So+,94.62,37.85,,,0 HCPCS,86341,Hc Enc2 Encephalopathy Autoimmuneparaneoplastic Evaluation Spinal Fluid Enc2 #2-So+,60.0,24.0,,,0 HCPCS,86341,"Hc Encephalopathy, Autoimm/Paraneo, S Ens2-So+",70.91,28.36,,,0 HCPCS,86341,Hc Gad65 Ab-So+,240.0,96.0,,,0 HCPCS,86341,"Hc Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum Mds2 #2-So+",55.72,22.29,,,0 HCPCS,86341,"Hc Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Spinal Fluid Mdc2 #3-So+",48.89,19.56,,,0 HCPCS,86341,"Hc Pediatric Autoimmune Encephalopathy/Cns Disorder Evaluation, Serum Pcdes #1-So+",138.64,55.46,,,0 HCPCS,86341,"Hc Pediatric Autoimmune Encephalopathy/Cns Disorder Evaluation, Spinal Fluid Pcdec-So+",100.0,40.0,,,0 HCPCS,86341,Hc Stiff-Person Spectrum Disorders Evaluation Spps #1-So+,220.5,88.2,,,0 HCPCS,86341,Islet cell antibody,,,16.81,58.92,16 HCPCS,86343,Leukocyte histamine release,,,10.59,31.15,16 HCPCS,86344,Leukocyte phagocytosis,,,6.79,25.98,16 HCPCS,86352,Cell function assay w/stim,,,115.46,339.65,16 HCPCS,86352,Hc 048 Cell Function W/Stim-So+,540.06,216.02,,,0 HCPCS,86352,Hc 229 Immune Cell Function-So+,255.0,102.0,,,0 HCPCS,86352,Hc 328 Neutr Oxid Burst Dhr-So+,268.92,107.57,,,0 HCPCS,86352,Hc 482 Functional Anti Fcer-So+,163.03,65.21,,,0 HCPCS,86352,Hc 512 Infliximab Activity-So+,669.6,267.84,,,0 HCPCS,86352,Hc Immuknow 9016-So+,239.54,95.82,,,0 HCPCS,86353,Hc 894 Lymph Trans Mit Or Ag-So+,394.8,157.92,,,0 HCPCS,86353,Hc 986 Lymph Trans Mit Or Ag-So+,406.8,162.72,,,0 HCPCS,86353,Hc Lymphocyte Antigen Proliferation-Arup 0096055-So+,185.25,74.1,,,0 HCPCS,86353,Hc Lymphocyte Mitogen Proliferation-Arup 0096043-So+,112.0,44.8,,,0 HCPCS,86353,Hc Lymphocyte Transformation Arup-So+,52.8,21.12,,,0 HCPCS,86353,Hc Pre/Post Procedure Metal Sensitivity Arup-Oa-So+,63.0,25.2,,,0 HCPCS,86353,Hc Toll-Like Receptor Function,58.83,23.53,,,0 HCPCS,86353,Lymphocyte transformation,,,41.66,122.58,16 HCPCS,86353,Noncdm Charge Record,140.11,56.04,,,0 HCPCS,86355,B cells total count,,,32.06,94.32,16 HCPCS,86355,Hc B Cell Total Count,60.72,24.29,,,0 HCPCS,86355,Hc B Cell Total Count Arup-So+,52.8,21.12,,,0 HCPCS,86355,"Hc B Cells, Total Count - B Cells, Total Count",238.05,95.22,,,0 HCPCS,86356,Hc 161 Kleinhauer Betke-So+,169.73,67.89,,,0 HCPCS,86356,"Hc Paroxysmal Nocturnal Hemoglobinuria (Pnh), High Sensitivity, Rbc And Wbc 2005006-So+",55.0,22.0,,,0 HCPCS,86356,Mononuclear cell antigen,,,22.75,66.95,16 HCPCS,86356,Noncdm Charge Record,52.99,21.2,,,0 HCPCS,86357,"Hc Natural Killer Cells, Total Count-So+",52.8,21.12,,,0 HCPCS,86357,"Hc Nk Cells, Total Count - Natural Killer Cell Count",231.15,92.46,,,0 HCPCS,86357,Nk cells total count,,,32.06,94.32,16 HCPCS,86357,Noncdm Charge Record,74.66,29.86,,,0 HCPCS,86359,"Hc T Cells, Total Count - T Cells, Total Count",350.75,140.3,,,0 HCPCS,86359,Noncdm Charge Record,74.66,29.86,,,0 HCPCS,86359,T cells total count,,,32.06,94.32,16 HCPCS,86360,Hc T Cell Absolute Count/Ratio - T-Helper Cells Cd4/Cd8 %,400.2,160.08,,,0 HCPCS,86360,T cell absolute count/ratio,,,39.93,117.45,16 HCPCS,86361,Hc Cd4 Percent And Absolute 0095885-So+,36.0,14.4,,,0 HCPCS,86361,T cell absolute count,,,22.75,66.95,16 HCPCS,86362,Mog-igg1 antb cba each,,,4.82,30.12,16 HCPCS,86363,"Hc Mog Facs Titer, S Mogts-So+",76.5,30.6,,,0 HCPCS,86363,"Hc Myelin Oligodendrocyte Glycoprotein (Mog-Igg1) Fluorescence-Activated Cell Sorting (Facs) Assay,",590.4,236.16,,,0 HCPCS,86363,Hc Pcdes Ab Reflex Ib-So+,104.4,41.76,,,0 HCPCS,86363,"Hc Pediatric Autoimmune Encephalopathy/Cns Disorder Evaluation, Serum Pcdes #4-So+",138.46,55.38,,,0 HCPCS,86363,Mog-igg1 antb flo cytmtry ea,,,4.82,94.32,16 HCPCS,86364,"Hc Tissue Transglutaminase Antibody , Iga 3016860-So+",13.84,5.54,,,0 HCPCS,86364,"Hc Tissue Transglutaminase Antibody, Iga 0097709-So+",13.84,5.54,,,0 HCPCS,86364,"Hc Tissue Transglutaminase Antibody, Igg 56009-So+",12.0,4.8,,,0 HCPCS,86364,Tiss trnsgltmnase ea ig clas,,,4.61,28.82,16 HCPCS,86366,"Hc Musk Igg Ab Cba, Serum, With Rflx 3006198-So+",354.0,141.6,,,0 HCPCS,86366,Muscle-specific kinase antb,,,7.36,46.0,16 HCPCS,86367,"Hc Stem Cells, Total Count - Stem Cells, Total Count",776.25,310.5,,,0 HCPCS,86367,Stem cells total count,,,32.06,194.45,16 HCPCS,86376,Hc 111 Liv-Kid Microsm Ab Igg-So+,52.32,20.93,,,0 HCPCS,86376,Hc Microsomal Antibody - Thyroid Peroxidase Antibody,207.0,82.8,,,0 HCPCS,86376,Hc Thyroid Peroxidase (Tpo) Ab 50075-So+,17.46,6.98,,,0 HCPCS,86376,Microsomal antibody each,,,12.37,36.38,16 HCPCS,86381,"Hc Mitochondrial M2 Antibody, Igg (Elisa) 50065-So+",30.54,12.22,,,0 HCPCS,86381,Mitochondrial antibody each,,,10.18,63.62,16 HCPCS,86382,Hc 365 Rabies Abs (Rffit)-So+,78.0,31.2,,,0 HCPCS,86382,Hc 720 Rabies Abs (Rffit)-So+,78.0,31.2,,,0 HCPCS,86382,Neutralization test viral,,,14.37,42.28,16 HCPCS,86384,Nitroblue tetrazolium dye,,,9.67,34.02,16 HCPCS,86386,Nuclear matrix protein 22,,,13.57,54.45,16 HCPCS,86403,"Hc Particle Agglutination Test, Screen - Cryptococcal Antigen",151.8,60.72,,,0 HCPCS,86403,Particle agglut antbdy scrn,,,8.66,28.85,16 HCPCS,86406,"Hc Particle Agglutination Test, Titer - Cryptococcal Antigen",131.0,52.4,,,0 HCPCS,86406,Particle agglut antbdy titr,,,9.04,26.6,16 HCPCS,86408,Neutrlzg antb sarscov2 scr,,,16.85,105.32,16 HCPCS,86409,Neutrlzg antb sarscov2 titer,,,6.0,199.02,16 HCPCS,86413,Sars-cov-2 antb quantitative,,,6.0,128.58,16 HCPCS,86430,Rheumatoid factor test qual,,,4.82,15.35,16 HCPCS,86431,"Hc Rheumatoid Factor, Quant - Rheumatoid Factor",121.9,48.76,,,0 HCPCS,86431,Rheumatoid factor quant,,,4.82,14.18,16 HCPCS,86480,"Hc Tb Test, Cell Mediated Antigen Response,Gamma Interfron - Tb Test",350.75,140.3,,,0 HCPCS,86480,Tb test cell immun measure,,,52.67,154.95,16 HCPCS,86481,Hc 348 T-Spot-So+,120.0,48.0,,,0 HCPCS,86481,Tb ag response t-cell susp,,,52.67,250.0,16 HCPCS,86485,Skin test candida,,,8.18,70.62,16 HCPCS,86486,Skin test nos antigen,,,2.82,70.62,9 HCPCS,86490,Coccidioidomycosis skin test,,,3.35,9.32,11 HCPCS,86510,Histoplasmosis skin test,,,3.35,91.19,16 HCPCS,86580,Hc Tb Intradermal Test,63.25,25.3,,,0 HCPCS,86580,NDC Description Not Available,49.114999999999995,19.645000000000003,,,0 HCPCS,86580,TB intradermal test,,,4.07,70.62,16 HCPCS,86580,"Tubersol: 1 Vial, Multi-Dose In 1 Carton (49281-752-21) / 1 Ml In 1 Vial, Multi-Dose (49281-752-78)",53.93,21.57,,,0 HCPCS,86580,"Tubersol: 1 Vial, Multi-Dose In 1 Carton (49281-752-22) / 5 Ml In 1 Vial, Multi-Dose (49281-752-98)",39.73,15.89,,,0 HCPCS,86581,"Hc Streptococcus Pneumoniae Antibodies, Igg (14 Serotypes) 0050725-So+",42.95,17.18,,,0 HCPCS,86581,"Hc Streptococcus Pneumoniae Antibodies, Igg (23 Serotypes) 205779-So+",84.42,33.77,,,0 HCPCS,86581,Strptcs pneum antb serot ia,,,6.61,230.08,9 HCPCS,86590,Streptokinase antibody,,,6.91,31.65,16 HCPCS,86592,Hc (Reflex) Rpr (Labcorp 082345-Reflex),62.1,24.84,,,0 HCPCS,86592,Hc 309 Syphilis Test Non Treponemal Antibody Qual - Vdrl Csf-So+,42.0,16.8,,,0 HCPCS,86592,Hc Rapid Plasma Reagin (Rpr) W Reflex To Titer,62.1,24.84,,,0 HCPCS,86592,Hc Reflex-Rpr Titer,79.35,31.74,,,0 HCPCS,86592,Hc Syphilis Test Non Treponemal Antibody Qual - Rapid Plasma Reagin-Syp,98.9,39.56,,,0 HCPCS,86592,Hc Syphilis Test Non Treponemal Antibody Qual - Vdrl Csf,98.9,39.56,,,0 HCPCS,86592,Syphilis test non-trep qual,,,3.63,10.68,16 HCPCS,86593,Hc Reflex-Rpr Titer,79.35,31.74,,,0 HCPCS,86593,Hc Rpr Titer,127.65,51.06,,,0 HCPCS,86593,"Hc Syphilis Test, Quantitative - Treponema Pallidum (Syphilis)",127.65,51.06,,,0 HCPCS,86593,Syphilis test non-trep quant,,,3.74,11.0,16 HCPCS,86596,"Hc Movement Disorder, Autoimmune/Paraneoplastic Evaluation, Serum Mds2 #1-So+",55.72,22.29,,,0 HCPCS,86596,Hc P/Q Type Calcium Channel Ab,178.8,71.52,,,0 HCPCS,86596,Voltage-gtd ca chnl antb ea,,,7.36,30.12,16 HCPCS,86602,Antinomyces antibody,,,8.65,25.45,16 HCPCS,86603,Adenovirus antibody,,,10.94,32.18,16 HCPCS,86606,Aspergillus antibody,,,12.8,37.62,16 HCPCS,86606,Hc Fungal Antibodies Immunodiffusion 50164 #1-So+,18.06,7.22,,,0 HCPCS,86606,"Hc Fungal Antibodies With Reflex, Serum #1-So+",18.06,7.22,,,0 HCPCS,86606,Hc Hypersensitivity Pneumonitis 1 3006065 (2)-So+,15.24,6.1,,,0 HCPCS,86606,Hc Hypersensitivity Pneumonitis 1 Panel 4-So+,15.24,6.1,,,0 HCPCS,86606,Hc Hypersensitivity Pneumonitis Ext Panel 3-So+,6.49,2.6,,,0 HCPCS,86609,Bacterium antibody,,,10.95,32.2,16 HCPCS,86611,Bartonella Antibody,,,8.65,25.45,16 HCPCS,86611,Hc 566 Bartonella Igg Csf-So+,36.61,14.64,,,0 HCPCS,86611,Hc 566 Bartonella Igm Csf-So+,36.61,14.64,,,0 HCPCS,86612,Blastomyces antibody,,,10.97,32.25,16 HCPCS,86612,Hc 457 Blastomyces Ab-So+,46.42,18.57,,,0 HCPCS,86612,Hc Fungal Antibodies Immunodiffusion 50164 #2-So+,15.48,6.19,,,0 HCPCS,86612,Hc Fungal Antibodies With Reflex To?Blastomyces Dermatitidis?Abs By Immunodiffusion (So),53.38,21.35,,,0 HCPCS,86612,"Hc Fungal Antibodies With Reflex, Serum #2-So+",14.31,5.72,,,0 HCPCS,86615,Bordetella antibody,,,11.21,32.98,16 HCPCS,86617,Hc 411 B Burgdorferi Igm Rflx-So+,18.59,7.44,,,0 HCPCS,86617,Hc 681 Lyme Ab Igg Ib -So+,18.57,7.43,,,0 HCPCS,86617,Hc 837 Borrelia Burg Igg-So+,22.2,8.88,,,0 HCPCS,86617,Hc 837 Borrelia Burg Igm-So+,22.2,8.88,,,0 HCPCS,86617,Lyme disease antibody,,,13.16,38.72,16 HCPCS,86618,Hc 566 Lyme Ab Igm Ifa Csf-So+,61.25,24.5,,,0 HCPCS,86618,"Hc Arup B. Burgdorferi Vise1 /Pepc10 Antibodies, Total (So+)",66.16,26.46,,,0 HCPCS,86618,Hc Borrelia Burgdorferi Igg And Igm Elisa Reflex-So+,30.0,12.0,,,0 HCPCS,86618,Lyme disease antibody,,,14.47,42.58,16 HCPCS,86619,Borrelia antibody,,,11.37,33.45,16 HCPCS,86622,Brucella antibody,,,7.59,22.32,16 HCPCS,86622,Hc 252 Brucella Igg-So+,64.8,25.92,,,0 HCPCS,86622,Hc 252 Brucella Igm-So+,14.86,5.94,,,0 HCPCS,86625,Campylobacter antibody,,,11.15,32.8,16 HCPCS,86625,Hc 261 Campy Jejuni Igg Ab-So+,70.62,28.25,,,0 HCPCS,86628,Candida antibody,,,10.21,30.02,16 HCPCS,86631,Chlamydia antibody,,,10.05,29.55,16 HCPCS,86631,Hc 165 Chlamydia Ab Igg Ea-So+,14.18,5.67,,,0 HCPCS,86631,Hc 461 Chlamydia Ab Igg Ea-So+,86.8,34.72,,,0 HCPCS,86631,"Hc Chlamydia Ab Differentiation (Lgv), Mif 98880 #1-So+",14.18,5.67,,,0 HCPCS,86631,Hc Hypersensitivity Pneumonitis 1 So+-Arup 0055076,38.1,15.24,,,0 HCPCS,86632,Chlamydia igm antibody,,,10.78,31.7,16 HCPCS,86632,Hc 165 Chlamydia Ab Igm Ea-So+,15.22,6.09,,,0 HCPCS,86632,"Hc Chlamydia Ab Differentiation (Lgv), Mif 98880 #2-So+",15.22,6.09,,,0 HCPCS,86632,Hc Chlamydia Igm Antibody-So+,15.22,6.09,,,0 HCPCS,86635,Coccidioides antibody,,,9.75,28.68,16 HCPCS,86635,Hc Fungal Antibodies Immunodiffusion 50164 #3-So+,13.76,5.5,,,0 HCPCS,86635,"Hc Fungal Antibodies With Reflex, Serum #3-So+",14.31,5.72,,,0 HCPCS,86638,Hc 691 Q-Fever Phase I Igg-So+,18.0,7.2,,,0 HCPCS,86638,Hc 691 Q-Fever Phase I Igm-So+,18.0,7.2,,,0 HCPCS,86638,Hc 691 Q-Fever Phase Ii Igg-So+,18.0,7.2,,,0 HCPCS,86638,Hc 691 Q-Fever Phase Ii Igm-So+,18.0,7.2,,,0 HCPCS,86638,"Hc Reflex Coxiella Burnetii (Q-Fever) Antibody, Igg Phase I Titer 2012630-So+",39.6,15.84,,,0 HCPCS,86638,"Hc Reflex Coxiella Burnetii (Q-Fever) Antibody, Igg Phase Ii Titer 2012632-So+",39.6,15.84,,,0 HCPCS,86638,"Hc Reflex Coxiella Burnetii (Q-Fever) Antibody, Igm Phase I Titer 2012643-So+",86.4,34.56,,,0 HCPCS,86638,"Hc Reflex Coxiella Burnetii (Q-Fever) Antibody, Igm Phase Ii Titer 2012645-So+",86.4,34.56,,,0 HCPCS,86638,Q fever antibody,,,10.31,30.3,16 HCPCS,86641,Cryptococcus antibody,,,12.25,36.02,16 HCPCS,86644,CMV antibody,,,12.23,35.98,16 HCPCS,86644,Hc 059 Cmv Ab (Kbc)-So+,51.77,20.71,,,0 HCPCS,86644,Hc 571 Cmv Igg Ab Csf-So+,17.27,6.91,,,0 HCPCS,86644,Hc Cmv Avidity,125.49,50.2,,,0 HCPCS,86644,Hc Cmv Igg Avidity Elisa,192.05,76.82,,,0 HCPCS,86645,Cmv antibody igm,,,14.32,42.12,16 HCPCS,86645,Hc 931 Cytomegalovirus Igm-So+,20.22,8.09,,,0 HCPCS,86645,"Hc Cmv Antibody, Igm - Cytomegalovirus Antibody, Igm",243.8,97.52,,,0 HCPCS,86648,Diphtheria antibody,,,12.92,38.02,16 HCPCS,86651,Encephalitis californ antbdy,,,11.21,32.98,16 HCPCS,86651,Hc 120 Enceph Calif Igg-Soq+,50.54,20.22,,,0 HCPCS,86651,Hc 120 Enceph Calif Igm-Soq+,50.54,20.22,,,0 HCPCS,86651,Hc 294 Enceph Calif Igg Csf-So+,23.08,9.23,,,0 HCPCS,86651,Hc 294 Enceph Calif Igm Csf-So+,23.08,9.23,,,0 HCPCS,86651,Hc 471 Enceph Calif Igg-So+,23.08,9.23,,,0 HCPCS,86651,Hc 471 Enceph Calif Igm-So+,23.08,9.23,,,0 HCPCS,86651,Hc 924 Enceph Calif Igg-So+,47.44,18.98,,,0 HCPCS,86652,Encephaltis east eqne anbdy,,,11.21,32.98,16 HCPCS,86652,Hc 120 Enceph East Equin Igg-So+,50.54,20.22,,,0 HCPCS,86652,Hc 120 Enceph East Equin Igm-Soq+,23.08,9.23,,,0 HCPCS,86652,Hc 294 Enceph East Equin Igg-So+,47.44,18.98,,,0 HCPCS,86652,Hc 294 Enceph East Equin Igm-So+,47.44,18.98,,,0 HCPCS,86652,Hc 471 Enceph East Equin Igg-So+,23.08,9.23,,,0 HCPCS,86652,Hc 471 Enceph East Equin Igm-So+,23.08,9.23,,,0 HCPCS,86652,Hc 924 Enceph East Equin Igg-So+,23.08,9.23,,,0 HCPCS,86653,Encephaltis st louis antbody,,,11.21,32.98,16 HCPCS,86653,Hc 120 Enceph St Louis Igg-Soq+,23.08,9.23,,,0 HCPCS,86653,Hc 120 Enceph St Louis Igm-Soq+,23.08,9.23,,,0 HCPCS,86653,Hc 294 Encph St Louis Igg Csf-So+,47.44,18.98,,,0 HCPCS,86653,Hc 294 Encph St Louis Igm Csf-So+,47.44,18.98,,,0 HCPCS,86653,Hc 471 Enceph St Louis Igg-So+,23.08,9.23,,,0 HCPCS,86653,Hc 471 Enceph St Louis Igm-So+,23.08,9.23,,,0 HCPCS,86653,Hc 924 Enceph St Louis Igg-So+,47.44,18.98,,,0 HCPCS,86654,Encephaltis west eqne antbdy,,,11.21,32.98,16 HCPCS,86654,Hc 120 Enceph West Equin Igg-Soq+,23.08,9.23,,,0 HCPCS,86654,Hc 120 Enceph West Equin Igm-Soq+,23.08,9.23,,,0 HCPCS,86654,Hc 294 Enceph West Equin Igg-So+,47.44,18.98,,,0 HCPCS,86654,Hc 294 Enceph West Equin Igm-So+,47.44,18.98,,,0 HCPCS,86654,Hc 471 Enceph West Equin Igg-So+,23.08,9.23,,,0 HCPCS,86654,Hc 471 Enceph West Equin Igm-So+,23.08,9.23,,,0 HCPCS,86654,Hc 924 Enceph West Equin Igg-So+,47.44,18.98,,,0 HCPCS,86658,Enterovirus antibody,,,11.08,32.58,16 HCPCS,86658,Hc Coxsackie A9 Virus Abs-So+,15.63,6.25,,,0 HCPCS,86658,Hc 102 Enterovr B Diphther-So+,15.63,6.25,,,0 HCPCS,86658,Hc 103 Diphtheria Echo Ea-So+,46.86,18.74,,,0 HCPCS,86658,Hc 218 Coxsackie A9 Virus Abs-So+,46.86,18.74,,,0 HCPCS,86658,Hc 699 Poliovirus Ab Type 3-So+,45.2,18.08,,,0 HCPCS,86663,Epstein-barr antibody,,,11.15,32.8,16 HCPCS,86663,Hc 161 Ebv Ab->Early D Ag Igg-So+,15.74,6.3,,,0 HCPCS,86664,Epstein-barr nuclear antigen,,,13.0,38.22,16 HCPCS,86664,Hc 170 Epstein Barr Ab Nuc Ag-So+,18.35,7.34,,,0 HCPCS,86665,Epstein-barr capsid vca,,,15.41,45.35,16 HCPCS,86665,"Hc 260 Epstein-Barr Capsid Vca - Epstein-Barr Virus Vca, Igg-So+",213.0,85.2,,,0 HCPCS,86665,"Hc Epstein-Barr Capsid Vca - Epstein-Barr Virus Vca, Igg",21.77,8.71,,,0 HCPCS,86665,"Hc Epstein-Barr Capsid Vca - Epstein-Barr Virus Vca, Igm",21.77,8.71,,,0 HCPCS,86665,Hc Epstein-Barr Virus Igm Antibodies,211.0,84.4,,,0 HCPCS,86666,Ehrlichia Antibody,,,8.65,25.45,16 HCPCS,86666,Hc 431 Ehrl Chaffennsis Igg-So+,36.61,14.64,,,0 HCPCS,86668,Francisella tularensis,,,8.84,35.4,16 HCPCS,86668,Hc 424 Tularemia Ab Igg-So+,37.4,14.96,,,0 HCPCS,86668,Hc 424 Tularemia Ab Igm-So+,37.4,14.96,,,0 HCPCS,86668,"Hc Francisella Tularensis Antibodies, Igg And Igm 3018856-So+",24.0,9.6,,,0 HCPCS,86671,Fungus nes antibody,,,10.42,30.62,16 HCPCS,86674,Giardia lamblia antibody,,,12.51,36.8,16 HCPCS,86674,Hc 442 Giardia Lamblia Igg-So+,75.6,30.24,,,0 HCPCS,86677,Helicobacter pylori antibody,,,12.34,42.12,16 HCPCS,86682,Hc 077 Strongyloides Ab Igg-So+,46.78,18.71,,,0 HCPCS,86682,Hc 275 Cysticercosis Ab Igg-So+,25.68,10.27,,,0 HCPCS,86682,Hc 330 Toxocara Ab Serum-Soq+,56.1,22.44,,,0 HCPCS,86682,Hc 477 Paragonimus Ab-So+,90.0,36.0,,,0 HCPCS,86682,Hc 593 Schistosomias Igg Ab-So+,108.0,43.2,,,0 HCPCS,86682,Hc 693 Filaria Ab Igg4-Soq+,81.6,32.64,,,0 HCPCS,86682,Hc 754 Echinococcosis Ab Igg-So+,46.78,18.71,,,0 HCPCS,86682,"Hc Toxocara Antibodies, Igg By Elisa-So+ Arup 3006066",108.0,43.2,,,0 HCPCS,86682,Helminth antibody,,,11.06,32.52,16 HCPCS,86684,Hemophilus influenza antibdy,,,13.46,39.6,16 HCPCS,86687,Hc 053 Anti-Htlv-I (Kbc)-So+,30.18,12.07,,,0 HCPCS,86687,Hc Htlv I - Htlv-I Antibody,37.01,14.8,,,0 HCPCS,86687,Htlv-i antibody,,,7.13,22.72,16 HCPCS,86688,Htlv-ii antibody,,,11.9,35.0,16 HCPCS,86689,Hc 084 Htlv 1/2 West Blt Arup-So+,109.2,43.68,,,0 HCPCS,86689,Htlv/hiv confirmj antibody,,,16.45,48.38,16 HCPCS,86692,Hc 101 Hepatitis D Ab-So+,20.59,8.24,,,0 HCPCS,86692,Hepatitis delta agent antbdy,,,14.59,42.9,16 HCPCS,86694,Hc 063 Hsv 1/2 Ab Igg-So+,51.77,20.71,,,0 HCPCS,86694,Hc 241 Higmsf-So+,88.2,35.28,,,0 HCPCS,86694,Hc 284 Hsv 1/2 Ab Igm-So+,51.77,20.71,,,0 HCPCS,86694,Herpes simplex nes antbdy,,,12.23,35.98,16 HCPCS,86695,Hc 825 Herpes Simplex Type 1-So+,15.83,6.33,,,0 HCPCS,86695,Herpes simplex type 1 test,,,11.21,32.98,16 HCPCS,86696,Hc 825 Herpes Simplex Type 2-So+,23.22,9.29,,,0 HCPCS,86696,Herpes simplex type 2 test,,,16.45,48.38,16 HCPCS,86698,Hc 201 Histoplasma Ab Serum-So+,44.93,17.97,,,0 HCPCS,86698,Hc Fungal Antibodies Immunodiffusion 50164 #4-So+,16.55,6.62,,,0 HCPCS,86698,"Hc Fungal Antibodies With Reflex, Serum300235 #4-So+",16.55,6.62,,,0 HCPCS,86698,Histoplasma antibody,,,10.63,34.48,16 HCPCS,86701,Hc Hiv-1 - Hiv 1 Antibody Eia,230.0,92.0,,,0 HCPCS,86701,"Hc Hiv-1/2 Ab Diff, Supplemental 2013107-So+",48.6,19.44,,,0 HCPCS,86701,Hiv-1antibody,,,7.55,22.22,16 HCPCS,86702,"Hc Hiv-1/2 Ab Diff, Supplemental 2013107 #2-So+",48.6,19.44,,,0 HCPCS,86702,Hc Hiv-2,16.22,6.49,,,0 HCPCS,86702,Hiv-2 antibody,,,11.48,33.8,16 HCPCS,86703,Hc 733 Hiv 1/2-So+,138.6,55.44,,,0 HCPCS,86703,"Hc Hiv-1/Hiv-2, Single Assay - Rapid Hiv 1 And 2 Screen",241.5,96.6,,,0 HCPCS,86703,Hiv-1/hiv-2 1 result antbdy,,,11.66,34.28,16 HCPCS,86704,"Hc 051-Hep B Core Ab Test, Total - Hepatitis B Core Antibody, Total-So+",43.32,17.33,,,0 HCPCS,86704,"Hc Hep B Core Ab Test, Total - Hepatitis B Core Antibody, Total",174.8,69.92,,,0 HCPCS,86704,Hc Hepatitis B Virus Core Antibodies (Total) 20091-So+,14.46,5.78,,,0 HCPCS,86704,Hep b core antibody total,,,10.24,30.12,16 HCPCS,86705,"Hc Hep B Core Ab Test, Igm - Hepatitis B Core Antibody, Igm",226.55,90.62,,,0 HCPCS,86705,"Hc Hepatitis B Virus Core Antibody, Igm 20092-So+",18.0,7.2,,,0 HCPCS,86705,Hep b core antibody igm,,,10.0,29.42,16 HCPCS,86706,Hc Hepatitis B Surface Ab Test - Hepatitis B Surface Antibody,200.1,80.04,,,0 HCPCS,86706,Hc Hepatitis B Virus Core Antibodies (Total) 20090-So+,12.89,5.16,,,0 HCPCS,86706,Hc Quant Hepatitis B Virus Surface Antibody 20090-So+,7.8,3.12,,,0 HCPCS,86706,Hep b surface antibody,,,9.13,26.85,16 HCPCS,86707,Hc 116 Hepatitis Be Ab-So+,41.6,16.64,,,0 HCPCS,86707,Hepatitis be antibody,,,9.83,28.92,16 HCPCS,86708,Hc Hepatitis A Total Ab Igg,197.8,79.12,,,0 HCPCS,86708,Hepatitis a antibody,,,10.53,30.98,16 HCPCS,86709,"Hc Hepatitis Antibody Haab Igm Antibody - Hepatitis A Antibody, Igm",215.05,86.02,,,0 HCPCS,86709,Hepatitis a igm antibody,,,9.57,28.15,16 HCPCS,86710,Influenza virus antibody,,,11.52,33.88,16 HCPCS,86711,John cunningham antibody,,,16.89,42.22,16 HCPCS,86713,Hc 649 Legionella 1-6 Ttr Igg-So+,55.04,22.02,,,0 HCPCS,86713,Legionella antibody,,,13.0,38.25,16 HCPCS,86717,Hc 694 Leishmania Igg-So+,56.04,22.42,,,0 HCPCS,86717,Leishmania antibody,,,10.41,30.62,16 HCPCS,86720,Hc 489 Leptospirosis Ab-So+,64.8,25.92,,,0 HCPCS,86720,Leptospira antibody,,,11.21,40.5,16 HCPCS,86723,Listeria monocytogenes,,,11.21,32.98,16 HCPCS,86727,Lymph choriomeningitis ab,,,10.94,32.18,16 HCPCS,86732,Mucormycosis antibody,,,11.21,37.5,16 HCPCS,86735,Hc 065 Mumps Ab Igm Arup-So+,46.91,18.76,,,0 HCPCS,86735,Hc Mumps - Mumps Igg Antibody,57.5,23.0,,,0 HCPCS,86735,Mumps antibody,,,11.09,32.62,16 HCPCS,86738,Hc 100 M Pneumoniae Igg-So+,47.63,19.05,,,0 HCPCS,86738,Hc 100 M Pneumoniae Igm-So+,47.63,19.05,,,0 HCPCS,86738,Mycoplasma antibody,,,11.26,33.1,16 HCPCS,86741,Neisseria meningitidis,,,11.21,32.98,16 HCPCS,86744,Nocardia antibody,,,11.21,39.98,16 HCPCS,86747,Hc Parvovirus B19 Ab Igg-So+,54.07,21.63,,,0 HCPCS,86747,Hc Parvovirus B19 Ab Igm-So+,54.07,21.63,,,0 HCPCS,86747,Parvovirus antibody,,,12.78,37.58,16 HCPCS,86750,Malaria antibody,,,11.21,32.98,16 HCPCS,86753,Hc 227 Protozoa Ab Nes-So+,44.53,17.81,,,0 HCPCS,86753,Hc 569 E Histolyt Amebias Igg-So+,44.53,17.81,,,0 HCPCS,86753,Hc 691 Trypanosoma Cruzi Igg-So+,44.53,17.81,,,0 HCPCS,86753,Hc 692 Trypanosoma Cruzi Igm-So+,44.53,17.81,,,0 HCPCS,86753,Protozoa antibody nos,,,10.53,30.98,16 HCPCS,86756,Respiratory virus antibody,,,10.96,39.72,16 HCPCS,86757,Hc 470 Rocky Mountain Spotted Fever Igm Ttr-So+,45.0,18.0,,,0 HCPCS,86757,Hc 548 Typhus Fever Ab Igg-So+,69.61,27.84,,,0 HCPCS,86757,Hc 548 Typhus Fever Ab Igm-So+,69.61,27.84,,,0 HCPCS,86757,Rickettsia Antibody,,,16.45,48.38,16 HCPCS,86759,Rotavirus antibody,,,11.21,45.58,16 HCPCS,86762,Hc Rubella - Rubella Antibody,17.27,6.91,,,0 HCPCS,86762,Hc Rubella-Rubella Ab,188.6,75.44,,,0 HCPCS,86762,Rubella antibody,,,12.23,35.98,16 HCPCS,86765,Hc 729 Rubeola - Rubeola Antibody Igm-So+,46.33,18.53,,,0 HCPCS,86765,Hc Rubeola - Rubeola Antibody Igg,56.35,22.54,,,0 HCPCS,86765,Rubeola antibody,,,10.95,32.2,16 HCPCS,86768,Salmonella antibody,,,11.21,32.98,16 HCPCS,86769,"Hc Covid-19 Igg(Spike),Semi Quant Cia-So+",50.56,20.22,,,0 HCPCS,86769,"Hc Covid-19 Igg, Qualitative By Cia-Arup 3002776-So+",50.56,20.22,,,0 HCPCS,86769,Hc Sars Cov-2 Igg Antibody,58.65,23.46,,,0 HCPCS,86769,Sars-cov-2 covid-19 antibody,,,16.85,105.32,16 HCPCS,86771,Shigella antibody,,,11.21,61.2,16 HCPCS,86774,Tetanus antibody,,,12.58,37.0,16 HCPCS,86777,Hc 106 Toxoplasma Gondii Ab Igg-So+,51.77,20.71,,,0 HCPCS,86777,Hc 184 Toxoplasma Igg Csf-So+,105.48,42.19,,,0 HCPCS,86777,Hc 482 Toxoplasma Gondii Igg-So+,51.77,20.71,,,0 HCPCS,86777,"Hc Toxoplasma Gondii Igg Antibody, Elisa (Csf) (So)",59.54,23.82,,,0 HCPCS,86777,"Hc Toxoplasma Gondii Igg Antibody, Elisa (Csf)-So+",94.48,37.79,,,0 HCPCS,86777,Toxoplasma antibody,,,12.23,35.98,16 HCPCS,86778,Hc 244 Toxoplasma Igm-So+,17.29,6.92,,,0 HCPCS,86778,Hc 578 Toxo Igm Csf-So+,99.6,39.84,,,0 HCPCS,86778,Toxoplasma antibody igm,,,12.24,36.02,16 HCPCS,86780,Hc 232 Antibody Treponema Pallidum - T. Pallidum Confirmatory-So+,27.32,10.93,,,0 HCPCS,86780,"Hc Antibody Treponema Pallidum - Fta Antibodies, Igg And Igm",190.9,76.36,,,0 HCPCS,86780,Hc Antibody Treponema Pallidum - T. Pallidum Confirmatory,190.9,76.36,,,0 HCPCS,86780,Hc Syphilis Antibody Igg/Igm,190.9,76.36,,,0 HCPCS,86780,Hc Treponema Pallidium Screen Casacade (Labcorp 082345),190.9,76.36,,,0 HCPCS,86780,Hc Treponema Pallidum Antibody By Tp-Pa 0050777-So+,15.6,6.24,,,0 HCPCS,86780,Treponema pallidum,,,5.42,33.1,16 HCPCS,86784,Hc 577 Trichinosis Ab-So+,89.77,35.91,,,0 HCPCS,86784,Trichinella antibody,,,10.68,31.4,16 HCPCS,86787,Hc 127 Varicella-Zoster - Varicella Zoster Igg-So+,18.0,7.2,,,0 HCPCS,86787,Hc 143 Varicella-Zoster - Varicella Zoster Igm-So+,46.33,18.53,,,0 HCPCS,86787,Hc Varicella-Zoster - Varicella Zoster Igg,185.15,74.06,,,0 HCPCS,86787,Varicella-zoster antibody,,,10.95,32.2,16 HCPCS,86788,Hc 181 West Nile Ab Igm Csf-So+,60.59,24.24,,,0 HCPCS,86788,Hc 294 West Nile Virus Igm-So+,23.08,9.23,,,0 HCPCS,86788,Hc 471 West Nile Ab Igm-So+,23.08,9.23,,,0 HCPCS,86788,Hc 853 West Nile Ab Igm-So+,72.48,28.99,,,0 HCPCS,86788,West nile virus ab igm,,,14.32,42.12,16 HCPCS,86789,Hc 181 West Nile Ab Igg Csf-So+,51.77,20.71,,,0 HCPCS,86789,Hc 294 West Nile Virus Igg-So+,51.77,20.71,,,0 HCPCS,86789,Hc 471 West Nile Ab Igg-So+,23.08,9.23,,,0 HCPCS,86789,Hc 472 West Nile Ab Igg-So+,51.77,20.71,,,0 HCPCS,86789,Hc 924 West Nile Ab Igg-So+,23.08,9.23,,,0 HCPCS,86789,West Nile Virus Antibody,,,12.23,35.98,16 HCPCS,86790,Hc 220 Hepatitis E Igm-So+,67.08,26.83,,,0 HCPCS,86790,Hc 735 Htlv I/Ii-So+,112.2,44.88,,,0 HCPCS,86790,"Hc Herpesvirus 6 Antibodies (Igg, Igm)34282-So+",21.1,8.44,,,0 HCPCS,86790,Hc Htlv I/Ii Antibodies W/Reflex To Confirm 51164-So+,14.82,5.93,,,0 HCPCS,86790,Virus antibody nos,,,10.95,32.2,16 HCPCS,86793,Yersinia antibody,,,11.21,32.98,16 HCPCS,86794,Hc Zika Virus Igm Elisa-So+,89.76,35.9,,,0 HCPCS,86794,Zika virus igm antibody,,,8.32,42.12,16 HCPCS,86800,Hc Thyroglobulin Antibody - Anti-Thyroglobulin Ab,196.65,78.66,,,0 HCPCS,86800,Hc Thyroglobulin Antibody 50105-So+,8.1,3.24,,,0 HCPCS,86800,Hc Thyroglobulin Reflex To Ms Or Ia Htgt-So+,256.75,102.7,,,0 HCPCS,86800,Thyroglobulin antibody,,,13.52,39.78,16 HCPCS,86803,Hc 052 Anti Hcv (Kbc)-So+,51.32,20.53,,,0 HCPCS,86803,Hc Client Bill Only - Empath - Hepatitis C Ab Test,4.13,1.65,,,0 HCPCS,86803,Hc Client Bill Only - Esh - Hepatitis C Ab Test,4.13,1.65,,,0 HCPCS,86803,Hc Hepatitis C Ab Test - Hepatitis C Antibody,235.75,94.3,,,0 HCPCS,86803,Hc Res Hep C Ab Ed Gilead Protocol,4.13,1.65,,,0 HCPCS,86803,Hepatitis c ab test,,,12.13,35.68,16 HCPCS,86804,Hep c ab test confirm,,,13.16,38.72,16 HCPCS,86805,Lymphocytotoxicity assay,,,44.44,473.78,16 HCPCS,86806,Lymphocytotoxicity assay,,,40.45,118.98,16 HCPCS,86807,Cytotoxic antibody screening,,,33.63,196.62,16 HCPCS,86807,Hc Mica Antibody #2-So+,171.0,68.4,,,0 HCPCS,86808,Cytotoxic antibody screening,,,25.22,74.2,16 HCPCS,86812,Hla typing a b or c,,,18.4,64.52,16 HCPCS,86813,Hc Hla Type Unit #2-So+,937.2,374.88,,,0 HCPCS,86813,"Hc Hla Typing, A,B,Or C /Multi - Hla A And B Phenotype",898.15,359.26,,,0 HCPCS,86813,Hla typing a b or c,,,49.28,145.0,16 HCPCS,86816,Hla typing dr/dq,,,23.68,75.42,16 HCPCS,86817,Hla typing dr/dq,,,54.72,265.35,16 HCPCS,86821,Lymphocyte culture mixed,,,36.56,93.13,16 HCPCS,86825,Hc Endothelial Cell Flow Cytometry Crossmatch-So+,522.0,208.8,,,0 HCPCS,86825,Hc Hla Flow Crossmatch 1St Serum,961.4,384.56,,,0 HCPCS,86825,Hc Xm One Crossmatch-So+,936.0,374.4,,,0 HCPCS,86825,Hla x-math non-cytotoxic,,,68.26,273.72,16 HCPCS,86826,Hc Hla Flow Crossmatch Addl Serum,325.45,130.18,,,0 HCPCS,86826,Hla x-match noncytotoxc addl,,,22.75,91.32,16 HCPCS,86828,Hc Hla Antibody Screen,824.55,329.82,,,0 HCPCS,86828,Hla class i&ii antibody qual,,,54.4,160.48,16 HCPCS,86829,Hla class i/ii antibody qual,,,40.8,160.48,16 HCPCS,86830,Hla class i phenotype qual,,,95.52,238.8,16 HCPCS,86831,Hc 283 Mica Ab-So+,204.0,81.6,,,0 HCPCS,86831,Hc Mica Antibody #1-So+,171.0,68.4,,,0 HCPCS,86831,Hla class ii phenotype qual,,,81.88,204.7,16 HCPCS,86832,Hc Dsa Ci & Cii Test-Ci Part,993.6,397.44,,,0 HCPCS,86832,Hc Lsa Ci & Cii Test-Ci Part,993.6,397.44,,,0 HCPCS,86832,Hc 399 C1Q Ab-Class I-So+,360.0,144.0,,,0 HCPCS,86832,"Hc Single Antigen Antibody Id, Ci & Cii-So+",441.0,176.4,,,0 HCPCS,86832,Hla class i high defin qual,,,164.67,809.38,16 HCPCS,86833,Hc Dsa Ci & Cii Test-Cii Part,755.55,302.22,,,0 HCPCS,86833,Hc Lsa Ci & Cii Test-Cii Part,755.55,302.22,,,0 HCPCS,86833,Hc 401 C1Q Ab-Class Ii-So+,360.0,144.0,,,0 HCPCS,86833,"Hc Single Antigen Antibody Id, Ci & Cii #2-So+",441.0,176.4,,,0 HCPCS,86833,Hla class ii high defin qual,,,149.7,814.5,16 HCPCS,86834,Hla class i semiquant panel,,,357.56,893.9,16 HCPCS,86835,Hla class ii semiquant panel,,,322.96,807.4,16 HCPCS,86849,Hc Client Bill Only - Cell Isolation-Immunology Procedure,1150.0,460.0,,,0 HCPCS,86849,"Hc Natural Killer Function, Fresh",325.2,130.08,,,0 HCPCS,86849,Immunology procedure,,,0.01,121.0,11 HCPCS,86850,Hc Atypical Antibody Screen,201.34,80.54,,,0 HCPCS,86850,RBC antibody screen,,,7.2,127.23,16 HCPCS,86860,Hc 709 Kbc 320 Ab Elution(Ea)-So+,172.2,68.88,,,0 HCPCS,86860,"Hc Rbc Antibody Elution - Elution & Antibody Identification, Rbc",275.32,110.13,,,0 HCPCS,86860,RBC antibody elution,,,18.3,415.96,9 HCPCS,86870,Hc Rbc Antibody Identification - Antibody Identification,367.5,147.0,,,0 HCPCS,86870,RBC antibody identification,,,15.3,875.15,9 HCPCS,86880,Coombs test direct,,,4.57,144.03,16 HCPCS,86880,Hc Direct Coombs Test,128.56,51.42,,,0 HCPCS,86885,Coombs test indirect qual,,,4.87,415.96,16 HCPCS,86885,"Hc Antihuman Globulin Indir Qual Ea Reagent Cell - Coombs Test, Ind",211.04,84.42,,,0 HCPCS,86886,Coombs test indirect titer,,,4.4,415.96,16 HCPCS,86886,Hc 708 Kbc 319 Ab Titrat(Ea)-So+,172.2,68.88,,,0 HCPCS,86886,Hc Antihuman Globulin Indirect Ea Antibody Titer - Antibody Titer,306.86,122.74,,,0 HCPCS,86890,Autologous blood process,,,41.16,415.96,9 HCPCS,86890,Hc Autologous Blood Procedure And Store,739.85,295.94,,,0 HCPCS,86891,Autologous blood op salvage,,,21.55,1967.07,9 HCPCS,86891,Hc Haemon Cell Saver Procedure,2266.85,906.74,,,0 HCPCS,86900,Blood typing serologic abo,,,2.54,324.84,16 HCPCS,86900,Hc Blood Typing Serologic Abo - Blood Type And Screen,155.25,62.1,,,0 HCPCS,86901,Blood typing serologic rh(d),,,2.54,91.19,16 HCPCS,86901,Hc Blood Typing Serologic Rh (D) - Cord Blood Type,107.95,43.18,,,0 HCPCS,86902,Blood type antigen donor ea,,,3.25,875.15,16 HCPCS,86902,Hc 714 Kbc 330 Ag Surchg(1Ag)-So+,340.09,136.04,,,0 HCPCS,86902,Hc Ag Typing Sur Kbc Ea Un-So+,340.09,136.04,,,0 HCPCS,86902,Hc Ag Typing/Unit Kbc 314-So+,340.09,136.04,,,0 HCPCS,86902,"Hc Blood Type Antigen Donor Reagent Serum Each - Blood Typing, Antigen",412.48,164.99,,,0 HCPCS,86904,Blood typing patient serum,,,8.08,144.03,16 HCPCS,86905,Blood typing rbc antigens,,,3.25,875.15,16 HCPCS,86905,"Hc Blood Typing Rbc Antigens Oth/Thn Abo/Rh D Each - Blood Typing, Rbc",399.03,159.61,,,0 HCPCS,86906,Bld typing serologic rh phnt,,,6.59,91.19,16 HCPCS,86910,Blood typing paternity test,,,15.54,28.0,12 HCPCS,86911,Blood typing antigen system,,,4.38,18.37,5 HCPCS,86920,Compatibility test spin,,,14.52,415.96,9 HCPCS,86920,Hc Crossmatch-Immediate Spin,232.87,93.15,,,0 HCPCS,86921,Compatibility test incubate,,,14.52,415.96,16 HCPCS,86922,Compatibility test antiglob,,,14.52,415.96,16 HCPCS,86922,Hc 713 Kbc 324 Compat(Ea)-So+,172.2,68.88,,,0 HCPCS,86922,Hc Crossmatch-Antiglobulin,257.13,102.85,,,0 HCPCS,86923,Compatibility test electric,,,14.52,415.96,9 HCPCS,86923,Hc Crossmatch-Electronic,208.61,83.44,,,0 HCPCS,86927,Hc Fresh Frozen Plasma Thawing,259.55,103.82,,,0 HCPCS,86927,Plasma fresh frozen,,,5.94,415.96,16 HCPCS,86930,Frozen blood prep,,,14.52,415.96,9 HCPCS,86930,Hc 720 Kbc 436 Freezing-So+,340.09,136.04,,,0 HCPCS,86930,Hc Kbc Freezing-So+,340.09,136.04,,,0 HCPCS,86931,Frozen blood thaw,,,21.9,415.96,9 HCPCS,86932,Frozen blood freeze/thaw,,,29.04,91.19,9 HCPCS,86940,Hemolysins/agglutinins auto,,,6.97,21.92,16 HCPCS,86941,Hemolysins/agglutinins,,,10.29,30.28,16 HCPCS,86945,Blood product/irradiation,,,7.14,91.19,9 HCPCS,86945,Hc Blood Irradiation,275.32,110.13,,,0 HCPCS,86945,Hc Blood Irradiation #2-So+,272.0,108.8,,,0 HCPCS,86950,Leukacyte transfusion,,,19.38,415.96,9 HCPCS,86960,Hc Volume Reduced Platelets,311.71,124.68,,,0 HCPCS,86960,Vol reduction of blood/prod,,,14.76,415.96,9 HCPCS,86965,Hc Pooling Of Blood Products,265.62,106.25,,,0 HCPCS,86965,Pooling blood platelets,,,14.76,415.96,9 HCPCS,86970,Hc 712 Kbc 322 Red Cell Treat-So+,120.0,48.0,,,0 HCPCS,86970,Hc Pretreatment Of Rbc,327.47,130.99,,,0 HCPCS,86970,Rbc pretx incubatj w/chemicl,,,9.72,144.03,9 HCPCS,86971,Rbc pretx incubatj w/enzymes,,,9.72,415.96,9 HCPCS,86972,Hc 715 Kbc 339 Cell Separatn-So+,172.2,68.88,,,0 HCPCS,86972,Rbc pretx incubatj w/density,,,11.88,415.96,9 HCPCS,86975,Rbc serum pretx incubj drugs,,,9.72,1090.68,9 HCPCS,86976,Rbc serum pretx id dilution,,,9.72,70.62,9 HCPCS,86977,Hc 711 Kbc 321 Ab Neutral(Ea)-So+,172.2,68.88,,,0 HCPCS,86977,Rbc serum pretx incubj/inhib,,,9.72,415.96,16 HCPCS,86978,Hc Auto Ab Adsorption Warm Each,309.28,123.71,,,0 HCPCS,86978,Hc Auto Abdy Adsorption Cold Each,309.28,123.71,,,0 HCPCS,86978,Rbc pretreatment serum,,,11.88,144.03,9 HCPCS,86985,Hc Splitting Blood Product,211.04,84.42,,,0 HCPCS,86985,Split blood or products,,,3.84,415.96,9 HCPCS,86999,Hc Res Crsp-Onc-001 Phase 1,727.72,291.09,,,0 HCPCS,86999,Transfusion procedure,,,0.01,70.62,9 HCPCS,87003,Small animal inoculation,,,14.3,42.1,16 HCPCS,87015,Hc Concentration For Infect Agent,89.34,35.74,,,0 HCPCS,87015,Specimen infect agnt concntj,,,3.82,16.7,16 HCPCS,87040,Blood culture for bacteria,,,8.77,25.8,16 HCPCS,87040,Hc Blood Culture,210.85,84.34,,,0 HCPCS,87045,Feces culture aerobic bact,,,7.91,23.6,16 HCPCS,87046,"Hc Stool Culture, Addl Pathogens - Campylobacter Culture, Stool",126.27,50.51,,,0 HCPCS,87046,Stool cultr aerobic bact ea,,,7.91,23.6,16 HCPCS,87070,Culture othr specimn aerobic,,,7.32,21.55,16 HCPCS,87070,Hc Bone Marrow Culture And Gram Stain,210.85,84.34,,,0 HCPCS,87070,Hc Bronchial Culture,210.85,84.34,,,0 HCPCS,87070,Hc Client Bill Only Ipac - Multi-Drug Resistance Test,210.85,84.34,,,0 HCPCS,87070,Hc Csf Culture,210.85,84.34,,,0 HCPCS,87070,Hc Genital Cultures,210.85,84.34,,,0 HCPCS,87070,Hc Protected Bronch Brush Cult,236.16,94.46,,,0 HCPCS,87070,Hc Rectal Scrn Fluoro Resistance,210.85,84.34,,,0 HCPCS,87070,Hc Respiratory Culture Cf*,210.85,84.34,,,0 HCPCS,87070,Hc Respiratory Cultures,210.85,84.34,,,0 HCPCS,87070,Hc Routine Culture,210.85,84.34,,,0 HCPCS,87070,Hc Wound Cultures,210.85,84.34,,,0 HCPCS,87071,Culture aerobic quant other,,,7.91,24.72,16 HCPCS,87071,Hc Endoscope Surveillance Culture,263.27,105.31,,,0 HCPCS,87071,Hc Quant Bronch Brush Culture And Gram Stain,263.27,105.31,,,0 HCPCS,87071,Hc Quantitative Bal/Pal Bronch Wash Cult And Gs,263.27,105.31,,,0 HCPCS,87071,Hc Quantitative Duodenal Culture,263.27,105.31,,,0 HCPCS,87073,Culture Bacteria Anaerobic,,,7.91,24.15,16 HCPCS,87075,Cultr bacteria except blood,,,8.04,23.68,16 HCPCS,87075,Hc Anaerobic Culture,264.46,105.78,,,0 HCPCS,87076,Culture anaerobe ident each,,,6.87,20.2,16 HCPCS,87076,Hc Anaerobic Culture Isolate Id,148.91,59.56,,,0 HCPCS,87077,Culture Aerobic Identify,,,6.87,20.2,16 HCPCS,87077,Hc Bacteria Id H.Pylori-So+,53.76,21.5,,,0 HCPCS,87077,"Hc Bacteria Identification, Aerobic Isolate - Organism Id Culture",119.13,47.65,,,0 HCPCS,87077,"Hc Client Bill Only Ipac - Bacteria Id, Aerobic Isolate-Organism Id Culture",93.23,37.29,,,0 HCPCS,87077,Hc H. Pylori Reflex Test Mayo Gid-So+,53.76,21.5,,,0 HCPCS,87081,Culture screen only,,,5.63,16.58,16 HCPCS,87081,Hc 347 Acanthamoeba Cult-So+,17.22,6.89,,,0 HCPCS,87081,Hc Client Bill Only Ipac - Culture Bacteria Screen 2,82.87,33.15,,,0 HCPCS,87081,Hc Culture Bacteria Screen,95.3,38.12,,,0 HCPCS,87081,Hc Helicobacter Pylori Culture-So+,82.2,32.88,,,0 HCPCS,87084,Culture of specimen by kit,,,7.32,67.68,16 HCPCS,87086,Hc Urine Culture Qnt Cc,106.14,42.455,,,0 HCPCS,87086,Urine culture/colony count,,,6.86,20.18,16 HCPCS,87088,Hc Urine Bacteria Culture,131.04,52.42,,,0 HCPCS,87088,Urine bacteria culture,,,6.88,20.22,16 HCPCS,87101,"Hc Culture Fungi-Skin Hair Nails - Fungal Culture, Cutaneous",212.04,84.82,,,0 HCPCS,87101,Skin fungi culture,,,6.56,19.28,16 HCPCS,87102,Fungus isolation culture,,,7.14,21.02,16 HCPCS,87102,Hc 586 Fungal Cx Isol-So+,30.23,12.09,,,0 HCPCS,87102,Hc Candida Panel Pcr 6351 #2-So+,29.14,11.66,,,0 HCPCS,87102,Hc Mycolog Culture Fluid/Tiss/Res,264.46,105.78,,,0 HCPCS,87103,Blood fungus culture,,,7.66,51.15,16 HCPCS,87103,Hc Mycological Culture Blood,276.37,110.55,,,0 HCPCS,87106,Fungi identification yeast,,,7.62,25.8,16 HCPCS,87106,Hc 586 Yeast Def Id Ea Isolat-So+,32.26,12.9,,,0 HCPCS,87106,Hc Candida Panel Pcr 6351 #3-So+,29.14,11.66,,,0 HCPCS,87106,Hc Client Bill Only Ipac - Fungus Exoantigen 2,146.06,58.42,,,0 HCPCS,87106,Hc Fungus Exoantigen,167.97,67.19,,,0 HCPCS,87107,Fungi identification mold,,,7.62,25.8,16 HCPCS,87107,"Hc Fungus Identification, Mold - Fungal Identification, Mold",157.25,62.9,,,0 HCPCS,87109,Hc 378 Ureoplasma Cx Arup-So+,55.33,22.13,,,0 HCPCS,87109,Hc Mycoplasma Culture - Mycoplasma / Ureaplasma Culture,45.99,18.4,,,0 HCPCS,87109,Mycoplasma,,,13.07,38.48,16 HCPCS,87110,Chlamydia culture,,,16.65,49.0,16 HCPCS,87110,"Hc Culture, Chlamydia Trachomatis 60850 #1-So+",31.05,12.42,,,0 HCPCS,87116,Hc Tb Culture Acid Fast,263.27,105.31,,,0 HCPCS,87116,Mycobacteria culture,,,9.18,27.0,16 HCPCS,87118,Hc Mycobacteria Identification - Mycobacteria Identification,341.89,136.76,,,0 HCPCS,87118,Mycobacteric identification,,,7.62,36.52,16 HCPCS,87140,Culture type immunofluoresc,,,3.03,13.92,16 HCPCS,87140,"Hc Culture, Chlamydia Trachomatis 60850 #2-So+",85.0,34.0,,,0 HCPCS,87140,Hc Reflex Herpes Simplex Virus (Hsv) Typing 2013897-So+,23.1,9.24,,,0 HCPCS,87143,Culture typing glc/hplc,,,10.65,31.3,16 HCPCS,87147,Culture type immunologic,,,4.4,12.95,16 HCPCS,87147,Hc Client Bill Only Ipac - Cult Typing Immunologic,81.83,32.73,,,0 HCPCS,87147,Hc Cult Typing Immunologic,94.11,37.64,,,0 HCPCS,87149,Dna/rna direct probe,,,16.76,50.12,16 HCPCS,87149,Hc Gram-Negative Bld Cult Pcr,377.63,151.05,,,0 HCPCS,87150,Dna/rna amplified probe,,,29.83,87.72,16 HCPCS,87150,Hc H. Pylori Reflex Test Mayo Hpcr1-So+,558.0,223.2,,,0 HCPCS,87150,Hc H.Pylori+Clarithro Resistance Pcr-So+,585.96,234.38,,,0 HCPCS,87152,Culture Type Pulse Field Gel,,,4.44,19.35,16 HCPCS,87153,Dna/rna sequencing,,,98.03,288.4,16 HCPCS,87153,Hc Aerobe Id By Sequencing H.Pylori-So+,136.8,54.72,,,0 HCPCS,87153,Hc Bill Only Ut Tyler 87153 Identification Partial Sequencing Each-So+,360.0,144.0,,,0 HCPCS,87153,Hc H. Pylori Reflex Test Mayo Isae-So+,414.85,165.94,,,0 HCPCS,87154,Cul typ id bld pthgn 6+ trgt,,,87.22,545.15,16 HCPCS,87154,Hc Bacterial Id Gram Negative Blood,446.72,178.69,,,0 HCPCS,87154,Hc Bacterial Id Gram Positive Blood,446.72,178.69,,,0 HCPCS,87154,Hc Biofire Blood Culture Panel By Pcr,446.72,178.69,,,0 HCPCS,87154,Hc Fungal Id Blood Panel,446.72,178.69,,,0 HCPCS,87158,Culture typing added method,,,4.44,19.35,16 HCPCS,87164,Dark field examination,,,6.28,26.85,16 HCPCS,87166,Dark field examination,,,6.28,28.25,16 HCPCS,87168,Hc Arthropod Id,95.3,38.12,,,0 HCPCS,87168,Macroscopic Exam Arthropod,,,3.05,10.68,16 HCPCS,87169,"Hc Macroscopic Exam, Parasite - Parasite Identification",35.74,14.3,,,0 HCPCS,87169,Macroscopic exam parasite,,,3.05,10.78,16 HCPCS,87172,Hc Pinworm Exam - Pinworm Prep,72.67,29.07,,,0 HCPCS,87172,Pinworm Exam,,,3.05,10.68,16 HCPCS,87176,Hc H. Pylori Reflex Test Mayo Tissr-So+,16.8,6.72,,,0 HCPCS,87176,Hc Homogenization Of Tissue,90.54,36.22,,,0 HCPCS,87176,Hc Tissue Processing (H.Pylori)-So+,16.8,6.72,,,0 HCPCS,87176,Tissue homogenization cultr,,,3.82,14.7,16 HCPCS,87177,"Hc Cryptosporidium And Coccidia Exam, Fecal 60046-So+",12.6,5.04,,,0 HCPCS,87177,"Hc Ova And Parasite, Fecal 301662 #1-So+",14.4,5.76,,,0 HCPCS,87177,Hc Ova And Parasites Smears - Ova And Parasite Examination,13.05,5.22,,,0 HCPCS,87177,Ova and parasites smears,,,7.42,22.25,16 HCPCS,87181,Hc Client Bill Only Ipac - Susceptibility Manual,73.55,29.42,,,0 HCPCS,87181,Hc H. Pylori Reflex Test Mayo Sus-So+,82.2,32.88,,,0 HCPCS,87181,Hc Susceptibility (H.Pylori)-So+,40.32,16.13,,,0 HCPCS,87181,Hc Susceptibility Manual,84.58,33.83,,,0 HCPCS,87181,Microbe susceptible diffuse,,,0.76,11.88,16 HCPCS,87183,Sc std carbapenem resist gen,,,35.09,87.72,5 HCPCS,87184,"Hc Antibiotic Sens,Disk,Each - Susceptibility Charge",120.32,48.13,,,0 HCPCS,87184,"Hc Client Bill Only Ipac - Antibiotic Sens, Disk, Each - Susceptibility",52.31,20.92,,,0 HCPCS,87184,Microbe susceptible disk,,,5.87,18.7,16 HCPCS,87185,Hc Beta-Lactamase Test,60.75,24.3,,,0 HCPCS,87185,Hc Carba-5 Carbapenemase Detection,52.83,21.13,,,0 HCPCS,87185,Hc Client Bill Only Ipac - Beta-Lactamase Test,52.83,21.13,,,0 HCPCS,87185,Hc Mdrt - Carba-5 Carbapenemase Detection,52.83,21.13,,,0 HCPCS,87185,Microbe susceptible enzyme,,,0.76,11.88,16 HCPCS,87186,Hc 586 Suscept Ea Agt/Plate-So+,31.1,12.44,,,0 HCPCS,87186,"Hc Antibiotic Sens,Mic,Each - Susceptibility Charge",210.85,84.34,,,0 HCPCS,87186,Hc Candida Panel Pcr 6351 #4-So+,29.14,11.66,,,0 HCPCS,87186,"Hc Client Bill Only Ipac - Antibiotic Sens, Mic, Each; Susceptibility Charge",183.35,73.34,,,0 HCPCS,87186,Hc H. Pylori Reflex Test Mayo Mic-So+,78.49,31.4,,,0 HCPCS,87186,Hc National Jewish 87186 Micsd-So+,120.0,48.0,,,0 HCPCS,87186,Hc National Jewish 87186 Micsd1-So+,127.2,50.88,,,0 HCPCS,87186,Hc National Jewish 87186 Ntm13-So+,429.6,171.84,,,0 HCPCS,87186,Hc National Jewish 87186 Ntm9-So+,128.4,51.36,,,0 HCPCS,87186,Hc National Jewish 87186 Ntmp5-So+,404.4,161.76,,,0 HCPCS,87186,Hc National Jewish 87186 Ntmp6-So+,558.0,223.2,,,0 HCPCS,87186,Hc National Jewish 87186 Ntmp9-So+,120.0,48.0,,,0 HCPCS,87186,Hc Susceptibility Mic (H.Pylori)-So+,78.49,31.4,,,0 HCPCS,87186,Hc Texas Health San Antonio 87186-So+,78.0,31.2,,,0 HCPCS,87186,Hc Ut Tyler 87186 Panel-So+,360.0,144.0,,,0 HCPCS,87186,Hc Ut Tyler 87186 Special Mic Per Drug-So+,420.0,168.0,,,0 HCPCS,87186,Microbe susceptible mic,,,7.35,21.62,16 HCPCS,87187,Microbe susceptible mlc,,,7.35,100.42,16 HCPCS,87188,Hc 383 Mycobac Susc Each Jmc-So+,63.16,25.26,,,0 HCPCS,87188,Hc National Jewish 87188 Macsd-So+,42.0,16.8,,,0 HCPCS,87188,Hc National Jewish 87188 Mictb6-So+,120.0,48.0,,,0 HCPCS,87188,Hc Texas Health San Antonio 87188-So+,78.0,31.2,,,0 HCPCS,87188,Microbe suscept macrobroth,,,5.64,16.6,16 HCPCS,87190,Microbe suscept mycobacteri,,,3.46,18.28,16 HCPCS,87197,Bactericidal level serum,,,12.77,37.55,16 HCPCS,87205,Hc Gram Stain Smear,114.36,45.74,,,0 HCPCS,87205,Smear gram stain,,,3.63,10.68,16 HCPCS,87206,"Hc Smear,Fluor Stain,Interp - Afb Stain",164.39,65.76,,,0 HCPCS,87206,"Hc Smear,Fluor Stain,Interp - Fungal Stain",164.39,65.76,,,0 HCPCS,87206,Smear fluorescent/acid stai,,,4.57,13.48,16 HCPCS,87207,Hc 076 Microsporidia Ex-So+,12.6,5.04,,,0 HCPCS,87207,"Hc Cryptosporidium And Coccidia Exam, Fecal 60046 #2-So+",12.6,5.04,,,0 HCPCS,87207,"Hc Smear,Inclusion Bodies/Parasites,Interp - Malaria Smear",210.85,84.34,,,0 HCPCS,87207,Smear special stain,,,5.09,14.98,16 HCPCS,87209,"Hc Ova And Parasite, Fecal 3001662 #2-So+",21.58,8.63,,,0 HCPCS,87209,Smear complex stain,,,15.28,44.95,16 HCPCS,87210,"Hc Smear,Stain,Wet Mnt,Interp",94.11,37.64,,,0 HCPCS,87210,Smear wet mount saline/ink,,,3.05,14.55,16 HCPCS,87220,Hc Tissue Exam By Koh - Koh Prep,100.07,40.03,,,0 HCPCS,87220,Tissue exam for fungi,,,3.63,10.68,16 HCPCS,87230,Assay toxin or antitoxin,,,16.78,49.35,16 HCPCS,87250,Virus inoculate eggs/animal,,,16.62,48.9,16 HCPCS,87252,Hc Unknown Virus Evaluation,399.07,159.63,,,0 HCPCS,87252,"Hc Viral Culture, Non-Respiratory-So+",52.8,21.12,,,0 HCPCS,87252,"Hc Viral Culture, Respiratory2006499-So+",66.0,26.4,,,0 HCPCS,87252,Virus inoculation tissue,,,22.15,65.18,16 HCPCS,87253,"Hc Viral Culture, Reflex Id 2006696-So+",52.5,21.0,,,0 HCPCS,87253,Virus inoculate tissue addl,,,17.17,50.5,16 HCPCS,87254,Hc Shell Vial W/Immunofluor Stain,228.72,91.49,,,0 HCPCS,87254,Virus inoculation shell via,,,16.62,48.9,16 HCPCS,87255,Genet virus isolate hsv,,,28.78,84.65,16 HCPCS,87255,Hc Herpes Simplex Virus Culture With Reflex To Hsv Typing 65065-So+,40.63,16.25,,,0 HCPCS,87260,Adenovirus ag if,,,9.73,36.08,16 HCPCS,87260,"Hc Inf Agent, Fluor, Adenovirus - Respiratory Virus Antigens Panel",364.53,145.81,,,0 HCPCS,87265,Pertussis ag if,,,9.73,29.95,16 HCPCS,87267,Enterovirus antibody dfa,,,9.73,33.55,16 HCPCS,87269,Giardia ag if,,,9.73,34.02,16 HCPCS,87270,Chlamydia trachomatis ag if,,,9.73,29.95,16 HCPCS,87271,Cytomegalovirus dfa,,,9.73,33.55,16 HCPCS,87272,Cryptosporidium ag if,,,9.73,29.95,16 HCPCS,87272,Hc Cryptosporidium By Fa,200.13,80.05,,,0 HCPCS,87273,Herpes simplex 2 ag if,,,9.73,29.95,16 HCPCS,87274,Herpes simplex 1 ag if,,,9.73,29.95,16 HCPCS,87275,Influenza b ag if,,,9.73,30.62,16 HCPCS,87276,Influenza a ag if,,,9.73,40.18,16 HCPCS,87278,Legion pneumophilia ag if,,,9.73,39.0,16 HCPCS,87279,Parainfluenza ag if,,,9.73,41.08,16 HCPCS,87280,Respiratory syncytial ag if,,,9.73,33.55,16 HCPCS,87281,Pneumocystis carinii ag if,,,9.73,29.95,16 HCPCS,87283,Rubeola ag if,,,9.73,152.0,16 HCPCS,87285,Hc Rpr With Reflex To Quant Rpr And Confirmatory Treponema Pallidum Abs(So),156.05,62.42,,,0 HCPCS,87285,"Hc Trepon Pallidum Ag, Dfa - Treponema Pallidum (Syphilis)",156.05,62.42,,,0 HCPCS,87285,Treponema pallidum ag if,,,9.73,30.45,16 HCPCS,87290,Varicella zoster ag if,,,9.73,33.55,16 HCPCS,87299,Antibody detection nos if,,,9.73,40.25,16 HCPCS,87300,Ag detection polyval if,,,9.73,29.95,16 HCPCS,87301,Adenovirus ag ia,,,9.73,29.95,16 HCPCS,87305,Aspergillus ag ia,,,9.73,29.95,16 HCPCS,87305,Hc 589 Aspergillus Galc Ag Sr-So+,142.43,56.97,,,0 HCPCS,87305,Hc 654 Aspergillus Galact Eia-So+,142.43,56.97,,,0 HCPCS,87320,Chylmd trach ag ia,,,9.73,37.5,16 HCPCS,87324,Clostridium ag ia,,,9.73,29.95,16 HCPCS,87324,Hc Iaad Ia Clostridium Difficile Toxin - C. Difficile Toxins (By Eia),208.47,83.39,,,0 HCPCS,87327,Cryptococcus neoform ag ia,,,9.73,33.55,16 HCPCS,87328,Cryptosporidium ag ia,,,9.73,34.55,16 HCPCS,87328,Hc Cryptosporidium Antigen By Eia60045-So+,18.0,7.2,,,0 HCPCS,87329,Giardia ag ia,,,9.73,29.95,16 HCPCS,87332,Cytomegalovirus ag ia,,,9.73,29.95,16 HCPCS,87335,E coli 0157 ag ia,,,9.73,31.65,16 HCPCS,87336,Entamoeb hist dispr ag ia,,,9.73,40.0,16 HCPCS,87337,Entamoeb hist group ag ia,,,9.73,29.95,16 HCPCS,87337,Hc 026 Entamoeba Ag-Soq+,54.69,21.88,,,0 HCPCS,87338,Hc Iaad Ia Hpylori Stool - H Pylori Antigen Stool,240.63,96.25,,,0 HCPCS,87338,Hpylori stool ia,,,12.22,35.95,16 HCPCS,87339,H pylori ag ia,,,9.73,40.0,16 HCPCS,87340,Hc 058 Hbsag Cdvr-So+,37.14,14.86,,,0 HCPCS,87340,Hc Client Bill Only - Empath - Hbsag,12.43,4.97,,,0 HCPCS,87340,Hc Client Bill Only - Esh - Hbsag,12.43,4.97,,,0 HCPCS,87340,Hc Hbsag,158.44,63.38,,,0 HCPCS,87340,Hc Hepatitis B Virus Surface Antigen With Reflex To Confirmation 20089-So+,12.4,4.96,,,0 HCPCS,87340,Hc Iaad Ia Hepatitis B Surface Antigen - Hepatitis B Surface Antigen,158.44,63.38,,,0 HCPCS,87340,Hepatitis b surface ag ia,,,8.78,25.82,16 HCPCS,87341,Hc Hepatitis B Surface Antigen Co,237.06,94.82,,,0 HCPCS,87341,"Hc Hepatitis B Virus Surface Antigen, Confirmation 20128-So+",41.88,16.75,,,0 HCPCS,87341,Hepatitis b surface ag ia,,,8.78,25.82,16 HCPCS,87350,Hc 115 Hepatitis Be Ag-So+,41.45,16.58,,,0 HCPCS,87350,Hepatitis be ag ia,,,9.79,28.82,16 HCPCS,87380,"Hc Iaad Ia Hepatitis Delta Antigen - Hepatitis Delta Virus Antigen, Eia",100.21,40.08,,,0 HCPCS,87380,Hepatitis delta ag ia,,,13.95,45.9,16 HCPCS,87385,Hc 371 Histoplasma Ag-So+,129.6,51.84,,,0 HCPCS,87385,Hc 490 Histoplasma Urine Ag-So+,132.0,52.8,,,0 HCPCS,87385,Hc Histoplasma Galactomannan Eia-So+,108.0,43.2,,,0 HCPCS,87385,Histoplasma capsul ag ia,,,9.73,33.12,16 HCPCS,87389,Hc 418 Hiv-1 Ag W/Comb 1&2 Ab,49.39,19.76,,,0 HCPCS,87389,Hc Hiv Antigen/Antibody Screen Stat-So+,340.8,136.32,,,0 HCPCS,87389,"Hc Hiv-1,2 Combo Ag/Ab, W/Rflx 2013333-So+",25.2,10.08,,,0 HCPCS,87389,Hiv-1 ag w/hiv-1 & hiv-2 ab,,,20.47,60.2,16 HCPCS,87390,Hiv-1 ag ia,,,14.99,60.15,16 HCPCS,87391,Hiv-2 ag ia,,,14.99,54.75,16 HCPCS,87400,Influenza a/b ag ia,,,9.73,35.32,16 HCPCS,87420,Resp syncytial ag ia,,,9.73,34.78,16 HCPCS,87425,Rotavirus ag ia,,,9.73,29.95,16 HCPCS,87426,Coronavirus ag ia,,,14.13,88.32,16 HCPCS,87427,Shiga-like toxin ag ia,,,9.73,29.95,16 HCPCS,87428,Sarscov & inf vir a&b ag ia,,,28.12,175.72,16 HCPCS,87430,Strep a ag ia,,,9.73,42.02,16 HCPCS,87449,Ag detect nos ia mult,,,9.73,29.95,16 HCPCS,87449,"Hc 054 Iaad Ia Mult Step Method Nos Each Organism - Legionella Antigen, Ur-So+",195.0,78.0,,,0 HCPCS,87449,Hc 321 Beta-D Glucan-So+,142.43,56.97,,,0 HCPCS,87449,Hc 323 Coccidioides Ag-So+,129.6,51.84,,,0 HCPCS,87449,Hc 395 Blastomyces Ag Mirav-So+,129.6,51.84,,,0 HCPCS,87449,Hc Coccidioides Antigen Quantitative By Eia 2011075-So+,152.4,60.96,,,0 HCPCS,87449,"Hc Iaad Ia Mult Step Method Nos Each Organism - Legionella Or Strep Pneumo Antigen, Ur",232.3,92.92,,,0 HCPCS,87450,Ag detect nos ia single,,,6.37,6.37,4 HCPCS,87451,Ag detect polyval ia mult,,,6.37,26.28,16 HCPCS,87467,"Hc Hepatitis B Surface Antigen, Quantitative, Monitor 007130-So+",312.0,124.8,,,0 HCPCS,87467,Hepatitis b surface ag quan,,,6.02,63.3,16 HCPCS,87468,Anaplsma phgcytophlm amp prb,,,14.04,87.72,16 HCPCS,87468,Hc Anaplasma Phagocytophilum-So+,37.5,15.0,,,0 HCPCS,87469,Babesia microti amp prb,,,14.04,87.72,16 HCPCS,87469,Hc Babesia Species By Pcr 2008665-So+,87.0,34.8,,,0 HCPCS,87471,Bartonella dna amp probe,,,29.83,87.72,16 HCPCS,87471,Hc 353 Bartonella Pcr Qlt-So+,156.0,62.4,,,0 HCPCS,87472,Bartonella dna quant,,,36.4,107.1,16 HCPCS,87475,Lyme dis dna dir probe,,,16.76,50.12,16 HCPCS,87476,Hc Borrelia Species By Pcr (Lyme Disease) 55570-So+,82.8,33.12,,,0 HCPCS,87476,Lyme dis dna amp probe,,,29.83,87.72,16 HCPCS,87478,Borrelia miyamotoi amp prb,,,14.04,87.72,16 HCPCS,87480,Candida dna dir probe,,,16.76,50.12,16 HCPCS,87481,Candida dna amp probe,,,29.83,87.72,16 HCPCS,87481,Hc Candida Panel Pcr 6351 #1-So+,42.11,16.84,,,0 HCPCS,87481,"Hc Client Bill Only Ipac - Canida Species, Amplified Probe Technique",51.79,20.72,,,0 HCPCS,87482,Candida dna quant,,,35.48,139.35,16 HCPCS,87483,Cns dna amp probe type 12-25,,,416.78,1041.95,16 HCPCS,87483,Hc Meningitis/Encph Pcr 12-25 Tgt,1072.13,428.85,,,0 HCPCS,87484,Ehrlicha chaffeensis amp prb,,,14.04,87.72,16 HCPCS,87484,Hc Ehrlichia And Anaplasma Species By Pcr-So+,37.5,15.0,,,0 HCPCS,87485,Chylmd pneum dna dir probe,,,16.76,50.12,16 HCPCS,87486,Chylmd pneum dna amp probe,,,29.83,87.72,16 HCPCS,87486,"Hc 386 Chylmd Pneum, Dna, Amp Probe - Chlamydia Pneumoniae Dna Probe, Amp-So+",178.2,71.28,,,0 HCPCS,87486,"Hc Chylmd Pneum, Dna, Amp Probe - Chlamydia Pneumoniae Dna Probe, Amp",301.39,120.56,,,0 HCPCS,87486,Hc Ipac Np Respiratory Pcr Chlamydia Pneumo,301.39,120.56,,,0 HCPCS,87487,Chylmd pneum dna quant,,,36.4,107.1,16 HCPCS,87490,Chylmd trach dna dir probe,,,16.76,56.88,16 HCPCS,87491,Chylmd trach dna amp probe,,,29.83,87.72,16 HCPCS,87491,Hc 985 Chlamydia Trach Pcr-So+,228.0,91.2,,,0 HCPCS,87491,Hc Chlamydia Trachomatis And Neisseria Gonorrhoeae (Ctng) By Transcription-Mediated Amplification (T,43.62,17.45,,,0 HCPCS,87491,"Hc Chylmd Trach, Dna, Amp Probe",294.24,117.7,,,0 HCPCS,87491,Hc Reflex Chlamydia Trachomatis Confirmation By Tma 3000300-So+,42.11,16.84,,,0 HCPCS,87492,Chylmd trach dna quant,,,29.71,133.68,16 HCPCS,87493,C diff amplified probe,,,29.83,93.18,16 HCPCS,87493,Hc Clostridium Difficile Pcr,333.55,133.42,,,0 HCPCS,87494,Chlmy trch&neisra gonor mult,,,70.18,175.45,5 HCPCS,87495,Cytomeg dna dir probe,,,16.76,75.08,16 HCPCS,87496,Cytomeg dna amp probe,,,29.83,87.72,16 HCPCS,87496,Hc 367 Cmv Dna Pcr Arup-So+,129.47,51.79,,,0 HCPCS,87496,"Hc Congenital Cytomegalovirus Pcr, Urine",355.31,142.12,,,0 HCPCS,87497,Cytomeg dna quant,,,36.4,107.1,16 HCPCS,87497,Hc 588 Cmv Pcr Qnt-So+,129.47,51.79,,,0 HCPCS,87497,Hc 919 Cmv Qnt Dna-So+,129.47,51.79,,,0 HCPCS,87497,"Hc Cmv Pcr, Aqueous Fluid-So+",129.47,51.79,,,0 HCPCS,87497,"Hc Cmv Pcr, Vitreous Fluid-So+",129.47,51.79,,,0 HCPCS,87497,"Hc Cytomeg, Dna, Quant - Cmv Dna, Quantitative, Pcr",464.59,185.84,,,0 HCPCS,87498,Enterovirus probe&revrs trns,,,29.83,87.72,16 HCPCS,87498,Hc 325 Enterovirus Pcr-So+,357.6,143.04,,,0 HCPCS,87498,Hc 343 Enterovirus By Rt Pcr-So+,102.0,40.8,,,0 HCPCS,87498,Hc 501 Enterovirus Pcr-So+,150.0,60.0,,,0 HCPCS,87500,Vanomycin dna amp probe,,,29.83,87.72,16 HCPCS,87501,Influenza dna amp prob 1+,,,43.61,128.28,16 HCPCS,87502,"Hc Influenza A & B, Rapid By Naat 2012778-So+",144.0,57.6,,,0 HCPCS,87502,Hc Influenza A/B,364.53,145.81,,,0 HCPCS,87502,Influenza dna amp probe,,,72.31,239.5,16 HCPCS,87503,Influenza dna amp prob addl,,,17.65,73.05,16 HCPCS,87505,Nfct agent detection gi,,,128.29,320.72,16 HCPCS,87506,Iadna-dna/rna probe tq 6-11,,,262.99,657.48,16 HCPCS,87507,"Hc, Iadna-Dna/Rna Probe Tq 12-25 - Gastrointestinal Panel",1804.76,721.9,,,0 HCPCS,87507,Iadna-dna/rna probe tq 12-25,,,416.78,1041.95,16 HCPCS,87510,Gardner vag dna dir probe,,,16.76,50.12,16 HCPCS,87511,Gardner vag dna amp probe,,,29.83,87.72,16 HCPCS,87511,Hc 587 Gardner Vag Amp Prb-So+,69.47,27.79,,,0 HCPCS,87512,Gardner vag dna quant,,,35.48,104.4,16 HCPCS,87512,Hc Bacterial Vaginosis & Aerobic Vaginitis Panel 7001 #4-So+,50.11,20.04,,,0 HCPCS,87513,H pylri clrthmcn rst amp prb,,,14.04,87.72,16 HCPCS,87516,"Hc Elite Hiv-1/2, Hcv, Hbv Nat Vira #1-So+",40.32,16.13,,,0 HCPCS,87516,Hepatitis b dna amp probe,,,29.83,87.72,16 HCPCS,87517,"Hc Hepatitis B , Dna, Quant - Hepatitis B Dna, Ultraquantitative, Pcr",321.64,128.66,,,0 HCPCS,87517,Hepatitis b dna quant,,,36.4,107.1,16 HCPCS,87520,Hepatitis c rna dir probe,,,16.76,78.05,16 HCPCS,87521,Hc 670 Hcv Ngi Qual-So+,498.91,199.56,,,0 HCPCS,87521,"Hc Ultrio Elite Hiv-1/2, Hcv, Hbv Nat Vira #2-So+",51.79,20.72,,,0 HCPCS,87521,Hepatitis c probe&rvrs trnsc,,,29.83,87.72,16 HCPCS,87522,Hc Client Bill Only - Esh - Hepatitis C Quant & Reverse Transcription,78.47,31.39,,,0 HCPCS,87522,Hc Iadna Hepatitis C Quant & Reverse Transcription - Hcv Quant Pcr,721.9,288.76,,,0 HCPCS,87522,Hc Res Hepatitis C Quant Pcr-Ed Gilead Protocol,78.5,31.4,,,0 HCPCS,87522,Hepatitis c revrs trnscrpj,,,36.4,107.1,16 HCPCS,87523,Hc Hepatitis D By Quantitative Pcr 2013881-So+,270.0,108.0,,,0 HCPCS,87523,Hepatitis d quantification,,,17.14,107.1,16 HCPCS,87525,Hepatitis g dna dir probe,,,16.76,74.5,16 HCPCS,87526,Hepatitis g dna amp probe,,,29.83,98.15,16 HCPCS,87527,Hepatitis g dna quant,,,35.48,104.4,16 HCPCS,87528,Hsv dna dir probe,,,16.76,50.12,16 HCPCS,87529,Hc Herpes Simplex Virus 1 & 2 (Hsv-1 & Hsv-2) Quantitative Real-Time Pcr Conjunctival Swab 8527-So+,113.3,45.32,,,0 HCPCS,87529,"Hc Hsv, Dna, Amp Probe - Hsv Pcr",363.33,145.33,,,0 HCPCS,87529,Hsv dna amp probe,,,29.83,87.72,16 HCPCS,87530,Hc 135 Hsv 1 Qnt Pcr Plasma-So+,113.3,45.32,,,0 HCPCS,87530,Hc 135 Hsv 2 Qnt Pcr Plasma-So+,113.3,45.32,,,0 HCPCS,87530,Hc 527 Hsv 1 Qnt Pcr Urn-So+,154.04,61.62,,,0 HCPCS,87530,Hc 527 Hsv 2 Qnt Pcr Urn-So+,154.04,61.62,,,0 HCPCS,87530,Hc 829 Hsv 1/2 Qnt Pcr Bal-So+,214.42,85.77,,,0 HCPCS,87530,Hc Hsv-1 Aqueous Fluid-So+,113.3,45.32,,,0 HCPCS,87530,Hc Hsv-1 Vitreous Fluid-So+,113.3,45.32,,,0 HCPCS,87530,Hc Hsv-2 Aqueous Fluid-So+,113.3,45.32,,,0 HCPCS,87530,Hc Hsv-2 Vitreous Fluid-So+,113.3,45.32,,,0 HCPCS,87530,Hsv dna quant,,,36.4,107.1,16 HCPCS,87531,Hhv-6 dna dir probe,,,16.76,145.0,16 HCPCS,87532,"Hc Hhv-6, Pcr Qual-So+",231.64,92.66,,,0 HCPCS,87532,Hhv-6 dna amp probe,,,29.83,87.72,16 HCPCS,87533,Hc 103 Hum Herpesvirus 6 Pcr-So+,213.64,85.46,,,0 HCPCS,87533,Hc 304 Herpes Virus 6 Pcr-So+,418.8,167.52,,,0 HCPCS,87533,Hc 315 Hhv-6 Qnt Rtpcr (Csf)-So+,213.64,85.46,,,0 HCPCS,87533,"Hc Hhv6 Pcr, Csf 6503-So+",213.64,85.46,,,0 HCPCS,87533,Hhv-6 dna quant,,,35.48,104.4,16 HCPCS,87534,Hiv-1 dna dir probe,,,16.76,54.8,16 HCPCS,87535,"Hc Ultrio Elite Hiv-1/2, Hcv, Hbv Nat Vira #3-So+",51.79,20.72,,,0 HCPCS,87535,Hiv-1 probe&reverse trnscrpj,,,29.83,87.72,16 HCPCS,87536,Hc 164 Hiv-1 Qnt Pcr-So+,306.02,122.41,,,0 HCPCS,87536,Hc Hiv-1 Quant&Revrse Trnscrpj - Hiv 1 Rna Quant By Pcr,863.66,345.46,,,0 HCPCS,87536,Hiv-1 quant&revrse trnscrpj,,,72.31,212.75,16 HCPCS,87537,Hiv-2 dna dir probe,,,16.76,54.8,16 HCPCS,87538,Hiv-2 probe&revrse trnscripj,,,29.83,87.72,16 HCPCS,87539,Hc Hiv 2 Rna Quantitation-So+,375.12,150.05,,,0 HCPCS,87539,Hiv-2 quant&revrse trnscripj,,,36.4,146.55,16 HCPCS,87540,Legion pneumo dna dir prob,,,16.76,50.12,16 HCPCS,87541,Hc 339 Legion Pneumo Dna Pcr-So+,59.1,23.64,,,0 HCPCS,87541,Legion pneumo dna amp prob,,,29.83,87.72,16 HCPCS,87542,Legion pneumo dna quant,,,35.48,104.4,16 HCPCS,87550,"Hc Mycobacteria, Dna, Dir Probe - Mycobacteria Dna Probe, Direct",341.89,136.76,,,0 HCPCS,87550,Mycobacteria dna dir probe,,,16.76,50.12,16 HCPCS,87551,"Hc Broad-Range Pcr, Afb #1-So+",379.54,151.82,,,0 HCPCS,87551,Mycobacteria dna amp probe,,,29.83,120.6,16 HCPCS,87552,Hc Client Bill Only - Empath - Hepatitis C Quant & Reverse Transcription,78.47,31.39,,,0 HCPCS,87552,Mycobacteria dna quant,,,36.4,107.1,16 HCPCS,87555,M.tuberculo dna dir probe,,,16.76,67.2,16 HCPCS,87556,Hc 585 Mtb Complex Pcr Blood-Soq+,155.38,62.15,,,0 HCPCS,87556,Hc 663 Tb Pcr Block-So+,63.6,25.44,,,0 HCPCS,87556,"Hc Broad Range Pcr, Afb Tbcdna #2-So+",379.54,151.82,,,0 HCPCS,87556,Hc M Tuberculosis Amplified Probe,421.71,168.68,,,0 HCPCS,87556,M.tuberculo dna amp probe,,,29.83,104.2,16 HCPCS,87557,M.tuberculo dna quant,,,36.4,107.1,16 HCPCS,87560,"Hc M.Avium-Intra, Dna, Dir Prob - M. Avium-Intra Dna Probe, Direct",346.66,138.66,,,0 HCPCS,87560,M.avium-intra dna dir prob,,,16.76,68.22,16 HCPCS,87561,M.avium-intra dna amp prob,,,29.83,87.72,16 HCPCS,87562,M.avium-intra dna quant,,,36.4,107.1,16 HCPCS,87563,Hc Ureaplasma And Mycoplasma Species By Pcr 2011172 #2-So+,58.16,23.26,,,0 HCPCS,87563,M. genitalium amp probe,,,14.04,87.72,16 HCPCS,87564,Mtb rifampin rst amp prb tq,,,30.71,191.92,16 HCPCS,87580,M.pneumon dna dir probe,,,16.76,50.12,16 HCPCS,87581,Hc 0-Np Resp Pcr Mycoplsm Pnm,421.71,168.68,,,0 HCPCS,87581,Hc 356 Mycopls Pneumo Dna Pcr-So+,126.19,50.48,,,0 HCPCS,87581,Hc Ipac Nasopharyngeal Respiratory Panel,421.71,168.68,,,0 HCPCS,87581,"Hc M.Pneumon, Dna, Amp Probe - Mycoplasma Pneumoniae Pcr",421.71,168.68,,,0 HCPCS,87581,M.pneumon dna amp probe,,,29.83,87.72,16 HCPCS,87582,M.pneumon dna quant,,,35.48,756.55,16 HCPCS,87590,N.gonorrhoeae dna dir prob,,,16.76,67.2,16 HCPCS,87591,Hc Chlamydia Trachomatis And Neisseria Gonorrhoeae (Ctng) By Transcription-Mediated Amplification (T,43.62,17.45,,,0 HCPCS,87591,"Hc N.Gonorrhoeae, Dna, Amp Prob - Gc Dna Pcr",289.48,115.79,,,0 HCPCS,87591,Hc Reflex Neisseria Gonorrhoeae Confirmation By Tma 3000302-So+,17.62,7.05,,,0 HCPCS,87591,N.gonorrhoeae dna amp prob,,,29.83,87.72,16 HCPCS,87592,N.gonorrhoeae dna quant,,,36.4,107.1,16 HCPCS,87593,Hc Orthopoxvirus By Pcr-Arup 3005716,121.51,48.6,,,0 HCPCS,87593,Orthopoxvirus amp prb each,,,17.33,128.28,16 HCPCS,87594,Hc Pneumocystis Jirovecii By Pcr 2006254-So+,211.2,84.48,,,0 HCPCS,87594,Pneumcysts jirovecii amp prb,,,14.04,87.72,16 HCPCS,87623,Hpv low-risk types,,,16.76,87.72,16 HCPCS,87624,Hc Hpv By Nucleic Acid Amplification 3003005-So+,57.6,23.04,,,0 HCPCS,87624,"Hc Hpv High Risk Screen By Tma, With Reflex To Genotypes 16 And 18/45, Thinprep 3016945-So+",45.6,18.24,,,0 HCPCS,87624,"Hc Iadna Human Papillomavirus High-Risk Types - Hpv Dna Probe, Amp",410.98,164.39,,,0 HCPCS,87624,Hpv high-risk types,,,16.76,87.72,16 HCPCS,87625,"Hc Hpv Genotypes 16 And 18/45, By Transcription-Mediated Amplification (Tma), Thinprep3016944-So+",54.0,21.6,,,0 HCPCS,87625,Hpv types 16 & 18 only,,,16.76,101.38,16 HCPCS,87626,"Hc Tp Hpv1618, 2011940-So+",84.24,33.7,,,0 HCPCS,87626,Hpv sep hi-rsk typ&pool rslt,,,28.08,175.5,16 HCPCS,87627,Jt spc pthgn&rx rsist gen26+,,,679.77,1699.42,5 HCPCS,87631,Hc Influenza A/B Rsv,704.03,281.61,,,0 HCPCS,87631,Resp virus 3-5 targets,,,142.63,356.58,16 HCPCS,87632,Hc 848 Resp Virus 6-11 Targets,1191.26,476.5,,,0 HCPCS,87632,Resp virus 6-11 targets,,,218.06,545.15,16 HCPCS,87633,Hc Iadna Respiratry Probe & Rev Trnscr 12-25 Target - Additional Charge,1985.83,794.33,,,0 HCPCS,87633,Hc Ipac Resp Pnl 12-15 Targets,1985.83,794.33,,,0 HCPCS,87633,Resp virus 12-25 targets,,,416.78,1041.95,16 HCPCS,87634,Rsv dna/rna amp probe,,,34.66,175.5,16 HCPCS,87635,Hc Poct Sars-Cov-2 Cov 19,107.21,42.88,,,0 HCPCS,87635,Hc Sars-2 Cov 19,107.21,42.88,,,0 HCPCS,87635,Sars-cov-2 covid-19 amp prb,,,20.52,128.28,16 HCPCS,87636,Hc Covi D- Flu A - Flu B,208.47,83.39,,,0 HCPCS,87636,Sarscov2 & inf a&b amp prb,,,57.05,356.58,16 HCPCS,87637,Hc Flu A And B - Rsv And Covid,215.62,86.25,,,0 HCPCS,87637,"Hc Poct Sars Cov2, Flu A/B, Rsv Pcr",141.92,56.77,,,0 HCPCS,87637,Sarscov2&inf a&b&rsv amp prb,,,57.05,356.58,16 HCPCS,87640,Hc 587 Staph A Dna Amp Prb-So+,126.19,50.48,,,0 HCPCS,87640,Hc Bacterial Vaginosis & Aerobic Vaginitis Panel 7001 #2-So+,42.11,16.84,,,0 HCPCS,87640,Staph a dna amp probe,,,29.83,87.72,16 HCPCS,87641,"Hc Mrsa, Dna, Amp Probe - Mrsa Dna Probe",402.65,161.06,,,0 HCPCS,87641,Mr-staph dna amp probe,,,29.83,87.72,16 HCPCS,87650,Strep a dna dir probe,,,16.76,50.12,16 HCPCS,87651,Hc Strep A Pcr,153.67,61.47,,,0 HCPCS,87651,"Hc Strep A, Dna, Amp Probe - Strep A Dna Probe, Amplification",227.53,91.01,,,0 HCPCS,87651,Strep a dna amp probe,,,29.83,87.72,16 HCPCS,87652,Strep a dna quant,,,35.48,104.4,16 HCPCS,87653,Hc Bacterial Vaginosis & Aerobic Vaginitis Panel 7001 #1-So+,42.11,16.84,,,0 HCPCS,87653,"Hc Strep B, Dna, Amp Probe - Strep B Dna Probe, Amplification",345.47,138.19,,,0 HCPCS,87653,Strep b dna amp probe,,,29.83,87.72,16 HCPCS,87660,Trichomonas vagin dir probe,,,16.76,50.12,16 HCPCS,87661,Hc 115 Trichom Vag Male Rna-So+,60.0,24.0,,,0 HCPCS,87661,Trichomonas vaginalis amplif,,,35.09,87.72,16 HCPCS,87662,Zika virus dna/rna amp probe,,,25.34,128.28,16 HCPCS,87797,Detect agent nos dna dir,,,16.76,75.08,16 HCPCS,87797,"Hc Detect Agent Nos, Dna, Dir",256.12,102.45,,,0 HCPCS,87798,Detect agent nos dna amp,,,29.83,87.72,16 HCPCS,87798,Hc 089 Borde Pertus/Parap Pcr-So+,42.0,16.8,,,0 HCPCS,87798,Hc 100 Varicella-Zoster Pcr-So+,82.8,33.12,,,0 HCPCS,87798,Hc 243 Acanthamoeba Pcr-So+,241.33,96.53,,,0 HCPCS,87798,Hc 319 Coxiella Burnetti Pcr-So+,229.09,91.64,,,0 HCPCS,87798,Hc 320 Norovirus Pcr-So+,95.11,38.04,,,0 HCPCS,87798,Hc 322 Babesia Micro Pcr Qlt-Soq+,90.12,36.05,,,0 HCPCS,87798,Hc 332 Aspergillus Sp Pcr-So+,124.08,49.63,,,0 HCPCS,87798,Hc 351 Humn Metapneumovir Pcr-So+,358.8,143.52,,,0 HCPCS,87798,Hc 358 Whipples Dna Pcr Qlt-Soq+,174.03,69.61,,,0 HCPCS,87798,Hc 408 Ehrlich & Anaplasm Pcr By 2007862-So+,37.5,15.0,,,0 HCPCS,87798,Hc 461 Toxoplasma Pcr Qlt-Soq+,155.38,62.15,,,0 HCPCS,87798,Hc 494 Bk Virus Qlt Pcr Ur-Soq+,382.86,153.14,,,0 HCPCS,87798,Hc 587 Inf Agt Det Amp Pr Ea-So+,126.19,50.48,,,0 HCPCS,87798,Hc 625 Malaria Pcr-So+,174.19,69.68,,,0 HCPCS,87798,Hc 891 Ureaplasma/Myco Sp-So+,129.0,51.6,,,0 HCPCS,87798,Hc 943 Pneumocys Cari Amp Pcr-So+,264.0,105.6,,,0 HCPCS,87798,Hc Bacterial Vaginosis & Aerobic Vaginitis Panel 7001 #3-So+,42.11,16.84,,,0 HCPCS,87798,Hc Bordetella Pertussis/Parapetussis,445.43,178.17,,,0 HCPCS,87798,"Hc Detect Agent Nos, Dna, Amp-So+",59.1,23.64,,,0 HCPCS,87798,"Hc Detect Agent Nos, Dna, Dir",234.73,93.89,,,0 HCPCS,87798,Hc Ehrlichia Pcr (Quest 11353),207.28,82.91,,,0 HCPCS,87798,"Hc Hhv-8 Pcr, Qualitative-So+",233.05,93.22,,,0 HCPCS,87798,"Hc Htlv I/Ii Dna, Qualitative Real-Time Pcr 2003075-So+",134.22,53.69,,,0 HCPCS,87798,Hc Monkey Pox So-Quest 12084,208.47,83.39,,,0 HCPCS,87798,Hc National Jewish 87798 Ntmdr-So+,137.4,54.96,,,0 HCPCS,87798,"Hc Toxoplasma Gonfii Dna, Pcr",192.98,77.19,,,0 HCPCS,87798,Hc Ureaplasma And Mycoplasma Species By Pcr 2011172 #1-So+,54.1,21.64,,,0 HCPCS,87799,Detect agent nos dna quant,,,36.4,107.1,16 HCPCS,87799,Hc 093 Parovirus B19 Qnt Pcr-So+,158.4,63.36,,,0 HCPCS,87799,Hc 159 Adenovirus Qnt Pct-So+,227.04,90.82,,,0 HCPCS,87799,Hc 283 Hepatitis D Pcr-So+,237.6,95.04,,,0 HCPCS,87799,Hc 313 Adenovirus Rt Pcr(Csf)-So+,213.64,85.46,,,0 HCPCS,87799,Hc 314 Cmv Pcr (Csf)-So+,154.04,61.62,,,0 HCPCS,87799,Hc 316 Jcv Qnt Pcr (Csf)-So+,258.0,103.2,,,0 HCPCS,87799,Hc 317 V Zoster Qnt Pcr (Csf)-So+,233.05,93.22,,,0 HCPCS,87799,Hc 331 Hhv 8 Qnt Pcr-So+,209.0,83.6,,,0 HCPCS,87799,Hc 354 Bk Virus Qnt Dna Pcr-So+,148.9,59.56,,,0 HCPCS,87799,Hc 362 Parvovirus Qnt Pcr Vir-So+,234.0,93.6,,,0 HCPCS,87799,Hc 397 Herpes Virus 7 Pcr-So+,144.36,57.74,,,0 HCPCS,87799,Hc 536 Inf Agt Det Qnt Ea-So+,135.43,54.17,,,0 HCPCS,87799,Hc 849 Enterovirus Pcr Csf-So+,374.1,149.64,,,0 HCPCS,87799,Hc 922 Herpes 7 Dna Qnt(Lavg)-So+,226.6,90.64,,,0 HCPCS,87799,Hc 925 Herpes 7 Dna Qnt(Fec)-So+,210.0,84.0,,,0 HCPCS,87799,Hc 926 Herpes 7 Dna Qnt(Tiss)-So+,226.6,90.64,,,0 HCPCS,87799,Hc 935 Epstn Bar Dna Qnt(Csf)-So+,135.43,54.17,,,0 HCPCS,87799,Hc Bacterial Vaginosis & Aerobic Vaginitis Panel 7001 #5-So+,51.41,20.56,,,0 HCPCS,87799,Hc Bk Quantitative Pcr Blood,481.27,192.51,,,0 HCPCS,87799,"Hc Detect Agent Nos, Dna, Quant - Epstein-Barr Virus Dna, Quantitative",481.27,192.51,,,0 HCPCS,87799,"Hc Hhv-8 Qpcr, Quantitative-So+",233.05,93.22,,,0 HCPCS,87799,Hc Parvovirus B19 Quant Pcr (Viracor 1504),293.97,117.59,,,0 HCPCS,87799,Hc Toxoplasma Gondii Quantitative Real-Time Pcr 2200-So+,381.97,152.79,,,0 HCPCS,87799,Hc Toxoplasma Gondii Quantitative Real-Time Pcr-Viracor 2200,455.03,182.01,,,0 HCPCS,87799,"Hc Varicella Pcr, Aqueous, Fluid-So+",233.05,93.22,,,0 HCPCS,87799,"Hc Varicella Pcr, Vitreous, Fluid-So+",233.05,93.22,,,0 HCPCS,87800,Detect agnt mult dna direc,,,33.52,109.18,16 HCPCS,87801,Detect agnt mult dna ampli,,,59.65,175.5,16 HCPCS,87801,Hc Lyme Dna Pcr Bld-So+,282.0,112.8,,,0 HCPCS,87801,Hc Lyme Dna Pcr Csf/Fld-So+,252.43,100.97,,,0 HCPCS,87801,Hc 179 Multi Bact Detect Pcr-So+,404.45,161.78,,,0 HCPCS,87801,Hc 374 Broad Range Pcr Fungi-So+,404.45,161.78,,,0 HCPCS,87801,"Hc Broad Range Pcr, Bacteria-So+",411.9,164.76,,,0 HCPCS,87801,"Hc Broad-Range Pcr, Fungi-So+",672.08,268.83,,,0 HCPCS,87801,"Hc Detect Agent, Mult Orgs, Dna, Amp - Bordetella Pertuss/Parapertuss",511.76,204.7,,,0 HCPCS,87801,Hc Next Gen Seq Uwash-So+,1510.0,604.0,,,0 HCPCS,87802,Strep b assay w/optic,,,9.73,31.82,16 HCPCS,87803,Clostridium toxin a w/optic,,,9.73,40.0,16 HCPCS,87804,"Hc Detect Agent,Immun,Dir Obs,Influenza - Rapid Flu",125.08,50.03,,,0 HCPCS,87804,Influenza assay w/optic,,,9.73,41.38,16 HCPCS,87806,Hiv antigen w/hiv antibodies,,,11.66,81.92,16 HCPCS,87807,"Hc Detect Agent,Immun,Dir Obs, Rsv - Poct Respiratory Syncytial Virus",136.99,54.8,,,0 HCPCS,87807,Rsv assay w/optic,,,9.73,32.75,16 HCPCS,87808,Hc Trichomonas Assay W/Optic - Trichomonas Screen,119.13,47.65,,,0 HCPCS,87808,Trichomonas assay w/optic,,,9.73,38.22,16 HCPCS,87809,Adenovirus assay w/optic,,,9.73,54.4,16 HCPCS,87810,Chylmd trach assay w/optic,,,9.73,88.22,16 HCPCS,87811,Sars-cov-2 covid19 w/optic,,,16.55,103.45,16 HCPCS,87812,Sarscov2&inf typ a&b w/optic,,,74.48,186.2,5 HCPCS,87850,N. gonorrhoeae assay w/optic,,,9.73,61.4,16 HCPCS,87880,Hc Strep A Assay W/Optic - Rapid Strep A Screen,156.05,62.42,,,0 HCPCS,87880,Strep a assay w/optic,,,9.73,41.32,16 HCPCS,87899,Agent nos assay w/optic,,,9.73,40.18,16 HCPCS,87899,Hc Cryptcoccus Ag Lfa,166.78,66.71,,,0 HCPCS,87899,Hc Rapid Malaria Screen,256.12,102.45,,,0 HCPCS,87899,Hc S. Pneumoniae And L. Pneumophila Urinary Antigen,50.79,20.32,,,0 HCPCS,87900,"Hc Cmv Drug Resistance By Ngs, Ganciclovir, Foscarnet, Cidofovir, Maribavir, And Letermovir 3004615",512.76,205.1,,,0 HCPCS,87900,Hc Hcv Genosure Ns3 And Ns4A 3001234-So+,382.44,152.98,,,0 HCPCS,87900,Hc Human Immunodeficiency Virus 1 (Hiv-1) Genosure Archive 551776 #1-So+,206.61,82.64,,,0 HCPCS,87900,"Hc Human Immunodeficiency Virus1,Drug Resistance Ngs",152.77,61.11,,,0 HCPCS,87900,Hc Phenosense Hiv Peredictor-So+,156.42,62.57,,,0 HCPCS,87900,Hc Phenotype Infectious Agent Drug-So+,156.42,62.57,,,0 HCPCS,87900,Phenotype infect agent drug,,,110.77,325.88,16 HCPCS,87901,Genotype dna hiv reverse t,,,218.78,643.62,16 HCPCS,87901,Hc 511 Hiv 1 Rvrs Tran & Prot-So+,308.94,123.58,,,0 HCPCS,87901,"Hc Hiv 1 Phenotyp Analysis Dna/Rna, 1-10 Drugs-So+",295.73,118.29,,,0 HCPCS,87901,Hc Human Immunodeficiency Virus 1 (Hiv-1) Genosure Archive 551776 #2-So+,206.61,82.64,,,0 HCPCS,87902,Genotype dna/rna hep c,,,218.78,643.62,16 HCPCS,87902,Hc 355 Hep C Vir Rna Ns5A Dr-So+,600.0,240.0,,,0 HCPCS,87902,Hc 379 Hepatits C Genotype Va-So+,925.82,370.33,,,0 HCPCS,87902,Hc 617 Hep C Rna Gen 3 Ns5A-So+,624.0,249.6,,,0 HCPCS,87902,Hc Hcv Genosure Ns3 And Ns4A 3001234 #2-So+,382.44,152.98,,,0 HCPCS,87902,Hc Hepatitis C Genotype,1387.82,555.13,,,0 HCPCS,87902,"Hc Hepatitis C Virus (Hcv) Genotyping, Nonreflex-So+",308.94,123.58,,,0 HCPCS,87903,Hc Hiv Phenotype-So+,586.39,234.56,,,0 HCPCS,87903,Phenotype dna hiv w/culture,,,415.26,1221.65,16 HCPCS,87904,Hc Phenoty Analysis Dna/Rna Each Additional Drug-So+,31.28,12.51,,,0 HCPCS,87904,Phenotype dna hiv w/clt add,,,22.15,65.18,16 HCPCS,87905,Hc Bact Vag Enzym Actv Non Viral,91.73,36.69,,,0 HCPCS,87905,Sialidase enzyme assay,,,10.39,30.55,16 HCPCS,87906,Genotype dna/rna hiv,,,109.39,321.82,16 HCPCS,87906,Hc 360 Hiv 1 Intergrs Res Seq-So+,684.0,273.6,,,0 HCPCS,87906,Hc 360 Hiv 1 Intervrs Res Seq - So+,147.48,58.99,,,0 HCPCS,87906,Hc 511 Hiv 1 Other Region-So+,462.92,185.17,,,0 HCPCS,87906,Hc Human Immunodeficiency Virus 1 (Hiv-1) Genosure Archive 551776 #3-So+,206.61,82.64,,,0 HCPCS,87910,Genotype cytomegalovirus,,,257.45,643.62,16 HCPCS,87910,Hc 925 Cmv Antiviral Resistnc-So+,2622.0,1048.8,,,0 HCPCS,87910,"Hc Cmv Drug Resistance By Ngs, Ganciclovir, Foscarnet, Cidofovir, Maribavir, And Letermovir 3004615",512.76,205.1,,,0 HCPCS,87912,Genotype dna hepatitis b,,,257.45,643.62,16 HCPCS,87912,Hc 403 Hbv Genotype-So+,308.94,123.58,,,0 HCPCS,87913,Nfct agt gntyp alys sarscov2,,,0.01,643.62,16 HCPCS,87999,Hc Biofire Joint Infection Panel Pcr,1095.96,438.38,,,0 HCPCS,87999,Microbiology procedure,,,0.01,0.01,4 HCPCS,88000,Autopsy (necropsy) gross,,,60.9,278.45,5 HCPCS,88005,Autopsy (necropsy) gross,,,60.9,324.98,5 HCPCS,88007,Autopsy (necropsy) gross,,,60.9,340.5,5 HCPCS,88012,Autopsy (necropsy) gross,,,60.9,278.45,5 HCPCS,88014,Autopsy (necropsy) gross,,,60.9,255.17,5 HCPCS,88016,Autopsy (necropsy) gross,,,60.9,356.02,5 HCPCS,88020,Autopsy (necropsy) complete,,,60.9,479.72,5 HCPCS,88025,Autopsy (necropsy) complete,,,60.9,464.21,5 HCPCS,88027,Autopsy (necropsy) complete,,,60.9,495.24,5 HCPCS,88028,Autopsy (necropsy) complete,,,60.9,278.45,5 HCPCS,88029,Autopsy (necropsy) complete,,,60.9,278.45,5 HCPCS,88036,Hc Autopsy-Va,2632.16,1052.86,,,0 HCPCS,88036,Limited autopsy,,,60.9,139.22,5 HCPCS,88037,Limited autopsy,,,60.9,123.71,5 HCPCS,88040,Forensic autopsy (necropsy),,,60.9,773.69,5 HCPCS,88045,Coroners autopsy (necropsy),,,60.9,77.57,5 HCPCS,88104,Cytopath fl nongyn smears,,,21.14,91.19,16 HCPCS,88106,Cytopath fl nongyn filter,,,28.12,70.62,16 HCPCS,88108,Cytopath concentrate tech,,,25.77,91.19,16 HCPCS,88108,"Hc Cytopath Concentrate Tech - Lab Cytopath Fluids,Concentratn,Interp",250.75,100.3,,,0 HCPCS,88112,Cytopath cell enhance tech,,,24.17,127.23,16 HCPCS,88112,"Hc Cytopath Cell Enhance Tech - Lab Cytopath, Cell Enhance Tech",277.26,110.9,,,0 HCPCS,88120,Cytp urne 3-5 probes ea spec,,,166.38,415.96,9 HCPCS,88121,Cytp urine 3-5 probes cmptr,,,166.38,415.96,9 HCPCS,88125,Forensic cytopathology,,,4.78,127.23,16 HCPCS,88130,Sex chromatin identification,,,12.79,44.95,16 HCPCS,88140,Sex chromatin identification,,,6.79,19.98,16 HCPCS,88141,Cytopath c/v interpret,,,16.33,38.26,12 HCPCS,88142,Cytopath c/v thin layer,,,17.22,50.65,16 HCPCS,88142,Hc Cytopath C/V Thin Layer - Lab Cytopath Cerv/Vag Thin Layer,32.03,12.81,,,0 HCPCS,88143,Cytopath c/v thin layer redo,,,17.22,57.6,16 HCPCS,88147,Cytopath c/v automated,,,8.98,126.4,16 HCPCS,88148,Cytopath c/v auto rescreen,,,8.98,46.35,16 HCPCS,88150,Cytopath c/v manual,,,8.98,46.35,16 HCPCS,88152,Cytopath c/v auto redo,,,8.98,69.1,16 HCPCS,88153,Cytopath c/v redo,,,8.98,60.08,16 HCPCS,88155,Cytopath c/v index add-on,,,5.09,36.62,16 HCPCS,88160,Cytopath smear other source,,,15.25,70.62,16 HCPCS,88160,"Hc Cytopath Smear Other Source - Lab Cytopath,Othr Sourc,Screen,Interp",172.32,68.93,,,0 HCPCS,88161,Cytopath smear other source,,,15.25,70.62,16 HCPCS,88162,Cytopath smear other source,,,25.06,127.23,16 HCPCS,88164,Cytopath tbs c/v manual,,,8.98,46.35,16 HCPCS,88165,Cytopath tbs c/v redo,,,8.98,105.55,16 HCPCS,88166,Cytopath tbs c/v auto redo,,,8.98,46.35,16 HCPCS,88167,Cytopath tbs c/v select,,,8.98,46.35,16 HCPCS,88172,Cytp dx eval fna 1st ea site,,,9.94,415.96,9 HCPCS,88172,"Hc Cytp Dx Eval Fna 1St Ea Site - Lab Evaluation Of Fna Smear, First",282.78,113.11,,,0 HCPCS,88173,Cytopath eval fna report,,,37.15,127.23,9 HCPCS,88173,Hc Cytopath Eval Fna Report - Lab Interpretation Of Fna Smear,387.72,155.09,,,0 HCPCS,88174,Cytopath c/v auto in fluid,,,18.16,63.42,16 HCPCS,88175,Cytopath c/v auto fluid redo,,,21.82,66.52,16 HCPCS,88175,"Hc Cytopath C/V Auto Fluid Redo - Lab Cytopat,Cer/Vag,Thin Layer,Inter",187.79,75.12,,,0 HCPCS,88175,Hc Pap(So) Diagnostic-So+,170.0,68.0,,,0 HCPCS,88177,Cytp fna eval ea addl,,,3.53,15.25,5 HCPCS,88177,"Hc Cytp Fna Eval Ea Addl - Lab Evaluation Of Fna Smear, Ea Add Eval",99.42,39.77,,,0 HCPCS,88177,Hc Cytp Fna Eval Each Additional,99.42,39.77,,,0 HCPCS,88182,Cell marker study,,,35.5,127.23,16 HCPCS,88182,Hc Telomeres,660.0,264.0,,,0 HCPCS,88184,Flowcytometry/ tc 1 marker,,,28.12,875.15,16 HCPCS,88184,Hc 869 Flow Cytom 1St Mark-So+,324.98,129.99,,,0 HCPCS,88184,Hc Alps Panel By Flow Cytometry,790.03,316.01,,,0 HCPCS,88184,Hc B Cell Panel-So+,84.0,33.6,,,0 HCPCS,88184,Hc B-All Bm D29+(Cog) End Of Induction Mrd-So+,58.82,23.53,,,0 HCPCS,88184,Hc Flow Cytometry 1St Marker,430.8,172.32,,,0 HCPCS,88184,Hc Flowcytometry Tc 1 Marker Arup-So+,52.8,21.12,,,0 HCPCS,88184,Hc Flowcytometry Tc 1 Marker-So+,52.8,21.12,,,0 HCPCS,88184,"Hc Flowcytometry/ Tech Component, 1 Marker - Lab Flowcytometry/Tech Cmp",455.11,182.04,,,0 HCPCS,88184,"Hc Minimal Residual Disease Detection(Aml, All T And B-Cell,Cll,Mds) #1-So+",75.0,30.0,,,0 HCPCS,88184,Hc T-All Mrd-So+,58.42,23.37,,,0 HCPCS,88184,Hc Tcr V-Beta Repertoire-Cinci Childrens 2900210,1259.27,503.71,,,0 HCPCS,88184,Hc Th17 Enumeration-Cinci Childrens 7372838,809.91,323.96,,,0 HCPCS,88185,Flowcytometry/tc add-on,,,15.25,26.12,12 HCPCS,88185,Hc 869 Flow Cytom Ea Add Mark-So+,15.0,6.0,,,0 HCPCS,88185,Hc B Cell Panel #2-So+,84.0,33.6,,,0 HCPCS,88185,Hc B-All Bm D29+(Cog) End Of Induction Mrd #2-So+,58.82,23.53,,,0 HCPCS,88185,Hc Flow Cytometry Ea Add Marker,198.83,79.53,,,0 HCPCS,88185,Hc Flowcytometry/Tc Add On Arup-So+,52.8,21.12,,,0 HCPCS,88185,Hc Flowcytometry/Tc Add On-So+,52.8,21.12,,,0 HCPCS,88185,"Hc Flowcytometry/Tech Component, Add-On - Lab Flowcytometry/Tech Cmp",209.88,83.95,,,0 HCPCS,88185,"Hc Minimal Residual Disease Detection(Aml, All T And B-Cell,Cll,Mds) #2-So+",75.0,30.0,,,0 HCPCS,88185,Hc T-All Mrd #2-So+,58.42,23.37,,,0 HCPCS,88187,Flowcytometry/read 2-8,,,28.12,57.3,12 HCPCS,88188,Flowcytometry/read 9-15,,,28.12,71.45,12 HCPCS,88189,Flowcytometry/read 16 & >,,,28.12,94.12,12 HCPCS,88189,Hc Flowcytometry/Read 16 & > Arup-So+,52.8,21.12,,,0 HCPCS,88189,Hc Flowcytometry/Read 16 & >-So+,52.8,21.12,,,0 HCPCS,88199,Cytopathology procedure,,,0.01,127.23,9 HCPCS,88230,"Hc Chromosome Analysis - Breakage, Fanconi Anemia, Whole Blood 0097688-#1-So+",247.8,99.12,,,0 HCPCS,88230,Hc Tissue Culture Lymphocytes C,1049.72,419.89,,,0 HCPCS,88230,Tissue culture lymphocyte,,,99.01,291.22,16 HCPCS,88233,Hc 839 Tissue Cx Skin/Bx-So+,506.09,202.44,,,0 HCPCS,88233,Hc Tissue Culture,1593.26,637.3,,,0 HCPCS,88233,Tissue culture skin/biopsy,,,119.6,351.82,16 HCPCS,88235,Hc Tis Culture Chorionic Villi,1302.17,520.87,,,0 HCPCS,88235,Hc Tissue Culture Amniotic Fluid,1302.17,520.87,,,0 HCPCS,88235,Tissue culture placenta,,,125.14,375.75,16 HCPCS,88237,Hc Tiss Cult/Chromo Bone Marrow,1604.85,641.94,,,0 HCPCS,88237,Tissue culture bone marrow,,,107.34,359.38,16 HCPCS,88239,Hc Tissue Culture-Solid Tumor,1344.0,537.6,,,0 HCPCS,88239,Tissue culture tumor,,,125.37,368.8,16 HCPCS,88240,Cell cryopreserve/storage,,,8.58,32.68,16 HCPCS,88240,Hc 218 Cryopres Fr&Stor-So+,50.66,20.26,,,0 HCPCS,88240,Hc 839 Cryopres Fr&Stor-So+,36.32,14.53,,,0 HCPCS,88240,Hc Cryopresrvation Freezing & Sto,730.3,292.12,,,0 HCPCS,88241,Frozen cell preparation,,,8.58,30.22,16 HCPCS,88241,Hc Res Client Bill Only Til Amtagvi Preparation,537.0,214.8,,,0 HCPCS,88245,Chromosome analysis 20-25,,,115.71,432.92,16 HCPCS,88248,Chromosome analysis 50-100,,,147.17,432.92,16 HCPCS,88249,Chromosome analysis 100,,,147.17,432.92,16 HCPCS,88249,"Hc Chromosome Analysis - Breakage, Fanconi Anemia, Whole Blood 0097688-#2-So+",247.8,99.12,,,0 HCPCS,88261,Chromosome analysis 5,,,150.19,660.85,16 HCPCS,88262,Chromosome analysis 15-20,,,105.92,313.72,16 HCPCS,88262,Hc Chromo Anal-A 15-20 Ce 2K,1369.14,547.66,,,0 HCPCS,88262,Hc Chromo Anal-C 15-20 Ce 2K,1369.14,547.66,,,0 HCPCS,88262,Hc Chromo Anal-D 15-20 Ce 2K,1369.14,547.66,,,0 HCPCS,88263,Chromosome analysis 45,,,127.72,375.72,16 HCPCS,88264,Chromosome analysis 20-25,,,105.92,361.52,16 HCPCS,88264,Hc Chromo Anal A 20-25,1469.61,587.84,,,0 HCPCS,88264,Hc Chromo Anal B 20-25,1469.61,587.84,,,0 HCPCS,88267,Chromosome analys placenta,,,152.77,471.42,16 HCPCS,88267,Hc Chrom Anal Cvs 15Ce,1593.26,637.3,,,0 HCPCS,88267,Hc Chrom Analysis -Amniotic Fluid,1593.26,637.3,,,0 HCPCS,88269,Chromosome analys amniotic,,,115.71,434.15,16 HCPCS,88271,Cytogenetics dna probe,,,12.3,53.55,16 HCPCS,88271,Hc 133 Mol Cyto Dna Prob-So+,68.7,27.48,,,0 HCPCS,88271,Hc 211-19Q Paraffin Fish Each Probe,328.44,131.38,,,0 HCPCS,88271,Hc 211-1P Paraffin Fish Each Probe,328.44,131.38,,,0 HCPCS,88271,Hc 535 Mol Cyto Dna Prob-So+,52.06,20.82,,,0 HCPCS,88271,Hc Alk Pariffin Fish Each Probe,328.44,131.38,,,0 HCPCS,88271,Hc Cytogenetics Dna Probe Ea,328.44,131.38,,,0 HCPCS,88271,Hc Ewsr1 Pariffin Fish Each Probe,328.44,131.38,,,0 HCPCS,88271,Hc Mdm2 Pariffin Fish Each Probe,328.44,131.38,,,0 HCPCS,88271,Hc Myelodysplastic Syndrome (Mds) Panel By Fish 2002709-So+,108.0,43.2,,,0 HCPCS,88271,Hc Ros1 Paraffin Fish Each Probe,328.44,131.38,,,0 HCPCS,88271,Hc Ss18 Pariffin Fish Probe Probe,293.25,117.3,,,0 HCPCS,88272,Cytogenetics 3-5,,,22.75,101.75,16 HCPCS,88273,Cytogenetics 10-30,,,27.31,87.02,16 HCPCS,88273,Hc 576 Chrom In Situ Hyb A10-30C,747.04,298.82,,,0 HCPCS,88274,Cytogenetics 25-99,,,29.59,105.95,16 HCPCS,88275,Cytogenetics 100-300,,,34.13,127.98,16 HCPCS,88275,Hc 211-19Q Paraffin Fish Each Additional Probe,985.32,394.13,,,0 HCPCS,88275,Hc 211-1P Paraffin Fish Each Additional Probe,985.32,394.13,,,0 HCPCS,88275,Hc 535 Mol Cyt Insitu 100-300-So+,144.41,57.76,,,0 HCPCS,88275,Hc Alk Pariffin Fish Each Additional Probe,985.32,394.13,,,0 HCPCS,88275,"Hc Cytogenetics, 100-300 - Bcr/Abl1, Fish",275.0,110.0,,,0 HCPCS,88275,Hc Ewsr1 Pariffin Fish Each Additional Probe,985.32,394.13,,,0 HCPCS,88275,Hc Inter In Situ Hybridization,985.32,394.13,,,0 HCPCS,88275,Hc Mdm2 Pariffin Fish Each Additional Probe,985.32,394.13,,,0 HCPCS,88275,Hc Mds Panel By Fish 2002709 #2-So+,108.0,43.2,,,0 HCPCS,88275,Hc Myelodysplastic Syndrome (Mds) Panel By Fish 2002709 #2-So+,108.0,43.2,,,0 HCPCS,88275,Hc Ros1 Paraffin Fish Each Additional Probe,985.32,394.13,,,0 HCPCS,88275,Hc Ss18 Pariffin Fish Probe Probe Each Additional Probe,985.32,394.13,,,0 HCPCS,88280,Chromosome karyotype study,,,21.33,83.68,16 HCPCS,88280,Hc Additional Karyotype,358.06,143.22,,,0 HCPCS,88283,Chromosome banding study,,,58.3,171.5,16 HCPCS,88285,Chromosome count additional,,,16.15,67.28,16 HCPCS,88285,Hc Additional Cells Counted,243.8,97.52000000000001,,,0 HCPCS,88289,Chromosome study additional,,,29.26,86.08,16 HCPCS,88291,Cyto/molecular report,,,16.6,36.74,12 HCPCS,88299,Cytogenetic study,,,0.01,127.23,9 HCPCS,88300,"Hc Surg Path,Gross,Level I - Lab Surg Path,Gross,Level I",134.76,53.9,,,0 HCPCS,88300,Surgical path gross,,,12.35,70.62,16 HCPCS,88302,"Hc Surg Path,Level Ii - Lab Surg Path,Level Ii",234.18,93.67,,,0 HCPCS,88302,Tissue exam by pathologist,,,25.77,91.19,16 HCPCS,88304,"Hc Surg Path,Level Iii - Lab Surg Path,Level Iii",371.15,148.46,,,0 HCPCS,88304,Tissue exam by pathologist,,,26.66,127.23,16 HCPCS,88305,Hc Comprehensive Muscle Biopsy Workup 2013260 #1-So+,102.56,41.02,,,0 HCPCS,88305,Hc Histology Cell Block Prep,494.87,197.95,,,0 HCPCS,88305,"Hc Surg Path,Level Iv - Lab Surg Path,Level Iv",494.87,197.95,,,0 HCPCS,88305,Tissue exam by pathologist,,,36.44,127.23,16 HCPCS,88307,"Hc Surg Path,Level V - Lab Surg Path,Level V",803.06,321.22,,,0 HCPCS,88307,Tissue exam by pathologist,,,72.54,875.15,16 HCPCS,88309,"Hc Surg Path,Level Vi - Lab Surg Path,Level Vi",957.71,383.08,,,0 HCPCS,88309,Tissue exam by pathologist,,,113.06,1967.07,16 HCPCS,88311,Decalcify tissue,,,3.71,15.25,12 HCPCS,88311,Hc Decalcify Tissue - Lab Decalcify Tissue,102.73,41.09,,,0 HCPCS,88311,"Hc Decalcify Tissue - Lab Surg Path,Level Iii",102.73,41.09,,,0 HCPCS,88312,"Hc Special Stains,Group I - Lab Special Stains,Group I",271.74,108.7,,,0 HCPCS,88312,Special stains group 1,,,28.12,127.23,16 HCPCS,88313,Hc Comprehensive Muscle Biopsy Workup 2013260 #2-So+,102.56,41.02,,,0 HCPCS,88313,"Hc Special Stains,Group Ii - Lab Special Stains,Group Ii",277.26,110.9,,,0 HCPCS,88313,Special stains group 2,,,28.12,324.84,16 HCPCS,88314,Hc Comprehensive Muscle Biopsy Workup 2013260 #4-So+,307.35,122.94,,,0 HCPCS,88314,Histochemical stains add-on,,,28.12,42.32,12 HCPCS,88319,Enzyme histochemistry,,,28.12,1967.07,16 HCPCS,88319,Hc Comprehensive Muscle Biopsy Workup 2013260 #3-So+,820.45,328.18,,,0 HCPCS,88319,Hc Enzyme Histochemistry - Lab Enzyme Histochemistry,585.45,234.18,,,0 HCPCS,88321,Microslide consultation,,,15.25,91.19,16 HCPCS,88323,Hc Microslide Consult W Slide Prep - Lab Microslide Consult W Sld Prep,226.45,90.58,,,0 HCPCS,88323,Microslide consultation,,,29.15,127.23,16 HCPCS,88325,Comprehensive review of data,,,72.54,415.96,16 HCPCS,88325,Hc Comprehensive Review Of Data Pro - Lab Comprehensive Review Of Data,408.71,163.48,,,0 HCPCS,88329,Path consult introp,,,15.25,144.03,16 HCPCS,88331,"Hc Path Consult In Surg,W Frz Sec - Bundled Charge",415.34,166.14,,,0 HCPCS,88331,Path consult intraop 1 bloc,,,17.59,415.96,16 HCPCS,88332,"Hc Path Consult In Surg,W Addn Frz Sec - Block",186.68,74.67,,,0 HCPCS,88332,Path consult intraop addl,,,6.02,33.41,12 HCPCS,88333,Hc Cytology Touch Prep,518.07,207.23,,,0 HCPCS,88333,Intraop cyto path consult 1,,,19.36,1967.07,16 HCPCS,88334,Hc Intraop Cyto Path Consult 2 - Lab Intraoperative Cyto Path Consult,166.8,66.72,,,0 HCPCS,88334,Intraop cyto path consult 2,,,12.25,37.24,12 HCPCS,88341,Hc Carbonic Anhydrase Ix Each Additional,197.96,79.18,,,0 HCPCS,88341,Hc Glutamine Synthetase Additional,511.44,204.58,,,0 HCPCS,88341,Hc Immunohisto Antb Addl Slide - Lab Imhistochem/Cytchm Ea Addl Ant Sld,511.44,204.58,,,0 HCPCS,88341,Hc Insulinoma Associated Protein 1 (Insm1) Additional,511.44,204.58,,,0 HCPCS,88341,Immunohisto antb addl slide,,,50.45,64.94,12 HCPCS,88342,Hc 187 Immunohist 1St Ab Stn-So+,162.47,64.99,,,0 HCPCS,88342,Hc Glutamine Synthetase 1St,537.95,215.18,,,0 HCPCS,88342,Hc Imhistochem/Cytchm Init Antibody Stain Procedure - Bundled Charge,537.95,215.18,,,0 HCPCS,88342,Hc Insulinoma Associated Protein 1 (Insm1) 1St,537.95,215.18,,,0 HCPCS,88342,Immunohisto antb 1st stain,,,33.77,415.96,16 HCPCS,88344,Hc Each Multiplex Ab Stain Procedure Ihc,740.1,296.04,,,0 HCPCS,88344,Immunohisto antibody slide,,,63.34,875.15,16 HCPCS,88346,Hc 151 Em Dx Cilia/Nasal-So+,753.84,301.54,,,0 HCPCS,88346,Hc 870 If Ab Per Spec 1St-So+,320.87,128.35,,,0 HCPCS,88346,"Hc Immunofluorescent Study,Indirect - Anti Ribonucleic Acid",395.46,158.18,,,0 HCPCS,88346,Immunofluor antb 1st stain,,,32.53,415.96,16 HCPCS,88347,Immunofluorescent study,,,19.36,19.36,4 HCPCS,88348,Electron microscopy,,,182.5,1967.07,16 HCPCS,88348,Hc Em Dx Misc-So+,753.84,301.54,,,0 HCPCS,88348,Hc 159 Em Dx Muscle-So+,753.48,301.39,,,0 HCPCS,88350,Hc 870 If Ab Per Spec Ea Add-So+,54.02,21.61,,,0 HCPCS,88350,Hc Albumin If Each Additional Antibody,376.68,150.67,,,0 HCPCS,88350,Hc C1Q If Ea Add Antib,376.68,150.67,,,0 HCPCS,88350,Hc C3 If Each Add Anti,376.68,150.67,,,0 HCPCS,88350,Hc Fibrinogen If Each Additional Antibody,376.68,150.67,,,0 HCPCS,88350,Hc Iga If Ea Add Antib,376.68,150.67,,,0 HCPCS,88350,Hc Igg If Ea Add Antibody,376.68,150.67,,,0 HCPCS,88350,Hc Igm If Ea Add Spec,376.68,150.67,,,0 HCPCS,88350,Hc Kappa If Each Additional Antibody,376.68,150.67,,,0 HCPCS,88350,Hc Lambda If Each Additional Antibody,376.68,150.67,,,0 HCPCS,88350,Immunofluor antb addl stain,,,45.02,59.81,12 HCPCS,88355,Analysis skeletal muscle,,,45.72,415.96,16 HCPCS,88356,Analysis nerve,,,45.72,214.72,16 HCPCS,88358,Analysis tumor,,,17.59,415.96,16 HCPCS,88360,Hc 162 Hpv High Risk-So+,542.0,216.8,,,0 HCPCS,88360,Hc Eber In-Situ,598.71,239.48,,,0 HCPCS,88360,Hc Imhc Pr-Progest Each Specimen,598.71,239.48,,,0 HCPCS,88360,Hc Pd-L1 Arup 3017615,542.0,216.8,,,0 HCPCS,88360,"Hc Reflex Pd-L1 22C3 By Ihc With Combined Positive Score (Cps) Interpretation, 3017681 #2-So+",342.0,136.8,,,0 HCPCS,88360,Hc Reflex Pd-L1 22C3 By Ihc With Tumor Proportion Score (Tps) Interpretation 3017680-So+,342.0,136.8,,,0 HCPCS,88360,Tumor immunohistochem/manual,,,36.26,415.96,16 HCPCS,88361,Tumor immunohistochem/comput,,,45.72,875.15,16 HCPCS,88362,Nerve teasing preparations,,,72.54,1967.07,16 HCPCS,88363,Xm archive tissue molec anal,,,15.25,70.62,16 HCPCS,88364,Insitu hybridization (fish),,,36.7,84.2,12 HCPCS,88365,Hc Eber In-Situ,1001.9,400.76,,,0 HCPCS,88365,Insitu hybridization (fish),,,45.72,415.96,16 HCPCS,88365,Noncdm Charge Record,460.76,184.3,,,0 HCPCS,88366,Hc Reflex Pathology Pancreatobiliary Fish Request2002453-So+,536.4,214.56,,,0 HCPCS,88366,Insitu hybridization (fish),,,45.13,415.96,16 HCPCS,88367,Insitu hybridization auto,,,45.72,875.15,16 HCPCS,88368,Hc 260 Probe Her 2,967.65,387.06,,,0 HCPCS,88368,Hc Bcl2 Paraffin Fish Each Probe,967.65,387.06,,,0 HCPCS,88368,Hc Bcl6 Paraffin Fish Each Probe,967.65,387.06,,,0 HCPCS,88368,Hc Ewsr1 Parrafin Fish Probe,967.65,387.06,,,0 HCPCS,88368,Hc Mdm2 Parrafin Fish Probe,967.65,387.06,,,0 HCPCS,88368,Hc Myc Pariffin Fish Each Probe Test,967.65,387.06,,,0 HCPCS,88368,Hc Ros1 Paraffin Fish Probe,967.65,387.06,,,0 HCPCS,88368,Hc Ss18 Parrafin Fish Probe,967.65,387.06,,,0 HCPCS,88368,Insitu hybridization manual,,,72.54,875.15,16 HCPCS,88369,Hc Bcl2 Paraffin Fish Each Additional Probe,497.08,198.83,,,0 HCPCS,88369,Hc Bcl6 Paraffin Fish Each Additional Probe,497.08,198.83,,,0 HCPCS,88369,Hc Myc Pariffin Fish Each Additional Probe Test,497.08,198.83,,,0 HCPCS,88369,M/phmtrc alysishquant/semiq,,,25.46,60.79,12 HCPCS,88371,Hc Mds Panel By Fish 2002709-So+,108.0,43.2,,,0 HCPCS,88371,Protein western blot tissue,,,18.89,36.66,12 HCPCS,88372,Hc Prion (Tissue) Western Blot (Reflexfor Ap Samples),59.65,23.86,,,0 HCPCS,88372,Protein analysis w/probe,,,19.33,37.52,12 HCPCS,88373,M/phmtrc alys ishquant/semiq,,,20.4,46.82,5 HCPCS,88374,M/phmtrc alys ishquant/semiq,,,83.71,415.96,9 HCPCS,88375,Optical endomicroscpy interp,,,8.18,43.52,12 HCPCS,88377,M/phmtrc alys ishquant/semiq,,,77.9,415.96,16 HCPCS,88380,Microdissection laser,,,56.36,157.55,12 HCPCS,88381,Hc 246 Microdissect Manual-So+,212.52,85.01,,,0 HCPCS,88381,Hc 286 Microdissect Manual-So+,293.35,117.34,,,0 HCPCS,88381,Hc 562 Microdissect Manual-So+,212.52,85.01,,,0 HCPCS,88381,Hc 790 Microdissect Manual-So+,307.17,122.87,,,0 HCPCS,88381,Microdissection manual,,,57.79,138.44,12 HCPCS,88387,Tiss exam molecular study,,,7.74,32.66,12 HCPCS,88388,Tiss ex molecul study add-on,,,24.52,26.97,7 HCPCS,88399,Surgical pathology procedure,,,15.25,127.23,5 HCPCS,88720,Bilirubin total transcut,,,4.26,12.55,16 HCPCS,88738,Hgb quant transcutaneous,,,4.26,12.55,16 HCPCS,88740,Transcutaneous carboxyhb,,,4.26,23.42,16 HCPCS,88741,Transcutaneous methb,,,4.26,23.42,16 HCPCS,88749,In vivo lab service,,,0.01,0.01,4 HCPCS,89049,Chct for mal hyperthermia,,,15.25,415.96,9 HCPCS,89050,Body fluid cell count,,,4.02,11.8,16 HCPCS,89050,"Hc Cell Count,Misc Body Fluids - Additional Charge",123.65,49.46,,,0 HCPCS,89050,"Hc Cell Count,Misc Body Fluids - Body Fluid Cell Count",110.4,44.16,,,0 HCPCS,89051,Body fluid cell count,,,4.68,14.0,16 HCPCS,89051,Hc Body Fluid Cell Count W Diff - Body Fluid Cell Count W/Diff,221.54,88.62,,,0 HCPCS,89055,Leukocyte assessment fecal,,,3.63,10.68,16 HCPCS,89060,Exam synovial fluid crystals,,,6.08,18.32,16 HCPCS,89060,"Hc Exam,Synovial Fluid Crystals - Synovial Fluid Crystal",168.73,67.49,,,0 HCPCS,89125,Specimen fat stain,,,3.67,14.7,16 HCPCS,89160,Exam feces for meat fibers,,,3.13,12.12,16 HCPCS,89190,Nasal smear for eosinophils,,,4.04,14.48,16 HCPCS,89220,Hc Sputum Specimen Collection,178.0,71.2,,,0 HCPCS,89220,Sputum specimen collection,,,8.51,415.96,9 HCPCS,89230,Collect sweat for test,,,1.4,127.23,9 HCPCS,89230,Hc Sweat Chloride Collection-Op,448.22,179.29,,,0 HCPCS,89240,Pathology lab procedure,,,0.01,127.23,9 HCPCS,89250,Cultr oocyte/embryo <4 days,,,72.54,415.96,9 HCPCS,89251,Cultr oocyte/embryo <4 days,,,72.54,415.96,9 HCPCS,89253,Embryo hatching,,,72.54,415.96,9 HCPCS,89254,Oocyte identification,,,72.54,415.96,9 HCPCS,89255,Prepare embryo for transfer,,,50.89,162.0,9 HCPCS,89257,Sperm identification,,,28.12,162.0,9 HCPCS,89258,Cryopreservation embryo(s),,,72.54,1967.07,9 HCPCS,89259,Cryopreservation sperm,,,28.12,415.96,9 HCPCS,89260,Sperm isolation simple,,,45.72,127.23,9 HCPCS,89261,Sperm isolation complex,,,45.72,127.23,9 HCPCS,89264,Identify sperm tissue,,,50.89,300.0,9 HCPCS,89268,Insemination of oocytes,,,60.0,415.96,9 HCPCS,89272,Extended culture of oocytes,,,72.54,1967.07,9 HCPCS,89280,Assist oocyte fertilization,,,45.72,1967.07,9 HCPCS,89281,Assist oocyte fertilization,,,72.54,720.0,9 HCPCS,89290,Biopsy oocyte polar body,,,72.54,1125.0,9 HCPCS,89291,Biopsy oocyte polar body,,,72.54,1125.0,9 HCPCS,89300,Semen analysis w/huhner,,,7.58,24.6,16 HCPCS,89310,"Hc Semen Analysis,Motil & Count W/O Huhner - Semen Analysis Motility",156.4,62.56,,,0 HCPCS,89310,Semen analysis w/count,,,7.32,21.52,16 HCPCS,89320,Semen anal vol/count/mot,,,10.24,30.78,16 HCPCS,89321,"Hc Postvasectomy Sperm Evaluation, Qualitative 519020-So+",20.72,8.29,,,0 HCPCS,89321,Semen anal sperm detection,,,10.24,30.12,16 HCPCS,89322,Semen anal strict criteria,,,13.18,38.75,16 HCPCS,89325,Sperm antibody test,,,9.07,26.68,16 HCPCS,89329,Sperm evaluation test,,,17.82,48.98,16 HCPCS,89330,Evaluation cervical mucus,,,8.41,25.95,16 HCPCS,89331,Retrograde ejaculation anal,,,16.64,48.98,16 HCPCS,89335,Cryopreserve testicular tiss,,,17.16,127.23,9 HCPCS,89337,Cryopreservation oocyte(s),,,5.18,415.96,9 HCPCS,89342,Storage/year embryo(s),,,21.6,415.96,9 HCPCS,89343,Storage/year sperm/semen,,,21.6,415.96,9 HCPCS,89344,Storage/year reprod tissue,,,21.6,415.96,9 HCPCS,89346,Storage/year oocyte(s),,,21.6,415.96,9 HCPCS,89352,Thawing cryopresrved embryo,,,72.54,415.96,9 HCPCS,89353,Thawing cryopresrved sperm,,,50.89,300.0,9 HCPCS,89354,Thaw cryoprsvrd reprod tiss,,,72.54,415.96,9 HCPCS,89356,Thawing cryopresrved oocyte,,,72.54,415.96,9 HCPCS,89398,Unlisted reprod med lab proc,,,0.01,127.23,9 HCPCS,90281,Human ig im,,,95.08,95.08,4 HCPCS,90283,Human ig iv,,,72.97,72.97,4 HCPCS,90284,Human ig sc,,,14.6,14.6,4 HCPCS,90291,Cmv ig iv,,,1756.85,1756.85,4 HCPCS,90371,Hep b ig im,,,138.23,345.57,9 HCPCS,90375,Hyperrab: 1 Vial In 1 Carton (13533-318-01) / 1 Ml In 1 Vial (13533-318-10),1878.61,751.44,,,0 HCPCS,90375,Hyperrab: 1 Vial In 1 Carton (13533-318-05) / 5 Ml In 1 Vial (13533-318-50),1924.27,769.71,,,0 HCPCS,90375,NDC Description Not Available,1682.4299999999998,672.9749999999999,,,0 HCPCS,90375,Rabies ig im/sc,,,276.04,690.11,9 HCPCS,90376,Rabies ig heat treated,,,352.44,881.1,9 HCPCS,90377,Rabies ig ht&sol human im/sc,,,241.15,626.36,9 HCPCS,90378,Rsv mab im 50mg,,,436.75,1820.66,9 HCPCS,90380,Beyfortus: 1 Syringe In 1 Carton (49281-575-00) / .5 Ml In 1 Syringe,2437.06,974.82,,,0 HCPCS,90380,Beyfortus: 5 Syringe In 1 Carton (49281-575-15) / .5 Ml In 1 Syringe,2139.8,855.92,,,0 HCPCS,90380,Rsv monoc antb seasn .5ml im,,,556.13,556.13,4 HCPCS,90381,Beyfortus: 5 Syringe In 1 Carton (49281-574-15) / 1 Ml In 1 Syringe,2013.03,805.21,,,0 HCPCS,90381,Rsv monoc antb seasnl 1ml im,,,556.13,556.13,4 HCPCS,90384,Rh ig full-dose im,,,82.83,82.83,4 HCPCS,90385,Rh ig minidose im,,,29.84,200.0,9 HCPCS,90386,Rh ig iv,,,10.31,10.31,4 HCPCS,90389,Tetanus ig im,,,649.17,649.17,4 HCPCS,90396,NDC Description Not Available,10491.5,4196.6,,,0 HCPCS,90396,Varicella-zoster ig im,,,2280.76,6242.26,9 HCPCS,90460,"Hc Immuniz Admin, Thru Age 18, Any Route,W Counsel, 1St Vaccine/Toxoid",123.84,49.54,,,0 HCPCS,90461,"Hc Immuniz Admin, Thru Age 18, Any Route,W Counsel, Ea Add Vaccine/Toxoid",103.79,41.52,,,0 HCPCS,90471,"Hc Immuniz Admin,1 Single/Comb Vac/Toxoid",116.65,46.66,,,0 HCPCS,90471,Immunization admin,,,70.32,175.79,4 HCPCS,90472,"Hc Immuniz,Admin,Each Additional",96.3,38.52,,,0 HCPCS,90473,"Hc Immuniz Admin,Intranasal/Oral,1 Vac/Tox",109.87,43.95,,,0 HCPCS,90473,Immune admin oral/nasal,,,70.32,175.79,4 HCPCS,90474,"Hc Immuniz Admin,Intranasal/Oral,Each Additional",89.52,35.81,,,0 HCPCS,90480,Admn sarscov2 vacc 1 dose,,,39.69,99.22,4 HCPCS,90480,Hc Administration Sarscov2 Vaccine 1 Dose,116.18,46.47,,,0 HCPCS,90581,Anthrax vaccine sc or im,,,99.0,99.0,4 HCPCS,90585,Bcg vaccine percut,,,176.67,176.67,4 HCPCS,90586,Bcg vaccine intravesical,,,156.96,156.96,4 HCPCS,90587,Dengue vacc quad 3 dose subq,,,66.0,66.0,4 HCPCS,90589,Chikungunya vaccine live im,,,275.0,275.0,4 HCPCS,90593,Chikungunya vacc recomb im,,,275.0,275.0,4 HCPCS,90611,Smallpox&monkeypox vac 0.5ml,,,0.01,270.0,9 HCPCS,90619,Menacwy-tt vaccine im,,,171.97,171.97,4 HCPCS,90619,NDC Description Not Available,580.41,232.16,,,0 HCPCS,90620,Bexsero: 10 Syringe In 1 Carton (58160-976-20) / .5 Ml In 1 Syringe (58160-976-02),724.24,289.7,,,0 HCPCS,90620,Menb rp w/omv vaccine im,,,237.13,237.13,4 HCPCS,90620,NDC Description Not Available,1039.7,415.88,,,0 HCPCS,90621,Menb rlp vaccine im,,,207.32,207.32,4 HCPCS,90622,Vaccinia vrs vac 0.3 ml perq,,,0.01,0.02,9 HCPCS,90623,Menacwy-tt menb-fhbp vacc im,,,230.75,230.75,4 HCPCS,90625,Cholera vaccine live oral,,,275.0,275.0,4 HCPCS,90626,Tic-brn enceph vac 0.25ml im,,,303.9,303.9,4 HCPCS,90627,Tic-brn enceph vac 0.5ml im,,,303.9,303.9,4 HCPCS,90632,Havrix: 10 Syringe In 1 Carton (58160-826-52) / 1 Ml In 1 Syringe (58160-826-43),367.6,147.04,,,0 HCPCS,90632,Hepa vaccine adult im,,,72.16,72.16,4 HCPCS,90632,NDC Description Not Available,371.79,148.72,,,0 HCPCS,90633,Havrix: 10 Syringe In 1 Carton (58160-825-52) / .5 Ml In 1 Syringe (58160-825-43),162.73,65.09,,,0 HCPCS,90633,Hepa vacc ped/adol 2 dose im,,,38.85,38.85,4 HCPCS,90633,NDC Description Not Available,169.98,67.99,,,0 HCPCS,90636,Hep a/hep b vacc adult im,,,132.43,132.43,4 HCPCS,90636,NDC Description Not Available,566.16,226.46,,,0 HCPCS,90636,Twinrix: 10 Syringe In 1 Carton (58160-815-52) / 1 Ml In 1 Syringe (58160-815-43),418.27,167.31,,,0 HCPCS,90644,Hib-mency vacc 6wk-18m0 im,,,0.01,0.01,4 HCPCS,90647,Hib prp-omp vacc 3 dose im,,,30.58,30.58,4 HCPCS,90647,NDC Description Not Available,118.56,47.42,,,0 HCPCS,90648,Hib prp-t vaccine 4 dose im,,,13.17,13.17,4 HCPCS,90648,Hiberix: 1 Kit In 1 Carton (58160-726-15) * .85 Ml In 1 Syringe (58160-817-02) * .5 Ml In 1 Vial (58160-816-03),56.96,22.78,,,0 HCPCS,90648,Hiberix: 1 Kit In 1 Carton (58160-818-11) * 10 Vial In 1 Carton (58160-816-05) / .5 Ml In 1 Vial (58160-816-01) * 10 Vial In 1 Package (58160-817-05) / .85 Ml In 1 Vial (58160-817-01),48.0,19.2,,,0 HCPCS,90648,NDC Description Not Available,57.93,23.17,,,0 HCPCS,90649,4vhpv vaccine 3 dose im,,,0.01,0.01,4 HCPCS,90650,2vhpv vaccine 3 dose im,,,0.01,0.01,4 HCPCS,90651,9vhpv vaccine 3 dose im,,,307.61,307.61,4 HCPCS,90651,"Gardasil 9: 10 Syringe, Glass In 1 Carton (0006-4121-02) / .5 Ml In 1 Syringe, Glass (0006-4121-01)",1223.59,489.44,,,0 HCPCS,90651,"Gardasil 9: 10 Vial, Single-Dose In 1 Carton (0006-4119-03) / .5 Ml In 1 Vial, Single-Dose (0006-4119-01)",759.71,303.88,,,0 HCPCS,90651,NDC Description Not Available,1413.44,565.38,,,0 HCPCS,90653,Iiv adjuvant vaccine im,,,83.49,119.76,5 HCPCS,90655,Iiv3 vacc no prsv 0.25 ml im,,,0.01,16.32,5 HCPCS,90656,"Afluria: 10 Syringe, Glass In 1 Carton (33332-024-03) / .5 Ml In 1 Syringe, Glass (33332-024-04)",83.11,33.24,,,0 HCPCS,90656,Fluarix 2024/2025: 10 Syringe In 1 Carton (58160-884-52) / .5 Ml In 1 Syringe (58160-884-41),69.23,27.69,,,0 HCPCS,90656,"Fluzone Trivalent Northern Hemisphere: 10 Syringe, Glass In 1 Package (49281-424-50) / .5 Ml In 1 Syringe, Glass (49281-424-88)",88.27,35.31,,,0 HCPCS,90656,Iiv3 vacc no prsv 0.5 ml im,,,22.35,28.33,5 HCPCS,90656,NDC Description Not Available,99.86,39.94,,,0 HCPCS,90657,Iiv3 vaccine splt 0.25 ml im,,,10.93,13.46,5 HCPCS,90658,Iiv3 vaccine splt 0.5 ml im,,,21.86,26.93,5 HCPCS,90660,Laiv3 vaccine intranasal,,,28.87,36.25,5 HCPCS,90661,Cciiv3 vac no prsv 0.5 ml im,,,36.85,60.39,5 HCPCS,90662,"Fluzone High Dose Northern Hemisphere: 5 Syringe, Glass In 1 Package (49281-124-65) / .5 Ml In 1 Syringe, Glass (49281-124-88)",303.5,121.4,,,0 HCPCS,90662,Iiv no prsv increased ag im,,,83.49,119.76,5 HCPCS,90662,NDC Description Not Available,302.79,121.12,,,0 HCPCS,90670,Pcv13 vaccine im,,,257.99,314.58,5 HCPCS,90670,Prevnar 13: 10 Syringe In 1 Carton (0005-1971-02) / .5 Ml In 1 Syringe (0005-1971-01),945.89,378.36,,,0 HCPCS,90671,Pcv15 vaccine im,,,261.15,328.56,5 HCPCS,90672,Laiv4 vaccine intranasal,,,24.5,24.5,4 HCPCS,90673,Riv3 vaccine no preserv im,,,83.49,119.76,5 HCPCS,90674,Cciiv4 vac no prsv 0.5 ml im,,,30.1,30.1,4 HCPCS,90675,NDC Description Not Available,1402.42,560.97,,,0 HCPCS,90675,"Rabavert: 1 Kit In 1 Carton (50632-010-01) * 1 Ml In 1 Syringe (50632-011-01) * 1 Ml In 1 Vial, Glass (50632-013-01)",1711.73,684.69,,,0 HCPCS,90675,Rabies vaccine im,,,317.67,819.97,9 HCPCS,90676,Rabies vaccine id,,,236.86,592.15,5 HCPCS,90677,NDC Description Not Available,964.55,385.82,,,0 HCPCS,90677,Pcv20 vaccine im,,,312.9,381.74,5 HCPCS,90677,Prevnar 20: 10 Syringe In 1 Carton (0005-2000-10) / .5 Ml In 1 Syringe (0005-2000-01),1300.41,520.16,,,0 HCPCS,90678,"Abrysvo: 1 Tray In 1 Carton (0069-0344-01) / 1 Kit In 1 Tray (0069-0344-21) * .5 Ml In 1 Vial, Glass (0069-0207-01) * .69 Ml In 1 Syringe, Glass (0069-0250-01)",1106.12,442.45,,,0 HCPCS,90678,Abrysvo: 10 Vial In 1 Carton (0069-2465-10) / .5 Ml In 1 Vial (0069-2465-19),1140.33,456.13,,,0 HCPCS,90678,"Abrysvo: 5 Tray In 1 Carton (0069-0344-05) / 1 Kit In 1 Tray (0069-0344-21) * .5 Ml In 1 Vial, Glass (0069-0207-01) * .69 Ml In 1 Syringe, Glass (0069-0250-01)",1122.44,448.98,,,0 HCPCS,90678,Rsv vacc pref bivalent im,,,306.8,306.8,4 HCPCS,90679,Arexvy: 1 Kit In 1 Carton (58160-848-11) * .5 Ml In 1 Vial (58160-723-03) * .5 Ml In 1 Vial (58160-744-03),1106.97,442.79,,,0 HCPCS,90679,NDC Description Not Available,1347.81,539.12,,,0 HCPCS,90679,Rsv vacc pref recomb adjt im,,,294.0,294.0,4 HCPCS,90680,Rv5 vacc 3 dose live oral,,,98.82,98.82,4 HCPCS,90681,NDC Description Not Available,441.03,176.41,,,0 HCPCS,90681,Rotarix: 10 Applicator In 1 Carton (58160-740-21) / 1.5 Ml In 1 Applicator (58160-740-02),426.72,170.69,,,0 HCPCS,90681,Rv1 vacc 2 dose live oral,,,147.02,147.02,4 HCPCS,90682,Flublok Quadrivalent Northern Hemisphere: 10 SYRINGE in 1 CARTON (49281-721-10) / .5 mL in 1 SYRINGE (49281-721-88),263.91,105.56,,,0 HCPCS,90682,Riv4 vacc recombinant dna im,,,64.51,64.51,4 HCPCS,90683,Rsv vacc mrna lipid nano im,,,290.0,290.0,4 HCPCS,90684,Pcv21 vaccine im,,,327.89,419.99,5 HCPCS,90685,Iiv4 vacc no prsv 0.25 ml im,,,0.01,0.01,4 HCPCS,90686,Flulaval 2024/2025: 10 Syringe In 1 Carton (19515-810-52) / .5 Ml In 1 Syringe (19515-810-41),67.9,27.16,,,0 HCPCS,90686,Iiv4 vacc no prsv 0.5 ml im,,,19.73,19.73,4 HCPCS,90686,NDC Description Not Available,69.7,27.88,,,0 HCPCS,90687,Iiv4 vaccine splt 0.25 ml im,,,9.22,9.22,4 HCPCS,90688,Iiv4 vaccine splt 0.5 ml im,,,18.44,18.44,4 HCPCS,90690,Typhoid vaccine oral,,,106.67,106.67,4 HCPCS,90691,NDC Description Not Available,627.36,250.94,,,0 HCPCS,90691,Typhim Vi: 1 Syringe In 1 Package (49281-790-51) / .5 Ml In 1 Syringe (49281-790-88),595.81,238.32,,,0 HCPCS,90691,Typhoid vaccine im,,,146.57,146.57,4 HCPCS,90694,Vacc aiiv4 no prsrv 0.5ml im,,,67.98,67.98,4 HCPCS,90696,Dtap-ipv vaccine 4-6 yrs im,,,62.82,62.82,4 HCPCS,90696,Kinrix: 10 Syringe In 1 Carton (58160-812-52) / .5 Ml In 1 Syringe (58160-812-43),257.23,102.89,,,0 HCPCS,90696,NDC Description Not Available,272.9,109.16,,,0 HCPCS,90697,Dtap-ipv-hib-hepb vaccine im,,,156.62,156.62,4 HCPCS,90697,NDC Description Not Available,552.995,221.195,,,0 HCPCS,90697,Vaxelis: 10 Syringe In 1 Package (63361-243-15) / .5 Ml In 1 Syringe (63361-243-88),644.35,257.74,,,0 HCPCS,90698,Dtap-ipv/hib vaccine im,,,120.06,120.06,4 HCPCS,90700,Dtap vaccine < 7 yrs im,,,29.59,29.59,4 HCPCS,90700,Infanrix: 10 Syringe In 1 Carton (58160-810-52) / .5 Ml In 1 Syringe (58160-810-43),169.43,67.77,,,0 HCPCS,90700,NDC Description Not Available,118.92999999999999,47.575,,,0 HCPCS,90702,Dt vaccine under 7 yrs im,,,66.09,66.09,4 HCPCS,90707,"M-M-R Ii: 10 Vial, Single-Dose In 1 Carton (0006-4681-00) / .5 Ml In 1 Vial, Single-Dose (0006-4681-01)",431.16,172.46,,,0 HCPCS,90707,Mmr vaccine sc,,,95.2,95.2,4 HCPCS,90707,NDC Description Not Available,413.7,165.48,,,0 HCPCS,90707,Priorix: 1 Kit In 1 Carton (58160-824-15) * .5 Ml In 1 Vial (58160-831-03) * .5 Ml In 1 Syringe (58160-833-02),423.13,169.25,,,0 HCPCS,90710,Mmrv vaccine sc,,,278.16,278.16,4 HCPCS,90710,NDC Description Not Available,1246.15,498.46,,,0 HCPCS,90710,"Proquad: 10 Vial, Single-Dose In 1 Carton (0006-4171-00) / .5 Ml In 1 Vial, Single-Dose (0006-4171-01)",1094.88,437.95,,,0 HCPCS,90713,"Ipol: 1 Vial, Multi-Dose In 1 Package (49281-860-10) / 5 Ml In 1 Vial, Multi-Dose (49281-860-78)",186.7,74.68,,,0 HCPCS,90713,NDC Description Not Available,171.04,68.42,,,0 HCPCS,90713,Poliovirus ipv sc/im,,,44.73,44.73,4 HCPCS,90714,NDC Description Not Available,202.77,81.11,,,0 HCPCS,90714,Td vacc no presv 7 yrs+ im,,,33.96,33.96,4 HCPCS,90715,Adacel Tdap: 10 Vial In 1 Package (49281-400-10) / .5 Ml In 1 Vial (49281-400-58),216.48,86.59,,,0 HCPCS,90715,Boostrix: 10 Syringe In 1 Carton (58160-842-52) / .5 Ml In 1 Syringe (58160-842-43),209.69,83.88,,,0 HCPCS,90715,Boostrix: 10 Vial In 1 Carton (58160-842-11) / .5 Ml In 1 Vial (58160-842-01),166.2,66.48,,,0 HCPCS,90715,NDC Description Not Available,211.98,84.79,,,0 HCPCS,90715,Noncdm Charge Record Pharmacy,158.58,63.43,,,0 HCPCS,90715,Tdap vaccine 7 yrs/> im,,,39.07,39.07,4 HCPCS,90716,NDC Description Not Available,822.54,329.02,,,0 HCPCS,90716,Var vaccine live subq,,,183.0,183.0,4 HCPCS,90716,"Varivax: 10 Vial, Single-Dose In 1 Carton (0006-4827-00) / .5 Ml In 1 Vial, Single-Dose (0006-4827-01)",670.87,268.35,,,0 HCPCS,90717,Yellow fever vaccine subq,,,223.97,223.97,4 HCPCS,90723,Dtap-hep b-ipv vaccine im,,,103.62,103.62,4 HCPCS,90723,NDC Description Not Available,423.55,169.42,,,0 HCPCS,90732,NDC Description Not Available,522.99,209.2,,,0 HCPCS,90732,"Pneumovax 23: 10 Syringe, Glass In 1 Carton (0006-4837-03) / .5 Ml In 1 Syringe, Glass (0006-4837-01)",489.69,195.88,,,0 HCPCS,90732,Ppsv23 vacc 2 yrs+ subq/im,,,133.47,162.83,5 HCPCS,90733,Mpsv4 vaccine subq,,,0.01,0.01,4 HCPCS,90734,Mcv4 menacwy vaccine im,,,166.75,166.75,4 HCPCS,90734,"Menveo: 1 Kit In 1 Carton (58160-955-09) * .5 Ml In 1 Vial, Single-Dose (58160-958-01) * .5 Ml In 1 Vial, Single-Dose (58160-959-01)",462.96,185.18,,,0 HCPCS,90734,Menveo: 10 Vial In 1 Carton (58160-827-30) / .5 Ml In 1 Vial (58160-827-03),707.99,283.2,,,0 HCPCS,90734,NDC Description Not Available,594.275,237.70999999999998,,,0 HCPCS,90736,Hzv vaccine live subq,,,0.01,0.01,4 HCPCS,90738,Inactivated je vacc im,,,295.08,295.08,4 HCPCS,90739,Hepb vacc 2 dose adult im,,,177.56,216.62,5 HCPCS,90739,Heplisav-B: 5 Syringe In 1 Carton (43528-003-05) / .5 Ml In 1 Syringe (43528-003-01),611.7,244.68,,,0 HCPCS,90739,NDC Description Not Available,671.4,268.56,,,0 HCPCS,90740,Hepb vacc 3 dose immunsup im,,,164.42,200.59,5 HCPCS,90740,NDC Description Not Available,427.47,170.99,,,0 HCPCS,90740,"Recombivax Hb: 1 Vial, Single-Dose In 1 Carton (0006-4992-00) / 1 Ml In 1 Vial, Single-Dose (0006-4992-01)",857.5,343.0,,,0 HCPCS,90743,Hepb vacc 2 dose adolesc im,,,75.15,91.68,5 HCPCS,90744,Engerix-B: 10 Syringe In 1 Carton (58160-820-52) / .5 Ml In 1 Syringe (58160-820-43),109.15,43.66,,,0 HCPCS,90744,Hepb vacc 3 dose ped/adol im,,,31.67,40.5,5 HCPCS,90744,NDC Description Not Available,123.12,49.25,,,0 HCPCS,90746,Hepb vaccine 3 dose adult im,,,70.38,91.68,5 HCPCS,90747,Hepb vacc 4 dose immunsup im,,,140.75,200.59,5 HCPCS,90748,Hib-hepb vaccine im,,,0.01,0.01,4 HCPCS,90750,Hc Zoster Hzv (Shingles) Vaccine Recombinant Adjuvanted Intramuscular Use,593.92,237.57,,,0 HCPCS,90750,Hzv vacc recombinant im njx,,,215.51,215.51,4 HCPCS,90750,NDC Description Not Available,627.6949999999999,251.07999999999998,,,0 HCPCS,90750,Shingrix: 1 KIT in 1 KIT (50090-5147-0) * .5 mL in 1 VIAL (58160-828-01) * .5 mL in 1 VIAL (58160-829-01),593.92,237.57,,,0 HCPCS,90750,Shingrix: 1 Kit In 1 Carton (58160-823-11) * .5 Ml In 1 Vial (58160-828-03) * .5 Ml In 1 Vial (58160-829-03),638.5,255.4,,,0 HCPCS,90756,Cciiv4 vacc abx free im,,,28.52,28.52,4 HCPCS,90759,Hep b vac 3ag 10mcg 3 dos im,,,73.82,90.06,5 HCPCS,90785,Hc Psychotherapy Complex Interactive,100.0,40.0,,,0 HCPCS,90791,Hc Psychiatric Diagnostic Evaluation,325.0,130.0,,,0 HCPCS,90791,Psych diagnostic evaluation,,,173.34,433.36,4 HCPCS,90792,Hc Psychiatric Diagnostic Eval W/Medical Services,350.0,140.0,,,0 HCPCS,90792,Psych diag eval w/med srvcs,,,173.34,433.36,4 HCPCS,90832,Hc Psychotherapy Patient &/ Family 30 Minutes,250.0,100.0,,,0 HCPCS,90832,Psytx w pt 30 minutes,,,173.34,433.36,4 HCPCS,90833,Hc Psychotherapy Patient & Family W/E&M Services 30 Minutes,75.0,30.0,,,0 HCPCS,90834,Hc Psychotherapy Patient &/ Family 45 Minutes,300.0,120.0,,,0 HCPCS,90834,Psytx w pt 45 minutes,,,173.34,433.36,4 HCPCS,90836,Hc Psychotherapy Pt&/Family W/E&M Srvcs 45 Min,100.0,40.0,,,0 HCPCS,90837,Hc Psychotherapy Patient &/ Family 60 Minutes,350.0,140.0,,,0 HCPCS,90837,Psytx w pt 60 minutes,,,173.34,433.36,4 HCPCS,90838,Hc Psychological Treatment With Patient With E/M 60 Minutes,125.0,50.0,,,0 HCPCS,90839,Hc Psychological Treatment Crisis Initial 60 Minutes,400.0,160.0,,,0 HCPCS,90839,Psytx crisis initial 60 min,,,173.34,433.36,4 HCPCS,90840,Hc Psychotherapy Treatment Crisis Each Additional 30 Minutes,200.0,80.0,,,0 HCPCS,90845,Psychoanalysis,,,173.34,433.36,4 HCPCS,90846,Family psytx w/o pt 50 min,,,173.34,433.36,4 HCPCS,90846,"Hc Family Psychotherapy,No Pt",225.0,90.0,,,0 HCPCS,90847,Family psytx w/pt 50 min,,,173.34,433.36,4 HCPCS,90847,Hc Family Psychotherapy W Phys,250.0,100.0,,,0 HCPCS,90849,Multiple family group psytx,,,173.34,433.36,4 HCPCS,90853,Group psychotherapy,,,99.21,248.03,4 HCPCS,90853,Hc Group Psychotherapy,125.0,50.0,,,0 HCPCS,90865,Narcosynthesis,,,173.34,433.36,4 HCPCS,90867,"Hc Transcranial Magnetic Stimulation Treatment,Initial",650.0,260.0,,,0 HCPCS,90867,Tcranial magn stim tx plan,,,210.87,527.18,4 HCPCS,90868,"Hc Transcranial Magnetic Stimulation Treatment,Delivery/Management",450.0,180.0,,,0 HCPCS,90868,Tcranial magn stim tx deli,,,210.87,527.18,4 HCPCS,90869,Hc Transcranial Magnetic Stimulation Treatment,765.0,306.0,,,0 HCPCS,90869,Tcran magn stim redetemine,,,210.87,527.18,4 HCPCS,90870,Electroconvulsive therapy,,,838.65,2096.62,4 HCPCS,90870,"Hc Electroconvulsive Therapy,1 Seiz",2523.82,1009.53,,,0 HCPCS,90880,Hypnotherapy,,,99.21,248.03,4 HCPCS,90887,Hc Consultation With Family,150.0,60.0,,,0 HCPCS,90899,Psychiatric service/therapy,,,36.59,91.48,4 HCPCS,90901,Biofeedback train any meth,,,16.08,40.2,4 HCPCS,90911,Hc Biofeedback Perineal/Urethral/Anorectal Sphincter,253.0,101.2,,,0 HCPCS,90912,Bfb training 1st 15 min,,,36.64,91.6,4 HCPCS,90912,Hc Bfb Training 1St 15 Minute,253.0,101.2,,,0 HCPCS,90913,Bfb training ea addl 15 min,,,20.59,51.48,4 HCPCS,90913,Hc Bfb Training Each Additional 15 Minute,253.0,101.2,,,0 HCPCS,90935,Hc Hemodialysis Procedure W/ Phys/Qhp Evaluation,417.0,166.8,,,0 HCPCS,90935,Hemodialysis one evaluation,,,670.26,1675.64,4 HCPCS,90945,Dialysis one evaluation,,,407.5,1018.75,4 HCPCS,90945,Hc Peritoneal Evaluation Inpatient,606.0,242.4,,,0 HCPCS,90945,Hc Peritoneal Initation,606.0,242.4,,,0 HCPCS,90999,Hc Dialysis Procedure - Hemodialysis Outpatient,2873.0,1149.2,,,0 HCPCS,91010,Esophagus motility study,,,364.43,911.07,4 HCPCS,91010,"Hc Esophageal Motility Study, Manometry - Manometry Esophageal",3549.13,1419.65,,,0 HCPCS,91013,Hc Esophageal Motility Study With Stimulaton Or Perfusion,2810.6,1124.24,,,0 HCPCS,91020,Gastric motility studies,,,364.43,911.07,4 HCPCS,91020,"Hc Gastric Motility Study - Manometry Study, Gastric",3209.76,1283.9,,,0 HCPCS,91022,Duodenal motility study,,,364.43,911.07,4 HCPCS,91030,Acid perfusion of esophagus,,,364.43,911.07,4 HCPCS,91034,Gastroesophageal reflux test,,,364.43,911.07,4 HCPCS,91034,Hc Esophageal Acid Prolong Infus,3404.05,1361.62,,,0 HCPCS,91035,G-esoph reflx tst w/electrod,,,838.65,2096.62,4 HCPCS,91035,Hc Bravo Placement/Retrieval,5329.61,2131.84,,,0 HCPCS,91037,Esoph imped function test,,,210.87,527.18,4 HCPCS,91037,Hc Esoph Function Test-Gstresop Reflx,2529.54,1011.82,,,0 HCPCS,91038,Esoph imped funct test > 1hr,,,364.43,911.07,4 HCPCS,91038,Hc Impedence Ph Testing >1Hr,2365.09,946.04,,,0 HCPCS,91040,Esoph balloon distension tst,,,364.43,911.07,4 HCPCS,91040,Hc Esophageal Balloon Distension Provocation Study,2661.1,1064.44,,,0 HCPCS,91065,Breath hydrogen/methane test,,,210.87,527.18,4 HCPCS,91110,Gi tract capsule endoscopy,,,885.77,2214.41,4 HCPCS,91110,Hc Gi Tract Capsule Endoscopy - Small Bowel Capsule Enteroscopy,5504.91,2201.96,,,0 HCPCS,91111,Esophageal Capsule Endoscopy,,,885.77,2214.41,4 HCPCS,91111,Hc Gastrointestinal Tract Imaging With Interpretation And Report,5488.17,2195.27,,,0 HCPCS,91112,Gi wireless capsule measure,,,885.77,2214.41,4 HCPCS,91112,Hc Gastrointestinal Tran Pressure,2537.36,1014.94,,,0 HCPCS,91113,Gi trc img intral colon i&r,,,908.2,2270.5,4 HCPCS,91117,Colon motility 6 hr study,,,210.87,527.18,4 HCPCS,91120,Hc Balloon Expulsion Study,2069.56,827.82,,,0 HCPCS,91122,Hc Anorectal Manometry,3005.55,1202.22,,,0 HCPCS,91124,Rct snsatn tone&cmplianc std,,,210.87,527.18,4 HCPCS,91125,Anrct mano rct snsatn&balo,,,364.43,911.07,4 HCPCS,91132,Electrogastrography,,,210.87,527.18,4 HCPCS,91133,Electrogastrography W/Test,,,129.94,324.84,4 HCPCS,91200,Hc Liver Elastography W/O Imag,692.94,277.18,,,0 HCPCS,91200,Liver elastography,,,125.66,314.16,4 HCPCS,91299,Gastroenterology procedure,,,125.66,314.16,4 HCPCS,91299,Hc Patency Capsule Test,679.9,271.96,,,0 HCPCS,91304,Coronavirus vaccine 5,,,161.54,234.14,5 HCPCS,91318,Sarscov2 vac 3mcg trs-suc im,,,65.55,79.87,5 HCPCS,91319,Sarscv2 vac 10mcg trs-suc im,,,87.78,115.66,5 HCPCS,91320,Sarscv2 vac 30mcg trs-suc im,,,155.9,205.41,5 HCPCS,91321,"Moderna COVID-19 Vaccine: 10 VIAL, SINGLE-DOSE in 1 CARTON (80777-287-92) / .25 mL in 1 VIAL, SINGLE-DOSE (80777-287-07)",525.81,210.32,,,0 HCPCS,91321,"Moderna Covid-19 Vaccine: 10 Syringe, Plastic In 1 Carton (80777-291-80) / .25 Ml In 1 Syringe, Plastic (80777-291-09)",386.14,154.46,,,0 HCPCS,91321,Sarscov2 vac 25 mcg/.25ml im,,,147.06,179.41,5 HCPCS,91322,NDC Description Not Available,531.97,212.79,,,0 HCPCS,91322,Sarscov2 vac 50 mcg/0.5ml im,,,161.65,197.21,5 HCPCS,91322,"Spikevax: 10 Syringe, Plastic In 1 Carton (80777-110-96) / .5 Ml In 1 Syringe, Plastic (80777-110-01)",417.6,167.04,,,0 HCPCS,91323,Sarscov2 vac 10 mcg/0.2ml im,,,246.33,246.33,1 HCPCS,92002,Eye exam new patient,,,130.02,325.05,4 HCPCS,92004,Eye exam new patient,,,130.02,325.05,4 HCPCS,92012,Eye exam establish patient,,,130.02,325.05,4 HCPCS,92014,Eye exam&tx estab pt 1/>vst,,,130.02,325.05,4 HCPCS,92018,New eye exam & treatment,,,2321.86,5804.65,4 HCPCS,92019,Eye exam & treatment,,,2321.86,5804.65,4 HCPCS,92020,"Hc Special Eye Evaluation,Gonioscopy",185.0,74.0,,,0 HCPCS,92020,Special eye evaluation,,,129.94,324.84,4 HCPCS,92025,Corneal Topography,,,57.61,144.03,4 HCPCS,92025,Hc Corneal Topography - Corneal Topography - Od - Unilateral,493.35,197.34,,,0 HCPCS,92060,Hc Sensormotor Exam With Multiple Measurements Of Ocular Deviation,331.2,132.48,,,0 HCPCS,92060,Special eye evaluation,,,57.61,144.03,4 HCPCS,92066,Orthop traing supvj phys/qhp,,,57.61,144.03,4 HCPCS,92071,Hc Fitting Contact Lens Treatment Ocular Surface Disease,135.0,54.0,,,0 HCPCS,92072,Hc Fitting Contact Lens For Management Of Keratoconus,415.0,166.0,,,0 HCPCS,92081,"Hc Visual Field Exam,Limited - Auto Visual Field, Single Isopter Od- Unilateral",254.0,101.6,,,0 HCPCS,92081,Visual field examination(s),,,57.61,144.03,4 HCPCS,92082,"Hc Visual Field Exam,Intermediate - Auto Visual Field, Intermediate Od-Unilateral",394.0,157.6,,,0 HCPCS,92082,Visual field examination(s),,,57.61,144.03,4 HCPCS,92083,"Hc Visual Field Exam,Extended - Auto Visual Field, Extended Od-Unilateral",383.0,153.2,,,0 HCPCS,92083,Visual field examination(s),,,129.94,324.84,4 HCPCS,92100,Hc Serial Tonometry Exam(S),153.0,61.2,,,0 HCPCS,92132,Cmptr ophth dx img ant segmt,,,57.61,144.03,4 HCPCS,92132,"Hc Computerized Ophthalmic Diagnositc Imaging, Anterior Segment - Heidelberg Retina Tomography Ou- B",156.98,62.79,,,0 HCPCS,92132,"Hc Computerized Ophthalmic Diagnositc Imaging, Anterior Segment - Heidelberg Retina Tomography Ou- U",463.45,185.38,,,0 HCPCS,92133,Cmptr ophth img optic nerve,,,57.61,144.03,4 HCPCS,92133,Hc Computerized Ophthalmic Diagnositc Imaging Optic Nerve -Optic Nerve - Od - Unilateral,568.1,227.24,,,0 HCPCS,92134,Cptr ophth dx img post segmt,,,57.61,144.03,4 HCPCS,92134,Hc Computerized Ophthalmic Diagnositc Imaging Posterior Segment - Retina - Od - Bilateral,278.07,111.23,,,0 HCPCS,92134,Hc Computerized Ophthalmic Diagnositc Imaging Posterior Segment - Retina - Od - Unilateral,590.52,236.21,,,0 HCPCS,92136,Hc Ophthalmic Biometry - Iol Biometry - Os - Bilateral,373.75,149.5,,,0 HCPCS,92136,Hc Ophthalmic Biometry - Iol Biometry - Os - Unilateral,449.79,179.92,,,0 HCPCS,92136,Ophthalmic biometry,,,129.94,324.84,4 HCPCS,92137,Cptrz oph img pst sg rta oct,,,210.87,527.18,4 HCPCS,92145,Corneal hysteresis deter,,,57.61,144.03,4 HCPCS,92201,Hc Ophthalmoscopy Extend Retina Drawing & Scleral Depression I&R Bilateral,351.32,140.53,,,0 HCPCS,92201,Hc Ophthalmoscopy Extend Retina Drawing & Scleral Depression I&R Unilateral,430.56,172.22,,,0 HCPCS,92201,Opscpy extnd rta draw uni/bi,,,57.61,144.03,4 HCPCS,92202,Opscpy extnd on/mac draw,,,57.61,144.03,4 HCPCS,92227,Remote dx retinal imaging,,,57.61,144.03,4 HCPCS,92228,Remote retinal imaging mgmt,,,36.48,91.19,4 HCPCS,92229,Hc Imaging Retina Detection/Monitoring Of Eye Disease-Poct,485.88,194.35,,,0 HCPCS,92229,Img rta detc/mntr ds poc aly,,,57.61,144.03,4 HCPCS,92230,Eye exam with photos,,,364.43,911.07,4 HCPCS,92235,Fluorescein angrph uni/bi,,,210.87,527.18,4 HCPCS,92235,Hc Fluorescein Angiography - Fluorescein Angiography - Os - Bilateral,676.0,270.4,,,0 HCPCS,92235,Hc Fluorescein Angiography - Fluorescein Angiography - Os - Unilateral,1423.0,569.2,,,0 HCPCS,92240,Hc Indocyanine Green Angiography - Icg Angiography - Od - Bilateral,874.58,349.83,,,0 HCPCS,92240,Hc Indocyanine Green Angiography - Icg Angiography - Od - Unilateral,2145.32,858.13,,,0 HCPCS,92240,Icg angiography uni/bi,,,210.87,527.18,4 HCPCS,92242,Fluorescein icg angiography,,,210.87,527.18,4 HCPCS,92242,Hc Fluorescein Icg Angiography W/Multiframe I&R Bilateral,2317.25,926.9,,,0 HCPCS,92242,Hc Fluorescein Icg Angiography W/Multiframe I&R Unilateral,1988.35,795.34,,,0 HCPCS,92250,Eye exam with photos,,,129.94,324.84,4 HCPCS,92250,Hc Fundal Photography - Monochromatic Fundus Photography Os Bilateral,255.0,102.0,,,0 HCPCS,92250,Hc Fundal Photography - Monochromatic Fundus Photography Os Unilateral,355.0,142.0,,,0 HCPCS,92260,Ophthalmoscopy/dynamometry,,,36.48,91.19,4 HCPCS,92265,Eye muscle evaluation,,,57.61,144.03,4 HCPCS,92270,Electro-oculography,,,129.94,324.84,4 HCPCS,92273,Full field erg w/i&r,,,210.87,527.18,4 HCPCS,92273,Hc Full Field Electoretinography W/I&R,825.0,330.0,,,0 HCPCS,92274,Hc Multifocal Electroretinography W/I&R,575.0,230.0,,,0 HCPCS,92274,Multifocal erg w/i&r,,,125.66,314.16,4 HCPCS,92283,Color vision examination,,,57.61,144.03,4 HCPCS,92283,Hc Color Vision Examination,235.0,94.0,,,0 HCPCS,92284,Dark adaptation eye exam,,,436.27,1090.68,4 HCPCS,92284,Hc Dark Adaptation Eye Exam - Dark Adaptation - Od - Bilateral,352.0,140.8,,,0 HCPCS,92284,Hc Dark Adaptation Eye Exam - Dark Adaptation - Od - Unilateral,265.0,106.0,,,0 HCPCS,92285,Eye photography,,,36.48,91.19,4 HCPCS,92285,Hc Eye Photography - Gonio Photography - Os - Bilateral,249.0,99.6,,,0 HCPCS,92285,Hc Eye Photography - Gonio Photography - Os - Unilateral,295.0,118.0,,,0 HCPCS,92286,Hc Internal Eye Photography - Endothelial Photo And Cell Count Os- Unilateral,278.0,111.2,,,0 HCPCS,92286,Hc Internal Eye Photography - Endothelial Photo And Cell Count Os-Bilateral,440.0,176.0,,,0 HCPCS,92286,Internal eye photography,,,129.94,324.84,4 HCPCS,92287,Internal eye photography,,,129.94,324.84,4 HCPCS,92310,"Hc Contact Lens Fitting, Bilateral",36.0,14.4,,,0 HCPCS,92311,Contact lens fitting,,,436.27,1090.68,4 HCPCS,92311,"Hc Contact Lens Fit,Aphakia Unilateral",310.0,124.0,,,0 HCPCS,92312,Contact lens fitting,,,129.94,324.84,4 HCPCS,92312,"Hc Contact Lens Fit,Aphakia Bilateral",332.0,132.8,,,0 HCPCS,92313,Contact lens fitting,,,129.94,324.84,4 HCPCS,92313,"Hc Contact Lens Fit,Corneoscleral Lens",269.0,107.6,,,0 HCPCS,92314,"Hc Script Contact Lens,Bilateral",255.0,102.0,,,0 HCPCS,92315,Rx cntact lens aphakia 1 eye,,,129.94,324.84,4 HCPCS,92316,Rx cntact lens aphakia 2 eye,,,129.94,324.84,4 HCPCS,92317,Rx corneoscleral cntact lens,,,36.48,91.19,4 HCPCS,92325,Modification of contact lens,,,129.94,324.84,4 HCPCS,92326,Replacement of contact lens,,,57.61,144.03,4 HCPCS,92352,Fit aphakia spectcl monofocl,,,57.61,144.03,4 HCPCS,92353,Fit aphakia spectcl multifoc,,,57.61,144.03,4 HCPCS,92354,Fit spectacles single system,,,36.48,91.19,4 HCPCS,92355,Fit spectacles compound lens,,,36.48,91.19,4 HCPCS,92358,Aphakia prosth service temp,,,57.61,144.03,4 HCPCS,92371,Repair & adjust spectacles,,,57.61,144.03,4 HCPCS,92499,Eye service or procedure,,,28.25,70.62,4 HCPCS,92502,Ear and throat examination,,,526.71,1316.78,4 HCPCS,92504,Hc Binocular Microscopy,126.0,50.4,,,0 HCPCS,92507,"Hc Slp Speech/Hearing Therapy, Individual",480.02,192.01,,,0 HCPCS,92507,Hc Speech Lang Therapy Telehealth,480.02,192.01,,,0 HCPCS,92507,Speech/hearing therapy,,,72.53,181.32,4 HCPCS,92508,"Hc Slp Speech/Hearing Therapy, Group",230.24,92.1,,,0 HCPCS,92508,Speech/hearing therapy,,,22.61,56.52,4 HCPCS,92511,Hc Nasopharyngoscopy,568.01,227.2,,,0 HCPCS,92511,Hc Slp Nasopharyngoscopy,568.01,227.2,,,0 HCPCS,92511,Nasopharyngoscopy,,,194.94,487.34,4 HCPCS,92512,Hc Nasal Function Studies,876.07,350.43,,,0 HCPCS,92512,Nasal function studies,,,210.87,527.18,4 HCPCS,92516,Facial nerve function test,,,210.87,527.18,4 HCPCS,92516,Hc Facial Nerve Function Test - Electroneuronography,609.96,243.98,,,0 HCPCS,92517,Hc Cervical Vemp Testing W/Interpratation And Report,313.95,125.58,,,0 HCPCS,92517,Vemp test i&r cervical,,,125.66,314.16,4 HCPCS,92518,Vemp test i&r ocular,,,125.66,314.16,4 HCPCS,92519,Vemp tst i&r cervical&ocular,,,210.87,527.18,4 HCPCS,92520,Hc Slp Laryngeal Function Studies,989.69,395.88,,,0 HCPCS,92520,Laryngeal function studies,,,129.94,324.84,4 HCPCS,92521,Evaluation of speech fluency,,,126.79,316.98,4 HCPCS,92521,Hc Slp Evaluation Of Speech Fluency (Stutter Clutter),662.47,264.99,,,0 HCPCS,92522,Evaluate speech production,,,106.63,266.58,4 HCPCS,92522,Hc Slp Evaluation Of Speech Sound Production Articulate,625.55,250.22,,,0 HCPCS,92523,Hc Slp Eval Speech Sound Product Language Comprehension,690.71,276.28,,,0 HCPCS,92523,Hc Speech Lang Eval Telehealth,690.71,276.28,,,0 HCPCS,92523,Speech sound lang comprehen,,,215.57,538.92,4 HCPCS,92524,Behavral qualit analys voice,,,104.54,261.35,4 HCPCS,92524,Hc Slp Behavioral & Qualit Analysis Voice And Resonance,655.95,262.38,,,0 HCPCS,92526,Hc Slp Oral Function Therapy,430.06,172.02,,,0 HCPCS,92526,Oral function therapy,,,79.8,199.5,4 HCPCS,92537,Caloric vstblr test w/rec,,,125.66,314.16,4 HCPCS,92537,Hc Caloric Vestibular Test W/Rec Bi Bithermal,272.0,108.8,,,0 HCPCS,92538,Caloric vstblr test w/rec,,,210.87,527.18,4 HCPCS,92538,Hc Caloric Vestibular Test W/Rec Bi Monothermal,242.0,96.8,,,0 HCPCS,92540,Basic vestibular evaluation,,,210.87,527.18,4 HCPCS,92540,Hc Basic Vestibular Evaluation,246.68,98.67,,,0 HCPCS,92541,Spontaneous nystagmus test,,,129.94,324.84,4 HCPCS,92542,Positional nystagmus test,,,129.94,324.84,4 HCPCS,92544,Optokinetic nystagmus test,,,125.66,314.16,4 HCPCS,92545,Oscillating tracking test,,,210.87,527.18,4 HCPCS,92546,Sinusoidal rotational test,,,125.66,314.16,4 HCPCS,92548,Posturography,,,129.94,324.84,4 HCPCS,92549,Cdp-sot 6 cond w/i&r mct&adt,,,129.94,324.84,4 HCPCS,92550,Hc Tympanometry And Reflex Threshold Measurements,284.05,113.62,,,0 HCPCS,92550,Tympanometry & reflex thresh,,,210.87,527.18,4 HCPCS,92552,"Hc Pure Tone Audiometry, Air",227.24,90.9,,,0 HCPCS,92552,Pure tone audiometry air,,,129.94,324.84,4 HCPCS,92553,Audiometry air & bone,,,125.66,314.16,4 HCPCS,92553,"Hc Audiometry, Air & Bone",306.48,122.59,,,0 HCPCS,92555,Hc Speech Threshold Audiometry,161.46,64.58,,,0 HCPCS,92555,Speech threshold audiometry,,,57.61,144.03,4 HCPCS,92556,"Hc Speech Audiometry, Complete",285.54,114.22,,,0 HCPCS,92556,Speech audiometry complete,,,57.61,144.03,4 HCPCS,92557,Comprehensive hearing test,,,125.66,314.16,4 HCPCS,92557,Hc Comprehensive Hearing Test,390.2,156.08,,,0 HCPCS,92562,Loudness balance test,,,210.87,527.18,4 HCPCS,92563,Tone decay hearing test,,,36.48,91.19,4 HCPCS,92565,Stenger test pure tone,,,57.61,144.03,4 HCPCS,92567,Hc Tympanometry,269.1,107.64,,,0 HCPCS,92567,Tympanometry,,,36.48,91.19,4 HCPCS,92568,Acoustic refl threshold tst,,,36.48,91.19,4 HCPCS,92570,Acoustic immitance testing,,,125.66,314.16,4 HCPCS,92570,Hc Acoustic Immit Test Tympanometry/Acoust Reflex/Decay,336.38,134.55,,,0 HCPCS,92571,Filtered speech hearing test,,,36.48,91.19,4 HCPCS,92572,Staggered spondaic word test,,,125.66,314.16,4 HCPCS,92575,Sensorineural acuity test,,,36.48,91.19,4 HCPCS,92576,Synthetic sentence test,,,36.48,91.19,4 HCPCS,92577,Stenger test speech,,,364.43,911.07,4 HCPCS,92579,Hc Visual Audiometry (Vra),373.75,149.5,,,0 HCPCS,92579,Visual audiometry (vra),,,210.87,527.18,4 HCPCS,92582,Conditioning play audiometry,,,125.66,314.16,4 HCPCS,92582,Hc Conditioning Play Audiometry,334.88,133.95,,,0 HCPCS,92583,Hc Select Picture Audiometry,313.95,125.58,,,0 HCPCS,92583,Select picture audiometry,,,57.61,144.03,4 HCPCS,92584,Electrocochleography,,,125.66,314.16,4 HCPCS,92584,Hc Electrocochleography,454.48,181.79,,,0 HCPCS,92587,Evoked auditory test limited,,,210.87,527.18,4 HCPCS,92587,"Hc Evoked Auditory Test,Limited",402.16,160.86,,,0 HCPCS,92588,Evoked auditory tst complete,,,364.43,911.07,4 HCPCS,92588,"Hc Evoked Auditory Test,Comprehsv",623.42,249.37,,,0 HCPCS,92596,Ear protector evaluation,,,36.48,91.19,4 HCPCS,92597,Hc Slp Eval Voice Prosth Device,499.57,199.83,,,0 HCPCS,92597,Oral speech device eval,,,67.82,169.55,4 HCPCS,92601,Cochlear implt f/up exam <7,,,125.66,314.16,4 HCPCS,92601,"Hc Dx Analysis Of Cochlear Implant,Pt <7 Yrs,W/Programming",579.93,231.97,,,0 HCPCS,92602,"Hc Dx Analysis Of Cochlear Implant,Pt <7 Yrs,Reprogramming",579.93,231.97,,,0 HCPCS,92602,Reprogram cochlear implt 7/>,,,125.66,314.16,4 HCPCS,92603,Cochlear implt f/up exam 7/>,,,125.66,314.16,4 HCPCS,92603,"Hc Dx Analysis Of Cochlear Implant,Pt >7 Yrs,W/Programming",696.14,278.46,,,0 HCPCS,92604,"Hc Dx Analysis Of Cochlear Implant,Pt >7 Yrs,Reprogramming",672.24,268.9,,,0 HCPCS,92604,Reprogram cochlear implt 7/>,,,125.66,314.16,4 HCPCS,92606,"Hc Slp Ther Srvc(S),Non-Speech Gen Dev, W/Prog",398.57,159.43,,,0 HCPCS,92607,Ex for speech device rx 1hr,,,115.55,288.88,4 HCPCS,92607,"Hc Slp Eval,Speech-Gen Aug/Alt Comm Dev,1St Hour",691.79,276.72,,,0 HCPCS,92608,Ex for speech device rx addl,,,45.06,112.65,4 HCPCS,92608,"Hc Slp Eval,Speech-Gen Aug/Alt Comm Dev,Additional 30 Minutes",221.55,88.62,,,0 HCPCS,92609,"Hc Slp Ther Srvc, Speech Gen Dev Use, W/Prog",409.43,163.77,,,0 HCPCS,92609,Use of speech device service,,,96.73,241.82,4 HCPCS,92610,Evaluate swallowing function,,,56.2,140.5,4 HCPCS,92610,"Hc Eval,Oral & Pharyngeal Swallow Function",687.45,274.98,,,0 HCPCS,92611,"Hc Slp Eval,Swallow Function,Cine/Video Record",860.12,344.05,,,0 HCPCS,92611,Motion fluoroscopy/swallow,,,86.26,215.65,4 HCPCS,92612,Endoscopy swallow (fees) vid,,,52.74,131.85,4 HCPCS,92612,"Hc Slp Endoscopic Eval,Swallow Cine/Video/W/Disp Scope",799.31,319.72,,,0 HCPCS,92614,Laryngoscopic sensory vid,,,52.75,131.88,4 HCPCS,92616,Fees w/laryngeal sense test,,,77.81,194.52,4 HCPCS,92620,Auditory function 60 min,,,125.66,314.16,4 HCPCS,92620,"Hc Auditory Function, 60 Min",335.58,134.23,,,0 HCPCS,92621,"Hc Auditory Function, + 15 Min",56.47,22.59,,,0 HCPCS,92622,Dx aly aud oi snd prcsr 1st,,,125.66,314.16,4 HCPCS,92625,Hc Tinnitus Assessment,231.32,92.53,,,0 HCPCS,92625,Tinnitus assessment,,,125.66,314.16,4 HCPCS,92626,Eval aud rehab status,,,125.66,314.16,4 HCPCS,92626,"Hc Eval Auditory Rehab Status, 1St Hour",501.74,200.7,,,0 HCPCS,92640,Aud brainstem implt programg,,,125.66,314.16,4 HCPCS,92650,Hc Aep Screen Auditory Potential W/Stimuli Auto Analysis,352.96,141.18,,,0 HCPCS,92651,Aep hearing status deter i&r,,,210.87,527.18,4 HCPCS,92651,Hc Auditory Evoked Potentials With Interpretation And Report,538.66,215.46,,,0 HCPCS,92652,Aep thrshld est mlt freq i&r,,,210.87,527.18,4 HCPCS,92652,Hc Auditory Brainstem Response Test,784.54,313.82,,,0 HCPCS,92653,Aep neurodiagnostic i&r,,,210.87,527.18,4 HCPCS,92700,Ent procedure/service,,,28.25,70.62,4 HCPCS,92920,Hc Ptca Single Vess Rms Initial,17216.65,6886.66,,,0 HCPCS,92920,Hc Ptca Single Vess Rt Coron,17216.65,6886.66,,,0 HCPCS,92920,Hc Ptca Single Vessel Circ,17216.65,6886.66,,,0 HCPCS,92920,Hc Ptca Single Vessel Left Anterior Desc,17216.65,6886.66,,,0 HCPCS,92920,Hc Ptca Single Vessel Left Main,17216.65,6886.66,,,0 HCPCS,92920,Prq cardiac angioplast 1 art,,,5558.41,13896.01,4 HCPCS,92921,Hc Ptca Ea Addl Vess Rms Int,13487.2,5394.88,,,0 HCPCS,92921,Hc Ptca Each Additonal Vessel Anter Des,13487.2,5394.88,,,0 HCPCS,92921,Hc Ptca Each Additonal Vessel Circ,13487.2,5394.88,,,0 HCPCS,92921,Hc Ptca Each Additonal Vessel Coron,13487.2,5394.88,,,0 HCPCS,92924,Hc Artherec Single Vessel Main,26966.35,10786.54,,,0 HCPCS,92924,Prq card angio/athrect 1 art,,,11274.1,28185.26,4 HCPCS,92928,Hc Prq Trluml Coronary Stent W/Angio One Art/Brnch-Lc,23806.15,9522.46,,,0 HCPCS,92928,Hc Prq Trluml Coronary Stent W/Angio One Art/Brnch-Ld,23806.15,9522.46,,,0 HCPCS,92928,Hc Prq Trluml Coronary Stent W/Angio One Art/Brnch-Lm,23806.15,9522.46,,,0 HCPCS,92928,Hc Prq Trluml Coronary Stent W/Angio One Art/Brnch-Rc,23806.15,9522.46,,,0 HCPCS,92928,Prq card stent w/angio 1 vsl,,,11274.1,28185.26,4 HCPCS,92929,Hc Stent Plc Lc W/Ptca Ea Add Lc*,21179.55,8471.82,,,0 HCPCS,92929,Hc Stent Plc Ld W/Ptca Ea Add Ld*,21179.55,8471.82,,,0 HCPCS,92929,Hc Stent Plc Rc W/Ptca Ea Add Rc*,21179.55,8471.82,,,0 HCPCS,92930,Prq tcat plmt ntrac st 2+les,,,17902.75,44756.89,4 HCPCS,92933,Hc Stent Plc/Ptca/Art 1 Ves Ld*,25258.6,10103.44,,,0 HCPCS,92933,Hc Stent Plc/Ptca/Art 1 Ves Rc*,25258.6,10103.44,,,0 HCPCS,92933,Prq card stent/ath/angio,,,17902.75,44756.89,4 HCPCS,92934,Hc Stent Plc/Ptca/Art Ea Add Ld*,20762.1,8304.84,,,0 HCPCS,92937,Hc Prc Rvsc Byp Grf 1 Vl W/St Lm,25510.45,10204.18,,,0 HCPCS,92937,Prq revasc byp graft 1 vsl,,,11274.1,28185.26,4 HCPCS,92941,Hc Prq Trluml Coronry Tot Occlus Revasc Mi One Vsl-Lc,27447.05,10978.82,,,0 HCPCS,92941,Hc Prq Trluml Coronry Tot Occlus Revasc Mi One Vsl-Ld,27447.05,10978.82,,,0 HCPCS,92941,Hc Prq Trluml Coronry Tot Occlus Revasc Mi One Vsl-Rc,27447.05,10978.82,,,0 HCPCS,92943,Hc Prc Rvsc Chron 1 Vl W/St Rc,24591.6,9836.64,,,0 HCPCS,92943,Prq card revasc chronic 1vsl,,,11274.1,28185.26,4 HCPCS,92944,Hc Cath Prq Trluml Coronry Chrnic Occlus Revasc Addl Vsl,20257.25,8102.9,,,0 HCPCS,92945,Prq trl rvs ch occ ant&rtrgr,,,11274.1,28185.26,4 HCPCS,92950,Hc Heart/Lung Resuscitation (Cpr),1000.35,400.14,,,0 HCPCS,92950,Hc Rt Heart/Lung Resuscitation (Cpr),1469.7,587.88,,,0 HCPCS,92950,Heart/lung resuscitation cpr,,,210.87,527.18,4 HCPCS,92953,Hc Temporary External Pacing,2610.39,1044.16,,,0 HCPCS,92953,Temporary external pacing,,,645.48,1613.7,4 HCPCS,92960,Cardioversion electric ext,,,645.48,2978.0,8 HCPCS,92960,Hc Cardioversion Elective Arrhythmia External,3975.02,1590.01,,,0 HCPCS,92960,Hc Cardioverson Electric External,2450.5,980.2,,,0 HCPCS,92960,"Hc Ep Cardioversion, Elective;Extern",3975.02,1590.01,,,0 HCPCS,92961,Cardioversion electric int,,,645.48,1613.7,4 HCPCS,92972,Hc Percutaneous Transluminal Coronary Lithotripsy,3864.0,1545.6,,,0 HCPCS,92973,Hc Catheter Percutaneous Transluminal Coronary Mechanical Thrombectomy,8822.8,3529.12,,,0 HCPCS,92977,"Hc Thrombolysis,Coronary,Iv Infusion",1799.75,719.9,,,0 HCPCS,92978,Hc Endoluminal Imaging Of Coronary Vessels- Initial Vessel,7266.28,2906.51,,,0 HCPCS,92979,Hc Endoluminal Imaging Of Coronary Vessels- Additional Vessel,4322.64,1729.06,,,0 HCPCS,92986,Hc Catheter Percutaneous Aortic Valvuloplasty,16742.85,6697.14,,,0 HCPCS,92986,Revision of aortic valve,,,5558.41,13896.01,4 HCPCS,92987,Hc Catheter Percutaneous Mitral Valvuloplasty,19125.65,7650.26,,,0 HCPCS,92987,Revision of mitral valve,,,11274.1,28185.26,4 HCPCS,92990,Hc Catheter Percutaneous Pulmonary Valvuloplasty,18856.55,7542.62,,,0 HCPCS,92990,Revision of pulmonary valve,,,11274.1,28185.26,4 HCPCS,92992,"Hc Cath Atrial Septostomy,Xvenous,Balloon",18419.55,7367.82,,,0 HCPCS,92997,Hc Catheter Pulmonary Arterial Balloon Repair Percutaneous First Vessel,16428.9,6571.56,,,0 HCPCS,92997,Pul art balloon repr percut,,,11274.1,28185.26,4 HCPCS,92998,Hc Catheter Pulmonary Arterial Balloon Repair Percutaneous Each Additional Vessel,9416.2,3766.48,,,0 HCPCS,93005,Electrocardiogram tracing,,,57.61,144.03,4 HCPCS,93005,"Hc Electrocardiogram, Tracing",428.7,171.48,,,0 HCPCS,93005,"Hc Electrocardiogram, Tracing - Ecg 12-Lead",428.7,171.48,,,0 HCPCS,93017,Cardiovascular stress test,,,210.87,2978.0,8 HCPCS,93017,"Hc Cardiac Stress Tst,Tracing Only",2092.05,836.82,,,0 HCPCS,93024,Cardiac drug stress test,,,436.27,1090.68,4 HCPCS,93025,Microvolt t-wave assess,,,125.66,314.16,4 HCPCS,93041,Rhythm ecg tracing,,,57.61,144.03,4 HCPCS,93050,Art pressure waveform analys,,,28.25,70.62,4 HCPCS,93145,Interrog crtd sins bat ip wo,,,125.66,314.16,4 HCPCS,93146,Interrog crtd sins bat ip w/,,,125.66,314.16,4 HCPCS,93150,Therapy activation ipnss,,,92.85,232.12,4 HCPCS,93151,Interrog&prgrmg ipnss,,,92.85,232.12,4 HCPCS,93152,Interrog&prgrmg ipnss polysm,,,299.95,749.88,4 HCPCS,93153,Interrog w/o prgrmg ipnss,,,92.85,232.12,4 HCPCS,93225,Ecg monit/reprt up to 48 hrs,,,129.94,324.84,4 HCPCS,93225,"Hc Ext Ecg Record Continuous 48 Hr, Record - Holter Monitor - 48 Hour",1119.19,447.68,,,0 HCPCS,93226,Ecg monit/reprt up to 48 hrs,,,57.61,144.03,11 HCPCS,93226,Hc Ecg Monit/Reprt Up To 48 Hrs - Holter Monitor - 48 Hour,1027.73,411.09,,,0 HCPCS,93227,Hc Ecg < 48 Hours,434.42,173.77,,,0 HCPCS,93229,Hc External Mobile Cv Telemetry W/Technical Support,1354.69,541.88,,,0 HCPCS,93229,Remote 30 day ecg tech supp,,,364.43,911.07,11 HCPCS,93242,Ext ecg>48hr<7d recording,,,36.48,91.19,4 HCPCS,93242,Hc Holter Hookup > 48Hrs-7 Days,414.98,165.99,,,0 HCPCS,93243,Ext ecg>48hr<7d scan a/r,,,129.94,324.84,4 HCPCS,93243,Hc Holter Analysis > 48Hrs-7 Day,585.32,234.13,,,0 HCPCS,93244,Hc Holter Analysis > 48Hrs <7 Day,497.29,198.92,,,0 HCPCS,93246,Ext ecg>7d<15d recording,,,36.48,91.19,4 HCPCS,93246,Hc Holter Hookup - 7-15 Days,414.98,165.99,,,0 HCPCS,93247,Ext ecg>7d<15d scan a/r,,,129.94,324.84,4 HCPCS,93247,Hc Holter Analysis 7-15 Days,585.32,234.13,,,0 HCPCS,93248,Hc Ekg 8-15 Days Review And Interpretation,400.12,160.05,,,0 HCPCS,93260,Hc Programming Device Eval Of Heart Monitoring System,120.0,48.0,,,0 HCPCS,93260,Prgrmg dev eval impltbl sys,,,36.45,91.12,4 HCPCS,93261,Hc Interrogation Eval F2F Implant Subq Lead Defib,1350.0,540.0,,,0 HCPCS,93261,Interrogate subq defib,,,36.45,91.12,4 HCPCS,93264,Rem mntr wrls p-art prs snr,,,36.45,91.12,4 HCPCS,93270,Hc Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor,627.62,251.05,,,0 HCPCS,93270,Remote 30 day ecg rev/report,,,36.45,91.12,4 HCPCS,93271,Ecg/monitoring and analysis,,,65.69,232.12,11 HCPCS,93271,Hc Ecg/Monitoring And Analysis - Cardiac Event Monitor,1047.17,418.87,,,0 HCPCS,93278,ECG/signal-averaged,,,57.61,144.03,4 HCPCS,93278,Hc Single Averaged Ecg,258.36,103.34,,,0 HCPCS,93279,Hc Ep Program Eval Implantable In Prsn 1 Ld Pacemaker,349.82,139.93,,,0 HCPCS,93279,Hc Pm Device Program Eval Sngle - Card Device Inpatient Pacemaker W/ Programming,349.82,139.93,,,0 HCPCS,93279,Pm device progr eval sngl,,,36.45,91.12,4 HCPCS,93280,Hc Pm Device Program Eval Dual - Card Device In Clinic Pacemaker Dual Chamber,405.84,162.34,,,0 HCPCS,93280,Hc Pm Device Program Eval Dual - Card Device Inpatient Pacemaker Dual Chamber,405.84,162.34,,,0 HCPCS,93280,Pm device progr eval dual,,,36.45,91.12,4 HCPCS,93281,Hc Ep Program Eval Implantable In Prsn Multi Ld Pacer,473.28,189.31,,,0 HCPCS,93281,Hc Pm Device Program Eval Multiple- Card Device In Clinic Pacemaker Bivalve Chamber,473.28,189.31,,,0 HCPCS,93281,Pm device progr eval multi,,,36.45,91.12,4 HCPCS,93282,Hc Programming Eval Implantable Dfb - Card Device In Clinic Icd Single Chamber,372.68,149.07,,,0 HCPCS,93282,Hc Programming Eval Implantable Dfb - Card Device Inpatient Icd Singlr Chamber,372.68,149.07,,,0 HCPCS,93282,Prgrmg eval implantable dfb,,,36.45,91.12,4 HCPCS,93283,Hc Programming Eval Implantable Dfb - Card Device In Clinic Icd Dual Chamber,418.41,167.36,,,0 HCPCS,93283,Hc Programming Eval Implantable Dfb - Card Device Inpatient Icd Dual Chamber,418.41,167.36,,,0 HCPCS,93283,Prgrmg eval implantable dfb,,,36.45,91.12,4 HCPCS,93284,Hc Programming Eval Implantable Dfb - Card Device Inpatient Icd Bivalve Chamber,523.58,209.43,,,0 HCPCS,93284,Hc Programming Eval Implantable Dfb - Cardiac Device Clinic Icd Bivalve Chamber,523.58,209.43,,,0 HCPCS,93284,Prgrmg eval implantable dfb,,,36.45,91.12,4 HCPCS,93285,Hc Ilr Device Eval Progr - Card Device In Clinic Loop Recorder (Ilr),349.82,139.93,,,0 HCPCS,93285,Hc Ilr Device Interrogat Remote - Card Device Remote - Loop Recorder,402.29,160.92,,,0 HCPCS,93285,Ilr device eval progr,,,36.45,91.12,4 HCPCS,93286,Hc Ep Peri-Px Eval&Program In Prsn Pacemaker System,515.78,206.31,,,0 HCPCS,93287,Hc Ep Peri-Px Dev Eval & Prog Sing/Dual/Multi Lead Dfb,515.78,206.31,,,0 HCPCS,93288,Hc Pm Device Eval In Person - Card Device In Clinic - Pacemaker,500.82,200.33,,,0 HCPCS,93288,Hc Pm Device Eval In Person - Card Device Inpatient - Pacemaker,500.82,200.33,,,0 HCPCS,93288,Pm device eval in person,,,36.45,91.12,4 HCPCS,93289,Hc Interrog Device Eval Heart - Card Device In Clinic - Icd,554.64,221.86,,,0 HCPCS,93289,Interrog device eval heart,,,36.45,91.12,4 HCPCS,93290,Hc In Person Icm Interrogation,370.76,148.3,,,0 HCPCS,93290,Icm device eval,,,36.45,91.12,4 HCPCS,93291,Hc Ilr Device Interrogate - Card Device In Clinic - Loop Recorder (Ilr),500.82,200.33,,,0 HCPCS,93291,Hc Ilr Device Interrogate - Card Device Inpatient - Loop Recorder (Ilr),500.82,200.33,,,0 HCPCS,93291,Ilr device interrogate,,,28.25,70.62,4 HCPCS,93292,Wcd device interrogate,,,36.45,91.12,4 HCPCS,93293,Pm phone r-strip device eval,,,36.45,91.12,4 HCPCS,93296,Hc Ep Interrogation Remote paramtrs,,,838.65,2096.62,4 HCPCS,95783,Hc Pediatric Cpap <6 Yo,7146.78,2858.71,,,0 HCPCS,95783,Hc Reduced/Elimated Svcs Pediatric Cpap <6 Yo,6214.59,2485.84,,,0 HCPCS,95783,Polysom <6 yrs cpap/bilvl,,,838.65,2096.62,4 HCPCS,95800,Slp stdy unattended,,,210.87,527.18,4 HCPCS,95801,Slp stdy unatnd w/anal,,,57.61,144.03,4 HCPCS,95803,Actigraphy testing,,,57.61,144.03,4 HCPCS,95803,Hc Actigraphy Test Rec/Analy/I&R,485.21,194.08,,,0 HCPCS,95805,Hc Multiple Sleep Latency Test,5020.37,2008.15,,,0 HCPCS,95805,Multiple sleep latency test,,,838.65,2096.62,4 HCPCS,95806,Hc Unattended Polysomnography,1175.56,470.22,,,0 HCPCS,95806,Sleep study unatt&resp efft,,,210.87,527.18,4 HCPCS,95807,Hc Pap Nap Reduced Serv,865.55,346.22,,,0 HCPCS,95807,Sleep study attended,,,364.43,911.07,4 HCPCS,95808,Hc Attended Hst,1265.0,506.0,,,0 HCPCS,95808,Polysom any age 1-3> param,,,838.65,2096.62,4 HCPCS,95810,Hc Polysom 6/>Yrs Sleep 4/> Addl Param Attnd,6830.99,2732.4,,,0 HCPCS,95810,Hc Reduced/Elimated Svcs Polysom 6/>Yrs Sleep 4/> Addl Param Attnd,5939.99,2376.0,,,0 HCPCS,95810,Polysom 6/> yrs 4/> param,,,838.65,2096.62,4 HCPCS,95811,Hc Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd,6819.45,2727.78,,,0 HCPCS,95811,Hc Reduced/Elimated Svcs Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd,5929.69,2371.88,,,0 HCPCS,95811,Polysom 6/>yrs cpap 4/> parm,,,838.65,2096.62,4 HCPCS,95812,Eeg 41-60 minutes,,,210.87,527.18,4 HCPCS,95812,"Hc Eeg,Extended Monitoring,41-60 Minutes - Eeg",1961.73,784.69,,,0 HCPCS,95812,Hc Poct Ceribell Eeg 41-60 Minutes,3594.21,1437.68,,,0 HCPCS,95813,Eeg over 1 hour,,,210.87,527.18,4 HCPCS,95813,"Hc Eeg , Greater Than 1 Hr",2600.77,1040.31,,,0 HCPCS,95813,Hc Poct Ceribell Eeg 61-119 Minutes,3822.85,1529.14,,,0 HCPCS,95816,Eeg awake and drowsy,,,210.87,527.18,4 HCPCS,95816,"Hc Eeg,W/Awake & Drowsy Record - Eeg Awake Or Drowsy Portable",1784.53,713.81,,,0 HCPCS,95816,Hc Poct Ceribell Eeg 20-40 Minutes,3422.73,1369.09,,,0 HCPCS,95819,Eeg awake and asleep,,,210.87,527.18,4 HCPCS,95819,"Hc Eeg,W/Awake & Asleep Record",1814.25,725.7,,,0 HCPCS,95822,Eeg coma or sleep only,,,210.87,527.18,4 HCPCS,95822,"Hc Eeg,Coma/Sleep Record Only - Eeg In Coma",1710.22,684.09,,,0 HCPCS,95824,Eeg cerebral death only,,,364.43,911.07,4 HCPCS,95829,Hc Surgery Electrocorticogram - Electrocorticogram At Surgery,10347.79,4139.12,,,0 HCPCS,95836,Ecog impltd brn npgt <=30 d,,,36.45,91.12,4 HCPCS,95836,Hc Electrocorticogram With Implanted Brain Neurostimulator,591.5,236.6,,,0 HCPCS,95851,"Hc Ot Range Motion Measure,Each Extrem",124.0,49.6,,,0 HCPCS,95851,Range of motion measurements,,,6.54,16.35,4 HCPCS,95852,Hc Rom Hand Ot,74.0,29.6,,,0 HCPCS,95852,Hc Rom Hand Pt,74.0,29.6,,,0 HCPCS,95852,Range of motion measurements,,,4.87,12.18,4 HCPCS,95857,Cholinesterase challenge,,,210.87,527.18,4 HCPCS,95860,"Hc Emg, Needle, One Limb",1131.9,452.76,,,0 HCPCS,95860,Muscle test one limb,,,129.94,324.84,4 HCPCS,95861,"Hc Emg, Needle, Two Limbs",1252.45,500.98,,,0 HCPCS,95861,"Hc Emg, Needle, Two Limbs - Emg 2 Limbs",1252.45,500.98,,,0 HCPCS,95861,Muscle test 2 limbs,,,129.94,324.84,4 HCPCS,95863,Hc Needle Emg 3 Extremities,304.2,121.68,,,0 HCPCS,95863,Muscle test 3 limbs,,,125.66,314.16,4 HCPCS,95864,"Hc Emg, Needle, 4 Limbs",2463.04,985.22,,,0 HCPCS,95864,Muscle test 4 limbs,,,125.66,314.16,4 HCPCS,95865,Hc Needle Emg Larynx,552.5,221.0,,,0 HCPCS,95865,Muscle test larynx,,,129.94,324.84,4 HCPCS,95866,Hc Needle Emg Hemidiaphragm,422.5,169.0,,,0 HCPCS,95866,Muscle test hemidiaphragm,,,125.66,314.16,4 HCPCS,95867,"Hc Emg,Needle,Cranial Nerve Supp Mus,Unilateral - Emg Head Or Neck Unilateral",1078.31,431.32,,,0 HCPCS,95867,Muscle test cran nerv unilat,,,210.87,527.18,4 HCPCS,95868,Hc Needle Electromyography Cranial Nerve Muscle-Bilateral,942.5,377.0,,,0 HCPCS,95868,Muscle test cran nerve bilat,,,210.87,527.18,4 HCPCS,95869,"Hc Needle Emg Thoracic Paraspinal Muscles, Excluding T1 Or T12)",646.1,258.44,,,0 HCPCS,95869,Muscle test thor paraspinal,,,210.87,527.18,4 HCPCS,95870,"Hc Emg,1 Extrem,Nonparaspinal",838.88,335.55,,,0 HCPCS,95870,Muscle test nonparaspinal,,,129.94,324.84,4 HCPCS,95872,Hc Needle Emg W/1 Fiber Electrode With Quantitative Measurement Of Jitter,1120.6,448.24,,,0 HCPCS,95872,Muscle test one fiber,,,210.87,527.18,4 HCPCS,95873,Hc E Stim Gde-Chemodenervation,231.84,92.74,,,0 HCPCS,95874,Hc Emg Guidance For Chemodenervat,919.24,367.7,,,0 HCPCS,95875,Limb exercise test,,,125.66,314.16,4 HCPCS,95885,Hc Needle Emg Ea Extremity W/Paraspinl Area Limited,962.78,385.11,,,0 HCPCS,95886,Hc Needle Emg Ea Extremty W/Paraspinl Area Complete,895.5,358.2,,,0 HCPCS,95887,Hc Needle Emg Nonextremty Mscles W/Nerve Conduction,831.22,332.49,,,0 HCPCS,95905,Hc Motor And/Or Sensesory Nerve Condition Each Limb,376.74,150.7,,,0 HCPCS,95905,Motor &/ sens nrve cndj test,,,436.27,1090.68,4 HCPCS,95907,Hc Motor &/Sens 1-2 Nrv Cndj Preconf Eltrode Limb,962.78,385.11,,,0 HCPCS,95907,Nvr cndj tst 1-2 studies,,,210.87,527.18,4 HCPCS,95908,Hc Motor &/Sens 3-4 Nerve Conduction Preconf Electrode Limb,1450.15,580.06,,,0 HCPCS,95908,Nrv cndj tst 3-4 studies,,,210.87,527.18,4 HCPCS,95909,Hc Motor &/Sens 5-6 Nerve Conduction Preconf Electrode Limb,1817.92,727.17,,,0 HCPCS,95909,Nrv cndj tst 5-6 studies,,,210.87,527.18,4 HCPCS,95910,Hc Motor &/Sens 7-8 Nerve Cnduction Preconf Electrode Limb,2167.75,867.1,,,0 HCPCS,95910,Nrv cndj test 7-8 studies,,,364.43,911.07,4 HCPCS,95911,Hc Motor &/Sens 9-10 Nrv Cndj Preconf Eltrode Limb,2985.52,1194.21,,,0 HCPCS,95911,Nrv cndj test 9-10 studies,,,364.43,911.07,4 HCPCS,95912,Hc Motor &/Sens 11-12 Nrv Cndj Preconf Eltrode Limb,3354.78,1341.91,,,0 HCPCS,95912,Nrv cndj test 11-12 studies,,,364.43,911.07,4 HCPCS,95913,Hc Motor &/Sens 13/> Nrv Cndj Preconf Eltrode Limb,3549.13,1419.65,,,0 HCPCS,95913,Nrv cndj test 13/> studies,,,364.43,911.07,4 HCPCS,95919,Quan puplmtry phy/qhp uni/bi,,,129.94,324.84,4 HCPCS,95921,Autonomic nrv parasym inervj,,,125.66,314.16,4 HCPCS,95922,Autonomic nrv adrenrg inervj,,,129.94,324.84,4 HCPCS,95923,Autonomic nrv syst funj test,,,129.94,324.84,4 HCPCS,95923,Hc Autonomic Nervous System Function Testing,943.34,377.34,,,0 HCPCS,95924,Ans parasymp & symp w/tilt,,,210.87,527.18,4 HCPCS,95925,Hc Somatosensory Evp Upper Limbs,1970.41,788.16,,,0 HCPCS,95925,Somatosensory testing,,,210.87,527.18,4 HCPCS,95926,"Hc Somatosensory Test,Lower Limbs - Somatosensory Test",2049.64,819.86,,,0 HCPCS,95926,Somatosensory testing,,,210.87,527.18,4 HCPCS,95927,Somatosensory testing,,,210.87,527.18,4 HCPCS,95928,C motor evoked uppr limbs,,,838.65,2096.62,4 HCPCS,95928,Hc Upper Tcemep,2128.88,851.55,,,0 HCPCS,95929,C motor evoked lwr limbs,,,364.43,911.07,4 HCPCS,95929,Hc Lower Tcemep,2128.88,851.55,,,0 HCPCS,95930,Hc Visual Ep Testing Cns Except Glaucoma W/I&R,1577.22,630.89,,,0 HCPCS,95930,Visual evoked potential test,,,210.87,527.18,4 HCPCS,95933,Blink reflex test,,,57.61,144.03,4 HCPCS,95933,Hc Blink Reflex Test,665.28,266.11,,,0 HCPCS,95937,Hc Neuromuscular Junction Test,804.31,321.72,,,0 HCPCS,95937,Neuromuscular junction test,,,125.66,314.16,4 HCPCS,95938,Hc Upper And Lower Sep,3151.46,1260.58,,,0 HCPCS,95938,Somatosensory testing,,,838.65,2096.62,4 HCPCS,95939,C motor evoked upr&lwr limbs,,,838.65,2096.62,4 HCPCS,95939,Hc Cmep Upper And Lower Limbs,3262.09,1304.84,,,0 HCPCS,95940,Hc Ionm 1 On 1 In Or W/Attendance Each 15 Minutes,897.0,358.8,,,0 HCPCS,95954,EEG monitoring/giving drugs,,,364.43,911.07,4 HCPCS,95955,Hc Eeg During Surgery - Eeg During Nonintracranial Surgery,4045.78,1618.31,,,0 HCPCS,95957,Hc Eeg Digital Analysis,1196.93,478.77,,,0 HCPCS,95958,EEG monitoring/function test,,,838.65,2096.62,4 HCPCS,95961,Electrode stimulation brain,,,838.65,2096.62,4 HCPCS,95961,Hc Cortical Map By Stim Init Hr,2657.4,1062.96,,,0 HCPCS,95962,Hc Cortical Map Stim Ea Ad Hr,1853.26,741.3,,,0 HCPCS,95965,Meg spontaneous,,,838.65,2096.62,4 HCPCS,95966,Meg evoked single,,,838.65,2096.62,4 HCPCS,95970,Analyze neurostim no prog,,,129.94,324.84,4 HCPCS,95970,Hc Analysis Of Implanted Brain/Peripheral Neurostimulator Without Programming,747.5,299.0,,,0 HCPCS,95971,Analyze neurostim simple,,,92.85,232.12,4 HCPCS,95971,"Hc Analyze Neurostimulator,Simple/Progress",1330.55,532.22,,,0 HCPCS,95972,Analyze neurostim complex,,,92.85,232.12,4 HCPCS,95972,Hc Elec Alys Nstim Pls Gen Cplx Sc/Perph W/Prgrmg,1215.44,486.18,,,0 HCPCS,95976,Alys smpl cn npgt prgrmg,,,36.45,91.12,4 HCPCS,95976,Hc Electronic Analysis Implant Simple Cn Npgt Programming,167.44,66.98,,,0 HCPCS,95977,Alys cplx cn npgt prgrmg,,,92.85,232.12,4 HCPCS,95977,Hc Electronic Analysis Of Complex Cranial Nerve Stimulator Programming,240.5,96.2,,,0 HCPCS,95981,Io anal gast n-stim subsq,,,57.61,144.03,4 HCPCS,95982,Io ga n-stim subsq w/reprog,,,36.45,91.12,4 HCPCS,95983,Alys brn npgt prgrmg 15 min,,,92.85,232.12,4 HCPCS,95983,Hc Analysis Brain Stimulation Device/Programming First 15 Mins,541.19,216.48,,,0 HCPCS,95984,Hc Analysis Brain Stimulation Device/Programming Each Additional 15 Mins,358.8,143.52,,,0 HCPCS,95990,Hc Refl & Maintn Pump Implant,772.0,308.8,,,0 HCPCS,95990,Spin/brain pump refil & main,,,322.58,806.45,4 HCPCS,95991,Hc Reflex & Maintain Implant Pump Implant-Md,543.0,217.2,,,0 HCPCS,95991,Spin/brain pump refil & main,,,299.77,749.43,4 HCPCS,95992,Canalith repositioning proc,,,29.15,72.88,4 HCPCS,95992,"Hc Canalith Repositioning Procedure, Per Day",297.0,118.8,,,0 HCPCS,95992,"Hc Pt Canalith Repositioning Procedure, Per Day",156.0,62.4,,,0 HCPCS,95999,Neurological procedure,,,125.66,314.16,4 HCPCS,96000,Motion analysis video/3d,,,364.43,911.07,4 HCPCS,96001,Motion test w/ft press meas,,,838.65,2096.62,4 HCPCS,96002,Dynamic surface emg,,,210.87,527.18,4 HCPCS,96002,Hc Dynamic Surface Emg,538.2,215.28,,,0 HCPCS,96020,Hc Functional Brain Mapping - Mr Head Functional Motor,1167.6,467.04,,,0 HCPCS,96105,Assessment of aphasia,,,92.94,232.35,4 HCPCS,96105,Hc Slp Assessment Of Aphasia,602.0,240.8,,,0 HCPCS,96112,Devel tst phys/qhp 1st hr,,,125.66,314.16,4 HCPCS,96112,Hc Developmental Tst Admin Phys/Qhp 1St Hour,404.0,161.6,,,0 HCPCS,96113,Hc Devel Tst Phys/Qhp Ea 30 Min,121.0,48.4,,,0 HCPCS,96116,"Hc Neurobehavioral Status, First Hour",676.0,270.4,,,0 HCPCS,96116,Neurobehavioral status exam,,,210.87,527.18,4 HCPCS,96121,Hc Neurobehavioral Status Each Additional Hour,364.0,145.6,,,0 HCPCS,96125,Cognitive test by hc pro,,,97.79,244.48,4 HCPCS,96125,Hc Slp Standardized Cognitive Performance Testing,423.55,169.42,,,0 HCPCS,96127,Brief emotional/behav assmt,,,36.48,91.19,4 HCPCS,96127,Hc Brief Emotional/Behavioral Assessment,125.58,50.23,,,0 HCPCS,96130,Hc Psychotherapy Test Eval Phys/Qhp 1St,485.88,194.35,,,0 HCPCS,96130,Psycl tst eval phys/qhp 1st,,,210.87,527.18,4 HCPCS,96131,Hc Psychological Test Evaluation Phys/Qhp Initial,373.75,149.5,,,0 HCPCS,96132,Hc Neuropsyhchological Testing Evaluation Phys/Qhp 1 Hour,695.18,278.07,,,0 HCPCS,96132,Nrpsyc tst eval phys/qhp 1st,,,364.43,911.07,4 HCPCS,96133,Hc Neuropsychological Testing Evaluation Phys/Qhp Each Additional Hour,448.5,179.4,,,0 HCPCS,96136,Hc Neuropsy Testing-Md Initial 30 Minutes,296.01,118.4,,,0 HCPCS,96136,Psycl/nrpsyc tst phy/qhp 1st,,,129.94,324.84,4 HCPCS,96137,Hc Neuropsy Testing-Md Additional 30 Minutes,127.08,50.83,,,0 HCPCS,96138,Hc Neuropsy Test-Tech 1St 30M,548.66,219.46,,,0 HCPCS,96138,Psycl/nrpsyc tech 1st,,,436.27,1090.68,4 HCPCS,96139,Hc Neuropsy Test-Tech Add 30 Min,224.25,89.7,,,0 HCPCS,96146,Psycl/nrpsyc tst auto result,,,28.25,70.62,4 HCPCS,96156,Hc Health Behavorial Assessment/Re-Assessement,169.0,67.6,,,0 HCPCS,96156,Hlth bhv assmt/reassessment,,,99.21,248.03,4 HCPCS,96158,Hc Health Behavorial Intervention 1St 30 Minutes,100.0,40.0,,,0 HCPCS,96158,Hlth bhv ivntj indiv 1st 30,,,173.34,433.36,4 HCPCS,96159,"Hc Health Behavorial Intervention, Each Additional 15 Minutes",65.0,26.0,,,0 HCPCS,96160,Hc Pateint Focused Health Risk Assessment/Std Instrumentation,56.0,22.4,,,0 HCPCS,96160,Pt-focused hlth risk assmt,,,36.59,91.48,4 HCPCS,96161,Caregiver health risk assmt,,,36.59,91.48,4 HCPCS,96164,Hlth bhv ivntj grp 1st 30,,,36.59,91.48,4 HCPCS,96167,Hc Health Behavior Intervention Family W/Pt F2F 1St 30 Min,125.0,50.0,,,0 HCPCS,96167,Hlth bhv ivntj fam 1st 30,,,36.59,91.48,4 HCPCS,96168,Hc Health Behavior Intervention Family W/Pt F2F Each Add 15 Min,80.0,32.0,,,0 HCPCS,96202,Mlt fam grp bhv train 1st 60,,,17.04,42.6,4 HCPCS,96203,Mlt fam grp bhv train ea add,,,4.91,12.28,4 HCPCS,96360,"Hc Iv Infusion, Hydration, 31-60 Min",992.88,397.15,,,0 HCPCS,96360,Hydration iv infusion init,,,207.73,519.32,4 HCPCS,96361,"Hc Iv Infusion, Hydration, Each Additional Hour",409.63,163.85,,,0 HCPCS,96361,Hydrate iv infusion add-on,,,45.73,114.33,4 HCPCS,96365,"Hc Iv Infusion, Therapy/Proph/Diagnostic,Initial,1St Hour",1336.05,534.42,,,0 HCPCS,96365,Ther/proph/diag iv inf init,,,207.73,519.32,4 HCPCS,96366,"Hc Iv Infusion, Therapy/Proph/Diagnostic,Initial,Each Additional Hour",575.11,230.04,,,0 HCPCS,96366,Ther/proph/diag iv inf addon,,,45.73,114.33,4 HCPCS,96367,"Hc Iv Infusion, Therapy/Proph/Diagnostic,Additional Infusion,1St Hour",647.0,258.8,,,0 HCPCS,96367,Tx/proph/dg addl seq iv inf,,,70.32,175.79,4 HCPCS,96368,"Hc Iv Infusion, Therapy/Proph/Diagnostic,Concurrent Infusion",610.38,244.15,,,0 HCPCS,96369,"Hc Subcut Infusion, Therap/Proph/Diagnost,Initial,1St Hour",1336.34,534.54,,,0 HCPCS,96369,Sc ther infusion up to 1 hr,,,207.73,519.32,4 HCPCS,96370,Sc ther infusion addl hr,,,45.73,114.33,4 HCPCS,96371,Sc ther infusion reset pump,,,70.32,175.79,4 HCPCS,96372,"Hc Injection,Therapy/Proph/Diagnostic, Im Or Subcut",275.35,110.14,,,0 HCPCS,96372,Ther/proph/diag inj sc/im,,,70.32,175.79,4 HCPCS,96373,Hc Ia Injection Therapeutic,702.61,281.04,,,0 HCPCS,96373,"Hc Injection Into Artery For Therapy, Diagnosis, Or Prevention",786.92,314.77,,,0 HCPCS,96373,Ther/proph/diag inj ia,,,207.73,519.32,4 HCPCS,96374,"Hc Injection,Therapy/Proph/Diagnostic, Iv Push, Initial Drug",472.03,188.81,,,0 HCPCS,96374,Ther/proph/diag inj iv push,,,207.73,519.32,4 HCPCS,96375,"Hc Injection,Therapy/Proph/Diagnostic, Iv Push, Each Additional, New Drug",432.69,173.08,,,0 HCPCS,96375,Tx/pro/dx inj new drug addon,,,45.73,114.33,4 HCPCS,96376,"Hc Injection,Therapy/Proph/Diagnostic, Iv Push, Each Additional, Same Drug",409.63,163.85,,,0 HCPCS,96377,Applicaton on-body injector,,,45.73,114.33,4 HCPCS,96377,Hc Appl On-Body Injector For Timed Subq Injection,159.54,63.82,,,0 HCPCS,96377,Hc Application On-Body Injector For Timed Injection,196.68,78.67,,,0 HCPCS,96379,Ther/prop/diag inj/inf proc,,,45.73,114.33,4 HCPCS,96380,Hc Administration Of Respiratory Syncytial Virus With Counseling By Physician,116.65,46.66,,,0 HCPCS,96381,Hc Administration Of Rsv,116.65,46.66,,,0 HCPCS,96401,Chemo anti-neopl sq/im,,,70.32,175.79,4 HCPCS,96401,Hc Chemotherapy Non-Hormone Anti-Neoplasma Subcutaneous/Intramuscular,427.79,171.12,,,0 HCPCS,96402,Chemo hormon antineopl sq/im,,,70.32,175.79,4 HCPCS,96402,Hc Chemotherapy Hormone Antineoplasma Subcutaneous/Intramuscular,427.79,171.12,,,0 HCPCS,96405,Chemo intralesional up to 7,,,70.32,175.79,4 HCPCS,96405,"Hc Intralesional Chemo Admin, Up To 8 Lesions",251.57,100.63,,,0 HCPCS,96405,"Hc Intralesional Chemo Admin,8+ Lesn",556.47,222.59,,,0 HCPCS,96406,Chemo intralesional over 7,,,207.73,519.32,4 HCPCS,96406,"Hc Intralesional Chemo Admin,8+ Lesn",552.0,220.8,,,0 HCPCS,96409,Chemo iv push sngl drug,,,322.58,806.45,4 HCPCS,96409,Hc Chemotherapy Iv Push Single Drug,591.26,236.5,,,0 HCPCS,96411,Chemo iv push addl drug,,,70.32,175.79,4 HCPCS,96411,Hc Chemotherapy Iv Push Each Additional Drug,568.08,227.23,,,0 HCPCS,96413,Chemo iv infusion 1 hr,,,322.58,806.45,4 HCPCS,96413,Hc Chemotherapy Iv Infusion 1St Hour,1208.03,483.21,,,0 HCPCS,96415,Chemo iv infusion addl hr,,,70.32,175.79,4 HCPCS,96415,Hc Chemotherapy Iv Infusion Each Additional Hour,579.67,231.87,,,0 HCPCS,96416,Chemo prolong infuse w/pump,,,322.58,806.45,4 HCPCS,96416,Hc Chemotherapy Prolong Infuse W/Pump,1194.11,477.64,,,0 HCPCS,96417,Chemo iv infus each addl seq,,,70.32,175.79,4 HCPCS,96417,Hc Chemotherapy Iv Infusion Each Subsequent,585.47,234.19,,,0 HCPCS,96420,Chemo ia push tecnique,,,322.58,806.45,4 HCPCS,96420,"Hc Chemother,Ia Push Technique",960.0,384.0,,,0 HCPCS,96422,Chemo ia infusion up to 1 hr,,,322.58,806.45,4 HCPCS,96422,Hc Chemotheraphy Administration Intra-Arterial Infusion <1 Hour,440.0,176.0,,,0 HCPCS,96423,Chemo ia infuse each addl hr,,,45.73,114.33,4 HCPCS,96425,Chemotherapy infusion method,,,322.58,806.45,4 HCPCS,96425,Hc Chemotherapy Infusion Intra-Arterial >8 Hours,938.95,375.58,,,0 HCPCS,96440,Chemotherapy intracavitary,,,322.58,806.45,4 HCPCS,96446,Chemotx admn prtl cavity,,,322.58,806.45,4 HCPCS,96450,Chemotherapy into cns,,,322.58,806.45,4 HCPCS,96450,Hc Chemotherapy Spinal Tap With Lumbar Puncture,1581.33,632.53,,,0 HCPCS,96521,"Hc Refill/Maint, Portable Pump",455.0,182.0,,,0 HCPCS,96521,Refill/maint portable pump,,,207.73,519.32,4 HCPCS,96522,Hc Refill/Maint Systemic Pump/Resvr,628.36,251.34,,,0 HCPCS,96522,Refill/maint pump/resvr syst,,,207.73,519.32,4 HCPCS,96523,Hc Irrig Drug Delivery Device,325.86,130.34,,,0 HCPCS,96523,Hc Irrig Implanted Drug Delivery Device,290.95,116.38,,,0 HCPCS,96523,Irrig drug delivery device,,,57.61,144.03,4 HCPCS,96542,Chemotherapy injection,,,322.58,806.45,4 HCPCS,96542,Hc Chemotherapy Injection Subarachnois/Intraventricular,687.48,274.99,,,0 HCPCS,96549,Chemotherapy unspecified,,,45.73,114.33,4 HCPCS,96549,Hc Intratumoral Injection Oncolytic Virus Asp9801,454.25,181.7,,,0 HCPCS,96567,Photodynamic tx skin,,,195.94,489.85,4 HCPCS,96573,Pdt dstr prmlg les phys/qhp,,,195.94,489.85,4 HCPCS,96574,Dbrdmt prmlg les w/pdt,,,195.94,489.85,4 HCPCS,96900,Ultraviolet light therapy,,,36.48,91.19,4 HCPCS,96910,Photochemotherapy with UV-B,,,57.61,144.03,4 HCPCS,96912,Photochemotherapy with UV-A,,,57.61,144.03,4 HCPCS,96913,Photochemotherapy uv-a or b,,,397.0,992.51,4 HCPCS,96920,Hc Laser Treatment For Inflammatory Skin Disease <250Sq Cm,650.0,260.0,,,0 HCPCS,96920,Laser tx skin < 250 sq cm,,,195.94,489.85,4 HCPCS,96921,Hc Laser Treatment For Inflammatory Skin Disease 250-500Sq Cm,975.0,390.0,,,0 HCPCS,96921,Laser tx skin 250-500 sq cm,,,195.94,489.85,4 HCPCS,96922,Hc Laser Treatment For Inflammatory Skin Disease > 500Sq Cm,1300.0,520.0,,,0 HCPCS,96922,Laser tx skin >500 sq cm,,,397.0,992.51,4 HCPCS,96999,Dermatological procedure,,,195.94,489.85,4 HCPCS,97010,Hc Ot Hot Or Cold Packs Therapy,1454.83,581.93,,,0 HCPCS,97010,Hc Pt Hot Or Cold Packs Therapy,67.09,26.84,,,0 HCPCS,97010,Hot or cold packs therapy,,,5.25,5.25,4 HCPCS,97012,Hc Pt Mechanical Traction Therapy,180.98,72.39,,,0 HCPCS,97012,Mechanical traction therapy,,,13.67,34.18,8 HCPCS,97014,Electric stimulation therapy,,,13.59,13.59,4 HCPCS,97016,Hc Ot Vasopneumatic Device Therapy,184.48,73.79,,,0 HCPCS,97016,Hc Pt Vasopneumatic Device Therapy,184.48,73.79,,,0 HCPCS,97016,Vasopneumatic device therapy,,,11.37,28.42,8 HCPCS,97018,Hc Ot Paraffin Bath Therapy,165.79,66.32,,,0 HCPCS,97018,Hc Pt Paraffin Bath Therapy,165.79,66.32,,,0 HCPCS,97018,Paraffin bath therapy,,,5.58,13.95,8 HCPCS,97022,Hc Whirlpool Therapy,240.52,96.21,,,0 HCPCS,97022,Whirlpool therapy,,,13.92,36.48,8 HCPCS,97024,Diathermy eg microwave,,,5.67,16.9,8 HCPCS,97026,Infrared therapy,,,4.73,15.42,8 HCPCS,97028,Ultraviolet therapy,,,6.62,19.32,8 HCPCS,97032,Electrical stimulation,,,13.59,35.0,8 HCPCS,97032,Hc Ot Electrical Stimulation,219.5,87.8,,,0 HCPCS,97032,Hc Pt Electrical Stimulation,219.5,87.8,,,0 HCPCS,97032,Hc Slp Electrical Stimulation,219.5,87.8,,,0 HCPCS,97033,Electric current therapy,,,15.19,44.75,8 HCPCS,97033,Hc Ionto W24Hr Patch(2) Ea 15,218.34,87.34,,,0 HCPCS,97033,Hc Ot Electric Current Therapy,218.34,87.34,,,0 HCPCS,97033,Hc Pt Electric Current Therapy,218.34,87.34,,,0 HCPCS,97034,Contrast bath therapy,,,13.26,33.15,8 HCPCS,97035,Hc Ot Ultrasound Therapy,200.82,80.33,,,0 HCPCS,97035,Hc Pt Ultrasound Therapy,200.82,80.33,,,0 HCPCS,97035,Ultrasound therapy,,,12.15,33.9,8 HCPCS,97036,Hydrotherapy,,,26.68,79.82,8 HCPCS,97037,Appl modality 1+lllt po pain,,,36.48,91.19,4 HCPCS,97039,Physical therapy treatment,,,8.53,8.53,4 HCPCS,97110,Hc Ind Ex W Tape 15 Min,241.68,96.67,,,0 HCPCS,97110,Hc Ot Therapeutic Exercises Each 15 Minutes,241.68,96.67,,,0 HCPCS,97110,Hc Pt Therapeutic Exercises Each 15 Minutes,241.68,96.67,,,0 HCPCS,97110,Hc Slp Therapeutic Exercises Each 15 Minutes,241.68,96.67,,,0 HCPCS,97110,Therapeutic exercises,,,27.51,68.78,8 HCPCS,97112,"Hc Ot Neuromuscular Reeducation,1+ Areas, Each 15 Minutes",219.5,87.8,,,0 HCPCS,97112,"Hc Pt Neuromuscular Reeducation,1+ Areas, Each 15 Minutes",219.5,87.8,,,0 HCPCS,97112,Neuromuscular reeducation,,,29.7,77.4,8 HCPCS,97113,Aquatic therapy/exercises,,,34.43,86.88,8 HCPCS,97113,Hc Ot Aquatic Therapy/Exercises,210.23,84.09,,,0 HCPCS,97113,Hc Pt Aquatic Therapy/Exercises,210.23,84.09,,,0 HCPCS,97116,Gait training therapy,,,27.51,68.78,8 HCPCS,97116,Hc Ot Gait Training Therapy Each 15 Minutes,182.14,72.86,,,0 HCPCS,97116,Hc Pt Gait Training Therapy Each 15 Minutes,182.14,72.86,,,0 HCPCS,97116,Hc Pta Gait Training Tech/15 Minutes Each 15 Minutes,182.14,72.86,,,0 HCPCS,97116,Hc Pta Gait Training With Belt & Crutches Each 15 Minutes,182.14,72.86,,,0 HCPCS,97116,Hc Pta Gait Training With Belt Each 15 Minutes,182.14,72.86,,,0 HCPCS,97116,Hc Pta Gait Training With Crutches Each 15 Minutes,182.14,72.86,,,0 HCPCS,97124,Hc Ot Massage Therapy,182.14,72.86,,,0 HCPCS,97124,Hc Pt Massage Therapy,182.14,72.86,,,0 HCPCS,97124,Massage therapy,,,22.95,69.32,8 HCPCS,97129,Hc Cog Ther Ivntj 1St 15 Min,189.15,75.66,,,0 HCPCS,97129,Hc Ot Therapeutic Ivntj W/Focus On Cognitive Function,189.15,75.66,,,0 HCPCS,97129,Hc Ota Cog Ther Ivntj 1St 15 Minutes,189.15,75.66,,,0 HCPCS,97129,Ther ivntj 1st 15 min,,,19.38,48.45,4 HCPCS,97130,Hc Ot Cog Therapy Ivn Each Additional 15 Minute Outpatient,189.15,75.66,,,0 HCPCS,97130,Hc Slp Coagulation Therapy Ivn Each Additional 15 Minute Outpatient,189.15,75.66,,,0 HCPCS,97130,Ther ivntj ea addl 15 min,,,18.11,45.28,4 HCPCS,97139,Physical medicine procedure,,,5.74,5.74,4 HCPCS,97140,"Hc Ot Manual Therapy Tech,1+Regions,Each 15 Minutes",221.84,88.74,,,0 HCPCS,97140,"Hc Pt Manual Therapy Tech,1+Regions,Eacg 15 Minutes",221.84,88.74,,,0 HCPCS,97140,"Hc Slp Manual Therapy Tech,1+Regions,Each 15 Minutes",221.84,88.74,,,0 HCPCS,97140,Manual therapy 1/> regions,,,26.25,65.62,8 HCPCS,97150,Group therapeutic procedures,,,17.12,42.8,8 HCPCS,97150,Hc Ot Group Activity >2,170.46,68.18,,,0 HCPCS,97150,Hc Ot Group Therapeutic Procedures,170.46,68.18,,,0 HCPCS,97150,Hc Pt Group Activity >2,170.46,68.18,,,0 HCPCS,97150,Hc Pt Group Therapeutic Procedures,116.16,46.46,,,0 HCPCS,97150,Hc Slp Group Activity >2,170.46,68.18,,,0 HCPCS,97150,Hc Slp Group Therapeutic Procedures,170.46,68.18,,,0 HCPCS,97151,Bhv id assmt by phys/qhp,,,99.21,248.03,4 HCPCS,97151,Hc Behavior Id Assessment By Physician/Other Qualified Professional 15 Min Each,162.5,65.0,,,0 HCPCS,97152,Bhv id suprt assmt by 1 tech,,,99.21,248.03,4 HCPCS,97153,Adaptive behavior tx by tech,,,99.21,248.03,4 HCPCS,97154,Grp adapt bhv tx by tech,,,36.59,91.48,4 HCPCS,97155,Adapt behavior tx phys/qhp,,,173.34,433.36,4 HCPCS,97156,Fam adapt bhv tx gdn phy/qhp,,,36.59,91.48,4 HCPCS,97157,Mult fam adapt bhv tx gdn,,,36.59,91.48,4 HCPCS,97158,Grp adapt bhv tx by phy/qhp,,,36.59,91.48,4 HCPCS,97161,Hc Pt Physical Therapy Evaluation Low Complex 20 Minutes,413.33,165.33,,,0 HCPCS,97161,Hc Slp Speech Therapy Evaluation Low Complex 20 Minutes,413.33,165.33,,,0 HCPCS,97161,Pt eval low complex 20 min,,,81.47,231.8,8 HCPCS,97162,Hc Ot Occupational Therapy Evaluation Mod Complex 30 Minutes,442.5,177.0,,,0 HCPCS,97162,Hc Pt Physical Therapy Evaluation Mod Complex 30 Minutes,442.5,177.0,,,0 HCPCS,97162,Hc Slp Speech Therapy Evaluation Mod Complex 30 Minutes,442.5,177.0,,,0 HCPCS,97162,Pt eval mod complex 30 min,,,81.47,231.8,8 HCPCS,97163,Hc Ot Occupational Therapy Evaluation High Complex 45 Minutes,471.69,188.68,,,0 HCPCS,97163,Hc Pt Physical Therapy Evaluation High Complex 45 Minutes,471.69,188.68,,,0 HCPCS,97163,Hc Slp Speech Therapy Evaluation High Complex 45 Minutes,470.77,188.31,,,0 HCPCS,97163,Pt eval high complex 45 min,,,81.47,231.8,8 HCPCS,97164,Hc Ot Occupational Therapy Re-Eval Est Plan Care 20 Minutes,312.9,125.16,,,0 HCPCS,97164,Hc Pt Physical Therapy Re-Eval Est Plan Care 20 Minutes,312.9,125.16,,,0 HCPCS,97164,Hc Slp Speech Therapy Re-Eval Est Plan Care 20 Minutes,312.9,125.16,,,0 HCPCS,97164,Pt re-eval est plan care,,,40.74,158.88,8 HCPCS,97165,Hc Ot Occupational Therapy Eval Low Complex 30 Minutes,449.51,179.8,,,0 HCPCS,97165,Hc Pt Physical Therapy Eval Low Complex 30 Minutes,449.51,179.8,,,0 HCPCS,97165,Hc Slp Speech Therapy Eval Low Complex 30 Minutes,449.51,179.8,,,0 HCPCS,97165,Ot eval low complex 30 min,,,82.85,237.75,8 HCPCS,97166,Hc Ot Occupational Therapy Eval Moderate Complex 45 Minutes,471.69,188.68,,,0 HCPCS,97166,Hc Pt Physical Therapy Eval Moderate Complex 45 Minutes,471.69,188.68,,,0 HCPCS,97166,Hc Slp Speech Therapy Eval Moderate Complex 45 Minutes,471.69,188.68,,,0 HCPCS,97166,Ot eval mod complex 45 min,,,82.85,237.75,8 HCPCS,97167,Hc Ot Occupational Therapy Eval High Complex 60 Minutes,500.89,200.36,,,0 HCPCS,97167,Hc Pt Physical Therapy Eval High Complex 60 Minutes,500.89,200.36,,,0 HCPCS,97167,Hc Slp Speech Therapy Eval High Complex 60 Minutes,500.89,200.36,,,0 HCPCS,97167,Ot eval high complex 60 min,,,82.85,237.75,8 HCPCS,97168,Hc Iadl Partial Evaluation Car,321.08,128.43,,,0 HCPCS,97168,Hc Iadl Partial Evaluation Van,437.83,175.13,,,0 HCPCS,97168,Hc Ot Occupational Therapy Re-Eval Est Plan Care 30 Minutes,324.58,129.83,,,0 HCPCS,97168,Hc Pt Physical Therapy Re-Eval Est Plan Care 30 Minutes,324.58,129.83,,,0 HCPCS,97168,Hc Slp Speech Therapy Re-Eval Est Plan Care 30 Minutes,324.58,129.83,,,0 HCPCS,97168,Ot re-eval est plan care,,,64.44,161.1,8 HCPCS,97169,Athletic trn eval low cmplx,,,103.64,103.64,4 HCPCS,97170,Athletic trn eval mod cmplx,,,103.64,103.64,4 HCPCS,97171,Athletic trn eval high cmplx,,,103.64,103.64,4 HCPCS,97172,Athletic trn re-eval plan cr,,,68.45,68.45,4 HCPCS,97530,Hc Ot Therapeutic Actvity Direct Patient Contact Each 15 Minutes,201.99,80.8,,,0 HCPCS,97530,Hc Pt Individual Activity 15 Minutes Stat,193.46,77.38,,,0 HCPCS,97530,Hc Pt Therapeutic Actvity Direct Patient Contact Each 15 Minutes,201.99,80.8,,,0 HCPCS,97530,Hc Slp Therapeutic Actvity Direct Patient Contact Each 15 Minutes,201.99,80.8,,,0 HCPCS,97530,Hc Therapeutic Actvity Direct Pt Contact Each 15 Minutes,201.99,80.8,,,0 HCPCS,97530,Therapeutic activities,,,24.8,82.05,8 HCPCS,97532,Cognitive Skills Development,,,19.31,19.31,4 HCPCS,97533,Hc Ot Sensory Integrative Techniques Each 15 Minutes,165.79,66.32,,,0 HCPCS,97533,Hc Pt Sensory Integrative Techniques Each 15 Minutes,158.79,63.52,,,0 HCPCS,97533,Sensory Integration,,,26.14,139.58,8 HCPCS,97535,Hc Ot Self-Care/Home Mangement Training Each 15 Minutes,192.65,77.06,,,0 HCPCS,97535,Hc Ota Adl Tech/15 Minutes,192.65,77.06,,,0 HCPCS,97535,Hc Pt Self-Care/Home Mangement Training Each 15 Minutes,192.65,77.06,,,0 HCPCS,97535,Hc Pta Adl Tech/15 Minutes,192.65,77.06,,,0 HCPCS,97535,Self care mngment training,,,28.19,76.2,8 HCPCS,97537,Community/work reintegration,,,27.28,75.72,8 HCPCS,97542,"Hc Ot Wheelchair Management Training, Each 15 Minute",184.48,73.79,,,0 HCPCS,97542,"Hc Pt Wheelchair Management Training, Each 15 Minutes",184.48,73.79,,,0 HCPCS,97542,Wheelchair mngment training,,,25.12,73.5,8 HCPCS,97545,Hc Work Hardening 1St Two Hours,608.88,243.55,,,0 HCPCS,97550,Caregiver traing 1st 30 min,,,39.05,97.62,4 HCPCS,97550,Hc Ot Caregiver Training,50.0,20.0,,,0 HCPCS,97550,Hc Pt Caregiver Training,65.0,26.0,,,0 HCPCS,97550,Hc Slp Caregiver Training,50.0,20.0,,,0 HCPCS,97551,Caregiver traing ea addl 15,,,20.71,51.78,4 HCPCS,97551,Hc Caregiver Training Strategies & Tq Each Additional 15 Mins,30.0,12.0,,,0 HCPCS,97551,Hc Ot Caregiver Training Strategies & Tq Each Additional 15 Mins,30.0,12.0,,,0 HCPCS,97551,Hc Pt Caregiver Training Strategies & Tq Each Additional 15 Mins,30.0,12.0,,,0 HCPCS,97552,Group caregiver training,,,9.18,22.95,4 HCPCS,97552,Hc Ot Group Caregiver Training,65.0,26.0,,,0 HCPCS,97552,Hc Pt Group Caregiver Training,65.0,26.0,,,0 HCPCS,97552,Hc Slp Group Caregiver Training,65.0,26.0,,,0 HCPCS,97597,Hc Debridement Open Wound 20 Sq Cm<,904.18,361.67,,,0 HCPCS,97597,Rmvl devital tis 20 cm/<,,,195.94,2978.0,8 HCPCS,97598,Hc Debridement Open Wound Ea Addl 20 Sq Cm,797.02,318.81,,,0 HCPCS,97602,"Hc Ot Wound Debridemnt, Non-Selective, Ea",713.3,285.32,,,0 HCPCS,97602,"Hc Pt Wound Debridemnt, Non-Selective, Each",713.3,285.32,,,0 HCPCS,97602,"Hc Wound Debridemnt, Non-Selective, Ea",713.3,285.32,,,0 HCPCS,97602,Wound(s) care non-selective,,,195.94,489.85,4 HCPCS,97605,Hc Negative Pressure Wound Therapy Dme 50 Sq Cm,925.94,370.38,,,0 HCPCS,97606,Neg press wound tx >50 cm,,,397.0,992.51,4 HCPCS,97607,Hc Neg Pressure Wound Therapy Non Dme 50 Sq Cm,838.88,335.55,,,0 HCPCS,97608,Neg press wound tx >50 cm,,,397.0,992.51,4 HCPCS,97610,Low frequency non-thermal us,,,195.94,489.85,4 HCPCS,97750,Hc Ot Physical Performance Test,147.12,58.85,,,0 HCPCS,97750,Hc Pt Physical Performance Test,147.12,58.85,,,0 HCPCS,97750,Physical performance test,,,27.42,79.18,8 HCPCS,97755,Assistive technology assess,,,35.86,89.65,8 HCPCS,97760,"Hc Ot Orthotics Mangement And Training, Each 15 Minutes",235.85,94.34,,,0 HCPCS,97760,"Hc Pt Orthotic Management And Training, Each 15 Minutes",235.85,94.34,,,0 HCPCS,97760,Orthotic mgmt and training,,,30.71,107.1,8 HCPCS,97761,"Hc Ot Prosthetic Training, Each 15 Min",176.68,70.67,,,0 HCPCS,97761,"Hc Pt Prosthetic Training, Each 15 Min",176.68,70.67,,,0 HCPCS,97761,Prosthetic training,,,28.19,94.48,8 HCPCS,97762,C/o for orthotic/prosth use,,,35.83,35.83,4 HCPCS,97763,Hc Ot Orthotics/Prosthetic Mangement &/Training Subsquemt Encounter 15 Minutes,217.18,86.87,,,0 HCPCS,97763,Hc Pt Orthotics/Prosthetic Management & Training Subsquent Encounter 15 Minutes,217.18,86.87,,,0 HCPCS,97763,Hc Pta Splint Follow-Up Management-Training/15 Minutes,217.18,86.87,,,0 HCPCS,97763,Orthc/prostc mgmt sbsq enc,,,46.33,115.82,4 HCPCS,97799,Hc Garment Fitting Ot,230.01,92.0,,,0 HCPCS,97799,Hc Garment Fitting Pt,230.01,92.0,,,0 HCPCS,97799,Physical medicine procedure,,,0.01,0.01,4 HCPCS,97802,"Hc Med Nutr Ther, 1St, Indiv, Ea 15 Min",162.42,64.97,,,0 HCPCS,97802,Medical nutrition indiv in,,,25.43,63.58,4 HCPCS,97803,"Hc Med Nutr Ther, Subsq, Indiv, Ea 15 Min",154.05,61.62,,,0 HCPCS,97803,Med nutrition indiv subseq,,,21.27,53.18,4 HCPCS,97804,"Hc Medical Nutritional Therapy, Group, Each 30 Minutes",130.6,52.24,,,0 HCPCS,97804,Medical nutrition group,,,11.92,29.8,4 HCPCS,97810,Acupunct w/o stimul 15 min,,,28.25,70.62,4 HCPCS,97810,Hc Acupuncture W/O Electric Stimulation 15 Minutes,217.67,87.07,,,0 HCPCS,97811,Hc Acupuncture W/O Electric Stimulation Additional 15 Minutes,162.42,64.97,,,0 HCPCS,97813,Acupunct w/stimul 15 min,,,28.25,70.62,4 HCPCS,97813,Hc Acupuncture With Electric Stimulation First 15 Mins,217.67,87.07,,,0 HCPCS,97814,Hc Accupuncture Electrical Stimulation Each Additional 15 Min,162.42,64.97,,,0 HCPCS,97814,Hc Acupuncture W Stimulation Additional 15 Minutes,162.42,64.97,,,0 HCPCS,98925,"Hc Osteopathic Manip,1-2 Body Regn",105.48,42.19,,,0 HCPCS,98925,Osteopath manj 1-2 regions,,,21.09,52.72,4 HCPCS,98926,"Hc Osteopathic Manip,3-4 Body Regn",105.48,42.19,,,0 HCPCS,98926,"Hc Osteopathic Manip,5-6 Body Regn",94.18,37.67,,,0 HCPCS,98926,Osteopath manj 3-4 regions,,,21.09,52.72,4 HCPCS,98927,Hc Osteo Manipulation 5-6 Body,105.48,42.19,,,0 HCPCS,98927,Osteopath manj 5-6 regions,,,21.09,52.72,4 HCPCS,98928,"Hc Osteopathic Manip,7-8 Body Regn",105.48,42.19,,,0 HCPCS,98928,Osteopath manj 7-8 regions,,,21.09,52.72,4 HCPCS,98929,"Hc Osteopathic Manip,9-10 Body Regn",105.48,42.19,,,0 HCPCS,98929,Osteopath manj 9-10 regions,,,21.09,52.72,4 HCPCS,98940,Chiropract manj 1-2 regions,,,21.09,52.72,4 HCPCS,98941,Chiropract manj 3-4 regions,,,21.09,52.72,4 HCPCS,98942,Chiropractic manj 5 regions,,,21.09,52.72,4 HCPCS,98960,Hc Education And Training Self-Management Individual Each 30 Minutes,162.5,65.0,,,0 HCPCS,98966,Hc pro phone call 5-10 min,,,10.14,25.35,4 HCPCS,98967,Hc pro phone call 11-20 min,,,19.69,49.22,4 HCPCS,98968,Hc pro phone call 21-30 min,,,28.63,71.58,4 HCPCS,98970,Noncdm Charge Record,44.0,17.6,,,0 HCPCS,98970,Qnhp ol dig e/m svc 5-10min,,,10.14,25.35,4 HCPCS,98971,Qnhp ol dig em svc 11-20min,,,18.57,46.42,4 HCPCS,98972,Qnhp ol dig e/m svc 21+ min,,,28.42,71.05,4 HCPCS,98975,Rem ther mntr 1st setup&edu,,,130.02,325.05,4 HCPCS,98976,Rem ther mntr dev sply resp,,,36.45,91.12,4 HCPCS,98977,Rem ther mntr dv sply mscskl,,,36.45,91.12,4 HCPCS,98978,Rem ther mntr dev sply cbt,,,36.45,91.12,4 HCPCS,98979,Rtm tx mgmt 1st 10 min,,,11.25,28.12,4 HCPCS,98980,Rem ther mntr 1st 20 min,,,25.19,62.98,4 HCPCS,98981,Rem ther mntr ea addl 20 min,,,24.85,62.12,4 HCPCS,98984,Rtm dev sply resp sys 2-15 d,,,36.45,91.12,4 HCPCS,98985,Rtm dev sply mscsk sys 2-15d,,,36.45,91.12,4 HCPCS,98986,Rtm dev sply cbt 2-15 d,,,36.45,91.12,4 HCPCS,99000,Specimen handling office-lab,,,7.75,7.75,1 HCPCS,99001,Hc Ap Send Out Processing Per Specimen,57.0,22.8,,,0 HCPCS,99001,Hc Cp Send Out Processing Per Specimen,57.0,22.8,,,0 HCPCS,99001,Hc Flow Cytometry Send Out Processing Per Specimen,57.0,22.8,,,0 HCPCS,99001,Hc Research Processing Per Specimen,7.0,2.8,,,0 HCPCS,99001,Specimen handling pt-lab,,,6.0,8.99,5 HCPCS,99070,Hc Dynamic Orthosis Splint Material-Custom,787.5,315.0,,,0 HCPCS,99070,Hc Orthotic Elbow Split Materials-Custom,590.62,236.25,,,0 HCPCS,99070,Hc Orthotic Finger Splint Material-Custom,26.25,10.5,,,0 HCPCS,99070,Hc Orthotic Forearm Splint Materials-Custom,393.75,157.5,,,0 HCPCS,99070,Hc Orthotic Hand Splint Material-Custom,196.88,78.75,,,0 HCPCS,99151,Hc Moderate Sedation Same Physician/Qualified Health Professional Initial 15 Minutes <5 Years,110.51,44.2,,,0 HCPCS,99152,Hc Moderate Sedation Other Physician/Qualified Health Professional Initial 15 Minutes 5/> Years,110.51,44.2,,,0 HCPCS,99152,Hc Moderate Sedation Same Physician/Qualified Health Professional Initial 15 Minutes 5/> Years,110.51,44.2,,,0 HCPCS,99153,Hc Moderate Sedation Same Physician/Qualified Health Professional Each Additional 15 Minutes,53.59,21.44,,,0 HCPCS,99155,Hc Moderate Sedation Other Physician/Qualified Health Professional Initial 15 Minutes <5 Years,110.51,44.2,,,0 HCPCS,99157,Hc Moderate Sedation Other Physician/Qualified Health Professional Each Additional 15 Minutes,43.16,17.26,,,0 HCPCS,99170,Anogenital exam child w imag,,,197.44,493.6,4 HCPCS,99173,Hc Visual Acuity Screen,97.5,39.0,,,0 HCPCS,99183,Hc Rt Phys/Qhp Attn&Supvj Hyprbaric Oxygen Tx /Session,164.15,65.66,,,0 HCPCS,99195,Hc Phlebotomy,848.93,339.57,,,0 HCPCS,99195,Phlebotomy,,,129.94,324.84,4 HCPCS,99211,Hc Clinical Nurse Visit,220.0,88.0,,,0 HCPCS,99281,Emergency dept visit,,,82.35,205.88,4 HCPCS,99281,Hc Emergency Department Level 1 Visit Limited/Minor Prob,443.83,177.53,,,0 HCPCS,99282,Emergency dept visit,,,149.95,374.88,4 HCPCS,99282,Hc Emergency Department Level 2 Visit Low/Moderate Severity,704.71,281.88,,,0 HCPCS,99283,Emergency dept visit,,,266.59,666.48,4 HCPCS,99283,Hc Emergency Department Level 3 Visit Moderate Severity,1435.39,574.16,,,0 HCPCS,99284,Emergency dept visit,,,407.5,1018.75,4 HCPCS,99284,Hc Emergency Department Level 4 Visit High/Urgent Severity,2265.46,906.18,,,0 HCPCS,99285,Emergency dept visit,,,581.6,1454.0,4 HCPCS,99285,Hc Emergency Department Level 5 Visit High Severity&Threat Function,4230.52,1692.21,,,0 HCPCS,99291,Critical care first hour,,,806.7,2016.76,4 HCPCS,99291,"Hc Critical Care, E/M 30-74 Minutes",7015.48,2806.19,,,0 HCPCS,99292,"Hc Critical Care, Addl 30 Min",3297.68,1319.07,,,0 HCPCS,99406,Behav chng smoking 3-10 min,,,36.59,91.48,4 HCPCS,99406,Hc Tobacco Use Cessation Intermediate 3-10 Minutes,51.0,20.4,,,0 HCPCS,99407,Behav chng smoking > 10 min,,,36.59,91.48,4 HCPCS,99407,Hc Tobacco Use Cessation Intensive >10 Minutes,76.0,30.4,,,0 HCPCS,99426,Prin care mgmt staff 1st 30,,,99.21,248.03,4 HCPCS,99445,Rem mntr physiol param 2-15,,,36.45,91.12,4 HCPCS,99453,Rem mntr physiol param setup,,,130.02,325.05,4 HCPCS,99454,Rem mntr physiol param dev,,,36.45,91.12,4 HCPCS,99460,Init nb em per day hosp,,,130.02,325.05,4 HCPCS,99463,Same day nb discharge,,,130.02,325.05,4 HCPCS,99465,Hc Delivery/Birthing Room Resuscitation,1141.0,456.4,,,0 HCPCS,99465,Hc Rt Delivery/Birthing Room Resuscitation,1141.0,456.4,,,0 HCPCS,99465,Nb resuscitation,,,645.48,1613.7,4 HCPCS,99473,Self-meas bp pt educaj/train,,,28.25,70.62,4 HCPCS,99483,Assmt & care pln pt cog imp,,,99.21,248.03,4 HCPCS,99484,Care mgmt svc bhvl hlth cond,,,36.59,91.48,4 HCPCS,99487,Cmplx chron care w/o pt vsit,,,173.34,433.36,4 HCPCS,99487,Hc Complex Chronic Care W/O Patient Visit,125.0,50.0,,,0 HCPCS,99489,Hc Complex Chronic Care Additional 30 Minutes,50.0,20.0,,,0 HCPCS,99490,Chron care mgmt srvc 20 min,,,99.21,248.03,4 HCPCS,99492,1st psyc collab care mgmt,,,99.21,248.03,4 HCPCS,99493,Sbsq psyc collab care mgmt,,,99.21,248.03,4 HCPCS,99495,Trans care mgmt 14 day disch,,,130.02,325.05,4 HCPCS,99496,Trans care mgmt 7 day disch,,,130.02,325.05,4 HCPCS,99497,Advncd care plan 30 min,,,99.21,248.03,4 HCPCS,99499,Hc Unlisted E/M Service,377.31,150.92,,,0 HCPCS,A0425,Hc Ground Transport Serv/Mile,26.48,10.59,,,0 HCPCS,A0426,Hc Patient Transfer Level 1,1426.49,570.6,,,0 HCPCS,A0427,Hc Als Emergency Transprt Level 1,2098.36,839.34,,,0 HCPCS,A0427,Hc Ground Neo/Ped Return,2787.88,1115.15,,,0 HCPCS,A0427,Hc Ground Neo/Ped Transport,4765.99,1906.4,,,0 HCPCS,A0428,Hc Basic Life Support (Bls),2018.92,807.57,,,0 HCPCS,A0433,Hc Advanced Life Support Level 2,3727.84,1491.14,,,0 HCPCS,A0434,Hc Specialty Care-Transport,11859.8,4743.92,,,0 HCPCS,A2001,Miscellaneous M >=66.50,,,121.53,303.83,5 HCPCS,A2002,Miscellaneous M >=55.50 and M <66.50,,,121.53,303.83,5 HCPCS,A2005,Miscellaneous M <46.50 and A <77.50,,,121.53,303.83,5 HCPCS,A2006,Novosorb synpath per sq cm,,,121.53,303.83,5 HCPCS,A2007,"Restrata, per sq cm",,,121.53,303.83,5 HCPCS,A2008,"Theragenesis, per sq cm",,,121.53,303.83,5 HCPCS,A2009,"Symphony, per sq cm",,,121.53,303.83,5 HCPCS,A2010,"Apis, per square centimeter",,,121.53,303.83,5 HCPCS,A2011,"Supra sdrm, per sq cm",,,121.53,303.83,5 HCPCS,A2012,"Suprathel, per sq cm",,,121.53,303.83,5 HCPCS,A2013,"Innovamatrix fs, per sq cm",,,121.53,303.83,5 HCPCS,A2015,"Phoenix wnd mtrx, per sq cm",,,121.53,303.83,5 HCPCS,A2016,"Permeaderm b, per sq cm",,,121.53,303.83,5 HCPCS,A2018,"Permeaderm c, per sq cm",,,121.53,303.83,5 HCPCS,A2019,Kerecis marigen shld sq cm,,,121.53,303.83,5 HCPCS,A2021,Neomatrix per sq cm,,,121.53,303.83,5 HCPCS,A2022,Innovabrn/innovamatx xl sqcm,,,121.53,303.83,5 HCPCS,A2024,Resolve matrix per sq cm,,,121.53,303.83,5 HCPCS,A2025,Miro3d per cubic cm,,,121.53,303.83,5 HCPCS,A2027,Matriderm per sq cm,,,121.53,303.83,5 HCPCS,A2029,Mirotract matrix sheet,,,121.53,303.83,5 HCPCS,A2031,"Mirodry, per sq cm",,,121.53,303.83,5 HCPCS,A2036,Cohealyx col dml mx pr sq cm,,,121.53,303.83,5 HCPCS,A2038,"Marigen pacto, per sq cm",,,121.53,303.83,5 HCPCS,A2039,"Innovamatrix fd, per sq cm",,,121.53,303.83,5 HCPCS,A4223,"Hc Pump Tubing - Laborie Pump Tubing Infusion Line, Sap#219813",75.44,30.18,,,0 HCPCS,A4248,Chlorhexidine antisept,,,0.03,0.03,4 HCPCS,A4270,Hc Sup Shell 272 Revenue Code A4270 Hcpcs,206.95499999999998,82.78,,,0 HCPCS,A4306,Hc Quickbloc Needle Set Sap#202783,136.08,54.43,,,0 HCPCS,A4311,"Hc Foley Cath 14 Fr I&O Kit, Sap#275",10.2,4.08,,,0 HCPCS,A4311,Hc Sup Shell 272 Revenue Code A4311 Hcpcs,10.2,4.08,,,0 HCPCS,A4340,"Hc Catheter Foley 2Way Sil, Mult Sap #451-457",46.335,18.534999999999997,,,0 HCPCS,A4340,"Hc Catheter Foley 5Cc 24Fr, Sap# 173221",13.03,5.21,,,0 HCPCS,A4340,"Hc Foley Catheter 14 Fr 2W 5Ml, Sap#264196",117.46,46.98,,,0 HCPCS,A4340,Hc Sup Shell 272 Revenue Code A4340 Hcpcs,13.155000000000001,5.26,,,0 HCPCS,A4344,"Hc Catheter Foley Pediatric 2Way Sil, Mult Sap#1466-1467",13.65,5.46,,,0 HCPCS,A4344,Hc Sup Shell 272 Revenue Code A4344 Hcpcs,13.695,5.475,,,0 HCPCS,A4351,"Hc Catheter Urethra 14Fr Coude Tp Red, Sap#459",13.74,5.5,,,0 HCPCS,A4352,"Hc Catheter Foley Coude 2Way, Mult Sap#550-555",34.58,13.83,,,0 HCPCS,A4453,"Hc Rectal Catheter - No Upp ( Fluid Catheter, Dual Lumen 9 Fr, Rectal), Sap #241351",105.92,42.37,,,0 HCPCS,A4556,"Hc Eletrode Emg 22In Grounding, Sap#219815",14.57,5.83,,,0 HCPCS,A4562,"Hc Pessary Device (All Sizes), Mult Sap#260920, 261061-261105",229.95,91.97999999999999,,,0 HCPCS,A4563,Vag inser rectal control sys,,,1689.73,4224.32,4 HCPCS,A4565,"Hc Sling Swathe, Sap# 76283",29.85,11.94,,,0 HCPCS,A4565,Hc Sup Shell 274 Revenue Code A4565 Hcpcs,195.9,78.36,,,0 HCPCS,A4593,Neuromod sti sys adj rehab,,,47.88,119.7,4 HCPCS,A4648,Hc Kit Procedure Pt Microseed Sap#237071,29137.5,11655.0,,,0 HCPCS,A4648,Hc Sup Shell 272 Revenue Code A4648 Hcpcs,297.0,118.8,,,0 HCPCS,A4648,Hc Sup Shell 278 Revenue Code A4648 Hcpcs,312.025,124.81,,,0 HCPCS,A4648,Hc Sup Shell 278 Revenue Code Without Hcpcs,80.32,32.13,,,0 HCPCS,A4648,Hc Tissue Marker Implantable,33.39,13.36,,,0 HCPCS,A4802,Protamine sulfate per 50 mg,,,13.32,13.32,4 HCPCS,A6196,Noncdm Charge Record Medical Supplies,17.64,7.06,,,0 HCPCS,A6209,Hc Gel Therahoney Wound Sap#238108,39.69,15.88,,,0 HCPCS,A6212,"Hc Dressing Wound Allevyn Life 6In X 6In, Sap#140009",11.18,4.47,,,0 HCPCS,A6212,Noncdm Charge Record Medical Supplies,21.58,8.63,,,0 HCPCS,A6248,Hc Sup Shell 272 Revenue Code A6248 Hcpcs,60.72,24.29,,,0 HCPCS,A6250,Hc Sup Shell 272 Revenue Code A6250 Hcpcs,17.68,7.07,,,0 HCPCS,A6520,G com garmnt glove nghttime,,,126.45,316.12,4 HCPCS,A6521,G com garmnt glove nght cust,,,501.75,1254.38,4 HCPCS,A6522,G com garment arm nighttime,,,307.26,768.15,4 HCPCS,A6523,G com garment arm nght custm,,,729.02,1822.55,4 HCPCS,A6524,G com garmnt lwr leg/ft nght,,,383.34,958.35,4 HCPCS,A6525,G com garm lwrleg/ft ngt cus,,,773.9,1934.75,4 HCPCS,A6526,G com garmt full leg/ft nght,,,693.06,1732.65,4 HCPCS,A6527,G garmt full leg/ft nght cus,,,1274.45,3186.12,4 HCPCS,A6528,G com garment bra nighttime,,,666.42,1666.05,4 HCPCS,A6529,G com garmt bra night custm,,,1053.04,2632.6,4 HCPCS,A6530,Compression stocking bk18-30,,,39.07,97.68,4 HCPCS,A6531,Compression stocking bk30-40,,,61.66,154.15,4 HCPCS,A6532,Compression stocking bk40-50,,,86.88,217.2,4 HCPCS,A6533,Gc stocking thighlngth 18-30,,,54.86,137.15,4 HCPCS,A6534,Gc stocking thighlngth 30-40,,,62.65,156.62,4 HCPCS,A6535,Gc stocking thighlngth 40-50,,,72.13,180.32,4 HCPCS,A6536,Gc stocking full lngth 18-30,,,73.95,184.88,4 HCPCS,A6537,Gc stocking full lngth 30-40,,,87.67,219.18,4 HCPCS,A6538,Gc stocking full lngth 40-50,,,102.65,256.62,4 HCPCS,A6539,Gc stocking waistlngth 18-30,,,97.86,244.65,4 HCPCS,A6540,Gc stocking waistlngth 30-40,,,116.68,291.7,4 HCPCS,A6541,Gc stocking waistlngth 40-50,,,138.21,345.52,4 HCPCS,A6544,Gc stocking garter belt,,,38.9,97.25,4 HCPCS,A6545,Grad comp non-elastic BK,,,121.41,303.52,4 HCPCS,A6548,Acces cust grad silic band,,,20.86,52.15,4 HCPCS,A6552,Grad com stocking bk 30-40,,,57.97,144.92,4 HCPCS,A6553,G com stcking bk 30-40 custm,,,226.38,565.95,4 HCPCS,A6554,Grad com stocking bk 40+,,,79.72,199.3,4 HCPCS,A6555,G com stcking bk 40+ custm,,,226.38,565.95,4 HCPCS,A6556,G com stcking thgh18-30 cust,,,310.25,775.62,4 HCPCS,A6557,G com stcking thgh30-40 cust,,,310.25,775.62,4 HCPCS,A6558,G com stcking thgh 40+ cust,,,320.17,800.42,4 HCPCS,A6562,G com stckng waist18-30 cust,,,1015.37,2538.42,4 HCPCS,A6563,G com stckng waist30-40 cust,,,1015.37,2538.42,4 HCPCS,A6564,G com stckng waist 40+ cust,,,1093.78,2734.45,4 HCPCS,A6565,Grad comp gauntlet custom,,,175.45,438.62,4 HCPCS,A6566,Grad com garment neck/head,,,254.75,636.88,4 HCPCS,A6567,G com garment neck/head cust,,,800.42,2001.05,4 HCPCS,A6568,G com garment torso/shldr,,,166.26,415.65,4 HCPCS,A6569,G com garmnt torso/shdr cust,,,946.74,2366.85,4 HCPCS,A6570,Grad com garment genital,,,113.28,283.2,4 HCPCS,A6571,G com garment genital custm,,,680.84,1702.1,4 HCPCS,A6572,Grad com garment toe caps,,,105.11,262.78,4 HCPCS,A6573,Grad com garmnt toe cap cust,,,249.43,623.58,4 HCPCS,A6574,Custom gradient sleev/glov,,,317.99,794.98,4 HCPCS,A6575,Gradient comp sleev/glov,,,103.05,257.62,4 HCPCS,A6576,Custom grad com sleeve med,,,195.16,487.9,4 HCPCS,A6577,Custom grad cm sleeve heavy,,,161.53,403.82,4 HCPCS,A6578,Gradient comp sleeve,,,79.55,198.88,4 HCPCS,A6579,Custom grad com glove med,,,313.26,783.15,4 HCPCS,A6580,Custom grad com glove heavy,,,310.96,777.4,4 HCPCS,A6581,Gradient comp glove,,,72.99,182.48,4 HCPCS,A6582,Gradient comp gauntlet,,,48.68,121.7,4 HCPCS,A6583,Grad com wrap w straps bk,,,160.13,400.32,4 HCPCS,A6585,Grad com wrap w straps ak,,,189.6,474.0,4 HCPCS,A6586,Grad com wrap w straps leg,,,558.59,1396.48,4 HCPCS,A6587,Grad com wrap w straps foot,,,73.17,182.92,4 HCPCS,A6588,Grad com wrap w straps arm,,,243.87,609.68,4 HCPCS,A6589,Grad com wrap w straps bra,,,96.27,240.68,4 HCPCS,A6594,G comp bandge liner lwr extr,,,35.05,87.62,4 HCPCS,A6595,G comp bandge liner upr extr,,,34.48,86.2,4 HCPCS,A6596,G comp bandge conform gauze,,,0.18,0.45,4 HCPCS,A6597,G comp bandage long stretch,,,1.55,3.88,4 HCPCS,A6598,G comp bandage med stretch,,,0.75,1.88,4 HCPCS,A6599,G comp bandage short stretch,,,1.7,4.25,4 HCPCS,A6600,G com bandge hgh dn foam sht,,,3.07,7.68,4 HCPCS,A6601,G com bandge hgh dn foam pad,,,3.45,8.62,4 HCPCS,A6602,G com bandge hgh dn foamroll,,,5.03,12.58,4 HCPCS,A6603,G com bandge low dn foamchnl,,,2.36,5.9,4 HCPCS,A6604,G com bandge low dn foam flt,,,1.38,3.45,4 HCPCS,A6605,G com bandage padded foam,,,1.57,3.92,4 HCPCS,A6606,G com bandage padded textile,,,4.67,11.68,4 HCPCS,A6607,G com bandage tub protct lyr,,,1.25,3.12,4 HCPCS,A6608,G com bandage tub protct pad,,,5.21,13.02,4 HCPCS,A6610,G com stcking bk 18-30 custm,,,226.38,565.95,4 HCPCS,A7508,Hc Flexiderm Round Sap#36681,17.37,6.95,,,0 HCPCS,A7520,Hc Sup Shell 274 Revenue Code A7520 Hcpcs,593.875,237.55,,,0 HCPCS,A7520,Hc Sup Shell 278 Revenue Code A7520 Hcpcs,854.44,341.78,,,0 HCPCS,A7521,Hc Tube Trach Size 7.5 Shiley Cuffed Disposable Ic Sap#826,166.52,66.61,,,0 HCPCS,A7521,"Hc Tube Trach Size 7.5 Shiley Flexible Cuffless Disposable Ic, Sap#828",152.42,60.97,,,0 HCPCS,A7521,"Hc Tube Trach Size 8.5 Shiley Flexible Cuffless Disposable Ic, Sap#829",152.42,60.97,,,0 HCPCS,A7524,Hc Sup Shell 274 Revenue Code A7524 Hcpcs,619.92,247.97,,,0 HCPCS,A7526,Hc Sup Shell 272 Revenue Code A7526 Hcpcs,10.12,4.05,,,0 HCPCS,A9156,Oral mucoadhesive per 1 ml,,,2.42,2.42,4 HCPCS,A9180,"Lice treatment, topical",,,0.89,0.89,4 HCPCS,A9500,5 VIAL in 1 CARTON (65857-500-05) / 5 mL in 1 VIAL,157.58,63.03,,,0 HCPCS,A9500,Kit For The Preparation Of Technetium Tc99M Sestamibi: 20 Vial In 1 Carton (65857-500-20) / 5 Ml In 1 Vial,153.65,61.46,,,0 HCPCS,A9502,Tc99m tetrofosmin,,,85.27,85.27,4 HCPCS,A9503,"Kit For The Preparation Of Technetium Tc 99M Medronate: 10 Injection, Powder, Lyophilized, For Solution In 1 Carton (65857-505-10)",219.41,87.76,,,0 HCPCS,A9503,"Kit For The Preparation Of Technetium Tc 99M Medronate: 5 Vial, Multi-Dose In 1 Kit (45567-0040-1) / 10 Ml In 1 Vial, Multi-Dose",199.92,79.97,,,0 HCPCS,A9503,Tc99m medronate,,,13.0,13.0,4 HCPCS,A9505,Tl201 thallium,,,32.66,32.66,4 HCPCS,A9506,Tc-99m graphite crucible,,,310.0,821.5,9 HCPCS,A9507,In111 capromab,,,0.01,4325.72,9 HCPCS,A9508,"I131 iodobenguate, dx",,,0.01,2382.52,9 HCPCS,A9509,Iodine I-123 sod iodide mil,,,0.01,0.01,4 HCPCS,A9510,Tc99m disofenin,,,0.01,0.01,4 HCPCS,A9512,Tc99m pertechnetate,,,1.69,1.69,4 HCPCS,A9512,Technelite: 1 Vial In 1 Carton (11994-091-03) / 16 Ml In 1 Vial,2.0,0.8,,,0 HCPCS,A9512,"Ultra-Technekow V4: 1 Injection, Solution In 1 Carton (69945-140-13)",2.15,0.86,,,0 HCPCS,A9513,Hc Lutetium Lu177 Dota Per 1 Mci,970.5,388.2,,,0 HCPCS,A9513,Lutathera: 1 Vial In 1 Package (69488-003-01) / 20.5 Ml In 1 Vial,963.19,385.28,,,0 HCPCS,A9513,Lutetium lu 177 dotatat ther,,,299.04,877.11,9 HCPCS,A9515,Choline c-11,,,2516.43,6291.08,9 HCPCS,A9516,Iodine I-123 sod iodide mic,,,106.24,106.24,4 HCPCS,A9516,"Sodium Iodide I 123: 1 Vial, Plastic In 1 Can (48815-1001-1) / 1 Capsule, Gelatin Coated In 1 Vial, Plastic",248.87,99.55,,,0 HCPCS,A9517,"I131 iodide cap, rx",,,0.01,60.18,9 HCPCS,A9517,"I3odine MAXTM: 1 VIAL, DISPENSING in 1 CANISTER (69208-001-15) / 1 mL in 1 VIAL, DISPENSING",59.89,23.96,,,0 HCPCS,A9517,NDC Description Not Available,64.65,25.86,,,0 HCPCS,A9517,Sodium Iodide I-131: 1 VIAL in 1 CAN (69945-451-04) / 4 mL in 1 VIAL,58.28,23.31,,,0 HCPCS,A9520,"Kit For The Preparation Of Lymphoseek (Technetium Tc 99M Tilmanocept): 1 Kit In 1 Carton (65857-425-05) / 1 Kit In 1 Kit * 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (65857-400-01)",1205.12,482.05,,,0 HCPCS,A9520,Tc99 tilmanocept diag 0.5mci,,,661.57,661.57,4 HCPCS,A9521,Ceretec: 1 KIT in 1 CARTON (17156-023-05) * 5 VIAL in 1 TRAY / 1 mL in 1 VIAL * 5 VIAL in 1 TRAY / 4.5 mL in 1 VIAL * 5 VIAL in 1 TRAY (17156-022-05) / 5 mL in 1 VIAL,11362.58,4545.03,,,0 HCPCS,A9521,"Ceretec: 1 Kit In 1 Carton (17156-025-05) * 5 Ml In 1 Vial, Glass (17156-022-05) * 2.5 Ml In 1 Vial, Glass (17156-027-01)",7797.28,3118.91,,,0 HCPCS,A9521,Tc99m exametazime,,,927.71,2319.28,9 HCPCS,A9526,Nitrogen n-13 ammonia,,,659.0,659.0,4 HCPCS,A9527,Iodine I-125 sodium iodide,,,396.32,990.8,5 HCPCS,A9529,"I3odine MAXTM: 1 VIAL, DISPENSING in 1 CANISTER (69208-001-15) / 1 mL in 1 VIAL, DISPENSING",60.23,24.09,,,0 HCPCS,A9529,NDC Description Not Available,64.65,25.86,,,0 HCPCS,A9529,SODIUM IODIDE I 131: 1 CAPSULE in 1 CAN (69945-452-05) / 5 mL in 1 CAPSULE,58.28,23.31,,,0 HCPCS,A9529,Sodium Iodide I-131: 1 VIAL in 1 CAN (69945-450-01) / 1 mL in 1 VIAL,56.29,22.52,,,0 HCPCS,A9530,Hicon: 1 Vial In 1 Kit (65174-880-00) / 1 Ml In 1 Vial,58.28,23.31,,,0 HCPCS,A9530,"I131 iodide sol, rx",,,20.77,51.92,5 HCPCS,A9531,SODIUM IODIDE I 131: 1 CAPSULE in 1 CAN (69945-452-01) / 1 mL in 1 CAPSULE,68.39,27.36,,,0 HCPCS,A9531,Sodium Iodide I 131 Diagnostic: 5 Capsule In 1 Vial (65174-461-05),3.89,1.56,,,0 HCPCS,A9532,"I125 serum albumin, dx",,,469.06,1172.65,5 HCPCS,A9537,"Kit For The Preparation Of Technetium Tc 99M Mebrofenin: 30 Vial, Multi-Dose In 1 Kit (45567-0455-2) / 10 Ml In 1 Vial, Multi-Dose",198.89,79.56,,,0 HCPCS,A9537,Tc99m mebrofenin,,,56.5,56.5,4 HCPCS,A9538,Tc99m pyrophosphate,,,64.05,64.05,4 HCPCS,A9539,"Draximage Dtpa: 30 Injection, Powder, Lyophilized, For Solution In 1 Kit (65174-288-30)",689.29,275.72,,,0 HCPCS,A9539,Tc99m pentetate,,,0.01,0.01,4 HCPCS,A9540,"Draximage Maa: 30 Injection, Powder, For Solution In 1 Kit (65174-270-30)",1066.65,426.66,,,0 HCPCS,A9540,"Pulmotech Maa: 30 Vial, Multi-Dose In 1 Carton (69945-139-40) / 15 Ml In 1 Vial, Multi-Dose (69945-139-10)",1154.12,461.65,,,0 HCPCS,A9540,Tc99m maa,,,30.0,30.0,4 HCPCS,A9541,Kit For The Prepartion Of Technetium Tc99M Sulfur Colloid: 1 Kit In 1 Package (45567-0030-1) * 3 Ml In 1 Vial * 3 Ml In 1 Vial * 10 Ml In 1 Vial,347.35,138.94,,,0 HCPCS,A9541,Tc99m sulfur colloid,,,267.37,267.37,4 HCPCS,A9542,"In111 ibritumomab, dx",,,0.01,0.01,4 HCPCS,A9543,"Y90 ibritumomab, rx",,,66804.65,186875.3,9 HCPCS,A9547,In111 oxyquinoline,,,831.46,2104.98,9 HCPCS,A9548,In111 pentetate,,,745.62,1864.05,9 HCPCS,A9551,NDC Description Not Available,1277.73,511.09,,,0 HCPCS,A9551,"Nephroscan: 5 Vial, Single-Dose In 1 Carton (71083-0020-5) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose (71083-0020-1)",5755.47,2302.19,,,0 HCPCS,A9551,Tc99m succimer,,,659.93,1649.82,5 HCPCS,A9552,"Fludeoxyglucose F 18: 30 Ml In 1 Vial, Multi-Dose (49609-101-01)",511.39,204.56,,,0 HCPCS,A9552,"Fludeoxyglucose F-18: 30 Ml In 1 Vial, Glass (65857-150-30)",546.67,218.67,,,0 HCPCS,A9553,Cr51 chromate,,,0.01,4794.9,9 HCPCS,A9554,"I125 iothalamate, dx",,,37.5,1624.1,9 HCPCS,A9555,"Ruby-Fill: 1 Injection, Solution In 1 Container (65174-021-10)",2943.75,1177.5,,,0 HCPCS,A9556,Ga67 gallium,,,0.01,0.01,4 HCPCS,A9556,Gallium Citrate Ga-67: 1 Vial In 1 Can (69945-180-12) / 6.6 Ml In 1 Vial,297.58,119.03,,,0 HCPCS,A9557,"Neurolite: 2 Kit In 1 Package, Combination (11994-006-02) / 1 Kit In 1 Kit * 1 Injection In 1 Vial (11994-002-01) * 1 Ml In 1 Vial (11994-004-01)",7283.44,2913.38,,,0 HCPCS,A9557,Tc99m bicisate,,,775.52,3666.33,9 HCPCS,A9558,"Kit For The Preparation Of Technetium Tc99M Pyrophosphate: 5 Vial, Multi-Dose In 1 Kit (45567-0060-1) / 10 Ml In 1 Vial, Multi-Dose",292.97,117.19,,,0 HCPCS,A9558,Xe133 xenon 10mci,,,255.1,255.1,4 HCPCS,A9559,Co57 cyano,,,0.01,0.01,4 HCPCS,A9560,Tc99m labeled rbc,,,100.0,100.0,4 HCPCS,A9560,"Ultratag Rbc: 5 Cello Pack In 1 Box (69945-068-20) / 1 Kit In 1 Cello Pack (69945-068-10) * .6 Ml In 1 Syringe, Glass * 1 Ml In 1 Syringe, Glass * 9.5 Mg In 1 Vial, Glass",620.85,248.34,,,0 HCPCS,A9561,Tc99m oxidronate,,,0.01,0.01,4 HCPCS,A9561,"Technescan Hdp: 5 Vial In 1 Cello Pack (69945-091-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (69945-091-01)",207.15,82.86,,,0 HCPCS,A9562,"Technescan Mag3: 5 Vial In 1 Cello Pack (69945-096-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",1304.46,521.78,,,0 HCPCS,A9563,P32 na phosphate,,,278.24,695.6,9 HCPCS,A9564,P32 chromic phosphate,,,0.01,0.01,4 HCPCS,A9568,Technetium tc99m arcitumomab,,,0.01,0.01,4 HCPCS,A9569,Ceretec: 5 Vial In 1 Tray (17156-022-05) / 5 Ml In 1 Vial,9290.74,3716.3,,,0 HCPCS,A9569,Technetium TC-99m auto WBC,,,934.13,2335.32,9 HCPCS,A9570,"Indium In 111 Oxyquinoline: 1 Ml In 1 Vial, Single-Dose (72536-0920-1)",4369.34,1747.74,,,0 HCPCS,A9570,Indium In-111 auto WBC,,,1103.19,4209.96,9 HCPCS,A9571,Indium IN-111 auto platelet,,,4209.96,4209.96,4 HCPCS,A9572,Indium In-111 pentetreotide,,,2000.94,5002.35,9 HCPCS,A9573,Elucirem: 10 Vial In 1 Carton (67684-4230-2) / 3 Ml In 1 Vial,90.65,36.26,,,0 HCPCS,A9573,Elucirem: 10 Vial In 1 Carton (67684-4231-2) / 7.5 Ml In 1 Vial,72.54,29.02,,,0 HCPCS,A9573,Elucirem: 10 Vial In 1 Carton (67684-4232-2) / 10 Ml In 1 Vial,81.06,32.42,,,0 HCPCS,A9573,"Inj, gadopiclenol, 1 ml",,,3.47,3.47,4 HCPCS,A9575,"Clariscan: 10 Vial, Glass In 1 Box (0407-2943-01) / 10 Ml In 1 Vial, Glass",1.08,0.43,,,0 HCPCS,A9575,Dotarem: 10 Vial In 1 Package (67684-2001-1) / 10 Ml In 1 Vial,1.47,0.59,,,0 HCPCS,A9575,Dotarem: 10 Vial In 1 Package (67684-2001-2) / 15 Ml In 1 Vial,1.25,0.5,,,0 HCPCS,A9575,Dotarem: 10 Vial In 1 Package (67684-2001-3) / 20 Ml In 1 Vial,0.68,0.27,,,0 HCPCS,A9575,Inj gadoterate meglumi 0.1ml,,,0.12,0.12,4 HCPCS,A9576,Inj prohance multipack,,,1.43,1.43,4 HCPCS,A9577,Inj multihance,,,1.82,1.82,4 HCPCS,A9578,Inj multihance multipack,,,1.81,1.81,4 HCPCS,A9579,"Gad-base MR contrast NOS,1ml",,,1.49,1.49,4 HCPCS,A9581,"Eovist: 5 Vial, Single-Dose In 1 Box (50419-320-05) / 10 Ml In 1 Vial, Single-Dose",84.765,33.91,,,0 HCPCS,A9581,Gadoxetate disodium inj,,,14.71,14.71,4 HCPCS,A9582,"Adreview: 1 Vial, Glass In 1 Container (17156-235-01) / 5 Ml In 1 Vial, Glass",18532.38,7412.95,,,0 HCPCS,A9582,Iodine I-123 iobenguane,,,2317.5,5793.75,9 HCPCS,A9583,Gadofosveset trisodium inj,,,0.01,0.01,4 HCPCS,A9584,"Datscan: 1 Vial, Glass In 1 Container (17156-210-01) / 2.5 Ml In 1 Vial, Glass",7722.98,3089.19,,,0 HCPCS,A9584,Iodine i-123 ioflupane,,,1387.74,3469.35,9 HCPCS,A9585,"Gadavist: 15 Carton In 1 Box (50419-325-37) / 3 Vial, Single-Dose In 1 Carton / 2 Ml In 1 Vial, Single-Dose",5.35,2.14,,,0 HCPCS,A9585,"Gadavist: 2 Carton In 1 Box (50419-325-11) / 10 Vial, Single-Dose In 1 Carton / 7.5 Ml In 1 Vial, Single-Dose",5.82,2.33,,,0 HCPCS,A9585,"Gadavist: 2 Carton In 1 Box (50419-325-12) / 10 Vial, Single-Dose In 1 Carton / 10 Ml In 1 Vial, Single-Dose",1.57,0.63,,,0 HCPCS,A9585,"Gadavist: 2 Carton In 1 Box (50419-325-13) / 10 Vial, Single-Dose In 1 Carton / 15 Ml In 1 Vial, Single-Dose",1.73,0.69,,,0 HCPCS,A9585,Gadobutrol injection,,,0.26,0.26,4 HCPCS,A9585,NDC Description Not Available,4.25,1.7,,,0 HCPCS,A9586,Florbetapir F18,,,1825.64,4564.1,9 HCPCS,A9586,NDC Description Not Available,10789.01,4315.6,,,0 HCPCS,A9587,Gallium ga-68,,,49.63,124.08,9 HCPCS,A9587,"Netspot: 1 Kit In 1 Kit (69488-001-40) * 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",211.75,84.7,,,0 HCPCS,A9588,Fluciclovine f-18,,,322.27,805.68,9 HCPCS,A9588,Hc F-18 Fluciclovine/Mci,1800.0,720.0,,,0 HCPCS,A9589,Insti hexaminolevulinate hcl,,,1378.41,1378.41,4 HCPCS,A9590,Iodine i-131 iobenguane 1mci,,,320.39,320.39,4 HCPCS,A9591,"Cerianna: 50 Ml In 1 Vial, Multi-Dose (72874-001-01)",2880.25,1152.1,,,0 HCPCS,A9591,Fluoroestradiol f 18,,,460.42,1151.05,9 HCPCS,A9592,Copper cu 64 dotatate diag,,,594.28,1485.7,9 HCPCS,A9592,"Detectnet: 1 Vial, Single-Use In 1 Can (69945-064-01) / 4 Ml In 1 Vial, Single-Use",3719.03,1487.61,,,0 HCPCS,A9593,Gallium ga-68 psma-11 ucsf,,,550.13,1375.32,9 HCPCS,A9594,"Gallium ga-68 psma-11, ucla",,,363.5,908.75,9 HCPCS,A9595,NDC Description Not Available,2149.2,859.68,,,0 HCPCS,A9595,"Piflu f-18, dia 1 millicurie",,,346.49,866.22,9 HCPCS,A9596,Gallium illuccix 1 millicure,,,478.52,1196.3,9 HCPCS,A9596,"Illuccix: 1 Kit In 1 Carton (74725-100-64) * 2.5 Ml In 1 Vial, Multi-Dose (74725-102-25) * 6.4 Ml In 1 Vial, Multi-Dose (74725-103-64) * 1 Injection, Powder, Lyophilized, For Solution In 1 Vial,",2647.28,1058.91,,,0 HCPCS,A9600,Sr89 strontium,,,3750.0,5058.53,5 HCPCS,A9601,Flortaucipir inj 1 millicuri,,,350.0,927.5,9 HCPCS,A9602,Fluorodopa f-18 diag per mci,,,498.87,2138.88,9 HCPCS,A9603,"Inj, pafolacianine, 0.1 mg",,,132.81,132.81,4 HCPCS,A9604,Sm 153 lexidronam,,,3159.8,16282.88,9 HCPCS,A9606,Hc Xofigo,533.7,213.48,,,0 HCPCS,A9606,Radium ra223 dichloride ther,,,169.02,451.06,9 HCPCS,A9606,"Xofigo: 6 Ml In 1 Vial, Single-Dose (50419-208-01)",522.66,209.06,,,0 HCPCS,A9607,Lutetium lu 177 vipivotide,,,243.52,666.35,9 HCPCS,A9607,"Pluvicto: 1 Vial, Glass In 1 Package (69488-010-61) / 7.5 Ml In 1 Vial, Glass",754.29,301.72,,,0 HCPCS,A9608,Flotufolastat f18 diag 1 mci,,,633.23,1787.56,9 HCPCS,A9609,NDC Description Not Available,539.97,215.99,,,0 HCPCS,A9610,"Xe129 xenon, diagnostic",,,1040.0,1040.0,4 HCPCS,A9611,"Flurpiridaz f18, diag, 1 mci",,,52.63,1325.0,9 HCPCS,A9615,"Inj, pegulicianine, 1 mg",,,35.38,93.77,9 HCPCS,A9616,Gallium gozellix 1 millicuri,,,1171.3,2928.25,5 HCPCS,A9697,"Inj, magtrace per study dose",,,1254.0,3135.0,5 HCPCS,A9800,Gallium locametz 1 millicuri,,,362.5,906.25,9 HCPCS,A9800,"Locametz: 1 Vial, Multi-Dose In 1 Carton (69488-017-61) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Multi-Dose",3806.73,1522.69,,,0 HCPCS,C1713,"Hc Pin Steinmann Threaded 4.8, Sap# 2680",46.94,18.78,,,0 HCPCS,C1713,Hc Sup Shell 272 Revenue Code C1713 Hcpcs,452.81,181.12,,,0 HCPCS,C1713,Hc Sup Shell 278 Revenue Code C1713 Hcpcs,1175.455,478.79999999999995,,,0 HCPCS,C1715,Hc Sup Shell 278 Revenue Code C1715 Hcpcs,256.665,102.67,,,0 HCPCS,C1721,Hc Sup Shell 275 Revenue Code C1721 Hcpcs,47712.66,19085.065000000002,,,0 HCPCS,C1722,Hc Sup Shell 275 Revenue Code C1722 Hcpcs,46471.85,18588.739999999998,,,0 HCPCS,C1724,Hc Sup Shell 278 Revenue Code C1724 Hcpcs,9617.345,3846.94,,,0 HCPCS,C1725,Hc Sup Shell 272 Revenue Code C1725 Hcpcs,10828.12,4331.25,,,0 HCPCS,C1725,Hc Sup Shell 278 Revenue Code C1725 Hcpcs,1191.09,476.44,,,0 HCPCS,C1726,"Hc Balloon Spiration Catheter 2Mm, Sap#237168",441.47,176.59,,,0 HCPCS,C1726,Hc Catheter Uromax Ultra Balloon Dilation 24Fr/8Cm Sap #251785,627.2,250.88,,,0 HCPCS,C1726,Hc Sup Shell 272 Revenue Code C1726 Hcpcs,13485.94,5394.38,,,0 HCPCS,C1726,Hc Sup Shell 278 Revenue Code C1726 Hcpcs,2008.12,803.25,,,0 HCPCS,C1726,"Hc Valve Bronchial Loader Deploy Catheter, Sap#219067",3937.5,1575.0,,,0 HCPCS,C1727,Hc Sup Shell 278 Revenue Code C1727 Hcpcs,738.145,295.26,,,0 HCPCS,C1729,"Hc Chest Drain Kit, Sap#22191",436.26,174.5,,,0 HCPCS,C1729,"Hc Denver Drain Kit, Sap#18195",216.56,86.62,,,0 HCPCS,C1729,Hc Sup Shell 278 Revenue Code C1729 Hcpcs,304.53,121.81,,,0 HCPCS,C1730,Hc Sup Shell 278 Revenue Code C1730 Hcpcs,1870.31,748.12,,,0 HCPCS,C1731,Hc Sup Shell 278 Revenue Code C1731 Hcpcs,4413.94,1765.58,,,0 HCPCS,C1732,Hc Sup Shell 278 Revenue Code C1732 Hcpcs,8347.5,3339.0,,,0 HCPCS,C1733,"Hc Catheter Safeline Coated Rf32, Sap#141051",6199.2,2479.68,,,0 HCPCS,C1733,Hc Sup Shell 278 Revenue Code C1733 Hcpcs,17521.88,7008.75,,,0 HCPCS,C1734,Hc Sup Shell 278 Revenue Code C1734 Hcpcs,13347.44,5338.98,,,0 HCPCS,C1747,"Hc Forceps Grasping Flexcysto Single Use, Sap#252083",528.02,211.21,,,0 HCPCS,C1747,Hc Sup Shell 272 Revenue Code C1747 Hcpcs,377.25,150.89999999999998,,,0 HCPCS,C1748,Hc Sup Shell 272 Revenue Code With C1748 Hcpcs,11536.88,4614.75,,,0 HCPCS,C1750,"Hc Kit Lg Bore Multi-Lumen Cath, Sap# 1653",529.67,211.87,,,0 HCPCS,C1750,Hc Sup Shell 278 Revenue Code C1750 Hcpcs,1177.71,471.08500000000004,,,0 HCPCS,C1751,Hc Cannula Mc3 Crescent 24 Fr Sap #260401,9351.56,3740.62,,,0 HCPCS,C1751,Hc Cannula Mc3 Crescent 26 Fr Sap #260402,9351.56,3740.62,,,0 HCPCS,C1751,Hc Cannula Mc3 Crescent 28 Fr Sap #260403,9351.56,3740.62,,,0 HCPCS,C1751,Hc Cannula Mc3 Crescent 30 Fr Sap #260404,9351.56,3740.62,,,0 HCPCS,C1751,Hc Cannula Mc3 Crescent 32 Fr Sap #260405,9351.56,3740.62,,,0 HCPCS,C1751,Hc Cath Cvc Triple Lumen 7Fr Sap #208409,108.65,43.46,,,0 HCPCS,C1751,Hc Catheter Kit,124.5,49.8,,,0 HCPCS,C1751,Hc Catheter Kits Multilumen/Introducer,584.86,233.94,,,0 HCPCS,C1751,Hc Catheter Picc Sl 26Gx30Cm Sap#37773,283.97,113.59,,,0 HCPCS,C1751,Hc Catheter Tray Picc Vygon Neonate Sap#37772,83.24,33.3,,,0 HCPCS,C1751,Hc Kit Cath 6Inx16Ga Adult Central Sap#412,107.42,42.97,,,0 HCPCS,C1751,"Hc Kit Gold Marker 17Ga Etw 1.2X3Mm, Sap#263793",297.96,119.18,,,0 HCPCS,C1751,Hc Kit Introducer Dual Lumen Mac Sap#207040,495.06,198.02,,,0 HCPCS,C1751,Hc Kit Picc Max Solo 4Fr Sl Sap#72002,929.09,371.64,,,0 HCPCS,C1751,Hc Kit Poly Picc Complete 1.4Fr Sap#234041,438.05,175.22,,,0 HCPCS,C1751,Hc Kit Power Picc 6Fr Dual Lumen Sap#76540,956.81,382.72,,,0 HCPCS,C1751,Hc Kit Silicone Picc Complete 1.9Fr Dl Sap#24203,409.23,163.69,,,0 HCPCS,C1751,Hc Kit Silicone Picc Complete 1.9Fr Sap#234043,409.27,163.71,,,0 HCPCS,C1751,Hc Needle Intro 1.9Fr 26Ga Autogrd Sap#37774,166.59,66.64,,,0 HCPCS,C1751,"Hc Picc 1.9Fr Sl W/Ez Flush, Sap#173196",125.41,50.16,,,0 HCPCS,C1751,Hc Picc 3Fr Morpheus Sap#146193,426.39,170.56,,,0 HCPCS,C1751,"Hc Picc Max Solo 4Fr Dual Lumen, Sap#69312",1077.73,431.09,,,0 HCPCS,C1751,Hc Picc Midline 4Fr Single Sap #203187,527.62,211.05,,,0 HCPCS,C1751,"Hc Picc Solo 5Fr Dl, Sap#220464",1291.5,516.6,,,0 HCPCS,C1751,Hc Set Cath 3Fr 8Cm 1Lumen Sap#645,142.18,56.87,,,0 HCPCS,C1751,Hc Sup Shell 278 Revenue Code C1751 Hcpcs,789.87,315.95,,,0 HCPCS,C1751,Hc Tray 3Fr Picc Sl Poly Cath Full Sap#72000,709.18,283.67,,,0 HCPCS,C1752,Hc Sup Shell 278 Revenue Code C1752 Hcpcs,497.005,198.8,,,0 HCPCS,C1753,Hc Sup Shell 278 Revenue Code C1753 Hcpcs,2953.12,1181.25,,,0 HCPCS,C1755,Hc Kit Percutaneous Intraspinal C Sap #76313,290.06,116.02,,,0 HCPCS,C1755,Hc Sup Shell 278 Revenue Code C1755 Hcpcs,2165.62,866.25,,,0 HCPCS,C1757,Hc Sup Shell 278 Revenue Code C1757 Hcpcs,7363.12,2945.25,,,0 HCPCS,C1757,Hc Sup Shell 624 Revenue Code C1757 Hcpcs,26578.12,10631.25,,,0 HCPCS,C1758,Hc Sup Shell 278 Revenue Code C1758 Hcpcs,51.795,20.72,,,0 HCPCS,C1759,Hc Sup Shell 278 Revenue Code C1759 Hcpcs,9723.33,3889.33,,,0 HCPCS,C1760,Hc Sup Shell 278 Revenue Code C1760 Hcpcs,929.25,371.7,,,0 HCPCS,C1761,Hc Sup Shell 272 Revenue Code C1761 Hcpcs,18506.25,7402.5,,,0 HCPCS,C1761,Hc Sup Shell 278 Revenue Code C1761 Hcpcs,18512.59,7405.04,,,0 HCPCS,C1762,Hc Sup Shell 278 Revenue Code C1762 Hcpcs,5068.325,2027.3300000000002,,,0 HCPCS,C1763,Hc Sup Shell 278 Revenue Code C1763 Hcpcs,8420.64,3368.26,,,0 HCPCS,C1764,"Hc Kit Axonics Sacral Neurostim Pne Lead Implant, Sap#258825",1023.75,409.5,,,0 HCPCS,C1764,Hc Loop Recorder Receal Linq Sap#219760,19667.81,7867.12,,,0 HCPCS,C1764,Hc Sup Shell 275 Revenue Code C1764 Hcpcs,19908.245,7963.3,,,0 HCPCS,C1764,Hc Sup Shell 278 Revenue Code C1764 Hcpcs,18112.5,7245.0,,,0 HCPCS,C1764,"Hc System Reveal Linq Ii Insertable Cardiac Monitor, Lnq22Sy, Sap#211254",20258.44,8103.38,,,0 HCPCS,C1765,Hc Sup Shell 278 Revenue Code C1765 Hcpcs,1605.275,642.1099999999999,,,0 HCPCS,C1766,Hc Sup Shell 278 Revenue Code C1766 Hcpcs,3890.25,1556.1,,,0 HCPCS,C1767,Hc Sup Shell 278 Revenue Code C1767 Hcpcs,68906.25,27562.5,,,0 HCPCS,C1768,Hc Graft Felt Ptfe 1X6 Sap #5303,101.0,40.4,,,0 HCPCS,C1768,Hc Sup Shell 278 Revenue Code C1768 Hcpcs,2363.6,945.44,,,0 HCPCS,C1769,Hc Guidewire Amplatz .035X260Cm Sap#152133,81.9,32.76,,,0 HCPCS,C1769,"Hc Guidewire Ampltz 0.035In 6Cm 180Cm, Sap#210372",165.38,66.15,,,0 HCPCS,C1769,"Hc Guidewire Art Insert Pik A Kit, Sap#204070",311.85,124.74,,,0 HCPCS,C1769,"Hc Guidewire Fem Insert Pik V Kit, Sap#212025",311.85,124.74,,,0 HCPCS,C1769,Hc Guidewire Spring,32.3,12.92,,,0 HCPCS,C1769,"Hc Guidewire Sprng 0.025In, Sap# 415",41.74,16.7,,,0 HCPCS,C1769,"Hc Kit Guidewire Avalon Insertion Kit 100 Cm, Sap#144611",570.94,228.38,,,0 HCPCS,C1769,"Hc Kit Guidewire Avalon Insertion Kit 210 Cm, Sap#144612",2854.69,1141.88,,,0 HCPCS,C1769,Hc Sup Shell 272 Revenue Code C1769 Hcpcs,1968.75,787.5,,,0 HCPCS,C1769,Hc Sup Shell 278 Revenue Code C1769 Hcpcs,259.88,103.95,,,0 HCPCS,C1771,Hc Sup Shell 278 Revenue Code C1771 Hcpcs,4703.76,1881.5,,,0 HCPCS,C1772,Hc Sup Shell 278 Revenue Code C1772 Hcpcs,43545.55,17418.22,,,0 HCPCS,C1773,Hc Sup Shell 278 Revenue Code C1773 Hcpcs,2312.0299999999997,924.81,,,0 HCPCS,C1776,Hc Sup Shell 278 Revenue Code C1776 Hcpcs,4765.56,1906.22,,,0 HCPCS,C1777,Hc Sup Shell 275 Revenue Code C1777 Hcpcs,10434.38,4173.75,,,0 HCPCS,C1777,Hc Sup Shell 278 Revenue Code C1777 Hcpcs,10434.38,4173.75,,,0 HCPCS,C1778,"Hc Kit Conversion Sprint, Sap#263422",19293.75,7717.5,,,0 HCPCS,C1778,"Hc Kit Procedure Dual Lead Sprint Pns, Sap#263421",31739.675,12695.869999999999,,,0 HCPCS,C1778,"Hc Kit Procedure Single Lead Sprint Pns, Sap#261717",19293.75,7717.5,,,0 HCPCS,C1778,Hc Lead Vectris Comp 1X8 90Cm Sap#177273,7658.44,3063.38,,,0 HCPCS,C1778,"Hc Sprint Pns Repl Microlead 2.0 Lead Warranity, Sap#",0.01,0.004,,,0 HCPCS,C1778,Hc Sup Shell 278 Revenue Code C1778 Hcpcs,13289.06,5315.62,,,0 HCPCS,C1778,"Hc Trial Lead Kit, Sap#177277",5473.12,2189.25,,,0 HCPCS,C1781,Hc Sup Shell 278 Revenue Code C1781 Hcpcs,4501.85,1800.74,,,0 HCPCS,C1781,Hc Sup Shell 624 Revenue Code C1781 Hcpcs,26578.12,10631.25,,,0 HCPCS,C1783,Hc Sup Shell 278 Revenue Code C1783 Hcpcs,4200.0,1680.0,,,0 HCPCS,C1784,"Artiss Fibrin Sealant: 1 Syringe, Plastic In 1 Carton (0338-8503-10) / 10 Ml In 1 Syringe, Plastic (0338-8503-09)",1576.28,630.51,,,0 HCPCS,C1784,Hc Ocular Device Intraop Detach,177.19,70.88,,,0 HCPCS,C1784,Hc Sup Shell 278 Revenue Code C1784 Hcpcs,89.715,35.885000000000005,,,0 HCPCS,C1785,Hc Sup Shell 275 Revenue Code C1785 Hcpcs,13584.38,5433.75,,,0 HCPCS,C1786,Hc Sup Shell 275 Revenue Code C1786 Hcpcs,12080.25,4832.1,,,0 HCPCS,C1786,Hc Sup Shell 278 Revenue Code C1786 Hcpcs,50774.06,20309.62,,,0 HCPCS,C1787,Hc Sup Shell 272 Revenue Code C1787 Hcpcs,3602.815,1441.125,,,0 HCPCS,C1787,Hc Sup Shell 278 Revenue Code C1787 Hcpcs,1181.25,472.5,,,0 HCPCS,C1788,Hc Sup Shell 278 Revenue Code C1788 Hcpcs,1204.88,481.95,,,0 HCPCS,C1789,Hc Sup Shell 278 Revenue Code C1789 Hcpcs,3309.29,1323.7150000000001,,,0 HCPCS,C1813,Hc Sup Shell 278 Revenue Code C1813 Hcpcs,15844.5,6337.8,,,0 HCPCS,C1814,Hc Sup Shell 278 Revenue Code C1814 Hcpcs,1655.09,662.04,,,0 HCPCS,C1815,Hc Sup Shell 278 Revenue Code C1815 Hcpcs,27373.5,10949.4,,,0 HCPCS,C1817,Hc Sup Shell 278 Revenue Code C1817 Hcpcs,31929.19,12771.68,,,0 HCPCS,C1819,"Hc Probe Ablation Rf 18G 70Mm 10Mm Star, Sap#265699",5866.88,2346.75,,,0 HCPCS,C1819,"Hc Probe Ablation Rf 18G 70Mm 7Mm Star, Sap#265698",5866.88,2346.75,,,0 HCPCS,C1820,Hc Sup Shell 278 Revenue Code C1820 Hcpcs,67429.69,26971.88,,,0 HCPCS,C1822,Hc Sup Shell 278 Revenue Code C1822 Hcpcs,75895.31,30358.12,,,0 HCPCS,C1825,Hc Sup Shell 278 Revenue Code C1825 Hcpcs? Hb Chargeables,137812.5,55125.0,,,0 HCPCS,C1827,Hc Sup Shell 278 Revenue Code C1827 Hcpcs,116156.25,46462.5,,,0 HCPCS,C1830,Hc Sup Shell 278 Revenue Code C1830 Hcpcs,1699.7,679.88,,,0 HCPCS,C1874,Hc Sup Shell 278 Revenue Code C1874 Hcpcs,12041.25,4816.5,,,0 HCPCS,C1876,Hc Sup Shell 278 Revenue Code C1876 Hcpcs,5866.88,2346.75,,,0 HCPCS,C1877,Hc Sup Shell 278 Revenue Code C1877 Hcpcs,5054.75,2021.9,,,0 HCPCS,C1880,Hc Sup Shell 278 Revenue Code C1880 Hcpcs,6595.31,2638.12,,,0 HCPCS,C1882,Hc Sup Shell 275 Revenue Code C1882 Hcpcs,60243.75,24097.5,,,0 HCPCS,C1883,"Hc Sprint Pns Repl Dual Lead Adapter Warranity, Sap#",0.01,0.004,,,0 HCPCS,C1883,"Hc Sprint Pns Repl Lead Connector And Key, Ch 1, St, Warranity, Sap#",0.01,0.004,,,0 HCPCS,C1883,"Hc Sprint Pns Repl Lead Connector And Key, Ch21, St Warranity, Sap#",0.01,0.004,,,0 HCPCS,C1883,Hc Sup Shell 272 Revenue Code C1883 Hcpcs,1968.75,787.5,,,0 HCPCS,C1883,Hc Sup Shell 278 Revenue Code C1883 Hcpcs,2255.4,902.16,,,0 HCPCS,C1884,Hc Sup Shell 278 Revenue Code C1884 Hcpcs,9150.28,3660.11,,,0 HCPCS,C1885,Hc Sup Shell 278 Revenue Code C1885 Hcpcs,14450.62,5780.25,,,0 HCPCS,C1886,Hc Sup Shell 278 Revenue Code C1886 Hcpcs,12029.06,4811.62,,,0 HCPCS,C1887,Hc Sup Shell 278 Revenue Code C1887 Hcpcs,704.24,281.7,,,0 HCPCS,C1888,Hc Sup Shell 278 Revenue Code C1888 Hcpcs,4134.38,1653.75,,,0 HCPCS,C1889,"Hc Allograft Injectable Allogeneic Disc Tissue, Sap#402554",31500.0,12600.0,,,0 HCPCS,C1889,"Hc Balloon Synflate, Sap#202106,202108,251825",3543.75,1417.5,,,0 HCPCS,C1889,"Hc Cannula Biomed Nextgen 23 Fr, Sap#173148",1554.29,621.72,,,0 HCPCS,C1889,"Hc Cartridge Ibv Valve 9Mm, Sap#220764",13584.38,5433.75,,,0 HCPCS,C1889,"Hc Hip Stem Spiration Ibv Valve 5Mm, Sap#218925",10434.38,4173.75,,,0 HCPCS,C1889,"Hc Hip Stem Spiration Ibv Valve 6Mm, Sap#218926",10434.38,4173.75,,,0 HCPCS,C1889,"Hc Hip Stem Spiration Ibv Valve 7Mm, Sap#218927",10434.38,4173.75,,,0 HCPCS,C1889,"Hc Kit Confidence Spinal Cement System Plus 11Cc, Sap# 251817",5512.5,2205.0,,,0 HCPCS,C1889,"Hc Mild Procedure Non-Billable Device, Sap#152102",0.01,0.004,,,0 HCPCS,C1889,"Hc Pack Universal Split, Sap#76179",73.2,29.28,,,0 HCPCS,C1889,"Hc Rezum Disposable Delivery Devices, Sap#263353",31500.0,12600.0,,,0 HCPCS,C1889,Hc Sup Shell 272 Revenue Code C1889 Hcpcs,10873.405,4349.360000000001,,,0 HCPCS,C1889,Hc Sup Shell 272 Revenue Code Without Hcpcs,177.79,71.115,,,0 HCPCS,C1889,Hc Sup Shell 278 Revenue Code C1889 Hcpcs,2012.06,826.88,,,0 HCPCS,C1889,Hc Sup Shell 278 Revenue Code Without Hcpcs,80.32,32.13,,,0 HCPCS,C1889,"Hc System Spaceoar Vue Hydrogel Spacer, Sap#261542",13564.69,5425.88,,,0 HCPCS,C1889,Hc Vap-Arrow Cath-Perph/Cntl/Midl,39.38,15.75,,,0 HCPCS,C1892,Hc Sup Shell 278 Revenue Code C1892 Hcpcs,217.39,86.96,,,0 HCPCS,C1893,Hc Sup Shell 278 Revenue Code C1893 Hcpcs,884.0699999999999,353.625,,,0 HCPCS,C1894,Hc Introducer 1.4Fr Sheath Sap#234042,159.35,63.74,,,0 HCPCS,C1894,Hc Introducer Picc 1.9Fr Sheath Sap#234044,146.75,58.7,,,0 HCPCS,C1894,"Hc Needle Set, Sap#75452",183.12,73.25,,,0 HCPCS,C1894,"Hc Sheath Super Arrow Flex 6Fr, Sap#234614",81.9,32.76,,,0 HCPCS,C1894,"Hc Sheath Super Arrow Flex 9Fr 11Cm, Sap#207293",106.9,42.76,,,0 HCPCS,C1894,Hc Sup Shell 278 Revenue Code C1894 Hcpcs,275.62,111.03,,,0 HCPCS,C1895,Hc Sup Shell 275 Revenue Code C1895 Hcpcs,11418.75,4567.5,,,0 HCPCS,C1895,Hc Sup Shell 278 Revenue Code C1895 Hcpcs,11123.439999999999,4449.375,,,0 HCPCS,C1896,Hc Sup Shell 275 Revenue Code C1896 Hcpcs,9843.75,3937.5,,,0 HCPCS,C1897,"Hc Lead Implant Axonics Sacral Neurostim Pne, Sap#258826",157.5,63.0,,,0 HCPCS,C1897,"Hc Lead Perc Trial 8 El 60Cm, Sap#145086",2362.5,945.0,,,0 HCPCS,C1897,Hc Lead Trial 50Cm Sap#229261,4725.0,1890.0,,,0 HCPCS,C1897,Hc Sup Shell 278 Revenue Code C1897 Hcpcs,1023.75,409.5,,,0 HCPCS,C1898,Hc Sup Shell 275 Revenue Code C1898 Hcpcs,1378.12,551.25,,,0 HCPCS,C1898,Hc Sup Shell 278 Revenue Code C1898 Hcpcs,1575.0,630.0,,,0 HCPCS,C1900,Hc Sup Shell 275 Revenue Code C1900 Hcpcs,7087.5,2835.0,,,0 HCPCS,C1982,Hc Sup Shell 278 Revenue Code C1982 Hcpcs,30653.24,12261.3,,,0 HCPCS,C2616,"Brachytx, non-str,Yttrium-90",,,17771.01,44427.52,4 HCPCS,C2616,NDC Description Not Available,69007.5,27603.0,,,0 HCPCS,C2617,Hc Sup Shell 278 Revenue Code C2617 Hcpcs,378.72,151.49,,,0 HCPCS,C2618,Hc Sup Shell 272 Revenue Code C2618 Hcpcs,5709.38,2283.75,,,0 HCPCS,C2618,Hc Sup Shell 278 Revenue Code C2618 Hcpcs,9164.535,3665.815,,,0 HCPCS,C2621,Hc Sup Shell 275 Revenue Code C2621 Hcpcs,21696.120000000003,8678.45,,,0 HCPCS,C2621,Hc Sup Shell 278 Revenue Code Hcpcs C2621,22591.41,9036.56,,,0 HCPCS,C2622,Hc Sup Shell 278 Revenue Code C2622 Hcpcs,45032.2,18012.88,,,0 HCPCS,C2623,Hc Sup Shell 278 Revenue Code C2623 Hcpcs,7372.965,2949.185,,,0 HCPCS,C2624,Hc Sup Shell 278 Revenue Code C2624 Hcpcs,84384.56,33753.82,,,0 HCPCS,C2625,Hc Sup Shell 278 Revenue Code C2625 Hcpcs,748.12,299.25,,,0 HCPCS,C2627,Hc Sup Shell 272 Revenue Code C2627 Hcpcs,630.44,252.18,,,0 HCPCS,C2628,Hc Sup Shell 278 Revenue Code C2628 Hcpcs,4685.62,1874.25,,,0 HCPCS,C2629,Hc Sup Shell 278 Revenue Code C2629 Hcpcs,12317.43,4926.97,,,0 HCPCS,C2630,Hc Sup Shell 278 Revenue Code C2630 Hcpcs,9316.13,3726.45,,,0 HCPCS,C2631,Hc Sup Shell 278 Revenue Code C2631 Hcpcs,1755.46,702.18,,,0 HCPCS,C2638,"Brachytx, stranded, I-125",,,35.26,88.15,4 HCPCS,C2638,Hc Brachy Source Strand Iodin125,221.26999999999998,88.50699999999999,,,0 HCPCS,C2643,"Brachytx, non-stranded,C-131",,,99.8,249.5,4 HCPCS,C2643,Hc Cesium 131 Non-Stranded,297.995,119.195,,,0 HCPCS,C5271,Hc Lc Grft 1St 25Sqcm <100Sc(Tal),2297.28,918.91,,,0 HCPCS,C5273,Hc Lc Grft 1St 100Sqcm >100Sc(Tal,2531.7,1012.68,,,0 HCPCS,C5275,Hc Lc Grft 1St 25Sqcm<100Sc(Oth),2297.28,918.91,,,0 HCPCS,C7900,"Hopd mntl hlt, 15-29 min",,,36.59,91.48,4 HCPCS,C7901,"Hopd mntl hlt, 30-60 min",,,99.21,248.03,4 HCPCS,C7903,"Hopd mntl hlt, grp",,,36.59,91.48,4 HCPCS,C8001,3d anat seg imaging preop,,,125.66,314.16,4 HCPCS,C8003,Imp extar knee shck absrb,,,17123.6,42809.0,4 HCPCS,C8004,Sim ang w/prs cath rad emb,,,11274.1,28185.26,4 HCPCS,C8006,Inst pleu-perit shnt w pump,,,6322.36,15805.9,4 HCPCS,C8007,Opn mplnt hpgls ns ary ps gn,,,30135.76,75339.4,4 HCPCS,C8008,Rv/rpl hpgls ns inc cnt pg,,,10882.0,27205.01,4 HCPCS,C8009,Rmv hpgls ns ary and pg,,,3336.22,8340.56,4 HCPCS,C8011,Opn mplnt hpgls ns ary rec,,,30135.76,75339.4,4 HCPCS,C8012,Rv/rpl hpgls ns ary rec,,,10882.0,27205.01,4 HCPCS,C8013,Rmv hpls ns ary rec,,,3336.22,8340.56,4 HCPCS,C8014,"Cysto, litho, w suct sheath",,,5236.35,13090.88,4 HCPCS,C8900,Hc Mra Abdomen W/Contrast,2804.91,1121.96,,,0 HCPCS,C8900,"Mra w/cont, abd",,,340.71,851.78,4 HCPCS,C8901,Hc Mra Abdomen W/O Contrast,2509.71,1003.88,,,0 HCPCS,C8901,"Mra w/o cont, abd",,,233.02,582.55,4 HCPCS,C8902,Hc Mra Abdomen Wo/W Contrast,3460.76,1384.3,,,0 HCPCS,C8902,"Mra w/o fol w/cont, abd",,,340.71,851.78,4 HCPCS,C8903,"Mri w/cont, breast, uni",,,171.3,428.24,4 HCPCS,C8905,"Mri w/o fol w/cont, brst, un",,,340.71,851.78,4 HCPCS,C8906,Hc Mri Breast W/Contrast Bilateral,3118.48,1247.39,,,0 HCPCS,C8906,"Mri w/cont, breast, bi",,,340.71,851.78,4 HCPCS,C8908,Hc Mri Breast W And W/O Contrast Bilateral,3602.04,1440.82,,,0 HCPCS,C8908,Hc Mri Breast Wo/W Contrast Right,3602.04,1440.82,,,0 HCPCS,C8908,"Mri w/o fol w/cont, breast,",,,340.71,851.78,4 HCPCS,C8909,Hc Mra Chest W/Contrast,3251.72,1300.69,,,0 HCPCS,C8909,"MRA w/cont, chest",,,340.71,851.78,4 HCPCS,C8910,Hc Mra Chest W/O Contrast,2738.29,1095.32,,,0 HCPCS,C8910,"MRA w/o cont, chest",,,233.02,582.55,4 HCPCS,C8911,Hc Mra Chest Wo/W Contrast,3642.24,1456.9,,,0 HCPCS,C8911,"MRA w/o fol w/cont, chest",,,340.71,851.78,4 HCPCS,C8912,Hc Mra Lower Extremity With Contrast - Bilateral,3396.61,1358.64,,,0 HCPCS,C8912,Hc Mra Lower Extremity With Contrast-Unilateral,3047.92,1219.17,,,0 HCPCS,C8912,"Mra w/cont, lwr ext",,,340.71,851.78,4 HCPCS,C8913,Hc Mra Lower Extremity W/O Contast - Bilateral,3396.61,1358.64,,,0 HCPCS,C8913,Hc Mra Lower Extremity Without Contrast - Unilateral,3047.92,1219.17,,,0 HCPCS,C8913,"Mra w/o cont, lwr ext",,,233.02,582.55,4 HCPCS,C8914,Hc Mra Lower Extremity Wo And W Contrast,3729.54,1491.82,,,0 HCPCS,C8914,"Mra w/o fol w/cont, lwr ext",,,340.71,851.78,4 HCPCS,C8918,Hc Mra Pelvis W/Contrast,2108.85,843.54,,,0 HCPCS,C8918,"MRA w/cont, pelvis",,,340.71,851.78,4 HCPCS,C8919,Hc Mra Pelvis W/O Contrast,1972.16,788.86,,,0 HCPCS,C8919,"MRA w/o cont, pelvis",,,233.02,582.55,4 HCPCS,C8920,Hc Mra Pelvis Wo/W Contrast,2808.35,1123.34,,,0 HCPCS,C8920,"Mra w/o fol w/cont, pelvis",,,340.71,851.78,4 HCPCS,C8921,Hc Tte With Or Without Contrast Followed By Contrast-Complete,1625.0,650.0,,,0 HCPCS,C8921,"Tte w or w/o fol w/cont, com",,,765.58,2978.0,8 HCPCS,C8922,Hc Tte With Or Without Contrast Followed By Contrast-Limited,1550.0,620.0,,,0 HCPCS,C8922,"Tte w or w/o fol w/cont, f/u",,,765.58,2978.0,8 HCPCS,C8923,"2d tte w or w/o fol w/con,co",,,765.58,2978.0,8 HCPCS,C8923,Hc 2D Tte With Or Without Contrast Followed By Contrast,1850.0,740.0,,,0 HCPCS,C8924,"2d tte w or w/o fol w/con,fu",,,340.71,2978.0,8 HCPCS,C8924,Hc 2D Transthoracic Echocardiography With Definity,1934.71,773.88,,,0 HCPCS,C8925,"2d tee w or w/o fol w/con,in",,,765.58,2978.0,8 HCPCS,C8926,"Tee w or w/o fol w/cont,cong",,,765.58,2978.0,8 HCPCS,C8927,"TEE w or w/o fol w/cont, mon",,,765.58,2978.0,8 HCPCS,C8928,Hc Pharm Stress Echo Comp Definty,3732.78,1493.11,,,0 HCPCS,C8928,"Tte w or w/o fol w/con,stres",,,765.58,2978.0,8 HCPCS,C8929,Hc Stress Echo (Exer) W Definity,5960.15,2384.06,,,0 HCPCS,C8929,"TTE w or wo fol wcon,Doppler",,,765.58,2978.0,8 HCPCS,C8930,Hc Tte With Or Without Contrast: With Continuous Ecg,2300.0,920.0,,,0 HCPCS,C8930,"TTE w or w/o contr, cont ECG",,,765.58,2978.0,8 HCPCS,C8931,"MRA, w/dye, spinal canal",,,340.71,851.78,4 HCPCS,C8932,"MRA, w/o dye, spinal canal",,,233.02,582.55,4 HCPCS,C8933,"MRA, w/o&w/dye, spinal canal",,,340.71,851.78,4 HCPCS,C8934,Hc Mra Upper Extremity W Contrast,2161.68,864.67,,,0 HCPCS,C8934,"MRA, w/dye, upper extremity",,,340.71,851.78,4 HCPCS,C8935,"MRA, w/o dye, upper extr",,,233.02,582.55,4 HCPCS,C8936,Hc Mra Upper Extremity Wo And W Contrast,2773.89,1109.56,,,0 HCPCS,C8936,"MRA, w/o&w/dye, upper extr",,,340.71,851.78,4 HCPCS,C8937,Hc Cad W/Breast Mri,174.59,69.84,,,0 HCPCS,C8957,"Prolonged iv inf, req pump",,,207.73,519.32,4 HCPCS,C9046,Cocaine hcl nasal solution,,,1.68,1.68,4 HCPCS,C9047,"Cablivi: 1 Kit In 1 Carton (58468-0225-1) * 1 Ml In 1 Vial, Glass (58468-0227-1) * 1 Ml In 1 Syringe, Glass (58468-0229-1)",2855.36,1142.14,,,0 HCPCS,C9047,"Injection, caplacizumab-yhdp",,,779.24,2094.78,9 HCPCS,C9067,Gallium ga-68 dotatoc,,,3.61,9.02,9 HCPCS,C9088,"Instill, bupivac and meloxic",,,0.76,0.76,4 HCPCS,C9089,"Bupivacaine implant, 1 mg",,,0.83,0.83,4 HCPCS,C9101,"Inj, oliceridine 0.1 mg",,,1.29,1.29,4 HCPCS,C9113,NDC Description Not Available,18.32,7.33,,,0 HCPCS,C9113,Pantoprazole Sodium: 10 Vial In 1 Carton (0781-3232-95) / 10 Ml In 1 Vial (0781-3232-94),9.63,3.85,,,0 HCPCS,C9113,Pantoprazole Sodium: 10 Vial In 1 Carton (25021-751-10) / 10 Ml In 1 Vial,8.81,3.52,,,0 HCPCS,C9143,Cocaine hcl nasal (numbrino),,,2.24,2.24,4 HCPCS,C9144,"Inj, bupivacaine (posimir)",,,0.48,0.48,4 HCPCS,C9145,"Inj, aponvie, 1 mg",,,1.86,2.39,5 HCPCS,C9170,Imdelltra (Amg757): 1 Kit In 1 Package (55513-059-01) * 1 Mg In 1 Vial (55513-103-01) * 7 Ml In 1 Vial (55513-068-01),6900.0,2760.0,,,0 HCPCS,C9170,Imdelltra (Amg757): 1 Kit In 1 Package (55513-077-01) * 10 Mg In 1 Vial (55513-069-01) * 7 Ml In 1 Vial (55513-068-01),6628.04,2651.22,,,0 HCPCS,C9173,"Inj, nypozi, 1 mcg",,,0.52,0.52,4 HCPCS,C9176,Dom nonHEU Tc99m add-on/dose,,,10.0,25.0,5 HCPCS,C9248,"Inj, clevidipine butyrate",,,3.53,3.53,4 HCPCS,C9248,NDC Description Not Available,14.44,5.78,,,0 HCPCS,C9250,"Artiss Fibrin Sealant: 1 Syringe, Plastic In 1 Carton (0338-8503-10) / 10 Ml In 1 Syringe, Plastic (0338-8503-09)",1451.81,580.72,,,0 HCPCS,C9250,"Artiss Fibrin Sealant: 2 Ml In 1 Syringe, Plastic (0338-9637-01)",2567.21,1026.88,,,0 HCPCS,C9250,Artiss fibrin sealant,,,145.76,364.41,5 HCPCS,C9250,Hc Sup Shell 250 Revenue Code C9250 Hcpcs,3249.38,1299.75,,,0 HCPCS,C9250,Hc Sup Shell 278 Revenue Code C9250 Hcpcs,1768.52,707.41,,,0 HCPCS,C9250,"Tisseel Fibrin Sealant: 1 Kit In 1 Carton (0338-4302-04) * 2 Ml In 1 Vial, Glass (0338-7332-02) * 2 Ml In 1 Vial, Glass (0338-7201-02) * 2 Ml In 1 Vial, Glass (0338-7401-02) * 2 Ml In 1 Vial, ",1451.81,580.72,,,0 HCPCS,C9254,"Injection, lacosamide",,,0.2,0.2,4 HCPCS,C9254,"Lacosamide: 10 Vial, Glass In 1 Carton (69543-455-10) / 20 Ml In 1 Vial, Glass (69543-455-20)",0.45,0.18,,,0 HCPCS,C9254,"Lacosamide: 10 Vial, Glass In 1 Carton (83090-012-10) / 20 Ml In 1 Vial, Glass",0.86,0.34,,,0 HCPCS,C9254,"Lacosamide: 10 Vial, Single-Dose In 1 Carton (43598-087-58) / 20 Ml In 1 Vial, Single-Dose (43598-087-11)",0.3,0.12,,,0 HCPCS,C9254,"Lacosamide: 10 Vial, Single-Dose In 1 Carton (70069-471-10) / 20 Ml In 1 Vial, Single-Dose (70069-471-01)",0.93,0.37,,,0 HCPCS,C9254,NDC Description Not Available,0.67,0.18,,,0 HCPCS,C9254,"Vimpat: 10 Vial, Glass In 1 Carton (0131-1810-67) / 20 Ml In 1 Vial, Glass",2.08,0.83,,,0 HCPCS,C9257,"Avastin: 1 Vial, Single-Use In 1 Carton (50242-060-01) / 4 Ml In 1 Vial, Single-Use",305.95,122.38,,,0 HCPCS,C9257,Bevacizumab injection,,,1.89,4.72,9 HCPCS,C9285,"Patch, lidocaine/tetracaine",,,16.95,16.95,4 HCPCS,C9293,"Injection, glucarpidase",,,411.74,1122.76,9 HCPCS,C9293,"Voraxaze: 1 Vial In 1 Carton (50633-210-11) / 1 Injection, Powder, For Solution In 1 Vial",1894.0,757.6,,,0 HCPCS,C9300,NDC Description Not Available,43.1,17.24,,,0 HCPCS,C9301,Obecabtagene car pos t,,,0.01,0.01,4 HCPCS,C9302,"Inj zanidatamab, 2 mg",,,23.7,23.7,4 HCPCS,C9303,"Inj zolbetuximab, 1 mg",,,16.0,16.0,4 HCPCS,C9304,"Inj marstacimab, 0.5 mg",,,51.0,51.0,4 HCPCS,C9307,Inj linvoseltamab-gcpt 1 mg,,,118.12,118.12,1 HCPCS,C9308,"Inj, carboplatin (avyxa)",,,6.28,6.28,1 HCPCS,C9363,Integra Meshed Bil Wound Mat,,,121.53,303.83,5 HCPCS,C9399,Defitelio: 2.5 Ml In 1 Vial (68727-800-01),4537.19,1814.88,,,0 HCPCS,C9399,Hc Car-T Ide-Cel Abecma,2482072.0,992828.8,,,0 HCPCS,C9399,Hc Car-T Liso-Cel Breyanzi,2427638.0,971055.2,,,0 HCPCS,C9399,Hc T-Cell Amtagvi (Lifileucel),2798760.0,1119504.0,,,0 HCPCS,C9399,Imdelltra (Amg757): 1 Kit In 1 Package (55513-077-01) * 10 Mg In 1 Vial (55513-069-01) * 7 Ml In 1 Vial (55513-068-01),69000.0,27600.0,,,0 HCPCS,C9399,NDC Description Not Available,45.02,18.01,,,0 HCPCS,C9399,"Paclitaxel: 1 Vial, Single-Dose In 1 Carton (0781-3531-91) / 20 Ml In 1 Vial, Single-Dose",78.18,31.27,,,0 HCPCS,C9399,Posaconazole: 1 Vial In 1 Carton (68462-904-01) / 16.7 Ml In 1 Vial,2468.14,987.26,,,0 HCPCS,C9399,"Posaconazole: 1 Vial, Glass In 1 Carton (67457-665-20) / 16.7 Ml In 1 Vial, Glass",2171.78,868.71,,,0 HCPCS,C9399,"Posaconazole: 1 Vial, Single-Dose In 1 Carton (55150-388-01) / 16.7 Ml In 1 Vial, Single-Dose",759.37,303.75,,,0 HCPCS,C9399,"Posaconazole: 1 Vial, Single-Dose In 1 Carton (63323-685-17) / 16.7 Ml In 1 Vial, Single-Dose",1310.65,524.26,,,0 HCPCS,C9399,"Praxbind: 2 Vial, Single-Dose In 1 Carton (0597-0197-05) / 50 Ml In 1 Vial, Single-Dose",11849.72,4739.89,,,0 HCPCS,C9399,Ryanodex Dantrolene Sodium: 1 Vial In 1 Carton (42367-540-32) / 20 Ml In 1 Vial,11969.19,4787.68,,,0 HCPCS,C9399,"Rytelo: 1 Vial, Single-Dose In 1 Carton (82959-111-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",237.63,95.05,,,0 HCPCS,C9399,"Xacduro: 1 Kit In 1 Carton (68547-111-10) * 5 Ml In 1 Vial, Single-Dose (68547-211-20) * 2.5 Ml In 1 Vial, Single-Dose (68547-311-30)",2109.52,843.81,,,0 HCPCS,C9460,"Injection, cangrelor",,,20.02,51.7,9 HCPCS,C9460,"Kengreal: 10 Vial, Single-Use In 1 Carton (10122-620-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Use (10122-620-01)",86.63,34.65,,,0 HCPCS,C9460,NDC Description Not Available,82.03,32.81,,,0 HCPCS,C9462,"Injection, delafloxacin",,,0.47,0.47,4 HCPCS,C9482,Sotalol Hydrochloride: 1 Vial In 1 Carton (69724-112-10) / 10 Ml In 1 Vial,101.1,40.44,,,0 HCPCS,C9482,Sotalol hydrochloride IV,,,24.15,30.61,5 HCPCS,C9488,Conivaptan HCL,,,44.57,44.57,4 HCPCS,C9600,Hc Des Plcm Lc W/Ptca 1 Ves Lc*,23806.15,9522.46,,,0 HCPCS,C9600,Hc Des Plcm Ld W/Ptca 1 Ves Ld*,23806.15,9522.46,,,0 HCPCS,C9600,Hc Des Plcm Ld W/Ptca 1 Ves Ri*,23806.15,9522.46,,,0 HCPCS,C9600,Hc Des Plcm Lm W/Ptca 1 Ves Lm*,23806.15,9522.46,,,0 HCPCS,C9600,Hc Des Plcm Rc W/Ptca 1 Ves Rc*,23806.15,9522.46,,,0 HCPCS,C9600,Perc drug-el cor stent sing,,,11274.1,28185.26,4 HCPCS,C9601,Hc Des Plcm Lc W/Ptca Ea Add Lc*,21179.55,8471.82,,,0 HCPCS,C9601,Hc Des Plcm Ld W/Ptca Ea Add Ld*,21179.55,8471.82,,,0 HCPCS,C9601,Hc Des Plcm Lm W/Ptca Ea Add Lm*,21179.55,8471.82,,,0 HCPCS,C9601,Hc Des Plcm Rc W/Ptca Ea Add Rc*,21179.55,8471.82,,,0 HCPCS,C9602,Hc Des Plc/Ptca/Arther 1 Ves Lc*,25258.6,10103.44,,,0 HCPCS,C9602,Hc Des Plc/Ptca/Arther 1 Ves Ld*,25258.6,10103.44,,,0 HCPCS,C9602,Hc Des Plc/Ptca/Arther 1 Ves Lm*,25258.6,10103.44,,,0 HCPCS,C9602,Hc Des Plc/Ptca/Arther 1 Ves Rc*,25258.6,10103.44,,,0 HCPCS,C9602,Perc d-e cor stent ather s,,,17902.75,44756.89,4 HCPCS,C9603,Hc Des Plc W/Arther Ea Add Ld*,20762.1,8304.84,,,0 HCPCS,C9603,Hc Des Plc W/Arther Ea Add Rc*,20762.1,8304.84,,,0 HCPCS,C9604,Hc Des-Perc Rvsc Byp Grf 1 Vl Lc,25510.45,10204.18,,,0 HCPCS,C9604,Hc Des-Perc Rvsc Byp Grf 1 Vl Ld,25510.45,10204.18,,,0 HCPCS,C9604,Hc Des-Perc Rvsc Byp Grf 1 Vl Rc,25510.45,10204.18,,,0 HCPCS,C9604,Perc d-e cor revasc t cabg s,,,11274.1,28185.26,4 HCPCS,C9605,Hc Des-Perc Rvsc Byp Grf Ad Vl Lc,22770.0,9108.0,,,0 HCPCS,C9605,Hc Des-Perc Rvsc Byp Grf Ad Vl Rc,22770.0,9108.0,,,0 HCPCS,C9606,Hc Des-Perc Rvsc Ac Mi 1 Vl Lc,27447.05,10978.82,,,0 HCPCS,C9606,Hc Des-Perc Rvsc Ac Mi 1 Vl Ld,27447.05,10978.82,,,0 HCPCS,C9606,Hc Des-Perc Rvsc Ac Mi 1 Vl Lm,27447.05,10978.82,,,0 HCPCS,C9606,Hc Des-Perc Rvsc Ac Mi 1 Vl Rc,27447.05,10978.82,,,0 HCPCS,C9606,Hc Des-Perc Rvsc Ac Mi 1 Vl Ri,27447.05,10978.82,,,0 HCPCS,C9607,Hc Des-Perc Rvsc Chron 1 Vl Lc,24591.6,9836.64,,,0 HCPCS,C9607,Hc Des-Perc Rvsc Chron 1 Vl Ld,24591.6,9836.64,,,0 HCPCS,C9607,Hc Des-Perc Rvsc Chron 1 Vl Lm,24591.6,9836.64,,,0 HCPCS,C9607,Hc Des-Perc Rvsc Chron 1 Vl Rc,24591.6,9836.64,,,0 HCPCS,C9607,Hc Des-Perc Rvsc Chron 1 Vl Rca,24591.6,9836.64,,,0 HCPCS,C9607,Hc Des-Perc Rvsc Chron 1 Vl Ri,24591.6,9836.64,,,0 HCPCS,C9607,Perc d-e cor revasc chro sin,,,17902.75,44756.89,4 HCPCS,C9608,Hc Des-Perc Rvsc Chron Ad Vl Rc,20257.25,8102.9,,,0 HCPCS,C9610,Hc Sup Shell 278 Revenue Code C9610 Hcpcs,24314.06,9725.62,,,0 HCPCS,C9725,Place endorectal app,,,908.2,2270.5,4 HCPCS,C9727,Insert palate implants,,,1515.28,3788.21,4 HCPCS,C9728,Hc Sup Shell 278 Revenue Code C9728 Hcpcs,1673.44,669.38,,,0 HCPCS,C9728,"Place device/marker, non pro",,,1351.75,3379.37,4 HCPCS,C9733,Non-ophthalmic FVA,,,340.71,851.78,4 HCPCS,C9734,"U/s trtmt, not leiomyomata",,,12538.31,31345.78,4 HCPCS,C9739,Cystoscopy prostatic imp 1-3,,,5236.35,13090.88,4 HCPCS,C9740,Cysto impl 4 or more,,,9244.99,23112.47,4 HCPCS,C9757,Spine/lumbar disk surgery,,,12538.31,31345.78,4 HCPCS,C9761,"Cysto, litho, vacuum kidney",,,9244.99,23112.47,4 HCPCS,C9762,Cardiac MRI seg dys strain,,,533.63,1334.08,4 HCPCS,C9763,Cardiac MRI seg dys stress,,,533.63,1334.08,4 HCPCS,C9764,Hc Shockwave And Pta Above The Knee,14300.0,5720.0,,,0 HCPCS,C9764,Revasc intravasc lithotripsy,,,11274.1,28185.26,4 HCPCS,C9765,Hc Revasc Intra Lithotrip-Stent,5462.5,2185.0,,,0 HCPCS,C9765,Revasc intra lithotrip-stent,,,17902.75,44756.89,4 HCPCS,C9766,Revasc intra lithotrip-ather,,,17902.75,44756.89,4 HCPCS,C9767,Revasc lithotrip-stent-ather,,,17902.75,44756.89,4 HCPCS,C9772,Revasc lithotrip tibi/perone,,,11274.1,28185.26,4 HCPCS,C9773,Revasc lithotr-stent tib/per,,,17902.75,44756.89,4 HCPCS,C9774,Revasc lithotr-ather tib/per,,,17902.75,44756.89,4 HCPCS,C9775,Revasc lith-sten-ath tib/per,,,17902.75,44756.89,4 HCPCS,C9777,Esophag mucosal integ add-on,,,3765.27,9413.18,4 HCPCS,C9778,"Colpopexy, min/inv, ex-perit",,,4885.41,12213.53,4 HCPCS,C9779,ESD endoscopy or colonoscopy,,,3765.27,9413.18,4 HCPCS,C9780,Hc Inout Cv Tunl Insrt 5+Yr,20720.7,8288.28,,,0 HCPCS,C9781,Arthro/shoul surg; w/spacer,,,12538.31,31345.78,4 HCPCS,C9783,Blind cor sinus reducer impl,,,11274.1,28185.26,4 HCPCS,C9785,Endo outlet restrict w/tube,,,10381.14,25952.85,4 HCPCS,C9793,Pre-plan 3d model w/ccta,,,838.65,2096.62,4 HCPCS,C9796,Rpr intst excl anrect fist,,,2710.72,6776.81,4 HCPCS,C9797,Hc Vasc Emb/Occ W/Prs Cath,27072.55,10829.02,,,0 HCPCS,C9797,Vasc emb/occ w/prs cath,,,17902.75,44756.89,4 HCPCS,C9803,HOPD covid-19 spec collect,,,22.98,22.98,4 HCPCS,C9803,Hc Covid-19 Test Specimen Collection,54.29,21.72,,,0 HCPCS,C9808,Hc Sup Shell 272 Revenue Code C9808 Hcpcs,10237.5,4095.0,,,0 HCPCS,C9809,"Hc Cryoablation Needle For Non-Opioid Device, Sap#237077",6300.0,2520.0,,,0 HCPCS,C9898,Inpnt stay radiolabeled item,,,0.01,0.01,4 HCPCS,C9901,Endo defect closure GI tract,,,10381.14,25952.85,4 HCPCS,D0120,Periodic oral evaluation,,,130.02,325.05,4 HCPCS,D0140,Limit oral eval problm focus,,,130.02,325.05,4 HCPCS,D0150,Comprehensve oral evaluation,,,130.02,325.05,4 HCPCS,D0160,Extensv oral eval prob focus,,,130.02,325.05,4 HCPCS,D0170,"Re-eval,est pt,problem focus",,,130.02,325.05,4 HCPCS,D0171,Re-eval post-op visit,,,130.02,325.05,4 HCPCS,D0180,Comp periodontal evaluation,,,130.02,325.05,4 HCPCS,D0191,Assessment of a patient,,,130.02,325.05,4 HCPCS,D0210,Intraor complete film series,,,233.02,582.55,4 HCPCS,D0220,Intraoral periapical first,,,84.99,212.47,4 HCPCS,D0240,Intraoral occlusal film,,,84.99,212.47,4 HCPCS,D0250,Extraoral 2d project image,,,84.99,212.47,4 HCPCS,D0251,Extraoral posterior image,,,84.99,212.47,4 HCPCS,D0270,Dental bitewing single image,,,84.99,212.47,4 HCPCS,D0272,Dental bitewings two images,,,84.99,212.47,4 HCPCS,D0273,Bitewings - three images,,,233.02,582.55,4 HCPCS,D0274,Bitewings four images,,,233.02,582.55,4 HCPCS,D0277,Vert bitewings 7 to 8 images,,,233.02,582.55,4 HCPCS,D0310,Dental saliography,,,233.02,582.55,4 HCPCS,D0320,Dental tmj arthrogram incl i,,,233.02,582.55,4 HCPCS,D0321,Other tmj images by report,,,84.99,212.47,4 HCPCS,D0322,Dental tomographic survey,,,102.1,255.25,4 HCPCS,D0330,Panoramic image,,,233.02,582.55,4 HCPCS,D0340,2d cephalometric image,,,84.99,212.47,4 HCPCS,D0350,Oral/facial photo images,,,84.99,212.47,4 HCPCS,D0364,Cone beam ct capt & interp,,,102.1,255.25,4 HCPCS,D0365,Cone beam ct interprete man,,,102.1,255.25,4 HCPCS,D0366,Cone beam ct interprete max,,,102.1,255.25,4 HCPCS,D0367,Cone beam ct interp both jaw,,,102.1,255.25,4 HCPCS,D0368,Cone beam ct interprete TMJ,,,102.1,255.25,4 HCPCS,D0369,Max MRI capture & interprete,,,102.1,255.25,4 HCPCS,D0370,Max ultrasound capt & interp,,,102.1,255.25,4 HCPCS,D0371,Sialoendoscopy capt & interp,,,84.99,212.47,4 HCPCS,D0380,Cone beam ct capture limited,,,102.1,255.25,4 HCPCS,D0381,Cone beam ct capt mandible,,,102.1,255.25,4 HCPCS,D0382,Cone beam ct capt maxilla,,,102.1,255.25,4 HCPCS,D0383,Cone beam ct both jaws,,,102.1,255.25,4 HCPCS,D0384,Cone beam ct capture TMJ,,,102.1,255.25,4 HCPCS,D0385,Max MRI image capture,,,102.1,255.25,4 HCPCS,D0386,Max ultrasound image capture,,,102.1,255.25,4 HCPCS,D0393,Trtmnt simulation 3d image,,,84.99,212.47,4 HCPCS,D0394,Digital sub 2 or more images,,,84.99,212.47,4 HCPCS,D0395,Fusion 2 or more 3d images,,,84.99,212.47,4 HCPCS,D0460,Pulp vitality test,,,631.36,1578.41,4 HCPCS,D0600,Non-ionizing diag proc,,,631.36,1578.41,4 HCPCS,D0701,Fracture of lower extremity M >=61.50,,,84.99,212.47,4 HCPCS,D0702,Fracture of lower extremity M >=52.50 and M <61.50,,,84.99,212.47,4 HCPCS,D0703,Fracture of lower extremity M >=41.50 and M <52.50,,,84.99,212.47,4 HCPCS,D0705,Extra oral post radio image,,,84.99,212.47,4 HCPCS,D0706,Intraoral occlus radio image,,,84.99,212.47,4 HCPCS,D0707,Intraoral periap radio image,,,84.99,212.47,4 HCPCS,D0708,Intraoral bite radio image,,,84.99,212.47,4 HCPCS,D0709,Intraoral cmplt radio images,,,84.99,212.47,4 HCPCS,D1110,Dental prophylaxis adult,,,130.02,325.05,4 HCPCS,D1510,Space maintainer fxd unilat,,,631.36,1578.41,4 HCPCS,D1516,"Fixed bilat space maint, max",,,631.36,1578.41,4 HCPCS,D1517,"Fixed bilat space maint, man",,,631.36,1578.41,4 HCPCS,D1520,Remove unilat space maintain,,,631.36,1578.41,4 HCPCS,D1526,"Remove bilat space main, max",,,631.36,1578.41,4 HCPCS,D1527,"Remove bilat space main, man",,,631.36,1578.41,4 HCPCS,D1551,Recement space maint - max,,,631.36,1578.41,4 HCPCS,D1552,Recement space maint - man,,,631.36,1578.41,4 HCPCS,D1553,Recement unilat space maint,,,631.36,1578.41,4 HCPCS,D1575,"Dist space maint, fixed unil",,,631.36,1578.41,4 HCPCS,D2140,Amalgam one surface permanen,,,631.36,1578.41,4 HCPCS,D2150,Amalgam two surfaces permane,,,631.36,1578.41,4 HCPCS,D2160,Amalgam three surfaces perma,,,631.36,1578.41,4 HCPCS,D2161,Amalgam 4 or > surfaces perm,,,631.36,1578.41,4 HCPCS,D2330,Resin one surface-anterior,,,631.36,1578.41,4 HCPCS,D2331,Resin two surfaces-anterior,,,631.36,1578.41,4 HCPCS,D2332,Resin three surfaces-anterio,,,631.36,1578.41,4 HCPCS,D2335,Resin 4/> surf or w incis an,,,631.36,1578.41,4 HCPCS,D2390,Ant resin-based cmpst crown,,,631.36,1578.41,4 HCPCS,D2391,Post 1 srfc resinbased cmpst,,,631.36,1578.41,4 HCPCS,D2392,Post 2 srfc resinbased cmpst,,,631.36,1578.41,4 HCPCS,D2393,Post 3 srfc resinbased cmpst,,,631.36,1578.41,4 HCPCS,D2394,Post >=4srfc resinbase cmpst,,,631.36,1578.41,4 HCPCS,D2410,Dental gold foil one surface,,,631.36,1578.41,4 HCPCS,D2420,Dental gold foil two surface,,,631.36,1578.41,4 HCPCS,D2430,Dental gold foil three surfa,,,631.36,1578.41,4 HCPCS,D2510,Dental inlay metalic 1 surf,,,631.36,1578.41,4 HCPCS,D2520,Dental inlay metallic 2 surf,,,631.36,1578.41,4 HCPCS,D2530,Dental inlay metl 3/more sur,,,631.36,1578.41,4 HCPCS,D2542,Dental onlay metallic 2 surf,,,631.36,1578.41,4 HCPCS,D2543,Dental onlay metallic 3 surf,,,631.36,1578.41,4 HCPCS,D2544,Dental onlay metl 4/more sur,,,631.36,1578.41,4 HCPCS,D2610,Inlay porcelain/ceramic 1 su,,,631.36,1578.41,4 HCPCS,D2620,Inlay porcelain/ceramic 2 su,,,631.36,1578.41,4 HCPCS,D2630,Dental onlay porc 3/more sur,,,631.36,1578.41,4 HCPCS,D2642,Dental onlay porcelin 2 surf,,,631.36,1578.41,4 HCPCS,D2643,Dental onlay porcelin 3 surf,,,631.36,1578.41,4 HCPCS,D2644,Dental onlay porc 4/more sur,,,631.36,1578.41,4 HCPCS,D2650,Inlay composite/resin one su,,,631.36,1578.41,4 HCPCS,D2651,Inlay composite/resin two su,,,631.36,1578.41,4 HCPCS,D2652,Dental inlay resin 3/mre sur,,,631.36,1578.41,4 HCPCS,D2662,Dental onlay resin 2 surface,,,631.36,1578.41,4 HCPCS,D2663,Dental onlay resin 3 surface,,,631.36,1578.41,4 HCPCS,D2664,Dental onlay resin 4/mre sur,,,631.36,1578.41,4 HCPCS,D2710,Crown resin-based indirect,,,631.36,1578.41,4 HCPCS,D2712,Crown 3/4 resin-based compos,,,631.36,1578.41,4 HCPCS,D2720,Crown resin w/ high noble me,,,631.36,1578.41,4 HCPCS,D2721,Crown resin w/ base metal,,,631.36,1578.41,4 HCPCS,D2722,Crown resin w/ noble metal,,,631.36,1578.41,4 HCPCS,D2740,Crown porcelain/ceramic subs,,,631.36,1578.41,4 HCPCS,D2750,Crown porcelain w/ h noble m,,,631.36,1578.41,4 HCPCS,D2751,Crown porcelain fused base m,,,631.36,1578.41,4 HCPCS,D2752,Crown porcelain w/ noble met,,,631.36,1578.41,4 HCPCS,D2753,Crown porc fused to titanium,,,631.36,1578.41,4 HCPCS,D2780,Crown 3/4 cast hi noble met,,,631.36,1578.41,4 HCPCS,D2781,Crown 3/4 cast base metal,,,631.36,1578.41,4 HCPCS,D2782,Crown 3/4 cast noble metal,,,631.36,1578.41,4 HCPCS,D2783,Crown 3/4 porcelain/ceramic,,,631.36,1578.41,4 HCPCS,D2790,Crown full cast high noble m,,,631.36,1578.41,4 HCPCS,D2791,Crown full cast base metal,,,631.36,1578.41,4 HCPCS,D2792,Crown full cast noble metal,,,631.36,1578.41,4 HCPCS,D2794,Crown-titanium,,,631.36,1578.41,4 HCPCS,D2799,Provisional crown,,,631.36,1578.41,4 HCPCS,D2910,Recement inlay onlay or part,,,631.36,1578.41,4 HCPCS,D2915,Recement cast or prefab post,,,631.36,1578.41,4 HCPCS,D2920,Re-cement or re-bond crown,,,631.36,1578.41,4 HCPCS,D2921,Reattach tooth fragment,,,631.36,1578.41,4 HCPCS,D2928,Prefab porc/cer crown perm,,,631.36,1578.41,4 HCPCS,D2929,Prefab porc/ceram crown pri,,,631.36,1578.41,4 HCPCS,D2930,Prefab stnlss steel crwn pri,,,631.36,1578.41,4 HCPCS,D2931,Prefab stnlss steel crown pe,,,631.36,1578.41,4 HCPCS,D2932,Prefabricated resin crown,,,631.36,1578.41,4 HCPCS,D2933,Prefab stainless steel crown,,,631.36,1578.41,4 HCPCS,D2934,Prefab steel crown primary,,,631.36,1578.41,4 HCPCS,D2940,Protective restoration,,,631.36,1578.41,4 HCPCS,D2949,Restorative foundation,,,631.36,1578.41,4 HCPCS,D2950,Core build-up incl any pins,,,631.36,1578.41,4 HCPCS,D2951,Tooth pin retention,,,631.36,1578.41,4 HCPCS,D2952,Post and core cast + crown,,,631.36,1578.41,4 HCPCS,D2954,Prefab post/core + crown,,,631.36,1578.41,4 HCPCS,D2957,Each addtnl prefab post,,,631.36,1578.41,4 HCPCS,D2960,Laminate labial veneer,,,631.36,1578.41,4 HCPCS,D2961,Lab labial veneer resin,,,631.36,1578.41,4 HCPCS,D2962,Lab labial veneer porcelain,,,631.36,1578.41,4 HCPCS,D2971,Add proc construct new crown,,,631.36,1578.41,4 HCPCS,D2975,Coping,,,631.36,1578.41,4 HCPCS,D2980,Crown repair,,,631.36,1578.41,4 HCPCS,D2981,Inlay repair,,,631.36,1578.41,4 HCPCS,D2982,Onlay repair,,,631.36,1578.41,4 HCPCS,D2983,Veneer repair,,,631.36,1578.41,4 HCPCS,D2990,Resin infiltration of lesion,,,631.36,1578.41,4 HCPCS,D2999,Dental unspec restorative pr,,,631.36,1578.41,4 HCPCS,D3110,Pulp cap direct,,,631.36,1578.41,4 HCPCS,D3120,Pulp cap indirect,,,631.36,1578.41,4 HCPCS,D3220,Therapeutic pulpotomy,,,631.36,1578.41,4 HCPCS,D3221,Gross pulpal debridement,,,631.36,1578.41,4 HCPCS,D3222,Part pulp for apexogenesis,,,631.36,1578.41,4 HCPCS,D3230,Pulpal therapy anterior prim,,,631.36,1578.41,4 HCPCS,D3240,Pulpal therapy posterior pri,,,631.36,1578.41,4 HCPCS,D3310,"End thxpy, anterior tooth",,,631.36,1578.41,4 HCPCS,D3320,"End thxpy, bicuspid tooth",,,631.36,1578.41,4 HCPCS,D3330,"End thxpy, molar",,,631.36,1578.41,4 HCPCS,D3331,Non-surg tx root canal obs,,,631.36,1578.41,4 HCPCS,D3332,Incomplete endodontic tx,,,631.36,1578.41,4 HCPCS,D3333,Internal root repair,,,631.36,1578.41,4 HCPCS,D3346,Retreat root canal anterior,,,631.36,1578.41,4 HCPCS,D3347,Retreat root canal bicuspid,,,631.36,1578.41,4 HCPCS,D3348,Retreat root canal molar,,,631.36,1578.41,4 HCPCS,D3351,Apexification/recalc initial,,,631.36,1578.41,4 HCPCS,D3352,Apexification/recalc interim,,,631.36,1578.41,4 HCPCS,D3353,Apexification/recalc final,,,631.36,1578.41,4 HCPCS,D3355,Pulpal regeneration initial,,,631.36,1578.41,4 HCPCS,D3356,Pulpal regeneration interim,,,631.36,1578.41,4 HCPCS,D3357,Pulpal regeneration complete,,,631.36,1578.41,4 HCPCS,D3410,Apicoectomy - anterior,,,631.36,1578.41,4 HCPCS,D3421,Root surgery bicuspid,,,631.36,1578.41,4 HCPCS,D3425,Root surgery molar,,,631.36,1578.41,4 HCPCS,D3428,Bone graft peri per tooth,,,631.36,1578.41,4 HCPCS,D3430,Retrograde filling,,,631.36,1578.41,4 HCPCS,D3431,Biological materials,,,631.36,1578.41,4 HCPCS,D3432,Guided tissue regeneration,,,631.36,1578.41,4 HCPCS,D3450,Root amputation,,,631.36,1578.41,4 HCPCS,D3460,Endodontic endosseous implan,,,631.36,1578.41,4 HCPCS,D3470,Intentional replantation,,,631.36,1578.41,4 HCPCS,D3471,Surg rep root res anterior,,,631.36,1578.41,4 HCPCS,D3472,Surg rep root res premolar,,,631.36,1578.41,4 HCPCS,D3473,Surg rep root res molar,,,631.36,1578.41,4 HCPCS,D3501,Surg exp root surf anterior,,,631.36,1578.41,4 HCPCS,D3502,Surg exp root surf premolar,,,631.36,1578.41,4 HCPCS,D3503,Surg exp root surf molar,,,631.36,1578.41,4 HCPCS,D3910,Isolation- tooth w rubb dam,,,631.36,1578.41,4 HCPCS,D3911,Intraorifice barrier,,,631.36,1578.41,4 HCPCS,D3920,Tooth splitting,,,631.36,1578.41,4 HCPCS,D3921,D?cor or submerg erupt tooth,,,631.36,1578.41,4 HCPCS,D3950,Canal prep/fitting of dowel,,,631.36,1578.41,4 HCPCS,D3999,Endodontic procedure,,,631.36,1578.41,4 HCPCS,D4210,Gingivectomy/plasty 4 or mor,,,3237.89,8094.73,4 HCPCS,D4211,Gingivectomy/plasty 1 to 3,,,3237.89,8094.73,4 HCPCS,D4212,Gingivectomy/plasty rest,,,3237.89,8094.73,4 HCPCS,D4230,Ana crown exp 4 or> per quad,,,3237.89,8094.73,4 HCPCS,D4231,Ana crown exp 1-3 per quad,,,1515.28,3788.21,4 HCPCS,D4240,Gingival flap proc w/ planin,,,3237.89,8094.73,4 HCPCS,D4241,Gngvl flap w rootplan 1-3 th,,,1515.28,3788.21,4 HCPCS,D4245,Apically positioned flap,,,1515.28,3788.21,4 HCPCS,D4249,Crown lengthen hard tissue,,,631.36,1578.41,4 HCPCS,D4260,Osseous surgery 4 or more,,,5781.33,14453.33,4 HCPCS,D4261,Osseous surg 1 to 3 teeth,,,3237.89,8094.73,4 HCPCS,D4263,Bone replce graft first site,,,631.36,1578.41,4 HCPCS,D4265,Bio mtrls to aid soft/os reg,,,631.36,1578.41,4 HCPCS,D4266,Guided tiss regen resorble,,,1515.28,3788.21,4 HCPCS,D4267,Guided tiss regen nonresorb,,,1515.28,3788.21,4 HCPCS,D4268,Surgical revision procedure,,,631.36,1578.41,4 HCPCS,D4270,Pedicle soft tissue graft pr,,,1515.28,3788.21,4 HCPCS,D4273,Auto tissue graft 1st tooth,,,1515.28,3788.21,4 HCPCS,D4274,Mesial/distal wedge proc,,,631.36,1578.41,4 HCPCS,D4275,Non-auto graft 1st tooth,,,1515.28,3788.21,4 HCPCS,D4276,Con tissue w dble ped graft,,,1515.28,3788.21,4 HCPCS,D4277,Soft tissue graft firsttooth,,,1515.28,3788.21,4 HCPCS,D4322,Splint intra-coronal,,,631.36,1578.41,4 HCPCS,D4323,Splint extra-coronal,,,631.36,1578.41,4 HCPCS,D4341,Periodontal scaling & root,,,631.36,1578.41,4 HCPCS,D4342,Periodontal scaling 1-3teeth,,,631.36,1578.41,4 HCPCS,D4346,Scaling gingiv inflammation,,,631.36,1578.41,4 HCPCS,D4355,Full mouth debridement,,,631.36,1578.41,4 HCPCS,D4381,Localized delivery antimicro,,,631.36,1578.41,4 HCPCS,D4910,Periodontal maint procedures,,,631.36,1578.41,4 HCPCS,D4920,Unscheduled dressing change,,,631.36,1578.41,4 HCPCS,D4921,Gingival irrigation per quad,,,130.02,325.05,4 HCPCS,D4999,Unspecified periodontal proc,,,231.31,578.27,4 HCPCS,D5911,Facial moulage sectional,,,631.36,1578.41,4 HCPCS,D5912,Facial moulage complete,,,631.36,1578.41,4 HCPCS,D5983,Radiation applicator,,,631.36,1578.41,4 HCPCS,D5984,Radiation shield,,,631.36,1578.41,4 HCPCS,D5985,Radiation cone locator,,,631.36,1578.41,4 HCPCS,D5987,Commissure splint,,,631.36,1578.41,4 HCPCS,D5988,Surgical splint,,,631.36,1578.41,4 HCPCS,D6920,Dental connector bar,,,631.36,1578.41,4 HCPCS,D7111,Extraction coronal remnants,,,631.36,1578.41,4 HCPCS,D7140,Extraction erupted tooth/exr,,,631.36,1578.41,4 HCPCS,D7210,Rem imp tooth w mucoper flp,,,1515.28,3788.21,4 HCPCS,D7220,Impact tooth remov soft tiss,,,631.36,1578.41,4 HCPCS,D7230,Impact tooth remov part bony,,,631.36,1578.41,4 HCPCS,D7240,Impact tooth remov comp bony,,,631.36,1578.41,4 HCPCS,D7241,Impact tooth rem bony w/comp,,,631.36,1578.41,4 HCPCS,D7250,Tooth root removal,,,631.36,1578.41,4 HCPCS,D7251,Coronectomy,,,1515.28,3788.21,4 HCPCS,D7260,Oral antral fistula closure,,,631.36,1578.41,4 HCPCS,D7261,Primary closure sinus perf,,,631.36,1578.41,4 HCPCS,D7270,Tooth reimplantation,,,631.36,1578.41,4 HCPCS,D7272,Tooth transplantation,,,631.36,1578.41,4 HCPCS,D7280,Exposure of unerupted tooth,,,631.36,1578.41,4 HCPCS,D7291,Transseptal fiberotomy,,,631.36,1578.41,4 HCPCS,D7310,Alveoplasty w/ extraction,,,1515.28,3788.21,4 HCPCS,D7311,Alveoloplasty w/extract 1-3,,,1515.28,3788.21,4 HCPCS,D7320,Alveoplasty w/o extraction,,,1515.28,3788.21,4 HCPCS,D7321,Alveoloplasty not w/extracts,,,1515.28,3788.21,4 HCPCS,D7340,Vestibuloplasty ridge extens,,,5781.33,14453.33,4 HCPCS,D7350,Vestibuloplasty exten graft,,,5781.33,14453.33,4 HCPCS,D7410,Rad exc lesion up to 1.25 cm,,,1515.28,3788.21,4 HCPCS,D7411,Excision benign lesion>1.25c,,,1515.28,3788.21,4 HCPCS,D7412,Excision benign lesion compl,,,1515.28,3788.21,4 HCPCS,D7413,Excision malig lesion<=1.25c,,,1515.28,3788.21,4 HCPCS,D7414,Excision malig lesion>1.25cm,,,1515.28,3788.21,4 HCPCS,D7415,Excision malig les complicat,,,1515.28,3788.21,4 HCPCS,D7440,Malig tumor exc to 1.25 cm,,,3237.89,8094.73,4 HCPCS,D7441,Malig tumor > 1.25 cm,,,3237.89,8094.73,4 HCPCS,D7450,Rem odontogen cyst to 1.25cm,,,3237.89,8094.73,4 HCPCS,D7451,Rem odontogen cyst > 1.25 cm,,,3237.89,8094.73,4 HCPCS,D7460,Rem nonodonto cyst to 1.25cm,,,631.36,1578.41,4 HCPCS,D7461,Rem nonodonto cyst > 1.25 cm,,,631.36,1578.41,4 HCPCS,D7471,Rem exostosis any site,,,3237.89,8094.73,4 HCPCS,D7472,Removal of torus palatinus,,,631.36,1578.41,4 HCPCS,D7473,Remove torus mandibularis,,,631.36,1578.41,4 HCPCS,D7485,Surg reduct osseoustuberosit,,,5781.33,14453.33,4 HCPCS,D7510,I&d absc intraoral soft tiss,,,691.56,1728.91,4 HCPCS,D7511,Incision/drain abscess intra,,,691.56,1728.91,4 HCPCS,D7520,I&d abscess extraoral,,,691.56,1728.91,4 HCPCS,D7521,Incision/drain abscess extra,,,691.56,1728.91,4 HCPCS,D7530,Removal fb skin/areolar tiss,,,631.36,1578.41,4 HCPCS,D7540,Removal of fb reaction,,,631.36,1578.41,4 HCPCS,D7550,Removal of sloughed off bone,,,631.36,1578.41,4 HCPCS,D7670,Closd rductn splint alveolus,,,3237.89,8094.73,4 HCPCS,D7671,Alveolus open reduction,,,5781.33,14453.33,4 HCPCS,D7770,Open reduc compd alveolus fx,,,5781.33,14453.33,4 HCPCS,D7771,Alveolus clsd reduc stblz te,,,3237.89,8094.73,4 HCPCS,D7874,Tmj arthroscopy disc reposit,,,3195.45,7988.62,4 HCPCS,D7922,Place intra-socket bio dress,,,631.36,1578.41,4 HCPCS,D7940,Reshaping bone orthognathic,,,631.36,1578.41,4 HCPCS,D7950,Mandible graft,,,5781.33,14453.33,4 HCPCS,D9930,Treatment of complications,,,631.36,1578.41,4 HCPCS,D9944,"Occ guard, hard, full arch",,,631.36,1578.41,4 HCPCS,D9945,"Occ guard, soft, full arch",,,631.36,1578.41,4 HCPCS,D9946,"Occ guard, hard, part arch",,,631.36,1578.41,4 HCPCS,D9950,Occlusion analysis,,,631.36,1578.41,4 HCPCS,D9951,Limited occlusal adjustment,,,631.36,1578.41,4 HCPCS,D9952,Complete occlusal adjustment,,,631.36,1578.41,4 HCPCS,E0201,Penile contractur devic manu,,,146.52,366.3,4 HCPCS,E0736,Transcut tibial nerv stimula,,,45.9,114.75,4 HCPCS,E0738,Upper extremity rehab,,,2039.64,5099.1,4 HCPCS,E0739,Rehab sys active assist rt,,,1597.66,3994.15,4 HCPCS,E1905,Vr cbt therapy,,,674.77,1686.92,4 HCPCS,E2104,Glucose monitor w cartridge,,,54.52,136.3,4 HCPCS,G0008,Admin influenza virus vac,,,45.73,114.33,4 HCPCS,G0008,Hc Administration Influenza Virus Vaccine,109.87,43.95,,,0 HCPCS,G0009,Admin pneumococcal vaccine,,,45.73,114.33,4 HCPCS,G0009,Hc Administration Pneumococcal Vaccine,109.87,43.95,,,0 HCPCS,G0010,Admin hepatitis b vaccine,,,45.73,114.33,4 HCPCS,G0010,Hc Administration Hepatitis B Vaccine,137.0,54.8,,,0 HCPCS,G0012,Injection of hiv prep drug,,,70.32,175.79,4 HCPCS,G0013,"Hiv prep counsel, clin staff",,,36.59,91.48,4 HCPCS,G0019,Comm hlth intg svs sdoh 60mn,,,99.21,248.03,4 HCPCS,G0023,Pin service 60m per month,,,99.21,248.03,4 HCPCS,G0027,Semen analysis,,,5.53,16.25,16 HCPCS,G0101,CA screen;pelvic/breast exam,,,99.21,248.03,4 HCPCS,G0101,Hc Cervical/Vaginal Cancer Screening-Pelvic/Breast Exam,230.0,92.0,,,0 HCPCS,G0102,Hc Prostate Cancer Screening-Digital Rectal Exam,63.0,25.2,,,0 HCPCS,G0103,Hc Psa Screen,189.78,75.91,,,0 HCPCS,G0103,PSA Screening,,,15.64,48.28,16 HCPCS,G0104,CA screen;flexi sigmoidscope,,,908.2,2270.5,4 HCPCS,G0104,Hc Colorectal Cancer Screening-Flexible Sigmoidscope,1761.8,704.72,,,0 HCPCS,G0105,Colorectal scrn; hi risk ind,,,908.2,4059.0,8 HCPCS,G0105,Hc Colorectal Scrn; Hi Risk Ind,3141.8,1256.72,,,0 HCPCS,G0108,Diab manage trn per indiv,,,52.96,132.4,4 HCPCS,G0108,Hc Diab Manage Trn Per Indiv,130.18,52.07,,,0 HCPCS,G0109,Diab manage trn ind/group,,,15.19,37.98,4 HCPCS,G0109,Hc Diab Manage Trn Ind/Group,73.92,29.57,,,0 HCPCS,G0117,Glaucoma scrn hgh risk direc,,,28.25,70.62,4 HCPCS,G0117,Hc Glaucoma Screening Hgh Risk Direct Opthalmologist,243.68,97.47,,,0 HCPCS,G0118,Glaucoma scrn hgh risk direc,,,36.48,91.19,4 HCPCS,G0118,Hc Glaucoma Screening Hgh Risk Direct Supervision,186.88,74.75,,,0 HCPCS,G0121,Colon ca scrn not hi rsk ind,,,908.2,4059.0,8 HCPCS,G0121,Hc Colon Ca Scrn Not Hi Rsk Ind,3141.8,1256.72,,,0 HCPCS,G0123,Hc Cytology Routine Thinprep Uhs,37.35,14.94,,,0 HCPCS,G0123,Screen cerv/vag thin layer,,,17.22,50.65,16 HCPCS,G0124,Screen c/v thin layer by MD,,,16.33,37.97,5 HCPCS,G0127,Hc Trimming Of Dystrophic Nails,557.57,223.03,,,0 HCPCS,G0127,Trim nail(s),,,57.61,144.03,4 HCPCS,G0130,Single energy x-ray study,,,102.1,255.25,4 HCPCS,G0136,Adm of soc dtr assess 5-15 m,,,36.59,91.48,4 HCPCS,G0140,Nav srv peer sup 60 min pr m,,,99.21,248.03,4 HCPCS,G0141,"Scr c/v cyto,autosys and md",,,37.97,37.97,1 HCPCS,G0143,"Scr c/v cyto,thinlayer,rescr",,,17.22,67.62,16 HCPCS,G0144,"Scr c/v cyto,thinlayer,rescr",,,18.16,109.92,16 HCPCS,G0145,Hc Pap (So) Screening-So+,129.92,51.97,,,0 HCPCS,G0145,Hc Routine Pap Imaging,149.41,59.76,,,0 HCPCS,G0145,"Scr c/v cyto,thinlayer,rescr",,,21.82,66.22,16 HCPCS,G0147,"Scr c/v cyto, automated sys",,,8.98,46.35,16 HCPCS,G0148,"Scr c/v cyto, autosys, rescr",,,8.98,79.85,16 HCPCS,G0166,"Extrnl counterpulse, per tx",,,129.94,324.84,4 HCPCS,G0175,"Opps service,sched team conf",,,407.5,1018.75,4 HCPCS,G0183,Software meas of cardiac vol,,,84.99,212.47,4 HCPCS,G0186,"Dstry eye lesn,fdr vssl tech",,,537.13,1342.82,4 HCPCS,G0235,PET not otherwise specified,,,390.42,976.05,4 HCPCS,G0237,Hc Therapeutic Procedure Strength Endurance,301.39,120.56,,,0 HCPCS,G0237,Therapeutic procd strg endur,,,28.25,70.62,4 HCPCS,G0238,"Hc Oth Resp Proc, Indiv",457.11,182.84,,,0 HCPCS,G0238,"Oth resp proc, indiv",,,28.25,70.62,4 HCPCS,G0239,"Hc Rt Oth Resp Proc, Group",380.09,152.04,,,0 HCPCS,G0239,"Oth resp proc, group",,,36.48,91.19,4 HCPCS,G0245,Initial foot exam pt lops,,,130.02,325.05,4 HCPCS,G0246,Followup eval of foot pt lop,,,130.02,325.05,4 HCPCS,G0247,Routine footcare pt w lops,,,195.94,489.85,4 HCPCS,G0248,Demonstrate use home inr mon,,,130.02,325.05,4 HCPCS,G0249,Provide INR test mater/equip,,,130.02,325.05,4 HCPCS,G0257,Hc Unscheduled Dialysis Esrd Pt Hos,5737.81,2295.12,,,0 HCPCS,G0257,Hc Unscheduled Dialysis Esrd Pt Hos-Emergent,6426.34,2570.54,,,0 HCPCS,G0257,Unsched dialysis ESRD pt hos,,,670.26,1675.64,4 HCPCS,G0259,Hc Injection For Sacroiliac Joint,1976.0,790.4,,,0 HCPCS,G0260,Hc Ct Guided In Anes Sacroiliac Joint-Bilateral,4666.56,1866.62,,,0 HCPCS,G0260,Hc Ct Guided In Anes Sacroiliac Joint-Unilateral,3109.37,1243.75,,,0 HCPCS,G0260,Hc Sc Si Joint Inj Bilateral,4666.56,1866.62,,,0 HCPCS,G0260,Hc Sc Si Joint Injection,3109.37,1243.75,,,0 HCPCS,G0260,Inj for sacroiliac jt anesth,,,689.37,2978.0,8 HCPCS,G0269,Hc Closure Device Placement,1917.19,766.88,,,0 HCPCS,G0270,Hc Mnt Reass/Inter 2Nd Ref Ind 15,60.0,24.0,,,0 HCPCS,G0270,MNT subs tx for change dx,,,21.27,53.18,4 HCPCS,G0271,Group MNT 2 or more 30 mins,,,11.92,29.8,4 HCPCS,G0271,Hc Mnt Reass/Inter 2Nd Ref Group,55.0,22.0,,,0 HCPCS,G0276,Pild/placebo control clin tr,,,7086.45,17716.12,4 HCPCS,G0277,"Hbot, full body chamber, 30m",,,134.39,335.97,4 HCPCS,G0277,Hc Hyperbaric Chamber 1/2Hr 2 Atm,1853.57,741.43,,,0 HCPCS,G0277,Hc Hyperbaric Chamber 1/2Hr 3 Atm,1853.57,741.43,,,0 HCPCS,G0277,Hc Hyperbaric Chamber-Add 1/2 Hr,1853.57,741.43,,,0 HCPCS,G0278,"Hc Vasc Iliac Art Angio,Cardiac Cath",3307.4,1322.96,,,0 HCPCS,G0279,Hc Tomo Diagnostic,128.0,51.2,,,0 HCPCS,G0279,"Tomosynthesis, mammo",,,11.28,28.2,4 HCPCS,G0281,Elec stim unattend for press,,,11.07,27.68,4 HCPCS,G0283,Elec stim other than wound,,,11.96,29.9,8 HCPCS,G0283,Hc Ot Electrical Stimulation Other Than Wound,363.35,145.34,,,0 HCPCS,G0283,Hc Pta Electrical Stimulation Unattended,363.35,145.34,,,0 HCPCS,G0293,"Non-cov surg proc,clin trial",,,36.48,91.19,4 HCPCS,G0294,"Non-cov proc, clinical trial",,,36.48,91.19,4 HCPCS,G0296,Hc Office Visit To Determine Lung Ca Screening Eligible,150.0,60.0,,,0 HCPCS,G0296,Visit to determ ldct elig,,,99.21,248.03,4 HCPCS,G0302,Pre-op service LVRS complete,,,364.43,911.07,4 HCPCS,G0303,Pre-op service LVRS 10-15dos,,,210.87,527.18,4 HCPCS,G0304,Pre-op service LVRS 1-9 dos,,,364.43,911.07,4 HCPCS,G0305,Post op service LVRS min 6,,,364.43,911.07,4 HCPCS,G0306,CBC/diffwbc w/o platelet,,,6.61,19.42,16 HCPCS,G0307,CBC without platelet,,,5.5,16.18,16 HCPCS,G0323,Care manage beh svs 20mins,,,36.59,91.48,4 HCPCS,G0327,Colon ca scrn;bld-bsd biomrk,,,203.55,203.55,4 HCPCS,G0328,Fecal blood scrn immunoassay,,,13.52,45.12,16 HCPCS,G0329,Electromagntic tx for ulcers,,,9.73,24.32,4 HCPCS,G0330,Facility svs dental rehab,,,3237.89,8094.73,4 HCPCS,G0378,Hc Cvicu/Sd Oncology Observation Per Hour,99.62,39.85,,,0 HCPCS,G0378,Hc Cvicu/Sd Telemetry Observation Per Hour,156.68,62.67,,,0 HCPCS,G0378,Hc Observation Carve Out - Interventional Radiology,93.59,37.44,,,0 HCPCS,G0378,Hc Observation Carve-Out - Ambulance Transport,93.59,37.44,,,0 HCPCS,G0378,Hc Observation Carve-Out - Gastrointestinal,93.59,37.44,,,0 HCPCS,G0378,Hc Observation Carve-Out - Respiratory,93.59,37.44,,,0 HCPCS,G0378,Hc Observation Carve-Out - Surgical,93.59,37.44,,,0 HCPCS,G0378,Hc Observation Hourly,93.59,37.44,,,0 HCPCS,G0378,Hc Observation Hourly Carve Out - Radiology,93.59,37.44,,,0 HCPCS,G0378,Hc Observation Hourly Progressive,227.31,90.92,,,0 HCPCS,G0378,Hc Observation Hourly With Telemetry,156.68,62.67,,,0 HCPCS,G0378,Hc Peds Cardiology Routine Observation Per Hour,365.38,146.15,,,0 HCPCS,G0379,Direct refer hospital observ,,,581.6,1454.0,4 HCPCS,G0379,Hc Direct Admit To Observation,671.6,268.64,,,0 HCPCS,G0390,Hc Trauma Response-Alert,18415.49,7366.2,,,0 HCPCS,G0390,Hc Trauma Response-Red Alert,21773.02,8709.21,,,0 HCPCS,G0390,Trauma Respons w/hosp criti,,,1301.73,3254.31,4 HCPCS,G0392,AV fistula or graft arterial,,,14697.0,17190.0,4 HCPCS,G0393,AV fistula or graft venous,,,14697.0,17190.0,4 HCPCS,G0396,Alcohol/subs interv 15-30mn,,,36.59,91.48,4 HCPCS,G0397,Alcohol/subs interv >30 min,,,173.34,433.36,4 HCPCS,G0398,Home sleep test/type 2 porta,,,210.87,527.18,4 HCPCS,G0399,Home sleep test/type 3 porta,,,210.87,527.18,4 HCPCS,G0400,Home sleep test/type 4 porta,,,210.87,527.18,4 HCPCS,G0402,Hc Initial Preventive Exam,199.0,79.6,,,0 HCPCS,G0402,Initial preventive exam,,,130.02,325.05,4 HCPCS,G0404,EKG tracing for initial prev,,,28.25,70.62,4 HCPCS,G0404,Hc Ekg Tracing Initial Preventive,142.9,57.16,,,0 HCPCS,G0410,Hc Group Psych Partial Hosp Or Intensive Op 45-50 Min,448.5,179.4,,,0 HCPCS,G0411,Hc Inter Active Group Partial Hosp Or Intensive Op Psych Participation,379.73,151.89,,,0 HCPCS,G0412,Open tx iliac spine uni/bil,,,7086.45,17716.12,4 HCPCS,G0413,Pelvic ring fracture uni/bil,,,7086.45,17716.12,4 HCPCS,G0414,Pelvic ring fx treat int fix,,,7086.45,17716.12,4 HCPCS,G0415,Open tx post pelvic fxcture,,,3195.45,7988.62,4 HCPCS,G0416,Hc Gross/Micro Prostate Biopsy,494.87,197.95,,,0 HCPCS,G0416,"Prostate biopsy, any mthd",,,188.46,875.15,9 HCPCS,G0420,Ed svc CKD ind per session,,,108.93,272.32,4 HCPCS,G0421,Ed svc CKD grp per session,,,26.23,65.58,4 HCPCS,G0422,Intens cardiac rehab w/exerc,,,125.89,314.73,4 HCPCS,G0423,Intens cardiac rehab no exer,,,125.89,314.73,4 HCPCS,G0424,Hc Pulmonary Rehab W Exer,326.0,130.4,,,0 HCPCS,G0427,Hc Hep C Screen High Risk/Other,93.15,37.26,,,0 HCPCS,G0429,Dermal filler injection(s),,,2015.01,5037.52,4 HCPCS,G0431,Drug screen single class,,,28.57,28.57,4 HCPCS,G0432,EIA HIV-1/HIV-2 screen,,,11.66,48.92,16 HCPCS,G0433,ELISA HIV-1/HIV-2 screen,,,18.29,45.72,12 HCPCS,G0434,Drug screen multi drug class,,,12.36,12.36,4 HCPCS,G0435,Oral hiv-1/hiv-2 screen,,,11.98,29.95,12 HCPCS,G0438,"PPPS, initial visit",,,164.79,411.98,4 HCPCS,G0439,"PPPS, subseq visit",,,129.57,323.92,4 HCPCS,G0442,Annual alcohol screen 15 min,,,36.59,91.48,4 HCPCS,G0443,Brief alcohol misuse counsel,,,99.21,248.03,4 HCPCS,G0443,Hc Brief Alcohol Misuse Counsel,125.0,50.0,,,0 HCPCS,G0444,Depression Screen annual,,,36.59,91.48,4 HCPCS,G0444,Hc Depression Screen Annual,65.0,26.0,,,0 HCPCS,G0445,High inten beh couns STD 30m,,,99.21,248.03,4 HCPCS,G0446,Intens behave ther cardio dx,,,36.59,91.48,4 HCPCS,G0447,Behavior counsel obesity 15m,,,99.21,248.03,4 HCPCS,G0447,Hc Behavior Counsel Obesity Each 15 Minutes,123.0,49.2,,,0 HCPCS,G0451,Devlopment test interpt&rep,,,99.21,248.03,4 HCPCS,G0451,Hc Developmntl Test Pt,190.0,76.0,,,0 HCPCS,G0452,Molecular pathology interpr,,,18.46,22.45,5 HCPCS,G0455,Fecal microbiota prep instil,,,908.2,2270.5,4 HCPCS,G0455,Hc Fecal Transplant Prep/Install,2042.17,816.87,,,0 HCPCS,G0460,Autologous PRP for ulcers,,,2015.01,5037.52,4 HCPCS,G0463,Hc Facility Visit,253.0,101.2,,,0 HCPCS,G0463,Hc Facility Visit-Pharmd Coumadin,175.0,70.0,,,0 HCPCS,G0463,Hc Pharmd Visit Fee,175.0,70.0,,,0 HCPCS,G0463,Hc Rn Nurse Visit Medicine Education,126.0,50.4,,,0 HCPCS,G0463,Hospital outpt clinic visit,,,130.02,325.05,4 HCPCS,G0463,Noncdm Charge Record,251.05,100.42,,,0 HCPCS,G0464,"Colorec CA scr, sto bas DNA",,,225.75,225.75,4 HCPCS,G0465,Autolog prp diab wound ulcer,,,2015.01,5037.52,4 HCPCS,G0471,Ven blood coll snf/hha,,,11.09,28.35,11 HCPCS,G0472,Hc Hep C Secreen High Risk/Other,191.36,76.54,,,0 HCPCS,G0472,Hep c screen high risk/other,,,12.13,115.88,16 HCPCS,G0473,Group behave couns 2-10,,,36.59,91.48,4 HCPCS,G0475,Hiv combination assay,,,24.08,60.2,16 HCPCS,G0476,Hpv combo assay ca screen,,,16.4,87.72,16 HCPCS,G0480,Drug test def 1-7 classes,,,47.96,286.08,16 HCPCS,G0480,Hc 060 Nicotine Serum/Plasma-So+,211.04,84.42,,,0 HCPCS,G0480,Hc 095 Xanax (Alprazolam)-So+,137.42,54.97,,,0 HCPCS,G0480,Hc 102 Resperidon & Metab S/P-So+,211.04,84.42,,,0 HCPCS,G0480,Hc 149 Syn Cannabinoid Met Ur-So+,211.04,84.42,,,0 HCPCS,G0480,Hc 157 Nicotine &Metab Ur Qnt,274.35,109.74,,,0 HCPCS,G0480,Hc 165 Olanzapine Level-So+,211.04,84.42,,,0 HCPCS,G0480,Hc 196 Amitriptyline Qnt-So+,137.42,54.97,,,0 HCPCS,G0480,Hc 311 Phosphatidylethanol-So+,211.04,84.42,,,0 HCPCS,G0480,Hc 369 Hypoglycem Sulfonl S/P-So+,211.04,84.42,,,0 HCPCS,G0480,Hc 373 Pcp Quant Urine Arup-So+,211.04,84.42,,,0 HCPCS,G0480,Hc 375 Clonazepam-So+,137.32,54.93,,,0 HCPCS,G0480,Hc 441 Hypoglycemia Pnl S/P-So+,153.6,61.44,,,0 HCPCS,G0480,Hc 446 Nortriptyline Hplc-So+,211.04,84.42,,,0 HCPCS,G0480,Hc 486 Synth Stimulnt Ur-Soq+,274.35,109.74,,,0 HCPCS,G0480,Hc 487 Ethyl Gluc&Sulf Ur Qnt-So+,211.04,84.42,,,0 HCPCS,G0480,Hc 801 Dextro/Levo Methrp S/P-So+,225.6,90.24,,,0 HCPCS,G0480,Hc 950 Clomipramn & Metb S/P-So+,137.32,54.93,,,0 HCPCS,G0480,Hc Alcohol Ethyl,324.42,129.77,,,0 HCPCS,G0480,Hc Alcohol Isopropyl,324.42,129.77,,,0 HCPCS,G0480,Hc Alcohols Urine Screen,324.42,129.77,,,0 HCPCS,G0480,"Hc Aripipazole And Metabolite, Serum/Plasma 2007945-So+",137.32,54.93,,,0 HCPCS,G0480,"Hc Brivaracetam Quantitative, Serum Or Plasma 3004978-So+",166.8,66.72,,,0 HCPCS,G0480,Hc Clobazam,165.76,66.3,,,0 HCPCS,G0480,Hc Diazepam And Nordiazepam 90076-So+,137.32,54.93,,,0 HCPCS,G0480,"Hc Digitoxin Quantitative, Serum Or Plasma 3002537-So+",137.32,54.93,,,0 HCPCS,G0480,"Hc Doxepin And Metabolite, Serum Or Plasma 90102-So+",137.32,54.93,,,0 HCPCS,G0480,Hc Drug Analysis-Pharm 1-7 Class,324.42,129.77,,,0 HCPCS,G0480,"Hc Drugs Of Abuse Confirmation, Lcmsms, Quantitative",282.1,112.84,,,0 HCPCS,G0480,"Hc Flucytosine By Mass Spectrometry, Serum/Plasma3018708-So+",462.0,184.8,,,0 HCPCS,G0480,"Hc Imipramine And Desipramine, Serum Or Plasma 90157-So+",153.6,61.44,,,0 HCPCS,G0480,"Hc Lsd Confirmation, Urine 91627-So+",181.2,72.48,,,0 HCPCS,G0480,"Hc Lsd, Urine - Screen With Reflex To Confirmation/Quantitation91224- So+",137.32,54.93,,,0 HCPCS,G0480,"Hc Nicotine And Metabolite, Serum, Lcmsms",345.34,138.14,,,0 HCPCS,G0480,Hc Oxycodone + Metabolite Urine,405.14,162.06,,,0 HCPCS,G0480,"Hc Oxycodone Confirmation, Urine",337.87,135.15,,,0 HCPCS,G0480,"Hc Pentobarbital, Serum Or Plasma 017194-So+",137.32,54.93,,,0 HCPCS,G0480,Hc Pentobarbital-So+,137.32,54.93,,,0 HCPCS,G0480,"Hc Phosphatidylethanol (Peth), Whole Blood, Quant (So)",186.88,74.75,,,0 HCPCS,G0480,"Hc Quetiapine, Serum Or Plasma-So+",137.32,54.93,,,0 HCPCS,G0480,"Hc Sertraline, Serum Or Plasma-Arup 3005859",178.52,71.41,,,0 HCPCS,G0480,"Hc Sulfonylurea Hypoglycemia Panel,Quant,Urine-So+",275.0,110.0,,,0 HCPCS,G0480,"Hc Synth Cannabinoid, S/P",425.88,170.35,,,0 HCPCS,G0480,Hc Tetrahydrocannabinol (Thc),324.42,129.77,,,0 HCPCS,G0481,Drug test def 8-14 classes,,,73.79,391.48,16 HCPCS,G0481,Hc Meconium Drug Scr 8-14,490.36,196.14,,,0 HCPCS,G0482,Drug test def 15-21 classes,,,99.62,496.85,16 HCPCS,G0482,Hc Abuse Drug Screning Lcmsms 15-21,662.28,264.91,,,0 HCPCS,G0483,Drug test def 22+ classes,,,129.14,617.3,16 HCPCS,G0483,Hc Qual Toxicol >22 Drug Classes,858.13,343.25,,,0 HCPCS,G0498,Chemo extend iv infus w/pump,,,322.58,806.45,4 HCPCS,G0498,Hc Home Infus W/Pump,380.26,152.1,,,0 HCPCS,G0499,Hepb screen high risk indiv,,,28.27,70.68,12 HCPCS,G0500,Hc Moderate Sedation Endoscopy Service >5Yrs,110.51,44.2,,,0 HCPCS,G0515,Hc Ot Cognitive Skills Development,162.0,64.8,,,0 HCPCS,G0515,Hc Pt Cognitive Skills Development,162.0,64.8,,,0 HCPCS,G0515,Hc Slp Cognitive Skills Development,162.0,64.8,,,0 HCPCS,G0516,"Insert drug del implant, >4",,,436.27,1090.68,4 HCPCS,G0517,Hc Removal Of Drug Implant 4 Or More,729.3,291.72,,,0 HCPCS,G0517,Remove drug implant,,,436.27,1090.68,4 HCPCS,G0518,Remove w insert drug implant,,,436.27,1090.68,4 HCPCS,G0537,Risk ascvd tst once pr 12 mo,,,36.59,91.48,4 HCPCS,G0538,Ascvd rsk mng clin stf pr mo,,,99.21,248.03,4 HCPCS,G0539,Initial care training 30 m,,,39.05,97.62,4 HCPCS,G0540,Train for caregiver add 15,,,20.71,51.78,4 HCPCS,G0541,No pt prsnt train initial 30,,,28.25,70.62,4 HCPCS,G0543,Group train w/o patient,,,28.25,70.62,4 HCPCS,G0544,Post d/c phone follow up,,,99.21,248.03,4 HCPCS,G0552,Supply of digital device,,,130.02,325.05,4 HCPCS,G0553,Monthly tx for dmht 20mins,,,130.02,325.05,4 HCPCS,G0555,Replacment pt electronic sys,,,838.65,2096.62,4 HCPCS,G0556,Adv prim care mgmt lvl 1,,,36.59,91.48,4 HCPCS,G0557,Adv prim care mgmt lvl 2,,,36.59,91.48,4 HCPCS,G0558,Adv prim care mgmt lvl 3,,,99.21,248.03,4 HCPCS,G0560,Safety plan interven,,,39.09,97.72,4 HCPCS,G0562,Complex simulation w/pet-ct,,,1864.48,4661.21,4 HCPCS,G0566,3d bn img algor drvd fr mri,,,125.66,314.16,4 HCPCS,G0567,Screening Hep C detect,,,35.09,87.72,5 HCPCS,G0568,"Int psych care mng, 1 cal mo",,,99.21,248.03,4 HCPCS,G0569,"Subs psych care mng, subs mo",,,99.21,248.03,4 HCPCS,G0570,"Care manage serv, pr cal mo",,,36.59,91.48,4 HCPCS,G0659,Drug test def simple all cl,,,34.27,155.35,16 HCPCS,G0685,Algorithm assessment for asd,,,129.94,324.84,4 HCPCS,G2000,Blinded conv. Tx MDD clin tr,,,364.43,911.07,4 HCPCS,G2011,Alcohol/sub abuse assess,,,28.25,70.62,4 HCPCS,G2023,Specimen collect COVID-19,,,23.46,23.46,4 HCPCS,G2024,Spec coll SNF/Lab COVID-19,,,25.46,25.46,4 HCPCS,G2061,Hc Spl Rehab 5-10 Minutes E Visit/7D,110.0,44.0,,,0 HCPCS,G2062,Hc Spl Rehab 11-20 Minutes E Visit/7D,157.0,62.8,,,0 HCPCS,G2063,Hc Spl Rehab 21 => Minutes E Visit/7D,209.0,83.6,,,0 HCPCS,G2086,Off base opioid tx 70min,,,173.34,433.36,4 HCPCS,G2087,"Off base opioid tx, 60 m",,,173.34,433.36,4 HCPCS,G2170,Avf by tissue w thermal e,,,7391.0,8644.0,4 HCPCS,G2171,Avf use magnetic/art/ven,,,7391.0,8644.0,4 HCPCS,G2214,Init/sub psych care m 1st 30,,,99.21,248.03,4 HCPCS,G2250,"Remot img sub by pt, non e/m",,,7.8,19.5,4 HCPCS,G2251,"Brief chkin, 5-10, non-e/m",,,10.44,26.1,4 HCPCS,G2252,"Brief chkin by md/qhp, 11-20",,,21.78,54.45,4 HCPCS,G6030,Assay of amitriptyline,,,15.21,15.21,4 HCPCS,G6031,Assay of benzodiazepines,,,15.72,15.72,4 HCPCS,G6032,Assay of desipramine,,,14.63,14.63,4 HCPCS,G6034,Assay of doxepin,,,13.18,13.18,4 HCPCS,G6035,Assay of gold,,,13.84,13.84,4 HCPCS,G6036,Assay of Imipramine,,,14.63,14.63,4 HCPCS,G6037,Assay of nortiptyline,,,11.51,11.51,4 HCPCS,G6038,Assay of salicylate,,,6.03,6.03,4 HCPCS,G6039,Assay of acetaminophen,,,17.2,17.2,4 HCPCS,G6040,Assay of ethanol,,,9.18,9.18,4 HCPCS,G6041,Assay of urine alkaloids,,,25.51,25.51,4 HCPCS,G6042,Assay of amphetamines,,,9.88,9.88,4 HCPCS,G6043,Assay of barbiturates,,,9.73,9.73,4 HCPCS,G6044,Assay of cocaine,,,12.88,12.88,4 HCPCS,G6045,Assay of dihydrocodeinone,,,17.55,17.55,4 HCPCS,G6046,Assay of dihydromorphinone,,,21.85,21.85,4 HCPCS,G6047,Assay of dihydrotestosterone,,,21.94,21.94,4 HCPCS,G6048,Assay of dimethadione,,,11.77,11.77,4 HCPCS,G6049,Assay of Epiandrosterone,,,18.26,18.26,4 HCPCS,G6050,Assay of Ethchlorvynol,,,14.69,14.69,4 HCPCS,G6051,Assay of flurazepam,,,16.82,16.82,4 HCPCS,G6052,Assay of meprobamate,,,14.98,14.98,4 HCPCS,G6053,Assay of methadone,,,13.88,13.88,4 HCPCS,G6054,Assay of methsuximide,,,12.59,12.59,4 HCPCS,G6055,Assay of nicotine,,,20.12,20.12,4 HCPCS,G6056,"Opiate(s),drug and metabolites, each procedure",,,16.54,16.54,4 HCPCS,G6057,Assay of phenothiazine,,,13.24,13.24,4 HCPCS,G6058,drug confirmation,,,11.26,11.26,4 HCPCS,G9143,Warfarin respon genetic test,,,120.72,199.12,8 HCPCS,G9873,Hc Mdpp Diabetes Prevent Prgm Core First Session,30.89,12.36,,,0 HCPCS,G9874,Hc Mdpp Diabetes Prevent Program Core Sessions - Attended A Total Of 4 Sessions,60.68,24.27,,,0 HCPCS,G9875,Hc Mdpp Diabetes Prevent Program Core Sessions - Attended A Total Of 9 Sessions,105.91,42.36,,,0 HCPCS,G9876,Hc Mdpp Attended 2-Diabetes Prevent Prgm Core Maint Sessions 7-9 Months Without Minimum Weight Loss,18.76,7.5,,,0 HCPCS,G9877,Hc Mdpp Attended 2-Diabetes Prevent Prgm Core Maint Sessions 10-12 Months Without Minimum Wt Loss,70.61,28.24,,,0 HCPCS,G9878,Hc Mdpp Attended 2-Diabetes Prevent Prgm Core Maint Sessions 7-9 Months W/ 5% Wt Loss Fr/Baseline,18.76,7.5,,,0 HCPCS,G9879,Hc Mdpp Attended 2-Diabetes Prevent Prgm Core Maint Sessions 10-12 Months W/ 5% Wt Loss Fr/Baseline,70.61,28.24,,,0 HCPCS,G9880,"Hc Mdpp Diabetes Prevent Prgm, Months 1-12, W/ 5% Wt Loss Fr/Baseline With In-Person Weight",19.86,7.94,,,0 HCPCS,G9881,"Hc Mdpp Diabetes Prevent Prgm, Months 1-24, W/ 9% Wt Loss Fr/Baseline With In Person Weight",30.89,12.36,,,0 HCPCS,G9882,"Hc Mdpp Attended 2-Diabetes Prevent Prgm Main Sessions Months 13-15, W/ 5% Wt Loss Fr/Baseline",60.68,24.27,,,0 HCPCS,G9883,"Hc Mdpp Attended 2-Diabetes Prevent Prgm Main Sessions, Months 16-18, W/ 5% Wt Loss Fr/Baseline",60.68,24.27,,,0 HCPCS,G9884,"Hc Mdpp Attended 2-Diabetes Prevent Prgm Main Sessions, Months 19-21, W/ 5% Wt Loss Fr/Baseline",60.68,24.27,,,0 HCPCS,G9885,"Hc Mdpp Attended 2-Diabetes Prevent Prgm Main Sessions, Months 22-24, W/ 5% Wt Loss Fr/Baseline",60.68,24.27,,,0 HCPCS,G9886,"Hc Behavorial Counseling For Diabetes Prevention, In Person/Group 60 Mins",63.25,25.3,,,0 HCPCS,G9887,"Hc Behavorial Counseling For Diabetes Prevention, Distance Learning 60 Mins",63.25,25.3,,,0 HCPCS,G9888,Hc Maintenance 5% Weight Loss From Baseline In Months 7-12,32.2,12.88,,,0 HCPCS,G9890,"Hc Mdpp Diabetes Prevent Prgm Bridge Payment, Months 1-24",30.89,12.36,,,0 HCPCS,G9891,Hc Mdpp Diabetes Prevent Prgm Session Reporting,0.01,0.004,,,0 HCPCS,I1020,Hc Group Of 2 Patients Saline And/Or Insulin Start Training,713.12,285.25,,,0 HCPCS,I1021,Hc Group Of 3 Patients Saline And/Or Insulin Start Training,792.35,316.94,,,0 HCPCS,J0121,"Inj., omadacycline, 1 mg",,,3.87,10.73,9 HCPCS,J0121,NDC Description Not Available,19.05,7.62,,,0 HCPCS,J0122,"Inj., eravacycline, 1 mg",,,1.21,3.33,9 HCPCS,J0122,"Xerava: 12 Vial, Glass In 1 Carton (71773-050-12) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Glass",5.66,2.26,,,0 HCPCS,J0129,Abatacept injection,,,43.38,114.84,9 HCPCS,J0129,"Orencia: 1 Vial, Single-Use In 1 Carton (0003-2187-13) / 15 Ml In 1 Vial, Single-Use",256.96500000000003,102.785,,,0 HCPCS,J0130,Abciximab injection,,,0.01,0.01,4 HCPCS,J0131,Acetaminophen injection,,,0.05,0.05,4 HCPCS,J0131,"Acetaminophen: 10 Vial, Glass In 1 Carton (0781-3156-95) / 100 Ml In 1 Vial, Glass (0781-3156-06)",0.18,0.07,,,0 HCPCS,J0131,"Acetaminophen: 24 Vial, Single-Dose In 1 Carton (55150-307-24) / 100 Ml In 1 Vial, Single-Dose (55150-307-01)",0.24,0.1,,,0 HCPCS,J0131,NDC Description Not Available,0.545,0.215,,,0 HCPCS,J0131,"Ofirmev: 24 VIAL, GLASS in 1 CARTON (43825-102-01) / 100 mL in 1 VIAL, GLASS",0.34,0.14,,,0 HCPCS,J0132,Acetylcysteine injection,,,0.45,0.45,4 HCPCS,J0132,Acetylcysteine: 4 Vial In 1 Carton (0574-0805-30) / 30 Ml In 1 Vial,2.92,1.17,,,0 HCPCS,J0132,Acetylcysteine: 4 Vial In 1 Carton (25021-812-30) / 30 Ml In 1 Vial,2.98,1.19,,,0 HCPCS,J0132,Acetylcysteine: 4 Vial In 1 Carton (70594-111-02) / 30 Ml In 1 Vial (70594-111-01),5.11,2.04,,,0 HCPCS,J0132,"Acetylcysteine: 4 Vial, Single-Dose In 1 Carton (55150-259-30) / 30 Ml In 1 Vial, Single-Dose",2.27,0.91,,,0 HCPCS,J0132,"Acetylcysteine: 4 Vial, Single-Dose In 1 Carton (72611-860-04) / 30 Ml In 1 Vial, Single-Dose (72611-860-01)",2.84,1.14,,,0 HCPCS,J0132,NDC Description Not Available,4.96,1.98,,,0 HCPCS,J0133,"Acyclovir Sodium: 10 Vial, Single-Dose In 1 Carton (55150-154-10) / 10 Ml In 1 Vial, Single-Dose",0.56,0.22,,,0 HCPCS,J0133,"Acyclovir Sodium: 10 Vial, Single-Dose In 1 Carton (55150-155-20) / 20 Ml In 1 Vial, Single-Dose",0.57,0.23,,,0 HCPCS,J0133,Acyclovir injection,,,0.04,0.04,4 HCPCS,J0133,"Acyclovir: 10 Vial, Single-Dose In 1 Tray (63323-325-10) / 10 Ml In 1 Vial, Single-Dose (63323-325-03)",0.13,0.05,,,0 HCPCS,J0133,"Acyclovir: 10 Vial, Single-Dose In 1 Tray (63323-325-20) / 20 Ml In 1 Vial, Single-Dose (63323-325-09)",0.1,0.04,,,0 HCPCS,J0133,NDC Description Not Available,0.74,0.29500000000000004,,,0 HCPCS,J0134,Inj acetaminophen -fresenius,,,0.05,0.05,4 HCPCS,J0136,"Inj, acetaminophen (b braun)",,,0.05,0.05,4 HCPCS,J0137,"Inj, acetaminophen (hikma)",,,0.03,0.03,4 HCPCS,J0137,NDC Description Not Available,0.48,0.19,,,0 HCPCS,J0138,"Injection, acetaminoph 10 mg",,,0.11,0.32,9 HCPCS,J0153,Adenosine inj 1mg,,,0.39,0.39,4 HCPCS,J0153,"Adenosine: 1 VIAL, SINGLE-DOSE in 1 CARTON (0409-1932-01) / 20 mL in 1 VIAL, SINGLE-DOSE",2.41,0.96,,,0 HCPCS,J0153,Adenosine: 1 Vial In 1 Carton (67457-857-30) / 30 Ml In 1 Vial,9.57,3.83,,,0 HCPCS,J0153,Adenosine: 10 Vial In 1 Carton (25021-318-02) / 2 Ml In 1 Vial,4.5,1.8,,,0 HCPCS,J0153,"Adenosine: 10 Vial, Single-Dose In 1 Carton (67457-855-02) / 2 Ml In 1 Vial, Single-Dose (67457-855-00)",4.71,1.88,,,0 HCPCS,J0153,"Adenosine: 10 Vial, Single-Use In 1 Tray (63323-651-02) / 2 Ml In 1 Vial, Single-Use (63323-651-00)",2.2,0.88,,,0 HCPCS,J0153,NDC Description Not Available,3.375,1.35,,,0 HCPCS,J0165,"Epinephrine: 2 Case In 1 Carton (0115-1694-49) / 1 Syringe, Glass In 1 Case / .3 Ml In 1 Syringe, Glass",175.39,70.16,,,0 HCPCS,J0165,NDC Description Not Available,4.84,1.94,,,0 HCPCS,J0166,Epinephrine: 10 Ampule In 1 Box (54288-103-10) / 1 Ml In 1 Ampule,4.9,1.96,,,0 HCPCS,J0167,"Epinephrine: 10 Carton In 1 Package (0409-4933-01) / 1 Syringe, Glass In 1 Carton / 10 Ml In 1 Syringe, Glass (0409-4933-11)",3.68,1.47,,,0 HCPCS,J0169,Adrenalin: 1 Vial In 1 Carton (42023-168-01) / 30 Ml In 1 Vial,4.57,1.83,,,0 HCPCS,J0171,Adrenalin epinephrine inject,,,0.73,0.73,4 HCPCS,J0171,Adrenalin: 25 Vial In 1 Carton (42023-159-25) / 1 Ml In 1 Vial (42023-159-01),6.67,2.67,,,0 HCPCS,J0171,Epinephrine: 1 Vial In 1 Carton (54288-120-01) / 10 Ml In 1 Vial,2.16,0.86,,,0 HCPCS,J0171,Epinephrine: 10 Carton In 1 Package (0409-4933-10) / 1 Syringe In 1 Carton / 10 Ml In 1 Syringe (0409-4933-05),6.04,2.42,,,0 HCPCS,J0171,Epinephrine: 10 Carton In 1 Package (76329-3318-1) / 1 Syringe In 1 Carton / 10 Ml In 1 Syringe,5.47,2.19,,,0 HCPCS,J0171,Epinephrine: 10 VIAL in 1 PACKAGE (76329-3316-1) / 10 mL in 1 VIAL,3.54,1.42,,,0 HCPCS,J0171,"Epinephrine: 2 Container In 1 Carton (49502-101-02) / 1 Syringe, Glass In 1 Container (49502-101-01) / .3 Ml In 1 Syringe, Glass",334.7,133.88,,,0 HCPCS,J0171,NDC Description Not Available,5.72,2.29,,,0 HCPCS,J0172,"Inj, aducanumab-avwa, 2 mg",,,5.98,5.98,4 HCPCS,J0173,"Inj, epinephrine (belcher)",,,2.25,2.25,4 HCPCS,J0174,"Inj, lecanemab-irmb",,,1.33,3.4,9 HCPCS,J0174,"Leqembi: 1 Vial, Single-Dose In 1 Carton (62856-212-01) / 2 Ml In 1 Vial, Single-Dose",5.68,2.27,,,0 HCPCS,J0174,"Leqembi: 1 Vial, Single-Dose In 1 Carton (62856-215-01) / 5 Ml In 1 Vial, Single-Dose",5.7,2.28,,,0 HCPCS,J0175,"Inj, donanemab-azbt, 2 mg",,,4.18,10.46,9 HCPCS,J0177,"Inj, aflibercept hd, 1 mg",,,290.9,727.26,9 HCPCS,J0178,Aflibercept injection,,,722.25,1805.63,9 HCPCS,J0179,"Inj, brolucizumab-dbll, 1 mg",,,339.99,901.1,9 HCPCS,J0180,Agalsidase beta injection,,,222.84,576.35,9 HCPCS,J0184,"Inj, amisulpride, 1 mg",,,9.54,11.69,5 HCPCS,J0185,"Cinvanti: 1 Vial, Glass In 1 Carton (47426-201-01) / 18 Ml In 1 Vial, Glass",14.66,5.86,,,0 HCPCS,J0185,"Inj., aprepitant, 1 mg",,,1.62,4.06,9 HCPCS,J0202,"Campath: 1 Vial, Single-Use In 1 Carton (58468-0357-1) / 1 Ml In 1 Vial, Single-Use",80.54,32.22,,,0 HCPCS,J0202,"Injection, alemtuzumab",,,2441.49,6265.5,9 HCPCS,J0205,Alglucerase injection,,,0.01,0.01,4 HCPCS,J0206,Inj allopurinol sodium 1 mg,,,4.29,10.73,9 HCPCS,J0207,Amifostine,,,1071.41,1071.41,4 HCPCS,J0208,Inj sodium thiosulfate 100mg,,,91.34,253.21,9 HCPCS,J0209,"Inj, sod thiosulfate (hope)",,,1.07,1.07,1 HCPCS,J0209,"Sodium Thiosulfate: 50 Ml In 1 Vial, Single-Dose (60267-705-50)",3.44,1.38,,,0 HCPCS,J0210,Methyldopate hcl injection,,,0.01,0.01,4 HCPCS,J0211,"Inj, nithiodote, 3mg / 125mg",,,2.65,2.65,1 HCPCS,J0215,Alefacept,,,0.01,0.01,4 HCPCS,J0217,Inj velmanase alfa-tycv 1 mg,,,444.98,1197.98,9 HCPCS,J0218,Inj olipudase alfa-rpcp 1mg,,,381.24,1011.96,9 HCPCS,J0219,Inj aval alfa-nqpt 4mg,,,77.82,209.54,9 HCPCS,J0219,"Nexviazyme: 1 Vial, Single-Dose In 1 Carton (58468-0426-1) / 10 Ml In 1 Vial, Single-Dose",334.88,133.95,,,0 HCPCS,J0220,Alglucosidase alfa injection,,,0.01,0.01,4 HCPCS,J0221,Lumizyme injection,,,201.57,527.64,9 HCPCS,J0222,"Inj., patisiran, 0.1 mg",,,99.04,252.95,9 HCPCS,J0223,Inj givosiran 0.5 mg,,,116.47,301.86,9 HCPCS,J0224,"Inj. lumasiran, 0.5 mg",,,318.85,841.6,9 HCPCS,J0225,"Amvuttra: 1 Syringe, Glass In 1 Carton (71336-1003-1) / .5 Ml In 1 Syringe, Glass",21005.78,8402.31,,,0 HCPCS,J0225,"Inj, vutrisiran, 1 mg",,,4956.31,12522.35,9 HCPCS,J0248,"Inj, remdesivir, 1 mg?",,,6.35,18.78,9 HCPCS,J0248,"Veklury: 1 Vial, Single-Dose In 1 Carton (61958-2901-2) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",27.19,10.88,,,0 HCPCS,J0256,Alpha 1 proteinase inhibitor,,,5.08,12.69,9 HCPCS,J0257,Glassia injection,,,5.45,14.1,9 HCPCS,J0270,Alprostadil for injection,,,10.27,10.27,4 HCPCS,J0270,Edex: 6 Blister Pack In 1 Carton (52244-020-06) / 1 Cartridge In 1 Blister Pack / 1 Ml In 1 Cartridge,29.67,11.87,,,0 HCPCS,J0270,NDC Description Not Available,1.84,0.74,,,0 HCPCS,J0270,Prostin Vr Pediatric: 5 Ampule In 1 Package (0009-3169-06) / 1 Ml In 1 Ampule (0009-3169-01),1.4,0.56,,,0 HCPCS,J0278,"Amikacin Sulfate: 10 VIAL, SINGLE-DOSE in 1 CARTON (0703-9032-03) / 2 mL in 1 VIAL, SINGLE-DOSE (0703-9032-01)",8.8,3.52,,,0 HCPCS,J0278,Amikacin Sulfate: 10 Vial In 1 Carton (0641-6166-10) / 4 Ml In 1 Vial (0641-6166-01),0.23,0.09,,,0 HCPCS,J0278,Amikacin sulfate injection,,,0.6,0.6,4 HCPCS,J0278,NDC Description Not Available,6.53,2.61,,,0 HCPCS,J0280,Aminophyllin 250 MG inj,,,11.05,11.05,4 HCPCS,J0280,"Aminophylline: 25 Vial, Single-Dose In 1 Tray (0409-5921-01) / 10 Ml In 1 Vial, Single-Dose (0409-5921-16)",29.54,11.82,,,0 HCPCS,J0280,"Aminophylline: 25 Vial, Single-Dose In 1 Tray (0409-5922-01) / 20 Ml In 1 Vial, Single-Dose (0409-5922-16)",28.57,11.43,,,0 HCPCS,J0280,NDC Description Not Available,24.0,9.6,,,0 HCPCS,J0281,"Aminocaproic Acid: 25 Vial, Single-Dose In 1 Tray (0409-4346-73) / 20 Ml In 1 Vial, Single-Dose (0409-4346-16)",7.02,2.81,,,0 HCPCS,J0281,Inj aminocaproic acid 1 gram,,,1.3,1.3,4 HCPCS,J0281,NDC Description Not Available,5.095000000000001,2.035,,,0 HCPCS,J0282,Amiodarone HCl,,,0.33,0.33,4 HCPCS,J0282,Amiodarone Hydrochloride: 10 Vial In 1 Box (0143-9875-10) / 3 Ml In 1 Vial (0143-9875-01),0.84,0.34,,,0 HCPCS,J0282,Amiodarone Hydrochloride: 25 Vial In 1 Box (0143-9875-25) / 3 Ml In 1 Vial (0143-9875-01),1.12,0.45,,,0 HCPCS,J0282,NDC Description Not Available,1.69,0.68,,,0 HCPCS,J0283,"Inj, amiodarone (nexterone)",,,2.59,2.59,4 HCPCS,J0283,Nexterone: 100 Ml In 1 Bag (43066-150-10),30.42,12.17,,,0 HCPCS,J0283,Nexterone: 200 Ml In 1 Bag (43066-360-20),16.83,6.73,,,0 HCPCS,J0285,Amphotericin B,,,50.07,50.07,4 HCPCS,J0285,Amphotericin B: 10 Ml In 1 Vial (39822-1055-5),148.34,59.34,,,0 HCPCS,J0287,Amphotericin b lipid complex,,,10.3,10.3,4 HCPCS,J0288,Ampho b cholesteryl sulfate,,,0.01,0.01,4 HCPCS,J0289,"Ambisome: 12.5 Ml In 1 Vial, Single-Dose (0469-3051-30)",275.78,110.31,,,0 HCPCS,J0289,"Amphotericin B: 1 Vial, Single-Dose In 1 Carton (55150-365-01) / 12.5 Ml In 1 Vial, Single-Dose",224.92,89.97,,,0 HCPCS,J0289,"Amphotericin B: 1 Vial, Single-Dose In 1 Carton (62756-233-01) / 1 Injectable, Liposomal In 1 Vial, Single-Dose",227.8,91.12,,,0 HCPCS,J0289,Amphotericin b liposome inj,,,17.85,44.63,9 HCPCS,J0290,Ampicillin 500 MG inj,,,0.6,0.6,4 HCPCS,J0290,"Ampicillin: 10 VIAL in 1 CARTON (70860-114-15) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL (70860-114-41)",16.5,6.6,,,0 HCPCS,J0290,"Ampicillin: 10 Vial In 1 Box (55150-113-10) / 1 Injection, Powder, For Solution In 1 Vial",11.16,4.46,,,0 HCPCS,J0290,"Ampicillin: 10 Vial In 1 Box (55150-114-20) / 1 Injection, Powder, For Solution In 1 Vial",9.12,3.65,,,0 HCPCS,J0290,"Ampicillin: 10 Vial In 1 Carton (25021-136-10) / 1 Injection, Powder, For Solution In 1 Vial",4.82,1.93,,,0 HCPCS,J0290,"Ampicillin: 10 Vial In 1 Carton (25021-137-20) / 1 Injection, Powder, For Solution In 1 Vial",3.75,1.5,,,0 HCPCS,J0290,"Ampicillin: 10 Vial In 1 Carton (65219-020-23) / 1 Injection, Powder, For Solution In 1 Vial (65219-020-03)",8.91,3.56,,,0 HCPCS,J0290,"Ampicillin: 10 Vial In 1 Carton (72485-421-10) / 1 Injection, Powder, For Solution In 1 Vial",2.04,0.82,,,0 HCPCS,J0290,"Ampicillin: 10 Vial In 1 Tray (44567-100-10) / 1 Injection, Powder, For Solution In 1 Vial",2.86,1.14,,,0 HCPCS,J0290,"Ampicillin: 10 Vial In 1 Tray (44567-102-10) / 1 Injection, Powder, For Solution In 1 Vial",13.66,5.46,,,0 HCPCS,J0290,"Ampicillin: 10 Vial In 1 Tray (44567-103-10) / 1 Injection, Powder, For Solution In 1 Vial",2.8,1.12,,,0 HCPCS,J0290,"Ampicillin: 10 Vial, Glass In 1 Package (0781-3402-95) / 1 Injection, Powder, For Solution In 1 Vial, Glass (0781-3402-78)",11.94,4.78,,,0 HCPCS,J0290,"Ampicillin: 10 Vial, Glass In 1 Package (0781-3408-95) / 1 Injection, Powder, For Solution In 1 Vial, Glass (0781-3408-80)",2.78,1.11,,,0 HCPCS,J0290,NDC Description Not Available,8.149999999999999,3.26,,,0 HCPCS,J0291,"Inj., plazomicin, 5 mg",,,3.52,8.8,9 HCPCS,J0295,Ampicillin And Sulbactam: 10 Vial In 1 Carton (0641-6116-10) / 1.5 G In 1 Vial (0641-6116-01),19.21,7.68,,,0 HCPCS,J0295,Ampicillin And Sulbactam: 10 Vial In 1 Carton (0641-6117-10) / 3 G In 1 Vial (0641-6117-01),20.75,8.3,,,0 HCPCS,J0295,"Ampicillin And Sulbactam: 10 Vial In 1 Carton (25021-143-30) / 1 Injection, Powder, For Solution In 1 Vial",20.05,8.02,,,0 HCPCS,J0295,Ampicillin And Sulbactam: 10 Vial In 1 Carton (44567-211-10) / 20 Ml In 1 Vial,31.65,12.66,,,0 HCPCS,J0295,"Ampicillin And Sulbactam: 10 Vial In 1 Carton (55150-117-20) / 1 Injection, Powder, For Solution In 1 Vial",11.79,4.72,,,0 HCPCS,J0295,"Ampicillin And Sulbactam: 10 Vial, Single-Dose In 1 Carton (71288-031-21) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose (71288-031-20)",9.37,3.75,,,0 HCPCS,J0295,"Ampicillin And Sulbactam: 10 Vial, Single-Dose In 1 Carton (71288-032-21) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose (71288-032-20)",7.65,3.06,,,0 HCPCS,J0295,"Ampicillin Sodium And Sulbactam Sodium: 10 Vial In 1 Carton (72485-417-10) / 1 Injection, Powder, For Solution In 1 Vial (72485-417-01)",7.84,3.14,,,0 HCPCS,J0295,Ampicillin sodium per 1.5 gm,,,1.57,1.57,4 HCPCS,J0295,NDC Description Not Available,19.355,7.745,,,0 HCPCS,J0295,"ampicillin sodium and sulbactam sodium: 1 VIAL in 1 CARTON (67457-348-15) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL",12.29,4.92,,,0 HCPCS,J0300,Amobarbital 125 MG inj,,,183.26,183.26,4 HCPCS,J0330,NDC Description Not Available,4.6899999999999995,1.88,,,0 HCPCS,J0330,Succinycholine chloride inj,,,0.8,0.8,4 HCPCS,J0330,"Succinylcholine Chloride: 1 VIAL, MULTI-DOSE in 1 CARTON (16729-493-03) / 10 mL in 1 VIAL, MULTI-DOSE",2.47,0.99,,,0 HCPCS,J0330,"Succinylcholine Chloride: 10 VIAL, MULTI-DOSE in 1 CARTON (16729-493-45) / 10 mL in 1 VIAL, MULTI-DOSE",3.86,1.54,,,0 HCPCS,J0330,"Succinylcholine Chloride: 25 Vial, Multi-Dose In 1 Carton (31722-981-31) / 10 Ml In 1 Vial, Multi-Dose (31722-981-10)",0.46,0.18,,,0 HCPCS,J0330,"Succinylcholine Chloride: 25 Vial, Multi-Dose In 1 Carton (63323-943-10) / 10 Ml In 1 Vial, Multi-Dose (63323-943-21)",3.49,1.4,,,0 HCPCS,J0330,"Succinylcholine Chloride: 25 Vial, Multi-Dose In 1 Carton (71288-719-11) / 10 Ml In 1 Vial, Multi-Dose (71288-719-10)",1.44,0.58,,,0 HCPCS,J0348,Anidulafungin injection,,,0.47,0.47,4 HCPCS,J0349,"Inj, rezafungin, 1 mg",,,10.42,27.96,9 HCPCS,J0360,"Hydralazine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (0641-6231-25) / 20 Ml In 1 Vial, Single-Dose (0641-6231-01)",7.89,3.16,,,0 HCPCS,J0360,"Hydralazine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (63323-614-01) / 1 Ml In 1 Vial, Single-Dose (63323-614-00)",58.84,23.54,,,0 HCPCS,J0360,Hydralazine hcl injection,,,4.4,4.4,4 HCPCS,J0360,NDC Description Not Available,38.93,15.575,,,0 HCPCS,J0364,Apomorphine hydrochloride,,,34.72,34.72,4 HCPCS,J0365,"Aprotonin, 10,000 kiu",,,0.01,0.01,4 HCPCS,J0391,"Inj, artesunate, 1mg",,,48.9,129.57,9 HCPCS,J0400,Aripiprazole injection,,,0.01,0.01,4 HCPCS,J0401,Inj aripiprazole ext rel 1mg,,,7.03,18.64,9 HCPCS,J0402,"Inj, abilify asimtufii, 1 mg",,,5.87,15.46,9 HCPCS,J0456,Azithromycin,,,2.22,2.22,4 HCPCS,J0456,Azithromycin Monohydrate: 10 Vial In 1 Carton (70095-025-02) / 10 Ml In 1 Vial (70095-025-01),9.06,3.62,,,0 HCPCS,J0456,Azithromycin: 10 Vial In 1 Box (70436-019-82) / 5 Ml In 1 Vial,16.85,6.74,,,0 HCPCS,J0456,"Azithromycin: 10 Vial, Single-Dose In 1 Carton (70860-100-10) / 5 Ml In 1 Vial, Single-Dose (70860-100-41)",22.0,8.8,,,0 HCPCS,J0456,NDC Description Not Available,22.0,8.8,,,0 HCPCS,J0457,"Azactam: 10 Vial, Single-Dose In 1 Carton (0003-2560-16) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose",12.81,5.12,,,0 HCPCS,J0457,"Azactam: 10 Vial, Single-Dose In 1 Carton (0003-2570-16) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose",13.32,5.33,,,0 HCPCS,J0457,"Aztreonam: 10 Vial In 1 Tray (63323-401-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (63323-401-01)",10.34,4.14,,,0 HCPCS,J0457,"Aztreonam: 10 Vial In 1 Tray (63323-402-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (63323-402-01)",13.44,5.38,,,0 HCPCS,J0457,"Aztreonam: 10 Vial, Single-Dose In 1 Carton (0409-0829-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose (0409-0829-11)",10.34,4.14,,,0 HCPCS,J0457,"Aztreonam: 10 Vial, Single-Dose In 1 Carton (0409-0830-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose (0409-0830-11)",10.56,4.22,,,0 HCPCS,J0457,"Injection, aztreonam, 100 mg",,,2.48,2.48,4 HCPCS,J0457,NDC Description Not Available,14.455,5.779999999999999,,,0 HCPCS,J0458,Aztreonam/avibactam 10 mg,,,1.76,4.39,5 HCPCS,J0461,"Atropine Sulfate: 1 Vial, Single-Dose In 1 Carton (16729-526-63) / 1 Ml In 1 Vial, Single-Dose",0.91,0.36,,,0 HCPCS,J0461,Atropine Sulfate: 10 Carton In 1 Package (76329-3340-1) / 1 Syringe In 1 Carton / 10 Ml In 1 Syringe,0.51,0.2,,,0 HCPCS,J0461,Atropine Sulfate: 10 SYRINGE in 1 CARTON (76329-3339-1) / 10 mL in 1 SYRINGE,0.37,0.15,,,0 HCPCS,J0461,"Atropine Sulfate: 25 VIAL, SINGLE-DOSE in 1 TRAY (0517-0401-25) / 1 mL in 1 VIAL, SINGLE-DOSE",0.46,0.18,,,0 HCPCS,J0461,"Atropine Sulfate: 25 Vial, Glass In 1 Tray (0517-1001-25) / 1 Ml In 1 Vial, Glass (0517-1001-01)",0.76,0.3,,,0 HCPCS,J0461,Atropine sulfate injection,,,0.11,0.11,4 HCPCS,J0461,NDC Description Not Available,0.48,0.19,,,0 HCPCS,J0470,Dimecaprol injection,,,56.42,56.42,4 HCPCS,J0475,Baclofen 10 mg injection,,,174.8,467.49,9 HCPCS,J0475,"Gablofen: 20 Ml In 1 Syringe, Glass (66794-155-01)",1180.42,472.17,,,0 HCPCS,J0475,"Gablofen: 20 Ml In 1 Syringe, Glass (66794-156-01)",1217.57,487.03,,,0 HCPCS,J0475,"Gablofen: 20 Ml In 1 Syringe, Glass (66794-157-01)",1218.58,487.43,,,0 HCPCS,J0475,Hc Baclofen 10Mg/0.5Mg/Ml 20Ml,821.1,328.44,,,0 HCPCS,J0475,Hc Baclofen 10Mg/2Mg/Ml 20Ml,761.25,304.5,,,0 HCPCS,J0475,Hc Baclofen/10Mg (1Mg/Ml-20Ml),809.37,323.75,,,0 HCPCS,J0476,Baclofen intrathecal trial,,,53.82,53.82,4 HCPCS,J0476,"Gablofen: 1 Ml In 1 Syringe, Glass (66794-151-01)",421.65,168.66,,,0 HCPCS,J0480,Basiliximab,,,4687.66,12294.08,9 HCPCS,J0480,"Simulect: 1 Vial, Single-Use In 1 Carton (0078-0331-84) / 5 Ml In 1 Vial, Single-Use",20547.63,8219.05,,,0 HCPCS,J0485,Belatacept injection,,,3.88,9.71,9 HCPCS,J0485,"Nulojix: 1 Vial, Single-Use In 1 Carton (0003-0371-13) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Use",17.21,6.88,,,0 HCPCS,J0490,Belimumab injection,,,54.97,145.83,9 HCPCS,J0490,Benlysta: 1 Vial In 1 Carton (49401-101-01) / 1.5 Ml In 1 Vial,235.0,94.0,,,0 HCPCS,J0490,Benlysta: 1 Vial In 1 Carton (49401-102-01) / 5 Ml In 1 Vial,237.82999999999998,95.13,,,0 HCPCS,J0491,Inj anifrolumab-fnia 1mg,,,17.78,46.15,9 HCPCS,J0491,"Saphnelo: 1 Vial, Glass In 1 Carton (0310-3040-00) / 2 Ml In 1 Vial, Glass",78.93,31.57,,,0 HCPCS,J0500,Bentyl: 5 Ampule In 1 Box (58914-080-52) / 2 Ml In 1 Ampule,362.27,144.91,,,0 HCPCS,J0500,Dicyclomine injection,,,12.86,12.86,4 HCPCS,J0500,NDC Description Not Available,82.45,32.98,,,0 HCPCS,J0515,Benztropine Mesylate: 5 Vial In 1 Box (0143-9233-05) / 2 Ml In 1 Vial (0143-9233-01),53.88,21.55,,,0 HCPCS,J0515,Inj benztropine mesylate,,,16.77,16.77,4 HCPCS,J0515,NDC Description Not Available,49.5,19.8,,,0 HCPCS,J0517,"Fasenra: 1 Syringe, Glass In 1 Carton (0310-1730-30) / 1 Ml In 1 Syringe, Glass",843.88,337.55,,,0 HCPCS,J0517,"Inj., benralizumab, 1 mg",,,163.3,412.7,9 HCPCS,J0558,PenG benzathine/procaine inj,,,17.37,48.81,9 HCPCS,J0561,Bicillin L-A: 10 Syringe In 1 Package (60793-700-10) / 1 Ml In 1 Syringe (60793-700-01),143.96,57.58,,,0 HCPCS,J0561,Bicillin L-A: 10 Syringe In 1 Package (60793-701-10) / 2 Ml In 1 Syringe (60793-701-02),119.54,47.82,,,0 HCPCS,J0561,Bicillin L-A: 10 Syringe In 1 Package (60793-702-10) / 4 Ml In 1 Syringe (60793-702-04),112.22,44.89,,,0 HCPCS,J0561,NDC Description Not Available,103.44,41.38,,,0 HCPCS,J0561,Penicillin g benzathine inj,,,25.61,64.03,9 HCPCS,J0565,"Inj, bezlotoxumab, 10 mg",,,39.87,48.59,5 HCPCS,J0565,NDC Description Not Available,174.21,69.68,,,0 HCPCS,J0567,"Inj., cerliponase alfa 1 mg",,,115.85,310.55,9 HCPCS,J0571,Buprenorphine oral 1mg,,,0.68,0.68,4 HCPCS,J0571,"Buprenorphine: 30 Blister Pack In 1 Box, Unit-Dose (60687-481-21) / 1 Tablet In 1 Blister Pack (60687-481-11)",4.4,1.76,,,0 HCPCS,J0571,Buprenorphine: 30 Blister Pack In 1 Carton (0904-7154-04) / 1 Tablet In 1 Blister Pack,4.26,1.7,,,0 HCPCS,J0571,Buprenorphine: 30 Tablet In 1 Bottle (0054-0176-13),2.23,0.89,,,0 HCPCS,J0571,NDC Description Not Available,2.82,1.13,,,0 HCPCS,J0577,"Brixadi: 1 Syringe, Glass In 1 Carton (58284-224-01) / .48 Ml In 1 Syringe, Glass",1885.28,754.11,,,0 HCPCS,J0577,"Inj, brixadi, 7 days or less",,,425.4,1082.92,9 HCPCS,J0578,"Brixadi: 1 Syringe, Glass In 1 Carton (58284-296-01) / .27 Ml In 1 Syringe, Glass",7556.75,3022.7,,,0 HCPCS,J0578,"Inj brixadi, more than 7 day",,,1701.62,4331.67,9 HCPCS,J0583,Bivalirudin,,,0.15,0.15,4 HCPCS,J0583,"Bivalirudin: 1 Injection, Powder, Lyophilized, For Suspension In 1 Vial, Single-Dose (70436-025-80)",0.95,0.38,,,0 HCPCS,J0583,"Bivalirudin: 10 Vial, Single-Dose In 1 Carton (55150-210-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",0.79,0.32,,,0 HCPCS,J0583,"Bivalirudin: 10 Vial, Single-Dose In 1 Carton (83634-400-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose (83634-400-41)",1.67,0.67,,,0 HCPCS,J0583,"Bivalirudin: 10 Vial, Single-Use In 1 Carton (0781-3158-95) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Use (0781-3158-94)",1.35,0.54,,,0 HCPCS,J0583,"Bivalirudin: 10 Vial, Single-Use In 1 Carton (16729-275-67) / 5 Ml In 1 Vial, Single-Use (16729-275-03)",0.76,0.3,,,0 HCPCS,J0583,"Bivalirudin: 10 Vial, Single-Use In 1 Carton (63323-562-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Use",0.86,0.34,,,0 HCPCS,J0583,NDC Description Not Available,1.26,0.505,,,0 HCPCS,J0584,"Crysvita: 1 Ml In 1 Vial, Single-Use (42747-102-01)",2053.83,821.53,,,0 HCPCS,J0584,"Crysvita: 1 Ml In 1 Vial, Single-Use (42747-203-01)",1912.11,764.84,,,0 HCPCS,J0584,"Crysvita: 1 Ml In 1 Vial, Single-Use (42747-304-01)",1934.62,773.85,,,0 HCPCS,J0584,"Injection, burosumab-twza 1m",,,469.74,1292.12,9 HCPCS,J0585,"Botox: 1 Vial In 1 Carton (0023-1145-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",28.48,11.39,,,0 HCPCS,J0585,"Botox: 1 Vial In 1 Carton (0023-1145-02) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",27.37,10.95,,,0 HCPCS,J0585,"Botox: 1 Vial In 1 Carton (0023-3921-02) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",28.67,11.47,,,0 HCPCS,J0585,Hc Botulinum Toxn A/1Un(100Un-Sdv,27.65,11.06,,,0 HCPCS,J0585,Hc Botulinum Toxn A/1Un-Wastage,27.65,11.06,,,0 HCPCS,J0585,"Injection,onabotulinumtoxina",,,6.48,16.28,9 HCPCS,J0586,Abobotulinumtoxina,,,8.94,22.34,9 HCPCS,J0586,"Dysport: 1 Vial In 1 Carton (15054-0500-1) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",38.66,15.46,,,0 HCPCS,J0586,"Dysport: 1 Vial In 1 Carton (15054-0530-6) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",38.68,15.47,,,0 HCPCS,J0586,Hc Abobotulunum/5 Units (300 Un),39.51,15.8,,,0 HCPCS,J0587,Hc Rimabtlnmtxnb/100U-Wastage,48.76,19.5,,,0 HCPCS,J0587,Hc Rimabtlnmtxnb/100Un (5K/Ml-2Ml,48.88,19.55,,,0 HCPCS,J0587,"Inj, rimabotulinumtoxinb",,,13.0,33.25,9 HCPCS,J0587,"Myobloc: 1 Vial, Single-Use In 1 Carton (10454-711-10) / 1 Ml In 1 Vial, Single-Use",55.52,22.21,,,0 HCPCS,J0587,"Myobloc: 1 Vial, Single-Use In 1 Carton (10454-712-10) / 2 Ml In 1 Vial, Single-Use",54.79,21.92,,,0 HCPCS,J0588,Hc Incobotulinum/Unit (100 Units),22.17,8.87,,,0 HCPCS,J0588,Hc Incobotulinum/Unit-Wastage,23.28,9.31,,,0 HCPCS,J0588,Incobotulinumtoxin a,,,5.26,13.16,9 HCPCS,J0588,"Xeomin: 1 Vial, Single-Use In 1 Carton (0259-1605-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Use",27.09,10.84,,,0 HCPCS,J0588,"Xeomin: 1 Vial, Single-Use In 1 Carton (0259-1610-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Use",22.48,8.99,,,0 HCPCS,J0589,Inj daxibotulinumtoxina-lanm,,,2.99,8.13,9 HCPCS,J0591,"Inj deoxycholic acid, 1 mg",,,15.0,15.0,4 HCPCS,J0592,Buprenorphine Hydrochloride: 5 Vial In 1 Carton (42023-179-05) / 1 Ml In 1 Vial,18.61,7.44,,,0 HCPCS,J0592,Buprenorphine hydrochloride,,,4.18,4.18,4 HCPCS,J0592,NDC Description Not Available,20.02,8.01,,,0 HCPCS,J0593,"Inj., lanadelumab-flyo, 1 mg",,,84.8,220.85,9 HCPCS,J0594,Busulfan injection,,,0.84,2.1,9 HCPCS,J0594,Busulfan: 8 Vial In 1 Carton (25021-241-10) / 10 Ml In 1 Vial,37.62,15.05,,,0 HCPCS,J0594,"Busulfan: 8 Vial, Single-Dose In 1 Carton (71288-116-11) / 10 Ml In 1 Vial, Single-Dose (71288-116-10)",2.24,0.9,,,0 HCPCS,J0594,NDC Description Not Available,2.24,0.9,,,0 HCPCS,J0595,"Butorphanol Tartrate: 10 Vial, Single-Dose In 1 Carton (0409-1626-01) / 1 Ml In 1 Vial, Single-Dose (0409-1626-21)",28.86,11.54,,,0 HCPCS,J0595,Butorphanol tartrate 1 mg,,,4.69,4.69,4 HCPCS,J0595,NDC Description Not Available,25.1,10.04,,,0 HCPCS,J0596,"Injection, ruconest",,,34.75,94.52,9 HCPCS,J0597,Berinert: 1 Kit In 1 Carton (63833-825-02) * 10 Ml In 1 Vial (63833-835-01) * 10 Ml In 1 Vial (63833-765-15),374.03,149.61,,,0 HCPCS,J0597,"C-1 esterase, berinert",,,72.27,198.32,9 HCPCS,J0598,"C-1 esterase, cinryze",,,63.88,167.66,9 HCPCS,J0599,"Inj., haegarda 10 units",,,12.1,12.1,4 HCPCS,J0600,Edetate calcium disodium inj,,,6273.86,15684.66,9 HCPCS,J0601,"Sevelamer Carbonate: 270 Tablet, Film Coated In 1 Bottle (69097-967-93)",0.15,0.06,,,0 HCPCS,J0601,"Sevelamer Carbonate: 50 Blister Pack In 1 Carton (0904-6707-06) / 1 Tablet, Film Coated In 1 Blister Pack",0.8,0.32,,,0 HCPCS,J0601,Sevelamer carbonate 20 mg,,,0.01,0.01,4 HCPCS,J0602,Sevelamer carbonate pdr 20mg,,,0.05,0.05,4 HCPCS,J0603,Sevelamer hydrochloride 20mg,,,0.12,0.12,4 HCPCS,J0604,"Cinacalcet, esrd on dialysis",,,0.02,0.02,4 HCPCS,J0605,Sucroferric oxyhydroxide 5mg,,,0.18,0.18,4 HCPCS,J0606,"Inj, etelcalcetide, 0.1 mg",,,2.46,6.14,9 HCPCS,J0607,Lanthanum carbonate oral 5mg,,,0.05,0.05,4 HCPCS,J0608,Lanthanum carbonate pwdr 5mg,,,0.06,0.06,4 HCPCS,J0609,Ferric citrate orl 3 mg iron,,,0.11,0.11,4 HCPCS,J0612,"Calcium Gluconate: 10 Vial, Plastic In 1 Carton (70069-728-10) / 100 Ml In 1 Vial, Plastic",0.12,0.05,,,0 HCPCS,J0612,"Calcium Gluconate: 20 Vial, Plastic In 1 Carton (70069-728-20) / 100 Ml In 1 Vial, Plastic (70069-728-01)",0.24,0.1,,,0 HCPCS,J0612,Calcium Gluconate: 25 Vial In 1 Carton (75834-171-19) / 10 Ml In 1 Vial (75834-171-01),0.44,0.18,,,0 HCPCS,J0612,"Calcium Gluconate: 25 Vial, Plastic In 1 Tray (63323-360-19) / 10 Ml In 1 Vial, Plastic (63323-360-01)",0.48,0.19,,,0 HCPCS,J0612,"Calcium Gluconate: 25 Vial, Plastic In 1 Tray (63323-360-59) / 50 Ml In 1 Vial, Plastic (63323-360-03)",0.27,0.11,,,0 HCPCS,J0612,Calcium glucon (fresenius),,,0.05,0.05,4 HCPCS,J0612,NDC Description Not Available,0.37,0.14500000000000002,,,0 HCPCS,J0613,Calcium glucon (wg critical),,,0.08,0.08,4 HCPCS,J0614,"Inj, treosulfan, 50 mg",,,32.33,80.82,5 HCPCS,J0615,Calcium Acetate: 100 Blister Pack In 1 Carton (0904-7119-61) / 1 Capsule In 1 Blister Pack,1.66,0.66,,,0 HCPCS,J0615,Calcium Acetate: 50 Blister Pack In 1 Carton (0904-7119-06) / 1 Capsule In 1 Blister Pack,0.37,0.15,,,0 HCPCS,J0615,"Calcium acetate, oral, 23 mg",,,0.02,0.02,4 HCPCS,J0616,Metoprolol: 10 Vial In 1 Carton (36000-033-10) / 5 Ml In 1 Vial,0.62,0.25,,,0 HCPCS,J0616,NDC Description Not Available,0.53,0.21000000000000002,,,0 HCPCS,J0618,Calcium Chloride: 10 Syringe In 1 Package (76329-3304-1) / 10 Ml In 1 Syringe,0.08,0.03,,,0 HCPCS,J0618,"Calcium Chloride: 24 Carton In 1 Carton (70121-2308-4) / 1 Syringe, Glass In 1 Carton (70121-2308-1) / 10 Ml In 1 Syringe, Glass",0.09,0.04,,,0 HCPCS,J0618,"Calcium Chloride: 60 Syringe, Plastic In 1 Box (64253-900-36) / 10 Ml In 1 Syringe, Plastic (64253-900-30)",0.07,0.03,,,0 HCPCS,J0618,NDC Description Not Available,0.09,0.035,,,0 HCPCS,J0620,Calcium glycer & lact/10 ML,,,0.01,0.01,4 HCPCS,J0630,"Calcitonin Salmon: 1 Vial, Multi-Dose In 1 Carton (24201-400-02) / 2 Ml In 1 Vial, Multi-Dose",4046.19,1618.48,,,0 HCPCS,J0630,"Calcitonin Salmon: 1 Vial, Multi-Dose In 1 Carton (42023-205-01) / 2 Ml In 1 Vial, Multi-Dose",4075.49,1630.2,,,0 HCPCS,J0630,"Calcitonin Salmon: 1 Vial, Multi-Dose In 1 Carton (43598-051-11) / 2 Ml In 1 Vial, Multi-Dose",8392.14,3356.86,,,0 HCPCS,J0630,Calcitonin salmon injection,,,1500.0,1500.0,4 HCPCS,J0636,Calcitriol: 10 Vial In 1 Carton (72266-251-10) / 1 Ml In 1 Vial (72266-251-01),2.63,1.05,,,0 HCPCS,J0636,Inj calcitriol per 0.1 mcg,,,0.99,0.99,4 HCPCS,J0637,Caspofungin acetate,,,3.34,3.34,4 HCPCS,J0638,Canakinumab injection,,,136.56,392.38,9 HCPCS,J0638,"Ilaris: 1 Vial, Single-Use In 1 Carton (0078-0734-61) / 1 Ml In 1 Vial, Single-Use",145.81,58.32,,,0 HCPCS,J0640,Leucovorin Calcium: 1 Vial In 1 Box (0143-9554-01) / 10 Ml In 1 Vial,31.43,12.57,,,0 HCPCS,J0640,Leucovorin Calcium: 1 Vial In 1 Box (63323-710-50) / 20 Ml In 1 Vial,24.07,9.63,,,0 HCPCS,J0640,"Leucovorin Calcium: 1 Vial In 1 Box, Unit-Dose (0143-9552-01) / 17.5 Ml In 1 Vial",15.99,6.4,,,0 HCPCS,J0640,"Leucovorin Calcium: 1 Vial In 1 Box, Unit-Dose (0143-9553-01) / 20 Ml In 1 Vial",24.88,9.95,,,0 HCPCS,J0640,Leucovorin Calcium: 1 Vial In 1 Carton (25021-814-30) / 10 Ml In 1 Vial,20.07,8.03,,,0 HCPCS,J0640,Leucovorin Calcium: 1 Vial In 1 Carton (25021-815-30) / 20 Ml In 1 Vial,15.9,6.36,,,0 HCPCS,J0640,Leucovorin Calcium: 1 Vial In 1 Carton (25021-816-30) / 17.5 Ml In 1 Vial,44.05,17.62,,,0 HCPCS,J0640,"Leucovorin Calcium: 1 Vial, Single-Dose In 1 Carton (67457-528-10) / 10 Ml In 1 Vial, Single-Dose",19.22,7.69,,,0 HCPCS,J0640,"Leucovorin Calcium: 1 Vial, Single-Dose In 1 Carton (67457-529-20) / 20 Ml In 1 Vial, Single-Dose",42.56,17.02,,,0 HCPCS,J0640,"Leucovorin Calcium: 1 Vial, Single-Dose In 1 Carton (67457-530-35) / 17.5 Ml In 1 Vial, Single-Dose",11.73,4.69,,,0 HCPCS,J0640,"Leucovorin Calcium: 1 Vial, Single-Dose In 1 Carton (71288-163-30) / 17.5 Ml In 1 Vial, Single-Dose",17.55,7.02,,,0 HCPCS,J0640,Leucovorin calcium injection,,,3.51,3.51,4 HCPCS,J0641,Levoleucovorin injection,,,0.02,0.02,4 HCPCS,J0642,"Injection, khapzory, 0.5 mg",,,1.18,1.18,4 HCPCS,J0650,"Inj, levothyroxine nos 10mcg",,,7.26,7.26,4 HCPCS,J0650,Levothyroxine Sodium: 1 VIAL in 1 CARTON (70860-451-10) / 5 mL in 1 VIAL,24.46,9.78,,,0 HCPCS,J0650,Levothyroxine Sodium: 1 Vial In 1 Carton (25021-468-10) / 5 Ml In 1 Vial,40.57,16.23,,,0 HCPCS,J0650,"Levothyroxine Sodium: 1 Vial, Single-Dose In 1 Carton (42023-201-01) / 5 Ml In 1 Vial, Single-Dose",28.28,11.31,,,0 HCPCS,J0650,"Levothyroxine Sodium: 1 Vial, Single-Dose In 1 Carton (70710-1833-1) / 5 Ml In 1 Vial, Single-Dose",41.19,16.48,,,0 HCPCS,J0651,"Inj, levothyroxine, freskabi",,,6.4,17.7,9 HCPCS,J0651,"Levothyroxine Sodium: 1 Vial, Single-Dose In 1 Carton (63323-648-10) / 5 Ml In 1 Vial, Single-Dose",47.07,18.83,,,0 HCPCS,J0651,"Levothyroxine Sodium: 1 Vial, Single-Dose In 1 Carton (63323-649-07) / 5 Ml In 1 Vial, Single-Dose",36.24,14.5,,,0 HCPCS,J0652,"Inj, levothyroxine, hikma",,,5.14,5.14,4 HCPCS,J0654,"Inj, liothyronine, 1 mcg",,,41.49,103.73,5 HCPCS,J0665,"Bupivacaine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (55150-250-50) / 50 Ml In 1 Vial, Multi-Dose",0.02,0.01,,,0 HCPCS,J0665,"Bupivacaine Hydrochloride: 25 Vial, Multi-Dose In 1 Tray (0409-1163-01) / 50 Ml In 1 Vial, Multi-Dose (0409-1163-18)",0.03,0.01,,,0 HCPCS,J0665,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-167-10) / 10 Ml In 1 Vial, Single-Dose",0.20500000000000002,0.08,,,0 HCPCS,J0665,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-168-30) / 30 Ml In 1 Vial, Single-Dose",0.07,0.03,,,0 HCPCS,J0665,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-169-10) / 10 Ml In 1 Vial, Single-Dose",0.12,0.05,,,0 HCPCS,J0665,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-170-30) / 30 Ml In 1 Vial, Single-Dose",0.04,0.02,,,0 HCPCS,J0665,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-171-10) / 10 Ml In 1 Vial, Single-Dose",0.08,0.03,,,0 HCPCS,J0665,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-1159-01) / 10 Ml In 1 Vial, Single-Dose (0409-1159-18)",0.21,0.08,,,0 HCPCS,J0665,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-1159-02) / 30 Ml In 1 Vial, Single-Dose (0409-1159-19)",0.07,0.03,,,0 HCPCS,J0665,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-1162-01) / 10 Ml In 1 Vial, Single-Dose (0409-1162-18)",0.11,0.04,,,0 HCPCS,J0665,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-1162-02) / 30 Ml In 1 Vial, Single-Dose (0409-1162-19)",0.04,0.02,,,0 HCPCS,J0665,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-1162-10) / 30 Ml In 1 Vial, Single-Dose (0409-1162-09)",0.03,0.01,,,0 HCPCS,J0665,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-1165-02) / 30 Ml In 1 Vial, Single-Dose (0409-1165-19)",0.05,0.02,,,0 HCPCS,J0665,Bupivacaine Spinal: 10 Ampule In 1 Carton (0409-3613-01) / 2 Ml In 1 Ampule (0409-3613-11),0.42,0.17,,,0 HCPCS,J0665,"Inj, bupivacaine, nos, 0.5mg",,,0.01,0.01,4 HCPCS,J0665,"Marcaine: 1 Vial, Multi-Dose In 1 Carton (0409-1610-50) / 50 Ml In 1 Vial, Multi-Dose",0.05,0.02,,,0 HCPCS,J0665,"Marcaine: 10 Vial, Single-Dose In 1 Carton (0409-1559-30) / 30 Ml In 1 Vial, Single-Dose (0409-1559-19)",0.14,0.06,,,0 HCPCS,J0665,"Marcaine: 10 Vial, Single-Dose In 1 Carton (0409-1560-29) / 30 Ml In 1 Vial, Single-Dose (0409-1560-19)",0.08,0.03,,,0 HCPCS,J0665,"Marcaine: 10 Vial, Single-Dose In 1 Tray (0409-1560-10) / 10 Ml In 1 Vial, Single-Dose (0409-1560-18)",0.21,0.08,,,0 HCPCS,J0665,"Marcaine: 10 Vial, Single-Dose In 1 Tray (0409-1582-10) / 10 Ml In 1 Vial, Single-Dose (0409-1582-18)",0.15,0.06,,,0 HCPCS,J0665,NDC Description Not Available,0.14,0.065,,,0 HCPCS,J0665,"Sensorcaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-464-17) / 10 Ml In 1 Vial, Single-Dose (63323-464-01)",0.63,0.25,,,0 HCPCS,J0665,"Sensorcaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-464-37) / 30 Ml In 1 Vial, Single-Dose (63323-464-02)",0.21,0.08,,,0 HCPCS,J0665,"Sensorcaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-466-17) / 10 Ml In 1 Vial, Single-Dose (63323-466-03)",0.24,0.1,,,0 HCPCS,J0665,"Sensorcaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-466-37) / 30 Ml In 1 Vial, Single-Dose (63323-466-01)",0.1,0.04,,,0 HCPCS,J0665,"Sensorcaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-472-37) / 30 Ml In 1 Vial, Single-Dose (63323-472-01)",0.08,0.03,,,0 HCPCS,J0666,Exparel: 10 Vial In 1 Carton (65250-266-09) / 20 Ml In 1 Vial (65250-266-20),6.89,2.76,,,0 HCPCS,J0666,"Inj, bupivacaine liposome",,,1.42,3.56,9 HCPCS,J0666,NDC Description Not Available,6.15,2.46,,,0 HCPCS,J0668,"Instill, bupivac and meloxic",,,0.85,2.12,5 HCPCS,J0670,"Carbocaine: 1 VIAL, SINGLE-DOSE in 1 CARTON (0409-1041-30) / 30 mL in 1 VIAL, SINGLE-DOSE",6.03,2.41,,,0 HCPCS,J0670,Inj mepivacaine HCL/10 ml,,,3.63,3.63,4 HCPCS,J0670,"Polocaine-Mpf: 25 Vial, Single-Dose In 1 Tray (63323-293-37) / 30 Ml In 1 Vial, Single-Dose (63323-293-01)",22.48,8.99,,,0 HCPCS,J0675,"Inj, carboprost, 0.1 mg",,,16.71,44.01,5 HCPCS,J0681,Inj ceftobipole medocarl 3mg,,,1.1,2.74,5 HCPCS,J0687,Inj cefazolin (wg crit care),,,0.97,0.97,4 HCPCS,J0688,"Cefazolin: 10 Vial, Pharmacy Bulk Package In 1 Carton (0143-9983-03) / 1 Injection, Powder, For Solution In 1 Vial, Pharmacy Bulk Package (0143-9983-91)",0.67,0.27,,,0 HCPCS,J0688,"Inj cefazolin sodium, hikma",,,0.98,0.98,4 HCPCS,J0688,NDC Description Not Available,2.0,0.8,,,0 HCPCS,J0689,"Inj cefazolin sodium, baxter",,,1.25,1.25,4 HCPCS,J0690,Cefazolin sodium injection,,,0.83,0.83,4 HCPCS,J0690,Cefazolin: 3 Ml In 1 Vial (0143-9924-90),3.06,1.22,,,0 HCPCS,J0690,NDC Description Not Available,2.065,0.83,,,0 HCPCS,J0691,Inj lefamulin 1 mg,,,0.68,0.68,4 HCPCS,J0692,Cefepime hcl for injection,,,1.2,1.2,4 HCPCS,J0692,"Cefepime: 1 Vial, Single-Dose In 1 Carton (60505-6146-0) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose",11.22,4.49,,,0 HCPCS,J0692,"Cefepime: 1 Vial, Single-Dose In 1 Carton (60505-6147-0) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose",10.32,4.125,,,0 HCPCS,J0692,"Cefepime: 10 Vial In 1 Carton (25021-121-20) / 1 Injection, Powder, For Solution In 1 Vial",9.42,3.77,,,0 HCPCS,J0692,Cefepime: 10 Vial In 1 Carton (44567-240-10) / 20 Ml In 1 Vial,6.25,2.5,,,0 HCPCS,J0692,Cefepime: 10 Vial In 1 Carton (44567-241-10) / 20 Ml In 1 Vial,8.6,3.44,,,0 HCPCS,J0692,"Cefepime: 10 Vial, Single-Dose In 1 Carton (60505-6146-4) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose",11.28,4.51,,,0 HCPCS,J0692,"Cefepime: 10 Vial, Single-Dose In 1 Carton (60505-6147-4) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose",15.77,6.31,,,0 HCPCS,J0692,NDC Description Not Available,8.31,3.275,,,0 HCPCS,J0694,Cefoxitin sodium injection,,,5.01,5.01,4 HCPCS,J0694,"Cefoxitin: 10 Vial In 1 Carton (25021-110-20) / 1 Injection, Powder, For Solution In 1 Vial",22.0,8.8,,,0 HCPCS,J0694,"Cefoxitin: 25 Vial In 1 Carton (44567-246-25) / 1 Injection, Powder, For Solution In 1 Vial",41.41,16.56,,,0 HCPCS,J0694,NDC Description Not Available,11.5,4.6,,,0 HCPCS,J0695,Inj ceftolozane tazobactam,,,8.04,25.04,9 HCPCS,J0695,"Zerbaxa: 10 Vial, Single-Dose In 1 Carton (67919-030-01) / 10 Ml In 1 Vial, Single-Dose",36.3,14.52,,,0 HCPCS,J0696,"Ceftriaxone Sodium: 1 Vial, Pharmacy Bulk Package In 1 Carton (0781-3210-46) / 100 Ml In 1 Vial, Pharmacy Bulk Package",3.1,1.24,,,0 HCPCS,J0696,"Ceftriaxone Sodium: 1 Vial, Single-Use In 1 Carton (0781-3207-85) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use",4.4,1.76,,,0 HCPCS,J0696,"Ceftriaxone Sodium: 1 Vial, Single-Use In 1 Carton (0781-3208-85) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use",3.76,1.5,,,0 HCPCS,J0696,"Ceftriaxone Sodium: 1 Vial, Single-Use In 1 Carton (60505-6148-0) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use",3.12,1.25,,,0 HCPCS,J0696,"Ceftriaxone Sodium: 1 Vial, Single-Use In 1 Carton (60505-6152-4) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use",4.93,1.97,,,0 HCPCS,J0696,"Ceftriaxone Sodium: 10 Vial, Single-Use In 1 Carton (0409-7332-01) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use (0409-7332-11)",1.67,0.67,,,0 HCPCS,J0696,"Ceftriaxone Sodium: 10 Vial, Single-Use In 1 Carton (0409-7332-20) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use (0409-7332-21)",0.8,0.32,,,0 HCPCS,J0696,"Ceftriaxone Sodium: 10 Vial, Single-Use In 1 Carton (0409-7335-03) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use (0409-7335-13)",1.3,0.52,,,0 HCPCS,J0696,"Ceftriaxone Sodium: 10 Vial, Single-Use In 1 Carton (0409-7338-01) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use (0409-7338-11)",1.99,0.8,,,0 HCPCS,J0696,"Ceftriaxone Sodium: 10 Vial, Single-Use In 1 Carton (0781-3207-95) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use",2.29,0.92,,,0 HCPCS,J0696,"Ceftriaxone Sodium: 10 Vial, Single-Use In 1 Carton (0781-3208-95) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use",1.45,0.58,,,0 HCPCS,J0696,"Ceftriaxone Sodium: 10 Vial, Single-Use In 1 Carton (0781-3209-95) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use (0781-3209-90)",3.3,1.32,,,0 HCPCS,J0696,"Ceftriaxone Sodium: 10 Vial, Single-Use In 1 Carton (60505-6148-4) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use",1.63,0.65,,,0 HCPCS,J0696,Ceftriaxone sodium injection,,,0.49,0.49,4 HCPCS,J0696,"Ceftriaxone: 25 Vial In 1 Box (0143-9856-25) / 1 Injection, Powder, For Solution In 1 Vial (0143-9856-01)",1.67,0.67,,,0 HCPCS,J0696,"Ceftriaxone: 25 Vial In 1 Carton (25021-106-10) / 1 Injection, Powder, For Solution In 1 Vial",2.1,0.84,,,0 HCPCS,J0696,"Ceftriaxone: 25 Vial In 1 Carton (25021-107-20) / 1 Injection, Powder, For Solution In 1 Vial",2.45,0.98,,,0 HCPCS,J0696,"Ceftriaxone: 25 Vial In 1 Carton (44567-702-25) / 1 Injection, Powder, For Solution In 1 Vial",3.62,1.45,,,0 HCPCS,J0696,"Ceftriaxone: 25 Vial In 1 Carton (63323-346-10) / 1 Injection, Powder, For Solution In 1 Vial (63323-346-01)",4.18,1.67,,,0 HCPCS,J0696,NDC Description Not Available,1.68,0.7,,,0 HCPCS,J0697,"Cefuroxime: 25 Vial In 1 Carton (0143-9979-22) / 1 Injection, Powder, For Solution In 1 Vial (0143-9979-90)",0.78,0.31,,,0 HCPCS,J0697,NDC Description Not Available,6.59,2.6399999999999997,,,0 HCPCS,J0697,Sterile cefuroxime injection,,,2.01,2.01,4 HCPCS,J0698,Cefotaxime sodium injection,,,9.8,9.8,4 HCPCS,J0698,NDC Description Not Available,22.44,8.975,,,0 HCPCS,J0699,"Fetroja: 10 Vial, Single-Use In 1 Carton (59630-266-10) / 10 Ml In 1 Vial, Single-Use (59630-266-01)",9.47,3.79,,,0 HCPCS,J0699,"Inj, cefiderocol, 10 mg",,,2.28,6.41,9 HCPCS,J0699,NDC Description Not Available,9.75,3.9,,,0 HCPCS,J0701,Inj. cefepime hcl (baxter),,,5.8,5.8,4 HCPCS,J0702,"Betamethasone Sodium Phosphate And Betamethasone Acetate: 1 Vial, Multi-Dose In 1 Box (51754-5060-1) / 5 Ml In 1 Vial, Multi-Dose",32.16,12.86,,,0 HCPCS,J0702,"Betamethasone Sodium Phosphate And Betamethasone Acetate: 1 Vial, Multi-Dose In 1 Carton (0517-0720-01) / 5 Ml In 1 Vial, Multi-Dose",48.17,19.27,,,0 HCPCS,J0702,Betamethasone acet&sod phosp,,,6.85,6.85,4 HCPCS,J0702,"Celestone Soluspan: 1 Vial, Multi-Dose In 1 Box (78206-118-01) / 5 Ml In 1 Vial, Multi-Dose",37.58,15.03,,,0 HCPCS,J0703,"Inj, cefepime hcl (b braun)",,,5.04,5.04,4 HCPCS,J0706,Caffeine Citrate: 1 Vial In 1 Box (63323-407-03) / 3 Ml In 1 Vial,7.8,3.12,,,0 HCPCS,J0706,Caffeine Citrate: 1 Vial In 1 Carton (25021-601-03) / 3 Ml In 1 Vial,1.33,0.53,,,0 HCPCS,J0706,Caffeine Citrate: 1 Vial In 1 Carton (51754-0500-1) / 3 Ml In 1 Vial,3.8,1.52,,,0 HCPCS,J0706,"Caffeine Citrate: 1 Vial, Glass In 1 Carton (72485-104-01) / 3 Ml In 1 Vial, Glass",2.41,0.96,,,0 HCPCS,J0706,Caffeine citrate injection,,,1.42,1.42,4 HCPCS,J0706,NDC Description Not Available,1.02,0.41,,,0 HCPCS,J0712,Ceftaroline fosamil inj,,,3.99,10.02,9 HCPCS,J0712,NDC Description Not Available,22.11,8.845,,,0 HCPCS,J0712,"Teflaro: 10 Vial, Single-Dose In 1 Carton (0456-0400-10) / 20 Ml In 1 Vial, Single-Dose (0456-0400-01)",24.57,9.83,,,0 HCPCS,J0712,"Teflaro: 10 Vial, Single-Dose In 1 Carton (0456-0600-10) / 20 Ml In 1 Vial, Single-Dose (0456-0600-01)",16.49,6.6,,,0 HCPCS,J0713,"Ceftazidime: 10 Vial In 1 Carton (44567-236-10) / 1 Injection, Powder, For Solution In 1 Vial",10.98,4.39,,,0 HCPCS,J0713,"Ceftazidime: 25 Vial In 1 Carton (44567-235-25) / 1 Injection, Powder, For Solution In 1 Vial",9.99,4.0,,,0 HCPCS,J0713,Ceftazidime: 6 Bottle In 1 Carton (25021-129-99) / 30 Ml In 1 Bottle,1.68,0.67,,,0 HCPCS,J0713,Inj ceftazidime per 500 mg,,,1.6,1.6,4 HCPCS,J0713,NDC Description Not Available,9.83,3.93,,,0 HCPCS,J0714,"Avycaz: 10 Vial, Single-Dose In 1 Carton (0456-2700-10) / 1 Powder, For Solution In 1 Vial, Single-Dose (0456-2700-01)",467.65,187.06,,,0 HCPCS,J0714,Ceftazidime and avibactam,,,100.5,273.64,9 HCPCS,J0714,NDC Description Not Available,454.88,181.95,,,0 HCPCS,J0715,Ceftizoxime sodium / 500 MG,,,0.01,0.01,4 HCPCS,J0716,Centruroides immune f(ab),,,1282.63,13624.12,9 HCPCS,J0717,Certolizumab pegol inj 1mg,,,3.14,7.85,9 HCPCS,J0717,"Cimzia: 2 Kit In 1 Carton (50474-700-62) / 1 Kit In 1 Kit * 1 Ml In 1 Vial, Glass * 1 Ml In 1 Vial, Glass",52.62,21.05,,,0 HCPCS,J0717,"Cimzia: 2 Syringe, Glass In 1 Carton (50474-710-79) / 1 Ml In 1 Syringe, Glass",62.07,24.83,,,0 HCPCS,J0720,Chloramphenicol sodium injec,,,48.65,61.32,5 HCPCS,J0725,"Chorionic Gonadotropin: 1 Kit In 1 Carton (63323-030-11) * 10 Ml In 1 Vial, Multi-Dose * 10 Ml In 1 Vial, Multi-Dose",140.33,56.13,,,0 HCPCS,J0725,Chorionic gonadotropin/1000u,,,18.25,18.25,4 HCPCS,J0735,"Clonidine Hydrochloride: 10 Ml In 1 Vial, Single-Use (0143-9724-01)",171.95,68.78,,,0 HCPCS,J0735,Clonidine hydrochloride,,,16.2,16.2,4 HCPCS,J0735,Duraclon: 1 Vial In 1 Carton (67457-218-10) / 10 Ml In 1 Vial,156.25,62.5,,,0 HCPCS,J0736,Cleocin Phosphate: 25 Vial In 1 Carton (0009-0902-18) / 6 Ml In 1 Vial (0009-0902-11),6.02,2.41,,,0 HCPCS,J0736,Clindamycin In 5 Percent Dextrose: 1 Vial In 1 Carton (0143-9269-01) / 50 Ml In 1 Vial,6.16,2.46,,,0 HCPCS,J0736,Clindamycin In 5 Percent Dextrose: 24 Bag In 1 Carton (0781-3288-09) / 50 Ml In 1 Bag (0781-3288-91),33.55,13.42,,,0 HCPCS,J0736,Clindamycin In 5 Percent Dextrose: 24 Bag In 1 Carton (0781-3289-09) / 50 Ml In 1 Bag (0781-3289-91),17.02,6.81,,,0 HCPCS,J0736,Clindamycin In 5 Percent Dextrose: 24 Bag In 1 Carton (0781-3290-09) / 50 Ml In 1 Bag (0781-3290-91),13.88,5.55,,,0 HCPCS,J0736,"Inj, clindamycin phosp 300mg",,,1.61,1.61,4 HCPCS,J0736,NDC Description Not Available,13.23,5.29,,,0 HCPCS,J0737,Clindamycin Phosphate: 24 Bag In 1 Carton (0338-3612-24) / 50 Ml In 1 Bag (0338-3612-50),18.58,7.43,,,0 HCPCS,J0737,Clindamycin Phosphate: 24 Bag In 1 Carton (0338-3814-24) / 50 Ml In 1 Bag (0338-3814-50),12.44,4.975,,,0 HCPCS,J0737,"Inj, clindamycin (baxter)",,,2.53,2.53,4 HCPCS,J0737,NDC Description Not Available,18.125,7.25,,,0 HCPCS,J0738,"Hiv prep, inj, lenacapavir",,,16.02,40.04,5 HCPCS,J0739,Apretude: 1 Kit In 1 Carton (49702-264-23) * 3 Ml In 1 Vial (49702-238-03),29.37,11.75,,,0 HCPCS,J0739,"Injection, cabotegravir 1 mg",,,6.89,18.2,9 HCPCS,J0739,NDC Description Not Available,28.8,11.52,,,0 HCPCS,J0740,"Cidofovir Dihydrate: 5 Ml In 1 Vial, Glass (23155-216-31)",2212.51,885.0,,,0 HCPCS,J0740,Cidofovir injection,,,521.83,1305.6,9 HCPCS,J0741,"Inj, cabote rilpivir 2mg 3mg",,,23.13,61.62,9 HCPCS,J0742,Inj imip 4 cilas 4 releb 2mg,,,2.5,2.5,4 HCPCS,J0742,NDC Description Not Available,4.17,1.67,,,0 HCPCS,J0742,"Recarbrio: 25 Vial, Single-Dose In 1 Carton (0006-3856-02) / 20 Ml In 1 Vial, Single-Dose (0006-3856-01)",4.23,1.69,,,0 HCPCS,J0743,Cilastatin sodium injection,,,7.34,7.34,4 HCPCS,J0743,NDC Description Not Available,45.15,18.06,,,0 HCPCS,J0744,Ciprofloxacin In Dextrose: 24 Pouch In 1 Carton (0409-2300-24) / 1 Bag In 1 Pouch (0409-2300-01) / 100 Ml In 1 Bag,12.88,5.15,,,0 HCPCS,J0744,Ciprofloxacin In Dextrose: 24 Pouch In 1 Carton (0409-3300-24) / 1 Bag In 1 Pouch (0409-3300-01) / 200 Ml In 1 Bag,8.18,3.27,,,0 HCPCS,J0744,Ciprofloxacin iv,,,2.1,2.1,4 HCPCS,J0744,Ciprofloxacin: 24 Pouch In 1 Carton (25021-192-87) / 1 Bag In 1 Pouch / 200 Ml In 1 Bag,5.98,2.39,,,0 HCPCS,J0744,NDC Description Not Available,11.335,4.535,,,0 HCPCS,J0745,Inj codeine phosphate /30 MG,,,0.01,0.01,4 HCPCS,J0750,"Hiv prep, ftc/tdf 200/300mg",,,0.45,1.63,9 HCPCS,J0751,"Hiv prep, ftc/taf 200/25mg",,,71.27,187.35,9 HCPCS,J0752,"Hiv prep, oral lenacapavir",,,617.95,1544.86,5 HCPCS,J0759,"Inj, clevidepine, 1 mg",,,2.95,7.38,5 HCPCS,J0770,Colistimethate sodium inj,,,11.94,11.94,4 HCPCS,J0770,Colistimethate: 1 Vial In 1 Box (63323-393-06) / 2 Ml In 1 Vial,124.97,49.99,,,0 HCPCS,J0775,"Collagenase, clost hist inj",,,73.38,202.68,9 HCPCS,J0775,"Xiaflex: 1 Kit In 1 Carton (66887-003-01) * 1 Injection, Powder, Lyophilized, For Solution In 1 Vial * 3 Ml In 1 Vial",323.09,129.24,,,0 HCPCS,J0780,NDC Description Not Available,16.35,6.54,,,0 HCPCS,J0780,Prochlorperazine Edisylate: 10 Vial In 1 Carton (25021-790-02) / 2 Ml In 1 Vial,14.24,5.7,,,0 HCPCS,J0780,Prochlorperazine Edisylate: 10 Vial In 1 Carton (70860-778-02) / 2 Ml In 1 Vial (70860-778-41),7.96,3.18,,,0 HCPCS,J0780,Prochlorperazine Edisylate: 10 Vial In 1 Carton (83634-778-02) / 2 Ml In 1 Vial (83634-778-41),6.63,2.65,,,0 HCPCS,J0780,Prochlorperazine Edisylate: 10 Vial In 1 Package (23155-294-42) / 2 Ml In 1 Vial (23155-294-31),31.8,12.72,,,0 HCPCS,J0780,Prochlorperazine Edisylate: 25 Vial In 1 Carton (0641-6135-25) / 2 Ml In 1 Vial (0641-6135-01),9.6,3.84,,,0 HCPCS,J0780,Prochlorperazine Edisylate: 25 Vial In 1 Package (0713-0351-25) / 2 Ml In 1 Vial (0713-0351-02),11.08,4.43,,,0 HCPCS,J0780,Prochlorperazine Edisylate: 25 Vial In 1 Package (23155-294-41) / 2 Ml In 1 Vial (23155-294-31),13.35,5.34,,,0 HCPCS,J0780,Prochlorperazine injection,,,2.92,2.92,4 HCPCS,J0791,"Adakveo: 10 Ml In 1 Vial, Glass (0078-0883-61)",539.65,215.86,,,0 HCPCS,J0791,Inj crizanlizumab-tmca 5mg,,,129.5,324.87,9 HCPCS,J0795,Corticorelin ovine triflutal,,,0.01,0.01,4 HCPCS,J0801,Inj. acthar gel to 40 units,,,3884.27,9710.67,9 HCPCS,J0802,"Inj. (ani), up to 40 units",,,3445.58,9116.14,9 HCPCS,J0834,Cortrosyn: 10 Vial In 1 Carton (0548-5900-00) / 1 Ml In 1 Vial,450.53,180.21,,,0 HCPCS,J0834,Cosyntropin cortrosyn inj,,,33.4,33.4,4 HCPCS,J0834,Cosyntropin: 10 Vial In 1 Carton (0781-3440-95) / 1 Ml In 1 Vial (0781-3440-71),352.88,141.15,,,0 HCPCS,J0834,NDC Description Not Available,169.52,67.81,,,0 HCPCS,J0840,"Crofab: 2 Vial, Glass In 1 Carton (50633-110-12) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Glass (50633-110-11)",10927.59,4371.04,,,0 HCPCS,J0840,Crotalidae poly immune fab,,,1755.81,5110.96,9 HCPCS,J0840,NDC Description Not Available,12823.32,5129.33,,,0 HCPCS,J0841,Inj crotalidae im f(ab')2 eq,,,1043.55,6008.7,9 HCPCS,J0850,Cytomegalovirus imm IV /vial,,,1812.01,4642.81,9 HCPCS,J0850,NDC Description Not Available,7730.14,3092.06,,,0 HCPCS,J0870,"Injection, imetelstat, 1 mg",,,55.51,148.39,9 HCPCS,J0872,Daptomycin (xellia) unrefrig,,,0.05,0.05,4 HCPCS,J0873,"Daptomycin: 1 Vial, Single-Use In 1 Carton (70594-034-01) / 10 Ml In 1 Vial, Single-Use",0.53,0.21,,,0 HCPCS,J0873,"Inj, daptomycin (xellia)",,,0.03,0.03,4 HCPCS,J0874,"Inj, daptomycin (baxter)",,,0.07,0.07,4 HCPCS,J0875,Dalvance: 1 Vial In 1 Package (57970-100-01) / 25 Ml In 1 Vial,79.67,31.87,,,0 HCPCS,J0875,"Injection, dalbavancin",,,9.44,23.6,9 HCPCS,J0877,"Daptomycin: 1 Vial, Single-Dose In 1 Carton (0409-0122-01) / 10 Ml In 1 Vial, Single-Dose",0.31,0.12,,,0 HCPCS,J0877,"Inj, daptomycin (hospira)",,,0.06,0.06,4 HCPCS,J0878,Daptomycin injection,,,0.03,0.03,4 HCPCS,J0878,"Daptomycin: 1 Vial, Single-Dose In 1 Carton (43598-413-11) / 10 Ml In 1 Vial, Single-Dose",0.89,0.36,,,0 HCPCS,J0878,"Daptomycin: 1 Vial, Single-Dose In 1 Carton (71288-016-15) / 10 Ml In 1 Vial, Single-Dose",0.13,0.05,,,0 HCPCS,J0878,"Daptomycin: 1 Vial, Single-Dose In 1 Carton (83090-011-01) / 10 Ml In 1 Vial, Single-Dose",0.26,0.1,,,0 HCPCS,J0878,"Daptomycin: 1 Vial, Single-Use In 1 Carton (60505-6229-4) / 10 Ml In 1 Vial, Single-Use",0.26,0.1,,,0 HCPCS,J0879,"Difelikefalin, esrd on dialy",,,0.23,0.23,4 HCPCS,J0881,Aranesp: 1 Blister Pack In 1 Package (55513-023-04) / 4 Syringe In 1 Blister Pack / .3 Ml In 1 Syringe (55513-023-01),34.37,13.75,,,0 HCPCS,J0881,Aranesp: 1 Blister Pack In 1 Package (55513-025-04) / 4 Syringe In 1 Blister Pack / .5 Ml In 1 Syringe (55513-025-01),15.0,6.0,,,0 HCPCS,J0881,Aranesp: 1 Blister Pack In 1 Package (55513-032-01) / 1 Syringe In 1 Blister Pack / 1 Ml In 1 Syringe,15.0,6.0,,,0 HCPCS,J0881,Aranesp: 1 Blister Pack In 1 Package (55513-111-01) / 1 Syringe In 1 Blister Pack / .6 Ml In 1 Syringe,35.27,14.11,,,0 HCPCS,J0881,"Darbepoetin alfa, non-esrd",,,2.92,7.7,9 HCPCS,J0881,NDC Description Not Available,34.900000000000006,13.96,,,0 HCPCS,J0882,Aranesp: 1 Blister Pack In 1 Package (55513-021-04) / 4 Syringe In 1 Blister Pack / .4 Ml In 1 Syringe (55513-021-01),36.04,14.42,,,0 HCPCS,J0882,Aranesp: 1 Blister Pack In 1 Package (55513-057-04) / 4 Syringe In 1 Blister Pack / .42 Ml In 1 Syringe (55513-057-01),36.0,14.4,,,0 HCPCS,J0882,"Darbepoetin alfa, esrd use",,,2.92,7.7,9 HCPCS,J0882,NDC Description Not Available,35.42,14.17,,,0 HCPCS,J0883,Argatroban nonesrd use 1mg,,,0.74,1.93,9 HCPCS,J0883,"Argatroban: 1 Vial, Glass In 1 Carton (67457-212-02) / 2.5 Ml In 1 Vial, Glass",9.11,3.64,,,0 HCPCS,J0883,"Argatroban: 1 Vial, Single-Dose In 1 Carton (0409-1140-01) / 2.5 Ml In 1 Vial, Single-Dose",1.1,0.44,,,0 HCPCS,J0883,Argatroban: 2.5 Ml In 1 Vial (0143-9674-01),2.15,0.86,,,0 HCPCS,J0884,Argatroban esrd dialysis 1mg,,,0.95,0.95,4 HCPCS,J0885,"Epoetin alfa, non-esrd",,,6.67,16.67,9 HCPCS,J0885,NDC Description Not Available,113.84,45.535,,,0 HCPCS,J0885,"Procrit: 4 Vial, Multi-Dose In 1 Carton (59676-320-04) / 1 Ml In 1 Vial, Multi-Dose (59676-320-00)",62.15,24.86,,,0 HCPCS,J0885,"Procrit: 4 Vial, Single-Dose In 1 Carton (59676-340-01) / 1 Ml In 1 Vial, Single-Dose (59676-340-00)",117.59,47.04,,,0 HCPCS,J0885,"Procrit: 6 Vial, Single-Dose In 1 Carton (59676-310-01) / 1 Ml In 1 Vial, Single-Dose (59676-310-00)",62.2,24.88,,,0 HCPCS,J0887,Epoetin beta esrd use,,,1.26,1.26,4 HCPCS,J0888,Epoetin beta non esrd,,,1.26,1.26,4 HCPCS,J0889,Daprodustat oral 1mg esrd,,,3.91,3.91,4 HCPCS,J0890,Peginesatide injection,,,0.01,0.01,4 HCPCS,J0891,Argatroban nonesrd (accord),,,2.22,3.96,5 HCPCS,J0892,Argatroban dialysis (accord),,,3.96,3.96,4 HCPCS,J0893,"Inj, decitabine (sun pharma)",,,0.78,0.78,4 HCPCS,J0894,Decitabine injection,,,1.77,1.77,4 HCPCS,J0894,Decitabine: 1 Vial In 1 Carton (25021-219-20) / 20 Ml In 1 Vial,3.88,1.55,,,0 HCPCS,J0894,"Decitabine: 1 Vial In 1 Carton (50742-430-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",9.89,3.96,,,0 HCPCS,J0894,"Decitabine: 1 Vial, Single-Dose In 1 Carton (0143-9385-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",3.44,1.38,,,0 HCPCS,J0894,"Decitabine: 1 Vial, Single-Dose In 1 Carton (71288-119-20) / 20 Ml In 1 Vial, Single-Dose",4.66,1.86,,,0 HCPCS,J0894,"Decitabine: 1 Vial, Single-Use In 1 Carton (55111-556-10) / 10 Ml In 1 Vial, Single-Use",6.47,2.59,,,0 HCPCS,J0895,"Deferoxamine Mesylate: 4 Injection, Powder, Lyophilized, For Solution In 1 Carton (60505-6236-6)",35.59,14.24,,,0 HCPCS,J0895,Deferoxamine mesylate inj,,,8.21,8.21,4 HCPCS,J0895,Deferoxamine: 1 Vial In 1 Box (63323-597-10) / 5.3 Ml In 1 Vial,55.76,22.3,,,0 HCPCS,J0896,Inj luspatercept-aamt 0.25mg,,,41.24,108.71,9 HCPCS,J0896,"Reblozyl: 1 Vial, Glass In 1 Carton (59572-711-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Glass",175.7,70.28,,,0 HCPCS,J0896,"Reblozyl: 1 Vial, Glass In 1 Carton (59572-775-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Glass",175.44,70.18,,,0 HCPCS,J0897,Denosumab injection,,,27.81,74.64,9 HCPCS,J0897,Prolia: 1 Syringe In 1 Carton (55513-710-01) / 1 Ml In 1 Syringe,128.9,51.56,,,0 HCPCS,J0897,Prolia: 1 Syringe In 1 Carton (55513-710-21) / 1 Ml In 1 Syringe,135.74,54.3,,,0 HCPCS,J0897,"Xgeva: 1 Vial, Single-Use In 1 Carton (55513-730-01) / 1.7 Ml In 1 Vial, Single-Use",125.25,50.1,,,0 HCPCS,J0898,Argatroban nonesrd (auromed),,,1.34,1.34,4 HCPCS,J0899,"Argatroban dialysis, auromed",,,1.34,1.34,4 HCPCS,J0901,Vadadustat oral 1mg for esrd,,,0.14,0.14,4 HCPCS,J0911,Inst tauro 1.35mg/hep 100u,,,3.55,8.88,9 HCPCS,J1000,Depo-estradiol cypionate inj,,,42.32,42.32,4 HCPCS,J1010,"Depo-Medrol: 1 Vial, Multi-Dose In 1 Carton (0009-0280-02) / 5 Ml In 1 Vial, Multi-Dose",1.08,0.43,,,0 HCPCS,J1010,"Depo-Medrol: 1 Vial, Single-Dose In 1 Package (0009-3073-01) / 1 Ml In 1 Vial, Single-Dose",1.28,0.51,,,0 HCPCS,J1010,"Depo-Medrol: 1 Vial, Single-Dose In 1 Package (0009-3073-22) / 1 Ml In 1 Vial, Single-Dose",0.51,0.2,,,0 HCPCS,J1010,"Depo-Medrol: 1 Vial, Single-Dose In 1 Package (0009-3475-01) / 1 Ml In 1 Vial, Single-Dose",1.08,0.43,,,0 HCPCS,J1010,"Depo-Medrol: 25 Vial, Multi-Dose In 1 Package (0009-0280-51) / 5 Ml In 1 Vial, Multi-Dose",0.69,0.28,,,0 HCPCS,J1010,"Depo-Medrol: 25 Vial, Single-Dose In 1 Package (0009-3073-03) / 1 Ml In 1 Vial, Single-Dose",1.26,0.5,,,0 HCPCS,J1010,"Depo-Medrol: 25 Vial, Single-Dose In 1 Package (0009-3475-03) / 1 Ml In 1 Vial, Single-Dose",0.46,0.18,,,0 HCPCS,J1010,"Depo-Medrol: 5 Ml In 1 Vial, Multi-Dose (0009-0306-02)",0.27,0.11,,,0 HCPCS,J1010,"Inj, methylpred acetate 1 mg",,,0.11,0.11,4 HCPCS,J1010,Methylprednisolone Acetate: 1 Vial In 1 Carton (25021-820-05) / 5 Ml In 1 Vial,0.8,0.32,,,0 HCPCS,J1010,"Methylprednisolone Acetate: 1 Vial, Single-Dose In 1 Carton (70121-1573-1) / 1 Ml In 1 Vial, Single-Dose",0.92,0.37,,,0 HCPCS,J1010,"Methylprednisolone Acetate: 1 Vial, Single-Dose In 1 Carton (70121-1574-1) / 1 Ml In 1 Vial, Single-Dose",0.9,0.36,,,0 HCPCS,J1010,"Methylprednisolone Acetate: 25 Vial, Single-Dose In 1 Carton (70121-1573-5) / 1 Ml In 1 Vial, Single-Dose",0.86,0.34,,,0 HCPCS,J1010,"Methylprednisolone Acetate: 25 Vial, Single-Dose In 1 Carton (70121-1574-5) / 1 Ml In 1 Vial, Single-Dose",0.91,0.36,,,0 HCPCS,J1050,Medroxyprogesterone Acetate: 1 Syringe In 1 Carton (0548-5701-00) / 1 Ml In 1 Syringe,1.3,0.52,,,0 HCPCS,J1050,Medroxyprogesterone Acetate: 1 Syringe In 1 Carton (55150-330-01) / 1 Ml In 1 Syringe,1.8,0.72,,,0 HCPCS,J1050,Medroxyprogesterone Acetate: 1 Syringe In 1 Carton (66993-371-79) / 1 Ml In 1 Syringe,1.61,0.64,,,0 HCPCS,J1050,Medroxyprogesterone Acetate: 1 Vial In 1 Carton (66993-370-83) / 1 Ml In 1 Vial,1.04,0.42,,,0 HCPCS,J1050,Medroxyprogesterone Acetate: 1 Vial In 1 Carton (67457-887-99) / 1 Ml In 1 Vial (67457-887-00),0.25,0.1,,,0 HCPCS,J1050,"Medroxyprogesterone Acetate: 1 Vial, Single-Dose In 1 Carton (0548-5400-00) / 1 Ml In 1 Vial, Single-Dose",0.63,0.25,,,0 HCPCS,J1050,Medroxyprogesterone acetate,,,0.01,0.01,4 HCPCS,J1050,NDC Description Not Available,1.09,0.44,,,0 HCPCS,J1071,Depo-Testosterone: 1 Vial In 1 Carton (0009-0417-01) / 1 Ml In 1 Vial,0.15,0.06,,,0 HCPCS,J1071,Inj testosterone cypionate,,,0.03,0.03,4 HCPCS,J1071,Testosterone Cypionate: 1 Ml In 1 Vial (0143-9659-01),0.01,0.004,,,0 HCPCS,J1071,"Testosterone Cypionate: 1 Vial, Glass In 1 Carton (0574-0820-01) / 1 Ml In 1 Vial, Glass",0.04,0.02,,,0 HCPCS,J1071,"Testosterone Cypionate: 1 Vial, Glass In 1 Carton (0574-0827-01) / 1 Ml In 1 Vial, Glass",0.02,0.01,,,0 HCPCS,J1071,"Testosterone Cypionate: 1 Vial, Single-Dose In 1 Carton (52536-625-01) / 1 Ml In 1 Vial, Single-Dose",0.06,0.02,,,0 HCPCS,J1072,"Inj, testosterone, azmiro",,,1.25,3.25,9 HCPCS,J1073,Testosterone pellet 75 mg,,,73.1,182.74,5 HCPCS,J1095,"Injection, dexamethasone 9%",,,1.15,1.15,4 HCPCS,J1096,Dexametha opth insert 0.1 mg,,,87.9,219.76,9 HCPCS,J1097,Phenylep ketorolac opth soln,,,96.06,240.16,9 HCPCS,J1100,"Dexamethasone Sodium Phosphate: 1 Vial, Multi-Dose In 1 Box (63323-165-30) / 30 Ml In 1 Vial, Multi-Dose",1.72,0.69,,,0 HCPCS,J1100,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (0641-0367-25) / 1 Ml In 1 Vial (0641-0367-21),0.63,0.25,,,0 HCPCS,J1100,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (0641-6145-25) / 1 Ml In 1 Vial (0641-6145-01),0.94,0.38,,,0 HCPCS,J1100,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (25021-053-01) / 1 Ml In 1 Vial,0.55,0.22,,,0 HCPCS,J1100,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (67457-418-05) / 5 Ml In 1 Vial (67457-418-00),0.11,0.04,,,0 HCPCS,J1100,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (67457-419-01) / 1 Ml In 1 Vial (67457-419-00),0.52,0.21,,,0 HCPCS,J1100,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (67457-421-30) / 30 Ml In 1 Vial (67457-421-00),0.19,0.08,,,0 HCPCS,J1100,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (67457-422-54) / 5 Ml In 1 Vial (67457-422-00),0.11,0.04,,,0 HCPCS,J1100,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (67457-423-12) / 1 Ml In 1 Vial (67457-423-00),0.86,0.34,,,0 HCPCS,J1100,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (70069-021-25) / 1 Ml In 1 Vial (70069-021-01),2.08,0.83,,,0 HCPCS,J1100,Dexamethasone Sodium Phosphate: 25 Vial In 1 Tray (63323-165-01) / 1 Ml In 1 Vial (63323-165-02),3.09,1.24,,,0 HCPCS,J1100,Dexamethasone Sodium Phosphate: 25 Vial In 1 Tray (63323-506-01) / 1 Ml In 1 Vial (63323-506-00),0.59,0.24,,,0 HCPCS,J1100,"Dexamethasone Sodium Phosphate: 25 Vial, Multi-Dose In 1 Carton (55150-238-05) / 5 Ml In 1 Vial, Multi-Dose",0.12,0.05,,,0 HCPCS,J1100,"Dexamethasone Sodium Phosphate: 25 Vial, Multi-Dose In 1 Carton (55150-239-30) / 30 Ml In 1 Vial, Multi-Dose",0.2,0.08,,,0 HCPCS,J1100,"Dexamethasone Sodium Phosphate: 25 Vial, Multi-Dose In 1 Tray (63323-165-05) / 5 Ml In 1 Vial, Multi-Dose (63323-165-03)",1.52,0.61,,,0 HCPCS,J1100,Dexamethasone sodium phos,,,0.09,0.09,4 HCPCS,J1100,NDC Description Not Available,1.07,0.43,,,0 HCPCS,J1110,Dihydroergotamine Mesylate: 5 Ampule In 1 Carton (0574-0850-05) / 1 Ml In 1 Ampule,566.09,226.44,,,0 HCPCS,J1110,Inj dihydroergotamine mesylt,,,85.75,85.75,4 HCPCS,J1110,NDC Description Not Available,401.08,160.43,,,0 HCPCS,J1120,Acetazolamid sodium injectio,,,19.06,19.06,4 HCPCS,J1120,"Acetazolamide: 1 Vial In 1 Box, Unit-Dose (0143-9503-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",195.28,78.11,,,0 HCPCS,J1120,"Acetazolamide: 1 Vial In 1 Carton (0143-9006-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",145.2,58.08,,,0 HCPCS,J1120,Acetazolamide: 1 Vial In 1 Carton (67457-853-50) / 5 Ml In 1 Vial,178.61,71.44,,,0 HCPCS,J1120,"Acetazolamide: 1 Vial, Glass In 1 Carton (39822-0190-1) / 5 Ml In 1 Vial, Glass",139.62,55.85,,,0 HCPCS,J1120,"Acetazolamide: 5 Ml In 1 Vial, Glass (23155-313-31)",170.14,68.06,,,0 HCPCS,J1120,NDC Description Not Available,126.04,50.42,,,0 HCPCS,J1130,Inj diclofenac sodium 0.5mg,,,0.01,0.01,4 HCPCS,J1160,Digoxin injection,,,4.88,4.88,4 HCPCS,J1160,Digoxin: 25 Ampule In 1 Carton (0641-1410-35) / 2 Ml In 1 Ampule (0641-1410-31),13.23,5.29,,,0 HCPCS,J1160,NDC Description Not Available,24.53,9.81,,,0 HCPCS,J1162,"Digifab: 1 Vial, Glass In 1 Carton (50633-120-11) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Glass (50633-120-12)",20180.93,8072.37,,,0 HCPCS,J1162,Digoxin immune fab (ovine),,,4968.58,14278.43,9 HCPCS,J1163,Diltiazem Hydrochloride: 10 VIAL in 1 CARTON (17478-937-05) / 5 mL in 1 VIAL,0.24,0.1,,,0 HCPCS,J1163,Diltiazem Hydrochloride: 10 Vial In 1 Carton (25021-319-05) / 5 Ml In 1 Vial,0.23,0.09,,,0 HCPCS,J1163,NDC Description Not Available,0.17,0.05500000000000001,,,0 HCPCS,J1165,Phenytoin sodium injection,,,0.52,0.52,4 HCPCS,J1170,Dilaudid: 10 Syringe In 1 Carton (76045-009-06) / .5 Ml In 1 Syringe (76045-009-96),7.01,2.8,,,0 HCPCS,J1170,Dilaudid: 24 SYRINGE in 1 CARTON (76045-009-05) / .5 mL in 1 SYRINGE (76045-009-03),8.69,3.48,,,0 HCPCS,J1170,Hydromorphone Hydrochloride: 10 Ampule In 1 Carton (0409-2552-01) / 1 Ml In 1 Ampule (0409-2552-11),1.39,0.56,,,0 HCPCS,J1170,NDC Description Not Available,1.23,0.49,,,0 HCPCS,J1171,10 SYRINGE in 1 CARTON (0409-1283-05) / .5 mL in 1 SYRINGE (0409-1283-04),2.8,1.12,,,0 HCPCS,J1171,Dilaudid: 10 Syringe In 1 Carton (76045-009-11) / 1 Ml In 1 Syringe (76045-009-01),2.13,0.85,,,0 HCPCS,J1171,Hydromorphone Hydrochloride: 1 Vial In 1 Carton (0703-0018-01) / 50 Ml In 1 Vial,0.13,0.05,,,0 HCPCS,J1171,"Hydromorphone Hydrochloride: 1 Vial, Single-Dose In 1 Box (0409-2634-50) / 50 Ml In 1 Vial, Single-Dose",0.21,0.08,,,0 HCPCS,J1171,Hydromorphone Hydrochloride: 10 Cartridge In 1 Carton (0409-1312-30) / 1 Ml In 1 Cartridge (0409-1312-03),0.45,0.18,,,0 HCPCS,J1171,Hydromorphone Hydrochloride: 10 Syringe In 1 Carton (0641-6169-10) / 1 Ml In 1 Syringe (0641-6169-01),6.55,2.62,,,0 HCPCS,J1171,Hydromorphone Hydrochloride: 10 Syringe In 1 Carton (0641-6206-10) / .5 Ml In 1 Syringe (0641-6206-01),2.3,0.92,,,0 HCPCS,J1171,Hydromorphone Hydrochloride: 10 Syringe In 1 Cello Pack (0409-4264-01) / .5 Ml In 1 Syringe (0409-4264-11),2.83,1.13,,,0 HCPCS,J1171,Hydromorphone Hydrochloride: 10 Vial In 1 Carton (0703-0113-03) / 5 Ml In 1 Vial (0703-0113-01),0.08,0.03,,,0 HCPCS,J1171,"Hydromorphone Hydrochloride: 10 Vial, Single-Dose In 1 Box (0409-2634-01) / 1 Ml In 1 Vial, Single-Dose (0409-2634-10)",0.1,0.04,,,0 HCPCS,J1171,"Hydromorphone Hydrochloride: 10 Vial, Single-Dose In 1 Box (0409-2634-05) / 5 Ml In 1 Vial, Single-Dose (0409-2634-25)",0.1,0.04,,,0 HCPCS,J1171,"Hydromorphone Hydrochloride: 25 Vial, Single-Dose In 1 Carton (63323-852-25) / 1 Ml In 1 Vial, Single-Dose (63323-852-03)",2.45,0.98,,,0 HCPCS,J1171,"Hydromorphone Hydrochloride: 25 Vial, Single-Dose In 1 Carton (63323-854-10) / 1 Ml In 1 Vial, Single-Dose (63323-854-03)",0.58,0.23,,,0 HCPCS,J1171,"Hydromorphone Hydrochloride: 50 Ml In 1 Vial, Single-Dose (63323-851-50)",0.04,0.02,,,0 HCPCS,J1171,"Inj, hydromorphone, 0.1 mg",,,0.14,0.14,4 HCPCS,J1171,NDC Description Not Available,0.61,0.24,,,0 HCPCS,J1190,Dexrazoxane hcl injection,,,30.83,80.96,9 HCPCS,J1190,"Dexrazoxane: 1 Kit In 1 Package (55150-434-01) * 25 Ml In 1 Vial, Single-Dose (55150-432-01) * 25 Ml In 1 Vial (55150-433-01)",1225.27,490.11,,,0 HCPCS,J1190,"Dexrazoxane: 1 Kit In 1 Package (55150-437-01) * 50 Ml In 1 Vial, Single-Dose (55150-435-01) * 50 Ml In 1 Vial (55150-436-01)",1125.05,450.02,,,0 HCPCS,J1190,NDC Description Not Available,199.675,79.87,,,0 HCPCS,J1200,Diphenhydramine Hydrochloride: 25 Vial In 1 Package (0641-0376-25) / 1 Ml In 1 Vial (0641-0376-21),5.25,2.1,,,0 HCPCS,J1200,"Diphenhydramine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (72485-101-25) / 1 Ml In 1 Vial, Single-Dose (72485-101-01)",8.01,3.2,,,0 HCPCS,J1200,Diphenhydramine hcl injectio,,,0.66,0.66,4 HCPCS,J1200,"Diphenhydramine: 25 Vial, Single-Dose In 1 Tray (63323-664-01) / 1 Ml In 1 Vial, Single-Dose (63323-664-00)",6.47,2.59,,,0 HCPCS,J1200,NDC Description Not Available,6.28,2.51,,,0 HCPCS,J1201,Inj. cetirizine hcl 0.5mg,,,15.62,42.68,9 HCPCS,J1202,Miglustat oral 65 mg,,,33.0,33.0,4 HCPCS,J1203,"Inj, cipaglucosidase, 5 mg",,,89.85,241.23,9 HCPCS,J1205,Chlorothiazide Sodium: 1 Vial In 1 Carton (0517-1820-01) / 18 Ml In 1 Vial,552.43,220.97,,,0 HCPCS,J1205,Chlorothiazide Sodium: 1 Vial In 1 Carton (25021-305-20) / 18 Ml In 1 Vial,232.27,92.91,,,0 HCPCS,J1205,Chlorothiazide sodium inj,,,32.48,32.48,4 HCPCS,J1205,Chlorothiazide: 1 Vial In 1 Box (63323-658-20) / 18 Ml In 1 Vial,183.18,73.27,,,0 HCPCS,J1212,Dimethyl sulfoxide 50% 50 ML,,,714.72,1872.03,9 HCPCS,J1212,NDC Description Not Available,158.1,63.24,,,0 HCPCS,J1212,"Rimso-50: 1 Vial, Glass In 1 Carton (67457-177-50) / 50 Ml In 1 Vial, Glass",2995.29,1198.12,,,0 HCPCS,J1230,"Methadone Hydrochloride: 1 Vial, Multi-Dose In 1 Carton (67457-217-20) / 20 Ml In 1 Vial, Multi-Dose",80.78,32.31,,,0 HCPCS,J1230,"Methadone Hydrochloride: 20 mL in 1 VIAL, MULTI-DOSE (17478-380-20)",11.13,4.45,,,0 HCPCS,J1230,Methadone injection,,,20.91,20.91,4 HCPCS,J1240,Dimenhydrinate injection,,,8.35,8.35,4 HCPCS,J1245,Dipyridamole injection,,,3.84,3.84,4 HCPCS,J1250,Dobutamine Hydrochloride In Dextrose: 18 Bag In 1 Carton (0338-1075-02) / 250 Ml In 1 Bag,82.56,33.02,,,0 HCPCS,J1250,"Dobutamine: 1 Vial, Single-Dose In 1 Carton (70436-203-80) / 20 Ml In 1 Vial, Single-Dose",21.16,8.46,,,0 HCPCS,J1250,"Dobutamine: 10 Vial, Single-Dose In 1 Tray (0409-2344-02) / 20 Ml In 1 Vial, Single-Dose (0409-2344-62)",22.74,9.1,,,0 HCPCS,J1250,Inj dobutamine HCL/250 mg,,,8.15,8.15,4 HCPCS,J1250,NDC Description Not Available,32.11,12.84,,,0 HCPCS,J1260,Dolasetron mesylate,,,0.01,0.01,4 HCPCS,J1265,Dopamine Hydrochloride And Dextrose: 18 Bag In 1 Carton (0338-1007-02) / 250 Ml In 1 Bag,5.65,2.26,,,0 HCPCS,J1265,Dopamine Hydrochloride And Dextrose: 18 Bag In 1 Carton (0338-1009-02) / 250 Ml In 1 Bag,3.74,1.5,,,0 HCPCS,J1265,Dopamine Hydrochloride In Dextrose: 12 Bag In 1 Carton (0409-7809-22) / 250 Ml In 1 Bag (0409-7809-11),7.88,3.15,,,0 HCPCS,J1265,"Dopamine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-5820-01) / 5 Ml In 1 Vial, Single-Dose (0409-5820-11)",2.45,0.98,,,0 HCPCS,J1265,Dopamine injection,,,0.71,0.71,4 HCPCS,J1265,NDC Description Not Available,2.1399999999999997,0.855,,,0 HCPCS,J1267,Doripenem injection,,,0.01,0.01,4 HCPCS,J1270,"Injection, doxercalciferol",,,0.38,0.38,4 HCPCS,J1271,Doxy 100: 10 Vial In 1 Tray (63323-130-11) / 10 Ml In 1 Vial (63323-130-02),0.71,0.28,,,0 HCPCS,J1271,Doxycycline: 10 Vial In 1 Carton (66794-237-41) / 10 Ml In 1 Vial,0.6,0.24,,,0 HCPCS,J1271,Inj doxycycline hyclate 1 mg,,,0.12,0.12,4 HCPCS,J1271,NDC Description Not Available,0.575,0.22999999999999998,,,0 HCPCS,J1290,Ecallantide injection,,,564.64,1499.04,9 HCPCS,J1299,"Inj, eculizumab, 2 mg",,,43.76,109.41,9 HCPCS,J1299,Soliris: 1 Vial In 1 Carton (25682-001-01) / 30 Ml In 1 Vial,506.49,202.6,,,0 HCPCS,J1301,"Injection, edaravone, 1 mg",,,6.38,21.31,9 HCPCS,J1302,"Inj, sutimlimab-jome, 10 mg",,,18.13,50.33,9 HCPCS,J1303,"Inj., ravulizumab-cwvz 10 mg",,,220.32,566.14,9 HCPCS,J1303,"Ultomiris: 1 Vial, Glass In 1 Carton (25682-025-01) / 3 Ml In 1 Vial, Glass",949.72,379.89,,,0 HCPCS,J1303,"Ultomiris: 1 Vial, Glass In 1 Carton (25682-028-01) / 11 Ml In 1 Vial, Glass",950.35,380.14,,,0 HCPCS,J1304,Inj tofersen intrathec 1 mg,,,155.34,412.03,9 HCPCS,J1304,"Qalsody: 1 Vial, Single-Use In 1 Carton (64406-109-01) / 15 Ml In 1 Vial, Single-Use",674.22,269.69,,,0 HCPCS,J1305,"Inj, evinacumab-dgnb, 5mg",,,186.31,506.44,9 HCPCS,J1306,"Injection, inclisiran, 1 mg",,,12.27,32.24,9 HCPCS,J1306,"Leqvio: 1 Syringe, Glass In 1 Carton (0078-1000-60) / 1.5 Ml In 1 Syringe, Glass",56.5,22.6,,,0 HCPCS,J1307,"Inj, crovalimab-akkz, 10 mg",,,520.29,1378.78,9 HCPCS,J1308,"Inj, famotidine, 0.25 mg",,,0.01,0.01,4 HCPCS,J1308,NDC Description Not Available,0.05,0.02,,,0 HCPCS,J1322,"Elosulfase alfa, injection",,,293.94,801.95,9 HCPCS,J1323,"Elrexfio: 1 Vial, Single-Dose In 1 Carton (0069-4494-02) / 1.9 Ml In 1 Vial, Single-Dose (0069-4494-01)",782.58,313.03,,,0 HCPCS,J1323,"Inj, elranatamab-bcmm, 1 mg",,,182.98,478.28,9 HCPCS,J1323,NDC Description Not Available,827.09,330.84,,,0 HCPCS,J1324,Enfuvirtide injection,,,0.66,0.66,4 HCPCS,J1325,Epoprostenol injection,,,16.08,16.08,4 HCPCS,J1325,Epoprostenol: 1 Vial In 1 Carton (62756-059-40) / 10 Ml In 1 Vial,100.77,40.31,,,0 HCPCS,J1325,Epoprostenol: 1 Vial In 1 Carton (62756-060-40) / 10 Ml In 1 Vial,78.75,31.5,,,0 HCPCS,J1325,Epoprostenol: 1 Vial In 1 Carton (67457-588-10) / 10 Ml In 1 Vial,55.01,22.0,,,0 HCPCS,J1325,NDC Description Not Available,90.51,36.2,,,0 HCPCS,J1326,"Inj, zolbetuximab-clzb, 2 mg",,,33.92,84.8,5 HCPCS,J1326,Vyloy: 1 Vial In 1 Box (0469-3425-10) / 5 Ml In 1 Vial,126.91,50.76,,,0 HCPCS,J1326,Vyloy: 1 Vial In 1 Box (0469-4425-30) / 15 Ml In 1 Vial,140.8,56.32,,,0 HCPCS,J1327,Eptifibatide injection,,,2.75,10.63,9 HCPCS,J1327,Eptifibatide: 1 Vial In 1 Carton (67457-629-10) / 10 Ml In 1 Vial,33.75,13.5,,,0 HCPCS,J1327,Eptifibatide: 1 Vial In 1 Carton (67457-631-10) / 100 Ml In 1 Vial,31.09,12.44,,,0 HCPCS,J1327,Eptifibatide: 100 Ml In 1 Vial (70436-027-80),16.84,6.74,,,0 HCPCS,J1330,Ergonovine maleate injection,,,0.01,0.01,4 HCPCS,J1335,Ertapenem injection,,,9.18,9.18,4 HCPCS,J1335,Ertapenem: 10 Vial In 1 Carton (60505-6196-4) / 20 Ml In 1 Vial (60505-6196-0),66.92,26.77,,,0 HCPCS,J1335,NDC Description Not Available,73.78999999999999,29.515,,,0 HCPCS,J1364,Erythro lactobionate /500 MG,,,65.96,65.96,4 HCPCS,J1364,Erythrocin Lactobionate: 10 Vial In 1 Tray (0409-6482-01) / 10 Ml In 1 Vial (0409-6482-11),251.16,100.46,,,0 HCPCS,J1364,NDC Description Not Available,429.96000000000004,171.985,,,0 HCPCS,J1380,"Delestrogen: 5 Ml In 1 Vial, Multi-Dose (42023-111-01)",62.6,25.04,,,0 HCPCS,J1380,Estradiol Valerate: 1 Vial In 1 Carton (0143-9290-01) / 5 Ml In 1 Vial,23.89,9.56,,,0 HCPCS,J1380,"Estradiol Valerate: 1 Vial, Multi-Dose In 1 Carton (0517-0420-01) / 5 Ml In 1 Vial, Multi-Dose",6.3,2.52,,,0 HCPCS,J1380,"Estradiol Valerate: 5 Ml In 1 Vial, Multi-Dose (70700-274-22)",0.01,0.004,,,0 HCPCS,J1380,Estradiol valerate 10 MG inj,,,7.3,7.3,4 HCPCS,J1410,Inj estrogen conjugate 25 MG,,,382.89,1005.33,9 HCPCS,J1410,Premarin: 1 Vial In 1 Carton (0046-0749-05) / 5 Ml In 1 Vial,1654.48,661.79,,,0 HCPCS,J1411,"Inj, hemgenix, per tx dose",,,0.01,9228625.0,9 HCPCS,J1412,Inj roctavian ml 2x10^13vc g,,,0.01,31384.28,9 HCPCS,J1413,Inj delandistrogene mox rokl,,,0.01,8253866.67,9 HCPCS,J1414,"Inj, beqvez, per tx dose",,,0.01,0.01,4 HCPCS,J1426,"Injection, casimersen, 10 mg",,,160.0,415.43,9 HCPCS,J1427,Inj. viltolarsen,,,56.4,56.4,4 HCPCS,J1428,"Inj, eteplirsen, 10 mg",,,160.0,418.63,9 HCPCS,J1429,Inj golodirsen 10 mg,,,160.0,160.0,4 HCPCS,J1430,Ethanolamine oleate 100 mg,,,497.7,1334.42,9 HCPCS,J1430,NDC Description Not Available,1763.38,705.35,,,0 HCPCS,J1434,"Inj, focinvez, 1mg",,,2.22,5.56,9 HCPCS,J1437,Inj. fe derisomaltose 10 mg,,,20.83,54.69,9 HCPCS,J1438,Etanercept injection,,,1019.7,1019.7,4 HCPCS,J1439,Inj ferric carboxymaltos 1mg,,,1.12,2.8,9 HCPCS,J1439,"Injectafer: 1 Vial, Single-Dose In 1 Box (0517-0602-01) / 2 Ml In 1 Vial, Single-Dose",8.49,3.4,,,0 HCPCS,J1439,"Injectafer: 1 Vial, Single-Dose In 1 Box (0517-0650-01) / 15 Ml In 1 Vial, Single-Dose",7.92,3.17,,,0 HCPCS,J1440,Fecal?microbiota jslm 1 ml,,,63.93,164.56,9 HCPCS,J1442,Inj filgrastim excl biosimil,,,0.98,2.48,9 HCPCS,J1442,NDC Description Not Available,4.54,1.815,,,0 HCPCS,J1442,Neupogen: 10 Vial In 1 Package (55513-530-10) / 1 Ml In 1 Vial (55513-530-01),4.52,1.81,,,0 HCPCS,J1443,Inj ferric pyrophosphate cit,,,0.03,0.03,4 HCPCS,J1444,Fe pyro cit pow 0.1 mg iron,,,0.03,0.03,4 HCPCS,J1445,Inj triferic avnu 0.1mg iron,,,0.18,0.18,4 HCPCS,J1447,Inj tbo filgrastim 1 microg,,,0.28,0.7,9 HCPCS,J1448,"Injection, trilaciclib, 1mg",,,5.39,15.0,9 HCPCS,J1449,Inj eflapegrastim-xnst 0.1mg,,,22.61,93.55,9 HCPCS,J1450,Fluconazole,,,3.58,3.58,4 HCPCS,J1450,Fluconazole in Sodium Chloride: 6 BAG in 1 CARTON (69784-003-06) / 200 mL in 1 BAG,15.06,6.02,,,0 HCPCS,J1450,Fluconazole: 10 Bag In 1 Carton (0338-6045-37) / 200 Ml In 1 Bag,42.78,17.11,,,0 HCPCS,J1450,Fluconazole: 10 Bag In 1 Carton (0338-6046-48) / 100 Ml In 1 Bag,59.34,23.74,,,0 HCPCS,J1450,Fluconazole: 10 Pouch In 1 Carton (25021-184-67) / 1 Bag In 1 Pouch / 200 Ml In 1 Bag,9.44,3.78,,,0 HCPCS,J1450,Fluconazole: 10 Pouch In 1 Carton (25021-184-82) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,39.6,15.84,,,0 HCPCS,J1450,Fluconazole: 10 Pouch In 1 Carton (25021-184-87) / 1 Bag In 1 Pouch / 200 Ml In 1 Bag,32.07,12.83,,,0 HCPCS,J1450,NDC Description Not Available,15.89,6.36,,,0 HCPCS,J1451,"Fomepizole, 15 mg",,,6.14,15.34,9 HCPCS,J1451,Fomepizole: 1 Vial In 1 Carton (70710-1478-1) / 1.5 Ml In 1 Vial,71.93,28.77,,,0 HCPCS,J1453,"Fosaprepitant Dimeglumine: 1 Vial, Single-Dose In 1 Carton (0143-9384-01) / 5 Ml In 1 Vial, Single-Dose",1.25,0.5,,,0 HCPCS,J1453,Fosaprepitant injection,,,0.12,0.12,4 HCPCS,J1454,"Inj fosnetupitant, palonoset",,,479.9,1199.76,9 HCPCS,J1455,"Foscarnet Sodium: 1 Bottle, Glass In 1 Carton (23155-771-31) / 250 Ml In 1 Bottle, Glass",126.32,50.53,,,0 HCPCS,J1455,Foscarnet Sodium: 10 Carton In 1 Case (0143-9192-01) / 1 Bottle In 1 Carton / 250 Ml In 1 Bottle,159.63,63.85,,,0 HCPCS,J1455,Foscarnet sodium injection,,,21.63,21.63,4 HCPCS,J1455,Foscarnet: 1 Bottle In 1 Carton (63323-875-50) / 250 Ml In 1 Bottle,277.31,110.92,,,0 HCPCS,J1455,NDC Description Not Available,235.91,94.36,,,0 HCPCS,J1456,"Inj, fosaprepitant (teva)",,,0.04,1.21,9 HCPCS,J1457,Gallium nitrate injection,,,0.01,0.01,4 HCPCS,J1458,Galsulfase injection,,,484.88,1323.95,9 HCPCS,J1458,Naglazyme: 1 Vial In 1 Carton (68135-020-01) / 5 Ml In 1 Vial,2122.19,848.88,,,0 HCPCS,J1459,Inj IVIG privigen 500 mg,,,48.96,122.41,9 HCPCS,J1459,NDC Description Not Available,317.885,127.155,,,0 HCPCS,J1459,"Privigen: 1 Vial, Glass In 1 Carton (44206-437-10) / 100 Ml In 1 Vial, Glass (44206-437-91)",399.33,159.73,,,0 HCPCS,J1459,"Privigen: 1 Vial, Glass In 1 Carton (44206-438-20) / 200 Ml In 1 Vial, Glass (44206-438-92)",402.19,160.88,,,0 HCPCS,J1460,Gamma globulin 1 CC inj,,,48.89,122.36,9 HCPCS,J1551,Inj cutaquig 100 mg,,,14.17,35.43,9 HCPCS,J1552,"Inj, alyglo, 500 mg",,,120.04,300.1,9 HCPCS,J1554,Inj. asceniv,,,496.68,1271.14,9 HCPCS,J1555,"Inj cuvitru, 100 mg",,,16.68,44.98,9 HCPCS,J1556,"Inj, imm glob bivigam, 500mg",,,77.3,201.98,9 HCPCS,J1557,Gammaplex injection,,,57.48,155.75,9 HCPCS,J1558,"Inj. xembify, 100 mg",,,14.28,38.0,9 HCPCS,J1559,Hizentra injection,,,13.64,36.96,9 HCPCS,J1560,Gamma globulin > 10 CC inj,,,118.15,488.85,9 HCPCS,J1561,"Gammaked: 1 Vial, Glass In 1 Carton (76125-900-10) / 100 Ml In 1 Vial, Glass (76125-900-11)",235.47,94.19,,,0 HCPCS,J1561,"Gammaked: 1 Vial, Glass In 1 Carton (76125-900-20) / 200 Ml In 1 Vial, Glass (76125-900-21)",235.47,94.19,,,0 HCPCS,J1561,"Gamunex-C: 1 Vial, Glass In 1 Carton (13533-800-12) / 10 Ml In 1 Vial, Glass (13533-800-13)",311.19,124.48,,,0 HCPCS,J1561,"Gamunex-C: 1 Vial, Glass In 1 Carton (13533-800-20) / 50 Ml In 1 Vial, Glass (13533-800-21)",395.44,158.18,,,0 HCPCS,J1561,"Gamunex-C: 1 Vial, Glass In 1 Carton (13533-800-24) / 200 Ml In 1 Vial, Glass (13533-800-25)",395.55,158.22,,,0 HCPCS,J1561,"Gamunex-C: 1 Vial, Glass In 1 Carton (13533-800-40) / 400 Ml In 1 Vial, Glass (13533-800-41)",398.14,159.26,,,0 HCPCS,J1561,"Gamunex-C: 1 Vial, Glass In 1 Carton (13533-800-71) / 100 Ml In 1 Vial, Glass (13533-800-72)",398.06,159.22,,,0 HCPCS,J1561,Gamunex-c/gammaked,,,48.02,120.06,9 HCPCS,J1561,NDC Description Not Available,392.89,157.16,,,0 HCPCS,J1562,"Vivaglobin, inj",,,0.01,0.01,4 HCPCS,J1566,"Immune globulin, powder",,,81.01,206.89,9 HCPCS,J1568,Octagam injection,,,47.13,117.83,9 HCPCS,J1569,"Gammagard Liquid: 1 Bottle, Glass In 1 Carton (0944-2700-02) / 10 Ml In 1 Bottle, Glass (0944-2700-08)",172.32,68.93,,,0 HCPCS,J1569,"Gammagard Liquid: 1 Bottle, Glass In 1 Carton (0944-2700-04) / 50 Ml In 1 Bottle, Glass (0944-2700-10)",387.73,155.09,,,0 HCPCS,J1569,"Gammagard Liquid: 1 Bottle, Glass In 1 Carton (0944-2700-05) / 100 Ml In 1 Bottle, Glass (0944-2700-11)",388.18,155.27,,,0 HCPCS,J1569,"Gammagard Liquid: 1 Bottle, Glass In 1 Carton (0944-2700-06) / 200 Ml In 1 Bottle, Glass (0944-2700-12)",387.85,155.14,,,0 HCPCS,J1569,"Gammagard Liquid: 1 Bottle, Glass In 1 Carton (0944-2700-07) / 300 Ml In 1 Bottle, Glass (0944-2700-13)",384.14,153.66,,,0 HCPCS,J1569,Gammagard liquid injection,,,45.13,123.74,9 HCPCS,J1569,NDC Description Not Available,384.7,153.88,,,0 HCPCS,J1570,Ganciclovir sodium injection,,,32.09,32.09,4 HCPCS,J1570,Ganciclovir: 25 Vial In 1 Carton (70436-089-55) / 10 Ml In 1 Vial,185.73,74.29,,,0 HCPCS,J1570,Ganciclovir: 25 Vial In 1 Tray (63323-315-10) / 10 Ml In 1 Vial (63323-315-01),375.87,150.35,,,0 HCPCS,J1570,NDC Description Not Available,110.82,44.33,,,0 HCPCS,J1571,HepaGam B IM injection,,,65.15,178.96,9 HCPCS,J1571,"Hepagam B: 1 Vial, Glass In 1 Carton (70257-051-51) / 5 Ml In 1 Vial, Glass (70257-051-05)",242.46,96.98,,,0 HCPCS,J1571,NDC Description Not Available,241.38,96.55,,,0 HCPCS,J1572,Flebogamma injection,,,52.94,226.85,9 HCPCS,J1573,"Hepagam B intravenous, inj",,,65.15,178.96,9 HCPCS,J1574,"Inj, ganciclovir (exela)",,,50.0,50.0,4 HCPCS,J1575,Hyqvia 100mg immuneglobulin,,,17.57,48.23,9 HCPCS,J1576,"Inj, panzyga, 500 mg",,,70.25,175.62,9 HCPCS,J1580,Garamycin gentamicin inj,,,2.47,2.47,4 HCPCS,J1580,Gentamicin Sulfate In Sodium Chloride: 100 Ml In 1 Bag (0338-0505-48),14.67,5.87,,,0 HCPCS,J1580,Gentamicin Sulfate In Sodium Chloride: 100 Ml In 1 Bag (0338-0507-48),8.61,3.44,,,0 HCPCS,J1580,Gentamicin Sulfate In Sodium Chloride: 50 Ml In 1 Bag (0338-0507-41),14.49,5.8,,,0 HCPCS,J1580,Gentamicin Sulfate In Sodium Chloride: 50 Ml In 1 Bag (0338-0509-41),12.65,5.06,,,0 HCPCS,J1580,"Gentamicin Sulfate: 25 Vial, Single-Dose In 1 Tray (0409-1207-03) / 2 Ml In 1 Vial, Single-Dose (0409-1207-13)",12.65,5.06,,,0 HCPCS,J1580,Gentamicin: 25 Vial In 1 Tray (63323-010-02) / 2 Ml In 1 Vial (63323-010-01),22.51,9.0,,,0 HCPCS,J1580,Gentamicin: 25 Vial In 1 Tray (63323-010-20) / 20 Ml In 1 Vial (63323-010-03),12.87,5.15,,,0 HCPCS,J1580,Gentamicin: 25 Vial In 1 Tray (63323-173-02) / 2 Ml In 1 Vial (63323-173-01),23.35,9.34,,,0 HCPCS,J1580,"Gentamicin: 25 Vial, Multi-Dose In 1 Tray (63323-010-94) / 2 Ml In 1 Vial, Multi-Dose (63323-010-41)",5.06,2.02,,,0 HCPCS,J1580,NDC Description Not Available,10.93,4.37,,,0 HCPCS,J1595,Injection glatiramer acetate,,,62.5,62.5,4 HCPCS,J1596,Glycopyrrolate: 25 Vial In 1 Carton (0143-9682-25) / 1 Ml In 1 Vial (0143-9682-01),0.03,0.01,,,0 HCPCS,J1596,"Glycopyrrolate: 25 Vial, Glass In 1 Carton (66794-204-42) / 5 Ml In 1 Vial, Glass (66794-204-02)",1.72,0.69,,,0 HCPCS,J1596,"Glycopyrrolate: 25 Vial, Single-Dose In 1 Carton (71288-414-03) / 1 Ml In 1 Vial, Single-Dose (71288-414-01)",1.97,0.79,,,0 HCPCS,J1596,"Inj, glycopyrrolate, 0.1 mg",,,0.51,0.51,4 HCPCS,J1596,NDC Description Not Available,2.31,0.925,,,0 HCPCS,J1597,"Inj glycopyrrolate, glyrx-pf",,,1.6,1.6,4 HCPCS,J1598,Inj glycopyrrolate fres kabi,,,1.66,1.66,4 HCPCS,J1600,Gold sodium thiomaleate inj,,,0.01,0.01,4 HCPCS,J1602,Golimumab for iv use 1mg,,,10.77,27.44,9 HCPCS,J1602,"Simponi Aria: 1 Vial, Single-Dose In 1 Carton (57894-350-01) / 4 Ml In 1 Vial, Single-Dose",170.86,68.34,,,0 HCPCS,J1610,"GlucaGen: 1 KIT in 1 KIT (0597-0260-10) * 1 mL in 1 VIAL, GLASS (0597-0053-01) * 1 mL in 1 VIAL, GLASS (0597-0265-94)",524.91,209.96,,,0 HCPCS,J1610,GlucaGen: 10 VIAL in 1 CARTON (0597-0053-45) / 1 mL in 1 VIAL,646.42,258.57,,,0 HCPCS,J1610,Glucagon hydrochloride/1 mg,,,105.49,263.73,9 HCPCS,J1610,Glucagon: 1 Kit In 1 Kit (0548-5850-00) * 1 Ml In 1 Vial (0548-5905-00) * 1 Ml In 1 Syringe (0548-5831-00),1274.43,509.77,,,0 HCPCS,J1610,NDC Description Not Available,877.32,350.93,,,0 HCPCS,J1611,"Glucagon: 1 Kit In 1 Carton (63323-593-03) * 1 Ml In 1 Vial, Single-Dose (63323-596-03) * 1 Ml In 1 Vial, Single-Dose (63323-185-03)",852.06,340.82,,,0 HCPCS,J1611,"Glucagon: 1 Kit In 1 Carton (63323-594-03) * 1 Ml In 1 Vial, Single-Dose (63323-596-06) * 1 Ml In 1 Vial, Single-Dose (63323-185-03)",508.88,203.55,,,0 HCPCS,J1611,"Inj glucagon hcl, fresenius",,,134.89,337.23,9 HCPCS,J1611,NDC Description Not Available,816.4649999999999,326.59000000000003,,,0 HCPCS,J1612,Inj glucagon (gvoke) 0.01 mg,,,1.8,4.5,5 HCPCS,J1626,Granisetron Hydrochloride: 1 Vial In 1 Carton (67457-863-01) / 1 Ml In 1 Vial,4.39,1.76,,,0 HCPCS,J1626,Granisetron Hydrochloride: 1 Vial In 1 Carton (67457-864-04) / 1 Ml In 1 Vial,2.8,1.12,,,0 HCPCS,J1626,"Granisetron Hydrochloride: 10 Vial, Single-Use In 1 Package (0143-9744-10) / 1 Ml In 1 Vial, Single-Use (0143-9744-01)",1.12,0.45,,,0 HCPCS,J1626,"Granisetron Hydrochloride: 5 Vial, Multi-Dose In 1 Carton (0143-9745-05) / 4 Ml In 1 Vial, Multi-Dose (0143-9745-01)",3.99,1.6,,,0 HCPCS,J1626,Granisetron hcl injection,,,0.26,0.26,4 HCPCS,J1626,"Granisetron: 1 Vial, Single-Use In 1 Box (63323-318-01) / 1 Ml In 1 Vial, Single-Use",8.8,3.52,,,0 HCPCS,J1626,NDC Description Not Available,4.275,1.71,,,0 HCPCS,J1627,"Inj, granisetron, xr, 0.1 mg",,,2.91,7.27,9 HCPCS,J1628,"Inj., guselkumab, 1 mg",,,67.0,167.5,9 HCPCS,J1628,"Tremfya: 1 Vial, Single-Dose In 1 Carton (57894-650-02) / 20 Ml In 1 Vial, Single-Dose (57894-650-01)",321.91,128.76,,,0 HCPCS,J1630,Haloperidol Lactate: 25 Vial In 1 Carton (67457-426-12) / 1 Ml In 1 Vial (67457-426-00),3.94,1.58,,,0 HCPCS,J1630,Haloperidol injection,,,0.78,0.78,4 HCPCS,J1630,NDC Description Not Available,3.94,1.58,,,0 HCPCS,J1631,Haloperidol Decanoate: 5 Ampule In 1 Box (10147-0922-5) / 1 Ml In 1 Ampule,75.42,30.17,,,0 HCPCS,J1631,Haloperidol Decanoate: 5 Vial In 1 Carton (67457-409-13) / 1 Ml In 1 Vial (67457-409-00),18.06,7.22,,,0 HCPCS,J1631,Haloperidol decanoate inj,,,4.61,4.61,4 HCPCS,J1631,NDC Description Not Available,107.8,43.12,,,0 HCPCS,J1632,"Inj., brexanolone, 1 mg",,,74.5,74.5,4 HCPCS,J1640,"Hemin, 1 mg",,,33.07,90.12,9 HCPCS,J1640,Panhematin: 1 Vial In 1 Carton (55292-702-55) / 48 Ml In 1 Vial (55292-702-54),130.91,52.36,,,0 HCPCS,J1642,Inj heparin sodium per 10 u,,,0.02,0.02,4 HCPCS,J1642,NDC Description Not Available,0.28500000000000003,0.115,,,0 HCPCS,J1642,Sodium Acetate: 25 Vial In 1 Case (0409-3299-06) / 100 Ml In 1 Vial (0409-3299-16),0.69,0.28,,,0 HCPCS,J1643,Heparin Sodium: 25 Vial In 1 Container (0069-0059-03) / 1 Ml In 1 Vial (0069-0059-04),3.41,1.36,,,0 HCPCS,J1643,"Inj heparin, pfizer, 1000u",,,2.94,2.94,4 HCPCS,J1643,NDC Description Not Available,0.84,0.34,,,0 HCPCS,J1644,Heparin Sodium In Dextrose: 24 Container In 1 Case (0264-9587-20) / 250 Ml In 1 Container,2.77,1.11,,,0 HCPCS,J1644,Heparin Sodium: 24 Bag In 1 Case (63323-517-74) / 250 Ml In 1 Bag (63323-517-01),1.89,0.76,,,0 HCPCS,J1644,Heparin Sodium: 25 Vial In 1 Carton (25021-400-10) / 10 Ml In 1 Vial,1.59,0.64,,,0 HCPCS,J1644,Heparin Sodium: 25 Vial In 1 Carton (25021-403-04) / 4 Ml In 1 Vial,0.84,0.34,,,0 HCPCS,J1644,Heparin Sodium: 25 Vial In 1 Tray (63323-047-10) / 10 Ml In 1 Vial (63323-047-01),1.56,0.62,,,0 HCPCS,J1644,Heparin Sodium: 25 Vial In 1 Tray (63323-262-01) / 1 Ml In 1 Vial,3.66,1.46,,,0 HCPCS,J1644,Heparin Sodium: 25 Vial In 1 Tray (63323-262-06) / 1 Ml In 1 Vial (63323-262-03),3.68,1.47,,,0 HCPCS,J1644,Heparin Sodium: 25 Vial In 1 Tray (63323-540-01) / 1 Ml In 1 Vial,6.73,2.69,,,0 HCPCS,J1644,Heparin Sodium: 25 Vial In 1 Tray (63323-540-11) / 10 Ml In 1 Vial,1.03,0.41,,,0 HCPCS,J1644,Heparin Sodium: 25 Vial In 1 Tray (63323-542-07) / 5 Ml In 1 Vial,0.97,0.39,,,0 HCPCS,J1644,"Heparin Sodium: 25 Vial, Multi-Dose In 1 Carton (63739-931-28) / 10 Ml In 1 Vial, Multi-Dose (63739-931-14)",1.65,0.66,,,0 HCPCS,J1644,"Heparin Sodium: 25 Vial, Multi-Dose In 1 Carton (71288-402-11) / 10 Ml In 1 Vial, Multi-Dose (71288-402-10)",0.93,0.37,,,0 HCPCS,J1644,"Heparin Sodium: 25 Vial, Multi-Dose In 1 Tray (0409-2720-02) / 10 Ml In 1 Vial, Multi-Dose (0409-2720-31)",1.55,0.62,,,0 HCPCS,J1644,"Heparin Sodium: 25 Vial, Single-Dose In 1 Carton (71288-403-02) / 1 Ml In 1 Vial, Single-Dose (71288-403-01)",0.78,0.31,,,0 HCPCS,J1644,Heparin Sodium: 30 Pouch In 1 Case (0409-7650-30) / 1 Bag In 1 Pouch / 250 Ml In 1 Bag (0409-7650-05),1.97,0.79,,,0 HCPCS,J1644,Inj heparin sodium per 1000u,,,0.22,0.22,4 HCPCS,J1644,NDC Description Not Available,1.8399999999999999,0.74,,,0 HCPCS,J1645,Dalteparin sodium,,,16.04,16.04,4 HCPCS,J1650,Enoxaparin Sodium: 1 Vial In 1 Carton (0548-5608-00) / 3 Ml In 1 Vial,4.6,1.84,,,0 HCPCS,J1650,"Enoxaparin Sodium: 1 Vial, Multi-Dose In 1 Carton (71288-426-03) / 3 Ml In 1 Vial, Multi-Dose",2.8,1.12,,,0 HCPCS,J1650,Enoxaparin Sodium: 10 Blister Pack In 1 Carton (63323-559-93) / 1 Syringe In 1 Blister Pack (63323-559-21) / .3 Ml In 1 Syringe,4.13,1.65,,,0 HCPCS,J1650,Enoxaparin Sodium: 10 Blister Pack In 1 Carton (63323-584-99) / 1 Syringe In 1 Blister Pack (63323-584-21) / .8 Ml In 1 Syringe,3.63,1.45,,,0 HCPCS,J1650,Enoxaparin Sodium: 10 Syringe In 1 Carton (0548-5602-00) / .4 Ml In 1 Syringe,6.6,2.64,,,0 HCPCS,J1650,Enoxaparin Sodium: 10 Syringe In 1 Carton (0548-5604-00) / .8 Ml In 1 Syringe,6.56,2.62,,,0 HCPCS,J1650,Enoxaparin Sodium: 10 Syringe In 1 Carton (0548-5606-00) / .8 Ml In 1 Syringe,7.03,2.81,,,0 HCPCS,J1650,Enoxaparin Sodium: 10 Syringe In 1 Carton (0781-3246-64) / .4 Ml In 1 Syringe (0781-3246-02),3.26,1.3,,,0 HCPCS,J1650,Enoxaparin Sodium: 10 Syringe In 1 Carton (0781-3268-69) / 1 Ml In 1 Syringe (0781-3268-05),3.59,1.44,,,0 HCPCS,J1650,Enoxaparin Sodium: 10 Syringe In 1 Carton (0781-3298-68) / .8 Ml In 1 Syringe (0781-3298-04),3.59,1.44,,,0 HCPCS,J1650,Enoxaparin Sodium: 10 Syringe In 1 Carton (71288-411-83) / 1 Ml In 1 Syringe (71288-411-82),4.04,1.62,,,0 HCPCS,J1650,Enoxaparin Sodium: 10 Syringe In 1 Carton (71288-432-81) / .3 Ml In 1 Syringe (71288-432-80),2.63,1.05,,,0 HCPCS,J1650,Enoxaparin Sodium: 10 Syringe In 1 Carton (71288-433-83) / .4 Ml In 1 Syringe (71288-433-82),4.12,1.65,,,0 HCPCS,J1650,Enoxaparin Sodium: 10 Syringe In 1 Carton (71288-434-85) / .6 Ml In 1 Syringe (71288-434-84),3.99,1.6,,,0 HCPCS,J1650,Enoxaparin Sodium: 10 Syringe In 1 Carton (71288-435-87) / .8 Ml In 1 Syringe (71288-435-86),3.95,1.58,,,0 HCPCS,J1650,Enoxaparin Sodium: 10 Syringe In 1 Carton (71288-436-89) / 1 Ml In 1 Syringe (71288-436-88),4.17,1.67,,,0 HCPCS,J1650,Enoxaparin Sodium: 10 Syringe In 1 Carton (71288-437-92) / .8 Ml In 1 Syringe (71288-437-91),4.1,1.64,,,0 HCPCS,J1650,Enoxaparin Sodium: 10 Syringe In 1 Carton (71288-438-94) / 1 Ml In 1 Syringe (71288-438-93),2.44,0.98,,,0 HCPCS,J1650,Enoxaparin Sodium: 10 Syringe In 1 Carton (71839-110-10) / .4 Ml In 1 Syringe,2.89,1.16,,,0 HCPCS,J1650,Inj enoxaparin sodium,,,0.52,0.52,4 HCPCS,J1650,Lovenox: 10 Cello Pack In 1 Carton (0075-0622-80) / 1 Syringe In 1 Cello Pack (0075-0622-01) / .8 Ml In 1 Syringe,10.67,4.27,,,0 HCPCS,J1650,NDC Description Not Available,4.04,1.62,,,0 HCPCS,J1652,Fondaparinux Sodium: 2 Syringe In 1 Carton (55111-679-02) / .4 Ml In 1 Syringe (55111-679-11),8.57,3.43,,,0 HCPCS,J1652,Fondaparinux Sodium: 2 Syringe In 1 Carton (55111-680-02) / .6 Ml In 1 Syringe (55111-680-11),16.66,6.66,,,0 HCPCS,J1652,Fondaparinux sodium,,,0.86,0.86,4 HCPCS,J1652,NDC Description Not Available,13.515,5.405,,,0 HCPCS,J1655,Tinzaparin sodium injection,,,0.01,0.01,4 HCPCS,J1670,"Hypertet: 1 Syringe, Glass In 1 Box (13533-634-02) / 1 Ml In 1 Syringe, Glass (13533-634-20)",2856.35,1142.54,,,0 HCPCS,J1670,NDC Description Not Available,2773.12,1109.25,,,0 HCPCS,J1670,Tetanus immune globulin inj,,,575.76,1501.59,9 HCPCS,J1720,Hydrocortisone sodium succ i,,,20.58,20.58,4 HCPCS,J1720,Solu-Cortef: 1 Vial In 1 Carton (0009-0825-01) / 2 Ml In 1 Vial,67.37,26.95,,,0 HCPCS,J1720,"Solu-Cortef: 1 Vial, Single-Dose In 1 Carton (0009-0011-03) / 2 Ml In 1 Vial, Single-Dose",85.85,34.34,,,0 HCPCS,J1720,"Solu-Cortef: 1 Vial, Single-Dose In 1 Carton (0009-0013-05) / 2 Ml In 1 Vial, Single-Dose",67.9,27.16,,,0 HCPCS,J1720,"Solu-Cortef: 25 Vial, Single-Dose In 1 Carton (0009-0011-04) / 2 Ml In 1 Vial, Single-Dose (0009-0011-03)",79.72,31.89,,,0 HCPCS,J1726,"Makena, 10 mg",,,19.65,19.65,4 HCPCS,J1729,Inj hydroxyprogst capoat nos,,,13.64,13.64,4 HCPCS,J1737,Inj meloxicam (azurity) 1mg,,,1.06,2.65,5 HCPCS,J1738,Inj. meloxicam 1 mg,,,3.13,3.13,4 HCPCS,J1740,"Ibandronate Sodium: 1 Syringe, Glass In 1 Carton (55150-191-83) / 3 Ml In 1 Syringe, Glass",358.53,143.41,,,0 HCPCS,J1740,"Ibandronate Sodium: 1 Syringe, Glass In 1 Carton (60505-6097-0) / 3 Ml In 1 Syringe, Glass",1084.88,433.95,,,0 HCPCS,J1740,"Ibandronate Sodium: 1 Syringe, Glass In 1 Carton (67457-524-33) / 3 Ml In 1 Syringe, Glass",332.58,133.03,,,0 HCPCS,J1740,Ibandronate sodium injection,,,22.22,22.22,4 HCPCS,J1741,Ibuprofen Lysine: 3 Vial In 1 Carton (39822-1030-2) / 2 Ml In 1 Vial (39822-1030-1),472.01,188.8,,,0 HCPCS,J1741,Ibuprofen injection,,,2.98,8.17,8 HCPCS,J1741,NDC Description Not Available,403.275,161.31,,,0 HCPCS,J1742,Ibutilide fumarate injection,,,129.36,323.39,9 HCPCS,J1743,"Elaprase: 1 Vial, Glass In 1 Box (54092-700-01) / 3 Ml In 1 Vial, Glass",2313.0,925.2,,,0 HCPCS,J1743,Idursulfase injection,,,542.57,1430.43,9 HCPCS,J1744,Icatibant injection,,,125.32,125.32,4 HCPCS,J1745,Infliximab not biosimil 10mg,,,29.86,74.64,9 HCPCS,J1745,"Infliximab: 1 Vial, Single-Use In 1 Box (57894-160-01) / 10 Ml In 1 Vial, Single-Use",200.83,80.33,,,0 HCPCS,J1745,"Remicade: 1 Vial, Single-Use In 1 Box (57894-030-01) / 10 Ml In 1 Vial, Single-Use",494.73,197.89,,,0 HCPCS,J1746,"Inj., ibalizumab-uiyk, 10 mg",,,76.95,199.99,9 HCPCS,J1747,"Inj, spesolimab-sbzo, 1 mg",,,61.43,164.32,9 HCPCS,J1748,"Inj, zymfentra, 10 mg",,,121.71,267.85,5 HCPCS,J1749,"Inj, iloprost, 0.1 mcg",,,5.5,5.5,4 HCPCS,J1750,Inj iron dextran,,,17.23,47.51,9 HCPCS,J1756,Iron sucrose injection,,,0.24,0.24,4 HCPCS,J1756,NDC Description Not Available,2.145,0.855,,,0 HCPCS,J1756,"Venofer: 10 Vial, Single-Dose In 1 Box (0517-2325-10) / 2.5 Ml In 1 Vial, Single-Dose (0517-2325-01)",2.83,1.13,,,0 HCPCS,J1756,"Venofer: 10 Vial, Single-Dose In 1 Box (0517-2340-10) / 5 Ml In 1 Vial, Single-Dose",2.9,1.16,,,0 HCPCS,J1756,"Venofer: 25 Vial, Single-Dose In 1 Tray (0517-2340-25) / 5 Ml In 1 Vial, Single-Dose",2.92,1.17,,,0 HCPCS,J1756,"Venofer: 5 Vial, Single-Dose In 1 Box (0517-2310-05) / 10 Ml In 1 Vial, Single-Dose (0517-2310-01)",2.86,1.14,,,0 HCPCS,J1786,Imuglucerase injection,,,43.14,108.01,9 HCPCS,J1790,Droperidol injection,,,8.57,8.57,4 HCPCS,J1790,"Droperidol: 25 Vial, Single-Dose In 1 Tray (0517-9702-25) / 2 Ml In 1 Vial, Single-Dose",13.68,5.47,,,0 HCPCS,J1790,NDC Description Not Available,23.155,9.26,,,0 HCPCS,J1800,Propranolol injection,,,9.74,9.74,4 HCPCS,J1800,"Propranolol: 10 Vial, Single-Dose In 1 Tray (63323-604-01) / 1 Ml In 1 Vial, Single-Dose",11.57,4.63,,,0 HCPCS,J1805,Brevibloc: 10 Bag In 1 Carton (10019-075-87) / 100 Ml In 1 Bag,11.31,4.52,,,0 HCPCS,J1805,Esmolol Hydrochloride: 10 Bag In 1 Carton (25021-309-82) / 100 Ml In 1 Bag,3.4,1.36,,,0 HCPCS,J1805,Esmolol Hydrochloride: 10 Pouch In 1 Carton (70121-1717-7) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,1.45,0.58,,,0 HCPCS,J1805,Esmolol Hydrochloride: 10 Vial In 1 Carton (67457-182-10) / 10 Ml In 1 Vial (67457-182-00),3.15,1.26,,,0 HCPCS,J1805,"Esmolol Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-194-10) / 10 Ml In 1 Vial, Single-Dose",1.9,0.76,,,0 HCPCS,J1805,"Inj, esmolol hcl, 10mg",,,0.28,0.28,4 HCPCS,J1805,NDC Description Not Available,3.43,1.37,,,0 HCPCS,J1806,Esmolol Hydrochloride In Water: 10 Bag In 1 Carton (44567-811-10) / 250 Ml In 1 Bag,2.09,0.84,,,0 HCPCS,J1806,Esmolol Hydrochloride: 10 Bag In 1 Carton (44567-451-10) / 100 Ml In 1 Bag (44567-451-01),1.91,0.76,,,0 HCPCS,J1806,Inj esmolol hcl wg crit care,,,0.41,0.41,4 HCPCS,J1806,NDC Description Not Available,2.35,0.94,,,0 HCPCS,J1807,"Inj, ethacrynate sod, 1 mg",,,9.94,24.85,5 HCPCS,J1808,"Folic Acid: 1 Vial, Multi-Dose In 1 Carton (39822-1100-1) / 10 Ml In 1 Vial, Multi-Dose",0.26,0.1,,,0 HCPCS,J1808,"Folic Acid: 1 Vial, Multi-Dose In 1 Carton (63323-184-10) / 10 Ml In 1 Vial, Multi-Dose",0.48,0.19,,,0 HCPCS,J1808,"Inj, folic acid, 0.1 mg",,,0.06,0.06,4 HCPCS,J1809,"Inj, fosdenopterin, 0.1mg",,,17.74,44.34,5 HCPCS,J1811,Fiasp for insulin pump use,,,6.67,6.67,4 HCPCS,J1812,Inj. Insulin (fiasp),,,1.45,1.45,4 HCPCS,J1813,Lyumjev for insulin pump use,,,15.33,15.33,4 HCPCS,J1814,Inj. insulin (lyumjev),,,1.37,1.37,4 HCPCS,J1815,"1 VIAL, MULTI-DOSE in 1 CARTON (0002-8715-17) / 3 mL in 1 VIAL, MULTI-DOSE",0.37,0.15,,,0 HCPCS,J1815,Admelog: 1 Vial In 1 Carton (0024-5926-05) / 3 Ml In 1 Vial,0.88,0.35,,,0 HCPCS,J1815,Humalog Kwikpen: 2 Syringe In 1 Carton (0002-7712-27) / 3 Ml In 1 Syringe (0002-7712-01),7.78,3.11,,,0 HCPCS,J1815,Humalog: 1 Vial In 1 Carton (0002-7510-01) / 10 Ml In 1 Vial,1.11,0.44,,,0 HCPCS,J1815,Humalog: 1 Vial In 1 Carton (0002-7510-17) / 3 Ml In 1 Vial,0.63,0.255,,,0 HCPCS,J1815,Humalog: 1 Vial In 1 Carton (0002-7533-01) / 3 Ml In 1 Vial,0.85,0.34,,,0 HCPCS,J1815,"Humulin 70/30: 1 Vial, Multi-Dose In 1 Carton (0002-8715-01) / 10 Ml In 1 Vial, Multi-Dose",0.685,0.275,,,0 HCPCS,J1815,"Humulin N: 1 Vial, Multi-Dose In 1 Carton (0002-8315-01) / 10 Ml In 1 Vial, Multi-Dose",0.585,0.235,,,0 HCPCS,J1815,"Humulin R U-500: 1 Vial, Multi-Dose In 1 Carton (0002-8501-01) / 20 Ml In 1 Vial, Multi-Dose",3.33,1.33,,,0 HCPCS,J1815,"Humulin R: 1 Vial, Multi-Dose In 1 Carton (0002-0213-01) / 3 Ml In 1 Vial, Multi-Dose",0.62,0.245,,,0 HCPCS,J1815,"Humulin R: 1 Vial, Multi-Dose In 1 Carton (0002-8215-01) / 10 Ml In 1 Vial, Multi-Dose",0.31,0.12,,,0 HCPCS,J1815,"Humulin R: 1 Vial, Multi-Dose In 1 Carton (0002-8215-17) / 3 Ml In 1 Vial, Multi-Dose",0.395,0.16,,,0 HCPCS,J1815,"Insulin Glargine: 1 Vial, Glass In 1 Carton (0955-1729-01) / 10 Ml In 1 Vial, Glass",1.49,0.6,,,0 HCPCS,J1815,"Insulin Glargine: 1 Vial, Multi-Dose In 1 Carton (49502-393-80) / 10 Ml In 1 Vial, Multi-Dose",1.33,0.53,,,0 HCPCS,J1815,"Insulin Glargine: 1 Vial, Multi-Dose In 1 Carton (83257-014-11) / 10 Ml In 1 Vial, Multi-Dose",1.26,0.5,,,0 HCPCS,J1815,Insulin injection,,,0.22,0.22,4 HCPCS,J1815,"Lantus: 1 Vial, Glass In 1 Carton (0088-2220-33) / 10 Ml In 1 Vial, Glass",1.35,0.54,,,0 HCPCS,J1815,Myxredlin: 12 Container In 1 Carton (0338-0126-12) / 100 Ml In 1 Container,4.52,1.81,,,0 HCPCS,J1815,NDC Description Not Available,1.45,0.58,,,0 HCPCS,J1815,Novolin 70/30: 1 Vial In 1 Carton (0169-1837-11) / 10 Ml In 1 Vial,0.59,0.24,,,0 HCPCS,J1815,"Novolin 70/30: 5 Syringe, Plastic In 1 Carton (0169-3007-15) / 3 Ml In 1 Syringe, Plastic (0169-3007-01)",1.31,0.52,,,0 HCPCS,J1815,Novolin N: 1 Vial In 1 Carton (0169-1834-11) / 10 Ml In 1 Vial,0.91,0.36,,,0 HCPCS,J1815,Novolin R: 1 Vial In 1 Carton (0169-1833-11) / 10 Ml In 1 Vial,0.2,0.08,,,0 HCPCS,J1815,"Semglee: 1 Vial, Multi-Dose In 1 Carton (49502-250-80) / 10 Ml In 1 Vial, Multi-Dose",5.41,2.16,,,0 HCPCS,J1815,"Semglee: 1 Vial, Multi-Dose In 1 Carton (83257-011-11) / 10 Ml In 1 Vial, Multi-Dose",5.29,2.12,,,0 HCPCS,J1817,Admelog: 1 Vial In 1 Carton (0024-5926-05) / 3 Ml In 1 Vial,2.79,1.12,,,0 HCPCS,J1817,Insulin for insulin pump use,,,2.49,2.49,4 HCPCS,J1817,"Novolog: 1 Vial, Glass In 1 Carton (0169-7501-11) / 10 Ml In 1 Vial, Glass",16.23,6.495,,,0 HCPCS,J1823,"Inj. inebilizumab-cdon, 1 mg",,,484.4,1278.93,9 HCPCS,J1823,"Uplizna: 3 Vial, Single-Dose In 1 Carton (75987-150-03) / 10 Ml In 1 Vial, Single-Dose (75987-150-01)",2047.18,818.87,,,0 HCPCS,J1826,Interferon Beta-1A inj,,,2159.45,2159.45,4 HCPCS,J1830,Interferon beta-1b / .25 MG,,,710.56,710.56,4 HCPCS,J1833,"Cresemba: 1 Vial, Single-Dose In 1 Carton (0469-0420-01) / 5 Ml In 1 Vial, Single-Dose",4.52,1.81,,,0 HCPCS,J1833,"Cresemba: 10 Carton In 1 Carton (0469-0420-99) / 1 Vial, Single-Dose In 1 Carton (0469-0420-01) / 5 Ml In 1 Vial, Single-Dose",4.43,1.77,,,0 HCPCS,J1833,"Injection, isavuconazonium",,,1.04,2.59,9 HCPCS,J1834,"Inj, isoniazid, 1 mg",,,0.3,0.76,5 HCPCS,J1835,Itraconazole injection,,,0.01,0.01,4 HCPCS,J1836,"Inj, metronidazole, 10 mg",,,0.03,0.03,4 HCPCS,J1836,Metronidazole: 1 Bag In 1 Pouch (47335-993-01) / 100 Ml In 1 Bag,0.24,0.1,,,0 HCPCS,J1836,Metronidazole: 24 Bag In 1 Carton (0338-1055-48) / 100 Ml In 1 Bag,0.17,0.07,,,0 HCPCS,J1836,Metronidazole: 24 Pouch In 1 Carton (0409-0152-24) / 1 Bag In 1 Pouch (0409-0152-01) / 100 Ml In 1 Bag,0.14,0.06,,,0 HCPCS,J1836,Metronidazole: 24 Pouch In 1 Carton (25021-131-82) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,0.18,0.07,,,0 HCPCS,J1836,NDC Description Not Available,0.14,0.06,,,0 HCPCS,J1837,"Inj, posaconazole, 1 mg",,,0.38,0.96,5 HCPCS,J1885,Ketorolac Tromethamine: 10 Vial In 1 Carton (0338-0069-10) / 1 Ml In 1 Vial,3.1,1.24,,,0 HCPCS,J1885,"Ketorolac Tromethamine: 24 Blister Pack In 1 Carton (76045-104-10) / 1 Syringe, Glass In 1 Blister Pack / 1 Ml In 1 Syringe, Glass",3.94,1.58,,,0 HCPCS,J1885,"Ketorolac Tromethamine: 24 Blister Pack In 1 Carton (76045-105-20) / 1 Syringe, Glass In 1 Blister Pack / 2 Ml In 1 Syringe, Glass",2.18,0.87,,,0 HCPCS,J1885,"Ketorolac Tromethamine: 24 Blister Pack In 1 Carton (76045-209-10) / 1 Syringe, Glass In 1 Blister Pack (76045-209-00) / 1 Ml In 1 Syringe, Glass",5.14,2.06,,,0 HCPCS,J1885,Ketorolac Tromethamine: 25 VIAL in 1 CARTON (70860-700-02) / 1 mL in 1 VIAL (70860-700-41),7.76,3.1,,,0 HCPCS,J1885,Ketorolac Tromethamine: 25 Vial In 1 Carton (0338-0072-25) / 1 Ml In 1 Vial,2.42,0.97,,,0 HCPCS,J1885,Ketorolac Tromethamine: 25 Vial In 1 Carton (70860-701-03) / 1 Ml In 1 Vial (70860-701-41),4.1,1.64,,,0 HCPCS,J1885,Ketorolac Tromethamine: 25 Vial In 1 Carton (72266-118-25) / 1 Ml In 1 Vial (72266-118-01),7.81,3.12,,,0 HCPCS,J1885,Ketorolac Tromethamine: 25 Vial In 1 Carton (72266-119-25) / 2 Ml In 1 Vial (72266-119-01),0.55,0.22,,,0 HCPCS,J1885,Ketorolac Tromethamine: 25 Vial In 1 Carton (72266-234-25) / 1 Ml In 1 Vial (72266-234-01),5.99,2.4,,,0 HCPCS,J1885,"Ketorolac Tromethamine: 25 Vial, Single-Dose In 1 Carton (68462-755-25) / 1 Ml In 1 Vial, Single-Dose (68462-755-01)",3.36,1.34,,,0 HCPCS,J1885,"Ketorolac Tromethamine: 25 Vial, Single-Dose In 1 Carton (72611-722-25) / 1 Ml In 1 Vial, Single-Dose (72611-722-01)",1.79,0.72,,,0 HCPCS,J1885,"Ketorolac Tromethamine: 25 Vial, Single-Dose In 1 Tray (0409-3793-01) / 1 Ml In 1 Vial, Single-Dose (0409-3793-19)",12.04,4.82,,,0 HCPCS,J1885,"Ketorolac Tromethamine: 25 Vial, Single-Use In 1 Tray (63323-161-01) / 1 Ml In 1 Vial, Single-Use (63323-161-00)",2.7,1.08,,,0 HCPCS,J1885,"Ketorolac Tromethamine: 25 Vial, Single-Use In 1 Tray (63323-162-01) / 1 Ml In 1 Vial, Single-Use (63323-162-00)",12.8,5.12,,,0 HCPCS,J1885,"Ketorolac Tromethamine: 25 Vial, Single-Use In 1 Tray (63323-162-02) / 2 Ml In 1 Vial, Single-Use (63323-162-03)",0.92,0.37,,,0 HCPCS,J1885,Ketorolac tromethamine inj,,,0.4,1.42,9 HCPCS,J1885,NDC Description Not Available,6.52,2.69,,,0 HCPCS,J1920,"Inj, labetalol hcl, 5mg",,,0.42,0.42,4 HCPCS,J1920,Labetalol Hydrochloride: 1 Vial In 1 Carton (36000-322-02) / 20 Ml In 1 Vial (36000-322-01),0.47,0.19,,,0 HCPCS,J1920,"Labetalol Hydrochloride: 1 Vial, Multi-Dose In 1 Carton (72266-102-01) / 20 Ml In 1 Vial, Multi-Dose",0.54,0.22,,,0 HCPCS,J1920,"Labetalol Hydrochloride: 1 Vial, Multi-Dose In 1 Carton (72266-103-01) / 40 Ml In 1 Vial, Multi-Dose",0.59,0.24,,,0 HCPCS,J1920,Labetalol Hydrochloride: 10 Carton In 1 Package (0409-2339-34) / 1 Cartridge In 1 Carton / 4 Ml In 1 Cartridge (0409-2339-24),9.96,3.98,,,0 HCPCS,J1920,Labetalol Hydrochloride: 10 Vial In 1 Carton (36000-320-10) / 4 Ml In 1 Vial (36000-320-01),3.66,1.46,,,0 HCPCS,J1920,NDC Description Not Available,7.96,3.18,,,0 HCPCS,J1921,"Inj labetalol hcl hikma, 5mg",,,1.38,1.38,4 HCPCS,J1930,Lanreotide injection,,,39.55,104.22,9 HCPCS,J1930,Somatuline Depot: 1 Pouch In 1 Carton (15054-1120-4) / 1 Syringe In 1 Pouch / .5 Ml In 1 Syringe,341.36,136.54,,,0 HCPCS,J1931,Laronidase injection,,,38.61,103.74,9 HCPCS,J1932,"Inj, lanreotide, (cipla) 1mg",,,20.33,50.82,9 HCPCS,J1932,Lanreotide Acetate: 1 Syringe In 1 Carton (69097-870-67) / .5 Ml In 1 Syringe,219.08,87.63,,,0 HCPCS,J1938,Furosemide: 25 Vial In 1 Tray (63323-280-02) / 2 Ml In 1 Vial (63323-280-01),1.89,0.76,,,0 HCPCS,J1938,"Furosemide: 25 Vial, Single-Dose In 1 Box (36000-283-25) / 4 Ml In 1 Vial, Single-Dose",0.17,0.07,,,0 HCPCS,J1938,"Furosemide: 25 Vial, Single-Dose In 1 Tray (0409-6102-02) / 2 Ml In 1 Vial, Single-Dose (0409-6102-19)",4.3,1.72,,,0 HCPCS,J1938,"Furosemide: 25 Vial, Single-Dose In 1 Tray (0409-6102-04) / 4 Ml In 1 Vial, Single-Dose (0409-6102-18)",2.23,0.89,,,0 HCPCS,J1938,"Inj, furosemide, 1 mg",,,0.02,0.02,4 HCPCS,J1938,NDC Description Not Available,0.39,0.16,,,0 HCPCS,J1939,Bumetanide: 10 VIAL in 1 BOX (0409-1412-04) / 4 mL in 1 VIAL (0409-1412-34),4.3,1.72,,,0 HCPCS,J1939,Bumetanide: 10 Vial In 1 Carton (0641-6007-10) / 10 Ml In 1 Vial (0641-6007-01),2.95,1.18,,,0 HCPCS,J1939,Bumetanide: 10 Vial In 1 Carton (0641-6008-10) / 4 Ml In 1 Vial (0641-6008-01),6.7,2.68,,,0 HCPCS,J1939,Bumetanide: 10 Vial In 1 Carton (25021-321-04) / 4 Ml In 1 Vial,5.61,2.24,,,0 HCPCS,J1939,Bumetanide: 10 Vial In 1 Carton (25021-321-10) / 10 Ml In 1 Vial,1.64,0.66,,,0 HCPCS,J1939,Bumetanide: 10 Vial In 1 Carton (72205-101-07) / 4 Ml In 1 Vial (72205-101-01),4.54,1.82,,,0 HCPCS,J1939,"Bumetanide: 10 Vial, Single-Dose In 1 Carton (68462-469-54) / 4 Ml In 1 Vial, Single-Dose (68462-469-40)",3.46,1.38,,,0 HCPCS,J1939,"Inj, bumetanide, 0.5 mg",,,0.57,0.57,4 HCPCS,J1939,NDC Description Not Available,5.095,2.04,,,0 HCPCS,J1940,Furosemide: 25 Vial In 1 Carton (25021-311-02) / 2 Ml In 1 Vial,3.23,1.29,,,0 HCPCS,J1940,Furosemide: 25 Vial In 1 Carton (25021-311-04) / 4 Ml In 1 Vial,2.19,0.88,,,0 HCPCS,J1940,Furosemide: 25 Vial In 1 Carton (25021-311-10) / 10 Ml In 1 Vial,1.32,0.53,,,0 HCPCS,J1940,"Furosemide: 25 Vial, Single-Dose In 1 Box (36000-284-25) / 10 Ml In 1 Vial, Single-Dose",1.53,0.61,,,0 HCPCS,J1940,"Furosemide: 25 Vial, Single-Dose In 1 Carton (71288-203-05) / 4 Ml In 1 Vial, Single-Dose (71288-203-04)",4.23,1.69,,,0 HCPCS,J1940,"Furosemide: 25 Vial, Single-Dose In 1 Carton (71288-203-11) / 10 Ml In 1 Vial, Single-Dose (71288-203-10)",1.21,0.48,,,0 HCPCS,J1940,"Furosemide: 25 Vial, Single-Dose In 1 Tray (0409-6102-10) / 10 Ml In 1 Vial, Single-Dose (0409-6102-20)",0.88,0.35,,,0 HCPCS,J1940,"Furosemide: 25 Vial, Single-Dose In 1 Tray (0409-6102-26) / 4 Ml In 1 Vial, Single-Dose (0409-6102-36)",1.56,0.62,,,0 HCPCS,J1940,NDC Description Not Available,2.9299999999999997,1.175,,,0 HCPCS,J1941,"Inj, furoscix, 20 mg",,,236.86,236.86,4 HCPCS,J1943,Aristada Initio: 1 Syringe In 1 Carton (65757-500-03) / 2.4 Ml In 1 Syringe,15.1,6.04,,,0 HCPCS,J1943,"Inj., aristada initio, 1 mg",,,3.14,8.65,9 HCPCS,J1944,Aripirazole lauroxil 1 mg,,,3.26,8.88,9 HCPCS,J1944,Aristada: 1 Syringe In 1 Carton (65757-401-03) / 1.6 Ml In 1 Syringe,15.74,6.3,,,0 HCPCS,J1945,Lepirudin,,,0.01,0.01,4 HCPCS,J1950,Leuprolide acetate /3.75 mg,,,1670.3,4497.63,9 HCPCS,J1950,Lupron Depot: 1 Kit In 1 Carton (0074-3641-03) * 1 Ml In 1 Syringe * 1 Ml In 1 Packet,7776.15,3110.46,,,0 HCPCS,J1950,Lupron Depot: 1 Kit In 1 Carton (0074-3663-03) * 1.5 Ml In 1 Syringe * 1 Ml In 1 Packet,6913.06,2765.22,,,0 HCPCS,J1951,Fensolvi: 1 Syringe In 1 Carton (62935-163-60) / .375 Ml In 1 Syringe,82.93,33.17,,,0 HCPCS,J1951,Inj fensolvi 0.25 mg,,,134.26,354.24,9 HCPCS,J1952,"Leuprolide inj, camcevi, 1mg",,,36.37,90.93,9 HCPCS,J1953,Levetiracetam injection,,,0.05,0.05,4 HCPCS,J1953,Levetiracetam: 10 Bag In 1 Carton (43598-637-10) / 100 Ml In 1 Bag (43598-637-52),0.42,0.17,,,0 HCPCS,J1953,Levetiracetam: 10 Bag In 1 Carton (44567-502-10) / 100 Ml In 1 Bag (44567-502-01),0.48,0.19,,,0 HCPCS,J1953,"Levetiracetam: 10 Vial, Single-Dose In 1 Carton (55150-177-05) / 5 Ml In 1 Vial, Single-Dose",0.11,0.04,,,0 HCPCS,J1953,"Levetiracetam: 10 Vial, Single-Dose In 1 Carton (72485-106-10) / 5 Ml In 1 Vial, Single-Dose (72485-106-01)",0.18,0.07,,,0 HCPCS,J1953,"Levetiracetam: 10 Vial, Single-Use In 1 Carton (51224-013-10) / 5 Ml In 1 Vial, Single-Use",0.23,0.09,,,0 HCPCS,J1953,"Levetiracetam: 10 Vial, Single-Use In 1 Carton (68094-313-10) / 5 Ml In 1 Vial, Single-Use",0.26,0.1,,,0 HCPCS,J1953,"Levetiracetam: 10 Vial, Single-Use In 1 Tray (63323-400-05) / 5 Ml In 1 Vial, Single-Use (63323-400-01)",0.31,0.12,,,0 HCPCS,J1953,Levetiracetam: 24 Container In 1 Case (0264-1009-90) / 100 Ml In 1 Container,0.48,0.19,,,0 HCPCS,J1953,Levetiracetam: 24 Container In 1 Case (0264-1509-90) / 100 Ml In 1 Container,0.4,0.16,,,0 HCPCS,J1953,"Levetiracetam: 25 Vial, Single-Dose In 1 Carton (0409-1886-02) / 5 Ml In 1 Vial, Single-Dose (0409-1886-22)",0.35,0.14,,,0 HCPCS,J1953,"Levetiracetam: 25 Vial, Single-Use In 1 Carton (51224-013-25) / 5 Ml In 1 Vial, Single-Use",0.28,0.11,,,0 HCPCS,J1953,NDC Description Not Available,0.46,0.16999999999999998,,,0 HCPCS,J1954,Leuprolide depot cipla 7.5mg,,,220.74,1709.65,9 HCPCS,J1955,Carnitor: 5 Vial In 1 Carton (54482-147-01) / 5 Ml In 1 Vial,8.08,3.23,,,0 HCPCS,J1955,Inj levocarnitine per 1 gm,,,24.38,24.38,4 HCPCS,J1955,NDC Description Not Available,56.185,22.47,,,0 HCPCS,J1956,Levofloxacin injection,,,1.03,1.03,4 HCPCS,J1956,Levofloxacin: 24 Bag In 1 Carton (0143-9317-24) / 150 Ml In 1 Bag (0143-9317-01),2.99,1.2,,,0 HCPCS,J1956,Levofloxacin: 24 Bag In 1 Carton (0143-9720-24) / 150 Ml In 1 Bag (0143-9720-01),4.46,1.78,,,0 HCPCS,J1956,Levofloxacin: 24 Bag In 1 Carton (0143-9721-24) / 100 Ml In 1 Bag (0143-9721-01),5.62,2.25,,,0 HCPCS,J1956,Levofloxacin: 24 Bag In 1 Carton (0143-9722-24) / 50 Ml In 1 Bag (0143-9722-01),6.44,2.58,,,0 HCPCS,J1956,Levofloxacin: 24 Pouch In 1 Carton (25021-132-82) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,4.6,1.84,,,0 HCPCS,J1956,Levofloxacin: 24 Pouch In 1 Carton (25021-132-83) / 1 Bag In 1 Pouch / 150 Ml In 1 Bag,10.86,4.34,,,0 HCPCS,J1956,Levofloxacin: 24 Pouch In 1 Carton (44567-436-24) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,5.38,2.15,,,0 HCPCS,J1956,Levofloxacin: 24 Pouch In 1 Carton (44567-437-24) / 1 Bag In 1 Pouch / 150 Ml In 1 Bag,4.52,1.81,,,0 HCPCS,J1956,Levofloxacin: 50 Ml In 1 Bag (36000-046-24),9.66,3.86,,,0 HCPCS,J1956,NDC Description Not Available,7.53,3.01,,,0 HCPCS,J1960,Levorphanol tartrate inj,,,0.01,0.01,4 HCPCS,J1961,"Inj, lenacapavir, 1 mg",,,22.03,57.34,9 HCPCS,J1980,Hyoscyamine sulfate inj,,,54.0,54.0,4 HCPCS,J1990,Chlordiazepoxide injection,,,0.01,0.01,4 HCPCS,J2001,Lidocaine Hydrochloride: 10 Carton In 1 Container (0409-4903-34) / 1 Syringe In 1 Carton / 5 Ml In 1 Syringe (0409-4903-11),0.36,0.14,,,0 HCPCS,J2001,Lidocaine Hydrochloride: 10 Syringe In 1 Package (76329-3390-1) / 5 Ml In 1 Syringe,0.54,0.22,,,0 HCPCS,J2001,"Lidocaine Hydrochloride: 10 Vial, Single-Dose In 1 Carton (55150-162-05) / 5 Ml In 1 Vial, Single-Dose",0.97,0.39,,,0 HCPCS,J2001,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Tray (0409-4277-01) / 20 Ml In 1 Vial, Multi-Dose (0409-4277-16)",0.02,0.01,,,0 HCPCS,J2001,"Lidocaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (0143-9595-25) / 5 Ml In 1 Vial, Single-Dose (0143-9595-01)",11.29,4.52,,,0 HCPCS,J2001,"Lidocaine: 25 Vial, Single-Dose In 1 Tray (63323-208-05) / 5 Ml In 1 Vial, Single-Dose (63323-208-01)",0.9,0.36,,,0 HCPCS,J2001,NDC Description Not Available,0.5499999999999999,0.22,,,0 HCPCS,J2001,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Carton (63323-492-27) / 2 Ml In 1 Vial, Single-Dose (63323-492-04)",7.75,3.1,,,0 HCPCS,J2001,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Carton (63323-495-07) / 5 Ml In 1 Vial, Single-Dose (63323-495-04)",0.91,0.36,,,0 HCPCS,J2001,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-492-37) / 30 Ml In 1 Vial, Single-Dose (63323-492-07)",7.62,3.05,,,0 HCPCS,J2002,"Inj, lidocaine in d5w, 1 mg",,,0.01,0.01,4 HCPCS,J2002,Lidocaine Hydrochloride And Dextrose: 24 Bag In 1 Carton (0338-0411-02) / 250 Ml In 1 Bag,0.02,0.01,,,0 HCPCS,J2002,Lidocaine Hydrochloride And Dextrose: 24 Container In 1 Case (0264-9598-20) / 250 Ml In 1 Container,0.01,0.004,,,0 HCPCS,J2003,"Inj, lidocaine hcl, 1 mg",,,0.01,0.01,4 HCPCS,J2003,Lidocaine Hydrochloride And Epinephrine: 10 Ampule In 1 Tray (0409-1209-01) / 5 Ml In 1 Ampule (0409-1209-10),0.2,0.08,,,0 HCPCS,J2003,"Lidocaine Hydrochloride And Epinephrine: 25 Vial, Multi-Dose In 1 Tray (0409-3177-01) / 50 Ml In 1 Vial, Multi-Dose (0409-3177-16)",0.04,0.02,,,0 HCPCS,J2003,"Lidocaine Hydrochloride And Epinephrine: 25 Vial, Multi-Dose In 1 Tray (0409-3178-02) / 30 Ml In 1 Vial, Multi-Dose (0409-3178-17)",0.05,0.02,,,0 HCPCS,J2003,"Lidocaine Hydrochloride And Epinephrine: 25 Vial, Multi-Dose In 1 Tray (0409-3178-03) / 50 Ml In 1 Vial, Multi-Dose (0409-3178-18)",0.07,0.03,,,0 HCPCS,J2003,"Lidocaine Hydrochloride And Epinephrine: 25 Vial, Multi-Dose In 1 Tray (0409-3182-02) / 30 Ml In 1 Vial, Multi-Dose (0409-3182-21)",0.03,0.01,,,0 HCPCS,J2003,Lidocaine Hydrochloride: 1 Vial In 1 Carton (70756-645-86) / 10 Ml In 1 Vial,0.07,0.03,,,0 HCPCS,J2003,Lidocaine Hydrochloride: 10 Ampule In 1 Carton (83090-007-10) / 5 Ml In 1 Ampule (83090-007-01),0.2,0.08,,,0 HCPCS,J2003,"Lidocaine Hydrochloride: 10 Carton In 1 Container (0409-1323-05) / 1 Syringe, Plastic In 1 Carton / 5 Ml In 1 Syringe, Plastic (0409-1323-15)",0.27,0.11,,,0 HCPCS,J2003,Lidocaine Hydrochloride: 10 Vial In 1 Box (71351-021-10) / 5 Ml In 1 Vial (71351-021-05),0.18,0.07,,,0 HCPCS,J2003,"Lidocaine Hydrochloride: 10 Vial, Multi-Dose In 1 Carton (31722-116-34) / 50 Ml In 1 Vial, Multi-Dose (31722-116-50)",0.03,0.01,,,0 HCPCS,J2003,"Lidocaine Hydrochloride: 10 Vial, Single-Dose In 1 Carton (0409-2066-05) / 5 Ml In 1 Vial, Single-Dose (0409-2066-10)",0.05,0.02,,,0 HCPCS,J2003,"Lidocaine Hydrochloride: 10 Vial, Single-Dose In 1 Carton (55150-162-05) / 5 Ml In 1 Vial, Single-Dose",0.1,0.04,,,0 HCPCS,J2003,"Lidocaine Hydrochloride: 10 Vial, Single-Dose In 1 Carton (55150-165-05) / 5 Ml In 1 Vial, Single-Dose",0.04,0.02,,,0 HCPCS,J2003,Lidocaine Hydrochloride: 25 Ampule In 1 Carton (0409-4282-02) / 10 Ml In 1 Ampule (0409-4282-12),0.05,0.02,,,0 HCPCS,J2003,Lidocaine Hydrochloride: 25 Ampule In 1 Carton (0409-4776-01) / 20 Ml In 1 Ampule (0409-4776-10),0.15,0.06,,,0 HCPCS,J2003,Lidocaine Hydrochloride: 25 Ampule In 1 Carton (65282-1605-1) / 5 Ml In 1 Ampule,0.32,0.13,,,0 HCPCS,J2003,Lidocaine Hydrochloride: 25 Vial In 1 Carton (70756-641-25) / 5 Ml In 1 Vial,0.12,0.05,,,0 HCPCS,J2003,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (55150-251-10) / 10 Ml In 1 Vial, Multi-Dose",0.05,0.02,,,0 HCPCS,J2003,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (55150-252-20) / 20 Ml In 1 Vial, Multi-Dose",0.02,0.01,,,0 HCPCS,J2003,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (55150-253-50) / 50 Ml In 1 Vial, Multi-Dose",0.05,0.02,,,0 HCPCS,J2003,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (55150-254-10) / 10 Ml In 1 Vial, Multi-Dose",0.02,0.01,,,0 HCPCS,J2003,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (55150-255-20) / 20 Ml In 1 Vial, Multi-Dose",0.01,0.004,,,0 HCPCS,J2003,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Tray (0409-4276-01) / 20 Ml In 1 Vial, Multi-Dose (0409-4276-16)",0.02,0.01,,,0 HCPCS,J2003,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Tray (0409-4276-02) / 50 Ml In 1 Vial, Multi-Dose (0409-4276-17)",0.04,0.02,,,0 HCPCS,J2003,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Tray (0409-4277-02) / 50 Ml In 1 Vial, Multi-Dose (0409-4277-17)",0.02,0.01,,,0 HCPCS,J2003,"Lidocaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (0143-9595-25) / 5 Ml In 1 Vial, Single-Dose (0143-9595-01)",0.14,0.06,,,0 HCPCS,J2003,"Lidocaine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-4279-02) / 30 Ml In 1 Vial, Single-Dose (0409-4279-16)",0.02,0.01,,,0 HCPCS,J2003,Lidocaine Hydrochloride: 5 Cello Pack In 1 Package (0409-4282-01) / 5 Ampule In 1 Cello Pack (0409-4282-25) / 2 Ml In 1 Ampule (0409-4282-11),0.1,0.04,,,0 HCPCS,J2003,Lidocaine Hydrochloride: 5 Cello Pack In 1 Package (0409-4283-01) / 5 Ampule In 1 Cello Pack (0409-4283-25) / 5 Ml In 1 Ampule (0409-4283-11),0.07,0.03,,,0 HCPCS,J2003,Lidocaine: 25 Vial In 1 Tray (63323-201-10) / 10 Ml In 1 Vial (63323-201-03),0.06,0.02,,,0 HCPCS,J2003,Lidocaine: 25 Vial In 1 Tray (63323-202-02) / 2 Ml In 1 Vial (63323-202-01),0.26,0.1,,,0 HCPCS,J2003,NDC Description Not Available,0.155,0.08499999999999999,,,0 HCPCS,J2003,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Carton (63323-492-27) / 2 Ml In 1 Vial, Single-Dose (63323-492-04)",0.41,0.16,,,0 HCPCS,J2003,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Carton (63323-492-57) / 5 Ml In 1 Vial, Single-Dose (63323-492-09)",0.35,0.14,,,0 HCPCS,J2003,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Carton (63323-495-07) / 5 Ml In 1 Vial, Single-Dose (63323-495-04)",0.09,0.04,,,0 HCPCS,J2003,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-487-17) / 10 Ml In 1 Vial, Single-Dose (63323-487-01)",0.37,0.15,,,0 HCPCS,J2003,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-489-17) / 10 Ml In 1 Vial, Single-Dose (63323-489-01)",0.26,0.1,,,0 HCPCS,J2003,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-489-27) / 20 Ml In 1 Vial, Single-Dose (63323-489-02)",0.19,0.08,,,0 HCPCS,J2003,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-492-37) / 30 Ml In 1 Vial, Single-Dose (63323-492-07)",0.16,0.06,,,0 HCPCS,J2003,Xylocaine Mpf: 5 Ampule In 1 Box (63323-492-97) / 10 Ml In 1 Ampule (63323-492-08),0.25,0.1,,,0 HCPCS,J2003,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-482-17) / 10 Ml In 1 Vial, Multi-Dose (63323-482-01)",0.15,0.06,,,0 HCPCS,J2003,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-482-27) / 20 Ml In 1 Vial, Multi-Dose (63323-482-03)",0.09,0.04,,,0 HCPCS,J2003,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-484-57) / 50 Ml In 1 Vial, Multi-Dose",0.1,0.04,,,0 HCPCS,J2003,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-485-27) / 20 Ml In 1 Vial, Multi-Dose (63323-485-01)",0.04,0.02,,,0 HCPCS,J2003,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-486-17) / 10 Ml In 1 Vial, Multi-Dose (63323-486-01)",0.08,0.03,,,0 HCPCS,J2003,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-486-27) / 20 Ml In 1 Vial, Multi-Dose (63323-486-02)",0.04,0.02,,,0 HCPCS,J2003,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-486-57) / 50 Ml In 1 Vial, Multi-Dose (63323-486-05)",0.02,0.01,,,0 HCPCS,J2004,"Inj, lidocaine w epinephrine",,,0.01,0.01,4 HCPCS,J2004,"Lidocaine Hydrochloride And Epinephrine: 5 Vial, Single-Dose In 1 Carton (0409-3183-01) / 20 Ml In 1 Vial, Single-Dose (0409-3183-11)",0.03,0.01,,,0 HCPCS,J2004,NDC Description Not Available,0.16999999999999998,0.07,,,0 HCPCS,J2004,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-487-37) / 30 Ml In 1 Vial, Single-Dose (63323-487-07)",0.17,0.07,,,0 HCPCS,J2004,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-488-37) / 30 Ml In 1 Vial, Single-Dose (63323-488-07)",0.15,0.06,,,0 HCPCS,J2004,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-482-26) / 20 Ml In 1 Vial, Multi-Dose (63323-482-41)",0.04,0.02,,,0 HCPCS,J2010,Lincomycin injection,,,6.24,6.24,4 HCPCS,J2020,Linezolid injection,,,3.47,3.47,4 HCPCS,J2020,Linezolid: 10 Bag In 1 Box (57664-683-57) / 300 Ml In 1 Bag (57664-683-31),38.98,15.59,,,0 HCPCS,J2020,Linezolid: 10 Bag In 1 Carton (66794-219-43) / 300 Ml In 1 Bag (66794-219-63),11.5,4.6,,,0 HCPCS,J2020,Linezolid: 10 Bag In 1 Case (63323-713-13) / 300 Ml In 1 Bag (63323-713-03),15.18,6.07,,,0 HCPCS,J2020,Linezolid: 10 Pouch In 1 Carton (55150-242-51) / 1 Bag In 1 Pouch / 300 Ml In 1 Bag,24.48,9.79,,,0 HCPCS,J2020,NDC Description Not Available,32.92,13.17,,,0 HCPCS,J2020,Zyvox: 10 Bag In 1 Box (0009-5140-04) / 300 Ml In 1 Bag (0009-5140-01),31.74,12.7,,,0 HCPCS,J2021,"Inj, linezolid (hospira)",,,6.34,6.34,4 HCPCS,J2060,Ativan: 25 Vial In 1 Carton (0641-6001-25) / 1 Ml In 1 Vial (0641-6001-01),8.16,3.26,,,0 HCPCS,J2060,Lorazepam injection,,,1.57,1.57,4 HCPCS,J2060,Lorazepam: 25 Vial In 1 Carton (0641-6044-25) / 1 Ml In 1 Vial (0641-6044-01),6.96,2.78,,,0 HCPCS,J2060,NDC Description Not Available,4.76,1.9,,,0 HCPCS,J2062,Loxapine for inhalation 1 mg,,,15.0,19.4,5 HCPCS,J2150,Mannitol injection,,,2.26,2.26,4 HCPCS,J2150,"Mannitol: 25 Vial, Single-Dose In 1 Tray (0409-4031-01) / 50 Ml In 1 Vial, Single-Dose (0409-4031-16)",27.39,10.96,,,0 HCPCS,J2150,"Mannitol: 25 Vial, Single-Dose In 1 Tray (63323-024-25) / 50 Ml In 1 Vial, Single-Dose (63323-024-01)",23.74,9.5,,,0 HCPCS,J2150,NDC Description Not Available,27.115000000000002,10.844999999999999,,,0 HCPCS,J2170,Mecasermin injection,,,367.63,367.63,4 HCPCS,J2175,Meperidine Hydrochloride: 25 Vial In 1 Carton (0641-6052-25) / 1 Ml In 1 Vial (0641-6052-01),4.9,1.96,,,0 HCPCS,J2175,Meperidine hydrochl /100 MG,,,10.14,10.14,4 HCPCS,J2175,NDC Description Not Available,16.575,6.63,,,0 HCPCS,J2182,"Injection, mepolizumab, 1mg",,,30.54,80.45,9 HCPCS,J2182,Nucala: 1 Syringe In 1 Carton (0173-0892-01) / 1 Ml In 1 Syringe,168.85,67.54,,,0 HCPCS,J2182,Nucala: 1 Vial In 1 Carton (0173-0881-01) / 1 Ml In 1 Vial,153.21,61.28,,,0 HCPCS,J2183,Inj meropenem (wg crit care),,,1.6,1.6,4 HCPCS,J2184,"Inj, meropenem (b. braun)",,,2.09,2.09,4 HCPCS,J2185,Meropenem,,,0.43,0.43,4 HCPCS,J2185,Meropenem: 10 Vial In 1 Carton (0143-9431-10) / 30 Ml In 1 Vial (0143-9431-01),2.68,1.07,,,0 HCPCS,J2185,Meropenem: 10 Vial In 1 Carton (0409-1391-22) / 20 Ml In 1 Vial (0409-1391-21),1.89,0.76,,,0 HCPCS,J2185,Meropenem: 10 Vial In 1 Carton (0781-3098-95) / 30 Ml In 1 Vial (0781-3098-94),2.41,0.96,,,0 HCPCS,J2185,"Meropenem: 10 Vial In 1 Carton (44567-401-10) / 1 Injection, Powder, For Solution In 1 Vial (44567-401-01)",2.33,0.93,,,0 HCPCS,J2185,"Meropenem: 10 Vial In 1 Carton (55150-207-20) / 1 Injection, Powder, For Solution In 1 Vial",5.43,2.17,,,0 HCPCS,J2185,"Meropenem: 10 Vial In 1 Carton (55150-208-30) / 1 Injection, Powder, For Solution In 1 Vial",5.24,2.1,,,0 HCPCS,J2185,Meropenem: 10 Vial In 1 Carton (63323-507-20) / 10 Ml In 1 Vial (63323-507-01),2.49,1.0,,,0 HCPCS,J2185,Meropenem: 10 Vial In 1 Carton (63323-508-30) / 20 Ml In 1 Vial (63323-508-01),2.58,1.03,,,0 HCPCS,J2185,NDC Description Not Available,4.505,1.8,,,0 HCPCS,J2186,"Inj., meropenem, vaborbactam",,,2.23,5.67,9 HCPCS,J2186,NDC Description Not Available,9.67,3.87,,,0 HCPCS,J2186,"Vabomere: 6 Vial, Single-Dose In 1 Carton (70842-120-06) / 2 G In 1 Vial, Single-Dose (70842-120-01)",8.38,3.35,,,0 HCPCS,J2210,Methylergonovin maleate inj,,,21.29,21.29,4 HCPCS,J2210,Methylergonovine Maleate: 10 Ampule In 1 Box (51991-144-17) / 1 Ml In 1 Ampule,70.64,28.26,,,0 HCPCS,J2210,"Methylergonovine Maleate: 20 Vial, Single-Dose In 1 Carton (0517-0740-20) / 1 Ml In 1 Vial, Single-Dose (0517-0740-01)",135.36,54.14,,,0 HCPCS,J2210,NDC Description Not Available,131.25,52.5,,,0 HCPCS,J2212,Methylnaltrexone injection,,,1.42,1.42,4 HCPCS,J2246,"Inj, micafungin (baxter)",,,0.64,0.64,4 HCPCS,J2247,"Inj, micafungin (par pharm)",,,0.31,0.31,4 HCPCS,J2247,"Micafungin: 10 Vial, Single-Dose In 1 Carton (42023-229-10) / 10 Ml In 1 Vial, Single-Dose",7.11,2.84,,,0 HCPCS,J2247,"Micafungin: 10 Vial, Single-Dose In 1 Carton (42023-230-10) / 10 Ml In 1 Vial, Single-Dose",6.94,2.78,,,0 HCPCS,J2247,NDC Description Not Available,6.575,2.63,,,0 HCPCS,J2248,Micafungin sodium injection,,,0.28,0.28,4 HCPCS,J2248,Micafungin: 1 Vial In 1 Carton (25021-191-10) / 5 Ml In 1 Vial,8.2,3.28,,,0 HCPCS,J2248,"Micafungin: 10 Carton In 1 Carton (63323-729-10) / 1 Vial, Single-Dose In 1 Carton (63323-729-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",1.46,0.58,,,0 HCPCS,J2248,"Micafungin: 10 Vial, Single-Dose In 1 Carton (71288-028-11) / 5 Ml In 1 Vial, Single-Dose (71288-028-10)",2.45,0.98,,,0 HCPCS,J2248,"Micafungin: 10 Vial, Single-Dose In 1 Carton (71288-029-11) / 5 Ml In 1 Vial, Single-Dose (71288-029-10)",2.34,0.94,,,0 HCPCS,J2248,"Mycamine: 10 Vial, Single-Dose In 1 Carton (0469-3211-10) / 10 Ml In 1 Vial, Single-Dose",8.06,3.22,,,0 HCPCS,J2248,NDC Description Not Available,2.4,0.96,,,0 HCPCS,J2249,"Inj, remimazolam, 1 mg",,,2.19,2.19,4 HCPCS,J2250,Inj midazolam hydrochloride,,,0.13,0.13,4 HCPCS,J2250,"Midazolam Hydrochloride: 10 Vial, Multi-Dose In 1 Carton (23155-601-42) / 10 Ml In 1 Vial, Multi-Dose (23155-601-32)",0.5,0.2,,,0 HCPCS,J2250,"Midazolam Hydrochloride: 25 Vial, Single-Dose In 1 Carton (23155-600-41) / 2 Ml In 1 Vial, Single-Dose (23155-600-31)",1.15,0.46,,,0 HCPCS,J2250,Midazolam: 10 Vial In 1 Carton (0641-6060-10) / 10 Ml In 1 Vial (0641-6060-01),0.14,0.06,,,0 HCPCS,J2250,Midazolam: 10 Vial In 1 Carton (70069-817-10) / 5 Ml In 1 Vial,6.57,2.63,,,0 HCPCS,J2250,Midazolam: 10 Vial In 1 Tray (63323-412-02) / 2 Ml In 1 Vial (63323-412-03),2.7,1.08,,,0 HCPCS,J2250,"Midazolam: 10 Vial, Multi-Dose In 1 Carton (0409-2587-05) / 10 Ml In 1 Vial, Multi-Dose (0409-2587-04)",0.54,0.22,,,0 HCPCS,J2250,"Midazolam: 10 Vial, Single-Dose In 1 Carton (0409-2305-05) / 5 Ml In 1 Vial, Single-Dose (0409-2305-04)",1.03,0.41,,,0 HCPCS,J2250,"Midazolam: 10 Vial, Single-Dose In 1 Carton (0409-2305-50) / 5 Ml In 1 Vial, Single-Dose (0409-2305-55)",0.79,0.32,,,0 HCPCS,J2250,"Midazolam: 10 Vial, Single-Dose In 1 Carton (0409-2308-02) / 2 Ml In 1 Vial, Single-Dose (0409-2308-22)",0.43,0.17,,,0 HCPCS,J2250,Midazolam: 25 Vial In 1 Tray (63323-411-12) / 2 Ml In 1 Vial (63323-411-15),2.66,1.06,,,0 HCPCS,J2250,"Midazolam: 25 Vial, Single-Dose In 1 Tray (0409-2305-17) / 2 Ml In 1 Vial, Single-Dose (0409-2305-16)",0.77,0.31,,,0 HCPCS,J2250,NDC Description Not Available,1.07,0.43,,,0 HCPCS,J2251,Inj midazolam (wg crit care),,,0.17,0.17,4 HCPCS,J2251,Midazolam In Sodium Chloride: 10 Bag In 1 Carton (44567-611-10) / 100 Ml In 1 Bag (44567-611-01),0.8,0.32,,,0 HCPCS,J2251,Midazolam In Sodium Chloride: 10 Pouch In 1 Carton (0143-9380-10) / 1 Bag In 1 Pouch (0143-9380-01) / 100 Ml In 1 Bag,0.98,0.39,,,0 HCPCS,J2251,NDC Description Not Available,1.58,0.63,,,0 HCPCS,J2252,Inj midazolam in 0.8% nacl,,,0.07,0.07,4 HCPCS,J2260,Inj milrinone lactate / 5 mg,,,1.57,1.57,4 HCPCS,J2260,Milrinone Lactate In Dextrose: 10 Bag In 1 Carton (0338-6010-48) / 100 Ml In 1 Bag,29.24,11.7,,,0 HCPCS,J2260,Milrinone Lactate In Dextrose: 10 Bag In 1 Carton (25021-313-82) / 100 Ml In 1 Bag,11.1,4.44,,,0 HCPCS,J2260,Milrinone Lactate In Dextrose: 10 Container In 1 Package (0143-9719-10) / 100 Ml In 1 Container (0143-9719-01),16.9,6.76,,,0 HCPCS,J2260,Milrinone Lactate: 10 Vial In 1 Carton (70069-807-10) / 10 Ml In 1 Vial (70069-807-01),9.86,3.94,,,0 HCPCS,J2260,"Milrinone Lactate: 10 Vial, Single-Dose In 1 Carton (71288-200-21) / 20 Ml In 1 Vial, Single-Dose (71288-200-20)",4.85,1.94,,,0 HCPCS,J2260,"Milrinone Lactate: 10 Vial, Single-Dose In 1 Tray (63323-617-10) / 10 Ml In 1 Vial, Single-Dose (63323-617-01)",10.08,4.03,,,0 HCPCS,J2260,Milrinone Lactate: 20 Ml In 1 Box (0143-9709-01),6.0,2.4,,,0 HCPCS,J2260,NDC Description Not Available,8.37,3.35,,,0 HCPCS,J2265,Minocin: 10 Vial In 1 Carton (70842-160-10) / 1 Injection In 1 Vial (70842-160-01),10.8,4.32,,,0 HCPCS,J2265,Minocycline hydrochloride,,,2.59,6.98,9 HCPCS,J2265,NDC Description Not Available,10.42,4.17,,,0 HCPCS,J2267,"Inj, mirikizumab-mrkz, 1 mg",,,32.58,81.46,9 HCPCS,J2270,"Morphine Sulfate: 1 Vial, Single-Dose In 1 Carton (0409-1896-20) / 20 Ml In 1 Vial, Single-Dose",0.85,0.34,,,0 HCPCS,J2270,Morphine Sulfate: 10 Cartridge In 1 Carton (0409-1890-01) / 1 Ml In 1 Cartridge (0409-1890-03),3.1,1.24,,,0 HCPCS,J2270,Morphine Sulfate: 10 Cartridge In 1 Carton (0409-1892-01) / 1 Ml In 1 Cartridge (0409-1892-03),1.77,0.71,,,0 HCPCS,J2270,"Morphine Sulfate: 25 Vial, Single-Dose In 1 Package (0641-6125-25) / 1 Ml In 1 Vial, Single-Dose (0641-6125-01)",8.47,3.39,,,0 HCPCS,J2270,"Morphine Sulfate: 25 Vial, Single-Dose In 1 Package (0641-6127-25) / 1 Ml In 1 Vial, Single-Dose (0641-6127-01)",11.01,4.4,,,0 HCPCS,J2270,Morphine sulfate injection,,,4.63,4.63,4 HCPCS,J2270,NDC Description Not Available,8.535,3.415,,,0 HCPCS,J2272,"Inj, morphine (fresenius)",,,6.64,6.64,4 HCPCS,J2272,"Morphine Sulfate: 10 Syringe, Glass In 1 Carton (76045-004-11) / 1 Ml In 1 Syringe, Glass (76045-004-01)",17.73,7.09,,,0 HCPCS,J2272,"Morphine Sulfate: 25 Vial, Single-Dose In 1 Box (63323-451-01) / 1 Ml In 1 Vial, Single-Dose (63323-451-00)",8.45,3.38,,,0 HCPCS,J2272,"Morphine Sulfate: 25 Vial, Single-Dose In 1 Box (63323-452-01) / 1 Ml In 1 Vial, Single-Dose (63323-452-00)",3.15,1.26,,,0 HCPCS,J2272,"Morphine Sulfate: 25 Vial, Single-Dose In 1 Box (63323-454-01) / 1 Ml In 1 Vial, Single-Dose (63323-454-00)",5.88,2.35,,,0 HCPCS,J2272,NDC Description Not Available,6.58,2.63,,,0 HCPCS,J2274,In morphine preservativ free,,,9.82,9.82,4 HCPCS,J2274,Infumorph 200: 20 Ml In 1 Ampule (0641-6039-01),46.31,18.52,,,0 HCPCS,J2274,Infumorph 500: 20 Ml In 1 Ampule (0641-6040-01),31.3,12.52,,,0 HCPCS,J2274,"Mitigo: 1 Ml In 1 Vial, Single-Use (66794-162-02)",26.33,10.53,,,0 HCPCS,J2274,"Morphine Sulfate: 5 Vial, Glass In 1 Carton (0409-3815-12) / 10 Ml In 1 Vial, Glass (0409-3815-11)",85.11,34.04,,,0 HCPCS,J2274,NDC Description Not Available,81.31,32.52,,,0 HCPCS,J2277,"Inj, motixafortide, 0.25 mg",,,25.22,66.2,9 HCPCS,J2278,Hc Ziconotide/Mcg (100Mcg/Ml),33.12,13.25,,,0 HCPCS,J2278,"Prialt: 1 VIAL, GLASS in 1 CARTON (18860-722-10) / 5 mL in 1 VIAL, GLASS",44.93,17.97,,,0 HCPCS,J2278,"Prialt: 1 Vial, Glass In 1 Carton (70720-720-10) / 1 Ml In 1 Vial, Glass",53.37,21.35,,,0 HCPCS,J2278,"Prialt: 1 Vial, Glass In 1 Carton (70720-722-10) / 5 Ml In 1 Vial, Glass",44.98,17.99,,,0 HCPCS,J2278,Ziconotide injection,,,9.7,26.64,9 HCPCS,J2280,"Inj, moxifloxacin 100 mg",,,8.57,8.57,4 HCPCS,J2281,Inj moxifloxacin (fres kabi),,,7.1,7.1,4 HCPCS,J2290,"Inj, nafcillin sodium, 20 mg",,,0.22,0.22,4 HCPCS,J2290,NDC Description Not Available,0.18,0.07,,,0 HCPCS,J2290,Nafcillin: 1 Bottle In 1 Carton (70860-119-99) / 100 Ml In 1 Bottle,0.29,0.12,,,0 HCPCS,J2290,"Nafcillin: 1 Vial, Pharmacy Bulk Package In 1 Box (55150-124-99) / 100 Ml In 1 Vial, Pharmacy Bulk Package",0.3,0.12,,,0 HCPCS,J2290,"Nafcillin: 1 Vial, Pharmacy Bulk Package In 1 Carton (44567-223-01) / 100 Ml In 1 Vial, Pharmacy Bulk Package",1.87,0.75,,,0 HCPCS,J2290,Nafcillin: 10 Vial In 1 Box (55150-122-15) / 4 Ml In 1 Vial,1.04,0.42,,,0 HCPCS,J2290,Nafcillin: 10 Vial In 1 Box (55150-123-15) / 8 Ml In 1 Vial,0.79,0.32,,,0 HCPCS,J2290,"Nafcillin: 10 Vial In 1 Carton (44567-221-10) / 1 Powder, For Solution In 1 Vial",1.27,0.51,,,0 HCPCS,J2290,"Nafcillin: 10 Vial In 1 Carton (44567-222-10) / 1 Powder, For Solution In 1 Vial",4.35,1.74,,,0 HCPCS,J2290,Nafcillin: 10 Vial In 1 Carton (63323-328-20) / 8 Ml In 1 Vial (63323-328-21),2.06,0.82,,,0 HCPCS,J2300,Inj nalbuphine hydrochloride,,,3.08,3.08,4 HCPCS,J2300,NDC Description Not Available,16.22,6.49,,,0 HCPCS,J2300,Nalbuphine Hydrochloride: 10 Ampule In 1 Tray (0409-1463-49) / 1 Ml In 1 Ampule (0409-1463-69),14.7,5.88,,,0 HCPCS,J2305,"Inj, nitroglycerin, 5 mg",,,1.34,1.34,4 HCPCS,J2305,"Nitroglycerin In Dextrose: 12 Bottle, Glass In 1 Box (0338-1047-02) / 250 Ml In 1 Bottle, Glass",1.26,0.5,,,0 HCPCS,J2305,"Nitroglycerin In Dextrose: 12 Bottle, Glass In 1 Box (0338-1049-02) / 250 Ml In 1 Bottle, Glass",7.46,2.98,,,0 HCPCS,J2305,"Nitroglycerin: 25 Vial, Single-Dose In 1 Tray (0517-4810-25) / 10 Ml In 1 Vial, Single-Dose (0517-4810-01)",0.11,0.04,,,0 HCPCS,J2310,Inj naloxone hydrochloride,,,9.21,9.21,4 HCPCS,J2310,NDC Description Not Available,57.36,22.945,,,0 HCPCS,J2310,Naloxone Hydrochloride: 1 Syringe In 1 Box (43598-750-11) / 2 Ml In 1 Syringe,67.9,27.16,,,0 HCPCS,J2310,Naloxone Hydrochloride: 10 Syringe In 1 Box (43598-750-58) / 2 Ml In 1 Syringe,68.97,27.59,,,0 HCPCS,J2310,Naloxone Hydrochloride: 10 Syringe In 1 Box (55150-345-10) / 2 Ml In 1 Syringe,9.95,3.98,,,0 HCPCS,J2310,Naloxone Hydrochloride: 10 Syringe In 1 Box (76329-3369-1) / 2 Ml In 1 Syringe,45.13,18.05,,,0 HCPCS,J2310,Naloxone Hydrochloride: 10 Vial In 1 Carton (70069-071-10) / 1 Ml In 1 Vial (70069-071-01),9.51,3.8,,,0 HCPCS,J2310,Naloxone Hydrochloride: 25 Vial In 1 Carton (0641-6132-25) / 1 Ml In 1 Vial (0641-6132-01),59.11,23.64,,,0 HCPCS,J2311,"Inj, naloxone hcl (zimhi)",,,1.5,1.5,4 HCPCS,J2312,NDC Description Not Available,12.33,4.935,,,0 HCPCS,J2312,Naloxone Hydrochloride: 10 Syringe In 1 Carton (0641-6205-10) / 2 Ml In 1 Syringe (0641-6205-01),22.22,8.89,,,0 HCPCS,J2312,"Naloxone Hydrochloride: 10 Vial, Single-Dose In 1 Carton (0409-1215-01) / 1 Ml In 1 Vial, Single-Dose (0409-1215-21)",14.97,5.99,,,0 HCPCS,J2315,"Naltrexone, depot form",,,4.12,11.34,9 HCPCS,J2315,"Vivitrol: 1 Kit In 1 Carton (65757-300-01) * 4 Ml In 1 Vial, Glass (65757-302-02) * 4 Ml In 1 Vial, Glass (65757-304-03)",0.88,0.35,,,0 HCPCS,J2320,Nandrolone decanoate 50 MG,,,0.01,0.01,4 HCPCS,J2323,Natalizumab injection,,,23.93,59.82,9 HCPCS,J2323,"Tysabri: 1 Vial, Single-Use In 1 Carton (64406-008-01) / 15 Ml In 1 Vial, Single-Use",86.74,34.7,,,0 HCPCS,J2325,Nesiritide injection,,,0.01,0.01,4 HCPCS,J2326,"Inj, nusinersen, 0.1mg",,,706.05,1765.12,9 HCPCS,J2326,"Spinraza: 1 Vial, Single-Use In 1 Box (64406-058-01) / 5 Ml In 1 Vial, Single-Use",4508.69,1803.48,,,0 HCPCS,J2327,Inj risankizumab-rzaa 1 mg,,,14.01,35.03,9 HCPCS,J2327,"Skyrizi: 1 Vial, Single-Dose In 1 Carton (0074-5015-01) / 10 Ml In 1 Vial, Single-Dose",76.12,30.45,,,0 HCPCS,J2329,"Briumvi: 1 Vial, Single-Dose In 1 Carton (73150-150-06) / 6 Ml In 1 Vial, Single-Dose",316.55,126.62,,,0 HCPCS,J2329,"Inj ublituximab-xiiy, 1 mg",,,68.66,177.72,9 HCPCS,J2350,"Injection, ocrelizumab, 1 mg",,,57.81,151.72,9 HCPCS,J2350,"Ocrevus: 1 Vial, Single-Use In 1 Carton (50242-150-01) / 10 Ml In 1 Vial, Single-Use",254.79,101.92,,,0 HCPCS,J2351,Inj ocrelizumab 1mg hya-ocsq,,,45.19,118.22,9 HCPCS,J2353,NDC Description Not Available,943.71,377.485,,,0 HCPCS,J2353,"Octreotide injection, depot",,,204.59,528.3,9 HCPCS,J2353,Sandostatin Lar Depot: 1 Kit In 1 Kit (0078-0818-81) * 6 Ml In 1 Vial (0078-0797-61) * 2 Ml In 1 Syringe,704.51,281.8,,,0 HCPCS,J2353,Sandostatin Lar Depot: 1 Kit In 1 Kit (0078-0825-81) * 2 Ml In 1 Syringe * 6 Ml In 1 Vial (0078-0804-61),1007.75,403.1,,,0 HCPCS,J2354,NDC Description Not Available,10.940000000000001,4.375,,,0 HCPCS,J2354,Octreotide Acetate: 1 Vial In 1 Carton (25021-467-05) / 5 Ml In 1 Vial,4.795,1.92,,,0 HCPCS,J2354,"Octreotide Acetate: 1 Vial, Multi-Dose In 1 Carton (0641-6178-01) / 5 Ml In 1 Vial, Multi-Dose",5.39,2.16,,,0 HCPCS,J2354,Octreotide Acetate: 10 Vial In 1 Carton (25021-463-01) / 1 Ml In 1 Vial,5.23,2.09,,,0 HCPCS,J2354,"Octreotide Acetate: 10 Vial, Glass In 1 Carton (23155-687-41) / 1 Ml In 1 Vial, Glass (23155-687-31)",7.44,2.98,,,0 HCPCS,J2354,"Octreotide Acetate: 10 Vial, Glass In 1 Carton (23155-688-41) / 1 Ml In 1 Vial, Glass (23155-688-31)",2.39,0.96,,,0 HCPCS,J2354,"Octreotide Acetate: 10 Vial, Single-Dose In 1 Carton (0641-6174-10) / 1 Ml In 1 Vial, Single-Dose (0641-6174-01)",9.98,3.99,,,0 HCPCS,J2354,"Octreotide Acetate: 10 Vial, Single-Dose In 1 Carton (0641-6176-10) / 1 Ml In 1 Vial, Single-Dose (0641-6176-01)",2.44,0.98,,,0 HCPCS,J2354,"Octreotide Acetate: 5 Ml In 1 Vial, Glass (23155-686-31)",3.49,1.395,,,0 HCPCS,J2354,"Octreotide inj, non-depot",,,0.59,0.59,4 HCPCS,J2354,"Octreotide: 1 Vial, Multi-Dose In 1 Carton (63323-379-05) / 5 Ml In 1 Vial, Multi-Dose",6.63,2.65,,,0 HCPCS,J2354,"Octreotide: 10 Vial, Single-Dose In 1 Tray (63323-376-01) / 1 Ml In 1 Vial, Single-Dose (63323-376-00)",2.7,1.08,,,0 HCPCS,J2355,Oprelvekin injection,,,0.01,0.01,4 HCPCS,J2356,"Inj tezepelumab-ekko, 1mg",,,17.77,44.6,9 HCPCS,J2357,Omalizumab injection,,,40.12,114.22,9 HCPCS,J2357,"Xolair Pfs: 1 Syringe, Glass In 1 Carton (50242-214-01) / .5 Ml In 1 Syringe, Glass",68.12,27.25,,,0 HCPCS,J2357,"Xolair Pfs: 1 Syringe, Glass In 1 Carton (50242-214-03) / .5 Ml In 1 Syringe, Glass",193.54,77.42,,,0 HCPCS,J2357,"Xolair Pfs: 1 Syringe, Glass In 1 Carton (50242-215-01) / 1 Ml In 1 Syringe, Glass",86.62,34.65,,,0 HCPCS,J2357,"Xolair Pfs: 1 Syringe, Glass In 1 Carton (50242-215-03) / 1 Ml In 1 Syringe, Glass",61.5,24.6,,,0 HCPCS,J2358,Olanzapine long-acting inj,,,2.92,2.92,4 HCPCS,J2358,Olanzapine: 1 Vial In 1 Carton (0781-3159-72) / 2 Ml In 1 Vial,14.7,5.88,,,0 HCPCS,J2358,"Olanzapine: 1 Vial, Single-Dose In 1 Carton (55150-308-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",9.71,3.88,,,0 HCPCS,J2359,"Inj. olanzapine, 0.5mg",,,0.93,0.93,4 HCPCS,J2359,Olanzapine: 1 Vial In 1 Carton (31722-308-01) / 2 Ml In 1 Vial,5.49,2.2,,,0 HCPCS,J2359,"Olanzapine: 1 Vial, Glass In 1 Carton (0517-0955-01) / 2 Ml In 1 Vial, Glass",10.82,4.33,,,0 HCPCS,J2360,Orphenadrine injection,,,12.33,12.33,4 HCPCS,J2371,Inj phenylephrine hcl 20 mcg,,,0.01,0.01,4 HCPCS,J2371,NDC Description Not Available,0.32,0.08,,,0 HCPCS,J2371,"Phenylephrine Hydrochloride: 10 Vial, Pharmacy Bulk Package In 1 Carton (0641-6188-10) / 5 Ml In 1 Vial, Pharmacy Bulk Package (0641-6188-01)",0.04,0.02,,,0 HCPCS,J2371,"Phenylephrine Hydrochloride: 10 Vial, Pharmacy Bulk Package In 1 Carton (0781-3458-95) / 5 Ml In 1 Vial, Pharmacy Bulk Package (0781-3458-75)",0.01,0.004,,,0 HCPCS,J2371,"Phenylephrine Hydrochloride: 10 Vial, Pharmacy Bulk Package In 1 Carton (70069-802-10) / 5 Ml In 1 Vial, Pharmacy Bulk Package (70069-802-01)",0.01,0.004,,,0 HCPCS,J2371,"Phenylephrine Hydrochloride: 10 Vial, Pharmacy Bulk Package In 1 Carton (70756-622-10) / 5 Ml In 1 Vial, Pharmacy Bulk Package (70756-622-85)",0.03,0.01,,,0 HCPCS,J2371,"Phenylephrine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (63323-751-01) / 1 Ml In 1 Vial, Single-Dose (63323-751-00)",0.04,0.02,,,0 HCPCS,J2372,"Inj, biorphen, 20 micrograms",,,0.18,0.18,4 HCPCS,J2373,"Inj, immphentiv, 20 mcg",,,0.14,0.14,4 HCPCS,J2401,Chloroprocaine hcl injection,,,0.04,0.04,4 HCPCS,J2401,NDC Description Not Available,0.195,0.08,,,0 HCPCS,J2401,"Nesacaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-478-27) / 20 Ml In 1 Vial, Single-Dose (63323-478-01)",0.17,0.07,,,0 HCPCS,J2402,Chloroprocaine (clorotekal),,,0.31,0.31,4 HCPCS,J2403,"Chloroprocaine opht gel, 1mg",,,0.6,0.71,5 HCPCS,J2404,Cardene IV: 10 CARTON in 1 BOX (10122-325-10) / 1 BAG in 1 CARTON (10122-325-01) / 200 mL in 1 BAG,2.13,0.85,,,0 HCPCS,J2404,Cardene Iv: 10 Bag In 1 Carton (43066-016-10) / 200 Ml In 1 Bag,0.68,0.27,,,0 HCPCS,J2404,"Inj, nicardipine 0.1 mg",,,0.09,0.09,4 HCPCS,J2404,NDC Description Not Available,1.43,0.575,,,0 HCPCS,J2404,"Nicardipine Hydrochloride: 1 Vial, Glass In 1 Carton (65219-818-10) / 10 Ml In 1 Vial, Glass",0.34,0.14,,,0 HCPCS,J2404,Nicardipine Hydrochloride: 10 Vial In 1 Carton (0143-9689-10) / 10 Ml In 1 Vial (0143-9689-01),0.23,0.09,,,0 HCPCS,J2404,Nicardipine Hydrochloride: 10 Vial In 1 Carton (72485-116-10) / 10 Ml In 1 Vial (72485-116-01),0.25,0.1,,,0 HCPCS,J2405,NDC Description Not Available,0.63,0.25,,,0 HCPCS,J2405,"Ondansetron Hydrochloride: 25 Vial, Single-Dose In 1 Carton (36000-012-25) / 2 Ml In 1 Vial, Single-Dose",0.49,0.2,,,0 HCPCS,J2405,Ondansetron hcl injection,,,0.09,0.09,4 HCPCS,J2405,Ondansetron: 1 Vial In 1 Carton (23155-549-31) / 20 Ml In 1 Vial,0.94,0.38,,,0 HCPCS,J2405,Ondansetron: 1 Vial In 1 Carton (72266-124-01) / 20 Ml In 1 Vial,0.28,0.11,,,0 HCPCS,J2405,Ondansetron: 10 Vial In 1 Carton (23155-547-41) / 2 Ml In 1 Vial (23155-547-31),0.49,0.2,,,0 HCPCS,J2405,Ondansetron: 20 Ml In 1 Carton (0641-6079-01),0.88,0.35,,,0 HCPCS,J2405,Ondansetron: 25 Vial In 1 Carton (0641-6078-25) / 2 Ml In 1 Vial (0641-6078-01),0.42,0.17,,,0 HCPCS,J2405,Ondansetron: 25 Vial In 1 Carton (23155-547-42) / 2 Ml In 1 Vial (23155-547-31),0.58,0.23,,,0 HCPCS,J2405,"Ondansetron: 25 Vial, Single-Use In 1 Carton (60505-6130-5) / 2 Ml In 1 Vial, Single-Use (60505-6130-0)",0.48,0.19,,,0 HCPCS,J2406,"Injection, oritavancin 10 mg",,,42.77,110.98,9 HCPCS,J2407,"Injection, oritavancin",,,28.53,74.53,9 HCPCS,J2407,NDC Description Not Available,117.53,47.01,,,0 HCPCS,J2410,Oxymorphone hcl injection,,,0.01,0.01,4 HCPCS,J2425,Palifermin injection,,,33.99,97.1,9 HCPCS,J2426,Invega Sustenna: 1 Syringe In 1 Kit (50458-563-01) / 1 Ml In 1 Syringe,3.84,1.54,,,0 HCPCS,J2426,Invega Sustenna: 1 Syringe In 1 Kit (50458-564-01) / 1.5 Ml In 1 Syringe,4.3,1.72,,,0 HCPCS,J2426,Paliperidone palmitate inj,,,14.74,38.59,9 HCPCS,J2427,"Inj, invega hafyera/trinza",,,12.67,33.12,9 HCPCS,J2428,"Inj, erzofri, 1 mg",,,15.59,38.97,9 HCPCS,J2430,Pamidronate Disodium: 1 Vial In 1 Carton (67457-430-10) / 10 Ml In 1 Vial,39.7,15.88,,,0 HCPCS,J2430,Pamidronate Disodium: 1 Vial In 1 Carton (67457-446-10) / 10 Ml In 1 Vial,171.8,68.72,,,0 HCPCS,J2430,"Pamidronate Disodium: 1 Vial, Single-Dose In 1 Carton (61703-324-18) / 10 Ml In 1 Vial, Single-Dose",64.45,25.78,,,0 HCPCS,J2430,Pamidronate disodium /30 mg,,,13.88,13.88,4 HCPCS,J2440,NDC Description Not Available,54.08,21.63,,,0 HCPCS,J2440,Papaverin hcl injection,,,37.5,37.5,4 HCPCS,J2440,Papaverine Hydrochloride: 10 Vial In 1 Carton (54288-142-10) / 2 Ml In 1 Vial (54288-142-01),32.36,12.94,,,0 HCPCS,J2440,Papaverine Hydrochloride: 25 Vial In 1 Carton (0517-4002-25) / 2 Ml In 1 Vial (0517-4002-01),82.66,33.06,,,0 HCPCS,J2468,"Inj, palonosetron (avyxa)",,,54.09,135.22,9 HCPCS,J2469,"Palonosetron Hydrochloride: 1 Vial, Single-Dose In 1 Carton (0781-3312-75) / 5 Ml In 1 Vial, Single-Dose",4.22,1.69,,,0 HCPCS,J2469,"Palonosetron Hydrochloride: 1 Vial, Single-Dose In 1 Carton (71288-409-05) / 5 Ml In 1 Vial, Single-Dose",5.92,2.37,,,0 HCPCS,J2469,"Palonosetron Hydrochloride: 1 Vial, Single-Dose In 1 Carton (83634-777-05) / 5 Ml In 1 Vial, Single-Dose",6.03,2.41,,,0 HCPCS,J2469,Palonosetron hcl,,,0.5,0.5,4 HCPCS,J2469,Palonosetron: 1 Vial In 1 Carton (60505-6193-1) / 5 Ml In 1 Vial,13.03,5.21,,,0 HCPCS,J2469,"Palonosetron: 1 Vial, Single-Use In 1 Carton (55111-694-07) / 5 Ml In 1 Vial, Single-Use",7.92,3.17,,,0 HCPCS,J2470,Inj pantoprazole sodium 40mg,,,4.55,4.55,4 HCPCS,J2470,NDC Description Not Available,18.740000000000002,7.495,,,0 HCPCS,J2470,Pantoprazole Sodium: 10 Carton In 1 Package (70095-024-02) / 1 Vial In 1 Carton / 10 Ml In 1 Vial (70095-024-01),37.52,15.01,,,0 HCPCS,J2470,"Pantoprazole Sodium: 10 Vial, Single-Dose In 1 Carton (55150-202-10) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose (55150-202-00)",15.53,6.21,,,0 HCPCS,J2470,"Pantoprazole Sodium: 10 Vial, Single-Dose In 1 Carton (71288-600-11) / 10 Ml In 1 Vial, Single-Dose (71288-600-10)",6.21,2.48,,,0 HCPCS,J2470,"Pantoprazole Sodium: 25 Vial, Glass In 1 Carton (67850-150-25) / 10 Ml In 1 Vial, Glass (67850-150-00)",8.99,3.6,,,0 HCPCS,J2470,Protonix I.V.: 1 Vial In 1 Carton (0008-0923-51) / 10 Ml In 1 Vial,19.81,7.92,,,0 HCPCS,J2470,Protonix I.V.: 10 Carton In 1 Package (0008-0923-55) / 1 Vial In 1 Carton / 10 Ml In 1 Vial,9.62,3.85,,,0 HCPCS,J2471,Inj pantoprazole(hikma) 40mg,,,6.5,6.5,4 HCPCS,J2471,"Pantoprazole Sodium: 10 Vial In 1 Carton (0143-9284-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (0143-9284-01)",11.72,4.69,,,0 HCPCS,J2472,"Inj, pantoprazole sodium chl",,,8.82,8.82,4 HCPCS,J2501,Paricalcitol,,,0.81,0.81,4 HCPCS,J2502,"Inj, pasireotide long acting",,,526.94,1532.85,9 HCPCS,J2503,Pegaptanib sodium injection,,,0.01,0.01,4 HCPCS,J2504,"Pegademase bovine, 25 iu",,,0.01,0.01,4 HCPCS,J2506,Inj pegfilgrast ex bio 0.5mg,,,19.98,503.1,9 HCPCS,J2506,Neulasta: 1 Kit In 1 Carton (55513-192-01) * .6 Ml In 1 Syringe,2204.23,881.69,,,0 HCPCS,J2506,Neulasta: 1 Syringe In 1 Carton (55513-190-01) / .6 Ml In 1 Syringe,2169.38,867.75,,,0 HCPCS,J2507,Krystexxa: 1 Vial In 1 Carton (75987-080-10) / 1 Ml In 1 Vial,16385.28,6554.11,,,0 HCPCS,J2507,Pegloticase injection,,,3565.32,10001.57,9 HCPCS,J2508,Pegunigalsidase alfa-iwxj,,,226.0,565.0,9 HCPCS,J2510,Penicillin g procaine inj,,,45.95,45.95,4 HCPCS,J2513,Pentastarch 10% solution,,,0.01,0.01,4 HCPCS,J2515,Pentobarbital Sodium: 1 Vial In 1 Carton (24201-010-20) / 20 Ml In 1 Vial,144.33,57.73,,,0 HCPCS,J2515,Pentobarbital Sodium: 1 Vial In 1 Carton (24201-010-50) / 50 Ml In 1 Vial,202.15,80.86,,,0 HCPCS,J2515,Pentobarbital Sodium: 1 Vial In 1 Carton (25021-676-20) / 20 Ml In 1 Vial,154.27,61.71,,,0 HCPCS,J2515,Pentobarbital Sodium: 1 Vial In 1 Carton (25021-676-50) / 50 Ml In 1 Vial,188.52,75.41,,,0 HCPCS,J2515,Pentobarbital sodium inj,,,20.31,52.83,9 HCPCS,J2540,NDC Description Not Available,3.83,1.53,,,0 HCPCS,J2540,"Penicillin G Potassium: 10 Vial In 1 Tray (44567-311-10) / 1 Injection, Powder, For Solution In 1 Vial",2.19,0.88,,,0 HCPCS,J2540,Penicillin G Potassium: 50 Ml In 1 Bag (0338-1023-41),12.93,5.17,,,0 HCPCS,J2540,Penicillin G Potassium: 50 Ml In 1 Bag (0338-1025-41),9.46,3.78,,,0 HCPCS,J2540,Penicillin g potassium inj,,,0.78,0.78,4 HCPCS,J2540,"Pfizerpen: 10 Vial In 1 Carton (0049-0520-83) / 1 Powder, For Solution In 1 Vial (0049-0520-84)",2.33,0.93,,,0 HCPCS,J2543,NDC Description Not Available,5.825,2.33,,,0 HCPCS,J2543,"Piperacillin And Tazobactam: 1 Bottle In 1 Box (44567-804-01) / 1 Injection, Powder, For Solution In 1 Bottle",3.01,1.2,,,0 HCPCS,J2543,"Piperacillin And Tazobactam: 1 Vial, Pharmacy Bulk Package In 1 Carton (64679-679-01) / 180 Ml In 1 Vial, Pharmacy Bulk Package (64679-679-02)",2.39,0.96,,,0 HCPCS,J2543,"Piperacillin And Tazobactam: 1 Vial, Pharmacy Bulk Package In 1 Carton (81284-155-01) / 180 Ml In 1 Vial, Pharmacy Bulk Package (81284-155-00)",1.34,0.54,,,0 HCPCS,J2543,"Piperacillin And Tazobactam: 10 Vial In 1 Box (44567-801-10) / 1 Injection, Powder, For Solution In 1 Vial",5.18,2.07,,,0 HCPCS,J2543,"Piperacillin And Tazobactam: 10 Vial In 1 Box (44567-802-10) / 1 Injection, Powder, For Solution In 1 Vial",9.82,3.93,,,0 HCPCS,J2543,"Piperacillin And Tazobactam: 10 Vial In 1 Box (44567-803-10) / 1 Injection, Powder, For Solution In 1 Vial",5.26,2.1,,,0 HCPCS,J2543,"Piperacillin And Tazobactam: 10 Vial In 1 Box (55150-119-30) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",6.7,2.68,,,0 HCPCS,J2543,"Piperacillin And Tazobactam: 10 Vial In 1 Box (55150-120-30) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",10.9,4.36,,,0 HCPCS,J2543,"Piperacillin And Tazobactam: 10 Vial In 1 Box (55150-121-50) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",7.25,2.9,,,0 HCPCS,J2543,"Piperacillin And Tazobactam: 10 Vial, Single-Dose In 1 Carton (60505-6157-4) / 15 Ml In 1 Vial, Single-Dose (60505-6157-0)",6.29,2.52,,,0 HCPCS,J2543,"Piperacillin And Tazobactam: 10 Vial, Single-Dose In 1 Carton (60505-6159-4) / 20 Ml In 1 Vial, Single-Dose (60505-6159-0)",7.59,3.04,,,0 HCPCS,J2543,"Piperacillin And Tazobactam: 10 Vial, Single-Use In 1 Carton (0409-3383-02) / 10 Ml In 1 Vial, Single-Use (0409-3383-11)",8.64,3.46,,,0 HCPCS,J2543,"Piperacillin And Tazobactam: 10 Vial, Single-Use In 1 Carton (0409-3390-04) / 20 Ml In 1 Vial, Single-Use (0409-3390-11)",10.3,4.12,,,0 HCPCS,J2543,"Piperacillin And Tazobactam: 10 Vial, Single-Use In 1 Carton (0781-3113-95) / 15 Ml In 1 Vial, Single-Use (0781-3113-90)",5.48,2.19,,,0 HCPCS,J2543,"Piperacillin And Tazobactam: 10 Vial, Single-Use In 1 Carton (63323-981-21) / 10 Ml In 1 Vial, Single-Use (63323-981-23)",5.14,2.06,,,0 HCPCS,J2543,"Piperacillin, Tazobactam: 10 Vial In 1 Carton (25021-176-20) / 15 Ml In 1 Vial",2.66,1.06,,,0 HCPCS,J2543,Piperacillin/tazobactam,,,1.12,1.12,4 HCPCS,J2543,"piperacillin and tazobactam: 10 VIAL, SINGLE-USE in 1 CARTON (67457-522-37) / 15 mL in 1 VIAL, SINGLE-USE (67457-522-00)",4.57,1.83,,,0 HCPCS,J2545,Pentamidine Isethionate: 10 Vial In 1 Tray (13925-515-10) / 300 Mg In 1 Vial,344.92,137.97,,,0 HCPCS,J2545,Pentamidine non-comp unit,,,79.5,79.5,4 HCPCS,J2547,"Injection, peramivir",,,1.58,4.2,9 HCPCS,J2550,NDC Description Not Available,6.17,2.47,,,0 HCPCS,J2550,"Promethazine Hydrochloride: 25 Vial, Single-Dose In 1 Package (0641-0928-25) / 1 Ml In 1 Vial, Single-Dose (0641-0928-21)",6.15,2.46,,,0 HCPCS,J2550,Promethazine hcl injection,,,3.31,3.31,4 HCPCS,J2560,NDC Description Not Available,108.76,43.5,,,0 HCPCS,J2560,"Phenobarbital Sodium: 10 Vial, Glass In 1 Carton (14789-127-05) / 1 Ml In 1 Vial, Glass (14789-127-07)",86.05,34.42,,,0 HCPCS,J2560,"Phenobarbital Sodium: 25 Vial In 1 Box, Unit-Dose (42494-416-25) / 1 Ml In 1 Vial",87.81,35.12,,,0 HCPCS,J2560,Phenobarbital Sodium: 25 Vial In 1 Carton (0641-0476-25) / 1 Ml In 1 Vial (0641-0476-21),5.76,2.3,,,0 HCPCS,J2560,Phenobarbital Sodium: 25 Vial In 1 Carton (0641-0477-25) / 1 Ml In 1 Vial (0641-0477-21),232.64,93.06,,,0 HCPCS,J2560,Phenobarbital sodium inj,,,29.44,29.44,4 HCPCS,J2561,"Inj, sezaby, 1 mg",,,0.04,1.44,9 HCPCS,J2561,"Sezaby: 1 Injection In 1 Vial, Single-Dose (62756-301-01)",5.8,2.32,,,0 HCPCS,J2562,Plerixafor injection,,,24.98,107.36,9 HCPCS,J2562,"Plerixafor: 1 Vial, Single-Dose In 1 Carton (0480-4320-01) / 1.2 Ml In 1 Vial, Single-Dose",233.87,93.55,,,0 HCPCS,J2562,"Plerixafor: 1 Vial, Single-Dose In 1 Carton (70121-1694-2) / 1.2 Ml In 1 Vial, Single-Dose",196.25,78.5,,,0 HCPCS,J2562,"Plerixafor: 1 Vial, Single-Dose In 1 Carton (71288-155-01) / 1.2 Ml In 1 Vial, Single-Dose",44.46,17.78,,,0 HCPCS,J2562,"Plerixafor: 1 Vial, Single-Use In 1 Carton (65219-284-12) / 1.2 Ml In 1 Vial, Single-Use",50.77,20.31,,,0 HCPCS,J2590,NDC Description Not Available,15.34,6.14,,,0 HCPCS,J2590,Oxytocin injection,,,1.4,1.4,4 HCPCS,J2590,Oxytocin: 25 Vial In 1 Tray (63323-012-07) / 1 Ml In 1 Vial (63323-012-17),6.09,2.44,,,0 HCPCS,J2590,Oxytocin: 25 Vial In 1 Tray (63323-012-11) / 1 Ml In 1 Vial (63323-012-03),4.19,1.68,,,0 HCPCS,J2590,Oxytocin: 25 Vial In 1 Tray (63323-012-12) / 1 Ml In 1 Vial (63323-012-21),2.68,1.07,,,0 HCPCS,J2597,Desmopressin Acetate: 1 Ml In 1 Ampule (69918-899-01),41.88,16.75,,,0 HCPCS,J2597,Desmopressin Acetate: 1 Vial In 1 Carton (43598-053-11) / 10 Ml In 1 Vial,19.58,7.83,,,0 HCPCS,J2597,"Desmopressin Acetate: 1 Vial, Multi-Dose In 1 Carton (65219-295-10) / 10 Ml In 1 Vial, Multi-Dose",16.41,6.56,,,0 HCPCS,J2597,"Desmopressin Acetate: 1 Vial, Multi-Dose In 1 Carton (69918-901-10) / 10 Ml In 1 Vial, Multi-Dose",44.35,17.74,,,0 HCPCS,J2597,Inj desmopressin acetate,,,4.49,4.49,4 HCPCS,J2597,NDC Description Not Available,29.0,11.6,,,0 HCPCS,J2598,"Inj, vasopressin, 1 unit",,,1.42,1.42,4 HCPCS,J2598,NDC Description Not Available,4.455,1.7850000000000001,,,0 HCPCS,J2598,Vasopressin: 1 Vial In 1 Carton (0548-9701-00) / 1 Ml In 1 Vial,6.21,2.48,,,0 HCPCS,J2598,"Vasopressin: 1 Vial, Multi-Dose In 1 Carton (55150-370-01) / 1 Ml In 1 Vial, Multi-Dose",5.37,2.145,,,0 HCPCS,J2598,Vasopressin: 25 Vial In 1 Carton (43598-914-06) / 1 Ml In 1 Vial (43598-914-11),2.37,0.95,,,0 HCPCS,J2598,"Vasopressin: 25 Vial, Single-Dose In 1 Tray (63323-930-01) / 1 Ml In 1 Vial, Single-Dose (63323-930-00)",3.93,1.5750000000000002,,,0 HCPCS,J2598,"Vasopressin: 25 Vial, Single-Dose In 1 Tray (65219-039-01) / 1 Ml In 1 Vial, Single-Dose (65219-039-00)",4.94,1.98,,,0 HCPCS,J2598,Vasostrict: 1 Vial In 1 Carton (42023-190-01) / 10 Ml In 1 Vial,4.4,1.76,,,0 HCPCS,J2598,Vasostrict: 25 Vial In 1 Carton (42023-164-25) / 1 Ml In 1 Vial (42023-164-01),13.215,5.285,,,0 HCPCS,J2599,Inj vasopressin (am reg) 1 u,,,1.33,1.33,4 HCPCS,J2599,NDC Description Not Available,11.805,4.720000000000001,,,0 HCPCS,J2599,"Vasopressin: 25 Vial, Single-Dose In 1 Carton (0517-1020-25) / 1 Ml In 1 Vial, Single-Dose (0517-1020-01)",4.55,1.82,,,0 HCPCS,J2601,"Inj, vasopressin (baxter)",,,2.33,5.82,9 HCPCS,J2675,Inj progesterone per 50 MG,,,0.66,0.66,4 HCPCS,J2679,Inj fluphenazine hcl 1.25 mg,,,7.15,7.15,4 HCPCS,J2680,Fluphenazine decanoate 25 MG,,,8.83,8.83,4 HCPCS,J2690,NDC Description Not Available,1508.155,603.26,,,0 HCPCS,J2690,"Procainamide Hydrochloride: 25 Carton In 1 Case (0409-1902-01) / 1 Vial, Multi-Dose In 1 Carton (0409-1902-11) / 10 Ml In 1 Vial, Multi-Dose",1803.26,721.3,,,0 HCPCS,J2690,Procainamide hcl injection,,,284.34,987.17,9 HCPCS,J2700,Oxacillin sodium injeciton,,,0.64,0.64,4 HCPCS,J2704,1 VIAL in 1 CARTON (0069-0234-01) / 50 mL in 1 VIAL,0.95,0.38,,,0 HCPCS,J2704,1 VIAL in 1 CARTON (0069-0248-01) / 100 mL in 1 VIAL,0.43,0.17,,,0 HCPCS,J2704,Diprivan: 10 Vial In 1 Box (63323-269-10) / 10 Ml In 1 Vial (63323-269-01),0.48,0.19,,,0 HCPCS,J2704,Diprivan: 10 Vial In 1 Box (63323-269-29) / 20 Ml In 1 Vial (63323-269-22),1.43,0.57,,,0 HCPCS,J2704,Diprivan: 10 Vial In 1 Box (63323-269-65) / 100 Ml In 1 Vial (63323-269-35),1.42,0.57,,,0 HCPCS,J2704,Diprivan: 10 Vial In 1 Box (63323-269-78) / 100 Ml In 1 Vial (63323-269-31),0.48,0.19,,,0 HCPCS,J2704,Diprivan: 20 Vial In 1 Box (63323-269-50) / 50 Ml In 1 Vial (63323-269-30),1.45,0.58,,,0 HCPCS,J2704,"Inj, propofol, 10 mg",,,0.09,0.09,4 HCPCS,J2704,NDC Description Not Available,0.45,0.23,,,0 HCPCS,J2704,Propofol: 10 Vial In 1 Carton (0069-0209-10) / 20 Ml In 1 Vial (0069-0209-01),1.57,0.63,,,0 HCPCS,J2704,Propofol: 10 Vial In 1 Carton (0069-0248-10) / 100 Ml In 1 Vial,0.56,0.22,,,0 HCPCS,J2704,Propofol: 10 Vial In 1 Carton (25021-608-51) / 100 Ml In 1 Vial,1.28,0.51,,,0 HCPCS,J2704,Propofol: 10 Vial In 1 Tray (0409-4699-24) / 100 Ml In 1 Vial (0409-4699-54),0.95,0.38,,,0 HCPCS,J2704,Propofol: 20 Vial In 1 Tray (0409-4699-33) / 50 Ml In 1 Vial (0409-4699-53),0.98,0.39,,,0 HCPCS,J2704,Propofol: 5 Vial In 1 Carton (0409-4699-30) / 20 Ml In 1 Vial (0409-4699-50),0.37,0.15,,,0 HCPCS,J2710,NDC Description Not Available,1.42,0.57,,,0 HCPCS,J2710,"Neostigmine Methylsulfate: 10 Vial, Multi-Dose In 1 Carton (31722-995-31) / 10 Ml In 1 Vial, Multi-Dose",1.25,0.5,,,0 HCPCS,J2710,Neostigmine methylslfte inj,,,0.8,0.8,4 HCPCS,J2710,"Neostigmine: 1 Vial, Multi-Dose In 1 Carton (43598-529-11) / 10 Ml In 1 Vial, Multi-Dose",3.99,1.6,,,0 HCPCS,J2720,Inj protamine sulfate/10 MG,,,1.4,1.4,4 HCPCS,J2720,NDC Description Not Available,13.62,5.45,,,0 HCPCS,J2720,"Protamine Sulfate: 1 Vial, Single-Dose In 1 Box (63323-229-30) / 25 Ml In 1 Vial, Single-Dose",9.45,3.78,,,0 HCPCS,J2720,"Protamine Sulfate: 1 Vial, Single-Dose In 1 Box (63323-229-35) / 25 Ml In 1 Vial, Single-Dose",5.64,2.26,,,0 HCPCS,J2720,"Protamine Sulfate: 25 Vial, Single-Dose In 1 Tray (63323-229-05) / 5 Ml In 1 Vial, Single-Dose (63323-229-01)",13.84,5.54,,,0 HCPCS,J2724,Protein C concentrate,,,15.02,37.58,9 HCPCS,J2730,Pralidoxime chloride inj,,,86.7,86.7,4 HCPCS,J2760,Phentolaine mesylate inj,,,296.85,742.12,9 HCPCS,J2760,Phentolamine Mesylate: 1 Vial In 1 Box (0143-9564-01) / 1 Ml In 1 Vial,2190.52,876.21,,,0 HCPCS,J2760,Phentolamine Mesylate: 1 Vial In 1 Carton (51224-012-20) / 1 Injection In 1 Vial,137.49,55.0,,,0 HCPCS,J2765,Metoclopramide hcl injection,,,1.13,1.13,4 HCPCS,J2765,Metoclopramide: 25 Vial In 1 Carton (23155-240-41) / 2 Ml In 1 Vial (23155-240-31),9.49,3.8,,,0 HCPCS,J2765,"Metoclopramide: 25 Vial, Single-Dose In 1 Tray (0409-3414-01) / 2 Ml In 1 Vial, Single-Dose (0409-3414-18)",4.15,1.66,,,0 HCPCS,J2765,"Metoclopramide: 25 Vial, Single-Dose In 1 Tray (0409-3414-11) / 2 Ml In 1 Vial, Single-Dose (0409-3414-21)",4.88,1.95,,,0 HCPCS,J2765,NDC Description Not Available,9.12,3.65,,,0 HCPCS,J2770,Quinupristin/dalfopristin,,,0.01,0.01,4 HCPCS,J2777,"Inj, faricimab-svoa, 0.1mg",,,31.32,78.3,9 HCPCS,J2778,Ranibizumab injection,,,26.38,90.41,9 HCPCS,J2779,"Inj, susvimo 0.1 mg",,,73.54,183.86,9 HCPCS,J2781,"Inj, pegcetacoplan, 1mg",,,135.27,338.17,9 HCPCS,J2782,Inj avacincaptad pegol 0.1mg,,,100.56,251.41,9 HCPCS,J2783,"Elitek: 3 Kit In 1 Carton (0024-5150-10) / 1 Kit In 1 Kit * 1 Ml In 1 Vial, Single-Use (0024-5154-11) * 1 Ml In 1 Ampule (0024-5152-11)",1605.11,642.04,,,0 HCPCS,J2783,NDC Description Not Available,1448.82,579.53,,,0 HCPCS,J2783,Rasburicase,,,370.46,966.57,9 HCPCS,J2785,"Lexiscan: 5 Ml In 1 Syringe, Plastic (0469-6501-89)",283.54,113.42,,,0 HCPCS,J2785,Regadenoson injection,,,4.41,4.41,4 HCPCS,J2785,Regadenoson: 1 Syringe In 1 Carton (76329-3321-0) / 5 Ml In 1 Syringe,33.0,13.2,,,0 HCPCS,J2785,"Regadenoson: 1 Syringe, Plastic In 1 Carton (71288-201-85) / 5 Ml In 1 Syringe, Plastic",21.13,8.45,,,0 HCPCS,J2786,"Injection, reslizumab, 1mg",,,10.49,29.77,9 HCPCS,J2787,Riboflavin 5?phos opth<=3ml,,,2280.0,2280.0,4 HCPCS,J2788,Rho d immune globulin 50 mcg,,,23.62,23.62,4 HCPCS,J2790,Rho d immune globulin inj,,,77.16,77.16,4 HCPCS,J2791,NDC Description Not Available,48.92,19.57,,,0 HCPCS,J2791,Rhophylac injection,,,4.88,4.88,4 HCPCS,J2791,"Rhophylac: 1 Syringe, Glass In 1 Carton (44206-300-01) / 2 Ml In 1 Syringe, Glass (44206-300-90)",50.97,20.39,,,0 HCPCS,J2791,"Rhophylac: 10 Syringe, Glass In 1 Carton (44206-300-10) / 2 Ml In 1 Syringe, Glass (44206-300-90)",22.27,8.91,,,0 HCPCS,J2792,"Rho(D) immune globulin h, sd",,,32.51,88.49,9 HCPCS,J2792,"Winrho Sdf: 1 Vial, Single-Dose In 1 Carton (70257-330-51) / 1 Liquid In 1 Vial, Single-Dose (70257-330-11)",635.97,254.39,,,0 HCPCS,J2793,Rilonacept injection,,,27.1,27.1,4 HCPCS,J2794,NDC Description Not Available,54.42,21.77,,,0 HCPCS,J2794,Risperdal Consta: 1 Kit In 1 Box (50458-307-11) * 2 Ml In 1 Vial * 2 Ml In 1 Syringe (50458-307-01),51.91,20.76,,,0 HCPCS,J2794,Risperdal Consta: 1 Kit In 1 Box (50458-308-11) * 2 Ml In 1 Vial * 2 Ml In 1 Syringe (50458-308-01),51.92,20.77,,,0 HCPCS,J2794,"Risperidone, long acting",,,10.5,26.66,9 HCPCS,J2795,NDC Description Not Available,0.6799999999999999,0.275,,,0 HCPCS,J2795,Naropin: 24 Bag In 1 Case (63323-285-63) / 200 Ml In 1 Bag (63323-285-04),0.76,0.3,,,0 HCPCS,J2795,"Naropin: 25 Vial, Single-Dose In 1 Carton (63323-285-13) / 10 Ml In 1 Vial, Single-Dose (63323-285-03)",1.23,0.49,,,0 HCPCS,J2795,"Naropin: 25 Vial, Single-Dose In 1 Carton (63323-286-23) / 20 Ml In 1 Vial, Single-Dose (63323-286-05)",0.74,0.3,,,0 HCPCS,J2795,"Naropin: 25 Vial, Single-Dose In 1 Carton (63323-286-35) / 30 Ml In 1 Vial, Single-Dose (63323-286-11)",0.14,0.06,,,0 HCPCS,J2795,Naropin: 5 Ampule In 1 Box (63323-285-10) / 10 Ml In 1 Ampule (63323-285-01),1.0,0.4,,,0 HCPCS,J2795,Ropivacaine HCl injection,,,0.06,0.06,4 HCPCS,J2795,"Ropivacaine Hydrochloride: 1 VIAL, SINGLE-DOSE in 1 CARTON (17478-081-30) / 30 mL in 1 VIAL, SINGLE-DOSE",0.17,0.07,,,0 HCPCS,J2795,Ropivacaine Hydrochloride: 1 Vial In 1 Carton (70069-064-01) / 30 Ml In 1 Vial,0.28,0.11,,,0 HCPCS,J2795,Ropivacaine Hydrochloride: 10 Bag In 1 Carton (25021-671-82) / 100 Ml In 1 Bag,0.99,0.4,,,0 HCPCS,J2795,Ropivacaine Hydrochloride: 10 Bag In 1 Carton (25021-671-87) / 200 Ml In 1 Bag,0.45,0.18,,,0 HCPCS,J2795,Ropivacaine Hydrochloride: 10 Pouch In 1 Carton (67457-799-99) / 1 Bag In 1 Pouch (67457-799-20) / 200 Ml In 1 Bag,0.37,0.15,,,0 HCPCS,J2795,"Ropivacaine Hydrochloride: 10 VIAL, SINGLE-DOSE in 1 CARTON (0409-9301-30) / 30 mL in 1 VIAL, SINGLE-DOSE (0409-9301-31)",0.2,0.08,,,0 HCPCS,J2795,Ropivacaine Hydrochloride: 10 Vial In 1 Carton (43066-015-10) / 20 Ml In 1 Vial (43066-015-01),0.56,0.22,,,0 HCPCS,J2795,Ropivacaine Hydrochloride: 10 Vial In 1 Carton (70069-061-10) / 10 Ml In 1 Vial (70069-061-01),1.09,0.44,,,0 HCPCS,J2795,Ropivacaine Hydrochloride: 10 Vial In 1 Carton (70069-062-10) / 20 Ml In 1 Vial (70069-062-01),0.95,0.38,,,0 HCPCS,J2795,Ropivacaine Hydrochloride: 24 Pouch In 1 Carton (70121-1733-9) / 1 Bag In 1 Pouch / 200 Ml In 1 Bag,0.33,0.13,,,0 HCPCS,J2795,Ropivacaine Hydrochloride: 25 Vial In 1 Carton (70069-064-25) / 30 Ml In 1 Vial,0.13,0.05,,,0 HCPCS,J2795,"Ropivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-195-20) / 20 Ml In 1 Vial, Single-Dose",0.99,0.4,,,0 HCPCS,J2795,"Ropivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-197-20) / 20 Ml In 1 Vial, Single-Dose",0.1,0.04,,,0 HCPCS,J2795,"Ropivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-198-30) / 30 Ml In 1 Vial, Single-Dose",0.24,0.1,,,0 HCPCS,J2795,"Ropivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (71288-732-11) / 10 Ml In 1 Vial, Single-Dose (71288-732-10)",0.54,0.22,,,0 HCPCS,J2796,Nplate: 1 Vial In 1 Carton (55513-221-01) / .5 Ml In 1 Vial,7.84,3.14,,,0 HCPCS,J2796,Nplate: 1 Vial In 1 Carton (55513-222-01) / 1 Ml In 1 Vial,64.76,25.9,,,0 HCPCS,J2797,"Inj., rolapitant, 0.5 mg",,,0.01,0.01,4 HCPCS,J2798,"Inj., perseris, 0.5 mg",,,12.15,30.48,9 HCPCS,J2799,"Inj, uzedy, 1 mg",,,24.62,65.57,9 HCPCS,J2800,Methocarbamol injection,,,6.36,6.36,4 HCPCS,J2800,NDC Description Not Available,44.94,17.98,,,0 HCPCS,J2800,Robaxin: 10 Vial In 1 Carton (0641-6103-10) / 10 Ml In 1 Vial (0641-6103-01),24.74,9.9,,,0 HCPCS,J2801,"Inj, rykindo, 0.5 mg",,,12.29,32.58,9 HCPCS,J2802,"Inj, romiplostim 1 microgram",,,10.52,29.28,9 HCPCS,J2802,"Nplate: 1 Vial, Single-Dose In 1 Carton (55513-223-01) / .25 Ml In 1 Vial, Single-Dose",62.36,24.94,,,0 HCPCS,J2804,"Inj, rifampin, 1 mg",,,0.14,0.14,4 HCPCS,J2804,"Rifampin: 1 Vial In 1 Box (63323-351-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",1.1,0.44,,,0 HCPCS,J2804,Rifampin: 1 Vial In 1 Carton (67457-445-60) / 10 Ml In 1 Vial,0.46,0.18,,,0 HCPCS,J2805,Kinevac: 10 Vial In 1 Package (0270-0556-15) / 5 Ml In 1 Vial,574.88,229.95,,,0 HCPCS,J2805,NDC Description Not Available,283.2,113.28,,,0 HCPCS,J2805,Sincalide injection,,,143.26,143.26,4 HCPCS,J2805,Sincalide: 10 Vial In 1 Package (63323-579-05) / 5 Ml In 1 Vial (63323-579-01),202.92,81.17,,,0 HCPCS,J2805,Sincalide: 5 Vial In 1 Package (72266-248-05) / 5 Ml In 1 Vial (72266-248-01),138.37,55.35,,,0 HCPCS,J2810,Inj theophylline per 40 MG,,,0.01,0.01,4 HCPCS,J2820,NDC Description Not Available,205.56,82.22,,,0 HCPCS,J2820,Sargramostim injection,,,59.88,156.18,9 HCPCS,J2840,Inj sebelipase alfa 1 mg,,,510.5,1348.96,9 HCPCS,J2850,"Chirhostim: 8 Ml In 1 Vial, Single-Use (67066-005-01)",176.43,70.57,,,0 HCPCS,J2850,Inj secretin synthetic human,,,39.38,109.35,9 HCPCS,J2860,"Injection, siltuximab",,,163.37,446.07,9 HCPCS,J2865,Inj sulfameth/trim 5 mg/1 mg,,,0.06,0.06,4 HCPCS,J2865,NDC Description Not Available,0.27,0.10500000000000001,,,0 HCPCS,J2865,Sulfamethoxazole And Trimethoprim: 1 Vial In 1 Carton (70069-363-01) / 30 Ml In 1 Vial,0.16,0.06,,,0 HCPCS,J2865,"Sulfamethoxazole And Trimethoprim: 1 Vial, Multi-Dose In 1 Carton (0703-9526-01) / 30 Ml In 1 Vial, Multi-Dose",0.35,0.14,,,0 HCPCS,J2910,Aurothioglucose injeciton,,,0.01,0.01,4 HCPCS,J2916,"Ferrlecit: 10 Vial, Single-Use In 1 Carton (0024-2792-10) / 5 Ml In 1 Vial, Single-Use (0024-2792-01)",27.41,10.96,,,0 HCPCS,J2916,NDC Description Not Available,27.41,10.96,,,0 HCPCS,J2916,Na ferric gluconate complex,,,1.94,1.94,4 HCPCS,J2919,"Inj, methylpred sod succ 5mg",,,0.25,0.25,4 HCPCS,J2919,"Methylprednisolone Sodium Succinate: 1 Vial, Multi-Dose In 1 Carton (43598-128-11) / 8 Ml In 1 Vial, Multi-Dose",0.98,0.39,,,0 HCPCS,J2919,"Methylprednisolone Sodium Succinate: 1 Vial, Multi-Dose In 1 Carton (43598-130-74) / 16 Ml In 1 Vial, Multi-Dose",0.73,0.29,,,0 HCPCS,J2919,"Methylprednisolone Sodium Succinate: 1 Vial, Multi-Dose In 1 Carton (63323-265-30) / 16 Ml In 1 Vial, Multi-Dose",0.77,0.31,,,0 HCPCS,J2919,"Methylprednisolone Sodium Succinate: 25 Vial, Single-Dose In 1 Carton (43598-127-25) / 1 Ml In 1 Vial, Single-Dose (43598-127-45)",1.21,0.48,,,0 HCPCS,J2919,"Methylprednisolone Sodium Succinate: 25 Vial, Single-Dose In 1 Carton (43598-129-25) / 2 Ml In 1 Vial, Single-Dose (43598-129-01)",0.4,0.16,,,0 HCPCS,J2919,"Methylprednisolone Sodium Succinate: 25 Vial, Single-Dose In 1 Tray (63323-255-03) / 1 Ml In 1 Vial, Single-Dose (63323-255-01)",4.1,1.64,,,0 HCPCS,J2919,"Methylprednisolone Sodium Succinate: 25 Vial, Single-Dose In 1 Tray (63323-258-03) / 2 Ml In 1 Vial, Single-Dose (63323-258-01)",2.24,0.9,,,0 HCPCS,J2919,NDC Description Not Available,2.1799999999999997,0.87,,,0 HCPCS,J2919,Solu-Medrol: 1 Vial In 1 Carton (0009-0003-02) / 4 Ml In 1 Vial,2.15,0.86,,,0 HCPCS,J2919,Solu-Medrol: 1 Vial In 1 Carton (0009-0018-20) / 8 Ml In 1 Vial,1.55,0.62,,,0 HCPCS,J2919,Solu-Medrol: 1 Vial In 1 Carton (0009-0698-01) / 16 Ml In 1 Vial,1.02,0.41,,,0 HCPCS,J2919,Solu-Medrol: 1 Vial In 1 Carton (0009-0758-01) / 8 Ml In 1 Vial,1.07,0.43,,,0 HCPCS,J2919,Solu-Medrol: 25 Vial In 1 Carton (0009-0039-28) / 1 Ml In 1 Vial (0009-0039-30),5.8,2.32,,,0 HCPCS,J2919,Solu-Medrol: 25 Vial In 1 Carton (0009-0047-22) / 2 Ml In 1 Vial (0009-0047-25),1.53,0.61,,,0 HCPCS,J2941,Somatropin injection,,,155.45,155.45,4 HCPCS,J2993,Reteplase injection,,,3021.04,3543.59,5 HCPCS,J2997,"Activase: 1 Kit In 1 Carton (50242-044-13) * 50 Ml In 1 Vial, Single-Use * 50 Ml In 1 Vial, Single-Use",392.37,156.95,,,0 HCPCS,J2997,"Activase: 1 Kit In 1 Carton (50242-085-27) * 100 Ml In 1 Vial, Single-Use * 100 Ml In 1 Vial, Single-Use",389.23,155.69,,,0 HCPCS,J2997,Alteplase recombinant,,,91.46,246.04,9 HCPCS,J2997,Cathflo Activase: 1 Vial In 1 Carton (50242-041-64) / 2 Ml In 1 Vial,397.8,159.12,,,0 HCPCS,J2997,Cathflo Activase: 10 Vial In 1 Carton (50242-041-10) / 2 Ml In 1 Vial,399.11,159.64,,,0 HCPCS,J2997,NDC Description Not Available,536.62,214.65,,,0 HCPCS,J2998,Inj plasminogen tvmh 1mg,,,32.99,95.46,9 HCPCS,J3000,Streptomycin injection,,,25.59,25.59,4 HCPCS,J3010,"Fentanyl Citrate: 1 Vial, Single-Dose In 1 Carton (63323-806-50) / 50 Ml In 1 Vial, Single-Dose",2.91,1.16,,,0 HCPCS,J3010,Fentanyl Citrate: 10 Ampule In 1 Carton (0641-6024-10) / 2 Ml In 1 Ampule (0641-6024-01),1.84,0.74,,,0 HCPCS,J3010,Fentanyl Citrate: 10 Ampule In 1 Cello Pack (0409-9093-35) / 5 Ml In 1 Ampule (0409-9093-45),4.19,1.68,,,0 HCPCS,J3010,"Fentanyl Citrate: 25 Carton In 1 Tray (0409-9094-61) / 1 Vial, Single-Dose In 1 Carton / 50 Ml In 1 Vial, Single-Dose (0409-9094-41)",1.67,0.67,,,0 HCPCS,J3010,Fentanyl Citrate: 25 Vial In 1 Carton (0641-6027-25) / 2 Ml In 1 Vial (0641-6027-01),11.27,4.51,,,0 HCPCS,J3010,"Fentanyl Citrate: 25 Vial, Single-Dose In 1 Tray (0409-9094-22) / 2 Ml In 1 Vial, Single-Dose (0409-9094-12)",3.54,1.42,,,0 HCPCS,J3010,Fentanyl Citrate: 50 Ml In 1 Vial (0641-6030-01),4.17,1.67,,,0 HCPCS,J3010,Fentanyl citrate injeciton,,,0.84,0.84,4 HCPCS,J3010,NDC Description Not Available,4.28,1.71,,,0 HCPCS,J3030,NDC Description Not Available,34.735,13.895,,,0 HCPCS,J3030,"Sumatriptan Succinate: 1 Vial, Single-Dose In 1 Carton (63323-273-01) / .5 Ml In 1 Vial, Single-Dose",25.9,10.36,,,0 HCPCS,J3030,Sumatriptan succinate / 6 MG,,,37.0,37.0,4 HCPCS,J3030,Sumatriptan: 5 Vial In 1 Carton (0143-9638-05) / .5 Ml In 1 Vial (0143-9638-01),25.87,10.35,,,0 HCPCS,J3030,"Sumatriptan: 5 Vial, Single-Dose In 1 Carton (55150-173-01) / .5 Ml In 1 Vial, Single-Dose",48.98,19.59,,,0 HCPCS,J3031,"Inj., fremanezumab-vfrm 1 mg",,,3.36,3.36,4 HCPCS,J3032,Inj. eptinezumab-jjmr 1 mg,,,19.32,53.11,9 HCPCS,J3032,"Vyepti: 1 Vial, Single-Dose In 1 Carton (67386-130-51) / 1 Ml In 1 Vial, Single-Dose",81.82,32.73,,,0 HCPCS,J3055,Inj talquetamab-tgvs 0.25 mg,,,70.0,193.68,9 HCPCS,J3055,"Talvey: 1 Vial, Single-Dose In 1 Carton (57894-469-01) / 1.5 Ml In 1 Vial, Single-Dose",274.02,109.61,,,0 HCPCS,J3055,"Talvey: 1 Vial, Single-Dose In 1 Carton (57894-470-01) / 1 Ml In 1 Vial, Single-Dose",306.05,122.42,,,0 HCPCS,J3060,"Inj, taliglucerace alfa 10 u",,,40.64,106.18,9 HCPCS,J3070,Pentazocine injection,,,0.01,0.01,4 HCPCS,J3090,Inj tedizolid phosphate,,,1.8,5.16,9 HCPCS,J3095,Telavancin injection,,,7.09,20.37,9 HCPCS,J3101,Tenecteplase injection,,,162.46,576.86,9 HCPCS,J3101,"Tnkase: 1 Kit In 1 Carton (50242-120-47) * 1 Vial, Single-Use In 1 Carton (50242-037-06) / 10 Ml In 1 Vial, Single-Use * 1 Vial, Single-Use In 1 Carton (50242-901-09) / 10 Ml In 1 Vial, Single-Us",636.14,254.46,,,0 HCPCS,J3101,"Tnkase: 1 Kit In 1 Carton (50242-176-01) * 1 Vial, Single-Use In 1 Carton (50242-037-06) / 10 Ml In 1 Vial, Single-Use * 1 Vial, Single-Use In 1 Carton (50242-901-09) / 10 Ml In 1 Vial, Single-Us",740.01,296.0,,,0 HCPCS,J3105,NDC Description Not Available,30.585,12.235,,,0 HCPCS,J3105,Terbutaline Sulfate: 10 Vial In 1 Carton (0143-9746-10) / 1 Ml In 1 Vial (0143-9746-01),1.36,0.54,,,0 HCPCS,J3105,"Terbutaline Sulfate: 25 Vial, Single-Use In 1 Tray (63323-665-01) / 1 Ml In 1 Vial, Single-Use (63323-665-00)",6.81,2.72,,,0 HCPCS,J3105,Terbutaline sulfate inj,,,1.41,1.41,4 HCPCS,J3110,Teriparatide injection,,,50.33,50.33,4 HCPCS,J3111,Evenity: 2 Syringe In 1 Carton (55513-880-02) / 1.17 Ml In 1 Syringe (55513-880-01),54.84,21.94,,,0 HCPCS,J3111,"Evenity: 2 Syringe, Glass In 1 Carton (55513-998-02) / 1.17 Ml In 1 Syringe, Glass (55513-998-01)",53.98,21.59,,,0 HCPCS,J3111,Inj. romosozumab-aqqg 1 mg,,,11.49,31.98,9 HCPCS,J3111,NDC Description Not Available,54.84,21.94,,,0 HCPCS,J3121,Inj testostero enanthate 1mg,,,0.05,0.05,4 HCPCS,J3145,Testosterone undecanoate 1mg,,,2.02,5.51,9 HCPCS,J3230,Chlorpromazine Hydrochloride: 25 Ampule In 1 Carton (0641-1397-35) / 1 Ml In 1 Ampule (0641-1397-31),213.78,85.51,,,0 HCPCS,J3230,Chlorpromazine hcl injection,,,29.04,29.04,4 HCPCS,J3230,NDC Description Not Available,191.615,76.64500000000001,,,0 HCPCS,J3240,NDC Description Not Available,9100.81,3640.32,,,0 HCPCS,J3240,"Thyrogen: 2 Vial, Single-Dose In 1 Carton (58468-0030-2) / 1 Ml In 1 Vial, Single-Dose (58468-0030-1)",8702.53,3481.01,,,0 HCPCS,J3240,Thyrotropin injection,,,2078.71,5387.78,9 HCPCS,J3241,Inj. teprotumumab-trbw 10 mg,,,352.56,954.07,9 HCPCS,J3243,NDC Description Not Available,1.96,0.78,,,0 HCPCS,J3243,Tigecycline injection,,,0.3,0.3,4 HCPCS,J3244,Inj. tigecycline (accord),,,2.5,2.5,4 HCPCS,J3245,"Inj., tildrakizumab, 1 mg",,,120.96,302.41,9 HCPCS,J3246,Tirofiban hcl,,,3.55,3.55,4 HCPCS,J3247,"Cosentyx: 5 Ml In 1 Vial, Glass (0078-1168-61)",77.63,31.05,,,0 HCPCS,J3247,Inj secukinumab intrav 1mg,,,17.73,45.33,9 HCPCS,J3250,Trimethobenzamide hcl inj,,,50.04,50.04,4 HCPCS,J3260,NDC Description Not Available,5.89,2.36,,,0 HCPCS,J3260,Tobramycin sulfate injection,,,1.6,1.6,4 HCPCS,J3260,Tobramycin: 1 Vial In 1 Carton (39822-0412-1) / 30 Ml In 1 Vial,23.33,9.33,,,0 HCPCS,J3260,"Tobramycin: 1 Vial, Multi-Dose In 1 Carton (36000-242-01) / 30 Ml In 1 Vial, Multi-Dose",5.46,2.18,,,0 HCPCS,J3260,Tobramycin: 10 Vial In 1 Carton (67457-428-30) / 30 Ml In 1 Vial (67457-428-00),6.09,2.44,,,0 HCPCS,J3260,"Tobramycin: 10 Vial, Multi-Dose In 1 Tray (63323-306-30) / 30 Ml In 1 Vial, Multi-Dose (63323-306-05)",3.49,1.4,,,0 HCPCS,J3260,Tobramycin: 25 Vial In 1 Carton (67457-473-22) / 2 Ml In 1 Vial (67457-473-00),3.58,1.43,,,0 HCPCS,J3260,Tobramycin: 6 Vial In 1 Carton (39822-0412-6) / 30 Ml In 1 Vial,20.41,8.16,,,0 HCPCS,J3262,"Actemra: 1 Vial, Single-Use In 1 Box (50242-135-01) / 4 Ml In 1 Vial, Single-Use",28.42,11.37,,,0 HCPCS,J3262,"Actemra: 1 Vial, Single-Use In 1 Box (50242-136-01) / 10 Ml In 1 Vial, Single-Use",28.43,11.37,,,0 HCPCS,J3262,"Actemra: 1 Vial, Single-Use In 1 Box (50242-137-01) / 20 Ml In 1 Vial, Single-Use",28.48,11.39,,,0 HCPCS,J3262,Tocilizumab injection,,,5.32,13.31,9 HCPCS,J3263,"Inj, toripalimab-tpzi, 1 mg",,,39.1,101.64,9 HCPCS,J3263,"Loqtorzi: 1 Vial, Glass In 1 Carton (70114-340-01) / 6 Ml In 1 Vial, Glass",171.96,68.78,,,0 HCPCS,J3265,Injection torsemide 10 mg/ml,,,0.01,0.01,4 HCPCS,J3285,Treprostinil injection,,,54.56,136.41,9 HCPCS,J3285,Treprostinil: 1 Vial In 1 Carton (42023-208-01) / 20 Ml In 1 Vial,86.16,34.46,,,0 HCPCS,J3285,"Treprostinil: 1 Vial, Multi-Dose In 1 Carton (0703-0686-01) / 20 Ml In 1 Vial, Multi-Dose",275.61,110.24,,,0 HCPCS,J3285,"Treprostinil: 1 Vial, Multi-Dose In 1 Carton (0781-3427-80) / 20 Ml In 1 Vial, Multi-Dose",243.72,97.49,,,0 HCPCS,J3299,Inj xipere 1 mg,,,47.7,119.26,9 HCPCS,J3300,Triamcinolone A inj PRS-free,,,17.2,43.0,9 HCPCS,J3300,"Triesence: 1 Blister Pack In 1 Carton (0078-0897-78) / 1 Vial, Glass In 1 Blister Pack / 1 Ml In 1 Vial, Glass",108.56,43.42,,,0 HCPCS,J3301,"Kenalog-10: 1 Vial, Multi-Dose In 1 Carton (0003-0494-20) / 5 Ml In 1 Vial, Multi-Dose",10.6,4.24,,,0 HCPCS,J3301,"Kenalog-10: 1 Vial, Multi-Dose In 1 Carton (50090-0295-1) / 5 Ml In 1 Vial, Multi-Dose",9.95,3.98,,,0 HCPCS,J3301,"Kenalog-40: 1 Vial, Multi-Dose In 1 Carton (0003-0293-20) / 5 Ml In 1 Vial, Multi-Dose",10.67,4.27,,,0 HCPCS,J3301,"Kenalog-40: 1 Vial, Multi-Dose In 1 Carton (0003-0293-28) / 10 Ml In 1 Vial, Multi-Dose",7.81,3.12,,,0 HCPCS,J3301,"Kenalog-40: 1 Vial, Single-Dose In 1 Carton (0003-0293-05) / 1 Ml In 1 Vial, Single-Dose",10.3,4.12,,,0 HCPCS,J3301,NDC Description Not Available,11.795,4.720000000000001,,,0 HCPCS,J3301,Triamcinolone Acetonide: 1 Vial In 1 Carton (70121-1049-2) / 1 Ml In 1 Vial (70121-1049-1),12.43,4.97,,,0 HCPCS,J3301,"Triamcinolone Acetonide: 1 Vial, Multi-Dose In 1 Carton (0703-0243-01) / 5 Ml In 1 Vial, Multi-Dose",4.91,1.96,,,0 HCPCS,J3301,"Triamcinolone Acetonide: 1 Vial, Multi-Dose In 1 Carton (0703-0245-01) / 10 Ml In 1 Vial, Multi-Dose",3.25,1.3,,,0 HCPCS,J3301,"Triamcinolone Acetonide: 1 Vial, Multi-Dose In 1 Carton (55150-384-01) / 5 Ml In 1 Vial, Multi-Dose",3.87,1.55,,,0 HCPCS,J3301,"Triamcinolone Acetonide: 1 Vial, Multi-Dose In 1 Carton (67457-622-05) / 5 Ml In 1 Vial, Multi-Dose",9.93,3.97,,,0 HCPCS,J3301,"Triamcinolone Acetonide: 1 Vial, Multi-Dose In 1 Carton (70121-1168-1) / 5 Ml In 1 Vial, Multi-Dose",15.12,6.05,,,0 HCPCS,J3301,"Triamcinolone Acetonide: 1 Vial, Multi-Dose In 1 Carton (70121-1169-1) / 10 Ml In 1 Vial, Multi-Dose",12.63,5.05,,,0 HCPCS,J3301,"Triamcinolone Acetonide: 1 Vial, Multi-Dose In 1 Carton (70121-1655-1) / 10 Ml In 1 Vial, Multi-Dose",2.64,1.06,,,0 HCPCS,J3301,"Triamcinolone Acetonide: 1 Vial, Multi-Dose In 1 Carton (81298-5783-3) / 10 Ml In 1 Vial, Multi-Dose",2.38,0.95,,,0 HCPCS,J3301,"Triamcinolone Acetonide: 1 Vial, Single-Dose In 1 Carton (0703-0241-01) / 1 Ml In 1 Vial, Single-Dose",12.8,5.12,,,0 HCPCS,J3301,Triamcinolone Acetonide: 25 Vial In 1 Carton (0143-9387-25) / 1 Ml In 1 Vial (0143-9387-01),5.72,2.29,,,0 HCPCS,J3301,Triamcinolone Acetonide: 25 Vial In 1 Carton (70121-1049-5) / 1 Ml In 1 Vial (70121-1049-1),17.36,6.94,,,0 HCPCS,J3301,Triamcinolone acet inj nos,,,0.87,0.87,4 HCPCS,J3303,Triamcinolone hexacetonl inj,,,8.13,8.13,4 HCPCS,J3304,Inj triamcinolone ace xr 1mg,,,18.01,47.9,9 HCPCS,J3305,Inj trimetrexate glucoronate,,,0.01,0.01,4 HCPCS,J3315,"Trelstar: 1 Kit In 1 Carton (74676-5902-1) * 2 Ml In 1 Vial, Single-Dose (74676-5902-0) * 2 Ml In 1 Syringe",4071.89,1628.76,,,0 HCPCS,J3315,"Trelstar: 1 Kit In 1 Carton (74676-5904-1) * 2 Ml In 1 Vial, Single-Dose (74676-5904-0) * 2 Ml In 1 Syringe",3166.96,1266.78,,,0 HCPCS,J3315,Triptorelin pamoate,,,467.06,1167.65,9 HCPCS,J3316,"Inj., triptorelin xr 3.75 mg",,,3506.04,9576.1,9 HCPCS,J3355,"Urofollitropin, 75 iu",,,0.01,0.01,4 HCPCS,J3357,"Stelara: 1 Vial, Single-Use In 1 Carton (57894-060-02) / .5 Ml In 1 Vial, Single-Use",989.39,395.76,,,0 HCPCS,J3357,"Ustekinumab sub cu inj, 1 mg",,,323.91,323.91,4 HCPCS,J3358,"Stelara: 1 Vial, Single-Use In 1 Box (57894-054-27) / 26 Ml In 1 Vial, Single-Use",69.79,27.92,,,0 HCPCS,J3358,"Ustekinumab, iv inject, 1 mg",,,10.25,25.62,9 HCPCS,J3360,Diazepam injection,,,5.79,5.79,4 HCPCS,J3360,Diazepam: 10 Cartridge In 1 Carton (0409-1273-32) / 2 Ml In 1 Cartridge (0409-1273-03),43.22,17.29,,,0 HCPCS,J3360,"Diazepam: 10 Syringe, Glass In 1 Carton (43598-106-10) / 2 Ml In 1 Syringe, Glass (43598-106-11)",44.03,17.61,,,0 HCPCS,J3360,"Diazepam: 24 Syringe, Glass In 1 Carton (76045-204-20) / 2 Ml In 1 Syringe, Glass (76045-204-00)",49.1,19.64,,,0 HCPCS,J3360,NDC Description Not Available,48.900000000000006,19.56,,,0 HCPCS,J3364,Urokinase 5000 IU injection,,,0.01,0.01,4 HCPCS,J3365,"Urokinase 250,000 IU inj",,,0.01,0.01,4 HCPCS,J3370,NDC Description Not Available,27.98,11.19,,,0 HCPCS,J3370,"Vancomycin Hydrochloride: 1 Bag In 1 Bag (66288-7100-1) / 1 Injection, Powder, Lyophilized, For Solution In 1 Bag",8.58,3.43,,,0 HCPCS,J3370,Vancomycin Hydrochloride: 1 Bottle In 1 Carton (63323-314-61) / 100 Ml In 1 Bottle,5.35,2.14,,,0 HCPCS,J3370,"Vancomycin Hydrochloride: 1 Vial In 1 Carton (70436-023-82) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",5.14,2.06,,,0 HCPCS,J3370,"Vancomycin Hydrochloride: 1 Vial, Pharmacy Bulk Package In 1 Carton (71288-026-75) / 95 Ml In 1 Vial, Pharmacy Bulk Package",46.78,18.71,,,0 HCPCS,J3370,"Vancomycin Hydrochloride: 10 Vial In 1 Carton (0143-9355-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (0143-9355-01)",18.8,7.52,,,0 HCPCS,J3370,Vancomycin Hydrochloride: 10 Vial In 1 Carton (67457-340-01) / 20 Ml In 1 Vial (67457-340-00),8.85,3.54,,,0 HCPCS,J3370,"Vancomycin Hydrochloride: 10 Vial In 1 Carton (70436-021-82) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",5.25,2.1,,,0 HCPCS,J3370,"Vancomycin Hydrochloride: 10 Vial In 1 Tray (0409-4332-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (0409-4332-11)",32.99,13.2,,,0 HCPCS,J3370,Vancomycin Hydrochloride: 10 Vial In 1 Tray (63323-203-20) / 15 Ml In 1 Vial (63323-203-01),20.45,8.18,,,0 HCPCS,J3370,"Vancomycin Hydrochloride: 10 Vial, Single-Dose In 1 Carton (71288-024-21) / 15 Ml In 1 Vial, Single-Dose (71288-024-20)",34.82,13.93,,,0 HCPCS,J3370,"Vancomycin Hydrochloride: 10 Vial, Single-Dose In 1 Carton (72078-065-99) / 50 Ml In 1 Vial, Single-Dose",43.64,17.46,,,0 HCPCS,J3370,"Vancomycin Hydrochloride: 10 Vial, Single-Dose In 1 Carton (72078-066-99) / 50 Ml In 1 Vial, Single-Dose",49.41,19.76,,,0 HCPCS,J3370,"Vancomycin Hydrochloride: 10 Vial, Single-Dose In 1 Tray (0409-6535-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose (0409-6535-11)",12.37,4.95,,,0 HCPCS,J3370,Vancomycin Hydrochloride: 200 Ml In 1 Bag (0338-3552-48),16.21,6.48,,,0 HCPCS,J3370,Vancomycin hcl injection,,,1.95,1.95,4 HCPCS,J3371,"Inj, vancomycin hcl (mylan)",,,6.31,6.31,4 HCPCS,J3371,NDC Description Not Available,34.519999999999996,13.809999999999999,,,0 HCPCS,J3372,"Inj, vancomycin hcl (xellia)",,,6.54,6.54,4 HCPCS,J3372,"Vancomycin Hydrochloride: 1 Vial, Glass In 1 Carton (70594-048-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Glass",5.92,2.37,,,0 HCPCS,J3373,NDC Description Not Available,2.965,1.185,,,0 HCPCS,J3373,"Vancomycin Hydrochloride: 1 Vial, Pharmacy Bulk Package In 1 Carton (0409-1319-01) / 100 Ml In 1 Vial, Pharmacy Bulk Package",24.36,9.74,,,0 HCPCS,J3373,"Vancomycin Hydrochloride: 10 Vial In 1 Carton (70436-020-82) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",3.27,1.31,,,0 HCPCS,J3373,"Vancomycin Hydrochloride: 10 Vial In 1 Tray (0409-6531-02) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (0409-6531-12)",7.43,2.97,,,0 HCPCS,J3375,"Vancomycin Hydrochloride: 10 Vial, Glass In 1 Carton (70594-046-02) / 1 Injection, Powder, For Solution In 1 Vial, Glass (70594-046-01)",2.66,1.06,,,0 HCPCS,J3380,"Entyvio: 1 Vial, Single-Dose In 1 Carton (64764-300-20) / 5 Ml In 1 Vial, Single-Dose",131.37,52.55,,,0 HCPCS,J3380,"Injection, vedolizumab",,,20.95,52.37,9 HCPCS,J3385,Velaglucerase alfa,,,374.36,984.82,9 HCPCS,J3385,"Vpriv: 1 Vial, Glass In 1 Box (54092-701-04) / 4 Ml In 1 Vial, Glass",1683.03,673.21,,,0 HCPCS,J3387,Inj elivaldogene autotemecel,,,3180000.0,7950000.0,5 HCPCS,J3389,Topi adm prad zami per treat,,,3285782.7,8214456.75,5 HCPCS,J3391,"Inj, atidarsagene autotemcel",,,4505000.0,11262500.0,5 HCPCS,J3392,"Inj, exagamglogene autotem",,,0.01,5796685.71,9 HCPCS,J3393,"Inj, betibeglogene autotemce",,,0.01,7312808.25,9 HCPCS,J3394,"Inj, lovotibeglogene autotem",,,0.01,8088248.72,9 HCPCS,J3396,Verteporfin injection,,,11.34,28.36,9 HCPCS,J3397,"Inj., vestronidase alfa-vjbk",,,271.6,729.77,9 HCPCS,J3398,Inj luxturna 1 billion vec g,,,0.01,7895.36,9 HCPCS,J3399,Inj onase abepar-xioi treat,,,0.01,6699542.63,9 HCPCS,J3399,Zolgensma: 1 Kit In 1 Carton (71894-120-02) * 1 Ml In 1 Pouch * 8.3 Ml In 1 Vial (71894-115-01),8707666.35,3483066.54,,,0 HCPCS,J3399,Zolgensma: 1 Kit In 1 Carton (71894-122-03) * 8.3 Ml In 1 Vial (71894-115-01) * 1 Ml In 1 Pouch * 5.5 Ml In 1 Vial (71894-110-01),8968896.34,3587558.54,,,0 HCPCS,J3401,"Vyjuvek 5x10^9pfu/ml, 0.1 ml",,,1016.67,2573.67,9 HCPCS,J3402,Inj. remestemcel-l-rknd/ td,,,202159.94,505399.84,5 HCPCS,J3410,"Hydroxyzine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0517-4201-25) / 1 Ml In 1 Vial, Single-Dose (0517-4201-01)",124.97,49.99,,,0 HCPCS,J3410,"Hydroxyzine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0517-5601-25) / 1 Ml In 1 Vial, Single-Dose (0517-5601-01)",74.17,29.67,,,0 HCPCS,J3410,Hydroxyzine hcl injection,,,17.76,17.76,4 HCPCS,J3411,NDC Description Not Available,15.64,6.26,,,0 HCPCS,J3411,Thiamine Hydrochloride: 25 Vial In 1 Carton (0641-6228-25) / 2 Ml In 1 Vial (0641-6228-01),7.76,3.1,,,0 HCPCS,J3411,Thiamine Hydrochloride: 25 Vial In 1 Carton (25021-500-02) / 2 Ml In 1 Vial,22.03,8.81,,,0 HCPCS,J3411,"Thiamine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (43598-050-25) / 2 Ml In 1 Vial, Multi-Dose (43598-050-11)",16.3,6.52,,,0 HCPCS,J3411,"Thiamine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (55150-273-25) / 2 Ml In 1 Vial, Multi-Dose (55150-273-01)",8.36,3.34,,,0 HCPCS,J3411,"Thiamine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (67457-196-02) / 2 Ml In 1 Vial, Multi-Dose (67457-196-00)",10.01,4.0,,,0 HCPCS,J3411,Thiamine hcl 100 mg,,,1.76,1.76,4 HCPCS,J3411,"Thiamine: 25 Vial, Multi-Dose In 1 Tray (63323-013-02) / 2 Ml In 1 Vial, Multi-Dose (63323-013-01)",3.04,1.22,,,0 HCPCS,J3415,NDC Description Not Available,65.59,26.24,,,0 HCPCS,J3415,Pyridoxine Hydrochloride: 25 Vial In 1 Tray (63323-180-01) / 1 Ml In 1 Vial (63323-180-00),26.1,10.44,,,0 HCPCS,J3415,Pyridoxine hcl 100 mg,,,12.57,12.57,4 HCPCS,J3420,Cyanocobalamin: 25 Vial In 1 Box (0143-9621-25) / 1 Ml In 1 Vial (0143-9621-01),14.12,5.65,,,0 HCPCS,J3420,Cyanocobalamin: 25 Vial In 1 Box (69680-112-25) / 1 Ml In 1 Vial (69680-112-01),8.74,3.5,,,0 HCPCS,J3420,"Cyanocobalamin: 25 Vial, Multi-Dose In 1 Carton (70710-1663-7) / 1 Ml In 1 Vial, Multi-Dose (70710-1663-1)",12.05,4.82,,,0 HCPCS,J3420,"Cyanocobalamin: 25 Vial, Multi-Dose In 1 Tray (0517-0031-25) / 1 Ml In 1 Vial, Multi-Dose (0517-0031-01)",9.83,3.93,,,0 HCPCS,J3420,"Cyanocobalamin: 25 Vial, Multi-Dose In 1 Tray (0517-0032-25) / 10 Ml In 1 Vial, Multi-Dose (0517-0032-01)",4.32,1.73,,,0 HCPCS,J3420,"Cyanocobalamin: 25 Vial, Multi-Dose In 1 Tray (63323-044-01) / 1 Ml In 1 Vial, Multi-Dose (63323-044-00)",9.19,3.68,,,0 HCPCS,J3420,NDC Description Not Available,7.755,3.105,,,0 HCPCS,J3420,Vitamin b12 injection,,,0.67,0.67,4 HCPCS,J3424,"Cyanokit: 1 VIAL, GLASS in 1 CARTON (11704-370-01) / 250 mL in 1 VIAL, GLASS",19.09,7.64,,,0 HCPCS,J3424,"Cyanokit: 1 Vial, Glass In 1 Carton (50633-310-11) / 250 Ml In 1 Vial, Glass",23.13,9.25,,,0 HCPCS,J3424,Inj hydroxocobalamin iv 25mg,,,4.99,13.61,9 HCPCS,J3425,"Hydroxocobalamin: 1 Vial, Multi-Dose In 1 Carton (0591-2888-30) / 30 Ml In 1 Vial, Multi-Dose",0.05,0.02,,,0 HCPCS,J3425,"Inj, hydroxocobalamin",,,0.01,0.01,4 HCPCS,J3425,NDC Description Not Available,0.32,0.13,,,0 HCPCS,J3430,NDC Description Not Available,18.78,7.935,,,0 HCPCS,J3430,Phytonadione Phytonadione: 25 Ampule In 1 Carton (43598-405-16) / 1 Ml In 1 Ampule (43598-405-11),9.68,3.87,,,0 HCPCS,J3430,Phytonadione: 1 Syringe In 1 Carton (76329-1240-1) / .5 Ml In 1 Syringe,110.4,44.16,,,0 HCPCS,J3430,Phytonadione: 10 Vial In 1 Carton (69097-709-96) / .5 Ml In 1 Vial,24.98,9.99,,,0 HCPCS,J3430,Vitamin K1: 5 Tray In 1 Container (0409-9158-01) / 5 Ampule In 1 Tray (0409-9158-50) / 1 Ml In 1 Ampule (0409-9158-31),21.55,8.62,,,0 HCPCS,J3430,Vitamin k phytonadione inj,,,2.45,2.45,4 HCPCS,J3465,"Injection, voriconazole",,,1.06,1.06,4 HCPCS,J3465,"Voriconazole: 1 Injection, Powder, Lyophilized, For Solution In 1 Box (70436-029-80)",3.32,1.33,,,0 HCPCS,J3465,"Voriconazole: 1 Vial, Single-Dose In 1 Carton (70594-067-01) / 20 Ml In 1 Vial, Single-Dose",8.8,3.52,,,0 HCPCS,J3465,"Voriconazole: 1 Vial, Single-Dose In 1 Carton (71288-027-30) / 20 Ml In 1 Vial, Single-Dose",7.7,3.08,,,0 HCPCS,J3470,Hyaluronidase injection,,,32.17,32.17,4 HCPCS,J3471,"Ovine, up to 999 usp units",,,0.5,0.5,4 HCPCS,J3472,"Ovine, 1000 USP units",,,0.01,0.01,4 HCPCS,J3473,Hyaluronidase recombinant,,,0.36,0.36,4 HCPCS,J3473,Hylenex Recombinant: 4 Box In 1 Carton (18657-117-04) / 1 Vial In 1 Box (18657-117-02) / 1 Ml In 1 Vial (18657-117-01),1.66,0.66,,,0 HCPCS,J3473,NDC Description Not Available,1.64,0.66,,,0 HCPCS,J3475,Inj magnesium sulfate,,,0.49,0.49,4 HCPCS,J3475,Magnesium Sulfate In Dextrose: 24 Bag In 1 Carton (44567-410-24) / 100 Ml In 1 Bag,5.93,2.37,,,0 HCPCS,J3475,Magnesium Sulfate In Dextrose: 24 Container In 1 Case (0264-4400-54) / 100 Ml In 1 Container,6.59,2.64,,,0 HCPCS,J3475,Magnesium Sulfate In Dextrose: 40 Bag In 1 Case (0338-1709-40) / 100 Ml In 1 Bag,14.36,5.74,,,0 HCPCS,J3475,Magnesium Sulfate In Water: 20 Pouch In 1 Case (0409-2050-20) / 1 Bag In 1 Pouch / 500 Ml In 1 Bag (0409-2050-01),0.69,0.28,,,0 HCPCS,J3475,Magnesium Sulfate In Water: 24 Container In 1 Case (0264-4204-52) / 50 Ml In 1 Container,5.34,2.14,,,0 HCPCS,J3475,Magnesium Sulfate In Water: 24 Container In 1 Case (0264-4206-54) / 100 Ml In 1 Container,1.97,0.79,,,0 HCPCS,J3475,Magnesium Sulfate In Water: 24 Pouch In 1 Carton (44567-420-24) / 1 Bag In 1 Pouch / 50 Ml In 1 Bag,7.48,2.99,,,0 HCPCS,J3475,Magnesium Sulfate In Water: 24 Pouch In 1 Carton (44567-421-24) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,2.01,0.8,,,0 HCPCS,J3475,Magnesium Sulfate In Water: 24 Pouch In 1 Carton (83634-500-81) / 1 Bag In 1 Pouch (83634-500-41) / 50 Ml In 1 Bag,5.78,2.31,,,0 HCPCS,J3475,Magnesium Sulfate: 1 Bag In 1 Pouch (67457-553-00) / 50 Ml In 1 Bag,3.68,1.47,,,0 HCPCS,J3475,Magnesium Sulfate: 24 Bag In 1 Case (63323-106-01) / 100 Ml In 1 Bag (63323-106-00),5.18,2.07,,,0 HCPCS,J3475,Magnesium Sulfate: 24 Bag In 1 Case (63323-106-05) / 50 Ml In 1 Bag (63323-106-02),4.31,1.72,,,0 HCPCS,J3475,Magnesium Sulfate: 24 Bag In 1 Case (63323-106-15) / 500 Ml In 1 Bag,0.66,0.26,,,0 HCPCS,J3475,Magnesium Sulfate: 24 Pouch In 1 Carton (70121-1719-9) / 1 Bag In 1 Pouch / 50 Ml In 1 Bag,4.43,1.77,,,0 HCPCS,J3475,Magnesium Sulfate: 24 Pouch In 1 Carton (70121-1720-9) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,4.05,1.62,,,0 HCPCS,J3475,Magnesium Sulfate: 24 Pouch In 1 Case (47335-992-01) / 1 Bag In 1 Pouch / 50 Ml In 1 Bag,13.69,5.48,,,0 HCPCS,J3475,Magnesium Sulfate: 24 Pouch In 1 Case (47335-992-02) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,3.62,1.45,,,0 HCPCS,J3475,"Magnesium Sulfate: 25 Vial, Single-Dose In 1 Carton (63323-064-03) / 2 Ml In 1 Vial, Single-Dose (63323-064-01)",3.98,1.59,,,0 HCPCS,J3475,"Magnesium Sulfate: 25 Vial, Single-Dose In 1 Tray (63323-064-11) / 10 Ml In 1 Vial, Single-Dose (63323-064-04)",0.83,0.33,,,0 HCPCS,J3475,"Magnesium Sulfate: 25 Vial, Single-Dose In 1 Tray (63323-642-20) / 20 Ml In 1 Vial, Single-Dose (63323-642-01)",2.01,0.8,,,0 HCPCS,J3475,Magnesium Sulfate: 40 Bag In 1 Carton (0338-1715-40) / 100 Ml In 1 Bag,2.11,0.84,,,0 HCPCS,J3475,NDC Description Not Available,2.065,0.825,,,0 HCPCS,J3480,Inj potassium chloride,,,0.21,0.21,4 HCPCS,J3480,NDC Description Not Available,1.69,0.68,,,0 HCPCS,J3480,Potassium Chloride In Sodium Chloride: 14 Bag In 1 Carton (0338-0691-04) / 1000 Ml In 1 Bag,3.14,1.26,,,0 HCPCS,J3480,Potassium Chloride: 24 Bag In 1 Box (14789-109-10) / 100 Ml In 1 Bag (14789-109-16),35.51,14.2,,,0 HCPCS,J3480,Potassium Chloride: 24 Bag In 1 Carton (0338-0703-41) / 50 Ml In 1 Bag,1.58,0.63,,,0 HCPCS,J3480,Potassium Chloride: 24 Bag In 1 Carton (0338-0709-48) / 100 Ml In 1 Bag,3.29,1.32,,,0 HCPCS,J3480,Potassium Chloride: 24 Container In 1 Case (0264-1944-20) / 250 Ml In 1 Container,0.41,0.16,,,0 HCPCS,J3480,Potassium Chloride: 24 POUCH in 1 CASE (0409-7077-14) / 1 BAG in 1 POUCH / 50 mL in 1 BAG,0.09,0.04,,,0 HCPCS,J3480,Potassium Chloride: 24 Pouch In 1 Case (0990-7074-26) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,4.48,1.79,,,0 HCPCS,J3480,Potassium Chloride: 24 Pouch In 1 Case (0990-7077-14) / 1 Bag In 1 Pouch / 50 Ml In 1 Bag,2.22,0.89,,,0 HCPCS,J3480,"Potassium Chloride: 25 Vial, Glass In 1 Carton (14789-137-05) / 20 Ml In 1 Vial, Glass (14789-137-07)",4.71,1.88,,,0 HCPCS,J3480,"Potassium Chloride: 25 Vial, Single-Dose In 1 Tray (63323-965-05) / 5 Ml In 1 Vial, Single-Dose (63323-965-01)",3.73,1.49,,,0 HCPCS,J3480,"Potassium Chloride: 25 Vial, Single-Dose In 1 Tray (63323-965-10) / 10 Ml In 1 Vial, Single-Dose (63323-965-03)",0.92,0.37,,,0 HCPCS,J3480,"Potassium Chloride: 25 Vial, Single-Dose In 1 Tray (63323-965-20) / 20 Ml In 1 Vial, Single-Dose (63323-965-02)",0.3,0.12,,,0 HCPCS,J3485,NDC Description Not Available,5.98,2.39,,,0 HCPCS,J3485,Zidovudine,,,1.51,3.78,9 HCPCS,J3486,NDC Description Not Available,92.625,37.05,,,0 HCPCS,J3486,"Ziprasidone Mesylate: 10 Vial, Single-Dose In 1 Carton (72266-160-10) / 1 Ml In 1 Vial, Single-Dose (72266-160-01)",73.69,29.48,,,0 HCPCS,J3486,Ziprasidone mesylate,,,5.18,5.18,4 HCPCS,J3489,Zoledronic Acid: 1 Bag In 1 Carton (25021-826-82) / 100 Ml In 1 Bag,201.0,80.4,,,0 HCPCS,J3489,Zoledronic Acid: 1 Bag In 1 Carton (25021-830-82) / 100 Ml In 1 Bag,312.32,124.93,,,0 HCPCS,J3489,Zoledronic Acid: 1 Vial In 1 Carton (16729-242-31) / 5 Ml In 1 Vial,15.31,6.12,,,0 HCPCS,J3489,Zoledronic Acid: 1 Vial In 1 Carton (54288-100-01) / 5 Ml In 1 Vial,24.24,9.7,,,0 HCPCS,J3489,Zoledronic Acid: 1 Vial In 1 Carton (67457-390-54) / 5 Ml In 1 Vial,31.77,12.71,,,0 HCPCS,J3489,"Zoledronic Acid: 1 Vial, Glass In 1 Carton (55111-685-07) / 5 Ml In 1 Vial, Glass",57.16,22.86,,,0 HCPCS,J3489,Zoledronic acid 1mg,,,9.52,9.52,4 HCPCS,J3490,"Ascor: 1 Vial, Glass In 1 Carton (67157-101-50) / 50 Ml In 1 Vial, Glass",20.55,8.22,,,0 HCPCS,J3490,"Bridion: 10 Vial, Single-Dose In 1 Carton (0006-5423-12) / 2 Ml In 1 Vial, Single-Dose (0006-5423-02)",384.74,153.9,,,0 HCPCS,J3490,NDC Description Not Available,425.47,170.19,,,0 HCPCS,J3490,"Noxafil: 1 Vial, Glass In 1 Carton (0085-4331-01) / 16.7 Ml In 1 Vial, Glass",2285.39,914.16,,,0 HCPCS,J3490,"Posaconazole: 1 Vial, Glass In 1 Carton (42023-195-01) / 16.7 Ml In 1 Vial, Glass",701.78,280.71,,,0 HCPCS,J3520,Edetate disodium per 150 mg,,,0.01,0.01,4 HCPCS,J3590,Hc T-Cell Amtagvi (Lifileucel),2798760.0,1119504.0,,,0 HCPCS,J3590,NDC Description Not Available,927.0,370.8,,,0 HCPCS,J7030,NDC Description Not Available,23.0,9.2,,,0 HCPCS,J7030,Normal saline solution infus,,,2.47,2.47,4 HCPCS,J7030,Sodium Chloride: 1000 Ml In 1 Bag (0338-0049-04),13.11,5.24,,,0 HCPCS,J7030,Sodium Chloride: 1000 Ml In 1 Bag (0338-9543-06),30.03,12.01,,,0 HCPCS,J7030,Sodium Chloride: 12 Container In 1 Case (0264-5802-00) / 1000 Ml In 1 Container,6.785,2.7150000000000003,,,0 HCPCS,J7030,Sodium Chloride: 12 Container In 1 Case (0264-7800-00) / 1000 Ml In 1 Container,11.83,4.73,,,0 HCPCS,J7030,Sodium Chloride: 12 Container In 1 Case (0264-7800-09) / 1000 Ml In 1 Container,13.2,5.28,,,0 HCPCS,J7030,Sodium Chloride: 12 POUCH in 1 CASE (0409-7983-09) / 1 BAG in 1 POUCH / 1000 mL in 1 BAG,16.5,6.6,,,0 HCPCS,J7030,Sodium Chloride: 12 Pouch In 1 Case (0990-7983-09) / 1 Bag In 1 Pouch / 1000 Ml In 1 Bag,13.305,5.32,,,0 HCPCS,J7040,NDC Description Not Available,13.19,5.28,,,0 HCPCS,J7040,Normal saline solution infus,,,1.24,1.24,4 HCPCS,J7040,Sodium Chloride: 24 Container In 1 Case (0264-5802-10) / 500 Ml In 1 Container,9.83,3.935,,,0 HCPCS,J7040,Sodium Chloride: 24 Container In 1 Case (0264-7800-10) / 500 Ml In 1 Container,15.97,6.39,,,0 HCPCS,J7040,Sodium Chloride: 24 Pouch In 1 Case (0990-7983-03) / 1 Bag In 1 Pouch / 500 Ml In 1 Bag,25.18,10.07,,,0 HCPCS,J7040,Sodium Chloride: 500 Ml In 1 Bag (0338-0049-03),12.44,4.98,,,0 HCPCS,J7040,Sodium Chloride: 500 Ml In 1 Bag (0338-9543-03),9.790000000000001,3.915,,,0 HCPCS,J7040,Sodium Chloride: 500 Ml In 1 Bag (0338-9543-04),18.4,7.36,,,0 HCPCS,J7040,Sodium Chloride: 500 Ml In 1 Bag (17271-701-06),20.7,8.28,,,0 HCPCS,J7040,Sodium Chloride: 500 Ml In 1 Bag (63323-623-75),11.0,4.4,,,0 HCPCS,J7042,5% dextrose/normal saline,,,1.25,1.25,4 HCPCS,J7042,Dextrose And Sodium Chloride: 12 Container In 1 Case (0264-7610-00) / 1000 Ml In 1 Container,8.8,3.52,,,0 HCPCS,J7042,Dextrose And Sodium Chloride: 14 Bag In 1 Carton (0338-0089-04) / 1000 Ml In 1 Bag,9.14,3.655,,,0 HCPCS,J7050,NDC Description Not Available,9.98,3.99,,,0 HCPCS,J7050,Normal saline solution infus,,,0.62,0.62,4 HCPCS,J7050,Sodium Chloride: 1 Bag In 1 Package (0338-0049-41) / 50 Ml In 1 Bag,13.745,5.5,,,0 HCPCS,J7050,Sodium Chloride: 1 Bag In 1 Package (0338-0049-48) / 100 Ml In 1 Bag,9.870000000000001,3.95,,,0 HCPCS,J7050,Sodium Chloride: 10 Pouch In 1 Case (0409-7101-66) / 5 Bag In 1 Pouch / 50 Ml In 1 Bag (0409-7101-68),19.32,7.73,,,0 HCPCS,J7050,Sodium Chloride: 10 Pouch In 1 Case (0409-7101-67) / 5 Bag In 1 Pouch / 100 Ml In 1 Bag (0409-7101-69),9.56,3.82,,,0 HCPCS,J7050,Sodium Chloride: 100 Ml In 1 Bag (0338-0553-18),10.365,4.15,,,0 HCPCS,J7050,Sodium Chloride: 100 Ml In 1 Bag (63323-623-61),6.99,2.8,,,0 HCPCS,J7050,Sodium Chloride: 16 Bag In 1 Package (0338-0049-38) / 100 Ml In 1 Bag,7.26,2.9,,,0 HCPCS,J7050,Sodium Chloride: 20 Pouch In 1 Case (0990-7984-36) / 4 Bag In 1 Pouch / 50 Ml In 1 Bag,6.0,2.4,,,0 HCPCS,J7050,Sodium Chloride: 24 Container In 1 Case (0264-7800-20) / 250 Ml In 1 Container,8.965,3.59,,,0 HCPCS,J7050,Sodium Chloride: 24 Pouch In 1 Case (0409-7101-02) / 1 Bag In 1 Pouch / 250 Ml In 1 Bag (0409-7101-04),13.8,5.52,,,0 HCPCS,J7050,Sodium Chloride: 24 Pouch In 1 Case (0990-7983-02) / 1 Bag In 1 Pouch / 250 Ml In 1 Bag,24.15,9.66,,,0 HCPCS,J7050,"Sodium Chloride: 25 Vial, Single-Dose In 1 Tray (0409-4888-20) / 20 Ml In 1 Vial, Single-Dose (0409-4888-03)",8.08,3.23,,,0 HCPCS,J7050,Sodium Chloride: 250 Ml In 1 Bag (0338-0049-02),12.06,4.824999999999999,,,0 HCPCS,J7050,Sodium Chloride: 250 Ml In 1 Bag (0338-9543-02),12.65,5.06,,,0 HCPCS,J7050,Sodium Chloride: 250 Ml In 1 Bag (17271-701-05),17.25,6.9,,,0 HCPCS,J7050,Sodium Chloride: 250 Ml In 1 Bag (63323-623-74),8.735,3.495,,,0 HCPCS,J7050,Sodium Chloride: 28 Bag In 1 Carton (79672-613-30) / 250 Ml In 1 Bag (79672-613-03),13.56,5.42,,,0 HCPCS,J7050,Sodium Chloride: 28 Bag In 1 Carton (81826-001-21) / 250 Ml In 1 Bag (81826-001-22),22.26,8.9,,,0 HCPCS,J7050,Sodium Chloride: 4 Bag In 1 Package (0338-0049-10) / 25 Ml In 1 Bag,8.969999999999999,3.59,,,0 HCPCS,J7050,Sodium Chloride: 4 Bag In 1 Package (0338-0049-11) / 50 Ml In 1 Bag,10.69,4.28,,,0 HCPCS,J7050,Sodium Chloride: 4 Bag In 1 Package (0338-0049-18) / 100 Ml In 1 Bag,8.17,3.27,,,0 HCPCS,J7050,Sodium Chloride: 50 Bag In 1 Case (65219-220-10) / 100 Ml In 1 Bag (65219-220-01),13.34,5.34,,,0 HCPCS,J7050,Sodium Chloride: 64 Container In 1 Case (0264-1800-32) / 100 Ml In 1 Container,7.699999999999999,3.08,,,0 HCPCS,J7050,Sodium Chloride: 70 Bag In 1 Carton (81826-001-11) / 100 Ml In 1 Bag (81826-001-12),9.45,3.7800000000000002,,,0 HCPCS,J7050,Sodium Chloride: 84 Container In 1 Case (0264-1800-31) / 50 Ml In 1 Container,12.795,5.12,,,0 HCPCS,J7060,5% dextrose/water,,,1.82,1.82,4 HCPCS,J7060,Dextrose: 1 Bag In 1 Package (0338-0017-41) / 50 Ml In 1 Bag,2.42,0.97,,,0 HCPCS,J7060,Dextrose: 1 Bag In 1 Package (0338-0017-48) / 100 Ml In 1 Bag,4.1,1.64,,,0 HCPCS,J7060,Dextrose: 10 Pouch In 1 Case (0409-7100-66) / 5 Bag In 1 Pouch / 50 Ml In 1 Bag (0409-7100-68),9.66,3.86,,,0 HCPCS,J7060,Dextrose: 100 Ml In 1 Bag (0338-0551-18),3.63,1.45,,,0 HCPCS,J7060,Dextrose: 12 POUCH in 1 CASE (0409-7923-20) / 4 BAG in 1 POUCH / 25 mL in 1 BAG,2.07,0.83,,,0 HCPCS,J7060,Dextrose: 16 Bag In 1 Pouch (0338-0017-31) / 50 Ml In 1 Bag,7.59,3.04,,,0 HCPCS,J7060,Dextrose: 24 Container In 1 Case (0264-7510-10) / 500 Ml In 1 Container,1.24,0.5,,,0 HCPCS,J7060,Dextrose: 24 Container In 1 Case (0264-7510-20) / 250 Ml In 1 Container,1.7,0.68,,,0 HCPCS,J7060,Dextrose: 24 Pouch In 1 Case (0990-7922-03) / 1 Bag In 1 Pouch / 500 Ml In 1 Bag,1.11,0.44,,,0 HCPCS,J7060,Dextrose: 250 Ml In 1 Bag (0338-0017-02),3.2,1.28,,,0 HCPCS,J7060,Dextrose: 4 Bag In 1 Pouch (0338-0017-11) / 50 Ml In 1 Bag,5.65,2.26,,,0 HCPCS,J7060,Dextrose: 4 Bag In 1 Pouch (0338-0017-18) / 100 Ml In 1 Bag,7.46,2.98,,,0 HCPCS,J7060,Dextrose: 50 Ml In 1 Bag (0338-0551-11),2.99,1.2,,,0 HCPCS,J7060,Dextrose: 500 Ml In 1 Bag (0338-0017-03),6.08,2.43,,,0 HCPCS,J7060,Dextrose: 64 Container In 1 Case (0264-1510-32) / 100 Ml In 1 Container,4.35,1.74,,,0 HCPCS,J7060,Dextrose: 84 Container In 1 Case (0264-1510-31) / 50 Ml In 1 Container,1.2,0.48,,,0 HCPCS,J7060,NDC Description Not Available,7.87,3.15,,,0 HCPCS,J7070,D5w infusion,,,3.64,3.64,4 HCPCS,J7070,Dextrose: 1000 Ml In 1 Bag (0338-0017-04),20.77,8.31,,,0 HCPCS,J7070,Dextrose: 12 Container In 1 Case (0264-7510-00) / 1000 Ml In 1 Container,18.53,7.41,,,0 HCPCS,J7070,Dextrose: 12 Pouch In 1 Case (0990-7922-09) / 1 Bag In 1 Pouch / 1000 Ml In 1 Bag,21.21,8.48,,,0 HCPCS,J7100,Dextran 40 infusion,,,42.94,42.94,4 HCPCS,J7100,NDC Description Not Available,194.405,77.75999999999999,,,0 HCPCS,J7110,Dextran 75 infusion,,,0.01,0.01,4 HCPCS,J7120,Lactated Ringers: 1000 Ml In 1 Bag (0338-0117-04),12.11,4.84,,,0 HCPCS,J7120,Lactated Ringers: 3000 Ml In 1 Bag (0338-0137-27),2.51,1.0,,,0 HCPCS,J7120,Lactated Ringers: 500 Ml In 1 Bag (0338-0117-03),11.22,4.49,,,0 HCPCS,J7120,Ringers lactate infusion,,,2.3,2.3,4 HCPCS,J7121,5% dextrose in lac ringers,,,7.98,7.98,4 HCPCS,J7131,Hypertonic saline sol,,,0.17,0.17,4 HCPCS,J7165,"Inj, human-lans, per i.u",,,1.71,4.28,9 HCPCS,J7168,"Kcentra: 1 Kit In 1 Carton (63833-386-02) * 20 Ml In 1 Vial, Single-Use (63833-396-01) * 20 Ml In 1 Vial, Single-Use (63833-761-20)",14.6,5.84,,,0 HCPCS,J7168,"Kcentra: 1 Kit In 1 Carton (63833-387-02) * 40 Ml In 1 Vial, Single-Use (63833-397-01) * 40 Ml In 1 Vial, Single-Use (63833-761-40)",10.28,4.11,,,0 HCPCS,J7168,NDC Description Not Available,9.18,3.67,,,0 HCPCS,J7168,Prothrombin complex kcentra,,,1.9,4.75,9 HCPCS,J7169,"Inj andexxa, 10 mg",,,125.0,327.91,9 HCPCS,J7170,"Inj., emicizumab-kxwh 0.5 mg",,,51.98,145.28,9 HCPCS,J7171,"Inj, adzynma, 10 iu",,,34.52,90.94,9 HCPCS,J7172,"Inj marstacim-hncq, 0.5 mg",,,50.76,126.9,5 HCPCS,J7173,"Inj. concizumab-mtci, 0.5 mg",,,84.78,211.96,5 HCPCS,J7174,Injection fitusiran 0.04 mg,,,133.48,333.69,5 HCPCS,J7175,"Inj, factor x, (human), 1iu",,,9.53,24.88,9 HCPCS,J7177,"Fibryga: 1 Kit In 1 Carton (68982-347-01) * 50 Ml In 1 Bottle, Glass (68982-348-01)",4.77,1.91,,,0 HCPCS,J7177,"Inj., fibryga, 1 mg",,,1.1,3.05,9 HCPCS,J7177,NDC Description Not Available,5.07,2.03,,,0 HCPCS,J7178,Human fibrinogen conc inj,,,1.43,3.57,9 HCPCS,J7178,"Riastap: 1 Vial, Single-Use In 1 Carton (63833-891-51) / 50 Ml In 1 Vial, Single-Use (63833-891-90)",5.12,2.05,,,0 HCPCS,J7179,Vonvendi inj 1 iu vwf:rco,,,1.83,4.56,9 HCPCS,J7180,Factor XIII anti-hem factor,,,10.48,28.1,9 HCPCS,J7181,Factor xiii recomb a-subunit,,,17.34,48.32,9 HCPCS,J7182,Factor viii recomb novoeight,,,1.4,3.89,9 HCPCS,J7183,Wilate injection,,,1.28,3.26,9 HCPCS,J7185,NDC Description Not Available,8.4,3.36,,,0 HCPCS,J7185,Xyntha inj,,,1.37,3.42,9 HCPCS,J7185,"Xyntha: 1 Kit In 1 Carton (58394-012-01) * 4 Ml In 1 Vial, Single-Use (58394-112-01) * 4 Ml In 1 Syringe (58394-018-01) * 1 Ml In 1 Packet",8.45,3.38,,,0 HCPCS,J7185,"Xyntha: 1 Kit In 1 Carton (58394-013-01) * 4 Ml In 1 Syringe (58394-018-01) * 1 Ml In 1 Packet * 4 Ml In 1 Vial, Single-Use (58394-113-01)",8.45,3.38,,,0 HCPCS,J7185,"Xyntha: 1 Kit In 1 Carton (58394-014-01) * 4 Ml In 1 Syringe (58394-018-01) * 1 Ml In 1 Packet * 4 Ml In 1 Vial, Single-Use (58394-114-01)",8.49,3.4,,,0 HCPCS,J7185,"Xyntha: 1 Kit In 1 Carton (58394-015-01) * 1 Ml In 1 Packet * 4 Ml In 1 Vial, Single-Use (58394-115-01) * 4 Ml In 1 Syringe (58394-018-01)",3.81,1.52,,,0 HCPCS,J7185,Xyntha: 1 Kit In 1 Carton (58394-022-03) * 4 Ml In 1 Syringe (58394-122-03) * 1 Ml In 1 Packet,3.81,1.52,,,0 HCPCS,J7185,Xyntha: 1 Kit In 1 Carton (58394-023-03) * 4 Ml In 1 Syringe (58394-123-03) * 1 Ml In 1 Packet,8.79,3.52,,,0 HCPCS,J7185,Xyntha: 1 Kit In 1 Carton (58394-025-03) * 4 Ml In 1 Syringe (58394-125-03) * 1 Ml In 1 Packet,8.79,3.52,,,0 HCPCS,J7186,Antihemophilic viii/vwf comp,,,1.2,3.17,9 HCPCS,J7187,"Humate-P, inj",,,1.45,3.83,9 HCPCS,J7187,"Humate-P: 1 Kit In 1 Carton (63833-615-02) * 5 Ml In 1 Vial (63833-625-01) * 5 Ml In 1 Vial, Single-Dose (63833-765-53)",6.17,2.47,,,0 HCPCS,J7187,"Humate-P: 1 Kit In 1 Carton (63833-616-02) * 10 Ml In 1 Vial (63833-626-01) * 10 Ml In 1 Vial, Single-Dose (63833-765-54)",4.73,1.89,,,0 HCPCS,J7187,"Humate-P: 1 Kit In 1 Carton (63833-617-02) * 15 Ml In 1 Vial (63833-627-01) * 15 Ml In 1 Vial, Single-Dose (63833-765-55)",6.77,2.71,,,0 HCPCS,J7187,NDC Description Not Available,4.28,1.71,,,0 HCPCS,J7188,Factor viii recomb obizur,,,3.23,8.09,9 HCPCS,J7189,Factor viia,,,2.53,6.94,9 HCPCS,J7189,NDC Description Not Available,9.86,3.94,,,0 HCPCS,J7189,"Novoseven Rt: 1 Kit In 1 Kit (0169-7201-01) * 1 Ml In 1 Vial, Glass (0169-7211-11) * 1 Ml In 1 Syringe, Glass (0169-7011-98)",11.83,4.73,,,0 HCPCS,J7189,"Novoseven Rt: 1 Kit In 1 Kit (0169-7202-01) * 2 Ml In 1 Vial, Glass (0169-7212-11) * 2 Ml In 1 Syringe, Glass (0169-7012-98)",12.1,4.84,,,0 HCPCS,J7189,"Novoseven Rt: 1 Kit In 1 Kit (0169-7205-01) * 5 Ml In 1 Vial, Glass (0169-7215-11) * 5 Ml In 1 Syringe, Glass (0169-7015-98)",11.79,4.72,,,0 HCPCS,J7190,Factor viii,,,1.12,3.12,9 HCPCS,J7191,Factor viii (porcine),,,5.46,13.65,5 HCPCS,J7192,Factor viii recombinant nos,,,1.56,4.04,9 HCPCS,J7193,Factor ix non-recombinant,,,1.38,3.53,9 HCPCS,J7194,Factor ix complex,,,1.66,4.37,9 HCPCS,J7195,"Benefix: 1 Kit In 1 Carton (58394-635-03) * 5 Ml In 1 Syringe (58394-041-11) * 1 Ml In 1 Packet (0069-1111-01) * 5 Ml In 1 Vial, Single-Use (58394-135-03)",7.66,3.06,,,0 HCPCS,J7195,Factor ix recombinant nos,,,1.85,4.67,9 HCPCS,J7196,Antithrombin recombinant,,,140.5,140.5,4 HCPCS,J7197,Antithrombin iii injection,,,3.94,10.66,9 HCPCS,J7197,"Thrombate Iii: 1 Kit In 1 Carton (13533-602-50) * 10 Ml In 1 Vial, Glass (13533-605-21) * 10 Ml In 1 Vial, Glass (13533-200-10)",19.04,7.62,,,0 HCPCS,J7197,"Thrombate Iii: 1 Kit In 1 Carton (13533-606-12) * 10 Ml In 1 Vial, Glass (13533-605-21) * 10 Ml In 1 Vial, Glass (76297-002-12)",19.31,7.72,,,0 HCPCS,J7198,Anti-inhibitor,,,2.4,6.18,9 HCPCS,J7200,Factor ix recombinan rixubis,,,1.63,4.28,9 HCPCS,J7201,Factor ix alprolix recomb,,,3.55,9.4,9 HCPCS,J7202,Factor ix idelvion inj,,,5.18,13.73,9 HCPCS,J7203,Factor ix recomb gly rebinyn,,,4.32,11.79,9 HCPCS,J7204,Inj recombin esperoct per iu,,,2.14,5.91,9 HCPCS,J7205,Factor viii fc fusion recomb,,,2.32,6.39,9 HCPCS,J7207,Factor viii pegylated recomb,,,2.1,5.46,9 HCPCS,J7208,Inj. jivi 1 iu,,,2.45,6.86,9 HCPCS,J7209,Factor viii nuwiq recomb 1iu,,,1.18,2.95,9 HCPCS,J7210,"Inj, afstyla, 1 i.u.",,,1.51,4.03,9 HCPCS,J7211,"Inj, kovaltry, 1 i.u.",,,1.49,3.94,9 HCPCS,J7212,Factor viia recomb sevenfact,,,2.25,5.62,9 HCPCS,J7213,"Inj, ixinity, 1 i.u.",,,1.92,5.09,9 HCPCS,J7214,Altuviiio per factor viii iu,,,4.6,11.64,9 HCPCS,J7294,Seg acet and eth estr yearly,,,2420.54,2420.54,4 HCPCS,J7295,Eth estr and eton monthly,,,122.72,122.72,4 HCPCS,J7296,"Kyleena, 19.5 mg",,,1214.63,1214.63,4 HCPCS,J7296,Kyleena: 1 Intrauterine Device In 1 Carton (50419-424-01),5232.64,2093.06,,,0 HCPCS,J7297,"Liletta, 52 mg",,,931.73,931.73,4 HCPCS,J7298,"Mirena, 52 mg",,,1214.63,1214.63,4 HCPCS,J7298,Mirena: 1 Intrauterine Device In 1 Carton (50419-423-01),5227.45,2090.98,,,0 HCPCS,J7300,Intraut copper contraceptive,,,1139.0,1139.0,4 HCPCS,J7300,Paragard T 380A: 1 Pouch In 1 Carton (59365-5128-1) / 1 Intrauterine Device In 1 Pouch,4971.51,1988.6,,,0 HCPCS,J7300,Paragard T 380A: 1 Pouch In 1 Carton (59365-5129-1) / 1 Intrauterine Device In 1 Pouch,5011.6,2004.64,,,0 HCPCS,J7301,"Skyla, 13.5 mg",,,1011.38,1011.38,4 HCPCS,J7301,Skyla: 1 Intrauterine Device In 1 Carton (50419-422-01),4395.13,1758.05,,,0 HCPCS,J7307,Etonogestrel implant system,,,1214.63,1214.63,4 HCPCS,J7307,Nexplanon: 1 BLISTER PACK in 1 CARTON (0052-4330-01) / 1 IMPLANT in 1 BLISTER PACK,4515.18,1806.07,,,0 HCPCS,J7307,Nexplanon: 1 Blister Pack In 1 Carton (78206-145-01) / 1 Implant In 1 Blister Pack,5120.09,2048.04,,,0 HCPCS,J7308,Aminolevulinic acid hcl top,,,390.52,976.31,9 HCPCS,J7309,"Methyl aminolevulinate, top",,,0.01,0.01,4 HCPCS,J7310,Ganciclovir long act implant,,,0.01,0.01,4 HCPCS,J7311,Fluocinolone acetonide implt,,,340.04,852.83,9 HCPCS,J7312,Dexamethasone intra implant,,,202.42,506.06,9 HCPCS,J7313,Fluocinol acet intravit imp,,,490.77,1291.29,9 HCPCS,J7314,"Inj., yutiq, 0.01 mg",,,463.33,646.47,9 HCPCS,J7315,Ophthalmic mitomycin,,,430.0,430.0,4 HCPCS,J7316,"Inj, ocriplasmin, 0.125 mg",,,0.01,0.01,4 HCPCS,J7318,"Inj, durolane 1 mg",,,6.31,15.78,9 HCPCS,J7318,NDC Description Not Available,83.37,33.35,,,0 HCPCS,J7320,"Genvisc 850, inj, 1mg",,,4.23,10.58,9 HCPCS,J7321,Hyalgan/supartz inj per dose,,,73.96,73.96,4 HCPCS,J7322,Hymovis injection 1 mg,,,17.5,44.85,9 HCPCS,J7323,Euflexxa inj per dose,,,103.6,259.01,9 HCPCS,J7323,NDC Description Not Available,5251.99,2100.8,,,0 HCPCS,J7324,Orthovisc inj per dose,,,116.79,291.98,9 HCPCS,J7325,NDC Description Not Available,184.235,73.695,,,0 HCPCS,J7325,Synvisc or Synvisc-One,,,6.01,15.03,9 HCPCS,J7326,Gel-one,,,524.06,1310.16,9 HCPCS,J7326,NDC Description Not Available,4480.475,1792.19,,,0 HCPCS,J7327,Monovisc inj per dose,,,626.14,1565.36,9 HCPCS,J7328,Gel-syn injection 0.1 mg,,,0.55,1.38,9 HCPCS,J7329,"Inj, trivisc 1 mg",,,4.21,10.52,9 HCPCS,J7330,Cultured chondrocytes implnt,,,65822.0,65822.0,4 HCPCS,J7331,"Synojoynt, inj., 1 mg",,,8.43,8.43,4 HCPCS,J7332,"Inj., triluron, 1 mg",,,10.19,25.47,9 HCPCS,J7336,Capsaicin 8% patch,,,3.38,8.77,9 HCPCS,J7340,Carbidopa levodopa ent 100ml,,,235.77,607.77,9 HCPCS,J7342,Ciprofloxacin otic susp 6 mg,,,28.32,28.32,4 HCPCS,J7345,"Aminolevulinic acid, 10% gel",,,1.78,4.62,9 HCPCS,J7351,Inj bimatoprost itc imp 1mcg,,,209.91,534.49,9 HCPCS,J7352,"Afamelanotide implant, 1 mg",,,2943.42,7358.55,5 HCPCS,J7353,Anacaulase-bcdb 8.8% gel 1 g,,,57.27,69.75,5 HCPCS,J7354,"Cantharidin top, applicator",,,682.26,1708.68,9 HCPCS,J7354,Ycanth: 1 Applicator In 1 Package (71349-070-01) / 1 Ampule In 1 Applicator / .45 Ml In 1 Ampule,1952.25,780.9,,,0 HCPCS,J7354,Ycanth: 6 Package In 1 Carton (71349-070-06) / 1 Applicator In 1 Package (71349-070-01) / 1 Ampule In 1 Applicator / .45 Ml In 1 Ampule,1952.25,780.9,,,0 HCPCS,J7355,Inj travoprost intra impl,,,194.41,492.01,9 HCPCS,J7402,Mometasone sinus sinuva,,,11.34,28.36,9 HCPCS,J7500,Azathioprine oral 50mg,,,1.01,1.01,4 HCPCS,J7500,Azathioprine: 100 Blister Pack In 1 Carton (68084-229-01) / 1 Tablet In 1 Blister Pack (68084-229-11),2.57,1.03,,,0 HCPCS,J7500,Azathioprine: 100 Tablet In 1 Bottle (60219-1076-1),1.93,0.77,,,0 HCPCS,J7500,NDC Description Not Available,2.09,0.8400000000000001,,,0 HCPCS,J7501,Azathioprine parenteral,,,240.48,601.21,9 HCPCS,J7502,"Cyclosporine Modified: 30 Blister Pack In 1 Carton (0093-9020-65) / 1 Capsule, Liquid Filled In 1 Blister Pack (0093-9020-19)",7.06,2.82,,,0 HCPCS,J7502,Cyclosporine oral 100 mg,,,2.02,2.02,4 HCPCS,J7502,Cyclosporine: 1 Bottle In 1 Package (0172-7313-20) / 50 Ml In 1 Bottle,13.88,5.55,,,0 HCPCS,J7502,Gengraf: 5 Blister Pack In 1 Carton (0074-3109-32) / 6 Capsule In 1 Blister Pack,21.44,8.58,,,0 HCPCS,J7502,NDC Description Not Available,12.69,5.08,,,0 HCPCS,J7503,"Envarsus Xr: 1 Pouch In 1 Carton (68992-3010-1) / 1 Bottle In 1 Pouch / 100 Tablet, Extended Release In 1 Bottle",5.15,2.06,,,0 HCPCS,J7503,"Envarsus Xr: 1 Pouch In 1 Carton (68992-3040-1) / 1 Bottle In 1 Pouch / 100 Tablet, Extended Release In 1 Bottle",5.18,2.07,,,0 HCPCS,J7503,"Envarsus Xr: 1 Pouch In 1 Carton (68992-3075-1) / 1 Bottle In 1 Pouch / 100 Tablet, Extended Release In 1 Bottle",5.16,2.06,,,0 HCPCS,J7503,Tacrol envarsus ex rel oral,,,1.81,1.81,4 HCPCS,J7504,Lymphocyte immune globulin,,,4376.29,13772.68,9 HCPCS,J7504,NDC Description Not Available,20487.74,8195.1,,,0 HCPCS,J7505,Monoclonal antibodies,,,0.01,0.01,4 HCPCS,J7507,NDC Description Not Available,5.21,2.08,,,0 HCPCS,J7507,"Prograf: 1 Bottle In 1 Carton (0469-0607-73) / 100 Capsule, Gelatin Coated In 1 Bottle",11.1,4.44,,,0 HCPCS,J7507,"Prograf: 1 Bottle In 1 Carton (0469-0617-73) / 100 Capsule, Gelatin Coated In 1 Bottle",22.16,8.86,,,0 HCPCS,J7507,Tacrolimus imme rel oral 1mg,,,0.19,0.19,4 HCPCS,J7507,Tacrolimus: 1 Bottle In 1 Carton (55111-527-01) / 100 Capsule In 1 Bottle,1.92,0.77,,,0 HCPCS,J7507,Tacrolimus: 100 Blister Pack In 1 Carton (0904-6623-61) / 1 Capsule In 1 Blister Pack,4.44,1.78,,,0 HCPCS,J7507,Tacrolimus: 100 Blister Pack In 1 Carton (0904-6624-61) / 1 Capsule In 1 Blister Pack,5.33,2.13,,,0 HCPCS,J7507,Tacrolimus: 100 Blister Pack In 1 Carton (0904-7097-61) / 1 Capsule In 1 Blister Pack,4.08,1.63,,,0 HCPCS,J7508,Tacrol astagraf ex rel oral,,,0.57,0.57,4 HCPCS,J7509,Methylprednisolone oral,,,0.24,0.24,4 HCPCS,J7509,"Methylprednisolone: 100 Blister Pack In 1 Box, Unit-Dose (68084-149-01) / 1 Tablet In 1 Blister Pack (68084-149-11)",6.76,2.7,,,0 HCPCS,J7509,Methylprednisolone: 100 Blister Pack In 1 Carton (0904-6914-61) / 1 Tablet In 1 Blister Pack,4.01,1.6,,,0 HCPCS,J7509,Methylprednisolone: 100 Tablet In 1 Bottle (59746-001-06),1.26,0.5,,,0 HCPCS,J7509,Methylprednisolone: 25 Tablet In 1 Bottle (59762-0051-1),1.6,0.64,,,0 HCPCS,J7509,Methylprednisolone: 50 Tablet In 1 Bottle (59762-0050-1),1.88,0.75,,,0 HCPCS,J7509,NDC Description Not Available,7.15,2.86,,,0 HCPCS,J7510,Prednisolone Sodium Phosphate: 237 Ml In 1 Bottle (0121-0759-08),1.17,0.47,,,0 HCPCS,J7510,Prednisolone oral per 5 mg,,,0.48,0.48,4 HCPCS,J7511,Antithymocyte globuln rabbit,,,939.35,2664.59,9 HCPCS,J7511,"Thymoglobulin: 1 Vial, Glass In 1 Carton (58468-0080-1) / 5 Ml In 1 Vial, Glass",4795.48,1918.19,,,0 HCPCS,J7512,NDC Description Not Available,0.05,0.02,,,0 HCPCS,J7512,Prednisone ir or dr oral 1mg,,,0.01,0.01,4 HCPCS,J7512,Prednisone: 10 Blister Pack In 1 Carton (0054-0017-20) / 10 Tablet In 1 Blister Pack,0.09,0.04,,,0 HCPCS,J7512,Prednisone: 10 Blister Pack In 1 Carton (0054-0018-20) / 10 Tablet In 1 Blister Pack,0.03,0.01,,,0 HCPCS,J7512,Prednisone: 10 Blister Pack In 1 Carton (0054-0019-20) / 10 Tablet In 1 Blister Pack,0.03,0.01,,,0 HCPCS,J7512,Prednisone: 10 Blister Pack In 1 Carton (0054-8724-25) / 10 Tablet In 1 Blister Pack,0.12,0.05,,,0 HCPCS,J7512,Prednisone: 10 Blister Pack In 1 Carton (0054-8739-25) / 10 Tablet In 1 Blister Pack,0.96,0.38,,,0 HCPCS,J7512,Prednisone: 10 Blister Pack In 1 Carton (0054-8740-25) / 10 Tablet In 1 Blister Pack,0.25,0.1,,,0 HCPCS,J7512,"Prednisone: 100 Blister Pack In 1 Box, Unit-Dose (60687-122-01) / 1 Tablet In 1 Blister Pack (60687-122-11)",0.14,0.06,,,0 HCPCS,J7512,"Prednisone: 100 Blister Pack In 1 Box, Unit-Dose (60687-134-01) / 1 Tablet In 1 Blister Pack (60687-134-11)",0.05,0.02,,,0 HCPCS,J7512,"Prednisone: 100 Blister Pack In 1 Box, Unit-Dose (60687-145-01) / 1 Tablet In 1 Blister Pack (60687-145-11)",0.03,0.01,,,0 HCPCS,J7512,Prednisone: 100 Blister Pack In 1 Carton (0904-6923-61) / 1 Tablet In 1 Blister Pack,0.05,0.02,,,0 HCPCS,J7512,Prednisone: 100 Blister Pack In 1 Carton (0904-7127-61) / 1 Tablet In 1 Blister Pack,0.03,0.01,,,0 HCPCS,J7512,Prednisone: 100 Tablet In 1 Bottle (0054-9828-25),0.11,0.04,,,0 HCPCS,J7512,Prednisone: 100 Tablet In 1 Bottle (0591-5443-01),0.03,0.01,,,0 HCPCS,J7512,Prednisone: 100 Tablet In 1 Bottle (59651-484-01),0.44,0.18,,,0 HCPCS,J7512,Prednisone: 100 Tablet In 1 Bottle (59746-171-06),0.44,0.18,,,0 HCPCS,J7512,Prednisone: 100 Tablet In 1 Bottle (59746-173-06),0.04,0.02,,,0 HCPCS,J7512,Prednisone: 100 Tablet In 1 Bottle (59746-175-06),0.03,0.01,,,0 HCPCS,J7512,Prednisone: 100 Tablet In 1 Bottle (64380-949-06),0.02,0.01,,,0 HCPCS,J7512,Prednisone: 100 Tablet In 1 Bottle (70954-060-10),0.01,0.004,,,0 HCPCS,J7512,Prednisone: 100 Tablet In 1 Bottle (70954-061-10),0.02,0.01,,,0 HCPCS,J7512,"Prednisone: 100 Tablet In 1 Bottle, Plastic (0054-0019-25)",0.03,0.01,,,0 HCPCS,J7512,"Prednisone: 100 Tablet In 1 Bottle, Plastic (0603-5336-21)",0.16,0.06,,,0 HCPCS,J7512,"Prednisone: 100 Tablet In 1 Bottle, Plastic (64380-782-06)",0.22,0.09,,,0 HCPCS,J7512,"Prednisone: 100 Tablet In 1 Bottle, Plastic (64380-835-06)",0.15,0.06,,,0 HCPCS,J7513,"Daclizumab, parenteral",,,0.01,0.01,4 HCPCS,J7514,Mycophenol (myhibbin) 100 mg,,,2.18,2.18,4 HCPCS,J7515,Cyclosporine oral 25 mg,,,0.74,0.74,4 HCPCS,J7515,"Cyclosporine: 30 Blister Pack In 1 Box (51862-458-47) / 1 Capsule, Liquid Filled In 1 Blister Pack (51862-458-01)",3.32,1.33,,,0 HCPCS,J7515,Gengraf: 3 Blister Pack In 1 Carton (0074-3108-32) / 10 Capsule In 1 Blister Pack,5.52,2.21,,,0 HCPCS,J7515,NDC Description Not Available,2.995,1.2000000000000002,,,0 HCPCS,J7516,Cyclosporin parenteral 250mg,,,71.4,71.4,4 HCPCS,J7516,NDC Description Not Available,87.54,35.02,,,0 HCPCS,J7516,Sandimmune: 10 Ampule In 1 Box (0078-0109-01) / 5 Ml In 1 Ampule (0078-0109-61),77.7,31.08,,,0 HCPCS,J7517,"Mycophenolate Mofetil: 1 Bottle, Plastic In 1 Carton (66689-307-08) / 250 Ml In 1 Bottle, Plastic",10.61,4.24,,,0 HCPCS,J7517,"Mycophenolate Mofetil: 1 Bottle, Plastic In 1 Carton (67877-230-22) / 225 Ml In 1 Bottle, Plastic",38.77,15.51,,,0 HCPCS,J7517,"Mycophenolate Mofetil: 100 Blister Pack In 1 Box, Unit-Dose (60687-494-01) / 1 Capsule In 1 Blister Pack (60687-494-11)",1.81,0.72,,,0 HCPCS,J7517,Mycophenolate Mofetil: 100 Blister Pack In 1 Carton (0904-7074-61) / 1 Capsule In 1 Blister Pack,1.81,0.72,,,0 HCPCS,J7517,Mycophenolate Mofetil: 100 Blister Pack In 1 Carton (60687-885-01) / 1 Capsule In 1 Blister Pack (60687-885-11),2.16,0.86,,,0 HCPCS,J7517,Mycophenolate Mofetil: 100 Capsule In 1 Bottle (67877-266-01),0.7,0.28,,,0 HCPCS,J7517,Mycophenolate Mofetil: 100 Capsule In 1 Bottle (72888-192-01),0.6,0.24,,,0 HCPCS,J7517,Mycophenolate Mofetil: 50 Blister Pack In 1 Box (50268-557-15) / 1 Capsule In 1 Blister Pack (50268-557-11),1.34,0.54,,,0 HCPCS,J7517,Mycophenolate Mofetil: 500 Capsule In 1 Bottle (16729-094-16),0.6,0.24,,,0 HCPCS,J7517,Mycophenolate Mofetil: 500 Capsule In 1 Bottle (72888-192-05),0.56,0.22,,,0 HCPCS,J7517,Mycophenolate mofetil oral,,,0.15,0.15,4 HCPCS,J7517,NDC Description Not Available,2.05,0.82,,,0 HCPCS,J7518,"Mycophenolic Acid: 30 Blister Pack In 1 Box, Unit-Dose (68084-907-21) / 1 Tablet, Delayed Release In 1 Blister Pack (68084-907-11)",15.21,6.08,,,0 HCPCS,J7518,"Mycophenolic Acid: 30 Blister Pack In 1 Carton (0904-6785-04) / 1 Tablet, Delayed Release In 1 Blister Pack",12.54,5.02,,,0 HCPCS,J7518,Mycophenolic acid,,,0.38,0.38,4 HCPCS,J7518,NDC Description Not Available,15.65,6.26,,,0 HCPCS,J7519,Inj. mycophenolate mofetil,,,0.31,0.31,4 HCPCS,J7519,"Mycophenolate Mofetil: 4 Vial, Single-Dose In 1 Carton (71288-803-21) / 20 Ml In 1 Vial, Single-Dose (71288-803-20)",6.46,2.58,,,0 HCPCS,J7519,NDC Description Not Available,5.37,2.15,,,0 HCPCS,J7520,NDC Description Not Available,87.69500000000001,35.08,,,0 HCPCS,J7520,"Sirolimus, oral",,,1.14,1.14,4 HCPCS,J7520,"Sirolimus: 1 Bottle, Glass In 1 Carton (60505-6197-2) / 60 Ml In 1 Bottle, Glass",58.1,23.24,,,0 HCPCS,J7520,"Sirolimus: 100 Tablet, Sugar Coated In 1 Bottle (59762-1001-1)",13.56,5.42,,,0 HCPCS,J7520,Sirolimus: 30 Blister Pack In 1 Box (50268-718-13) / 1 Tablet In 1 Blister Pack (50268-718-11),40.37,16.15,,,0 HCPCS,J7520,"Sirolimus: 30 Blister Pack In 1 Carton (0904-7248-04) / 1 Tablet, Film Coated In 1 Blister Pack",29.26,11.7,,,0 HCPCS,J7521,Tacrolim granules oral susp,,,1.33,1.33,4 HCPCS,J7525,Prograf: 10 Ampule In 1 Box (0469-3016-01) / 1 Ml In 1 Ampule,1116.58,446.63,,,0 HCPCS,J7525,Tacrolimus injection,,,242.07,605.18,9 HCPCS,J7527,Everolimus: 6 Blister Pack In 1 Carton (67877-718-31) / 10 Tablet In 1 Blister Pack (67877-718-33),17.96,7.18,,,0 HCPCS,J7527,Everolimus: 6 Blister Pack In 1 Carton (67877-719-31) / 10 Tablet In 1 Blister Pack (67877-719-33),12.42,4.97,,,0 HCPCS,J7527,NDC Description Not Available,13.355,5.345,,,0 HCPCS,J7527,Oral everolimus,,,2.02,2.02,4 HCPCS,J7601,Ensifentrine inh 3 mg,,,52.12,52.12,4 HCPCS,J7605,Arformoterol non-comp unit,,,0.69,0.69,4 HCPCS,J7606,"Formoterol fumarate, inh",,,1.7,1.7,4 HCPCS,J7606,NDC Description Not Available,13.94,5.58,,,0 HCPCS,J7606,Perforomist: 30 Pouch In 1 Carton (49502-605-30) / 1 Vial In 1 Pouch / 2 Ml In 1 Vial,21.27,8.51,,,0 HCPCS,J7608,Acetylcysteine non-comp unit,,,8.44,8.44,4 HCPCS,J7609,Albuterol comp unit,,,0.75,0.75,4 HCPCS,J7611,Albuterol non-comp con,,,0.18,0.18,4 HCPCS,J7611,NDC Description Not Available,2.53,1.01,,,0 HCPCS,J7612,Levalbuterol non-comp con,,,0.28,0.28,4 HCPCS,J7613,Albuterol Sulfate Inhalation Solution: 25 Pouch In 1 Carton (76204-011-55) / 5 Vial In 1 Pouch (76204-011-05) / 3 Ml In 1 Vial,1.3,0.52,,,0 HCPCS,J7613,Albuterol non-comp unit,,,0.08,0.08,4 HCPCS,J7613,NDC Description Not Available,3.76,1.5,,,0 HCPCS,J7614,Levalbuterol non-comp unit,,,0.09,0.09,4 HCPCS,J7614,Levalbuterol: 30 Pouch In 1 Carton (76204-900-01) / 1 Ampule In 1 Pouch (76204-900-11) / 3 Ml In 1 Ampule,2.28,0.91,,,0 HCPCS,J7614,NDC Description Not Available,1.59,0.64,,,0 HCPCS,J7620,Albuterol ipratrop non-comp,,,0.19,0.19,4 HCPCS,J7626,Budesonide non-comp unit,,,1.19,1.19,4 HCPCS,J7627,Budesonide comp unit,,,0.3,0.3,4 HCPCS,J7631,Cromolyn sodium noncomp unit,,,0.29,0.29,4 HCPCS,J7633,Budesonide non-comp con,,,0.01,0.01,4 HCPCS,J7639,Dornase alfa non-comp unit,,,53.59,53.59,4 HCPCS,J7639,NDC Description Not Available,133.67,53.47,,,0 HCPCS,J7639,Pulmozyme: 5 Pouch In 1 Carton (50242-100-40) / 6 Ampule In 1 Pouch (50242-100-39) / 2.5 Ml In 1 Ampule,159.2,63.68,,,0 HCPCS,J7644,Ipratropium bromide non-comp,,,0.36,0.36,4 HCPCS,J7665,Mannitol for inhaler,,,6.58,6.58,4 HCPCS,J7669,Metaproterenol non-comp unit,,,0.01,0.01,4 HCPCS,J7674,"Methacholine chloride, neb",,,1.63,1.63,4 HCPCS,J7674,"Provocholine Inhalation Solution: 6 Package In 1 Package (64281-110-06) / 6 Carton In 1 Package (64281-110-05) / 1 Kit In 1 Carton * 1 Vial, Plastic In 1 Kit / 3 Ml In 1 Vial, Plastic (64281-113-00",18.69,7.48,,,0 HCPCS,J7677,Revefenacin inh non-com 1mcg,,,0.2,0.2,4 HCPCS,J7682,Tobramycin non-comp unit,,,14.8,14.8,4 HCPCS,J7686,"Treprostinil, non-comp unit",,,760.4,760.4,4 HCPCS,J8501,Aprepitant: 1 Blister Pack In 1 Carton (0781-2321-06) / 1 Capsule In 1 Blister Pack,33.49,13.4,,,0 HCPCS,J8501,Aprepitant: 1 Blister Pack In 1 Carton (0781-2323-68) / 6 Capsule In 1 Blister Pack (0781-2323-06),37.05,14.82,,,0 HCPCS,J8501,Aprepitant: 1 Blister Pack In 1 Carton (68462-583-40) / 1 Capsule In 1 Blister Pack,32.98,13.19,,,0 HCPCS,J8501,Aprepitant: 1 Blister Pack In 1 Carton (68462-584-76) / 6 Capsule In 1 Blister Pack (68462-584-40),30.79,12.32,,,0 HCPCS,J8501,Aprepitant: 5 Blister Pack In 1 Carton (68462-583-85) / 1 Capsule In 1 Blister Pack,48.04,19.22,,,0 HCPCS,J8501,"Emend: 1 Pouch In 1 Carton (0006-3066-03) / 1 Powder, For Suspension In 1 Pouch (0006-3066-01)",40.71,16.28,,,0 HCPCS,J8501,NDC Description Not Available,29.805,11.92,,,0 HCPCS,J8501,Oral aprepitant,,,3.04,3.04,4 HCPCS,J8510,Oral busulfan,,,10.12,137.37,9 HCPCS,J8515,"Cabergoline, oral 0.25mg",,,1.56,1.56,4 HCPCS,J8515,Cabergoline: 8 TABLET in 1 BOTTLE (49884-673-14),48.06,19.22,,,0 HCPCS,J8515,Cabergoline: 8 Tablet In 1 Bottle (50742-118-08),4.18,1.67,,,0 HCPCS,J8521,"Capecitabine: 120 Tablet, Film Coated In 1 Bottle (67877-459-12)",1.05,0.42,,,0 HCPCS,J8521,"Xeloda: 120 Tablet, Film Coated In 1 Bottle, Plastic (0004-1101-50)",194.06,77.62,,,0 HCPCS,J8522,"Capecitabine, oral, 50 mg",,,0.03,0.07,9 HCPCS,J8530,Cyclophosphamide oral 25 MG,,,1.14,1.14,4 HCPCS,J8530,Cyclophosphamide: 100 Capsule In 1 Bottle (0054-0382-25),24.04,9.62,,,0 HCPCS,J8530,Cyclophosphamide: 100 Capsule In 1 Bottle (0054-0383-25),13.13,5.25,,,0 HCPCS,J8530,Cyclophosphamide: 100 Capsule In 1 Bottle (62332-618-31),4.74,1.9,,,0 HCPCS,J8530,Cyclophosphamide: 100 Capsule In 1 Bottle (62332-619-31),4.11,1.64,,,0 HCPCS,J8530,Cyclophosphamide: 100 Capsule In 1 Bottle (69097-517-07),12.45,4.98,,,0 HCPCS,J8540,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (67457-421-30) / 30 Ml In 1 Vial (67457-421-00),0.05,0.02,,,0 HCPCS,J8540,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (67457-422-54) / 5 Ml In 1 Vial (67457-422-00),0.03,0.01,,,0 HCPCS,J8540,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (67457-423-12) / 1 Ml In 1 Vial (67457-423-00),0.13,0.05,,,0 HCPCS,J8540,Dexamethasone: 100 Blister Pack In 1 Carton (0054-8175-25) / 1 Tablet In 1 Blister Pack,0.23,0.095,,,0 HCPCS,J8540,Dexamethasone: 100 Blister Pack In 1 Carton (0054-8179-25) / 1 Tablet In 1 Blister Pack,0.26,0.1,,,0 HCPCS,J8540,Dexamethasone: 100 Blister Pack In 1 Carton (0054-8181-25) / 1 Tablet In 1 Blister Pack,0.23,0.09,,,0 HCPCS,J8540,Dexamethasone: 100 Blister Pack In 1 Carton (0904-7266-61) / 1 Tablet In 1 Blister Pack,0.22,0.09,,,0 HCPCS,J8540,Dexamethasone: 100 Tablet In 1 Bottle (60505-6249-1),0.17,0.07,,,0 HCPCS,J8540,Dexamethasone: 100 Tablet In 1 Bottle (72578-170-01),0.15,0.06,,,0 HCPCS,J8540,"Dexamethasone: 100 Tablet In 1 Bottle, Plastic (0054-4179-25)",0.17,0.07,,,0 HCPCS,J8540,"Dexamethasone: 100 Tablet In 1 Bottle, Plastic (0054-4182-25)",0.2,0.08,,,0 HCPCS,J8540,"Dexamethasone: 500 Ml In 1 Bottle, Plastic (0054-3177-63)",0.18,0.07,,,0 HCPCS,J8540,NDC Description Not Available,0.25,0.1,,,0 HCPCS,J8540,Oral dexamethasone,,,0.06,0.06,4 HCPCS,J8541,"Oral, hemady, 0.25 mg",,,0.36,0.36,4 HCPCS,J8560,Etoposide oral 50 mg,,,76.46,220.41,9 HCPCS,J8562,Oral fludarabine phosphate,,,0.01,0.01,4 HCPCS,J8565,Gefitinib oral,,,140.21,140.21,4 HCPCS,J8600,Melphalan oral 2 MG,,,9.16,9.16,4 HCPCS,J8610,Methotrexate oral 2.5 MG,,,0.2,0.2,4 HCPCS,J8610,Methotrexate: 20 Blister Pack In 1 Carton (51079-670-05) / 1 Tablet In 1 Blister Pack (51079-670-01),11.45,4.58,,,0 HCPCS,J8610,NDC Description Not Available,8.5,3.4,,,0 HCPCS,J8611,Oral methotrexate (jylamvo),,,18.26,45.66,9 HCPCS,J8612,Oral methotrexate (xatmep),,,20.84,57.14,9 HCPCS,J8650,Nabilone oral,,,0.01,0.01,4 HCPCS,J8655,Netupitant palonosetron oral,,,409.01,1139.4,9 HCPCS,J8670,"Rolapitant, oral, 1mg",,,1.79,2.44,5 HCPCS,J8700,Temozolomide,,,0.38,0.38,4 HCPCS,J8700,Temozolomide: 1 Bottle In 1 Carton (65162-802-14) / 14 Capsule In 1 Bottle,2.62,1.05,,,0 HCPCS,J8700,Temozolomide: 14 Capsule In 1 Bottle (16571-817-41),6.56,2.62,,,0 HCPCS,J8700,Temozolomide: 14 Capsule In 1 Bottle (16571-818-41),3.49,1.4,,,0 HCPCS,J8700,Temozolomide: 5 Blister Pack In 1 Carton (47335-892-74) / 1 Capsule In 1 Blister Pack,3.51,1.4,,,0 HCPCS,J8705,Topotecan oral,,,124.9,313.65,9 HCPCS,J9000,Doxorubicin Hydrochloride: 1 Vial In 1 Carton (25021-207-51) / 100 Ml In 1 Vial,5.74,2.3,,,0 HCPCS,J9000,"Doxorubicin Hydrochloride: 1 Vial, Multi-Dose In 1 Carton (0069-1542-20) / 100 Ml In 1 Vial, Multi-Dose",12.08,4.83,,,0 HCPCS,J9000,"Doxorubicin Hydrochloride: 1 Vial, Multi-Dose In 1 Carton (0069-3034-20) / 100 Ml In 1 Vial, Multi-Dose",13.48,5.39,,,0 HCPCS,J9000,"Doxorubicin Hydrochloride: 1 Vial, Multi-Dose In 1 Carton (45963-733-60) / 100 Ml In 1 Vial, Multi-Dose",14.81,5.92,,,0 HCPCS,J9000,"Doxorubicin Hydrochloride: 1 Vial, Single-Dose In 1 Carton (0069-3032-20) / 25 Ml In 1 Vial, Single-Dose",19.6,7.84,,,0 HCPCS,J9000,"Doxorubicin Hydrochloride: 1 Vial, Single-Dose In 1 Carton (45963-733-68) / 25 Ml In 1 Vial, Single-Dose",18.91,7.56,,,0 HCPCS,J9000,Doxorubicin hcl injection,,,3.15,3.15,4 HCPCS,J9011,"Datopotamab deruxtecan, 1 mg",,,52.5,131.26,5 HCPCS,J9015,Aldesleukin injection,,,3338.87,8347.18,9 HCPCS,J9017,Arsenic Trioxide: 10 Vial In 1 Carton (25021-226-10) / 10 Ml In 1 Vial,32.35,12.94,,,0 HCPCS,J9017,Arsenic Trioxide: 10 Vial In 1 Carton (68382-997-10) / 10 Ml In 1 Vial (68382-997-01),184.92,73.97,,,0 HCPCS,J9017,"Arsenic Trioxide: 10 Vial, Single-Dose In 1 Carton (63323-637-10) / 10 Ml In 1 Vial, Single-Dose (63323-637-03)",24.82,9.93,,,0 HCPCS,J9017,"Arsenic Trioxide: 10 Vial, Single-Dose In 1 Carton (72205-171-07) / 10 Ml In 1 Vial, Single-Dose (72205-171-01)",10.28,4.11,,,0 HCPCS,J9017,Arsenic trioxide injection,,,4.79,4.79,4 HCPCS,J9017,NDC Description Not Available,22.22,8.89,,,0 HCPCS,J9019,Erwinaze injection,,,403.08,403.08,4 HCPCS,J9020,"Asparaginase, nos",,,0.01,0.01,4 HCPCS,J9021,"Inj, aspara, rylaze, 0.1 mg",,,54.38,147.6,9 HCPCS,J9021,NDC Description Not Available,227.46,90.98,,,0 HCPCS,J9021,"Rylaze: 3 Vial, Single-Dose In 1 Carton (68727-900-03) / .5 Ml In 1 Vial, Single-Dose (68727-900-01)",230.59,92.24,,,0 HCPCS,J9022,"Inj, atezolizumab,10 mg",,,89.39,242.18,9 HCPCS,J9022,"Tecentriq: 1 Vial, Single-Use In 1 Carton (50242-917-01) / 20 Ml In 1 Vial, Single-Use",399.92,159.97,,,0 HCPCS,J9022,"Tecentriq: 1 Vial, Single-Use In 1 Carton (50242-918-01) / 14 Ml In 1 Vial, Single-Use",405.06,162.02,,,0 HCPCS,J9023,"Bavencio: 1 Vial, Single-Dose In 1 Carton (44087-3535-1) / 10 Ml In 1 Vial, Single-Dose",436.83,174.73,,,0 HCPCS,J9023,"Injection, avelumab, 10 mg",,,97.14,272.48,9 HCPCS,J9024,Inj atezolizumb 5mg hya-tqjs,,,30.88,81.05,9 HCPCS,J9024,"Tecentriq Hybreza: 1 Vial, Single-Dose In 1 Box (50242-933-01) / 15 Ml In 1 Vial, Single-Dose",133.43,53.37,,,0 HCPCS,J9025,Azacitidine injection,,,0.32,0.32,4 HCPCS,J9025,"Azacitidine: 1 Injection, Powder, Lyophilized, For Solution In 1 Carton (43598-305-62)",8.8,3.52,,,0 HCPCS,J9025,"Azacitidine: 1 Injection, Powder, Lyophilized, For Solution In 1 Carton (60505-6271-1)",7.52,3.01,,,0 HCPCS,J9025,"Azacitidine: 1 Injection, Powder, Lyophilized, For Solution In 1 Carton (72485-201-01)",4.11,1.64,,,0 HCPCS,J9025,"Azacitidine: 1 Vial In 1 Carton (0143-9606-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",1.08,0.43,,,0 HCPCS,J9025,"Azacitidine: 1 Vial, Single-Dose In 1 Carton (71288-115-30) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",1.25,0.5,,,0 HCPCS,J9026,"Inj, tarlatamab-dlle, 1 mg",,,1570.77,4034.38,9 HCPCS,J9027,Clofarabine injection,,,15.52,38.8,9 HCPCS,J9028,"Inj, nogapendekin pmln, 1mcg",,,94.14,235.35,9 HCPCS,J9029,Adstiladrin: 4 Vial In 1 Carton (55566-1050-1) / 20 Ml In 1 Vial (55566-1050-0),267960.0,107184.0,,,0 HCPCS,J9029,"Inj, adstiladrin, per tx dos",,,63235.61,163001.41,9 HCPCS,J9029,NDC Description Not Available,267290.1,106916.04,,,0 HCPCS,J9030,Bcg live intravesical 1mg,,,3.14,8.83,9 HCPCS,J9030,Tice Bcg: 1 Vial In 1 Carton (0052-0602-02) / 50 Ml In 1 Vial (0052-0602-01),17.73,7.09,,,0 HCPCS,J9032,"Injection, belinostat, 10mg",,,50.92,138.82,9 HCPCS,J9033,"Inj., treanda 1 mg",,,1.24,4.62,9 HCPCS,J9034,"Bendeka: 1 Vial, Multi-Dose In 1 Carton (63459-348-04) / 4 Ml In 1 Vial, Multi-Dose",93.75,37.5,,,0 HCPCS,J9034,"Inj., bendeka 1 mg",,,11.42,28.56,9 HCPCS,J9035,"Avastin: 1 Vial, Single-Use In 1 Carton (50242-061-01) / 16 Ml In 1 Vial, Single-Use",322.22,128.89,,,0 HCPCS,J9035,Bevacizumab injection,,,72.73,188.73,9 HCPCS,J9036,Inj. belrapzo/bendamustine,,,9.26,23.16,9 HCPCS,J9038,Inj axatilimab-csfr 0.1 mg,,,52.5,141.24,9 HCPCS,J9039,Blincyto: 1 Kit In 1 Package (55513-160-01) * 3.088 Ml In 1 Vial (55513-150-01) * 10.6 Ml In 1 Vial (55513-155-01),670.56,268.22,,,0 HCPCS,J9039,"Injection, blinatumomab",,,152.28,432.62,9 HCPCS,J9040,Bleomycin sulfate injection,,,21.56,21.56,4 HCPCS,J9040,"Bleomycin: 1 Vial In 1 Box, Unit-Dose (0143-9241-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",84.34,33.74,,,0 HCPCS,J9040,"Bleomycin: 1 Vial In 1 Carton (63323-137-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",134.34,53.74,,,0 HCPCS,J9040,"Bleomycin: 1 Vial, Single-Dose In 1 Carton (71288-107-20) / 30 Powder, For Solution In 1 Vial, Single-Dose",124.67,49.87,,,0 HCPCS,J9041,Bortezomib injection,,,2.5,2.5,4 HCPCS,J9041,"Bortezomib: 1 Vial In 1 Carton (0143-9098-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",4.56,1.82,,,0 HCPCS,J9041,"Bortezomib: 1 Vial In 1 Carton (25021-244-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",3.33,1.33,,,0 HCPCS,J9041,"Bortezomib: 1 Vial, Single-Dose In 1 Carton (43598-426-60) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",2.16,0.86,,,0 HCPCS,J9041,"Bortezomib: 1 Vial, Single-Dose In 1 Carton (70710-1411-1) / 3.5 Ml In 1 Vial, Single-Dose",3.38,1.35,,,0 HCPCS,J9041,"Bortezomib: 1 Vial, Single-Dose In 1 Carton (71288-118-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",5.44,2.18,,,0 HCPCS,J9042,"Adcetris: 1 Vial, Single-Dose In 1 Box (51144-050-01) / 10.5 Ml In 1 Vial, Single-Dose",1072.29,428.92,,,0 HCPCS,J9042,Brentuximab vedotin inj,,,248.93,698.02,9 HCPCS,J9043,Cabazitaxel injection,,,221.71,579.22,9 HCPCS,J9043,"Jevtana: 1 Kit In 1 Carton (0024-5824-11) * 5.7 Ml In 1 Vial, Glass (0024-5823-15) * 5.7 Ml In 1 Vial, Glass (0024-5822-01)",1044.8,417.92,,,0 HCPCS,J9045,Carboplatin injection,,,2.93,2.93,4 HCPCS,J9045,Carboplatin: 1 Vial In 1 Box (63323-172-60) / 60 Ml In 1 Vial,18.1,7.24,,,0 HCPCS,J9045,"Carboplatin: 1 Vial, Multi-Dose In 1 Carton (0703-4239-01) / 60 Ml In 1 Vial, Multi-Dose",23.91,9.56,,,0 HCPCS,J9045,"Carboplatin: 1 Vial, Multi-Dose In 1 Carton (16729-295-12) / 60 Ml In 1 Vial, Multi-Dose",20.28,8.11,,,0 HCPCS,J9045,"Carboplatin: 1 Vial, Multi-Dose In 1 Carton (54288-167-01) / 60 Ml In 1 Vial, Multi-Dose",22.66,9.06,,,0 HCPCS,J9045,"Carboplatin: 1 Vial, Multi-Dose In 1 Carton (55150-386-01) / 60 Ml In 1 Vial, Multi-Dose",13.84,5.54,,,0 HCPCS,J9046,"Inj, bortezomib, dr. reddy's",,,3.46,45.8,9 HCPCS,J9047,"Injection, carfilzomib, 1 mg",,,51.85,150.98,9 HCPCS,J9047,"Kyprolis: 1 Vial, Single-Dose In 1 Carton (76075-102-01) / 15 Ml In 1 Vial, Single-Dose",248.05,99.22,,,0 HCPCS,J9047,"Kyprolis: 1 Vial, Single-Dose In 1 Carton (76075-103-01) / 10 Ml In 1 Vial, Single-Dose",247.86,99.14,,,0 HCPCS,J9047,"Kyprolis: 1 Vial, Single-Use In 1 Carton (76075-101-01) / 30 Ml In 1 Vial, Single-Use",253.17,101.27,,,0 HCPCS,J9048,"Inj, bortezomib freseniuskab",,,6.97,45.8,9 HCPCS,J9049,"Inj, bortezomib, hospira",,,1.43,1.43,4 HCPCS,J9050,Carmustine injection,,,145.6,489.32,9 HCPCS,J9050,"Carmustine: 1 Kit In 1 Carton (23155-649-41) * 3 Ml In 1 Vial (23155-648-31) * 30 Ml In 1 Vial, Single-Dose (23155-647-31)",1168.39,467.36,,,0 HCPCS,J9050,"Carmustine: 1 Kit In 1 Carton (70121-1482-2) * 3 Ml In 1 Vial (70121-3639-1) * 30 Ml In 1 Vial, Single-Dose (70121-1668-1)",1385.19,554.08,,,0 HCPCS,J9050,"Carmustine: 1 Kit In 1 Carton (70710-1525-9) * 3 Ml In 1 Vial (70710-1523-1) * 30 Ml In 1 Vial, Single-Dose (70710-1524-1)",1288.6,515.44,,,0 HCPCS,J9050,"Carmustine: 1 Kit In 1 Carton (71288-126-90) * 30 Ml In 1 Vial, Single-Dose (71288-124-30) * 3 Ml In 1 Vial (71288-125-03)",2455.8,982.32,,,0 HCPCS,J9050,"Carmustine: 1 Kit In 1 Carton (72205-198-01) * 3 Ml In 1 Vial (72205-196-01) * 30 Ml In 1 Vial, Single-Dose (72205-197-01)",1057.54,423.02,,,0 HCPCS,J9051,"Inj, bortezomib (maia)",,,3.43,3.43,4 HCPCS,J9052,"Inj, carmustine (accord)",,,245.0,245.0,4 HCPCS,J9054,Inj bortezomib boruzu 0.1 mg,,,23.9,59.76,9 HCPCS,J9055,Cetuximab injection,,,77.52,202.14,9 HCPCS,J9055,"Erbitux: 1 Vial, Single-Dose In 1 Carton (66733-948-23) / 50 Ml In 1 Vial, Single-Dose",368.06,147.22,,,0 HCPCS,J9055,"Erbitux: 1 Vial, Single-Dose In 1 Carton (66733-958-23) / 100 Ml In 1 Vial, Single-Dose",368.06,147.22,,,0 HCPCS,J9056,"Inj, bendamustine, 1 mg",,,27.24,71.54,9 HCPCS,J9056,"Vivimusta: 1 Vial, Multi-Dose In 1 Carton (24338-270-01) / 4 Ml In 1 Vial, Multi-Dose",144.04,57.62,,,0 HCPCS,J9056,"Vivimusta: 1 Vial, Multi-Dose In 1 Carton (71225-120-01) / 4 Ml In 1 Vial, Multi-Dose",144.0,57.6,,,0 HCPCS,J9057,"Inj., copanlisib, 1 mg",,,87.56,87.56,4 HCPCS,J9060,Cisplatin 10 mg injection,,,2.86,2.86,4 HCPCS,J9060,Cisplatin: 1 Vial In 1 Carton (63323-103-64) / 200 Ml In 1 Vial,18.37,7.35,,,0 HCPCS,J9060,Cisplatin: 1 Vial In 1 Carton (63323-103-65) / 100 Ml In 1 Vial,17.16,6.86,,,0 HCPCS,J9060,"Cisplatin: 1 Vial, Multi-Dose In 1 Carton (0703-5748-11) / 100 Ml In 1 Vial, Multi-Dose",16.9,6.76,,,0 HCPCS,J9060,Cisplatin: 100 Ml In 1 Vial (16729-288-38),10.33,4.13,,,0 HCPCS,J9061,"Inj, amivantamab-vmjw",,,21.51,59.06,9 HCPCS,J9061,"Rybrevant: 1 Vial, Single-Use In 1 Carton (57894-501-01) / 1 Injection In 1 Vial, Single-Use (57894-501-00)",94.4,37.76,,,0 HCPCS,J9063,"Elahere: 1 Vial, Single-Use In 1 Carton (72903-853-01) / 20 Ml In 1 Vial, Single-Use",292.03,116.81,,,0 HCPCS,J9063,"Inj, elahere, 1 mg",,,68.07,178.96,9 HCPCS,J9065,"Cladribine: 1 Ml In 1 Vial, Single-Dose (42658-010-01)",37.9,15.16,,,0 HCPCS,J9065,"Cladribine: 1 Vial In 1 Box, Unit-Dose (0143-9871-01) / 10 Ml In 1 Vial",49.35,19.74,,,0 HCPCS,J9065,"Cladribine: 1 Vial, Single-Dose In 1 Carton (63323-140-10) / 10 Ml In 1 Vial, Single-Dose",193.07,77.23,,,0 HCPCS,J9065,Inj cladribine per 1 mg,,,7.87,19.68,9 HCPCS,J9071,Inj cyclophosphamd auromedic,,,0.47,1.18,9 HCPCS,J9072,Inj cyclophos dr.reddy's 5mg,,,8.12,20.3,9 HCPCS,J9073,Inj cyclophosphamd (ingenus),,,0.46,1.76,9 HCPCS,J9074,"Cyclophosphamide: 1 Vial, Single-Dose In 1 Carton (0781-3244-94) / 50 Ml In 1 Vial, Single-Dose",13.85,5.54,,,0 HCPCS,J9074,"Inj, cyclophosphamd, sandoz",,,3.24,8.1,9 HCPCS,J9075,Cyclophosphamide: 1 Vial In 1 Carton (25021-248-51) / 50 Ml In 1 Vial,5.58,2.23,,,0 HCPCS,J9075,"Cyclophosphamide: 1 Vial, Single-Dose In 1 Carton (39822-0255-1) / 50 Ml In 1 Vial, Single-Dose",4.05,1.62,,,0 HCPCS,J9075,"Cyclophosphamide: 1 Vial, Single-Dose In 1 Carton (65219-131-20) / 50 Ml In 1 Vial, Single-Dose",5.27,2.11,,,0 HCPCS,J9075,"Cyclophosphamide: 1 Vial, Single-Dose In 1 Carton (70121-1239-1) / 50 Ml In 1 Vial, Single-Dose",5.45,2.18,,,0 HCPCS,J9075,"Cyclophosphamide: 1 Vial, Single-Dose In 1 Carton (81298-8112-1) / 50 Ml In 1 Vial, Single-Dose",10.6,4.24,,,0 HCPCS,J9075,"Inj, cyclophosphamide, nos",,,0.69,1.73,9 HCPCS,J9076,"Cyclophosphamide: 1 Vial, Single-Dose In 1 Carton (10019-956-01) / 50 Ml In 1 Vial, Single-Dose (10019-956-16)",15.07,6.03,,,0 HCPCS,J9076,"Inj, cyclophos (baxter) 5mg",,,4.6,11.5,9 HCPCS,J9076,NDC Description Not Available,15.63,6.25,,,0 HCPCS,J9098,Cytarabine liposome inj,,,0.01,0.01,4 HCPCS,J9100,Cytarabine hcl 100 mg inj,,,0.81,0.81,4 HCPCS,J9100,Cytarabine: 1 VIAL in 1 CARTON (67457-452-20) / 20 mL in 1 VIAL,1.69,0.68,,,0 HCPCS,J9100,Cytarabine: 1 Vial In 1 Carton (25021-223-20) / 20 Ml In 1 Vial,2.26,0.9,,,0 HCPCS,J9100,"Cytarabine: 1 Vial, Single-Dose In 1 Carton (61703-319-22) / 20 Ml In 1 Vial, Single-Dose",4.75,1.9,,,0 HCPCS,J9100,"Cytarabine: 1 Vial, Single-Dose In 1 Carton (63323-120-20) / 20 Ml In 1 Vial, Single-Dose",4.59,1.84,,,0 HCPCS,J9100,"Cytarabine: 1 Vial, Single-Dose In 1 Carton (71288-109-20) / 20 Ml In 1 Vial, Single-Dose",39.43,15.77,,,0 HCPCS,J9118,"Asparlas: 1 Vial, Single-Use In 1 Carton (72694-515-01) / 5 Ml In 1 Vial, Single-Use",332.02,132.81,,,0 HCPCS,J9118,Inj. calaspargase pegol-mknl,,,76.53,215.45,9 HCPCS,J9119,"Inj., cemiplimab-rwlc, 1 mg",,,28.92,77.06,9 HCPCS,J9119,"Libtayo: 1 Vial, Single-Use In 1 Carton (61755-008-01) / 7 Ml In 1 Vial, Single-Use",133.6,53.44,,,0 HCPCS,J9120,Dactinomycin injection,,,288.8,802.25,9 HCPCS,J9120,"Dactinomycin: 1 Vial, Single-Dose In 1 Carton (39822-2100-2) / 1 Ml In 1 Vial, Single-Dose (39822-2100-1)",3306.88,1322.75,,,0 HCPCS,J9130,Dacarbazine 100 mg inj,,,4.5,4.5,4 HCPCS,J9130,"Dacarbazine: 10 Vial In 1 Carton (0143-9245-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (0143-9245-01)",20.8,8.32,,,0 HCPCS,J9130,"Dacarbazine: 10 Vial, Single-Dose In 1 Tray (63323-128-20) / 20 Ml In 1 Vial, Single-Dose (63323-128-00)",24.94,9.98,,,0 HCPCS,J9130,NDC Description Not Available,17.135,6.855,,,0 HCPCS,J9144,"Daratumumab, hyaluronidase",,,52.99,144.93,9 HCPCS,J9144,"Darzalex Faspro: 1 Vial, Single-Dose In 1 Box (57894-503-01) / 15 Ml In 1 Vial, Single-Dose",249.45,99.78,,,0 HCPCS,J9145,"Darzalex Iv: 1 Vial, Single-Dose In 1 Box (57894-505-05) / 5 Ml In 1 Vial, Single-Dose",327.41,130.96,,,0 HCPCS,J9145,"Darzalex Iv: 1 Vial, Single-Dose In 1 Box (57894-505-20) / 20 Ml In 1 Vial, Single-Dose",1089.68,435.87,,,0 HCPCS,J9145,"Injection, daratumumab 10 mg",,,67.63,188.07,9 HCPCS,J9150,Daunorubicin Hydrochloride: 1 Vial In 1 Box (42658-021-01) / 4 Ml In 1 Vial,104.71,41.88,,,0 HCPCS,J9150,Daunorubicin Hydrochloride: 1 Vial In 1 Carton (0143-9550-01) / 10 Ml In 1 Vial,130.65,52.26,,,0 HCPCS,J9150,Daunorubicin Hydrochloride: 10 Vial In 1 Box (0143-9551-10) / 4 Ml In 1 Vial (0143-9551-01),192.89,77.16,,,0 HCPCS,J9150,Daunorubicin Hydrochloride: 10 Vial In 1 Carton (42658-021-02) / 4 Ml In 1 Vial,67.71,27.08,,,0 HCPCS,J9150,Daunorubicin injection,,,26.4,26.4,4 HCPCS,J9150,NDC Description Not Available,130.06,52.02,,,0 HCPCS,J9150,"daunorubicin hydrochloride: 10 VIAL, SINGLE-DOSE in 1 CARTON (0703-5233-13) / 4 mL in 1 VIAL, SINGLE-DOSE (0703-5233-11)",289.06,115.62,,,0 HCPCS,J9151,Daunorubicin citrate inj,,,0.01,0.01,4 HCPCS,J9153,"Inj daunorubicin, cytarabine",,,249.02,685.75,9 HCPCS,J9153,Vyxeos: 20 Ml In 1 Vial (68727-745-01),1107.54,443.02,,,0 HCPCS,J9153,Vyxeos: 40 Ml In 1 Carton (68727-745-02),1061.95,424.78,,,0 HCPCS,J9155,Degarelix injection,,,4.36,11.27,9 HCPCS,J9155,"Firmagon: 1 Kit In 1 Carton (55566-8303-1) * 4 Ml In 1 Vial, Glass * 4.2 Ml In 1 Syringe",26.31,10.52,,,0 HCPCS,J9155,"Firmagon: 1 Kit In 1 Carton (55566-8403-1) * 3 Ml In 1 Syringe * 3 Ml In 1 Vial, Glass",13.68,5.47,,,0 HCPCS,J9171,Docetaxel injection,,,0.61,0.61,4 HCPCS,J9171,"Docetaxel: 1 Vial, Multi-Dose In 1 Carton (66758-050-03) / 16 Ml In 1 Vial, Multi-Dose",2.18,0.87,,,0 HCPCS,J9171,"Docetaxel: 1 Vial, Multi-Dose In 1 Carton (67457-533-16) / 16 Ml In 1 Vial, Multi-Dose",13.06,5.22,,,0 HCPCS,J9172,"Docetaxel (ingenus), 1 mg",,,46.19,115.48,9 HCPCS,J9173,Imfinzi: 1 Vial In 1 Carton (0310-4500-12) / 2.4 Ml In 1 Vial,394.36,157.74,,,0 HCPCS,J9173,Imfinzi: 1 Vial In 1 Carton (0310-4611-50) / 10 Ml In 1 Vial,370.72,148.29,,,0 HCPCS,J9173,"Inj., durvalumab, 10 mg",,,83.87,219.14,9 HCPCS,J9174,"Inj, docetaxel (beizray) 1mg",,,46.53,116.33,5 HCPCS,J9175,Elliotts b solution per ml,,,10.2,10.2,4 HCPCS,J9176,"Empliciti: 1 Vial, Single-Use In 1 Carton (0003-2291-11) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Use",33.21,13.28,,,0 HCPCS,J9176,"Empliciti: 1 Vial, Single-Use In 1 Carton (0003-4522-11) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Use",33.28,13.31,,,0 HCPCS,J9176,"Injection, elotuzumab, 1mg",,,7.73,20.47,9 HCPCS,J9177,Inj enfort vedo-ejfv 0.25mg,,,36.54,91.34,9 HCPCS,J9177,"Padcev Ejfv: 1 Vial, Single-Dose In 1 Box (51144-020-01) / 2 Ml In 1 Vial, Single-Dose",155.22,62.09,,,0 HCPCS,J9177,"Padcev Ejfv: 1 Vial, Single-Dose In 1 Box (51144-030-01) / 3 Ml In 1 Vial, Single-Dose",155.24,62.1,,,0 HCPCS,J9178,"Inj, epirubicin hcl, 2 mg",,,1.62,1.62,4 HCPCS,J9179,"Eribulin Mesylate: 1 Vial, Single-Dose In 1 Carton (0143-9167-01) / 2 Ml In 1 Vial, Single-Dose",569.01,227.6,,,0 HCPCS,J9179,Eribulin mesylate injection,,,63.97,159.93,9 HCPCS,J9179,"Halaven: 1 Vial, Single-Dose In 1 Carton (62856-389-01) / 2 Ml In 1 Vial, Single-Dose",617.51,247.0,,,0 HCPCS,J9181,"Etopophos: 1 Vial, Single-Dose In 1 Carton (61269-410-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",68.4,27.36,,,0 HCPCS,J9181,Etoposide injection,,,1.07,1.07,4 HCPCS,J9181,"Etoposide: 1 Vial In 1 Box, Unit-Dose (0143-9510-01) / 5 Ml In 1 Vial",4.12,1.65,,,0 HCPCS,J9181,"Etoposide: 1 Vial In 1 Box, Unit-Dose (0143-9511-01) / 25 Ml In 1 Vial",3.03,1.21,,,0 HCPCS,J9181,"Etoposide: 1 Vial In 1 Box, Unit-Dose (0143-9512-01) / 50 Ml In 1 Vial",3.39,1.36,,,0 HCPCS,J9181,"Etoposide: 1 Vial, Multi-Dose In 1 Box (16729-114-08) / 25 Ml In 1 Vial, Multi-Dose",3.75,1.5,,,0 HCPCS,J9181,"Etoposide: 1 Vial, Multi-Dose In 1 Box (16729-114-11) / 50 Ml In 1 Vial, Multi-Dose",5.48,2.19,,,0 HCPCS,J9181,"Etoposide: 1 Vial, Multi-Dose In 1 Box (16729-114-31) / 5 Ml In 1 Vial, Multi-Dose",4.41,1.76,,,0 HCPCS,J9181,"Etoposide: 1 Vial, Multi-Dose In 1 Carton (63323-104-06) / 5 Ml In 1 Vial, Multi-Dose",5.22,2.09,,,0 HCPCS,J9181,"Etoposide: 1 Vial, Multi-Dose In 1 Carton (63323-104-25) / 25 Ml In 1 Vial, Multi-Dose",1.72,0.69,,,0 HCPCS,J9184,Inj gemcitabin (avyxa) 200mg,,,403.46,1008.66,5 HCPCS,J9185,Fludarabine Phosphate: 1 Vial In 1 Carton (25021-242-02) / 2 Ml In 1 Vial,720.44,288.18,,,0 HCPCS,J9185,Fludarabine phosphate inj,,,59.53,59.53,4 HCPCS,J9185,Fludarabine: 1 Vial In 1 Box (63323-192-02) / 2 Ml In 1 Vial,118.92,47.57,,,0 HCPCS,J9190,Fluorouracil injection,,,2.21,2.21,4 HCPCS,J9190,Fluorouracil: 1 Bottle In 1 Carton (25021-215-98) / 50 Ml In 1 Bottle,11.3,4.52,,,0 HCPCS,J9190,Fluorouracil: 1 Bottle In 1 Carton (25021-215-99) / 100 Ml In 1 Bottle,11.27,4.51,,,0 HCPCS,J9190,"Fluorouracil: 1 Vial, Pharmacy Bulk Package In 1 Carton (55150-498-01) / 100 Ml In 1 Vial, Pharmacy Bulk Package",7.36,2.94,,,0 HCPCS,J9190,"Fluorouracil: 1 Vial, Pharmacy Bulk Package In 1 Carton (63323-117-51) / 50 Ml In 1 Vial, Pharmacy Bulk Package",12.61,5.04,,,0 HCPCS,J9190,"Fluorouracil: 1 Vial, Pharmacy Bulk Package In 1 Carton (63323-117-61) / 100 Ml In 1 Vial, Pharmacy Bulk Package",12.6,5.04,,,0 HCPCS,J9190,"Fluorouracil: 1 Vial, Pharmacy Bulk Package In 1 Carton (70700-188-22) / 50 Ml In 1 Vial, Pharmacy Bulk Package",23.7,9.48,,,0 HCPCS,J9190,"Fluorouracil: 1 Vial, Pharmacy Bulk Package In 1 Carton (70700-189-22) / 100 Ml In 1 Vial, Pharmacy Bulk Package",25.34,10.14,,,0 HCPCS,J9190,"Fluorouracil: 1 Vial, Pharmacy Bulk Package In 1 Carton (71288-154-76) / 100 Ml In 1 Vial, Pharmacy Bulk Package",6.1,2.44,,,0 HCPCS,J9190,"Fluorouracil: 1 Vial, Pharmacy Bulk Package In 1 Carton (71288-170-75) / 50 Ml In 1 Vial, Pharmacy Bulk Package",6.54,2.62,,,0 HCPCS,J9190,Fluorouracil: 10 Vial In 1 Carton (16729-276-68) / 10 Ml In 1 Vial (16729-276-03),55.02,22.01,,,0 HCPCS,J9190,Fluorouracil: 10 Vial In 1 Carton (70700-187-23) / 20 Ml In 1 Vial (70700-187-22),27.32,10.93,,,0 HCPCS,J9190,"Fluorouracil: 10 Vial, Single-Dose In 1 Tray (63323-117-10) / 10 Ml In 1 Vial, Single-Dose (63323-117-00)",15.28,6.11,,,0 HCPCS,J9190,"Fluorouracil: 10 Vial, Single-Dose In 1 Tray (63323-117-20) / 20 Ml In 1 Vial, Single-Dose (63323-117-01)",14.84,5.94,,,0 HCPCS,J9190,NDC Description Not Available,16.66,6.66,,,0 HCPCS,J9196,Inj gemcitabine hcl (accord),,,8.65,8.65,4 HCPCS,J9198,"Inj. infugem, 100 mg",,,38.0,38.0,4 HCPCS,J9200,Floxuridine injection,,,3988.33,10974.62,9 HCPCS,J9200,"Floxuridine: 1 Vial In 1 Box, Unit-Dose (81643-9270-1) / 5 Injection, Powder, Lyophilized, For Solution In 1 Vial",3796.06,1518.42,,,0 HCPCS,J9201,Gemcitabine hcl injection,,,2.98,2.98,4 HCPCS,J9201,"Gemcitabine: 1 Vial, Single-Dose In 1 Carton (0409-0182-01) / 52.6 Ml In 1 Vial, Single-Dose",23.2,9.28,,,0 HCPCS,J9201,"Gemcitabine: 1 Vial, Single-Dose In 1 Carton (71288-117-54) / 52.6 Ml In 1 Vial, Single-Dose",24.23,9.69,,,0 HCPCS,J9202,Goserelin acetate implant,,,705.14,948.55,5 HCPCS,J9203,Gemtuzumab ozogamicin 0.1 mg,,,233.12,618.42,9 HCPCS,J9203,"Mylotarg: 1 Vial, Single-Dose In 1 Carton (0008-4510-01) / 5 Ml In 1 Vial, Single-Dose",974.98,389.99,,,0 HCPCS,J9204,"Inj mogamulizumab-kpkc, 1 mg",,,243.63,646.34,9 HCPCS,J9204,"Poteligeo: 1 Vial, Glass In 1 Carton (42747-761-01) / 5 Ml In 1 Vial, Glass",1052.13,420.85,,,0 HCPCS,J9205,Inj irinotecan liposome 1 mg,,,65.28,167.14,9 HCPCS,J9205,"Onivyde: 1 Vial, Single-Dose In 1 Carton (15054-0043-1) / 10 Ml In 1 Vial, Single-Dose",303.22,121.29,,,0 HCPCS,J9206,"Camptosar: 1 Vial, Single-Dose In 1 Carton (0009-7529-03) / 5 Ml In 1 Vial, Single-Dose",17.56,7.02,,,0 HCPCS,J9206,"Irinotecan Hydrochloride: 1 Vial, Single-Dose In 1 Carton (70700-170-22) / 5 Ml In 1 Vial, Single-Dose",9.0,3.6,,,0 HCPCS,J9206,"Irinotecan Hydrochloride: 1 Vial, Single-Use In 1 Carton (60505-6128-1) / 5 Ml In 1 Vial, Single-Use",13.4,5.36,,,0 HCPCS,J9206,"Irinotecan Hydrochloride: 5 Ml In 1 Vial, Glass (0143-9701-01)",13.12,5.25,,,0 HCPCS,J9206,Irinotecan injection,,,1.64,1.64,4 HCPCS,J9207,Ixabepilone injection,,,136.21,348.74,9 HCPCS,J9208,Ifosfamide injection,,,24.62,24.62,4 HCPCS,J9208,"Ifosfamide: 1 Vial, Single-Dose In 1 Carton (10019-926-02) / 60 Ml In 1 Vial, Single-Dose (10019-926-16)",139.72,55.89,,,0 HCPCS,J9208,NDC Description Not Available,96.03,38.41,,,0 HCPCS,J9209,Mesna injection,,,1.36,1.36,4 HCPCS,J9209,Mesna: 1 Vial In 1 Carton (25021-201-10) / 10 Ml In 1 Vial,17.56,7.02,,,0 HCPCS,J9209,"Mesna: 1 Vial, Multi-Dose In 1 Box (10019-953-01) / 10 Ml In 1 Vial, Multi-Dose (10019-953-62)",22.29,8.92,,,0 HCPCS,J9209,"Mesnex: 1 Vial, Multi-Dose In 1 Box (0338-1305-01) / 10 Ml In 1 Vial, Multi-Dose",7.82,3.13,,,0 HCPCS,J9209,NDC Description Not Available,22.29,8.92,,,0 HCPCS,J9210,"Gamifant: 1 Vial, Single-Use In 1 Carton (66658-501-01) / 2 Ml In 1 Vial, Single-Use",3072.71,1229.08,,,0 HCPCS,J9210,"Gamifant: 1 Vial, Single-Use In 1 Carton (66658-505-01) / 10 Ml In 1 Vial, Single-Use",1553.42,621.37,,,0 HCPCS,J9210,"Gamifant: 1 Vial, Single-Use In 1 Carton (66658-510-01) / 20 Ml In 1 Vial, Single-Use",1553.42,621.37,,,0 HCPCS,J9210,"Inj., emapalumab-lzsg, 1 mg",,,381.5,979.65,9 HCPCS,J9211,"Idamycin Pfs: 1 Vial, Single-Dose In 1 Carton (0013-2576-05) / 5 Ml In 1 Vial, Single-Dose",157.3,62.92,,,0 HCPCS,J9211,"Idamycin Pfs: 1 Vial, Single-Dose In 1 Carton (0013-2576-91) / 5 Ml In 1 Vial, Single-Dose",101.58,40.63,,,0 HCPCS,J9211,"Idamycin Pfs: 1 Vial, Single-Dose In 1 Carton (0013-2586-91) / 10 Ml In 1 Vial, Single-Dose",181.58,72.63,,,0 HCPCS,J9211,"Idamycin Pfs: 1 Vial, Single-Dose In 1 Carton (0013-2596-20) / 20 Ml In 1 Vial, Single-Dose",210.96,84.38,,,0 HCPCS,J9211,"Idamycin Pfs: 1 Vial, Single-Dose In 1 Carton (0013-2596-91) / 20 Ml In 1 Vial, Single-Dose",198.06,79.22,,,0 HCPCS,J9211,"Idarubicin Hydrochloride: 1 Vial, Glass In 1 Box (0143-9217-01) / 5 Ml In 1 Vial, Glass",328.57,131.43,,,0 HCPCS,J9211,"Idarubicin Hydrochloride: 1 Vial, Glass In 1 Box (0143-9218-01) / 10 Ml In 1 Vial, Glass",279.81,111.92,,,0 HCPCS,J9211,"Idarubicin Hydrochloride: 1 Vial, Glass In 1 Box (0143-9219-01) / 20 Ml In 1 Vial, Glass",113.1,45.24,,,0 HCPCS,J9211,Idarubicin hcl injection,,,43.51,43.51,4 HCPCS,J9212,Interferon alfacon-1 inj,,,0.01,0.01,4 HCPCS,J9213,Interferon alfa-2a inj,,,0.01,0.01,4 HCPCS,J9214,Interferon alfa-2b inj,,,30.73,30.73,4 HCPCS,J9215,Interferon alfa-n3 inj,,,30.0,30.0,4 HCPCS,J9216,Interferon gamma 1-b inj,,,8459.66,8459.66,4 HCPCS,J9217,Eligard: 1 Syringe In 1 Carton (62935-227-10) / .375 Ml In 1 Syringe,550.0,220.0,,,0 HCPCS,J9217,Eligard: 1 Syringe In 1 Carton (62935-461-50) / .375 Ml In 1 Syringe,550.0,220.0,,,0 HCPCS,J9217,Leuprolide acetate suspnsion,,,172.29,472.12,9 HCPCS,J9217,Lupron Depot: 1 Kit In 1 Carton (0074-3346-03) * 1.5 Ml In 1 Syringe * 1 Swab In 1 Packet,9241.75,3696.7,,,0 HCPCS,J9217,Lupron Depot: 1 Kit In 1 Carton (0074-3473-03) * 1 Swab In 1 Packet * 1.5 Ml In 1 Syringe,9389.97,3755.99,,,0 HCPCS,J9217,Lupron Depot: 1 Kit In 1 Carton (0074-3642-03) * 1 Ml In 1 Syringe * 1 Swab In 1 Packet,9232.83,3693.13,,,0 HCPCS,J9217,Lupron Depot: 1 Kit In 1 Carton (0074-3683-03) * 1.5 Ml In 1 Syringe * 1 Swab In 1 Packet,9309.02,3723.61,,,0 HCPCS,J9218,"Leuprolide Acetate: 1 Kit In 1 Carton (0781-4003-32) * 1 Vial, Multi-Dose In 1 Carton (0781-3006-42) / 2.8 Ml In 1 Vial, Multi-Dose * 1 Ml In 1 Packet",3269.08,1307.63,,,0 HCPCS,J9218,Leuprolide acetate injeciton,,,50.56,50.56,4 HCPCS,J9219,Leuprolide acetate implant,,,0.01,0.01,4 HCPCS,J9220,Indigotindisulfonate sod 1mg,,,8.15,20.38,5 HCPCS,J9223,"Inj. lurbinectedin, 0.1 mg",,,205.04,539.3,9 HCPCS,J9223,"Zepzelca: 8 Ml In 1 Vial, Single-Dose (68727-712-01)",904.6,361.84,,,0 HCPCS,J9225,Vantas implant,,,0.01,0.01,4 HCPCS,J9226,Supprelin LA implant,,,37837.55,94593.87,9 HCPCS,J9226,"Supprelin La: 1 Vial, Glass In 1 Carton (67979-002-01) / 1 Implant In 1 Vial, Glass",190924.26,76369.7,,,0 HCPCS,J9227,Inj. isatuximab-irfc 10 mg,,,78.86,224.53,9 HCPCS,J9227,"Sarclisa: 1 Vial, Single-Dose In 1 Carton (0024-0654-01) / 5 Ml In 1 Vial, Single-Dose",359.86,143.94,,,0 HCPCS,J9227,"Sarclisa: 1 Vial, Single-Dose In 1 Carton (0024-0656-01) / 25 Ml In 1 Vial, Single-Dose",359.86,143.94,,,0 HCPCS,J9228,Ipilimumab injection,,,180.22,476.08,9 HCPCS,J9228,"Yervoy: 1 Vial, Single-Use In 1 Carton (0003-2327-11) / 10 Ml In 1 Vial, Single-Use",780.86,312.34,,,0 HCPCS,J9228,"Yervoy: 1 Vial, Single-Use In 1 Carton (0003-2328-22) / 40 Ml In 1 Vial, Single-Use",780.01,312.0,,,0 HCPCS,J9229,"Besponsa: 1 Vial, Single-Dose In 1 Carton (0008-0100-01) / 4 Ml In 1 Vial, Single-Dose",11218.4,4487.36,,,0 HCPCS,J9229,Inj inotuzumab ozogam 0.1 mg,,,2658.13,7182.76,9 HCPCS,J9230,Mechlorethamine hcl inj,,,0.01,0.01,4 HCPCS,J9245,Inj melphalan hydrochl 50 MG,,,90.03,225.08,9 HCPCS,J9245,Melphalan Hydrochloride: 1 Kit In 1 Carton (25021-258-61) * 10 Ml In 1 Vial (25021-256-10) * 10 Ml In 1 Vial (25021-257-10),558.12,223.25,,,0 HCPCS,J9245,"Melphalan Hydrochloride: 1 Kit In 1 Carton (54288-109-02) * 10 Ml In 1 Vial, Single-Dose (54288-106-01) * 10 Ml In 1 Vial, Single-Use (54288-107-01)",689.41,275.76,,,0 HCPCS,J9245,"Melphalan Hydrochloride: 1 Kit In 1 Carton (67457-195-01) * 10 Ml In 1 Vial, Glass (67457-193-50) * 10 Ml In 1 Vial, Glass (67457-194-10)",705.17,282.07,,,0 HCPCS,J9245,"Melphalan Hydrochloride: 1 Kit In 1 Carton (71288-132-90) * 15 Ml In 1 Vial, Single-Dose (71288-130-15) * 10 Ml In 1 Vial, Single-Use (71288-131-10)",367.46,146.98,,,0 HCPCS,J9245,"Melphalan Hydrochloride: 1 Kit In 1 Carton (72266-128-01) * 10 Ml In 1 Vial, Single-Dose (72266-144-01) * 10 Ml In 1 Vial, Single-Use (72266-145-01)",1198.81,479.52,,,0 HCPCS,J9245,"Melphalan Hydrochloride: 1 Kit In 1 Carton (83634-202-61) * 15 Ml In 1 Vial, Single-Dose (83634-200-15) * 10 Ml In 1 Vial, Single-Use (83634-201-10)",1015.55,406.22,,,0 HCPCS,J9246,"Inj., evomela, 1 mg",,,18.5,46.42,9 HCPCS,J9248,Inj melphalan (hepzato) 1 mg,,,773.8,1993.54,9 HCPCS,J9249,"Inj, melphalan (apotex) 1 mg",,,61.11,161.94,9 HCPCS,J9255,Methotrexate: 1 Vial In 1 Carton (16729-277-30) / 2 Ml In 1 Vial,6.47,2.59,,,0 HCPCS,J9255,Methotrexate: 1 Vial In 1 Carton (16729-277-35) / 40 Ml In 1 Vial,7.12,2.85,,,0 HCPCS,J9256,"Inj, nipocalimab-aahu, 3 mg",,,32.32,80.8,5 HCPCS,J9260,Methotrexate sodium inj,,,2.58,2.58,4 HCPCS,J9260,"Methotrexate: 1 Vial, Single-Dose In 1 Carton (0703-3671-01) / 2 Ml In 1 Vial, Single-Dose",12.25,4.9,,,0 HCPCS,J9260,"Methotrexate: 1 Vial, Single-Dose In 1 Carton (0703-3675-01) / 10 Ml In 1 Vial, Single-Dose",6.12,2.45,,,0 HCPCS,J9260,"Methotrexate: 1 Vial, Single-Dose In 1 Carton (0703-3678-01) / 40 Ml In 1 Vial, Single-Dose",5.13,2.05,,,0 HCPCS,J9260,"Methotrexate: 1 Vial, Single-Dose In 1 Carton (61703-408-41) / 40 Ml In 1 Vial, Single-Dose",7.61,3.04,,,0 HCPCS,J9260,Methotrexate: 10 Vial In 1 Carton (0143-9519-10) / 2 Ml In 1 Vial,5.79,2.32,,,0 HCPCS,J9260,NDC Description Not Available,6.34,2.54,,,0 HCPCS,J9261,Arranon: 50 Ml In 1 Vial (0078-0683-61),626.93,250.77,,,0 HCPCS,J9261,Nelarabine injection,,,40.87,102.18,9 HCPCS,J9261,Nelarabine: 1 Vial In 1 Carton (25021-259-50) / 50 Ml In 1 Vial,215.69,86.28,,,0 HCPCS,J9261,Nelarabine: 1 Vial In 1 Carton (72205-154-01) / 50 Ml In 1 Vial,647.17,258.87,,,0 HCPCS,J9261,"Nelarabine: 1 Vial, Single-Dose In 1 Carton (43598-142-11) / 50 Ml In 1 Vial, Single-Dose",792.21,316.88,,,0 HCPCS,J9261,"Nelarabine: 1 Vial, Single-Dose In 1 Carton (70121-1743-1) / 50 Ml In 1 Vial, Single-Dose",217.58,87.03,,,0 HCPCS,J9261,"Nelarabine: 1 Vial, Single-Dose In 1 Carton (70710-1726-1) / 50 Ml In 1 Vial, Single-Dose",827.15,330.86,,,0 HCPCS,J9261,"Nelarabine: 1 Vial, Single-Dose In 1 Carton (71288-165-54) / 50 Ml In 1 Vial, Single-Dose (71288-165-52)",665.06,266.02,,,0 HCPCS,J9261,"Nelarabine: 1 Vial, Single-Dose In 1 Carton (81927-111-01) / 50 Ml In 1 Vial, Single-Dose",568.88,227.55,,,0 HCPCS,J9261,Nelarabine: 6 Vial In 1 Carton (72205-154-04) / 50 Ml In 1 Vial,253.65,101.46,,,0 HCPCS,J9261,"Nelarabine: 6 Vial, Single-Dose In 1 Carton (43598-142-06) / 50 Ml In 1 Vial, Single-Dose",331.1,132.44,,,0 HCPCS,J9261,"Nelarabine: 6 Vial, Single-Dose In 1 Carton (70121-1743-4) / 50 Ml In 1 Vial, Single-Dose (70121-1743-1)",209.75,83.9,,,0 HCPCS,J9262,"Inj, omacetaxine mep, 0.01mg",,,3.8,3.8,4 HCPCS,J9263,Oxaliplatin,,,0.05,0.05,4 HCPCS,J9263,Oxaliplatin: 1 Vial In 1 Carton (60505-6132-7) / 20 Ml In 1 Vial,0.89,0.36,,,0 HCPCS,J9263,Oxaliplatin: 1 Vial In 1 Carton (67457-442-20) / 20 Ml In 1 Vial,0.97,0.39,,,0 HCPCS,J9263,"Oxaliplatin: 1 Vial, Single-Dose In 1 Carton (61703-363-22) / 20 Ml In 1 Vial, Single-Dose",4.5,1.8,,,0 HCPCS,J9263,"Oxaliplatin: 1 Vial, Single-Dose In 1 Carton (71288-101-20) / 20 Ml In 1 Vial, Single-Dose",0.26,0.1,,,0 HCPCS,J9263,"Oxaliplatin: 1 Vial, Single-Use In 1 Carton (0703-3986-01) / 20 Ml In 1 Vial, Single-Use",1.39,0.56,,,0 HCPCS,J9264,"Abraxane: 1 Vial, Single-Use In 1 Carton (68817-134-50) / 20 Ml In 1 Vial, Single-Use",66.81,26.72,,,0 HCPCS,J9264,Paclitaxel Protein Bound Particles Albumin Bound: 1 Vial In 1 Carton (0517-4300-01) / 20 Ml In 1 Vial,61.86,24.74,,,0 HCPCS,J9264,Paclitaxel protein bound,,,3.64,13.06,9 HCPCS,J9266,"Oncaspar: 1 Vial, Single-Use In 1 Carton (72694-954-01) / 5 Ml In 1 Vial, Single-Use",114693.12,45877.25,,,0 HCPCS,J9266,Pegaspargase injection,,,27070.53,74613.16,9 HCPCS,J9267,"Paclitaxel Paclitaxel: 1 Vial, Multi-Dose In 1 Carton (23155-884-31) / 50 Ml In 1 Vial, Multi-Dose",0.79,0.32,,,0 HCPCS,J9267,Paclitaxel injection,,,0.13,0.13,4 HCPCS,J9267,"Paclitaxel: 1 Vial, Multi-Dose In 1 Carton (0703-3218-01) / 50 Ml In 1 Vial, Multi-Dose",1.02,0.41,,,0 HCPCS,J9267,"Paclitaxel: 1 Vial, Multi-Dose In 1 Carton (61703-342-50) / 50 Ml In 1 Vial, Multi-Dose",0.85,0.34,,,0 HCPCS,J9267,"Paclitaxel: 1 Vial, Multi-Dose In 1 Carton (63323-763-50) / 50 Ml In 1 Vial, Multi-Dose",1.32,0.53,,,0 HCPCS,J9267,"Paclitaxel: 1 Vial, Multi-Dose In 1 Carton (72205-063-01) / 50 Ml In 1 Vial, Multi-Dose",0.45,0.18,,,0 HCPCS,J9268,Pentostatin injection,,,2612.89,6532.23,9 HCPCS,J9269,Inj. tagraxofusp-erzs 10 mcg,,,338.53,893.23,9 HCPCS,J9271,Inj pembrolizumab,,,59.35,155.63,9 HCPCS,J9271,Keytruda: 1 Vial In 1 Carton (0006-3026-02) / 4 Ml In 1 Vial (0006-3026-01),265.98,106.39,,,0 HCPCS,J9271,Keytruda: 2 Vial In 1 Carton (0006-3026-04) / 4 Ml In 1 Vial (0006-3026-01),253.8,101.52,,,0 HCPCS,J9271,NDC Description Not Available,249.18,99.67,,,0 HCPCS,J9272,"Inj, dostarlimab-gxly, 10 mg",,,240.14,626.37,9 HCPCS,J9272,Jemperli: 1 Vial In 1 Carton (0173-0898-03) / 10 Ml In 1 Vial,1034.28,413.71,,,0 HCPCS,J9273,"Inj tisotu vedotin-tftv, 1mg",,,188.65,490.3,9 HCPCS,J9273,Tivdak: 1 Vial In 1 Carton (51144-003-01) / 4 Ml In 1 Vial,780.52,312.21,,,0 HCPCS,J9274,"Inj, tebentafusp-tebn, 1 mcg",,,214.76,570.02,9 HCPCS,J9274,"Kimmtrak: 1 Vial, Glass In 1 Carton (80446-401-01) / .5 Ml In 1 Vial, Glass",906.23,362.49,,,0 HCPCS,J9275,"Inj cosibelimab-ipdl, 2 mg",,,21.99,54.97,5 HCPCS,J9276,"Inj zanidatamab-hrii, 2 mg",,,25.73,64.34,5 HCPCS,J9280,Mitomycin injection,,,25.6,87.1,9 HCPCS,J9280,"Mitomycin: 1 Vial In 1 Box, Unit-Dose (0143-9279-01) / 40 Ml In 1 Vial",56.73,22.69,,,0 HCPCS,J9280,"Mitomycin: 1 Vial In 1 Box, Unit-Dose (16729-108-11) / 40 Ml In 1 Vial",154.83,61.93,,,0 HCPCS,J9280,Mitomycin: 1 Vial In 1 Carton (25021-251-50) / 40 Ml In 1 Vial,590.9,236.36,,,0 HCPCS,J9280,Mitomycin: 1 Vial In 1 Carton (65219-566-20) / 40 Ml In 1 Vial,669.3,267.72,,,0 HCPCS,J9280,Mitomycin: 1 Vial In 1 Carton (72819-153-02) / 40 Ml In 1 Vial,152.54,61.02,,,0 HCPCS,J9280,"Mitomycin: 1 Vial, Single-Dose In 1 Carton (71288-138-50) / 40 Ml In 1 Vial, Single-Dose",494.99,198.0,,,0 HCPCS,J9281,Mitomycin instillation,,,313.0,822.68,9 HCPCS,J9282,Mitomycin intravesical inst,,,272.92,682.3,5 HCPCS,J9285,"Inj, olaratumab, 10 mg",,,0.01,0.01,4 HCPCS,J9286,"Columvi: 1 Vial, Single-Dose In 1 Carton (50242-125-01) / 2.5 Ml In 1 Vial, Single-Dose",11303.04,4521.22,,,0 HCPCS,J9286,"Columvi: 1 Vial, Single-Dose In 1 Carton (50242-127-01) / 10 Ml In 1 Vial, Single-Dose",11609.22,4643.69,,,0 HCPCS,J9286,"Inj glofitamab gxbm, 2.5 mg",,,2772.8,7147.79,9 HCPCS,J9289,Inj nivolumab 2 mg hyaluron,,,27.99,69.97,5 HCPCS,J9292,"Inj, pemetrexed (avyxa) 10mg",,,76.69,191.72,9 HCPCS,J9293,Mitoxantrone hydrochl / 5 MG,,,19.42,48.54,9 HCPCS,J9293,"Mitoxantrone: 1 Vial, Multi-Dose In 1 Carton (61703-343-18) / 10 Ml In 1 Vial, Multi-Dose",193.59,77.44,,,0 HCPCS,J9293,"Mitoxantrone: 1 Vial, Multi-Dose In 1 Carton (61703-343-65) / 12.5 Ml In 1 Vial, Multi-Dose",118.02,47.21,,,0 HCPCS,J9294,"Inj pemetrexed, hospira 10mg",,,3.68,9.2,9 HCPCS,J9295,"Injection, necitumumab, 1 mg",,,5.73,14.33,9 HCPCS,J9296,Inj pemetrexed (accord) 10mg,,,9.74,11.88,5 HCPCS,J9297,Inj pemetrexed (sandoz) 10mg,,,1.74,1.74,4 HCPCS,J9298,Inj nivol relatlimab 3mg/1mg,,,194.08,513.6,9 HCPCS,J9298,"Opdualag: 1 Vial, Single-Dose In 1 Carton (0003-7125-11) / 20 Ml In 1 Vial, Single-Dose",830.72,332.29,,,0 HCPCS,J9299,"Injection, nivolumab",,,32.35,85.48,9 HCPCS,J9299,"Opdivo: 1 Vial, Single-Dose In 1 Carton (0003-3734-13) / 24 Ml In 1 Vial, Single-Dose",141.84,56.74,,,0 HCPCS,J9299,"Opdivo: 1 Vial, Single-Dose In 1 Carton (0003-3756-14) / 12 Ml In 1 Vial, Single-Dose",141.13,56.45,,,0 HCPCS,J9299,"Opdivo: 1 Vial, Single-Dose In 1 Carton (0003-3772-11) / 4 Ml In 1 Vial, Single-Dose",142.21,56.88,,,0 HCPCS,J9299,"Opdivo: 1 Vial, Single-Dose In 1 Carton (0003-3774-12) / 10 Ml In 1 Vial, Single-Dose",141.82,56.73,,,0 HCPCS,J9301,"Gazyva: 1 Vial, Single-Use In 1 Carton (50242-070-01) / 40 Ml In 1 Vial, Single-Use",374.22,149.69,,,0 HCPCS,J9301,Obinutuzumab inj,,,75.21,212.6,9 HCPCS,J9302,Ofatumumab injection,,,60.34,75.92,5 HCPCS,J9303,Panitumumab injection,,,164.92,458.19,9 HCPCS,J9303,"Vectibix: 1 Vial, Single-Dose In 1 Carton (55513-954-01) / 5 Ml In 1 Vial, Single-Dose",754.55,301.82,,,0 HCPCS,J9303,"Vectibix: 1 Vial, Single-Dose In 1 Carton (55513-956-01) / 20 Ml In 1 Vial, Single-Dose",749.4,299.76,,,0 HCPCS,J9304,"Inj. pemetrexed, 10 mg",,,46.35,231.26,9 HCPCS,J9305,Alimta: 1 Vial In 1 Carton (0002-7623-01) / 20 Ml In 1 Vial,348.49,139.4,,,0 HCPCS,J9305,Alimta: 1 Vial In 1 Carton (0002-7640-01) / 4 Ml In 1 Vial,348.49,139.4,,,0 HCPCS,J9305,"Pemetrexed Disodium: 1 Vial, Single-Dose In 1 Carton (43598-370-74) / 40 Ml In 1 Vial, Single-Dose",6.25,2.5,,,0 HCPCS,J9305,"Pemetrexed Disodium: 1 Vial, Single-Dose In 1 Carton (43598-386-62) / 4 Ml In 1 Vial, Single-Dose",6.18,2.47,,,0 HCPCS,J9305,"Pemetrexed Disodium: 1 Vial, Single-Dose In 1 Carton (43598-387-11) / 20 Ml In 1 Vial, Single-Dose",6.18,2.47,,,0 HCPCS,J9305,Pemetrexed injection,,,1.23,4.38,9 HCPCS,J9305,Pemetrexed: 1 Vial In 1 Carton (55150-381-01) / 4 Ml In 1 Vial,8.36,3.34,,,0 HCPCS,J9305,Pemetrexed: 1 Vial In 1 Carton (55150-383-01) / 40 Ml In 1 Vial,6.47,2.59,,,0 HCPCS,J9305,"Pemetrexed: 1 Vial, Single-Dose In 1 Carton (71288-147-50) / 30 Ml In 1 Vial, Single-Dose",6.32,2.53,,,0 HCPCS,J9305,"Pemetrexed: 1 Vial, Single-Dose In 1 Carton (71288-148-51) / 40 Ml In 1 Vial, Single-Dose",6.12,2.45,,,0 HCPCS,J9305,"Pemetrexed: 1 Vial, Single-Dose In 1 Carton (71288-166-10) / 10 Ml In 1 Vial, Single-Dose",4.9,1.96,,,0 HCPCS,J9305,"Pemetrexed: 1 Vial, Single-Dose In 1 Carton (71288-167-50) / 50 Ml In 1 Vial, Single-Dose",4.05,1.62,,,0 HCPCS,J9305,"Pemetrexed: 1 Vial, Single-Use In 1 Carton (63323-134-10) / 4 Ml In 1 Vial, Single-Use",55.88,22.35,,,0 HCPCS,J9305,"Pemetrexed: 1 Vial, Single-Use In 1 Carton (63323-450-50) / 20 Ml In 1 Vial, Single-Use",53.0,21.2,,,0 HCPCS,J9305,"Pemetrexed: 100 Injection, Powder, For Solution In 1 Vial (43547-632-01)",5.31,2.12,,,0 HCPCS,J9306,"Injection, pertuzumab, 1 mg",,,16.23,43.17,9 HCPCS,J9306,"Perjeta: 1 Vial, Single-Use In 1 Carton (50242-145-01) / 14 Ml In 1 Vial, Single-Use",70.09,28.04,,,0 HCPCS,J9307,Folotyn: 1 Vial In 1 Carton (72893-003-01) / 1 Ml In 1 Vial,1638.58,655.43,,,0 HCPCS,J9307,Folotyn: 1 Vial In 1 Carton (72893-005-01) / 2 Ml In 1 Vial,1638.23,655.29,,,0 HCPCS,J9307,Pralatrexate injection,,,373.77,961.43,9 HCPCS,J9307,"Pralatrexate: 1 Vial, Single-Dose In 1 Carton (65219-550-01) / 1 Ml In 1 Vial, Single-Dose",1073.55,429.42,,,0 HCPCS,J9308,"Cyramza: 1 Vial, Single-Dose In 1 Carton (0002-7669-01) / 10 Ml In 1 Vial, Single-Dose",321.99,128.8,,,0 HCPCS,J9308,"Cyramza: 1 Vial, Single-Dose In 1 Carton (0002-7678-01) / 50 Ml In 1 Vial, Single-Dose",321.6,128.64,,,0 HCPCS,J9308,"Injection, ramucirumab",,,73.37,191.0,9 HCPCS,J9309,"Inj, polatuzumab vedotin 1mg",,,132.73,360.26,9 HCPCS,J9309,Polivy: 1 Vial In 1 Carton (50242-103-01) / 6 Ml In 1 Vial,524.82,209.93,,,0 HCPCS,J9309,"Polivy: 1 Vial, Single-Dose In 1 Carton (50242-105-01) / 20 Ml In 1 Vial, Single-Dose",571.64,228.66,,,0 HCPCS,J9311,"Inj rituximab, hyaluronidase",,,36.26,90.66,9 HCPCS,J9311,"Rituxan Hycela: 1 Vial, Single-Dose In 1 Carton (50242-108-01) / 11.7 Ml In 1 Vial, Single-Dose",207.51,83.0,,,0 HCPCS,J9311,"Rituxan Hycela: 1 Vial, Single-Dose In 1 Carton (50242-109-01) / 13.4 Ml In 1 Vial, Single-Dose",216.09,86.44,,,0 HCPCS,J9312,"Inj., rituximab, 10 mg",,,72.09,180.24,9 HCPCS,J9312,"Rituxan: 1 Vial, Single-Use In 1 Carton (50242-051-21) / 10 Ml In 1 Vial, Single-Use",389.32,155.73,,,0 HCPCS,J9312,"Rituxan: 1 Vial, Single-Use In 1 Carton (50242-053-06) / 50 Ml In 1 Vial, Single-Use",405.56,162.22,,,0 HCPCS,J9313,"Inj., lumoxiti, 0.01 mg",,,22.07,28.54,5 HCPCS,J9314,Inj pemetrexed (teva) 10mg,,,8.37,27.46,9 HCPCS,J9316,"Pertuzu, trastuzu, 10 mg",,,59.49,148.73,9 HCPCS,J9316,"Phesgo: 1 Vial, Single-Dose In 1 Carton (50242-245-01) / 15 Ml In 1 Vial, Single-Dose",324.31,129.72,,,0 HCPCS,J9316,"Phesgo: 1 Vial, Single-Dose In 1 Carton (50242-260-01) / 10 Ml In 1 Vial, Single-Dose",327.47,130.99,,,0 HCPCS,J9317,Sacituzumab govitecan-hziy,,,35.8,93.84,9 HCPCS,J9317,"Trodelvy: 1 Vial In 1 Box (55135-132-01) / 1 Powder, For Solution In 1 Vial",152.27,60.91,,,0 HCPCS,J9318,Inj romidepsin non-lyo 0.1mg,,,31.99,82.16,9 HCPCS,J9319,Inj romidepsin lyophil 0.1mg,,,31.54,80.86,9 HCPCS,J9319,"Istodax: 1 Kit In 1 Carton (59572-984-01) * 2.2 Ml In 1 Vial, Glass (59572-962-10) * 2.4 Ml In 1 Vial, Glass (59572-973-02)",147.14,58.86,,,0 HCPCS,J9320,Streptozocin injection,,,349.23,349.23,4 HCPCS,J9321,"Epkinly: 1 Vial, Glass In 1 Carton (82705-002-01) / .8 Ml In 1 Vial, Glass",235.35,94.14,,,0 HCPCS,J9321,"Epkinly: 1 Vial, Glass In 1 Carton (82705-010-01) / .8 Ml In 1 Vial, Glass",234.73,93.89,,,0 HCPCS,J9321,Inj epcoritamab-bysp 0.16 mg,,,54.86,144.94,9 HCPCS,J9322,Inj pemetrexed (bluepoint),,,9.61,26.5,9 HCPCS,J9323,Inj pemetrexed ditromethamin,,,0.16,10.34,5 HCPCS,J9324,"Inj, pemrydi rtu, 10 mg",,,63.58,158.95,9 HCPCS,J9325,Imlygic: 1 Vial In 1 Carton (55513-078-01) / 1 Ml In 1 Vial,209.61,83.84,,,0 HCPCS,J9325,Imlygic: 1 Vial In 1 Carton (55513-079-01) / 1 Ml In 1 Vial,203.52,81.41,,,0 HCPCS,J9325,Inj talimogene laherparepvec,,,70.38,194.14,9 HCPCS,J9326,Telisotuzumab vedotin-tllv,,,145.95,364.86,5 HCPCS,J9328,Temozolomide injection,,,10.41,26.02,9 HCPCS,J9329,"Inj, tislelizumab-jsgr",,,54.64,145.22,9 HCPCS,J9330,Temsirolimus injection,,,24.79,69.27,9 HCPCS,J9331,"Fyarro: 1 Vial, Single-Use In 1 Carton (80803-153-50) / 20 Ml In 1 Vial, Single-Use",344.03,137.61,,,0 HCPCS,J9331,Inj sirolimus prot part 1 mg,,,91.03,227.58,9 HCPCS,J9332,Inj efgartigimod 2mg,,,32.35,80.87,9 HCPCS,J9332,"Vyvgart: 1 Vial, Single-Dose In 1 Carton (73475-3041-5) / 20 Ml In 1 Vial, Single-Dose",136.18,54.47,,,0 HCPCS,J9333,Inj ronzanolixizum-noli 1 mg,,,22.84,59.06,9 HCPCS,J9333,"Rystiggo: 1 Vial, Glass In 1 Carton (50474-981-83) / 3 Ml In 1 Vial, Glass",239.93,95.97,,,0 HCPCS,J9333,"Rystiggo: 1 Vial, Glass In 1 Carton (50474-982-84) / 4 Ml In 1 Vial, Glass",100.64,40.26,,,0 HCPCS,J9333,"Rystiggo: 1 Vial, Glass In 1 Carton (50474-983-86) / 6 Ml In 1 Vial, Glass",96.94,38.78,,,0 HCPCS,J9334,Inj efgart-alfa 2mg hya-qvfc,,,33.37,83.98,9 HCPCS,J9334,"Vyvgart Hytrulo: 1 Vial, Single-Dose In 1 Carton (73475-3102-3) / 5.6 Ml In 1 Vial, Single-Dose",138.91,55.56,,,0 HCPCS,J9340,"Tepadina: 1 Vial, Glass In 1 Box (70121-1631-1) / 1 Injection, Powder, For Solution In 1 Vial, Glass",1370.17,548.07,,,0 HCPCS,J9340,Thiotepa injection,,,245.05,245.05,4 HCPCS,J9340,"Thiotepa: 1 Vial In 1 Box, Unit-Dose (0143-9292-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",458.56,183.42,,,0 HCPCS,J9340,"Thiotepa: 1 Vial In 1 Carton (43598-171-11) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",1060.04,424.02,,,0 HCPCS,J9340,"Thiotepa: 1 Vial In 1 Carton (65219-029-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",1207.8,483.12,,,0 HCPCS,J9340,"Thiotepa: 1 Vial, Glass In 1 Box (72205-045-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Glass",578.8,231.52,,,0 HCPCS,J9340,"Thiotepa: 1 Vial, Glass In 1 Box (72205-046-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Glass",133.38,53.35,,,0 HCPCS,J9340,"Thiotepa: 1 Vial, Single-Dose In 1 Carton (71288-157-10) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose",1509.93,603.97,,,0 HCPCS,J9342,Inj thiotepa nos 1 mg,,,5.87,14.68,5 HCPCS,J9345,"Inj, retifanlimab-dlwr, 1 mg",,,29.74,77.33,9 HCPCS,J9347,Imjudo: 1 Vial In 1 Carton (0310-4535-30) / 15 Ml In 1 Vial,590.58,236.23,,,0 HCPCS,J9347,"Inj, tremelimumab-actl, 1 mg",,,138.24,367.48,9 HCPCS,J9348,"Inj. naxitamab-gqgk, 1 mg",,,641.83,1714.97,9 HCPCS,J9349,"Inj., tafasitamab-cxix",,,13.93,36.07,9 HCPCS,J9349,Monjuvi: 1 Vial In 1 Carton (50881-013-03) / 5 Ml In 1 Vial,60.43,24.17,,,0 HCPCS,J9349,Monjuvi: 1 Vial In 1 Carton (73535-208-01) / 5 Ml In 1 Vial,61.88,24.75,,,0 HCPCS,J9350,"Inj mosunetuzumab-axgb, 1 mg",,,640.96,1691.21,9 HCPCS,J9350,Lunsumio: 1 Vial In 1 Carton (50242-142-01) / 30 Ml In 1 Vial,2752.4,1100.96,,,0 HCPCS,J9350,Lunsumio: 1 Vial In 1 Carton (50242-159-01) / 1 Ml In 1 Vial,2746.7,1098.68,,,0 HCPCS,J9351,Topotecan injection,,,1.27,1.27,4 HCPCS,J9351,"Topotecan: 1 Vial, Multi-Dose In 1 Carton (16729-243-31) / 4 Ml In 1 Vial, Multi-Dose",14.36,5.74,,,0 HCPCS,J9351,"Topotecan: 1 Vial, Single-Dose In 1 Carton (0409-0302-01) / 4 Ml In 1 Vial, Single-Dose",14.65,5.86,,,0 HCPCS,J9352,Injection trabectedin 0.1mg,,,363.83,477.11,5 HCPCS,J9352,"Yondelis: 20 Ml In 1 Vial, Single-Use (59676-610-01)",1580.86,632.34,,,0 HCPCS,J9353,"Inj. margetuximab-cmkb, 5 mg",,,48.53,140.12,9 HCPCS,J9354,"Inj, ado-trastuzumab emt 1mg",,,41.11,109.65,9 HCPCS,J9354,"Kadcyla: 1 Vial, Single-Use In 1 Carton (50242-087-01) / 8 Ml In 1 Vial, Single-Use",174.06,69.62,,,0 HCPCS,J9354,"Kadcyla: 1 Vial, Single-Use In 1 Carton (50242-088-01) / 5 Ml In 1 Vial, Single-Use",174.4,69.76,,,0 HCPCS,J9355,"Herceptin: 1 Vial, Single-Dose In 1 Carton (50242-132-01) / 15 Ml In 1 Vial, Single-Dose",475.11,190.04,,,0 HCPCS,J9355,Trastuzumab injection,,,68.87,172.18,9 HCPCS,J9356,"Herceptin Hylecta: 1 Vial, Single-Dose In 1 Carton (50242-077-01) / 5 Ml In 1 Vial, Single-Dose",344.21,137.68,,,0 HCPCS,J9356,"Inj. herceptin hylecta, 10mg",,,58.04,145.1,9 HCPCS,J9357,Valrubicin injection,,,1230.66,3076.66,9 HCPCS,J9358,"Enhertu: 1 Vial, Single-Dose In 1 Carton (65597-406-01) / 5 Ml In 1 Vial, Single-Dose",127.75,51.1,,,0 HCPCS,J9358,Inj fam-trastu deru-nxki 1mg,,,28.9,81.63,9 HCPCS,J9359,Inj lon tesirin-lpyl 0.075mg,,,212.0,566.41,9 HCPCS,J9360,"Vinblastine Sulfate: 1 Vial, Multi-Dose In 1 Box (63323-278-10) / 10 Ml In 1 Vial, Multi-Dose",23.9,9.56,,,0 HCPCS,J9360,Vinblastine sulfate inj,,,5.14,5.14,4 HCPCS,J9370,"Vincristine Sulfate: 1 Vial, Single-Dose In 1 Carton (61703-309-06) / 1 Ml In 1 Vial, Single-Dose",78.85,31.54,,,0 HCPCS,J9370,"Vincristine Sulfate: 1 Vial, Single-Dose In 1 Carton (61703-309-16) / 2 Ml In 1 Vial, Single-Dose",30.87,12.35,,,0 HCPCS,J9370,Vincristine sulfate 1 MG inj,,,8.2,8.2,4 HCPCS,J9376,"Inj pozelimab-bbfg, 1 mg",,,86.54,229.32,9 HCPCS,J9380,Inj teclistamab cqyv 0.5 mg,,,32.42,89.54,9 HCPCS,J9380,"Tecvayli: 1 Vial, Single-Dose In 1 Carton (57894-449-01) / 3 Ml In 1 Vial, Single-Dose",133.65,53.46,,,0 HCPCS,J9380,"Tecvayli: 1 Vial, Single-Dose In 1 Carton (57894-450-01) / 1.7 Ml In 1 Vial, Single-Dose",150.17,60.07,,,0 HCPCS,J9381,Inj teplizumab mzwv 5 mcg,,,37.31,98.18,9 HCPCS,J9382,Inj zenocutuzumab-zbco 1 mg,,,33.87,84.67,5 HCPCS,J9390,Vinorelbine tartrate inj,,,6.59,6.59,4 HCPCS,J9390,Vinorelbine: 1 Vial In 1 Carton (25021-204-05) / 5 Ml In 1 Vial,87.0,34.8,,,0 HCPCS,J9393,"Inj, fulvestrant (teva)",,,20.0,104.18,9 HCPCS,J9394,"Inj, fulvestrant (fresenius)",,,3.32,33.07,5 HCPCS,J9395,"Faslodex: 2 Syringe, Glass In 1 Carton (0310-0720-10) / 5 Ml In 1 Syringe, Glass",417.84,167.14,,,0 HCPCS,J9395,"Fulvestrant: 2 Syringe, Glass In 1 Carton (0143-9022-02) / 5 Ml In 1 Syringe, Glass (0143-9022-01)",22.09,8.84,,,0 HCPCS,J9395,"Fulvestrant: 2 Syringe, Glass In 1 Carton (43598-262-02) / 5 Ml In 1 Syringe, Glass (43598-262-11)",23.54,9.42,,,0 HCPCS,J9395,"Fulvestrant: 2 Syringe, Glass In 1 Carton (43598-262-23) / 5 Ml In 1 Syringe, Glass (43598-262-11)",23.62,9.45,,,0 HCPCS,J9395,"Injection, Fulvestrant",,,6.9,6.9,4 HCPCS,J9395,NDC Description Not Available,19.285,7.715,,,0 HCPCS,J9400,"Inj, ziv-aflibercept, 1mg",,,8.3,24.26,9 HCPCS,J9600,Porfimer sodium injection,,,23323.0,29558.67,5 HCPCS,K0672,Removable soft interface le,,,104.76,261.9,4 HCPCS,K1007,Bil hkaf pc s/d micro sensor,,,95081.03,237702.58,4 HCPCS,K1034,Covid test self-admn/collect,,,0.01,0.01,4 HCPCS,L0112,Cranial cervical orthosis,,,1729.39,4323.48,4 HCPCS,L0113,Cranial cervical torticollis,,,352.38,880.95,4 HCPCS,L0120,Cerv flex n/adj foam pre ots,,,34.57,86.42,4 HCPCS,L0130,Flex thermoplastic collar mo,,,249.97,624.92,4 HCPCS,L0140,Cervical semi-rigid adjustab,,,86.25,215.62,4 HCPCS,L0150,Cerv semi-rig adj molded chn,,,143.84,359.6,4 HCPCS,L0160,Cerv sr wire occ/man pre ots,,,204.81,512.02,4 HCPCS,L0170,Cervical collar molded to pt,,,866.65,2166.62,4 HCPCS,L0172,Cerv col sr foam 2pc pre ots,,,175.72,439.3,4 HCPCS,L0174,Cerv sr 2pc thor ext pre ots,,,315.67,789.18,4 HCPCS,L0174,Hc Sup Shell 274 Revenue Code L0174 Hcpcs,570.94,228.38,,,0 HCPCS,L0180,Cer post col occ/man sup adj,,,429.3,1073.25,4 HCPCS,L0190,Cerv collar supp adj cerv ba,,,646.26,1615.65,4 HCPCS,L0200,Cerv col supp adj bar & thor,,,593.42,1483.55,4 HCPCS,L0220,Thor rib belt custom fabrica,,,140.73,351.82,4 HCPCS,L0450,Tlso flex trunk/thor pre ots,,,145.1,362.75,4 HCPCS,L0454,Tlso trnk sj-t9 pre cst,,,428.54,1071.35,4 HCPCS,L0455,Tlso flex trnk sj-t9 pre ots,,,269.37,673.42,4 HCPCS,L0456,Tlso flex trnk sj-ss pre cst,,,1228.92,3072.3,4 HCPCS,L0457,Tlso flex trnk sj-ss pre ots,,,772.46,1931.15,4 HCPCS,L0458,TLSO 2Mod symphis-xipho pre,,,1101.98,2754.95,4 HCPCS,L0460,Tlso 2 shl symphys-stern cst,,,1240.37,3100.92,4 HCPCS,L0462,TLSO 3Mod sacro-scap pre,,,1542.8,3857.0,4 HCPCS,L0464,TLSO 4Mod sacro-scap pre,,,1836.64,4591.6,4 HCPCS,L0466,Tlso r fram soft ant pre cst,,,472.27,1180.68,4 HCPCS,L0467,Tlso r fram soft pre ots,,,302.1,755.25,4 HCPCS,L0468,Tlso rig fram pelvic pre cst,,,592.16,1480.4,4 HCPCS,L0469,Tlso rig fram pelvic pre ots,,,384.93,962.32,4 HCPCS,L0470,TLSO rigid frame pre subclav,,,843.0,2107.5,4 HCPCS,L0472,TLSO rigid frame hyperex pre,,,529.16,1322.9,4 HCPCS,L0480,TLSO rigid plastic custom fa,,,1636.27,4090.68,4 HCPCS,L0482,TLSO rigid lined custom fab,,,1875.79,4689.48,4 HCPCS,L0484,TLSO rigid plastic cust fab,,,2187.12,5467.8,4 HCPCS,L0486,TLSO rigidlined cust fab two,,,2166.6,5416.5,4 HCPCS,L0488,TLSO rigid lined pre one pie,,,1240.37,3100.92,4 HCPCS,L0490,TLSO rigid plastic pre one,,,349.51,873.78,4 HCPCS,L0491,TLSO 2 piece rigid shell,,,948.92,2372.3,4 HCPCS,L0492,TLSO 3 piece rigid shell,,,614.99,1537.48,4 HCPCS,L0621,Sio flex pelvic/sacr pre ots,,,76.5,191.25,4 HCPCS,L0622,Sio flex pelvisacral custom,,,298.76,746.9,4 HCPCS,L0623,Sio rig pnl pelv/sac pre ots,,,137.13,342.82,4 HCPCS,L0625,Lo flex l1-below l5 pre ots,,,42.8,107.0,4 HCPCS,L0626,Lo sag rig pnl stays pre cst,,,96.32,240.8,4 HCPCS,L0627,Lo sag ri an/pos pnl pre cst,,,507.93,1269.82,4 HCPCS,L0628,Lso flex no ri stays pre ots,,,65.17,162.92,4 HCPCS,L0630,Lso r post pnl sj-t9 pre cst,,,200.07,500.18,4 HCPCS,L0631,Lso sag r an/pos pnl pre cst,,,1268.47,3171.18,4 HCPCS,L0633,Lso sc r pos/lat pnl pre cst,,,354.33,885.82,4 HCPCS,L0635,Lso sagit rigid panel prefab,,,1313.9,3284.75,4 HCPCS,L0636,Lso sagittal rigid panel cus,,,1938.77,4846.92,4 HCPCS,L0637,Lso sc r ant/pos pnl pre cst,,,1682.1,4205.25,4 HCPCS,L0638,Lso sag-coronal panel custom,,,1629.67,4074.18,4 HCPCS,L0639,Lso s/c shell/panel prefab,,,1682.1,4205.25,4 HCPCS,L0640,Lso s/c shell/panel custom,,,1292.96,3232.4,4 HCPCS,L0641,Lo rig pos pnl l1-l5 pre ots,,,60.55,151.38,4 HCPCS,L0642,Lo sag ri an/pos pnl pre ots,,,319.33,798.32,4 HCPCS,L0643,Lso sag ctr rigi pos pre ots,,,125.81,314.52,4 HCPCS,L0648,Lso sag r an/pos pnl pre ots,,,797.49,1993.72,4 HCPCS,L0649,Lso sc r pos/lat pnl pre ots,,,222.77,556.92,4 HCPCS,L0650,Lso sc r ant/pos pnl pre ots,,,922.75,2306.88,4 HCPCS,L0651,LSO sag-co shell pnl pre ots,,,922.75,2306.88,4 HCPCS,L0700,Ctlso a-p-l control molded,,,2660.31,6650.78,4 HCPCS,L0710,Ctlso a-p-l control w/ inter,,,2903.9,7259.75,4 HCPCS,L0720,Ctlso a-p-l control custom,,,2265.94,5664.85,4 HCPCS,L0810,Halo cervical into jckt vest,,,3084.99,7712.48,4 HCPCS,L0820,Halo cervical into body jack,,,2495.61,6239.02,4 HCPCS,L0830,Halo cerv into milwaukee typ,,,3603.4,9008.5,4 HCPCS,L0859,MRI compatible system,,,1399.89,3499.72,4 HCPCS,L0861,Halo repl liner/interface,,,266.32,665.8,4 HCPCS,L0970,Tlso corset front,,,131.34,328.35,4 HCPCS,L0972,Lso corset front,,,134.25,335.62,4 HCPCS,L0974,Tlso full corset,,,274.31,685.78,4 HCPCS,L0976,Lso full corset,,,244.99,612.48,4 HCPCS,L0978,Axillary crutch extension,,,221.2,553.0,4 HCPCS,L0980,Peroneal straps pair pre ots,,,20.07,50.18,4 HCPCS,L0982,Stocking sup grips 4 pre ots,,,21.87,54.68,4 HCPCS,L0984,Protect body sock ea pre ots,,,69.77,174.42,4 HCPCS,L1000,Ctlso milwauke initial model,,,2332.97,5832.42,4 HCPCS,L1005,Tension based scoliosis orth,,,3954.81,9887.02,4 HCPCS,L1010,Ctlso axilla sling,,,93.95,234.88,4 HCPCS,L1020,Kyphosis pad,,,128.37,320.92,4 HCPCS,L1025,Kyphosis pad floating,,,145.9,364.75,4 HCPCS,L1030,Lumbar bolster pad,,,97.47,243.68,4 HCPCS,L1040,Lumbar or lumbar rib pad,,,117.32,293.3,4 HCPCS,L1050,Sternal pad,,,101.56,253.9,4 HCPCS,L1060,Thoracic pad,,,114.57,286.42,4 HCPCS,L1070,Trapezius sling,,,117.15,292.88,4 HCPCS,L1080,Outrigger,,,81.17,202.92,4 HCPCS,L1085,Outrigger bil w/ vert extens,,,225.49,563.72,4 HCPCS,L1090,Lumbar sling,,,105.33,263.32,4 HCPCS,L1100,Ring flange plastic/leather,,,185.94,464.85,4 HCPCS,L1110,Ring flange plas/leather mol,,,314.94,787.35,4 HCPCS,L1120,Covers for upright each,,,50.16,125.4,4 HCPCS,L1200,Furnsh initial orthosis only,,,1997.03,4992.58,4 HCPCS,L1210,Lateral thoracic extension,,,300.68,751.7,4 HCPCS,L1220,Anterior thoracic extension,,,254.58,636.45,4 HCPCS,L1230,Milwaukee type superstructur,,,653.22,1633.05,4 HCPCS,L1240,Lumbar derotation pad,,,112.41,281.02,4 HCPCS,L1250,Anterior asis pad,,,110.69,276.72,4 HCPCS,L1260,Anterior thoracic derotation,,,113.77,284.42,4 HCPCS,L1270,Abdominal pad,,,113.64,284.1,4 HCPCS,L1280,Rib gusset (elastic) each,,,101.29,253.22,4 HCPCS,L1290,Lateral trochanteric pad,,,114.83,287.08,4 HCPCS,L1300,Body jacket mold to patient,,,1919.53,4798.82,4 HCPCS,L1310,Post-operative body jacket,,,1975.19,4937.98,4 HCPCS,L1600,Ho flex frejka w/cov pre cst,,,148.08,370.2,4 HCPCS,L1610,Ho frejka cov only pre cst,,,50.45,126.12,4 HCPCS,L1620,Ho flex pavlik harns pre cst,,,166.13,415.32,4 HCPCS,L1630,Abduct control hip semi-flex,,,198.25,495.62,4 HCPCS,L1640,Pelv band/spread bar thigh c,,,530.24,1325.6,4 HCPCS,L1650,HO abduction hip adjustable,,,281.19,702.98,4 HCPCS,L1652,HO bi thighcuffs w sprdr bar,,,440.48,1101.2,4 HCPCS,L1660,HO abduction static plastic,,,196.66,491.65,4 HCPCS,L1680,Pelvic & hip control thigh c,,,1616.8,4042.0,4 HCPCS,L1681,Ho bilateral hip abduction,,,2289.0,5722.5,4 HCPCS,L1685,Hc Sup Shell 274 Revenue Code L1685 Hcpcs,4843.12,1937.25,,,0 HCPCS,L1685,Post-op hip abduct custom fa,,,1705.99,4264.98,4 HCPCS,L1686,HO post-op hip abduction,,,1144.5,2861.25,4 HCPCS,L1690,Combination bilateral HO,,,2389.39,5973.48,4 HCPCS,L1700,Leg perthes orth toronto typ,,,1987.82,4969.55,4 HCPCS,L1710,Legg perthes orth newington,,,2336.55,5841.38,4 HCPCS,L1720,Legg perthes orthosis trilat,,,1726.01,4315.02,4 HCPCS,L1730,Legg perthes orth scottish r,,,1302.22,3255.55,4 HCPCS,L1755,Legg perthes patten bottom t,,,1895.44,4738.6,4 HCPCS,L1810,Ko elastic with joints,,,149.59,373.98,4 HCPCS,L1812,Hc Sup Shell 274 Revenue Code Without Hcpcs,1098.56,439.42,,,0 HCPCS,L1812,Ko elastic w/joints pre ots,,,85.71,214.28,4 HCPCS,L1820,Ko elas w/ condyle pads & jo,,,148.99,372.48,4 HCPCS,L1830,Hc Imobilizer Knee,45.075,18.03,,,0 HCPCS,L1830,Hc Sup Shell 274 Revenue Code L1830 Hcpcs,48.735,19.494999999999997,,,0 HCPCS,L1830,Ko immob canvas long pre ots,,,77.23,193.08,4 HCPCS,L1831,Knee orth pos locking joint,,,363.64,909.1,4 HCPCS,L1832,Ko adj jnt pos r sup pre cst,,,931.51,2328.78,4 HCPCS,L1833,Ko adj jnt pos r sup pre ots,,,556.31,1390.78,4 HCPCS,L1834,Ko w/0 joint rigid molded to,,,1095.91,2739.78,4 HCPCS,L1836,Ko rigid w/o joints pre ots,,,109.2,273.0,4 HCPCS,L1840,Ko derot ant cruciate custom,,,1151.99,2879.98,4 HCPCS,L1843,Ko single upright pre cst,,,1108.66,2771.65,4 HCPCS,L1844,Ko w/adj jt rot cntrl molded,,,1921.07,4802.68,4 HCPCS,L1845,Ko double upright pre cst,,,1157.34,2893.35,4 HCPCS,L1846,Ko w adj flex/ext rotat mold,,,1468.46,3671.15,4 HCPCS,L1847,Ko dbl upright w/air pre cst,,,710.72,1776.8,4 HCPCS,L1848,Ko dbl upright w/air pre ots,,,710.72,1776.8,4 HCPCS,L1850,Ko swedish type pre ots,,,251.5,628.75,4 HCPCS,L1851,Ko single upright prefab ots,,,734.28,1835.7,4 HCPCS,L1852,Ko double upright prefab ots,,,700.49,1751.22,4 HCPCS,L1860,Ko supracondylar socket mold,,,1282.92,3207.3,4 HCPCS,L1900,Afo sprng wir drsflx calf bd,,,347.57,868.92,4 HCPCS,L1902,Afo ankle gauntlet pre ots,,,94.39,235.98,4 HCPCS,L1904,Afo molded ankle gauntlet,,,540.36,1350.9,4 HCPCS,L1906,Afo multilig ank sup pre ots,,,157.92,394.8,4 HCPCS,L1907,AFO supramalleolar custom,,,695.27,1738.18,4 HCPCS,L1910,Afo sing bar clasp attach sh,,,307.3,768.25,4 HCPCS,L1920,Afo sing upright w/ adjust s,,,401.73,1004.32,4 HCPCS,L1930,Afo plastic,,,271.84,679.6,4 HCPCS,L1932,Afo rig ant tib prefab TCF/=,,,1102.62,2756.55,4 HCPCS,L1933,Afo rig ant tib tcf/= ots,,,1102.62,2756.55,4 HCPCS,L1940,Afo molded to patient plasti,,,614.33,1535.82,4 HCPCS,L1945,Afo molded plas rig ant tib,,,1128.15,2820.38,4 HCPCS,L1950,Afo spiral molded to pt plas,,,855.92,2139.8,4 HCPCS,L1951,AFO spiral prefabricated,,,1037.71,2594.28,4 HCPCS,L1952,Afo spiral prefab ots,,,1037.71,2594.28,4 HCPCS,L1960,Afo pos solid ank plastic mo,,,636.95,1592.38,4 HCPCS,L1970,Afo plastic molded w/ankle j,,,942.1,2355.25,4 HCPCS,L1971,"AFO w/ankle joint, prefab",,,579.17,1447.92,4 HCPCS,L1980,Afo sing solid stirrup calf,,,421.73,1054.32,4 HCPCS,L1990,Afo doub solid stirrup calf,,,541.86,1354.65,4 HCPCS,L2000,Kafo sing fre stirr thi/calf,,,1165.54,2913.85,4 HCPCS,L2005,KAFO sng/dbl mechanical act,,,5063.24,12658.1,4 HCPCS,L2010,Kafo sng solid stirrup w/o j,,,1062.5,2656.25,4 HCPCS,L2020,Kafo dbl solid stirrup band/,,,1341.77,3354.42,4 HCPCS,L2030,Kafo dbl solid stirrup w/o j,,,1164.11,2910.28,4 HCPCS,L2034,Kafo pla sin up w/wo k/a cus,,,2537.13,6342.82,4 HCPCS,L2035,KAFO plastic pediatric size,,,214.06,535.15,4 HCPCS,L2036,Kafo plas doub free knee mol,,,2131.99,5329.98,4 HCPCS,L2037,Kafo plas sing free knee mol,,,1964.76,4911.9,4 HCPCS,L2038,Kafo w/o joint multi-axis an,,,1642.94,4107.35,4 HCPCS,L2040,Hkafo torsion bil rot straps,,,209.85,524.62,4 HCPCS,L2050,Hkafo torsion cable hip pelv,,,558.87,1397.18,4 HCPCS,L2060,Hkafo torsion ball bearing j,,,717.28,1793.2,4 HCPCS,L2070,Hkafo torsion unilat rot str,,,206.05,515.12,4 HCPCS,L2080,Hkafo unilat torsion cable,,,439.45,1098.62,4 HCPCS,L2090,Hkafo unilat torsion ball br,,,541.63,1354.08,4 HCPCS,L2106,Afo tib fx cast plaster mold,,,781.31,1953.28,4 HCPCS,L2108,Afo tib fx cast molded to pt,,,1227.78,3069.45,4 HCPCS,L2112,Afo tibial fracture soft,,,582.98,1457.45,4 HCPCS,L2114,Afo tib fx semi-rigid,,,666.99,1667.48,4 HCPCS,L2116,Afo tibial fracture rigid,,,878.76,2196.9,4 HCPCS,L2126,Kafo fem fx cast thermoplas,,,1563.58,3908.95,4 HCPCS,L2128,Kafo fem fx cast molded to p,,,1970.44,4926.1,4 HCPCS,L2132,Kafo femoral fx cast soft,,,926.98,2317.45,4 HCPCS,L2134,Kafo fem fx cast semi-rigid,,,1111.41,2778.52,4 HCPCS,L2136,Kafo femoral fx cast rigid,,,1358.95,3397.38,4 HCPCS,L2180,Plas shoe insert w ank joint,,,134.58,336.45,4 HCPCS,L2182,Drop lock knee,,,105.33,263.32,4 HCPCS,L2184,Limited motion knee joint,,,189.8,474.5,4 HCPCS,L2186,Adj motion knee jnt lerman t,,,210.31,525.78,4 HCPCS,L2188,Quadrilateral brim,,,458.87,1147.18,4 HCPCS,L2190,Waist belt,,,119.18,297.95,4 HCPCS,L2192,Pelvic band & belt thigh fla,,,409.73,1024.32,4 HCPCS,L2200,Limited ankle motion ea jnt,,,54.63,136.58,4 HCPCS,L2210,Dorsiflexion assist each joi,,,88.64,221.6,4 HCPCS,L2220,Dorsi & plantar flex ass/res,,,101.79,254.48,4 HCPCS,L2221,Ank mcrop plant & dorsi flex,,,1799.42,4498.55,4 HCPCS,L2230,Split flat caliper stirr & p,,,88.17,220.42,4 HCPCS,L2232,"Rocker bottom, contact AFO",,,119.38,298.45,4 HCPCS,L2240,Round caliper and plate atta,,,96.11,240.28,4 HCPCS,L2250,Foot plate molded stirrup at,,,408.31,1020.78,4 HCPCS,L2260,Reinforced solid stirrup,,,230.35,575.88,4 HCPCS,L2265,Long tongue stirrup,,,135.33,338.32,4 HCPCS,L2270,Varus/valgus strap padded/li,,,61.71,154.28,4 HCPCS,L2275,Plastic mod low ext pad/line,,,150.16,375.4,4 HCPCS,L2280,Molded inner boot,,,557.83,1394.58,4 HCPCS,L2300,Abduction bar jointed adjust,,,314.89,787.22,4 HCPCS,L2310,Abduction bar-straight,,,141.37,353.42,4 HCPCS,L2320,Non-molded lacer,,,236.44,591.1,4 HCPCS,L2330,Lacer molded to patient mode,,,451.21,1128.02,4 HCPCS,L2335,Anterior swing band,,,265.43,663.58,4 HCPCS,L2340,Pre-tibial shell molded to p,,,626.36,1565.9,4 HCPCS,L2350,Prosthetic type socket molde,,,1023.92,2559.8,4 HCPCS,L2360,Extended steel shank,,,59.45,148.62,4 HCPCS,L2370,Patten bottom,,,294.98,737.45,4 HCPCS,L2375,Torsion ank & half solid sti,,,129.84,324.6,4 HCPCS,L2380,Torsion straight knee joint,,,141.47,353.68,4 HCPCS,L2385,Straight knee joint heavy du,,,153.92,384.8,4 HCPCS,L2387,Add le poly knee custom kafo,,,208.88,522.2,4 HCPCS,L2390,Offset knee joint each,,,125.79,314.48,4 HCPCS,L2395,Offset knee joint heavy duty,,,192.05,480.12,4 HCPCS,L2397,Suspension sleeve lower ext,,,134.68,336.7,4 HCPCS,L2405,Knee joint drop lock ea jnt,,,107.74,269.35,4 HCPCS,L2415,Knee joint cam lock each joi,,,150.1,375.25,4 HCPCS,L2425,Knee disc/dial lock/adj flex,,,177.12,442.8,4 HCPCS,L2430,Knee jnt ratchet lock ea jnt,,,177.12,442.8,4 HCPCS,L2492,Knee lift loop drop lock rin,,,117.18,292.95,4 HCPCS,L2500,Thi/glut/ischia wgt bearing,,,362.52,906.3,4 HCPCS,L2510,Th/wght bear quad-lat brim m,,,970.6,2426.5,4 HCPCS,L2520,Th/wght bear quad-lat brim c,,,529.38,1323.45,4 HCPCS,L2525,Th/wght bear nar m-l brim mo,,,1816.17,4540.42,4 HCPCS,L2526,Th/wght bear nar m-l brim cu,,,978.93,2447.32,4 HCPCS,L2530,Thigh/wght bear lacer non-mo,,,269.99,674.98,4 HCPCS,L2540,Thigh/wght bear lacer molded,,,485.83,1214.58,4 HCPCS,L2550,Thigh/wght bear high roll cu,,,330.04,825.1,4 HCPCS,L2570,Hip clevis type 2 posit jnt,,,729.78,1824.45,4 HCPCS,L2580,Pelvic control pelvic sling,,,691.79,1729.48,4 HCPCS,L2600,Hip clevis/thrust bearing fr,,,236.01,590.02,4 HCPCS,L2610,Hip clevis/thrust bearing lo,,,279.07,697.68,4 HCPCS,L2620,Pelvic control hip heavy dut,,,307.25,768.12,4 HCPCS,L2622,Hip joint adjustable flexion,,,352.39,880.98,4 HCPCS,L2624,Hc Sup Shell 274 Revenue Code L2624 Hcpcs,2953.12,1181.25,,,0 HCPCS,L2624,Hip adj flex ext abduct cont,,,479.06,1197.65,4 HCPCS,L2627,Plastic mold recipro hip & c,,,1973.72,4934.3,4 HCPCS,L2628,Metal frame recipro hip & ca,,,2318.48,5796.2,4 HCPCS,L2630,Pelvic control band & belt u,,,284.55,711.38,4 HCPCS,L2640,Pelvic control band & belt b,,,386.17,965.42,4 HCPCS,L2650,Pelv & thor control gluteal,,,137.9,344.75,4 HCPCS,L2660,Thoracic control thoracic ba,,,214.17,535.42,4 HCPCS,L2670,Thorac cont paraspinal uprig,,,196.02,490.05,4 HCPCS,L2680,Thorac cont lat support upri,,,179.82,449.55,4 HCPCS,L2750,Plating chrome/nickel pr bar,,,96.05,240.12,4 HCPCS,L2755,Carbon graphite lamination,,,161.49,403.72,4 HCPCS,L2760,Extension per extension per,,,69.82,174.55,4 HCPCS,L2768,Ortho sidebar disconnect,,,161.0,402.5,4 HCPCS,L2780,Non-corrosive finish,,,82.59,206.48,4 HCPCS,L2785,Drop lock retainer each,,,48.56,121.4,4 HCPCS,L2795,Knee control full kneecap,,,97.65,244.12,4 HCPCS,L2800,Knee cap medial or lateral p,,,122.57,306.42,4 HCPCS,L2810,Knee control condylar pad,,,89.75,224.38,4 HCPCS,L2820,Soft interface below knee se,,,99.79,249.48,4 HCPCS,L2830,Soft interface above knee se,,,112.21,280.52,4 HCPCS,L2840,Tibial length sock fx or equ,,,62.64,156.6,4 HCPCS,L2850,Femoral lgth sock fx or equa,,,71.15,177.88,4 HCPCS,L3000,Ft insert ucb berkeley shell,,,388.16,970.4,4 HCPCS,L3001,Foot insert remov molded spe,,,163.43,408.58,4 HCPCS,L3002,Foot insert plastazote or eq,,,199.55,498.88,4 HCPCS,L3003,Foot insert silicone gel eac,,,215.29,538.22,4 HCPCS,L3010,Foot longitudinal arch suppo,,,215.29,538.22,4 HCPCS,L3020,Foot longitud/metatarsal sup,,,245.15,612.88,4 HCPCS,L3030,Foot arch support remov prem,,,94.31,235.78,4 HCPCS,L3031,Foot lamin/prepreg composite,,,151.32,378.3,4 HCPCS,L3040,Ft arch suprt premold longit,,,58.15,145.38,4 HCPCS,L3050,Foot arch supp premold metat,,,58.15,145.38,4 HCPCS,L3060,Foot arch supp longitud/meta,,,91.14,227.85,4 HCPCS,L3070,Arch suprt att to sho longit,,,39.28,98.2,4 HCPCS,L3080,Arch supp att to shoe metata,,,39.28,98.2,4 HCPCS,L3090,Arch supp att to shoe long/m,,,50.31,125.78,4 HCPCS,L3100,Hallus-valgus nt dyn pre ots,,,53.41,133.52,4 HCPCS,L3140,Abduction rotation bar shoe,,,110.03,275.08,4 HCPCS,L3150,Abduct rotation bar w/o shoe,,,100.58,251.45,4 HCPCS,L3170,Foot plas heel stabi pre ots,,,62.87,157.18,4 HCPCS,L3224,Woman's shoe oxford brace,,,67.57,168.92,4 HCPCS,L3225,Man's shoe oxford brace,,,77.73,194.32,4 HCPCS,L3300,Sho lift taper to metatarsal,,,64.41,161.02,4 HCPCS,L3310,Shoe lift elev heel/sole neo,,,100.58,251.45,4 HCPCS,L3330,Lifts elevation metal extens,,,699.28,1748.2,4 HCPCS,L3332,Shoe lifts tapered to one-ha,,,91.14,227.85,4 HCPCS,L3334,Shoe lifts elevation heel /i,,,47.13,117.82,4 HCPCS,L3340,Shoe wedge sach,,,105.33,263.32,4 HCPCS,L3350,Shoe heel wedge,,,28.26,70.65,4 HCPCS,L3360,Shoe sole wedge outside sole,,,44.0,110.0,4 HCPCS,L3370,Shoe sole wedge between sole,,,61.3,153.25,4 HCPCS,L3380,Shoe clubfoot wedge,,,61.3,153.25,4 HCPCS,L3390,Shoe outflare wedge,,,61.3,153.25,4 HCPCS,L3400,Shoe metatarsal bar wedge ro,,,50.31,125.78,4 HCPCS,L3410,Shoe metatarsal bar between,,,114.74,286.85,4 HCPCS,L3420,Full sole/heel wedge btween,,,67.55,168.88,4 HCPCS,L3430,Sho heel count plast reinfor,,,198.0,495.0,4 HCPCS,L3440,Heel leather reinforced,,,94.31,235.78,4 HCPCS,L3450,Shoe heel sach cushion type,,,130.4,326.0,4 HCPCS,L3455,Shoe heel new leather standa,,,50.31,125.78,4 HCPCS,L3460,Shoe heel new rubber standar,,,42.41,106.02,4 HCPCS,L3465,Shoe heel thomas with wedge,,,72.28,180.7,4 HCPCS,L3470,Shoe heel thomas extend to b,,,76.99,192.48,4 HCPCS,L3480,Shoe heel pad & depress for,,,76.99,192.48,4 HCPCS,L3500,Ortho shoe add leather insol,,,36.18,90.45,4 HCPCS,L3510,Orthopedic shoe add rub insl,,,36.18,90.45,4 HCPCS,L3520,O shoe add felt w leath insl,,,39.28,98.2,4 HCPCS,L3530,Ortho shoe add half sole,,,39.28,98.2,4 HCPCS,L3540,Ortho shoe add full sole,,,62.87,157.18,4 HCPCS,L3550,O shoe add standard toe tap,,,11.02,27.55,4 HCPCS,L3560,O shoe add horseshoe toe tap,,,28.26,70.65,4 HCPCS,L3570,O shoe add instep extension,,,105.33,263.32,4 HCPCS,L3580,O shoe add instep velcro clo,,,80.14,200.35,4 HCPCS,L3590,O shoe convert to sof counte,,,66.01,165.02,4 HCPCS,L3595,Ortho shoe add march bar,,,51.85,129.62,4 HCPCS,L3600,Trans shoe calip plate exist,,,94.31,235.78,4 HCPCS,L3610,Trans shoe caliper plate new,,,124.12,310.3,4 HCPCS,L3620,Trans shoe solid stirrup exi,,,94.31,235.78,4 HCPCS,L3630,Trans shoe solid stirrup new,,,124.12,310.3,4 HCPCS,L3640,Shoe dennis browne splint bo,,,53.41,133.52,4 HCPCS,L3650,So 8 abd restraint pre ots,,,67.31,168.28,4 HCPCS,L3660,So 8 ab rstr can/web pre ots,,,115.57,288.92,4 HCPCS,L3670,So acro/clav can web pre ots,,,161.08,402.7,4 HCPCS,L3671,SO cap design w/o jnts CF,,,1013.24,2533.1,4 HCPCS,L3674,SO airplane w/wo joint CF,,,1329.23,3323.08,4 HCPCS,L3675,So vest canvas/web pre ots,,,197.34,493.35,4 HCPCS,L3678,"Hc Hemi Shoulder Sling, Sap#259245",175.35,70.14,,,0 HCPCS,L3702,EO w/o joints CF,,,324.72,811.8,4 HCPCS,L3702,Hc Eo Static,361.2,144.48,,,0 HCPCS,L3710,Eo elas w/metal jnts pre ots,,,163.06,407.65,4 HCPCS,L3720,Forearm/arm cuffs free motio,,,813.4,2033.5,4 HCPCS,L3730,Forearm/arm cuffs ext/flex a,,,1070.75,2676.88,4 HCPCS,L3740,Cuffs adj lock w/ active con,,,1203.36,3008.4,4 HCPCS,L3740,Hc Sup Shell 274 Revenue Code L3740 Hcpcs,339.1,135.64,,,0 HCPCS,L3760,"EO withjoint, Prefabricated",,,562.35,1405.88,4 HCPCS,L3760,Hc Innovator X Post Op Elbow Brace Unilateral,478.64,191.46,,,0 HCPCS,L3760,Hc Mayo Clinic Elbow Brace Unilateral,1359.86,543.94,,,0 HCPCS,L3761,"Eo, adj lock joint prefab ot",,,562.35,1405.88,4 HCPCS,L3762,Eo rigid w/o joints pre ots,,,120.93,302.32,4 HCPCS,L3762,Hc Elbow Stabilizer,175.68,70.27000000000001,,,0 HCPCS,L3763,EWHO rigid w/o jnts CF,,,892.81,2232.02,4 HCPCS,L3763,Hc Ewho Static,1032.15,412.86,,,0 HCPCS,L3764,EWHO w/joint(s) CF,,,890.38,2225.95,4 HCPCS,L3764,Hc Ewho W/Joint(S) Cf,1029.0,411.6,,,0 HCPCS,L3765,EWHFO rigid w/o jnts CF,,,1441.9,3604.75,4 HCPCS,L3765,Hc Ewhfo Static,1666.35,666.54,,,0 HCPCS,L3766,EWHFO w/joint(s) CF,,,1526.89,3817.22,4 HCPCS,L3766,Hc Ewhfo Dynamic,1764.0,705.6,,,0 HCPCS,L3806,Hc Whfo Dynamic,590.1,236.04,,,0 HCPCS,L3806,WHFO w/joint(s) custom fab,,,510.8,1277.0,4 HCPCS,L3807,Hc Cool Comfort Thumb Cmc Splint,80.55,32.22,,,0 HCPCS,L3807,Hc Rolyan Fit Thumb Spica,113.33500000000001,45.33,,,0 HCPCS,L3807,Whfo w/o joints pre cst,,,281.19,702.98,4 HCPCS,L3808,"Hc Whfo, Rigid W/O Joints, Sap# 259509",231.68,92.67,,,0 HCPCS,L3808,"WHFO, rigid w/o joints",,,375.59,938.98,4 HCPCS,L3809,Whfo w/o joints pre ots,,,281.19,702.98,4 HCPCS,L3900,Hc Whfo Dynamic Flexor Hinge,2029.65,811.86,,,0 HCPCS,L3900,Hinge extension/flex wrist/f,,,1756.7,4391.75,4 HCPCS,L3901,Hinge ext/flex wrist finger,,,1969.72,4924.3,4 HCPCS,L3904,Whfo electric custom fitted,,,4009.81,10024.52,4 HCPCS,L3905,Hc Who Dynamic,1288.35,515.34,,,0 HCPCS,L3905,Who w/nontorsion jnt(s) cf,,,1115.21,2788.02,4 HCPCS,L3906,Hc Who W/O Joints Cf,548.1,219.24,,,0 HCPCS,L3906,Who w/o joints cf,,,474.38,1185.95,4 HCPCS,L3908,"Hc Comfort Cool Ulnar Booster, Sap#",107.85,43.14,,,0 HCPCS,L3908,Hc Rolyan D-Ring Wrist Black,61.38,24.55,,,0 HCPCS,L3908,Hc Sup Shell 274 Revenue Code L3908 Hcpcs,39.53,15.81,,,0 HCPCS,L3908,Hc Wrist Widget,148.29,59.32,,,0 HCPCS,L3908,"Hc Wristable Brace, Sap#",210.69,84.28,,,0 HCPCS,L3908,"Hc Wristband Bullseye, Sap#263361-263364",153.56,61.42,,,0 HCPCS,L3908,Who cock-up nonmolde pre ots,,,67.37,168.42,4 HCPCS,L3912,Hc Traction Glove Unilateral,49.769999999999996,19.905,,,0 HCPCS,L3912,Hfo flexion glove pre ots,,,108.07,270.18,4 HCPCS,L3913,HFO w/o joints CF,,,304.58,761.45,4 HCPCS,L3913,Hc Hfo W/O Joints Cf,351.75,140.7,,,0 HCPCS,L3915,Who nontorsion jnts pre cst,,,597.78,1494.45,4 HCPCS,L3916,Who nontorsion jnts pre ots,,,597.78,1494.45,4 HCPCS,L3917,Metacarp fx orthosis pre cst,,,118.79,296.98,4 HCPCS,L3918,Metacarp fx orthosis pre ots,,,118.79,296.98,4 HCPCS,L3919,HO w/o joints CF,,,304.58,761.45,4 HCPCS,L3919,Hc Ho Static,351.75,140.7,,,0 HCPCS,L3921,HFO w/joint(s) CF,,,361.18,902.95,4 HCPCS,L3921,Hc Hfo Dynamic,416.85,166.74,,,0 HCPCS,L3923,"Hc Push Metagrip Thumb Cmc Splint Unilateral, Sap# 245012",343.43,137.37,,,0 HCPCS,L3923,Hfo without joints pre cst,,,97.81,244.52,4 HCPCS,L3924,Hfo without joints pre ots,,,97.81,244.52,4 HCPCS,L3925,Fo pip dip jnt/sprng pre ots,,,59.39,148.48,4 HCPCS,L3925,Hc Dynamic Digit Extension Tube,88.36,35.345,,,0 HCPCS,L3925,Hc Joint Jack Finger Splint,94.97,37.99,,,0 HCPCS,L3925,Hc Rolyan Pip Ligament Repair,99.97,39.989999999999995,,,0 HCPCS,L3925,Hc Sofstretch Short Extension Black,224.135,89.65,,,0 HCPCS,L3925,"Hc Static Progressive Pip Extension, Sap# 245018",150.21,60.08,,,0 HCPCS,L3927,Fo pip dip no jt spr pre ots,,,39.34,98.35,4 HCPCS,L3927,Hc 3Pp Buddy Loop Black 1/2In,7.17,2.87,,,0 HCPCS,L3927,"Hc 3Pp Final Flexion Wrap, Per Wrap",183.27,73.30999999999999,,,0 HCPCS,L3927,"Hc Imak Finger Sleeve, Sap# 245009",39.3,15.72,,,0 HCPCS,L3927,Hc Oval 8 Splints,23.415,9.365,,,0 HCPCS,L3927,"Hc Trigger Finger Solution, Sap# 156295",41.38,16.55,,,0 HCPCS,L3929,Hc Knuckle Bender Splint,72.85,29.14,,,0 HCPCS,L3929,Hfo nontorsion jnts pre cst,,,94.67,236.68,4 HCPCS,L3930,Hfo nontorsion jnts pre ots,,,94.67,236.68,4 HCPCS,L3931,Hc Splint Wrist,18.73,7.49,,,0 HCPCS,L3931,Hc Splint Wrist 6In F Lg Hk & Loop Close Left Sap#688,22.2,8.88,,,0 HCPCS,L3931,Hc Splint Wrist 6In F Med Hk & Loop Close Left Sap#689,22.48,8.99,,,0 HCPCS,L3931,"Hc Splint Wrist 6In F Rt Lg Hk & Loop Closure, Sap#690",54.6,21.84,,,0 HCPCS,L3931,Hc Splint Wrist 6In F Rt Xl Hk & Loop Closure Sap#693,22.05,8.82,,,0 HCPCS,L3931,Hc Splint Wrist 6In F Sm Hk & Loop Close Left Sap#694,22.2,8.88,,,0 HCPCS,L3931,Hc Splint Wrist 6In F Sm Hk & Loop Close Right Sap#692,22.48,8.99,,,0 HCPCS,L3931,Hc Splint Wrist 6In Xl Hk & Loop Close Left Sap#695,22.2,8.88,,,0 HCPCS,L3931,Hc Splint Wrist 6In-6.5In F Med Right Sap#691,22.48,8.99,,,0 HCPCS,L3931,WHFO nontorsion joint prefab,,,229.01,572.52,4 HCPCS,L3933,FO w/o joints CF,,,239.92,599.8,4 HCPCS,L3933,Hc Fo Static,277.2,110.88,,,0 HCPCS,L3935,FO nontorsion joint CF,,,248.47,621.18,4 HCPCS,L3935,Hc Fo Dynamaic,286.65,114.66,,,0 HCPCS,L3960,Sewho airplan desig abdu pos,,,926.91,2317.28,4 HCPCS,L3961,Sewho cap design w/o jnts cf,,,1889.33,4723.32,4 HCPCS,L3962,Sewho erbs palsey design abd,,,965.12,2412.8,4 HCPCS,L3967,Sewho airplane w/o jnts cf,,,2230.66,5576.65,4 HCPCS,L3971,Sewho cap design w/jnt(s) cf,,,2117.37,5293.42,4 HCPCS,L3973,Sewho airplane w/jnt(s) cf,,,2230.66,5576.65,4 HCPCS,L3975,Sewhfo cap design w/o jnt cf,,,1889.33,4723.32,4 HCPCS,L3976,Sewhfo airplane w/o jnts cf,,,1889.33,4723.32,4 HCPCS,L3977,Sewhfo cap desgn w/jnt(s) cf,,,2117.37,5293.42,4 HCPCS,L3978,Sewhfo airplane w/jnt(s) cf,,,2230.66,5576.65,4 HCPCS,L3980,Hc Rolyan Aqua Humerus Fx,100.8,40.32,,,0 HCPCS,L3980,Hc Sup Shell 274 Revenue Code L3980 Hcpcs,236.45,94.58,,,0 HCPCS,L3980,Up ext fx orthos humeral nos,,,347.63,869.08,4 HCPCS,L3981,Ue fx orth shoul cap forearm,,,1131.9,2829.75,4 HCPCS,L3982,Upper ext fx orthosis rad/ul,,,429.48,1073.7,4 HCPCS,L3984,Upper ext fx orthosis wrist,,,458.44,1146.1,4 HCPCS,L3995,Sock fracture or equal each,,,38.45,96.12,4 HCPCS,L3999,"Hc Rolyan Gel/Air Universal Elbow Support Brace, Sap#259620",43.9,17.56,,,0 HCPCS,L4000,Repl girdle milwaukee orth,,,1499.07,3747.68,4 HCPCS,L4010,Replace trilateral socket br,,,843.58,2108.95,4 HCPCS,L4020,Replace quadlat socket brim,,,1053.71,2634.28,4 HCPCS,L4030,Replace socket brim cust fit,,,580.17,1450.42,4 HCPCS,L4040,Replace molded thigh lacer,,,469.07,1172.68,4 HCPCS,L4045,Replace non-molded thigh lac,,,376.94,942.35,4 HCPCS,L4050,Replace molded calf lacer,,,474.4,1186.0,4 HCPCS,L4055,Replace non-molded calf lace,,,307.2,768.0,4 HCPCS,L4060,Replace high roll cuff,,,365.19,912.98,4 HCPCS,L4070,Replace prox & dist upright,,,348.4,871.0,4 HCPCS,L4080,Repl met band kafo-afo prox,,,122.83,307.08,4 HCPCS,L4090,Repl met band kafo-afo calf/,,,108.72,271.8,4 HCPCS,L4100,Repl leath cuff kafo prox th,,,122.63,306.58,4 HCPCS,L4110,Repl leath cuff kafo-afo cal,,,97.45,243.62,4 HCPCS,L4130,Replace pretibial shell,,,670.68,1676.7,4 HCPCS,L4205,Ortho dvc repair per 15 min,,,38.36,95.9,4 HCPCS,L4350,Ankle control ortho pre ots,,,120.83,302.08,4 HCPCS,L4350,Hc Brace Ankle Stirrup Universal Sap #140321,43.93,17.57,,,0 HCPCS,L4360,"Hc Ankle Walker, Sap# 215476",598.11,239.24,,,0 HCPCS,L4360,Hc Moonboot Sap #139008,128.95,51.58,,,0 HCPCS,L4360,Hc Sup Shell 274 Revenue Code L4360 Hcpcs,128.95,51.58,,,0 HCPCS,L4360,Pneumat walking boot pre cst,,,338.06,845.15,4 HCPCS,L4361,Pneuma/vac walk boot pre ots,,,338.06,845.15,4 HCPCS,L4370,Hc Sup Shell 274 Revenue Code L4370 Hcpcs,15.05,6.02,,,0 HCPCS,L4370,Pneum full leg splnt pre ots,,,216.94,542.35,4 HCPCS,L4386,Non-pneum walk boot pre cst,,,195.89,489.72,4 HCPCS,L4387,Non-pneum walk boot pre ots,,,195.89,489.72,4 HCPCS,L4392,Replace AFO soft interface,,,29.1,72.75,4 HCPCS,L4394,Replace foot drop spint,,,21.24,53.1,4 HCPCS,L4396,Static or dynami afo pre cst,,,207.41,518.52,4 HCPCS,L4397,Static or dynami afo pre ots,,,207.41,518.52,4 HCPCS,L4398,Foot drop splint pre ots,,,95.45,238.62,4 HCPCS,L4631,"Afo, walk boot type, cus fab",,,1843.94,4609.85,4 HCPCS,L5000,Sho insert w arch toe filler,,,647.9,1619.75,4 HCPCS,L5010,Mold socket ank hgt w/ toe f,,,1564.83,3912.08,4 HCPCS,L5020,Tibial tubercle hgt w/ toe f,,,2657.4,6643.5,4 HCPCS,L5050,Ank symes mold sckt sach ft,,,2939.57,7348.92,4 HCPCS,L5060,Symes met fr leath socket ar,,,3381.38,8453.45,4 HCPCS,L5100,Molded socket shin sach foot,,,2946.06,7365.15,4 HCPCS,L5105,Plast socket jts/thgh lacer,,,4252.97,10632.42,4 HCPCS,L5150,Mold sckt ext knee shin sach,,,4299.18,10747.95,4 HCPCS,L5160,Mold socket bent knee shin s,,,4676.12,11690.3,4 HCPCS,L5200,Kne sing axis fric shin sach,,,4478.06,11195.15,4 HCPCS,L5210,No knee/ankle joints w/ ft b,,,2970.73,7426.82,4 HCPCS,L5220,No knee joint with artic ali,,,3376.78,8441.95,4 HCPCS,L5230,Fem focal defic constant fri,,,4657.24,11643.1,4 HCPCS,L5250,Hip canad sing axi cons fric,,,6352.07,15880.18,4 HCPCS,L5270,Tilt table locking hip sing,,,6323.89,15809.72,4 HCPCS,L5280,Hemipelvect canad sing axis,,,6275.46,15688.65,4 HCPCS,L5301,Bk mold socket sach ft endo,,,3367.55,8418.88,4 HCPCS,L5312,"Knee disart, SACH ft, endo",,,4820.42,12051.05,4 HCPCS,L5321,Ak open end sach,,,4881.34,12203.35,4 HCPCS,L5331,Hip disart canadian sach ft,,,6219.83,15549.58,4 HCPCS,L5341,Hemipelvectomy canadian sach,,,6474.88,16187.2,4 HCPCS,L5400,Postop dress & 1 cast chg bk,,,1667.22,4168.05,4 HCPCS,L5410,Postop dsg bk ea add cast ch,,,511.51,1278.78,4 HCPCS,L5420,Postop dsg & 1 cast chg ak/d,,,2043.12,5107.8,4 HCPCS,L5430,Postop dsg ak ea add cast ch,,,616.07,1540.18,4 HCPCS,L5450,Postop app non-wgt bear dsg,,,501.19,1252.98,4 HCPCS,L5460,Postop app non-wgt bear dsg,,,667.75,1669.38,4 HCPCS,L5500,Init bk ptb plaster direct,,,1572.33,3930.82,4 HCPCS,L5505,Init ak ischal plstr direct,,,2174.6,5436.5,4 HCPCS,L5510,Prep BK ptb plaster molded,,,1782.34,4455.85,4 HCPCS,L5520,Perp BK ptb thermopls direct,,,1760.53,4401.32,4 HCPCS,L5530,Prep BK ptb thermopls molded,,,2114.56,5286.4,4 HCPCS,L5535,Prep BK ptb open end socket,,,2076.09,5190.22,4 HCPCS,L5540,Prep BK ptb laminated socket,,,2215.83,5539.58,4 HCPCS,L5560,Prep AK ischial plast molded,,,2379.43,5948.58,4 HCPCS,L5570,Prep AK ischial direct form,,,2473.76,6184.4,4 HCPCS,L5580,Prep AK ischial thermo mold,,,2887.94,7219.85,4 HCPCS,L5585,Prep AK ischial open end,,,3554.08,8885.2,4 HCPCS,L5590,Prep AK ischial laminated,,,2943.01,7357.52,4 HCPCS,L5595,Hip disartic sach thermopls,,,5199.23,12998.08,4 HCPCS,L5600,Hip disart sach laminat mold,,,5588.93,13972.32,4 HCPCS,L5610,Above knee hydracadence,,,2534.66,6336.65,4 HCPCS,L5611,Ak 4 bar link w/fric swing,,,1972.47,4931.18,4 HCPCS,L5613,Ak 4 bar ling w/hydraul swig,,,3083.91,7709.78,4 HCPCS,L5614,4-bar link above knee w/swng,,,2089.13,5222.82,4 HCPCS,L5615,Ak 4 bar link hydl swg/stanc,,,6841.95,17104.88,4 HCPCS,L5616,Ak univ multiplex sys frict,,,1666.52,4166.3,4 HCPCS,L5617,AK/BK self-aligning unit ea,,,692.69,1731.72,4 HCPCS,L5618,Test socket symes,,,366.46,916.15,4 HCPCS,L5620,Test socket below knee,,,340.36,850.9,4 HCPCS,L5622,Test socket knee disarticula,,,443.82,1109.55,4 HCPCS,L5624,Test socket above knee,,,445.08,1112.7,4 HCPCS,L5626,Test socket hip disarticulat,,,583.7,1459.25,4 HCPCS,L5628,Test socket hemipelvectomy,,,624.13,1560.32,4 HCPCS,L5629,Below knee acrylic socket,,,389.06,972.65,4 HCPCS,L5630,Syme typ expandabl wall sckt,,,549.44,1373.6,4 HCPCS,L5631,Ak/knee disartic acrylic soc,,,537.91,1344.78,4 HCPCS,L5632,Symes type ptb brim design s,,,300.21,750.52,4 HCPCS,L5634,Symes type poster opening so,,,372.4,931.0,4 HCPCS,L5636,Symes type medial opening so,,,311.94,779.85,4 HCPCS,L5637,Below knee total contact,,,353.67,884.18,4 HCPCS,L5638,Below knee leather socket,,,616.08,1540.2,4 HCPCS,L5639,Below knee wood socket,,,1372.6,3431.5,4 HCPCS,L5640,Knee disarticulat leather so,,,782.83,1957.08,4 HCPCS,L5642,Above knee leather socket,,,758.5,1896.25,4 HCPCS,L5643,Hip flex inner socket ext fr,,,1905.46,4763.65,4 HCPCS,L5644,Above knee wood socket,,,723.09,1807.72,4 HCPCS,L5645,Bk flex inner socket ext fra,,,976.81,2442.02,4 HCPCS,L5646,Below knee cushion socket,,,670.77,1676.92,4 HCPCS,L5647,Below knee suction socket,,,973.84,2434.6,4 HCPCS,L5648,Above knee cushion socket,,,806.01,2015.02,4 HCPCS,L5649,Isch containmt/narrow m-l so,,,2920.65,7301.62,4 HCPCS,L5650,Tot contact ak/knee disart s,,,597.66,1494.15,4 HCPCS,L5651,Ak flex inner socket ext fra,,,1470.22,3675.55,4 HCPCS,L5652,Suction susp ak/knee disart,,,533.75,1334.38,4 HCPCS,L5653,Knee disart expand wall sock,,,712.51,1781.28,4 HCPCS,L5654,Socket insert symes,,,406.02,1015.05,4 HCPCS,L5655,Socket insert below knee,,,344.08,860.2,4 HCPCS,L5656,Socket insert knee articulat,,,461.57,1153.92,4 HCPCS,L5657,Add low ext man aut vol any,,,306.32,765.8,4 HCPCS,L5658,Socket insert above knee,,,445.13,1112.82,4 HCPCS,L5661,Multi-durometer symes,,,745.01,1862.52,4 HCPCS,L5665,Multi-durometer below knee,,,626.84,1567.1,4 HCPCS,L5666,Below knee cuff suspension,,,85.69,214.22,4 HCPCS,L5668,Bk molded distal cushion,,,138.23,345.58,4 HCPCS,L5670,Bk molded supracondylar susp,,,332.2,830.5,4 HCPCS,L5671,Bk/ak locking mechanism,,,703.98,1759.95,4 HCPCS,L5672,Bk removable medial brim sus,,,365.06,912.65,4 HCPCS,L5673,Socket insert w lock mech,,,870.51,2176.28,4 HCPCS,L5676,Bk knee joints single axis p,,,443.63,1109.08,4 HCPCS,L5677,Bk knee joints polycentric p,,,603.62,1509.05,4 HCPCS,L5678,Bk joint covers pair,,,48.61,121.52,4 HCPCS,L5679,Socket insert w/o lock mech,,,725.39,1813.48,4 HCPCS,L5680,Bk thigh lacer non-molded,,,405.77,1014.42,4 HCPCS,L5681,Intl custm cong/latyp insert,,,1628.51,4071.28,4 HCPCS,L5682,Bk thigh lacer glut/ischia m,,,765.63,1914.08,4 HCPCS,L5683,Initial custom socket insert,,,1628.51,4071.28,4 HCPCS,L5684,Bk fork strap,,,58.93,147.32,4 HCPCS,L5685,Below knee sus/seal sleeve,,,158.57,396.42,4 HCPCS,L5686,Bk back check,,,62.55,156.38,4 HCPCS,L5688,Bk waist belt webbing,,,74.78,186.95,4 HCPCS,L5690,Bk waist belt padded and lin,,,119.8,299.5,4 HCPCS,L5692,Ak pelvic control belt light,,,162.67,406.68,4 HCPCS,L5694,Ak pelvic control belt pad/l,,,222.1,555.25,4 HCPCS,L5695,Ak sleeve susp neoprene/equa,,,205.01,512.52,4 HCPCS,L5696,Ak/knee disartic pelvic join,,,226.51,566.28,4 HCPCS,L5697,Ak/knee disartic pelvic band,,,98.28,245.7,4 HCPCS,L5698,Ak/knee disartic silesian ba,,,160.7,401.75,4 HCPCS,L5699,Shoulder harness,,,289.51,723.78,4 HCPCS,L5700,Replace socket below knee,,,3507.7,8769.25,4 HCPCS,L5701,Replace socket above knee,,,4212.49,10531.22,4 HCPCS,L5702,Replace socket hip,,,5329.4,13323.5,4 HCPCS,L5703,Symes ankle w/o (sach) foot,,,2758.03,6895.08,4 HCPCS,L5704,Custom shape cover bk,,,656.22,1640.55,4 HCPCS,L5705,Custom shape cover ak,,,1172.55,2931.38,4 HCPCS,L5706,Custom shape cvr knee disart,,,1149.39,2873.48,4 HCPCS,L5707,Custom shape cvr hip disart,,,1515.28,3788.2,4 HCPCS,L5710,Kne-shin exo sng axi mnl loc,,,457.86,1144.65,4 HCPCS,L5711,Knee-shin exo mnl lock ultra,,,639.88,1599.7,4 HCPCS,L5712,Knee-shin exo frict swg & st,,,536.15,1340.38,4 HCPCS,L5714,Knee-shin exo variable frict,,,550.71,1376.78,4 HCPCS,L5716,Knee-shin exo mech stance ph,,,892.28,2230.7,4 HCPCS,L5718,Knee-shin exo frct swg & sta,,,1115.26,2788.15,4 HCPCS,L5722,Knee-shin pneum swg frct exo,,,1178.22,2945.55,4 HCPCS,L5724,Knee-shin exo fluid swing ph,,,1847.9,4619.75,4 HCPCS,L5726,Knee-shin ext jnts fld swg e,,,2129.66,5324.15,4 HCPCS,L5728,Knee-shin fluid swg & stance,,,2913.09,7282.72,4 HCPCS,L5780,Knee-shin pneum/hydra pneum,,,1401.65,3504.12,4 HCPCS,L5781,Lower limb pros vacuum pump,,,4953.58,12383.95,4 HCPCS,L5782,HD low limb pros vacuum pump,,,5222.21,13055.52,4 HCPCS,L5783,Add low ext mec limb vol sys,,,3150.07,7875.18,4 HCPCS,L5785,Exoskeletal bk ultralt mater,,,787.9,1969.75,4 HCPCS,L5790,Exoskeletal ak ultra-light m,,,880.26,2200.65,4 HCPCS,L5795,Exoskel hip ultra-light mate,,,1752.61,4381.52,4 HCPCS,L5810,Endoskel knee-shin mnl lock,,,596.04,1490.1,4 HCPCS,L5811,Endo knee-shin mnl lck ultra,,,892.86,2232.15,4 HCPCS,L5812,Endo knee-shin frct swg & st,,,692.06,1730.15,4 HCPCS,L5814,Endo knee-shin hydral swg ph,,,4597.89,11494.72,4 HCPCS,L5816,Endo knee-shin polyc mch sta,,,1047.44,2618.6,4 HCPCS,L5818,Endo knee-shin frct swg & st,,,1175.67,2939.18,4 HCPCS,L5822,Endo knee-shin pneum swg frc,,,2084.77,5211.92,4 HCPCS,L5824,Endo knee-shin fluid swing p,,,1877.46,4693.65,4 HCPCS,L5826,Miniature knee joint,,,3866.22,9665.55,4 HCPCS,L5827,Endo knee shin single axis,,,7007.5,17518.75,4 HCPCS,L5828,Endo knee-shin fluid swg/sta,,,3457.19,8642.98,4 HCPCS,L5830,Endo knee-shin pneum/swg pha,,,2323.05,5807.62,4 HCPCS,L5840,Multi-axial knee/shin system,,,4295.32,10738.3,4 HCPCS,L5841,Addition endoskletl knee-shi,,,2870.47,7176.18,4 HCPCS,L5845,Knee-shin sys stance flexion,,,2219.05,5547.62,4 HCPCS,L5848,Knee-shin sys hydraul stance,,,1331.26,3328.15,4 HCPCS,L5850,Endo ak/hip knee extens assi,,,156.61,391.52,4 HCPCS,L5855,Mech hip extension assist,,,420.83,1052.08,4 HCPCS,L5856,Elec knee-shin swing/stance,,,29719.96,74299.9,4 HCPCS,L5857,Elec knee-shin swing only,,,10545.73,26364.32,4 HCPCS,L5858,Stance phase only,,,23009.05,57522.62,4 HCPCS,L5859,Knee-shin pro flex/ext cont,,,17962.99,44907.48,4 HCPCS,L5910,Endo below knee alignable sy,,,443.39,1108.48,4 HCPCS,L5920,Endo ak/hip alignable system,,,649.58,1623.95,4 HCPCS,L5925,Above knee manual lock,,,548.48,1371.2,4 HCPCS,L5926,Endoskel posit rotat unit,,,697.41,1743.52,4 HCPCS,L5930,High activity knee frame,,,4167.07,10417.68,4 HCPCS,L5940,Endo bk ultra-light material,,,614.1,1535.25,4 HCPCS,L5950,Endo ak ultra-light material,,,960.18,2400.45,4 HCPCS,L5960,Endo hip ultra-light materia,,,1180.22,2950.55,4 HCPCS,L5961,"Endo poly hip, pneu/hyd/rot",,,5627.8,14069.5,4 HCPCS,L5962,Below knee flex cover system,,,776.72,1941.8,4 HCPCS,L5964,Above knee flex cover system,,,1146.54,2866.35,4 HCPCS,L5966,Hip flexible cover system,,,1460.97,3652.42,4 HCPCS,L5968,Multiaxial ankle w dorsiflex,,,4498.91,11247.28,4 HCPCS,L5970,Foot external keel sach foot,,,248.63,621.58,4 HCPCS,L5971,"SACH foot, replacement",,,248.63,621.58,4 HCPCS,L5972,Flexible keel foot,,,464.44,1161.1,4 HCPCS,L5973,Ank-foot sys dors-plant flex,,,21299.94,53249.85,4 HCPCS,L5974,Foot single axis ankle/foot,,,285.29,713.22,4 HCPCS,L5975,Combo ankle/foot prosthesis,,,573.98,1434.95,4 HCPCS,L5976,Energy storing foot,,,685.61,1714.02,4 HCPCS,L5978,Ft prosth multiaxial ankl/ft,,,357.27,893.18,4 HCPCS,L5979,Multi-axial ankle/ft prosth,,,2793.44,6983.6,4 HCPCS,L5980,Flex foot system,,,4539.15,11347.88,4 HCPCS,L5981,Flex-walk sys low ext prosth,,,3667.02,9167.55,4 HCPCS,L5982,Exoskeletal axial rotation u,,,707.75,1769.38,4 HCPCS,L5984,Endoskeletal axial rotation,,,697.41,1743.52,4 HCPCS,L5985,Lwr ext dynamic prosth pylon,,,349.58,873.95,4 HCPCS,L5986,Multi-axial rotation unit,,,775.79,1939.48,4 HCPCS,L5987,Shank ft w vert load pylon,,,8906.07,22265.18,4 HCPCS,L5988,Vertical shock reducing pylo,,,2473.19,6182.98,4 HCPCS,L5990,User adjustable heel height,,,2246.04,5615.1,4 HCPCS,L5991,Low pros ext osseo connector,,,11755.04,29387.6,4 HCPCS,L5992,Low prosth foot shell repl,,,127.11,317.78,4 HCPCS,L6026,Part hand myo exclu term dev,,,6119.92,15299.8,4 HCPCS,L6028,Part handfng endoskel molded,,,1727.75,4319.38,4 HCPCS,L6029,Test interface part handfing,,,284.03,710.08,4 HCPCS,L6030,External frame part handfing,,,706.16,1765.4,4 HCPCS,L6031,Rep interface handfng molded,,,1602.89,4007.22,4 HCPCS,L6032,Part handfng ultralite tcf/=,,,379.46,948.65,4 HCPCS,L6033,Part handfing acrylic,,,455.94,1139.85,4 HCPCS,L6034,Part hand finger distal amp,,,343.12,857.8,4 HCPCS,L6035,Prosthetic digit mechanical,,,1482.21,3705.52,4 HCPCS,L6036,Prosthetic thumb mechanical,,,1482.21,3705.52,4 HCPCS,L6037,Postop dsg cast chg handfing,,,1495.35,3738.38,4 HCPCS,L6038,Multiax rotation attachment,,,339.5,848.75,4 HCPCS,L6039,Passive custom digit/thumb,,,2179.81,5449.52,4 HCPCS,L6050,Wrst MLd sck flx hng tri pad,,,2325.6,5814.0,4 HCPCS,L6055,Wrst mold sock w/exp interfa,,,3241.3,8103.25,4 HCPCS,L6100,Elb mold sock flex hinge pad,,,2356.19,5890.48,4 HCPCS,L6110,Elbow mold sock suspension t,,,2499.14,6247.85,4 HCPCS,L6120,Elbow mold doub splt soc ste,,,2912.39,7280.98,4 HCPCS,L6130,Elbow stump activated lock h,,,3169.22,7923.05,4 HCPCS,L6200,Elbow mold outsid lock hinge,,,3339.85,8349.62,4 HCPCS,L6205,Elbow molded w/ expand inter,,,4458.17,11145.42,4 HCPCS,L6250,Elbow inter loc elbow forarm,,,3499.39,8748.48,4 HCPCS,L6300,Shlder disart int lock elbow,,,4561.09,11402.72,4 HCPCS,L6310,Shoulder passive restor comp,,,3938.3,9845.75,4 HCPCS,L6320,Shoulder passive restor cap,,,2151.39,5378.48,4 HCPCS,L6350,Thoracic intern lock elbow,,,4795.29,11988.22,4 HCPCS,L6360,Thoracic passive restor comp,,,4312.59,10781.48,4 HCPCS,L6370,Thoracic passive restor cap,,,2580.53,6451.32,4 HCPCS,L6380,Postop dsg cast chg wrst/elb,,,1495.35,3738.38,4 HCPCS,L6382,Postop dsg cast chg elb dis/,,,2249.69,5624.22,4 HCPCS,L6384,Postop dsg cast chg shlder/t,,,3112.22,7780.55,4 HCPCS,L6386,Postop ea cast chg & realign,,,491.64,1229.1,4 HCPCS,L6388,Postop applicat rigid dsg on,,,538.21,1345.52,4 HCPCS,L6400,Below elbow prosth tiss shap,,,2840.74,7101.85,4 HCPCS,L6450,Elb disart prosth tiss shap,,,3795.18,9487.95,4 HCPCS,L6500,Above elbow prosth tiss shap,,,3970.5,9926.25,4 HCPCS,L6550,Shldr disar prosth tiss shap,,,4772.61,11931.52,4 HCPCS,L6570,Scap thorac prosth tiss shap,,,5358.37,13395.92,4 HCPCS,L6580,Wrist/elbow bowden cable mol,,,2045.72,5114.3,4 HCPCS,L6582,Wrist/elbow bowden cbl dir f,,,1852.87,4632.18,4 HCPCS,L6584,Elbow fair lead cable molded,,,2905.79,7264.48,4 HCPCS,L6586,Elbow fair lead cable dir fo,,,2719.34,6798.35,4 HCPCS,L6588,Shdr fair lead cable molded,,,3573.15,8932.88,4 HCPCS,L6590,Shdr fair lead cable direct,,,3393.93,8484.82,4 HCPCS,L6600,Polycentric hinge pair,,,229.64,574.1,4 HCPCS,L6605,Single pivot hinge pair,,,226.75,566.88,4 HCPCS,L6610,Flexible metal hinge pair,,,217.74,544.35,4 HCPCS,L6611,"Additional switch, ext power",,,509.7,1274.25,4 HCPCS,L6615,Disconnect locking wrist uni,,,234.61,586.52,4 HCPCS,L6616,Disconnect insert locking wr,,,86.93,217.32,4 HCPCS,L6620,Flexion/extension wrist unit,,,375.39,938.48,4 HCPCS,L6621,Flex/ext wrist w/wo friction,,,2831.71,7079.28,4 HCPCS,L6623,Spring-ass rot wrst w/ latch,,,1047.08,2617.7,4 HCPCS,L6624,Flex/ext/rotation wrist unit,,,4662.49,11656.22,4 HCPCS,L6625,Rotation wrst w/ cable lock,,,743.95,1859.88,4 HCPCS,L6628,Quick disconn hook adapter o,,,586.48,1466.2,4 HCPCS,L6629,Lamination collar w/ couplin,,,179.11,447.78,4 HCPCS,L6630,Stainless steel any wrist,,,263.85,659.62,4 HCPCS,L6632,Latex suspension sleeve each,,,91.64,229.1,4 HCPCS,L6635,Lift assist for elbow,,,215.63,539.08,4 HCPCS,L6637,Nudge control elbow lock,,,459.92,1149.8,4 HCPCS,L6638,Elec lock on manual pw elbow,,,3095.98,7739.95,4 HCPCS,L6640,Shoulder abduction joint pai,,,408.59,1021.48,4 HCPCS,L6641,Excursion amplifier pulley t,,,196.4,491.0,4 HCPCS,L6642,Excursion amplifier lever ty,,,266.21,665.52,4 HCPCS,L6645,Shoulder flexion-abduction j,,,491.37,1228.42,4 HCPCS,L6646,Multipo locking shoulder jnt,,,3904.74,9761.85,4 HCPCS,L6647,Shoulder lock actuator,,,642.83,1607.08,4 HCPCS,L6648,Ext pwrd shlder lock/unlock,,,4027.16,10067.9,4 HCPCS,L6650,Shoulder universal joint,,,510.16,1275.4,4 HCPCS,L6655,Standard control cable extra,,,100.26,250.65,4 HCPCS,L6660,Heavy duty control cable,,,112.37,280.92,4 HCPCS,L6665,Teflon or equal cable lining,,,56.38,140.95,4 HCPCS,L6670,Hook to hand cable adapter,,,62.34,155.85,4 HCPCS,L6672,Harness chest/shlder saddle,,,247.39,618.48,4 HCPCS,L6675,Harness figure of 8 sing con,,,147.02,367.55,4 HCPCS,L6676,Harness figure of 8 dual con,,,169.95,424.88,4 HCPCS,L6677,UE triple control harness,,,367.3,918.25,4 HCPCS,L6680,Test sock wrist disart/bel e,,,284.03,710.08,4 HCPCS,L6682,Test sock elbw disart/above,,,314.04,785.1,4 HCPCS,L6684,Test socket shldr disart/tho,,,426.74,1066.85,4 HCPCS,L6686,Suction socket,,,963.67,2409.18,4 HCPCS,L6687,Frame typ socket bel elbow/w,,,706.16,1765.4,4 HCPCS,L6688,Frame typ sock above elb/dis,,,701.89,1754.72,4 HCPCS,L6689,Frame typ socket shoulder di,,,840.96,2102.4,4 HCPCS,L6690,Frame typ sock interscap-tho,,,916.41,2291.02,4 HCPCS,L6691,Removable insert each,,,424.15,1060.38,4 HCPCS,L6692,Silicone gel insert or equal,,,684.63,1711.58,4 HCPCS,L6693,Lockingelbow forearm cntrbal,,,3514.73,8786.82,4 HCPCS,L6694,Elbow socket ins use w/lock,,,870.51,2176.28,4 HCPCS,L6695,Elbow socket ins use w/o lck,,,725.39,1813.48,4 HCPCS,L6696,Cus elbo skt in for con/atyp,,,1628.51,4071.28,4 HCPCS,L6697,Cus elbo skt in not con/atyp,,,1628.51,4071.28,4 HCPCS,L6698,Below/above elbow lock mech,,,703.98,1759.95,4 HCPCS,L6700,Ue add ext power myoel,,,29510.19,73775.48,4 HCPCS,L6703,"Term dev, passive hand mitt",,,445.07,1112.68,4 HCPCS,L6704,"Term dev, sport/rec/work att",,,716.96,1792.4,4 HCPCS,L6706,Term dev mech hook vol open,,,427.16,1067.9,4 HCPCS,L6707,Term dev mech hook vol close,,,1574.47,3936.18,4 HCPCS,L6708,Term dev mech hand vol open,,,1029.27,2573.18,4 HCPCS,L6709,Term dev mech hand vol close,,,1483.22,3708.05,4 HCPCS,L6711,"Ped term dev, hook, vol open",,,832.33,2080.82,4 HCPCS,L6712,"Ped term dev, hook, vol clos",,,1532.52,3831.3,4 HCPCS,L6713,"Ped term dev, hand, vol open",,,1934.13,4835.32,4 HCPCS,L6714,"Ped term dev, hand, vol clos",,,1638.27,4095.68,4 HCPCS,L6715,"Term device, multi art digit",,,3908.64,9771.6,4 HCPCS,L6721,"Hook/hand, hvy dty, vol open",,,2911.82,7279.55,4 HCPCS,L6722,"Hook/hand, hvy dty, vol clos",,,2510.19,6275.48,4 HCPCS,L6805,Term dev modifier wrist unit,,,416.53,1041.32,4 HCPCS,L6810,Term dev precision pinch dev,,,236.08,590.2,4 HCPCS,L6880,Elec hand ind art digits,,,29579.67,73949.18,4 HCPCS,L6881,Term dev auto grasp feature,,,5061.33,12653.32,4 HCPCS,L6882,Microprocessor control uplmb,,,3839.33,9598.32,4 HCPCS,L6883,Replc sockt below e/w disa,,,1942.73,4856.82,4 HCPCS,L6884,Replc sockt above elbow disa,,,2883.44,7208.6,4 HCPCS,L6885,Replc sockt shldr dis/interc,,,4312.59,10781.48,4 HCPCS,L6890,Prefab glove for term device,,,208.23,520.58,4 HCPCS,L6895,Custom glove for term device,,,766.02,1915.05,4 HCPCS,L6900,Hand restorat thumb/1 finger,,,2186.02,5465.05,4 HCPCS,L6905,Hand restoration multiple fi,,,2173.6,5434.0,4 HCPCS,L6910,Hand restoration no fingers,,,1858.64,4646.6,4 HCPCS,L6915,Hand restoration replacmnt g,,,937.1,2342.75,4 HCPCS,L6920,Wrist disarticul switch ctrl,,,8170.29,20425.72,4 HCPCS,L6925,Wrist disart myoelectronic c,,,10998.63,27496.58,4 HCPCS,L6930,Below elbow switch control,,,8220.96,20552.4,4 HCPCS,L6935,Below elbow myoelectronic ct,,,11169.31,27923.28,4 HCPCS,L6940,Elbow disarticulation switch,,,10741.21,26853.02,4 HCPCS,L6945,Elbow disart myoelectronic c,,,13124.47,32811.18,4 HCPCS,L6950,Above elbow switch control,,,12208.9,30522.25,4 HCPCS,L6955,Above elbow myoelectronic ct,,,14621.82,36554.55,4 HCPCS,L6960,Shldr disartic switch contro,,,16562.87,41407.18,4 HCPCS,L6965,Shldr disartic myoelectronic,,,17664.91,44162.28,4 HCPCS,L6970,Interscapular-thor switch ct,,,18407.12,46017.8,4 HCPCS,L6975,Interscap-thor myoelectronic,,,20131.45,50328.62,4 HCPCS,L7007,Adult electric hand,,,4212.72,10531.8,4 HCPCS,L7008,Pediatric electric hand,,,6630.37,16575.92,4 HCPCS,L7009,Adult electric hook,,,4298.3,10745.75,4 HCPCS,L7040,Prehensile actuator,,,3451.37,8628.42,4 HCPCS,L7045,Pediatric electric hook,,,1978.79,4946.98,4 HCPCS,L7170,Electronic elbow hosmer swit,,,9111.07,22777.68,4 HCPCS,L7180,Electronic elbow sequential,,,39992.59,99981.48,4 HCPCS,L7181,Electronic elbo simultaneous,,,49605.45,124013.62,4 HCPCS,L7185,Electron elbow adolescent sw,,,8997.32,22493.3,4 HCPCS,L7186,Electron elbow child switch,,,10829.14,27072.85,4 HCPCS,L7190,Elbow adolescent myoelectron,,,9450.26,23625.65,4 HCPCS,L7191,Elbow child myoelectronic ct,,,11315.81,28289.52,4 HCPCS,L7259,Electronic wrist rotator any,,,3912.59,9781.48,4 HCPCS,L7360,Six volt bat otto bock/eq ea,,,292.13,730.32,4 HCPCS,L7362,Battery chrgr six volt otto,,,306.73,766.82,4 HCPCS,L7364,Twelve volt battery utah/equ,,,487.84,1219.6,4 HCPCS,L7366,Battery chrgr 12 volt utah/e,,,657.13,1642.82,4 HCPCS,L7367,Replacemnt lithium ionbatter,,,481.97,1204.92,4 HCPCS,L7368,Lithium ion battery charger,,,624.83,1562.08,4 HCPCS,L7400,"Add ue prost be/wd, ultlite",,,379.46,948.65,4 HCPCS,L7401,Add ue prost a/e ultlite mat,,,424.81,1062.02,4 HCPCS,L7402,Add ue prost s/d ultlite mat,,,458.7,1146.75,4 HCPCS,L7403,Add UE prost b/e acrylic,,,455.94,1139.85,4 HCPCS,L7404,Add UE prost a/e acrylic,,,688.07,1720.18,4 HCPCS,L7405,Add UE prost s/d acrylic,,,899.94,2249.85,4 HCPCS,L7406,Add to upp extr user adj mec,,,3150.07,7875.18,4 HCPCS,L7520,Repair prosthesis per 15 min,,,52.0,130.0,4 HCPCS,L7700,Pros soc insert gasket/seal,,,138.17,345.42,4 HCPCS,L8000,Mastectomy bra,,,53.85,134.62,4 HCPCS,L8001,Breast prosthesis bra & form,,,155.28,388.2,4 HCPCS,L8002,Brst prsth bra & bilat form,,,204.28,510.7,4 HCPCS,L8015,Ext breastprosthesis garment,,,74.19,185.48,4 HCPCS,L8020,Mastectomy form,,,279.11,697.78,4 HCPCS,L8030,Breast prosthes w/o adhesive,,,403.72,1009.3,4 HCPCS,L8031,Breast prosthesis w adhesive,,,403.72,1009.3,4 HCPCS,L8032,Reusable nipple prosthesis,,,48.49,121.22,4 HCPCS,L8035,Custom breast prosthesis,,,4535.66,11339.15,4 HCPCS,L8040,Nasal prosthesis,,,2992.53,7481.32,4 HCPCS,L8041,Midfacial prosthesis,,,3606.94,9017.35,4 HCPCS,L8042,Orbital prosthesis,,,4052.7,10131.75,4 HCPCS,L8043,Upper facial prosthesis,,,4539.05,11347.62,4 HCPCS,L8044,Hemi-facial prosthesis,,,5025.35,12563.38,4 HCPCS,L8045,Auricular prosthesis,,,3147.02,7867.55,4 HCPCS,L8046,Partial facial prosthesis,,,3242.18,8105.45,4 HCPCS,L8047,Nasal septal prosthesis,,,1661.59,4153.98,4 HCPCS,L8300,Truss single w/ standard pad,,,119.24,298.1,4 HCPCS,L8310,Truss double w/ standard pad,,,183.33,458.32,4 HCPCS,L8320,Truss addition to std pad wa,,,80.07,200.18,4 HCPCS,L8330,Truss add to std pad scrotal,,,79.38,198.45,4 HCPCS,L8400,Sheath below knee,,,23.21,58.02,4 HCPCS,L8410,Sheath above knee,,,26.4,66.0,4 HCPCS,L8415,Sheath upper limb,,,26.24,65.6,4 HCPCS,L8417,Pros sheath/sock w gel cushn,,,93.1,232.75,4 HCPCS,L8420,Prosthetic sock multi ply BK,,,30.67,76.68,4 HCPCS,L8430,Prosthetic sock multi ply AK,,,33.75,84.38,4 HCPCS,L8435,Pros sock multi ply upper lm,,,30.27,75.68,4 HCPCS,L8440,Shrinker below knee,,,64.18,160.45,4 HCPCS,L8460,Shrinker above knee,,,89.33,223.32,4 HCPCS,L8465,Shrinker upper limb,,,79.62,199.05,4 HCPCS,L8470,Pros sock single ply BK,,,8.17,20.42,4 HCPCS,L8480,Pros sock single ply AK,,,11.27,28.18,4 HCPCS,L8485,Pros sock single ply upper l,,,13.62,34.05,4 HCPCS,L8500,Artificial larynx,,,807.95,2019.88,4 HCPCS,L8501,Hc Tracheostomy Speaking Valve Sap #4675,289.8,115.92,,,0 HCPCS,L8501,Tracheostomy speaking valve,,,179.42,448.55,4 HCPCS,L8507,Trach-esoph voice pros pt in,,,51.86,129.65,4 HCPCS,L8509,Hc Kit Repl 6Mm Insert Gel Cp Sap#36348,927.68,371.07,,,0 HCPCS,L8509,"Hc Tracheoesophageal Voice Prosthesis Sap#36348, 36349, 36350",1004.06,401.62,,,0 HCPCS,L8509,Trach-esoph voice pros md in,,,135.22,338.05,4 HCPCS,L8510,Voice amplifier,,,312.86,782.15,4 HCPCS,L8511,Indwelling trach insert,,,90.05,225.12,4 HCPCS,L8512,Gel cap for trach voice pros,,,2.7,6.75,4 HCPCS,L8513,Trach pros cleaning device,,,6.47,16.18,4 HCPCS,L8514,"Hc Puncture Dilator For Tep 18Fr, Sap#36357",448.88,179.55,,,0 HCPCS,L8514,"Hc Trach Puncture Dilator, Sap# 202034",231.0,92.4,,,0 HCPCS,L8514,Repl trach puncture dilator,,,116.74,291.85,4 HCPCS,L8515,Gel cap app device for trach,,,78.14,195.35,4 HCPCS,L8600,Hc Sup Shell 278 Revenue Code L8600 Hcpcs,4232.81,1693.12,,,0 HCPCS,L8604,Hc Sup Shell 278 Revenue Code L8604 Hcpcs,13013.44,5205.38,,,0 HCPCS,L8605,Inj bulking agent anal canal,,,1467.44,1467.44,4 HCPCS,L8606,Hc Sup Shell 278 Revenue Code L8606 Hcpcs,4528.12,1811.25,,,0 HCPCS,L8607,Hc Sup Shell 270 Revenue Code L8607 Hcpcs,2842.2,1136.88,,,0 HCPCS,L8610,Hc Sup Shell 278 Revenue Code L8610 Hcpcs,40278.655,16111.46,,,0 HCPCS,L8613,Hc Sup Shell 278 Revenue Code L8613 Hcpcs,1343.2,537.28,,,0 HCPCS,L8613,Hc Triune Tympanostomy .76Mm Sap#177070,500.07,200.03,,,0 HCPCS,L8614,Hc Sup Shell 278 Revenue Code L8614 Hcpcs,54381.565,21752.625,,,0 HCPCS,L8615,Coch implant headset replace,,,558.37,1395.92,4 HCPCS,L8616,Coch implant microphone repl,,,130.06,325.15,4 HCPCS,L8617,Coch implant trans coil repl,,,113.64,284.1,4 HCPCS,L8618,Coch implant tran cable repl,,,32.46,81.15,4 HCPCS,L8619,Coch imp ext proc/contr rplc,,,10053.97,25134.92,4 HCPCS,L8621,Repl zinc air battery,,,0.77,1.92,4 HCPCS,L8622,Repl alkaline battery,,,0.4,1.0,4 HCPCS,L8623,"Lith ion batt cid,non-earlvl",,,80.07,200.18,4 HCPCS,L8624,"Lith ion batt cid, ear level",,,199.62,499.05,4 HCPCS,L8625,Charger coch impl/aoi battry,,,233.81,584.52,4 HCPCS,L8627,CID ext speech process repl,,,8522.43,21306.08,4 HCPCS,L8628,CID ext controller repl,,,1531.57,3828.92,4 HCPCS,L8629,CID transmit coil and cable,,,221.67,554.18,4 HCPCS,L8630,Hc Sup Shell 278 Revenue Code L8630 Hcpcs,4491.665,1796.665,,,0 HCPCS,L8641,Hc Sup Shell 278 Revenue Code L8641 Hcpcs,68797.97,27519.19,,,0 HCPCS,L8670,"Hc Heartware Graft Hvad Outlaw, Sap# 173753",7875.0,3150.0,,,0 HCPCS,L8670,Hc Sup Shell 278 Revenue Code L8670 Hcpcs,2110.64,844.26,,,0 HCPCS,L8680,Hc Kit Procedure Single Lead Sprint Pns Sap#261717,19293.75,7717.5,,,0 HCPCS,L8681,Hc Sup Shell 272 Revenue Code L8681 Hcpcs,75895.31,30358.12,,,0 HCPCS,L8681,Pt prgrm for implt neurostim,,,1398.33,3495.82,4 HCPCS,L8683,Radiofq trsmtr for implt neu,,,6496.7,16241.75,4 HCPCS,L8684,Radiof trsmtr implt scrl neu,,,853.14,2132.85,4 HCPCS,L8689,External recharg sys intern,,,2135.51,5338.78,4 HCPCS,L8690,Hc Sup Shell 278 Revenue Code L8690 Hcpcs,17462.81,6985.12,,,0 HCPCS,L8691,Hc Sup Shell 274 Revenue Code L8691 Hcpcs,44795.595,17918.239999999998,,,0 HCPCS,L8691,Hc Sup Shell 278 Revenue Code L8691 Hcpcs,24210.305,9684.119999999999,,,0 HCPCS,L8691,Osseointegrated snd proc rpl,,,2132.09,5330.22,4 HCPCS,L8693,"Aud osseo dev, abutment",,,1877.27,4693.18,4 HCPCS,L8694,Aoi transducer/actuator repl,,,1169.21,2923.02,4 HCPCS,L8694,Hc Sup Shell 274 Revenue Code L8694 Hcpcs,48628.12,19451.25,,,0 HCPCS,L8695,External recharg sys extern,,,20.61,51.52,4 HCPCS,L8699,Hc Sup Shell 278 Revenue Code L8699 Hcpcs,5177.8150000000005,2071.13,,,0 HCPCS,L8701,Pow ue rom dev ewh uprt cust,,,34970.13,87425.32,4 HCPCS,L8702,Pow ue rom dev ewhf uprt cus,,,68801.71,172004.28,4 HCPCS,M0201,Covid-19 vaccine home admin,,,18.77,88.06,8 HCPCS,M0220,Hc Administration Tixagevimab And Cilgavimab Injection >12 Years Old,687.69,275.08,,,0 HCPCS,M0221,Hc Administration Of Tixagevimab & Cilgavimab (Evusheld) Antibody >12 Years Old,339.1,135.64,,,0 HCPCS,M0224,"Hc Intravenous Infusion, Pemgarda (Pemivibart)",1414.19,565.68,,,0 HCPCS,M0239,Hc Bamlanivimab Infusion/Post Mon,1559.28,623.71,,,0 HCPCS,M0243,Hc Admin Tixagevimab & Cilgavimab (Evusheld) Antibody,0.01,0.004,,,0 HCPCS,M0245,Hc Bamlan & Etesev Infus/Post Mon,1413.36,565.34,,,0 HCPCS,M1017,Hc New Pump Therapy,450.5,180.2,,,0 HCPCS,M1018,Hc Client Bill Only - New Platform Upgrade Pump Education,212.0,84.8,,,0 HCPCS,M1019,Hc Client Bill Only - Same Platform Pump Upgrade Pump Education,106.0,42.4,,,0 HCPCS,M1020,Hc Client Bill Only - Sensor Education,238.5,95.4,,,0 HCPCS,M1022,Hc Sensor Upgrade,106.0,42.4,,,0 HCPCS,M1023,Hc Client Bill Only - Additional Support,106.0,42.4,,,0 HCPCS,M1024,Hc Therapy Review,106.0,42.4,,,0 HCPCS,M1025,Hc Non-Medtronic Pump Upgrade Education,318.0,127.2,,,0 HCPCS,M1026,Hc Client Bill Only - Auto Mode Education,159.0,63.6,,,0 HCPCS,P2028,Cephalin floculation test,,,4.95,12.38,12 HCPCS,P2029,Congo red blood test,,,4.95,12.38,12 HCPCS,P2031,Hair analysis,,,4.95,7.33,8 HCPCS,P2033,Blood thymol turbidity,,,4.95,12.38,12 HCPCS,P2038,Blood mucoprotein,,,4.27,12.38,16 HCPCS,P3000,Screen pap by tech w md supv,,,8.98,46.35,16 HCPCS,P3001,Screening pap smear by phys,,,37.97,37.97,1 HCPCS,P7001,Culture bacterial urine,,,22.04,22.04,1 HCPCS,P9010,Hc Whole Blood-Kbc,865.65,346.26,,,0 HCPCS,P9011,Hc Pedi Pheresis Platelet,1080.06,432.02,,,0 HCPCS,P9011,Hc Pedi-Plasma 31-60Ml,278.96,111.58,,,0 HCPCS,P9011,Hc Pedi-Rbc L/R 1-30Ml,347.56,139.02,,,0 HCPCS,P9011,Hc Pedi-Rbc L/R 1/2 Unit,369.93,147.97,,,0 HCPCS,P9012,Hc Cryoprecipitate Ahf Ea,339.6,135.84,,,0 HCPCS,P9012,Hc Cryoprecipitate-5 Pooled,1091.58,436.63,,,0 HCPCS,P9012,Hc Cryoprecipitate-Single Unit,256.19,102.48,,,0 HCPCS,P9016,Hc Rare Rbc L/R-Ckbc,1369.33,547.73,,,0 HCPCS,P9016,Hc Red Blood Cells Leuko Red-Ckbc,1287.41,514.96,,,0 HCPCS,P9016,Rbc leukocytes reduced,,,36.0,462.28,8 HCPCS,P9017,Hc Fresh Frozen Plasma-Ckbc,266.83,106.73,,,0 HCPCS,P9017,Hc Jumbo Fresh Frozen Plasma-Ckbc,470.59,188.24,,,0 HCPCS,P9021,Hc Red Blood Cells-Ckbc,1287.41,514.96,,,0 HCPCS,P9022,Hc Washed Red Cells-Ckbc,1342.44,536.98,,,0 HCPCS,P9023,"Frozen plasma, pooled, sd",,,0.85,139.9,8 HCPCS,P9025,Plasma cryo redu path each,,,26.28,334.4,8 HCPCS,P9026,Cryo fib comp path redu each,,,31.94,1373.2,8 HCPCS,P9031,Hc Platelet-Pooled Lr Ea-Kbc,1080.06,432.02,,,0 HCPCS,P9035,Hc Platelet Pheresis Leukored-Ckb,3702.26,1480.9,,,0 HCPCS,P9035,Hc Platelet Pheresis Leukored-Ckbc #2-So+,3163.2,1265.28,,,0 HCPCS,P9035,Hc Research Chips Cold Stored Platelets,0.01,0.004,,,0 HCPCS,P9035,Hc Research Chips Study Product Processing Fee,18.19,7.28,,,0 HCPCS,P9035,Platelet pheres leukoreduced,,,511.59,1278.98,4 HCPCS,P9037,"Hc Platelet Pheresis Leukored Irr, Each Unit",2715.13,1086.05,,,0 HCPCS,P9037,Plate pheres leukoredu irrad,,,680.61,1701.52,4 HCPCS,P9039,Hc Rare Degly Rbc-Ckbc,2084.6,833.84,,,0 HCPCS,P9039,Hc Red Blood Cells Degly-Ckbc,1895.65,758.26,,,0 HCPCS,P9040,Hc Red Blood Cells-Lr-Irr-Ckbc,1944.89,777.96,,,0 HCPCS,P9040,RBC leukoreduced irradiated,,,265.41,663.52,4 HCPCS,P9041,"Albumin (Human): 250 Ml In 1 Bottle, Glass (68982-623-02)",222.43,88.97,,,0 HCPCS,P9041,"Albumin (human),5%, 50ml",,,10.62,26.54,9 HCPCS,P9041,"Alburx: 1 Vial, Glass In 1 Carton (44206-310-25) / 250 Ml In 1 Vial, Glass (44206-310-90)",195.74,78.3,,,0 HCPCS,P9041,Albutein: 1 Vial In 1 Carton (68516-5214-5) / 50 Ml In 1 Vial (68516-5214-6),2.59,1.04,,,0 HCPCS,P9041,NDC Description Not Available,30.41,12.16,,,0 HCPCS,P9043,"Plasma protein fract,5%,50ml",,,8.11,22.52,8 HCPCS,P9044,Hc Plasma Cryo Reduced,266.83,106.73,,,0 HCPCS,P9045,Albuked: 1 Vial In 1 Carton (76125-790-25) / 250 Ml In 1 Vial (76125-790-26),37.68,15.07,,,0 HCPCS,P9045,"Albumin (human), 5%, 250 ml",,,53.08,132.7,9 HCPCS,P9045,Albutein: 1 Vial In 1 Carton (68516-5214-1) / 250 Ml In 1 Vial (68516-5214-3),92.05,36.82,,,0 HCPCS,P9045,Flexbumin: 2 Bag In 1 Carton (0944-0495-05) / 250 Ml In 1 Bag (0944-0495-06),50.99,20.4,,,0 HCPCS,P9045,NDC Description Not Available,63.1,25.24,,,0 HCPCS,P9046,"Albumin (human), 25%, 20 ml",,,21.23,53.32,9 HCPCS,P9047,"Albumin (human), 25%, 50ml",,,53.08,133.31,9 HCPCS,P9047,Flexbumin: 12 Bag In 1 Carton (0944-0493-01) / 50 Ml In 1 Bag (0944-0493-03),249.11,99.64,,,0 HCPCS,P9047,NDC Description Not Available,233.17499999999998,93.27000000000001,,,0 HCPCS,P9048,"Plasmaprotein fract,5%,250ml",,,35.32,88.3,8 HCPCS,P9050,Hc Granulocyte Pheresis - Ckbc,2339.0,935.6,,,0 HCPCS,P9052,"Hc Platelet, Hla-M, L/R, Irrad, Unit",2317.62,927.05,,,0 HCPCS,P9052,"Platelets, hla-m, l/r, unit",,,708.06,1770.15,4 HCPCS,P9100,Hc Verax Platelet Pgd Test,242.57,97.03,,,0 HCPCS,P9100,Pathogen test for platelets,,,25.5,144.03,9 HCPCS,P9603,One-way allow prorated miles,,,0.6,0.6,4 HCPCS,P9604,One-way allow prorated trip,,,6.0,6.0,4 HCPCS,P9612,Catheterize for urine spec,,,1.8,23.35,16 HCPCS,P9612,Hc Cath Specimen Collection,133.0,53.2,,,0 HCPCS,P9615,Urine specimen collect mult,,,1.8,10.0,12 HCPCS,Q0035,Cardiokymography,,,36.48,91.19,4 HCPCS,Q0091,Hc Obtaining Screen Pap Smear,105.3,42.12,,,0 HCPCS,Q0091,Obtaining screen pap smear,,,9.9,70.62,5 HCPCS,Q0111,Wet mounts/ w preparations,,,3.05,46.35,16 HCPCS,Q0112,Potassium hydroxide preps,,,3.63,14.58,16 HCPCS,Q0113,Pinworm examinations,,,4.27,10.68,16 HCPCS,Q0114,Fern test,,,6.08,24.35,16 HCPCS,Q0115,Post-coital mucous exam,,,8.41,62.5,16 HCPCS,Q0138,"Feraheme: 1 Vial, Single-Use In 1 Carton (59338-775-01) / 17 Ml In 1 Vial, Single-Use",10.46,4.18,,,0 HCPCS,Q0138,"Ferumoxytol, non-esrd",,,0.33,0.83,9 HCPCS,Q0139,"Ferumoxytol, esrd use",,,0.33,0.83,9 HCPCS,Q0144,"Azithromycin dihydrate, oral",,,24.7,24.7,4 HCPCS,Q0155,Dronabinol (syndros) 0.1 mg,,,3.24,3.24,4 HCPCS,Q0161,Chlorpromazine hcl 5mg oral,,,0.35,0.35,4 HCPCS,Q0162,NDC Description Not Available,0.22,0.09,,,0 HCPCS,Q0162,Ondansetron oral,,,0.01,0.01,4 HCPCS,Q0162,"Ondansetron: 10 Tablet, Orally Disintegrating In 1 Box, Unit-Dose (68462-158-11)",0.17,0.07,,,0 HCPCS,Q0162,"Ondansetron: 3 Blister Pack In 1 Carton (65862-391-10) / 10 Tablet, Orally Disintegrating In 1 Blister Pack",0.32,0.13,,,0 HCPCS,Q0162,"Ondansetron: 3 Blister Pack In 1 Dose Pack (62756-356-64) / 10 Tablet, Orally Disintegrating In 1 Blister Pack",0.33,0.13,,,0 HCPCS,Q0163,Diphenhydramine HCl 50mg,,,0.02,0.02,4 HCPCS,Q0163,Diphenhydramine Hydrochloride: 10 Blister Pack In 1 Carton (68094-018-61) / 10 Tablet In 1 Blister Pack (68094-018-59),0.63,0.25,,,0 HCPCS,Q0163,NDC Description Not Available,0.64,0.26,,,0 HCPCS,Q0164,NDC Description Not Available,3.4850000000000003,1.395,,,0 HCPCS,Q0164,Prochlorperazine Maleate: 100 Tablet In 1 Bottle (59746-113-06),1.5,0.6,,,0 HCPCS,Q0164,Prochlorperazine Maleate: 50 Blister Pack In 1 Box (50268-684-15) / 1 Tablet In 1 Blister Pack (50268-684-11),3.26,1.3,,,0 HCPCS,Q0164,Prochlorperazine Maleate: 50 Blister Pack In 1 Box (50268-685-15) / 1 Tablet In 1 Blister Pack (50268-685-11),1.77,0.71,,,0 HCPCS,Q0164,Prochlorperazine Maleate: 50 Blister Pack In 1 Carton (0904-7381-06) / 1 Tablet In 1 Blister Pack,3.79,1.52,,,0 HCPCS,Q0164,Prochlorperazine maleate 5mg,,,0.35,0.35,4 HCPCS,Q0166,Granisetron HCl 1 mg oral,,,3.0,3.0,4 HCPCS,Q0166,"Granisetron Hydrochloride: 2 Blister Pack In 1 Carton (69452-350-92) / 10 Tablet, Film Coated In 1 Blister Pack",4.07,1.63,,,0 HCPCS,Q0167,DRONABINOL: 100 BLISTER PACK in 1 CARTON (0904-6745-61) / 1 CAPSULE in 1 BLISTER PACK,14.41,5.76,,,0 HCPCS,Q0167,Dronabinol 2.5mg oral,,,1.48,1.48,4 HCPCS,Q0167,"Dronabinol: 100 Blister Pack In 1 Box, Unit-Dose (60687-375-01) / 1 Capsule In 1 Blister Pack (60687-375-11)",30.5,12.2,,,0 HCPCS,Q0167,Dronabinol: 100 Blister Pack In 1 Carton (0904-7144-61) / 1 Capsule In 1 Blister Pack,19.02,7.61,,,0 HCPCS,Q0167,Dronabinol: 20 Blister Pack In 1 Carton (60687-386-94) / 1 Capsule In 1 Blister Pack (60687-386-11),20.12,8.05,,,0 HCPCS,Q0167,"Dronabinol: 30 Blister Pack In 1 Box, Unit-Dose (60687-386-21) / 1 Capsule In 1 Blister Pack (60687-386-11)",21.37,8.55,,,0 HCPCS,Q0167,Dronabinol: 30 Blister Pack In 1 Carton (0904-7145-04) / 1 Capsule In 1 Blister Pack,11.14,4.46,,,0 HCPCS,Q0167,Dronabinol: 30 Blister Pack In 1 Carton (60687-375-21) / 1 Capsule In 1 Blister Pack (60687-375-11),30.5,12.2,,,0 HCPCS,Q0167,Dronabinol: 60 Capsule In 1 Bottle (42858-868-06),4.48,1.79,,,0 HCPCS,Q0167,Dronabinol: 60 Capsule In 1 Bottle (67877-753-60),5.58,2.23,,,0 HCPCS,Q0167,Dronabinol: 60 Capsule In 1 Bottle (67877-754-60),4.37,1.75,,,0 HCPCS,Q0167,NDC Description Not Available,19.89,7.955,,,0 HCPCS,Q0169,NDC Description Not Available,0.8600000000000001,0.345,,,0 HCPCS,Q0169,Promethazine HCl 12.5mg oral,,,0.08,0.08,4 HCPCS,Q0169,Promethazine Hydrochloride: 100 Blister Pack In 1 Carton (0904-6461-61) / 1 Tablet In 1 Blister Pack,0.25,0.1,,,0 HCPCS,Q0169,Promethazine Hydrochloride: 100 Blister Pack In 1 Carton (0904-7304-61) / 1 Tablet In 1 Blister Pack,0.23,0.09,,,0 HCPCS,Q0169,Promethazine Hydrochloride: 100 Blister Pack In 1 Carton (60687-660-01) / 1 Tablet In 1 Blister Pack (60687-660-11),1.32,0.53,,,0 HCPCS,Q0169,Promethazine Hydrochloride: 100 Tablet In 1 Bottle (68382-040-01),0.2,0.08,,,0 HCPCS,Q0169,Promethazine Hydrochloride: 473 Ml In 1 Bottle (0121-0927-16),1.27,0.51,,,0 HCPCS,Q0169,Promethazine Hydrochloride: 473 Ml In 1 Bottle (70408-146-34),2.4,0.96,,,0 HCPCS,Q0169,"Promethazine Hydrochloride: 473 Ml In 1 Bottle, Plastic (70752-138-12)",3.86,1.54,,,0 HCPCS,Q0169,Promethazine Hydrochloride: 473 mL in 1 BOTTLE (50383-801-16),4.19,1.68,,,0 HCPCS,Q0175,Perphenazine 4mg oral,,,0.47,0.47,4 HCPCS,Q0175,"Perphenazine: 100 Tablet, Film Coated In 1 Bottle (52536-164-01)",1.36,0.54,,,0 HCPCS,Q0175,"Perphenazine: 100 Tablet, Film Coated In 1 Bottle (64980-291-01)",1.59,0.64,,,0 HCPCS,Q0177,"Hydroxyzine Pamoate: 100 Capsule In 1 Bottle, Plastic (0115-1804-01)",0.25,0.1,,,0 HCPCS,Q0177,Hydroxyzine Pamoate: 50 Blister Pack In 1 Box (50268-399-50) / 1 Capsule In 1 Blister Pack (50268-399-11),0.62,0.25,,,0 HCPCS,Q0177,Hydroxyzine pamoate 25mg,,,0.1,0.1,4 HCPCS,Q0177,NDC Description Not Available,0.725,0.29000000000000004,,,0 HCPCS,Q0180,Dolasetron mesylate oral,,,60.32,60.32,4 HCPCS,Q0224,"Inj, pemivibart, 4500 mg",,,6583.5,8831.58,5 HCPCS,Q0237,"Inj, tocilizumab-anoh, hospi",,,6.32,6.32,1 HCPCS,Q0249,Tocilizumab for covid-19,,,7.57,9.24,5 HCPCS,Q0477,Pwr module pt cable lvad rpl,,,960.54,2401.35,4 HCPCS,Q0478,Hc Heartware Ac Adapter Sap#263442,938.44,375.38,,,0 HCPCS,Q0478,"Power adapter, combo vad",,,227.5,568.75,4 HCPCS,Q0479,"Hc Heartmate Iii Mobile Cable Unit, Sap#234537",34020.0,13608.0,,,0 HCPCS,Q0479,"Power module combo vad, rep",,,14835.04,37087.6,4 HCPCS,Q0480,"driver pneumatic vad, rep",,,111502.61,278756.52,4 HCPCS,Q0481,"Hc Controller Heartmate 3 Lvad With Battery, Sap# 218193",23388.75,9355.5,,,0 HCPCS,Q0481,Hc Heartmate Ii Pocket Controller System Sap #173918,21656.25,8662.5,,,0 HCPCS,Q0481,Hc Sup Shell 274 Revenue Code Q0481 Hcpcs,23388.75,9355.5,,,0 HCPCS,Q0481,Hc Sup Shell 278 Revenue Code Q0481 Hcpcs,424931.06,169972.42,,,0 HCPCS,Q0481,"microprcsr cu elec vad, rep",,,17989.68,44974.2,4 HCPCS,Q0482,Hc Adaptor Heartware Dc Sap #173762,7875.0,3150.0,,,0 HCPCS,Q0482,Hc Heartware Controller Kit,28153.12,11261.25,,,0 HCPCS,Q0482,"microprcsr cu combo vad, rep",,,5634.71,14086.78,4 HCPCS,Q0483,"monitor elec vad, rep",,,23212.4,58031.0,4 HCPCS,Q0484,monitor elec or comb vad rep,,,4507.79,11269.48,4 HCPCS,Q0485,"monitor cable elec vad, rep",,,435.21,1088.02,4 HCPCS,Q0486,Hc Heartware Cable Drive Ext,10237.5,4095.0,,,0 HCPCS,Q0486,mon cable elec/pneum vad rep,,,362.21,905.52,4 HCPCS,Q0487,"leads any type vad, rep only",,,422.6,1056.5,4 HCPCS,Q0489,Hc Heartware Charger Battery,24018.75,9607.5,,,0 HCPCS,Q0489,"pwr pck base combo vad, rep",,,20123.89,50309.72,4 HCPCS,Q0490,"emr pwr source elec vad, rep",,,870.47,2176.18,4 HCPCS,Q0491,emr pwr source combo vad rep,,,1368.43,3421.08,4 HCPCS,Q0492,"emr pwr cbl elec vad, rep",,,110.28,275.7,4 HCPCS,Q0493,"emr pwr cbl combo vad, rep",,,313.85,784.62,4 HCPCS,Q0494,"emr hd pmp elec/combo, rep",,,265.6,664.0,4 HCPCS,Q0495,"Hc Charger Battery Universal Hm3, Sap#236950",30618.0,12247.2,,,0 HCPCS,Q0495,"charger elec/combo vad, rep",,,5171.38,12928.45,4 HCPCS,Q0496,"Hc Battery Lvad, Sap#173347",354.38,141.75,,,0 HCPCS,Q0496,"battery elec/combo vad, rep",,,1856.1,4640.25,4 HCPCS,Q0497,"Hc Heartmate Battery Clip Set 14V, Sap#246552",4677.75,1871.1,,,0 HCPCS,Q0497,"bat clps elec/comb vad, rep",,,579.54,1448.85,4 HCPCS,Q0498,"Hc Holster Battery, Sap#174712",1679.74,671.9,,,0 HCPCS,Q0498,"holster elec/combo vad, rep",,,635.9,1589.75,4 HCPCS,Q0499,"Hc Bag Consolidated, Sap#174711",1382.06,552.82,,,0 HCPCS,Q0499,belt/vest elec/combo vad rep,,,206.62,516.55,4 HCPCS,Q0500,"filters elec/combo vad, rep",,,37.8,94.5,4 HCPCS,Q0501,"Hc Bag Shower, Sap#174715",956.81,382.72,,,0 HCPCS,Q0501,Hc Heartware Bag Shower Sap #173766,1181.25,472.5,,,0 HCPCS,Q0501,"shwr cov elec/combo vad, rep",,,632.25,1580.62,4 HCPCS,Q0502,"mobility cart pneum vad, rep",,,804.93,2012.32,4 HCPCS,Q0503,battery pneum vad replacemnt,,,1609.89,4024.72,4 HCPCS,Q0504,"pwr adpt pneum vad, rep veh",,,849.48,2123.7,4 HCPCS,Q0506,"Hc Battery Lith 14V, Sap#254420",10631.25,4252.5,,,0 HCPCS,Q0506,Hc Battery Lith Pocket Contrller,1968.75,787.5,,,0 HCPCS,Q0506,"Hc Battery Lith Pocket Controller, Sap# 173913",1968.75,787.5,,,0 HCPCS,Q0506,Hc Heartware Battery Sap #173765,2953.12,1181.25,,,0 HCPCS,Q0506,Lith-ion batt elec/pneum VAD,,,1057.44,2643.6,4 HCPCS,Q0507,Hc Heartware Pack Patient,1673.44,669.38,,,0 HCPCS,Q0508,Hc Cable Heartmate 3 Lvad Mod Sap#218198,21049.88,8419.95,,,0 HCPCS,Q0508,"Hc Case Travel, Sap#218897",630.0,252.0,,,0 HCPCS,Q0508,"Hc Heartware Alarm Adapter, Sap#263443",1082.81,433.12,,,0 HCPCS,Q0508,Hc Kit Daily Driveline Management Sap #203124,64.98,25.99,,,0 HCPCS,Q0508,Hc Kit Extended Wear Sap #203125,74.57,29.83,,,0 HCPCS,Q0508,"Hc Lvad Custom Dressing Kit, Sap#265922",189.91,75.96,,,0 HCPCS,Q0508,"Hc Shoulder Pack Patient Magnetic F/Vent, Sap# 234313",1771.88,708.75,,,0 HCPCS,Q0515,Sermorelin acetate injection,,,0.01,0.01,4 HCPCS,Q2004,Bladder calculi irrig sol,,,101.19,101.19,4 HCPCS,Q2009,Cerebyx: 10 Vial In 1 Package (0069-6001-21) / 10 Ml In 1 Vial (0069-6001-10),5.62,2.25,,,0 HCPCS,Q2009,Cerebyx: 25 Vial In 1 Carton (0069-6001-25) / 2 Ml In 1 Vial (0069-6001-02),4.3,1.72,,,0 HCPCS,Q2009,"Fosphenytoin Sodium: 10 VIAL, SINGLE-DOSE in 1 CARTON (67457-517-01) / 10 mL in 1 VIAL, SINGLE-DOSE (67457-517-00)",6.0,2.4,,,0 HCPCS,Q2009,"Fosphenytoin Sodium: 10 Vial, Single-Dose In 1 Carton (68462-622-10) / 10 Ml In 1 Vial, Single-Dose (68462-622-64)",9.97,3.99,,,0 HCPCS,Q2009,"Fosphenytoin Sodium: 10 Vial, Single-Dose In 1 Carton (68462-622-64) / 10 Ml In 1 Vial, Single-Dose (68462-622-10)",10.03,4.01,,,0 HCPCS,Q2009,Fosphenytoin inj pe,,,1.55,3.88,9 HCPCS,Q2009,NDC Description Not Available,12.985,5.195,,,0 HCPCS,Q2017,"Teniposide, 50 mg",,,2495.95,2495.95,4 HCPCS,Q2026,Radiesse injection,,,349.19,872.98,5 HCPCS,Q2028,"Inj, sculptra, 0.5mg",,,0.01,5.4,9 HCPCS,Q2035,"Afluria vacc, 3 yrs & >, im",,,0.01,31.4,5 HCPCS,Q2036,"Flulaval vacc, 3 yrs & >, im",,,0.01,0.01,4 HCPCS,Q2037,"Fluvirin vacc, 3 yrs & >, im",,,0.01,15.08,5 HCPCS,Q2038,"Fluzone vacc, 3 yrs & >, im",,,0.01,68.25,5 HCPCS,Q2041,Axicabtagene ciloleucel car+,,,0.01,1444858.14,9 HCPCS,Q2041,Hc Yescarta,2722544.0,1089017.6,,,0 HCPCS,Q2042,Hc Kymriah Car-T,2434856.01,973942.4,,,0 HCPCS,Q2042,Hc Kymriah Car-T Ped And Young Adult W/ R/R All Age <25 Yrs,2955796.03,1182318.41,,,0 HCPCS,Q2042,Tisagenlecleucel car-pos t,,,0.01,1565789.58,9 HCPCS,Q2043,Sipuleucel-t auto cd54+,,,55663.13,139157.83,9 HCPCS,Q2049,Imported Lipodox inj,,,0.01,746.85,9 HCPCS,Q2050,"Doxil: 1 Vial, Single-Use In 1 Carton (0338-0063-01) / 10 Ml In 1 Vial, Single-Use",474.6,189.84,,,0 HCPCS,Q2050,"Doxil: 1 Vial, Single-Use In 1 Carton (0338-0067-01) / 25 Ml In 1 Vial, Single-Use",233.14,93.26,,,0 HCPCS,Q2050,"Doxorubicin Hydrochloride: 1 Vial, Single-Dose In 1 Carton (70710-1530-1) / 10 Ml In 1 Vial, Single-Dose",1752.84,701.14,,,0 HCPCS,Q2050,"Doxorubicin Hydrochloride: 1 Vial, Single-Dose In 1 Carton (70710-1531-1) / 25 Ml In 1 Vial, Single-Dose",253.59,101.44,,,0 HCPCS,Q2050,"Doxorubicin Hydrochloride: 1 Vial, Single-Dose In 1 Package (43598-283-35) / 10 Ml In 1 Vial, Single-Dose",376.49,150.6,,,0 HCPCS,Q2050,"Doxorubicin Hydrochloride: 1 Vial, Single-Dose In 1 Package (47335-049-40) / 10 Ml In 1 Vial, Single-Dose",929.01,371.6,,,0 HCPCS,Q2050,"Doxorubicin Hydrochloride: 1 Vial, Single-Dose In 1 Package (47335-050-40) / 25 Ml In 1 Vial, Single-Dose",1074.27,429.71,,,0 HCPCS,Q2050,"Doxorubicin Hydrochloride: 1 Vial, Single-Use In 1 Carton (70748-339-01) / 10 Ml In 1 Vial, Single-Use",850.43,340.17,,,0 HCPCS,Q2050,"Doxorubicin Hydrochloride: 1 Vial, Single-Use In 1 Carton (70748-340-01) / 25 Ml In 1 Vial, Single-Use",837.36,334.94,,,0 HCPCS,Q2050,Doxorubicin inj 10mg,,,97.82,244.56,9 HCPCS,Q2053,Brexucabtagene car pos t,,,0.01,1330881.85,9 HCPCS,Q2053,Hc Tecartus,2507470.0,1002988.0,,,0 HCPCS,Q2054,Hc Car-T Liso-Cel Breyanzi,2778431.0,1111372.4,,,0 HCPCS,Q2054,Lisocabtagene mara car pos t,,,0.01,1474616.93,9 HCPCS,Q2055,Hc Car-T Ide-Cel Abecma,2709926.0,1083970.4,,,0 HCPCS,Q2055,Idecabtagene vicleucel car,,,0.01,1439626.16,9 HCPCS,Q2056,Ciltacabtagene car-pos t,,,0.01,1485280.64,9 HCPCS,Q2056,Hc Car-T Cilta-Cel Carvykti,2665490.0,1066196.0,,,0 HCPCS,Q2057,Afamitresgene autoleucel,,,0.01,2034918.44,9 HCPCS,Q2058,Obecbtge autol up to 400 mil,,,293725.7,734314.26,5 HCPCS,Q3014,Hc Telehealth Fee,66.19,26.48,,,0 HCPCS,Q3014,Hc Telehealth Fee Peds Cardiology,55.16,22.06,,,0 HCPCS,Q3027,Inj beta interferon im 1 mcg,,,71.98,71.98,4 HCPCS,Q3028,Inj beta interferon sq 1 mcg,,,41.62,41.62,4 HCPCS,Q4074,Iloprost non-comp unit dose,,,148.76,148.76,4 HCPCS,Q4081,"Epoetin alfa, 100 units ESRD",,,0.71,0.71,4 HCPCS,Q4100,Hc Sup Shell 278 Revenue Code Q4100 Hcpcs,3883.32,1553.33,,,0 HCPCS,Q4101,Apligraf,,,121.53,303.83,5 HCPCS,Q4101,Hc Sup Shell 272 Revenue Code Q4101 Hcpcs,5020.31,2008.12,,,0 HCPCS,Q4101,Hc Sup Shell 278 Revenue Code Q4101 Hcpcs,5020.31,2008.12,,,0 HCPCS,Q4101,NDC Description Not Available,4781.25,1912.5,,,0 HCPCS,Q4102,Oasis wound matrix,,,121.53,303.83,5 HCPCS,Q4103,Oasis burn matrix,,,121.53,303.83,5 HCPCS,Q4104,Hc Sup Shell 272 Revenue Code Q4104 Hcpcs,16828.705,6731.48,,,0 HCPCS,Q4104,Hc Sup Shell 636 Revenue Code Q4104 Hcpcs,13220.62,5288.25,,,0 HCPCS,Q4104,Integra bmwd,,,121.53,303.83,5 HCPCS,Q4104,NDC Description Not Available,19735.52,7894.21,,,0 HCPCS,Q4105,Hc Sup Shell 278 Revenue Code Q4105 Hcpcs,13577.75,5431.1,,,0 HCPCS,Q4105,Integra drt or omnigraft,,,121.53,303.83,5 HCPCS,Q4107,Graftjacket,,,121.53,303.83,5 HCPCS,Q4107,Hc Sup Shell 250 Revenue Code Q4107 Hcpcs,9288.75,3715.5,,,0 HCPCS,Q4108,Integra matrix,,,121.53,303.83,5 HCPCS,Q4110,Primatrix,,,121.53,303.83,5 HCPCS,Q4111,Gammagraft,,,121.53,303.83,5 HCPCS,Q4115,Alloskin,,,121.53,303.83,5 HCPCS,Q4116,Alloderm,,,121.53,303.83,5 HCPCS,Q4117,Hyalomatrix,,,121.53,303.83,5 HCPCS,Q4121,Theraskin,,,121.53,303.83,5 HCPCS,Q4122,Dermacell,,,121.53,303.83,5 HCPCS,Q4122,Hc Sup Shell 278 Revenue Code Q4122 Hcpcs,7517.145,3006.86,,,0 HCPCS,Q4123,Alloskin,,,121.53,303.83,5 HCPCS,Q4124,Oasis tri-layer wound matrix,,,121.53,303.83,5 HCPCS,Q4125,Arthroflex,,,121.53,303.83,5 HCPCS,Q4126,Memoderm/derma/tranz/integup,,,121.53,303.83,5 HCPCS,Q4127,Talymed,,,121.53,303.83,5 HCPCS,Q4128,Flexhd/allopatchhd/matrixhd,,,121.53,303.83,5 HCPCS,Q4128,Hc Sup Shell 278 Revenue Code Q4128 Hcpcs,4921.88,1968.75,,,0 HCPCS,Q4130,Hc Sup Shell 278 Revenue Code Q4130 Hcpcs,37989.0,15195.6,,,0 HCPCS,Q4130,Strattice TM,,,121.53,303.83,5 HCPCS,Q4132,Grafix core,,,121.53,303.83,5 HCPCS,Q4133,Grafix prime,,,121.53,303.83,5 HCPCS,Q4134,hMatrix,,,121.53,303.83,5 HCPCS,Q4135,Mediskin,,,121.53,303.83,5 HCPCS,Q4136,EZderm,,,121.53,303.83,5 HCPCS,Q4137,"Amnioexcel or biodexcel, 1cm",,,121.53,303.83,5 HCPCS,Q4138,"Biodfence dryflex, 1cm",,,121.53,303.83,5 HCPCS,Q4140,Biodfence 1cm,,,121.53,303.83,5 HCPCS,Q4141,"Alloskin ac, 1 cm",,,121.53,303.83,5 HCPCS,Q4142,Xcm biologic tiss matrix 1cm,,,121.53,303.83,5 HCPCS,Q4143,"Repriza, 1cm",,,121.53,303.83,5 HCPCS,Q4146,"Tensix, 1cm",,,121.53,303.83,5 HCPCS,Q4147,Architect ecm px fx 1 sq cm,,,121.53,303.83,5 HCPCS,Q4148,"Neox 1k, 1cm",,,121.53,303.83,5 HCPCS,Q4150,Allowrap ds or dry 1 sq cm,,,121.53,303.83,5 HCPCS,Q4151,"Amnioband, guardian 1 sq cm",,,121.53,303.83,5 HCPCS,Q4152,Dermapure 1 square cm,,,121.53,303.83,5 HCPCS,Q4153,"Dermavest, plurivest sq cm",,,121.53,303.83,5 HCPCS,Q4154,Biovance 1 square cm,,,121.53,303.83,5 HCPCS,Q4156,Neox 100 1 square cm,,,121.53,303.83,5 HCPCS,Q4157,Revitalon 1 square cm,,,121.53,303.83,5 HCPCS,Q4158,Marigen 1 square cm,,,121.53,303.83,5 HCPCS,Q4159,Affinity1 square cm,,,121.53,303.83,5 HCPCS,Q4160,Hc Sup Shell 636 Revenue Code Q4160 Hcpcs Hb Chargeables,3318.75,1327.5,,,0 HCPCS,Q4160,NDC Description Not Available,5296.875,2118.75,,,0 HCPCS,Q4160,Nushield 1 square cm,,,121.53,303.83,5 HCPCS,Q4161,Bio-connekt per square cm,,,121.53,303.83,5 HCPCS,Q4163,Amnio bio and woundex sq cm,,,121.53,303.83,5 HCPCS,Q4164,"Helicoll, per square cm",,,121.53,303.83,5 HCPCS,Q4165,"Keramatrix, per square cm",,,121.53,303.83,5 HCPCS,Q4166,"Cytal, per square centimeter",,,121.53,303.83,5 HCPCS,Q4167,"Truskin, per sq centimeter",,,121.53,303.83,5 HCPCS,Q4169,"Artacent wound, per sq cm",,,121.53,303.83,5 HCPCS,Q4170,"Cygnus, per sq cm",,,121.53,303.83,5 HCPCS,Q4173,Palingen or palingen xplus,,,121.53,303.83,5 HCPCS,Q4175,Miroderm,,,121.53,303.83,5 HCPCS,Q4176,"Neopatch, per sq centimeter",,,121.53,303.83,5 HCPCS,Q4178,"Floweramniopatch, per sq cm",,,121.53,303.83,5 HCPCS,Q4179,"Flowerderm, per sq cm",,,121.53,303.83,5 HCPCS,Q4180,"Revita, per sq cm",,,121.53,303.83,5 HCPCS,Q4181,"Amnio wound, per square cm",,,121.53,303.83,5 HCPCS,Q4182,"Transcyte, per sq centimeter",,,121.53,303.83,5 HCPCS,Q4183,"Surgigraft, 1 sq cm",,,121.53,303.83,5 HCPCS,Q4184,"Cellesta, 1 sq cm",,,121.53,303.83,5 HCPCS,Q4186,Epifix 1 sq cm,,,121.53,303.83,5 HCPCS,Q4187,Epicord 1 sq cm,,,121.53,303.83,5 HCPCS,Q4188,Amnioarmor 1 sq cm,,,121.53,303.83,5 HCPCS,Q4190,Artacent ac 1 sq cm,,,121.53,303.83,5 HCPCS,Q4191,Restorigin 1 sq cm,,,121.53,303.83,5 HCPCS,Q4193,Coll-e-derm 1 sq cm,,,121.53,303.83,5 HCPCS,Q4194,Novachor 1 sq cm,,,121.53,303.83,5 HCPCS,Q4195,Puraply 1 sq cm,,,121.53,303.83,5 HCPCS,Q4196,Hc Sup Shell 278 Revenue Code Q4196 Hcpcs,10237.5,4095.0,,,0 HCPCS,Q4196,Puraply am 1 sq cm,,,121.53,303.83,5 HCPCS,Q4197,Puraply xt 1 sq cm,,,121.53,303.83,5 HCPCS,Q4198,Genesis amnio membrane 1sqcm,,,121.53,303.83,5 HCPCS,Q4199,"Cygnus matrix, per sq cm",,,121.53,303.83,5 HCPCS,Q4200,Skin te 1 sq cm,,,121.53,303.83,5 HCPCS,Q4201,Matrion 1 sq cm,,,121.53,303.83,5 HCPCS,Q4203,"Derma-gide, 1 sq cm",,,121.53,303.83,5 HCPCS,Q4204,Xwrap 1 sq cm,,,121.53,303.83,5 HCPCS,Q4205,Membrane graft or wrap sq cm,,,121.53,303.83,5 HCPCS,Q4208,Novafix per sq cm,,,121.53,303.83,5 HCPCS,Q4209,Surgraft per sq cm,,,121.53,303.83,5 HCPCS,Q4211,Amnion bio or axobio sq cm,,,121.53,303.83,5 HCPCS,Q4214,Cellesta cord per sq cm,,,121.53,303.83,5 HCPCS,Q4216,Artacent cord per sq cm,,,121.53,303.83,5 HCPCS,Q4217,Woundfix biowound plus xplus,,,121.53,303.83,5 HCPCS,Q4218,Surgicord per sq cm,,,121.53,303.83,5 HCPCS,Q4219,Surgigraft dual per sq cm,,,121.53,303.83,5 HCPCS,Q4220,"Bellacell HD, Surederm sq cm",,,121.53,303.83,5 HCPCS,Q4221,Amniowrap2 per sq cm,,,121.53,303.83,5 HCPCS,Q4222,"Progenamatrix, per sq cm",,,121.53,303.83,5 HCPCS,Q4225,"Amniobind, per sq cm",,,121.53,303.83,5 HCPCS,Q4227,Amniocore per sq cm,,,121.53,303.83,5 HCPCS,Q4229,Cogenex amnio memb per sq cm,,,121.53,303.83,5 HCPCS,Q4232,"Corplex, per sq cm",,,121.53,303.83,5 HCPCS,Q4234,"Xcellerate, per sq cm",,,121.53,303.83,5 HCPCS,Q4235,Amniorepair or altiply sq cm,,,121.53,303.83,5 HCPCS,Q4236,Carepatch per sq cm,,,121.53,303.83,5 HCPCS,Q4237,"cryo-cord, per sq cm",,,121.53,303.83,5 HCPCS,Q4238,"Derm-maxx, per sq cm",,,121.53,303.83,5 HCPCS,Q4239,Amnio-maxx or lite per sq cm,,,121.53,303.83,5 HCPCS,Q4247,"Amniotext patch, per sq cm",,,121.53,303.83,5 HCPCS,Q4248,Dermacyte Amn mem allo sq cm,,,121.53,303.83,5 HCPCS,Q4249,"Amniply, per sq cm",,,121.53,303.83,5 HCPCS,Q4250,AmnioAMP-MP per sq cm,,,121.53,303.83,5 HCPCS,Q4251,"Vim, per square centimeter",,,121.53,303.83,5 HCPCS,Q4252,"Vendaje, per square centimet",,,121.53,303.83,5 HCPCS,Q4253,Zenith amniotic membrane psc,,,121.53,303.83,5 HCPCS,Q4254,Novafix dl per sq cm,,,121.53,303.83,5 HCPCS,Q4255,"Reguard, topical use per sq",,,121.53,303.83,5 HCPCS,Q4256,"Mlg complet, per sq cm",,,121.53,303.83,5 HCPCS,Q4257,"Relese, per sq cm",,,121.53,303.83,5 HCPCS,Q4258,"Enverse, per sq cm",,,121.53,303.83,5 HCPCS,Q4259,Celera per sq cm,,,121.53,303.83,5 HCPCS,Q4260,"Signature apatch, per sq cm",,,121.53,303.83,5 HCPCS,Q4261,"Tag, per square centimeter",,,121.53,303.83,5 HCPCS,Q4262,"Dual layer impax, per sq cm",,,121.53,303.83,5 HCPCS,Q4263,"Surgraft tl, per sq cm",,,121.53,303.83,5 HCPCS,Q4264,"Cocoon membrane, per sq cm",,,121.53,303.83,5 HCPCS,Q4265,Neostim tl per sq cm,,,121.53,303.83,5 HCPCS,Q4266,Neostim per sq cm,,,121.53,303.83,5 HCPCS,Q4267,Neostim dl per sq cm,,,121.53,303.83,5 HCPCS,Q4268,Surgraft ft per sq cm,,,121.53,303.83,5 HCPCS,Q4269,Surgraft xt per sq cm,,,121.53,303.83,5 HCPCS,Q4270,Complete sl per sq cm,,,121.53,303.83,5 HCPCS,Q4271,Complete ft per sq cm,,,121.53,303.83,5 HCPCS,Q4272,"Esano a, per sq cm",,,121.53,303.83,5 HCPCS,Q4273,"Esano aaa, per sq cm",,,121.53,303.83,5 HCPCS,Q4274,"Esano ac, per sq cm",,,121.53,303.83,5 HCPCS,Q4275,"Esano aca, per sq cm",,,121.53,303.83,5 HCPCS,Q4276,"Orion, per sq cm",,,121.53,303.83,5 HCPCS,Q4278,"Epieffect, per sq cm",,,121.53,303.83,5 HCPCS,Q4279,"Vendaje ac, per sq cm",,,121.53,303.83,5 HCPCS,Q4280,Xcell amnio matrix per sq cm,,,121.53,303.83,5 HCPCS,Q4281,Barrera slor dl per sq cm,,,121.53,303.83,5 HCPCS,Q4282,Cygnus dual per sq cm,,,121.53,303.83,5 HCPCS,Q4283,"Biovance tri or 3l, sq cm",,,121.53,303.83,5 HCPCS,Q4284,"Dermabind sl, per sq cm",,,121.53,303.83,5 HCPCS,Q4285,Nudyn dl or dl mesh pr sq cm,,,121.53,303.83,5 HCPCS,Q4286,"Nudyn sl or slw, per sq cm",,,121.53,303.83,5 HCPCS,Q4287,"Dermabind dl, per sq cm",,,121.53,303.83,5 HCPCS,Q4288,"Dermabind ch, per sq cm",,,121.53,303.83,5 HCPCS,Q4289,"Revoshield+ amnio, per sq cm",,,121.53,303.83,5 HCPCS,Q4290,Membrane wrap hydr per sq cm,,,121.53,303.83,5 HCPCS,Q4291,"Lamellas xt, per sq cm",,,121.53,303.83,5 HCPCS,Q4292,"Lamellas, per sq cm",,,121.53,303.83,5 HCPCS,Q4293,"Acesso dl, per sq cm",,,121.53,303.83,5 HCPCS,Q4294,"Amnio quad-core, per sq cm",,,121.53,303.83,5 HCPCS,Q4295,"Amnio tri-core, per sq cm",,,121.53,303.83,5 HCPCS,Q4296,"Rebound matrix, per sq cm",,,121.53,303.83,5 HCPCS,Q4297,"Emerge matrix, per sq cm",,,121.53,303.83,5 HCPCS,Q4298,"Amnicore pro, per sq cm",,,121.53,303.83,5 HCPCS,Q4299,"Amnicore pro+, per sq cm",,,121.53,303.83,5 HCPCS,Q4300,"Acesso tl, per sq cm",,,121.53,303.83,5 HCPCS,Q4301,"Activate matrix, per sq cm",,,121.53,303.83,5 HCPCS,Q4302,"Complete aca, per sq cm",,,121.53,303.83,5 HCPCS,Q4303,"Complete aa, per sq cm",,,121.53,303.83,5 HCPCS,Q4304,"Grafix plus, per sq cm",,,121.53,303.83,5 HCPCS,Q4305,Amer am ac tri-lay per sq cm,,,121.53,303.83,5 HCPCS,Q4306,Americ amnion ac per sq cm,,,121.53,303.83,5 HCPCS,Q4307,"American amnion, per sq cm",,,121.53,303.83,5 HCPCS,Q4308,"Sanopellis, per sq cm",,,121.53,303.83,5 HCPCS,Q4309,"Via matrix, per sq cm",,,121.53,303.83,5 HCPCS,Q4311,"Acesso, per sq cm",,,121.53,303.83,5 HCPCS,Q4312,"Acesso ac, per sq cm",,,121.53,303.83,5 HCPCS,Q4313,"Dermabind fm, per sq cm",,,121.53,303.83,5 HCPCS,Q4314,"Reeva, per sq cm",,,121.53,303.83,5 HCPCS,Q4315,Regenelink amniotic mem allo,,,121.53,303.83,5 HCPCS,Q4316,"Amchoplast, per sq cm",,,121.53,303.83,5 HCPCS,Q4317,"Vitograft, per sq cm",,,121.53,303.83,5 HCPCS,Q4318,"E-graft, per sq cm",,,121.53,303.83,5 HCPCS,Q4319,"Sanograft, per sq cm",,,121.53,303.83,5 HCPCS,Q4320,"Pellograft, per sq cm",,,121.53,303.83,5 HCPCS,Q4321,"Renograft, per sq cm",,,121.53,303.83,5 HCPCS,Q4322,"Caregraft, per sq cm",,,121.53,303.83,5 HCPCS,Q4323,"Alloply, per sq cm",,,121.53,303.83,5 HCPCS,Q4324,"Amniotx, per sq cm",,,121.53,303.83,5 HCPCS,Q4325,"Acapatch, per sq cm",,,121.53,303.83,5 HCPCS,Q4326,"Woundplus, per sq cm",,,121.53,303.83,5 HCPCS,Q4327,"Duoamnion, per sq cm",,,121.53,303.83,5 HCPCS,Q4328,"Most, per sq cm",,,121.53,303.83,5 HCPCS,Q4329,"Singlay, per sq cm",,,121.53,303.83,5 HCPCS,Q4330,"Total, per sq cm",,,121.53,303.83,5 HCPCS,Q4331,"Axolotl graft, per sq cm",,,121.53,303.83,5 HCPCS,Q4332,"Axolotl dualgraft, per sq cm",,,121.53,303.83,5 HCPCS,Q4333,"Ardeograft, per sq cm",,,121.53,303.83,5 HCPCS,Q4334,"Amnioplast 1, per sq cm",,,121.53,303.83,5 HCPCS,Q4335,"Amnioplast 2, per sq cm",,,121.53,303.83,5 HCPCS,Q4336,"Artecent c, per sq cm",,,121.53,303.83,5 HCPCS,Q4337,"Artecent trident, per sq cm",,,121.53,303.83,5 HCPCS,Q4338,"Artacent velos, per sq cm",,,121.53,303.83,5 HCPCS,Q4339,"Artacent vericlen, per sq cm",,,121.53,303.83,5 HCPCS,Q4340,"Simpligraft, per sq cm",,,121.53,303.83,5 HCPCS,Q4341,"Simplimax, per sq cm",,,121.53,303.83,5 HCPCS,Q4342,"Theramend, per sq cm",,,121.53,303.83,5 HCPCS,Q4343,Dermacyte ac matrx per sq cm,,,121.53,303.83,5 HCPCS,Q4344,"Tri membrane wrap, per sq cm",,,121.53,303.83,5 HCPCS,Q4345,Matrix hd allogrft per sq cm,,,121.53,303.83,5 HCPCS,Q4346,Shelter dm matrix per sq cm,,,121.53,303.83,5 HCPCS,Q4347,Rampart dl matrix per sq cm,,,121.53,303.83,5 HCPCS,Q4348,Sentry sl matrix per sq cm,,,121.53,303.83,5 HCPCS,Q4349,Mantle dl matrix per sq cm,,,121.53,303.83,5 HCPCS,Q4350,Palisade dm matrix per sq cm,,,121.53,303.83,5 HCPCS,Q4351,"Enclose tl matrix, per sq cm",,,121.53,303.83,5 HCPCS,Q4352,"Overlay sl matrix, per sq cm",,,121.53,303.83,5 HCPCS,Q4353,Xceed tl matrix per sq cm,,,121.53,303.83,5 HCPCS,Q4354,Palingen dual-layer sq cm,,,121.53,303.83,5 HCPCS,Q4355,Abio xpl abio xpl hy p sq cm,,,121.53,303.83,5 HCPCS,Q4356,Abio mem abio hyd per sq cm,,,121.53,303.83,5 HCPCS,Q4357,"Xwrap plus, per sq cm",,,121.53,303.83,5 HCPCS,Q4358,"Xwrap dual, per sq cm",,,121.53,303.83,5 HCPCS,Q4359,"Choriply, per sq cm",,,121.53,303.83,5 HCPCS,Q4360,Amchoplast fd per sq cm,,,121.53,303.83,5 HCPCS,Q4361,"Epixpress, per sq cm",,,121.53,303.83,5 HCPCS,Q4362,"Cygnus disk, per sq cm",,,121.53,303.83,5 HCPCS,Q4363,Am bur mem hydro per sq cm,,,121.53,303.83,5 HCPCS,Q4364,Am bur xp mem xpl hy p sq cm,,,121.53,303.83,5 HCPCS,Q4365,Amnio bur dl mem per sq cm,,,121.53,303.83,5 HCPCS,Q4366,Dl amnio bur x-mem per sq cm,,,121.53,303.83,5 HCPCS,Q4367,"Amniocore sl, per sq cm",,,121.53,303.83,5 HCPCS,Q4368,Amchothick per sq cm,,,121.53,303.83,5 HCPCS,Q4369,Amnioplast 3 per sq cm,,,121.53,303.83,5 HCPCS,Q4370,Aeroguard per sq cm,,,121.53,303.83,5 HCPCS,Q4371,Neoguard per sq cm,,,121.53,303.83,5 HCPCS,Q4372,Amchoplast excl per sq cm,,,121.53,303.83,5 HCPCS,Q4373,Membrane wrp lt per sq cm,,,121.53,303.83,5 HCPCS,Q4375,Duograft ac per sq cm,,,121.53,303.83,5 HCPCS,Q4376,Duograft aa per sq cm,,,121.53,303.83,5 HCPCS,Q4377,Trigraft ft per sq cm,,,121.53,303.83,5 HCPCS,Q4378,Renew ft matrix per sq cm,,,121.53,303.83,5 HCPCS,Q4379,Amniodefend ft per sq cm,,,121.53,303.83,5 HCPCS,Q4380,Advograft one per sq cm,,,121.53,303.83,5 HCPCS,Q4382,Advograft dual per sq cm,,,121.53,303.83,5 HCPCS,Q4383,Axolotl graft ult per sq cm,,,121.53,303.83,5 HCPCS,Q4384,Axolotl dual ult per sq cm,,,121.53,303.83,5 HCPCS,Q4385,Apollo ft per sq cm,,,121.53,303.83,5 HCPCS,Q4386,Acesso trifaca per sq cm,,,121.53,303.83,5 HCPCS,Q4387,Neothelium ft per sq cm,,,121.53,303.83,5 HCPCS,Q4388,Neothelium 4l per sq cm,,,121.53,303.83,5 HCPCS,Q4389,Neothelium 4l+ per sq cm,,,121.53,303.83,5 HCPCS,Q4390,Ascendion per sq cm,,,121.53,303.83,5 HCPCS,Q4391,Amnioplast double per sq cm,,,121.53,303.83,5 HCPCS,Q4392,Grafix duo per sq cm,,,121.53,303.83,5 HCPCS,Q4393,Surgraft ac per sq cm,,,121.53,303.83,5 HCPCS,Q4394,Surgraft aca per sq cm,,,121.53,303.83,5 HCPCS,Q4395,Acelagraft per sq cm,,,121.53,303.83,5 HCPCS,Q4396,Natalin per sq cm,,,121.53,303.83,5 HCPCS,Q4397,Summit aaa per sq cm,,,121.53,303.83,5 HCPCS,Q4398,Summit ac per sq cm,,,121.53,303.83,5 HCPCS,Q4399,Summit fx per sq cm,,,121.53,303.83,5 HCPCS,Q4400,Polygon3 per sq cm,,,121.53,303.83,5 HCPCS,Q4401,Absolv3 per sq cm,,,121.53,303.83,5 HCPCS,Q4402,Xwrap 2.0 per sq cm,,,121.53,303.83,5 HCPCS,Q4403,Xwrap dual plus per sq cm,,,121.53,303.83,5 HCPCS,Q4404,Xwrap hydro plus per sq cm,,,121.53,303.83,5 HCPCS,Q4405,Xwrap fenestra plus sq cm,,,121.53,303.83,5 HCPCS,Q4406,Xwrap fenestra per sq cm,,,121.53,303.83,5 HCPCS,Q4407,Xwrap tribus per sq cm,,,121.53,303.83,5 HCPCS,Q4408,Xwrap hydro per sq cm,,,121.53,303.83,5 HCPCS,Q4409,Amniomatrixf3x per sq cm,,,121.53,303.83,5 HCPCS,Q4410,Amchomatrixdl per sq cm,,,121.53,303.83,5 HCPCS,Q4411,Amniomatrixf4x per sq cm,,,121.53,303.83,5 HCPCS,Q4412,Choriofix per sq cm,,,121.53,303.83,5 HCPCS,Q4413,Cygnus solo per sq cm,,,121.53,303.83,5 HCPCS,Q4414,Simplichor per sq cm,,,121.53,303.83,5 HCPCS,Q4415,Alexiguard st-l per sq cm,,,121.53,303.83,5 HCPCS,Q4416,Alexiguard tl-t per sq cm,,,121.53,303.83,5 HCPCS,Q4417,Alexiguard dl-t per sq cm,,,121.53,303.83,5 HCPCS,Q4420,Nuform per sq cm,,,121.53,303.83,5 HCPCS,Q4431,"Pma skin substitute, nos",,,121.53,303.83,5 HCPCS,Q4432,"510(k) skin subs, nos",,,121.53,303.83,5 HCPCS,Q4433,"361 hct/p skin subs, nos",,,121.53,303.83,5 HCPCS,Q5100,"Inj ustekinumab-kfce, 1 mg",,,3.08,30.11,5 HCPCS,Q5101,Inj filgrastim gcsf biosimil,,,0.33,0.84,9 HCPCS,Q5101,NDC Description Not Available,3.97,1.585,,,0 HCPCS,Q5101,Zarxio: 1 Blister Pack In 1 Carton (61314-318-01) / 1 Syringe In 1 Blister Pack / .5 Ml In 1 Syringe,4.02,1.61,,,0 HCPCS,Q5101,Zarxio: 1 Blister Pack In 1 Carton (61314-326-01) / 1 Syringe In 1 Blister Pack / .8 Ml In 1 Syringe,4.01,1.6,,,0 HCPCS,Q5101,Zarxio: 2 Blister Pack In 1 Carton (61314-318-10) / 5 Syringe In 1 Blister Pack (61314-318-05) / .5 Ml In 1 Syringe,1.68,0.67,,,0 HCPCS,Q5101,Zarxio: 2 Blister Pack In 1 Carton (61314-326-10) / 5 Syringe In 1 Blister Pack (61314-326-05) / .8 Ml In 1 Syringe,1.85,0.74,,,0 HCPCS,Q5103,"Inflectra: 1 Vial, Single-Use In 1 Carton (0069-0809-01) / 10 Ml In 1 Vial, Single-Use",401.3,160.52,,,0 HCPCS,Q5103,"Injection, inflectra",,,15.91,71.14,9 HCPCS,Q5104,"Injection, renflexis",,,25.65,64.12,9 HCPCS,Q5104,"Renflexis: 1 Vial In 1 Carton (78206-162-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (78206-162-99)",332.71,133.08,,,0 HCPCS,Q5105,Inj Retacrit esrd on dialysi,,,0.71,0.71,4 HCPCS,Q5106,Inj Retacrit non-esrd use,,,7.07,20.43,9 HCPCS,Q5106,NDC Description Not Available,45.35,18.14,,,0 HCPCS,Q5106,"Retacrit: 10 Vial, Multi-Dose In 1 Carton (0069-1311-10) / 1 Ml In 1 Vial, Multi-Dose (0069-1311-01)",38.37,15.35,,,0 HCPCS,Q5106,"Retacrit: 10 Vial, Single-Dose In 1 Carton (0069-1307-10) / 1 Ml In 1 Vial, Single-Dose (0069-1307-01)",40.5,16.2,,,0 HCPCS,Q5106,"Retacrit: 4 Vial, Single-Dose In 1 Carton (0069-1309-04) / 1 Ml In 1 Vial, Single-Dose (0069-1309-01)",40.5,16.2,,,0 HCPCS,Q5107,Inj mvasi 10 mg,,,28.29,70.74,9 HCPCS,Q5107,Mvasi: 1 Vial In 1 Carton (55513-206-01) / 4 Ml In 1 Vial,295.75,118.3,,,0 HCPCS,Q5107,Mvasi: 1 Vial In 1 Carton (55513-207-01) / 16 Ml In 1 Vial,295.79,118.32,,,0 HCPCS,Q5108,Fulphila: 1 Syringe In 1 Carton (83257-005-41) / .6 Ml In 1 Syringe,646.46,258.58,,,0 HCPCS,Q5108,"Injection, fulphila",,,55.96,139.91,9 HCPCS,Q5110,Nivestym,,,0.29,0.82,9 HCPCS,Q5111,"Injection, udenyca 0.5 mg",,,128.97,322.42,9 HCPCS,Q5111,Udenyca: 1 Syringe In 1 Carton (70114-101-01) / .6 Ml In 1 Syringe,1488.36,595.34,,,0 HCPCS,Q5111,Udenyca: 1 Syringe In 1 Carton (70114-130-01) / .6 Ml In 1 Syringe,1468.51,587.4,,,0 HCPCS,Q5112,Inj ontruzant 10 mg,,,28.74,81.98,9 HCPCS,Q5113,Inj herzuma 10 mg,,,55.3,138.24,9 HCPCS,Q5114,Inj ogivri 10 mg,,,29.51,73.77,9 HCPCS,Q5115,Inj truxima 10 mg,,,34.76,89.97,9 HCPCS,Q5115,"Truxima: 1 Vial, Single-Use In 1 Carton (63459-103-10) / 10 Ml In 1 Vial, Single-Use",364.16,145.66,,,0 HCPCS,Q5115,"Truxima: 1 Vial, Single-Use In 1 Carton (63459-104-50) / 50 Ml In 1 Vial, Single-Use",361.29,144.52,,,0 HCPCS,Q5116,"Inj., trazimera, 10 mg",,,10.02,28.18,9 HCPCS,Q5116,"Trazimera: 1 Kit In 1 Kit (0069-0305-01) * 20 Ml In 1 Vial, Multi-Dose (0069-0306-01) * 20 Ml In 1 Vial (0069-0307-01)",351.28,140.51,,,0 HCPCS,Q5116,Trazimera: 1 Vial In 1 Carton (0069-0308-01) / 7.15 Ml In 1 Vial,341.23,136.49,,,0 HCPCS,Q5117,"Inj., kanjinti, 10 mg",,,27.91,159.68,9 HCPCS,Q5117,"Kanjinti: 1 Vial, Multi-Dose In 1 Carton (55513-132-01) / 20 Ml In 1 Vial, Multi-Dose",410.88,164.35,,,0 HCPCS,Q5117,"Kanjinti: 1 Vial, Single-Dose In 1 Carton (55513-141-01) / 7.15 Ml In 1 Vial, Single-Dose",412.53,165.01,,,0 HCPCS,Q5118,"Inj., zirabev, 10 mg",,,25.94,64.85,9 HCPCS,Q5118,"Zirabev: 1 Vial, Single-Use In 1 Carton (0069-0315-01) / 4 Ml In 1 Vial, Single-Use",260.96,104.38,,,0 HCPCS,Q5118,"Zirabev: 1 Vial, Single-Use In 1 Carton (0069-0342-01) / 16 Ml In 1 Vial, Single-Use",262.33,104.93,,,0 HCPCS,Q5119,"Inj ruxience, 10 mg",,,5.79,24.94,9 HCPCS,Q5119,"Ruxience: 1 Vial, Single-Use In 1 Carton (0069-0238-01) / 10 Ml In 1 Vial, Single-Use",304.32,121.73,,,0 HCPCS,Q5119,"Ruxience: 1 Vial, Single-Use In 1 Carton (0069-0249-01) / 50 Ml In 1 Vial, Single-Use",306.46,122.58,,,0 HCPCS,Q5120,Inj pegfilgrastim-bmez 0.5mg,,,24.71,755.62,9 HCPCS,Q5121,"Avsola: 1 Vial, Single-Dose In 1 Carton (55513-670-01) / 10 Ml In 1 Vial, Single-Dose",211.86,84.74,,,0 HCPCS,Q5121,"Inj. avsola, 10 mg",,,19.75,86.72,9 HCPCS,Q5122,"Inj, nyvepria",,,134.25,353.22,9 HCPCS,Q5122,Nyvepria: 1 Carton In 1 Carton (0069-0324-01) / 1 Syringe In 1 Carton / .6 Ml In 1 Syringe,1439.17,575.67,,,0 HCPCS,Q5123,"Inj. riabni, 10 mg",,,21.08,52.71,9 HCPCS,Q5123,"Riabni: 1 Vial, Single-Dose In 1 Carton (55513-224-01) / 10 Ml In 1 Vial, Single-Dose",349.92,139.97,,,0 HCPCS,Q5123,"Riabni: 1 Vial, Single-Dose In 1 Carton (55513-326-01) / 50 Ml In 1 Vial, Single-Dose",349.35,139.74,,,0 HCPCS,Q5124,"Inj. byooviz, 0.1 mg",,,73.47,623.73,9 HCPCS,Q5125,"Inj, releuko 1 mcg",,,0.31,0.77,9 HCPCS,Q5126,Alymsys: 1 Vial In 1 Carton (70121-1754-1) / 4 Ml In 1 Vial,324.23,129.69,,,0 HCPCS,Q5126,Alymsys: 1 Vial In 1 Carton (70121-1755-1) / 16 Ml In 1 Vial,324.3,129.72,,,0 HCPCS,Q5126,Inj alymsys 10 mg,,,40.27,199.96,9 HCPCS,Q5127,"Inj, stimufend, 0.5 mg",,,163.95,409.87,9 HCPCS,Q5128,"Inj, cimerli, 0.1 mg",,,81.13,202.82,9 HCPCS,Q5129,"Inj, vegzelma, 10 mg",,,21.14,52.85,9 HCPCS,Q5130,Fylnetra: 1 Syringe In 1 Carton (70121-1627-1) / .6 Ml In 1 Syringe,790.12,316.05,,,0 HCPCS,Q5130,"Inj, fylnetra, 0.5 mg",,,94.29,235.73,9 HCPCS,Q5133,"Inj, tofidence, 1 mg",,,4.71,11.76,9 HCPCS,Q5134,"Inj, tyruko, 1 mg",,,24.4,60.99,5 HCPCS,Q5135,"Inj, tyenne, 1 mg",,,4.07,10.92,9 HCPCS,Q5136,"Inj. denosumab-bbdz, 1 mg",,,26.99,67.48,5 HCPCS,Q5137,"Inj, wezlana, sub cu, 1 mg",,,61.87,61.87,4 HCPCS,Q5138,"Inj, wezlana, iv, 1 mg",,,2.27,14.2,9 HCPCS,Q5142,"Inj adalimumab-ryvk, 1 mg",,,12.98,12.98,4 HCPCS,Q5144,"Inj, idacio, 1 mg",,,22.48,22.48,4 HCPCS,Q5146,"Inj, hercessi, 10 mg",,,30.26,88.2,9 HCPCS,Q5147,"Inj, aflibercept-ayyh, 1 mg",,,763.38,1908.44,9 HCPCS,Q5148,"Inj, nyposi 1 mcg",,,0.52,2.56,9 HCPCS,Q5151,"Inj, eculizumab-aagh, 2 mg",,,30.44,78.87,9 HCPCS,Q5152,"Inj, eculizumab-aeeb, 2 mg?",,,39.14,101.03,9 HCPCS,Q5157,"Inj, denosumab-bmwo, 1 mg",,,24.0,60.0,5 HCPCS,Q5158,"Inj, denosumab-bnht, 1 mg",,,28.7,71.76,5 HCPCS,Q5160,"Inj, jobevne, 10 mg",,,82.14,205.35,5 HCPCS,Q9950,Inj sulf hexa lipid microsph,,,18.72,18.72,4 HCPCS,Q9950,Lumason: 5 Kit In 1 Box (0270-7099-16) / 1 Kit In 1 Kit * 25 Mg In 1 Vial * 5 Ml In 1 Syringe,154.05,61.62,,,0 HCPCS,Q9953,"Inj fe-based mr contrast,1ml",,,0.01,0.01,4 HCPCS,Q9954,"Oral MR contrast, 100 ml",,,0.01,0.01,4 HCPCS,Q9956,"Inj octafluoropropane mic,ml",,,41.88,41.88,4 HCPCS,Q9957,"Definity: 16 Vial, Glass In 1 Carton (11994-011-16) / 1.5 Ml In 1 Vial, Glass",727.23,290.89,,,0 HCPCS,Q9957,"Definity: 4 Vial, Glass In 1 Carton (11994-011-04) / 1.5 Ml In 1 Vial, Glass",1132.19,452.88,,,0 HCPCS,Q9957,Hc Definity Perflutren/Ml,215.81,86.32,,,0 HCPCS,Q9957,"Inj perflutren lip micros,ml",,,41.88,41.88,4 HCPCS,Q9958,"Cysto-Conray Ii: 12 Bottle, Glass In 1 Box (0019-0862-50) / 250 Ml In 1 Bottle, Glass",0.66,0.26,,,0 HCPCS,Q9958,"HOCM <=149 mg/ml iodine, 1ml",,,0.08,0.08,4 HCPCS,Q9958,NDC Description Not Available,0.48,0.19,,,0 HCPCS,Q9960,"HOCM 200-249mg/ml iodine,1ml",,,0.01,0.01,4 HCPCS,Q9961,"HOCM 250-299mg/ml iodine,1ml",,,0.29,0.29,4 HCPCS,Q9962,"HOCM 300-349mg/ml iodine,1ml",,,0.01,0.01,4 HCPCS,Q9963,"HOCM 350-399mg/ml iodine,1ml",,,0.22,0.22,4 HCPCS,Q9964,"Hocm>= 400mg/ml iodine, 1ml",,,0.01,0.01,4 HCPCS,Q9965,"LOCM 100-199mg/ml iodine,1ml",,,0.93,0.93,4 HCPCS,Q9965,"Omnipaque: 10 Vial, Glass In 1 Box (0407-1411-10) / 10 Ml In 1 Vial, Glass",20.33,8.13,,,0 HCPCS,Q9965,"Omnipaque: 10 Vial, Glass In 1 Box (0407-1411-20) / 20 Ml In 1 Vial, Glass",10.53,4.21,,,0 HCPCS,Q9966,"LOCM 200-299mg/ml iodine,1ml",,,0.41,0.41,4 HCPCS,Q9966,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1412-30) / 50 Ml In 1 Bottle, Plastic",3.89,1.56,,,0 HCPCS,Q9966,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1412-34) / 150 Ml In 1 Bottle, Plastic",0.37,0.15,,,0 HCPCS,Q9967,"Iodixanol: 10 Bottle, Plastic In 1 Box (65219-383-05) / 50 Ml In 1 Bottle, Plastic (65219-383-02)",1.29,0.52,,,0 HCPCS,Q9967,"Iodixanol: 10 Bottle, Plastic In 1 Box (65219-383-10) / 100 Ml In 1 Bottle, Plastic (65219-383-04)",4.06,1.62,,,0 HCPCS,Q9967,"Iodixanol: 10 Bottle, Plastic In 1 Box (65219-383-50) / 150 Ml In 1 Bottle, Plastic (65219-383-06)",3.73,1.49,,,0 HCPCS,Q9967,"LOCM 300-399mg/ml iodine,1ml",,,0.14,0.14,4 HCPCS,Q9967,NDC Description Not Available,4.07,1.63,,,0 HCPCS,Q9967,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1413-59) / 30 Ml In 1 Bottle, Plastic",10.55,4.22,,,0 HCPCS,Q9967,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1413-61) / 50 Ml In 1 Bottle, Plastic",6.14,2.46,,,0 HCPCS,Q9967,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1413-63) / 100 Ml In 1 Bottle, Plastic",3.93,1.57,,,0 HCPCS,Q9967,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1413-65) / 150 Ml In 1 Bottle, Plastic",4.01,1.6,,,0 HCPCS,Q9967,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1414-89) / 50 Ml In 1 Bottle, Plastic",3.92,1.57,,,0 HCPCS,Q9967,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1414-91) / 100 Ml In 1 Bottle, Plastic",4.67,1.87,,,0 HCPCS,Q9967,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1414-94) / 200 Ml In 1 Bottle, Plastic",7.13,2.85,,,0 HCPCS,Q9967,"Omnipaque: 10 Vial, Glass In 1 Box (0407-1413-10) / 10 Ml In 1 Vial, Glass",15.8,6.32,,,0 HCPCS,Q9967,"Visipaque: 10 Bottle, Plastic In 1 Box (0407-2223-16) / 50 Ml In 1 Bottle, Plastic",6.33,2.53,,,0 HCPCS,Q9967,"Visipaque: 10 Bottle, Plastic In 1 Box (0407-2223-17) / 100 Ml In 1 Bottle, Plastic",1.88,0.75,,,0 HCPCS,Q9967,"Visipaque: 10 Bottle, Plastic In 1 Box (0407-2223-19) / 150 Ml In 1 Bottle, Plastic",3.92,1.57,,,0 HCPCS,Q9967,"Visipaque: 10 Bottle, Plastic In 1 Box (0407-2223-21) / 200 Ml In 1 Bottle, Plastic",1.68,0.67,,,0 HCPCS,Q9968,"Isosulfan Blue: 6 Vial, Glass In 1 Carton (67457-220-05) / 5 Ml In 1 Vial, Glass (67457-220-00)",108.33,43.33,,,0 HCPCS,Q9968,Methylene Blue: 5 Vial In 1 Carton (70710-1838-5) / 10 Ml In 1 Vial (70710-1838-1),899.65,359.86,,,0 HCPCS,Q9968,NDC Description Not Available,107.83,43.13,,,0 HCPCS,Q9968,Provayblue: 5 Ampule In 1 Carton (0517-0374-05) / 10 Ml In 1 Ampule (0517-0374-01),14.29,5.72,,,0 HCPCS,Q9968,"Provayblue: 5 Vial, Single-Dose In 1 Carton (0517-0381-05) / 10 Ml In 1 Vial, Single-Dose (0517-0381-01)",12.47,4.99,,,0 HCPCS,Q9968,Visualization adjunct,,,8.54,21.35,5 HCPCS,Q9969,5 VIAL in 1 CARTON (65857-500-05) / 5 mL in 1 VIAL,0.01,0.004,,,0 HCPCS,Q9969,"Artiss Fibrin Sealant: 1 Syringe, Plastic In 1 Carton (0338-8503-10) / 10 Ml In 1 Syringe, Plastic (0338-8503-09)",0.01,0.004,,,0 HCPCS,Q9969,Ceretec: 1 KIT in 1 CARTON (17156-023-05) * 5 VIAL in 1 TRAY / 1 mL in 1 VIAL * 5 VIAL in 1 TRAY / 4.5 mL in 1 VIAL * 5 VIAL in 1 TRAY (17156-022-05) / 5 mL in 1 VIAL,0.01,0.004,,,0 HCPCS,Q9969,"Draximage Dtpa: 30 Injection, Powder, Lyophilized, For Solution In 1 Kit (65174-288-30)",0.01,0.004,,,0 HCPCS,Q9969,"Draximage Maa: 30 Injection, Powder, For Solution In 1 Kit (65174-270-30)",0.01,0.004,,,0 HCPCS,Q9969,Hc Tc-99M Radiopharmaceutical Add On,0.01,0.004,,,0 HCPCS,Q9969,"Kit For The Preparation Of Lymphoseek (Technetium Tc 99M Tilmanocept): 1 Kit In 1 Carton (65857-425-05) / 1 Kit In 1 Kit * 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (65857-400-01)",0.01,0.004,,,0 HCPCS,Q9969,"Kit For The Preparation Of Technetium Tc 99M Mebrofenin: 30 Vial, Multi-Dose In 1 Kit (45567-0455-2) / 10 Ml In 1 Vial, Multi-Dose",0.01,0.004,,,0 HCPCS,Q9969,"Kit For The Preparation Of Technetium Tc 99M Medronate: 10 Injection, Powder, Lyophilized, For Solution In 1 Carton (65857-505-10)",0.01,0.004,,,0 HCPCS,Q9969,Kit For The Preparation Of Technetium Tc99M Sestamibi: 20 Vial In 1 Carton (65857-500-20) / 5 Ml In 1 Vial,0.01,0.004,,,0 HCPCS,Q9969,Kit For The Prepartion Of Technetium Tc99M Sulfur Colloid: 1 Kit In 1 Package (45567-0030-1) * 3 Ml In 1 Vial * 3 Ml In 1 Vial * 10 Ml In 1 Vial,0.01,0.004,,,0 HCPCS,Q9969,NDC Description Not Available,0.01,0.004,,,0 HCPCS,Q9969,"Nephroscan: 5 Vial, Single-Dose In 1 Carton (71083-0020-5) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose (71083-0020-1)",0.01,0.004,,,0 HCPCS,Q9969,"Pulmotech Maa: 30 Vial, Multi-Dose In 1 Carton (69945-139-40) / 15 Ml In 1 Vial, Multi-Dose (69945-139-10)",0.01,0.004,,,0 HCPCS,Q9969,"Technescan Mag3: 5 Vial In 1 Cello Pack (69945-096-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",0.01,0.004,,,0 HCPCS,Q9969,"Ultra-Technekow V4: 1 Injection, Solution In 1 Carton (69945-140-13)",0.01,0.004,,,0 HCPCS,Q9982,flutemetamol f18 diagnostic,,,1944.01,4860.02,9 HCPCS,Q9983,florbetaben f18 diagnostic,,,1584.67,3961.68,9 HCPCS,Q9991,Buprenorph xr 100 mg or less,,,1925.23,5150.33,9 HCPCS,Q9991,Sublocade: 1 Pouch In 1 Carton (12496-0300-1) / 1 Syringe In 1 Pouch (12496-0300-2) / 1 Solution In 1 Syringe (12496-0300-5),335.73,134.29,,,0 HCPCS,Q9992,Buprenorphine xr over 100 mg,,,1925.23,5150.33,9 HCPCS,Q9996,Ustekinumab- ttwe sub cu inj,,,64.78,64.78,4 HCPCS,Q9997,Ustekinumab-ttwe iv inj 1 mg,,,8.59,21.48,9 HCPCS,Q9998,Ustekinumab-aekn inj,,,10.48,52.7,9 HCPCS,Q9999,Inj ustekinumab-aauz 1 mg,,,12.97,40.21,9 HCPCS,S0012,"Butorphanal tartrate, nasal spray, 25 mg",,,60.63,60.63,4 HCPCS,S0014,"Tacrine HCl, 10mg",,,0.01,0.01,4 HCPCS,S0023,"Injection, cimetidine HCl, 300 mg",,,0.01,0.01,4 HCPCS,S0040,"Injection, ticarcillin disodium and clavulanate potassium, 3.1 g",,,0.01,0.01,4 HCPCS,S0074,"Injection, cefotetan disodium, 500 mg",,,11.98,11.98,4 HCPCS,S0078,"Injection, fosphenytoin sodium, 750 mg",,,39.75,39.75,4 HCPCS,S0080,"Injection, pentamidine isethonate, 300 mg",,,97.7,97.7,4 HCPCS,S0081,"Injection, piperacillin sodium, 500 mg",,,0.01,0.01,4 HCPCS,S0088,"Imatinib, 100 mg",,,2.97,2.97,4 HCPCS,S0090,"Sildenafil citrate, 25 mg",,,0.27,0.27,4 HCPCS,S0091,"Granisetron HCl, 1mg (for circumstances falling under the Medicare Statute, use Q0166)",,,3.0,3.0,4 HCPCS,S0092,"Injection, hydromorphone HCl, 250 mg (loading dose for infusion pump)",,,83.4,83.4,4 HCPCS,S0093,"Injection, morphine sulfate, 500mg (loding dose for infusion pump)",,,8.48,8.48,4 HCPCS,S0104,"Zidovudine, oral, 100 mg",,,1.51,1.51,4 HCPCS,S0106,"Buproprion HCl sustained release tablit, 150 mg, per bottle of 60 tablets",,,15.39,15.39,4 HCPCS,S0108,"Mercaptopuine, oral, 50 mg",,,2.85,2.85,4 HCPCS,S0109,"Methadone, oral, 5 mg",,,0.31,0.31,4 HCPCS,S0117,"Tretinoin, topical, 5 g",,,3.75,3.75,4 HCPCS,S0122,"Injection, menotropins, 75 IU",,,242.75,242.75,4 HCPCS,S0126,"Injection, follitropin alfa, 75 IU",,,241.51,241.51,4 HCPCS,S0128,"Injection, follitropin beta, 75 IU",,,217.5,217.5,4 HCPCS,S0132,"Injection, ganirelix acetate, 250 mcg",,,184.0,184.0,4 HCPCS,S0136,"Clozapine, 25 mg",,,0.65,0.65,4 HCPCS,S0137,"Didanosine (ddI), 25 mg",,,0.01,0.01,4 HCPCS,S0138,"Finasteride, 5 mg",,,0.15,0.15,4 HCPCS,S0139,"Minoxidil, 10 mg",,,0.46,0.46,4 HCPCS,S0140,"Saquinavir, 200 mg",,,0.01,0.01,4 HCPCS,S0145,"pegylated interferon alfa-2a, 180 mcg/ ml",,,1113.42,1113.42,4 HCPCS,S0148,Peg interferon alfa-2B/10,,,0.01,0.01,4 HCPCS,S0155,"Sterile dilutant for epoprostenol, 50 ml",,,14.5,14.5,4 HCPCS,S0156,"Exemestane, 25 mg",,,1.67,1.67,4 HCPCS,S0157,"Becaplermin gel 0.01%, 0.5 gm",,,45.32,45.32,4 HCPCS,S0160,"Dextoamphetamine sulfate, 5 mg",,,0.69,0.69,4 HCPCS,S0169,Calcitrol,,,0.27,0.27,4 HCPCS,S0170,"Anastrozole, oral, 1 mg",,,0.48,0.48,4 HCPCS,S0172,"Chlorambucil, oral, 2 mg",,,264.15,264.15,4 HCPCS,S0174,"Dolasetron mesylate, oral 50 mg (for circumstances falling under the medicare statute, use q0180)",,,29.56,29.56,4 HCPCS,S0176,"Hydroxyurea, oral, 500 mg",,,0.4,0.4,4 HCPCS,S0178,"Lomustine, oral, 10 mg",,,121.49,121.49,4 HCPCS,S0179,"Megestrol acetate, oral, 20 mg",,,0.28,0.28,4 HCPCS,S0182,"Procarbazine HCl, oral, 50 mg",,,148.52,148.52,4 HCPCS,S0183,"Prochlorperazine maleate, oral, 5 mg (for circumstances falling under the medicare statute, use q0164)",,,0.35,0.35,4 HCPCS,S0187,"Tamoxifen citrate, oral, 10 mg",,,0.19,0.19,4 HCPCS,S0189,"testosterone pellet, 75 mg",,,105.13,105.13,4 HCPCS,S0190,"Mitepristone, oral, 200 mg",,,43.0,43.0,4 HCPCS,S0191,"Misoprostol, oral, 200 mcg",,,0.97,0.97,4 HCPCS,S0194,"Dialysis/stress vitamin supplement, oral, 100 capsules",,,9.85,9.85,4 HCPCS,S3620,Newborn metabolic screening,,,0.01,0.01,4 HCPCS,S3865,Comp genet test hyp cardiomy,,,28.2,28.2,4 HCPCS,S3866,Spec gene test hyp cardiomy,,,28.2,28.2,4 HCPCS,S3870,CGH test developmental delay,,,28.2,28.2,4 HCPCS,S4991,Nicotine patch nonlegend,,,1.78,1.78,4 HCPCS,S4993,Contraceptive pills for bc,,,0.78,0.78,4 HCPCS,S5010,5% dextrose and 0.45% saline,,,7.9,7.9,4 HCPCS,S5012,5% dextrose with potassium,,,4.75,4.75,4 HCPCS,S5550,Insulin rapid 5 u,,,0.23,0.23,4 HCPCS,S5551,Insulin most rapid 5 u,,,0.43,0.43,4 HCPCS,S5552,Insulin intermed 5 u,,,0.23,0.23,4 HCPCS,S5553,Insulin long acting 5 u,,,0.97,0.97,4 HCPCS,S5566,Insulin cartridge 300 u,,,26.87,26.87,4 HCPCS,S5570,Insulin dispos pen 1.5 ml,,,100.0,100.0,4 HCPCS,S5571,Insulin dispos pen 3 ml,,,31.82,31.82,4 HCPCS,S9480,"Hc Intensive Op Psychiatric Svc, Per Diem",718.0,287.2,,,0 HCPCS,T1017,Hc Client Bill Only - New Pump Training,424.0,169.6,,,0 HCPCS,T1018,Hc Client Bill Only - Currently Pumping Training,371.0,148.4,,,0 HCPCS,T1019,Hc Saline Start Only,371.0,148.4,,,0 HCPCS,T1020,Hc Client Bill Only - Group Training,265.0,106.0,,,0 HCPCS,T1021,Hc Client Bill Only - Upgrade Training From Non-Tandem Pump Or/Only A Saline Start,371.0,148.4,,,0 HCPCS,U0001,2019 nCoV diagnostic P,,,14.37,89.8,16 HCPCS,U0002,COVID-19 lab test non-CDC,,,20.52,128.28,16 HCPCS,U0002,Hc 082 Covid-19 Rt Pcr Noncdc-So+,61.57,24.63,,,0 HCPCS,U0002,Hc Sars-2 Cov 19,72.69,29.08,,,0 HCPCS,U0003,Cov-19 amp prb hgh thruput,,,20.52,20.52,4 HCPCS,U0004,Cov-19 test non-cdc hgh thru,,,20.52,20.52,4 HCPCS,U0005,Hc Covid-19 Htp Comp 2Days Add-On,0.01,0.004,,,0 HCPCS,U0005,Infec agen detec ampli probe,,,10.0,10.0,4 HCPCS,V2524,Cntct lens hydrophil photoch,,,154.45,386.12,4 HCPCS,V2630,Hc Sup Shell 276 Revenue Code V2630 Hcpcs,334.69,133.88,,,0 HCPCS,V2632,Hc Sup Shell 276 Revenue Code V2632 Hcpcs,592.595,237.04000000000002,,,0 HCPCS,V2785,Hc Sup Shell 278 Revenue Code V2785 Hcpcs,18250.31,7300.12,,,0 HCPCS,V2787,Hc Sup Shell 276 Revenue Code V2787 Hcpcs,1988.44,795.38,,,0 HCPCS,V2788,Hc Sup Shell 278 Revenue Code V2788 Hcpcs,3839.06,1535.62,,,0 HCPCS,V2790,Hc Sup Shell 278 Revenue Code V2790 Hcpcs,3029.91,1211.9650000000001,,,0 MS-DRG,001,Heart Transplant Or Implant Of Heart Assist System With Mcc,,,201295.67,403796.38,21 MS-DRG,002,Heart Transplant Or Implant Of Heart Assist System Without Mcc,,,81396.32,163279.91,21 MS-DRG,003,"Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Neck With Major",,,152460.61,305833.91,21 MS-DRG,004,"Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Neck Without Major O.R.",,,99494.61,199584.82,21 MS-DRG,005,Liver Transplant With Mcc Or Intestinal Transplant,,,74060.32,148563.99,21 MS-DRG,006,Liver Transplant Without Mcc,,,33307.57,66814.53,21 MS-DRG,007,Lung Transplant,,,93021.29,186599.43,21 MS-DRG,008,"Simultaneous Pancreas, Islet Cell And Kidney Transplant",,,40257.84,80756.68,21 MS-DRG,010,Pancreas Or Islet Cell Transplant,,,51543.05,103394.66,21 MS-DRG,011,"Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc",,,39176.8,78588.13,21 MS-DRG,012,"Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc",,,30283.53,60748.34,21 MS-DRG,013,"Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc",,,20699.97,41523.86,21 MS-DRG,014,Allogeneic Bone Marrow Transplant,,,86324.58,173165.92,21 MS-DRG,016,Autologous Bone Marrow Transplant With Cc/Mcc,,,42593.04,85441.05,21 MS-DRG,017,Autologous Bone Marrow Transplant Without Cc/Mcc,,,39020.21,78274.01,21 MS-DRG,018,Chimeric Antigen Receptor (Car) T-Cell And Other Immunotherapies,,,310182.05,622220.97,21 MS-DRG,019,"Simultaneous Pancreas, Islet Cell And Kidney Transplant With Hemodialysis",,,51247.83,102802.45,21 MS-DRG,020,Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc,,,56521.59,113381.54,21 MS-DRG,021,Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc,,,38025.37,76278.36,21 MS-DRG,022,Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/Mcc,,,22823.26,45783.16,21 MS-DRG,023,Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis With Mcc Or Antineopla,,,41160.74,82567.89,21 MS-DRG,024,Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Without Mcc,,,28099.18,56366.57,21 MS-DRG,025,Craniotomy And Endovascular Intracranial Procedures With Mcc,,,32658.95,65513.4,21 MS-DRG,026,Craniotomy And Endovascular Intracranial Procedures With Cc,,,22333.38,44800.46,21 MS-DRG,027,Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc,,,18121.99,36352.47,21 MS-DRG,028,Spinal Procedures With Mcc,,,43157.62,86573.59,21 MS-DRG,029,Spinal Procedures With Cc Or Spinal Neurostimulators,,,24505.52,49157.74,21 MS-DRG,030,Spinal Procedures Without Cc/Mcc,,,15768.12,31630.64,21 MS-DRG,031,Ventricular Shunt Procedures With Mcc,,,32183.43,64559.52,21 MS-DRG,032,Ventricular Shunt Procedures With Cc,,,15306.97,30705.58,21 MS-DRG,033,Ventricular Shunt Procedures Without Cc/Mcc,,,11944.61,23960.73,21 MS-DRG,034,Carotid Artery Stent Procedures With Mcc,,,27803.24,55772.92,21 MS-DRG,035,Carotid Artery Stent Procedures With Cc,,,17170.96,34444.71,21 MS-DRG,036,Carotid Artery Stent Procedures Without Cc/Mcc,,,13955.13,27993.81,21 MS-DRG,037,Extracranial Procedures With Mcc,,,23647.15,47435.87,21 MS-DRG,038,Extracranial Procedures With Cc,,,11655.14,23380.04,21 MS-DRG,039,Extracranial Procedures Without Cc/Mcc,,,8443.62,16937.78,21 MS-DRG,040,"Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc",,,27735.0,55636.03,21 MS-DRG,041,"Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Peripheral Neurostimulator",,,15793.26,31681.07,21 MS-DRG,042,"Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/Mcc",,,12410.07,24894.43,21 MS-DRG,052,Spinal Disorders And Injuries With Cc/Mcc,,,13010.57,26099.02,21 MS-DRG,053,Spinal Disorders And Injuries Without Cc/Mcc,,,7033.59,14421.66,21 MS-DRG,054,Nervous System Neoplasms With Mcc,,,10967.72,22001.1,21 MS-DRG,055,Nervous System Neoplasms Without Mcc,,,7323.79,14929.04,21 MS-DRG,056,Degenerative Nervous System Disorders With Mcc,,,16686.83,33473.55,21 MS-DRG,057,Degenerative Nervous System Disorders Without Mcc,,,9306.29,18668.3,21 MS-DRG,058,Multiple Sclerosis And Cerebellar Ataxia With Mcc,,,12279.34,24632.19,21 MS-DRG,059,Multiple Sclerosis And Cerebellar Ataxia With Cc,,,8913.38,17880.13,21 MS-DRG,060,Multiple Sclerosis And Cerebellar Ataxia Without Cc/Mcc,,,6606.92,13675.7,21 MS-DRG,061,"Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic Agent With Mcc",,,19804.25,39727.05,21 MS-DRG,062,"Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic Agent With Cc",,,12621.97,25319.49,21 MS-DRG,063,"Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic Agent Without Cc/Mcc",,,10083.5,20227.35,21 MS-DRG,064,Intracranial Hemorrhage Or Cerebral Infarction With Mcc,,,14445.01,28976.5,21 MS-DRG,065,Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours,,,7256.98,14812.23,21 MS-DRG,066,Intracranial Hemorrhage Or Cerebral Infarction Without Cc/Mcc,,,4916.05,10719.42,21 MS-DRG,067,Precerebral Occlusion Without Infarction With Mcc,,,10549.67,21162.5,21 MS-DRG,068,Precerebral Occlusion Without Infarction Without Mcc,,,6208.99,12979.95,21 MS-DRG,069,Transient Ischemia Without Thrombolytic,,,5737.78,12156.1,21 MS-DRG,070,Other Cerebrovascular Disorders With Mcc,,,11958.26,23988.1,21 MS-DRG,071,Other Cerebrovascular Disorders With Cc,,,7369.76,15009.4,21 MS-DRG,072,Other Cerebrovascular Disorders Without Cc/Mcc,,,5431.78,11621.12,21 MS-DRG,073,Cranial And Peripheral Nerve Disorders With Mcc,,,11523.69,23116.36,21 MS-DRG,074,Cranial And Peripheral Nerve Disorders Without Mcc,,,7404.24,15069.69,21 MS-DRG,075,Viral Meningitis With Cc/Mcc,,,13773.4,27629.26,21 MS-DRG,076,Viral Meningitis Without Cc/Mcc,,,5927.41,12487.65,21 MS-DRG,077,Hypertensive Encephalopathy With Mcc,,,,,0 MS-DRG,078,Hypertensive Encephalopathy With Cc,,,,,0 MS-DRG,079,Hypertensive Encephalopathy Without Cc/Mcc,,,,,0 MS-DRG,080,Nontraumatic Stupor And Coma With Mcc,,,13001.23,26080.29,21 MS-DRG,081,Nontraumatic Stupor And Coma Without Mcc,,,6433.09,13371.78,21 MS-DRG,082,Traumatic Stupor And Coma >1 Hour With Mcc,,,16417.46,32933.21,21 MS-DRG,083,Traumatic Stupor And Coma >1 Hour With Cc,,,10026.03,20112.08,21 MS-DRG,084,Traumatic Stupor And Coma >1 Hour Without Cc/Mcc,,,6865.51,14127.8,21 MS-DRG,085,Traumatic Stupor And Coma <1 Hour With Mcc,,,16319.06,32735.81,21 MS-DRG,086,Traumatic Stupor And Coma <1 Hour With Cc,,,9357.29,18770.6,21 MS-DRG,087,Traumatic Stupor And Coma <1 Hour Without Cc/Mcc,,,6570.29,13611.64,21 MS-DRG,088,Concussion With Mcc,,,9709.98,19478.09,21 MS-DRG,089,Concussion With Cc,,,7891.24,15921.15,21 MS-DRG,090,Concussion Without Cc/Mcc,,,5913.05,12462.54,21 MS-DRG,091,Other Disorders Of Nervous System With Mcc,,,12614.78,25305.09,21 MS-DRG,092,Other Disorders Of Nervous System With Cc,,,7348.21,14971.72,21 MS-DRG,093,Other Disorders Of Nervous System Without Cc/Mcc,,,5719.82,12124.71,21 MS-DRG,094,Bacterial And Tuberculous Infections Of Nervous System With Mcc,,,25279.85,50711.03,21 MS-DRG,095,Bacterial And Tuberculous Infections Of Nervous System With Cc,,,18526.39,37163.69,21 MS-DRG,096,Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc,,,18526.39,37163.69,21 MS-DRG,097,Non-Bacterial Infection Of Nervous System Except Viral Meningitis With Mcc,,,25943.56,52042.43,21 MS-DRG,098,Non-Bacterial Infection Of Nervous System Except Viral Meningitis With Cc,,,16484.27,33067.21,21 MS-DRG,099,Non-Bacterial Infection Of Nervous System Except Viral Meningitis Without Cc/Mcc,,,9786.12,19630.82,21 MS-DRG,100,Seizures With Mcc,,,13912.03,27907.35,21 MS-DRG,101,Seizures Without Mcc,,,6483.38,13459.68,21 MS-DRG,102,Headaches With Mcc,,,8051.42,16201.2,21 MS-DRG,103,Headaches Without Mcc,,,6007.14,12627.06,21 MS-DRG,113,Orbital Procedures With Cc/Mcc,,,16887.95,33877.0,21 MS-DRG,114,Orbital Procedures Without Cc/Mcc,,,9718.6,19495.38,21 MS-DRG,115,Extraocular Procedures Except Orbit,,,11025.19,22116.37,21 MS-DRG,116,Intraocular Procedures With Cc/Mcc,,,12987.58,26052.91,21 MS-DRG,117,Intraocular Procedures Without Cc/Mcc,,,7792.84,15749.1,21 MS-DRG,121,Acute Major Eye Infections With Cc/Mcc,,,8355.98,16761.99,21 MS-DRG,122,Acute Major Eye Infections Without Cc/Mcc,,,5644.4,11992.84,21 MS-DRG,123,Neurological Eye Disorders,,,5736.34,12153.6,21 MS-DRG,124,Other Disorders Of The Eye With Mcc Or Thrombolytic Agent,,,9503.83,19064.55,21 MS-DRG,125,Other Disorders Of The Eye Without Mcc,,,5515.11,11766.8,21 MS-DRG,135,Sinus And Mastoid Procedures With Cc/Mcc,,,15587.11,31267.53,21 MS-DRG,136,Sinus And Mastoid Procedures Without Cc/Mcc,,,7292.9,14875.04,21 MS-DRG,137,Mouth Procedures With Cc/Mcc,,,10725.66,21515.52,21 MS-DRG,138,Mouth Procedures Without Cc/Mcc,,,6365.57,13253.73,21 MS-DRG,139,Salivary Gland Procedures,,,8876.03,17805.2,21 MS-DRG,140,Major Head And Neck Procedures With Mcc,,,30637.65,61458.71,21 MS-DRG,141,Major Head And Neck Procedures With Cc,,,15666.84,31427.47,21 MS-DRG,142,Major Head And Neck Procedures Without Cc/Mcc,,,11466.94,23002.53,21 MS-DRG,143,"Other Ear, Nose, Mouth And Throat O.R. Procedures With Mcc",,,26911.83,53984.76,21 MS-DRG,144,"Other Ear, Nose, Mouth And Throat O.R. Procedures With Cc",,,12447.42,24969.36,21 MS-DRG,145,"Other Ear, Nose, Mouth And Throat O.R. Procedures Without Cc/Mcc",,,8636.12,17323.94,21 MS-DRG,146,"Ear, Nose, Mouth And Throat Malignancy With Mcc",,,15209.28,30509.62,21 MS-DRG,147,"Ear, Nose, Mouth And Throat Malignancy With Cc",,,9133.18,18321.04,21 MS-DRG,148,"Ear, Nose, Mouth And Throat Malignancy Without Cc/Mcc",,,5725.57,12134.76,21 MS-DRG,149,Dysequilibrium,,,5398.74,11563.35,21 MS-DRG,150,Epistaxis With Mcc,,,9564.16,19185.58,21 MS-DRG,151,Epistaxis Without Mcc,,,5272.32,11342.32,21 MS-DRG,152,Otitis Media And Uri With Mcc,,,8491.74,17034.32,21 MS-DRG,153,Otitis Media And Uri Without Mcc,,,5302.49,11395.06,21 MS-DRG,154,"Other Ear, Nose, Mouth And Throat Diagnoses With Mcc",,,11230.62,22528.47,21 MS-DRG,155,"Other Ear, Nose, Mouth And Throat Diagnoses With Cc",,,6583.22,13634.25,21 MS-DRG,156,"Other Ear, Nose, Mouth And Throat Diagnoses Without Cc/Mcc",,,4964.17,10803.56,21 MS-DRG,157,Dental And Oral Diseases With Mcc,,,12331.77,24737.37,21 MS-DRG,158,Dental And Oral Diseases With Cc,,,6535.09,13550.1,21 MS-DRG,159,Dental And Oral Diseases Without Cc/Mcc,,,5089.16,11022.08,21 MS-DRG,163,Major Chest Procedures With Mcc,,,32192.77,64578.26,21 MS-DRG,164,Major Chest Procedures With Cc,,,18129.89,36368.32,21 MS-DRG,165,Major Chest Procedures Without Cc/Mcc,,,13749.7,27581.71,21 MS-DRG,166,Other Respiratory System O.R. Procedures With Mcc,,,26847.9,53856.52,21 MS-DRG,167,Other Respiratory System O.R. Procedures With Cc,,,12953.82,25985.19,21 MS-DRG,168,Other Respiratory System O.R. Procedures Without Cc/Mcc,,,9814.85,19688.46,21 MS-DRG,173,Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary Embolism,,,21379.48,42886.95,21 MS-DRG,175,Pulmonary Embolism With Mcc Or Acute Cor Pulmonale,,,9866.57,19792.2,21 MS-DRG,176,Pulmonary Embolism Without Mcc,,,5782.32,12233.97,21 MS-DRG,177,Respiratory Infections And Inflammations With Mcc,,,11224.87,22516.94,21 MS-DRG,178,Respiratory Infections And Inflammations With Cc,,,7010.61,14381.48,21 MS-DRG,179,Respiratory Infections And Inflammations Without Cc/Mcc,,,5423.17,11606.06,21 MS-DRG,180,Respiratory Neoplasms With Mcc,,,12685.18,25446.29,21 MS-DRG,181,Respiratory Neoplasms With Cc,,,7692.99,15574.53,21 MS-DRG,182,Respiratory Neoplasms Without Cc/Mcc,,,5414.55,11590.98,21 MS-DRG,183,Major Chest Trauma With Mcc,,,10989.27,22044.33,21 MS-DRG,184,Major Chest Trauma With Cc,,,7643.43,15487.89,21 MS-DRG,185,Major Chest Trauma Without Cc/Mcc,,,5649.43,12001.64,21 MS-DRG,186,Pleural Effusion With Mcc,,,11194.71,22456.43,21 MS-DRG,187,Pleural Effusion With Cc,,,7104.71,14546.0,21 MS-DRG,188,Pleural Effusion Without Cc/Mcc,,,5151.65,11131.34,21 MS-DRG,189,Pulmonary Edema And Respiratory Failure,,,8873.88,17800.88,21 MS-DRG,190,Chronic Obstructive Pulmonary Disease With Mcc,,,7956.61,16035.44,21 MS-DRG,191,Chronic Obstructive Pulmonary Disease With Cc,,,6055.27,12711.2,21 MS-DRG,192,Chronic Obstructive Pulmonary Disease Without Cc/Mcc,,,4611.49,10186.94,21 MS-DRG,193,Simple Pneumonia And Pleurisy With Mcc,,,9441.34,18939.19,21 MS-DRG,194,Simple Pneumonia And Pleurisy With Cc,,,5788.78,12245.28,21 MS-DRG,195,Simple Pneumonia And Pleurisy Without Cc/Mcc,,,4514.52,10017.39,21 MS-DRG,196,Interstitial Lung Disease With Mcc,,,13555.76,27192.66,21 MS-DRG,197,Interstitial Lung Disease With Cc,,,6817.39,14043.66,21 MS-DRG,198,Interstitial Lung Disease Without Cc/Mcc,,,5144.46,11118.78,21 MS-DRG,199,Pneumothorax With Mcc,,,12671.53,25418.92,21 MS-DRG,200,Pneumothorax With Cc,,,7896.27,15929.94,21 MS-DRG,201,Pneumothorax Without Cc/Mcc,,,5136.56,11104.96,21 MS-DRG,202,Bronchitis And Asthma With Cc/Mcc,,,6976.13,14321.2,21 MS-DRG,203,Bronchitis And Asthma Without Cc/Mcc,,,4812.61,10538.58,21 MS-DRG,204,Respiratory Signs And Symptoms,,,5799.55,12264.12,21 MS-DRG,205,Other Respiratory System Diagnoses With Mcc,,,13152.07,26382.88,21 MS-DRG,206,Other Respiratory System Diagnoses Without Mcc,,,6759.92,13943.19,21 MS-DRG,207,Respiratory System Diagnosis With Ventilator Support >96 Hours,,,46220.45,92717.59,21 MS-DRG,208,Respiratory System Diagnosis With Ventilator Support <=96 Hours,,,19743.91,39606.02,21 MS-DRG,209,Complex Aortic Arch Procedures,,,81302.94,163092.59,21 MS-DRG,210,Cardiac Pacemaker Revision Or Device Replacement With Mcc,,,,,0 MS-DRG,211,Cardiac Pacemaker Revision Or Device Replacement Without Mcc,,,,,0 MS-DRG,212,Concomitant Aortic And Mitral Valve Procedures,,,78108.66,156684.91,21 MS-DRG,213,Endovascular Abdominal Aorta With Iliac Branch Procedures,,,40992.66,82230.72,21 MS-DRG,215,Other Heart Assist System Implant,,,71521.13,143470.41,21 MS-DRG,216,Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization With Mcc,,,70269.85,140960.37,21 MS-DRG,217,Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization With Cc,,,47230.38,94743.5,21 MS-DRG,218,Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization Without Cc/Mcc,,,47230.38,94743.5,21 MS-DRG,219,Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheterization With Mcc,,,55153.23,110636.62,21 MS-DRG,220,Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheterization With Cc,,,38305.5,76840.32,21 MS-DRG,221,Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheterization Without Cc/M,,,36203.76,72624.24,21 MS-DRG,228,Other Cardiothoracic Procedures With Mcc,,,35537.17,71287.09,21 MS-DRG,229,Other Cardiothoracic Procedures Without Mcc,,,22622.86,45381.15,21 MS-DRG,231,Coronary Bypass With Ptca With Mcc,,,60551.97,121466.43,21 MS-DRG,232,Coronary Bypass With Ptca Without Mcc,,,43547.66,87356.0,21 MS-DRG,233,Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc,,,54915.47,110159.69,21 MS-DRG,234,Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc,,,39238.57,78712.04,21 MS-DRG,235,Coronary Bypass Without Cardiac Catheterization With Mcc,,,42154.15,84560.66,21 MS-DRG,236,Coronary Bypass Without Cardiac Catheterization Without Mcc,,,30088.15,60356.42,21 MS-DRG,239,Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc,,,35352.57,70916.78,21 MS-DRG,240,Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc,,,20475.14,41072.85,21 MS-DRG,241,Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc/Mcc,,,9944.15,19947.82,21 MS-DRG,242,Permanent Cardiac Pacemaker Implant With Mcc,,,22933.88,46005.06,21 MS-DRG,243,Permanent Cardiac Pacemaker Implant With Cc,,,15306.25,30704.14,21 MS-DRG,244,Permanent Cardiac Pacemaker Implant Without Cc/Mcc,,,12983.27,26044.27,21 MS-DRG,245,Aicd Generator Procedures,,,32771.72,65739.62,21 MS-DRG,250,Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc,,,15676.9,31447.64,21 MS-DRG,251,Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc,,,10734.99,21534.25,21 MS-DRG,252,Other Vascular Procedures With Mcc,,,25056.46,50262.91,21 MS-DRG,253,Other Vascular Procedures With Cc,,,18644.19,37400.0,21 MS-DRG,254,Other Vascular Procedures Without Cc/Mcc,,,12797.95,25672.52,21 MS-DRG,255,Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc,,,19375.42,38866.84,21 MS-DRG,256,Upper Limb And Toe Amputation For Circulatory System Disorders With Cc,,,12196.02,24465.04,21 MS-DRG,257,Upper Limb And Toe Amputation For Circulatory System Disorders Without Cc/Mcc,,,7845.27,15840.78,21 MS-DRG,258,Cardiac Pacemaker Device Replacement With Mcc,,,22569.7,45274.52,21 MS-DRG,259,Cardiac Pacemaker Device Replacement Without Mcc,,,14524.74,29136.44,21 MS-DRG,260,Cardiac Pacemaker Revision Except Device Replacement With Mcc,,,23364.86,46869.6,21 MS-DRG,261,Cardiac Pacemaker Revision Except Device Replacement With Cc,,,13579.46,27240.21,21 MS-DRG,262,Cardiac Pacemaker Revision Except Device Replacement Without Cc/Mcc,,,11707.57,23485.23,21 MS-DRG,263,Vein Ligation And Stripping,,,21961.3,44054.08,21 MS-DRG,264,Other Circulatory System O.R. Procedures,,,23995.53,48134.71,21 MS-DRG,265,Aicd Lead Procedures,,,25989.53,52134.64,21 MS-DRG,266,Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc,,,44020.3,88304.12,21 MS-DRG,267,Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc,,,34196.83,68598.37,21 MS-DRG,268,Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc,,,49403.96,99103.66,21 MS-DRG,269,Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc,,,30335.25,60852.09,21 MS-DRG,270,Other Major Cardiovascular Procedures With Mcc,,,37899.66,76026.21,21 MS-DRG,271,Other Major Cardiovascular Procedures With Cc,,,25544.9,51242.73,21 MS-DRG,272,Other Major Cardiovascular Procedures Without Cc/Mcc,,,18338.2,36786.18,21 MS-DRG,273,Percutaneous And Other Intracardiac Procedures With Mcc,,,29633.47,59444.33,21 MS-DRG,274,Percutaneous And Other Intracardiac Procedures Without Mcc,,,23644.28,47430.11,21 MS-DRG,275,Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc,,,51217.66,102741.93,21 MS-DRG,276,Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator,,,43145.41,86549.1,21 MS-DRG,277,Cardiac Defibrillator Implant Without Mcc,,,33174.69,66547.97,21 MS-DRG,278,Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures With Mcc,,,39982.01,80203.38,21 MS-DRG,279,Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures Without Mcc,,,25904.77,51964.62,21 MS-DRG,280,"Acute Myocardial Infarction, Discharged Alive With Mcc",,,11522.25,23113.48,21 MS-DRG,281,"Acute Myocardial Infarction, Discharged Alive With Cc",,,6601.9,13666.9,21 MS-DRG,282,"Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc",,,5194.03,11205.44,21 MS-DRG,283,"Acute Myocardial Infarction, Expired With Mcc",,,14228.09,28541.35,21 MS-DRG,284,"Acute Myocardial Infarction, Expired With Cc",,,4972.07,10817.37,21 MS-DRG,285,"Acute Myocardial Infarction, Expired Without Cc/Mcc",,,4301.9,9645.66,21 MS-DRG,286,"Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc",,,15894.54,31884.24,21 MS-DRG,287,"Circulatory Disorders Except Ami, With Cardiac Catheterization Without Mcc",,,7686.53,15563.24,21 MS-DRG,288,Acute And Subacute Endocarditis With Mcc,,,19438.63,38993.64,21 MS-DRG,289,Acute And Subacute Endocarditis With Cc,,,12260.66,24594.72,21 MS-DRG,290,Acute And Subacute Endocarditis Without Cc/Mcc,,,6678.04,13800.02,21 MS-DRG,291,Heart Failure And Shock With Mcc,,,9221.54,18498.27,21 MS-DRG,292,Heart Failure And Shock With Cc,,,6098.37,12786.56,21 MS-DRG,293,Heart Failure And Shock Without Cc/Mcc,,,4065.58,9232.48,21 MS-DRG,294,Deep Vein Thrombophlebitis With Cc/Mcc,,,,,0 MS-DRG,295,Deep Vein Thrombophlebitis Without Cc/Mcc,,,,,0 MS-DRG,296,"Cardiac Arrest, Unexplained With Mcc",,,11219.13,22505.42,21 MS-DRG,297,"Cardiac Arrest, Unexplained With Cc",,,4554.02,10086.46,21 MS-DRG,298,"Cardiac Arrest, Unexplained Without Cc/Mcc",,,3268.98,7839.75,21 MS-DRG,299,Peripheral Vascular Disorders With Mcc,,,11727.68,23525.57,21 MS-DRG,300,Peripheral Vascular Disorders With Cc,,,7667.85,15530.58,21 MS-DRG,301,Peripheral Vascular Disorders Without Cc/Mcc,,,5169.61,11162.73,21 MS-DRG,302,Atherosclerosis With Mcc,,,8595.18,17241.81,21 MS-DRG,303,Atherosclerosis Without Mcc,,,4835.6,10578.76,21 MS-DRG,304,Hypertension With Mcc,,,8547.77,17146.71,21 MS-DRG,305,Hypertension Without Mcc,,,5423.88,11607.3,21 MS-DRG,306,Cardiac Congenital And Valvular Disorders With Mcc,,,11318.97,22705.7,21 MS-DRG,307,Cardiac Congenital And Valvular Disorders Without Mcc,,,6559.52,13592.8,21 MS-DRG,308,Cardiac Arrhythmia And Conduction Disorders With Mcc,,,8648.33,17348.44,21 MS-DRG,309,Cardiac Arrhythmia And Conduction Disorders With Cc,,,5284.53,11363.67,21 MS-DRG,310,Cardiac Arrhythmia And Conduction Disorders Without Cc/Mcc,,,4066.3,9233.74,21 MS-DRG,311,Angina Pectoris,,,5041.75,10939.18,21 MS-DRG,312,Syncope And Collapse,,,6260.7,13070.37,21 MS-DRG,313,Chest Pain,,,5171.76,11166.5,21 MS-DRG,314,Other Circulatory System Diagnoses With Mcc,,,14977.99,30045.65,21 MS-DRG,315,Other Circulatory System Diagnoses With Cc,,,6919.38,14221.98,21 MS-DRG,316,Other Circulatory System Diagnoses Without Cc/Mcc,,,4899.52,10690.53,21 MS-DRG,317,Concomitant Left Atrial Appendage Closure And Cardiac Ablation,,,48029.13,96345.78,21 MS-DRG,318,Percutaneous Coronary Atherectomy Without Intraluminal Device,,,17398.66,34901.48,21 MS-DRG,319,Other Endovascular Cardiac Valve Procedures With Mcc,,,32057.01,64305.93,21 MS-DRG,320,Other Endovascular Cardiac Valve Procedures Without Mcc,,,17277.27,34657.97,21 MS-DRG,321,Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ Arteries/Intraluminal,,,19543.51,39204.01,21 MS-DRG,322,Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc,,,12663.63,25403.07,21 MS-DRG,323,Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc,,,31083.71,62353.51,21 MS-DRG,324,Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc,,,22633.63,45402.76,21 MS-DRG,325,Coronary Intravascular Lithotripsy Without Intraluminal Device,,,23060.3,46258.65,21 MS-DRG,326,"Stomach, Esophageal And Duodenal Procedures With Mcc",,,35824.49,71863.45,21 MS-DRG,327,"Stomach, Esophageal And Duodenal Procedures With Cc",,,17556.69,35218.48,21 MS-DRG,328,"Stomach, Esophageal And Duodenal Procedures Without Cc/Mcc",,,11509.32,23087.54,21 MS-DRG,329,Major Small And Large Bowel Procedures With Mcc,,,33016.66,66230.97,21 MS-DRG,330,Major Small And Large Bowel Procedures With Cc,,,17219.09,34541.25,21 MS-DRG,331,Major Small And Large Bowel Procedures Without Cc/Mcc,,,12088.27,24248.91,21 MS-DRG,332,Rectal Resection With Mcc,,,26007.49,52170.67,21 MS-DRG,333,Rectal Resection With Cc,,,16824.02,33748.76,21 MS-DRG,334,Rectal Resection Without Cc/Mcc,,,11765.04,23600.5,21 MS-DRG,335,Peritoneal Adhesiolysis With Mcc,,,25649.77,51453.1,21 MS-DRG,336,Peritoneal Adhesiolysis With Cc,,,15146.79,30384.26,21 MS-DRG,337,Peritoneal Adhesiolysis Without Cc/Mcc,,,11025.91,22117.82,21 MS-DRG,344,Minor Small And Large Bowel Procedures With Mcc,,,18552.25,37215.57,21 MS-DRG,345,Minor Small And Large Bowel Procedures With Cc,,,10808.26,21681.22,21 MS-DRG,346,Minor Small And Large Bowel Procedures Without Cc/Mcc,,,8520.47,17091.96,21 MS-DRG,347,Anal And Stomal Procedures With Mcc,,,16489.29,33077.3,21 MS-DRG,348,Anal And Stomal Procedures With Cc,,,9401.11,18858.5,21 MS-DRG,349,Anal And Stomal Procedures Without Cc/Mcc,,,6253.52,13057.82,21 MS-DRG,350,Inguinal And Femoral Hernia Procedures With Mcc,,,17899.32,35905.79,21 MS-DRG,351,Inguinal And Femoral Hernia Procedures With Cc,,,10950.48,21966.52,21 MS-DRG,352,Inguinal And Femoral Hernia Procedures Without Cc/Mcc,,,8388.31,16826.83,21 MS-DRG,353,Hernia Procedures Except Inguinal And Femoral With Mcc,,,20845.07,41814.92,21 MS-DRG,354,Hernia Procedures Except Inguinal And Femoral With Cc,,,12084.68,24241.7,21 MS-DRG,355,Hernia Procedures Except Inguinal And Femoral Without Cc/Mcc,,,9661.14,19380.11,21 MS-DRG,356,Other Digestive System O.R. Procedures With Mcc,,,31553.48,63295.86,21 MS-DRG,357,Other Digestive System O.R. Procedures With Cc,,,16704.07,33508.13,21 MS-DRG,358,Other Digestive System O.R. Procedures Without Cc/Mcc,,,10041.12,20142.34,21 MS-DRG,359,Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc,,,24699.46,49546.79,21 MS-DRG,360,Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc,,,17341.92,34787.65,21 MS-DRG,361,Other Circulatory System O.R. Procedures With Mcc,,,,,0 MS-DRG,362,Other Circulatory System O.R. Procedures Without Mcc,,,,,0 MS-DRG,368,Major Esophageal Disorders With Mcc,,,11434.62,22937.69,21 MS-DRG,369,Major Esophageal Disorders With Cc,,,7184.44,14685.39,21 MS-DRG,370,Major Esophageal Disorders Without Cc/Mcc,,,5033.85,10925.37,21 MS-DRG,371,Major Gastrointestinal Disorders And Peritoneal Infections With Mcc,,,12736.18,25548.6,21 MS-DRG,372,Major Gastrointestinal Disorders And Peritoneal Infections With Cc,,,7333.84,14946.62,21 MS-DRG,373,Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/Mcc,,,5224.91,11259.44,21 MS-DRG,374,Digestive Malignancy With Mcc,,,15362.28,30816.53,21 MS-DRG,375,Digestive Malignancy With Cc,,,8688.56,17429.13,21 MS-DRG,376,Digestive Malignancy Without Cc/Mcc,,,6639.25,13732.2,21 MS-DRG,377,Gastrointestinal Hemorrhage With Mcc,,,13130.52,26339.65,21 MS-DRG,378,Gastrointestinal Hemorrhage With Cc,,,7044.37,14440.5,21 MS-DRG,379,Gastrointestinal Hemorrhage Without Cc/Mcc,,,4528.16,10041.26,21 MS-DRG,380,Complicated Peptic Ulcer With Mcc,,,14094.48,28273.34,21 MS-DRG,381,Complicated Peptic Ulcer With Cc,,,7782.78,15731.52,21 MS-DRG,382,Complicated Peptic Ulcer Without Cc/Mcc,,,5750.71,12178.71,21 MS-DRG,383,Uncomplicated Peptic Ulcer With Mcc,,,9917.57,19894.51,21 MS-DRG,384,Uncomplicated Peptic Ulcer Without Mcc,,,6140.03,12859.4,21 MS-DRG,385,Inflammatory Bowel Disease With Mcc,,,11365.66,22799.36,21 MS-DRG,386,Inflammatory Bowel Disease With Cc,,,7012.76,14385.24,21 MS-DRG,387,Inflammatory Bowel Disease Without Cc/Mcc,,,4893.78,10680.48,21 MS-DRG,388,Gastrointestinal Obstruction With Mcc,,,10607.85,21279.21,21 MS-DRG,389,Gastrointestinal Obstruction With Cc,,,5673.13,12043.08,21 MS-DRG,390,Gastrointestinal Obstruction Without Cc/Mcc,,,3907.55,8956.2,21 MS-DRG,391,"Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc",,,9110.2,18274.93,21 MS-DRG,392,"Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc",,,5599.87,11915.0,21 MS-DRG,393,Other Digestive System Diagnoses With Mcc,,,11487.77,23044.31,21 MS-DRG,394,Other Digestive System Diagnoses With Cc,,,6721.13,13875.38,21 MS-DRG,395,Other Digestive System Diagnoses Without Cc/Mcc,,,4661.77,10274.85,21 MS-DRG,397,Appendix Procedures With Mcc,,,17202.57,34508.11,21 MS-DRG,398,Appendix Procedures With Cc,,,10872.19,21809.46,21 MS-DRG,399,Appendix Procedures Without Cc/Mcc,,,8222.38,16500.1,21 MS-DRG,400,Knee Procedures With Principal Diagnosis Of Infection,,,,,0 MS-DRG,402,Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical,,,28879.25,57931.38,21 MS-DRG,403,Hip Or Knee Procedures With Principal Diagnosis Of Periprosthetic Joint Infection With Mcc Or Insert,,,,,0 MS-DRG,404,Hip Or Knee Procedures With Principal Diagnosis Of Periprosthetic Joint Infection Without Mcc,,,,,0 MS-DRG,405,"Pancreas, Liver And Shunt Procedures With Mcc",,,39294.6,78824.43,21 MS-DRG,406,"Pancreas, Liver And Shunt Procedures With Cc",,,20832.14,41788.98,21 MS-DRG,407,"Pancreas, Liver And Shunt Procedures Without Cc/Mcc",,,15943.39,31982.22,21 MS-DRG,408,Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.D.E. With Mcc,,,25611.7,51376.73,21 MS-DRG,409,Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.D.E. With Cc,,,15639.55,31372.72,21 MS-DRG,410,Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.D.E. Without Cc/Mcc,,,11404.45,22877.17,21 MS-DRG,411,Cholecystectomy With C.D.E. With Mcc,,,23727.6,47597.25,21 MS-DRG,412,Cholecystectomy With C.D.E. With Cc,,,15102.26,30294.92,21 MS-DRG,413,Cholecystectomy With C.D.E. Without Cc/Mcc,,,11927.37,23926.14,21 MS-DRG,414,Cholecystectomy Except By Laparoscope Without C.D.E. With Mcc,,,25590.16,51333.5,21 MS-DRG,415,Cholecystectomy Except By Laparoscope Without C.D.E. With Cc,,,14845.11,29779.08,21 MS-DRG,416,Cholecystectomy Except By Laparoscope Without C.D.E. Without Cc/Mcc,,,9792.58,19643.79,21 MS-DRG,417,Laparoscopic Cholecystectomy Without C.D.E. With Mcc,,,17141.51,34385.64,21 MS-DRG,418,Laparoscopic Cholecystectomy Without C.D.E. With Cc,,,12150.76,24374.26,21 MS-DRG,419,Laparoscopic Cholecystectomy Without C.D.E. Without Cc/Mcc,,,9810.54,19679.81,21 MS-DRG,420,Hepatobiliary Diagnostic Procedures With Mcc,,,24473.2,49092.9,21 MS-DRG,421,Hepatobiliary Diagnostic Procedures With Cc,,,12480.46,25035.64,21 MS-DRG,422,Hepatobiliary Diagnostic Procedures Without Cc/Mcc,,,10052.61,20165.4,21 MS-DRG,423,Other Hepatobiliary Or Pancreas O.R. Procedures With Mcc,,,29831.0,59840.58,21 MS-DRG,424,Other Hepatobiliary Or Pancreas O.R. Procedures With Cc,,,15715.69,31525.45,21 MS-DRG,425,Other Hepatobiliary Or Pancreas O.R. Procedures Without Cc/Mcc,,,10776.65,21617.82,21 MS-DRG,426,Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical With Mcc,,,79165.28,158804.47,21 MS-DRG,427,Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical With Cc,,,51851.2,104012.81,21 MS-DRG,428,Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Without Cc/Mcc,,,40382.83,81007.4,21 MS-DRG,429,Combined Anterior And Posterior Cervical Spinal Fusion With Mcc,,,64715.96,129819.33,21 MS-DRG,430,Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc,,,41425.08,83098.14,21 MS-DRG,432,Cirrhosis And Alcoholic Hepatitis With Mcc,,,14137.58,28359.79,21 MS-DRG,433,Cirrhosis And Alcoholic Hepatitis With Cc,,,7586.68,15388.66,21 MS-DRG,434,Cirrhosis And Alcoholic Hepatitis Without Cc/Mcc,,,5117.89,11072.31,21 MS-DRG,435,Malignancy Of Hepatobiliary System Or Pancreas With Mcc,,,13193.02,26465.01,21 MS-DRG,436,Malignancy Of Hepatobiliary System Or Pancreas With Cc,,,8124.69,16329.3,21 MS-DRG,437,Malignancy Of Hepatobiliary System Or Pancreas Without Cc/Mcc,,,6129.25,12840.56,21 MS-DRG,438,Disorders Of Pancreas Except Malignancy With Mcc,,,11709.73,23489.55,21 MS-DRG,439,Disorders Of Pancreas Except Malignancy With Cc,,,6042.34,12688.59,21 MS-DRG,440,Disorders Of Pancreas Except Malignancy Without Cc/Mcc,,,4463.52,9928.23,21 MS-DRG,441,"Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc",,,12891.33,25859.83,21 MS-DRG,442,"Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc",,,6933.75,14247.1,21 MS-DRG,443,"Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis Without Cc/Mcc",,,5025.95,10911.57,21 MS-DRG,444,Disorders Of The Biliary Tract With Mcc,,,12002.07,24076.0,21 MS-DRG,445,Disorders Of The Biliary Tract With Cc,,,7861.08,15868.41,21 MS-DRG,446,Disorders Of The Biliary Tract Without Cc/Mcc,,,5942.5,12514.04,21 MS-DRG,447,Multiple Level Spinal Fusion Except Cervical With Mcc,,,47993.93,96275.17,21 MS-DRG,448,Multiple Level Spinal Fusion Except Cervical Without Mcc,,,30461.67,61105.69,21 MS-DRG,449,Revision Of Hip Or Knee Prosthesis,,,,,0 MS-DRG,450,Single Level Spinal Fusion Except Cervical With Mcc,,,38282.52,76794.21,21 MS-DRG,451,Single Level Spinal Fusion Except Cervical Without Mcc,,,23203.96,46546.83,21 MS-DRG,453,Combined Anterior And Posterior Spinal Fusion With Mcc,,,,,0 MS-DRG,454,Combined Anterior And Posterior Spinal Fusion With Cc,,,,,0 MS-DRG,455,Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc,,,,,0 MS-DRG,456,"Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Or Infection With Mcc",,,60361.62,121084.59,21 MS-DRG,457,"Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Or Infection With Cc",,,42832.95,85922.31,21 MS-DRG,458,"Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Or Infection Without Cc/Mcc",,,29971.79,60122.99,21 MS-DRG,459,Spinal Fusion Except Cervical With Mcc,,,,,0 MS-DRG,460,Spinal Fusion Except Cervical Without Mcc,,,,,0 MS-DRG,461,Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc,,,39671.71,79580.91,21 MS-DRG,462,Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc,,,19106.78,38327.94,21 MS-DRG,463,Wound Debridement Or Skin Graft Except Hand For Musculoskeletal And Connective Tissue Disorders With,,,40939.51,82124.1,21 MS-DRG,464,Wound Debridement Or Skin Graft Except Hand For Musculoskeletal And Connective Tissue Disorders With,,,22372.89,44879.71,21 MS-DRG,465,Wound Debridement Or Skin Graft Except Hand For Musculoskeletal And Connective Tissue Disorders With,,,13099.64,26277.69,21 MS-DRG,466,Revision Of Hip Or Knee Replacement With Mcc,,,37390.39,75004.61,21 MS-DRG,467,Revision Of Hip Or Knee Replacement With Cc,,,25331.57,50814.78,21 MS-DRG,468,Revision Of Hip Or Knee Replacement Without Cc/Mcc,,,19738.88,39595.93,21 MS-DRG,469,Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc Or Total Ankle Repl,,,21787.48,43705.38,21 MS-DRG,470,Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without Mcc,,,13855.29,27793.52,21 MS-DRG,471,Cervical Spinal Fusion With Mcc,,,34684.55,69576.74,21 MS-DRG,472,Cervical Spinal Fusion With Cc,,,21161.84,42450.35,21 MS-DRG,473,Cervical Spinal Fusion Without Cc/Mcc,,,17535.86,35176.69,21 MS-DRG,474,Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc Or Insertion Of Antib,,,30835.9,61856.4,21 MS-DRG,475,Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc,,,16346.35,32790.56,21 MS-DRG,476,Amputation For Musculoskeletal System And Connective Tissue Disorders Without Cc/Mcc,,,8477.38,17005.5,21 MS-DRG,477,Biopsies Of Musculoskeletal System And Connective Tissue With Mcc Or Insertion Of Antibiotic-Eluting,,,24814.39,49777.33,21 MS-DRG,478,Biopsies Of Musculoskeletal System And Connective Tissue With Cc,,,17664.43,35434.61,21 MS-DRG,479,Biopsies Of Musculoskeletal System And Connective Tissue Without Cc/Mcc,,,13352.48,26784.89,21 MS-DRG,480,Hip And Femur Procedures Except Major Joint With Mcc Or Insertion Of Antibiotic-Eluting Bone Void Fi,,,20919.05,41963.33,21 MS-DRG,481,Hip And Femur Procedures Except Major Joint With Cc,,,15044.79,30179.65,21 MS-DRG,482,Hip And Femur Procedures Except Major Joint Without Cc/Mcc,,,11715.47,23501.08,21 MS-DRG,483,Major Joint Or Limb Reattachment Procedures Of Upper Extremities,,,19910.56,39940.31,21 MS-DRG,485,Knee Procedures With Principal Diagnosis Of Infection With Mcc,,,23180.26,46499.28,21 MS-DRG,486,Knee Procedures With Principal Diagnosis Of Infection With Cc,,,15020.37,30130.66,21 MS-DRG,487,Knee Procedures With Principal Diagnosis Of Infection Without Cc/Mcc,,,11250.01,22567.38,21 MS-DRG,488,Knee Procedures Without Principal Diagnosis Of Infection With Cc/Mcc,,,12706.01,25488.08,21 MS-DRG,489,Knee Procedures Without Principal Diagnosis Of Infection Without Cc/Mcc,,,8021.97,16149.72,21 MS-DRG,492,"Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc Or Insertion Of Antibioti",,,26373.1,52904.08,21 MS-DRG,493,"Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc",,,18216.81,36542.66,21 MS-DRG,494,"Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/Mcc",,,14412.69,28911.66,21 MS-DRG,495,Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur With Mcc,,,26043.4,52242.71,21 MS-DRG,496,Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur With Cc,,,12957.41,25992.4,21 MS-DRG,497,Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Without Cc/Mcc,,,8679.22,17410.39,21 MS-DRG,498,Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc/Mcc,,,21669.67,43469.07,21 MS-DRG,499,Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur Without Cc/Mcc,,,14472.31,29031.25,21 MS-DRG,500,Soft Tissue Procedures With Mcc,,,22732.76,45601.6,21 MS-DRG,501,Soft Tissue Procedures With Cc,,,12556.6,25188.37,21 MS-DRG,502,Soft Tissue Procedures Without Cc/Mcc,,,9667.6,19393.07,21 MS-DRG,503,Foot Procedures With Mcc,,,20048.47,40216.96,21 MS-DRG,504,Foot Procedures With Cc,,,13426.46,26933.3,21 MS-DRG,505,Foot Procedures Without Cc/Mcc,,,12877.68,25832.46,21 MS-DRG,506,Major Thumb Or Joint Procedures,,,9691.3,19440.62,21 MS-DRG,507,Major Shoulder Or Elbow Joint Procedures With Cc/Mcc,,,12975.37,26028.42,21 MS-DRG,508,Major Shoulder Or Elbow Joint Procedures Without Cc/Mcc,,,10877.94,21820.99,21 MS-DRG,509,Arthroscopy,,,,,0 MS-DRG,510,"Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc",,,21696.25,43522.38,21 MS-DRG,511,"Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc",,,14936.33,29962.07,21 MS-DRG,512,"Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures Without Cc/Mcc",,,11890.74,23852.66,21 MS-DRG,513,"Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures With Cc/Mcc",,,11308.2,22684.09,21 MS-DRG,514,"Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures Without Cc/Mcc",,,7343.18,14962.94,21 MS-DRG,515,Other Musculoskeletal System And Connective Tissue O.R. Procedures With Mcc,,,22891.5,45920.04,21 MS-DRG,516,Other Musculoskeletal System And Connective Tissue O.R. Procedures With Cc,,,14926.99,29943.34,21 MS-DRG,517,Other Musculoskeletal System And Connective Tissue O.R. Procedures Without Cc/Mcc,,,11038.12,22142.31,21 MS-DRG,518,Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurostimulator,,,26845.03,53850.76,21 MS-DRG,519,Back And Neck Procedures Except Spinal Fusion With Cc,,,14367.44,28820.88,21 MS-DRG,520,Back And Neck Procedures Except Spinal Fusion Without Cc/Mcc,,,10730.68,21525.61,21 MS-DRG,521,Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc,,,20616.65,41356.71,21 MS-DRG,522,Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc,,,15211.44,30513.94,21 MS-DRG,523,Extensive Or Complex Spinal Fusion Procedures Except Cervical With Mcc,,,,,0 MS-DRG,524,Extensive Or Complex Spinal Fusion Procedures Except Cervical With Cc,,,,,0 MS-DRG,525,Extensive Or Complex Spinal Fusion Procedures Except Cervical Without Cc/Mcc,,,,,0 MS-DRG,533,Fractures Of Femur With Mcc,,,11260.79,22588.99,21 MS-DRG,534,Fractures Of Femur Without Mcc,,,5790.22,12247.78,21 MS-DRG,535,Fractures Of Hip And Pelvis With Mcc,,,9208.61,18472.34,21 MS-DRG,536,Fractures Of Hip And Pelvis Without Mcc,,,5800.99,12266.62,21 MS-DRG,537,"Sprains, Strains, And Dislocations Of Hip, Pelvis And Thigh With Cc/Mcc",,,6854.74,14108.96,21 MS-DRG,538,"Sprains, Strains, And Dislocations Of Hip, Pelvis And Thigh Without Cc/Mcc",,,5173.91,11170.28,21 MS-DRG,539,Osteomyelitis With Mcc,,,14148.36,28381.41,21 MS-DRG,540,Osteomyelitis With Cc,,,9311.32,18678.39,21 MS-DRG,541,Osteomyelitis Without Cc/Mcc,,,5655.89,12012.94,21 MS-DRG,542,Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With Mcc,,,12688.77,25453.5,21 MS-DRG,543,Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With Cc,,,7384.12,15034.52,21 MS-DRG,544,Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy Without Cc/Mcc,,,5420.29,11601.03,21 MS-DRG,545,Connective Tissue Disorders With Mcc,,,17826.05,35758.82,21 MS-DRG,546,Connective Tissue Disorders With Cc,,,8284.87,16619.34,21 MS-DRG,547,Connective Tissue Disorders Without Cc/Mcc,,,6006.42,12625.8,21 MS-DRG,548,Septic Arthritis With Mcc,,,13869.65,27822.34,21 MS-DRG,549,Septic Arthritis With Cc,,,8671.32,17394.54,21 MS-DRG,550,Septic Arthritis Without Cc/Mcc,,,6278.66,13101.76,21 MS-DRG,551,Medical Back Problems With Mcc,,,12039.43,24150.92,21 MS-DRG,552,Medical Back Problems Without Mcc,,,6905.02,14196.87,21 MS-DRG,553,Bone Diseases And Arthropathies With Mcc,,,9311.32,18678.39,21 MS-DRG,554,Bone Diseases And Arthropathies Without Mcc,,,5962.61,12549.2,21 MS-DRG,555,Signs And Symptoms Of Musculoskeletal System And Connective Tissue With Mcc,,,9494.49,19045.82,21 MS-DRG,556,Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc,,,5966.2,12555.46,21 MS-DRG,557,"Tendonitis, Myositis And Bursitis With Mcc",,,10680.4,21424.74,21 MS-DRG,558,"Tendonitis, Myositis And Bursitis Without Mcc",,,6415.86,13341.63,21 MS-DRG,559,"Aftercare, Musculoskeletal System And Connective Tissue With Mcc",,,13395.58,26871.34,21 MS-DRG,560,"Aftercare, Musculoskeletal System And Connective Tissue With Cc",,,8088.78,16266.51,21 MS-DRG,561,"Aftercare, Musculoskeletal System And Connective Tissue Without Cc/Mcc",,,5774.41,12220.16,21 MS-DRG,562,"Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh With Mcc",,,10234.34,20529.94,21 MS-DRG,563,"Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Without Mcc",,,6432.38,13370.52,21 MS-DRG,564,Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc,,,11087.68,22241.73,21 MS-DRG,565,Other Musculoskeletal System And Connective Tissue Diagnoses With Cc,,,6999.12,14361.39,21 MS-DRG,566,Other Musculoskeletal System And Connective Tissue Diagnoses Without Cc/Mcc,,,5382.22,11534.46,21 MS-DRG,570,Skin Debridement With Mcc,,,21125.92,42378.31,21 MS-DRG,571,Skin Debridement With Cc,,,12135.68,24344.01,21 MS-DRG,572,Skin Debridement Without Cc/Mcc,,,8233.87,16520.19,21 MS-DRG,573,Skin Graft For Skin Ulcer Or Cellulitis With Mcc,,,47058.71,94399.12,21 MS-DRG,574,Skin Graft For Skin Ulcer Or Cellulitis With Cc,,,24935.07,50019.4,21 MS-DRG,575,Skin Graft For Skin Ulcer Or Cellulitis Without Cc/Mcc,,,12907.85,25892.97,21 MS-DRG,576,Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc,,,35205.32,70621.39,21 MS-DRG,577,Skin Graft Except For Skin Ulcer Or Cellulitis With Cc,,,19039.98,38193.94,21 MS-DRG,578,Skin Graft Except For Skin Ulcer Or Cellulitis Without Cc/Mcc,,,11538.77,23146.62,21 MS-DRG,579,"Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc",,,23262.15,46663.55,21 MS-DRG,580,"Other Skin, Subcutaneous Tissue And Breast Procedures With Cc",,,12412.22,24898.75,21 MS-DRG,581,"Other Skin, Subcutaneous Tissue And Breast Procedures Without Cc/Mcc",,,10365.79,20793.63,21 MS-DRG,582,Mastectomy For Malignancy With Cc/Mcc,,,13838.77,27760.38,21 MS-DRG,583,Mastectomy For Malignancy Without Cc/Mcc,,,12386.37,24846.88,21 MS-DRG,584,"Breast Biopsy, Local Excision And Other Breast Procedures With Cc/Mcc",,,15376.65,30845.35,21 MS-DRG,585,"Breast Biopsy, Local Excision And Other Breast Procedures Without Cc/Mcc",,,13856.73,27796.4,21 MS-DRG,592,Skin Ulcers With Mcc,,,13901.26,27885.74,21 MS-DRG,593,Skin Ulcers With Cc,,,8521.19,17093.4,21 MS-DRG,594,Skin Ulcers Without Cc/Mcc,,,6226.22,13010.08,21 MS-DRG,595,Major Skin Disorders With Mcc,,,15232.99,30557.17,21 MS-DRG,596,Major Skin Disorders Without Mcc,,,7775.6,15718.96,21 MS-DRG,597,Malignant Breast Disorders With Mcc,,,11974.78,24021.24,21 MS-DRG,598,Malignant Breast Disorders With Cc,,,8126.13,16331.82,21 MS-DRG,599,Malignant Breast Disorders Without Cc/Mcc,,,5526.6,11786.9,21 MS-DRG,600,Non-Malignant Breast Disorders With Cc/Mcc,,,7481.81,15205.32,21 MS-DRG,601,Non-Malignant Breast Disorders Without Cc/Mcc,,,4345.72,9722.26,21 MS-DRG,602,Cellulitis With Mcc,,,10209.2,20479.51,21 MS-DRG,603,Cellulitis Without Mcc,,,6255.67,13061.58,21 MS-DRG,604,"Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc",,,10574.09,21211.49,21 MS-DRG,605,"Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc",,,6579.63,13627.96,21 MS-DRG,606,Minor Skin Disorders With Mcc,,,10869.32,21803.7,21 MS-DRG,607,Minor Skin Disorders Without Mcc,,,6510.67,13507.41,21 MS-DRG,614,Adrenal And Pituitary Procedures With Cc/Mcc,,,15743.7,31581.65,21 MS-DRG,615,Adrenal And Pituitary Procedures Without Cc/Mcc,,,10051.17,20162.51,21 MS-DRG,616,"Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With Mcc Or Insertion Of",,,25049.99,50249.95,21 MS-DRG,617,"Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With Cc",,,13434.36,26949.15,21 MS-DRG,618,"Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders Without Cc/Mcc",,,10187.65,20436.28,21 MS-DRG,619,O.R. Procedures For Obesity With Mcc,,,20740.19,41604.55,21 MS-DRG,620,O.R. Procedures For Obesity With Cc,,,11494.95,23058.72,21 MS-DRG,621,O.R. Procedures For Obesity Without Cc/Mcc,,,10834.84,21734.54,21 MS-DRG,622,"Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disorders With Mcc",,,25565.73,51284.51,21 MS-DRG,623,"Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disorders With Cc",,,12885.58,25848.31,21 MS-DRG,624,"Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disorders Without Cc/Mcc",,,8992.4,18038.63,21 MS-DRG,625,"Thyroid, Parathyroid And Thyroglossal Procedures With Mcc",,,21693.38,43516.62,21 MS-DRG,626,"Thyroid, Parathyroid And Thyroglossal Procedures With Cc",,,10770.19,21604.85,21 MS-DRG,627,"Thyroid, Parathyroid And Thyroglossal Procedures Without Cc/Mcc",,,9541.18,19139.47,21 MS-DRG,628,"Other Endocrine, Nutritional And Metabolic O.R. Procedures With Mcc Or Insertion Of Antibiotic-Eluti",,,26769.6,53699.46,21 MS-DRG,629,"Other Endocrine, Nutritional And Metabolic O.R. Procedures With Cc",,,15650.32,31394.33,21 MS-DRG,630,"Other Endocrine, Nutritional And Metabolic O.R. Procedures Without Cc/Mcc",,,10483.59,21029.94,21 MS-DRG,637,Diabetes With Mcc,,,10319.82,20701.41,21 MS-DRG,638,Diabetes With Cc,,,6437.4,13379.31,21 MS-DRG,639,Diabetes Without Cc/Mcc,,,4462.08,9925.72,21 MS-DRG,640,"Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With Mcc",,,9593.61,19244.66,21 MS-DRG,641,"Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Without Mcc",,,5589.81,11897.4,21 MS-DRG,642,Inborn And Other Disorders Of Metabolism,,,10214.94,20491.04,21 MS-DRG,643,Endocrine Disorders With Mcc,,,11823.94,23718.65,21 MS-DRG,644,Endocrine Disorders With Cc,,,7362.58,14996.85,21 MS-DRG,645,Endocrine Disorders Without Cc/Mcc,,,5518.7,11773.08,21 MS-DRG,650,Kidney Transplant With Hemodialysis With Mcc,,,33770.16,67742.47,21 MS-DRG,651,Kidney Transplant With Hemodialysis Without Mcc,,,26618.76,53396.87,21 MS-DRG,652,Kidney Transplant,,,23197.5,46533.87,21 MS-DRG,653,Major Bladder Procedures With Mcc,,,37325.74,74874.93,21 MS-DRG,654,Major Bladder Procedures With Cc,,,20107.37,40335.11,21 MS-DRG,655,Major Bladder Procedures Without Cc/Mcc,,,15203.54,30498.09,21 MS-DRG,656,Kidney And Ureter Procedures For Neoplasm With Mcc,,,22869.24,45875.37,21 MS-DRG,657,Kidney And Ureter Procedures For Neoplasm With Cc,,,13144.89,26368.47,21 MS-DRG,658,Kidney And Ureter Procedures For Neoplasm Without Cc/Mcc,,,11146.58,22359.89,21 MS-DRG,659,Kidney And Ureter Procedures For Non-Neoplasm With Mcc,,,18251.28,36611.83,21 MS-DRG,660,Kidney And Ureter Procedures For Non-Neoplasm With Cc,,,9493.77,19044.38,21 MS-DRG,661,Kidney And Ureter Procedures For Non-Neoplasm Without Cc/Mcc,,,7437.28,15127.46,21 MS-DRG,662,Minor Bladder Procedures With Mcc,,,21990.75,44113.15,21 MS-DRG,663,Minor Bladder Procedures With Cc,,,10919.6,21904.56,21 MS-DRG,664,Minor Bladder Procedures Without Cc/Mcc,,,7519.88,15271.88,21 MS-DRG,665,Prostatectomy With Mcc,,,22419.58,44973.37,21 MS-DRG,666,Prostatectomy With Cc,,,12565.22,25205.66,21 MS-DRG,667,Prostatectomy Without Cc/Mcc,,,7945.83,16016.6,21 MS-DRG,668,Transurethral Procedures With Mcc,,,20974.36,42074.28,21 MS-DRG,669,Transurethral Procedures With Cc,,,11148.02,22362.77,21 MS-DRG,670,Transurethral Procedures Without Cc/Mcc,,,7019.95,14397.81,21 MS-DRG,671,Urethral Procedures With Cc/Mcc,,,12893.49,25864.16,21 MS-DRG,672,Urethral Procedures Without Cc/Mcc,,,7754.05,15681.28,21 MS-DRG,673,Other Kidney And Urinary Tract Procedures With Mcc,,,30180.09,60540.85,21 MS-DRG,674,Other Kidney And Urinary Tract Procedures With Cc,,,16798.16,33696.89,21 MS-DRG,675,Other Kidney And Urinary Tract Procedures Without Cc/Mcc,,,11790.18,23650.93,21 MS-DRG,682,Renal Failure With Mcc,,,10638.02,21339.73,21 MS-DRG,683,Renal Failure With Cc,,,6290.87,13123.11,21 MS-DRG,684,Renal Failure Without Cc/Mcc,,,4311.95,9663.24,21 MS-DRG,686,Kidney And Urinary Tract Neoplasms With Mcc,,,12955.98,25989.51,21 MS-DRG,687,Kidney And Urinary Tract Neoplasms With Cc,,,7526.35,15283.18,21 MS-DRG,688,Kidney And Urinary Tract Neoplasms Without Cc/Mcc,,,5676.72,12049.36,21 MS-DRG,689,Kidney And Urinary Tract Infections With Mcc,,,8334.43,16718.76,21 MS-DRG,690,Kidney And Urinary Tract Infections Without Mcc,,,5814.64,12290.49,21 MS-DRG,693,Urinary Stones With Mcc,,,9657.54,19372.9,21 MS-DRG,694,Urinary Stones Without Mcc,,,5614.95,11941.36,21 MS-DRG,695,Kidney And Urinary Tract Signs And Symptoms With Mcc,,,8215.92,16488.8,21 MS-DRG,696,Kidney And Urinary Tract Signs And Symptoms Without Mcc,,,4949.09,10777.18,21 MS-DRG,697,Urethral Stricture,,,7741.84,15659.94,21 MS-DRG,698,Other Kidney And Urinary Tract Diagnoses With Mcc,,,11883.56,23838.25,21 MS-DRG,699,Other Kidney And Urinary Tract Diagnoses With Cc,,,7290.75,14871.26,21 MS-DRG,700,Other Kidney And Urinary Tract Diagnoses Without Cc/Mcc,,,4955.55,10788.5,21 MS-DRG,707,Major Male Pelvic Procedures With Cc/Mcc,,,14368.15,28822.32,21 MS-DRG,708,Major Male Pelvic Procedures Without Cc/Mcc,,,11020.16,22106.29,21 MS-DRG,709,Penis Procedures With Cc/Mcc,,,16715.56,33531.18,21 MS-DRG,710,Penis Procedures Without Cc/Mcc,,,10064.82,20189.89,21 MS-DRG,711,Testes Procedures With Cc/Mcc,,,14967.94,30025.47,21 MS-DRG,712,Testes Procedures Without Cc/Mcc,,,7899.15,15934.96,21 MS-DRG,713,Transurethral Prostatectomy With Cc/Mcc,,,10798.92,21662.49,21 MS-DRG,714,Transurethral Prostatectomy Without Cc/Mcc,,,7595.3,15403.74,21 MS-DRG,715,Male Reproductive System And Other O.R. Procedures For Malignancy With Cc/Mcc,,,16070.53,32237.26,21 MS-DRG,716,Male Reproductive System And Other O.R. Procedures For Malignancy Without Cc/Mcc,,,10566.19,21195.64,21 MS-DRG,717,Other Male Reproductive System O.R. Procedures With Cc/Mcc,,,13579.46,27240.21,21 MS-DRG,718,Other Male Reproductive System O.R. Procedures Without Cc/Mcc,,,9647.49,19352.73,21 MS-DRG,722,"Malignancy, Male Reproductive System With Mcc",,,12999.08,26075.97,21 MS-DRG,723,"Malignancy, Male Reproductive System With Cc",,,8208.01,16474.98,21 MS-DRG,724,"Malignancy, Male Reproductive System Without Cc/Mcc",,,4709.89,10358.98,21 MS-DRG,725,Benign Prostatic Hypertrophy With Mcc,,,8405.55,16861.41,21 MS-DRG,726,Benign Prostatic Hypertrophy Without Mcc,,,5186.13,11191.62,21 MS-DRG,727,Inflammation Of The Male Reproductive System With Mcc,,,10651.67,21367.11,21 MS-DRG,728,Inflammation Of The Male Reproductive System Without Mcc,,,5826.85,12311.84,21 MS-DRG,729,Other Male Reproductive System Diagnoses With Cc/Mcc,,,7604.64,15420.06,21 MS-DRG,730,Other Male Reproductive System Diagnoses Without Cc/Mcc,,,4826.98,10563.69,21 MS-DRG,731,Uterine And Adnexa Procedures For Malignancy With Mcc,,,,,0 MS-DRG,732,Uterine And Adnexa Procedures For Malignancy With Cc,,,,,0 MS-DRG,733,Uterine And Adnexa Procedures For Malignancy Without Cc/Mcc,,,,,0 MS-DRG,734,"Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/Mcc",,,15299.79,30691.17,21 MS-DRG,735,"Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy Without Cc/Mcc",,,9664.73,19387.31,21 MS-DRG,736,Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc,,,25675.63,51504.97,21 MS-DRG,737,Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc,,,14801.29,29691.19,21 MS-DRG,738,Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy Without Cc/Mcc,,,10548.24,21159.62,21 MS-DRG,739,Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy With Mcc,,,25735.25,51624.57,21 MS-DRG,740,Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy With Cc,,,12998.36,26074.53,21 MS-DRG,741,Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy Without Cc/Mcc,,,10243.68,20548.67,21 MS-DRG,742,Uterine And Adnexa Procedures For Non-Malignancy With Cc/Mcc,,,13179.37,26437.63,21 MS-DRG,743,Uterine And Adnexa Procedures For Non-Malignancy Without Cc/Mcc,,,8911.95,17877.25,21 MS-DRG,744,"D&C, Conization, Laparoscopy And Tubal Interruption With Cc/Mcc",,,14718.69,29525.48,21 MS-DRG,745,"D&C, Conization, Laparoscopy And Tubal Interruption Without Cc/Mcc",,,8170.66,16409.68,21 MS-DRG,746,"Vagina, Cervix And Vulva Procedures With Cc/Mcc",,,12477.59,25029.87,21 MS-DRG,747,"Vagina, Cervix And Vulva Procedures Without Cc/Mcc",,,6175.23,12920.92,21 MS-DRG,748,Female Reproductive System Reconstructive Procedures,,,9964.98,19989.61,21 MS-DRG,749,Other Female Reproductive System O.R. Procedures With Cc/Mcc,,,18443.07,36996.55,21 MS-DRG,750,Other Female Reproductive System O.R. Procedures Without Cc/Mcc,,,10600.67,21264.8,21 MS-DRG,754,"Malignancy, Female Reproductive System With Mcc",,,13228.93,26537.06,21 MS-DRG,755,"Malignancy, Female Reproductive System With Cc",,,7813.67,15785.52,21 MS-DRG,756,"Malignancy, Female Reproductive System Without Cc/Mcc",,,6899.27,14186.82,21 MS-DRG,757,"Infections, Female Reproductive System With Mcc",,,10285.34,20632.25,21 MS-DRG,758,"Infections, Female Reproductive System With Cc",,,7032.16,14419.16,21 MS-DRG,759,"Infections, Female Reproductive System Without Cc/Mcc",,,4766.64,10458.2,21 MS-DRG,760,Menstrual And Other Female Reproductive System Disorders With Cc/Mcc,,,7236.87,14777.07,21 MS-DRG,761,Menstrual And Other Female Reproductive System Disorders Without Cc/Mcc,,,4097.9,9289.0,21 MS-DRG,768,Vaginal Delivery With O.R. Procedures Except Sterilization And/Or D&C,,,7697.3,15582.08,21 MS-DRG,769,Postpartum And Post Abortion Diagnoses With O.R. Procedures,,,12137.83,24348.33,21 MS-DRG,770,"Abortion With D&C, Aspiration Curettage Or Hysterotomy",,,7202.39,14716.78,21 MS-DRG,776,Postpartum And Post Abortion Diagnoses Without O.R. Procedures,,,4702.71,10346.43,21 MS-DRG,779,Abortion Without D&C,,,6043.06,12689.85,21 MS-DRG,783,Cesarean Section With Sterilization With Mcc,,,17634.98,35375.54,21 MS-DRG,784,Cesarean Section With Sterilization With Cc,,,7614.7,15437.66,21 MS-DRG,785,Cesarean Section With Sterilization Without Cc/Mcc,,,6879.88,14152.92,21 MS-DRG,786,Cesarean Section Without Sterilization With Mcc,,,11848.36,23767.65,21 MS-DRG,787,Cesarean Section Without Sterilization With Cc,,,8021.97,16149.72,21 MS-DRG,788,Cesarean Section Without Sterilization Without Cc/Mcc,,,6887.06,14165.48,21 MS-DRG,789,"Neonates, Died Or Transferred To Another Acute Care Facility",,,12945.2,25967.9,21 MS-DRG,790,"Extreme Immaturity Or Respiratory Distress Syndrome, Neonate",,,42692.16,85639.89,21 MS-DRG,791,Prematurity With Major Problems,,,29155.8,58486.13,21 MS-DRG,792,Prematurity Without Major Problems,,,17592.6,35290.52,21 MS-DRG,793,Full Term Neonate With Major Problems,,,29950.24,60079.77,21 MS-DRG,794,Neonate With Other Significant Problems,,,10601.39,21266.24,21 MS-DRG,795,Normal Newborn,,,1435.16,4633.56,21 MS-DRG,796,Vaginal Delivery With Sterilization And/Or D&C With Mcc,,,8382.56,16815.3,21 MS-DRG,797,Vaginal Delivery With Sterilization And/Or D&C With Cc,,,7185.87,14687.91,21 MS-DRG,798,Vaginal Delivery With Sterilization And/Or D&C Without Cc/Mcc,,,6874.85,14144.13,21 MS-DRG,799,Splenic Procedures With Mcc,,,32531.09,65256.92,21 MS-DRG,800,Splenic Procedures With Cc,,,20179.92,40480.64,21 MS-DRG,801,Splenic Procedures Without Cc/Mcc,,,13711.63,27505.34,21 MS-DRG,802,Other O.R. Procedures Of The Blood And Blood Forming Organs With Mcc,,,28617.79,57406.9,21 MS-DRG,803,Other O.R. Procedures Of The Blood And Blood Forming Organs With Cc,,,13352.48,26784.89,21 MS-DRG,804,Other O.R. Procedures Of The Blood And Blood Forming Organs Without Cc/Mcc,,,9740.15,19538.6,21 MS-DRG,805,Vaginal Delivery Without Sterilization Or D&C With Mcc,,,7751.89,15677.52,21 MS-DRG,806,Vaginal Delivery Without Sterilization Or D&C With Cc,,,5415.98,11593.48,21 MS-DRG,807,Vaginal Delivery Without Sterilization Or D&C Without Cc/Mcc,,,4842.78,10591.32,21 MS-DRG,808,Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Coagulation Disorders ,,,15859.35,31813.63,21 MS-DRG,809,Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Coagulation Disorders ,,,9092.96,18240.35,21 MS-DRG,810,Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Coagulation Disorders ,,,7517.73,15268.11,21 MS-DRG,811,Red Blood Cell Disorders With Mcc,,,10087.09,20234.56,21 MS-DRG,812,Red Blood Cell Disorders Without Mcc,,,6595.43,13655.6,21 MS-DRG,813,Coagulation Disorders,,,10956.23,21978.05,21 MS-DRG,814,Reticuloendothelial And Immunity Disorders With Mcc,,,15276.09,30643.62,21 MS-DRG,815,Reticuloendothelial And Immunity Disorders With Cc,,,7283.56,14858.7,21 MS-DRG,816,Reticuloendothelial And Immunity Disorders Without Cc/Mcc,,,4539.66,10061.36,21 MS-DRG,817,Other Antepartum Diagnoses With O.R. Procedures With Mcc,,,16388.73,32875.57,21 MS-DRG,818,Other Antepartum Diagnoses With O.R. Procedures With Cc,,,8326.53,16702.91,21 MS-DRG,819,Other Antepartum Diagnoses With O.R. Procedures Without Cc/Mcc,,,6176.66,12923.43,21 MS-DRG,820,Lymphoma And Leukemia With Major O.R. Procedures With Mcc,,,42126.86,84505.9,21 MS-DRG,821,Lymphoma And Leukemia With Major O.R. Procedures With Cc,,,16079.86,32255.99,21 MS-DRG,822,Lymphoma And Leukemia With Major O.R. Procedures Without Cc/Mcc,,,8648.33,17348.44,21 MS-DRG,823,Lymphoma And Non-Acute Leukemia With Other Procedures With Mcc,,,32932.62,66062.38,21 MS-DRG,824,Lymphoma And Non-Acute Leukemia With Other Procedures With Cc,,,16273.8,32645.03,21 MS-DRG,825,Lymphoma And Non-Acute Leukemia With Other Procedures Without Cc/Mcc,,,9692.74,19443.5,21 MS-DRG,826,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.R. Procedures With Mcc,,,33600.64,67402.42,21 MS-DRG,827,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.R. Procedures With Cc,,,16601.35,33302.08,21 MS-DRG,828,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.R. Procedures Without C,,,12238.4,24550.05,21 MS-DRG,829,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Procedures With Cc/Mcc,,,22698.28,45532.44,21 MS-DRG,830,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Procedures Without Cc/Mcc,,,10810.42,21685.55,21 MS-DRG,831,Other Antepartum Diagnoses Without O.R. Procedures With Mcc,,,8637.56,17326.82,21 MS-DRG,832,Other Antepartum Diagnoses Without O.R. Procedures With Cc,,,5183.25,11186.6,21 MS-DRG,833,Other Antepartum Diagnoses Without O.R. Procedures Without Cc/Mcc,,,3755.99,8691.22,21 MS-DRG,834,Acute Leukemia With Mcc,,,39433.95,79103.97,21 MS-DRG,835,Acute Leukemia With Cc,,,14982.3,30054.29,21 MS-DRG,836,Acute Leukemia Without Cc/Mcc,,,8759.67,17571.78,21 MS-DRG,837,Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemotherapy Agent With Mc,,,34509.29,69225.16,21 MS-DRG,838,Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Chemotherapy Agent,,,14993.79,30077.35,21 MS-DRG,839,Chemotherapy With Acute Leukemia As Secondary Diagnosis Without Cc/Mcc,,,10371.53,20805.16,21 MS-DRG,840,Lymphoma And Non-Acute Leukemia With Mcc,,,23236.29,46611.67,21 MS-DRG,841,Lymphoma And Non-Acute Leukemia With Cc,,,11718.35,23506.84,21 MS-DRG,842,Lymphoma And Non-Acute Leukemia Without Cc/Mcc,,,7257.7,14813.49,21 MS-DRG,843,Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses With Mcc,,,14328.65,28743.07,21 MS-DRG,844,Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses With Cc,,,8744.58,17541.52,21 MS-DRG,845,Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses Without Cc/Mcc,,,6117.04,12819.2,21 MS-DRG,846,Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc,,,18621.93,37355.33,21 MS-DRG,847,Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Cc,,,9396.8,18849.85,21 MS-DRG,848,Chemotherapy Without Acute Leukemia As Secondary Diagnosis Without Cc/Mcc,,,6101.24,12791.56,21 MS-DRG,849,Radiotherapy,,,19462.34,39041.19,21 MS-DRG,850,Acute Leukemia With Other Procedures,,,62201.19,124774.74,21 MS-DRG,853,Infectious And Parasitic Diseases With O.R. Procedures With Mcc,,,35473.96,71160.29,21 MS-DRG,854,Infectious And Parasitic Diseases With O.R. Procedures With Cc,,,14352.35,28790.62,21 MS-DRG,855,Infectious And Parasitic Diseases With O.R. Procedures Without Cc/Mcc,,,10754.39,21573.15,21 MS-DRG,856,Postoperative Or Post-Traumatic Infections With O.R. Procedures With Mcc,,,32673.31,65542.22,21 MS-DRG,857,Postoperative Or Post-Traumatic Infections With O.R. Procedures With Cc,,,15382.39,30856.87,21 MS-DRG,858,Postoperative Or Post-Traumatic Infections With O.R. Procedures Without Cc/Mcc,,,10005.2,20070.3,21 MS-DRG,862,Postoperative And Post-Traumatic Infections With Mcc,,,13099.64,26277.69,21 MS-DRG,863,Postoperative And Post-Traumatic Infections Without Mcc,,,7167.92,14656.52,21 MS-DRG,864,Fever And Inflammatory Conditions,,,6376.35,13272.57,21 MS-DRG,865,Viral Illness With Mcc,,,10762.29,21589.0,21 MS-DRG,866,Viral Illness Without Mcc,,,6246.34,13045.26,21 MS-DRG,867,Other Infectious And Parasitic Diseases Diagnoses With Mcc,,,15035.46,30160.92,21 MS-DRG,868,Other Infectious And Parasitic Diseases Diagnoses With Cc,,,7406.39,15073.46,21 MS-DRG,869,Other Infectious And Parasitic Diseases Diagnoses Without Cc/Mcc,,,5241.44,11288.32,21 MS-DRG,870,Septicemia Or Severe Sepsis With Mv >96 Hours,,,49647.46,99592.13,21 MS-DRG,871,Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc,,,13952.98,27989.48,21 MS-DRG,872,Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc,,,7350.36,14975.49,21 MS-DRG,876,O.R. Procedures With Principal Diagnosis Of Mental Illness,,,27761.58,55689.34,21 MS-DRG,880,Acute Adjustment Reaction And Psychosocial Dysfunction,,,6897.12,14183.06,21 MS-DRG,881,Depressive Neuroses,,,6758.48,13940.67,21 MS-DRG,882,Neuroses Except Depressive,,,7713.11,15609.7,21 MS-DRG,883,Disorders Of Personality And Impulse Control,,,14123.93,28332.42,21 MS-DRG,884,Organic Disturbances And Intellectual Disability,,,11556.73,23182.64,21 MS-DRG,885,Psychoses,,,10033.21,20126.49,21 MS-DRG,886,Behavioral And Developmental Disorders,,,14906.88,29903.0,21 MS-DRG,887,Other Mental Disorder Diagnoses,,,7692.27,15573.28,21 MS-DRG,894,"Alcohol, Drug Abuse Or Dependence, Left Ama",,,4431.19,9871.72,21 MS-DRG,895,"Alcohol, Drug Abuse Or Dependence With Rehabilitation Therapy",,,10168.25,20397.38,21 MS-DRG,896,"Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc",,,12535.05,25145.15,21 MS-DRG,897,"Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc",,,6341.15,13211.02,21 MS-DRG,901,Wound Debridements For Injuries With Mcc,,,30144.18,60468.81,21 MS-DRG,902,Wound Debridements For Injuries With Cc,,,13751.85,27586.03,21 MS-DRG,903,Wound Debridements For Injuries Without Cc/Mcc,,,8401.24,16852.77,21 MS-DRG,904,Skin Grafts For Injuries With Cc/Mcc,,,26383.88,52925.7,21 MS-DRG,905,Skin Grafts For Injuries Without Cc/Mcc,,,10655.26,21374.31,21 MS-DRG,906,Hand Procedures For Injuries,,,14109.57,28303.6,21 MS-DRG,907,Other O.R. Procedures For Injuries With Mcc,,,27577.69,55320.47,21 MS-DRG,908,Other O.R. Procedures For Injuries With Cc,,,14331.52,28748.84,21 MS-DRG,909,Other O.R. Procedures For Injuries Without Cc/Mcc,,,9429.12,18914.69,21 MS-DRG,913,Traumatic Injury With Mcc,,,11741.33,23552.95,21 MS-DRG,914,Traumatic Injury Without Mcc,,,6360.55,13244.94,21 MS-DRG,915,Allergic Reactions With Mcc,,,12078.93,24230.17,21 MS-DRG,916,Allergic Reactions Without Mcc,,,4786.03,10492.11,21 MS-DRG,917,Poisoning And Toxic Effects Of Drugs With Mcc,,,11265.82,22599.08,21 MS-DRG,918,Poisoning And Toxic Effects Of Drugs Without Mcc,,,6156.55,12888.27,21 MS-DRG,919,Complications Of Treatment With Mcc,,,13150.64,26380.0,21 MS-DRG,920,Complications Of Treatment With Cc,,,7199.52,14711.78,21 MS-DRG,921,Complications Of Treatment Without Cc/Mcc,,,4944.78,10769.66,21 MS-DRG,922,"Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc",,,12565.94,25207.1,21 MS-DRG,923,"Other Injury, Poisoning And Toxic Effect Diagnoses Without Mcc",,,7310.14,14905.17,21 MS-DRG,927,Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft,,,153360.64,307639.35,21 MS-DRG,928,Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc,,,51521.5,103351.43,21 MS-DRG,929,Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc,,,23135.01,46408.51,21 MS-DRG,933,Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft,,,27972.04,56111.53,21 MS-DRG,934,Full Thickness Burn Without Skin Graft Or Inhalation Injury,,,15878.74,31852.54,21 MS-DRG,935,Non-Extensive Burns,,,14796.98,29682.54,21 MS-DRG,939,O.R. Procedures With Diagnoses Of Other Contact With Health Services With Mcc,,,26063.52,52283.06,21 MS-DRG,940,O.R. Procedures With Diagnoses Of Other Contact With Health Services With Cc,,,16785.95,33672.39,21 MS-DRG,941,O.R. Procedures With Diagnoses Of Other Contact With Health Services Without Cc/Mcc,,,14564.97,29217.13,21 MS-DRG,945,Rehabilitation With Cc/Mcc,,,11123.59,22313.78,21 MS-DRG,946,Rehabilitation Without Cc/Mcc,,,8237.46,16526.48,21 MS-DRG,947,Signs And Symptoms With Mcc,,,9118.1,18290.78,21 MS-DRG,948,Signs And Symptoms Without Mcc,,,5749.99,12177.46,21 MS-DRG,949,Aftercare With Cc/Mcc,,,8545.62,17142.39,21 MS-DRG,950,Aftercare Without Cc/Mcc,,,4508.77,10007.36,21 MS-DRG,951,Other Factors Influencing Health Status,,,3993.75,9106.9,21 MS-DRG,955,Craniotomy For Multiple Significant Trauma,,,48349.49,96988.42,21 MS-DRG,956,"Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma",,,27029.63,54221.07,21 MS-DRG,957,Other O.R. Procedures For Multiple Significant Trauma With Mcc,,,54733.74,109795.14,21 MS-DRG,958,Other O.R. Procedures For Multiple Significant Trauma With Cc,,,30268.44,60718.09,21 MS-DRG,959,Other O.R. Procedures For Multiple Significant Trauma Without Cc/Mcc,,,21147.47,42421.54,21 MS-DRG,963,Other Multiple Significant Trauma With Mcc,,,19636.89,39391.32,21 MS-DRG,964,Other Multiple Significant Trauma With Cc,,,11008.67,22083.23,21 MS-DRG,965,Other Multiple Significant Trauma Without Cc/Mcc,,,6755.61,13935.64,21 MS-DRG,969,Hiv With Extensive O.R. Procedures With Mcc,,,43969.3,88201.81,21 MS-DRG,970,Hiv With Extensive O.R. Procedures Without Mcc,,,18944.44,38002.3,21 MS-DRG,974,Hiv With Major Related Condition With Mcc,,,20730.14,41584.37,21 MS-DRG,975,Hiv With Major Related Condition With Cc,,,9301.99,18659.66,21 MS-DRG,976,Hiv With Major Related Condition Without Cc/Mcc,,,6484.09,13460.94,21 MS-DRG,977,Hiv With Or Without Other Related Condition,,,9321.38,18698.56,21 MS-DRG,981,Extensive O.R. Procedures Unrelated To Principal Diagnosis With Mcc,,,33701.2,67604.15,21 MS-DRG,982,Extensive O.R. Procedures Unrelated To Principal Diagnosis With Cc,,,17659.41,35424.53,21 MS-DRG,983,Extensive O.R. Procedures Unrelated To Principal Diagnosis Without Cc/Mcc,,,12311.66,24697.03,21 MS-DRG,987,Non-Extensive O.R. Procedures Unrelated To Principal Diagnosis With Mcc,,,24626.2,49399.82,21 MS-DRG,988,Non-Extensive O.R. Procedures Unrelated To Principal Diagnosis With Cc,,,11805.98,23682.63,21 MS-DRG,989,Non-Extensive O.R. Procedures Unrelated To Principal Diagnosis Without Cc/Mcc,,,8613.85,17279.27,21 MS-DRG,998,Principal Diagnosis Invalid As Discharge Diagnosis,,,,,0 MS-DRG,999,Ungroupable,,,,,0 NDC,00002021301,"Humulin R: 1 Vial, Multi-Dose In 1 Carton (0002-0213-01) / 3 Ml In 1 Vial, Multi-Dose",0.62,0.245,,,0 NDC,00002120001,NDC Description Not Available,10789.01,4315.6,,,0 NDC,00002418230,"Olumiant: 30 Tablet, Film Coated In 1 Bottle (0002-4182-30)",370.86,148.34,,,0 NDC,00002751001,Humalog: 1 Vial In 1 Carton (0002-7510-01) / 10 Ml In 1 Vial,1.11,0.44,,,0 NDC,00002751017,Humalog: 1 Vial In 1 Carton (0002-7510-17) / 3 Ml In 1 Vial,0.87,0.35,,,0 NDC,00002751601,NDC Description Not Available,1.45,0.58,,,0 NDC,00002753301,Humalog: 1 Vial In 1 Carton (0002-7533-01) / 3 Ml In 1 Vial,0.895,0.36,,,0 NDC,00002759701,Zyprexa Intramuscular: 1 Vial In 1 Carton (0002-7597-01) / 2 Ml In 1 Vial,37.12,14.85,,,0 NDC,00002762301,Alimta: 1 Vial In 1 Carton (0002-7623-01) / 20 Ml In 1 Vial,348.49,139.4,,,0 NDC,00002764001,Alimta: 1 Vial In 1 Carton (0002-7640-01) / 4 Ml In 1 Vial,348.49,139.4,,,0 NDC,00002766901,"Cyramza: 1 Vial, Single-Dose In 1 Carton (0002-7669-01) / 10 Ml In 1 Vial, Single-Dose",321.99,128.8,,,0 NDC,00002767801,"Cyramza: 1 Vial, Single-Dose In 1 Carton (0002-7678-01) / 50 Ml In 1 Vial, Single-Dose",321.6,128.64,,,0 NDC,00002771227,Humalog Kwikpen: 2 Syringe In 1 Carton (0002-7712-27) / 3 Ml In 1 Syringe (0002-7712-01),7.78,3.11,,,0 NDC,00002821501,"Humulin R: 1 Vial, Multi-Dose In 1 Carton (0002-8215-01) / 10 Ml In 1 Vial, Multi-Dose",0.32,0.125,,,0 NDC,00002821517,"Humulin R: 1 Vial, Multi-Dose In 1 Carton (0002-8215-17) / 3 Ml In 1 Vial, Multi-Dose",0.4,1.915,,,0 NDC,00002831501,"Humulin N: 1 Vial, Multi-Dose In 1 Carton (0002-8315-01) / 10 Ml In 1 Vial, Multi-Dose",0.585,0.235,,,0 NDC,00002850101,"Humulin R U-500: 1 Vial, Multi-Dose In 1 Carton (0002-8501-01) / 20 Ml In 1 Vial, Multi-Dose",3.33,1.33,,,0 NDC,00002871501,"Humulin 70/30: 1 Vial, Multi-Dose In 1 Carton (0002-8715-01) / 10 Ml In 1 Vial, Multi-Dose",0.685,0.275,,,0 NDC,00002871517,"1 VIAL, MULTI-DOSE in 1 CARTON (0002-8715-17) / 3 mL in 1 VIAL, MULTI-DOSE",0.37,0.15,,,0 NDC,00003029305,"Kenalog-40: 1 Vial, Single-Dose In 1 Carton (0003-0293-05) / 1 Ml In 1 Vial, Single-Dose",10.3,4.12,,,0 NDC,00003029320,"Kenalog-40: 1 Vial, Multi-Dose In 1 Carton (0003-0293-20) / 5 Ml In 1 Vial, Multi-Dose",10.67,4.27,,,0 NDC,00003029328,"Kenalog-40: 1 Vial, Multi-Dose In 1 Carton (0003-0293-28) / 10 Ml In 1 Vial, Multi-Dose",7.81,3.12,,,0 NDC,00003037113,"Nulojix: 1 Vial, Single-Use In 1 Carton (0003-0371-13) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Use",17.21,6.88,,,0 NDC,00003049420,"Kenalog-10: 1 Vial, Multi-Dose In 1 Carton (0003-0494-20) / 5 Ml In 1 Vial, Multi-Dose",10.6,4.24,,,0 NDC,00003052411,Sprycel: 1 Bottle In 1 Carton (0003-0524-11) / 60 Tablet In 1 Bottle,1012.38,404.95,,,0 NDC,00003052711,Sprycel: 1 Bottle In 1 Carton (0003-0527-11) / 60 Tablet In 1 Bottle,506.19,202.48,,,0 NDC,00003085222,Sprycel: 1 Bottle In 1 Carton (0003-0852-22) / 30 Tablet In 1 Bottle,1824.64,729.86,,,0 NDC,00003089331,"Eliquis: 10 Blister Pack In 1 Carton (0003-0893-31) / 10 Tablet, Film Coated In 1 Blister Pack",30.78,12.31,,,0 NDC,00003089431,"Eliquis: 10 Blister Pack In 1 Carton (0003-0894-31) / 10 Tablet, Film Coated In 1 Blister Pack",30.76,12.3,,,0 NDC,00003161412,Baraclude: 1 Bottle In 1 Carton (0003-1614-12) / 210 Ml In 1 Bottle,249.7,99.88,,,0 NDC,00003218713,"Orencia: 1 Vial, Single-Use In 1 Carton (0003-2187-13) / 15 Ml In 1 Vial, Single-Use",256.96500000000003,102.785,,,0 NDC,00003229111,"Empliciti: 1 Vial, Single-Use In 1 Carton (0003-2291-11) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Use",33.21,13.28,,,0 NDC,00003232711,"Yervoy: 1 Vial, Single-Use In 1 Carton (0003-2327-11) / 10 Ml In 1 Vial, Single-Use",780.86,312.34,,,0 NDC,00003232822,"Yervoy: 1 Vial, Single-Use In 1 Carton (0003-2328-22) / 40 Ml In 1 Vial, Single-Use",780.01,312.0,,,0 NDC,00003256016,"Azactam: 10 Vial, Single-Dose In 1 Carton (0003-2560-16) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose",12.81,5.12,,,0 NDC,00003257016,"Azactam: 10 Vial, Single-Dose In 1 Carton (0003-2570-16) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose",13.32,5.33,,,0 NDC,00003373413,"Opdivo: 1 Vial, Single-Dose In 1 Carton (0003-3734-13) / 24 Ml In 1 Vial, Single-Dose",141.84,56.74,,,0 NDC,00003375614,"Opdivo: 1 Vial, Single-Dose In 1 Carton (0003-3756-14) / 12 Ml In 1 Vial, Single-Dose",141.13,56.45,,,0 NDC,00003377211,"Opdivo: 1 Vial, Single-Dose In 1 Carton (0003-3772-11) / 4 Ml In 1 Vial, Single-Dose",142.21,56.88,,,0 NDC,00003377412,"Opdivo: 1 Vial, Single-Dose In 1 Carton (0003-3774-12) / 10 Ml In 1 Vial, Single-Dose",141.82,56.73,,,0 NDC,00003452211,"Empliciti: 1 Vial, Single-Use In 1 Carton (0003-4522-11) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Use",33.28,13.31,,,0 NDC,00003712511,"Opdualag: 1 Vial, Single-Dose In 1 Carton (0003-7125-11) / 20 Ml In 1 Vial, Single-Dose",830.72,332.29,,,0 NDC,00004080285,Tamiflu: 1 Blister Pack In 1 Carton (0004-0802-85) / 10 Capsule In 1 Blister Pack,60.06,24.02,,,0 NDC,00004110150,"Xeloda: 120 Tablet, Film Coated In 1 Bottle, Plastic (0004-1101-50)",194.06,77.62,,,0 NDC,00005197102,Prevnar 13: 10 Syringe In 1 Carton (0005-1971-02) / .5 Ml In 1 Syringe (0005-1971-01),945.89,378.36,,,0 NDC,00005200001,NDC Description Not Available,964.55,385.82,,,0 NDC,00005200010,Prevnar 20: 10 Syringe In 1 Carton (0005-2000-10) / .5 Ml In 1 Syringe (0005-2000-01),1300.41,520.16,,,0 NDC,00005417758,NDC Description Not Available,0.44,0.18,,,0 NDC,00005434415,NDC Description Not Available,0.71,0.28,,,0 NDC,00005434462,NDC Description Not Available,1.2,0.48,,,0 NDC,00006022101,NDC Description Not Available,47.7,19.08,,,0 NDC,00006022128,"Januvia: 100 Blister Pack In 1 Carton (0006-0221-28) / 1 Tablet, Film Coated In 1 Blister Pack (0006-0221-01)",74.08,29.63,,,0 NDC,00006022761,"Isentress: 60 Tablet, Film Coated In 1 Bottle (0006-0227-61)",95.94,38.38,,,0 NDC,00006027701,NDC Description Not Available,41.3,16.52,,,0 NDC,00006027728,"Januvia: 100 Blister Pack In 1 Carton (0006-0277-28) / 1 Tablet, Film Coated In 1 Blister Pack (0006-0277-01)",52.67,21.07,,,0 NDC,00006033530,"Belsomra: 3 Case In 1 Carton (0006-0335-30) / 1 Blister Pack In 1 Case (0006-0335-10) / 10 Tablet, Film Coated In 1 Blister Pack",63.83,25.53,,,0 NDC,00006047761,"Isentress: 60 Tablet, Chewable In 1 Bottle (0006-0477-61)",26.04,10.42,,,0 NDC,00006302501,NDC Description Not Available,174.21,69.68,,,0 NDC,00006302601,NDC Description Not Available,249.18,99.67,,,0 NDC,00006302602,Keytruda: 1 Vial In 1 Carton (0006-3026-02) / 4 Ml In 1 Vial (0006-3026-01),265.98,106.39,,,0 NDC,00006302604,Keytruda: 2 Vial In 1 Carton (0006-3026-04) / 4 Ml In 1 Vial (0006-3026-01),253.8,101.52,,,0 NDC,00006306601,NDC Description Not Available,57.53,23.01,,,0 NDC,00006306603,"Emend: 1 Pouch In 1 Carton (0006-3066-03) / 1 Powder, For Suspension In 1 Pouch (0006-3066-01)",40.71,16.28,,,0 NDC,00006306901,"Pifeltro: 30 Tablet, Film Coated In 1 Bottle (0006-3069-01)",175.42,70.17,,,0 NDC,00006307502,"Prevymis: 4 Dose Pack In 1 Carton (0006-3075-02) / 7 Tablet, Film Coated In 1 Dose Pack (0006-3075-01)",1144.81,457.92,,,0 NDC,00006307503,NDC Description Not Available,766.2,306.48,,,0 NDC,00006307504,"Prevymis: 14 Blister Pack In 1 Carton (0006-3075-04) / 1 Tablet, Film Coated In 1 Blister Pack (0006-3075-03)",1202.08,480.83,,,0 NDC,00006307601,NDC Description Not Available,666.82,266.73,,,0 NDC,00006307603,NDC Description Not Available,769.13,307.65,,,0 NDC,00006307604,"Prevymis: 14 Blister Pack In 1 Carton (0006-3076-04) / 1 Tablet, Film Coated In 1 Blister Pack (0006-3076-03)",1202.08,480.83,,,0 NDC,00006360301,NDC Description Not Available,11.66,4.66,,,0 NDC,00006360361,"Isentress: 60 Packet In 1 Carton (0006-3603-61) / 1 Granule, For Suspension In 1 Packet (0006-3603-01)",21.16,8.46,,,0 NDC,00006385601,NDC Description Not Available,4.17,1.67,,,0 NDC,00006385602,"Recarbrio: 25 Vial, Single-Dose In 1 Carton (0006-3856-02) / 20 Ml In 1 Vial, Single-Dose (0006-3856-01)",4.23,1.69,,,0 NDC,00006411903,"Gardasil 9: 10 Vial, Single-Dose In 1 Carton (0006-4119-03) / .5 Ml In 1 Vial, Single-Dose (0006-4119-01)",759.71,303.88,,,0 NDC,00006412101,NDC Description Not Available,1413.44,565.38,,,0 NDC,00006412102,"Gardasil 9: 10 Syringe, Glass In 1 Carton (0006-4121-02) / .5 Ml In 1 Syringe, Glass (0006-4121-01)",1223.59,489.44,,,0 NDC,00006417100,"Proquad: 10 Vial, Single-Dose In 1 Carton (0006-4171-00) / .5 Ml In 1 Vial, Single-Dose (0006-4171-01)",1094.88,437.95,,,0 NDC,00006417101,NDC Description Not Available,1246.15,498.46,,,0 NDC,00006468100,"M-M-R Ii: 10 Vial, Single-Dose In 1 Carton (0006-4681-00) / .5 Ml In 1 Vial, Single-Dose (0006-4681-01)",431.16,172.46,,,0 NDC,00006482700,"Varivax: 10 Vial, Single-Dose In 1 Carton (0006-4827-00) / .5 Ml In 1 Vial, Single-Dose (0006-4827-01)",670.87,268.35,,,0 NDC,00006482701,NDC Description Not Available,822.54,329.02,,,0 NDC,00006483701,NDC Description Not Available,522.99,209.2,,,0 NDC,00006483703,"Pneumovax 23: 10 Syringe, Glass In 1 Carton (0006-4837-03) / .5 Ml In 1 Syringe, Glass (0006-4837-01)",489.69,195.88,,,0 NDC,00006489701,NDC Description Not Available,118.56,47.42,,,0 NDC,00006499200,"Recombivax Hb: 1 Vial, Single-Dose In 1 Carton (0006-4992-00) / 1 Ml In 1 Vial, Single-Dose (0006-4992-01)",857.5,343.0,,,0 NDC,00006499201,NDC Description Not Available,427.47,170.99,,,0 NDC,00006500401,"Prevymis: 1 Vial, Single-Dose In 1 Carton (0006-5004-01) / 24 Ml In 1 Vial, Single-Dose (0006-5004-02)",1662.63,665.05,,,0 NDC,00006500402,NDC Description Not Available,1579.23,631.69,,,0 NDC,00006500701,"Delstrigo: 30 Tablet, Film Coated In 1 Bottle (0006-5007-01)",384.99,154.0,,,0 NDC,00006542302,NDC Description Not Available,493.61,197.445,,,0 NDC,00006542312,"Bridion: 10 Vial, Single-Dose In 1 Carton (0006-5423-12) / 2 Ml In 1 Vial, Single-Dose (0006-5423-02)",491.355,196.54500000000002,,,0 NDC,00006542505,NDC Description Not Available,500.175,200.07,,,0 NDC,00006542515,"Bridion: 10 Vial, Single-Dose In 1 Carton (0006-5425-15) / 5 Ml In 1 Vial, Single-Dose (0006-5425-05)",326.8,130.72,,,0 NDC,00008010001,"Besponsa: 1 Vial, Single-Dose In 1 Carton (0008-0100-01) / 4 Ml In 1 Vial, Single-Dose",11218.4,4487.36,,,0 NDC,00008092351,Protonix I.V.: 1 Vial In 1 Carton (0008-0923-51) / 10 Ml In 1 Vial,19.81,7.92,,,0 NDC,00008092355,Protonix I.V.: 10 Carton In 1 Package (0008-0923-55) / 1 Vial In 1 Carton / 10 Ml In 1 Vial,9.62,3.85,,,0 NDC,00008103004,NDC Description Not Available,135.52,54.21,,,0 NDC,00008451001,"Mylotarg: 1 Vial, Single-Dose In 1 Carton (0008-4510-01) / 5 Ml In 1 Vial, Single-Dose",974.98,389.99,,,0 NDC,00009000302,Solu-Medrol: 1 Vial In 1 Carton (0009-0003-02) / 4 Ml In 1 Vial,2.15,0.86,,,0 NDC,00009001103,"Solu-Cortef: 1 Vial, Single-Dose In 1 Carton (0009-0011-03) / 2 Ml In 1 Vial, Single-Dose",85.85,34.34,,,0 NDC,00009001104,"Solu-Cortef: 25 Vial, Single-Dose In 1 Carton (0009-0011-04) / 2 Ml In 1 Vial, Single-Dose (0009-0011-03)",79.72,31.89,,,0 NDC,00009001305,"Solu-Cortef: 1 Vial, Single-Dose In 1 Carton (0009-0013-05) / 2 Ml In 1 Vial, Single-Dose",67.9,27.16,,,0 NDC,00009001820,Solu-Medrol: 1 Vial In 1 Carton (0009-0018-20) / 8 Ml In 1 Vial,1.55,0.62,,,0 NDC,00009003928,Solu-Medrol: 25 Vial In 1 Carton (0009-0039-28) / 1 Ml In 1 Vial (0009-0039-30),5.8,2.32,,,0 NDC,00009003930,NDC Description Not Available,4.82,1.93,,,0 NDC,00009004722,Solu-Medrol: 25 Vial In 1 Carton (0009-0047-22) / 2 Ml In 1 Vial (0009-0047-25),1.53,0.61,,,0 NDC,00009004725,NDC Description Not Available,2.13,0.85,,,0 NDC,00009004727,NDC Description Not Available,1.74,0.7,,,0 NDC,00009006501,Provera: 100 Tablet In 1 Bottle (0009-0065-01),11.25,4.5,,,0 NDC,00009028002,"Depo-Medrol: 1 Vial, Multi-Dose In 1 Carton (0009-0280-02) / 5 Ml In 1 Vial, Multi-Dose",1.08,0.43,,,0 NDC,00009028051,"Depo-Medrol: 25 Vial, Multi-Dose In 1 Package (0009-0280-51) / 5 Ml In 1 Vial, Multi-Dose",0.69,0.28,,,0 NDC,00009030602,"Depo-Medrol: 5 Ml In 1 Vial, Multi-Dose (0009-0306-02)",0.27,0.11,,,0 NDC,00009034201,NDC Description Not Available,136.63,54.65,,,0 NDC,00009041701,Depo-Testosterone: 1 Vial In 1 Carton (0009-0417-01) / 1 Ml In 1 Vial,0.15,0.06,,,0 NDC,00009043601,R-Gene: 1 Container In 1 Carton (0009-0436-01) / 300 Ml In 1 Container,132.905,53.16,,,0 NDC,00009069801,Solu-Medrol: 1 Vial In 1 Carton (0009-0698-01) / 16 Ml In 1 Vial,1.02,0.41,,,0 NDC,00009075801,Solu-Medrol: 1 Vial In 1 Carton (0009-0758-01) / 8 Ml In 1 Vial,1.07,0.43,,,0 NDC,00009082501,Solu-Cortef: 1 Vial In 1 Carton (0009-0825-01) / 2 Ml In 1 Vial,67.37,26.95,,,0 NDC,00009085605,Hemabate: 1 Ml In 1 Ampule (0009-0856-05),564.83,225.93,,,0 NDC,00009087021,NDC Description Not Available,7.31,2.92,,,0 NDC,00009090211,NDC Description Not Available,6.01,2.4,,,0 NDC,00009090218,Cleocin Phosphate: 25 Vial In 1 Carton (0009-0902-18) / 6 Ml In 1 Vial (0009-0902-11),6.02,2.41,,,0 NDC,00009307301,"Depo-Medrol: 1 Vial, Single-Dose In 1 Package (0009-3073-01) / 1 Ml In 1 Vial, Single-Dose",1.28,0.51,,,0 NDC,00009307303,"Depo-Medrol: 25 Vial, Single-Dose In 1 Package (0009-3073-03) / 1 Ml In 1 Vial, Single-Dose",1.26,0.5,,,0 NDC,00009307322,"Depo-Medrol: 1 Vial, Single-Dose In 1 Package (0009-3073-22) / 1 Ml In 1 Vial, Single-Dose",0.51,0.2,,,0 NDC,00009316901,NDC Description Not Available,1.84,0.74,,,0 NDC,00009316906,Prostin Vr Pediatric: 5 Ampule In 1 Package (0009-3169-06) / 1 Ml In 1 Ampule (0009-3169-01),1.4,0.56,,,0 NDC,00009347501,"Depo-Medrol: 1 Vial, Single-Dose In 1 Package (0009-3475-01) / 1 Ml In 1 Vial, Single-Dose",1.08,0.43,,,0 NDC,00009347503,"Depo-Medrol: 25 Vial, Single-Dose In 1 Package (0009-3475-03) / 1 Ml In 1 Vial, Single-Dose",0.46,0.18,,,0 NDC,00009513803,"Zyvox: 30 Blister Pack In 1 Box, Unit-Dose (0009-5138-03) / 1 Tablet, Film Coated In 1 Blister Pack",27.09,10.84,,,0 NDC,00009514001,NDC Description Not Available,31.2,12.48,,,0 NDC,00009514004,Zyvox: 10 Bag In 1 Box (0009-5140-04) / 300 Ml In 1 Bag (0009-5140-01),31.74,12.7,,,0 NDC,00009722401,NDC Description Not Available,20487.74,8195.1,,,0 NDC,00009752903,"Camptosar: 1 Vial, Single-Dose In 1 Carton (0009-7529-03) / 5 Ml In 1 Vial, Single-Dose",17.56,7.02,,,0 NDC,00013010250,"Azulfidine En-Tabs: 1 Bottle In 1 Carton (0013-0102-50) / 100 Tablet, Delayed Release In 1 Bottle",6.44,2.58,,,0 NDC,00013111401,NDC Description Not Available,5.35,2.14,,,0 NDC,00013111420,NDC Description Not Available,55.67,22.27,,,0 NDC,00013257605,"Idamycin Pfs: 1 Vial, Single-Dose In 1 Carton (0013-2576-05) / 5 Ml In 1 Vial, Single-Dose",157.3,62.92,,,0 NDC,00013257691,"Idamycin Pfs: 1 Vial, Single-Dose In 1 Carton (0013-2576-91) / 5 Ml In 1 Vial, Single-Dose",101.58,40.63,,,0 NDC,00013258691,"Idamycin Pfs: 1 Vial, Single-Dose In 1 Carton (0013-2586-91) / 10 Ml In 1 Vial, Single-Dose",181.58,72.63,,,0 NDC,00013259620,"Idamycin Pfs: 1 Vial, Single-Dose In 1 Carton (0013-2596-20) / 20 Ml In 1 Vial, Single-Dose",210.96,84.38,,,0 NDC,00013259691,"Idamycin Pfs: 1 Vial, Single-Dose In 1 Carton (0013-2596-91) / 20 Ml In 1 Vial, Single-Dose",198.06,79.22,,,0 NDC,00019086250,"Cysto-Conray Ii: 12 Bottle, Glass In 1 Box (0019-0862-50) / 250 Ml In 1 Bottle, Glass",0.66,0.26,,,0 NDC,00023040330,"Refresh Plus: 30 Vial, Single-Use In 1 Carton (0023-0403-30) / .4 Ml In 1 Vial, Single-Use",0.91,0.36,,,0 NDC,00023114501,"Botox: 1 Vial In 1 Carton (0023-1145-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",28.48,11.39,,,0 NDC,00023114502,"Botox: 1 Vial In 1 Carton (0023-1145-02) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",27.37,10.95,,,0 NDC,00023392102,"Botox: 1 Vial In 1 Carton (0023-3921-02) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",28.67,11.47,,,0 NDC,00023455430,"Refresh Celluvisc: 30 Vial, Single-Use In 1 Carton (0023-4554-30) / .4 Ml In 1 Vial, Single-Use",1.05,0.42,,,0 NDC,00023599002,NDC Description Not Available,44.09,17.64,,,0 NDC,00023916330,"Restasis: 30 Vial, Single-Use In 1 Tray (0023-9163-30) / .4 Ml In 1 Vial, Single-Use",31.21,12.48,,,0 NDC,00023921105,"Combigan: 1 Bottle, Dropper In 1 Carton (0023-9211-05) / 5 Ml In 1 Bottle, Dropper",879.34,351.74,,,0 NDC,00024065401,"Sarclisa: 1 Vial, Single-Dose In 1 Carton (0024-0654-01) / 5 Ml In 1 Vial, Single-Dose",359.86,143.94,,,0 NDC,00024065601,"Sarclisa: 1 Vial, Single-Dose In 1 Carton (0024-0656-01) / 25 Ml In 1 Vial, Single-Dose",359.86,143.94,,,0 NDC,00024159601,"Primaquine Phosphate: 100 Tablet, Film Coated In 1 Bottle (0024-1596-01)",6.24,2.5,,,0 NDC,00024279201,NDC Description Not Available,27.41,10.96,,,0 NDC,00024279210,"Ferrlecit: 10 Vial, Single-Use In 1 Carton (0024-2792-10) / 5 Ml In 1 Vial, Single-Use (0024-2792-01)",27.41,10.96,,,0 NDC,00024414260,"Multaq: 60 Tablet, Film Coated In 1 Bottle (0024-4142-60)",40.33,16.13,,,0 NDC,00024515010,"Elitek: 3 Kit In 1 Carton (0024-5150-10) / 1 Kit In 1 Kit * 1 Ml In 1 Vial, Single-Use (0024-5154-11) * 1 Ml In 1 Ampule (0024-5152-11)",1605.11,642.04,,,0 NDC,00024515411,NDC Description Not Available,1448.82,579.53,,,0 NDC,00024582411,"Jevtana: 1 Kit In 1 Carton (0024-5824-11) * 5.7 Ml In 1 Vial, Glass (0024-5823-15) * 5.7 Ml In 1 Vial, Glass (0024-5822-01)",1044.8,417.92,,,0 NDC,00024591400,NDC Description Not Available,8195.41,3278.16,,,0 NDC,00024591401,"Dupixent: 2 Syringe, Glass In 1 Carton (0024-5914-01) / 2 Ml In 1 Syringe, Glass (0024-5914-00)",8785.4,3514.16,,,0 NDC,00024591801,"Dupixent: 2 Syringe, Glass In 1 Carton (0024-5918-01) / 1.14 Ml In 1 Syringe, Glass (0024-5918-00)",8195.41,3278.16,,,0 NDC,00024592605,Admelog: 1 Vial In 1 Carton (0024-5926-05) / 3 Ml In 1 Vial,2.79,1.12,,,0 NDC,00025100131,"Aldactone: 100 Tablet, Film Coated In 1 Bottle (0025-1001-31)",5.84,2.34,,,0 NDC,00032004670,"Creon: 100 Capsule, Delayed Release Pellets In 1 Bottle (0032-0046-70)",6.39,2.56,,,0 NDC,00032004770,"Creon: 100 Capsule, Delayed Release Pellets In 1 Bottle (0032-0047-70)",12.74,5.1,,,0 NDC,00032120601,"Creon: 1 Bottle In 1 Carton (0032-1206-01) / 100 Capsule, Delayed Release Pellets In 1 Bottle",8.96,3.58,,,0 NDC,00032121201,"Creon: 100 Capsule, Delayed Release Pellets In 1 Bottle (0032-1212-01)",17.9,7.16,,,0 NDC,00032122401,"Creon: 100 Capsule, Delayed Release Pellets In 1 Bottle (0032-1224-01)",33.67,13.47,,,0 NDC,00032263601,"Creon: 100 Capsule, Delayed Release Pellets In 1 Bottle (0032-2636-01)",25.31,10.12,,,0 NDC,00032301613,"Creon: 100 Capsule, Delayed Release Pellets In 1 Bottle (0032-3016-13)",38.42,15.37,,,0 NDC,00037682315,Proctofoam Ns: 1 Canister In 1 Carton (0037-6823-15) / 15 G In 1 Canister,283.09,113.24,,,0 NDC,00037683015,Cortifoam: 1 Canister In 1 Carton (0037-6830-15) / 15 G In 1 Canister,1344.01,537.6,,,0 NDC,00045008002,NDC Description Not Available,0.27,0.11,,,0 NDC,00045012304,NDC Description Not Available,10.09,4.04,,,0 NDC,00045013404,NDC Description Not Available,5.51,2.2,,,0 NDC,00045016604,NDC Description Not Available,2.95,1.18,,,0 NDC,00045018404,NDC Description Not Available,2.09,0.84,,,0 NDC,00045019201,NDC Description Not Available,4.73,1.89,,,0 NDC,00045019204,NDC Description Not Available,1.13,0.45,,,0 NDC,00045055320,NDC Description Not Available,0.69,0.28,,,0 NDC,00045090926,NDC Description Not Available,0.7,0.28,,,0 NDC,00046074905,Premarin: 1 Vial In 1 Carton (0046-0749-05) / 5 Ml In 1 Vial,1654.48,661.79,,,0 NDC,00046087221,"Premarin Vaginal: 1 Tube, With Applicator In 1 Carton (0046-0872-21) / 30 G In 1 Tube, With Applicator",1379.87,551.95,,,0 NDC,00046110081,"Premarin: 100 Tablet, Film Coated In 1 Bottle (0046-1100-81)",21.17,8.47,,,0 NDC,00046110281,"Premarin: 100 Tablet, Film Coated In 1 Bottle (0046-1102-81)",29.77,11.91,,,0 NDC,00046110481,"Premarin: 100 Tablet, Film Coated In 1 Bottle (0046-1104-81)",21.17,8.47,,,0 NDC,00049001481,NDC Description Not Available,31.67,12.67,,,0 NDC,00049052083,"Pfizerpen: 10 Vial In 1 Carton (0049-0520-83) / 1 Powder, For Solution In 1 Vial (0049-0520-84)",2.33,0.93,,,0 NDC,00049052084,NDC Description Not Available,2.33,0.93,,,0 NDC,00049234079,NDC Description Not Available,242.31,96.92,,,0 NDC,00049316044,Vfend: 1 Bottle In 1 Carton (0049-3160-44) / 75 Ml In 1 Bottle,219.27,87.71,,,0 NDC,00049392020,NDC Description Not Available,123.45,49.38,,,0 NDC,00052060202,Tice Bcg: 1 Vial In 1 Carton (0052-0602-02) / 50 Ml In 1 Vial (0052-0602-01),17.73,7.09,,,0 NDC,00052433001,Nexplanon: 1 BLISTER PACK in 1 CARTON (0052-4330-01) / 1 IMPLANT in 1 BLISTER PACK,4515.18,1806.07,,,0 NDC,00054001125,Flecainide Acetate: 100 Tablet In 1 Bottle (0054-0011-25),2.05,0.82,,,0 NDC,00054001720,Prednisone: 10 Blister Pack In 1 Carton (0054-0017-20) / 10 Tablet In 1 Blister Pack,0.09,0.04,,,0 NDC,00054001820,Prednisone: 10 Blister Pack In 1 Carton (0054-0018-20) / 10 Tablet In 1 Blister Pack,0.03,0.01,,,0 NDC,00054001920,Prednisone: 10 Blister Pack In 1 Carton (0054-0019-20) / 10 Tablet In 1 Blister Pack,0.03,0.01,,,0 NDC,00054001925,"Prednisone: 100 Tablet In 1 Bottle, Plastic (0054-0019-25)",0.03,0.01,,,0 NDC,00054004544,"Ipratropium Bromide: 1 Bottle, Spray In 1 Carton (0054-0045-44) / 345 Spray In 1 Bottle, Spray",108.0,43.2,,,0 NDC,00054005746,Digoxin: 60 Ml In 1 Bottle (0054-0057-46),16.34,6.54,,,0 NDC,00054006405,NDC Description Not Available,36.67,14.67,,,0 NDC,00054017613,Buprenorphine: 30 Tablet In 1 Bottle (0054-0176-13),2.23,0.89,,,0 NDC,00054017713,Buprenorphine: 30 Tablet In 1 Bottle (0054-0177-13),5.19,2.08,,,0 NDC,00054023524,Morphine Sulfate: 100 Blister Pack In 1 Carton (0054-0235-24) / 1 Tablet In 1 Blister Pack,2.05,0.82,,,0 NDC,00054023525,Morphine Sulfate: 100 Tablet In 1 Bottle (0054-0235-25),1.11,0.44,,,0 NDC,00054023763,Morphine Sulfate: 500 Ml In 1 Bottle (0054-0237-63),0.06,0.02,,,0 NDC,00054024324,Codeine Sulfate: 10 Blister Pack In 1 Box (0054-0243-24) / 10 Tablet In 1 Blister Pack,3.11,1.24,,,0 NDC,00054024424,Codeine Sulfate: 10 Blister Pack In 1 Box (0054-0244-24) / 10 Tablet In 1 Blister Pack,2.52,1.01,,,0 NDC,00054024425,Codeine Sulfate: 100 Tablet In 1 Bottle (0054-0244-25),2.22,0.89,,,0 NDC,00054038225,Cyclophosphamide: 100 Capsule In 1 Bottle (0054-0382-25),24.04,9.62,,,0 NDC,00054038325,Cyclophosphamide: 100 Capsule In 1 Bottle (0054-0383-25),13.13,5.25,,,0 NDC,00054039168,Methadone Hydrochloride: 1000 Ml In 1 Bottle (0054-0391-68),1.14,0.46,,,0 NDC,00054039268,Methadone Hydrochloride: 1000 Ml In 1 Bottle (0054-0392-68),0.55,0.22,,,0 NDC,00054042523,"Rufinamide: 120 Tablet, Film Coated In 1 Bottle (0054-0425-23)",8.38,3.35,,,0 NDC,00054042623,"Rufinamide: 120 Tablet, Film Coated In 1 Bottle (0054-0426-23)",18.13,7.25,,,0 NDC,00054044949,"Posaconazole: 1 Bottle, Glass In 1 Carton (0054-0449-49) / 105 Ml In 1 Bottle, Glass",397.24,158.9,,,0 NDC,00054051701,NDC Description Not Available,0.47,0.19,,,0 NDC,00054051741,Morphine Sulfate: 15 Ml In 1 Bottle (0054-0517-41),1.47,0.59,,,0 NDC,00054051744,Morphine Sulfate: 30 Ml In 1 Bottle (0054-0517-44),1.45,0.58,,,0 NDC,00054052863,Rufinamide: 1 Bottle In 1 Carton (0054-0528-63) / 460 Ml In 1 Bottle,231.47,92.59,,,0 NDC,00054071020,Methadone Hydrochloride: 1 Blister Pack In 1 Carton (0054-0710-20) / 100 Tablet In 1 Blister Pack,0.88,0.35,,,0 NDC,00054074287,"Albuterol Sulfate: 1 Canister In 1 Carton (0054-0742-87) / 200 Aerosol, Metered In 1 Canister",194.74,77.9,,,0 NDC,00054312041,"Calcitriol: 1 Bottle, Glass In 1 Carton (0054-3120-41) / 15 Ml In 1 Bottle, Glass",11.56,4.62,,,0 NDC,00054317763,"Dexamethasone: 500 Ml In 1 Bottle, Plastic (0054-3177-63)",0.18,0.07,,,0 NDC,00054319446,Diphenoxylate Hydrochloride And Atropine Sulfate: 1 Bottle In 1 Carton (0054-3194-46) / 60 Ml In 1 Bottle,29.4,11.76,,,0 NDC,00054327099,"Fluticasone Propionate: 1 Bottle, Glass In 1 Carton (0054-3270-99) / 120 Spray, Metered In 1 Bottle, Glass",40.95,16.38,,,0 NDC,00054329450,Furosemide: 120 Ml In 1 Bottle (0054-3294-50),0.21,0.08,,,0 NDC,00054350049,Lidocaine Viscous: 1 Bottle In 1 Carton (0054-3500-49) / 100 Ml In 1 Bottle,1.4100000000000001,0.56,,,0 NDC,00054350547,Lidocaine Hydrochloride: 50 Ml In 1 Bottle (0054-3505-47),174.8,69.92,,,0 NDC,00054353244,Lorazepam: 1 Bottle In 1 Carton (0054-3532-44) / 30 Ml In 1 Bottle,2.48,0.99,,,0 NDC,00054355344,Methadone Hydrochloride: 1 Bottle In 1 Carton (0054-3553-44) / 30 Ml In 1 Bottle,7.89,3.16,,,0 NDC,00054355563,Methadone Hydrochloride: 500 Ml In 1 Bottle (0054-3555-63),0.21,0.08,,,0 NDC,00054372763,"Propranolol Hydrochloride: 500 Ml In 1 Bottle, Plastic (0054-3727-63)",0.79,0.32,,,0 NDC,00054414622,"Clotrimazole: 70 Lozenge In 1 Bottle, Plastic (0054-4146-22)",5.97,2.39,,,0 NDC,00054417925,"Dexamethasone: 100 Tablet In 1 Bottle, Plastic (0054-4179-25)",0.17,0.07,,,0 NDC,00054418225,"Dexamethasone: 100 Tablet In 1 Bottle, Plastic (0054-4182-25)",0.2,0.08,,,0 NDC,00054449613,Leucovorin Calcium: 30 Tablet In 1 Bottle (0054-4496-13),4.78,1.91,,,0 NDC,00054449625,Leucovorin Calcium: 100 Tablet In 1 Bottle (0054-4496-25),4.66,1.86,,,0 NDC,00054458111,"Mercaptopurine: 25 Tablet In 1 Bottle, Plastic (0054-4581-11)",7.26,2.9,,,0 NDC,00054814622,Clotrimazole: 70 Blister Pack In 1 Carton (0054-8146-22) / 1 Lozenge In 1 Blister Pack,5.02,2.01,,,0 NDC,00054817525,Dexamethasone: 100 Blister Pack In 1 Carton (0054-8175-25) / 1 Tablet In 1 Blister Pack,0.23,0.095,,,0 NDC,00054817925,Dexamethasone: 100 Blister Pack In 1 Carton (0054-8179-25) / 1 Tablet In 1 Blister Pack,0.26,0.1,,,0 NDC,00054818125,Dexamethasone: 100 Blister Pack In 1 Carton (0054-8181-25) / 1 Tablet In 1 Blister Pack,0.23,0.09,,,0 NDC,00054829725,Furosemide: 10 Blister Pack In 1 Carton (0054-8297-25) / 10 Tablet In 1 Blister Pack,0.5,0.2,,,0 NDC,00054829925,Furosemide: 10 Blister Pack In 1 Carton (0054-8299-25) / 10 Tablet In 1 Blister Pack,0.56,0.22,,,0 NDC,00054849619,Leucovorin Calcium: 5 Blister Pack In 1 Carton (0054-8496-19) / 10 Tablet In 1 Blister Pack,4.82,1.93,,,0 NDC,00054852825,Lithium Carbonate: 10 Tablet In 1 Blister Pack (0054-8528-25),0.73,0.29,,,0 NDC,00054872425,Prednisone: 10 Blister Pack In 1 Carton (0054-8724-25) / 10 Tablet In 1 Blister Pack,0.12,0.05,,,0 NDC,00054873925,Prednisone: 10 Blister Pack In 1 Carton (0054-8739-25) / 10 Tablet In 1 Blister Pack,0.96,0.38,,,0 NDC,00054874025,Prednisone: 10 Blister Pack In 1 Carton (0054-8740-25) / 10 Tablet In 1 Blister Pack,0.25,0.1,,,0 NDC,00054982825,Prednisone: 100 Tablet In 1 Bottle (0054-9828-25),0.11,0.04,,,0 NDC,00065002315,"Miostat: 12 Vial, Glass In 1 Carton (0065-0023-15) / 1.5 Ml In 1 Vial, Glass",69.81,27.92,,,0 NDC,00065034905,"Phenylephrine Hydrochloride: 1 Bottle, Dropper In 1 Carton (0065-0349-05) / 2 Ml In 1 Bottle, Dropper",55.44,22.18,,,0 NDC,00065035902,"Cyclomydril: 2 Ml In 1 Bottle, Plastic (0065-0359-02)",103.27,41.31,,,0 NDC,00065039515,"Cyclogyl: 1 Bottle, Plastic In 1 Carton (0065-0395-15) / 15 Ml In 1 Bottle, Plastic",293.99,117.6,,,0 NDC,00065039702,"Cyclogyl: 1 Bottle, Plastic In 1 Carton (0065-0397-02) / 2 Ml In 1 Bottle, Plastic",129.3,51.72,,,0 NDC,00065041130,Betadine: 1 Bottle In 1 Carton (0065-0411-30) / 30 Ml In 1 Bottle,56.45,22.58,,,0 NDC,00065050935,Systane Nighttime: 1 Tube In 1 Carton (0065-0509-35) / 3.5 G In 1 Tube,34.75,13.9,,,0 NDC,00065051801,Genteal Tears Night-Time: 1 Tube In 1 Carton (0065-0518-01) / 3.5 G In 1 Tube,21.45,8.58,,,0 NDC,00065064435,TOBREX: 3.5 g in 1 TUBE (0065-0644-35),601.86,240.74,,,0 NDC,00065074114,"Tetracaine Hydrochloride: 12 Blister Pack In 1 Carton (0065-0741-14) / 1 Bottle, Dropper In 1 Blister Pack / 4 Ml In 1 Bottle, Dropper",38.77,15.51,,,0 NDC,00065079515,Bss: 15 Ml In 1 Bottle (0065-0795-15),26.884999999999998,10.75,,,0 NDC,00065079550,Bss: 500 Ml In 1 Bottle (0065-0795-50),162.02,64.81,,,0 NDC,00065081701,"Atropine Sulfate: 1 Bottle, Dropper In 1 Carton (0065-0817-01) / 5 Ml In 1 Bottle, Dropper",254.32,101.73,,,0 NDC,00065401303,"VIGAMOX: 1 BOTTLE, PLASTIC in 1 CARTON (0065-4013-03) / 3 mL in 1 BOTTLE, PLASTIC",744.61,297.84,,,0 NDC,00065806401,Genteal Tears Severe: 1 Tube In 1 Carton (0065-8064-01) / 10 G In 1 Tube,41.73,16.69,,,0 NDC,00065905095,NDC Description Not Available,0.01,0.004,,,0 NDC,00067000524,"EX-LAX: 2 PACKAGE in 1 BOX (0067-0005-24) / 12 TABLET, CHEWABLE in 1 PACKAGE",0.43,0.17,,,0 NDC,00067000548,"EX-LAX: 4 PACKAGE in 1 BOX (0067-0005-48) / 12 TABLET, CHEWABLE in 1 PACKAGE",0.48,0.19,,,0 NDC,00067022812,NDC Description Not Available,14.63,5.85,,,0 NDC,00067815203,Voltaren Arthritis Pain: 1 Tube In 1 Carton (0067-8152-03) / 100 G In 1 Tube,83.26,33.3,,,0 NDC,00068059701,"Rifadin Iv: 1 Vial, Glass In 1 Carton (0068-0597-01) / 10 Ml In 1 Vial, Glass",238.36,95.34,,,0 NDC,00069005902,NDC Description Not Available,1.05,0.42,,,0 NDC,00069005903,Heparin Sodium: 25 Vial In 1 Container (0069-0059-03) / 1 Ml In 1 Vial (0069-0059-04),3.41,1.36,,,0 NDC,00069005904,NDC Description Not Available,0.84,0.34,,,0 NDC,00069020901,NDC Description Not Available,0.95,0.38,,,0 NDC,00069020910,Propofol: 10 Vial In 1 Carton (0069-0209-10) / 20 Ml In 1 Vial (0069-0209-01),1.57,0.63,,,0 NDC,00069023401,1 VIAL in 1 CARTON (0069-0234-01) / 50 mL in 1 VIAL,0.95,0.38,,,0 NDC,00069023801,"Ruxience: 1 Vial, Single-Use In 1 Carton (0069-0238-01) / 10 Ml In 1 Vial, Single-Use",304.32,121.73,,,0 NDC,00069024801,1 VIAL in 1 CARTON (0069-0248-01) / 100 mL in 1 VIAL,0.43,0.17,,,0 NDC,00069024810,Propofol: 10 Vial In 1 Carton (0069-0248-10) / 100 Ml In 1 Vial,0.56,0.22,,,0 NDC,00069024901,"Ruxience: 1 Vial, Single-Use In 1 Carton (0069-0249-01) / 50 Ml In 1 Vial, Single-Use",306.46,122.58,,,0 NDC,00069030501,"Trazimera: 1 Kit In 1 Kit (0069-0305-01) * 20 Ml In 1 Vial, Multi-Dose (0069-0306-01) * 20 Ml In 1 Vial (0069-0307-01)",351.28,140.51,,,0 NDC,00069030801,Trazimera: 1 Vial In 1 Carton (0069-0308-01) / 7.15 Ml In 1 Vial,341.23,136.49,,,0 NDC,00069031501,"Zirabev: 1 Vial, Single-Use In 1 Carton (0069-0315-01) / 4 Ml In 1 Vial, Single-Use",260.96,104.38,,,0 NDC,00069032401,Nyvepria: 1 Carton In 1 Carton (0069-0324-01) / 1 Syringe In 1 Carton / .6 Ml In 1 Syringe,1439.17,575.67,,,0 NDC,00069034201,"Zirabev: 1 Vial, Single-Use In 1 Carton (0069-0342-01) / 16 Ml In 1 Vial, Single-Use",262.33,104.93,,,0 NDC,00069034401,"Abrysvo: 1 Tray In 1 Carton (0069-0344-01) / 1 Kit In 1 Tray (0069-0344-21) * .5 Ml In 1 Vial, Glass (0069-0207-01) * .69 Ml In 1 Syringe, Glass (0069-0250-01)",1106.12,442.45,,,0 NDC,00069034405,"Abrysvo: 5 Tray In 1 Carton (0069-0344-05) / 1 Kit In 1 Tray (0069-0344-21) * .5 Ml In 1 Vial, Glass (0069-0207-01) * .69 Ml In 1 Syringe, Glass (0069-0250-01)",1122.44,448.98,,,0 NDC,00069080901,"Inflectra: 1 Vial, Single-Use In 1 Carton (0069-0809-01) / 10 Ml In 1 Vial, Single-Use",401.3,160.52,,,0 NDC,00069130601,NDC Description Not Available,39.8,15.92,,,0 NDC,00069130701,NDC Description Not Available,48.53,19.41,,,0 NDC,00069130710,"Retacrit: 10 Vial, Single-Dose In 1 Carton (0069-1307-10) / 1 Ml In 1 Vial, Single-Dose (0069-1307-01)",40.5,16.2,,,0 NDC,00069130801,NDC Description Not Available,38.37,15.35,,,0 NDC,00069130901,NDC Description Not Available,46.62,18.65,,,0 NDC,00069130904,"Retacrit: 4 Vial, Single-Dose In 1 Carton (0069-1309-04) / 1 Ml In 1 Vial, Single-Dose (0069-1309-01)",40.5,16.2,,,0 NDC,00069131101,NDC Description Not Available,45.35,18.14,,,0 NDC,00069131110,"Retacrit: 10 Vial, Multi-Dose In 1 Carton (0069-1311-10) / 1 Ml In 1 Vial, Multi-Dose (0069-1311-01)",38.37,15.35,,,0 NDC,00069154220,"Doxorubicin Hydrochloride: 1 Vial, Multi-Dose In 1 Carton (0069-1542-20) / 100 Ml In 1 Vial, Multi-Dose",12.08,4.83,,,0 NDC,00069246510,Abrysvo: 10 Vial In 1 Carton (0069-2465-10) / .5 Ml In 1 Vial (0069-2465-19),1140.33,456.13,,,0 NDC,00069303220,"Doxorubicin Hydrochloride: 1 Vial, Single-Dose In 1 Carton (0069-3032-20) / 25 Ml In 1 Vial, Single-Dose",19.6,7.84,,,0 NDC,00069303420,"Doxorubicin Hydrochloride: 1 Vial, Multi-Dose In 1 Carton (0069-3034-20) / 100 Ml In 1 Vial, Multi-Dose",13.48,5.39,,,0 NDC,00069306030,"30 TABLET, FILM COATED in 1 BOTTLE (0069-3060-30)",4.56,1.82,,,0 NDC,00069406189,"Zithromax: 50 Blister Pack In 1 Box, Unit-Dose (0069-4061-89) / 1 Tablet, Film Coated In 1 Blister Pack",14.88,5.95,,,0 NDC,00069449401,NDC Description Not Available,827.09,330.84,,,0 NDC,00069449402,"Elrexfio: 1 Vial, Single-Dose In 1 Carton (0069-4494-02) / 1.9 Ml In 1 Vial, Single-Dose (0069-4494-01)",782.58,313.03,,,0 NDC,00069531702,NDC Description Not Available,299.53,119.81,,,0 NDC,00069531720,"Paxlovid: 10 Blister Pack In 1 Carton (0069-5317-20) / 1 Kit In 1 Blister Pack (0069-5317-02) * 1 Tablet, Film Coated In 1 Blister Pack (0069-2085-11) * 1 Tablet, Film Coated In 1 Blister Pack (0",212.98,85.19,,,0 NDC,00069532103,NDC Description Not Available,145.7,58.28,,,0 NDC,00069532130,"Paxlovid: 10 Blister Pack In 1 Carton (0069-5321-30) / 1 Kit In 1 Blister Pack (0069-5321-03) * 2 Tablet, Film Coated In 1 Blister Pack (0069-2085-02) * 1 Tablet, Film Coated In 1 Blister Pack (0",149.6,59.84,,,0 NDC,00069600102,NDC Description Not Available,11.07,4.43,,,0 NDC,00069600110,NDC Description Not Available,14.9,5.96,,,0 NDC,00069600121,Cerebyx: 10 Vial In 1 Package (0069-6001-21) / 10 Ml In 1 Vial (0069-6001-10),5.62,2.25,,,0 NDC,00069600125,Cerebyx: 25 Vial In 1 Carton (0069-6001-25) / 2 Ml In 1 Vial (0069-6001-02),4.3,1.72,,,0 NDC,00071000740,"Dilantin Infatabs: 100 Blister Pack In 1 Box, Unit-Dose (0071-0007-40) / 1 Tablet, Chewable In 1 Blister Pack",6.71,2.68,,,0 NDC,00071036940,Dilantin: 100 Blister Pack In 1 Carton (0071-0369-40) / 1 Capsule In 1 Blister Pack,5.74,2.3,,,0 NDC,00071101341,Lyrica: 100 Blister Pack In 1 Carton (0071-1013-41) / 1 Capsule In 1 Blister Pack,47.89,19.16,,,0 NDC,00071101441,Lyrica: 100 Blister Pack In 1 Carton (0071-1014-41) / 1 Capsule In 1 Blister Pack,47.97,19.19,,,0 NDC,00071101541,Lyrica: 100 Blister Pack In 1 Carton (0071-1015-41) / 1 Capsule In 1 Blister Pack,33.4,13.36,,,0 NDC,00074056111,"Venclexta: 1 Blister Pack In 1 Carton (0074-0561-11) / 2 Tablet, Film Coated In 1 Blister Pack",58.52,23.41,,,0 NDC,00074056114,"Venclexta: 1 Blister Pack In 1 Carton (0074-0561-14) / 14 Tablet, Film Coated In 1 Blister Pack",38.17,15.27,,,0 NDC,00074056607,"Venclexta: 1 Blister Pack In 1 Carton (0074-0566-07) / 7 Tablet, Film Coated In 1 Blister Pack",193.23,77.29,,,0 NDC,00074056611,"Venclexta: 1 Blister Pack In 1 Carton (0074-0566-11) / 1 Tablet, Film Coated In 1 Blister Pack",292.61,117.04,,,0 NDC,00074057622,"Venclexta: 120 Tablet, Film Coated In 1 Bottle (0074-0576-22)",585.26,234.1,,,0 NDC,00074057630,"Venclexta: 1 Bottle In 1 Carton (0074-0576-30) / 28 Tablet, Film Coated In 1 Bottle",381.66,152.66,,,0 NDC,00074104328,"Rinvoq: 28 Tablet, Extended Release In 1 Bottle (0074-1043-28)",1273.09,509.24,,,0 NDC,00074230630,"Rinvoq: 30 Tablet, Extended Release In 1 Bottle (0074-2306-30)",621.51,248.6,,,0 NDC,00074262528,"Mavyret: 4 Carton In 1 Carton (0074-2625-28) / 7 Dose Pack In 1 Carton / 3 Tablet, Film Coated In 1 Dose Pack",581.12,232.45,,,0 NDC,00074310832,Gengraf: 3 Blister Pack In 1 Carton (0074-3108-32) / 10 Capsule In 1 Blister Pack,5.52,2.21,,,0 NDC,00074310932,Gengraf: 5 Blister Pack In 1 Carton (0074-3109-32) / 6 Capsule In 1 Blister Pack,21.44,8.58,,,0 NDC,00074334603,Lupron Depot: 1 Kit In 1 Carton (0074-3346-03) * 1.5 Ml In 1 Syringe * 1 Swab In 1 Packet,9241.75,3696.7,,,0 NDC,00074347303,Lupron Depot: 1 Kit In 1 Carton (0074-3473-03) * 1 Swab In 1 Packet * 1.5 Ml In 1 Syringe,9389.97,3755.99,,,0 NDC,00074364103,Lupron Depot: 1 Kit In 1 Carton (0074-3641-03) * 1 Ml In 1 Syringe * 1 Ml In 1 Packet,7776.15,3110.46,,,0 NDC,00074364203,Lupron Depot: 1 Kit In 1 Carton (0074-3642-03) * 1 Ml In 1 Syringe * 1 Swab In 1 Packet,9232.83,3693.13,,,0 NDC,00074366303,Lupron Depot: 1 Kit In 1 Carton (0074-3663-03) * 1.5 Ml In 1 Syringe * 1 Ml In 1 Packet,6913.06,2765.22,,,0 NDC,00074368303,Lupron Depot: 1 Kit In 1 Carton (0074-3683-03) * 1.5 Ml In 1 Syringe * 1 Swab In 1 Packet,9309.02,3723.61,,,0 NDC,00074434190,Synthroid: 90 Tablet In 1 Bottle (0074-4341-90),2.63,1.05,,,0 NDC,00074455211,"Synthroid: 10 Blister Pack In 1 Box, Unit-Dose (0074-4552-11) / 10 Tablet In 1 Blister Pack",4.77,1.91,,,0 NDC,00074455290,Synthroid: 90 Tablet In 1 Bottle (0074-4552-90),4.85,1.94,,,0 NDC,00074501501,"Skyrizi: 1 Vial, Single-Dose In 1 Carton (0074-5015-01) / 10 Ml In 1 Vial, Single-Dose",76.12,30.45,,,0 NDC,00074518211,"Synthroid: 10 Blister Pack In 1 Box, Unit-Dose (0074-5182-11) / 10 Tablet In 1 Blister Pack",4.27,1.71,,,0 NDC,00074518290,Synthroid: 90 Tablet In 1 Bottle (0074-5182-90),6.8,2.72,,,0 NDC,00074662411,"Synthroid: 10 Blister Pack In 1 Box, Unit-Dose (0074-6624-11) / 10 Tablet In 1 Blister Pack",4.95,1.98,,,0 NDC,00074662490,Synthroid: 90 Tablet In 1 Bottle (0074-6624-90),6.8,2.72,,,0 NDC,00074709430,Qulipta: 30 Tablet In 1 Bottle (0074-7094-30),156.96,62.78,,,0 NDC,00074714811,"Synthroid: 10 Blister Pack In 1 Box, Unit-Dose (0074-7148-11) / 10 Tablet In 1 Blister Pack",4.89,1.96,,,0 NDC,00074929690,Synthroid: 90 Tablet In 1 Bottle (0074-9296-90),6.46,2.58,,,0 NDC,00075062201,NDC Description Not Available,10.7,4.28,,,0 NDC,00075062280,Lovenox: 10 Cello Pack In 1 Carton (0075-0622-80) / 1 Syringe In 1 Cello Pack (0075-0622-01) / .8 Ml In 1 Syringe,10.67,4.27,,,0 NDC,00078010901,Sandimmune: 10 Ampule In 1 Box (0078-0109-01) / 5 Ml In 1 Ampule (0078-0109-61),77.7,31.08,,,0 NDC,00078010961,NDC Description Not Available,87.54,35.02,,,0 NDC,00078024661,NDC Description Not Available,9.7,3.88,,,0 NDC,00078033184,"Simulect: 1 Vial, Single-Use In 1 Carton (0078-0331-84) / 5 Ml In 1 Vial, Single-Use",20547.63,8219.05,,,0 NDC,00078034442,Vivelle-Dot: 8 Pouch In 1 Box (0078-0344-42) / 1 Patch In 1 Pouch (0078-0344-62) / 3.5 D In 1 Patch,82.9,33.16,,,0 NDC,00078034462,NDC Description Not Available,79.91,31.96,,,0 NDC,00078043005,"Focalin Xr: 100 Capsule, Extended Release In 1 Bottle (0078-0430-05)",21.19,8.48,,,0 NDC,00078043105,"Focalin Xr: 100 Capsule, Extended Release In 1 Bottle (0078-0431-05)",14.98,5.99,,,0 NDC,00078056845,Coartem: 24 Tablet In 1 Bottle (0078-0568-45),17.21,6.88,,,0 NDC,00078065920,"Entresto: 60 Tablet, Film Coated In 1 Bottle (0078-0659-20)",35.22,14.09,,,0 NDC,00078065967,"Entresto: 180 Tablet, Film Coated In 1 Bottle (0078-0659-67)",35.27,14.11,,,0 NDC,00078067515,"ZOFRAN: 30 TABLET, FILM COATED in 1 BOTTLE (0078-0675-15)",99.95,39.98,,,0 NDC,00078068266,Tafinlar: 120 Capsule In 1 Bottle (0078-0682-66),433.3,173.32,,,0 NDC,00078068361,Arranon: 50 Ml In 1 Vial (0078-0683-61),626.93,250.77,,,0 NDC,00078068415,"Promacta: 30 Tablet, Film Coated In 1 Bottle (0078-0684-15)",735.92,294.37,,,0 NDC,00078068615,"Promacta: 30 Tablet, Film Coated In 1 Bottle (0078-0686-15)",1313.15,525.26,,,0 NDC,00078069620,"Entresto: 60 Tablet, Film Coated In 1 Bottle (0078-0696-20)",35.19,14.08,,,0 NDC,00078069802,NDC Description Not Available,500.48,200.19,,,0 NDC,00078069851,NDC Description Not Available,575.41,230.16,,,0 NDC,00078069899,"Rydapt: 2 Carton In 1 Carton (0078-0698-99) / 14 Blister Pack In 1 Carton (0078-0698-51) / 2 Capsule, Liquid Filled In 1 Blister Pack (0078-0698-02)",854.56,341.82,,,0 NDC,00078073461,"Ilaris: 1 Vial, Single-Use In 1 Carton (0078-0734-61) / 1 Ml In 1 Vial, Single-Use",145.81,58.32,,,0 NDC,00078077720,"Entresto: 60 Tablet, Film Coated In 1 Bottle (0078-0777-20)",33.7,13.48,,,0 NDC,00078077767,"Entresto: 180 Tablet, Film Coated In 1 Bottle (0078-0777-67)",35.23,14.09,,,0 NDC,00078079761,NDC Description Not Available,965.49,386.2,,,0 NDC,00078080461,NDC Description Not Available,921.93,368.77,,,0 NDC,00078081301,Tobrex: 3.5 G In 1 Tube (0078-0813-01),780.73,312.29,,,0 NDC,00078081881,Sandostatin Lar Depot: 1 Kit In 1 Kit (0078-0818-81) * 6 Ml In 1 Vial (0078-0797-61) * 2 Ml In 1 Syringe,704.51,281.8,,,0 NDC,00078082581,Sandostatin Lar Depot: 1 Kit In 1 Kit (0078-0825-81) * 2 Ml In 1 Syringe * 6 Ml In 1 Vial (0078-0804-61),1007.75,403.1,,,0 NDC,00078086225,Durezol: 1 Bottle In 1 Carton (0078-0862-25) / 5 Ml In 1 Bottle,812.7,325.08,,,0 NDC,00078087601,Tobradex: 3.5 G In 1 Tube (0078-0876-01),841.29,336.52,,,0 NDC,00078088361,"Adakveo: 10 Ml In 1 Vial, Glass (0078-0883-61)",539.65,215.86,,,0 NDC,00078089778,"Triesence: 1 Blister Pack In 1 Carton (0078-0897-78) / 1 Vial, Glass In 1 Blister Pack / 1 Ml In 1 Vial, Glass",108.56,43.42,,,0 NDC,00078092525,Maxidex: 5 Ml In 1 Bottle (0078-0925-25),131.96,52.785,,,0 NDC,00078093926,Vigamox: 1 Bottle In 1 Carton (0078-0939-26) / 3 Ml In 1 Bottle,865.9,346.36,,,0 NDC,00078100060,"Leqvio: 1 Syringe, Glass In 1 Carton (0078-1000-60) / 1.5 Ml In 1 Syringe, Glass",56.5,22.6,,,0 NDC,00078116147,Mekinist: 90 Ml In 1 Bottle (0078-1161-47),166.23,66.49,,,0 NDC,00078116861,"Cosentyx: 5 Ml In 1 Vial, Glass (0078-1168-61)",77.63,31.05,,,0 NDC,00081079888,NDC Description Not Available,15.09,6.04,,,0 NDC,00085433101,"Noxafil: 1 Vial, Glass In 1 Carton (0085-4331-01) / 16.7 Ml In 1 Vial, Glass",2285.39,914.16,,,0 NDC,00085461005,Dulera: 1 CANISTER in 1 CARTON (0085-4610-05) / 60 AEROSOL in 1 CANISTER,248.09,99.24,,,0 NDC,00085720607,Dulera: 1 CANISTER in 1 CARTON (0085-7206-07) / 60 AEROSOL in 1 CANISTER,151.36,60.54,,,0 NDC,00087040203,NDC Description Not Available,0.27,0.11,,,0 NDC,00087040255,NDC Description Not Available,0.32,0.13,,,0 NDC,00087040265,NDC Description Not Available,0.23,0.09,,,0 NDC,00087074002,NDC Description Not Available,0.2,0.08,,,0 NDC,00087074054,NDC Description Not Available,0.28,0.11,,,0 NDC,00087074081,NDC Description Not Available,0.08,0.03,,,0 NDC,00087086644,NDC Description Not Available,0.33,0.13,,,0 NDC,00088210201,NDC Description Not Available,21.33,8.53,,,0 NDC,00088222033,"Lantus: 1 Vial, Glass In 1 Carton (0088-2220-33) / 10 Ml In 1 Vial, Glass",1.35,0.54,,,0 NDC,00093005301,Buspirone Hydrochloride: 100 Tablet In 1 Bottle (0093-0053-01),0.17,0.07,,,0 NDC,00093010901,Carbamazepine: 100 Tablet In 1 Bottle (0093-0109-01),2.88,1.15,,,0 NDC,00093026230,Fluocinonide: 1 Tube In 1 Carton (0093-0262-30) / 30 G In 1 Tube,308.43,123.37,,,0 NDC,00093031401,"Ketorolac Tromethamine: 100 Tablet, Film Coated In 1 Bottle (0093-0314-01)",3.25,1.3,,,0 NDC,00093031801,"Diltiazem Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (0093-0318-01)",0.44,0.18,,,0 NDC,00093031901,"Diltiazem Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (0093-0319-01)",0.65,0.26,,,0 NDC,00093032001,"Diltiazem Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (0093-0320-01)",0.83,0.33,,,0 NDC,00093081001,Nortriptyline Hydrochloride: 100 Capsule In 1 Bottle (0093-0810-01),0.79,0.32,,,0 NDC,00093081101,Nortriptyline Hydrochloride: 100 Capsule In 1 Bottle (0093-0811-01),1.1,0.44,,,0 NDC,00093083201,Clonazepam: 100 Tablet In 1 Bottle (0093-0832-01),0.14,0.06,,,0 NDC,00093101042,Mupirocin: 1 Tube In 1 Carton (0093-1010-42) / 22 G In 1 Tube,140.17,56.07,,,0 NDC,00093117701,Neomycin Sulfate: 100 Tablet In 1 Bottle (0093-1177-01),2.95,1.18,,,0 NDC,00093202631,Azithromycin: 30 Ml In 1 Bottle (0093-2026-31),23.64,9.46,,,0 NDC,00093206506,Cilostazol: 60 Tablet In 1 Bottle (0093-2065-06),1.37,0.55,,,0 NDC,00093227434,"Amoxicillin And Clavulanate Potassium: 20 Tablet, Film Coated In 1 Bottle (0093-2274-34)",4.17,1.67,,,0 NDC,00093310905,Amoxicillin: 500 Capsule In 1 Bottle (0093-3109-05),0.72,0.29,,,0 NDC,00093312301,Dicloxacillin Sodium: 100 Capsule In 1 Bottle (0093-3123-01),1.97,0.79,,,0 NDC,00093312701,Disopyramide Phosphate: 100 Capsule In 1 Bottle (0093-3127-01),8.59,3.44,,,0 NDC,00093314705,Cephalexin: 500 Capsule In 1 Bottle (0093-3147-05),0.89,0.36,,,0 NDC,00093317431,"Albuterol Sulfate Hfa: 1 Inhaler In 1 Carton (0093-3174-31) / 200 Aerosol, Metered In 1 Inhaler",107.95,43.18,,,0 NDC,00093342501,"Lorazepam: 100 Tablet In 1 Bottle, Plastic (0093-3425-01)",0.13,0.05,,,0 NDC,00093342505,"Lorazepam: 500 Tablet In 1 Bottle, Plastic (0093-3425-05)",0.1,0.04,,,0 NDC,00093342601,"Lorazepam: 100 Tablet In 1 Bottle, Plastic (0093-3426-01)",0.14,0.06,,,0 NDC,00093342605,"Lorazepam: 500 Tablet In 1 Bottle, Plastic (0093-3426-05)",0.22,0.09,,,0 NDC,00093365621,NDC Description Not Available,158.87,63.55,,,0 NDC,00093365640,Buprenorphine: 4 Pouch In 1 Carton (0093-3656-40) / 1 Patch In 1 Pouch / 168 H In 1 Patch,160.83,64.33,,,0 NDC,00093365721,NDC Description Not Available,238.3,95.32,,,0 NDC,00093412774,Penicillin V Potassium: 200 Ml In 1 Bottle (0093-4127-74),0.68,0.27,,,0 NDC,00093416173,Amoxicillin: 100 Ml In 1 Bottle (0093-4161-73),1.6,0.64,,,0 NDC,00093417773,Cephalexin: 100 Ml In 1 Bottle (0093-4177-73),2.52,1.01,,,0 NDC,00093417774,Cephalexin: 200 Ml In 1 Bottle (0093-4177-74),4.81,1.92,,,0 NDC,00093503156,"Tiagabine Hydrochloride: 30 Tablet, Film Coated In 1 Bottle (0093-5031-56)",17.6,7.04,,,0 NDC,00093555001,"Dexmethylphenidate Hydrochloride: 100 Capsule, Extended Release In 1 Bottle (0093-5550-01)",5.53,2.21,,,0 NDC,00093598627,Epinephrine: 2 Container In 1 Carton (0093-5986-27) / 1 Syringe In 1 Container (0093-5986-19) / .3 Ml In 1 Syringe,689.98,275.99,,,0 NDC,00093681519,NDC Description Not Available,24.67,9.87,,,0 NDC,00093681555,"Budesonide: 30 Pouch In 1 Carton (0093-6815-55) / 1 Vial, Single-Dose In 1 Pouch / 2 Ml In 1 Vial, Single-Dose",26.87,10.75,,,0 NDC,00093681619,NDC Description Not Available,26.65,10.66,,,0 NDC,00093681655,"Budesonide: 30 Pouch In 1 Carton (0093-6816-55) / 1 Vial, Single-Dose In 1 Pouch / 2 Ml In 1 Vial, Single-Dose",26.59,10.64,,,0 NDC,00093716498,"Tolterodine Tartrate: 90 Capsule, Extended Release In 1 Bottle (0093-7164-98)",19.57,7.83,,,0 NDC,00093729501,"Carvedilol: 100 Tablet, Film Coated In 1 Bottle (0093-7295-01)",0.18,0.07,,,0 NDC,00093738598,"Venlafaxine Hydrochloride: 90 Capsule, Extended Release In 1 Bottle (0093-7385-98)",0.86,0.34,,,0 NDC,00093762998,"Imatinib Mesylate: 90 Tablet, Film Coated In 1 Bottle (0093-7629-98)",3.72,1.49,,,0 NDC,00093763056,"Imatinib Mesylate: 30 Tablet, Film Coated In 1 Bottle (0093-7630-56)",13.12,5.25,,,0 NDC,00093873901,Mexiletine Hydrochloride: 100 Capsule In 1 Bottle (0093-8739-01),5.54,2.22,,,0 NDC,00093874001,Mexiletine Hydrochloride: 100 Capsule In 1 Bottle (0093-8740-01),4.63,1.85,,,0 NDC,00093901819,NDC Description Not Available,3.34,1.34,,,0 NDC,00093902019,NDC Description Not Available,12.69,5.08,,,0 NDC,00093902065,"Cyclosporine Modified: 30 Blister Pack In 1 Carton (0093-9020-65) / 1 Capsule, Liquid Filled In 1 Blister Pack (0093-9020-19)",7.06,2.82,,,0 NDC,00093970301,Carbidopa And Levodopa: 100 Tablet In 1 Bottle (0093-9703-01),0.86,0.34,,,0 NDC,00096070735,NDC Description Not Available,28.0,11.2,,,0 NDC,00115168774,Budesonide Inhalation: 6 Pouch In 1 Carton (0115-1687-74) / 5 Vial In 1 Pouch (0115-1687-76) / 2 Ml In 1 Vial,12.13,4.85,,,0 NDC,00115168974,Budesonide Inhalation: 6 Pouch In 1 Carton (0115-1689-74) / 5 Vial In 1 Pouch (0115-1689-76) / 2 Ml In 1 Vial,3.57,1.43,,,0 NDC,00115169449,"Epinephrine: 2 Case In 1 Carton (0115-1694-49) / 1 Syringe, Glass In 1 Case / .3 Ml In 1 Syringe, Glass",373.8,149.51999999999998,,,0 NDC,00115180401,"Hydroxyzine Pamoate: 100 Capsule In 1 Bottle, Plastic (0115-1804-01)",0.25,0.1,,,0 NDC,00115262201,Terbutaline Sulfate: 100 Tablet In 1 Bottle (0115-2622-01),9.95,3.98,,,0 NDC,00115443301,Dantrolene Sodium: 100 Capsule In 1 Bottle (0115-4433-01),1.98,0.79,,,0 NDC,00115991901,"Dexmethylphenidate Hydrochloride: 100 Capsule, Extended Release In 1 Bottle, Plastic (0115-9919-01)",7.52,3.01,,,0 NDC,00116200116,Chlorhexidine Gluconate: 473 Ml In 1 Bottle (0116-2001-16),3.38,1.35,,,0 NDC,00116400511,"Lactulose: 100 Case In 1 Case (0116-4005-11) / 40 Tray In 1 Case (0116-4005-41) / 10 Cup, Unit-Dose In 1 Tray / 30 Ml In 1 Cup, Unit-Dose (0116-4005-30)",3.29,1.32,,,0 NDC,00116400530,"Lactulose: 30 Ml In 1 Cup, Unit-Dose (0116-4005-30)",4.640000000000001,1.855,,,0 NDC,00121043130,"Milk Of Magnesia: 10 Tray In 1 Case (0121-0431-30) / 10 Cup, Unit-Dose In 1 Tray / 30 Ml In 1 Cup, Unit-Dose",7.13,2.85,,,0 NDC,00121048900,"Diphenhydramine Hydrochloride: 10 Tray In 1 Case (0121-0489-00) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (0121-0489-05)",9.59,3.84,,,0 NDC,00121048905,NDC Description Not Available,9.39,3.76,,,0 NDC,00121053005,NDC Description Not Available,10.36,4.14,,,0 NDC,00121063800,"Guaifenesin Dm: 10 Tray In 1 Case (0121-0638-00) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (0121-0638-05)",3.3,1.32,,,0 NDC,00121063805,NDC Description Not Available,6.81,2.72,,,0 NDC,00121064616,Amantadine Hydrochloride: 473 Ml In 1 Bottle (0121-0646-16),1.48,0.59,,,0 NDC,00121065705,NDC Description Not Available,1.36,0.54,,,0 NDC,00121065816,Trihexyphenidyl Hydrochloride: 473 Ml In 1 Bottle (0121-0658-16),2.74,1.1,,,0 NDC,00121065916,NDC Description Not Available,0.12,0.05,,,0 NDC,00121067016,Ethosuximide: 473 Ml In 1 Bottle (0121-0670-16),2.14,0.86,,,0 NDC,00121067516,473 mL in 1 BOTTLE (0121-0675-16),0.72,0.29,,,0 NDC,00121067585,Valproic Acid: 473 Ml In 1 Bottle (0121-0675-85),1.0,0.4,,,0 NDC,00121067616,Potassium Citrate And Citric Acid: 473 Ml In 1 Bottle (0121-0676-16),1.94,0.78,,,0 NDC,00121067716,Tricitrates: 473 Ml In 1 Bottle (0121-0677-16),0.63,0.25,,,0 NDC,00121072104,Fluoxetine: 120 Ml In 1 Bottle (0121-0721-04),10.64,4.26,,,0 NDC,00121075908,Prednisolone Sodium Phosphate: 237 Ml In 1 Bottle (0121-0759-08),1.17,0.47,,,0 NDC,00121076616,Calcium Carbonate: 12 Bottle In 1 Case (0121-0766-16) / 473 Ml In 1 Bottle,0.12,0.05,,,0 NDC,00121077516,Guaifenesin And Codeine Phosphate: 473 Ml In 1 Bottle (0121-0775-16),1.06,0.42,,,0 NDC,00121082016,Theophylline: 473 Ml In 1 Bottle (0121-0820-16),4.79,1.92,,,0 NDC,00121082501,Morphine Sulfate: 30 Ml In 1 Bottle (0121-0825-01),0.92,0.37,,,0 NDC,00121082601,Oxycodone Hydrochloride: 1 Bottle In 1 Carton (0121-0826-01) / 30 Ml In 1 Bottle,3.62,1.45,,,0 NDC,00121085320,"Sulfamethoxazole And Trimethoprim: 10 Cup, Unit-Dose In 1 Tray (0121-0853-20) / 20 Ml In 1 Cup, Unit-Dose",13.53,5.41,,,0 NDC,00121085416,Sulfatrim: 473 Ml In 1 Bottle (0121-0854-16),2.23,0.89,,,0 NDC,00121086800,"Nystatin: 10 Tray In 1 Case (0121-0868-00) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (0121-0868-05)",4.59,1.84,,,0 NDC,00121086805,NDC Description Not Available,2.1,0.84,,,0 NDC,00121087332,Lactulose: 946 Ml In 1 Bottle (0121-0873-32),26.795,10.719999999999999,,,0 NDC,00121089300,"Chlorhexidine Gluconate: 10 Tray In 1 Case (0121-0893-00) / 10 Cup, Unit-Dose In 1 Tray / 15 Ml In 1 Cup, Unit-Dose (0121-0893-15)",5.3,2.12,,,0 NDC,00121089315,NDC Description Not Available,2.51,1.0,,,0 NDC,00121090315,NDC Description Not Available,4.61,1.84,,,0 NDC,00121090405,NDC Description Not Available,2.1,0.84,,,0 NDC,00121090494,"Morphine Sulfate: 3 Tray In 1 Case (0121-0904-94) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (0121-0904-05)",2.41,0.96,,,0 NDC,00121090505,NDC Description Not Available,2.1,0.84,,,0 NDC,00121091400,"Childrens Ibuprofen Oral Suspension: 10 Tray In 1 Case (0121-0914-00) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (0121-0914-05)",1.93,0.77,,,0 NDC,00121091405,NDC Description Not Available,1.92,0.77,,,0 NDC,00121091805,NDC Description Not Available,1.86,0.74,,,0 NDC,00121092716,Promethazine Hydrochloride: 473 Ml In 1 Bottle (0121-0927-16),1.27,0.51,,,0 NDC,00121094205,NDC Description Not Available,6.01,2.4,,,0 NDC,00121094289,NDC Description Not Available,4.39,1.76,,,0 NDC,00121094816,Potassium Chloride: 473 Ml In 1 Bottle (0121-0948-16),0.54,0.22,,,0 NDC,00121095003,Lidocaine Hydrochloride: 12 Bottle In 1 Case (0121-0950-03) / 100 Ml In 1 Bottle,3.48,1.39,,,0 NDC,00121096605,NDC Description Not Available,3.21,1.28,,,0 NDC,00121097251,"Lidocaine Hydrochloride: 1 Bottle, Glass In 1 Carton (0121-0972-51) / 50 Ml In 1 Bottle, Glass",59.0,23.6,,,0 NDC,00121097410,NDC Description Not Available,16.75,6.7,,,0 NDC,00121097800,"Diphenhydramine Hydrochloride: 10 Tray In 1 Case (0121-0978-00) / 10 Cup, Unit-Dose In 1 Tray / 10 Ml In 1 Cup, Unit-Dose (0121-0978-10)",16.2,6.48,,,0 NDC,00121097810,NDC Description Not Available,11.66,4.66,,,0 NDC,00121101605,NDC Description Not Available,85.71,34.28,,,0 NDC,00121102205,"Dye Free Childrens Ibuprofen: 10 Cup, Unit-Dose In 1 Tray (0121-1022-05) / 5 Ml In 1 Cup, Unit-Dose",2.78,1.11,,,0 NDC,00121115400,"Lactulose: 10 Tray In 1 Case (0121-1154-00) / 10 Cup, Unit-Dose In 1 Tray / 30 Ml In 1 Cup, Unit-Dose (0121-1154-30)",5.11,2.04,,,0 NDC,00121115430,NDC Description Not Available,3.0,1.2,,,0 NDC,00121115440,"Lactulose: 4 Tray In 1 Case (0121-1154-40) / 10 Cup, Unit-Dose In 1 Tray / 30 Ml In 1 Cup, Unit-Dose (0121-1154-30)",4.43,1.77,,,0 NDC,00121119000,"Sodium Citrate And Citric Acid: 10 Tray In 1 Case (0121-1190-00) / 10 Cup, Unit-Dose In 1 Tray / 30 Ml In 1 Cup, Unit-Dose (0121-1190-30)",14.3,5.72,,,0 NDC,00121119030,NDC Description Not Available,14.42,5.77,,,0 NDC,00121127600,"Guaifenesin Dm: 10 Tray In 1 Case (0121-1276-00) / 10 Cup, Unit-Dose In 1 Tray / 10 Ml In 1 Cup, Unit-Dose (0121-1276-10)",7.61,3.04,,,0 NDC,00121127610,NDC Description Not Available,7.35,2.94,,,0 NDC,00121131411,NDC Description Not Available,3.58,1.43,,,0 NDC,00121148800,"Guaifenesin: 10 Tray In 1 Case (0121-1488-00) / 10 Cup, Unit-Dose In 1 Tray / 10 Ml In 1 Cup, Unit-Dose (0121-1488-10)",3.74,1.5,,,0 NDC,00121148810,NDC Description Not Available,3.16,1.26,,,0 NDC,00121155000,"Guaifenesin And Codeine Phosphate: 10 Tray In 1 Case (0121-1550-00) / 10 Cup, Unit-Dose In 1 Tray / 10 Ml In 1 Cup, Unit-Dose (0121-1550-10)",2.34,0.94,,,0 NDC,00121155010,NDC Description Not Available,2.54,1.02,,,0 NDC,00121157610,"Metoclopramide: 10 Tray In 1 Case (0121-1576-10) / 10 Cup, Unit-Dose In 1 Tray / 10 Ml In 1 Cup, Unit-Dose",8.0,3.2,,,0 NDC,00121174400,"Guaifenesin: 10 Tray In 1 Case (0121-1744-00) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (0121-1744-05)",3.26,1.3,,,0 NDC,00121174405,NDC Description Not Available,4.05,1.62,,,0 NDC,00121176130,"Mag-Al Plus: 10 Tray In 1 Case (0121-1761-30) / 10 Cup, Unit-Dose In 1 Tray / 30 Ml In 1 Cup, Unit-Dose",8.36,3.34,,,0 NDC,00121176230,"Mag-Al Plus Xs: 10 Tray In 1 Case (0121-1762-30) / 10 Cup, Unit-Dose In 1 Tray / 30 Ml In 1 Cup, Unit-Dose",5.43,2.17,,,0 NDC,00121178105,NDC Description Not Available,2.98,1.19,,,0 NDC,00121182810,NDC Description Not Available,3.16,1.26,,,0 NDC,00121183605,"Childrens Ibuprofen: 10 TRAY in 1 CASE (0121-1836-05) / 10 CUP, UNIT-DOSE in 1 TRAY / 5 mL in 1 CUP, UNIT-DOSE",1.36,0.54,,,0 NDC,00121187000,"Docusate Sodium: 10 Tray In 1 Case (0121-1870-00) / 10 Cup, Unit-Dose In 1 Tray / 10 Ml In 1 Cup, Unit-Dose (0121-1870-10)",4.68,1.87,,,0 NDC,00121187010,NDC Description Not Available,3.9,1.56,,,0 NDC,00121188200,"Acetaminophen: 10 Tray In 1 Case (0121-1882-00) / 10 Cup, Unit-Dose In 1 Tray / 10.15 Ml In 1 Cup, Unit-Dose (0121-1882-11)",3.03,1.21,,,0 NDC,00121188211,NDC Description Not Available,2.62,1.05,,,0 NDC,00121223200,"Guaifenesin: 10 Tray In 1 Case (0121-2232-00) / 10 Cup, Unit-Dose In 1 Tray / 15 Ml In 1 Cup, Unit-Dose (0121-2232-15)",3.42,1.37,,,0 NDC,00121223215,NDC Description Not Available,4.45,1.78,,,0 NDC,00121231615,NDC Description Not Available,10.95,4.38,,,0 NDC,00121467500,"Valproic Acid: 10 Tray In 1 Case (0121-4675-00) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (0121-4675-05)",3.51,1.4,,,0 NDC,00121467505,NDC Description Not Available,2.57,1.03,,,0 NDC,00121476605,"Calcium Carbonate: 4 Tray In 1 Case (0121-4766-05) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose",6.46,2.58,,,0 NDC,00121479905,NDC Description Not Available,6.67,2.67,,,0 NDC,00121479940,"Levetiracetam: 4 Tray In 1 Case (0121-4799-40) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (0121-4799-05)",11.62,4.65,,,0 NDC,00121482705,NDC Description Not Available,11.67,4.67,,,0 NDC,00121494800,"Potassium Chloride: 10 Tray In 1 Case (0121-4948-00) / 10 Cup, Unit-Dose In 1 Tray / 15 Ml In 1 Cup, Unit-Dose (0121-4948-15)",21.6,8.64,,,0 NDC,00121494815,NDC Description Not Available,19.97,7.99,,,0 NDC,00121495015,NDC Description Not Available,8.28,3.31,,,0 NDC,00121495040,"Lidocaine Hydrochloride: 4 Tray In 1 Case (0121-4950-40) / 10 Cup, Unit-Dose In 1 Tray / 15 Ml In 1 Cup, Unit-Dose (0121-4950-15)",7.22,2.89,,,0 NDC,00121496705,NDC Description Not Available,2.9,1.16,,,0 NDC,00131181067,"Vimpat: 10 Vial, Glass In 1 Carton (0131-1810-67) / 20 Ml In 1 Vial, Glass",2.08,0.83,,,0 NDC,00131247760,"Vimpat: 6 Blister Pack In 1 Carton (0131-2477-60) / 10 Tablet, Film Coated In 1 Blister Pack",53.93,21.57,,,0 NDC,00131248060,"Vimpat: 6 Blister Pack In 1 Carton (0131-2480-60) / 10 Tablet, Film Coated In 1 Blister Pack",55.7,22.28,,,0 NDC,00131541070,"465 mL in 1 BOTTLE, PLASTIC (0131-5410-70)",108.64,43.46,,,0 NDC,00131541072,"Vimpat: 200 Ml In 1 Bottle, Glass (0131-5410-72)",83.62,33.45,,,0 NDC,00132008112,Pedia-Lax: 12 Suppository In 1 Jar (0132-0081-12),0.18,0.07,,,0 NDC,00132020140,"Fleet: 133 Ml In 1 Bottle, With Applicator (0132-0201-40)",5.61,2.24,,,0 NDC,00132020142,"Fleet: 133 Ml In 1 Bottle, With Applicator (0132-0201-42)",3.6,1.44,,,0 NDC,00132020220,"Pedia-Lax: 66 Ml In 1 Bottle, With Applicator (0132-0202-20)",4.06,1.62,,,0 NDC,00132030140,"Fleet: 133 Ml In 1 Bottle, With Applicator (0132-0301-40)",5.97,2.39,,,0 NDC,00143122701,"Dicyclomine: 100 Tablet In 1 Bottle, Plastic (0143-1227-01)",1.14,0.46,,,0 NDC,00143177201,"Isosorbide Dinitrate: 100 Tablet In 1 Bottle, Plastic (0143-1772-01)",1.86,0.74,,,0 NDC,00143900601,"Acetazolamide: 1 Vial In 1 Carton (0143-9006-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",145.2,58.08,,,0 NDC,00143902201,NDC Description Not Available,15.03,6.01,,,0 NDC,00143902202,"Fulvestrant: 2 Syringe, Glass In 1 Carton (0143-9022-02) / 5 Ml In 1 Syringe, Glass (0143-9022-01)",22.09,8.84,,,0 NDC,00143909801,"Bortezomib: 1 Vial In 1 Carton (0143-9098-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",4.56,1.82,,,0 NDC,00143914101,NDC Description Not Available,32.11,12.84,,,0 NDC,00143916701,"Eribulin Mesylate: 1 Vial, Single-Dose In 1 Carton (0143-9167-01) / 2 Ml In 1 Vial, Single-Dose",569.01,227.6,,,0 NDC,00143918001,NDC Description Not Available,0.57,0.23,,,0 NDC,00143919201,Foscarnet Sodium: 10 Carton In 1 Case (0143-9192-01) / 1 Bottle In 1 Carton / 250 Ml In 1 Bottle,159.63,63.85,,,0 NDC,00143921701,"Idarubicin Hydrochloride: 1 Vial, Glass In 1 Box (0143-9217-01) / 5 Ml In 1 Vial, Glass",328.57,131.43,,,0 NDC,00143921801,"Idarubicin Hydrochloride: 1 Vial, Glass In 1 Box (0143-9218-01) / 10 Ml In 1 Vial, Glass",279.81,111.92,,,0 NDC,00143921901,"Idarubicin Hydrochloride: 1 Vial, Glass In 1 Box (0143-9219-01) / 20 Ml In 1 Vial, Glass",113.1,45.24,,,0 NDC,00143923305,Benztropine Mesylate: 5 Vial In 1 Box (0143-9233-05) / 2 Ml In 1 Vial (0143-9233-01),53.88,21.55,,,0 NDC,00143924101,"Bleomycin: 1 Vial In 1 Box, Unit-Dose (0143-9241-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",84.34,33.74,,,0 NDC,00143924501,NDC Description Not Available,32.0,12.8,,,0 NDC,00143924510,"Dacarbazine: 10 Vial In 1 Carton (0143-9245-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (0143-9245-01)",20.8,8.32,,,0 NDC,00143925001,NDC Description Not Available,19.6,7.84,,,0 NDC,00143925010,Rocuronium Bromide: 10 Vial In 1 Box (0143-9250-10) / 5 Ml In 1 Vial (0143-9250-01),8.625,3.45,,,0 NDC,00143925201,NDC Description Not Available,1.92,0.77,,,0 NDC,00143926201,NDC Description Not Available,1.24,0.5,,,0 NDC,00143926901,Clindamycin In 5 Percent Dextrose: 1 Vial In 1 Carton (0143-9269-01) / 50 Ml In 1 Vial,6.16,2.46,,,0 NDC,00143927301,NDC Description Not Available,401.08,160.43,,,0 NDC,00143927901,"Mitomycin: 1 Vial In 1 Box, Unit-Dose (0143-9279-01) / 40 Ml In 1 Vial",56.73,22.69,,,0 NDC,00143928401,NDC Description Not Available,56.44,22.58,,,0 NDC,00143928410,"Pantoprazole Sodium: 10 Vial In 1 Carton (0143-9284-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (0143-9284-01)",11.72,4.69,,,0 NDC,00143929001,Estradiol Valerate: 1 Vial In 1 Carton (0143-9290-01) / 5 Ml In 1 Vial,23.89,9.56,,,0 NDC,00143929201,"Thiotepa: 1 Vial In 1 Box, Unit-Dose (0143-9292-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",458.56,183.42,,,0 NDC,00143931701,NDC Description Not Available,3.15,1.26,,,0 NDC,00143931724,Levofloxacin: 24 Bag In 1 Carton (0143-9317-24) / 150 Ml In 1 Bag (0143-9317-01),2.99,1.2,,,0 NDC,00143931801,NDC Description Not Available,66.1,26.44,,,0 NDC,00143931810,Norepinephrine Bitartrate: 10 Vial In 1 Carton (0143-9318-10) / 4 Ml In 1 Vial (0143-9318-01),12.76,5.1,,,0 NDC,00143933001,NDC Description Not Available,0.2,0.08,,,0 NDC,00143933101,NDC Description Not Available,0.16,0.06,,,0 NDC,00143933301,NDC Description Not Available,0.19,0.08,,,0 NDC,00143933801,NDC Description Not Available,7.01,2.8,,,0 NDC,00143935501,NDC Description Not Available,18.8,7.52,,,0 NDC,00143935510,"Vancomycin Hydrochloride: 10 Vial In 1 Carton (0143-9355-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (0143-9355-01)",18.8,7.52,,,0 NDC,00143938001,NDC Description Not Available,0.91,0.36,,,0 NDC,00143938010,Midazolam In Sodium Chloride: 10 Pouch In 1 Carton (0143-9380-10) / 1 Bag In 1 Pouch (0143-9380-01) / 100 Ml In 1 Bag,0.98,0.39,,,0 NDC,00143938401,"Fosaprepitant Dimeglumine: 1 Vial, Single-Dose In 1 Carton (0143-9384-01) / 5 Ml In 1 Vial, Single-Dose",1.25,0.5,,,0 NDC,00143938501,"Decitabine: 1 Vial, Single-Dose In 1 Carton (0143-9385-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",3.44,1.38,,,0 NDC,00143938701,NDC Description Not Available,5.72,2.29,,,0 NDC,00143938725,Triamcinolone Acetonide: 25 Vial In 1 Carton (0143-9387-25) / 1 Ml In 1 Vial (0143-9387-01),5.72,2.29,,,0 NDC,00143939201,NDC Description Not Available,399.53,159.81,,,0 NDC,00143939210,Remifentanil Hydrochloride: 10 Vial In 1 Carton (0143-9392-10) / 5 Ml In 1 Vial (0143-9392-01),356.66,142.66,,,0 NDC,00143943101,NDC Description Not Available,2.66,1.06,,,0 NDC,00143943110,Meropenem: 10 Vial In 1 Carton (0143-9431-10) / 30 Ml In 1 Vial (0143-9431-01),2.68,1.07,,,0 NDC,00143950301,"Acetazolamide: 1 Vial In 1 Box, Unit-Dose (0143-9503-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",195.28,78.11,,,0 NDC,00143950601,NDC Description Not Available,29.02,11.61,,,0 NDC,00143950610,"Etomidate: 10 Vial, Single-Dose In 1 Carton (0143-9506-10) / 10 Ml In 1 Vial, Single-Dose (0143-9506-01)",27.81,11.12,,,0 NDC,00143950701,NDC Description Not Available,25.64,10.26,,,0 NDC,00143950710,"Etomidate: 10 Vial, Single-Dose In 1 Carton (0143-9507-10) / 20 Ml In 1 Vial, Single-Dose (0143-9507-01)",13.5,5.4,,,0 NDC,00143950801,NDC Description Not Available,10.72,4.29,,,0 NDC,00143950810,Ketamine Hydrochloride: 10 Vial In 1 Box (0143-9508-10) / 10 Ml In 1 Vial (0143-9508-01),5.78,2.31,,,0 NDC,00143950901,NDC Description Not Available,41.29,16.52,,,0 NDC,00143950910,Ketamine Hydrochloride: 10 Vial In 1 Box (0143-9509-10) / 5 Ml In 1 Vial (0143-9509-01),89.23,35.69,,,0 NDC,00143951001,"Etoposide: 1 Vial In 1 Box, Unit-Dose (0143-9510-01) / 5 Ml In 1 Vial",4.12,1.65,,,0 NDC,00143951101,"Etoposide: 1 Vial In 1 Box, Unit-Dose (0143-9511-01) / 25 Ml In 1 Vial",3.03,1.21,,,0 NDC,00143951201,"Etoposide: 1 Vial In 1 Box, Unit-Dose (0143-9512-01) / 50 Ml In 1 Vial",3.39,1.36,,,0 NDC,00143951401,NDC Description Not Available,11.98,4.79,,,0 NDC,00143951901,NDC Description Not Available,6.34,2.54,,,0 NDC,00143951910,Methotrexate: 10 Vial In 1 Carton (0143-9519-10) / 2 Ml In 1 Vial,5.79,2.32,,,0 NDC,00143952501,NDC Description Not Available,140.8,56.32,,,0 NDC,00143953201,NDC Description Not Available,9.04,3.62,,,0 NDC,00143953401,NDC Description Not Available,11.04,4.42,,,0 NDC,00143955001,Daunorubicin Hydrochloride: 1 Vial In 1 Carton (0143-9550-01) / 10 Ml In 1 Vial,130.65,52.26,,,0 NDC,00143955101,NDC Description Not Available,130.06,52.02,,,0 NDC,00143955110,Daunorubicin Hydrochloride: 10 Vial In 1 Box (0143-9551-10) / 4 Ml In 1 Vial (0143-9551-01),192.89,77.16,,,0 NDC,00143955201,"Leucovorin Calcium: 1 Vial In 1 Box, Unit-Dose (0143-9552-01) / 17.5 Ml In 1 Vial",15.99,6.4,,,0 NDC,00143955301,"Leucovorin Calcium: 1 Vial In 1 Box, Unit-Dose (0143-9553-01) / 20 Ml In 1 Vial",24.88,9.95,,,0 NDC,00143955401,Leucovorin Calcium: 1 Vial In 1 Box (0143-9554-01) / 10 Ml In 1 Vial,31.43,12.57,,,0 NDC,00143956401,Phentolamine Mesylate: 1 Vial In 1 Box (0143-9564-01) / 1 Ml In 1 Vial,2190.52,876.21,,,0 NDC,00143957701,NDC Description Not Available,0.03,0.01,,,0 NDC,00143957710,"Lidocaine: 10 Vial, Multi-Dose In 1 Package (0143-9577-10) / 50 Ml In 1 Vial, Multi-Dose (0143-9577-01)",0.12,0.05,,,0 NDC,00143959501,NDC Description Not Available,5.119999999999999,2.05,,,0 NDC,00143959525,"Lidocaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (0143-9595-25) / 5 Ml In 1 Vial, Single-Dose (0143-9595-01)",5.715,2.2899999999999996,,,0 NDC,00143960601,"Azacitidine: 1 Vial In 1 Carton (0143-9606-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",1.08,0.43,,,0 NDC,00143962101,NDC Description Not Available,13.88,5.55,,,0 NDC,00143962125,Cyanocobalamin: 25 Vial In 1 Box (0143-9621-25) / 1 Ml In 1 Vial (0143-9621-01),14.12,5.65,,,0 NDC,00143963301,NDC Description Not Available,1.97,0.79,,,0 NDC,00143963701,NDC Description Not Available,7.61,3.04,,,0 NDC,00143963710,"Valproate Sodium: 10 Vial, Single-Dose In 1 Tray (0143-9637-10) / 5 Ml In 1 Vial, Single-Dose (0143-9637-01)",9.95,3.98,,,0 NDC,00143963801,NDC Description Not Available,34.735,13.895,,,0 NDC,00143963805,Sumatriptan: 5 Vial In 1 Carton (0143-9638-05) / .5 Ml In 1 Vial (0143-9638-01),25.87,10.35,,,0 NDC,00143965901,Testosterone Cypionate: 1 Ml In 1 Vial (0143-9659-01),0.01,0.004,,,0 NDC,00143966001,NDC Description Not Available,8.9,3.56,,,0 NDC,00143966010,Metoprolol Tartrate: 10 Vial In 1 Carton (0143-9660-10) / 5 Ml In 1 Vial (0143-9660-01),2.32,0.93,,,0 NDC,00143967301,NDC Description Not Available,0.47,0.19,,,0 NDC,00143967401,Argatroban: 2.5 Ml In 1 Vial (0143-9674-01),2.15,0.86,,,0 NDC,00143968001,NDC Description Not Available,2.5,1.0,,,0 NDC,00143968201,NDC Description Not Available,24.195,9.68,,,0 NDC,00143968225,Glycopyrrolate: 25 Vial In 1 Carton (0143-9682-25) / 1 Ml In 1 Vial (0143-9682-01),0.03,0.01,,,0 NDC,00143968901,NDC Description Not Available,0.89,0.36,,,0 NDC,00143968910,Nicardipine Hydrochloride: 10 Vial In 1 Carton (0143-9689-10) / 10 Ml In 1 Vial (0143-9689-01),0.23,0.09,,,0 NDC,00143970101,"Irinotecan Hydrochloride: 5 Ml In 1 Vial, Glass (0143-9701-01)",13.12,5.25,,,0 NDC,00143970901,Milrinone Lactate: 20 Ml In 1 Box (0143-9709-01),6.0,2.4,,,0 NDC,00143971001,NDC Description Not Available,8.17,3.27,,,0 NDC,00143971901,NDC Description Not Available,23.99,9.6,,,0 NDC,00143971910,Milrinone Lactate In Dextrose: 10 Container In 1 Package (0143-9719-10) / 100 Ml In 1 Container (0143-9719-01),16.9,6.76,,,0 NDC,00143972001,NDC Description Not Available,5.2,2.08,,,0 NDC,00143972024,Levofloxacin: 24 Bag In 1 Carton (0143-9720-24) / 150 Ml In 1 Bag (0143-9720-01),4.46,1.78,,,0 NDC,00143972101,NDC Description Not Available,5.66,2.26,,,0 NDC,00143972124,Levofloxacin: 24 Bag In 1 Carton (0143-9721-24) / 100 Ml In 1 Bag (0143-9721-01),5.62,2.25,,,0 NDC,00143972201,NDC Description Not Available,9.4,3.76,,,0 NDC,00143972224,Levofloxacin: 24 Bag In 1 Carton (0143-9722-24) / 50 Ml In 1 Bag (0143-9722-01),6.44,2.58,,,0 NDC,00143972401,"Clonidine Hydrochloride: 10 Ml In 1 Vial, Single-Use (0143-9724-01)",171.95,68.78,,,0 NDC,00143974401,NDC Description Not Available,5.03,2.01,,,0 NDC,00143974410,"Granisetron Hydrochloride: 10 Vial, Single-Use In 1 Package (0143-9744-10) / 1 Ml In 1 Vial, Single-Use (0143-9744-01)",1.12,0.45,,,0 NDC,00143974501,NDC Description Not Available,3.52,1.41,,,0 NDC,00143974505,"Granisetron Hydrochloride: 5 Vial, Multi-Dose In 1 Carton (0143-9745-05) / 4 Ml In 1 Vial, Multi-Dose (0143-9745-01)",3.99,1.6,,,0 NDC,00143974601,NDC Description Not Available,7.54,3.02,,,0 NDC,00143974610,Terbutaline Sulfate: 10 Vial In 1 Carton (0143-9746-10) / 1 Ml In 1 Vial (0143-9746-01),1.36,0.54,,,0 NDC,00143975301,NDC Description Not Available,2.23,0.89,,,0 NDC,00143975401,NDC Description Not Available,1.43,0.57,,,0 NDC,00143978401,NDC Description Not Available,7.17,2.87,,,0 NDC,00143978410,"Flumazenil: 10 Vial, Multi-Dose In 1 Box (0143-9784-10) / 5 Ml In 1 Vial, Multi-Dose (0143-9784-01)",19.12,7.65,,,0 NDC,00143978501,NDC Description Not Available,27.18,10.87,,,0 NDC,00143978510,"Valproate Sodium: 10 Vial, Single-Dose In 1 Carton (0143-9785-10) / 5 Ml In 1 Vial, Single-Dose (0143-9785-01)",27.62,11.05,,,0 NDC,00143978601,NDC Description Not Available,7.58,3.03,,,0 NDC,00143978610,Enalaprilat: 10 Vial In 1 Carton (0143-9786-10) / 2 Ml In 1 Vial (0143-9786-01),4.32,1.73,,,0 NDC,00143985201,NDC Description Not Available,79.01,31.6,,,0 NDC,00143985601,NDC Description Not Available,1.67,0.67,,,0 NDC,00143985625,"Ceftriaxone: 25 Vial In 1 Box (0143-9856-25) / 1 Injection, Powder, For Solution In 1 Vial (0143-9856-01)",1.67,0.67,,,0 NDC,00143987101,"Cladribine: 1 Vial In 1 Box, Unit-Dose (0143-9871-01) / 10 Ml In 1 Vial",49.35,19.74,,,0 NDC,00143987501,NDC Description Not Available,1.69,0.68,,,0 NDC,00143987510,Amiodarone Hydrochloride: 10 Vial In 1 Box (0143-9875-10) / 3 Ml In 1 Vial (0143-9875-01),0.84,0.34,,,0 NDC,00143987525,Amiodarone Hydrochloride: 25 Vial In 1 Box (0143-9875-25) / 3 Ml In 1 Vial (0143-9875-01),1.12,0.45,,,0 NDC,00143987701,NDC Description Not Available,11.5,4.6,,,0 NDC,00143988701,Amoxicillin: 100 Ml In 1 Bottle (0143-9887-01),0.62,0.25,,,0 NDC,00143992490,Cefazolin: 3 Ml In 1 Vial (0143-9924-90),3.06,1.22,,,0 NDC,00143992801,"Ciprofloxacin: 100 Tablet, Film Coated In 1 Bottle (0143-9928-01)",0.9,0.36,,,0 NDC,00143997790,NDC Description Not Available,13.14,5.26,,,0 NDC,00143997922,"Cefuroxime: 25 Vial In 1 Carton (0143-9979-22) / 1 Injection, Powder, For Solution In 1 Vial (0143-9979-90)",0.78,0.31,,,0 NDC,00143997990,NDC Description Not Available,0.04,0.02,,,0 NDC,00143998201,Amoxicillin And Clavulanate Potassium: 100 Ml In 1 Bottle (0143-9982-01),4.45,1.78,,,0 NDC,00143998303,"Cefazolin: 10 Vial, Pharmacy Bulk Package In 1 Carton (0143-9983-03) / 1 Injection, Powder, For Solution In 1 Vial, Pharmacy Bulk Package (0143-9983-91)",0.67,0.27,,,0 NDC,00143998391,NDC Description Not Available,2.0,0.8,,,0 NDC,00168000315,Triamcinolone Acetonide: 1 Tube In 1 Carton (0168-0003-15) / 15 G In 1 Tube,11.16,4.46,,,0 NDC,00168000415,Triamcinolone Acetonide: 1 Tube In 1 Carton (0168-0004-15) / 15 G In 1 Tube,11.6,4.64,,,0 NDC,00168000615,Triamcinolone Acetonide: 15 G In 1 Tube (0168-0006-15),13.95,5.58,,,0 NDC,00168000680,Triamcinolone Acetonide: 80 G In 1 Tube (0168-0006-80),29.81,11.92,,,0 NDC,00168001516,Hydrocortisone: 453.6 G In 1 Jar (0168-0015-16),110.68,44.27,,,0 NDC,00168001531,Hydrocortisone: 1 Tube In 1 Carton (0168-0015-31) / 28.35 G In 1 Tube,8.74,3.5,,,0 NDC,00168004160,Betamethasone Valerate: 60 Ml In 1 Bottle (0168-0041-60),190.53,76.21,,,0 NDC,00168005415,nystatin: 1 TUBE in 1 CARTON (0168-0054-15) / 15 g in 1 TUBE,60.17,24.07,,,0 NDC,00168005546,Betamethasone Dipropionate: 1 Tube In 1 Carton (0168-0055-46) / 45 G In 1 Tube,279.18,111.67,,,0 NDC,00168005615,Betamethasone Dipropionate: 1 Tube In 1 Carton (0168-0056-15) / 15 G In 1 Tube,152.8,61.12,,,0 NDC,00168006231,ZINC OXIDE: 1 TUBE in 1 CARTON (0168-0062-31) / 28.35 g in 1 TUBE,7.74,3.1,,,0 NDC,00168008031,Hydrocortisone: 30 G In 1 Tube (0168-0080-31),9.84,3.94,,,0 NDC,00168009930,Ketoconazole: 1 Tube In 1 Carton (0168-0099-30) / 30 G In 1 Tube,94.41,37.76,,,0 NDC,00168011109,Bacitracin Zinc: 144 PACKET in 1 CARTON (0168-0111-09) / .9 g in 1 PACKET,0.46,0.18,,,0 NDC,00168014630,Hydrocortisone: 29 G In 1 Tube (0168-0146-30),10.07,4.03,,,0 NDC,00168020437,Lidocaine: 1 Tube In 1 Carton (0168-0204-37) / 35.44 G In 1 Tube,28.12,11.25,,,0 NDC,00168025846,Clotrimazole And Betamethasone Dipropionate: 45 G In 1 Tube (0168-0258-46),101.85,40.74,,,0 NDC,00168035756,Lidocaine And Prilocaine: 1 Tube In 1 Carton (0168-0357-56) / 5 G In 1 Tube (0168-0357-05),123.96,49.58,,,0 NDC,00169183311,Novolin R: 1 Vial In 1 Carton (0169-1833-11) / 10 Ml In 1 Vial,0.2,0.08,,,0 NDC,00169183411,Novolin N: 1 Vial In 1 Carton (0169-1834-11) / 10 Ml In 1 Vial,0.91,0.36,,,0 NDC,00169183711,Novolin 70/30: 1 Vial In 1 Carton (0169-1837-11) / 10 Ml In 1 Vial,0.59,0.24,,,0 NDC,00169300715,"Novolin 70/30: 5 Syringe, Plastic In 1 Carton (0169-3007-15) / 3 Ml In 1 Syringe, Plastic (0169-3007-01)",1.31,0.52,,,0 NDC,00169430713,3 BLISTER PACK in 1 CARTON (0169-4307-13) / 10 TABLET in 1 BLISTER PACK (0169-4307-01),59.45,23.78,,,0 NDC,00169720101,"Novoseven Rt: 1 Kit In 1 Kit (0169-7201-01) * 1 Ml In 1 Vial, Glass (0169-7211-11) * 1 Ml In 1 Syringe, Glass (0169-7011-98)",11.83,4.73,,,0 NDC,00169720201,"Novoseven Rt: 1 Kit In 1 Kit (0169-7202-01) * 2 Ml In 1 Vial, Glass (0169-7212-11) * 2 Ml In 1 Syringe, Glass (0169-7012-98)",12.1,4.84,,,0 NDC,00169720501,"Novoseven Rt: 1 Kit In 1 Kit (0169-7205-01) * 5 Ml In 1 Vial, Glass (0169-7215-11) * 5 Ml In 1 Syringe, Glass (0169-7015-98)",11.79,4.72,,,0 NDC,00169721111,NDC Description Not Available,9.86,3.94,,,0 NDC,00169750111,"Novolog: 1 Vial, Glass In 1 Carton (0169-7501-11) / 10 Ml In 1 Vial, Glass",16.23,6.495,,,0 NDC,00172208360,Hydrochlorothiazide: 100 Tablet In 1 Bottle (0172-2083-60),0.13,0.05,,,0 NDC,00172392560,Diazepam: 100 Tablet In 1 Bottle (0172-3925-60),0.09,0.04,,,0 NDC,00172409660,Baclofen: 100 Tablet In 1 Bottle (0172-4096-60),0.35,0.14,,,0 NDC,00172731320,Cyclosporine: 1 Bottle In 1 Package (0172-7313-20) / 50 Ml In 1 Bottle,13.88,5.55,,,0 NDC,00173038879,"Beconase Aq: 1 Bottle, Pump In 1 Carton (0173-0388-79) / 180 Spray, Suspension In 1 Bottle, Pump",1247.98,499.19,,,0 NDC,00173052700,"Lamictal: 100 Tablet, For Suspension In 1 Bottle (0173-0527-00)",34.98,13.99,,,0 NDC,00173068220,"Ventolin Hfa: 1 Inhaler In 1 Carton (0173-0682-20) / 200 Aerosol, Metered In 1 Inhaler",174.73,69.89,,,0 NDC,00173068224,"Ventolin Hfa: 1 Inhaler In 1 Carton (0173-0682-24) / 60 Aerosol, Metered In 1 Inhaler",69.49,27.8,,,0 NDC,00173071622,"Advair Hfa: 1 Inhaler In 1 Carton (0173-0716-22) / 60 Aerosol, Metered In 1 Inhaler",667.67,267.07,,,0 NDC,00173071920,"Flovent Hfa: 1 Inhaler In 1 Carton (0173-0719-20) / 120 Aerosol, Metered In 1 Inhaler",692.54,277.02,,,0 NDC,00173086906,Anoro Ellipta: 1 Tray In 1 Carton (0173-0869-06) / 1 Inhaler In 1 Tray / 7 Powder In 1 Inhaler,350.84,140.34,,,0 NDC,00173088101,Nucala: 1 Vial In 1 Carton (0173-0881-01) / 1 Ml In 1 Vial,153.21,61.28,,,0 NDC,00173089201,Nucala: 1 Syringe In 1 Carton (0173-0892-01) / 1 Ml In 1 Syringe,168.85,67.54,,,0 NDC,00173089803,Jemperli: 1 Vial In 1 Carton (0173-0898-03) / 10 Ml In 1 Vial,1034.28,413.71,,,0 NDC,00178031430,"Potassium Iodide: 1 Bottle, Dropper In 1 Carton (0178-0314-30) / 30 Ml In 1 Bottle, Dropper",3.24,1.3,,,0 NDC,00185067401,Hydroxyzine Pamoate: 100 Capsule In 1 Bottle (0185-0674-01),0.24,0.1,,,0 NDC,00185560001,Metolazone: 100 Tablet In 1 Bottle (0185-5600-01),2.52,1.01,,,0 NDC,00186077660,Brilinta: 60 Tablet In 1 Bottle (0186-0776-60),32.25,12.9,,,0 NDC,00186077739,"Brilinta: 10 Blister Pack In 1 Box, Unit-Dose (0186-0777-39) / 10 Tablet In 1 Blister Pack",23.21,9.28,,,0 NDC,00186402001,"Nexium: 30 Granule, Delayed Release In 1 Carton (0186-4020-01)",29.32,11.73,,,0 NDC,00186404001,"Nexium: 30 Granule, Delayed Release In 1 Carton (0186-4040-01)",28.95,11.58,,,0 NDC,00187074633,NDC Description Not Available,11.68,4.67,,,0 NDC,00187301220,Mestinon: 473 Ml In 1 Bottle (0187-3012-20),55.75,22.3,,,0 NDC,00187301330,"Mestinon: 30 Tablet, Extended Release In 1 Bottle (0187-3013-30)",160.03,64.01,,,0 NDC,00187320447,Efudex: 1 Tube In 1 Carton (0187-3204-47) / 40 G In 1 Tube,180.0,72.0,,,0 NDC,00223172001,NDC Description Not Available,0.16,0.06,,,0 NDC,00225052547,NDC Description Not Available,8.04,3.22,,,0 NDC,00225080047,"Neo-Synephrine Mild: 15 Ml In 1 Bottle, Spray (0225-0800-47)",3.2,1.28,,,0 NDC,00225080547,"Neo-Synephrine Regular: 15 Ml In 1 Bottle, Spray (0225-0805-47)",2.46,0.98,,,0 NDC,00228203110,Alprazolam: 100 Tablet In 1 Bottle (0228-2031-10),0.17,0.07,,,0 NDC,00228206710,"Oxazepam: 100 Capsule, Gelatin Coated In 1 Bottle (0228-2067-10)",2.89,1.16,,,0 NDC,00228207610,Temazepam: 100 Capsule In 1 Bottle (0228-2076-10),0.28,0.11,,,0 NDC,00228212710,Clonidine Hydrochloride: 100 Tablet In 1 Bottle (0228-2127-10),0.12,0.05,,,0 NDC,00228212810,Clonidine Hydrochloride: 100 Tablet In 1 Bottle (0228-2128-10),0.03,0.01,,,0 NDC,00228253910,Carbidopa And Levodopa: 100 Tablet In 1 Bottle (0228-2539-10),0.17,0.07,,,0 NDC,00228254010,Carbidopa And Levodopa: 100 Tablet In 1 Bottle (0228-2540-10),0.54,0.22,,,0 NDC,00228262011,Isosorbide Mononitrate: 100 Tablet In 1 Bottle (0228-2620-11),1.08,0.43,,,0 NDC,00245014701,Pacerone: 100 Blister Pack In 1 Carton (0245-0147-01) / 1 Tablet In 1 Blister Pack (0245-0147-89),0.92,0.37,,,0 NDC,00245014789,NDC Description Not Available,1.02,0.41,,,0 NDC,00245021201,Midodrine Hydrochloride: 100 Blister Pack In 1 Carton (0245-0212-01) / 1 Tablet In 1 Blister Pack (0245-0212-89),19.42,7.77,,,0 NDC,00245021289,NDC Description Not Available,2.62,1.05,,,0 NDC,00245036089,NDC Description Not Available,4.6,1.84,,,0 NDC,00245531601,"Klor-Con: 100 Blister Pack In 1 Blister Pack (0245-5316-01) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack (0245-5316-89)",4.44,1.78,,,0 NDC,00245531689,NDC Description Not Available,1.76,0.7,,,0 NDC,00245531789,NDC Description Not Available,1.6,0.64,,,0 NDC,00254101019,"Diazoxide: 1 Bottle, Dropper In 1 Carton (0254-1010-19) / 30 Ml In 1 Bottle, Dropper",26.41,10.56,,,0 NDC,00254101636,"Posaconazole: 1 Bottle, Glass In 1 Carton (0254-1016-36) / 105 Ml In 1 Bottle, Glass",208.62,83.45,,,0 NDC,00254301255,Alvimopan: 6 Blister Pack In 1 Carton (0254-3012-55) / 5 Capsule In 1 Blister Pack,478.03,191.21,,,0 NDC,00254301278,NDC Description Not Available,471.33,188.53,,,0 NDC,00254302802,"Lubiprostone: 60 Capsule, Gelatin Coated In 1 Bottle (0254-3028-02)",11.65,4.66,,,0 NDC,00254302902,"Lubiprostone: 60 Capsule, Gelatin Coated In 1 Bottle (0254-3029-02)",5.36,2.14,,,0 NDC,00259050116,Cuvposa: 1 Bottle In 1 Carton (0259-0501-16) / 473 Ml In 1 Bottle,10.08,4.03,,,0 NDC,00259160501,"Xeomin: 1 Vial, Single-Use In 1 Carton (0259-1605-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Use",27.09,10.84,,,0 NDC,00259161001,"Xeomin: 1 Vial, Single-Use In 1 Carton (0259-1610-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Use",22.48,8.99,,,0 NDC,00264100990,Levetiracetam: 24 Container In 1 Case (0264-1009-90) / 100 Ml In 1 Container,0.48,0.19,,,0 NDC,00264150990,Levetiracetam: 24 Container In 1 Case (0264-1509-90) / 100 Ml In 1 Container,0.4,0.16,,,0 NDC,00264151031,Dextrose: 84 Container In 1 Case (0264-1510-31) / 50 Ml In 1 Container,1.2,0.48,,,0 NDC,00264151032,Dextrose: 64 Container In 1 Case (0264-1510-32) / 100 Ml In 1 Container,4.35,1.74,,,0 NDC,00264180031,Sodium Chloride: 84 Container In 1 Case (0264-1800-31) / 50 Ml In 1 Container,12.795,5.12,,,0 NDC,00264180032,Sodium Chloride: 64 Container In 1 Case (0264-1800-32) / 100 Ml In 1 Container,7.699999999999999,3.08,,,0 NDC,00264193310,Trophamine: 12 Container In 1 Case (0264-1933-10) / 500 Ml In 1 Container,126.11,50.44,,,0 NDC,00264194420,Potassium Chloride: 24 Container In 1 Case (0264-1944-20) / 250 Ml In 1 Container,0.41,0.16,,,0 NDC,00264220100,Sodium Chloride: 16 Container In 1 Case (0264-2201-00) / 1000 Ml In 1 Container,12.0,4.8,,,0 NDC,00264420452,Magnesium Sulfate In Water: 24 Container In 1 Case (0264-4204-52) / 50 Ml In 1 Container,5.34,2.14,,,0 NDC,00264420654,Magnesium Sulfate In Water: 24 Container In 1 Case (0264-4206-54) / 100 Ml In 1 Container,1.97,0.79,,,0 NDC,00264440054,Magnesium Sulfate In Dextrose: 24 Container In 1 Case (0264-4400-54) / 100 Ml In 1 Container,6.59,2.64,,,0 NDC,00264450000,Plenamine: 8 Container In 1 Case (0264-4500-00) / 1000 Ml In 1 Container,112.89,45.16,,,0 NDC,00264450005,Plenamine: 4 Container In 1 Case (0264-4500-05) / 2000 Ml In 1 Container,146.05,58.42,,,0 NDC,00264580200,Sodium Chloride: 12 Container In 1 Case (0264-5802-00) / 1000 Ml In 1 Container,6.785,2.7150000000000003,,,0 NDC,00264580210,Sodium Chloride: 24 Container In 1 Case (0264-5802-10) / 500 Ml In 1 Container,9.83,3.935,,,0 NDC,00264580400,Sodium Chloride: 12 Container In 1 Case (0264-5804-00) / 1000 Ml In 1 Container,13.73,5.49,,,0 NDC,00264738550,Sterile Water: 4 Container In 1 Case (0264-7385-50) / 2000 Ml In 1 Container,15.4,6.16,,,0 NDC,00264738560,Sterile Water: 4 Container In 1 Case (0264-7385-60) / 3000 Ml In 1 Container,4.8,1.92,,,0 NDC,00264738750,Dextrose: 4 Container In 1 Case (0264-7387-50) / 2000 Ml In 1 Container,3.17,1.27,,,0 NDC,00264751000,Dextrose: 12 Container In 1 Case (0264-7510-00) / 1000 Ml In 1 Container,18.53,7.41,,,0 NDC,00264751010,Dextrose: 24 Container In 1 Case (0264-7510-10) / 500 Ml In 1 Container,1.24,0.5,,,0 NDC,00264751020,Dextrose: 24 Container In 1 Case (0264-7510-20) / 250 Ml In 1 Container,1.7,0.68,,,0 NDC,00264757810,Mannitol: 24 Container In 1 Case (0264-7578-10) / 500 Ml In 1 Container,64.34,25.74,,,0 NDC,00264761000,Dextrose And Sodium Chloride: 12 Container In 1 Case (0264-7610-00) / 1000 Ml In 1 Container,8.8,3.52,,,0 NDC,00264761200,Dextrose And Sodium Chloride: 12 Container In 1 Case (0264-7612-00) / 1000 Ml In 1 Container,3.36,1.34,,,0 NDC,00264775100,Dextrose In Lactated Ringers: 12 Container In 1 Case (0264-7751-00) / 1000 Ml In 1 Container,10.81,4.32,,,0 NDC,00264780000,Sodium Chloride: 12 Container In 1 Case (0264-7800-00) / 1000 Ml In 1 Container,11.83,4.73,,,0 NDC,00264780009,Sodium Chloride: 12 Container In 1 Case (0264-7800-09) / 1000 Ml In 1 Container,13.2,5.28,,,0 NDC,00264780010,Sodium Chloride: 24 Container In 1 Case (0264-7800-10) / 500 Ml In 1 Container,15.97,6.39,,,0 NDC,00264780020,Sodium Chloride: 24 Container In 1 Case (0264-7800-20) / 250 Ml In 1 Container,8.965,3.59,,,0 NDC,00264780200,Sodium Chloride: 12 Container In 1 Case (0264-7802-00) / 1000 Ml In 1 Container,13.54,5.42,,,0 NDC,00264780510,Sodium Chloride: 24 Container In 1 Case (0264-7805-10) / 500 Ml In 1 Container,23.73,9.49,,,0 NDC,00264785000,Sterile Water: 12 Container In 1 Case (0264-7850-00) / 1000 Ml In 1 Container,9.63,3.85,,,0 NDC,00264785010,Sterile Water: 24 Container In 1 Case (0264-7850-10) / 500 Ml In 1 Container,10.67,4.27,,,0 NDC,00264785020,Sterile Water: 24 Container In 1 Case (0264-7850-20) / 250 Ml In 1 Container,7.27,2.91,,,0 NDC,00264958720,Heparin Sodium In Dextrose: 24 Container In 1 Case (0264-9587-20) / 250 Ml In 1 Container,2.77,1.11,,,0 NDC,00264959820,Lidocaine Hydrochloride And Dextrose: 24 Container In 1 Case (0264-9598-20) / 250 Ml In 1 Container,0.01,0.004,,,0 NDC,00264987210,Heparin Sodium In Sodium Chloride: 24 Container In 1 Case (0264-9872-10) / 500 Ml In 1 Container,1.98,0.79,,,0 NDC,00268024901,NDC Description Not Available,35.38,14.15,,,0 NDC,00270055615,Kinevac: 10 Vial In 1 Package (0270-0556-15) / 5 Ml In 1 Vial,574.88,229.95,,,0 NDC,00270709916,Lumason: 5 Kit In 1 Box (0270-7099-16) / 1 Kit In 1 Kit * 25 Mg In 1 Vial * 5 Ml In 1 Syringe,154.05,61.62,,,0 NDC,00281032608,Nitro-Bid: 48 Packet In 1 Box (0281-0326-08) / 1 G In 1 Packet,6.93,2.77,,,0 NDC,00281032630,Nitro-Bid: 30 G In 1 Tube (0281-0326-30),104.45,41.78,,,0 NDC,00283067902,Hurricaine Topical Anesthetic: 59.7 G In 1 Can (0283-0679-02),90.39,36.16,,,0 NDC,00283067960,Hurricaine Topical Anesthetic: 1 Can In 1 Box (0283-0679-60) / 59.7 G In 1 Can (0283-0679-02),54.95,21.98,,,0 NDC,00283091402,Hurricaine Topical Anesthetic: 59.7 G In 1 Can (0283-0914-02),54.95,21.98,,,0 NDC,00310009530,"Daliresp: 30 Tablet In 1 Bottle, Plastic (0310-0095-30)",61.29,24.52,,,0 NDC,00310072010,"Faslodex: 2 Syringe, Glass In 1 Carton (0310-0720-10) / 5 Ml In 1 Syringe, Glass",417.84,167.14,,,0 NDC,00310110501,NDC Description Not Available,50.9,20.36,,,0 NDC,00310110530,Lokelma: 30 Packet In 1 Box (0310-1105-30) / 5 G In 1 Packet (0310-1105-01),20.04,8.02,,,0 NDC,00310110539,Lokelma: 11 Packet In 1 Box (0310-1105-39) / 5 G In 1 Packet (0310-1105-01),75.42,30.17,,,0 NDC,00310111001,NDC Description Not Available,50.75,20.3,,,0 NDC,00310111030,Lokelma: 30 Packet In 1 Box (0310-1110-30) / 10 G In 1 Packet (0310-1110-01),20.04,8.02,,,0 NDC,00310111039,Lokelma: 11 Packet In 1 Box (0310-1110-39) / 10 G In 1 Packet (0310-1110-01),52.27,20.91,,,0 NDC,00310173030,"Fasenra: 1 Syringe, Glass In 1 Carton (0310-1730-30) / 1 Ml In 1 Syringe, Glass",843.88,337.55,,,0 NDC,00310304000,"Saphnelo: 1 Vial, Glass In 1 Carton (0310-3040-00) / 2 Ml In 1 Vial, Glass",78.93,31.57,,,0 NDC,00310450012,Imfinzi: 1 Vial In 1 Carton (0310-4500-12) / 2.4 Ml In 1 Vial,394.36,157.74,,,0 NDC,00310453530,Imjudo: 1 Vial In 1 Carton (0310-4535-30) / 15 Ml In 1 Vial,590.58,236.23,,,0 NDC,00310461150,Imfinzi: 1 Vial In 1 Carton (0310-4611-50) / 10 Ml In 1 Vial,370.72,148.29,,,0 NDC,00310621039,"Farxiga: 3 Blister Pack In 1 Carton (0310-6210-39) / 10 Tablet, Film Coated In 1 Blister Pack",68.18,27.27,,,0 NDC,00316022130,Nystatin Cream: 1 Tube In 1 Carton (0316-0221-30) / 30 G In 1 Tube,59.94,23.98,,,0 NDC,00316023125,Zeasorb: 71 G In 1 Bottle (0316-0231-25),15.09,6.04,,,0 NDC,00316023225,Zeasorb: 71 G In 1 Bottle (0316-0232-25),14.71,5.88,,,0 NDC,00338000402,"Sterile Water: 24 Bottle, Plastic In 1 Carton (0338-0004-02) / 250 Ml In 1 Bottle, Plastic",0.07,0.03,,,0 NDC,00338000404,"Sterile Water: 12 Bottle, Plastic In 1 Carton (0338-0004-04) / 1000 Ml In 1 Bottle, Plastic",1.85,0.74,,,0 NDC,00338001304,Sterile Water: 1000 Ml In 1 Bag (0338-0013-04),8.58,3.43,,,0 NDC,00338001306,Sterile Water: 2000 Ml In 1 Bag (0338-0013-06),4.13,1.65,,,0 NDC,00338001308,Sterile Water: 3000 Ml In 1 Bag (0338-0013-08),5.36,2.14,,,0 NDC,00338001329,Sterile Water: 5000 Ml In 1 Bag (0338-0013-29),5.83,2.33,,,0 NDC,00338001702,Dextrose: 250 Ml In 1 Bag (0338-0017-02),3.2,1.28,,,0 NDC,00338001703,Dextrose: 500 Ml In 1 Bag (0338-0017-03),15.559999999999999,6.225,,,0 NDC,00338001704,Dextrose: 1000 Ml In 1 Bag (0338-0017-04),20.77,8.31,,,0 NDC,00338001711,Dextrose: 4 Bag In 1 Pouch (0338-0017-11) / 50 Ml In 1 Bag,5.65,2.26,,,0 NDC,00338001718,Dextrose: 4 Bag In 1 Pouch (0338-0017-18) / 100 Ml In 1 Bag,7.46,2.98,,,0 NDC,00338001731,Dextrose: 16 Bag In 1 Pouch (0338-0017-31) / 50 Ml In 1 Bag,7.59,3.04,,,0 NDC,00338001741,Dextrose: 1 Bag In 1 Package (0338-0017-41) / 50 Ml In 1 Bag,2.42,0.97,,,0 NDC,00338001748,Dextrose: 1 Bag In 1 Package (0338-0017-48) / 100 Ml In 1 Bag,4.1,1.64,,,0 NDC,00338002303,Dextrose: 500 Ml In 1 Bag (0338-0023-03),12.2,4.88,,,0 NDC,00338002304,Dextrose: 1000 Ml In 1 Bag (0338-0023-04),4.56,1.82,,,0 NDC,00338004303,Sodium Chloride: 500 Ml In 1 Bag (0338-0043-03),5.3100000000000005,2.125,,,0 NDC,00338004304,Sodium Chloride: 1000 Ml In 1 Bag (0338-0043-04),9.935,3.975,,,0 NDC,00338004804,"Sodium Chloride: 12 Bottle, Plastic In 1 Carton (0338-0048-04) / 1000 Ml In 1 Bottle, Plastic",4.23,1.69,,,0 NDC,00338004902,Sodium Chloride: 250 Ml In 1 Bag (0338-0049-02),12.06,4.824999999999999,,,0 NDC,00338004903,Sodium Chloride: 500 Ml In 1 Bag (0338-0049-03),12.44,4.98,,,0 NDC,00338004904,Sodium Chloride: 1000 Ml In 1 Bag (0338-0049-04),13.11,5.24,,,0 NDC,00338004910,Sodium Chloride: 4 Bag In 1 Package (0338-0049-10) / 25 Ml In 1 Bag,8.969999999999999,3.59,,,0 NDC,00338004911,Sodium Chloride: 4 Bag In 1 Package (0338-0049-11) / 50 Ml In 1 Bag,10.69,4.28,,,0 NDC,00338004918,Sodium Chloride: 4 Bag In 1 Package (0338-0049-18) / 100 Ml In 1 Bag,8.17,3.27,,,0 NDC,00338004938,Sodium Chloride: 16 Bag In 1 Package (0338-0049-38) / 100 Ml In 1 Bag,7.26,2.9,,,0 NDC,00338004941,Sodium Chloride: 1 Bag In 1 Package (0338-0049-41) / 50 Ml In 1 Bag,13.745,5.5,,,0 NDC,00338004948,Sodium Chloride: 1 Bag In 1 Package (0338-0049-48) / 100 Ml In 1 Bag,9.870000000000001,3.95,,,0 NDC,00338005403,Sodium Chloride: 24 Bag In 1 Carton (0338-0054-03) / 500 Ml In 1 Bag,23.0,9.2,,,0 NDC,00338006301,"Doxil: 1 Vial, Single-Use In 1 Carton (0338-0063-01) / 10 Ml In 1 Vial, Single-Use",474.6,189.84,,,0 NDC,00338006701,"Doxil: 1 Vial, Single-Use In 1 Carton (0338-0067-01) / 25 Ml In 1 Vial, Single-Use",233.14,93.26,,,0 NDC,00338006910,Ketorolac Tromethamine: 10 Vial In 1 Carton (0338-0069-10) / 1 Ml In 1 Vial,3.1,1.24,,,0 NDC,00338007225,Ketorolac Tromethamine: 25 Vial In 1 Carton (0338-0072-25) / 1 Ml In 1 Vial,2.42,0.97,,,0 NDC,00338007704,Dextrose And Sodium Chloride: 14 Bag In 1 Carton (0338-0077-04) / 1000 Ml In 1 Bag,5.28,2.11,,,0 NDC,00338008503,Dextrose And Sodium Chloride: 24 Bag In 1 Carton (0338-0085-03) / 500 Ml In 1 Bag,7.45,2.98,,,0 NDC,00338008504,Dextrose And Sodium Chloride: 14 Bag In 1 Carton (0338-0085-04) / 1000 Ml In 1 Bag,13.8,5.52,,,0 NDC,00338008904,Dextrose And Sodium Chloride: 14 Bag In 1 Carton (0338-0089-04) / 1000 Ml In 1 Bag,9.14,3.655,,,0 NDC,00338010820,Norepinephrine Bitartrate: 20 Container In 1 Carton (0338-0108-20) / 250 Ml In 1 Container,146.72,58.69,,,0 NDC,00338011703,Lactated Ringers: 500 Ml In 1 Bag (0338-0117-03),11.22,4.49,,,0 NDC,00338011704,Lactated Ringers: 1000 Ml In 1 Bag (0338-0117-04),12.11,4.84,,,0 NDC,00338012504,Lactated Ringers And Dextrose: 1000 Ml In 1 Bag (0338-0125-04),12.829999999999998,5.135,,,0 NDC,00338012612,Myxredlin: 12 Container In 1 Carton (0338-0126-12) / 100 Ml In 1 Container,25.259999999999998,10.104999999999999,,,0 NDC,00338013727,Lactated Ringers: 3000 Ml In 1 Bag (0338-0137-27),2.51,1.0,,,0 NDC,00338022104,Plasma-Lyte A: 1000 Ml In 1 Bag (0338-0221-04),25.39,10.16,,,0 NDC,00338032201,Recothrom: 1 Kit In 1 Kit (0338-0322-01) * 5 Ml In 1 Vial (0338-0324-01) * 5 Ml In 1 Syringe,256.25,102.5,,,0 NDC,00338032401,NDC Description Not Available,190.29,76.12,,,0 NDC,00338035703,Osmitrol: 500 Ml In 1 Bag (0338-0357-03),161.19,64.48,,,0 NDC,00338041102,Lidocaine Hydrochloride And Dextrose: 24 Bag In 1 Carton (0338-0411-02) / 250 Ml In 1 Bag,0.02,0.01,,,0 NDC,00338050548,Gentamicin Sulfate In Sodium Chloride: 100 Ml In 1 Bag (0338-0505-48),14.67,5.87,,,0 NDC,00338050741,Gentamicin Sulfate In Sodium Chloride: 50 Ml In 1 Bag (0338-0507-41),14.49,5.8,,,0 NDC,00338050748,Gentamicin Sulfate In Sodium Chloride: 100 Ml In 1 Bag (0338-0507-48),8.61,3.44,,,0 NDC,00338050941,Gentamicin Sulfate In Sodium Chloride: 50 Ml In 1 Bag (0338-0509-41),12.65,5.06,,,0 NDC,00338051909,Intralipid: 250 Ml In 1 Bag (0338-0519-09),11.48,4.59,,,0 NDC,00338055111,Dextrose: 50 Ml In 1 Bag (0338-0551-11),2.99,1.2,,,0 NDC,00338055118,Dextrose: 100 Ml In 1 Bag (0338-0551-18),3.63,1.45,,,0 NDC,00338055318,Sodium Chloride: 100 Ml In 1 Bag (0338-0553-18),10.365,4.15,,,0 NDC,00338064406,Travasol: 2000 Ml In 1 Bag (0338-0644-06),120.91,48.36,,,0 NDC,00338065604,"Acetic Acid: 1000 Ml In 1 Bottle, Plastic (0338-0656-04)",24.49,9.8,,,0 NDC,00338066304,Potassium Chloride In Dextrose And Sodium Chloride: 1000 Ml In 1 Bag (0338-0663-04),32.2,12.88,,,0 NDC,00338067104,Potassium Chloride In Dextrose And Sodium Chloride: 1000 Ml In 1 Bag (0338-0671-04),14.08,5.63,,,0 NDC,00338069104,Potassium Chloride In Sodium Chloride: 14 Bag In 1 Carton (0338-0691-04) / 1000 Ml In 1 Bag,3.14,1.26,,,0 NDC,00338070341,Potassium Chloride: 24 Bag In 1 Carton (0338-0703-41) / 50 Ml In 1 Bag,1.58,0.63,,,0 NDC,00338070948,Potassium Chloride: 24 Bag In 1 Carton (0338-0709-48) / 100 Ml In 1 Bag,3.29,1.32,,,0 NDC,00338071906,Dextrose: 2000 Ml In 1 Bag (0338-0719-06),9.9,3.96,,,0 NDC,00338100702,Dopamine Hydrochloride And Dextrose: 18 Bag In 1 Carton (0338-1007-02) / 250 Ml In 1 Bag,5.65,2.26,,,0 NDC,00338100902,Dopamine Hydrochloride And Dextrose: 18 Bag In 1 Carton (0338-1009-02) / 250 Ml In 1 Bag,3.74,1.5,,,0 NDC,00338102341,Penicillin G Potassium: 50 Ml In 1 Bag (0338-1023-41),12.93,5.17,,,0 NDC,00338102541,Penicillin G Potassium: 50 Ml In 1 Bag (0338-1025-41),9.46,3.78,,,0 NDC,00338104702,"Nitroglycerin In Dextrose: 12 Bottle, Glass In 1 Box (0338-1047-02) / 250 Ml In 1 Bottle, Glass",1.26,0.5,,,0 NDC,00338104902,"Nitroglycerin In Dextrose: 12 Bottle, Glass In 1 Box (0338-1049-02) / 250 Ml In 1 Bottle, Glass",7.46,2.98,,,0 NDC,00338105548,Metronidazole: 24 Bag In 1 Carton (0338-1055-48) / 100 Ml In 1 Bag,1.915,0.765,,,0 NDC,00338107502,Dobutamine Hydrochloride In Dextrose: 18 Bag In 1 Carton (0338-1075-02) / 250 Ml In 1 Bag,82.56,33.02,,,0 NDC,00338113004,Premasol - Sulfite-Free (Amino Acid): 1000 Ml In 1 Bag (0338-1130-04),24.74,9.9,,,0 NDC,00338130501,"Mesnex: 1 Vial, Multi-Dose In 1 Box (0338-1305-01) / 10 Ml In 1 Vial, Multi-Dose",7.82,3.13,,,0 NDC,00338170940,Magnesium Sulfate In Dextrose: 40 Bag In 1 Case (0338-1709-40) / 100 Ml In 1 Bag,14.36,5.74,,,0 NDC,00338171540,Magnesium Sulfate: 40 Bag In 1 Carton (0338-1715-40) / 100 Ml In 1 Bag,2.11,0.84,,,0 NDC,00338341050,NDC Description Not Available,30.45,12.18,,,0 NDC,00338355248,Vancomycin Hydrochloride: 200 Ml In 1 Bag (0338-3552-48),16.21,6.48,,,0 NDC,00338361224,Clindamycin Phosphate: 24 Bag In 1 Carton (0338-3612-24) / 50 Ml In 1 Bag (0338-3612-50),18.58,7.43,,,0 NDC,00338361250,NDC Description Not Available,20.15,8.06,,,0 NDC,00338381424,Clindamycin Phosphate: 24 Bag In 1 Carton (0338-3814-24) / 50 Ml In 1 Bag (0338-3814-50),12.44,4.975,,,0 NDC,00338381450,NDC Description Not Available,10.3,4.12,,,0 NDC,00338430204,"Tisseel Fibrin Sealant: 1 Kit In 1 Carton (0338-4302-04) * 2 Ml In 1 Vial, Glass (0338-7332-02) * 2 Ml In 1 Vial, Glass (0338-7201-02) * 2 Ml In 1 Vial, Glass (0338-7401-02) * 2 Ml In 1 Vial, ",1451.81,580.72,,,0 NDC,00338601048,Milrinone Lactate In Dextrose: 10 Bag In 1 Carton (0338-6010-48) / 100 Ml In 1 Bag,29.24,11.7,,,0 NDC,00338604537,Fluconazole: 10 Bag In 1 Carton (0338-6045-37) / 200 Ml In 1 Bag,42.78,17.11,,,0 NDC,00338604648,Fluconazole: 10 Bag In 1 Carton (0338-6046-48) / 100 Ml In 1 Bag,59.34,23.74,,,0 NDC,00338850310,"Artiss Fibrin Sealant: 1 Syringe, Plastic In 1 Carton (0338-8503-10) / 10 Ml In 1 Syringe, Plastic (0338-8503-09)",1451.81,580.72,,,0 NDC,00338954124,Metronidazole: 24 Bag In 1 Carton (0338-9541-24) / 100 Ml In 1 Bag,2.6,1.04,,,0 NDC,00338954302,Sodium Chloride: 250 Ml In 1 Bag (0338-9543-02),12.65,5.06,,,0 NDC,00338954303,Sodium Chloride: 500 Ml In 1 Bag (0338-9543-03),9.790000000000001,3.915,,,0 NDC,00338954304,Sodium Chloride: 500 Ml In 1 Bag (0338-9543-04),18.4,7.36,,,0 NDC,00338954306,Sodium Chloride: 1000 Ml In 1 Bag (0338-9543-06),30.03,12.01,,,0 NDC,00338955712,Dexmedetomidine Hydrochloride: 12 Bag In 1 Carton (0338-9557-12) / 100 Ml In 1 Bag,88.06,35.22,,,0 NDC,00338963701,"Artiss Fibrin Sealant: 2 Ml In 1 Syringe, Plastic (0338-9637-01)",2567.21,1026.88,,,0 NDC,00378001801,"Metoprolol Tartrate: 100 Tablet, Film Coated In 1 Bottle, Plastic (0378-0018-01)",0.11,0.04,,,0 NDC,00378013701,Allopurinol: 100 Tablet In 1 Bottle (0378-0137-01),1.22,0.49,,,0 NDC,00378014491,Tamoxifen Citrate: 60 Tablet In 1 Bottle (0378-0144-91),0.58,0.23,,,0 NDC,00378050301,"Bisoprolol Fumarate And Hydrochlorothiazide: 100 Tablet, Film Coated In 1 Bottle, Plastic (0378-0503-01)",1.12,0.45,,,0 NDC,00378087116,NDC Description Not Available,26.58,10.63,,,0 NDC,00378087199,Clonidine: 4 Pouch In 1 Carton (0378-0871-99) / 1 Patch In 1 Pouch (0378-0871-16) / 7 D In 1 Patch,31.12,12.45,,,0 NDC,00378087216,NDC Description Not Available,47.69,19.08,,,0 NDC,00378087299,Clonidine: 4 Pouch In 1 Carton (0378-0872-99) / 1 Patch In 1 Pouch (0378-0872-16) / 7 D In 1 Patch,53.06,21.22,,,0 NDC,00378087316,NDC Description Not Available,74.44,29.78,,,0 NDC,00378087399,Clonidine: 4 Pouch In 1 Carton (0378-0873-99) / 1 Patch In 1 Pouch (0378-0873-16) / 7 D In 1 Patch,69.64,27.86,,,0 NDC,00378224693,"Imatinib Mesylate: 30 Tablet, Film Coated In 1 Bottle, Plastic (0378-2246-93)",34.34,13.74,,,0 NDC,00378261001,"Amitriptyline Hydrochloride: 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-2610-01)",0.31,0.12,,,0 NDC,00378392593,"Febuxostat: 30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-3925-93)",10.82,4.33,,,0 NDC,00378427193,"Ambrisentan: 30 Tablet, Film Coated In 1 Bottle, Plastic (0378-4271-93)",115.21,46.08,,,0 NDC,00378464216,NDC Description Not Available,27.5,11.0,,,0 NDC,00378561305,"Levetiracetam: 500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-5613-05)",1.24,0.5,,,0 NDC,00378623201,"Citalopram: 100 Tablet, Film Coated In 1 Bottle, Plastic (0378-6232-01)",0.22,0.09,,,0 NDC,00378633380,"Acamprosate Calcium: 180 Tablet, Delayed Release In 1 Bottle, Plastic (0378-6333-80)",2.48,0.99,,,0 NDC,00378647016,NDC Description Not Available,69.58,27.83,,,0 NDC,00378698501,NDC Description Not Available,1.195,0.48,,,0 NDC,00378699789,NDC Description Not Available,0.68,0.27,,,0 NDC,00378727253,Norethindrone: 3 Pouch In 1 Carton (0378-7272-53) / 1 Blister Pack In 1 Pouch (0378-7272-85) / 28 Tablet In 1 Blister Pack,0.58,0.23,,,0 NDC,00378773293,"Ondansetron: 30 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE, PLASTIC (0378-7732-93)",1.72,0.69,,,0 NDC,00378803005,"Lansoprazole: 500 Capsule, Delayed Release Pellets In 1 Bottle, Plastic (0378-8030-05)",4.32,1.73,,,0 NDC,00378876616,NDC Description Not Available,9.65,3.86,,,0 NDC,00378876693,Buprenorphine And Naloxone: 30 Pouch In 1 Carton (0378-8766-93) / 1 Film In 1 Pouch (0378-8766-16),17.07,6.83,,,0 NDC,00378905593,Lidocaine: 30 Pouch In 1 Carton (0378-9055-93) / 1 Patch In 1 Pouch (0378-9055-16),24.66,9.86,,,0 NDC,00378910216,NDC Description Not Available,1.81,0.72,,,0 NDC,00378911916,NDC Description Not Available,29.16,11.66,,,0 NDC,00378912116,NDC Description Not Available,21.39,8.56,,,0 NDC,00378912216,NDC Description Not Available,38.01,15.2,,,0 NDC,00378912298,Fentanyl: 5 Pouch In 1 Carton (0378-9122-98) / 1 Patch In 1 Pouch (0378-9122-16) / 72 H In 1 Patch,55.35,22.14,,,0 NDC,00378912316,NDC Description Not Available,60.06,24.02,,,0 NDC,00378912398,Fentanyl: 5 Pouch In 1 Carton (0378-9123-98) / 1 Patch In 1 Pouch (0378-9123-16) / 72 H In 1 Patch,87.5,35.0,,,0 NDC,00378912416,NDC Description Not Available,82.68,33.07,,,0 NDC,00378912498,Fentanyl: 5 Pouch In 1 Carton (0378-9124-98) / 1 Patch In 1 Pouch (0378-9124-16) / 72 H In 1 Patch,120.43,48.17,,,0 NDC,00378967130,Ipratropium Bromide And Albuterol Sulfate: 1 Pouch In 1 Carton (0378-9671-30) / 30 Ampule In 1 Pouch (0378-9671-64) / 3 Ml In 1 Ampule,2.17,0.87,,,0 NDC,00378967131,NDC Description Not Available,1.45,0.58,,,0 NDC,00378967193,Ipratropium Bromide And Albuterol Sulfate: 30 Pouch In 1 Carton (0378-9671-93) / 1 Ampule In 1 Pouch (0378-9671-31) / 3 Ml In 1 Ampule,1.43,0.57,,,0 NDC,00386000102,NDC Description Not Available,88.04,35.22,,,0 NDC,00386000103,NDC Description Not Available,96.05,38.42,,,0 NDC,00386000111,NDC Description Not Available,86.3,34.52,,,0 NDC,00395009416,NDC Description Not Available,0.7,0.28,,,0 NDC,00395100392,"Humco Gentian Violet 1%: 59 Ml In 1 Bottle, Plastic (0395-1003-92)",0.17,0.07,,,0 NDC,00395103116,NDC Description Not Available,5.455,2.185,,,0 NDC,00395140194,NDC Description Not Available,6.68,2.67,,,0 NDC,00395266116,NDC Description Not Available,0.7,0.28,,,0 NDC,00395266216,NDC Description Not Available,0.04,0.02,,,0 NDC,00395268501,"Humco Sodium Bicarbonate: 454 G In 1 Bottle, Plastic (0395-2685-01)",0.08,0.03,,,0 NDC,00395268594,"Humco Sodium Bicarbonate: 113 G In 1 Bottle, Plastic (0395-2685-94)",0.16999999999999998,0.065,,,0 NDC,00406012323,Hydrocodone Bitartrate And Acetaminophen: 1 Tablet In 1 Blister Pack (0406-0123-23),1.78,0.71,,,0 NDC,00406012362,Hydrocodone Bitartrate And Acetaminophen: 100 Tablet In 1 Blister Pack (0406-0123-62),1.5,0.6,,,0 NDC,00406052710,"Methadose: 1000 Ml In 1 Bottle, Plastic (0406-0527-10)",2.02,0.81,,,0 NDC,00406055201,Oxycodone Hydrochloride: 100 Tablet In 1 Bottle (0406-0552-01),0.6,0.24,,,0 NDC,00406055223,Oxycodone Hydrochloride: 1 Tablet In 1 Blister Pack (0406-0552-23),1.48,0.59,,,0 NDC,00406055262,Oxycodone Hydrochloride: 100 Tablet In 1 Blister Pack (0406-0552-62),1.5,0.6,,,0 NDC,00406123601,Diphenoxylate Hydrochloride And Atropine Sulfate: 100 Tablet In 1 Bottle (0406-1236-01),0.57,0.23,,,0 NDC,00406324401,Hydromorphone Hydrochloride: 100 Tablet In 1 Bottle (0406-3244-01),0.44,0.18,,,0 NDC,00406412303,"Methadone Hydrochloride: 1 Bottle, Dropper In 1 Carton (0406-4123-03) / 30 Ml In 1 Bottle, Dropper",6.97,2.79,,,0 NDC,00406511862,Morphine Sulfate: 10 Blister Pack In 1 Carton (0406-5118-62) / 10 Tablet In 1 Blister Pack,2.79,1.12,,,0 NDC,00406575523,Methadone Hydrochloride: 1 Tablet In 1 Blister Pack (0406-5755-23),1.16,0.46,,,0 NDC,00406575562,Methadone Hydrochloride: 100 Tablet In 1 Blister Pack (0406-5755-62),0.85,0.34,,,0 NDC,00406577123,Methadone Hydrochloride: 1 Tablet In 1 Blister Pack (0406-5771-23),0.73,0.29,,,0 NDC,00406622501,NDC Description Not Available,0.12,0.05,,,0 NDC,00406622505,Methadone Hydrochloride: 500 Ml In 1 Bottle (0406-6225-05),0.44,0.18,,,0 NDC,00406800330,"Morphine Sulfate: 6 Carton In 1 Case (0406-8003-30) / 1 Bottle, Plastic In 1 Carton / 30 Ml In 1 Bottle, Plastic",2.24,0.9,,,0 NDC,00406831523,"Morphine Sulfate: 1 Tablet, Extended Release In 1 Blister Pack (0406-8315-23)",3.59,1.44,,,0 NDC,00406833023,"Morphine Sulfate: 1 Tablet, Extended Release In 1 Blister Pack (0406-8330-23)",3.39,1.36,,,0 NDC,00406851023,Oxycodone Hydrochloride: 1 Tablet In 1 Blister Pack (0406-8510-23),1.73,0.69,,,0 NDC,00406855730,"Oxycodone Hydrochloride: 1 Bottle, Plastic In 1 Carton (0406-8557-30) / 30 Ml In 1 Bottle, Plastic",4.96,1.98,,,0 NDC,00406855755,NDC Description Not Available,1.99,0.8,,,0 NDC,00406872510,"Methadose Sugar-Free: 1000 Ml In 1 Bottle, Plastic (0406-8725-10)",1.67,0.67,,,0 NDC,00406889101,Dextroamphetamine Saccharate And Amphetamine Aspartate And Dextroamphetamine Sulfate And Amphetamine Sulfate: 100 Tablet In 1 Bottle (0406-8891-01),1.41,0.56,,,0 NDC,00406895101,"Mixed Salts Of A Single Entity Amphetamine Product Xr: 100 Capsule, Extended Release In 1 Bottle (0406-8951-01)",3.36,1.34,,,0 NDC,00407141110,"Omnipaque: 10 Vial, Glass In 1 Box (0407-1411-10) / 10 Ml In 1 Vial, Glass",20.33,8.13,,,0 NDC,00407141120,"Omnipaque: 10 Vial, Glass In 1 Box (0407-1411-20) / 20 Ml In 1 Vial, Glass",10.53,4.21,,,0 NDC,00407141230,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1412-30) / 50 Ml In 1 Bottle, Plastic",3.89,1.56,,,0 NDC,00407141234,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1412-34) / 150 Ml In 1 Bottle, Plastic",0.37,0.15,,,0 NDC,00407141310,"Omnipaque: 10 Vial, Glass In 1 Box (0407-1413-10) / 10 Ml In 1 Vial, Glass",15.8,6.32,,,0 NDC,00407141359,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1413-59) / 30 Ml In 1 Bottle, Plastic",10.55,4.22,,,0 NDC,00407141361,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1413-61) / 50 Ml In 1 Bottle, Plastic",6.14,2.46,,,0 NDC,00407141363,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1413-63) / 100 Ml In 1 Bottle, Plastic",3.93,1.57,,,0 NDC,00407141365,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1413-65) / 150 Ml In 1 Bottle, Plastic",4.01,1.6,,,0 NDC,00407141489,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1414-89) / 50 Ml In 1 Bottle, Plastic",3.92,1.57,,,0 NDC,00407141491,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1414-91) / 100 Ml In 1 Bottle, Plastic",4.67,1.87,,,0 NDC,00407141494,"Omnipaque: 10 Bottle, Plastic In 1 Box (0407-1414-94) / 200 Ml In 1 Bottle, Plastic",7.13,2.85,,,0 NDC,00407222316,"Visipaque: 10 Bottle, Plastic In 1 Box (0407-2223-16) / 50 Ml In 1 Bottle, Plastic",6.33,2.53,,,0 NDC,00407222317,"Visipaque: 10 Bottle, Plastic In 1 Box (0407-2223-17) / 100 Ml In 1 Bottle, Plastic",1.88,0.75,,,0 NDC,00407222319,"Visipaque: 10 Bottle, Plastic In 1 Box (0407-2223-19) / 150 Ml In 1 Bottle, Plastic",3.92,1.57,,,0 NDC,00407222321,"Visipaque: 10 Bottle, Plastic In 1 Box (0407-2223-21) / 200 Ml In 1 Bottle, Plastic",1.68,0.67,,,0 NDC,00407294301,"Clariscan: 10 Vial, Glass In 1 Box (0407-2943-01) / 10 Ml In 1 Vial, Glass",1.08,0.43,,,0 NDC,00409000701,NDC Description Not Available,0.05,0.02,,,0 NDC,00409006410,Carboprost Tromethamine: 10 Vial In 1 Carton (0409-0064-10) / 1 Ml In 1 Vial,255.19,102.08,,,0 NDC,00409012201,"Daptomycin: 1 Vial, Single-Dose In 1 Carton (0409-0122-01) / 10 Ml In 1 Vial, Single-Dose",0.31,0.12,,,0 NDC,00409015201,NDC Description Not Available,2.3899999999999997,0.9600000000000001,,,0 NDC,00409015224,Metronidazole: 24 Pouch In 1 Carton (0409-0152-24) / 1 Bag In 1 Pouch (0409-0152-01) / 100 Ml In 1 Bag,0.14,0.06,,,0 NDC,00409018201,"Gemcitabine: 1 Vial, Single-Dose In 1 Carton (0409-0182-01) / 52.6 Ml In 1 Vial, Single-Dose",23.2,9.28,,,0 NDC,00409021211,NDC Description Not Available,4.83,1.93,,,0 NDC,00409030201,"Topotecan: 1 Vial, Single-Dose In 1 Carton (0409-0302-01) / 4 Ml In 1 Vial, Single-Dose",14.65,5.86,,,0 NDC,00409082901,"Aztreonam: 10 Vial, Single-Dose In 1 Carton (0409-0829-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose (0409-0829-11)",10.34,4.14,,,0 NDC,00409082911,NDC Description Not Available,10.94,4.38,,,0 NDC,00409083001,"Aztreonam: 10 Vial, Single-Dose In 1 Carton (0409-0830-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose (0409-0830-11)",10.56,4.22,,,0 NDC,00409083011,NDC Description Not Available,14.61,5.84,,,0 NDC,00409104130,"Carbocaine: 1 VIAL, SINGLE-DOSE in 1 CARTON (0409-1041-30) / 30 mL in 1 VIAL, SINGLE-DOSE",6.03,2.41,,,0 NDC,00409110311,NDC Description Not Available,294.12,117.65,,,0 NDC,00409114001,"Argatroban: 1 Vial, Single-Dose In 1 Carton (0409-1140-01) / 2.5 Ml In 1 Vial, Single-Dose",1.1,0.44,,,0 NDC,00409114402,Verapamil Hydrochloride: 5 Vial In 1 Carton (0409-1144-02) / 4 Ml In 1 Vial (0409-1144-62),145.8,58.32,,,0 NDC,00409115901,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-1159-01) / 10 Ml In 1 Vial, Single-Dose (0409-1159-18)",0.21,0.08,,,0 NDC,00409115902,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-1159-02) / 30 Ml In 1 Vial, Single-Dose (0409-1159-19)",0.07,0.03,,,0 NDC,00409115918,NDC Description Not Available,0.18,0.07,,,0 NDC,00409115919,NDC Description Not Available,0.07,0.03,,,0 NDC,00409116201,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-1162-01) / 10 Ml In 1 Vial, Single-Dose (0409-1162-18)",0.11,0.04,,,0 NDC,00409116202,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-1162-02) / 30 Ml In 1 Vial, Single-Dose (0409-1162-19)",0.04,0.02,,,0 NDC,00409116210,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-1162-10) / 30 Ml In 1 Vial, Single-Dose (0409-1162-09)",0.03,0.01,,,0 NDC,00409116218,NDC Description Not Available,0.09,0.04,,,0 NDC,00409116219,NDC Description Not Available,0.04,0.02,,,0 NDC,00409116301,"Bupivacaine Hydrochloride: 25 Vial, Multi-Dose In 1 Tray (0409-1163-01) / 50 Ml In 1 Vial, Multi-Dose (0409-1163-18)",0.03,0.01,,,0 NDC,00409116318,NDC Description Not Available,0.03,0.01,,,0 NDC,00409116502,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-1165-02) / 30 Ml In 1 Vial, Single-Dose (0409-1165-19)",0.05,0.02,,,0 NDC,00409116518,NDC Description Not Available,0.09,0.04,,,0 NDC,00409116519,NDC Description Not Available,0.04,0.02,,,0 NDC,00409117603,NDC Description Not Available,25.46,10.18,,,0 NDC,00409120703,"Gentamicin Sulfate: 25 Vial, Single-Dose In 1 Tray (0409-1207-03) / 2 Ml In 1 Vial, Single-Dose (0409-1207-13)",13.465,5.385,,,0 NDC,00409120713,NDC Description Not Available,12.23,4.89,,,0 NDC,00409120715,NDC Description Not Available,3.62,1.45,,,0 NDC,00409120811,NDC Description Not Available,41.21,16.48,,,0 NDC,00409120901,Lidocaine Hydrochloride And Epinephrine: 10 Ampule In 1 Tray (0409-1209-01) / 5 Ml In 1 Ampule (0409-1209-10),7.824999999999999,3.13,,,0 NDC,00409120910,NDC Description Not Available,0.19,0.08,,,0 NDC,00409121501,"Naloxone Hydrochloride: 10 Vial, Single-Dose In 1 Carton (0409-1215-01) / 1 Ml In 1 Vial, Single-Dose (0409-1215-21)",14.97,5.99,,,0 NDC,00409121521,NDC Description Not Available,102.54,41.02,,,0 NDC,00409127303,NDC Description Not Available,61.25,24.5,,,0 NDC,00409127332,Diazepam: 10 Cartridge In 1 Carton (0409-1273-32) / 2 Ml In 1 Cartridge (0409-1273-03),43.22,17.29,,,0 NDC,00409128305,10 SYRINGE in 1 CARTON (0409-1283-05) / .5 mL in 1 SYRINGE (0409-1283-04),2.8,1.12,,,0 NDC,00409128317,NDC Description Not Available,2.45,0.98,,,0 NDC,00409131230,Hydromorphone Hydrochloride: 10 Cartridge In 1 Carton (0409-1312-30) / 1 Ml In 1 Cartridge (0409-1312-03),0.45,0.18,,,0 NDC,00409131901,"Vancomycin Hydrochloride: 1 Vial, Pharmacy Bulk Package In 1 Carton (0409-1319-01) / 100 Ml In 1 Vial, Pharmacy Bulk Package",24.36,9.74,,,0 NDC,00409132305,"Lidocaine Hydrochloride: 10 Carton In 1 Container (0409-1323-05) / 1 Syringe, Plastic In 1 Carton / 5 Ml In 1 Syringe, Plastic (0409-1323-15)",0.27,0.11,,,0 NDC,00409132315,NDC Description Not Available,0.29,0.12,,,0 NDC,00409139121,NDC Description Not Available,3.18,1.27,,,0 NDC,00409139122,Meropenem: 10 Vial In 1 Carton (0409-1391-22) / 20 Ml In 1 Vial (0409-1391-21),1.89,0.76,,,0 NDC,00409141204,Bumetanide: 10 VIAL in 1 BOX (0409-1412-04) / 4 mL in 1 VIAL (0409-1412-34),4.3,1.72,,,0 NDC,00409146349,Nalbuphine Hydrochloride: 10 Ampule In 1 Tray (0409-1463-49) / 1 Ml In 1 Ampule (0409-1463-69),14.7,5.88,,,0 NDC,00409146371,NDC Description Not Available,16.22,6.49,,,0 NDC,00409155918,NDC Description Not Available,0.35,0.14,,,0 NDC,00409155919,NDC Description Not Available,0.14,0.06,,,0 NDC,00409155930,"Marcaine: 10 Vial, Single-Dose In 1 Carton (0409-1559-30) / 30 Ml In 1 Vial, Single-Dose (0409-1559-19)",0.14,0.06,,,0 NDC,00409156010,"Marcaine: 10 Vial, Single-Dose In 1 Tray (0409-1560-10) / 10 Ml In 1 Vial, Single-Dose (0409-1560-18)",0.21,0.08,,,0 NDC,00409156018,NDC Description Not Available,0.2,0.08,,,0 NDC,00409156019,NDC Description Not Available,0.08,0.03,,,0 NDC,00409156029,"Marcaine: 10 Vial, Single-Dose In 1 Carton (0409-1560-29) / 30 Ml In 1 Vial, Single-Dose (0409-1560-19)",0.08,0.03,,,0 NDC,00409158210,"Marcaine: 10 Vial, Single-Dose In 1 Tray (0409-1582-10) / 10 Ml In 1 Vial, Single-Dose (0409-1582-18)",0.15,0.06,,,0 NDC,00409161050,"Marcaine: 1 Vial, Multi-Dose In 1 Carton (0409-1610-50) / 50 Ml In 1 Vial, Multi-Dose",0.05,0.02,,,0 NDC,00409162601,"Butorphanol Tartrate: 10 Vial, Single-Dose In 1 Carton (0409-1626-01) / 1 Ml In 1 Vial, Single-Dose (0409-1626-21)",28.86,11.54,,,0 NDC,00409162621,NDC Description Not Available,25.1,10.04,,,0 NDC,00409163015,NDC Description Not Available,0.41,0.16,,,0 NDC,00409163140,NDC Description Not Available,0.11,0.04,,,0 NDC,00409163221,NDC Description Not Available,0.38,0.15,,,0 NDC,00409163832,NDC Description Not Available,54.18,21.67,,,0 NDC,00409166010,Precedex: 10 Bottle In 1 Tray (0409-1660-10) / 100 Ml In 1 Bottle (0409-1660-35),8.09,3.24,,,0 NDC,00409166020,Precedex: 10 Vial In 1 Carton (0409-1660-20) / 20 Ml In 1 Vial (0409-1660-22),23.85,9.54,,,0 NDC,00409166022,NDC Description Not Available,24.02,9.61,,,0 NDC,00409166050,Precedex: 20 Bottle In 1 Tray (0409-1660-50) / 50 Ml In 1 Bottle (0409-1660-55),11.61,4.64,,,0 NDC,00409166055,NDC Description Not Available,128.93,51.57,,,0 NDC,00409174610,"Marcaine With Epinephrine: 10 Vial, Single-Dose In 1 Carton (0409-1746-10) / 10 Ml In 1 Vial, Single-Dose (0409-1746-70)",23.24,9.3,,,0 NDC,00409174630,"Marcaine With Epinephrine: 10 Vial, Single-Dose In 1 Carton (0409-1746-30) / 30 Ml In 1 Vial, Single-Dose (0409-1746-71)",34.27,13.71,,,0 NDC,00409174671,NDC Description Not Available,49.63,19.85,,,0 NDC,00409174929,"Marcaine With Epinephrine: 10 Vial, Single-Dose In 1 Carton (0409-1749-29) / 30 Ml In 1 Vial, Single-Dose (0409-1749-71)",19.1,7.64,,,0 NDC,00409174970,NDC Description Not Available,13.6,5.44,,,0 NDC,00409175550,"Marcaine With Epinephrine: 1 Vial, Multi-Dose In 1 Carton (0409-1755-50) / 50 Ml In 1 Vial, Multi-Dose",23.03,9.21,,,0 NDC,00409176118,NDC Description Not Available,1.31,0.52,,,0 NDC,00409177510,"Dextrose: 10 Carton In 1 Package (0409-1775-10) / 1 Syringe, Plastic In 1 Carton / 10 Ml In 1 Syringe, Plastic (0409-1775-40)",90.6,36.24,,,0 NDC,00409177540,NDC Description Not Available,70.03,28.01,,,0 NDC,00409177805,"Metoprolol Tartrate: 10 Vial, Single-Dose In 1 Carton (0409-1778-05) / 5 Ml In 1 Vial, Single-Dose (0409-1778-15)",2.26,0.9,,,0 NDC,00409177815,NDC Description Not Available,2.625,1.05,,,0 NDC,00409188602,"Levetiracetam: 25 Vial, Single-Dose In 1 Carton (0409-1886-02) / 5 Ml In 1 Vial, Single-Dose (0409-1886-22)",0.35,0.14,,,0 NDC,00409188622,NDC Description Not Available,0.35,0.14,,,0 NDC,00409189001,Morphine Sulfate: 10 Cartridge In 1 Carton (0409-1890-01) / 1 Ml In 1 Cartridge (0409-1890-03),3.1,1.24,,,0 NDC,00409189013,NDC Description Not Available,8.19,3.28,,,0 NDC,00409189201,Morphine Sulfate: 10 Cartridge In 1 Carton (0409-1892-01) / 1 Ml In 1 Cartridge (0409-1892-03),1.77,0.71,,,0 NDC,00409189620,"Morphine Sulfate: 1 Vial, Single-Dose In 1 Carton (0409-1896-20) / 20 Ml In 1 Vial, Single-Dose",0.85,0.34,,,0 NDC,00409190201,"Procainamide Hydrochloride: 25 Carton In 1 Case (0409-1902-01) / 1 Vial, Multi-Dose In 1 Carton (0409-1902-11) / 10 Ml In 1 Vial, Multi-Dose",1803.26,721.3,,,0 NDC,00409190211,NDC Description Not Available,1662.8,665.12,,,0 NDC,00409193201,"Adenosine: 1 VIAL, SINGLE-DOSE in 1 CARTON (0409-1932-01) / 20 mL in 1 VIAL, SINGLE-DOSE",2.41,0.96,,,0 NDC,00409196602,NDC Description Not Available,3.1,1.24,,,0 NDC,00409198503,NDC Description Not Available,10.91,4.36,,,0 NDC,00409204501,NDC Description Not Available,17.53,7.01,,,0 NDC,00409205001,NDC Description Not Available,0.69,0.28,,,0 NDC,00409205020,Magnesium Sulfate In Water: 20 Pouch In 1 Case (0409-2050-20) / 1 Bag In 1 Pouch / 500 Ml In 1 Bag (0409-2050-01),0.69,0.28,,,0 NDC,00409205105,"Ketamine Hydrochloride: 10 Vial, Multi-Dose In 1 Box (0409-2051-05) / 5 Ml In 1 Vial, Multi-Dose (0409-2051-15)",16.33,6.53,,,0 NDC,00409205115,NDC Description Not Available,26.47,10.59,,,0 NDC,00409206605,"Lidocaine Hydrochloride: 10 Vial, Single-Dose In 1 Carton (0409-2066-05) / 5 Ml In 1 Vial, Single-Dose (0409-2066-10)",0.05,0.02,,,0 NDC,00409206610,NDC Description Not Available,2.39,0.955,,,0 NDC,00409216817,NDC Description Not Available,0.86,0.34,,,0 NDC,00409222001,NDC Description Not Available,18.4,7.36,,,0 NDC,00409222201,NDC Description Not Available,9.2,3.68,,,0 NDC,00409230001,NDC Description Not Available,13.59,5.44,,,0 NDC,00409230024,Ciprofloxacin In Dextrose: 24 Pouch In 1 Carton (0409-2300-24) / 1 Bag In 1 Pouch (0409-2300-01) / 100 Ml In 1 Bag,12.88,5.15,,,0 NDC,00409230504,NDC Description Not Available,1.04,0.42,,,0 NDC,00409230505,"Midazolam: 10 Vial, Single-Dose In 1 Carton (0409-2305-05) / 5 Ml In 1 Vial, Single-Dose (0409-2305-04)",1.03,0.41,,,0 NDC,00409230516,NDC Description Not Available,2.57,1.03,,,0 NDC,00409230517,"Midazolam: 25 Vial, Single-Dose In 1 Tray (0409-2305-17) / 2 Ml In 1 Vial, Single-Dose (0409-2305-16)",0.77,0.31,,,0 NDC,00409230550,"Midazolam: 10 Vial, Single-Dose In 1 Carton (0409-2305-50) / 5 Ml In 1 Vial, Single-Dose (0409-2305-55)",0.79,0.32,,,0 NDC,00409230802,"Midazolam: 10 Vial, Single-Dose In 1 Carton (0409-2308-02) / 2 Ml In 1 Vial, Single-Dose (0409-2308-22)",1.085,0.435,,,0 NDC,00409230822,NDC Description Not Available,0.6,0.24,,,0 NDC,00409233924,NDC Description Not Available,7.5,3.0,,,0 NDC,00409233934,Labetalol Hydrochloride: 10 Carton In 1 Package (0409-2339-34) / 1 Cartridge In 1 Carton / 4 Ml In 1 Cartridge (0409-2339-24),9.96,3.98,,,0 NDC,00409234402,"Dobutamine: 10 Vial, Single-Dose In 1 Tray (0409-2344-02) / 20 Ml In 1 Vial, Single-Dose (0409-2344-62)",22.74,9.1,,,0 NDC,00409234462,NDC Description Not Available,19.08,7.63,,,0 NDC,00409234731,NDC Description Not Available,86.4,34.56,,,0 NDC,00409255201,Hydromorphone Hydrochloride: 10 Ampule In 1 Carton (0409-2552-01) / 1 Ml In 1 Ampule (0409-2552-11),1.39,0.56,,,0 NDC,00409258705,"Midazolam: 10 Vial, Multi-Dose In 1 Carton (0409-2587-05) / 10 Ml In 1 Vial, Multi-Dose (0409-2587-04)",0.54,0.22,,,0 NDC,00409263401,"Hydromorphone Hydrochloride: 10 Vial, Single-Dose In 1 Box (0409-2634-01) / 1 Ml In 1 Vial, Single-Dose (0409-2634-10)",0.1,0.04,,,0 NDC,00409263405,"Hydromorphone Hydrochloride: 10 Vial, Single-Dose In 1 Box (0409-2634-05) / 5 Ml In 1 Vial, Single-Dose (0409-2634-25)",0.1,0.04,,,0 NDC,00409263425,NDC Description Not Available,0.09,0.04,,,0 NDC,00409263450,"Hydromorphone Hydrochloride: 1 Vial, Single-Dose In 1 Box (0409-2634-50) / 50 Ml In 1 Vial, Single-Dose",0.21,0.08,,,0 NDC,00409272002,"Heparin Sodium: 25 Vial, Multi-Dose In 1 Tray (0409-2720-02) / 10 Ml In 1 Vial, Multi-Dose (0409-2720-31)",1.55,0.62,,,0 NDC,00409272030,NDC Description Not Available,8.42,3.37,,,0 NDC,00409272031,NDC Description Not Available,1.53,0.61,,,0 NDC,00409272331,NDC Description Not Available,1.07,0.43,,,0 NDC,00409316401,NDC Description Not Available,0.46,0.18,,,0 NDC,00409317701,"Lidocaine Hydrochloride And Epinephrine: 25 Vial, Multi-Dose In 1 Tray (0409-3177-01) / 50 Ml In 1 Vial, Multi-Dose (0409-3177-16)",1.775,0.71,,,0 NDC,00409317716,NDC Description Not Available,0.04,0.02,,,0 NDC,00409317801,"Lidocaine Hydrochloride And Epinephrine: 25 Vial, Multi-Dose In 1 Tray (0409-3178-01) / 20 Ml In 1 Vial, Multi-Dose (0409-3178-16)",2.225,0.89,,,0 NDC,00409317802,"Lidocaine Hydrochloride And Epinephrine: 25 Vial, Multi-Dose In 1 Tray (0409-3178-02) / 30 Ml In 1 Vial, Multi-Dose (0409-3178-17)",21.08,8.43,,,0 NDC,00409317803,"Lidocaine Hydrochloride And Epinephrine: 25 Vial, Multi-Dose In 1 Tray (0409-3178-03) / 50 Ml In 1 Vial, Multi-Dose (0409-3178-18)",0.07,0.03,,,0 NDC,00409317816,NDC Description Not Available,0.03,0.01,,,0 NDC,00409317817,NDC Description Not Available,0.05,0.02,,,0 NDC,00409318202,"Lidocaine Hydrochloride And Epinephrine: 25 Vial, Multi-Dose In 1 Tray (0409-3182-02) / 30 Ml In 1 Vial, Multi-Dose (0409-3182-21)",0.03,0.01,,,0 NDC,00409318301,"Lidocaine Hydrochloride And Epinephrine: 5 Vial, Single-Dose In 1 Carton (0409-3183-01) / 20 Ml In 1 Vial, Single-Dose (0409-3183-11)",3.5050000000000003,1.4,,,0 NDC,00409329461,NDC Description Not Available,44.36,17.74,,,0 NDC,00409329905,Sodium Acetate: 25 Vial In 1 Tray (0409-3299-05) / 50 Ml In 1 Vial (0409-3299-15),0.92,0.37,,,0 NDC,00409329906,Sodium Acetate: 25 Vial In 1 Case (0409-3299-06) / 100 Ml In 1 Vial (0409-3299-16),0.69,0.28,,,0 NDC,00409329915,NDC Description Not Available,47.81,19.12,,,0 NDC,00409329916,NDC Description Not Available,10.45,4.18,,,0 NDC,00409330001,NDC Description Not Available,9.08,3.63,,,0 NDC,00409330024,Ciprofloxacin In Dextrose: 24 Pouch In 1 Carton (0409-3300-24) / 1 Bag In 1 Pouch (0409-3300-01) / 200 Ml In 1 Bag,8.18,3.27,,,0 NDC,00409330803,Acetylcysteine: 3 Vial In 1 Carton (0409-3308-03) / 30 Ml In 1 Vial (0409-3308-11),20.8,8.32,,,0 NDC,00409330811,NDC Description Not Available,11.76,4.7,,,0 NDC,00409333001,NDC Description Not Available,16.39,6.56,,,0 NDC,00409336511,NDC Description Not Available,0.25,0.1,,,0 NDC,00409337514,NDC Description Not Available,19.38,7.75,,,0 NDC,00409338211,NDC Description Not Available,38.58,15.43,,,0 NDC,00409338221,"Sufentanil Citrate: 10 Vial, Single-Dose In 1 Carton (0409-3382-21) / 1 Ml In 1 Vial, Single-Dose (0409-3382-11)",35.56,14.22,,,0 NDC,00409338302,"Piperacillin And Tazobactam: 10 Vial, Single-Use In 1 Carton (0409-3383-02) / 10 Ml In 1 Vial, Single-Use (0409-3383-11)",8.64,3.46,,,0 NDC,00409338311,NDC Description Not Available,15.34,6.14,,,0 NDC,00409339004,"Piperacillin And Tazobactam: 10 Vial, Single-Use In 1 Carton (0409-3390-04) / 20 Ml In 1 Vial, Single-Use (0409-3390-11)",10.3,4.12,,,0 NDC,00409339011,NDC Description Not Available,14.52,5.81,,,0 NDC,00409341401,"Metoclopramide: 25 Vial, Single-Dose In 1 Tray (0409-3414-01) / 2 Ml In 1 Vial, Single-Dose (0409-3414-18)",4.15,1.66,,,0 NDC,00409341411,"Metoclopramide: 25 Vial, Single-Dose In 1 Tray (0409-3414-11) / 2 Ml In 1 Vial, Single-Dose (0409-3414-21)",4.88,1.95,,,0 NDC,00409341418,NDC Description Not Available,4.31,1.72,,,0 NDC,00409351021,NDC Description Not Available,71.12,28.45,,,0 NDC,00409361301,Bupivacaine Spinal: 10 Ampule In 1 Carton (0409-3613-01) / 2 Ml In 1 Ampule (0409-3613-11),0.42,0.17,,,0 NDC,00409379301,"Ketorolac Tromethamine: 25 Vial, Single-Dose In 1 Tray (0409-3793-01) / 1 Ml In 1 Vial, Single-Dose (0409-3793-19)",12.04,4.82,,,0 NDC,00409379319,NDC Description Not Available,11.59,4.64,,,0 NDC,00409379519,NDC Description Not Available,13.6,5.44,,,0 NDC,00409381511,NDC Description Not Available,81.31,32.52,,,0 NDC,00409381512,"Morphine Sulfate: 5 Vial, Glass In 1 Carton (0409-3815-12) / 10 Ml In 1 Vial, Glass (0409-3815-11)",85.11,34.04,,,0 NDC,00409403101,"Mannitol: 25 Vial, Single-Dose In 1 Tray (0409-4031-01) / 50 Ml In 1 Vial, Single-Dose (0409-4031-16)",27.39,10.96,,,0 NDC,00409403116,NDC Description Not Available,27.61,11.04,,,0 NDC,00409409001,"Zinc: 25 Vial, Plastic In 1 Tray (0409-4090-01) / 10 Ml In 1 Vial, Plastic (0409-4090-11)",7.28,2.91,,,0 NDC,00409409201,"Copper: 25 Vial, Single-Dose In 1 Tray (0409-4092-01) / 10 Ml In 1 Vial, Single-Dose (0409-4092-11)",1.27,0.51,,,0 NDC,00409409211,NDC Description Not Available,77.2,30.88,,,0 NDC,00409409310,"Chromium: 25 Vial, Single-Dose In 1 Tray (0409-4093-10) / 10 Ml In 1 Vial, Single-Dose (0409-4093-09)",0.08,0.03,,,0 NDC,00409426401,Hydromorphone Hydrochloride: 10 Syringe In 1 Cello Pack (0409-4264-01) / .5 Ml In 1 Syringe (0409-4264-11),2.83,1.13,,,0 NDC,00409426411,NDC Description Not Available,2.85,1.14,,,0 NDC,00409427601,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Tray (0409-4276-01) / 20 Ml In 1 Vial, Multi-Dose (0409-4276-16)",3.8449999999999998,1.5399999999999998,,,0 NDC,00409427602,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Tray (0409-4276-02) / 50 Ml In 1 Vial, Multi-Dose (0409-4276-17)",0.375,0.15000000000000002,,,0 NDC,00409427616,NDC Description Not Available,6.64,2.655,,,0 NDC,00409427617,NDC Description Not Available,0.195,0.07500000000000001,,,0 NDC,00409427701,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Tray (0409-4277-01) / 20 Ml In 1 Vial, Multi-Dose (0409-4277-16)",3.6799999999999997,1.4749999999999999,,,0 NDC,00409427702,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Tray (0409-4277-02) / 50 Ml In 1 Vial, Multi-Dose (0409-4277-17)",7.74,3.0949999999999998,,,0 NDC,00409427716,NDC Description Not Available,3.925,1.5699999999999998,,,0 NDC,00409427717,NDC Description Not Available,0.02,0.01,,,0 NDC,00409427816,NDC Description Not Available,0.4,0.16,,,0 NDC,00409427902,"Lidocaine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-4279-02) / 30 Ml In 1 Vial, Single-Dose (0409-4279-16)",7.3,2.92,,,0 NDC,00409427916,NDC Description Not Available,7.17,2.87,,,0 NDC,00409428201,Lidocaine Hydrochloride: 5 Cello Pack In 1 Package (0409-4282-01) / 5 Ampule In 1 Cello Pack (0409-4282-25) / 2 Ml In 1 Ampule (0409-4282-11),0.1,0.04,,,0 NDC,00409428202,Lidocaine Hydrochloride: 25 Ampule In 1 Carton (0409-4282-02) / 10 Ml In 1 Ampule (0409-4282-12),0.05,0.02,,,0 NDC,00409428301,Lidocaine Hydrochloride: 5 Cello Pack In 1 Package (0409-4283-01) / 5 Ampule In 1 Cello Pack (0409-4283-25) / 5 Ml In 1 Ampule (0409-4283-11),5.915,2.365,,,0 NDC,00409428311,NDC Description Not Available,8.559999999999999,3.42,,,0 NDC,00409433201,"Vancomycin Hydrochloride: 10 Vial In 1 Tray (0409-4332-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (0409-4332-11)",32.99,13.2,,,0 NDC,00409433211,NDC Description Not Available,0.73,0.29,,,0 NDC,00409434616,NDC Description Not Available,20.405,8.16,,,0 NDC,00409434673,"Aminocaproic Acid: 25 Vial, Single-Dose In 1 Tray (0409-4346-73) / 20 Ml In 1 Vial, Single-Dose (0409-4346-16)",20.945,8.379999999999999,,,0 NDC,00409452002,NDC Description Not Available,1.9,0.76,,,0 NDC,00409468816,NDC Description Not Available,15.89,6.36,,,0 NDC,00409469924,Propofol: 10 Vial In 1 Tray (0409-4699-24) / 100 Ml In 1 Vial (0409-4699-54),0.95,0.38,,,0 NDC,00409469930,Propofol: 5 Vial In 1 Carton (0409-4699-30) / 20 Ml In 1 Vial (0409-4699-50),0.37,0.15,,,0 NDC,00409469933,Propofol: 20 Vial In 1 Tray (0409-4699-33) / 50 Ml In 1 Vial (0409-4699-53),0.98,0.39,,,0 NDC,00409469950,NDC Description Not Available,0.39,0.16,,,0 NDC,00409469953,NDC Description Not Available,0.71,0.28,,,0 NDC,00409469954,NDC Description Not Available,0.99,0.4,,,0 NDC,00409471201,Lidocaine Hydrochloride and Dextrose: 5 CELLO PACK in 1 PACKAGE (0409-4712-01) / 5 AMPULE in 1 CELLO PACK (0409-4712-25) / 2 mL in 1 AMPULE (0409-4712-11),27.06,10.82,,,0 NDC,00409471375,NDC Description Not Available,1.69,0.675,,,0 NDC,00409475518,NDC Description Not Available,1.67,0.67,,,0 NDC,00409477601,Lidocaine Hydrochloride: 25 Ampule In 1 Carton (0409-4776-01) / 20 Ml In 1 Ampule (0409-4776-10),0.15,0.06,,,0 NDC,00409477610,NDC Description Not Available,0.15,0.06,,,0 NDC,00409488710,"Sterile Water: 25 Vial, Plastic In 1 Tray (0409-4887-10) / 10 Ml In 1 Vial, Plastic (0409-4887-17)",9.53,3.81,,,0 NDC,00409488717,NDC Description Not Available,9.19,3.68,,,0 NDC,00409488720,"Sterile Water: 25 Vial, Plastic In 1 Tray (0409-4887-20) / 20 Ml In 1 Vial, Plastic (0409-4887-23)",20.89,8.36,,,0 NDC,00409488723,NDC Description Not Available,9.96,3.98,,,0 NDC,00409488724,NDC Description Not Available,13.49,5.4,,,0 NDC,00409488725,NDC Description Not Available,11.28,4.51,,,0 NDC,00409488750,"Sterile Water: 25 Vial, Plastic In 1 Tray (0409-4887-50) / 50 Ml In 1 Vial, Plastic (0409-4887-24)",0.9,0.36,,,0 NDC,00409488799,"Sterile Water: 25 Vial, Glass In 1 Case (0409-4887-99) / 100 Ml In 1 Vial, Glass (0409-4887-25)",7.63,3.05,,,0 NDC,00409488802,NDC Description Not Available,2.93,1.17,,,0 NDC,00409488803,NDC Description Not Available,3.91,1.56,,,0 NDC,00409488820,"Sodium Chloride: 25 Vial, Single-Dose In 1 Tray (0409-4888-20) / 20 Ml In 1 Vial, Single-Dose (0409-4888-03)",8.08,3.23,,,0 NDC,00409490234,Dextrose: 10 Carton In 1 Container (0409-4902-34) / 1 Syringe In 1 Carton / 50 Ml In 1 Syringe (0409-4902-64),16.06,6.42,,,0 NDC,00409490264,NDC Description Not Available,40.5,16.2,,,0 NDC,00409490311,NDC Description Not Available,0.22,0.09,,,0 NDC,00409490334,Lidocaine Hydrochloride: 10 Carton In 1 Container (0409-4903-34) / 1 Syringe In 1 Carton / 5 Ml In 1 Syringe (0409-4903-11),0.36,0.14,,,0 NDC,00409493301,"Epinephrine: 10 Carton In 1 Package (0409-4933-01) / 1 Syringe, Glass In 1 Carton / 10 Ml In 1 Syringe, Glass (0409-4933-11)",1.9100000000000001,0.765,,,0 NDC,00409493310,Epinephrine: 10 Carton In 1 Package (0409-4933-10) / 1 Syringe In 1 Carton / 10 Ml In 1 Syringe (0409-4933-05),6.04,2.42,,,0 NDC,00409493311,NDC Description Not Available,3.77,1.51,,,0 NDC,00409508413,NDC Description Not Available,9.83,3.93,,,0 NDC,00409553424,NDC Description Not Available,37.43,14.97,,,0 NDC,00409553434,NDC Description Not Available,42.53,17.01,,,0 NDC,00409573801,NDC Description Not Available,15.88,6.35,,,0 NDC,00409582001,"Dopamine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0409-5820-01) / 5 Ml In 1 Vial, Single-Dose (0409-5820-11)",2.45,0.98,,,0 NDC,00409582011,NDC Description Not Available,2.36,0.94,,,0 NDC,00409592101,"Aminophylline: 25 Vial, Single-Dose In 1 Tray (0409-5921-01) / 10 Ml In 1 Vial, Single-Dose (0409-5921-16)",29.54,11.82,,,0 NDC,00409592116,NDC Description Not Available,19.29,7.72,,,0 NDC,00409592201,"Aminophylline: 25 Vial, Single-Dose In 1 Tray (0409-5922-01) / 20 Ml In 1 Vial, Single-Dose (0409-5922-16)",28.57,11.43,,,0 NDC,00409592216,NDC Description Not Available,28.71,11.48,,,0 NDC,00409610202,"Furosemide: 25 Vial, Single-Dose In 1 Tray (0409-6102-02) / 2 Ml In 1 Vial, Single-Dose (0409-6102-19)",4.3,1.72,,,0 NDC,00409610204,"Furosemide: 25 Vial, Single-Dose In 1 Tray (0409-6102-04) / 4 Ml In 1 Vial, Single-Dose (0409-6102-18)",2.23,0.89,,,0 NDC,00409610210,"Furosemide: 25 Vial, Single-Dose In 1 Tray (0409-6102-10) / 10 Ml In 1 Vial, Single-Dose (0409-6102-20)",0.88,0.35,,,0 NDC,00409610218,NDC Description Not Available,2.54,1.02,,,0 NDC,00409610219,NDC Description Not Available,16.59,6.64,,,0 NDC,00409610220,NDC Description Not Available,3.32,1.33,,,0 NDC,00409610226,"Furosemide: 25 Vial, Single-Dose In 1 Tray (0409-6102-26) / 4 Ml In 1 Vial, Single-Dose (0409-6102-36)",1.56,0.62,,,0 NDC,00409610236,NDC Description Not Available,0.23,0.09,,,0 NDC,00409648201,Erythrocin Lactobionate: 10 Vial In 1 Tray (0409-6482-01) / 10 Ml In 1 Vial (0409-6482-11),251.16,100.46,,,0 NDC,00409648211,NDC Description Not Available,418.25,167.3,,,0 NDC,00409653102,"Vancomycin Hydrochloride: 10 Vial In 1 Tray (0409-6531-02) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (0409-6531-12)",7.43,2.97,,,0 NDC,00409653112,NDC Description Not Available,5.67,2.27,,,0 NDC,00409653501,"Vancomycin Hydrochloride: 10 Vial, Single-Dose In 1 Tray (0409-6535-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose (0409-6535-11)",12.37,4.95,,,0 NDC,00409662502,Sodium Bicarbonate: 25 VIAL in 1 TRAY (0409-6625-02) / 50 mL in 1 VIAL,42.79,17.12,,,0 NDC,00409662514,"Sodium Bicarbonate: 25 Vial, Single-Dose In 1 Tray (0409-6625-14) / 50 Ml In 1 Vial, Single-Dose (0409-6625-22)",7.49,3.0,,,0 NDC,00409662522,NDC Description Not Available,38.99,15.6,,,0 NDC,00409663714,Sodium Bicarbonate: 10 Carton In 1 Package (0409-6637-14) / 1 Syringe In 1 Carton / 50 Ml In 1 Syringe (0409-6637-24),69.46,27.78,,,0 NDC,00409663724,NDC Description Not Available,59.87,23.95,,,0 NDC,00409664802,"Dextrose: 25 Vial, Single-Dose In 1 Tray (0409-6648-02) / 50 Ml In 1 Vial, Single-Dose (0409-6648-16)",12.93,5.17,,,0 NDC,00409664816,NDC Description Not Available,15.31,6.12,,,0 NDC,00409665119,NDC Description Not Available,1.69,0.68,,,0 NDC,00409665318,NDC Description Not Available,1.21,0.48,,,0 NDC,00409669511,NDC Description Not Available,21.54,8.62,,,0 NDC,00409707714,Potassium Chloride: 24 POUCH in 1 CASE (0409-7077-14) / 1 BAG in 1 POUCH / 50 mL in 1 BAG,0.09,0.04,,,0 NDC,00409710066,Dextrose: 10 Pouch In 1 Case (0409-7100-66) / 5 Bag In 1 Pouch / 50 Ml In 1 Bag (0409-7100-68),9.66,3.86,,,0 NDC,00409710068,NDC Description Not Available,7.87,3.15,,,0 NDC,00409710102,Sodium Chloride: 24 Pouch In 1 Case (0409-7101-02) / 1 Bag In 1 Pouch / 250 Ml In 1 Bag (0409-7101-04),13.8,5.52,,,0 NDC,00409710104,NDC Description Not Available,10.399999999999999,4.16,,,0 NDC,00409710166,Sodium Chloride: 10 Pouch In 1 Case (0409-7101-66) / 5 Bag In 1 Pouch / 50 Ml In 1 Bag (0409-7101-68),19.32,7.73,,,0 NDC,00409710167,Sodium Chloride: 10 Pouch In 1 Case (0409-7101-67) / 5 Bag In 1 Pouch / 100 Ml In 1 Bag (0409-7101-69),9.56,3.82,,,0 NDC,00409710168,NDC Description Not Available,37.555,15.025,,,0 NDC,00409710169,NDC Description Not Available,8.75,3.5,,,0 NDC,00409724803,Hetastarch In Sodium Chloride: 12 Container In 1 Case (0409-7248-03) / 500 Ml In 1 Container (0409-7248-13),66.7,26.68,,,0 NDC,00409729501,"Potassium Phosphates: 25 Vial, Single-Dose In 1 Tray (0409-7295-01) / 15 Ml In 1 Vial, Single-Dose (0409-7295-11)",31.76,12.7,,,0 NDC,00409729511,NDC Description Not Available,29.55,11.82,,,0 NDC,00409729973,"Sodium Acetate: 25 Vial, Single-Dose In 1 Tray (0409-7299-73) / 20 Ml In 1 Vial, Single-Dose (0409-7299-83)",6.41,2.56,,,0 NDC,00409729983,NDC Description Not Available,24.81,9.92,,,0 NDC,00409733201,"Ceftriaxone Sodium: 10 Vial, Single-Use In 1 Carton (0409-7332-01) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use (0409-7332-11)",1.67,0.67,,,0 NDC,00409733211,NDC Description Not Available,1.83,0.73,,,0 NDC,00409733220,"Ceftriaxone Sodium: 10 Vial, Single-Use In 1 Carton (0409-7332-20) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use (0409-7332-21)",0.8,0.32,,,0 NDC,00409733503,"Ceftriaxone Sodium: 10 Vial, Single-Use In 1 Carton (0409-7335-03) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use (0409-7335-13)",1.3,0.52,,,0 NDC,00409733513,NDC Description Not Available,1.6,0.64,,,0 NDC,00409733711,NDC Description Not Available,2.67,1.07,,,0 NDC,00409733801,"Ceftriaxone Sodium: 10 Vial, Single-Use In 1 Carton (0409-7338-01) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use (0409-7338-11)",1.99,0.8,,,0 NDC,00409733811,NDC Description Not Available,1.68,0.67,,,0 NDC,00409739172,"Sodium Phosphates: 25 Vial, Single-Dose In 1 Tray (0409-7391-72) / 15 Ml In 1 Vial, Single-Dose (0409-7391-82)",15.9,6.36,,,0 NDC,00409739182,NDC Description Not Available,60.48,24.19,,,0 NDC,00409741813,NDC Description Not Available,255.41,102.16,,,0 NDC,00409741914,NDC Description Not Available,133.4,53.36,,,0 NDC,00409751716,"Dextrose: 10 Carton In 1 Container (0409-7517-16) / 1 Syringe, Plastic In 1 Carton / 50 Ml In 1 Syringe, Plastic (0409-7517-66)",22.38,8.95,,,0 NDC,00409751766,NDC Description Not Available,47.47,18.99,,,0 NDC,00409762003,Heparin Sodium: 18 Pouch In 1 Case (0409-7620-03) / 1 Bag In 1 Pouch / 500 Ml In 1 Bag (0409-7620-13),2.47,0.99,,,0 NDC,00409762013,NDC Description Not Available,24.2,9.68,,,0 NDC,00409765005,NDC Description Not Available,2.62,1.05,,,0 NDC,00409765030,Heparin Sodium: 30 Pouch In 1 Case (0409-7650-30) / 1 Bag In 1 Pouch / 250 Ml In 1 Bag (0409-7650-05),1.97,0.79,,,0 NDC,00409765052,NDC Description Not Available,1.79,0.72,,,0 NDC,00409771513,NDC Description Not Available,35.66,14.26,,,0 NDC,00409780911,NDC Description Not Available,3.2,1.28,,,0 NDC,00409780922,Dopamine Hydrochloride In Dextrose: 12 Bag In 1 Carton (0409-7809-22) / 250 Ml In 1 Bag (0409-7809-11),7.88,3.15,,,0 NDC,00409781011,NDC Description Not Available,2.36,0.94,,,0 NDC,00409792320,Dextrose: 12 POUCH in 1 CASE (0409-7923-20) / 4 BAG in 1 POUCH / 25 mL in 1 BAG,2.07,0.83,,,0 NDC,00409798309,Sodium Chloride: 12 POUCH in 1 CASE (0409-7983-09) / 1 BAG in 1 POUCH / 1000 mL in 1 BAG,16.5,6.6,,,0 NDC,00409818311,NDC Description Not Available,18.24,7.3,,,0 NDC,00409904516,NDC Description Not Available,6.46,2.58,,,0 NDC,00409904517,"Bupivacaine Hydrochloride And Epinephrine: 25 Vial, Single-Dose In 1 Tray (0409-9045-17) / 30 Ml In 1 Vial, Single-Dose (0409-9045-16)",3.05,1.22,,,0 NDC,00409909335,Fentanyl Citrate: 10 Ampule In 1 Cello Pack (0409-9093-35) / 5 Ml In 1 Ampule (0409-9093-45),4.19,1.68,,,0 NDC,00409909412,NDC Description Not Available,5.06,2.02,,,0 NDC,00409909416,NDC Description Not Available,11.205,4.48,,,0 NDC,00409909418,NDC Description Not Available,2.6,1.04,,,0 NDC,00409909422,"Fentanyl Citrate: 25 Vial, Single-Dose In 1 Tray (0409-9094-22) / 2 Ml In 1 Vial, Single-Dose (0409-9094-12)",3.54,1.42,,,0 NDC,00409909431,"Fentanyl Citrate: 25 Vial, Single-Dose In 1 Tray (0409-9094-31) / 20 Ml In 1 Vial, Single-Dose (0409-9094-16)",12.88,5.15,,,0 NDC,00409909441,NDC Description Not Available,4.22,1.69,,,0 NDC,00409909461,"Fentanyl Citrate: 25 Carton In 1 Tray (0409-9094-61) / 1 Vial, Single-Dose In 1 Carton / 50 Ml In 1 Vial, Single-Dose (0409-9094-41)",1.67,0.67,,,0 NDC,00409910421,NDC Description Not Available,0.93,0.37,,,0 NDC,00409915731,NDC Description Not Available,20.9,8.36,,,0 NDC,00409915801,Vitamin K1: 5 Tray In 1 Container (0409-9158-01) / 5 Ampule In 1 Tray (0409-9158-50) / 1 Ml In 1 Ampule (0409-9158-31),21.55,8.62,,,0 NDC,00409930130,"Ropivacaine Hydrochloride: 10 VIAL, SINGLE-DOSE in 1 CARTON (0409-9301-30) / 30 mL in 1 VIAL, SINGLE-DOSE (0409-9301-31)",0.2,0.08,,,0 NDC,00409955805,"Rocuronium Bromide: 10 Vial, Multi-Dose In 1 Box (0409-9558-05) / 5 Ml In 1 Vial, Multi-Dose (0409-9558-11)",8.29,3.32,,,0 NDC,00409955811,NDC Description Not Available,17.09,6.84,,,0 NDC,00409956601,NDC Description Not Available,8.07,3.23,,,0 NDC,00409973501,NDC Description Not Available,6.85,2.74,,,0 NDC,00436067216,Dakins Quarter: 473 Ml In 1 Bottle (0436-0672-16),53.93,21.57,,,0 NDC,00440701001,NDC Description Not Available,0.08,0.03,,,0 NDC,00440762620,NDC Description Not Available,0.56,0.22,,,0 NDC,00456040001,NDC Description Not Available,26.43,10.57,,,0 NDC,00456040010,"Teflaro: 10 Vial, Single-Dose In 1 Carton (0456-0400-10) / 20 Ml In 1 Vial, Single-Dose (0456-0400-01)",24.57,9.83,,,0 NDC,00456045801,Armour Thyroid: 100 Tablet In 1 Bottle (0456-0458-01),2.74,1.1,,,0 NDC,00456045901,Armour Thyroid: 100 Tablet In 1 Bottle (0456-0459-01),3.3,1.32,,,0 NDC,00456060001,NDC Description Not Available,17.79,7.12,,,0 NDC,00456060010,"Teflaro: 10 Vial, Single-Dose In 1 Carton (0456-0600-10) / 20 Ml In 1 Vial, Single-Dose (0456-0600-01)",16.49,6.6,,,0 NDC,00456120130,"Linzess: 1 Bottle In 1 Carton (0456-1201-30) / 30 Capsule, Gelatin Coated In 1 Bottle",55.75,22.3,,,0 NDC,00456120230,"Linzess: 1 Bottle In 1 Carton (0456-1202-30) / 30 Capsule, Gelatin Coated In 1 Bottle",55.54,22.22,,,0 NDC,00456120330,"Linzess: 1 Bottle In 1 Carton (0456-1203-30) / 30 Capsule, Gelatin Coated In 1 Bottle",55.59,22.24,,,0 NDC,00456241060,Saphris: 6 Case In 1 Carton (0456-2410-60) / 1 Blister Pack In 1 Case (0456-2410-06) / 10 Tablet In 1 Blister Pack,86.21,34.48,,,0 NDC,00456241063,10 BLISTER PACK in 1 CARTON (0456-2410-63) / 10 TABLET in 1 BLISTER PACK (0456-2410-11),85.74,34.3,,,0 NDC,00456270001,NDC Description Not Available,454.88,181.95,,,0 NDC,00456270010,"Avycaz: 10 Vial, Single-Dose In 1 Carton (0456-2700-10) / 1 Powder, For Solution In 1 Vial, Single-Dose (0456-2700-01)",467.65,187.06,,,0 NDC,00456320511,NDC Description Not Available,31.91,12.76,,,0 NDC,00469042001,"Cresemba: 1 Vial, Single-Dose In 1 Carton (0469-0420-01) / 5 Ml In 1 Vial, Single-Dose",4.52,1.81,,,0 NDC,00469042099,"Cresemba: 10 Carton In 1 Carton (0469-0420-99) / 1 Vial, Single-Dose In 1 Carton (0469-0420-01) / 5 Ml In 1 Vial, Single-Dose",4.43,1.77,,,0 NDC,00469052002,Cresemba: 2 Blister Pack In 1 Carton (0469-0520-02) / 7 Capsule In 1 Blister Pack,345.89,138.36,,,0 NDC,00469052014,Cresemba: 4 Carton In 1 Carton (0469-0520-14) / 14 Blister Pack In 1 Carton (0469-0520-02) / 1 Capsule In 1 Blister Pack,484.16,193.66,,,0 NDC,00469060773,"Prograf: 1 Bottle In 1 Carton (0469-0607-73) / 100 Capsule, Gelatin Coated In 1 Bottle",11.1,4.44,,,0 NDC,00469061773,"Prograf: 1 Bottle In 1 Carton (0469-0617-73) / 100 Capsule, Gelatin Coated In 1 Bottle",22.16,8.86,,,0 NDC,00469065773,"Prograf: 1 Bottle In 1 Carton (0469-0657-73) / 100 Capsule, Gelatin Coated In 1 Bottle",3.34,1.34,,,0 NDC,00469260130,"Myrbetriq: 1 Bottle In 1 Carton (0469-2601-30) / 30 Tablet, Film Coated, Extended Release In 1 Bottle",46.73,18.69,,,0 NDC,00469260230,"Myrbetriq: 1 Bottle In 1 Carton (0469-2602-30) / 30 Tablet, Film Coated, Extended Release In 1 Bottle",46.54,18.62,,,0 NDC,00469301601,Prograf: 10 Ampule In 1 Box (0469-3016-01) / 1 Ml In 1 Ampule,1116.58,446.63,,,0 NDC,00469305130,"Ambisome: 12.5 Ml In 1 Vial, Single-Dose (0469-3051-30)",275.78,110.31,,,0 NDC,00469321110,"Mycamine: 10 Vial, Single-Dose In 1 Carton (0469-3211-10) / 10 Ml In 1 Vial, Single-Dose",8.06,3.22,,,0 NDC,00469342510,Vyloy: 1 Vial In 1 Box (0469-3425-10) / 5 Ml In 1 Vial,126.91,50.76,,,0 NDC,00469442530,Vyloy: 1 Vial In 1 Box (0469-4425-30) / 15 Ml In 1 Vial,140.8,56.32,,,0 NDC,00469650189,"Lexiscan: 5 Ml In 1 Syringe, Plastic (0469-6501-89)",283.54,113.42,,,0 NDC,00472008216,Acyclovir: 473 Ml In 1 Bottle (0472-0082-16),24.0,9.6,,,0 NDC,00472017934,Triple Antibiotic: 1 TUBE in 1 CARTON (0472-0179-34) / 14 g in 1 TUBE,2.69,1.08,,,0 NDC,00472032126,Hydrocortisone: 1 Tube In 1 Carton (0472-0321-26) / 28.4 G In 1 Tube,16.19,6.48,,,0 NDC,00472037945,Clotrimazole And Betamethasone Dipropionate: 1 Tube In 1 Carton (0472-0379-45) / 45 G In 1 Tube,65.34,26.14,,,0 NDC,00472110534,Bacitracin Zinc: 1 TUBE in 1 CARTON (0472-1105-34) / 14 g in 1 TUBE,2.69,1.08,,,0 NDC,00472110556,Bacitracin Zinc: 1 TUBE in 1 CARTON (0472-1105-56) / 28 g in 1 TUBE,4.71,1.88,,,0 NDC,00472173803,Miconazole Nitrate: 3 Suppository In 1 Carton (0472-1738-03),40.18,16.07,,,0 NDC,00480372056,"Pyrimethamine: 30 Tablet In 1 Bottle, Plastic (0480-3720-56)",719.18,287.67,,,0 NDC,00480432001,"Plerixafor: 1 Vial, Single-Dose In 1 Carton (0480-4320-01) / 1.2 Ml In 1 Vial, Single-Dose",233.87,93.55,,,0 NDC,00486112501,"K Phos Neutral: 100 Tablet, Coated In 1 Bottle (0486-1125-01)",3.19,1.28,,,0 NDC,00487020101,"Ipratropium Bromide And Albuterol Sulfate: 30 Pouch In 1 Carton (0487-0201-01) / 1 Vial, Single-Use In 1 Pouch / 3 Ml In 1 Vial, Single-Use",1.76,0.7,,,0 NDC,00487278401,"Asthmanefrin: 30 Pouch In 1 Carton (0487-2784-01) / 1 Vial, Single-Use In 1 Pouch / .5 Ml In 1 Vial, Single-Use",3.11,1.24,,,0 NDC,00487590199,"S2: 30 Pouch In 1 Carton (0487-5901-99) / 1 Vial, Single-Use In 1 Pouch / .5 Ml In 1 Vial, Single-Use",3.28,1.31,,,0 NDC,00487900330,NDC Description Not Available,1.9,0.76,,,0 NDC,00487900360,NDC Description Not Available,0.58,0.23,,,0 NDC,00487900730,NDC Description Not Available,2.01,0.8,,,0 NDC,00487900760,NDC Description Not Available,0.69,0.28,,,0 NDC,00487930103,NDC Description Not Available,0.43,0.17,,,0 NDC,00487950101,"Albuterol Sulfate: 30 Pouch In 1 Carton (0487-9501-01) / 1 Vial, Single-Dose In 1 Pouch / 3 Ml In 1 Vial, Single-Dose",0.82,0.33,,,0 NDC,00487950102,NDC Description Not Available,0.9,0.36,,,0 NDC,00487960101,Budesonide: 6 Pouch In 1 Carton (0487-9601-01) / 5 Ampule In 1 Pouch / 2 Ml In 1 Ampule,31.47,12.59,,,0 NDC,00487970101,Budesonide: 6 Pouch In 1 Carton (0487-9701-01) / 5 Ampule In 1 Pouch / 2 Ml In 1 Ampule,43.55,17.42,,,0 NDC,00487980101,"Ipratropium Bromide: 30 Pouch In 1 Carton (0487-9801-01) / 1 Vial, Single-Dose In 1 Pouch / 2.5 Ml In 1 Vial, Single-Dose",0.72,0.29,,,0 NDC,00496088205,Lmx4: 5 G In 1 Tube (0496-0882-05),16.8,6.72,,,0 NDC,00517003101,NDC Description Not Available,31.19,12.48,,,0 NDC,00517003125,"Cyanocobalamin: 25 Vial, Multi-Dose In 1 Tray (0517-0031-25) / 1 Ml In 1 Vial, Multi-Dose (0517-0031-01)",9.83,3.93,,,0 NDC,00517003225,"Cyanocobalamin: 25 Vial, Multi-Dose In 1 Tray (0517-0032-25) / 10 Ml In 1 Vial, Multi-Dose (0517-0032-01)",4.32,1.73,,,0 NDC,00517037401,NDC Description Not Available,43.1,17.24,,,0 NDC,00517037405,Provayblue: 5 Ampule In 1 Carton (0517-0374-05) / 10 Ml In 1 Ampule (0517-0374-01),14.29,5.72,,,0 NDC,00517037501,NDC Description Not Available,540.76,216.3,,,0 NDC,00517038101,NDC Description Not Available,45.02,18.01,,,0 NDC,00517038105,"Provayblue: 5 Vial, Single-Dose In 1 Carton (0517-0381-05) / 10 Ml In 1 Vial, Single-Dose (0517-0381-01)",12.47,4.99,,,0 NDC,00517040125,"Atropine Sulfate: 25 VIAL, SINGLE-DOSE in 1 TRAY (0517-0401-25) / 1 mL in 1 VIAL, SINGLE-DOSE",0.46,0.18,,,0 NDC,00517042001,"Estradiol Valerate: 1 Vial, Multi-Dose In 1 Carton (0517-0420-01) / 5 Ml In 1 Vial, Multi-Dose",6.3,2.52,,,0 NDC,00517060201,"Injectafer: 1 Vial, Single-Dose In 1 Box (0517-0602-01) / 2 Ml In 1 Vial, Single-Dose",8.49,3.4,,,0 NDC,00517065001,"Injectafer: 1 Vial, Single-Dose In 1 Box (0517-0650-01) / 15 Ml In 1 Vial, Single-Dose",7.92,3.17,,,0 NDC,00517072001,"Betamethasone Sodium Phosphate And Betamethasone Acetate: 1 Vial, Multi-Dose In 1 Carton (0517-0720-01) / 5 Ml In 1 Vial, Multi-Dose",48.17,19.27,,,0 NDC,00517074001,NDC Description Not Available,131.25,52.5,,,0 NDC,00517074020,"Methylergonovine Maleate: 20 Vial, Single-Dose In 1 Carton (0517-0740-20) / 1 Ml In 1 Vial, Single-Dose (0517-0740-01)",135.36,54.14,,,0 NDC,00517090101,NDC Description Not Available,38.12,15.25,,,0 NDC,00517095501,"Olanzapine: 1 Vial, Glass In 1 Carton (0517-0955-01) / 2 Ml In 1 Vial, Glass",10.82,4.33,,,0 NDC,00517100101,NDC Description Not Available,0.76,0.3,,,0 NDC,00517100125,"Atropine Sulfate: 25 Vial, Glass In 1 Tray (0517-1001-25) / 1 Ml In 1 Vial, Glass (0517-1001-01)",0.76,0.3,,,0 NDC,00517100401,NDC Description Not Available,0.48,0.19,,,0 NDC,00517102001,NDC Description Not Available,11.805,4.720000000000001,,,0 NDC,00517102025,"Vasopressin: 25 Vial, Single-Dose In 1 Carton (0517-1020-25) / 1 Ml In 1 Vial, Single-Dose (0517-1020-01)",4.55,1.82,,,0 NDC,00517104501,NDC Description Not Available,33.36,13.34,,,0 NDC,00517182001,Chlorothiazide Sodium: 1 Vial In 1 Carton (0517-1820-01) / 18 Ml In 1 Vial,552.43,220.97,,,0 NDC,00517210201,NDC Description Not Available,86.42,34.57,,,0 NDC,00517231001,NDC Description Not Available,1.43,0.57,,,0 NDC,00517231005,"Venofer: 5 Vial, Single-Dose In 1 Box (0517-2310-05) / 10 Ml In 1 Vial, Single-Dose (0517-2310-01)",2.86,1.14,,,0 NDC,00517232501,NDC Description Not Available,2.86,1.14,,,0 NDC,00517232510,"Venofer: 10 Vial, Single-Dose In 1 Box (0517-2325-10) / 2.5 Ml In 1 Vial, Single-Dose (0517-2325-01)",2.83,1.13,,,0 NDC,00517234010,"Venofer: 10 Vial, Single-Dose In 1 Box (0517-2340-10) / 5 Ml In 1 Vial, Single-Dose",2.9,1.16,,,0 NDC,00517234025,"Venofer: 25 Vial, Single-Dose In 1 Tray (0517-2340-25) / 5 Ml In 1 Vial, Single-Dose",2.92,1.17,,,0 NDC,00517250201,NDC Description Not Available,133.24,53.3,,,0 NDC,00517250210,"Caffeine And Sodium Benzoate: 10 Vial, Single-Dose In 1 Box (0517-2502-10) / 2 Ml In 1 Vial, Single-Dose (0517-2502-01)",102.65,41.06,,,0 NDC,00517400201,NDC Description Not Available,182.21,72.88,,,0 NDC,00517400225,Papaverine Hydrochloride: 25 Vial In 1 Carton (0517-4002-25) / 2 Ml In 1 Vial (0517-4002-01),82.66,33.06,,,0 NDC,00517420125,"Hydroxyzine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0517-4201-25) / 1 Ml In 1 Vial, Single-Dose (0517-4201-01)",124.97,49.99,,,0 NDC,00517430001,Paclitaxel Protein Bound Particles Albumin Bound: 1 Vial In 1 Carton (0517-4300-01) / 20 Ml In 1 Vial,61.86,24.74,,,0 NDC,00517481025,"Nitroglycerin: 25 Vial, Single-Dose In 1 Tray (0517-4810-25) / 10 Ml In 1 Vial, Single-Dose (0517-4810-01)",0.11,0.04,,,0 NDC,00517560125,"Hydroxyzine Hydrochloride: 25 Vial, Single-Dose In 1 Tray (0517-5601-25) / 1 Ml In 1 Vial, Single-Dose (0517-5601-01)",74.17,29.67,,,0 NDC,00517656005,"Selenious Acid: 5 Vial, Pharmacy Bulk Package In 1 Box (0517-6560-05) / 10 Ml In 1 Vial, Pharmacy Bulk Package (0517-6560-01)",14.8,5.92,,,0 NDC,00517671001,NDC Description Not Available,87.03,34.81,,,0 NDC,00517731501,NDC Description Not Available,70.47,28.19,,,0 NDC,00517731525,"Sodium Phosphates: 25 Vial, Single-Dose In 1 Tray (0517-7315-25) / 15 Ml In 1 Vial, Single-Dose (0517-7315-01)",3.61,1.44,,,0 NDC,00517760401,NDC Description Not Available,13.58,5.43,,,0 NDC,00517760425,"Acetylcysteine: 25 Vial, Glass In 1 Tray (0517-7604-25) / 4 Ml In 1 Vial, Glass",73.13,29.25,,,0 NDC,00517912001,NDC Description Not Available,17.9,7.16,,,0 NDC,00517930201,NDC Description Not Available,53.66,21.46,,,0 NDC,00517930225,"Multrys: 25 Vial, Single-Dose In 1 Tray (0517-9302-25) / 1 Ml In 1 Vial, Single-Dose (0517-9302-01)",58.85,23.54,,,0 NDC,00517930501,NDC Description Not Available,115.6,46.24,,,0 NDC,00517930525,"Tralement: 25 Vial, Single-Dose In 1 Tray (0517-9305-25) / 1 Ml In 1 Vial, Single-Dose (0517-9305-01)",91.23,36.49,,,0 NDC,00517970201,NDC Description Not Available,34.33,13.73,,,0 NDC,00517970225,"Droperidol: 25 Vial, Single-Dose In 1 Tray (0517-9702-25) / 2 Ml In 1 Vial, Single-Dose",13.68,5.47,,,0 NDC,00521234500,NDC Description Not Available,16.56,6.62,,,0 NDC,00527079137,"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate And Amphetamine Sulfate: 100 Capsule, Extended Release In 1 Bottle (0527-0791-37)",2.87,1.15,,,0 NDC,00527131101,Terbutaline Sulfate: 100 Tablet In 1 Bottle (0527-1311-01),23.24,9.3,,,0 NDC,00527132601,Ursodiol: 100 Capsule In 1 Bottle (0527-1326-01),2.4099999999999997,0.965,,,0 NDC,00527136801,Danazol: 100 Capsule In 1 Bottle (0527-1368-01),11.49,4.6,,,0 NDC,00527169501,"Butalbital, Acetaminophen, And Caffeine: 100 Tablet In 1 Bottle, Plastic (0527-1695-01)",0.81,0.32,,,0 NDC,00527178901,"Fluphenazine Hydrochloride: 100 Tablet, Film Coated In 1 Bottle, Plastic (0527-1789-01)",10.0,4.0,,,0 NDC,00527194866,"Levofloxacin: 1 Bottle, Plastic In 1 Carton (0527-1948-66) / 100 Ml In 1 Bottle, Plastic",55.04,22.02,,,0 NDC,00527194868,"Levofloxacin: 1 Bottle, Plastic In 1 Carton (0527-1948-68) / 200 Ml In 1 Bottle, Plastic",50.96,20.38,,,0 NDC,00527194947,"Cyproheptadine Hydrochloride: 473 mL in 1 BOTTLE, PLASTIC (0527-1949-47)",1.42,0.57,,,0 NDC,00527213335,"Posaconazole: 60 Tablet, Delayed Release In 1 Bottle (0527-2133-35)",27.2,10.88,,,0 NDC,00527224432,Febuxostat: 30 Tablet In 1 Bottle (0527-2244-32),1.56,0.62,,,0 NDC,00527411737,"Propranolol Hydrochloride: 100 Capsule, Extended Release In 1 Bottle (0527-4117-37)",0.68,0.27,,,0 NDC,00527512578,Lactulose: 946 Ml In 1 Bottle (0527-5125-78),4.89,1.96,,,0 NDC,00536009185,Aluminum Hydroxide: 473 Ml In 1 Bottle (0536-0091-85),0.29,0.12,,,0 NDC,00536105224,Rugby Peg 3350: 238 G In 1 Bottle (0536-1052-24),0.79,0.315,,,0 NDC,00536105429,"Aspirin: 1 Bottle, Plastic In 1 Carton (0536-1054-29) / 100 Tablet, Film Coated In 1 Bottle, Plastic",0.05,0.02,,,0 NDC,00536110788,Nicotine Transdermal System Step 2: 14 Patch In 1 Carton (0536-1107-88) / 24 H In 1 Patch,3.43,1.37,,,0 NDC,00536110888,Nicotine Transdermal System Step 1: 14 Patch In 1 Carton (0536-1108-88) / 24 H In 1 Patch,3.43,1.37,,,0 NDC,00536111825,Rugby Arthritis Pain Relieving Topical Analgesic: 1 Tube In 1 Carton (0536-1118-25) / 57 G In 1 Tube,14.03,5.61,,,0 NDC,00536114398,Rugby Petrolatum Hydrating Skin Protectant: 454 G In 1 Jar (0536-1143-98),20.49,8.2,,,0 NDC,00536118612,Rugby Hemorrhoidal: 12 Blister Pack In 1 Carton (0536-1186-12) / 1 Suppository In 1 Blister Pack,0.6,0.24,,,0 NDC,00536120610,"Calcium Carbonate 10 Gr (648 Mg) (Antacid): 1000 Tablet In 1 Bottle, Plastic (0536-1206-10)",0.03,0.01,,,0 NDC,00536121195,Dibucaine Topical Anesthetic 1% Hemorrhoidal: 1 Tube In 1 Box (0536-1211-95) / 28 G In 1 Tube,5.77,2.31,,,0 NDC,00536121794,"Rugby Tetrahydrozoline Ophthalmic Solution: 1 Bottle, Dropper In 1 Box (0536-1217-94) / 15 Ml In 1 Bottle, Dropper",2.94,1.18,,,0 NDC,00536122497,"Rugby Eye Wash: 1 Bottle, Dropper In 1 Box (0536-1224-97) / 118 Ml In 1 Bottle, Dropper",9.21,3.68,,,0 NDC,00536122858,"Rugby Cherry Flavor: 177 Ml In 1 Bottle, Spray (0536-1228-58)",0.61,0.24,,,0 NDC,00536123927,"Nicotine Mini: 1 Bottle, Plastic In 1 Box (0536-1239-27) / 27 Lozenge In 1 Bottle, Plastic",1.05,0.42,,,0 NDC,00536123981,"Nicotine Mini: 3 Bottle, Plastic In 1 Box (0536-1239-81) / 27 Lozenge In 1 Bottle, Plastic",1.27,0.51,,,0 NDC,00536124181,"Mini Nicotine: 3 Bottle, Plastic In 1 Box (0536-1241-81) / 27 Lozenge In 1 Bottle, Plastic",1.34,0.54,,,0 NDC,00536124701,"Senexon-S: 100 Tablet, Film Coated In 1 Bottle, Plastic (0536-1247-01)",0.13,0.05,,,0 NDC,00536124710,"Senexon-S: 1000 Tablet, Film Coated In 1 Bottle, Plastic (0536-1247-10)",0.07,0.03,,,0 NDC,00536124801,"Stimulant Laxative Plus Stool Softener: 100 Tablet, Film Coated In 1 Bottle, Plastic (0536-1248-01)",0.07,0.03,,,0 NDC,00536125240,"Ketotifen Fumarate: 1 Bottle, Dropper In 1 Carton (0536-1252-40) / 5 Ml In 1 Bottle, Dropper",31.22,12.49,,,0 NDC,00536125494,Sodium Chlorode Hypertonicity Ophthalmic Solution: 1 Bottle In 1 Carton (0536-1254-94) / 15 Ml In 1 Bottle,13.04,5.22,,,0 NDC,00536125628,Bacitracin: 30 G In 1 Box (0536-1256-28),5.93,2.37,,,0 NDC,00536126328,Bacitracin Zinc: 1 Tube In 1 Box (0536-1263-28) / 28 G In 1 Tube,7.48,2.99,,,0 NDC,00536126595,Rugby Clotrimazole Antifungal Cream: 1 Tube In 1 Box (0536-1265-95) / 28 G In 1 Tube,0.41,0.16,,,0 NDC,00536126659,Senna Liquid: 237 Ml In 1 Bottle (0536-1266-59),0.42,0.17,,,0 NDC,00536126812,"Rugby Anti-Itch: 212 G In 1 Bottle, Pump (0536-1268-12)",16.07,6.43,,,0 NDC,00536127222,Rugby Antifungal Clotrimazole: 1 Tube In 1 Carton (0536-1272-22) / 28 G In 1 Tube,6.05,2.42,,,0 NDC,00536128806,Hemorrhoidal: 1 Tube In 1 Box (0536-1288-06) / 57 G In 1 Tube,7.36,2.94,,,0 NDC,00536130353,NDC Description Not Available,0.06,0.02,,,0 NDC,00536130375,"Infants: 1 Bottle, Dropper In 1 Carton (0536-1303-75) / 30 Ml In 1 Bottle, Dropper",0.21,0.08,,,0 NDC,00536130485,Docusate Sodium Liquid: 473 Ml In 1 Bottle (0536-1304-85),0.29,0.12,,,0 NDC,00536131625,Rugby Zinc Oxide 20%: 72 Tube In 1 Case (0536-1316-25) / 60 G In 1 Tube,8.77,3.51,,,0 NDC,00536132601,"Acetaminophen, Aspirin, Caffeine: 1 Bottle In 1 Carton (0536-1326-01) / 100 Tablet, Film Coated In 1 Bottle",0.1,0.04,,,0 NDC,00536132926,"Rugby Tolnaftate 1% Powder: 24 Bottle, Plastic In 1 Case (0536-1329-26) / 45 G In 1 Bottle, Plastic",3.96,1.58,,,0 NDC,00536134380,NDC Description Not Available,0.1,0.04,,,0 NDC,00536134480,NDC Description Not Available,0.08,0.03,,,0 NDC,00536134481,NDC Description Not Available,0.08,0.03,,,0 NDC,00536135301,NDC Description Not Available,0.16,0.06,,,0 NDC,00536136307,NDC Description Not Available,0.52,0.21,,,0 NDC,00536137575,Miconazole Nitrate 2% Cream Antifungal: 1 Tube In 1 Box (0536-1375-75) / 28.3 G In 1 Tube,5.32,2.13,,,0 NDC,00536137785,NDC Description Not Available,0.55,0.22,,,0 NDC,00536138754,NDC Description Not Available,0.05,0.02,,,0 NDC,00536138792,"Rugby Lubricant Eye Drops: 30 Vial, Single-Use In 1 Box (0536-1387-92) / .4 Ml In 1 Vial, Single-Use",0.71,0.28,,,0 NDC,00536138793,"Rugby Lubricant Eye Drops: 50 Vial, Single-Use In 1 Box (0536-1387-93) / .4 Ml In 1 Vial, Single-Use",0.2,0.08,,,0 NDC,00536252525,Capsaicin: 1 Tube In 1 Carton (0536-2525-25) / 60 G In 1 Tube,21.13,8.45,,,0 NDC,00536311201,"Rugby Nicotine Polacrilex Gum, Coated Mint Flavor: 10 Blister Pack In 1 Carton (0536-3112-01) / 10 Gum, Chewing In 1 Blister Pack",0.89,0.36,,,0 NDC,00536430611,"Fiber Lax: 90 Tablet, Film Coated In 1 Bottle (0536-4306-11)",0.19,0.08,,,0 NDC,00536440601,NDC Description Not Available,0.07,0.03,,,0 NDC,00536741551,Ready-To-Use: 1 Bottle In 1 Carton (0536-7415-51) / 133 Ml In 1 Bottle,4.39,1.76,,,0 NDC,00548540000,"Medroxyprogesterone Acetate: 1 Vial, Single-Dose In 1 Carton (0548-5400-00) / 1 Ml In 1 Vial, Single-Dose",0.63,0.25,,,0 NDC,00548560200,Enoxaparin Sodium: 10 Syringe In 1 Carton (0548-5602-00) / .4 Ml In 1 Syringe,6.6,2.64,,,0 NDC,00548560400,Enoxaparin Sodium: 10 Syringe In 1 Carton (0548-5604-00) / .8 Ml In 1 Syringe,6.56,2.62,,,0 NDC,00548560600,Enoxaparin Sodium: 10 Syringe In 1 Carton (0548-5606-00) / .8 Ml In 1 Syringe,7.03,2.81,,,0 NDC,00548560800,Enoxaparin Sodium: 1 Vial In 1 Carton (0548-5608-00) / 3 Ml In 1 Vial,4.6,1.84,,,0 NDC,00548570100,Medroxyprogesterone Acetate: 1 Syringe In 1 Carton (0548-5701-00) / 1 Ml In 1 Syringe,1.3,0.52,,,0 NDC,00548585000,Glucagon: 1 Kit In 1 Kit (0548-5850-00) * 1 Ml In 1 Vial (0548-5905-00) * 1 Ml In 1 Syringe (0548-5831-00),1274.43,509.77,,,0 NDC,00548590000,Cortrosyn: 10 Vial In 1 Carton (0548-5900-00) / 1 Ml In 1 Vial,450.53,180.21,,,0 NDC,00548950200,Isoproterenol Hydrochloride: 10 Vial In 1 Carton (0548-9502-00) / 5 Ml In 1 Vial,689.33,275.73,,,0 NDC,00548970100,Vasopressin: 1 Vial In 1 Carton (0548-9701-00) / 1 Ml In 1 Vial,6.21,2.48,,,0 NDC,00555007102,Isoniazid: 100 Tablet In 1 Bottle (0555-0071-02),0.76,0.3,,,0 NDC,00555015802,Chlordiazepoxide Hydrochloride: 100 Capsule In 1 Bottle (0555-0158-02),0.58,0.23,,,0 NDC,00555015902,Chlordiazepoxide Hydrochloride: 100 Capsule In 1 Bottle (0555-0159-02),0.7,0.28,,,0 NDC,00555060602,Megestrol Acetate: 100 Tablet In 1 Bottle (0555-0606-02),0.52,0.21,,,0 NDC,00555063402,Danazol: 100 Capsule In 1 Bottle (0555-0634-02),16.65,6.66,,,0 NDC,00555077902,Medroxyprogesterone Acetate: 100 Tablet In 1 Bottle (0555-0779-02),0.52,0.21,,,0 NDC,00555087202,Medroxyprogesterone Acetate: 100 Tablet In 1 Bottle (0555-0872-02),0.32,0.13,,,0 NDC,00555088602,Estradiol: 100 Tablet In 1 Bottle (0555-0886-02),0.85,0.34,,,0 NDC,00555097202,"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate And Amphetamine Sulfate: 100 Tablet In 1 Bottle (0555-0972-02)",2.44,0.98,,,0 NDC,00555901658,Sprintec: 6 Pouch In 1 Carton (0555-9016-58) / 1 Blister Pack In 1 Pouch / 1 Kit In 1 Blister Pack,2.35,0.94,,,0 NDC,00555904979,NDC Description Not Available,2.27,0.91,,,0 NDC,00573017920,"Junior Strength Advil: 1 Bottle In 1 Carton (0573-0179-20) / 24 Tablet, Chewable In 1 Bottle",0.47,0.19,,,0 NDC,00573051330,NDC Description Not Available,1.3,0.52,,,0 NDC,00574006915,Glutose: 37.5 g in 1 TUBE (0574-0069-15),7.91,3.16,,,0 NDC,00574006930,Glutose: 3 TUBE in 1 CARTON (0574-0069-30) / 37.5 g in 1 TUBE,8.72,3.49,,,0 NDC,00574007015,NDC Description Not Available,6.89,2.76,,,0 NDC,00574007216,NDC Description Not Available,0.04,0.02,,,0 NDC,00574010603,"Bromocriptine Mesylate: 30 Tablet In 1 Bottle, Plastic (0574-0106-03)",10.93,4.37,,,0 NDC,00574010770,"Clotrimazole: 70 Lozenge In 1 Bottle, Plastic (0574-0107-70)",3.28,1.31,,,0 NDC,00574015004,"Midazolam Hydrochloride: 1 Bottle, Glass In 1 Carton (0574-0150-04) / 118 Ml In 1 Bottle, Glass",12.34,4.94,,,0 NDC,00574027500,NDC Description Not Available,0.74,0.3,,,0 NDC,00574029201,Amiloride Hydrochloride: 100 Tablet In 1 Bottle (0574-0292-01),0.64,0.26,,,0 NDC,00574030216,NDC Description Not Available,0.43,0.17,,,0 NDC,00574030316,NDC Description Not Available,0.44,0.18,,,0 NDC,00574030416,NDC Description Not Available,0.44,0.18,,,0 NDC,00574031116,NDC Description Not Available,0.25,0.1,,,0 NDC,00574050801,NDC Description Not Available,0.14,0.06,,,0 NDC,00574050811,NDC Description Not Available,0.27,0.11,,,0 NDC,00574052176,Actidose Aqua: 240 Ml In 1 Tube (0574-0521-76),52.91,21.16,,,0 NDC,00574060801,NDC Description Not Available,0.09,0.04,,,0 NDC,00574060811,NDC Description Not Available,0.27,0.11,,,0 NDC,00574079101,"Methazolamide: 100 Tablet In 1 Bottle, Plastic (0574-0791-01)",19.68,7.87,,,0 NDC,00574080530,Acetylcysteine: 4 Vial In 1 Carton (0574-0805-30) / 30 Ml In 1 Vial,2.92,1.17,,,0 NDC,00574082001,"Testosterone Cypionate: 1 Vial, Glass In 1 Carton (0574-0820-01) / 1 Ml In 1 Vial, Glass",0.04,0.02,,,0 NDC,00574082701,"Testosterone Cypionate: 1 Vial, Glass In 1 Carton (0574-0827-01) / 1 Ml In 1 Vial, Glass",0.02,0.01,,,0 NDC,00574085005,Dihydroergotamine Mesylate: 5 Ampule In 1 Carton (0574-0850-05) / 1 Ml In 1 Ampule,566.09,226.44,,,0 NDC,00574113316,Spironolactone: 473 Ml In 1 Bottle (0574-1133-16),18.45,7.38,,,0 NDC,00574200815,"Nystop: 15 G In 1 Bottle, Plastic (0574-2008-15)",21.02,8.41,,,0 NDC,00574200830,"Nystop: 30 G In 1 Bottle, Plastic (0574-2008-30)",166.02,66.41,,,0 NDC,00574402411,NDC Description Not Available,27.43,10.97,,,0 NDC,00574402435,Erythromycin: 1 Tube In 1 Carton (0574-4024-35) / 3.5 G In 1 Tube,42.67,17.07,,,0 NDC,00574703412,Aspirin: 12 Packet In 1 Carton (0574-7034-12) / 1 Suppository In 1 Packet,2.85,1.14,,,0 NDC,00574704512,Belladonna And Opium: 12 Packet In 1 Box (0574-7045-12) / 1 Suppository In 1 Packet,94.78,37.91,,,0 NDC,00574705012,Bisacodyl: 12 Blister Pack In 1 Carton (0574-7050-12) / 1 Suppository In 1 Blister Pack,1.05,0.42,,,0 NDC,00574705050,Bisacodyl: 50 Blister Pack In 1 Carton (0574-7050-50) / 1 Suppository In 1 Blister Pack,0.72,0.29,,,0 NDC,00574722612,Compro: 12 Packet In 1 Carton (0574-7226-12) / 1 Suppository In 1 Packet,26.84,10.74,,,0 NDC,00574985510,Budesonide: 1 Bottle In 1 Carton (0574-9855-10) / 100 Capsule In 1 Bottle,2.97,1.19,,,0 NDC,00575620030,"Proglycem: 1 Bottle, Dropper In 1 Box (0575-6200-30) / 30 Ml In 1 Bottle, Dropper",15.61,6.24,,,0 NDC,00591044401,"Guanfacine: 100 Tablet In 1 Bottle, Plastic (0591-0444-01)",0.59,0.24,,,0 NDC,00591058201,"Propafenone Hcl: 100 Tablet, Film Coated In 1 Bottle, Plastic (0591-0582-01)",1.07,0.43,,,0 NDC,00591231245,NDC Description Not Available,398.93,159.57,,,0 NDC,00591257920,"Valganciclovir Hydrochloride For Oral: 100 Ml In 1 Bottle, Glass (0591-2579-20)",352.73,141.09,,,0 NDC,00591288830,"Hydroxocobalamin: 1 Vial, Multi-Dose In 1 Carton (0591-2888-30) / 30 Ml In 1 Vial, Multi-Dose",0.05,0.02,,,0 NDC,00591292754,"Levalbuterol Tartrate Hfa Inhalation: 1 Inhaler In 1 Carton (0591-2927-54) / 200 Aerosol, Metered In 1 Inhaler",176.9,70.76,,,0 NDC,00591333119,"Bupropion Hydrochloride Xl: 90 Tablet, Film Coated, Extended Release In 1 Bottle, Plastic (0591-3331-19)",5.71,2.28,,,0 NDC,00591352511,NDC Description Not Available,9.73,3.89,,,0 NDC,00591352530,Lidocaine: 30 Pouch In 1 Carton (0591-3525-30) / 1 G In 1 Pouch (0591-3525-11),6.51,2.6,,,0 NDC,00591365930,"Desvenlafaxine: 30 Tablet, Extended Release In 1 Bottle (0591-3659-30)",4.21,1.68,,,0 NDC,00591379730,Albuterol Sulfate: 30 VIAL in 1 CARTON (0591-3797-30) / 3 mL in 1 VIAL,0.42,0.17,,,0 NDC,00591387044,"Memantine Hydrochloride: 10 Blister Pack In 1 Box, Unit-Dose (0591-3870-44) / 10 Tablet In 1 Blister Pack (0591-3870-45)",1.31,0.52,,,0 NDC,00591387045,NDC Description Not Available,0.91,0.36,,,0 NDC,00591387544,"Memantine Hydrochloride: 10 Blister Pack In 1 Box, Unit-Dose (0591-3875-44) / 10 Tablet In 1 Blister Pack (0591-3875-45)",0.9,0.36,,,0 NDC,00591387545,NDC Description Not Available,0.82,0.33,,,0 NDC,00591406030,"Desvenlafaxine: 30 Tablet, Extended Release In 1 Bottle (0591-4060-30)",4.21,1.68,,,0 NDC,00591533501,"Trihexyphenidyl Hydrochloride: 100 Tablet In 1 Bottle, Plastic (0591-5335-01)",0.43,0.17,,,0 NDC,00591533701,"Trihexyphenidyl Hydrochloride: 100 Tablet In 1 Bottle, Plastic (0591-5337-01)",0.81,0.32,,,0 NDC,00591534701,"Probenecid: 100 Tablet, Film Coated In 1 Bottle, Plastic (0591-5347-01)",1.82,0.73,,,0 NDC,00591544301,Prednisone: 100 Tablet In 1 Bottle (0591-5443-01),0.03,0.01,,,0 NDC,00591569460,"Minocycline Hydrochloride: 60 Capsule In 1 Bottle, Plastic (0591-5694-60)",0.64,0.26,,,0 NDC,00597005345,GlucaGen: 10 VIAL in 1 CARTON (0597-0053-45) / 1 mL in 1 VIAL,646.42,258.57,,,0 NDC,00597008717,"Atrovent Hfa: 1 Canister In 1 Carton (0597-0087-17) / 200 Aerosol, Metered In 1 Canister",1270.45,508.18,,,0 NDC,00597010051,"Spiriva Respimat: 1 Cartridge In 1 Carton (0597-0100-51) / 10 Spray, Metered In 1 Cartridge",228.23,91.29,,,0 NDC,00597010061,"Spiriva Respimat: 1 Cartridge In 1 Carton (0597-0100-61) / 60 Spray, Metered In 1 Cartridge",1616.15,646.46,,,0 NDC,00597015237,"Jardiance: 30 Blister Pack In 1 Carton (0597-0152-37) / 1 Tablet, Film Coated In 1 Blister Pack",62.6,25.04,,,0 NDC,00597015337,"Jardiance: 30 Blister Pack In 1 Carton (0597-0153-37) / 1 Tablet, Film Coated In 1 Blister Pack",62.59,25.04,,,0 NDC,00597019705,"Praxbind: 2 Vial, Single-Dose In 1 Carton (0597-0197-05) / 50 Ml In 1 Vial, Single-Dose",11849.72,4739.89,,,0 NDC,00597026010,"GlucaGen: 1 KIT in 1 KIT (0597-0260-10) * 1 mL in 1 VIAL, GLASS (0597-0053-01) * 1 mL in 1 VIAL, GLASS (0597-0265-94)",524.91,209.96,,,0 NDC,00597035556,Pradaxa: 60 Blister Pack In 1 Carton (0597-0355-56) / 1 Capsule In 1 Blister Pack,13.54,5.42,,,0 NDC,00597036082,Pradaxa: 60 Blister Pack In 1 Carton (0597-0360-82) / 1 Capsule In 1 Blister Pack,10.08,4.03,,,0 NDC,00603116158,"Dicyclomine Hydrochloride: 473 Ml In 1 Bottle, Plastic (0603-1161-58)",5.76,2.3,,,0 NDC,00603154258,"Potassium Chloride: 473 Ml In 1 Bottle, Plastic (0603-1542-58)",0.6,0.24,,,0 NDC,00603155410,NDC Description Not Available,23.03,9.21,,,0 NDC,00603188010,NDC Description Not Available,14.32,5.73,,,0 NDC,00603188016,Lidocaine: 30 Pouch In 1 Carton (0603-1880-16) / .7 G In 1 Pouch (0603-1880-10),12.82,5.13,,,0 NDC,00603516721,"Phenobarbital: 100 Tablet In 1 Bottle, Plastic (0603-5167-21)",1.91,0.76,,,0 NDC,00603533621,"Prednisone: 100 Tablet In 1 Bottle, Plastic (0603-5336-21)",0.16,0.06,,,0 NDC,00603548421,Propranolol Hydrochloride: 100 Tablet In 1 Bottle (0603-5484-21),0.77,0.31,,,0 NDC,00641036721,NDC Description Not Available,0.51,0.2,,,0 NDC,00641036725,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (0641-0367-25) / 1 Ml In 1 Vial (0641-0367-21),0.63,0.25,,,0 NDC,00641037621,NDC Description Not Available,6.28,2.51,,,0 NDC,00641037625,Diphenhydramine Hydrochloride: 25 Vial In 1 Package (0641-0376-25) / 1 Ml In 1 Vial (0641-0376-21),5.25,2.1,,,0 NDC,00641040037,NDC Description Not Available,6.71,2.68,,,0 NDC,00641047621,NDC Description Not Available,108.76,43.5,,,0 NDC,00641047625,Phenobarbital Sodium: 25 Vial In 1 Carton (0641-0476-25) / 1 Ml In 1 Vial (0641-0476-21),5.76,2.3,,,0 NDC,00641047721,NDC Description Not Available,285.51,114.2,,,0 NDC,00641047725,Phenobarbital Sodium: 25 Vial In 1 Carton (0641-0477-25) / 1 Ml In 1 Vial (0641-0477-21),232.64,93.06,,,0 NDC,00641092821,NDC Description Not Available,6.17,2.47,,,0 NDC,00641092825,"Promethazine Hydrochloride: 25 Vial, Single-Dose In 1 Package (0641-0928-25) / 1 Ml In 1 Vial, Single-Dose (0641-0928-21)",6.15,2.46,,,0 NDC,00641139731,NDC Description Not Available,196.9,78.76,,,0 NDC,00641139735,Chlorpromazine Hydrochloride: 25 Ampule In 1 Carton (0641-1397-35) / 1 Ml In 1 Ampule (0641-1397-31),213.78,85.51,,,0 NDC,00641141031,NDC Description Not Available,24.53,9.81,,,0 NDC,00641141035,Digoxin: 25 Ampule In 1 Carton (0641-1410-35) / 2 Ml In 1 Ampule (0641-1410-31),13.23,5.29,,,0 NDC,00641600101,NDC Description Not Available,4.76,1.9,,,0 NDC,00641600125,Ativan: 25 Vial In 1 Carton (0641-6001-25) / 1 Ml In 1 Vial (0641-6001-01),8.16,3.26,,,0 NDC,00641600701,NDC Description Not Available,3.39,1.36,,,0 NDC,00641600710,Bumetanide: 10 Vial In 1 Carton (0641-6007-10) / 10 Ml In 1 Vial (0641-6007-01),2.95,1.18,,,0 NDC,00641600801,NDC Description Not Available,7.8,3.12,,,0 NDC,00641600810,Bumetanide: 10 Vial In 1 Carton (0641-6008-10) / 4 Ml In 1 Vial (0641-6008-01),6.7,2.68,,,0 NDC,00641601301,NDC Description Not Available,4.245,1.6949999999999998,,,0 NDC,00641601310,Diltiazem Hydrochloride: 10 Vial In 1 Carton (0641-6013-10) / 5 Ml In 1 Vial (0641-6013-01),7.22,2.89,,,0 NDC,00641601501,NDC Description Not Available,37.08,14.83,,,0 NDC,00641601510,Diltiazem Hydrochloride: 10 Vial In 1 Carton (0641-6015-10) / 25 Ml In 1 Vial (0641-6015-01),24.04,9.62,,,0 NDC,00641602101,NDC Description Not Available,1.12,0.45,,,0 NDC,00641602110,Famotidine: 10 Vial In 1 Carton (0641-6021-10) / 20 Ml In 1 Vial (0641-6021-01),0.26,0.1,,,0 NDC,00641602410,Fentanyl Citrate: 10 Ampule In 1 Carton (0641-6024-10) / 2 Ml In 1 Ampule (0641-6024-01),1.84,0.74,,,0 NDC,00641602701,NDC Description Not Available,6.3,2.52,,,0 NDC,00641602725,Fentanyl Citrate: 25 Vial In 1 Carton (0641-6027-25) / 2 Ml In 1 Vial (0641-6027-01),11.27,4.51,,,0 NDC,00641602801,NDC Description Not Available,4.0,1.6,,,0 NDC,00641603001,Fentanyl Citrate: 50 Ml In 1 Vial (0641-6030-01),4.17,1.67,,,0 NDC,00641603901,Infumorph 200: 20 Ml In 1 Ampule (0641-6039-01),46.31,18.52,,,0 NDC,00641604001,Infumorph 500: 20 Ml In 1 Ampule (0641-6040-01),31.3,12.52,,,0 NDC,00641604401,NDC Description Not Available,5.46,2.18,,,0 NDC,00641604425,Lorazepam: 25 Vial In 1 Carton (0641-6044-25) / 1 Ml In 1 Vial (0641-6044-01),6.96,2.78,,,0 NDC,00641604801,NDC Description Not Available,2.08,0.83,,,0 NDC,00641605201,NDC Description Not Available,7.69,3.08,,,0 NDC,00641605225,Meperidine Hydrochloride: 25 Vial In 1 Carton (0641-6052-25) / 1 Ml In 1 Vial (0641-6052-01),4.9,1.96,,,0 NDC,00641605701,NDC Description Not Available,2.79,1.12,,,0 NDC,00641605901,NDC Description Not Available,1.12,0.45,,,0 NDC,00641606001,NDC Description Not Available,0.65,0.26,,,0 NDC,00641606010,Midazolam: 10 Vial In 1 Carton (0641-6060-10) / 10 Ml In 1 Vial (0641-6060-01),0.14,0.06,,,0 NDC,00641606301,NDC Description Not Available,0.5700000000000001,0.22999999999999998,,,0 NDC,00641607801,NDC Description Not Available,1.05,0.42,,,0 NDC,00641607825,Ondansetron: 25 Vial In 1 Carton (0641-6078-25) / 2 Ml In 1 Vial (0641-6078-01),0.42,0.17,,,0 NDC,00641607901,Ondansetron: 20 Ml In 1 Carton (0641-6079-01),0.88,0.35,,,0 NDC,00641610301,NDC Description Not Available,30.52,12.21,,,0 NDC,00641610310,Robaxin: 10 Vial In 1 Carton (0641-6103-10) / 10 Ml In 1 Vial (0641-6103-01),24.74,9.9,,,0 NDC,00641611601,NDC Description Not Available,10.8,4.32,,,0 NDC,00641611610,Ampicillin And Sulbactam: 10 Vial In 1 Carton (0641-6116-10) / 1.5 G In 1 Vial (0641-6116-01),19.21,7.68,,,0 NDC,00641611701,NDC Description Not Available,20.42,8.17,,,0 NDC,00641611710,Ampicillin And Sulbactam: 10 Vial In 1 Carton (0641-6117-10) / 3 G In 1 Vial (0641-6117-01),20.75,8.3,,,0 NDC,00641612501,NDC Description Not Available,8.88,3.55,,,0 NDC,00641612525,"Morphine Sulfate: 25 Vial, Single-Dose In 1 Package (0641-6125-25) / 1 Ml In 1 Vial, Single-Dose (0641-6125-01)",8.47,3.39,,,0 NDC,00641612701,NDC Description Not Available,10.34,4.14,,,0 NDC,00641612725,"Morphine Sulfate: 25 Vial, Single-Dose In 1 Package (0641-6127-25) / 1 Ml In 1 Vial, Single-Dose (0641-6127-01)",11.01,4.4,,,0 NDC,00641613201,NDC Description Not Available,13.17,5.27,,,0 NDC,00641613225,Naloxone Hydrochloride: 25 Vial In 1 Carton (0641-6132-25) / 1 Ml In 1 Vial (0641-6132-01),59.11,23.64,,,0 NDC,00641613501,NDC Description Not Available,17.8,7.12,,,0 NDC,00641613525,Prochlorperazine Edisylate: 25 Vial In 1 Carton (0641-6135-25) / 2 Ml In 1 Vial (0641-6135-01),9.6,3.84,,,0 NDC,00641614501,NDC Description Not Available,1.07,0.43,,,0 NDC,00641614525,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (0641-6145-25) / 1 Ml In 1 Vial (0641-6145-01),0.94,0.38,,,0 NDC,00641614701,NDC Description Not Available,1.93,0.77,,,0 NDC,00641615101,NDC Description Not Available,1.56,0.62,,,0 NDC,00641616401,NDC Description Not Available,1.02,0.41,,,0 NDC,00641616601,NDC Description Not Available,6.53,2.61,,,0 NDC,00641616610,Amikacin Sulfate: 10 Vial In 1 Carton (0641-6166-10) / 4 Ml In 1 Vial (0641-6166-01),0.385,0.155,,,0 NDC,00641616701,NDC Description Not Available,2.19,0.88,,,0 NDC,00641616901,NDC Description Not Available,1.2,0.48,,,0 NDC,00641616910,Hydromorphone Hydrochloride: 10 Syringe In 1 Carton (0641-6169-10) / 1 Ml In 1 Syringe (0641-6169-01),6.55,2.62,,,0 NDC,00641617401,NDC Description Not Available,11.22,4.49,,,0 NDC,00641617410,"Octreotide Acetate: 10 Vial, Single-Dose In 1 Carton (0641-6174-10) / 1 Ml In 1 Vial, Single-Dose (0641-6174-01)",9.98,3.99,,,0 NDC,00641617610,"Octreotide Acetate: 10 Vial, Single-Dose In 1 Carton (0641-6176-10) / 1 Ml In 1 Vial, Single-Dose (0641-6176-01)",2.44,0.98,,,0 NDC,00641617801,"Octreotide Acetate: 1 Vial, Multi-Dose In 1 Carton (0641-6178-01) / 5 Ml In 1 Vial, Multi-Dose",5.39,2.16,,,0 NDC,00641618801,NDC Description Not Available,0.04,0.02,,,0 NDC,00641618810,"Phenylephrine Hydrochloride: 10 Vial, Pharmacy Bulk Package In 1 Carton (0641-6188-10) / 5 Ml In 1 Vial, Pharmacy Bulk Package (0641-6188-01)",0.04,0.02,,,0 NDC,00641620501,NDC Description Not Available,12.18,4.87,,,0 NDC,00641620510,Naloxone Hydrochloride: 10 Syringe In 1 Carton (0641-6205-10) / 2 Ml In 1 Syringe (0641-6205-01),22.22,8.89,,,0 NDC,00641620601,NDC Description Not Available,2.95,1.18,,,0 NDC,00641620610,Hydromorphone Hydrochloride: 10 Syringe In 1 Carton (0641-6206-10) / .5 Ml In 1 Syringe (0641-6206-01),2.3,0.92,,,0 NDC,00641622801,NDC Description Not Available,22.88,9.15,,,0 NDC,00641622825,Thiamine Hydrochloride: 25 Vial In 1 Carton (0641-6228-25) / 2 Ml In 1 Vial (0641-6228-01),7.76,3.1,,,0 NDC,00641623101,NDC Description Not Available,39.74,15.9,,,0 NDC,00641623125,"Hydralazine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (0641-6231-25) / 20 Ml In 1 Vial, Single-Dose (0641-6231-01)",7.89,3.16,,,0 NDC,00641623601,NDC Description Not Available,30.34,12.14,,,0 NDC,00641624401,NDC Description Not Available,40.92,16.37,,,0 NDC,00641624701,NDC Description Not Available,4.38,1.75,,,0 NDC,00641921701,NDC Description Not Available,4.76,1.9,,,0 NDC,00703001801,Hydromorphone Hydrochloride: 1 Vial In 1 Carton (0703-0018-01) / 50 Ml In 1 Vial,0.13,0.05,,,0 NDC,00703011001,NDC Description Not Available,0.17,0.07,,,0 NDC,00703011301,NDC Description Not Available,0.08,0.03,,,0 NDC,00703011303,Hydromorphone Hydrochloride: 10 Vial In 1 Carton (0703-0113-03) / 5 Ml In 1 Vial (0703-0113-01),0.08,0.03,,,0 NDC,00703024101,"Triamcinolone Acetonide: 1 Vial, Single-Dose In 1 Carton (0703-0241-01) / 1 Ml In 1 Vial, Single-Dose",12.8,5.12,,,0 NDC,00703024301,"Triamcinolone Acetonide: 1 Vial, Multi-Dose In 1 Carton (0703-0243-01) / 5 Ml In 1 Vial, Multi-Dose",4.91,1.96,,,0 NDC,00703024501,"Triamcinolone Acetonide: 1 Vial, Multi-Dose In 1 Carton (0703-0245-01) / 10 Ml In 1 Vial, Multi-Dose",3.25,1.3,,,0 NDC,00703068601,"Treprostinil: 1 Vial, Multi-Dose In 1 Carton (0703-0686-01) / 20 Ml In 1 Vial, Multi-Dose",275.61,110.24,,,0 NDC,00703291401,NDC Description Not Available,21.55,8.62,,,0 NDC,00703321801,"Paclitaxel: 1 Vial, Multi-Dose In 1 Carton (0703-3218-01) / 50 Ml In 1 Vial, Multi-Dose",1.02,0.41,,,0 NDC,00703367101,"Methotrexate: 1 Vial, Single-Dose In 1 Carton (0703-3671-01) / 2 Ml In 1 Vial, Single-Dose",12.25,4.9,,,0 NDC,00703367501,"Methotrexate: 1 Vial, Single-Dose In 1 Carton (0703-3675-01) / 10 Ml In 1 Vial, Single-Dose",6.12,2.45,,,0 NDC,00703367801,"Methotrexate: 1 Vial, Single-Dose In 1 Carton (0703-3678-01) / 40 Ml In 1 Vial, Single-Dose",5.13,2.05,,,0 NDC,00703398601,"Oxaliplatin: 1 Vial, Single-Use In 1 Carton (0703-3986-01) / 20 Ml In 1 Vial, Single-Use",1.39,0.56,,,0 NDC,00703423901,"Carboplatin: 1 Vial, Multi-Dose In 1 Carton (0703-4239-01) / 60 Ml In 1 Vial, Multi-Dose",23.91,9.56,,,0 NDC,00703450201,NDC Description Not Available,9.12,3.65,,,0 NDC,00703523313,"daunorubicin hydrochloride: 10 VIAL, SINGLE-DOSE in 1 CARTON (0703-5233-13) / 4 mL in 1 VIAL, SINGLE-DOSE (0703-5233-11)",289.06,115.62,,,0 NDC,00703574811,"Cisplatin: 1 Vial, Multi-Dose In 1 Carton (0703-5748-11) / 100 Ml In 1 Vial, Multi-Dose",16.9,6.76,,,0 NDC,00703903203,"Amikacin Sulfate: 10 VIAL, SINGLE-DOSE in 1 CARTON (0703-9032-03) / 2 mL in 1 VIAL, SINGLE-DOSE (0703-9032-01)",8.8,3.52,,,0 NDC,00703951401,NDC Description Not Available,13.38,5.35,,,0 NDC,00703952601,"Sulfamethoxazole And Trimethoprim: 1 Vial, Multi-Dose In 1 Carton (0703-9526-01) / 30 Ml In 1 Vial, Multi-Dose",66.905,26.76,,,0 NDC,00713013506,NDC Description Not Available,25.62,10.25,,,0 NDC,00713022531,Triamcinolone Acetonide: 1 Tube In 1 Carton (0713-0225-31) / 30 G In 1 Tube,17.39,6.96,,,0 NDC,00713022880,Triamcinolone Acetonide: 1 Tube In 1 Carton (0713-0228-80) / 80 G In 1 Tube,39.01,15.6,,,0 NDC,00713026831,Triple Antibiotic: 1 Tube In 1 Carton (0713-0268-31) / 28.4 G In 1 Tube,9.28,3.71,,,0 NDC,00713028031,Bacitracin: 28.4 G In 1 Tube (0713-0280-31),4.21,1.68,,,0 NDC,00713035102,NDC Description Not Available,10.26,4.1,,,0 NDC,00713035125,Prochlorperazine Edisylate: 25 Vial In 1 Package (0713-0351-25) / 2 Ml In 1 Vial (0713-0351-02),11.08,4.43,,,0 NDC,00713050306,NDC Description Not Available,34.5,13.8,,,0 NDC,00713050312,Anucort-Hc: 12 Suppository In 1 Carton (0713-0503-12),34.5,13.8,,,0 NDC,00713052612,Promethegan: 12 Suppository In 1 Box (0713-0526-12),29.15,11.66,,,0 NDC,00713053606,NDC Description Not Available,29.25,11.7,,,0 NDC,00713055273,Terconazole: 3 Blister Pack In 1 Carton (0713-0552-73) / 1 Suppository In 1 Blister Pack,82.51,33.0,,,0 NDC,00713068215,Gentamicin Sulfate: 1 Tube In 1 Carton (0713-0682-15) / 15 G In 1 Tube,52.24,20.9,,,0 NDC,00713068315,Gentamicin Sulfate: 1 Tube In 1 Carton (0713-0683-15) / 15 G In 1 Tube,41.47,16.59,,,0 NDC,00713068615,Nystatin: 1 Tube In 1 Carton (0713-0686-15) / 15 G In 1 Tube,42.27,16.91,,,0 NDC,00781106101,Alprazolam: 100 Tablet In 1 Bottle (0781-1061-01),0.09,0.04,,,0 NDC,00781152601,"Potassium Chloride: 100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0781-1526-01)",1.98,0.79,,,0 NDC,00781165501,Penicillin V Potasium: 100 TABLET in 1 BOTTLE (0781-1655-01),4.02,1.61,,,0 NDC,00781185220,"Amoxicillin And Clavulanate Potassium: 20 Tablet, Film Coated In 1 Bottle (0781-1852-20)",3.41,1.36,,,0 NDC,00781194339,"Amoxicillin And Clavulanate Potassium: 40 Tablet, Multilayer, Extended Release In 1 Bottle (0781-1943-39)",17.51,7.0,,,0 NDC,00781194382,"Amoxicillin And Clavulanate Potassium: 28 Tablet, Multilayer, Extended Release In 1 Bottle (0781-1943-82)",15.8,6.32,,,0 NDC,00781202001,Amoxicillin: 100 Capsule In 1 Bottle (0781-2020-01),0.35,0.14,,,0 NDC,00781214501,Ampicillin: 100 Capsule In 1 Bottle (0781-2145-01),1.56,0.62,,,0 NDC,00781232106,Aprepitant: 1 Blister Pack In 1 Carton (0781-2321-06) / 1 Capsule In 1 Blister Pack,33.49,13.4,,,0 NDC,00781232306,NDC Description Not Available,29.35,11.74,,,0 NDC,00781232368,Aprepitant: 1 Blister Pack In 1 Carton (0781-2323-68) / 6 Capsule In 1 Blister Pack (0781-2323-06),37.05,14.82,,,0 NDC,00781236101,"Methylphenidate: 100 Capsule, Extended Release In 1 Bottle (0781-2361-01)",24.37,9.75,,,0 NDC,00781261301,Amoxicillin: 100 Capsule In 1 Bottle (0781-2613-01),0.54,0.22,,,0 NDC,00781309894,NDC Description Not Available,5.83,2.33,,,0 NDC,00781309895,Meropenem: 10 Vial In 1 Carton (0781-3098-95) / 30 Ml In 1 Vial (0781-3098-94),2.41,0.96,,,0 NDC,00781311090,NDC Description Not Available,7.46,2.98,,,0 NDC,00781311390,NDC Description Not Available,10.16,4.06,,,0 NDC,00781311395,"Piperacillin And Tazobactam: 10 Vial, Single-Use In 1 Carton (0781-3113-95) / 15 Ml In 1 Vial, Single-Use (0781-3113-90)",5.48,2.19,,,0 NDC,00781311491,NDC Description Not Available,4.61,1.84,,,0 NDC,00781315295,"Cisatracurium Besylate: 10 Vial, Multi-Dose In 1 Carton (0781-3152-95) / 10 Ml In 1 Vial, Multi-Dose (0781-3152-70)",16.48,6.59,,,0 NDC,00781315606,NDC Description Not Available,0.31,0.12,,,0 NDC,00781315695,"Acetaminophen: 10 Vial, Glass In 1 Carton (0781-3156-95) / 100 Ml In 1 Vial, Glass (0781-3156-06)",0.18,0.07,,,0 NDC,00781315894,NDC Description Not Available,1.29,0.52,,,0 NDC,00781315895,"Bivalirudin: 10 Vial, Single-Use In 1 Carton (0781-3158-95) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Use (0781-3158-94)",1.35,0.54,,,0 NDC,00781315972,Olanzapine: 1 Vial In 1 Carton (0781-3159-72) / 2 Ml In 1 Vial,14.7,5.88,,,0 NDC,00781320785,"Ceftriaxone Sodium: 1 Vial, Single-Use In 1 Carton (0781-3207-85) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use",4.4,1.76,,,0 NDC,00781320795,"Ceftriaxone Sodium: 10 Vial, Single-Use In 1 Carton (0781-3207-95) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use",2.29,0.92,,,0 NDC,00781320885,"Ceftriaxone Sodium: 1 Vial, Single-Use In 1 Carton (0781-3208-85) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use",3.76,1.5,,,0 NDC,00781320895,"Ceftriaxone Sodium: 10 Vial, Single-Use In 1 Carton (0781-3208-95) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use",1.45,0.58,,,0 NDC,00781320990,NDC Description Not Available,3.43,1.37,,,0 NDC,00781320995,"Ceftriaxone Sodium: 10 Vial, Single-Use In 1 Carton (0781-3209-95) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use (0781-3209-90)",3.3,1.32,,,0 NDC,00781321046,"Ceftriaxone Sodium: 1 Vial, Pharmacy Bulk Package In 1 Carton (0781-3210-46) / 100 Ml In 1 Vial, Pharmacy Bulk Package",3.1,1.24,,,0 NDC,00781322075,NDC Description Not Available,8.67,3.47,,,0 NDC,00781323294,NDC Description Not Available,27.21,10.88,,,0 NDC,00781323295,Pantoprazole Sodium: 10 Vial In 1 Carton (0781-3232-95) / 10 Ml In 1 Vial (0781-3232-94),9.63,3.85,,,0 NDC,00781324494,"Cyclophosphamide: 1 Vial, Single-Dose In 1 Carton (0781-3244-94) / 50 Ml In 1 Vial, Single-Dose",13.85,5.54,,,0 NDC,00781324602,NDC Description Not Available,3.13,1.25,,,0 NDC,00781324664,Enoxaparin Sodium: 10 Syringe In 1 Carton (0781-3246-64) / .4 Ml In 1 Syringe (0781-3246-02),3.26,1.3,,,0 NDC,00781325603,NDC Description Not Available,3.47,1.39,,,0 NDC,00781326805,NDC Description Not Available,2.99,1.2,,,0 NDC,00781326869,Enoxaparin Sodium: 10 Syringe In 1 Carton (0781-3268-69) / 1 Ml In 1 Syringe (0781-3268-05),3.59,1.44,,,0 NDC,00781326971,NDC Description Not Available,32.88,13.15,,,0 NDC,00781328809,Clindamycin In 5 Percent Dextrose: 24 Bag In 1 Carton (0781-3288-09) / 50 Ml In 1 Bag (0781-3288-91),33.55,13.42,,,0 NDC,00781328891,NDC Description Not Available,34.07,13.63,,,0 NDC,00781328909,Clindamycin In 5 Percent Dextrose: 24 Bag In 1 Carton (0781-3289-09) / 50 Ml In 1 Bag (0781-3289-91),17.02,6.81,,,0 NDC,00781328991,NDC Description Not Available,20.76,8.3,,,0 NDC,00781329009,Clindamycin In 5 Percent Dextrose: 24 Bag In 1 Carton (0781-3290-09) / 50 Ml In 1 Bag (0781-3290-91),13.88,5.55,,,0 NDC,00781329091,NDC Description Not Available,13.25,5.3,,,0 NDC,00781329804,NDC Description Not Available,3.48,1.39,,,0 NDC,00781329868,Enoxaparin Sodium: 10 Syringe In 1 Carton (0781-3298-68) / .8 Ml In 1 Syringe (0781-3298-04),3.59,1.44,,,0 NDC,00781331275,"Palonosetron Hydrochloride: 1 Vial, Single-Dose In 1 Carton (0781-3312-75) / 5 Ml In 1 Vial, Single-Dose",4.22,1.69,,,0 NDC,00781340278,NDC Description Not Available,11.96,4.78,,,0 NDC,00781340295,"Ampicillin: 10 Vial, Glass In 1 Package (0781-3402-95) / 1 Injection, Powder, For Solution In 1 Vial, Glass (0781-3402-78)",11.94,4.78,,,0 NDC,00781340485,NDC Description Not Available,13.78,5.51,,,0 NDC,00781340880,NDC Description Not Available,14.85,5.94,,,0 NDC,00781340895,"Ampicillin: 10 Vial, Glass In 1 Package (0781-3408-95) / 1 Injection, Powder, For Solution In 1 Vial, Glass (0781-3408-80)",2.78,1.11,,,0 NDC,00781341170,NDC Description Not Available,2.02,0.81,,,0 NDC,00781342780,"Treprostinil: 1 Vial, Multi-Dose In 1 Carton (0781-3427-80) / 20 Ml In 1 Vial, Multi-Dose",243.72,97.49,,,0 NDC,00781344071,NDC Description Not Available,169.52,67.81,,,0 NDC,00781344095,Cosyntropin: 10 Vial In 1 Carton (0781-3440-95) / 1 Ml In 1 Vial (0781-3440-71),352.88,141.15,,,0 NDC,00781345895,"Phenylephrine Hydrochloride: 10 Vial, Pharmacy Bulk Package In 1 Carton (0781-3458-95) / 5 Ml In 1 Vial, Pharmacy Bulk Package (0781-3458-75)",0.01,0.004,,,0 NDC,00781349380,NDC Description Not Available,8.27,3.31,,,0 NDC,00781349491,NDC Description Not Available,132.0,52.8,,,0 NDC,00781349546,NDC Description Not Available,211.2,84.48,,,0 NDC,00781349595,Dexmedetomidine Hydrochloride In 0.9% Sodium Chloride: 10 Bottle In 1 Carton (0781-3495-95) / 100 Ml In 1 Bottle,283.16,113.26,,,0 NDC,00781353191,"Paclitaxel: 1 Vial, Single-Dose In 1 Carton (0781-3531-91) / 20 Ml In 1 Vial, Single-Dose",78.18,31.27,,,0 NDC,00781354010,NDC Description Not Available,0.37,0.15,,,0 NDC,00781354510,NDC Description Not Available,1.31,0.52,,,0 NDC,00781375575,NDC Description Not Available,15.04,6.02,,,0 NDC,00781400332,"Leuprolide Acetate: 1 Kit In 1 Carton (0781-4003-32) * 1 Vial, Multi-Dose In 1 Carton (0781-3006-42) / 2.8 Ml In 1 Vial, Multi-Dose * 1 Ml In 1 Packet",3269.08,1307.63,,,0 NDC,00781523864,"Ondansetron: 3 BLISTER PACK in 1 CARTON (0781-5238-64) / 10 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (0781-5238-06)",2.76,1.1,,,0 NDC,00781600078,Difluprednate Ophthalmic: 1 Bottle In 1 Carton (0781-6000-78) / 5 Ml In 1 Bottle,451.15999999999997,180.465,,,0 NDC,00781602346,Clarithromycin: 100 Ml In 1 Bottle (0781-6023-46),54.5,21.8,,,0 NDC,00781613594,NDC Description Not Available,5.33,2.13,,,0 NDC,00781615394,NDC Description Not Available,146.44,58.58,,,0 NDC,00781717156,Tobramycin: 56 AMPULE in 1 CARTON (0781-7171-56) / 5 mL in 1 AMPULE (0781-7171-75),281.25,112.5,,,0 NDC,00781718675,Brimonidine Tartrate And Timolol Maleate: 1 Bottle In 1 Carton (0781-7186-75) / 5 Ml In 1 Bottle,341.76,136.7,,,0 NDC,00781729685,"Albuterol Sulfate: 1 Canister In 1 Carton (0781-7296-85) / 200 Aerosol, Metered In 1 Canister",54.74,21.9,,,0 NDC,00781808931,"Azithromycin: 30 Tablet, Film Coated In 1 Bottle (0781-8089-31)",6.48,2.59,,,0 NDC,00799000104,Calmoseptine: 113 G In 1 Tube (0799-0001-04),14.58,5.83,,,0 NDC,00802392016,NDC Description Not Available,0.53,0.21,,,0 NDC,00832003800,Oxybutynin Chloride: 100 Tablet In 1 Bottle (0832-0038-00),0.23,0.09,,,0 NDC,00832003889,NDC Description Not Available,1.2,0.48,,,0 NDC,00832046515,"Nyamyc: 1 Bottle, Plastic In 1 Carton (0832-0465-15) / 15 G In 1 Bottle, Plastic",20.87,8.35,,,0 NDC,00832046530,"Nyamyc: 1 Bottle, Plastic In 1 Carton (0832-0465-30) / 30 G In 1 Bottle, Plastic",44.99,18.0,,,0 NDC,00832051100,Bethanechol Chloride: 100 Tablet In 1 Bottle (0832-0511-00),0.06,0.02,,,0 NDC,00832051101,Bethanechol Chloride: 100 Blister Pack In 1 Carton (0832-0511-01) / 1 Tablet In 1 Blister Pack (0832-0511-89),0.825,0.32999999999999996,,,0 NDC,00832051189,NDC Description Not Available,1.3,0.52,,,0 NDC,00832051201,Bethanechol Chloride: 100 Blister Pack In 1 Carton (0832-0512-01) / 1 Tablet In 1 Blister Pack (0832-0512-89),2.22,0.89,,,0 NDC,00832051289,NDC Description Not Available,2.8,1.12,,,0 NDC,00832058011,Clobazam: 100 Tablet In 1 Bottle (0832-0580-11),0.91,0.36,,,0 NDC,00832105511,Baclofen: 100 Tablet In 1 Bottle (0832-1055-11),0.96,0.38,,,0 NDC,00832121101,Jantoven: 100 Blister Pack In 1 Carton (0832-1211-01) / 1 Tablet In 1 Blister Pack (0832-1211-89),1.14,0.46,,,0 NDC,00832121189,NDC Description Not Available,0.93,0.37,,,0 NDC,00832121201,Jantoven: 100 Blister Pack In 1 Carton (0832-1212-01) / 1 Tablet In 1 Blister Pack (0832-1212-89),1.22,0.49,,,0 NDC,00832121289,NDC Description Not Available,1.18,0.47,,,0 NDC,00832121301,Jantoven: 100 Blister Pack In 1 Carton (0832-1213-01) / 1 Tablet In 1 Blister Pack (0832-1213-89),0.73,0.29,,,0 NDC,00832121389,NDC Description Not Available,1.14,0.46,,,0 NDC,00832121401,Jantoven: 100 Blister Pack In 1 Carton (0832-1214-01) / 1 Tablet In 1 Blister Pack (0832-1214-89),1.19,0.48,,,0 NDC,00832121489,NDC Description Not Available,1.18,0.47,,,0 NDC,00832121501,Jantoven: 100 Blister Pack In 1 Carton (0832-1215-01) / 1 Tablet In 1 Blister Pack (0832-1215-89),1.05,0.42,,,0 NDC,00832121589,NDC Description Not Available,1.09,0.44,,,0 NDC,00832121601,Jantoven: 100 Blister Pack In 1 Carton (0832-1216-01) / 1 Tablet In 1 Blister Pack (0832-1216-89),1.12,0.45,,,0 NDC,00832121689,NDC Description Not Available,1.14,0.46,,,0 NDC,00832121701,Jantoven: 100 Blister Pack In 1 Carton (0832-1217-01) / 1 Tablet In 1 Blister Pack (0832-1217-89),1.73,0.69,,,0 NDC,00832121789,NDC Description Not Available,0.73,0.29,,,0 NDC,00832121800,Jantoven: 100 Tablet In 1 Bottle (0832-1218-00),1.74,0.7,,,0 NDC,00832121801,Jantoven: 100 Blister Pack In 1 Carton (0832-1218-01) / 1 Tablet In 1 Blister Pack (0832-1218-89),1.03,0.41,,,0 NDC,00832121889,NDC Description Not Available,1.6,0.64,,,0 NDC,00832121900,Jantoven: 100 Tablet In 1 Bottle (0832-1219-00),0.76,0.3,,,0 NDC,00832121901,Jantoven: 100 Blister Pack In 1 Carton (0832-1219-01) / 1 Tablet In 1 Blister Pack (0832-1219-89),1.82,0.73,,,0 NDC,00832121989,NDC Description Not Available,1.78,0.71,,,0 NDC,00832135911,Doxazosin: 100 Tablet In 1 Bottle (0832-1359-11),0.68,0.27,,,0 NDC,00832152089,NDC Description Not Available,1.48,0.59,,,0 NDC,00832532310,"Potassium Chloride: 1000 Tablet, Film Coated, Extended Release In 1 Bottle (0832-5323-10)",1.38,0.55,,,0 NDC,00832602311,"Carbamazepin: 100 Tablet, Extended Release In 1 Bottle (0832-6023-11)",2.42,0.97,,,0 NDC,00832712301,"Divalproex Sodium: 100 Blister Pack In 1 Carton (0832-7123-01) / 1 Tablet, Delayed Release In 1 Blister Pack (0832-7123-89)",0.67,0.27,,,0 NDC,00832712389,NDC Description Not Available,0.76,0.3,,,0 NDC,00832712401,"Divalproex Sodium: 100 Blister Pack In 1 Carton (0832-7124-01) / 1 Tablet, Delayed Release In 1 Blister Pack (0832-7124-89)",0.75,0.3,,,0 NDC,00832712489,NDC Description Not Available,0.84,0.34,,,0 NDC,00904001261,Allergy: 10 Blister Pack In 1 Carton (0904-0012-61) / 10 Tablet In 1 Blister Pack,0.12,0.05,,,0 NDC,00904043004,"Doxycycline Hyclate: 30 Blister Pack In 1 Carton (0904-0430-04) / 1 Tablet, Coated In 1 Blister Pack",10.88,4.35,,,0 NDC,00904043006,"Doxycycline Hyclate: 50 Blister Pack In 1 Carton (0904-0430-06) / 1 Tablet, Coated In 1 Blister Pack",6.55,2.62,,,0 NDC,00904052361,NDC Description Not Available,0.11,0.04,,,0 NDC,00904073431,Triple Antibiotic: 1 Tube In 1 Carton (0904-0734-31) / 28 G In 1 Tube,3.92,1.57,,,0 NDC,00904188361,NDC Description Not Available,0.13,0.05,,,0 NDC,00904253321,"Calamine: 177 Ml In 1 Bottle, Plastic (0904-2533-21)",4.25,1.7,,,0 NDC,00904272561,Sulfamethoxazole And Trimethoprim: 100 Blister Pack In 1 Carton (0904-2725-61) / 1 Tablet In 1 Blister Pack,0.56,0.22,,,0 NDC,00904385461,"Carbamazepine: 100 Blister Pack In 1 Carton (0904-3854-61) / 1 Tablet, Chewable In 1 Blister Pack",1.49,0.6,,,0 NDC,00904386575,NDC Description Not Available,2.1100000000000003,0.845,,,0 NDC,00904429909,NDC Description Not Available,5.67,2.27,,,0 NDC,00904505359,"Sudogest: 1 Bottle, Plastic In 1 Carton (0904-5053-59) / 100 Tablet, Film Coated In 1 Bottle, Plastic",0.06,0.02,,,0 NDC,00904522452,NDC Description Not Available,0.23,0.09,,,0 NDC,00904528261,RIFAMPIN: 100 BLISTER PACK in 1 CARTON (0904-5282-61) / 1 CAPSULE in 1 BLISTER PACK,2.56,1.02,,,0 NDC,00904535431,Banophen: 1 Tube In 1 Carton (0904-5354-31) / 28 G In 1 Tube,5.38,2.15,,,0 NDC,00904539561,NDC Description Not Available,0.39,0.16,,,0 NDC,00904544861,"Pentoxifylline: 100 Blister Pack In 1 Carton (0904-5448-61) / 1 Tablet, Extended Release In 1 Blister Pack",0.86,0.34,,,0 NDC,00904549261,NDC Description Not Available,0.09,0.04,,,0 NDC,00904552361,Doxazosin: 100 Blister Pack In 1 Carton (0904-5523-61) / 1 Tablet In 1 Blister Pack,1.65,0.66,,,0 NDC,00904552461,Doxazosin: 100 Blister Pack In 1 Carton (0904-5524-61) / 1 Tablet In 1 Blister Pack,2.59,1.04,,,0 NDC,00904555159,"Banophen: 1 Bottle, Plastic In 1 Carton (0904-5551-59) / 100 Tablet, Film Coated In 1 Bottle, Plastic",0.03,0.01,,,0 NDC,00904561061,ENALAPRIL MALEATE: 100 BLISTER PACK in 1 CARTON (0904-5610-61) / 1 TABLET in 1 BLISTER PACK,2.16,0.86,,,0 NDC,00904567661,"Paroxetine: 100 Blister Pack In 1 Box, Unit-Dose (0904-5676-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.85,0.74,,,0 NDC,00904567761,"Paroxetine: 100 Blister Pack In 1 Box, Unit-Dose (0904-5677-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.73,0.29,,,0 NDC,00904573182,Petroleum Skin Protectant: 368 G In 1 Jar (0904-5731-82),9.94,3.98,,,0 NDC,00904578461,Fluoxetine: 100 Blister Pack In 1 Carton (0904-5784-61) / 1 Capsule In 1 Blister Pack,0.25,0.1,,,0 NDC,00904578561,Fluoxetine: 100 Blister Pack In 1 Carton (0904-5785-61) / 1 Capsule In 1 Blister Pack,0.27,0.11,,,0 NDC,00904578961,Acyclovir: 100 Blister Pack In 1 Carton (0904-5789-61) / 1 Capsule In 1 Blister Pack,0.41,0.16,,,0 NDC,00904579061,"Acyclovir: 100 Blister Pack In 1 Box, Unit-Dose (0904-5790-61) / 1 Tablet In 1 Blister Pack",1.21,0.48,,,0 NDC,00904579146,"Childrens Mapap: 1 Bottle, Plastic In 1 Carton (0904-5791-46) / 30 Tablet, Chewable In 1 Bottle, Plastic",0.21,0.08,,,0 NDC,00904585361,Ibuprofen: 100 Blister Pack In 1 Carton (0904-5853-61) / 1 Tablet In 1 Blister Pack,0.21,0.08,,,0 NDC,00904585440,Ibuprofen: 500 Tablet In 1 Bottle (0904-5854-40),0.24,0.1,,,0 NDC,00904585460,Ibuprofen: 100 Tablet In 1 Bottle (0904-5854-60),0.27,0.11,,,0 NDC,00904585461,Ibuprofen: 100 Blister Pack In 1 Carton (0904-5854-61) / 1 Tablet In 1 Blister Pack,0.26,0.1,,,0 NDC,00904585561,Ibuprofen: 100 Blister Pack In 1 Carton (0904-5855-61) / 1 Tablet In 1 Blister Pack,0.23,0.09,,,0 NDC,00904588061,"Diazepam: 100 BLISTER PACK in 1 BOX, UNIT-DOSE (0904-5880-61) / 1 TABLET in 1 BLISTER PACK",0.19,0.08,,,0 NDC,00904589161,"Pravastatin Sodium: 100 Blister Pack In 1 Box, Unit-Dose (0904-5891-61) / 1 Tablet In 1 Blister Pack",1.17,0.47,,,0 NDC,00904589361,"Pravastatin Sodium: 100 Blister Pack In 1 Box, Unit-Dose (0904-5893-61) / 1 Tablet In 1 Blister Pack",2.04,0.82,,,0 NDC,00904589430,"INFANTS GAS RELIEF: 1 BOTTLE, DROPPER in 1 CARTON (0904-5894-30) / 30 mL in 1 BOTTLE, DROPPER",0.14,0.06,,,0 NDC,00904592161,Digoxin: 100 Blister Pack In 1 Carton (0904-5921-61) / 1 Tablet In 1 Blister Pack,3.83,1.53,,,0 NDC,00904592261,Digoxin: 100 Blister Pack In 1 Carton (0904-5922-61) / 1 Tablet In 1 Blister Pack,3.81,1.52,,,0 NDC,00904595961,Clindamycin Hydrochloride: 100 Blister Pack In 1 Carton (0904-5959-61) / 1 Capsule In 1 Blister Pack,1.0,0.4,,,0 NDC,00904598426,NDC Description Not Available,11.53,4.61,,,0 NDC,00904600761,Lorazepam: 100 Blister Pack In 1 Carton (0904-6007-61) / 1 Tablet In 1 Blister Pack,0.23,0.09,,,0 NDC,00904600861,Lorazepam: 100 Blister Pack In 1 Carton (0904-6008-61) / 1 Tablet In 1 Blister Pack,0.26,0.1,,,0 NDC,00904608261,Zolpidem Tartrate: 100 Blister Pack In 1 Carton (0904-6082-61) / 1 Tablet In 1 Blister Pack,0.23,0.09,,,0 NDC,00904608561,"Citalopram: 100 Blister Pack In 1 Carton (0904-6085-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.17,0.07,,,0 NDC,00904617261,Carbamazepine: 100 Blister Pack In 1 Carton (0904-6172-61) / 1 Tablet In 1 Blister Pack,2.52,1.01,,,0 NDC,00904618761,Extended Phenytoin Sodium: 100 Blister Pack In 1 Carton (0904-6187-61) / 1 Capsule In 1 Blister Pack,1.87,0.75,,,0 NDC,00904622106,Ursodiol: 50 Blister Pack In 1 Carton (0904-6221-06) / 1 Capsule In 1 Blister Pack,11.25,4.5,,,0 NDC,00904622161,Ursodiol: 100 Blister Pack In 1 Carton (0904-6221-61) / 1 Capsule In 1 Blister Pack,8.82,3.53,,,0 NDC,00904623861,Carbidopa And Levodopa: 100 Blister Pack In 1 Carton (0904-6238-61) / 1 Tablet In 1 Blister Pack,0.98,0.39,,,0 NDC,00904626908,Ziprasidone: 40 Blister Pack In 1 Carton (0904-6269-08) / 1 Capsule In 1 Blister Pack,13.69,5.48,,,0 NDC,00904627008,Ziprasidone: 40 Blister Pack In 1 Carton (0904-6270-08) / 1 Capsule In 1 Blister Pack,13.5,5.4,,,0 NDC,00904627208,Ziprasidone: 40 Blister Pack In 1 Carton (0904-6272-08) / 1 Capsule In 1 Blister Pack,15.36,6.14,,,0 NDC,00904628361,"Olanzapine: 100 Blister Pack In 1 Carton (0904-6283-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.03,0.41,,,0 NDC,00904629061,"Atorvastatin Calcium: 100 Blister Pack In 1 Carton (0904-6290-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.74,0.3,,,0 NDC,00904629206,"Atorvastatin Calcium: 50 Blister Pack In 1 Carton (0904-6292-06) / 1 Tablet, Film Coated In 1 Blister Pack",0.89,0.36,,,0 NDC,00904629261,"Atorvastatin Calcium: 100 Blister Pack In 1 Carton (0904-6292-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.94,0.38,,,0 NDC,00904629461,"Clopidogrel: 100 Blister Pack In 1 Carton (0904-6294-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.71,0.28,,,0 NDC,00904630061,"Carvedilol: 100 Tablet, Film Coated In 1 Box, Unit-Dose (0904-6300-61)",0.25,0.1,,,0 NDC,00904630161,"Carvedilol: 100 Tablet, Film Coated In 1 Box, Unit-Dose (0904-6301-61)",0.28,0.11,,,0 NDC,00904630261,"Carvedilol: 100 Tablet, Film Coated In 1 Box, Unit-Dose (0904-6302-61)",0.36,0.14,,,0 NDC,00904630361,"Carvedilol: 100 Tablet, Film Coated In 1 Box, Unit-Dose (0904-6303-61)",0.25,0.1,,,0 NDC,00904630521,"Sore Throat Cherry: 177 Ml In 1 Bottle, Spray (0904-6305-21)",7.44,2.98,,,0 NDC,00904631256,Cough Dm: 1 Bottle In 1 Carton (0904-6312-56) / 89 Ml In 1 Bottle,0.61,0.24,,,0 NDC,00904632078,Saline Laxative: 133 Ml In 1 Bottle (0904-6320-78),2.66,1.06,,,0 NDC,00904632206,"Metoprolol Succinate: 50 Blister Pack In 1 Carton (0904-6322-06) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack",1.49,0.6,,,0 NDC,00904632261,"Metoprolol Succinate: 100 Blister Pack In 1 Carton (0904-6322-61) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack",2.4,0.96,,,0 NDC,00904632361,"Metoprolol Succinate: 100 Blister Pack In 1 Carton (0904-6323-61) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack",2.74,1.1,,,0 NDC,00904632946,"Lubricating Plus: 6 Pouch In 1 Carton (0904-6329-46) / 5 Vial, Single-Use In 1 Pouch / .4 Ml In 1 Vial, Single-Use",0.88,0.35,,,0 NDC,00904634061,Metoprolol Tartrate: 100 BLISTER PACK in 1 CARTON (0904-6340-61) / 1 TABLET in 1 BLISTER PACK,0.23,0.09,,,0 NDC,00904635161,"Levofloxacin: 100 Blister Pack In 1 Carton (0904-6351-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.63,0.25,,,0 NDC,00904635261,"Levofloxacin: 100 Blister Pack In 1 Carton (0904-6352-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.72,0.29,,,0 NDC,00904635361,"Levofloxacin: 100 Blister Pack In 1 Carton (0904-6353-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.31,0.52,,,0 NDC,00904635861,"Risperidone: 100 Tablet In 1 Box, Unit-Dose (0904-6358-61)",0.74,0.3,,,0 NDC,00904635961,"Risperidone: 100 Tablet In 1 Box, Unit-Dose (0904-6359-61)",0.6,0.24,,,0 NDC,00904636061,"Risperidone: 100 Tablet In 1 Box, Unit-Dose (0904-6360-61)",0.74,0.3,,,0 NDC,00904636161,"Risperidone: 100 Tablet In 1 Box, Unit-Dose (0904-6361-61)",0.79,0.32,,,0 NDC,00904636361,"Divalproex Sodium: 100 Blister Pack In 1 Carton (0904-6363-61) / 1 Tablet, Extended Release In 1 Blister Pack",3.87,1.55,,,0 NDC,00904636561,"TRAMADOL HYDROCHLORIDE: 100 BLISTER PACK in 1 CARTON (0904-6365-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK",0.22,0.09,,,0 NDC,00904637061,Amlodipine Besylate: 100 Blister Pack In 1 Carton (0904-6370-61) / 1 Tablet In 1 Blister Pack,0.24,0.1,,,0 NDC,00904637461,"Ropinirole: 100 Blister Pack In 1 Carton (0904-6374-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.62,0.65,,,0 NDC,00904637661,"Olanzapine: 100 Blister Pack In 1 Carton (0904-6376-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.33,0.53,,,0 NDC,00904637761,"Olanzapine: 100 Blister Pack In 1 Carton (0904-6377-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.47,0.19,,,0 NDC,00904640161,100 BLISTER PACK in 1 CARTON (0904-6401-61) / 1 CAPSULE in 1 BLISTER PACK,0.9,0.36,,,0 NDC,00904640761,"Bisacodyl: 10 Blister Pack In 1 Box (0904-6407-61) / 10 Tablet, Delayed Release In 1 Blister Pack",0.08,0.03,,,0 NDC,00904641861,Tizanidine: 100 Blister Pack In 1 Carton (0904-6418-61) / 1 Tablet In 1 Blister Pack,1.37,0.55,,,0 NDC,00904642285,PEG 3350: 14 PACKET in 1 CARTON (0904-6422-85) / 17 g in 1 PACKET,1.98,0.79,,,0 NDC,00904642661,"Escitalopram: 100 Blister Pack In 1 Carton (0904-6426-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.47,0.19,,,0 NDC,00904642761,"Escitalopram: 100 Blister Pack In 1 Carton (0904-6427-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.52,0.21,,,0 NDC,00904643604,Temazepam: 30 Blister Pack In 1 Carton (0904-6436-04) / 1 Capsule In 1 Blister Pack,9.71,3.88,,,0 NDC,00904644061,"Hydralazine Hydrochloride: 100 BLISTER PACK in 1 CARTON (0904-6440-61) / 1 TABLET, FILM COATED in 1 BLISTER PACK",0.46,0.18,,,0 NDC,00904644161,"Hydralazine Hydrochloride: 100 Blister Pack In 1 Carton (0904-6441-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.5699999999999998,0.63,,,0 NDC,00904644261,"Hydralazine Hydrochloride: 100 Blister Pack In 1 Carton (0904-6442-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.42,0.17,,,0 NDC,00904644961,"Isosorbide Mononitrate: 100 Blister Pack In 1 Carton (0904-6449-61) / 1 Tablet, Extended Release In 1 Blister Pack",1.12,0.45,,,0 NDC,00904645061,"Isosorbide Mononitrate: 100 Blister Pack In 1 Carton (0904-6450-61) / 1 Tablet, Extended Release In 1 Blister Pack",1.24,0.5,,,0 NDC,00904646161,Promethazine Hydrochloride: 100 Blister Pack In 1 Carton (0904-6461-61) / 1 Tablet In 1 Blister Pack,0.25,0.1,,,0 NDC,00904647461,"Pantoprazole Sodium: 100 Blister Pack In 1 Carton (0904-6474-61) / 1 Tablet, Delayed Release In 1 Blister Pack",0.9,0.36,,,0 NDC,00904647561,Baclofen: 100 Blister Pack In 1 Carton (0904-6475-61) / 1 Tablet In 1 Blister Pack,1.1,0.44,,,0 NDC,00904647661,Baclofen: 100 Blister Pack In 1 Carton (0904-6476-61) / 1 Tablet In 1 Blister Pack,1.74,0.7,,,0 NDC,00904647761,"Donepezil Hydrochloride: 100 Blister Pack In 1 Carton (0904-6477-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.41,0.16,,,0 NDC,00904647861,"Donepezil Hydrochloride: 100 Blister Pack In 1 Carton (0904-6478-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.37,0.15,,,0 NDC,00904648838,Major Lubrifresh Pm: 1 Tube In 1 Carton (0904-6488-38) / 3.5 G In 1 Tube,15.12,6.05,,,0 NDC,00904650061,Fluconazole: 100 Blister Pack In 1 Carton (0904-6500-61) / 1 Tablet In 1 Blister Pack,4.2,1.68,,,0 NDC,00904650106,Fluconazole: 50 Blister Pack In 1 Carton (0904-6501-06) / 1 Tablet In 1 Blister Pack,5.3,2.12,,,0 NDC,00904650161,Fluconazole: 100 Blister Pack In 1 Carton (0904-6501-61) / 1 Tablet In 1 Blister Pack,6.12,2.45,,,0 NDC,00904650261,Celecoxib: 100 Blister Pack In 1 Carton (0904-6502-61) / 1 Capsule In 1 Blister Pack,3.58,1.43,,,0 NDC,00904650361,Celecoxib: 100 Blister Pack In 1 Carton (0904-6503-61) / 1 Capsule In 1 Blister Pack,5.98,2.39,,,0 NDC,00904650561,"Memantine Hydrochloride: 100 Blister Pack In 1 Carton (0904-6505-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.3,0.52,,,0 NDC,00904650606,"Memantine Hydrochloride: 50 Blister Pack In 1 Carton (0904-6506-06) / 1 Tablet, Film Coated In 1 Blister Pack",1.22,0.49,,,0 NDC,00904650661,"Memantine Hydrochloride: 100 Blister Pack In 1 Carton (0904-6506-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.13,0.45,,,0 NDC,00904650904,Aripiprazole: 30 Blister Pack In 1 Carton (0904-6509-04) / 1 Tablet In 1 Blister Pack,26.2,10.48,,,0 NDC,00904651006,Aripiprazole: 50 Blister Pack In 1 Carton (0904-6510-06) / 1 Tablet In 1 Blister Pack,27.06,10.82,,,0 NDC,00904651061,Aripiprazole: 100 Blister Pack In 1 Carton (0904-6510-61) / 1 Tablet In 1 Blister Pack,54.28,21.71,,,0 NDC,00904651161,Aripiprazole: 100 Blister Pack In 1 Carton (0904-6511-61) / 1 Tablet In 1 Blister Pack,46.7,18.68,,,0 NDC,00904651204,Aripiprazole: 30 Blister Pack In 1 Carton (0904-6512-04) / 1 Tablet In 1 Blister Pack,18.92,7.57,,,0 NDC,00904651961,"Mirtazapine: 100 Blister Pack In 1 Carton (0904-6519-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.33,0.13,,,0 NDC,00904652261,"Senna-Lax: 10 Blister Pack In 1 Box (0904-6522-61) / 10 Tablet, Film Coated In 1 Blister Pack",0.1,0.04,,,0 NDC,00904653061,Methadone Hydrochloride: 100 Blister Pack In 1 Carton (0904-6530-61) / 1 Tablet In 1 Blister Pack,0.74,0.3,,,0 NDC,00904655061,Propranolol Hydrochloride: 100 Blister Pack In 1 Carton (0904-6550-61) / 1 Tablet In 1 Blister Pack,0.68,0.27,,,0 NDC,00904655161,"Ondansetron: 100 Blister Pack In 1 Carton (0904-6551-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.49,0.6,,,0 NDC,00904655261,"Ondansetron: 100 Blister Pack In 1 Carton (0904-6552-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.68,0.67,,,0 NDC,00904655304,"Linezolid: 30 Blister Pack In 1 Carton (0904-6553-04) / 1 Tablet, Film Coated In 1 Blister Pack",15.04,6.02,,,0 NDC,00904655761,"Morphine Sulfate Extended Release: 100 Blister Pack In 1 Carton (0904-6557-61) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack",2.6,1.04,,,0 NDC,00904655861,"Morphine Sulfate Extended Release: 100 Blister Pack In 1 Carton (0904-6558-61) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack",3.57,1.43,,,0 NDC,00904655961,"Morphine Sulfate Extended Release: 100 Blister Pack In 1 Carton (0904-6559-61) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack",7.56,3.02,,,0 NDC,00904656061,"Morphine Sulfate Extended Release: 100 Blister Pack In 1 Carton (0904-6560-61) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack",9.97,3.99,,,0 NDC,00904656460,Benzonatate: 100 Capsule In 1 Bottle (0904-6564-60),1.51,0.6,,,0 NDC,00904656461,100 BLISTER PACK in 1 CARTON (0904-6564-61) / 1 CAPSULE in 1 BLISTER PACK,0.96,0.38,,,0 NDC,00904656561,"Valacyclovir Hydrochloride: 100 Blister Pack In 1 Carton (0904-6565-61) / 1 Tablet, Film Coated In 1 Blister Pack",5.83,2.33,,,0 NDC,00904657006,"Oxybutynin Chloride: 50 Blister Pack In 1 Carton (0904-6570-06) / 1 Tablet, Extended Release In 1 Blister Pack",6.37,2.55,,,0 NDC,00904657061,"Oxybutynin Chloride: 100 Blister Pack In 1 Carton (0904-6570-61) / 1 Tablet, Extended Release In 1 Blister Pack",6.88,2.75,,,0 NDC,00904657261,Allopurinol: 100 Blister Pack In 1 Carton (0904-6572-61) / 1 Tablet In 1 Blister Pack,1.425,0.5700000000000001,,,0 NDC,00904657561,Phenobarbital: 100 Blister Pack In 1 Carton (0904-6575-61) / 1 Tablet In 1 Blister Pack,0.85,0.34,,,0 NDC,00904659604,"Voriconazole: 30 Blister Pack In 1 Carton (0904-6596-04) / 1 Tablet, Film Coated In 1 Blister Pack",24.19,9.68,,,0 NDC,00904661561,"Divalproex Sodium: 100 Blister Pack In 1 Carton (0904-6615-61) / 1 Capsule, Delayed Release In 1 Blister Pack",2.14,0.86,,,0 NDC,00904661761,"Hydroxyzine Hydrochloride: 100 Blister Pack In 1 Carton (0904-6617-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.75,0.3,,,0 NDC,00904661961,Isosorbide Dinitrate: 100 Blister Pack In 1 Carton (0904-6619-61) / 1 Tablet In 1 Blister Pack,1.54,0.62,,,0 NDC,00904662061,Isosorbide Dinitrate: 100 Blister Pack In 1 Carton (0904-6620-61) / 1 Tablet In 1 Blister Pack,1.66,0.66,,,0 NDC,00904662261,Pyridostigmine Bromide: 100 Blister Pack In 1 Carton (0904-6622-61) / 1 Tablet In 1 Blister Pack,3.42,1.37,,,0 NDC,00904662361,Tacrolimus: 100 Blister Pack In 1 Carton (0904-6623-61) / 1 Capsule In 1 Blister Pack,4.44,1.78,,,0 NDC,00904662461,Tacrolimus: 100 Blister Pack In 1 Carton (0904-6624-61) / 1 Capsule In 1 Blister Pack,5.33,2.13,,,0 NDC,00904662735,Ear Drops Major: 1 Bottle In 1 Carton (0904-6627-35) / 15 Ml In 1 Bottle,5.67,2.27,,,0 NDC,00904663061,amantadine hydrochloride: 100 BLISTER PACK in 1 CARTON (0904-6630-61) / 1 CAPSULE in 1 BLISTER PACK,4.54,1.82,,,0 NDC,00904663561,"Bupropion Hydrochloride: 100 Blister Pack In 1 Carton (0904-6635-61) / 1 Tablet, Film Coated In 1 Blister Pack",3.92,1.57,,,0 NDC,00904663661,"Bupropion Hydrochloride: 100 Blister Pack In 1 Carton (0904-6636-61) / 1 Tablet, Film Coated In 1 Blister Pack",4.03,1.61,,,0 NDC,00904663761,Glipizide: 100 Blister Pack In 1 Carton (0904-6637-61) / 1 Tablet In 1 Blister Pack,1.03,0.41,,,0 NDC,00904663861,"Quetiapine: 100 Blister Pack In 1 Carton (0904-6638-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.82,0.33,,,0 NDC,00904664061,"Quetiapine: 100 Blister Pack In 1 Carton (0904-6640-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.29,0.52,,,0 NDC,00904664161,"Quetiapine: 100 Blister Pack In 1 Carton (0904-6641-61) / 1 Tablet, Film Coated In 1 Blister Pack",2.78,1.11,,,0 NDC,00904664524,"Childrens Mapap: 4 Blister Pack In 1 Carton (0904-6645-24) / 6 Tablet, Chewable In 1 Blister Pack",0.23,0.09,,,0 NDC,00904666561,Gabapentin: 100 Blister Pack In 1 Carton (0904-6665-61) / 1 Capsule In 1 Blister Pack,0.34,0.14,,,0 NDC,00904666661,Gabapentin: 100 Blister Pack In 1 Carton (0904-6666-61) / 1 Capsule In 1 Blister Pack,0.43,0.17,,,0 NDC,00904666761,Gabapentin: 100 Blister Pack In 1 Carton (0904-6667-61) / 1 Capsule In 1 Blister Pack,0.5,0.2,,,0 NDC,00904667104,"Sildenafil: 30 Blister Pack In 1 Carton (0904-6671-04) / 1 Tablet, Film Coated In 1 Blister Pack",2.55,1.02,,,0 NDC,00904667106,"Sildenafil: 50 Blister Pack In 1 Carton (0904-6671-06) / 1 Tablet, Film Coated In 1 Blister Pack",2.32,0.93,,,0 NDC,00904668108,Dofetilide: 40 Blister Pack In 1 Carton (0904-6681-08) / 1 Capsule In 1 Blister Pack,19.2,7.68,,,0 NDC,00904668208,Dofetilide: 40 Blister Pack In 1 Carton (0904-6682-08) / 1 Capsule In 1 Blister Pack,19.42,7.77,,,0 NDC,00904668961,Metformin hydrochloride: 100 BLISTER PACK in 1 CARTON (0904-6689-61) / 1 TABLET in 1 BLISTER PACK,0.23,0.09,,,0 NDC,00904670310,Leucovorin Calcium: 20 Blister Pack In 1 Carton (0904-6703-10) / 1 Tablet In 1 Blister Pack,28.23,11.29,,,0 NDC,00904670461,Pramipexole Dihydrochloride: 100 Blister Pack In 1 Carton (0904-6704-61) / 1 Tablet In 1 Blister Pack,0.87,0.35,,,0 NDC,00904670506,Propranolol Hydrochloride: 50 Blister Pack In 1 Carton (0904-6705-06) / 1 Tablet In 1 Blister Pack,1.5,0.6,,,0 NDC,00904670561,Propranolol Hydrochloride: 100 Blister Pack In 1 Carton (0904-6705-61) / 1 Tablet In 1 Blister Pack,1.33,0.53,,,0 NDC,00904670706,"Sevelamer Carbonate: 50 Blister Pack In 1 Carton (0904-6707-06) / 1 Tablet, Film Coated In 1 Blister Pack",0.8,0.32,,,0 NDC,00904670806,azithromycin monohydrate: 5 BLISTER PACK in 1 CARTON (0904-6708-06) / 10 TABLET in 1 BLISTER PACK,2.6,1.04,,,0 NDC,00904670861,azithromycin monohydrate: 10 BLISTER PACK in 1 CARTON (0904-6708-61) / 10 TABLET in 1 BLISTER PACK,3.96,1.58,,,0 NDC,00904670961,Glycopyrrolate: 100 Blister Pack In 1 Carton (0904-6709-61) / 1 Tablet In 1 Blister Pack,2.74,1.1,,,0 NDC,00904671761,"Cetirizine: 100 Blister Pack In 1 Carton (0904-6717-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.36,0.14,,,0 NDC,00904671839,"Mucus Relief Er: 100 Blister Pack In 1 Carton (0904-6718-39) / 1 Tablet, Extended Release In 1 Blister Pack",2.65,1.06,,,0 NDC,00904672040,Acetaminophen: 500 Tablet In 1 Bottle (0904-6720-40),0.03,0.01,,,0 NDC,00904672059,Acetaminophen: 1 Bottle In 1 Carton (0904-6720-59) / 100 Tablet In 1 Bottle,0.06,0.02,,,0 NDC,00904672080,Acetaminophen: 1000 Tablet In 1 Bottle (0904-6720-80),0.06,0.02,,,0 NDC,00904673060,Acetaminophen: 100 Tablet In 1 Bottle (0904-6730-60),0.08,0.03,,,0 NDC,00904673061,"Acetaminophen: 10 Blister Pack In 1 Box, Unit-Dose (0904-6730-61) / 10 Tablet In 1 Blister Pack",0.12,0.05,,,0 NDC,00904673080,Acetaminophen: 1000 Tablet In 1 Bottle (0904-6730-80),0.06,0.02,,,0 NDC,00904674561,DRONABINOL: 100 BLISTER PACK in 1 CARTON (0904-6745-61) / 1 CAPSULE in 1 BLISTER PACK,14.41,5.76,,,0 NDC,00904676130,"Nasal Decongestant: 1 Bottle, Spray In 1 Carton (0904-6761-30) / 30 Ml In 1 Bottle, Spray",4.19,1.68,,,0 NDC,00904676520,Childrens Cetirizine Hydrochloride: 1 Bottle In 1 Carton (0904-6765-20) / 118 Ml In 1 Bottle,0.33,0.13,,,0 NDC,00904677361,"Acetaminophen: 10 Blister Pack In 1 Box, Unit-Dose (0904-6773-61) / 10 Tablet In 1 Blister Pack",0.16,0.06,,,0 NDC,00904677861,"Rosuvastatin Calcium: 100 Blister Pack In 1 Carton (0904-6778-61) / 1 Tablet, Coated In 1 Blister Pack",3.01,1.2,,,0 NDC,00904678061,"Rosuvastatin Calcium: 100 Blister Pack In 1 Carton (0904-6780-61) / 1 Tablet, Coated In 1 Blister Pack",4.11,1.64,,,0 NDC,00904678261,Haloperidol: 100 Blister Pack In 1 Carton (0904-6782-61) / 1 Tablet In 1 Blister Pack,2.28,0.91,,,0 NDC,00904678504,"Mycophenolic Acid: 30 Blister Pack In 1 Carton (0904-6785-04) / 1 Tablet, Delayed Release In 1 Blister Pack",12.54,5.02,,,0 NDC,00904678861,Benztropine Mesylate: 100 BLISTER PACK in 1 CARTON (0904-6788-61) / 1 TABLET in 1 BLISTER PACK,1.39,0.56,,,0 NDC,00904679430,"Aspirin Low Dose Chewable Orange: 300 Blister Pack In 1 Carton (0904-6794-30) / 1 Tablet, Chewable In 1 Blister Pack",0.22,0.09,,,0 NDC,00904679480,"Aspirin Low Dose Chewable Orange: 1000 Tablet, Chewable In 1 Package (0904-6794-80)",0.02,0.01,,,0 NDC,00904679761,Lisinopril: 100 Blister Pack In 1 Carton (0904-6797-61) / 1 Tablet In 1 Blister Pack,0.17,0.07,,,0 NDC,00904679861,Lisinopril: 100 Blister Pack In 1 Carton (0904-6798-61) / 1 Tablet In 1 Blister Pack,0.16,0.06,,,0 NDC,00904679961,Lisinopril: 100 Blister Pack In 1 Carton (0904-6799-61) / 1 Tablet In 1 Blister Pack,0.21,0.08,,,0 NDC,00904680161,"Quetiapine: 100 Blister Pack In 1 Carton (0904-6801-61) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack",2.26,0.9,,,0 NDC,00904680361,"Quetiapine: 100 Blister Pack In 1 Carton (0904-6803-61) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack",3.3,1.32,,,0 NDC,00904680461,"Quetiapine: 100 Blister Pack In 1 Carton (0904-6804-61) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack",3.25,1.3,,,0 NDC,00904680806,"Montelukast Sodium: 50 Blister Pack In 1 Carton (0904-6808-06) / 1 Tablet, Film Coated In 1 Blister Pack",0.99,0.4,,,0 NDC,00904680861,"Montelukast Sodium: 100 Blister Pack In 1 Carton (0904-6808-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.98,0.39,,,0 NDC,00904681806,Midodrine Hydrochloride: 50 Blister Pack In 1 Carton (0904-6818-06) / 1 Tablet In 1 Blister Pack,1.77,0.71,,,0 NDC,00904681861,Midodrine Hydrochloride: 100 Blister Pack In 1 Carton (0904-6818-61) / 1 Tablet In 1 Blister Pack,5.6,2.24,,,0 NDC,00904682461,Hydrocodone Bitartrate And Acetaminophen: 100 Blister Pack In 1 Carton (0904-6824-61) / 1 Tablet In 1 Blister Pack,1.02,0.41,,,0 NDC,00904682805,NDC Description Not Available,10.15,4.06,,,0 NDC,00904682892,"Oxycodone Hydrochloride: 5 Tray In 1 Carton (0904-6828-92) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (0904-6828-05)",15.4,6.16,,,0 NDC,00904683006,"Finasteride: 50 Blister Pack In 1 Carton (0904-6830-06) / 1 Tablet, Film Coated In 1 Blister Pack",2.02,0.81,,,0 NDC,00904683620,Loperamide Hydrochloride: 120 Ml In 1 Bottle (0904-6836-20),3.72,1.49,,,0 NDC,00904686061,"Divalproex Sodium: 100 Blister Pack In 1 Carton (0904-6860-61) / 1 Tablet, Delayed Release In 1 Blister Pack",0.6,0.24,,,0 NDC,00904686161,"Divalproex Sodium: 100 Blister Pack In 1 Carton (0904-6861-61) / 1 Tablet, Delayed Release In 1 Blister Pack",0.58,0.23,,,0 NDC,00904686190,"Divalproex Sodium: 90 Blister Pack In 1 Carton (0904-6861-90) / 1 Tablet, Delayed Release In 1 Blister Pack",0.95,0.38,,,0 NDC,00904686704,Tretinoin: 30 Blister Pack In 1 Carton (0904-6867-04) / 1 Capsule In 1 Blister Pack,115.0,46.0,,,0 NDC,00904686861,Trazodone Hydrochloride: 100 Blister Pack In 1 Carton (0904-6868-61) / 1 Tablet In 1 Blister Pack,0.35,0.14,,,0 NDC,00904686961,Trazodone Hydrochloride: 100 Blister Pack In 1 Carton (0904-6869-61) / 1 Tablet In 1 Blister Pack,0.53,0.21,,,0 NDC,00904687045,"Pantoprazole Sodium: 80 Blister Pack In 1 Carton (0904-6870-45) / 1 Tablet, Delayed Release In 1 Blister Pack",0.66,0.26,,,0 NDC,00904687204,"Clarithromycin: 30 Blister Pack In 1 Carton (0904-6872-04) / 1 Tablet, Film Coated In 1 Blister Pack",9.73,3.89,,,0 NDC,00904688806,Minocycline Hydrochloride: 50 Blister Pack In 1 Carton (0904-6888-06) / 1 Capsule In 1 Blister Pack,3.42,1.37,,,0 NDC,00904689961,Buspirone Hydrochloride: 100 Blister Pack In 1 Carton (0904-6899-61) / 1 Tablet In 1 Blister Pack,1.47,0.59,,,0 NDC,00904690061,Chlorthalidone: 100 Blister Pack In 1 Carton (0904-6900-61) / 1 Tablet In 1 Blister Pack,6.39,2.56,,,0 NDC,00904690204,"Raloxifene Hydrochloride: 30 Blister Pack In 1 Carton (0904-6902-04) / 1 Tablet, Film Coated In 1 Blister Pack",22.1,8.84,,,0 NDC,00904690706,Pseudoephedrine Hydrochloride: 5 Blister Pack In 1 Box (0904-6907-06) / 10 Tablet In 1 Blister Pack,0.17,0.07,,,0 NDC,00904690804,Atomoxetine: 30 Blister Pack In 1 Carton (0904-6908-04) / 1 Capsule In 1 Blister Pack,18.84,7.54,,,0 NDC,00904691461,Methylprednisolone: 100 Blister Pack In 1 Carton (0904-6914-61) / 1 Tablet In 1 Blister Pack,4.01,1.6,,,0 NDC,00904691761,"Omeprazole: 100 Blister Pack In 1 Carton (0904-6917-61) / 1 Capsule, Delayed Release In 1 Blister Pack",0.42,0.17,,,0 NDC,00904692361,Prednisone: 100 Blister Pack In 1 Carton (0904-6923-61) / 1 Tablet In 1 Blister Pack,0.05,0.02,,,0 NDC,00904692461,"Sertraline Hydrochloride: 100 Blister Pack In 1 Carton (0904-6924-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.98,0.39,,,0 NDC,00904692561,"Sertraline Hydrochloride: 100 Blister Pack In 1 Carton (0904-6925-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.16,0.46,,,0 NDC,00904692761,"Spironolactone: 100 Blister Pack In 1 Carton (0904-6927-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.33,0.13,,,0 NDC,00904692861,"Topiramate: 100 Blister Pack In 1 Carton (0904-6928-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.83,0.33,,,0 NDC,00904692961,"Topiramate: 100 Blister Pack In 1 Carton (0904-6929-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.48,0.59,,,0 NDC,00904693061,"Potassium Chloride: 100 Blister Pack In 1 Carton (0904-6930-61) / 1 Capsule, Coated, Extended Release In 1 Blister Pack",2.76,1.1,,,0 NDC,00904693181,Polyethylene Glycol 3350: 100 Packet In 1 Carton (0904-6931-81) / 17 G In 1 Packet,2.165,0.865,,,0 NDC,00904693186,Polyethylene Glycol 3350: 17 G In 1 Packet (0904-6931-86),4.18,1.67,,,0 NDC,00904693806,"Butalbital, Acetaminophen, And Caffeine: 50 Blister Pack In 1 Carton (0904-6938-06) / 1 Tablet In 1 Blister Pack",5.44,2.18,,,0 NDC,00904693961,Hydroxyurea: 100 Blister Pack In 1 Carton (0904-6939-61) / 1 Capsule In 1 Blister Pack,2.375,0.95,,,0 NDC,00904694961,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (0904-6949-61) / 1 Tablet In 1 Blister Pack,1.34,0.54,,,0 NDC,00904695061,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (0904-6950-61) / 1 Tablet In 1 Blister Pack,1.35,0.54,,,0 NDC,00904695161,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (0904-6951-61) / 1 Tablet In 1 Blister Pack,1.7,0.68,,,0 NDC,00904695261,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (0904-6952-61) / 1 Tablet In 1 Blister Pack,1.75,0.7,,,0 NDC,00904695361,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (0904-6953-61) / 1 Tablet In 1 Blister Pack,1.74,0.7,,,0 NDC,00904695461,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (0904-6954-61) / 1 Tablet In 1 Blister Pack,2.04,0.82,,,0 NDC,00904695561,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (0904-6955-61) / 1 Tablet In 1 Blister Pack,2.05,0.82,,,0 NDC,00904695661,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (0904-6956-61) / 1 Tablet In 1 Blister Pack,2.11,0.84,,,0 NDC,00904695761,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (0904-6957-61) / 1 Tablet In 1 Blister Pack,2.51,1.0,,,0 NDC,00904696661,Oxycodone Hydrochloride: 100 Blister Pack In 1 Carton (0904-6966-61) / 1 Tablet In 1 Blister Pack,0.94,0.38,,,0 NDC,00904698520,"Diphenhydramine Hcl: 118 Ml In 1 Bottle, Plastic (0904-6985-20)",0.25,0.1,,,0 NDC,00904698761,Dicyclomine Hydrochloride: 100 Blister Pack In 1 Carton (0904-6987-61) / 1 Capsule In 1 Blister Pack,1.71,0.68,,,0 NDC,00904698861,Dicyclomine Hydrochloride: 100 Blister Pack In 1 Carton (0904-6988-61) / 1 Tablet In 1 Blister Pack,1.48,0.59,,,0 NDC,00904699061,"Pseudoephedrine Hcl: 10 Blister Pack In 1 Carton (0904-6990-61) / 10 Tablet, Film Coated In 1 Blister Pack",0.11,0.04,,,0 NDC,00904699161,Pregabalin: 100 Blister Pack In 1 Carton (0904-6991-61) / 1 Capsule In 1 Blister Pack,2.31,0.92,,,0 NDC,00904699261,Pregabalin: 100 Blister Pack In 1 Carton (0904-6992-61) / 1 Capsule In 1 Blister Pack,2.28,0.91,,,0 NDC,00904699361,Amiodarone Hydrochloride: 100 Blister Pack In 1 Carton (0904-6993-61) / 1 Tablet In 1 Blister Pack,0.85,0.34,,,0 NDC,00904700061,Pregabalin: 100 Blister Pack In 1 Carton (0904-7000-61) / 1 Capsule In 1 Blister Pack,2.31,0.92,,,0 NDC,00904700161,Pregabalin: 100 Blister Pack In 1 Carton (0904-7001-61) / 1 Capsule In 1 Blister Pack,2.53,1.01,,,0 NDC,00904700761,Lamotrigine: 100 Blister Pack In 1 Carton (0904-7007-61) / 1 Tablet In 1 Blister Pack,0.51,0.2,,,0 NDC,00904700861,Lamotrigine: 100 Blister Pack In 1 Carton (0904-7008-61) / 1 Tablet In 1 Blister Pack,0.4,0.16,,,0 NDC,00904701606,Bumetanide: 50 Blister Pack In 1 Carton (0904-7016-06) / 1 Tablet In 1 Blister Pack,3.05,1.22,,,0 NDC,00904701661,Bumetanide: 100 Blister Pack In 1 Carton (0904-7016-61) / 1 Tablet In 1 Blister Pack,3.52,1.41,,,0 NDC,00904702061,Prazosin Hydrochloride: 100 Blister Pack In 1 Carton (0904-7020-61) / 1 Capsule In 1 Blister Pack,4.06,1.62,,,0 NDC,00904702161,Prazosin Hydrochloride: 100 Blister Pack In 1 Carton (0904-7021-61) / 1 Capsule In 1 Blister Pack,5.62,2.25,,,0 NDC,00904702261,Prazosin Hydrochloride: 100 Blister Pack In 1 Carton (0904-7022-61) / 1 Capsule In 1 Blister Pack,13.36,5.34,,,0 NDC,00904702761,Oxybutynin Chloride: 100 Blister Pack In 1 Carton (0904-7027-61) / 1 Tablet In 1 Blister Pack,1.65,0.66,,,0 NDC,00904703580,Major Oral Rinse: 1500 Ml In 1 Package (0904-7035-80),5.55,2.22,,,0 NDC,00904703588,"Major Oral Rinse: 15 Ml In 1 Cup, Unit-Dose (0904-7035-88)",3.74,1.5,,,0 NDC,00904703604,"Naltrexone Hydrochloride: 30 Blister Pack In 1 Carton (0904-7036-04) / 1 Tablet, Film Coated In 1 Blister Pack",4.23,1.69,,,0 NDC,00904704161,Allopurinol: 100 Blister Pack In 1 Carton (0904-7041-61) / 1 Tablet In 1 Blister Pack,0.95,0.38,,,0 NDC,00904704206,Amantadine Hydrochloride: 50 Blister Pack In 1 Carton (0904-7042-06) / 1 Capsule In 1 Blister Pack,4.21,1.68,,,0 NDC,00904704261,Amantadine Hydrochloride: 100 Blister Pack In 1 Carton (0904-7042-61) / 1 Capsule In 1 Blister Pack,3.87,1.55,,,0 NDC,00904704304,"Duloxetine: 30 Blister Pack In 1 Carton (0904-7043-04) / 1 Capsule, Delayed Release In 1 Blister Pack",4.36,1.74,,,0 NDC,00904704361,"Duloxetine: 100 Blister Pack In 1 Carton (0904-7043-61) / 1 Capsule, Delayed Release In 1 Blister Pack",4.83,1.93,,,0 NDC,00904704461,"Duloxetine: 100 Blister Pack In 1 Carton (0904-7044-61) / 1 Capsule, Delayed Release In 1 Blister Pack",4.31,1.72,,,0 NDC,00904704561,"Duloxetine: 100 Blister Pack In 1 Carton (0904-7045-61) / 1 Capsule, Delayed Release In 1 Blister Pack",4.3,1.72,,,0 NDC,00904704661,"Hydroxychloroquine Sulfate: 100 Blister Pack In 1 Carton (0904-7046-61) / 1 Tablet, Film Coated In 1 Blister Pack",2.53,1.0150000000000001,,,0 NDC,00904704761,"Losartan Potassium: 100 Blister Pack In 1 Carton (0904-7047-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.63,0.65,,,0 NDC,00904704861,"Losartan Potassium: 100 Blister Pack In 1 Carton (0904-7048-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.98,0.79,,,0 NDC,00904705261,Doxepin Hydrochloride: 100 Blister Pack In 1 Carton (0904-7052-61) / 1 Capsule In 1 Blister Pack,1.81,0.72,,,0 NDC,00904705361,Doxepin Hydrochloride: 100 Blister Pack In 1 Carton (0904-7053-61) / 1 Capsule In 1 Blister Pack,2.94,1.18,,,0 NDC,00904705761,Methocarbamol: 100 Blister Pack In 1 Carton (0904-7057-61) / 1 Tablet In 1 Blister Pack,0.68,0.27,,,0 NDC,00904705861,Methocarbamol: 100 Blister Pack In 1 Carton (0904-7058-61) / 1 Tablet In 1 Blister Pack,0.84,0.34,,,0 NDC,00904706441,NDC Description Not Available,58.03,23.21,,,0 NDC,00904706561,Hydroxyzine Pamoate: 100 Blister Pack In 1 Carton (0904-7065-61) / 1 Capsule In 1 Blister Pack,1.43,0.57,,,0 NDC,00904706704,"Cinacalcet: 30 Blister Pack In 1 Carton (0904-7067-04) / 1 Tablet, Film Coated In 1 Blister Pack",103.63,41.45,,,0 NDC,00904707007,Nadolol: 30 Blister Pack In 1 Carton (0904-7070-07) / 1 Tablet In 1 Blister Pack,8.87,3.55,,,0 NDC,00904707107,Nadolol: 30 Blister Pack In 1 Carton (0904-7071-07) / 1 Tablet In 1 Blister Pack,10.84,4.34,,,0 NDC,00904707341,NDC Description Not Available,35.51,14.2,,,0 NDC,00904707393,Ondansetron: 30 Cup In 1 Carton (0904-7073-93) / 5 Ml In 1 Cup (0904-7073-41),37.78,15.11,,,0 NDC,00904707461,Mycophenolate Mofetil: 100 Blister Pack In 1 Carton (0904-7074-61) / 1 Capsule In 1 Blister Pack,1.81,0.72,,,0 NDC,00904707561,"Venlafaxine Hydrochloride: 100 Blister Pack In 1 Carton (0904-7075-61) / 1 Capsule, Extended Release In 1 Blister Pack",1.43,0.57,,,0 NDC,00904707761,"Venlafaxine Hydrochloride: 100 Blister Pack In 1 Carton (0904-7077-61) / 1 Capsule, Extended Release In 1 Blister Pack",1.57,0.63,,,0 NDC,00904708161,"Nifedipine: 100 Blister Pack In 1 Carton (0904-7081-61) / 1 Tablet, Extended Release In 1 Blister Pack",8.79,3.52,,,0 NDC,00904708206,"Nifedipine: 50 Blister Pack In 1 Carton (0904-7082-06) / 1 Tablet, Extended Release In 1 Blister Pack",2.62,1.05,,,0 NDC,00904708361,"Ciprofloxacin: 100 Blister Pack In 1 Carton (0904-7083-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.83,0.33,,,0 NDC,00904708461,"Bupropion Hydrochloride Xl: 100 Blister Pack In 1 Carton (0904-7084-61) / 1 Tablet, Extended Release In 1 Blister Pack",5.55,2.22,,,0 NDC,00904708761,Clozapine: 100 Blister Pack In 1 Carton (0904-7087-61) / 1 Tablet In 1 Blister Pack,2.77,1.11,,,0 NDC,00904708961,Clozapine: 100 Blister Pack In 1 Carton (0904-7089-61) / 1 Tablet In 1 Blister Pack,1.09,0.44,,,0 NDC,00904709761,Tacrolimus: 100 Blister Pack In 1 Carton (0904-7097-61) / 1 Capsule In 1 Blister Pack,4.08,1.63,,,0 NDC,00904710304,Ezetimibe: 30 Blister Pack In 1 Carton (0904-7103-04) / 1 Tablet In 1 Blister Pack,20.07,8.03,,,0 NDC,00904710561,Captopril: 100 Blister Pack In 1 Carton (0904-7105-61) / 1 Tablet In 1 Blister Pack,1.36,0.54,,,0 NDC,00904710661,Captopril: 100 Blister Pack In 1 Carton (0904-7106-61) / 1 Tablet In 1 Blister Pack,3.69,1.48,,,0 NDC,00904710761,Rivastigmine Tartrate: 100 Blister Pack In 1 Carton (0904-7107-61) / 1 Capsule In 1 Blister Pack,9.89,3.96,,,0 NDC,00904711341,NDC Description Not Available,25.19,10.08,,,0 NDC,00904711741,NDC Description Not Available,4.06,1.62,,,0 NDC,00904711793,"Diazepam: 30 Cup, Unit-Dose In 1 Case (0904-7117-93) / 5 Ml In 1 Cup, Unit-Dose (0904-7117-41)",10.63,4.25,,,0 NDC,00904711861,Metoprolol Tartrate: 100 Blister Pack In 1 Carton (0904-7118-61) / 1 Tablet In 1 Blister Pack,0.33,0.13,,,0 NDC,00904711906,Calcium Acetate: 50 Blister Pack In 1 Carton (0904-7119-06) / 1 Capsule In 1 Blister Pack,0.37,0.15,,,0 NDC,00904711961,Calcium Acetate: 100 Blister Pack In 1 Carton (0904-7119-61) / 1 Capsule In 1 Blister Pack,1.66,0.66,,,0 NDC,00904712161,Buspirone Hydrochloride: 100 Blister Pack In 1 Carton (0904-7121-61) / 1 Tablet In 1 Blister Pack,0.51,0.2,,,0 NDC,00904712261,Buspirone Hydrochloride: 100 Blister Pack In 1 Carton (0904-7122-61) / 1 Tablet In 1 Blister Pack,0.38,0.15,,,0 NDC,00904712361,"Levetiracetam: 100 Blister Pack In 1 Carton (0904-7123-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.5,0.2,,,0 NDC,00904712461,"Levetiracetam: 100 Blister Pack In 1 Carton (0904-7124-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.52,0.21,,,0 NDC,00904712661,Metronidazole: 100 Blister Pack In 1 Carton (0904-7126-61) / 1 Tablet In 1 Blister Pack,2.11,0.84,,,0 NDC,00904712761,Prednisone: 100 Blister Pack In 1 Carton (0904-7127-61) / 1 Tablet In 1 Blister Pack,0.03,0.01,,,0 NDC,00904713061,"Chlorpromazine Hydrochloride: 100 Blister Pack In 1 Carton (0904-7130-61) / 1 Tablet, Film Coated In 1 Blister Pack",15.53,6.21,,,0 NDC,00904713261,"Chlorpromazine Hydrochloride: 100 Blister Pack In 1 Carton (0904-7132-61) / 1 Tablet, Film Coated In 1 Blister Pack",35.61,14.24,,,0 NDC,00904713761,Nitrofurantoin Monohydrate/ Macrocrystalline: 100 Blister Pack In 1 Carton (0904-7137-61) / 1 Capsule In 1 Blister Pack,7.05,2.82,,,0 NDC,00904713961,METOLAZONE: 100 BLISTER PACK in 1 CARTON (0904-7139-61) / 1 TABLET in 1 BLISTER PACK,11.18,4.47,,,0 NDC,00904714461,Dronabinol: 100 Blister Pack In 1 Carton (0904-7144-61) / 1 Capsule In 1 Blister Pack,19.02,7.61,,,0 NDC,00904714504,Dronabinol: 30 Blister Pack In 1 Carton (0904-7145-04) / 1 Capsule In 1 Blister Pack,11.14,4.46,,,0 NDC,00904715404,Buprenorphine: 30 Blister Pack In 1 Carton (0904-7154-04) / 1 Tablet In 1 Blister Pack,4.26,1.7,,,0 NDC,00904715504,Buprenorphine: 30 Blister Pack In 1 Carton (0904-7155-04) / 1 Tablet In 1 Blister Pack,9.57,3.83,,,0 NDC,00904715661,Metronidazole: 100 Blister Pack In 1 Carton (0904-7156-61) / 1 Tablet In 1 Blister Pack,1.09,0.44,,,0 NDC,00904716104,Fenofibrate: 30 Blister Pack In 1 Carton (0904-7161-04) / 1 Tablet In 1 Blister Pack,4.44,1.78,,,0 NDC,00904716261,Metformin Hydrochloride: 100 Blister Pack In 1 Carton (0904-7162-61) / 1 Tablet In 1 Blister Pack,0.2,0.08,,,0 NDC,00904716361,Metformin Hydrochloride: 100 Blister Pack In 1 Carton (0904-7163-61) / 1 Tablet In 1 Blister Pack,0.63,0.25,,,0 NDC,00904716806,Ursodiol: 50 Blister Pack In 1 Carton (0904-7168-06) / 1 Capsule In 1 Blister Pack,6.96,2.78,,,0 NDC,00904716861,Ursodiol: 100 Blister Pack In 1 Carton (0904-7168-61) / 1 Capsule In 1 Blister Pack,12.53,5.01,,,0 NDC,00904717207,"Emtricitabine And Tenofovir Disoproxil Fumarate: 30 Blister Pack In 1 Carton (0904-7172-07) / 1 Tablet, Film Coated In 1 Blister Pack",5.86,2.34,,,0 NDC,00904717761,Furosemide: 100 Blister Pack In 1 Carton (0904-7177-61) / 1 Tablet In 1 Blister Pack,0.22,0.09,,,0 NDC,00904717861,Furosemide: 100 Blister Pack In 1 Carton (0904-7178-61) / 1 Tablet In 1 Blister Pack,0.21,0.08,,,0 NDC,00904717961,Tramadol Hydrochloride: 100 Blister Pack In 1 Carton (0904-7179-61) / 1 Tablet In 1 Blister Pack,0.43,0.17,,,0 NDC,00904718245,"Divalproex Sodium: 80 Blister Pack In 1 Carton (0904-7182-45) / 1 Tablet, Extended Release In 1 Blister Pack",7.29,2.92,,,0 NDC,00904718261,"Divalproex Sodium: 100 Blister Pack In 1 Carton (0904-7182-61) / 1 Tablet, Extended Release In 1 Blister Pack",5.38,2.15,,,0 NDC,00904718361,"Docusate Sodium - Stool Softener Laxative: 10 Blister Pack In 1 Carton (0904-7183-61) / 10 Capsule, Liquid Filled In 1 Blister Pack",0.15,0.06,,,0 NDC,00904718461,"Amitriptyline Hydrochloride: 100 Blister Pack In 1 Carton (0904-7184-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.1,0.44,,,0 NDC,00904718561,"Amitriptyline Hydrochloride: 100 Blister Pack In 1 Carton (0904-7185-61) / 10 Tablet, Film Coated In 1 Blister Pack",1.64,0.66,,,0 NDC,00904718761,Atenolol: 100 Blister Pack In 1 Carton (0904-7187-61) / 1 Tablet In 1 Blister Pack,0.53,0.21,,,0 NDC,00904718861,Hydrocortisone: 100 Blister Pack In 1 Carton (0904-7188-61) / 1 Tablet In 1 Blister Pack,4.36,1.74,,,0 NDC,00904719106,NDC Description Not Available,0.43,0.17,,,0 NDC,00904719306,"Famotidine: 50 Blister Pack In 1 Carton (0904-7193-06) / 1 Tablet, Film Coated In 1 Blister Pack",0.38,0.15,,,0 NDC,00904719361,"Famotidine: 100 Blister Pack In 1 Carton (0904-7193-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.19,0.08,,,0 NDC,00904720660,"Antiflatulent: 100 Tablet, Chewable In 1 Bottle (0904-7206-60)",0.05,0.02,,,0 NDC,00904720806,"Nifedipine: 50 Blister Pack In 1 Carton (0904-7208-06) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack",3.29,1.32,,,0 NDC,00904721104,Dantrolene Sodium: 30 Blister Pack In 1 Carton (0904-7211-04) / 1 Capsule In 1 Blister Pack,4.72,1.89,,,0 NDC,00904721461,"Bupropion Hydrochloride Sr: 100 Blister Pack In 1 Carton (0904-7214-61) / 1 Tablet, Extended Release In 1 Blister Pack",1.95,0.78,,,0 NDC,00904721661,"Potassium Chloride: 100 Blister Pack In 1 Carton (0904-7216-61) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack",0.81,0.32,,,0 NDC,00904721761,"Diltiazem Hydrochloride: 100 Blister Pack In 1 Carton (0904-7217-61) / 1 Capsule, Extended Release In 1 Blister Pack",1.33,0.53,,,0 NDC,00904721861,"Diltiazem Hydrochloride: 100 Blister Pack In 1 Carton (0904-7218-61) / 1 Capsule, Extended Release In 1 Blister Pack",1.17,0.47,,,0 NDC,00904721961,"Diltiazem Hydrochloride: 100 Blister Pack In 1 Carton (0904-7219-61) / 1 Capsule, Extended Release In 1 Blister Pack",1.44,0.58,,,0 NDC,00904722461,Folic Acid: 100 Blister Pack In 1 Carton (0904-7224-61) / 1 Tablet In 1 Blister Pack,0.51,0.2,,,0 NDC,00904722761,Clonazepam: 100 Blister Pack In 1 Carton (0904-7227-61) / 1 Tablet In 1 Blister Pack,1.54,0.62,,,0 NDC,00904723661,Megestrol Acetate: 100 Blister Pack In 1 Carton (0904-7236-61) / 1 Tablet In 1 Blister Pack,0.7,0.28,,,0 NDC,00904723961,NDC Description Not Available,0.34,0.14,,,0 NDC,00904724161,Haloperidol: 100 BLISTER PACK in 1 CARTON (0904-7241-61) / 1 TABLET in 1 BLISTER PACK,1.07,0.43,,,0 NDC,00904724361,"Ciprofloxacin: 100 Blister Pack In 1 Carton (0904-7243-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.87,0.35,,,0 NDC,00904724468,"Lacosamide: 60 Blister Pack In 1 Carton (0904-7244-68) / 1 Tablet, Film Coated In 1 Blister Pack",3.69,1.48,,,0 NDC,00904724768,"Lacosamide: 60 Blister Pack In 1 Carton (0904-7247-68) / 1 Tablet, Film Coated In 1 Blister Pack",6.45,2.58,,,0 NDC,00904724804,"Sirolimus: 30 Blister Pack In 1 Carton (0904-7248-04) / 1 Tablet, Film Coated In 1 Blister Pack",29.26,11.7,,,0 NDC,00904725261,"Sennosides: 10 Blister Pack In 1 Box, Unit-Dose (0904-7252-61) / 10 Tablet, Film Coated In 1 Blister Pack",0.13,0.05,,,0 NDC,00904725761,Carbidopa And Levodopa: 100 Blister Pack In 1 Carton (0904-7257-61) / 1 Tablet In 1 Blister Pack,0.65,0.26,,,0 NDC,00904726161,"Sodium Bicarbonate: 10 Blister Pack In 1 Box, Unit-Dose (0904-7261-61) / 10 Tablet In 1 Blister Pack",0.23,0.09,,,0 NDC,00904726261,"Oxcarbazepine: 100 Blister Pack In 1 Carton (0904-7262-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.71,0.68,,,0 NDC,00904726361,"Oxcarbazepine: 100 Blister Pack In 1 Carton (0904-7263-61) / 1 Tablet, Film Coated In 1 Blister Pack",2.51,1.0,,,0 NDC,00904726541,NDC Description Not Available,7.18,2.87,,,0 NDC,00904726661,Dexamethasone: 100 Blister Pack In 1 Carton (0904-7266-61) / 1 Tablet In 1 Blister Pack,0.22,0.09,,,0 NDC,00904726918,"Sucralfate: 4 Tray In 1 Case (0904-7269-18) / 10 Cup, Unit-Dose In 1 Tray / 10 Ml In 1 Cup, Unit-Dose (0904-7269-66)",21.51,8.6,,,0 NDC,00904726966,NDC Description Not Available,21.34,8.54,,,0 NDC,00904727061,"Bupropion Hydrochloride Sr: 100 Blister Pack In 1 Carton (0904-7270-61) / 1 Tablet, Extended Release In 1 Blister Pack",3.0,1.2,,,0 NDC,00904727670,"Nystatin: 10 Tray In 1 Case (0904-7276-70) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (0904-7276-41)",2.04,0.82,,,0 NDC,00904727770,NDC Description Not Available,3.26,1.3,,,0 NDC,00904727966,NDC Description Not Available,3.26,1.3,,,0 NDC,00904728060,"Stool Softener Laxative: 100 Capsule, Liquid Filled In 1 Bottle, Plastic (0904-7280-60)",0.07,0.03,,,0 NDC,00904728361,Torsemide: 100 Blister Pack In 1 Carton (0904-7283-61) / 1 Tablet In 1 Blister Pack,1.14,0.46,,,0 NDC,00904728454,NDC Description Not Available,9.46,3.78,,,0 NDC,00904728861,Benztropine Mesylate: 100 Blister Pack In 1 Carton (0904-7288-61) / 1 Tablet In 1 Blister Pack,1.35,0.54,,,0 NDC,00904728961,Benztropine Mesylate: 100 Blister Pack In 1 Carton (0904-7289-61) / 1 Tablet In 1 Blister Pack,1.25,0.5,,,0 NDC,00904730461,Promethazine Hydrochloride: 100 Blister Pack In 1 Carton (0904-7304-61) / 1 Tablet In 1 Blister Pack,0.23,0.09,,,0 NDC,00904730561,"Carvedilol: 100 Blister Pack In 1 Carton (0904-7305-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.28,0.11,,,0 NDC,00904730661,"Carvedilol: 100 Blister Pack In 1 Carton (0904-7306-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.32,0.13,,,0 NDC,00904730761,"Carvedilol: 100 Blister Pack In 1 Carton (0904-7307-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.24,0.1,,,0 NDC,00904730861,"Carvedilol: 100 Blister Pack In 1 Carton (0904-7308-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.28,0.11,,,0 NDC,00904731761,Fludrocortisone Acetate: 100 Blister Pack In 1 Carton (0904-7317-61) / 1 Tablet In 1 Blister Pack,2.16,0.86,,,0 NDC,00904732562,NDC Description Not Available,10.15,4.06,,,0 NDC,00904732573,"Aluminum Hydroxide, Magnesium Hydroxide And Simethicone Suspension: 10 Tray In 1 Case (0904-7325-73) / 10 Cup, Unit-Dose In 1 Tray / 30 Ml In 1 Cup, Unit-Dose (0904-7325-62)",4.39,1.76,,,0 NDC,00904732961,Metolazone: 100 Blister Pack In 1 Carton (0904-7329-61) / 1 Tablet In 1 Blister Pack,12.11,4.84,,,0 NDC,00904733761,Cephalexin: 100 Blister Pack In 1 Carton (0904-7337-61) / 1 Capsule In 1 Blister Pack,1.38,0.55,,,0 NDC,00904734661,Fluoxetine: 100 Blister Pack In 1 Carton (0904-7346-61) / 1 Capsule In 1 Blister Pack,0.29,0.12,,,0 NDC,00904735006,"Azithromycin: 50 Blister Pack In 1 Carton (0904-7350-06) / 1 Tablet, Film Coated In 1 Blister Pack",3.72,1.49,,,0 NDC,00904735504,"Lurasidone Hydrochloride: 30 Blister Pack In 1 Carton (0904-7355-04) / 1 Tablet, Film Coated In 1 Blister Pack",2.99,1.2,,,0 NDC,00904736161,"Risperidone: 100 Blister Pack In 1 Carton (0904-7361-61) / 1 Tablet, Film Coated In 1 Blister Pack",0.78,0.31,,,0 NDC,00904736361,"Risperidone: 100 Blister Pack In 1 Carton (0904-7363-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.18,0.47,,,0 NDC,00904736461,"Risperidone: 100 Blister Pack In 1 Carton (0904-7364-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.47,0.59,,,0 NDC,00904736604,Aripiprazole: 30 Blister Pack In 1 Carton (0904-7366-04) / 1 Tablet In 1 Blister Pack,25.05,10.02,,,0 NDC,00904736904,Aripiprazole: 30 Blister Pack In 1 Carton (0904-7369-04) / 1 Tablet In 1 Blister Pack,8.92,3.57,,,0 NDC,00904738106,Prochlorperazine Maleate: 50 Blister Pack In 1 Carton (0904-7381-06) / 1 Tablet In 1 Blister Pack,3.79,1.52,,,0 NDC,00904738361,Tamsulosin Hydrochloride: 100 Blister Pack In 1 Carton (0904-7383-61) / 1 Capsule In 1 Blister Pack,1.3,0.52,,,0 NDC,00904739061,Haloperidol: 100 Blister Pack In 1 Carton (0904-7390-61) / 1 Tablet In 1 Blister Pack,1.47,0.59,,,0 NDC,00904740004,"Cyclobenzaprine Hydrochloride: 30 Blister Pack In 1 Carton (0904-7400-04) / 1 Tablet, Film Coated In 1 Blister Pack",1.57,0.63,,,0 NDC,00904741061,Amitriptyline Hydrochloride: 100 Blister Pack In 1 Carton (0904-7410-61) / 1 Tablet In 1 Blister Pack,0.8,0.32,,,0 NDC,00904741161,Amitriptyline Hydrochloride: 100 Blister Pack In 1 Carton (0904-7411-61) / 1 Tablet In 1 Blister Pack,1.75,0.7,,,0 NDC,00904741761,Methadone Hydrochloride: 100 Blister Pack In 1 Carton (0904-7417-61) / 1 Tablet In 1 Blister Pack,0.66,0.26,,,0 NDC,00904741844,"Magnesium Citrate: 296 Ml In 1 Bottle, Plastic (0904-7418-44)",8.67,3.47,,,0 NDC,00904743535,"Major Nasal Decongestant: 1 Bottle, Spray In 1 Carton (0904-7435-35) / 15 Ml In 1 Bottle, Spray",7.64,3.06,,,0 NDC,00904744061,"Sennosides, Docusate Sodium: 10 Blister Pack In 1 Box, Unit-Dose (0904-7440-61) / 10 Tablet, Film Coated In 1 Blister Pack",0.5,0.2,,,0 NDC,00904744261,Clonidine Hydrochloride: 100 Blister Pack In 1 Carton (0904-7442-61) / 1 Tablet In 1 Blister Pack,1.05,0.42,,,0 NDC,00904744761,Hydralazine Hydrochloride: 100 Blister Pack In 1 Carton (0904-7447-61) / 1 Tablet In 1 Blister Pack,0.02,0.01,,,0 NDC,00904744861,Hydralazine Hydrochloride: 100 Blister Pack In 1 Carton (0904-7448-61) / 1 Tablet In 1 Blister Pack,0.72,0.29,,,0 NDC,00904744961,Hydralazine Hydrochloride: 100 Blister Pack In 1 Carton (0904-7449-61) / 1 Tablet In 1 Blister Pack,0.9,0.36,,,0 NDC,00904745161,"Labetalol Hydrochloride: 100 Blister Pack In 1 Carton (0904-7451-61) / 1 Tablet, Film Coated In 1 Blister Pack",1.38,0.55,,,0 NDC,00904745953,"Atovaquone: 7 Tray In 1 Case (0904-7459-53) / 6 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (0904-7459-41)",63.6,25.44,,,0 NDC,00904746188,"Potassium Chloride: 15 Ml In 1 Cup, Unit-Dose (0904-7461-88)",8.0,3.2,,,0 NDC,00904746806,Propranolol Hydrochloride: 50 Blister Pack In 1 Carton (0904-7468-06) / 1 Tablet In 1 Blister Pack,1.27,0.51,,,0 NDC,00904747072,"Sucralfate: 100 Cup, Unit-Dose In 1 Case (0904-7470-72) / 10 Ml In 1 Cup, Unit-Dose (0904-7470-66)",23.42,9.37,,,0 NDC,00904749661,"Tramadol Hydrochloride: 100 Blister Pack In 1 Carton (0904-7496-61) / 1 Tablet, Coated In 1 Blister Pack",0.44,0.18,,,0 NDC,00904750161,Carbidopa And Levodopa: 100 Blister Pack In 1 Carton (0904-7501-61) / 1 Tablet In 1 Blister Pack,0.86,0.34,,,0 NDC,00904772512,"Anti Diarrheal: 12 Blister Pack In 1 Carton (0904-7725-12) / 1 Tablet, Film Coated In 1 Blister Pack",0.29,0.12,,,0 NDC,00904772524,"Anti Diarrheal: 24 Blister Pack In 1 Carton (0904-7725-24) / 1 Tablet, Film Coated In 1 Blister Pack",0.37,0.15,,,0 NDC,00904772861,Clonazepam: 100 Blister Pack In 1 Carton (0904-7728-61) / 1 Tablet In 1 Blister Pack,1.055,0.425,,,0 NDC,00904773445,"Miconazole 7: 1 Tube, With Applicator In 1 Carton (0904-7734-45) / 45 G In 1 Tube, With Applicator",9.45,3.78,,,0 NDC,00904775127,NDC Description Not Available,9.82,3.93,,,0 NDC,00904782231,Major Clotrimazole: 1 Tube In 1 Carton (0904-7822-31) / 28.35 G In 1 Tube,7.31,2.92,,,0 NDC,00904791259,"Ibuprofen: 1 Bottle In 1 Carton (0904-7912-59) / 100 Tablet, Film Coated In 1 Bottle",0.03,0.01,,,0 NDC,00904791459,"Ibuprofen: 1 Bottle, Plastic In 1 Carton (0904-7914-59) / 100 Tablet, Film Coated In 1 Bottle, Plastic",0.08,0.03,,,0 NDC,00904791461,"Ibuprofen: 10 Blister Pack In 1 Carton (0904-7914-61) / 10 Tablet, Film Coated In 1 Blister Pack",0.2,0.08,,,0 NDC,00904880567,Major Triple Antibiotic: 144 Packet In 1 Carton (0904-8805-67) / .9 G In 1 Packet,0.4,0.16,,,0 NDC,00906990441,NDC Description Not Available,1.82,0.73,,,0 NDC,00924540101,First Aid Only Ammonia Inhalants: 10 Ampule In 1 Carton (0924-5401-01) / .3 Ml In 1 Ampule,1.75,0.7,,,0 NDC,00942064104,Acd-A: 1000 Ml In 1 Bag (0942-0641-04),43.96,17.58,,,0 NDC,00942950410,"Sodium Citrate Blood-Pack Units, (Pl 146 Plastic): 500 Ml In 1 Bag (0942-9504-10)",0.44,0.18,,,0 NDC,00942950510,"Sodium Citrate Blood-Pack Units, (Pl 146 Plastic): 250 Ml In 1 Bag (0942-9505-10)",0.03,0.01,,,0 NDC,00942950625,"Sodium Citrate Blood-Pack Units, (Pl 146 Plastic): 250 Ml In 1 Bag (0942-9506-25)",0.93,0.37,,,0 NDC,00944049301,Flexbumin: 12 Bag In 1 Carton (0944-0493-01) / 50 Ml In 1 Bag (0944-0493-03),249.11,99.64,,,0 NDC,00944049303,NDC Description Not Available,261.53,104.61,,,0 NDC,00944049505,Flexbumin: 2 Bag In 1 Carton (0944-0495-05) / 250 Ml In 1 Bag (0944-0495-06),50.99,20.4,,,0 NDC,00944049506,NDC Description Not Available,83.26,33.3,,,0 NDC,00944270002,"Gammagard Liquid: 1 Bottle, Glass In 1 Carton (0944-2700-02) / 10 Ml In 1 Bottle, Glass (0944-2700-08)",172.32,68.93,,,0 NDC,00944270004,"Gammagard Liquid: 1 Bottle, Glass In 1 Carton (0944-2700-04) / 50 Ml In 1 Bottle, Glass (0944-2700-10)",387.73,155.09,,,0 NDC,00944270005,"Gammagard Liquid: 1 Bottle, Glass In 1 Carton (0944-2700-05) / 100 Ml In 1 Bottle, Glass (0944-2700-11)",388.18,155.27,,,0 NDC,00944270006,"Gammagard Liquid: 1 Bottle, Glass In 1 Carton (0944-2700-06) / 200 Ml In 1 Bottle, Glass (0944-2700-12)",387.85,155.14,,,0 NDC,00944270007,"Gammagard Liquid: 1 Bottle, Glass In 1 Carton (0944-2700-07) / 300 Ml In 1 Bottle, Glass (0944-2700-13)",384.14,153.66,,,0 NDC,00944270008,NDC Description Not Available,384.04,153.62,,,0 NDC,00944270010,NDC Description Not Available,384.7,153.88,,,0 NDC,00944270011,NDC Description Not Available,386.23,154.49,,,0 NDC,00944270012,NDC Description Not Available,387.6,155.04,,,0 NDC,00944270013,NDC Description Not Available,384.21,153.68,,,0 NDC,00955100401,NDC Description Not Available,9.13,3.65,,,0 NDC,00955101001,NDC Description Not Available,9.14,3.66,,,0 NDC,00955101201,NDC Description Not Available,9.14,3.66,,,0 NDC,00955105027,"Sevelamer Carbonate: 270 Tablet, Film Coated In 1 Bottle (0955-1050-27)",1.63,0.65,,,0 NDC,00955172901,"Insulin Glargine: 1 Vial, Glass In 1 Carton (0955-1729-01) / 10 Ml In 1 Vial, Glass",1.49,0.6,,,0 NDC,00990707426,Potassium Chloride: 24 Pouch In 1 Case (0990-7074-26) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,4.48,1.79,,,0 NDC,00990707714,Potassium Chloride: 24 Pouch In 1 Case (0990-7077-14) / 1 Bag In 1 Pouch / 50 Ml In 1 Bag,2.22,0.89,,,0 NDC,00990711509,Potassium Chloride In Sodium Chloride: 12 Pouch In 1 Case (0990-7115-09) / 1 Bag In 1 Pouch / 1000 Ml In 1 Bag,32.2,12.88,,,0 NDC,00990771503,Mannitol: 12 Pouch In 1 Case (0990-7715-03) / 1 Bag In 1 Pouch / 500 Ml In 1 Bag (0990-7715-13),55.06,22.02,,,0 NDC,00990771513,NDC Description Not Available,56.46,22.58,,,0 NDC,00990792203,Dextrose: 24 Pouch In 1 Case (0990-7922-03) / 1 Bag In 1 Pouch / 500 Ml In 1 Bag,1.11,0.44,,,0 NDC,00990792209,Dextrose: 12 Pouch In 1 Case (0990-7922-09) / 1 Bag In 1 Pouch / 1000 Ml In 1 Bag,21.21,8.48,,,0 NDC,00990792403,Dextrose And Sodium Chloride: 24 Pouch In 1 Case (0990-7924-03) / 1 Bag In 1 Pouch / 500 Ml In 1 Bag,14.3,5.72,,,0 NDC,00990793519,Dextrose: 12 Pouch In 1 Case (0990-7935-19) / 1 Bag In 1 Pouch / 500 Ml In 1 Bag,31.12,12.445,,,0 NDC,00990798302,Sodium Chloride: 24 Pouch In 1 Case (0990-7983-02) / 1 Bag In 1 Pouch / 250 Ml In 1 Bag,24.15,9.66,,,0 NDC,00990798303,Sodium Chloride: 24 Pouch In 1 Case (0990-7983-03) / 1 Bag In 1 Pouch / 500 Ml In 1 Bag,25.18,10.07,,,0 NDC,00990798309,Sodium Chloride: 12 Pouch In 1 Case (0990-7983-09) / 1 Bag In 1 Pouch / 1000 Ml In 1 Bag,13.305,5.32,,,0 NDC,00990798436,Sodium Chloride: 20 Pouch In 1 Case (0990-7984-36) / 4 Bag In 1 Pouch / 50 Ml In 1 Bag,6.0,2.4,,,0 NDC,00990798509,Sodium Chloride: 12 Pouch In 1 Case (0990-7985-09) / 1 Bag In 1 Pouch / 1000 Ml In 1 Bag,22.0,8.8,,,0 NDC,00990799009,Sterile Water: 12 Pouch In 1 Case (0990-7990-09) / 1 Bag In 1 Pouch / 1000 Ml In 1 Bag,12.98,5.19,,,0 NDC,00998061505,"Maxidex: 5 mL in 1 BOTTLE, PLASTIC (0998-0615-05)",38.43,15.37,,,0 NDC,01490003908,NDC Description Not Available,0.99,0.4,,,0 NDC,01490003916,NDC Description Not Available,0.04,0.02,,,0 NDC,05730051315,NDC Description Not Available,1.71,0.68,,,0 NDC,08065 0,NDC Description Not Available,955.88,382.35,,,0 NDC,08290 0,NDC Description Not Available,1.4,0.56,,,0 NDC,09978 0,NDC Description Not Available,4781.25,1912.5,,,0 NDC,09999000091,NDC Description Not Available,0.08,0.03,,,0 NDC,09999001503,NDC Description Not Available,90.51,36.2,,,0 NDC,09999001802,NDC Description Not Available,0.32,0.13,,,0 NDC,09999172694,NDC Description Not Available,51.09,20.44,,,0 NDC,09999200108,NDC Description Not Available,591.0,236.4,,,0 NDC,09999200111,NDC Description Not Available,9.54,3.82,,,0 NDC,09999200501,NDC Description Not Available,0.6,0.24,,,0 NDC,09999210001,NDC Description Not Available,4.02,1.61,,,0 NDC,09999400567,NDC Description Not Available,206.1,82.44,,,0 NDC,09999408302,NDC Description Not Available,0.09,0.04,,,0 NDC,09999408315,NDC Description Not Available,4.43,1.77,,,0 NDC,09999408340,NDC Description Not Available,6.39,2.56,,,0 NDC,09999409171,NDC Description Not Available,44.375,17.75,,,0 NDC,09999409261,NDC Description Not Available,1.57,0.63,,,0 NDC,09999409468,NDC Description Not Available,123.74,49.5,,,0 NDC,09999483022,NDC Description Not Available,0.48,0.19,,,0 NDC,09999505004,NDC Description Not Available,3.96,1.58,,,0 NDC,09999505005,NDC Description Not Available,0.35,0.14,,,0 NDC,09999505006,NDC Description Not Available,0.10500000000000001,0.045,,,0 NDC,09999505007,NDC Description Not Available,0.14,0.06,,,0 NDC,09999555501,NDC Description Not Available,26.28,10.51,,,0 NDC,09999700011,NDC Description Not Available,126.04,50.42,,,0 NDC,09999700032,NDC Description Not Available,67481.25,26992.5,,,0 NDC,09999700074,NDC Description Not Available,70533.75,28213.5,,,0 NDC,09999701350,NDC Description Not Available,27.6,11.04,,,0 NDC,09999708815,NDC Description Not Available,33.1,13.24,,,0 NDC,09999727064,NDC Description Not Available,536.62,214.65,,,0 NDC,10006070013,NDC Description Not Available,0.24,0.1,,,0 NDC,10006070028,NDC Description Not Available,0.22,0.09,,,0 NDC,10006070038,NDC Description Not Available,0.14,0.06,,,0 NDC,10019007587,Brevibloc: 10 Bag In 1 Carton (10019-075-87) / 100 Ml In 1 Bag,11.31,4.52,,,0 NDC,10019012039,NDC Description Not Available,5.36,2.14,,,0 NDC,10019055304,Transderm Scop: 24 Pouch In 1 Box (10019-553-04) / 1 Patch In 1 Pouch / 3 D In 1 Patch,63.89,25.56,,,0 NDC,10019055390,Transderm Scop: 1 Patch In 1 Pouch (10019-553-90) / 3 D In 1 Patch,54.87,21.95,,,0 NDC,10019092602,"Ifosfamide: 1 Vial, Single-Dose In 1 Carton (10019-926-02) / 60 Ml In 1 Vial, Single-Dose (10019-926-16)",139.72,55.89,,,0 NDC,10019092616,NDC Description Not Available,96.03,38.41,,,0 NDC,10019095301,"Mesna: 1 Vial, Multi-Dose In 1 Box (10019-953-01) / 10 Ml In 1 Vial, Multi-Dose (10019-953-62)",22.29,8.92,,,0 NDC,10019095362,NDC Description Not Available,22.29,8.92,,,0 NDC,10019095601,"Cyclophosphamide: 1 Vial, Single-Dose In 1 Carton (10019-956-01) / 50 Ml In 1 Vial, Single-Dose (10019-956-16)",15.07,6.03,,,0 NDC,10019095616,NDC Description Not Available,15.63,6.25,,,0 NDC,10119000252,NDC Description Not Available,9.92,3.97,,,0 NDC,10119002239,NDC Description Not Available,22.02,8.81,,,0 NDC,10122032501,NDC Description Not Available,2.13,0.85,,,0 NDC,10122032510,Cardene IV: 10 CARTON in 1 BOX (10122-325-10) / 1 BAG in 1 CARTON (10122-325-01) / 200 mL in 1 BAG,2.13,0.85,,,0 NDC,10122051001,"Curosurf: 1.5 Ml In 1 Vial, Glass (10122-510-01)",2292.12,916.85,,,0 NDC,10122061001,NDC Description Not Available,2.39,0.96,,,0 NDC,10122061101,NDC Description Not Available,357.93,143.17499999999998,,,0 NDC,10122061110,"Cleviprex: 10 Carton In 1 Carton (10122-611-10) / 1 Vial, Single-Use In 1 Carton (10122-611-01) / 100 Ml In 1 Vial, Single-Use",722.66,289.06,,,0 NDC,10122062001,NDC Description Not Available,82.03,32.81,,,0 NDC,10122062010,"Kengreal: 10 Vial, Single-Use In 1 Carton (10122-620-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Use (10122-620-01)",86.63,34.65,,,0 NDC,10147015001,Itraconazole: 150 Ml In 1 Bottle (10147-0150-1),164.96,65.98,,,0 NDC,10147092205,Haloperidol Decanoate: 5 Ampule In 1 Box (10147-0922-5) / 1 Ml In 1 Ampule,75.42,30.17,,,0 NDC,10223020104,"Cetacaine Anesthetic: 1 Bottle, Glass In 1 Box (10223-0201-4) / 5 G In 1 Bottle, Glass",249.73,99.89,,,0 NDC,10361079301,E-Z-Gas Ii: 50 Pouch In 1 Box (10361-793-01) / 4 G In 1 Pouch,8.41,3.36,,,0 NDC,10454071110,"Myobloc: 1 Vial, Single-Use In 1 Carton (10454-711-10) / 1 Ml In 1 Vial, Single-Use",55.52,22.21,,,0 NDC,10454071210,"Myobloc: 1 Vial, Single-Use In 1 Carton (10454-712-10) / 2 Ml In 1 Vial, Single-Use",54.79,21.92,,,0 NDC,10702000601,"Cyclobenzaprine Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (10702-006-01)",0.21,0.08,,,0 NDC,10702005601,Oxycodone Hydrochloride: 100 Tablet In 1 Bottle (10702-056-01),0.7,0.28,,,0 NDC,10702005650,Oxycodone Hydrochloride: 500 Tablet In 1 Bottle (10702-056-50),0.73,0.29,,,0 NDC,10702023701,Ursodiol: 100 Capsule In 1 Bottle (10702-237-01),3.41,1.36,,,0 NDC,10956061801,"Pinworm: 30 mL in 1 BOTTLE, PLASTIC (10956-618-01)",2.16,0.86,,,0 NDC,11523720401,A And D First Aid: 1 Tube In 1 Carton (11523-7204-1) / 42.5 G In 1 Tube,6.72,2.69,,,0 NDC,11534016644,Sodium Polystyrene Sulfonate: 454 G In 1 Jar (11534-166-44),2.84,1.14,,,0 NDC,11701004814,Baza Clear: 142 G In 1 Tube (11701-048-14),11.36,4.54,,,0 NDC,11701006723,Critic Aid Clear Af: 57 G In 1 Tube (11701-067-23),24.0,9.6,,,0 NDC,11701008333,Critic-Aid Clear: 71 G In 1 Tube (11701-083-33),19.35,7.74,,,0 NDC,11704037001,"Cyanokit: 1 VIAL, GLASS in 1 CARTON (11704-370-01) / 250 mL in 1 VIAL, GLASS",19.09,7.64,,,0 NDC,11845007791,NDC Description Not Available,0.19,0.08,,,0 NDC,11845009151,NDC Description Not Available,0.11,0.04,,,0 NDC,11845071401,NDC Description Not Available,0.18,0.07,,,0 NDC,11980017410,"Pred Mild: 1 Bottle, Dropper In 1 Carton (11980-174-10) / 10 Ml In 1 Bottle, Dropper",983.11,393.24,,,0 NDC,11994000602,"Neurolite: 2 Kit In 1 Package, Combination (11994-006-02) / 1 Kit In 1 Kit * 1 Injection In 1 Vial (11994-002-01) * 1 Ml In 1 Vial (11994-004-01)",7283.44,2913.38,,,0 NDC,11994001104,"Definity: 4 Vial, Glass In 1 Carton (11994-011-04) / 1.5 Ml In 1 Vial, Glass",1132.19,452.88,,,0 NDC,11994001116,"Definity: 16 Vial, Glass In 1 Carton (11994-011-16) / 1.5 Ml In 1 Vial, Glass",727.23,290.89,,,0 NDC,11994009103,Technelite: 1 Vial In 1 Carton (11994-091-03) / 16 Ml In 1 Vial,2.0,0.8,,,0 NDC,12165010001,Grafco Applicator 15 Cm: 100 Stick In 1 Tube (12165-100-01),1.04,0.42,,,0 NDC,12496030001,Sublocade: 1 Pouch In 1 Carton (12496-0300-1) / 1 Syringe In 1 Pouch (12496-0300-2) / 1 Solution In 1 Syringe (12496-0300-5),335.73,134.29,,,0 NDC,12547049380,NDC Description Not Available,12.6,5.04,,,0 NDC,12870000101,Silver Nitrate Applicators: 10 Packet In 1 Box (12870-0001-1) / 10 Applicator In 1 Packet / 100 Mg In 1 Applicator,2.97,1.19,,,0 NDC,12870000102,Silver Nitrate Applicators: 100 Applicator In 1 Vial (12870-0001-2) / 100 Mg In 1 Applicator,2.73,1.09,,,0 NDC,13107003134,"Mirtazapine: 30 Tablet, Film Coated In 1 Bottle (13107-031-34)",0.22,0.09,,,0 NDC,13107008401,Lorazepam: 100 Tablet In 1 Bottle (13107-084-01),0.15,0.06,,,0 NDC,13107008405,Lorazepam: 500 Tablet In 1 Bottle (13107-084-05),0.22,0.09,,,0 NDC,13107031901,Clorazepate Dipotassium: 100 Tablet In 1 Bottle (13107-319-01),3.63,1.45,,,0 NDC,13517010716,"Phenobarbital: 473 Ml In 1 Bottle, Plastic (13517-107-16)",2.69,1.08,,,0 NDC,13533031801,Hyperrab: 1 Vial In 1 Carton (13533-318-01) / 1 Ml In 1 Vial (13533-318-10),1878.61,751.44,,,0 NDC,13533031805,Hyperrab: 1 Vial In 1 Carton (13533-318-05) / 5 Ml In 1 Vial (13533-318-50),1924.27,769.71,,,0 NDC,13533031810,NDC Description Not Available,1682.02,672.81,,,0 NDC,13533031850,NDC Description Not Available,1682.84,673.14,,,0 NDC,13533060250,"Thrombate Iii: 1 Kit In 1 Carton (13533-602-50) * 10 Ml In 1 Vial, Glass (13533-605-21) * 10 Ml In 1 Vial, Glass (13533-200-10)",19.04,7.62,,,0 NDC,13533060612,"Thrombate Iii: 1 Kit In 1 Carton (13533-606-12) * 10 Ml In 1 Vial, Glass (13533-605-21) * 10 Ml In 1 Vial, Glass (76297-002-12)",19.31,7.72,,,0 NDC,13533063402,"Hypertet: 1 Syringe, Glass In 1 Box (13533-634-02) / 1 Ml In 1 Syringe, Glass (13533-634-20)",2856.35,1142.54,,,0 NDC,13533063420,NDC Description Not Available,2773.12,1109.25,,,0 NDC,13533080012,"Gamunex-C: 1 Vial, Glass In 1 Carton (13533-800-12) / 10 Ml In 1 Vial, Glass (13533-800-13)",311.19,124.48,,,0 NDC,13533080013,NDC Description Not Available,316.63,126.65,,,0 NDC,13533080020,"Gamunex-C: 1 Vial, Glass In 1 Carton (13533-800-20) / 50 Ml In 1 Vial, Glass (13533-800-21)",395.44,158.18,,,0 NDC,13533080021,NDC Description Not Available,397.44,158.98,,,0 NDC,13533080024,"Gamunex-C: 1 Vial, Glass In 1 Carton (13533-800-24) / 200 Ml In 1 Vial, Glass (13533-800-25)",395.55,158.22,,,0 NDC,13533080025,NDC Description Not Available,372.34,148.94,,,0 NDC,13533080040,"Gamunex-C: 1 Vial, Glass In 1 Carton (13533-800-40) / 400 Ml In 1 Vial, Glass (13533-800-41)",398.14,159.26,,,0 NDC,13533080041,NDC Description Not Available,408.04,163.22,,,0 NDC,13533080071,"Gamunex-C: 1 Vial, Glass In 1 Carton (13533-800-71) / 100 Ml In 1 Vial, Glass (13533-800-72)",398.06,159.22,,,0 NDC,13533080072,NDC Description Not Available,392.89,157.16,,,0 NDC,13668000701,Zolpidem Tartrate: 100 Tablet In 1 Bottle (13668-007-01),0.27,0.11,,,0 NDC,13668001001,"Citalopram: 100 Tablet, Film Coated In 1 Bottle (13668-010-01)",0.14,0.06,,,0 NDC,13668009490,Pramipexole Dihydrochloride: 90 Tablet In 1 Bottle (13668-094-90),0.44,0.18,,,0 NDC,13668010290,"Donepezil Hydrochloride: 90 Tablet, Film Coated In 1 Bottle (13668-102-90)",0.66,0.26,,,0 NDC,13668013301,"Felodipine: 100 Tablet, Extended Release In 1 Bottle (13668-133-01)",1.16,0.46,,,0 NDC,13668013401,"Felodipine: 100 Tablet, Extended Release In 1 Bottle (13668-134-01)",2.08,0.83,,,0 NDC,13668013701,"Escitalopram: 100 Tablet, Film Coated In 1 Bottle (13668-137-01)",0.48,0.19,,,0 NDC,13668018590,"Sildenafil: 90 Tablet, Film Coated In 1 Bottle (13668-185-90)",3.03,1.21,,,0 NDC,13668033101,Trazodone Hydrochloride: 100 Tablet In 1 Bottle (13668-331-01),0.38,0.15,,,0 NDC,13668044001,Fenofibrate: 100 Capsule In 1 Bottle (13668-440-01),0.67,0.27,,,0 NDC,13668059180,NDC Description Not Available,20.02,8.01,,,0 NDC,13668059283,NDC Description Not Available,28.02,11.21,,,0 NDC,13668059380,NDC Description Not Available,39.86,15.94,,,0 NDC,13668060630,"Erythromycin: 30 Tablet, Coated In 1 Bottle (13668-606-30)",14.37,5.75,,,0 NDC,13811000710,NDC Description Not Available,0.65,0.26,,,0 NDC,13811070610,"Methylphenidate Hydrochloride: 100 Tablet, Extended Release In 1 Bottle (13811-706-10)",2.21,0.88,,,0 NDC,13811070710,"Methylphenidate Hydrochloride: 100 Tablet, Extended Release In 1 Bottle (13811-707-10)",2.27,0.91,,,0 NDC,13925051510,Pentamidine Isethionate: 10 Vial In 1 Tray (13925-515-10) / 300 Mg In 1 Vial,344.92,137.97,,,0 NDC,13925052201,Pentamidine Isethionate: 1 Vial In 1 Carton (13925-522-01) / 300 Mg In 1 Vial,439.44,175.78,,,0 NDC,14428000944,NDC Description Not Available,3.63,1.45,,,0 NDC,14789001505,"Isoproterenol Hydrochloride: 10 Vial, Single-Dose In 1 Carton (14789-015-05) / 5 Ml In 1 Vial, Single-Dose",3769.81,1507.92,,,0 NDC,14789001507,NDC Description Not Available,500.02,200.01,,,0 NDC,14789010910,Potassium Chloride: 24 Bag In 1 Box (14789-109-10) / 100 Ml In 1 Bag (14789-109-16),35.51,14.2,,,0 NDC,14789010916,NDC Description Not Available,35.51,14.2,,,0 NDC,14789011607,NDC Description Not Available,441.67,176.67,,,0 NDC,14789012107,NDC Description Not Available,21.81,8.72,,,0 NDC,14789012205,Fluorescein: 10 Vial In 1 Carton (14789-122-05) / 5 Ml In 1 Vial (14789-122-07),886.26,354.5,,,0 NDC,14789012705,"Phenobarbital Sodium: 10 Vial, Glass In 1 Carton (14789-127-05) / 1 Ml In 1 Vial, Glass (14789-127-07)",86.05,34.42,,,0 NDC,14789012707,NDC Description Not Available,44.68,17.87,,,0 NDC,14789012807,NDC Description Not Available,100.53,40.21,,,0 NDC,14789013607,NDC Description Not Available,7.13,2.85,,,0 NDC,14789013705,"Potassium Chloride: 25 Vial, Glass In 1 Carton (14789-137-05) / 20 Ml In 1 Vial, Glass (14789-137-07)",4.71,1.88,,,0 NDC,14789013707,NDC Description Not Available,4.62,1.85,,,0 NDC,14789025007,NDC Description Not Available,73.97,29.59,,,0 NDC,14789025010,Emerphed: 10 Vial In 1 Carton (14789-250-10) / 10 Ml In 1 Vial (14789-250-07),18.6,7.44,,,0 NDC,14789090107,NDC Description Not Available,1353.51,541.4,,,0 NDC,15054004301,"Onivyde: 1 Vial, Single-Dose In 1 Carton (15054-0043-1) / 10 Ml In 1 Vial, Single-Dose",303.22,121.29,,,0 NDC,15054050001,"Dysport: 1 Vial In 1 Carton (15054-0500-1) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",38.66,15.46,,,0 NDC,15054053006,"Dysport: 1 Vial In 1 Carton (15054-0530-6) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",38.68,15.47,,,0 NDC,15054112004,Somatuline Depot: 1 Pouch In 1 Carton (15054-1120-4) / 1 Syringe In 1 Pouch / .5 Ml In 1 Syringe,341.36,136.54,,,0 NDC,16500054605,NDC Description Not Available,0.11,0.04,,,0 NDC,16500059918,NDC Description Not Available,0.32,0.13,,,0 NDC,16571010501,Amitriptyline Hydrochloride: 100 Tablet In 1 Bottle (16571-105-01),0.2,0.08,,,0 NDC,16571012706,"Tolterodine Tartrate: 60 Tablet, Film Coated In 1 Bottle (16571-127-06)",1.35,0.54,,,0 NDC,16571012815,NDC Description Not Available,5.87,2.35,,,0 NDC,16571012852,"Chlorhexidine Gluconate Oral Rinse: 100 Cup, Unit-Dose In 1 Box, Unit-Dose (16571-128-52) / 15 Ml In 1 Cup, Unit-Dose (16571-128-15)",5.74,2.3,,,0 NDC,16571040210,Cetirizine Hydrochloride: 100 Tablet In 1 Bottle (16571-402-10),0.17,0.07,,,0 NDC,16571067101,Phenobarbital: 100 Tablet In 1 Bottle (16571-671-01),0.25,0.1,,,0 NDC,16571067301,Phenobarbital: 100 Tablet In 1 Bottle (16571-673-01),0.44,0.18,,,0 NDC,16571067621,Hydrocortisone Acetate: 12 Suppository In 1 Carton (16571-676-21),5.07,2.03,,,0 NDC,16571068309,Clomipramine Hydrochloride: 90 Capsule In 1 Bottle (16571-683-09),1.43,0.57,,,0 NDC,16571072360,Sulfamylon: 1 Tube In 1 Carton (16571-723-60) / 56.7 G In 1 Tube,312.21,124.88,,,0 NDC,16571073521,Methylergonovine Maleate: 12 Tablet In 1 Bottle (16571-735-21),47.09,18.84,,,0 NDC,16571075453,Neomycin And Polymyxin B Sulfates And Bacitracin Zinc: 1 Tube In 1 Carton (16571-754-53) / 3.5 G In 1 Tube,74.16,29.66,,,0 NDC,16571078101,Carisoprodol: 100 Tablet In 1 Bottle (16571-781-01),0.3,0.12,,,0 NDC,16571078812,"Levetiracetam: 120 Tablet, Film Coated In 1 Bottle (16571-788-12)",0.64,0.26,,,0 NDC,16571078850,"Levetiracetam: 500 Tablet, Film Coated In 1 Bottle (16571-788-50)",0.45,0.18,,,0 NDC,16571081741,Temozolomide: 14 Capsule In 1 Bottle (16571-817-41),6.56,2.62,,,0 NDC,16571081841,Temozolomide: 14 Capsule In 1 Bottle (16571-818-41),3.49,1.4,,,0 NDC,16571086209,"Bupropion Hydrochloride: 90 Tablet, Extended Release In 1 Bottle (16571-862-09)",0.72,0.29,,,0 NDC,16729009416,Mycophenolate Mofetil: 500 Capsule In 1 Bottle (16729-094-16),0.6,0.24,,,0 NDC,16729010811,"Mitomycin: 1 Vial In 1 Box, Unit-Dose (16729-108-11) / 40 Ml In 1 Vial",154.83,61.93,,,0 NDC,16729011408,"Etoposide: 1 Vial, Multi-Dose In 1 Box (16729-114-08) / 25 Ml In 1 Vial, Multi-Dose",3.75,1.5,,,0 NDC,16729011411,"Etoposide: 1 Vial, Multi-Dose In 1 Box (16729-114-11) / 50 Ml In 1 Vial, Multi-Dose",5.48,2.19,,,0 NDC,16729011431,"Etoposide: 1 Vial, Multi-Dose In 1 Box (16729-114-31) / 5 Ml In 1 Vial, Multi-Dose",4.41,1.76,,,0 NDC,16729013600,"Clonazepam: 100 Tablet In 1 Bottle, Plastic (16729-136-00)",0.17,0.07,,,0 NDC,16729013700,"Clonazepam: 100 Tablet In 1 Bottle, Plastic (16729-137-00)",0.09,0.04,,,0 NDC,16729021615,"Sertraline Hydrochloride: 90 Tablet, Film Coated In 1 Bottle (16729-216-15)",0.17,0.07,,,0 NDC,16729022501,"Spironolactone: 100 Tablet, Film Coated In 1 Bottle (16729-225-01)",0.24,0.1,,,0 NDC,16729023930,NDC Description Not Available,4.55,1.82,,,0 NDC,16729023993,Dexmedetomidine: 25 Vial In 1 Carton (16729-239-93) / 2 Ml In 1 Vial (16729-239-30),16.26,6.5,,,0 NDC,16729024231,Zoledronic Acid: 1 Vial In 1 Carton (16729-242-31) / 5 Ml In 1 Vial,15.31,6.12,,,0 NDC,16729024331,"Topotecan: 1 Vial, Multi-Dose In 1 Carton (16729-243-31) / 4 Ml In 1 Vial, Multi-Dose",14.36,5.74,,,0 NDC,16729027567,"Bivalirudin: 10 Vial, Single-Use In 1 Carton (16729-275-67) / 5 Ml In 1 Vial, Single-Use (16729-275-03)",0.76,0.3,,,0 NDC,16729027668,Fluorouracil: 10 Vial In 1 Carton (16729-276-68) / 10 Ml In 1 Vial (16729-276-03),55.02,22.01,,,0 NDC,16729027730,Methotrexate: 1 Vial In 1 Carton (16729-277-30) / 2 Ml In 1 Vial,6.47,2.59,,,0 NDC,16729027735,Methotrexate: 1 Vial In 1 Carton (16729-277-35) / 40 Ml In 1 Vial,7.12,2.85,,,0 NDC,16729028838,Cisplatin: 100 Ml In 1 Vial (16729-288-38),10.33,4.13,,,0 NDC,16729029512,"Carboplatin: 1 Vial, Multi-Dose In 1 Carton (16729-295-12) / 60 Ml In 1 Vial, Multi-Dose",20.28,8.11,,,0 NDC,16729044315,"Bupropion Hydrochloride: 90 Tablet, Extended Release In 1 Bottle (16729-443-15)",0.56,0.22,,,0 NDC,16729049303,"Succinylcholine Chloride: 1 VIAL, MULTI-DOSE in 1 CARTON (16729-493-03) / 10 mL in 1 VIAL, MULTI-DOSE",2.47,0.99,,,0 NDC,16729049345,"Succinylcholine Chloride: 10 VIAL, MULTI-DOSE in 1 CARTON (16729-493-45) / 10 mL in 1 VIAL, MULTI-DOSE",3.86,1.54,,,0 NDC,16729052663,"Atropine Sulfate: 1 Vial, Single-Dose In 1 Carton (16729-526-63) / 1 Ml In 1 Vial, Single-Dose",0.91,0.36,,,0 NDC,16784011402,NDC Description Not Available,0.15,0.06,,,0 NDC,16864004002,Triple Antifungal: 1 Tube In 1 Carton (16864-040-02) / 56.7 G In 1 Tube,60.68,24.27,,,0 NDC,16864024001,"Domeboro: 12 Powder, For Solution In 1 Box (16864-240-01)",1.19,0.48,,,0 NDC,16864068003,Dermoplast Pain Relieving: 85 G In 1 Can (16864-680-03),17.07,6.83,,,0 NDC,17156002205,Ceretec: 5 Vial In 1 Tray (17156-022-05) / 5 Ml In 1 Vial,9290.74,3716.3,,,0 NDC,17156002305,Ceretec: 1 KIT in 1 CARTON (17156-023-05) * 5 VIAL in 1 TRAY / 1 mL in 1 VIAL * 5 VIAL in 1 TRAY / 4.5 mL in 1 VIAL * 5 VIAL in 1 TRAY (17156-022-05) / 5 mL in 1 VIAL,5681.295,2272.517,,,0 NDC,17156002505,"Ceretec: 1 Kit In 1 Carton (17156-025-05) * 5 Ml In 1 Vial, Glass (17156-022-05) * 2.5 Ml In 1 Vial, Glass (17156-027-01)",7797.28,3118.91,,,0 NDC,17156021001,"Datscan: 1 Vial, Glass In 1 Container (17156-210-01) / 2.5 Ml In 1 Vial, Glass",7722.98,3089.19,,,0 NDC,17156023501,"Adreview: 1 Vial, Glass In 1 Container (17156-235-01) / 5 Ml In 1 Vial, Glass",18532.38,7412.95,,,0 NDC,17238090011,Bioglo: 100 Packet In 1 Box (17238-900-11) / 1 Mg In 1 Packet (17238-900-99),0.63,0.25,,,0 NDC,17271070105,Sodium Chloride: 250 Ml In 1 Bag (17271-701-05),17.25,6.9,,,0 NDC,17271070106,Sodium Chloride: 500 Ml In 1 Bag (17271-701-06),20.7,8.28,,,0 NDC,17478008130,"Ropivacaine Hydrochloride: 1 VIAL, SINGLE-DOSE in 1 CARTON (17478-081-30) / 30 mL in 1 VIAL, SINGLE-DOSE",0.17,0.07,,,0 NDC,17478021505,"Atropine: 1 BOTTLE, DROPPER in 1 CARTON (17478-215-05) / 5 mL in 1 BOTTLE, DROPPER",161.23,64.49,,,0 NDC,17478023835,AK-POLY-BAC: 1 TUBE in 1 CARTON (17478-238-35) / 3.5 g in 1 TUBE,57.37,22.95,,,0 NDC,17478025310,"AK-FLUOR: 12 VIAL, SINGLE-DOSE in 1 PACKAGE (17478-253-10) / 5 mL in 1 VIAL, SINGLE-DOSE",39.23,15.69,,,0 NDC,17478038020,"Methadone Hydrochloride: 20 mL in 1 VIAL, MULTI-DOSE (17478-380-20)",11.13,4.45,,,0 NDC,17478040401,FUL-GLO: 100 APPLICATOR in 1 CARTON (17478-404-01) / 1 STRIP in 1 APPLICATOR,0.46,0.18,,,0 NDC,17478051500,Ephedrine Sulfate: 10 AMPULE in 1 CARTON (17478-515-00) / 1 mL in 1 AMPULE,1.42,0.57,,,0 NDC,17478076610,"Progesterone: 100 CAPSULE in 1 BOTTLE, PLASTIC (17478-766-10)",2.48,0.99,,,0 NDC,17478093705,Diltiazem Hydrochloride: 10 VIAL in 1 CARTON (17478-937-05) / 5 mL in 1 VIAL,3.335,1.335,,,0 NDC,17478093725,Diltiazem Hydrochloride: 1 VIAL in 1 CARTON (17478-937-25) / 25 mL in 1 VIAL,5.64,2.26,,,0 NDC,17772012201,Oxtellar Xr: 100 Tablet In 1 Bottle (17772-122-01),38.84,15.54,,,0 NDC,17772013230,"Qelbree: 30 Capsule, Extended Release In 1 Bottle (17772-132-30)",36.38,14.55,,,0 NDC,17856131301,Bismatrol: 15 mL in 1 CUP (17856-1313-1),4.42,1.77,,,0 NDC,17856502301,NDC Description Not Available,0.34,0.14,,,0 NDC,18657011701,NDC Description Not Available,1.64,0.66,,,0 NDC,18657011704,Hylenex Recombinant: 4 Box In 1 Carton (18657-117-04) / 1 Vial In 1 Box (18657-117-02) / 1 Ml In 1 Vial (18657-117-01),1.66,0.66,,,0 NDC,18860072210,"Prialt: 1 VIAL, GLASS in 1 CARTON (18860-722-10) / 5 mL in 1 VIAL, GLASS",44.93,17.97,,,0 NDC,19515081041,NDC Description Not Available,83.88,33.55,,,0 NDC,19515081052,Flulaval 2024/2025: 10 Syringe In 1 Carton (19515-810-52) / .5 Ml In 1 Syringe (19515-810-41),67.9,27.16,,,0 NDC,19515081441,NDC Description Not Available,74.27,29.71,,,0 NDC,19515081841,NDC Description Not Available,69.7,27.88,,,0 NDC,19903001020,NDC Description Not Available,0.37,0.15,,,0 NDC,19903001023,NDC Description Not Available,0.6,0.24,,,0 NDC,20555003300,NDC Description Not Available,0.08,0.03,,,0 NDC,20555003600,NDC Description Not Available,0.43,0.17,,,0 NDC,20555004000,NDC Description Not Available,0.56,0.22,,,0 NDC,21586011002,NDC Description Not Available,38.7,15.48,,,0 NDC,21922000301,"Fluocinolone Acetonide Topical Solution Usp, 0.01%: 1 Bottle In 1 Carton (21922-003-01) / 60 Ml In 1 Bottle",17.93,7.17,,,0 NDC,21922001605,"Clobetasol Propionate Cream Usp, 0.05% Clobetasol Propionate Cream Usp, 0.05%: 30 G In 1 Tube (21922-016-05)",33.12,13.25,,,0 NDC,21922002107,Permethrin: 1 Tube In 1 Carton (21922-021-07) / 60 G In 1 Tube,94.19,37.68,,,0 NDC,21922002707,Clindamycin Phosphate: 1 Tube In 1 Carton (21922-027-07) / 60 G In 1 Tube,86.51,34.6,,,0 NDC,21922002904,Mupirocin: 1 Tube In 1 Carton (21922-029-04) / 15 G In 1 Tube,76.8,30.72,,,0 NDC,23155000101,"Hydralazine Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (23155-001-01)",0.16,0.06,,,0 NDC,23155000301,"Hydralazine Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (23155-003-01)",0.2,0.08,,,0 NDC,23155000901,Hydrochlorothiazide: 100 Tablet In 1 Bottle (23155-009-01),0.2,0.08,,,0 NDC,23155002601,Verapamil Hydrochloride: 100 Tablet In 1 Bottle (23155-026-01),0.82,0.33,,,0 NDC,23155004403,Leflunomide: 30 Tablet In 1 Bottle (23155-044-03),1.87,0.75,,,0 NDC,23155005601,Glyburide: 100 Tablet In 1 Bottle (23155-056-01),0.15,0.06,,,0 NDC,23155005801,Glyburide: 100 Tablet In 1 Bottle (23155-058-01),0.96,0.38,,,0 NDC,23155016631,NDC Description Not Available,13.0,5.2,,,0 NDC,23155016641,"Tranexamic Acid: 10 Vial, Glass In 1 Carton (23155-166-41) / 10 Ml In 1 Vial, Glass (23155-166-31)",8.33,3.33,,,0 NDC,23155019401,Nifedipine: 100 Capsule In 1 Bottle (23155-194-01),1.055,0.42,,,0 NDC,23155019501,Nifedipine: 100 Capsule In 1 Bottle (23155-195-01),2.34,0.94,,,0 NDC,23155021631,"Cidofovir Dihydrate: 5 Ml In 1 Vial, Glass (23155-216-31)",2212.51,885.0,,,0 NDC,23155022701,Acyclovir: 100 Tablet In 1 Bottle (23155-227-01),0.77,0.31,,,0 NDC,23155024031,NDC Description Not Available,9.89,3.96,,,0 NDC,23155024041,Metoclopramide: 25 Vial In 1 Carton (23155-240-41) / 2 Ml In 1 Vial (23155-240-31),9.49,3.8,,,0 NDC,23155028701,Acetazolamide: 100 Tablet In 1 Bottle (23155-287-01),0.73,0.29,,,0 NDC,23155028801,Acetazolamide: 100 Tablet In 1 Bottle (23155-288-01),1.01,0.4,,,0 NDC,23155029032,NDC Description Not Available,7.13,2.85,,,0 NDC,23155029431,NDC Description Not Available,26.21,10.48,,,0 NDC,23155029441,Prochlorperazine Edisylate: 25 Vial In 1 Package (23155-294-41) / 2 Ml In 1 Vial (23155-294-31),13.35,5.34,,,0 NDC,23155029442,Prochlorperazine Edisylate: 10 Vial In 1 Package (23155-294-42) / 2 Ml In 1 Vial (23155-294-31),31.8,12.72,,,0 NDC,23155031331,"Acetazolamide: 5 Ml In 1 Vial, Glass (23155-313-31)",170.14,68.06,,,0 NDC,23155034532,NDC Description Not Available,0.38,0.15,,,0 NDC,23155047332,NDC Description Not Available,0.59,0.24,,,0 NDC,23155048601,Verapamil Hydrochloride: 100 Tablet In 1 Bottle (23155-486-01),1.13,0.45,,,0 NDC,23155049001,Desmopressin Acetate: 100 Tablet In 1 Bottle (23155-490-01),2.35,0.94,,,0 NDC,23155050001,Hydroxyzine Hydrochloride: 100 Tablet In 1 Bottle (23155-500-01),0.13,0.05,,,0 NDC,23155050101,Hydroxyzine Hydrochloride: 100 Tablet In 1 Bottle (23155-501-01),0.18,0.07,,,0 NDC,23155051230,"Nimodipine: 3 Blister Pack In 1 Carton (23155-512-30) / 10 Capsule, Liquid Filled In 1 Blister Pack",1.53,0.61,,,0 NDC,23155051831,NDC Description Not Available,1.48,0.59,,,0 NDC,23155054731,NDC Description Not Available,0.63,0.25,,,0 NDC,23155054741,Ondansetron: 10 Vial In 1 Carton (23155-547-41) / 2 Ml In 1 Vial (23155-547-31),0.49,0.2,,,0 NDC,23155054742,Ondansetron: 25 Vial In 1 Carton (23155-547-42) / 2 Ml In 1 Vial (23155-547-31),0.58,0.23,,,0 NDC,23155054931,Ondansetron: 1 Vial In 1 Carton (23155-549-31) / 20 Ml In 1 Vial,0.94,0.38,,,0 NDC,23155057901,Desipramine Hydrochloride: 100 Tablet In 1 Bottle (23155-579-01),3.29,1.32,,,0 NDC,23155060031,NDC Description Not Available,1.1,0.44,,,0 NDC,23155060041,"Midazolam Hydrochloride: 25 Vial, Single-Dose In 1 Carton (23155-600-41) / 2 Ml In 1 Vial, Single-Dose (23155-600-31)",1.15,0.46,,,0 NDC,23155060132,NDC Description Not Available,0.54,0.22,,,0 NDC,23155060142,"Midazolam Hydrochloride: 10 Vial, Multi-Dose In 1 Carton (23155-601-42) / 10 Ml In 1 Vial, Multi-Dose (23155-601-32)",0.5,0.2,,,0 NDC,23155064941,"Carmustine: 1 Kit In 1 Carton (23155-649-41) * 3 Ml In 1 Vial (23155-648-31) * 30 Ml In 1 Vial, Single-Dose (23155-647-31)",1168.39,467.36,,,0 NDC,23155066131,NDC Description Not Available,252.2,100.88,,,0 NDC,23155066201,Calcitriol: 100 Capsule In 1 Bottle (23155-662-01),0.59,0.24,,,0 NDC,23155066301,Calcitriol: 100 Capsule In 1 Bottle (23155-663-01),1.27,0.51,,,0 NDC,23155068631,"Octreotide Acetate: 5 Ml In 1 Vial, Glass (23155-686-31)",3.49,1.395,,,0 NDC,23155068741,"Octreotide Acetate: 10 Vial, Glass In 1 Carton (23155-687-41) / 1 Ml In 1 Vial, Glass (23155-687-31)",7.44,2.98,,,0 NDC,23155068841,"Octreotide Acetate: 10 Vial, Glass In 1 Carton (23155-688-41) / 1 Ml In 1 Vial, Glass (23155-688-31)",2.39,0.96,,,0 NDC,23155070401,Enalapril Maleate: 100 Tablet In 1 Bottle (23155-704-01),0.39,0.16,,,0 NDC,23155070501,Enalapril Maleate: 100 Tablet In 1 Bottle (23155-705-01),0.63,0.25,,,0 NDC,23155074831,NDC Description Not Available,403.83,161.53,,,0 NDC,23155074841,"Pentamidine Isethionate: 10 Vial, Single-Dose In 1 Carton (23155-748-41) / 300 Mg In 1 Vial, Single-Dose (23155-748-31)",393.3,157.32,,,0 NDC,23155076701,Tetracycline Hydrochloride: 100 Capsule In 1 Bottle (23155-767-01),5.08,2.03,,,0 NDC,23155077131,"Foscarnet Sodium: 1 Bottle, Glass In 1 Carton (23155-771-31) / 250 Ml In 1 Bottle, Glass",126.32,50.53,,,0 NDC,23155077201,Enalapril Maleate: 100 Tablet In 1 Bottle (23155-772-01),0.64,0.26,,,0 NDC,23155077301,Enalapril Maleate: 100 Tablet In 1 Bottle (23155-773-01),0.44,0.18,,,0 NDC,23155083711,NDC Description Not Available,2.65,1.06,,,0 NDC,23155087201,Torsemide: 100 Tablet In 1 Bottle (23155-872-01),0.38,0.15,,,0 NDC,23155088431,"Paclitaxel Paclitaxel: 1 Vial, Multi-Dose In 1 Carton (23155-884-31) / 50 Ml In 1 Vial, Multi-Dose",0.79,0.32,,,0 NDC,23635052460,"Amitiza: 60 Capsule, Gelatin Coated In 1 Bottle (23635-524-60)",20.23,8.09,,,0 NDC,23731605305,NDC Description Not Available,1.11,0.44,,,0 NDC,24201001020,Pentobarbital Sodium: 1 Vial In 1 Carton (24201-010-20) / 20 Ml In 1 Vial,144.33,57.73,,,0 NDC,24201001050,Pentobarbital Sodium: 1 Vial In 1 Carton (24201-010-50) / 50 Ml In 1 Vial,202.15,80.86,,,0 NDC,24201010001,NDC Description Not Available,0.48,0.19,,,0 NDC,24201040002,"Calcitonin Salmon: 1 Vial, Multi-Dose In 1 Carton (24201-400-02) / 2 Ml In 1 Vial, Multi-Dose",4046.19,1618.48,,,0 NDC,24208027615,Muro 128: 1 Bottle In 1 Carton (24208-276-15) / 15 Ml In 1 Bottle,48.92,19.57,,,0 NDC,24208029005,"Tobramycin: 1 Bottle, Dropper In 1 Carton (24208-290-05) / 5 Ml In 1 Bottle, Dropper",35.25,14.1,,,0 NDC,24208029525,"Tobramycin And Dexamethasone: 1 Bottle, Dropper In 1 Carton (24208-295-25) / 2.5 Ml In 1 Bottle, Dropper",151.71,60.68,,,0 NDC,24208031510,"Polymyxin B Sulfate And Trimethoprim: 1 Bottle, Dropper In 1 Carton (24208-315-10) / 10 Ml In 1 Bottle, Dropper",46.0,18.4,,,0 NDC,24208031705,"Sulfacetamide Sodium And Prednisolone Sodium Phosphate: 1 Bottle, Dropper In 1 Carton (24208-317-05) / 5 Ml In 1 Bottle, Dropper",45.0,18.0,,,0 NDC,24208039830,"Ipratropium Bromide: 1 Bottle, Spray In 1 Carton (24208-398-30) / 345 Spray, Metered In 1 Bottle, Spray",109.53,43.81,,,0 NDC,24208041105,"Brimonidine Tartrate: 1 Bottle, Dropper In 1 Carton (24208-411-05) / 5 Ml In 1 Bottle, Dropper",63.39,25.36,,,0 NDC,24208043410,"Ofloxacin: 1 Bottle, Dropper In 1 Carton (24208-434-10) / 10 Ml In 1 Bottle, Dropper",166.16,66.46,,,0 NDC,24208046325,Latanoprost: 1 Bottle In 1 Carton (24208-463-25) / 2.5 Ml In 1 Bottle,78.66,31.46,,,0 NDC,24208048510,"Dorzolamide Hcl: 1 Bottle, Dropper In 1 Carton (24208-485-10) / 10 Ml In 1 Bottle, Dropper",145.41,58.16,,,0 NDC,24208048610,"Dorzolamide Hydrochloride And Timolol Maleate: 1 Bottle, Dropper In 1 Carton (24208-486-10) / 10 Ml In 1 Bottle, Dropper",151.06,60.42,,,0 NDC,24208050912,NDC Description Not Available,0.49,0.2,,,0 NDC,24208053920,Miochol E: 1 Kit In 1 Blister Pack (24208-539-20) * 2 Ml In 1 Vial * 2 Ml In 1 Ampule,543.75,217.5,,,0 NDC,24208055555,Bacitracin Zinc And Polymyxin B Sulfate: 1 Tube In 1 Carton (24208-555-55) / 3.5 G In 1 Tube,68.93,27.57,,,0 NDC,24208058060,"Gentamicin Sulfate: 1 Bottle, Dropper In 1 Carton (24208-580-60) / 5 Ml In 1 Bottle, Dropper",152.77,61.11,,,0 NDC,24208063562,"Neomycin And Polymyxin B Sulfates And Hydrocortisone: 1 Bottle, Dropper In 1 Carton (24208-635-62) / 10 Ml In 1 Bottle, Dropper",250.51,100.2,,,0 NDC,24208073501,"Cyclopentolate Hydrochloride: 1 Bottle, Dropper In 1 Carton (24208-735-01) / 2 Ml In 1 Bottle, Dropper",36.3,14.52,,,0 NDC,24208078055,Neomycin And Polymyxin B Sulfates And Bacitracin Zinc: 1 Tube In 1 Carton (24208-780-55) / 3.5 G In 1 Tube,244.24,97.7,,,0 NDC,24208078555,"Neomycin And Polymyxin B Sulfates, Bacitracin Zinc And Hydrocortisone: 1 Tube In 1 Carton (24208-785-55) / 3.5 G In 1 Tube",95.59,38.24,,,0 NDC,24208079535,Neomycin And Polymyxin B Sulfates And Dexamethasone: 1 Tube In 1 Carton (24208-795-35) / 3.5 G In 1 Tube,47.75,19.1,,,0 NDC,24208091019,Erythromycin: 50 Tube In 1 Box (24208-910-19) / 1 G In 1 Tube,28.36,11.34,,,0 NDC,24208091055,Erythromycin: 1 Tube In 1 Carton (24208-910-55) / 3.5 G In 1 Tube,39.1,15.64,,,0 NDC,24338013213,Ery-Ped: 100 Ml In 1 Bottle (24338-132-13),70.51,28.2,,,0 NDC,24338027001,"Vivimusta: 1 Vial, Multi-Dose In 1 Carton (24338-270-01) / 4 Ml In 1 Vial, Multi-Dose",144.04,57.62,,,0 NDC,24338053025,Sotylize: 250 Ml In 1 Bottle (24338-530-25),27.58,11.03,,,0 NDC,24357030030,NDC Description Not Available,2801.4,1120.56,,,0 NDC,24357070105,NDC Description Not Available,48.4,19.36,,,0 NDC,24357070106,Anecream: 5 Tube In 1 Carton (24357-701-06) / 5 G In 1 Tube (24357-701-05),74.53,29.81,,,0 NDC,24357070107,Anecream: 5 Tube In 1 Carton (24357-701-07) / 5 G In 1 Tube (24357-701-05),74.66,29.86,,,0 NDC,24357070115,Anecream: 1 Tube In 1 Carton (24357-701-15) / 15 G In 1 Tube,34.79,13.92,,,0 NDC,24385006003,Good Neighbor Pharmacy Bacitracin Zinc: 1 Tube In 1 Carton (24385-060-03) / 28.4 G In 1 Tube,10.74,4.3,,,0 NDC,24385019003,Good Neighbor Pharmacy Hydrocortisone With Aloe For Sensitive Skin: 1 Tube In 1 Carton (24385-190-03) / 28.4 G In 1 Tube,5.68,2.27,,,0 NDC,24385035210,"Good Neighbor Pharmacy Nasal: 1 Bottle, Spray In 1 Carton (24385-352-10) / 30 Ml In 1 Bottle, Spray",4.14,1.66,,,0 NDC,24385090530,NDC Description Not Available,3.59,1.44,,,0 NDC,24571011606,Phoxillum Bk4/2.5: 2 Bag In 1 Case (24571-116-06) / 5 L In 1 Bag,132.0,52.8,,,0 NDC,24643001179,NDC Description Not Available,0.025,0.01,,,0 NDC,24643002303,NDC Description Not Available,5.28,2.11,,,0 NDC,24643006330,NDC Description Not Available,0.06,0.02,,,0 NDC,24979018646,"Sevelamer Carbonate: 270 Tablet, Film Coated In 1 Bottle (24979-186-46)",1.67,0.67,,,0 NDC,24979053301,"Guanfacine Extended-Release: 100 Tablet, Extended Release In 1 Bottle (24979-533-01)",1.26,0.5,,,0 NDC,25021005301,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (25021-053-01) / 1 Ml In 1 Vial,0.55,0.22,,,0 NDC,25021010610,"Ceftriaxone: 25 Vial In 1 Carton (25021-106-10) / 1 Injection, Powder, For Solution In 1 Vial",2.1,0.84,,,0 NDC,25021010720,"Ceftriaxone: 25 Vial In 1 Carton (25021-107-20) / 1 Injection, Powder, For Solution In 1 Vial",2.45,0.98,,,0 NDC,25021011020,"Cefoxitin: 10 Vial In 1 Carton (25021-110-20) / 1 Injection, Powder, For Solution In 1 Vial",22.0,8.8,,,0 NDC,25021012120,"Cefepime: 10 Vial In 1 Carton (25021-121-20) / 1 Injection, Powder, For Solution In 1 Vial",9.42,3.77,,,0 NDC,25021012999,Ceftazidime: 6 Bottle In 1 Carton (25021-129-99) / 30 Ml In 1 Bottle,1.68,0.67,,,0 NDC,25021013182,Metronidazole: 24 Pouch In 1 Carton (25021-131-82) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,0.185,0.07500000000000001,,,0 NDC,25021013282,Levofloxacin: 24 Pouch In 1 Carton (25021-132-82) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,4.6,1.84,,,0 NDC,25021013283,Levofloxacin: 24 Pouch In 1 Carton (25021-132-83) / 1 Bag In 1 Pouch / 150 Ml In 1 Bag,10.86,4.34,,,0 NDC,25021013610,"Ampicillin: 10 Vial In 1 Carton (25021-136-10) / 1 Injection, Powder, For Solution In 1 Vial",4.82,1.93,,,0 NDC,25021013720,"Ampicillin: 10 Vial In 1 Carton (25021-137-20) / 1 Injection, Powder, For Solution In 1 Vial",3.75,1.5,,,0 NDC,25021014330,"Ampicillin And Sulbactam: 10 Vial In 1 Carton (25021-143-30) / 1 Injection, Powder, For Solution In 1 Vial",20.05,8.02,,,0 NDC,25021017620,"Piperacillin, Tazobactam: 10 Vial In 1 Carton (25021-176-20) / 15 Ml In 1 Vial",2.66,1.06,,,0 NDC,25021018467,Fluconazole: 10 Pouch In 1 Carton (25021-184-67) / 1 Bag In 1 Pouch / 200 Ml In 1 Bag,9.44,3.78,,,0 NDC,25021018482,Fluconazole: 10 Pouch In 1 Carton (25021-184-82) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,39.6,15.84,,,0 NDC,25021018487,Fluconazole: 10 Pouch In 1 Carton (25021-184-87) / 1 Bag In 1 Pouch / 200 Ml In 1 Bag,32.07,12.83,,,0 NDC,25021019110,Micafungin: 1 Vial In 1 Carton (25021-191-10) / 5 Ml In 1 Vial,8.2,3.28,,,0 NDC,25021019287,Ciprofloxacin: 24 Pouch In 1 Carton (25021-192-87) / 1 Bag In 1 Pouch / 200 Ml In 1 Bag,5.98,2.39,,,0 NDC,25021020110,Mesna: 1 Vial In 1 Carton (25021-201-10) / 10 Ml In 1 Vial,17.56,7.02,,,0 NDC,25021020405,Vinorelbine: 1 Vial In 1 Carton (25021-204-05) / 5 Ml In 1 Vial,87.0,34.8,,,0 NDC,25021020751,Doxorubicin Hydrochloride: 1 Vial In 1 Carton (25021-207-51) / 100 Ml In 1 Vial,5.74,2.3,,,0 NDC,25021021598,Fluorouracil: 1 Bottle In 1 Carton (25021-215-98) / 50 Ml In 1 Bottle,11.3,4.52,,,0 NDC,25021021599,Fluorouracil: 1 Bottle In 1 Carton (25021-215-99) / 100 Ml In 1 Bottle,11.27,4.51,,,0 NDC,25021021920,Decitabine: 1 Vial In 1 Carton (25021-219-20) / 20 Ml In 1 Vial,3.88,1.55,,,0 NDC,25021022320,Cytarabine: 1 Vial In 1 Carton (25021-223-20) / 20 Ml In 1 Vial,2.26,0.9,,,0 NDC,25021022610,Arsenic Trioxide: 10 Vial In 1 Carton (25021-226-10) / 10 Ml In 1 Vial,32.35,12.94,,,0 NDC,25021024110,Busulfan: 8 Vial In 1 Carton (25021-241-10) / 10 Ml In 1 Vial,37.62,15.05,,,0 NDC,25021024202,Fludarabine Phosphate: 1 Vial In 1 Carton (25021-242-02) / 2 Ml In 1 Vial,720.44,288.18,,,0 NDC,25021024410,"Bortezomib: 1 Vial In 1 Carton (25021-244-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",3.33,1.33,,,0 NDC,25021024851,Cyclophosphamide: 1 Vial In 1 Carton (25021-248-51) / 50 Ml In 1 Vial,5.58,2.23,,,0 NDC,25021025150,Mitomycin: 1 Vial In 1 Carton (25021-251-50) / 40 Ml In 1 Vial,590.9,236.36,,,0 NDC,25021025861,Melphalan Hydrochloride: 1 Kit In 1 Carton (25021-258-61) * 10 Ml In 1 Vial (25021-256-10) * 10 Ml In 1 Vial (25021-257-10),558.12,223.25,,,0 NDC,25021025950,Nelarabine: 1 Vial In 1 Carton (25021-259-50) / 50 Ml In 1 Vial,215.69,86.28,,,0 NDC,25021030520,Chlorothiazide Sodium: 1 Vial In 1 Carton (25021-305-20) / 18 Ml In 1 Vial,232.27,92.91,,,0 NDC,25021030982,Esmolol Hydrochloride: 10 Bag In 1 Carton (25021-309-82) / 100 Ml In 1 Bag,3.4,1.36,,,0 NDC,25021031102,Furosemide: 25 Vial In 1 Carton (25021-311-02) / 2 Ml In 1 Vial,3.23,1.29,,,0 NDC,25021031104,Furosemide: 25 Vial In 1 Carton (25021-311-04) / 4 Ml In 1 Vial,2.19,0.88,,,0 NDC,25021031110,Furosemide: 25 Vial In 1 Carton (25021-311-10) / 10 Ml In 1 Vial,1.32,0.53,,,0 NDC,25021031382,Milrinone Lactate In Dextrose: 10 Bag In 1 Carton (25021-313-82) / 100 Ml In 1 Bag,11.1,4.44,,,0 NDC,25021031802,Adenosine: 10 Vial In 1 Carton (25021-318-02) / 2 Ml In 1 Vial,4.5,1.8,,,0 NDC,25021031905,Diltiazem Hydrochloride: 10 Vial In 1 Carton (25021-319-05) / 5 Ml In 1 Vial,5.16,2.065,,,0 NDC,25021032104,Bumetanide: 10 Vial In 1 Carton (25021-321-04) / 4 Ml In 1 Vial,5.61,2.24,,,0 NDC,25021032110,Bumetanide: 10 Vial In 1 Carton (25021-321-10) / 10 Ml In 1 Vial,1.64,0.66,,,0 NDC,25021040010,Heparin Sodium: 25 Vial In 1 Carton (25021-400-10) / 10 Ml In 1 Vial,1.59,0.64,,,0 NDC,25021040304,Heparin Sodium: 25 Vial In 1 Carton (25021-403-04) / 4 Ml In 1 Vial,0.84,0.34,,,0 NDC,25021041510,Tranexamic Acid: 10 Vial In 1 Carton (25021-415-10) / 10 Ml In 1 Vial,9.51,3.8,,,0 NDC,25021046301,Octreotide Acetate: 10 Vial In 1 Carton (25021-463-01) / 1 Ml In 1 Vial,5.23,2.09,,,0 NDC,25021046705,Octreotide Acetate: 1 Vial In 1 Carton (25021-467-05) / 5 Ml In 1 Vial,4.795,1.92,,,0 NDC,25021046810,Levothyroxine Sodium: 1 Vial In 1 Carton (25021-468-10) / 5 Ml In 1 Vial,40.57,16.23,,,0 NDC,25021050002,Thiamine Hydrochloride: 25 Vial In 1 Carton (25021-500-02) / 2 Ml In 1 Vial,22.03,8.81,,,0 NDC,25021060103,Caffeine Citrate: 1 Vial In 1 Carton (25021-601-03) / 3 Ml In 1 Vial,9.21,3.685,,,0 NDC,25021060851,Propofol: 10 Vial In 1 Carton (25021-608-51) / 100 Ml In 1 Vial,1.28,0.51,,,0 NDC,25021067182,Ropivacaine Hydrochloride: 10 Bag In 1 Carton (25021-671-82) / 100 Ml In 1 Bag,0.99,0.4,,,0 NDC,25021067187,Ropivacaine Hydrochloride: 10 Bag In 1 Carton (25021-671-87) / 200 Ml In 1 Bag,0.45,0.18,,,0 NDC,25021067376,Glydo: 10 Syringe In 1 Carton (25021-673-76) / 6 Ml In 1 Syringe,10.21,4.08,,,0 NDC,25021067420,Etomidate: 10 Vial In 1 Carton (25021-674-20) / 20 Ml In 1 Vial,19.76,7.9,,,0 NDC,25021067620,Pentobarbital Sodium: 1 Vial In 1 Carton (25021-676-20) / 20 Ml In 1 Vial,154.27,61.71,,,0 NDC,25021067650,Pentobarbital Sodium: 1 Vial In 1 Carton (25021-676-50) / 50 Ml In 1 Vial,188.52,75.41,,,0 NDC,25021068220,Ketamine Hydrochloride: 10 Vial In 1 Carton (25021-682-20) / 20 Ml In 1 Vial,10.98,4.39,,,0 NDC,25021075110,Pantoprazole Sodium: 10 Vial In 1 Carton (25021-751-10) / 10 Ml In 1 Vial,8.81,3.52,,,0 NDC,25021079002,Prochlorperazine Edisylate: 10 Vial In 1 Carton (25021-790-02) / 2 Ml In 1 Vial,14.24,5.7,,,0 NDC,25021081230,Acetylcysteine: 4 Vial In 1 Carton (25021-812-30) / 30 Ml In 1 Vial,2.98,1.19,,,0 NDC,25021081430,Leucovorin Calcium: 1 Vial In 1 Carton (25021-814-30) / 10 Ml In 1 Vial,20.07,8.03,,,0 NDC,25021081530,Leucovorin Calcium: 1 Vial In 1 Carton (25021-815-30) / 20 Ml In 1 Vial,15.9,6.36,,,0 NDC,25021081630,Leucovorin Calcium: 1 Vial In 1 Carton (25021-816-30) / 17.5 Ml In 1 Vial,44.05,17.62,,,0 NDC,25021082005,Methylprednisolone Acetate: 1 Vial In 1 Carton (25021-820-05) / 5 Ml In 1 Vial,0.8,0.32,,,0 NDC,25021082682,Zoledronic Acid: 1 Bag In 1 Carton (25021-826-82) / 100 Ml In 1 Bag,201.0,80.4,,,0 NDC,25021083082,Zoledronic Acid: 1 Bag In 1 Carton (25021-830-82) / 100 Ml In 1 Bag,312.32,124.93,,,0 NDC,25682000101,Soliris: 1 Vial In 1 Carton (25682-001-01) / 30 Ml In 1 Vial,506.49,202.6,,,0 NDC,25682002501,"Ultomiris: 1 Vial, Glass In 1 Carton (25682-025-01) / 3 Ml In 1 Vial, Glass",949.72,379.89,,,0 NDC,25682002801,"Ultomiris: 1 Vial, Glass In 1 Carton (25682-028-01) / 11 Ml In 1 Vial, Glass",950.35,380.14,,,0 NDC,25866059361,NDC Description Not Available,73.6,29.44,,,0 NDC,27241006303,"Voriconazole: 30 Tablet, Film Coated In 1 Bottle (27241-063-03)",21.54,8.62,,,0 NDC,27241015504,"Oxybutynin Chloride: 100 Tablet, Extended Release In 1 Bottle (27241-155-04)",0.85,0.34,,,0 NDC,27241016201,Captopril: 100 Tablet In 1 Bottle (27241-162-01),0.35,0.14,,,0 NDC,27241017356,"Varenicline: 56 Tablet, Film Coated In 1 Bottle (27241-173-56)",2.97,1.19,,,0 NDC,27241017529,Sildenafil: 1 Pouch In 1 Carton (27241-175-29) / 1 Bottle In 1 Pouch / 112 Ml In 1 Bottle,6.54,2.62,,,0 NDC,27241024949,Famotidine: 50 Ml In 1 Bottle (27241-249-49),2.95,1.18,,,0 NDC,27808008202,"Morphine Sulfate: 1 Bottle, Unit-Dose In 1 Carton (27808-082-02) / 120 Ml In 1 Bottle, Unit-Dose",1.51,0.6,,,0 NDC,27808009201,Dexmethylphenidate Hydrochloride: 100 Tablet In 1 Bottle (27808-092-01),1.19,0.48,,,0 NDC,27808015501,"Rosuvastatin Calcium: 90 Tablet, Film Coated In 1 Bottle (27808-155-01)",0.49,0.2,,,0 NDC,27808022301,"Paliperidone: 30 Tablet, Extended Release In 1 Bottle (27808-223-01)",9.31,3.72,,,0 NDC,29300013601,"Clonidine Hydrochloride: 100 Tablet In 1 Bottle, Plastic (29300-136-01)",0.07,0.03,,,0 NDC,29300014901,"Quetiapine Fumarate: 100 Tablet, Film Coated In 1 Bottle, Plastic (29300-149-01)",0.48,0.19,,,0 NDC,29300035501,"Tramadol Hydrochloride: 100 Tablet, Film Coated In 1 Bottle, Plastic (29300-355-01)",0.14,0.06,,,0 NDC,30103004100,NDC Description Not Available,10.38,4.15,,,0 NDC,31722000631,"Itraconazole: 1 Bottle, Glass In 1 Carton (31722-006-31) / 150 Ml In 1 Bottle, Glass",126.6,50.64,,,0 NDC,31722011620,NDC Description Not Available,0.07,0.03,,,0 NDC,31722011634,"Lidocaine Hydrochloride: 10 Vial, Multi-Dose In 1 Carton (31722-116-34) / 50 Ml In 1 Vial, Multi-Dose (31722-116-50)",0.03,0.01,,,0 NDC,31722013747,NDC Description Not Available,3.64,1.46,,,0 NDC,31722020431,NDC Description Not Available,18.32,7.33,,,0 NDC,31722023001,"Dexmethylphenidate Hydrochloride: 100 Capsule, Extended Release In 1 Bottle (31722-230-01)",3.21,1.28,,,0 NDC,31722030801,Olanzapine: 1 Vial In 1 Carton (31722-308-01) / 2 Ml In 1 Vial,5.49,2.2,,,0 NDC,31722051901,Hydralazine Hydrochloride: 100 Tablet In 1 Bottle (31722-519-01),0.68,0.27,,,0 NDC,31722052001,Hydralazine Hydrochloride: 100 Tablet In 1 Bottle (31722-520-01),0.2,0.08,,,0 NDC,31722052101,Hydralazine Hydrochloride: 100 Tablet In 1 Bottle (31722-521-01),0.75,0.3,,,0 NDC,31722053530,"Tenofovir Disoproxil Fumarate: 30 Tablet, Film Coated In 1 Bottle (31722-535-30)",4.32,1.73,,,0 NDC,31722053712,"Levetiracetam: 120 Tablet, Film Coated In 1 Bottle (31722-537-12)",0.74,0.3,,,0 NDC,31722056224,Abacavir: 240 Ml In 1 Bottle (31722-562-24),2.29,0.92,,,0 NDC,31722056560,"Indomethacin: 60 Capsule, Extended Release In 1 Bottle (31722-565-60)",3.8,1.52,,,0 NDC,31722057447,Levetiracetam: 473 Ml In 1 Bottle (31722-574-47),4.77,1.91,,,0 NDC,31722059730,Ritonavir: 30 Tablet In 1 Bottle (31722-597-30),11.66,4.66,,,0 NDC,31722062705,NDC Description Not Available,11.99,4.8,,,0 NDC,31722062726,Lacosamide: 1 Bottle In 1 Carton (31722-627-26) / 200 Ml In 1 Bottle,13.83,5.53,,,0 NDC,31722062921,Atovaquone: 1 Bottle In 1 Carton (31722-629-21) / 210 Ml In 1 Bottle,34.66,13.86,,,0 NDC,31722063630,Silodosin: 30 Capsule In 1 Bottle (31722-636-30),4.28,1.71,,,0 NDC,31722064630,"Tadalafil: 30 Tablet, Film Coated In 1 Bottle (31722-646-30)",0.98,0.39,,,0 NDC,31722066860,"Ranolazine: 60 Tablet, Film Coated, Extended Release In 1 Bottle (31722-668-60)",0.97,0.39,,,0 NDC,31722066960,"Ranolazine: 60 Tablet, Film Coated, Extended Release In 1 Bottle (31722-669-60)",1.41,0.56,,,0 NDC,31722081930,Aripiprazole: 30 Tablet In 1 Bottle (31722-819-30),1.12,0.45,,,0 NDC,31722082111,"Tetrabenazine: 112 Tablet, Coated In 1 Bottle (31722-821-11)",11.46,4.58,,,0 NDC,31722083260,"Valganciclovir: 60 Tablet, Film Coated In 1 Bottle (31722-832-60)",11.83,4.73,,,0 NDC,31722083330,Entecavir: 30 Tablet In 1 Bottle (31722-833-30),3.98,1.59,,,0 NDC,31722083430,Entecavir: 30 Tablet In 1 Bottle (31722-834-30),3.83,1.53,,,0 NDC,31722086525,"Linezolid: 1 Bottle, Glass In 1 Carton (31722-865-25) / 150 Ml In 1 Bottle, Glass",199.79,79.92,,,0 NDC,31722086831,NDC Description Not Available,144.78,57.91,,,0 NDC,31722095201,"Methylphenidate Hydrochloride: 100 Tablet, Extended Release In 1 Bottle (31722-952-01)",2.18,0.87,,,0 NDC,31722098110,NDC Description Not Available,0.94,0.38,,,0 NDC,31722098131,"Succinylcholine Chloride: 25 Vial, Multi-Dose In 1 Carton (31722-981-31) / 10 Ml In 1 Vial, Multi-Dose (31722-981-10)",0.46,0.18,,,0 NDC,31722099510,NDC Description Not Available,1.42,0.57,,,0 NDC,31722099531,"Neostigmine Methylsulfate: 10 Vial, Multi-Dose In 1 Carton (31722-995-31) / 10 Ml In 1 Vial, Multi-Dose",1.25,0.5,,,0 NDC,33332002403,"Afluria: 10 Syringe, Glass In 1 Carton (33332-024-03) / .5 Ml In 1 Syringe, Glass (33332-024-04)",83.11,33.24,,,0 NDC,33342000109,"Lamivudine: 60 Tablet, Film Coated In 1 Bottle (33342-001-09)",2.49,1.0,,,0 NDC,33342009607,"Tenofovir Disoproxil Fumarate: 30 Tablet, Film Coated In 1 Bottle (33342-096-07)",1.62,0.65,,,0 NDC,33342009809,"Tolterodine Tartrate: 60 Tablet, Film Coated In 1 Bottle (33342-098-09)",0.82,0.33,,,0 NDC,33342011607,Candesartan: 30 Tablet In 1 Container (33342-116-07),3.1,1.24,,,0 NDC,33342021558,"Sevelamer Carbonate: 270 Tablet, Film Coated In 1 Bottle (33342-215-58)",0.56,0.22,,,0 NDC,33342027407,Febuxostat: 30 Film In 1 Bottle (33342-274-07),1.6,0.64,,,0 NDC,33342032980,Triamcinolone Acetonide: 1 Tube In 1 Carton (33342-329-80) / 80 G In 1 Tube,27.6,11.04,,,0 NDC,33342033354,Triamcinolone Acetonide: 454 G In 1 Jar (33342-333-54),75.74,30.3,,,0 NDC,34324000607,NDC Description Not Available,6.18,2.47,,,0 NDC,35573043330,Ketoconazole: 30 Tablet In 1 Bottle (35573-433-30),3.16,1.26,,,0 NDC,36000001225,"Ondansetron Hydrochloride: 25 Vial, Single-Dose In 1 Carton (36000-012-25) / 2 Ml In 1 Vial, Single-Dose",0.49,0.2,,,0 NDC,36000003310,Metoprolol: 10 Vial In 1 Carton (36000-033-10) / 5 Ml In 1 Vial,1.82,0.73,,,0 NDC,36000004624,Levofloxacin: 50 Ml In 1 Bag (36000-046-24),9.66,3.86,,,0 NDC,36000014801,NDC Description Not Available,14.35,5.74,,,0 NDC,36000016210,Norepinephrine Bitartrate: 10 Ampule In 1 Carton (36000-162-10) / 4 Ml In 1 Ampule (36000-162-01),5.22,2.09,,,0 NDC,36000024201,"Tobramycin: 1 Vial, Multi-Dose In 1 Carton (36000-242-01) / 30 Ml In 1 Vial, Multi-Dose",5.46,2.18,,,0 NDC,36000028325,"Furosemide: 25 Vial, Single-Dose In 1 Box (36000-283-25) / 4 Ml In 1 Vial, Single-Dose",0.17,0.07,,,0 NDC,36000028425,"Furosemide: 25 Vial, Single-Dose In 1 Box (36000-284-25) / 10 Ml In 1 Vial, Single-Dose",1.53,0.61,,,0 NDC,36000032010,Labetalol Hydrochloride: 10 Vial In 1 Carton (36000-320-10) / 4 Ml In 1 Vial (36000-320-01),3.66,1.46,,,0 NDC,36000032201,NDC Description Not Available,0.45,0.18,,,0 NDC,36000032202,Labetalol Hydrochloride: 1 Vial In 1 Carton (36000-322-02) / 20 Ml In 1 Vial (36000-322-01),0.47,0.19,,,0 NDC,36000032401,NDC Description Not Available,0.2,0.08,,,0 NDC,37000002404,Metamucil Therapy For Regularity: 30 Packet In 1 Carton (37000-024-04) / 5.8 G In 1 Packet,1.37,0.55,,,0 NDC,37000002410,Metamucil Therapy For Regularity: 5.8 G In 1 Packet (37000-024-10),1.55,0.62,,,0 NDC,38779000904,Hydrocortisone: 25 G In 1 Jar (38779-0009-4),24.755,9.899999999999999,,,0 NDC,38779010208,NDC Description Not Available,0.04,0.02,,,0 NDC,38779036403,Beclomethasone Dipropionate: 5 G In 1 Jar (38779-0364-3),1.41,0.56,,,0 NDC,38779050305,NDC Description Not Available,22.35,8.94,,,0 NDC,38779051008,NDC Description Not Available,0.56,0.225,,,0 NDC,38779052409,Bupivacaine Hydrochloride: 1000 G In 1 Jar (38779-0524-9),45.1,18.04,,,0 NDC,38779055108,NDC Description Not Available,0.26,0.1,,,0 NDC,38779056104,Clonidine Hydrochloride: 25 G In 1 Jar (38779-0561-4),264.26,105.7,,,0 NDC,38779061409,NDC Description Not Available,158.1,63.24,,,0 NDC,38779062908,NDC Description Not Available,0.06,0.02,,,0 NDC,38779067303,"Morphine Sulfate: 5 G In 1 Bottle, Glass (38779-0673-3)",121.36,48.54,,,0 NDC,38779067307,"Morphine Sulfate: 250 G In 1 Bottle, Glass (38779-0673-7)",158.46,63.38,,,0 NDC,38779073105,Hydromorphone Hydrochloride: 100 G In 1 Vial (38779-0731-5),35.22,14.09,,,0 NDC,38779083505,NDC Description Not Available,6.84,2.74,,,0 NDC,38779094908,NDC Description Not Available,4.01,1.6,,,0 NDC,38779104605,NDC Description Not Available,164.19,65.68,,,0 NDC,38779175603,"Fentanyl Citrate: 5 G In 1 Vial, Glass (38779-1756-3)",500.94,200.38,,,0 NDC,38779175604,"Fentanyl Citrate: 25 G In 1 Vial, Glass (38779-1756-4)",19.32,7.73,,,0 NDC,38779177908,NDC Description Not Available,8.59,3.44,,,0 NDC,38779193805,NDC Description Not Available,325.53,130.21,,,0 NDC,38779247108,NDC Description Not Available,789.635,315.855,,,0 NDC,38779298501,NDC Description Not Available,0.5,0.2,,,0 NDC,39328006250,NDC Description Not Available,35.48,14.19,,,0 NDC,39328006325,NDC Description Not Available,35.91,14.36,,,0 NDC,39328006412,NDC Description Not Available,23.65,9.46,,,0 NDC,39328006712,NDC Description Not Available,76.86,30.74,,,0 NDC,39328010710,NDC Description Not Available,0.97,0.39,,,0 NDC,39328015705,NDC Description Not Available,6.09,2.44,,,0 NDC,39328051150,"Levetiracetam: 5 Tray In 1 Case (39328-511-50) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose",12.21,4.88,,,0 NDC,39328053016,"Amantadine Hydrochloride: 473 Ml In 1 Bottle, Plastic (39328-530-16)",1.43,0.57,,,0 NDC,39328055750,NDC Description Not Available,0.13,0.05,,,0 NDC,39822019001,"Acetazolamide: 1 Vial, Glass In 1 Carton (39822-0190-1) / 5 Ml In 1 Vial, Glass",139.62,55.85,,,0 NDC,39822025501,"Cyclophosphamide: 1 Vial, Single-Dose In 1 Carton (39822-0255-1) / 50 Ml In 1 Vial, Single-Dose",4.05,1.62,,,0 NDC,39822031005,"Neomycin Sulfate: 100 Blister Pack In 1 Box, Unit-Dose (39822-0310-5) / 1 Tablet In 1 Blister Pack (39822-0310-7)",4.15,1.66,,,0 NDC,39822041201,Tobramycin: 1 Vial In 1 Carton (39822-0412-1) / 30 Ml In 1 Vial,23.33,9.33,,,0 NDC,39822041206,Tobramycin: 6 Vial In 1 Carton (39822-0412-6) / 30 Ml In 1 Vial,20.41,8.16,,,0 NDC,39822100001,Tranexamic Acid: 10 Vial In 1 Carton (39822-1000-1) / 10 Ml In 1 Vial,19.83,7.93,,,0 NDC,39822103001,NDC Description Not Available,510.07,204.03,,,0 NDC,39822103002,Ibuprofen Lysine: 3 Vial In 1 Carton (39822-1030-2) / 2 Ml In 1 Vial (39822-1030-1),472.01,188.8,,,0 NDC,39822105505,Amphotericin B: 10 Ml In 1 Vial (39822-1055-5),148.34,59.34,,,0 NDC,39822110001,"Folic Acid: 1 Vial, Multi-Dose In 1 Carton (39822-1100-1) / 10 Ml In 1 Vial, Multi-Dose",1.7850000000000001,0.7100000000000001,,,0 NDC,39822210002,"Dactinomycin: 1 Vial, Single-Dose In 1 Carton (39822-2100-2) / 1 Ml In 1 Vial, Single-Dose (39822-2100-1)",3306.88,1322.75,,,0 NDC,39822420001,NDC Description Not Available,9.61,3.84,,,0 NDC,39822420002,Rocuronium Bromide: 10 Vial In 1 Carton (39822-4200-2) / 5 Ml In 1 Vial (39822-4200-1),6.365,2.545,,,0 NDC,39822930002,Dehydrated Alcohol: 10 Ampule In 1 Carton (39822-9300-2) / 5 Ml In 1 Ampule (39822-9300-1),2368.77,947.51,,,0 NDC,39822990001,Ammonia Inhalants: 10 AMPULE in 1 CARTON (39822-9900-1) / .3 mL in 1 AMPULE,1.62,0.65,,,0 NDC,40093010116,NDC Description Not Available,0.12,0.05,,,0 NDC,40565012249,NDC Description Not Available,256.56,102.62,,,0 NDC,40565012255,NDC Description Not Available,70.52,28.21,,,0 NDC,40565012256,NDC Description Not Available,70.52,28.21,,,0 NDC,40985022368,NDC Description Not Available,0.11,0.04,,,0 NDC,40985022928,NDC Description Not Available,0.13,0.05,,,0 NDC,40985027116,NDC Description Not Available,0.11,0.04,,,0 NDC,40985027435,NDC Description Not Available,0.6,0.24,,,0 NDC,41100081122,NDC Description Not Available,3.16,1.26,,,0 NDC,41100081123,NDC Description Not Available,18.3,7.32,,,0 NDC,41100081125,NDC Description Not Available,23.46,9.38,,,0 NDC,41167000362,NDC Description Not Available,11.2,4.48,,,0 NDC,41167000623,NDC Description Not Available,0.42,0.17,,,0 NDC,41167005723,NDC Description Not Available,14.28,5.71,,,0 NDC,41167005743,NDC Description Not Available,36.6,14.64,,,0 NDC,42023010501,"Brevital Sodium: 1 Vial In 1 Carton (42023-105-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",31.17,12.47,,,0 NDC,42023011101,"Delestrogen: 5 Ml In 1 Vial, Multi-Dose (42023-111-01)",62.6,25.04,,,0 NDC,42023011310,Ketalar: 10 Vial In 1 Carton (42023-113-10) / 20 Ml In 1 Vial,5.59,2.24,,,0 NDC,42023011410,Ketalar: 10 Vial In 1 Carton (42023-114-10) / 10 Ml In 1 Vial,2.88,1.15,,,0 NDC,42023014625,Dexmedetomidine Hydrochloride: 25 Vial In 1 Carton (42023-146-25) / 2 Ml In 1 Vial,14.47,5.79,,,0 NDC,42023015701,Ethacrynate Sodium: 1 Vial In 1 Carton (42023-157-01) / 50 Ml In 1 Vial,2400.51,960.2,,,0 NDC,42023015901,NDC Description Not Available,6.67,2.67,,,0 NDC,42023015925,Adrenalin: 25 Vial In 1 Carton (42023-159-25) / 1 Ml In 1 Vial (42023-159-01),6.67,2.67,,,0 NDC,42023016401,NDC Description Not Available,10.03,4.01,,,0 NDC,42023016425,Vasostrict: 25 Vial In 1 Carton (42023-164-25) / 1 Ml In 1 Vial (42023-164-01),13.215,5.285,,,0 NDC,42023016801,Adrenalin: 1 Vial In 1 Carton (42023-168-01) / 30 Ml In 1 Vial,4.57,1.83,,,0 NDC,42023017301,NDC Description Not Available,110.82,44.33,,,0 NDC,42023017901,NDC Description Not Available,20.02,8.01,,,0 NDC,42023017905,Buprenorphine Hydrochloride: 5 Vial In 1 Carton (42023-179-05) / 1 Ml In 1 Vial,18.61,7.44,,,0 NDC,42023018701,NDC Description Not Available,352.0,140.8,,,0 NDC,42023019001,Vasostrict: 1 Vial In 1 Carton (42023-190-01) / 10 Ml In 1 Vial,4.4,1.76,,,0 NDC,42023019501,"Posaconazole: 1 Vial, Glass In 1 Carton (42023-195-01) / 16.7 Ml In 1 Vial, Glass",701.78,280.71,,,0 NDC,42023020101,"Levothyroxine Sodium: 1 Vial, Single-Dose In 1 Carton (42023-201-01) / 5 Ml In 1 Vial, Single-Dose",37.67,15.065000000000001,,,0 NDC,42023020501,"Calcitonin Salmon: 1 Vial, Multi-Dose In 1 Carton (42023-205-01) / 2 Ml In 1 Vial, Multi-Dose",4075.49,1630.2,,,0 NDC,42023020801,Treprostinil: 1 Vial In 1 Carton (42023-208-01) / 20 Ml In 1 Vial,86.16,34.46,,,0 NDC,42023021401,NDC Description Not Available,0.04,0.02,,,0 NDC,42023022901,NDC Description Not Available,6.57,2.63,,,0 NDC,42023022910,"Micafungin: 10 Vial, Single-Dose In 1 Carton (42023-229-10) / 10 Ml In 1 Vial, Single-Dose",7.11,2.84,,,0 NDC,42023023001,NDC Description Not Available,6.58,2.63,,,0 NDC,42023023010,"Micafungin: 10 Vial, Single-Dose In 1 Carton (42023-230-10) / 10 Ml In 1 Vial, Single-Dose",6.94,2.78,,,0 NDC,42023024301,"Ephedrine Sulfate: 10 Ml In 1 Vial, Single-Dose (42023-243-01)",43.68,17.47,,,0 NDC,42023050001,NDC Description Not Available,352.26,140.9,,,0 NDC,42023050010,Adrenalin (Epinephrine In Sodium Chloride): 10 Bag In 1 Carton (42023-500-10) / 250 Ml In 1 Bag (42023-500-01),357.42,142.97,,,0 NDC,42037010479,NDC Description Not Available,19.4,7.76,,,0 NDC,42192034001,Hyoscyamine Sulfate Tab: 100 Tablet In 1 Bottle (42192-340-01),1.35,0.54,,,0 NDC,42192060816,Gabapentin: 470 Ml In 1 Bottle (42192-608-16),0.47,0.19,,,0 NDC,42192061916,Naproxen: 473 Ml In 1 Bottle (42192-619-16),4.25,1.7,,,0 NDC,42195012814,"Ciprofloxacin And Fluocinolone Acetonide: 1 Pouch In 1 Carton (42195-128-14) / 14 Vial, Single-Dose In 1 Pouch / .25 Ml In 1 Vial, Single-Dose",63.67,25.47,,,0 NDC,42292003801,NDC Description Not Available,2.37,0.95,,,0 NDC,42292003820,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (42292-038-20) / 1 Tablet In 1 Blister Pack (42292-038-01),2.19,0.88,,,0 NDC,42292003901,NDC Description Not Available,2.8,1.12,,,0 NDC,42292003920,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (42292-039-20) / 1 Tablet In 1 Blister Pack (42292-039-01),2.54,1.02,,,0 NDC,42292004101,NDC Description Not Available,2.77,1.11,,,0 NDC,42292004120,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (42292-041-20) / 1 Tablet In 1 Blister Pack (42292-041-01),1.79,0.72,,,0 NDC,42367054032,Ryanodex Dantrolene Sodium: 1 Vial In 1 Carton (42367-540-32) / 20 Ml In 1 Vial,11969.19,4787.68,,,0 NDC,42385095330,"Emtricitabine And Tenofovir Disoproxil Fumarate: 30 Tablet, Film Coated In 1 Bottle (42385-953-30)",2.78,1.11,,,0 NDC,42494041501,NDC Description Not Available,44.69,17.88,,,0 NDC,42494041601,NDC Description Not Available,130.49,52.2,,,0 NDC,42494041625,"Phenobarbital Sodium: 25 Vial In 1 Box, Unit-Dose (42494-416-25) / 1 Ml In 1 Vial",87.81,35.12,,,0 NDC,42494042301,"Ribavirin: 1 Vial, Glass In 1 Carton (42494-423-01) / 1 Powder, For Solution In 1 Vial, Glass",6878.98,2751.59,,,0 NDC,42571016142,"Amoxicillin And Clavulanate Potassium: 20 Tablet, Film Coated In 1 Bottle (42571-161-42)",2.19,0.88,,,0 NDC,42571024301,Acetazolamide Extended-Release: 100 Capsule In 1 Bottle (42571-243-01),2.25,0.9,,,0 NDC,42571025930,Roflumilast: 30 Tablet In 1 Bottle (42571-259-30),4.3,1.72,,,0 NDC,42571027560,"Dalfampridine: 60 Tablet, Extended Release In 1 Bottle (42571-275-60)",1.77,0.71,,,0 NDC,42571034230,Clomipramine Hydrochloride: 30 Capsule In 1 Bottle (42571-342-30),1.43,0.57,,,0 NDC,42571035707,Potassium Chloride: 473 Ml In 1 Bottle (42571-357-07),3.43,1.37,,,0 NDC,42658001001,"Cladribine: 1 Ml In 1 Vial, Single-Dose (42658-010-01)",37.9,15.16,,,0 NDC,42658002101,Daunorubicin Hydrochloride: 1 Vial In 1 Box (42658-021-01) / 4 Ml In 1 Vial,104.71,41.88,,,0 NDC,42658002102,Daunorubicin Hydrochloride: 10 Vial In 1 Carton (42658-021-02) / 4 Ml In 1 Vial,67.71,27.08,,,0 NDC,42747010201,"Crysvita: 1 Ml In 1 Vial, Single-Use (42747-102-01)",2053.83,821.53,,,0 NDC,42747020301,"Crysvita: 1 Ml In 1 Vial, Single-Use (42747-203-01)",1912.11,764.84,,,0 NDC,42747030401,"Crysvita: 1 Ml In 1 Vial, Single-Use (42747-304-01)",1934.62,773.85,,,0 NDC,42747076101,"Poteligeo: 1 Vial, Glass In 1 Carton (42747-761-01) / 5 Ml In 1 Vial, Glass",1052.13,420.85,,,0 NDC,42799011002,Albendazole: 2 Tablet In 1 Bottle (42799-110-02),417.29,166.92,,,0 NDC,42799080601,Ivermectin: 2 Blister Pack In 1 Carton (42799-806-01) / 10 Tablet In 1 Blister Pack,10.96,4.38,,,0 NDC,42806001101,Sulindac: 100 Tablet In 1 Bottle (42806-011-01),0.92,0.37,,,0 NDC,42806015134,"Azithromycin: 30 Ml In 1 Bottle, Plastic (42806-151-34)",3.29,1.32,,,0 NDC,42806031205,"Doxycycline Hyclate: 500 Tablet, Film Coated In 1 Bottle (42806-312-05)",0.87,0.35,,,0 NDC,42806035801,Leucovorin Calcium: 100 Tablet In 1 Bottle (42806-358-01),3.65,1.46,,,0 NDC,42806035830,Leucovorin Calcium: 30 Tablet In 1 Bottle (42806-358-30),3.95,1.58,,,0 NDC,42806050109,Nicardipine Hydrochloride: 90 Capsule In 1 Bottle (42806-501-09),6.29,2.52,,,0 NDC,42806050301,Ursodiol: 100 Capsule In 1 Bottle (42806-503-01),3.44,1.38,,,0 NDC,42806051230,Quinidine Sulfate: 30 Tablet In 1 Bottle (42806-512-30),36.55,14.62,,,0 NDC,42806051330,Quinidine Sulfate: 30 Tablet In 1 Bottle (42806-513-30),32.26,12.9,,,0 NDC,42806065830,"Entecavir: 30 Tablet In 1 Bottle, Plastic (42806-658-30)",0.82,0.33,,,0 NDC,42806065930,"Entecavir: 30 Tablet In 1 Bottle, Plastic (42806-659-30)",1.3,0.52,,,0 NDC,42806075760,Sulfadiazine: 60 Tablet In 1 Bottle (42806-757-60),69.08,27.63,,,0 NDC,42858000110,Oxycodone Hydrochloride: 10 Blister Pack In 1 Carton (42858-001-10) / 10 Tablet In 1 Blister Pack,1.33,0.53,,,0 NDC,42858000210,Oxycodone Hydrochloride: 10 Blister Pack In 1 Carton (42858-002-10) / 10 Tablet In 1 Blister Pack,1.72,0.69,,,0 NDC,42858030101,"Hydromorphone Hydrochloride: 100 Tablet In 1 Bottle, Plastic (42858-301-01)",0.64,0.26,,,0 NDC,42858030125,Hydromorphone Hydrochloride: 4 Blister Pack In 1 Carton (42858-301-25) / 25 Tablet In 1 Blister Pack,0.44,0.18,,,0 NDC,42858030201,"Hydromorphone Hydrochloride: 100 Tablet In 1 Bottle, Plastic (42858-302-01)",0.67,0.27,,,0 NDC,42858030225,Hydromorphone Hydrochloride: 4 Blister Pack In 1 Carton (42858-302-25) / 25 Tablet In 1 Blister Pack,0.6,0.24,,,0 NDC,42858051501,"Ms Contin: 100 Tablet In 1 Bottle, Plastic (42858-515-01)",14.72,5.89,,,0 NDC,42858061001,"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, And Amphetamine Sulfate Extended-Release: 100 Capsule, Extended Release In 1 Bottle, Plastic (42858-610-01)",1.83,0.73,,,0 NDC,42858080101,"Morphine Sulfate Extended Release: 100 Tablet, Film Coated, Extended Release In 1 Bottle, Plastic (42858-801-01)",0.7,0.28,,,0 NDC,42858086806,Dronabinol: 60 Capsule In 1 Bottle (42858-868-06),4.48,1.79,,,0 NDC,43066000710,Rocuronium Bromide: 10 Vial In 1 Carton (43066-007-10) / 5 Ml In 1 Vial,4.35,1.74,,,0 NDC,43066000801,NDC Description Not Available,7.31,2.92,,,0 NDC,43066001501,NDC Description Not Available,0.57,0.23,,,0 NDC,43066001510,Ropivacaine Hydrochloride: 10 Vial In 1 Carton (43066-015-10) / 20 Ml In 1 Vial (43066-015-01),0.56,0.22,,,0 NDC,43066001610,Cardene Iv: 10 Bag In 1 Carton (43066-016-10) / 200 Ml In 1 Bag,178.095,71.235,,,0 NDC,43066015010,Nexterone: 100 Ml In 1 Bag (43066-150-10),30.42,12.17,,,0 NDC,43066036020,Nexterone: 200 Ml In 1 Bag (43066-360-20),16.83,6.73,,,0 NDC,43066099701,NDC Description Not Available,32.61,13.04,,,0 NDC,43066099710,"Norepinephrine Bitartrate: 10 Vial, Single-Dose In 1 Carton (43066-997-10) / 4 Ml In 1 Vial, Single-Dose (43066-997-01)",21.42,8.57,,,0 NDC,43386003860,Voriconazole: 1 Bottle In 1 Carton (43386-038-60) / 75 Ml In 1 Bottle,270.34,108.14,,,0 NDC,43386005019,Gavilyte-N: 438.4 G In 1 Bottle (43386-050-19),38.48,15.39,,,0 NDC,43386016101,Misoprostol: 100 Tablet In 1 Bottle (43386-161-01),4.13,1.65,,,0 NDC,43386048024,"Orphenadrine Citrate: 100 Tablet, Extended Release In 1 Bottle (43386-480-24)",1.33,0.53,,,0 NDC,43386077001,Flucytosine: 100 Capsule In 1 Bottle (43386-770-01),83.27,33.31,,,0 NDC,43528000301,NDC Description Not Available,671.4,268.56,,,0 NDC,43528000305,Heplisav-B: 5 Syringe In 1 Carton (43528-003-05) / .5 Ml In 1 Syringe (43528-003-01),611.7,244.68,,,0 NDC,43547005103,Tadalafil: 30 Tablet In 1 Bottle (43547-051-03),1.18,0.47,,,0 NDC,43547026910,"Ropinirole Hydrochloride: 100 Tablet, Film Coated In 1 Bottle, Plastic (43547-269-10)",0.35,0.14,,,0 NDC,43547027010,"Ropinirole Hydrochloride: 100 Tablet, Film Coated In 1 Bottle, Plastic (43547-270-10)",0.42,0.17,,,0 NDC,43547028910,"Bupropion Hydrochloride Sr: 100 Tablet, Film Coated, Extended Release In 1 Bottle (43547-289-10)",0.75,0.3,,,0 NDC,43547034506,"Levetiracetam: 60 Tablet, Film Coated, Extended Release In 1 Bottle (43547-345-06)",1.27,0.51,,,0 NDC,43547034903,"Paroxetine: 30 Tablet, Film Coated In 1 Bottle (43547-349-03)",1.17,0.47,,,0 NDC,43547038709,Fosinopril Sodium: 90 Tablet In 1 Bottle (43547-387-09),0.64,0.26,,,0 NDC,43547039910,"Cyclobenzaprine Hydrochloride: 100 Tablet, Film Coated In 1 Bottle, Plastic (43547-399-10)",0.18,0.07,,,0 NDC,43547040010,"Cyclobenzaprine Hydrochloride: 100 Tablet, Film Coated In 1 Bottle, Plastic (43547-400-10)",0.24,0.1,,,0 NDC,43547040110,"Furosemide: 100 Tablet In 1 Bottle, Plastic (43547-401-10)",0.13,0.05,,,0 NDC,43547040210,"Furosemide: 100 Tablet In 1 Bottle, Plastic (43547-402-10)",0.14,0.06,,,0 NDC,43547040310,"Furosemide: 100 Tablet In 1 Bottle, Plastic (43547-403-10)",0.22,0.09,,,0 NDC,43547040610,"Clonazepam: 100 Tablet In 1 Bottle, Plastic (43547-406-10)",0.17,0.07,,,0 NDC,43547043506,"Clonidine Hydrochloride: 60 Tablet, Extended Release In 1 Bottle (43547-435-06)",9.75,3.9,,,0 NDC,43547052503,Nebivolol: 30 Tablet In 1 Bottle (43547-525-03),0.66,0.26,,,0 NDC,43547060210,Lisdexamfetamine Dimesylate: 100 Capsule In 1 Bottle (43547-602-10),2.27,0.91,,,0 NDC,43547060510,Lisdexamfetamine Dimesylate: 100 Capsule In 1 Bottle (43547-605-10),3.18,1.27,,,0 NDC,43547063201,"Pemetrexed: 100 Injection, Powder, For Solution In 1 Vial (43547-632-01)",5.31,2.12,,,0 NDC,43598005011,NDC Description Not Available,15.64,6.26,,,0 NDC,43598005025,"Thiamine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (43598-050-25) / 2 Ml In 1 Vial, Multi-Dose (43598-050-11)",16.3,6.52,,,0 NDC,43598005111,"Calcitonin Salmon: 1 Vial, Multi-Dose In 1 Carton (43598-051-11) / 2 Ml In 1 Vial, Multi-Dose",8392.14,3356.86,,,0 NDC,43598005311,Desmopressin Acetate: 1 Vial In 1 Carton (43598-053-11) / 10 Ml In 1 Vial,19.58,7.83,,,0 NDC,43598008711,NDC Description Not Available,0.89,0.36,,,0 NDC,43598008758,"Lacosamide: 10 Vial, Single-Dose In 1 Carton (43598-087-58) / 20 Ml In 1 Vial, Single-Dose (43598-087-11)",0.3,0.12,,,0 NDC,43598010610,"Diazepam: 10 Syringe, Glass In 1 Carton (43598-106-10) / 2 Ml In 1 Syringe, Glass (43598-106-11)",44.03,17.61,,,0 NDC,43598010611,NDC Description Not Available,47.24,18.9,,,0 NDC,43598012725,"Methylprednisolone Sodium Succinate: 25 Vial, Single-Dose In 1 Carton (43598-127-25) / 1 Ml In 1 Vial, Single-Dose (43598-127-45)",1.21,0.48,,,0 NDC,43598012745,NDC Description Not Available,2.66,1.06,,,0 NDC,43598012811,"Methylprednisolone Sodium Succinate: 1 Vial, Multi-Dose In 1 Carton (43598-128-11) / 8 Ml In 1 Vial, Multi-Dose",0.98,0.39,,,0 NDC,43598012901,NDC Description Not Available,1.36,0.54,,,0 NDC,43598012925,"Methylprednisolone Sodium Succinate: 25 Vial, Single-Dose In 1 Carton (43598-129-25) / 2 Ml In 1 Vial, Single-Dose (43598-129-01)",0.4,0.16,,,0 NDC,43598013074,"Methylprednisolone Sodium Succinate: 1 Vial, Multi-Dose In 1 Carton (43598-130-74) / 16 Ml In 1 Vial, Multi-Dose",0.73,0.29,,,0 NDC,43598014011,NDC Description Not Available,186.33,74.53,,,0 NDC,43598014206,"Nelarabine: 6 Vial, Single-Dose In 1 Carton (43598-142-06) / 50 Ml In 1 Vial, Single-Dose",331.1,132.44,,,0 NDC,43598014211,"Nelarabine: 1 Vial, Single-Dose In 1 Carton (43598-142-11) / 50 Ml In 1 Vial, Single-Dose",792.21,316.88,,,0 NDC,43598016360,"Lubiprostone: 60 Capsule, Gelatin Coated In 1 Bottle (43598-163-60)",7.43,2.97,,,0 NDC,43598017111,"Thiotepa: 1 Vial In 1 Carton (43598-171-11) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",1060.04,424.02,,,0 NDC,43598021050,Ssd Cream: 50 G In 1 Tube (43598-210-50),47.38,18.95,,,0 NDC,43598026202,"Fulvestrant: 2 Syringe, Glass In 1 Carton (43598-262-02) / 5 Ml In 1 Syringe, Glass (43598-262-11)",23.54,9.42,,,0 NDC,43598026211,NDC Description Not Available,23.54,9.42,,,0 NDC,43598026223,"Fulvestrant: 2 Syringe, Glass In 1 Carton (43598-262-23) / 5 Ml In 1 Syringe, Glass (43598-262-11)",23.62,9.45,,,0 NDC,43598028335,"Doxorubicin Hydrochloride: 1 Vial, Single-Dose In 1 Package (43598-283-35) / 10 Ml In 1 Vial, Single-Dose",376.49,150.6,,,0 NDC,43598030562,"Azacitidine: 1 Injection, Powder, Lyophilized, For Solution In 1 Carton (43598-305-62)",8.8,3.52,,,0 NDC,43598035130,"Lurasidone Hydrochloride: 30 Tablet, Film Coated In 1 Bottle (43598-351-30)",2.53,1.01,,,0 NDC,43598037074,"Pemetrexed Disodium: 1 Vial, Single-Dose In 1 Carton (43598-370-74) / 40 Ml In 1 Vial, Single-Dose",6.25,2.5,,,0 NDC,43598038662,"Pemetrexed Disodium: 1 Vial, Single-Dose In 1 Carton (43598-386-62) / 4 Ml In 1 Vial, Single-Dose",6.18,2.47,,,0 NDC,43598038711,"Pemetrexed Disodium: 1 Vial, Single-Dose In 1 Carton (43598-387-11) / 20 Ml In 1 Vial, Single-Dose",6.18,2.47,,,0 NDC,43598040511,NDC Description Not Available,18.77,7.51,,,0 NDC,43598040516,Phytonadione Phytonadione: 25 Ampule In 1 Carton (43598-405-16) / 1 Ml In 1 Ampule (43598-405-11),9.68,3.87,,,0 NDC,43598041311,"Daptomycin: 1 Vial, Single-Dose In 1 Carton (43598-413-11) / 10 Ml In 1 Vial, Single-Dose",0.89,0.36,,,0 NDC,43598042660,"Bortezomib: 1 Vial, Single-Dose In 1 Carton (43598-426-60) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",2.16,0.86,,,0 NDC,43598043635,NDC Description Not Available,36.98,14.79,,,0 NDC,43598044674,Nicotine Transdermal System Step 3: 14 Patch In 1 Carton (43598-446-74) / 24 H In 1 Patch,5.41,2.16,,,0 NDC,43598044774,Nicotine Transdermal System Step 2: 14 Patch In 1 Carton (43598-447-74) / 24 H In 1 Patch,5.41,2.16,,,0 NDC,43598044870,Nicotine Transdermal System Step 1: 7 Patch In 1 Carton (43598-448-70) / 24 H In 1 Patch,6.39,2.56,,,0 NDC,43598044874,Nicotine Transdermal System Step 1: 14 Patch In 1 Carton (43598-448-74) / 24 H In 1 Patch,5.41,2.16,,,0 NDC,43598052911,"Neostigmine: 1 Vial, Multi-Dose In 1 Carton (43598-529-11) / 10 Ml In 1 Vial, Multi-Dose",3.99,1.6,,,0 NDC,43598054952,NDC Description Not Available,0.44,0.18,,,0 NDC,43598058201,NDC Description Not Available,15.08,6.03,,,0 NDC,43598058230,"Buprenorphine And Naloxone: 30 Pouch In 1 Carton (43598-582-30) / 1 Film, Soluble In 1 Pouch (43598-582-01)",15.07,6.03,,,0 NDC,43598058723,"Sodium Nitroprusside: 1 Vial, Single-Dose In 1 Carton (43598-587-23) / 2 Ml In 1 Vial, Single-Dose",73.69,29.48,,,0 NDC,43598058811,Difluprednate Ophthalmic Emulsion: 1 Bottle In 1 Carton (43598-588-11) / 5 Ml In 1 Bottle,581.49,232.6,,,0 NDC,43598063710,Levetiracetam: 10 Bag In 1 Carton (43598-637-10) / 100 Ml In 1 Bag (43598-637-52),0.42,0.17,,,0 NDC,43598063752,NDC Description Not Available,0.46,0.18,,,0 NDC,43598067201,"Pyrimethamine: 100 Tablet In 1 Bottle, Plastic (43598-672-01)",1062.83,425.13,,,0 NDC,43598069811,"Carboprost Tromethamine: 1 Vial, Single-Dose In 1 Carton (43598-698-11) / 1 Ml In 1 Vial, Single-Dose",250.84,100.34,,,0 NDC,43598074811,Timolol Maleate Ophthalmic Gel Forming Solution 0.5%: 1 Bottle In 1 Carton (43598-748-11) / 5 Ml In 1 Bottle,553.09,221.24,,,0 NDC,43598075011,Naloxone Hydrochloride: 1 Syringe In 1 Box (43598-750-11) / 2 Ml In 1 Syringe,67.9,27.16,,,0 NDC,43598075058,Naloxone Hydrochloride: 10 Syringe In 1 Box (43598-750-58) / 2 Ml In 1 Syringe,68.97,27.59,,,0 NDC,43598083911,NDC Description Not Available,44.94,17.98,,,0 NDC,43598089152,"Potassium Chloride: 50 Cup, Unit-Dose In 1 Package (43598-891-52) / 15 Ml In 1 Cup, Unit-Dose (43598-891-16)",12.01,4.8,,,0 NDC,43598091406,Vasopressin: 25 Vial In 1 Carton (43598-914-06) / 1 Ml In 1 Vial (43598-914-11),2.37,0.95,,,0 NDC,43598091411,NDC Description Not Available,2.27,0.91,,,0 NDC,43598093111,NDC Description Not Available,29.0,11.6,,,0 NDC,43598097511,NDC Description Not Available,58.88,23.55,,,0 NDC,43825010201,"Ofirmev: 24 VIAL, GLASS in 1 CARTON (43825-102-01) / 100 mL in 1 VIAL, GLASS",0.34,0.14,,,0 NDC,43900097647,NDC Description Not Available,1.52,0.61,,,0 NDC,43975035003,"Paliperidone: 30 Tablet, Extended Release In 1 Bottle (43975-350-03)",9.34,3.74,,,0 NDC,44087353501,"Bavencio: 1 Vial, Single-Dose In 1 Carton (44087-3535-1) / 10 Ml In 1 Vial, Single-Dose",436.83,174.73,,,0 NDC,44206030001,"Rhophylac: 1 Syringe, Glass In 1 Carton (44206-300-01) / 2 Ml In 1 Syringe, Glass (44206-300-90)",50.97,20.39,,,0 NDC,44206030010,"Rhophylac: 10 Syringe, Glass In 1 Carton (44206-300-10) / 2 Ml In 1 Syringe, Glass (44206-300-90)",22.27,8.91,,,0 NDC,44206030090,NDC Description Not Available,48.92,19.57,,,0 NDC,44206031025,"Alburx: 1 Vial, Glass In 1 Carton (44206-310-25) / 250 Ml In 1 Vial, Glass (44206-310-90)",195.74,78.3,,,0 NDC,44206031090,NDC Description Not Available,30.41,12.16,,,0 NDC,44206043710,"Privigen: 1 Vial, Glass In 1 Carton (44206-437-10) / 100 Ml In 1 Vial, Glass (44206-437-91)",399.33,159.73,,,0 NDC,44206043791,NDC Description Not Available,403.82,161.53,,,0 NDC,44206043820,"Privigen: 1 Vial, Glass In 1 Carton (44206-438-20) / 200 Ml In 1 Vial, Glass (44206-438-92)",402.19,160.88,,,0 NDC,44206043892,NDC Description Not Available,231.95,92.78,,,0 NDC,44567010010,"Ampicillin: 10 Vial In 1 Tray (44567-100-10) / 1 Injection, Powder, For Solution In 1 Vial",2.86,1.14,,,0 NDC,44567010210,"Ampicillin: 10 Vial In 1 Tray (44567-102-10) / 1 Injection, Powder, For Solution In 1 Vial",13.66,5.46,,,0 NDC,44567010310,"Ampicillin: 10 Vial In 1 Tray (44567-103-10) / 1 Injection, Powder, For Solution In 1 Vial",2.8,1.12,,,0 NDC,44567021110,Ampicillin And Sulbactam: 10 Vial In 1 Carton (44567-211-10) / 20 Ml In 1 Vial,31.65,12.66,,,0 NDC,44567022110,"Nafcillin: 10 Vial In 1 Carton (44567-221-10) / 1 Powder, For Solution In 1 Vial",1.27,0.51,,,0 NDC,44567022210,"Nafcillin: 10 Vial In 1 Carton (44567-222-10) / 1 Powder, For Solution In 1 Vial",4.35,1.74,,,0 NDC,44567022301,"Nafcillin: 1 Vial, Pharmacy Bulk Package In 1 Carton (44567-223-01) / 100 Ml In 1 Vial, Pharmacy Bulk Package",1.87,0.75,,,0 NDC,44567023525,"Ceftazidime: 25 Vial In 1 Carton (44567-235-25) / 1 Injection, Powder, For Solution In 1 Vial",9.99,4.0,,,0 NDC,44567023610,"Ceftazidime: 10 Vial In 1 Carton (44567-236-10) / 1 Injection, Powder, For Solution In 1 Vial",10.98,4.39,,,0 NDC,44567024010,Cefepime: 10 Vial In 1 Carton (44567-240-10) / 20 Ml In 1 Vial,6.25,2.5,,,0 NDC,44567024110,Cefepime: 10 Vial In 1 Carton (44567-241-10) / 20 Ml In 1 Vial,8.6,3.44,,,0 NDC,44567024625,"Cefoxitin: 25 Vial In 1 Carton (44567-246-25) / 1 Injection, Powder, For Solution In 1 Vial",41.41,16.56,,,0 NDC,44567031110,"Penicillin G Potassium: 10 Vial In 1 Tray (44567-311-10) / 1 Injection, Powder, For Solution In 1 Vial",2.19,0.88,,,0 NDC,44567040101,NDC Description Not Available,16.53,6.61,,,0 NDC,44567040110,"Meropenem: 10 Vial In 1 Carton (44567-401-10) / 1 Injection, Powder, For Solution In 1 Vial (44567-401-01)",2.33,0.93,,,0 NDC,44567041024,Magnesium Sulfate In Dextrose: 24 Bag In 1 Carton (44567-410-24) / 100 Ml In 1 Bag,5.93,2.37,,,0 NDC,44567042024,Magnesium Sulfate In Water: 24 Pouch In 1 Carton (44567-420-24) / 1 Bag In 1 Pouch / 50 Ml In 1 Bag,7.48,2.99,,,0 NDC,44567042124,Magnesium Sulfate In Water: 24 Pouch In 1 Carton (44567-421-24) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,2.01,0.8,,,0 NDC,44567043624,Levofloxacin: 24 Pouch In 1 Carton (44567-436-24) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,5.38,2.15,,,0 NDC,44567043724,Levofloxacin: 24 Pouch In 1 Carton (44567-437-24) / 1 Bag In 1 Pouch / 150 Ml In 1 Bag,4.52,1.81,,,0 NDC,44567045101,NDC Description Not Available,2.35,0.94,,,0 NDC,44567045110,Esmolol Hydrochloride: 10 Bag In 1 Carton (44567-451-10) / 100 Ml In 1 Bag (44567-451-01),1.91,0.76,,,0 NDC,44567050201,NDC Description Not Available,0.48,0.19,,,0 NDC,44567050210,Levetiracetam: 10 Bag In 1 Carton (44567-502-10) / 100 Ml In 1 Bag (44567-502-01),0.48,0.19,,,0 NDC,44567050301,NDC Description Not Available,0.41,0.16,,,0 NDC,44567060104,Dexmedetomidine: 4 Vial In 1 Carton (44567-601-04) / 10 Ml In 1 Vial,450.06,180.02,,,0 NDC,44567061101,NDC Description Not Available,1.58,0.63,,,0 NDC,44567061110,Midazolam In Sodium Chloride: 10 Bag In 1 Carton (44567-611-10) / 100 Ml In 1 Bag (44567-611-01),0.8,0.32,,,0 NDC,44567064101,NDC Description Not Available,234.24,93.7,,,0 NDC,44567064110,Norepinephrine Bitartrate In Sodium Chloride: 10 Bag In 1 Carton (44567-641-10) / 250 Ml In 1 Bag (44567-641-01),148.55,59.42,,,0 NDC,44567064201,NDC Description Not Available,250.34,100.14,,,0 NDC,44567064210,Norepinephrine Bitartrate In Sodium Chloride: 10 Bag In 1 Carton (44567-642-10) / 250 Ml In 1 Bag (44567-642-01),414.94,165.98,,,0 NDC,44567070225,"Ceftriaxone: 25 Vial In 1 Carton (44567-702-25) / 1 Injection, Powder, For Solution In 1 Vial",3.62,1.45,,,0 NDC,44567080110,"Piperacillin And Tazobactam: 10 Vial In 1 Box (44567-801-10) / 1 Injection, Powder, For Solution In 1 Vial",5.18,2.07,,,0 NDC,44567080210,"Piperacillin And Tazobactam: 10 Vial In 1 Box (44567-802-10) / 1 Injection, Powder, For Solution In 1 Vial",9.82,3.93,,,0 NDC,44567080310,"Piperacillin And Tazobactam: 10 Vial In 1 Box (44567-803-10) / 1 Injection, Powder, For Solution In 1 Vial",5.26,2.1,,,0 NDC,44567080401,"Piperacillin And Tazobactam: 1 Bottle In 1 Box (44567-804-01) / 1 Injection, Powder, For Solution In 1 Bottle",3.01,1.2,,,0 NDC,44567081110,Esmolol Hydrochloride In Water: 10 Bag In 1 Carton (44567-811-10) / 250 Ml In 1 Bag,2.09,0.84,,,0 NDC,44677010202,NDC Description Not Available,6.64,2.66,,,0 NDC,45567003001,Kit For The Prepartion Of Technetium Tc99M Sulfur Colloid: 1 Kit In 1 Package (45567-0030-1) * 3 Ml In 1 Vial * 3 Ml In 1 Vial * 10 Ml In 1 Vial,173.68,69.472,,,0 NDC,45567004001,"Kit For The Preparation Of Technetium Tc 99M Medronate: 5 Vial, Multi-Dose In 1 Kit (45567-0040-1) / 10 Ml In 1 Vial, Multi-Dose",199.92,79.97,,,0 NDC,45567006001,"Kit For The Preparation Of Technetium Tc99M Pyrophosphate: 5 Vial, Multi-Dose In 1 Kit (45567-0060-1) / 10 Ml In 1 Vial, Multi-Dose",292.97,117.19,,,0 NDC,45567045502,"Kit For The Preparation Of Technetium Tc 99M Mebrofenin: 30 Vial, Multi-Dose In 1 Kit (45567-0455-2) / 10 Ml In 1 Vial, Multi-Dose",99.44999999999999,39.782000000000004,,,0 NDC,45802004064,Selenium Sulfide: 118 Ml In 1 Bottle (45802-040-64),22.61,9.04,,,0 NDC,45802004611,Gentamicin Sulfate: 1 Tube In 1 Carton (45802-046-11) / 30 G In 1 Tube,345.28,138.11,,,0 NDC,45802004635,Gentamicin Sulfate: 1 Tube In 1 Carton (45802-046-35) / 15 G In 1 Tube,118.49,47.4,,,0 NDC,45802005535,Triamcinolone Acetonide: 1 Tube In 1 Carton (45802-055-35) / 15 G In 1 Tube,13.55,5.42,,,0 NDC,45802005635,Gentamicin Sulfate: 1 Tube In 1 Carton (45802-056-35) / 15 G In 1 Tube,120.04,48.02,,,0 NDC,45802005911,Nystatin: 1 Tube In 1 Carton (45802-059-11) / 30 G In 1 Tube,60.54,24.22,,,0 NDC,45802006001,Bacitracin: 1 Tube In 1 Carton (45802-060-01) / 14 G In 1 Tube,3.03,1.21,,,0 NDC,45802006003,Bacitracin: 1 Tube In 1 Carton (45802-060-03) / 28 G In 1 Tube,7.32,2.93,,,0 NDC,45802006070,Bacitracin: 144 Packet In 1 Carton (45802-060-70) / .9 G In 1 Packet,0.4,0.16,,,0 NDC,45802006435,Triamcinolone Acetonide: 1 Tube In 1 Carton (45802-064-35) / 15 G In 1 Tube,9.72,3.89,,,0 NDC,45802006436,Triamcinolone Acetonide: 1 Tube In 1 Carton (45802-064-36) / 80 G In 1 Tube,33.86,13.54,,,0 NDC,45802006535,Triamcinolone Acetonide: 1 Tube In 1 Carton (45802-065-35) / 15 G In 1 Tube,24.57,9.83,,,0 NDC,45802009846,Mesalamine: 60 Ml In 1 Bottle (45802-098-46),22.32,8.93,,,0 NDC,45802011222,Mupirocin: 1 Tube In 1 Carton (45802-112-22) / 22 G In 1 Tube,27.0,10.8,,,0 NDC,45802014303,Triple Antibiotic: 1 Tube In 1 Carton (45802-143-03) / 28 G In 1 Tube,4.71,1.88,,,0 NDC,45802016000,Diclofenac Sodium: 1 Tube In 1 Carton (45802-160-00) / 100 G In 1 Tube,189.06,75.62,,,0 NDC,45802018816,Hemorrhoidal: 1 Tube In 1 Carton (45802-188-16) / 57 G In 1 Tube,4.68,1.87,,,0 NDC,45802027603,Hydrocortisone: 1 Tube In 1 Carton (45802-276-03) / 28 G In 1 Tube,5.89,2.36,,,0 NDC,45802036862,Imiquimod: 24 Packet In 1 Carton (45802-368-62) / .25 G In 1 Packet,0.71,0.28,,,0 NDC,45802041059,"Oxymetazoline Hcl: 1 Bottle, Spray In 1 Carton (45802-410-59) / 30 Ml In 1 Bottle, Spray",5.88,2.35,,,0 NDC,45802041954,"Ammonium Lactate: 225 G In 1 Bottle, Plastic (45802-419-54)",37.35,14.94,,,0 NDC,45802043805,Hydrocortisone: 454 G In 1 Jar (45802-438-05),120.35,48.14,,,0 NDC,45802046564,Ketoconazole: 120 Ml In 1 Bottle (45802-465-64),35.51,14.2,,,0 NDC,45802071700,NDC Description Not Available,118.93,47.57,,,0 NDC,45802071708,Terconazole: 3 Blister Pack In 1 Carton (45802-717-08) / 1 Suppository In 1 Blister Pack (45802-717-00),118.93,47.57,,,0 NDC,45802073000,Acetaminophen Pain Reliever Fever Reducer: 1 Suppository In 1 Blister Pack (45802-730-00),0.64,0.26,,,0 NDC,45802073030,Acetaminophen Pain Reliever Fever Reducer: 12 Blister Pack In 1 Carton (45802-730-30) / 1 Suppository In 1 Blister Pack,1.07,0.43,,,0 NDC,45802073200,NDC Description Not Available,0.81,0.32,,,0 NDC,45802073230,Acetaminophen For Children: 12 Blister Pack In 1 Carton (45802-732-30) / 1 Suppository In 1 Blister Pack,0.84,0.34,,,0 NDC,45802091987,"Cetirizine Hydrochloride: 1 Bottle In 1 Carton (45802-919-87) / 300 Tablet, Film Coated In 1 Bottle",0.23,0.09,,,0 NDC,45802093716,Hydrocortisone: 59 Ml In 1 Bottle (45802-937-16),96.26,38.5,,,0 NDC,45802095243,Ibuprofen: 473 Ml In 1 Bottle (45802-952-43),3.91,1.56,,,0 NDC,45802095301,Diclofenac Sodium: 1 Tube In 1 Carton (45802-953-01) / 100 G In 1 Tube,38.81,15.52,,,0 NDC,45963041806,"Ranolazine: 60 Tablet, Film Coated, Extended Release In 1 Bottle (45963-418-06)",4.27,1.71,,,0 NDC,45963041906,"Ranolazine: 60 Tablet, Film Coated, Extended Release In 1 Bottle (45963-419-06)",7.14,2.86,,,0 NDC,45963043965,Constulose: 946 Ml In 1 Bottle (45963-439-65),20.7,8.28,,,0 NDC,45963073360,"Doxorubicin Hydrochloride: 1 Vial, Multi-Dose In 1 Carton (45963-733-60) / 100 Ml In 1 Vial, Multi-Dose",14.81,5.92,,,0 NDC,45963073368,"Doxorubicin Hydrochloride: 1 Vial, Single-Dose In 1 Carton (45963-733-68) / 25 Ml In 1 Vial, Single-Dose",18.91,7.56,,,0 NDC,46122016510,"Good Neighbor Pharmacy Nasal: 1 Bottle, Spray In 1 Carton (46122-165-10) / 30 Ml In 1 Bottle, Spray",2.16,0.86,,,0 NDC,46122027830,"Sore Throat Menthol: 177 Ml In 1 Bottle, Spray (46122-278-30)",3.54,1.42,,,0 NDC,46122039516,"Mineral Oil: 473 Ml In 1 Bottle, Plastic (46122-395-16)",1.09,0.44,,,0 NDC,46122046143,Epsom Salt: 454 G In 1 Pouch (46122-461-43),8.18,3.27,,,0 NDC,46122074876,"Good Neighbor Sore Throat Cherry Flavor: 177 Ml In 1 Bottle, Spray (46122-748-76)",3.19,1.28,,,0 NDC,46122075237,Arthritis Pain Reliever: 1 Tube In 1 Carton (46122-752-37) / 50 G In 1 Tube,20.01,8.0,,,0 NDC,46287000601,Sodium Polystyrene Sulfonate: 473 Ml In 1 Bottle (46287-006-01),121.79,48.72,,,0 NDC,46287000660,"Sodium Polystyrene Sulfonate: 10 Bottle, Unit-Dose In 1 Carton (46287-006-60) / 60 Ml In 1 Bottle, Unit-Dose",75.21,30.08,,,0 NDC,46287000901,Isoniazid: 473 Ml In 1 Bottle (46287-009-01),176.74,70.7,,,0 NDC,46287002001,Carospir: 473 Ml In 1 Bottle (46287-020-01),21.12,8.45,,,0 NDC,46287050001,NDC Description Not Available,4.785,1.9100000000000001,,,0 NDC,46287050030,NDC Description Not Available,7.2,2.88,,,0 NDC,46783022152,Asclera: 2 mL in 1 AMPULE (46783-221-52),92.0,36.8,,,0 NDC,47335004940,"Doxorubicin Hydrochloride: 1 Vial, Single-Dose In 1 Package (47335-049-40) / 10 Ml In 1 Vial, Single-Dose",929.01,371.6,,,0 NDC,47335005040,"Doxorubicin Hydrochloride: 1 Vial, Single-Dose In 1 Package (47335-050-40) / 25 Ml In 1 Vial, Single-Dose",1074.27,429.71,,,0 NDC,47335017148,NDC Description Not Available,27.68,11.07,,,0 NDC,47335017149,Tobramycin: 14 Pouch In 1 Carton (47335-171-49) / 4 Ampule In 1 Pouch (47335-171-48) / 5 Ml In 1 Ampule,28.89,11.56,,,0 NDC,47335023683,"Ambrisentan: 30 Tablet, Film Coated In 1 Bottle (47335-236-83)",137.56,55.02,,,0 NDC,47335023783,"Ambrisentan: 30 Tablet, Film Coated In 1 Bottle (47335-237-83)",115.21,46.08,,,0 NDC,47335047281,"Imatinib Mesylate: 90 Tablet, Film Coated In 1 Bottle (47335-472-81)",7.02,2.81,,,0 NDC,47335048583,"Bicalutamide: 30 Tablet, Film Coated In 1 Bottle (47335-485-83)",1.27,0.51,,,0 NDC,47335053981,"Niacin: 90 Tablet, Film Coated, Extended Release In 1 Bottle (47335-539-81)",1.2,0.48,,,0 NDC,47335057883,Lurasidone Hydrochloride: 30 Tablet In 1 Bottle (47335-578-83),7.59,3.04,,,0 NDC,47335076583,"Paliperidone: 30 Tablet, Extended Release In 1 Bottle (47335-765-83)",6.08,2.43,,,0 NDC,47335089274,Temozolomide: 5 Blister Pack In 1 Carton (47335-892-74) / 1 Capsule In 1 Blister Pack,3.51,1.4,,,0 NDC,47335093140,NDC Description Not Available,21.28,8.51,,,0 NDC,47335099201,Magnesium Sulfate: 24 Pouch In 1 Case (47335-992-01) / 1 Bag In 1 Pouch / 50 Ml In 1 Bag,13.69,5.48,,,0 NDC,47335099202,Magnesium Sulfate: 24 Pouch In 1 Case (47335-992-02) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,3.62,1.45,,,0 NDC,47335099301,Metronidazole: 1 Bag In 1 Pouch (47335-993-01) / 100 Ml In 1 Bag,0.24,0.1,,,0 NDC,47426020101,"Cinvanti: 1 Vial, Glass In 1 Carton (47426-201-01) / 18 Ml In 1 Vial, Glass",14.66,5.86,,,0 NDC,47682022335,Triple Antibiotic: 144 Pouch In 1 Box (47682-223-35) / .5 G In 1 Pouch (47682-223-99),0.35,0.14,,,0 NDC,47781017401,"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate Tablets,Cii: 100 Tablet In 1 Bottle (47781-174-01)",1.06,0.42,,,0 NDC,47781017601,"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate Tablets,Cii: 100 Tablet In 1 Bottle (47781-176-01)",1.07,0.43,,,0 NDC,47781035503,Buprenorphine And Naloxone Sublingual Film: 30 Pouch In 1 Carton (47781-355-03) / 1 Film In 1 Pouch (47781-355-11),6.77,2.71,,,0 NDC,47781035511,NDC Description Not Available,6.33,2.53,,,0 NDC,47781035603,Buprenorphine And Naloxone Sublingual Film: 30 Pouch In 1 Carton (47781-356-03) / 1 Film In 1 Pouch (47781-356-11),18.23,7.29,,,0 NDC,47781035611,NDC Description Not Available,15.21,6.08,,,0 NDC,47781035703,Buprenorphine And Naloxone Sublingual Film: 30 Pouch In 1 Carton (47781-357-03) / 1 Film In 1 Pouch (47781-357-11),19.11,7.64,,,0 NDC,47781035711,NDC Description Not Available,10.59,4.24,,,0 NDC,47781038426,"Oseltamivir Phosphate For Oral Suspension: 1 Bottle, Glass In 1 Carton (47781-384-26) / 60 Ml In 1 Bottle, Glass",65.77,26.31,,,0 NDC,47781042411,NDC Description Not Available,21.39,8.56,,,0 NDC,47781042447,Fentanyl System: 5 Pouch In 1 Carton (47781-424-47) / 1 Patch In 1 Pouch (47781-424-11),16.96,6.78,,,0 NDC,47781042611,NDC Description Not Available,20.35,8.14,,,0 NDC,47781042647,Fentanyl System: 5 Pouch In 1 Carton (47781-426-47) / 1 Patch In 1 Pouch (47781-426-11),38.0,15.2,,,0 NDC,47781042711,NDC Description Not Available,57.61,23.04,,,0 NDC,47781042747,Fentanyl System: 5 Pouch In 1 Carton (47781-427-47) / 1 Patch In 1 Pouch (47781-427-11),40.75,16.3,,,0 NDC,47781042811,NDC Description Not Available,47.21,18.88,,,0 NDC,47781056201,Lisdexamfetamine Dimesylate: 100 Capsule In 1 Bottle (47781-562-01),39.87,15.95,,,0 NDC,48433010401,NDC Description Not Available,0.61,0.24,,,0 NDC,48433010601,"Calcium Antacid: 100 Tablet, Chewable In 1 Box, Unit-Dose (48433-106-01)",0.48,0.19,,,0 NDC,48433012801,NDC Description Not Available,0.58,0.23,,,0 NDC,48433020016,NDC Description Not Available,0.79,0.32,,,0 NDC,48433020230,"Mineral Oil: 30 Ml In 1 Cup, Unit-Dose (48433-202-30)",4.79,1.92,,,0 NDC,48433021105,NDC Description Not Available,4.16,1.66,,,0 NDC,48433021501,NDC Description Not Available,0.43,0.17,,,0 NDC,48433021905,NDC Description Not Available,6.35,2.54,,,0 NDC,48433021940,"Senna Syrup: 40 Cup, Unit-Dose In 1 Box (48433-219-40) / 5 Ml In 1 Cup, Unit-Dose (48433-219-05)",5.04,2.02,,,0 NDC,48433023015,Strong Iodine Solution: 14 Ml In 1 Bottle (48433-230-15),74.49,29.8,,,0 NDC,48582000440,NDC Description Not Available,1.35,0.54,,,0 NDC,48582000592,NDC Description Not Available,2.66,1.06,,,0 NDC,48648023000,NDC Description Not Available,1.16,0.46,,,0 NDC,48783011208,"Monsels Solution: 14 G In 1 Vial, Single-Dose (48783-112-08)",35.99,14.4,,,0 NDC,48815100101,"Sodium Iodide I 123: 1 Vial, Plastic In 1 Can (48815-1001-1) / 1 Capsule, Gelatin Coated In 1 Vial, Plastic",248.87,99.55,,,0 NDC,49100040008,NDC Description Not Available,2.12,0.85,,,0 NDC,49100040015,NDC Description Not Available,2.23,0.89,,,0 NDC,49100040053,NDC Description Not Available,1.9,0.76,,,0 NDC,49281012465,"Fluzone High Dose Northern Hemisphere: 5 Syringe, Glass In 1 Package (49281-124-65) / .5 Ml In 1 Syringe, Glass (49281-124-88)",303.5,121.4,,,0 NDC,49281012488,NDC Description Not Available,312.795,125.12,,,0 NDC,49281021588,NDC Description Not Available,202.77,81.11,,,0 NDC,49281040010,Adacel Tdap: 10 Vial In 1 Package (49281-400-10) / .5 Ml In 1 Vial (49281-400-58),216.48,86.59,,,0 NDC,49281042450,"Fluzone Trivalent Northern Hemisphere: 10 Syringe, Glass In 1 Package (49281-424-50) / .5 Ml In 1 Syringe, Glass (49281-424-88)",88.27,35.31,,,0 NDC,49281057415,Beyfortus: 5 Syringe In 1 Carton (49281-574-15) / 1 Ml In 1 Syringe,2013.03,805.21,,,0 NDC,49281057500,Beyfortus: 1 Syringe In 1 Carton (49281-575-00) / .5 Ml In 1 Syringe,2437.06,974.82,,,0 NDC,49281057515,Beyfortus: 5 Syringe In 1 Carton (49281-575-15) / .5 Ml In 1 Syringe,2139.8,855.92,,,0 NDC,49281059058,NDC Description Not Available,580.41,232.16,,,0 NDC,49281072110,Flublok Quadrivalent Northern Hemisphere: 10 SYRINGE in 1 CARTON (49281-721-10) / .5 mL in 1 SYRINGE (49281-721-88),263.91,105.56,,,0 NDC,49281075221,"Tubersol: 1 Vial, Multi-Dose In 1 Carton (49281-752-21) / 1 Ml In 1 Vial, Multi-Dose (49281-752-78)",53.93,21.57,,,0 NDC,49281075222,"Tubersol: 1 Vial, Multi-Dose In 1 Carton (49281-752-22) / 5 Ml In 1 Vial, Multi-Dose (49281-752-98)",39.73,15.89,,,0 NDC,49281075278,NDC Description Not Available,54.86,21.94,,,0 NDC,49281075298,NDC Description Not Available,43.37,17.35,,,0 NDC,49281079051,Typhim Vi: 1 Syringe In 1 Package (49281-790-51) / .5 Ml In 1 Syringe (49281-790-88),595.81,238.32,,,0 NDC,49281079088,NDC Description Not Available,627.36,250.94,,,0 NDC,49281086010,"Ipol: 1 Vial, Multi-Dose In 1 Package (49281-860-10) / 5 Ml In 1 Vial, Multi-Dose (49281-860-78)",186.7,74.68,,,0 NDC,49281086078,NDC Description Not Available,171.04,68.42,,,0 NDC,49401010101,Benlysta: 1 Vial In 1 Carton (49401-101-01) / 1.5 Ml In 1 Vial,235.0,94.0,,,0 NDC,49401010201,Benlysta: 1 Vial In 1 Carton (49401-102-01) / 5 Ml In 1 Vial,237.82999999999998,95.13,,,0 NDC,49452403503,NDC Description Not Available,0.05,0.02,,,0 NDC,49483008001,"Senna Time: 100 Tablet, Coated In 1 Bottle, Plastic (49483-080-01)",0.04,0.02,,,0 NDC,49483008010,"Senna Time: 1000 Tablet, Coated In 1 Bottle, Plastic (49483-080-10)",0.03,0.01,,,0 NDC,49483034150,"Acetaminophen Extra Strength: 500 Tablet, Film Coated In 1 Bottle, Plastic (49483-341-50)",0.1,0.04,,,0 NDC,49483060250,"Ibuprofen: 500 Tablet, Film Coated In 1 Bottle (49483-602-50)",0.14,0.06,,,0 NDC,49483060350,"Ibuprofen: 500 Tablet, Film Coated In 1 Bottle (49483-603-50)",0.2,0.08,,,0 NDC,49483060601,Gabapentin: 100 Capsule In 1 Bottle (49483-606-01),0.26,0.1,,,0 NDC,49502010101,NDC Description Not Available,195.71,78.28,,,0 NDC,49502010102,"Epinephrine: 2 Container In 1 Carton (49502-101-02) / 1 Syringe, Glass In 1 Container (49502-101-01) / .3 Ml In 1 Syringe, Glass",334.7,133.88,,,0 NDC,49502025080,"Semglee: 1 Vial, Multi-Dose In 1 Carton (49502-250-80) / 10 Ml In 1 Vial, Multi-Dose",5.41,2.16,,,0 NDC,49502039380,"Insulin Glargine: 1 Vial, Multi-Dose In 1 Carton (49502-393-80) / 10 Ml In 1 Vial, Multi-Dose",1.33,0.53,,,0 NDC,49502060530,Perforomist: 30 Pouch In 1 Carton (49502-605-30) / 1 Vial In 1 Pouch / 2 Ml In 1 Vial,21.27,8.51,,,0 NDC,49502060595,NDC Description Not Available,13.94,5.58,,,0 NDC,49580033406,Mineral Oil: 473 Ml In 1 Bottle (49580-0334-6),0.72,0.29,,,0 NDC,49591012611,NDC Description Not Available,10491.5,4196.6,,,0 NDC,49591053250,NDC Description Not Available,7730.14,3092.06,,,0 NDC,49609010101,"Fludeoxyglucose F 18: 30 Ml In 1 Vial, Multi-Dose (49609-101-01)",511.39,204.56,,,0 NDC,49702021301,NDC Description Not Available,5.98,2.39,,,0 NDC,49702022248,Ziagen: 1 Bottle In 1 Carton (49702-222-48) / 240 Ml In 1 Bottle,2.64,1.06,,,0 NDC,49702022813,"Tivicay: 30 Tablet, Film Coated In 1 Bottle (49702-228-13)",222.99,89.2,,,0 NDC,49702023113,"Triumeq: 30 Tablet, Film Coated In 1 Bottle (49702-231-13)",367.43,146.97,,,0 NDC,49702023803,NDC Description Not Available,28.8,11.52,,,0 NDC,49702025018,"Rukobia: 1 Bottle In 1 Carton (49702-250-18) / 60 Tablet, Film Coated, Extended Release In 1 Bottle",647.18,258.87,,,0 NDC,49702026423,Apretude: 1 Kit In 1 Carton (49702-264-23) * 3 Ml In 1 Vial (49702-238-03),29.37,11.75,,,0 NDC,49884004801,"Dexmethylphenidate Hydrochloride: 100 Capsule, Extended Release In 1 Bottle (49884-048-01)",3.15,1.26,,,0 NDC,49884005501,Imipramine Hydrochloride: 100 Tablet In 1 Bottle (49884-055-01),0.52,0.21,,,0 NDC,49884015576,"Varenicline: 56 Tablet, Film Coated In 1 Bottle (49884-155-76)",19.15,7.66,,,0 NDC,49884015676,"Varenicline: 56 Tablet, Film Coated In 1 Bottle (49884-156-76)",5.74,2.3,,,0 NDC,49884023183,"Praziquantel: 6 Tablet, Film Coated In 1 Bottle (49884-231-83)",150.02,60.01,,,0 NDC,49884030602,"Clonazepam: 60 Tablet, Orally Disintegrating In 1 Blister Pack (49884-306-02)",2.83,1.13,,,0 NDC,49884030652,NDC Description Not Available,1.38,0.55,,,0 NDC,49884031152,NDC Description Not Available,14.8,5.92,,,0 NDC,49884031191,"Risperidone: 7 Blister Pack In 1 Carton (49884-311-91) / 4 Tablet, Orally Disintegrating In 1 Blister Pack (49884-311-52)",14.8,5.92,,,0 NDC,49884031552,NDC Description Not Available,12.26,4.9,,,0 NDC,49884031555,"Risperidone: 5 Blister Pack In 1 Carton (49884-315-55) / 6 Tablet, Orally Disintegrating In 1 Blister Pack",12.35,4.94,,,0 NDC,49884031591,"Risperidone: 7 Blister Pack In 1 Carton (49884-315-91) / 4 Tablet, Orally Disintegrating In 1 Blister Pack (49884-315-52)",17.29,6.92,,,0 NDC,49884034801,Pimozide: 100 Tablet In 1 Bottle (49884-348-01),7.19,2.88,,,0 NDC,49884036401,Dantrolene Sodium: 100 Capsule In 1 Bottle (49884-364-01),2.94,1.18,,,0 NDC,49884041301,"Ursodiol: 100 Tablet, Film Coated In 1 Bottle (49884-413-01)",7.71,3.08,,,0 NDC,49884046565,Cholestyramine: 60 Packet In 1 Carton (49884-465-65) / 9 G In 1 Packet (49884-465-64),33.49,13.4,,,0 NDC,49884067314,Cabergoline: 8 TABLET in 1 BOTTLE (49884-673-14),48.06,19.22,,,0 NDC,49884077052,NDC Description Not Available,359.44,143.78,,,0 NDC,49938010230,Dapsone: 2 Blister Pack In 1 Carton (49938-102-30) / 15 Tablet In 1 Blister Pack,9.84,3.94,,,0 NDC,49999018720,NDC Description Not Available,128.8,51.52,,,0 NDC,50016095711,NDC Description Not Available,4160.44,1664.18,,,0 NDC,50024043100,NDC Description Not Available,14.99,6.0,,,0 NDC,50090029501,"Kenalog-10: 1 Vial, Multi-Dose In 1 Carton (50090-0295-1) / 5 Ml In 1 Vial, Multi-Dose",9.95,3.98,,,0 NDC,50090084500,Bacitracin: 144 Packet In 1 Carton (50090-0845-0) / .9 G In 1 Packet,0.18,0.07,,,0 NDC,50090514700,Shingrix: 1 KIT in 1 KIT (50090-5147-0) * .5 mL in 1 VIAL (58160-828-01) * .5 mL in 1 VIAL (58160-829-01),593.92,237.57,,,0 NDC,50111039801,Hydralazine Hydrochloride: 100 Tablet In 1 Bottle (50111-398-01),0.52,0.21,,,0 NDC,50111064802,Fluoxetine: 500 Capsule In 1 Bottle (50111-648-02),0.24,0.1,,,0 NDC,50111078710,"Azithromycin: 30 Tablet, Film Coated In 1 Bottle (50111-787-10)",9.01,3.6,,,0 NDC,50190014123,NDC Description Not Available,1.9,0.76,,,0 NDC,50190014263,NDC Description Not Available,1.57,0.63,,,0 NDC,50228017601,"Bupropion Hydrochloride Sr: 100 Tablet, Film Coated, Extended Release In 1 Bottle, Plastic (50228-176-01)",0.21,0.08,,,0 NDC,50228037930,Ezetimibe: 30 Tablet In 1 Bottle (50228-379-30),0.26,0.1,,,0 NDC,50228045701,Carbidopa And Levodopa: 100 Tablet In 1 Bottle (50228-457-01),0.39,0.16,,,0 NDC,50228046501,Nabumetone: 100 Tablet In 1 Bottle (50228-465-01),0.26,0.1,,,0 NDC,50242004110,Cathflo Activase: 10 Vial In 1 Carton (50242-041-10) / 2 Ml In 1 Vial,399.11,159.64,,,0 NDC,50242004164,Cathflo Activase: 1 Vial In 1 Carton (50242-041-64) / 2 Ml In 1 Vial,397.8,159.12,,,0 NDC,50242004413,"Activase: 1 Kit In 1 Carton (50242-044-13) * 50 Ml In 1 Vial, Single-Use * 50 Ml In 1 Vial, Single-Use",392.37,156.95,,,0 NDC,50242005121,"Rituxan: 1 Vial, Single-Use In 1 Carton (50242-051-21) / 10 Ml In 1 Vial, Single-Use",389.32,155.73,,,0 NDC,50242005306,"Rituxan: 1 Vial, Single-Use In 1 Carton (50242-053-06) / 50 Ml In 1 Vial, Single-Use",405.56,162.22,,,0 NDC,50242006001,"Avastin: 1 Vial, Single-Use In 1 Carton (50242-060-01) / 4 Ml In 1 Vial, Single-Use",305.95,122.38,,,0 NDC,50242006101,"Avastin: 1 Vial, Single-Use In 1 Carton (50242-061-01) / 16 Ml In 1 Vial, Single-Use",322.22,128.89,,,0 NDC,50242007001,"Gazyva: 1 Vial, Single-Use In 1 Carton (50242-070-01) / 40 Ml In 1 Vial, Single-Use",374.22,149.69,,,0 NDC,50242007701,"Herceptin Hylecta: 1 Vial, Single-Dose In 1 Carton (50242-077-01) / 5 Ml In 1 Vial, Single-Dose",344.21,137.68,,,0 NDC,50242008527,"Activase: 1 Kit In 1 Carton (50242-085-27) * 100 Ml In 1 Vial, Single-Use * 100 Ml In 1 Vial, Single-Use",389.23,155.69,,,0 NDC,50242008701,"Kadcyla: 1 Vial, Single-Use In 1 Carton (50242-087-01) / 8 Ml In 1 Vial, Single-Use",174.06,69.62,,,0 NDC,50242008801,"Kadcyla: 1 Vial, Single-Use In 1 Carton (50242-088-01) / 5 Ml In 1 Vial, Single-Use",174.4,69.76,,,0 NDC,50242009002,"Zelboraf: 1 Bottle, Plastic In 1 Carton (50242-090-02) / 112 Tablet, Film Coated In 1 Bottle, Plastic",216.97,86.79,,,0 NDC,50242010039,NDC Description Not Available,133.67,53.47,,,0 NDC,50242010040,Pulmozyme: 5 Pouch In 1 Carton (50242-100-40) / 6 Ampule In 1 Pouch (50242-100-39) / 2.5 Ml In 1 Ampule,159.2,63.68,,,0 NDC,50242010301,Polivy: 1 Vial In 1 Carton (50242-103-01) / 6 Ml In 1 Vial,524.82,209.93,,,0 NDC,50242010501,"Polivy: 1 Vial, Single-Dose In 1 Carton (50242-105-01) / 20 Ml In 1 Vial, Single-Dose",571.64,228.66,,,0 NDC,50242010801,"Rituxan Hycela: 1 Vial, Single-Dose In 1 Carton (50242-108-01) / 11.7 Ml In 1 Vial, Single-Dose",207.51,83.0,,,0 NDC,50242010901,"Rituxan Hycela: 1 Vial, Single-Dose In 1 Carton (50242-109-01) / 13.4 Ml In 1 Vial, Single-Dose",216.09,86.44,,,0 NDC,50242012047,"Tnkase: 1 Kit In 1 Carton (50242-120-47) * 1 Vial, Single-Use In 1 Carton (50242-037-06) / 10 Ml In 1 Vial, Single-Use * 1 Vial, Single-Use In 1 Carton (50242-901-09) / 10 Ml In 1 Vial, Single-Us",636.14,254.46,,,0 NDC,50242012501,"Columvi: 1 Vial, Single-Dose In 1 Carton (50242-125-01) / 2.5 Ml In 1 Vial, Single-Dose",11303.04,4521.22,,,0 NDC,50242012701,"Columvi: 1 Vial, Single-Dose In 1 Carton (50242-127-01) / 10 Ml In 1 Vial, Single-Dose",11609.22,4643.69,,,0 NDC,50242013201,"Herceptin: 1 Vial, Single-Dose In 1 Carton (50242-132-01) / 15 Ml In 1 Vial, Single-Dose",475.11,190.04,,,0 NDC,50242013501,"Actemra: 1 Vial, Single-Use In 1 Box (50242-135-01) / 4 Ml In 1 Vial, Single-Use",28.42,11.37,,,0 NDC,50242013601,"Actemra: 1 Vial, Single-Use In 1 Box (50242-136-01) / 10 Ml In 1 Vial, Single-Use",28.43,11.37,,,0 NDC,50242013701,"Actemra: 1 Vial, Single-Use In 1 Box (50242-137-01) / 20 Ml In 1 Vial, Single-Use",28.48,11.39,,,0 NDC,50242014201,Lunsumio: 1 Vial In 1 Carton (50242-142-01) / 30 Ml In 1 Vial,2752.4,1100.96,,,0 NDC,50242014501,"Perjeta: 1 Vial, Single-Use In 1 Carton (50242-145-01) / 14 Ml In 1 Vial, Single-Use",70.09,28.04,,,0 NDC,50242015001,"Ocrevus: 1 Vial, Single-Use In 1 Carton (50242-150-01) / 10 Ml In 1 Vial, Single-Use",254.79,101.92,,,0 NDC,50242015901,Lunsumio: 1 Vial In 1 Carton (50242-159-01) / 1 Ml In 1 Vial,2746.7,1098.68,,,0 NDC,50242017601,"Tnkase: 1 Kit In 1 Carton (50242-176-01) * 1 Vial, Single-Use In 1 Carton (50242-037-06) / 10 Ml In 1 Vial, Single-Use * 1 Vial, Single-Use In 1 Carton (50242-901-09) / 10 Ml In 1 Vial, Single-Us",740.01,296.0,,,0 NDC,50242021401,"Xolair Pfs: 1 Syringe, Glass In 1 Carton (50242-214-01) / .5 Ml In 1 Syringe, Glass",68.12,27.25,,,0 NDC,50242021403,"Xolair Pfs: 1 Syringe, Glass In 1 Carton (50242-214-03) / .5 Ml In 1 Syringe, Glass",193.54,77.42,,,0 NDC,50242021501,"Xolair Pfs: 1 Syringe, Glass In 1 Carton (50242-215-01) / 1 Ml In 1 Syringe, Glass",86.62,34.65,,,0 NDC,50242021503,"Xolair Pfs: 1 Syringe, Glass In 1 Carton (50242-215-03) / 1 Ml In 1 Syringe, Glass",61.5,24.6,,,0 NDC,50242024501,"Phesgo: 1 Vial, Single-Dose In 1 Carton (50242-245-01) / 15 Ml In 1 Vial, Single-Dose",324.31,129.72,,,0 NDC,50242026001,"Phesgo: 1 Vial, Single-Dose In 1 Carton (50242-260-01) / 10 Ml In 1 Vial, Single-Dose",327.47,130.99,,,0 NDC,50242086001,"Xofluza: 1 Blister Pack In 1 Carton (50242-860-01) / 1 Tablet, Film Coated In 1 Blister Pack",495.04,198.02,,,0 NDC,50242087701,"Xofluza: 1 Blister Pack In 1 Carton (50242-877-01) / 1 Tablet, Film Coated In 1 Blister Pack",502.31,200.92,,,0 NDC,50242091701,"Tecentriq: 1 Vial, Single-Use In 1 Carton (50242-917-01) / 20 Ml In 1 Vial, Single-Use",399.92,159.97,,,0 NDC,50242091801,"Tecentriq: 1 Vial, Single-Use In 1 Carton (50242-918-01) / 14 Ml In 1 Vial, Single-Use",405.06,162.02,,,0 NDC,50242093301,"Tecentriq Hybreza: 1 Vial, Single-Dose In 1 Box (50242-933-01) / 15 Ml In 1 Vial, Single-Dose",133.43,53.37,,,0 NDC,50268005011,NDC Description Not Available,5.31,2.12,,,0 NDC,50268005015,Acebutolol Hydrochloride: 50 Blister Pack In 1 Box (50268-050-15) / 1 Capsule In 1 Blister Pack (50268-050-11),5.65,2.26,,,0 NDC,50268005411,NDC Description Not Available,6.97,2.79,,,0 NDC,50268005711,NDC Description Not Available,10.98,4.39,,,0 NDC,50268005811,NDC Description Not Available,14.25,5.7,,,0 NDC,50268006111,NDC Description Not Available,0.86,0.34,,,0 NDC,50268006211,NDC Description Not Available,3.41,1.36,,,0 NDC,50268007411,NDC Description Not Available,2.52,1.01,,,0 NDC,50268007415,"Azithromycin Dihydrate: 50 Blister Pack In 1 Box (50268-074-15) / 1 Tablet, Film Coated In 1 Blister Pack (50268-074-11)",2.69,1.08,,,0 NDC,50268007511,NDC Description Not Available,2.98,1.19,,,0 NDC,50268008711,NDC Description Not Available,3.02,1.21,,,0 NDC,50268008712,"Aripiprazole: 20 Blister Pack In 1 Box, Unit-Dose (50268-087-12) / 1 Tablet In 1 Blister Pack (50268-087-11)",17.3,6.92,,,0 NDC,50268008911,NDC Description Not Available,1.8,0.72,,,0 NDC,50268008915,"Aripiprazole: 50 Blister Pack In 1 Box, Unit-Dose (50268-089-15) / 1 Tablet In 1 Blister Pack (50268-089-11)",1.71,0.68,,,0 NDC,50268009511,NDC Description Not Available,1.33,0.53,,,0 NDC,50268009515,"Atorvastatin Calcium: 50 Blister Pack In 1 Box, Unit-Dose (50268-095-15) / 1 Tablet, Film Coated In 1 Blister Pack (50268-095-11)",1.14,0.46,,,0 NDC,50268010611,NDC Description Not Available,1.34,0.54,,,0 NDC,50268011011,NDC Description Not Available,1.76,0.7,,,0 NDC,50268011015,Benazepril Hydrochloride: 50 Blister Pack In 1 Box (50268-110-15) / 1 Tablet In 1 Blister Pack (50268-110-11),1.28,0.51,,,0 NDC,50268011111,NDC Description Not Available,2.19,0.88,,,0 NDC,50268011115,Benazepril Hydrochloride: 50 Blister Pack In 1 Box (50268-111-15) / 1 Tablet In 1 Blister Pack (50268-111-11),1.79,0.72,,,0 NDC,50268013011,NDC Description Not Available,3.87,1.55,,,0 NDC,50268013015,Bumetanide: 50 Blister Pack In 1 Box (50268-130-15) / 1 Tablet In 1 Blister Pack (50268-130-11),4.12,1.65,,,0 NDC,50268013111,NDC Description Not Available,3.33,1.33,,,0 NDC,50268013115,Bumetanide: 50 Blister Pack In 1 Box (50268-131-15) / 1 Tablet In 1 Blister Pack (50268-131-11),3.77,1.51,,,0 NDC,50268013211,NDC Description Not Available,3.71,1.48,,,0 NDC,50268013215,Bumetanide: 50 Blister Pack In 1 Box (50268-132-15) / 1 Tablet In 1 Blister Pack (50268-132-11),4.91,1.96,,,0 NDC,50268014211,NDC Description Not Available,2.81,1.12,,,0 NDC,50268014215,"Bupropion Hydrochloride: 50 Blister Pack In 1 Box, Unit-Dose (50268-142-15) / 1 Tablet, Film Coated In 1 Blister Pack (50268-142-11)",3.44,1.38,,,0 NDC,50268015111,NDC Description Not Available,1.3,0.52,,,0 NDC,50268015115,Cephalexin: 50 Blister Pack In 1 Box (50268-151-15) / 1 Capsule In 1 Blister Pack (50268-151-11),1.21,0.48,,,0 NDC,50268015211,NDC Description Not Available,0.87,0.35,,,0 NDC,50268015215,Cephalexin: 50 Blister Pack In 1 Box (50268-152-15) / 1 Capsule In 1 Blister Pack (50268-152-11),1.23,0.49,,,0 NDC,50268016811,NDC Description Not Available,3.29,1.32,,,0 NDC,50268017311,NDC Description Not Available,1.43,0.57,,,0 NDC,50268017315,Clonazepam: 50 Blister Pack In 1 Box (50268-173-15) / 1 Tablet In 1 Blister Pack (50268-173-11),1.91,0.76,,,0 NDC,50268017611,NDC Description Not Available,2.88,1.15,,,0 NDC,50268017615,"Cilostazol: 50 Blister Pack In 1 Box, Unit-Dose (50268-176-15) / 1 Tablet In 1 Blister Pack (50268-176-11)",3.19,1.28,,,0 NDC,50268027911,NDC Description Not Available,10.75,4.3,,,0 NDC,50268029511,NDC Description Not Available,10.34,4.14,,,0 NDC,50268029711,NDC Description Not Available,3.78,1.51,,,0 NDC,50268029715,Vitamin D: 50 Blister Pack In 1 Box (50268-297-15) / 1 Capsule In 1 Blister Pack (50268-297-11),3.99,1.6,,,0 NDC,50268029911,NDC Description Not Available,0.42,0.17,,,0 NDC,50268029915,"Famotidine: 50 Blister Pack In 1 Box (50268-299-15) / 1 Tablet, Film Coated In 1 Blister Pack (50268-299-11)",0.47,0.19,,,0 NDC,50268031411,NDC Description Not Available,1.81,0.72,,,0 NDC,50268031415,"Finasteride: 50 Blister Pack In 1 Box (50268-314-15) / 1 Tablet, Film Coated In 1 Blister Pack (50268-314-11)",2.08,0.83,,,0 NDC,50268032111,NDC Description Not Available,1.99,0.8,,,0 NDC,50268032115,"Flecainide Acetate: 50 Blister Pack In 1 Box, Unit-Dose (50268-321-15) / 1 Tablet In 1 Blister Pack (50268-321-11)",1.76,0.7,,,0 NDC,50268033011,NDC Description Not Available,1.96,0.78,,,0 NDC,50268033015,"Fludrocortisone Acetate: 50 Blister Pack In 1 Box, Unit-Dose (50268-330-15) / 1 Tablet In 1 Blister Pack (50268-330-11)",2.05,0.82,,,0 NDC,50268033911,NDC Description Not Available,7.88,3.15,,,0 NDC,50268034611,NDC Description Not Available,4.06,1.62,,,0 NDC,50268035011,NDC Description Not Available,0.93,0.37,,,0 NDC,50268035911,NDC Description Not Available,1.14,0.46,,,0 NDC,50268035915,Glimepiride: 50 Blister Pack In 1 Box (50268-359-15) / 1 Tablet In 1 Blister Pack (50268-359-11),1.41,0.56,,,0 NDC,50268036211,NDC Description Not Available,1.77,0.71,,,0 NDC,50268039811,NDC Description Not Available,1.31,0.52,,,0 NDC,50268039850,Hydroxyzine Pamoate: 50 Blister Pack In 1 Box (50268-398-50) / 1 Capsule In 1 Blister Pack (50268-398-11),1.33,0.53,,,0 NDC,50268039911,NDC Description Not Available,0.62,0.25,,,0 NDC,50268039950,Hydroxyzine Pamoate: 50 Blister Pack In 1 Box (50268-399-50) / 1 Capsule In 1 Blister Pack (50268-399-11),0.62,0.25,,,0 NDC,50268043011,NDC Description Not Available,1.07,0.43,,,0 NDC,50268043015,"Indomethacin: 50 Blister Pack In 1 Box, Unit-Dose (50268-430-15) / 1 Capsule In 1 Blister Pack (50268-430-11)",1.08,0.43,,,0 NDC,50268044711,NDC Description Not Available,2.82,1.13,,,0 NDC,50268044715,"Isosorbide Dinitrate: 50 Blister Pack In 1 Box, Unit-Dose (50268-447-15) / 1 Tablet In 1 Blister Pack (50268-447-11)",2.61,1.04,,,0 NDC,50268044811,NDC Description Not Available,2.29,0.92,,,0 NDC,50268044911,NDC Description Not Available,2.78,1.11,,,0 NDC,50268045011,NDC Description Not Available,9.0,3.6,,,0 NDC,50268047011,NDC Description Not Available,18.15,7.26,,,0 NDC,50268047611,NDC Description Not Available,1.16,0.46,,,0 NDC,50268047615,Letrozole: 50 Blister Pack In 1 Box (50268-476-15) / 1 Tablet In 1 Blister Pack (50268-476-11),1.68,0.67,,,0 NDC,50268048211,NDC Description Not Available,3.38,1.35,,,0 NDC,50268050511,NDC Description Not Available,1.05,0.42,,,0 NDC,50268050515,"Losortan Potassium: 50 Blister Pack In 1 Box (50268-505-15) / 1 Tablet, Film Coated In 1 Blister Pack (50268-505-11)",1.11,0.44,,,0 NDC,50268052211,NDC Description Not Available,1.42,0.57,,,0 NDC,50268052215,"Meclizine Hydrochloride: 50 Blister Pack In 1 Box, Unit-Dose (50268-522-15) / 1 Tablet In 1 Blister Pack (50268-522-11)",1.58,0.63,,,0 NDC,50268052411,NDC Description Not Available,0.33,0.13,,,0 NDC,50268052415,NDC Description Not Available,0.35,0.14,,,0 NDC,50268052511,NDC Description Not Available,0.5,0.2,,,0 NDC,50268052515,"Meloxicam: 50 Blister Pack In 1 Box, Unit-Dose (50268-525-15) / 1 Tablet In 1 Blister Pack (50268-525-11)",0.48,0.19,,,0 NDC,50268053511,NDC Description Not Available,1.84,0.74,,,0 NDC,50268053515,Metronidazole: 50 Blister Pack In 1 Box (50268-535-15) / 1 Tablet In 1 Blister Pack (50268-535-11),1.89,0.76,,,0 NDC,50268054111,NDC Description Not Available,1.35,0.54,,,0 NDC,50268054115,"Metoprolol Succinate: 50 Blister Pack In 1 Box, Unit-Dose (50268-541-15) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack (50268-541-11)",1.49,0.6,,,0 NDC,50268054911,NDC Description Not Available,9.03,3.61,,,0 NDC,50268055311,NDC Description Not Available,4.98,1.99,,,0 NDC,50268055711,NDC Description Not Available,1.34,0.54,,,0 NDC,50268055715,Mycophenolate Mofetil: 50 Blister Pack In 1 Box (50268-557-15) / 1 Capsule In 1 Blister Pack (50268-557-11),1.34,0.54,,,0 NDC,50268056211,NDC Description Not Available,2.09,0.84,,,0 NDC,50268056811,NDC Description Not Available,10.85,4.34,,,0 NDC,50268056815,Mupirocin: 50 Tube In 1 Box (50268-568-15) / 50 G In 1 Tube (50268-568-11),11.62,4.65,,,0 NDC,50268057260,mupirocin: 60 SYRINGE in 1 BOX (50268-572-60) / 1 g in 1 SYRINGE (50268-572-11),12.5,5.0,,,0 NDC,50268057311,NDC Description Not Available,3.08,1.23,,,0 NDC,50268057411,NDC Description Not Available,2.93,1.17,,,0 NDC,50268057415,"Montelukast Sodium: 50 Blister Pack In 1 Box (50268-574-15) / 1 Tablet, Chewable In 1 Blister Pack (50268-574-11)",2.82,1.13,,,0 NDC,50268059411,NDC Description Not Available,0.84,0.34,,,0 NDC,50268059415,"Naproxen: 50 Blister Pack In 1 Box, Unit-Dose (50268-594-15) / 1 Tablet In 1 Blister Pack (50268-594-11)",0.78,0.31,,,0 NDC,50268059711,NDC Description Not Available,3.58,1.43,,,0 NDC,50268059715,"Nifedipine Er: 50 Blister Pack In 1 Box, Unit-Dose (50268-597-15) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack (50268-597-11)",3.71,1.48,,,0 NDC,50268059911,NDC Description Not Available,8.25,3.3,,,0 NDC,50268060411,NDC Description Not Available,1.93,0.77,,,0 NDC,50268062111,NDC Description Not Available,1.25,0.5,,,0 NDC,50268062511,NDC Description Not Available,6.11,2.44,,,0 NDC,50268062515,"Nitrofurantoin (Monohydrate/Macrocrystals): 50 Blister Pack In 1 Box, Unit-Dose (50268-625-15) / 1 Capsule In 1 Blister Pack (50268-625-11)",8.53,3.41,,,0 NDC,50268063211,NDC Description Not Available,0.54,0.22,,,0 NDC,50268063911,NDC Description Not Available,0.52,0.21,,,0 NDC,50268063915,"Pantoprazole Sodium: 50 Blister Pack In 1 Box (50268-639-15) / 1 Tablet, Delayed Release In 1 Blister Pack (50268-639-11)",0.57,0.23,,,0 NDC,50268064211,NDC Description Not Available,1.37,0.55,,,0 NDC,50268064215,"Paroxetine: 50 Blister Pack In 1 Box, Unit-Dose (50268-642-15) / 1 Tablet, Film Coated In 1 Blister Pack (50268-642-11)",1.38,0.55,,,0 NDC,50268064711,NDC Description Not Available,29.72,11.89,,,0 NDC,50268064714,"Ondansetron: 40 Cup, Unit-Dose In 1 Tray (50268-647-14) / 5 Ml In 1 Cup, Unit-Dose (50268-647-11)",36.49,14.6,,,0 NDC,50268066215,Propranolol Hydrochloride: 50 Blister Pack In 1 Box (50268-662-15) / 1 Tablet In 1 Blister Pack (50268-662-11),0.91,0.36,,,0 NDC,50268066311,NDC Description Not Available,1.24,0.5,,,0 NDC,50268066315,Propranolol Hydrochloride: 50 Blister Pack In 1 Box (50268-663-15) / 1 Tablet In 1 Blister Pack (50268-663-11),1.1,0.44,,,0 NDC,50268066511,NDC Description Not Available,1.07,0.43,,,0 NDC,50268066515,Pravastatin Sodium: 50 Blister Pack In 1 Box (50268-665-15) / 1 Tablet In 1 Blister Pack (50268-665-11),1.49,0.6,,,0 NDC,50268068411,NDC Description Not Available,3.625,1.45,,,0 NDC,50268068415,Prochlorperazine Maleate: 50 Blister Pack In 1 Box (50268-684-15) / 1 Tablet In 1 Blister Pack (50268-684-11),3.26,1.3,,,0 NDC,50268068511,NDC Description Not Available,1.71,0.68,,,0 NDC,50268068515,Prochlorperazine Maleate: 50 Blister Pack In 1 Box (50268-685-15) / 1 Tablet In 1 Blister Pack (50268-685-11),1.77,0.71,,,0 NDC,50268068611,NDC Description Not Available,1.48,0.59,,,0 NDC,50268068711,NDC Description Not Available,1.7,0.68,,,0 NDC,50268068715,"Primidone: 50 Blister Pack In 1 Box, Unit-Dose (50268-687-15) / 1 Tablet In 1 Blister Pack (50268-687-11)",2.17,0.87,,,0 NDC,50268070115,"Propranolol Hydrochloride: 50 BLISTER PACK in 1 BOX, UNIT-DOSE (50268-701-15) / 1 TABLET in 1 BLISTER PACK (50268-701-11)",0.76,0.3,,,0 NDC,50268071011,NDC Description Not Available,2.17,0.87,,,0 NDC,50268071015,"Rosuvastatin: 50 Blister Pack In 1 Box (50268-710-15) / 1 Tablet, Film Coated In 1 Blister Pack (50268-710-11)",2.23,0.89,,,0 NDC,50268071711,NDC Description Not Available,4.14,1.66,,,0 NDC,50268071813,Sirolimus: 30 Blister Pack In 1 Box (50268-718-13) / 1 Tablet In 1 Blister Pack (50268-718-11),40.37,16.15,,,0 NDC,50268072211,NDC Description Not Available,4.69,1.88,,,0 NDC,50268072811,NDC Description Not Available,0.86,0.34,,,0 NDC,50268072815,"Sulfamethoxazole And Trimethoprim: 50 Blister Pack In 1 Box, Unit-Dose (50268-728-15) / 1 Tablet In 1 Blister Pack (50268-728-11)",0.8,0.32,,,0 NDC,50268073124,"Senna Syrup: 24 Cup, Unit-Dose In 1 Box (50268-731-24) / 5 Ml In 1 Cup, Unit-Dose (50268-731-11)",4.63,1.85,,,0 NDC,50268074011,NDC Description Not Available,0.85,0.34,,,0 NDC,50268074015,"Tamsulosin Hydrochloride: 50 Blister Pack In 1 Box, Unit-Dose (50268-740-15) / 1 Capsule In 1 Blister Pack (50268-740-11)",0.8,0.32,,,0 NDC,50268074511,NDC Description Not Available,24.1,9.64,,,0 NDC,50268075511,NDC Description Not Available,0.98,0.39,,,0 NDC,50268075515,"Torsemide: 50 Blister Pack In 1 Box, Unit-Dose (50268-755-15) / 1 Tablet In 1 Blister Pack (50268-755-11)",1.01,0.4,,,0 NDC,50268075711,NDC Description Not Available,1.3,0.52,,,0 NDC,50268075811,NDC Description Not Available,7.07,2.83,,,0 NDC,50268076411,NDC Description Not Available,2.41,0.96,,,0 NDC,50268076415,Terazosin: 50 Blister Pack In 1 Box (50268-764-15) / 1 Capsule In 1 Blister Pack (50268-764-11),3.03,1.21,,,0 NDC,50268076511,NDC Description Not Available,1.77,0.71,,,0 NDC,50268076515,Terazosin: 50 Blister Pack In 1 Box (50268-765-15) / 1 Capsule In 1 Blister Pack (50268-765-11),2.74,1.1,,,0 NDC,50268076611,NDC Description Not Available,2.51,1.0,,,0 NDC,50268076615,Terazosin: 50 Blister Pack In 1 Box (50268-766-15) / 1 Capsule In 1 Blister Pack (50268-766-11),2.67,1.07,,,0 NDC,50268076911,NDC Description Not Available,1.06,0.42,,,0 NDC,50268076915,"Sertraline: 50 Blister Pack In 1 Box (50268-769-15) / 1 Tablet, Film Coated In 1 Blister Pack (50268-769-11)",1.61,0.64,,,0 NDC,50268077911,NDC Description Not Available,2.46,0.98,,,0 NDC,50268077915,Temazepam: 50 Blister Pack In 1 Box (50268-779-15) / 1 Capsule In 1 Blister Pack (50268-779-11),3.34,1.34,,,0 NDC,50268079711,NDC Description Not Available,12.41,4.96,,,0 NDC,50268081611,NDC Description Not Available,1.49,0.6,,,0 NDC,50268081615,Zonisamide: 50 Blister Pack In 1 Box (50268-816-15) / 1 Capsule In 1 Blister Pack (50268-816-11),1.47,0.59,,,0 NDC,50268081715,"Venlafaxine Hydrochloride: 50 BLISTER PACK in 1 BOX (50268-817-15) / 1 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (50268-817-11)",1.43,0.57,,,0 NDC,50268085111,NDC Description Not Available,0.49,0.2,,,0 NDC,50268085211,NDC Description Not Available,0.51,0.2,,,0 NDC,50268085215,NDC Description Not Available,0.28,0.11,,,0 NDC,50268085311,NDC Description Not Available,0.58,0.23,,,0 NDC,50268085315,NDC Description Not Available,0.54,0.22,,,0 NDC,50268085515,NDC Description Not Available,0.31,0.12,,,0 NDC,50268085811,NDC Description Not Available,0.44,0.18,,,0 NDC,50268086011,NDC Description Not Available,0.6,0.24,,,0 NDC,50268086015,NDC Description Not Available,0.39,0.16,,,0 NDC,50268086711,NDC Description Not Available,0.93,0.37,,,0 NDC,50268086715,NDC Description Not Available,0.97,0.39,,,0 NDC,50268087411,NDC Description Not Available,1.78,0.71,,,0 NDC,50289325001,Aer Pre-Moistened Witch Hazel Pad: 40 Applicator In 1 Jar (50289-3250-1) / 2.8 Ml In 1 Applicator,0.19,0.08,,,0 NDC,50383031147,Gabapentin: 470 mL in 1 BOTTLE (50383-311-47),0.54,0.22,,,0 NDC,50383062750,NDC Description Not Available,0.08,0.03,,,0 NDC,50383062781,NDC Description Not Available,0.06,0.02,,,0 NDC,50383077116,Docu Liquid: 473 mL in 1 BOTTLE (50383-771-16),0.06,0.02,,,0 NDC,50383077515,NDC Description Not Available,0.71,0.28,,,0 NDC,50383077932,Lactulose: 946 mL in 1 BOTTLE (50383-779-32),44.71,17.88,,,0 NDC,50383080116,Promethazine Hydrochloride: 473 mL in 1 BOTTLE (50383-801-16),4.19,1.68,,,0 NDC,50383080716,Amantadine Hydrochloride: 473 mL in 1 BOTTLE (50383-807-16),0.53,0.21,,,0 NDC,50383081016,Acyclovir: 473 mL in 1 BOTTLE (50383-810-16),7.99,3.2,,,0 NDC,50383091750,NDC Description Not Available,0.19,0.08,,,0 NDC,50419020801,"Xofigo: 6 Ml In 1 Vial, Single-Dose (50419-208-01)",522.66,209.06,,,0 NDC,50419025191,"Adempas: 9 Tablet, Film Coated In 1 Bottle (50419-251-91)",470.34,188.14,,,0 NDC,50419025401,"Adempas: 90 Tablet, Film Coated In 1 Bottle (50419-254-01)",470.34,188.14,,,0 NDC,50419025491,"Adempas: 9 Tablet, Film Coated In 1 Bottle (50419-254-91)",470.34,188.14,,,0 NDC,50419032005,"Eovist: 5 Vial, Single-Dose In 1 Box (50419-320-05) / 10 Ml In 1 Vial, Single-Dose",84.765,33.91,,,0 NDC,50419032501,NDC Description Not Available,4.16,1.66,,,0 NDC,50419032502,NDC Description Not Available,4.25,1.7,,,0 NDC,50419032507,NDC Description Not Available,5.26,2.1,,,0 NDC,50419032511,"Gadavist: 2 Carton In 1 Box (50419-325-11) / 10 Vial, Single-Dose In 1 Carton / 7.5 Ml In 1 Vial, Single-Dose",5.82,2.33,,,0 NDC,50419032512,"Gadavist: 2 Carton In 1 Box (50419-325-12) / 10 Vial, Single-Dose In 1 Carton / 10 Ml In 1 Vial, Single-Dose",1.57,0.63,,,0 NDC,50419032513,"Gadavist: 2 Carton In 1 Box (50419-325-13) / 10 Vial, Single-Dose In 1 Carton / 15 Ml In 1 Vial, Single-Dose",1.73,0.69,,,0 NDC,50419032537,"Gadavist: 15 Carton In 1 Box (50419-325-37) / 3 Vial, Single-Dose In 1 Carton / 2 Ml In 1 Vial, Single-Dose",5.35,2.14,,,0 NDC,50419042201,Skyla: 1 Intrauterine Device In 1 Carton (50419-422-01),4395.13,1758.05,,,0 NDC,50419042301,Mirena: 1 Intrauterine Device In 1 Carton (50419-423-01),5227.45,2090.98,,,0 NDC,50419042401,Kyleena: 1 Intrauterine Device In 1 Carton (50419-424-01),5232.64,2093.06,,,0 NDC,50419077301,"Cipro: 1 Kit In 1 Kit (50419-773-01) * 100 Ml In 1 Bottle, Glass * 100 Ml In 1 Bottle, Glass",22.03,8.81,,,0 NDC,50419077501,NDC Description Not Available,20.91,8.36,,,0 NDC,50458009801,"Elmiron: 100 Capsule, Gelatin Coated In 1 Bottle (50458-098-01)",34.63,13.85,,,0 NDC,50458030001,"Risperdal: 10 Blister Pack In 1 Box, Unit-Dose (50458-300-01) / 10 Tablet In 1 Blister Pack",21.1,8.44,,,0 NDC,50458030711,Risperdal Consta: 1 Kit In 1 Box (50458-307-11) * 2 Ml In 1 Vial * 2 Ml In 1 Syringe (50458-307-01),51.91,20.76,,,0 NDC,50458030801,NDC Description Not Available,54.42,21.77,,,0 NDC,50458030811,Risperdal Consta: 1 Kit In 1 Box (50458-308-11) * 2 Ml In 1 Vial * 2 Ml In 1 Syringe (50458-308-01),51.92,20.77,,,0 NDC,50458056301,Invega Sustenna: 1 Syringe In 1 Kit (50458-563-01) / 1 Ml In 1 Syringe,3.84,1.54,,,0 NDC,50458056401,Invega Sustenna: 1 Syringe In 1 Kit (50458-564-01) / 1.5 Ml In 1 Syringe,4.3,1.72,,,0 NDC,50458057501,"Xarelto: 1 Bottle In 1 Carton (50458-575-01) / 1 Granule, For Suspension In 1 Bottle",60.08,24.03,,,0 NDC,50458057701,NDC Description Not Available,1860.37,744.15,,,0 NDC,50458057710,"Xarelto: 10 Blister Pack In 1 Box, Unit-Dose (50458-577-10) / 10 Tablet, Film Coated In 1 Blister Pack (50458-577-01)",29.91,11.96,,,0 NDC,50458057801,NDC Description Not Available,59.8,23.92,,,0 NDC,50458057810,"Xarelto: 10 Blister Pack In 1 Carton (50458-578-10) / 10 Tablet, Film Coated In 1 Blister Pack (50458-578-01)",59.81,23.92,,,0 NDC,50458057901,NDC Description Not Available,0.03,0.01,,,0 NDC,50458057910,"Xarelto: 10 Blister Pack In 1 Carton (50458-579-10) / 10 Tablet, Film Coated In 1 Blister Pack (50458-579-01)",59.78,23.91,,,0 NDC,50458058001,NDC Description Not Available,59.43,23.77,,,0 NDC,50458058010,"Xarelto: 10 Blister Pack In 1 Carton (50458-580-10) / 10 Tablet, Film Coated In 1 Blister Pack (50458-580-01)",58.04,23.22,,,0 NDC,50458058501,"Concerta: 100 Tablet, Extended Release In 1 Bottle (50458-585-01)",55.6,22.24,,,0 NDC,50458058801,"Concerta: 100 Tablet, Extended Release In 1 Bottle (50458-588-01)",40.06,16.02,,,0 NDC,50458059601,Risperidone: 30 Ml In 1 Bottle (50458-596-01),12.61,5.04,,,0 NDC,50474057009,"Briviact: 100 Blister Pack In 1 Carton (50474-570-09) / 1 Tablet, Film Coated In 1 Blister Pack",70.8,28.32,,,0 NDC,50474070062,"Cimzia: 2 Kit In 1 Carton (50474-700-62) / 1 Kit In 1 Kit * 1 Ml In 1 Vial, Glass * 1 Ml In 1 Vial, Glass",52.62,21.05,,,0 NDC,50474071079,"Cimzia: 2 Syringe, Glass In 1 Carton (50474-710-79) / 1 Ml In 1 Syringe, Glass",62.07,24.83,,,0 NDC,50474087015,Briviact: 1 Bottle In 1 Carton (50474-870-15) / 300 Ml In 1 Bottle,156.98,62.79,,,0 NDC,50474097063,NDC Description Not Available,826.9,330.76,,,0 NDC,50474097075,"Briviact: 10 Vial, Glass In 1 Carton (50474-970-75) / 5 Ml In 1 Vial, Glass (50474-970-63)",21.22,8.49,,,0 NDC,50474098183,"Rystiggo: 1 Vial, Glass In 1 Carton (50474-981-83) / 3 Ml In 1 Vial, Glass",239.93,95.97,,,0 NDC,50474098284,"Rystiggo: 1 Vial, Glass In 1 Carton (50474-982-84) / 4 Ml In 1 Vial, Glass",27052.765,10821.109999999999,,,0 NDC,50474098386,"Rystiggo: 1 Vial, Glass In 1 Carton (50474-983-86) / 6 Ml In 1 Vial, Glass",96.94,38.78,,,0 NDC,50484001030,Collagenase Santyl: 1 Tube In 1 Carton (50484-010-30) / 30 G In 1 Tube,923.74,369.5,,,0 NDC,50486055032,Zilactin-B: 1 Tube In 1 Carton (50486-550-32) / 7 G In 1 Tube,16.05,6.42,,,0 NDC,50580013404,Imodium A-D: 120 Ml In 1 Bottle (50580-134-04),3.17,1.27,,,0 NDC,50580023201,"Childrens Benadryl Chewables: 2 Blister Pack In 1 Carton (50580-232-01) / 10 Tablet, Chewable In 1 Blister Pack",1.68,0.67,,,0 NDC,50580041202,"10 BLISTER PACK in 1 CARTON (50580-412-02) / 10 TABLET, FILM COATED in 1 BLISTER PACK",0.04,0.02,,,0 NDC,50580045711,"Tylenol Extra Strength: 10 Blister Pack In 1 Carton (50580-457-11) / 10 Tablet, Film Coated In 1 Blister Pack",0.31,0.12,,,0 NDC,50580045811,"Tylenol Regular Strength: 10 Blister Pack In 1 Carton (50580-458-11) / 10 Tablet, Film Coated In 1 Blister Pack",0.15,0.06,,,0 NDC,50580053604,Childrens Sudafed Nasal Decongestant: 1 Bottle In 1 Carton (50580-536-04) / 118 Ml In 1 Bottle,2.75,1.1,,,0 NDC,50580057902,Childrens Tylenol: 1 Bottle In 1 Carton (50580-579-02) / 120 Ml In 1 Bottle,0.36,0.14,,,0 NDC,50580060002,"10 BLISTER PACK in 1 CARTON (50580-600-02) / 10 TABLET, FILM COATED in 1 BLISTER PACK",0.05,0.02,,,0 NDC,50632001001,"Rabavert: 1 Kit In 1 Carton (50632-010-01) * 1 Ml In 1 Syringe (50632-011-01) * 1 Ml In 1 Vial, Glass (50632-013-01)",1711.73,684.69,,,0 NDC,50632001301,NDC Description Not Available,1402.42,560.97,,,0 NDC,50633011011,NDC Description Not Available,12823.32,5129.33,,,0 NDC,50633011012,"Crofab: 2 Vial, Glass In 1 Carton (50633-110-12) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Glass (50633-110-11)",10927.59,4371.04,,,0 NDC,50633012011,"Digifab: 1 Vial, Glass In 1 Carton (50633-120-11) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Glass (50633-120-12)",20180.93,8072.37,,,0 NDC,50633021011,"Voraxaze: 1 Vial In 1 Carton (50633-210-11) / 1 Injection, Powder, For Solution In 1 Vial",1894.0,757.6,,,0 NDC,50633031011,"Cyanokit: 1 Vial, Glass In 1 Carton (50633-310-11) / 250 Ml In 1 Vial, Glass",23.13,9.25,,,0 NDC,50742011808,Cabergoline: 8 Tablet In 1 Bottle (50742-118-08),4.18,1.67,,,0 NDC,50742018130,Leucovorin Calcium: 30 Tablet In 1 Bottle (50742-181-30),1.5,0.6,,,0 NDC,50742023901,Mexiletine Hydrochloride: 100 Capsule In 1 Bottle (50742-239-01),1.06,0.42,,,0 NDC,50742035401,"Mesna: 1 Blister Pack In 1 Carton (50742-354-01) / 10 Tablet, Film Coated In 1 Blister Pack",268.25,107.3,,,0 NDC,50742037401,NDC Description Not Available,269.08,107.63,,,0 NDC,50742043001,"Decitabine: 1 Vial In 1 Carton (50742-430-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",9.89,3.96,,,0 NDC,50742050504,"Scopolamine: 4 Pouch In 1 Carton (50742-505-04) / 1 Patch, Extended Release In 1 Pouch",30.33,12.13,,,0 NDC,50742050524,"Scopolamine: 24 Pouch In 1 Carton (50742-505-24) / 1 Patch, Extended Release In 1 Pouch",29.63,11.85,,,0 NDC,50742064501,"Triazolam: 100 Tablet In 1 Bottle, Plastic (50742-645-01)",3.22,1.29,,,0 NDC,50881000560,"Jakafi: 60 Tablet In 1 Bottle, Plastic (50881-005-60)",864.79,345.92,,,0 NDC,50881001303,Monjuvi: 1 Vial In 1 Carton (50881-013-03) / 5 Ml In 1 Vial,60.43,24.17,,,0 NDC,51079002301,NDC Description Not Available,10.89,4.36,,,0 NDC,51079002401,NDC Description Not Available,11.0,4.4,,,0 NDC,51079005101,NDC Description Not Available,1.22,0.49,,,0 NDC,51079005801,NDC Description Not Available,5.41,2.16,,,0 NDC,51079005820,Chlorthalidone: 100 Blister Pack In 1 Carton (51079-058-20) / 1 Tablet In 1 Blister Pack (51079-058-01),7.84,3.14,,,0 NDC,51079007201,NDC Description Not Available,0.29,0.12,,,0 NDC,51079007301,NDC Description Not Available,0.29,0.12,,,0 NDC,51079007401,NDC Description Not Available,0.64,0.26,,,0 NDC,51079007420,Hydralazine Hydrochloride: 100 Blister Pack In 1 Carton (51079-074-20) / 1 Tablet In 1 Blister Pack (51079-074-01),0.61,0.24,,,0 NDC,51079007501,NDC Description Not Available,0.82,0.33,,,0 NDC,51079007520,Hydralazine Hydrochloride: 100 Blister Pack In 1 Carton (51079-075-20) / 1 Tablet In 1 Blister Pack (51079-075-01),0.83,0.33,,,0 NDC,51079007601,NDC Description Not Available,0.85,0.34,,,0 NDC,51079007620,Hydralazine Hydrochloride: 100 Blister Pack In 1 Carton (51079-076-20) / 1 Tablet In 1 Blister Pack (51079-076-01),1.04,0.42,,,0 NDC,51079008301,NDC Description Not Available,2.83,1.13,,,0 NDC,51079008320,Isoniazid: 100 Blister Pack In 1 Carton (51079-083-20) / 1 Tablet In 1 Blister Pack (51079-083-01),4.54,1.82,,,0 NDC,51079008601,NDC Description Not Available,0.44,0.18,,,0 NDC,51079008701,NDC Description Not Available,0.7,0.28,,,0 NDC,51079008720,"Mirtazapine: 100 Blister Pack In 1 Carton (51079-087-20) / 1 Tablet, Film Coated In 1 Blister Pack (51079-087-01)",0.92,0.37,,,0 NDC,51079010301,NDC Description Not Available,0.52,0.21,,,0 NDC,51079010320,"Spironolactone: 100 Blister Pack In 1 Carton (51079-103-20) / 1 Tablet, Film Coated In 1 Blister Pack (51079-103-01)",0.69,0.28,,,0 NDC,51079014101,NDC Description Not Available,5.29,2.12,,,0 NDC,51079014120,Chlordiazepoxide Hydrochloride: 100 Blister Pack In 1 Carton (51079-141-20) / 1 Capsule In 1 Blister Pack (51079-141-01),2.29,0.92,,,0 NDC,51079016901,NDC Description Not Available,2.74,1.1,,,0 NDC,51079016920,"Metoprolol Succinate: 100 Blister Pack In 1 Carton (51079-169-20) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack (51079-169-01)",2.01,0.8,,,0 NDC,51079017001,NDC Description Not Available,4.14,1.66,,,0 NDC,51079020501,NDC Description Not Available,0.95,0.38,,,0 NDC,51079020520,Allopurinol: 100 Blister Pack In 1 Carton (51079-205-20) / 1 Tablet In 1 Blister Pack (51079-205-01),1.36,0.54,,,0 NDC,51079020601,NDC Description Not Available,1.91,0.76,,,0 NDC,51079021001,NDC Description Not Available,1.73,0.69,,,0 NDC,51079024106,"Acamprosate Calcium: 50 BLISTER PACK in 1 CARTON (51079-241-06) / 1 TABLET, DELAYED RELEASE in 1 BLISTER PACK (51079-241-01)",3.52,1.41,,,0 NDC,51079025501,NDC Description Not Available,0.27,0.11,,,0 NDC,51079025520,"Metoprolol Tartrate: 100 Blister Pack In 1 Carton (51079-255-20) / 1 Tablet, Film Coated In 1 Blister Pack (51079-255-01)",0.35,0.14,,,0 NDC,51079028401,NDC Description Not Available,0.17,0.07,,,0 NDC,51079028420,Diazepam: 100 Blister Pack In 1 Carton (51079-284-20) / 1 Tablet In 1 Blister Pack (51079-284-01),0.19,0.08,,,0 NDC,51079028501,NDC Description Not Available,0.2,0.08,,,0 NDC,51079028520,Diazepam: 100 Blister Pack In 1 Carton (51079-285-20) / 1 Tablet In 1 Blister Pack (51079-285-01),0.2,0.08,,,0 NDC,51079037401,NDC Description Not Available,12.42,4.97,,,0 NDC,51079043601,NDC Description Not Available,1.49,0.6,,,0 NDC,51079043620,Doxepin Hydrochloride: 100 Blister Pack In 1 Carton (51079-436-20) / 1 Capsule In 1 Blister Pack (51079-436-01),2.3,0.92,,,0 NDC,51079043701,NDC Description Not Available,1.98,0.79,,,0 NDC,51079043720,Doxepin Hydrochloride: 100 Blister Pack In 1 Carton (51079-437-20) / 1 Capsule In 1 Blister Pack (51079-437-01),1.99,0.8,,,0 NDC,51079044001,NDC Description Not Available,2.39,0.96,,,0 NDC,51079044201,NDC Description Not Available,2.59,1.04,,,0 NDC,51079044301,NDC Description Not Available,1.89,0.76,,,0 NDC,51079044320,Levothyroxine Sodium: 100 Blister Pack In 1 Carton (51079-443-20) / 1 Tablet In 1 Blister Pack (51079-443-01),2.86,1.14,,,0 NDC,51079044401,NDC Description Not Available,2.1,0.84,,,0 NDC,51079045301,NDC Description Not Available,3.46,1.38,,,0 NDC,51079052701,NDC Description Not Available,0.52,0.21,,,0 NDC,51079059701,NDC Description Not Available,0.41,0.16,,,0 NDC,51079059720,"Cetirizine Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (51079-597-20) / 1 Tablet, Film Coated In 1 Blister Pack (51079-597-01)",0.23,0.09,,,0 NDC,51079060801,NDC Description Not Available,11.91,4.76,,,0 NDC,51079060820,"Fenofibrate: 100 Blister Pack In 1 Carton (51079-608-20) / 1 Tablet, Film Coated In 1 Blister Pack (51079-608-01)",11.94,4.78,,,0 NDC,51079063001,NDC Description Not Available,4.6,1.84,,,0 NDC,51079063020,Prazosin Hydrochloride: 100 Blister Pack In 1 Carton (51079-630-20) / 1 Capsule In 1 Blister Pack (51079-630-01),4.53,1.81,,,0 NDC,51079063201,NDC Description Not Available,11.0,4.4,,,0 NDC,51079067001,NDC Description Not Available,8.5,3.4,,,0 NDC,51079067005,Methotrexate: 20 Blister Pack In 1 Carton (51079-670-05) / 1 Tablet In 1 Blister Pack (51079-670-01),11.45,4.58,,,0 NDC,51079068401,NDC Description Not Available,0.23,0.09,,,0 NDC,51079068420,Atenolol: 100 Blister Pack In 1 Carton (51079-684-20) / 1 Tablet In 1 Blister Pack (51079-684-01),0.24,0.1,,,0 NDC,51079068501,NDC Description Not Available,0.23,0.09,,,0 NDC,51079068520,Atenolol: 100 Blister Pack In 1 Carton (51079-685-20) / 1 Tablet In 1 Blister Pack (51079-685-01),0.12,0.05,,,0 NDC,51079072101,NDC Description Not Available,2.18,0.87,,,0 NDC,51079073301,NDC Description Not Available,0.78,0.31,,,0 NDC,51079073320,Haloperidol: 100 Blister Pack In 1 Carton (51079-733-20) / 1 Tablet In 1 Blister Pack (51079-733-01),0.79,0.32,,,0 NDC,51079073401,NDC Description Not Available,1.11,0.44,,,0 NDC,51079073420,Haloperidol: 100 Blister Pack In 1 Carton (51079-734-20) / 1 Tablet In 1 Blister Pack (51079-734-01),1.23,0.49,,,0 NDC,51079073501,NDC Description Not Available,1.52,0.61,,,0 NDC,51079073520,Haloperidol: 100 Blister Pack In 1 Carton (51079-735-20) / 1 Tablet In 1 Blister Pack (51079-735-01),1.47,0.59,,,0 NDC,51079075301,NDC Description Not Available,0.93,0.37,,,0 NDC,51079075320,Sucralfate: 100 Blister Pack In 1 Carton (51079-753-20) / 1 Tablet In 1 Blister Pack (51079-753-01),0.93,0.37,,,0 NDC,51079075901,NDC Description Not Available,0.44,0.18,,,0 NDC,51079075920,Atenolol: 100 Blister Pack In 1 Carton (51079-759-20) / 1 Tablet In 1 Blister Pack (51079-759-01),0.46,0.18,,,0 NDC,51079080101,NDC Description Not Available,0.23,0.09,,,0 NDC,51079080120,"Metoprolol Tartrate: 100 Blister Pack In 1 Carton (51079-801-20) / 1 Tablet, Film Coated In 1 Blister Pack (51079-801-01)",0.23,0.09,,,0 NDC,51079081701,NDC Description Not Available,5.21,2.08,,,0 NDC,51079081801,NDC Description Not Available,3.23,1.29,,,0 NDC,51079082101,NDC Description Not Available,2.37,0.95,,,0 NDC,51079086301,NDC Description Not Available,11.67,4.67,,,0 NDC,51079088601,NDC Description Not Available,2.24,0.9,,,0 NDC,51079092101,NDC Description Not Available,2.61,1.04,,,0 NDC,51079092120,Clozapine: 100 Blister Pack In 1 Carton (51079-921-20) / 1 Tablet In 1 Blister Pack (51079-921-01),1.42,0.57,,,0 NDC,51079092201,NDC Description Not Available,4.89,1.96,,,0 NDC,51079092501,NDC Description Not Available,11.84,4.74,,,0 NDC,51079093101,NDC Description Not Available,0.35,0.14,,,0 NDC,51079093201,NDC Description Not Available,0.56,0.22,,,0 NDC,51079096001,NDC Description Not Available,1.16,0.46,,,0 NDC,51079096020,Buspirone Hydrochloride: 100 Blister Pack In 1 Carton (51079-960-20) / 1 Tablet In 1 Blister Pack (51079-960-01),1.13,0.45,,,0 NDC,51079097801,NDC Description Not Available,1.08,0.43,,,0 NDC,51079098501,NDC Description Not Available,0.28,0.11,,,0 NDC,51079098520,Buspirone Hydrochloride: 100 Blister Pack In 1 Carton (51079-985-20) / 1 Tablet In 1 Blister Pack (51079-985-01),0.28,0.11,,,0 NDC,51079098601,NDC Description Not Available,0.37,0.15,,,0 NDC,51079098620,Buspirone Hydrochloride: 100 Blister Pack In 1 Carton (51079-986-20) / 1 Tablet In 1 Blister Pack (51079-986-01),0.35,0.14,,,0 NDC,51144000301,Tivdak: 1 Vial In 1 Carton (51144-003-01) / 4 Ml In 1 Vial,780.52,312.21,,,0 NDC,51144002001,"Padcev Ejfv: 1 Vial, Single-Dose In 1 Box (51144-020-01) / 2 Ml In 1 Vial, Single-Dose",155.22,62.09,,,0 NDC,51144003001,"Padcev Ejfv: 1 Vial, Single-Dose In 1 Box (51144-030-01) / 3 Ml In 1 Vial, Single-Dose",155.24,62.1,,,0 NDC,51144005001,"Adcetris: 1 Vial, Single-Dose In 1 Box (51144-050-01) / 10.5 Ml In 1 Vial, Single-Dose",1072.29,428.92,,,0 NDC,51167033101,"Trikafta: 4 Blister Pack In 1 Carton (51167-331-01) / 1 Kit In 1 Blister Pack * 14 Tablet, Film Coated In 1 Blister Pack (51167-431-14) * 7 Tablet, Film Coated In 1 Blister Pack (51167-531-07)",33.81,13.52,,,0 NDC,51224001220,Phentolamine Mesylate: 1 Vial In 1 Carton (51224-012-20) / 1 Injection In 1 Vial,137.49,55.0,,,0 NDC,51224001310,"Levetiracetam: 10 Vial, Single-Use In 1 Carton (51224-013-10) / 5 Ml In 1 Vial, Single-Use",0.23,0.09,,,0 NDC,51224001325,"Levetiracetam: 25 Vial, Single-Use In 1 Carton (51224-013-25) / 5 Ml In 1 Vial, Single-Use",0.28,0.11,,,0 NDC,51552005506,Acetic Acid: 500 G In 1 Container (51552-0055-6),3.18,1.27,,,0 NDC,51552006208,NDC Description Not Available,0.03,0.01,,,0 NDC,51552045605,Bupivacaine Hcl: 100 G In 1 Container (51552-0456-5),180.34,72.14,,,0 NDC,51552048005,Clonidine Hcl: 100 G In 1 Container (51552-0480-5),0.04,0.02,,,0 NDC,51552061305,Baclofen: 100 G In 1 Container (51552-0613-5),0.02,0.01,,,0 NDC,51552068206,Hydromorphone Hydrochloride: 500 G In 1 Container (51552-0682-6),0.11,0.04,,,0 NDC,51552069702,Ketamine Hydrochloride: 5 G In 1 Container (51552-0697-2),178.09,71.24,,,0 NDC,51552134501,Lets Kit: 1 Kit In 1 Box (51552-1345-1) * 180 Mg In 1 Container (51552-0454-9) * 500 Mg In 1 Container (51552-0269-9) * 4 G In 1 Container (51552-0106-9),8.37,3.35,,,0 NDC,51660012312,Loperamide Hydrochloride: 2 Blister Pack In 1 Carton (51660-123-12) / 6 Tablet In 1 Blister Pack,0.18,0.07,,,0 NDC,51660020030,Ezetimibe: 30 Tablet In 1 Bottle (51660-200-30),0.9,0.36,,,0 NDC,51672125802,Clobetasol Propionate: 1 Tube In 1 Carton (51672-1258-2) / 30 G In 1 Tube,61.12,24.45,,,0 NDC,51672126003,"Clotrimazole: 1 Bottle, Plastic In 1 Carton (51672-1260-3) / 30 Ml In 1 Bottle, Plastic",181.79,72.72,,,0 NDC,51672126302,Nystatin And Triamcinolone Acetonide: 1 Tube In 1 Carton (51672-1263-2) / 30 G In 1 Tube,88.29,35.32,,,0 NDC,51672127406,Betamethasone Dipropionate: 1 Tube In 1 Carton (51672-1274-6) / 45 G In 1 Tube,211.28,84.51,,,0 NDC,51672128003,Desonide: 1 Tube In 1 Carton (51672-1280-3) / 60 G In 1 Tube,236.92,94.77,,,0 NDC,51672128902,Nystatin: 1 Tube In 1 Carton (51672-1289-2) / 30 G In 1 Tube,36.45,14.58,,,0 NDC,51672129802,Ketoconazole: 1 Tube In 1 Carton (51672-1298-2) / 30 G In 1 Tube,114.12,45.65,,,0 NDC,51672130406,"Terconazole: 1 Tube, With Applicator In 1 Carton (51672-1304-6) / 45 G In 1 Tube, With Applicator",107.16,42.86,,,0 NDC,51672131200,Mupirocin: 1 Tube In 1 Carton (51672-1312-0) / 22 G In 1 Tube,27.08,10.83,,,0 NDC,51672131201,Mupirocin: 1 Tube In 1 Carton (51672-1312-1) / 15 G In 1 Tube,25.47,10.19,,,0 NDC,51672136001,Acyclovir: 1 Tube In 1 Carton (51672-1360-1) / 15 G In 1 Tube,256.68,102.67,,,0 NDC,51672138508,Ibuprofen: 1 Bottle In 1 Carton (51672-1385-8) / 118 Ml In 1 Bottle,5.94,2.38,,,0 NDC,51672200102,Miconazole Nitrate: 1 Tube In 1 Carton (51672-2001-2) / 30 G In 1 Tube,14.37,5.75,,,0 NDC,51672201002,Hydrocortisone: 1 Tube In 1 Carton (51672-2010-2) / 28.4 G In 1 Tube,9.89,3.96,,,0 NDC,51672201302,Hydrocortisone With Aloe: 1 Tube In 1 Carton (51672-2013-2) / 28.4 G In 1 Tube,9.89,3.96,,,0 NDC,51672202001,Tolnaftate Antifungal: 1 Tube In 1 Carton (51672-2020-1) / 15 G In 1 Tube,12.28,4.91,,,0 NDC,51672203506,"Miconazole Nitrate: 1 Tube, With Applicator In 1 Carton (51672-2035-6) / 45 G In 1 Tube, With Applicator",25.71,10.28,,,0 NDC,51672206302,Hydrocortisone Plus 12 Moisturizers: 1 Tube In 1 Carton (51672-2063-2) / 28.4 G In 1 Tube,8.47,3.39,,,0 NDC,51672207502,Bacitracin Zinc: 1 Tube In 1 Carton (51672-2075-2) / 30 G In 1 Tube,13.88,5.55,,,0 NDC,51672210208,Childrens Cetirizine Hydrochloride Sugar Free Grape: 1 Bottle In 1 Carton (51672-2102-8) / 120 Ml In 1 Bottle,0.39,0.16,,,0 NDC,51672211400,NDC Description Not Available,2.0,0.8,,,0 NDC,51672211402,Feverall Infants: 6 Blister Pack In 1 Carton (51672-2114-2) / 1 Suppository In 1 Blister Pack (51672-2114-0),1.87,0.75,,,0 NDC,51672211500,NDC Description Not Available,2.42,0.97,,,0 NDC,51672211502,Feverall Childrens: 6 Blister Pack In 1 Carton (51672-2115-2) / 1 Suppository In 1 Blister Pack (51672-2115-0),1.48,0.59,,,0 NDC,51672211602,Feverall Jr. Strength: 6 Blister Pack In 1 Carton (51672-2116-2) / 1 Suppository In 1 Blister Pack (51672-2116-0),2.43,0.97,,,0 NDC,51672211604,Feverall Jr. Strength: 50 Blister Pack In 1 Carton (51672-2116-4) / 1 Suppository In 1 Blister Pack (51672-2116-0),0.03,0.01,,,0 NDC,51672300302,Hydrocortisone: 1 Tube In 1 Carton (51672-3003-2) / 28.35 G In 1 Tube,12.65,5.06,,,0 NDC,51672302009,Lidocaine: 1 Tube In 1 Carton (51672-3020-9) / 35.44 G In 1 Tube,401.7,160.68,,,0 NDC,51672402301,Acetazolamide: 100 Tablet In 1 Bottle (51672-4023-1),8.38,3.35,,,0 NDC,51672403101,Warfarin Sodium: 100 Tablet In 1 Bottle (51672-4031-1),0.93,0.37,,,0 NDC,51672403701,Enalapril Maleate: 100 Tablet In 1 Bottle (51672-4037-1),0.69,0.28,,,0 NDC,51672404001,Enalapril Maleate: 100 Tablet In 1 Bottle (51672-4040-1),0.96,0.38,,,0 NDC,51672404201,Clorazepate Dipotassium: 100 Tablet In 1 Bottle (51672-4042-1),9.9,3.96,,,0 NDC,51672404709,Carbamazepine: 450 Ml In 1 Bottle (51672-4047-9),5.97,2.39,,,0 NDC,51672404806,Clotrimazole And Betamethasone Dipropionate: 1 Tube In 1 Carton (51672-4048-6) / 45 G In 1 Tube,101.25,40.5,,,0 NDC,51672406901,Phenytoin: 237 Ml In 1 Bottle (51672-4069-1),1.07,0.43,,,0 NDC,51672411101,"Phenytoin Sodium: 100 Capsule, Extended Release In 1 Bottle (51672-4111-1)",0.74,0.3,,,0 NDC,51672411806,Fluorouracil: 1 Tube In 1 Carton (51672-4118-6) / 40 G In 1 Tube,222.28,88.91,,,0 NDC,51672412301,"Carbamazepine: 100 Tablet, Extended Release In 1 Bottle (51672-4123-1)",1.38,0.55,,,0 NDC,51672422708,Clobazam: 120 Ml In 1 Bottle (51672-4227-8),6.14,2.46,,,0 NDC,51672529701,Promethazine Hydrochloride: 12 Blister Pack In 1 Carton (51672-5297-1) / 1 Suppository In 1 Blister Pack,33.53,13.41,,,0 NDC,51672531609,Glycopyrrolate Oral Solution: 1 Bottle In 1 Carton (51672-5316-9) / 500 Ml In 1 Bottle,4.48,1.79,,,0 NDC,51672533002,Hydrocortisone With Aloe: 1 Tube In 1 Carton (51672-5330-2) / 28.4 G In 1 Tube,9.89,3.96,,,0 NDC,51754010301,NDC Description Not Available,71.92,28.77,,,0 NDC,51754010801,Tranexamic Acid In Sodium Chloride: 100 Ml In 1 Bag (51754-0108-1),91.17,36.47,,,0 NDC,51754010803,Tranexamic Acid In Sodium Chloride: 1000 Ml In 1 Case (51754-0108-3),112.45,44.98,,,0 NDC,51754050001,Caffeine Citrate: 1 Vial In 1 Carton (51754-0500-1) / 3 Ml In 1 Vial,3.8,1.52,,,0 NDC,51754100601,Nipride Rtu: 1 Vial In 1 Vial (51754-1006-1) / 100 Ml In 1 Vial,153.15,61.26,,,0 NDC,51754100703,Elcys: 100 Ml In 1 Carton (51754-1007-3),183.55,73.42,,,0 NDC,51754200104,"Potassium Acetate: 25 Vial, Single-Dose In 1 Carton (51754-2001-4) / 20 Ml In 1 Vial, Single-Dose",11.01,4.4,,,0 NDC,51754425001,NDC Description Not Available,33.97,13.59,,,0 NDC,51754500101,NDC Description Not Available,35.23,14.09,,,0 NDC,51754500104,Sodium Bicarbonate: 25 Vial In 1 Carton (51754-5001-4) / 50 Ml In 1 Vial,20.33,8.13,,,0 NDC,51754500105,Sodium Bicarbonate: 20 Vial In 1 Carton (51754-5001-5) / 50 Ml In 1 Vial,24.02,9.61,,,0 NDC,51754501104,Sodium Bicarbonate: 25 Vial In 1 Carton (51754-5011-4) / 10 Ml In 1 Vial,26.08,10.43,,,0 NDC,51754501201,NDC Description Not Available,15.5,6.2,,,0 NDC,51754501204,Sodium Bicarbonate: 25 Vial In 1 Carton (51754-5012-4) / 10 Ml In 1 Vial,23.9,9.56,,,0 NDC,51754506001,"Betamethasone Sodium Phosphate And Betamethasone Acetate: 1 Vial, Multi-Dose In 1 Box (51754-5060-1) / 5 Ml In 1 Vial, Multi-Dose",32.16,12.86,,,0 NDC,51801000130,"Effer-K Orange: 30 Pouch In 1 Carton (51801-001-30) / 1 Tablet, Effervescent In 1 Pouch",1.06,0.42,,,0 NDC,51803000101,Iosat: 14 Tablet In 1 Package (51803-001-01),3.94,1.58,,,0 NDC,51803000110,Iosat: 10 Package In 1 Bag (51803-001-10) / 14 Tablet In 1 Package (51803-001-01),1.43,0.57,,,0 NDC,51862009501,Disopyramide Phosphate: 100 Capsule In 1 Bottle (51862-095-01),5.19,2.08,,,0 NDC,51862032001,"Liothyronine Sodium: 100 Tablet In 1 Bottle, Plastic (51862-320-01)",3.13,1.25,,,0 NDC,51862032101,"Liothyronine Sodium: 100 Tablet In 1 Bottle, Plastic (51862-321-01)",5.87,2.35,,,0 NDC,51862045801,NDC Description Not Available,2.2,0.88,,,0 NDC,51862045847,"Cyclosporine: 30 Blister Pack In 1 Box (51862-458-47) / 1 Capsule, Liquid Filled In 1 Blister Pack (51862-458-01)",3.32,1.33,,,0 NDC,51862048601,Trimethoprim: 100 Tablet In 1 Bottle (51862-486-01),5.09,2.04,,,0 NDC,51862056401,NDC Description Not Available,3.58,1.43,,,0 NDC,51862056406,Low-Ogestrel: 6 Blister Pack In 1 Carton (51862-564-06) / 1 Kit In 1 Blister Pack (51862-564-01),3.58,1.43,,,0 NDC,51862061201,"Methylphenidate Hydrochloride (La): 100 Capsule, Extended Release In 1 Bottle, Plastic (51862-612-01)",7.48,2.99,,,0 NDC,51927100000,Morphine Sulfate: 1 G In 1 Container (51927-1000-0),161.17,64.47,,,0 NDC,51927100200,Chloral Hydrate: 1 Kg In 1 Container (51927-1002-0),8.12,3.25,,,0 NDC,51927123400,NDC Description Not Available,5.35,2.14,,,0 NDC,51927279000,NDC Description Not Available,2.52,1.01,,,0 NDC,51927453900,NDC Description Not Available,0.1,0.04,,,0 NDC,51927478200,NDC Description Not Available,24.14,9.66,,,0 NDC,51927482500,NDC Description Not Available,59.72,23.89,,,0 NDC,51991014417,Methylergonovine Maleate: 10 Ampule In 1 Box (51991-144-17) / 1 Ml In 1 Ampule,70.64,28.26,,,0 NDC,51991031133,"Desvenlafaxine: 30 Tablet, Extended Release In 1 Bottle (51991-311-33)",2.26,0.9,,,0 NDC,51991036060,Asenapine: 6 Blister Pack In 1 Box (51991-360-60) / 10 Tablet In 1 Blister Pack,14.23,5.69,,,0 NDC,51991065116,Levetiracetam: 473 Ml In 1 Bottle (51991-651-16),0.24,0.1,,,0 NDC,51991090701,"Tetracycline Hydrochloride: 100 Capsule In 1 Bottle, Plastic (51991-907-01)",10.06,4.02,,,0 NDC,51991098399,NDC Description Not Available,57.63,23.05,,,0 NDC,52015008001,"Dificid: 1 Bottle In 1 Carton (52015-080-01) / 20 Tablet, Film Coated In 1 Bottle",768.23,307.29,,,0 NDC,52244002006,Edex: 6 Blister Pack In 1 Carton (52244-020-06) / 1 Cartridge In 1 Blister Pack / 1 Ml In 1 Cartridge,29.67,11.87,,,0 NDC,52244010010,"Theo-24: 100 Capsule, Extended Release In 1 Bottle (52244-100-10)",11.32,4.53,,,0 NDC,52244020010,"Theo-24: 100 Capsule, Extended Release In 1 Bottle (52244-200-10)",16.71,6.68,,,0 NDC,52276031205,"Carbaglu: 5 Tablet, For Suspension In 1 Bottle (52276-312-05)",661.71,264.68,,,0 NDC,52276031260,"Carbaglu: 60 Tablet, For Suspension In 1 Bottle (52276-312-60)",642.94,257.18,,,0 NDC,52276040001,Cystadane: 180 G In 1 Bottle (52276-400-01),3.29,1.32,,,0 NDC,52536016401,"Perphenazine: 100 Tablet, Film Coated In 1 Bottle (52536-164-01)",1.36,0.54,,,0 NDC,52536018603,"Erythromycin: 30 Tablet, Delayed Release In 1 Bottle (52536-186-03)",33.34,13.34,,,0 NDC,52536060011,Baclofen: 1 Bottle In 1 Carton (52536-600-11) / 120 Ml In 1 Bottle,26.17,10.47,,,0 NDC,52536062501,"Testosterone Cypionate: 1 Vial, Single-Dose In 1 Carton (52536-625-01) / 1 Ml In 1 Vial, Single-Dose",0.06,0.02,,,0 NDC,52565000814,Lidocaine: 1 TUBE in 1 CARTON (52565-008-14) / 35.44 g in 1 TUBE,29.46,11.78,,,0 NDC,52565001259,"Fluocinolone Acetonide: 1 BOTTLE, WITH APPLICATOR in 1 CARTON (52565-012-59) / 60 mL in 1 BOTTLE, WITH APPLICATOR",343.9,137.56,,,0 NDC,52652195001,"Thyquidity: 1 Bottle, Glass In 1 Carton (52652-1950-1) / 100 Ml In 1 Bottle, Glass",17.63,7.05,,,0 NDC,52652195002,"Thyquidity: 2 Carton In 1 Carton (52652-1950-2) / 1 Bottle, Glass In 1 Carton / 100 Ml In 1 Bottle, Glass",34.73,13.89,,,0 NDC,52652300101,Qbrelis: 150 Ml In 1 Bottle (52652-3001-1),86.25,34.5,,,0 NDC,52652500101,Katerzia: 1 Bottle In 1 Carton (52652-5001-1) / 150 Ml In 1 Bottle,27.94,11.18,,,0 NDC,52652600102,Fleqsuvy: 1 Bottle In 1 Carton (52652-6001-2) / 300 Ml In 1 Bottle,34.96,13.98,,,0 NDC,52652800101,Zonisade: 1 Bottle In 1 Carton (52652-8001-1) / 150 Ml In 1 Bottle,58.59,23.44,,,0 NDC,52652900101,Eprontia: 473 Ml In 1 Bottle (52652-9001-1),15.62,6.25,,,0 NDC,52817020110,"Acetazolamide: 100 Tablet In 1 Bottle, Plastic (52817-201-10)",0.37,0.15,,,0 NDC,52817021010,"Cyproheptadine Hydrochloride: 100 Tablet In 1 Bottle, Plastic (52817-210-10)",0.3,0.12,,,0 NDC,52817027010,"Bisoprolol: 100 Tablet, Film Coated In 1 Bottle (52817-270-10)",0.74,0.3,,,0 NDC,52817027030,"Bisoprolol: 30 Tablet, Film Coated In 1 Bottle (52817-270-30)",2.48,0.99,,,0 NDC,52817032010,Baclofen: 100 Tablet In 1 Bottle (52817-320-10),0.26,0.1,,,0 NDC,52817032110,Baclofen: 100 Tablet In 1 Bottle (52817-321-10),0.32,0.13,,,0 NDC,52817033010,"Cyclobenzaprine Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (52817-330-10)",0.12,0.05,,,0 NDC,52817036210,"Metoprolol Tartrate: 100 Tablet, Film Coated In 1 Bottle (52817-362-10)",0.17,0.07,,,0 NDC,52817081508,"Aminocaproic Acid: 236.5 Ml In 1 Bottle, Plastic (52817-815-08)",91.05,36.42,,,0 NDC,52959014406,Sulfamethoxazole and Trimethoprim: 6 TABLET in 1 BOTTLE (52959-144-06),0.23,0.09,,,0 NDC,53489014101,"Quinidine Gluconate: 100 Tablet, Extended Release In 1 Bottle, Plastic (53489-141-01)",23.29,9.32,,,0 NDC,53489017601,Albuterol Sulfate: 100 Tablet In 1 Bottle (53489-176-01),1.74,0.7,,,0 NDC,53746036101,Folic Acid: 100 Tablet In 1 Bottle (53746-361-01),0.22,0.09,,,0 NDC,53746051101,Spironolactone: 100 Tablet In 1 Bottle (53746-511-01),0.27,0.11,,,0 NDC,53746071101,Guanfacine Hydrochloride: 100 Tablet In 1 Bottle (53746-711-01),1.54,0.62,,,0 NDC,53746073490,Felbamate: 90 Tablet In 1 Bottle (53746-734-90),10.35,4.14,,,0 NDC,54022510001,NDC Description Not Available,0.19,0.08,,,0 NDC,54092018981,Pentasa: 240 Capsule In 1 Bottle (54092-189-81),9.2,3.68,,,0 NDC,54092038301,"Adderall Xr: 100 Capsule, Extended Release In 1 Bottle (54092-383-01)",30.7,12.28,,,0 NDC,54092054601,"Motegrity: 30 Tablet, Film Coated In 1 Bottle (54092-546-01)",47.61,19.04,,,0 NDC,54092054701,"Motegrity: 30 Tablet, Film Coated In 1 Bottle (54092-547-01)",47.97,19.19,,,0 NDC,54092070001,"Elaprase: 1 Vial, Glass In 1 Box (54092-700-01) / 3 Ml In 1 Vial, Glass",2313.0,925.2,,,0 NDC,54092070104,"Vpriv: 1 Vial, Glass In 1 Box (54092-701-04) / 4 Ml In 1 Vial, Glass",1683.03,673.21,,,0 NDC,54288010001,Zoledronic Acid: 1 Vial In 1 Carton (54288-100-01) / 5 Ml In 1 Vial,24.24,9.7,,,0 NDC,54288010301,NDC Description Not Available,4.84,1.94,,,0 NDC,54288010310,Epinephrine: 10 Ampule In 1 Box (54288-103-10) / 1 Ml In 1 Ampule,4.9,1.96,,,0 NDC,54288010502,NDC Description Not Available,4313.38,1725.35,,,0 NDC,54288010515,Dehydrated Alcohol: 10 Ampule In 1 Carton (54288-105-15) / 5 Ml In 1 Ampule (54288-105-02),4472.04,1788.82,,,0 NDC,54288010902,"Melphalan Hydrochloride: 1 Kit In 1 Carton (54288-109-02) * 10 Ml In 1 Vial, Single-Dose (54288-106-01) * 10 Ml In 1 Vial, Single-Use (54288-107-01)",689.41,275.76,,,0 NDC,54288012001,Epinephrine: 1 Vial In 1 Carton (54288-120-01) / 10 Ml In 1 Vial,2.16,0.86,,,0 NDC,54288012510,Potassium Chloride For Oral Solution: 100 Pouch In 1 Carton (54288-125-10) / 1.58 G In 1 Pouch (54288-125-01),21.54,8.62,,,0 NDC,54288012530,Potassium Chloride For Oral Solution: 30 Pouch In 1 Carton (54288-125-30) / 1.58 G In 1 Pouch (54288-125-01),14.96,5.98,,,0 NDC,54288013601,NDC Description Not Available,111.61,44.64,,,0 NDC,54288014101,NDC Description Not Available,2.64,1.06,,,0 NDC,54288014201,NDC Description Not Available,54.08,21.63,,,0 NDC,54288014210,Papaverine Hydrochloride: 10 Vial In 1 Carton (54288-142-10) / 2 Ml In 1 Vial (54288-142-01),32.36,12.94,,,0 NDC,54288016701,"Carboplatin: 1 Vial, Multi-Dose In 1 Carton (54288-167-01) / 60 Ml In 1 Vial, Multi-Dose",22.66,9.06,,,0 NDC,54482014701,Carnitor: 5 Vial In 1 Carton (54482-147-01) / 5 Ml In 1 Vial,8.08,3.23,,,0 NDC,54482014801,"Carnitor Sf: 24 Bottle, Plastic In 1 Case (54482-148-01) / 118 Ml In 1 Bottle, Plastic",5.23,2.09,,,0 NDC,54629011001,NDC Description Not Available,0.1,0.04,,,0 NDC,54629020001,NDC Description Not Available,0.14,0.06,,,0 NDC,54629084121,NDC Description Not Available,0.12,0.05,,,0 NDC,54629398501,NDC Description Not Available,0.15,0.06,,,0 NDC,54629409760,NDC Description Not Available,0.22,0.09,,,0 NDC,54629797530,NDC Description Not Available,0.93,0.37,,,0 NDC,54643564601,Infuvite Pediatric: 1 Kit In 1 Carton (54643-5646-1) * 4 Ml In 1 Vial (54643-5648-1) * 1 Ml In 1 Vial (54643-5651-1),66.83,26.73,,,0 NDC,54643564700,Infuvite Pediatric: 1 Kit In 1 Carton (54643-5647-0) * 40 Ml In 1 Vial (54643-5653-0) * 10 Ml In 1 Vial (54643-5655-0),71.62,28.65,,,0 NDC,54643564901,Infuvite Adult: 1 Kit In 1 Carton (54643-5649-1) * 5 Ml In 1 Vial (54643-5657-1) * 5 Ml In 1 Vial (54643-5659-1),56.084999999999994,22.43,,,0 NDC,54838000180,NDC Description Not Available,0.72,0.29,,,0 NDC,54838000530,NDC Description Not Available,17.06,6.82,,,0 NDC,54838000650,NDC Description Not Available,0.46,0.18,,,0 NDC,54838000655,NDC Description Not Available,0.08,0.03,,,0 NDC,54838001150,NDC Description Not Available,0.12,0.05,,,0 NDC,54838001152,NDC Description Not Available,0.04,0.02,,,0 NDC,54838001153,NDC Description Not Available,0.08,0.03,,,0 NDC,54838001154,NDC Description Not Available,0.1,0.04,,,0 NDC,54838011680,"Silace: 473 Ml In 1 Bottle, Plastic (54838-116-80)",0.06,0.02,,,0 NDC,54838050140,"Haloperidol: 120 Ml In 1 Bottle, Dropper (54838-501-40)",0.42,0.17,,,0 NDC,54838050280,"Hydroxyzine Hydrochloride: 473 Ml In 1 Bottle, Plastic (54838-502-80)",4.45,1.78,,,0 NDC,54838050615,"Hyosyne: 15 Ml In 1 Bottle, Plastic (54838-506-15)",6.16,2.46,,,0 NDC,54838051080,"Oxybutynin Chloride: 473 Ml In 1 Bottle, Plastic (54838-510-80)",0.4,0.16,,,0 NDC,54838051240,"Doxepin Hydrochloride: 120 Ml In 1 Bottle, Plastic (54838-512-40)",9.33,3.73,,,0 NDC,54859051608,NDC Description Not Available,0.71,0.28,,,0 NDC,55111014630,Fluconazole: 30 Tablet In 1 Bottle (55111-146-30),8.83,3.53,,,0 NDC,55111019630,"Clopidogrel Bisulfate: 30 Tablet, Film Coated In 1 Bottle (55111-196-30)",0.51,0.2,,,0 NDC,55111026279,"Olanzapine: 10 Tablet, Orally Disintegrating In 1 Blister Pack (55111-262-79)",6.53,2.61,,,0 NDC,55111026281,"Olanzapine: 3 Blister Pack In 1 Carton (55111-262-81) / 10 Tablet, Orally Disintegrating In 1 Blister Pack",6.34,2.54,,,0 NDC,55111026379,"Olanzapine: 10 Tablet, Orally Disintegrating In 1 Blister Pack (55111-263-79)",5.91,2.36,,,0 NDC,55111026381,"Olanzapine: 3 Blister Pack In 1 Carton (55111-263-81) / 10 Tablet, Orally Disintegrating In 1 Blister Pack",7.26,2.9,,,0 NDC,55111029209,Sumatriptan Succinate: 9 Blister Pack In 1 Carton (55111-292-09) / 9 Tablet In 1 Blister Pack,7.6,3.04,,,0 NDC,55111032001,Glimepiride: 100 Tablet In 1 Bottle (55111-320-01),0.13,0.05,,,0 NDC,55111051930,Atomoxetine: 30 Capsule In 1 Bottle (55111-519-30),4.89,1.96,,,0 NDC,55111052130,Atomoxetine: 30 Capsule In 1 Bottle (55111-521-30),7.49,3.0,,,0 NDC,55111052701,Tacrolimus: 1 Bottle In 1 Carton (55111-527-01) / 100 Capsule In 1 Bottle,1.92,0.77,,,0 NDC,55111055610,"Decitabine: 1 Vial, Single-Use In 1 Carton (55111-556-10) / 10 Ml In 1 Vial, Single-Use",6.47,2.59,,,0 NDC,55111065207,NDC Description Not Available,5.04,2.02,,,0 NDC,55111067811,NDC Description Not Available,20.31,8.12,,,0 NDC,55111067902,Fondaparinux Sodium: 2 Syringe In 1 Carton (55111-679-02) / .4 Ml In 1 Syringe (55111-679-11),8.57,3.43,,,0 NDC,55111068002,Fondaparinux Sodium: 2 Syringe In 1 Carton (55111-680-02) / .6 Ml In 1 Syringe (55111-680-11),16.66,6.66,,,0 NDC,55111068011,NDC Description Not Available,13.83,5.53,,,0 NDC,55111068507,"Zoledronic Acid: 1 Vial, Glass In 1 Carton (55111-685-07) / 5 Ml In 1 Vial, Glass",57.16,22.86,,,0 NDC,55111069407,"Palonosetron: 1 Vial, Single-Use In 1 Carton (55111-694-07) / 5 Ml In 1 Vial, Single-Use",7.92,3.17,,,0 NDC,55111071830,"Lamotrigine: 30 Tablet, Extended Release In 1 Bottle (55111-718-30)",4.12,1.65,,,0 NDC,55111072030,"Lamotrigine: 30 Tablet, Extended Release In 1 Bottle (55111-720-30)",5.375,2.1500000000000004,,,0 NDC,55111072901,Allopurinol: 100 Tablet In 1 Bottle (55111-729-01),0.34,0.14,,,0 NDC,55111073130,"Valsartan: 30 Tablet, Film Coated In 1 Bottle (55111-731-30)",0.44,0.18,,,0 NDC,55135013201,"Trodelvy: 1 Vial In 1 Box (55135-132-01) / 1 Powder, For Solution In 1 Vial",152.27,60.91,,,0 NDC,55150011310,"Ampicillin: 10 Vial In 1 Box (55150-113-10) / 1 Injection, Powder, For Solution In 1 Vial",11.16,4.46,,,0 NDC,55150011420,"Ampicillin: 10 Vial In 1 Box (55150-114-20) / 1 Injection, Powder, For Solution In 1 Vial",9.12,3.65,,,0 NDC,55150011720,"Ampicillin And Sulbactam: 10 Vial In 1 Carton (55150-117-20) / 1 Injection, Powder, For Solution In 1 Vial",11.79,4.72,,,0 NDC,55150011930,"Piperacillin And Tazobactam: 10 Vial In 1 Box (55150-119-30) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",6.7,2.68,,,0 NDC,55150012030,"Piperacillin And Tazobactam: 10 Vial In 1 Box (55150-120-30) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",10.9,4.36,,,0 NDC,55150012150,"Piperacillin And Tazobactam: 10 Vial In 1 Box (55150-121-50) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",7.25,2.9,,,0 NDC,55150012215,Nafcillin: 10 Vial In 1 Box (55150-122-15) / 4 Ml In 1 Vial,1.04,0.42,,,0 NDC,55150012315,Nafcillin: 10 Vial In 1 Box (55150-123-15) / 8 Ml In 1 Vial,2.035,0.8150000000000001,,,0 NDC,55150012499,"Nafcillin: 1 Vial, Pharmacy Bulk Package In 1 Box (55150-124-99) / 100 Ml In 1 Vial, Pharmacy Bulk Package",47.865,19.145,,,0 NDC,55150015410,"Acyclovir Sodium: 10 Vial, Single-Dose In 1 Carton (55150-154-10) / 10 Ml In 1 Vial, Single-Dose",0.56,0.22,,,0 NDC,55150015520,"Acyclovir Sodium: 10 Vial, Single-Dose In 1 Carton (55150-155-20) / 20 Ml In 1 Vial, Single-Dose",0.57,0.23,,,0 NDC,55150016102,"Lidocaine Hydrochloride: 10 Vial, Single-Dose In 1 Carton (55150-161-02) / 2 Ml In 1 Vial, Single-Dose",2.825,1.1300000000000001,,,0 NDC,55150016205,"Lidocaine Hydrochloride: 10 Vial, Single-Dose In 1 Carton (55150-162-05) / 5 Ml In 1 Vial, Single-Dose",0.535,0.215,,,0 NDC,55150016330,"Lidocaine Hydrochloride: 1 Vial, Single-Dose In 1 Carton (55150-163-30) / 30 Ml In 1 Vial, Single-Dose",4.72,1.89,,,0 NDC,55150016505,"Lidocaine Hydrochloride: 10 Vial, Single-Dose In 1 Carton (55150-165-05) / 5 Ml In 1 Vial, Single-Dose",4.8149999999999995,1.93,,,0 NDC,55150016613,"Sildenafil: 1 Vial, Single-Dose In 1 Carton (55150-166-13) / 12.5 Ml In 1 Vial, Single-Dose",77.67,31.07,,,0 NDC,55150016710,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-167-10) / 10 Ml In 1 Vial, Single-Dose",0.20500000000000002,0.08,,,0 NDC,55150016830,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-168-30) / 30 Ml In 1 Vial, Single-Dose",0.07,0.03,,,0 NDC,55150016910,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-169-10) / 10 Ml In 1 Vial, Single-Dose",0.12,0.05,,,0 NDC,55150017030,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-170-30) / 30 Ml In 1 Vial, Single-Dose",0.04,0.02,,,0 NDC,55150017110,"Bupivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-171-10) / 10 Ml In 1 Vial, Single-Dose",0.08,0.03,,,0 NDC,55150017301,"Sumatriptan: 5 Vial, Single-Dose In 1 Carton (55150-173-01) / .5 Ml In 1 Vial, Single-Dose",48.98,19.59,,,0 NDC,55150017705,"Levetiracetam: 10 Vial, Single-Dose In 1 Carton (55150-177-05) / 5 Ml In 1 Vial, Single-Dose",0.11,0.04,,,0 NDC,55150018810,"Tranexamic Acid: 10 Vial, Single-Dose In 1 Carton (55150-188-10) / 10 Ml In 1 Vial, Single-Dose",14.13,5.65,,,0 NDC,55150019183,"Ibandronate Sodium: 1 Syringe, Glass In 1 Carton (55150-191-83) / 3 Ml In 1 Syringe, Glass",358.53,143.41,,,0 NDC,55150019410,"Esmolol Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-194-10) / 10 Ml In 1 Vial, Single-Dose",1.9,0.76,,,0 NDC,55150019520,"Ropivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-195-20) / 20 Ml In 1 Vial, Single-Dose",0.99,0.4,,,0 NDC,55150019720,"Ropivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-197-20) / 20 Ml In 1 Vial, Single-Dose",0.1,0.04,,,0 NDC,55150019830,"Ropivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (55150-198-30) / 30 Ml In 1 Vial, Single-Dose",0.24,0.1,,,0 NDC,55150020200,NDC Description Not Available,13.49,5.4,,,0 NDC,55150020210,"Pantoprazole Sodium: 10 Vial, Single-Dose In 1 Carton (55150-202-10) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose (55150-202-00)",15.53,6.21,,,0 NDC,55150020720,"Meropenem: 10 Vial In 1 Carton (55150-207-20) / 1 Injection, Powder, For Solution In 1 Vial",5.43,2.17,,,0 NDC,55150020830,"Meropenem: 10 Vial In 1 Carton (55150-208-30) / 1 Injection, Powder, For Solution In 1 Vial",5.24,2.1,,,0 NDC,55150020902,Dexmedetomidine: 25 Vial In 1 Carton (55150-209-02) / 2 Ml In 1 Vial,7.59,3.04,,,0 NDC,55150021010,"Bivalirudin: 10 Vial, Single-Dose In 1 Carton (55150-210-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",0.79,0.32,,,0 NDC,55150022110,"Etomidate: 10 Vial, Single-Dose In 1 Carton (55150-221-10) / 10 Ml In 1 Vial, Single-Dose",20.82,8.33,,,0 NDC,55150023501,NDC Description Not Available,10.45,4.18,,,0 NDC,55150023510,"Vecuronium Bromide: 10 Vial In 1 Carton (55150-235-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (55150-235-01)",13.58,5.43,,,0 NDC,55150023805,"Dexamethasone Sodium Phosphate: 25 Vial, Multi-Dose In 1 Carton (55150-238-05) / 5 Ml In 1 Vial, Multi-Dose",0.12,0.05,,,0 NDC,55150023930,"Dexamethasone Sodium Phosphate: 25 Vial, Multi-Dose In 1 Carton (55150-239-30) / 30 Ml In 1 Vial, Multi-Dose",0.2,0.08,,,0 NDC,55150024251,Linezolid: 10 Pouch In 1 Carton (55150-242-51) / 1 Bag In 1 Pouch / 300 Ml In 1 Bag,24.48,9.79,,,0 NDC,55150025050,"Bupivacaine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (55150-250-50) / 50 Ml In 1 Vial, Multi-Dose",0.02,0.01,,,0 NDC,55150025110,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (55150-251-10) / 10 Ml In 1 Vial, Multi-Dose",2.28,0.91,,,0 NDC,55150025220,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (55150-252-20) / 20 Ml In 1 Vial, Multi-Dose",5.7,2.28,,,0 NDC,55150025350,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (55150-253-50) / 50 Ml In 1 Vial, Multi-Dose",0.05,0.02,,,0 NDC,55150025410,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (55150-254-10) / 10 Ml In 1 Vial, Multi-Dose",4.25,1.7,,,0 NDC,55150025520,"Lidocaine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (55150-255-20) / 20 Ml In 1 Vial, Multi-Dose",0.01,0.004,,,0 NDC,55150025930,"Acetylcysteine: 4 Vial, Single-Dose In 1 Carton (55150-259-30) / 30 Ml In 1 Vial, Single-Dose",2.27,0.91,,,0 NDC,55150027301,NDC Description Not Available,8.68,3.47,,,0 NDC,55150027325,"Thiamine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (55150-273-25) / 2 Ml In 1 Vial, Multi-Dose (55150-273-01)",8.36,3.34,,,0 NDC,55150028220,"Ertapenem: 10 Vial, Single-Dose In 1 Carton (55150-282-20) / 1 Injection In 1 Vial, Single-Dose",133.44,53.38,,,0 NDC,55150029701,NDC Description Not Available,63.8,25.52,,,0 NDC,55150030401,NDC Description Not Available,2.18,0.87,,,0 NDC,55150030701,NDC Description Not Available,0.78,0.31,,,0 NDC,55150030724,"Acetaminophen: 24 Vial, Single-Dose In 1 Carton (55150-307-24) / 100 Ml In 1 Vial, Single-Dose (55150-307-01)",0.24,0.1,,,0 NDC,55150030801,"Olanzapine: 1 Vial, Single-Dose In 1 Carton (55150-308-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",9.71,3.88,,,0 NDC,55150032401,NDC Description Not Available,1.43,0.57,,,0 NDC,55150033001,Medroxyprogesterone Acetate: 1 Syringe In 1 Carton (55150-330-01) / 1 Ml In 1 Syringe,1.8,0.72,,,0 NDC,55150034510,Naloxone Hydrochloride: 10 Syringe In 1 Box (55150-345-10) / 2 Ml In 1 Syringe,9.95,3.98,,,0 NDC,55150036501,"Amphotericin B: 1 Vial, Single-Dose In 1 Carton (55150-365-01) / 12.5 Ml In 1 Vial, Single-Dose",224.92,89.97,,,0 NDC,55150037001,"Vasopressin: 1 Vial, Multi-Dose In 1 Carton (55150-370-01) / 1 Ml In 1 Vial, Multi-Dose",5.37,2.145,,,0 NDC,55150038101,Pemetrexed: 1 Vial In 1 Carton (55150-381-01) / 4 Ml In 1 Vial,8.36,3.34,,,0 NDC,55150038301,Pemetrexed: 1 Vial In 1 Carton (55150-383-01) / 40 Ml In 1 Vial,6.47,2.59,,,0 NDC,55150038401,"Triamcinolone Acetonide: 1 Vial, Multi-Dose In 1 Carton (55150-384-01) / 5 Ml In 1 Vial, Multi-Dose",3.87,1.55,,,0 NDC,55150038601,"Carboplatin: 1 Vial, Multi-Dose In 1 Carton (55150-386-01) / 60 Ml In 1 Vial, Multi-Dose",13.84,5.54,,,0 NDC,55150038801,"Posaconazole: 1 Vial, Single-Dose In 1 Carton (55150-388-01) / 16.7 Ml In 1 Vial, Single-Dose",759.37,303.75,,,0 NDC,55150040001,NDC Description Not Available,20.38,8.15,,,0 NDC,55150042101,NDC Description Not Available,3.43,1.37,,,0 NDC,55150043201,NDC Description Not Available,223.19,89.28,,,0 NDC,55150043401,"Dexrazoxane: 1 Kit In 1 Package (55150-434-01) * 25 Ml In 1 Vial, Single-Dose (55150-432-01) * 25 Ml In 1 Vial (55150-433-01)",1225.27,490.11,,,0 NDC,55150043501,NDC Description Not Available,176.16,70.46,,,0 NDC,55150043701,"Dexrazoxane: 1 Kit In 1 Package (55150-437-01) * 50 Ml In 1 Vial, Single-Dose (55150-435-01) * 50 Ml In 1 Vial (55150-436-01)",1125.05,450.02,,,0 NDC,55150043801,NDC Description Not Available,4.52,1.81,,,0 NDC,55150043901,NDC Description Not Available,11.17,4.47,,,0 NDC,55150044001,NDC Description Not Available,27.14,10.86,,,0 NDC,55150045901,NDC Description Not Available,231.6,92.64,,,0 NDC,55150049801,"Fluorouracil: 1 Vial, Pharmacy Bulk Package In 1 Carton (55150-498-01) / 100 Ml In 1 Vial, Pharmacy Bulk Package",7.36,2.94,,,0 NDC,55292020111,Chemet: 100 Capsule In 1 Bottle (55292-201-11),101.36500000000001,40.545,,,0 NDC,55292070255,Panhematin: 1 Vial In 1 Carton (55292-702-55) / 48 Ml In 1 Vial (55292-702-54),130.91,52.36,,,0 NDC,55513002101,NDC Description Not Available,35.42,14.17,,,0 NDC,55513002104,Aranesp: 1 Blister Pack In 1 Package (55513-021-04) / 4 Syringe In 1 Blister Pack / .4 Ml In 1 Syringe (55513-021-01),36.04,14.42,,,0 NDC,55513002301,NDC Description Not Available,35.27,14.11,,,0 NDC,55513002304,Aranesp: 1 Blister Pack In 1 Package (55513-023-04) / 4 Syringe In 1 Blister Pack / .3 Ml In 1 Syringe (55513-023-01),34.37,13.75,,,0 NDC,55513002501,NDC Description Not Available,36.04,14.42,,,0 NDC,55513002504,Aranesp: 1 Blister Pack In 1 Package (55513-025-04) / 4 Syringe In 1 Blister Pack / .5 Ml In 1 Syringe (55513-025-01),15.0,6.0,,,0 NDC,55513002701,NDC Description Not Available,34.53,13.81,,,0 NDC,55513003201,Aranesp: 1 Blister Pack In 1 Package (55513-032-01) / 1 Syringe In 1 Blister Pack / 1 Ml In 1 Syringe,15.0,6.0,,,0 NDC,55513005701,NDC Description Not Available,35.11,14.04,,,0 NDC,55513005704,Aranesp: 1 Blister Pack In 1 Package (55513-057-04) / 4 Syringe In 1 Blister Pack / .42 Ml In 1 Syringe (55513-057-01),36.0,14.4,,,0 NDC,55513005901,Imdelltra (Amg757): 1 Kit In 1 Package (55513-059-01) * 1 Mg In 1 Vial (55513-103-01) * 7 Ml In 1 Vial (55513-068-01),6763.014999999999,2705.205,,,0 NDC,55513007701,Imdelltra (Amg757): 1 Kit In 1 Package (55513-077-01) * 10 Mg In 1 Vial (55513-069-01) * 7 Ml In 1 Vial (55513-068-01),37814.02,15125.61,,,0 NDC,55513007801,Imlygic: 1 Vial In 1 Carton (55513-078-01) / 1 Ml In 1 Vial,209.61,83.84,,,0 NDC,55513007901,Imlygic: 1 Vial In 1 Carton (55513-079-01) / 1 Ml In 1 Vial,203.52,81.41,,,0 NDC,55513011101,Aranesp: 1 Blister Pack In 1 Package (55513-111-01) / 1 Syringe In 1 Blister Pack / .6 Ml In 1 Syringe,35.27,14.11,,,0 NDC,55513013201,"Kanjinti: 1 Vial, Multi-Dose In 1 Carton (55513-132-01) / 20 Ml In 1 Vial, Multi-Dose",410.88,164.35,,,0 NDC,55513014101,"Kanjinti: 1 Vial, Single-Dose In 1 Carton (55513-141-01) / 7.15 Ml In 1 Vial, Single-Dose",412.53,165.01,,,0 NDC,55513016001,Blincyto: 1 Kit In 1 Package (55513-160-01) * 3.088 Ml In 1 Vial (55513-150-01) * 10.6 Ml In 1 Vial (55513-155-01),670.56,268.22,,,0 NDC,55513019001,Neulasta: 1 Syringe In 1 Carton (55513-190-01) / .6 Ml In 1 Syringe,2169.38,867.75,,,0 NDC,55513019201,Neulasta: 1 Kit In 1 Carton (55513-192-01) * .6 Ml In 1 Syringe,2204.23,881.69,,,0 NDC,55513020601,Mvasi: 1 Vial In 1 Carton (55513-206-01) / 4 Ml In 1 Vial,295.75,118.3,,,0 NDC,55513020701,Mvasi: 1 Vial In 1 Carton (55513-207-01) / 16 Ml In 1 Vial,295.79,118.32,,,0 NDC,55513022101,Nplate: 1 Vial In 1 Carton (55513-221-01) / .5 Ml In 1 Vial,7.84,3.14,,,0 NDC,55513022201,Nplate: 1 Vial In 1 Carton (55513-222-01) / 1 Ml In 1 Vial,64.76,25.9,,,0 NDC,55513022301,"Nplate: 1 Vial, Single-Dose In 1 Carton (55513-223-01) / .25 Ml In 1 Vial, Single-Dose",62.36,24.94,,,0 NDC,55513022401,"Riabni: 1 Vial, Single-Dose In 1 Carton (55513-224-01) / 10 Ml In 1 Vial, Single-Dose",349.92,139.97,,,0 NDC,55513032601,"Riabni: 1 Vial, Single-Dose In 1 Carton (55513-326-01) / 50 Ml In 1 Vial, Single-Dose",349.35,139.74,,,0 NDC,55513053001,NDC Description Not Available,4.48,1.79,,,0 NDC,55513053010,Neupogen: 10 Vial In 1 Package (55513-530-10) / 1 Ml In 1 Vial (55513-530-01),4.52,1.81,,,0 NDC,55513054601,NDC Description Not Available,4.6,1.84,,,0 NDC,55513067001,"Avsola: 1 Vial, Single-Dose In 1 Carton (55513-670-01) / 10 Ml In 1 Vial, Single-Dose",211.86,84.74,,,0 NDC,55513071001,Prolia: 1 Syringe In 1 Carton (55513-710-01) / 1 Ml In 1 Syringe,128.9,51.56,,,0 NDC,55513071021,Prolia: 1 Syringe In 1 Carton (55513-710-21) / 1 Ml In 1 Syringe,135.74,54.3,,,0 NDC,55513073001,"Xgeva: 1 Vial, Single-Use In 1 Carton (55513-730-01) / 1.7 Ml In 1 Vial, Single-Use",125.25,50.1,,,0 NDC,55513080060,"Corlanor: 60 Tablet, Film Coated In 1 Bottle (55513-800-60)",29.05,11.62,,,0 NDC,55513081060,"Corlanor: 60 Tablet, Film Coated In 1 Bottle (55513-810-60)",42.76,17.1,,,0 NDC,55513081301,NDC Description Not Available,10.13,4.05,,,0 NDC,55513088001,NDC Description Not Available,54.84,21.94,,,0 NDC,55513088002,Evenity: 2 Syringe In 1 Carton (55513-880-02) / 1.17 Ml In 1 Syringe (55513-880-01),54.84,21.94,,,0 NDC,55513095401,"Vectibix: 1 Vial, Single-Dose In 1 Carton (55513-954-01) / 5 Ml In 1 Vial, Single-Dose",754.55,301.82,,,0 NDC,55513095601,"Vectibix: 1 Vial, Single-Dose In 1 Carton (55513-956-01) / 20 Ml In 1 Vial, Single-Dose",749.4,299.76,,,0 NDC,55513099802,"Evenity: 2 Syringe, Glass In 1 Carton (55513-998-02) / 1.17 Ml In 1 Syringe, Glass (55513-998-01)",53.98,21.59,,,0 NDC,55566105000,NDC Description Not Available,267290.1,106916.04,,,0 NDC,55566105001,Adstiladrin: 4 Vial In 1 Carton (55566-1050-1) / 20 Ml In 1 Vial (55566-1050-0),267960.0,107184.0,,,0 NDC,55566280001,Cervidil: 1 Pouch In 1 Carton (55566-2800-1) / 10 Mg In 1 Pouch (55566-2800-0),1633.44,653.38,,,0 NDC,55566410001,NDC Description Not Available,5251.99,2100.8,,,0 NDC,55566650001,NDC Description Not Available,44.22,17.69,,,0 NDC,55566830301,"Firmagon: 1 Kit In 1 Carton (55566-8303-1) * 4 Ml In 1 Vial, Glass * 4.2 Ml In 1 Syringe",26.31,10.52,,,0 NDC,55566840301,"Firmagon: 1 Kit In 1 Carton (55566-8403-1) * 3 Ml In 1 Syringe * 3 Ml In 1 Vial, Glass",13.68,5.47,,,0 NDC,56151161111,NDC Description Not Available,0.28,0.11,,,0 NDC,56184012041,NDC Description Not Available,0.33,0.13,,,0 NDC,56184012053,NDC Description Not Available,0.16,0.06,,,0 NDC,56184012062,NDC Description Not Available,0.16,0.06,,,0 NDC,57237000330,Fluconazole: 30 Tablet In 1 Bottle (57237-003-30),1.0,0.4,,,0 NDC,57237007710,"Ondansetron: 3 Blister Pack In 1 Carton (57237-077-10) / 10 Tablet, Orally Disintegrating In 1 Blister Pack",1.08,0.43,,,0 NDC,57237015035,Fluconazole: 1 Bottle In 1 Carton (57237-150-35) / 35 Ml In 1 Bottle,24.1,9.64,,,0 NDC,57237017201,Venlafaxine: 100 Tablet In 1 Bottle (57237-172-01),0.44,0.18,,,0 NDC,57237017501,Venlafaxine: 100 Tablet In 1 Bottle (57237-175-01),0.37,0.15,,,0 NDC,57237018090,Pramipexole Dihydrochloride: 90 Tablet In 1 Bottle (57237-180-90),0.34,0.14,,,0 NDC,57237027424,Lamivudine: 240 Ml In 1 Bottle (57237-274-24),7.98,3.19,,,0 NDC,57237032521,Glycerin: 2 Blister Pack In 1 Carton (57237-325-21) / 6 Suppository In 1 Blister Pack (57237-325-16),1.11,0.44,,,0 NDC,57237032552,Glycerin: 5 Blister Pack In 1 Carton (57237-325-52) / 5 Suppository In 1 Blister Pack (57237-325-51),0.78,0.31,,,0 NDC,57237032621,Glycerin Children: 2 Blister Pack In 1 Carton (57237-326-21) / 6 Suppository In 1 Blister Pack (57237-326-16),1.26,0.5,,,0 NDC,57237032652,Glycerin Children: 5 Blister Pack In 1 Carton (57237-326-52) / 5 Suppository In 1 Blister Pack (57237-326-51),0.99,0.4,,,0 NDC,57664004688,Lisdexamfetamine Dimesylate: 100 Capsule In 1 Bottle (57664-046-88),14.26,5.7,,,0 NDC,57664004988,Lisdexamfetamine Dimesylate: 100 Capsule In 1 Bottle (57664-049-88),13.85,5.54,,,0 NDC,57664050389,Tizanidine: 150 Tablet In 1 Bottle (57664-503-89),0.28,0.11,,,0 NDC,57664068331,NDC Description Not Available,56.26,22.5,,,0 NDC,57664068357,Linezolid: 10 Bag In 1 Box (57664-683-57) / 300 Ml In 1 Bag (57664-683-31),38.98,15.59,,,0 NDC,57771000702,NDC Description Not Available,2.74,1.1,,,0 NDC,57877000506,NDC Description Not Available,13383.385,5353.355,,,0 NDC,57877000518,NDC Description Not Available,3562.5,1425.0,,,0 NDC,57894003001,"Remicade: 1 Vial, Single-Use In 1 Box (57894-030-01) / 10 Ml In 1 Vial, Single-Use",494.73,197.89,,,0 NDC,57894005427,"Stelara: 1 Vial, Single-Use In 1 Box (57894-054-27) / 26 Ml In 1 Vial, Single-Use",69.79,27.92,,,0 NDC,57894006002,"Stelara: 1 Vial, Single-Use In 1 Carton (57894-060-02) / .5 Ml In 1 Vial, Single-Use",989.39,395.76,,,0 NDC,57894016001,"Infliximab: 1 Vial, Single-Use In 1 Box (57894-160-01) / 10 Ml In 1 Vial, Single-Use",200.83,80.33,,,0 NDC,57894035001,"Simponi Aria: 1 Vial, Single-Dose In 1 Carton (57894-350-01) / 4 Ml In 1 Vial, Single-Dose",170.86,68.34,,,0 NDC,57894044901,"Tecvayli: 1 Vial, Single-Dose In 1 Carton (57894-449-01) / 3 Ml In 1 Vial, Single-Dose",133.65,53.46,,,0 NDC,57894045001,"Tecvayli: 1 Vial, Single-Dose In 1 Carton (57894-450-01) / 1.7 Ml In 1 Vial, Single-Dose",150.17,60.07,,,0 NDC,57894046901,"Talvey: 1 Vial, Single-Dose In 1 Carton (57894-469-01) / 1.5 Ml In 1 Vial, Single-Dose",274.02,109.61,,,0 NDC,57894047001,"Talvey: 1 Vial, Single-Dose In 1 Carton (57894-470-01) / 1 Ml In 1 Vial, Single-Dose",306.05,122.42,,,0 NDC,57894050101,"Rybrevant: 1 Vial, Single-Use In 1 Carton (57894-501-01) / 1 Injection In 1 Vial, Single-Use (57894-501-00)",94.4,37.76,,,0 NDC,57894050301,"Darzalex Faspro: 1 Vial, Single-Dose In 1 Box (57894-503-01) / 15 Ml In 1 Vial, Single-Dose",249.45,99.78,,,0 NDC,57894050505,"Darzalex Iv: 1 Vial, Single-Dose In 1 Box (57894-505-05) / 5 Ml In 1 Vial, Single-Dose",327.41,130.96,,,0 NDC,57894050520,"Darzalex Iv: 1 Vial, Single-Dose In 1 Box (57894-505-20) / 20 Ml In 1 Vial, Single-Dose",1089.68,435.87,,,0 NDC,57894065002,"Tremfya: 1 Vial, Single-Dose In 1 Carton (57894-650-02) / 20 Ml In 1 Vial, Single-Dose (57894-650-01)",321.91,128.76,,,0 NDC,57896018105,Artificial Tears: 1 Bottle In 1 Carton (57896-181-05) / 15 Mg In 1 Bottle,4.56,1.82,,,0 NDC,57896018405,Gericare Artificial Tears Lubricant Eye: 1 BOTTLE in 1 CARTON (57896-184-05) / 15 mg in 1 BOTTLE,3.83,1.53,,,0 NDC,57896019945,"Tolnaftate Antifungal: 45 G In 1 Bottle, Dispensing (57896-199-45)",9.18,3.67,,,0 NDC,57896038124,NDC Description Not Available,0.06,0.02,,,0 NDC,57896062101,NDC Description Not Available,0.12,0.05,,,0 NDC,57896062912,Geri-Lanta Antacid Antigas: 355 Ml In 1 Bottle (57896-629-12),0.7,0.28,,,0 NDC,57896064912,Milk Of Magnesia Original: 355 Ml In 1 Bottle (57896-649-12),0.21,0.08,,,0 NDC,57896070916,NDC Description Not Available,0.13,0.05,,,0 NDC,57896084401,NDC Description Not Available,0.55,0.22,,,0 NDC,57896092101,"Regular Strength Enteric Coated Aspirin: 100 Tablet, Coated In 1 Bottle (57896-921-01)",0.06,0.02,,,0 NDC,57962001428,"Imbruvica: 1 Blister Pack In 1 Carton (57962-014-28) / 28 Tablet, Film Coated In 1 Blister Pack",2692.91,1077.16,,,0 NDC,57970010001,Dalvance: 1 Vial In 1 Package (57970-100-01) / 25 Ml In 1 Vial,79.67,31.87,,,0 NDC,58108060935,NDC Description Not Available,2.29,0.92,,,0 NDC,58151031052,Nitrostat: 4 Bottle In 1 Carton (58151-310-52) / 25 Tablet In 1 Bottle (58151-310-94),40.42,16.17,,,0 NDC,58151031094,NDC Description Not Available,121.28,48.51,,,0 NDC,58160072303,NDC Description Not Available,1347.81,539.12,,,0 NDC,58160072615,Hiberix: 1 Kit In 1 Carton (58160-726-15) * .85 Ml In 1 Syringe (58160-817-02) * .5 Ml In 1 Vial (58160-816-03),56.96,22.78,,,0 NDC,58160074002,NDC Description Not Available,441.03,176.41,,,0 NDC,58160074021,Rotarix: 10 Applicator In 1 Carton (58160-740-21) / 1.5 Ml In 1 Applicator (58160-740-02),426.72,170.69,,,0 NDC,58160081011,NDC Description Not Available,109.19,43.68,,,0 NDC,58160081043,NDC Description Not Available,128.67,51.47,,,0 NDC,58160081052,Infanrix: 10 Syringe In 1 Carton (58160-810-52) / .5 Ml In 1 Syringe (58160-810-43),169.43,67.77,,,0 NDC,58160081143,NDC Description Not Available,423.55,169.42,,,0 NDC,58160081243,NDC Description Not Available,272.9,109.16,,,0 NDC,58160081252,Kinrix: 10 Syringe In 1 Carton (58160-812-52) / .5 Ml In 1 Syringe (58160-812-43),257.23,102.89,,,0 NDC,58160081543,NDC Description Not Available,566.16,226.46,,,0 NDC,58160081552,Twinrix: 10 Syringe In 1 Carton (58160-815-52) / 1 Ml In 1 Syringe (58160-815-43),418.27,167.31,,,0 NDC,58160081601,NDC Description Not Available,48.01,19.2,,,0 NDC,58160081603,NDC Description Not Available,57.93,23.17,,,0 NDC,58160081811,Hiberix: 1 Kit In 1 Carton (58160-818-11) * 10 Vial In 1 Carton (58160-816-05) / .5 Ml In 1 Vial (58160-816-01) * 10 Vial In 1 Package (58160-817-05) / .85 Ml In 1 Vial (58160-817-01),48.0,19.2,,,0 NDC,58160082043,NDC Description Not Available,123.12,49.25,,,0 NDC,58160082052,Engerix-B: 10 Syringe In 1 Carton (58160-820-52) / .5 Ml In 1 Syringe (58160-820-43),109.15,43.66,,,0 NDC,58160082311,Shingrix: 1 Kit In 1 Carton (58160-823-11) * .5 Ml In 1 Vial (58160-828-03) * .5 Ml In 1 Vial (58160-829-03),638.5,255.4,,,0 NDC,58160082415,Priorix: 1 Kit In 1 Carton (58160-824-15) * .5 Ml In 1 Vial (58160-831-03) * .5 Ml In 1 Syringe (58160-833-02),423.13,169.25,,,0 NDC,58160082543,NDC Description Not Available,169.98,67.99,,,0 NDC,58160082552,Havrix: 10 Syringe In 1 Carton (58160-825-52) / .5 Ml In 1 Syringe (58160-825-43),162.73,65.09,,,0 NDC,58160082643,NDC Description Not Available,371.79,148.72,,,0 NDC,58160082652,Havrix: 10 Syringe In 1 Carton (58160-826-52) / 1 Ml In 1 Syringe (58160-826-43),367.6,147.04,,,0 NDC,58160082703,NDC Description Not Available,725.37,290.15,,,0 NDC,58160082730,Menveo: 10 Vial In 1 Carton (58160-827-30) / .5 Ml In 1 Vial (58160-827-03),707.99,283.2,,,0 NDC,58160082803,NDC Description Not Available,690.085,276.03,,,0 NDC,58160082903,NDC Description Not Available,627.6949999999999,251.07999999999998,,,0 NDC,58160083103,NDC Description Not Available,413.7,165.48,,,0 NDC,58160084211,Boostrix: 10 Vial In 1 Carton (58160-842-11) / .5 Ml In 1 Vial (58160-842-01),166.2,66.48,,,0 NDC,58160084243,NDC Description Not Available,211.98,84.79,,,0 NDC,58160084252,Boostrix: 10 Syringe In 1 Carton (58160-842-52) / .5 Ml In 1 Syringe (58160-842-43),209.69,83.88,,,0 NDC,58160084811,Arexvy: 1 Kit In 1 Carton (58160-848-11) * .5 Ml In 1 Vial (58160-723-03) * .5 Ml In 1 Vial (58160-744-03),1106.97,442.79,,,0 NDC,58160088452,Fluarix 2024/2025: 10 Syringe In 1 Carton (58160-884-52) / .5 Ml In 1 Syringe (58160-884-41),69.23,27.69,,,0 NDC,58160095509,"Menveo: 1 Kit In 1 Carton (58160-955-09) * .5 Ml In 1 Vial, Single-Dose (58160-958-01) * .5 Ml In 1 Vial, Single-Dose (58160-959-01)",462.96,185.18,,,0 NDC,58160095801,NDC Description Not Available,463.18,185.27,,,0 NDC,58160097602,NDC Description Not Available,1039.7,415.88,,,0 NDC,58160097620,Bexsero: 10 Syringe In 1 Carton (58160-976-20) / .5 Ml In 1 Syringe (58160-976-02),724.24,289.7,,,0 NDC,58204000409,NDC Description Not Available,1.64,0.66,,,0 NDC,58204000413,NDC Description Not Available,1.64,0.66,,,0 NDC,58284022401,"Brixadi: 1 Syringe, Glass In 1 Carton (58284-224-01) / .48 Ml In 1 Syringe, Glass",1885.28,754.11,,,0 NDC,58284029601,"Brixadi: 1 Syringe, Glass In 1 Carton (58284-296-01) / .27 Ml In 1 Syringe, Glass",7556.75,3022.7,,,0 NDC,58394001201,"Xyntha: 1 Kit In 1 Carton (58394-012-01) * 4 Ml In 1 Vial, Single-Use (58394-112-01) * 4 Ml In 1 Syringe (58394-018-01) * 1 Ml In 1 Packet",8.45,3.38,,,0 NDC,58394001301,"Xyntha: 1 Kit In 1 Carton (58394-013-01) * 4 Ml In 1 Syringe (58394-018-01) * 1 Ml In 1 Packet * 4 Ml In 1 Vial, Single-Use (58394-113-01)",8.45,3.38,,,0 NDC,58394001401,"Xyntha: 1 Kit In 1 Carton (58394-014-01) * 4 Ml In 1 Syringe (58394-018-01) * 1 Ml In 1 Packet * 4 Ml In 1 Vial, Single-Use (58394-114-01)",8.49,3.4,,,0 NDC,58394001501,"Xyntha: 1 Kit In 1 Carton (58394-015-01) * 1 Ml In 1 Packet * 4 Ml In 1 Vial, Single-Use (58394-115-01) * 4 Ml In 1 Syringe (58394-018-01)",3.81,1.52,,,0 NDC,58394002203,Xyntha: 1 Kit In 1 Carton (58394-022-03) * 4 Ml In 1 Syringe (58394-122-03) * 1 Ml In 1 Packet,3.81,1.52,,,0 NDC,58394002303,Xyntha: 1 Kit In 1 Carton (58394-023-03) * 4 Ml In 1 Syringe (58394-123-03) * 1 Ml In 1 Packet,8.79,3.52,,,0 NDC,58394002503,Xyntha: 1 Kit In 1 Carton (58394-025-03) * 4 Ml In 1 Syringe (58394-125-03) * 1 Ml In 1 Packet,8.79,3.52,,,0 NDC,58394011401,NDC Description Not Available,8.4,3.36,,,0 NDC,58394063503,"Benefix: 1 Kit In 1 Carton (58394-635-03) * 5 Ml In 1 Syringe (58394-041-11) * 1 Ml In 1 Packet (0069-1111-01) * 5 Ml In 1 Vial, Single-Use (58394-135-03)",7.66,3.06,,,0 NDC,58468003001,NDC Description Not Available,9100.81,3640.32,,,0 NDC,58468003002,"Thyrogen: 2 Vial, Single-Dose In 1 Carton (58468-0030-2) / 1 Ml In 1 Vial, Single-Dose (58468-0030-1)",8702.53,3481.01,,,0 NDC,58468008001,"Thymoglobulin: 1 Vial, Glass In 1 Carton (58468-0080-1) / 5 Ml In 1 Vial, Glass",4795.48,1918.19,,,0 NDC,58468009001,NDC Description Not Available,199.6,79.84,,,0 NDC,58468009003,NDC Description Not Available,168.87,67.55,,,0 NDC,58468013202,"Renvela: 90 Packet In 1 Carton (58468-0132-2) / 1 Powder, For Suspension In 1 Packet (58468-0132-1)",76.93,30.77,,,0 NDC,58468022501,"Cablivi: 1 Kit In 1 Carton (58468-0225-1) * 1 Ml In 1 Vial, Glass (58468-0227-1) * 1 Ml In 1 Syringe, Glass (58468-0229-1)",2855.36,1142.14,,,0 NDC,58468035701,"Campath: 1 Vial, Single-Use In 1 Carton (58468-0357-1) / 1 Ml In 1 Vial, Single-Use",80.54,32.22,,,0 NDC,58468042601,"Nexviazyme: 1 Vial, Single-Dose In 1 Carton (58468-0426-1) / 10 Ml In 1 Vial, Single-Dose",334.88,133.95,,,0 NDC,58657031016,Sodium Citrate-Citric Acid: 473 mL in 1 BOTTLE (58657-310-16),2.51,1.0,,,0 NDC,58657032550,"Multi-Vitamin With Fluoride: 1 Bottle, Dropper In 1 Box (58657-325-50) / 50 Ml In 1 Bottle, Dropper",0.85,0.34,,,0 NDC,58657050016,Codeine-Guaifenesin: 473 Ml In 1 Bottle (58657-500-16),2.17,0.87,,,0 NDC,58657064801,Clonidine Hydrochloride: 100 Tablet In 1 Bottle (58657-648-01),0.24,0.1,,,0 NDC,58914008052,Bentyl: 5 Ampule In 1 Box (58914-080-52) / 2 Ml In 1 Ampule,362.27,144.91,,,0 NDC,58914050156,Canasa: 30 Suppository In 1 Box (58914-501-56),118.68,47.47,,,0 NDC,58980001205,Double Antibiotic: 1 Tube In 1 Box (58980-012-05) / 14.2 G In 1 Tube,20.45,8.18,,,0 NDC,58980035050,White Petrolatum: 144 Packet In 1 Box (58980-350-50) / 5 G In 1 Packet,0.43,0.17,,,0 NDC,58980040912,Stratuscare Glycerin Laxative Pediatric: 12 Suppository In 1 Jar (58980-409-12),0.32,0.13,,,0 NDC,58980040925,Stratuscare Glycerin Laxative Pediatric: 25 Suppository In 1 Jar (58980-409-25),0.33,0.13,,,0 NDC,58980041012,Stratuscare Adult Glycerin: 12 Suppository In 1 Jar (58980-410-12),0.27,0.11,,,0 NDC,58980078021,NDC Description Not Available,90.85,36.34,,,0 NDC,59011041020,"Oxycontin: 2 Blister Pack In 1 Carton (59011-410-20) / 10 Tablet, Film Coated, Extended Release In 1 Blister Pack",17.03,6.81,,,0 NDC,59011042010,"Oxycontin: 100 Tablet, Film Coated, Extended Release In 1 Bottle (59011-420-10)",32.13,12.85,,,0 NDC,59011042020,"Oxycontin: 2 Blister Pack In 1 Carton (59011-420-20) / 10 Tablet, Film Coated, Extended Release In 1 Blister Pack",31.31,12.52,,,0 NDC,59011044020,"Oxycontin: 2 Blister Pack In 1 Carton (59011-440-20) / 10 Tablet, Film Coated, Extended Release In 1 Blister Pack",54.29,21.72,,,0 NDC,59011048020,"Oxycontin: 2 Blister Pack In 1 Carton (59011-480-20) / 10 Tablet, Film Coated, Extended Release In 1 Blister Pack",97.16,38.86,,,0 NDC,59011075004,Butrans: 4 Pouch In 1 Carton (59011-750-04) / 1 Patch In 1 Pouch / 168 H In 1 Patch,156.71,62.68,,,0 NDC,59148003713,Rexulti: 1 Bottle In 1 Carton (59148-037-13) / 30 Tablet In 1 Bottle,139.48,55.79,,,0 NDC,59310057922,"PROAIR: 1 INHALER in 1 CARTON (59310-579-22) / 200 AEROSOL, METERED in 1 INHALER",335.29,134.12,,,0 NDC,59338077501,"Feraheme: 1 Vial, Single-Use In 1 Carton (59338-775-01) / 17 Ml In 1 Vial, Single-Use",10.46,4.18,,,0 NDC,59365512801,Paragard T 380A: 1 Pouch In 1 Carton (59365-5128-1) / 1 Intrauterine Device In 1 Pouch,4971.51,1988.6,,,0 NDC,59365512901,Paragard T 380A: 1 Pouch In 1 Carton (59365-5129-1) / 1 Intrauterine Device In 1 Pouch,5011.6,2004.64,,,0 NDC,59385002101,NDC Description Not Available,30.75,12.3,,,0 NDC,59385002201,NDC Description Not Available,21.37,8.55,,,0 NDC,59385002260,"Belbuca: 60 Pouch In 1 Carton (59385-022-60) / 1 Film, Soluble In 1 Pouch (59385-022-01)",30.75,12.3,,,0 NDC,59385002301,NDC Description Not Available,32.79,13.12,,,0 NDC,59385002360,"Belbuca: 60 Pouch In 1 Carton (59385-023-60) / 1 Film, Soluble In 1 Pouch (59385-023-01)",48.29,19.32,,,0 NDC,59385002501,NDC Description Not Available,48.69,19.48,,,0 NDC,59385002560,"Belbuca: 60 Pouch In 1 Carton (59385-025-60) / 1 Film, Soluble In 1 Pouch (59385-025-01)",70.01,28.0,,,0 NDC,59390002601,NDC Description Not Available,0.25,0.1,,,0 NDC,59390002662,NDC Description Not Available,37.48,14.99,,,0 NDC,59390018213,Goniotaire: 1 Bottle In 1 Carton (59390-182-13) / 15 Ml In 1 Bottle,59.27,23.71,,,0 NDC,59390021805,"Altafluor: 5 Ml In 1 Bottle, Dropper (59390-218-05)",61.62,24.65,,,0 NDC,59417010110,Vyvanse: 100 Capsule In 1 Bottle (59417-101-10),38.78,15.51,,,0 NDC,59417010410,Vyvanse: 100 Capsule In 1 Bottle (59417-104-10),38.19,15.28,,,0 NDC,59572071101,"Reblozyl: 1 Vial, Glass In 1 Carton (59572-711-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Glass",175.7,70.28,,,0 NDC,59572077501,"Reblozyl: 1 Vial, Glass In 1 Carton (59572-775-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Glass",175.44,70.18,,,0 NDC,59572098401,"Istodax: 1 Kit In 1 Carton (59572-984-01) * 2.2 Ml In 1 Vial, Glass (59572-962-10) * 2.4 Ml In 1 Vial, Glass (59572-973-02)",147.14,58.86,,,0 NDC,59584013801,"Candin: 1 Ml In 1 Vial, Multi-Dose (59584-138-01)",141.68,56.67,,,0 NDC,59630026601,NDC Description Not Available,9.75,3.9,,,0 NDC,59630026610,"Fetroja: 10 Vial, Single-Use In 1 Carton (59630-266-10) / 10 Ml In 1 Vial, Single-Use (59630-266-01)",9.47,3.79,,,0 NDC,59651000830,Azithromycin: 1 Bottle In 1 Carton (59651-008-30) / 30 Ml In 1 Bottle,8.59,3.44,,,0 NDC,59651003230,NDC Description Not Available,2.44,0.98,,,0 NDC,59651003247,Ibuprofen: 1 Bottle In 1 Carton (59651-032-47) / 473 Ml In 1 Bottle,2.43,0.97,,,0 NDC,59651013830,Nebivolol: 30 Tablet In 1 Bottle (59651-138-30),0.66,0.26,,,0 NDC,59651015201,Progesterone: 100 Capsule In 1 Bottle (59651-152-01),0.87,0.35,,,0 NDC,59651033101,Flucytosine: 100 Capsule In 1 Bottle (59651-331-01),31.62,12.65,,,0 NDC,59651033201,Flucytosine: 100 Capsule In 1 Bottle (59651-332-01),143.225,57.290000000000006,,,0 NDC,59651042011,Sildenafil Citrate: 1 Bottle In 1 Carton (59651-420-11) / 112 Ml In 1 Bottle,0.88,0.35,,,0 NDC,59651044401,"Valganciclovir: 1 Bottle, Glass In 1 Carton (59651-444-01) / 100 Ml In 1 Bottle, Glass",158.7,63.48,,,0 NDC,59651048401,Prednisone: 100 Tablet In 1 Bottle (59651-484-01),0.44,0.18,,,0 NDC,59651059001,Pyrimethamine: 100 Tablet In 1 Bottle (59651-590-01),1260.6,504.24,,,0 NDC,59651078201,"Glipizide: 100 Tablet, Extended Release In 1 Bottle (59651-782-01)",0.77,0.31,,,0 NDC,59651086705,"Ciprofloxacin: 500 Tablet, Film Coated In 1 Bottle (59651-867-05)",0.64,0.26,,,0 NDC,59676027801,"Edurant: 30 Tablet, Film Coated In 1 Bottle (59676-278-01)",142.64,57.06,,,0 NDC,59676030200,NDC Description Not Available,114.84,45.94,,,0 NDC,59676031000,NDC Description Not Available,113.25,45.3,,,0 NDC,59676031001,"Procrit: 6 Vial, Single-Dose In 1 Carton (59676-310-01) / 1 Ml In 1 Vial, Single-Dose (59676-310-00)",62.2,24.88,,,0 NDC,59676032000,NDC Description Not Available,32.75,13.1,,,0 NDC,59676032004,"Procrit: 4 Vial, Multi-Dose In 1 Carton (59676-320-04) / 1 Ml In 1 Vial, Multi-Dose (59676-320-00)",62.15,24.86,,,0 NDC,59676034000,NDC Description Not Available,114.43,45.77,,,0 NDC,59676034001,"Procrit: 4 Vial, Single-Dose In 1 Carton (59676-340-01) / 1 Ml In 1 Vial, Single-Dose (59676-340-00)",117.59,47.04,,,0 NDC,59676056501,"Prezista: 1 Bottle, Glass In 1 Carton (59676-565-01) / 200 Ml In 1 Bottle, Glass",220.58,88.23,,,0 NDC,59676056630,"Prezista: 30 Tablet, Film Coated In 1 Bottle, Plastic (59676-566-30)",310.04,124.02,,,0 NDC,59676057530,"Prezcobix: 30 Tablet, Film Coated In 1 Bottle (59676-575-30)",239.72,95.89,,,0 NDC,59676061001,"Yondelis: 20 Ml In 1 Vial, Single-Use (59676-610-01)",1580.86,632.34,,,0 NDC,59676080030,"Symtuza: 30 Tablet, Film Coated In 1 Bottle (59676-800-30)",457.39,182.96,,,0 NDC,59746000106,Methylprednisolone: 100 Tablet In 1 Bottle (59746-001-06),1.26,0.5,,,0 NDC,59746001032,"Risperidone: 3 Blister Pack In 1 Carton (59746-010-32) / 10 Tablet, Orally Disintegrating In 1 Blister Pack",4.45,1.78,,,0 NDC,59746002022,"Risperidone: 7 Blister Pack In 1 Carton (59746-020-22) / 4 Tablet, Orally Disintegrating In 1 Blister Pack",6.18,2.47,,,0 NDC,59746003022,"Risperidone: 7 Blister Pack In 1 Carton (59746-030-22) / 4 Tablet, Orally Disintegrating In 1 Blister Pack",9.47,3.79,,,0 NDC,59746011306,Prochlorperazine Maleate: 100 Tablet In 1 Bottle (59746-113-06),1.5,0.6,,,0 NDC,59746017106,Prednisone: 100 Tablet In 1 Bottle (59746-171-06),0.44,0.18,,,0 NDC,59746017306,Prednisone: 100 Tablet In 1 Bottle (59746-173-06),0.04,0.02,,,0 NDC,59746017506,Prednisone: 100 Tablet In 1 Bottle (59746-175-06),0.03,0.01,,,0 NDC,59746021106,"Cyclobenzaprine Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (59746-211-06)",0.71,0.28,,,0 NDC,59762005001,Methylprednisolone: 50 Tablet In 1 Bottle (59762-0050-1),1.88,0.75,,,0 NDC,59762005101,Methylprednisolone: 25 Tablet In 1 Bottle (59762-0051-1),1.6,0.64,,,0 NDC,59762006701,"Sertraline Hydrochloride: 1 Bottle, Dropper In 1 Carton (59762-0067-1) / 60 Ml In 1 Bottle, Dropper",6.36,2.54,,,0 NDC,59762007301,Hydrocortisone: 50 Tablet In 1 Bottle (59762-0073-1),0.51,0.2,,,0 NDC,59762007401,Hydrocortisone: 100 Tablet In 1 Bottle (59762-0074-1),0.51,0.20500000000000002,,,0 NDC,59762010405,"Sulfasalazine: 1 Bottle In 1 Carton (59762-0104-5) / 100 Tablet, Delayed Release In 1 Bottle",0.92,0.37,,,0 NDC,59762011901,"Phenelzine Sulfate: 60 Tablet, Film Coated In 1 Bottle (59762-0119-1)",2.87,1.15,,,0 NDC,59762080002,"Tolterodine Tartrate: 60 Tablet, Film Coated In 1 Bottle (59762-0800-2)",3.08,1.23,,,0 NDC,59762100101,"Sirolimus: 100 Tablet, Sugar Coated In 1 Bottle (59762-1001-1)",13.56,5.42,,,0 NDC,59762100401,Nifedipine: 100 Capsule In 1 Bottle (59762-1004-1),3.02,1.21,,,0 NDC,59762106101,Diphenoxylate Hydrochloride And Atropine Sulfate: 100 Tablet In 1 Bottle (59762-1061-1),1.77,0.71,,,0 NDC,59762120601,Liothyronine Sodium: 100 Tablet In 1 Bottle (59762-1206-1),2.04,0.82,,,0 NDC,59762130804,Linezolid: 150 Ml In 1 Bottle (59762-1308-4),246.86,98.74,,,0 NDC,59762135001,Rifabutin: 100 Capsule In 1 Bottle (59762-1350-1),39.7,15.88,,,0 NDC,59762171002,"Eplerenone: 30 Tablet, Film Coated In 1 Bottle (59762-1710-2)",5.86,2.34,,,0 NDC,59762314001,Azithromycin: 1 Bottle In 1 Carton (59762-3140-1) / 30 Ml In 1 Bottle,1.77,0.71,,,0 NDC,59762330403,"Nitroglycerin: 4 Bottle, Glass In 1 Carton (59762-3304-3) / 25 Tablet In 1 Bottle, Glass",20.86,8.34,,,0 NDC,59762500005,Sulfasalazine: 1 Bottle In 1 Carton (59762-5000-5) / 100 Tablet In 1 Bottle,0.79,0.32,,,0 NDC,59762500006,Sulfasalazine: 1 Bottle In 1 Carton (59762-5000-6) / 300 Tablet In 1 Bottle,0.61,0.24,,,0 NDC,59762500701,Misoprostol: 60 Tablet In 1 Bottle (59762-5007-1),1.2,0.48,,,0 NDC,59762505007,"Gabapentin: 1 Bottle, Plastic In 1 Carton (59762-5050-7) / 470 Ml In 1 Bottle, Plastic",2.35,0.94,,,0 NDC,59767000401,"Pertzye: 100 Capsule, Delayed Release In 1 Bottle (59767-004-01)",5.56,2.22,,,0 NDC,59767001601,"Pertzye: 100 Capsule, Delayed Release In 1 Bottle (59767-016-01)",16.65,6.66,,,0 NDC,59767002401,"Pertzye: 80 Capsule, Delayed Release In 1 Bottle (59767-024-01)",24.8,9.92,,,0 NDC,60219107601,Azathioprine: 100 Tablet In 1 Bottle (60219-1076-1),1.93,0.77,,,0 NDC,60219126601,Oseltamivir Phosphate: 1 Blister Pack In 1 Carton (60219-1266-1) / 10 Capsule In 1 Blister Pack,37.38,14.95,,,0 NDC,60219150301,Erythromycin Ethylsuccinate: 100 Ml In 1 Bottle (60219-1503-1),10.64,4.26,,,0 NDC,60219161701,NDC Description Not Available,4.84,1.94,,,0 NDC,60219161708,Potassium Chloride: 100 Pouch In 1 Carton (60219-1617-8) / 1.58 G In 1 Pouch (60219-1617-1),6.56,2.62,,,0 NDC,60219174802,"Atropine: 1 Bottle, Dropper In 1 Carton (60219-1748-2) / 2 Ml In 1 Bottle, Dropper",89.61,35.84,,,0 NDC,60219174903,"Atropine: 1 Bottle, Dropper In 1 Carton (60219-1749-3) / 5 Ml In 1 Bottle, Dropper",112.55,45.02,,,0 NDC,60258000116,"Cytra-2: 473 mL in 1 BOTTLE, PLASTIC (60258-001-16)",6.54,2.62,,,0 NDC,60258000615,NDC Description Not Available,1.63,0.65,,,0 NDC,60258016001,NDC Description Not Available,0.23,0.09,,,0 NDC,60258016101,NDC Description Not Available,0.58,0.23,,,0 NDC,60258017201,NDC Description Not Available,0.39,0.16,,,0 NDC,60267070550,"Sodium Thiosulfate: 50 Ml In 1 Vial, Single-Dose (60267-705-50)",3.44,1.38,,,0 NDC,60429011805,"Methocarbamol: 500 TABLET, FILM COATED in 1 BOTTLE (60429-118-05)",0.28,0.11,,,0 NDC,60432003816,"Generlac: 473 mL in 1 BOTTLE, PLASTIC (60432-038-16)",0.95,0.38,,,0 NDC,60432006500,"Amoxicillin And Clavulanate Potassium: 100 Ml In 1 Bottle, Plastic (60432-065-00)",2.11,0.84,,,0 NDC,60432012616,"Megestrol Acetate: 480 mL in 1 BOTTLE, PLASTIC (60432-126-16)",8.08,3.23,,,0 NDC,60432015016,"Hydroxyzine Hydrochloride: 473 mL in 1 BOTTLE, PLASTIC (60432-150-16)",2.16,0.86,,,0 NDC,60505003901,Etodolac: 100 Capsule In 1 Bottle (60505-0039-1),3.24,1.3,,,0 NDC,60505005501,Selegiline Hydrochloride: 60 Capsule In 1 Bottle (60505-0055-1),4.98,1.99,,,0 NDC,60505008000,Sotalol Hydrochloride: 100 Tablet In 1 Bottle (60505-0080-0),0.24,0.1,,,0 NDC,60505015900,Sotalol Hydrochloride: 100 Tablet In 1 Bottle (60505-0159-0),0.33,0.13,,,0 NDC,60505018300,Carbamazepine: 100 Tablet In 1 Bottle (60505-0183-0),1.14,0.46,,,0 NDC,60505058901,"Brimonidine Tartrate/Timolol Maleate Ophthalmic Solution: 1 Bottle, Dropper In 1 Carton (60505-0589-1) / 5 Ml In 1 Bottle, Dropper",494.67,197.87,,,0 NDC,60505059304,Travoprost: 1 Bottle In 1 Carton (60505-0593-4) / 2.5 Ml In 1 Bottle,377.28,150.91,,,0 NDC,60505081500,"Desmopressin Acetate: 1 Bottle, Spray In 1 Carton (60505-0815-0) / 50 Spray In 1 Bottle, Spray",246.89,98.76,,,0 NDC,60505082306,"Calcitonin Salmon: 1 Bottle, Glass In 1 Carton (60505-0823-6) / 30 Spray, Metered In 1 Bottle, Glass",75.35,30.14,,,0 NDC,60505082601,"Ipratropium Bromide: 1 Bottle, Spray In 1 Carton (60505-0826-1) / 345 Spray, Metered In 1 Bottle, Spray",154.01,61.6,,,0 NDC,60505082901,"Fluticasone Propionate: 1 Bottle, Spray In 1 Carton (60505-0829-1) / 120 Spray, Metered In 1 Bottle, Spray",51.68,20.67,,,0 NDC,60505265301,Trazodone Hydrochloride: 100 Tablet In 1 Bottle (60505-2653-1),0.2,0.08,,,0 NDC,60505265701,Triamterene And Hydrochlorothiazide: 100 Tablet In 1 Bottle (60505-2657-1),0.86,0.34,,,0 NDC,60505280507,"Carbamazepine: 120 Capsule, Extended Release In 1 Bottle (60505-2805-7)",4.91,1.96,,,0 NDC,60505290103,"Imatinib Mesylate: 30 Tablet, Film Coated In 1 Bottle (60505-2901-3)",53.52,21.41,,,0 NDC,60505311000,"Olanzapine: 10 Blister Pack In 1 Carton (60505-3110-0) / 10 Tablet, Film Coated In 1 Blister Pack",0.59,0.24,,,0 NDC,60505311100,"Olanzapine: 10 Blister Pack In 1 Carton (60505-3111-0) / 10 Tablet, Film Coated In 1 Blister Pack",0.75,0.3,,,0 NDC,60505311300,"Olanzapine: 10 Blister Pack In 1 Carton (60505-3113-0) / 10 Tablet, Film Coated In 1 Blister Pack",1.05,0.42,,,0 NDC,60505327500,"Olanzapine: 10 Blister Pack In 1 Carton (60505-3275-0) / 10 Tablet, Orally Disintegrating In 1 Blister Pack",4.9,1.96,,,0 NDC,60505327600,"Olanzapine: 10 Blister Pack In 1 Carton (60505-3276-0) / 10 Tablet, Orally Disintegrating In 1 Blister Pack",7.65,3.06,,,0 NDC,60505392701,"Guanfacine Extended-Release: 100 Tablet, Extended Release In 1 Bottle (60505-3927-1)",0.74,0.3,,,0 NDC,60505412907,"Oxcarbazepine: 100 Tablet, Extended Release In 1 Bottle (60505-4129-7)",35.0,14.0,,,0 NDC,60505464303,"Prasugrel: 30 Tablet, Film Coated In 1 Bottle (60505-4643-3)",2.39,0.96,,,0 NDC,60505609700,"Ibandronate Sodium: 1 Syringe, Glass In 1 Carton (60505-6097-0) / 3 Ml In 1 Syringe, Glass",1084.88,433.95,,,0 NDC,60505612801,"Irinotecan Hydrochloride: 1 Vial, Single-Use In 1 Carton (60505-6128-1) / 5 Ml In 1 Vial, Single-Use",13.4,5.36,,,0 NDC,60505613000,NDC Description Not Available,0.5,0.2,,,0 NDC,60505613005,"Ondansetron: 25 Vial, Single-Use In 1 Carton (60505-6130-5) / 2 Ml In 1 Vial, Single-Use (60505-6130-0)",0.48,0.19,,,0 NDC,60505613207,Oxaliplatin: 1 Vial In 1 Carton (60505-6132-7) / 20 Ml In 1 Vial,0.89,0.36,,,0 NDC,60505614200,NDC Description Not Available,2.89,1.16,,,0 NDC,60505614600,"Cefepime: 1 Vial, Single-Dose In 1 Carton (60505-6146-0) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose",11.22,4.49,,,0 NDC,60505614604,"Cefepime: 10 Vial, Single-Dose In 1 Carton (60505-6146-4) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose",11.28,4.51,,,0 NDC,60505614700,"Cefepime: 1 Vial, Single-Dose In 1 Carton (60505-6147-0) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose",10.32,4.125,,,0 NDC,60505614704,"Cefepime: 10 Vial, Single-Dose In 1 Carton (60505-6147-4) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose",15.77,6.31,,,0 NDC,60505614800,"Ceftriaxone Sodium: 1 Vial, Single-Use In 1 Carton (60505-6148-0) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use",3.12,1.25,,,0 NDC,60505614804,"Ceftriaxone Sodium: 10 Vial, Single-Use In 1 Carton (60505-6148-4) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use",1.63,0.65,,,0 NDC,60505614900,NDC Description Not Available,1.51,0.6,,,0 NDC,60505615204,"Ceftriaxone Sodium: 1 Vial, Single-Use In 1 Carton (60505-6152-4) / 1 Injection, Powder, For Solution In 1 Vial, Single-Use",4.93,1.97,,,0 NDC,60505615600,NDC Description Not Available,7.07,2.83,,,0 NDC,60505615700,NDC Description Not Available,4.76,1.9,,,0 NDC,60505615704,"Piperacillin And Tazobactam: 10 Vial, Single-Dose In 1 Carton (60505-6157-4) / 15 Ml In 1 Vial, Single-Dose (60505-6157-0)",6.29,2.52,,,0 NDC,60505615900,NDC Description Not Available,13.46,5.38,,,0 NDC,60505615904,"Piperacillin And Tazobactam: 10 Vial, Single-Dose In 1 Carton (60505-6159-4) / 20 Ml In 1 Vial, Single-Dose (60505-6159-0)",7.59,3.04,,,0 NDC,60505619301,Palonosetron: 1 Vial In 1 Carton (60505-6193-1) / 5 Ml In 1 Vial,13.03,5.21,,,0 NDC,60505619600,NDC Description Not Available,76.46,30.58,,,0 NDC,60505619604,Ertapenem: 10 Vial In 1 Carton (60505-6196-4) / 20 Ml In 1 Vial (60505-6196-0),66.92,26.77,,,0 NDC,60505619702,"Sirolimus: 1 Bottle, Glass In 1 Carton (60505-6197-2) / 60 Ml In 1 Bottle, Glass",58.1,23.24,,,0 NDC,60505622904,"Daptomycin: 1 Vial, Single-Use In 1 Carton (60505-6229-4) / 10 Ml In 1 Vial, Single-Use",0.26,0.1,,,0 NDC,60505623606,"Deferoxamine Mesylate: 4 Injection, Powder, Lyophilized, For Solution In 1 Carton (60505-6236-6)",35.59,14.24,,,0 NDC,60505624901,Dexamethasone: 100 Tablet In 1 Bottle (60505-6249-1),0.17,0.07,,,0 NDC,60505627101,"Azacitidine: 1 Injection, Powder, Lyophilized, For Solution In 1 Carton (60505-6271-1)",7.52,3.01,,,0 NDC,60505706200,NDC Description Not Available,3.45,1.38,,,0 NDC,60505706400,Nicotine Transdermal System: 14 Pouch In 1 Carton (60505-7064-0) / 1 H In 1 Pouch,0.19,0.08,,,0 NDC,60505708100,NDC Description Not Available,11.03,4.41,,,0 NDC,60505708200,NDC Description Not Available,18.48,7.39,,,0 NDC,60505708300,NDC Description Not Available,28.44,11.38,,,0 NDC,60505708400,NDC Description Not Available,39.98,15.99,,,0 NDC,60687010011,NDC Description Not Available,17.72,7.09,,,0 NDC,60687010511,NDC Description Not Available,4.1,1.64,,,0 NDC,60687010521,"Medroxyprogesterone Acetate: 30 Blister Pack In 1 Box, Unit-Dose (60687-105-21) / 1 Tablet In 1 Blister Pack (60687-105-11)",5.95,2.38,,,0 NDC,60687011211,NDC Description Not Available,2.78,1.11,,,0 NDC,60687011221,"Anastrozole: 30 Blister Pack In 1 Box, Unit-Dose (60687-112-21) / 1 Tablet, Coated In 1 Blister Pack (60687-112-11)",3.91,1.56,,,0 NDC,60687011301,"Clonidine Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-113-01) / 1 Tablet In 1 Blister Pack (60687-113-11)",0.85,0.34,,,0 NDC,60687011311,NDC Description Not Available,0.81,0.32,,,0 NDC,60687011995,NDC Description Not Available,17.07,6.83,,,0 NDC,60687012201,"Prednisone: 100 Blister Pack In 1 Box, Unit-Dose (60687-122-01) / 1 Tablet In 1 Blister Pack (60687-122-11)",0.14,0.06,,,0 NDC,60687012211,NDC Description Not Available,0.1,0.04,,,0 NDC,60687012401,"Clonidine Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-124-01) / 1 Tablet In 1 Blister Pack (60687-124-11)",0.79,0.315,,,0 NDC,60687012411,NDC Description Not Available,0.82,0.33,,,0 NDC,60687012901,"Docusate Sodium: 100 Blister Pack In 1 Box, Unit-Dose (60687-129-01) / 1 Capsule, Liquid Filled In 1 Blister Pack (60687-129-11)",0.34,0.14,,,0 NDC,60687012911,NDC Description Not Available,0.54,0.22,,,0 NDC,60687013401,"Prednisone: 100 Blister Pack In 1 Box, Unit-Dose (60687-134-01) / 1 Tablet In 1 Blister Pack (60687-134-11)",0.05,0.02,,,0 NDC,60687013411,NDC Description Not Available,0.05,0.02,,,0 NDC,60687014501,"Prednisone: 100 Blister Pack In 1 Box, Unit-Dose (60687-145-01) / 1 Tablet In 1 Blister Pack (60687-145-11)",0.03,0.01,,,0 NDC,60687014511,NDC Description Not Available,0.03,0.01,,,0 NDC,60687015511,NDC Description Not Available,0.38,0.15,,,0 NDC,60687015625,"Phenytoin: 30 Blister Pack In 1 Box, Unit-Dose (60687-156-25) / 1 Tablet, Chewable In 1 Blister Pack (60687-156-95)",5.23,2.09,,,0 NDC,60687015695,NDC Description Not Available,4.44,1.78,,,0 NDC,60687015711,NDC Description Not Available,37.62,15.05,,,0 NDC,60687016301,"Cephalexin: 100 Blister Pack In 1 Box, Unit-Dose (60687-163-01) / 1 Capsule In 1 Blister Pack (60687-163-11)",1.52,0.61,,,0 NDC,60687016311,NDC Description Not Available,0.92,0.37,,,0 NDC,60687018811,NDC Description Not Available,12.66,5.06,,,0 NDC,60687019501,"Diltiazem Hydrochloride Extended-Release: 100 Blister Pack In 1 Box, Unit-Dose (60687-195-01) / 1 Capsule, Coated, Extended Release In 1 Blister Pack (60687-195-11)",2.12,0.85,,,0 NDC,60687019511,NDC Description Not Available,2.45,0.98,,,0 NDC,60687019901,"Meloxicam: 100 Blister Pack In 1 Box, Unit-Dose (60687-199-01) / 1 Tablet In 1 Blister Pack (60687-199-11)",0.68,0.27,,,0 NDC,60687019911,NDC Description Not Available,0.48,0.19,,,0 NDC,60687020601,"Diltiazem Hydrochloride Extended-Release: 100 Blister Pack In 1 Box, Unit-Dose (60687-206-01) / 1 Capsule, Coated, Extended Release In 1 Blister Pack (60687-206-11)",1.5,0.6,,,0 NDC,60687020611,NDC Description Not Available,2.34,0.94,,,0 NDC,60687021111,NDC Description Not Available,2.33,0.93,,,0 NDC,60687021121,"Divalproex Sodium: 30 Blister Pack In 1 Box, Unit-Dose (60687-211-21) / 1 Tablet, Delayed Release In 1 Blister Pack (60687-211-11)",2.82,1.13,,,0 NDC,60687021501,"Propranolol Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-215-01) / 1 Capsule, Extended Release In 1 Blister Pack (60687-215-11)",8.24,3.3,,,0 NDC,60687021511,NDC Description Not Available,5.2,2.08,,,0 NDC,60687021711,NDC Description Not Available,2.37,0.95,,,0 NDC,60687022401,"Gemfibrozil: 100 Blister Pack In 1 Box, Unit-Dose (60687-224-01) / 1 Tablet In 1 Blister Pack (60687-224-11)",0.99,0.4,,,0 NDC,60687022411,NDC Description Not Available,0.75,0.3,,,0 NDC,60687022611,NDC Description Not Available,9.89,3.96,,,0 NDC,60687022801,"Diltiazem Hydrochloride Extended-Release: 100 Blister Pack In 1 Box, Unit-Dose (60687-228-01) / 1 Capsule, Coated, Extended Release In 1 Blister Pack (60687-228-11)",6.85,2.74,,,0 NDC,60687022811,NDC Description Not Available,4.65,1.86,,,0 NDC,60687023101,"Sertraline Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-231-01) / 1 Tablet In 1 Blister Pack (60687-231-11)",1.27,0.51,,,0 NDC,60687023111,NDC Description Not Available,1.23,0.49,,,0 NDC,60687023401,"Rosuvastatin Calcium: 100 Blister Pack In 1 Box, Unit-Dose (60687-234-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-234-11)",3.88,1.55,,,0 NDC,60687023411,NDC Description Not Available,3.99,1.6,,,0 NDC,60687024195,NDC Description Not Available,15.92,6.37,,,0 NDC,60687024201,"Sertraline Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-242-01) / 1 Tablet In 1 Blister Pack (60687-242-11)",1.41,0.56,,,0 NDC,60687024211,NDC Description Not Available,1.18,0.47,,,0 NDC,60687024940,NDC Description Not Available,17.11,6.84,,,0 NDC,60687024977,"Levetiracetam: 4 Tray In 1 Case (60687-249-77) / 10 Cup, Unit-Dose In 1 Tray (60687-249-46) / 5 Ml In 1 Cup, Unit-Dose (60687-249-40)",13.56,5.42,,,0 NDC,60687025240,NDC Description Not Available,32.34,12.94,,,0 NDC,60687025286,"Ondansetron: 3 Tray In 1 Case (60687-252-86) / 10 Cup, Unit-Dose In 1 Tray (60687-252-46) / 5 Ml In 1 Cup, Unit-Dose (60687-252-40)",37.67,15.07,,,0 NDC,60687025611,NDC Description Not Available,4.46,1.78,,,0 NDC,60687026611,NDC Description Not Available,17.05,6.82,,,0 NDC,60687027211,NDC Description Not Available,10.89,4.36,,,0 NDC,60687027562,NDC Description Not Available,20.04,8.02,,,0 NDC,60687028111,NDC Description Not Available,1.31,0.52,,,0 NDC,60687029211,NDC Description Not Available,0.41,0.16,,,0 NDC,60687029311,NDC Description Not Available,1.73,0.69,,,0 NDC,60687029925,"Itraconazole: 30 Blister Pack In 1 Box, Unit-Dose (60687-299-25) / 1 Capsule In 1 Blister Pack (60687-299-95)",14.0,5.6,,,0 NDC,60687029995,NDC Description Not Available,9.97,3.99,,,0 NDC,60687030295,NDC Description Not Available,10.55,4.22,,,0 NDC,60687030311,NDC Description Not Available,0.35,0.14,,,0 NDC,60687030411,NDC Description Not Available,6.1,2.44,,,0 NDC,60687030911,NDC Description Not Available,18.69,7.48,,,0 NDC,60687030921,"Linezolid: 30 Blister Pack In 1 Box, Unit-Dose (60687-309-21) / 1 Tablet, Film Coated In 1 Blister Pack (60687-309-11)",15.11,6.04,,,0 NDC,60687031395,NDC Description Not Available,10.39,4.16,,,0 NDC,60687031711,NDC Description Not Available,5.22,2.09,,,0 NDC,60687033301,"Lisinopril: 100 Blister Pack In 1 Box, Unit-Dose (60687-333-01) / 1 Tablet In 1 Blister Pack (60687-333-11)",0.53,0.21,,,0 NDC,60687033311,NDC Description Not Available,0.39,0.16,,,0 NDC,60687033611,NDC Description Not Available,3.27,1.31,,,0 NDC,60687034011,NDC Description Not Available,3.31,1.32,,,0 NDC,60687034501,"Calcitriol: 100 Blister Pack In 1 Box, Unit-Dose (60687-345-01) / 1 Capsule In 1 Blister Pack (60687-345-11)",2.37,0.95,,,0 NDC,60687034511,NDC Description Not Available,2.32,0.93,,,0 NDC,60687034901,"Quetiapine Fumarate: 100 Blister Pack In 1 Box, Unit-Dose (60687-349-01) / 1 Tablet In 1 Blister Pack (60687-349-11)",0.99,0.4,,,0 NDC,60687036001,"Quetiapine Fumarate: 100 Blister Pack In 1 Box, Unit-Dose (60687-360-01) / 1 Tablet In 1 Blister Pack (60687-360-11)",1.63,0.65,,,0 NDC,60687036011,NDC Description Not Available,1.61,0.64,,,0 NDC,60687036801,"Benztropine Mesylate: 100 BLISTER PACK in 1 BOX, UNIT-DOSE (60687-368-01) / 1 TABLET in 1 BLISTER PACK (60687-368-11)",1.12,0.45,,,0 NDC,60687036811,NDC Description Not Available,1.12,0.45,,,0 NDC,60687036901,"Dicyclomine Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-369-01) / 1 Capsule In 1 Blister Pack (60687-369-11)",2.09,0.84,,,0 NDC,60687036911,NDC Description Not Available,1.65,0.66,,,0 NDC,60687037501,"Dronabinol: 100 Blister Pack In 1 Box, Unit-Dose (60687-375-01) / 1 Capsule In 1 Blister Pack (60687-375-11)",30.5,12.2,,,0 NDC,60687037511,NDC Description Not Available,19.66,7.86,,,0 NDC,60687037521,Dronabinol: 30 Blister Pack In 1 Carton (60687-375-21) / 1 Capsule In 1 Blister Pack (60687-375-11),30.5,12.2,,,0 NDC,60687038011,NDC Description Not Available,1.28,0.51,,,0 NDC,60687038611,NDC Description Not Available,20.12,8.05,,,0 NDC,60687038621,"Dronabinol: 30 Blister Pack In 1 Box, Unit-Dose (60687-386-21) / 1 Capsule In 1 Blister Pack (60687-386-11)",21.37,8.55,,,0 NDC,60687038694,Dronabinol: 20 Blister Pack In 1 Carton (60687-386-94) / 1 Capsule In 1 Blister Pack (60687-386-11),20.12,8.05,,,0 NDC,60687038811,NDC Description Not Available,0.96,0.38,,,0 NDC,60687038911,NDC Description Not Available,39.75,15.9,,,0 NDC,60687039001,"Metoprolol Succinate: 100 Blister Pack In 1 Box, Unit-Dose (60687-390-01) / 1 Tablet, Extended Release In 1 Blister Pack (60687-390-11)",2.53,1.01,,,0 NDC,60687039011,NDC Description Not Available,3.13,1.25,,,0 NDC,60687039479,NDC Description Not Available,0.61,0.24,,,0 NDC,60687039579,NDC Description Not Available,0.73,0.29,,,0 NDC,60687039583,Albuterol Sulfate: 30 Pouch In 1 Carton (60687-395-83) / 1 Ampule In 1 Pouch (60687-395-79) / 3 Ml In 1 Ampule,1.12,0.45,,,0 NDC,60687039601,"Hydrocodone Bitartrate And Acetaminophen: 100 Blister Pack In 1 Box, Unit-Dose (60687-396-01) / 1 Tablet In 1 Blister Pack (60687-396-11)",1.68,0.67,,,0 NDC,60687039801,"Midodrine Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-398-01) / 1 Tablet In 1 Blister Pack (60687-398-11)",3.24,1.3,,,0 NDC,60687039811,NDC Description Not Available,2.29,0.92,,,0 NDC,60687040201,"Metoprolol Succinate: 100 Blister Pack In 1 Box, Unit-Dose (60687-402-01) / 1 Tablet, Extended Release In 1 Blister Pack (60687-402-11)",2.57,1.03,,,0 NDC,60687040211,NDC Description Not Available,3.22,1.29,,,0 NDC,60687040579,NDC Description Not Available,1.02,0.41,,,0 NDC,60687040583,Ipratropium Bromide And Albuterol Sulfate: 30 Pouch In 1 Carton (60687-405-83) / 1 Ampule In 1 Pouch (60687-405-79) / 3 Ml In 1 Ampule,1.62,0.65,,,0 NDC,60687041744,NDC Description Not Available,8.48,3.39,,,0 NDC,60687041771,"Hydrocodone Bitartrate And Acetaminophen: 5 Tray In 1 Case (60687-417-71) / 10 Cup, Unit-Dose In 1 Tray (60687-417-50) / 15 Ml In 1 Cup, Unit-Dose (60687-417-44)",9.64,3.86,,,0 NDC,60687042095,NDC Description Not Available,27.66,11.06,,,0 NDC,60687042201,"Amantadine: 100 Blister Pack In 1 Box, Unit-Dose (60687-422-01) / 1 Capsule In 1 Blister Pack (60687-422-11)",5.96,2.38,,,0 NDC,60687042211,NDC Description Not Available,4.78,1.91,,,0 NDC,60687042311,NDC Description Not Available,5.8,2.32,,,0 NDC,60687042321,"Clobazam: 30 Blister Pack In 1 Box, Unit-Dose (60687-423-21) / 1 Tablet In 1 Blister Pack (60687-423-11)",5.75,2.3,,,0 NDC,60687042811,NDC Description Not Available,2.62,1.05,,,0 NDC,60687042945,NDC Description Not Available,8.28,3.31,,,0 NDC,60687043001,"Chlorpromazine Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-430-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-430-11)",14.89,5.96,,,0 NDC,60687043011,NDC Description Not Available,11.1,4.44,,,0 NDC,60687043192,Polyethylene Glycol 3350: 100 Pouch In 1 Carton (60687-431-92) / 17 G In 1 Pouch (60687-431-99),2.95,1.18,,,0 NDC,60687043199,NDC Description Not Available,4.43,1.77,,,0 NDC,60687043301,"Amitriptyline Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-433-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-433-11)",1.38,0.55,,,0 NDC,60687043311,NDC Description Not Available,1.55,0.62,,,0 NDC,60687043611,NDC Description Not Available,4.35,1.74,,,0 NDC,60687043701,"Amiodarone Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-437-01) / 1 Tablet In 1 Blister Pack (60687-437-11)",0.96,0.38,,,0 NDC,60687043711,NDC Description Not Available,1.14,0.46,,,0 NDC,60687043901,"Labetalol Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-439-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-439-11)",1.19,0.48,,,0 NDC,60687043911,NDC Description Not Available,1.28,0.51,,,0 NDC,60687044301,Trazodone Hydrochloride: 100 Blister Pack In 1 Carton (60687-443-01) / 1 Tablet In 1 Blister Pack (60687-443-11),0.5,0.2,,,0 NDC,60687044311,NDC Description Not Available,0.38,0.15,,,0 NDC,60687044411,NDC Description Not Available,1.86,0.74,,,0 NDC,60687044611,NDC Description Not Available,0.38,0.15,,,0 NDC,60687044711,NDC Description Not Available,6.39,2.56,,,0 NDC,60687045111,NDC Description Not Available,11.77,4.71,,,0 NDC,60687045121,"Eplerenone: 30 Blister Pack In 1 Box, Unit-Dose (60687-451-21) / 1 Tablet, Film Coated In 1 Blister Pack (60687-451-11)",12.51,5.0,,,0 NDC,60687045211,NDC Description Not Available,35.23,14.09,,,0 NDC,60687045311,NDC Description Not Available,1.39,0.56,,,0 NDC,60687045401,Trazodone Hydrochloride: 100 Blister Pack In 1 Carton (60687-454-01) / 1 Tablet In 1 Blister Pack (60687-454-11),0.54,0.22,,,0 NDC,60687045411,NDC Description Not Available,0.56,0.22,,,0 NDC,60687045711,NDC Description Not Available,0.58,0.23,,,0 NDC,60687046101,"Labetalol Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-461-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-461-11)",3.6,1.44,,,0 NDC,60687046111,NDC Description Not Available,2.41,0.96,,,0 NDC,60687046411,NDC Description Not Available,1.39,0.56,,,0 NDC,60687046501,"Spironolactone: 100 Blister Pack In 1 Box, Unit-Dose (60687-465-01) / 1 Tablet In 1 Blister Pack (60687-465-11)",0.69,0.28,,,0 NDC,60687046511,NDC Description Not Available,0.63,0.25,,,0 NDC,60687047301,"Pregabalin: 100 Blister Pack In 1 Box, Unit-Dose (60687-473-01) / 1 Capsule In 1 Blister Pack (60687-473-11)",2.79,1.12,,,0 NDC,60687047311,NDC Description Not Available,4.07,1.63,,,0 NDC,60687048111,NDC Description Not Available,2.82,1.13,,,0 NDC,60687048121,"Buprenorphine: 30 Blister Pack In 1 Box, Unit-Dose (60687-481-21) / 1 Tablet In 1 Blister Pack (60687-481-11)",4.4,1.76,,,0 NDC,60687048401,"Pregabalin: 100 Blister Pack In 1 Box, Unit-Dose (60687-484-01) / 1 Capsule In 1 Blister Pack (60687-484-11)",2.57,1.03,,,0 NDC,60687048411,NDC Description Not Available,36.21,14.48,,,0 NDC,60687048611,NDC Description Not Available,2.17,0.87,,,0 NDC,60687048701,"Spironolactone: 100 Blister Pack In 1 Box, Unit-Dose (60687-487-01) / 1 Tablet In 1 Blister Pack (60687-487-11)",2.13,0.85,,,0 NDC,60687048711,NDC Description Not Available,2.05,0.82,,,0 NDC,60687048801,"Amlodipine Besylate: 100 Blister Pack In 1 Box, Unit-Dose (60687-488-01) / 1 Tablet In 1 Blister Pack (60687-488-11)",0.65,0.26,,,0 NDC,60687048811,NDC Description Not Available,0.5,0.2,,,0 NDC,60687049211,NDC Description Not Available,9.67,3.87,,,0 NDC,60687049221,"Buprenorphine: 30 Blister Pack In 1 Box, Unit-Dose (60687-492-21) / 1 Tablet In 1 Blister Pack (60687-492-11)",15.09,6.04,,,0 NDC,60687049401,"Mycophenolate Mofetil: 100 Blister Pack In 1 Box, Unit-Dose (60687-494-01) / 1 Capsule In 1 Blister Pack (60687-494-11)",1.81,0.72,,,0 NDC,60687049411,NDC Description Not Available,2.05,0.82,,,0 NDC,60687049511,NDC Description Not Available,6.28,2.51,,,0 NDC,60687049711,NDC Description Not Available,1.85,0.74,,,0 NDC,60687050011,NDC Description Not Available,4.03,1.61,,,0 NDC,60687050301,"Baclofen: 100 Blister Pack In 1 Box, Unit-Dose (60687-503-01) / 1 Tablet In 1 Blister Pack (60687-503-11)",1.71,0.68,,,0 NDC,60687050311,NDC Description Not Available,1.48,0.59,,,0 NDC,60687050601,"Pregabalin: 100 Blister Pack In 1 Box, Unit-Dose (60687-506-01) / 1 Capsule In 1 Blister Pack (60687-506-11)",2.57,1.03,,,0 NDC,60687050611,NDC Description Not Available,9.56,3.82,,,0 NDC,60687050811,NDC Description Not Available,2.69,1.08,,,0 NDC,60687052511,NDC Description Not Available,77.13,30.85,,,0 NDC,60687052611,NDC Description Not Available,1.01,0.4,,,0 NDC,60687053436,"Atovaquone: 2 Tray In 1 Case (60687-534-36) / 10 Cup, Unit-Dose In 1 Tray (60687-534-46) / 5 Ml In 1 Cup, Unit-Dose (60687-534-40)",58.98,23.59,,,0 NDC,60687053440,NDC Description Not Available,38.46,15.38,,,0 NDC,60687054001,"Digoxin: 100 Blister Pack In 1 Box, Unit-Dose (60687-540-01) / 1 Tablet In 1 Blister Pack (60687-540-11)",4.23,1.69,,,0 NDC,60687054011,NDC Description Not Available,4.54,1.82,,,0 NDC,60687054111,NDC Description Not Available,2.57,1.03,,,0 NDC,60687054401,"Clonazepam: 100 Blister Pack In 1 Box, Unit-Dose (60687-544-01) / 1 Tablet In 1 Blister Pack (60687-544-11)",1.76,0.7,,,0 NDC,60687054411,NDC Description Not Available,1.11,0.44,,,0 NDC,60687055001,"Metronidazole: 100 Blister Pack In 1 Box, Unit-Dose (60687-550-01) / 1 Tablet In 1 Blister Pack (60687-550-11)",2.42,0.97,,,0 NDC,60687055011,NDC Description Not Available,2.24,0.9,,,0 NDC,60687055201,"Levothyroxine Sodium: 100 Blister Pack In 1 Box, Unit-Dose (60687-552-01) / 1 Tablet In 1 Blister Pack (60687-552-11)",2.98,1.19,,,0 NDC,60687055311,NDC Description Not Available,35.19,14.08,,,0 NDC,60687055501,"Clonazepam: 100 Blister Pack In 1 Box, Unit-Dose (60687-555-01) / 1 Tablet In 1 Blister Pack (60687-555-11)",1.4,0.56,,,0 NDC,60687055511,NDC Description Not Available,0.85,0.34,,,0 NDC,60687055633,NDC Description Not Available,20.5,8.2,,,0 NDC,60687055901,"Methocarbamol: 100 Blister Pack In 1 Box, Unit-Dose (60687-559-01) / 1 Tablet In 1 Blister Pack (60687-559-11)",0.71,0.28,,,0 NDC,60687055911,NDC Description Not Available,0.73,0.29,,,0 NDC,60687056311,NDC Description Not Available,2.14,0.86,,,0 NDC,60687056801,"Methocarbamol: 100 Blister Pack In 1 Box, Unit-Dose (60687-568-01) / 1 Tablet In 1 Blister Pack (60687-568-11)",1.21,0.48,,,0 NDC,60687056811,NDC Description Not Available,0.94,0.38,,,0 NDC,60687057011,NDC Description Not Available,0.91,0.36,,,0 NDC,60687057232,"Prazosin Hydrochloride: 20 Blister Pack In 1 Box, Unit-Dose (60687-572-32) / 1 Capsule In 1 Blister Pack (60687-572-33)",12.94,5.18,,,0 NDC,60687057233,NDC Description Not Available,10.11,4.04,,,0 NDC,60687057511,NDC Description Not Available,8.88,3.55,,,0 NDC,60687057603,NDC Description Not Available,13.11,5.24,,,0 NDC,60687057901,"Hydromorphone Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-579-01) / 1 Tablet In 1 Blister Pack (60687-579-11)",1.22,0.49,,,0 NDC,60687057911,NDC Description Not Available,0.75,0.3,,,0 NDC,60687058001,"Gabapentin: 100 Blister Pack In 1 Box, Unit-Dose (60687-580-01) / 1 Capsule In 1 Blister Pack (60687-580-11)",0.52,0.21,,,0 NDC,60687058011,NDC Description Not Available,0.35,0.14,,,0 NDC,60687058111,NDC Description Not Available,2.3,0.92,,,0 NDC,60687058121,"Pramipexole Dihydrochloride: 30 Blister Pack In 1 Box, Unit-Dose (60687-581-21) / 1 Tablet In 1 Blister Pack (60687-581-11)",2.33,0.93,,,0 NDC,60687058311,NDC Description Not Available,10.13,4.05,,,0 NDC,60687058321,"Carbamazepine: 30 Blister Pack In 1 Box, Unit-Dose (60687-583-21) / 1 Tablet, Extended Release In 1 Blister Pack (60687-583-11)",14.49,5.8,,,0 NDC,60687058601,"Rifampin: 100 Blister Pack In 1 Box, Unit-Dose (60687-586-01) / 1 Capsule In 1 Blister Pack (60687-586-11)",8.02,3.21,,,0 NDC,60687058611,NDC Description Not Available,4.51,1.8,,,0 NDC,60687058701,"Propranolol Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-587-01) / 1 Tablet In 1 Blister Pack (60687-587-11)",0.58,0.23,,,0 NDC,60687058711,NDC Description Not Available,0.69,0.28,,,0 NDC,60687058801,"Ropinirole Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-588-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-588-11)",1.83,0.73,,,0 NDC,60687058811,NDC Description Not Available,1.74,0.7,,,0 NDC,60687059001,"Hydromorphone Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-590-01) / 1 Tablet In 1 Blister Pack (60687-590-11)",1.23,0.49,,,0 NDC,60687059011,NDC Description Not Available,0.95,0.38,,,0 NDC,60687059101,"Gabapentin: 100 Blister Pack In 1 Box, Unit-Dose (60687-591-01) / 1 Capsule In 1 Blister Pack (60687-591-11)",0.54,0.22,,,0 NDC,60687059111,NDC Description Not Available,0.39,0.16,,,0 NDC,60687059211,NDC Description Not Available,2.62,1.05,,,0 NDC,60687059221,"Pramipexole Dihydrochloride: 30 Blister Pack In 1 Box, Unit-Dose (60687-592-21) / 1 Tablet In 1 Blister Pack (60687-592-11)",4.1,1.64,,,0 NDC,60687059301,"Hydrochlorothiazide: 100 Blister Pack In 1 Box, Unit-Dose (60687-593-01) / 1 Tablet In 1 Blister Pack (60687-593-11)",0.49,0.2,,,0 NDC,60687059311,NDC Description Not Available,0.46,0.18,,,0 NDC,60687059501,"Famotidine: 100 Blister Pack In 1 Box, Unit-Dose (60687-595-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-595-11)",0.86,0.34,,,0 NDC,60687059511,NDC Description Not Available,0.59,0.24,,,0 NDC,60687059801,"Propranolol Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-598-01) / 1 Tablet In 1 Blister Pack (60687-598-11)",1.74,0.7,,,0 NDC,60687059811,NDC Description Not Available,1.4,0.56,,,0 NDC,60687060211,NDC Description Not Available,0.6,0.24,,,0 NDC,60687060311,NDC Description Not Available,0.92,0.37,,,0 NDC,60687060711,NDC Description Not Available,6.44,2.58,,,0 NDC,60687060721,"Desvenlafaxine: 30 Blister Pack In 1 Box, Unit-Dose (60687-607-21) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack (60687-607-11)",6.42,2.57,,,0 NDC,60687060901,"Propranolol Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (60687-609-01) / 1 Tablet In 1 Blister Pack (60687-609-11)",2.39,0.96,,,0 NDC,60687060911,NDC Description Not Available,1.67,0.67,,,0 NDC,60687061211,NDC Description Not Available,2.01,0.8,,,0 NDC,60687061221,"Valsartan: 30 Blister Pack In 1 Box, Unit-Dose (60687-612-21) / 1 Tablet, Film Coated In 1 Blister Pack (60687-612-11)",3.5,1.4,,,0 NDC,60687061811,NDC Description Not Available,3.03,1.21,,,0 NDC,60687061821,"Fenofibrate: 30 Blister Pack In 1 Box, Unit-Dose (60687-618-21) / 1 Tablet In 1 Blister Pack (60687-618-11)",2.85,1.14,,,0 NDC,60687062001,"Metoclopramide: 100 Blister Pack In 1 Box, Unit-Dose (60687-620-01) / 1 Tablet In 1 Blister Pack (60687-620-11)",1.73,0.69,,,0 NDC,60687062011,NDC Description Not Available,1.74,0.7,,,0 NDC,60687062201,"Sennosides And Docusate Sodium: 100 Blister Pack In 1 Box, Unit-Dose (60687-622-01) / 1 Tablet In 1 Blister Pack (60687-622-11)",0.46,0.18,,,0 NDC,60687062211,NDC Description Not Available,0.44,0.18,,,0 NDC,60687062301,"Valsartan: 100 Blister Pack In 1 Box, Unit-Dose (60687-623-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-623-11)",3.1,1.24,,,0 NDC,60687062311,NDC Description Not Available,3.06,1.22,,,0 NDC,60687062701,Lorazepam: 100 Blister Pack In 1 Carton (60687-627-01) / 1 Tablet In 1 Blister Pack (60687-627-11),0.58,0.23,,,0 NDC,60687062711,NDC Description Not Available,0.38,0.15,,,0 NDC,60687062911,NDC Description Not Available,5.29,2.12,,,0 NDC,60687063011,NDC Description Not Available,3.34,1.34,,,0 NDC,60687063101,"Metoclopramide: 100 Blister Pack In 1 Box, Unit-Dose (60687-631-01) / 1 Tablet In 1 Blister Pack (60687-631-11)",1.7,0.68,,,0 NDC,60687063111,NDC Description Not Available,1.68,0.67,,,0 NDC,60687063311,NDC Description Not Available,6.13,2.45,,,0 NDC,60687063511,NDC Description Not Available,11.31,4.52,,,0 NDC,60687063801,"Lorazepam: 100 Blister Pack In 1 Box, Unit-Dose (60687-638-01) / 1 Tablet In 1 Blister Pack (60687-638-11)",0.58,0.23,,,0 NDC,60687063811,NDC Description Not Available,0.52,0.21,,,0 NDC,60687064811,NDC Description Not Available,45.22,18.09,,,0 NDC,60687065311,NDC Description Not Available,2.59,1.04,,,0 NDC,60687065701,"Levetiracetam: 100 Blister Pack In 1 Carton (60687-657-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-657-11)",0.82,0.33,,,0 NDC,60687065711,NDC Description Not Available,1.03,0.41,,,0 NDC,60687065801,"Diclofenac Sodium: 100 Blister Pack In 1 Carton (60687-658-01) / 1 Tablet, Delayed Release In 1 Blister Pack (60687-658-11)",2.33,0.93,,,0 NDC,60687065811,NDC Description Not Available,2.0,0.8,,,0 NDC,60687066001,Promethazine Hydrochloride: 100 Blister Pack In 1 Carton (60687-660-01) / 1 Tablet In 1 Blister Pack (60687-660-11),1.32,0.53,,,0 NDC,60687066011,NDC Description Not Available,1.08,0.43,,,0 NDC,60687066101,Carbidopa And Levodopa: 100 Blister Pack In 1 Carton (60687-661-01) / 1 Tablet In 1 Blister Pack (60687-661-11),0.85,0.34,,,0 NDC,60687066111,NDC Description Not Available,1.05,0.42,,,0 NDC,60687066401,"Hydroxyzine Hydrochloride: 100 Blister Pack In 1 Carton (60687-664-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-664-11)",0.75,0.3,,,0 NDC,60687066411,NDC Description Not Available,0.71,0.28,,,0 NDC,60687066711,NDC Description Not Available,0.49,0.2,,,0 NDC,60687066901,Methimazole: 100 Blister Pack In 1 Carton (60687-669-01) / 1 Tablet In 1 Blister Pack (60687-669-11),3.5999999999999996,1.44,,,0 NDC,60687066911,NDC Description Not Available,1.6,0.64,,,0 NDC,60687067011,NDC Description Not Available,1.29,0.52,,,0 NDC,60687067140,NDC Description Not Available,4.96,1.98,,,0 NDC,60687067167,"Phenobarbital: 5 Tray In 1 Case (60687-671-67) / 10 Cup, Unit-Dose In 1 Tray (60687-671-46) / 5 Ml In 1 Cup, Unit-Dose (60687-671-40)",3.78,1.51,,,0 NDC,60687067211,NDC Description Not Available,4.88,1.95,,,0 NDC,60687067265,"Butalbital, Acetaminophen And Caffeine: 50 Blister Pack In 1 Carton (60687-672-65) / 1 Tablet In 1 Blister Pack (60687-672-11)",5.67,2.27,,,0 NDC,60687067501,"Hydroxyzine Hydrochloride: 100 Blister Pack In 1 Carton (60687-675-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-675-11)",0.86,0.34,,,0 NDC,60687067511,NDC Description Not Available,0.91,0.36,,,0 NDC,60687067611,NDC Description Not Available,8.44,3.38,,,0 NDC,60687067711,NDC Description Not Available,1.19,0.48,,,0 NDC,60687068011,NDC Description Not Available,2.47,0.99,,,0 NDC,60687068101,Folic Acid: 100 Blister Pack In 1 Carton (60687-681-01) / 1 Tablet In 1 Blister Pack (60687-681-11),0.96,0.38,,,0 NDC,60687068111,NDC Description Not Available,2.12,0.85,,,0 NDC,60687068811,NDC Description Not Available,2.16,0.86,,,0 NDC,60687069501,Sucralfate: 100 Blister Pack In 1 Carton (60687-695-01) / 1 Tablet In 1 Blister Pack (60687-695-11),1.5,0.6,,,0 NDC,60687069511,NDC Description Not Available,0.91,0.36,,,0 NDC,60687069611,NDC Description Not Available,1.45,0.58,,,0 NDC,60687069711,NDC Description Not Available,1.16,0.46,,,0 NDC,60687069811,NDC Description Not Available,6.77,2.71,,,0 NDC,60687070101,Glipizide: 100 Blister Pack In 1 Carton (60687-701-01) / 1 Tablet In 1 Blister Pack (60687-701-11),2.07,0.83,,,0 NDC,60687070111,NDC Description Not Available,2.07,0.83,,,0 NDC,60687070711,NDC Description Not Available,0.83,0.33,,,0 NDC,60687071711,NDC Description Not Available,1.31,0.52,,,0 NDC,60687072201,"Oxcarbazepine: 100 Blister Pack In 1 Carton (60687-722-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-722-11)",2.63,1.05,,,0 NDC,60687072211,NDC Description Not Available,2.47,0.99,,,0 NDC,60687072311,NDC Description Not Available,7.76,3.1,,,0 NDC,60687072321,"Duloxetine: 30 Blister Pack In 1 Carton (60687-723-21) / 1 Capsule, Delayed Release In 1 Blister Pack (60687-723-11)",5.31,2.12,,,0 NDC,60687073001,Meclizine Hydrochloride: 100 Blister Pack In 1 Carton (60687-730-01) / 1 Tablet In 1 Blister Pack (60687-730-11),1.81,0.72,,,0 NDC,60687073011,NDC Description Not Available,1.91,0.76,,,0 NDC,60687073842,NDC Description Not Available,27.27,10.91,,,0 NDC,60687073856,"Sucralfate: 10 Tray In 1 Case (60687-738-56) / 10 Cup, Unit-Dose In 1 Tray (60687-738-48) / 10 Ml In 1 Cup, Unit-Dose (60687-738-42)",30.82,12.33,,,0 NDC,60687074211,NDC Description Not Available,2.33,0.93,,,0 NDC,60687074317,"Childrens Ibuprofen: 10 Tray In 1 Case (60687-743-17) / 10 Cup, Unit-Dose In 1 Tray (60687-743-46) / 5 Ml In 1 Cup, Unit-Dose (60687-743-40)",2.19,0.88,,,0 NDC,60687074340,NDC Description Not Available,1.94,0.78,,,0 NDC,60687074501,"Duloxetine: 100 Blister Pack In 1 Carton (60687-745-01) / 1 Capsule, Delayed Release In 1 Blister Pack (60687-745-11)",4.12,1.65,,,0 NDC,60687074511,NDC Description Not Available,5.18,2.07,,,0 NDC,60687074611,NDC Description Not Available,7.91,3.16,,,0 NDC,60687076040,NDC Description Not Available,1.9,0.76,,,0 NDC,60687076086,"Morphine Sulfate: 3 Tray In 1 Case (60687-760-86) / 10 Cup, Unit-Dose In 1 Tray (60687-760-46) / 5 Ml In 1 Cup, Unit-Dose (60687-760-40)",2.95,1.18,,,0 NDC,60687078811,NDC Description Not Available,3.51,1.4,,,0 NDC,60687079511,NDC Description Not Available,0.42,0.17,,,0 NDC,60687080017,"Nystatin: 10 Tray In 1 Case (60687-800-17) / 10 Cup, Unit-Dose In 1 Tray (60687-800-46) / 5 Ml In 1 Cup, Unit-Dose (60687-800-40)",6.95,2.78,,,0 NDC,60687080040,NDC Description Not Available,5.03,2.01,,,0 NDC,60687081009,"Potassium Chloride: 80 Blister Pack In 1 Carton (60687-810-09) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack (60687-810-11)",0.92,0.37,,,0 NDC,60687081011,NDC Description Not Available,0.65,0.26,,,0 NDC,60687081111,NDC Description Not Available,0.82,0.33,,,0 NDC,60687081411,NDC Description Not Available,3.85,1.54,,,0 NDC,60687081501,Baclofen: 100 Blister Pack In 1 Carton (60687-815-01) / 1 Tablet In 1 Blister Pack (60687-815-11),1.67,0.67,,,0 NDC,60687081511,NDC Description Not Available,1.17,0.47,,,0 NDC,60687081886,"Methadone Hydrochloride: 3 Tray In 1 Case (60687-818-86) / 10 Cup, Unit-Dose In 1 Tray (60687-818-46) / 5 Ml In 1 Cup, Unit-Dose (60687-818-40)",2.9,1.16,,,0 NDC,60687082201,Hydralazine Hydrochloride: 100 Blister Pack In 1 Carton (60687-822-01) / 1 Tablet In 1 Blister Pack (60687-822-11),0.74,0.3,,,0 NDC,60687082211,NDC Description Not Available,0.64,0.26,,,0 NDC,60687082311,NDC Description Not Available,1.19,0.48,,,0 NDC,60687082601,Baclofen: 100 Blister Pack In 1 Carton (60687-826-01) / 1 Tablet In 1 Blister Pack (60687-826-11),3.04,1.22,,,0 NDC,60687082611,NDC Description Not Available,2.24,0.9,,,0 NDC,60687083301,Hydralazine Hydrochloride: 100 Blister Pack In 1 Carton (60687-833-01) / 1 Tablet In 1 Blister Pack (60687-833-11),0.98,0.39,,,0 NDC,60687083311,NDC Description Not Available,0.77,0.31,,,0 NDC,60687083611,NDC Description Not Available,0.95,0.38,,,0 NDC,60687083742,NDC Description Not Available,8.1,3.24,,,0 NDC,60687083801,"Zolpidem Tartrate: 100 Blister Pack In 1 Carton (60687-838-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-838-11)",0.53,0.21,,,0 NDC,60687084111,NDC Description Not Available,35.99,14.4,,,0 NDC,60687085611,NDC Description Not Available,1.27,0.51,,,0 NDC,60687086001,"Ciprofloxacin: 100 Blister Pack In 1 Carton (60687-860-01) / 1 Tablet, Film Coated In 1 Blister Pack (60687-860-11)",1.06,0.42,,,0 NDC,60687086011,NDC Description Not Available,0.8,0.32,,,0 NDC,60687086111,NDC Description Not Available,1.77,0.71,,,0 NDC,60687088501,Mycophenolate Mofetil: 100 Blister Pack In 1 Carton (60687-885-01) / 1 Capsule In 1 Blister Pack (60687-885-11),2.16,0.86,,,0 NDC,60687088611,NDC Description Not Available,1.48,0.59,,,0 NDC,60758011905,"Prednisolone Acetate: 1 Bottle, Dropper In 1 Carton (60758-119-05) / 5 Ml In 1 Bottle, Dropper",188.24,75.3,,,0 NDC,60758080105,"Timolol Maleate: 1 Bottle, Dropper In 1 Carton (60758-801-05) / 5 Ml In 1 Bottle, Dropper",16.49,6.6,,,0 NDC,60758090810,"Polymyxin B Sulfate And Trimethoprim Sulfate: 1 Bottle, Dropper In 1 Carton (60758-908-10) / 10 Ml In 1 Bottle, Dropper",30.54,12.22,,,0 NDC,60793011501,Cytomel: 100 Tablet In 1 Bottle (60793-115-01),1.65,0.66,,,0 NDC,60793070001,NDC Description Not Available,113.62,45.45,,,0 NDC,60793070010,Bicillin L-A: 10 Syringe In 1 Package (60793-700-10) / 1 Ml In 1 Syringe (60793-700-01),143.96,57.58,,,0 NDC,60793070102,NDC Description Not Available,91.18,36.47,,,0 NDC,60793070110,Bicillin L-A: 10 Syringe In 1 Package (60793-701-10) / 2 Ml In 1 Syringe (60793-701-02),119.54,47.82,,,0 NDC,60793070204,NDC Description Not Available,103.44,41.38,,,0 NDC,60793070210,Bicillin L-A: 10 Syringe In 1 Package (60793-702-10) / 4 Ml In 1 Syringe (60793-702-04),112.22,44.89,,,0 NDC,61269041020,"Etopophos: 1 Vial, Single-Dose In 1 Carton (61269-410-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",68.4,27.36,,,0 NDC,61269073063,"Miconazole 7: 1 Tube, With Applicator In 1 Carton (61269-730-63) / 45 G In 1 Tube, With Applicator",11.88,4.75,,,0 NDC,61269073607,Miconazole 7: 7 Suppository In 1 Box (61269-736-07),1.64,0.66,,,0 NDC,61314001601,Proparacaine Hydrochloride: 1 Bottle In 1 Carton (61314-016-01) / 15 Ml In 1 Bottle,105.31,42.12,,,0 NDC,61314001910,Dorzolamide Hydrochloride: 10 Ml In 1 Bottle (61314-019-10),37.95,15.18,,,0 NDC,61314014305,Brimonidine Tartrate: 1 Bottle In 1 Carton (61314-143-05) / 5 Ml In 1 Bottle,26.36,10.54,,,0 NDC,61314014310,Brimonidine Tartrate: 1 Bottle In 1 Carton (61314-143-10) / 10 Ml In 1 Bottle,43.8,17.52,,,0 NDC,61314020315,Pilocarpine Hydrochloride: 1 Bottle In 1 Carton (61314-203-15) / 15 Ml In 1 Bottle,238.12,95.25,,,0 NDC,61314022705,"Timolol Maleate: 5 Ml In 1 Bottle, Plastic (61314-227-05)",20.29,8.12,,,0 NDC,61314024501,"Betaxolol Hydrochloride: 1 Bottle, Plastic In 1 Carton (61314-245-01) / 5 Ml In 1 Bottle, Plastic",152.91,61.16,,,0 NDC,61314031801,Zarxio: 1 Blister Pack In 1 Carton (61314-318-01) / 1 Syringe In 1 Blister Pack / .5 Ml In 1 Syringe,4.02,1.61,,,0 NDC,61314031805,NDC Description Not Available,3.91,1.56,,,0 NDC,61314031810,Zarxio: 2 Blister Pack In 1 Carton (61314-318-10) / 5 Syringe In 1 Blister Pack (61314-318-05) / .5 Ml In 1 Syringe,1.68,0.67,,,0 NDC,61314032601,Zarxio: 1 Blister Pack In 1 Carton (61314-326-01) / 1 Syringe In 1 Blister Pack / .8 Ml In 1 Syringe,4.01,1.6,,,0 NDC,61314032605,NDC Description Not Available,4.03,1.61,,,0 NDC,61314032610,Zarxio: 2 Blister Pack In 1 Carton (61314-326-10) / 5 Syringe In 1 Blister Pack (61314-326-05) / .8 Ml In 1 Syringe,1.85,0.74,,,0 NDC,61314035401,"Tropicamide: 1 Bottle, Plastic In 1 Carton (61314-354-01) / 15 Ml In 1 Bottle, Plastic",65.59,26.24,,,0 NDC,61314035501,"Tropicamide: 1 Bottle, Plastic In 1 Carton (61314-355-01) / 3 Ml In 1 Bottle, Plastic",29.98,11.99,,,0 NDC,61314039601,Cyclopentolate Hydrochloride: 2 Ml In 1 Bottle (61314-396-01),32.21,12.88,,,0 NDC,61314054701,Latanoprost: 1 Bottle In 1 Carton (61314-547-01) / 2.5 Ml In 1 Bottle,32.1,12.84,,,0 NDC,61314054703,Latanoprost: 3 Bottle In 1 Carton (61314-547-03) / 2.5 Ml In 1 Bottle,17.4,6.96,,,0 NDC,61314062810,"Polymyxin B Sulfate And Trimethoprim: 10 Ml In 1 Bottle, Plastic (61314-628-10)",30.95,12.38,,,0 NDC,61314063136,Neomycin And Polymyxin B Sulfates And Dexamethasone: 3.5 G In 1 Tube (61314-631-36),77.01,30.8,,,0 NDC,61314063305,"Gentamicin Sulfate: 1 Bottle, Dropper In 1 Carton (61314-633-05) / 5 Ml In 1 Bottle, Dropper",19.78,7.91,,,0 NDC,61314063705,"Prednisolone Acetate: 1 Bottle, Plastic In 1 Carton (61314-637-05) / 5 Ml In 1 Bottle, Plastic",132.33,52.93,,,0 NDC,61314063710,"Prednisolone Acetate: 1 Bottle, Plastic In 1 Carton (61314-637-10) / 10 Ml In 1 Bottle, Plastic",194.45,77.78,,,0 NDC,61314064175,"Neomycin And Polymyxin B Sulfates And Hydrocortisone: 7.5 Ml In 1 Bottle, Plastic (61314-641-75)",586.95,234.78,,,0 NDC,61314064511,"Neomycin And Polymyxin B Sulfates And Hydrocortisone: 10 Ml In 1 Bottle, Plastic (61314-645-11)",253.48,101.39,,,0 NDC,61314065605,"Ciprofloxacin Hydrochloride: 1 Bottle, Plastic In 1 Carton (61314-656-05) / 5 Ml In 1 Bottle, Plastic",28.91,11.56,,,0 NDC,61442011201,"Acyclovir: 24 Bottle, Plastic In 1 Box (61442-112-01) / 100 Tablet In 1 Bottle, Plastic",0.48,0.19,,,0 NDC,61553039765,NDC Description Not Available,10.21,4.08,,,0 NDC,61570013125,Silvadene: 1 Tube In 1 Carton (61570-131-25) / 25 G In 1 Tube,19.05,7.62,,,0 NDC,61570013140,Silvadene: 400 G In 1 Jar (61570-131-40),214.75,85.9,,,0 NDC,61570013150,Silvadene: 50 G In 1 Jar (61570-131-50),25.2,10.08,,,0 NDC,61570013155,Silvadene: 1 Tube In 1 Carton (61570-131-55) / 50 G In 1 Tube,38.7,15.48,,,0 NDC,61703030906,"Vincristine Sulfate: 1 Vial, Single-Dose In 1 Carton (61703-309-06) / 1 Ml In 1 Vial, Single-Dose",78.85,31.54,,,0 NDC,61703030916,"Vincristine Sulfate: 1 Vial, Single-Dose In 1 Carton (61703-309-16) / 2 Ml In 1 Vial, Single-Dose",30.87,12.35,,,0 NDC,61703031922,"Cytarabine: 1 Vial, Single-Dose In 1 Carton (61703-319-22) / 20 Ml In 1 Vial, Single-Dose",4.75,1.9,,,0 NDC,61703032418,"Pamidronate Disodium: 1 Vial, Single-Dose In 1 Carton (61703-324-18) / 10 Ml In 1 Vial, Single-Dose",64.45,25.78,,,0 NDC,61703034250,"Paclitaxel: 1 Vial, Multi-Dose In 1 Carton (61703-342-50) / 50 Ml In 1 Vial, Multi-Dose",0.85,0.34,,,0 NDC,61703034318,"Mitoxantrone: 1 Vial, Multi-Dose In 1 Carton (61703-343-18) / 10 Ml In 1 Vial, Multi-Dose",193.59,77.44,,,0 NDC,61703034365,"Mitoxantrone: 1 Vial, Multi-Dose In 1 Carton (61703-343-65) / 12.5 Ml In 1 Vial, Multi-Dose",118.02,47.21,,,0 NDC,61703036322,"Oxaliplatin: 1 Vial, Single-Dose In 1 Carton (61703-363-22) / 20 Ml In 1 Vial, Single-Dose",4.5,1.8,,,0 NDC,61703040841,"Methotrexate: 1 Vial, Single-Dose In 1 Carton (61703-408-41) / 40 Ml In 1 Vial, Single-Dose",7.61,3.04,,,0 NDC,61755000801,"Libtayo: 1 Vial, Single-Use In 1 Carton (61755-008-01) / 7 Ml In 1 Vial, Single-Use",133.6,53.44,,,0 NDC,61874011511,NDC Description Not Available,133.06,53.22,,,0 NDC,61874011520,"Vraylar: 2 Blister Pack In 1 Carton (61874-115-20) / 10 Capsule, Gelatin Coated In 1 Blister Pack (61874-115-11)",207.71,83.08,,,0 NDC,61874011530,"Vraylar: 30 Capsule, Gelatin Coated In 1 Bottle (61874-115-30)",207.71,83.08,,,0 NDC,61958060101,"Emtriva: 30 Capsule In 1 Bottle, Plastic (61958-0601-1)",77.08,30.83,,,0 NDC,61958060201,"Emtriva: 1 Bottle, Dispensing In 1 Carton (61958-0602-1) / 170 Ml In 1 Bottle, Dispensing",43.49,17.4,,,0 NDC,61958090101,Cayston: 2 Carton In 1 Package (61958-0901-1) / 1 Kit In 1 Carton * 1 Ml In 1 Vial * 1 Ml In 1 Ampule,656.19,262.48,,,0 NDC,61958190101,"Genvoya: 30 Tablet In 1 Bottle, Plastic (61958-1901-1)",393.15,157.26,,,0 NDC,61958200201,"Descovy: 30 Tablet In 1 Bottle, Plastic (61958-2002-1)",215.0,86.0,,,0 NDC,61958230101,"Vemlidy: 30 Tablet In 1 Bottle, Plastic (61958-2301-1)",149.89,59.96,,,0 NDC,61958250101,"Biktarvy: 30 Tablet In 1 Bottle, Plastic (61958-2501-1)",394.26,157.7,,,0 NDC,61958290102,"Veklury: 1 Vial, Single-Dose In 1 Carton (61958-2901-2) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",27.19,10.88,,,0 NDC,61959000101,NDC Description Not Available,7.72,3.09,,,0 NDC,61959000130,Lidoderm: 30 Pouch In 1 Carton (61959-001-30) / 1 Patch In 1 Pouch (61959-001-01),114.24,45.7,,,0 NDC,61990061100,NDC Description Not Available,17.98,7.19,,,0 NDC,61990061102,"tranexamic acid: 10 VIAL, SINGLE-DOSE in 1 CARTON (61990-0611-2) / 10 mL in 1 VIAL, SINGLE-DOSE (61990-0611-0)",95.22,38.09,,,0 NDC,62135000294,Lactulose: 946 Ml In 1 Package (62135-002-94),409.86,163.94,,,0 NDC,62135000394,"Lactulose: 946 Ml In 1 Bottle, Plastic (62135-003-94)",53.82,21.53,,,0 NDC,62135001047,Amantadine Hydrochloride: 473 Ml In 1 Bottle (62135-010-47),50.39,20.16,,,0 NDC,62135052047,Oxybutynin Chloride: 473 Ml In 1 Bottle (62135-520-47),6.38,2.55,,,0 NDC,62135071242,Lidocaine Hydrochloride: 100 Ml In 1 Bottle (62135-712-42),16.48,6.59,,,0 NDC,62135075047,Hydroxyzine Hydrochloride: 473 Ml In 1 Bottle (62135-750-47),36.07,14.43,,,0 NDC,62205000020,NDC Description Not Available,362.55,145.02,,,0 NDC,62327033303,NDC Description Not Available,772.2,308.88,,,0 NDC,62327033343,"Steritalc 3G: 4 Vial, Glass In 1 Box (62327-333-43) / 10 Ml In 1 Vial, Glass (62327-333-03)",703.8,281.52,,,0 NDC,62327044404,NDC Description Not Available,860.2,344.08,,,0 NDC,62327044444,"Steritalc 4G: 4 Vial, Glass In 1 Box (62327-444-44) / 50 Ml In 1 Vial, Glass (62327-444-04)",782.0,312.8,,,0 NDC,62332001131,Venlafaxine: 100 Tablet In 1 Bottle (62332-011-31),0.92,0.37,,,0 NDC,62332002531,"Theophylline: 100 Tablet, Extended Release In 1 Bottle (62332-025-31)",7.68,3.07,,,0 NDC,62332017160,"Lacosamide: 60 Tablet, Film Coated In 1 Bottle (62332-171-60)",1.27,0.51,,,0 NDC,62332023230,"Vilazodone Hydrochloride: 30 Tablet, Film Coated In 1 Bottle (62332-232-30)",10.7,4.28,,,0 NDC,62332023430,"Vilazodone Hydrochloride: 30 Tablet, Film Coated In 1 Bottle (62332-234-30)",10.33,4.13,,,0 NDC,62332025330,"Azithromycin: 30 Tablet, Film Coated In 1 Bottle (62332-253-30)",13.8,5.52,,,0 NDC,62332034290,Candesartan Cilexetil: 90 Tablet In 1 Bottle (62332-342-90),7.43,2.97,,,0 NDC,62332034390,Candesartan Cilexetil: 90 Tablet In 1 Bottle (62332-343-90),3.42,1.37,,,0 NDC,62332036406,"Clonazepam: 60 Blister Pack In 1 Carton (62332-364-06) / 6 Tablet, Orally Disintegrating In 1 Blister Pack",2.81,1.12,,,0 NDC,62332041310,Oseltamivir: 1 Carton In 1 Blister Pack (62332-413-10) / 10 Capsule In 1 Carton,31.69,12.68,,,0 NDC,62332051805,Tobramycin Ophthalmic Solution: 1 Bottle In 1 Carton (62332-518-05) / 5 Ml In 1 Bottle,33.58,13.43,,,0 NDC,62332060630,Nystatin And Triamcinolone Acetonide: 1 Tube In 1 Carton (62332-606-30) / 30 G In 1 Tube,125.86,50.34,,,0 NDC,62332061831,Cyclophosphamide: 100 Capsule In 1 Bottle (62332-618-31),4.74,1.9,,,0 NDC,62332061931,Cyclophosphamide: 100 Capsule In 1 Bottle (62332-619-31),4.11,1.64,,,0 NDC,62332067960,"Ivabradine: 60 Tablet, Film Coated In 1 Bottle (62332-679-60)",6.88,2.75,,,0 NDC,62332070605,"Brimonidine Tartrate And Timolol Maleate: 1 Bottle, Dropper In 1 Carton (62332-706-05) / 5 Ml In 1 Bottle, Dropper",300.0,120.0,,,0 NDC,62372063015,"Mylicon Infants Gas Relief Original: 1 Bottle, Dropper In 1 Carton (62372-630-15) / 15 Ml In 1 Bottle, Dropper",0.37,0.15,,,0 NDC,62372063030,"Mylicon Infants Gas Relief Original: 1 Bottle, Dropper In 1 Carton (62372-630-30) / 30 Ml In 1 Bottle, Dropper",0.55,0.22,,,0 NDC,62372063053,NDC Description Not Available,0.06,0.02,,,0 NDC,62484002001,NDC Description Not Available,162.71,65.08,,,0 NDC,62484002002,Purixan: 1 Bottle In 1 Carton (62484-0020-2) / 100 Ml In 1 Bottle (62484-0020-1),15.97,6.39,,,0 NDC,62530000011,NDC Description Not Available,10.29,4.12,,,0 NDC,62559013807,Hydrocortisone: 7 Bottle In 1 Box (62559-138-07) / 60 Ml In 1 Bottle (62559-138-11),64.26,25.7,,,0 NDC,62559015116,Oxycodone Hydrochloride: 1 Bottle In 1 Carton (62559-151-16) / 473 Ml In 1 Bottle,3.09,1.24,,,0 NDC,62559015717,NDC Description Not Available,5.21,2.08,,,0 NDC,62559015901,"Fluvoxamine Maleate: 100 Tablet, Coated In 1 Bottle (62559-159-01)",1.57,0.63,,,0 NDC,62559019016,"Metoclopramide: 473 Ml In 1 Bottle, Plastic (62559-190-16)",0.38,0.15,,,0 NDC,62559026616,Valproic Acid: 473 Ml In 1 Bottle (62559-266-16),1.24,0.5,,,0 NDC,62559035660,NDC Description Not Available,106.82,42.73,,,0 NDC,62559043130,Hydrocortisone: 1 Tube In 1 Carton (62559-431-30) / 30 G In 1 Tube,212.28,84.91,,,0 NDC,62559072101,Terbutaline Sulfate: 100 Tablet In 1 Bottle (62559-721-01),2.89,1.16,,,0 NDC,62559073001,Felbamate: 100 Tablet In 1 Bottle (62559-730-01),2.35,0.94,,,0 NDC,62584026501,"Metoprolol Tartrate: 100 Blister Pack In 1 Box, Unit-Dose (62584-265-01) / 1 Tablet, Film Coated In 1 Blister Pack (62584-265-11)",0.18,0.07,,,0 NDC,62584026511,NDC Description Not Available,0.25,0.1,,,0 NDC,62584026701,"Metoprolol Tartrate: 100 Blister Pack In 1 Box, Unit-Dose (62584-267-01) / 1 Tablet, Film Coated In 1 Blister Pack (62584-267-11)",0.38,0.155,,,0 NDC,62584026711,NDC Description Not Available,0.61,0.24,,,0 NDC,62584069311,NDC Description Not Available,12.16,4.86,,,0 NDC,62584069321,"Doxycycline: 30 Blister Pack In 1 Box, Unit-Dose (62584-693-21) / 1 Tablet, Coated In 1 Blister Pack (62584-693-11)",10.9,4.36,,,0 NDC,62584073301,"Hydralazine Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (62584-733-01) / 1 Tablet, Film Coated In 1 Blister Pack (62584-733-11)",0.74,0.3,,,0 NDC,62584073311,NDC Description Not Available,0.74,0.3,,,0 NDC,62584073411,NDC Description Not Available,1.12,0.45,,,0 NDC,62584081311,NDC Description Not Available,7.43,2.97,,,0 NDC,62584099411,NDC Description Not Available,0.95,0.38,,,0 NDC,62643007099,NDC Description Not Available,0.77,0.31,,,0 NDC,62756005940,Epoprostenol: 1 Vial In 1 Carton (62756-059-40) / 10 Ml In 1 Vial,100.77,40.31,,,0 NDC,62756006040,Epoprostenol: 1 Vial In 1 Carton (62756-060-40) / 10 Ml In 1 Vial,78.75,31.5,,,0 NDC,62756013802,Gabapentin: 100 Capsule In 1 Bottle (62756-138-02),0.36,0.14,,,0 NDC,62756023301,"Amphotericin B: 1 Vial, Single-Dose In 1 Carton (62756-233-01) / 1 Injectable, Liposomal In 1 Vial, Single-Dose",227.8,91.12,,,0 NDC,62756024064,"Ondansetron: 3 Blister Pack In 1 Dose Pack (62756-240-64) / 10 Tablet, Orally Disintegrating In 1 Blister Pack",2.64,1.06,,,0 NDC,62756030101,"Sezaby: 1 Injection In 1 Vial, Single-Dose (62756-301-01)",5.8,2.32,,,0 NDC,62756035664,"Ondansetron: 3 Blister Pack In 1 Dose Pack (62756-356-64) / 10 Tablet, Orally Disintegrating In 1 Blister Pack",0.33,0.13,,,0 NDC,62756051788,Carbidopa And Levodopa: 100 Tablet In 1 Bottle (62756-517-88),1.13,0.45,,,0 NDC,62756079688,"Divalproex Sodium: 100 Tablet, Delayed Release In 1 Bottle (62756-796-88)",0.19,0.08,,,0 NDC,62756079888,"Divalproex Sodium: 100 Tablet, Delayed Release In 1 Bottle (62756-798-88)",0.76,0.3,,,0 NDC,62756095501,Mexiletine Hydrochloride: 100 Capsule In 1 Bottle (62756-955-01),1.75,0.7,,,0 NDC,62756095601,Mexiletine Hydrochloride: 100 Capsule In 1 Bottle (62756-956-01),5.05,2.02,,,0 NDC,62856021201,"Leqembi: 1 Vial, Single-Dose In 1 Carton (62856-212-01) / 2 Ml In 1 Vial, Single-Dose",5.68,2.27,,,0 NDC,62856021501,"Leqembi: 1 Vial, Single-Dose In 1 Carton (62856-215-01) / 5 Ml In 1 Vial, Single-Dose",5.7,2.28,,,0 NDC,62856027230,Fycompa: 30 Tablet In 1 Bottle (62856-272-30),84.23,33.69,,,0 NDC,62856027630,Fycompa: 30 Tablet In 1 Bottle (62856-276-30),165.76,66.3,,,0 NDC,62856038901,"Halaven: 1 Vial, Single-Dose In 1 Carton (62856-389-01) / 2 Ml In 1 Vial, Single-Dose",617.51,247.0,,,0 NDC,62856058252,"Banzel: 120 Tablet, Film Coated In 1 Bottle (62856-582-52)",42.67,17.07,,,0 NDC,62856058352,"Banzel: 120 Tablet, Film Coated In 1 Bottle (62856-583-52)",94.82,37.93,,,0 NDC,62935016360,Fensolvi: 1 Syringe In 1 Carton (62935-163-60) / .375 Ml In 1 Syringe,82.93,33.17,,,0 NDC,62935022710,Eligard: 1 Syringe In 1 Carton (62935-227-10) / .375 Ml In 1 Syringe,550.0,220.0,,,0 NDC,62935046150,Eligard: 1 Syringe In 1 Carton (62935-461-50) / .375 Ml In 1 Syringe,550.0,220.0,,,0 NDC,62991101303,Baclofen: 100 G In 1 Jar (62991-1013-3),311.28,124.51,,,0 NDC,62991140307,Morphine Sulfate: 500 G In 1 Jar (62991-1403-7),170.97,68.39,,,0 NDC,62991140504,Fentanyl Citrate: 5 G In 1 Jar (62991-1405-4),987.39,394.96,,,0 NDC,62991142202,Clonidine Hydrochloride: 5 G In 1 Jar (62991-1422-2),0.26,0.1,,,0 NDC,62991170105,NDC Description Not Available,0.45,0.18,,,0 NDC,62991201403,Bupivacaine Hydrochloride: 1000 G In 1 Jar (62991-2014-3),53.25,21.3,,,0 NDC,62991309207,Hydromorphone Hydrochloride: 500 G In 1 Jar (62991-3092-7),291.86,116.74,,,0 NDC,63020053530,"Iclusig: 30 Tablet, Film Coated In 1 Bottle (63020-535-30)",1923.32,769.33,,,0 NDC,63090034030,"Nuplazid: 30 Capsule In 1 Bottle, Plastic (63090-340-30)",557.83,223.13,,,0 NDC,63275110005,NDC Description Not Available,199.94,79.98,,,0 NDC,63275210005,"Hydromorphone Hcl: 100 G In 1 Bottle, Plastic (63275-2100-5)",252.13,100.85,,,0 NDC,63304024159,Calcitriol: 15 Ml In 1 Bottle (63304-241-59),38.99,15.6,,,0 NDC,63323001001,NDC Description Not Available,14.18,5.67,,,0 NDC,63323001002,Gentamicin: 25 Vial In 1 Tray (63323-010-02) / 2 Ml In 1 Vial (63323-010-01),22.51,9.0,,,0 NDC,63323001003,NDC Description Not Available,9.63,3.85,,,0 NDC,63323001020,Gentamicin: 25 Vial In 1 Tray (63323-010-20) / 20 Ml In 1 Vial (63323-010-03),12.87,5.15,,,0 NDC,63323001094,"Gentamicin: 25 Vial, Multi-Dose In 1 Tray (63323-010-94) / 2 Ml In 1 Vial, Multi-Dose (63323-010-41)",5.06,2.02,,,0 NDC,63323001203,NDC Description Not Available,15.34,6.14,,,0 NDC,63323001207,Oxytocin: 25 Vial In 1 Tray (63323-012-07) / 1 Ml In 1 Vial (63323-012-17),6.09,2.44,,,0 NDC,63323001211,Oxytocin: 25 Vial In 1 Tray (63323-012-11) / 1 Ml In 1 Vial (63323-012-03),4.19,1.68,,,0 NDC,63323001212,Oxytocin: 25 Vial In 1 Tray (63323-012-12) / 1 Ml In 1 Vial (63323-012-21),2.68,1.07,,,0 NDC,63323001302,"Thiamine: 25 Vial, Multi-Dose In 1 Tray (63323-013-02) / 2 Ml In 1 Vial, Multi-Dose (63323-013-01)",3.04,1.22,,,0 NDC,63323002401,NDC Description Not Available,26.62,10.65,,,0 NDC,63323002425,"Mannitol: 25 Vial, Single-Dose In 1 Tray (63323-024-25) / 50 Ml In 1 Vial, Single-Dose (63323-024-01)",23.74,9.5,,,0 NDC,63323003011,"Chorionic Gonadotropin: 1 Kit In 1 Carton (63323-030-11) * 10 Ml In 1 Vial, Multi-Dose * 10 Ml In 1 Vial, Multi-Dose",140.33,56.13,,,0 NDC,63323004400,NDC Description Not Available,15.21,6.08,,,0 NDC,63323004401,"Cyanocobalamin: 25 Vial, Multi-Dose In 1 Tray (63323-044-01) / 1 Ml In 1 Vial, Multi-Dose (63323-044-00)",9.19,3.68,,,0 NDC,63323004701,NDC Description Not Available,1.55,0.62,,,0 NDC,63323004710,Heparin Sodium: 25 Vial In 1 Tray (63323-047-10) / 10 Ml In 1 Vial (63323-047-01),1.56,0.62,,,0 NDC,63323006401,NDC Description Not Available,5.06,2.02,,,0 NDC,63323006403,"Magnesium Sulfate: 25 Vial, Single-Dose In 1 Carton (63323-064-03) / 2 Ml In 1 Vial, Single-Dose (63323-064-01)",3.98,1.59,,,0 NDC,63323006404,NDC Description Not Available,1.16,0.46,,,0 NDC,63323006411,"Magnesium Sulfate: 25 Vial, Single-Dose In 1 Tray (63323-064-11) / 10 Ml In 1 Vial, Single-Dose (63323-064-04)",0.83,0.33,,,0 NDC,63323008305,"Sodium Bicarbonate: 25 Vial, Single-Dose In 1 Tray (63323-083-05) / 5 Ml In 1 Vial, Single-Dose (63323-083-03)",104.4,41.76,,,0 NDC,63323008861,"Sodium Chloride: 10 Vial, Pharmacy Bulk Package In 1 Tray (63323-088-61) / 100 Ml In 1 Vial, Pharmacy Bulk Package",8.02,3.21,,,0 NDC,63323008863,"Sodium Chloride: 10 Vial, Pharmacy Bulk Package In 1 Tray (63323-088-63) / 200 Ml In 1 Vial, Pharmacy Bulk Package",5.52,2.21,,,0 NDC,63323008950,"Sodium Bicarbonate: 25 Vial, Single-Dose In 1 Tray (63323-089-50) / 50 Ml In 1 Vial, Single-Dose (63323-089-25)",106.23,42.49,,,0 NDC,63323009301,NDC Description Not Available,19.74,7.9,,,0 NDC,63323009330,"Sodium Chloride: 25 Vial, Plastic In 1 Tray (63323-093-30) / 30 Ml In 1 Vial, Plastic (63323-093-01)",16.8,6.72,,,0 NDC,63323009502,NDC Description Not Available,21.91,8.76,,,0 NDC,63323009561,"Sodium Chloride: 20 Vial, Plastic In 1 Tray (63323-095-61) / 100 Ml In 1 Vial, Plastic (63323-095-02)",6.22,2.49,,,0 NDC,63323009903,NDC Description Not Available,32.9,13.16,,,0 NDC,63323009963,"Sodium Chloride: 10 Vial, Plastic In 1 Tray (63323-099-63) / 200 Ml In 1 Vial, Plastic (63323-099-03)",7.36,2.94,,,0 NDC,63323010364,Cisplatin: 1 Vial In 1 Carton (63323-103-64) / 200 Ml In 1 Vial,18.37,7.35,,,0 NDC,63323010365,Cisplatin: 1 Vial In 1 Carton (63323-103-65) / 100 Ml In 1 Vial,17.16,6.86,,,0 NDC,63323010406,"Etoposide: 1 Vial, Multi-Dose In 1 Carton (63323-104-06) / 5 Ml In 1 Vial, Multi-Dose",5.22,2.09,,,0 NDC,63323010425,"Etoposide: 1 Vial, Multi-Dose In 1 Carton (63323-104-25) / 25 Ml In 1 Vial, Multi-Dose",1.72,0.69,,,0 NDC,63323010600,NDC Description Not Available,5.18,2.07,,,0 NDC,63323010601,Magnesium Sulfate: 24 Bag In 1 Case (63323-106-01) / 100 Ml In 1 Bag (63323-106-00),5.18,2.07,,,0 NDC,63323010602,NDC Description Not Available,14.39,5.76,,,0 NDC,63323010605,Magnesium Sulfate: 24 Bag In 1 Case (63323-106-05) / 50 Ml In 1 Bag (63323-106-02),4.31,1.72,,,0 NDC,63323010615,Magnesium Sulfate: 24 Bag In 1 Case (63323-106-15) / 500 Ml In 1 Bag,0.66,0.26,,,0 NDC,63323010800,NDC Description Not Available,19.18,7.67,,,0 NDC,63323011301,NDC Description Not Available,555.77,222.31,,,0 NDC,63323011310,Pentam 300: 10 Vial In 1 Tray (63323-113-10) / 3 Ml In 1 Vial (63323-113-01),599.53,239.81,,,0 NDC,63323011700,NDC Description Not Available,16.66,6.66,,,0 NDC,63323011701,NDC Description Not Available,14.5,5.8,,,0 NDC,63323011710,"Fluorouracil: 10 Vial, Single-Dose In 1 Tray (63323-117-10) / 10 Ml In 1 Vial, Single-Dose (63323-117-00)",15.28,6.11,,,0 NDC,63323011720,"Fluorouracil: 10 Vial, Single-Dose In 1 Tray (63323-117-20) / 20 Ml In 1 Vial, Single-Dose (63323-117-01)",14.84,5.94,,,0 NDC,63323011751,"Fluorouracil: 1 Vial, Pharmacy Bulk Package In 1 Carton (63323-117-51) / 50 Ml In 1 Vial, Pharmacy Bulk Package",12.61,5.04,,,0 NDC,63323011761,"Fluorouracil: 1 Vial, Pharmacy Bulk Package In 1 Carton (63323-117-61) / 100 Ml In 1 Vial, Pharmacy Bulk Package",12.6,5.04,,,0 NDC,63323012020,"Cytarabine: 1 Vial, Single-Dose In 1 Carton (63323-120-20) / 20 Ml In 1 Vial, Single-Dose",4.59,1.84,,,0 NDC,63323012800,NDC Description Not Available,2.27,0.91,,,0 NDC,63323012820,"Dacarbazine: 10 Vial, Single-Dose In 1 Tray (63323-128-20) / 20 Ml In 1 Vial, Single-Dose (63323-128-00)",24.94,9.98,,,0 NDC,63323013002,NDC Description Not Available,71.07,28.43,,,0 NDC,63323013011,Doxy 100: 10 Vial In 1 Tray (63323-130-11) / 10 Ml In 1 Vial (63323-130-02),73.78500000000001,29.51,,,0 NDC,63323013410,"Pemetrexed: 1 Vial, Single-Use In 1 Carton (63323-134-10) / 4 Ml In 1 Vial, Single-Use",55.88,22.35,,,0 NDC,63323013720,"Bleomycin: 1 Vial In 1 Carton (63323-137-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",134.34,53.74,,,0 NDC,63323014010,"Cladribine: 1 Vial, Single-Dose In 1 Carton (63323-140-10) / 10 Ml In 1 Vial, Single-Dose",193.07,77.23,,,0 NDC,63323016100,NDC Description Not Available,16.11,6.44,,,0 NDC,63323016101,"Ketorolac Tromethamine: 25 Vial, Single-Use In 1 Tray (63323-161-01) / 1 Ml In 1 Vial, Single-Use (63323-161-00)",2.7,1.08,,,0 NDC,63323016201,"Ketorolac Tromethamine: 25 Vial, Single-Use In 1 Tray (63323-162-01) / 1 Ml In 1 Vial, Single-Use (63323-162-00)",12.8,5.12,,,0 NDC,63323016202,"Ketorolac Tromethamine: 25 Vial, Single-Use In 1 Tray (63323-162-02) / 2 Ml In 1 Vial, Single-Use (63323-162-03)",0.92,0.37,,,0 NDC,63323016501,Dexamethasone Sodium Phosphate: 25 Vial In 1 Tray (63323-165-01) / 1 Ml In 1 Vial (63323-165-02),3.09,1.24,,,0 NDC,63323016502,NDC Description Not Available,2.82,1.13,,,0 NDC,63323016503,NDC Description Not Available,1.55,0.62,,,0 NDC,63323016505,"Dexamethasone Sodium Phosphate: 25 Vial, Multi-Dose In 1 Tray (63323-165-05) / 5 Ml In 1 Vial, Multi-Dose (63323-165-03)",1.52,0.61,,,0 NDC,63323016530,"Dexamethasone Sodium Phosphate: 1 Vial, Multi-Dose In 1 Box (63323-165-30) / 30 Ml In 1 Vial, Multi-Dose",1.72,0.69,,,0 NDC,63323017015,"Sodium Phosphates: 25 Vial, Single-Dose In 1 Tray (63323-170-15) / 15 Ml In 1 Vial, Single-Dose",13.13,5.25,,,0 NDC,63323017260,Carboplatin: 1 Vial In 1 Box (63323-172-60) / 60 Ml In 1 Vial,18.1,7.24,,,0 NDC,63323017302,Gentamicin: 25 Vial In 1 Tray (63323-173-02) / 2 Ml In 1 Vial (63323-173-01),23.35,9.34,,,0 NDC,63323018000,NDC Description Not Available,65.59,26.24,,,0 NDC,63323018001,Pyridoxine Hydrochloride: 25 Vial In 1 Tray (63323-180-01) / 1 Ml In 1 Vial (63323-180-00),26.1,10.44,,,0 NDC,63323018410,"Folic Acid: 1 Vial, Multi-Dose In 1 Carton (63323-184-10) / 10 Ml In 1 Vial, Multi-Dose",3.0599999999999996,1.2249999999999999,,,0 NDC,63323018507,NDC Description Not Available,12.67,5.07,,,0 NDC,63323018508,NDC Description Not Available,14.03,5.61,,,0 NDC,63323018509,NDC Description Not Available,13.92,5.57,,,0 NDC,63323018510,Sterile Water: 25 Vial In 1 Tray (63323-185-10) / 10 Ml In 1 Vial (63323-185-07),19.07,7.63,,,0 NDC,63323018520,Sterile Water: 25 Vial In 1 Tray (63323-185-20) / 20 Ml In 1 Vial (63323-185-08),26.64,10.66,,,0 NDC,63323018601,NDC Description Not Available,10.3,4.12,,,0 NDC,63323018730,"Sodium Chloride: 25 Vial, Single-Dose In 1 Tray (63323-187-30) / 30 Ml In 1 Vial, Single-Dose",12.43,4.97,,,0 NDC,63323019202,Fludarabine: 1 Vial In 1 Box (63323-192-02) / 2 Ml In 1 Vial,118.92,47.57,,,0 NDC,63323020101,NDC Description Not Available,0.595,0.23500000000000001,,,0 NDC,63323020102,Lidocaine: 25 Vial In 1 Tray (63323-201-02) / 2 Ml In 1 Vial (63323-201-01),4.09,1.635,,,0 NDC,63323020103,NDC Description Not Available,3.73,1.49,,,0 NDC,63323020110,Lidocaine: 25 Vial In 1 Tray (63323-201-10) / 10 Ml In 1 Vial (63323-201-03),26.44,10.575,,,0 NDC,63323020201,NDC Description Not Available,4.805,1.9200000000000002,,,0 NDC,63323020202,Lidocaine: 25 Vial In 1 Tray (63323-202-02) / 2 Ml In 1 Vial (63323-202-01),6.6499999999999995,2.6599999999999997,,,0 NDC,63323020320,Vancomycin Hydrochloride: 10 Vial In 1 Tray (63323-203-20) / 15 Ml In 1 Vial (63323-203-01),20.45,8.18,,,0 NDC,63323020521,NDC Description Not Available,188.9,75.56,,,0 NDC,63323020805,"Lidocaine: 25 Vial, Single-Dose In 1 Tray (63323-208-05) / 5 Ml In 1 Vial, Single-Dose (63323-208-01)",0.9,0.36,,,0 NDC,63323022901,NDC Description Not Available,13.62,5.45,,,0 NDC,63323022905,"Protamine Sulfate: 25 Vial, Single-Dose In 1 Tray (63323-229-05) / 5 Ml In 1 Vial, Single-Dose (63323-229-01)",13.84,5.54,,,0 NDC,63323022930,"Protamine Sulfate: 1 Vial, Single-Dose In 1 Box (63323-229-30) / 25 Ml In 1 Vial, Single-Dose",9.45,3.78,,,0 NDC,63323022935,"Protamine Sulfate: 1 Vial, Single-Dose In 1 Box (63323-229-35) / 25 Ml In 1 Vial, Single-Dose",5.64,2.26,,,0 NDC,63323025402,NDC Description Not Available,51.67,20.67,,,0 NDC,63323025410,NDC Description Not Available,63.644999999999996,25.46,,,0 NDC,63323025501,NDC Description Not Available,3.36,1.34,,,0 NDC,63323025503,"Methylprednisolone Sodium Succinate: 25 Vial, Single-Dose In 1 Tray (63323-255-03) / 1 Ml In 1 Vial, Single-Dose (63323-255-01)",4.1,1.64,,,0 NDC,63323025803,"Methylprednisolone Sodium Succinate: 25 Vial, Single-Dose In 1 Tray (63323-258-03) / 2 Ml In 1 Vial, Single-Dose (63323-258-01)",2.24,0.9,,,0 NDC,63323026201,Heparin Sodium: 25 Vial In 1 Tray (63323-262-01) / 1 Ml In 1 Vial,3.66,1.46,,,0 NDC,63323026203,NDC Description Not Available,3.66,1.46,,,0 NDC,63323026206,Heparin Sodium: 25 Vial In 1 Tray (63323-262-06) / 1 Ml In 1 Vial (63323-262-03),3.68,1.47,,,0 NDC,63323026530,"Methylprednisolone Sodium Succinate: 1 Vial, Multi-Dose In 1 Carton (63323-265-30) / 16 Ml In 1 Vial, Multi-Dose",0.77,0.31,,,0 NDC,63323026910,Diprivan: 10 Vial In 1 Box (63323-269-10) / 10 Ml In 1 Vial (63323-269-01),0.48,0.19,,,0 NDC,63323026922,NDC Description Not Available,0.45,0.18,,,0 NDC,63323026929,Diprivan: 10 Vial In 1 Box (63323-269-29) / 20 Ml In 1 Vial (63323-269-22),1.43,0.57,,,0 NDC,63323026950,Diprivan: 20 Vial In 1 Box (63323-269-50) / 50 Ml In 1 Vial (63323-269-30),1.45,0.58,,,0 NDC,63323026965,Diprivan: 10 Vial In 1 Box (63323-269-65) / 100 Ml In 1 Vial (63323-269-35),1.42,0.57,,,0 NDC,63323026978,Diprivan: 10 Vial In 1 Box (63323-269-78) / 100 Ml In 1 Vial (63323-269-31),0.48,0.19,,,0 NDC,63323027301,"Sumatriptan Succinate: 1 Vial, Single-Dose In 1 Carton (63323-273-01) / .5 Ml In 1 Vial, Single-Dose",25.9,10.36,,,0 NDC,63323027810,"Vinblastine Sulfate: 1 Vial, Multi-Dose In 1 Box (63323-278-10) / 10 Ml In 1 Vial, Multi-Dose",23.9,9.56,,,0 NDC,63323028001,NDC Description Not Available,6.29,2.52,,,0 NDC,63323028002,Furosemide: 25 Vial In 1 Tray (63323-280-02) / 2 Ml In 1 Vial (63323-280-01),1.89,0.76,,,0 NDC,63323028110,Fluphenazine Hydrochloride: 1 Vial In 1 Box (63323-281-10) / 10 Ml In 1 Vial,20.5,8.2,,,0 NDC,63323028501,NDC Description Not Available,1.04,0.42,,,0 NDC,63323028510,Naropin: 5 Ampule In 1 Box (63323-285-10) / 10 Ml In 1 Ampule (63323-285-01),1.0,0.4,,,0 NDC,63323028513,"Naropin: 25 Vial, Single-Dose In 1 Carton (63323-285-13) / 10 Ml In 1 Vial, Single-Dose (63323-285-03)",1.23,0.49,,,0 NDC,63323028563,Naropin: 24 Bag In 1 Case (63323-285-63) / 200 Ml In 1 Bag (63323-285-04),0.76,0.3,,,0 NDC,63323028605,NDC Description Not Available,0.15,0.06,,,0 NDC,63323028623,"Naropin: 25 Vial, Single-Dose In 1 Carton (63323-286-23) / 20 Ml In 1 Vial, Single-Dose (63323-286-05)",0.74,0.3,,,0 NDC,63323028635,"Naropin: 25 Vial, Single-Dose In 1 Carton (63323-286-35) / 30 Ml In 1 Vial, Single-Dose (63323-286-11)",0.14,0.06,,,0 NDC,63323028807,NDC Description Not Available,0.12,0.05,,,0 NDC,63323029337,"Polocaine-Mpf: 25 Vial, Single-Dose In 1 Tray (63323-293-37) / 30 Ml In 1 Vial, Single-Dose (63323-293-01)",22.48,8.99,,,0 NDC,63323030605,NDC Description Not Available,5.74,2.3,,,0 NDC,63323030630,"Tobramycin: 10 Vial, Multi-Dose In 1 Tray (63323-306-30) / 30 Ml In 1 Vial, Multi-Dose (63323-306-05)",2.87,1.15,,,0 NDC,63323031461,Vancomycin Hydrochloride: 1 Bottle In 1 Carton (63323-314-61) / 100 Ml In 1 Bottle,11.149999999999999,4.46,,,0 NDC,63323031510,Ganciclovir: 25 Vial In 1 Tray (63323-315-10) / 10 Ml In 1 Vial (63323-315-01),375.87,150.35,,,0 NDC,63323031801,"Granisetron: 1 Vial, Single-Use In 1 Box (63323-318-01) / 1 Ml In 1 Vial, Single-Use",8.8,3.52,,,0 NDC,63323032201,NDC Description Not Available,67.38,26.95,,,0 NDC,63323032221,NDC Description Not Available,22.92,9.17,,,0 NDC,63323032503,NDC Description Not Available,0.65,0.26,,,0 NDC,63323032509,NDC Description Not Available,0.83,0.33,,,0 NDC,63323032510,"Acyclovir: 10 Vial, Single-Dose In 1 Tray (63323-325-10) / 10 Ml In 1 Vial, Single-Dose (63323-325-03)",0.13,0.05,,,0 NDC,63323032520,"Acyclovir: 10 Vial, Single-Dose In 1 Tray (63323-325-20) / 20 Ml In 1 Vial, Single-Dose (63323-325-09)",0.1,0.04,,,0 NDC,63323032820,Nafcillin: 10 Vial In 1 Carton (63323-328-20) / 8 Ml In 1 Vial (63323-328-21),2.06,0.82,,,0 NDC,63323034021,NDC Description Not Available,10.63,4.25,,,0 NDC,63323034610,"Ceftriaxone: 25 Vial In 1 Carton (63323-346-10) / 1 Injection, Powder, For Solution In 1 Vial (63323-346-01)",4.18,1.67,,,0 NDC,63323035120,"Rifampin: 1 Vial In 1 Box (63323-351-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",286.475,114.59,,,0 NDC,63323036001,NDC Description Not Available,0.48,0.19,,,0 NDC,63323036003,NDC Description Not Available,0.26,0.1,,,0 NDC,63323036005,NDC Description Not Available,0.17,0.07,,,0 NDC,63323036019,"Calcium Gluconate: 25 Vial, Plastic In 1 Tray (63323-360-19) / 10 Ml In 1 Vial, Plastic (63323-360-01)",0.48,0.19,,,0 NDC,63323036059,"Calcium Gluconate: 25 Vial, Plastic In 1 Tray (63323-360-59) / 50 Ml In 1 Vial, Plastic (63323-360-03)",0.27,0.11,,,0 NDC,63323036061,"Calcium Gluconate: 20 Vial, Plastic In 1 Tray (63323-360-61) / 100 Ml In 1 Vial, Plastic (63323-360-05)",0.25,0.1,,,0 NDC,63323037600,NDC Description Not Available,6.805,2.725,,,0 NDC,63323037601,"Octreotide: 10 Vial, Single-Dose In 1 Tray (63323-376-01) / 1 Ml In 1 Vial, Single-Dose (63323-376-00)",2.7,1.08,,,0 NDC,63323037700,NDC Description Not Available,10.96,4.38,,,0 NDC,63323037905,"Octreotide: 1 Vial, Multi-Dose In 1 Carton (63323-379-05) / 5 Ml In 1 Vial, Multi-Dose",6.63,2.65,,,0 NDC,63323039306,Colistimethate: 1 Vial In 1 Box (63323-393-06) / 2 Ml In 1 Vial,124.97,49.99,,,0 NDC,63323040005,"Levetiracetam: 10 Vial, Single-Use In 1 Tray (63323-400-05) / 5 Ml In 1 Vial, Single-Use (63323-400-01)",0.31,0.12,,,0 NDC,63323040101,NDC Description Not Available,17.39,6.96,,,0 NDC,63323040120,"Aztreonam: 10 Vial In 1 Tray (63323-401-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (63323-401-01)",10.34,4.14,,,0 NDC,63323040201,NDC Description Not Available,14.3,5.72,,,0 NDC,63323040220,"Aztreonam: 10 Vial In 1 Tray (63323-402-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (63323-402-01)",13.44,5.38,,,0 NDC,63323040703,Caffeine Citrate: 1 Vial In 1 Box (63323-407-03) / 3 Ml In 1 Vial,7.8,3.12,,,0 NDC,63323041112,Midazolam: 25 Vial In 1 Tray (63323-411-12) / 2 Ml In 1 Vial (63323-411-15),2.66,1.06,,,0 NDC,63323041115,NDC Description Not Available,1.48,0.59,,,0 NDC,63323041202,Midazolam: 10 Vial In 1 Tray (63323-412-02) / 2 Ml In 1 Vial (63323-412-03),15.6,6.24,,,0 NDC,63323041203,NDC Description Not Available,4.7,1.8800000000000001,,,0 NDC,63323042101,NDC Description Not Available,151.28,60.51,,,0 NDC,63323042102,Dexmedetomidine Hydrochloride: 25 Vial In 1 Tray (63323-421-02) / 2 Ml In 1 Vial (63323-421-01),12.93,5.17,,,0 NDC,63323042405,"Flumazenil: 10 Vial, Multi-Dose In 1 Tray (63323-424-05) / 5 Ml In 1 Vial, Multi-Dose (63323-424-01)",26.12,10.45,,,0 NDC,63323045050,"Pemetrexed: 1 Vial, Single-Use In 1 Carton (63323-450-50) / 20 Ml In 1 Vial, Single-Use",53.0,21.2,,,0 NDC,63323045100,NDC Description Not Available,6.97,2.79,,,0 NDC,63323045101,"Morphine Sulfate: 25 Vial, Single-Dose In 1 Box (63323-451-01) / 1 Ml In 1 Vial, Single-Dose (63323-451-00)",8.45,3.38,,,0 NDC,63323045200,NDC Description Not Available,4.18,1.67,,,0 NDC,63323045201,"Morphine Sulfate: 25 Vial, Single-Dose In 1 Box (63323-452-01) / 1 Ml In 1 Vial, Single-Dose (63323-452-00)",3.15,1.26,,,0 NDC,63323045400,NDC Description Not Available,6.58,2.63,,,0 NDC,63323045401,"Morphine Sulfate: 25 Vial, Single-Dose In 1 Box (63323-454-01) / 1 Ml In 1 Vial, Single-Dose (63323-454-00)",5.88,2.35,,,0 NDC,63323046201,NDC Description Not Available,46.19,18.48,,,0 NDC,63323046204,NDC Description Not Available,32.65,13.06,,,0 NDC,63323046237,"Sensorcaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-462-37) / 30 Ml In 1 Vial, Single-Dose (63323-462-01)",45.58,18.23,,,0 NDC,63323046357,"Sensorcaine: 25 Vial, Multi-Dose In 1 Tray (63323-463-57) / 50 Ml In 1 Vial, Multi-Dose (63323-463-01)",37.28,14.91,,,0 NDC,63323046401,NDC Description Not Available,0.56,0.22,,,0 NDC,63323046417,"Sensorcaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-464-17) / 10 Ml In 1 Vial, Single-Dose (63323-464-01)",0.63,0.25,,,0 NDC,63323046437,"Sensorcaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-464-37) / 30 Ml In 1 Vial, Single-Dose (63323-464-02)",0.21,0.08,,,0 NDC,63323046601,NDC Description Not Available,0.11,0.04,,,0 NDC,63323046617,"Sensorcaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-466-17) / 10 Ml In 1 Vial, Single-Dose (63323-466-03)",0.24,0.1,,,0 NDC,63323046637,"Sensorcaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-466-37) / 30 Ml In 1 Vial, Single-Dose (63323-466-01)",0.1,0.04,,,0 NDC,63323046701,NDC Description Not Available,0.09,0.04,,,0 NDC,63323046801,NDC Description Not Available,27.29,10.92,,,0 NDC,63323046802,NDC Description Not Available,32.22,12.89,,,0 NDC,63323046817,"Sensorcaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-468-17) / 10 Ml In 1 Vial, Single-Dose (63323-468-01)",27.59,11.04,,,0 NDC,63323046837,"Sensorcaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-468-37) / 30 Ml In 1 Vial, Single-Dose (63323-468-02)",46.73,18.69,,,0 NDC,63323047203,NDC Description Not Available,0.14,0.06,,,0 NDC,63323047237,"Sensorcaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-472-37) / 30 Ml In 1 Vial, Single-Dose (63323-472-01)",0.08,0.03,,,0 NDC,63323047701,NDC Description Not Available,0.22,0.09,,,0 NDC,63323047801,NDC Description Not Available,0.17,0.07,,,0 NDC,63323047827,"Nesacaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-478-27) / 20 Ml In 1 Vial, Single-Dose (63323-478-01)",0.17,0.07,,,0 NDC,63323048101,NDC Description Not Available,2.345,0.935,,,0 NDC,63323048201,NDC Description Not Available,7.01,2.8049999999999997,,,0 NDC,63323048203,NDC Description Not Available,3.59,1.44,,,0 NDC,63323048205,NDC Description Not Available,0.08,0.03,,,0 NDC,63323048217,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-482-17) / 10 Ml In 1 Vial, Multi-Dose (63323-482-01)",7.3950000000000005,2.96,,,0 NDC,63323048226,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-482-26) / 20 Ml In 1 Vial, Multi-Dose (63323-482-41)",0.04,0.02,,,0 NDC,63323048227,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-482-27) / 20 Ml In 1 Vial, Multi-Dose (63323-482-03)",0.09,0.04,,,0 NDC,63323048457,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-484-57) / 50 Ml In 1 Vial, Multi-Dose",0.1,0.04,,,0 NDC,63323048501,NDC Description Not Available,3.37,1.35,,,0 NDC,63323048503,NDC Description Not Available,0.305,0.12000000000000001,,,0 NDC,63323048527,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-485-27) / 20 Ml In 1 Vial, Multi-Dose (63323-485-01)",0.04,0.02,,,0 NDC,63323048601,NDC Description Not Available,4.694999999999999,1.8800000000000001,,,0 NDC,63323048602,NDC Description Not Available,11.1,4.4399999999999995,,,0 NDC,63323048605,NDC Description Not Available,8.795,3.52,,,0 NDC,63323048617,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-486-17) / 10 Ml In 1 Vial, Multi-Dose (63323-486-01)",0.08,0.03,,,0 NDC,63323048627,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-486-27) / 20 Ml In 1 Vial, Multi-Dose (63323-486-02)",0.04,0.02,,,0 NDC,63323048657,"Xylocaine: 25 Vial, Multi-Dose In 1 Tray (63323-486-57) / 50 Ml In 1 Vial, Multi-Dose (63323-486-05)",0.02,0.01,,,0 NDC,63323048701,NDC Description Not Available,0.46,0.18,,,0 NDC,63323048707,NDC Description Not Available,12.76,5.1,,,0 NDC,63323048717,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-487-17) / 10 Ml In 1 Vial, Single-Dose (63323-487-01)",21.509999999999998,8.604999999999999,,,0 NDC,63323048737,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-487-37) / 30 Ml In 1 Vial, Single-Dose (63323-487-07)",27.11,10.845,,,0 NDC,63323048807,NDC Description Not Available,14.49,5.8,,,0 NDC,63323048837,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-488-37) / 30 Ml In 1 Vial, Single-Dose (63323-488-07)",6.945,2.78,,,0 NDC,63323048901,NDC Description Not Available,18.16,7.26,,,0 NDC,63323048902,NDC Description Not Available,22.355,8.944999999999999,,,0 NDC,63323048917,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-489-17) / 10 Ml In 1 Vial, Single-Dose (63323-489-01)",0.26,0.1,,,0 NDC,63323048927,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-489-27) / 20 Ml In 1 Vial, Single-Dose (63323-489-02)",0.19,0.08,,,0 NDC,63323049101,NDC Description Not Available,0.24,0.1,,,0 NDC,63323049204,NDC Description Not Available,5.445,2.18,,,0 NDC,63323049207,NDC Description Not Available,14.3,5.720000000000001,,,0 NDC,63323049208,NDC Description Not Available,0.26,0.1,,,0 NDC,63323049209,NDC Description Not Available,4.1,1.64,,,0 NDC,63323049227,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Carton (63323-492-27) / 2 Ml In 1 Vial, Single-Dose (63323-492-04)",4.08,1.6300000000000001,,,0 NDC,63323049237,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Tray (63323-492-37) / 30 Ml In 1 Vial, Single-Dose (63323-492-07)",3.89,1.555,,,0 NDC,63323049243,NDC Description Not Available,0.34,0.14,,,0 NDC,63323049257,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Carton (63323-492-57) / 5 Ml In 1 Vial, Single-Dose (63323-492-09)",0.35,0.14,,,0 NDC,63323049297,Xylocaine Mpf: 5 Ampule In 1 Box (63323-492-97) / 10 Ml In 1 Ampule (63323-492-08),0.25,0.1,,,0 NDC,63323049405,"Valproate Sodium: 10 Vial, Single-Dose In 1 Tray (63323-494-05) / 5 Ml In 1 Vial, Single-Dose (63323-494-01)",5.34,2.14,,,0 NDC,63323049504,NDC Description Not Available,0.5499999999999999,0.22,,,0 NDC,63323049507,"Xylocaine Mpf: 25 Vial, Single-Dose In 1 Carton (63323-495-07) / 5 Ml In 1 Vial, Single-Dose (63323-495-04)",0.5,0.19999999999999998,,,0 NDC,63323050600,NDC Description Not Available,3.35,1.34,,,0 NDC,63323050601,Dexamethasone Sodium Phosphate: 25 Vial In 1 Tray (63323-506-01) / 1 Ml In 1 Vial (63323-506-00),13.165,5.2700000000000005,,,0 NDC,63323050720,Meropenem: 10 Vial In 1 Carton (63323-507-20) / 10 Ml In 1 Vial (63323-507-01),2.49,1.0,,,0 NDC,63323050830,Meropenem: 10 Vial In 1 Carton (63323-508-30) / 20 Ml In 1 Vial (63323-508-01),2.58,1.03,,,0 NDC,63323051701,NDC Description Not Available,1.89,0.76,,,0 NDC,63323051774,Heparin Sodium: 24 Bag In 1 Case (63323-517-74) / 250 Ml In 1 Bag (63323-517-01),1.89,0.76,,,0 NDC,63323052301,NDC Description Not Available,1.96,0.78,,,0 NDC,63323053021,NDC Description Not Available,12.39,4.96,,,0 NDC,63323053075,Sodium Chloride: 20 Bag In 1 Case (63323-530-75) / 500 Ml In 1 Bag (63323-530-21),5.18,2.07,,,0 NDC,63323054001,Heparin Sodium: 25 Vial In 1 Tray (63323-540-01) / 1 Ml In 1 Vial,6.73,2.69,,,0 NDC,63323054011,Heparin Sodium: 25 Vial In 1 Tray (63323-540-11) / 10 Ml In 1 Vial,1.03,0.41,,,0 NDC,63323054204,NDC Description Not Available,0.97,0.39,,,0 NDC,63323054207,Heparin Sodium: 25 Vial In 1 Tray (63323-542-07) / 5 Ml In 1 Vial,0.97,0.39,,,0 NDC,63323054505,NDC Description Not Available,0.16,0.065,,,0 NDC,63323055921,NDC Description Not Available,4.04,1.62,,,0 NDC,63323055993,Enoxaparin Sodium: 10 Blister Pack In 1 Carton (63323-559-93) / 1 Syringe In 1 Blister Pack (63323-559-21) / .3 Ml In 1 Syringe,4.13,1.65,,,0 NDC,63323056210,"Bivalirudin: 10 Vial, Single-Use In 1 Carton (63323-562-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Use",0.86,0.34,,,0 NDC,63323056421,NDC Description Not Available,3.68,1.47,,,0 NDC,63323057901,NDC Description Not Available,336.43,134.57,,,0 NDC,63323057905,Sincalide: 10 Vial In 1 Package (63323-579-05) / 5 Ml In 1 Vial (63323-579-01),202.92,81.17,,,0 NDC,63323058421,NDC Description Not Available,4.19,1.68,,,0 NDC,63323058499,Enoxaparin Sodium: 10 Blister Pack In 1 Carton (63323-584-99) / 1 Syringe In 1 Blister Pack (63323-584-21) / .8 Ml In 1 Syringe,3.63,1.45,,,0 NDC,63323059303,"Glucagon: 1 Kit In 1 Carton (63323-593-03) * 1 Ml In 1 Vial, Single-Dose (63323-596-03) * 1 Ml In 1 Vial, Single-Dose (63323-185-03)",852.06,340.82,,,0 NDC,63323059403,"Glucagon: 1 Kit In 1 Carton (63323-594-03) * 1 Ml In 1 Vial, Single-Dose (63323-596-06) * 1 Ml In 1 Vial, Single-Dose (63323-185-03)",508.88,203.55,,,0 NDC,63323059603,NDC Description Not Available,1010.89,404.36,,,0 NDC,63323059606,NDC Description Not Available,622.04,248.82,,,0 NDC,63323059608,NDC Description Not Available,696.49,278.6,,,0 NDC,63323059611,NDC Description Not Available,1058.15,423.26,,,0 NDC,63323059710,Deferoxamine: 1 Vial In 1 Box (63323-597-10) / 5.3 Ml In 1 Vial,55.76,22.3,,,0 NDC,63323060401,"Propranolol: 10 Vial, Single-Dose In 1 Tray (63323-604-01) / 1 Ml In 1 Vial, Single-Dose",11.57,4.63,,,0 NDC,63323061400,NDC Description Not Available,50.49,20.2,,,0 NDC,63323061401,"Hydralazine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (63323-614-01) / 1 Ml In 1 Vial, Single-Dose (63323-614-00)",58.84,23.54,,,0 NDC,63323061710,"Milrinone Lactate: 10 Vial, Single-Dose In 1 Tray (63323-617-10) / 10 Ml In 1 Vial, Single-Dose (63323-617-01)",10.08,4.03,,,0 NDC,63323062361,Sodium Chloride: 100 Ml In 1 Bag (63323-623-61),6.99,2.8,,,0 NDC,63323062374,Sodium Chloride: 250 Ml In 1 Bag (63323-623-74),8.735,3.495,,,0 NDC,63323062375,Sodium Chloride: 500 Ml In 1 Bag (63323-623-75),11.0,4.4,,,0 NDC,63323063703,NDC Description Not Available,293.87,117.55,,,0 NDC,63323063710,"Arsenic Trioxide: 10 Vial, Single-Dose In 1 Carton (63323-637-10) / 10 Ml In 1 Vial, Single-Dose (63323-637-03)",24.82,9.93,,,0 NDC,63323064201,NDC Description Not Available,2.03,0.81,,,0 NDC,63323064202,NDC Description Not Available,2.1,0.84,,,0 NDC,63323064220,"Magnesium Sulfate: 25 Vial, Single-Dose In 1 Tray (63323-642-20) / 20 Ml In 1 Vial, Single-Dose (63323-642-01)",2.01,0.8,,,0 NDC,63323064810,"Levothyroxine Sodium: 1 Vial, Single-Dose In 1 Carton (63323-648-10) / 5 Ml In 1 Vial, Single-Dose",47.07,18.83,,,0 NDC,63323064907,"Levothyroxine Sodium: 1 Vial, Single-Dose In 1 Carton (63323-649-07) / 5 Ml In 1 Vial, Single-Dose",36.175,14.469999999999999,,,0 NDC,63323065100,NDC Description Not Available,1.88,0.75,,,0 NDC,63323065102,"Adenosine: 10 Vial, Single-Use In 1 Tray (63323-651-02) / 2 Ml In 1 Vial, Single-Use (63323-651-00)",2.2,0.88,,,0 NDC,63323065820,Chlorothiazide: 1 Vial In 1 Box (63323-658-20) / 18 Ml In 1 Vial,183.18,73.27,,,0 NDC,63323065903,Indomethacin: 1 Vial In 1 Carton (63323-659-03) / 1 Ml In 1 Vial,202.72,81.09,,,0 NDC,63323066400,NDC Description Not Available,8.45,3.38,,,0 NDC,63323066401,"Diphenhydramine: 25 Vial, Single-Dose In 1 Tray (63323-664-01) / 1 Ml In 1 Vial, Single-Dose (63323-664-00)",6.47,2.59,,,0 NDC,63323066500,NDC Description Not Available,53.63,21.45,,,0 NDC,63323066501,"Terbutaline Sulfate: 25 Vial, Single-Use In 1 Tray (63323-665-01) / 1 Ml In 1 Vial, Single-Use (63323-665-00)",6.81,2.72,,,0 NDC,63323068517,"Posaconazole: 1 Vial, Single-Dose In 1 Carton (63323-685-17) / 16.7 Ml In 1 Vial, Single-Dose",1310.65,524.26,,,0 NDC,63323069030,Acetylcysteine: 3 Vial In 1 Carton (63323-690-30) / 30 Ml In 1 Vial (63323-690-22),20.75,8.3,,,0 NDC,63323069404,Acetylcysteine: 25 Vial In 1 Carton (63323-694-04) / 4 Ml In 1 Vial (63323-694-22),46.43,18.57,,,0 NDC,63323069602,NDC Description Not Available,4.77,1.91,,,0 NDC,63323071050,Leucovorin Calcium: 1 Vial In 1 Box (63323-710-50) / 20 Ml In 1 Vial,24.07,9.63,,,0 NDC,63323071303,NDC Description Not Available,63.68,25.47,,,0 NDC,63323071313,Linezolid: 10 Bag In 1 Case (63323-713-13) / 300 Ml In 1 Bag (63323-713-03),15.18,6.07,,,0 NDC,63323072405,"Remifentanil Hydrochloride: 10 Vial, Single-Dose In 1 Carton (63323-724-05) / 5 Ml In 1 Vial, Single-Dose (63323-724-01)",424.36,169.74,,,0 NDC,63323072901,NDC Description Not Available,2.4,0.96,,,0 NDC,63323072910,"Micafungin: 10 Carton In 1 Carton (63323-729-10) / 1 Vial, Single-Dose In 1 Carton (63323-729-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",1.46,0.58,,,0 NDC,63323073806,NDC Description Not Available,0.30500000000000005,0.12,,,0 NDC,63323075100,NDC Description Not Available,0.01,0.004,,,0 NDC,63323075101,"Phenylephrine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (63323-751-01) / 1 Ml In 1 Vial, Single-Dose (63323-751-00)",0.04,0.02,,,0 NDC,63323076350,"Paclitaxel: 1 Vial, Multi-Dose In 1 Carton (63323-763-50) / 50 Ml In 1 Vial, Multi-Dose",1.32,0.53,,,0 NDC,63323080612,NDC Description Not Available,8.42,3.37,,,0 NDC,63323080613,NDC Description Not Available,4.28,1.71,,,0 NDC,63323080650,"Fentanyl Citrate: 1 Vial, Single-Dose In 1 Carton (63323-806-50) / 50 Ml In 1 Vial, Single-Dose",2.91,1.16,,,0 NDC,63323082000,Smoflipid: 10 Bag In 1 Case (63323-820-00) / 100 Ml In 1 Bag (63323-820-01),9.41,3.76,,,0 NDC,63323082001,NDC Description Not Available,31.37,12.55,,,0 NDC,63323082004,NDC Description Not Available,70.81,28.32,,,0 NDC,63323082074,Smoflipid: 10 Bag In 1 Case (63323-820-74) / 250 Ml In 1 Bag (63323-820-04),48.72,19.49,,,0 NDC,63323085103,NDC Description Not Available,0.23,0.09,,,0 NDC,63323085150,"Hydromorphone Hydrochloride: 50 Ml In 1 Vial, Single-Dose (63323-851-50)",0.04,0.02,,,0 NDC,63323085203,NDC Description Not Available,2.12,0.85,,,0 NDC,63323085225,"Hydromorphone Hydrochloride: 25 Vial, Single-Dose In 1 Carton (63323-852-25) / 1 Ml In 1 Vial, Single-Dose (63323-852-03)",2.45,0.98,,,0 NDC,63323085303,NDC Description Not Available,1.23,0.49,,,0 NDC,63323085403,NDC Description Not Available,0.56,0.22,,,0 NDC,63323085410,"Hydromorphone Hydrochloride: 25 Vial, Single-Dose In 1 Carton (63323-854-10) / 1 Ml In 1 Vial, Single-Dose (63323-854-03)",0.58,0.23,,,0 NDC,63323087550,Foscarnet: 1 Bottle In 1 Carton (63323-875-50) / 250 Ml In 1 Bottle,277.31,110.92,,,0 NDC,63323087715,"Nebupent: 1 Vial, Single-Dose In 1 Carton (63323-877-15) / 6 Ml In 1 Vial, Single-Dose",506.0,202.4,,,0 NDC,63323088101,NDC Description Not Available,62.63,25.05,,,0 NDC,63323088116,"Sodium Phosphates: 25 Vial, Single-Dose In 1 Tray (63323-881-16) / 15 Ml In 1 Vial, Single-Dose (63323-881-01)",98.14,39.26,,,0 NDC,63323088601,NDC Description Not Available,59.21,23.68,,,0 NDC,63323092403,NDC Description Not Available,14.67,5.87,,,0 NDC,63323093000,NDC Description Not Available,3.405,1.3650000000000002,,,0 NDC,63323093001,"Vasopressin: 25 Vial, Single-Dose In 1 Tray (63323-930-01) / 1 Ml In 1 Vial, Single-Dose (63323-930-00)",3.93,1.5750000000000002,,,0 NDC,63323094004,"Norepinephrine Bitartrate: 10 Vial, Single-Dose In 1 Carton (63323-940-04) / 4 Ml In 1 Vial, Single-Dose (63323-940-21)",25.88,10.35,,,0 NDC,63323094021,NDC Description Not Available,21.62,8.65,,,0 NDC,63323094310,"Succinylcholine Chloride: 25 Vial, Multi-Dose In 1 Carton (63323-943-10) / 10 Ml In 1 Vial, Multi-Dose (63323-943-21)",3.49,1.4,,,0 NDC,63323096501,NDC Description Not Available,3.99,1.6,,,0 NDC,63323096502,NDC Description Not Available,0.57,0.23,,,0 NDC,63323096503,NDC Description Not Available,0.67,0.27,,,0 NDC,63323096505,"Potassium Chloride: 25 Vial, Single-Dose In 1 Tray (63323-965-05) / 5 Ml In 1 Vial, Single-Dose (63323-965-01)",3.73,1.49,,,0 NDC,63323096510,"Potassium Chloride: 25 Vial, Single-Dose In 1 Tray (63323-965-10) / 10 Ml In 1 Vial, Single-Dose (63323-965-03)",0.92,0.37,,,0 NDC,63323096520,"Potassium Chloride: 25 Vial, Single-Dose In 1 Tray (63323-965-20) / 20 Ml In 1 Vial, Single-Dose (63323-965-02)",0.3,0.12,,,0 NDC,63323096701,NDC Description Not Available,0.5,0.2,,,0 NDC,63323098121,"Piperacillin And Tazobactam: 10 Vial, Single-Use In 1 Carton (63323-981-21) / 10 Ml In 1 Vial, Single-Use (63323-981-23)",5.14,2.06,,,0 NDC,63323098323,NDC Description Not Available,6.19,2.48,,,0 NDC,63361024315,Vaxelis: 10 Syringe In 1 Package (63361-243-15) / .5 Ml In 1 Syringe (63361-243-88),644.35,257.74,,,0 NDC,63361024358,NDC Description Not Available,557.23,222.89,,,0 NDC,63361024388,NDC Description Not Available,548.76,219.5,,,0 NDC,63402020230,Aptiom: 30 Tablet In 1 Bottle (63402-202-30),126.78,50.71,,,0 NDC,63402020430,Aptiom: 30 Tablet In 1 Bottle (63402-204-30),131.32,52.53,,,0 NDC,63459010310,"Truxima: 1 Vial, Single-Use In 1 Carton (63459-103-10) / 10 Ml In 1 Vial, Single-Use",364.16,145.66,,,0 NDC,63459010450,"Truxima: 1 Vial, Single-Use In 1 Carton (63459-104-50) / 50 Ml In 1 Vial, Single-Use",361.29,144.52,,,0 NDC,63459034804,"Bendeka: 1 Vial, Multi-Dose In 1 Carton (63459-348-04) / 4 Ml In 1 Vial, Multi-Dose",93.75,37.5,,,0 NDC,63629877401,"Sertraline Hydrochloride: 1 Bottle, Dropper In 1 Carton (63629-8774-1) / 60 Ml In 1 Bottle, Dropper",1.48,0.59,,,0 NDC,63736012002,NDC Description Not Available,26.73,10.69,,,0 NDC,63739005110,Amiodarone Hydrochloride: 10 Blister Pack In 1 Box (63739-051-10) / 10 Tablet In 1 Blister Pack,0.85,0.34,,,0 NDC,63739005269,Sky Oral Rinse: 1500 Ml In 1 Package (63739-052-69),4.97,1.99,,,0 NDC,63739005802,NDC Description Not Available,0.27,0.11,,,0 NDC,63739006010,"Clonidine Hydrochloride: 10 BLISTER PACK in 1 BOX, UNIT-DOSE (63739-060-10) / 10 TABLET in 1 BLISTER PACK",0.2,0.08,,,0 NDC,63739007410,"Aripiprazole: 10 Blister Pack In 1 Box, Unit-Dose (63739-074-10) / 10 Tablet In 1 Blister Pack",22.17,8.87,,,0 NDC,63739007833,"Aripiprazole: 3 Blister Pack In 1 Box, Unit-Dose (63739-078-33) / 10 Tablet In 1 Blister Pack",30.71,12.28,,,0 NDC,63739009810,"Mirtazapine: 10 Blister Pack In 1 Box (63739-098-10) / 10 Tablet, Film Coated In 1 Blister Pack",0.35,0.14,,,0 NDC,63739011510,"Fluconazole: 10 Blister Pack In 1 Box, Unit-Dose (63739-115-10) / 10 Tablet In 1 Blister Pack",5.87,2.35,,,0 NDC,63739014310,"Tamoxifen Citrate: 10 Blister Pack In 1 Box, Unit-Dose (63739-143-10) / 10 Tablet, Film Coated In 1 Blister Pack",1.9,0.76,,,0 NDC,63739014510,"Midodrine Hydrochloride: 10 Blister Pack In 1 Box, Unit-Dose (63739-145-10) / 10 Tablet In 1 Blister Pack",1.82,0.73,,,0 NDC,63739019210,Phenobarbital: 10 Blister Pack In 1 Box (63739-192-10) / 10 Tablet In 1 Blister Pack,1.55,0.62,,,0 NDC,63739019351,"Sucralfate: 2 Tray In 1 Case (63739-193-51) / 10 Cup, Unit-Dose In 1 Tray / 10 Ml In 1 Cup, Unit-Dose (63739-193-72)",25.98,10.39,,,0 NDC,63739019372,NDC Description Not Available,25.35,10.14,,,0 NDC,63739022502,"Gas Relief: 30 Blister Pack In 1 Box (63739-225-02) / 10 Tablet, Chewable In 1 Blister Pack",0.21,0.08,,,0 NDC,63739026310,"Clonazepam: 10 BLISTER PACK in 1 BOX, UNIT-DOSE (63739-263-10) / 10 TABLET in 1 BLISTER PACK",0.22,0.09,,,0 NDC,63739032710,Hydralazine Hydrochloride: 10 Blister Pack In 1 Case (63739-327-10) / 10 Tablet In 1 Blister Pack,0.36,0.14,,,0 NDC,63739032810,Hydralazine Hydrochloride: 10 Blister Pack In 1 Case (63739-328-10) / 10 Tablet In 1 Blister Pack,0.41,0.16,,,0 NDC,63739041010,"Allopurinol: 10 Blister Pack In 1 Box, Unit-Dose (63739-410-10) / 10 Tablet In 1 Blister Pack",1.13,0.45,,,0 NDC,63739043401,"25 BLISTER PACK in 1 BOX, UNIT-DOSE (63739-434-01) / 30 TABLET in 1 BLISTER PACK",0.04,0.02,,,0 NDC,63739043402,Aspirin Chewable: 30 Blister Pack In 1 Box (63739-434-02) / 10 Tablet In 1 Blister Pack,0.12,0.05,,,0 NDC,63739047802,"Docusate Sodium: 30 Blister Pack In 1 Box, Unit-Dose (63739-478-02) / 10 Capsule, Liquid Filled In 1 Blister Pack",0.08,0.03,,,0 NDC,63739047910,"Baclofen: 10 Blister Pack In 1 Box, Unit-Dose (63739-479-10) / 10 Tablet In 1 Blister Pack",1.72,0.69,,,0 NDC,63739048310,"Hydroxyzine Hydrochloride: 10 Blister Pack In 1 Box, Unit-Dose (63739-483-10) / 10 Tablet In 1 Blister Pack",0.65,0.26,,,0 NDC,63739048610,"Hydroxyzine Hydrochloride: 10 Blister Pack In 1 Box, Unit-Dose (63739-486-10) / 10 Tablet In 1 Blister Pack",0.78,0.31,,,0 NDC,63739054410,"Spironolactone: 10 Blister Pack In 1 Box, Unit-Dose (63739-544-10) / 10 Tablet In 1 Blister Pack",0.64,0.26,,,0 NDC,63739054833,"Oxybutynin Chloride Extended Release: 3 Blister Pack In 1 Box, Unit-Dose (63739-548-33) / 10 Tablet, Extended Release In 1 Blister Pack",11.27,4.51,,,0 NDC,63739056710,"Tamsulosin Hydrochloride: 10 Blister Pack In 1 Box, Unit-Dose (63739-567-10) / 10 Capsule In 1 Blister Pack",1.49,0.6,,,0 NDC,63739056910,"Isosorbide Dinitrate: 10 Blister Pack In 1 Box, Unit-Dose (63739-569-10) / 10 Tablet In 1 Blister Pack",2.06,0.82,,,0 NDC,63739064510,"Famotidine: 10 Blister Pack In 1 Box, Unit-Dose (63739-645-10) / 10 Tablet In 1 Blister Pack",0.23,0.09,,,0 NDC,63739067310,"Losortan Potassium: 10 Blister Pack In 1 Box, Unit-Dose (63739-673-10) / 10 Tablet, Film Coated In 1 Blister Pack",1.86,0.74,,,0 NDC,63739068610,"Losartan Potassium: 10 Blister Pack In 1 Box, Unit-Dose (63739-686-10) / 10 Tablet, Film Coated In 1 Blister Pack",1.38,0.55,,,0 NDC,63739072401,NDC Description Not Available,12.7,5.08,,,0 NDC,63739072450,"Potassium Chloride: 5 Tray In 1 Case (63739-724-50) / 10 Cup, Unit-Dose In 1 Tray / 15 Ml In 1 Cup, Unit-Dose (63739-724-01)",12.7,5.08,,,0 NDC,63739079510,"Levetiracetam: 10 Blister Pack In 1 Box, Unit-Dose (63739-795-10) / 10 Tablet, Film Coated In 1 Blister Pack",0.7,0.28,,,0 NDC,63739090210,Gabapentin: 10 Blister Pack In 1 Carton (63739-902-10) / 10 Capsule In 1 Blister Pack,0.27,0.11,,,0 NDC,63739090310,Gabapentin: 10 Blister Pack In 1 Carton (63739-903-10) / 10 Capsule In 1 Blister Pack,0.36,0.14,,,0 NDC,63739090410,Gabapentin: 10 Blister Pack In 1 Carton (63739-904-10) / 10 Capsule In 1 Blister Pack,0.38,0.15,,,0 NDC,63739093114,NDC Description Not Available,1.66,0.66,,,0 NDC,63739093128,"Heparin Sodium: 25 Vial, Multi-Dose In 1 Carton (63739-931-28) / 10 Ml In 1 Vial, Multi-Dose (63739-931-14)",1.65,0.66,,,0 NDC,63739095311,NDC Description Not Available,1.68,0.67,,,0 NDC,63739099110,"Methocarbamol: 10 Blister Pack In 1 Box, Unit-Dose (63739-991-10) / 10 Tablet, Coated In 1 Blister Pack",0.93,0.37,,,0 NDC,63739099210,"Methocarbamol: 10 Blister Pack In 1 Box, Unit-Dose (63739-992-10) / 10 Tablet, Coated In 1 Blister Pack",0.87,0.35,,,0 NDC,63807010030,NDC Description Not Available,1.32,0.53,,,0 NDC,63807010075,NDC Description Not Available,2.62,1.05,,,0 NDC,63807060005,NDC Description Not Available,0.12,0.05,,,0 NDC,63824017165,Delsym: 1 Bottle In 1 Carton (63824-171-65) / 148 Ml In 1 Bottle,1.57,0.63,,,0 NDC,63824017563,Delsym: 1 Bottle In 1 Carton (63824-175-63) / 89 Ml In 1 Bottle,1.82,0.73,,,0 NDC,63824017565,Delsym: 1 Bottle In 1 Carton (63824-175-65) / 148 Ml In 1 Bottle,0.87,0.35,,,0 NDC,63833038602,"Kcentra: 1 Kit In 1 Carton (63833-386-02) * 20 Ml In 1 Vial, Single-Use (63833-396-01) * 20 Ml In 1 Vial, Single-Use (63833-761-20)",14.6,5.84,,,0 NDC,63833038702,"Kcentra: 1 Kit In 1 Carton (63833-387-02) * 40 Ml In 1 Vial, Single-Use (63833-397-01) * 40 Ml In 1 Vial, Single-Use (63833-761-40)",10.28,4.11,,,0 NDC,63833039601,NDC Description Not Available,9.18,3.67,,,0 NDC,63833061502,"Humate-P: 1 Kit In 1 Carton (63833-615-02) * 5 Ml In 1 Vial (63833-625-01) * 5 Ml In 1 Vial, Single-Dose (63833-765-53)",6.17,2.47,,,0 NDC,63833061602,"Humate-P: 1 Kit In 1 Carton (63833-616-02) * 10 Ml In 1 Vial (63833-626-01) * 10 Ml In 1 Vial, Single-Dose (63833-765-54)",4.73,1.89,,,0 NDC,63833061702,"Humate-P: 1 Kit In 1 Carton (63833-617-02) * 15 Ml In 1 Vial (63833-627-01) * 15 Ml In 1 Vial, Single-Dose (63833-765-55)",6.77,2.71,,,0 NDC,63833062501,NDC Description Not Available,4.21,1.68,,,0 NDC,63833062601,NDC Description Not Available,4.38,1.75,,,0 NDC,63833062701,NDC Description Not Available,4.28,1.71,,,0 NDC,63833082502,Berinert: 1 Kit In 1 Carton (63833-825-02) * 10 Ml In 1 Vial (63833-835-01) * 10 Ml In 1 Vial (63833-765-15),374.03,149.61,,,0 NDC,63833089151,"Riastap: 1 Vial, Single-Use In 1 Carton (63833-891-51) / 50 Ml In 1 Vial, Single-Use (63833-891-90)",5.12,2.05,,,0 NDC,64067021601,"Uvadex: 12 Vial, Glass In 1 Carton (64067-216-01) / 10 Ml In 1 Vial, Glass",674.44,269.78,,,0 NDC,64253011130,NDC Description Not Available,2.3,0.92,,,0 NDC,64253022230,NDC Description Not Available,0.72,0.29,,,0 NDC,64253022235,NDC Description Not Available,0.43,0.17,,,0 NDC,64253033330,NDC Description Not Available,0.05,0.02,,,0 NDC,64253033335,NDC Description Not Available,0.095,0.04,,,0 NDC,64253040030,NDC Description Not Available,0.37,0.15,,,0 NDC,64253090030,NDC Description Not Available,19.865,7.944999999999999,,,0 NDC,64253090036,"Calcium Chloride: 60 Syringe, Plastic In 1 Box (64253-900-36) / 10 Ml In 1 Syringe, Plastic (64253-900-30)",16.595,6.64,,,0 NDC,64281011006,"Provocholine Inhalation Solution: 6 Package In 1 Package (64281-110-06) / 6 Carton In 1 Package (64281-110-05) / 1 Kit In 1 Carton * 1 Vial, Plastic In 1 Kit / 3 Ml In 1 Vial, Plastic (64281-113-00",18.69,7.48,,,0 NDC,64370037501,"Hemangeol: 1 Bottle, Glass In 1 Carton (64370-375-01) / 120 Ml In 1 Bottle, Glass",30.97,12.39,,,0 NDC,64380015801,Megestrol Acetate: 100 Tablet In 1 Bottle (64380-158-01),0.82,0.33,,,0 NDC,64380015901,Megestrol Acetate: 100 Tablet In 1 Bottle (64380-159-01),0.96,0.38,,,0 NDC,64380016002,"Megestrol Acetate: 480 Ml In 1 Bottle, Plastic (64380-160-02)",2.69,1.08,,,0 NDC,64380016601,"Phenobarbital: 473 Ml In 1 Bottle, Plastic (64380-166-01)",0.78,0.31,,,0 NDC,64380017101,"Imipramine Hydrochloride: 100 Tablet In 1 Bottle, Plastic (64380-171-01)",0.53,0.21,,,0 NDC,64380017202,"Olanzapine: 3 Blister Pack In 1 Carton (64380-172-02) / 10 Tablet, Orally Disintegrating In 1 Blister Pack (64380-172-01)",4.11,1.64,,,0 NDC,64380076921,"Polyethylene Glycol 3350, Sodium Chloride, Sodium Bicarbonate And Potassium Chloride With Lemon Flavor: 4 L In 1 Jug (64380-769-21)",140.7,56.28,,,0 NDC,64380078206,"Prednisone: 100 Tablet In 1 Bottle, Plastic (64380-782-06)",0.22,0.09,,,0 NDC,64380079701,Oseltamivir Phosphate: 10 Capsule In 1 Blister Pack (64380-797-01),3.6,1.44,,,0 NDC,64380079901,Oseltamivir Phosphate: 10 Capsule In 1 Blister Pack (64380-799-01),5.54,2.22,,,0 NDC,64380083506,"Prednisone: 100 Tablet In 1 Bottle, Plastic (64380-835-06)",0.15,0.06,,,0 NDC,64380087806,Ethosuximide: 100 Capsule In 1 Bottle (64380-878-06),1.27,0.51,,,0 NDC,64380088304,"Cinacalcet: 30 Tablet, Film Coated In 1 Bottle (64380-883-04)",2.06,0.82,,,0 NDC,64380091906,Ursodiol: 100 Tablet In 1 Bottle (64380-919-06),2.66,1.06,,,0 NDC,64380094906,Prednisone: 100 Tablet In 1 Bottle (64380-949-06),0.02,0.01,,,0 NDC,64406000801,"Tysabri: 1 Vial, Single-Use In 1 Carton (64406-008-01) / 15 Ml In 1 Vial, Single-Use",86.74,34.7,,,0 NDC,64406005801,"Spinraza: 1 Vial, Single-Use In 1 Box (64406-058-01) / 5 Ml In 1 Vial, Single-Use",4508.69,1803.48,,,0 NDC,64406010901,"Qalsody: 1 Vial, Single-Use In 1 Carton (64406-109-01) / 15 Ml In 1 Vial, Single-Use",674.22,269.69,,,0 NDC,64597030160,"Nuedexta: 60 Capsule, Gelatin Coated In 1 Bottle (64597-301-60)",113.05,45.22,,,0 NDC,64679001202,NDC Description Not Available,4.98,1.99,,,0 NDC,64679005602,NDC Description Not Available,5.41,2.16,,,0 NDC,64679067901,"Piperacillin And Tazobactam: 1 Vial, Pharmacy Bulk Package In 1 Carton (64679-679-01) / 180 Ml In 1 Vial, Pharmacy Bulk Package (64679-679-02)",2.39,0.96,,,0 NDC,64679067902,NDC Description Not Available,1.31,0.52,,,0 NDC,64764030020,"Entyvio: 1 Vial, Single-Dose In 1 Carton (64764-300-20) / 5 Ml In 1 Vial, Single-Dose",131.37,52.55,,,0 NDC,64764073030,"Trintellix: 30 Tablet, Film Coated In 1 Bottle (64764-730-30)",47.68,19.07,,,0 NDC,64764080028,"Livtencity: 1 Bottle In 1 Carton (64764-800-28) / 28 Tablet, Coated In 1 Bottle",670.65,268.26,,,0 NDC,64764080056,"Livtencity: 1 Bottle In 1 Carton (64764-800-56) / 56 Tablet, Coated In 1 Bottle",1022.68,409.07,,,0 NDC,64850050001,"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate And Amphetamine Sulfate: 100 Tablet In 1 Bottle (64850-500-01)",0.82,0.33,,,0 NDC,64850050201,"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate And Amphetamine Sulfate: 100 Tablet In 1 Bottle (64850-502-01)",0.6,0.24,,,0 NDC,64850051001,"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, And Amphetamine Sulfate: 100 Capsule, Extended Release In 1 Bottle (64850-510-01)",1.29,0.52,,,0 NDC,64850051101,"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, And Amphetamine Sulfate: 100 Capsule, Extended Release In 1 Bottle (64850-511-01)",1.27,0.51,,,0 NDC,64850055001,Lisdexamfetamine Dimesylate: 100 Capsule In 1 Bottle (64850-550-01),15.07,6.03,,,0 NDC,64875000101,NDC Description Not Available,197.8,79.12,,,0 NDC,64896066301,"Rytary: 100 Capsule, Extended Release In 1 Bottle (64896-663-01)",10.22,4.09,,,0 NDC,64950034316,Hydrocodone Bitartrate And Acetaminophen: 473 Ml In 1 Bottle (64950-343-16),26.12,10.45,,,0 NDC,64950035405,NDC Description Not Available,10.73,4.29,,,0 NDC,64950035455,"Oxycodone Hydrochloride: 50 Cup, Unit-Dose In 1 Case (64950-354-55) / 5 Ml In 1 Cup, Unit-Dose (64950-354-05)",17.45,6.98,,,0 NDC,64980010401,"Dibasic Sodium Phosphate, Monobasic Potassium Phosphate And Monobasic Sodium Phosphate: 100 Tablet In 1 Bottle (64980-104-01)",0.87,0.35,,,0 NDC,64980012950,NDC Description Not Available,0.38,0.15,,,0 NDC,64980014612,NDC Description Not Available,3.92,1.57,,,0 NDC,64980014698,NDC Description Not Available,3.9,1.56,,,0 NDC,64980028001,"Glipizide: 100 Tablet, Film Coated, Extended Release In 1 Bottle, Plastic (64980-280-01)",0.58,0.23,,,0 NDC,64980028101,"Glipizide: 100 Tablet, Film Coated, Extended Release In 1 Bottle, Plastic (64980-281-01)",1.09,0.44,,,0 NDC,64980029101,"Perphenazine: 100 Tablet, Film Coated In 1 Bottle (64980-291-01)",1.59,0.64,,,0 NDC,64980032430,Proctozone-Hc: 1 Tube In 1 Carton (64980-324-30) / 30 G In 1 Tube,60.38,24.15,,,0 NDC,64980040310,Cefpodoxime Proxetil: 1 Bottle In 1 Carton (64980-403-10) / 100 Ml In 1 Bottle,39.47,15.79,,,0 NDC,64980040906,"Sertraline Hydrochloride: 1 Bottle, Plastic In 1 Carton (64980-409-06) / 60 Ml In 1 Bottle, Plastic",5.66,2.26,,,0 NDC,64980044715,"Calcitriol: 1 Bottle, Glass In 1 Carton (64980-447-15) / 15 Ml In 1 Bottle, Glass",52.54,21.02,,,0 NDC,64980050448,Cyproheptadine Hydrochloride: 473 Ml In 1 Bottle (64980-504-48),1.32,0.53,,,0 NDC,64980051110,Clindamycin Palmitate Hydrochloride (Pediatric): 100 Ml In 1 Bottle (64980-511-10),6.75,2.7,,,0 NDC,64980051501,"Ofloxacin: 1 Bottle, Plastic In 1 Carton (64980-515-01) / 10 Ml In 1 Bottle, Plastic",59.25,23.7,,,0 NDC,64980051505,"Ofloxacin: 1 Bottle, Plastic In 1 Carton (64980-515-05) / 5 Ml In 1 Bottle, Plastic",27.56,11.02,,,0 NDC,64980052660,"Nitazoxanide: 6 Tablet, Film Coated In 1 Bottle (64980-526-60)",382.67,153.07,,,0 NDC,64980056201,Furosemide: 100 Tablet In 1 Bottle (64980-562-01),0.12,0.05,,,0 NDC,64980056301,Furosemide: 100 Tablet In 1 Bottle (64980-563-01),0.23,0.09,,,0 NDC,64980056401,Furosemide: 100 Tablet In 1 Bottle (64980-564-01),0.2,0.08,,,0 NDC,64980058805,NDC Description Not Available,21562.5,8625.0,,,0 NDC,64980059295,Lactulose Solution: 946 Ml In 1 Bottle (64980-592-95),0.87,0.35,,,0 NDC,64980059324,Nitrofurantoin: 1 Bottle In 1 Carton (64980-593-24) / 230 Ml In 1 Bottle,313.83,125.53,,,0 NDC,65145011901,NDC Description Not Available,16.35,6.54,,,0 NDC,65145012901,NDC Description Not Available,13.44,5.38,,,0 NDC,65145014601,NDC Description Not Available,5.49,2.2,,,0 NDC,65162005827,"Sevelamer Carbonate: 270 Tablet, Film Coated In 1 Bottle (65162-058-27)",0.35,0.14,,,0 NDC,65162006205,Sucralfate: 420 Ml In 1 Bottle (65162-062-05),5.09,2.04,,,0 NDC,65162008774,"Itraconazole: 150 Ml In 1 Bottle, Glass (65162-087-74)",167.49,67.0,,,0 NDC,65162028103,"Paliperidone: 30 Tablet, Extended Release In 1 Bottle (65162-281-03)",9.27,3.71,,,0 NDC,65162032109,"Niacin: 90 Tablet, Extended Release In 1 Bottle (65162-321-09)",1.27,0.51,,,0 NDC,65162037110,"Oxybutynin Chloride: 100 Tablet, Extended Release In 1 Bottle (65162-371-10)",0.69,0.28,,,0 NDC,65162051210,Salsalate: 100 Tablet In 1 Bottle (65162-512-10),0.9,0.36,,,0 NDC,65162064978,Oxcarbazepine: 1 Bottle In 1 Carton (65162-649-78) / 250 Ml In 1 Bottle,10.58,4.23,,,0 NDC,65162067384,Risperidone: 30 Ml In 1 Bottle (65162-673-84),5.06,2.02,,,0 NDC,65162068110,Phenazopyridine Hydrochloride: 100 Tablet In 1 Bottle (65162-681-10),0.97,0.39,,,0 NDC,65162068210,Phenazopyridine Hydrochloride: 100 Tablet In 1 Bottle (65162-682-10),1.29,0.52,,,0 NDC,65162068784,"Lorazepam: 30 Ml In 1 Bottle, Dropper (65162-687-84)",3.78,1.51,,,0 NDC,65162069179,Ondansetron: 50 Ml In 1 Bottle (65162-691-79),4.37,1.75,,,0 NDC,65162069890,Gabapentin: 473 Ml In 1 Bottle (65162-698-90),2.02,0.81,,,0 NDC,65162077810,"Budesonide: 100 Capsule, Delayed Release In 1 Bottle (65162-778-10)",6.71,2.68,,,0 NDC,65162079104,NDC Description Not Available,7.53,3.01,,,0 NDC,65162079108,Lidocaine: 30 Pouch In 1 Carton (65162-791-08) / 1 Patch In 1 Pouch (65162-791-04),8.67,3.47,,,0 NDC,65162080214,Temozolomide: 1 Bottle In 1 Carton (65162-802-14) / 14 Capsule In 1 Bottle,2.62,1.05,,,0 NDC,65162082534,Rivastigmine: 30 Patch In 1 Carton (65162-825-34) / 24 H In 1 Patch,7.6,3.04,,,0 NDC,65162083366,Diclofenac Sodium: 1 Tube In 1 Carton (65162-833-66) / 100 G In 1 Tube,72.07,28.83,,,0 NDC,65162083594,Acyclovir: 1 Tube In 1 Carton (65162-835-94) / 15 G In 1 Tube,53.43,21.37,,,0 NDC,65162084106,Lubiprostone: 60 Capsule In 1 Bottle (65162-841-06),4.31,1.72,,,0 NDC,65162089374,Aripiprazole: 1 Bottle In 1 Carton (65162-893-74) / 150 Ml In 1 Bottle,56.32,22.53,,,0 NDC,65162089703,Aripiprazole: 30 Tablet In 1 Bottle (65162-897-03),0.9,0.36,,,0 NDC,65162091322,Voriconazole: 75 Ml In 1 Bottle (65162-913-22),236.22,94.49,,,0 NDC,65162091446,Tobramycin: 56 Ampule In 1 Carton (65162-914-46) / 5 Ml In 1 Ampule,50.9,20.36,,,0 NDC,65162099704,NDC Description Not Available,27.23,10.89,,,0 NDC,65174002110,"Ruby-Fill: 1 Injection, Solution In 1 Container (65174-021-10)",2943.75,1177.5,,,0 NDC,65174027030,"Draximage Maa: 30 Injection, Powder, For Solution In 1 Kit (65174-270-30)",533.33,213.33200000000002,,,0 NDC,65174028830,"Draximage Dtpa: 30 Injection, Powder, Lyophilized, For Solution In 1 Kit (65174-288-30)",344.65,137.86200000000002,,,0 NDC,65174046105,Sodium Iodide I 131 Diagnostic: 5 Capsule In 1 Vial (65174-461-05),3.89,1.56,,,0 NDC,65174088000,Hicon: 1 Vial In 1 Kit (65174-880-00) / 1 Ml In 1 Vial,58.28,23.31,,,0 NDC,65197040010,Ad First Aid Multipurpose: 1 Tube In 1 Box (65197-400-10) / 42.5 G In 1 Tube,10.07,4.03,,,0 NDC,65219001401,NDC Description Not Available,6.59,2.64,,,0 NDC,65219001801,NDC Description Not Available,10.33,4.13,,,0 NDC,65219002003,NDC Description Not Available,8.54,3.42,,,0 NDC,65219002023,"Ampicillin: 10 Vial In 1 Carton (65219-020-23) / 1 Injection, Powder, For Solution In 1 Vial (65219-020-03)",8.91,3.56,,,0 NDC,65219002920,"Thiotepa: 1 Vial In 1 Carton (65219-029-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",1207.8,483.12,,,0 NDC,65219003900,NDC Description Not Available,4.89,1.96,,,0 NDC,65219003901,"Vasopressin: 25 Vial, Single-Dose In 1 Tray (65219-039-01) / 1 Ml In 1 Vial, Single-Dose (65219-039-00)",4.94,1.98,,,0 NDC,65219005209,NDC Description Not Available,25.48,10.19,,,0 NDC,65219005229,"Potassium Phosphates: 25 Vial, Single-Dose In 1 Tray (65219-052-29) / 5 Ml In 1 Vial, Single-Dose (65219-052-09)",58.47,23.39,,,0 NDC,65219005409,NDC Description Not Available,73.45,29.38,,,0 NDC,65219005429,"Potassium Phosphates: 25 Vial, Single-Dose In 1 Tray (65219-054-29) / 15 Ml In 1 Vial, Single-Dose (65219-054-09)",149.64,59.86,,,0 NDC,65219005609,NDC Description Not Available,70.96,28.38,,,0 NDC,65219013120,"Cyclophosphamide: 1 Vial, Single-Dose In 1 Carton (65219-131-20) / 50 Ml In 1 Vial, Single-Dose",5.27,2.11,,,0 NDC,65219022001,NDC Description Not Available,13.34,5.34,,,0 NDC,65219022010,Sodium Chloride: 50 Bag In 1 Case (65219-220-10) / 100 Ml In 1 Bag (65219-220-01),13.34,5.34,,,0 NDC,65219028412,"Plerixafor: 1 Vial, Single-Use In 1 Carton (65219-284-12) / 1.2 Ml In 1 Vial, Single-Use",50.77,20.31,,,0 NDC,65219029510,"Desmopressin Acetate: 1 Vial, Multi-Dose In 1 Carton (65219-295-10) / 10 Ml In 1 Vial, Multi-Dose",16.41,6.56,,,0 NDC,65219036801,NDC Description Not Available,4.37,1.75,,,0 NDC,65219038302,NDC Description Not Available,4.07,1.63,,,0 NDC,65219038304,NDC Description Not Available,4.62,1.85,,,0 NDC,65219038305,"Iodixanol: 10 Bottle, Plastic In 1 Box (65219-383-05) / 50 Ml In 1 Bottle, Plastic (65219-383-02)",1.29,0.52,,,0 NDC,65219038306,NDC Description Not Available,2.29,0.92,,,0 NDC,65219038310,"Iodixanol: 10 Bottle, Plastic In 1 Box (65219-383-10) / 100 Ml In 1 Bottle, Plastic (65219-383-04)",4.06,1.62,,,0 NDC,65219038350,"Iodixanol: 10 Bottle, Plastic In 1 Box (65219-383-50) / 150 Ml In 1 Bottle, Plastic (65219-383-06)",3.73,1.49,,,0 NDC,65219043301,NDC Description Not Available,8.4,3.36,,,0 NDC,65219044501,NDC Description Not Available,20.5,8.2,,,0 NDC,65219044510,"Etomidate: 10 Vial, Single-Dose In 1 Carton (65219-445-10) / 10 Ml In 1 Vial, Single-Dose (65219-445-01)",19.74,7.9,,,0 NDC,65219047005,NDC Description Not Available,8.3,3.32,,,0 NDC,65219047205,NDC Description Not Available,8.7,3.48,,,0 NDC,65219047405,NDC Description Not Available,13.8,5.52,,,0 NDC,65219053301,NDC Description Not Available,34.86,13.94,,,0 NDC,65219053325,Intralipid: 10 Bag In 1 Case (65219-533-25) / 250 Ml In 1 Bag (65219-533-01),58.44,23.38,,,0 NDC,65219055001,"Pralatrexate: 1 Vial, Single-Dose In 1 Carton (65219-550-01) / 1 Ml In 1 Vial, Single-Dose",1073.55,429.42,,,0 NDC,65219056620,Mitomycin: 1 Vial In 1 Carton (65219-566-20) / 40 Ml In 1 Vial,669.3,267.72,,,0 NDC,65219057001,NDC Description Not Available,7.61,3.04,,,0 NDC,65219057201,NDC Description Not Available,3.7,1.48,,,0 NDC,65219057900,NDC Description Not Available,349.09,139.64,,,0 NDC,65219057901,Carboprost Tromethamine: 10 Vial In 1 Carton (65219-579-01) / 1 Ml In 1 Vial (65219-579-00),347.9,139.16,,,0 NDC,65219081810,"Nicardipine Hydrochloride: 1 Vial, Glass In 1 Carton (65219-818-10) / 10 Ml In 1 Vial, Glass",0.34,0.14,,,0 NDC,65250026609,Exparel: 10 Vial In 1 Carton (65250-266-09) / 20 Ml In 1 Vial (65250-266-20),6.89,2.76,,,0 NDC,65250026620,NDC Description Not Available,6.15,2.46,,,0 NDC,65282160501,Lidocaine Hydrochloride: 25 Ampule In 1 Carton (65282-1605-1) / 5 Ml In 1 Ampule,7.825,3.13,,,0 NDC,65597040601,"Enhertu: 1 Vial, Single-Dose In 1 Carton (65597-406-01) / 5 Ml In 1 Vial, Single-Dose",127.75,51.1,,,0 NDC,65628005001,"Diphenhydramine Hydrochloride And Lidocaine Hydrochloride And Aluminum Hydroxide And Magnesium Hydro: 1 Kit In 1 Container (65628-050-01) * 236 Ml In 1 Bottle, Plastic * .2 G In 1 Bottle, Glass * ",23.26,9.3,,,0 NDC,65628005004,"Diphenhydramine Hydrochloride And Lidocaine Hydrochloride And Aluminum Hydroxide And Magnesium Hydro: 1 Kit In 1 Container (65628-050-04) * 118 Ml In 1 Bottle, Plastic * .1 G In 1 Bottle, Glass * ",47.91,19.16,,,0 NDC,65628020810,Firvanq: 1 Kit In 1 Carton (65628-208-10) * 15 G In 1 Bottle * 289 Ml In 1 Bottle,10.02,4.01,,,0 NDC,65628027010,NDC Description Not Available,26.75,10.7,,,0 NDC,65628027203,Konvomep: 1 Kit In 1 Carton (65628-272-03) * 150 Ml In 1 Bottle (65628-270-05) * 300 Ml In 1 Bottle (65628-270-10) * 150 Ml In 1 Bottle (65628-271-05) * 300 Ml In 1 Bottle (65628-271-10) * 9,33.67,13.47,,,0 NDC,65628027210,Konvomep: 1 Kit In 1 Carton (65628-272-10) * 150 Ml In 1 Bottle (65628-270-05) * 300 Ml In 1 Bottle (65628-270-10) * 150 Ml In 1 Bottle (65628-271-05) * 300 Ml In 1 Bottle (65628-271-10) * 9,28.82,11.53,,,0 NDC,65649010302,"Apriso: 1 Bottle In 1 Carton (65649-103-02) / 120 Capsule, Extended Release In 1 Bottle",18.33,7.33,,,0 NDC,65649030303,Xifaxan: 6 Blister Pack In 1 Carton (65649-303-03) / 10 Tablet In 1 Blister Pack,168.02,67.21,,,0 NDC,65649031112,Diuril: 1 Bottle In 1 Carton (65649-311-12) / 237 Ml In 1 Bottle,1.02,0.41,,,0 NDC,65649055102,"Relistor: 1 Vial, Single-Dose In 1 Carton (65649-551-02) / .6 Ml In 1 Vial, Single-Dose",645.82,258.33,,,0 NDC,65757030001,"Vivitrol: 1 Kit In 1 Carton (65757-300-01) * 4 Ml In 1 Vial, Glass (65757-302-02) * 4 Ml In 1 Vial, Glass (65757-304-03)",0.88,0.35,,,0 NDC,65757040103,Aristada: 1 Syringe In 1 Carton (65757-401-03) / 1.6 Ml In 1 Syringe,15.74,6.3,,,0 NDC,65757050003,Aristada Initio: 1 Syringe In 1 Carton (65757-500-03) / 2.4 Ml In 1 Syringe,15.1,6.04,,,0 NDC,65857010010,NDC Description Not Available,539.97,215.99,,,0 NDC,65857015030,"Fludeoxyglucose F-18: 30 Ml In 1 Vial, Glass (65857-150-30)",546.67,218.67,,,0 NDC,65857040001,NDC Description Not Available,638.87,255.547,,,0 NDC,65857042505,"Kit For The Preparation Of Lymphoseek (Technetium Tc 99M Tilmanocept): 1 Kit In 1 Carton (65857-425-05) / 1 Kit In 1 Kit * 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (65857-400-01)",602.5649999999999,241.02700000000002,,,0 NDC,65857050005,5 VIAL in 1 CARTON (65857-500-05) / 5 mL in 1 VIAL,78.795,31.517,,,0 NDC,65857050020,Kit For The Preparation Of Technetium Tc99M Sestamibi: 20 Vial In 1 Carton (65857-500-20) / 5 Ml In 1 Vial,76.83,30.732,,,0 NDC,65857050510,"Kit For The Preparation Of Technetium Tc 99M Medronate: 10 Injection, Powder, Lyophilized, For Solution In 1 Carton (65857-505-10)",109.71,43.882000000000005,,,0 NDC,65862000601,"Citalopram: 100 Tablet, Film Coated In 1 Bottle (65862-006-01)",0.24,0.1,,,0 NDC,65862001901,Cephalexin: 100 Capsule In 1 Bottle (65862-019-01),0.55,0.22,,,0 NDC,65862002106,"Mirtazapine: 5 Blister Pack In 1 Carton (65862-021-06) / 6 Tablet, Orally Disintegrating In 1 Blister Pack",1.11,0.44,,,0 NDC,65862004824,Zidovudine: 240 Ml In 1 Bottle (65862-048-24),0.97,0.39,,,0 NDC,65862005724,Nevirapine: 240 Ml In 1 Bottle (65862-057-24),3.54,1.42,,,0 NDC,65862006201,"Metoprolol Tartrate: 100 Tablet, Film Coated In 1 Bottle (65862-062-01)",0.03,0.01,,,0 NDC,65862007101,Amoxicillin: 100 Ml In 1 Bottle (65862-071-01),1.77,0.71,,,0 NDC,65862007930,Terbinafine: 30 Tablet In 1 Bottle (65862-079-30),0.75,0.3,,,0 NDC,65862008401,Cefadroxil: 100 Ml In 1 Bottle (65862-084-01),6.87,2.75,,,0 NDC,65862009620,"Cefpodoxime Proxetil: 20 Tablet, Film Coated In 1 Bottle (65862-096-20)",12.25,4.9,,,0 NDC,65862014636,Sumatriptan: 1 Blister Pack In 1 Carton (65862-146-36) / 9 Tablet In 1 Blister Pack,0.93,0.37,,,0 NDC,65862014736,Sumatriptan: 1 Blister Pack In 1 Carton (65862-147-36) / 9 Tablet In 1 Blister Pack,1.24,0.5,,,0 NDC,65862014836,Sumatriptan: 1 Blister Pack In 1 Carton (65862-148-36) / 9 Tablet In 1 Blister Pack,1.98,0.79,,,0 NDC,65862017501,"Penicillin V Potassium: 100 Tablet, Film Coated In 1 Bottle (65862-175-01)",0.45,0.18,,,0 NDC,65862017601,"Penicillin V Potassium: 100 Tablet, Film Coated In 1 Bottle (65862-176-01)",0.73,0.29,,,0 NDC,65862017760,Cefdinir: 60 Capsule In 1 Bottle (65862-177-60),2.47,0.99,,,0 NDC,65862018730,"Ondansetron Hydrochloride: 30 Tablet, Film Coated In 1 Bottle (65862-187-30)",0.38,0.15,,,0 NDC,65862018830,"Ondansetron Hydrochloride: 30 Tablet, Film Coated In 1 Bottle (65862-188-30)",0.58,0.23,,,0 NDC,65862019201,Fluoxetine: 100 Capsule In 1 Bottle (65862-192-01),0.18,0.07,,,0 NDC,65862019301,Fluoxetine: 100 Capsule In 1 Bottle (65862-193-01),0.12,0.05,,,0 NDC,65862020768,"Ribavirin: 168 Tablet, Film Coated In 1 Bottle (65862-207-68)",1.83,0.73,,,0 NDC,65862021150,Minocycline Hydrochloride: 50 Capsule In 1 Bottle (65862-211-50),2.41,0.96,,,0 NDC,65862025047,"Levetiracetam: 473 Ml In 1 Bottle, Plastic (65862-250-47)",0.31,0.12,,,0 NDC,65862029390,"Rosuvastatin Calcium: 90 Tablet, Film Coated In 1 Bottle (65862-293-90)",0.21,0.08,,,0 NDC,65862030612,"Fluoxetine: 120 Ml In 1 Bottle, Glass (65862-306-12)",11.81,4.72,,,0 NDC,65862037501,"Escitalopram: 100 Tablet, Film Coated In 1 Bottle (65862-375-01)",0.65,0.26,,,0 NDC,65862039010,"Ondansetron: 3 Blister Pack In 1 Carton (65862-390-10) / 10 Tablet, Orally Disintegrating In 1 Blister Pack",2.68,1.07,,,0 NDC,65862039110,"Ondansetron: 3 Blister Pack In 1 Carton (65862-391-10) / 10 Tablet, Orally Disintegrating In 1 Blister Pack",0.32,0.13,,,0 NDC,65862041901,Sulfamethoxazole And Trimethoprim: 100 Tablet In 1 Bottle (65862-419-01),0.18,0.07,,,0 NDC,65862047501,Ramipril: 100 Capsule In 1 Bottle (65862-475-01),0.17,0.07,,,0 NDC,65862047601,Ramipril: 100 Capsule In 1 Bottle (65862-476-01),0.56,0.22,,,0 NDC,65862049647,Sulfamethoxazole And Trimethoprim: 473 Ml In 1 Bottle (65862-496-47),4.12,1.65,,,0 NDC,65862049730,"Efavirenz, Emtricitabine And Tenofovir Disoproxil Fumarate: 30 Tablet, Film Coated In 1 Bottle (65862-497-30)",11.71,4.68,,,0 NDC,65862050220,"Amoxicillin And Clavulanate Potassium: 20 Tablet, Film Coated In 1 Bottle (65862-502-20)",1.33,0.53,,,0 NDC,65862050301,"Amoxicillin And Clavulanate Potassium: 100 Tablet, Film Coated In 1 Bottle (65862-503-01)",1.44,0.58,,,0 NDC,65862052890,"Venlafaxine Hydrochloride: 90 Capsule, Extended Release In 1 Bottle (65862-528-90)",0.7,0.28,,,0 NDC,65862053401,Amoxicillin And Clavulanate Potassium: 100 Ml In 1 Bottle (65862-534-01),3.48,1.39,,,0 NDC,65862053513,Amoxicillin And Clavulanate Potassium: 125 Ml In 1 Bottle (65862-535-13),2.43,0.97,,,0 NDC,65862053575,Amoxicillin And Clavulanate Potassium: 75 Ml In 1 Bottle (65862-535-75),3.17,1.27,,,0 NDC,65862060101,Modafinil: 100 Tablet In 1 Bottle (65862-601-01),1.18,0.47,,,0 NDC,65862060130,Modafinil: 30 Tablet In 1 Bottle (65862-601-30),1.2,0.48,,,0 NDC,65862060330,"Moxifloxacin Hydrochloride: 30 Tablet, Film Coated In 1 Bottle (65862-603-30)",5.77,2.31,,,0 NDC,65862064860,Rivastigmine Tartrate: 60 Capsule In 1 Bottle (65862-648-60),1.07,0.43,,,0 NDC,65862067605,Alprazolam: 500 Tablet In 1 Bottle (65862-676-05),0.12,0.05,,,0 NDC,65862067799,Alprazolam: 1000 Tablet In 1 Bottle (65862-677-99),0.09,0.04,,,0 NDC,65862067801,Alprazolam: 100 Tablet In 1 Bottle (65862-678-01),0.09,0.04,,,0 NDC,65862069201,Extended Phenytoin Sodium: 100 Capsule In 1 Bottle (65862-692-01),1.02,0.41,,,0 NDC,65862070020,Cefuroxime Axetil: 20 Tablet In 1 Bottle (65862-700-20),4.73,1.89,,,0 NDC,65862078201,Methenamine Hippurate: 100 Tablet In 1 Bottle (65862-782-01),2.38,0.95,,,0 NDC,65862089230,"Voriconazole: 30 Tablet, Film Coated In 1 Bottle (65862-892-30)",20.4,8.16,,,0 NDC,65862092127,"Sevelamer Carbonate: 270 Tablet, Film Coated In 1 Bottle (65862-921-27)",0.11,0.04,,,0 NDC,65862093008,NDC Description Not Available,1.22,0.49,,,0 NDC,65862093090,"Sevelamer Carbonate: 90 Pouch In 1 Carton (65862-930-90) / 1 Powder, For Suspension In 1 Pouch (65862-930-08)",4.0,1.6,,,0 NDC,65862096730,"Eszopiclone: 30 Tablet, Film Coated In 1 Bottle (65862-967-30)",0.69,0.28,,,0 NDC,66215040201,Veletri: 1 Vial In 1 Carton (66215-402-01) / 10 Ml In 1 Vial,214.25,85.7,,,0 NDC,66215040301,Veletri: 1 Vial In 1 Carton (66215-403-01) / 10 Ml In 1 Vial,13.51,5.4,,,0 NDC,66215050115,"Opsumit: 1 Blister Pack In 1 Carton (66215-501-15) / 15 Tablet, Film Coated In 1 Blister Pack",1295.5,518.2,,,0 NDC,66215060206,"Uptravi: 1 Bottle In 1 Carton (66215-602-06) / 60 Tablet, Coated In 1 Bottle",738.82,295.53,,,0 NDC,66215060806,"Uptravi: 1 Bottle In 1 Carton (66215-608-06) / 60 Tablet, Coated In 1 Bottle",1098.53,439.41,,,0 NDC,66215061606,"Uptravi: 1 Bottle In 1 Carton (66215-616-06) / 60 Tablet, Coated In 1 Bottle",1193.46,477.38,,,0 NDC,66288710001,"Vancomycin Hydrochloride: 1 Bag In 1 Bag (66288-7100-1) / 1 Injection, Powder, Lyophilized, For Solution In 1 Bag",8.58,3.43,,,0 NDC,66302031001,"Orenitram: 100 Tablet, Extended Release In 1 Bottle (66302-310-01)",260.68,104.27,,,0 NDC,66302031002,"Orenitram: 1 Blister Pack In 1 Carton (66302-310-02) / 10 Tablet, Extended Release In 1 Blister Pack",178.15,71.26,,,0 NDC,66302032501,"Orenitram: 100 Tablet, Extended Release In 1 Bottle (66302-325-01)",651.68,260.67,,,0 NDC,66302032502,"Orenitram: 1 Blister Pack In 1 Carton (66302-325-02) / 10 Tablet, Extended Release In 1 Blister Pack",445.38,178.15,,,0 NDC,66553000201,NDC Description Not Available,0.14,0.06,,,0 NDC,66553000401,NDC Description Not Available,0.15,0.06,,,0 NDC,66553000801,NDC Description Not Available,0.15,0.06,,,0 NDC,66658023401,NDC Description Not Available,927.0,370.8,,,0 NDC,66658050101,"Gamifant: 1 Vial, Single-Use In 1 Carton (66658-501-01) / 2 Ml In 1 Vial, Single-Use",3072.71,1229.08,,,0 NDC,66658050501,"Gamifant: 1 Vial, Single-Use In 1 Carton (66658-505-01) / 10 Ml In 1 Vial, Single-Use",1553.42,621.37,,,0 NDC,66658051001,"Gamifant: 1 Vial, Single-Use In 1 Carton (66658-510-01) / 20 Ml In 1 Vial, Single-Use",1553.42,621.37,,,0 NDC,66689002301,NDC Description Not Available,15.64,6.26,,,0 NDC,66689003601,NDC Description Not Available,27.38,10.95,,,0 NDC,66689003650,"Phenytoin: 5 Tray In 1 Case (66689-036-50) / 10 Cup, Unit-Dose In 1 Tray / 4 Ml In 1 Cup, Unit-Dose (66689-036-01)",27.38,10.95,,,0 NDC,66689003801,NDC Description Not Available,2.99,1.2,,,0 NDC,66689004701,NDC Description Not Available,25.88,10.35,,,0 NDC,66689005804,"Clobazam: 1 Bottle, Plastic In 1 Carton (66689-058-04) / 120 Ml In 1 Bottle, Plastic",7.0,2.8,,,0 NDC,66689020108,"Insta-Char Aqueous: 240 Ml In 1 Bottle, Plastic (66689-201-08)",54.93,21.97,,,0 NDC,66689020208,"Insta-Char Aqueous Cherry: 240 Ml In 1 Bottle, Plastic (66689-202-08)",84.94,33.98,,,0 NDC,66689020308,"Insta-Char Sorbitol: 240 Ml In 1 Bottle, Plastic (66689-203-08)",14.28,5.71,,,0 NDC,66689030708,"Mycophenolate Mofetil: 1 Bottle, Plastic In 1 Carton (66689-307-08) / 250 Ml In 1 Bottle, Plastic",10.61,4.24,,,0 NDC,66689069479,Methadone Hydrochloride: 1000 Ml In 1 Bottle (66689-694-79),1.81,0.72,,,0 NDC,66689069579,Methadone Hydrochloride: 1000 Ml In 1 Bottle (66689-695-79),0.7,0.28,,,0 NDC,66689082010,Methadone Hydrochloride: 100 Tablet In 1 Bottle (66689-820-10),0.69,0.28,,,0 NDC,66733094823,"Erbitux: 1 Vial, Single-Dose In 1 Carton (66733-948-23) / 50 Ml In 1 Vial, Single-Dose",368.06,147.22,,,0 NDC,66733095823,"Erbitux: 1 Vial, Single-Dose In 1 Carton (66733-958-23) / 100 Ml In 1 Vial, Single-Dose",368.06,147.22,,,0 NDC,66758005003,"Docetaxel: 1 Vial, Multi-Dose In 1 Carton (66758-050-03) / 16 Ml In 1 Vial, Multi-Dose",2.18,0.87,,,0 NDC,66794015101,"Gablofen: 1 Ml In 1 Syringe, Glass (66794-151-01)",421.65,168.66,,,0 NDC,66794015501,"Gablofen: 20 Ml In 1 Syringe, Glass (66794-155-01)",1180.42,472.17,,,0 NDC,66794015601,"Gablofen: 20 Ml In 1 Syringe, Glass (66794-156-01)",1217.57,487.03,,,0 NDC,66794015701,"Gablofen: 20 Ml In 1 Syringe, Glass (66794-157-01)",1218.58,487.43,,,0 NDC,66794016202,"Mitigo: 1 Ml In 1 Vial, Single-Use (66794-162-02)",26.33,10.53,,,0 NDC,66794020402,NDC Description Not Available,1.59,0.64,,,0 NDC,66794020442,"Glycopyrrolate: 25 Vial, Glass In 1 Carton (66794-204-42) / 5 Ml In 1 Vial, Glass (66794-204-02)",1.72,0.69,,,0 NDC,66794021002,NDC Description Not Available,10.64,4.26,,,0 NDC,66794021943,Linezolid: 10 Bag In 1 Carton (66794-219-43) / 300 Ml In 1 Bag (66794-219-63),11.5,4.6,,,0 NDC,66794021963,NDC Description Not Available,32.92,13.17,,,0 NDC,66794022802,NDC Description Not Available,16.41,6.56,,,0 NDC,66794022841,Rocuronium: 10 Vial In 1 Carton (66794-228-41) / 5 Ml In 1 Vial (66794-228-02),7.489999999999999,2.995,,,0 NDC,66794023002,NDC Description Not Available,22.0,8.8,,,0 NDC,66794023302,NDC Description Not Available,10.7,4.28,,,0 NDC,66794023342,"Dexmedetomidine: 25 Vial, Glass In 1 Carton (66794-233-42) / 2 Ml In 1 Vial, Glass (66794-233-02)",9.46,3.78,,,0 NDC,66794023502,NDC Description Not Available,164.01,65.6,,,0 NDC,66794023702,NDC Description Not Available,55.43,22.169999999999998,,,0 NDC,66794023741,Doxycycline: 10 Vial In 1 Carton (66794-237-41) / 10 Ml In 1 Vial,82.36999999999999,32.949999999999996,,,0 NDC,66794025802,NDC Description Not Available,19.27,7.71,,,0 NDC,66887000301,"Xiaflex: 1 Kit In 1 Carton (66887-003-01) * 1 Injection, Powder, Lyophilized, For Solution In 1 Vial * 3 Ml In 1 Vial",323.09,129.24,,,0 NDC,66992012814,"Otovel: 1 Pouch In 1 Carton (66992-128-14) / 14 Vial, Single-Dose In 1 Pouch / .25 Ml In 1 Vial, Single-Dose",83.26,33.3,,,0 NDC,66993001968,"Albuterol Sulfate Hfa: 1 Inhaler In 1 Carton (66993-019-68) / 200 Aerosol, Metered In 1 Inhaler",110.03,44.01,,,0 NDC,66993007896,"Fluticasone Propionate Hfa: 1 Inhaler In 1 Carton (66993-078-96) / 120 Aerosol, Metered In 1 Inhaler",400.56,160.22,,,0 NDC,66993007996,"Fluticasone Propionate Hfa: 1 Inhaler In 1 Carton (66993-079-96) / 120 Aerosol, Metered In 1 Inhaler",535.19,214.08,,,0 NDC,66993037083,Medroxyprogesterone Acetate: 1 Vial In 1 Carton (66993-370-83) / 1 Ml In 1 Vial,1.04,0.42,,,0 NDC,66993037179,Medroxyprogesterone Acetate: 1 Syringe In 1 Carton (66993-371-79) / 1 Ml In 1 Syringe,1.61,0.64,,,0 NDC,66993049084,NDC Description Not Available,296.48,118.59,,,0 NDC,66993073051,NDC Description Not Available,0.25,0.1,,,0 NDC,67066000501,"Chirhostim: 8 Ml In 1 Vial, Single-Use (67066-005-01)",176.43,70.57,,,0 NDC,67157010150,"Ascor: 1 Vial, Glass In 1 Carton (67157-101-50) / 50 Ml In 1 Vial, Glass",20.55,8.22,,,0 NDC,67386013051,"Vyepti: 1 Vial, Single-Dose In 1 Carton (67386-130-51) / 1 Ml In 1 Vial, Single-Dose",81.82,32.73,,,0 NDC,67457016302,"Sotradecol: 5 Vial, Multi-Dose In 1 Carton (67457-163-02) / 2 Ml In 1 Vial, Multi-Dose (67457-163-00)",332.2,132.88,,,0 NDC,67457017750,"Rimso-50: 1 Vial, Glass In 1 Carton (67457-177-50) / 50 Ml In 1 Vial, Glass",2995.29,1198.12,,,0 NDC,67457018100,NDC Description Not Available,46.99,18.8,,,0 NDC,67457018200,NDC Description Not Available,3.15,1.26,,,0 NDC,67457018210,Esmolol Hydrochloride: 10 Vial In 1 Carton (67457-182-10) / 10 Ml In 1 Vial (67457-182-00),3.15,1.26,,,0 NDC,67457019501,"Melphalan Hydrochloride: 1 Kit In 1 Carton (67457-195-01) * 10 Ml In 1 Vial, Glass (67457-193-50) * 10 Ml In 1 Vial, Glass (67457-194-10)",705.17,282.07,,,0 NDC,67457019600,NDC Description Not Available,24.08,9.63,,,0 NDC,67457019602,"Thiamine Hydrochloride: 25 Vial, Multi-Dose In 1 Carton (67457-196-02) / 2 Ml In 1 Vial, Multi-Dose (67457-196-00)",10.01,4.0,,,0 NDC,67457019899,NDC Description Not Available,414.5,165.8,,,0 NDC,67457021202,"Argatroban: 1 Vial, Glass In 1 Carton (67457-212-02) / 2.5 Ml In 1 Vial, Glass",9.11,3.64,,,0 NDC,67457021720,"Methadone Hydrochloride: 1 Vial, Multi-Dose In 1 Carton (67457-217-20) / 20 Ml In 1 Vial, Multi-Dose",80.78,32.31,,,0 NDC,67457021810,Duraclon: 1 Vial In 1 Carton (67457-218-10) / 10 Ml In 1 Vial,156.25,62.5,,,0 NDC,67457022000,NDC Description Not Available,107.83,43.13,,,0 NDC,67457022005,"Isosulfan Blue: 6 Vial, Glass In 1 Carton (67457-220-05) / 5 Ml In 1 Vial, Glass (67457-220-00)",108.33,43.33,,,0 NDC,67457022810,"Rocuronium Bromide: 10 Vial, Multi-Dose In 1 Carton (67457-228-10) / 10 Ml In 1 Vial, Multi-Dose (67457-228-99)",30.8,12.32,,,0 NDC,67457025100,NDC Description Not Available,15.5,6.2,,,0 NDC,67457025600,NDC Description Not Available,1.01,0.4,,,0 NDC,67457026600,NDC Description Not Available,0.69,0.28,,,0 NDC,67457029200,NDC Description Not Available,11.49,4.6,,,0 NDC,67457034000,NDC Description Not Available,5.2,2.08,,,0 NDC,67457034001,Vancomycin Hydrochloride: 10 Vial In 1 Carton (67457-340-01) / 20 Ml In 1 Vial (67457-340-00),8.85,3.54,,,0 NDC,67457034815,"ampicillin sodium and sulbactam sodium: 1 VIAL in 1 CARTON (67457-348-15) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL",12.29,4.92,,,0 NDC,67457037412,NDC Description Not Available,2.58,1.03,,,0 NDC,67457039054,Zoledronic Acid: 1 Vial In 1 Carton (67457-390-54) / 5 Ml In 1 Vial,31.77,12.71,,,0 NDC,67457039910,NDC Description Not Available,1.26,0.5,,,0 NDC,67457040913,Haloperidol Decanoate: 5 Vial In 1 Carton (67457-409-13) / 1 Ml In 1 Vial (67457-409-00),18.06,7.22,,,0 NDC,67457041805,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (67457-418-05) / 5 Ml In 1 Vial (67457-418-00),0.11,0.04,,,0 NDC,67457041900,NDC Description Not Available,0.86,0.34,,,0 NDC,67457041901,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (67457-419-01) / 1 Ml In 1 Vial (67457-419-00),0.52,0.21,,,0 NDC,67457042100,NDC Description Not Available,0.34,0.14,,,0 NDC,67457042130,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (67457-421-30) / 30 Ml In 1 Vial (67457-421-00),0.12,0.05,,,0 NDC,67457042200,NDC Description Not Available,0.44,0.18,,,0 NDC,67457042254,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (67457-422-54) / 5 Ml In 1 Vial (67457-422-00),0.07,0.025,,,0 NDC,67457042300,NDC Description Not Available,0.87,0.35,,,0 NDC,67457042312,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (67457-423-12) / 1 Ml In 1 Vial (67457-423-00),0.495,0.195,,,0 NDC,67457042600,NDC Description Not Available,3.94,1.58,,,0 NDC,67457042612,Haloperidol Lactate: 25 Vial In 1 Carton (67457-426-12) / 1 Ml In 1 Vial (67457-426-00),3.94,1.58,,,0 NDC,67457042800,NDC Description Not Available,5.89,2.36,,,0 NDC,67457042830,Tobramycin: 10 Vial In 1 Carton (67457-428-30) / 30 Ml In 1 Vial (67457-428-00),6.09,2.44,,,0 NDC,67457043010,Pamidronate Disodium: 1 Vial In 1 Carton (67457-430-10) / 10 Ml In 1 Vial,39.7,15.88,,,0 NDC,67457043300,NDC Description Not Available,1.14,0.455,,,0 NDC,67457043322,Famotidine: 25 Vial In 1 Carton (67457-433-22) / 2 Ml In 1 Vial (67457-433-00),0.9400000000000001,0.375,,,0 NDC,67457043700,NDC Description Not Available,0.72,0.29,,,0 NDC,67457044220,Oxaliplatin: 1 Vial In 1 Carton (67457-442-20) / 20 Ml In 1 Vial,0.97,0.39,,,0 NDC,67457044560,Rifampin: 1 Vial In 1 Carton (67457-445-60) / 10 Ml In 1 Vial,344.195,137.675,,,0 NDC,67457044610,Pamidronate Disodium: 1 Vial In 1 Carton (67457-446-10) / 10 Ml In 1 Vial,171.8,68.72,,,0 NDC,67457045220,Cytarabine: 1 VIAL in 1 CARTON (67457-452-20) / 20 mL in 1 VIAL,1.69,0.68,,,0 NDC,67457045700,NDC Description Not Available,0.05,0.02,,,0 NDC,67457047300,NDC Description Not Available,8.79,3.52,,,0 NDC,67457047322,Tobramycin: 25 Vial In 1 Carton (67457-473-22) / 2 Ml In 1 Vial (67457-473-00),3.58,1.43,,,0 NDC,67457051701,"Fosphenytoin Sodium: 10 VIAL, SINGLE-DOSE in 1 CARTON (67457-517-01) / 10 mL in 1 VIAL, SINGLE-DOSE (67457-517-00)",6.0,2.4,,,0 NDC,67457052200,NDC Description Not Available,4.1,1.64,,,0 NDC,67457052237,"piperacillin and tazobactam: 10 VIAL, SINGLE-USE in 1 CARTON (67457-522-37) / 15 mL in 1 VIAL, SINGLE-USE (67457-522-00)",4.57,1.83,,,0 NDC,67457052433,"Ibandronate Sodium: 1 Syringe, Glass In 1 Carton (67457-524-33) / 3 Ml In 1 Syringe, Glass",332.58,133.03,,,0 NDC,67457052810,"Leucovorin Calcium: 1 Vial, Single-Dose In 1 Carton (67457-528-10) / 10 Ml In 1 Vial, Single-Dose",19.22,7.69,,,0 NDC,67457052920,"Leucovorin Calcium: 1 Vial, Single-Dose In 1 Carton (67457-529-20) / 20 Ml In 1 Vial, Single-Dose",42.56,17.02,,,0 NDC,67457053035,"Leucovorin Calcium: 1 Vial, Single-Dose In 1 Carton (67457-530-35) / 17.5 Ml In 1 Vial, Single-Dose",11.73,4.69,,,0 NDC,67457053316,"Docetaxel: 1 Vial, Multi-Dose In 1 Carton (67457-533-16) / 16 Ml In 1 Vial, Multi-Dose",13.06,5.22,,,0 NDC,67457055300,Magnesium Sulfate: 1 Bag In 1 Pouch (67457-553-00) / 50 Ml In 1 Bag,3.68,1.47,,,0 NDC,67457058200,NDC Description Not Available,8.63,3.45,,,0 NDC,67457058300,NDC Description Not Available,13.2,5.28,,,0 NDC,67457058810,Epoprostenol: 1 Vial In 1 Carton (67457-588-10) / 10 Ml In 1 Vial,55.01,22.0,,,0 NDC,67457060305,NDC Description Not Available,0.98,0.39,,,0 NDC,67457062205,"Triamcinolone Acetonide: 1 Vial, Multi-Dose In 1 Carton (67457-622-05) / 5 Ml In 1 Vial, Multi-Dose",9.93,3.97,,,0 NDC,67457062910,Eptifibatide: 1 Vial In 1 Carton (67457-629-10) / 10 Ml In 1 Vial,33.75,13.5,,,0 NDC,67457063110,Eptifibatide: 1 Vial In 1 Carton (67457-631-10) / 100 Ml In 1 Vial,31.09,12.44,,,0 NDC,67457064000,NDC Description Not Available,23.61,9.44,,,0 NDC,67457066520,"Posaconazole: 1 Vial, Glass In 1 Carton (67457-665-20) / 16.7 Ml In 1 Vial, Glass",2171.78,868.71,,,0 NDC,67457077930,"Sulfamethoxazole And Trimethoprim: 1 Vial, Multi-Dose In 1 Carton (67457-779-30) / 30 Ml In 1 Vial, Multi-Dose",64.73,25.89,,,0 NDC,67457079920,NDC Description Not Available,0.92,0.37,,,0 NDC,67457079999,Ropivacaine Hydrochloride: 10 Pouch In 1 Carton (67457-799-99) / 1 Bag In 1 Pouch (67457-799-20) / 200 Ml In 1 Bag,0.37,0.15,,,0 NDC,67457085200,NDC Description Not Available,2.6,1.04,,,0 NDC,67457085204,"Norepinephrine Bitartrate: 10 Vial, Single-Dose In 1 Carton (67457-852-04) / 4 Ml In 1 Vial, Single-Dose (67457-852-00)",0.39,0.16,,,0 NDC,67457085350,Acetazolamide: 1 Vial In 1 Carton (67457-853-50) / 5 Ml In 1 Vial,178.61,71.44,,,0 NDC,67457085500,NDC Description Not Available,4.87,1.95,,,0 NDC,67457085502,"Adenosine: 10 Vial, Single-Dose In 1 Carton (67457-855-02) / 2 Ml In 1 Vial, Single-Dose (67457-855-00)",4.71,1.88,,,0 NDC,67457085730,Adenosine: 1 Vial In 1 Carton (67457-857-30) / 30 Ml In 1 Vial,9.57,3.83,,,0 NDC,67457086301,Granisetron Hydrochloride: 1 Vial In 1 Carton (67457-863-01) / 1 Ml In 1 Vial,4.39,1.76,,,0 NDC,67457086404,Granisetron Hydrochloride: 1 Vial In 1 Carton (67457-864-04) / 1 Ml In 1 Vial,2.8,1.12,,,0 NDC,67457088700,NDC Description Not Available,1.09,0.44,,,0 NDC,67457088799,Medroxyprogesterone Acetate: 1 Vial In 1 Carton (67457-887-99) / 1 Ml In 1 Vial (67457-887-00),0.25,0.1,,,0 NDC,67457090210,Etomidate: 10 Vial In 1 Carton (67457-902-10) / 10 Ml In 1 Vial (67457-902-00),10.72,4.29,,,0 NDC,67457092400,NDC Description Not Available,201.49,80.6,,,0 NDC,67457092500,NDC Description Not Available,126.96,50.78,,,0 NDC,67618011128,"Colace: 1 Bottle In 1 Carton (67618-111-28) / 28 Capsule, Liquid Filled In 1 Bottle",0.78,0.31,,,0 NDC,67618030010,"Senokot: 1 Bottle, Plastic In 1 Carton (67618-300-10) / 100 Tablet In 1 Bottle, Plastic",0.33,0.13,,,0 NDC,67684190102,Lipiodol: 1 Vial In 1 Carton (67684-1901-2) / 10 Ml In 1 Vial,5346.865,2138.745,,,0 NDC,67684200101,Dotarem: 10 Vial In 1 Package (67684-2001-1) / 10 Ml In 1 Vial,1.47,0.59,,,0 NDC,67684200102,Dotarem: 10 Vial In 1 Package (67684-2001-2) / 15 Ml In 1 Vial,1.25,0.5,,,0 NDC,67684200103,Dotarem: 10 Vial In 1 Package (67684-2001-3) / 20 Ml In 1 Vial,0.68,0.27,,,0 NDC,67684423002,Elucirem: 10 Vial In 1 Carton (67684-4230-2) / 3 Ml In 1 Vial,90.65,36.26,,,0 NDC,67684423102,Elucirem: 10 Vial In 1 Carton (67684-4231-2) / 7.5 Ml In 1 Vial,72.54,29.02,,,0 NDC,67684423202,Elucirem: 10 Vial In 1 Carton (67684-4232-2) / 10 Ml In 1 Vial,81.06,32.42,,,0 NDC,67777022007,Bacitracin Zinc: 425.3 g in 1 JAR (67777-220-07),51.0,20.4,,,0 NDC,67777025101,NDC Description Not Available,1.03,0.41,,,0 NDC,67850002200,NDC Description Not Available,5.38,2.15,,,0 NDC,67850003200,NDC Description Not Available,8.86,3.54,,,0 NDC,67850014100,NDC Description Not Available,99.44,39.78,,,0 NDC,67850014105,Asclera: 2 Ml In 1 Ampule (67850-141-05),14.62,5.85,,,0 NDC,67850015000,NDC Description Not Available,8.32,3.33,,,0 NDC,67850015025,"Pantoprazole Sodium: 25 Vial, Glass In 1 Carton (67850-150-25) / 10 Ml In 1 Vial, Glass (67850-150-00)",8.99,3.6,,,0 NDC,67871479006,NDC Description Not Available,1763.38,705.35,,,0 NDC,67877012440,Silver Sulfadiazine: 400 G In 1 Jar (67877-124-40),157.64,63.06,,,0 NDC,67877012450,Silver Sulfadiazine: 50 G In 1 Jar (67877-124-50),27.89,11.16,,,0 NDC,67877019890,Amlodipine Besylate: 90 Tablet In 1 Bottle (67877-198-90),0.09,0.04,,,0 NDC,67877022301,Gabapentin: 100 Capsule In 1 Bottle (67877-223-01),0.2,0.08,,,0 NDC,67877022401,Gabapentin: 100 Capsule In 1 Bottle (67877-224-01),0.19,0.08,,,0 NDC,67877023022,"Mycophenolate Mofetil: 1 Bottle, Plastic In 1 Carton (67877-230-22) / 225 Ml In 1 Bottle, Plastic",38.77,15.51,,,0 NDC,67877025115,Triamcinolone Acetonide: 15 G In 1 Tube (67877-251-15),7.8,3.12,,,0 NDC,67877025145,Triamcinolone Acetonide: 454 G In 1 Jar (67877-251-45),68.01,27.2,,,0 NDC,67877025180,Triamcinolone Acetonide: 80 G In 1 Tube (67877-251-80),14.36,5.74,,,0 NDC,67877026030,Rasagiline: 30 Tablet In 1 Bottle (67877-260-30),28.46,11.38,,,0 NDC,67877026601,Mycophenolate Mofetil: 100 Capsule In 1 Bottle (67877-266-01),0.7,0.28,,,0 NDC,67877027690,Clopidogrel: 90 Tablet In 1 Bottle (67877-276-90),0.18,0.07,,,0 NDC,67877031901,"Ibuprofen: 100 Tablet, Film Coated In 1 Bottle (67877-319-01)",0.22,0.09,,,0 NDC,67877031905,"Ibuprofen: 500 Tablet, Film Coated In 1 Bottle (67877-319-05)",0.2,0.08,,,0 NDC,67877032001,"Ibuprofen: 100 Tablet, Film Coated In 1 Bottle (67877-320-01)",0.27,0.11,,,0 NDC,67877041920,"Linezolid: 20 Tablet, Film Coated In 1 Bottle (67877-419-20)",8.25,3.3,,,0 NDC,67877041933,"Linezolid: 1 Blister Pack In 1 Carton (67877-419-33) / 10 Tablet, Film Coated In 1 Blister Pack",10.5,4.2,,,0 NDC,67877043103,Aripiprazole: 30 Tablet In 1 Bottle (67877-431-03),0.65,0.26,,,0 NDC,67877045912,"Capecitabine: 120 Tablet, Film Coated In 1 Bottle (67877-459-12)",1.05,0.42,,,0 NDC,67877046390,Pregabalin: 90 Capsule In 1 Bottle (67877-463-90),0.33,0.13,,,0 NDC,67877049030,Ezetimibe: 30 Tablet In 1 Bottle (67877-490-30),0.7,0.28,,,0 NDC,67877049160,Ticagrelor: 60 Tablet In 1 Bottle (67877-491-60),2.38,0.95,,,0 NDC,67877052560,"Ranolazine: 60 Tablet, Film Coated, Extended Release In 1 Bottle (67877-525-60)",0.88,0.35,,,0 NDC,67877054568,Cephalexin: 200 Ml In 1 Bottle (67877-545-68),2.57,1.03,,,0 NDC,67877054788,Cefdinir: 100 Ml In 1 Bottle (67877-547-88),2.71,1.08,,,0 NDC,67877056105,Metformin Hcl: 500 Tablet In 1 Bottle (67877-561-05),0.12,0.05,,,0 NDC,67877058901,Colchicine: 100 Tablet In 1 Bottle (67877-589-01),0.57,0.23,,,0 NDC,67877063830,"Lurasidone Hydrochloride: 30 Tablet, Film Coated In 1 Bottle (67877-638-30)",1.13,0.45,,,0 NDC,67877064130,"Lurasidone Hydrochloride: 30 Tablet, Film Coated In 1 Bottle (67877-641-30)",2.76,1.1,,,0 NDC,67877065861,Clobazam: 1 Bottle In 1 Carton (67877-658-61) / 120 Ml In 1 Bottle,3.52,1.41,,,0 NDC,67877067001,Morphine Sulfate: 100 Tablet In 1 Bottle (67877-670-01),0.91,0.36,,,0 NDC,67877067362,Rufinamide: 1 Bottle In 1 Carton (67877-673-62) / 460 Ml In 1 Bottle,44.23,17.69,,,0 NDC,67877071831,Everolimus: 6 Blister Pack In 1 Carton (67877-718-31) / 10 Tablet In 1 Blister Pack (67877-718-33),17.96,7.18,,,0 NDC,67877071833,NDC Description Not Available,12.72,5.09,,,0 NDC,67877071931,Everolimus: 6 Blister Pack In 1 Carton (67877-719-31) / 10 Tablet In 1 Blister Pack (67877-719-33),12.42,4.97,,,0 NDC,67877071933,NDC Description Not Available,13.99,5.6,,,0 NDC,67877073295,Lacosamide Oral Solution: 200 Ml In 1 Bottle (67877-732-95),9.21,3.68,,,0 NDC,67877073360,"Lacosamide: 60 Tablet, Film Coated In 1 Bottle (67877-733-60)",0.32,0.13,,,0 NDC,67877074957,"Fosfomycin Tromethamine: 1 Packet In 1 Carton (67877-749-57) / 1 Granule, For Solution In 1 Packet",254.8,101.92,,,0 NDC,67877075360,Dronabinol: 60 Capsule In 1 Bottle (67877-753-60),5.58,2.23,,,0 NDC,67877075460,Dronabinol: 60 Capsule In 1 Bottle (67877-754-60),4.37,1.75,,,0 NDC,67877084210,"Famotidine: 1000 Tablet, Film Coated In 1 Bottle (67877-842-10)",0.17,0.07,,,0 NDC,67919003001,"Zerbaxa: 10 Vial, Single-Dose In 1 Carton (67919-030-01) / 10 Ml In 1 Vial, Single-Dose",36.3,14.52,,,0 NDC,67919004105,"Sivextro: 1 Blister Pack In 1 Carton (67919-041-05) / 6 Tablet, Film Coated In 1 Blister Pack",2000.95,800.38,,,0 NDC,67919004199,NDC Description Not Available,1304.97,521.99,,,0 NDC,67979000201,"Supprelin La: 1 Vial, Glass In 1 Carton (67979-002-01) / 1 Implant In 1 Vial, Glass",190924.26,76369.7,,,0 NDC,68001043616,Cetirizine Hydrochloride (Allergy): 10 Tablet In 1 Blister Pack (68001-436-16),0.41,0.16,,,0 NDC,68084002711,NDC Description Not Available,0.98,0.39,,,0 NDC,68084004001,"Misoprostol: 100 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-040-01) / 1 TABLET in 1 BLISTER PACK (68084-040-11)",4.39,1.76,,,0 NDC,68084004011,NDC Description Not Available,2.02,0.81,,,0 NDC,68084004411,NDC Description Not Available,2.61,1.04,,,0 NDC,68084007001,"Ciprofloxacin: 100 Blister Pack In 1 Box, Unit-Dose (68084-070-01) / 1 Tablet, Film Coated In 1 Blister Pack (68084-070-11)",1.51,0.6,,,0 NDC,68084007011,NDC Description Not Available,0.95,0.38,,,0 NDC,68084008211,NDC Description Not Available,2.54,1.02,,,0 NDC,68084008311,NDC Description Not Available,3.02,1.21,,,0 NDC,68084009711,NDC Description Not Available,1.58,0.63,,,0 NDC,68084009911,NDC Description Not Available,1.78,0.71,,,0 NDC,68084010801,"Acyclovir: 100 Blister Pack In 1 Box, Unit-Dose (68084-108-01) / 1 Tablet In 1 Blister Pack (68084-108-11)",1.15,0.46,,,0 NDC,68084010811,NDC Description Not Available,1.06,0.42,,,0 NDC,68084010901,"Acyclovir: 100 Blister Pack In 1 Box, Unit-Dose (68084-109-01) / 1 Tablet In 1 Blister Pack (68084-109-11)",3.69,1.48,,,0 NDC,68084010911,NDC Description Not Available,2.67,1.07,,,0 NDC,68084011111,NDC Description Not Available,2.44,0.98,,,0 NDC,68084012001,"Mirtazapine: 100 Blister Pack In 1 Box, Unit-Dose (68084-120-01) / 1 Tablet, Film Coated In 1 Blister Pack (68084-120-11)",1.0,0.4,,,0 NDC,68084012011,NDC Description Not Available,1.27,0.51,,,0 NDC,68084012801,"Omeprazole: 100 Blister Pack In 1 Box, Unit-Dose (68084-128-01) / 1 Capsule, Delayed Release In 1 Blister Pack (68084-128-11)",0.51,0.2,,,0 NDC,68084012811,NDC Description Not Available,0.76,0.3,,,0 NDC,68084014901,"Methylprednisolone: 100 Blister Pack In 1 Box, Unit-Dose (68084-149-01) / 1 Tablet In 1 Blister Pack (68084-149-11)",6.76,2.7,,,0 NDC,68084014911,NDC Description Not Available,7.15,2.86,,,0 NDC,68084015511,NDC Description Not Available,0.64,0.26,,,0 NDC,68084018901,"Zolpidem Tartrate: 100 Blister Pack In 1 Box, Unit-Dose (68084-189-01) / 1 Tablet, Coated In 1 Blister Pack (68084-189-11)",0.52,0.21,,,0 NDC,68084018911,NDC Description Not Available,0.5,0.2,,,0 NDC,68084020201,"Primidone: 100 Blister Pack In 1 Box, Unit-Dose (68084-202-01) / 1 Tablet In 1 Blister Pack (68084-202-11)",3.4,1.36,,,0 NDC,68084020211,NDC Description Not Available,2.39,0.96,,,0 NDC,68084020411,NDC Description Not Available,1.5,0.6,,,0 NDC,68084020501,"Minoxidil: 100 Blister Pack In 1 Box, Unit-Dose (68084-205-01) / 1 Tablet In 1 Blister Pack (68084-205-11)",2.37,0.95,,,0 NDC,68084020511,NDC Description Not Available,1.97,0.79,,,0 NDC,68084021401,Benzonatate: 10 Blister Pack In 1 Carton (68084-214-01) / 10 Capsule In 1 Blister Pack (68084-214-11),1.79,0.72,,,0 NDC,68084021411,NDC Description Not Available,1.44,0.58,,,0 NDC,68084021501,"Valacyclovir Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (68084-215-01) / 1 Tablet, Film Coated In 1 Blister Pack (68084-215-11)",6.51,2.6,,,0 NDC,68084021511,NDC Description Not Available,10.75,4.3,,,0 NDC,68084022011,NDC Description Not Available,1.53,0.61,,,0 NDC,68084022901,Azathioprine: 100 Blister Pack In 1 Carton (68084-229-01) / 1 Tablet In 1 Blister Pack (68084-229-11),2.57,1.03,,,0 NDC,68084022911,NDC Description Not Available,1.89,0.76,,,0 NDC,68084024311,NDC Description Not Available,1.33,0.53,,,0 NDC,68084027301,"Risperidone: 100 Blister Pack In 1 Box, Unit-Dose (68084-273-01) / 1 Tablet, Film Coated In 1 Blister Pack (68084-273-11)",1.28,0.51,,,0 NDC,68084027311,NDC Description Not Available,1.48,0.59,,,0 NDC,68084028001,"Ethambutol Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (68084-280-01) / 1 Tablet In 1 Blister Pack (68084-280-11)",2.61,1.04,,,0 NDC,68084028011,NDC Description Not Available,2.53,1.01,,,0 NDC,68084028111,NDC Description Not Available,2.31,0.92,,,0 NDC,68084028211,NDC Description Not Available,2.05,0.82,,,0 NDC,68084028411,NDC Description Not Available,3.58,1.43,,,0 NDC,68084028801,"Fludrocortisone Acetate: 100 Blister Pack In 1 Box, Unit-Dose (68084-288-01) / 1 Tablet In 1 Blister Pack (68084-288-11)",2.52,1.01,,,0 NDC,68084028811,NDC Description Not Available,2.34,0.94,,,0 NDC,68084029111,NDC Description Not Available,5.8,2.32,,,0 NDC,68084029121,"Naltrexone Hydrochloride: 30 Blister Pack In 1 Box, Unit-Dose (68084-291-21) / 1 Tablet, Film Coated In 1 Blister Pack (68084-291-11)",5.11,2.04,,,0 NDC,68084029911,NDC Description Not Available,1.07,0.43,,,0 NDC,68084030011,NDC Description Not Available,5.98,2.39,,,0 NDC,68084030021,"Dantrolene Sodium: 30 Blister Pack In 1 Box, Unit-Dose (68084-300-21) / 1 Capsule In 1 Blister Pack (68084-300-11)",6.61,2.64,,,0 NDC,68084031001,"Divalproex Sodium: 100 Blister Pack In 1 Box, Unit-Dose (68084-310-01) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack (68084-310-11)",4.39,1.76,,,0 NDC,68084031011,NDC Description Not Available,5.06,2.02,,,0 NDC,68084031301,"Divalproex Sodium: 100 Blister Pack In 1 Box, Unit-Dose (68084-313-01) / 1 Capsule, Coated Pellets In 1 Blister Pack (68084-313-11)",3.4,1.36,,,0 NDC,68084031311,NDC Description Not Available,2.27,0.91,,,0 NDC,68084031801,"Lamotrigine: 100 Blister Pack In 1 Box, Unit-Dose (68084-318-01) / 1 Tablet In 1 Blister Pack (68084-318-11)",0.57,0.23,,,0 NDC,68084031811,NDC Description Not Available,0.6,0.24,,,0 NDC,68084031911,NDC Description Not Available,0.55,0.22,,,0 NDC,68084032611,NDC Description Not Available,2.04,0.82,,,0 NDC,68084034201,"Topiramate: 100 Blister Pack In 1 Box, Unit-Dose (68084-342-01) / 1 Tablet, Film Coated In 1 Blister Pack (68084-342-11)",0.92,0.37,,,0 NDC,68084034211,NDC Description Not Available,0.91,0.36,,,0 NDC,68084034401,"Topiramate: 100 Blister Pack In 1 Box, Unit-Dose (68084-344-01) / 1 Tablet, Film Coated In 1 Blister Pack (68084-344-11)",1.46,0.58,,,0 NDC,68084034411,NDC Description Not Available,1.42,0.57,,,0 NDC,68084034601,"Losartan Potassium: 100 Blister Pack In 1 Box, Unit-Dose (68084-346-01) / 1 Tablet, Film Coated In 1 Blister Pack (68084-346-11)",1.59,0.64,,,0 NDC,68084034611,NDC Description Not Available,1.64,0.66,,,0 NDC,68084034701,"Losartan Potassium: 100 Blister Pack In 1 Box, Unit-Dose (68084-347-01) / 1 Tablet, Film Coated In 1 Blister Pack (68084-347-11)",1.74,0.7,,,0 NDC,68084034711,NDC Description Not Available,2.0,0.8,,,0 NDC,68084035401,Oxycodone Hydrochloride: 100 Blister Pack In 1 Carton (68084-354-01) / 1 Tablet In 1 Blister Pack (68084-354-11),1.9,0.76,,,0 NDC,68084035411,NDC Description Not Available,1.78,0.71,,,0 NDC,68084037601,"Extended Phenytoin Sodium: 100 Blister Pack In 1 Box, Unit-Dose (68084-376-01) / 1 Capsule In 1 Blister Pack (68084-376-11)",2.2,0.88,,,0 NDC,68084038101,"Benztropine Mesylate: 100 Blister Pack In 1 Box, Unit-Dose (68084-381-01) / 1 Tablet In 1 Blister Pack (68084-381-11)",1.39,0.56,,,0 NDC,68084038111,NDC Description Not Available,1.48,0.59,,,0 NDC,68084038801,"Benztropine Mesylate: 100 Blister Pack In 1 Box, Unit-Dose (68084-388-01) / 1 Tablet In 1 Blister Pack (68084-388-11)",1.45,0.58,,,0 NDC,68084038811,NDC Description Not Available,1.34,0.54,,,0 NDC,68084038911,NDC Description Not Available,1.63,0.65,,,0 NDC,68084041501,"Divalproex Sodium: 100 Blister Pack In 1 Box, Unit-Dose (68084-415-01) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack (68084-415-11)",6.66,2.66,,,0 NDC,68084041511,NDC Description Not Available,6.59,2.64,,,0 NDC,68084044411,NDC Description Not Available,1.62,0.65,,,0 NDC,68084044711,NDC Description Not Available,0.74,0.3,,,0 NDC,68084044911,NDC Description Not Available,8.56,3.42,,,0 NDC,68084045011,NDC Description Not Available,4.94,1.98,,,0 NDC,68084045111,NDC Description Not Available,6.65,2.66,,,0 NDC,68084047911,NDC Description Not Available,2.88,1.15,,,0 NDC,68084048001,"Oxybutynin Chloride Extended Release: 100 Blister Pack In 1 Box, Unit-Dose (68084-480-01) / 1 Tablet, Extended Release In 1 Blister Pack (68084-480-11)",6.07,2.43,,,0 NDC,68084048011,NDC Description Not Available,9.25,3.7,,,0 NDC,68084049401,"Pyridostigmine Bromide: 100 Blister Pack In 1 Box, Unit-Dose (68084-494-01) / 1 Tablet In 1 Blister Pack (68084-494-11)",3.76,1.5,,,0 NDC,68084053611,NDC Description Not Available,0.66,0.26,,,0 NDC,68084053901,Torsemide: 100 Blister Pack In 1 Carton (68084-539-01) / 1 Tablet In 1 Blister Pack (68084-539-11),1.09,0.44,,,0 NDC,68084053911,NDC Description Not Available,1.05,0.42,,,0 NDC,68084057201,"Mucinex: 100 Blister Pack In 1 Box, Unit-Dose (68084-572-01) / 1 Tablet, Extended Release In 1 Blister Pack (68084-572-11)",2.51,1.0,,,0 NDC,68084057211,NDC Description Not Available,2.59,1.04,,,0 NDC,68084059711,NDC Description Not Available,3.42,1.37,,,0 NDC,68084059801,"Nifedipine: 100 Blister Pack In 1 Box, Unit-Dose (68084-598-01) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack (68084-598-11)",7.52,3.01,,,0 NDC,68084059811,NDC Description Not Available,7.55,3.02,,,0 NDC,68084060311,NDC Description Not Available,9.44,3.78,,,0 NDC,68084060421,"Desmopressin Acetate: 30 BLISTER PACK in 1 BOX, UNIT-DOSE (68084-604-21) / 1 TABLET in 1 BLISTER PACK (68084-604-11)",4.4,1.76,,,0 NDC,68084061811,NDC Description Not Available,1.01,0.4,,,0 NDC,68084064001,"Lithium Carbonate: 100 Blister Pack In 1 Box, Unit-Dose (68084-640-01) / 1 Tablet, Extended Release In 1 Blister Pack (68084-640-11)",1.44,0.58,,,0 NDC,68084064011,NDC Description Not Available,1.09,0.44,,,0 NDC,68084064501,"Tizanidine: 100 Blister Pack In 1 Box, Unit-Dose (68084-645-01) / 1 Tablet In 1 Blister Pack (68084-645-11)",1.56,0.62,,,0 NDC,68084064511,NDC Description Not Available,1.79,0.72,,,0 NDC,68084065501,"Lithium Carbonate: 100 Blister Pack In 1 Box, Unit-Dose (68084-655-01) / 1 Tablet, Extended Release In 1 Blister Pack (68084-655-11)",1.17,0.47,,,0 NDC,68084065511,NDC Description Not Available,1.3,0.52,,,0 NDC,68084069701,"Bupropion Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (68084-697-01) / 1 Tablet, Film Coated, Extended Release In 1 Blister Pack (68084-697-11)",2.48,0.99,,,0 NDC,68084069711,NDC Description Not Available,2.38,0.95,,,0 NDC,68084069801,"Venlafaxine Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (68084-698-01) / 1 Capsule, Extended Release In 1 Blister Pack (68084-698-11)",2.05,0.82,,,0 NDC,68084069811,NDC Description Not Available,1.44,0.58,,,0 NDC,68084070901,"Venlafaxine Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (68084-709-01) / 1 Capsule, Extended Release In 1 Blister Pack (68084-709-11)",1.66,0.66,,,0 NDC,68084070911,NDC Description Not Available,1.66,0.66,,,0 NDC,68084073501,"Fluconazole: 100 Blister Pack In 1 Box, Unit-Dose (68084-735-01) / 1 Tablet In 1 Blister Pack (68084-735-11)",8.22,3.29,,,0 NDC,68084073511,NDC Description Not Available,8.77,3.51,,,0 NDC,68084075025,"Triamterene And Hydrochlorothiazide: 30 Blister Pack In 1 Box, Unit-Dose (68084-750-25) / 1 Tablet In 1 Blister Pack (68084-750-95)",3.51,1.4,,,0 NDC,68084075095,NDC Description Not Available,2.29,0.92,,,0 NDC,68084075325,"Cyclobenzaprine Hydrochloride: 30 Blister Pack In 1 Box, Unit-Dose (68084-753-25) / 1 Tablet, Film Coated In 1 Blister Pack (68084-753-95)",2.07,0.83,,,0 NDC,68084075395,NDC Description Not Available,1.43,0.57,,,0 NDC,68084077601,"Divalproex Sodium: 100 Blister Pack In 1 Box, Unit-Dose (68084-776-01) / 1 Tablet, Delayed Release In 1 Blister Pack (68084-776-11)",0.67,0.27,,,0 NDC,68084078211,NDC Description Not Available,0.9,0.36,,,0 NDC,68084080511,NDC Description Not Available,5.52,2.21,,,0 NDC,68084080521,"Methylphenidate Hydrochloride: 30 Blister Pack In 1 Box, Unit-Dose (68084-805-21) / 1 Tablet In 1 Blister Pack (68084-805-11)",4.38,1.75,,,0 NDC,68084080801,"Tramadol Hydrochloride: 100 Blister Pack In 1 Box, Unit-Dose (68084-808-01) / 1 Tablet, Coated In 1 Blister Pack (68084-808-11)",0.57,0.23,,,0 NDC,68084080811,NDC Description Not Available,0.55,0.22,,,0 NDC,68084082311,NDC Description Not Available,3.83,1.53,,,0 NDC,68084082321,"Methylphenidate Hydrochloride: 30 Blister Pack In 1 Box, Unit-Dose (68084-823-21) / 1 Tablet In 1 Blister Pack (68084-823-11)",6.22,2.49,,,0 NDC,68084083625,"Doxazosin: 30 Blister Pack In 1 Box, Unit-Dose (68084-836-25) / 1 Tablet In 1 Blister Pack (68084-836-95)",2.58,1.03,,,0 NDC,68084083695,NDC Description Not Available,2.47,0.99,,,0 NDC,68084084411,NDC Description Not Available,2.56,1.02,,,0 NDC,68084084701,"Hydroxyzine Pamoate: 100 Blister Pack In 1 Box, Unit-Dose (68084-847-01) / 1 Capsule In 1 Blister Pack (68084-847-11)",1.58,0.63,,,0 NDC,68084084711,NDC Description Not Available,2.14,0.86,,,0 NDC,68084085311,NDC Description Not Available,2.88,1.15,,,0 NDC,68084085401,"Carvedilol: 100 Blister Pack In 1 Box, Unit-Dose (68084-854-01) / 1 Tablet, Film Coated In 1 Blister Pack (68084-854-11)",0.36,0.14,,,0 NDC,68084085411,NDC Description Not Available,0.28,0.11,,,0 NDC,68084085601,"Venlafaxine: 100 Blister Pack In 1 Box, Unit-Dose (68084-856-01) / 1 Tablet In 1 Blister Pack (68084-856-11)",2.25,0.9,,,0 NDC,68084085611,NDC Description Not Available,2.46,0.98,,,0 NDC,68084085911,NDC Description Not Available,0.76,0.3,,,0 NDC,68084086201,"Doxazosin: 100 Blister Pack In 1 Box, Unit-Dose (68084-862-01) / 1 Tablet In 1 Blister Pack (68084-862-11)",2.63,1.05,,,0 NDC,68084086211,NDC Description Not Available,2.56,1.02,,,0 NDC,68084089625,"Venlafaxine: 30 Blister Pack In 1 Box, Unit-Dose (68084-896-25) / 1 Tablet In 1 Blister Pack (68084-896-95)",3.6,1.44,,,0 NDC,68084089695,NDC Description Not Available,2.66,1.06,,,0 NDC,68084090711,NDC Description Not Available,15.65,6.26,,,0 NDC,68084090721,"Mycophenolic Acid: 30 Blister Pack In 1 Box, Unit-Dose (68084-907-21) / 1 Tablet, Delayed Release In 1 Blister Pack (68084-907-11)",15.21,6.08,,,0 NDC,68084091595,NDC Description Not Available,39.87,15.95,,,0 NDC,68084092825,"Pilocarpine Hydrochloride: 30 Blister Pack In 1 Box, Unit-Dose (68084-928-25) / 1 Tablet, Film Coated In 1 Blister Pack (68084-928-95)",9.81,3.92,,,0 NDC,68084092895,NDC Description Not Available,6.56,2.62,,,0 NDC,68084096495,NDC Description Not Available,8.09,3.24,,,0 NDC,68084096595,NDC Description Not Available,68.7,27.48,,,0 NDC,68084096801,Oxycodone Hydrochloride: 100 Blister Pack In 1 Carton (68084-968-01) / 1 Tablet In 1 Blister Pack (68084-968-11),1.99,0.8,,,0 NDC,68084096811,NDC Description Not Available,1.9,0.76,,,0 NDC,68084098832,"Antacid Peppermint Flavour Regular Strength: 20 Blister Pack In 1 Box, Unit-Dose (68084-988-32) / 1 Tablet, Chewable In 1 Blister Pack (68084-988-33)",1.33,0.53,,,0 NDC,68084098833,NDC Description Not Available,2.2,0.88,,,0 NDC,68084099611,NDC Description Not Available,4.53,1.81,,,0 NDC,68094000159,NDC Description Not Available,2.16,0.86,,,0 NDC,68094000162,"Morphine Sulfate: 3 Tray In 1 Case (68094-001-62) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (68094-001-59)",0.52,0.21,,,0 NDC,68094000459,NDC Description Not Available,8.27,3.31,,,0 NDC,68094000462,"Dye Free Childrens Cetirizine Hydrocholride: 3 Tray In 1 Case (68094-004-62) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (68094-004-59)",4.11,1.64,,,0 NDC,68094001559,NDC Description Not Available,3.5,1.4,,,0 NDC,68094001859,NDC Description Not Available,0.64,0.26,,,0 NDC,68094001861,Diphenhydramine Hydrochloride: 10 Blister Pack In 1 Carton (68094-018-61) / 10 Tablet In 1 Blister Pack (68094-018-59),0.63,0.25,,,0 NDC,68094002459,NDC Description Not Available,8.24,3.3,,,0 NDC,68094003062,"Acetaminophen: 3 Tray In 1 Case (68094-030-62) / 10 Cup, Unit-Dose In 1 Tray / 20.3 Ml In 1 Cup, Unit-Dose (68094-030-59)",7.76,3.1,,,0 NDC,68094003159,NDC Description Not Available,1.98,0.79,,,0 NDC,68094003162,"Methadone Hydrochloride: 3 Tray In 1 Case (68094-031-62) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (68094-031-59)",2.25,0.9,,,0 NDC,68094003464,"Sevelamer Carbonate: 9 Blister Pack In 1 Carton (68094-034-64) / 10 Tablet, Film Coated In 1 Blister Pack (68094-034-59)",8.2,3.28,,,0 NDC,68094004159,NDC Description Not Available,16.17,6.47,,,0 NDC,68094005459,NDC Description Not Available,0.41,0.16,,,0 NDC,68094006159,NDC Description Not Available,3.88,1.55,,,0 NDC,68094011259,NDC Description Not Available,0.48,0.19,,,0 NDC,68094011359,NDC Description Not Available,0.55,0.22,,,0 NDC,68094011659,NDC Description Not Available,0.5,0.2,,,0 NDC,68094012959,NDC Description Not Available,9.01,3.6,,,0 NDC,68094012962,"Loperamide Hydrochloride: 3 Tray In 1 Case (68094-129-62) / 10 Cup, Unit-Dose In 1 Tray / 15 Ml In 1 Cup, Unit-Dose (68094-129-59)",4.53,1.81,,,0 NDC,68094014720,Dexmedetomidine Hydrochloride In Sodium Chloride: 20 Bottle In 1 Carton (68094-147-20) / 50 Ml In 1 Bottle (68094-147-01),11.39,4.56,,,0 NDC,68094019361,"Valproic Acid: 10 TRAY in 1 CASE (68094-193-61) / 10 CUP, UNIT-DOSE in 1 TRAY / 5 mL in 1 CUP, UNIT-DOSE (68094-193-59)",1.96,0.78,,,0 NDC,68094023159,NDC Description Not Available,2.24,0.9,,,0 NDC,68094023161,"Acetaminophen: 10 Tray In 1 Case (68094-231-61) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (68094-231-59)",1.52,0.61,,,0 NDC,68094023162,"Acetaminophen: 3 Tray In 1 Case (68094-231-62) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (68094-231-59)",0.7,0.28,,,0 NDC,68094024701,NDC Description Not Available,103.38,41.35,,,0 NDC,68094031310,"Levetiracetam: 10 Vial, Single-Use In 1 Carton (68094-313-10) / 5 Ml In 1 Vial, Single-Use",0.26,0.1,,,0 NDC,68094033059,NDC Description Not Available,3.44,1.38,,,0 NDC,68094035601,NDC Description Not Available,9.46,3.78,,,0 NDC,68094035658,"Morphine Sulfate: 50 Bag In 1 Case (68094-356-58) / 1 Syringe, Plastic In 1 Bag / 1 Ml In 1 Syringe, Plastic (68094-356-01)",4.92,1.97,,,0 NDC,68094049459,NDC Description Not Available,2.29,0.92,,,0 NDC,68094050359,NDC Description Not Available,3.9,1.56,,,0 NDC,68094050361,"Childrens Ibuprofen: 10 Tray In 1 Case (68094-503-61) / 10 Cup, Unit-Dose In 1 Tray / 10 Ml In 1 Cup, Unit-Dose (68094-503-59)",4.07,1.63,,,0 NDC,68094058759,NDC Description Not Available,1.4,0.56,,,0 NDC,68094059959,NDC Description Not Available,3.42,1.37,,,0 NDC,68094060059,NDC Description Not Available,2.62,1.05,,,0 NDC,68094060061,"Dye Free Childrens Ibuprofen: 10 Tray In 1 Case (68094-600-61) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (68094-600-59)",3.73,1.49,,,0 NDC,68094075059,NDC Description Not Available,4.08,1.63,,,0 NDC,68094075062,"Diazepam: 3 Tray In 1 Case (68094-750-62) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (68094-750-59)",4.72,1.89,,,0 NDC,68094076259,NDC Description Not Available,12.81,5.12,,,0 NDC,68094076262,"Midazolam Hydrochloride: 3 Tray In 1 Case (68094-762-62) / 10 Cup, Unit-Dose In 1 Tray / 2.5 Ml In 1 Cup, Unit-Dose (68094-762-59)",22.21,8.88,,,0 NDC,68094076359,NDC Description Not Available,29.74,11.9,,,0 NDC,68094076459,NDC Description Not Available,15.24,6.1,,,0 NDC,68094076462,"Midazolam Hydrochloride: 3 Tray In 1 Case (68094-764-62) / 10 Cup, Unit-Dose In 1 Tray / 5 Ml In 1 Cup, Unit-Dose (68094-764-59)",19.62,7.85,,,0 NDC,68094085362,"Naltrexone Hydrochloride: 3 Blister Pack In 1 Carton (68094-853-62) / 10 Tablet, Film Coated In 1 Blister Pack (68094-853-59)",5.61,2.24,,,0 NDC,68134020116,"Naproxen: 500 mL in 1 BOTTLE, PLASTIC (68134-201-16)",46.4,18.56,,,0 NDC,68135002001,Naglazyme: 1 Vial In 1 Carton (68135-020-01) / 5 Ml In 1 Vial,2122.19,848.88,,,0 NDC,68176000010,NDC Description Not Available,3.82,1.53,,,0 NDC,68176000011,NDC Description Not Available,1.56,0.62,,,0 NDC,68180012201,Cephalexin: 100 Capsule In 1 Bottle (68180-122-01),0.89,0.36,,,0 NDC,68180015001,Famotidine: 50 Ml In 1 Bottle (68180-150-01),1.8,0.72,,,0 NDC,68180015701,Clobazam: 1 Bottle In 1 Carton (68180-157-01) / 100 Tablet In 1 Bottle,1.59,0.64,,,0 NDC,68180015901,Ethacrynic Acid: 100 Tablet In 1 Bottle (68180-159-01),5.82,2.33,,,0 NDC,68180018001,Cefadroxil: 100 Capsule In 1 Bottle (68180-180-01),1.37,0.55,,,0 NDC,68180018008,Cefadroxil: 50 Capsule In 1 Bottle (68180-180-08),1.44,0.58,,,0 NDC,68180018203,Cefadroxil: 100 Ml In 1 Bottle (68180-182-03),6.91,2.76,,,0 NDC,68180021430,"Cyclosporine: 30 Vial, Single-Use In 1 Tray (68180-214-30) / .4 Ml In 1 Vial, Single-Use",7.9,3.16,,,0 NDC,68180028001,Ethambutol Hydrochloride: 100 Tablet In 1 Bottle (68180-280-01),1.24,0.5,,,0 NDC,68180028101,Ethambutol Hydrochloride: 100 Tablet In 1 Bottle (68180-281-01),4.03,1.61,,,0 NDC,68180029407,"Duloxetine: 60 Capsule, Delayed Release In 1 Bottle (68180-294-07)",1.87,0.75,,,0 NDC,68180029509,"Duloxetine: 90 Capsule, Delayed Release In 1 Bottle (68180-295-09)",1.28,0.51,,,0 NDC,68180029603,"Duloxetine: 1000 Capsule, Delayed Release In 1 Bottle (68180-296-03)",2.41,0.96,,,0 NDC,68180029609,"Duloxetine: 90 Capsule, Delayed Release In 1 Bottle (68180-296-09)",0.9,0.36,,,0 NDC,68180031906,"Bupropion Hydrochloride Xl: 30 Tablet, Extended Release In 1 Bottle (68180-319-06)",0.55,0.22,,,0 NDC,68180039507,Celecoxib: 60 Capsule In 1 Bottle (68180-395-07),0.58,0.23,,,0 NDC,68180044102,Cephalexin: 200 Ml In 1 Bottle (68180-441-02),8.01,3.2,,,0 NDC,68180044701,Quetiapine Fumarate: 100 Tablet In 1 Bottle (68180-447-01),0.55,0.22,,,0 NDC,68180052406,"Paliperidone: 30 Tablet, Extended Release In 1 Bottle (68180-524-06)",9.31,3.72,,,0 NDC,68180065701,Doxycycline: 60 Ml In 1 Bottle (68180-657-01),8.39,3.36,,,0 NDC,68180067006,Lurasidone Hydrochloride: 30 Tablet In 1 Bottle (68180-670-06),2.85,1.14,,,0 NDC,68180067511,Oseltamivir Phosphate: 1 Blister Pack In 1 Carton (68180-675-11) / 10 Capsule In 1 Blister Pack,5.76,2.3,,,0 NDC,68180067611,Oseltamivir Phosphate: 1 Blister Pack In 1 Carton (68180-676-11) / 10 Capsule In 1 Blister Pack,3.99,1.6,,,0 NDC,68180067711,Oseltamivir Phosphate: 1 Blister Pack In 1 Carton (68180-677-11) / 10 Capsule In 1 Blister Pack,5.06,2.02,,,0 NDC,68180067801,"Oseltamivir Phosphate: 1 Bottle, Glass In 1 Carton (68180-678-01) / 60 Ml In 1 Bottle, Glass",8.02,3.21,,,0 NDC,68180072204,Cefdinir: 60 Ml In 1 Bottle (68180-722-04),21.26,8.5,,,0 NDC,68180072205,Cefdinir: 100 Ml In 1 Bottle (68180-722-05),11.84,4.74,,,0 NDC,68180085211,My Way: 1 Blister Pack In 1 Carton (68180-852-11) / 1 Tablet In 1 Blister Pack,40.65,16.26,,,0 NDC,68180095602,Clobetasol Propionate: 1 Tube In 1 Carton (68180-956-02) / 30 G In 1 Tube,34.47,13.79,,,0 NDC,68180096301,"Albuterol Sulfate: 1 Canister In 1 Carton (68180-963-01) / 200 Aerosol, Metered In 1 Canister",102.17,40.87,,,0 NDC,68180096501,Levothyroxine Sodium: 100 Tablet In 1 Bottle (68180-965-01),0.3,0.12,,,0 NDC,68180098101,Lisinopril: 100 Tablet In 1 Bottle (68180-981-01),0.12,0.05,,,0 NDC,68308015230,"Nystatin: 30 G In 1 Bottle, Plastic (68308-152-30)",59.9,23.96,,,0 NDC,68382000414,"Topiramate: 60 Capsule, Coated Pellets In 1 Bottle (68382-004-14)",2.81,1.12,,,0 NDC,68382000514,"Topiramate: 60 Capsule, Coated Pellets In 1 Bottle (68382-005-14)",3.73,1.49,,,0 NDC,68382001801,Venlafaxine: 100 Tablet In 1 Bottle (68382-018-01),0.9,0.36,,,0 NDC,68382004001,Promethazine Hydrochloride: 100 Tablet In 1 Bottle (68382-040-01),0.2,0.08,,,0 NDC,68382009301,"Carvedilol: 100 Tablet, Film Coated In 1 Bottle (68382-093-01)",0.09,0.04,,,0 NDC,68382009401,"Carvedilol: 100 Tablet, Film Coated In 1 Bottle (68382-094-01)",0.11,0.04,,,0 NDC,68382009405,"Carvedilol: 500 Tablet, Film Coated In 1 Bottle (68382-094-05)",0.12,0.05,,,0 NDC,68382009501,"Carvedilol: 100 Tablet, Film Coated In 1 Bottle (68382-095-01)",0.12,0.05,,,0 NDC,68382010601,"Divalproex Sodium: 100 Capsule, Coated Pellets In 1 Bottle (68382-106-01)",1.01,0.4,,,0 NDC,68382011414,"Risperidone: 60 Tablet, Film Coated In 1 Bottle (68382-114-14)",0.36,0.14,,,0 NDC,68382035306,"Bupropion: 30 Tablet, Extended Release In 1 Bottle (68382-353-06)",1.47,0.59,,,0 NDC,68382037001,"Nystatin: 15 G In 1 Bottle, Plastic (68382-370-01)",21.02,8.41,,,0 NDC,68382039501,NDC Description Not Available,10672.83,4269.13,,,0 NDC,68382039504,"Ribavirin: 4 Vial In 1 Carton (68382-395-04) / 1 Powder, For Solution In 1 Vial",20000.0,8000.0,,,0 NDC,68382039601,Sodium Phenylacetate And Sodium Benzoate: 1 Vial In 1 Carton (68382-396-01) / 50 Ml In 1 Vial,34569.0,13827.6,,,0 NDC,68382044405,"Famotidine: 50 Ml In 1 Bottle, Plastic (68382-444-05)",1.47,0.59,,,0 NDC,68382047001,"Indomethacin: 1 Vial In 1 Carton (68382-470-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",102.15,40.86,,,0 NDC,68382052960,Cholestyramine: 60 Pouch In 1 Carton (68382-529-60) / 5.5 G In 1 Pouch,19.38,7.755,,,0 NDC,68382058301,Liothyronine Sodium: 100 Tablet In 1 Bottle (68382-583-01),1.78,0.71,,,0 NDC,68382080501,Trazodone Hydrochloride: 100 Tablet In 1 Bottle (68382-805-01),0.21,0.08,,,0 NDC,68382080505,Trazodone Hydrochloride: 500 Tablet In 1 Bottle (68382-805-05),0.19,0.08,,,0 NDC,68382084994,"Esomeprazole Magnesium: 30 Granule, Delayed Release In 1 Carton (68382-849-94)",23.35,9.34,,,0 NDC,68382085701,Triamterene And Hydrochlorothiazide: 100 Tablet In 1 Bottle (68382-857-01),0.92,0.37,,,0 NDC,68382086002,NDC Description Not Available,49.5,19.8,,,0 NDC,68382091001,NDC Description Not Available,1.06,0.42,,,0 NDC,68382099701,NDC Description Not Available,22.22,8.89,,,0 NDC,68382099710,Arsenic Trioxide: 10 Vial In 1 Carton (68382-997-10) / 10 Ml In 1 Vial (68382-997-01),184.92,73.97,,,0 NDC,68403110006,NDC Description Not Available,38918.78,15567.51,,,0 NDC,68462010130,Fluconazole: 30 Tablet In 1 Bottle (68462-101-30),2.01,0.8,,,0 NDC,68462010530,"Ondansetron: 30 Tablet, Film Coated In 1 Bottle (68462-105-30)",0.4,0.16,,,0 NDC,68462012801,Zonisamide: 100 Capsule In 1 Bottle (68462-128-01),0.48,0.19,,,0 NDC,68462013701,"Oxcarbazepine: 100 Tablet, Film Coated In 1 Bottle (68462-137-01)",1.28,0.51,,,0 NDC,68462015713,"Ondansetron: 30 Tablet, Orally Disintegrating In 1 Box, Unit-Dose (68462-157-13)",1.13,0.45,,,0 NDC,68462015740,NDC Description Not Available,0.5,0.2,,,0 NDC,68462015811,"Ondansetron: 10 Tablet, Orally Disintegrating In 1 Box, Unit-Dose (68462-158-11)",0.17,0.07,,,0 NDC,68462015840,NDC Description Not Available,0.22,0.09,,,0 NDC,68462016201,"Carvedilol: 100 Tablet, Film Coated In 1 Bottle (68462-162-01)",0.18,0.07,,,0 NDC,68462016401,"Carvedilol: 100 Tablet, Film Coated In 1 Bottle (68462-164-01)",0.18,0.07,,,0 NDC,68462016501,"Carvedilol: 100 Tablet, Film Coated In 1 Bottle (68462-165-01)",0.26,0.1,,,0 NDC,68462018022,Mupirocin: 22 G In 1 Tube (68462-180-22),39.37,15.75,,,0 NDC,68462022801,"Lamotrigine: 100 Tablet, Chewable In 1 Bottle (68462-228-01)",1.25,0.5,,,0 NDC,68462022901,"Lamotrigine: 100 Tablet, Chewable In 1 Bottle (68462-229-01)",1.27,0.51,,,0 NDC,68462025501,"Ropinirole: 100 Tablet, Film Coated In 1 Bottle (68462-255-01)",0.36,0.14,,,0 NDC,68462026001,"Verapamil Hydrochloride: 100 Tablet, Film Coated, Extended Release In 1 Bottle (68462-260-01)",0.93,0.37,,,0 NDC,68462026190,"Rosuvastatin Calcium: 90 Tablet, Film Coated In 1 Bottle (68462-261-90)",0.57,0.23,,,0 NDC,68462026630,Atomoxetine: 30 Capsule In 1 Bottle (68462-266-30),4.86,1.94,,,0 NDC,68462028169,"Brimonidine Tartrate/Timolol Maleate: 1 Bottle, Dropper In 1 Carton (68462-281-69) / 5 Ml In 1 Bottle, Dropper",83.94,33.58,,,0 NDC,68462029201,"Verapamil Hydrochloride: 100 Tablet, Film Coated, Extended Release In 1 Bottle (68462-292-01)",1.72,0.69,,,0 NDC,68462029301,"Verapamil Hydrochloride: 100 Tablet, Film Coated, Extended Release In 1 Bottle (68462-293-01)",0.96,0.38,,,0 NDC,68462030450,Norethindrone Acetate: 50 Tablet In 1 Bottle (68462-304-50),1.81,0.72,,,0 NDC,68462033090,Pramipexole Dihydrochloride: 90 Tablet In 1 Bottle (68462-330-90),0.48,0.19,,,0 NDC,68462033390,Pramipexole Dihydrochloride: 90 Tablet In 1 Bottle (68462-333-90),0.17,0.07,,,0 NDC,68462039601,"Omeprazole: 100 Capsule, Delayed Release In 1 Bottle (68462-396-01)",0.32,0.13,,,0 NDC,68462040601,Indomethacin: 100 Capsule In 1 Bottle (68462-406-01),0.33,0.13,,,0 NDC,68462041820,Lidocaine: 1 Tube In 1 Carton (68462-418-20) / 35.44 G In 1 Tube,118.46,47.38,,,0 NDC,68462043518,"Acamprosate Calcium: 180 Tablet, Delayed Release In 1 Bottle (68462-435-18)",3.29,1.32,,,0 NDC,68462046940,NDC Description Not Available,5.17,2.07,,,0 NDC,68462046954,"Bumetanide: 10 Vial, Single-Dose In 1 Carton (68462-469-54) / 4 Ml In 1 Vial, Single-Dose (68462-469-40)",3.46,1.38,,,0 NDC,68462047040,NDC Description Not Available,2.49,1.0,,,0 NDC,68462056417,Mupirocin: 15 G In 1 Tube (68462-564-17),845.25,338.1,,,0 NDC,68462058340,Aprepitant: 1 Blister Pack In 1 Carton (68462-583-40) / 1 Capsule In 1 Blister Pack,32.98,13.19,,,0 NDC,68462058385,Aprepitant: 5 Blister Pack In 1 Carton (68462-583-85) / 1 Capsule In 1 Blister Pack,48.04,19.22,,,0 NDC,68462058440,NDC Description Not Available,30.26,12.1,,,0 NDC,68462058476,Aprepitant: 1 Blister Pack In 1 Carton (68462-584-76) / 6 Capsule In 1 Blister Pack (68462-584-40),30.79,12.32,,,0 NDC,68462062210,"Fosphenytoin Sodium: 10 Vial, Single-Dose In 1 Carton (68462-622-10) / 10 Ml In 1 Vial, Single-Dose (68462-622-64)",9.97,3.99,,,0 NDC,68462062264,"Fosphenytoin Sodium: 10 Vial, Single-Dose In 1 Carton (68462-622-64) / 10 Ml In 1 Vial, Single-Dose (68462-622-10)",10.03,4.01,,,0 NDC,68462075501,NDC Description Not Available,6.52,2.61,,,0 NDC,68462075525,"Ketorolac Tromethamine: 25 Vial, Single-Dose In 1 Carton (68462-755-25) / 1 Ml In 1 Vial, Single-Dose (68462-755-01)",3.36,1.34,,,0 NDC,68462079201,Tretinoin: 100 Capsule In 1 Bottle (68462-792-01),88.5,35.4,,,0 NDC,68462090401,Posaconazole: 1 Vial In 1 Carton (68462-904-01) / 16.7 Ml In 1 Vial,2468.14,987.26,,,0 NDC,68516521401,Albutein: 1 Vial In 1 Carton (68516-5214-1) / 250 Ml In 1 Vial (68516-5214-3),92.05,36.82,,,0 NDC,68516521403,NDC Description Not Available,114.72,45.89,,,0 NDC,68516521405,Albutein: 1 Vial In 1 Carton (68516-5214-5) / 50 Ml In 1 Vial (68516-5214-6),2.59,1.04,,,0 NDC,68516521407,NDC Description Not Available,63.1,25.24,,,0 NDC,68516521607,NDC Description Not Available,204.82,81.93,,,0 NDC,68546017160,"Austedo: 60 Tablet, Coated In 1 Bottle (68546-171-60)",150.26,60.1,,,0 NDC,68547011110,"Xacduro: 1 Kit In 1 Carton (68547-111-10) * 5 Ml In 1 Vial, Single-Dose (68547-211-20) * 2.5 Ml In 1 Vial, Single-Dose (68547-311-30)",2109.52,843.81,,,0 NDC,68547021120,NDC Description Not Available,1092.5,437.0,,,0 NDC,68547031130,NDC Description Not Available,1274.62,509.85,,,0 NDC,68547050102,"Giapreza: 1 Vial, Single-Dose In 1 Carton (68547-501-02) / 1 Ml In 1 Vial, Single-Dose",7309.59,2923.835,,,0 NDC,68585000575,NDC Description Not Available,0.25,0.1,,,0 NDC,68682030130,"Pyridostigmine Bromide: 30 Tablet, Extended Release In 1 Bottle (68682-301-30)",28.06,11.22,,,0 NDC,68682042112,Tetrabenazine: 112 Tablet In 1 Bottle (68682-421-12),55.96,22.38,,,0 NDC,68727071201,"Zepzelca: 8 Ml In 1 Vial, Single-Dose (68727-712-01)",904.6,361.84,,,0 NDC,68727074501,Vyxeos: 20 Ml In 1 Vial (68727-745-01),1107.54,443.02,,,0 NDC,68727074502,Vyxeos: 40 Ml In 1 Carton (68727-745-02),1061.95,424.78,,,0 NDC,68727080001,Defitelio: 2.5 Ml In 1 Vial (68727-800-01),4537.19,1814.88,,,0 NDC,68727090001,NDC Description Not Available,227.46,90.98,,,0 NDC,68727090003,"Rylaze: 3 Vial, Single-Dose In 1 Carton (68727-900-03) / .5 Ml In 1 Vial, Single-Dose (68727-900-01)",230.59,92.24,,,0 NDC,68803061210,"Visionblue: 10 Pouch In 1 Carton (68803-612-10) / 1 Syringe, Glass In 1 Pouch / .5 Ml In 1 Syringe, Glass",29.24,11.7,,,0 NDC,68803072205,"Tissueblue: 10 Pouch In 1 Carton (68803-722-05) / 1 Syringe, Glass In 1 Pouch / .5 Ml In 1 Syringe, Glass",234.34,93.74,,,0 NDC,68803072225,NDC Description Not Available,212.4,84.96,,,0 NDC,68817013450,"Abraxane: 1 Vial, Single-Use In 1 Carton (68817-134-50) / 20 Ml In 1 Vial, Single-Use",66.81,26.72,,,0 NDC,68883060010,NDC Description Not Available,1.72,0.69,,,0 NDC,68982034701,"Fibryga: 1 Kit In 1 Carton (68982-347-01) * 50 Ml In 1 Bottle, Glass (68982-348-01)",4.77,1.91,,,0 NDC,68982034801,NDC Description Not Available,5.07,2.03,,,0 NDC,68982062302,"Albumin (Human): 250 Ml In 1 Bottle, Glass (68982-623-02)",222.43,88.97,,,0 NDC,68992301001,"Envarsus Xr: 1 Pouch In 1 Carton (68992-3010-1) / 1 Bottle In 1 Pouch / 100 Tablet, Extended Release In 1 Bottle",5.15,2.06,,,0 NDC,68992304001,"Envarsus Xr: 1 Pouch In 1 Carton (68992-3040-1) / 1 Bottle In 1 Pouch / 100 Tablet, Extended Release In 1 Bottle",5.18,2.07,,,0 NDC,68992307501,"Envarsus Xr: 1 Pouch In 1 Carton (68992-3075-1) / 1 Bottle In 1 Pouch / 100 Tablet, Extended Release In 1 Bottle",5.16,2.06,,,0 NDC,69097014260,Albuterol Sulfate: 1 Canister In 1 Carton (69097-142-60) / 200 Inhalant In 1 Canister,78.53,31.41,,,0 NDC,69097017364,Ipratropium Bromide And Albuterol Sulfate: 12 Pouch In 1 Carton (69097-173-64) / 5 Vial In 1 Pouch / 3 Ml In 1 Vial,1.13,0.45,,,0 NDC,69097042303,Celecoxib: 60 Capsule In 1 Bottle (69097-423-03),0.41,0.16,,,0 NDC,69097051707,Cyclophosphamide: 100 Capsule In 1 Bottle (69097-517-07),12.45,4.98,,,0 NDC,69097052444,Diclofenac Sodium: 1 Tube In 1 Carton (69097-524-44) / 100 G In 1 Tube,38.35,15.34,,,0 NDC,69097052734,"Esomeprazole Magnesium: 30 Granule, For Suspension, Extended Release In 1 Carton (69097-527-34)",23.43,9.37,,,0 NDC,69097052834,Esomeprazole Magnesium: 30 For Suspension In 1 Carton (69097-528-34),24.58,9.83,,,0 NDC,69097052934,Esomeprazole Magnesium: 30 For Suspension In 1 Carton (69097-529-34),24.49,9.8,,,0 NDC,69097057967,"Fosfomycin Tromethamine: 1 Dose Pack In 1 Carton (69097-579-67) / 1 Granule, For Solution In 1 Dose Pack",292.34,116.94,,,0 NDC,69097067905,"Pregabalin Capsules, Cv: 90 Capsule In 1 Bottle (69097-679-05)",0.33,0.13,,,0 NDC,69097070831,NDC Description Not Available,18.78,7.51,,,0 NDC,69097070996,Phytonadione: 10 Vial In 1 Carton (69097-709-96) / .5 Ml In 1 Vial,24.98,9.99,,,0 NDC,69097083305,Sertraline Hydrochloride: 90 Tablet In 1 Bottle (69097-833-05),0.34,0.14,,,0 NDC,69097084064,Ipratropium Bromide And Albuterol Sulfate: 2 Pouch In 1 Carton (69097-840-64) / 30 Vial In 1 Pouch / 3 Ml In 1 Vial,1.01,0.4,,,0 NDC,69097084087,Ipratropium Bromide And Albuterol Sulfate: 1 Pouch In 1 Carton (69097-840-87) / 30 Vial In 1 Pouch / 3 Ml In 1 Vial,1.3,0.52,,,0 NDC,69097085605,Fosinopril Sodium: 90 Tablet In 1 Bottle (69097-856-05),0.55,0.22,,,0 NDC,69097085705,Fosinopril Sodium: 90 Tablet In 1 Bottle (69097-857-05),0.87,0.35,,,0 NDC,69097087067,Lanreotide Acetate: 1 Syringe In 1 Carton (69097-870-67) / .5 Ml In 1 Syringe,219.08,87.63,,,0 NDC,69097096453,Vigabatrin: 50 Packet In 1 Carton (69097-964-53) / 10 Ml In 1 Packet,11.12,4.45,,,0 NDC,69097096793,"Sevelamer Carbonate: 270 Tablet, Film Coated In 1 Bottle (69097-967-93)",0.15,0.06,,,0 NDC,69097097902,"Vilazodone Hydrochloride: 30 Tablet, Film Coated In 1 Bottle (69097-979-02)",10.27,4.11,,,0 NDC,69208000115,"I3odine MAXTM: 1 VIAL, DISPENSING in 1 CANISTER (69208-001-15) / 1 mL in 1 VIAL, DISPENSING",60.06,24.025,,,0 NDC,69208000315,NDC Description Not Available,64.65,25.86,,,0 NDC,69230031111,Ibuprofen Oral: 1 Bottle In 1 Carton (69230-311-11) / 118 Ml In 1 Bottle,3.76,1.5,,,0 NDC,69238112601,Ethacrynic Acid: 100 Tablet In 1 Bottle (69238-1126-1),10.35,4.14,,,0 NDC,69238115403,Ezetimibe: 30 Tablet In 1 Bottle (69238-1154-3),1.29,0.52,,,0 NDC,69238120202,Buprenorphine: 4 Pouch In 1 Carton (69238-1202-2) / 1 Patch In 1 Pouch / 168 H In 1 Patch,226.55,90.62,,,0 NDC,69238120302,Buprenorphine: 4 Pouch In 1 Carton (69238-1203-2) / 1 Patch In 1 Pouch / 168 H In 1 Patch,238.3,95.32,,,0 NDC,69238131209,Pregabalin: 90 Capsule In 1 Bottle (69238-1312-9),0.27,0.11,,,0 NDC,69238138003,Difluprednate: 1 Bottle In 1 Carton (69238-1380-3) / 5 Ml In 1 Bottle,753.71,301.48,,,0 NDC,69238147303,"Erythromycin: 30 Tablet, Delayed Release In 1 Bottle (69238-1473-3)",31.22,12.49,,,0 NDC,69238150301,Erythromycin Ethylsuccinate: 100 Ml In 1 Bottle (69238-1503-1),7.34,2.94,,,0 NDC,69238153502,"Clobazam: 1 Bottle, Glass In 1 Carton (69238-1535-2) / 120 Ml In 1 Bottle, Glass",4.36,1.74,,,0 NDC,69238157401,"Sildenafil: 1 Bottle, Glass In 1 Carton (69238-1574-1) / 112 Ml In 1 Bottle, Glass",1.2,0.48,,,0 NDC,69238159608,"Aminocaproic Acid: 236.5 Ml In 1 Bottle, Plastic (69238-1596-8)",100.76,40.3,,,0 NDC,69238161708,Potassium Chloride: 100 POUCH in 1 CARTON (69238-1617-8) / 1.58 g in 1 POUCH (69238-1617-1),6.4,2.56,,,0 NDC,69238167901,"Fluphenazine Hydrochloride: 100 Tablet, Film Coated In 1 Bottle, Plastic (69238-1679-1)",4.58,1.83,,,0 NDC,69238172907,Enalapril Maleate: 1 Bottle In 1 Carton (69238-1729-7) / 150 Ml In 1 Bottle,9.31,3.72,,,0 NDC,69238173002,Naproxen: 473 Ml In 1 Bottle (69238-1730-2),11.7,4.68,,,0 NDC,69238201603,"Ipratropium Bromide: 1 Bottle, Spray In 1 Carton (69238-2016-3) / 345 Spray In 1 Bottle, Spray",102.96,41.18,,,0 NDC,69238202905,Mupirocin: 1 Tube In 1 Carton (69238-2029-5) / 15 G In 1 Tube,129.31,51.72,,,0 NDC,69238207701,Propranolol Hydrochloride: 100 Tablet In 1 Bottle (69238-2077-1),0.48,0.19,,,0 NDC,69238207801,Propranolol Hydrochloride: 100 Tablet In 1 Bottle (69238-2078-1),0.44,0.18,,,0 NDC,69238214107,Enalapril Maleate: 1 Bottle In 1 Carton (69238-2141-7) / 150 Ml In 1 Bottle,11.01,4.4,,,0 NDC,69292072225,"Flurbiprofen Sodium: 1 Bottle, Dropper In 1 Carton (69292-722-25) / 2.5 Ml In 1 Bottle, Dropper",109.59,43.84,,,0 NDC,69315011601,Furosemide: 100 Tablet In 1 Bottle (69315-116-01),0.12,0.05,,,0 NDC,69315011701,Furosemide: 100 Tablet In 1 Bottle (69315-117-01),0.18,0.07,,,0 NDC,69315013401,"Imipramine Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (69315-134-01)",0.72,0.29,,,0 NDC,69315030615,"Nystatin: 15 G In 1 Bottle, Plastic (69315-306-15)",125.83,50.33,,,0 NDC,69315030805,"Ciprofloxacin: 1 Bottle, Plastic In 1 Carton (69315-308-05) / 5 Ml In 1 Bottle, Plastic",15.79,6.32,,,0 NDC,69315031228,Procto-Med Hc: 1 Tube In 1 Carton (69315-312-28) / 28 G In 1 Tube,35.42,14.17,,,0 NDC,69315070150,"Ethacrynate Sodium: 1 Vial, Single-Dose In 1 Carton (69315-701-50) / 50 Ml In 1 Vial, Single-Dose",2327.28,930.91,,,0 NDC,69315090401,Lorazepam: 100 Tablet In 1 Bottle (69315-904-01),0.12,0.05,,,0 NDC,69315090501,Lorazepam: 100 Tablet In 1 Bottle (69315-905-01),0.18,0.07,,,0 NDC,69315090505,Lorazepam: 500 Tablet In 1 Bottle (69315-905-05),0.18,0.07,,,0 NDC,69315091001,Diphenoxylate Hydrochloride And Atropine Sulfate: 100 Tablet In 1 Bottle (69315-910-01),1.4,0.56,,,0 NDC,69339013815,"Dash Chlorhexidine Gluconate 0.12% Oral Rinse: 15 Ml In 1 Cup, Unit-Dose (69339-138-15)",5.72,2.29,,,0 NDC,69339013819,Dash Chlorhexidine Gluconate 0.12% Oral Rinse: 1500 Ml In 1 Dose Pack (69339-138-19),6.46,2.58,,,0 NDC,69339014801,NDC Description Not Available,32.07,12.83,,,0 NDC,69339015705,NDC Description Not Available,12.17,4.87,,,0 NDC,69339020901,NDC Description Not Available,30.98,12.39,,,0 NDC,69344010233,Indocin: 30 Suppository In 1 Box (69344-102-33),1556.58,622.63,,,0 NDC,69367028302,NDC Description Not Available,5.25,2.1,,,0 NDC,69367029360,"Ranolazine: 60 Tablet, Film Coated, Extended Release In 1 Bottle (69367-293-60)",4.27,1.71,,,0 NDC,69367029460,"Ranolazine: 60 Tablet, Film Coated, Extended Release In 1 Bottle (69367-294-60)",7.01,2.8,,,0 NDC,69367032409,Pregabalin: 90 Capsule In 1 Bottle (69367-324-09),0.53,0.21,,,0 NDC,69367033360,"Levetiracetam Er: 60 Tablet, Film Coated, Extended Release In 1 Bottle, Plastic (69367-333-60)",1.72,0.69,,,0 NDC,69367033801,"Carbidopa And Levodopa: 100 Tablet In 1 Bottle, Plastic (69367-338-01)",0.27,0.11,,,0 NDC,69367038801,"Amitriptyline Hydrochloride: 100 Tablet, Coated In 1 Bottle (69367-388-01)",0.2,0.08,,,0 NDC,69367039001,"Amitriptyline Hydrochloride: 100 Tablet, Coated In 1 Bottle (69367-390-01)",0.55,0.22,,,0 NDC,69367061101,Phenazopyridine Hydrochloride: 100 Tablet In 1 Bottle (69367-611-01),3.72,1.49,,,0 NDC,69367061201,Phenazopyridine Hydrochloride: 100 Tablet In 1 Bottle (69367-612-01),5.25,2.1,,,0 NDC,69374030210,NDC Description Not Available,0.32,0.13,,,0 NDC,69374051550,NDC Description Not Available,230.0,92.0,,,0 NDC,69374090105,NDC Description Not Available,39.74,15.9,,,0 NDC,69374090305,NDC Description Not Available,7.59,3.04,,,0 NDC,69374091910,NDC Description Not Available,5.29,2.12,,,0 NDC,69374094905,NDC Description Not Available,0.37,0.15,,,0 NDC,69374095710,NDC Description Not Available,0.52,0.21,,,0 NDC,69374098255,NDC Description Not Available,26.45,10.58,,,0 NDC,69374098810,NDC Description Not Available,880.0,352.0,,,0 NDC,69396001420,Miconazole Nitrate 2% Cream Antifungal: 1 Tube In 1 Box (69396-014-20) / 30 G In 1 Tube,15.39,6.16,,,0 NDC,69452011645,Clobazam: 1 Bottle In 1 Carton (69452-116-45) / 120 Ml In 1 Bottle,10.23,4.09,,,0 NDC,69452013117,Dofetilide: 60 Capsule In 1 Bottle (69452-131-17),1.94,0.78,,,0 NDC,69452013217,Dofetilide: 60 Capsule In 1 Bottle (69452-132-17),1.65,0.66,,,0 NDC,69452013317,Dofetilide: 60 Capsule In 1 Bottle (69452-133-17),1.47,0.59,,,0 NDC,69452014320,"Benzonatate: 100 Capsule In 1 Bottle, Plastic (69452-143-20)",1.32,0.53,,,0 NDC,69452017313,"Azithromycin: 30 Tablet, Film Coated In 1 Bottle (69452-173-13)",7.26,2.9,,,0 NDC,69452020820,"Calcitriol: 100 Capsule, Liquid Filled In 1 Bottle, Plastic (69452-208-20)",1.27,0.51,,,0 NDC,69452020907,NDC Description Not Available,3.67,1.47,,,0 NDC,69452020913,"Nimodipine: 3 Blister Pack In 1 Carton (69452-209-13) / 10 Capsule, Liquid Filled In 1 Blister Pack",6.125,2.45,,,0 NDC,69452023320,Progesterone: 100 Capsule In 1 Bottle (69452-233-20),1.29,0.52,,,0 NDC,69452024120,Trihexyphenidyl Hydrochloride: 100 Tablet In 1 Bottle (69452-241-20),0.6,0.24,,,0 NDC,69452024220,Trihexyphenidyl Hydrochloride: 100 Tablet In 1 Bottle (69452-242-20),0.98,0.39,,,0 NDC,69452035092,"Granisetron Hydrochloride: 2 Blister Pack In 1 Carton (69452-350-92) / 10 Tablet, Film Coated In 1 Blister Pack",4.07,1.63,,,0 NDC,69452035720,"Ropinirole: 100 Tablet, Film Coated In 1 Bottle, Plastic (69452-357-20)",0.42,0.17,,,0 NDC,69452038998,"Magnesium Citrate: 296 Ml In 1 Bottle, Plastic (69452-389-98)",55.95,22.38,,,0 NDC,69488000140,"Netspot: 1 Kit In 1 Kit (69488-001-40) * 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",211.75,84.7,,,0 NDC,69488000301,Lutathera: 1 Vial In 1 Package (69488-003-01) / 20.5 Ml In 1 Vial,963.19,385.28,,,0 NDC,69488001061,"Pluvicto: 1 Vial, Glass In 1 Package (69488-010-61) / 7.5 Ml In 1 Vial, Glass",754.29,301.72,,,0 NDC,69488001761,"Locametz: 1 Vial, Multi-Dose In 1 Carton (69488-017-61) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Multi-Dose",3806.73,1522.69,,,0 NDC,69543035610,NDC Description Not Available,0.96,0.38,,,0 NDC,69543041972,Sildenafil: 1 Bottle In 1 Carton (69543-419-72) / 112 Ml In 1 Bottle,2.72,1.09,,,0 NDC,69543045101,NDC Description Not Available,9.8,3.92,,,0 NDC,69543045110,Potassium Chloride: 100 Packet In 1 Carton (69543-451-10) / 1.77 G In 1 Packet (69543-451-01),12.02,4.81,,,0 NDC,69543045510,"Lacosamide: 10 Vial, Glass In 1 Carton (69543-455-10) / 20 Ml In 1 Vial, Glass (69543-455-20)",0.45,0.18,,,0 NDC,69543045520,NDC Description Not Available,0.45,0.18,,,0 NDC,69547035302,"Narcan: 2 Vial, Single-Dose In 1 Package (69547-353-02) / .1 Ml In 1 Vial, Single-Dose",269.36,107.74,,,0 NDC,69547062702,"Narcan: 2 Vial, Single-Dose In 1 Carton (69547-627-02) / .1 Ml In 1 Vial, Single-Dose",103.5,41.4,,,0 NDC,69584011110,Carisoprodol: 100 Tablet In 1 Bottle (69584-111-10),0.2,0.08,,,0 NDC,69584042610,Imipramine Hydrochloride: 100 Tablet In 1 Bottle (69584-426-10),0.3,0.12,,,0 NDC,69584061110,Methocarbamol: 100 Tablet In 1 Bottle (69584-611-10),0.26,0.1,,,0 NDC,69616027230,Fycompa: 30 Tablet In 1 Bottle (69616-272-30),56.63,22.65,,,0 NDC,69616027630,Fycompa: 30 Tablet In 1 Bottle (69616-276-30),121.59,48.64,,,0 NDC,69618000506,NDC Description Not Available,0.19,0.08,,,0 NDC,69618000815,NDC Description Not Available,1.07,0.43,,,0 NDC,69618000858,NDC Description Not Available,0.71,0.28,,,0 NDC,69618001959,NDC Description Not Available,0.14,0.06,,,0 NDC,69680011201,NDC Description Not Available,6.83,2.73,,,0 NDC,69680011225,Cyanocobalamin: 25 Vial In 1 Box (69680-112-25) / 1 Ml In 1 Vial (69680-112-01),8.74,3.5,,,0 NDC,69724011210,Sotalol Hydrochloride: 1 Vial In 1 Carton (69724-112-10) / 10 Ml In 1 Vial,101.1,40.44,,,0 NDC,69784000306,Fluconazole in Sodium Chloride: 6 BAG in 1 CARTON (69784-003-06) / 200 mL in 1 BAG,15.06,6.02,,,0 NDC,69784018001,NDC Description Not Available,5.98,2.39,,,0 NDC,69784023010,"Sodium Acetate: 50 Ml In 1 Vial, Pharmacy Bulk Package (69784-230-10)",196.54,78.62,,,0 NDC,69784023020,"Sodium Acetate: 50 Ml In 1 Vial, Pharmacy Bulk Package (69784-230-20)",2.51,1.0,,,0 NDC,69784023110,"Sodium Acetate: 100 Ml In 1 Vial, Pharmacy Bulk Package (69784-231-10)",1.45,0.58,,,0 NDC,69784023120,"Sodium Acetate: 100 Ml In 1 Vial, Pharmacy Bulk Package (69784-231-20)",76.15,30.46,,,0 NDC,69784063025,Tabloid: 1 Bottle In 1 Carton (69784-630-25) / 25 Tablet In 1 Bottle,54.28,21.71,,,0 NDC,69918030130,Tranexamic Acid: 30 Tablet In 1 Bottle (69918-301-30),6.42,2.57,,,0 NDC,69918073110,"Isoproterenol Hydrochloride: 10 Vial, Single-Dose In 1 Carton (69918-731-10) / 1 Ml In 1 Vial, Single-Dose",322.17,128.87,,,0 NDC,69918073501,NDC Description Not Available,616.0,246.4,,,0 NDC,69918073510,"Isoproterenol Hydrochloride: 10 Vial, Single-Dose In 1 Carton (69918-735-10) / 5 Ml In 1 Vial, Single-Dose",531.81,212.72,,,0 NDC,69918089901,Desmopressin Acetate: 1 Ml In 1 Ampule (69918-899-01),41.88,16.75,,,0 NDC,69918090110,"Desmopressin Acetate: 1 Vial, Multi-Dose In 1 Carton (69918-901-10) / 10 Ml In 1 Vial, Multi-Dose",44.35,17.74,,,0 NDC,69945006401,"Detectnet: 1 Vial, Single-Use In 1 Can (69945-064-01) / 4 Ml In 1 Vial, Single-Use",3719.03,1487.61,,,0 NDC,69945006820,"Ultratag Rbc: 5 Cello Pack In 1 Box (69945-068-20) / 1 Kit In 1 Cello Pack (69945-068-10) * .6 Ml In 1 Syringe, Glass * 1 Ml In 1 Syringe, Glass * 9.5 Mg In 1 Vial, Glass",620.85,248.34,,,0 NDC,69945009120,"Technescan Hdp: 5 Vial In 1 Cello Pack (69945-091-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (69945-091-01)",207.15,82.86,,,0 NDC,69945009620,"Technescan Mag3: 5 Vial In 1 Cello Pack (69945-096-20) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",652.235,260.892,,,0 NDC,69945013940,"Pulmotech Maa: 30 Vial, Multi-Dose In 1 Carton (69945-139-40) / 15 Ml In 1 Vial, Multi-Dose (69945-139-10)",577.0649999999999,230.827,,,0 NDC,69945014013,"Ultra-Technekow V4: 1 Injection, Solution In 1 Carton (69945-140-13)",1.0799999999999998,0.432,,,0 NDC,69945018012,Gallium Citrate Ga-67: 1 Vial In 1 Can (69945-180-12) / 6.6 Ml In 1 Vial,297.58,119.03,,,0 NDC,69945045001,Sodium Iodide I-131: 1 VIAL in 1 CAN (69945-450-01) / 1 mL in 1 VIAL,56.29,22.52,,,0 NDC,69945045104,Sodium Iodide I-131: 1 VIAL in 1 CAN (69945-451-04) / 4 mL in 1 VIAL,58.28,23.31,,,0 NDC,69945045201,SODIUM IODIDE I 131: 1 CAPSULE in 1 CAN (69945-452-01) / 1 mL in 1 CAPSULE,68.39,27.36,,,0 NDC,69945045205,SODIUM IODIDE I 131: 1 CAPSULE in 1 CAN (69945-452-05) / 5 mL in 1 CAPSULE,58.28,23.31,,,0 NDC,70000002101,Epsom Salt: 454 G In 1 Pouch (70000-0021-1),5.45,2.18,,,0 NDC,70000004402,"Stomach Relief Original Strength: 237 Ml In 1 Bottle, Plastic (70000-0044-2)",0.39,0.16,,,0 NDC,70000005101,"Cardinal Health Infants Gas Relief: 1 Bottle, Dropper In 1 Carton (70000-0051-1) / 30 Ml In 1 Bottle, Dropper",0.09,0.04,,,0 NDC,70000005162,NDC Description Not Available,0.39,0.16,,,0 NDC,70000007901,Leader Baby Skin Protectant: 85 G In 1 Tube (70000-0079-1),10.82,4.33,,,0 NDC,70000010901,Leader Ready To Use Mineral Oil Laxative: 1 Bottle In 1 Carton (70000-0109-1) / 133 Ml In 1 Bottle,3.99,1.6,,,0 NDC,70000016901,Leader Maximum Strength Pain Relieving Analgesic: 1 Tube In 1 Carton (70000-0169-1) / 85 G In 1 Tube,8.9,3.56,,,0 NDC,70000023901,"Leader Ibuprofen: 1 Bottle In 1 Carton (70000-0239-1) / 24 Tablet, Chewable In 1 Bottle",0.38,0.15,,,0 NDC,70000032301,"Miconazole Nitrate: 71 G In 1 Bottle, With Applicator (70000-0323-1)",11.29,4.52,,,0 NDC,70000034802,"Nicotine Polacrilex Coated Ice Mint: 100 Blister Pack In 1 Carton (70000-0348-2) / 1 Gum, Chewing In 1 Blister Pack",0.89,0.36,,,0 NDC,70000038801,Leader Anti Itch: 1 Tube In 1 Carton (70000-0388-1) / 28 G In 1 Tube,3.62,1.45,,,0 NDC,70000040001,Leader Calamine Plus: 177 Ml In 1 Container (70000-0400-1),7.44,2.98,,,0 NDC,70000040901,Caffeine: 2 Blister Pack In 1 Carton (70000-0409-1) / 8 Tablet In 1 Blister Pack,0.22,0.09,,,0 NDC,70000041503,Leader Clearlax: 510 G In 1 Bottle (70000-0415-3),4.404999999999999,1.7600000000000002,,,0 NDC,70000041701,Leader Anti Diarrheal: 120 Ml In 1 Bottle (70000-0417-1),1.97,0.79,,,0 NDC,70000041715,NDC Description Not Available,0.78,0.31,,,0 NDC,70000041801,Leader Anti Diarrheal: 120 Ml In 1 Bottle (70000-0418-1),0.3,0.12,,,0 NDC,70000042901,Glycerin: 25 Suppository In 1 Jar (70000-0429-1),0.15,0.06,,,0 NDC,70000044801,"Leader Mineral Oil: 473 Ml In 1 Bottle, Plastic (70000-0448-1)",0.53,0.21,,,0 NDC,70000045801,"Sore Throat Relief Cherry Flavor: 177 Ml In 1 Bottle, Spray (70000-0458-1)",5.31,2.12,,,0 NDC,70000047401,Leader Childrens Allergy Relief: 1 Bottle In 1 Carton (70000-0474-1) / 118 Ml In 1 Bottle,0.18,0.07,,,0 NDC,70000047701,Leader Regular Strength Chocolate Laxative Sennosides: 2 Pouch In 1 Carton (70000-0477-1) / 12 Tablet In 1 Pouch,0.16,0.06,,,0 NDC,70000048501,Hydrocortisone: 72 Box In 1 Case (70000-0485-1) / 1 Tube In 1 Box / 28.4 G In 1 Tube,5.46,2.18,,,0 NDC,70000049001,"Leader Earwax Removal Kit: 1 Bottle, Dropper In 1 Carton (70000-0490-1) / 15 Ml In 1 Bottle, Dropper",4.5,1.8,,,0 NDC,70000050201,"Leader Dry Eye Relief Eye Drops: 1 Bottle, Plastic In 1 Carton (70000-0502-1) / 15 Ml In 1 Bottle, Plastic",7.62,3.05,,,0 NDC,70000052601,"Stool Softener Plus Stimulant Laxative: 100 Tablet, Film Coated In 1 Bottle, Plastic (70000-0526-1)",0.03,0.01,,,0 NDC,70000054202,Leader Athletes Foot Clotrimazole: 1 Tube In 1 Carton (70000-0542-2) / 28 G In 1 Tube,23.06,9.22,,,0 NDC,70000054601,"Leader Anti-Itch: 212 G In 1 Bottle, Pump (70000-0546-1)",8.0,3.2,,,0 NDC,70000054701,Leader Bacitracin Zinc: 1 Tube In 1 Box (70000-0547-1) / 28 G In 1 Tube,5.5,2.2,,,0 NDC,70000055502,Diclofenac Sodium: 1 Tube In 1 Carton (70000-0555-2) / 100 G In 1 Tube,22.72,9.09,,,0 NDC,70000056701,Sleep-Aid: 3 Blister Pack In 1 Carton (70000-0567-1) / 16 Tablet In 1 Blister Pack,0.26,0.1,,,0 NDC,70000066301,"Mineral Oil: 473 Ml In 1 Bottle, Plastic (70000-0663-1)",0.45,0.18,,,0 NDC,70000067901,"Antifungal Powder: 71 G In 1 Bottle, Plastic (70000-0679-1)",11.29,4.52,,,0 NDC,70010002901,"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate And Amphetamine Sulfate: 100 Capsule, Extended Release In 1 Bottle (70010-029-01)",1.82,0.73,,,0 NDC,70010003001,"Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate And Amphetamine Sulfate: 100 Capsule, Extended Release In 1 Bottle (70010-030-01)",1.84,0.74,,,0 NDC,70010011101,"Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate And Amphetamine Sulfate: 100 Tablet In 1 Bottle (70010-111-01)",1.01,0.4,,,0 NDC,70010075401,"Methocarbamol: 100 Tablet, Coated In 1 Bottle (70010-754-01)",0.18,0.07,,,0 NDC,70069000501,NDC Description Not Available,5.53,2.21,,,0 NDC,70069001301,NDC Description Not Available,1.82,0.73,,,0 NDC,70069002101,NDC Description Not Available,2.7,1.08,,,0 NDC,70069002125,Dexamethasone Sodium Phosphate: 25 Vial In 1 Carton (70069-021-25) / 1 Ml In 1 Vial (70069-021-01),2.08,0.83,,,0 NDC,70069003101,NDC Description Not Available,107.8,43.12,,,0 NDC,70069005101,Dorzolamide Hydrochloride And Timolol Maleate: 1 Bottle In 1 Carton (70069-051-01) / 10 Ml In 1 Bottle,42.88,17.15,,,0 NDC,70069006110,Ropivacaine Hydrochloride: 10 Vial In 1 Carton (70069-061-10) / 10 Ml In 1 Vial (70069-061-01),1.09,0.44,,,0 NDC,70069006201,NDC Description Not Available,0.79,0.32,,,0 NDC,70069006210,Ropivacaine Hydrochloride: 10 Vial In 1 Carton (70069-062-10) / 20 Ml In 1 Vial (70069-062-01),0.95,0.38,,,0 NDC,70069006401,Ropivacaine Hydrochloride: 1 Vial In 1 Carton (70069-064-01) / 30 Ml In 1 Vial,0.28,0.11,,,0 NDC,70069006425,Ropivacaine Hydrochloride: 25 Vial In 1 Carton (70069-064-25) / 30 Ml In 1 Vial,0.13,0.05,,,0 NDC,70069007110,Naloxone Hydrochloride: 10 Vial In 1 Carton (70069-071-10) / 1 Ml In 1 Vial (70069-071-01),9.51,3.8,,,0 NDC,70069010101,NDC Description Not Available,70.91,28.36,,,0 NDC,70069012101,Tropicamide: 1 Bottle In 1 Carton (70069-121-01) / 15 Ml In 1 Bottle,25.89,10.36,,,0 NDC,70069013101,Tobramycin: 1 Bottle In 1 Carton (70069-131-01) / 5 Ml In 1 Bottle,15.28,6.11,,,0 NDC,70069015101,Cisatracurium Besylate: 1 Vial In 1 Carton (70069-151-01) / 20 Ml In 1 Vial,434.83,173.93,,,0 NDC,70069015110,Cisatracurium Besylate: 10 Vial In 1 Carton (70069-151-10) / 20 Ml In 1 Vial,486.96,194.78,,,0 NDC,70069016110,"Cisatracurium Besylate: 10 Vial, Multi-Dose In 1 Carton (70069-161-10) / 10 Ml In 1 Vial, Multi-Dose",26.64,10.66,,,0 NDC,70069023101,Brimonidine Tartrate: 1 Bottle In 1 Carton (70069-231-01) / 5 Ml In 1 Bottle,18.63,7.45,,,0 NDC,70069026101,Sodium Nitroprusside: 1 Vial In 1 Carton (70069-261-01) / 2 Ml In 1 Vial,44.02,17.61,,,0 NDC,70069027101,NDC Description Not Available,44.36,17.74,,,0 NDC,70069027105,Verapamil Hydrochloride: 5 Vial In 1 Carton (70069-271-05) / 2 Ml In 1 Vial (70069-271-01),10.03,4.01,,,0 NDC,70069036201,NDC Description Not Available,0.33,0.13,,,0 NDC,70069036210,Sulfamethoxazole And Trimethoprim: 10 Vial In 1 Carton (70069-362-10) / 10 Ml In 1 Vial (70069-362-01),27.88,11.15,,,0 NDC,70069036301,Sulfamethoxazole And Trimethoprim: 1 Vial In 1 Carton (70069-363-01) / 30 Ml In 1 Vial,26.29,10.514999999999999,,,0 NDC,70069042101,Latanoprost: 1 Bottle In 1 Carton (70069-421-01) / 2.5 Ml In 1 Bottle,19.55,7.82,,,0 NDC,70069047101,NDC Description Not Available,0.91,0.36,,,0 NDC,70069047110,"Lacosamide: 10 Vial, Single-Dose In 1 Carton (70069-471-10) / 20 Ml In 1 Vial, Single-Dose (70069-471-01)",0.93,0.37,,,0 NDC,70069064101,NDC Description Not Available,0.73,0.29,,,0 NDC,70069072801,NDC Description Not Available,0.14,0.06,,,0 NDC,70069072810,"Calcium Gluconate: 10 Vial, Plastic In 1 Carton (70069-728-10) / 100 Ml In 1 Vial, Plastic",0.12,0.05,,,0 NDC,70069072820,"Calcium Gluconate: 20 Vial, Plastic In 1 Carton (70069-728-20) / 100 Ml In 1 Vial, Plastic (70069-728-01)",0.24,0.1,,,0 NDC,70069080201,NDC Description Not Available,0.01,0.004,,,0 NDC,70069080210,"Phenylephrine Hydrochloride: 10 Vial, Pharmacy Bulk Package In 1 Carton (70069-802-10) / 5 Ml In 1 Vial, Pharmacy Bulk Package (70069-802-01)",0.01,0.004,,,0 NDC,70069080701,NDC Description Not Available,9.26,3.7,,,0 NDC,70069080710,Milrinone Lactate: 10 Vial In 1 Carton (70069-807-10) / 10 Ml In 1 Vial (70069-807-01),9.86,3.94,,,0 NDC,70069081710,Midazolam: 10 Vial In 1 Carton (70069-817-10) / 5 Ml In 1 Vial,6.57,2.63,,,0 NDC,70069082301,Potassium Chloride For Oral Solution: 1.58 G In 1 Pouch (70069-823-01),4.53,1.81,,,0 NDC,70092100944,NDC Description Not Available,8.79,3.515,,,0 NDC,70092104646,NDC Description Not Available,0.45,0.18,,,0 NDC,70092106807,NDC Description Not Available,96.8,38.72,,,0 NDC,70092110336,NDC Description Not Available,102.52,41.01,,,0 NDC,70092111536,NDC Description Not Available,0.56,0.225,,,0 NDC,70092111944,NDC Description Not Available,15.54,6.22,,,0 NDC,70092113243,NDC Description Not Available,2.9,1.16,,,0 NDC,70092125575,NDC Description Not Available,219.03,87.61,,,0 NDC,70092131046,NDC Description Not Available,95.7,38.28,,,0 NDC,70092138036,NDC Description Not Available,5.66,2.26,,,0 NDC,70092141836,NDC Description Not Available,1.1,0.44,,,0 NDC,70092143350,NDC Description Not Available,229.38,91.75,,,0 NDC,70092152350,NDC Description Not Available,7.26,2.9,,,0 NDC,70092168748,NDC Description Not Available,0.32,0.13,,,0 NDC,70092200944,NDC Description Not Available,9.16,3.66,,,0 NDC,70092208746,NDC Description Not Available,13.47,5.39,,,0 NDC,70092905405,NDC Description Not Available,37.34,14.94,,,0 NDC,70092905605,NDC Description Not Available,54.69,21.88,,,0 NDC,70092911944,NDC Description Not Available,13.51,5.4,,,0 NDC,70095002401,NDC Description Not Available,27.57,11.03,,,0 NDC,70095002402,Pantoprazole Sodium: 10 Carton In 1 Package (70095-024-02) / 1 Vial In 1 Carton / 10 Ml In 1 Vial (70095-024-01),37.52,15.01,,,0 NDC,70095002502,Azithromycin Monohydrate: 10 Vial In 1 Carton (70095-025-02) / 10 Ml In 1 Vial (70095-025-01),9.06,3.62,,,0 NDC,70095005001,NDC Description Not Available,149.59,59.84,,,0 NDC,70100042401,NDC Description Not Available,70.84,28.34,,,0 NDC,70100042402,"Indocyanine Green: 6 Package In 1 Carton (70100-424-02) / 1 Kit In 1 Package * 1 Injection, Powder, Lyophilized, For Solution In 1 Vial * 10 Ml In 1 Vial, Plastic (0409-4887-17)",767.11,306.84,,,0 NDC,70114010101,Udenyca: 1 Syringe In 1 Carton (70114-101-01) / .6 Ml In 1 Syringe,1488.36,595.34,,,0 NDC,70114013001,Udenyca: 1 Syringe In 1 Carton (70114-130-01) / .6 Ml In 1 Syringe,1468.51,587.4,,,0 NDC,70114034001,"Loqtorzi: 1 Vial, Glass In 1 Carton (70114-340-01) / 6 Ml In 1 Vial, Glass",171.96,68.78,,,0 NDC,70121104901,NDC Description Not Available,17.87,7.15,,,0 NDC,70121104902,Triamcinolone Acetonide: 1 Vial In 1 Carton (70121-1049-2) / 1 Ml In 1 Vial (70121-1049-1),12.43,4.97,,,0 NDC,70121104905,Triamcinolone Acetonide: 25 Vial In 1 Carton (70121-1049-5) / 1 Ml In 1 Vial (70121-1049-1),17.36,6.94,,,0 NDC,70121116801,"Triamcinolone Acetonide: 1 Vial, Multi-Dose In 1 Carton (70121-1168-1) / 5 Ml In 1 Vial, Multi-Dose",15.12,6.05,,,0 NDC,70121116901,"Triamcinolone Acetonide: 1 Vial, Multi-Dose In 1 Carton (70121-1169-1) / 10 Ml In 1 Vial, Multi-Dose",12.63,5.05,,,0 NDC,70121123901,"Cyclophosphamide: 1 Vial, Single-Dose In 1 Carton (70121-1239-1) / 50 Ml In 1 Vial, Single-Dose",5.45,2.18,,,0 NDC,70121138801,NDC Description Not Available,40.48,16.19,,,0 NDC,70121138901,NDC Description Not Available,365.24,146.1,,,0 NDC,70121145301,NDC Description Not Available,9.32,3.73,,,0 NDC,70121147901,NDC Description Not Available,0.82,0.33,,,0 NDC,70121148202,"Carmustine: 1 Kit In 1 Carton (70121-1482-2) * 3 Ml In 1 Vial (70121-3639-1) * 30 Ml In 1 Vial, Single-Dose (70121-1668-1)",1385.19,554.08,,,0 NDC,70121157301,"Methylprednisolone Acetate: 1 Vial, Single-Dose In 1 Carton (70121-1573-1) / 1 Ml In 1 Vial, Single-Dose",0.92,0.37,,,0 NDC,70121157305,"Methylprednisolone Acetate: 25 Vial, Single-Dose In 1 Carton (70121-1573-5) / 1 Ml In 1 Vial, Single-Dose",0.86,0.34,,,0 NDC,70121157401,"Methylprednisolone Acetate: 1 Vial, Single-Dose In 1 Carton (70121-1574-1) / 1 Ml In 1 Vial, Single-Dose",0.9,0.36,,,0 NDC,70121157405,"Methylprednisolone Acetate: 25 Vial, Single-Dose In 1 Carton (70121-1574-5) / 1 Ml In 1 Vial, Single-Dose",0.91,0.36,,,0 NDC,70121157601,NDC Description Not Available,14.53,5.81,,,0 NDC,70121157607,Norepinephrine Bitartrate: 10 Vial In 1 Carton (70121-1576-7) / 4 Ml In 1 Vial (70121-1576-1),14.52,5.81,,,0 NDC,70121157801,NDC Description Not Available,0.08,0.03,,,0 NDC,70121162701,Fylnetra: 1 Syringe In 1 Carton (70121-1627-1) / .6 Ml In 1 Syringe,790.12,316.05,,,0 NDC,70121163101,"Tepadina: 1 Vial, Glass In 1 Box (70121-1631-1) / 1 Injection, Powder, For Solution In 1 Vial, Glass",1370.17,548.07,,,0 NDC,70121163701,NDC Description Not Available,12.37,4.95,,,0 NDC,70121163705,"Ephedrine Sulfate: 25 Vial, Single-Dose In 1 Carton (70121-1637-5) / 1 Ml In 1 Vial, Single-Dose (70121-1637-1)",6.89,2.76,,,0 NDC,70121164201,NDC Description Not Available,5.08,2.03,,,0 NDC,70121164701,NDC Description Not Available,1.96,0.78,,,0 NDC,70121165501,"Triamcinolone Acetonide: 1 Vial, Multi-Dose In 1 Carton (70121-1655-1) / 10 Ml In 1 Vial, Multi-Dose",2.64,1.06,,,0 NDC,70121168001,Carboprost Tromethamine: 1 Vial In 1 Carton (70121-1680-1) / 1 Ml In 1 Vial,309.34,123.74,,,0 NDC,70121168007,Carboprost Tromethamine: 10 Vial In 1 Carton (70121-1680-7) / 1 Ml In 1 Vial,309.34,123.74,,,0 NDC,70121169402,"Plerixafor: 1 Vial, Single-Dose In 1 Carton (70121-1694-2) / 1.2 Ml In 1 Vial, Single-Dose",196.25,78.5,,,0 NDC,70121171203,Dexmedetomidine Hydrochloride: 12 Pouch In 1 Carton (70121-1712-3) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,86.02,34.41,,,0 NDC,70121171707,Esmolol Hydrochloride: 10 Pouch In 1 Carton (70121-1717-7) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,1.45,0.58,,,0 NDC,70121171909,Magnesium Sulfate: 24 Pouch In 1 Carton (70121-1719-9) / 1 Bag In 1 Pouch / 50 Ml In 1 Bag,4.43,1.77,,,0 NDC,70121172001,NDC Description Not Available,1.43,0.57,,,0 NDC,70121172009,Magnesium Sulfate: 24 Pouch In 1 Carton (70121-1720-9) / 1 Bag In 1 Pouch / 100 Ml In 1 Bag,4.05,1.62,,,0 NDC,70121173309,Ropivacaine Hydrochloride: 24 Pouch In 1 Carton (70121-1733-9) / 1 Bag In 1 Pouch / 200 Ml In 1 Bag,0.33,0.13,,,0 NDC,70121174301,"Nelarabine: 1 Vial, Single-Dose In 1 Carton (70121-1743-1) / 50 Ml In 1 Vial, Single-Dose",217.58,87.03,,,0 NDC,70121174304,"Nelarabine: 6 Vial, Single-Dose In 1 Carton (70121-1743-4) / 50 Ml In 1 Vial, Single-Dose (70121-1743-1)",209.75,83.9,,,0 NDC,70121175401,Alymsys: 1 Vial In 1 Carton (70121-1754-1) / 4 Ml In 1 Vial,324.23,129.69,,,0 NDC,70121175501,Alymsys: 1 Vial In 1 Carton (70121-1755-1) / 16 Ml In 1 Vial,324.3,129.72,,,0 NDC,70121230804,"Calcium Chloride: 24 Carton In 1 Carton (70121-2308-4) / 1 Syringe, Glass In 1 Carton (70121-2308-1) / 10 Ml In 1 Syringe, Glass",0.09,0.04,,,0 NDC,70127010001,NDC Description Not Available,123.95,49.58,,,0 NDC,70127010010,"Epidiolex: 1 Bottle, Glass In 1 Carton (70127-100-10) / 100 Ml In 1 Bottle, Glass (70127-100-01)",121.23,48.49,,,0 NDC,70156010401,Hyoscyamine Sulfate: 100 TABLET in 1 BOTTLE (70156-104-01),1.0,0.4,,,0 NDC,70166028401,Methadone Hydrochloride: 30 BAG in 1 BOX (70166-284-01) / 1 SYRINGE in 1 BAG / 1 mL in 1 SYRINGE,0.1,0.04,,,0 NDC,70199002611,"Aquasol A: 1 Vial, Single-Dose In 1 Carton (70199-026-11) / 2 Ml In 1 Vial, Single-Dose",206.1,82.44,,,0 NDC,70257005105,NDC Description Not Available,241.38,96.55,,,0 NDC,70257005151,"Hepagam B: 1 Vial, Glass In 1 Carton (70257-051-51) / 5 Ml In 1 Vial, Glass (70257-051-05)",242.46,96.98,,,0 NDC,70257033051,"Winrho Sdf: 1 Vial, Single-Dose In 1 Carton (70257-330-51) / 1 Liquid In 1 Vial, Single-Dose (70257-330-11)",635.97,254.39,,,0 NDC,70370106001,Ingrezza: 30 Capsule In 1 Bottle (70370-1060-1),1265.77,506.31,,,0 NDC,70377000612,"Rosuvastatin Calcium: 90 Tablet, Film Coated In 1 Bottle, Plastic (70377-006-12)",0.4,0.16,,,0 NDC,70377011412,Liothyronine Sodium: 100 Tablet In 1 Bottle (70377-114-12),1.5,0.6,,,0 NDC,70377011831,"Nitrofurantoin: 1 Bottle, Glass In 1 Carton (70377-118-31) / 230 Ml In 1 Bottle, Glass",101.0,40.4,,,0 NDC,70408014634,Promethazine Hydrochloride: 473 Ml In 1 Bottle (70408-146-34),2.4,0.96,,,0 NDC,70408023932,"Nitrofurantoin: 240 Ml In 1 Bottle, Plastic (70408-239-32)",259.02,103.61,,,0 NDC,70436001982,Azithromycin: 10 Vial In 1 Box (70436-019-82) / 5 Ml In 1 Vial,16.85,6.74,,,0 NDC,70436002082,"Vancomycin Hydrochloride: 10 Vial In 1 Carton (70436-020-82) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",3.27,1.31,,,0 NDC,70436002182,"Vancomycin Hydrochloride: 10 Vial In 1 Carton (70436-021-82) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",5.25,2.1,,,0 NDC,70436002382,"Vancomycin Hydrochloride: 1 Vial In 1 Carton (70436-023-82) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial",5.14,2.06,,,0 NDC,70436002580,"Bivalirudin: 1 Injection, Powder, Lyophilized, For Suspension In 1 Vial, Single-Dose (70436-025-80)",0.95,0.38,,,0 NDC,70436002780,Eptifibatide: 100 Ml In 1 Vial (70436-027-80),16.84,6.74,,,0 NDC,70436002980,"Voriconazole: 1 Injection, Powder, Lyophilized, For Solution In 1 Box (70436-029-80)",28.555,11.425,,,0 NDC,70436006001,"Bupropion Hydrochloride Sr: 100 Tablet, Extended Release In 1 Bottle (70436-060-01)",1.35,0.54,,,0 NDC,70436008955,Ganciclovir: 25 Vial In 1 Carton (70436-089-55) / 10 Ml In 1 Vial,185.73,74.29,,,0 NDC,70436020380,"Dobutamine: 1 Vial, Single-Dose In 1 Carton (70436-203-80) / 20 Ml In 1 Vial, Single-Dose",21.16,8.46,,,0 NDC,70436020780,"Sodium Nitroprusside In 0.9% Sodium Chloride: 1 Vial, Single-Dose In 1 Carton (70436-207-80) / 100 Ml In 1 Vial, Single-Dose",181.44,72.58,,,0 NDC,70436023039,Voriconazole: 1 Bottle In 1 Carton (70436-230-39) / 75 Ml In 1 Bottle,132.75,53.1,,,0 NDC,70512084001,NDC Description Not Available,7.49,3.0,,,0 NDC,70512085901,NDC Description Not Available,564.7,225.88,,,0 NDC,70515059415,Zanaflex: 150 Tablet In 1 Bottle (70515-594-15),13.38,5.35,,,0 NDC,70594003401,"Daptomycin: 1 Vial, Single-Use In 1 Carton (70594-034-01) / 10 Ml In 1 Vial, Single-Use",0.53,0.21,,,0 NDC,70594004602,"Vancomycin Hydrochloride: 10 Vial, Glass In 1 Carton (70594-046-02) / 1 Injection, Powder, For Solution In 1 Vial, Glass (70594-046-01)",2.66,1.06,,,0 NDC,70594004801,"Vancomycin Hydrochloride: 1 Vial, Glass In 1 Carton (70594-048-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Glass",5.92,2.37,,,0 NDC,70594006701,"Voriconazole: 1 Vial, Single-Dose In 1 Carton (70594-067-01) / 20 Ml In 1 Vial, Single-Dose",8.8,3.52,,,0 NDC,70594008701,NDC Description Not Available,7.76,3.1,,,0 NDC,70594009001,NDC Description Not Available,9.465,3.785,,,0 NDC,70594011101,NDC Description Not Available,4.96,1.98,,,0 NDC,70594011102,Acetylcysteine: 4 Vial In 1 Carton (70594-111-02) / 30 Ml In 1 Vial (70594-111-01),5.11,2.04,,,0 NDC,70594011201,NDC Description Not Available,189.73,75.89,,,0 NDC,70594011202,Carboprost Tromethamine: 10 Vial In 1 Carton (70594-112-02) / 1 Ml In 1 Vial (70594-112-01),190.63,76.25,,,0 NDC,70594011401,NDC Description Not Available,0.11,0.04,,,0 NDC,70594011701,NDC Description Not Available,0.06,0.02,,,0 NDC,70700016201,Progesterone: 100 Capsule In 1 Bottle (70700-162-01),1.73,0.69,,,0 NDC,70700016722,NDC Description Not Available,7.47,2.99,,,0 NDC,70700017022,"Irinotecan Hydrochloride: 1 Vial, Single-Dose In 1 Carton (70700-170-22) / 5 Ml In 1 Vial, Single-Dose",9.0,3.6,,,0 NDC,70700018722,NDC Description Not Available,22.43,8.97,,,0 NDC,70700018723,Fluorouracil: 10 Vial In 1 Carton (70700-187-23) / 20 Ml In 1 Vial (70700-187-22),27.32,10.93,,,0 NDC,70700018822,"Fluorouracil: 1 Vial, Pharmacy Bulk Package In 1 Carton (70700-188-22) / 50 Ml In 1 Vial, Pharmacy Bulk Package",23.7,9.48,,,0 NDC,70700018922,"Fluorouracil: 1 Vial, Pharmacy Bulk Package In 1 Carton (70700-189-22) / 100 Ml In 1 Vial, Pharmacy Bulk Package",25.34,10.14,,,0 NDC,70700026894,Fosfomycin Tromethamine: 1 Dose Pack In 1 Carton (70700-268-94) / 1 Powder In 1 Dose Pack,238.47,95.39,,,0 NDC,70700026899,Fosfomycin Tromethamine: 1 Powder In 1 Packet (70700-268-99),240.96,96.38,,,0 NDC,70700027422,"Estradiol Valerate: 5 Ml In 1 Vial, Multi-Dose (70700-274-22)",0.01,0.004,,,0 NDC,70710101401,Phytonadione: 1 Bottle In 1 Carton (70710-1014-1) / 100 Tablet In 1 Bottle,88.1,35.24,,,0 NDC,70710113703,Fluconazole: 30 Tablet In 1 Bottle (70710-1137-3),0.99,0.4,,,0 NDC,70710123304,Betamethasone Dipropionate: 1 Tube In 1 Carton (70710-1233-4) / 45 G In 1 Tube,181.33,72.53,,,0 NDC,70710135901,NDC Description Not Available,0.05,0.02,,,0 NDC,70710141101,"Bortezomib: 1 Vial, Single-Dose In 1 Carton (70710-1411-1) / 3.5 Ml In 1 Vial, Single-Dose",3.38,1.35,,,0 NDC,70710146002,Azithromycin: 1 Bottle In 1 Carton (70710-1460-2) / 30 Ml In 1 Bottle,5.65,2.26,,,0 NDC,70710147801,Fomepizole: 1 Vial In 1 Carton (70710-1478-1) / 1.5 Ml In 1 Vial,71.93,28.77,,,0 NDC,70710152509,"Carmustine: 1 Kit In 1 Carton (70710-1525-9) * 3 Ml In 1 Vial (70710-1523-1) * 30 Ml In 1 Vial, Single-Dose (70710-1524-1)",1288.6,515.44,,,0 NDC,70710153001,"Doxorubicin Hydrochloride: 1 Vial, Single-Dose In 1 Carton (70710-1530-1) / 10 Ml In 1 Vial, Single-Dose",1752.84,701.14,,,0 NDC,70710153101,"Doxorubicin Hydrochloride: 1 Vial, Single-Dose In 1 Carton (70710-1531-1) / 25 Ml In 1 Vial, Single-Dose",253.59,101.44,,,0 NDC,70710161306,"Varenicline: 56 Tablet, Film Coated In 1 Bottle (70710-1613-6)",18.09,7.24,,,0 NDC,70710164206,Lubiprostone: 60 Capsule In 1 Bottle (70710-1642-6),3.18,1.27,,,0 NDC,70710166307,"Cyanocobalamin: 25 Vial, Multi-Dose In 1 Carton (70710-1663-7) / 1 Ml In 1 Vial, Multi-Dose (70710-1663-1)",12.05,4.82,,,0 NDC,70710172601,"Nelarabine: 1 Vial, Single-Dose In 1 Carton (70710-1726-1) / 50 Ml In 1 Vial, Single-Dose",827.15,330.86,,,0 NDC,70710174503,Dasatinib: 30 Tablet In 1 Bottle (70710-1745-3),315.07,126.03,,,0 NDC,70710183301,"Levothyroxine Sodium: 1 Vial, Single-Dose In 1 Carton (70710-1833-1) / 5 Ml In 1 Vial, Single-Dose",41.19,16.48,,,0 NDC,70710183801,NDC Description Not Available,655.5550000000001,262.21999999999997,,,0 NDC,70710183805,Methylene Blue: 5 Vial In 1 Carton (70710-1838-5) / 10 Ml In 1 Vial (70710-1838-1),899.65,359.86,,,0 NDC,70710185207,Indomethacin: 5 Blister Pack In 1 Carton (70710-1852-7) / 6 Suppository In 1 Blister Pack (70710-1852-6),1198.74,479.5,,,0 NDC,70710192601,Sodium Phenylacetate And Sodium Benzoate: 1 Vial In 1 Carton (70710-1926-1) / 20 Ml In 1 Vial,5919.62,2367.85,,,0 NDC,70720072010,"Prialt: 1 Vial, Glass In 1 Carton (70720-720-10) / 1 Ml In 1 Vial, Glass",53.37,21.35,,,0 NDC,70720072210,"Prialt: 1 Vial, Glass In 1 Carton (70720-722-10) / 5 Ml In 1 Vial, Glass",44.98,17.99,,,0 NDC,70748012749,"Varenicline: 56 Tablet, Film Coated In 1 Bottle (70748-127-49)",7.29,2.92,,,0 NDC,70748025807,"Posaconazole: 60 Tablet, Delayed Release In 1 Bottle (70748-258-07)",22.51,9.0,,,0 NDC,70748032301,NDC Description Not Available,6.64,2.66,,,0 NDC,70748033203,Prednisolone Acetate: 1 Bottle In 1 Carton (70748-332-03) / 10 Ml In 1 Bottle,245.52,98.21,,,0 NDC,70748033901,"Doxorubicin Hydrochloride: 1 Vial, Single-Use In 1 Carton (70748-339-01) / 10 Ml In 1 Vial, Single-Use",850.43,340.17,,,0 NDC,70748034001,"Doxorubicin Hydrochloride: 1 Vial, Single-Use In 1 Carton (70748-340-01) / 25 Ml In 1 Vial, Single-Use",837.36,334.94,,,0 NDC,70752010406,"Cetirizine Hydrochloride: 1 Bottle, Plastic In 1 Carton (70752-104-06) / 118 Ml In 1 Bottle, Plastic",0.17,0.07,,,0 NDC,70752011303,Lidocaine: 1 Tube In 1 Carton (70752-113-03) / 35.44 G In 1 Tube,29.34,11.74,,,0 NDC,70752013812,"Promethazine Hydrochloride: 473 Ml In 1 Bottle, Plastic (70752-138-12)",3.86,1.54,,,0 NDC,70756020111,"Amitriptyline Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (70756-201-11)",0.2,0.08,,,0 NDC,70756020311,"Amitriptyline Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (70756-203-11)",0.55,0.22,,,0 NDC,70756061430,"Phenylephrine Hydrochloride: 1 Bottle, Dropper In 1 Carton (70756-614-30) / 5 Ml In 1 Bottle, Dropper",187.46,74.98,,,0 NDC,70756062210,"Phenylephrine Hydrochloride: 10 Vial, Pharmacy Bulk Package In 1 Carton (70756-622-10) / 5 Ml In 1 Vial, Pharmacy Bulk Package (70756-622-85)",0.03,0.01,,,0 NDC,70756062285,NDC Description Not Available,0.01,0.004,,,0 NDC,70756062925,"Phenylephrine Hydrochloride: 1 Bottle, Dropper In 1 Carton (70756-629-25) / 2 Ml In 1 Bottle, Dropper",118.77,47.51,,,0 NDC,70756064125,Lidocaine Hydrochloride: 25 Vial In 1 Carton (70756-641-25) / 5 Ml In 1 Vial,2.01,0.805,,,0 NDC,70756064586,Lidocaine Hydrochloride: 1 Vial In 1 Carton (70756-645-86) / 10 Ml In 1 Vial,0.07,0.03,,,0 NDC,70756064935,"Phenylephrine Hydrochloride: 1 Bottle, Dropper In 1 Carton (70756-649-35) / 15 Ml In 1 Bottle, Dropper",386.27,154.51,,,0 NDC,70842012001,NDC Description Not Available,9.67,3.87,,,0 NDC,70842012006,"Vabomere: 6 Vial, Single-Dose In 1 Carton (70842-120-06) / 2 G In 1 Vial, Single-Dose (70842-120-01)",8.38,3.35,,,0 NDC,70842014001,NDC Description Not Available,117.53,47.01,,,0 NDC,70842016001,NDC Description Not Available,10.42,4.17,,,0 NDC,70842016010,Minocin: 10 Vial In 1 Carton (70842-160-10) / 1 Injection In 1 Vial (70842-160-01),10.8,4.32,,,0 NDC,70860010010,"Azithromycin: 10 Vial, Single-Dose In 1 Carton (70860-100-10) / 5 Ml In 1 Vial, Single-Dose (70860-100-41)",22.0,8.8,,,0 NDC,70860010041,NDC Description Not Available,22.0,8.8,,,0 NDC,70860011415,"Ampicillin: 10 VIAL in 1 CARTON (70860-114-15) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL (70860-114-41)",16.5,6.6,,,0 NDC,70860011999,Nafcillin: 1 Bottle In 1 Carton (70860-119-99) / 100 Ml In 1 Bottle,43.355000000000004,17.345,,,0 NDC,70860012641,NDC Description Not Available,2.04,0.82,,,0 NDC,70860030105,Diltiazem Hydrochloride: 10 Vial In 1 Carton (70860-301-05) / 5 Ml In 1 Vial (70860-301-41),6.72,2.69,,,0 NDC,70860030125,Diltiazem Hydrochloride: 10 Vial In 1 Carton (70860-301-25) / 25 Ml In 1 Vial (70860-301-43),34.86,13.94,,,0 NDC,70860030141,NDC Description Not Available,4.845,1.94,,,0 NDC,70860030143,NDC Description Not Available,20.07,8.03,,,0 NDC,70860030241,NDC Description Not Available,0.16,0.06,,,0 NDC,70860040010,Tranexamic Acid: 10 Vial In 1 Carton (70860-400-10) / 10 Ml In 1 Vial (70860-400-41),8.6,3.44,,,0 NDC,70860040541,NDC Description Not Available,5.02,2.01,,,0 NDC,70860045110,Levothyroxine Sodium: 1 VIAL in 1 CARTON (70860-451-10) / 5 mL in 1 VIAL,134.59,53.835,,,0 NDC,70860060041,NDC Description Not Available,2.31,0.92,,,0 NDC,70860060142,NDC Description Not Available,0.18,0.07,,,0 NDC,70860070002,Ketorolac Tromethamine: 25 VIAL in 1 CARTON (70860-700-02) / 1 mL in 1 VIAL (70860-700-41),7.76,3.1,,,0 NDC,70860070041,NDC Description Not Available,6.93,2.77,,,0 NDC,70860070103,Ketorolac Tromethamine: 25 Vial In 1 Carton (70860-701-03) / 1 Ml In 1 Vial (70860-701-41),4.1,1.64,,,0 NDC,70860070141,NDC Description Not Available,3.24,1.3,,,0 NDC,70860077641,NDC Description Not Available,0.5,0.2,,,0 NDC,70860077802,Prochlorperazine Edisylate: 10 Vial In 1 Carton (70860-778-02) / 2 Ml In 1 Vial (70860-778-41),7.96,3.18,,,0 NDC,70860077841,NDC Description Not Available,8.57,3.43,,,0 NDC,70954004110,Rifabutin: 100 Capsule In 1 Bottle (70954-041-10),54.28,21.71,,,0 NDC,70954005110,Felbamate: 237 Ml In 1 Bottle (70954-051-10),14.37,5.75,,,0 NDC,70954006010,Prednisone: 100 Tablet In 1 Bottle (70954-060-10),0.01,0.004,,,0 NDC,70954006110,Prednisone: 100 Tablet In 1 Bottle (70954-061-10),0.02,0.01,,,0 NDC,70954013510,Dapsone: 30 Tablet In 1 Bottle (70954-135-10),2.95,1.18,,,0 NDC,70954013610,Dapsone: 30 Tablet In 1 Bottle (70954-136-10),3.6,1.44,,,0 NDC,70954014010,Levocarnitine: 118 Ml In 1 Bottle (70954-140-10),5.98,2.39,,,0 NDC,70954014810,Pyridostigmine: 473 Ml In 1 Bottle (70954-148-10),44.29,17.72,,,0 NDC,70954016810,Sildenafil: 1 Bottle In 1 Carton (70954-168-10) / 112 Ml In 1 Bottle,1.25,0.5,,,0 NDC,70954018810,Acyclovir: 473 Ml In 1 Bottle (70954-188-10),6.31,2.52,,,0 NDC,70954021110,Trihexyphenidyl Hydrochloride: 100 Tablet In 1 Bottle (70954-211-10),0.67,0.27,,,0 NDC,70954025810,Sulfamethoxazole And Trimethoprim: 473 Ml In 1 Bottle (70954-258-10),5.68,2.27,,,0 NDC,70954027410,Fluphenazine Hydrochloride: 100 Tablet In 1 Bottle (70954-274-10),1.84,0.74,,,0 NDC,70954031610,Famotidine: 50 Ml In 1 Bottle (70954-316-10),2.34,0.94,,,0 NDC,70954031910,Paroxetine: 250 Ml In 1 Bottle (70954-319-10),62.63,25.05,,,0 NDC,70954036510,Phenoxybenzamine Hydrochloride: 100 Capsule In 1 Bottle (70954-365-10),118.52,47.41,,,0 NDC,70954041710,NDC Description Not Available,80.67,32.27,,,0 NDC,70954041720,"L-Glutamine: 60 Packet In 1 Carton (70954-417-20) / 1 Powder, For Solution In 1 Packet (70954-417-10)",80.67,32.27,,,0 NDC,70954044310,Misoprostol: 60 Tablet In 1 Bottle (70954-443-10),1.63,0.65,,,0 NDC,70954044410,Misoprostol: 60 Tablet In 1 Bottle (70954-444-10),2.9,1.16,,,0 NDC,70954048430,Pyrazinamide: 100 Tablet In 1 Bottle (70954-484-30),15.52,6.21,,,0 NDC,70954048810,"Lacosamide: 200 Ml In 1 Bottle, Plastic (70954-488-10)",12.81,5.12,,,0 NDC,70954049210,Levocarnitine: 90 Blister Pack In 1 Carton (70954-492-10) / 10 Tablet In 1 Blister Pack,2.48,0.99,,,0 NDC,70954060010,"Fluoxetine Hydrochloride: 120 Ml In 1 Bottle, Plastic (70954-600-10)",7.39,2.96,,,0 NDC,70954066210,"Ketoconazole: 120 Ml In 1 Bottle, Plastic (70954-662-10)",45.27,18.11,,,0 NDC,70954089620,Megestrol Acetate: 480 Ml In 1 Bottle (70954-896-20),24.24,9.7,,,0 NDC,71083002005,"Nephroscan: 5 Vial, Single-Dose In 1 Carton (71083-0020-5) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose (71083-0020-1)",2877.7400000000002,1151.097,,,0 NDC,71225012001,"Vivimusta: 1 Vial, Multi-Dose In 1 Carton (71225-120-01) / 4 Ml In 1 Vial, Multi-Dose",144.0,57.6,,,0 NDC,71225013201,NDC Description Not Available,47.15,18.86,,,0 NDC,71225013301,NDC Description Not Available,87.86,35.14,,,0 NDC,71258002200,NDC Description Not Available,2149.2,859.68,,,0 NDC,71266200102,NDC Description Not Available,4.09,1.64,,,0 NDC,71266200108,NDC Description Not Available,6.22,2.49,,,0 NDC,71266503001,NDC Description Not Available,0.92,0.37,,,0 NDC,71266503501,NDC Description Not Available,0.595,0.235,,,0 NDC,71266507201,NDC Description Not Available,58.695,23.48,,,0 NDC,71266507301,NDC Description Not Available,27.5,11.0,,,0 NDC,71266507501,NDC Description Not Available,30.01,12.0,,,0 NDC,71266508201,NDC Description Not Available,38.225,15.290000000000001,,,0 NDC,71266508301,NDC Description Not Available,6.3,2.52,,,0 NDC,71266508501,NDC Description Not Available,5.27,2.11,,,0 NDC,71266510001,NDC Description Not Available,68.2,27.28,,,0 NDC,71266510301,NDC Description Not Available,68.18,27.27,,,0 NDC,71266513001,NDC Description Not Available,88.55,35.42,,,0 NDC,71266523001,NDC Description Not Available,43.48,17.39,,,0 NDC,71266629001,NDC Description Not Available,26.55,10.62,,,0 NDC,71266650901,NDC Description Not Available,316.31,126.52,,,0 NDC,71266651901,NDC Description Not Available,305.77,122.31,,,0 NDC,71266664101,NDC Description Not Available,17.53,7.01,,,0 NDC,71266802001,NDC Description Not Available,630.6,252.24,,,0 NDC,71266861301,NDC Description Not Available,52.44,20.98,,,0 NDC,71266901101,NDC Description Not Available,0.48,0.19,,,0 NDC,71266908002,NDC Description Not Available,11.26,4.5,,,0 NDC,71266908004,NDC Description Not Available,8.78,3.51,,,0 NDC,71266909001,NDC Description Not Available,0.23,0.09,,,0 NDC,71266911501,NDC Description Not Available,0.42,0.17,,,0 NDC,71285020201,NDC Description Not Available,262.44,104.98,,,0 NDC,71288001615,"Daptomycin: 1 Vial, Single-Dose In 1 Carton (71288-016-15) / 10 Ml In 1 Vial, Single-Dose",0.13,0.05,,,0 NDC,71288002420,NDC Description Not Available,10.38,4.15,,,0 NDC,71288002421,"Vancomycin Hydrochloride: 10 Vial, Single-Dose In 1 Carton (71288-024-21) / 15 Ml In 1 Vial, Single-Dose (71288-024-20)",34.82,13.93,,,0 NDC,71288002675,"Vancomycin Hydrochloride: 1 Vial, Pharmacy Bulk Package In 1 Carton (71288-026-75) / 95 Ml In 1 Vial, Pharmacy Bulk Package",46.78,18.71,,,0 NDC,71288002730,"Voriconazole: 1 Vial, Single-Dose In 1 Carton (71288-027-30) / 20 Ml In 1 Vial, Single-Dose",7.7,3.08,,,0 NDC,71288002810,NDC Description Not Available,3.64,1.46,,,0 NDC,71288002811,"Micafungin: 10 Vial, Single-Dose In 1 Carton (71288-028-11) / 5 Ml In 1 Vial, Single-Dose (71288-028-10)",2.45,0.98,,,0 NDC,71288002910,NDC Description Not Available,2.36,0.94,,,0 NDC,71288002911,"Micafungin: 10 Vial, Single-Dose In 1 Carton (71288-029-11) / 5 Ml In 1 Vial, Single-Dose (71288-029-10)",2.34,0.94,,,0 NDC,71288003020,NDC Description Not Available,35.760000000000005,14.305000000000001,,,0 NDC,71288003120,NDC Description Not Available,22.9,9.16,,,0 NDC,71288003121,"Ampicillin And Sulbactam: 10 Vial, Single-Dose In 1 Carton (71288-031-21) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose (71288-031-20)",9.37,3.75,,,0 NDC,71288003220,NDC Description Not Available,18.29,7.32,,,0 NDC,71288003221,"Ampicillin And Sulbactam: 10 Vial, Single-Dose In 1 Carton (71288-032-21) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose (71288-032-20)",7.65,3.06,,,0 NDC,71288010120,"Oxaliplatin: 1 Vial, Single-Dose In 1 Carton (71288-101-20) / 20 Ml In 1 Vial, Single-Dose",0.26,0.1,,,0 NDC,71288010720,"Bleomycin: 1 Vial, Single-Dose In 1 Carton (71288-107-20) / 30 Powder, For Solution In 1 Vial, Single-Dose",124.67,49.87,,,0 NDC,71288010920,"Cytarabine: 1 Vial, Single-Dose In 1 Carton (71288-109-20) / 20 Ml In 1 Vial, Single-Dose",39.43,15.77,,,0 NDC,71288011530,"Azacitidine: 1 Vial, Single-Dose In 1 Carton (71288-115-30) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",1.25,0.5,,,0 NDC,71288011610,NDC Description Not Available,2.24,0.9,,,0 NDC,71288011611,"Busulfan: 8 Vial, Single-Dose In 1 Carton (71288-116-11) / 10 Ml In 1 Vial, Single-Dose (71288-116-10)",2.24,0.9,,,0 NDC,71288011754,"Gemcitabine: 1 Vial, Single-Dose In 1 Carton (71288-117-54) / 52.6 Ml In 1 Vial, Single-Dose",24.23,9.69,,,0 NDC,71288011810,"Bortezomib: 1 Vial, Single-Dose In 1 Carton (71288-118-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",5.44,2.18,,,0 NDC,71288011920,"Decitabine: 1 Vial, Single-Dose In 1 Carton (71288-119-20) / 20 Ml In 1 Vial, Single-Dose",4.66,1.86,,,0 NDC,71288012690,"Carmustine: 1 Kit In 1 Carton (71288-126-90) * 30 Ml In 1 Vial, Single-Dose (71288-124-30) * 3 Ml In 1 Vial (71288-125-03)",2455.8,982.32,,,0 NDC,71288013290,"Melphalan Hydrochloride: 1 Kit In 1 Carton (71288-132-90) * 15 Ml In 1 Vial, Single-Dose (71288-130-15) * 10 Ml In 1 Vial, Single-Use (71288-131-10)",367.46,146.98,,,0 NDC,71288013850,"Mitomycin: 1 Vial, Single-Dose In 1 Carton (71288-138-50) / 40 Ml In 1 Vial, Single-Dose",494.99,198.0,,,0 NDC,71288014750,"Pemetrexed: 1 Vial, Single-Dose In 1 Carton (71288-147-50) / 30 Ml In 1 Vial, Single-Dose",6.32,2.53,,,0 NDC,71288014851,"Pemetrexed: 1 Vial, Single-Dose In 1 Carton (71288-148-51) / 40 Ml In 1 Vial, Single-Dose",6.12,2.45,,,0 NDC,71288015476,"Fluorouracil: 1 Vial, Pharmacy Bulk Package In 1 Carton (71288-154-76) / 100 Ml In 1 Vial, Pharmacy Bulk Package",6.1,2.44,,,0 NDC,71288015501,"Plerixafor: 1 Vial, Single-Dose In 1 Carton (71288-155-01) / 1.2 Ml In 1 Vial, Single-Dose",44.46,17.78,,,0 NDC,71288015710,"Thiotepa: 1 Vial, Single-Dose In 1 Carton (71288-157-10) / 1 Injection, Powder, For Solution In 1 Vial, Single-Dose",1509.93,603.97,,,0 NDC,71288016330,"Leucovorin Calcium: 1 Vial, Single-Dose In 1 Carton (71288-163-30) / 17.5 Ml In 1 Vial, Single-Dose",17.55,7.02,,,0 NDC,71288016554,"Nelarabine: 1 Vial, Single-Dose In 1 Carton (71288-165-54) / 50 Ml In 1 Vial, Single-Dose (71288-165-52)",665.06,266.02,,,0 NDC,71288016610,"Pemetrexed: 1 Vial, Single-Dose In 1 Carton (71288-166-10) / 10 Ml In 1 Vial, Single-Dose",4.9,1.96,,,0 NDC,71288016750,"Pemetrexed: 1 Vial, Single-Dose In 1 Carton (71288-167-50) / 50 Ml In 1 Vial, Single-Dose",4.05,1.62,,,0 NDC,71288017075,"Fluorouracil: 1 Vial, Pharmacy Bulk Package In 1 Carton (71288-170-75) / 50 Ml In 1 Vial, Pharmacy Bulk Package",6.54,2.62,,,0 NDC,71288020010,NDC Description Not Available,5.8,2.32,,,0 NDC,71288020020,NDC Description Not Available,8.37,3.35,,,0 NDC,71288020021,"Milrinone Lactate: 10 Vial, Single-Dose In 1 Carton (71288-200-21) / 20 Ml In 1 Vial, Single-Dose (71288-200-20)",4.85,1.94,,,0 NDC,71288020185,"Regadenoson: 1 Syringe, Plastic In 1 Carton (71288-201-85) / 5 Ml In 1 Syringe, Plastic",21.13,8.45,,,0 NDC,71288020302,NDC Description Not Available,0.39,0.16,,,0 NDC,71288020304,NDC Description Not Available,2.73,1.09,,,0 NDC,71288020305,"Furosemide: 25 Vial, Single-Dose In 1 Carton (71288-203-05) / 4 Ml In 1 Vial, Single-Dose (71288-203-04)",4.23,1.69,,,0 NDC,71288020310,NDC Description Not Available,0.17,0.07,,,0 NDC,71288020311,"Furosemide: 25 Vial, Single-Dose In 1 Carton (71288-203-11) / 10 Ml In 1 Vial, Single-Dose (71288-203-10)",1.21,0.48,,,0 NDC,71288030301,NDC Description Not Available,8.02,3.21,,,0 NDC,71288040210,NDC Description Not Available,2.37,0.95,,,0 NDC,71288040211,"Heparin Sodium: 25 Vial, Multi-Dose In 1 Carton (71288-402-11) / 10 Ml In 1 Vial, Multi-Dose (71288-402-10)",0.93,0.37,,,0 NDC,71288040301,NDC Description Not Available,1.0,0.4,,,0 NDC,71288040302,"Heparin Sodium: 25 Vial, Single-Dose In 1 Carton (71288-403-02) / 1 Ml In 1 Vial, Single-Dose (71288-403-01)",0.78,0.31,,,0 NDC,71288040310,NDC Description Not Available,1.53,0.61,,,0 NDC,71288040701,NDC Description Not Available,3.49,1.4,,,0 NDC,71288040905,"Palonosetron Hydrochloride: 1 Vial, Single-Dose In 1 Carton (71288-409-05) / 5 Ml In 1 Vial, Single-Dose",5.92,2.37,,,0 NDC,71288041080,NDC Description Not Available,3.53,1.41,,,0 NDC,71288041082,NDC Description Not Available,6.6,2.64,,,0 NDC,71288041084,NDC Description Not Available,3.23,1.29,,,0 NDC,71288041086,NDC Description Not Available,3.33,1.33,,,0 NDC,71288041088,NDC Description Not Available,3.34,1.34,,,0 NDC,71288041180,NDC Description Not Available,6.6,2.64,,,0 NDC,71288041182,NDC Description Not Available,2.42,0.97,,,0 NDC,71288041183,Enoxaparin Sodium: 10 Syringe In 1 Carton (71288-411-83) / 1 Ml In 1 Syringe (71288-411-82),4.04,1.62,,,0 NDC,71288041401,NDC Description Not Available,2.795,1.115,,,0 NDC,71288041403,"Glycopyrrolate: 25 Vial, Single-Dose In 1 Carton (71288-414-03) / 1 Ml In 1 Vial, Single-Dose (71288-414-01)",6.83,2.735,,,0 NDC,71288042603,"Enoxaparin Sodium: 1 Vial, Multi-Dose In 1 Carton (71288-426-03) / 3 Ml In 1 Vial, Multi-Dose",2.8,1.12,,,0 NDC,71288042710,NDC Description Not Available,1.23,0.49,,,0 NDC,71288043280,NDC Description Not Available,4.59,1.84,,,0 NDC,71288043281,Enoxaparin Sodium: 10 Syringe In 1 Carton (71288-432-81) / .3 Ml In 1 Syringe (71288-432-80),2.63,1.05,,,0 NDC,71288043382,NDC Description Not Available,4.17,1.67,,,0 NDC,71288043383,Enoxaparin Sodium: 10 Syringe In 1 Carton (71288-433-83) / .4 Ml In 1 Syringe (71288-433-82),4.12,1.65,,,0 NDC,71288043484,NDC Description Not Available,3.94,1.58,,,0 NDC,71288043485,Enoxaparin Sodium: 10 Syringe In 1 Carton (71288-434-85) / .6 Ml In 1 Syringe (71288-434-84),3.99,1.6,,,0 NDC,71288043586,NDC Description Not Available,4.08,1.63,,,0 NDC,71288043587,Enoxaparin Sodium: 10 Syringe In 1 Carton (71288-435-87) / .8 Ml In 1 Syringe (71288-435-86),3.95,1.58,,,0 NDC,71288043688,NDC Description Not Available,4.16,1.66,,,0 NDC,71288043689,Enoxaparin Sodium: 10 Syringe In 1 Carton (71288-436-89) / 1 Ml In 1 Syringe (71288-436-88),4.17,1.67,,,0 NDC,71288043791,NDC Description Not Available,4.11,1.64,,,0 NDC,71288043792,Enoxaparin Sodium: 10 Syringe In 1 Carton (71288-437-92) / .8 Ml In 1 Syringe (71288-437-91),4.1,1.64,,,0 NDC,71288043893,NDC Description Not Available,4.06,1.62,,,0 NDC,71288043894,Enoxaparin Sodium: 10 Syringe In 1 Carton (71288-438-94) / 1 Ml In 1 Syringe (71288-438-93),2.44,0.98,,,0 NDC,71288050502,NDC Description Not Available,24.17,9.67,,,0 NDC,71288050503,"Dexmedetomidine: 25 Vial, Single-Dose In 1 Carton (71288-505-03) / 2 Ml In 1 Vial, Single-Dose (71288-505-02)",10.48,4.19,,,0 NDC,71288060010,NDC Description Not Available,18.21,7.28,,,0 NDC,71288060011,"Pantoprazole Sodium: 10 Vial, Single-Dose In 1 Carton (71288-600-11) / 10 Ml In 1 Vial, Single-Dose (71288-600-10)",6.21,2.48,,,0 NDC,71288070005,NDC Description Not Available,13.91,5.5600000000000005,,,0 NDC,71288070006,"Rocuronium Bromide: 10 Vial, Multi-Dose In 1 Carton (71288-700-06) / 5 Ml In 1 Vial, Multi-Dose (71288-700-05)",19.26,7.7,,,0 NDC,71288071410,NDC Description Not Available,15.54,6.22,,,0 NDC,71288071411,"Cisatracurium Besylate: 10 Vial, Multi-Dose In 1 Carton (71288-714-11) / 10 Ml In 1 Vial, Multi-Dose (71288-714-10)",37.62,15.05,,,0 NDC,71288071910,NDC Description Not Available,1.29,0.52,,,0 NDC,71288071911,"Succinylcholine Chloride: 25 Vial, Multi-Dose In 1 Carton (71288-719-11) / 10 Ml In 1 Vial, Multi-Dose (71288-719-10)",1.44,0.58,,,0 NDC,71288073211,"Ropivacaine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (71288-732-11) / 10 Ml In 1 Vial, Single-Dose (71288-732-10)",0.54,0.22,,,0 NDC,71288080320,NDC Description Not Available,8.44,3.38,,,0 NDC,71288080321,"Mycophenolate Mofetil: 4 Vial, Single-Dose In 1 Carton (71288-803-21) / 20 Ml In 1 Vial, Single-Dose (71288-803-20)",6.46,2.58,,,0 NDC,71321080230,NDC Description Not Available,16.87,6.75,,,0 NDC,71336100301,"Amvuttra: 1 Syringe, Glass In 1 Carton (71336-1003-1) / .5 Ml In 1 Syringe, Glass",21005.78,8402.31,,,0 NDC,71349007001,Ycanth: 1 Applicator In 1 Package (71349-070-01) / 1 Ampule In 1 Applicator / .45 Ml In 1 Ampule,1952.25,780.9,,,0 NDC,71349007006,Ycanth: 6 Package In 1 Carton (71349-070-06) / 1 Applicator In 1 Package (71349-070-01) / 1 Ampule In 1 Applicator / .45 Ml In 1 Ampule,1952.25,780.9,,,0 NDC,71351001001,NDC Description Not Available,0.9,0.36,,,0 NDC,71351001012,NDC Description Not Available,3.51,1.4,,,0 NDC,71351001099,NDC Description Not Available,0.35,0.13999999999999999,,,0 NDC,71351001101,NDC Description Not Available,0.97,0.39,,,0 NDC,71351001399,NDC Description Not Available,4.88,1.95,,,0 NDC,71351001460,NDC Description Not Available,115.1,46.04,,,0 NDC,71351002105,NDC Description Not Available,2.225,0.89,,,0 NDC,71351002110,Lidocaine Hydrochloride: 10 Vial In 1 Box (71351-021-10) / 5 Ml In 1 Vial (71351-021-05),0.18,0.07,,,0 NDC,71399003906,Onelax: 473 Ml In 1 Bottle (71399-0039-6),0.37,0.15,,,0 NDC,71399005101,Onelax Saline Laxative: 296 Ml In 1 Bottle (71399-0051-1),8.81,3.52,,,0 NDC,71399510101,Hydrophor: 454 G In 1 Jar (71399-5101-1),14.53,5.81,,,0 NDC,71399748005,NDC Description Not Available,0.1,0.04,,,0 NDC,71399788901,Magnesium Citrate Saline Laxative: 296 Ml In 1 Bottle (71399-7889-1),7.7,3.08,,,0 NDC,71428000260,Fluocinolone Acetonide: 1 Bottle In 1 Carton (71428-002-60) / 60 Ml In 1 Bottle,2.4,0.96,,,0 NDC,71506001558,NDC Description Not Available,27.98,11.19,,,0 NDC,71506001858,NDC Description Not Available,84.19,33.68,,,0 NDC,71506002859,NDC Description Not Available,63.31,25.32,,,0 NDC,71506004645,NDC Description Not Available,7.785,3.1100000000000003,,,0 NDC,71506006058,NDC Description Not Available,292.64,117.06,,,0 NDC,71656002150,"Potassium Chloride: 5 Tray In 1 Case (71656-021-50) / 10 Cup, Unit-Dose In 1 Tray / 15 Ml In 1 Cup, Unit-Dose (71656-021-15)",16.21,6.48,,,0 NDC,71656006620,Likmez: 200 Ml In 1 Bottle (71656-066-20),16.49,6.6,,,0 NDC,71699005030,"Xcopri: 30 Tablet, Film Coated In 1 Bottle (71699-050-30)",112.43,44.97,,,0 NDC,71699020030,"Xcopri: 30 Tablet, Film Coated In 1 Bottle (71699-200-30)",119.84,47.94,,,0 NDC,71715000101,NDC Description Not Available,19.05,7.62,,,0 NDC,71715000221,"Nuzyra: 1 Blister Pack In 1 Carton (71715-002-21) / 6 Tablet, Film Coated In 1 Blister Pack (71715-002-28)",812.61,325.04,,,0 NDC,71773005012,"Xerava: 12 Vial, Glass In 1 Carton (71773-050-12) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Glass",5.66,2.26,,,0 NDC,71776000515,"Natacyn: 1 Bottle, Glass In 1 Carton (71776-005-15) / 15 Ml In 1 Bottle, Glass",2178.75,871.5,,,0 NDC,71837584301,NDC Description Not Available,205.56,82.22,,,0 NDC,71839011010,Enoxaparin Sodium: 10 Syringe In 1 Carton (71839-110-10) / .4 Ml In 1 Syringe,2.89,1.16,,,0 NDC,71839013701,NDC Description Not Available,176.7,70.68,,,0 NDC,71839014325,"Norepinephrine Bitartrate: 25 Vial, Single-Dose In 1 Carton (71839-143-25) / 4 Ml In 1 Vial, Single-Dose (71839-143-01)",23.92,9.57,,,0 NDC,71894012002,Zolgensma: 1 Kit In 1 Carton (71894-120-02) * 1 Ml In 1 Pouch * 8.3 Ml In 1 Vial (71894-115-01),8707666.35,3483066.54,,,0 NDC,71894012203,Zolgensma: 1 Kit In 1 Carton (71894-122-03) * 8.3 Ml In 1 Vial (71894-115-01) * 1 Ml In 1 Pouch * 5.5 Ml In 1 Vial (71894-110-01),8968896.34,3587558.54,,,0 NDC,71930002330,Oxycodone Hydrochloride: 1 Bottle In 1 Carton (71930-023-30) / 30 Ml In 1 Bottle,8.2,3.28,,,0 NDC,72060012140,Caplyta: 30 Capsule In 1 Bottle (72060-121-40),238.73,95.49,,,0 NDC,72078003401,"Ultiva: 10 Vial, Glass In 1 Carton (72078-034-01) / 3 Ml In 1 Vial, Glass (72078-034-00)",446.45,178.58,,,0 NDC,72078003502,"Ultiva: 10 Vial, Glass In 1 Carton (72078-035-02) / 5 Ml In 1 Vial, Glass (72078-035-00)",400.37,160.15,,,0 NDC,72078006550,NDC Description Not Available,25.14,10.06,,,0 NDC,72078006599,"Vancomycin Hydrochloride: 10 Vial, Single-Dose In 1 Carton (72078-065-99) / 50 Ml In 1 Vial, Single-Dose",43.64,17.46,,,0 NDC,72078006650,NDC Description Not Available,43.9,17.56,,,0 NDC,72078006699,"Vancomycin Hydrochloride: 10 Vial, Single-Dose In 1 Carton (72078-066-99) / 50 Ml In 1 Vial, Single-Dose",49.41,19.76,,,0 NDC,72140000021,NDC Description Not Available,35.41,14.16,,,0 NDC,72140001715,NDC Description Not Available,25.79,10.32,,,0 NDC,72140001945,NDC Description Not Available,28.12,11.25,,,0 NDC,72140003263,NDC Description Not Available,18.81,7.52,,,0 NDC,72140011019,NDC Description Not Available,19.5,7.8,,,0 NDC,72140063377,NDC Description Not Available,21.05,8.42,,,0 NDC,72205000130,"Moxifloxacin Hydrochloride Tablets, 400 Mg: 30 Tablet, Film Coated In 1 Bottle (72205-001-30)",12.65,5.06,,,0 NDC,72205001190,Pregabalin: 90 Capsule In 1 Bottle (72205-011-90),0.29,0.12,,,0 NDC,72205001290,Pregabalin: 90 Capsule In 1 Bottle (72205-012-90),0.21,0.08,,,0 NDC,72205001390,Pregabalin: 90 Capsule In 1 Bottle (72205-013-90),0.21,0.08,,,0 NDC,72205001490,Pregabalin: 90 Capsule In 1 Bottle (72205-014-90),0.21,0.08,,,0 NDC,72205001901,Valganciclovir Hydrochloride: 1 Bottle In 1 Carton (72205-019-01) / 100 Ml In 1 Bottle,299.53,119.81,,,0 NDC,72205002830,"Febuxostat: 30 Tablet, Film Coated In 1 Bottle (72205-028-30)",1.5,0.6,,,0 NDC,72205004211,Oseltamivir Phosphate: 1 Blister Pack In 1 Carton (72205-042-11) / 10 Capsule In 1 Blister Pack,7.07,2.83,,,0 NDC,72205004411,Oseltamivir Phosphate: 1 Blister Pack In 1 Carton (72205-044-11) / 10 Capsule In 1 Blister Pack,7.92,3.17,,,0 NDC,72205004501,"Thiotepa: 1 Vial, Glass In 1 Box (72205-045-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Glass",578.8,231.52,,,0 NDC,72205004601,"Thiotepa: 1 Vial, Glass In 1 Box (72205-046-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Glass",133.38,53.35,,,0 NDC,72205005108,Albendazole: 2 Tablet In 1 Bottle (72205-051-08),87.46,34.98,,,0 NDC,72205006301,"Paclitaxel: 1 Vial, Multi-Dose In 1 Carton (72205-063-01) / 50 Ml In 1 Vial, Multi-Dose",0.45,0.18,,,0 NDC,72205008530,Tiagabine Hydrochloride: 30 Tablet In 1 Bottle (72205-085-30),8.94,3.58,,,0 NDC,72205010101,NDC Description Not Available,5.72,2.29,,,0 NDC,72205010107,Bumetanide: 10 Vial In 1 Carton (72205-101-07) / 4 Ml In 1 Vial (72205-101-01),4.54,1.82,,,0 NDC,72205010201,NDC Description Not Available,3.77,1.51,,,0 NDC,72205015401,Nelarabine: 1 Vial In 1 Carton (72205-154-01) / 50 Ml In 1 Vial,647.17,258.87,,,0 NDC,72205015404,Nelarabine: 6 Vial In 1 Carton (72205-154-04) / 50 Ml In 1 Vial,253.65,101.46,,,0 NDC,72205017072,Acyclovir Suspension: 473 Ml In 1 Bottle (72205-170-72),5.49,2.2,,,0 NDC,72205017101,NDC Description Not Available,9.07,3.63,,,0 NDC,72205017107,"Arsenic Trioxide: 10 Vial, Single-Dose In 1 Carton (72205-171-07) / 10 Ml In 1 Vial, Single-Dose (72205-171-01)",10.28,4.11,,,0 NDC,72205018530,"Darunavir: 30 Tablet, Film Coated In 1 Bottle, Plastic (72205-185-30)",5.72,2.29,,,0 NDC,72205019801,"Carmustine: 1 Kit In 1 Carton (72205-198-01) * 3 Ml In 1 Vial (72205-196-01) * 30 Ml In 1 Vial, Single-Dose (72205-197-01)",1057.54,423.02,,,0 NDC,72205020030,Roflumilast: 30 Tablet In 1 Bottle (72205-200-30),1.74,0.7,,,0 NDC,72266010201,"Labetalol Hydrochloride: 1 Vial, Multi-Dose In 1 Carton (72266-102-01) / 20 Ml In 1 Vial, Multi-Dose",0.54,0.22,,,0 NDC,72266010301,"Labetalol Hydrochloride: 1 Vial, Multi-Dose In 1 Carton (72266-103-01) / 40 Ml In 1 Vial, Multi-Dose",0.59,0.24,,,0 NDC,72266011801,NDC Description Not Available,7.57,3.03,,,0 NDC,72266011825,Ketorolac Tromethamine: 25 Vial In 1 Carton (72266-118-25) / 1 Ml In 1 Vial (72266-118-01),7.81,3.12,,,0 NDC,72266011901,NDC Description Not Available,3.9,1.56,,,0 NDC,72266011925,Ketorolac Tromethamine: 25 Vial In 1 Carton (72266-119-25) / 2 Ml In 1 Vial (72266-119-01),0.55,0.22,,,0 NDC,72266012301,NDC Description Not Available,0.54,0.22,,,0 NDC,72266012401,Ondansetron: 1 Vial In 1 Carton (72266-124-01) / 20 Ml In 1 Vial,0.28,0.11,,,0 NDC,72266012701,NDC Description Not Available,82.45,32.98,,,0 NDC,72266012801,"Melphalan Hydrochloride: 1 Kit In 1 Carton (72266-128-01) * 10 Ml In 1 Vial, Single-Dose (72266-144-01) * 10 Ml In 1 Vial, Single-Use (72266-145-01)",1198.81,479.52,,,0 NDC,72266014601,NDC Description Not Available,16.15,6.46,,,0 NDC,72266014610,Etomidate: 10 Vial In 1 Carton (72266-146-10) / 10 Ml In 1 Vial (72266-146-01),11.95,4.78,,,0 NDC,72266014710,Etomidate: 10 Vial In 1 Carton (72266-147-10) / 20 Ml In 1 Vial (72266-147-01),8.56,3.42,,,0 NDC,72266015801,Moxifloxacin Ophthalmic Solution: 1 Bottle In 1 Carton (72266-158-01) / 3 Ml In 1 Bottle,39.93,15.97,,,0 NDC,72266016001,NDC Description Not Available,61.8,24.72,,,0 NDC,72266016010,"Ziprasidone Mesylate: 10 Vial, Single-Dose In 1 Carton (72266-160-10) / 1 Ml In 1 Vial, Single-Dose (72266-160-01)",73.69,29.48,,,0 NDC,72266019701,Dorzolamide Hydrochloride: 1 Bottle In 1 Carton (72266-197-01) / 10 Ml In 1 Bottle,45.95,18.38,,,0 NDC,72266020401,NDC Description Not Available,11.86,4.74,,,0 NDC,72266023401,NDC Description Not Available,5.5,2.2,,,0 NDC,72266023425,Ketorolac Tromethamine: 25 Vial In 1 Carton (72266-234-25) / 1 Ml In 1 Vial (72266-234-01),5.99,2.4,,,0 NDC,72266023601,"Sodium Phenylacetate And Sodium Benzoate: 1 Vial, Single-Dose In 1 Carton (72266-236-01) / 20 Ml In 1 Vial, Single-Dose",6372.35,2548.94,,,0 NDC,72266024801,NDC Description Not Available,229.97,91.99,,,0 NDC,72266024805,Sincalide: 5 Vial In 1 Package (72266-248-05) / 5 Ml In 1 Vial (72266-248-01),138.37,55.35,,,0 NDC,72266025110,Calcitriol: 10 Vial In 1 Carton (72266-251-10) / 1 Ml In 1 Vial (72266-251-01),2.63,1.05,,,0 NDC,72319002102,"Ranolazine: 60 Tablet, Film Coated, Extended Release In 1 Bottle, Plastic (72319-021-02)",0.88,0.35,,,0 NDC,72485010101,NDC Description Not Available,2.58,1.03,,,0 NDC,72485010125,"Diphenhydramine Hydrochloride: 25 Vial, Single-Dose In 1 Carton (72485-101-25) / 1 Ml In 1 Vial, Single-Dose (72485-101-01)",8.01,3.2,,,0 NDC,72485010401,"Caffeine Citrate: 1 Vial, Glass In 1 Carton (72485-104-01) / 3 Ml In 1 Vial, Glass",4.965,1.9849999999999999,,,0 NDC,72485010601,NDC Description Not Available,0.16,0.06,,,0 NDC,72485010610,"Levetiracetam: 10 Vial, Single-Dose In 1 Carton (72485-106-10) / 5 Ml In 1 Vial, Single-Dose (72485-106-01)",0.18,0.07,,,0 NDC,72485010805,Verapamil Hydrochloride: 5 Vial In 1 Carton (72485-108-05) / 2 Ml In 1 Vial (72485-108-01),16.84,6.74,,,0 NDC,72485011601,NDC Description Not Available,0.24,0.1,,,0 NDC,72485011610,Nicardipine Hydrochloride: 10 Vial In 1 Carton (72485-116-10) / 10 Ml In 1 Vial (72485-116-01),0.25,0.1,,,0 NDC,72485020101,"Azacitidine: 1 Injection, Powder, Lyophilized, For Solution In 1 Carton (72485-201-01)",4.11,1.64,,,0 NDC,72485040301,NDC Description Not Available,6.87,2.75,,,0 NDC,72485040401,NDC Description Not Available,5.46,2.18,,,0 NDC,72485040601,NDC Description Not Available,0.18,0.07,,,0 NDC,72485041501,NDC Description Not Available,5.37,2.15,,,0 NDC,72485041701,NDC Description Not Available,13.0,5.2,,,0 NDC,72485041710,"Ampicillin Sodium And Sulbactam Sodium: 10 Vial In 1 Carton (72485-417-10) / 1 Injection, Powder, For Solution In 1 Vial (72485-417-01)",7.84,3.14,,,0 NDC,72485042101,NDC Description Not Available,4.88,1.95,,,0 NDC,72485042110,"Ampicillin: 10 Vial In 1 Carton (72485-421-10) / 1 Injection, Powder, For Solution In 1 Vial",2.04,0.82,,,0 NDC,72485042201,NDC Description Not Available,5.71,2.28,,,0 NDC,72485051001,NDC Description Not Available,8.33,3.33,,,0 NDC,72485067031,Erythromycin: 50 Tube In 1 Carton (72485-670-31) / 1 G In 1 Tube,30.6,12.24,,,0 NDC,72536092001,"Indium In 111 Oxyquinoline: 1 Ml In 1 Vial, Single-Dose (72536-0920-1)",4369.34,1747.74,,,0 NDC,72572065001,NDC Description Not Available,8.22,3.29,,,0 NDC,72578000201,Acyclovir: 100 Capsule In 1 Bottle (72578-002-01),0.36,0.14,,,0 NDC,72578017001,Dexamethasone: 100 Tablet In 1 Bottle (72578-170-01),0.15,0.06,,,0 NDC,72611072201,NDC Description Not Available,1.83,0.73,,,0 NDC,72611072225,"Ketorolac Tromethamine: 25 Vial, Single-Dose In 1 Carton (72611-722-25) / 1 Ml In 1 Vial, Single-Dose (72611-722-01)",1.79,0.72,,,0 NDC,72611074001,NDC Description Not Available,2.035,0.815,,,0 NDC,72611074010,"Metoprolol Tartrate: 10 Vial, Single-Dose In 1 Carton (72611-740-10) / 5 Ml In 1 Vial, Single-Dose (72611-740-01)",2.59,1.04,,,0 NDC,72611075601,NDC Description Not Available,21.29,8.52,,,0 NDC,72611075610,"Rocuronium Bromide: 10 Vial, Multi-Dose In 1 Carton (72611-756-10) / 5 Ml In 1 Vial, Multi-Dose (72611-756-01)",13.25,5.3,,,0 NDC,72611075701,NDC Description Not Available,26.87,10.75,,,0 NDC,72611086004,"Acetylcysteine: 4 Vial, Single-Dose In 1 Carton (72611-860-04) / 30 Ml In 1 Vial, Single-Dose (72611-860-01)",2.84,1.14,,,0 NDC,72618300002,"Nurtec Odt: 1 Blister Pack In 1 Carton (72618-3000-2) / 8 Tablet, Orally Disintegrating In 1 Blister Pack",383.03,153.21,,,0 NDC,72626270101,"Sofosbuvir And Velpatasvir: 2 Blister Pack In 1 Carton (72626-2701-1) / 14 Tablet, Film Coated In 1 Blister Pack",722.8,289.12,,,0 NDC,72694051501,"Asparlas: 1 Vial, Single-Use In 1 Carton (72694-515-01) / 5 Ml In 1 Vial, Single-Use",332.02,132.81,,,0 NDC,72694095401,"Oncaspar: 1 Vial, Single-Use In 1 Carton (72694-954-01) / 5 Ml In 1 Vial, Single-Use",114693.12,45877.25,,,0 NDC,72819015302,Mitomycin: 1 Vial In 1 Carton (72819-153-02) / 40 Ml In 1 Vial,152.54,61.02,,,0 NDC,72874000101,"Cerianna: 50 Ml In 1 Vial, Multi-Dose (72874-001-01)",2880.25,1152.1,,,0 NDC,72888001201,"Cyclobenzaprine Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (72888-012-01)",0.12,0.05,,,0 NDC,72888002406,NDC Description Not Available,3.28,1.31,,,0 NDC,72888002410,Potassium Chloride: 100 Pouch In 1 Carton (72888-024-10) / 1.58 G In 1 Pouch (72888-024-06),3.26,1.3,,,0 NDC,72888003401,"Carvedilol: 100 Tablet, Film Coated In 1 Bottle (72888-034-01)",0.18,0.07,,,0 NDC,72888003960,Amiodarone Hydrochloride: 60 Tablet In 1 Bottle (72888-039-60),0.58,0.23,,,0 NDC,72888005201,Metolazone: 100 Tablet In 1 Bottle (72888-052-01),0.92,0.37,,,0 NDC,72888005301,Metolazone: 100 Tablet In 1 Bottle (72888-053-01),0.88,0.35,,,0 NDC,72888006701,"Amitriptyline Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (72888-067-01)",0.16,0.06,,,0 NDC,72888006901,"Amitriptyline Hydrochloride: 100 Tablet, Film Coated In 1 Bottle (72888-069-01)",0.45,0.18,,,0 NDC,72888008001,"Tramadol Hydrochloride: 100 Tablet, Coated In 1 Bottle (72888-080-01)",0.08,0.03,,,0 NDC,72888015201,Clonazepam: 100 Tablet In 1 Bottle (72888-152-01),0.08,0.03,,,0 NDC,72888017530,"Desvenlafaxine: 30 Tablet, Extended Release In 1 Package (72888-175-30)",1.72,0.69,,,0 NDC,72888019201,Mycophenolate Mofetil: 100 Capsule In 1 Bottle (72888-192-01),0.6,0.24,,,0 NDC,72888019205,Mycophenolate Mofetil: 500 Capsule In 1 Bottle (72888-192-05),0.56,0.22,,,0 NDC,72893000301,Folotyn: 1 Vial In 1 Carton (72893-003-01) / 1 Ml In 1 Vial,1638.58,655.43,,,0 NDC,72893000501,Folotyn: 1 Vial In 1 Carton (72893-005-01) / 2 Ml In 1 Vial,1638.23,655.29,,,0 NDC,72903085301,"Elahere: 1 Vial, Single-Use In 1 Carton (72903-853-01) / 20 Ml In 1 Vial, Single-Use",292.03,116.81,,,0 NDC,73150015006,"Briumvi: 1 Vial, Single-Dose In 1 Carton (73150-150-06) / 6 Ml In 1 Vial, Single-Dose",316.55,126.62,,,0 NDC,73177010505,NDC Description Not Available,13.6,5.44,,,0 NDC,73177014633,NDC Description Not Available,83.155,33.260000000000005,,,0 NDC,73177016333,NDC Description Not Available,147.56,59.02,,,0 NDC,73302045601,Ella: 1 Blister Pack In 1 Carton (73302-456-01) / 1 Tablet In 1 Blister Pack,117.07,46.83,,,0 NDC,73475304105,"Vyvgart: 1 Vial, Single-Dose In 1 Carton (73475-3041-5) / 20 Ml In 1 Vial, Single-Dose",136.18,54.47,,,0 NDC,73475310203,"Vyvgart Hytrulo: 1 Vial, Single-Dose In 1 Carton (73475-3102-3) / 5.6 Ml In 1 Vial, Single-Dose",138.91,55.56,,,0 NDC,73535020801,Monjuvi: 1 Vial In 1 Carton (73535-208-01) / 5 Ml In 1 Vial,61.88,24.75,,,0 NDC,73562010410,Viokace: 1 Bottle In 1 Carton (73562-104-10) / 100 Tablet In 1 Bottle,12.77,5.11,,,0 NDC,73562011001,"Zenpep: 100 Capsule, Delayed Release In 1 Bottle (73562-110-01)",12.58,5.03,,,0 NDC,73562011201,"Zenpep: 100 Capsule, Delayed Release In 1 Bottle (73562-112-01)",24.59,9.84,,,0 NDC,73562011301,"Zenpep: 100 Capsule, Delayed Release In 1 Bottle (73562-113-01)",6.64,2.66,,,0 NDC,73562011401,"Zenpep: 100 Capsule, Delayed Release In 1 Bottle (73562-114-01)",48.58,19.43,,,0 NDC,73562011501,"Zenpep: 100 Capsule, Delayed Release In 1 Bottle (73562-115-01)",5.85,2.34,,,0 NDC,73562011601,"Zenpep: 100 Capsule, Delayed Release In 1 Bottle (73562-116-01)",30.42,12.17,,,0 NDC,74300000065,NDC Description Not Available,5.26,2.1,,,0 NDC,74300000071,NDC Description Not Available,19.485,7.795,,,0 NDC,74312000640,NDC Description Not Available,0.34,0.14,,,0 NDC,74312003201,NDC Description Not Available,0.08,0.03,,,0 NDC,74676590201,"Trelstar: 1 Kit In 1 Carton (74676-5902-1) * 2 Ml In 1 Vial, Single-Dose (74676-5902-0) * 2 Ml In 1 Syringe",4071.89,1628.76,,,0 NDC,74676590401,"Trelstar: 1 Kit In 1 Carton (74676-5904-1) * 2 Ml In 1 Vial, Single-Dose (74676-5904-0) * 2 Ml In 1 Syringe",3166.96,1266.78,,,0 NDC,74725010064,"Illuccix: 1 Kit In 1 Carton (74725-100-64) * 2.5 Ml In 1 Vial, Multi-Dose (74725-102-25) * 6.4 Ml In 1 Vial, Multi-Dose (74725-103-64) * 1 Injection, Powder, Lyophilized, For Solution In 1 Vial,",2647.28,1058.91,,,0 NDC,75826011410,"Phenazopyridine Hydrochloride: 100 Tablet In 1 Bottle, Plastic (75826-114-10)",1.16,0.46,,,0 NDC,75826011510,"Phenazopyridine Hydrochloride: 100 Tablet In 1 Bottle, Plastic (75826-115-10)",1.11,0.44,,,0 NDC,75834001060,NDC Description Not Available,3.81,1.52,,,0 NDC,75834017119,Calcium Gluconate: 25 Vial In 1 Carton (75834-171-19) / 10 Ml In 1 Vial (75834-171-01),0.44,0.18,,,0 NDC,75907004301,Trimethoprim: 100 Tablet In 1 Bottle (75907-043-01),5.75,2.3,,,0 NDC,75907005860,"Tamoxifen Citrate: 60 Tablet, Film Coated In 1 Bottle (75907-058-60)",0.57,0.23,,,0 NDC,75987005006,Ravicti: 1 Bottle In 1 Carton (75987-050-06) / 25 Ml In 1 Bottle,6311.43,2524.57,,,0 NDC,75987008010,Krystexxa: 1 Vial In 1 Carton (75987-080-10) / 1 Ml In 1 Vial,16385.28,6554.11,,,0 NDC,75987015003,"Uplizna: 3 Vial, Single-Dose In 1 Carton (75987-150-03) / 10 Ml In 1 Vial, Single-Dose (75987-150-01)",2047.18,818.87,,,0 NDC,76014000430,NDC Description Not Available,0.03,0.01,,,0 NDC,76045000401,NDC Description Not Available,4.09,1.64,,,0 NDC,76045000411,"Morphine Sulfate: 10 Syringe, Glass In 1 Carton (76045-004-11) / 1 Ml In 1 Syringe, Glass (76045-004-01)",17.73,7.09,,,0 NDC,76045000901,NDC Description Not Available,2.15,0.86,,,0 NDC,76045000905,Dilaudid: 24 SYRINGE in 1 CARTON (76045-009-05) / .5 mL in 1 SYRINGE (76045-009-03),8.69,3.48,,,0 NDC,76045000906,Dilaudid: 10 Syringe In 1 Carton (76045-009-06) / .5 Ml In 1 Syringe (76045-009-96),7.01,2.8,,,0 NDC,76045000911,Dilaudid: 10 Syringe In 1 Carton (76045-009-11) / 1 Ml In 1 Syringe (76045-009-01),2.13,0.85,,,0 NDC,76045000996,NDC Description Not Available,3.64,1.46,,,0 NDC,76045010410,"Ketorolac Tromethamine: 24 Blister Pack In 1 Carton (76045-104-10) / 1 Syringe, Glass In 1 Blister Pack / 1 Ml In 1 Syringe, Glass",3.94,1.58,,,0 NDC,76045010520,"Ketorolac Tromethamine: 24 Blister Pack In 1 Carton (76045-105-20) / 1 Syringe, Glass In 1 Blister Pack / 2 Ml In 1 Syringe, Glass",2.18,0.87,,,0 NDC,76045020400,NDC Description Not Available,50.56,20.22,,,0 NDC,76045020420,"Diazepam: 24 Syringe, Glass In 1 Carton (76045-204-20) / 2 Ml In 1 Syringe, Glass (76045-204-00)",49.1,19.64,,,0 NDC,76045020910,"Ketorolac Tromethamine: 24 Blister Pack In 1 Carton (76045-209-10) / 1 Syringe, Glass In 1 Blister Pack (76045-209-00) / 1 Ml In 1 Syringe, Glass",5.14,2.06,,,0 NDC,76075010101,"Kyprolis: 1 Vial, Single-Use In 1 Carton (76075-101-01) / 30 Ml In 1 Vial, Single-Use",253.17,101.27,,,0 NDC,76075010201,"Kyprolis: 1 Vial, Single-Dose In 1 Carton (76075-102-01) / 15 Ml In 1 Vial, Single-Dose",248.05,99.22,,,0 NDC,76075010301,"Kyprolis: 1 Vial, Single-Dose In 1 Carton (76075-103-01) / 10 Ml In 1 Vial, Single-Dose",247.86,99.14,,,0 NDC,76125079025,Albuked: 1 Vial In 1 Carton (76125-790-25) / 250 Ml In 1 Vial (76125-790-26),37.68,15.07,,,0 NDC,76125079026,NDC Description Not Available,32.53,13.01,,,0 NDC,76125090010,"Gammaked: 1 Vial, Glass In 1 Carton (76125-900-10) / 100 Ml In 1 Vial, Glass (76125-900-11)",235.47,94.19,,,0 NDC,76125090020,"Gammaked: 1 Vial, Glass In 1 Carton (76125-900-20) / 200 Ml In 1 Vial, Glass (76125-900-21)",235.47,94.19,,,0 NDC,76154047515,NDC Description Not Available,6.6,2.64,,,0 NDC,76204001011,NDC Description Not Available,3.76,1.5,,,0 NDC,76204001155,Albuterol Sulfate Inhalation Solution: 25 Pouch In 1 Carton (76204-011-55) / 5 Vial In 1 Pouch (76204-011-05) / 3 Ml In 1 Vial,1.3,0.52,,,0 NDC,76204002160,NDC Description Not Available,1.76,0.7,,,0 NDC,76204002260,NDC Description Not Available,1.23,0.49,,,0 NDC,76204010001,Ipratropium Bromide: 30 Pouch In 1 Carton (76204-100-01) / 1 Ampule In 1 Pouch / 2.5 Ml In 1 Ampule,0.5,0.2,,,0 NDC,76204020001,Albuterol Sulfate: 30 Pouch In 1 Carton (76204-200-01) / 1 Ampule In 1 Pouch / 3 Ml In 1 Ampule,0.93,0.37,,,0 NDC,76204060001,Ipratropium Bromide And Albuterol Sulfate: 30 Pouch In 1 Carton (76204-600-01) / 1 Ampule In 1 Pouch / 3 Ml In 1 Ampule,1.99,0.8,,,0 NDC,76204090001,Levalbuterol: 30 Pouch In 1 Carton (76204-900-01) / 1 Ampule In 1 Pouch (76204-900-11) / 3 Ml In 1 Ampule,2.28,0.91,,,0 NDC,76204090011,NDC Description Not Available,1.59,0.64,,,0 NDC,76297000132,NDC Description Not Available,14.695,5.88,,,0 NDC,76310002415,NDC Description Not Available,235.91,94.36,,,0 NDC,76329124001,Phytonadione: 1 Syringe In 1 Carton (76329-1240-1) / .5 Ml In 1 Syringe,110.4,44.16,,,0 NDC,76329301105,"Lidocaine Hydrochloride: 25 Vial, Single-Use In 1 Box (76329-3011-5) / 5 Ml In 1 Vial, Single-Use",20.92,8.370000000000001,,,0 NDC,76329301205,"Lidocaine Hydrochloride: 25 Vial, Single-Use In 1 Box (76329-3012-5) / 5 Ml In 1 Vial, Single-Use",20.83,8.335,,,0 NDC,76329301305,"Lidocaine Hydrochloride: 25 Vial, Single-Use In 1 Box (76329-3013-5) / 10 Ml In 1 Vial, Single-Use",27.6,11.04,,,0 NDC,76329330201,Dextrose Monohydrate: 1 Syringe In 1 Carton (76329-3302-1) / 50 Ml In 1 Syringe,56.8,22.72,,,0 NDC,76329330401,Calcium Chloride: 10 Syringe In 1 Package (76329-3304-1) / 10 Ml In 1 Syringe,22.005,8.8,,,0 NDC,76329331601,Epinephrine: 10 VIAL in 1 PACKAGE (76329-3316-1) / 10 mL in 1 VIAL,3.54,1.42,,,0 NDC,76329331801,Epinephrine: 10 Carton In 1 Package (76329-3318-1) / 1 Syringe In 1 Carton / 10 Ml In 1 Syringe,5.47,2.19,,,0 NDC,76329332100,Regadenoson: 1 Syringe In 1 Carton (76329-3321-0) / 5 Ml In 1 Syringe,33.0,13.2,,,0 NDC,76329333901,Atropine Sulfate: 10 SYRINGE in 1 CARTON (76329-3339-1) / 10 mL in 1 SYRINGE,0.37,0.15,,,0 NDC,76329334001,Atropine Sulfate: 10 Carton In 1 Package (76329-3340-1) / 1 Syringe In 1 Carton / 10 Ml In 1 Syringe,0.51,0.2,,,0 NDC,76329335201,Sodium Bicarbonate: 1 Syringe In 1 Carton (76329-3352-1) / 50 Ml In 1 Syringe,72.81,29.12,,,0 NDC,76329336901,Naloxone Hydrochloride: 10 Syringe In 1 Box (76329-3369-1) / 2 Ml In 1 Syringe,45.13,18.05,,,0 NDC,76329339001,Lidocaine Hydrochloride: 10 Syringe In 1 Package (76329-3390-1) / 5 Ml In 1 Syringe,0.54,0.22,,,0 NDC,76385010201,Primaquine Phosphate: 100 Tablet In 1 Bottle (76385-102-01),4.02,1.61,,,0 NDC,76385012301,"Methocarbamol: 100 Tablet, Film Coated In 1 Bottle (76385-123-01)",0.34,0.14,,,0 NDC,76385012401,"Methocarbamol: 100 Tablet, Film Coated In 1 Bottle (76385-124-01)",0.41,0.16,,,0 NDC,76385013601,Metolazone: 100 Tablet In 1 Bottle (76385-136-01),1.95,0.78,,,0 NDC,77333011010,NDC Description Not Available,0.33,0.13,,,0 NDC,77333012025,NDC Description Not Available,1.26,0.5,,,0 NDC,77333012050,Fiber Laxative Caplets: 50 Blister Pack In 1 Box (77333-120-50) / 1 Tablet In 1 Blister Pack (77333-120-25),0.86,0.34,,,0 NDC,77333030810,NDC Description Not Available,0.48,0.19,,,0 NDC,77333030825,NDC Description Not Available,4.54,1.82,,,0 NDC,77333044110,NDC Description Not Available,0.64,0.26,,,0 NDC,77333044125,NDC Description Not Available,0.6,0.24,,,0 NDC,77333081210,"Simethicone 80Mg: 100 Blister Pack In 1 Box (77333-812-10) / 1 Tablet, Chewable In 1 Blister Pack (77333-812-25)",0.29,0.12,,,0 NDC,77333081225,NDC Description Not Available,0.43,0.17,,,0 NDC,77333083525,NDC Description Not Available,0.34,0.14,,,0 NDC,77333084410,Sodium Chloride 1 Gram: 100 Blister Pack In 1 Box (77333-844-10) / 1 Tablet In 1 Blister Pack (77333-844-25),0.53,0.21,,,0 NDC,77333084425,NDC Description Not Available,0.51,0.2,,,0 NDC,77333093425,NDC Description Not Available,0.48,0.19,,,0 NDC,77333093810,NDC Description Not Available,0.38,0.15,,,0 NDC,77333093825,NDC Description Not Available,0.38,0.15,,,0 NDC,77333094010,NDC Description Not Available,0.3,0.12,,,0 NDC,77333094025,NDC Description Not Available,3.21,1.28,,,0 NDC,77333098325,NDC Description Not Available,4.17,1.67,,,0 NDC,78112001103,NDC Description Not Available,11.33,4.53,,,0 NDC,78112001104,NDC Description Not Available,11.33,4.53,,,0 NDC,78112001106,NDC Description Not Available,0.41,0.16,,,0 NDC,78112001266,NDC Description Not Available,0.42,0.17,,,0 NDC,78112073623,NDC Description Not Available,10.11,4.04,,,0 NDC,78206011801,"Celestone Soluspan: 1 Vial, Multi-Dose In 1 Box (78206-118-01) / 5 Ml In 1 Vial, Multi-Dose",37.58,15.03,,,0 NDC,78206012601,Dulera: 1 Canister In 1 Carton (78206-126-01) / 120 Aerosol In 1 Canister,1702.21,680.88,,,0 NDC,78206012602,Dulera: 1 Canister In 1 Carton (78206-126-02) / 60 Aerosol In 1 Canister,900.46,360.18,,,0 NDC,78206012701,Dulera: 1 Canister In 1 Carton (78206-127-01) / 120 Aerosol In 1 Canister,1700.68,680.27,,,0 NDC,78206012702,Dulera: 1 Canister In 1 Carton (78206-127-02) / 60 Aerosol In 1 Canister,850.08,340.03,,,0 NDC,78206014501,Nexplanon: 1 Blister Pack In 1 Carton (78206-145-01) / 1 Implant In 1 Blister Pack,5120.09,2048.04,,,0 NDC,78206016201,"Renflexis: 1 Vial In 1 Carton (78206-162-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial (78206-162-99)",332.71,133.08,,,0 NDC,78573000086,NDC Description Not Available,0.1,0.04,,,0 NDC,78573000095,NDC Description Not Available,0.13,0.05,,,0 NDC,79672061301,NDC Description Not Available,6.44,2.58,,,0 NDC,79672061303,NDC Description Not Available,12.36,4.94,,,0 NDC,79672061304,NDC Description Not Available,75.39,30.16,,,0 NDC,79672061305,NDC Description Not Available,32.2,12.88,,,0 NDC,79672061330,Sodium Chloride: 28 Bag In 1 Carton (79672-613-30) / 250 Ml In 1 Bag (79672-613-03),13.56,5.42,,,0 NDC,79854005024,NDC Description Not Available,0.08,0.03,,,0 NDC,79854007882,NDC Description Not Available,34.5,13.8,,,0 NDC,79854011603,NDC Description Not Available,0.18,0.07,,,0 NDC,80446040101,"Kimmtrak: 1 Vial, Glass In 1 Carton (80446-401-01) / .5 Ml In 1 Vial, Glass",906.23,362.49,,,0 NDC,80681007100,NDC Description Not Available,0.06,0.02,,,0 NDC,80681009700,NDC Description Not Available,0.08,0.03,,,0 NDC,80681009800,NDC Description Not Available,0.11,0.04,,,0 NDC,80681009900,NDC Description Not Available,0.05,0.02,,,0 NDC,80681016800,NDC Description Not Available,0.07,0.03,,,0 NDC,80681016900,NDC Description Not Available,0.03,0.01,,,0 NDC,80681017200,NDC Description Not Available,1.435,0.575,,,0 NDC,80725063025,Tabloid: 1 Bottle In 1 Carton (80725-630-25) / 25 Tablet In 1 Bottle,986.25,394.5,,,0 NDC,80777010201,NDC Description Not Available,531.97,212.79,,,0 NDC,80777011096,"Spikevax: 10 Syringe, Plastic In 1 Carton (80777-110-96) / .5 Ml In 1 Syringe, Plastic (80777-110-01)",417.6,167.04,,,0 NDC,80777028792,"Moderna COVID-19 Vaccine: 10 VIAL, SINGLE-DOSE in 1 CARTON (80777-287-92) / .25 mL in 1 VIAL, SINGLE-DOSE (80777-287-07)",525.81,210.32,,,0 NDC,80777029180,"Moderna Covid-19 Vaccine: 10 Syringe, Plastic In 1 Carton (80777-291-80) / .25 Ml In 1 Syringe, Plastic (80777-291-09)",386.14,154.46,,,0 NDC,80803015350,"Fyarro: 1 Vial, Single-Use In 1 Carton (80803-153-50) / 20 Ml In 1 Vial, Single-Use",344.03,137.61,,,0 NDC,80830169101,NDC Description Not Available,247.64,99.06,,,0 NDC,80830169102,"Potassium Phosphates: 10 Vial, Single-Dose In 1 Carton (80830-1691-2) / 15 Ml In 1 Vial, Single-Dose (80830-1691-1)",282.12,112.85,,,0 NDC,80830232901,NDC Description Not Available,90.2,36.08,,,0 NDC,81033000205,NDC Description Not Available,1.4,0.56,,,0 NDC,81033001105,NDC Description Not Available,7.76,3.1,,,0 NDC,81033002001,NDC Description Not Available,7.51,3.0,,,0 NDC,81033002050,Mupirocin: 50 Tube In 1 Package (81033-020-50) / 1 G In 1 Tube (81033-020-01),7.87,3.15,,,0 NDC,81033002099,Mupirocin: 100 Tube In 1 Package (81033-020-99) / 1 G In 1 Tube (81033-020-01),10.76,4.3,,,0 NDC,81033006620,Likmez: 200 Ml In 1 Bottle (81033-066-20),32.31,12.92,,,0 NDC,81033010210,NDC Description Not Available,4.93,1.97,,,0 NDC,81033010252,"Guaifenesin: 50 Cup, Unit-Dose In 1 Carton (81033-102-52) / 10 Ml In 1 Cup, Unit-Dose (81033-102-10)",5.4,2.16,,,0 NDC,81033010405,NDC Description Not Available,57.77,23.11,,,0 NDC,81033051215,NDC Description Not Available,2.93,1.17,,,0 NDC,81033051250,"Chlorhexidine Gluconate, 0.12% Oral Rinse Solution: 100 Cup, Unit-Dose In 1 Carton (81033-512-50) / 15 Ml In 1 Cup, Unit-Dose (81033-512-15)",2.83,1.13,,,0 NDC,81284015200,NDC Description Not Available,4.12,1.65,,,0 NDC,81284015300,NDC Description Not Available,6.58,2.63,,,0 NDC,81284015500,NDC Description Not Available,2.3,0.92,,,0 NDC,81284015501,"Piperacillin And Tazobactam: 1 Vial, Pharmacy Bulk Package In 1 Carton (81284-155-01) / 180 Ml In 1 Vial, Pharmacy Bulk Package (81284-155-00)",1.34,0.54,,,0 NDC,81284031500,NDC Description Not Available,1043.63,417.45,,,0 NDC,81284061100,NDC Description Not Available,5.47,2.19,,,0 NDC,81284061110,"Tranexamic Acid: 10 Vial, Single-Dose In 1 Carton (81284-611-10) / 10 Ml In 1 Vial, Single-Dose (81284-611-00)",20.84,8.34,,,0 NDC,81298501001,NDC Description Not Available,653.7,261.48,,,0 NDC,81298578303,"Triamcinolone Acetonide: 1 Vial, Multi-Dose In 1 Carton (81298-5783-3) / 10 Ml In 1 Vial, Multi-Dose",2.38,0.95,,,0 NDC,81298762001,NDC Description Not Available,46.28,18.51,,,0 NDC,81298762003,Sodium Bicarbonate: 20 Vial In 1 Carton (81298-7620-3) / 50 Ml In 1 Vial (81298-7620-1),19.425,7.7700000000000005,,,0 NDC,81298811201,"Cyclophosphamide: 1 Vial, Single-Dose In 1 Carton (81298-8112-1) / 50 Ml In 1 Vial, Single-Dose",10.6,4.24,,,0 NDC,81298866001,NDC Description Not Available,316.8,126.72,,,0 NDC,81298866003,"Ak-Fluor: 12 Vial, Glass In 1 Carton (81298-8660-3) / 5 Ml In 1 Vial, Glass (81298-8660-1)",124.97,49.99,,,0 NDC,81298965501,NDC Description Not Available,197.81,79.12,,,0 NDC,81298965503,Norepinephrine: 10 Pouch In 1 Box (81298-9655-3) / 1 Bag In 1 Pouch (81298-9655-1) / 250 Ml In 1 Bag,138.0,55.2,,,0 NDC,81298965801,NDC Description Not Available,257.6,103.04,,,0 NDC,81421002002,NDC Description Not Available,0.67,0.27,,,0 NDC,81421002102,NDC Description Not Available,2.38,0.95,,,0 NDC,81520010030,"Voquezna: 30 Tablet In 1 Bottle, Plastic (81520-100-30)",93.38,37.35,,,0 NDC,81643927001,"Floxuridine: 1 Vial In 1 Box, Unit-Dose (81643-9270-1) / 5 Injection, Powder, Lyophilized, For Solution In 1 Vial",3796.06,1518.42,,,0 NDC,81665010310,Isosorbide Mononitrate: 100 Tablet In 1 Bottle (81665-103-10),7.09,2.84,,,0 NDC,81665020025,Sodium Bicarbonate: 25 Vial In 1 Carton (81665-200-25) / 50 Ml In 1 Vial (81665-200-01),65.32,26.13,,,0 NDC,81665030102,"Cocaine Hydrochloride Nasal: 1 Bottle, Glass In 1 Carton (81665-301-02) / 4 Ml In 1 Bottle, Glass",1100.47,440.19,,,0 NDC,81826000111,Sodium Chloride: 70 Bag In 1 Carton (81826-001-11) / 100 Ml In 1 Bag (81826-001-12),9.45,3.7800000000000002,,,0 NDC,81826000121,Sodium Chloride: 28 Bag In 1 Carton (81826-001-21) / 250 Ml In 1 Bag (81826-001-22),22.26,8.9,,,0 NDC,81927011101,"Nelarabine: 1 Vial, Single-Dose In 1 Carton (81927-111-01) / 50 Ml In 1 Vial, Single-Dose",568.88,227.55,,,0 NDC,81952011101,NDC Description Not Available,2.27,0.91,,,0 NDC,82154044901,"Pegasys: 1 Vial, Single-Use In 1 Box (82154-0449-1) / 1 Ml In 1 Vial, Single-Use",4899.05,1959.62,,,0 NDC,82182045505,"Brimonidine Tartrate And Timolol Maleate: 5 Ml In 1 Bottle, Plastic (82182-455-05)",383.4,153.36,,,0 NDC,82347050504,NDC Description Not Available,8.55,3.42,,,0 NDC,82347050505,Lidocaine 5%: 30 Pouch In 1 Package (82347-0505-5) / 14 G In 1 Pouch (82347-0505-4),12.29,4.92,,,0 NDC,82667060005,"Maxidex: 1 Bottle, Plastic In 1 Carton (82667-600-05) / 5 Ml In 1 Bottle, Plastic",101.39999999999999,40.56,,,0 NDC,82667070003,Vigamox: 1 Bottle In 1 Carton (82667-700-03) / 3 Ml In 1 Bottle,438.94,175.58,,,0 NDC,82705000201,"Epkinly: 1 Vial, Glass In 1 Carton (82705-002-01) / .8 Ml In 1 Vial, Glass",235.35,94.14,,,0 NDC,82705001001,"Epkinly: 1 Vial, Glass In 1 Carton (82705-010-01) / .8 Ml In 1 Vial, Glass",234.73,93.89,,,0 NDC,82959011101,"Rytelo: 1 Vial, Single-Dose In 1 Carton (82959-111-01) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose",237.63,95.05,,,0 NDC,83090000701,NDC Description Not Available,0.2,0.08,,,0 NDC,83090000710,Lidocaine Hydrochloride: 10 Ampule In 1 Carton (83090-007-10) / 5 Ml In 1 Ampule (83090-007-01),0.2,0.08,,,0 NDC,83090001101,"Daptomycin: 1 Vial, Single-Dose In 1 Carton (83090-011-01) / 10 Ml In 1 Vial, Single-Dose",0.26,0.1,,,0 NDC,83090001210,"Lacosamide: 10 Vial, Glass In 1 Carton (83090-012-10) / 20 Ml In 1 Vial, Glass",0.86,0.34,,,0 NDC,83257000541,Fulphila: 1 Syringe In 1 Carton (83257-005-41) / .6 Ml In 1 Syringe,646.46,258.58,,,0 NDC,83257001111,"Semglee: 1 Vial, Multi-Dose In 1 Carton (83257-011-11) / 10 Ml In 1 Vial, Multi-Dose",5.29,2.12,,,0 NDC,83257001411,"Insulin Glargine: 1 Vial, Multi-Dose In 1 Carton (83257-014-11) / 10 Ml In 1 Vial, Multi-Dose",1.26,0.5,,,0 NDC,83490020760,NDC Description Not Available,4.26,1.7,,,0 NDC,83490030760,NDC Description Not Available,0.88,0.35,,,0 NDC,83634020261,"Melphalan Hydrochloride: 1 Kit In 1 Carton (83634-202-61) * 15 Ml In 1 Vial, Single-Dose (83634-200-15) * 10 Ml In 1 Vial, Single-Use (83634-201-10)",1015.55,406.22,,,0 NDC,83634030342,NDC Description Not Available,249.14,99.66,,,0 NDC,83634040010,"Bivalirudin: 10 Vial, Single-Dose In 1 Carton (83634-400-10) / 1 Injection, Powder, Lyophilized, For Solution In 1 Vial, Single-Dose (83634-400-41)",1.67,0.67,,,0 NDC,83634040110,"Tranexamic Acid: 10 Vial, Single-Dose In 1 Carton (83634-401-10) / 10 Ml In 1 Vial, Single-Dose (83634-401-41)",0.62,0.25,,,0 NDC,83634040141,NDC Description Not Available,9.85,3.94,,,0 NDC,83634050041,NDC Description Not Available,5.71,2.28,,,0 NDC,83634050081,Magnesium Sulfate In Water: 24 Pouch In 1 Carton (83634-500-81) / 1 Bag In 1 Pouch (83634-500-41) / 50 Ml In 1 Bag,5.78,2.31,,,0 NDC,83634077705,"Palonosetron Hydrochloride: 1 Vial, Single-Dose In 1 Carton (83634-777-05) / 5 Ml In 1 Vial, Single-Dose",6.03,2.41,,,0 NDC,83634077802,Prochlorperazine Edisylate: 10 Vial In 1 Carton (83634-778-02) / 2 Ml In 1 Vial (83634-778-41),6.63,2.65,,,0 NDC,83851010001,NDC Description Not Available,0.66,0.26,,,0 NDC,83851010030,C20H10Na2O5 Fluorescein Sodium Ophthalmic Strips: 300 Packet In 1 Box (83851-100-30) / 1 Mg In 1 Packet,0.71,0.28,,,0 NDC,86067000000,NDC Description Not Available,0.1,0.04,,,0 NDC,86067000004,NDC Description Not Available,0.07,0.03,,,0 NDC,86067000006,NDC Description Not Available,0.07,0.03,,,0 NDC,86067000008,NDC Description Not Available,0.01,0.004,,,0 NDC,87541030091,NDC Description Not Available,4800.51,1920.2,,,0 NDC,87701040065,NDC Description Not Available,2.91,1.16,,,0 NDC,88395001540,NDC Description Not Available,1.45,0.58,,,0 NDC,89130202001,NDC Description Not Available,83.37,33.35,,,0 NDC,89476081780,NDC Description Not Available,15.93,6.37,,,0 NDC,96974000002,NDC Description Not Available,0.2,0.08,,,0 NDC,98115000250,NDC Description Not Available,0.65,0.26,,,0 NDC,99999000564,NDC Description Not Available,118.68,47.47,,,0 NDC,99999200301,NDC Description Not Available,0.78,0.31,,,0 NDC,99999999817,NDC Description Not Available,2.29,0.92,,,0 NDC,99999999819,NDC Description Not Available,7.0,2.8,,,0 NDC,99999999910,NDC Description Not Available,10.49,4.2,,,0 NDC,99999999948,NDC Description Not Available,66.24,26.5,,,0